PMID- 2754046 TI - Enkephalin-like immunoreactivity in the cat superior colliculus: distribution, ultrastructure, and colocalization with GABA. AB - The distribution of enkephalin (ENK) immunoreactivity has been examined in the cat superior colliculus (SC) by means of light and electron microscope immunocytochemistry. The antisera were directed against leucine enkephalin but also recognized methionine enkephalin. Colocalization of ENK with gamma aminobutyric acid (GABA) was studied with a two-chromagen double-labeling technique. Enkephalin antiserum labeling was highly specific. Dense neuropil labeling was found only in a thin band 75-100 microns wide within the upper superficial gray layer of SC. Negligible neuropil labeling was seen deeper, except for patches of label within the intermediate gray layer. Intensely labeled neurons also had a specific distribution. Forty-seven percent were located within the upper 200 microns of SC, 40% within the deep superficial gray layer, 11% in the optic layer, and only 2% below that layer. Almost all ENK-labeled cells were small (mean area of 117 microns2). Some of these had horizontal fusiform cell bodies and horizontally oriented dendrites. Others had small round somata and thin, obliquely oriented dendrites. In double-labeling experiments, 18% of anti ENK-labeled cells were also immunoreactive for GABA. Four distinct types of ENK labeled profile were identified with the electron microscope. Presynaptic dendrites (PSD) with loose accumulations of synaptic vesicles were densely labeled with the antiserum. Conventional dendrites were also labeled. Both types of labeled profile received input from unlabeled synaptic terminals, including those from the retina that contained pale mitochondria and round synaptic vesicles and formed asymmetric synaptic contacts. Retinal terminals were never labeled with the antisera. However, some axon terminals with round synaptic vesicles, dark mitochondria, and symmetric synaptic densities were labeled by the antisera, as were some thinly myelinated axons. These results show that there is a small population of enkephalinergic neurons in the cat SC, some of which also contain GABA. Because not all cells with identical morphologies were double labeled, it appears that neurons of like morphology are chemically heterogeneous. PMID- 2754047 TI - Terminal arbors of individual "feedback" axons projecting from area V2 to V1 in the macaque monkey: a study using immunohistochemistry of anterogradely transported Phaseolus vulgaris-leucoagglutinin. AB - In the present study, the anterograde tracer Phaseolus vulgaris-leucoagglutinin (PHA-L) was injected into area V2 in order to demonstrate the precise morphology of individual axons from area V2 to V1. On the basis of 28 complete axon reconstructions, several characteristic features have been identified. 1) Individual axons arborize in multiple layers: 1, 2, 5, and (inconstantly) 3. A single axon may have numerous terminal clusters in layers 1 and 2, but at most one in layer 3. 2) Axons typically ascend to layer 1, turn asymmetrically in one direction, and travel for long distances in this layer (1.10-4.30 mm; dimensions uncorrected for shrinkage). A few axons (three of 28 reconstructed) were found to have a single terminal cluster (0.3-0.5 mm wide) in layers 1 and 2. 3) Collaterals in layer 5 seem to extend over shorter distances (0.60 mm or less). 4) Delicate sprays of boutons (both beads and spines) are clustered along the main trunk. Spacing is variable but usually ranges from 0.35 mm to 0.65 mm. 5) In addition to clustered boutons, there can be linear collaterals, continuously studded with boutons, parallel to the main axon in layer 1. These results indicate that axons from V2 have complex radial and tangential distributions in V1. Terminations in different layers may be directed to different sets of neurons or to different portions of the dendritic tree (for example, distal portions of pyramidal neuron apical dendrites in layers 1 and 2, but more proximal portions in layer 3). Clustered terminations over wide tangential areas may imply a divergent innervation by a single axon of multiple compartmental structures, such as ocular dominance columns or cytochrome oxidase patches. PMID- 2754048 TI - Terminal field of cholecystokinin-8-like immunoreactive projection neurons of the rat main olfactory bulb. AB - The terminal field of cholecystokinin-8 (CCK)-like immunoreactive (CCK-IR) tufted cells in the rat main olfactory bulb was examined by means of immunohistochemistry combined with either an anterograde tracer or a degeneration method. CCK immunostaining was carried out in animals in which Phaseolus vulgaris agglutinin (PHA) had been injected into the main olfactory bulb. Pairs of adjacent sections were processed for CCK and PHA immunostaining, respectively. Dense CCK-IR terminallike staining was noted in layer Ia of the anterior olfactory nucleus and lateral part of the olfactory tubercle; weaker staining was also observed in the transitional area between the anterior olfactory nucleus and the piriform cortex, in the medial part of the olfactory tubercle, and in the cortical amygdaloid nucleus. The CCK-IR staining was limited to the area containing PHA-labeled terminals and was diminished in these sites after unilateral olfactory bulbectomy. Immuno-electron microscopic analysis showed that CCK-IR profiles in such regions made asymmetric synaptic contacts, mainly with dendritic spines. These results suggest that CCK-IR tufted cells project mainly to the anterior olfactory nucleus and lateral part of the olfactory tubercle, and act mainly via axospinous synapses. PMID- 2754049 TI - Nonspiking interneurons in the ventilatory central pattern generator of the shore crab, Carcinus maenas. AB - Eight nonspiking interneurons were identified that are elements of the central pattern generator controlling ventilation in the shore crab, Carcinus maenas. Intracellular recordings from these neurons in an isolated ganglion preparation revealed that these cells exhibit large amplitude oscillations in their membrane potentials, which are in-phase with the ventilatory motor pattern. These oscillations are present during the expression of the two distinct ventilatory motor output patterns corresponding to forward and reversed ventilation, and the oscillations stopped during pauses in the ventilatory rhythm. Injection of intracellular current pulses into these interneurons caused a resetting of the ongoing ventilatory rhythm, indicating that these cells are part of the ventilatory central pattern generator. The structure of each interneuron was determined by the intracellular injection of Lucifer Yellow dye. These neurons have a large diameter main neurite ranging from 10 to 20 microns in diameter with very restricted primary and secondary branching from the main neurite. All of the interneurons are restricted to a single hemiganglion and perturbation of these cells with intracellular current pulses only affect the motor output of the hemiganglion containing the interneuron. These eight nonspiking interneurons appear to be the primary components of the central pattern generator underlying ventilation in the crab. PMID- 2754050 TI - Lobule structure and somatotopic organization of the medullary facial lobe in the channel catfish Ictalurus punctatus. AB - Correlation of the somatotopic organization of the facial lobe (FL), a primary medullary gustatory nucleus in the channel catfish Ictalurus punctatus, with its lobular substructure was investigated to examine a possible structural basis for the excellent ability of ictalurid catfishes to localize a food source in the environment. The FL in the channel catfish is composed of six longitudinal columns (i.e., lobules) extending rostrocaudally and differing from each other in their length and location within the lobe. Each lobule receives segregated input from discrete portions of the external body surface. The three more medial lobules in the FL receive input (from medial to lateral) from the medial mandibular barbel, the lateral mandibular barbel, and the maxillary barbel, respectively. The proximal-distal axis of each of the barbels is represented in a posteroanterior lobule axis. The largest lobule, the face-flank lobule, is located dorsolaterally in the FL, whereas the anteroposterior body axis is represented in the posteroanterior lobule axis. This indicates that the neural representation of the external body surface of the channel catfish faces caudally in the FL. The two shortest lobules, positioned ventral to the face-flank lobule, receive input from the nasal barbel and the pectoral fin, respectively. The rostrocaudal dimensions of each of the barbel lobules correlate well with the relative lengths of the barbels. Taste-sensitive portions within the three barbel lobules examined were generally confined to the dorsal region, whereas tactile responses were observed throughout the lobules.2+ primarily tactile, zone. PMID- 2754051 TI - Disseminated superficial actinic porokeratosis: a clinical study. AB - Disseminated superficial actinic porokeratosis is an autosomal dominant condition that requires sun exposure for full expression. It affects only sun-exposed areas, with relative sparing of the face. In sun-damaged skin of Australians disseminated superficial actinic porokeratosis is commonly mistaken for solar keratosis. Twenty-nine subjects with disseminated superficial actinic porokeratosis were involved in an extensive questionnaire and clinical study. The distribution of lesions was charted on all subjects, with a mean count of 268 lesions per subject. We found no evidence that skin cancer had arisen in disseminated superficial actinic porokeratosis lesions. A review of the etiologic and clinical features of disseminated superficial actinic porokeratosis also is presented. PMID- 2754052 TI - Comparative study of systemic interferon alfa-nl and isotretinoin in the treatment of resistant condylomata acuminata. AB - This study evaluated the effectiveness of systemic interferon alfa-nl versus isotretinoin in the treatment of condylomata acuminata. Patients were randomly assigned interferon alfa-nl, 5 million units, subcutaneously daily for 2 weeks then twice weekly for 4 weeks, or isotretinoin, 1 mg/kg by mouth daily for 6 weeks. Seventeen otherwise healthy men with histologically confirmed condylomata acuminata refractory to standard treatment completed 6 study weeks. Five of nine men (56%) treated with interferon alfa-nl had an objective clinical response (greater than or equal to 50% clearance of baseline disease), with one patient clearing completely. None of the patients treated with isotretinoin alone had an objective response (p = 0.009). Those whose clearing was incomplete with interferon alone were then assigned to interferon therapy three times weekly in combination with daily isotretinoin for 6 weeks, and those receiving isotretinoin were switched to interferon three times weekly for 6 weeks. There was continued clearing in all patients in the combination treatment group but in only three of seven in the sequential treatment group. Side effects were common and generally predictable for each drug but were generally not exacerbated when interferon and isotretinoin were used in combination. Parenteral interferon alfa-nl is an effective alternative treatment modality for patients with refractory condylomata acuminata. PMID- 2754053 TI - Assessment by mouse model of the ultraviolet A protective effect of topical sunscreens. AB - We have developed an animal model to assess the ultraviolet A (UVA) protective effect of topical sunscreens with the use of BALB/cJ mice in which contact photosensitivity to 3, 3', 4', 5 tetrachlorosalicylanilide had been induced. The mice were sensitized on the clipped dorsal skin and challenged on the ears. Changes in ear thickness after challenge were used to measure the degree of photosensitivity. The efficacy of two doses of each topical sunscreen was assessed by the degree of suppression of the contact photosensitivity response at challenge. Control studies were performed with the base of each sunscreen. Some but not all sunscreens that contained UVA-absorbing chemicals showed active suppression of contact photosensitivity in this test system. Several sunscreens gave greater suppression at 5 microliters/cm2 than at 2 microliters/cm2, which suggests a dose-related effect. One sunscreen, however, gave greater suppression at 2 microliters/cm2. Several of the bases tested also suppressed the contact photosensitivity response. An unexpected finding was an enhancement of the contact photosensitivity reaction by two of the bases tested. PMID- 2754054 TI - Prevalence and relevance of allergic reactions in patients patch tested in North America--1984 to 1985. AB - Between Jan. 1, 1984, and May 1, 1985, 1199 patients with suspected allergic contact dermatitis were patch tested with 32 "standard" allergens, 707 patients with 19 "vehicle and preservative" allergens, and 613 patients with 10 "special study" allergens. Ten dermatologists representing nine geographic centers collected and analyzed data with the use of the American Academy of Dermatology's mainframe computer in Evanston, Illinois. The most common sensitizers identified were nickel, p-phenylenediamine, quaternium-15, neomycin, thimerosal, formaldehyde, cinnamic aldehyde, ethylenediamine, potassium dichromate, and thiuram mix. Each positive reaction was assessed for its clinical relevance. PMID- 2754055 TI - Melanocytic nevi in schoolchildren in Queensland. AB - In a group of 211 schoolchildren in Queensland less than 12 years of age, the mean total melanocytic nevus (mole) count was 28 (median 19), and the mean count for raised nevi was 11 (median 8). The upper aspect of the back and chest were the most commonly affected sites, with the neck being the third. Boys had significantly (p less than 0.01) more melanocytic nevi than girls, and prevalence was highest in children with pale skin and light-colored hair. Nonwhite heritage had a protective effect independent of pigmentary characteristics. Total numbers of nevi on children also were related to maternal tendency to large numbers of moles and to family history of melanoma. The only significant association observed for the presence of large (greater than 5 mm) nevi on children was a family history of melanoma. The children studied come from a general population that has the highest known risk of melanoma. In Australia they have been shown to have the highest prevalence of nevi ever reported in the prepubertal age group. These descriptive data, together with the specific pigmentary and family associations described, extend the known links between benign nevi and malignant melanoma. PMID- 2754056 TI - Treatment of aphthae with thalidomide. AB - We report our experience in the treatment of major and minor aphthae with thalidomide. With doses of 100 to 300 mg daily for 3 months, a cure was obtained in 34% of cases, and marked improvement was evident in the rest. The follow-up period varied from 1 to 8 years. Two patients experienced dysesthesias, which disappeared when the medication was stopped. Thalidomide cannot be prescribed to women of childbearing potential because of its teratogenic potential. PMID- 2754057 TI - Familial cervical hypertrichosis with underlying kyphoscoliosis. AB - A family with congenital localized hypertrichosis transmitted in an autosomal dominant pattern is presented. The excessive hair growth was localized to the cervical region and was associated with underlying kyphoscoliosis. No additional cutaneous or skeletal abnormalities were identified. To our knowledge these are the first cases of familial congenital cervical hypertrichosis associated with underlying kyphoscoliosis reported in the literature. PMID- 2754058 TI - Palmoplantar psoriasis: experience with 8-methoxypsoralen soaks plus ultraviolet A with the use of a high-output metal halide device. AB - The use of 8-methoxypsoralen water soaks plus ultraviolet A was evaluated retrospectively in 11 patients with moderate to severe palmoplantar psoriasis that had been resistant to previous topical therapies. Patients received twice- or thrice-weekly 30-minute hand and/or foot soaks in 8-methoxypsoralen, 2.5 mg/L, followed by UVA irradiation. The condition of one patient cleared completely, and seven showed good improvement. The range of treatments required for maximal improvement was 14 to 43 with a mean of 28. The range of maximum UVA dosage per treatment was 3.5 to 17.5 joules/cm2, and the range of cumulative UVA required for maximal improvement was 45 to 388 joules/cm2 with a mean of 165 joules/cm2. The mean serum level of 8-methoxypsoralen 60 minutes after completion of hand and foot soaks was 2.5 +/- 0.5 ng/ml compared with 95.75 +/- 10.43 ng/ml after oral 8 methoxypsoralen, 0.5 mg/kg. In our experience this treatment has been a safe and relatively effective form of therapy for resistant palmoplantar psoriasis. PMID- 2754059 TI - Papillary eccrine adenoma: an electron microscopic study. AB - A case of papillary eccrine adenoma was studied by electron microscopy. Dilated ducts that contained granular eosinophilic material, often associated with intraluminal papillary projections were observed. The ductlike structures were composed of basal and luminal cells. Within the luminal cells there were intracytoplasmic cavities, but neither secretory granules nor glandular structure were observed. On the basis of our observations, papillary eccrine adenoma appears to differentiate toward ductal structures of the eccrine sweat apparatus. PMID- 2754060 TI - Semiquantitative analysis of histologic criteria in thin malignant melanomas. AB - To evaluate the sensitivity of histologic criteria 396 hematoxylin-eosin-stained step sections of 150 randomly sampled thin malignant melanomas (tumor thickness, less than or equal to 1.5 mm; level of invasion, I-III) were analyzed. The highest sensitivity was determined for nuclear atypia (84%), followed by the asymmetry of the lesion (81.3%) and the presence of single cells in the upper layers of the epidermis (80.3%). The sensitivity was limited for the inflammatory reaction of the dermis (56%), poor demarcation of the lesion (49.3%), and infiltration of the adnexa (47.7%). For the mitotic activity a low sensitivity was found (33.3%). In only 7.6% of cases all criteria investigated (with the exception of the infiltration of adnexa) were simultaneously present. The three most sensitive criteria could be found in 46% of cases and two of these criteria in 88% of cases. In conclusion, this semiquantitative analysis of histologic criteria revealed that (1) thin malignant melanomas can be diagnosed with a few, but very sensitive, criteria and (2) the absence of criteria with minor sensitivity is not helpful for correct diagnosis. PMID- 2754061 TI - Linear keratosis follicularis: a specific entity? Report of a case responding to combined topical retinoid and alpha-hydroxy acid therapy. PMID- 2754062 TI - Complete resolution of Kaposi's sarcoma with systemic etretinate therapy in a patient with mycosis fungoides. PMID- 2754063 TI - Malignant melanoma in a man seropositive for the human immunodeficiency virus. PMID- 2754064 TI - Intestinal amebiasis, lichen planus, and treatment with metronidazole. PMID- 2754065 TI - Facial telangiectasia associated with long-term application of a topical corticosteroid to the scalp. PMID- 2754066 TI - Management of fingertip cracking with Epilyt. PMID- 2754067 TI - Long-term survival of a harlequin fetus. AB - Harlequin ichthyosis is a rare, severe form of congenital ichthyosis, which probably represents a heterogeneous group of disorders. Unfortunately very little is known regarding the pathogenesis, course, and prognosis of harlequin ichthyosis because most of these infants die within a few weeks of birth. A case of an 9-year-old girl that had been a harlequin fetus, with clinical and histologic features similar to nonbullous congenital ichthyosiform erythroderma, is described. PMID- 2754068 TI - Transient blueberry muffin appearance of a newborn with congenital monoblastic leukemia. AB - A full-term male infant was born with skin findings suggesting a blueberry muffin appearance. Biopsy of a cutaneous nodule was consistent with monoblastic leukemia cutis, and bone marrow examination confirmed the diagnosis of leukemia. The infant has remained well 2 years after spontaneous resolution of the cutaneous eruption. Infiltrative neoplasms should be considered along with congenital infections and hematologic disorders in the differential diagnosis of a newborn with a blueberry muffin appearance. PMID- 2754069 TI - Plasma cell panniculitis: a unique clinical and pathologic presentation of linear scleroderma. AB - A 64-year-old woman had an 11-month history of a highly inflamed linear eruption that affected the left arm, including the dorsal aspect of the hand. It was characterized histologically by an intense plasma cell infiltrate extending throughout the dermis and subcutaneous fat. During the subsequent 2 years, the area evolved into a linear sclerotic plaque in keeping with the diagnosis of linear scleroderma. This case represents a clinical and pathologic presentation of linear scleroderma not previously emphasized in the literature. PMID- 2754070 TI - Reactive perforating collagenosis in a setting of double disaster: acquired immunodeficiency syndrome and end-stage renal disease. AB - We report reactive perforating collagenosis in an intravenous heroin abuser with acquired immunodeficiency syndrome and end-stage renal disease. The literature on perforating disorders in patients with acquired immunodeficiency syndrome and the pathogenesis of reactive perforating collagenosis in this setting is reviewed. PMID- 2754071 TI - Cutis laxa with ultrastructural abnormalities of elastic fiber. AB - A case of a congenital, autosomal recessive form of generalized cutis laxa is reported. The patient was a 27-month-old boy with generalized flaccid skin and short stature. Radiologic examination revealed that the age of the bones of the wrist was compatible with a chronologic age of only 1 year. Elastic fibers were diminished throughout the dermis, and results of electron microscopic study showed globular and unstained elastin and relatively large amounts of the microfibrillar components of elastic fibers. PMID- 2754072 TI - Eruptive disseminated lobular capillary hemangioma (pyogenic granuloma). AB - A 43-year-old man reported a 2-month history of numerous widespread vascular lesions that had developed suddenly on his scalp, trunk, and extremities. The lesions were 2 to 6 mm in diameter, firm, dark red papules that bled easily with minor trauma. Histopathologic examination of four lesions revealed lobular capillary hemangioma, also known as pyogenic granuloma. Treated lesions did not recur after surgical excision or electrocauterization. Five months after the onset of the eruption, no new lesions were developing, and some were resolving spontaneously after bleeding. Eruptive, disseminated lobular capillary hemangioma is a rare, self-limited cutaneous disorder that occurs in otherwise healthy persons. PMID- 2754073 TI - Papular lesions associated with annular elastolytic giant cell granuloma. AB - A 55-year-old man with multiple annular lesions on the trunk developed numerous papules on the upper part of the back and forearms. Examination of a biopsy specimen taken from a papule revealed annular elastolytic giant cell granuloma. PMID- 2754074 TI - Histiocytoid hemangioma: a disease spectrum. Report of a case with simultaneous cutaneous and bone involvement limited to one extremity. AB - The collective term histiocytoid hemangioma encompasses a spectrum of diseases that share a histologic features characterized by distinctive histiocytoid endothelial cells. Several incompletely defined cutaneous and extracutaneous vascular tumors, including atypical pyogenic granuloma, pseudopyogenic granuloma, papular angioplasia, angiolymphoid hyperplasia with eosinophilia, Kimura's disease, and inflammatory arteriovenous hemangioma, have been included in this group. We describe a 31-year-old Mexican-American man with multiple histiocytoid hemangiomas involving skin, subcutaneous tissue, and bone limited to the left arm and hand. Examination of skin and bone lesion biopsy specimens showed a proliferation of histiocytoid endothelial cells with intracytoplasmic vacuoles and associated vascular lumen formation. Ultrastructural and immunoperoxidase studies supported endothelial cell differentiation. Radiation therapy resulted in significant clinical improvement. Current concepts regarding the clinical and pathologic features of this disease spectrum also are discussed. PMID- 2754075 TI - Leukemia cutis presenting as a scrotal ulcer. AB - A patient with acute nonlymphocytic leukemia developed a painful scrotal ulcer thought initially to be caused by infection. The lesion failed to heal with oral antibiotic therapy and local wound care. Histopathologic examination of a biopsy specimen revealed an infiltrate of leukemic cells. This cutaneous lesion heralded the relapse of acute myelogenous leukemia. A review of the literature indicates that acute nonlymphocytic leukemia rarely presents as an ulcer or on the genitalia, thus emphasizing the uniqueness of this case regarding morphology, and site of presentation. To our knowledge, this is the first case of leukemia cutis presenting as a scrotal ulcer. Therefore leukemia cutis should be added to the differential diagnosis of chronic genital ulcers. Also, because a variety of skin lesions may signify the relapse of leukemia, any skin lesion in a patient with leukemia should be examined by biopsy. PMID- 2754076 TI - Ultraviolet light-induced confluent and reticulated papillomatosis. AB - A 16-year-old girl initially had an eruption consisting of dark gray, flat, pin sized, confluent papules with a slight hyperkeratotic surface. The lesions appeared after her summer holidays and were restricted to the tanned skin of sun exposed areas, mainly the abdomen and back. Clinical and histologic findings were consistent with confluent and reticulated papillomatosis. If a basic disorder of keratinization is the cause of confluent and reticulated papillomatosis, it seems likely that the development of the disease in our patient may be due to an abnormal epidermal response to ultraviolet light. PMID- 2754077 TI - Erythema dyschromicum perstans and lichen planus: are they related? AB - A 53-year-old woman initially had lichen planus primarily on her extremities. Approximately 1 year later, lesions consistent with erythema dyschromicum perstans were observed. Both diseases cleared with griseofulvin therapy but returned after discontinuation of the drug. Retreatment with griseofulvin again resulted in clearing. PMID- 2754078 TI - Pew National Dental Education Program: developing an agenda for change. PMID- 2754079 TI - Effectiveness of a national board review course for dental students. AB - In view of national concerns about student aptitude and overcrowded curricula, the effectiveness of review courses must be evaluated objectively. The present study is a statistical analysis of the impact of a review course on National Board Examination (NBE) Part I performance at the University of Detroit. The performance of dental students who had taken the course between 1985 and 1987 (N = 175) was compared to that of the prior three classes (N = 212). Analysis of covariance (ANCOVA) was used to adjust and compare mean scores on the NBE, using entering GPA and DAT scores, both measures of aptitude, as covariates. Only two of the five NBE scores demonstrated significant improvement. While aptitude contributed as much as 23 percent to NBE performance, the contribution of the review course was limited to 1.5 percent. The review course was most effective in areas that (1) were covered during the greatest number of terms, (2) were presented most recently, or (3) had the least number of topics on the NBE. This strategy for evaluating course effectiveness permits a dental school to easily assess the value of an NBE review course, as well as identify strengths and weaknesses in the curriculum. PMID- 2754080 TI - Economic growth in the U.S. dental sector, 1950-1986. AB - Previous research has shown that over the period 1950 through 1977 the dental sector experienced a faster rate of economic growth than did the economy at large. This study extends the period of analysis through 1986. The findings show that dentistry maintained its economic strength relative to the economy. The annual growth rate for dentistry of 4.8 percent was significantly greater (p less than 0.001) than the 3.3 percent rate for the economy. In addition, inflation has been less in dentistry, and growth in the dental sector was not adversely affected by the economic recession of 1978-1984. PMID- 2754081 TI - Status of direct gold in dental education. PMID- 2754082 TI - An interprofessional learning experience in sports dentistry. PMID- 2754083 TI - A mock surgery laboratory experience in implant dentistry. PMID- 2754084 TI - A modified technique for excision of syringomas. AB - An easy, rapid, and inexpensive technique for excision of syringomas from eyelids is outlined, using a fine needle as a skin hook and a #11 scalpel blade and leaving superficial wounds for secondary closure. Possible advantages and disadvantages are discussed. We recommend this procedure as an effective alternative that provides good cosmetic results. PMID- 2754085 TI - Electrodes for high-frequency electrosurgery. AB - Among the varied types of electrosurgical electrodes available, many dermatologists find a tapered or needle-shaped electrodesiccation electrode most useful. Cutting current procedures are best accomplished with fine needle or wire electrodes. Both monopolar and bipolar forceps are useful for pinpoint coagulation of small blood vessels. Because of increasing concerns about electrode contamination, several kinds of disposable electrodes are now available. PMID- 2754086 TI - The facelift. AB - Facelift (rhytidectomy) is an advanced form of cutaneous surgery and therefore a part of dermatologic plastic surgery. The technique has been refined, so that almost uniformly good results can be achieved with few complications, and most of these procedures can be done on an outpatient basis using local anesthesia with sedation. For the advanced dermatologic surgeon, the technique is not difficult to master, and his/her high level of knowledge in the conditions, wound healing, and surgeries of the superficial facial tissues makes this procedure all the more apropos. PMID- 2754087 TI - Intralesional steroids in cutaneous hemangioma. AB - Cutaneous hemangiomas are present in 2.6% of all newborn children. Conservative management is the preferred method of treatment, and only cases with a high risk of complications should be treated. Periocular cutaneous hemangiomas have been associated with ophthalmic complications in 41%-100% of such cases. Intralesional steroids are frequently used by ophthalmologists for treatment of periocular hemangiomas. We present a case of cutaneous hemangioma treated with this modality. No previous cases have been reported in the dermatologic literature. A review, description, and complications of the use of intralesional steroids in hemangiomas are included. PMID- 2754088 TI - Radiofrequency hyperthermia therapy of murine melanoma: a comparison of fractionated versus single-dose treatments. AB - The effects of single and fractionated doses of radiofrequency hyperthermia were investigated in the treatment of cutaneous murine melanoma. S91 murine melanoma cells were implanted into preformed intradermal blister cavities on the backs of DBA/2J mice. Evaluation of treatment response was undertaken after single and fractionated doses of hyperthermia. A single 60-second treatment at 46 degrees C did not result in any complete regressions, while 3 weekly 46 degrees C treatments produced a 40% incidence of tumor regression. Higher temperature therapy was associated with improved cure rates. A single treatment for 60 seconds at 50 degrees C resulted in a 25% complete response rate while 3 weekly 50 degrees C treatments resulted in the eradication of 92% of the treated tumors. In those tumors that responded only partially to hyperthermia, fractionated low- (46 degrees C) and (50 degrees C) high-dose regimens resulted in significantly smaller melanomas than single-treatment schedules at the same temperatures. It is concluded that fractionated hyperthermia is an effective modality in the control of intracutaneous murine melanoma. If other cutaneous malignancies are also sensitive to heat, this may provide a useful nonsurgical means of treating skin cancer. PMID- 2754089 TI - Magnetic resonance imaging of cutaneous melanocytic lesions. AB - This is the first literature report on magnetic resonance imaging (MRI) examination of cutaneous melanocytic or any other type of skin lesions. Good resolution, clinically useful MRI scans of a congenital nevus and a metastatic melanoma to the skin are presented. The potential usefulness of MRI technique to physicians dealing with cutaneous disease is discussed. PMID- 2754090 TI - The use of carbon dioxide laser in lichen myxedematosus. AB - Lichen myxedematosus is characterized by deposits of mucin in the dermis. Treatment can be systemic or local, depending on the clinical findings. We present a patient with pedunculated lesions on his nose, and a generalized thickening of his facial skin. The patient requested treatment of his nasal lesions. We elected to remove his nodules surgically using the carbon dioxide (CO2) laser. The technique is described and treatment options are reviewed. PMID- 2754091 TI - Nevoid basal cell carcinoma syndrome: combined etretinate and surgical treatment. AB - Aromatic retinoids have been shown to be useful in the management of various genodermatoses, including nevoid basal cell carcinoma syndrome (NBCCS). A patient with this condition was treated by combined etretinate and surgical therapy. Over the course of 12 months, the patient was placed on oral etretinate therapy, with a dosage of 1 mg/kg/day for 3 months, and 0.5 mg/kg/day for 9 months. In the first period, notable tumor reduction was observed in the larger tumors. Complete clinical regression was seen in only 26% of BCCs with an overall tumor size of less than 1 cm in diameter. In the second period, no tumor changes were observed, but no new tumors appeared. Surgical excisions of the remaining tumors were carried out 3 months after the end of the etretinate treatment, with excellent results and no recurrences after 6 months of follow-up. Treatment with etretinate permits a less aggressive surgical excision and recurrence rate than surgical excision alone. PMID- 2754092 TI - Lymphatic bullae arising as a complication of second-intention healing. AB - Cutaneous bullae secondary to lymphatic fluid reflux are rare. We report the case of a patient with lymphatic bullae without lymphedema following second-intention wound healing. PMID- 2754093 TI - Melanoma update. PMID- 2754094 TI - Marking the spot. PMID- 2754095 TI - Auditory thresholds in the American cockroach (Orthoptera: Blattidae): estimates using single-unit and compound-action potential recordings. AB - Recent commercial suggestions that insect populations can be controlled through the use of ultrasound raises the question of whether or not certain insects have receptors that are sensitive to high-frequency sound. Single neural unit discharges and compound-action potentials were recorded from the ventral nerve cord in the American cockroach, Periplaneta americana L., to constant rise time tone pulses from 100 to 40,000 hertz (Hz). Unit responses and compound-action potentials show that the cockroach is insensitive to sound above approximately 3,000 Hz. Data relating latency of the response to intensity of the stimulus suggest that the cockroach cercal system operates on the principle of energy envelope detection. Decreases in latency likely occur primarily as a result of increases in the rate of membrane depolarization in cercal dendrites. PMID- 2754096 TI - Comparative activity of fenoxycarb and hydroprene in sterilizing the German cockroach (Dictyoptera: Blattellidae). AB - Last-instar German cockroaches, Blattella germanica (L.), were treated topically with the juvenoids, fenoxycarb and hydroprene, and observed for reproductive capabilities during adulthood. Hydroprene had a significantly lower SD50 (dose required to sterilize 50% of the cockroaches) for males (39.82 micrograms/g body weight) compared with females (86.64 micrograms/g body weight). In contrast, SD50's of fenoxycarb did not differ significantly between the sexes (18.04 and 13.66 micrograms/g body weight for females and males) and were significantly lower when compared with SD50's of hydroprene. A strong positive relationship between wing twisting (a morphogenetic effect caused by juvenoids) and sterility was observed among cockroaches treated with 100 and 10 micrograms/microliters of each juvenoid. However, only 16% of females displaying twisted wings were sterile when treated with 1 microgram/microliter of hydroprene. Cockroaches treated with 100 micrograms/microliters of hydroprene lived 10-14 wk fewer than control adults and often attempted a sixth (supernumerary) molt. PMID- 2754097 TI - Susceptibility of the cat flea (Siphonaptera: Pulicidae) to pyrethroids. AB - Adult cat fleas, Ctenocephalides felis felis (Bouche), from two laboratory colonies (one originating in California and one from Florida) were exposed to residues of eight pyrethroids to compare their susceptibilities. The Florida strain was more tolerant than the California strain, with 6.8-, 5.2-, and 4.8 fold tolerance to cyfluthrin, cypermethrin, and fluvalinate, respectively. The Florida strain showed less than 3-fold tolerance to the other five insecticides (permethrin, tralomethrin, d-phenothrin, resmethrin, and fenvalerate). Overall, the pyrethroids were ineffective against the Florida strain. PMID- 2754098 TI - Effect of sublethal propoxur exposure on male German cockroaches (Orthoptera: Blattellidae) and their feeding behavior. AB - Exposure of male German cockroaches, Blattella germanica L., to propoxur produced significant water loss at 2 and 24 h after treatment. This effect was dependent upon the state of hydration before insecticide exposure. Hydrated males lost as much as 10% of their total body mass in the form of water; dehydrated males lost about 4.3%; and untreated controls lost approximately 1.8% during the same time period. No significant compensatory feeding responses were observed 1-4 d after treatment. Water depletion associated with propoxur exposure resulted in increased water consumption for the first 2 d after treatment and then reached a plateau for the duration of the study. Males consumed water daily regardless of insecticide exposure. PMID- 2754099 TI - Topically applied ivermectin: efficacy against torsalo (Diptera: Cuterebridae). AB - To determine the systemic efficacy and persistence of a 0.5% ivermectin topical formulation against natural infestation of torsalo, Dermatobia hominis (L., Jr.), larvae in cattle, two trials in Colombia and two trials in Brazil were done. Of 56 infested cattle used in these trials, 28 were treated and 28 served as untreated controls. The formulation was poured along the back of each animal at a rate of 0.5 mg (AI)/kg body weight. Significantly fewer larvae were counted in the treated animals than on controls on days 9 and 10; greater than 99% control resulted. The first reinfesting larvae were observed in a few animals on days 30 and 31. PMID- 2754100 TI - Efficacy and stability of wettable powder amitraz in field and laboratory studies against Boophilus annulatus (Acari: Ixodidae) in south Texas. AB - A study was done at the USDA-ARS, Cattle Fever Tick Research Laboratory, Mission, Tex., to determine the efficacy of a 50% wettable powder (WP) amitraz formulation applied as a whole-body spray in a standard dip vat, and in a laboratory bioassay against Boophilus annulatus (Say) on cattle. A study also was done at the King Ranch in Kleberg County, Tex., to determine the stability of 50% WP amitraz in a dip vat under South Texas conditions Cattle were infested with all parasitic life stages of B. annulatus and were sprayed or dipped with a concentration of 0.025% amitraz. As determined by calculations of the index of reproduction, the whole body spray treatment provided 86% control of the ticks and the dip treatment provided 99.8% control. Laboratory bioassay results compared favorably with those obtained with the dip vat treatment. Amitraz WP settled very rapidly in the freshly charged ranch vat. However, as more cattle were dipped and the vat became polluted with dirt and excrement, settling occurred much more slowly. Overall, amitraz remained stable in the vat during the test period. PMID- 2754101 TI - Habitat use by cattle affects host contact with lone star ticks (Acari: Ixodidae). AB - The location of Zebu, British, and Zebu x British cattle in tick-infested plots from March through September 1986 was compared with the location of Amblyomma americanum L. in the same plots. In April, May, and June, Zebu cattle spent less time (9.3-19.4%) in tick-infested quadrats than British (44.4-63.9%) or Zebu British (49.0-69.3%) cattle. In the same months, the probability that A. americanum would contact Zebu cattle (1.5-19.6%) was significantly lower than for British (34.7-41.7%) or Zebu-British (30.2-56.9%) cattle. In April, May, June, and September, the probability that A. americanum detaching from cattle would drop into a quadrat presumed to be habitable for ticks was significantly lower for Zebu cattle (4.0-29.9%) than for British (64.9-72.6%) or Zebu-British (48.1 78.7%) cattle. PMID- 2754102 TI - Determination of the acoustic nonlinearity parameter in biological media using FAIS and ITD methods. AB - Two methods for determination of the acoustic nonlinearity parameter B/A in biological media are presented. One is the finite amplitude insert-substitution method (FAIS), considering the influence of both the sound attenuation of samples and the diffraction of the transducer on the experimental measurement. The other is the improved thermodynamic method (ITD), based on the measurement of phase shifts in the acoustic wave due to the change of ambient pressure. The nonlinearity parameter B/A has been measured for various biological solutions and soft tissues using these two methods. Some results of dependence of B/A values on the concentration and temperature are also presented here. PMID- 2754103 TI - Intensity discrimination determined with two paradigms in normal and hearing impaired subjects. AB - The literature on auditory intensity jnd's is ambiguous with respect to the relationship between the jnd's measured with gated and continuous pedestals and with respect to changes in this relationship in the presence of loudness recruitment accompanying cochlear pathology. In an attempt to clarify these issues and to lay a foundation for systematic investigations of the dependence on the jnd's on loudness functions, the jnd's for pure tones with gated- and continuous-pedestal paradigms of two groups of subjects, one with normal hearing and one with hearing loss of cochlear origin, were measured. The experiments were performed at 0.5, 2, and 6 kHz, and at a wide range of sensation levels (SLs) by means of an adaptive two-alternative, forced-choice (2IFC) procedure. The jnd's obtained with the continuous-pedestal method were smaller than those obtained with the gated-pedestal method for both groups of subjects. They also had smaller intersubject standard deviations. When jnd's of the two groups were compared on the basis of equal SLs, the group with hearing loss showed smaller jnd values than the group with normal hearing for both pedestal paradigms. When the comparisons were made on the basis of equal sound-pressure levels (SPLs), both groups showed similar values for moderate and high SPLs. At relatively low SPLs, the group with hearing loss tended to have somewhat higher values. PMID- 2754104 TI - Perception of complex tone pairs mistuned from unison. AB - Periodic sounds mistuned from unison may interact to produce pitch glides: When a broad-spectrum complex tone having a fundamental frequency of 400 Hz or less and containing several harmonics above the 8th is mixed with itself after a slight change in the waveform repetition frequency (1 Hz or less), listeners hear a rising glissando when corresponding portions of the waveforms approach alignment and a falling glissando as they recede from alignment. Glissandi are unimpaired if harmonics below the 8th are absent, but if, instead, harmonics above the 8th are removed, only amplitude fluctuations are heard (not glissandi). When two broad-spectrum complex tones with independent, randomly derived phase spectra are mistuned slightly from unison and mixed, complex repeated patterns other than glissandi are heard. These observations, along with others involving a variety of periodic sounds mistuned from unison, provide information concerning the nature of frequency domain and time domain mechanisms employed for the perception of iterated acoustic patterns. PMID- 2754105 TI - Comparison of discomfort levels obtained with pure tones and multitone complexes. AB - The relationship between threshold of discomfort (TD) estimates and the number of components in a complex signal has been investigated. The thresholds of discomfort were first obtained for 16 pure tones located at the center frequency of critical bands from 250 to 4000 Hz. Subsequently, thresholds of discomfort were obtained for 2, 4, 8, and 16 tone complexes. The pure-tone components of the complexes were systematically selected from the same 16 pure tones. For each subject, the relative intensities of the components in the four complexes were determined in such a way so as to parallel the pure tone TD contour obtained for that subject. Data were obtained from 15 normal and 15 hearing impaired adults. The individuals in the latter group all had mild to moderate sensorineural hearing loss. Summation of discomfort (S) was defined as the difference between the threshold of discomfort for a pure tone presented in isolation and within the complex. The two groups demonstrated different summation values. For both groups, however, the summation was shown to be a linear function of the logarithm of the number of components in the complex: S = a + b log (n) where n is the number of components (2, 4, 8, 16). For the normal hearing group, a and b are 2.05 and 11.51, respectively, while for the hearing impaired group, they are 3.95 and 12.88, respectively. While the future digital hearing aids can easily regulate their limiting levels so as to accurately account for this summation, present day hearing aids may underestimate this effect.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2754106 TI - Realistic mechanical tuning in a micromechanical cochlear model. AB - Two assumptions were made in the formulation of a recent cochlear model [P.J. Kolston, J. Acoust. Soc. Am. 83, 1481-1487 (1988)]: (1) The basilar membrane has two radial modes of vibration, corresponding to division into its arcuate and pectinate zones; and (2) the impedance of the outer hair cells (OHCs) greatly modifies the mechanics of the arcuate zone. Both of these assumptions are strongly supported by cochlear anatomy. This paper presents a revised version of the outer hair cell, arcuate-pectinate (OHCAP) model, which is an improvement over the original model in two important ways: First, a model for the OHCs is included so that the OHC impedance is no longer prescribed functionally; and, second, the presence of the OHCs enhances the basilar membrane motion, so that the model is now consistent with observed response changes resulting from trauma. The OHCAP model utilizes the unusual spatial arrangement of the OHCs, the Deiters cells, their phalangeal processes, and the pillars of Corti. The OHCs do not add energy to the cochlear partition and hence the OHCAP model is passive. In spite of the absence of active processes, the model exhibits mechanical tuning very similar to those measured by Sellick et al. [Hear. Res. 10, 93-100 (1983)] in the guinea pig cochlea and by Robles et al. [J. Acoust. Soc. Am. 80, 1364-1374 (1986)] in the chinchilla cochlea. Therefore, it appears that mechanical response tuning and response changes resulting from trauma should not be used as justifications for the hypothesis of active processes in the real cochlea. PMID- 2754107 TI - Active noise control in ducts: some physical insights. AB - The mechanisms of active noise control in a duct are examined. Acoustical measurements are used to determine directly the acoustic power flow associated with both primary and secondary sources as a function of secondary to primary source strength ratio and volume velocity relative phase angles. A complete analytical model is also developed which allows calculation of individual source power flows and total downstream power flow as a function of source strengths and relative phase angles for finite size sources. It is evaluated for monopole and dual secondary source arrangements, but can be extended easily to any number of secondary sources. The model considers a finite size primary source in the plane of the duct cross section and evaluates the effect that the secondary sources have on the primary source power output. Measurements of individual source output powers and total downstream acoustic powers agree well with theoretical predictions. It is demonstrated that, for the monopole system, sound attenuation is achieved primarily by suppression of the primary source acoustic power output, with a little remaining power being absorbed by the secondary source. For the dual secondary source system, it is shown that the power is primarily absorbed by the secondary sources, but that, at phase and amplitude values slightly different to optimum, noise reduction is achieved by a combination of energy absorption and primary source power suppression. The analysis also demonstrates the dependence of the achievable noise reduction on secondary source size and location with respect to the primary source. PMID- 2754108 TI - A theoretical study of cavitation generated by an extracorporeal shock wave lithotripter. AB - The intense acoustic wave generated at the focus of an extracorporeal shock wave lithotripter is modeled as the impulse response of a parallel RLC circuit. The shock wave consists of a zero rise time positive spike that falls to 0 at 1 microsecond followed by a negative pressure component 6 microseconds long with amplitudes scaled to +1000 and -160 bars, P+ and P-, respectively. This pressure wave drives the Gilmore-Akulichev formulation for bubble dynamics; the zero-order effect of gas diffusion on bubble response is included. The negative pressure component of a 1000-bar shock wave will cause a preexisting bubble in the 1- to 10-microns range to expand to over 100 times its initial size, R0, for 250 microseconds, with a peak radius of approximately 1400 microns, then collapse very violently, emitting far UV or soft x-ray photons (black body). Gas diffusion does not appreciably mitigate the amplitude of the pressure wave radiated at the primary collapse, but does significantly reduce the collapse temperature. Diffusion also increases the bubble radius from R0 up to 40 microns and extends the duration of ringing following the primary collapse, assuming that the bubble does not break up or shed microbubbles. Results are sensitive to P+/P- and to the duration of the negative pressure cycle but not to rise time. PMID- 2754109 TI - Ultrasonic reflection mode imaging of the nonlinear parameter B/A. II: Signal processing. AB - The nonlinear acoustic interaction between a reflected single-frequency sinusoid and a broadband pump waveform propagating in the opposite direction produces phase changes in the probe proportional to the nonlinear parameter B/A in the spatial region of interaction. The instantaneous phase change along the received probe can be expressed as the convolution of the pump waveform with the spatial distribution of B/A along the propagation path over which the pump and reflected probe interact. In theory, the phase modulated sinusoidal probe can be processed (phase detection and deconvolution) to produce an "A-mode" representation of B/A. If the pump is an intense unipolar impulse and the probe a swept-frequency sinusoid, then the pump interacts with the probe at each point along the propagation path at a unique frequency. Thus the phase modulation that carries information about the spatial distribution of B/A can be extracted from the phase spectrum by a simple Fourier transformation analogous to the space to frequency mapping so basic to magnetic resonance imaging. If the impulsive pump is replaced by another swept-frequency sinusoid, then the phase change in the probe due to B/A at a particular point along the propagation path will be spread out for the duration of the pump along the probe. Passage of the received signal through an appropriate matched filter restores spatial coherence to the phase information in the probe so that it can be processed as if the pump were a broadbanded impulse. This approach suggests a means of approaching the design of effective pump waveforms that can resolve a wide range of spatial frequencies in (B/A)(x). PMID- 2754110 TI - Kinematic and electromyographic responses to perturbation of the jaw. AB - The task-dependent organization of sensorimotor mechanisms during the production of speech was investigated using a perturbation paradigm. Six subjects received unanticipated jaw perturbations before and during tongue elevation for [aedae], in which the lips do not participate, and bilabial closure for [aebae], in which the tongue does not participate. A strain gauge system was used to monitor inferior-superior displacements of the upper lip, lower lip, and jaw, while hooked-wire electrodes monitored muscle activity in various muscles of the lips, jaw, and tongue. Results indicated significant compensatory kinematic adjustments to jaw perturbations in the lips and/or jaw during [aebae], but no labial compensations during [aedae] (with the exception of one subject). EMG responses were inconsistent and not necessarily indicative of the kinematic findings. Individual subjects responded to perturbations reliably but differently, using different combinations of involved articulators to achieve bilabial closure and lingua-alveolar contact. The current study supports earlier research which suggests that the components of the motor system are flexibly assembled, based on the requirements of the specific task. That is, compensatory responses to sensory information occur only when such responses are functionally necessary. PMID- 2754111 TI - Directional sensitivity of sound-pressure levels in the human ear canal. AB - Changes in sound pressures measured in the ear canal are reported for broadband sound sources positioned at various locations about the subject. These location dependent pressures are one source of acoustical cues for sound localization by human listeners. Sound source locations were tested with horizontal and vertical resolution of 10 degrees. Sound levels were measured with miniature microphones placed inside the two ear canals. Although the measured amplitude spectra varied with the position of the microphone in the ear canal, it is shown that the directional sensitivity at any particular frequency of the broadband stimulus is independent of microphone position anywhere within the ear canal. At any given frequency, the distribution of sound pressures as a function of sound source location formed a characteristic spatial pattern comprising one or two discrete areas from which sound sources produced maximum levels in the ear canal. The locations of these discrete areas varied in horizontal and vertical location according to sound frequency. For example, around 8 kHz, two areas of maximum sensitivity typically were found that were located laterally and were separated from each other vertically, whereas, around 12 kHz, two such areas were found located on the horizontal plane and separated horizontally. The spatial patterns of sound levels were remarkably similar among different subjects, although some frequency scaling was required to accommodate for differences in the subjects' physical sizes. Interaural differences in sound-pressure level (ILDs) at frequencies below about 8 kHz tended to increase monotonically with increasing distance of the sound source from the frontal midline and tended to be relatively constant as a function of vertical source location. At higher frequencies, however, ILDs varied both with the horizontal and with the vertical location of the sound source. At some frequencies, asymmetries between the left and right ears in a given subject resulted in substantial ILDs even for midline sound sources. These results indicate the types of horizontal and vertical spatial information that are available from sound level cues over various ranges of frequency and, within a small subject population, indicate the nature of intersubject variability. PMID- 2754112 TI - Relations between hyperactive and aggressive behavior and peer relations at three elementary grade levels. AB - Sociometrics and teacher ratings of hyperactivity and aggression were obtained on 390 boys in grades 1-6 to explore the relative contributions of hyperactivity and aggression to children's social adjustment. Both hyperactivity and aggression were correlated with negative sociometric nominations at all grade levels; however, only hyperactivity showed consistent inverse correlations with positive sociometric nominations. In multiple regression analyses, hyperactivity contributed incremental variance to the prediction of problematic sociometric status at all grade levels, while aggression did so only at grades 3-4. An examination of the core symptoms of hyperactivity revealed that motor hyperactivity, in the absence of impulsivity and inattention, did not predict negative sociometric status at any grade level. Subgroups of boys categorized as hyperactive only, aggressive only, hyperactive/aggressive, and nonhyperactive/nonaggressive controls were compared on teacher ratings and sociometrics. Hyperactive/aggressive boys had higher hyperactivity and aggression ratings than boys in either of the single-problem groups; all three behavior problem groups had more negative social status than controls. Developmental changes in children's normative expectations for social behavior were discussed as possible mechanisms mediating the age-related differences in relations among aggression, hyperactivity, and peer relations. PMID- 2754113 TI - Evaluative factors in social problem solving by aggressive boys. AB - Components of social problem solving (problem definition, generation and prioritization of solutions, and generation and evaluation of consequences) were assessed in high aggressive and low aggressive boys from grades 2-3 and 5-6. When compared with their low aggressive peers, high aggressive boys at both grade levels were more likely to (1) define social problems based on the perception that others were hostilely-motivated adversaries, (2) generate few consequences for exhibiting aggression, (3) choose a "second-best" solution that was rated as ineffective, and (4) evaluate their own affective reactions to self-generated consequences of aggression as "wouldn't care" or as not "unhappy." In addition, within the group of aggressive boys, problem definition was found to be significantly related to both number of solutions generated and effectiveness of solutions that subjects chose as best and second-best. These findings are discussed in terms of early patterns of cognitive mediation that differentiate high aggressive children from their low aggressive peers. PMID- 2754114 TI - Reading, spelling, and vigilance in attention deficit and conduct disorder. AB - A group of 51 male children, average age 9.1 years, presenting at a child psychiatric clinic because of attention and conduct problems were investigated for reading and phonetic spelling ability, vigilance, and intellectual level. Each child was given a DSM-III diagnosis prior to being tested. The Boder Test of Reading and Spelling patterns was used to obtain scores for reading age, number of syllables read correctly in the word list at the child's reading level, and number of phonetically correct syllables spelled in the known and unknown word lists, at and just above the child's reading level. A factor analysis with varimax rotation produced two significant factors, a Reading factor with high loadings for verbal and reading scores, aand a second Vigilance factor. Phonetic spelling ability loaded separately from reading into the Vigilance factor. The Vigilance factor was significantly related to the diagnosis of moderate and severe attention deficit disorder with hyperactivity (ADDH). The correlation of short-term working memory with vigilance in moderate to severe ADDH children is discussed. PMID- 2754115 TI - Replication of empirically derived syndromes as a basis for taxonomy of child/adolescent psychopathology. AB - To advance the empirical identification of child/adolescent syndromes, principal components analyses were performed on four sets of parents' ratings of 8,194 6- to 16-year-olds referred to American and Dutch mental health services. The following syndromes replicated well for both sexes at ages 6-16: Aggressive, Anxious/Depressed, Attention Problems, Delinquent, Somatic Complaints, and Withdrawn. For both age ranges, a syndrome designated as Socially Inept replicated well among boys, and one designated as Mean replicated well among girls. Evidence was also found for a Schizoid syndrome in all sex/age groups and a Sex Problems syndrome among girls at ages 6-11. Syndrome scores discriminated well between nationwide normative and clinical samples. The replicated syndromes contribute to the empirical basis for a taxonomy of the kinds of disorders commonly seen between the ages of 6 and 16. PMID- 2754116 TI - Cognitive appraisal and attributional correlates of depressive symptoms in children. AB - This study examined differences in cognitive appraisal and causal attributions in response to a task among schoolchildren reporting high and low depressive symptomatology. From a sample of 361 fifth- and sixth-grade students, 72 children were classified as depressed or nondepressed on the basis of their scores on the Children's Depression Inventory. They were then presented with modified Picture Arrangement problems from the WISC-R and questioned about their performance. Pretask expectations, evaluations, and future expectations of performance for the self and that of same-aged peers were assessed, as well as causal explanations for solvable and unsolvable problems. Despite similar performance, the depressed group of children provided lower evaluations for themselves than for others on all three measures of self-appraisal, whereas the nondepressed group did not show this tendency. Further, the attribution results indicated that the two groups differed in their explanations for failure, with the depressed group emphasizing the importance of ability in failure and the nondepressed group emphasizing factors other than ability. Overall, the results provide support for the presence of negative cognitions and self-defeating attributional style among depressed relative to nondepressed children, as well as pointing to the importance of social comparison processes in depression. PMID- 2754117 TI - A rating scale for assessing dysphoria in youth. AB - A rating scale (RSD) for children and adolescents was developed consisting of 12 items from the Peer Nomination Inventory of Depression (Lefkowitz & Tesiny, 1980) converted to a Likert-type format for obtaining self-ratings or ratings by significant others of dysphoria. The measure was administered to 784 mothers whose children's modal age was 10 years. Longitudinal data were gathered for 124 of these mother-child pairs after an interval of 2 years and for 133 mother-child pairs after an interval of 4 years. At the second interval, 82 of the 133 children's fathers also contributed RSD data. Analyses of reliability and validity indicate that the RSD possesses adequate psychometric properties and may be used for purposes of research and screening, and, experimentally, for clinical assessment. PMID- 2754118 TI - Parents' attributions for achieving compliance from attention-deficit-disordered children. AB - Ninety-one parents provided reasons for the compliance and noncompliance of either their attention-deficit-disordered, hyperactive (ADDH) or non-ADDH child in six different situations. These attributions were rated on Weiner's (1979) dimensions of locus, stability, and controllability. While parents used the same categories to explain the reasons for their children's compliance behavior, they used different dimensional ratings for these explanations. Mothers rated attributions for noncompliance as more external than did fathers. Mothers of ADDH children viewed the causes of their children's behavior to be more unstable than did mothers of control children. Also, ADDH parents had lower expectations of achieving future compliance from their child than did non-ADDH parents. Results were discussed in terms of parental experiences, the need to consider an idiosyncratic approach to attributional meaning, and treatment implications. PMID- 2754119 TI - Inducibility of sustained monomorphic ventricular tachycardia as a prognostic indicator in survivors of recent myocardial infarction: a prospective evaluation in relation to other prognostic variables. AB - The prognostic significance of sustained monomorphic ventricular tachycardia inducible with up to three extrastimuli was assessed in relation to other prognostic markers, including clinical assessment, signal-average electrocardiogram (ECG), Holter monitoring, ejection fraction measurement and exercise testing, in 75 patients after recent myocardial infarction. Among eight patients with inducible sustained monomorphic ventricular tachycardia, six suffered arrhythmic events during a median follow-up period of 16 months. No patient without inducible sustained monomorphic ventricular tachycardia suffered an arrhythmic event. Multivariate analysis showed that of all the variables examined, inducible sustained monomorphic ventricular tachycardia was the only independent predictor of arrhythmic events during the follow-up period. The sensitivity for predicting arrhythmic events by this response was 100%, the specificity 97% and the positive predictive accuracy 75%. Individually, the other prognostic variables were less sensitive and much less accurate predictors of arrhythmic events, but the combination of the occurrence of acute phase complications or frequent ectopic activity with an abnormal signal-averaged ECG approached the sensitivity and accuracy of inducible sustained monomorphic ventricular tachycardia. The prognostic utility of programmed ventricular stimulation in patients with recent myocardial infarction is limited because comparable information can be obtained less invasively. However, the test may have a role in selecting therapy in patients judged to be at risk from arrhythmias on the basis of noninvasive assessment. PMID- 2754120 TI - Does the rest electrocardiogram after myocardial infarction determine the predictive value of exercise-induced ST depression? A 2 year follow-up study in a veteran population. AB - The failure of exercise-induced ST segment depression to consistently predict prognosis in patients after myocardial infarction could be a result of population differences and the rest electrocardiogram (ECG). These hypotheses were tested by studying 198 veterans who survived a myocardial infarction, underwent a submaximal predischarge treadmill exercise test and were followed up for cardiac events for 2 years. During the 2 years, 29 deaths, 19 reinfarctions and 28 revascularization procedures were documented. The prevalence of death or reinfarction was two times higher in patients who had exercise-induced ST depression than in patients who did not. However, in the 55 patients without Q waves, the risk increased to 11 times for an abnormal ST response. These findings suggest that exercise-induced ST depression only predicts high risk in patients after myocardial infarction whose ECG at rest does not exhibit Q waves and that differences in the prevalence of rest ECG patterns are the most likely explanation for the failure of agreement among prior studies. PMID- 2754121 TI - Isolated chronic mitral regurgitation with preserved systolic left ventricular function and severe pulmonary hypertension. AB - Pulmonary hypertension in chronic mitral valve disease has been related most commonly to left ventricular dysfunction or mitral stenosis; its association with chronic, isolated mitral regurgitation and preserved left ventricular systolic function is unclear. In 41 catheterized patients with chronic mitral regurgitation (known history of mitral regurgitation for greater than 18 months) and preserved left ventricular systolic function (ejection fraction greater than 0.55), historic, electrocardiographic, echocardiographic and hemodynamic variables were analyzed. Ten patients (Group I) had normal pulmonary artery systolic pressure (less than 30 mm Hg), whereas 31 patients had pulmonary hypertension. Pulmonary artery systolic pressure was mildly increased (30 to 49 mm Hg) in 13 patients (Group II) and was greater than or equal to 50 mm Hg in 18 patients (Group III). Univariate analysis showed the more frequent occurrence of male gender and ruptured chordae tendineae in the groups with pulmonary hypertension. Mean pulmonary capillary wedge pressure, size of the V wave in pulmonary capillary wedge pressure and pulmonary arteriole resistance were higher, whereas cardiac index was lower in the hypertension groups. Multivariate stepwise analysis revealed higher mean pulmonary capillary wedge pressure and pulmonary arteriole resistance as the only variables independently differing among groups. In conclusion, pulmonary hypertension occurs frequently (76% of cases) in patients with chronic, isolated mitral regurgitation with preserved left ventricular systolic function. In these patients, a severe increase in pulmonary capillary wedge pressure is associated with elevation in pulmonary artery resistance, a finding similar to that in mitral stenosis. PMID- 2754122 TI - Clinical results and in vivo valve function after implantation of a Bicer valve prosthesis in the aortic position. AB - Between December 1981 and June 1987, 71 patients underwent aortic valve replacement with a Bicer monostrut tilting disc prosthesis. Clinical results and in vivo function of the artificial valve were assessed. The average age of the 71 patients at the time of operation was 51.3 +/- 11.5 years. The hospital mortality rate was 2.8% (two patients) and there were no further deaths during a mean (+/- SD) follow-up period of 2.4 +/- 1.6 years (range 1 month to 5.5 years) after surgery. There was also no occurrence of thromboembolism or valve dysfunction. Function of the Bicer valve prosthesis was assessed in 17 patients: 5 with a 21 mm valve, 7 with a 23 mm valve and 5 with a 25 mm valve. Examination was performed on average 10.3 +/- 8.1 months after surgery. Valve function was examined at rest and during exercise performed with a bicycle ergometer. Pressure gradients at rest were low: 21 mm valve = 8 mm Hg, 23 mm valve = 3 mm Hg and 25 mm valve = 2 mm Hg; the gradients during exercise were 11, 8 and 8 mm Hg, respectively. The valves had the following effective orifice area at rest: 21 mm valve = 1.54 cm2, 23 mm valve = 4.20 cm2 and 25 mm valve = 3.76 cm2; during exercise, the respective areas were 1.57, 3.48 and 3.01 cm2. These valves are deemed to be sufficiently wide for effective valve function. Aortographic observation indicated mild regurgitation that was within reasonable limits and posed no problem.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2754123 TI - Load dependence of the single beat maximal pressure (stress)/volume ratios in humans. AB - To determine whether the slopes of the single beat maximal pressure (stress)/volume ratios are sensitive to changes in loading conditions in humans, 16 patients without cardiac disease were studied with simultaneous micromanometer determined left ventricular pressures and biplane contrast cineangiograms under control conditions and during methoxamine and nitroprusside infusions. Left ventricular volumes were calculated with use of a Simpson's rule algorithm, wall thickness was obtained iteratively, and both midwall circumferential and meridional stresses were computed frame by frame. The maximal pressure/volume and both circumferential and meridional maximal stress/volume ratios were calculated using a single beat from each loading condition assuming a zero volume-axis intercept. Mean left ventricular systolic pressure increased 47% during the methoxamine infusion and decreased 22% during the nitroprusside infusion compared with control (p less than 0.001 for both). Despite these changes in left ventricular systolic pressure, heart rate was eliminated as a confounding variable by right atrial pacing; and mean maximal rate of change of left ventricular pressure [(+)dP/dtmax] and rate of change at developed pressure 40 mm Hg [(+)(dP/dt) per DP40] values did not differ significantly. Mean single beat maximal pressure/volume ratios also did not differ significantly among the three loading conditions. In contrast, mean single beat circumferential and meridional maximal stress/volume ratios were 3.15 +/- 1.83 and 1.40 +/- 0.82 g/cm2 per ml at control; they increased to 4.47 +/- 2.44 and 2.21 +/- 1.25 g/cm2 per ml during the methoxamine infusion (p less than 0.001 for both), and they decreased during the nitroprusside infusion to 2.58 +/- 1.47 and 1.14 +/- 0.57 g/cm2 per ml (p less than 0.05 and p less than 0.01, respectively).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2754124 TI - High dose dipyridamole echocardiography early after uncomplicated acute myocardial infarction: correlation with exercise testing and coronary angiography. AB - The feasibility, safety and usefulness of dipyridamole echocardiography (two dimensional echocardiography and 12 lead electrocardiographic monitoring during dipyridamole infusion, up to 0.84 mg/kg over 10 min) were evaluated in 94 asymptomatic patients 8 to 10 days after uncomplicated acute myocardial infarction. The results were compared with those of symptom-limited treadmill exercise testing and correlated with coronary angiography. Two mechanical patterns of positivity of dipyridamole echocardiography could be identified: 1) a new wall motion abnormality confined to the infarct zone or to the adjacent segments (24 patients), and 2) transient remote asynergy (33 patients). The success rate in recording adequate images during dipyridamole infusion was 100%. Interobserver agreement concerning diagnosis occurred in 89 (93%) of 94 patients. Dipyridamole echocardiography was well tolerated; no complication was observed during or after the test. Seventy-three patients underwent coronary angiography within 6 weeks after acute myocardial infarction. Transient remote asynergy on echocardiography was present in 27 of 40 patients with multivessel disease and in none of 33 patients without multivessel disease. Results of treadmill exercise testing were positive in 28 patients with multivessel disease and 8 patients without multivessel disease. Thus, the sensitivity of dipyridamole-induced transient remote asynergy was 68% compared with 52% for treadmill testing (p less than 0.05); specificity was 100% and 72%, respectively (p less than 0.005). The overall accuracy of dipyridamole echocardiography (81%) was higher than that of dipyridamole stress electrocardiography (63%) or exercise electrocardiography (60%) (p less than 0.02). It is concluded that dipyridamole echocardiography is a useful, feasible and inexpensive nonexercise-dependent test for detecting the extent of coronary artery disease early after acute myocardial infarction. PMID- 2754125 TI - Effect of long-term high intensity aerobic training on left ventricular volume during maximal upright exercise. AB - The purpose of this study was to determine whether high intensity, long-term aerobic training causes the left ventricle to develop different mechanisms for increasing cardiac output during submaximal and maximal upright bicycle exercise. Fifteen competitive collegiate long distance runners and 14 healthy sedentary adults were studied with use of subcostal view four chamber two-dimensional echocardiography at rest and during and at peak maximal upright bicycle exercise. At rest, the athletes had a larger end-diastolic volume index (85 +/- 14 ml/m2) (mean +/- 1 SD) than that of the sedentary adults (62 +/- 14 ml/m2) and a larger end-systolic volume index (37 +/- 11 versus 21 +/- 6 ml/m2). During low and moderate intensity exercise, end-diastolic and stroke volume indexes increased in both groups, but at high intensity exercise and at peak exercise the end diastolic volume index of both groups decreased significantly below rest value (athletes, 61 +/- 14; sedentary subjects, 46 +/- 10 ml/m2, both p less than 0.001 compared with rest). Reflecting the decreased end-diastolic volume index, at peak exercise, the stroke volume index had decreased from intermediate exercise values in both groups and was not different from rest values. Therefore, although long distance runners have a dilated left ventricle at rest, they utilize the same mechanisms as sedentary adults for increasing cardiac output during upright dynamic exercise. At low and moderate level exercise, the Frank-Starling mechanism is a dominant mechanism for increasing cardiac output, but at peak exercise, probably because of reduced diastolic left ventricular filling, enhanced contractility is the major mechanism for maintaining stroke volume. PMID- 2754126 TI - Significance of signal-averaged electrocardiography in relation to endomyocardial biopsy and ventricular stimulation studies in patients with ventricular tachycardia without clinically apparent heart disease. AB - Signal-averaged electrocardiography (ECG) was performed in 38 patients (mean age 38 years, range 15 to 70) with ventricular tachycardia who had no clinical evidence of structural heart disease. Spontaneous ventricular tachycardia was nonsustained in 23 patients and sustained in 15. None of the patients had symptoms of heart failure or ischemic heart disease, and at cardiac catheterization none had significant coronary artery disease or left ventricular wall motion abnormalities. In addition, all patients underwent left and right ventricular endomyocardial biopsy and ventricular stimulation studies. Signal averaged ECG was performed and late QRS potentials were defined with use of Simson's method. Late QRS potentials were detected in a minority (18%) of patients including 2 of 23 with nonsustained and 5 of 15 with sustained (p = NS) ventricular tachycardia. Fifteen patients (40%) had abnormal endomyocardial biopsy results and these findings were more common in patients with sustained than in those with nonsustained ventricular tachycardia (9 of 15 versus 6 of 23, p less than 0.05). Late potentials were associated with abnormal endomyocardial biopsy findings (6 of 15 versus 1 of 23, p less than 0.01). An increase in fibrous tissue was the most frequent histopathologic abnormality; this increase was quantified by morphometric methods and compared with biopsy findings in normal control subjects. In the control group the proportion of collagen in relation to myocytes was less than 10%. All patients with both late potentials and abnormal biopsy findings had a greater than 15% ratio of collagen to myocytes in at least one specimen and the biopsies revealed marked interstitial fibrosis.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2754127 TI - Preferential effect of procainamide on the reentrant circuit of ventricular tachycardia. AB - Transient entrainment was used to test the hypotheses that 1) procainamide prolongs the cycle length of ventricular tachycardia in patients with coronary artery disease because it has a preferential effect on the reentrant tachycardia circuit, and 2) regions of slow conduction in the reentrant circuit are more susceptible to the effect of procainamide than are other areas of the ventricles. In five patients with prior myocardial infarction, sustained ventricular tachycardia with identical QRS configuration was inducible before and after intravenous infusion of procainamide. Transient entrainment of ventricular tachycardia was demonstrated at two or more cycle lengths by rapid pacing in the baseline state and after procainamide. Rapid pacing was performed from the same site during sinus rhythm at the cycle lengths that demonstrated transient entrainment of ventricular tachycardia. The conduction interval to the transiently entrained site during ventricular tachycardia (orthodromic interval) was compared with the conduction interval to the same site during pacing in sinus rhythm (antidromic interval). The mean tachycardia cycle length increased by 27% after procainamide administration (p = 0.002). The antidromic conduction intervals were prolonged by 9% (p = 0.06) compared with a 28% increase in the mean orthodromic conduction interval (p = 0.002). The difference between the orthodromic and antidromic conduction intervals increased by 40% (p = 0.003). Prolongation of the tachycardia cycle length after procainamide administration correlated positively with increases in the orthodromic conduction intervals (r = 0.94, p = 0.02) but not with changes in the antidromic intervals (r = -0.08, p = NS). The effect of procainamide on the difference between correlated strongly with changes in the cycle length of ventricular tachycardia (r = 0.97, p = 0.006).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2754128 TI - Natural history of patients with unexplained syncope and a nondiagnostic electrophysiologic study. AB - The purpose of this study was to define the natural history of 99 patients with unexplained syncope who underwent an electrophysiologic test that either was entirely normal or demonstrated nonspecific abnormalities that were nondiagnostic (inducible polymorphic ventricular tachycardia or ventricular fibrillation, a mildly prolonged sinus node recovery time of less than 2 s, a His-ventricular interval of 55 to 99 ms or supraventricular tachycardia not associated with hypotension). The mean age (+/- SD) of the patients was 56 +/- 19 years; structural heart disease was present in 47 patients and absent in 52. Complete follow-up was available in 95 patients. During 20 +/- 11 months of follow-up, 2 patients (2%) died suddenly, 19 patients (20%) had recurrent syncope and 74 patients (78%) had no further episodes of syncope. Among the 19 patients who continued to have syncope after the electrophysiologic testing, the cause of syncope was established clinically in 4 and was found to be high degree atrioventricular (AV) block (2 patients) or sinus node dysfunction (2 patients). No clinical or laboratory findings distinguished patients who had sudden death or syncope during follow-up from patients who did not. In conclusion, in patients with unexplained syncope who undergo an electrophysiologic test that is nondiagnostic 1) the incidence of sudden death is low (2%); 2) the remission rate of syncope is high (80%); 3) the electrophysiologic test may be documented to have been falsely negative in greater than or equal to 20% of patients who continue to have syncope, syncope in these patients being caused by AV block or sinus node dysfunction; and 4) patients at risk of sudden death or recurrent syncope, or both, cannot be readily identified prospectively. PMID- 2754129 TI - Balloon dilation of postoperative right ventricular outflow obstructions. AB - Balloon dilation was attempted in 16 patients, aged 5 months to 19.5 years, with right ventricular outflow obstruction after repair of congenital heart defects. Stenosis of a valved conduit between the pulmonary ventricle and pulmonary artery was present in nine patients with a mean transvalvular peak systolic ejection gradient of 61.6 +/- 21.0 mm Hg and a mean right ventricle to aorta pressure ratio of 0.9 +/- 0.2. Supravalvular pulmonary stenosis was present in seven patients; in five, stenosis was at the anastomotic site after the arterial switch operation with a mean peak systolic ejection gradient of 72.2 +/- 10.6 mm Hg and mean right ventricle to aorta pressure ratio of 0.93 +/- 0.05. The other two patients had stenosis at a previous pulmonary artery band site with a peak systolic ejection gradient of 60 and 65 mm Hg and right ventricle to aorta pressure ratio of 0.75 and 0.72, respectively. Balloon dilation was successful in three of nine patients with a valved conduit; two of them had additional successful balloon dilation of the right pulmonary artery. In five of the nine patients (including one with successful dilation) the conduit was replaced 5.7 +/ 4.5 months after balloon dilation. Balloon dilation was successful in only one of the five patients with supravalvular pulmonary stenosis after the arterial switch operation and partially successful in the two patients with supravalvular pulmonary stenosis at a previous band site. The success rate of balloon dilation of postoperative right ventricular outflow obstruction is much lower than that for other right heart obstructions. PMID- 2754130 TI - Constriction of a large coronary artery contributes to serotonin-induced myocardial ischemia in the dog with pliable coronary stenosis. AB - To clarify the role of serotonin in eliciting myocardial ischemia, the effects of serotonin on coronary vasculature and cardiac performance were examined in anesthetized open chest dogs. Without coronary stenosis, intracoronary infusion of serotonin (0.001 to 1.0 micrograms/kg per min) for 40 s caused dose-dependent increases in coronary blood flow up to 175 +/- 8.3%. During fixed coronary stenosis produced by a metal constrictor that restricted active vasomotion of the stenosed segment, only the highest dose of serotonin increased coronary blood flow by 23 +/- 5.7% and decreased distal coronary pressure without any changes in stenosis resistance and systemic hemodynamic variables. During dynamic coronary stenosis created by inflation of an intraluminal microballoon that preserved active vasomotion of the stenosed segment, intracoronary serotonin (0.1 and 1.0 micrograms/kg per min) evoked marked decreases in coronary blood flow and distal coronary pressure and an increase in stenosis resistance, resulting in an elevation of left ventricular end-diastolic pressure and worsening of left ventricular dP/dt. These deleterious effects were reversed by additive intracoronary infusion of nitroglycerin (10 micrograms/min). The detrimental effects of serotonin were not attenuated by pretreatment with aspirin (10 mg/kg, intravenously), which suppressed adenosine disphosphate- and arachidonic acid induced platelet aggregation in vitro. Furthermore, intracoronary infusion of serotonin (0.1 and 1.0 micrograms/kg per min) from the site distal to coronary stenosis failed to decrease coronary blood flow during dynamic coronary stenosis. Therefore, these detrimental effects of serotonin during dynamic coronary stenosis could be caused by constriction of a large coronary artery but not by platelet aggregation. Vascular effects of serotonin without coronary stenosis and with dynamic coronary stenosis were inhibited by pretreatment with methysergide (0.3 mg/kg, intravenously), but not with ketanserin (0.5 mg/kg, intravenously) which inhibited serotonin-induced platelet aggregation in vitro. Thus, serotonin produced opposing effects on coronary vasculature, that is, small coronary artery dilation and large coronary artery constriction. Both vascular effects were mediated by non-S2-serotonergic receptor activation of the coronary artery. The data obtained in this study suggest that serotonin-elicited constriction of a large coronary artery may play a crucial role in the pathogenesis of myocardial ischemia during pliable coronary stenosis. PMID- 2754131 TI - Early identification with ultrasonic integrated backscatter of viable but stunned myocardium in dogs. AB - It has been shown that canine and human hearts exhibit a cardiac cycle-dependent variation of integrated backscatter (cyclic variation) that reflects intrinsic regional contractile performance. To determine whether ultrasound tissue characterization can identify viable though stunned myocardium before recovery of regional wall thickening, transient ischemic injury was produced in eight open chest dogs for 15 min followed by reperfusion for 2 h. Cyclic variation and wall thickening were measured before ischemia, at 15 min after the onset of ischemia and at selected intervals after the onset of reperfusion from multiple sites within the ischemic zone with a novel combined two-dimensional and M-mode acquisition system. Cyclic variation and wall thickening were computed from digitized M-mode integrated backscatter images with an algorithm developed and validated for this purpose. Magnitude and "delay" of cyclic variation and wall thickening were compared. Delay represents the degree of synchrony of regional cyclic variation or wall thickening with global ventricular mechanical systole. Baseline cyclic variation and wall thickening magnitudes were 3.8 +/- 0.2 dB and 37 +/- 1.4%, respectively. With ischemia, cyclic variation and wall thickening decreased to 1.7 +/- 0.2 dB and 17 +/- 2%, respectively (p less than 0.05, compared with baseline). Cyclic variation recovered to baseline levels within 20 min after reperfusion (3.3 +/- 0.4 dB, p = NS). Wall thickening remained depressed for 2 h after the onset of reperfusion (23 +/- 2%, p less than 0.05 compared with baseline). Delay of cyclic variation in a unitless ratio expressed as delay (in milliseconds) divided by the QT interval (in milliseconds) increased from 0.87 +/- 0.03 at baseline to 1.10 +/- 0.12 with ischemia, a change consistent with mild asynchrony, and returned to baseline (0.95 +/- 0.07, p = NS compared with baseline) within 20 min after reperfusion. Delay of wall thickening was 0.88 +/- 0.02 at baseline, increased to 1.23 +/- 0.09 with ischemia and remained significantly increased 2 h after reperfusion (1.07 +/- 0.05, p less than 0.05 compared with baseline). Recovery time constants for cyclic variation and wall thickening with reperfusion reflected earlier restoration of cyclic variation (8.1 min) than of wall thickening (420.5 min). Thus, cyclic variation recovers before wall thickening with reperfusion. Its analysis appears to provide a useful index of the presence of viable and potentially salvageable tissue in regions of stunned myocardium that is independent of wall thickening. PMID- 2754132 TI - In vivo nuclear magnetic resonance imaging of myocardial perfusion using the paramagnetic contrast agent manganese gluconate. AB - Previous nuclear magnetic resonance (NMR) imaging studies have indicated that coronary occlusion does not produce sufficient changes in standard tissue relaxation times to allow the detection of acute ischemia. To identify acute myocardial perfusion abnormalities, the use of the paramagnetic agent manganese gluconate combined with calcium gluconate (MnGlu/CaGlu) was investigated in canine models of acute coronary artery occlusion. In vitro studies showed that MnGlu/CaGlu was a more efficient relaxing agent than gadolinium-DTPA (relaxivity of 7.8 versus 5.1 s-1 mM-1) and demonstrated affinity for normal myocardium. The distribution of MnGlu/CaGlu as measured by manganese-54 tracer studies was proportional to myocardial blood flow in both normal and ischemic tissue. Hearts excised from dogs after coronary artery occlusion and administration of 0.035 mM/kg MnGlu/CaGlu were imaged ex vivo using a relatively spin-lattice relaxation time (T1)-weighted gradient reversal technique (repetition time [TR] 50 ms and echo time [TE] 9 ms). These images showed increased signal intensity in the normally perfused myocardium with a mean signal intensity ratio of hypoperfused to normal myocardium of 0.55 +/- 0.12 (mean +/- SD). In vivo images obtained in nine dogs after coronary artery occlusion and administration of the same dose of MnGlu/CaGlu demonstrated the region of hypoperfused myocardium in six dogs with a signal intensity ratio of hypoperfused to normal myocardium of 0.64 +/- 0.23 (p less than 0.05 versus control). When a higher dose of 0.1 mM/kg MnGlu/CaGlu was utilized and in vivo imaging was performed using a relatively spin-spin relaxation time (T2)-weighted (TR gated, TE 60 ms) spin-echo sequence in six dogs, the signal intensity of normal myocardium was decreased.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2754133 TI - Functional relation between infarct thickness and regional systolic function in the acutely and subacutely infarcted canine left ventricle. AB - Specific information regarding the relation between infarct thickness and regional systolic function is important to the overall understanding of both the pathophysiology of acute and subacute myocardial infarction and the functional benefits of myocardial salvage interventions designed to limit the transmural extent of infarction and thereby preserve left ventricular function. In the present study, quantitative computer-assisted two-dimensional echocardiography was used to define the relation between infarct thickness and systolic function in the acutely and subacutely infarcted canine left ventricle. Echocardiograms were obtained at the mid-papillary muscle level at baseline and 6 h after occlusion (acute infarction) in eight animals and at baseline and 72 h after occlusion (subacute infarction) in nine animals. Systolic function was assessed by measuring the extent of fractional radial shortening along each of 36 evenly spaced endocardial targets from end-diastole to end-systole; the transmural extent of infarction was determined from the triphenyltetrazolium chloride staining deficit at 6 and 72 h. The relation between systolic function and transmural extent of infarction was analyzed in two ways. First, the extent of fractional radial shortening in each group was examined as a function of quartile (25%) increments in transmural infarct thickness. This analysis revealed 1) a significant overall loss of fractional radial shortening with increasing transmural extent of infarction in both groups; and 2) significant differences in the extent of systolic dysfunction between successive quartile increments of infarction. Second, the relation between infarct thickness and systolic dysfunction was modeled mathematically by fitting the data from each infarct series to linear, logarithmic and exponential functions.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2754134 TI - Evaluation of ventricular contractility indexes in the dog with left ventricular dysfunction induced by rapid atrial pacing. AB - Eight dogs were studied by simultaneous invasive hemodynamic and two-dimensional echocardiographic methods to determine whether left ventricular contractility is altered by 2 weeks of rapid atrial pacing. Additionally, this study evaluated the response of three ventricular contractility indexes to both the pacing intervention and acute load alteration. The indexes compared were ejection fraction, peak systolic pressure to end-systolic volume index ratio (SBP/ESVI) and end-systolic wall stress to end-systolic volume index ratio (ESWS/ESVI). After 2 weeks of pacing at 265 +/- 20 min-1 (mean +/- SD), cardiac index and ejection fraction were reduced to 73 +/- 38 ml/kg per min and 22 +/- 6%, respectively, from 161 +/- 22 and 46 +/- 7 before pacing (both p less than 0.001). Concomitantly, SBP/ESVI and ESWS/ESVI were reduced to 34 +/- 10 mm Hg/ml per kg and 54 +/- 19 g/cm2 per ml per kg, respectively, from 84 +/- 29 and 121 +/ 36 before pacing (both p less than 0.005). There were high correlations for the changes in SBP/ESVI and ejection fraction (r = 0.94, p less than 0.001) and ESWS/ESVI and ejection fraction (r = 0.89, p less than 0.003). Acute afterload alteration with phenylephrine depressed ejection fraction but not SBP/ESVI or ESWS/ESVI. Therefore, this study demonstrates 1) that left ventricular contractility is markedly depressed in the dog by 2 weeks of rapid atrial pacing, and 2) that SBP/ESVI and ESWS/ESVI are superior to ejection fraction as ventricular contractility indexes because these ratios accurately measure contractility changes but are influenced less by after-load conditions. PMID- 2754135 TI - The hemodynamic benefit of differential atrioventricular delay intervals for sensed and paced atrial events during physiologic pacing. AB - The ability to program different atrioventricular (AV) delay intervals for paced and sensed atrial events is incorporated in the design of some newer dual chamber pacemakers. However, little is known regarding the hemodynamic benefit of differential AV delay intervals or the magnitude of difference between optimal AV delay intervals for paced and sensed P waves in individual patients. In this study, Doppler-derived cardiac output was used to examine the optimal timing of paced and sensed atrial events in 24 patients with a permanent dual chamber pacemaker. The hemodynamic effect of utilizing separate optimal delay intervals for sensed and paced events compared with utilizing the same fixed AV delay interval for both was determined. The optimal delay interval during DVI (AV sequential) pacing and VDD (atrial triggered, ventricular inhibited) pacing at similar heart rates was 176 +/- 44 and 144 +/- 48 ms (p less than 0.002), respectively. The mean difference between the optimal AV delay intervals for sensed (VDD) and paced (DVI) P waves was 32 ms and was up to 100 ms in some individuals. The difference between optimal AV delay intervals for sensed and paced atrial events was similar in patients with complete heart block and those with intact AV node conduction. At the respective optimal AV delay intervals for sensed and paced P waves, there was no significant difference in the cardiac output during VDD compared with DVI pacing. However, cardiac output significant declined during VDD pacing at the optimal AV delay interval for a paced event and during DVI pacing at the optimal interval for a sensed event.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2754136 TI - Time to first shock and clinical outcome in patients receiving an automatic implantable cardioverter-defibrillator. AB - The relation between time to first shock and clinical outcome was studied in 60 patients who received an automatic implantable cardioverter-defibrillator (AICD) from August 1983 through May 1988. The mean (+/- SD) patient age was 64 +/- 10 years, 82% were men and the mean ejection fraction was 33 +/- 13%. During follow up, 38 patients (63%) had one or more shocks; there were no differences in age, gender distribution or ejection fraction at entry between the shock and no shock groups. Among 51 patients with coronary artery disease, 31 (61%) had one or more shocks, whereas all seven patients with cardiomyopathy had one or more shocks (p less than 0.05). Neither of the two patients with idiopathic ventricular fibrillation had shocks. Of the 13 deaths, 12 occurred during post-hospital follow-up and 1 during the index hospitalization. Of the four sudden post hospital deaths, only one was due to tachyarrhythmia in the absence of acute myocardial infarction. All four sudden deaths and five of eight post-hospital nonsudden deaths occurred in patients who had had one or more appropriate shocks during follow-up. Eight of the nine first appropriate shocks among patients who subsequently died occurred within the first 3 months of follow-up, but the actual deaths were delayed to a mean of 14.1 +/- 13.9 months (p less than 0.05). The mean time to all deaths was 14.8 +/- 13.1 months. The ejection fraction was significantly lower among patients who died than among patients who survived (25 +/- 7% versus 35 +/- 14%, p less than 0.02), but it did not distinguish risk of first shocks.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2754137 TI - Comparative effects of verapamil and nitroprusside on left ventricular function in patients with hypertension. AB - The effects of verapamil were compared with those of nitroprusside at matched mean arterial pressures and heart rates in 10 symptomatic hypertensive patients during cardiac catheterization. Simultaneous radionuclide angiography and micromanometer pressure measurements were obtained to assess left ventricular pressure-volume relations. Compared with control conditions, verapamil increased left ventricular end-diastolic volume index from 57 +/- 16 to 70 +/- 28 ml/m2 (p = 0.05) without a significant increase in left ventricular end-diastolic pressure (from 10 +/- 4 to 13 +/- 6 mm Hg). Despite a downward and rightward shift in the end-systolic pressure-volume relation indicating negative inotropic effects, ejection fraction did not decrease significantly (from 52 +/- 9% to 46 +/- 9%); cardiac index and stroke volume index remained unchanged. The change in stroke volume index with verapamil was directly related to the magnitude of change in end-diastolic volume index (r = 0.82, p less than 0.005), suggesting that the increase in end-diastolic volume did not arise purely from negative inotropic effects. Systemic vascular resistance index decreased from 42 +/- 8 to 34 +/- 7 mm Hg.min.m2/liter (p less than 0.05). In contrast, nitroprusside decreased left ventricular end-diastolic volume index from 57 +/- 16 to 41 +/- 10 ml/m2 (p less than 0.05), cardiac index from 3.2 +/- 0.7 to 2.8 +/- 0.6 liters/min per m2 (p less than 0.05) and stroke volume index from 28 +/- 6 to 24 +/- 5 ml/m2 (p less than 0.01), with no change in systemic vascular resistance index (40 +/- 10 mm Hg.min.m2).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2754138 TI - Angiographic demonstration of spontaneous diffuse three vessel coronary artery spasm. AB - The spontaneous occurrence of diffuse three vessel coronary artery spasm was documented during routine coronary angiography in three patients with a history of variant angina. Quantitative angiographic analysis of 18 arterial segments demonstrated that the mean luminal diameter of 1.47 mm during spasm increased to 2.47 mm after the administration of nitroglycerin (p less than 0.0001). The underlying coronary arteries were normal or near normal. Although multivessel spasm has previously been considered to be uncommon and its spontaneous occurrence during angiography only rarely documented, these cases suggest that it may be more common than previously recognized. In addition to important diagnostic considerations, this phenomenon may have important implications regarding the pathophysiologic role of endothelium in coronary artery spasm. PMID- 2754139 TI - A view of cardio-cortical connections. PMID- 2754140 TI - Concerns about fragmentation of adult cardiology. PMID- 2754141 TI - Allergenic and antigenic relationship between three species of storage mite and the house dust mite, Dermatophagoides pteronyssinus. AB - We have explored the antigenic and allergenic relationship between the house dust mite Dermatophagoides pteronyssinus and three species of storage mite, Glycyphagus destructor, Acarus siro, and Tyrophagus longior. Crossed immunoelectrophoresis demonstrated that all the mite extracts contained multiple antigens but that there was only limited cross-reactivity between the different species. Six sera were obtained from workers exposed to storage mites and with occupationally related lower respiratory tract symptoms. All workers had specific IgE to D. pteronyssinus and to one or more of the storage mites. The pattern of reactivity varied between the different sera, two responded primarily to D. pteronyssinus and A. siro and four sera to D. pteronyssinus and G. destructor. Only weak responses were observed to T. longior. RAST-inhibition and affinity absorption experiments demonstrated that D. pteronyssinus had at least three groups of distinct allergenic determinants, determinants specific to D. pteronyssinus, determinants shared with A. siro, and determinants shared with G. destructor. Similarly, both A. siro and G. destructor have specific allergenic determinants and determinants shared with D. pteronyssinus. The findings demonstrate the complexity of the immunologic responses to the different mite species. PMID- 2754142 TI - Pharmacist substitution of slow-release theophylline products. PMID- 2754143 TI - Studies of spontaneous proliferation of mononuclear cells in human immunodeficiency virus (HIV-1)-infected individuals. AB - We evaluated the ability of mononuclear cell populations from 56 hemophiliac subjects, 69 homosexuals, and 32 control subjects to proliferate spontaneously in vitro. Levels of spontaneous proliferation (SP) were not significantly different among homosexuals or hemophiliac subjects when they were grouped as asymptomatic human immunodeficiency virus (HIV) seronegative, asymptomatic seropositive, persistent generalized lymphadenopathy, acquired immunodeficiency syndrome related complex, or acquired immunodeficiency syndrome groups. There was, however, a stepwise increase in levels of SP corresponding with progression of disease in both patient groups. No correlations were noted between SP and CD8+ cell populations or mitogenic responses in study subjects, but SP correlated inversely to percentages and numbers of CD4+ lymphocytes. Depletion of CD4+ cells from mononuclear cell populations of HIV-infected subjects decreased SP. Thus, in HIV-1-infected subjects, SP increases as HIV-1-related disease progresses and appears to be CD4 dependent. PMID- 2754144 TI - Fluctuation of the number of CD-1(T6)-positive dendritic cells, presumably Langerhans cells, in the nasal mucosa of patients with an isolated grass-pollen allergy before, during, and after the grass-pollen season. AB - A monoclonal antibody against CD-1(T6) was used for studies in the nasal mucosa of patients with isolated grass-pollen allergy to determine whether the number of CD-1-positive cells, presumably Langerhans cells, depends on the season in which the nasal biopsy is performed. An earlier study had demonstrated that during the grass-pollen season, there are significantly more CD-1-positive cells in nasal mucosa of patients with isolated grass-pollen allergy than in nonallergic control subjects without nasal complaints. During the grass-pollen season, the nasal epithelium of patients with an isolated grass-pollen allergy demonstrated significantly more CD-1-positive cells than before and after the season. Before and after the season, the number of CD-1-positive cells in epithelium of the allergic patients was not significantly greater than the corresponding number in epithelium of nonallergic subjects without nasal complaints. PMID- 2754145 TI - Are theophylline "levels" a reliable indicator of compliance? AB - Clinicians frequently rely on serum theophylline concentrations (STCs) as an indicator of compliance for asthma medications. Most patients with good compliance do not have excessive fluctuations during routine STC monitoring. However, our experience is that in certain patients, persistently low or erratic STCs may be a sign of abnormal theophylline disposition. With careful analysis of theophylline absorption (STC every 2 hours for 24 hours after oral theophylline doses) and elimination (serial STC for 12 hours after an intravenous dose of aminophylline), we identified several patients with previously unrecognized anomalies of theophylline pharmacokinetics. These include (1) a 16-year-old girl with consistent temporal fluctuation in STCs during administration of a sustained release formulation every 8 hours because of delayed absorption and enhanced elimination of theophylline at night, (2) a 13-year-old girl with markedly delayed absorption of a once-daily preparation administered in the evening, (3) a 5-year-old boy with erratic absorption of a liquid theophylline preparation with significantly increased STCs during the night, and (4) a 49-year-old man with 60% bioavailability of aminophylline tablets. Based on these observations, we suggest that clinicians carefully consider the possibility of abnormalities in theophylline disposition before assuming unexpected deviations in STCs are solely the result of noncompliance. PMID- 2754146 TI - Syndrome of idiopathic chronic urticaria and angioedema with thyroid autoimmunity: a study of 90 patients. AB - From a pool of 624 patients with idiopathic chronic urticaria and angioedema, 90 patients had evidence of associated thyroid autoimmunity (TA). Since the number expected by chance alone is 37, given that less than 6% of normal subjects have TA, the association is significant (p less than 0.01; chi-square test). Age and sex distribution was typical of patients with TA. Clinically, most patients suffered relentless and severe urticaria and/or angioedema. With the exception of thyroid function and thyroid antibody tests, other laboratory tests were not rewarding. In most cases, treatment with 1 thyroxine did not improve urticaria or angioedema, but a few patients demonstrated a dramatic response. Awareness of the association resulted in the identification of previously undiagnosed thyroid disease. The authors hypothesize that a subset of idiopathic chronic urticaria and angioedema may be an autoimmune disease. PMID- 2754147 TI - Effect of combined maternal and infant food-allergen avoidance on development of atopy in early infancy: a randomized study. AB - The effect of maternal and infant avoidance of allergenic foods on food allergy was examined in a prenatally randomized, controlled trial of infants of atopic parents. The diet of the prophylactic-treated group (N = 103) included (1) maternal avoidance of cow's milk, egg, and peanut during the third trimester of pregnancy and lactation and (2) infant use of casein hydrolysate (Nutramigen) for supplementation or weaning, and avoidance of solid foods for 6 months; cow's milk, corn, soy, citrus, and wheat, for 12 months; and egg, peanut, and fish, for 24 months. In the control group (N = 185), mothers had unrestricted diets, and infants followed American Academy of Pediatrics feeding guidelines. The cumulative prevalence of atopy was lower at 12 months in the prophylactic-treated (16.2%) compared to the control (27.1%) group (p = 0.039), resulting from reduced food-associated atopic dermatitis, urticaria and/or gastrointestinal disease by 12 months (5.1% versus 16.4%; p = 0.007), and any positive food skin test by 24 months (16.5% versus 29.4%; p = 0.019), caused primarily by fewer positive milk skin tests (1% versus 12.4%; p = 0.001). The prevalences of allergic rhinitis, asthma, and inhalant skin tests were unaffected. Serum IgE levels in the prophylactic-treated group were marginally lower only at 4 months. Thus, reduced exposure of infants to allergenic foods appeared to reduce food sensitization and allergy primarily during the first year of life. PMID- 2754148 TI - Identification of potential allergens in white oak (Quercus alba) pollen by immunoblotting. AB - Aqueous extracts of white oak pollen were separated by sodium dodecyl sulfate polyacrylamide gel electrophoresis and transferred onto nitrocellulose membranes. The nitrocellulose membranes were blocked with phosphate-buffered saline 15% nonfat dry milk, incubated with dilutions of sera from atopic or control subjects, and probed with a radiolabeled or peroxidase-labeled antihuman IgE. The IgE binding bands were detected by autoradiography or enzymatic reaction; 45 to 50 protein bands were observed in silver-stained gels. IgE from 30 of the 38 sera tested from oak-sensitive subjects bound to 23 bands with molecular weights (MWs) between 106 to 108 kd (band 1) and 13.2 to 15.2 kd (band 23). No band was recognized by sera of every patient. Band 5 (MW 74.0 to 77.9 kd) and band 21 (MW 16.2 to 17.7 kd) were recognized by 71% of the patients' sera. Multiple bands were recognized by 30% to 50% of the sera tested. All patients who were skin test positive to oak by prick testing had positive immunoblots. Of 12 patients positive by intradermal skin testing, only four patients had positive immunoblots. The average number of allergens recognized by a single patient was 6.6. The maximum number of allergens to which any individual reacted was 18; the minimum number was one. Extracts separated under nonreducing conditions resulted in aggregates that did not enter the polyacrylamide gel. Of the protein that did enter the gel, the higher MW species elicited banding patterns similar to patterns observed under reducing conditions, whereas lower MW IgE binding bands were lost. These data suggest that the extractable proteins of white oak pollen contain multiple proteins that are potentially allergenic. PMID- 2754149 TI - Epinephrine improves expiratory flow rates in patients with asthma who do not respond to inhaled metaproterenol sulfate. AB - One hundred patients with acute asthma and peak expiratory flow rates (PEFR) less than 150 L/min were randomized and treated in a double-blind treatment protocol with either metaproterenol sulfate aerosol (MPA) inhalation and placebo injection or epinephrine injection (EPI) and inhaled placebo at entry and at 30 and 60 minutes, and then were treated with the crossover comparison regimen at 120, 150, and 180 minutes. The two groups had similar entry PEFRs and FEV1 (MPA, 112 L/min; 0.94 L, respectively; EPI, 111 L/min; 0.85 L, respectively) and similar plasma theophylline levels (MPA, 12.2 micrograms/ml; EPI, 13.8 micrograms/ml). PEFR and FEV1 were measured every 30 minutes for 4 hours. Mean expiratory flow rates among both groups were similar at entry and at 120 and 240 minutes. At 120 minutes, flow rates had improved in 28/46 MPA-treated patients (61%) and 48/54 EPI-treated patients (89%). Among these improved patients, flow rates were significantly higher in the MPA-treated group. At 120 minutes, 18/46 MPA-treated patients (39%) and 6/54 EPI-treated patients (11%) had PEFRs less than 120 L/min and PEFR and FEV1 less than 120% of baseline values (p less than 0.01). In 13 of these 18 MPA treated patients who did not improve compared to 1/6 EPI-treated patients who did not improve, PEFRs were greater than 120 L/min, and PEFR and FEV1 had increased 20% or more above baseline values after treatment with the crossover comparison regimen (p less than 0.02).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2754150 TI - Inhalation of hypertonic saline as a bronchial challenge in children with mild asthma and normal children. AB - The response to bronchial challenge with ultrasonically nebulized 4.5% saline was compared to the response to histamine and isocapneic hyperventilation in a group of children with mild asthma and control subjects. Challenge with 4.5% saline was found to have an accuracy of approximately 80%, compared to 90% for histamine and 80% for hyperventilation. The challenge test was well tolerated by all children. Increasing the dose of 4.5% saline delivered to the children by use of a nebulizer with a higher output improved the accuracy of challenge with 4.5% saline to approximately 90%. This finding suggests that the nebulizer output is an important determinant of the accuracy of bronchial challenge with 4.5% saline. Bronchial challenge with 4.5% saline appears to be a promising addition to the tests of bronchial responsiveness in children, but further studies, particularly documenting the reproducibility and the relationship to clinical asthma, are needed before it can replace the current standard tests. PMID- 2754151 TI - Influence of hospitalization on drug therapy in the elderly. AB - In order to determine whether acute hospitalization leads to changes in the medications used by the elderly after discharge, we studied the medications used at admission and discharge for 197 elderly subjects admitted to one hospital. We found that 40% of all admission medications were discontinued by discharge and 45% of all discharge medications were newly started during the hospitalization. Although the number of drugs used did not increase significantly from admission to discharge (4.50 to 4.80, P = .128), the number of narcotics, laxatives, and antibiotics increased significantly. For those elderly subjects admitted to the hospital taking less than the average number of medications, the overall use of medication increased from admission to discharge (2.89 to 3.75, P less than .0001). These "low users" were discharged on more benzodiazepines, narcotics, laxatives, antibiotics, and cardiac medications. Our data suggest that during hospitalization admission medications are discontinued and new medications are started in large numbers and that these changes are accompanied by a tendency towards the increased use of certain categories of medications. These changes may place the elderly patient at increased risk of polypharmacy and its complications. PMID- 2754152 TI - Deciding about resuscitation in a nursing home. Theory and practice. AB - This study examines how plans about cardiopulmonary resuscitation (CPR) were made, what relevant orders were written, and what actual events occurred at the time of death in a nursing home. A chart review of 119 residents who died in a 233-bed nursing home in 1987 found one who underwent (unsuccessful) CPR. Nine records were unusable. The remaining 109 cases, none of which involved CPR, were studied. Documentation of discussions about CPR between physicians and residents or their surrogates was present in 90 charts. Of 85 residents with cognitive impairment, four were included in the CPR discussion and surrogates were consulted for 66. In 15, no discussion was documented. Of 24 residents without documented cognitive impairment, 11 were consulted. For nine others, surrogates were asked, and in four no discussion was recorded. One resident and three surrogates requested CPR. All others who were asked accepted a do-not-resuscitate (DNR) order. For 67 residents DNR orders were written. In six of these cases, physicians wrote the order without documenting consultation with resident or surrogate. For five residents orders to resuscitate (full code orders) were written. For 37 residents no order about CPR was recorded. Of the 42 residents who died without a DNR order, 37 were found dead by nursing staff, but in only one case was a physician contacted urgently. In this nursing home advance planning about CPR was frequently undertaken. Regardless of planning or the orders in the chart, CPR was a rare event. PMID- 2754153 TI - Dietary supplement use in a randomly selected group of elderly Australians. Results from a large nutrition and health survey. AB - The prevalence of dietary supplementation and its relationship to health and dietary habits was investigated in a random mail survey of 2,195 people aged 65 years and over in Adelaide, South Australia. Subjects were selected from the electoral rolls in an urban area, and 77% returned completed survey instruments. Thirty-five percent of men and 46% of women reported taking some form of supplement at least once a week regularly throughout the year (these are defined as "regular" supplementers). The most popular supplements (in descending order of popularity for the total group) were: unprocessed bran, wheatgerm, vitamin C, and multivitamins or minerals. Thirteen percent of men and 15% of women reported the use of supplements on an occasional basis (once every few months or "now and then")--these are defined as "irregular" or "occasional" supplementers. Supplement users did not differ from non-supplementers in their use of medical facilities or in the number of bouts of minor illness they had experienced in the preceding year. Regular supplement users had more favorable dietary habits and higher intakes of several vitamins, minerals, trace elements and fiber than either non-supplementers or occasional supplementers. PMID- 2754154 TI - Caregiving spouses. Physical and mental health in perspective. AB - The self-reported physical and mental health of 315 persons caring for a spouse who had been diagnosed with Alzheimer's disease or a related disorder was compared with general population norms for existing data bases controlling for age and gender. Results suggest that across all indicators of mental health, spouse caregivers are more depressed, express higher levels of negative affect, are more likely to use psychotropic drugs, and have more symptoms of psychological distress than the general population. In terms of physical health, caregivers report higher than expected rates of diabetes, arthritis, ulcers, and anemia, yet they use medical services at rates which are similar or lower than those reported by the general population. Since no simultaneous control group was studied, these results suggest, but do not prove, the presence of differences between caregivers and non-caregivers. PMID- 2754155 TI - Simplified tests of lower urinary tract function in the evaluation of geriatric urinary incontinence. PMID- 2754156 TI - Prospective evaluation of an assessment strategy for geriatric urinary incontinence. AB - The objectives of this study were to design and prospectively evaluate a strategy to assess geriatric urinary incontinence in primary care settings. A management plan for urinary incontinence was determined for 264 elderly incontinent patients (205 females and 59 males) based on a clinical evaluation, simple tests of lower urinary tract function, and several criteria for referral for further evaluation derived from the literature on incontinence. Of the 264 patients, 168 (64%) also consented to undergo a urologic and formal urodynamic evaluation. Half of these 168 patients met at least one criterion for referral for further evaluation. At least one-quarter of the patients who met one or more of the criteria were found not to require surgical intervention, and probably did not benefit from the urologic and urodynamic evaluation. Among 84 patients who did not meet any of the criteria for referral, the urologic and urodynamic evaluation changed the initial treatment plan in only 10 (12%). The risks associated with the treatment plan based on the clinical assessment in these patients were, however, relatively small. While further refinement and testing in larger numbers of incontinent patients are needed, the data presented document that a substantial proportion of elderly patients with a treatable and often ignored problem can be appropriately managed based on a relatively simple and inexpensive assessment, which can easily be carried out in primary care settings. PMID- 2754157 TI - Clock drawing in Alzheimer's disease. A novel measure of dementia severity. AB - We have tested a simple and reliable measure of visuospatial ability in Alzheimer patients--the Clock Drawing Test. To determine the usefulness of this measure, we asked 67 Alzheimer patients and 83 normal controls to draw the face of a clock reading the time of 2:45. Six independent observers blindly evaluated the results with ratings from 10 (best) to 1 (worst). The mean performance score of Alzheimer subjects was 4.9 +/- 2.7 compared to 8.7 +/- 1.1 for normal controls (P less than .001). Inter-rater reliability for the clocks drawn by Alzheimer patients was highly significant (r = 0.86; P less than .001), and there was relatively little overlap between ratings for Alzheimer patients and normal controls. Furthermore, correlations were highly significant (P less than .001) between the mean score of clock drawings and three independent global measures of dementia severity. Although the Clock Drawing Test is certainly not a definitive indicator of Alzheimer's disease, the test is easy to administer and provides a useful measure of dementia severity for both research and office settings where sophisticated neuropsychological testing is not available. PMID- 2754158 TI - Screening for Alzheimer's disease by clock drawing. AB - The fear of Alzheimer's disease for both patients and families is growing along with the increasing evidence of the disease itself. This study (N = 312) of the validity of the clock drawing test in screening patients with probable Alzheimer's disease was conducted in an active outpatient geriatric clinic. Clock drawings by patients with normal mental status or depression were essentially normal. Alzheimer's patients were unable to complete a normal clock and demonstrated five characteristically abnormal patterns. As a test for Alzheimer's disease, clock drawing had a sensitivity of 86.7% and a specificity of 92.7%. There was correct identification in 97.2% of normals. These findings indicate that the clock drawing test, an easily administered, low cost screening tool, can be useful to health care professionals in characterizing cognitive loss in a general geriatric clinic population. PMID- 2754159 TI - The effect of visual deprivation and proprioceptive change on postural sway in healthy adults. AB - In 39 healthy active people aged 17 to 79 who had not fallen, anteroposterior sway during quiet standing increased slightly with age; there was no increase with age in lateral sway. Sway increased on deprivation of visual information and altered proprioception due to foot pressure sensory change in all age groups, and especially when both forms of sensation were altered concurrently; but the increase of sway on pressure sensory change was no greater in the older than in the younger subjects. PMID- 2754160 TI - Bilateral spontaneous rupture of the quadriceps tendons misdiagnosed as a "neurological condition". PMID- 2754161 TI - Permanent pacemakers in centenarians. AB - We have described six centenarians who have benefited from permanent pacemakers. In all of these patients, their initial symptoms of syncope, presyncope, dyspnea, and transient cerebral ischemic attacks resolved promptly after pacemaker implantation. In most of these patients quality of life, as measured by lifestyle and independence, improved after pacemaker implantation. None of these patients exhibited evidence of ischemic heart disease or cardiac failure. Because of increasing longevity and age-related degenerative and destructive changes in the conduction system and the sinus node, we expect that the number of patients requiring pacemakers in this age group will continue to grow. Ischemic heart disease as an underlying pathology necessitating pacemaker implantation appears to be rare in this age group. PMID- 2754162 TI - Hypertension in the aging patient. Implications for the selection of drug therapy. AB - Although earlier debates had questioned the wisdom of treating hypertension in elderly patients, it is now becoming apparent that such treatment is warranted. Systolic hypertension, which prevails in this population, is more closely correlated to hypertensive complications than is diastolic blood pressure. Recent multicenter trials have demonstrated that in this age group, as in younger patients, control of hypertension can significantly decrease the rate of cardiovascular and cerebrovascular events. Many effective antihypertensive agents are available today, but elderly patients, because of their hemodynamic and biochemical characteristics, are particularly vulnerable to the common side effects of most drugs. However, the two newer classes of drugs (the angiotensin converting enzyme inhibitors and the calcium channel blockers) offer several advantages in terms of favorable hemodynamic and biochemical profiles, convenience of dosing, and maintenance of quality of life. These characteristics justify choosing these agents as first-line therapy for hypertension. PMID- 2754163 TI - Smoking as a risk factor for Alzheimer's disease. PMID- 2754164 TI - The Cockroft-Gault formula. PMID- 2754165 TI - Vitamin B-12 deficiency and dementia. PMID- 2754166 TI - Reflections on a sabbatical. PMID- 2754167 TI - Critical care planning. PMID- 2754168 TI - Fetus not a child. PMID- 2754169 TI - The attack in Central Park. PMID- 2754170 TI - New beginnings: one day at a time. PMID- 2754171 TI - Psychological profile of dysphoric women postabortion. AB - Women who identified themselves as having poorly assimilated the abortion experience were surveyed using a demographic questionnaire, the Beck Depression Inventory (BDI), and the Million Clinical Multiaxial Inventory (MCMI). Eighty-one surveys were returned from the sample of 150 women. Seventeen percent (N = 12) of the women had had multiple abortions. Women with multiple abortions scored significantly higher on the BDI and also scored higher on the borderline personality subscales of the MCMI. Besides multiple abortions, other risk factors for postabortion dysphoria identified in this study were premorbid psychiatric illness, lack of family support, ambivalence, and feeling coerced into having an abortion. PMID- 2754172 TI - Pregnant women in the health care professions. PMID- 2754173 TI - Women physicians and their mentors. AB - This study surveyed 189 women physicians in order to compare the experiences of those who had male mentors with those who had female mentors. Respondents with high-ranking male mentors reported more career sponsorship. However, those with lower ranking female mentors reported more personal advice. In addition, those with female mentors reported fewer problems retaining their autonomy in the relationship. The mentor's administrative or academic rank, rather than gender, was the chief determinant of sponsoring effectiveness. These results suggest that women physicians face a dilemma in their choice of mentors, and underscore the importance of promoting women physicians to positions of authority in medical schools and training hospitals. PMID- 2754174 TI - The other side of the bedpan. PMID- 2754175 TI - Women and crack addiction. PMID- 2754176 TI - Gustatory-salivary reflex: neural activity of sympathetic and parasympathetic fibers innervating the submandibular gland of the hamster. AB - Electrophysiological experiments were performed to clarify the neural control mechanisms subserving gustatory-salivary reflex in anesthetized and decerebrate hamsters. Efferent neural activities of postganglionic sympathetic and preganglionic parasympathetic fibers, innervating the submandibular gland, were recorded when taste stimuli were infused into the oral cavity. Neural activities of primary gustatory afferents were also recorded from the chorda tympani (innervating the anterior part of the tongue) and the glossopharyngeal nerve (innervating the posterior part of the tongue). The parasympathetic fibers showed a low rate of spontaneous discharges (about 0.3 Hz), and responded tonically in an excitatory manner to taste stimulation. The magnitude of parasympathetic activity was highly correlated with the magnitude of gustatory afferent responses of the chorda tympani rather than that of the glossopharyngeal nerve. On the other hand, the sympathetic fibers showed irregular burst discharges (1.5 burst/s), and the rate of burst discharges was increased in response to high concentrations of HCl (0.03 M) or NaCl (1 M) solutions. Deafferentation experiments suggest that the parasympathetic activity is mainly influenced by gustatory information via the chorda tympani, while the sympathetic activity can be evoked by both the chorda tympani and glossopharyngeal nerve. PMID- 2754177 TI - Ganglionic distribution of afferent neurons innervating the canine heart and cardiopulmonary nerves. AB - The ganglionic distribution of the perikarya of afferent axons in cardiopulmonary nerves or the heart was studied in 64 dogs by injecting horseradish peroxidase into physiologically identified cardiopulmonary nerves or different regions of the heart. In 6 additional dogs, horseradish peroxidase was injected into the aortic arch, pericardial sac, left ventricular cavity or the skin. After injections into cardiopulmonary nerves, retrogradely labeled perikarya were found in the ipsilateral nodose ganglion and the ipsilateral C7-T7 dorsal root ganglia. After injections into different regions of the heart, retrogradely labeled neurons were found in the nodose ganglia bilaterally and in the C6-T6 dorsal root ganglia bilaterally. Many more retrogradely labeled neurons were found in the nodose ganglia in comparison to the dorsal root ganglia. The largest numbers of retrogradely labeled perikarya in the dorsal root ganglia occurred in the T 2-4 ganglia following nerve or heart injections. Following injections into specific regions of the heart or individual physiologically identified cardiopulmonary nerves, regional distributions of labeled neurons could not be identified within or among ganglia with respect to the structures injected. Perikarya in dorsal root ganglia which were labeled after heart injections ranged in area from 436 3280 microns 2 (X = 1279 +/- 51 S.E.M.) while after skin injections labeled perikarya ranged in area from 224-5701 microns 2 (X = 1631 +/- 104 S.E.M.). The results show that the afferent innervation of the canine heart is provided by neurons located throughout the nodose ganglia and to a lesser degree in the C6-T6 dorsal root ganglia bilaterally. The bilateral distribution of cardiac afferent neurons raises questions regarding mechanisms underlying unilateral symptoms frequently associated with heart disease. PMID- 2754178 TI - Effect of low-dose atropine on heart rate fluctuations during orthostatic load: a spectral analysis. AB - Spectral analysis was utilized in order to determine the influence of low (0.7 microgram/kg)-dose atropine sulfate injections on the isolated spectral power components of heart rate fluctuations in contrast to moderate (0.02 mg/dose)-dose atropine and unmedicated states in human subjects during orthostatic load. Low dose atropine decreased mean heart rate and increased respiration-related spectral power compared with controls in both the supine and standing posture. In supine subjects total power (0.01-0.5 Hz) was unchanged compared with controls due to a decreasing trend of low-frequency (0.01-0.05 Hz) and mid-frequency (0.05 0.15 Hz) heart rate spectral power. Standing upright, there was a distinct increase in total power with significantly higher values than in the controls resulting from an enormous activation of mid-frequency heart rate fluctuations. The peak frequency of the mid-frequency component was increased with a strong tendency compared with controls. Moderate-dose atropine increased mean heart rate and decreased total power, mid-frequency and respiration-related heart rate spectral power and peak frequency compared with controls in both positions. Our results suggest that low-dose atropine affects the interaction between sympathetic and parasympathetic limbs in the autonomic control of cardiac function in a complex manner producing a differentiated pattern of heart rate fluctuations dependent on the body posture. We suggest that low-dose atropine augments and moderate-dose atropine attenuates the vagal cardiac efferent activity in each position. PMID- 2754179 TI - Co-localization of RNAs coding for phenylethanolamine N-methyltransferase and proenkephalin A in bovine and ovine adrenals. AB - A 29-mer oligodeoxyribonucleotide probe, complementary to the coding region of bovine phenylethanolamine N-methyltransferase (PNMT) mRNA was synthesized. Characterization of this probe by Northern blot hybridization showed that it hybridized to a single band in RNA extracted from bovine and ovine adrenal medullae. The molecular size of this hybridized band was approximately 1.0-1.2 kb which is consistent with recently reported data on the molecular weight of bovine PNMT mRNA. In situ hybridization histochemistry was carried out with this probe on bovine and ovine adrenal sections and results compared on adjacent sections with a probe against proenkephalin A (ProEnk A) mRNA synthesized previously. Both showed a similar localization to the outer margin of cells in the adrenal medulla. The results of this study provide strong evidence at the level of mRNA expression that ProEnk A mRNA is expressed preferentially in the adrenaline synthesizing cells within the adrenal medulla. Further, it demonstrates the usefulness of a synthetic oligodeoxyribonucleotide probe for the study of PNMT gene expression. PMID- 2754180 TI - Control of the heart rate by sympathetic nerves in cats. AB - Pre- and postganglionic sympathetic nerves were electrically stimulated and heart rate was recorded in chloralose-anaesthetised cats. The vagal nerves and white rami were cut on both sides. Electrical stimulation was performed with a 15- or 30-s train of 0.2-ms pulses at a frequency of 30 Hz. The control heart rate was 150 beats/min. Heart rate was increased when the T3 white ramus on the left (52 beats/min above control) and T3, T4 white rami on the right side (100 beats/min above control) were stimulated electrically. The magnitude of the heart rate increase declined when the neighbouring thoracic white rami were stimulated. The increase of the heart rate was caused by group B preganglionic fibres. Electrical stimulation of the sympathetic fibres in the right vagus nerve and the right inferior cardiac nerve increased the heart rate by 92 beats/min and by 67 beats/min above the control level respectively. Electrical stimulation of the left inferior cardiac nerve, the left middle cardiac nerve and the sympathetic fibres in the left vagus nerve resulted in an increase of the heart rate of 43 beats/min, 30 beats/min and 49 beats/min from the control level respectively. This indicates that a majority of the preganglionic cardiac sympathetic fibres, whose activity influences the heart rate, originate from the T3 and T4 segments of the spinal cord. The majority of the postganglionic cardiac sympathetic fibres which affect the heart rate are located in the vagal nerves. PMID- 2754181 TI - Skin color, aging, and plasma L-dopa levels. AB - Although plasma levels of L-dopa are derived substantially from catecholamine synthesizing tissues, melanocytes--which produce L-dopa as part of the melanin synthetic cascade--also may be a source of circulating L-dopa. We compared plasma L-dopa levels in albino subjects and in Caucasian and Black normal volunteers and patients with essential hypertension. DOPA levels were similar among the subject groups. Among Caucasian normal volunteers, L-dopa levels were negatively correlated with subject age (r = -0.30, P less than 0.05), whereas norepinephrine levels tended to increase with subject age (r = 0.25, 0.05 less than P less than 0.10), so that the L-dopa:norepinephrine ratio was highly negatively correlated with subject age (r = -0.50, P less than 0.01). Skin pigmentation does not contribute importantly to plasma L-dopa levels in humans. In contrast with levels of norepinephrine, L-dopa levels appear to decrease during normal aging. PMID- 2754182 TI - Adrenergic blocking agents and lipoprotein lipase activity. AB - Lipoprotein lipase activity, total serum cholesterol and triglycerides, HDL cholesterol were determined before and after two weeks of treatment with a low dose of an alpha 1-blocking agent (prazosin) or of a beta-adrenergic-blocking drug (metoprolol). Lipoprotein lipase activity was almost doubled after prazosin (p less than 0.02) and practically unchanged after metoprolol, at a time and at a drug dosage when only minor changes in blood pressure and serum lipids were detectable. HDL cholesterol was slightly but significantly increased after prazosin (p less than 0.05). Heart rate was increased after prazosin (p less than 0.05) and decreased after metoprolol (p less than 0.01). PMID- 2754183 TI - Partial beneficial effects of the so called "silent iodine prophylaxis" on iodine deficiency disorders (IDD) in northeastern Sicily endemia. AB - The prevalence of goiter among schoolchildren and the daily urinary iodine excretion in the general population were evaluated in 4 municipalities in the endemic goiter area in Northeastern Sicily in two different surveys. The first, carried out in 1977-1978, covered 2,493 (91%) schoolchildren; the second, in 1987 1988, covered 2,167 (92%) schoolchildren. A dramatic decrease in goiter prevalence was apparent in each community as follows: in Castell'Umberto (3,904 inhabitants, altitude 641/750 m above sea level) goiter prevalence (G) decreased from 79.7% to 44.2% with a percent reduction (%r) of 44.5 and an increase in 24-h urinary iodine excretion (UIE) from 22.3 +/- 16.4 micrograms/24 h (n = 30) to 48.7 +/- 43.4 (n = 50). A similar trend was apparent in Tortorici (10,194 inhabitants, 475/700 m) where G decreased from 62.2 to 26.5% (% r 57.4) with a UIE increase from 28.4 +/- 29.6 (n = 35) to 47.6 +/- 59.3 (n = 40); in Sinagra (3,387 inhabitants, 300 m) where G decreased from 61.6 to 32.7% (% r 46.9) and UIE increased from 26.0 +/- 21.1 (n = 25) to 66.6 +/- 69.6 (n = 102) and in Sant'Angelo di Brolo (5,732 inhabitants, 380 m) where G decreased from 48.7 to 27.5% (% r 43.5) and UIE increased from 26.3 +/- 16.7 (n = 30) to 47.7 +/- 73.8 (n = 34). These events are clearly related and certainly dependent on the changed alimentary habits in the area due to the improved distribution of frozen food and industrially prepared dairy products, eventually enriched by iodine.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2754184 TI - Primary hyperparathyroidism: changes on biochemical and hormonal profile related to pregnancy. AB - A woman with mild asymptomatic hypercalcemia due to primary hyperparathyroidism became pregnant and her serum calcium normalized while her hypophosphatemia worsered. The PTH was low normal, but her urinary cAMP was elevated. In the second trimester of pregnancy a parathyroid adenoma was removed. After surgery, a transient hypocalcemia that normalized ten days later, a partial recovery of hypophosphatemia, and a 40% reduction of the elevated urinary cAMP excretion were observed. Pregnancy continued uneventful and a normal newborn was delivered. This case demonstrates the diagnostic difficulties posed by primary hyperparathyroidism during pregnancy, derived from inapparent changes in serum calcium and PTH. However, phosphorus and urinary cAMP deviations are significant constituting the basis for a correct diagnosis. PMID- 2754185 TI - Previous human GH treatment and leukemia. PMID- 2754186 TI - Treatment of thyrotoxic storm by charcoal plasmaperfusion. PMID- 2754187 TI - Binding of thyrotropin to selected Mycoplasma species: detection of serum antibodies against a specific Mycoplasma membrane antigen in patients with autoimmune thyroid disease. AB - Radiolabeled human (hTSH) and bovine (bTSH) thyroid stimulating hormone was shown to bind to five species of Mycoplasma, the wall-less prokaryotes. The maximum binding capacity of 125I-bTSH to these five species was about 7.9 x 10(-13) moles 1.4 x 10(-12) moles for 50-100 micrograms protein with dissociation constants of approximately 1.7 to 2.2 x 10(-7)M. Approximately 50% of the 125I-bTSH binding was displaced by excess, unlabeled bTSH or hTSH, but labeled bTSH was not effectively displaced by growth hormone, LH, FSH, prolactin, or the beta subunit of hTSH, FSH and LH. Antisera prepared against Mycoplasma gallisepticum and Mycoplasma pneumoniae bound to human thyroid membranes and guinea pig fat cells, suggesting that receptors on human thyroid tissues and on Mycoplasma cells may have similarities in antigenicity. These findings were substantiated by the occurrence of TSH binding to Mycoplasma antisera. Further, sera from three of six patients with Graves' disease containing antibodies to thyroid tissues also reacted to a 108 Kd polypeptide of Mycoplasma gallisepticum. PMID- 2754188 TI - Acute administration of pyridostigmine and clonidine has an additive stimulatory effect on GH release in normal children. AB - It has been shown in humans that both alpha 2-adrenoceptor activation by clonidine (CLON) and cholinergic enhancement by pyridostigmine (PD) have a clear cut stimulatory effect on GH release. As this effect is probably mediated by two different mechanisms, i.e. via increased endogenous GHRH for CLON and via inhibition of endogenous somatostatin for PD, in 8 normal children we studied the effect of both single and combined acute oral administration of CLON (150 micrograms/m2) and PD (60 mg). When administered alone, CLON and PD induced a similar GH increase (peak, mean +/- SE: 14.6 +/- 2.4 vs 14.2 +/- 3.1 ng/ml; area under curve, AUC: 376.9 +/- 57.6 vs 390.0 +/- 74.3 ng/ml/h). Combined administration of CLON and PD had an additive effect on GH release (peak: 27.5 +/ 4.5 ng/ml; AUC: 920.8 +/- 153.3 ng/ml/h; p less than 0.005 vs CLON and PD alone). In conclusion, presented data show that: i) CLON and PD have similar GH releasing effect in normal children; ii) The additive stimulatory effect on GH release exerted by acute combined administration of CLON and PD agrees with the hypothesized different mechanism of action of these two drugs; iii) A therapeutic association of CLON and PD may be envisaged in the treatment of some children of short stature. PMID- 2754189 TI - Development of certification in hand surgery. PMID- 2754190 TI - Measuring ulnar variance: a comparison of techniques. AB - This study compared three commonly used methods of measuring ulnar variance. The comparison included the project- a-line technique (A), the method of concentric circles (B), and the method of perpendiculars (C). Specific features studied were variations in results generated by each technique as well as the interobserver and intraobserver reliability for each technique. The only significant difference among techniques was between techniques A and B (p = 0.0224), where mean A values were more positive than mean B values. Observers were found to differ significantly (p = 0.0092) independent of technique. All methods studied were highly reliable, although the method of perpendiculars was most reliable for both interobserver (reliability = 0.9801) and intraobserver (reliability = 0.9719) reliability. This study shows that the clinician may choose whichever technique he prefers when measuring ulnar variance. PMID- 2754191 TI - Extensor carpi ulnaris and flexor carpi ulnaris tenodesis of the unstable distal ulna. AB - A procedure for stabilizing the distal ulna using the extensor carpi ulnaris and flexor carpi ulnaris is described. Seven patients who had sustained posttraumatic distal ulnar dorsal instability and articular degeneration and one patient with instability caused by rheumatoid arthritis were operated on. All eight obtained stable ulnae with mean motion of 62 degrees of supination and 86 degrees of pronation (mean increase of 32 degrees of supination and 43 degrees of pronation). Follow-up averaged 28 months (range, 18 to 63 months). The tenodesis, using a weave of a distally-based slip of flexor carpi ulnaris and a proximally based slip of extensor carpi ulnaris combined with a Darrach procedure, is a reliable, reproducible salvage procedure for stabilizing the degenerated distal radioulnar joint and for salvaging the symptomatic unstable ulna after excessive distal ulna resection. PMID- 2754192 TI - Modified technique of intramedullary fixation for wrist arthrodesis. AB - Twenty-five normal subjects were studied to assess the possible relation of various wrist postures on grip strengths. Most subjects were found to have the strongest grip strengths in a position of neutral deviation and one half of their maximum extension. A small subpopulation normally postured their clenched fists in slight ulnar deviation rather than in neutral deviation. These patients were strongest in ulnar deviation and one half of their maximum extension. A modification of the wrist arthrodesis technique was developed using intramedullary pin fixation in a series of 10 patients. Fusion was successful in all 10 wrists. This technique retains the advantages of speed and simplicity of previous intramedullary fixation methods and also affords the additional advantage of permitting the wrist to be placed in varying degrees of extension and ulnar deviation. PMID- 2754193 TI - Stress carpal tunnel pressures in patients with carpal tunnel syndrome and normal patients. AB - Twenty-two patients with carpal tunnel syndrome scheduled to have a carpal tunnel release, and six volunteer control subjects had carpal tunnel pressures measured with their wrist in neutral position, maximum flexion, and maximum extension. The wrist was then repetitively flexed and extended to maximum position at a rate of 30 full cycles per minute for 1 minute. Pressures were then continually monitored and recorded at 30-second intervals. The pressures were found to be significantly elevated in the immediate post-exercise period in the patients with carpal tunnel syndrome, and they demonstrated a prolonged recovery time to reach the resting pressure when compared with the normal control subjects. This property of prolonged recovery time in patients with carpal tunnel syndrome suggests a possible cause for carpal tunnel syndrome in the occupational setting. PMID- 2754194 TI - Radius fracture after total wrist arthroplasty. AB - Four cases of radius fracture are presented; each was caused by a fall and happened at least 18 months after total wrist arthroplasty. One patient had bilateral fractures occurring 12 months apart. All injuries were initially treated nonoperatively. Nonunion or healing with deformity occurred in three fractures. Revision arthroplasty was done in two cases with satisfactory results, and is being considered for a third. PMID- 2754195 TI - Translunate, palmar perilunate fracture-subluxation of the wrist. AB - Three cases of palmar perilunate subluxation associated with a fracture of the palmar pole of the lunate are described. Wrist hyperflexion with a longitudinal loading force transmitted through the capitate probably accounts for this injury. PMID- 2754196 TI - Diagnosis of ganglion in Guyon's canal by magnetic resonance imaging. AB - Compression of the ulnar nerve at the wrist can be caused by a multitude of intrinsic and extrinsic factors. The exact diagnosis and location of compression can frequently be difficult to determine. Magnetic resonance imaging can be a useful method in diagnosing the cause and location of ulnar nerve compression. A case is presented of ulnar nerve compression caused by a ganglion in Guyon's and diagnosed preoperatively by magnetic resonance imaging. PMID- 2754197 TI - Prediction of recurrence in the treatment of Dupuytren's disease: evaluation of a histologic classification. AB - Histologic staging of Dupuytren's lesions into three types is proposed: a proliferative type with high cellularity and mitosis, a fibrocellular type characterized by the presence of a reticulin network, and a fibrous type with few cells. Sixty-three patients (77 hands) who had selective fasciectomy as a primary procedure and whose histologic specimen was available were clinically reviewed for disease recurrence and extension. Twenty-two hands (29%) were free of disease; twenty-five (32%) were free from recurrence but showed an extension, and thirty (39%) had a recurrence. This histologic classification seems to have a prognostic value because the recurrence rate is higher in type I (70%) and lower in type III (18%). The risk of extension did not correlate with the histologic type. PMID- 2754198 TI - Distal interphalangeal joint flexible implant arthroplasty. AB - Twenty-one osteoarthritic distal interphalangeal joints in 13 patients were treated by flexible implant arthroplasty. Follow-up to 5 years showed results that were good to excellent, with only one complication, and a high degree of patient satisfaction. The procedure should be considered a good alternative to the more traditional distal interphalangeal joint arthrodesis. PMID- 2754199 TI - Extension splinting of palmar plate avulsion injuries of the proximal interphalangeal joint. AB - Hyperextension injuries of the proximal interphalangeal joint have traditionally been immobilized in flexion. This may lead to a proximal interphalangeal flexion contracture of the joint. In an effort to prevent flexion contracture and to simultaneously avoid hyperextension laxity, we have immobilized these injuries in zero degrees of extension for 7 to 10 days. Immobilization is followed by buddy taping and active range of motion until 3 weeks after injury. Protective buddy taping is used until the 6-week point. We report our results using this treatment for only palmar plate avulsion fractures. We did not include proximal interphalangeal joint injuries associated with dorsal dislocation or major collateral ligament injury. Twenty-two of 45 patients were available for follow up evaluation. Length of follow-up averaged 30 months (range, 6 to 36 months). A high percentage of patients had good or excellent results. In no patient did hyperextension laxity develop and in only one was there a flexion contracture. On the basis of these results, we recommend this treatment protocol for hyperextension injuries of the palmar plate of the proximal interphalangeal joint associated with small avulsion fractures. PMID- 2754200 TI - A new class of ring avulsion injuries. AB - Sixteen patients with ring avulsion injuries treated at Loma Linda University over 10 years were reviewed. According to Urbaniak's classification scheme, there were two class I, seven class II, and seven class III injuries. Follow-up functional measurements showed that the grip strength of our class II patients were, on the average, no better than that of the class III patients, even though all of class III patients had amputation revisions. Five class II patients required only venous microvascular repair. We propose to modify Urbaniak's classification to IIC to include only ring avulsion injuries with venous compromise. These patients had excellent functional results, with an average total active motion of 224 degrees. PMID- 2754201 TI - Composite wiring of metacarpal and phalangeal fractures. AB - Composite wiring techniques using various configurations of Kirschner pins and stainless steel wire sutures have been applied to the treatment of 63 fractures of the long bones of the hand. The secure fixation achieved allowed active motion within 1 week of operation. Thirty-three metacarpal fractures achieved a final mean total active motion of 256 degrees (standard deviation 13.4) (normal total active motion -260 degrees). Twenty-one phalangeal fractures achieved a mean total active motion of 215 degrees (standard deviation, 46 degrees). There were no instances of infection, malunion, nonunion, loss of reduction, or tendon rupture in the 63 fractures that were treated. PMID- 2754202 TI - Painful extensor digitorum brevis manus muscle. AB - Diagnosis was confirmed of 10 extensor digitorum brevis manus muscles in 7 patients. The muscle is located on the dorsum of the hand, just distal to the wrist. It is most prominent with the wrist flexed to 30 degrees and the fingers fully extended. We propose that pain in the extensor digitorum brevis manus muscle is due to compression of the muscle in the rigid fibro-osseous fourth dorsal compartment. Extensor retinacular release is the treatment of choice. PMID- 2754203 TI - Large lipomas in the deep palmar space. AB - Lipoma in the deep palmar space of the hand is an unusual tumor. Our experience with seven of these tumors indicates that they can be unusually large at initial examination, can first be seen with paresthesias in branches of the median nerve, and can be difficult to surgically expose. Marginal resection of this tumor is curative. PMID- 2754204 TI - Lipofibroma of the superficial branch of the radial nerve. AB - Lipofibromas of nerve are rare hamartomatous lesions almost exclusively involving the median nerve. To our knowledge, this is the first reported case of a lipofibroma involving a branch of the radial nerve. PMID- 2754205 TI - Intraneural lipofibroma of the median nerve. AB - A case of an intraneural lipofibroma of the median nerve is described. The patient was first seen with an enlarging mass on the flexor side of the wrist and in the palm. After interfascicular dissection of the tumor there was a permanent loss in sensibility and motor function. In most cases decompression of the nerve will suffice; resection by means of interfascicular dissection is rarely justified. PMID- 2754206 TI - Aeromonas hydrophila upper extremity infection. AB - A severe soft tissue infection of the upper extremity caused by Aeromonas hydrophila followed a water skiing injury in which a tow rope caused degloving of a portion of the skin and severe contusion to underlying muscle. Infection was established within 36 hours of the injury, accompanied by fever, leukocytosis, and a foul odor. Rapid clinical improvement occurred following radical debridement of all nonviable tissue and antibiotic therapy. In cases involving water contamination, Aeromonas hydrophila infection should be suspected with the onset of a rapidly developing infection with a febrile response. Rapid surgical intervention and treatment with an aminoglycoside or a third-generation cephalosporin antibiotic is the treatment of choice. PMID- 2754207 TI - Efficacy of cortisone injection in treatment of trigger fingers and thumbs. AB - One hundred eight trigger fingers and thumbs in 74 consecutive patients were treated by injections of triamcinalone and followed for an average of 3 1/2 years. Minimum follow-up was 1 year. Eighty four percent of trigger fingers and 92% of trigger thumbs were cured with a single injection, and a repeat injection for treatment of recurrent symptoms raised these figures to 91% and 97%, respectively. All injections were done by one physician. There were no complications. We conclude that intrasynovial injection of a steroid compound is the appropriate initial treatment for trigger fingers and thumbs. PMID- 2754208 TI - Treatment of duplicated thumb using a ligamentous/periosteal flap. AB - Since 1975, 22 duplicated thumbs in 21 children were treated by ablation of one of the digits, elevation of a ligament and periosteal flap from the proximal bone, reduction osteotomy to narrow the widened proximal bone, centralization of the retained thumb, and stabilization of the joint by reattaching the ligament and periosteal flap. In addition to improving the cosmetic appearance by centralizing the retained thumb on the narrowed proximal bone, good joint stability was provided. Three patients had subsequent joint arthrodesis because of laxity of the contralateral collateral ligament. The procedure is preferred to the reconstruction of a single digit by using component parts of both duplicated thumbs because the described procedure is technically simpler and does not potentially interfere with physeal growth or leave a nail matrix defect. PMID- 2754209 TI - Degenerative arthritis of the carpus associated with congenital hypoplastic thumb. AB - The case history of a young man with bilteral congenital hypoplastic thumbs and early degenerative arthritis involving the base of the thumb and scaphotrapeziotrapezoid joints is reported. To our knowledge this association has not been previously made. Limited intercarpal arthrodesis and/or trapezium arthroplasty may be required at a relatively early age in patients with thumb dysplasia. We believe the hypoplastic thenar musculature may lead to instability and excessive shear stresses on the radial side of the carpus, causing the early arthritic changes. PMID- 2754210 TI - Flexion contracture of the thumb: a malignant etiology. AB - A patient was first seen with a flexion deformity of the thumb interphalangeal joint that was initially diagnosed and treated as traumatic in origin. A painful forearm soft tissue mass was ultimately discovered; biopsy of the flexor pollicis longus tendon showed metastatic adenocarcinoma. Extensive evaluation failed to locate the origin of the primary tumor. Treatment consisted of local radiation and systemic chemotherapy. After 1 year, the patient is alive and well, has no evidence of disease, and refuses correction of the thumb interphalangeal flexion contracture. PMID- 2754211 TI - Magnetic resonance imaging of the collateral ligaments of the thumb. AB - Injury to the ulnar collateral ligament of the metacarpal phalangeal joint of the thumb can usually be diagnosed on the basis of a combination of history, radiographic examination, and clinical stress testing of the joint when appropriate. Occasionally, when the patient is seen late and the diagnosis is doubtful, stress evaluation may be ill-advised because a nondisplaced ligament may be displaced in the process. We had recent experience with three patients in whom the use of magnetic resonance imaging was helpful in diagnosing a displaced ulnar collateral ligament in two cases, and an intraligamentous injury in the other. These studies were conducted at no charge to the patient as part of institutional investigational research. The current cost of this technology is prohibitive for routine use; however, when it becomes less expensive, it may be helpful as a diagnostic tool. PMID- 2754212 TI - The sandwich switch flap. PMID- 2754213 TI - Linear erosions on Kerckring's folds may be diagnostic of Zollinger-Ellison syndrome. AB - Endoscopy of the upper gastrointestinal tract was performed in eight patients with Zollinger-Ellison syndrome (ZES) and in 20 patients with stomal ulcer (non ZES). All ZES patients had hypergastrinemia and a positive secretin provocation test. In three ZES patients studied before gastric surgery, edematous or erosive changes were present in the second portion of the duodenum. In the seven ZES patients studied postoperatively, examination revealed erosive changes in the distal portion of the duodenum and/or upper jejunum. These changes were frequently in a line on the uppermost part of Kerckring's folds. In the non-ZES patients, however, endoscopy revealed no erosive change in the distal part of the duodenum. We propose that such linear erosions on Kerckring's folds may be diagnostic of ZES. PMID- 2754214 TI - Long-acting somatostatin analog controls acid and gastrin secretion in benign, not in malignant, Zollinger-Ellison syndrome. AB - The long-acting somatostatin (SMS) analog, SMS 201-995 has beneficial effects on APUDomas. In two Zollinger-Ellison syndrome (ZES) patients we assessed basal acid output (BAO) and 24-h pH under SMS and compared them to controls. We also assessed total gastrin, gastrin 17, insulin, glucagon, C-peptide, and SMS by radioimmunoassay. In the benign gastrinoma, an acid-controlling action of SMS was shown, elevating the 24-h pH threshold over the pH range 1.5-5 of 55-10% compared with control. A parallel inhibition of the gastrins greater than 90% was apparent. We found no beneficial effect on gastric acid secretion and on tumor gastrin in the malignant gastrinoma despite a fourfold higher plasma SMS level. Non-tumor-related peptides were suppressed by approximately 50% and in contrast to gastrin they again reached pre-SMS levels before the next dose of the drug. We conclude that SMS is more effective in benign than in malignant gastrinomas, and may be exclusively so. PMID- 2754215 TI - Breath hydrogen excretion after lactose and whole milk ingestion. A prospective comparison in lactase deficiency. AB - As the 50 g of lactose in the usual clinical test is unphysiologic both because it is equivalent to 1 L milk and because the usual dietary intake is not the purified sugar, but milk, we undertook a prospective comparison of the absorption of lactose after both lactose and milk ingestion with an equivalent lactose content. We studied 51 healthy volunteers, using the hydrogen breath test technique. All patients received 25 g lactose in aqueous solution. Subjects with an abnormal test had the test repeated with 500 ml whole cow's milk, whereas subjects with a normal test repeated the test after ingesting the unabsorbable sugar lactulose to detect the capacity of their colonic flora to produce the gas. Symptoms of gastrointestinal intolerance were also recorded. Compared to an equivalent lactose amount, milk lactose is better absorbed (8% of the entire population malabsorbed 500 ml whole milk, whereas 33.33% malabsorbed 25 g lactose) and induces intolerance in fewer subjects. We conclude that milk rather than pure lactose must be used in clinical evaluation of lactose malabsorption and intolerance. PMID- 2754216 TI - Skin tags are not a risk factor for colorectal polyps. AB - To ascertain whether acrochordons (simple skin tags) are associated with a higher risk for colon polyps, we prospectively studied 218 male and female patients, age 40 or older without history of colon cancer, polyps, ulcerative colitis, familial polyposis, or recent lower intestinal symptoms. Each patient was assessed for the presence of skin tags. A screening flexible sigmoidoscopy was then performed without knowledge of the dermatologic findings. All polypoid lesions were recorded, and patients with polyps greater than or equal to 3 mm in diameter underwent full colonoscopy and polypectomy. Twenty patients (9.2%) had documented adenomatous polyps on colonoscopy. Nineteen other patients had hyperplastic polyps and mamillations. There was no significant difference in the prevalence of polypoid lesions in those with skin tags compared with those without skin tags, either analyzed as group totals or stratified by age, sex, or type of polyp. We conclude that skin tags are not associated with a higher than usual risk for colonic polyps and should not be used as a marker for more intensive screening. PMID- 2754217 TI - Patients who seek a second opinion: are they different from the typical referral? AB - Little is known about what factors determine when a patient decides to seek a second opinion from an internist. The Canadian health care system, which places no responsibility for payment on the patient, allows a unique opportunity to assess such factors when financial influences are minimized. We hypothesized that in such a milieu patients with functional diseases might be more apt to seek a second opinion. In a university-based gastrointestinal unit we investigated how many of the patients, referred for the first time, were seeking a second opinion- i.e., a second consultation within 2 years of seeing a gastroenterologist. We compared the characteristics of 20 patients with 246 patients referred for the first time to a university-based gastrointestinal unit. All patients were interviewed at clinic registration, prior to seeing the gastroenterologist. Variables assessed included demographic characteristics, health care utilization within the last year, and perceived health status. A second questionnaire was offered to second opinion patients to determine (1) reasons for seeking a second opinion, and (2) whose decision it was to seek the second opinion. Following the interview, the patient's referring physician was contacted and asked identical questions. Both referring physician and gastroenterologist assessed every patient on a functional rating (FR) scale of 1 to 5 (with 1 being definitely organic and 5 being definitely functional).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2754218 TI - Fibronectin in acute and subacute hepatic failure. AB - The mean plasma fibronectin (FN) concentrations in 30 patients with fulminant hepatic failure (FHF) and in 10 patients with subacute hepatic failure (SAHF) were 111.2 +/- 70 and 123.5 +/- 46.5 micrograms/ml, respectively, significantly lower than that of normal controls (362.0 +/- 69.2 micrograms/ml) and patients with uncomplicated viral hepatitis (320 +/- 58.5 micrograms/ml) (p less than 0.001). Plasma FN levels showed significant negative correlation with serum glutamic pyruvate transaminase values in the FHF group (p less than 0.02) and with prothrombin time in the SAHF group (p less than 0.02). Serial estimation of plasma FN showed that failure of FN levels to rise despite fresh plasma infusions indicates poor prognosis in these patients. The reduced availability of FN may be responsible for the impaired Kupffer cell function and consequent increased susceptibility to endotoxemia and the bacterial infections seen in these patients. PMID- 2754219 TI - Adenocarcinoma of the jejunum in association with celiac sprue. AB - An increased incidence of small bowel lymphoma in patients with long-standing celiac sprue is well documented in the literature. Less common is the association of adenocarcinoma of the small intestine. We report a patient with celiac sprue who initially responded to a gluten-free diet. Eighteen months later, diarrhea, abdominal cramps, and bloating was found to have its origin in partial small bowel obstruction. At laparotomy, two distinct adenocarcinomas of the jejunum were resected. Celiac patients who initially respond to gluten withdrawal and subsequently suffer exacerbation while adhering to strict dietary therapy should be carefully evaluated for evidence of a small bowel malignancy. PMID- 2754220 TI - Regression of amyloid in Crohn's disease after bowel resection. A 19-year follow up. AB - A 41-year-old man, who in 1969 had Crohn's disease and extensive hepatic and renal amyloidosis, has done well for 19 years after intestinal resection, with regression of massive proteinuria and maintenance of normal renal and hepatic function tests, although renal amyloidosis persists. PMID- 2754221 TI - Ulcerative colitis: prolonged remission following azathioprine-induced pancytopenia. AB - The patient reported here has had prolonged remission following a chronic relapsing course of ulcerative colitis requiring frequent use of systemic steroids. All inflammatory bowel disease symptoms resolved after treatment with azathioprine, which was associated with the development of pancytopenia. The patient remains in clinical, sigmoidoscopic, and histological remission 56 months after receiving azathioprine. PMID- 2754222 TI - Acute left colonic obstruction: a new nonsurgical treatment. AB - Acute obstruction of the left side of the colon is traditionally treated by colostomy, which entails two or three surgical procedures usually in a high-risk group of patients. We present a new nonsurgical approach by which decompression of the bowel is achieved with a tube introduced proximal to the obstruction with the aid of a flexible sigmoidoscope. This procedure was successful in six of nine patients with left-sided large-bowel obstruction, thus avoiding staged surgery and allowing one definitive operation. No complications were encountered. PMID- 2754223 TI - Giant hemangioma of the liver (Kasabach-Merritt syndrome): successful suppression of intravascular coagulation permitting surgical removal. AB - The clinical course of a patient presenting with thrombocytopenia (86 X 10(3)/L) and signs of intravascular coagulation (prothrombin time, 45%; partial thromboplastin time, 49 s; fibrinogen, 40 mg/dl; antithrombin III, 85%; factor X, 73%; plasminogen, 42%) due to a giant hemangioma of the liver (Kasabach-Merritt syndrome) is reported. Treatment with i.v. heparin, fibrinogen, and fresh-frozen plasma led to significant elevation of fibrinogen (156 mg/dl) and antithrombin III (102%) without changing the decreased activities of the procoagulant factors. Similarly, the signs of hyperfibrinolysis persisted (fibrinogen degradation products, 50 micrograms/dl; plasminogen, 43%; alpha-2 antiplasmin, 74%). The hemangioma was completely removed by excision of the left lobe of the liver. Subsequently, all coagulation parameters returned to normal, indicating a complete reversibility of the coagulation disorder. PMID- 2754224 TI - Epidemiologic aspects of peptic ulcer disease in northern Italy. AB - In a retrospective study of endoscopy clinic patients in Northern Italy from 1981 to 1985, the number of confirmed duodenal ulcers (DU) exceeded that of gastric ulcers (GU) by a ratio of 6.6 to 1. This is in marked contrast to findings from recent studies in Northern Europe, but similar to those in the United States. Of 1,383 patients studied, 33% exhibited DU, 5% had GU, and 1% had both duodenal and gastric lesions; 20% were diagnosed with nonulcer dyspepsia (NUD), while the remaining 41% had other upper gastrointestinal diseases. Patients with confirmed peptic ulcers (n = 531) were compared to those with NUD (n = 271). Significant differences were noted regarding sex, smoking habits, symptomatology, and hospitalization rates. Patients with endoscopically or radiologically confirmed peptic ulcers were more often males and smokers. They more often presented with typical symptoms and had higher total hospitalization rates than NUD patients. No differences were noted regarding age distribution or coffee or alcohol consumption. PMID- 2754225 TI - Elevated gastrin levels in patients with colorectal cancer. PMID- 2754226 TI - Elevated cerebrospinal fluid glutamine in septic encephalopathy. PMID- 2754227 TI - Economics, effectiveness, evidence, ethics and education--five essentials for intensive care. PMID- 2754228 TI - Effect of counselling on anxiety and depression in coronary patients. PMID- 2754229 TI - Problems and nursing management strategies related to respiratory distress syndrome in the very preterm baby. PMID- 2754230 TI - The bridge beyond: strengthening nursing practice in attitudes towards death, dying, and the terminally ill, and helping the spouses of critically ill patients. AB - Death and dying are often surrounded by a conspiracy of silence. Usually it is an unconsciously organised silence, leaving those whose lives are threatened by terminal illness or an accelerated death with a physiological insult and without much-needed communication. The silence seems self-protecting for relatives, medical and nursing staff. Silence is a false reassurance and offers no emotional growth or understanding of the events which surround death in its finality. People who fear death of a close family member often begin the process of grieving their loss before actual loss occurs, and can remain locked in grief for years unless helped by the right communication. According to Hampe (1975) this phenomenon is known as 'anticipating grief' or grieving. If medical staff and nurses are to feel confident in anything to do with death and dying, or to feel comfortable in dealing with terminal illness, they should have some understanding of death itself. They should also feel confident in opening up and maintaining an effective dialogue. This requires training in the relevant interviewing, assessment and counselling skills (Maguire, 1985). A systematic approach is necessary to provide good care for the spouses of critically ill patients, who may suffer anticipatory grief. Excerpts from a very helpful paper by Breu (1982) and an adapted care plan are included (with permission) at the end of this paper. PMID- 2754231 TI - Molecular evidence of Y-autosomal translocations in owl monkeys. AB - Probe pDP1007, which contains highly conserved DNA sequences from the sex determining region of the human Y chromosome, cross-hybridized with owl monkey EcoRI restriction fragments of 1.8 kb and 6.6 kb. Southern transfer analysis of owl monkey (karyotype VI)--rodent somatic cell hybrids localized the 1.8-kb fragment on the owl monkey X chromosome and the 6.6-kb fragment, which is male specific, on chromosome 14/Y. Regional in situ chromosome mapping of pDP1007 revealed specific sites of hybridization: the distal short arm of the X chromosome of karyotypes IV, VI, and VII; the small metacentric Y of karyotype IV; the C-band positive region on the short arm of chromosome 17/Y (karyotype VII); and the C-band positive region on the long arm of chromosome 14/Y (karyotype VI). These molecular findings reinforce cytological evidence that Y chromosomal material has been transferred to autosomes 14 and 17 in owl monkeys of karyotypes VI and VII, respectively, in which there are no independently segregating Y chromosomes. PMID- 2754232 TI - Genetic control of juvenile growth rate in mice: variation between a congenic strain and its background strain. AB - Studies on the genetic regulation of growth are confounded by the multigenic basis of growth. There is a need to isolate simplified genetic systems for the study of growth. We compared two closely related mouse strains and their F1 hybrids with regard to birth and weaning weights. The strains we used were C57BL/6 (B6) and a congenic derivative of B6 (HW54) that contains a short segment of BALB/c chromosome 7 spanning the H-24 and Gpi-1 loci. Despite the genetic similarity of these strains, they differed significantly in both birth and weaning weights. At birth, B6 pups were on average as much as 6.6% heavier than were pups from HW54. By the time of weaning, this trend was reversed; HW54 pups were as much as 13.8% heavier than were B6 pups. (B6 x HW54)F1 hybrids were intermediate between the parental strains in birth weight but were identical to B6 animals at weaning. An analysis of the F2 generation suggested that postnatal growth differences between B6 and HW54 are probably dependent on the maternal genotype. These strain-specific growth rates result from polymorphism at a restricted portion of the genome and represent a highly simplified system for the study of the genetics of growth. PMID- 2754233 TI - Heritable susceptibility to environmentally induced glaucoma in several mutants of Japanese quail. AB - We compared albino (aI), dilute (aID), and wild-type (AI+) quail in their ocular responses to continuous light, the rearing condition that brings on light-induced avian glaucoma (LIAG) in domestic chickens. At age 3 months, all quail kept under 24L/OD showed the retarded corneal growth and corneal flattening characteristic of LIAG. Unlike chickens, quail did not suffer pathological eye enlargement during the early growing period. However, by 6 months of age, 24L/OD albinos showed an almost 20% increase in eye weight compared with 12L/12D albinos. The increase in eye weight for 24L/OD dilutes at 6 months of age was 18%; for 24L/OD wild types, it was 16%. Intraocular pressure, the key criterion for glaucoma, was almost twice as high at 6 months of age in 24L/OD wild types as it was in 12L/12D wild types and showed similar but even greater increases in dilutes and albinos reared under continuous light. Across-genotype comparisons revealed additional effects of the mutant genes themselves: the eyes of albinos were 22.6% larger. The eyes of dilutes showed a similar but smaller response--5% and 6.6%, respectively, and correlated increases in globe dimensional parameters. The flat cornea characteristic of LIAG appeared in all three mutants, but only when environmental light had been kept at 24L/OD. This further separates the LIAG effect from the phenomenon we call albino quail macrophthalmos. PMID- 2754234 TI - Anaerobic tolerant null: a mutant that allows Adh1 nulls to survive anaerobic treatment. AB - Anaerobic tolerant null (ATN) is a recessive factor that allows alcohol dehydrogenase-1 (ADH1) null individuals of Zea mays L. to survive 24 h of anaerobic conditions. ADH1 null lines that do not possess this factor survive only a few hours of anoxia. We studied ADH activity levels in protein extracts from the primary root tissue of ATN. ADH levels were similar in ATN and other ADH1 null lines, suggesting that ADH activity does not account for differences in the ability of ATN to survive anaerobic treatment. The ATN survival trait segregated as a single recessive locus in crosses between ATN and double null (Adh1-S5657, Adh2-33). We also made crosses between ATN and 1s2p, an inbred line with ADH1 activity that carries an electrophoretic mutation of Adh2, to determine whether atn increases the number of survivors over that which would be expected from the segregation of Adh1 alone and to use the Adh2P allele to study the cosegregation of Adh2 and atn. The observed number of survivors in that cross exceeded the expected number of survivors by a margin consistent with a single recessive gene adding to the ADH+ survivors. Extracts from the primary root or scutellum of induced F2 seedlings from the above crosses were assayed for ADH activity by native polyacrylamide gel electrophoresis (PAGE) and simultaneously scored for survival to determine whether Adh2 and atn were segregating independently. We screened the (ATN x 1s2p)F2 progeny for ADH1 activity by staining root tips with an ADH-specific stain to select Adh1 null individuals prior to gel assay. Atn was found to be assorting independently of Adh1 and Adh2 in both crosses. PMID- 2754235 TI - Mutant allele frequencies of domestic cats of western Illinois and eastern Iowa. PMID- 2754236 TI - Neonatal extracorporeal membrane oxygenation. PMID- 2754237 TI - Percutaneous coronary atherectomy: a preliminary report. PMID- 2754238 TI - Percutaneous atherectomy of the popliteal artery. PMID- 2754239 TI - A painless, slow-growing mass in a 31-year-old man. PMID- 2754240 TI - Marketing your practice: how to get started. PMID- 2754241 TI - Peer review proceedings. PMID- 2754242 TI - Compensating key employees. PMID- 2754243 TI - Indianapolis cholesterol screening 1987: does mass screening accomplish its goal? AB - To evaluate the impact of large scale population screening for elevated total cholesterol, a city-wide event was scheduled in Indianapolis during nine days in February 1987. Altogether, 29,954 individuals were screened, and more than 32% were found to be at moderate or high risk using the classification recommended by the National Institutes of Health at the time of the screening for heart disease on the basis of their total plasma cholesterol concentrations. Although larger numbers of females and whites volunteered to be screened, the screened population represented a broad range of age and education levels. Results of a followup questionnaire returned by 18% of those at moderate of high risk revealed that after receipt of an elevated cholesterol result, 67% of the respondents scheduled a physician visit. The majority of those not doing so (53%) contacted their physician for other reasons or by telephone. Results of the followup indicate that screened subjects responded appropriately to the results received. The results of this project indicate that mass screening is only one tool to successfully identify individuals at risk. Given the biases present in the screened population, other strategies should be used to identify at-risk members of population groups unlikely to participate in similar screening events. PMID- 2754244 TI - The psychological crisis of reproductive failure. PMID- 2754245 TI - Informed consent to HIV antibody testing: toward a standard of professional practice. PMID- 2754246 TI - Marketing in Indiana's medical community. PMID- 2754247 TI - Radon: a new look at an old risk. PMID- 2754249 TI - Technician dismissed for refusal to do AIDS tests. PMID- 2754248 TI - Peer review materials protected by statute. PMID- 2754250 TI - Multiple hormone storage by cells of the human pituitary. AB - While immunostaining serial semi-thin sections of acrylic resin-embedded normal human pituitary using antisera to human pituitary hormones, it became clear that several cells were stained by more than one antiserum. The tissue had been surgically excised from a patient with a prolactinoma. The tumor, which was immunoreactive only with antiprolactin antiserum, was distinctly different from the pieces of tissue under study which had normal pituitary architecture and demonstrated immunoreactivity with antisera against all six of the common pituitary hormones. A major immunoelectron microscopic investigation, using immunocolloidal gold and immunoperoxidase methods, revealed cells in which follicle-stimulating hormone (FSH), luteinizing hormone (LH), and prolactin (PRL) were co-localized to the same electron-dense granules. Some similar cells also possessed electron-lucent granules immunoreactive only for anti-PRL antiserum. Adrenocorticotrophic hormone (ACTH) and PRL were also found in the same cell but were very largely localized to separate, morphologically different populations of electron-dense and -lucent storage granules. By employing double immunolabeling, a few granules in the ACTH/PRL cells were shown to be immunoreactive to both anti ACTH and anti-PRL antisera. The possibility that the multipotential stem cells is discussed. PMID- 2754251 TI - New freeze-dry and vapor fixation method for immunohistochemistry of soluble proteins: subcellular location of the progesterone receptor. AB - We describe a new application of freeze-drying and vapor fixation for immunohistochemical location of soluble proteins. The method avoids the liquid phase, which eliminates the possible diffusion of soluble proteins. Two vapor fixatives, paraformaldehyde and p-benzoquinone, were tested and p-benzoquinone was found to preserve antigenicity of progesterone receptor (PR) and ovalbumin better than paraformaldehyde. The method proved to be highly sensitive, since higher concentrations of antigen were found in some tissues and some tissues found to be antigen negative by earlier liquid fixation methods proved to contain antigen. The location of PR as a highly soluble protein was studied. With the present method, both unoccupied and occupied PR were located in the nuclei, a similar finding as with the earlier liquid fixation method. The results further support the concept that PR is an intranuclear protein independent of its ligand occupation. PR was detected in a few cells inside the follicles of the bursa of Fabricius and in the smooth muscle cell nuclei of the small intestine, observations not previously made owing to the insensitivity of the earlier methods. PMID- 2754252 TI - Glycoconjugates on corneal epithelial surface: effect of neuraminidase treatment. AB - The purpose of this study was to develop a procedure to quantitatively examine corneal epithelial apical cell membrane-associated glycoconjugates. Saccharide moieties on young, mature, and aged corneal epithelial cells were detected and localized in corneas of immature and adult mice by using colloidal gold-labeled lectins and transmission electron microscopy (TEM). In general, dense binding to the corneal epithelial apical surface cell membranes with wheat germ agglutinin (WGA) was seen in the adult, whereas the immature cornea bound less WGA-gold. Neuraminidase digestion decreased binding of the conjugate on epithelial plasma membranes of young and mature cells in adult cornea. Lectin-gold binding was decreased in the immature cornea on mature and aged cells. WGA-gold binding after neuraminidase was elevated on young cells of immature and on aged cells of adult animals. No binding of peanut agglutinin (PNA) or horse gram agglutinin (DBA) to the corneal epithelial surface was seen in animals of either age. After neuraminidase digestion, PNA binding sites were exposed only on the adult corneal surface. These data suggest that a terminal trisaccharide sequence, sialic acid galactose beta(1----3)-N-acetylgalactosamine, is present at the adult corneal surface but is absent or at undetectable levels at the corneal surface of the immature animal. These data may be of significance in light of the dissimilar pattern of P. aeruginosa recognition and binding to the immature vs adult corneal epithelium. PMID- 2754253 TI - Expression of actin isoforms in developing rat intestinal epithelium. AB - A minimum of six very similar but distinct actin isoforms are encoded by the mammalian genome. Developmental regulation of these genes results in a tissue specific distribution of the isoforms in the adult. Using a panel of actin specific monoclonal antibodies (MAb), we recently reported the expression of two unique actin isoforms in adult rat intestinal brush border. In this report, we examine the developmental expression of these and other actin isoforms in rat intestinal epithelial cells. Isoforms containing the HUC 1-1 and/or C4 epitopes are present by day 15 of gestation and are continuously expressed throughout adult life. Unexpectedly, the gamma-enteric smooth muscle isoactin, defined by the B4 epitope, is transiently expressed in these non-muscle cells late in gestation. The alpha-vascular smooth muscle isoform, however, is not expressed in intestinal epithelial cells during development and, as previously reported, both smooth muscle isoforms are absent in epithelial cells of adult intestine. In addition, we demonstrate that although multiple isoforms are expressed simultaneously in these cells, they are not uniformly distributed at the subcellular level, suggesting that the cell recognizes the actin isoforms as functionally distinct entities. PMID- 2754254 TI - Preparation of monoclonal antibodies to glutathione S-transferase-pi and application to immunohistochemical study. AB - Glutathione S-transferase (GST) EC 2.5.2.18) catalyzes conjugation of reduced glutathione with hydrophobic substrates, such as S-epoxide active molecules. It participates in glutathione metabolism and the gamma-glutamyl cycle, playing an important role in detoxification and biosynthesis of many compounds. It is also known as a marker of pre-neoplasia in chemical hepatocarcinogenesis. Isoelectric focusing studies have revealed that this enzyme is composed of several isozymes, one of which, an acidic form of GST called GST-pi, has been extracted from human placenta. In this study, we prepared monoclonal antibodies (MAb) against human GST-pi from placenta. Specificity was confirmed by immunoblots of GST-pi after polyacrylamide gel electrophoresis and inhibition testing of enzyme activity by the antibody. The subclass of the antibody was IgG1 and the light chain was kappa. In light microscopic immunohistochemical studies of human placenta using the MAb, GST-pi was localized diffusely in the cytoplasm and along the apical cell membranes of syncytial cells in villi and in the cytoplasm of cytotrophoblastic cells in the basal plate. The MAb we prepared may also be useful for analyzing the enzyme's function in detoxification and biosynthesis of many compounds, as well as for oncological studies, such as diagnosis of malignant disease and localization of oncofetal proteins in malignant tissues. PMID- 2754255 TI - A new microphotometric method for measurement of cytochrome P-450 in sections of liver. AB - We developed a new microphotometric method for measuring the amounts of cytochrome P-450 (P-450) in fresh frozen sections of liver. Four serial frozen sections cut from the liver were separately incubated in 50 mM Tris-HCl buffer (pH 8.0) alone, in buffer containing sodium dithionite, in buffer saturated with carbon monoxide (CO), and in buffer saturated with CO and containing sodium dithionite. The difference between absorbance at 450 nm and that at 490 nm was measured in these sections with a simple microphotometer system. This method yielded precise amounts of P-450 in sections by measuring the true extinction of P-450 and by minimizing the effect of contaminating hemoproteins. Livers of adult rats contained large amounts of P-450, which was greater in perivenular hepatocytes than in periportal hepatocytes. In livers of newborn rats, however, small amounts of the enzyme were distributed evenly throughout the lobule. PMID- 2754256 TI - Bandeiraea simplicifolia lectin demonstrates significantly more capillaries in rat skeletal muscle than enzyme methods. PMID- 2754257 TI - Natural killer function in flow cytometry. II. Evaluation of NK lytic activity by means of target cell morphological changes detected by right angle light scatter. AB - Morphological changes that occur in K562 cells after natural killing produce profound changes in cellular light scattering properties. The possibility of gating out all the effector cells by thresholding on perpendicular light scatter and the subsequent identification of two distinct clusters of cells, which correspond to dead and viable targets, have permitted the measurement of natural killer activity in vitro. The changes in scattering properties after cell death are mainly determined by the variation of internal refractive index of the dying cell. A comparison of the scattering and propidium iodide staining procedures showed good correlation. The morphological detection and measurement of cellular death is therefore used to estimate NK lytic activity. This methodology permits the measurement of NK activity without staining the target and the measurement of perpendicular light scatter provides an alternative approach to the study of lytic processes in vitro. PMID- 2754258 TI - Comments on 'Measurement of Tumour Reactive Antibody and Antibody Conjugate by Competition, Quantitated by Flow Cytometry', by Robins et al. PMID- 2754259 TI - Recovery of functional human lymphocytes from Leukotrap filters. AB - We report here a method by which functional human PBL may be recovered from a blood product preparation unit (Leukotrap) which is normally employed by blood banks to prepare a leukocyte-poor blood product and which is commonly discarded after use. Blood filters which were back-flushed with cold, phosphate-buffered saline (PBS) and the resulting buffy coats collected and separated on Histopaque gradients yielded an average of 2.67 x 10(8) (+/- 1.17 x 10(8] cells per filter processed (n = 38), with viability greater than 95%. The percentages of cell types recovered before or after Histopaque separation closely approximated those reported for freshly drawn blood when examined using differential staining and morphological criteria. Fluorescent antibody analysis revealed a normal distribution of Leu-4 (T), Leu-12 (B), Leu-3a (T helper), Leu-2a (T suppressor) and Leu-M3 (macrophage) positive cell subsets. Recovered lymphocytes were fully responsive to phytohemagglutinin (PHA), concanavalin A (ConA) and pokeweed (PWM) mitogens. Random donor lymphocytes which were co-cultured in a two-way mixed lymphocyte response (MLR) were fully capable of proliferative responses compared to the same populations cultured alone. The results from our study indicate that Leukotrap filters provide a readily available, easily processed and convenient source of functional human PBL for use in the in vitro study of the human immune system. PMID- 2754260 TI - Production of multilamellar, small unilamellar and reverse-phase liposomes containing house dust mite allergens. Potential adjuvants in the immunotherapy of allergic disease. AB - The capacity of multilamellar (MLV), small unilamellar (SUV) and reverse-phase vesicle (REV) liposomes to incorporate house dust mite allergens has been studied. All three liposome preparations entrapped mite proteins with efficiencies of 36% (SUV), 29% (MLV) and 14% (REV). MLV incorporated the complete range of proteins contained in mite extracts with apparent molecular weights ranging from 14,000 to greater than 67,000 as judged by sodium dodecyl sulphate polyacrylamide gel electrophoresis. However, several proteins with apparent molecular weights (MW) of 16,000, 36,000 and 43,000 were excluded from the REV and SUV. Immunoblotting analysis using a serum pool prepared from mite allergic individuals showed that whereas the whole spectrum of allergens was incorporated into the MLV, a MW 43,000 allergen was excluded from the REV and SUV. The exclusion of these mite components is probably a function of the relatively prolonged exposure of the original extract to organic solvent in the preparation of the REV and SUV liposomes. PMID- 2754261 TI - Biotinylation: a simple method for labelling complement component C8 with preservation of functional activity. AB - Biotinylation of human C8 with the water-soluble biotin derivative biotinylamidohexanoic acid, N-hydroxysulfosuccinimide ester is an excellent method for labelling this terminal complement component with preservation of its functional activity. The biotinylated product can be detected both in native form and also following its incorporation into the terminal complement complexes. Detection assays include Western blotting, crossed immunoblotting, ELISA, and immunocytochemistry. Biotinylation is an attractive alternative method for labelling C8 and may be used for detecting and quantifying C8 and C5b-9 complexes in their soluble and membrane-bound forms. PMID- 2754262 TI - Evaluation of methods for isolating human peripheral blood monocytes. Studies on chemotactic locomotion and other functional characteristics. AB - We have compared six different methods of purifying human blood monocytes for their usefulness in relation to assays of polarization, locomotion and chemotaxis. For polarization assays it is essential to prepare an unstimulated, spherical, cell population in suspension. The techniques compared were based either on density differences between monocytes and lymphocytes using Percoll or Nycodenz, or on the separation of adherent monocytes from non-adherent cells on protein-coated surfaces, i.e., foetal calf serum (FCS); gelatin-FCS; gelatin plasma; baby hamster kidney (BHK) microexudate coats. The BHK microexudate technique (Ackerman and Douglas, 1978) gave the best yield and purity of monocytes. These were spherical and had not been activated by the separation procedure. This technique provided monocytes in suspension that were functionally normal in locomotion and chemotaxis assays, phagocytosis, chemiluminescence and Fc receptor expression. To achieve a good yield of spherical cells, it was necessary to use tubes to which monocytes did not adhere. Siliconized glass was superior to tissue culture plastic for this purpose. PMID- 2754263 TI - The evolution of medicine. PMID- 2754264 TI - Primary carcinoma of vagina with uterine prolapse. AB - Eleven cases of primary carcinoma of vagina were admitted in Kasturba Medical College Hospital during the last 10 years, of which 6 cases aged 44-72 years, were associated with 3rd degree uterine prolapse. All the patients attended the hospital in late stage in spite of having 3rd degree uterine prolapse. Blood stained discharge and ulceration on the prolapsed part, irreducible prolapse with urinary retention and marked oedema of local and surrounding tissues were the presenting symptoms. Lesion on the vagina varied in size from 5 cm to 15 cm. IVP in both the cases of irreducible prolapse and retention of urine revealed hydroureter and hydronephrosis bilaterally. X-ray chest revealed secondaries in one patient only. Histopathology of vaginal biopsy revealed well differentiated squamous cell carcinoma in 5 cases and undifferentiated squamous cell carcinoma in one. Since the patients were in late stage of malignancy and were inoperable, treatment with external telecobalt therapy was undertaken. One patient developed vesicovaginal fistula during the treatment period and another patient developed it at the end of telecobalt therapy. PMID- 2754265 TI - Serum protein patterns in adenocarcinoma of breast and rectum. AB - Serum protein patterns were studied in 27 cases of adenocarcinoma of breast and rectum by polyacrylamide gel disc electrophoresis. Pretreatment and post treatment cases showed different protein patterns. The increased number of bands in zone A in pretreatment rectal cancer cases decreased after chemotherapy. Thus, the number and position of bands before and after treatment and in different types of cancer may be used in diagnosis and prognosis of the disease. PMID- 2754266 TI - Squamous cell carcinoma in a horseshoe kidney. AB - Malignancy in a horseshoe kidney is uncommon. First case of malignancy in a horseshoe kidney was described by Hildebrand in 1895. Here a case of squamous cell carcinoma in a horseshoe kidney in a 62-year-old male is reported for its rarity. PMID- 2754267 TI - Giant cell tumour of ilium. AB - Most common tumours of ilium are chondrosarcoma and reticulum cell sarcoma. Giant cell tumour commonly presents at the ends of long bones. It is quite uncommon to find osteoclastoma in flat bones, especially ilium. This is the only case of osteoclastoma of ilium seen during the last 7 years in this institution and is reported for its rarity. PMID- 2754268 TI - Electromagnetic energy and its application to human including detection of cancer. PMID- 2754269 TI - Income tax exemption of capital gains--new scheme. PMID- 2754270 TI - Efficacy of one herbal product in prostatorrhoea and spermatorrhoea cases. PMID- 2754271 TI - Do mercury and aneroid sphygmomanometers give identical readings at high altitude? PMID- 2754272 TI - A study on laboratory diagnosis of liver abscess in Pondicherry. AB - A study was carried out to evaluate the role of laboratory investigations for diagnosis of liver abscess from the year 1976 to 1981. Bacteriological, parasitological, serological, haematological, histopathological studies and liver function tests were carried out in 240 confirmed cases of liver abscess during the study period. Out of 219 cases, pus culture for pyogenic bacteria was positive in 68 cases (including 27 cases of secondary bacterial infection of amoebic liver abscess) and sterile in 151 cases. Ent histolytica was demonstrated in pus of 24 cases. The diagnostic titre of 1:128 and above was detected in 137 sera by isohaemagglutination test. The liver function tests were of limited value. Albumin globulin ratio was altered in 91.25% cases and there was moderate increase in the levels of alkaline phosphatase. Histopathological studies demonstrated Ent histolitica in 2 cases only. Changes characteristic of pyogenic liver abscess were observed in 6 cases. Rest showed no specific changes. PMID- 2754273 TI - Role of intrathecal tetanus antitoxin (equine) in tetanus neonatorum. AB - The present study includes 50 cases of tetanus neonatorum who were given 200 IU of tetanus antitoxin (equine) intrathecally once only and 500 IU intravenously daily for 3 consecutive days. Nutrition was provided with intravenous drip containing dextrose and other electrolytes. The overall mortality was 78%. It appears that the course of the disease remains unaltered with intrathecal tetanus antitoxin in tetanus neonatorum. PMID- 2754274 TI - Generation of C5-dependent bioactivity by tissue-bound anti-BMZ autoantibodies. AB - We previously reported that complement-binding antibasement membrane zone (BMZ) autoantibodies can mediate complement-dependent directed migration and adherence of leukocytes to the BMZ in cryostat skin sections and that there is heterogeneity in the ability of anti-BMZ autoantibodies to mediate that response. Those observations suggested that directed migration and adherence of leukocytes to the BMZ might be dependent on the amount of complement-activating autoantibody deposited at the BMZ and the extent to which those antibodies could activate complement and generate C5-derived peptides (C5a, C5a des arg). In this study, we have examined the role of autoantibody concentration and C5 in mediating the adherence response. When cryostat skin sections were pretreated with anti-BMZ autoantibodies and subsequently incubated with neutrophils suspended in fresh serum, neutrophils adhered to the BMZ. Adherence was anti-BMZ autoantibody specific and proportional to anti-BMZ autoantibody concentration. To determine the role of C5 in mediating adherence, neutrophils were suspended in increasing concentrations of: 1) fresh serum, 2) heat-inactivated serum, 3) serum pretreated with antihuman C5, 4) serum pretreated with antihuman IgG, 5) C5-depleted serum, 6) purified C5, and 7) C5-depleted serum reconstituted with increasing concentrations of purified C5. The suspensions were then incubated with autoantibody-treated skin sections. The results showed a dose-dependent requirement for fresh serum and for C5-depleted serum reconstituted with increasing doses of C5. Adherence could be detected with C5 concentrations less than 200 ng/ml, which correspond to a C5a/C5a des arg concentration of 10(-8)-10( 9) molar. These results suggest that complement-dependent neutrophil adherence is a highly sensitive method for detecting and quantitating the ability of tissue deposited anti-BMZ autoantibodies to activate complement and generate C5-derived bioactive peptides, for estimating the amount of C-activating anti-BMZ autoantibody deposited at the BMZ in vivo, and for evaluating the potential role of C-activating anti-BMZ autoantibodies in the pathogenesis of lesions. PMID- 2754275 TI - Photosensitivity and hyperpigmentation in amiodarone-treated patients: incidence, time course, and recovery. AB - Amiodarone (AD) induces photosensitivity in 75% of the patients treated with this drug. Phototoxic reactions can be experimentally elicited with UVA but not with UVB. The UVA-MED is significantly reduced after 12 months of treatment. The development of photosensitivity depends on the total dose of AD; 40 g is the minimal cumulative dose requirement. Under the regimens commonly used, photosensitivity can be expected after 4 months of continuous AD treatment and appears to be unrelated to the skin type. Photosensitivity gradually decreases and returns to normal between 4 and 12 months after the withdrawal of AD. AD related hyperpigmentation develops after an average of 20 months of continuous AD treatment and a minimal total dose of 160 g AD in about 8% of the patients (mainly of skin type I). Electron microscopic examination of the sun-exposed skin of patients without AD discoloration shows pigment deposits similar to those already described in patients with AD hyperpigmentation in exposed and non exposed skin. Light and electronmicroscopic examination of sun-exposed skin of both clinically photosensitive and non-photosensitive patients reveals perivascular inflammation even in the absence of a clinical rash. Reduplications of vascular basal laminae occur in sun-exposed skin of both patients with and without UVA photosensitivity but are absent from non-exposed skin. In one patient, followed for 33 months after drug withdrawal, massive AD-induced hyperpigmentation was found to be reversible. PMID- 2754276 TI - Cutaneous papillomatous hyperplasia in cyclosporine-A treated beagles. AB - All twelve Beagle dogs undergoing long-term therapy (26 weeks) with the immunosuppressive drug cyclosporine-A (30 mg/kg), developed cutaneous papillomatous hyperplasia. By week 7 all dogs developed generalized lesions distributed over the entire body. These occurred as irregular, oval, sessile, unpigmented, firm masses. The incidence and severity of the skin lesions varied among dogs and anatomic site, with no correlation to the blood level of cyclosporine. Microscopic analysis revealed that the epidermis formed short papillary folds on broad fibrovascular stalks and was hyperkeratotic and acanthotic. Mild hyperplasia of hair follicles and sebaceous glands was also evident. A mild diffuse infiltrate of lymphocytes and plasma cells was present in the papillary dermis. No histopathologic changes typical of papillomavirus infection were identified, nor were papillomavirus group-specific antigens or viral DNA detected. Other cutaneous side effects included hyperkeratosis of footpads, increased growth of hair and nails, and hyperkeratinization of the haired skin of the prepuce. All cutaneous lesions regressed spontaneously within 8 weeks following termination of cyclosporine administration. The hyperplastic lesions may have resulted from the action of cyclosporine via the T-lymphocyte system. Conversely a direct action of this drug on epithelial cells may have stimulated proliferation and keratinization. PMID- 2754277 TI - Solute structure-permeability relationships in human stratum corneum. AB - The permeability coefficients (kp) of a series of methyl-substituted p-cresols were determined in human stratum corneum along with their partition coefficients (PC) between water and untreated stratum corneum, delipidized stratum corneum, octanol, and heptane. The PC values were identical in untreated and delipidized stratum corneum, suggesting that the stratum corneum/water PC data reflect the protein domain rather than the lipids. Although uptake into human stratum corneum was relatively insensitive to solute lipophilicity, reflecting the predominant role of proteins in the uptake, permeability coefficients were found to be more sensitive to lipophilicity, suggesting that transport is by a lipid pathway. A log-log plot of kp versus stratum corneum/water PC within the phenol series is linear, but with a slope of 3.6, indicating that kp is not directly proportional to PC. Functional group contributions to the free energy of the transfer process reflected in permeability or partitioning experiments were compared with group contribution data generated previously for the same substituents attached to the chain terminus of 21-esters of hydrocortisone. Within experimental error, a given functional group altered permeability by the same factor in either series of compounds. Group contributions of polar, hydrogen bonding substituents obtained from kp data were similar to those from octanol/water PC data, suggesting that the barrier microenvironment resembles that of a hydrogen bonding organic solvent. Comparison of the kp values of substituted p-cresols with those of hydrocortisone esters having similar lipophilicities also indicated a steep dependence of kp on molecular weight (log kp = constant + psi log PC - n log MW, n = 4.6) similar to the dependence observed in other biomembranes and isolated lipid bilayers. PMID- 2754278 TI - Cyclosporin, calmodulin, and psoriasis. PMID- 2754279 TI - Abstracts of the 4th Immunodermatology Symposium. Amsterdam, The Netherlands, September 21-23, 1989. PMID- 2754280 TI - Induction of morphologic differentiation of endothelial cells in culture. AB - Human endothelial cells when grown in cell culture assume a "cobblestone" morphology and do not form tubes or capillarylike structures. We have recently identified a culture substrate containing basement membrane-derived proteins that promotes morphologic differentiation of human umbilical vein and human dermal microvascular endothelial cells into capillarylike tubes. This differentiation is rapid, beginning within 1 h and is complete by 8-12 h. On electron microscopy these cells form a lumen, derived from remodeling of multiple cells and also by forming holes in the cytoplasm of individual cells. The endothelial cells no longer proliferate when cultured on this substrate known as matrigel, but can be induced to do so when cultured on fibronectin. We have also identified a critical molecular signal for endothelial cell differentiation induced by matrigel. Laminin, a prime constituent of matrigel, and to lesser extent collagen IV appear to be key elements in the differentiation of endothelial cells induced by matrigel. PMID- 2754282 TI - [Changes in autonomic nerve function during the normal menstrual cycle measured by the coefficient of variation of R-R intervals]. AB - The purpose of this study was to determine if there is a change in autonomic nerve function during the menstrual cycle. The subjects were 20 females (average age 26.1 years +/- 4.6) with a normal menstrual cycle. The coefficient of variation of R-R intervals (CV R.R) was measured to investigate autonomic function in the menstrual, follicular, ovulatory, luteal, and premenstrual phases. Average CV R-R for all phases was 5.2 +/- 1.9%. And the CV R-R tended to be lower in those in their 30s than in those in their 20s. And no noticeable difference was seen in the CV R-R among the 5 phases of the menstrual cycle. On the other hand, the CV R-R of 11 females with premenstrual syndrome was low in the ovulatory, luteal and premenstrual phases. These results, which provide basic data for clinical use, suggest the following. (1) The age of subjects should be taken into consideration. (2) Changes in the CV R-R during the menstrual cycle are negligible. (3) However, in those showing symptoms associated with the menstrual cycle such as premenstrual syndrome, changes during the menstrual cycle should be taken into account. At the same time psychological changes in the subjects were evaluated by the following tests: Cornell Medical Index, Taylor's manifest anxiety scale, and Zung's self-rating depression scale. The results of these tests did not vary significantly during the menstrual cycle. PMID- 2754281 TI - [Effects of alfacalcidol (1 alpha-OH-D3) on post oophorectomy osteopenia as measured by microdensitometry]. AB - The present study included 24 relatively young patients (48.4 years on average) who had decreased bone mineral levels after oophorectomy (severity scores of 4 or above as judged by the MD method), and the efficacy of active vitamin D3 (D3) was assessed according to the mean percentage of change in MD indices. The patients were randomly divided into two groups of 12 cases each, the D3-treated group and the non-treated group. The D3 treatment was given in the form of 1 microgram/day alfacalcidol for 9.67 months on average. Before and after treatment, the MD indices and serum Al-p, calcium and potassium were measured. The non-treated group was observed for 9.92 months on average, and the same parameters were measured before and after the observation period. There were no significant intergroup differences with regard to age, height, body weight, duration after oophorectomy, severity of decreased bone mineral levels and other background factors. In the treated group, MCI and d tended to increase and to decrease, respectively, GSmin and sigma GS/D also tended to increase and GSmax tended to increase (p less than 0.10). In the non-treated group, MCI decreased and d tended to increase, GSmin and GSmax tended to decrease, and sigma GS/D decreased (p less than 0.05). In the intergroup comparison, GSmax increased in the treated group (p less than 0.05) and sigma GS/D also tended to increase more in the treated group (p less than 0.10).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2754283 TI - [Prognostic significance of histopathological classification in patients with carcinoma of the uterine cervix]. AB - In a retrospective study of 724 patients with histologically proven carcinoma of the uterine cervix from 1980 through 1986, the histological classification and clinical stage (FIGO) were investigated for their prognostic value. The clinical stage was very important in relation to prognosis. The histological type of the squamous cell carcinoma (keratinizing, large cell non-keratinizing, small cell non-keratinizing) did not have any value in predicting survival, but small cell non-keratinizing tumor showed a less favorable prognosis than other tumors when surgery was employed. As to survival, there was no difference between adenocarcinoma and squamous cell carcinoma when compared in all patients, but adenocarcinoma had a worse prognosis than squamous cell carcinoma when surgery was employed. The pelvic lymphnode status at operation was correlated with the clinical stage. Adenocarcinoma had more positive nodes than squamous cell carcinoma. There was no significant difference in the frequency of pelvic node involvement among cell types of squamous cell carcinoma. The present histopathological classification of the uterine cervical carcinoma was of little prognostic value in predicting patient outcome. PMID- 2754284 TI - [Stimulatory action of shakuyaku on aromatase activity in cultured rat follicles]. AB - The direct action of herbal medicines on aromatase activity was investigated in cultured rat follicles. Mature follicles were obtained from PMSG-treated immature rats. Aromatase inhibitor, 4-hydroxy-4-androstene-3,17-dione (4-OHA) was also used in the experiment. Follicles were incubated in the medium for 24 hour with toki-shakuyaku-san, Keisi-bukuryo-gan. unkei-to (10-500 micrograms) or their ingredients (100 micrograms), respectively. The addition of 4-OHA reduced estradiol secretion in a dose-response manner. The addition of each medicine (100, 500 micrograms) as well as 4-OHA (10(-5) M) restored estradiol secretion to the control level. Among the ingredients, Shakuyaku stimulated estradiol secretion in the medium in the presence or absence of 4-OHA. It is noteworthy that shakuyaku alone had a stimulatory action on aromatase activity and is the only one which is equally contained in the three medicines. PMID- 2754285 TI - [Phenotypic expression and functional manifestation of fetal and maternal natural killer (NK) cells]. AB - The NK cells, considered to play an important role in host defense, are reported to show heterogeneity during the cellular development. To document the heterogeneity, studies were carried out on the phenotypic expressions, the cytolytic activities, the responsiveness to recombinant interleukin 2 (rIL-2) and on the ultrastructure of the NK cells of the blood obtained at the time of delivery from 24 pairs of mothers and umbilical cords. The phenotypic expressions were Leu7+-11-(6.2 +/- 2.1%, SD), Leu7+-11+(5.6 +/- 1.8), and Leu7--11+(5.5 +/- 2.1) in the maternal NK cells, whereas the cord blood NK cells expressed only Leu7--11+(8.2 +/- 2.4). The cytolytic effect of the NK cells on K562 target cells was assayed by a method to determine ATP release. The activity of the maternal blood NK cells was 80.4 +/- 10.5%, SD whereas the cord blood samples showed only 40.5 +/- 8.5, after 4-hour incubation; the difference between the maternal and cord NK cells was statistically significant (p less than 0.01). The NK cells were incubated with rIL-2 (10 units), and the cytolytic activity was determined. The activity of the cord blood NK cells was significantly enhanced already after incubation for 2 hours and it lasted until incubation had continued for 4 hours. However, the rIL-2 effect was not significant after incubation for 5 hours. On the other hand, the activity of the maternal blood NK cells was not influenced significantly by rIL-2.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2754286 TI - [Morphological and functional changes in 3 beta-HSD positive cells in corpora lutea during pregnancy in rats]. AB - On days 5, 10, 15 and 20 of pregnancy, rat corpora lutea (CLs) were dissected and dissociated into single cell suspensions by enzyme treatments. To assess 3 beta hydroxysteroid dehydrogenase (HSD) activity, a histochemical suspension-staining procedure was used. The number of cells positive for 3 beta-HSD in CL were 148.0 +/- 13.7, 130.1 +/- 25.4, 134.0 +/- 23.5 and 116.8 +/- 13.5 X 10(3) cells on days 5, 10, 15 and 20 of pregnancy, respectively. The 3 beta-HSD positive cells increased in size from 18.5 +/- 0.28 microns on day 5 to 35.7 +/- 0.50 microns on day 20 of pregnancy. The suspended luteal cells were incubated in serum-free DME F12 for 20 hours with or without human chorionic gonadotropin (hCG, 100 ng/ml) or dibutyryl cyclic AMP (dbcAMP, 10mM) to test their functionality, and progesterone accumulation was determined by radioimmunoassay. Progesterone secretion from the 3 beta-HSD positive cells was maintained at the same levels until day 15 and decreased significantly on day 20 of pregnancy. However the response to hCG stimulation of the 3 beta-HSD positive cells decreased significantly on day 20, the 3 beta-HSD positive cells maintained the same responsiveness to dbcAMP stimulation on progesterone secretion throughout pregnancy. These data suggest that the steroidogenic rat luteal cells may be regulated by morphologically and functionally different mechanisms, and that progesterone may be secreted by at least two different pathways. PMID- 2754287 TI - [Analysis of factors influencing prognosis in patients with advanced ovarian cancer]. AB - Sixty-eight patients with advanced ovarian cancer were evaluated to determine factors influencing prognosis. In the background between 49 patients who died within three years after treatment and 19 still living after more than 3 years, there is no significant difference in age. Performance Status (PS), clinical stage, pathological type, mode of operation, number of PAC chemotherapy, use of radiation therapy, the volume of ascites, the degree of peritonitis carcinomatosa or the preoperative serum CA125 level. On the other hand, factors affecting prognosis are the presence of retroperitoneal lymph node metastasis, liver metastasis, and a decrease in the decline rate of serum CA125. The factors which worsened prognosis in the patients who died were: (1) advanced stage of PS (2) the mode of surgery (non-curative surgery), (3) ascites more than 2,000ml, (4) severe peritonitis carcinomatosa, (5) liver metastasis, (6) retroperitoneal lymph node metastasis, (7) mucinous cystadenocarcinoma as to pathological type, (8) the low decline rate of serum CA125. PMID- 2754288 TI - [Effects of gestrinone on serum lipid and lipoprotein levels in women with endometriosis]. AB - Gestrinone (G) was given to 12 females with endometriosis in weekly doses of 5 or 10mg for 4 to 6 months, and the change in serum lipids and lipoproteins was analysed. G decreased total cholesterol by 20% (p less than 0.05), triglycerides by 36% (p less than 0.05), phospholipids by 28% (p less than 0.01) and lipid peroxides by 34% (p less than 0.05), among which reductions in them were statistically significant when compared with the pretreatment levels. Levels of high density lipoproteins (HDL) also fell: HDL-cholesterol by 41% (p less than 0.01), HDL-triglycerides by 49% (p less than 0.05) and HDL-phospholipids by 38% (p less than 0.01) which were significant. Concurrently apolipoproteins (Apo) and lecithin-cholesterol acyltransferase activity (LCAT) decreased: Apo A-I by 31% (p less than 0.01), Apo A-II by 13% (p less than 0.05) and LCAT by 53% (p less than 0.05), which were significant. In contrast, there were few changes in the levels of low density lipoproteins (LDL) and Apo B. There was also little effect on very low density lipoproteins (VLDL) except VLDL-triglycerides which decreased by 52% (p less than 0.05). Meanwhile free fatty acids increased by 61% (p less than 0.05). Therefore, the atherogenic index defined as the ratio of LDL-cholesterol to HDL-cholesterol rose as much as 92% (p less than 0.01) of the initial value in 24 weeks of medication. When these results were examined with respect to the 5 and 10mg administration group, dose-dependent effects were observed, but these were not marked.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2754289 TI - [The clinical usefulness of serum CA72-4 analysis in patients with ovarian cancer]. AB - Serum CA72-4 levels were measured by a radioimmunoassay using the murine monoclonal antibody B72.3 in gynecologic disease. The sensitivity and specificity was compared with those of CA125. If the upper limit of normal is set at 3.9U/ml of serum, all serum of normal healthy donors is negative, and in only 5 of 73 serum samples (6.8%) from patients with benign gynecologic disease is CA72-4 increased, whereas in 28 of 63 (44.4%) of ovarian cancer patients it is positive. The positivity of serum CA72-4 in ovarian cancer is as follows: 8.3% in stage I, 25.0% in stage II, 48.0% in stage III, and 85.7% in stage IV, respectively. Serum CA72-4 is increased in 39.1% of serous cystadenocarcinoma, 52.0% of mucinous cystadenocarcinoma, 44.4% of endometrioid carcinoma, and 33.3% of clear cell carcinoma. Consequently, the one positive finding is that the CA72-4 test appears to be more useful in mucinous tumors than is the CA125. The use of CA72-4 and CA125 in combination is useful in increasing sensitivity because of the poor reaction of CA125 in mucinous tumors. PMID- 2754290 TI - Effects of pregnancy, delivery and lactation in hyperprolactinemia with prolactin producing pituitary adenoma. AB - The effects of pregnancy, delivery and lactation on changes in serum prolactin (PRL) values were investigated in patients with hyperprolactinemia. Thirty-seven patients with hyperprolactinemia who wished to become pregnant were treated by transsphenoidal surgery, bromocriptine therapy, or a combination of the two. In 33 patients whose pre-pregnancy serum PRL concentration exceeded 30ng/ml, only in two did serum PRL return to the normal range below 30ng/ml after pregnancy, delivery and lactation. However, the serum PRL concentration was decreased in 28 patients. When classified according to the pre-pregnancy serum PRL concentrations, PRL less than or equal to 100 (Group A), 100 less than PRL less than or equal to 200 (Group B) and 200 less than PRL (Group C), patients with the greatest pre-pregnancy serum PRL concentration showed the greatest reduction. The ratios of post-pregnancy serum PRL to pre-pregnancy PRL in group A, B and C were 91.4 +/- 22.1%, 81.5 +/- 7.0% and 65.0 +/- 6.5% (Mean +/- SE), respectively. Group C with the highest pre-pregnancy serum PRL concentration consisted almost entirely of patients with macroadenoma. Thus, the reduction in serum PRL after pregnancy, delivery and lactation was considered to be the result of a decrease in the size of the adenoma due to adenoma enlargement over the sella turcica through the estrogen effects during pregnancy, and from impairment of pituitary circulation. PMID- 2754291 TI - The evaluation of systolic time intervals and impedance cardiogram of neonates. AB - The left ventricular systolic time intervals (STI) and impedance cardiogram were studied in 295 newborn infants. The wave pattern of the carotid was mainly anacrotic, similar to the wave pattern of hypertensive adult patients. In the neonatal period Q-I and Q-II intervals were gradually shortened and the prolongation of the preejection period (PEP), isometric contraction time (ICT) and an increase in PEP/ET were most prominent in the group at 24-72 hours after birth. The impedance cardiogram was able to be recorded clearly in newborn infants by the 4 electrode method. Stroke volume and cardiac output calculated from Kubicek's formula were most decreased in the group at 5-6 hours after birth. The estimated values were 3.79 +/- 0.78 ml and 456.2 +/- 92.2 ml/min. respectively at that stage, and gradually increased thereafter. In the babies in which the umbilical cord was clamped and tied later than 3 minutes after delivery, prolongation of the Q-I, Q-II intervals, pulse propagation time, PEP, ICT and a decrease in ET/PEP were remarkable, and cardiac output and blood pressure were relatively increased until about 120 hours after birth. These STI measurement and impedance cardiograms were useful to use in observing various cardiovascular changes in newborn infants. It was clear that the timing of clamping of the umbilical cord after delivery affected the cardiovascular hemodynamics of neonates. PMID- 2754292 TI - [A case of myotonic dystrophy diagnosed after delivery]. PMID- 2754293 TI - [A case of massive ovarian edema]. PMID- 2754294 TI - [A case of Sheehan's syndrome complicated by diabetes insipidus]. PMID- 2754295 TI - Preparation and evaluation in rabbits of topical solutions containing forskolin. AB - Forskolin, a diterpene which displays a potent IOP-lowering activity in several animal species, is very poorly water soluble. This characteristic imposes the ocular administration of the drug as a suspension, a type of formulation which may present several preparative and biological disadvantages, such as e.g. difficulty of sterilization and poor bioavailability. The present report is concerned with an investigation on the solubilization of forskolin by some eye compatible polymeric agents. While beta- and gamma-cyclodextrin were not particularly effective solubilizers, one polyoxyethylene-polyoxypropylene block copolymer (PluronicR F-127) increased 40 times the drug solubility in water (c. 120 mg/100 ml vs. c. 3 mg/100 ml). When tested on rabbits with artificially increased IOP, the Pluronic vehicle prolonged significantly the duration of the hypotensive activity of forskolin with respect to a standard 1.0% suspension of the drug. The potential of these alternative formulations for increasing the ocular bioavailability of forskolin is discussed. PMID- 2754296 TI - Influence of ophthalmic ointments on the penetration of pilocarpine drops. AB - To evaluate the influence of prior administered ointments upon the intraocular penetration of drops, we applied either a combination antibiotic ointment, a combination antibiotic-steroid ointment, or a lubricant ointment at different time periods before instillation of 2% pilocarpine drops into rabbit eyes. The level of pilocarpine measured in aqueous humor at one hour was compared to the level achieved in eyes without ointment application. No change was found in pilocarpine levels following application of the lubricant ointment. Pilocarpine concentrations were significantly lower (38%-48%) in animals receiving the antibiotic ointment at 5 or 15 minutes before pilocarpine drops. Pilocarpine levels also were decreased significantly when the steroid-antibiotic ointment was applied 15, 30 or 60 minutes before the drops. To verify these effects at other time periods, ointments were applied 15 minutes before pilocarpine drops and aqueous humor samples aspirated at 30 minutes or two hours. A 22% decrease in aqueous humor pilocarpine was found at 30 minutes with both the antibiotic and steroid-antibiotic combination; no effect was observed at two hours. To determine the influence of each drug component within the ointment on the penetration of pilocarpine, solutions of dexamethasone, neomycin, bacitracin and polymyxin B were mixed individually with pilocarpine drops and applied into the animal eyes. Bacitracin and polymyxin B significantly reduced one-hour pilocarpine levels in aqueous humor; however, no significant effect was observed with either neomycin or dexamethasone. PMID- 2754297 TI - Ophthalmic epinephrine, phenylephrine, and pilocarpine affect the systemic absorption of ocularly applied timolol. AB - Ocularly applied timolol eyedrops may cause serious systemic side-effects in some patients. In this study we evaluated the effects of pretreatment with epinephrine and pilocarpine eyedrops on systemic absorption of ophthalmic timolol. Epinephrine decreased the systemic absorption of timolol, while pilocarpine increased the peak concentrations of timolol in plasma. When applied in the same solution with timolol, pilocarpine had no effect and phenylephrine decreased the systemic absorption of timolol. The observed effects were due to the conjunctival and nasal vasoconstricting effects of epinephrine and phenylephrine and to the vasodilating effects of pilocarpine. These pharmacokinetic interactions demonstrate the importance of the conjunctival and nasal blood flow in the systemic absorption of timolol. PMID- 2754298 TI - Ocular biodistribution of clonidine after topical application with ophthalmic rods or solution. AB - We compared the ocular tissue and systemic blood distribution patterns of clonidine, an alpha 2-adrenergic agonist with ocular hypotensive activity, after topical application with ophthalmic rods or ophthalmic solution (eyedrops) in rabbits. We measured tissue concentrations at 0-240 minutes after administration with rods containing 5 micrograms, 10 micrograms, or 20 micrograms clonidine, or a 0.125% (62.5 micrograms) solution. The delivery efficiency of the rods was 65 - 71%. The rods and eyedrops had similar absorption and distribution patterns intraocularly and in systemic blood. Tissue concentrations of clonidine achieved were proportional to the dose delivered; peak ocular tissue concentrations were reached within 20 minutes (except for the lens). Clonidine concentrations were: tears greater than cornea greater than iris/ciliary body greater than or equal to aqueous humor greater than lens. We concluded that the ophthalmic rod offers a viable alternative to ophthalmic solution for the topical delivery of clonidine. PMID- 2754299 TI - Sustained release of 5-fluorouracil from ethylene acetate copolymer. AB - Pharmacologic inhibition of fibroblast proliferation and scar formation remains an important consideration in many ophthalmologic surgical procedures. Such inhibition is particularly important in glaucoma filtration surgery. A sustained release system for 5-fluorouracil (5-FU) using ethylene vinyl acetate copolymer (Elvax) was characterized in vitro. 5-FU was incorporated into Elvax discs of 4 mm diameter. Discs were coated to allow sustained and predictable release over a 14 day period. Alteration of coatings, which act as rate-controlling membranes, allowed variation in the pattern of 5-FU release from the core which acts as the drug reservoir. This system for the sustained release of 5-FU may prove valuable in glaucoma surgery where the suppression of cellular proliferation is desired. The non-inflammatory nature of Elvax suggests this compound may provide an alternative means of 5-FU delivery. PMID- 2754300 TI - Ocular hypotensive activity and disposition of the topical carbonic anhydrase inhibitor 6-hydroxy-benzo[b]thiophene-2-sulfonamide, L-650,719, in the rabbit. AB - The carbonic anhydrase (C.A.) inhibitor, L-650,719 (6-hydroxy-benzo[b]thiophene-2 sulfonamide) is an advance over the corresponding 6-OH benzothiazole-2 sulfonamide in increased water solubility (4 mM) and CHCl3/buffer partition (0.05). KI vs CA is 10(-8) M. Topical treatment with 1 drop of 0.15-8% suspensions (in hydroxyethylcellulose-HEC) lowered intraocular pressure (IOP) up to 2.6 mmHg, with a plateau at 2%. Two hours after 2% treatment ocular drug distribution showed (microM or mumole/kg): cornea, 115, anterior aqueous 27, posterior aqueous 4, ciliary processes 15. Calculated inhibition of C.A. is 99.7%. IOP lowering effect disappeared at 6 hrs. L-650,719 was also given in solution (17 mM, pH 9.3). One drop every 5 min x 5 or 10 min residence on cornea of this solution produced an IOP lowering and drug distribution similar to that of the 2% suspension. Increasing HEC concentration in the single drop solution from 0 to 1%, led to a 3-fold increase in anterior aqueous drug levels and an improved delta IOP. The pressure lowering is somewhat less than achieved with parenteral sulfonamides in the rabbit. Clinical trials showed modest activity, so L-650,719 is not being developed further. It is evident, however, that sulfonamides with a variety of chemical and pharmacological properties are conducive to development for topical treatment of glaucoma. PMID- 2754301 TI - Content and biosynthesis of cortisol in aldosterone-producing adenomas. AB - The content and biosynthesis of aldosterone and cortisol were examined and compared in the aldosterone-producing adenomas and adjacent adrenal glands from patients with primary aldosteronism that resulted from solitary, benign adrenocortical tumors (0.8 to 32.3 gm). Histologic examination of the six aldosterone-producing adenomas studied confirmed a predominance of cells resembling zona fasciculata rather than zona glomerulosa, as reported in previous studies. Measurement by radioimmunoassay of the tissue content of steroids preformed in vivo demonstrated that aldosterone was present in concentrations 8 times higher in aldosterone-producing adenomas (1.5 +/- 0.5 micrograms/gm tissue; mean +/- SEM) than in adrenal glands (0.2 +/- 0.06 micrograms/gm tissue). Cortisol concentration in aldosterone-producing adenomas (5.4 +/- 1.4 micrograms/gm tissue) was approximately one third that in adrenal glands (15.8 +/ 6.3 micrograms/gm tissue), but cortisol was by far the major steroid in both types of tissue. In vitro, the most important metabolic product quantitatively from 4-carbon 14-labeled cholesterol incubated with mitochondria plus microsomes and from 4-14C-labeled pregnenolone incubated with tissue slices was cortisol, formed in a time-dependent manner in both types of preparations; cortisol synthesis greatly exceed that of aldosterone in adrenal glands, but even in aldosterone-producing adenomas the formation of cortisol was at least 5 times greater than that of aldosterone. The fasciculata structure and dual biosynthetic capacity of aldosterone producing adenomas for cortisol and aldosterone are interpreted in the light of developing concepts of the roles of adrenocorticotropic hormone and of alterations in the microenvironment of the cell in the zonal differentiation of the normal adrenal cortex.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2754302 TI - Neutrophil chemotaxis and adherence in vitro and localization in vivo in rabbits with Staphylococcus aureus abscesses. AB - Decreased neutrophil (PMN) function may contribute to an altered host defense system in hosts with bacterial abscesses but has not been well correlated to in vivo outcome. We have found that blood PMNs from rabbits with chronic (2-week) experimental Staphylococcus aureus abscesses have decreased chemotaxis in response to an S. aureus supernatant (370 +/- 130 microns migration vs 570 +/- 180 microns, p less than 0.05) and decreased adherence (11.5% +/- 13.2% vs 32.9% +/- 18.6%, p less than 0.005) compared with PMNs from animals with acute (24 hour) abscesses. No differences were found in chemokinesis, random migration, and chemotaxis in response to zymosan-activated serum. No plasma inhibitors of PMN chemotaxis or inhibitors of chemotaxins were found. Although animals with chronic abscesses had higher levels of circulating chemotaxins, in both groups of animals abscess chemotaxin levels were greater than the plasma chemotaxin level. Animals with a concomitant chronic abscess had less PMN influx into an acute abscess but also less bacterial growth within the abscess than animals without a concomitant chronic abscess. We conclude that rabbits with chronic staphylococcal abscesses have decreased chemotaxis and adherence measured in vitro and decreased PMN localization in vivo. In this model, these functions were not associated with increased bacterial proliferation in vivo. PMID- 2754303 TI - Public cholesterol screening: motivation for participation, follow-up outcome, self-knowledge, and coronary heart disease risk factor intervention. AB - We used a mailed questionnaire and telephone interviews with 1717 shopping center screenees whose total serum cholesterol was greater than 200 mg/dl. Our specific aim was to assess the subjects' motivations for participation in cholesterol screening, their follow-up outcome, their self-knowledge, and any coronary heart disease risk factor intervention. Of 1717 questionnaires mailed, 507 (30%) were returned; 64 of 100 subjects randomly selected for telephone interview could be contacted, and 61 were interviewed. Responses to the questionnaire and telephone interview were congruent, indicating little self-selection response bias. Before the cholesterol screening, 50% and 67% of questionnaire and telephone interview subjects knew their cholesterol levels. The nine most commonly cited reasons for cholesterol screening participation were: a desire to "watch" health (72%), convenience (70%), low cost (64%), to recheck previously measured total cholesterol (54%), publicity (34%), curiosity (30%), a relative with premature coronary heart disease (27%), the subjects' obesity (26%), and a relative's high cholesterol level (25%). As a result of cholesterol screening, 65% and 63% of questionnaire and telephone interview subjects, respectively, followed up with their doctors; 67% and 56%, respectively, had total cholesterol remeasured, but 17% and 18%, respectively, were told to "do nothing." At their doctors' follow up, 74% and 51% of questionnaire and telephone interview respondents, respectively, began a low-saturated fat, low-cholesterol diet; 10% and 15% started taking a cholesterol-lowering drug. As a result of cholesterol screening, 76% and 85% of questionnaire and telephone interview subjects, respectively, changed their diets; 78% and 84% lowered their dietary cholesterol intakes, 62% and 74% increased their fiber intakes, 49% and 57% tried to lose weight, and 44% and 43% increased their exercise. Of questionnaire subjects, 94% thought that by lowering cholesterol, coronary heart disease risk could be reduced; 95% had become more aware of cholesterol in the last 5 years. Of telephone interview subjects, 91% concluded that cholesterol screening had motivated them to reduce cholesterol levels. Public cholesterol screening is convenient, inexpensive, facilitates self-knowledge about cholesterol, stimulates follow-up, and motivates physician and subject-guided dietary changes to reduce cholesterol levels and coronary heart disease risk. PMID- 2754304 TI - L-triiodothyronine at a slightly over physiologic dose increases leucine flux, which suggests an increase in protein degradation in normal subjects. AB - The present study was undertaken to determine whether minor alterations of serum thyroid hormone concentration have an effect on plasma amino acid kinetics. Flux rates of 2H3-labeled leucine, 15N-labeled leucine, and 2H3-labeled alanine were determined in the basal state and after a 7-day course of L-triiodothyronine (T3) supplementation in seven normal adult subjects. A small dose of T3 was given (0.8 microgram/kg/day) that resulted in only slightly higher than physiologic serum T3 concentration. After T3 treatment, leucine carbon flux increased from 1.22 +/- 0.05 to 1.40 +/- 0.05 mumol/kg/minute (p less than 0.001) and leucine nitrogen flux increased from 2.10 +/- 0.15 to 2.48 +/- 0.14 mumol/kg/minute (p less than 0.005), but alanine carbon flux did not change significantly, going from 6.26 +/- 0.67 to 6.58 +/- 0.58 (p = not significant). Because the experiment was performed in the postabsorptive state, increased leucine flux after T3 treatment suggests accelerated protein degradation. PMID- 2754305 TI - Catecholamines in CSF, plasma, and tissue after autologous transplantation of adrenal medulla to the brain in patients with Parkinson's disease. AB - Catecholamine concentrations were measured in tissue samples of caudate and adrenal medulla in eight patients with Parkinson's disease who were taking L-dopa and were undergoing autologous transplantation of adrenal medulla to caudate nucleus. High-performance liquid chromatography with electrochemical detection was used for the measurement of analytes. Dopamine concentrations were quite similar in the caudate and the adrenal medulla; epinephrine and norepinephrine concentrations were some 600 times and 90 times higher, respectively, than that of dopamine in adrenal medulla but were barely detectable in caudate nucleus. Catecholamines and metabolites were also measured, before and after transplantation, in lumbar cerebrospinal fluid (CSF) and plasma 1 hour after the patients' first morning dose of L-dopa. The major fractions of the catecholamines in CSF were sulfoconjugated. The concentrations of sulfoconjugated but not free dopamine were modestly increased in CSF after the transplantation, although plasma concentrations were unchanged. CSF concentrations of free and conjugated norepinephrine and epinephrine, 3-methoxy-4-hydroxyphenylglycol, and homovanillic acid were unchanged after the transplantation. The data suggest that the grafted tissue does not retain its noradrenergic or adrenergic properties after transplantation, and that dopamine formation in the brain may be modestly increased. Plasma catecholamines were unaffected after the removal of one adrenal gland for the transplant. PMID- 2754306 TI - Transfusional iron overload in patients undergoing dialysis: treatment with erythropoietin and phlebotomy. AB - Five patients undergoing long-term hemodialysis with transfusional iron overload received treatment for 18 weeks with a regimen of recombinant human erythropoietin (150 U/kg) and regular phlebotomy to maintain the hematocrit value at 25% and reduce the total body iron burden. In the 149 phlebotomy sessions performed in these patients, a mean of 228 +/- 8 ml (mean +/- SEM) of whole blood was removed; it had a hematocrit value of 27.7% +/- 0.2%. The iron content of the erythrocytes removed (erythrocyte iron concentration, 787 +/- 11 micrograms/ml in 133 samples) accounted for more than 99% of the total iron removal by phlebotomy. Serum iron (serum iron concentration, 1.57 +/- 0.09 micrograms/ml in 65 samples) accounted for an insignificant fraction of the total iron removed. The iron removed at each phlebotomy session averaged 49.1 +/- 2.0 mg, similar to the amount of iron removed with deferoxamine administration in patients undergoing dialysis who had iron overload, but without the potential for adverse side effects reported with long-term deferoxamine therapy. Total iron removal during the 18 weeks of this study ranged from 732 to 2797 mg. Mean serum ferritin level decreased from 3189 +/- 1076 micrograms/L to 1676 +/- 342 micrograms/L (p less than 0.02, Wilcoxon signed rank test). When compared with a group of five patients without transfusional iron overload who received recombinant human erythropoietin and did not undergo therapeutic phlebotomy, the patients with iron overload had much greater iron losses and a larger decrease in serum ferritin levels.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2754307 TI - Amelioration of habu venom-induced glomerular lesions: potential role for platelet secretory proteins. AB - Platelets have been implicated as mediators of mesangial cell proliferation. Of interest is a potential role for platelet secretory proteins (some of which are known to be growth factors) in proliferative glomerular disease. This study examines the effect of sulindac, an inhibitor of platelet thromboxane A2 generation and platelet activation, on the development of glomerular cystic and proliferative lesions after injection of habu snake venom (HSV). To examine the association of platelet secretory proteins with glomerular lesions after HSV, antiserum against a pool of platelet secretory cationic proteins (PSCPs) was used, by immunofluorescence, as a marker of the secretory component of platelet activation in platelet-compromised and normal rats. Uninephrectomized rats received sulindac (60 mg/kg body weight) or vehicle daily before and after HSV (2 mg/kg body weight, IV). Glomerular cysts, proliferative nodules, and mixed lesions (cystic plus proliferative) were quantitated and PSCP localization was examined 48 hours after HSV. Sulindac substantially reduced the total number of glomerular lesions and preferentially reduced proliferative lesions when compared with controls. PSCPs localized in glomerular lesions in both groups and paralleled the severity of disease, but overall intensity of PSCP staining was less in sulindac-treated rats. Sulindac did not alter renal function before HSV, ruling out hemodynamic factors. The concomitant localization of PSCPs in glomerular lesions and amelioration by antiplatelet therapy supports a role for platelet secretory proteins in this model of proliferative glomerular disease. PMID- 2754308 TI - Two different balanced salt solutions. PMID- 2754309 TI - Diagnosis by gene amplification. PMID- 2754310 TI - Synchronous mycotic aneurysms secondary to tuberculosis. AB - Mycotic aneurysm secondary to Mycobacterium tuberculosis is extremely unusual. We describe a 28-year-old female patient with tuberculosis who developed synchronous mycotic aneurysms of the abdominal aorta and the innominate artery. The pathogenesis, diagnosis, and treatment of tuberculous mycotic aneurysm is reviewed. PMID- 2754311 TI - Osteoradionecrosis of the jaw bones at the University of Kentucky Medical Center. AB - There is disagreement over the management of teeth in irradiated head and neck cancer patients. Some oral surgeons support preirradiation extraction; others favor maintaining teeth. Before 1974, The University of Kentucky Department of Radiation Medicine found osteoradionecrosis (ORN) of the jaw in 10.9% of 220 irradiated cancer patients. After a program of oral care was instituted, the incidence declined to 2.7%. Of 109 patients who received radiotherapy between 1976 and 1985, only three (2.7%) developed ORN of the mandible. There was also a reduction in patients treated with interstitial therapy during this time. A review of the most recent experiences shows that, with present management methods at the University of Kentucky, ORN is not a significant problem. Of 30 patients treated in 1986, only one had ORN, and this was of the maxilla. Post-irradiation extractions were not identified as a significant risk for necrosis. Hyperbaric oxygen is used as a treatment for persistent ORN. PMID- 2754312 TI - Physician heal thyself. PMID- 2754313 TI - Diagnostic imaging of the nose and paranasal sinuses. AB - There are four principal modalities now used by the Radiologist to investigate the nose and paranasal sinuses. These are: plain X-ray, conventional tomography, computerised tomography (CT), and magnetic resonance (MR). Plain X-ray is the initial examination, and is used as a screening procedure before employing one of the tomographic techniques. Conventional pluridirectional tomography has now been superseded by CT scanning, which has the advantage of providing both good bone detail and soft tissue imaging. Since the introduction of magnetic resonance (MR), this technique has replaced CT as the optimum method of showing the extent of soft tissue tumour in the sinuses. The introduction of the paramagnetic contrast agent Gadolinium (Gd DTPA) has improved its accuracy. In the anterior fossa discrimination between cerebral oedema and tumour invasion is better shown, and in the sinuses tumour is more easily identified from retained secretion and inflamed mucosa. The best method currently available to show pathology in the nose and sinuses is a combination of GdMR and CT: the former to identify the soft tissues and the latter to show bone changes. PMID- 2754314 TI - Normal growth pattern of the middle ear cleft in the human fetus. AB - The normal growth pattern of the middle ear cleft was studied on macro- and histological sections of the human fetus. When compared with adult temporal bones, the inclination of the tympanic ring remains unaltered throughout fetal development. Expansion of the middle ear cleft is caused by intrinsic growth and by lateral displacement of its constituent elements: tympanic ring, otic capsule and squamous bone. Not only are the two mutually different modes of growth movement quite dissimilar in magnitude and direction, but so is their resultant vector for each constituent; this dissimilarity in growth movement leads to a characteristic change in shape of the middle ear cleft and to curvature of the tympanic membrane. The intrinsic growth of these elements is simultaneously accompanied by remodelling of their shape; lateral displacement of the squamous bone and tympanic ring is caused by the pressure of the enlarging brain. The consequences of developmental disturbances on the normal growth pattern are discussed. PMID- 2754315 TI - Transplanted ossicles after two decades. AB - The authors now report on the histological appearance of two very long-term ossicles, an autologous incus removed from the middle ear at revision surgery 21 years after repositioning and a homologous incus removed from the middle ear after 20 years. Having been placed in formalin immediately after removal from the ear, both specimens were later decalcified by ethylene diamine tetra-acetic acid, embedded in paraffin wax, serially sectioned and stained with haematoxylin and eosin. PMID- 2754316 TI - Recurrent meningitis in children due to inner ear abnormalities. AB - Recurrent meningitis in children is not only a potentially life threatening condition, but often involves the child in the trauma of repeated hospital admissions and multiple and invasive investigations to try and find an underlying cause. Symptoms and signs of CSF rhinorrhoea or otorrhoea are infrequent in these patients. Unilateral deafness may be difficult to diagnose in the young child. Full ENT examination may be normal. We report seven cases of children with recurrent meningitis in whom inner ear abnormalities were only indicated as the site of entry of infection by hypocycloidal tomography or high resolution CT scanning of the temporal bone. Subsequent tympanotomy confirmed the site of the CSF leak as the oval window in the majority of cases; packing the vestibule with muscle halted further attacks in these patients. PMID- 2754317 TI - A system for accelerated provision of hearing aids to residents of homes for the elderly. AB - A study was undertaken to detect undiagnosed deafness in elderly people, living in Part III Residential Homes in North Tees, South Tees and Hartlepool Health Districts, to provide hearing aids and to estimate the subsequent success in rehabilitation. The residents were referred by the senior staff in the homes and assessed by a doctor and audiology technician in a domiciliary setting. Those found to have a significant hearing impairment were prescribed hearing aids without formal pure tone audiometry. A pilot study compared the method of hearing evaluation employed with such conventional testing. Six months after fitting, the degree of compliance with aiding was assessed. The results show a significant level of undiagnosed deafness in the community and, with this method of provision, an acceptance rate of 41.2 per cent of those recommended for aiding at six months which is higher than suggested by previous similar studies of this population. PMID- 2754318 TI - Nasal myiasis: review of 10 years experience. AB - Nasal myiasis is a manifestation of the nasal cavities by larvae of the fly of genus Chrysomia. It is prevalent in tropical countries. Atrophic rhinitis is the most commonest predisposing factor for this condition. The maggots can cause extensive erosion of the nose, face and intra-cranial structures occasionally causing meningitis and death. Conservative management by packing the nose with a chloroform and turpentine (1:4) mixture followed by manual removal of the dead maggots is an effective method. Recurrence is known but partial closure of both nostrils to improve the condition of nasal mucosa is the important part of management. PMID- 2754319 TI - Endoscopic transnasal surgery in chronic maxillary sinusitis. AB - The treatment of chronic maxillary sinusitis aims at the re-establishment of proper aeration and drainage of the antrum. Middle meatal antrostomy offers ventilation and clearance of the antrum and has anatomical, physiological, physical and pathological basis. This work included 66 cases of chronic maxillary sinusitis, for whom 94 operations of endoscopic middle meatal antrostomy were performed (38 unilateral and 28 bilateral procedures). Any associated anatomical variations and/or pathological abnormalities at the ostiomeatal area were dealt with. Follow-up of these cases for periods ranging from four to 12 months showed that 95.5 per cent of the cases experienced subjective improvement. Endoscopically 96.8 per cent of the antrostomies were patent and 94.7 per cent of the maxillary sinuses were clear and regained healthy mucosa. The author concluded that middle meatal antrostomy, when done endoscopically, is a safe procedure with good results. PMID- 2754320 TI - Antroscopic study of the maxillary antrum in lepromatous leprosy. AB - The technique of antroscopy affords an accurate assessment of chronic sinus disease. It was performed in twelve patients suffering from lepromatous leprosy in order to determine the type, nature and site of the lesion. Antral involvement with lepromatous leprosy may begin with a localized area of erythema progressing to granuloma formation or ulceration. The antero-inferior part of the antrum is the most commonly affected site. PMID- 2754321 TI - Subtotal laryngectomy with myomucosal shunt. AB - This is a modified subtotal laryngectomy. On the tumour-free side of the larynx, some posterior structures, with their neurovascular supply are preserved. The endolaryngeal mucosa is tubed in continuity with the trachea below and projects into the pharynx above. Thus a myomucosal shunt is formed. Air is directed into it by finger occlusion of the tracheal stoma. The voice production is highly satisfactory. Aspiration is prevented by constriction of the thyroarytenoid muscle which provides a valved upper end of the tube. The possibility of leaving tumour in the laryngeal remnant is eliminated by careful selection of patients, and re-confirmation of tumour extent intra-operatively and a frozen section. Eleven such operations have been performed since October 1983 for squamous cell carcinoma, some previously irradiated. None of the patients had local recurrence. Only one had an aspiration problem which later resolved. All acquired a satisfactory voice. PMID- 2754322 TI - Late onset Cogan's syndrome. AB - Previous reports describe Cogan's syndrome occurring in young adults this case shows that it can be diagnosed in an older patient, and that prompt treatment is often successful, making it a worthwhile diagnosis to consider in patients with sudden hearing loss. The erythrocyte sedimentation rate was a useful marker for disease activity in this patient. PMID- 2754323 TI - Recovery from sensorineural deafness in Wegener's granulomatosis. AB - Wegener's granulomatosis may present with deafness or other aural symptoms. This report describes two patients with histological evidence of Wegener's granulomatosis who developed reversible sensorineural hearing loss during the course of their illness. The first patient showed complete recovery of a sensorineural hearing loss averaging 50 dB after ten months treatment with cyclophosphamide and high-dose prednisolone. The second patient, who was on maintenance haemodialysis, achieved a 40 dB improvement in sensorineural hearing loss within two weeks of adding cyclophosphamide to pre-existing corticosteroid therapy. These findings suggest that the prognosis of sensorineural hearing loss in Wegener's granulomatosis can be improved with suppression of the vasculitic process by early treatment with combined cytotoxic-immunosuppressive therapy. PMID- 2754324 TI - Wegener's granulomatosis: false positive anti-neutrophil cytoplasmic antibody test. AB - The anti-neutrophil cytoplasmic antibody (A.N.C.A.) test is a solid phase radioimmunoassay which detects auto-antibodies specific for Wegener's granulomatosis. The case of a young male is reported with a nasal septal perforation who was extensively investigated revealing no other clinical features, apart from a positive A.N.C.A. test, warranting a diagnosis of Wegener's granulomatosis. It is felt the case represents a false positive A.N.C.A. test and emphasises that the test, whilst useful, should be interpreted in the context of other diagnostic criteria. PMID- 2754325 TI - Isolated sphenoiditis: a diagnostic problem. AB - A case of primary isolated sphenoiditis that developed cavernous sinus thrombosis is presented. It is difficult to diagnose and patients are often not seen initially by an ENT surgeon, making it more important for other branches of medicine to be aware of this condition. We discuss isolated sphenoiditis with particular reference to the diagnosis, management and complications of this condition. PMID- 2754326 TI - Transitional type papilloma of the nasopharynx. AB - A case of transitional-type papilloma arising in the nasopharynx is reported. The various theories for the aetiology of the condition are considered in the light of this finding. PMID- 2754327 TI - Spontaneous perforation of cervical oesophagus associated with oesophageal web. AB - A case is described, of a patient who sustained a spontaneous perforation of the cervical oesophagus in association with a congenital oesophageal web. PMID- 2754328 TI - Intrahyoid thyroglossal cyst. AB - A rare case of an intrahyoid thyroglossal duct cyst in a 63-year-old woman is reported. The pertinent literature is discussed. PMID- 2754329 TI - View from within--radiology in focus. Bilateral carotid body tumours. PMID- 2754330 TI - View from beneath--pathology in focus. Primary intracranial mesenchymal chondrosarcoma. PMID- 2754331 TI - Radiological help? PMID- 2754332 TI - Bovine gallbladder mucin promotes cholesterol crystal nucleation from cholesterol transporting vesicles in supersaturated model bile. AB - This study examined the ability of purified gallbladder mucin to accelerate the nucleation of cholesterol monohydrate crystals from the cholesterol-transporting particles in supersaturated model bile. Mixed lipid micelles and cholesterol phosphatidylcholine vesicles in supersaturated model bile were separated by Sephadex G-200 column chromatography. Mixed lipid micelles prepared by column chromatography had a low cholesterol-phosphatidylcholine ratio (0.30) and did not spontaneously nucleate cholesterol monohydrate crystals. In contrast, vesicles prepared by column chromatography had a cholesterol-phosphatidylcholine ratio of 1.00 and nucleated cholesterol crystals rapidly (P less than 0.001). Nucleation of cholesterol crystals was significantly accelerated in a concentration- and time-dependent manner by purified bovine gallbladder mucin in cholesterol containing vesicles, but not in mixed lipid micelles (P less than 0.001). A rapid filtration binding assay demonstrated significant binding of cholesterol and phosphatidylcholine in vesicles to gallbladder mucin but only minimal binding of cholesterol and phosphatidylcholine in mixed micelles. These data indicate that gallbladder mucin binds cholesterol and phosphatidylcholine in vesicles and accelerates the nucleation of cholesterol monohydrate crystals from these cholesterol-transporting particles in supersaturated model bile. PMID- 2754333 TI - Nitrosylated high density lipoprotein is recognized by a scavenger receptor in rat liver. AB - In order to assess the presence of specific recognition sites for high density lipoprotein (HDL) in vivo, HDL was nitrosylated with tetranitromethane and the decay and liver uptake were compared with that of native HDL. The association of intravenously injected nitrosylated HDL (TNM-HDL) with liver was greatly increased as compared to native HDL. Using a cold cell isolation method, it became evident that the liver endothelial cells were responsible for the increased uptake of the modified HDL. The involvement of the endothelial cells in the uptake of TNM-HDL from the circulation could also be demonstrated morphologically by using the fluorescent dye dioctadecyl-tetramethyl indocarbocyanine perchlorate (Dil) to label HDL. In vitro competition studies with isolated liver endothelial cells indicated that unlabeled modified HDL and acetylated LDL displaced iodine-labeled TNM-HDL, while no competition was seen with LDL and a slight displacement was seen with unlabeled native HDL. Nonlipoprotein competitors of the scavenger receptor such as fucoidin and polyinosinic acid blocked the interaction of TNM-HDL with the liver endothelial cells. Also the degradation of TNM-HDL was blocked by low concentrations of chloroquine. It can be concluded that a scavenger receptor on liver endothelial cells is involved in the clearance of tetranitromethane-modified HDL, which excludes the possibility of using TNM-HDL in vivo to assess the non-receptor dependent uptake of HDL. The use of nitrosylated HDL in vitro as a low affinity control is limited to cell types that do not possess scavenger receptors, because cell types with scavenger receptors will recognize and internalize TNM-HDL by a high affinity scavenger pathway. PMID- 2754334 TI - Bile acid sulfotransferase I from rat liver sulfates bile acids and 3-hydroxy steroids: purification, N-terminal amino acid sequence, and kinetic properties. AB - A bile acid:3'phosphoadenosine-5'phosphosulfate:sulfotransferase (BAST I) from adult female rat liver cytosol has been purified 157-fold by a two-step isolation procedure. The N-terminal amino acid sequence of the 30,000 subunit has been determined for the first 35 residues. The Vmax of purified BAST I is 18.7 nmol/min per mg protein with N-(3-hydroxy-5 beta-cholanoyl)glycine (glycolithocholic acid) as substrate, comparable to that of the corresponding purified human BAST (Chen, L-J., and I. H. Segel, 1985. Arch. Biochem. Biophys. 241: 371-379). BAST I activity has a broad pH optimum from 5.5-7.5. Although maximum activity occurs with 5 mM MgCl2, Mg2+ is not essential for BAST I activity. The greatest sulfotransferase activity and the highest substrate affinity is observed with bile acids or steroids that have a steroid nucleus containing a 3 beta-hydroxy group and a 5-6 double bond or a trans A-B ring junction. These substrates have normal hyperbolic initial velocity curves with substrate inhibition occurring above 5 microM. Of the saturated 5 beta-bile acids, those with a single 3-hydroxy group are the most active. The addition of a second hydroxy group at the 6- or 7-position eliminates more than 99% of the activity. In contrast, 3 alpha,12 alpha-dihydroxy-5 beta-cholan-24-oic acid (deoxycholic acid) is an excellent substrate. The initial velocity curves for glycolithocholic and deoxycholic acid conjugates are sigmoidal rather than hyperbolic, suggestive of an allosteric effect. Maximum activity is observed at 80 microM for glycolithocholic acid. All substrates, bile acids and steroids, are inhibited by the 5 beta-bile acid, 3-keto-5 beta-cholanoic acid. The data suggest that BAST I is the same protein as hydrosteroid sulfotransferase 2 (Marcus, C. J., et al. 1980. Anal. Biochem. 107: 296-304). PMID- 2754335 TI - Identification of (22R)-3 alpha,7 alpha,12 alpha,22- and (23R)-3 alpha,7 alpha,12 alpha,23-tetrahydroxy-5 beta-cholestanoic acids in urine from a patient with Zellweger's syndrome. AB - The nature of two novel C27 bile acids present as the taurine conjugates in urine from a patient with Zellweger's syndrome was studied. Bile acids conjugated with taurine were isolated from unconjugated and glycine-conjugated bile acids by means of ion-exchange chromatography. After alkaline hydrolysis of the taurine conjugates, the hydrolysate was acidified and extracted with ether; the extract was again subjected to ion-exchange chromatography to separate neutral from acidic compounds. The neutral fraction, which consisted mainly of two steroidal lactones, was treated with lithium aluminum hydride, and the reduction products were identified as (22R)-5 beta-cholestane-3 alpha,7 alpha,12 alpha,22,26-pentol and (23R)-5 beta-cholestane-3 alpha,7 alpha,12 alpha,23,26-pentol by direct comparison of their gas-liquid chromatographic behaviors and mass spectral data with those of chemically synthesized authentic samples. Thus, the chemical structure of two native bile acids present in urine from a patient with Zellweger's syndrome should be formulated as (22R)-3 alpha,7 alpha,12 alpha,22 tetrahydroxy-5 beta-cholestanoic acid and (23R)-3 alpha,7 alpha,12 alpha,12 alpha,23-tetrahydroxy-5 beta-cholestanoic acid, respectively. PMID- 2754336 TI - Interaction of aging and dietary fat in the regulation of low density lipoprotein transport in the hamster. AB - These studies were undertaken to examine the effect of aging on low density lipoprotein (LDL) metabolism in the male hamster. When the hamsters were maintained on a low-cholesterol, low-triglyceride diet, rates of LDL transport in the various tissues of the body and plasma LDL-cholesterol concentrations remained constant over the entire life span (1-24 months) of the hamster. In contrast, rates of de novo cholesterol synthesis fell 50-97% in the various tissues of the body during the transition from rapid body growth in the young animal to the stable adult size. Thus, changes in tissue requirements for cholesterol over the life span of these animals were met by an appropriate adjustment in the rate of de novo synthesis rather than by alterations in LDL transport. When animals were fed a diet enriched in cholesterol and saturated triglycerides, rates of LDL production increased, total body LDL receptor activity was suppressed, and plasma LDL-cholesterol levels rose. Older animals, however, were not more susceptible than young animals to the detrimental effects of these dietary fats. These studies support the view that aging per se has not effect on LDL transport by the liver or other tissues. Rather, the progressive rise in plasma LDL-cholesterol levels seen in Western man is likely due to the consumption of a diet enriched in cholesterol and saturated triglyceride which increases the LDL-cholesterol production rate and suppresses receptor-dependent LDL transport. PMID- 2754337 TI - In vitro study of the action of adipokinetic hormone in locusts. AB - The in vitro study was performed in order to demonstrate the structural changes of lipophorin induced in vivo by the injection of adipokinetic hormone (AKH) into adult locusts. After many unsuccessful attempts, we have established the reconstructed incubation system in which purified lipophorin and apolipophorin III (9 mol/mol lipophorin) are incubated with the fat body in the presence of AKH under a supply of excess oxygen. In this system, high density lipophorin (HDLp) originally present in the incubation medium can be transformed entirely into low density lipophorin (LDLp) due to the loading of an increased amount of diacylglycerol from the fat body. The LDLp formed in this incubation system was exactly the same as the LDLp formed in vivo by the injection of AKH, in terms of density, particle size, diacylglycerol content, and the association with apolipophorin-III (apoLp-III). In the absence of apoLp-III, AKH did not exhibit its function to any extent. It was also demonstrated that the transformation of HDLp to LDLp requires calcium ions. Moreover, it appears that, up to a certain limit, the increase of diacylglycerol content of lipophorin and the amount of apoLp-III associated with lipophorin is nearly proportional to the amount of apoLp-III added to the incubation medium. PMID- 2754338 TI - Effect of tumor necrosis factor administration in vivo on lipoprotein lipase activity in various tissues of the rat. AB - When added to murine adipocytes in culture, tumor necrosis factor (TNF) decreases the levels of lipoprotein lipase (LPL). Semb et al (1987. J. Biol Chem. 262: 8390 8394) have shown that administration of murine TNF to rats decreases lipoprotein lipase (LPL) in the epididymal fat pad with maximal inhibition requiring several hours. We have now tested the effects of treatment of rats with TNF on LPL activity in a variety of tissues and find that few show decreases in LPL under conditions that acutely increase serum triglycerides. Ninety minutes after treatment of male rats with human TNF (25 micrograms/200 g, i.v.), serum triglycerides rose 2.2-fold but there was no decrease in LPL activity in epididymal fat. Sixteen hours after TNF treatment LPL activity had decreased by 44% in epididymal fat, consistent with the previously reported data. In contrast, in female rats, no significant decrease was seen in LPL activity in parametrial adipose tissue at either 90 min or 16 hr after TNF administration despite increases in serum triglycerides (1.8-fold and 1.5-fold, respectively). There was little change in LPL activity in most other adipose tissue sites of male or female rats at either time after TNF treatment. No effect of TNF was seen on heart or diaphragm muscle LPL at any time. TNF treatment of both male and female rats produces consistent increases in de novo hepatic lipogenesis in vivo under conditions that increase serum triglycerides. It is unlikely that the limited effects of TNF on LPL in vivo can account for the rapid and sustained increase in serum triglycerides. PMID- 2754339 TI - A potential complication in the use of monoclonal antibodies: inhibition of apoB mediated receptor binding by an anti-apoE antibody. AB - Monoclonal antibody (Mab) 1D7 is specific for human apolipoprotein (apo) E and blocks binding of lipid-associated apoE to the low density lipoprotein (LDL) receptor. We report here that 1D7 can also block the binding of apoE-free LDL to the LDL receptor. The inhibition of LDL-receptor binding is not due to immunological cross-reactivity between the anti-apoE Mab and apoB, the ligand responsible for the interaction of LDL with the LDL receptor: 1) Mab 1D7 did not react with apoE-depleted LDL; 2) the LDL receptor binding inhibitory activity of 1D7 immunoglobulin G (IgG) preparations could be dissociated from the anti-apoE activity; 3) the inhibition was maintained when the fibroblasts were preincubated with the 1D7 IgG, extensively washed, and only then exposed to 125I-labeled LDL. Rather, it appears that 1D7 recognizes mouse apoE, that mouse apoE-1D7 immune complexes contaminate 1D7 IgG preparations and that the contaminating mouse apoE can compete with 125I-labeled LDL for the LDL receptor. We have demonstrated mouse apoE in IgG preparations of 1D7 but not in those of other anti-apoE Mabs that do not influence LDL-receptor binding. Precipitation of 1D7 IgG with NH4SO4 eliminates both apoE and the capacity of 1D7 to block LDL receptor binding. Finally, mouse apoE can be isolated by immunoaffinity chromatography of mouse serum on immobilized 1D7 Mab. As this is probably not a unique case, the observation has important implications for the use of Mabs as structural probes. PMID- 2754340 TI - Determination of phosphatidylcholine and disaturated phosphatidylcholine content in lung surfactant by high performance liquid chromatography. AB - A rapid isocratic method for determining the total phosphatidylcholine and disaturated phosphatidylcholine levels in lung surfactant preparations by high performance liquid chromatography (HPLC) is described. The analysis was performed on a 3.9 x 300 mm mu-Porasil column with detection by refractive index. The lipids were eluted with a solvent system of chloroform-acetonitrile-methanol water-85% phosphoric acid 650:650:500:130:2 (v/v/v/v/v). A 4.6 x 30 mm silica guard column was used in place of an injector loop which served as a sample concentrator and purifier. Phosphatidylinositol, phosphatidylserine, phosphatidylethanolamine, and phosphatidylglycerol, all known components of lung surfactants, were eluted from the loop column and were prevented from reaching the analytical column. Sphingomyelin and lysophosphatidylcholine elute later than the phosphatidylcholines on the analytical column. The method was developed so that phosphatidylcholines elute as a single peak regardless of the fatty acid chain length (C12-C20). When the sample was first oxidized with a potassium permanganate-potassium metaperiodate solution, and potentially interfering oxidation products were removed by extraction into a basic aqueous phase, then only the disaturated phosphatidylcholines were analyzed. PMID- 2754341 TI - A facile enzymatic synthesis of sphingosine-1-phosphate and dihydrosphingosine-1 phosphate. AB - A procedure is described to prepare sphingosine-1-phosphate by treatment of sphingosylphosphocholine with phospholipase D, isolated from Streptomyces chromofuscus. The phosphorylated long chain bases were purified by selective precipitation and differential extraction. Milligram quantities can be obtained in a yield of about 70%. Application of the procedure to dihydrosphingosylphosphocholine results in the synthesis of dihydrosphingosine-1 phosphate. PMID- 2754342 TI - Separation of derivatized glycosphingolipids into individual molecular species by high performance liquid chromatography. AB - The high performance liquid chromatography separation of the perbenzoyl derivatives of the neutral glycosphingolipids (GlcCer, LacCer, GbOse3Cer, GbOse4Cer, and GgOse3Cer) and the p-bromophenacyl and 2,4-dinitrophenyl hydrazide derivatives of the gangliosides (GM4, GM3, GM2, GM1, GD1a) into individual molecular species on a C18 reversed-phase column is described. Peaks were identified by comparing their relative retention times to the relative retention time of the corresponding glycosphingolipid of known molecular species composition. As little as 5 to 10 pmol of each molecular species of neutral glycosphingolipids and 3 to 5 pmol of the gangliosides can be detected. The effects of changes in the proportion of acetonitrile, methanol, and water in the mobile phase and of column temperature on the molecular species separation are described. A procedure for the tentative identification of glycosphingolipid molecular species based on their relative retention times is presented. PMID- 2754343 TI - A spectrophotometric assay for lipid peroxides in serum lipoproteins using a commercially available reagent. AB - A method is described for measuring lipid peroxides by means of the color reagent of a commercially available test kit for cholesterol estimation. In principle, this assay makes use of the oxidative capacity of lipid peroxides to convert iodide to iodine, which can be measured photometrically at 365 nm. Calibration curves were obtained using peroxides such as H2O2, t-butyl hydroperoxide, and cumene hydroperoxide. A stoichiometric relationship was observed between the amount of organic peroxides assayed and the concentration of iodine produced. Concentrations of lipid peroxides as small as 1 nmol/ml could be measured. The ability to estimate lipid peroxides of isolated low density lipoprotein was demonstrated. PMID- 2754344 TI - [Venous hemodynamics. Basic equations]. AB - The hydrodynamics in tubes with inert walls collapsed by a negative transmural pressure (inside pressure minus outside pressure) set up a fundamental and original approach in venous hemodynamics. Mechanisms of flow regulation and flow limitation can occur especially when the upstream pressure is held constant or when the average flow speed in a cross-section equals the local speed of the pressure waves. Three baseline equations on mechanics are required to demonstrate these properties: the tube law, the equation of motion, the equation of continuity. It is shown that the behaviour of the tube varies with the nature of the flow (subcritical, critical or super-critical, subsonic, sonic or supersonic, according to the aerodynamics). Though this study does not take all the physiological and biological data into account, it includes indeed the three fundamental aspects on mechanics of the veins. The rheologic equation on the state of the venous wall, normal or pathologic, plays a major and determinant role. PMID- 2754345 TI - [Rheologic particulars of venous flow. Physiopathologic consequences]. AB - Hemorheological parameters must be taken into account for a better knowledge of venous flow properties. The postcapillary venules are the region of lowest shear rates and therefore the region of highest whole blood viscosity. Red cell aggregation plays a major role in blood viscosity, especially at low shear rate. This microrheological parameter can be increased in pathological circumstances, including a low capillary flow, venular insufficiency, elevated hematocrit, high levels of acute phase proteins. At the level of the capillaries, microcirculatory stasis leads to a low oxygen supply and consequently to poor metabolic state lowering local ATP levels. As a result, both platelet and white blood cell functions are compromised. Hemorheological studies have shown that both deep venous thrombosis and chronic venous insufficiency are associated with high blood viscosity mainly due to an increased red cell aggregation. This hemorheological vicious circle--stasis promoting hyperviscosity leading to further stasis--could be broken up by therapeutic intervention including hemodilution, fibrinolytic drugs or other specific agents. PMID- 2754346 TI - [Impotence of vascular origin]. AB - Between 1977 and 1986, 3,500 patients were examined for the symptom of impotence; 1,250 of them received multidisciplinary investigation permitting the diagnosis of a pure organic or mixed disorder in 85% of cases, including 62% of vascular disease subdivided into arterial (40%) and venous (22%). For 1,062 patients, 1 or several of the following therapies were used: intracavernous infusion of vasoactive drugs (N = 725), auto-injections (N = 235), vascular surgery (N = 357) and prostheses (N = 23). The diagnostic approach, formerly analytical and making use of multiple non-invasive methods, such as nocturnal erection plethysmography (NPT) and invasive methods (artificial erection, arteriography) have been transformed by the use of pharmacological tests associated with visual sexual stimulation (VSS) which enable, together with Doppler velocimetric examination, simple screening of vascular impotence based on the study of 4 parameters: penile pressure index (PPI) when less than 0.91 is always a sign of an arterial problem, the severity of which is directly proportional to the lowering of this index and the association with maintenance insufficiency; the initial intracavernous flow rate (IICF) depends overall on the maintenance flow and the state of erectile tissue, resulting from pharmacological stimulation by a low dose of papaverine (8 mg); penile rigidity attained by the combined action of pharmacological and visual sexual stimulation, reflecting the functional erectile capacity; the duration of the rigidity thus obtained on stoppage of VSS indicating the capacity for maintenance of erection. In the event of suspicion of an isolated venous leak or in association with arterial problems, it is the artificial erection with cavernosography, carried out after pharmacological stimulation, which enables the severity of the leak to be assessed. The following specific investigations are carried out to investigate a specific associated etiology: electromyogram for neurological disorders, hormone assay for endocrine disorders and psychological study using the MMPI questionnaire (Multiphasic Minnesota Personality Inventory). One can thus distinguish several groups of patients suffering from vascular impotence depending on the degree of arterial involvement: minor (PPI between 0.75 and 0.9), moderate (PPI between 0.65 and 0.75) and severe (PPI less than 0.65); depending on the degree of venous leaking: absent (MI less than 0.3 and/or MF less than 25 ml/min), minor (MI between 0.3 and 0.5 and MF between 30 and 50 ml/min), moderate (MI between 0.5 and 75 ml/min) and severe (MI greater than 0.75 and/or MF greater than 75 ml/mn).(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2754347 TI - [Holter erectometry. A new approach to erectile disorders]. AB - A Holter-type portable computerised electronic system for measurement of the apparent volume of the penis, eye movements and heart rate over 12 hours, enables investigation of erectile disorders by the patient himself, under more physiological conditions at home. Data processing and ease of use will permit scientific use on a large scale. PMID- 2754348 TI - [Impotence in a urologic service]. AB - In a recent experience we have studied 297 patients for impotence. 102 were considered psychogenic and 195 organic; 105 of the latter had isolated or associated arterial or venous lesions. The remaining 81 patients had preponderant organic pathology: Peyronie's disease, neurological disease, diabetes and pelvic trauma. All patients were explored by NPT (nocturnal penile tumescence), Doppler examination, intra-cavernous papaverine test, angiography and erectile flow associated with cavernography. We report our microvascular surgery results from the last seven years. 80 reconstructive vascular procedures were performed on a population of patients who averaged 50 years of age. 50 epigastric-cavernous by passes were performed. Complete recovery has been observed in 14% with an average of 42 months follow-up. Erection improvement with possibility of vaginal intromission in 58%. Immediate or secondary thrombosis and priapism in 28%. 21 arterial epigastric-dorsal unilateral by-passes were performed with an average follow-up of 20 months. In 11 cases the arterial micro-revascularization was associated with deep dorsal vein ligature. Results are as follows: 10 excellent, 4 significant improvement, 3 failures and too short follow-up in three. 9 isolated venous ligature with a mean follow-up of 15 months. Complete recovery was observed in 3 patients, improvement in 3 and failure in 2. The author emphasizes the interest of a better selection of surgical indications, improvement of microsurgical techniques with epigastric-dorsal anastomosis associated with postoperative anticoagulant therapy whenever possible. PMID- 2754349 TI - [Impotence in the diabetic]. AB - Two-hundred-and-two impotent diabetic patients gave their consent to be investigated. Impotence is linked to diabetes mellitus in 58.9% of patients so all the other etiologies have to be systematically eliminated. Neuropathy or arteriopathy, when isolated, are found with the same frequency, but these 2 etiologies are often associated (47 patients). No statistical difference between IDDM and NIDDM was found. Mercury strain gauge plethysmography and venous occlusion coupled to ECG allows detection of arterial lesions in diabetic impotence. Patients agreed to submit to all of the various therapeutic possibilities. Combination of alpha-blockade and good glycemic control induced the best results. PMID- 2754350 TI - [Definition and treatment of patients with venous leakage]. PMID- 2754351 TI - [Treatment of the unstable erection syndrome caused by venous leakage. Preliminary study]. PMID- 2754352 TI - [Procedure to follow with a resistant venous ulcer of the ankle]. AB - In this study the authors present details of the clinical and paraclinical examination, in particular, examination of vascular function, which enable identification of the reasons why a venous ulcer on the lower leg fails to heal or recurs despite the usual treatment. Two important possibilities are stressed: 1. Progressive aggravation of the causal venous insufficiency, in which incompetence of calf perforators plays a fundamental role in both varicose veins and phlebitis. 2. Combination of venous insufficiency with a loco-regional or general factor, which contributes to trophic tissue deterioration. It is, thus, at a loco-regional level that ankle stiffness, major sub-ulcer sclerosis with possibility of formation of calcified plaques, lymphatic stasis and exceptionally malignant degeneration should be systematically investigated. It is necessary to act effectively on the various associated factors in order that treatment of the venous insufficiency responsible for the ulcer may succeed in spontaneous healing or allow successful grafting. However, the most important occurrence in the event of resistant ulceration is due to a combination, in patients over 60 years, of arterial insufficiency and venous insufficiency of variable duration. This is the context of mixed ulceration, in which treatment of both etiological factors must be modulated as a function of good identification of concomitant venous and arterial lesions. PMID- 2754353 TI - [The motor structures responsible for venous flow]. AB - There are numerous forces which propel the blood within the veins: --At tissue venule level the residual arteriolar pressure especially intervenes. --At peripheral vein level, the dominant forces are those which lower the transmural pressure, either by decreasing intravascular pressure (gravity, aspiration from neighbouring veins), or by increasing the extravascular pressure creating a compression effect by squeezing of the flexible vessel between muscles and a rigid aponeurosis. --At central vein level, the principal role is ensured by the thoraco-abdominal mechanics, whereby contraction of the diaphragm produces compression and aspiration. The right heart intervenes, when required, and directs blood towards the pulmonary circulation. The result of the simultaneous, successive application of these forces, differs depending on the organ. In addition, the flexibility of the vessel varies according to neuro-hormonal control. Finally, the rheological properties of the fluid and the degree of backflow must be taken into account. Thus, one gets a double flow (hydraulic transfer, propagated waves) which varies according to requirements. The energy expenditure due to flow is a function of the characteristics and volume of the liquid displaced. The complexity of such a flow has the advantage of adaptability but the inconvenience of fragility. PMID- 2754354 TI - [Round table: Recent advances in the risk determination, diagnosis and treatment of deep venous thromboses of the legs. Meeting of the French Society of Phlebology and the 22d meeting of the French College of Vascular Pathology. Paris, 18 March 1989]. PMID- 2754355 TI - [Complications of postoperative systematic preventive anticoagulant treatment]. AB - In a series of 887 cases who underwent visceral, orthopedic or vascular surgery and who received systematic post-operative prophylactic anticoagulant treatment (calciparine S.C. or in 4.8% of cases low dose heparin IV), the author reports 31 accidents (3.5%). These included 9 thromboembolic disorders with 2 deaths (0.45%) due to pulmonary embolism, 19 hemorrhagic episodes (2.14%) with 2 deaths, and 3 cases of intolerance to heparin (0.34%): 2 cases of uncomplicated thrombocytopenia and 1 case of white clot successfully treated surgically. In spite of the good results obtained as far as prevention of thromboembolic disease is concerned, this study confirms the significant frequency and severity of iatrogenic accidents. These may be reduced partly by greater care in the prescription and execution of this treatment, but it is impossible to completely avoid them; it is therefore desirable in certain cases to avoid systematic prophylactic treatment by using other first line methods such as early mobilisation, elastic contention, hemodilution or indeed in certain cases the insertion of a vena cava filter. Moreover, in 11 out of 19 patients who presented a hemorrhagic complication of heparin therapy, the insertion of such a filter was judged indispensable in order to avoid possible pulmonary embolism favored by stoppage of anticoagulant treatment. PMID- 2754356 TI - [Pitfalls in phlebography]. AB - Despite the progress in functional investigation procedures, phlebography remains the standard test in venous disease of the lower extremities. The development of better quality contrast media has significantly improved patients tolerance. After a review of the regular, routine procedure, the authors stress the technic's pitfalls. Uncomplicated pitfalls are air bubbles, Venturi's effect, venous malformations, and superimposed venous axes or gases. This type of problems is easily circumvented. Flow images caused by confluent axes of high flow veins (internal iliac veins, renal veins) or layer courants (gutter effect) are presented as a reminder. Compression images are often more treacherous: related to normal veins: compression of left iliac vein by aortic junction; of inferior vena cava by enlarged aorta or by osteophyte; tourniquet too low, iliac vein compressed by a dilated bladder; or compression due to intramuscular hematoma,... related to pathological veins: to be mentioned are bridle-caused obstruction of the popliteal vein (Klippel-Trenaunay syndrome), and retroperitoneal fibrosis. Although the present description of phlebography related pitfalls is neither new, nor exhaustive, it should be reconsidered, as phlebography of the lower limbs, while being currently better tolerated, is still an update technic that needs to be rendered more reliable. PMID- 2754357 TI - [Long-term heparinotherapy in the treatment of acute venous thromboses]. AB - This is a retrospective analytical study of the results of prolonged heparin therapy: 4 to 6 days for calf phlebitis--10 days for phlebitis reaching the level of the inguinal ligament with in both cases subcutaneous heparin injections for a further 1 to 2 months. Monitoring venography was carried out and demonstrated evidence of a lytic effect on the clot but not in all cases. In 33 cases control venography demonstrated that 2 groups of patients could be distinguished. In the first group, plethysmographic parameters were rapidly normalized (probably corresponding to lysis of the clot). In the second group, there was a slow and progressive improvement in these parameters (probably corresponding to the development of collateral circulation). The persistence of plethysmographic signs of venous stasis in certain patients constitutes an argument in favor of the maintenance of heparin therapy until an almost normal venous emptying index is established. PMID- 2754358 TI - A function for ovarian oxytocin. PMID- 2754359 TI - Somatotrophin increases thyroxine-5'-monodeiodinase activity in lactating mammary tissue of the cow. AB - The effect of administration of bovine somatotrophin (bST) on peripheral conversion of thyroxine (T4) to tri-iodothyronine (T3) was studied in non pregnant lactating Holstein cows. Six cows were injected daily for 5 days with 40 mg recombinantly derived bST, while six control cows received excipient alone. Blood samples were collected hourly from 08.00 to 19.00 h on a single day the week before treatment and on days 4-5 of treatment. All other tissue samples were obtained at slaughter, 20-23 h after the last injection. Administration of bST increased milk production and caused a 9% increase in hepatic DNA. Consumption of feed did not differ between control and bST-treated cows. Treatment did not alter serum concentrations of T4 or T3, although concentrations of thyroid hormones in the serum increased from 08.00 to 19.00 h. Activity of thyroxine-5' monodeiodinase (5'-D) in liver and kidney was similarly unaffected. However, activity of 5'-D in mammary tissue increased approximately twofold in response to bST administration. We suggest that an increase in mammary conversion of T4 to the more biologically potent thyroid hormone T3 plays a role in mediating the galactopoietic response of dairy cattle to bST. PMID- 2754360 TI - Seizure-induced delay of puberty in female rats: effects of age, stress and opioid antagonists. AB - We have shown that pre- and post-pubertal female rats are sensitive to seizures. For example, daily convulsions commencing at 24 days of age delay puberty. Here we examine the effect of seizures at various ages. In addition, because opioid peptides are implicated in regulating the onset of puberty and are activated by convulsions, we also investigate the effect of opioid antagonists in the seizure induced delay of puberty. A single daily electroconvulsive shock (ECS) was given for 10 days to neonatal (days 2-11), infantile (days 15-24) and juvenile (days 22 31) rats. The treatment delayed vaginal opening (VO) in juvenile rats. Neonatal and infantile rats were unaffected. VO was also delayed by daily ECS for only 5 days in the late juvenile (days 27-31) period. The opioid receptor antagonists naloxone, naltrexone and nalmefene injected before and after single daily ECS were unable to block this effect of ECS on VO. To examine whether the effect of ECS is related to stress, we examined several stressors known to induce opioid mediated alterations in gonadotrophin secretion. Footshock, immobilization and ether stress administered in the juvenile period (days 27-31) did not affect the timing of VO. In addition, rats anaesthetized with halothane, and then given ECS, still showed a delay of VO. These data demonstrate that rats in the late juvenile stage of development are most sensitive to convulsions. We also suggest that opioids are not critical to the mechanism by which the ECS disturbs puberty, and that ECS elicits its effect seemingly independently of the convulsive stress. PMID- 2754361 TI - Changes in the pulsatile secretion of LH after the removal of and subsequent resuckling by pups in ovariectomized lactating rats. AB - Changes in the pulsatile secretion of LH after removal of pups and subsequent resuckling were examined in ovariectomized lactating rats, and the change after removal of pups was compared with that after the removal of ovaries in cyclic female rats. The day of parturition was designated day 0 of lactation. All lactating rats were ovariectomized on day 2 of lactation. They were deprived of their pups for 6, 12, 18, 24 or 45 h before blood sampling on day 8 of lactation, or were resuckled by their pups for 1, 4, 7 or 12 h before blood collection after separation from pups for 24 h. Cyclic female rats were ovariectomized on the day of dioestrus and blood samples were taken 12, 18, 24 or 48 h or 6 days after ovariectomy. Typical LH pulses appeared in some animals from 12 h after the removal of pups. The mean LH level and the frequency and amplitude of LH pulses gradually increased after removal of pups, until after 45 h of separation the frequency reached the high level observed 6 days after ovariectomy in cyclic rats. The subsequent resuckling by pups after a 24-h separation decreased these three parameters of LH pulses rapidly. In contrast, the frequency of LH pulses was unchanged after ovariectomy in cyclic rats, although the mean LH level and the amplitude of LH pulses increased. These results suggest that the suckling stimulus suppresses pulsatile LH secretion in a different manner from that of ovarian steroids. PMID- 2754362 TI - Macrophage activation enhances the human chorionic gonadotrophin-induced disruption of spermatogenesis in the rat. AB - The objective of this study was to examine the role of intertubular macrophages in modifying the response of the rat testis to stimulation by human chorionic gonadotrophin (hCG). The phagocytic activity of macrophages was stimulated by a unilateral intratesticular injection of polystyrene latex beads. Latex beads were engulfed by the resident macrophages and retained within their cytoplasm. Contralateral testes received injection of vehicle alone. A group of control rats was killed 3 days later; other groups received 100 IU hCG s.c. and the morphological and functional responses of the testes were examined 12, 24 and 48 h later. Spermatogenesis was unaffected in control rats, whereas in the testes of all hCG-treated rats leukocytes infiltrated into the intertubular tissue and the seminiferous tubules exhibited focal disruptions of spermatogenesis which were more severe in testes containing activated macrophages. Spermatogenic disruption was dependent upon the stage of the spermatogenic cycle, with the maximum tubule degeneration occurring at or near stages III and IX-XI. However these changes were not a consequence of androgen deprivation, since no consistent correlation was demonstrated between alterations in testosterone levels in testicular interstitial fluid and the accompanying damage to germ cells. It is concluded that hCG alone or in combination with activated macrophages induces an inflammatory-type response of the intertubular tissue and localized degeneration of the seminiferous epithelium. The antispermatogenic effects of hCG may have important implications for in-vivo investigations of Leydig cell function in laboratory animals and for the efficacy of hCG administration used in the clinical treatment of male hypogonadism. PMID- 2754363 TI - Effect of the glycogenolytic gluconeogenetic hormones, glucagon, vasopressin and angiotensin II, on biliary excretion of iodothyronines in rats is possibly related to the inhibition of 5'-monodeiodination in the liver. AB - Polyethylene tubes were inserted into the bile duct and femoral vein of rats under pentobarbital anaesthesia and bile was collected for three 2-h periods. After the first (control) period the animals were infused intravenously at a rate of 1.2 ml/h with the following compounds: (1) 0.9% (w/v) NaCl (control group), (2) glucagon (1200 ng/h), (3) vasopressin (1200 ng/h) or (4) angiotensin II (600 ng/h). The concentrations of thyroxine (T4), tri-iodothyronine (T3) and reverse tri-iodothyronine (rT3) in the bile were estimated by radioimmunoassay. No significant differences between groups were found in the biliary excretion of T4 and T3, while the excretion of rT3 after the infusion of all the hormones used was significantly (P less than 0.001 at 2 to 4 h of the infusion) increased, no such increase being found in the controls. It may be concluded therefore that the administration of the above hormones resulted in some changes in iodothyronine metabolism in the liver. These may be explained by an inhibition of iodothyronine 5'-monodeiodination related to the glycogenolytic and gluconeogenetic effects of these hormones. PMID- 2754364 TI - Testosterone concentrations in testicular interstitial fluid collected with a push-pull cannula or by drip-collection from adult rats given testosterone or aminoglutethimide. AB - This study was designed to investigate the differences in testosterone concentrations measured in testicular extracellular interstitial fluid obtained with a push-pull cannula or by post-mortem drip-collection. In the first experiment, testosterone-filled silicone elastomer capsules (2-16 cm lengths) or empty 2 cm capsules were implanted s.c. in adult male rats for 1 week. Animals were then anaesthetized and interstitial fluid was collected with a push-pull cannula for 1 h from one testis in each animal. Testicular and peripheral venous blood were then sampled and supernatant fluid was collected from the dispersed cells of the same testis. The contralateral testis in each animal was removed, and postmortem interstitial fluid obtained by drip-collection for 20 h at 4 degrees C. In animals given empty capsules, testosterone concentrations in drip collected interstitial fluid were significantly (P less than 0.01) greater than testicular and peripheral venous blood levels, testicular fluid levels, and levels in interstitial fluid calculated from push-pull cannula samples. The concentrations of testosterone calculated in interstitial fluid collected with a push-pull cannula were never significantly greater than testicular venous blood levels. In animals with testosterone-filled capsules, testosterone concentrations measured in drip-collected interstitial fluid were similar to those calculated from push pull cannulae samples, and to testicular venous blood levels. In a second experiment, a group of adult male rats was pretreated with amino glutethimide to block steroidogenesis. Two hours later, interstitial fluid was drip-collected from the testes of these animals and from a group of vehicle treated controls.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2754365 TI - Effect of a single injection of human chorionic gonadotrophin on testosterone levels in testicular interstitial fluid, and in testicular and peripheral venous blood in adult rats. AB - We have used a push pull cannula to collect interstitial fluid from the testes of anaesthetized rats at various times after a single injection of human chorionic gonadotrophin (hCG; 50 IU), and compared the levels of testosterone in this fluid with the levels in testicular and peripheral venous blood collected at the same times. Following hCG injection, significant increases in testosterone concentrations were observed in all fluids with notable peaks occurring in interstitial fluid at 2, 8 and 24 h, in testicular venous blood at 2, 8 and 30 h, and in peripheral venous blood at 2, 8, 24 and 72 h. The results demonstrate for the first time that changes in testosterone concentrations in interstitial fluid can be different from those in testicular venous blood. In addition, when testosterone levels in interstitial fluid were compared with levels in testicular venous blood at each time-point, the results suggested that the partitioning of testosterone between these two compartments can be regulated. Furthermore, the changes in both interstitial fluid and testicular venous blood levels of testosterone do not always parallel those in peripheral venous blood, suggesting that changes in testicular blood flow and peripheral clearance rates of testosterone may also be important in the control of circulating testosterone concentrations. PMID- 2754366 TI - gamma-Aminobutyric acid regulation of neurohypophysial hormone secretion in male and female rats. AB - The role of gamma-aminobutyric acid (GABA) in the control of oxytocin and arginine vasopressin (AVP) release from the posterior pituitary was investigated using the GABA agonist muscimol and the GABA antagonists bicuculline and picrotoxin. Two perifusion model systems were studied using (a) intact isolated posterior pituitaries (IPP) and (b) neurosecretosomes from both male and female rats. In experiments on tissue from male rats, the stimulated release of oxytocin and AVP in both models was inhibited by muscimol, an effect which was reversed in the presence of bicuculline. Bicuculline alone increased the release of oxytocin only. Although similar responses to muscimol or bicuculline were seen in neurosecretosomes from female animals, neither agent affected oxytocin and AVP release from the intact IPP. Picrotoxin had a similar effect to bicuculline on oxytocin in isolated posterior pituitaries from male as well as female rats, although at the neurosecretosome level a paradoxical inhibition was observed. These results provide evidence for an endogenous GABA receptor mechanism at the level of the neurosecretory terminals in both male and female rats. The sexually dimorphic IPP response suggests a second more complex mechanism involving either pituicytenerve terminal interactions and/or a secondary role of other neurotransmitters in the GABA regulation of neurohypophysial hormones. PMID- 2754367 TI - Pulsatile growth hormone, insulin-like growth factors and antler development in red deer (Cervus elaphus scoticus) stags. AB - Plasma samples taken every 30 min over a 26-h period each month from six 4- to 15 month-old red deer stags were analysed for GH. In addition, two samples taken at 10.00 and 22.00 h were analysed for insulin-like growth factor-I (IGF-I) and insulin-like growth factor-II (IGF-II). A concentrate diet was available ad libitum. Food intake, body weight and antler status were recorded. Concentrations of GH were analysed using the PULSAR peak detection routine. Secretion of GH was pulsatile in every month of sampling, but the pattern of pulsatility differed seasonally. During the autumn and early winter (April-June in the Southern hemisphere) GH pulses were frequent and of low amplitude. In contrast, GH pulses in spring (August-September) were of high amplitude and high frequency resulting in a high mean level of GH circulating in the plasma. In early summer (November) the GH pulse amplitude was much lower and pulse frequency fell. There was a rise in GH pulse frequency not accompanied by an increase in GH pulse amplitude in summer (December-January). GH pulse amplitude seemed to be the main determinant of mean GH plasma level. Secretion of IGF-I was raised 1 month after peak monthly mean GH secretion. There was little consistent relationship between concentrations of IGF-II and mean daily GH. Concentrations of GH correlated positively and significantly with liveweight gain and antler growth rate with a delay of 1 month. Significantly positive correlations between concentrations of IGF-I, liveweight gain and antler growth rate were observed. It is considered that the spring and summer (September-December) seasonal acceleration of liveweight gain and antler development in stags could be a consequence of high winter/early spring (August-September) GH pulse frequency and amplitude resulting in increased concentrations of IGF-I, particularly in October. PMID- 2754368 TI - Influence of tri-iodothyronine or lipid administration on the response of the pituitary-thyroid axis to exposure to cold in the newborn lamb. AB - The influence of the administration of tri-iodothyronine (T3) or a solution of soya oil and egg lecithin on the response of the pituitary-thyroid axis to moderate exposure to cold (4 degrees C for 4 h) was studied in 24-h old lambs. In control lambs, plasma concentrations of TSH. T3 and total and free thyroxine (T4) rose significantly whereas plasma concentrations of reverse T3 remained unchanged during the test. In lambs injected i.v. with a small amount of T3 (1.23 nmol/kg) 30 min before the onset of exposure to cold, plasma concentrations of TSH, reverse T3 and total and free T4 did not change during the test. Administration of lipid 30 min before exposure to cold induced, as expected, a sharp rise in plasma free fatty acid (FFA) concentrations and a transient increase in free T4 concentrations. In these animals, plasma concentrations of TSH increased during the test as observed in control lambs, but plasma concentrations of T3, reverse T3 and total T4 did not show any significant change, whereas free T4 levels decreased during the first 2 h. These results strongly suggest, in contrast to previous results, that T3 exerts a negative feedback upon the hypothalamic pituitary-thyroid axis in the newborn lamb. Moreover, it appears that a rise in plasma concentrations of FFA could affect neonatal thyroid function. PMID- 2754369 TI - Progesterone concentrations in samples of saliva from adolescent girls living in Britain and Thailand, two countries where women are at widely differing risk of breast cancer. AB - Menstrual-cycle patterns of salivary progesterone concentration were obtained for 131 and 245 adolescent girls up to 4 years postmenarche living in Britain and Thailand respectively. These patterns were graded on a scale of 1 (little or no activity) to 5 (activity similar to that exhibited by the mature premenopausal woman) and the frequency of these grades within groups of girls from each centre was analysed. The major finding was that British girls exhibited a predominance of higher grades of progesterone activity when compared with their Thai counterparts (n = 2 x 58) when matched for chronological and gynaecological ages (P approximately 0.002). This was particularly so for the girls from these two matched groups in the gynaecological age range 2-4 years (P approximately 0.03). The major contribution to this significant difference between the two groups is attributed to the greater effect of chronological age on progesterone secretion in the British girls (P approximately 0.03) compared with the Thai girls (P approximately 0.29). These findings may have implications for facilitating our understanding of the reason for the differing risk of breast cancer in women in both countries. PMID- 2754370 TI - Effect of fetal hypophysectomy on the localization of the catecholamine biosynthetic enzymes and enkephalins in the adrenal medulla of the fetal sheep. AB - We have investigated the effect of fetal hypophysectomy on the localization of dopamine B-hydroxylase (DBH), phenylethanolamine N-methyltransferase (PNMT) and enkephalin-containing peptides in the fetal sheep adrenal, using immunocytochemical techniques. Staining with anti-DBH was observed throughout the adrenal medulla in the intact (140-146 days of gestation) and hypophysectomized fetal sheep (147-164 days of gestation) and the newborn lamb (10-12 days after birth). In the adrenal medulla of the late-gestation intact fetal sheep and newborn lamb, positive staining with anti-PNMT was observed in the peripheral rim of medullary cells adjacent to the adrenal cortex. After hypophysectomy, there was intense positive staining with anti-PNMT in the peripheral adrenal medullary cells and a small and variable proportion of central adrenal medullary cells were stained with anti-PNMT. In the adrenal gland of the intact fetal sheep and the newborn lamb, there was intense staining with anti-enkephalin in the peripheral rim of adrenal medullary cells. Staining with anti-enkephalin was less intense in the central medullary cells of the adrenal gland of the intact fetal sheep and the 10- to 12-day-old newborn lamb, and many unstained central medullary cells were present. After hypophysectomy, intense positive staining with anti enkephalin was observed throughout the entire fetal adrenal medulla. Therefore, the fetal pituitary, either directly or indirectly through the adrenal cortex, plays a role in regulating the pattern of localization of both PNMT and enkephalin in the fetal sheep adrenal. PMID- 2754371 TI - Effects of amiodarone on 5'-deiodination of thyroxine to tri-iodothyronine in rat myocardium. AB - The present work studied the effects of amiodarone (AMD) and iopanoic acid (IA) on the conversion of thyroxine (T4) to tri-iodothyronine (T3) by rat myocardium. In vivo: male Wistar rats weighing 200-250 g were injected i.p. with AMD (2.5 mg/100 g body weight per day for 12 days) or IA (5 mg/100 g body weight every 12 h for 72 h). Hearts were then removed and processed as in the in-vitro studies. In vitro: hearts were homogenized in Krebs-Ringer phosphate buffer (pH 7.4) and AMD (0.1 mmol/l) or IA (10 mmol/l) plus dithiothreitol (8 mmol/l) and 0.01 microCi [125I]T4 or [125I]T3 were added. After incubation for 2 h at 37 degrees C, radioactive compounds were identified by paper chromatography. Both AMD and IA given in vivo blocked T4 and T3 conversion significantly (P less than 0.005). When added in vitro, AMD failed to inhibit T4 deiodination to T3 whereas IA induced a significant (P less than 0.005) decrease in T3 generation. Deiodination of [125I]T3 by heart homogenates was not altered by AMD or IA. While the expected increase in circulating T4 (P less than 0.001) and decrease in T3 (P less than 0.001) did occur after AMD or IA treatment, plasma TSH in AMD-treated rats was decreased (P less than 0.001), while in IA-treated animals it was increased (P less than 0.001), thus indicating that AMD did not inhibit pituitary type-II 5' monodeiodinase.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2754372 TI - Heterogeneity in the luteal population following superovulation with pregnant mare serum gonadotrophin and human chorionic gonadotrophin in the sheep. AB - In order to investigate the development and possible heterogeneity in the luteal population following superovulation, anoestrous ewes were induced to ovulate using progestagen priming followed by injections of pregnant mare serum gonadotrophin (1000 IU) and hCG (1000 IU). Ovaries were recovered from ewes on each of days 2, 4, 6, 8, 10, 12 and 15, and the weight, progesterone content, 125I-labelled hCG binding and progesterone synthesis in vitro of the individual corpora lutea measured. The results obtained showed that plasma progesterone concentrations on the day of slaughter were significantly correlated with time (P less than 0.05), total weight of luteal tissue (P less than 0.001) and number of corpora lutea (P less than 0.05). The number of corpora lutea recovered per animal ranged from two to 12 and was significantly (P less than 0.05) correlated with the day after hCG injection until day 10. There was much variation between individual corpora lutea, particularly in terms of weight and progesterone content, although both were significantly (P less than 0.001) correlated with day of recovery until day 10. 125I-labelled hCG binding was significantly (P less than 0.001) correlated with time until day 15. There was a significant (P less than 0.001) effect of age of the tissue on progesterone production in vitro, with output declining throughout the luteal phase. These results show that the number of corpora lutea induced by superovulation in anoestrous ewes was very variable, and suggest that ovulation may have continued to occur during the luteal phase.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2754374 TI - The effect of 5-methoxytryptamine on golden hamster gonads is not a consequence of its acetylation into melatonin. AB - Radioimmunoassay and high performance liquid chromatography were used to determine if the gonadal atrophy induced by late afternoon injections of 5 methoxytryptamine (5-MT) in golden hamsters kept under long photoperiod could be due to the acetylation of this compound into melatonin. An increase in plasma concentrations of melatonin (10-13 nmol/l) was detected 15 min after injection of 130 nmol 5-MT. An injection of 4.3 nmol melatonin generated a similar plasma concentration of melatonin. 5-MT (130 nmol) and melatonin (4.3 nmol) were then injected daily in the late afternoon to golden hamsters kept under long photoperiod. After 8 weeks, 5-MT induced total testicular regression, while melatonin induced partial atrophy only. Thus under these experimental conditions, 5-MT had a physiological activity independent of that of melatonin. PMID- 2754373 TI - Dexamethasone induces an increased biosynthesis of chromogranin A in rat pituitary gland. AB - The influence of dexamethasone on the regulation of the biosynthesis of chromogranins A and B, two proteins originally described in adrenal chromaffin granules, was investigated in the rat pituitary gland. Dexamethasone increased chromogranin A levels and its corresponding mRNA in a dose-dependent manner. Induction of chromogranin A occurred with a time-lag of 24 h. As shown by immunohistochemistry, chromogranin A was present in control and dexamethasone treated rats in gonadotrophic cells only. Chromogranin B, secretogranin II and the respective pituitary hormones co-stored with chromogranin A were not changed by dexamethasone. Thus dexamethasone selectively increased chromogranin A levels in gonadotrophic cells. PMID- 2754375 TI - Indomethacin inhibits the effects of oestrogen in the anterior pituitary gland of the rat. AB - Two inhibitors of prostaglandin synthesis, indomethacin and aspirin, blocked the increase of oestrogen-binding sites in the nuclear subcellular fraction, an increase which occurs after the administration of oestradiol. Consequently the biological effects of oestrogens in the anterior pituitary gland of the rat (prolactin synthesis, concentration of progesterone-binding sites and cell proliferation) are diminished. The anterior pituitary gland synthesized prostaglandin F2 alpha (PGF2 alpha), PGE2 and PGD2 from arachidonic acid. This synthesis was blocked when indomethacin was added to the culture media. Oestrogen increased the concentration of PGE2: an increase that was partially prevented by indomethacin. Prostaglandins may have an important role on the effects of oestrogen in the anterior pituitary gland of the rat. PMID- 2754376 TI - Interruption of parturition in rats by morphine: a result of inhibition of oxytocin secretion. AB - Oxytocin secretion is inhibited by opioids, and oxytocin is important in parturition. The effects on parturition of morphine, a relatively selective mu opioid receptor agonist, were studied in the rat. Morphine or vehicle with or without the opiate antagonist naloxone were administered immediately after the birth of the second pup and the subsequent course of parturition was recorded in a total of 80 rats. Both s.c. morphine (10 mg/kg) and intracerebroventricular (i.c.v.) morphine (18 micrograms through a previously implanted cannula) interrupted parturition, delaying the birth of the sixth pup after treatment to 187.3 +/- 35.9 (S.E.M.) min and 195.4 +/- 19.5 min respectively, compared with 46.4 +/- 3.7 and 66.1 +/- 17.5 min after vehicle alone. The dose of morphine given i.c.v. had no effect when given s.c. Naloxone given concurrently prevented the effects of morphine. Eventually the rate of parturition in the morphine treated groups recovered. Perinatal pup mortality rate was not increased when morphine was given to the mothers, but it did inhibit the expression of normal intrapartum maternal behaviour. Pup mortality was increased 48 h post partum by morphine given during parturition, and it reduced the proportion of rats with normal maternal behaviour 24 h post partum. Morphine did not affect spontaneous or oxytocin-stimulated contractile activity of the parturient uterus in vitro. The concentration of oxytocin in trunk blood plasma was decreased 40 min after i.c.v. morphine (24.3 +/- 3.9 vs 39.3 +/- 6.5 pmol/l in controls), as was vasopressin (7.2 +/- 1.5 vs 19.7 +/- 4.5 pmol/l in controls). Intravenous infusion of oxytocin (2-5 mU/min for 144.3 +/- 8.2 min; total infused 448.5 +/- 61.9 mU) after i.c.v. morphine re-started parturition; all pups were born to these rats (mean time to pup 6, 110.3 +/- 12.7 min) before the i.v. vehicle infused rats given i.c.v. morphine re-started (mean time to pup 6, 406.3 +/- 125.2 min). It is concluded that morphine given during parturition acts centrally through opioid receptors to inhibit oxytocin secretion, and impairs the expression of maternal behaviour. Reversal of the effects of morphine on parturition by i.v. oxytocin demonstrates the important role of oxytocin in fetus ejection and expulsion. PMID- 2754377 TI - A peptidase activity from primate liver that inactivates oxytocin in vitro: purification and partial characterization. AB - An aminopeptidase from monkey (Macaca radiata) liver, inactivating oxytocin in vitro and located predominantly in the lysosomal and microsomal fractions, was purified by chromatography on Bio-Gel HTP, DEAE-Sephacel and nickel ion chelate gel and gel filtration on Sephacryl S300. Absence of binding to nickel ion chelate gel indicated the absence of exposed histidine and thiol residues on the enzyme. The enzyme appeared to be a high molecular weight (Mr 106,000) monomeric protein. It was sensitive to inhibition by metal chelators and was found to be a zinc metalloprotein by atomic absorption spectrophotometry. Divalent metal ions Ni2+ and Co2+, and sulphydryl activators glutathione and 2-mercaptoethanol had activating effects, while 4-chloro mercuribenzoate, amino acids with large hydrophobic side chains and L-cystine, beta-lactam antibiotic cloxacillin and peptidase inhibitor amastatin had inhibitory effects on the enzyme activity. The enzyme was most active against S-benzyl L-cysteine 4-nitroanilide substrate. The properties of the enzyme were distinct from those of the well-characterized alanine and leucine aminopeptidases (EC 3.4.11.2 and EC 3.4.11.1 respectively) of liver, and of primate placental cystine aminopeptidases (EC 3.4.11.3). PMID- 2754378 TI - Nocturnal changes in serum melatonin during female puberty in rhesus monkeys: a longitudinal study. AB - Diurnal concentrations of serum melatonin were determined longitudinally in female rhesus monkeys throughout sexual maturation to ascertain how levels varied with advancing age and reproductive onset. Females were housed either in outdoor enclosures (n = 8) exposed to ambient environmental conditions, or indoors (n = 4) under a photoperiod of 12 h light: 12 h darkness and fixed temperature of 20 23 degrees C. Animals were studied from immaturity (15 months) through first ovulation and were additionally compared with fully adult female rhesus monkeys (n = 5) studied during the annual breeding season. The diurnal melatonin pattern was described for the developing females in the summer, autumn and winter in 3 successive years from samples collected at 10.00, 18.00, 22.00, 02.00, 06.00 and 10.00 h. Nocturnal levels of melatonin declined significantly during development in both indoor- and outdoor-housed females with a progressive decrease up to 33 months of age. Daytime values were consistently low but exhibited a slight decline also with age. Nocturnal values in all months sampled fell significantly with greater decreases occurring at the earliest ages. Furthermore, superimposed upon this developmental change, animals housed outdoors responded to seasonal changes in photoperiod with diurnal increases in melatonin occurring after sunset. The females in the present study exhibited first ovulation at two distinct ages: 32-37 months ('early', n = 6) and 41-45 months ('later', n = 5). One female did not ovulate within the study period. Although nocturnal levels of serum melatonin were similar between the two groups up to 29 months of age, a post-hoc analysis revealed that concentrations were significantly lower by 34 months of age for the early group, a time coincident with first ovulation. Nocturnal levels of melatonin remained high, relative to the early group, in the later ovulating females until 43 months of age, coincident with first ovulation for these animals. The diurnal pattern of serum melatonin at first ovulation, regardless of chronological age, was similar to that observed during the ovulatory season for adult female rhesus monkeys. These data suggest that nocturnal melatonin concentrations decline with advancing chronological age in prepubertal female rhesus monkeys.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2754379 TI - Growth hormone and testosterone can independently stimulate the growth of hypophysectomized prepubertal lambs without any alteration in circulating concentrations of insulin-like growth factors. AB - Castrated prepubertal lambs were hypophysectomized and then treated with GH and testosterone either alone or in combination over a series of 3-week treatment periods. Hypophysectomy resulted in a rapid reduction in skeletal growth rate which could be reversed by the administration of either GH (4 IU three times a week for 3 weeks) or testosterone propionate (10 mg daily for 3 weeks). When GH or testosterone treatment was withdrawn, skeletal growth fell to the post operative rate. Combined treatment with both GH and testosterone was no more or less effective than either hormone given singly. The order of administration did not have any effect on the growth rate. Circulating concentrations of insulin like growth factor-I (IGF-I) were reduced by hypophysectomy, but neither GH nor testosterone treatment, alone or in combination, had any effect on IGF-I concentrations. Concentrations of IGF-II rose following hypophysectomy, and again were not affected by any of the hormonal replacement treatments. In conclusion, both GH and testosterone could stimulate skeletal growth in the hypophysectomized lamb without any alteration of circulating IGF concentrations, and testosterone can clearly stimulate skeletal growth in the complete absence of GH. PMID- 2754380 TI - Thyrotrophin (TSH)-binding proteins in bacteria and their cross-reaction with autoantibodies against the human TSH receptor. AB - A screen of a range of bacteria normally found in gut flora identified eight with the ability to bind TSH specifically. These included the previously reported Yersinia enterocolitica, Gram-positive, Gram-negative, pathogenic and commensal organisms. Eleven preparations of TSH-receptor autoantibodies strongly able to displace 125I-labelled TSH from the mammalian TSH receptor differed in their ability to displace the tracer from binding to bacterial extracts. None could displace the tracer from E. coli 06-1, four displaced 125I-labelled TSH from E. coli V21/1 and five displaced the tracer from Y. enterocolitica. Of those immunoglobulin preparations which did react with the bacterial protein, their apparent potency compared with that of TSH in displacing tracer from bacterial binders was an order of magnitude greater than with the mammalian receptor. This is consistent with the autoantibodies having a relatively better fit with the bacterial antigen than with the receptor when compared with TSH. The bacterial binding activity and mammalian receptor-binding activities in each of two samples co-chromatographed on a Remazol yellow GGL-Sepharose affinity column strongly indicated that the same immunoglobulin species reacts with both antigens. These results are consistent with the proposal that a bacterial protein is the primary immunogen for the TSH-receptor antibodies in at least some patients with Graves' disease. PMID- 2754381 TI - Uptake of 3,5,3'-L-tri-iodothyronine in human erythrocytes. AB - The mechanisms of 3,5,3'-L-tri-iodothyronine (T3) uptake into human erythrocytes were examined. Purified membranes of human erythrocytes were shown to have two classes of T3-binding sites with one being a high-affinity site (dissociation constant, 59.2 +/- 17.8 nmol/l; maximum binding capacity, 344.3 +/- 95.5 fmol/micrograms protein). Furthermore, it was shown that there were two pathways for T3 uptake in human erythrocytes; one was saturable, stereospecific (T3 much greater than thyroxine greater than 3,5,3'-D-tri-iodothyronine), energy-dependent and dominant at 15 degrees C; the other was not displaced by unlabelled T3 and was energy-independent but did not occur by passive diffusion. The former pathway which, it is suggested, is a receptor-mediated transport pathway, was inhibited by monodansylcadaverine, phloretin or oligomycin at 15 or 37 degrees C, but the latter pathway was not inhibited by these inhibitors. Our results strongly suggest that uptake of T3 by the energy-independent pathway became predominant over the energy-dependent pathway at 37 degrees C and accounted for 83% of total T3 uptake of human erythrocytes. PMID- 2754382 TI - The prevalence of retinopathy and associated medical risk factors in type I (insulin-dependent) diabetes mellitus. AB - The prevalence of diabetic retinopathy and the associated medical risk factors, such as age at onset and duration of diabetes, metabolic control, blood pressure, albumin clearance and serum creatinine, were studied in 501 patients with type I diabetes mellitus. The prevalence of retinopathy, characterized as simplex, maculopathy, preproliferative, and proliferative, was 60.5%. Patients with retinopathy were younger at the onset of diabetes, and had a longer duration of disease. In patients with more than 10 years of diabetes, proliferative retinopathy was more frequent if onset was before they were 15 years old, despite the fact that the duration of diabetes did not differ. Patients with severe retinopathy had worse metabolic control, and were more frequently treated for hypertension. In addition, the systolic blood pressure was elevated in all groups of patients with any type of retinopathy, whereas the diastolic blood pressure was elevated only in patients with more severe forms. Patients with severe retinopathy also had higher levels of albumin clearance. PMID- 2754383 TI - Studies on mechanisms for enhanced clearance of low-density lipoproteins in patients with primary hypertriglyceridaemia. AB - Patients with primary hypertriglyceridaemia usually have increased clearance rates for plasma low-density lipoproteins (LDL). To evaluate the mechanisms for this effect, simultaneous turnover rates for autologous and normal homologous LDL were determined in 12 patients with primary hypertriglyceridaemia. On average, the autologous LDL was cleared more rapidly than the normal homologous LDL. Fractional catabolic rates (FCRs) for autologous LDL averaged 0.61 +/- 0.06 (SEM) pools d-1, whereas FCRs for homologous LDL averaged 0.49 +/- 0.04 pools d-1. In eight of the 12 patients the FCRs for 'hypertriglyceridaemic' LDL were found to be significantly higher than for normal LDL; in four others both forms of LDL were cleared at essentially the same rate. In all cases, however, both for the normal and 'hypertriglyceridaemic' LDL, clearance rates were higher than normal. Thus, besides the variability in LDL affinity for removal pathways, hypertriglyceridaemic patients appear to have an increased availability of LDL receptors for removal of circulating LDL. PMID- 2754384 TI - Fulminant severe retinopathy in a newly diagnosed diabetic without risk factors. AB - The authors describe a 26-year-old female developing severe proliferative retinopathy within 2 weeks of diagnosis of insulin-dependent diabetes mellitus. The patient presented with profound diabetic ketoacidosis, but had no other risk factors for retinopathy. She had marked bilateral myopia which did not protect her from retinopathy. Nine months after diagnosis of diabetes, she has profound visual impairment despite correction for myopia, and has also developed marked autonomic neuropathy and diabetic nephropathy. PMID- 2754385 TI - Is dependence on phonological information in children's reading a product of instructional approach? AB - Eight-year-old British children were found to be less accurate at rejecting pseudohomophones than ordinary nonwords in a lexical decision task, but 8-year old New Zealand children did not show this effect. A subsequent homophone decision task showed that this difference was not due to the New Zealand children being unable to distinguish pseudohomophones from other nonwords. The New Zealand children, however, were less accurate than the British children in pronouncing the pseudohomophones they had identified. It was argued that the British children tended to sound out the items before making a choice in the lexical decision task, which gave salience to phonological rather than visual information, resulting in increased errors to the pseudohomophones. It was concluded that where the British children showed this dependency on use of phonological information it was a product of the teaching approach they had experienced. PMID- 2754386 TI - Discriminating between memories: evidence for children's spontaneous elaborations. AB - Children are more confused than adults about memories for what they said and what they imagined saying. The present studies examine the extent to which this confusion is related to the person subjects imagine. In Experiment 1, subjects (7, 10, and adult) said words and imagined someone (themselves, a parent, or a friend) saying other words. They were then asked to distinguish words they said from words they imagined. Performance varied with age as well as with the person subjects imagined. Further, performance was better for words subjects imagined than for words they said. Metamemory responses indicated subjects of all ages remembered elaborative processing activated spontaneously during imagination when discriminating between memories. When the nature of subjects encodings was constrained (i.e., subjects said and imagined someone saying words as part of a sentence completion task. Experiment 2), performance declined for all age groups. Experiments 3 and 4 suggest that elaborations reported in response to our metamemory questions occurred during imagination and were not solely prompted by our metamemory questions. PMID- 2754387 TI - Young children's knowledge of their memory span: effects of task and experience. AB - This study investigated the hypothesis that young children have knowledge about their memory that they may be unable to articulate, but are able to reflect on and use in problem-solving. Forty-eight kindergarteners made one of two types of judgments about their memory span for words. Half of the children made prospective verbal predictions about the number of words they thought they could recall from a list of 10. The other half made concurrent, nonverbal predictions by listening to words on a tape and manually stopping the tape when they heard as many words as they thought they could recall. Children's actual recall for words was then assessed. All children participated in multiple trials to assess the effect of task experience on their predictions. Analyses revealed that predictions made in the concurrent task were significantly more accurate than those made in the prospective task. All children lowered their predictions across trials, although only in the concurrent task were children's final-trial predictions not significantly greater than their actual recall. No meaningful effects or interactions were associated with actual recall scores. These results revealed that young children manifested greater memory knowledge when this knowledge was assessed through their concurrent problem-solving behavior rather than through their prospective verbal predictions. PMID- 2754388 TI - Metamemory, memory performance, and causal attributions in gifted and average children. AB - Fifth and seventh graders who had been teacher-selected as high- or average achieving were tested on the Kognitiver Fahigkeits Test, a standardized test of intellectual abilities for German children. Children who met preestablished criteria as gifted or average were then tested on measures of metacognitive knowledge, attributional beliefs, and performance on a sort recall task. Results indicated ability-related differences in metamemory and sort recall performances. Responses to the attributional questionnaires also varied systematically according to ability: gifted children were more likely to attribute their academic successes to high ability than were average children, who showed a stronger belief in the importance of effort in determining task outcomes. Causal modeling analyses illustrated the strength of metacognitive knowledge as a performance predictor on the memory task, especially for average children. Results are discussed in terms of the value of metacognitive theory in understanding individual performance differences. PMID- 2754389 TI - Children's understanding of class inclusion hierarchies: the relationship between external representation and task performance. AB - Three experiments were designed to investigate children's understanding of class inclusion hierarchies and to determine whether such understanding may be related to children's ability to construct external representations for information that was hierarchical in nature. Understanding of hierarchies was studied through tasks designed to demonstrate children's ability with subset/superset classification and knowledge of asymmetric and transitive relations. Children were asked to construct their own external representations for passages containing information that could be represented hierarchically. It was hypothesized that the quality of children's external representations would be related to their ability to respond to questions related to the passages. Children's responses to questions, as well as their external representations, suggested that children as young as second grade have substantial understanding of hierarchical relations. Although the external representations were constructed in drawing, written, or structured modes, the data revealed a strong relationship between the quality of children's external representations and their performance on question tasks requiring both recognition and reasoning. Finally, children understood the relationships expressed in tree diagrams and could construct such diagrams to respond to questions. Implications of the findings, particularly as related to note-taking skills, and suggestions for further research are discussed. PMID- 2754390 TI - Reasoning about conditional sentences: development of understanding of cues to quantification. AB - The previous literature has reported that when children are asked to judge the truth or falsity of universally quantified conditional sentences of the form If a thing is P then it is Q they typically give responses, e.g., responding "true" whenever there is a case of P and Q even if there are also cases of P and not-Q. Three experiments are reported that address possible sources of this error. Experiment 1 shows that the error survives on sentences that refer to particular things as well as to things of a particular kind, and further shows that articulating the necessity of the consequent (... then it has to be Q) eliminates the error for adults and reduces it for fifth graders, although it does not affect second grade performance. Experiment 2 shows that for second and fifth graders the error survives to problems that are not universally quantified and for second graders to problems that are not conditionals although are otherwise structurally similar. Experiment 3 compares various verbal formulations of such universally quantified conditionals: Second and fifth graders do not make the error when the quantification is expressed with the surface structure that makes its universality most explicit (all things ...); the error tendency is greatest when the indefinite article is used (if a thing ...); and formulations using any fall in between. We argue that such erroneous evaluations of universally quantified conditionals have more to do with the quantificational aspect than the conditional aspect of the problems; children interpret the indefinite article as existential, although they resist the error when the cue to universal quantification is completely clear. The error appears to result more from the surface-structure form of the stimuli than from an inability of children to appreciate the logic of universally quantified conditionals. PMID- 2754391 TI - Multiple molecular forms of human lactoferrin. Identification of a class of lactoferrins that possess ribonuclease activity and lack iron-binding capacity. AB - Lactoferrin (Lf), the major iron-binding component of milk, also a major constituent of the specific granules of neutrophils involved in antimicrobial activity and a glycoprotein thought to play a role in regulatory functions in the hematopoietic system as well as other physiologic activities, is shown to occur in three isoforms. One, Lf-alpha, binds iron; the other two, Lf-beta and Lf gamma, express potent RNase activity, but do not bind iron. The three isoforms are very similar or identical in Mr, pI, partial proteolytic peptide patterns, NH2-terminal amino acid sequence, and reactivity with mAbs and polyclonal antisera against the RNase and Lf, respectively. The finding of structurally similar but enzymatically distinct forms of Lf may be related to the diverse functions of the molecule. PMID- 2754392 TI - Vaccinia virus hemagglutinin. A novel member of the immunoglobulin superfamily. AB - Striking similarities between vaccinia virus hemagglutinin (VVHA) and proteins belonging to the Ig superfamily clearly indicate that VVHA, a 315-amino acid glycoprotein expressed on the surface of the infected cells, is a novel viral protein that can be added to the expanding list of the Ig superfamily. Its deduced amino acid sequence contains one Ig-like domain at the NH2 terminus, followed by two tandem repeating units and a hydrophobic region, suggestive of membrane spanning. The results offer an opportunity for the further study of the probable evolutionary and possible functional relationship between VVHA and other members of the Ig superfamily. Our observation, together with a recent finding that human CMV possibly encodes a protein similar to the MHC class I antigens (13), provides evidence supporting the fact that the viral capture of cellular Ig related genes is more common than expected in vaccinia and other viruses, and that usage of an Ig-like domain as recognition signals might be extended from higher animals to animal viruses. PMID- 2754394 TI - Determination of tissue iron and ferritin in liver pathology comparison of histochemical and biochemical results. AB - Results are presented from the determination of tissue iron and ferritin in 15 pathological livers (6 with steatosis, 8 with fibrosis/cirrhosis and 1 with haemochromatosis). The histological assessment according to the Rowe system, after Perls' staining, was compared with the measurement of the iron content in liver homogenate by flameless atomic absorption spectrophotometry. The results of the flameless atomic absorption spectrophotometry were less accurate than in normal livers, but the method can still be considered reliable with satisfactory precision. As in normal livers, the range of chemically determined values in the histological staining grades was considerable and there was quite an overlap between consecutive grades. The chemical determination of liver iron content is to be preferred. The levels of ferritin protein and ferritin iron follow the same pattern as the total iron content. PMID- 2754393 TI - Tumor necrosis factor identified in multiple sclerosis brain. AB - Frozen brain specimens from patients with multiple sclerosis (MS) and other neurologic diseases were analyzed using immunocytochemical techniques for the presence of TNF. In brain lesions in MS, and subacute sclerosing panencephalitis, TNF+ cells were demonstrated. At the lesion site in MS, TNF+ staining is associated with both astrocytes and macrophages. These observations were not made in Alzheimer's disease or normal brain tissue. The presence of TNF in MS lesions suggests a significant role for cytokines and the immune response in disease progression. PMID- 2754395 TI - The application of a photon-counting camera in sensitive, bioluminescence enhanced detection systems for nucleic acid hybridization. Ultrasensitive detection systems for protein blotting and DNA hybridization, III. AB - A relatively simple, bioluminescence-enhanced detection system for nucleic acid hybridization, using alkaline phosphatase as a label, was described recently (Hauber, R. & Geiger, R. (1988) Nucl. Acid Res. 16, 1213). The principle of detection is as follows: Alkaline phosphatase releases D-luciferin (Photinus pyralis) from D-luciferin-O-phosphate. Liberated D-luciferin reacts with luciferase, ATP and oxygen with light emission. Light produced is measured with a very sensitive photon counting camera system (Argus-100), allowing the visualization and localization of the specifically bound alkaline phosphatase on nitrocellulose sheets. Under non-optimized conditions the limit of detection is at present about 30 pg of pBR322. A sulphonylated nucleotide probe was used for hybridization. PMID- 2754396 TI - Automated blood count analysis by trimodal size distribution of leukocytes with the SYSMEX E-5000. AB - The automated haematology analyser, SYSMEX E-5000, measures and computes quantitative haematological parameters, and determines the size distribution of blood cells and platelets. After partial lysis, the analyser classifies the leukocytes into 3 populations: small cells (lymphocytes), intermediate sized cells (basophils, eosinophils, monocytes) and large cells (neutrophils, including band cells). One thousand blood samples from inpatients and outpatients were analysed automatically in the SYSMEX as well as being submitted to microscopic blood smear differentiation, and the results were compared. The trimodal size distribution of the automated analysis revealed 1.8% false normal results. Ten cases of eosinophilia of between 6.6 and 12.5% remained undetected by the automated method, which also failed to detect 7 cases of left shift with normal leukocyte count, as well as a single sample containing 2% of myelocytes. Both diagnostic sensitivity and diagnostic specificity were high, i.e. 97.1% and 81.8%, respectively. The predictive values were also high for both pathological and normal results. Since certain changes in blood cell morphology are not detected by the SYSMEX, certain clinical indications still call for a microscopic blood smear examination. With due regard to these limitations, the apparatus yields reliable results and economizes considerably the routine laboratory work load. In the present study, 31% of the microscopic blood cell differential counts were saved by using the SYSMEX E-5000. PMID- 2754397 TI - International Federation of Clinical Chemistry (IFCC), Education Division. Guidelines (1988) for training in clinical laboratory management. 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- 2754398 TI - Obstetric risk scoring. PMID- 2754399 TI - Generalist-specialist boundary. PMID- 2754400 TI - Myocardial infarction and denial. PMID- 2754401 TI - Exercise tolerance testing. PMID- 2754402 TI - Diagnosis and management of urolithiasis. PMID- 2754403 TI - Clinical prevention in primary care--the time is now! PMID- 2754405 TI - Effect of a microcomputer-based registry on adult immunizations. AB - A survey of patients attending the Cosmopolitan International Diabetes Center showed that one third of those born prior to 1935 did not know their immunization status, and only 56% of this group remembered ever receiving tetanus vaccine. In contrast, of those born after 1935, 98% gave a history of being vaccinated for tetanus, either as a child (76%) or as an adult (22%). Eight of the 35 patients who could not remember or denied receiving pneumococcal vaccine had in fact received it. Most patients could remember whether and when they had received influenza vaccine. A microcomputer-based registry was used to generate summaries of clinical information at each patient visit. These summaries included prevention-related items. There was a three- to five-fold increase in immunization rates when the dates of the most recent vaccinations were prominently displayed on the summary at the time of each visit. PMID- 2754404 TI - Compliance with five health promotion recommendations in a university-based family practice. AB - Although numerous recommendations are available to guide the primary care physician's provision of preventive health services, a minority of Americans receive recommended care. This study assessed the extent to which patients in a large, university-based family medicine program were receiving five well-accepted health promotion services. These services included fecal occult blood testing, Papanicolaou smears, mammography, serum cholesterol measurements, and tetanus immunization. Demographic factors associated with receipt of these services were assessed. A minority of active patients received the five health promotion services in the recommended interval: fecal occult blood testing 13%, Papanicolaou smear 41%, mammography 16%, cholesterol measurements 20%, and tetanus immunization 19%. The patient's physician practice group, type of medical insurance, physician visit frequency, and increasing age were associated with compliance with the five studied health promotion services. PMID- 2754406 TI - Teenagers' beliefs about AIDS education and physicians' perceptions about them. AB - A survey of 189 Louisiana teenagers and 80 Louisiana family physicians revealed that the teenagers overwhelmingly preferred to learn about acquired immune deficiency syndrome (AIDS) from a physician. This result stimulated an interest in learning whether family physicians shared adolescents' opinions that they are the best teachers for AIDS education and whether family physicians understand adolescents' knowledge and beliefs about AIDS sufficiently well to be effective AIDS educators. Family physicians' responses to a questionnaire based, in part, on the Health Belief Model were compared with teenagers' responses about their knowledge, health beliefs, and preferred format and method of learning about AIDS. Results indicated that family physicians' predictions about teenagers' knowledge and beliefs about AIDS were not always accurate, but, except when physicians underestimated the teenagers' perceived obstacles to AIDS prevention, the data suggested that physicians would be effective in teaching teenagers about AIDS. Family physicians showed good agreement with teens in estimating their desired method and format for learning about AIDS, including their preference for a physician instructor. PMID- 2754407 TI - Obstetric privileges for family physicians: a national study. AB - In 1988 the American Academy of Family Physicians sampled 4400 active members whose mailing address was in one of the 50 states or the District of Columbia. The sample was stratified by nine census regions; after two mailings a 76.2% response rate was achieved. Nine in ten active members have hospital admission privileges. A higher proportion of family physicians in the West North Central census region have privileges at various levels of obstetric care than in other census regions. For those family physicians who do not have privileges for any obstetrics, most indicated that they chose not to include obstetric care in their hospital practices. Family physicians most likely to have obstetric privileges include those who practice in nonmetropolitan areas and those who have completed a family practice residency program. Although disparities in the proportion of family physicians with certain hospital privileges exist among regions, the majority in each region indicated that the privileges afforded them were appropriate. PMID- 2754408 TI - Should there be a merger to a single primary care specialty for the 21st century? An affirmative view. PMID- 2754409 TI - Should there be a merger to a single primary care specialty for the 21st century? An opposing view. PMID- 2754410 TI - Computer use by family physicians in the United States. AB - In March 1988 the American Academy of Family Physicians (AAFP) sampled approximately 4400 active members to ascertain their interest in office computers. After two mailings an overall response rate of 58.9% was achieved. Approximately 45% of active members currently use a computer in their office practices while 3% use a service bureau. There is a wide variation of use by US census region with approximately one in two family physicians in the West North Central census region using office computers compared to one in three in the Middle Atlantic. Accounts receivable and billing are the principal applications and are used by 86.9% of family physicians with computers in their offices. Very few are using a computer for medical records. Approximately two in five indicated that they have a personal or home computer. It is estimated that approximately 65% of AAFP active members have access to a computer either at home or at their office. PMID- 2754411 TI - Financial crisis in a family practice residency: a successful strategy. AB - A family practice residency program in a California public teaching hospital was faced with a financial crisis that threatened its elimination. Hospital officials and medical leaders developed a strategy that resulted in (1) personnel reductions focused principally on hospital overhead departments, (2) reductions in faculty teaching fees, (3) increased resident and faculty productivity, (4) increased patient access to ambulatory areas, (5) decreased utilization of laboratory, radiology, respiratory, physical therapy, pharmacy, and cardiology services, and (6) more favorable contracts with providers for patient care services. The hospital met its financial objectives primarily as a result of collaborative efforts of the hospital management team and a committed faculty vested in the success of the institution. PMID- 2754412 TI - Acute umbilical sepsis and pilonidal disease. PMID- 2754413 TI - Quality-of-life measures. PMID- 2754414 TI - Graduate training in family practice. PMID- 2754415 TI - Three deaths involving triazolam--analytical aspects. AB - This case report describes three case histories and the analytical procedures used for the identification and quantification of triazolam. The levels of triazolam detected in the blood are interpreted with reference to those previously reported in the literature. PMID- 2754416 TI - Retinal projections to the medial terminal nucleus of the rat with induced unilateral congenital eye defects. AB - Retinal projections, particularly the ipsilateral projections, to the medial terminal nucleus (MTN) of the accessory optic system were investigated by autoradiography in adult rats after being reared in one of three different conditions: (1) normal visual experiences, (2) an application of trypan blue for intrauterine induction of congenital unilateral anophthalmia; and (3) the procedures for intrauterine production of congenital microphthalmia in which both eyes are reduced in size. In congenital monocular rats, there was an increase of uncrossed retinal projections to the MTN which does not normally exist. The expansion of the ipsilateral projection was markedly greater in the monocular rats than those inflicted with microphthalmia. The expansion may be due to the failure of the retraction of the ipsilateral retinal projections to the MTN and the collateral sprouting of optic fibers from the remaining eye. PMID- 2754417 TI - Surgical treatment of prosthetic valve endocarditis. AB - From January 1980 to June 1987, a total of 16 consecutive patients underwent surgical therapy in addition to an antimicrobial regimen for prosthetic valve endocarditis at the National Taiwan University Hospital. The ages ranged from 26 to 55 years, with a mean of 40. Nine of these 16 patients (56%) were men and 7 (44%) women. The infected valve prostheses were located at the aortic position in 5 patients, at the mitral position in 6 patients and at both mitral and aortic position in 5 patients. Among the total of 21 infected valve prostheses, 19 were bioprosthetic tissue valves and only 2 were mechanical valve prostheses. Hospital death occurred in 5 patients with an early mortality rate of 31%. Among them, 1 had fungal infection, 2 had streptococcal infection, and 2 had enterococcal infection. Four patients died of low cardiac output due to extensive myocardial involvement and one patient died of uncontrollable upper gastrointestinal bleeding. Late mortality occurred in 1 patient with fungal endocarditis and the cause of death was clinical deterioration due to multiple organ failure. The follow-up period ranged from 7 to 93 months. Except for one who was lost to follow-up, all of the patients survived in good condition without any complication. PMID- 2754418 TI - Color flow mapping in perimembranous ventricular septal defect with left ventricular-to-right atrial shunts. AB - The natural history of ventricular septal defect (VSD) varies with the exact location of the defect and also with the tissue changes surrounding it. Seven cases of perimembranous trabecular VSD were noted during color Doppler echocardiographic examination to have left ventricular-to-right atrial (LV-to-RA) shunts in association with aneurysmal transformation of VSD. Repeated cardiac catheterization documented the role of aneurysmal transformation in the increase of LV-to-RA shunts. A VSD located near the antero-septal commissure was diagnosed in all cases by echocardiography from the apical 5-chamber and parasternal inflow views. Echocardiographic signs of LV-to-RA shunts are high velocity backward turbulence in the RA without the presence of an elevated right ventricular systolic pressure and a two-directional turbulence through the "transformed" VSD. Corrective surgery confirmed the diagnosis in one case. Another case was complicated by an episode of viridans streptococcal endocarditis. The significance of LV-to-RA shunts in perimembranous trabecular VSD remains unknown. PMID- 2754419 TI - HLA-A,B,C and DR antigens in Chinese with non-insulin-dependent diabetes: comparison with goitrous diabetics. AB - To examine the relationship between HLA antigens and Type 2 non-insulin-dependent diabetes (NIDDM), 72 patients were studied and compared with 282 controls. Twenty of 72 patients had an associated non-toxic goiter. The clinical features of the goitrous diabetic patients were similar to those without goiter except that those with goiter were predominantly female (95%). Of the 46 antigens assayed, only A10 was increased in the 72 diabetics when compared with the controls (12.5 vs 5.7%, RR = 2.37, chi 2 = 4.07, p less than 0.05), but statistically this was not significant after p value correction. In the patients with goiter, antigens A2, A9, A10, B27, BW46, CW1, DR1, DR5, DR8, DRW9 showed 2 folds or greater differences in frequencies when compared to the non-goitrous diabetics. However, only A2 had a significant decrease in the former as compared with the latter (30.0 vs 59.6%, chi 2 = 5.07, p less than 0.05), but this was also statistically insignificant. The present study showed no significant HLA associations in Chinese NIDDM patients with or without non-toxic goiter, and the distribution of each antigen was not related to the presence or absence of goiter. PMID- 2754420 TI - Prevention of postlaminectomy membrane: experimental and clinical observations. AB - An animal experimental study was performed to investigate the prevention of scar formation after laminectomy by applying Gelfoam, a free-fat graft and steroids as interposing material between the dura and muscles. There were 52 adult guinea pigs equally divided into four groups. They were sacrificed 2 weeks, 4 weeks and 12 weeks respectively after surgery. In the control group, there was young fibrous tissue at 2 weeks, which became more mature at 4 weeks. At 12 weeks, it became mature with varying thickness and canal extension. In the steroid group, it showed the same picture as the control group. In the Gelfoam group, there was foreign body reaction with disintegration of Gelfoam at 2 to 4 weeks. At 12 weeks, however in the free-fat graft group, viable fat graft could be seen at the laminectomy site with little fibrous tissue overlying the dura. In the clinical part, from September 1981 to September 1984, one of the authors (PQC) performed 100 laminectomies on patients with various causes of low back pain. A piece of free subcutaneous fat was laid on dura before wound closure. At follow-up, there was no adverse effect pertaining to its application. Most patients had considerable pain relief after the surgery. From the above observation, we believe that a free-fat graft is a simple and effective way to prevent postlaminectomy membrane. Steroids and Gelfoam do not have such advantage. PMID- 2754421 TI - [Prognosis of comatose patients on ventilator: a prospective study of brain death]. AB - The concept of brain death is widely accepted in most countries. However, there are differences in the criteria for the diagnosis of brain death. In Taiwan, the diagnostic criteria of brain death has just been established. These criteria require strict preconditions to be fulfilled, necessary exclusions to be made, and adequate time of observation to ensure the irremediability of the disease. Tests of brainstem reflexes and apnea are then performed and should be repeated at an interval of at least 4 hours to establish the diagnosis. This prospective study was undertaken in order to examine the reliability of the present criteria. A total of 79 comatose patients (57 males and 22 females) on the ventilator were collected. Their ages ranged from 2.3 to 89 years, with a mean of 46.3 +/- 20.3 years. The preconditions or exclusions were not fulfilled in 5 patients (3 with drug intoxication, 1 with septicemia, and 1 due to an unknown cause). Among them, 1 with alcohol intoxication recovered well. Of 16 patients with hypoxic/ischemic brain damage, brain death was diagnosed in only 2; in the remaining 14 patients, 6 became vegetative and 8 died from cardiac arrest. Fifty-eight patients sustained structural brain damage, and brain death was diagnosed in 50 of these patients. The most frequent cause of brain death was head injury (31 cases), followed by intracerebral hemorrhage (11 cases). Of the 52 patients fulfilling the criteria of brain death, all sustained cardiac asystole in a limited interval of time (96% in 7 days).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2754422 TI - [Electroencephalography and brainstem auditory evoked potential in brain death]. AB - The usefulness of electrophysiologic examination in the diagnosis of brain death has been a controversy. This study was undertaken to examine the role of electroencephalography (EEG) and brainstem auditory evoked potential (BAEP) in the brain death diagnosis. From March to November 1986, EEG and BAEP were studied in 21 patients (14 males, 7 females; aged 26-73 years) fulfilling the diagnostic criteria of brain death proposed by a special committee organized by the Department of Health, R.O.C. All the EEG and BAEP were performed within 24 hours after the diagnosis of brain death. Of the 15 patients who underwent EEG test, isoelectric tracing (less than 2.5 microV) was found in 5 (33%), low-potential record (less than 5 V) in 3 (20%), and obvious residual activity in 7 (47%). Of the 20 patients who had BAEP examination, absence of all waveforms was noted in 11 (55%), and Wave-I only was preserved in 9 (45%; 6 unilateral, and 3 bilateral). Half of the preserved Wave-I were of prolonged latency (greater than 1.97 msec). Regardless of the EEG and BAEP findings, all of the 21 patients developed cardiac asystole within 77 hours after the diagnosis of brain death. During the study period, we observed 2 patients with absence of auditory evoked responses; both were deaf, but were not brain death victims. From this study, it is obvious that the EEG findings do not correlate well with the diagnosis of brain death. The reason is understandable since EEG is essentially a test of cortical function, while brain death can be diagnosed on the basis of irreversible loss of brainstem function.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2754423 TI - The relation between Campylobacter pylori and inflammatory cell infiltration of antral mucosa in patients with dyspepsia. AB - In order to understand the relation between the prevalence of Campylobacter pylori and the severity of gastritis, we conducted a survey of 166 randomly selected dyspeptic patients. The presence of C. pylori on the antral mucosa was aseptically determined by both urease and bacterial culture tests. Specimens of antral mucosa were obtained for pathologic gradings of inflammation: active gastritis, mononuclear cell infiltration C0 (nil) to C3 (lymphoid follicle); presence or absence of intestinal metaplasia. Pathologically, chronic gastritis was invariably present in almost all patients with dyspepsia: three-fourths of them showed evidence of active gastritis, one-third showed intestinal metaplasia. Half of the dyspeptic individuals had C. pylori colonization. The results suggest that the prevalence of C. pylori was closely related to the different grades of active gastritis; neither the different grades of chronic gastritis nor intestinal metaplasia affected the prevalence of C. pylori on gastric mucosa. We conclude from this study that C. pylori is closely related to active chronic gastritis because of the common presence of chronic gastritis in patients with dyspepsia. PMID- 2754424 TI - [Intracorporeal injection of papaverine for diagnosis of impotence: clinical evaluation of 120 patients]. AB - Intracorporeal papaverine injections were performed for evaluation of penile erection on 120 patients with sexual impotence. This diagnostic technique was found to be simple, objective, realistic, and more precise in the differentiation of sexual dysfunction in men. In addition to observing the onset and duration of erection after papaverine injection, we could also classify the erectile rigidity by measuring the erectile angle while standing. The penile deformity after erection that possibly contributed to the etiology of patient's impotence could also easily be detected after papaverine injection. Thus we could differentiate 120 cases of impotence into the following types: psychogenic (26 cases), neurogenic (2 cases), mild vasculogenic (including physiologic) (33 cases), severe vasculogenic (54 cases) and pure venous leakage syndrome (5 cases). None of our patients developed fatal complications during or after the papaverine intracorporeal injection test; however, we experienced 5 cases of priapism requiring emergency management. Therefore, the injection must be done under the supervision of an experienced urologist. PMID- 2754425 TI - [Diagnostic value of serum total bile acid in hepatobiliary diseases]. AB - The purpose of this study was to evaluate the clinical diagnostic value of serum total bile acid (STBA) in hepatobiliary diseases. Fasting STBA was measured using the enzymatic colorimetric method in 44 normal control cases and 153 cases of hepatobiliary disease, and then abnormal rates were compared to other conventional liver function tests. These 153 cases of hepatobiliary diseases included acute viral hepatitis (10 cases), chronic persistent hepatitis (32 cases), chronic active hepatitis (16 cases), liver cirrhosis (15 cases), alcoholic hepatitis (11 cases), alcoholic fatty liver (23 cases), alcoholic cirrhosis (17 cases), chronic liver diseases with slight fatty changes (10 cases) and hepatocellular carcinoma (6 cases). Except for 8 cases of acute viral hepatitis, the above cases were verified by liver biopsy. There were also 13 cases of biliary tract diseases. Fasting STBA and other conventional liver function tests were used in the above hepatobiliary diseases during the acute, exacerbated or decompensated stage, and the stable or compensated stage, and their abnormal rates compared. The results of this study revealed that the concentration of STBA is raised in various hepatobiliary diseases, which is related to the degree of hepatic cell injury and the various stages of liver. The concentration of STBA was higher in the acute, exacerbated or decompensated stage than in the convalescent, stable or compensated stage of liver diseases. When the abnormal rates of STBA were compared to other conventional liver function tests, the abnormal rates of STBA were not inferior to r-GT, GOT and GPT, and were more accurate than the other liver function tests.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2754426 TI - Guillain-Barre syndrome associated with acute delta hepatitis virus superinfection. AB - We describe a patient with the clinical characteristics of Guillain-Barre syndrome, including progressive ascending paresis; cerebrospinal fluid albumino cytological dissociation; polyphasic small evoked potential, with prolonged latency and slow motor nerve conduction velocity; and active denervation pattern on electromyography, in association with acute delta hepatitis virus superinfection. The patient recovered from Guillain-Barre syndrome but developed chronic active delta hepatitis. PMID- 2754427 TI - Clearance of hepatitis B virus DNA and pre-S surface antigens in patients with markers of acute viral replication. AB - To clarify the relationship between the pre-S antigens and other serological markers of hepatitis B virus (HBV) replication, we followed up 27 patients: 21 presented with symptoms of acute hepatitis (two progressed to chronicity) and six suffered from chronic hepatitis. Pre-S1, pre-S2, HBV DNA, IgM antihepatitis core antigen (HBc), hepatitis B e antigen (HBeAg), and anti-HBe were detected in about 200 sera serially collected at different times for at least 6-12 months from the onset of clinical observation. In the early symptomatic phase of acute hepatitis, the pre-S1 and pre-S2 antigens were present in 95% of the cases and correlated well with high levels of alanine-transferase (ALT) and IgM anti-HBc, while HBV DNA was present in the sera of only six (28.6%) patients (P less than 0.0001). This was the first marker to disappear (1 month after the initial stage). All of the HBV DNA-positive patients were also HBeAg positive, whereas no HBeAg-negative subjects were found with serum HBV DNA. In the six chronic patients, pre-S antigens were always present independently of the HBeAg/anti-HBe status; HBV DNA was detected in three of them, even if transiently, and in two of these it reappeared together with pre-S2 epitope. The follow-up data suggest that, in acute hepatitis, the clearance of pre-S antigens can be considered as a prognostic index of clinical resolution and that, in chronic hepatitis, the persistence of pre-S antigens seems to indicate progression of the disease. In particular, pre-S2, in patients in whom it is intermittent, can be considered as an index of reactivation. PMID- 2754428 TI - GABA and its neural regulation in rat brown adipose tissue. AB - By using a radioreceptor assay GABA was detectable in rat interscapular brown adipose tissue (IBAT), the levels being 1% those of CNS and 10-fold those of peripheral plasma. Injection of the glutamic acid decarboxylase (GAD) inhibitor 3 mercaptopropionic acid lowered IBAT GABA levels by about half while injection of the GABA transaminase inhibitor gamma-acetylenic GABA increased them by 230%. Rats kept at 4 degrees C for 14 days exhibited IBAT GABA levels that were about half those found at 22 degrees C. Accumulation of IBAT GABA after gamma acetylenic GABA increased by 2-fold in cold-exposed rats. Sympathetic denervation of IBAT prevented the effect of the cold environment on GABA content and impaired that on GABA accumulation. GAD activity was detectable in IBAT homogenates and isolated brown adipocytes. Exposure of rats to cold increased Vmax of GAD without modifying its Km, regardless of intactness of innervation. In binding studies with 3H-GABA as a ligand, two types of sites were uncovered of KD = 14 and 146 nM, respectively. In the presence of 2.5 mM Ca2+ bicuculline and baclofen were 57 and 46% as effective as GABA to displace 3H-GABA from IBAT binding sites. The results indicate existence, possible synthesis and type A and B receptors of GABA in rat IBAT. PMID- 2754429 TI - Influence of food intake on the enantiomeric composition of urinary salsolinol in man. AB - Salsolinol is present in human fluids and tissues as well as in foods and beverages. It was shown previously that the R enantiomer of salsolinol predominates in human urine, whereas the S enantiomer predominates in Port wine. An R/S ratio very near to 1 was found in dried banana, a food particularly rich in salsolinol. In this study 100 g of dried banana were administered to 6 healthy subjects. The urinary excretion of the R and S enantiomers of salsolinol was measured 24h before and 24h after banana intake, each time in two fractions. Whereas the S enantiomer was present only in the fraction 5 p.m.-9 a.m. and only in 3 out of the 6 subjects before banana intake, this enantiomer was found in the two intervals 9 a.m.-5 p.m. and 5 p.m.-9 a.m. in all the subjects after banana intake. The presence of the S enantiomer in urine in 3 subjects before dried banana might be related to alcohol intake. The amount of R + S salsolinol eliminated in the 24h urine was found to represent 0.75% of the total dose administered. In conclusion a normal diet should have a negligible influence on urinary salsolinol concentrations, with, perhaps, the exception of alcohol; interestingly the R enantiomer might represent endogenous salsolinol. PMID- 2754430 TI - [3H]5-HT binding in post-mortem human cerebral cortex: methodological considerations. AB - The effects of different membrane preparations and assay conditions on [3H]5-HT binding to post-mortem human cortical tissue was studied. Optimal binding necessitated thorough removal of endogenous 5-HT and this was achieved either by hypotonic lysis or by preincubation of the membranes at 37 degrees C. Calcium chloride (4 mM) increased specific [3H]5-HT binding. The further addition of ascorbic acid (5.7 mM) or ascorbic acid and clorgyline (10 microM) reduced specific [3H]5-HT binding. PMID- 2754431 TI - Neuropeptide Y increases the inhibitory effects of clonidine on potassium evoked 3H-noradrenaline but not 3H-5-hydroxytryptamine release from synaptosomes of the hypothalamus and the frontoparietal cortex of the male Sprague-Dawley rat. AB - The release of 3H-noradrenaline (3H-NA) and of 3H-5-hydroxytryptamine (3H-5-HT) evoked by high-K+ (15 mM) was studied in synaptosomes isolated from the hypothalamus and the frontoparietal cortex of the male Sprague-Dawley rat using a superfusion apparatus. Based on concentration-response curves obtained by analyzing the full-time course of the inhibitory effects of clonidine on 3H-NA and on 3H-5-HT release neuropeptide Y (NPY) (1 nM) was shown to significantly increase the ability of clonidine to inhibit 3H-NA release in synaptosomes isolated from the hypothalamus and from the frontoparietal cortex. NPY (1 nM) alone had no effect on K+-evoked 3H-NA release from these regions. In contrast, NPY (1 nM) did not modulate the inhibitory effects of clonidine on 3H-5-HT release in the above mentioned regions. These results indicate that NPY can increase the sensitivity of the alpha 2-autoreceptors belonging to hypothalamic NA and/or to adrenaline nerve terminals and to cortical NA nerve terminals, while the alpha 2-heteroreceptors inhibiting 3H-HT release in the same brain regions appear not to be regulated by high affinity NPY receptors. Thus, alpha 2 autoreceptors and alpha 2-heteroreceptors appear to be differentially controlled by high affinity NPY receptors at least with regard to regulation of 3H-NA and 3H 5-HT release, respectively. PMID- 2754432 TI - Diurnal variation in norepinephrine-stimulated release of pineal serotonin in vitro. AB - Adult, male rats were maintained under 12L:12D with lights on at 06.00h. Their pineal glands were incubated at 37 degrees C in the presence or absence of 10( 4)M norepinephrine (NE). 5-HT and various metabolites were quantitated in post incubation media and pineal glands by high performance liquid chromatography coupled with electrochemical detection. No differences were observed in the quantities of 5-HT released by pineal glands in four hour incubations starting at either 06.00, 13.00 or 18.00 h; however, a highly significant decrease below these levels was observed at 01.00h. NE significantly stimulated 5-HT release at 13.00 and 18.00 h, but was ineffective at 01.00 and 06.00h. These results confirm recently reported stimulatory effects of NE on the release of 5-HT into pineal gland incubation medium and further suggest a diurnal rhythm of pineal gland sensitivity to NE in vitro with maximum stimulation of 5-HT release at midphotophase. PMID- 2754433 TI - Androgens modulate endplate size and ACh receptor density at synapses in rat levator ani muscle. AB - The dorsal bulbocavernosus or "levator ani" muscle of the rat is highly responsive to androgens. Both the muscle and the motoneurons which innervate it contain high concentrations of androgen receptors. The neuromuscular synapses in this muscle are also affected by changing androgen levels. In particular, the total number of ACh receptors (AChRs) in the muscle is lower in males that have been castrated, and it increases after treatment with the androgens, testosterone and 5 alpha-dihydrotestosterone. An examination of individual endplates using histochemistry and quantitative autoradiography suggested that the reduction in AChR number following castration is caused by reductions in both the size of endplates and in the density of AChRs at each synapse. PMID- 2754435 TI - Long-term remission in a patient with erythroleukemia following interferon-alpha treatment. AB - A patient in second relapse of acute erythroleukemia (AEL) was treated with 10 MU of recombinant interferon (IFN)-alpha subcutaneously for 24 days after he had failed standard chemotherapy. Besides fever up to 38.9 degrees C and a transient raise in liver function parameters, treatment was well tolerated but had to be discontinued because of a severe decrease in white blood cell and platelet count. After termination of IFN treatment, both cell populations showed a continuous rise during the following weeks and hemoglobin increased concomitantly. Partial remission could be reached as was demonstrated by a decrease in PAS-positive erythroblasts in bone marrow biopsy. Further studies with IFN in patients with AEL refractory to cytostatic chemotherapy are recommended. PMID- 2754434 TI - Cell death of motoneurons in the chick embryo spinal cord. X. Synapse formation on motoneurons following the reduction of cell death by neuromuscular blockade. AB - Chronic treatment of chick embryos with neuromuscular blocking agents, such as curare, rescues motoneurons from naturally occurring cell death. In the present study, embryos treated with curare from E6 to E9 had 35% more motoneurons than controls on E10 and 42% more than controls on E16. Previous studies have shown that several aspects of motoneuron differentiation occur normally in curare treated embryos. We report here that dendrite growth and arborization is also unaltered on E10 and E16 following curare treatment. A quantitative analysis of afferent synapses on motoneurons shows that the packing density of both axosomatic and axodendritic synapses is also normal on E10 in curare-treated embryos, despite the greater number of motoneurons present. This indicates that the interneurons that provide presynaptic input to motoneurons are able to compensate for the increased number of synaptic sites made available by curare treatment. However, by E16 the packing density of synapses is reduced by about half. Because motoneurons and their dendrites continue to grow between E10 and E16, the further increase in synaptic sites made available in curare-treated embryos apparently exceeds the compensatory capacity of presynaptic interneurons on E16. One can conclude from these results that the increased survival of motoneurons in curare-treated embryos is not owing to an increase in afferent synapses. Motoneurons in these embryos continue to survive in the face of either no change (E10) or a reduction (E16) in the number of axodendritic and axosomatic synapses. Therefore, increased motoneuron survival in this situation is very likely regulated primarily by motoneuron-target interactions. PMID- 2754436 TI - Induction of tumor-infiltrating lymphocytes in human malignant melanoma metastases by immunization to melanoma antigen vaccine. AB - We report a statistically significant increase in tumor-infiltrating lymphocytes in subcutaneous melanoma metastases removed from patients immunized with a melanoma vaccine. Dense cellular infiltrates were seen in 10 of 11 nodules from vaccine-immunized patients, compared with 9 of 22 nodules from non-immunized patients (p = 0.02). Furthermore, these dense lymphocytic collections more frequently infiltrated the body of tumor nodules from immunized patients, whereas in non-immunized patients, lymphocytes were more often present only in the dermal tissue at the periphery of the nodule. Thus, allogeneic melanoma vaccines may augment immune responses to a patient's own tumor. PMID- 2754437 TI - Regression of MOPC 104E plasmacytoma with monoclonal anti-idiotype antibodies. AB - We investigated the therapeutic effectiveness of monoclonal anti-idiotype (anti M104E5) antibodies. Our in vitro studies show monoclonal anti-idiotype-specific antibody SJL18-1 showed a selective inhibitory property for MOPC 104E cells over two cross-reactive idiotype antibodies N-20-2 (IgM, IdX-M104E, and J558) and CD3 2 (IgG1, IdX-M104E, and J558). Based on these observations, we further examined their biological activities in vivo. Mice given 2 x 10(4) MOPC cells s.c. were treated with various doses of the antibodies i.v. on days 0, 7, 14, 21, and 28 after tumor transplantation. In the group treated with 100 micrograms of N-20-2 antibody, the antibody treatment prevented the growth of MOPC 104E in some of the mice. Treatment of tumor-bearing mice with SJL18-1 antibody (10 to 1,000 micrograms/mouse) did not provide any survival benefit. On the other hand, in mice treated with 50 micrograms of CD3-2 antibody, four of ten mice had regression of their palpable tumors. It is important to note that the least effective antibody (CD3-2) in vitro was the most effective in vivo, and the most effective antibody (SJL18-1) in vitro did not show any survival benefit. Preliminary data indicate that the most likely mechanism of in vivo regulation of MOPC 104E myeloma is by cytostatic lymphocytes. PMID- 2754438 TI - Immunomodulating and antitumor activities of a synthetic lauroyltripeptide (RP 56 142). AB - Lauroyltripeptide (RP 56 142) (N2-[N-(N-lauroyl-L-alanyl)-gamma-D-glutamyl]-L,L 2,6-diaminopimelami c acid) was shown in murine models to activate several immune mechanisms involved in host defense against tumors. RP 56 142 induced macrophage activation and enhanced cytotoxicity of natural killer cells in spleen, blood, and liver. These activities correlated with prophylactic and therapeutic effects of RP 56 142 on artificial liver metastases of M5076 histiocytosarcoma. RP 56 142 alone did not inhibit spontaneous liver metastases of M5076 sarcoma; however, in combination with surgery or suboptimal doses of cisplatin, the compound exerted synergistic antimetastatic effects in the same model. These findings suggest that RP 56 142 could be used in cancer patients as an immunotherapeutic agent in combination with surgery, radiotherapy and/or conventional chemotherapy. PMID- 2754439 TI - WHO issues report on heavy metal and PAH compounds from municipal incinerators. PMID- 2754440 TI - Overview of proposed revisions to the superfund hazard ranking system. AB - The Comprehensive Environmental Response, Compensation, and Liability Act of 1980 required the federal government to establish criteria for setting priorities among releases of hazardous substances, pollutants, and contaminants. The U.S. Environmental Protection Agency responded by developing the Hazard Ranking System (HRS), which is a scoring system used to establish the National Priorities List (NPL). The Superfund Amendments and Reauthorization Act of 1986 required EPA to amend the HRS so it will more accurately assess relative risks and take into account certain specific elements of risk. On December 23, 1988, EPA published in the Federal Register the proposed rule to revise the HRS. EPA expects to issue the final rule in 1990 after reviewing public comments. This paper describes the proposed revisions and summarizes major technical findings that support the revisions. As a result of the HRS revisions, there may be some changes in the types of sites that score high enough to be placed on the NPL. A projection of those changes is discussed. PMID- 2754441 TI - Health risks of short-term SO2 exposure to exercising asthmatics. AB - A method is described for quantifying health risks to asthmatics briefly exposed to elevated levels of SO2. By combining symptomological and physiological measurements, we have developed a dose-response surface that relates both severity and incidence of response to ambient air quality levels. The complete model to assess potentially avoidable risks includes power plant emission data; ambient SO2 background levels; demographic and activity patterns of asthmatics, the identified population at risk; and the dose-response surface. The estimated annual risk to persons experiencing an SO2-induced response due to a nearby power plant is quite small (response rates under 3 percent). Uncertainties due to modeling errors, variations in activity patterns, demographics and physiological response are discussed. PMID- 2754442 TI - Chemical and biological characterization of products of incomplete combustion from the simulated field burning of agricultural plastic. AB - Chemical and biological analyses were performed to characterize products of incomplete combustion emitted during the simulated open field burning of agricultural plastic. A small utility shed equipped with an air delivery system was used to simulate pile burning and forced-air-curtain incineration of a nonhalogenated agricultural plastic that reportedly consisted of polyethylene and carbon black. Emissions were analyzed for combustion gases; volatile, semi volatile, and particulate organics; and toxic and mutagenic properties. Emission samples, as well as samples of the used (possibly pesticide-contaminated) plastic, were analyzed for the presence of several pesticides to which the plastic may have been exposed. Although a variety of alkanes, alkenes, and aromatic and polycyclic aromatic hydrocarbon (PAH) compounds were identified in the volatile, semi-volatile, and particulate fractions of these emissions, a substantial fraction of higher molecular weight organic material was not identified. No pesticides were identified in either combustion emission samples or dichloromethane washes of the used plastic. When mutagenicity was evaluated by exposing Salmonella bacteria (Ames assay) to whole vapor and vapor/particulate emissions, no toxic or mutagenic effects were observed. However, organic extracts of the particulate samples were moderately mutagenic. This mutagenicity compares approximately to that measured from residential wood heating on a revertant per unit heat release basis. Compared to pile burning, forced air slightly decreased the time necessary to burn a charge of plastic. There was not a substantial difference, however, in the variety or concentrations of organic compounds identified in samples from these two burn conditions. This study highlights the benefits of a combined chemical/biological approach to the characterization of complex, multi-component combustion emissions. These results may not reflect those of other types of plastic that may be used for agricultural purposes, especially those containing halogens. PMID- 2754443 TI - EPA announces "right to know" results of 1987 toxic release inventory. PMID- 2754444 TI - Nursing as comprehensive process. PMID- 2754445 TI - Nursing the terminally sick. PMID- 2754446 TI - Patterns of failure following local excision and local excision and postoperative radiation therapy for invasive rectal adenocarcinoma. AB - The clinical course of 40 patients undergoing conservative surgical excision and 26 patients undergoing local excision and postoperative radiation therapy of rectal carcinoma was reviewed. Surgical procedures were transanal excision (55 patients), Kraske procedure (ten patients), and fulguration (one patient). The five-year actuarial survival, disease-free survival, and local control of all 66 patients were 70%, 77%, and 63%, respectively. For patients undergoing local excision alone, the prognostic features of lesion size greater than 3 cm, poorly differentiated histology, invasion into muscularis propria or deeper, moderate to marked stromal fibrosis, vascular or lymph vessel invasion, fragmented resection, and positive resection margins were associated with a local failure rate of 20% or greater. Of the 26 patients receiving postoperative radiation therapy, four patients have developed local failure. For subgroups of patients with small rectal carcinomas confined to the mucosa, local excision may be a reasonable alternative to abdominoperineal resection. For tumors with deeper invasion but limited to the bowel wall, local excision plus pelvic irradiation can be offered to preserve anorectal function. PMID- 2754447 TI - Increased risk of lung cancer, non-Hodgkin's lymphoma, and leukemia following Hodgkin's disease. AB - The risk of second cancers (SCs) was assessed in 744 patients with Hodgkin's disease (HD) admitted to The Netherlands Cancer Institute from 1966 to 1983. Sixty-nine SCs were observed one month or more after start of first treatment. These included 14 cases of lung cancer, nine cases of non-Hodgkin's lymphoma (NHL), 16 cases of leukemia, and six cases of the myelodysplastic syndrome (MDS). The median interval between the diagnosis of HD and that of second lung cancer, NHL, and leukemia was 8.1, 13.3, and 5.7 years, respectively. The overall relative risks (RR) (observed/expected [O/E] ratios) of developing lung cancer, NHL, and leukemia were 4.9 (95% confidence limit [CL], 2.7 to 8.2), 31.0 (95% CL, 14.2 to 58.9) and 45.7 (95% CL, 26.1 to 74.2), respectively. At 15 years the cumulative risk of developing an SC amounted to 20.6% +/- 2.9%. The 15-year estimates of lung cancer, NHL, and leukemia were 6.2% +/- 1.9%, 5.9% +/- 2.1% and 6.3% +/- 1.7%, respectively. Increased lung cancer risk following HD has not frequently been clearly demonstrated before; that we were able to demonstrate such risk may be due to the completeness of follow-up over long periods that could be achieved in this study. Excess lung cancer risk was only noted in treatment regimens with radiotherapy (RT); also, all lung cancers arose in irradiation fields. Excess risk of leukemia was only found in treatment regimens involving chemotherapy (CT). For NHL, combined modality treatment was shown to be the most important risk factor. Risk of lung cancer and NHL increased with time since diagnosis. A time-dependent covariate analysis (Cox model) performed on leukemia and MDS showed an increasing risk with intensity of CT, age (greater than 40 years), and a splenectomy. PMID- 2754448 TI - Stage IA-IIB Hodgkin's disease: staging and treatment of patients with large mediastinal adenopathy. AB - Ninety-two patients with clinically staged (CS) IA-IIB Hodgkin's disease (HD) with large mediastinal adenopathy (LMA) underwent three different staging and treatment approaches between April 1969 and December 1984. These approaches included: (1) staging laparotomy followed by radiation therapy (RT) alone; (2) staging laparotomy followed by combined RT and chemotherapy (CMT); or (3) clinical staging followed by CMT. Patients treated with CMT were more likely to have "B" symptoms, extension into extranodal sites, or stage III disease. Patients treated with RT alone had a significantly higher risk of relapse as compared to patients receiving CMT. No overall survival differences were seen between the three groups of patients. For patients treated with CMT without RT to the spleen or abdominal nodes, the risk of relapse in the abdomen was low (4%). These data suggest that for those CS I-II HD patients with LMA who are treated with CMT, the role for staging laparotomy and abdominal irradiation is limited. RT alone remains an option for some patients with LMA, but careful assessment of the anatomic extent of thoracic disease as well as staging laparotomy is essential if such treatment is recommended. PMID- 2754449 TI - Association of granulocytosis with poor prognosis in patients with acute myelogenous leukemia and translocation of chromosomes 8 and 21. AB - Forty-three patients with acute myelogenous leukemia (AML) and a translocation 8;21 were reviewed. The patients' median age was 30 years, and 62% were men. Twenty-three patients (53%) had loss of a sex chromosome and ten (23%) had other chromosomal abnormalities in addition to the 8;21 translocation. Complete remission (CR) with induction chemotherapy was achieved in 40 patients (93%). The median CR duration was 18 months (range, 1 to 137+ months). Median survival time was 17 months (range, 0.5 to 138+ months) with a 3-year survival rate of 31%. Twenty-three patients (53%) relapsed between 1 and 58 months after entering remission with reinduction therapy resulting in 8 CRs (35%). Thirteen characteristics were examined for an effect on survival. The most striking finding was a significant association between elevated absolute granulocyte count and poor survival (P = .002). WBC count greater than 10,000/microL was also associated with shorter survival (P = .05). Patient age, albumin level, and platelet count showed trends for survival association. Although patients with AML and t(8;21) are regarded as a favorable group with respect to survival, we found a subset of patients who do very poorly. Intensive or more investigational approaches in first remission should be considered for these patients. PMID- 2754450 TI - Flow cytometry as a predictive indicator in patients with operable gastric cancer. AB - Adenocarcinoma of the proximal portion of the stomach (gastroesophageal [GE] junction and cardia) is increasing in incidence. The inferior survival of patients with GE-cardia lesions as compared with patients with tumors located in the body and antrum has been attributed to anatomic features. To determine if a biological difference could explain the varying prognosis, flow cytometric studies were performed prospectively in 50 patients with operable gastric cancer and analyzed for association with site, histology, gender, age, stage, and disease-free survival. DNA aneuploidy significantly correlated with tumor location: 96% of GE-cardia carcinomas were aneuploid as compared with 48% of body antrum tumors (P = .0008). Nodal involvement was more common in aneuploid tumors (P = .0548), and women were more likely to have diploid tumors than were men (P = .0233). The median disease-free survival for patients with diploid tumors was 18.5 months as compared with 5.4 months for patients with aneuploid carcinomas (P = .076). Furthermore, within the body-antrum of the stomach, patients with diploid tumors had a significantly better disease-free survival than did those with aneuploid tumors from the same site (18.4 v 4.7 months, P = .0185). These results indicate there is a difference in the DNA content of gastric tumors located in different sites within the stomach and that DNA content correlates with prognosis. PMID- 2754451 TI - Computed tomography-guided retroperitoneal biopsies. AB - A retrospective review was performed on consecutive patients who had a computed tomographic (CT) biopsy of the retroperitoneum at University Hospitals of Cleveland. Biopsies were performed using a 20-gauge Chiba needle (University Medical Instruments Corp, Ballston Spa, NY) and a 14-gauge Tru-Cut needle (Baxter Pharmaseal, Valencia, CA). The results included success rate, failure, and complications, and were determined by a review of patient charts, surgical results, and autopsy results. The 20-gauge needle aspirations were accurate in suggesting the diagnosis in 20 of 22 cases of metastatic disease and ten of 15 cases of lymphoma. Using the 20-gauge needle, it was not possible to make a specific diagnosis in any of the lymphoma patients or for unusual benign disorders. With the 14-gauge Tru-Cut needle, the correct diagnosis was made in 13 of 13 cases of metastatic disease, ten of 11 cases of lymphoma, and two of 2 cases of unusual benign disorders. It was also possible to make the specific diagnosis of the lymphoma type in ten of 11 cases. The only complication was a small subcutaneous hematoma following a biopsy with a 20-gauge Chiba needle. PMID- 2754452 TI - A rational next step in the treatment of some rectal adenocarcinomas. PMID- 2754453 TI - Pinealomas and germinomas in children. AB - A series of 34 pinealomas and intracranial germinomas in childhood (age less than 20), from two tumor registries, is analyzed. Male to female ratio was 2:1. Median age was 12 years. Visual complaints and endocrine disturbances were the most common presenting symptoms. Papilledema, visual field deficits, and oculomotor abnormalities were the principal findings at diagnosis. Cumulative probability of survival (CPS) of the entire series at one year was 0.65, at two years 0.54, and at five years 0.54. Best survival was with treatment by operation and radiation: CPS at one year was 0.82, at two years 0.82, and at five years still 0.82. Survival was similar with pineal region tumors and with suprasellar tumors. Most long-term survivors, particularly with suprasellar germinomas, had permanent hormonal deficits requiring replacement therapy. PMID- 2754454 TI - Fibrous dysplasia of the skull with acromegaly and sarcomatous transformation. Two cases with a review of the literature. AB - Two cases of fibrous dysplasia of the skull are reported. Both patients were young women with acromegaly and were treated with radiotherapy. Progressive pareses of cranial nerves, pain, and a malignant course of the disease were characteristic in both patients, and the diagnosis of osteogenous sarcoma proved in one of them by histological examination. The clinical picture of fibrous dysplasia of the skull and the role of radiotherapy with the risk of development of malignancy is discussed. PMID- 2754455 TI - Red blood cell polyamines as a diagnostic indicator of glioma presence and recurrence. AB - Red blood cell (RBC) polyamines, spermine and spermidine have been assayed from 103 patients with confirmed intracranial tumours and 87 controls. For spermine the test had a specificity of 97% and a sensitivity of 30% in preoperative patients, increasing to 40% in glioma patients. Tumour recurrence in postoperative patients gave a sensitivity of 48% increasing to 60% in glioma groups. For initial tumour presentation, therefore, this test is suggestive, though not unequivocal, of tumour presence. Its major role probably lies in monitoring the progress of the patient and its major importance in the detection of tumour recurrence. PMID- 2754456 TI - A phase II study of cisplatin therapy in recurrent childhood brain tumors. A report from the Childrens Cancer Study Group. AB - Thirty-six children with brain tumors were treated with surgery, radiation and/or adjuvant chemotherapy. After tumor recurrence, cisplatin (60 mg/m2/day IV X 2) was given every three to four weeks. CT scans were used to measure drug response prior to the first, third and fifth courses. Complete and partial responses were demonstrated in nine of 31 evaluable patients. Dose limiting toxicities were renal and auditory. Seven patients developed the syndrome of inappropriate antidiuretic hormone secretion. This study confirms that cisplatin is active in a spectrum of brain tumors. PMID- 2754457 TI - Cultured brain endothelium inhibits the cytocidal action of natural killer cells on glioma. AB - The killing of GL26 and YAC-1 cells by natural killer cells (NKC) is reduced in the presence of a monolayer of endothelial cells. This reduction in cytotoxicity correlates with the degree of adhesion between the tumor cells and the endothelial monolayers. The cytotoxicity of NKC toward glioma was 10% when carried out on plastic, but a monolayer of endothelium derived from brain inhibited the cytotoxicity by about 90%. Endothelium from thoracic duct and lung also inhibited cytotoxicity by about 90%, endothelium from aorta inhibited by 55% and that from ovary by only 45%. Cytotoxicity of NKC toward YAC-1 (a control NK target) was 40% on plastic, but a monolayer of endothelium from thoracic duct inhibited the cytotoxicity by 75%. Endothelium from brain and lung inhibited cytotoxicity by about 60%, aorta by 50%, and ovary by 40%. Interactions between tumor cells and the host-organ microvascular endothelium appear to protect neoplastic cells from natural surveillance mechanisms and may play a role in the formation of metastatic tumor deposits. PMID- 2754458 TI - Prolongation of G1 phase in cultured glioma cells by cis-dichlorodiammineplatinum (II) (CDDP): analysis using bromodeoxyuridine (BrdU)-Hoechst technique. AB - The cytokinetic response of three murine (AC) and human (GB-1 and GB-2) glioma cell lines to cisdichlorodiammineplatinum (II) (CDDP) was investigated by flow cytometry. Using the 5-bromodeoxyuridine (BrdU)-Hoechst technique, percentages of cultured glioma cells in the various phases of the cell cycle, and relative phase duration were calculated. This technique proved to be a rapid and easily performed method to characterize phase length and transition rate for the complete cell cycle. In the presence of CDDP IC10 (a concentration in which 10% inhibition of cell growth be induced as compared to controls), perturbations of the cell cycle in AC and GB-1 cells included G2 delay or block, decreased transit velocity from G1 to S phase, and prolongation of G1 phase. The mean cell cycle time increased 1.4 times in AC and 1.6 times in GB-1 as compared to controls. In CDDP IC 50-treated GB-2 cells, the mean cell cycle time was prolonged three times longer than control: however, duration of each phase could not be calculated because of significant perturbation of cell cycle. These results suggest that CDDP influences glioma cells at the G1/S boundary and in the G2 phase, resulting in prolongation of the G1 phase and, to a minor degree, in block of the G2 phase. PMID- 2754459 TI - Hospital acquired infection and its control. PMID- 2754460 TI - Preoperative whole body disinfection (viewpoint Sweden). AB - This review is a historical summary of twenty years of experience with preoperative whole body disinfection in the western part of Sweden. PMID- 2754461 TI - The role of antiseptics and disinfectants in the control of nosocomial infections. AB - More than 600,000 cases per year of nosocomial infection in Italy reflect, in part, the scant attention given to the vehicles of infection, conditions which favour cross-contamination and not least to the inappropriate use of antiseptics and disinfectants in our hospitals. Disinfection procedures are intended to remove or neutralise sources of potentially pathogenic organisms or to prevent their transmission by blocking the routes of transmission. Data to support many disinfection policies, particularly those of routine disinfection of inanimate surfaces, i.e. floors and walls, appear unable to show significant benefit to the patient. With the exception of particular areas, a correlation between reduction in counts of airborne bacteria and microbial colonisation or clinical infection has failed to be demonstrated. However, certain antiseptic practices e.g. correct hand washing procedures, surgical skin preparation and instrument sterilisation are of invaluable use in the control of nosocomial infection. It is therefore of critical importance in this period of cost cutting and financial restraint within the hospital services that we adopt those infection control measures which are of greatest cost effectiveness. A recent critical evaluation of the use of antiseptics in several Italian hospitals, illustrates the principal characteristics of antiseptics and their fundamental role in the control of hospital infection. This study also highlights common misuses of antiseptics and their cost/benefit ratio. PMID- 2754462 TI - The development of infection control in Italy. AB - A coordinated national program for the control of Hospital Infection (H.I.) was started in 1981 in Italy as a result of growing interest in many fields of public health. The first three years of the program provided greater awareness of the problem on a national scale. The survey showed that out of 38,000 patients, 6.8% developed a hospital acquired infection. Hospitals as well as research institutions responded with studies, periodical surveys and incidence surveys- some of which were on a national scale. One national incidence survey in intensive care units showed a 30% H.I. incidence rate from 6,000 patients. A five year research fund from the National Research Council provided for the study of H.I. by 18 different research groups. There have been several initiatives regarding presentation and control, such as two national guideline regulations made by the Minister of Health for the establishment of H.I. Control Committees in each hospital. Infection Control Nurses have been identified as key persons for the surveillance program. Two hospital schools have started a one-year, 700 hour course for Infection Control Nurses. The first 50 nurses graduated in June 1988. Health officials have agreed that prevention of hospital infection is feasible, and have mandated for a two year experimental prevention project for the Italian region, coordinated by the National Institute of Health. The project is called PRINOS, and the preliminary results are presented. PMID- 2754463 TI - The use of antiseptics for handwashing by medical personnel. AB - Numerous studies have shown that the major reservoir of nosocomial infection in the hospital is the infected or colonised patient and the major mode of spread of organisms between patients is on the hands of medical personnel. A prolonged preoperative scrub with an antiseptic is one of the most time-honoured rituals of surgical asepsis. Hygienic handwashing in the hospital or clinic, to remove transient contaminants acquired from patients or the environment and prevent cross-infection to vulnerable patients, is similarly regarded as one of the most fundamental infection control measures, yet is done infrequently by personnel in most hospitals. Following a typical brief (7.10 second) handwashing with a nonmedicated soap, the number of organisms that can be transmitted from the person's hands may, paradoxically, actually increase. Use of chlorhexidine for handwashing or application of an evaporative alcohol-based lotion has been found to reduce shedding of bacteria-laden skin squames. Routine use of antiseptic containing handwashing agents is clearly more effective than nonmedicated soaps for microbial removal, can enhance the value of the handwashings that are done and might further confer protection against contaminants acquired between handwashings. In a sequential comparative trial of three handwashing agents in a surgical intensive care unit--a nonmedicated soap, 10% povidone-iodine solution, and 4% aqueous chlorhexidine, each used exclusively for approximately six weeks- the incidence of nosocomial infection was 50% lower during the use of the antiseptic handwashing products than during the use of nonmedicated soap (P less than .001). Novel approaches are needed to improve the frequency of hygienic handwashing.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2754464 TI - Membrane properties of rat substantia gelatinosa neurons in vitro. AB - 1. The membrane properties of substantia gelatinosa (SG) neurons in an in vitro adult rat transverse spinal cord slice preparation with attached dorsal root have been examined. Intracellular recordings were obtained from identified SG neurons. 2. Seventy-six percent of SG neurons exhibited a time-dependent anomalous rectification (AR) when the membrane was hyperpolarized from the resting potential. The time-dependent AR was blocked by cesium (Cs+, 2 mM) but not by barium (Ba2+, 2 mM). Application of Cs+ itself caused membrane hyperpolarization in those SG neurons that expressed the time-dependent AR. The activation of the time-dependent AR was maximal at potentials 5-10 mV below the resting membrane potential. 3. In a few SG neurons, the current-voltage relationship revealed a marked inward rectification, even though there was no detectable time-dependent anomalous rectification during hyperpolarization. Analysis of the Ba2+- and Cs+ sensitivity of these neurons confirmed that SG neurons expressed two distinct ARs, one of which is fast and Ba2+-sensitive and the other of which is time dependent and Ba2+-insensitive. 4. Fifty-one percent of SG neurons exhibited a transient outward rectification when hyperpolarizing current pulses were applied from potentials more positive than -60 mV or when depolarizing pulses were applied from potentials more negative than -65 mV. The transient outward rectification persisted for 0.3-2 s when hyperpolarizing pulses were applied at 55 mV. 5. The transient outward rectification was associated with a decrease in membrane resistance and was enhanced in low K+ solutions. 4-aminopyridine (4-AP, 2 mM) reversibly blocked the transient outward rectification. 6. The time dependent anomalous and transient outward rectifying currents exerted opposite effects on the firing properties of SG neurons. Activation of the time-dependent AR increased neuronal excitability. In neurons that exhibited the time-dependent AR, membrane depolarization caused the appearance of a rebound depolarization that resulted in the generation of spikes with only a short delay after application of the depolarizing pulse. In contrast, the transient outward rectifying current markedly delayed spike firing in response to depolarizing pulses. This delay was blocked by application of 4-AP. 7. The diversity in response properties of subpopulations of SG neurons may result in part from this heterogeneity in membrane properties. PMID- 2754465 TI - Effects of ionic calcium on the responses of canine testicular polymodal receptors to algesic substances. AB - 1. To explore possible mechanisms of the responses to algesic substances (bradykinin, hypertonic saline, and high K+ solution) of polymodal receptors in the canine testis, the Ca2+ concentration was varied in vitro. 2. After 1 min in Ca2+-free media, the responses to both high K+ solution (60 mM K+) and hypertonic saline (0.6 M Na+) were significantly augmented and tended to increase further with time; return to normal Ca2+ concentration quickly reversed these changes. These augmenting effects were blocked by the substitution of Mg2+ for Ca2+. The excitation produced by 60 mM K+ was decreased by increasing Ca2+ in a concentration-dependent fashion. 3. Reducing the bath concentration of K+ decreased responses evoked by 9 X 10(-8) M bradykinin (BK), whereas increased K+ concentration had the opposite effect. 4. The excitatory effects of BK were significantly suppressed in extracellular Ca2+-free condition. The suppression was not affected by the addition of Mg2+. Prostaglandin E2, which has been known to be released by BK and to augment the BK response, failed to restore the suppressed response by either preapplication (2.8 X 10(-7) M) or simultaneous application in high concentration (1.4 X 10(-5) M). 5. On the basis of these observations, it was postulated that Ca2+ concentration-dependent changes of the responses to 60 mM K+ and 0.6 M Na+ results from Ca2+-dependent "membrane surface potential" changes. The suppressed response to BK by Ca2+ depletion may be explained by the intervention of Ca2+-dependent processes other than PG production. PMID- 2754466 TI - Induction of paroxysmal discharges in the dentate gyrus: frequency dependence and relationship to afterdischarge production. AB - 1. Electrical-stimulus trains activated hippocampal circuits in urethan anesthetized rats. Responses were monitored with recordings of extracellular potentials and with measurements of the extracellular potassium ([K+]o). Stimulating electrodes were placed in the CA3 region contralateral to the recording electrode (cCA3) and in the ipsilateral angular bundle (AB) while recording in the CA1 pyramidal-cell layer or the granule-cell layer of the dentate gyrus. Patterns of maximal activation were identified. 2. In the CA1 region, maximal activation was indicated by the presence of 10- to 15-mV population spikes, a smooth rise in [K+]o of 5-6 mM above base-line levels of 3 mM, and a negative shift of the sustained DC potential of 2-4 mV. The dentate gyrus was considered to be maximally activated when bursts of large-amplitude (20 40 mV) population spikes were present. These population spikes were associated with a secondary rise in [K+]o to 6-8 mM above base line and an abrupt negative shift of the DC potential of 5-8 mV. 3. Maximal activation depended on the stimulus intensity, frequency, and duration. Trains of 10-Hz stimuli were used to determine the lowest stimulus intensity needed to elicit complete activation in CA1 and in the dentate gyrus. At this intensity, afterdischarges were not produced, and these responses could be elicited repeatedly. 4. By the use of this threshold stimulus intensity, cCA3 stimulation produced a rapid and progressive augmentation of CA1 responses until maximal activation was reached. In comparison, stimulation of the AB could produce the same end result, but the appearance of CA1 population spikes was delayed. Stimulation of the AB produced a steady increase in the evoked granule-cell population spike until the appearance of the paroxysmal large-amplitude population spikes. In contrast, cCA3 stimulation produced two positive evoked responses in the dentate gyrus before the paroxysms of population spikes began. 5. The frequency dependence of the responses was determined by giving stimulus trains ranging from 2 to 100 Hz. Stimulation of cCA3 produced population spikes in CA1 up to 100 Hz that were all associated with the same peak rise in [K+]o. AB stimulation only produced CA1 responses with stimulation frequencies between 15 and 25 Hz. The paroxysmal dentate population spikes were generated by stimulus frequencies between 15 and 30 Hz with both AB and cCA3 stimulation. 6. Unilateral colchicine injections caused a loss of dentate granule cells and a loss of maximal dentate activation on the side of the injection.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2754467 TI - Maximal dentate gyrus activation: characteristics and alterations after repeated seizures. AB - 1. The dentate gyrus was activated by trains of stimulation to either the contralateral CA3 region or the ipsilateral angular bundle. Responses were monitored with recordings of extracellular field potentials and extracellular potassium ([K+]o. Maximal dentate activation was identified by the appearance of bursts of large-amplitude (20-40 mV) population spikes associated with a secondary rise in [K+]o and an abrupt negative shift of the DC potential. 2. Several parameters were defined to characterize features of maximal dentate activation. These included 1) time to onset of maximal dentate activation, 2) duration of maximal dentate activation, 3) stimulus threshold for maximal dentate activation, 4) threshold for afterdischarge production, and 5) afterdischarge durations. The time to onset of maximal dentate activation and the duration of maximal dentate activation depended on the stimulus intensity until, above a certain stimulus intensity, both parameters reached constant values. The total period of maximal dentate activation (during both stimulation and afterdischarge) was constant. 3. The characteristics of maximal dentate activation were then determined in kindled animals and compared with age-matched controls. Kindled animals had a significant increase in the total duration of maximal dentate activation and a decrease in the ratio of afterdischarge threshold to the threshold for maximal dentate activation to 1 from a ratio in control animals of 6. 4. In a set of urethan-anesthetized animals, the characteristics of maximal dentate activation before and after 36 stimuli were determined. One hour after the last of 36 stimulus-evoked seizures, there was a trend towards a decrease in the threshold for maximal dentate activation and in the time to its onset.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2754468 TI - Responses of low-frequency cells in the inferior colliculus to interaural time differences of clicks: excitatory and inhibitory components. AB - 1. We studied extracellular responses of low-frequency cells in the central nucleus of the inferior colliculus (ICC) to interaural time differences (ITDs) of clicks and compared their responses to ITDs of noise and tones. Most cells that displayed sensitivity to ITDs of clicks responded cyclically as a function of ITD with central peaks and troughs at the same ITDs as in response to noise. The positions of these peaks and troughs also matched those predicted from tonal ITD curves. Thus over the range of physiologically relevant ITDs, the binaural cells in the ICC showed similar sensitivity to ITDs of tones, noise, and clicks. 2. The transient nature of the response to a click allowed association of individual discharges with either the ipsilateral or contralateral stimulus when the binaural stimulus included a large ITD. We studied the influence of the click presented to one side on responses to the click presented to the other side. By examining responses to clicks with large ITDs, ranging from 2 to 3 up to 200 ms, we could identify both excitatory and inhibitory components in response to binaural clicks. 3. For many cells, there was evidence for a short-lasting excitation arising from one or both inputs of the binaural stimulus. Inhibitory interactions could also be demonstrated over a large range of ITDs. Long-lasting, late inhibitory components arose from both contralateral and ipsilateral inputs. In 87% of cells that were driven by the contralateral input, a late inhibitory component originating from the ipsilateral side was detected. In all cells that were driven by the ipsilateral side, a late inhibitory contralateral component was detected. This late inhibition of the excitatory response to one side by a leading stimulus to the other side could be evoked even when the leading stimulus was not effective in evoking an excitatory response. 4. Some cells also exhibited an early inhibitory component that preceded the excitation. An early contralateral inhibition was detected in 44% of cells that were driven by the ipsilateral input, whereas an early ipsilateral component was detected in 17% of cells driven by the contralateral input. 5. We confirmed hypotheses about the laterality and time course of the inhibitory and excitatory components by introducing interaural level differences (ILDs) into the binaural clicks and thus varying the strengths of the different components. 6. Inhibitory components may play a role in shaping the sensitivity of individual cells to ITDs of stimuli other than clicks; they were also apparent in responses to noise.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2754469 TI - Changes in membrane currents of hippocampal neurons evoked by brief anoxia. AB - 1. Effects of anoxia (2-4 min of 95% N2-5% CO2) on membrane currents of CA1 neurons were studied by single-electrode voltage clamp in hippocampal slices (from Sprague-Dawley rats) kept in an interface-type chamber at 33.5 degree. 2. When recording with KCl electrodes at a holding potential (VH) near-70 mV, anoxia evoked a slow outward current [0.18 +/- 0.06 (SE) nA], accompanied by a conductance increase ( + 46 +/- 20%, mean +/- SE). The difference current evoked by N2 had a reversal potential near-100 mV. It was much smaller in presence of 2 4 mM extracellular Cs, and any remaining outward current was abolished by 10 mM tetraethylammonium (TEA). Only inward currents were observed when recording with CsCl electrodes. 3. Inward relaxations evoked by large hyperpolarizing pulses from VH less than or equal to - 70 mV (Q-type) were not significantly depressed by anoxia (-1.5 +/- 6.0%). 4. Some voltage-dependent outward currents (evoked by 200-ms depolarizing pulses) were depressed during anoxia: 1) a fast-inactivating (A-like) current, obtained at VH less than or equal to -70 mV and suppressed by 200 microM 4-AP, was reduced by 25.6 +/- 7.3% (n = 5); 2) a slower, noninactivating (C-like) current, suppressed by TEA, was reduced by 52 +/- 7.2% (n = 16). Neither of these currents (1 or 2) was observed when recording with 2- to 3-M CsCl electrodes; and 3) small (M-like) inward relaxations, observed at VH approximately -40 mV 5. Net inward currents could be evoked after blockage of GK with 10 mM TEA when recording with KCl electrodes or by recording with CsCl electrodes. At VH less than or equal to -70 mV, large, transient, and incompletely controlled currents were evoked by depolarizing pulses; at VH less than or equal to -50 mV, smaller and more persistent currents were evoked by depolarizing pulses (L-like), and transient currents (T-like?) were seen immediately after hyperpolarizing pulses. 6.L-type currents (at VH less than or equal to -50 mV) were nearly abolished after 1-2 min anoxia (by approximately 90%). This was equally true of the currents evoked by constant pulses or peak currents in I-V plots. After reoxygenation, recovery was biphasic, with a quick early phase (to 50-80% in 2 min) and then a much slower one (to 60-90% by 10-15 min).(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2754470 TI - Mutable and immutable features of paw-shake responses after hindlimb deafferentation in the cat. AB - 1. Hindlimb paw-shake responses were assessed before and after unilateral deafferentation (L3-S1) in chronic-spinal cats (n = 5), spinalized at the T12 level 1 yr earlier. Selected ankle flexor [tibialis anterior (TA)] and extensor [lateral gastrocnemius (LG)] and knee extensor [vastus lateralis (VL)] muscles were surgically implanted with chronic electromyographic (EMG) electrodes to determine mutable features of cycle characteristics and muscle synergies that are modulated by motion-dependent feedback as opposed to immutable features that are centrally programmed and not modulated by limb afference. 2. Paw-shake responses were difficult to elicit in the extensively deafferented hindlimb; this was true particularly during the first recovery weeks after deafferentation. By the end of the first month, however, brief responses of 1 or 2 cycles were commonly elicited in four of five cats, and responses of 3-7 cycles were common by the end of the second month in three of five cats. Initially, responses in the deafferented limb were elicited by stimuli applied to the dorsolateral thigh, an oval patch of skin innervated by intact S2 afferents. Over the 4-mo recovery period, however, the receptive field of the largely denervated skin expanded, and responses were also elicited by stimuli applied to the lateral aspect of the knee and shank, but usually not the paw. 3. In addition to fewer average cycles per response (5 vs. 10 cycles), paw shaking evoked in the deafferented hindlimb was characterized by longer-than-average cycle periods (124 vs. 98 ms), but the average cycle period varied widely among responses, ranging from 99 to 239 ms. Before deafferentation, the temporal organization of consecutive cycles was stereotypic; cycle periods increased linearly throughout a response. After deafferentation, however, there was no systematic relationship between cycle period and cycle number, and approximately 14% of the records with greater than or equal to 3 cycles were characterized by arhythmical sequences of EMG bursts. 4. At the ankle, LG burst duration was not altered by deafferentation, but TA onset and burst duration were affected. Before deafferentation, TA onset was invariant with respect to the beginning of the cycle, and burst duration increased linearly with cycle period. After deafferentation, however, TA onset was delayed, and the delay increased linearly with cycle period. Consequently, the TA burst duration was brief and unrelated to cycle period.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2754471 TI - Chronic recordings from single sites of kitten striate cortex during experience dependent modifications of receptive-field properties. AB - 1. With the use of chronically implanted floating microelectrodes, we obtained simultaneous single-unit recordings from multiple sites in the kitten striate cortex and followed experience-dependent modifications of receptive-field properties. For induction of experimental modifications, we used the paradigm of monocular deprivation and reverse occlusion. Kittens were implanted when 4-5 wk old. During the following 2 days, receptive-field properties of the recorded units were determined once under light ketamine anesthesia and repeatedly while the kittens were awake and only lightly restrained. Subsequently, one eye was patched, and the resulting changes in neuronal eye preference were followed by repeated measurements of response properties. For investigation of the effects of reverse occlusion, the deprived eye was opened and the previously open eye closed when the neurons had become unresponsive to the initially deprived eye. Alternatively, kittens were monocularly deprived for 1 wk by lid suture before implantation. The closed eye was then opened, the other eye patched, and the effects of reverse occlusion were studied for up to 1 wk by repeated measurements of receptive-field properties. 2. The earliest effect of monocular deprivation was the disappearance of binocular summation, i.e., binocular responses ceased to be superior over monocular responses. Overt changes of ocular dominance were observed as early as 6 h after the beginning of monocular deprivation. These consisted of a gradual decrease of the excitatory response to deprived eye stimulation and, on occasions, of an additional moderate increase of responses to the normal eye. A complete loss of excitatory responses to deprived-eye stimulation was seen as early as 12 h after occlusion. In numerous cells, however, stimulation of the deprived eye continued to evoke inhibitory responses even after excitatory responses had vanished completely. During this shift in ocularity, neurons preserved their orientation and direction selectively. 3. The minimal time required for the manifestation of ocular dominance changes was similar regardless of whether the animals were stimulated continuously or were asleep part of the time, suggesting the existence of an experience-independent consolidation period for ocular dominance changes. 4. The first change after reverse occlusion was a reduction of the response to the newly deprived eye. The time course of this inactivation was similar to that observed after initial deprivation, whereas the recovery of responses to the previously deprived eye had a considerably slower time course.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2754472 TI - Cerebellar neuronal activity related to whole-arm reaching movements in the monkey. AB - 1. Three monkeys were trained to make whole-arm reaching movements from a common central starting position toward eight radially arranged targets disposed at 45 degrees intervals. A sample of 312 cerebellar neurons with proximal-arm receptive fields or discharge related to shoulder or elbow movements was studied in the task. The sample included 69 Purkinje cells, 115 unidentified cortical cells, 65 interpositus neurons, and 63 dentate units. 2. The reaching task was divided into three movement-related epochs: a reaction time, a movement time, and holding over the target. All neurons demonstrated significant changes in discharge during one or more of these three epochs. Almost all of the cells (95%) showed a significant change in activity during the movement, whereas 68-69% of the cells showed significant changes from premovement activity during the reaction time and holding periods. 3. During the combined reaction time-movement period, 231/312 cells were strongly active in the task. Of these, 151 cells (65.4%) demonstrated unimodal directional responses. Sixty-three had a reciprocal relation to movement direction, whereas 88 showed only graded increases or decreases in activity. A further 37 cells (16.0%) were nondirectional, with statistically uniform changes in discharge in all eight directions. The remaining 43 cells (18.6%) showed significant differences in activity for different directions of movement, but their response patterns were not readily classifiable. 4. The proportion of directional versus nondirectional cells was consistent across the four cell populations. However, graded response patterns were more common and reciprocal responses less common among Purkinje and dentate neurons than among unidentified cortical cells and interpositus neurons. 5. The distribution of preferred directions of the population of cerebellar neurons covered all possible movement directions away from the common central starting position in the horizontal plane. When the preferred direction of each cell in the sample population was aligned, the mean direction-related activity of the cerebellar population formed a bell-shaped tuning curve for the activity recorded during both the reaction time and the movement, as well as during the time the arm maintained a fixed posture over the targets. A vector representation also showed that the overall activity of the cerebellar population during normal reaching arm movements generated a signal that varied with movement direction. 6. These results demonstrate that the cerebellum generates a signal that varies with the direction of movement of the proximal arm during normal aimed reaching movements and is consistent with a role in the control of the activity of muscles or muscle groups generating these movements. PMID- 2754473 TI - Evidence that peaks in EMG averages can sometimes be caused by inhibition of motoneurons. AB - 1. It has been reported that an excitatory response occurs before strong inhibition in masticatory muscles. We tested the hypothesis that this small monopolar wave in the EMG, called by us the early exteroceptive component (EEC), is in fact the first response to inhibition. 2. A mapping of the electrical activity of the masseter muscle was performed using a 3 x 4 matrix of surface electrodes with reference to the back of the neck. Subjects sat with the jaw closing muscles relaxed or contracting at approximately 75% of the maximum voluntary level. The chin was tapped to evoke a jaw jerk reflex and the EEC was elicited by electrical stimulation to the palate. 3. In addition, bipolar EMGs and jaw position were recorded at minimal bite forces and at contraction levels of 5, 10, 15, or 20 N. 4. Data were computer average, with and without rectification, for 32 stimuli. 5. The EEC [latency 12.1 +/- 1.0 (SD)ms] was found to have the same polarity, shape, and duration as the repolarizing wave of the stretch reflex. 6. After electrical stimulation, an increase of bite force was never observed during or immediately after the EEC. Instead, bite force began to decrease 5-7 ms after the onset of the EEC. 7. The amplitude of the EECs never exceeded the level of the peaks in the preceding background EMG, even when the left and right palatal electrodes were stimulated simultaneously at high intensity.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2754474 TI - Properties of motor units in nerve-intact autografts of cat extensor digitorum longus muscles. AB - 1. In cats, isometric contractile properties were measured on five extensor digitorum longus (EDL) muscles and four EDL muscle grafts 150-270 days after autografting with nerves intact. Comparisons were made between the properties of whole muscles and grafts and between 36 motor units in control EDL muscles and 41 motor units in grafts. 2. The time-to-peak twitch force (TPT) of 23 +/- 1.7 (SE) ms for grafts was significantly prolonged compared with the value of 17 +/- 0.7 ms observed for whole EDL muscles. The mean values for the TPT of motor units were not different from the respective values for whole grafts or for whole muscles. The maximum specific force of whole grafts of 19.7 +/- 0.6 (SE) N/cm2 was significantly less than the control value of 23.6 +/- 0.6 N/cm2, an observation consistent with all previous data on the maximum specific force of grafts and control muscles. 3. Based on the presence or absence of sag and an index of fatigue, motor units were classified as fast fatigable (FF), fast intermediate (FI), fast fatigue-resistant (FR), and slow (S). Motor units were classified 33% FF, 22% FI, 27% FR, and 17% S in control muscles and 17% FF, 43% FI, 29% FR, and 12% S in autografted muscles. Compared with control muscles, the number of small FF units increased significantly in the autografts, but no significant difference was observed in the fatigue properties of motor units.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2754475 TI - Phosphatidylinositol system's role in serotonin-induced facilitation at the crayfish neuromuscular junction. AB - 1. In a crustacean neuromuscular preparation, the walking leg opener muscle of the freshwater crayfish Procambarus clarkii, application of serotonin (1 microM) produces presynaptic depolarization and long-lasting facilitation of excitatory postsynaptic potentials (EPSPs). The frequency of spontaneously released transmitter quanta also increases. Facilitation of evoked EPSPs declines after serotonin application in two phases. 2. Serotonin-induced facilitation was examined using simultaneous pre- and postsynaptic intracellular microelectrode recording. A presynaptic microelectrode recorded action potentials and membrane potential of a presynaptic axonal branch, and one or more postsynaptic microelectrodes recorded EPSPs in muscle fibers innervated by the excitatory motor axon. Components of the phosphatidylinositol second messenger system and pharmacologic agents affecting this system were injected through the presynaptic electrode, and changes in synaptic transmission were measured. 3. Presynaptic injection of inositol 1,4,5-triphosphate (IP3) causes presynaptic depolarization, increases the frequency of spontaneously released transmitter quanta, and promotes a relatively short-lasting facilitation of evoked EPSPs. These actions are consistent with elevation of intracellular Ca2+ and resemble the early phase of serotonin-induced facilitation. 4. Application of a phorbol ester, 12-O tetradecanoyl-phorbol-13-acetate (TPA), that activates protein kinase C (C kinase), produces a long-lasting, low-level facilitation of evoked EPSPs. Application of another phorbol ester, phorbol-12-monoacetate (PTMA), which does not activate C-kinase has no effect. 5. Presynaptic injection of RA 233, a phospholipase C (PLP-C) inhibitor, blocks all aspects of serotonin-induced facilitation. This compound was found to have no general deleterious effects on synaptic transmission and does not block other forms of synaptic facilitation in this preparation.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2754476 TI - Contribution of the otoliths to the calculation of linear displacement. AB - 1. The present work is a quantitative study of the eye movements induced by linear translation when the subject is instructed to stabilize his gaze on a memorized earth-fixed target. These experiments may allow a better understanding of the central processing of otolithic signals. 2. Human subjects were submitted to either sinusoidal or step-like horizontal linear displacements along the interaural (Y)-axis in darkness, seated in a cart moving along a linear track. Each subject's head was fixed by a helmet secured to the cart. They were asked to keep their eyes on an earth-fixed memorized target at 63 cm from them on the X axis. 3. During sinusoidal motion, a combination of low smooth compensatory eye movements and of compensatory saccades allowed the subjects to track the memorized target. The linear model of the responses of five subjects (seven sessions) exhibited a near-ideal slope of 1.14 (range 0.84-1.58). Two subjects did not compensate properly for their displacement. The mean "vestibular saccadic" (VS) gain (ratio of overall eye movement peak-peak amplitude versus head displacement amplitude) was 1.52 +/- 0.80 (SD), showing an overestimation of head displacement. 4. The otolith-ocular reflex (OOR) mean gain values (ratio of slow phase cumulated peak-peak amplitude versus head displacement amplitude) were about 0.13 degrees/cm. This value is 5 times higher than what has been reported in the literature, probably due to the fact that the target was at a short distance. 5. The number of saccades occurring during sinusoidal stimulations varied according to the different subjects. They were obviously compensatory saccades and not quick phases. They indicate that although the gain of the OOR was small, the brain has computed the adequate desired eye position. 6. During steplike head displacements in darkness, although the OOR gain was also small, seven of the eight subjects could stabilize their gaze with a mean VS gain of 1.01 +/- 0.70. The linear model for the pooled responses of these subjects exhibited a slope of 0.82. 7. When subjects were instructed not to move their eyes during the translation, three of the five examined could still correctly reproduce the head movement amplitude with saccades, even as late as 50 s after motion had stopped. This indicates that head displacement was stored with the adequate metrics and could be used to drive the saccadic system. 8. Bilabyrinthectomized patients could not perform any adequate gaze stabilization. This shows that the observed performance was of vestibular origin. PMID- 2754477 TI - Performance of the human vestibuloocular reflex during locomotion. AB - 1. The stability of gaze was measured in nine normal subjects during 30-s epochs of standing, walking in place, and running in place. The angle of gaze and head rotations in horizontal and vertical planes were measured using the magnetic search coil technique. Subjects visually fixed on a stationary object located at a distance of 100 m; thus measurements of gaze indicated the stability of images on the retina. 2. During standing, walking, or running in place, the standard deviation of the angle of gaze was less than 0.4 degrees, both horizontally and vertically. During standing and walking in place, peak gaze velocity (Gp) was less than 3.0 degrees/s. During running in place, Gp was less than 3.0 degrees/s horizontally but ranged up to 9.3 degrees/s vertically. 3. Visual acuity was measured during standing, walking, and running in place. During walking in place, five of nine subjects showed a small but significant (P = 0.03) decline in visual acuity compared with standing. During running in place, all nine subjects showed a small but significant (P = 0.002) decline in visual acuity compared with standing. 4. Stability of gaze was also measured during vigorous, voluntary head rotations in the horizontal (yaw) or vertical (pitch) planes, for 15-s epochs. Gp ranged as high as 70 degrees/s horizontally and 41 degrees/s vertically. All subjects reported illusory movement of the seen environment during these head rotations. 5. The suitability of linear systems techniques for analysis of the horizontal and vertical vestibuloocular reflex (VOR) during walking and running in place was assessed using coherence spectral analysis.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2754478 TI - Mastication in the rabbit: a description of movement and muscle activity. AB - 1. Mastication was studied in awake rabbits that had previously been prepared for chronic recording of jaw movement and jaw muscle electromyography (EMG) under general anesthesia. Data were stored on tape and replayed for computer-assisted analysis. Most data was taken from the mastication of rabbit chow, but the basic features described in the paper also apply to eating of other foods. The series of movements was divided into cycles, and the phases that compose them, using peaks in the vertical movement, velocity, and acceleration. 2. The whole series of movements from ingestion to swallowing was termed the masticatory sequence. We found, as have others, that the sequence can be divided into three consecutive periods, based on the form of the movements. These were named the preparatory, reduction, and preswallowing series of cycles. 3. The results of earlier studies suggest that the food is transported back to the molar teeth during the preparatory series, ground up during the reduction series, and that the bolus is formed for swallowing during the preswallowing series. 4. The typical cycle of the preparatory series was called type I; it had two phases: opening (O) and fast closing (FC). The jaw-opening muscles were very active during O, but EMG bursts from the closer muscles were small or undefinable during FC. There was not much movement away from the midline in either phase, and the cycles were the shortest in the sequence. 5. The reduction series was predominantly composed of type II cycles. These were of intermediate duration and had three phases [O, a short FC, and a slow closing phase (SC)], during which the pellets were crushed between the molar teeth. The jaw moved toward the working side during FC. At or soon after the start of SC, the closer muscles became very active and continued to contract as the teeth were drawn toward the midline and slightly backwards. 6. The preswallowing series was made up of five-phase cycles that we called type III. These were the longest of the sequence. Jaw opening now occurred in three stages: O1 was the fall from tooth contact to approximately the postural position, O2 was a pause, and O3 was defined as the final movement to maximum opening. The digastric burst occurred during O3. There were again two closing phases, FC and SC, but closer bursts were smaller than in type II, and SC was shorter.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2754479 TI - Efferent neurons and suspected interneurons in S-1 vibrissa cortex of the awake rabbit: receptive fields and axonal properties. AB - 1. The behavioral tractability of the rabbit was exploited and enabled, in the fully awake state, receptive-field analysis of antidromically identified efferent neurons within the vibrissa representation of primary somatosensory cortex (S-1). Efferent neurons studied included ipsilateral corticocortical neurons (C-IC neurons, n = 56) that project to or beyond the second somatosensory cortical area (S-2) and corticofugal neurons of layer 5 (CF-5 neurons, n = 75) and layer 6 (CF 6 neurons, n = 92) that project to and/or beyond the thalamus. 2. An additional class of neurons was studied that was not activated antidromically from any stimulus site, but which responded synaptically to electrical stimulation of the ventrobasal (VB) thalamus with a burst of three or more spikes at frequencies of 600 to greater than 900 Hz. Most of these neurons also responded synaptically to stimulation of S-2. The action potentials of these neurons were much shorter (mean = 0.43 ms), than those of efferent neurons (mean = 0.98 ms). Such properties have been associated with interneurons found throughout the central nervous system, and these neurons are thereby referred to as suspected interneurons (SINs). Although SINs were found at all cortical depths, a strong peak in the distribution occurred just superficial to the peak in the distribution of CF-5 neurons. Most SINs located within this peak responded to deflection of only a single vibrissa. In contrast, SINs located in layer 6 and in layer 2-3 responded to deflection of many vibrissae (median = 11.0 and 5.5 vibrissae, respectively). In addition, SINs of layer 6 and layer 2-3 had significantly longer synaptic latencies to stimulation of VB thalamus than did SINs located at intermediate cortical depths. 3. The properties of efferent neurons and SINs differed considerably. Efferent neurons never responded to stimulation of VB thalamus with the high-frequency burst of spikes characteristic of SINs. Although greater than 70% of CF-6, CF-5 and C-IC neurons had receptive fields that were directionally selective, only 20% of SINs showed any degree of directional selectivity. Furthermore, SINs showed both much lower angular thresholds to vibrissa deflection and a much greater ability to follow high stimulus frequencies than was seen in efferent neurons. The spontaneous firing rates of SINs had a mean value of 16.5 spikes/s, which was the highest seen in any population within S-1. 4. CF-5 neurons had a number of properties which contrasted with those of both CF-6 and C-IC neurons.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2754480 TI - Modulation of pursuit eye movements by stimulation of cortical areas MT and MST. AB - 1. Many cells in the superior temporal sulcus (STS) of the monkey that represent the foveal region of the visual field discharge during pursuit eye movements. Damage to these areas produces a deficit in the maintenance of pursuit eye movements when the target towards the side of the brain with the lesion. In the present experiments, we electrically stimulated these areas to better localize and understand the mechanisms underlying this directional pursuit deficit. 2. Monkeys were trained to pursue a moving target using a step-ramp task in which the target first stepped to an eccentric position and then moved smoothly across the screen. Trains of stimulation were applied after the monkey had begun to pursue the target to study stimulation effects of maintenance of pursuit. 3. Stimulation during pursuit frequently produced eye acceleration toward the side of the brain stimulated. Eye speed increased during pursuit toward the side stimulated and decreased during pursuit away from the side stimulated. This increase in velocity toward the side of the brain where stimulation presumably activated cells is consistent with the decrease in pursuit velocity toward the side of the brain after cells were removed by chemical lesions. 4. The increase or decrease in pursuit speed following stimulation produced a slip of the target on the retina. The pursuit system seemed to be insensitive to this slip during the period of stimulation, however, since the effect of stimulation during pursuit of a stabilized image (open-loop condition) was similar to that resulting from stimulation under normal pursuit conditions (closed-loop). This insensitivity to visual motion during stimulation suggests that the stimulation substitutes for that visual input. 5. The separation of eye and target position that resulted from stimulation did produce catch-up saccades. This provides added evidence that alteration of middle temporal area (MT) and medial superior temporal area (MST) modifies visual-motion but not visual-position information. 6. Stimulation that produced eye acceleration during pursuit produced only a slight effect during fixation of a stationary target. The effectiveness of the stimulation also increased as the speed of the pursuit increased between 5 and 25 degrees/s. These observations, which show that pursuit velocity altered the effect of stimulation, suggest that the stimulation acted on visual motion processing before information about the pursuit movement itself is incorporated. Since this stimulation produces directional pursuit effects, we hypothesize that the directional bias for pursuit originates in the visual signal conveyed to the pursuit system.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2754481 TI - Identification of excitatory interneurons contributing to generation of locomotion in lamprey: structure, pharmacology, and function. AB - 1. In the in vitro preparation of the lamprey spinal cord, paired intracellular recordings of membrane potential were used to identify interneurons producing excitatory postsynaptic potentials (EPSPs) on myotomal motoneurons. 2. Seventy nine interneurons (8.4% of all neuron-motoneuron pairs tested) elicited unitary EPSPs that followed one-for-one at short, constant latencies and were therefore considered monosynaptic according to conventional criteria. Evidence was obtained for selectivity and divergence of excitatory interneuron (EIN) outputs and for convergence of EIN input to motoneurons. 3. The neurotransmitter released by EINs may be an excitatory amino acid such as glutamate, because the EPSPs were depressed by antagonists of excitatory amino acids. 4. Intracellular dye injection revealed that EINs have small cell bodies (average 11 x 27 microns), transversely oriented dendrites, and thin (less than 3 microns) slowly conducting axons (0.7 m/s) that project caudally and ipsilaterally. One EIN exhibited a system of thin multi-branching axon collaterals with periodic swellings. Ultrastructurally, these swellings contained clear spherical vesicles, and they apposed postsynaptic membrane specializations. 5. During fictive locomotion, the membrane-potential oscillations of EINs were greater in amplitude than, but similar in shape and timing to, those of their postsynaptic motoneurons. EINs fired action potentials during fictive locomotion and contributed to the depolarization of motoneurons. 6. These interneurons are proposed to be a source of excitation to motoneurons and interneurons in the lamprey spinal cord, participating in motor activity including locomotion. PMID- 2754482 TI - Abducens internuclear neurons carry an inappropriate signal for ocular convergence. AB - 1. Single-unit recording studies in alert Rhesus monkeys characterized the vergence signal carried by abducens internuclear neurons. These cells were identified by antidromic activation and the collision of spontaneous with antidromic action potentials. The behavior of abducens internuclear neurons during vergence was compared with that of horizontal burst-tonic fibers in the medial longitudinal fasciculus (MLF) and to that of a large sample of unidentified abducens cells (presumably both motoneurons and internuclear neurons). 2. The results indicate that abducens internuclear neurons and lateral rectus motoneurons behave similarly during vergence eye movements: the majority of both groups of cells decrease their firing rate for convergence eye movements: a minority show no change for vergence. This finding is strongly supported by recordings of horizontal burst-tonic fibers in the MLF, the majority of which decrease their activity significantly for convergence eye movements. 3. These findings indicate that a net inappropriate vergence signal is sent to medial rectus motoneurons via the abducens internuclear pathway. Because medial rectus motoneurons increase their activity appropriately during symmetrical convergence, this inappropriate MLF signal must be overcome by a more potent direct vergence input. 4. Overall, both abducens internuclear neurons and lateral rectus motoneurons decrease their activity for convergence less than would be expected based on their conjugate gain. This implies that some degree of co-contraction of the lateral and medial rectus muscles occurs during convergence eye movements. 5. Some horizontal burst-tonic MLF fibers decrease their activity more for convergence than any recorded abducens neuron. These fibers may arise from cells in the nucleus prepositus hypoglossi or vestibular nuclei. PMID- 2754483 TI - Lidocaine-induced unilateral internuclear ophthalmoplegia: effects on convergence and conjugate eye movements. AB - 1. To characterize the vergence signal carried by the medial longitudinal fasciculus (MLF), it was subjected to reversible blockade by small injections of 10% lidocaine hydrochloride. The effects of these blockades on both conjugate and vergence eye movements were studied. 2. With this procedure, experimentally induced internuclear ophthalmoplegia (INO) and its effects on conjugate eye movements could be studied acutely, without possible contamination from long-term oculomotor adaptation. In the eye contralateral to the MLF blockade, saccadic and horizontal smooth-pursuit eye movements were normal. Horizontal abducting nystagmus, often seen in patients with INO, was not observed in this eye. 3. As previously reported for INO, profound oculomotor deficits were seen in the eye ipsilateral to the MLF blockade. During maximal blockade, adducting saccades and horizontal smooth-pursuit movements in this eye did not cross the midline. Adducting saccades were reduced in amplitude and peak velocity and showed significantly increased durations. Abducting saccades, which were slightly hypometric, displayed a marked postsaccadic centripetal drift. 4. The eye ipsilateral to the blockade displayed a pronounced, upward, slow drift, whereas the eye contralateral to the blockade showed virtually no drift. Furthermore, although vertical saccades to visual targets remained essentially conjugate, the size of the resetting quick phases in each eye was related to the amplitude of the slow phase movement in that eye. Thus the eye on the affected side displayed large quick phases, whereas the eye on the unaffected side showed only slight movements. On occasion, unilateral downbeating nystagmus was seen. This strongly suggests that the vertical saccade generators for the two eyes can act independently. 5. The effect of MLF blockade on the vergence gain of the eye on the affected side was investigated. As a measure of open-loop vergence gain, the relationship of accommodative convergence to accommodation (AC/A) was measured before, during, and after reversible lidocaine block of the MLF. After taking conjugate deficits into account, the net vergence signal to the eye ipsilateral to the injection was found to increase significantly during the reversible blockade. 6. The most parsimonious explanation for this increased vergence signal is suggested by the accompanying single-unit study. This study showed that abducens internuclear neurons, whose axons course in the MLF, provide medial rectus motoneurons with an appropriate horizontal conjugate eye position signal but an inappropriate vergence signal. Ordinarily, this incorrect vergence signal is overcome by another, more potent, v PMID- 2754484 TI - Primary afferent-evoked synaptic responses and slow potential generation in rat substantia gelatinosa neurons in vitro. AB - 1. Primary afferent fiber-evoked synaptic responses and the mechanisms of spike and slow potential generation have been examined in adult rat substantia gelatinosa (SG) neurons in an in vitro transverse spinal cord slice preparation in which an attached dorsal root is retained. Intracellular recordings were made from SG neurons identified by morphological and electrophysiological criteria. Afferent fiber-evoked fast excitatory postsynaptic potentials (fast EPSPs) and slow EPSPs have been analyzed. 2. SG neurons had mean resting membrane potentials of -67.1 +/- 0.5 mV (mean +/- SE), mean input resistance of 257 +/- 17.7 (SE) M omega, and a mean time constant of 21.3 +/- 1.9 ms and exhibited spontaneous EPSPs. 3. Single low-intensity stimuli applied to the dorsal root using a suction electrode produced, in 70% of SG neurons, short-latency, presumed monosynaptic fast EPSPs which had a half decay time of 10-30 ms and an amplitude of 8-28 mV. The conduction velocity of afferent fibers evoking fast EPSPs was 2-7 m/s, corresponding to that of thinly myelinated A-delta-fibers. Dorsal root stimulation at higher intensities evoked, in 10% of SG neurons, long-latency and apparently monosynaptic EPSPs which had a time course and amplitude similar to that evoked by low-intensity stimulation. The conduction velocity of fibers evoking long-latency EPSPs was 0.4-2 m/s, suggesting that they constitute predominantly C-fibers. A-delta- and C-fiber-mediated fast EPSPs were detected in 20% of SG neurons examined. 4. Low-intensity stimuli produced slow EPSPs in 20% of SG neurons. Slow EPSPs were 3-15 mV in amplitude and of up to 2 min in duration. A-delta-fibers appeared to be responsible for the generation of slow EPSPs. Slow EPSPs were associated with an increase in membrane resistance and were decreased in amplitude with membrane hyperpolarization. 5. Action potentials in SG neurons had a mean amplitude of 76.3 +/- 1.1 mV and a mean duration of 1.0 +/- 0.07 ms. Na+ ions represent the main charge carrier during the rising phase of the action potential and Ca2+ ions contribute to the shoulder on the falling phase. 6. In 20% of SG neurons, subthreshold depolarizing pulses were followed by long-lasting slow-inactivating depolarizing potentials which were able to initiate spikes. The slow depolarizing potentials were blocked by TTX and enhanced by application of TEA and Ba2+, suggesting that Na+ and K+ are involved in this slow-inactivating potential.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2754485 TI - Magnitude estimation is coming. PMID- 2754486 TI - SNM/ACNP petition NRC to change 10 CFR 35. PMID- 2754487 TI - In vitro complex formation and biodistribution of mouse antitumor monoclonal antibody in cancer patients. AB - The serum clearance and biodistribution of a murine monoclonal antibody were compared to the in vitro complex formation of the antibody with patients' sera. Iodine-125-labeled 9.2.27, an anti-melanoma antibody, was incubated with sera from ten melanoma patients who had received 9.2.27 in an earlier study. Complexes were observed in all patients using size exclusion high performance liquid chromatography and complex formation was partially blocked by nonspecific murine antibody, suggesting the presence of human anti-murine antibody in serum. All patients subsequently underwent imaging studies with [131I] 9.2.27 given intravenously. The serum levels of the antibody obtained after the second administration were inversely correlated with the level of in vitro complex formation. Patients whose serum formed high levels of complex showed a rapid serum clearance, high hepatic uptake, and accelerated whole body clearance and urinary excretion of 131I. This suggests that in patients who receive repetitive administration of murine antibody the serum clearance rate and biodistribution of intravenously injected antibody are altered by antibody complex formation in the serum. PMID- 2754488 TI - Bone secondaries in breast cancer: the solitary metastasis. AB - The bone scan findings of 160 consecutive cases of breast cancer metastatic to bone presenting to Guy's Hospital between 1982-1987 were retrospectively assessed for number and distribution of lesions. Twenty-one percent of patients relapsed with a solitary bone metastasis. The spine was the commonest site for both solitary (52% of cases) and multiple (87%) metastases. Solitary bone metastases are more common than previously thought. PMID- 2754489 TI - Technetium-99m HM-PAO-labeled leukocytes in detection of inflammatory lesions: comparison with gallium-67 citrate. AB - Forty-three patients with suspected benign, inflammatory, or infectious diseases were imaged with [99mTc]HM-PAO-labeled leukocytes and [67Ga]citrate. Technetium 99m leukocytes showed 22 true-positive, no false-positive, 19 true-negative, and two false-negative findings and [67Ga]citrate 23, 7, 12 and 1, respectively. The sensitivity, specificity, and accuracy values with 99mTc leukocytes were 92%, 100%, and 95%, and with [67Ga]citrate 96%, 63%, and 81%. Technetium-99m leukocyte scintigraphy has a promising future in comparison with [67Ga]citrate because of the ready availability of [99mTc]HM-PAO, the good image quality, more rapid results (within few hours), and the lower radiation exposure to the patient with 99mTc leukocytes. The usefulness of 99mTc leukocytes in chronic osteomyelitis needs further evaluation. PMID- 2754490 TI - Pharmacokinetic evaluation of technetium-99-metallothionein-conjugated mouse monoclonal antibody B72.3 in rhesus monkeys. AB - These studies were conducted to determine the biodistribution and pharmacokinetics of [99mTc]metallothionein-conjugated B72.3 ([ Tc]MT-B72.3) in Rhesus monkeys (Macaca mulatta) that were performed as part of the preclinical evaluation of [Tc]MT-B72.3. The B72.3-MT conjugate was studied at three doses of B72.3 ranging from 0.03 mg/kg to 1 mg/kg to determine whether a relationship existed between the dose of total antibody administered intravenously and the biodistribution and clearance of the radiolabeled protein. Results indicated that [Tc]MT-B72.3 distributes rapidly to central body cavity organs and that there was no difference in the rate of blood elimination for the three doses of B72.3 studied. The terminal phase of blood elimination was found to be 26.2 +/- 6.1 hr for the combined groups of monkeys. Approximately one-half of injected 99mTc activity was recovered in the urine within 24 hr. A second purpose of these studies was to evaluate the overall immunogenicity of the mouse monoclonal B72.3 IgG1 antibody in Rhesus monkeys. These results demonstrated that a single i.v. exposure to mouse monoclonal B72.3 at doses of 0.3 mg/kg or greater elicited antibody production to B72.3 in Rhesus monkeys within 3 wk. Analysis of [Tc]MT B72.3 biodistribution and clearance in monkeys with circulating levels of antibodies to B72.3 (immunized monkeys) revealed that the liver was the primary site of clearance of the presumed immune complex and that blood elimination was greatly accelerated. PMID- 2754491 TI - Measurement and estimation of organ Bremsstrahlung radiation dose. AB - Bremsstrahlung radiation doses were measured in an anthropomorphic phantom using thermoluminescent dosimeters. A single source of 90Y (beta-ray range less than or equal to 1.0 cm) was inserted in the bladder region and dosimeters were placed at distances greater than or equal to 3 cm to preclude detection of decay betas. Doses were corrected so as to represent the case of no biologic clearance. By comparing dosimeter location with the standard MIRD human geometry, sample organ doses could be determined. Representative results were 432 +/- 76 mrad/mCi at 3 cm (bladder), 260 +/- 60 mrad/mCi (uterus), 71 +/- 4 mrad/mCi (lower large intestine), and 1.4 +/- 0.7 mrad/mCi (liver). An estimation method, based on absorbed fraction tables, gave organ doses that were within the errors of measurement for all tissues with the exception of the bladder site. We conclude that organ bremsstrahlung radiation doses are not negligible and that they can be estimated using an integration over both the brake and beta-ray spectra. PMID- 2754492 TI - Quantification of amplitude images of gated radionuclide heart studies: a new universal method. AB - Absolute quantification in nuclear medicine is difficult because of the individual shape, size, and position of human organs. In this study, a general data processing procedure is presented that allows inter-individual comparison and definition of normal count density pattern of unevenly shaped scintigraphic structures. This new method is demonstrated on Fourier amplitude images of gated heart studies. The information contained in the original irregularly shaped left ventricular amplitude scans was transformed into a standard sized circle by interpolating the radiant profiles of varying length from the original left ventricular ROI into the radii of the standard circle using 720, 360, 180, and 72 sampling angles. Retransformation of the individual left ventricular amplitude image from the standard circle area is feasible with only approximately 1% error with the 180, 360, or 720 sampling steps. As a first application of this new method 20 normal amplitude studies were transferred into the standard circle, which allowed the definition of a statistically normal reference image against which individual left ventricular amplitude images may be compared for documenting areas of significantly depressed amplitudes quantitatively. This simple and unique approach may be applied to most organ-related scans such as brain, kidneys, lung, and liver both in planar and tomographic studies to first create a normal reference image and second, to quantify the significance of locally increased or decreased activity in routine scans automatically. PMID- 2754493 TI - An improved radiolabeling technique of ivalon and its use for dynamic monitoring of complications during therapeutic transcatheter embolization. AB - Transcatheter embolization by Ivalon particles for treatment of arteriovenous malformations has been an accepted therapeutic technique for many years. We describe a new and efficient radiolabeling technique of Ivalon particles using [99mTc]sulfur colloid. Continuous and dynamic monitoring of injected radiolabeled Ivalon particles is made possible by viewing the persistence scope of a portable gamma camera whose head is positioned over the patient undergoing therapeutic embolization. Therefore, if inadvertent pulmonary embolism or reflux migration of radiolabeled Ivalon particles has occurred, the angiographer is immediately aware of this potentially serious or fatal complication and can take corrective action. We describe two patients, each with an arteriovenous malformation, who had therapeutic embolization with radiolabeled Ivalon particles, one resulting in reflux migration and the other resulting in inadvertent pulmonary embolism. PMID- 2754494 TI - Functional assessment of the total artificial heart by blood-pool radionuclide angiography. AB - Blood-pool radionuclide angiography was used to image a patient with a Jarvik 7 (70) total artificial heart. Excellent delineation of the chambers was achieved, allowing assessment of the total artificial heart pumping function. Estimation of the left ventricular volumes, cardiac output, and filling rates by radionuclide angiography corresponded closely with those simultaneously obtained from the total artificial heart driving lines. Radionuclide angiography affords the unique possibility to assess the function of the artificial heart noninvasively. PMID- 2754495 TI - Carbon-11-L-methionine uptake with PET as a predictor of prognosis for bronchogenic carcinoma patients. PMID- 2754496 TI - Ultrastructural localization of DNA on ultrathin sections of resin-embedded tissues by the lactoferrin-gold complex. AB - Lactoferrin, a DNA-binding protein, was complexed to colloidal gold and applied on ultrathin sections of resin-embedded plant tissues and bacterial cultures. Optimal results were obtained when lactoferrin was tagged to colloidal gold particles at pH 9.2. Postfixation with osmium tetroxide and embedding with Epon did not prevent the accessibility of the protein towards its corresponding binding sites. In plant nuclei, labeling was observed over the dense chromatin and to a lesser extent over the dispersed chromatin. Nucleolar labeling was preferentially located over the dense fibrillar component. Gold particles were also found to be associated with chloroplasts and mitochondria. In prokaryotic cells, a dispersed labeling was noted over the cytoplasm and, in some cases, the aggregation of few gold particles suggested the presence of packed DNA fibrils. Various control experiments confirmed the specificity of the labeling pattern obtained. Lactoferrin-gold complex appears to be a valuable probe for the intracellular demonstration of DNA molecules in double-fixed and Epon-embedded tissues. PMID- 2754497 TI - Achievement of atomic resolution electron microscopy. AB - Atomic-level details are easily resolved in the latest generation of intermediate voltage electron microscopes, but structural information on the same scale can only be extracted under certain specific conditions. Some understanding of imaging theory, as well as an awareness of correct operating conditions, is required for reliable image interpretation. Several representative examples are chosen to illustrate the possibilities for atomic-resolution imaging of materials, and perspectives and outlook for the technique are briefly discussed. PMID- 2754498 TI - Light, scanning, and transmission electron microscopy of a single population of detergent-extracted cardiac myocytes in vitro. AB - A technique for performing light, scanning, and transverse transmission electron microscopy on cultured cells grown within a single tissue culture flask is described. Permanent light microscopy slides are obtained by removing selected portions of the plastic tissue culture vessel and mounting them on glass slides with an aqueous mounting solution. The images obtained from these slides are superior to viewing through the bottom of the flask with an inverted stage microscope. For scanning electron microscopy, selected areas are also cut from the remainder of the vessel and prepared for viewing. The final portion of the culture container is transferred and attached to a new tissue culture vessel and prepared for transmission electron microscopy using alcohol instead of acetone and propylene oxide during dehydration, infiltration, and embedding. PMID- 2754499 TI - FORTRAN source listing for simulating three-dimensional convergent beam patterns with absorption by the Bloch wave method. AB - The FORTRAN source code is given for a computer program that calculates the two dimensional intensity distribution in convergent-beam transmission electron microdiffraction (CBED) patterns from perfect crystals. The program uses the eigenvalue or Bloch-wave method. It allows three-dimensional dynamical diffraction, and so includes all higher-order Laue zone effects without approximation. No symmetry reduction is included. The program accepts noncentrosymmetric or centrosymmetric crystal structures and allows absorption corrections to be included. It uses the "EISPACK" subroutines for the diagonalisation of a general complex matrix. Up to 100 CBED disks may be included. The code is also available via "Bitnet." PMID- 2754500 TI - Sample preparation technique for transmission electron microscopy of thin films on sapphire. PMID- 2754501 TI - Spin drying for scanning electron microscopy sample preparation. PMID- 2754502 TI - Observation of GaAs--AlxGa1--xAs heterostructures and quantum-well-wire structures using backscattered electron image. AB - As a microscale tool for observing GaAs-Alx Ga1-xAs heterostructures, backscattered electron (BE) images in the scanning electron microscope (SEM) were compared with conventional secondary electron (SE) images. BE images were found to be more sensitive to compositional differences between GaAs and AlxGa1-xAs and less sensitive to surface roughness. BE images have a spatial resolution of 10 nm or better. This method enables the nondestructive observation of ultrafine lateral periodic structures, such as quantum-well-wire (QWW) structures, fabricated by compositional disordering technology using focused Ga ion-beam (Ga FIB) implantation into GaAs-AlxGa1-xAs material. PMID- 2754503 TI - Use of membrane filters and osmium tetroxide etching in the preparation of sperm for scanning electron microscopy. AB - A new method was developed which is suitable for the preparation of mammalian sperm for scanning electron microscopy under either laboratory or field conditions. Samples of ejaculates from humans, two ferret species, and epididymal sperm from the African elephant were diluted in Millonig phosphate buffer and then fixed in glutaraldehyde solution. A small sample of the fixed sperm suspension was diluted in the same buffer, withdrawn with a syringe, and injected very slowly onto either a cellulose acetate or a polycarbonate membrane filter. This step was essential to concentrate the dilute sperm samples. During the various dilution steps most of the granular prostatic secretions were lost. However, a protein-like sheath, which remained attached to most sperm, obscured the surface features and had to be removed for SEM studies. It was removed by prolonged fixation/etching in 1% osmium tetroxide. Membrane filters containing sperm on their surfaces then were dehydrated, dried by the critical point drying method, and sputter coated with gold. Polycarbonate filters were superior to cellulose acetate filters in producing a flat and homogeneous background. PMID- 2754504 TI - Application of ion-beam etching techniques to the fine structure of biological specimens as examined with a field emission SEM at low voltage. AB - The term "etching," in electron microscopy, refers to the removal of specimen surface layers and includes chemical, electrolytic, and ion-beam methods. The ion beam etching process is used to remove layers of a target material by bombarding it with ionized gas molecules. Recently, the method has been applied to the field of biological specimens; however, the practical procedures for such organic materials have not been developed. In the present study, we used an apparatus in which a beam of argon ions is collimated and focused by electrostatic lenses onto an appropriate target. We demonstrated the optimum conditions to observe biological specimens that were treated with osmium tetroxide and tannic acid. The specimens were examined uncoated at low accelerating voltage using a field emission scanning electron microscope. According to our experiments, when a biological specimen was observed under high-resolution conditions at over 50,000x magnification, the optimum condition of ion-beam etching consisted of an accelerating volage of E = 1 keV and an ion-beam dose of It = 360-400 microA.min, depending on parts of the specimens. In order to decrease overetching, we had to choose factors such as E = 1-2 keV and It = 500 microA.min. PMID- 2754505 TI - Influence of dietary methionine on the metabolism of selenomethionine in rats. AB - To determine the influence of methionine on selenomethionine (SeMet) metabolism, weanling male rats were fed for 8 wk a basal diet marginally deficient in sulfur amino acids, containing 2.0 micrograms selenium (Se)/g as DL-SeMet and supplemented with 0, 0.3, 0.6 or 1.2% DL-methionine. Increased dietary methionine caused decreased selenium deposition in all tissues examined but increased glutathione peroxidase (GSHPx, EC 1.11.1.9) activity in testes, liver and lungs. A positive correlation was found between dietary methionine and the calculated percentage of selenium associated with GSHPx. In a second experiment, 75SeMet was injected into weanling male rats which had been fed the basal diet containing 2.0 micrograms selenium as DL-SeMet with or without the addition of 1.0% methionine. The selenoamino acid content of tissues and the distribution of 75Se in erythrocyte proteins were determined. In comparison to the rats fed the basal diet without added methionine, significantly more 75Se-selenocysteine was found in liver and muscle, more 75Se was found in erythrocyte GSHPx and less 75Se was found in erythrocyte hemoglobin of rats fed 1.0% methionine. These data suggest that methionine diverts SeMet from incorporation into general proteins and enhances its conversion to selenocysteine for specific selenium-requiring proteins, such as GSHPx. PMID- 2754506 TI - Dietary selenium intake controls rat plasma selenoprotein P concentration. AB - The purpose of this study was to determine the effect of dietary selenium on selenoprotein P concentration. Selenoprotein P was quantitated in plasma by radioimmunoassay. Selenium-dependent glutathione peroxidase activity in plasma and liver 105,000 x g supernatant was measured for comparison. Weanling male rats were fed a selenium-deficient diet or a control diet that contained 0.5 mg selenium/kg as Na2SeO4. The concentration of selenoprotein P fell at approximately the same rate in the rats fed the selenium-deficient diet as did plasma glutathione peroxidase activity. Groups of weanling rats were fed different levels of selenium for 8 wk. Selenoprotein P concentration was proportional to dietary selenium level up to 0.1 mg/kg and was a greater percentage of control values than was glutathione peroxidase activity. No increment in selenoprotein P concentration occurred between 0.1 and 0.5 mg selenium/kg diet. These results indicate that the concentration of selenoprotein P in the plasma is directly dependent on selenium supply in the diet up to 0.1 mg/kg. There is overlap between the dietary selenium ranges in which selenoprotein P concentration and glutathione peroxidase activity increase, but the selenoprotein P range is lower than the glutathione peroxidase range. PMID- 2754507 TI - Bioavailability of a natural isomer mixture as compared with synthetic all-trans beta-carotene in rats and chicks. AB - The unicellular halotolerant alga Dunaliella bardawil was previously shown to contain high concentrations of beta-carotene composed of about equal amounts of the all-trans and 9-cis isomers. One-d-old chicks and 7-wk-old male rats were fed diets supplemented with synthetic all-trans-beta-carotene or dry D. bardawil at equivalent levels of beta-carotene. The chicks were fed diets containing up to 0.025% beta-carotene for 2 mo, and the rats up to 0.1% beta-carotene for 2 wk. Liver analyses at the end of these periods indicated that both species showed at least a tenfold higher accumulation of the algal beta-carotene isomer mixture than of the synthetic all-trans-beta-carotene. The ratio of 9-cis-beta-carotene to the all-trans isomer in the livers of the algae-fed rats and chicks was similar to or higher, respectively, than that present in the algae. Retinol plus retinyl ester accumulated to a similar extent in the rats and chicks fed diets supplemented with synthetic all-trans or the natural isomer mixture of beta carotene. The preferable accumulation of the natural isomer mixture of beta carotene suggests that attention should be paid to the different sources of beta carotene when testing their efficacy in effects other than providing retinol, such as in their possible role in the prevention of some types of cancer. PMID- 2754508 TI - Vitamin B-6 requirement of growing kittens. AB - Two experiments were conducted to determine the vitamin B-6 requirement for growing kittens. Ten kittens were divided into two groups and given a purified diet containing 8.0 mg pyridoxine (PN)/kg diet (+PN) or a PN-free diet (-PN) for 11 wk. Daily body weight gain, food intake, weekly plasma free amino acids, plasma B-6 vitamers, urinary oxalate excretion, hemoglobin (Hb) and hematocrit were measured. Kittens fed a -PN diet had depressed body weight gain, food intake, plasma pyridoxal phosphate (PLP) and pyridoxal (PL), Hb and hematocrit, and had elevated urinary oxalate, plasma tyrosine and plasma cystathionine. In a second experiment, 24 kittens were given a -PN diet for 45 d to deplete their body reserves. The kittens were then divided into six groups of four kittens each and given a purified diet containing either 0.5, 1.0, 2.0, 3.0, 4.0 or 8.0 mg PN/kg diet for 46 d. Following supplementation, positive responses in body weight gain, PLP, Hb and hematocrit, and decreased urinary oxalate excretion, plasma tyrosine and plasma cystathionine occurred in all groups except those fed 0.5 mg PN/kg diet. At the end of the repletion period, kittens fed 1.0 mg PN/kg diet had lower body weight gain, higher plasma tyrosine and cystathionine, slower rate of decrease in urinary oxalate, and lower values for Hb, hematocrit and PLP than did the kittens from groups fed 2.0-8.0 mg PN/kg diet. These findings indicate that the dietary requirement for PN is greater than 1.0 mg/kg diet, but 2.0 mg PN/kg diet is adequate for growing kittens given a 35% casein diet. PMID- 2754509 TI - Body protein and energy accretion in response to dietary protein level in mice from weaning to maturity. AB - The accumulation of body protein and body energy in mice from weaning to maturity as a response to dietary protein level was studied. Seven groups of ddY male mice were fed for 75 d purified diets with a range of 15-70% protein concentration, calculated on a gross energy basis. The food intake and body weight data were analyzed by nonlinear regression to Parks' feeding and growth equation, and data of body protein (%) and body energy (kcal/g) were analyzed using stepwise multiple regression. Body protein (approximately 17%) was independent of both dietary protein level and age. Body energy, as a function of time after weaning, increased to a plateau at about 30 d after weaning. At every dietary protein level the accumulation of body protein and energy increased with age asymptotically to a plateau at approximately 40 d and approximately 30 d after weaning, respectively. At every dietary protein level, the protein accretion rose rapidly with age to attain a maximum at about 7 d after weaning, when it depended on the dietary protein level, then decreased markedly to where differences due to dietary protein level became negligible. It is clearly shown in this study that manipulation of dietary protein level has a greater effect on protein growth and energy gain during the pre-peak part of the body protein accretion and body energy accretion curves than during other portions of those curves. PMID- 2754510 TI - Effects of dietary amines on the small intestine in calves fed soybean protein. AB - An experiment was conducted using 16 Holstein male calves from 4 to 21 d of age to compare 1) the effects of an all-milk protein milk replacer (MPR) and a milk replacer with 20% of the protein from soy protein concentrate (SPC) on morphological and enzymic small intestinal variables, and 2) the effects of SPC plus putrescine (SPP) or SPC plus ethylamine (SPE) on intestinal variables. Small intestinal absorption, based on xylose absorption tests, was greater in calves fed MPR than in those fed SPC (P less than 0.01) and was intermediate in SPP- and SPE-fed calves. Small intestinal segments were surgically excised from the proximal and distal jejunum of all calves at 7, 14 and 21 d of age. Villus length tended to be greatest in calves fed MPR, and mitotic index was least in SPC-fed calves (P less than 0.05). Mucosal protein concentration was 46, 41, 44 and 44 micrograms/mg mucosa for calves fed MPR, SPC, SPP and SPE, respectively. The ratio of mucosal protein:RNA was greatest in calves fed MPR, least in those fed SPC at d 7 (P less than 0.01) and d 14 (P less than 0.05), and intermediate in calves fed SPP and SPE. In proximal jejunum, activity of mucosal ornithine decarboxylase (ODC, EC 4.1.1.17; the rate-limiting enzyme in polyamine biosynthesis) in calves fed SPP was less than 50% of that in calves fed MPR, SPC or SPE. The activity of lactase (EC 3.2.1.108) and ODC in distal jejunum was 50% less in calves fed soybean protein than in those fed MPR.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2754511 TI - Prolonged acetaminophen ingestion in mice: effects on the availability of methionine for metabolic functions. AB - The objective of this study was to determine the effect of prolonged ingestion of acetaminophen (ACAP) on the availability of methionine for its metabolic functions in mice. ACAP was fed to weanling mice at levels of 0.0, 0.3, 0.5 or 0.8% of the diet, with methionine provided at requirement (0.5%) or at twice the requirement (1.0%) level, for 2 wk to assess its effect on the availability of methionine for growth. In another study, ACAP was fed to adult mice at levels of 0.0, 0.4, or 0.6% of the diet, with methionine at 0.5 or 1.0% of the diet, for 2 wk to assess its effect on the availability of methionine for protein synthesis and methylation reactions. The growth rate of weanling mice decreased with increasing dietary ACAP in mice fed 0.5% methionine, but not in those fed 1.0%. Hepatic reduced glutathione (GSH) decreased and plasma glutamic-pyruvic transaminase activity increased in an ACAP dose-dependent manner in weanling mice fed 0.5% methionine. Protein synthesizing ability decreased in adult mice fed 0.5% methionine and 0.6% ACAP. Relative liver weight and liver lipid decreased with increasing dietary ACAP in mice fed methionine at or above requirement. Neither plasma creatinine or muscle creatine was affected by variations in dietary methionine or ACAP. Ingestion of ACAP for a prolonged period of time increased the methionine requirement for growth, maintenance of hepatic GSH level and protein synthesis, but did not affect the methionine requirement for methylation reactions. PMID- 2754512 TI - Reduction of plasma and hepatic triacylglycerides with whole milk-containing diets in rats. AB - Two studies were conducted to determine the effect of diets containing milk on plasma cholesterol, triacylglycerides, apolipoproteins, and lipoprotein composition and hepatic lipid levels in rats. In the first study four groups were fed either a diet containing skim milk (SM) powder or whole milk (WM) powder or one of two control diets with casein as the protein source. The SM diet and one casein diet (SM control) each contained 5% fat by weight as corn oil. The WM diet contained 20% fat by weight, derived from the milk powder, and the second casein diet (WM control) contained 20% fat by weight from corn oil and lard. The SM group had similar plasma and hepatic lipids, as did the SM control group; plasma apolipoprotein AI, AIV and B did not differ between the groups, but the apo E level was lower in the control group. The WM group had lower plasma triacylglycerides and apo B and lower hepatic cholesterol and triacylglycerides than did the WM control group. In the second study the WM diet was fed again, and the two control diets contained casein as the protein source, 20% butter oil (so that the level of dietary fat was comparable to that of the WM diet), and either lactose or sucrose was added. The plasma apo B and triacylglycerides and the hepatic cholesterol and triacylglycerides were significantly lower in the WM group than in the casein/lactose or casein/sucrose groups. The amount of protein, cholesterol and triacylglycerides in the VLDL fraction of the plasma was lower in the WM group than in the casein/lactose or casein/sucrose groups.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2754513 TI - Nutritional assessment in humans and rats of leucrose [D-glucopyranosyl-alpha(1-- -5)-D-fructopyranose] as a sugar substitute. AB - Leucrose [D-glucosyl-alpha(1----5)-D-fructopyranose], prepared by an enzyme catalyzed transglycosidation from sucrose with greater than 99% purity, has previously been shown to be noncariogenic and was found in the present study to be apparently easily digestible when given to humans as a single oral dose of 100 g, or when fed to rats at a level of 35 g/kg body wt daily. Weanling rats fed a 25% leucrose diet grew as well as rats fed a diet containing 25% sucrose or corn starch. When 1 g of leucrose was given intravenously to adult rats, 70% of this disaccharide was excreted in the urine within 24 h, and feeding and drinking behavior of the rats was not altered. No adverse effects on their general health were observed. The substrate properties of leucrose for alpha-glucosidase from yeast and for carbohydrases from human jejunal mucosa were determined, and these data were then compared with those of maltose and sucrose. The cleavage rate of leucrose in vitro by human digestive carbohydrases was 31% that of maltose and 63% that of sucrose. Hydrogenated leucrose (leucritol) was cleaved 10 times slower, with a Michaelis constant close to that of leucrose. Blood glucose and fructose profiles in humans given leucrose per os tended to be lower than those in humans given sucrose, while insulin and C-peptide profiles were unaltered. PMID- 2754515 TI - How much is a physician worth? PMID- 2754516 TI - Losing our independence? PMID- 2754514 TI - Long-term benefit versus risk in therapeutic blockade of the renin-angiotensin system. AB - Inhibitors of the renin-angiotensin system, which are promising therapeutic agents with few side effects, have measurably improved the management of many patients with primary or secondary hypertension and those with heart failure. This paper briefly reviews the emerging evidence for the potential risk associated with long-term inhibition of the renin system. The current lack of methodology for quantification of renin-angiotensin inhibition in various tissues, however, precludes firm conclusions. Preliminary evidence suggests that in functional terms, a downregulation of the renin-angiotensin system, if therapeutically successful, is safer than aggressive and longer-lasting inhibition. It has been questioned whether antihypertensive therapy 'normalizes' the structural cardiovascular changes and whether interference with the initial adaptive phase may prove detrimental. However, no specific role for renin inhibition, apart from the antihypertensive effect, has yet been defined. PMID- 2754517 TI - The efficacy of ground versus helicopter transport in patient outcome. PMID- 2754518 TI - Presidential address. PMID- 2754519 TI - Impact of the RCT proposal on specialty nursing practice. AB - The nursing shortage is clearly the major human resource challenge facing our practice today. According to the American Medical Association (AMA), the RCT plan is intended to be an innovative solution to the shortage of bedside personnel and will prove to be timely, cost-effective and efficient. The impact of this proposal and others involving the use of clinically assistive personnel in health care facilities today is a concern for all nurses. The author addresses the latest solutions to the nursing shortage and the effect of such programs on the specialty of intravenous nursing. PMID- 2754520 TI - The Seldinger method for PICC insertion. AB - This article outlines a new insertion technique for introducing a peripherally inserted central catheter into the veins of the antecubital fossa by using a PICC made by Cook Critical Care, a Division of Cook Incorporated. Included along with the technique is a summary of the uses, benefits and care of the PICC. PMID- 2754521 TI - [A clinico-pathological study of adenocarcinomas of the nasal cavity and paranasal sinuses]. AB - A adenocarcinoma arises rarely in the nasal cavity and paranasal sinus, 19 patients with this disease hospitalized in Shikoku Cancer Center Hospital were investigated. They were five with colonic-type, three with adenosquamous cell type, and twelve with adenocarcinomas derived from mucous duct. Three cases of benign adenomas, i.e. one mucous duct-type adenomas and two pleomorphic type were also studied as references. In order to investigate the histological oncogenesis of adenocarcinomas, the histochemical studies were performed on the tissues in a comparison with those of squamous cell carcinomas. The methods employed were routine H-E stain, PAS stain, Alcian blue stain as well as special stains of immunohistological method using ABC (avidin biotin peroxidase complex) method, to identify a localization of CEA and cytokeratin. CEA was found to be localized at the apical surface with papillary or tubular shapes in colonic-type adenocarcinomas and adenosquamous carcinomas. On the other hand the mucous epithelium of the ductal portion was positive for CEA on the ductal-type adenocarcinomas. The positive localization of cytokeratin was found only in adenosquamous carcinoma and mucoepidermoid carcinoma, where squamous metaplasia of ductal epithelium was seen as the same pattern. This study concluded that the nature of the apical membrane surface and squamous metaplasias, which were often seen in the nasal and paranasal mucosa, might become one of the causes in the developing the squamous cell carcinoma predominantly rather than adenocarcinoma in the nasal and paranasal sinuses. PMID- 2754522 TI - [A clinico-pathological study of squamous cell carcinomas of the sino-nasal cavity metaplasia and dysplasia]. AB - We report a clinicopathological study in 193 cases with squamous cell carcinoma (SCC) in the sino-nasal cavity. Squamous metaplasia were found in 62.6% and squamous dysplasia in 25.3% of the SCC cases. These lesions seem to be important factors related with cancer development. Etiologically, metaplasia was found to be related with age and sex (male-dominant), but not with smoking and history of sinusitis. Chronic inflammation, papillary or stratified proliferation and reserved cell hyperplasia were considered as factors inducing squamous metaplasia in review of pathological specimens. We infered from the distribution pattern of cytokeratin that it might occur serial changes from metaplasia, dysplasia, CIS to microinvasive carcinoma, whose phenomenon was commonly seen in cases of uterus squamous cell carcinoma. PMID- 2754523 TI - [Clinical observation of acute otitis media in children]. AB - This report presents the results of the clinical observation of 96 children under ten years of age with acute otitis media (107 ears) who visited our out-patient clinic from May 1986 to August 1987. The patients were classified into the following three groups according to clinical course: Group 1: 25 cases (26.0%) in which acute inflammatory findings rapidly disappeared and otitis media was cured within two weeks with no evidence of effusion; Group 2: 62 cases (64.6%) in which acute inflammatory findings rapidly disappeared but obvious accumulation of effusion which resolved gradually was observed and in which otitis media was cured from two weeks to three months after onset; Group 3: 9 cases (9.4%) in which persistent accumulation of effusion for more than three months was observed and which required myringotomy and insertion of a ventilation tube and in which a diagnosis of otitis media with effusion was made. The presence or absence of allergic diseases, adenoid symptoms, and otorrhea, or history of tonsillitis had no affect on the prognosis of acute otitis media. However, patients with a history of acute otitis media were at a significantly higher risk of developing the disease chronically. At the time of the resolution of the tympanic redness, abnormal findings in the tympanic membrane and tympanogram (TG), suggestive of the presence of middle ear effusion, were observed in approximately 80% of the patients. Approximately 20% of the patients who showed Type Cs or B in TG at that time developed otitis media with effusion.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2754524 TI - [Inputs to cerebellar dentate nucleus from the pontine nucleus in the cat]. AB - We have reported before that there are excitatory inputs to the cerebellar dentate nucleus (DN) from the cerebral cortex. This study was performed to examine whether the pontine nucleus (PN) and the nucleus reticularis tegmenti pontis (NRTP), which are among the precerebellar nuclei that relay inputs to the cerebellar cortex, also play a role as the relay nucleus of the excitatory input to the DN. In anesthetized cats, we stimulated the PN and the NRTP, and recorded intracellular potentials from DN neurons. Short-latency EPSPs were evoked from these nuclei and their latencies ranged from 1.1 to 3.6 msec, which are compatible with monosynaptic latencies. Systematic stimulation of the PN and the NRTP with weak stimulus intensities revealed that low-threshold foci for monosynaptic EPSPs in each cell were localized in the PN or the NRTP or both. We could not find monosynaptic inputs from the red nucleus and by recurrent collaterals of the dentate output neurons. Accordingly, the possibility was excluded that the monosynaptic EPSPs evoked from the PN and the NRTP were evoked by inadvertent current spread to the descending axons of DN neurons in the brain stem. The conditioning-testing stimuli of the cerebral peduncle and the PN or the NRTP yielded spatial facilitation. This result showed that the input from the cerebral cortex to the DN was relayed by way of the PN or the NRTP. PMID- 2754525 TI - [A diagnostic and etiologic studies of Sjogren's syndrome--I. Sialographical and histopathological findings of the major and minor salivary glands]. AB - This work was an attempt to elucidate the diagnostic evaluation of sialography+ and histopathological examination of the salivary gland in Sjogren's syndrome. The author investigated the correlation of the sialography and histopathology features of the salivary gland in 89 confirmed cases of Sjogren's syndrome and 26 suspected cases, a total of 115 subjects and the following results were obtained. 1) In determining the histopathological severity of the salivary gland lesions from sialography, the parotid sialography was more useful than the submaxillary sialography. 2) The severity of parotid sialography correlated well that of labial gland histopathology. 3) Biopsy of the labial gland was useful for histopathological diagnosis on Sjogren's syndrome but the histopathological change occurred to a greater degree in the submaxillary gland than in the labial gland. 4) From above results, in histopathological examination of severe case of Sjogren's syndrome, biopsy of the labial gland will be sufficient, but biopsy of the submaxillary gland must be employed for studying mild cases. PMID- 2754526 TI - [A diagnostic and etiologic studies of Sjogren's syndrome--II. On the relationship between Sjogren's syndrome and chronic thyroiditis]. AB - The histopathological findings of the salivary glands in Sjogren's syndrome and of the thyroid gland in chronic thyroiditis have similarity in lymphocytic infiltration of the stroma and decrease or disappearance of parenchyma. In order to investigate the pathogenesis of Sjogren's syndrome, the author performed serological and histopathological examination of the thyroid gland in 89 confirmed cases of Sjogren's syndrome and 26 suspected cases, a total of 115 subjects and the following results were obtained. 1) Thyroidal microsomal and thyroglobulin antibodies were detected in 34.5% and 21.4% of 89 confirmed Sjogren's syndrome. 2) The positivity rate of the antithyroid antibodies increased in the more severe histopathological changes of the thyroid gland and thyroidal microsomal antibody, in particular, reflected the absence or presence of lymphocytic infiltration of the stroma. 3) The correlation between histopathological findings of the thyroid gland and titers of antithyroid antibodies was insignificant. 4) The correlation between histopathological grading of thyroid gland and of salivary glands was insignificant. 5) Approximately 30% of confirmed cases of Sjogren's syndrome presented chronic thyroiditis as a complication, therefore, it was suggested that both Sjogren's syndrome and chronic thyroiditis might have a common etiology. PMID- 2754527 TI - [Superstructure of stapes: an analysis by high-resolution computed tomography]. AB - High-resolution Computed Tomography (HRCT) of the temporal bone has now become a routine test for the diagnosis of various temporal bone lesions. Correct assessment of such minute structures as ossicles, especially stapes, is important in the pre-operative HRCT evaluation. On the other hand, analysis for the reliability of HRCT findings has not been done, including the superstructure of the stapes. A retrospectively study was done in order to assess the availability of HRCT findings in axial overlapping scans in 226 ears, with respect to the superstructures of stapes. The study was concerned with the analysis of HRCTs of 148 normal ears, 71 ears of chronic otitis media and 7 ears of ossicular abnormalities. HRCT findings were compared to those of surgeries in pathological cases. The present study revealed that the superstructures of stapes are noted in 70% when the stapes surrounded by air. The major limitations in the proper analysis of stapes by HRCT are partial volume averaging and effects of soft tissue silhouetting, this is especially so when the stapes is surrounded by soft tissue density. PMID- 2754528 TI - [Radiographic anatomy by waters' view on the innominate and Tuber maxillae lines]. AB - Radiographic innominate line and TM line (Tuber maxillae line) which superimpose upon the maxillary sinus by Water's view were classified into four types. These are, no visualization, visualization of the whole length, upper half and lower half, respectively. 324 sides of maxillary sinuses by Waters' were included in this study; of innominate line, no visualization 45%, whole length 17%, upper half 27%, and lower half 11%. Of TM line, no visualization 67%, whole length 9%, upper half 1.5%, and lower half 23%. Of diagnostic significance of the present study, the innominate line, especially the lower half with it's inferior extension, might be confused with bone tips of blow-out fractures, and the TM line, when destroyed, will indicate posterior extension of the lesions. However, These lines only have limited application since about 30 to 50% of them are visualized by Waters' view. PMID- 2754529 TI - [The desensitization therapy in children with nasal allergy to house dust]. AB - A study about the desensitization therapy carried out on children with nasal allergy to house dust who were under 15 years old. The good effect was seemed in 35.7% of patients with the desensitization for 3 months, and 62.7% for 6 months, 90.0% for 12 months, 92.7% for 24 months. The patients with the desensitization for over 6 months had a considerable effect, as if they dropped out. In the questionnaire to patients who dropped out with no contact to us, the effect of this therapy was seemed on 83.3% in those who answered questions, as so we considered that the sensitization for children with nasal allergy was very important as the basic therapy. Refer to the efficacy of this therapy, it was seemed to be recommended to children who were about from 7 to 9 years old, or those who had allergic rhinitis for a long time. At the point of 6 months after starting HD desensitization, the patients who reacted intensively to the provocation test had not significantly the efficacy compared with those who reacted slightly, but other clinical data were not significantly concerned with the efficacy of this therapy. PMID- 2754530 TI - [Potentiation of inner ear damage following electron beam irradiation with CDDP administration]. AB - The study was designed to examine the combined ototoxic effect of CDDP (Cisplatin, Cis-diammine dichloroplatinum) and electron beam irradiation, using guinea pigs. One group received physiological saline solution of 4 ml/kg/day, and another group received CDDP of 2 mg/kg/day for five days. And following the injection of saline or CDDP, the electron beam of 14Gy/day was applied to the both groups to the right ear for five days. Animals were sacrificed after 21 days, and temporal bones of these animals were removed for the inner ear histopathology. Temporal bones were classified into four groups (control, electron beam irradiation, CDDP administration, and combined administration group), and the inner ears were observed by the surface preparation technique with a phase contrast microscope, and by scanning and transmission electron microscopy, and by temporal bone study of serial sectioned slides. The main pathologic findings of the inner ear are as follows: Electron beam irradiation group showed no hair cell damage. CDDP group induced slight damage to the outer hair cells. Combined administration group (CDDP + electron beam irradiation) showed severe outer hair cell damage. Stria vascularis was degenerated moderately in the combined administration group and slightly in some animals of electron beam irradiation group. And Reissner's membrane and Hensen's cells, were damaged in the basal turn of cochlea of the combined administration group. All other cochlear structures (spiral ganglion, spiral lamina, basilar membrane, spiral prominence, tectorial membrane, blood vessels of the cochlea) and vestibular organs were lack of significant changes in all groups by a light microscopic observation. This study was clarified that combined administration of CDDP and electron beam irradiation showed severe ototoxic potentiation. Therefore, it is important that we must pay attention to the inner ear damage caused by combined therapy of CDDP and electron beam irradiation involving inner ear for the head and neck tumor. PMID- 2754531 TI - [Local control after radiation therapy for T1N0M0 glottic carcinoma]. AB - From 1978 through 1984, we had 151 patients with T1N0M0 glottic carcinoma. They were treated by radiotherapy with 4MV x-ray in parallel opposing field of 5 X 5 cm2 or 6 X 6 cm2. The total dose was 60 Gy/30 fractions/6 weeks. The local control rate was 88.1%, the local recurrence being noted in 18 cases (11.9%). Of these 18 cases, 6 underwent partial laryngectomy, and 10 total laryngectomy. The remaining two cases died: one refused further treatment for recurrence and the other died in spite of total laryngectomy due to recurrence after partial laryngectomy. The salvage rate was 94.1%. The cumulative survival rate was 82.6% in Tla, 71.5% in Tlb and 81.1% in 151 T1N0. The tumor response was poor in the presence of lesion occupying the whole length of the vocal cord. Also, in the cases with ulcer formation or thickened vocal cord as seen on laryngogram, local control rate was not good. Better results will be achieved by improving treatment techniques, specially by improving dose-distribution by wedge-filtered technique and method for immobilization in plastic shell during radio-therapy. PMID- 2754532 TI - Comparison of phenotyping and genotyping of lymphoid neoplasms. AB - Comparison of phenotyping (PT) and genotyping (GT) of lymphoid neoplasms was performed on 51 specimens including lymph nodes, bone marrows, and body fluids. PT was performed with a flow cytometer using a large monoclonal antibody panel. GT included the testing for gene rearrangements of heavy chain, kappa and lambda light chains, and T-cell receptor beta-chain genes with DNA probes. The results obtained from these two techniques were generally compatible in terms of clonality and cell lineage. Only one case of B-cell lymphoma was not diagnosed by PT but showed gene rearrangement. For T-cell lymphoma, GT offers a more definitive diagnosis than does PT. Biclonality was demonstrated in one case of hairy cell leukemia by GT only. The rearranged band also offers a definitive clonal identification based on electrophoretic mobility. GT can detect a monoclonal population as small as 5% and can be performed on old or fresh specimens. PT requires 20% abnormal cells and a fresh specimen. It is concluded that GT is superior to PT for lymphoid tumor diagnosis, but it should be reserved as a supplementary test at this stage because of its technical complexity. PMID- 2754533 TI - Detection of a tumor-associated glycoprotein antigen in serum and urine of melanoma patients by murine monoclonal antibody (AD1-40F4) in enzyme immunoassay. AB - The urine of 68% of melanoma patients contains a high molecular weight glycoprotein which is expressed by melanoma cells and reacts with autologous antibody. Since high levels of this antigen in urine correlate with disease recurrence in surgically treated melanoma patients, it has been termed urinary tumor-associated antigen (U-TAA). We report the development of a murine monoclonal IgM antibody (AD1-40F4), which is specific for U-TAA. AD1-40F4 showed the same pattern of reactivity as the allo-antibodies previously used for the detection of U-TAA. The antigen recognized by AD1-40F4 has a high molecular weight (590-620 kilodaltons [kd]) and is heat stable. The AD1-40F4-reactive epitope is a protein. When AD1-40F4 was applied in an enzyme immunoassay, it allowed for the detection of U-TAA in the serum of 64% (33/52) of melanoma patients as opposed to only 5% (1/20) of normal controls. Thus, the murine monoclonal antibody AD1-40F4, which has been specifically developed against an allogeneic antibody defined antigen, U-TAA, appears to be important for immuno prognosis of human melanoma. PMID- 2754534 TI - Humoral and cellular immune responses to Salmonella typhi in patients with typhoid fever. AB - Humoral and cellular immune responses to Salmonella typhi have been studied in nine children with typhoid fever. By using dot immunobinding assay, anti-O polysaccharide chain and antilipid A antibody titers have been evaluated during the course of the disease. Anti-O-polysaccharide chain antibody titers are lower at the first week and increase up to the third week of the infection. On the other hand, antilipid A antibody levels, which are already higher at the beginning of the disease, progressively augment during the following weeks. Concerning cellular immunity to S. typhi, antibacterial activity mediated by typhoid peripheral mononuclear cells has been determined. Results show this function to be depressed in the initial phase of typhoid, increasing with the time. Together, these data bring new insight on immunity in typhoid patients. PMID- 2754535 TI - Suggested guidelines for the use of emergency tests in clinical biochemistry. AB - We have discussed the need for guidelines as a means of reducing out-of-hours investigations in clinical biochemistry, and suggest protocols that can be modified to suit local needs. PMID- 2754536 TI - Lymphocytic gastritis versus varioliform gastritis. A historical series revisited. AB - A historical series of varioliform gastritis published in 1978 by Lambert et al. (Digestion 1978; 17: 159-167) was revisited by two pathologists. The histological preparations from 35 patients were reread and interpreted in the light of endoscopic data found in the files. The results demonstrate a strict correlation between clinical diffuse varioliform gastritis and a recently recognized histopathological entity--lymphocytic gastritis, which is characterized by intense lymphocytic infiltration of the surface and foveolar epithelium. The rare discrepancies occur in Crohn's disease and in varioliform gastritis limited to part of the stomach, mostly the antrum. PMID- 2754537 TI - The relationship between number of interphase nors and nor-bearing chromosomes in non-Hodgkin's lymphoma. AB - The ribosomal genes (located on the acrocentric chromosomes 13-15, 21-22) may be identified by their silver stained gene products, i.e. NOR related proteins. The NOR bearing chromosome activity can be observed at metaphase with the potential for all ten chromosomes to be positively stained. On the other hand, during interphase they fuse so that eventually only a single silver positive structure is seen in resting normal cells. Investigations of histopathological sections of non-Hodgkin's lymphoma (NHL) have demonstrated a correlation between the numbers of interphase NORs and the grade of tumour. There is generally a higher number of interphase in high-grade, and a lower number in low-grade tumours. This histopathological and cytogenetic study of 13 patients with NHL shows that the higher numbers of interphase NORs in the high-grade tumours is not necessarily a reflection of increased numbers of NOR-bearing chromosomes. Examples were found of high-grade neoplasms, showing the expected high numbers of interphase NORs, but not an increased number of NOR-bearing chromosomes. Conversely, some low grade tumours, with the expected low number of interphase NORs, had increased numbers of NOR-bearing chromosomes. Our conclusion is that the interphase NOR number is related to factors other than chromosome numbers. We suggest that NOR numbers at interphase may be related to cell turnover. This is supported by previous investigations using DNA flow cytometry and the monoclonal antibody Ki67. PMID- 2754538 TI - Correlation of morphology, immunophenotype, and flow cytometry with remission induction and survival in high grade non-Hodgkin's lymphoma. AB - A series of cases of high grade non-Hodgkin's lymphomas has been studied by morphology (110 cases), immunocytochemistry (90 cases), using reagents reactive in fixed paraffin-embedded tissue, and flow cytometry (77 cases). B-cell tumours constituted 67.0 per cent of the total, T-cell tumours 22.0 per cent, and unclassified cases 8.8 per cent. Immunocytochemistry revealed two anaplastic carcinomas. Of the 77 cases studied by flow cytometry, 67.5 per cent were diploid and 32.5 per cent DNA aneuploid. T-cell tumours were more likely to be diploid than B-cell tumours, though the difference did not reach statistical significance. T-cell tumours had a significantly lower proliferative index (%S + G2) than B-cell tumours (P = 0.002). The overall remission induction rate was 68 per cent and actuarial 3-year survival 47 per cent. There was a trend for cases with %S + G2 less than 22 per cent to survive longer (P = 0.07). This trend became statistically significant when aneuploid cases were added to the high PI group (P = 0.04). No correlation was seen between morphological or immunophenotypic groups and remission induction rates or survival. PMID- 2754539 TI - Pleural mesothelioma of connective tissue type, localized fibrous tumour of the pleura, and reactive submesothelial hyperplasia. An immunohistochemical comparison. AB - Ten diffuse pleural mesotheliomas of connective tissue type have been compared with 14 examples of pleural granulation tissue and 7 localized fibrous tumours of the pleura, using immunohistochemistry to identify cytokeratins of low and high molecular weight and vimentin. Low molecular weight cytokeratin and vimentin were both detected in 8 of the 10 mesotheliomas and in 12 of the 14 reactive lesions. High molecular weight cytokeratin was rarely detected in either lesion. The seven localized fibrous tumours of the pleura were all positive for vimentin and negative for both cytokeratins. These findings support an origin of connective tissue type mesotheliomas from multipotential submesothelial spindle cells and of localized fibrous tumours of the pleura from either conventional fibroblasts or resting submesothelial spindle cells. Antibodies to cytokeratin help distinguish these two neoplasms but provide no assistance in the more difficult diagnostic problem of distinguishing mesotheliomas of connective tissue type from pleural reactions characterized by abundant granulation tissue. PMID- 2754540 TI - Low-temperature and conventional scanning electron microscopy of human urothelial neoplasms. AB - The appearance of neoplastic human urothelium viewed by low-temperature scanning electron microscopy (LTSEM) and conventional scanning electron microscopy (CSEM) was compared. Fixed, dehydrated neoplastic cells viewed by CSEM had well-defined, often raised cell junctions; no intercellular gaps; and varying degrees of pleomorphic surface microvilli. The frozen hydrated material viewed by LTSEM, however, was quite different. The cells had a flat or dimpled surface, but no microvilli. There were labyrinthine lateral processes which interdigitated with those of adjacent cells and outlined large intercellular gaps. The process of fixation and dehydration will inevitably distort cell contours and on theoretical grounds, the images of frozen hydrated material should more closely resemble the in vivo appearance. PMID- 2754541 TI - Diagnostic fine needle core biopsy of deep lymph nodes for the diagnosis of lymphoma in patients unfit for surgery. AB - The use of a technique for safe percutaneous fine needle biopsy of inaccessible lymph nodes is described. In a prospective study of 24 patients, including five cases positive for the human immunodeficiency virus (HIV), this technique was used to provide diagnostic material. A firm diagnosis was made in 21 cases; four cases of Hodgkin's disease, 14 non-Hodgkin's lymphomas, one case of Kaposi's sarcoma, one case of mycobacterial infection, and one which showed the features of persistent generalized lymphadenopathy (PGL). In the cases of lymphoma, available serial sections allowed characterization of the tumour with immunocytochemistry. In three cases, no diagnosis could be made, with one of these requiring a subsequent open biopsy. Percutaneous fine needle biospy is ideal for patients unfit or unsuitable for general anaesthesia or surgery. The biopsy obtained gives the pathologist sufficient tissue for an accurate diagnosis in the majority of cases. The preservation of architecture and multiple sections available are advantages over fine needle aspiration. PMID- 2754542 TI - Cell death by apoptosis in acute leukaemia. AB - We have previously demonstrated that when freshly isolated childhood T-cell acute lymphoblastic leukaemia cells are incubated in growth medium after isolation from blood, chromatin is rapidly cleaved into nucleosomal sized fragments that are multiples of 200 bp. The fragmentation is similar to that observed in other types of cells undergoing apoptosis or programmed cell death. In this study we describe a more comprehensive approach to the study of DNA fragmentation in leukaemia. Fragmentation was observed in freshly isolated cells from patients with T-cell acute lymphoblastic leukaemia and in one with common acute lymphoblastic leukaemia. Frozen samples of T-cell acute lymphoblastic leukaemia, common acute lymphoblastic leukaemia, and acute myeloid leukaemia cells also showed fragmentation of DNA. However, no fragmentation was evident in normal leukocytes treated under the same conditions. Ultrastructural studies on the isolated leukaemia cells demonstrate that the chromatin cleavage observed biochemically is associated with morphological changes characteristic of apoptosis. PMID- 2754543 TI - Metallothionein and copper in liver disease with copper retention--a histopathological study. AB - We have examined the relationship between (a) histochemically demonstrable copper using rubeanic acid, (b) copper-associated protein (CAP) using orcein, and (c) immunoreactive metallothionein (MT) using DNP hapten sandwich staining and have correlated these with histological lesions in 95 liver biopsies from patients with conditions associated with hepatic copper retention, 4 fetal livers, and 25 histologically normal adult controls. No copper or CAP was present in normal adult liver but periportal CAP was present in fetal liver. MT was present in hepatocytes of normal livers with a predominantly perivenular (centrilobular) cytoplasmic distribution varying in staining intensity; all fetal hepatocytes stained strongly for MT. Fifty-two of 95 (55 per cent) abnormal livers contained CAP and 42 (44 per cent) contained both CAP and copper. In CAP-positive livers, the commonest histological lesions were piecemeal necrosis and cholestasis. CAP was present in (a) 15/15 cases of primary biliary cirrhosis including early cases with minimal pathology; and (b) 5/5 cases of Wilson's disease, 6/6 cases of biliary atresia, and 3/9 cases of sclerosing cholangitis. In other conditions, it was present in 25-50 per cent of cases. MT distribution was abnormal in most CAP positive livers. Necrotic hepatocytes were intensely MT-positive and in Wilson's disease had a characteristic appearance. PMID- 2754544 TI - A simple method for assessment of glomerular size and its use in the study of kidneys in acromegaly and compensatory renal enlargement. AB - As measurement of absolute glomerular size is difficult we developed a method of assessing glomerular size that was simple and practical and could be used to compare the kidneys in different groups of patients. Using a semi-automatic image analyser, the cross-sectional area of 100 randomly-selected glomeruli, outlined by Bowman's capsule, was measured on sections of kidneys taken at necropsy. The mean of the logarithms of the largest 25 areas was calculated. The method was applied to compare control kidneys (53) with the kidneys in acromegalics (20), in patients with one kidney (10) and in patients with asymmetrical kidneys (12). Kidneys were heavier in the three test groups than in controls. Glomerular sizes were similar in controls and in acromegalics but were larger in single and disparate kidneys. There was a relationship between glomerular size and kidney weight within the control group and across the four groups taken together. This only partly accounted for the observed differences in glomerular size between the groups. Histological comparison of the acromegalic and single kidneys showed more global glomerulosclerosis in single kidneys and also segmental lesions, mainly at the glomerular hilum, only in the single kidneys. These findings show that renal enlargement occurs in acromegaly and in single and disparate kidneys but is accompanied by markedly different glomerular features. This implies different mechanisms for the renal enlargement. The method of assessing glomerular size is useful in the study of these and other conditions affecting the kidney. PMID- 2754545 TI - Protamine sulphate-induced proteinuria: the roles of glomerular injury and depletion of polyanion. AB - It has been claimed that intrarenal injection of polycations results in proteinuria due to neutralization of glomerular basement membrane polyanionic charge without any glomerular morphological changes. To study the effects of polycation infusion on the renal glomerulus, the left kidney of rats was directly injected with protamine sulphate through the renal artery. Urine was collected from each kidney before and after injection, and protein excretion rates were determined. Ninety minutes after completion of the injection both kidneys were perfusion-fixed and the morphology and colloidal iron staining of the kidneys were studied by light and electron microscopy. Intrarenal injection of 0.5, 1, and 2 mg of protamine sulphate produced minimal or mild proteinuria in the majority of animals. Higher doses (5 mg) commonly resulted in decreased protein excretion associated with oliguria. Colloidal iron staining of glomerular polyanionic sites was undiminished when compared with control kidneys. Injection of protamine sulphate resulted in capillary thrombosis and severe damage to both glomerular and tubular epithelium in 6 of 16 kidneys. In the remaining kidneys, milder focal changes were apparent. Although its mechanism of action is unclear, it is apparent that protamine sulphate, even in small doses, is toxic to the cellular components of the glomerulus and tubules, thus accounting for the range of changes observed in renal function. PMID- 2754546 TI - Hepatic sinusoidal cell destruction in the development of intravascular coagulation in acute liver failure of rats. AB - Rats received a dose of dimethylnitrosamine (DMN) or carbon tetrachloride (CCl4). In the liver of rats given DMN, apoptosis of fat-storing cells occurred at 7.5 h, and sinusoidal endothelial cell degeneration followed, with parenchymal cell necrosis after 9 h. Fibrin thrombi appeared in the sinusoids as well as in these necrotic areas after 12 h. In contrast, in the liver of rats given CCl4, parenchymal cell degeneration was seen after 6 h and necrosis with fibrin thrombi developed after 9 h. Fat-storing cells and endothelial cells were almost intact, and fibrin thrombi were not present in the sinusoids. SGPT values increased with decreased plasma levels of fibrinogen and antithrombin III and prolonged prothrombin time after 3 and 6 h, in the CCl4 and DMN models, respectively. An extensive reduction in plasma factor VIIIC levels and peripheral platelets was seen after 18 and 24 h, respectively, only in the DMN model. These results suggest that endothelial cells destruction can cause fibrin formation in the hepatic sinusoids in acute liver injury. Fat-storing cell injury may contribute to the destruction. PMID- 2754547 TI - In vitro proliferation of aortic smooth muscle cells from spontaneously hypertensive and normotensive rats. AB - The characteristics and proliferation of aortic smooth muscle cells (SMC) from spontaneously hypertensive rats (SHR) and normotensive Wistar-Kyoto (WKY) rats were studied in culture. Smooth muscle cells were isolated from the tunica media of the thoracic aorta by an explant method. Immunofluorescence microscopy showed that 93-95 per cent of cells were positively labelled with antibodies raised against smooth muscle actin, indicating that these were smooth muscle cells. The proliferative activity was compared between aortic smooth muscle cells from hypertensive and normotensive rats in culture by thymidine incorporation and cell number determinations. The results demonstrate that aortic smooth muscle cells from hypertensive rats grew faster than those from normotensive rats in culture. The increased proliferative activity of cultured aortic smooth muscle cells from hypertensive rats was detectable even when they were cultured in a chemically defined serum-free medium. These data have shown that an increased proliferative activity of aortic smooth muscle cells from hypertensive rats can occur in culture conditions without the influence of arterial pressure or other stimuli as in intact animals. The mechanisms underlying the accelerated proliferative activity of aortic smooth muscle cells from genetically hypertensive rats in vitro remain to be determined. PMID- 2754548 TI - Parental history of cardiovascular disease as an indication for screening for lipoprotein abnormalities in children. AB - We studied the relationship between parental history of cardiovascular disease and risk for adverse lipid and lipoprotein levels in a total community study of 3313 children (ages 4 to 17 years, 63% white, 37% black). Older white children (11 to 17 years) with a parental history of heart attack or diabetes were 4.3 and 5.6 times, respectively, more likely to have high levels (greater than or equal to 95th percentile) of serum total cholesterol than those without such a history (all p less than 0.05). White children with a parental history of heart attack or diabetes were twice as likely to have an elevated (greater than or equal to 95th percentile) low-density lipoprotein cholesterol (LDL-C) level than those without such a history (both p less than 0.05). In contrast, parental history of cardiovascular disease did not predict elevated levels of total cholesterol or LDL-C in black children. However, older black children with a parental history of heart attack, hypertension, or diabetes were 4 1/2 to 5 times more likely to have low levels (less than or equal to 5th percentile) of high-density lipoprotein cholesterol than those without such a history (all p less than 0.05). Only 40% of white children and 21% of black children with elevated LDL-C levels had a parental history of vascular disease. These findings raise questions about the current practice of screening only children with a family history of cardiovascular disease to identify those with elevated total cholesterol and LDL C levels. PMID- 2754549 TI - Polymerase chain reaction compared with concurrent viral cultures for rapid identification of human immunodeficiency virus infection among high-risk infants and children. AB - To determine the usefulness of DNA amplification by polymerase chain reaction for the early identification of human immunodeficiency virus type 1 (HIV-1) infection in infants and children, we compared the polymerase chain reaction and concurrent viral cultures of peripheral blood mononuclear cells from 25 high-risk subjects aged 5 weeks to 8 years. In two separate primer pairs, HIV-1 proviral DNA gag sequences were successfully identified in cell lysates from seven patients, including two infants with previously indeterminate HIV-1 status on the basis of serologic and culture results. In the remaining 18 patients the polymerase chain reaction was negative for HIV-1. Simultaneously grown HIV-1 cultures concurred with polymerase chain reaction results for all patients. In an 18-month-old infant who had had a single HIV-1 positive culture at 1 month of age with four subsequent negative cultures, both polymerase chain reaction and HIV-1 culture were negative. Our data demonstrate the clinical applicability of polymerase chain reaction on crude cell lysates for the rapid, early, definitive detection of HIV-1 infection in high-risk infants and children. PMID- 2754550 TI - Hydrostatic reduction of ileocolic intussusception: a second attempt in the operating room with general anesthesia. AB - Over a 3-year-period, standard treatment with hydrostatic pressure from a contrast enema failed to reduce ileocolic intussusception in 31 of 62 children. With the child anesthetized in the operating room, a second contrast enema was given before laparotomy. Of the 31 intussusceptions, 21 (68%) were reduced without complication, thereby avoiding the discomfort, longer hospitalization, complications, and expense of surgery. Nine of the remaining 10 intussusceptions were difficult to reduce manually during surgery or required resection. The overall nonoperative reduction rate for the 3-year period was 84%; for the last 2 years it was 90%. Success with the second enema may be related to the effects of general anesthesia. In addition, partial reduction with the first enema may improve blood flow from the intussusceptum so that it becomes smaller and easier to reduce with the second enema. Because it can easily be added to standard management protocols without increased risk, routine use of this second enema with anesthesia is recommended. PMID- 2754551 TI - Congenital muscular dystrophy. AB - We report the cases of 18 patients with congenital muscular dystrophy, six of whom also have involvement of the central nervous system, corresponding to the Fukuyama type of congenital muscular dystrophy. In four patients, both the central nervous system and the eyes are involved, and the diagnosis of "muscle, eye and brain disease" was made. A comparative study of these patients with those whose cases were recently reported indicates that there is a wide variability of clinical and laboratory expression of the dystrophy, but a constant feature in all patients is a progression of motor disability. The association of congenital muscular dystrophy with brain abnormalities indicates a poor clinical prognosis. At present it remains an open question whether the three variants of the disease are separate diseases or only different expressions of the same syndrome, but our study tends to support the latter hypothesis. PMID- 2754552 TI - Effect on renal function of essential fatty acid supplementation in cystic fibrosis. AB - Changes in renal hemodynamics, sodium homeostasis, renal acidifying capacity, and aldosterone excretion were studied before and after long-term intravenous essential fatty acid supplementation for a period of 3 years in 11 patients with cystic fibrosis. The mean (+/- SD) glomerular filtration rate was high at the start of the study (133 +/- 18 ml/min/1.73 m2 body surface area) and decreased significantly (p less than 0.05) to within normal values after 1 year of essential fatty acid supplementation. The urinary elimination of an oral sodium load initially was very low (3.6 +/- 2.5 mmol/hr/1.73 m2 body surface area vs control subjects' values of 7.9 +/- 2.0; p less than 0.001) and increased during treatment but was not normalized (p less than 0.05 vs control subjects' values). Free water clearance and distal tubular sodium delivery, which were significantly decreased before treatment (p less than 0.01 and p less than 0.001 vs control subjects' values, respectively) did not increase significantly. The mean urinary aldosterone excretion did not significantly differ from that in control subjects before and after treatment. The acidifying capacity was disturbed, indicating a low renal bicarbonate threshold, and was changed during treatment in only 2 of 10 patients. These data indicate that essential fatty acid deficiency may contribute to the renal disturbances in cystic fibrosis. PMID- 2754553 TI - Corticosteroids in croup: a chink in the ivory tower? PMID- 2754554 TI - Esophageal adenocarcinoma after gastroesophageal reflux in children. PMID- 2754555 TI - Influence of bacterial adhesion on ureteral width in children with acute pyelonephritis. PMID- 2754556 TI - Familial concordance of pancreatic function in cystic fibrosis. PMID- 2754557 TI - Hereditary xanthinuria with severe urolithiasis occurring in infancy as renal tubular acidosis and hypercalciuria. PMID- 2754558 TI - Effect of lactation in a mother with galactosemia. PMID- 2754559 TI - Aicardi syndrome in two sisters. PMID- 2754560 TI - Abnormal brain-stem function (brain-stem auditory evoked response) correlates with acoustic cry features in term infants with hyperbilirubinemia. AB - We hypothesized that changes in brain-stem auditory evoked responses related to bilirubin would be associated with changes in cry because of the anatomic proximity in the brain stem of cranial nerves 8 (auditory) and 9 to 12 (vagal complex, which controls cry). Brain-stem auditory evoked responses and computerized cry analysis were used to study the concurrent effects of moderate hyperbilirubinemia on auditory function and cry. Fifty term infants were divided equally into two groups on the basis of serum bilirubin concentrations: low (less than 8 mg/dl; 136) mumol/L and moderate (10 to 20 mg/dl, 170 to 342 mumol/L). Forty-three infants had successful tracings of brain-stem auditory evoked responses recorded with a Cadwell model 5200A evoked response unit during two successive trials, and a cry recording of each infant was analyzed by computer. The moderate serum bilirubin group had an increase in percent cry phonation (p less than 0.02) and an increase in the variability of the first formant (p less than 0.04) in comparison with the low serum bilirubin group. Serum bilirubin values correlated positively with brain-stem conduction time (r = 0.36, p less than 0.01), percent phonation (r = 0.42, p less than 0.004), and variability of the first formant (r = 0.39, p less than 0.02). Percent phonation, the voiced component produced by increased neural control, correlated with the interpeak of waves latencies I to III (r = 0.32, p less than 0.03) and brain-stem conduction time (wave I to V) (r = 0.35, p less than 0.01). We conclude that hyperbilirubinemia affects adjoining areas of the brain stem that control hearing and cry production. PMID- 2754561 TI - Late hyporegenerative anemia in Rh hemolytic disease. PMID- 2754562 TI - A prospective randomized double-blind study to evaluate the effect of dexamethasone in acute laryngotracheitis. AB - To determine whether a single dose of dexamethasone (0.6 mg/kg) is useful in the treatment of acute laryngotracheitis (croup), 29 hospitalized patients with acute laryngotracheitis were randomly assigned in a double-blind fashion to receive either parenterally administered dexamethasone (n = 16) or a saline placebo (n = 13). Severity of the illness was assessed by a clinical croup score based on retractions, stridor, air entry, cyanosis, and level of consciousness. Twelve hours from the time of injection, the patients receiving the dexamethasone had a statistically significant decline in median croup score from 4.5 to 1.0 (p less than 0.001), whereas the patients receiving the placebo did not. By 24 hours, a decline of two or more points in the total croup score was noted in 85% of the patients in the dexamethasone group compared with 33% of the patients in the placebo group (p = 0.027). During this same period, only 19% of patients receiving dexamethasone required two or more racemic epinephrine treatments in comparison with 62% of patients who received the placebo (p less than 0.05). There was no statistical difference between the two groups in improvement in oxygen saturation, respiratory rates, or duration of hospitalization. We conclude that dexamethasone is beneficial in reducing the overall severity of moderate to severe acute laryngotracheitis during the first 24 hours after injection. PMID- 2754563 TI - T cell immunodeficiency in a patient with 10p deletion syndrome. PMID- 2754564 TI - Factors affecting outcome after posthemorrhagic ventriculomegaly. PMID- 2754565 TI - Hypogammaglobulinemia in orotic aciduria. PMID- 2754566 TI - Maternal cocaine use and risk of sudden infant death. PMID- 2754567 TI - Lactose tolerance in colicky infants. PMID- 2754568 TI - Temperament problems and congenital hypothyroidism. PMID- 2754569 TI - Congenital heart disease and necrotizing enterocolitis. PMID- 2754570 TI - Glycogen storage disease and inflammatory bowel disease. PMID- 2754571 TI - Myelomeningocele and necrotizing enterocolitis. PMID- 2754572 TI - Pulmonary sequelae of meconium aspiration. PMID- 2754573 TI - Families of young adolescents who have survived cancer: social-emotional adjustment, adaptability, and social support. AB - Young adolescent (10-15 year old) survivors of childhood cancer and their families (n = 35) completed self-report measures of perceived self-competence, social support, child behavior, parental distress, and family adaptability and cohesion, at two data points, 6 months apart. Relative to instrument norms and a comparison group (n = 13), survivors and their families scored within normative levels. The overall lack of group differences is discussed in terms of the implications of tests of the null hypothesis for families with chronically ill children. Changes over time for the survivors suggest a decline in available social support. Parents of survivors who received educational assistance reported less family adaptability and more distress than parents of survivors not receiving these services. PMID- 2754574 TI - Children with recurrent abdominal pain and their parents: more somatic complaints, anxiety, and depression than other patient families? AB - Patients presenting with abdominal pain were classified into two groups: the recurrent abdominal pain (RAP) group (n = 41), consisting of patients without identifiable organic etiology for abdominal pain, and the organic group (n = 28), consisting of patients with organic findings (primarily ulcer-related conditions). A control group of well patients (n = 41) also participated. RAP and organic patients had higher anxiety, depression, and somatic complaints than well patients, but did not differ from each other. Anxiety, depression, and somatization were greater in RAP mothers than well mothers. Father symptomatology did not differ for the groups. Results suggest that psychological distress does not discriminate between patients with and without identifiable organic etiology for abdominal pain. The high levels of anxiety and depression in RAP and organic patients suggest that they should be targeted in efforts to address "the new hidden morbidity" in pediatrics. PMID- 2754575 TI - The family environment in nonorganic failure to thrive: a controlled study. AB - Compared 48 families of nonorganic failure to thrive (NOFT) infants with those of 52 physically healthy infants of similar demographic characteristics using the Family Environment Scale (FES). Families of NOFT infants had more problematic relationships as indicated by lower scores on the Family Relationships Inventory (FRI) components of the FES, including lower Cohesion and Expressiveness, than families of physically healthy infants. Contrary to predictions, families did not differ in level of Conflict or Organization. Families of NOFT infants had lower intellectual and Cultural Orientation. These findings suggest that problematic intrafamilial relationships are associated with NOFT and may influence the psychological outcomes of children with this condition. Studies are needed to document the effects of family functioning on the physical growth and psychosocial development of NOFT children. PMID- 2754576 TI - Diabetes in adolescence: effects of multifamily group intervention and parent simulation of diabetes. AB - Insulin-dependent diabetes mellitus (IDDM) is a complex, chronic disease that is difficult to control during adolescence. This study evaluated the effects of a 6 week, family-oriented, group intervention on adolescents' metabolic control and psychosocial and family functioning. Thirty-two families were randomly assigned to one of three groups: multifamily (MF), multifamily plus parent simulation of diabetes (MF + S), and control (C). Outcome measures included glycosylated hemoglobin (Hb Al); perceptions of diabetes; estimates of youngsters' self-care; and family functioning. Adolescents in the MF + S group displayed significant decrements in Hb Al, and adolescents in both intervention groups reported more positive perceptions of a "teen-ager with diabetes" at posttreatment, relative to controls. Adolescents participating in smaller family groups demonstrated clinically significant improvements in Hb Al that were maintained at 6-month follow-up. Parent reports suggested that adolescents in the intervention groups improved their diabetes care. Findings support the use of multifamily groups plus parent simulation of diabetes as an intervention strategy for adolescents with IDDM. PMID- 2754578 TI - A study of tinea capitis in Sri Lanka. AB - Between January 1978 and December 1987, 106 cases of tinea capitis were detected in Sri Lanka. Diagnosis was confirmed mycologically by microscopic examination and by culture. Tinea capitis accounted for 3.4% of all superficial fungal infections seen during this period. This figure is low when compared with the incidence of this disease reported in other countries. Five main types of clinical manifestation were encountered. Inflammatory lesions were observed in 50% of the patients. Eighty-five percent of infections occurred in children below 15 years of age and 76% in children under 10 years of age. The 6-10 year age group was the most vulnerable. The zoophilic fungi Trichophyton mentagrophytes, Microsporum canis and the geophilic species Microsporum gypseum were together responsible for 81% of tinea capitis infections, and the zoophilic fungus Trichophyton simii accounted for a further 10% of infections. It is postulated that the Sri Lankan custom of frequent head baths with soap and water, especially among children, may account in part for the low prevalence of tinea capitis in the community. PMID- 2754577 TI - Familial similarities of changes in cognitive, behavioral, and physiological variables in a cardiovascular health promotion program. AB - A number of studies have demonstrated that physiological and behavioral cardiovascular disease (CVD) risk factors aggregate within families. This fact, and the potential mediating role that the family plays in behavior change, have led to the development of family-based CVD risk reduction programs, including the San Diego Family Health Project. The aggregation of behavioral, physiological, and cognitive changes within families was assessed during a 1-year intervention. We found evidence of modest but significant aggregation of change. There was more aggregation of change in behavioral variables than in physiological or cognitive variables. More significant correlations were found among 3-day food record measures than among 24-hour recall dietary measures, suggesting an influence of assessment method. Aggregation of change within families was stronger within generations than across generations. These data point to the importance of involving all age groups in health promotion programs. PMID- 2754579 TI - Appendicovesicostomy: a new technique for bladder diversion during reconstruction of cloacal exstrophy. AB - Urinary tract diversion in the reconstruction of cloacal exstrophy presents a difficult problem. Many methods have been used, but none has been found to be ideal. We describe a simple technique that incorporates the ileocecal plate in the bladder augmentation, and uses the appendix as a conduit for urinary diversion. This technique offers the advantages of primary closure, effective urinary drainage without tubes, and simplicity of bowel reconstruction with preservation of maximal absorptive surface. PMID- 2754580 TI - Splenic cysts: aspiration, sclerosis, or resection. AB - Percutaneous aspiration and tetracycline sclerosis is a safe but temporary therapy of large splenic cysts in children. Between 1985 and 1987, three girls with splenic cysts were seen. Their ages ranged from 5 to 14 years, and the cysts were from 8 to 16 cm in diameter. Despite their large size, all were asymptomatic and were discovered upon physical examination or ultrasound for unrelated conditions. All cysts were avascular by scan and had irregular crenated or smooth walls by ultrasound. Further investigation excluded infectious or parasitic causes. Each cyst was aspirated for diagnosis, and a pigtail catheter was inserted for drainage and sclerotherapy. All needle aspirations resulted in cyst collapse, but in one patient the pigtail catheter insertion was unsuccessful, and in the other two cases, multiple attempts of tetracycline sclerosis failed to obliterate the cysts. There were no other complications. Surgery for the recurrent splenic cysts was performed 3 months to 2 years following the percutaneous procedures. The two patients operated on with 3 months of aspiration underwent successful partial splenectomy and have normal splenic function by ultrasound scan, and absence of RBCs. The third patient had progression of the cystic disease throughout the spleen, and required splenectomy. Pathology confirmed multiseptate congenital mesothelial cysts in the first two patients and massive lymphangiomatosis in the third. In all three cases, percutaneous therapy was safe but did not result in long-term control. In one patient, the cystic disease progressed following sclerotherapy and may have influenced the need for complete splenectomy. Prior manipulation did not adversely affect the dissection and mobilization of the spleens.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2754581 TI - The effect of adenosine triphosphate on the functional status of the ductus arteriosus. AB - We investigated whether a low-dose infusion of ATP-MgCl2 could affect the functional status of the ductus arteriosus during hypoxia-induced pulmonary vasoconstriction. Three-day-old piglets were made hypoxic by ventilation with a mixture containing 10% oxygen, 4% CO2, and balance nitrogen. Serial infusions of ATP-MgCl2 at 0.1, 0.5, and 1.0 mg/kg/min were compared with preinfusion hypoxia baselines. The functional status of the ductus arteriosus was determined by change in transit time of a bolus of iced saline between thermistor probes in the pulmonary artery and aorta. The method was validated using a Blalock-Taussing shunt (subclavian to pulmonary artery) in 3-week-old piglets instrumented in a similar manner. In these three-day-old piglets, hypoxia alone produced a significant elevation in pulmonary artery pressure and reduction in PO2. All dose rates of ATP-MgCl2 produced a significant decrease in mean pulmonary artery pressure. Systemic pressure was significantly decreased only during the 1.0 mg/kg/min infusion. Transit times of a bolus of iced saline during the validation were definitive for characterizing a situation of "shunt open" or "shunt closed." Infusion of ATP-MgCl2 produced no change in the status of the ductus arteriosus in 45 (94%) of the determinations. In only three cases was the effect of ATP MgCl2 sufficient to result in a functional change in the status of the ductus arteriosus. Pre- and postductal pulmonary artery PO2 were not altered during ATP MgCl2 infusion, thus corroborating the transit time determinations. From these results, we conclude that an infusion of ATP-MgCl2 does not alter the functional status of the ductus arteriosus. PMID- 2754582 TI - Postpneumonic empyema in childhood: selecting appropriate therapy. AB - In order to identify appropriate treatment options for postpneumonic empyema, we reviewed the medical records and, when possible, obtained long-term follow-up chest radiographs and pulmonary function tests on children treated for empyema during the past 11 years. Fifty-one patients were treated in various ways, with antibiotics alone (N = 10), or in combination with tube thoracostomy (N = 23) or decortication (N = 18). Despite administration of appropriate antibiotics and establishment of pleural drainage, many children required prolonged hospitalization and eventual decortication. Based on this review, a scoring system was developed allowing early classification by severity of pleural disease. Factors found to be predictors of severe pleural disease include (1) low pleural fluid pH or (2) glucose; (3) presence of moderate or severe scoliosis or (4) pleural peel or parenchymal entrapment by chest radiography; and (5) infection due to anaerobes, gram-negative organisms, or mycoplasma. Complete opacification of a hemithorax on chest radiography and a pleural peel to thoracic ratio greater than 40% were also associated with severe pleural disease. In patients with mild disease (N = 7), response to antibiotics alone, rapid resolution of fever, and shorter hospital stays were observed. In patients with more severe infections (moderate = 22, severe = 22), decortication accomplished earlier defervescence, radiographic improvement, and hospital discharge than simple tube thoracostomy. No deaths or morbidity were associated with decortication, which could often be accomplished through a minithoracotomy. Follow-up chest radiographs and pulmonary fuction tests showed a prompt return to normal after decortication. This experience indicates utility of a pleural disease severity scoring system in selection of treatment options for children with postpneumonic empyema.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2754583 TI - Biliary appendico-duodenostomy: a nonrefluxing conduit for biliary reconstruction. AB - Biliary conduits constructed during operations for choledochal cysts or biliary atresia are frequently complicated by reflux of gastrointestinal contents, stasis, and obstruction with resulting cholangitis. We have used the appendix as a biliary conduit for cases of biliary atresia and choledochal cyst, adapting the urologic technique of a tunneled, nonrefluxing anastomosis for reconstruction of the biliary tree--biliary appendico-duodenostomy (BAD). From our preliminary experience with this technique, it appears promising. PMID- 2754584 TI - Hypoalbuminemia may predispose infants to necrotizing enterocolitis. AB - Numerous risk factors for necrotizing enterocolitis (NEC) including prematurity, bowel ischemia, pathogenic bacteria, and hyperosmolar feedings have been proposed. Recent studies have demonstrated feeding intolerance and bowel dysfunction in children with hypoalbuminemia. No association between hypoalbuminemia and NEC has been suggested. The records of 45 patients with NEC and complete documentation of prenatal and birth histories were reviewed. A control (CONT) group of 90 children matched for maternal age (+/- 1 year), parity, gestational age (+/- 1 week), birth weight (+/- 20 g), type of delivery, sex, race, type of initial feeding, and perinatal stress was compiled. While all other measured parameters were similar in the two groups, premorbid albumin was significantly lower in the patients who subsequently developed NEC (P less than .001). These data suggest that newborns with hypoalbuminemia may have an increased risk of developing NEC. PMID- 2754585 TI - Use of magnetic resonance imaging in planning the separation of omphalopagus conjoined twins. AB - Magnetic resonance imaging (MRI) was used for the first time in the preoperative planning for separation of conjoined twins. In these omphalopagus infants, MRI showed normal biliary and cardiovascular structures and demonstrated, in detail, a relatively avascular plane through the liver bridge, which enabled safe separation with minimal blood loss at 3 1/2 months of age. A single MRI study supplied information superior to that obtained with multiple previously available imaging studies. MRI should be an essential part of the preoperative workup of all types of conjoined twins. PMID- 2754586 TI - Analysis of energy and macronutrient balance in the postoperative infant. AB - The purpose of this study was to better define the energy and macronutrient balance of infants after major surgery. Forty studies were conducted in 29 full term surgical infants (mean weight, 3.27 +/- 0.19 kg; mean days postsurgery, 8 +/ 1). Nineteen infants were receiving total parenteral nutrition, 13 were orally fed, and eight received a combination of intravenous and oral nutrition (mean caloric intake, 84 +/- 4 kcal/kg/d). Each study was comprised of a three-day nutritional balance measuring energy intake and energy losses in excreta. Metabolizable energy intake (MEI) was determined by subtracting losses from gross intake. Energy expenditure and macronutrient oxidation were determined on the second day of the balance using continuous open-circuit indirect calorimetry in combination with timed urinary nitrogen excretion. Energy and macronutrient storage were calculated by subtracting oxidation and losses from measured intake. The mean global energy expenditure was 57 +/- 1 kcal/kg/d. Linear regression analysis of the nutritional balance data allowed estimates of energy, fat, and protein storage at various MEI. The data suggest that in the surgical infant, protein balance is maintained, even during hypocaloric nutritional regimens. In infants receiving adequate calories to maintain energy balance, maintenance metabolism is supported by the oxidation of endogenous fat. Net fat deposition will predictably only occur at metabolizable intakes of greater than 71 kcal/kg/d. PMID- 2754588 TI - Splenic microabscesses in the immune-compromised patient. AB - Four immune-compromised children who were receiving antineoplastic chemotherapy (three for leukemia), presented with recurrent episodes of fever and left upper abdominal pain. Blood cultures grew enteric gram-negative organisms in three children. Multiple blood cultures were negative for fungus although three patients had mucocutaneous and urinary candidiasis. All remained febrile and symptomatic despite treatment with broad spectrum antibiotics and antifungal chemotherapy. Computed tomography (CT) scans in all patients showed 2- to 10-mm focal defects in the spleen. The larger defects could be seen by ultrasonography but not on the live-spleen nuclear scan. A splenectomy was performed 2 to 4 weeks after the onset of symptoms in each child, and the cut surface of the spleens showed multiple small abscesses. All operative cultures were negative. A histological examination confirmed Candida infection in two patients and Aspergillus in one. Necrotizing granulomas strongly suggestive of fungus were seen in the fourth child. The patients defervesced and appeared well within three days. Antifungal therapy was continued. One child remains in remission from acute lymphocytic leukemia; one continues on chemotherapy; and one has recurrent widespread tumor. The patient with Aspergillus died following a bone marrow transplantation 6 months after the splenectomy. He had disseminated aspergillosis. An immune-compromised patient with persistent unexplained fever should have a CT scan of the abdomen. The presence of multiple splenic lesions strongly suggests fungal disease. If antifungal therapy does not result in complete resolution of fever and the splenic lesions, a splenectomy is indicated. PMID- 2754587 TI - Partial splenectomy: the preferred alternative for the treatment of splenic cysts. AB - We report six pediatric patients who had a partial splenectomy for splenic cysts and a seventh patient who had a total splenectomy. There were six epidermoid cysts and one traumatic cyst. All patients had benign postoperative courses. All patients who underwent partial splenectomy had a significant postoperative rise in platelet count that subsequently returned toward baseline. This rise implies a loss of splenic function, although the exact meaning of this is unclear. All patients had late postoperative liver-spleen scans that showed mean spleen size and function to be normal. We have described several methods of partial splenectomy used at Children's Hospital of Philadelphia. Recommendations for patients undergoing partial splenectomy include preoperative pneumococcus and Hemophilus influenzae vaccinations and prophylactic antibiotics postoperatively. The antibiotics are terminated if a liver-spleen scan and platelet count at the end of 3 months' time are normal. PMID- 2754589 TI - Giant iatrogenic splenic pseudocyst. AB - Partial splenic arterial embolization was used to treat hypersplenism in a 10 year-old boy with portal hypertension secondary to congenital hepatic fibrosis. After embolization the spleen remained enlarged, but the boy's platelet count increased and his variceal bleeding ceased. One month later, he returned with vomiting and an abdominal mass. Computed tomography showed a large cyst of the spleen with a small rim of residual splenic tissue. Percutaneous drainage with ultrasound guidance yielded 2,800 mL of brown fluid. Wedge-shaped infarctions are described early after splenic embolization, and these areas eventually fibrose and contract. In this case, the embolization resulted in splenic necrosis and liquefaction with pseudocyst formation. This unusual complication was effectively treated without surgery. PMID- 2754590 TI - Outpatient bowel preparation in children. AB - A polyethylene glycol electrolyte solution was evaluated as a mechanical bowel preparation prior to surgery in an outpatient setting. Twelve children underwent outpatient bowel preparation (OPBP) prior to a variety of surgical procedures. The technique was well tolerated and consistently produced a well-prepared intestinal tract. This technique will decrease the overall cost of hospitalization, and it enhances patient and parental acceptance of mechanical bowel preparation. PMID- 2754591 TI - Is there a place for parents in the operating room? AB - The presence of a parent in the operating room (OR) during induction of anesthesia is controversial. In order to assess the feasibility, safety, and acceptance of this practice, we evaluated a near-4-year experience with 3,086 patients less than 15 years of age, who were operated on at a free-standing ambulatory surgical center. The age distribution was: 1 to 23 months, 790; 2 to 5 years, 1,190; 6 to 10 years, 775; and 10 to 15 years, 331. The distribution of patients by service was: otorhinolaryngology, 1,597; pediatric surgery, pediatric urology, and plastic surgery, 948; ophthalmology, 443; orthopaedics, 72; and dental, 26. No premedication was employed. Anesthetic gases were delivered via a mask while the parent held or remained close to the child. Vascular access was established after the induction. Only five patients (tonsillectomy, four; circumcision, one) were admitted to the base hospital and subsequently discharged. Advantages of parental presence in the OR during anesthesia induction are decreased psychological trauma (child), smoother induction (child), and decreased parental anxiety. Possible disadvantages include disruption of OR routine, unpredictability of parental behavior, and increased time and cost. Because of careful preoperative preparation of parents by the nurses and anesthetists, the first three problems rarely occurred. The cost of supplies used by each parent was minimal. Practically all parents chose to accompany the child to the OR. The feedback during follow-up from those parents has been excellent. Nurses, anesthesiologists, and surgeons are enthusiastic about the program. In the examined setting, this approach has proven safe, simple, and effective. PMID- 2754592 TI - Thrombolytic therapy of aortic thrombosis in the premature infant. PMID- 2754593 TI - Violence: the epidemic is growing. PMID- 2754594 TI - Pressuring children to learn versus developmentally appropriate education. AB - Preschool and kindergarten programs have changed focus from an emphasis on play to an emphasis on formal academics. This trend is evaluated in light of research on children's development and learning. An alternative model of a developmentally appropriate program for young children is discussed. PMID- 2754595 TI - Homeless children: their evaluation and treatment. AB - The number of homeless families in the United States is growing at an alarming rate. More families are becoming homeless primarily because of financial and housing problems, such as loss of job and income, loss of welfare benefits, being victims of robbery, and eviction. Many of the homeless families have complex psychosocial and medical problems. Their children have a higher prevalence than the general population of all categories of illness, including acute illnesses such as colds, fevers, and diarrhea; chronic health problems such as epilepsy and asthma; developmental delay; and behavior and mental health problems. Clinical evaluation of the homeless family and child is presented, incorporating their special needs and considerations. PMID- 2754596 TI - Transient erythroblastopenia of childhood: implications for nurse practitioners. AB - Pediatric nurse practitioners in all areas of practice encounter anemic children. This article describes transient erythroblastopenia of childhood (TEC), a rare type of anemia that baffles health care providers and causes anxiety in parents. Understanding the cause, course, and treatment of TEC allows the nurse practitioner to educate and reassure affected children and their parents. PMID- 2754597 TI - Growing pains: a myth or a reality. PMID- 2754598 TI - Obesity in adolescence. PMID- 2754599 TI - Instrumentality as a life-stress moderator for early versus middle adolescents. AB - Used a longitudinal design to test the main and stress-buffering effects of instrumentality of measures of trait anxiety, depression, and self-esteem. Ss were early (junior high school) and middle (senior high school) adolescent boys and girls. The hypothesis that instrumentality would be negatively related to psychological distress was supported by the cross-sectional and longitudinal regression analyses of every subgroup of Ss. The hypothesized stress-buffering effect of instrumentality was found in the cross-sectional and longitudinal analyses of senior high girls, specifically in the context of interpersonal negative events (relationship stress). The analyses for junior high girls revealed that instrumentality was beneficial only at a low level of relationship stress. There were no significant interaction effects in the regression analyses of boys. The findings suggest that, when experiencing relationship stress, instrumentality is helpful for middle adolescent girls but not for early adolescent girls. Therefore, future research on adolescents' life-stress adjustment should consider the roles of gender, age, personality, and type of life stress. PMID- 2754600 TI - Life events, fitness, hardiness, and health: a simultaneous analysis of proposed stress-resistance effects. AB - The effects of exercise participation, self-perceived fitness level, and dispositional hardiness for promoting stress resistance were examined in a sample of 373 college students. Self-report measures of stressful life experience and recent physical illness were positively correlated, and fitness and hardiness were negatively correlated with illness as expected. Multiple regression analyses indicated that neither fitness nor hardiness provided a stress-moderator effect because neither was found to significantly interact with stress in the prediction of illness scores. Structural equation analyses suggested that hardiness may affect health indirectly by first influencing either the occurrence or subjective interpretation of stressful life events. No direct effect on health was found for exercise participation, although exercise may reduce illness indirectly by improving fitness. Implications for the multivariate modeling of proposed stress resistance-enhancing effects are discussed. PMID- 2754601 TI - From rarity to evaluative extremity: effects of prevalence information on evaluations of positive and negative characteristics. AB - Experiments showed a scarcity principle in evaluative judgments such that the identical characteristic is evaluated more extremely the lower its perceived prevalence. In Study 1, Ss evaluated a fictitious medical condition that was described as either beneficial or detrimental to health and as occurring in either 30% or in one half of 1% of a test population. The condition was evaluated more extremely--as as a more positive health asset or a more negative health liability--in the low-prevalence than in the high-prevalence conditions. Study 2 demonstrated the same effect in self-evaluations and with a different manipulation of perceived prevalence. Ss were told that they actually had the fictitious medical condition, that it was either beneficial or detrimental to their health, and either that they were the only 1 of 5 Ss who had it or that 4 of the 5 did. Low-prevalence Ss exhibited more extreme evaluative, affective, and behavioral reactions to the medical condition than did high-prevalence Ss. The origins and validity of the scarcity principle are discussed, as are its implications for uniqueness theory, reactance theory, and social evaluation theories. PMID- 2754602 TI - Processing deficits and the mediation of positive affect in persuasion. AB - Motivational and cognitive mediators of the reduced processing of persuasive messages shown by recipients in a positive mood were tested. Ss in positive or neutral moods read strong or weak counterattitudinal advocadies for either a limited time or for as long as they wanted. Under limited exposure conditions, neutral mood Ss showed attitude change indicative of systemic processing, whereas positive mood Ss showed no differentiation of strong and weak versions of the message. When message exposure was unlimited, positive mood Ss viewed the message longer than did neutral mood Ss and systematically processed it rather than relying on persuasion heuristics. These findings replicated with 2 manipulations of mood and 2 different attitude issues. We interpret the results as providing evidence that reduced cognitive capacity to process the message contributes to the decrements shown by positive mood Ss. PMID- 2754603 TI - Mental addition versus subtraction in counterfactual reasoning: on assessing the impact of personal actions and life events. AB - Assessing the consequences of actions and events often requires comparing a mental stimulation of the world in which the action is present to one in which the action is absent. We propose that people perceive more impact when asked to assess whether an action would increase the likelihood or degree of a potential outcome (mental addition) than when asked whether it would reduce the probability or extent of a potential consequence (mental subtraction). This judgmental asymmetry occurs because people (a) give more weight to features of the particular mental stimulation (the action or its absence) serving as the subject of comparison and (b) give more weight to factors that produce as opposed to inhibit the relevant outcome. In 4 studies, Ss assessed the impact of personal actions (e.g., studying for an exam). Ss perceived more impact when the assessment was placed in an additive frame (e.g., "how many more questions will you get right if you study?") as opposed to a subtractive one (e.g., "how many fewer will you get right if you do not study?"). This effect was not influenced by the hedonic value of the event or by whether the S had actually experienced it. Discussion centers on the relevance of these results for the undoing of scenarios and causal attribution. PMID- 2754604 TI - Relation of sympathy and personal distress to prosocial behavior: a multimethod study. AB - Assessed sympathy and personal distress with facial and physiological indexes (heart rate) as well as self-report indexes and examined the relations of these various indexes to prosocial behavior for children and adults in an easy escape condition. Heart rate deceleration during exposure to the needy others was associated with increased willingness to help. In addition, adults' reports of sympathy, as well as facial sadness and concerned attention, were positively related to their intention to assist. For children, there was some indication that report of positive affect and facial distress were negatively related to prosocial intentions and behavior, whereas facial concern was positively related to the indexes of prosocial behavior. These findings are interpreted as providing additional, convergent support for the notion that sympathy and personal distress are differentially related to prosocial behavior. PMID- 2754606 TI - A nurse's upstream battle against river blindness. PMID- 2754605 TI - Socialization and attentional deficits under focusing and divided attention conditions. AB - We conducted two studies to test and refine the hypothesis that, when undersocialized individuals focus on events of immediate interest, they allocate too large a proportion of their processing resources to those events and have little attention available for processing other important events. College students who completed the Socialization (So) scale (Gough, 1960) performed visual and auditory tasks simultaneously under conditions favoring the visual task, an equal division of processing resources between the tasks, or both. In both studies, low-So Ss performed relatively poorly on the auditory task under focusing conditions but displayed no primary task advantage and no significant performance deficits under divided attention conditions. These data support the utility of theories relating antisocial behavior to individual differences in allocation of attention. Low-So Ss' unresponsiveness to secondary events is not a simple function of the reallocation of resources to the primary task or a speed accuracy trade-off. Moreover, under certain conditions, this deficit may disappear, given substantial practice. PMID- 2754608 TI - Living and learning. Earning a hearing. PMID- 2754607 TI - Putting spiritual care into the curriculum. PMID- 2754609 TI - Stricken by AIDS, upheld by community. PMID- 2754610 TI - Mobilizing an AIDS ministry in your church. PMID- 2754611 TI - HIV-1 isolates are rapidly evolving quasispecies: evidence for viral mixtures and preferred nucleotide substitutions. AB - RNA viruses are renowed for their genetic variability. The human immunodeficiency viruses (HIV) are no exception. A rapid method has been established for the genetic identification and differentiation of viral strains based on the sequencing of many M13 clones of gene-amplified products. Some isolates are internally relatively homogeneous while others are heterogeneous. There was no correlation between virus complexity and disease stage. One isolate was in fact a mixture of two distinct strains. A strong preference for G----A base substitutions was observed. These data indicate that HIV isolates cannot be described in simple molecular terms and should rather be considered as quasispecies. PMID- 2754612 TI - Spongiform encephalopathy in AIDS dementia complex: report of five cases. AB - We describe the morphological findings in the brain of five AIDS patients who died with a clinical diagnosis of dementia. We have found a spongiform change (small rounded vacuoles) in different parts of the brain and a similar but morphologically different sponginess, the status spongiosus, characterized by looser and coarser microcystic cavitations of the grey matter in which the tiny cysts and vacuoles are enmeshed by glial fibrils. At the ultrastructural level, round and oval clear spaces, divided by septae into several smaller ones, appeared in the neuropil. The pathogenesis of the majority of the vacuoles and cavitations is not clear yet but a focal loss of cortical neurons was evident and furthermore some of the vacuoles were identified as remnants of dendrites. The light and electron microscopic findings can not be interpreted as artefacts or as a simple edema of the brain and also can not be explained by the different infective complications. We have found spongiform alterations in all cases of clinically diagnosed dementia and therefore it seems obvious that these findings are quite frequent in AIDS dementia. PMID- 2754613 TI - Seroepidemiological survey of HTLV-I infection among randomized populations of western central African countries. AB - Between 1987 and 1988, a survey to determine the distribution of HTLV-I infection was conducted in a representative population of adults, living in southern Chad, Cameroon, and Equatorial Guinea. Populations studied were selected by the cluster sampling technique. Sera were tested for IgG antibodies to HTLV-I by ELISA. ELISA positive sera were retested by Western blot. The study comprised 2,301 adults, all apparently healthy. Crude prevalence rates range from 0.5 to 11.8%. We found three clearly different areas of HTLV-I seroprevalence rates. An area of low seropositivity in southern Chad and northern Cameroon (0.5-2.0%), an area of moderate seropositivity in the savannah region of Ngaoundere, Cameroon (4.2%) and in Bata, Equatorial Guinea (6.5%), and lastly an area of high seropositivity (8.6 11.8%) in the equatorial forest area of Equatorial Guinea and southern Cameroon. HTLV-I seroprevalence rates increased with age up to 12.6% after 40 years old in the areas of high seropositivity. There was no difference between male and female age-adjusted prevalence rates in all of the areas studied. PMID- 2754614 TI - San people (bushmen) from the central Kalahari desert found free of antibodies to HIV-1 and HIV-2. PMID- 2754615 TI - Why don't intravenous drug users use condoms? PMID- 2754617 TI - [A highly sensitive assay method of oxalic acid in human plasma using high performance liquid chromatography with fluorescent labeling reagent]. AB - An assay method for the plasma level of oxalic acid (OA) was developed by using high-performance liquid chromatography (HPLC). Low molecular weight carboxylic acids including OA were separated from interfering plasma components by passing through ultrafilter (Centriflow CF 25, Amicon) and a Sep-Pak C18 cartridge (Waters), and OA was extracted with tri-n-butyl phosphate. The OA in the organic layer was converted to a fluorescent substance by the esterification with 9 anthryldiazomethane (ADAM). This reaction mixture was injected into a HPLC apparatus with a fluorophotometric detector. In the experiment using standard OA, a linear relationship was obtained in concentrations ranging from 0.2 to 2.0 micrograms/ml. The detection limit of this method was 0.1 micrograms/ml, and the coefficient of variation was 2.0%. The method developed in the present study is considered to be useful as a routine assay method for the human plasma OA level. PMID- 2754616 TI - [The synthesis of 4'-(2-carboxyethyl)phenyl trans-4-aminomethyl cyclohexane carboxylate hydrochloride (cetraxate hydrochloride) by means of enzymatic debenzylation]. AB - Cetraxate hydrochloride (1) (antiulcer agent) has been industrially produced by the chemical protective method of p-hydroxy propionic acid derivatives. Screening of enzymes which quantitatively hydrolyzed cetraxate benzyl ester hydrochloride (2) into 1 was undertaken to establish a novel enzymatic method of production of 1. It was found that the enzyme activity for debenzylation of 2 is contained in cellulase enzymes originated from Aspergillus sp. Lower alkyl groups or phenyl groups of p-hydroxy propionic acid derivatives are likewise selectively hydrolyzed by the cellulase enzyme. This enzymatic synthetic method is very useful for the industrial preparation of 1. PMID- 2754618 TI - [Studies on the constituents of Leucoseptrum stellipillum]. AB - Flavonoids, triterpenoids, and steroids were isolated from the leaves of Leucoseptrum stellipillum (MIQ). Kitamura et Murata and identified as apigenin, luteolin, chrysoeriol, ursolic acid, pomolic acid, tormentic acid, beta sitosterol, and beta-sitosterol glucoside by comparison of their spectral data with those of authentic specimens. Among these compounds, the triterpenoids showed significant antibacterial activities against Streptococcus mutans. PMID- 2754619 TI - [Studies on the anti-hemorrhagic substances in herbs classified as hemostatics in Chinese medicine. X. On hemostatic activities of the parched herbs for hemostatics]. AB - The effect of heat treatment on the anti-hemorrhagic action of seven hemostatic herbs employed especially after parching in order to work effectively as an anti hemorrhagic agent in traditional Chinese medicine, was examined. It was found that the anti-hemorrhagic activities of the following 5 herbs are apparently increased by parching: Kaika (Sophorae immaturus Flos), Renbo.(Nelumnbins Receptaculum), Gusetsu (Nelumnbins Rhizomatis Nodus), Chiyu (Sanguisorbae Radix) and Gaiyou (Artemisiae argyi Folium). PMID- 2754620 TI - [Antimicrobial activity of N-alkylethylenediamines against oral and other microorganisms]. AB - Six N-alkylethylenediamines were synthesized and antimicrobial activity of each compound against oral microorganisms such as Streptococcus mutans, Actinomyces viscosus and Actinomyces naeslundii, and some others were determined in vitro. Dodecyl or tetradecyl derivative possessed maximum bacteriostatic activity among the test compounds. On the other hand, killing time of S. mutans in aqueous solution decreased with increasing alkyl-chain length. PMID- 2754621 TI - [Quantitative analysis of methoxylated flavonoids in iyo (Citrus iyo) peels by high-performance liquid chromatography]. AB - The quantitative analysis of eight kinds of methoxylated flavonoids in Citrus iyo Hort. ex Tanaka (Rutaceae) was examined by high-performance liquid chromatography. These compounds could be determined within 50 min on C-18 reversed-phase column. Elution system was carried out with a mixture of 1,4 dioxane-water-acetic acid in ratios of 2:7:1 and 7:2:1 in the form of a gradient from 8:2 to 2:8 for 60 min. PMID- 2754622 TI - [Synthesis of 1-(difluoro-1,3,5-triazinyl)-2-methylisoindole as a fluorescent derivatization reagent and its reactivity for corticosteroids]. AB - A fluorescence high-performance liquid chromatographic method for the determination of corticosteroids is described. Corticosteroids were labeled quantitatively by treatment with 1-(difluoro-1,3,5-triazinyl)-2-methylisoindole in an alkaline medium at room temperature for 10 s and the fluorescent adducts were eluted isocratically on a reversed-phase column by a mobile phase of aqueous methanol. The detection limit of cortisone was 3 pmol for an injection volume of 10 microliter. PMID- 2754623 TI - Clinical evaluation of a desktop robotic assistant. AB - A desktop vocational assistant robotic workstation was evaluated by 24 high-level quadriplegics from the Palo Alto Veterans Affairs Spinal Cord Injury Center. The system is capable of performing daily living and vocational activities for individuals with high-level quadriplegia via voice control. Subjects were asked to use the robot to perform a repertoire of daily living activities, including preparing a meal and feeding themselves, washing their face, shaving, and brushing teeth. Pre- and post-test questionnaires, interviews, and observer assessments were conducted to determine the quality of the robot performance and the reaction of the disabled users toward this technology. Results of the evaluations were generally positive and demonstrated the usefulness of this technology in assisting high-level quadriplegics to perform daily activities and to gain a modicum of independence and privacy in their lives. PMID- 2754624 TI - Functional outcomes and rehabilitation: an acute care field study. AB - The effectiveness of intervention including occupational therapy in combination with other rehabilitation services was investigated in 193 acute care patients with a variety of diagnostic conditions. The study was conducted in two phases. In both phases, patients who received occupational therapy in conjunction with other services were compared to patients who did not receive occupational therapy. In the first phase, patients (N = 77) were matched according to diagnostic category, age, sex, and severity of impairment. In both phases, outcome measures included length of hospital stay, Barthel Index change scores, and discharge destination. Results revealed statistically significant findings for the measure of discharge destination. Patients who received occupational therapy as part of their rehabilitation program were more likely to be discharged to home environments. This result occurred despite the fact that patients receiving occupational therapy were rated as more severely impaired than patients who did not receive occupational therapy as part of their rehabilitation program. PMID- 2754625 TI - Theoretical prediction of a time-at-pressure curve for avoiding pressure sores. AB - A theoretical development of the pressure versus time curve for the onset of pressure sores is presented which is based upon the use of dimensional analysis. Comparison with available experimental data from humans and from dogs and swine indicate that this approach agrees well with experiment and also shows some promise for predicting the effects of skin elastic modulus and skin blood flow on the allowable pressures which can be safely tolerated by specific individuals. PMID- 2754626 TI - Clinical correlations of auditory P200 topography and left temporo-central deficits in schizophrenia: a preliminary study. AB - A number of studies using nontopographic analyses have reported an amplitude decrement of the auditory P200 component in schizophrenics compared to normal controls. Here we report a topographic analysis of the auditory P200 (204-272 ms; peak to baseline) in chronic medicated schizophrenics (N = 11) and normal controls (N = 18) and the correlation between this measure and clinical symptoms in schizophrenia. Exploratory T-statistic mapping (SPM) and "protected" Hotelling's T-squared contrasts of integrated voltages over the entire scalp showed that schizophrenics' P200 component had diminished amplitude in the left temporo-central region. Furthermore, P200 amplitude in the same scalp region during the experimental condition of counting infrequent tones was highly correlated with negative symptoms in the schizophrenic group. PMID- 2754627 TI - Reliability of self-reported age at onset of major depression. AB - Reliability of self-reported age at onset of major depressive disorder was studied in a sample of 335 subjects who were ascertained from a large epidemiologic survey conducted in several U.S. communities and who were interviewed blindly at two different times. Reliability was generally good for these subjects who met DSM-III criteria for depression at two interviews. A large proportion of the variability in the difference of test-retest values can be accounted for by recency of last episode of depression and interactions of age with duration of illness, having been treated for a mental health problem, and comorbidity of other mental disorders. Interactions between duration and comorbidity and between geographic region and treatment were also significant. Contrary to previous studies which do not consider the interval between current age and age at onset and which suggest that reliability diminishes with age, our findings show that older respondents tend to systematically decrease and not increase age at onset across the two interviews. These findings do not support the hypothesis that recently reported secular changes in major depression, including a decreased age at onset and higher rates in younger as compared to older cohorts, can be explained by a differential reporting effect. Furthermore, the findings suggest that factors which contribute to variability in an individual's age at onset should be incorporated in genetic and clinical studies of major depression. PMID- 2754628 TI - Inpatient violence: trait and state. AB - This study compared patients who showed persistent violence, transient violence and no violence. The presence of neurological abnormalities was found to be the factor that differentiated most clearly among the three groups. The persistently violent patients, in addition to showing significantly more neurological abnormalities, also evidenced a more disturbed family background. Both violent groups had a higher incidence of violent crime prior to hospitalization than the nonviolent controls. A logistic regression model simultaneously relating the effects of six factors on violent behavior was developed and used to predict violent group membership. PMID- 2754629 TI - Screening and selection process for studies of menstrually-related changes. AB - The screening process of women who volunteered to participate in "studies of the menstrual cycle" is described. It is demonstrated that in order to arrive at a desired number of subjects who meet criteria for premenstrual changes and are in a good physical and mental status, one should recruit an extremely large number of candidates to start with. The yield of each screening procedure is presented. It is clear that fulfillment of inclusion and exclusion criteria can be obtained by a phone interview while important criteria can be clarified only by prospective monitoring of symptoms and personal structured interviews. Methods and procedures that can improve yield and decrease effort in recruitment are suggested. PMID- 2754630 TI - Plasma levels of nortriptyline and 10-hydroxynortriptyline and treatment-related electrocardiographic changes in the elderly depressed. AB - Thirty-one elderly depressed patients were treated for seven weeks with nortriptyline with plasma levels kept between 50-180 ng/ml. Electrocardiograms were taken at the third and seventh weeks of treatment. There were significant increases in the PR interval, QTc interval, and heart rate from before and after treatment. However, there were no consistent correlations between electrocardiographic changes during treatment and plasma levels of nortriptyline, 10-hydroxynortriptyline and either of its two isomers (E-10-hydroxynortriptyline, Z-10-hydroxynortriptyline). Increased QRS duration after seven weeks of treatment was correlated with daily dose of nortriptyline. PMID- 2754631 TI - Fantasy play in 5- and 6-year-old children. AB - We studied the verbal pretend play of 5- and 6-year-old boys and girls to delineate age and sex differences during the later preoperational period. Sixteen children with average language ability were paired by age and sex and were videotaped for three 15-min intervals. Verbal interactions were transcribed, and the pretend play was classified as object fantasy, imaginative action plans/themes, or fantasy roles. Language used for pretend play increased in proportion to all utterances with age. Older children referred to more invented objects than younger ones but primarily in the service of realistic action formats. Girls' conversations were scored as having significantly more verbal pretending than boys' and a higher proportion of it referred to play roles. There were both age and sex differences in the types of themes, toys used, and roles enacted, including more sex-typed behavior in older children. The continued increase in the proportion of pretend play to all verbal interaction with age and the characteristics of play behavior is consistent with developmental theory. PMID- 2754632 TI - Delusions and hallucinations as a reflection of the subcultural milieu among psychotic patients of the 1930s and 1980s. AB - Delusions and hallucinations reported in the social histories of 150 patients admitted to an East Texas state hospital during the 1930s and of 150 patients admitted during the 1980s were examined for content that would characterize and contrast the patient subcultural milieu of the two time periods. Patients admitted during the 1930s tended to reflect the material deprivation and personal powerlessness of the great depression in delusions of great wealth and positive "special powers." The hallucinatory visions and voices of the 1980s patients reflected a more threatening and negative subcultural milieu, with more visions of blood, snakes, and dead people or animals. Command hallucinations to hurt, to kill, or to do "perverse things" would also suggest that the subculture milieu of the 1980s had become more dangerous. PMID- 2754633 TI - Arousal as an explanation for differences in rats selectively bred for differential alcohol sensitivity. AB - A common error made by behavior genetics researchers is breeding two lines for differences in central arousal rather than for a specific behavioral feature. Two lines of rats (Riley, Freed, & Lester, 1976) were selectively bred for locomotor impairment in response to a subhypnotic dose (1.5 g/kg) of ethanol. These lines (designated "most affected" and "least affected") were compared in a variety of tests and showed differences in a number of phenotypic traits in addition to locomotor impairment to ethanol. The published findings have been interpreted in light of a hypothesis suggesting adventitiously selected differences in central arousal between the two lines. This interpretation showed that their usefulness as animal models of alcoholism is seriously compromised. PMID- 2754634 TI - Non-involvement of the accessory olfactory system in the LH response of anoestrous ewes to male odour. AB - In anoestrous ewes, male chemosignals elicit rapid increases in luteinizing hormone (LH) secretion that can ultimately lead to ovulation. To assess the possible involvement of the accessory (vomeronasal) olfactory system in the mediation of those chemical cues, we destroyed this pathway by vomeronasal organ electrocauterization (Exp. I) and vomeronasal nerve section (Exp. II). Neither of these lesions inhibited the LH response of ewes to the odour of the male. These results suggest that the vomeronasal system is not necessary to mediate the neuroendocrine response of the ewe to the male odour. As both surgical methods spared the main olfactory system but destroyed the vomeronasal system, it is likely that the main olfactory system is involved in the LH response to chemical stimulation in sexually experienced ewes. PMID- 2754635 TI - Daily and seasonal variations in plasma LH and testosterone concentrations in the adult male hedgehog (Erinaceus europaeus). AB - A double-antibody heterologous radioimmunoassay (RIA) was developed to measure plasma LH values in hedgehogs. This RIA system used anti-rat LH serum and rabbit LH (AFP-559B) for radioiodination and as standard. The accuracy of the method was evaluated and indicated the ability to detect various relative concentrations of LH in plasma. The minimum detectable dose was 0.2 ng/ml. The intra- and inter assay coefficients of variation were 4.2 and 7.9% respectively. Biological tests, e.g. effect of castration, effect of castration + testosterone implant and GnRH administration, confirmed that this method was suitable to determine subsequent changes in pituitary gonadotrophic activity in the hedgehog. LH concentrations were determined in blood samples obtained during 1 year: (a) each month, at 4-h intervals during 24 h, from different groups of unanaesthetized animals fitted with a catheter and (b) twice a month, under a light anaesthesia, from the same group of 6 animals. During the year: (1) the range of LH change was narrow (minimum values congruent to 0.25 ng/ml and maximum values congruent to 2.00 ng/ml); (2) the 24-h LH patterns did not exhibit any daily rhythm; (3) a clear annual rhythm was observed with the highest values from February to April and the lowest values in October and November. LH decreased rapidly at the end of summer and increased progressively from December to February, during hibernation. In these experiments, it was not possible to determine the characteristics of LH release patterns in the hedgehog but individual profiles indicated clearly the episodic secretion of LH, particularly during the highest pituitary activity period. During the year, a close relationship between the seasonal cycles of plasma LH and testosterone was observed. PMID- 2754636 TI - Histological evidence for heterogeneity in the development of preovulatory pig follicles. AB - Ovaries were collected from naturally cycling gilts during the preovulatory period and the stage relative to the LH surge estimated by measurement of oestradiol and progesterone concentrations in follicular fluid. Many of the follicles recovered had become flaccid with an associated increase in follicular fluid viscosity. Marked infolding of both the granulosa and theca tissue in some follicles suggested early luteinization. However, these morphological changes did not necessarily occur simultaneously in the same follicle, or in all follicles within an ovary. Moreover, they were not consistently related to characteristic differences in the concentration of follicular fluid steroids, suggesting either that the morphological and biochemical aspects of the luteinization of follicles may be independently controlled, or may respond at different rates to the same signal. PMID- 2754637 TI - Morphological and biochemical characteristics during ovarian follicular development in the pig. AB - Ovaries were recovered from groups of naturally cyclic pigs (N = 5) on each of Days 16, 18, 20 and 21 of the oestrous cycle. Follicular diameter, follicular fluid volume and concentrations of oestradiol, testosterone and progesterone, and granulosa cell number were determined in all follicles greater than or equal to 2 mm in diameter (n = 511). In alternate follicles either granulosa cell aromatase activity and theca testosterone content or 125I-labelled hCG binding to granulosa and theca were determined. The mean total number of follicles recovered per animal decreased as the follicular phase progressed and a strong positive relationship (P less than 0.001) existed between follicular diameter and volume on all days. The number of granulosa cells recovered per follicle was variable, and not related to oestrogenic activity of the follicles. Mean follicular fluid oestradiol, testosterone and 125I-labelled hCG binding all increased until Day 20 and decreased on Day 21, whereas mean theca testosterone content, 125I-labelled hCG binding to theca tissue and aromatase were all maximal on Day 21. On Days 20 and 21 a subset of 14-16 large follicles was readily distinguishable from the remaining smaller, less oestrogenically active population in each animal. Yet, consistently within these subsets there was a difference in follicular diameter of approximately 2.0 mm and also a considerable range of biochemical development even among follicles of equal size. These results indicate asynchrony at the time of recruitment and selection among follicles destined to ovulate and suggest that heterogeneity continues into the immediate preovulatory period. PMID- 2754638 TI - Concentrations of spermatozoa in the vagina of heifers after deposition of semen in the uterine horns, uterine body or cervix. AB - In Exp. I, virgin Holstein heifers (N = 18) were induced into oestrus with PGF-2 alpha. Animals which stood to be mounted were paired for insemination approximately 8 h later with 56.1 x 10(6) spermatozoa from a single bull. Semen was deposited in the uterine body of one female. Each matched female was inseminated by deposition of one-half of the inseminate into the right uterine horn and one-half into the left uterine horn approximately 7.0 cm anterior to the internal cervical os. In Exp. II, additional heifers (N = 18) were induced into oestrus and inseminated by deposition into the uterine horns or cervix (2.0 cm anterior to the external cervical os). A 1.0 ml aspirate of vaginal mucus was collected at hourly intervals for 8 h after insemination. Concentration of spermatozoa was determined by haemocytometry. In Exp. I, cumulative percentage spermatozoa recovered in an 8 h collection period were similar (P greater than 0.10) for insemination into the uterine horns (17.9 +/- 2.9%) and uterine body (18.5 +/- 4.5%). In Exp. II, cumulative % sperm recovery from the vagina was greater (P less than 0.10) for cervical deposition (59.1 +/- 14.1%) than for that into the uterine horns (30.9 +/- 7.8%). In Exp. II, the insemination treatment x hour of sample interaction was significant (P less than 0.08). Recovery of spermatozoa from the vagina was greatest (P less than 0.05) within 3 h after cervical insemination (31.4 +/- 9.9% compared to 9.4 +/- 2.5% for uterine horn deposition). Percentage recovery of spermatozoa from the remaining hourly collections were similar (P greater than 0.10).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2754639 TI - Circulating progesterone concentrations and ovarian functional anatomy in the African elephant (Loxodonta africana). AB - Mean plasma progesterone concentrations measured in pregnant and non-pregnant elephants did not differ significantly from each other because of considerable variation, particularly for stage of pregnancy. Maximum progesterone values were recorded during pregnancy (5-8 months) and declined towards term (22 months). The numbers of corpora lutea or total luteal tissue volume were not critical in maintaining progesterone secretion. An increase in plasma progesterone concentrations with the luteal phase of the ovarian cycle was evident. A possible role of the placenta in the second half of gestation is indicated by an increase in fetal progesterone concentrations towards term. PMID- 2754640 TI - Oxytocin infusion from day 10 after oestrus extends the luteal phase in non pregnant cattle. AB - Oestrus was synchronized in 8 cyclic heifers by progesterone treatment (PRID), after which the animals were monitored for one control cycle to measure the inter oestrous interval. Osmotic minipumps containing saline (controls, N = 3) or oxytocin (N = 5) were implanted subcutaneously on Day 10 of the second cycle, and removed 12 days later. Jugular venous blood samples were collected daily for measurement of progesterone, and every 2 days for oxytocin. In addition, blood samples were taken every 10 min from 1 h before to 3 h after minipump insertion for measurement of plasma 15-keto-13,14-dihydroprostaglandin-F-2 alpha (PGFM) and every 30 min over the same period for measurement of progesterone and oxytocin. The lengths of the first untreated cycle in both groups of heifers were 20.2 +/- 0.56 (mean +/- s.e.m.) days compared with 25.4 +/- 0.81 days after oxytocin treatment (P less than 0.001). Oxytocin plasma concentrations in treated animals rose from less than 10 pg/ml to 70-500 pg/ml by 2 h after the start of oxytocin infusion and remained elevated until treatment was withdrawn. There was no increase in PGFM concentrations immediately after minipump insertion. Plasma progesterone concentrations were similar in treated and control animals but remained at mid-luteal levels for an average of 5 days longer in treated heifers. It is concluded that continuous administration of oxytocin can extend the luteal life-span in cattle. PMID- 2754641 TI - Effect of castration on epididymal sperm storage in male musk shrews (Suncus murinus) and mice (Mus musculus). AB - Reproductively mature male musk shrews and mice were bilaterally castrated. Epididymal sperm numbers and motility were assessed 0, 2, 4 and 6 weeks after surgery. Seminal vesicle weights and plasma concentrations of total androgens were also measured. In male musk shrews, 30% of the original epididymal sperm numbers were still present 2 weeks after castration and motile spermatozoa were present in 2 of 7 individuals. By 4 and 6 weeks after castration the numbers of spermatozoa remaining declined to about 10% and no sperm motility was noted. Seminal vesicle weights were maintained at about 30% of their original size even up to 6 weeks after castration. In male mice, epididymal sperm numbers, seminal vesicle weights, and androgen levels declined more dramatically after castration. Although androgen concentrations in gonadally intact male musk shrews were approximately 50% of the values in male mice, after castration the concentrations in musk shrews were approximately 2-fold higher than in mice at all times. The results suggest that post-castration retention of epididymal sperm and seminal vesicle weights in the male musk shrew as compared with male mice, is facilitated either by a relatively greater adrenal contribution to circulating androgen levels and/or greater target tissue sensitivity. PMID- 2754642 TI - Calcium channel antagonists modulate the acrosome reaction but not capacitation in mouse spermatozoa. AB - Mouse spermatozoa require micromolar concentrations of calcium for capacitation but millimolar levels to initiate an acrosome reaction. Sperm suspensions were capacitated by incubation for 120 min in modified Tyrode's medium containing 90 microM-CaCl2 and then verapamil (0.5-50 microM) or nifedipine (0.1-100 nM), drugs shown to inhibit voltage-sensitive calcium channels in other cell types, was added before the introduction of 1.80 mM-CaCl2. Verapamil at 5-50 microM and nifedipine at 1-100 nM significantly inhibited the calcium-stimulated acrosome reaction response, relative to the drug-free control samples. The possibility that these compounds might inhibit calcium entry during capacitation was examined by incubating suspensions for 120 min in medium containing 90 microM-CaCl2 plus either 5 microM-verapamil or 1 nM-nifedipine, diluting to reduce drug concentration to one-tenth and then adding 1.80 mM-CaCl2. The considerable acrosome reaction response obtained indicated that spermatozoa had undergone capacitation and were able to respond to calcium, despite the continuous presence of calcium channel antagonist at a concentration able to inhibit the response at the end of capacitation. In-vitro fertilization studies indicated that both drugs significantly decreased ability of the spermatozoa to fertilize eggs, consistent with acrosome reaction data. However, results indicated that 50 microM-verapamil was able to induce initial stages of egg activation and thus prevent sperm-egg fusion in zona-intact eggs. The addition of verapamil or nifedipine to suspensions capacitated for 120 min in 1.80 mM-CaCl2 significantly potentiated the acrosome reaction response, compared with drug-free controls. Similar treatment of suspensions incubated for only 30 min, and hence only partly capacitated, failed to evoke a response. The potentiation of the acrosome reaction response by verapamil in cells capacitated in high calcium may indicate either retention, due to the action of antagonists, of released intracellular calcium stores, resulting in intracellular calcium concentrations above the threshold required to trigger the acrosome reaction or action of an activated guanine nucleotide binding (G) protein to produce an agonistic rather than an antagonistic response. These results suggest that calcium channels similar to those termed voltage-sensitive in other cell types may exist and play an important role in calcium movements at the end of capacitation, but not during earlier phases of capacitation. PMID- 2754643 TI - Evidence that oestrogen exerts an equivalent negative feedback action on LH secretion in male and female ferrets. AB - Gonadally intact male ferrets in breeding condition, which received an aromatase inhibitor, 1,4,6-androstatriene-3,17-dione (ATD) s.c. in Silastic capsules, had significantly more LH pulses and higher mean LH concentrations in plasma than did control males implanted with empty capsules. Aromatase activity in the hypothalamus + preoptic area and temporal lobe was strongly suppressed by ATD treatment whereas circulating concentrations of testosterone and oestradiol were not affected. These results suggest that oestradiol, formed via neural aromatization of circulating testosterone, contributes to the feedback regulation of LH secretion in breeding male ferrets just as oestradiol of ovarian origin controls LH secretion in females. No sex difference was observed in the rate at which mean plasma LH concentrations rose after the removal from gonadectomized ferrets of s.c. Silastic capsules containing oestradiol. Daily s.c. injections of oestradiol in oil caused an equivalent, dose-dependent inhibition of LH pulse frequency and mean LH concentrations in plasma of male and female ferrets. These findings suggest that the negative feedback control of pulsatile LH secretion by oestrogen is not sexually differentiated in this reflexly ovulating species. The ferret appears to differ from spontaneously ovulating mammalian species in which the female is generally more sensitive than the male to the inhibitory feedback action of oestradiol on LH secretion. PMID- 2754644 TI - Effect of pregnancy, injection of oestradiol benzoate or hCG on steroid concentration and release by pig luteal cells. AB - Corpora lutea were obtained from pig ovaries on Day 18 of pregnancy or pseudopregnancy. Pseudopregnancy was induced by the administration of oestradiol benzoate on Days 11-15 of the oestrous cycle or by the administration of hCG on Day 12. The luteal cells were prepared for morphometric analysis and investigation of steroid production in vitro by dispersion with 0.25% trypsin. A blood sample from each sow was collected at slaughter for measurement of progesterone, oestradiol-17 beta and testosterone. The concentrations of these steroids were also estimated in luteal tissue and in the medium after incubation. Progesterone concentration was significantly higher (P less than 0.01) in luteal tissue and in plasma of pregnant than of pseudopregnant sows. Testosterone content of luteal tissue from all sows was 20-fold higher than oestradiol, although plasma concentrations of these hormones were not different. The luteal cells from hCG-treated sows produced more progesterone (P less than 0.01) in vitro than did those from the other groups. The luteal cells from oestradiol treated sows generally released smaller amounts of steroids during incubation. Treatment with hCG increased the proportion of large luteal cells and decreased the proportion of small luteal cells. These results demonstrate that hCG or oestradiol benzoate injections altered the steroidogenic activity of luteal cells and that treatment with hCG was also associated with changes in the diameter of the luteal cells and thus in the ratio of small to large luteal cells. PMID- 2754645 TI - Capacitation status of hamster spermatozoa in the oviduct at various times after mating. AB - Female hamsters were mated shortly after the onset of oestrus or immediately after ovulation. At various times after mating, spermatozoa were flushed from the isthmus of the oviduct using a modified Tyrode's medium supplemented with 20% hamster serum. Cumulus oophorus-free eggs were introduced into the suspensions of isthmic spermatozoa. Some eggs were removed every 30 min and examined for evidence of fertilization. For females mated shortly after the onset of oestrus, spermatozoa recovered from the oviducts 8 h after mating (about 1.5 h after ovulation) could penetrate eggs within 30 min and were considered fully capacitated. When spermatozoa were recovered at earlier times (1, 2, 4 and 6 h after mating) they required additional time (2, 1.5, 1 and 1 h respectively) in vitro before penetrating eggs. Therefore, when mating occurs shortly after the onset of oestrus, spermatozoa in the oviduct do not appear to become fully capacitated until about the time of ovulation. For females mated immediately after ovulation, spermatozoa recovered from the oviducts at 4 h after mating could penetrate eggs within 30 min. Spermatozoa recovered at 1 and 3 h after mating required 2 and 1 h respectively in vitro before penetrating eggs. These results suggest that sperm capacitation proceeds at a faster rate when mating occurs after ovulation. PMID- 2754646 TI - The mechanisms of reversible immobilization of fowl spermatozoa at body temperature. AB - Intact fowl spermatozoa became almost immotile at 40 degrees C, but motility increased significantly at 30 degrees C. The oxygen consumption at both temperatures was 8-11 microliters O2/10(10) spermatozoa.min-1. The ATP concentration at 40 degrees C was higher than that at 30 degrees C but ADP concentration at 30 degrees C was higher than that at 40 degrees C. Consequently, the ATP/ADP ratio at 30 degrees C (1.9-2.2) increased to 3.5-3.7 at 40 degrees C. The motility of intact spermatozoa at 40 degrees C was effectively restored by 2 mM-Ca2+, 10% seminal plasma and 10% peritoneal fluid taken at the time of ovulation. In contrast, these effectors did not restore the motility of demembranated spermatozoa at 40 degrees C. Motility of demembranated spermatozoa was restored at 30 degrees C. These results suggest that the immobilization of fowl spermatozoa at 40 degrees C occurs due to a decrease in flagellar dynein ATPase activity. Furthermore, the action of effectors for motility such as Ca2+ may not be directly on the axoneme, but mediated by solubilized substances which have been removed by demembranation of the spermatozoa. PMID- 2754647 TI - Morphological demonstration of the failure of Mus caroli trophoblast in the Mus musculus uterus. AB - A histological study of Mus caroli embryos gestating in the Mus musculus uterus was undertaken at Day 8.5 of gestation, 1 day after such embryos are reported to be normal and 1 day before the earliest events associated with death of the xenogeneic embryos. In comparison to control M. caroli embryos recovered from M. caroli and to control M. musculus embryos recovered from M. musculus, the xenogeneically transferred embryos showed intrauterine growth retardation that was associated with trophoblastic insufficiency. Trophoblast cell degeneration was observed, in the absence of lymphocytic infiltration. Therefore, loss of trophoblast cell function rather than lymphocyte-mediated destruction of trophoblast appears to underlie the death of M. caroli embryos in the M. musculus uterus. PMID- 2754648 TI - Translational capacity of sheep oocytes microinjected with messenger RNA. AB - Sheep oocytes were microinjected with tobacco mosaic virus RNA (TMV-RNA) and isotopically labelled with L-[35S]methionine. Total incorporation of labelled methionine was similar in TMV-RNA-injected and in carrier-injected control oocytes, whether injections were performed during the period of high protein synthesis at maturation or during the period of reduced synthesis at a time equivalent to the mid-cleavage transition (48 h after germinal vesicle breakdown). Varying the amount of TMV-RNA injected from 2.5 to 10 pg had little effect on the overall level of amino acid incorporation. Furthermore TMV-RNA appeared to be very stable in oocytes and eggs; the proportion of total polypeptide synthesis directed by TMV-RNA did not diminish during the first 48 h after injection. Synthesis of most endogenous proteins was uniformly reduced to compensate for the synthesis of TMV-polypeptides. Our results suggest, therefore, that the translational capacity of sheep oocytes is fully saturated during maturation. PMID- 2754649 TI - Relationship between heparin binding characteristics and ability of human spermatozoa to penetrate hamster ova. AB - Heparin binding site affinity and density on human spermatozoa were compared between fertile and infertile men with normal or abnormal results in the zona free hamster ova-sperm penetration assay (SPA). A portion of fresh semen from fertile donors and potentially infertile men was processed through the SPA while the remainder of the ejaculate was used to quantitate heparin binding on spermatozoa. Saturation binding assays with [3H]heparin (15-375 nM) were analysed for 3 groups of men: (1) infertile patients with abnormal SPA results, (2) infertile patients with normal SPA results and (3) fertile donors. The heparin binding site density was significantly higher in men who possessed normal SPA results (infertile men and fertile donors) than in infertile men with abnormal scores in the SPA. There was no difference in heparin binding affinity between the three groups. These findings suggest that the heparin binding-site density may be related to the ability of human spermatozoa to undergo successfully the acrosome reaction. PMID- 2754650 TI - Ovarian response to hCG treatment during the oestrous cycle in heifers. AB - The aims of this study were to investigate whether treatment with a single ovulatory dose of hCG, between the day of oestrus and the end of the luteal phase, could induce extra ovulations in heifers and whether the presence of an existing corpus luteum (CL) affected the response. Heifers (N = 32) were injected with 1500 i.u. hCG or saline on a given day of the oestrous cycle. Treatments were repeated during subsequent cycles to provide a total of 71 observations, 57 of which followed an injection of hCG, given between Day 0 (oestrus) and Day 16, and 14 of which followed saline injections as controls. Ovulatory responses were noted by laparoscopy 2 days after hCG treatment. No heifers injected with saline produced additional CL. Of the hCG-treated cycles, 23 resulted in the formation of an additional CL, and this was significantly affected by the stage of the oestrous cycle when hCG was given; a greater response was observed during the early (Days 4-7) and late (Days 14-16) stages of the luteal phase than at the mid luteal phase of the oestrous cycle. Two heifers were also treated with hCG on Days 17 or 18 of the oestrous cycle, but before oestrus; both had induced CL. There were no significant differences between the left-right orientation of the existing CL or the hCG-induced CL. These results demonstrate that the large, luteal-phase follicle of the cow is capable of ovulating in response to hCG and that the induced CL is not affected by the presence of an existing CL. PMID- 2754651 TI - Effect of pentobarbitone sodium and bromocriptine on follicular oestradiol production in the rat. AB - Injection of an ovulation-blocking dose of pentobarbitone sodium given in the early afternoon of pro-oestrus in rats decreased follicular oestradiol production in vitro the next day (2.42 +/- 0.11 ng/4 h/follicle in pro-oestrous rats, 0.49 +/- 0.04 ng/4 h/follicle in pentobarbitone-treated rats). Pentobarbitone, given 1 day earlier (at dioestrus II), prevented the increase in oestradiol production that normally occurs between di-oestrus II and pro-oestrus. Injection of a subovulatory amount of hCG (0.5 i.u.) given after pentobarbitone injection inhibited the decrease in follicular oestradiol production induced by pentobarbitone. The pentobarbitone-induced decrease in oestradiol production was also prevented by bromocriptine (1 mg) given at di-oestrus II (15:00 h) and pro oestrus (09:00 h). Bromocriptine is an effective inhibitor of prolactin secretion and this suggests therefore that the decrease in follicular oestradiol production after pentobarbitone is due to the preovulatory surge of prolactin. However, pretreatment with bromocriptine also inhibited the effect of pentobarbitone on oestradiol production when pentobarbitone was given at di-oestrus II. Moreover, when ergocornine (another inhibitor of prolactin secretion) was used instead of pentobarbitone to block ovulation, follicular oestradiol production was also decreased the next day. In contrast to bromocriptine, ergocornine was not able to prevent the pentobarbitone-induced decrease in follicular oestradiol production. These results indicate that the decrease in follicular oestradiol production after pentobarbitone injection is due to inhibition of the serum concentrations of LH rather than the preovulatory surge of prolactin. How bromocriptine (but not ergocornine) prevents the pentobarbitone-induced decrease in oestradiol production is not clear. PMID- 2754652 TI - Crystallization patterns in anterior vaginal fluid from bitches in oestrus. AB - Bitches exhibited a characteristic arborization pattern of the fluid from the anterior vagina during pro-oestrus and oestrus. These changes were monitored together with conventional vaginal cytology and plasma oestrogen and progestagen concentrations. A classical ferning pattern, similar to that seen in bovine cervical mucus at oestrus, occurred after the peak in plasma oestrogen concentrations. Ferning was most intense after the second peak of cornification of vaginal epithelial cells. It is suggested that a 'Ferning Index', when combined with conventional vaginal cytology, can be of use in determining the optimum mating time in the bitch. PMID- 2754653 TI - Effect of food restriction on reproduction and lactation in house mice mated post partum. AB - Primiparous, post-partum mated BALB/c bom inbred mice were allowed to raise litters of 6 young until Day 22 of lactation: 11 of 25 females were restricted to 60% of food consumption of ad-libitum fed dams after stud male removal at Day 2 of lactation. Since weight gain of restricted females during lactation was not inhibited and infanticidal behaviour was not enhanced, food deprivation can be considered to have been relatively mild. However, none of the food-restricted dams gave birth to a second litter whereas 12 of the 14 ad-libitum fed mice littered. This pregnancy failure is suggested to be due to implantation failure or abortion shortly after implantation, which is attributed to maternal manipulation rather than to immediate consequences of energetic demands of lactated young. The dynamics of the weight changes of dams and young suggest that milk production in suckling house mice drops most markedly between Days 17 and 18 of lactation, irrespective of whether the dams are non-pregnant, pregnant, or food-restricted. PMID- 2754654 TI - Social environment and reproduction in female pouched mice, Saccostomus campestris. AB - Pouched mice were kept under controlled conditions of illumination (10D:14L) and temperature (22 +/- 2 degrees C). Age at vaginal opening, first oestrus and first conception did not differ significantly between juvenile females raised singly, in single-sex groups of 5, or with an adult male. After the introduction of a male, sterile cycles and/or matings before first conception were experienced by all females whether they were raised singly or in single-sex groups. Of 10 females raised with a male, 4 conceived at their first mating. Onset of puberty in juvenile females raised with an adult female was delayed, while in juvenile females raised with their families (mother, father and litter mates) only vaginal opening was delayed. However, when raised in family groups without the father, vaginal opening as well as first oestrus were delayed. Grouping of females after weaning, with or without a male, did not change the oestrous cycle pattern. Females in these groups cycled independently of each other and the females grouped with a male also mated and conceived independently of each other. Pregnancy was blocked in 7 of 8 females when the stud male was removed and a strange male was introduced. In females exposed to a succession of males, pregnancy was blocked up to 4 times. PMID- 2754655 TI - Changes in electrical activity of myometrium during intrauterine distribution of rat blastocysts and after prazosin administration. AB - In the early pregnant rat, electrical activity of the myometrium consisted of regular bursts of spike potential, which appeared well propagated on Day 2 of pregnancy. During Day 3, there was a gradual disappearance of propagated activity. Concomitantly, there was a 7-fold increase (P less than 0.001) of uterine progesterone concentrations. At this stage, mean duration of bursts was 15.2 +/- 0.9 sec and intervals of complete quiescence between bursts were 84.2 +/ 7.0 sec. At 10:00 h on Day 4, there were peaks in the uterine concentrations of oestradiol and progesterone, +36% and +654%, respectively, compared with values on Day 2 (P less than 0.05). Between 10:00 and 20:00 h on Day 4, EMG activity exhibited a rapid and transient rise: bursts were of longer duration at the utero tubal end of the horn (+60%, P less than 0.05) with an increased amplitude of spike potentials (+67% and +90% respectively at the tubal and cervical ends of the uterus, P less than 0.05). The administration of prazosin depressed EMG activity reversibly in a dose-dependent manner with maximal inhibition at about 2 3 h later. It is concluded that the changes observed during EMG recordings are relevant to the intrauterine distribution of blastocysts and related to changes in the steroidal environment and/or to catecholamine effects via alpha 1 adrenoceptors. PMID- 2754656 TI - Extended exposure to follicular fluid is required for significant stimulation of the acrosome reaction in human spermatozoa. AB - The effect of human follicular fluid (FF) on the incidence of spontaneous acrosome reactions (AR) in human spermatozoa was examined over a 24-25 h period using electron microscopy. Suspensions of motile spermatozoa were prepared by a swim-up method in Earle's medium, known to support in-vitro fertilization. After adjusting the concentration to 10 x 10(6) cells/ml, suspensions were diluted 1:1 with medium (control) or FF, the latter giving a final concentration of 50% FF. In addition, at 5 h and 24 h an aliquant of the control suspension was removed, diluted 1:1 with FF and incubated for 1 h; the three suspensions were examined at 6 h and 25 h. Continuous exposure to 50% FF stimulated the AR, the effect being significant (P less than 0.001) at 25 h. However, the 1-h short exposure of spermatozoa to FF did not produce an increase in AR, even after 24 h preincubation. In a separate series of experiments, the effect of continuous incubation for 24 h in increasing concentrations of FF was investigated. A significant linear dose-dependent effect on the AR was observed with all concentrations assessed (P less than 0.01 for 12.5% FF and P less than 0.001 for 25, 50, 75 and 100% FF, compared with FF-free control). Therefore, human FF can stimulate the AR, but only after a continuous exposure to FF. A short exposure to FF, even after 24 h preincubation, does not trigger an increased AR response. PMID- 2754657 TI - Ontogeny and implication of pregnancy-associated agglutinin of the rat uterus. AB - The mannose/fructose-binding agglutinin from Day 1-7 post coitum (p.c.) rat uteri was purified on Concanavalin A. The specific haemagglutination activity peaked on Days 4 and 5 p.c. and a 1.4-fold increase in the yield was accompanied by a 10-12 fold increase in specific agglutination titre. The mannose-binding affinity of the protein also increased, but the highest fructose-binding affinity was found on Day 1 p.c., which may indicate a role of the protein in fructose concentration for utilization by the spermatozoa. Rats that were pseudopregnant, superovulated and pseudopregnant, and had one uterine horn ligated showed that, although a basal level of the protein was induced by the hormonal milieu, actual stimulation of the protein synthesis occurred in the presence of the fertilized ova. PMID- 2754658 TI - Multiple forms of alkaline phosphatase in mouse preimplantation embryos. AB - Mouse embryos were extracted with 0.5% Triton X-100 and subjected to cellulose acetate electrophoresis. In fertilized eggs, two forms of alkaline phosphatase (ALP), a slow-moving form and a fast-moving form, were observed. As cleavage proceeded, the fast-moving form disappeared, and the slow-moving form, the mobility of which was similar to that of the slow-moving form of the kidney, became gradually dominant up to the blastocyst stage (named 'embryonic' form). With blastulation, another fast-moving form showing a similar mobility to the lung ALP began to appear in blastocysts and showed a transient dominance in hatched blastocysts. After implantation, both the embryonic form and the fast moving form gradually faded, and were eventually replaced by the new form, which may be named 'fetal form' in Day 7 embryos. These results clearly demonstrated that ALP activity does exist in embryos at all stages of preimplantation development. Moreover, the changes in multiple forms of ALP correlated with embryonic development may suggest that these multiple forms may have differential roles in the process of early development. PMID- 2754660 TI - Remodeling the pyramid--a concept whose time has come. AB - It is clear that the traditional treatment program, as illustrated by the pyramid, does not suppress inflammation in most patients with RA to an extent sufficient to prevent joint damage. There is no basis for the concept that slow acting drugs are uniquely disease modifying. Disease modification correlates best with control of inflammation. Contrary to popular wisdom, this has been best demonstrated with prednisone. The arbitrary concept of a drug being either antiinflammatory or disease modifying serves no useful purpose and should be dropped. Many medications provide incomplete or temporary suppression of inflammation, presumably by differing mechanisms of action. Based on this rationale, a therapeutic program is proposed, employing a combination of drugs to control inflammation in the critical early stages of RA. With this step-down bridge concept, medications are sequentially withdrawn in contrast to the traditional pyramid, in which they have been sequentially added. Our early experience with patients indicates that toxicity is no greater problem with combined drugs than with the same drugs used individually. Time and comparative observations will be needed to show the optimum combination of drugs and whether the step-down bridge concept will achieve the sought-for and presently unobtained goal of early and sustained control of inflammation, improved quality of life, and prevention of bone and joint damage. PMID- 2754659 TI - Is protein synthesis necessary for prostaglandin production by guinea-pig endometrium? AB - The outputs of prostaglandin (PG) F-2 alpha, PGE-2 and 6-keto-PGF-1 alpha from Day-7 and Day-15 guinea-pig endometrium in culture were reduced by the inclusion of actinomycin D, cycloheximide and puromycin in the culture medium, with the output of PGF-2 alpha from Day-15 endometrium being particularly affected during the first 6 h of culture. The intrauterine administration of actinomycin D on Day 10 decreased the outputs of PGF-2 alpha and PGE-2, but not of 6-keto-PGF-1 alpha, from Day-15 endometrium in culture without affecting PG output from Day-15 myometrium in culture. Actinomycin D, cycloheximide and puromycin did not reduce PG output when superfused over the Day-7 and Day-15 guinea-pig uterus in vitro for 20 min, indicating that these compounds do not have a rapid inhibitory effect on endometrial PG synthesis. In fact, they tended to stimulate PG output during this 20-min period, with cycloheximide having a pronounced effect on PGE-2 output. The synthesis of secreted proteins, but not of cellular proteins, was greater by Day-15 than by Day-7 endometrium in culture. Actinomycin D, cycloheximide and puromycin inhibited the synthesis of secreted and cellular proteins by Day-7 and Day-15 endometrium in culture. Protein synthesis and PG synthesis in the endometrium were both inhibited to a greater extent by cycloheximide and puromycin than by actinomycin D. The intrauterine administration of actinomycin D on Day 10 reduced the syntheses of secreted and cellular proteins by Day-15 endometrium in culture. These findings indicate that the endometrial synthesis of PGs, particularly of PGF-2 alpha towards the end of the oestrous cycle, is dependent upon endometrial protein synthesis. PMID- 2754661 TI - Atheroma, arthritis and all that. PMID- 2754662 TI - Elevated activity of myeloid growth factor in bone marrow adjacent to joints affected by rheumatoid arthritis. AB - Myeloid growth activity of rheumatoid arthritis (RA) and normal serum was measured with a newly developed simple method. Abnormally high titers of this activity were found in the bone marrow blood serum adjacent to joints with RA where abnormal myelopoiesis had been found. Maximal activity for myeloid growth was found at a molecular weight of 70 kDa in gel filtration of serum, different from the size of any known factors involved with myelopoiesis. PMID- 2754663 TI - Evidence of significant radiographic damage in rheumatoid arthritis within the first 2 years of disease. AB - Quantitative radiographic scores for joint space narrowing erosion, and malalignment in the hands and wrists of 200 patients with rheumatoid arthritis (RA) were significantly correlated with duration of disease. Nonetheless, most of the 42 patients who reported disease for less than 2 years had evidence of radiographic damage, including 35 with joint space narrowing, 28 with erosions but only one with malalignment. Significant radiographic damage in the absence of malalignment may be seen in many patients within the first 2 years after presentation of RA. PMID- 2754664 TI - The presence of Campylobacter pylori in nonsteroidal antiinflammatory drug associated gastritis. AB - Although Campylobacter pylori has recently been causally linked to active chronic gastritis and peptic ulcer disease, its relationship to nonsteroidal antiinflammatory drug (NSAID) associated gastritis is unclear. We performed a case-control study of 100 patients who had undergone gastritis biopsy. Blinded review of Giemsa stained slides demonstrated the presence of C. pylori in 32% of 19 NSAID treated cases with active chronic gastritis vs 3% of 36 controls with chronic gastritis not taking NSAID, and 69% of 45 "positive" controls with active chronic gastritis not taking NSAID (p less than 0.001). Our results suggest a possible multifactorial etiology of NSAID associated gastritis. PMID- 2754665 TI - Fall in antiphospholipid antibody at time of thromboocclusive episodes in systemic lupus erythematosus. AB - A relationship between antiphospholipid antibodies (APLA) and thromboses has been proposed in patients with systemic lupus erythematosus (SLE). In most instances, however, the thromboocclusive episodes were historic and did not coincide with the study of APLA. We studied 6 patients with SLE who, having had sequential determinations with high levels of APLA, were found to have falls in them coincident with thromboocclusive episode(s) and not attributable to treatment. Because our patients had recurrent thrombotic episodes, higher previous and subsequent titers of APLA, and other manifestations that have been similarly proposed to associate with APLA, our observations may indicate consumption of the APLA in the course of the thromboocclusive episode. PMID- 2754666 TI - Rheumatoid factor in patients with systemic lupus erythematosus. AB - One hundred sixty-six patients with systemic lupus erythematosus (SLE) were surveyed and their sera tested for the presence of rheumatoid factor (RF). Fifteen were positive whenever tested, with titers of at least 1:40; the remainder were either positive only in titers of 1:20, were inconsistently positive or were persistently negative. The former group were less likely to have severe manifestations of SLE, less likely to have required treatment with "high dose" steroids or a cytotoxic drug, and less likely to have had an episode of herpes zoster. We conclude that in patients with SLE, RF may be a reflection of relative immune competence so that they are partially protected against the more serious manifestations of SLE and the development of herpes zoster. PMID- 2754667 TI - Osteoarthritis in the hand: a comparison of handedness and hand use. AB - Osteoarthritis (OA) of the hand has been suggested to be the result of "wear" and "tear." If so, OA should develop more frequently in the dominant hand. We compared dominant with nondominant hands of 134 consecutive community subjects aged 53-75 by questionnaire, radiographs of hands, and rheumatologic evaluation. Mean age was 60 years, 93% were right handed, and 95% were in occupations classified as nonphysical. Subjects estimated dominant hand use of 2-10 times the amount of the nondominant hand. OA was found in 133 of 134 subjects. No radiologic or clinical differences were found between the dominant and nondominant hands. Twenty-six subjects who self-reported heavier lifetime hand use had somewhat greater clinical and hand radiographic OA scores than the 36 subjects reporting lighter hand use (43.5 vs 34.5) (p less than 0.01). In our study population, OA was not more prevalent in the dominant hand. PMID- 2754668 TI - Musculoskeletal manifestations in patients with hypercholesterolemia. AB - Musculoskeletal symptoms were assessed in 33 patients with familial and 36 patients with nonfamilial type IIa hypercholesterolemia and compared to 33 healthy controls. Significant joint pain was reported by 47.8% of the patients with hypercholesterolemia vs 25.8% of the control group. Pain in the hyperlipidemic patients was significantly more prevalent in ankles and feet compared to the control group. The pain was not due to local effects of xanthoma, and was not accompanied by symptoms of inflammation or systemic rheumatic symptoms such as morning stiffness. PMID- 2754669 TI - In vitro effects of tiaprofenic acid, sodium salicylate and hydrocortisone on the proteoglycan metabolism of human osteoarthritic cartilage. AB - We examined the in vitro effects of therapeutic doses of tiaprofenic acid (26 micrograms/ml; 2.6 micrograms/ml), sodium salicylate (160 micrograms/ml), and hydrocortisone (7.25 micrograms/ml; 0.725 micrograms/ml) on the proteoglycan metabolism (catabolism and synthesis) and chondrocyte ultrastructure of organ explant cultures of human osteoarthritic (OA) articular cartilage. The effect of these drugs on chondrocyte neutral metalloprotease synthesis was also examined. Tiaprofenic acid and the higher concentration of hydrocortisone had a similar suppressive effect on proteoglycan catabolism (38%). The effect of the lower concentration of hydrocortisone was less marked (29%), while sodium salicylate had the least effect (21%). The proteoglycan released in each treated group was significantly lower (p less than 0.05) than that of the untreated one. The suppression of proteoglycan catabolism by tiaprofenic acid was reversible in all but one specimen. This reversal was only seen in 4 of the 8 patient specimens treated with sodium salicylate and in 2 of the 8 patient specimens treated with the higher dose of hydrocortisone. The decrease in proteoglycan catabolism induced by these drugs correlated with their potential to reduce synthesis of neutral metalloprotease. The proteoglycan synthesis in cartilage organ explant cultures was reduced by sodium salicylate and hydrocortisone, but not by tiaprofenic acid. These findings were corroborated through an electron microscopic study, showing extensive vesicular dilatation of chondrocytic endoplasmic reticulum seen only in explants treated with hydrocortisone or sodium salicylate. Our data suggests that some nonsteroidal antiinflammatory drugs (NSAID) are able to decrease OA cartilage catabolism. However, caution should be taken since certain NSAID, like salicylate, may also possibly jeopardize the cartilage repair process by inhibiting the proteoglycan synthesis. PMID- 2754670 TI - Biomechanical characteristics of iliac crest bone in elderly women according to osteoarthritis grade at the hand joints. AB - Postmortem iliac crest trabecular bone specimens were tested in compression to determine their mechanical characteristics. Trabecular bone volume and width were evaluated by histomorphometry and radiographic grading of osteoarthritis (OA) of hand joints was also done. Patients were divided into 2 groups: no or low grade OA (Group 1) and manifest OA Grades II-IV (Group 2). From the 27 specimens tested (women 56-80 years old), 17 were in Group 1 and 10 in Group 2. Significant differences in stiffness (E), compressive strength, trabecular bone volume and trabecular width between the 2 groups were found. In the group with manifest OA, bone was significantly stiffer, had a significantly increased compressive strength value, a significantly higher trabecular bone volume and trabecular width, compared to the group with no or low OA grade. Significant correlations were found between elastic modulus and trabecular bone volume and width, and also between compressive strength and trabecular bone volume and width. Our findings support the hypothesis that the primary defect in OA is not in the articular cartilage but in the subchondral bone and that primary OA is part of a more general bone disease. PMID- 2754671 TI - Multiple stress fractures in the hindfoot in rheumatoid arthritis. AB - A case of nontraumatic bilateral multiple stress fractures of the hindfoot in a 60-year-old white man with rheumatoid arthritis (RA) is described. Review of the literature indicates that stress fractures of the calcaneus and other bones of the hindfoot are an unusual complication of RA and have not been reported previously. Factors leading to the development of stress fractures in the patient with RA are discussed. PMID- 2754672 TI - Arthralgias as a presenting manifestation of primary biliary cirrhosis. AB - Two patients presenting with arthralgias had associated minor elevations in liver enzymes. Each patient's serum had a cytoplasmic pattern of fluorescence on HEp-2 cells which led to the detection of antimitochondrial antibodies. Liver biopsy in both patients revealed primary biliary cirrhosis. Awareness of this limited, articular presentation of primary biliary cirrhosis may result in early treatment and the potential to arrest liver damage in some patients. PMID- 2754673 TI - Internuclear ophthalmoplegia in giant cell arteritis. AB - Ophthalmoplegia from ischemia to peripheral ocular motor nerves or muscles may complicate the course of giant cell arteritis (GCA). Although brainstem ischemia is known to occur in GCA, internuclear ophthalmoplegia has not been described. Two cases of biopsy-proven GCA are described in which internuclear ophthalmoplegia resulted from brainstem ischemia. Embolization from thrombosed extradural segments of inflammed vertebral arteries, or arteritis of brainstem perforating vessels may account for brainstem infarction. Rapid tapering of steroids was temporally related to brainstem infarction in both cases. PMID- 2754674 TI - Hypercholesterolemic (type II hyperlipoproteinemic) arthritis. AB - The rheumatic manifestations of familial hypercholesterolemia include recurrent Achilles pain or tendinitis, acute mono/oligoarthritis and migratory (rheumatic fever-like) polyarthritis. Diagnosis is made by finding skin and tendon xanthomas, hypercholesterolemia, and ruling out other rheumatic conditions such as rheumatic fever, gout, pseudogout and septic arthritis. A patient, homozygous for familial hypercholesterolemia, with a rheumatic fever-like migratory arthritis is presented. PMID- 2754675 TI - Cytokines in synovial fluid in rheumatoid arthritis. PMID- 2754677 TI - No fault compensation. PMID- 2754676 TI - Resolution of Felty's syndrome with cyclophosphamide. PMID- 2754679 TI - Specialist training and accident & emergency. PMID- 2754678 TI - Certification and re-certification--a time and a place for action. PMID- 2754680 TI - Cancer patients: their desire for information and participation in treatment decisions. AB - The relationship between cancer patients' desire for information and their preference for participation in decision making has been examined. Approximately 77% of the 52 patients reported that they had participated in decision making to the extent that they wished, while most of the remaining 23% would have preferred an opportunity to have greater input. Although many of the patients actively sought information, a majority preferred the physician to assume the role of the primary decision maker. Ethically, the disclosure of information has been assumed to be necessary for autonomous decision making. Nevertheless, the results of this study indicate that patients may actively seek information to satisfy an as yet unidentified aspect of psychological autonomy that does not necessarily include participation in decision making. PMID- 2754681 TI - Safety and efficacy of nifedipine 20 mg tablets in hypertension using electronic data collection in general practice. AB - Electronic data collection was used in this open study to survey the safety and efficacy of nifedipine when used in the treatment of 3972 patients with mild to moderate essential hypertension. The safety and efficacy results are presented and discussed as well as the advantages, disadvantages and reliability of electronic data collection. The validity of data collected electronically has not previously been tested, such data having been assumed to be reliable. The pattern of adverse events reported in this study is compared with the pattern of reports to the Committee on Safety of Medicine (CSM), to Bayer UK and in a large paper based study of nifedipine, in order to test these assumptions. Reported adverse medical events pre-treatment, prior to entry to the study and noted at visit 1, were compared with reports during treatment in the study at visits 2 and 3. The expected incidence of flushing and headache was seen which diminished with continued treatment. Reductions were seen in dyspnoea and impotence. Ankle oedema was observed and was not reduced by time alone. After one month of treatment with nifedipine 20 mg tablets twice daily, 66.5% of patients had a sitting phase V diastolic blood pressure of 90 mmHg or below and 79% of 95 mmHg or below. PMID- 2754682 TI - Assaults in south east London. AB - A survey was performed of 425 consecutive patients attending Lewisham Hospital as a result of deliberate physical violence. Eighty-two per cent attended 'out of hours', and in at least 50% alcohol was a contributing factor. Less than half the incidents were reported to the police. Fifteen per cent of the attacks were due to knives and accounted for 47% of the admissions and 90% of the serious injuries. The results support the view that it is becoming common for youths to be armed. Assault victims, particularly those with knife wounds place a considerable burden on hospital resources. Accident and Emergency departments are ideal places to monitor the epidemiology of assaults. PMID- 2754683 TI - Microcomputer networking in the hospital environment: powerful computing for the common man? Discussion paper. PMID- 2754684 TI - Medical student selection--time for change: discussion paper. PMID- 2754685 TI - Interactive television teaching: a student's point of view. PMID- 2754686 TI - Water induced epilepsy. PMID- 2754687 TI - 'Disappearing foot disease': an unusual presentation of primary lymphoma of bone. PMID- 2754688 TI - Crohn's ileocolitis presenting as chronic diffuse hair loss. PMID- 2754689 TI - Acute proptosis and blindness in a patient with orbital phycomycosis. PMID- 2754690 TI - S-(2-oxopentadecyl)-CoA, a nonhydrolyzable analogue of myristoyl-CoA, is a potent inhibitor of myristoyl-CoA:protein N-myristoyltransferase. PMID- 2754691 TI - C2,N6-disubstituted adenosines: synthesis and structure-activity relationships. AB - Extracellular adenosine receptors have been divided into two major subtypes, called A1 and A2. Substitution of the adenosine molecule with appropriate groups at C2 or N6 is known to impart selectivity for the A2 receptor over the A1 receptor. In the present study, we investigated whether substitution at both C2 and N6 would have additive effects on the A2/A1 affinity ratio, thereby providing compounds with greater A2 selectivity than presently available agents. Disappointingly, additivity appeared to hold only when an A1-selective group was present at N6. For instance, 2-(phenylamino) substitution of the A1-selective agonist N6-cyclopentyladenosine resulted in a 70-fold shift in selectivity in favor of the A2 receptor, but the same substitution applied to the A2-selective agonist N6-[2-(3,5-dimethoxyphenyl)-2-(2-methylphenyl)ethyl]adenosine resulted in a 100-fold loss of affinity with no change in A2 selectivity. PMID- 2754692 TI - Cholecystokinin antagonists. Synthesis and biological evaluation of 3-substituted benzolactams. AB - A series of 1,3-substituted benzolactams are reported that are potent nonpeptidal antagonists of the peptide hormone cholecystokinin (CCK). Design considerations were based upon the natural product CCK antagonist asperlicin and the potent benzodiazepine antagonist series exemplified by L-364,718 (1). Compound 19, the most potent compound in the benzolactam series, had an IC50 = 3 nM for inhibition of binding of 125I-CCK-8 to CCK receptors in rat pancreatic tissue, and its racemic analogue 8 was found to be orally active in inhibiting CCK-induced gastric emptying in mice, with an ED50 = 2.6 mg/kg po. The effects of ring size, substitution at positions 1 and 3, and stereochemistry at position 3 are discussed. Conformational studies of compound 19 and L-364,718 have delineated similarities that these molecules share in their core conformations and substituent orientations. PMID- 2754693 TI - Antiulcer agents. 4. Conformational considerations and the antiulcer activity of substituted imidazo[1,2-a]pyridines and related analogues. AB - Definition of the interrelationship between the conformational characteristics of a series of substituted imidazo[1,2-a]pyridines and their antiulcer activity was investigated by examining the conformational properties of 3-cyano-2-methyl-8 (phenylmethoxy)imidazo[1,2-a]pyridine (1), using a variety of experimental and theoretical methods. The results of these studies was the identification of two distinctly different candidates, designated the "folded" and the "extended" conformation, respectively, to represent the two possible minimum-energy conformations of 1. In order to select the biologically relevant conformer, a group of 3-substituted 2-methylimidazo[1,2-a]pyridines, having either a cis or a trans 2-phenylethenyl substituent at the 8-position were designed as conceptually simple and synthetically accessible semirigid analogues of the respective candidate conformers. Gastric antisecretory activity was found to reside only in the trans isomers (compounds 11, 15, and 17), which mimic the "extended" conformation. This observation led to the construction of 8,9-dihydro-2-methyl-9 phenyl-7H-imidazo[1,2-a]pyrano[2,3-c]pyridi ne-3- acetonitrile (40), a rigid tricyclic analogue that is effectively locked in the "extended" conformation and that exhibited an antiulcer profile comparable to that of prototype 1. These results unequivocally demonstrate that, in accord with expectation for a drug operating at a specific receptor, the conformational characteristics of the molecule have a substantial effect in determining its antiulcer activity. More precisely, it has been demonstrated that it is the "extended" conformation of 1 that represents the "bioactive" form of the drug. These results constitute the basis for a molecular probe that should aid in the investigation of the as yet uncharacterized gastric proton pump enzyme (H+/K+-ATPase), by means of which 1 and its analogues presumably exert their pharmacologic actions. PMID- 2754694 TI - Structure-activity relationship of antiestrogens: a study using triarylbutenone, benzofuran, and triarylfuran analogues as models for triarylethylenes and triarylpropenones. AB - In a study of the structure-activity relationship (SAR) of antiestrogens use has been made of certain 1,2,3-triarylbutenones, of 2-arylbenzofurans carrying aryl or aroyl substituents at C3, and of 2,3,4-triarylfurans as conformationally constrained models for triarylethylene (TAE) and triarylpropenone (TAP) prototypes. The position-specific contributions of substituents to receptor affinity and to agonist-antagonist profiles were used as aids in characterizing the relative binding orientation of the prototypes. Although most compounds were found to be weak receptor ligands and poorly active in vivo, the following conclusions could be drawn about their SAR: (i) (Z)-TAPs and TAEs interact with the receptor in an analogous manner using the trans-stilbene core, with their agonist-antagonist profiles depending on the nature of other substructures. (ii) Incorporation into the benzofuran framework introduces a stereoelectronic constraint that compromises the normal binding interactions of TAE, as well as TAP, prototypes, resulting in their poor affinities and weak biological activities. (iii) (E)-TAPs can interact with the receptor through their S-cis conformation, but such a binding mode is unlikely to account for their behavior as antagonists. PMID- 2754695 TI - Minimum-structure enkephalin analogues incorporating L-tyrosine, D(or L) phenylalanine, and a diamine spacer. AB - In order to test the theory that high mu-activity of opioid peptides could be elicited by the presence of an amino-terminal L-Tyr residue and a Phe aromatic ring held in the proper relative spatial disposition, a novel series of hybrid retro peptides were prepared in which L-Tyr was linked to N-acyl Phe through a variety of diamine spacers. These compounds were evaluated for opioid agonist and antagonist activity in the guinea pig ileum (GPI) in vitro assay. Analogues containing a 1,2-ethanediamine spacer, which conferred a Tyr-Phe separation distance closest to that found in Phe3 opioid peptides, were more potent agonists than the corresponding analogues containing a 1,3-propanediamine spacer. Agonist activity was observed for both L-Phe and D-Phe analogues, consistent with the known activity for both Phe stereochemistries for certain Phe3 opioid peptide analogues. Concerning the diamine spacer, conformational constraints imposed by 4 aminopiperidine and 4-(aminomethyl)piperidine as well as the presence of a hydroxyl group eliminated activity, but the presence of gem-dimethyl substitution next to the nitrogen attached to Tyr increased activity substantially for the D Phe derivatives. Removal of the N-acetyl group from Phe did not eliminate activity. Naloxone Ke values determined for six of the most potent analogues are indicative of predominantly mu-agonism, but the D-Phe compounds 3a and 6a (1.4 2.1 nM) appear to be more mu-selective than the L-Phe compounds 2b, 3b, 5b, and 6b (3.3-4.4 nM), even though the latter are more potent agonists. Compounds 3a and 3b, which were found to be 10 and 21 times more potent, respectively, than morphine in the GPI, are two of the most structurally simple yet potent opioid peptide analogues described to date. PMID- 2754696 TI - Tricyclic compounds as selective muscarinic receptor antagonists. 3. Structure selectivity relationships in a series of cardioselective (M2) antimuscarinics. AB - On the basis of the cardioselective muscarinic receptor antagonist AF-DX 116 (2), a series of 11-substituted pyridobenzodiazepinones (9-35) was prepared and screened for their binding affinity to muscarinic receptors located in cardiac (M2) and glandular (M3) tissue. The ratio of IC50 values of the test compounds in the two different tissues was taken as a measure of cardiac (M2) receptor selectivity. Qualitative structure-selectivity relationships point to the fact that it is the spatial orientation of the protonated side-chain nitrogen atom in relation to the tricycle that is the main determinant for receptor subtype recognition and hence is important for the achievement of cardiac (M2) selectivity. PMID- 2754697 TI - Synthesis of unsymmetrically substituted 1,4-bis[(aminoalkyl)amino]anthracene 9,10-diones as potential antileukemic agents. AB - The synthesis of unsymmetrically substituted 1,4-bis[(aminoalkyl)amino]anthracene 9,10-diones bearing one "mitoxantrone side arm" and another (aminoalkyl)amino moiety has been described. These unsymmetrical anthracene-9,10-diones exhibit cytotoxic activity against L1210 leukemia cells and antitumor activity against P388 leukemia in mice. PMID- 2754698 TI - Synthesis and antiviral activity of 3'-C-cyano-3'-deoxynucleosides. AB - A series of 3'-C-cyano-3'-deoxynucleosides have been synthesized and evaluated as antiviral agents. Reaction of 2',5'-bis-O-(tert-butyldimethylsilyl)-beta-D erythro-pentofuranos- 3'-ulosyl derivatives of uracil, 4-N-acetylcytosine, and adenine with sodium cyanide gave a mixture of epimeric cyanohydrins, which after 3'-deoxygenation yielded the corresponding 3'-C-cyano-3'-deoxy-beta-D-xylo pentofuranosyl derivatives 10. These compounds were epimerized to the corresponding beta-D-ribo-pentofuranosyl derivatives 11. Desilylation of 10 and 11 gave the deprotected 3'-C-cyano-3'-deoxy-beta-D-xylo- and -ribo-pentofuranosyl nucleosides. These derivatives of uridine, cytidine, and adenine, as well as the 3'-C-cyano-3'-deoxy-beta-D-xylo- and -ribo-pentofuranosyl, 3'-C-cyano-2',3' dideoxy-beta-D-threo- and -erythro-pentofuranosyl, and 3'-C-cyano-2',3'-dideoxy beta-D-glycero-pent-2'-enofuranosyl derivatives of thymine, were evaluated for their antiviral activity. None of the compounds proved active against the replication of retroviruses (human immunodeficiency virus, murine sarcoma virus) at concentrations that were not toxic to the host cells. However, the 3'-C-cyano 3'-deoxy-beta-D-xylo- (12e) and -ribo-pentofuranosyl (13e) derivatives of adenine showed activity against some DNA (i.e., vaccinia) and RNA (i.e., Sindbis, Semliki forest) viruses at concentrations well below the cytotoxicity threshold. PMID- 2754699 TI - Prodrugs of the selective antiherpesvirus agent 9-[4-hydroxy-3-(hydroxymethyl)but 1-yl]guanine (BRL 39123) with improved gastrointestinal absorption properties. AB - Potential oral prodrugs of the antiherpesvirus acyclonucleoside 9-[4-hydroxy-3 (hydroxymethyl)but-1-yl]guanine (1, BRL 39123) have been synthesized and evaluated for bioavailability of 1 in the blood of mice. Reduction of 9-[4 acetoxy-3-(acetoxymethyl)but-1-yl]-2-amino-6-chloropurine (13) using ammonium formate and 10% palladium on carbon afforded the 2-aminopurine 14, which was hydrolyzed to the monoacetate 15 and to 2-amino-9-[4-hydroxy-3-(hydroxymethyl)but 1-yl]purine (5). The 2-aminopurine 5 was subsequently converted to additional monoester (17, 21-23) and diester (16, 24) derivatives and to its di-O isopropylidene derivative 18. Both 5 and its esters (14-17, 21, 22) and also 18 were well absorbed after oral administration and converted efficiently to 1, the diacetyl (14) and dipropionyl (16) esters providing concentrations of 1 in the blood that were more than 15-fold higher than those observed after dosing either 1 or its esters (25-27). Some 6-alkoxy-9-[4-hydroxy-3-(hydroxymethyl)but-1 yl]purines (8-10), the preparation of which has been reported previously, also showed improved absorption properties, but their conversion to 1 was less efficient than for the 2-aminopurine derivatives. On the basis of these results and subsequent experiments involving determinations of rates of conversion to 1 in the presence of rat and human tissue preparations, 9-[4-acetoxy-3 (acetoxymethyl)but-1-yl]-2-aminopurine (14, BRL 42810) was identified as the preferred prodrug of 1. Oral bioavailability studies in healthy human subjects confirmed 14 as an effective prodrug, and this compound is now being evaluated in clinical trials. PMID- 2754700 TI - 3'-Fluoro-2',3'-dideoxy-5-chlorouridine: most selective anti-HIV-1 agent among a series of new 2'- and 3'-fluorinated 2',3'-dideoxynucleoside analogues. AB - A series of 2'- and 3'-fluorinated 2',3'-dideoxynucleosides and 3'-azido-2',3' dideoxynucleosides were synthesized and evaluated for their inhibitory activity against human immunodeficiency virus-1 (HIV-1) replication in MT-4 cells. Neither conversion of 3'-fluoro- or 3'-azido-2',3'-dideoxyadenosine to the corresponding inosine derivatives nor 8-bromination of 2',3'-dideoxyadenosine resulted in increased anti-HIV-1 activity. Nor did introduction of a 2'-fluorine in the erythro or threo configuration lead to improved anti-HIV-1 activity of the parent 2',3'-dideoxynucleosides. 1-(2-Fluoro-2,3-dideoxy-beta-D-threo pentofuranosyl)cytosine and 1-(2-fluoro-2,3-dideoxy-beta-D erythropentofuranosyl)thymine were only marginally active. However, 3'-fluoro 2',3'-dideoxyuridine (FddUrd) proved to be potent and a relatively nontoxic inhibitor of HIV-1. 5-Halogenated derivatives of FddUrd were prepared in attempts to further increase its anti-HIV potency and selectivity. Of these 5-halogenated derivatives, 3'-fluoro-2',3'-dideoxy-5-chlorouridine emerged as the most selective inhibitor of HIV-1 replication. Its selectivity index was comparable to that of azidothymidine when evaluated under the same conditions. PMID- 2754701 TI - N-azamonobactams. 2. Synthesis of some N-iminoacetic acid and N-glycyl analogues. AB - The synthesis of the title compounds has been accomplished. The N-iminoacetic acid analogues (12a and 12b) containing the aminothiazole type side chain exhibited good in vitro antibacterial activity against Gram-negative organisms. The corresponding N-glycyl derivative (17) was not active. PMID- 2754702 TI - Nucleic acid related compounds. 57. Synthesis, x-ray crystal structure, lipophilic partition properties, and antiretroviral activities of anomeric 3' azido-2',3'-dideoxy-2,6-diaminopurine ribosides. AB - Trimethylsilyl triflate-catalyzed transfer glycosylation of 2,6-diamino-9-(3 azido-2,3-dideoxy-alpha- and -beta-D-erythro-pentofuranosyl)purines (3 and 4) in low yields. Selective 2'-O-tosylation of 2,6-diamino-9-(beta-D ribofuranosyl)purine (2,6-diaminopurine riboside, DAPR, 5) followed by our lithium triethylborohydride promoted 1,2-hydride rearrangement gave 2,6-diamino-9 (2-deoxy-beta-D-threo-pentofuranosyl)purine (7). Tritylation of 7 followed by mesylation at O3', deprotection, and displacement of the 3'-mesylate with azide provided a stereodefined synthesis of 2,6-diamino-9-(3-azido-2, 3-dideoxy-beta-D erythro-pentofuranosyl)purine (AzddDAPR, 4). X-ray crystallographic analysis of 4 showed two orientations of the azido group, but consistent conformational features in the remainder of the molecule. In contrast, two independent conformations have been found for AZT. The azido function confers enhanced lipophilicity, which could be expected to contribute significantly to nonselective transport across membranes. A large difference in the octanol/water partition coefficients of the alpha (3) and beta (4) anomers wes found. The beta anomer (4) exerts potent inhibition of HIV-induced cytopathogenicity in human MT 4 cells (ED50: 0.3 microM). This concentration is an order of magnitude lower than that required for ddDAPR, AzddAdo, and AzddGuo. Potent inhibition of Moloney sarcoma virus induced transformation of murine C3H cells by AzddDAPR (4) was also observed. The alpha anomer (3) had no observed antiviral activity. PMID- 2754703 TI - 31P NMR studies of the kinetics of bisalkylation by isophosphoramide mustard: comparisons with phosphoramide mustard. AB - 31P nuclear magnetic resonance spectroscopy was used to measure the pKa (4.28 +/- 0.2) of isophosphoramide mustard (IPM) at 20 degrees C and to study the kinetics and products of the decomposition of IPM at a solution pH value of ca. 7.4 and at temperatures between 20 and 47 degrees C in the presence of nucleophilic trapping agents. At 37 degrees C, the half-life for the first alkylation was ca. 77 min and ca. 171 min for the second alkylation; these data may be compared with those for phosphoramide mustard (Engle, T.W.; Zon, G.; Egan, W.J. Med. Chem. 1982, 25, 1347), wherein the half-lives for the first and second alkylations are approximately the same (18 min). The rate of fragmentation of aldoifosfamide to IPM and acrolein was also studied by NMR spectroscopy (pH 7.0; 37 degrees C; 0.07 M phosphate); under the noted conditions, the half-life of aldoifosfamide was found to be ca. 60 min. PMID- 2754704 TI - Brain-specific chemical delivery systems for beta-lactam antibiotics. Synthesis and properties of some dihydropyridine and dihydroiosquinoline derivatives of benzylpenicillin. AB - Six chemical delivery systems (CDS) were synthesized for benzylpenicillin in order to improve its transport across the blood-brain barrier. The CDS's were based on a dihydropyridine----quaternary pyridinium ion redox system, analogous to the naturally occurring NADH----NAD+ system. Two different types of CDS's were prepared: benzylpenicillin esters of diols in which the other hydroxyl group is esterified by dihydrotrigonelline and benzylpenicillin esters of amino alcohols in which the amine group is acylated by dihydrotrigonelline, or by 1,2-dihydro-2 methyl-4-isoquinolinecarboxylic acid. Lipophilicities of the CDS's were proved to be much higher than those of benzylpenicillin by using Rm values as lipophilicity indexes. Upon oxidation, all of the CDS's gave the quaternary ion forms. Kinetic studies in buffer (pH profiles) indicated that the quaternary salts released benzylpenicillin in pH range of 5-9 via hydrolysis. The CDS's in acidic media yielded as the major reaction product 6-hydroxy-1,4,5,6-tetrahydropyridines as a result of water addition, while in basic conditions benzylpenicillin was released. The water addition reaction was dependent on the CDS's structure, being more prevalent in the case of the "amide-esters". The dihydroisoquinoline CDS was rather stable in the pH range 5-8. PMID- 2754705 TI - Brain-specific chemical delivery systems for beta-lactam antibiotics. In vitro and in vivo studies of some dihydropyridine and dihydroisoquinoline derivatives of benzylpenicillin in rats. AB - Four chemical delivery systems (CDS's) based on a dihydropyridine----quaternary pyridinium salt redox system were used for the brain delivery of benzylpenicillin (BP). CDS's 5 and 9 are diesters of C1 and C2 diols in which one hydroxyl group is esterified by the benzylpenicillin-3-carboxylic group and the other by dihydrotrigonelline. CDS's 13a and 17 are benzylpenicillin esters of amino alcohols in which the amine group is acylated by dihydro-trigonelline (13a) or by 1,2-dihydro-2-methyl-4-isoquinolinecarboxylic acid (17). In vitro relative stability studies showed that both CDS's and quaternary pyridinium salts were quite unstable in rat and rabbit blood or brain but much more stable in dog or human blood. Kinetic studies performed in rat brain homogenate demonstrated the facile enzymatic oxidation of the CDS's to the corresponding quaternary salts. Hydrolysis of the CDS's and the quaternary salts resulted in the release of benzylpenicillin. In biological media CDS 13a also yielded a water addition product, the 6-hydroxy-1,4,5,6-tetrahydropyridine derivative. In vivo distribution studies were carried out in rats. After iv administration of equimolar doses of BP and CDS's, brain benzylpenicillin levels were found to be substantially higher and more prolonged in case of 5 and 9 than of BP itself. However, administration of 13a and 17 resulted in lower brain benzylpenicillin levels due to the water addition reaction and a nonspecific brain delivery, respectively. The remarkable increase of BP levels as well as the prolonged effect after the administration of 5 and 9 is a result of an improved penetration through the blood-brain barrier of the lipophilic CDS's and a "lock-in" effect of the corresponding quaternary salts generated in situ. PMID- 2754706 TI - Chemical delivery systems for some penicillinase-resistant semisynthetic penicillins. AB - Chemical delivery systems (CDS's) based on a dihydropyridine----quaternary pyridinium ion redox system analogous to the naturally occurring NADH----NAD+ system were synthesized for a group of staphylococcal penicillinase resistant penicillins, including methicillin, oxacillin, cloxacillin, and dicloxacillin, in order to improve their penetration of the central nervous system (CNS). The CDS's are penicillin monoesters of gem-diols in which the other hydroxyl group is esterified by the dihydrotrigonelline carrier. The CDS's were found to be much more lipopholic than the parent drugs by comparing their log k' values used as lipophilicity indexes. A study of the chemical oxidation of the CDS's performed by a UV spectrophotometric method showed relatively slow reaction. Stability studies were performed in buffers and different animal tissues for both the CDS's and the quaternary salt type derivatives. These studies showed that the CDS's were oxidized to the quaternary salt forms at neutral and basic pH and added water at lower pH. The quaternary salts released the parent drugs both in buffers and in vitro. A preliminary in vivo distribution study in the rat and rabbit demonstrated blood-brain barrier (BBB) penetration by the CDS, whereas no drug was detected by administering the drug itself. PMID- 2754707 TI - 9-Amino-1,2,3,4-tetrahydroacridin-1-ols: synthesis and evaluation as potential Alzheimer's disease therapeutics. AB - The synthesis of a series of 9-amino-1,2,3,4-tetrahydroacridin-1-ols is reported. These compounds are related to 1,2,3,4-tetrahydro-9-acridinamine (THA, tacrine). They inhibit acetylcholinesterase in vitro and are active in a model that may be predictive of activity in Alzheimer's disease--the scopolamine-induced impairment of 24-h memory of a passive dark-avoidance paradigm in mice. Two compounds, (+/-) 9-amino-1,2,3,4-tetrahydroacridin-1-ol maleate (1a, HP-029) and (+/-)-9 (benzylamino)-1,2,3,4-tetrahydroacridin-1-ol maleate (1p, HP-128), were also active in reversing the deficit in 72-h retention of a one-trial dark-avoidance task in rats, induced by ibotenic acid lesions in the nucleus basalis magnocellularis. In addition, compound 1 p showed potent in vitro inhibition of the uptake of radiolabeled noradrenaline and dopamine (IC50 = 0.070 and 0.30 microM, respectively). Compounds 1a and 1p, which showed less acute toxicity in both rats and mice than THA, are in phase II and phase I clinical trials, respectively, for Alzheimer's disease. PMID- 2754708 TI - Biphenylcarboxamide derivatives as antagonists of platelet-activating factor. AB - A series of N-[4-(3-pyridinyl)butyl]-1,1'-biphenyl-4-carboxamides was prepared, and the compounds were evaluated for platelet-activating factor (PAF) antagonist activity in a binding assay employing washed, whole dog platelets and in vivo for their ability to inhibit PAF-induced bronchoconstriction in the guinea pig. The inclusion of a methyl group in the R configuration on the side-chain carbon adjacent to the carboxamide nitrogen atom of these derivatives resulted in a marked enhancement of potency in the binding assay for compounds unsubstituted in the biphenyl 2-position and, more importantly, in improved oral bioavailability. Previous work with related pyrido[2,1-b]-quinazoline-8-carboxamides suggests that the presence of such an alkyl group improves bioavailability by rendering the resulting compounds resistant to degradation by liver amidases. The most interesting compounds to emerge from this work are (R)-2-bromo-3',4'-dimethoxy-N [1-methyl-4-(3-pyridinyl)butyl]-1,1'-bi phe nyl- 4-carboxamide (33) and (R)-2 butyl-3',4'-dimethoxy-N-[1-methyl-4-(3-pyridinyl)butyl]- 1,1'-biphenyl-4 carboxamide (40) each of which inhibits PAF-induced bronchoconstriction in the guinea pig by greater than 55%. 6 h after an oral dose of 50 mg/kg. PMID- 2754709 TI - Pentadienyl carboxamide derivatives as antagonists of platelet-activating factor. AB - A series of N-[4-(3-pyridinyl)butyl]-5,5-disubstituted-pentadienamides was prepared and evaluated for PAF-antagonist activity. Compounds were assayed in vitro in a PAF-binding assay employing washed, whole dog platelets as the receptor source and in vivo after intravenous or oral administration for their ability to prevent PAF-induced bronchoconstriction in guinea pigs. Criteria required for good oral activity in the latter model include an (E,-E)-5-phenyl 2,4-pentadienamide, a second phenyl or a four- or five-carbon alkyl moiety in the 5-position of the diene, and an (R)-[1-alkyl-4-(3-pyridinyl)butyl] substituent on the carboxamide nitrogen atom. The alkyl substituent on this side chain can be methyl, ethyl, or cyclopropyl. Two members of this series, [R-(E)]-5,5-bis(4 methoxy-phenyl)-N- [1-methyl-4-(3-pyridinyl)butyl]- 2,4-pentadienamide (31) and [R-(E,E)]-5-(4-methoxyphenyl)-N-[1-methyl-4- (3-pyridinyl)butyl]-2,4 decadienamide (58), were selected for further pharmacological evaluation. Both were found to be substantially longer acting after oral administration than the corresponding S enantiomers in the guinea pig bronchoconstriction assay. A second in vivo model used to evaluate PAF antagonists determines the ability of test compounds to decrease the area of skin wheals induced by an intradermal injection of PAF. In this model, using both rats and guinea pigs, compounds 31 and 58 were found to be as active as the reference PAF antagonist 3-[4-(2-chlorophenyl)-9 methyl-6H- 1-(4-morpholinyl)-1-propanone (45). PMID- 2754710 TI - New 2-substituted indoloquinone mitomycin analogues. AB - Previously reported 2-(hydroxymethyl)indoloquinones, prepared as their acetates or carbamates, were less active than 2-methyl analogues in bacterial cultures and they had no activity in mice, despite functionality appropriate for DNA cross linking. On the basis of the hypothesis that these compounds might have been too reactive chemically for selective alkylation of DNA, we prepared new analogues with substituents that could give variation in the reduction potential of the quinone ring, which might control their rate of bioactivation. The 5 methoxyindoloquinones were much more potent cytotoxics than mitomycin C against human tumor cell lines, but they were inactive against P388 leukemia in mice. Two 5-aziridinylindoloquinones were also more potent than mitomycin C against the cell lines and one of them was active in the P388 model upon in vivo assay. The corresponding 5-amino analogues were less potent than mitomycin C against both the cell lines and murine P388 leukemia. A 2-(1-hydroxyethyl)carbamate was prepared by a 20-step synthesis. It was about one-fourth as potent as mitomycin C against two cell lines. PMID- 2754712 TI - Synthesis and antiviral activity of several 2,5'-anhydro analogues of 3'-azido-3' deoxythymidine, 3'-azido-2',3'-dideoxyuridine, 3'-azido-2',3'-dideoxy-5 halouridines, and 3'-deoxythymidine against human immunodeficiency virus and Rauscher-murine leukemia virus. AB - Several 2,5'-anhydro analogues of 3'-azido-3'-deoxythymidine (AZT), 3'-azido-2'3' dideoxyuridine (AZU), 3'-azido-2'3'-dideoxy-5-bromouridine, 3'-azido-2',3' dideoxy-5-iodouridine, and 3'-deoxythymidine and the 3'-azido derivative of 5 methyl-2'-deoxyisocytidine have been synthesized for evaluation as potential anti HIV (human immunodeficiency virus) agents. These 2,5'-anhydro derivatives, compounds 13-17, demonstrated significant anti-HIV-1 activity with IC50 values of 0.56, 4.95, 26.5, 27.1, and 48 microM, respectively. Compared to that of the parent compounds AZT and AZU, the respective 2,5'-anhydro analogues, compounds 13 and 14, were somewhat less active. Whereas AZT was cytotoxic with a TCID50 of 29 microM, the toxicity of the 2,5'-anhydro derivative of AZT, compound 13, was reduced considerably to a TCID50 value of greater than 100 microM. The 2,5' anhydro analogue of 5-methyl-2'-deoxyisocytidine also demonstrated anti-HIV-1 activity with an IC50 value of 12 microM. These compounds were also evaluated against Rauscher-Murine leukemia virus (R-MuLV) in cell culture. Among them, AZT, 3'-azido-2',3'-dideoxy-5-iodouridine, 3'-azido-2',3'-dideoxy-5-bromouridine, and 2,5'-anhydro-3'-azido-3'-deoxythymidine (13) were found to be most active, with IC50 values of 0.023, 0.21, 0.23, and 0.27 microM, respectively. PMID- 2754713 TI - Nucleoside peptides. 10. Synthesis and T-cell immunostimulatory properties of certain peptide derivatives of 6-azacadeguomycin. AB - Several amino acid and peptide conjugates of 6-azacadeguomycin (6-amino-1-beta-D ribofuranosyl-4,5-dihydro-4-oxopyrazolo[3,4-d]py rimidine- 3-carboxylic acid, 2) have been prepared in good yields, via a two-step procedure involving 1 hydroxybenzotriazole and 1-ethyl-3-[3-(dimethylamino)propyl]carbodiimide hydrochloride mediated coupling of 2 with an appropriately protected amino acid or peptide, followed by ammonolysis. Thus, condensation of 2 with L-phenylalanine methyl ester, glycine ethyl ester, and L-glutamic acid diethyl ester gave the corresponding protected linear nucleoside peptides (3, 5 and 7, respectively). Subsequent ammonolysis of 3, 5 and 7 furnished L-phenylalanine amide (4), glycine amide (6) and L-glutamic acid diamide (8) conjugates of 6-azacadeguomycin, respectively. Saponification of 7 gave the corresponding L-glutamic acid derivative 9. A similar coupling of 2 with L-phenylalaninyl-N epsilon-nitro-L arginine methyl ester trifluoroacetate and subsequent ammonolysis (after catalytic hydrogenation) gave L-phenylalaninyl-L-arginine amide conjugate (12) of 6-azacadeguomycin. Compounds 2, 4, 6, 8, 9, and 12 were evaluated for their ability to potentiate T-cell responses to plant mitogens, in comparison with cadeguomycin (1). Compounds 4, 6, and 9 exhibited an increase in the T-cell proliferation in a dose-dependent manner. PMID- 2754711 TI - Sulfur-containing 1,3-dialkylxanthine derivatives as selective antagonists at A1 adenosine receptors. AB - Sulfur-containing analogues of 8-substituted xanthines were prepared in an effort to increase selectivity or potency as antagonists at adenosine receptors. Either cyclopentyl or various aryl substituents were utilized at the 8-position, because of the association of these groups with high potency at A1-adenosine receptors. Sulfur was incorporated on the purine ring at positions 2 and/or 6, in the 8 position substituent in the form of 2- or 3-thienyl groups, or via thienyl groups separated from an 8-aryl substituent through an amide-containing chain. The feasibility of using the thienyl group as a prosthetic group for selective iodination via its Hg2+ derivative was explored. Receptor selectivity was determined in binding assays using membrane homogenates from rat cortex [( 3H]-N6 (phenylisopropyl)adenosine as radioligand] or striatum [3H]-5'-(N ethylcarbamoyl)adenosine as radioligand] for A1- and A2-adenosine receptors, respectively. Generally, 2-thio-8-cycloalkylxanthines were at least as A1 selective as the corresponding oxygen analogue. 2-Thio-8-aryl derivatives tended to be more potent at A2 receptors than the oxygen analogue. 8-[4-[(Carboxy methyl)oxyl] phenyl]-1,3-dipropyl-2-thioxanthine ethyl ester was greater than 740 fold A1 selective. PMID- 2754714 TI - Ester derivatives of 2,6-bis(1-pyrrolidinylmethyl)-4-benzamidophenol as short acting antiarrhythmic agents. 1. AB - In an effort to find a replacement for the iv antiarrhythmic drug lidocaine having reduced systemic and central nervous system effects, activity against supraventricular as well as ventricular arrhythmias, and a biological half-life of less than 15 min, derivatives of the orally active class Ic clinical agent 2,6 bis(1-pyrrolidinylmethyl)-4-benzamidophenol, 1 (ACC-9358), were synthesized and tested. Compounds with ester groups attached to the phenyl ring were either weakly active or toxic. Replacement of the formanilide function with alkyl esters afforded compounds with antiarrhythmic activity in the range of 1. When the ester carboxyl was separated from the bis(aminomethyl)phenol by methylene units, very short half-lives were observed in human blood. In general, these compounds also had low lipophilic character. PMID- 2754715 TI - N-(phthalimidoalkyl) derivatives of serotonergic agents: a common interaction at 5-HT1A serotonin binding sites? AB - Several classes of agents are known to bind at central 5-HT1A serotonin sites In order to challenge the hypothesis that these agents bind in a relatively similar manner (i.e., share common aryl and terminal amine sites), we prepared N (phthalimidobutyl) derivatives of examples of several such agents. With regard to arylpiperazines, we had previously shown that introduction of this functionality at the terminal amine is tolerated by the receptor and normally results in a significant (greater than 10-fold) enhancement in affinity. The results of the present study show that this bulky functionality is also tolerated by the receptor when incorporated into examples of all other major classes of 5-HT1A agents (e.g., 2-aminotetralin, phenylalklamine, indolylalkylamine, and (aryloxy)alkylamine derivatives). The length of the alkyl chain that separates the terminal amine from the phthalimido group is of major importance, and a four carbon chain appears optimal. Alteration of the length of this chain can have a significant influence on affinity; decreasing the chain length from four to three carbon atoms can reduce affinity by an order of magnitude, and further shortening can have an even more pronounced effect. PMID- 2754716 TI - 2,4-Diamino-5-benzylpyrimidines as antibacterial agents. 13. Some alkenyl derivatives with high in vitro activity against anaerobic organisms. AB - A series of 2,4-diamino-5-(3,5-dialkenyl-4-methoxy- or -4 hydroxybenzyl)pyrimidines was prepared from [(allyloxy)benzyl]pyrimidines by Claisen rearrangements, and the resulting allyl phenols were further modified by methylation and rearrangement to 1-propenyl analogues. Analogous 3,4-dimethoxy-5 alkenyl derivatives were prepared by similar techniques. High in vitro antibacterial activity was obtained against certain anaerobic organisms, such as Bacteroides species and Fusobacterium, which was equal to or better than the control, metronidazole, in several cases. The profile was similar against Neisseria gonorrhoeae and Staphylococcus aureus. The 3,5-bis(1-propenyl)-4 methoxy derivative 8 was 1 order of magnitude more active against Escherichia coli dihydrofolate reductase than its saturated counterpart, and it was also more active than trimethoprim, 1. However, it was considerably less active in vitro against the Gram-negative organisms. The 3,4-dimethoxy-5-alkenyl, -5-alkyl, and 5-alkoxy analogues had very high broad-spectrum antibacterial activity. However, pharmacokinetic studies of four of the compounds in dogs and rats and in vivo studies with an abdominal sepsis model in rats showed no advantages over trimethoprim. PMID- 2754717 TI - Cardiac glycoside-like structure and function of 5 beta,14 beta-pregnanes. AB - 5 beta-Reduction and 14 beta-substitution convert the planar progesterone molecule to the cardiac glycoside configuration--A and D rings of the steroid moiety are bent toward the alpha-face relative to the B and C rings. Potency of the 5 beta,14 beta-derivative in a [3H]ouabain binding assay or its ability to inhibit the sodium pump in red blood cells is enhanced by 3 beta-hydroxylation, 20 beta-hydroxylation, and 3 beta-glycosidation. Synthesis of 14,20 beta dihydroxy-3 beta-(beta-D-glucopyranosyloxy)- 5 beta,14 beta-pregnane from digitoxin is described. The glucoside is 1/20 as potent as ouabain and elicits prominent, sustained, positive inotropy in isolated cardiac muscle. PMID- 2754718 TI - Synthesis, biological activity, and conformational analysis of (2S,3R,4S)-MeBmt1 cyclosporin, a novel 1-position epimer of cyclosporin A. AB - Cyclosporin A (CsA, 1), an immunosuppressive cyclic undecapeptide, contains a unique amino acid, (4R)-4-[(E)-butenyl]-4,N-dimethyl-L-threonine (MeBmt), that appears to be critically involved in the biological activity of CsA. In order to further explore the effect that structural elements in MeBmt have on the conformation and biological activity of CsA, the 4-epimer of MeBmt [(4S)-MeBmt, 2] and the corresponding CsA analogue [(4S)-MeBmt1-CsA, 3] have been synthesized. Biological assay using concanavalin A stimulated thymocytes indicated that (4S) MeBmt1-CsA (3) has only 2-4% immunosuppressive activity relative to CsA. The NMR analysis by 1D and 2D NMR methods establishes the conformation of 3, of which the 33-membered cyclic peptide ring system in chloroform is very similar to that of CsA. However, the NMR analysis also reveals that the 1-position side chain orientation in (4S)-MeBmt1-CsA (3) is very different from that of CsA. Specifically, the (4S)-MeBmt alpha,beta-torsion angle (chi 1) has been rotated approximately 120 degrees relative to that of CsA, and the orientation of the butenyl side chain relative to the 33-membered peptide backbond is different. The orientation of the (4S)-MeBmt side chain is consistent with the possible conformations calculated for (4S)-MeBmt1-CsA (3) by using molecular mechanics (in vacuo) calculations. The conformational analysis suggests that the loss of biological activity for 3 results from an altered conformation of the 1-position side chain relative to the peptide backbond due to the changed chirality at C4 of MeBmt. PMID- 2754719 TI - Lipophilic analogues of sparsomycin as strong inhibitors of protein synthesis and tumor growth: a structure-activity relationship study. AB - Fourteen derivatives of sparsomycin (1) were synthesized. Six of them were prepared following a novel synthetic route starting from the L-amino acid alanine. Some physicochemical properties, viz. lipophilicity and water solubility, of selected derivatives were measured. The biological activity was tested in vitro in cell-free protein synthesis inhibition assays, in bacterial and tumor cell growth inhibition assays, and in the L1210 leukemia in vivo model in mice. Also for selected drugs the acute toxicity in mice was determined. Ribosomes from both an eukaryotic and a prokaryotic organism were used in the protein synthesis inhibition systems. A linear correlation between the lipophilicity parameters measured was observed. Water solubility and drug toxicity in mice were found to be linearly correlated with lipophilicity. All the derivatives studied are more lipophilic than 1. The deshydroxysparsomycin analogues (30-33) showed an interesting phenomenon: increase in hydrophobicity was accompanied by a considerable increase in water solubility. We found that an increase in hydrophobicity of the drug as a result of replacing the SMe group of 1 with larger alkylthio groups causes an increase in the biological activity of the drug. However, not only the hydrophobicity but also shape and size of the substituent are important; in the homologous series 1-9-10-11-12, 21-22-23-24, and 30-31-32-33, highest protein synthesis inhibitory and in vitro cytostatic activity is found with compounds 11, 23, and 32, respectively, and in comparison with the highly active n-butyl compound 10, the isomeric tert-butyl compound 13 is rather inactive. Polar substituents replacing the SMe group, i.e. Cl in 17 and 35, also render the molecule inactive. Substituting the bivalent sulfur atom for a methylene group decreases the drug's activity. This effect can be compensated for by increasing the length of the alkylsulfinyl side chain. The agreement between the results derived from cell-free and "in vivo" tests is good. The assays using ribosomes of bacterial and eukaryotic organisms give similar results although the latter seem to be more sensitive to changes in hydrophobicity of the drug. Our results confirm the presence of a hydrophobic region at the peptidyl transferase center of the ribosome; the interaction of sparsomycin with this region is more pronounced in the eukaryotic particles. The sparsomycin analogues 11, 23, and 30 show the highest antitumor activity against L1210 leukemia in mice, their median T/C values are 386, 330, and 216%, respectively.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2754720 TI - Water-soluble third generation antitumor platinum complexes, [2,2-bis (aminomethyl)-1,3-propanediol-N,N']-[1,1-cyclobutanedicarboxylato (2-) O,O']platinum(II) and [1,1-cyclobutanedicarboxylato(2-)-O,O'] [tetrahydro-4H pyran-4,4-dimethanamine-N,N']platinum(II). AB - The synthesis, stability, and antitumor activity of a series of water-soluble third generation platinum(II) complexes have been described. Among these complexes, [2,2-bis(aminomethyl)-1,3- propanediol-N,N'] [1,1 cyclobutanedicarboxylato(2-)-O,O']platinum(II) and [1,1 cyclobutanedicarboxylate(2-)-O,O'](tetrahydro-4H-pyran-4,4- dimethanamine-N,N' )platinum(II) have shown the greatest promise for further investigation and are currently under clinical evaluation. PMID- 2754721 TI - The view from Walter's window: social environment and the communicative competence of adults with a mental handicap. AB - This paper reports on a study of the communicative competence of adults with a mental handicap living in hospital and community settings. One hundred and twenty subjects, half from hospital settings and half from community settings, were assessed on the Communication Assessment profile (CASP). Significant differences were found between the hospital and community groups on pragmatic competence. The communication environment was shown to be an important determinant of pragmatic skills. The implications of this finding are discussed. PMID- 2754722 TI - Assessing the understanding of emotional states in a population of adolescents and young adults with mental handicaps. AB - This study investigated emotional awareness, the recognition and understanding of different emotional states, among a non-clinical population of adolescents and young adults with mental handicaps. While emotional awareness showed a high positive correlation with language comprehension, the results suggest that many of these individuals have specific emotional awareness deficits which are not in line with their language comprehension abilities. This finding suggests that the assessment of emotional awareness would be an important step in the choice of a self-report measure to assess an individual's emotional state. PMID- 2754723 TI - Prader Willi syndrome with hypothyroidism. AB - A case of Prader Willi Syndrome who suffered from hypothyroidism is described. This patient on cytogenetic examination was found to have Mosaic 46,XX/46,XX,del(15)(q11.1q11.2) karyotype. PMID- 2754724 TI - Unbalanced form of translocation deletion between chromosomes 6 and 22 in a mentally handicapped female [45,XX,-6,-22,+der(6),t(6;22)(q25.1:q11.2)]. AB - A case of a mentally handicapped female with unbalanced form of translocation deletion between chromosomes 6 and 22 is reported. Clinical features, mental disorder and abnormal dermatoglyphs of the propositus are described. PMID- 2754725 TI - Coexistent discoid lupus erythematosus and psoriasis: a therapeutic dilemma. AB - The author notes that psoriasis is a common condition and primary care physicians should be aware of drugs that can worsen this disease. He describes the case of a patient with coexistent discoid lupus erythematosus (LE) and psoriasis. He discusses therapeutic problems encountered in this case and reviews drugs reported to exacerbate psoriasis. PMID- 2754726 TI - Our image: self-service or self-sacrifice. PMID- 2754727 TI - Pediatrician liable for failure to diagnose infant's hip problem. PMID- 2754728 TI - Paramyosin gene (unc-15) of Caenorhabditis elegans. Molecular cloning, nucleotide sequence and models for thick filament structure. AB - Paramyosin is a major structural component of thick filaments isolated from many invertebrate muscles. The Caenorhabditis elegans paramyosin gene (unc-15) was identified by screening with specific antibodies an "exon-expression" library containing lacZ/nematode gene fusions. Short probes recovered from the library were used to identify bacteriophage lambda and cosmid clones that encompass the entire paramyosin (unc-15) gene. From these clones, numerous subclones containing epitopes reacting with anti-paramyosin sera were obtained, providing strong evidence that the initial cloned fragment was, in fact, derived from the structural gene for paramyosin. The complete nucleotide sequence of a 12 x 10(3) base-pair region spanning the gene was obtained. The gene is composed of ten short exons encoding a protein of 866 [corrected] amino acid residues. Paramyosin is highly similar to residues 267 to 1089 of myosin heavy chain rods. For most of its length, paramyosin appears to form an alpha-helical coiled-coil and shows the expected heptad repeat of hydrophobic amino acid residues and the 28-residue repeat of charged amino acids characteristic of myosin heavy chain rods. However, paramyosin differs from myosin in having non-helical extensions at both the N and C termini and an additional "skip" residue that interrupts the 28-residue repeat. The distribution of charges along the length of the paramyosin rod is also significantly different from that of myosin heavy chain rods. Potential charge mediated interactions between paramyosin rods and between paramyosin and myosin rods were calculated using a model successfully applied previously to the analysis of the myosin rod sequences. Myosin rods aligned in parallel show optimal charge-charge interactions at multiples of 98 residue staggers (i.e. at axial displacements of multiples of 143 A). Paramyosin rods, in contrast, appear to interact optimally at parallel staggers of 493 residues (i.e. at axial displacements of 720 A) but show only weak interaction peaks at 98 or 296 residues. Similar calculations suggest optimal interactions between paramyosin molecules and myosin rods and in their anti-parallel alignments. The implications of these results for the structure of the bare zone and the assembly of nematode thick filaments are discussed. PMID- 2754729 TI - Construction of plasmids containing a unique acetylaminofluorene adduct located within a mutation hot spot. A new probe for frameshift mutagenesis. AB - N-2-acetylaminofluorene (AAF), a potent rat liver carcinogen, binds primarily to the C-8 position of guanine residues. In a bacterial forward mutation assay, more than 90% of the mutations induced by -AAF adducts are frameshift mutations located at specific sites: the so-called mutation hot spots. We are particularly interested in a class of -2 frameshift mutations occurring within a specific sequence, the NarI sequence. The NarI site, GGCGCC, contains three guanine residues that are approximately equally reactive toward -AAF substitution. To study further the mechanism by which mutations are induced by -AAF adducts at this site, we designed a new plasmid probe. In this paper we describe the construction and the effectiveness of this probe, pSM14, which provides a simple phenotypic test for detecting frameshift mutations within the NarI site. The construction and the characterization of plasmids with a single -AAF adduct in each of the three positions of the NarI site are also described. The strategy of construction that was used involves the ligation of oligonucleotides containing a single adduct in a NarI site into a gapped-duplex pSM14 plasmid. Plasmids that have successfully integrated the oligonucleotides by ligation at both the 5' and the 3' ends were purified by centrifugation on CsCl gradients. These constructs have been used in single adduct mutation studies. PMID- 2754730 TI - Computer modeling from solution data of spinach chloroplast and of Xenopus laevis somatic and oocyte 5 S rRNAs. AB - Detailed atomic models of a eubacterial 5 S rRNA (spinach chloroplast 5 S rRNA) and of a eukaryotic 5 S rRNA (somatic and oocyte 5 S rRNA from Xenopus laevis) were built using computer graphic. Both models integrate stereochemical constraints and experimental data on the accessibility of bases and phosphates towards several structure-specific probes. The base sequence was first inserted on to three-dimensional structural fragments picked up in a specially devised databank. The fragments were modified and assembled interactively on an Evans & Sutherland PS330. Modeling was finalized by stereochemical and energy refinement. In spite of some uncertainty in the relative spatial orientation of the substructures, the broad features of the models can be generalized and several conclusions can be reached: (1) both models adopt a distorted Y-shape structure, with helices B and D not far from colinearity; (2) no tertiary interactions exist between loop c and region d or loop e; (3) the internal loops, in particular region d, contain several non-canonical base-pairs of A.A, U.U and A.G types; (4) invariant residues appear to be more important for protein or RNA binding than for maintaining the tertiary structure. The models are corroborated by footprinting experiments with ribosomal proteins and by the analysis of various mutants. Such models help to clarify the structure-function relationship of 5 S rRNA and are useful for designing site-directed mutagenesis experiments. PMID- 2754731 TI - Theoretical prediction of base sequence effects in DNA. Experimental reactivity of Z-DNA and B-Z transition enthalpies. AB - Molecular modeling is used to study the sequence dependence of conformation and stability within helically regular duplex Z-DNA. The variations of conformation that are found are sufficiently important to be classified as a new type of polymorphism within the Z family. It is also demonstrated that certain sequences can adopt more than one of these polymorphic forms. Comparison with experimental studies of chemical reactivity within a natural DNA fragment, forced into a left handed conformation, suggests that the results of our modeling may be used to explain the chemical reactivity observed. Comparison of the Z results with similar studies of the B form allow enthalpies of transition to be calculated as a function of base sequence. PMID- 2754732 TI - The DNA bending by acetylaminofluorene residues and by apurinic sites. AB - We have studied the distortions induced in double-stranded oligonucleotides by covalently bound acetylaminofluorene residues and by apurinic sites. Within the acetylaminofluorene-modified oligonucleotide three base-pairs are unpaired as detected by the chemical probes chloroacetaldehyde and osmium tetroxide. These two probes reveal that the bases adjacent to the apurinic site are paired. In both the modified double-stranded oligonucleotides, the backbone on the 5' side of the modification is more reactive with 1,10-phenanthroline copper than the backbone on the 3' side. On polyacrylamide gels, the ligated multimers of acetylaminofluorene or apurinic site-modified oligonucleotides migrate slower than the multimers of the unmodified oligonucleotides. It is suggested that the acetylaminofluorene-modified guanine residues and the apurinic sites behave more as hinge joints than as the centres of directed bends. PMID- 2754733 TI - Phosphorylation of the N-terminal region of Caenorhabditis elegans paramyosin. AB - Paramyosin from Caenorhabditis elegans was examined for post-translational modification by phosphorylation. Paramyosin purified from populations of mixed age animals contained 0.7 to 2.0 moles of phosphate per mole of paramyosin. Paramyosin was also phosphorylated in vitro by an endogenous kinase in the particulate fraction. Analysis of the in vitro phosphorylated paramyosin in comparison with the DNA sequence of the unc-15 paramyosin gene of C. elegans shows that serine residues in the non-alpha-helical N-terminal region are the targets of the kinase. The N-terminal region of paramyosin has significant similarity to the non-helical C-terminal region of the two body wall myosin heavy chains of C. elegans. All three regions contain three copies of a Ser-*-Ser-*-Ala motif, the most likely target for phosphorylation in paramyosin, suggesting that these regions may be modified by the same kinase. PMID- 2754734 TI - Crystal structure and stability of a DNA duplex containing A(anti).G(syn) base pairs. AB - The synthetic dodecanucleotide d(CGCAAATTGGCG) has been analysed by single crystal X-ray diffraction techniques and the structure refined to R = 0.16 and 2.25 A resolution, with the location of 94 solvent molecules. The sequence crystallizes as a full turn of a B-DNA helix with ten Watson-Crick base-pairs and two adenine-guanine mispairs. The analysis clearly shows that the mismatches are of the form A(anti).G(syn). Thermal denaturation studies indicate that the stability of the duplex is strongly pH dependent, with a maximum at pH 5.0, suggesting that the base-pair is stabilized by protonation. Three different arrangements have been observed for base-pairs between guanine and adenine and it is likely that A.G mismatch conformation is strongly influenced by dipole-dipole interactions with adjacent base-pairs. PMID- 2754735 TI - Structure of myoglobin-ethyl isocyanide. Histidine as a swinging door for ligand entry. AB - The structure of myoglobin(Fe II)-ethyl isocyanide has been solved at 1.68 A resolution by X-ray crystallography. The isocyano group of the ligand is distorted from the linear conformation observed in solution and in model compounds. Local changes in the protein conformation are also seen. The side chain of Arg-CD3 moves out into the solvent, and the side-chain of His-E7 swings up and away from the ligand. Both of these side-chains show disorder indicative of dynamic behavior. These outward movements of His-E7 and Arg-CD3 side-chains clear a path from the solvent to the heme iron, suggesting a mechanism for ligand entry. PMID- 2754736 TI - Spinal cord sodium, potassium, calcium, and water concentration changes in rats after graded contusion injury. AB - Spinal cord Na, K, Ca, and H2O changes were measured 6 h after graded contusion injuries in 40 Sprague-Dawley rats. A 10 g weight was dropped 1.25 cm (n = 6), 2.5 cm (n = 7), 5.0 cm (n = 6), or 7.5 cm (n = 7) onto the thoracic spinal cord of 26 rats. An additional 10 rats served as laminectomy controls and 4 rats were unoperated controls. At 6 h after surgery or injury, the spinal cords were rapidly cut into 4 mm segments, weighed to obtain tissue wet weights (W), dried for 14-16 h at 97 degrees C in a vacuum oven (30 mmHg), and reweighed for tissue dry weights (D). Water concentrations ([H2O]d) were estimated from (W-D)/D in units of ml/g D. Ionic concentrations ([Na]d, [K]d, and [Ca]d) of the tissue samples were measured by atomic absorption spectroscopy with units of mumol/g D. Ionic shifts (delta [Na]d, delta [K]d, delta [Ca]d) were calculated by subtracting laminectomy control values from those measured in injured cords. Laminectomy alone significantly increased [Na]d and [H2O]d compared to unoperated controls. Mean +/- standard deviations of [H2O]d, [Na]d, [K]d, and [Ca]d were, respectively, 1.95 +/- 0.07, 182.6 +/- 5.9, 277.2 +/- 11.8, and 12.1 +/- 1.4 in unoperated controls; 2.12 +/- 0.08, 238.6 +/- 9.2, 277.8 +/- 9.2, and 11.7 +/- 1.1 in laminectomy controls. At the impact site, [K]d fell by 14-37% and [H2O]d rose by 14-24%, [Na]d by 13-64%, and [Ca]d by 65-137% of laminectomy control values. delta [Na]d, delta [K]d, and delta [Ca]d correlated linearly with impact velocities; [Ca]d increased by 1.0% per cm/sec (r = 0.995, p less than 0.005), [Na]d increased 0.67% per cm/sec (r = 0.950, p less than 0.01), and [K]d decreased 0.34% per cm/sec (r = 0.964, p less than 0.01). Neither delta [H2O] nor delta [Na]d + delta [K]d consistently predicted impact velocity. [Na]d + [K]d correlated with [H2O]d with a slope of 177.4 mumol/ml (r = 0.697, p less than 0.005). Since Na and K constitute greater than 95% of tissue inorganic ions, the slope approximates net ionic shift per ml of water entry or the ionic osmolarity of edema fluid. These results indicate that increasing contusions produce graded ionic shifts and that edema does not predict contusion severity. These data support our hypothesis that net ionic shifts cause edema in injured spinal cords. PMID- 2754737 TI - Infertility in patients with testicular cancer: testis, tumor, or treatment? PMID- 2754738 TI - ACS reports on cancer and the poor. PMID- 2754739 TI - "We need help"--testimony at hearing on cancer and the poor. PMID- 2754740 TI - Swedish studies link hormone use to higher breast cancer risk. PMID- 2754741 TI - ACR program accredits nearly 800 mammography units. PMID- 2754742 TI - Genome project to expand intramural participation. PMID- 2754743 TI - Airplane smoking ban to expire; extension debated. PMID- 2754744 TI - New project begins testing ways to cut red tape. PMID- 2754745 TI - Resistance to drugs associated with the multidrug resistance phenotype following selection with high-concentration methotrexate. AB - To study patterns of resistance at extreme but nevertheless clinically relevant drug concentrations, we developed a series of methotrexate-selected CCRF-CEM sublines, all of which were highly resistant to this antifolate (relative resistance, 10(2)- to greater than 10(5)-fold). The least methotrexate-resistant subline was completely sensitive to drugs associated with the multidrug resistance phenotype. However, more highly methotrexate-resistant sublines were significantly cross-resistant to vincristine, vinblastine, and dactinomycin (maximum relative resistance, 40-fold). These sublines were not cross-resistant to doxorubicin, daunorubicin, and teniposide. Regression analysis indicated that relative resistance to methotrexate was correlated with relative resistance to vincristine (r = 0.96) and vinblastine (r = 0.99). Such cross-resistance in highly methotrexate-resistant cells may have important clinical implications. PMID- 2754746 TI - Cigarette smoking and leukemia. PMID- 2754747 TI - Approach to hair loss reduction. PMID- 2754748 TI - A dilemma for physicians and surgeons. PMID- 2754749 TI - Schizophrenia and affective disorder in black and white patients: a methodologic note. AB - Contrary to many published reports of higher rates of schizophrenia and lower rates of affective disorder among blacks, this analysis of data collected over a ten-year period in a psychiatric clinic that serves a predominantly black population found minimal differences between the two ethnic groups. Methodologic considerations that reduce spurious black-white differences are discussed. The authors urge proper caution in evaluating such reported differences and propose screening measures to identify biased diagnostic procedures. PMID- 2754750 TI - Breast self-examination: knowledge, attitudes, and performance among black women. AB - This survey assessed the reported frequency of breast self-examination (BSE): the knowledge of the technique and attitudes regarding the self-exam of 180 black women. Most respondents indicated having practiced the exam during the previous year, and 50% reported practicing it monthly or more often. Less than half of the sample indicated performing the exam according to American Cancer Society guidelines, although 92% reported being either very confident or somewhat confident of their performance ability. Attitudinal and demographic variables were tested for significant relationships with BSE practice. Compared with nonperformers, BSE performers were older, had higher annual incomes, and were more likely to believe in the benefits of BSE, to perceive social approval for BSE practice, to have been taught to perform BSE, to have had a Pap smear, a clinical breast exam, and a general physical exam within one year, and to visit a physician in a private office or clinic (as opposed to a hospital emergency room). Frequency of self-examination was significantly associated with the performer's competency level, age, belief in the benefits of performing BSE, perceived social approval for practice, having been taught to perform the exam, and level of confidence in ability to perform it. PMID- 2754751 TI - Anatomy of the abdomen, back, and pelvis as displayed by magnetic resonance imaging: Part Two. AB - In April 1986, magnetic resonance imaging (MRI) of the thorax and shoulder girdle was presented at the 99th Annual Meeting of the American Association of Anatomists. These images were the authors' first attempt to correlate the magnetic resonance display of the muscles and soft tissues of the chest in the coronal plane with surface gross anatomy. The original purpose of this study was to introduce the role of magnetic resonance imaging to anatomists, medical students, and the specialty of radiology. However, this approach has been expanded by imaging other sections of the body and applying the display of surface anatomy to augment the teaching of anatomy to surgical oncology, pathology, and kinesiology. This three-part article will display magnetic resonance images and will explain how magnetic imaging of the soft tissues can visually augment the teaching of gross anatomy without dissecting surface tissues. PMID- 2754752 TI - Protecting our children. AB - American society will face major economic and social difficulties in the years to come if we do not address the serious threat to our prosperity posed by the growing numbers of young people who lack the education to function in a highly technical world. The author identifies some of the circumstances and behaviors that place children at risk of academic failure, including poverty, teenage pregnancy, drug abuse, unstable families, and suicide. Failure of the education, health, and social service systems set up to deal with these risk factors is also identified as part of the problem. The author offers four proposals for restructuring failing systems to provide our youth with the support they need to mature, learn, and develop. PMID- 2754753 TI - Progression from hypertrophic cardiomyopathy to dilated cardiomyopathy. AB - The incidence of hypertrophic cardiomyopathy progressing to dilated cardiomyopathy is rare. A patient diagnosed at age 22 and followed for 24 years who progressed to a dilated cardiomyopathy with severe congestive heart failure is reported. Left ventricular dilatation in hypertrophic cardiomyopathy may be due to a complication of surgery, beta-blocker therapy, or myocardial infarction. It may also represent the natural history in a subset of patients with hypertrophic cardiomyopathy. PMID- 2754754 TI - Toxicity of complex waste mixtures: a comparison of observed and predicted lethality. AB - The ability to predict the biological effect of complex waste mixtures from chemical characterization data was examined by comparing observed mortality to that predicted by a mathematical additivity model with literature LD50 values for the chemicals identified in the mixtures. Male F344 rats were exposed by gavage to 1 of 10 samples of complex industrial waste. Seven of the 10 waste samples caused death within 24 h of administration at dosages ranging from 1 to 5 ml/kg body weight. Two of the 7 lethal waste samples produced 100% mortality at a dosage of 2.5 ml/kg; another 2 waste samples produced 100% mortality at 5 ml/kg. The partial chemical analysis, although providing more extensive information on chemical composition than might normally be available for most complex waste mixtures, was not sufficient to distinguish lethal from nonlethal waste samples or to indicate lethal potency. Possible explanations for the apparent inability to predict readily lethality from the chemical characterization data include the possible inappropriateness of an additivity model due to the presence of interactions, such as synergism or antagonism; the kinetics of chemical absorption, distribution, and elimination, which may be affected by administration of the chemical in a complex matrix; and the presence of unidentified chemicals in the mixture that may have contributed to the observed toxicity. PMID- 2754755 TI - Experimental design constraints on carcinogenic potency estimates. AB - The multistage model is used by U.S. regulatory agencies to calculate estimates of the carcinogenic potency (beta) of chemicals; the data for these estimates are generally obtained from chronic rodent bioassays. Three quantities characterize each group tested in the chronic bioassay: the dose level, the sample size, and the number responding to the dose. The dose levels tested are fixed by conventional protocols; the typical National Toxicology Program (NTP) experimental design calls for use of the maximum tolerated dose (MTD), one-half and one-fourth MTD, plus a control group. Only rarely are doses even one order of magnitude less than the MTD utilized in chronic bioassays. This experimental design constraint on dose selection limits the possible values of beta that can arise from multistage model analyses of chronic bioassay data. Sample size is also constrained by the experimental design of the chronic bioassay; the typical sample size in NTP studies is 50 animals. Occasionally, fewer animals are used, but only rarely are more. Thus, the multistage model which theoretically has three variable quantities with which to estimate carcinogenic potency, has in practice only one: the incidence of treatment-related response. Even this can vary within only a narrow range determined by sample size, the control incidence, and the level of statistical significance desired. The net result of these design constraints is that carcinogenic potency estimates derived from multistage-model analyses of chronic bioassay data may vary within only a narrow range surrounding the inverse maximum dose tested. We have illustrated this by calculating the largest possible finite potency estimates that could have arisen from the experimental designs used to test 82 mouse carcinogens in chronic bioassays. On average these maximum potency estimates were within one order of magnitude of the inverse maximum dose tested. We thus conclude that the chronic rodent bioassay, in and of itself, is altogether inadequate as a data source for estimating the risk to humans from exposure to carcinogenic chemicals. PMID- 2754756 TI - Male fertility study on N,N-dimethylacetamide administered by the inhalation route to Sprague-Dawley rats. AB - Male Sprague-Dawley rats were exposed to N,N-dimethylacetamide (DMAC) and mated to untreated virgin females. Mean analytical exposure concentrations were 40, 116, and 386 ppm, respectively. A control group was exposed to air containing no DMAC. A total of 69 d of exposure to DMAC at these levels produced treatment related effects of increased liver weights and liver/body weight ratios in the high- and medium-exposure groups of male rats. Reproductive data indicated no treatment-related effects on copulation efficiency or efficiency in effecting pregnancy, and there were no detectable treatment-related effects on preimplantation loss, postimplantation loss, embryotoxicity, or fetotoxicity in litters of females mated to males exposed to DMAC at the levels used in this study. The significance of these findings is discussed. PMID- 2754757 TI - Effect of carbon monoxide on the cytochrome P-450-mediated metabolism of aniline and p-nitroanisole in the isolated perfused rabbit lung. AB - Carbon monoxide (CO), an environmental pollutant, inhibits the cytochrome P-450 mediated metabolism of xenobiotics in vitro. In recent years, the importance of the lung in the metabolic disposition of certain airborne and systemically administered xenobiotics has been demonstrated. The purpose of this investigation was to establish a threshold for the CO-induced inhibition of cytochrome P-450 mediated activities in the isolated perfused rabbit lung and to determine if these reactions are equally sensitive to this toxicant in this model. Neither the mixed-function oxidase-mediated hydroxylation nor the acetylation of aniline was altered by exposure to 7.5% CO/20% O2 for 2.5 h in the isolated perfused rabbit lung. p-Nitroanisole O-demethylation by isolated rabbit lungs ventilated with 7.5% CO/20% O2 was significantly decreased (approximately 37%) in comparison to controls. That these reactions are not similarly influenced by carbon monoxide may indicate that the constitutive isozymes of cytochrome P-450 in the rabbit lung are differentially sensitive to CO-induced inhibition. PMID- 2754758 TI - Effect of carbon monoxide on the cytochrome P-450-mediated activation of 4 ipomeanol by the isolated perfused rabbit lung. AB - 4-Ipomeanol is a naturally occurring toxin that induces lesions in the lung following its activation to an alkylating metabolite by the pulmonary cytochrome P-450 system. The aim of this study was to determine if an environmentally relevant concentration of carbon monoxide could inhibit the activation of 4 ipomeanol and prevent the associated toxic sequelae in the isolated perfused rabbit lung. The lungs of male New Zealand rabbits were removed and perfused with [14C]-4-ipomeanol for 2 h starting with an initial concentration of 0.1 mM. Lungs were ventilated with either air (control) or 7.5% CO/20% O2. 4-Ipomeanol-derived covalent binding was identical in the control and carbon monoxide treatment groups. Lungs perfused with 4-ipomeanol and ventilated with air or 7.5% CO/20% O2 both displayed alveolar type II cell hyperplasia and alveolar macrophage infiltration. Surprisingly, there was no histological evidence of Clara cell damage in any of the 4-ipomeanol-perfused lungs. These results suggest that the isozymes of pulmonary cytochrome P-450 that act in concert to metabolize 4 ipomeanol are relatively insensitive to inhibition by carbon monoxide. PMID- 2754759 TI - Mechanistic study on formaldehyde-induced hepatotoxicity. AB - In isolated, hemoglobin-free perfused livers of fasted rats, formaldehyde at an initial concentration of 10 mmol/l produced toxicity as evidenced by a release of enzymes (GPT, SDH) and of glutathione (mainly GSSG) into the perfusate, an accumulation of calcium in the liver, and a depletion of hepatic glutathione. Formaldehyde also led to an enhanced release of malondialdehyde into the perfusate, indicating peroxidative processes and decreased hepatic oxygen consumption by about 50-70%. The electron microscopic investigation of formaldehyde-exposed livers showed a destruction of the mitochondria (ruptured membranes, loss of the cristae) and some damage of the rough endoplasmic reticulum. Feeding the rats prior to surgery attenuated the hepatotoxic effects of 10 mmol/l formaldehyde. At an initial concentration of 3 mmol/l, formaldehyde did not release enzymes from livers of fed or fasted rats but only from those whose glutathione content had been depleted by treatment with phorone (250 mg/kg ip 2 h earlier). Formaldehyde liberated glucose and lactate from the livers of fed but not from those of fasted rats, indicating anaerobic energy supply in the fed state. The hepatotoxic action of formaldehyde is not due to its metabolism to formate or to the 10% methanol added as a stabilizing agent to the commercially available 37% solution named formalin. In conclusion, by destruction of mitochondria, formaldehyde inhibits aerobic energy supply and thereby presumably produces hepatocellular damage. PMID- 2754760 TI - Inhibition of monoamine oxidase by the fungicide metalaxyl. AB - The in vitro effect of metalaxyl on monoamine oxidase (MAO) activity in rat heart was studied. Metalaxyl decreased MAO activity in a dose-dependent manner. The inhibitory concentration (IC50) for metalaxyl was found to be 19 mumol. Substrate dependent kinetic studies demonstrated noncompetitive inhibition as evidenced by decreased velocity of enzyme activity (Vmax) without significant change in enzyme substrate affinity (Km). The inhibition of MAO activity by metalaxyl suggests interference with amine metabolism. PMID- 2754761 TI - Ganglioside and lipid composition of bulk-isolated rat and bovine oligodendroglia. AB - We have examined the ganglioside composition of 30-day and 60-day postnatal rat oligodendroglia, adult bovine oligodendroglia, gray matter, white matter, and myelin and also the total lipid composition of the oligodendroglial preparations. The ganglioside patterns of rat and bovine oligodendroglia, as previously found for human oligodendroglia, were more complex than those of myelin. These data indicate that oligodendroglial perikarya can synthesize many brain type gangliosides, not all of which are incorporated into the compact myelin. Alternatively, the ganglioside composition of myelin may be altered in situ by the myelin-associated neuraminidase. In these two species, as in human, GM4 appears specific to oligodendroglia and myelin, while GD3 and GM3 are enriched in oligodendroglia but not myelin. In bovine oligodendrocytes GD3 is the major ganglioside. The total lipid concentration, as well as the percentage of cholesterol, sphingomyelin, phosphatidylinositol, and phosphatidylserine, differ for 30- and 60-day-old rat oligodendroglia and may be developmentally correlated with changes in myelin composition during myelinogenesis. There are also marked differences in the lipid composition of bovine oligodendroglia compared to rat oligodendroglia, with the former having more galactolipid and less ethanolamine phosphoglycerides. PMID- 2754762 TI - Development and regional expression of chicken neuroleukin (glucose-6-phosphate isomerase) messenger RNA. AB - Neuroleukin (NLK) is a protein identical with the glycolytic enzyme glucose-6 phosphate isomerase (GPI) that has been reported to support the survival of a subpopulation of neurons in embryonic dorsal root ganglia and spinal cord neurons in culture. In this report we have studied the developmental expression of NLK mRNA in the chick embryo in order to evaluate its possible role as a neurotrophic factor. The chicken gene encoding NLK was isolated by cross-hybridization to a mouse NLK cDNA clone. A DNA fragment from the chicken NLK gene with a 90% nucleotide sequence homology to mouse NLK cDNA encoding amino acids 310-355 was then used as a hybridization probe in a series of RNA-blots. In the entire embryo NLK mRNA was found already at embryonic day 3.5 (E3.5) and the level of expression was significantly decreased between E3.5 and hatching. Roughly similar levels of NLK mRNA were found in all tissues of the E8 embryo analyzed with the exception of the brain, which contained only low levels. When the developmental expression was analyzed in different tissues separately, NLK mRNA expression was found to decrease during development in the heart and bursa of Fabricius, whereas the level of mRNA in the brain showed a large increase shortly after hatching. The spinal cord and the pectoral and femoral muscles all showed high levels of NLK mRNA throughout development. In the adult chick, the highest levels of NLK mRNA were found in the muscle, brain, and kidney, where the NLK mRNA was estimated to account for approximately 0.1% of the total mRNA in these tissues. A widespread expression of NLK mRNA was observed in the adult brain with approximately similar levels in all brain regions tested. Similar results were also obtained when NLK mRNA expression was analyzed in adult rats. Our results show that developmental expression of the NLK gene is independently regulated in different tissues. The widespread and abundant expression of both the avian and rodent NLK gene is in accordance with its newly discovered identity as a glycolytic enzyme. Consequently, the developmental and adult pattern of NLK mRNA expression does not favour a specific trophic role for this protein in accordance with other known neurotrophic factors. PMID- 2754763 TI - Aged adrenal medullary tissue survives intraocular grafting, forms nerve fibers and responds to nerve growth factor. AB - Adrenal medullary tissue from aged (24 months old) and young adult (2 months old) rats was grafted to the anterior chamber of the eye of previously sympathectomized animals. Nerve growth factor (NGF) was administered by weekly bilateral intraocular injections. Five weeks postgrafting, irides were prepared as whole mounts and processed for Falck-Hillarp histochemistry for visualization of catecholamines. NGF appeared to partially prevent the reduction in volume that both old and young grafts underwent. In the presence of NGF, an extensive, dense fiber network, closely resembling the normal adrenergic innervation, was formed in the host irides by grafts from aged donors. The area of outgrowth from aged transplants without NGF treatment was as large as with NGF treatment but less dense. The reinnervation of irides by NGF-treated young adult grafts occupied a similar area as that seen with aged grafts, but the pattern of innervation was irregular, particularly close to the transplants. Transplants from young adult donors without NGF treatment generated a sparse, limited network of nerves in the irides. All grafts were tyrosine hydroxylase-, adrenaline-, and dopamine-beta hydroxylase-immunoreactive in about the same proportion of cells, but the grafts from the young donors were smaller in size. We concluded that the ability of chromaffin cells to transform toward a neuronal phenotype, produce nerve fibers, and respond to exogenous NGF is maintained in aged adrenals. PMID- 2754764 TI - Implantation of rabbit embryo brain fragments into newborn mice: integration and survival of xenogeneic astrocytes. AB - Brain fragments containing embryonic rabbit glia were implanted into the brains of newborn mice. The hosts developed an astroglial reaction around the transplants and along the needle tracks. Transplant-derived astrocytes were identified in the operated brain by their expression of rabbit GFAP. During the first few days post-implantation (PI) glial cells were exchanged between the transplant and the host. Less than 3 to 5 days PI, the transplant was extensively invaded by host astrocytes. Xenogeneic astroglial cells were first detected 10 days PI in the immediate proximity of the transplant. At 2 to 11 weeks, they could be detected either close to or at distance from the point of implantation. Most often, transplant-derived astrocytes presented a morphology similar to that of neighboring host astrocytes. Xenogeneic glial cells were found to participate in various types of astroglial features: sub-pial, pericapillary, fibrous, and protoplasmic. This morphological integration suggests that they are physiologically integrated, at least to a certain degree, in the host tissue. In spite of their integration into the host, xenogeneic astrocytes disappear after 3 months without signs of an inflammatory reaction. PMID- 2754765 TI - Purification and culture of adult rat dorsal root ganglia neurons. AB - To study the trophic requirements of adult rat dorsal root ganglia neurons (DRG) in vitro, we developed a purification procedure that yields highly enriched neuronal cultures. Forty to fifty ganglia are dissected from the spinal column of an adult rat. After enzymatic and mechanical dissociation of the ganglia, myelin debris are eliminated by centrifugation on a Percoll gradient. The resulting cell suspension is layered onto a nylon mesh with a pore size of 10 microns. Most of the neurons, the diameter of which ranged from 17 microns to greater than 100 microns, are retained on the upper surface of the sieve; most of the non-neuronal cells with a caliber of less than 10 microns after trypsinization go through it. Recovery of neurons is achieved by reversing the mesh onto a Petri dish containing culture medium. Neurons to non-neurons ratio is 1 to 10 in the initial cell suspension and 1 to 1 after separation. When these purified neurons are seeded at a density of 3,000 neurons/cm2 in 6 mm polyornithine-laminin (PORN-LAM) coated wells, neuronal survival (assessed by the ability to extend neurites), measured after 48 hr of culture, is very low (from 0 to 16%). Addition of nerve growth factor (NGF) does not improve neuronal survival. However, when neurons are cultured in the presence of medium conditioned (CM) by astrocytes or Schwann cells, 60-80% of the seeded, dye-excluding neurons survive. So, purified adult DRG neurons require for their short-term survival and regeneration in culture, a trophic support that is present in conditioned medium from PNS or CNS glia.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2754766 TI - Anthropometric parameters of Zambian infants at birth. AB - Mean, standard deviations, and percentile values for weight, length, head, chest, and mid-arm circumferences were calculated by measuring 2353 'normal' singleton babies born at University Teaching Hospital (UTH), Lusaka, Zambia. The mean values were as follows: birth weight 3.08 +/- 0.40 kg; crown-heel length 48.57 +/ 2.53 cm; head circumference 34.55 +/- 1.57 cm; chest circumference 32.14 +/- 1.92 cm; and mid-arm circumference 10.68 +/- 0.96 cm. Physical measurements increased with increase in gestational age up to 42 weeks and male babies were larger than their female counterparts. PMID- 2754767 TI - Vitamin A levels and mortality among hospitalized measles patients, Kinshasa, Zaire. AB - Treatment with high dose vitamin A has recently been recommended for children with measles in communities where vitamin A deficiency is a recognized problem. However, the relationship between vitamin A and measles mortality has not been clearly established. We studied serum vitamin A levels in 283 children less than or equal to 5 years of age admitted to Mama Yemo and Kalembe Lembe Hospitals in Kinshasa, Zaire, between January and March, 1987. Vitamin A levels were determined by high performance liquid chromatography. Vitamin A levels ranged from less than 5 to 63 micrograms/dl (median, 8). The overall case-fatality rate was 26 per cent. On univariate analysis, age less than 24 months, pneumonia on admission, lymphopenia (less than 2000/mm3), and lower vitamin A levels were associated with death during hospitalization. In a multivariate logistic regression model, a vitamin A level less than 5 micrograms/dl was associated with fatal outcome for children younger than 24 months old (relative risk = 2.9, 95 per cent CI 1.3, 6.8), but not for older children. Further studies are needed to determine whether low vitamin A levels predispose children to severe measles and the role of vitamin A supplements in the prevention of measles mortality. PMID- 2754768 TI - Study of EEG and CT scan in neurologically normal cases of focal convulsions. AB - Twenty-three neurologically normal children with focal convulsions were studied with EEG and CT scan. Thirty-five per cent had an abnormal CT scan. Lesions of potential therapeutic significance were seen in 30 per cent of all scans. Abnormalities detected on CT scans were as follows: tuberculomas, five cases; acute infarct, one case; gliosis, one case; multiple cortical cysts, one case. All the cases with intracranial tuberculomas were aged more than 5 years. A good correlation was found between the EEG and the CT scan findings. Maximum percentage (57 per cent) of CT scan abnormality was seen in cases exhibiting focal abnormality on EEG and minimum percentage in those with a normal EEG (18 per cent). PMID- 2754769 TI - Mothers in an urban township in Zambia. AB - Two hundred and forty-nine mothers living in an urban township were followed at their home from delivery for 1 year. Sixty-four families were lost to follow up due to moving house. The neonatal mortality was 50.6 per thousand and the infant mortality 118 per thousand live births. Child loss increased after parity 8 of the mother. The mean (SD) weight of mothers was 56.8 kg (8.8), the mean height 157.8 cm (6.1) and the mean ponderal index 22.53 (3.51). The mid-arm circumference was 26.1 cm (2.8). Body size varied considerably with around 10 per cent of mothers being undernourished and 10 per cent obese. Weight and mid-arm circumference generally decreased after 6 months post-partum. Breast feeding became less frequent after 8 months and by a year four babies had stopped receiving any breast milk. Average birth intervals were around 30 months, but thirty-seven mothers (20 per cent of multiparous mothers) had intervals of less than two years often following the loss of a previous child. Women generally received less education than their husbands with 35 (17 per cent) having had no education and only 23 (11 per cent) with some secondary education. Thirty-five mothers (18 per cent) had no men living at home with them although some fathers provided support. By one year fifteen fathers had abandoned the mother. Incomes of most families were insufficient and half the mothers worked, usually by selling food at the market or outside their homes.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2754770 TI - Longitudinal study in biochemical composition of human milk during first year of lactation. AB - The composition (total solids, total protein, casein, coagulable proteins, lactose, fat, and ash) and mineral content (calcium, phosphorus, sodium, potassium, magnesium, zinc, and copper) of human milk was estimated longitudinally for the first year of lactation. Concentration of various nutrients, except zinc and copper, remained nearly constant throughout the first year of lactation and did not show any specific trend of variation. Zinc and copper decreased linearly in the first 6 months. Milk composition was found identical to the data reported from developed countries. PMID- 2754771 TI - Infant mortality in Madura, Indonesia. Implications for action. AB - Infant mortality by age at death and birth weight was assessed in a prospective, population-based study in Madura, East Java. Even after elimination of neonatal tetanus by vaccination during pregnancy as a major cause of death, the infant mortality rate was high, viz. 121 per 1000 live births. The majority of live born infants died in the first 6 months of life. Birth weight was the best practical indicator of survival. The implications for Primary Health Care are discussed. PMID- 2754772 TI - Brazil's progress towards meeting WHO goal of health for all by the year 2000. PMID- 2754773 TI - Mortality from neonatal tetanus in Ilorin: results of a community-based survey. PMID- 2754774 TI - Acute respiration infections in childhood: tackling the problem at the level of the nose. PMID- 2754775 TI - Magnitude of ARI--a hospital based experience. PMID- 2754776 TI - Health in childhood and later performances. PMID- 2754777 TI - Assessment of MCH services in the district of Solenzo, Burkina Faso. II. Acceptability. AB - Acceptability of professional MCH services in the district of Solenzo was assessed using the techniques of time and motion study combined with a user survey of attending mothers. A large proportion of mothers said to have difficulty in using the services. Three types of problems were identified and their relevance discussed: (i) wasting mothers' time through inappropriate opening hours, long waiting time in contrast with short contact time; (ii) organizational features, i.e. fragmentation of clinics offering single MCH components at different times; and (iii) staff behaviour, i.e. poor communication with users. While services do little to help mothers to utilize them, mothers were shown to receive little support in their work at home from their families while attending the clinic. Possible ways to increase acceptability of MCH care are outlined. PMID- 2754778 TI - Assessment of MCH services in the district of Solenzo, Burkina Faso. III. Effectiveness of MCH services in detecting of and caring for mothers and children at risk. AB - A time and motion study was carried out in all five professional MCH-facilities in the study area. The chain of decision making process--from (i) collecting information, (ii) interpreting it as indicating risk to (iii) action--was followed while taking care not to interfere with it. At each step specific shortcomings were identified: a great number of commonly accepted risk factors was not looked for (e.g. outcome of previous pregnancies in a woman in labour). On the other hand, information indicating risk was collected, but not recognized as such (e.g. weight loss). The most striking feature of both under fives' (UFC), antenatal clinics (ANC) and maternity care was the consistent lack of any action taken as a consequence of a recognized risk factor. The possible underlying causes for the poor functioning of the risk approach in the studied peripheral services are discussed: (i) implementation failure, (ii) inappropriateness of cut off points for risk definition leading to an unmanageably great proportion of risk clients, and (iii) a conceptual problem, i.e. the reluctance of the auxiliary staff as well as the patients to act on the basis of risk prediction, i.e. something that has not yet happened. PMID- 2754779 TI - Assessment of MCH services offered by professional and community health workers in the district of Solenzo, Burkina Faso. I. Utilization of MCH services. AB - A representative household survey of a district of Burkina Faso was carried out in order to study the utilization of trained birth attendants (TBA) versus professional health workers as providers of under fives' (UFC), antenatal (ANC), and maternity care (MC). Overall utilization by the target groups varied between 13 per cent (UFC), 31 per cent (ANC), and 32 per cent (MC). The presence of a village health post did not increase utilization of MCH care. Furthermore, those who did utilize, preferred to choose another source of care: the professional midwife for ANC, the traditional 'old woman' for delivery. Sick infants were generally not taken to the village health worker (VHW), but rather treated by the family itself. The determinants of utilization were assessed by means of multivariate analysis. The level of care offered in the village (health post, dispensary, and medical centre), educational level of both the mother and the husband, and ethnic group were identified as major factors influencing health seeking behaviour in MCH. A strong case is made for improvement of quality of care before extension of geographical coverage. The importance of involving husbands in sensitization for the utilization of MCH-care is stressed and the implications are discussed for the role of the community health workers in caring for mothers and children. PMID- 2754780 TI - Source apparently as important as content of some genes. PMID- 2754781 TI - Characterizing healthy adolescent development; distinguishing it from possible disturbances. PMID- 2754782 TI - From the Centers for Disease Control. HIV infection reporting--United States. PMID- 2754783 TI - From the Centers for Disease Control. Counseling and testing intravenous-drug users for HIV Infection--Boston. PMID- 2754784 TI - The outcome of surgery in patients more than 90 years old. PMID- 2754785 TI - Ciprofloxacin levels when receiving sucralfate. PMID- 2754786 TI - The taxes of sin: do smokers pay their way? PMID- 2754787 TI - Pseudomembranous colitis associated with single-dose cephalosporin prophylaxis. PMID- 2754788 TI - Does anesthesia contribute to operative mortality? PMID- 2754789 TI - Congenital syphilis and necrotizing funisitis. PMID- 2754790 TI - Functional status and well-being of patients with chronic conditions. Results from the Medical Outcomes Study. AB - Enhancing daily functioning and well-being is an increasingly advocated goal in the treatment of patients with chronic conditions. We evaluated the functioning and well-being of 9385 adults at the time of office visits to 362 physicians in three US cities, using brief surveys completed by both patients and physicians. For eight of nine common chronic medical conditions, patients with the condition showed markedly worse physical, role, and social functioning; mental health; health perceptions; and/or bodily pain compared with patients with no chronic conditions. Each condition had a unique profile among the various health components. Hypertension had the least overall impact; heart disease and patient reported gastrointestinal disorders had the greatest impact. Patients with multiple conditions showed greater decrements in functioning and well-being than those with only one condition. Substantial variations in functioning and well being within each chronic condition group remain to be explained. PMID- 2754791 TI - The functioning and well-being of depressed patients. Results from the Medical Outcomes Study. AB - We describe the functioning and well-being of patients with depression, relative to patients with chronic medical conditions or no chronic conditions. Data are from 11,242 outpatients in three health care provision systems in three US sites. Patients with either current depressive disorder or depressive symptoms in the absence of disorder tended to have worse physical, social, and role functioning, worse perceived current health, and greater bodily pain than did patients with no chronic conditions. The poor functioning uniquely associated with depressive symptoms, with or without depressive disorder, was comparable with or worse than that uniquely associated with eight major chronic medical conditions. For example, the unique association of days in bed with depressive symptoms was significantly greater than the comparable association with hypertension, diabetes, and arthritis. Depression and chronic medical conditions had unique and additive effects on patient functioning. PMID- 2754792 TI - Treatment-induced blood pressure reduction and the risk of myocardial infarction. AB - To examine the relationship between degree of treatment-induced blood pressure (BP) reduction and myocardial infarction, the experience of 1765 previously untreated, mild to moderate hypertensives (initial BP greater than or equal to 160 and/or greater than or equal to 95 mm Hg) in a systematic treatment program was reviewed. Over an average of 4.2 years, there were 39 morbid or fatal myocardial infarctions. Three types of fall in diastolic BP (final minus pretreatment) were defined: small (less than or equal to 6 mm Hg), moderate (7 to 17 mm Hg), and large (greater than or equal to 18 mm Hg). By Cox regression, an association was observed between myocardial infarctions and both a large and a small fall, relative to a moderate decline. Age and sex were independent risk factors. Body mass index, cholesterol level, electrocardiogram, race, prior cardiovascular disease, smoking status, initial and final revisit BP, total intreatment BP, and systolic BP were not. Since both a large and small reduction in diastolic BP were associated with a higher incidence of myocardial infarction (relative to a moderate fall), perhaps a moderate reduction in diastolic BP should be the goal of treatment for mild and moderate hypertensives. PMID- 2754793 TI - The Medical Outcomes Study. An application of methods for monitoring the results of medical care. AB - The Medical Outcomes Study was designed to (1) determine whether variations in patient outcomes are explained by differences in system of care, clinician specialty, and clinicians' technical and interpersonal styles and (2) develop more practical tools for the routine monitoring of patient outcomes in medical practice. Outcomes included clinical end points; physical, social, and role functioning in everyday living; patients' perceptions of their general health and well-being; and satisfaction with treatment. Populations of clinicians (n = 523) were randomly sampled from different health care settings in Boston, Mass; Chicago, Ill; and Los Angeles, Calif. In the cross-sectional study, adult patients (n = 22,462) evaluated their health status and treatment. A sample of these patients (n = 2349) with diabetes, hypertension, coronary heart disease, and/or depression were selected for the longitudinal study. Their hospitalizations and other treatments were monitored and they periodically reported outcomes of care. At the beginning and end of the longitudinal study, Medical Outcomes Study staff performed physical examinations and laboratory tests. Results will be reported serially, primarily in The Journal. PMID- 2754794 TI - The 1988 Bethesda System for reporting cervical/vaginal cytological diagnoses. National Cancer Institute Workshop. PMID- 2754795 TI - Lymphocytic enterocolitis in patients with 'refractory sprue'. AB - We describe a patient with refractory sprue with malabsorption, a flat small bowel biopsy specimen unresponsive to a gluten-free diet, and colonic biopsy specimens consistent with lymphocytic (microscopic) colitis. To investigate further the relation between celiac disease and lymphocytic or collagenous colitis (a similar and possibly related entity), we examined colorectal and small bowel biopsy specimens in patients indexed histologically as having celiac disease who have been seen at The Johns Hopkins Hospital since 1958. Of 135 indexed patients, 21 had colorectal biopsies. Colorectal biopsy specimens were abnormal in 7 of the 21 patients. Four patients had biopsy specimens resembling lymphocytic colitis, 2 patients had acute colitis, and another patient had both lymphocytic and acute colitis. No patients had collagenous colitis. Three of the patients with lymphocytic colitis and celiac-like changes of the small bowel never responded to a gluten-free diet and may represent a distinctive panintestinal disease for which the term "lymphocytic enterocolitis" with malabsorption is proposed. PMID- 2754796 TI - Cytopathological interpretation and medical consultation. PMID- 2754797 TI - The Medical Outcomes Study. PMID- 2754798 TI - The intraepithelial lesion: a spectrum of problems. PMID- 2754799 TI - Providing reliable medical information to the public--caveat lector. PMID- 2754800 TI - A piece of my mind. Partner in crime. PMID- 2754801 TI - [Automated fluorogenic method for hypercoagulability]. PMID- 2754802 TI - [Platelet function and intracellular Ca2+ mobilization, especially with regard to morphological abnormalities]. PMID- 2754803 TI - [Recent progress on analysis of blood coagulation factors and fibrinolytic agents; fibrinopeptide A]. PMID- 2754804 TI - [FDP-E--quantitative analysis by LPIA (latex photometric immunoassay) method]. PMID- 2754805 TI - [A new method for determination of DD/E complex using latex agglutination]. PMID- 2754806 TI - [Recent progress on analysis of blood coagulation factors and fibrinolytic agents; FDP D dimer analysis using NANOPIA FDP]. PMID- 2754807 TI - [Recent progress on analysis of blood coagulation factors and fibrinolytic agents; measurement with new synthetic substrate method]. PMID- 2754808 TI - [Recent progress on analysis of blood coagulation factors and fibrinolytic agents; new synthetic chromogenic substrate assays for hemostatic parameters]. PMID- 2754809 TI - [Recent progress on analysis of blood coagulation factors and fibrinolytic agents; protein C]. PMID- 2754810 TI - [Heparin and platelet; reference to heparin induced thrombocytopenia]. PMID- 2754811 TI - [Reduced platelet aggregation in hereditary haemorrhagic telangiectasia]. PMID- 2754812 TI - [Analysis of abnormal fibrinogens--introduction of new strategies]. PMID- 2754813 TI - [Blood coagulation factor IX/factor X-binding proteins with anticoagulant activity]. PMID- 2754814 TI - [Platelet-activating factor producing cell--target cell interactions]. PMID- 2754815 TI - [Localization of spinal tumors by MRI]. AB - Exact localization of the spinal tumors is particularly important for differential diagnosis and surgery. Therefore, it was attempted to evaluate the diagnostic accuracy of MRI in localizing the spinal tumors exactly. Nineteen cases of spinal cord tumors, being localized in the intradural extramedullary, extradural and both intradural and extradural spaces, were studied with MRI. Intradural extramedullary tumors showed small CSF spaces just below and above the tumor which were demonstrated as CSF intensity on T1 and T2 weighted images. Although extradural tumors did not show CSF spaces, there was extradural sign or dural density between the tumor and the spinal cord. Intradural and extradural tumors were outlined as having both characteristics. Signal intensities of the spinal tumors were not characteristic for specific histology. Gd-DTPA was quite useful for accurate localization of the tumors. In comparison with myelography, MRI was superior to myelography in extradural tumors and equally useful for intradural and extradural tumors, but it was less diagnostic in intradural extramedullary tumors. In general, MRI was quite useful in localizing the spinal tumors exactly and the accuracy of MRI was quite high. In the near future this technique will replace myelography and other radiologic methods. PMID- 2754816 TI - [The anatomy and pathology of the brain stem demonstrated by thin slice CT cisternography]. AB - We demonstrated normal CT anatomy of the brain stem and adjacent structures using thin slice CT cisternography. Reducing the streak artifact caused by bony structures, thin slice CT cisternography can visualize the detailed features of the brain stem and its pathological changes. In addition, reconstructed images are also useful in diagnosis. PMID- 2754817 TI - [Angiographic findings of gallbladder cancer]. AB - The patients with gallbladder cancer often accompany with chronic cholecystitis. This fact leads angiographic diagnosis difficult. So the angiographic findings of the chronic cholecystitis are first analyzed precisely and subtracting the angiographic findings of the gallbladder cancer from these gives us the pure (true) angiographic findings of the gallbladder cancer. Characteristic angiographic findings of the gallbladder cancer only are stretched cystic artery encasement (27/37 cases) and short straight tumor vessels "bristly vessel" (36/37 cases). PMID- 2754818 TI - [CT appearance of uterine adenomyosis]. AB - CT findings in 37 cases with pathological diagnosis of uterine adenomyosis were reviewed retrospectively. The attenuation coefficient of adenomyosis is almost same as normal parenchyma on both plain and enhanced CT. The margin was obscure except for one case. In focal type, deviation of the endometrium and deformity of the uterus may be a clue to the detection of adenomyosis. But differential diagnosis of adenomyosis from leiomyoma with ill-defined margin was very difficult. In diffuse type, the uterine body is swollen without deviation of the endometrium. This type can be diagnosed if the endometrium identified clearly. PMID- 2754819 TI - [Excretory urography with non-ionic contrast medium; clinical reassessment of the necessity of water deprivation]. AB - The prospective study was performed to reassess the necessity of water deprivation before excretory urography (IVP) with non-ionic contrast medium. 35 adults were deprived of water before IVP and divided into two groups. First group was received 250 ml 5% glucose solution and lopamidol-300 (1 ml/kg, maximum dose; 50 ml). Second group received contrast medium only. Image quality of IVP of the two groups were compared. In the first group the visualization of ureter and bladder were better than the second group. There was no significant difference in the caliceal and pelvic visualization between the two groups. Water deprivation was suggested to be unnecessary in IVP with non-ionic contrast medium. PMID- 2754820 TI - [Clinical experience of hyperthermia in malignant tumors]. AB - Results in 44 cases of malignant tumors treated by localized radiofrequency hyperthermia are presented. All patients had either one or more failed attempts at conventional therapy or had such advanced disease at presentation that control with conventional modalities was considered unlikely. Hyperthermia were used together with radiation in 42 patients with chemotherapy in 1 patient, and alone in 1 patient. The overall response (CR plus PR) was 50% including a 18% complete response. Tumor response was somewhat better for superficial tumors. We retrospectively have analyzed the association between tumor response and histology, tumor size, temperature, radiation dose and total number of heat sessions. Clinical factors influencing the tumor response were initial tumor size and intratumor temperature. The incidence of overall response increased with a decrease in initial tumor size and an increase of intratumor temperature. PMID- 2754821 TI - [McKusick-Kaufman syndrome]. PMID- 2754822 TI - [Usefulness of factor analysis of the kidney in congenital hydronephrosis]. PMID- 2754823 TI - [Report of a case of intracranial metastases from malignant spinal cord astrocytoma]. AB - A 22-year-old female with intracranial metastases after partial removal of malignant spinal cord astrocytoma followed with radiation therapy was reported. 20 cases of spinal cord astrocytoma with intracranial metastases were reviewed. Almost all cases were malignant. Malignant spinal cord astrocytoma seems to have much tendency to metastasize to the brain. PMID- 2754824 TI - [MRI findings of locked-in syndrome--a case report]. AB - We report a case of Locked-in syndrome caused by thrombus in basilar artery resulting in a brainstem infarction in the ventral pons, magnetic resonance imaging (MRI) shows abnormal signal intensity regions in the ventral pons and basilar artery clearly. PMID- 2754825 TI - [Infected chronic subdural hematoma due to an ethmoiditis; a case report]. AB - The patient was a 50-year-old female, and the initial symptoms were disturbance of consciousness and fever. CT scan showed a chronic subdural hematoma and left ethmoiditis. Emergency surgery disclosed infected chronic subdural hematoma. We classified this as infected chronic subdural hematoma caused by ethmoiditis. PMID- 2754826 TI - [Yersinia enterocolitis--report of two cases]. AB - We reported two cases of terminal ileitis caused by Yersinia enterocolitica (Y.e.). Y.e. was proven by stool culture in each case. They were admitted to the hospital complaining abdominal pain. They are examined by X-ray and endoscopy in the different time, and their examination revealed edema, coarse mucosa and varioliform elevated lesions with the passage of time. PMID- 2754827 TI - [Role of lipid peroxidation and polymorphonuclear leukocytes-derived oxygen radicals in acute gastric lesions induced by hyperthermic treatment]. AB - Acute gastric lesions were experimentally induced by local hyperthermic treatment (42 degrees C, 40 min). Thiobarbituric acid (TBA) reactants in the gastric mucosa were significantly increased 40 min after the hyperthermia. There were no changes in gastric mucosal blood flow and gastric acid secretion. The total area of gastric erosions and TBA reactant in gastric mucosa of rats deficient in vitamin E were significantly increased compared with those of rats supplemented with vitamin E. The increase in the total area of gastric erosions and TBA reactants in gastric mucosa were significantly inhibited by the treatment of bovine Cu, Zn SOD and bovine catalase, and by the depletion of polymorphonuclear leukocytes (PMN). Allopurinol did not show any influence on these pathological changes induced by hyperthermia. These results suggest that lipid peroxidation and PMN derived oxygen radicals may play an important role in the pathogenesis of gastric lesions induced by hyperthermic treatment. PMID- 2754828 TI - [Effects of indomethacin on cellular resistance and synthesis of prostaglandins in epithelial cells isolated from rat gastric mucosa]. AB - This study was done to test effects of indomethacin (IND) on cell damage and prostaglandin (PG) synthesis in mucosal epithelial cells isolated from rat stomach in vitro. IND caused the cell damage in a dose-related way at concentrations over 5 X 10(-4) M. This damage was inhibited by 16,16-dimethyl PGE2 (10(-6) M). IND abolished the synthesis of PGE2, PGI2, and TXA2 at the concentration of 10(-4) M at which IND alone did not cause cell damage. The cells treated with 10(-4) M IND were significantly susceptible to damage caused by 15% ethanol compared to the cells not treated with IND. 16,16-Dimethyl PGE2 also inhibited the damage caused by IND + ethanol. These results suggest that the IND induced susceptibility of the cells to damage is related to PG deficiency. PMID- 2754829 TI - [Analysis with immunoreactive CCKs and bioactive CCKs in rat duodenum and brain]. AB - We extracted immunoreactive CCKs from rat duodenum and brain. We fractionated these samples by gel-filtration and analyzed with immunoreactivity and bioactivity of each fraction. 1) Elution profile of CCKs in duodenum and brain was well corresponding to that of bioactive CCKs. 2) Contents of CCKs determined by both RIA and Bioassay in each fraction were well correlated with each other. 3) Apparent molecular weights of CCKs of duodenum calibrated in column chromatography were approximately 2200, 1000 and 800. 4) Apparent molecular weight of CCK of brain seemed to be 1000. PMID- 2754830 TI - [Immunological studies on the patients with Crohn's disease and a new attempt of interferon treatment]. AB - Natural Killer cell activity and lymphocyte subset in peripheral blood were studied in 16 patients with Crohn's disease. The effect of interferon administration was evaluated in 4 patients with Crohn's disease. In the patients with active Crohn's disease, natural killer cell activity was significantly lower in level compared to that in normal controls. Those without increase of natural killer cell activity in non-active stage, had trend of early relapsing. Peripheral lymphocyte subpopulations of OKT4, OKT8, OKIal, OKT4/8 and Leu7 by flow-cytometry showed no significant differences between the patients and the normal controls. Clinical remission was maintained in 2 out of 4 patients for the period from 7 to 21 months after the interferon administration. Benefit of interferon administration was suggested in patients with Crohn's disease. PMID- 2754831 TI - [Two cases of pachydermoperiostosis with peptic ulcers]. PMID- 2754832 TI - [A case of paroxysmal nocturnal hemoglobinuria which was aggravated by onset of type B acute hepatitis]. PMID- 2754833 TI - [Seven cases of acute exacerbation accompanied with icterus and ascites in chronic type B hepatitis]. PMID- 2754834 TI - [A case of chronic calcifying pancreatitis with serum CA19-9 levels markedly elevated due to the incarceration of the pancreatic calculi into the main pancreatic duct]. PMID- 2754835 TI - [The prophylactic effect of haptoglobin administration on renal disfunction in endoscopic injection sclerotherapy]. PMID- 2754836 TI - [The studies on the blood supply of metastatic liver tumor induced by VX2 using BrdU]. PMID- 2754837 TI - [An analysis of DNA histogram and the expression of carbohydrate antigens regarding the degree of malignancy in gastric cancer]. AB - We investigated both DNA histogram and the expression of carbohydrate antigens concerning to 168 patients with gastric cancer. Gastric cancer with type II DNA ploidy pattern showed a high incidence of vascular invasion and liver metastasis in the DNA analysis. Furthermore, ten patients with Stage II died of recurrence of gastric cancer within 2 years, of these nine patients showed type II or III DNA ploidy pattern. Then, gastric cancer with type II or III DNA ploidy pattern showed a high incidence of the expression of carbohydrate antigens, where they tended to distribute to cytoplasm and stroma. In conclusion, an analysis of nuclear DNA content appeared useful to predict prognosis in gastric cancer, in which type II DNA ploidy pattern showed the highest degree of malignancy, and both the expression of carbohydrate antigens and their localization possibly fill the role of parameter of the degree of malignancy. PMID- 2754838 TI - [Gastric mucosa in patients with fundic hyperplastic polyps]. AB - To assess the functional and morphological characteristics of the gastric mucosa of patients with fundic hyperplastic polyps (FP), the determination of gastric acid secretion, serum gastrin levels, serum pepsinogen 1 (PG1) levels and histological examination were undertaken in 24 patients with FP, 34 with foveolar hyperplastic polyps (HP) and 62 controls, who had no gastric lesions. The following were the results of our investigation. 1) There were no differences between the patients with FP and the controls as to gastric acid secretion, serum gastrin levels, and serum PG1 levels. On the other hand, hypochlorhydria, hypergastrinemia and hypopepsinogenemia were common in those with HP. 2) Histological examination using gastric biopsy specimens showed almost normal gastric mucosa in patients with FP. However, severe atrophic gastritis of the fundus was common in patients with HP. 3) It was shown that there were definite differences between the patients with FP and those with HP with regard to the gastric function and morphology, although both types of gastric polyp were histologically classified as hyperplastic. PMID- 2754839 TI - [Effect on uptake of D-glucose, L-leucine and L-leucylglycine into intestinal brush border membrane vesicles isolated from rats fed either oligopeptide or amino acid elemental diet]. AB - The uptake of D-glucose, L-leucine and L-leucylglycine into intestinal brush border membrane vesicles isolated from rats was investigated. They were fed either oligopeptide (SP group) or amino acid (AA group) elemental diets for four weeks. The results are as follows. As for L-leucine uptake, there was no significant difference in Km value between SP group and AA group. But Jmax value of SP group is significantly 1.7 times as large as that of AA group. As for L leucylglycine uptake, there was no difference in Km value between the two groups, but Jmax value of SP group is significantly about twice as large as that of AA group. There is however, no difference in Km value and Jmax value between the both groups. These results indicate that L-leucine and L-leucylglycine transport carriers in the brush border membrane significantly increased in SP group compared with that in AA group, and that these carriers might be induced by oligopeptides as intraintestinal substrate. PMID- 2754840 TI - [Clinical course and prognosis of primary biliary cirrhosis--multivariant analysis on cases of national survey]. AB - In order to predict prognosis and clinical course of BPC, theory quantification was applied and the discriminated rate was calculated concerning the cases of PBC national survey in Japan. We examined the prediction of three and five year's survival about all cases, the prediction of appearance of symptoms about asymptomatic PBC and that of jaundice about asymptomatic PBC and symptomatic PBC alone with pruritus. The useful items for the prediction of prognosis were serum bilirubin, albumin and the presence of esophageal varices at first medical examination. Fairly good discriminated rate was obtained on the prediction of three and five year's survival. However poor results were obtained concerning the prediction of appearance of symptoms. In conclusion we can predict the prognosis of PBC based on clinical features. PMID- 2754841 TI - [Effect of combined administration of HBs antigen and anti-HBs antibody on induction of anti-HBs antibody production in vitro and in vivo]. AB - It was considered that nonresponsiveness to hepatitis B surface antigen was in part due to a failure in the antigen recognition (i.e., antigens' phagocytosis, processing and presentation by accessory cells). In order to enhance the capture of antigens, we investigated the effect of simultaneous administration of HBs antigen and anti-HBs IgG on antibody responses in vitro and in vivo. As a result, in vitro sensitization of mononuclear cells from anti-HBs-positive subjects with HBs antigen and anti-HBs IgG induced significant amounts of anti-HBs IgG production in 5 of 6 cases, whereas sensitization with HBs antigen alone failed to induce the antibody production in most cases. In vivo administration of HBs vaccine and anti-HBs immunoglobulin to non-responders to the vaccine triggered active anti-HBs antibody responses in 3 of 7 cases in vivo and in 5 of 7 cases in vitro. PMID- 2754842 TI - [Predictive value of serum aminoterminal type III procollagen peptide levels, serum laminin levels, and liver membrane antibodies for prognosis of chronic hepatitis]. AB - Serum concentration of aminoterminal type III procollagen peptide (P3P) and laminin have been shown as serum markers of liver fibrosis. In addition, liver membrane antibody (LMA) is suggested to play a role in the pathogenesis of chronic hepatitis. However, it is not known whether these serum markers are useful to predict the prognosis of chronic hepatitis. To test this, we measured P3P, laminin, and LMA in sera at the time of liver biopsies in 43 patients with chronic hepatitis who had serial liver biopsies more than two times during the 2 81 months (mean 25 months) follow-up period. Serum contents of P3P and laminin were measured by radioimmunoassay. Serum LMA was measured by radioimmunoassay according to the method of Thomas et al. The histological grading of liver fibrosis and of inflammation were scored according to Histology Activity Index by Knodell et al. Among thirty-two patients who had liver biopsies during 12-55 months, 16 patients showed histological progression on their latest liver biopsies compared with the first biopsies (Group 1). At the first biopsies, serum P3P levels were significantly higher in Group 1 than in 16 patients without histological progression (Group 2) (p less than 0.05). However, no difference were observed in serum laminin levels and in serum LMA between the two groups. Serum laminin levels were significantly correlated with the histological scores of fibrosis (comparison chisq = 0.0089, df = 2, p = 0.995584) and inflammation (comparison chisq = 21.4103, df = 4, p = 0.000263), respectively. In addition, serum P3P levels showed no correlation with the histological scores.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2754843 TI - [Ontogeny of pancreatic gastrin cells in neonatal rat]. AB - It is well known that gastrin immunoreactive cells are observed in the fetal and postnatal rat pancreas. The role of the gastrin cells is unknown, however, it has been suspected that pancreatic gastrin may influence the development of pancreas and the gastrointestinal tract. The present study shows the localization of pancreatic gastrin cells and the ability of auto-proliferation of them in development. Gastrin cells were seen in 0-d to 2-wk-old rats in islet and in 0-d to 4-wk-old rats among exocrine cells. The ratio of gastrin cells to islet cells decreased in neonatal development and in rats older than 14-d gastrin cells were never observed in islet. Labeling indices of pancreatic gastrin cells after one injection of tritiated thymidine were 2.6% to 4.6% for 10 days after birth. It was suggested that gastrin cells have the ability of autoproliferation for 10 days after birth. PMID- 2754844 TI - [A case of achalasia with megacolon]. PMID- 2754845 TI - [A case of carcinosarcoma of the esophagus]. PMID- 2754846 TI - [A case of synchronous Borrmann 4 type cancer of the stomach and early cancer of papilla Vateri associated with acanthosis nigricans]. PMID- 2754847 TI - [A case of old traumatic intrahepatic hematoma]. PMID- 2754848 TI - [An autopsy case of autoimmune hepatitis with hepatolithiasis]. PMID- 2754849 TI - [A case of abnormal GOT]. PMID- 2754850 TI - [Clinical effect of biphenyl dimethyl dicarboxylate administration on chronic hepatitis]. PMID- 2754851 TI - [Enzyme-linked immunospot (ELISPOT) assay for detection of anti-HBs antibody secreting cells in peripheral blood]. PMID- 2754852 TI - [The ideal and the reality of environmental health]. PMID- 2754853 TI - [Studies of trichloroethylene-induced glycosuria: blood glucose and renal glucose reabsorption in rats exposed to trichloroethylene]. AB - In our previous experiments, a remarkable increase in urinary excretion of glucose was found in rats exposed to 821 ppm trichloroethylene for 12 wk. This was not accompanied with proteinuria, aminoaciduria, phosphaturia and definite histological changes in renal tubular structure. In order to ascertain the mechanism of the increase in urinary glucose excretion, blood glucose level and renal glucose reabsorption were studied in 10 male rats exposed to 783 ppm trichloroethylene for more than 3 wk. Another 10 male rats were studied as control. The following results were obtained: 1. Urine glucose of the trichloroethylene group increased after exposure for 2 wk. All the rats showed glycosuria (above 250 mg/dl) by the 4th week of exposure. 2. Plasma glucose levels were depressed by trichloroethylene to as low as 77% of that of the control group. Glycohemoglobin was similarly decreased. 3. Intravenous glucose tolerance tests (0.5 g/kg load) revealed that decreasing constant of plasma glucose (K value) was elevated by trichloroethylene, suggesting that induced hyperglycemia in the exposed rats improved more rapidly than in the controls. Trichloroethylene did not modify the secretion of insulin after glucose load, regardless of the depression in plasma insulin level before load. 4. Glucose titration tests revealed that tubular transport maximum for glucose (TmG) was decreased by trichloroethylene to as low as 46% of that of the control group. The ratio of TmG to glomerular filtration rate (the theoretical renal threshold for glucose) was also depressed to as low as 55% of that of the control group. The foregoing results indicate that trichloroethylene-induced glycosuria is attributable to deteriorated tubular reabsorption of glucose, and not to hyperglycemia. However, the mechanism for the selective disturbance of renal reabsorption of glucose is yet unknown. PMID- 2754854 TI - [Blood and urinary chromium concentration of workers engaged in chromate pigment production]. PMID- 2754855 TI - [Effect of Ni2O3 dust on the respiratory system]. PMID- 2754856 TI - [Urinary N-acetyl-beta-D-glucosaminidase activity in workers exposed to organic solvents]. PMID- 2754857 TI - [Depressive states in workers using computers]. PMID- 2754858 TI - [Deformity of the fingers among women workers at a papermaking mill]. AB - With regard to deformity of the fingers (chiefly Heberden's nodes) frequently occurring in Japan among workers preparing school lunches, an epidemiological study was carried out with a suspicion that this deformity might be an occupational disease. We studied the deformity of fingers among woman employees of a papermaking mill (262 mill workers in comparison with 108 office workers) who excessively use their fingers on the job like workers preparing school lunches. The results of this study showed that the number of mill workers suffering from deformity of the fingers (chiefly Heberden's nodes) was significantly (p less than 0.01) greater than that of office workers. Genetic factor, aging factor and mechanical factor have been cited as the etiological factors for the development of Heberden's nodes. However, our findings suggest that mechanical factor is a more important rather than the genetic or aging factor. As for mechanical factor, we have proposed for the first time that repetition of strong and precise pinching movement with the use of all fingers of both hands is an important factor. PMID- 2754859 TI - [Questionnaire survey of full-time occupational health physicians in Japan]. AB - In August 1987 the University of Occupational and Environmental Health conducted a mail questionnaire survey on occupational health physicians (OHPs) located throughout Japan. The objective was to obtain preliminary information concerning the actual situation of OHPs together with their opinions on post-graduate training in this field. A summary of the results based on 187 valid responses (valid response rate = 59.4%) is as follows: 1. Age distribution of the respondents was in excess of 55 years of age (mean age of 61.4 yr), suggesting aging of the work force. 2. Comparison of the present age with period in present position revealed that a significant proportion of the respondents assumed their current position following retirement from clinical service. 3. Routine work schedules such as clinical activities and making site visits within factory tended to be influenced by the number of employees. 4. Conduct of special physical examinations on workers in hazardous environments was rated the highest among the necessary abilities of OHPs. 5. It was found that 30-34 years of age and 2-5 years of clinical experience were the minimal qualifications for a full time OHP. PMID- 2754860 TI - [A tetrapolar circuit method using magnetic field for biological resistivity measurement]. AB - A local impedance and its change were measured using a tetrapolar circuit combined with magnetic eddy current generator. By this method, current distribution can be restricted to a desired part, so as to eliminate errors due to uncertainty of the resistance between the electrode and the skin. The resistivity of a substance in a biological model measured by this method was nearly equal to that of the substance separated from the model. Sensitivity and localization were assessed in the other model composed of a piece of metal plate in a saline pool. The detection sensitivity was validated theoretically. The localization of the impedance pulsatile waveforms, measured at the proximal part of the forearm, was consistent with that of the arteries at this part. These results suggest that this method using eddy current should expand the application area of bio-impedance measurements. PMID- 2754861 TI - [Mass flow anesthesia delivery system and its application]. AB - Microcomputer-based anesthesia delivery system using mass flow control devices has been developed. System is superior in computer control to conventional anesthesia machine because there is no mechanical setting. System consists of three thermal mass flow controllers (TMFC), one vapor source controller (VSC), personal computer system, and air circuits. Personal computer system has facilities of digital output, analogue input and analogue output interfaces. TMFCs and VSC are devices which operational principle is based on the thermal conductance and they are controlled by electrical signals from computer in the system. TMFCs control the mass flow of nitrous oxide, oxygen and carbon oxide according to each input voltage signal. VSC regulates mass vapor of halothane in order to keep set value up by means of alteration of oxygen carrier gas flow. Computer always monitors the gas flow of the TMFCs and VSC so that computer compensates the change of the carrier gas flow of VSC by regulating the TMFC for oxygen. Mixed gas from TMFCs and VSC is supplied through the air circuit to subject. Characteristics of the system was measured by mass spectrometer and flowmeter. Stability was 0.05% change after 30 minutes at the initial set of 3%. Experiment on animals using mongrel dogs has been performed to verify the system functions. PMID- 2754862 TI - [Development of laser systems in the treatment of hyperpigmented skin lesions]. AB - Laser beams have been in common use for the treatment of hyperpigmented skin lesions. However, therapeutic efficacy has been limited mainly because the output is circular with a Gaussian distribution of intensity, which makes it difficult to apply a uniformly distributed dose to the lesions. We have developed a technique whereby a laser beam is converted to have a square and uniform output intensity distribution. The principle of this technique is that the divergent laser beam enters a glass square pillar, propagates through the pillar repeating the total reflection and emerges with a uniform intensity distribution over the cross-section at the end of the pillar. The device applied this technique is incorporated in a hand-piece and both ruby and argon laser systems have been developed. The ruby laser has been used for the treatment of the melanistic skin lesions such as nevus cell nevus and nevus spilus. In clinical application, 36 of 67 cases have shown remarkably effective results with an improvement rate of 53.7%. The argon laser has been used for the treatment of vasogenic skin lesions such as portwine stain. In clinical application, 44 of 66 cases have shown effective results and the improvement rate is 66.7%. These results are excellent when compared with the other methods of treatment and with laser therapy previously used. PMID- 2754863 TI - [Development of passive telemetry system for intracranial pressure measurement with corrector of errors caused by temperature variation]. AB - A new passive telemeter for the intracranial pressure monitoring have been developed. The completely implantable pressure sensor used in this system consists of a crystal, a coil and a ferrite rod attached on a diaphragm. The pressure on the diaphragm alters the volume of air in the receptacle and then the ferrite rod moves in and out of the coil and alters the resonance frequency of the sensor. Although the sensor doesn't have a battery or other energy storer, for example, a capacitor, the resonance frequency can be measured without contact. Therefore, at any time, we can measure the intracranial pressure with this sensor implanted under the scalp beforehand. However, not only pressure but also temperature alters the resonance frequency of the sensor, because the volume of air alters in proportion to temperature. Hence, we have developed a new passive telemetry pressure sensor which contains a passive telemetry temperature sensor. The temperature sensor consists of a coil and a special crystal whose resonance frequency varies with ambient temperature and its resonance frequency can be measured in the same way that we measure the resonance frequency of pressure sensor from outside of the body. With this system, we can measure the intracranial pressure about 60 times per second and the intracranial temperature every 8 seconds. The measured value of the pressure was automatically corrected by analog temperature correcting electric circuits. In animal experiment, the output of this system was similar to one of the catheter-tip type pressure transducer and we could observe the intracranial pressure altered synchronizing with respiration and with heart beat. PMID- 2754864 TI - [Synthesis and evaluation of the adaptive control system for the ventricular assist device by using the circulatory system simulator]. AB - An on-line digital simulator using microcomputer system was developed to mimic the hemodynamic behavior of the human circulatory system under ventricular assist device (VAD) pumping. This simulator could calculate the response to the variation of the cardiac function or the driving mode of VAD in the real-time fashion. This simulator was used as the mock controlled object to evaluate and improve the algorithm of an adaptive controller of the drive unit for VAD. The adaptive one-step ahead controller was introduced as the precompensator for the PI-controller, which decides the outflow volume from VAD in order to follow up the reference flow value by changing the systolic duration. It was confirmed that the proposed adaptive control system improved the response speed of the VAD driving system automatically according to the variation of the controlled object. PMID- 2754865 TI - [Nursing of cancer patients undergoing chemotherapy--current and future problems]. PMID- 2754866 TI - [Nursing of cancer patients undergoing chemotherapy. Management of stomatitis after chemotherapy--use of wrap film to ease pain and promote healing]. PMID- 2754867 TI - [Factors affecting the gastrointestinal reactions to antineoplastic agents and management of the symptoms--nausea, vomiting, constipation, and diarrhea]. PMID- 2754868 TI - [Nursing of cancer patients undergoing chemotherapy. Management of alopecia from chemotherapy--introduction of scalp cooling treatment]. PMID- 2754869 TI - [Nursing of cancer patients undergoing chemotherapy. Cleansing methods during bone marrow suppression after chemotherapy]. PMID- 2754870 TI - [QOL (quality of life) of cancer patients hospitalized for a short period for chemotherapy]. PMID- 2754871 TI - [Nursing of a breast cancer patient undergoing adjuvant chemotherapy]. PMID- 2754872 TI - [Nursing of a patient with liver cancer following hepatic artery embolization]. PMID- 2754873 TI - [Nursing of a patient with testicular cancer undergoing chemotherapy--revelation of the nature of the illness during treatment]. PMID- 2754874 TI - [Nursing of a patient with ovarian cancer undergoing postoperative chemotherapy]. PMID- 2754875 TI - [Intra-arterial chemotherapy--with special reference to the treatment of gastrointestinal cancer]. PMID- 2754876 TI - [Nursing of a patient with ascites being treated with OK-432]. PMID- 2754877 TI - [Questions and answers on respiratory care. Respiratory care to suit patients' life patterns and associated nursing]. PMID- 2754878 TI - [Questions and answers on circulatory care. Accident prevention in patients using temporary pacing]. PMID- 2754879 TI - [Questions and answers on the care of the digestive system. Nursing following TAE (transarterial embolization) in hepatic cancer with a respiratory complication]. PMID- 2754881 TI - [Questions and answers on the care of the motor system. Early release of a patient following surgery of coxarthrosis]. PMID- 2754880 TI - [Questions and answers on the care in urology. Key points in nursing of an apprehensive patient scheduled for extracorporeal shock wave lithotripsy]. PMID- 2754882 TI - [Questions and answers on pediatric care. Nursing of a 4-year old child during infusion and blood specimen collection]. PMID- 2754883 TI - [Questions and answers on the care in gynecology and obstetrics. Approach to an adolescent patient with amenorrhea]. PMID- 2754884 TI - [Questions and answers on emergency care. Approach to an emergency case admitted after attempted suicide]. PMID- 2754885 TI - [Questions and answers on psychiatric care. Nursing process for a psychiatric patient]. PMID- 2754886 TI - [Postoperative critical care. Postoperative shock]. PMID- 2754887 TI - [Self-care following discharge. 3. Instructions to be given to patients with chronic respiratory insufficiency at the time of discharge--with special reference to oxygen inhalation therapy at home]. PMID- 2754888 TI - [Attempt at improvement of appetite during chemotherapy including cisplatin]. PMID- 2754889 TI - [Nursing research on self care of diabetic patients. 3. Knowledge of diabetes and ego status]. PMID- 2754890 TI - [Urinary bladder carcinogenicity of BBN in beige mice (Chediak-Higashi disease model)]. AB - To study the effect of natural killer (NK) activity on chemical carcinogenesis in urinary bladder cancer, beige mice (NK deficient mice) and C57BL/6 mice (NK normal mice) received N-bytyl-(4-hydroxybutyl) nitrosamine (BBN) in drinking water. The effect was evaluated by measuring the incidence of early neoplastic change in the urinary bladder. OK-432, a biological response modifier, was administered in drinking-water and its effect on carcinogenesis was evaluated. The beige and C57BL/6 mice were divided into two groups. Group A, C57BL/6 mice and group C, beige mice received 0.1% BBN in their drinking-water. Group B, C57BL/6 mice, and group D, beige mice, received 0.1% BBN and OK-432 (5KE/1000 ml) in their drinking-water for 4 weeks. The mice were sacrificed at 12, 14, 16, 18 and 24 weeks after BBN administration and the urinary bladder was examined histologically by light and scanning electron microscopy. In the light microscopic findings, all groups had no neoplastic change at 12, 14 and 16 weeks, although at 18 and 24 weeks, neoplastic changes were observed. The incidence at 18 weeks was 0/10 in in group B, 2/5 in group C and 3/6 in group D. (p less than 0.01 between beige and C57BL/6 mice at 18 weeks). In the scanning electron microscopic findings, cells with a cobble stone appearance, pleomorphic microvilli and short uniform microvilli on luminal surfaces are observed during carcinogenesis in urinary bladder.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2754891 TI - [Natural killer (NK) activity of peripheral blood and regional lymph nodes in patients with genitourinary malignant tumors. 1. NK activity of peripheral blood in patients with genitourinary malignant tumors]. AB - 51Cr-release assay is a popular method to measure the cytotoxicity of natural killer cells, so-called NK activity, but this assay includes trouble-some steps and management because of using radioisotope (RI) reagent. ATP-chemiluminescence assay (ATP assay), a new method, does not require RI. This assay measures intracellular adenosintriphosphate (ATP) volume by Luciferin-Luciferase reaction. In the research for this paper, the NK activity in 40 healthy donors, 40 patients with urological benign diseases and 39 patients with malignant tumors was measured by both 51Cr-release and ATP assay. The values obtained by these two methods showed a high correlation (r = 0.78). And the NK activity in patients with malignant tumors was lower in high stage patients than it was in low stage patients. These results proposed that ATP assay would be more suitable than 51Cr release assay for measuring not only NK activity but also the other cytotoxic tests, because ATP is present only in living cells and that, in patients with genitourinary malignant tumors, NK activity of peripheral blood would be a useful tumor marker. PMID- 2754893 TI - [Ureteral compliance of dilated ureters in dogs]. AB - Compliance and histological findings of dilated ureters in dogs were successively examined after partial ligature. Ureteral compliance was measured by the impedance method using a special probe. This probe, with a balloon at the tip, is equipped with two detecting electrodes and two generating electrodes. Adult mongrel dogs were anesthetized with pentobarbital, and the lower part of the extravesical ureter was partially ligated. At 1, 2, 4, 8, 12, and 26 weeks after ligature, ureteral compliance and histological findings were investigated. Moreover, the closure pressure and the initial cross sectional area of the dilated ureter were measured. The results of the study were as follows: 1) In the dilated ureter, compliance increased gradually for 8 weeks after ligature. However, compliance began to decrease at 12 weeks. 2) The ureteral closure pressure of the normal ureter was statistically higher than that of the dilated ureter. 3) The initial cross sectional area of the normal ureter was statistically lower than that of the dilated ureter. 4) Hypertrophy and hyperplasia of the muscle bundles were found in the dilated ureteral wall. 5) The stellate configuration of the ureteral epithelium almost disappeared 8 weeks after ligature. 6) The proliferation of connective tissues around the muscle bundles were observed 8 weeks after ligature. 7) Ureteral compliance increased in proportion to hypertrophy of the muscle. However, compliance decreased with the increase of the proliferation of connective tissues. These results indicated that the decrease in compliance caused by the proliferation of the connective tissues was one of the reasons for dysfunction of urine transport in the dilated ureter.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2754892 TI - [Studies on recent clinically isolated Staphylococcus aureus--drug susceptibility and incidence of MRSA in clinical isolates]. AB - Susceptibility of various antimicrobial agents against clinically isolated Staphylococcus aureus was evaluated by Kirby Bauer methods. The incidence of MRSA (Methicillin cephem resistant Staphylococcus aureus) was also investigated. When S. aureus was isolated from urine, the clinical background of the case was further studied. The results are listed below; 1) M1N0 showed the highest susceptibility rate (83.1%) against 537 strains of S. aureus tested, followed by CMZ (63.7%) and CET (63.5%). The susceptibility rate of DMPPC was 41.9%. The incidence of MRSA was 31.3%. 2) In effusion, MRSA was most highly isolated (72.2%). 3) S. aureus isolated from blood and sputa was relatively more resistant to beta-lactams. 4) Strains from urine showed relatively high susceptibility rates. No MRSA was isolated from urine. 5) Thirteen out of twenty-four cases, whose urines were proven to be S. aureus positive, were polymicrobial infection patients. PMID- 2754894 TI - [Clinical significance of phosphaturia]. AB - From September 1986 to August 1987, heavy precipitation of amorphous calcium phosphate, that is phosphaturia, was found at our outpatient clinic in 153 postprandial urine specimens from 115 patients, in 1.5% of all the specimens examined during this period. One patient was excluded because he had both urolithiasis and urinary tract infection. The remaining 152 specimens with phosphaturia were then divided into 3 groups; Group I from patients with urolithiasis, Group II from patients with urinary tract infection and Group III from patients without either urolithiasis or urinary tract infection (Phosphaturia Group, Table 1). It is evident from this table that phosphaturia is repeated more frequently in patients with urolithiasis than in patients without urolithiasis (p less than 0.01). 200 urine specimens examined during this period were selected randomly. Three bloody or purulent specimens were excluded. The remaining 197 specimens from 189 patients were divided into 3 groups, as in the phosphaturia group (Control Group, Table 2). When the proportion of the number of specimens to the total is compared between the phosphaturia group and the control group, it is clear that phosphaturia is found more frequently in specimens from patients with urolithiasis than in specimens from patients without urolithiasis (p less than 0.01). Since phosphaturia was almost always found in the specimens with urine pH greater than or equal to 7, 486 patients, in whom the pH of the first urine specimen was equal to or above 7, were selected from among 1434 patients undergoing urinalyses during this period and divided into 3 groups as has been described above (Table 3).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2754895 TI - [Treatment of congenital urethral stenosis (urethral ring) in children. Optic internal urethrotomy in the congenital bulbar urethral stenosis in boys]. AB - Congenital urethral stenosis in boys occurs at the junction of the entodermal primary urethra and ectodermal secondary urethra. Endoscopically this lesion is recognized as a ring-form stenosis just distal to the external urethral sphincter. It has been considered as rare congenital anomaly in American literature. But in our experience congenital urethral stenosis is an important cause of recurrent urinary tract infections, enuresis, pollakisuria or hematuria in pediatric urological practice. It also disturbs spontaneous healing of vesicoureteral reflux. The most effective treatment of this lesion is optic internal urethrotomy under direct vision. We would like to report our experience of optic internal urethrotomy for congenital urethral stenosis in boys. From 1974 to 1986, 226 boys with congenital bulbar urethral stenosis were treated in our clinic. Optic internal urethrotomy was performed using a Sachse urethrotome with a 10 or 13 Fr. sheath. Of the 176 ureters with vesicoureteral reflux, spontaneous disappearance of reflux after optic internal urethrotomy was noted in 62.5% of Grade I-II, 65.0% of Grade III, 28.9% of Grade IV and 16.7% of Grade V ureters. These spontaneous disappearance rates were significantly higher than those of primary vesicoureteral reflux in Grade III, IV and V ureters. Of the drug resistant enuretic boys with a congenital bulbar urethral stenosis, enuresis disappeared or ameliorated in 69.4% after optic internal urethrotomy. Furthermore, urinary tract infections were mostly prevented by optic internal urethrotomy, irrespective of the presence or absence of vesicoureteral reflux. Our results support the view that congenital urethral stenosis (urethral ring) is an important clinical entity in pediatric urology. PMID- 2754896 TI - [Clinical studies on the continent ileocecocolonic reservoir]. AB - Continent urinary reservoir has recently been paid much attention by urologists for its contribution to improvement in quality of life in patients who are in need of urinary diversion. We, herein, present some preliminary result in the operation of continent ileocecocolonic (ICC) or ileocecal reservoir which was performed on 13 patients. Since several improvements have been made on the operative procedures for ICC reservoir, the most recent techniques are described below: A 20-25 cm of cecocolonic and 12 cm of terminal ileal segment were isolated after a full length mesenteric incision. The cecocolonic segment was longitudinally split open in 15-20 cm on its antimesenteric border to be re configuration later. The mesentery was detached for 8 cm in the terminal ileum which was randomly incised into its seromuscular layer. Following the intussusception of the terminal ileum into the cecal lumen, the nipple valve of the ileum was stabilized by three row-staples and two row-paired nonabsorbable sutures. The valve was re-enforced by nonabsorbable sutures and dacron mesh which were placed at the base of the intussusception. The ureter was implanted in the tenia of the colon with antireflux technique of the submucosa tunnel. The distal end of the split cecocolonic segment was, the, folded to and sutured with its proximal end, making a Heineke-Mikulicz type of re-configuration reservoir. A flush type of stoma was constructed, with dacron mesh placed around the ileum which was fixed to the rectus muscle and its anterior sheath.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2754897 TI - [A case report of septicemia caused by methicillin cephem resistant Staphylococcus aureus (MRSA)]. AB - The frequency of MRSA (Methicillin cephem resistant Staphylococcus aureus) infection has increased recently. A case of septicemia caused by MRSA is reported with discussion on its prophylaxis. PMID- 2754898 TI - [A case report of Cushing's syndrome due to adrenocortical nodular dysplasia, with remission period of 6 years after unilateral adrenalectomy]. AB - A 29 y.o. female had been associated with Cushing's syndrome, gradually, from 1977. She was advised to get further examination at our hospital on September 1980. A pre-operative diagnosis of Cushing's syndrome due to bilateral adrenocortical tumors was made and right adrenalectomy was performed on December 22, 1980, as the 1st of two stage operation. The right adrenal, 1.8 cm in diameter, had a pigmented nodule and multiple pigmented micronodules, which were diagnosed pathologically as primary adrenocortical nodular dysplasia. It was not necessary for this patient to maintain steroid therapy, but after 3 months she complained of the withdrawal syndrome and was administered dexamethasone. Since July, 1981, she had no symptom without adrenocortical steroid administration. In November 1986, she became cushingoid and on June 1, 1987, we performed left adrenalectomy on her. The appearance of the left adrenal was similar to the right. We have found no reports of the cases of adrenocortical nodular dysplasia such as delayed appearance of withdrawal syndrome after unilateral adrenalectomy. In this case, plasma ACTH had relatively poor correlation with cortisol. Her plasma ACTH was not always suppressed and sometimes within normal range. Her adrenals had not only autonomy but also pituitary dependency. It is concluded that in this case there may have been a pituitary-adrenal dual control. PMID- 2754900 TI - Nursing and the ethic of care. PMID- 2754899 TI - [A case of cystitis glandularis. Its relationship to bladder carcinoma]. AB - A 41-year-old male was admitted to the hospital for frequent urination and severe retardation before voiding. Roentgenography revealed exophytic lesions which were located mainly in the trigone of the bladder, and he underwent transurethral resection. The pathological diagnosis was cystitis glandularis. There was no literature which reported cystitis glandularis causing urinary disturbance. This case, moreover, had been diagnosed as cystitis glandularis 13 years before by endoscopical biopsy. The origin of cystitis glandularis and its potentiality as a pre-malignant lesion were discussed from the clinical course for over 10 years. PMID- 2754901 TI - Kansas legislative year in review 1989. PMID- 2754902 TI - Nurses celebrate nurses. PMID- 2754903 TI - Personal versus professional ethics: toward reconciliation. PMID- 2754904 TI - [Magnetic resonance tomographic examination of patients with hypertension and arterial renal hypertension]. PMID- 2754905 TI - [Effect of an early single physical load on hemodynamics and plasma aldosterone level in patients with acute myocardial infarction]. PMID- 2754906 TI - [Pigmentation of the skin after long-term treatment with amiodarone]. PMID- 2754907 TI - [Atherogenic properties of sera from patients with ischemic heart disease demonstrated in vitro]. AB - The sera of coronary patients with angiographically-documented stenosis of 1 to 3 coronary arteries caused a two-to-fivefold accumulation of intracellular cholesterol in intact human aortic intimal cell culture. This property, qualified as "atherogenic", was exhibited by the sera of 90% of the coronary patients examined (97 males and females, aged 29 to 55 years). Only 20% of normal subjects revealed atherogenic properties in cell cultures. The capacity of the sera to accumulate intracellular cholesterol was unrelated to the levels of total cholesterol, high density lipoprotein cholesterol, apo-B or apo-AI, taken separately, but showed a weak correlation to the apo-B/apo-AI ratio. The sera of coronary patients caused lipid accumulation in human aortic medial smooth-muscle cells and blood mononuclear cells, in human and mouse peritoneal macrophages, but never in human aortic or umbilical vein endothelial cells, nor human embryo fibroblasts. PMID- 2754908 TI - [Study of the changes in protein-lipid components of blood lipoproteins and the dynamics of coronary arteriosclerosis based on repeated angiographic examination]. PMID- 2754909 TI - [Possibilities of the use of various biochemical and immunologic indicators in the differential diagnosis of unstable stenocardia and acute myocardial infarction]. AB - Changes of systemic immune status, involved in the immunopathogenesis of atherosclerosis, have been identified in patients with unstable angina pectoris. The developing acute myocardial infarction is accompanied by the formation of a myocardial aseptic inflammatory focus, from which biologically active products are absorbed, resulting in additional immunologic shifts. A differential diagnosis algorithm has been evolved on the basis of the comparison of a series of biochemical and immunologic parameters in patients with unstable angina, investigated at the peak of its clinical manifestations, and those with acute myocardial infarction. PMID- 2754910 TI - [Prognostic significance of the area of myocardial lesion and the status of the coronary bed during restoration of work capacity in patients with a complicated course of acute myocardial infarction]. AB - The effect of heart failure and acute left-ventricular aneurysm on the recovery of working capacity was assessed with reference to the size of necrotic focus and the extent of coronary arterial involvement in 117 patients with acute myocardial infarction. The size of necrotic focus and magnitude of coronary arterial affection were shown to be the principal determinants of heart failure in acute myocardial infarction. The presence of heart failure and acute left-ventricular aneurysm in combination with multiple coronary-arterial lesions is an adverse predictive sign in the assessment of the severity of acute myocardial infarction and the recovery of patients' working capacity. On the contrary, the presence of a local aneurysm in combination with an isolated coronary-arterial lesion should not be regarded as an unequivocal indicator of disability. PMID- 2754912 TI - [Adaptive capacity of the myocardium in middle-aged and elderly persons]. AB - Myocardial activity was evaluated in 165 individuals between 60 and 82 years of age. Only one parameter, myocardial stress adaptation index (MSAI), was shown to differ significantly between individuals. An earlier diagnosis of coronary heart disease was not confirmed in 43 (26.1%) patients. Myocardial adaptability was quite good (MSAI greater than 7.1) in 98 (60%) patients. There was a direct correlation between plasma potassium levels and ST depression in response to stress, which makes the hypoxic origin of ST depression in the absence of other signs of coronary insufficiency in this category of patients rather questionable. PMID- 2754911 TI - [Effectiveness of low-volume hemofiltration in treating severe arterial hypertension with initial manifestations of renal failure]. AB - High efficiency of low-volume hemofiltration, replacing 7 to 8 litres of the filtrate, is demonstrated. It has been used as part of combined treatment in 10 patients with severe arterial hypertension in combination with early signs of chronic renal failure. Low-volume hemofiltration brings down arterial blood pressure and allows reduced doses of hypotensive drugs; moreover, it improves basically eye-ground appearance in cases of malignant arterial hypertension as well as renal nitrogen excretion. Possible mechanisms of the hypotensive effect of low-volume hemofiltration, in addition to volume reduction, may be the control of secondary hyperaldosteronism and increased diuresis and natriuresis. PMID- 2754913 TI - [Effect of molsidomine preparations on the contractile function of the myocardium and coronary circulation in patients with ischemic heart disease complicated by heart failure after isometric load]. AB - Isometric stress tests were conducted in 95 coronary patients and 15 normal subjects. Load tests were repeated 1 hr after a single dose administration and at the end of a two-week treatment course. Left-ventricular contractility was found to be impaired at isometric stress in 66.7% of patients showing no clinical signs of heart failure, and coronary insufficiency was detected in 44.1%. A single molsidomin dose reduced diastolic and systolic left-ventricular volume by an average of 10.9 and 13.3%, respectively. At repeated isometric stress after molsidomin administration, only 15.7% of patients showed ischemic ST displacement on the electrocardiogram. Eleven (32.4%) of 34 patients with early phases of heart failure showed increased ejection fraction and a higher myocardial fibre circular shortening rate (by 4.9 and 11.7%, respectively) during hand grip under molsidomin effect. Long-term treatment with molsidomin preparations produced general improvement in 84.4% of patients, as reflected in the reduction of the signs of heart failure as well as the rate and intensity of anginal attacks. PMID- 2754914 TI - [Painless myocardial ischemia]. PMID- 2754915 TI - [Central hemodynamics and oxygen supply in patients with ischemic heart disease associated with chronic bronchitis]. AB - A comparative study of central hemodynamics and systemic oxygen supply was carried out with reference to hemodynamic type in patients with uncomplicated coronary heart disease (CHD) and CHD combined with chronic nonobstructive bronchitis. Patients with combined pathology and hyper- or hypokinetic circulation type showed the same hemodynamic pattern at rest and oxygen supply during exercise, as did coronary patients with similar circulation types, that suggested latent heart failure and were more marked in patients with hypokinetic circulation. In coronary patients with chronic bronchitis and eukinetic circulation, central hemodynamics and oxygen supply were impaired, as compared to coronary patients with similar circulation types. PMID- 2754916 TI - [Binding of monoclonal antibodies to fragmented erythrocyte membranes in patients with arterial hypertension]. AB - The data obtained by radioimmunoassay indicate that monoclonal antibodies (MA) to sarcoplasmic reticulum membranes can also bind to erythrocyte membranes. The binding of MA to fragmented erythrocyte membranes from patients with essential hypertension (n = 20) is 35% higher, as compared to normal subjects (n = 14) or patients with secondary (renal) hypertension (n = 9). Possible use of radioimmunoassays for MA is discussed with reference to differential diagnosis of arterial hypertensions. PMID- 2754917 TI - [Relation of the effectiveness of surgical treatment of vasorenal hypertension and morphologic changes of the kidneys]. AB - Renal puncture and incision biopsy specimens were investigated, using light and electron microscopic techniques, in 34 patients with vasorenal hypertension. The magnitude of the hypotensive effect of reconstructive surgery on renal arteries is shown to be largely dependent on the severity of arteriolosclerosis in the ischemized kidney rather than the contralateral one. Quantitative assessment of the severity of renal arteriolar sclerosis has established a critical vascular index (the ratio of arteriolar wall thickness to lumen diameter) above which the probability of reconstructive surgery producing a hypotensive effect becomes rather low. PMID- 2754918 TI - [Evaluation of disorders of renal hemodynamics in Leriche's syndrome and vasorenal hypertension]. AB - Combined assessment of changes in renal angio-architectonics and hemodynamics demonstrated significant disorders of those in cases of Leriche syndrome and vasorenal hypertension. These changes should not be neglected, if an adequate assessment of renal circulation and metabolism is to be made. It is in this way only that valid data on renal function can be obtained, an essential prerequisite for rational indications for the reconstruction of terminal abdominal aorta and renal arteries as well as the choice of an adequate scope and steps of intervention. In addition immediate and long-term prognosis of the course of the disease and the efficiency of intervention can thus be made. PMID- 2754919 TI - [Myoglobin level in patients with occlusive diseases of the lower extremities]. AB - Serum myoglobin (MG) concentration was measured in 25 patients with obliterating atherosclerosis of the aorta and main arteries of the lower extremities and in 30 normal subjects. Serum MG levels were also measured repeatedly following aortofemoral bifurcation shunting. An original one-step enzyme (immunoassay technique was used to determine serum MG concentration. Serum MG was increased in patients with obliterating diseases of the lower extremities. There was marked myoglobinemia, reaching its peak within 8 to 10 hours after the reconstructive operations on the aorto-iliac segments. PMID- 2754920 TI - [Effect of hyperbaric oxygenation on myocardial blood supply in patients with chronic ischemia of the lower extremities in the preoperative period]. AB - ECG and central hemodynamic parameters were examined in 24 patients with chronic ischemia of lower extremities under the effect of a course of hyperbaric oxygenation, and were shown to be improved in 67% of the cases. Deteriorating ECG pattern in combination with unfavorable central hemodynamic changes, seen in 29%, suggest that electrocardiographic monitoring is essential during the hyperbaric oxygenation course, so that treatment regimen could be timely adjusted. PMID- 2754921 TI - [Effect of occupational therapy on the psychosocial status of patients with myocardial infarction at the second stage of rehabilitation]. AB - Occupational therapy was added to the rehabilitation program at the second stage of rehabilitation in 42 myocardial infarction patients. Its psychosocial effect was assessed by psychological tests in comparison to a control group of patients, unexposed to occupational therapy. PMID- 2754922 TI - [Measurement of biological tissue destruction time after exposure to eximer XeCl laser]. AB - Relationship between atherosclerotic patch destruction time under UV light from a XeCl laser and energy density of 1.3-4.7 J/cm2 has been studied experimentally. As energy density increased, the destruction time, estimated on the basis of exploring product release by continuous-wave He-Ne laser, decrease from 40 to 3.5 microseconds. PMID- 2754923 TI - [Ways of improving the results in treating patients with acute gastrointestinal hemorrhage of peptic ulcer etiology]. AB - The results of treatment of 1837 patients with gastric and duodenal ulcers, complicated by bleeding are presented. Emergency surgical interventions were performed in 468 patients, 92 (19.7%) died, early elective operations--in 416 patients, 13 (3.1%) died, conservative treatment was performed in 953 patients, 55 (5.8%) died. In 1274 patients, the actively expectant tactics was used, in 563 -surgical tactics based on endoscopic characteristics of the source of bleeding and degree of the severity of blood loss. The use of this tactics permitted to reduce lethality after emergency operations from 27.7 to 9.6%, in patients treated conservatively--from 7.5 to 0.8%, to increase operative activity from 44.6 to 56.1%. PMID- 2754924 TI - [Free-radical lipid peroxidation in patients with acute gastro-intestinal hemorrhage]. AB - Free-radical lipid oxidation (FRLO), antioxidant system and rheological blood properties were studied in 63 patients with ulcer disease, of them, in 39- complicated by acute bleeding. Twenty healthy subjects served as a control. It was established, that hemorrhage led to considerable FRLO activation. The correlation between the increase in the content of the FRLO products in the erythrocytes and their functional properties was revealed. PMID- 2754925 TI - [Clinical characteristics and the surgical treatment of patients with perforated gastroduodenal ulcers]. AB - The peculiarities of diagnosis and treatment of perforated gastric and duodenal ulcer in 367 patients with regard to age, history of the disease were studied. The expediency of early surgical treatment of the ulcer disease is noted. PMID- 2754926 TI - [Acute erosive-ulcerous lesions of the digestive tract in patients with acute appendicitis]. AB - Examined were 98 patients with different forms of acute appendicitis. In acute common appendicitis, the stress lesions were diagnosed in 8.3%, in phlegmonous- in 15.4%, gangrenous--in 24.1%, gangrenous perforative--in 36.8% of the patients. PMID- 2754927 TI - [Analysis of the causes of postoperative mortality in tumor-related large intestinal obstruction]. AB - The immediate results of surgical treatment of 134 patients with colonic obstruction of tumour nature were studied. The indications for the choice of a method for operative intervention, depending on peculiarities of the tumor process and state of a patient were established. In operable tumour, the radical removal of the damaged portion of the intestine is indicated. However, the obligatory aiming at creation of primary anastomosis in colonic obstruction is unexpedient because of high postoperative lethality. The necessary condition for the one-stage resection is a good preoperative decompression of the intestine. PMID- 2754928 TI - [Characteristics of clinical manifestations of closed abdominal injuries in combined cranio-abdominal trauma]. AB - The analysis of the results of treatment of 818 sufferers with severe craniocerebral trauma was carried out. Among the patients, 102 had associated injuries to the abdominal organs. The difficulties of timely diagnosis were related to atypical manifestation of intraabdominal complications, insufficient pronouncement of clinical symptoms; therefore, the special methods of investigation--roentgenologic, instrumental, the use of liquid-crystal colour thermography acquire special value. The lethality was 37.2%. PMID- 2754929 TI - [Current methods of treating post-injection abscesses]. AB - The results of treatment of 137 patients with post-injection abscesses are analysed. The specific weight of such abscesses in the general structure of purulent diseases was 10.8%. Diabetes mellitus was present in 19.7% of the patients. Seventy nine patients were treated by a conventional method. In 58 patients, the surgical treatment with the use of a drainage-irrigative system was employed. Of them, in 15 patients, the prolonged aspiration by means of the adapted VK-1 microcompressor were performed. In therapy of post-injection abscesses by a conventional method, the mean period of temporary invalidity was 37.8 days, and in surgical treatment with the use of a drainage-irrigative system -16.2 days. PMID- 2754931 TI - [Use of charcoal enterosorbents in the complex treatment of patients with obstructive jaundice. Report II. Experimental study]. AB - In the experiments on rats with modelled bile duct obstruction and hepatic failure, the pronounced detoxicative value of the SKN P-1 and SKN P-2 carbonic sorbents is proved. PMID- 2754930 TI - [Methods of hemostasis and hepatectomy in injuries of the liver]. AB - In 77 animals, 154 operations of gauze tamponade of a hepatic wound with the use of hemostatic preparations were performed. On the 12 human cadavers and 10 dogs, the technique of placing a vascular suture in injuries to efferent hepatic veins was tried. The dynamics of acid phosphatase activity as a criterium of hepatic cirrhosis involution after partial hepatectomy in 30 albino mice was traced. The use of gauze tamponade of a hepatic wound with the performance of relaparotomy (optimal time: within 1-3 days) and definitive hemostasis is expedient, mainly, in coagulopathy. No differences in the regression of hepatic cirrhosis in partial resection of the liver and without it were revealed. PMID- 2754932 TI - [Difficulties in the diagnosis of acute intestinal obstruction]. AB - The experience with treatment of 679 patients admitted with diagnosis of acute ileus is summarized. In complex examination, the diagnosis was confirmed in 237 patients, in remaining, the other diseases were revealed. PMID- 2754933 TI - [Closed injuries of the spleen]. AB - The 10-year experience with diagnosis and treatment of closed injuries to the spleen in 84 patients is presented. In 13 patients, the two-instant splenic rupture, in 5--spontaneous was noted. Seventy (83.3%) patients had isolated injuries. In 17 patients, blood reinfusion with total volume of 22,800 ml was performed at operation. Post-operative lethality was 4.8%, total--5.9%. One patient died without operation. PMID- 2754934 TI - [A method of treating diffuse postoperative peritonitis]. AB - The results of autopsy of 184 patients, who died in diffuse peritonitis, are analysed. The impaired leakproof state of the hollow abdominal organs was the most common cause of postoperative peritonitis. Eighty four relaparotomies were performed for peritonitis. In 7 patients, the programmed peritoneal lavage was used. For temporary closure of the abdomen, the polyurethane film was used. In all the patients, the signs of peritonitis were liquidated. Two patients died. PMID- 2754935 TI - [Plasmapheresis with extracorporeal membrane oxygenation of the blood in the treatment of peritonitis]. AB - Plasmapheresis with extracorporeal low-flow membrane oxygenation of the blood was used in 18 patients with peritonitis. The superiority of plasmapheresis over the other methods of extracorporeal organism detoxication is shown. PMID- 2754936 TI - [Experience with the use of endolymphatic antibacterial therapy]. AB - In 98 patients with different purulent-inflammatory processes, the method of antegrad endolymphatic antibacterial therapy was used in the complex of treatment. One of the antibiotics (ampicillin, gentamycin, claforan), and metrogyl, dioxydin, contrical, heparin at the routine therapeutic doses 1 time at 24-48 h were introduced into the lymphatic vessel of the lower extremity via a catheter. The duration of treatment depended on the severity of the course of inflammatory process. In 74.4% of cases, the treatment was effective. PMID- 2754937 TI - [Diagnosis and surgical treatment of acute gastrointestinal hemorrhage]. AB - Of 596 patients with acute gastrointestinal bleeding, it developed from the gastric and duodenal, and peptic anastomotic ulcer in 382 (64.1%). The authors consider, that at every regional centre, it is expedient to hospitalize the patients with gastrointestinal bleeding in a single surgical unit, equipped with the endoscopic apparatus and all the necessary facilities for giving emergency surgical aid. PMID- 2754938 TI - [Reserves for improving early diagnosis of acute surgical diseases of the abdominal organs at the pre-hospital stage]. PMID- 2754939 TI - [Causes of diagnostic errors and complications in acute appendicitis in middle aged and elderly patients]. PMID- 2754940 TI - [Injury of the ureter during appendectomy]. PMID- 2754941 TI - [Perforation of the ileum by a foreign body]. PMID- 2754942 TI - [Acute surgical diseases of the abdominal organs in patients with Meckel's diverticulum]. PMID- 2754943 TI - [Destructive appendicitis associated with diverticulitis]. PMID- 2754944 TI - [Characteristics of the course of appendicitis in miners exposed to trinitrotoluene-containing substances]. PMID- 2754945 TI - [Acute inflammation of the appendix located in the mesentery of the transverse colon]. PMID- 2754946 TI - [A case of location of the appendix in the ileal mesentery]. PMID- 2754947 TI - [Acute appendicitis in a patient with dextrocardia]. PMID- 2754948 TI - [Incarceration of the appendix and small intestine in femoral hernia]. PMID- 2754949 TI - [Acute appendicitis in strangulation of the cecum in a left-sided inguino-scrotal hernia]. PMID- 2754950 TI - [Chylous peritonitis associated with acute phlegmonous appendicitis]. PMID- 2754951 TI - [Polytrauma as a result of a fall from a height]. PMID- 2754952 TI - [Rupture of the common bile duct and duodenum in closed abdominal trauma]. PMID- 2754953 TI - [Stress-induced ulcers in thoraco-abdominal injuries]. PMID- 2754954 TI - [A case of combined gunshot injuries of the maxillofacial and cervical regions]. PMID- 2754955 TI - [Gastroduodenofibroscopy in the prognostic evaluation of local factors of hemostasis in acute gastrointestinal hemorrhage]. AB - On the basis of the experience with endoscopic examination of 422 patients with ulcer disease complicated by bleeding, the stages of local haemostasis and factors indicating the high likelihood of recurrent bleeding from a gastric, or duodenal ulcer were defined. PMID- 2754956 TI - [Knife wound of the neck with injury of the carotid artery]. PMID- 2754957 TI - [Forceps for gripping the destructively changed appendix]. PMID- 2754958 TI - [A method of drainage of the wound after appendectomy]. PMID- 2754959 TI - [Prevention of postoperative intestinal paresis in abdominal injuries]. PMID- 2754960 TI - [Means of improving the efficacy of the treatment of cancer of the rectum (experience in the surgical and combination treatment of 3185 patients)]. AB - The analysis of the results of surgical and combined treatment of 3185 patients with rectal cancer was carried out. Of these patients, 88.2% were operated on at the stages III and IV of the disease. Radical operative interventions were performed in 2564 (80.5%) patients. The postoperative lethality was 8.1%. Sphincter-preserving operations comprised 53%. The combined treatment with the use of preoperative intensive irradiation was performed in 1174 patients and resulted in 2-fold decrease in the incidence of recurrences. The five-year survival of patients after surgical treatment was 60.1%, after combined--75.4%. PMID- 2754961 TI - [Use of the indices of the kallikrein-kinin system of the blood in evaluating the efficacy of the prevention and treatment of postoperative purulent complications in oncologic patients]. AB - The kallikrein-kinin system of the blood was studied in 59 patients with tumours of the abdominal cavity and small pelvis. In 33 patients, the postoperative course was complicated by wound suppuration, formation of intraabdominal and pelvic abscesses. It was established, that the development of purulent complications was accompanied by regular activation of the system of proteolysis and increase in the blood level of the middle molecular mass substances. The changes in the indices of kallikrein-kinin system can serve as an additional criterium of the effectiveness of treatment and prophylaxis of postoperative complications. PMID- 2754962 TI - [Dynamics of indices of the natural resistance of patients with cancer of the stomach]. AB - The complement titer, bactericidal serum activity and cation protein content of the peripheral blood granulocytes in gastric cancer, polyps and gastric ulcer disease were studied in dynamics. The most decrease in the indices listed was noted in patients with stage IV gastric cancer. The results of the tests mentioned permit to judge about the state of the non-specific resistance of the body of patients with gastric cancer, and in the complex with the other clinico laboratory findings are of prognostic value. PMID- 2754963 TI - [The effect of combination cryosurgical treatment on the natural resistance of patients with cancer of the lung]. AB - By the method of measuring the percentage and absolute content of the large granule-containing lymphocytes in the peripheral blood of the healthy subjects, in pulmonary cancer and benign process in the lungs at admission, just before the operation, at day 1 and at days 13-14 after the operative intervention and combined cryosurgical treatment, the data about the stimulating effect of cryodestruction on the natural resistance of an organism of the patients were obtained. PMID- 2754964 TI - [An individualized approach to the treatment of recurrences of cancer of the stomach]. AB - The observations on 54 patients with a gastric cancer recurrence and 121 patients with the gastric cancer recurrence passing to the esophagus are presented. The time of the onset, clinical manifestations, histologic structure, location of recurrences were analysed. The results of surgical, combined and conservative (with the use of local SHF-hyperthermia and artificial hyperglycemia) treatment are presented. The effectiveness of the therapy performed is shown. PMID- 2754965 TI - [Teratomas of the sacrococcygeal region in newborn infants and infants]. AB - The clinical manifestations, diagnosis and results of the treatment of 52 children, suffering from teratomas of the sacrococcygeal region, are presented. The optimal time for the performance of surgical intervention is defined. Three newborns and 3 children, operated on at the age over 1 year with malignization of teratoma, died. PMID- 2754966 TI - [Efficacy of methods of treating primary malignant epithelial tumors of the skin]. AB - The long-term results of the treatment of 817 patients with primary malignant epithelial cutaneous tumours were studied. In total, 916 tumours were revealed in patients. The comparative effectiveness of the surgical and radiation methods of treatment, which were used, is established. The criteria for the choice of a method for treatment are suggested. PMID- 2754967 TI - [Clinico-morphologic manifestations of the regression of a primary focus of malignant melanoma of the skin]. AB - The general laws and clinico-morphologic peculiarities of the regression of cutaneous melanoma in 4 patients, which occurred spontaneously or under the influence of the local use of non-conventional methods of therapy are presented. It is shown that resorption of primary neoplasm is not the ultimate outcome of the tumour process, and because of the development of metastases, the prognosis remains unfavourable. Regression of a primary focus of cutaneous melanoma is estimated as one of the manifestations of the progression of tumour growth. PMID- 2754968 TI - [Clinico-morphologic aspects of the combined treatment of locally disseminated cancer of the rectum]. AB - In 1174 patients, the pathomorphosis of rectal cancer conditioned by the combined treatment with preoperative irradiation was studied. Preoperative radiotherapy caused considerable disorders in the morphologic structure of a tumour. The survival of patients and incidence of tumour recurrences, depending on the pronouncement of morphologic changes after radiotherapy, were studied. The use of radiation modifiers in combination with radiotherapy facilitated more pronounced damage to the tumour. PMID- 2754969 TI - [Combination methods of local treatment of tumors of the abdominal organs]. AB - On the basis of the analysis of the results of treatment by the methods of cryosurgery, roentgeno-endovascular embolization, local use of immobilized chemo preparations and systemic administration of a high-molecular platinum compound of 218 patients with IV stage tumours of different location, it is shown that the mean lifetime of the patients increases 12-fold, the number of postoperative complications and lethality decrease. PMID- 2754970 TI - [Combination treatment of cancer of the stomach using preoperative telegammatherapy in combination with local SHF-hyperthermia]. AB - The immediate and long-term results of treatment of 178 patients with gastric cancer, who underwent before surgery intensive telegammatherapy in combination with local SHF-hyperthermia, and without it, were studied. The total focal dosage was 20 Gy, temperature on the surface of a tumour reached 41-43 degrees C. At the late period, the increase in survival of the patients, who had no lesions of the regional lymphatic nodes was noted. In patients with regional metastases, the reverse effect was observed. PMID- 2754971 TI - [Potentialities of a fluorescent method in determining the completeness of resection of the stomach in cancer]. AB - Examined were 78 resected stomachs of the patients, operated on for infiltrative cancer. Before the operation, a fluorescent dye was injected to all the patients. Fluorescence was excited by light with a wavelength of 441 nm, and fixed at the wavelength of the dye fluorescence of 520 nm. In histologic study of the brightly fluorescing sites, it was established that in 3 cases, the resection was performed through the tumour, and in 4--a tumour was invading along the tela submucosa and muscular layer up to the margin of resection. PMID- 2754972 TI - [Surgical correction of duodenal obstruction caused by malignant tumor]. AB - The results of treatment of 6 patients with duodenostasis, caused by cancer of the duodenum (2) and pancreas (3), metastasis of the sigmoid colon cancer (1) are analysed. Creation of duodenojejunoanastomosis with Brown's interintestinal stoma should be the obligatory condition of palliative operation. For diversion of the main food mass, the anterior gastroenteroanastomosis with Brown's interintestinal stoma was created. PMID- 2754973 TI - [Treatment of patients with malignant tumors of organs in the pancreaticobiliary zone complicated by the development of emergency situations]. AB - The results of surgical treatment of patients with cancer of the gallbladder (23), extrahepatic bile ducts (16), pancreas (28), major duodenal papilla (10), with tumour metastases in the liver (10), who developed, as a consequence of the tumour process progression, acute abdominal conditions--inflammatory syndrome, increasing jaundice, high ileus and hemorrhage are analysed. Emergency operative interventions were directed at solving the urgent situations and had, mainly, the palliative character. After the operation, 16 (21%) patients died. PMID- 2754974 TI - [Combination therapy of cancer of the colon]. AB - Combined treatment of colonic cancer with pre- and postoperative chemotherapy, or with preoperative irradiation by intensive method increases the five-year survival by 9.2 and 14.1%, respectively, when compared with the surgical treatment only, but simultaneously the number of purulent complications at the early postoperative period increases 3-fold. A cryosurgical method in colonic cancer has not the disadvantages of the radio- and chemotherapy. PMID- 2754975 TI - [Percutaneous transhepatic cholangiostomy in malignant tumors of the proximal sections of the extrahepatic bile ducts]. AB - The results of the use of percutaneous transhepatic cholangiostomy (PTCS) in 21 patient with obstructive jaundice, caused by tumour obstruction of the proximal bile ducts were studied. PTCS in 15 patients was a definitive intervention, which adequately substituted palliative bile-diverting operations, and in 6--served as an effective method of preoperative preparation. In 3 patients, the PTCS was used for combined internal-external bile diversion. PMID- 2754976 TI - [Cancer of the gallbladder and bile ducts]. AB - On the basis of the experience with treatment of cancer of the gallbladder and bile ducts in 21 patients, the difficulties of preoperative diagnosis are shown. The results of surgical treatment of the patients are unsatisfactory. PMID- 2754977 TI - [Enteral administration of pancreatic juice with the object of reducing the exocrine activity of the pancreas following pancreatoduodenal resection]. AB - Enteral administration of pancreatic juice in 17 patients after pancreatoduodenal resection caused a decrease in the activity of trypsin, amylase and lipase, pancreatic lipase and trypsin of the pancreatic juice in the blood. The increase in the level of insulin in the blood was noted. The mentioned method can be used for prevention of the development of postoperative pancreatogenic complications. PMID- 2754978 TI - [The role of large granular lymphocytes of the blood in the differential diagnosis of mediastinal neoplasms]. AB - Examined were 57 patients with teratomas, cysts, lymphoepithelial and malignant thymomas. One hundred donors of the blood served as a control. In the blood of the normal subjects, (0.315 +/- 0.014) X 10(9)/L of large granule-containing lymphocytes were revealed, in patients with benign tumours--(0.2 +/- 0.02) X 10(9)/L, with lymphoepithelial thymomas--(0.037 +/- 0.004) X 10(9)/L. The data obtained indicate the increased immune depression in the organism in development of tumour process, and depend on degree of its malignization. PMID- 2754979 TI - [Prognostic value of the method of treatment and various modelling factors in the localized form of primary cutaneous melanoma]. AB - On the basis of studying the long-term results of treatment of 268 patients with a localized form of primary cutaneous melanoma, the prognostic value of the used methods of treatment, level of tumour invasion into the skin, sex and age of a patient, tumour localization, presence or absence of its ulceration was established. PMID- 2754980 TI - [Means of activating cognitive activity and the development of clinical thinking in students at departments of surgical diseases]. PMID- 2754981 TI - [The value of student scientific circles in increasing the efficacy of a course in general surgery]. PMID- 2754982 TI - [Ambulatory care of the population and its role in the mastery of practical skills by subordinate surgeons]. PMID- 2754983 TI - [Cancer of the stomach in a 16-year-old patient]. PMID- 2754984 TI - [Cases of leiomyoma of the stomach]. PMID- 2754985 TI - [A suppurating angioleiomyoma of the duodenum]. PMID- 2754986 TI - [Polyneoplasia of the stomach and intestines]. PMID- 2754987 TI - [Fibrosarcomatosis of the small intestine mesentery]. PMID- 2754988 TI - [Pigmented melanoma of the common bile duct]. PMID- 2754989 TI - [Recanalization of the bile ducts in tumors]. PMID- 2754990 TI - [Treatment of hepatic hemangioma by cryodestruction]. PMID- 2754991 TI - [A rare case of the splenogenous form of lymphogranulomatosis]. PMID- 2754993 TI - [The Peutz-Jeghers syndrome]. PMID- 2754992 TI - [Combination primary restorative surgical interventions in cancer of the rectum in women]. AB - In the past 15 years, 136 combined operations in women with locally disseminated rectal cancer were performed. Eighty-two (60.3%) operations were primary restorative. After them, the lethality was 2.9%, 3- and 5-year survival--64 and 40%, respectively. The performance of the combined sphincter-preserving operations is expedient, despite the spreading of the primary tumour. PMID- 2754994 TI - [Primary multiple metachronous cancer of the small and large intestines]. PMID- 2754995 TI - [Surgical tactics in obstruction of the large intestine of tumor origin]. PMID- 2754996 TI - [A case of a free fibroma in the abdominal cavity]. PMID- 2754997 TI - [A large lipoma in the small pelvic cavity simulating a perineal hernia]. PMID- 2754998 TI - [Peritonitis caused by the rupture of a teratoma]. PMID- 2754999 TI - [A combination of a nodular uterine fibromyoma and a carcinoid of the vermiform process]. PMID- 2755000 TI - [Neuroblastoma of the lung]. PMID- 2755002 TI - [Mesothelioma of a hernial sac]. PMID- 2755001 TI - [Hemangiopericytoma of the lung]. PMID- 2755003 TI - [Hemosorption in the complex treatment of sepsis at a rural district hospital]. PMID- 2755004 TI - [Use of the human placenta for detoxication]. PMID- 2755005 TI - [A method of ultraviolet irradiation of the blood]. PMID- 2755006 TI - [Radiation and chemoradiation therapy of patients with cancer of the lung following exploratory thoracotomy]. AB - The results of radio- and chemoradiotherapy of 109 patients with pulmonary cancer after exploratory thoracotomy were studied. In these patients, the tumour invasion to the adjacent organs and vessels, involvement of the root of a lung and lymphatic mediastinal nodes, metastatic pleural lesion were revealed. As a result of the use of radio- and chemoradiotherapy, the tumour diminishing was documented in 48.8 and 53.2% of the cases, respectively. The adverse effects were cupped off in most patients by means of the symptomatic agents. A conclusion of the expediency to perform radio- and chemoradiotherapy in patients with pulmonary cancer after exploratory thoracotomy was made. PMID- 2755007 TI - [Proximal selective vagotomy in the treatment of uncomplicated forms of duodenal ulcer]. AB - Experience is recorded with 893 operations of duodenal ulcer for a period of 15 years. Of these, 872 patients (97.6 per cent) were operated as nonemergency planned cases, 48 of them subjected during a period of 7 years to proximal selective vagotomy in 3 variants. During the postoperative period one patient died of fatty pulmonary embolism. During the early postoperative period in 4 patients developed bronchopneumonia (8.3 per cent), in 3 transient cardiospasm (6.2 per cent) successfully controlled without surgical intervention. According to Visick's classification, excellent and very good postoperative results were recorded in 41 patients (87.2 per cent). Recurrent ulcer was demonstrated in 3 patients (6.4 per cent); only one of them required operative treatment- antrumectomy with revagotomy. It is pointed out that postoperative pH-metry of the stomach is not a pathognomonic sign, but may be criterion for a potentially possible recurrence. Continuous control is needed, since the majority of recurrent ulcers are not manifested by characteristic clinical symptoms. PMID- 2755008 TI - [The role of the laser in gastrointestinal surgery]. AB - In a series of 2500 operations with laser in the gastrointestinal region the authors used laser CO2 with up to 90 W strength and Nd--Yag with up to 80 W strength, both alone and in combination. Principal application of this technique is in oncologic surgery: resection of liver, volatilization of hepatic and other metastases, destruction of inoperable carcinoma in the middle and distal portion of the rectum and in other fields of proctologic surgery. In this aspect, laser technique is a powerful palliative means in the general arsenal of surgery. PMID- 2755009 TI - [A case of simple intestinal ulcer]. PMID- 2755010 TI - [Decubital wound of the ischial tuberosity fistulizing on the posterior surface of the thigh]. PMID- 2755011 TI - [Plasma cortisol dynamics during epidural analgesia in patients undergoing transurethral resection]. PMID- 2755013 TI - [Partial resection of the single kidney in hypernephroid carcinoma]. PMID- 2755012 TI - [Neurogenic urination disorders following radical surgical interventions in rectal carcinoma]. AB - Experience is recorded with the study of 16 patients with neurogenic disorders of urination following radical operative interventions for rectal cancer. Their causes and the changes which they produce in the urinary tract are discussed in detail. The need of purposely carried out urologic investigations, such as excretory urography, cystography in anteroposterior, lateral and oblique projections and during micturition, bladder tonometry and measurement of residual urine is emphasize. The experience gained with conservative, operative and physical therapy is discussed. Particular attention is focused on the provision of adequate drainage of the urine from the bladder during the early postoperative period and the prophylaxis of urinary infection. Inferences are drawn on the complexity of the problem and the need of early diagnosis, treatment and repeated check-up of the patient state. PMID- 2755014 TI - [Intratesticular stimulation of spermatogenesis]. AB - The possibility to exert local effect on suppressed spermatogenesis in patients with different forms of secretory sterility is presented. To this end, the authors created an experimental model of 10-minute acute ischemia in mouse testis. Destructive changes in the testicular parenchyma after the 3., 9., 22. and 30 day were observed and described. Testosterone concentration in the tissues of the ischemic and the contralateral testis was determined by highly effective liquid chromatography. It is concluded that saturation of the interstitium with androgens may avert irreversible postischemic sequelae in the testis. At first chorion gonadotropin and testosterone, but later on Sustanon-250 with prolonged action, were used as protectors. This experimental study is a contribution both to the investigation of spermatogenesis physiology and disturbances and to the refinement of the treatment of secretory forms of male sterility. PMID- 2755015 TI - [Kidney failure in urologic diseases]. AB - Among a series of 3100 patients with urologic disease, treated over a period of 7 years, chronic renal failure (CRF) had 161. In rank order CRF was most common in patients with prostate adenoma (36.02 per cent), followed by patients with renal calculosis (27.33 per cent) and renal cancer (10.56 per cent). The causes of CRF and its dynamics, depending on the underlying disease, the therapeutic approach and the principles of treatment are discussed in detail. The inferences from the experience gained at the clinic point to the need of accentuating the attention of urologists and nephrologists for early diagnosis and adequate treatment of urologic diseases, which might cause CRF. The principles of its treatment are outlined. PMID- 2755016 TI - [A case of cystadenocarcinoma of the liver]. PMID- 2755018 TI - [Surgical procedures in duodenal ulcer hemorrhage]. AB - Analysis was made of 893 patients operated for duodenal ulcer. Of these, 872 (97.6 per cent) were operated as nonemergency planned patients; the outcome was fatal in 5 (0.57 per cent). Emergency operative intervention at the acme of the bleeding was performed in 21 patients (2.4 per cent) because of failure to control the bleeding by conservative means. Six of these patients died (24.0 per cent) during the early postoperative period. Highest was the percentage of patients in whom extended gastric resection was made; there were no lethal cases among patients subjected to antrumectomy and truncus resection. Preference is given to truncus vagotomy with sparing resection of the stomach; this is considered a reliable and safe method for stopping the bleeding and curing the patients from the ulcer. PMID- 2755017 TI - [The current treatment of calculi of the upper urinary tract]. PMID- 2755019 TI - [A case of bilidigestive and bilibiliary fistula]. PMID- 2755020 TI - [Lipoma of the mesentery causing ileus]. PMID- 2755021 TI - [Cervical localization of a neurinoma of the n. vagus treated surgically]. PMID- 2755022 TI - [The use of Ampoxen in treating a large hemangioma of the liver]. PMID- 2755023 TI - [A case of chronic pancreatogenic ascites]. PMID- 2755024 TI - [A case of large intestine rupture resulting from minor blunt abdominal trauma]. PMID- 2755025 TI - [A case of retrograde incarceration in inguinal hernia]. PMID- 2755026 TI - [Malignant neurinoma (schwannoma) of the stomach simulating the picture of a bleeding ulcer]. PMID- 2755027 TI - [Leiomyosarcoma of the small intestine]. PMID- 2755028 TI - [A case of a lesion of the pancreas during left-sided nephrectomy]. PMID- 2755030 TI - [A new technologic module (method) for performing drainage in surgical practice]. PMID- 2755029 TI - [Biliary ileus resembling the clinical picture of acute appendicitis]. PMID- 2755031 TI - Plasma concentrations of free and sulfoconjugated dopamine, epinephrine, and norepinephrine in healthy infants and children. AB - Plasma concentrations of free and sulfoconjugated catecholamines were measured in healthy infants and children under resting conditions. Free norepinephrine and epinephrine levels were up to three times higher in healthy children under 2 years than in adults, even under true resting conditions. In contrast, free dopamine concentrations of all age groups fell within the normal range for adults. The levels of sulfoconjugation were in the adult range. PMID- 2755032 TI - Platelet cytosolic free calcium concentration in hypertension associated with early stage kidney disease. AB - Chronic hypertension accompanying early stage kidney disease is characterized by increased vascular resistance, but the underlying processes responsible for the enhanced vascular tone are unclear. We studied free calcium levels in blood platelets with the fluorescent dye quin-2. Platelets have many features in common with vascular smooth muscle cells. The cytosolic calcium concentration in platelets was elevated in 27 renal hypertensive patients, who were compared with 12 normotensive subjects (P less than 0.001). There was a close correlation between the free calcium level and mean blood pressure (r = 0.88, P less than 0.001). Short-term antihypertensive treatment with a calcium entry blocker or a diuretic resulted in a significant reduction in cytosolic calcium (P less than 0.05), and this correlated with the fall in blood pressure (r = 0.95, P less than 0.001). These data suggest an integrative contributory role of calcium in the pathophysiology of hypertension accompanying early stage kidney disease. PMID- 2755033 TI - [Acute interstitial nephritis following piperacillin]. AB - A 75-year-old woman developed fever, exanthema and nonoliguric renal failure 16 days after the beginning of Piperacillin treatment. Renal biopsy revealed lympho plasma-cellular acute interstitial nephritis (AIN). A lymphocyte-transformation test showed significant stimulation of patient's lymphocytes by Piperacillin. Corticosteroid-therapy correlated to clinical and renal improvement. Nevertheless the patient died of foudroyant septicemia caused by E. coli. Our report describes the first immunologically documented case of AIN following Piperacillin treatment. PMID- 2755034 TI - Occult papillary carcinoma of the thyroid with pulmonary lymphangitic spread diagnosed by lung biopsy. AB - Distant metastases from occult papillary carcinoma of the thyroid, which is defined as a tumor less than 15 mm in diameter, are extremely rare. A 21-year-old patient with miliary micronodular densities in both lungs is described, in whom pulmonary lymphangitic spread of occult papillary thyroid carcinoma was diagnosed by transthoracic lung biopsy. PMID- 2755035 TI - [Porphyria cutanea harda complicated by hemorrhagic capillary toxicosis]. PMID- 2755036 TI - [Analysis of the causes of fatal outcome in fractures of the upper third of the femur]. AB - Analysis of 5-year mortality of 1348 patients with fractures of the proximal end of the femur is presented. The effectiveness of measures aimed at the prevention of developing complications has been assessed. The data obtained demonstrate the effectiveness of these measures. PMID- 2755037 TI - [Diagnosis and treatment of fat embolism]. PMID- 2755038 TI - [2 cases of complications after intravenous administration of ethacizine]. PMID- 2755039 TI - [A case of generalized actinomycosis]. PMID- 2755040 TI - [A case of latent pyelonephritis in old age]. PMID- 2755041 TI - [Myelotoxic hypoplastic reaction of the blood]. PMID- 2755042 TI - [Benign lymphoreticulosis]. PMID- 2755043 TI - [Rare combination of granulomatous thymoma and multiple dysontogenetic cysts of the thymus gland]. PMID- 2755044 TI - [A case of Horton-Marath-Brown syndrome]. PMID- 2755045 TI - [Heterotopic gastric mucosa in the rectum]. PMID- 2755046 TI - [Isolated rupture of the duodenum in closed abdominal trauma]. PMID- 2755047 TI - [Cancer of the gallbladder manifesting itself as kidney disease]. PMID- 2755048 TI - [Hemolytic-uremic syndrome in an adult]. PMID- 2755049 TI - [Pulmonary thromboembolism: its diagnosis, treatment and prevention]. PMID- 2755051 TI - [Treatment of chronic pulmonary insufficiency]. PMID- 2755050 TI - [Diabetic polyneuropathy]. PMID- 2755052 TI - [Clinico-hemodynamic variants of borderline hypertension]. PMID- 2755053 TI - [Principles of clinical morphology in nephrology]. AB - Causes of the numerous changes found in kidney biopsy specimens and the absence of their commonly accepted classification are revealed. Principles of clinical morphology underlying nephrology have been formulated which emphasize the need to study the qualitative and quantitative characteristics of all renal structures, maintenance of the nosological independence of primary glomerulonephritis whose diagnosis must be supplemented by the morphological characteristics of kidney biopsy specimens. Kidney affection in different diseases should be designated by the term "nephropathy" specifying the causative factor and the character of affection of renal structures. PMID- 2755054 TI - [Current problems of systemic vasculitis]. PMID- 2755055 TI - [Clinical significance of conjunctival biomicroscopy in influenza and acute respiratory viral infections]. PMID- 2755056 TI - [Clinico-endoscopic and morphologic characteristics of patients with Campylobacter infection]. AB - Bacteriological examination of feces of 120 patients with signs of acute gastroenterocolitis revealed C. jejuni infection in 19 (7 per cent) of them. There was a certain difference between the clinical course of C. jejuni infection and acute dysentery. The endoscopic examination of the large intestine in jejuni infection demonstrated acute hemorrhagic or catarrhal colitis and phenomena of acute exudative inflammation were found during histomorphological study. C. jejuni infection can be diagnosed on the basis of the clinico-epidemiological findings and the results of bacteriological examination of the patients' feces. PMID- 2755057 TI - [Study of cardiac function in generalized meningococcal infection based on various biochemical indicators]. AB - The complicated course of meningococcal infection is distinguished by a long-term increase in the level of aspartate transferase and creatine phosphokinase. There were three types of changes in the activity of creatine phosphokinase, while changes in the activity of aspartate transferase were not so diverse. Patients had isolated as well as combined increase in the activity of both these enzymes. Lipid peroxidation was also augmented which corresponded to changes in the level of aspartate transferase. The high level of enzymes in the blood in meningococcal infection is the result of cytolysis as well as myocardial hyperfunction in the acute period of the disease. PMID- 2755058 TI - [The plasma fibronectin level in food poisoning]. AB - Blood plasma content of fibronectin was studied in 125 patients with food poisoning using rocket immunoelectrophoresis. enzyme immunoassay and antibody neutralization reaction. During the development of the process the content of fibronectin was reduced in most of the patients. This parameter usually drops at the peak of the disease and is normalized on recovery. Measurement of fibronectin in blood plasma can be an additional criterion for determining the degree of severity and the course of the disease and recovery of patients. This method that makes use of the antibody neutralization reaction is simple, can be rapidly performed and produces accurate results. PMID- 2755060 TI - [Infectious pathology in the practice of a family physician]. PMID- 2755059 TI - [Thermographic semeiotics of food poisoning and its differential diagnosis]. AB - A thermographic study has revealed zones of hyperthermia in the epigastrium and other abdominal regions in 91.4 per cent of the patients with food poisoning. The temperature gradient in the epigastrium depended on the degree of severity of the disease (in mild course--0.60 +/- 0.11 degrees C, in moderately severe and severe course--1.15 +/- 0.09 degrees C). In salmonellosis a zone of hyperthermia was also found in the right iliac region. Clinical recovery in most cases preceded temperature normalization on the abdomen. In patients with acute dysentery the hyperthermic zone was constantly revealed in the left iliac region, in acute appendicitis in the right iliac region, in acute cholecystitis in the right hypochondrium, in acute pancreatitis in the epigastrium or in the hypochondrium with a clearly defined upper border. Thermography contributed to the differential diagnosis of food poisoning and the above diseases. PMID- 2755061 TI - [Psychological rehabilitation of patients with implanted electrocardiostimulators]. AB - Principles of psychological rehabilitation of patients with implanted cardiac pacemakers are examined. A scheme of stage-by-stage psychoprophylactic and psychotherapeutic measures is proposed. The influence of the psychocorrective action on the process of sociopsychological adaptation of patients is discussed. PMID- 2755062 TI - [Cardiac lesions in alimentary toxic paroxysmal myoglobinuria]. PMID- 2755063 TI - [Thrombocytic hemostasis and the prostaglandin system at early stages of arterial hypertension]. AB - In young patients with borderline arterial hypertension the system of pressor and depressor prostaglandins (PG) is activated with maintenance of their physiological proportion. In patients with I stage essential hypertension a considerable rise in the level of PGF2 alpha and thromboxane determines the system imbalance in the direction of the predominance of pressor components. The platelet hemostatic link in I stage essential hypertension is characterized by an increase in platelet aggregation activity which is mediated by the imbalance of the prostacyclin-thromboxane system in the direction to thromboxane. PMID- 2755064 TI - [Pathogenesis of non-inflammatory arteriopathies with livedo-type lesions of the brain and skin (Sneddon's syndrome)]. PMID- 2755065 TI - [Clinico-endoscopic diagnosis of cancer of the large intestine]. AB - Appearance of the clinical signs of large-intestinal cancer usually demonstrates advanced stages of the process. Endoscopic polypectomy, along with screening and active follow-up of patients, can be one of the measures for identification and prevention of tumours in early terms. PMID- 2755066 TI - [Clinical picture and diagnosis of pyelonephritis in patients with multiple myeloma]. PMID- 2755067 TI - [Isotope nephrography in patients with obesity]. AB - 131I-hippuran nephrography conducted in 80 patients aged 26-53 with I and II degree obesity has revealed changes in the excretory phase (36.9 per cent of the patients with I degree obesity) and secretory and excretory and some vascular and metabolic abnormalities were registered in 79.4 per cent of those with II degree obesity. Weight gain had an adverse effect on the condition of such patients. Isotope nephrography enables one to study risk factors (arterial hypertension, atherosclerosis, diabetes mellitus). PMID- 2755068 TI - [Team work with everyone involved with nursing care. Sharing of competencies and power!]. PMID- 2755069 TI - [Professional and lay care from the sociological viewpoint. 2 sides of the coin]. PMID- 2755070 TI - [Nursing in Bangladesh]. PMID- 2755071 TI - [Blindness caused by gunshot wounds in Gaza]. PMID- 2755072 TI - [Team work, in the limelight!]. PMID- 2755073 TI - [Computers in nursing care. It moves---slowly!]. PMID- 2755074 TI - [From medical supervision to nursing supervision. Experience of a change-over (2)]. PMID- 2755075 TI - [Observations on various important aspects. Role of the Swiss Nurses' Association in the development of research]. PMID- 2755076 TI - [Elias and the raven. Miraculous feeding]. PMID- 2755077 TI - Alterations to subplasmalemmal leptomeres in adult canine myocytes during total in vitro ischemia. AB - Published evidence suggests that ischemia-induced cell swelling renders myocytes vulnerable to plasmalemmal disruption and consequent cell death. Alterations to the myocyte cytoskeleton may be involved in the pathogenesis of this plasmalemmal injury. One putative cytoskeletal structure in cardiac muscle that has received little consideration is the subplasmalemmal network of periodic densities with linking microfilaments termed leptomeres or leptofibrils. We demonstrate these structures in dog heart papillary muscle and describe the improvement in their definition brought about by tissue fixation at 37 degrees C in 2% glutaraldehyde with addition of 0.05 M lysine-HCl, followed by brief postfixation with osmium tetroxide. Alterations to leptomeres during ischemic injury were examined in myocardium subjected to total in vitro ischemia for 30-180 min at 37 degrees C. Leptomeres showed little morphological alteration during the first 90-120 min, after which leptomere periodic densities (striae) increased in size, from 10-20 to 50-80 nm, and were more densely stained. The leptomeres eventually (150-180 minutes) lose definition. The course of these alterations coincided with the appearance of ultrastructural evidence of irreversible ischemic injury to the myocytes. PMID- 2755078 TI - Retention of glomerular basement membrane-proteoglycans accompanying loss of anionic site staining in experimental diabetes. AB - The occurrence of heparan sulfate proteoglycan anionic site staining in the glomerular basement membranes of healthy and streptozotocin-induced diabetic rats was investigated. After 12 weeks diabetes, a marked loss of staining by ruthenium red was observed, compared with the age-matched controls. However, extraction and quantitation of total proteoglycan from the glomerular basement membrane revealed no significant differences between the two groups, in terms of absolute yield of glycosaminoglycan, when the latter is expressed per glomerulus. Glomerular basement membranes from both groups become thicker in an age-dependent manner, although they do so at a faster rate in the diabetic group, and a higher collagen content is found in the diabetic membrane at 12 weeks. Thus when proteoglycan content is expressed per mass protein, relative decreases are observed in diabetes. Similarly, a relative but not absolute decrease in proteoglycan content was observed in glomerular basement membranes from spontaneously diabetic BB rats with diabetes of 12 weeks duration. Glycosaminoglycans isolated from control and diabetic glomerular basement membrane have similar characteristics on ion exchange chromatography, to each other, and to newly sulfated, intact glomerular proteoglycans labelled in vitro. We conclude that loss of anionic site staining with ruthenium red in early diabetes is not a consequence of absolute loss or undersulfation of heparan sulfate proteoglycan but reflects structural or biochemical changes in the diabetic matrix. PMID- 2755079 TI - A canine model of beryllium-induced granulomatous lung disease. AB - Groups of beagle dogs were exposed by inhalation to attain either low or high initial lung burdens (ILB) of BeO calcined at 500 degrees or 1000 degrees C. Dogs were killed at 8, 32, 64, 180, and 365 days after exposure for evaluation of beryllium tissue burdens and histopathologic examination. Histologic lesions were characterized by perivascular and peribronchiolar infiltrates of lymphocytes and macrophages 8 days after exposure. These lesions progressed to distinct microgranulomas accompanied by patchy granulomatous pneumonia. Lesions were more severe in dogs exposed to 500 degrees C BeO. Additional dogs were sampled by bronchoalveolar lavage at 3, 6, 7, 11, 15, 18, and 22 months after exposure for characterization of lung cytology and lung immune responses. Lymphocyte percentages and numbers were increased in lavage samples 3 months after exposure in dogs with both the high and low ILB of 500 degrees C. Values for both parameters decreased rapidly thereafter. Dogs with either low or high ILB of 1000 degrees C-treated BeO displayed negligible to low and variable changes in both lymphocyte percentages and numbers. In vitro lymphocyte stimulation by beryllium was increased 180 and 210 days after exposure in dogs with the high ILB 500 degrees C BeO only. A marked degree of individual variation in both histologic lesions and lymphocyte responses among dogs was noted. Less soluble 1000 degrees C-treated BeO was retained in the lung longer than the more soluble 500 degrees C treated material that was cleared almost entirely by 1 year after exposure. Because these changes are similar to those reported in humans with chronic beryllium disease, these data suggest that the beagle represents a good model to study histologic and immunologic aspects of this disease syndrome. PMID- 2755080 TI - Interphase cytogenetics in paraffin embedded sections from human testicular germ cell tumor xenografts and in corresponding cultured cells. AB - A protocol was developed that allows determination of chromosome aberrations in interphase nuclei from paraffin embedded human tissues. As a model system tissue sections from xenografts derived from three testicular germ cell tumors (two teratocarcinoma and one embryonal carcinoma), as well as sections from normal intestine and testicular tissues, were hybridized with a biotin-labeled DNA probe specific for 1q12. For comparison, isolated nuclei in suspension and metaphase spreads from in vitro cell lines derived from the respective xenografts were assayed. Our results show that interphase tumor cells with aberrant numbers of chromosome 1 can be reliably detected both in vitro and in vivo. Subclones with two and three labeled chromosomes, respectively, could be defined and quantitatively evaluated. Present and future possibilities to pinpoint specific chromosome aberrations directly in cells present in body fluids or in tumor tissues are discussed. PMID- 2755081 TI - Classifying cells from light microscopic bit features by binary logic. Application to grade neuronal injury in cerebral ischemia. AB - Degradative cellular processes within neurons were analyzed and graded by a conceptually new approach that decoupled the process of subcellular feature analysis and grading, the latter being based on the severity of observed deterioration in subcellular features. Rather than evaluate the cell's histologic image in a panoramic manner, investigators were required to give simple yes-no decisions about the presence or absence of a specific pathologic feature (bit feature as opposed to panoramic analysis). Multiple elementary decisions create a binary representation of the cell image that can be easily handled and analyzed using computer techniques to generate all possible unique phenotypes of the scanned neuronal population. In the first application of this method, however, the number of possible phenotypes were reduced by imposed a priori logic on the separation scheme focusing on a single cellular structure (the nucleus) that was followed through the stages of structural decay. We experimentally validated four neuronal types of five theoretical possibilities when three nuclear bit features were used in typing. Grading of neuronal injury for groups of normal, ischemic, and ischemic and reperfused rats into two, three, and four categories are reported. The consistency at which the method can be implemented was assessed by calculating the mean and standard deviation of the reconciled typing decisions given by the four investigators. The group of the four investigators showed less than 2, 3, and 5% error when grading cells from control, ischemic, and ischemic reperfused animals, respectively. PMID- 2755082 TI - The contribution of low tar cigarettes to environmental tobacco smoke. AB - A series of low tar cigarettes (LTC) were smoked and the quantities of condensable mainstream (inhaled) and sidestream (between puffs) smoke compounds were determined and compared to those produced by a high tar, nonfilter cigarette. It was found that the LTC produced large quantities of sidestream smoke condensates, about equal to the high tar cigarette, and contained very high levels of toxic or cocarcinogenic phenols. On an equal weight basis, the LTC emitted more of these hazardous compounds into sidestream and environmental tobacco smoke. Higher smoke yields of a flavor additive and a sugar degradation product indicated addition of such compounds during the manufacture of LTC. It was concluded that, compared to a high tar cigarette, smoking LTC may be better for the smoker, but not for the nearby nonsmoker. Information should be developed to allow smokers to choose LTC that produce lower levels of hazardous compounds in their environmentally emitted sidestream smoke. PMID- 2755083 TI - Determination of terbium in organs of mice administered terbium chloride: comparative study of fluorometry and atomic absorption spectrometry. AB - The determination of terbium (Tb) in organs by fluorometry and atomic absorption spectrometry (AAS) was investigated. The organs of mice were ashed before the instrumental applications. The fluorometric measurement of Tb was performed after formation of a complex with dipicolinate. The detection limit was 0.1 micrograms/mL and the coefficient of variation was less than 5% (N = 6). AAS measurement of Tb was carried out with a pyrolytic graphite furnace. The detection limit by AAS was 1 microgram/mL. The concentrations of Tb in various organs of mice intraperitoneally administered TbCl3 at doses of 10, 50, and 250 mg Tb/kg were measured by both methods. The values obtained from each organ were dependent on the dose. High concentrations of Tb were found in spleen, pancreas, and seminal vesicle; lesser amounts were found in liver and testis. The correlation coefficient for both methods was high; r = 0.991 (N = 20) in liver and r = 0.988 (N = 20) in pancreas. PMID- 2755084 TI - The stability of the alcohol concentration in urine specimens. AB - The stability of alcohol in urine during storage of up to 12 months was investigated. The decrease in concentration appeared to be limited. No formation of alcohol was observed. It can be concluded that the storage conditions are suitable for forensic purposes. PMID- 2755085 TI - Quantitation of methamphetamine and amphetamine in urine by capillary GC/MS. Part I. Advantages of trichloroacetyl derivatization. AB - A urine assay for methamphetamine and amphetamine that is compatible with our existing high-volume GC/MS assays for other drugs of abuse has been developed. Trichloroacetic anhydride is used for derivatization and its derivative is substantially less volatile than other commonly used derivatives. The internal standard is the primary amine 2-methylphenethylamine. The procedure utilizes an initial liquid-liquid extraction, a liquid-liquid back extraction for specimen cleanup, and derivatization for removal of excess trichloroacetic anhydride and acid by-product. A GC temperature of about 180 degrees C results in retention times of approximately 2.8, 3.2, and 4.3 min for amphetamine, the internal standard, and methamphetamine, respectively. Five ions are monitored: 91+, 118+, 188+ for amphetamine; 105+, 118+ for 2-methylphenethylamine; and 91+, 118+, 202+ for methamphetamine. Full scan GC/MS data from a variety of other derivatives are examined and used to illustrate the advantages of derivatizing molecules with strongly electronegative atoms near the reaction site. This situation forces fragmentation patterns in which positive charges are located on larger and structurally acceptable identifying mass fragments of the original methamphetamine or amphetamine molecule. PMID- 2755086 TI - A rapid and sensitive quantitation of Dipterex in serum by solid-phase extraction and gas chromatography with flame thermionic detection. AB - A simple, sensitive, and rapid quantitative method for Dipterex in serum is described. A SepPak C18 cartridge for the extraction and gas chromatography with flame thermionic detection for determination are used. The detection limit is 2.5 ng/mL, and linearity is obtained in the range 5-500 ng/mL. PMID- 2755087 TI - Quantification of selected herbicides and chlorinated phenols in urine by using gas chromatography/mass spectrometry/mass spectrometry. AB - We have developed a method for determining selected chlorinated phenols and phenoxy herbicides in urine. The process of preparing the samples includes acid hydrolysis, extraction with benzene, derivatization with diazoethane, and column chromatography cleanup. We quantify the more volatile compounds by using capillary column gas chromatography/positive chemical ionization/mass spectrometry/mass spectrometry. Less volatile compounds are quantified by using electron capture negative chemical ionization in a single stage mass spectrometry mode. Quality control samples are included in each analytical run, and the results demonstrate that the analytical system is in control. Positive values for the target analytes are determined on the basis of appropriate relative retention time, a signal-to-noise ratio greater than 3:1, and a calculated concentration greater than 1 ppb. We determine the chlorine isotope ratios for each compound to assess the presence or absence of interferences. This analytical method has been applied in a case-control study of 199 individuals to examine exposure to the 12 target analytes. PMID- 2755088 TI - Pyrolysis and volatilization of cocaine. AB - The increasing popularity of inhaling cocaine vapor prompted the present study, to determine cocaine's fate during this process. The free base of [3H]cocaine (1 microCi/50 mg) was added to a glass pipe, which was then heated in a furnace to simulate freebasing. Negative pressure was used to draw the vapor through a series of glass wool, ethanol, acidic, and basic traps. Air flow rate and temperature were found to have profound effects on the volatilization and pyrolysis of cocaine. At a temperature of 260 degrees C and a flow rate of 400 mL/min, 37% of the radioactivity remained in the pipe, 39% was found in the glass wool trap, and less than 1% in the remainder of the volatilization apparatus after a 10-min volatilization. Reducing the air flow rate to 100 mL/min reduced the amount of radioactivity collected in the glass wool trap to less than 10% of the starting material and increased the amount that remained in the pipe to 58%. GC/MS analysis of the contents of the glass wool trap after volatilization at 260 degrees C and a flow rate of 400 mL/min revealed that 60% of the cocaine remained intact, while approximately 6 and 2% of the starting material was recovered as benzoic acid and methylecgonidine, respectively. As the temperature was increased to 650 degrees C, benzoic acid and methylecgonidine accounted for 83 and 89% of the starting material, respectively, whereas only 2% of the cocaine remained intact. Quantitation of cocaine in the vapor during the course of volatilization revealed high concentrations during the first two min and low concentrations for the remaining time.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2755089 TI - Forensic applications of the determination of benzodiazepines in blood samples by microcolumn cleanup and high-performance liquid chromatography with reductive mode electrochemical detection. AB - Recently described microcolumn cleanup and high-performance liquid chromatography with electrochemical reductive mode detection have facilitated the determination of benzodiazepines in contaminated and degraded blood samples. Examples from an extensive application of the procedure to British forensic science casework are given here. PMID- 2755090 TI - Analysis of methamphetamine in hair, nail, sweat, and saliva by mass fragmentography. AB - A method for the detection and quantitation of methamphetamine and its major metabolite in hair, nails, sweat, and saliva from habitual users of methamphetamine by mass fragmentography has been developed. Hair and nail samples were washed with water and methanol to remove the external contamination, processed with 0.6M HCl, alkalinized, and extracted with CHCl3/isopropanol (3:1 v/v). Sweat and saliva samples were extracted with methanol. After trifluoroacetyl derivatization, the samples were analyzed by mass fragmentography. Methamphetamine and its major metabolite, amphetamine, were detected in hair, nail, and sweat samples, but methamphetamine alone was detected in saliva samples. PMID- 2755091 TI - Quantitation and confirmation of the diazolo- and triazolobenzodiazepines in human urine by gas chromatography/mass spectrometry. AB - We report a reliable, rapid, sensitive, and quantitative method for the N- and O trimethylsilyl (TMS) derivatives of the diazolo- and triazolobenzodiazepines after enzymatic incubation (2 h) and liquid-liquid extraction of 0.5-mL urine volumes. Each analyte was identified by gas chromatography/mass spectrometry through the retention time for the total ion current (TIC) and selected ion monitoring (SIM) of four ion currents. Quantitation of the diazolobenzodiazepines was obtained by the ratio of the base peak ion of the TMS analyte to that of the internal standard bromazepam in the concentration range 50-500 ng/mL (1-10 ng injected into the GC/MS). The limit of detection (LOD) at p less than 0.01 was 50 ng/mL for all the diazolobenzodiazepines. The assay was not quite as sensitive for triazolobenzodiazepines (5-20 ng injected in the GC/MS). The extraction efficiency of the assay ranged from 75 to 92% for all the analytes. The coefficient of variation (CV) for the diazolobenzodiazepines ranged from 5.4 to 9.4% for within-day runs and from 11.1 to 13.9% for between-day runs. For the triazolobenzodiazepines the values were 3.8 to 18.9% for a single day and 3.4 to 19.9% between days. The selected ion current ratio for each analyte was determined for a single day and over a one-week period. There was no statistical difference in the ratios during this time. The confirmation of diazolobenzodiazepines in urine by this method was relatively easy after screening by the immunoassay technique. Identification of triazolobenzodiazepines appeared to be more difficult by both the screening technique and the GC/EI/MS analysis. PMID- 2755092 TI - Application of HPLC-thermospray ionization mass spectrometry for the analysis of triprolidine and its metabolite hydroxymethyltriprolidine in biological samples. AB - High-performance liquid chromatography coupled to positive ion mode thermospray ionization mass spectrometry has been used to characterize triprolidine and its known metabolite hydroxymethyltriprolidine. The method allows direct analysis of these compounds in complex biological matrices. Analysis of an extract from a microbial biotransformation experiment with triprolidine was performed and the results included two baseline-resolved chromatographic peaks. The [M + H]+ ion obtained from the mass spectrum of the first peak was consistent with that of hydroxymethyltriprolidine, and the mass spectrum of the second peak corresponded to triprolidine. Under the described conditions, the minimum detectable level of triprolidine without filament enhancement was estimated at about 10 micrograms injected on column. PMID- 2755093 TI - The matrix effect in the cold-vapor atomic absorption analysis of mercury in environmental samples. AB - In contrast to analyses of biological samples, the cold-vapor atomic absorption determination of mercury in environmental samples exhibits essentially no matrix effect. PMID- 2755094 TI - Psycho-behavioral characteristics of children with vocal nodules: WPBIC ratings. AB - The parents of 30 children referred to speech pathology because of vocal nodules completed the Walker Problem Behavior Identification Checklist (WPBIC) on their children. These checklist responses were then compared to those from the parents of a matched, vocally normal, control group. The nodule children had significantly higher scores on the scales for acting out, distractibility, disturbed peer relations, and immature behaviors. The implications of these results for nodule formation and intervention are discussed. PMID- 2755095 TI - The relationship of stuttering severity and treatment length to temporal measures of stutterers' perceptually fluent speech. AB - The purpose of this study was to investigate the relationship between stuttering severity and treatment length to temporal measures of stutterers' perceptually fluent speech. Seventeen adult stutterers (4 mild, 8 moderate, and 5 severe) were divided into two treatment categories. One group with limited exposure to treatment (n = 7) consisted of stutterers who had completed 0-10 hr of treatment. Another group with an extensive period of treatment (n = 10) consisted of stutterers who had completed 47-212 hr of treatment. All subjects were asked to repeat a simple phrase and read a prose passage. Spectrographic measures of the stutterers' voice onset times, vowel, consonant, and phrase durations were obtained from perceptibly fluent productions of the isolated phrase and from a phrase extracted from the oral reading. Results showed that there were no significant differences among stuttering severity groups or the two groups with different lengths of treatment. These results suggest that changes in temporal measures of stutterers' fluency might occur through the process of treatment, but those changes are not related to stuttering severity or length of treatment. PMID- 2755096 TI - Turn exchange characteristics of SLI children's simultaneous and nonsimultaneous speech. AB - The specifically language impaired (SLI) child's turn exchange behaviors were examined in adult-child interaction and compared to those of children of similar chronological ages or language structural levels. Videotaped language samples were analyzed for verbal and nonverbal behaviors associated with the children's production of simultaneous and nonsimultaneous speech. The results indicated qualitative differences from those of the normal language children in terms of turn errors, interruptions, interactive attention, responsiveness, and turn switch times, as well as variability related to SLI subtype. PMID- 2755097 TI - Maternal question use predicts later language development in specific-language disordered children. AB - The present study used a longitudinal correlational design to test whether variation in mothers' use of information-seeking and confirmation questions predicts variation in auxiliary and copula development in a sample of specific language-disordered children. The study's confirmatory approach provides a sound empirical basis to conclude that the results of the present study did not occur by chance. Post hoc analyses were carried out to clarify the explanation of the predictive relationships. The main finding of the study was that mothers of specific-language-disordered children who used proportionally more information seeking questions had children who showed greater mastery of auxiliary use 12 months later. PMID- 2755098 TI - Effects of elicitation procedures on the narratives of normal and closed head injured adults. AB - Stories were elicited under two conditions--story retelling and story generation- from a group of 23 normal young adults and 4 closed head-injured (CHI) adults who had reached a high level of language recovery. Sentence production, intersentential cohesion, and story grammar were analyzed. The results demonstrated that the two elicitation tasks differentially influenced the performance of both normal and CHI subjects at all levels of analysis, and the two groups differed in the cohesive and story grammar measures only in the story generation task. It is concluded that comparing performance across tasks of story retelling and story generation is a useful procedure for characterizing the discourse problems of CHI subjects with recovery of high-level language skills. PMID- 2755099 TI - Youngsters with moderate or severe mental retardation and severe spoken language impairments. I: Extant communicative patterns. AB - This study characterizes the communicative patterns of youngsters with moderate or severe mental retardation and severe spoken language impairments who are not independent speakers with conversational partners at home and at school. Nine subjects were observed during six 1-hr mealtime sampling periods in both settings for a total of 12 hr. Live continuous observations were made, employing a coding scheme designed to record occurrences of the subjects' communicative behaviors. Findings are discussed with respect to the modes and functions of the youngsters' communications with home and school conversational partners. PMID- 2755100 TI - Key word signing: listeners' classification of signed and spoken narratives. AB - Suprasegmental changes in speaker-signers' speech may be an important component of the results obtained in key-word-sign programs. The aim of this study was to investigate whether untrained listeners could tell a difference between the speech of a person using key word signing with speech and using speech only. Fifty untrained listeners heard an audiotape of six speaker-signers who sometimes used key word signing and sometimes used speech only in their production of 24 spoken narratives. The results demonstrated that listeners could accurately classify all keyword-signed communication of three speaker-signers and the spoken only communication of all four speaker-signers who had been previously identified as demonstrating natural spoken communication. The major perceived differences between the use of key-word-signed communication and spoken-only communication were differences in speech rate and word emphasis and differences in pausing. PMID- 2755101 TI - Using structured discourse as a language intervention technique with autistic children. AB - A structured discourse strategy, employing child echoic imitations and adult expansion, was used to teach 5 autistic children two-term semantic relations. The 5 male preschoolers in late Stage I of linguistic development were exposed systematically to two-term semantic relations in a structured dialogue with a clinician. A combined multiple baseline and AB(A) design was used to examine the relationship between the clinician expansions and the children's subsequent spontaneous imitations and spontaneous productions. The results showed that an increase in modeling and expansion was related to an increase in the children's initial spontaneous imitations of two-term relations. Further, following the increase in spontaneous imitations, spontaneous productions of the two-term relations increased and were maintained, whereas spontaneous imitations subsequently decreased. PMID- 2755103 TI - Speech production deficits in developmental dyslexia. AB - In this study, dyslexic and normal subjects rapidly repeated a series of phonologically complex and simple phrases. Dyslexic subjects repeated the phrases at a significantly slower rate and, in the complex condition, made significantly more errors. An examination of errors suggested that dyslexics may have difficulties in the planning stage of speech production. Findings are discussed in reference to other phonological deficits and oral reading problems in dyslexia. PMID- 2755102 TI - Lexical learning and language abilities in preschoolers with perinatal brain damage. AB - Studies of children with early-acquired brain damage have noted limitations on language development following such damage and have raised questions regarding the process by which these children acquire language skills. The purpose of this study was to examine the effects of perinatally acquired brain damage on early language abilities and on lexical development through the use of standard assessments, language samples, and a miniature linguistic system approach to teach a novel lexicon. Four children, ages 26-41 months, with localized, perinatal brain lesions documented on ultrasound or CT scan were selected for this study and were compared to 4 matched controls. The results show no differences in the pattern of scores and learning in children with right and left brain damage. With the exception of phonological development, subjects scored below controls on all formal language measures; however, the subjects often scored at or above test norms. Brain-injured subjects were similar to controls with respect to the number of novel words that they initially learned on comprehension and production tasks and the number that they consistently comprehended. Brain-injured subjects generally acquired fewer words when the criterion was consistent accurate production. Interestingly, subjects required more exposures to novel lexical items than did controls before reaching a given level of proficiency. Production seemed to be more difficult for all children, but more so for the brain-injured subjects. It appears that the effects of early damage have an impact on many aspects of language development and that these apparent deficits may reflect the child's need for greater exposure to language skills and structures before acquiring them. PMID- 2755104 TI - Factors influencing fundamental frequency range estimates in children. AB - Selected elicitation conditions were manipulated to determine their effect on fundamental frequency (Fo) range estimates in children. Forty normal children each responded to five autiotaped tone conditions: (a) discrete steps, (b) slow steps, (c) fast steps, (d) slow glissando, and (e) fast glissando. These tonal stimuli were devised to elicit each child's maximal and minimal Fo. The traditional discrete-steps condition was associated with a lower maximal Fo, higher minimal Fo, and a more restricted Fo range than all other conditions. PMID- 2755105 TI - Narrative analysis: clinical applications of story generation and story retelling. AB - Narratives were produced by groups of language-disordered and nonimpaired children ages 9:0-11:4 (years:months) in story generation and story retelling tasks. The stories were analyzed in terms of the number of story grammar components, number of complete episodes, relative frequency of story components, and story length. For both groups of children, the results indicated strong overall homogeneity between story generation and story retelling. The retold narratives were longer and contained more story grammar components and complete episode structures for both groups of children. Clause length within complete episodes differentiated story generation from story retelling for the language disordered children but not for the control group. The clinical advantages of using story retelling in language assessment are discussed. PMID- 2755106 TI - An experimental analysis of milieu language intervention: teaching the action object form. AB - The syntactic and pragmatic effects of a milieu language teaching intervention implemented to teach the action-object form were investigated. Subjects were 3 young children with borderline to moderate levels of mental retardation, all in the early stages of productive language development. After a prolonged baseline period, each subject received three to four training sessions per week in a small group interactive play situation. Experimental control was demonstrated by a multiple baseline design across subjects. Generalization was measured along a variety of dimensions. Results indicated that subjects learned to generatively produce action-object combinations. These combinations were used in nonobligatory conversational situations as requests for objects/actions and as declaratives. Subjects also began to respond correctly to probe questions. The results support the conclusion that milieu training procedures can be used to enhance the acquisition and generative use of basic syntactic-semantic forms. The results also suggest that systemic adult commenting, child conversational "scaffolding," and spontaneous imitation may play significant roles for some children in the acquisition and generalization of language taught via a milieu approach. PMID- 2755107 TI - Outcome of intensive language treatment in aphasia. AB - Sixty-eight aphasic inpatients received intensive language treatment (9 hr per week over a period of 6-8 weeks). Outcome was assessed by means of the Aachen Aphasia Test (AAT), a standardized test battery for the German language. For patients with duration of aphasia up to 12 months, amount of improvement was corrected by the expected rate of spontaneous recovery as determined by a previous multicenter follow-up study. About two thirds of the patients showed significant improvement in AAT performance according to psychometric single case analysis procedures. A similar rate of improvement was found for individuals with chronic aphasia beyond the stage of spontaneous recovery. PMID- 2755108 TI - Thermoelastic analysis of laser iridectomies. AB - We have attempted to derive the stress-strain-temperature relationships of the iris stroma subject to a restrictive thermal burn from a laser. The corresponding displacement equation embodies the mechanical impulses due to this thermal insult. This thermoelastic analysis of laser iridectomy attempts to describe the mechanism involved in the surgical procedure. It is clear from this study that the flexural behaviour of the iris is principally due to thermal insult and not due to vapour bubbles or redistribution of the aqueous. PMID- 2755109 TI - Real-time patient weight monitoring system for chair based renal dialysis. AB - A system is described for monitoring weight changes in patients undergoing renal dialysis. Relatively fit patients dialyse in easy chairs rather than in bed but no commercial system is currently available to monitor weight changes under these conditions. The authors have considered basic requirements and have developed a cost effective system based on a Single Point Off-Centre load cell, all components being mounted under a platform on which the easy chair is located. There is an electrical output signal which may be used to drive a display or be sampled by a computer system. PMID- 2755110 TI - Study of cardiac arrhythmia using zero-crossing analysis. AB - It has been known for some time that the variability of the R-R intervals in the electrocardiogram yields valuable information concerning the types of arrhythmia which might be present. In this paper, an investigation is made into the application of zero-crossing analysis to the study of such variability. The number of times the R-R interval crosses its mean value over a specified interval of time is counted, and may be associated with a particular characteristic frequency, related to the dominant frequency components of the power spectrum of R-R intervals. Higher order crossing counts may be computed by taking combinations of sum and difference operations on the original time series. The advantage of using zero-crossing analysis over spectral analysis is the computational simplicity of the former. It is demonstrated, by analysing data taken from the MIT-BIH Arrhythmia database, that zero crossing analysis can sometimes be used t distinguish between different arrhythmias, but forethought concerning the number of sum and difference operations to be taken on the original data set is required when computing the higher order crossing counts. PMID- 2755111 TI - Pericardial heterografts: a comparative study of suture pull-out and tissue strength. AB - The force required to pull sutures out of glutaraldehyde fixed bovine pericardium, for four different suture bites: 0.5 mm, 1 mm, 1.5 mm and 2.0 mm, was compared with the tissue strength. The mean suture pull-out force was significantly lower than the tissue strength for all bites, with a minimum value of 2.86 +/- 1.02 N for the 0.5 mm bite and a maximum value of 6.32 +/- 0.77 N for the 2.0 mm bite. The mean force which produced failure of the chemically modified pericardium was 15.49 +/- 8.48 N. The mean force at pull-out of the sutures lay on a regression line: force at failure = 1.68 + 2.25 x Bite. A video film of the experiments showed that the suture does not cut through the pericardium. It pulls a V-shaped band of collagen fibre bundles through the stationary pericardium. Eventually this band breaks away from the free edge of the tissue specimen. The specimens under uniaxial load failed by laminate debonding of two layers of tissue, rupture of the serosal surface layer followed by shear and fibre slippage. These results indicate that any suture which bears load, during the normal functioning of a heart valve substitute, will be a source of weakness, compared to the overall tissue strength. As a consequence the alignment/holding suture of the Standard Ionescu-Shiley valve and the modified stitch of the low profile valve are likely to be potential sites of fatigue failure. PMID- 2755112 TI - Statistical approach for the estimation of daily physical activity levels using the probability density function of heart rate. AB - An investigation was undertaken into the statistical properties of heart rate during daily physical activity. The probability density function of the heart rate was estimated using the Gram-Charlier series. In addition, the probability density was separated into two Gaussian distributions: relatively low and relatively high heart rates. The former appeared to correspond to the metabolic rate associated with basic daily living and the latter appeared to be associated with more active physical activity of the type necessary to sustain or elevate the level of physical fitness. The higher heart rate distribution of five subjects occupied 8.72 +/- 2.15% of a period of waking. The validity of the statistical approach was confirmed with fractional estimation error of 1.22 +/- 0.62%. PMID- 2755113 TI - Algorithmic sequential decision-making in the frequency domain for life threatening ventricular arrhythmias and imitative artefacts: a diagnostic system. AB - A preliminary study to approach the problem of reliably detecting life threatening ventricular arrhythmias in real time is described. An algorithm (DIAGNOSIS) has been developed in order to classify ECG signal records on the basis of the computation of four simple parameters calculated from a representation in the frequency domain. This algorithm uses a set of rules constituting an operative classification scheme based on the comparison of the parameters with a set of pre-established thresholds. This allows us to differentiate four general categories: ventricular fibrillation-flutter, ventricular rhythms, imitative artefacts and predominant sinus rhythm. PMID- 2755114 TI - Electromagnetic therapy: science or quackery? PMID- 2755115 TI - 5-Bromo-2'-deoxyuridine incorporation into DNA in hepatic VX2 tumor-bearing rabbits. AB - The halogenated pyrimidine 5-bromo-2'-deoxyuridine (BrdUrd) possesses both radiosensitizing and antimetabolite effects through its incorporation as a thymidine analog in replicating DNA. To evaluate the regional advantage for treatment of hepatic malignancy by hepatic arterial infusion, BrdUrd was infused into either the hepatic artery (HA) or a central vein (iv) in 26 rabbits with intrahepatic VX2 tumor. After a 24-hr constant rate infusion of 10, 20, or 40 mg/kg/24 hr, the percentage BrdUrd incorporation into the DNA of bone marrow, duodenal mucosa, liver, and hepatic VX2 tumor was measured by gas chromatography/mass spectrometry methods. VX2 tumor BrdUrd incorporation was greater by HA than by iv routes (P less than 0.001). At doses of 10 and 20 mg/kg/day, HA to iv BrdUrd incorporation ratios for VX2 tumor significantly exceeded those for bone marrow and duodenum (P less than 0.05). At appropriate dose rates, hepatic arterial administration of BrdUrd provides a regional advantage for DNA BrdUrd incorporation in the rabbit intrahepatic VX2 tumor. PMID- 2755116 TI - The effect of a neurotoxin (benzalkonium chloride) on the lower esophagus. AB - Achalasia of the esophagus may be associated with abnormalities of the myenteric plexus (hypo- and anganglionosis). This report evaluates this relationship by studying the effect of benzalkonium chloride (BK, a topical neurotoxin) on the lower esophagus. Following midline laparotomy, topical BK (0.5%) was applied to the muscularis of the lower 1.0 cm of the esophagus for 30 min in 38 Sprague Dawley rats (200 g). Thirty-eight additional rats acted as controls (unoperated, n = 19; sham laparotomy, n = 19). At 1 and 3 months animals were evaluated for weight gain, daily food intake (g/100 gm body wt), lower esophageal sphincter (LES) manometry, and contrast esophagram. At 3 months, the esophagus was evaluated for histologic study and acetylcholinesterase staining. Esophagram showed distal narrowing with proximal dilatation in BK rats (inner diameter 4.71 +/- 0.61 vs 6.17 +/- 0.58 in controls, P less than 0.001). Daily food intake was significantly less in BK rats (5.57 +/- 0.41 g vs controls 7.69 +/- 0.33 g P less than 0.001). Daily weight gain was also less in BK rats (1.13 +/- 0.34 vs controls 1.83 +/- 0.25, P less than 0.001). An increased LES pressure was noted in BK rats (5.45 +/- 0.89 mmHg vs controls 4.04 +/- 1.04 mmHg; P less than 0.1). A histologic study showed aganglionosis in BK rats with positive cholinesterase staining fibers compared to controls. Topical BK results in distal esophageal aganglionosis characterized by distal narrowing, proximal dilatation, decreased food intake, and limited weight gain when compared to controls. These findings are similar to those observed in achalasia and support a primary neurogenic cause for its etiology. PMID- 2755117 TI - Effects of fibrinogen degradation fragments D and E on cell-mediated immunity. AB - Serum taken from severely traumatized victims suppresses in vitro the response of normal lymphocytes to the mitogenic stimulant phytohemagglutinin (PHA). In the postburn period, fibrin degradation products (fragments D and E) are elevated in a high percentage. Controversy exists as to whether these fragments contribute to what is clinically evident as cell-mediated immune (CMI) suppression. Purified fragments D and E were isolated over an ion exchange cellulose column after activating, with streptokinase, a solution containing fibrinogen and plasminogen. Lymphocytes from six volunteers were cultured with PHA and serial dilutions of fragments D and E; each was analyzed for ability to incorporate radiolabeled thymidine. Fragment E possessed in vitro CMI suppression at pharmacologic doses. Fragment D demonstrated immune suppressive capabilities at doses approximating those estimated to occur in the acute postburn phases of injury. PMID- 2755118 TI - The electrical and sodium transport characteristics of sutured premalignant mouse colon. AB - Depolarization of the plasma membrane and increased sodium influx have both been suggested as mitogenic signals. Following bowel resection the intestinal suture line has been reported a fertile site for tumor recurrence. Whether alterations in cell surface signaling occur at suture lines has not been previously examined the electrical changes of sodium transport occurring at a suture line in an animal model of large bowel cancer. Forty-eight female CF1 mice underwent colotomies with repair utilizing silk or chromic sutures. Twenty-four mice underwent sham operations to serve as controls. The mice were injected subcutaneously with the carcinogen DMH (1,2-dimethylhydrazine) 20 mg/kg or an identical volume of 0.9% saline for 6 weeks and were sacrificed 1 week after the last injection. The sites of the sutured colotomies or a piece of distal colon from the sham-operated mice were mounted in a modified Ussing chamber and the electrical properties and unidirectional sodium fluxes were measured. The potential difference (pd) across the distal colon was not significantly different in any suture group compared to that in sham-operated controls when treated with saline (pd sham, -2.3 +/- 0.2 mV (mean +/- SEM); silk, -1.7 +/- 0.3 mV, chromic, 1.9 +/- 0.3 mV, P greater than 0.05, unpaired Student t test). The potential difference was significantly lowered in both suture groups compared to sham operated animals after treatment with DMH (pd sham, -2.6 +/- 0.3 mV; silk, -1.5 +/- 0.2 mV, P less than 0.05; chromic, -1.6 +/- 0.4 mV, P less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2755119 TI - Transport of beta-aminopropionitrile through intact skin or scar tissue. AB - A lathyrogen, [C14]aminopropionitrile (beta APN), was administered to 34 rats either in K-Y jelly or saline vehicles onto intact shaven skin or onto a healed splinted deep excision wound. The dynamics of beta APN transport and content in the skin or repair tissue was observed after 2, 5, 8, and 24 hr of topical administration. The repair tissue quickly absorbed the lathyrogen and reached maximum at the 2-hr sampling. The content of beta APN in the repair tissue was twice as high as that in K-Y jelly vehicle and remained high and stable for at least 24 hr only when beta APN was administered through a saline vehicle. The transport of beta APN through intact skin, irrespective of the vehicle tested, was slow and continuously increased. The study showed that almost 20% of the beta APN administered onto the wounded skin area was transported into the repair tissue within 2 hr. We suggest that, due to the absence of epidermal stratum corneum from the repair tissue, drugs, such as beta APN, penetrate quickly into the wound. PMID- 2755120 TI - Effect of cannulation site on the primary determinants of myocardial oxygen consumption during left heart bypass. PMID- 2755121 TI - Reperfusion-induced arrhythmias in the conscious rat: a comparative study with three calcium antagonists. AB - The effects of three calcium antagonists (diltiazem, verapamil, and nifedipine) on reperfusion-induced arrhythmias were compared in a conscious rat preparation with coronary artery occlusion and implanted electrocardiogram limb electrodes. Upon reperfusion after a 5-min period of occlusion, all (15/15) untreated control rats exhibited immediate ventricular tachycardia, which rapidly deteriorated to ventricular fibrillation; 87% (13/15) of the rats died as a consequence of these rhythm disturbances. In the groups treated with calcium antagonists, each drug (diltiazem, verapamil, or nifedipine) was given as an intravenous bolus 10 min prior to coronary occlusion (n = 12 in each group). The incidence of ventricular fibrillation was significantly reduced by all three calcium antagonists and this antifibrillatory effect resulted in a significantly lower mortality in all drug treated groups. With diltiazem (0.5 and 2.0 mg/kg) mortality fell from 87 to 42% (P less than 0.05) and 35% (P less than 0.01), respectively; with verapamil (0.5 and 5.0 mg/kg) it fell to 25% (P less than 0.01) and 0% (P less than 0.001); and with nifedipine (5.0 and 50 micrograms/kg), it fell to 25% (P less than 0.01) and 8% (P less than 0.001). At a dose of 5.0 mg/kg, verapamil caused a large reduction in heart rate both prior to and during coronary occlusion and reperfusion; however, with other doses and drugs no significant changes in heart rate were observed. ST segment elevation during the 5-min ischemic period was reduced by pretreatment with all drugs. In conclusion, in the conscious rat, pretreatment with diltiazem, verapamil, or nifedipine affords some protection against reperfusion-induced arrhythmias.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2755122 TI - Glucan enhances survival in an intraabdominal infection model. AB - The immunomodulator glucan exists in two forms, particulate (glucan-P) and soluble (glucan-F). Both preparations of glucan, either alone or in combination with antibiotic therapy, were evaluated for their ability to augment survival in rats following cecal ligation and puncture (CL/P). Adult male rats were infused once daily for 5 consecutive days with either glucan-P (10 mg/kg), glucan-F (10 mg/kg), or 5% (w/v) dextrose in water. Three days later all rats underwent CL/P. Postoperatively, the rats received (a) no therapy, (b) saline (1 ml subcutaneously every 12 hr) or (c) ampicillin (33 mg/kg subcutaneously every 12 hr) for 7 days. Without any associated pre-or postoperative treatment, CL/P was associated with an 85% 7-day mortality. Neither glucan preparation alone significantly altered this mortality. Administering ampicillin postoperatively decreased the mortality to 53% (P less than 0.001 vs untreated controls). When postoperative ampicillin therapy was combined with preoperative glucan treatment, the mortality was reduced even further (26% for glucan-P, 21% for glucan-F; P less than 0.02 vs ampicillin-treated controls). We conclude from these results that (i) neither glucan preparation alone effectively enhances survival following CL/P when using the doses and administration schedule employed herein, (ii) both glucan-P and glucan-F do act synergistically with antibiotics to enhance survival in this rat model of polymicrobial sepsis, and (iii) in this particular model, nontoxic glucan-F is as efficacious as glucan-P. PMID- 2755123 TI - Role of porcine endometrial estrogen sulfotransferase in progesterone mediated downregulation of estrogen receptor. AB - Estrogen sulfotransferase (EST) is a progesterone (Pg) induced secretory endometrial enzyme which may effect estrogen receptor levels by esterifying estradiol-17 beta (E2) to an inactive, sulfate form. The effects of this enzyme were studied using specific inhibitors of EST that do not bind to estrogen receptor (ER): 4-nitroestrone 3-methyl ether and 4-fluoroestrone 3-methyl ether. A 1 h pulse with 4 nM E2 caused ERn (i.e. E2-bound, chromatin-bound receptor) to increase 40% in incubations of proliferative gilt endometrium (no EST activity), while the same E2 treatment of secretory endometrium (high EST activity) caused no increase in ERn. ERn accumulation was completely restored in these experiments by preincubating secretory endometrium with 4 microM 4-fluoroestrone 3-methyl ether. Gilt endometrial explants cultured 7 days with 1 nM E2 plus 1 microM Pg (which induced EST activity) possessed half the ERn as explants devoid of EST activity which were cultured in E2 alone. The addition of 10 microM 4 nitroestrone 3-methyl ester to the cultures of secretory endometrium restored ERn to the levels seen in minces cultured with E2 alone. Furthermore, ovariectomized gilts injected daily with 250 micrograms E2 plus 25 mg Pg had much lower ERn (0.06 fmol/micrograms DNA) than gilts injected with E2 only (0.21 fmol/microgram DNA). ERn was restored completely by supplementing the E2 plus Pg injections with 0.5 g 4-nitroestrone 3-methyl ether administered by vaginal suppositories.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2755124 TI - Purification and characterization of a heat- and acid-stable progestin binding protein of rat lung. AB - We report on the purification and characterization of a heat- and acid-stable progestin binding protein of rat lung cytosol, the binding behaviour and capacity of which have already been described by us. Using heat treatment, fractionated acetone precipitation, DEAE, HAP and Sephadex G-100 chromatography, the protein was pure when analyzed by SDS-gel electrophoresis. The molecular weight was found to be 12-13,000 by sucrose density and analytical ultracentrifugation and by SDS gel electrophoresis whereas gel chromatography revealed an apparent molecular weight of 22,000 and a Stockes' radius of 21 A. Among several species tested, only mouse lung contained a similar binding protein, which was only slightly different with respect to binding specificity. The interaction of [3H]R-5020 occurred with the following constants k1 = 5.1 x 10(4) M-1 min-1, k-1 = 0.9-3.5 x 10(-2) min-1 giving an equilibrium dissociation constant of 1.8-6.7 x 10(-7) M compared to 3 x 10(-7) M obtained by Scatchard plot analysis. PMID- 2755125 TI - Mapping on the calf estrogen receptor of the binding domain for an antibody interfering with receptor activation. AB - The localization on the calf estrogen receptor of the binding domain for B36 (an IgM antibody which prevents and reverses the effects of receptor activation) has been studied by means of controlled proteolysis of the receptor-estradiol complex using trypsin, chymotrypsin, and papain. We successively determined for intact and proteolyzed receptor-estradiol complex (i) the abilities of estradiol-binding species to aggregate in low salt medium, to bind to nonspecific DNA absorbed onto cellulose, and to interact with B36 antibody in sucrose gradients; (ii) the hydrodynamic properties of estradiol-binding species, by gel permeation chromatography and sucrose gradient centrifugation in high salt media and (iii) the molecular weights of B36-reactive species, by immunoblot analysis. Three tryptic receptor fragments of Mr 36,000, 34,000, and 33,000 and two chymotryptic fragments of Mr 36,000 and 33,000 included both the hormone- and B36-binding domains but did not interact with DNA, whereas at least two receptor fragments resulting from the action of chymotrypsin and papain bound estradiol with high affinity but interacted neither with DNA nor with B36. Taking into account these results and assuming that structure of the calf estrogen receptor is similar to those of sequenced estrogen receptors (which show a highly conserved organization with considerable homologies in the functional domains), we propose that the B36 binding domain is located either between the DNA- and hormone-binding domains (model I) or at the C-terminal end of the estrogen receptor (model II). The regions that include the main proteolytic cleavage sites of the receptor are also specified, and the abilities of the two models of the calf estrogen receptor to account for the effect of B36 on receptor activation are discussed. PMID- 2755127 TI - Partial purification and characterisation of the human skin fibroblast androgen receptor: detection of abnormal receptor complexes in cells from patients with androgen insensitivity syndromes. AB - After incubation of hGSF with [3H]5 alpha-dihydrotestosterone, 17 beta-hydroxy-7 alpha, 17 alpha-dimethyl-4-estrene-3-one, or 17 beta-hydroxy-17 alpha-methyl 4,9,11-estrien-3-one, androgen-receptor complexes were extracted with 0.5 M KCl and precipitated by 35% ammonium sulphate. Receptor complexes from control hGSF sedimented at approximately 4S on linear 5-20% sucrose gradients. The 4S peak was diminished or absent in cells from androgen insensitive patients exhibiting absent, deficient or unstable binding of androgens in intact hGSF. This procedure may be a useful means of distinguishing quantitative and qualitative defects in androgen binding to receptor, since one cell line found to have normal levels of androgen receptor complexes in whole cell assays had a profile resembling that of receptor negative cells on sucrose gradients. The complexes from one patient with complete androgen insensitivity having normal androgen binding in intact hGSF were indistinguishable from control complexes after sucrose gradient analysis and ADP-Sepharose chromatography. Receptor complexes were eluted from the ADP Sepharose between 0.5-1.0 M KCl. HPLC-gel filtration of androgen receptor complexes at 22 degrees C revealed two peaks, the larger had a Mr of 60-65K, Stokes radius of 3.16 nm and a frictional ratio between 1.21 and 1.43. The second peak, Mr of 15K, was believed to represent a fragment of the receptor containing the steroid binding domain. On gel filtration at 22 degrees C the complexes from a patient with partial androgen insensitivity, who showed a diminished 4S receptor peak on sucrose gradients, revealed only the small "meroreceptor" fragment, suggesting that the mutation in this individual might render the androgen receptor more susceptible to proteolysis in vitro. PMID- 2755126 TI - R 76713, a new specific non-steroidal aromatase inhibitor. AB - The effects of R 76713, a new triazole derivative, on rat ovarian, testicular and adrenal steroidogenesis were investigated both in vitro and in vivo. In vitro R 76713 is a very potent inhibitor of the aromatase enzyme in rat granulosa cells, showing an IC50-value of 3.0 +/- 0.2 nM. The compound is about 1000 times more active than aminoglutethimide which shows an IC50-value of 3900 +/- 2800 nM in the same system. R 76713 is also a highly selective aromatase inhibitor. In cultures of ovarian, testicular and adrenal cells, formation of progesterone, androgens and glucocorticoids was only affected by drug concentrations higher than 1 microM. In vivo, single oral drug doses of 0.05 mg/kg lowered plasma estradiol levels of PMSG-primed female rats by more than 90%. An ED50-value of 0.005 mg/kg could be calculated. A single oral dose of 1 mg/kg suppressed plasma estradiol levels almost completely for 24 h. A dose of 0.1 mg/kg lowered plasma estradiol by more than 90% for 8 h. In vivo, R 76713 also showed a highly selective profile. In LHRH/ACTH-injected rats, plasma levels of testicular and adrenal steroids remained unchanged after administration of a drug dose of 20 mg/kg. R 76713 at drug concentrations of 10 microM, showed no interaction in vitro with estrogen-, progestin-, androgen- and glucocorticoid-receptors. Given orally at 20 mg/kg for 3 days the compound also showed no estrogen or androgen agonistic or antagonistic effects. PMID- 2755128 TI - Plasma estradiol 17-sulfate and 2-hydroxyestradiol 17-sulfate levels and their metabolic clearance rates in rats. AB - By using highly specific antisera against estradiol 17-sulfate (E2-17-S) and against 2-hydroxyestradiol 17-sulfate (2-OH-E2-17-S), plasma concentrations of these sulfates in Wistar rats were determined. The plasma levels of E2-17-S and 2 OH-E2-17-S in the male were 23.5 +/- 5.3 and 21.6 +/- 6.2 pg/ml, respectively. During the estrus cycle of the female, the plasma concentration of E2-17-S reached its highest level 69.0 +/- 11.8 pg/ml, during the diestrus stage, and its lowest level 36.9 +/- 6.6 pg/ml, during the proestrus stage. Similar tendencies were observed in the case of 2-OH-E2-17-S. To examine the dynamic behavior of both sulfates, the plasma metabolic clearance rate (MCRp) of E2-17-S and 2-OH-E2 17-S were determined by infusion experiments. MCRp of E2-17-S and 2-OH-E2-17-S in male rats were 102 and 653 ml/h (means), respectively, and in female rats were 115 and 644 ml/h (means), respectively. The low MCRp values of both sulfates imply their slow metabolic turn-over. PMID- 2755129 TI - Synthesis of tritium labeled cortoic acids. AB - A procedure is described for the microsynthesis and purification of the high specific activity tritium labeled cortisol metabolites, 20 alpha- and 20 beta cortolic acids and 20 alpha- and 20 beta-cortolonic acids. PMID- 2755130 TI - Alternate hydroxylating activities in newborn rat adrenal cells in primary culture. AB - During the course of a study to produce reference compounds, the metabolism of tetrahydrogenated derivatives (ring A reduced) of progesterone, 6 alpha hydroxyprogesterone, 11-deoxycorticosterone and corticosterone in newborn rat adrenal cells in primary culture was studied. Analysis of the metabolites was made by gas chromatography-mass spectrometry. Most products resulted from the enzymatic reactions of 11 beta-, 18- and 21-hydroxylation, reduction of the 20 oxo group and oxidoreduction of the 3-hydroxyl group. However, unexpected metabolites were produced from the incubation of 3 beta, 5 alpha tetrahydroprogesterone and 6 alpha-hydroxy-3 alpha, 5 beta tetrahydroprogesterone. They resulted from the 16 alpha-hydroxylation of the precursors and probably from the 15 alpha-, 16 beta- and 17 alpha-hydroxylation of 6 alpha-hydroxy-3 alpha, 5 beta-tetrahydroprogesterone. These hydroxylating activities are weak and were not detected from the endogenous steroidogenesis. They were not detected either from the incubation of exogenous steroids with a 3 oxo-4-ene structure or from steroids with a 21-hydroxyl substituent. They result only from substrates showing diminished or no affinity towards the 11 beta/18- and 21-steroid hydroxylase systems. These unusual hydroxylations could be catalyzed by monooxygenase systems in the endoplasmic reticulum similar to those present in the liver or by the monooxygenase systems specific to steroidogenesis. In particular, the reaction specificity of cytochrome P-450(11) beta could be altered by the presence of a 6 alpha-hydroxyl group in a tetrahydrogenated steroid. PMID- 2755131 TI - Low polarity ligands of sex hormone-binding globulin in pregnancy. Part I- Characterization. AB - Certain previously unidentified substances of low polarity binding to the sex hormone binding globulin (SHBG) in pregnancy were investigated. This material consisted of four major peaks (designated 1a, 1b, 2 and 3) as defined in maternal serum on Sephadex LH-20 chromatography. They were characterized with respect to changes in their concentration at various gestational ages and at premature and term labour in maternal serum, cord serum, placenta and maternal urine. Levels were much higher in placenta than in serum, suggesting that all four peaks were of placental origin. In the serum of mothers not in labour, while there was a significant increase in the mean serum concentration of peak (1a + 1b) and peak 3 for 12-24 weeks to 30-38 weeks gestation, there was no significant difference in the mean level of peak 2. However, there was a significant decrease in the serum levels of peak 2, but not peaks (1a + 1b) and 3, from 30-38 weeks gestation to 39 41 weeks gestation (P less than or equal to 0.05). In the serum of mothers in premature labour (30-38 weeks gestation), the levels of peak 2 but not those of peak (1a + 1b) and 3, were decreased (P less than or equal to 0.01) compared to those not in labour. These findings are consistent with the identification of peak 1a as 5 alpha-dihydroprogesterone, peak 1b as progesterone and peak 3 as 2 methoxyestrone as described in part 2. The decrease in the levels of peak 2 (for which the identification remains unconfirmed) in association with premature and impending term spontaneous labour suggest that it may be involved in the maintenance of pregnancy. PMID- 2755132 TI - Low polarity ligands of sex hormone-binding globulin in pregnancy. Part II- Identification. AB - Certain previously unrecognized ligands of SHBG of low polarity in pregnancy were identified. They include two weakly bound compounds: 5 alpha-pregnane-3,20-dione and progesterone; and two strongly bound substances, 2-methoxyestrone and a new steroid, estradienolone (17 beta-hydroxy-1,5-estradiene-3-one). The identification of the first three peaks was based on chromatographic elution patterns, binding characteristics and gas chromatography-mass spectrometry. The identification of the fourth peak, the new steroid, was based on similar kinds of evidence and, in addition, solubility characteristics and ultraviolet absorption spectrum. PMID- 2755133 TI - Drinking-driving compliance in the United States: perceptions and behavior in 1983 and 1986. AB - This investigation of drinking and driving explored American attitudes, beliefs, legal knowledge and self-reported violations through national surveys in 1983 (1,000 drivers) and 1986 (1,800 drivers). The findings from 1986 replicated all of the basic drinking-driving control tactics reported in 1983, and there were modest gains in compliance rates over time. There was a decrease in perceived certainty of arrests, but, in view of the compliance gains, this decrease seems to have been compensated by increases in legal knowledge, credibility of sanctions and personal support for drunk-driving controls. While there was support for some elements of simple deterrence theory, the findings are more fully accommodated by the inculcation process implied in general deterrence theory. PMID- 2755134 TI - Drinking-related locus of control and the drinking status of urban Native Americans. AB - Although promising, the available data concerning drinking-related locus of control have been almost entirely limited to treatment samples of white men. The major purpose of this study was to extend our understanding by comparing the drinking-related expectancies of three groups of Native Americans: problem drinkers, nonproblem drinkers and recovered alcoholics. Multivariate analyses were employed to control statistically for important sociodemographic differences between groups and included a test of the possibility that sex moderated the relationship between drinking status and drinking expectancies. As predicted, problem drinkers reported significantly less personal control of alcohol use than either nonproblem drinkers or recovered alcoholics. There were no significant differences between nonproblem drinkers and recovered alcoholics. Native American men were found to hold significantly more external orientations towards drinking than did women. The results were discussed in terms of comparisons with the available literature, and future research needs were identified. The findings provide indirect support for current treatment philosophies that seek to modify patient perceptions of the controllability of drinking behavior in a more internal direction. PMID- 2755135 TI - An evaluated community action project on alcohol. AB - This article reports outcomes of an evaluated community action program directed toward alcohol problem prevention. In a quasi-experimental design, change was monitored in six cities--two cities with an alcohol-focused community organizer and media campaign, two cities with the media campaign only and two reference cities. The community organizers worked with a local alcohol coordinating committee and other local organizations. They focused on alcohol availability (including the promotion of nonalcoholic beverages), advertising and, to a lesser extent, pricing policies. The media campaign focused on reducing the large quantity drinking of young men, and generated considerable controversy. Before and after surveys of the general population were carried out to evaluate the outcome of the project. Support for control policies on advertising, availability and price held steady in the treatment communities but dropped in the reference communities. The perception of alcohol being essential to entertaining and as being relatively innocuous decreased significantly in the community-action cities. The project thus appears to have met its objectives in these areas, although primarily by stemming the national trend toward greater support for liberalization. PMID- 2755136 TI - Communication skills training with alcoholics for improving performance of two of the alcoholics anonymous recovery steps. AB - Thousands of men and women have begun their recovery from alcoholism through the support of Alcoholics Anonymous (AA). AA recognizes its social support role in defining itself as a "fellowship," but it also sees itself as offering a program of recovery. This program is comprised of the well-known "12-Step" method, which has been adapted by a variety of self-help groups. The purpose of the present study was to determine whether performance of two of these steps, Steps 4 and 5, could be facilitated by teaching communication skills specifically designed to improve their performance. Hospitalized alcoholics were assigned to communication skills training, discussion and assessment-only groups, and their pre- and posttreatment performance on videotaped role-plays of Steps 4 and 5 was assessed. Subjects in the communication-skills training group were found to improve significantly on internal versus external focus, personal responsibility taking, congruent affect and composite skill variables compared to the discussion and assessment-only groups. These results suggest that, among treatment programs that utilize AA's recovery program, the behavioral skills inherent in completing Steps 4 and 5 need to be taught. Merely discussing or alluding to the steps, as is often-times done in group therapy of "step-study" sessions, is unlikely to have any effect on alcoholics' abilities to "work the steps." PMID- 2755137 TI - Lung cancer in chromate workers: high-risk group for multiple lung cancer. AB - We diagnosed eight (8.9%) lung cancer patients in 90 workers exposed to chromate compounds. The duration of exposure ranged from 8 to 31 years, with a mean value of 18 +/- 8 years. The histological classification was squamous-cell carcinoma in seven patients and adenocarcinoma in one patient. The site of origin of the primary tumors was located peripherally in two (25%) and centrally in six (75%). All but one of these patients underwent surgery. In three (37.5%) of these patients, lung cancer foci were detected during the postoperative follow-up by sputum cytology and bronchoscopy. Two of these three patients had multicentric cancer foci: double primary early squamous-cell carcinoma in one and early squamous-cell carcinoma + small-cell lung cancer in the other. In a high-risk group such as chromate workers, we should emphasize early detection of lung cancer by serial sputum cytology, chest x-rays, and bronchoscopy. Lung cancer patients with chromate exposure should be treated with due regard to the possibility of synchronous or metachronous cancer. PMID- 2755138 TI - Natural history and treatment of mucosal melanoma. AB - Forty-three patients with primary mucosal melanomas seen between 1960 and 1987 were reviewed. There were 17 patients with tumors arising from the head and neck, 17 from the vulva and/or vagina, 8 from the anorectum, and 1 from the esophagus. Twenty-one patients were resected with curative intent. In patients with head and neck tumors, local recurrence was the initial cause of failure in the majority of cases, whereas with tumors arising from the anorectum, vulva, and vagina, systemic recurrence was more common. There were four long-term survivors, and three of these had melanomas less than 1 mm thick with negative regional lymph nodes; no patients with mucosal melanoma less than 1 mm thick developed recurrent disease. Overall, actuarial survival was 64% after 1 year and 23% after 5 years. Mucosal melanoma has a poor prognosis, and adequate resectional surgery affords the only chance of long-term survival. PMID- 2755139 TI - Completely obstructive colorectal cancer. AB - Forty-five patients with obstructing carcinoma of the colon and rectum were compared with 176 patients with nonobstructing tumor diagnosed over a 10-year period. The age and sex distribution did not differ between the two groups. The site of greatest risk for obstruction was the splenic flexure and descending colon (50%); median survival in these patients was one-half that for other sites. In the obstructed group no patient had Dukes' stage A vs. 9.6% in the nonobstructed patients, and 22% of the obstructed patients had Dukes' D vs. 14% of the nonobstructed patients. The 5-year survival in Dukes' A was 82%, while no survivors were found for Dukes' D. The crude 5-year survival rate was 22.4% in the obstructed patients and 49.1% in the nonobstructed patients; in-hospital mortality was 22.4% and 6.8%, respectively, and the adjusted actuarial survival was 39% vs. 64%, respectively. Curative resection was performed in 68% of the obstructed and 83% of the nonobstructed patients. The adjusted actuarial 5-year survival rates for these patients were 53% and 76%, respectively. The criteria for the tumor grade tested in this study, which included differentiation of the tumor cells, size, and the presence of perforation, did not influence the survival. Twenty-one patients underwent primary resection, 15 had stage resection, and 9 had diversion procedures. The in-hospital mortality rates were 35% for primary resection and diversion procedures and 7% for stage resection. The crude 5-year survival was 32% for primary resection, 42% for stage resection (not statistically significant), and 0 for diversion procedures. The poor prognosis for the obstructed patients in our study was mainly related to 1) high in-hospital mortality, 2) the lower rate of curative resection, 3) unequal distribution of the tumor site, and 4) to a small extent, the difference in Dukes' stage. PMID- 2755140 TI - Local recurrence after curative resection of rectal cancer: a comparison of low anterior resection and abdominoperineal resection. AB - Local recurrence rates after either low anterior resection or abdominoperineal resection were compared in 109 patients undergoing curative surgery for adenocarcinoma of the rectum between 1979 and 1984. Follow-up information was available for 99 patients (91%). The overall recurrence rate was 19%; ten recurrences (26.3%) for low anterior resections and nine (14.7%) for abdominoperineal resections. (P less than .08). Recurrences were confirmed by biopsy or at reoperation. No significant difference in size of the lesion was evident at initial resection (average largest dimension 4.8 cm for low anterior and 5.5 cm for abdominoperineal resection). The average time to recurrence after resection was 18 months (16.5 months in the low anterior group vs. 19 months in the abdominoperineal group). Mean survival after recurrence was shorter for the abdominoperineal (3.4 months) as compared to the low anterior group (9.5 months) (P = .10). The overall median survival was 21 months (range 0-75 months) in both groups, and 38 patients were alive. Risk factors for recurrence were Dukes C lesions in patients who had a low anterior resection (8/18 or 44% recurrence) and poor histologic differentiation in patients who had either operation (3/6 or 50% recurrence). PMID- 2755141 TI - Morbidity and mortality associated with intraoperative radiotherapy. AB - From May 1984 through July 1988, 67 patients have been treated with intraoperative radiation therapy (IORT) at LDS Hospital. We conducted a detailed evaluation of the morbidity and mortality related to our intraoperative experience. Major complications were classified as those requiring reoperation or resulting in death. Minor complications included all others that could not be attributed to tumor growth or recurrence. Of twelve major complications, three resulted in death. Nonfatal complications included anastomotic leak (5), wound dehiscence (1), gastric outlet obstruction (1), and bowel obstruction (1). When compared with historical controls undergoing comparable surgery at this institution prior to the availability of IORT, complication rates were similar. We feel in our institution, intraoperative radiotherapy has not added to morbidity of aggressive abdominal surgery. PMID- 2755142 TI - Chronic radiation enteritis: a community hospital experience. AB - A retrospective study was undertaken to evaluate the operative management of patients with chronic radiation enteropathy. Thirty-eight affected patients from 1974 to 1986 were reviewed. Patients with recurrent cancer responsible for symptoms were excluded. Seventy-one percent of patients presented with bowel obstruction. Twenty-one patients were treated with bowel resection, while 17 were treated with a bypass procedure or diverting ostomy alone. Overall morbidity was 45%, and postoperative mortality was 16%. Patients in the bypass group were significantly older than those in the resection group (70.3 vs. 55.5 years, P = .024), suggesting that age may have been a determinant of the procedure performed. In our study there was no difference in outcome based on preexisting vascular disease, tumor site, type of procedure performed, or radiation dose. We conclude that resection is the procedure of choice in cases of chronic radiation enteritis requiring surgery except in cases with dense adhesions when enteroenterostomal bypass is a viable alternative. PMID- 2755143 TI - Right colon cancer: long-term results after curative surgery and prognostic significance of duration of symptoms. AB - Between 1976 and 1986, a consecutive series of 195 patients with right colon cancer were admitted at the First Department of Surgery of the University of Rome. Patients were divided into five groups according to the absence of intestinal symptoms (group 1) and the duration of the symptomatic phase (groups 2 5). Analysis of the preoperative investigation showed that colonoscopy was able to identify 33 (26.2%) of tumors misdiagnosed by double contrast X-ray barium enema. We did not notice any correlation among symptom duration and tumor stage, tumor differentiation, operability rate, and survival. Patients admitted in the asymptomatic phase presented tumors of less advanced stage and, thus, had the best survival rate (71.4%). In this group, patients promptly treated had a better survival rate (87.5%) than those treated after 2 months (50%). Our study suggests that only neoplasms diagnosed in asymptomatic patients and treated promptly are related to a good survival rate. We, therefore, emphasize the importance of education of patients and family physicians about right colon cancer and the necessity to investigate all patients with a suspected right colon cancer by means of colonoscopy. PMID- 2755144 TI - Extremity soft tissue sarcomas: analysis of prognostic variables in 300 cases and evaluation of tumor necrosis as a factor in stratifying higher-grade sarcomas. AB - From July 1975 to February 1985, 300 patients with extremity soft tissue sarcomas (STS) were entered into treatment protocols at the National Cancer Institute. Using the Cox proportional hazards model, the STS were analyzed for independent prognostic variables that had significant association with disease-free and overall survival. The effects of adjuvant treatment were also included in the analysis. Percent tumor necrosis was the basis for separating intermediate and high-grade STS (less than 15% necrosis = grade 2; greater than 15% necrosis = grade 3). The most important prognostic variable was histologic grade, which was highly associated with relative risk of metastasis and fatal outcome (P less than .0001). Histologic type of STS was not a significant prognostic variable in predicting metastases. Patients with tumors located on the proximal or middle part of the extremity had a fivefold increased risk of death (P = .02) compared with patients who had STS located more distally. Mitotic activity (P = .0005) and vascular invasion (P = .0034) were also associated with malignant behavior, but histologic grade was the most significant predictor of outcome. Histologic grade of malignancy was based upon a combination of tumor typing and visual estimation of extent of tumor necrosis; using these two features, one can reliably separate low-grade (i.e., grade 1) from high-grade STS and also stratify the more aggressive (i.e., grade 2 and 3) tumors. Over the 9.5-year period of study, the tumor-related mortality was as follows: grade 1 (1/38), 3%; grade 2 (19/142), 13%; and grade 3 (45/120), 38%. PMID- 2755145 TI - Anesthetized rabbit as a model for ischemia- and reperfusion-induced arrhythmias: effects of quinidine and bretylium. AB - Experiments were performed to assess the feasibility of using anesthetized rabbits for the study of ischemia- and reperfusion-induced arrhythmias. Initial studies indicated that occlusion of the left anterior descending coronary artery produced ectopic activity in only one out of eight rabbits. All rabbits subject to occlusion of the left circumflex artery below where it emerges from under the left atrial appendage had ECG changes (ST-segment elevation, Lead II), 80% had arrhythmias, and 50% died in ventricular fibrillation during the first 20 min of coronary artery occlusion. Subsequent reperfusion in the survivors produced further arrhythmias in the majority of rabbits, and one fibrillated. Although a high incidence of ectopic activity was also observed in rabbits subject to occlusion of the left circumflex artery close to its origin, or both the left anterior descending and circumflex arteries, this was accompanied by marked reductions in arterial blood pressure. Thus, occlusion of the left circumflex artery at the lower site was chosen for all further studies. Quinidine hydrochloride 10 mg kg-1 (n = 10) or bretylium tosylate 20 mg kg-1 (n = 10) administered 15 min prior to coronary artery occlusion reduced the incidence of ischemia-induced ventricular fibrillation to 10% compared with 60% in controls (n = 15). Although bretylium reduced arterial blood pressure and heart rate, neither drug altered the hemodynamic consequences of coronary artery occlusion (e.g., increased left ventricular end diastolic pressure). Bretylium at doses of 5 and 20 mg kg-1, but not quinidine, reduced the ST-segment elevation that developed during the ischemic period. The ability to detect the antifibrillatory activity of quinidine and bretylium suggests that the anesthetized rabbit may provide a useful alternative or additional model for the study of arrhythmias induced by acute myocardial ischemia. PMID- 2755146 TI - Plasma exudation. Correlation between Evans blue dye and radiolabeled albumin in guinea pig airways in vivo. AB - We quantified the tissue exudation and luminal transudation of two plasma markers, Evans blue (EB) dye and [125I]-human serum albumin (HSA), into the airways of the anesthetized guinea pig in response to platelet activating factor (PAF). There was a highly significant correlation between the tissue content of EB and [125I]-HSA in all airways studied. Significant correlation for transudation of the two markers was limited to high rates of plasma leakage. [125I]-HSA was the more sensitive marker for the association between exudation and transudation and the effect of PAF on transudation. EB was the better marker for assessing the relationship between the dose of PAF and plasma exudation. PMID- 2755147 TI - Evaluation of the JT and corrected JT intervals as a new ECG method for monitoring doxorubicin cardiotoxicity in the dog. AB - A comparison was made of the sensitivity of ECG, ultrastructural heart pathology, and plasma enzymes CK-MB and alpha-HBDH as methods to assess doxorubicin cardiotoxicity in adult beagle dogs given doxorubicin 30 mg/m2 i.v. once a week for three times. A progressive increase in JT and QT intervals, in corrected JT (JTc) and QT (QTc) intervals as well as a reduction in both T wave amplitude and RR duration, were observed in doxorubicin-treated dogs; the electrocardiogram (ECG) abnormalities were associated with doxorubicin-induced ultrastructural changes in cardiac tissue, consisting of dilation of the sarcoplasmic reticulum, multiform, flasklike invaginations of T-tubules containing electrondense material, and interruption of the junctional sarcoplasmic reticulum, which became more severe as the observation period progressed. On the contrary, doxorubicin treatment was associated with transient changes in plasma CK-MB and alpha-HBDH, which were unrelated to the severity of chronic cardiotoxicity. Overall results suggest that the monitoring of the ECG parameters related to the repolarization of the cardiac muscle, and particularly JT and JTc, might be regarded as a noninvasive method for the study of doxorubicin cardiotoxocity in the dog. PMID- 2755148 TI - Characterized and predictable rabbit uveitis model for antiinflammatory drug screening. AB - A model has been developed for the screening of antiinflammatory ophthalmic drugs in rabbits. This simple and rapid method is reproducible and uses fewer animals than do some other methods. Rabbits are sensitized to bovine serum proteins, then challenged intravitreally to induce a uveitis. The basis of the inflammatory response is shown to be due primarily to an immunologic mechanism. At 24 hr postchallenge, animals are sorted into treatment groups of approximately equal "titer" as defined by the slit lamp examination iris score which measures the magnitude of the immunologic response. Topical ocular treatment (control or drug) is then initiated and continued for a total of four days. Iris inflammation is evaluated by daily slit lamp exams. Results indicate that this model has statistically narrower frequency distribution of iris ratings than another published method, and is faster than other equally accurate and precise methods that depend upon blood antibody titer to sort animals. PMID- 2755149 TI - Left ventricular function in subacute and chronic mitral regurgitation. Effect on function early postoperatively. AB - Quantitative analysis of biplane ventriculograms, including calculation of the end-systolic pressure/volume ratio, was used to define left ventricular systolic performance in 10 normal subjects, 10 patients with symptomatic subacute (less than 6 months' duration) mitral regurgitation, and 18 patients with symptomatic chronic mitral regurgitation. Left ventricular volume, mass, and systolic function were similar for patients with subacute and with chronic mitral regurgitation, suggesting that some patients with recent-onset nonischemic mitral regurgitation have partial adaptation to chronic valve insufficiency prior to their symptomatic event. Rate of development of left ventricular wall stress in early systole was increased in subacute mitral regurgitation compared with chronic mitral regurgitation and normal subjects. Duration of symptoms did not correlate with degree of ventricular adaptation to mitral regurgitation, and end systolic indices of left ventricular performance did not predict early postoperative clinical response to valve replacement or repair. PMID- 2755150 TI - An assessment of the mechanical properties of leaflets from four second generation porcine bioprostheses with biaxial testing techniques. AB - The aim of this study was to determine whether second-generation porcine bioprostheses, glutaraldehyde fixed at pressures said to be less than 4 mm Hg, exhibit more natural leaflet material properties than earlier valves fixed at 80 to 100 mm Hg. Biaxial mechanical testing techniques were used to compare Carpentier-Edwards SAV, St. Jude Medical BioImplant, Hancock II, and Medtronic Intact bioprostheses (12 leaflets from four valves in each case) with fresh porcine aortic valves and high pressure-fixed Carpentier-Edwards 6625 bioprostheses (14 leaflets from five valves in each case). The circumferential extensibility of leaflets from Medtronic Intact bioprostheses and from fresh porcine aortic valves were not significantly different (p greater than 0.05), whereas leaflets from the other second-generation valves tested and from Carpentier-Edwards 6625 valves were highly inextensible in the circumferential direction. The radial material properties of leaflets from all bioprostheses differed from those of fresh porcine aortic valves, which were very extensible with a high pretransitional compliance. The radial extensibility and compliance of Hancock II, St. Jude Medical BioImplant, and Carpentier-Edwards 6625 leaflets were not significantly different (p greater than 0.05). In the radial direction, Carpentier-Edwards SAV and Medtronic Intact valve leaflets were substantially more extensible than Carpentier-Edwards 6625 leaflets (p less than 0.01), whereas Medtronic Intact leaflets were more compliant than all other bioprostheses. These data demonstrate (1) that second-generation porcine bioprosthetic valves do not necessarily exhibit more natural leaflet material properties than earlier high pressure-fixed xenografts and (2) that Medtronic Intact valve leaflets have material properties most closely approximating the fresh porcine aortic valve. PMID- 2755151 TI - Early follow-up of patients with the Medtronic Intact porcine valve. A new cardiac bioprosthesis. AB - A new-generation porcine valve fixed in glutaraldehyde at zero pressure and mounted on an acetal copolymer flexible stent was inserted in 97 patients between August 1983 and October 1986. The mean age of the patients was 51 years (range 10 to 76) and eight were under the age of 20 years. There were 57 mitral, 33 aortic, and 10 tricuspid valve replacements. Concomitant coronary artery bypass grafting was performed in 9% of patients, 40% underwent multiple valve operations, and in 40% the procedure was a reoperation. Mean follow-up was 26 months (range 12 to 49) and was 99% complete. There were no examples of primary tissue failure, and only to reoperations have been undertaken for infective endocarditis alone. The early mortality rate was 8.2% and the late mortality rate, 12.1%. Four late deaths were valve related (two caused by infective endocarditis and two by embolism). The actuarial 3-year survival rate was 70%, freedom from infective endocarditis 879%, freedom from embolism 87%, freedom from reoperation 90%, and freedom from valve-related complications 77%. All but three surviving patients were in New York Heart Association class I or II. Doppler echocardiography, performed in 62 of 76 survivors, showed thin and mobile leaflets in all patients and trivial or mild regurgitation in four (6%). The mean gradient across the Medtronic Intact valves (Medtronic Blood Systems Inc., Minneapolis, Minn.) in the aortic position was 17 +/- 5.2 mm Hg, in the mitral position 3.8 +/- 1.33 mm Hg, and in the tricuspid position 4.1 +/- 1.14 mm Hg. We conclude that early results with the Intact valve are encouraging. PMID- 2755152 TI - Evaluation of patients at risk for protamine reactions. AB - Patients with neutral protamine Hagedorn and protamine-zinc insulin-dependent diabetes, a history of fish allergy, or prior vasectomy have been reported to be at an increased risk for protamine reactions after cardiopulmonary bypass because of prior sensitization. We prospectively evaluated cardiac surgical patients with prior vasectomies and fish allergies and retrospectively evaluated a cohort of 3245 consecutive cardiac surgical patients requiring cardiopulmonary bypass over a 2-year period for protamine-containing insulin use and clinical evidence of adverse reactions after protamine administration for heparin reversal after cardiopulmonary bypass. Clinical reactions to protamine did not occur in six patients with fish allergies or 16 patients with prior vasectomies. There was one reaction (0.6%) in 160 patients with neutral protamine Hagedorn insulin-dependent diabetes. The incidence of clinical reactions in the other patients was 2/3085 (0.06%). The incidence of clinical reactions in the patients with neutral protamine Hagedorn insulin-dependent diabetes is not significantly different from that in other patients. We conclude that prior neutral protamine Hagedorn insulin use, a history of fish allergy, or prior vasectomy does not represent a contraindication to protamine administration after cardiopulmonary bypass. PMID- 2755153 TI - Transposition of the great arteries with straddling tricuspid valve. Report of two rare cases with acquired subaortic stenosis after main pulmonary artery banding. AB - The clinical, hemodynamic, angiocardiographic, and postmortem findings of a previously unreported type of subaortic stenosis are presented in two patients who also had straddling tricuspid valve and transposition of the great arteries. The subaortic stenosis became apparent after banding of the main pulmonary artery and was due to hypertrophy of a probably abnormally positioned moderator band resulting in a double-chambered right ventricle. Fibrous tissue accumulation at the stenotic os infundibuli also contributed to the subaortic obstruction. Both patients had situs solitus of the atria. Patient 1 had ventricular inversion (L loop ventricles) and atresia of the right-sided mitral valve. Patient 2 had normally positioned ventricles (D-loop) and two atrioventricular valves. The presence of a large left ventricle and a small right ventricle in the angiocardiogram led to the erroneous diagnosis of a single left ventricle with an infundibular outlet chamber in both patients. Consequently, the subaortic obstruction was thought preoperatively to be at the site of a restrictive bulboventricular foramen. Patient 1 died 36 hours after placement of a valved conduit from the left ventricle to the descending aorta. Patient 2 was operated on successfully and the surgical procedures performed are described. PMID- 2755154 TI - Creation of brachial artery-basilic vein fistula. A supplement to the cavopulmonary shunt. AB - Since 1984 five patients who had previously had cavopulmonary shunts for cyanotic congenital heart disease have returned to the Birmingham Childrens' Hospital with increasing breathlessness and cyanosis. Two had had a classic Glenn (unidirectional) cavopulmonary shunt and three, a bidirectional shunt; all shunts had been performed 5 to 18 years earlier. Each patient was reinvestigated and underwent creation of a brachial artery-basilic vein fistula. This procedure is known to have good patency rates when used in other situations (for example, for hemodialysis), but it has not been previously described for use in this context. Of the five patients, four had a considerable and sustained symptomatic improvement on follow-up of 12 to 49 months (mean 31 months), but the condition of one continued to deteriorate; that child has subsequently undergone a Fontan procedure, also with no improvement. Only one patient complained of coldness of the arm, and there were no other complications. We believe a brachial artery basilic vein fistula has considerable advantages in terms of ease of operation and postoperative complications when compared with an axillary arteriovenous fistula, used as a supplement to an inadequate cavopulmonary shunt. PMID- 2755155 TI - Studies on prolonged acute regional ischemia. II. Implications of progression from dyskinesia to akinesia in the ischemic segment. AB - This study analyzed the pattern of regional wall motion in 58 dogs undergoing 4 to 6 hours of left anterior descending coronary artery occlusion. Regional wall motion was measured by ultrasonic crystals and ischemic muscle either remained dyskinetic (-40% of control systolic shortening, n = 26) or progressed toward akinesia (less than 20% of control systolic shortening or greater than 50% reduction in passive lengthening, n = 32). Ten dogs underwent unmodified blood reperfusion. Regional blood flow (radioactive microspheres), histochemical damage (triphenyltetrazolium chloride staining), and mitochondrial function were determined. Hearts showing persistent dyskinesia had more collateral flow (12 versus 2 ml/100 gm/min, p less than 0.05), less histochemical damage (26% versus 63% area at risk/area of nonstaining, p less than 0.05), and better retention of mitochondrial oxidative phosphorylation capacity (adenosine triphosphate, 622 versus 444 nmol/mg protein/min, p less than 0.05), and tended toward mitochondrial calcium accumulation (48 versus 64 nmol/mg protein). Unmodified blood reperfusion after 4 hours of ischemia produced prompt akinesia (-2% +/- 3% systolic shortening) and was associated with increased edema (82% water content), caused the low-reflow phenomenon (19% control subendocardial flow, 13 ml/100 gm/min), and increased histochemical damage (69% triphenyltetrazolium chloride nonstaining, p less than 0.05). These findings suggest that persistent dyskinesia during early ischemia (first 6 hours) may reflect a relatively optimistic sign, as regression to akinesia occurs in muscle with less collateral flow, more impaired mitochondrial function, worsened calcium homeostasis, and more severe histochemical and ultrastructural damage. These observations imply that careful evaluation of ischemic wall motion may provide a valuable insight into potential muscle salvage. PMID- 2755156 TI - Elastofibroma dorsi: benign chest wall tumor. AB - Elastofibroma dorsi was diagnosed in seven patients at the Columbia-Presbyterian Medical Center between 1976 and 1986. The ages of the patients ranged from 6 to 79 years (mean 49.3 years). No sex predominance was seen. Five cases of unilateral subscapular tumor and two cases of bilateral masses were identified. Four patients had pain with arm motion, and the remaining patients were free of symptoms. A nonencapsulated soft tissue mass elevating the scapula was identified by computed tomography. Incisional biopsy was performed in all cases, followed by local excision of the tumor. On gross examination, these lesions were firm and rubbery. Histologic evaluation demonstrated a slightly hypercellular fibrous tissue that contained variable numbers of fragmented elastic fibers. All patients with symptomatic tumors had complete relief of their pain after the operation. No recurrences were observed. Clinically, elastofibroma may mimic sarcoma and fibromatosis (extraabdominal desmoid tumors). Whether elastofibroma is a true neoplasm or a reactive fibrous lesion that produces not only collagen, but also abnormal elastic fibers, has been the subject of controversy and remains undetermined. PMID- 2755157 TI - Importance of topical hypothermia during heterogeneous distribution of cardioplegic solution. AB - Recent studies have suggested that topical hypothermia may be unnecessary during coronary bypass operations because of possible pulmonary complications resulting from phrenic nerve damage. This study was undertaken to determine whether topical hypothermia is necessary for optimal myocardial protection when distribution of the cardioplegic solution is heterogeneous because of coronary occlusions. Twenty pigs were subjected to 120 minutes of ischemic arrest with multidose potassium crystalloid cardioplegia (4 degrees C). During arrest, the mid-left anterior descending coronary artery was occluded with a snare that was released on reperfusion. Ten of these pigs received topical hypothermia and 10 others served as controls. Hearts protected with topical hypothermia had lower temperatures in the left anterior descending (7.0 degrees +/- 0.7 degree C versus 18.5 degrees +/ 0.5 degree C; p less than 0.05) and circumflex regions (8.9 degrees +/- 0.5 degree C versus 15.5 degrees +/- 0.5 degree C; p less than 0.05). The pH values were higher in hearts protected with topical hypothermia in both the left anterior descending (7.36 +/- 0.09 versus 6.73 degrees +/- 0.07; p less than 0.05) and circumflex regions (7.40 +/- 0.07 versus 7.05 +/- 0.07; p less than 0.05). Topical hypothermia also resulted in better preservation of postischemic stroke work index (0.64 +/- 0.06 versus 0.40 +/- 0.08 gm-m/kg; p less than 0.05) and wall motion scores (1.0 +/- 0.3 hypothermia versus 1.8 +/- 0.4 no hypothermia; p less than 0.05). We conclude that topical hypothermia affords maximal myocardial protection when coronary occlusions are present and should be used during all coronary operations. PMID- 2755158 TI - Depressed myocardial contractility and normal ejection performance after aortic valve replacement in patients with aortic regurgitation. AB - Left ventricular cineangiography and pressure measurement were performed in 33 patients with chronic aortic regurgitation before and after aortic valve replacement and in 25 normal control subjects. Stress and volume were analyzed. The 33 patients were divided into three groups based on preoperative end-systolic volume index: 15 with an index of less than 100 ml/m2 (group I), 12 with an index of 100 to 200 ml/m2 (group II), and six with an index of more than 200 ml/m2 (group III). Afterload estimated as end-systolic stress, which was significantly elevated in all groups before operation, returned to normal postoperatively. Systolic pump function improved postoperatively in all groups; group I and group II showing the most improvement with group III still having an abnormal ejection fraction. The ratio of end-systolic stress to end-systolic volume index, which is an index of contractile state that is relatively independent of preload and afterload, was abnormal in each group preoperatively. Postoperatively, the ratio improved in each group (from 2.8 +/- 0.5 to 4.8 +/- 0.9 for group I, from 1.4 +/- 0.3 to 3.2 +/- 0.6 for group II, and from 0.8 +/- 0.2 to 2.6 +/- 0.8 for group III, compared with 5.9 +/- 1.0 for control subjects). Group I had normal values whereas group II and group III had subnormal ratios, suggesting a depressed contractility. All 15 patients in group I had values that fell within the 95% confidence limits of the linear inverse relationship between ejection fraction and end-systolic stress for control subjects. Nine of the 12 patients in group II and all six in group III had values that fell below the 95% confidence limits of the normal ejection fraction-end-systolic stress relationship. Aortic valve replacement may reduce afterload and improve systolic pump function in many patients with aortic regurgitation. However, there is a subgroup of patients who, despite normal or near-normal pump performance as assessed by ejection fraction, have depressed myocardial contractility characterized by an abnormal relationship between end-systolic stress and either ejection fraction or end-systolic volume. PMID- 2755159 TI - Cardioplegia and communication. PMID- 2755160 TI - Complement activation caused by different oxygenators. PMID- 2755161 TI - A simple "solution" worth consideration to combat limb ischemia induced by intraaortic balloon pumping. PMID- 2755162 TI - Real pulmonary resistance depends on real pulmonary flow. PMID- 2755163 TI - Surgical treatment of aberrant right subclavian artery aneurysms. PMID- 2755164 TI - Thrombotic complications with the Omniscience valve: a current review. PMID- 2755165 TI - Traumatic rupture of the thoracic aorta. PMID- 2755166 TI - Atherosclerosis and blood flow velocity. PMID- 2755167 TI - Occlusion of the coronary perfusion graft: an exceptional complication after reconstruction of the ascending aorta with the Cabrol technique. PMID- 2755168 TI - Listeria prosthetic valve endocarditis. PMID- 2755169 TI - An easy and safe approach for simultaneous repair of severe pectus excavatum and the underlying lesions of the heart and thoracic aorta. PMID- 2755170 TI - Delayed myocardial rupture after the use of an implantable left ventricular assist device intractable ventricular fibrillation caused by myocardial infarction. PMID- 2755171 TI - Replacement of the transverse aortic arch during emergency operations for type A acute aortic dissection. PMID- 2755172 TI - Atrial myxoma: a new surgical approach using neodymium:yttrium-aluminum-garnet laser photocoagulation. PMID- 2755173 TI - Improvement of the tetramethyl benzidine reaction with ammonium molybdate as a stabilizer for light and electron microscopic ligand-HRP neurohistochemistry, immunocytochemistry and double-labelling. AB - Ammonium heptamolybdate (AHM) was used as a stabilizing agent in the tetramethyl benzidine (TMB) reaction of choleragen subunit B conjugated horseradish peroxidase (CB-HRP) neurohistochemistry (TMB-AHM method). In comparison with Mesulam's TMB method employing sodium nitroprusside as a stabilizing agent (TMB SNP method), the TMB-AHM procedure offers a similar sensitivity with regard to the visualization of CB-HRP labelled neurons and their extranuclear Golgi-phobic dendrites. However, it is less sensitive for the demonstration of anterogradely transported CB-HRP in axon terminals. At the nearly physiological pH value of the reaction medium (pH 6-8), it demonstrates better preservation of tissue and cell structures in the reacted sections. Under the electron microscope, the specific reaction product can be clearly distinguished and little damage of cellular and subcellular structures occurred. Preliminary application of TMB-AHM method to choleragen subunit B (CB) immunocytochemistry and double labelling technique which paired the neuronal tracing methods of HRP neurohistochemistry and CB immunocytochemistry, was also carried out with small modification. PMID- 2755174 TI - A simple method for the Schwann cell preparation from newborn rat sciatic nerves. AB - We have developed a simple and relatively rapid method for obtaining a sufficient number of Schwann cells with a favorable purification ratio from newborn rat sciatic nerves. Perineurium-free nerves were torn into small fascicles of approximately 150-200 microns in diameter and explanted twice on type I collagen gel every 2 days of the culture period in order to reduce the number of contaminant fibroblasts. The last explanted tissues were fed with Dulbecco's modified Eagle medium supplemented with 10% fetal bovine serum and 100 micrograms/ml bovine pituitary extract for 10 days. More than 10 X 10(4) Schwann cells (greater than 95% purity) were obtained from newborn rat sciatic nerves. PMID- 2755175 TI - Alterations in the corticomotor evoked potential following spinal cord ischemia. AB - A simple yet reliable model of spinal cord ischemia has been previously developed by inserting a Swan-Ganz catheter into the abdominal aorta of rabbits and inflating the balloon just inferior to the renal arteries. Recent investigations have shown that paraplegia is consistently reproduced if the balloon remains inflated for 20 min after loss of the N3 component of the somatosensory evoked potential. Because of its high reliability, this model has been frequently and successfully used to determine the efficacy of pharmacological agents thought to provide protection against spinal cord ischemia. Results from the present report demonstrate that a similar degree of reliability can be achieved in this model for testing motor activity. A simple method of evoking highly reproducible motor potentials, that can be percutaneously recorded from the spinal cord in response to cortical stimulation, was developed. Predictable and repeatable changes in the configuration of the corticomotor evoked potential were found during spinal cord ischemia and reperfusion. With this added dimension of functional assessment, future application of the current spinal cord ischemia model have been greatly expanded. PMID- 2755176 TI - An eyecup slice preparation for intracellular recording in vertebrate retinas. AB - This report describes a new preparation for intracellular recording from the vertebrate retina, the eyecup slice preparation. It consists of a small (2 X 5 mm) strip cut from the posterior wall of the eye and thereby keeps the sclera, pigment epithelium and neural retina in place. Initial results are presented here for two vertebrates: the turtle, Pseudemys scripta elegans, and the toad, Bufo marinus. With conventional microscopy, the histological layers of the retina can be resolved, as well as individual photoreceptors, to provide landmarks for intracellular recording. When superfused, the eyecup slice remains in good condition for many hours and yields intracellular recordings of good quality and stability. Recordings of the light-evoked responses of cones and horizontal cells show that the slice is large enough to preserve the characteristic spatial interactions mediated by the laterally coursing neural networks of the distal retina. Recordings from rods show that full dark adaptation is achieved. Thus, photochemical dark adaptation as well as other normal cellular interactions between the neural retina and pigment epithelium can be preserved in this preparation, in contrast to isolated retinal slice preparations. The eyecup slice preparation might be particularly useful for work on mammalian retinas. PMID- 2755177 TI - Inner ear implants for experimental electrical stimulation of auditory nerve arrays. AB - Electrode arrays chronically implanted in the inner ear are gaining increased use for experimental studies of the auditory nervous system, as well as for studies related to development of improved auditory prostheses. Commercially available electrode arrays are designed for human use and thus may be unsuitable for experimental studies, particularly in small animals. This paper describes a simple, inexpensive method for making custom electrode arrays in a variety of configurations, suitable for animals ranging from small rodents to non-human primates. PMID- 2755178 TI - A new method for relating behavior to neuronal activity in performing monkeys. AB - A new method is presented for the analysis and interpretation of data from single neuronal recording in behaving monkeys. Most current methods relate changes in neuronal activity to behavior by constructing rasters and histograms centered on specific previously defined behavioral events whose relevance to neuronal activity cannot be determined beforehand. As a consequence false conclusions may result. The new method aligns rasters and histograms of neuronal activity relative to patterns inherent in the neuronal activity irrespective of the animal's behavior. The behavior is then related to the neuronal activity. This frees interpretation from a priori notions as to the relevant behavior. The method also determines the variability of temporal latencies between changes in neuronal activity and any behavioral event on an individual trial by trial basis. With the assumption that the latencies will be least variable between the change in neuronal activity and the most relevant behavioral event, the relatedness of neuronal activity changes to behavior can be tested so that physiological conclusions can be inferred. The same method and subsequent analyses can be applied to electromyographic activity. PMID- 2755180 TI - Improving performance of motorized slides for micromanipulation. AB - Motorized linear slides used as micromanipulators for biological use suffer from 3 problems: vibration at low speed, poor ergonomic design of the controller and slow coarse positioning. These problems are not hard to solve by minor modifications to the controller and the slides. PMID- 2755179 TI - Multisite recording of brain field potentials and unit activity in freely moving rats. AB - A technique has been developed to record from 16 different brain sites of the freely moving rat using subminiature MOSFET preamplifiers. The high input impedance, small size, durability and light weight of the amplifiers and connecting cable allows high quality multisite recording of field potentials and unit activity. In addition, a movable headstage for positioning multiple microelectrodes is described. The compact recording system permits one to construct neocortical EEG maps, instant depth profiles of evoked and spontaneous field data, and to study neuronal synchrony of distant cell populations. PMID- 2755181 TI - Effect of fixatives on rat brain acetylcholinesterase activity. AB - Biochemical measurement of acetylcholinesterase (AChE) activity on sonicates of samples of rat cortex, striatum and cerebellum which had been treated with either 4% formaldehyde (HCHO) or 4% HCHO/0.5% glutaraldehyde suggest that fixation of tissue causes a rather large loss (50-80%) in AChE activity which may vary considerably from region to region of brain. Attempts to protect the activity by treatment with diisopropyl fluorophosphate (DFP) before fixation and reactivation after fixation with pyridine-2-aldoxime methiodide (PAM) were unsuccessful. The results suggest care must be exercised in attempting to use AChE histochemistry on fixed tissue for quantitative measurements. PMID- 2755182 TI - Use of formamide increases the number of detectable inputs to polyneuronally innervated mammalian skeletal muscle. AB - We evaluated the extent of polyneuronal innervation in neonatal rat lateral gastrocnemius muscle with intracellular recording techniques using both formamide and d-tubocurarine as paralytic agents. We detected more polyneuronal innervation during the first postnatal week using formamide than d-tubocurarine. Both the average number of inputs per muscle cell and the percentage of polyinnervated cells were greater when formamide, rather than d-tubocurarine, was used to diminish muscle contraction. The difference in the extent of polyneuronal innervation detected using the two methods declines during the first postnatal week and the number of inputs observed with formamide during the second postnatal week does not differ from that seen with d-tubocurarine. PMID- 2755183 TI - [Check points in nursing management. Advice on activation of stereotyped nursing teams]. PMID- 2755184 TI - [Check points in nursing management. Re-evaluation of work manuals used on the job]. PMID- 2755185 TI - [Personality: Ms. Nobuko Munakata, a nutrition consultant and the organizer of the Health Planning Munakata]. PMID- 2755186 TI - [Check points in nursing education. Reviewing of the overall nursing study for a new start of the profession]. PMID- 2755187 TI - [Check points in nursing education. A trusting relationship between instructors and students based on professional attitudes and sincerity]. PMID- 2755188 TI - [On methodology in education of nursing managers--possibilities and limitations]. PMID- 2755189 TI - [On education of nursing administrators]. PMID- 2755191 TI - [Training of nursing administrators at our hospital: individualized, organized, and continuing education]. PMID- 2755190 TI - [Training of nursing administrators at our hospital: through seminars and work inside or outside the hospital]. PMID- 2755192 TI - [Training of nurse administrators at our hospital: humane growth through various learning experiences]. PMID- 2755193 TI - [On training of successors in nursing management]. PMID- 2755194 TI - [The current status and problems of the programmed training of nursing administrators]. PMID- 2755195 TI - [Experience through a study on food ecology: an observation on the direction in nursing]. PMID- 2755196 TI - [Problems of nursing supervisors: earning the trust of the nursing staff and the superior]. PMID- 2755198 TI - [A crucial moment in nursing: to overcome the problem of nursing manpower shortage]. PMID- 2755197 TI - [Prevention of accidents involving inpatients]. PMID- 2755199 TI - [Clinical training in nursing. 3. Guidance based on individual students' pace]. PMID- 2755200 TI - [On man and nursing. Care. Discussion (1)]. PMID- 2755201 TI - [Public knowledge of nursing terminology--on appropriate terminology in nursing]. PMID- 2755202 TI - [On attending an AIDS counseling training course]. PMID- 2755203 TI - On touching "The Happy Isles": reflections about past, future, and present. PMID- 2755204 TI - Controlling the woman to protect the fetus. PMID- 2755205 TI - Appropriate collaboration between industry and government in the development of an AIDS vaccine. PMID- 2755206 TI - AIDS: the ethical dilemma for surgeons. PMID- 2755207 TI - Reconceptualizing the euthanasia debate. PMID- 2755208 TI - Solving the medical malpractice problem: difficulties in defining what "works". PMID- 2755209 TI - Community care and the discharge of patients from mental hospitals. PMID- 2755210 TI - The syngamy debate: when precisely does a human life begin? PMID- 2755211 TI - Comparison of magnesium in human lymphocytes and mononuclear blood cells. AB - The population of mononuclear blood cells (MBCs) separated by a discontinuous gradient from healthy normal volunteers consists of lymphocytes (L), monocytes (M) and relatively few granulocytes (G). We attempted to remove the phagocytic cells (M and G) by pretreatment of the blood with carbonyl iron particles (CIP). In 50 volunteers (21 males and 29 females, ages 17-75, mean 33.3 years), we determined the content and concentration of Mg in MBCs before and after pretreatment with CIP. The results (mean +/- SEM) show a significant decrease in the MBC Mg content (from 3.12 +/- 0.08 to 2.39 +/- 0.05 fmol/cell; p less than 0.0001), concentration (from 10.4 +/- 0.2 to 9.6 +/- 0.3 mmol/l; p less than 0.004) and M percentage (from 14.5 +/- 1.0 to 1.0 +/- 0.2%; p less than 0.0001) after CIP pretreatment. The L percentage significantly increased from 81.6 +/- 1.0 to 96.1 +/- 0.2% (p less than 0.0001) after CIP pretreatment. These date suggest that M have both a larger content and concentration of Mg than L. PMID- 2755212 TI - Preliminary report of decreased serum magnesium in postmenopausal osteoporosis. AB - Serum, red cell, urinary and bone Mg levels have been measured in 10 post menopausal osteoporotics. Osteoporosis was confirmed by clinical fracture, histological analysis and dual-photon absorptiometry quantification. When compared to a healthy population matched for age and sex, serum Mg levels were statistically significantly (p less than 0.05) lower in osteoporotics (0.82 +/- 0.06 mmol/l) compared to normal subjects (0.87 +/- 0.04 mmol/l). No difference appeared for red cell, urinary or bone Mg determination. If these results are confirmed in a long-term study, serum Mg might be added to a batch of tests used to discriminate a subset of patients with an increased risk of developing postmenopausal osteoporosis. PMID- 2755213 TI - Validity of the parenteral magnesium load test for mature mammals. AB - Because of the difficulty in accurately assessing the Mg status of a hospitalized patient, the parenteral Mg retention test may be a valuable diagnostic tool. In former studies in animal models, this test has reliably identified adult rats fed two extremes of dietary Mg, but we found no tests of intermediate levels of Mg in adult animals. As a means of assessing the validity of the parenteral Mg retention tests in adult rats, the present study was conducted to learn (1) the relationship between Mg in plasma and bone in adult mammals that had optimal nutrition at the onset of the experiment, and (2) the relationship between Mg retention and Mg in plasma and bone in those animals. Animals were fed five levels of dietary Mg from 0 to 150 mg/100 g purified diet. Parenteral Mg retention tests were conducted after 2 weeks of dietary treatment, and 18 h after the completion of the tests, plasma and bone were analyzed for Mg. We found that plasma and femur levels of Mg varied linearly under conditions of Mg deficit, indicated by a high retention of the Mg load. As the deficit diminished, both plasma and femur levels approached a limit and the slope of the curve tends to zero. Mg retention and plasma or femur Mg level was approximated by a negative exponential curve. Stated another way, the logarithmic values of Mg retention decreased approximately linearly with increase in bone or plasma Mg. It was concluded that the parenteral Mg retention test is a valid test to evaluate Mg deficiency and to identify Mg sufficiency in adult mammals. PMID- 2755215 TI - Serum magnesium levels in patients with head and neck cancer. AB - Serum magnesium levels have been estimated in 25 patients with head and neck cancer. The results have been compared with a group of 25 healthy controls. In cancer patients the mean value was significantly reduced when compared with the control group. A progressive, and significant, increase in serum magnesium concentration was observed following radiotherapy. PMID- 2755214 TI - Comparison of potassium alone and potassium-magnesium supplementation in patients with heart failure using hydrochlorothiazide. AB - Supplementation of potassium alone and in combination with magnesium was compared in 10 patients with chronic compensated heart failure receiving hydrochlorothiazide 50 mg twice daily for the whole trial. After a 3-week run-in period, the patients were randomized to receive active supplementation for 6 weeks in a double-blind cross-over manner. A 3-week wash-out period was kept in between. Addition of 2 g potassium chloride daily (27 mmol K+) did not efficiently correct the serum potassium concentration. After the combined supplementation of 2 g potassium and 1 g magnesium (27 mmol K+ and 17 mmol Mg2+ daily), both serum potassium and magnesium concentrations increased statistically significantly during the first 2 weeks of treatment. After a longer treatment of 6 weeks, the effect of combined supplementation was less clear, even though a trend toward a better maintenance of serum potassium was still evident. PMID- 2755216 TI - Complement activation, phagocytosis, tumor growth and parasitic infection after magnesium supplementation in diet of mice. AB - Very little study has been devoted to Mg2+ supplementation in the diet and the effects produced upon biological functions. In the present study, mice were given supplemental amounts of MgCl2 or MgSO4 in the feed ration, while the following were examined: activation of serum complement, phagocytosis, growth of tumor transplants and infections with Trichinella spiralis. Increased complement activation, increased phagocytosis, decreased tumor growth and decreased severity of parasitic infection were observed in mice fed Mg2+ supplement. It is not yet certain how Mg2+ functions in order to produce an enhancement of resistance in the susceptible naive animal. PMID- 2755217 TI - Suppression of catecholamine-induced abnormal pacemaker activities by magnesium ion in guinea pig cardiac muscle cells. AB - The effect of magnesium ion on the abnormal pacemaker activity of guinea pig ventricular muscle cells depolarized by 27 mM K+ was studied. Isoproterenol produced a small depolarization in the resting membrane and elicited automatic repetitive action potentials at higher concentrations in the presence of 0.2 mM Ba2+. This model was used to assess the antiarrhythmic effect of magnesium ion on cardiac muscle cells. Isoproterenol concentrations needed for depolarization alone or for depolarization plus automatic activity were taken as a basis for evaluation. The responsiveness of muscle cells to isoproterenol was suppressed significantly by increasing the magnesium concentration. It is concluded that magnesium ion may have an antiarrhythmic effect on partially depolarized cardiac muscle cells. PMID- 2755218 TI - Health services research and quality of care. Assignments for the 1990s. AB - The unabated rise in health care costs is bringing health services research into center stage as an applied science to help guide health care managers, purchasers, and regulators. To be equal to the task, health services research must pursue at least four intellectual agendas: the study of efficacy (knowing what works), the study of appropriateness (using what works), the study of the execution of care (doing well what works), and the study of the purposes of care (the values that underlie action). The responsibility for the financing and conduct of the research agendas varies with the level of aggregation of data and effort needed for each topic. All four topics must be pursued effectively if health care quality is to be successfully defined, measured, and protected. PMID- 2755219 TI - Reforming nursing home quality regulation. Impact on cited deficiencies and nursing home outcomes. AB - The federally-mandated nursing home survey and certification process has been criticized for focusing more on the potential of each facility to provide good care than on the demonstrated quality of care delivered or on resultant resident outcomes. This paper presents the results of an evaluation of the pilot of a new federal survey process (Patient Care and Services, PaCS) that concentrates surveyor time on the review of resident care, reduces surveyor time spent reviewing policy and procedures, and, for the first time, mandates personal interviews with a sample of facility residents. In Rhode Island, a randomized control design was used to evaluate the impact of the survey on both the number and type of deficiencies cited, as well as on resident outcomes at six month follow-up. The PaCS team cited significantly more deficiencies, in total, than the traditional survey team, and significantly more patient-oriented deficiencies. However, no significant differences in resident outcomes were found when comparing nursing homes in which PaCS was administered and nursing homes in which only the traditional survey was administered. PMID- 2755220 TI - The hierarchical structure of geriatric patient satisfaction. An Older Patient Satisfaction Scale designed for HMOs. AB - This paper describes an instrument design effort aimed at measuring patient satisfaction among older (65 years and over) subscribers of HMOs. The study was conducted in a multi-satellite prepaid group practice in Buffalo, New York. In order to be able to construct a satisfaction measure that would reflect the interests of the actual consumers of HMO-services, a series of four focused group interviews were held with 24 randomly selected elderly enrollees. The substantive content of these interviews was systematically analyzed for both topics and ideas, yielding a total of 173 distinct ideas about the perceived satisfaction with the services received expressed over 3,176 lines of narrative. From this substantive pool, sixty attitudinal statements were constructed with the ideas represented in these statements being proportional to the number of lines of transcribed discussion devoted to each topic. This 60-item Older Patient Satisfaction Scale (OPSS) was submitted to a systematic sample of 229 elderly HMO subscribers. They also were asked to complete two existing scales: the Ware PSQ, and the Larsen CSQ-8. Factor analysis performed on the OPSS-items yielded 14 primary factors of geriatric patient satisfaction, two second-order and one third order general factor. As the second-order factors accounted for the largest proportion of the common variance, those items of the original 60-item OPSS were identified that had highest loadings on these second-order factors, yielding 7 such items for one and 5 for the other. These scales had alpha-reliabilities of .83 and .80, respectively. It was also found that the OPSS had good convergent validity with the PSQ and CSQ-8. The overall psychometric properties identified for the OPSS, as well as the fact that it was constructed from a health-care consumer's perspective, makes it well suited for use with a unique and rapidly expanding geriatric patient population. PMID- 2755221 TI - Telephone patient management by primary care physicians. PMID- 2755222 TI - Social network structure and prenatal care utilization. AB - The associations between social network structural characteristics, sociodemographic factors, and prenatal care utilization were examined in a sample of 185 low-income, inner-city, maternity patients. It was predicted that the networks of women who underutilized care would be larger and of higher density than those of women who utilized care appropriately. They were also expected to be less disperse, with members living near one another; less diverse, with members drawn mainly from immediate family and extended kin; and composed primarily of strong relational ties between members. Findings indicated that women were more likely to underutilize care if they were embedded in strong-tie, nondisperse networks where most members were immediate family or relatives. Of the sociodemographic variables, only parity was associated with prenatal care utilization. The findings support the underlying assumption that social networks have a significant influence on individuals' utilization of prenatal services. This suggests that providers of services to pregnant women may need to revise their current strategies for bringing women into care and their methods of delivering educational services to women already in care. PMID- 2755223 TI - [Gammagraphy with 123I-meta-iodobenzylguanidine in the diagnosis of pheochromocytoma]. AB - At times pheochromocytoma raises diagnostic problems which cannot be solved by methods already incorporated into diagnostic evaluation, such as catecholamine measurement, echography and computed tomography. These drawbacks are more common with small size tumors, malignant extra-adrenal pheochromocytoma and some cases of relapse after surgery. The present study reports the results of 123I-meta iodobenzylguanidine (MIBG) scintiscan in 30 patients with suspected pheochromocytoma. The head, the thorax and the abdomen were scanned in all patients after 3, 24 and 48 hours. Areas of normal and abnormal uptake were evaluated in these areas. The scintiscan was positive in seven cases with a diagnosis of pheochromocytoma, which showed markedly increased uptake persisting throughout the study. The results of other studies are analyzed and the functional character of MIBG, its sensitivity and specificity, and the advantages of 123I over 131I are discussed. PMID- 2755224 TI - [Adverse reactions to drugs as a reason for consulting the emergency service of a general hospital]. AB - The reports from the emergency service of La Paz General Hospital were daily reviewed for 4 months to investigate the number of consultations which, on the judgement of the physician on care, were due to adverse reactions to drugs. An overall number of 11,326 patients consulted. In 438 (3.9%) it was considered that the consultation was due to one or more definite, likely or possible adverse drug reactions. In 69 patients (15.8%), the reactions were considered to be severe, and 54 (12.3%) required admission; 59 reactions (13.4%) were moderate, and 310 (70.8%) were mild. The most common localizations were the skin and its appendages (37.7%) and gastrointestinal tract (25.3%). The most commonly implicated pharmacologic groups were analgesic and non-steroidal anti-inflammatory drugs (33.6%) and antimicrobials (22.1%). The incidence of adverse reactions was significantly higher in women (4.4% vs 3.3% in males, p less than 0.01). Depending on the age groups (14-29, 30-59, greater than or equal to 60 years) the incidence of nonallergic adverse reactions was significantly higher in patients aged 60 years or more (1.5%, 2%, 2.9%; chi 2 = 15.2, gl = 2, p less than 0.001). In presumably allergic adverse reactions, the incidence was significantly higher among those under 30 years (2.9%, 2.2%, 0.5%; chi 2 = 50.2; gl = 2, p less than 0.0001). The incidence of severe adverse reactions was significantly higher in patients over age 60 years (0.2%, 0.6%, 1.2%, chi 2 = 29.2, gl = 2, p less than 0.001). In 32% of cases the adverse reactions might have been prevented. PMID- 2755226 TI - [Trichomegaly: an exceptional expression of the acquired immunodeficiency syndrome]. PMID- 2755225 TI - [Lupus nephropathy in childhood and familial lupus. Genetic study of a family]. AB - We report a case of a 14 1/2-year-old boy who was diagnosed of systemic lupus erythematosus in the background of an acute nephritic syndrome, 3 1/2 years after being diagnosed of idiopathic thrombocytopenic purpura. The familial history suggested the presence of other cases of SLE, which were proven with relevant clinical and laboratory studies. A genetic study for disease markers was carried out and a correlation was found with haplotypes HLA A25, B18, BW6, DRX, and DQW; C2 deficiency was ruled out. We conclude that it is of paramount importance to rule out the existence of familial SLE in front of infantile SLE, particularly in boys, and we emphasize the necessity of keeping on further searching for genetic markers of the disease. PMID- 2755227 TI - [Endocarditis in heroin addicts: the end of an epidemic?]. PMID- 2755228 TI - [Metabolic control and vascular manifestations of diabetes mellitus]. PMID- 2755229 TI - [Subacute nodular thyroiditis, de Quervain's type]. PMID- 2755230 TI - [Early detection of tuberculosis by the evaluation of contacts]. AB - We have evaluated the close contacts of 191 patients diagnosed of tuberculosis in our center between 1984 and 1987. The overall number of evaluated contacts was 666, and the mean number of contacts for each index case was 3.7. In 55% of the evaluated population PPD reaction was positive, and their mean age was 33.3 years. In 132 cases chemoprophylaxis was given during one year (22%). Forty-one new cases of tuberculosis were detected, with a mean age of 25.6 years. In ten new cases the source of infection was familial. When the contacts were distributed according to the bacteriologic status of the index case (direct investigation of tubercle bacilli positive in 103 cases and negative in 167), the rate of disease and infection was significantly higher among those related to positive patients. In the group related to negative patients we discovered 7 new cases of active tuberculosis. Our results confirm the usefulness of the systematic evaluation of the contacts of tuberculous patients in our area, as it permits the identification of an important number of new patients which should be adequately treated. This practice contributes to interrupt the epidemiologic transmission chain of the disease and to facilitate its eradication. PMID- 2755231 TI - [Multiple aneurysms and cerebral vasculitis in systemic lupus erythematosus]. AB - A female in whom systemic lupus erythematosus had been diagnosed 5 years before suddenly developed headache and recurrent vomiting. Cranial computed tomography (CT) was consistent with subarachnoid hemorrhage, and cerebral arteriography disclosed cerebral aneurysms, multiple microaneurysms and cerebral vasculitis. After 7 days she developed left hemiparesis, and a cerebral infarct area was apparent in a new CT scan. Despite the poor prognosis of these lesions, the patient had a favorable outcome, without residual neurological deficit, after having been treated with intravenous corticosteroid boluses and oral cyclophosphamide. PMID- 2755232 TI - [Acute encephalitis associated with gastric carcinoma]. PMID- 2755233 TI - [Chronic eosinophilic pneumonia and thrombocytosis: a rare association]. PMID- 2755234 TI - [Pyrazolone-induced agranulocytosis, consumption coagulopathy and acute pancreatitis]. PMID- 2755235 TI - [Common variable immunodeficiency. Report of a case simulating lymphoma]. PMID- 2755236 TI - [Liver abscesses. Medical treatment]. PMID- 2755237 TI - [Unexpected presence of hepatitis B virus DNA in hepatocytes of patients with chronic autoimmune (lupoid) hepatitis]. AB - Three patients with an histological, clinical and immunological diagnosis of chronic autoimmune (lupoid) hepatitis (CAH) and negative hepatitis B virus (HBV) markers were evaluated. The hepatic tissue of these patients, which was obtained through transjugular hepatic biopsy, was investigated with radioactive DNA probes of the previously cloned HBV and hybridized with the DNA from the mentioned tissues. In two of the three samples, viral nucleotide sequences were detected in the nuclei of the hepatocytes. Their appearance was consistent either with a free state or with the presence of integrated concatomeres. Although these findings require further evaluation in larger series, they suggest the possibility that certain proteins encoded or modified by the HBV DNA might represent a hidden antigenic stimulus in an autoimmune disease such as CAH, even in the absence of serological markers of HBV infection. PMID- 2755238 TI - [Syncope: epidemiological characteristics of a hospital series]. AB - Three hundred hospital patients with syncope (193 males and 107 females, mean age 61 +/- 17 years) were prospectively evaluated with a standard protocol. Associated diseases were found in 76.7% of cases. The incidence of heart diseases was 50.8% in males vs 32.7% in females (p less than 0.003). The cause of syncope was diagnosed in 250 patients (84%). The diagnosis was made at initial evaluation in 101 patients (group A); in the remaining patients (group B), no diagnosis was made in 25% (16.6% of the overall series) despite a wide array of investigations. Syncope due to arrhythmia was diagnosed in 57.6% (group A: 91.1% group B: 40.7; p less than 0.0001); cardiac syncope not due to arrhythmia was diagnosed in 4%, and other types of syncope in 21.6% (group A; 6.9%; group B: 29.1%; p less than 0.0001). It is concluded that a) the hospital population of patients with syncope represents a subgroup of advanced age and a high incidence of associated diseases; b) one third of patients were diagnosed at the initial evaluation, whereas in 25% of the remaining ones no diagnosis was obtained, and c) in these patients, arrhythmia is the most likely cause of syncope. PMID- 2755239 TI - [Noninvasive cardiac electric stimulation in emergencies]. AB - The results of electrical transcutaneous cardiac stimulation (ETCCS) were evaluated in 38 emergency situations seen at the Emergency Service of the Hospital 12 de Octubre (Madrid) during one year. ETCCS is a noninvasive stimulation procedure through electrodes placed on the chest surface (negative left sub-mamillary and positive right infraclavicular--AA--or left subscapular- AP2--). The stimulation impulse has a duration of 0.01-0.04 seconds depending on the type of device used, with intensities which can achieve 200 mA and stimulation frequencies up to 180/min. The high electrical (97.4%) and mechanical (75.7%) effectiveness of ETCCS in our series, its acceptable tolerance (80.1% of the conscious patients) and its easy management have led us to support the use of electrocardiographic monitor-defibrillator-ETCCS units for the complete early electrical support of emergencies associated with disorders of the cardiac rhythm. This support may be given in emergency areas with minimal training requirements. PMID- 2755240 TI - [Detection of hepatitis B virus DNA. Its use in the etiological diagnosis of chronic hepatopathies]. PMID- 2755241 TI - [Cardiopulmonary resuscitation in a general hospital]. PMID- 2755242 TI - [Asymmetric septal myocardial hypertrophy associated with pheochromocytoma: reversibility of cardiopathy after extirpation of chromaffin tumor]. AB - Left adrenal pheochromocytoma and mesenteric paraganglioma were diagnosed in a 52 year-old female with diabetes mellitus (fasting blood glucose 14.5 mmol/l), hypertension and myocardial asymmetric septal hypertrophy (septal/left ventricular free wall thickness 1.31). Carbohydrate metabolism and cardiac disease returned to normal after the resection of both tumors (fasting blood glucose 5.2 mmol/l, septal/left ventricular free wall thickness 1.10). This is the first patient reported in the Spanish literature in whom asymmetric septal hypertrophy has been correlated with the hypersecretion of catecholamines. PMID- 2755243 TI - [Cushing's disease in a patient with primary empty sella turcica]. AB - Primary empty sella is a neuroanatomical condition which is more common in middle aged obese multiparous females with long-standing hypertension. Usually there are no symptoms, but occasionally nonspecific headache may be present. Hormone studies are commonly normal in these patients, although several functional hypothalamic and pituitary abnormalities have been reported. We report a 64-year old female with primary empty sella in whom Cushing's disease was diagnosed. The association of both disorders is exceptional. PMID- 2755244 TI - [Laser photoresection in tracheobronchial pathology]. PMID- 2755245 TI - [Protein C anticoagulant in myocardial infarct in patients under 40 years of age]. PMID- 2755246 TI - [Libman-Sacks endocarditis and anticardiolipin antibodies]. PMID- 2755247 TI - [Confusional state and cyclosporin A]. PMID- 2755248 TI - [Bronchial asthma and thyroid dysfunction]. PMID- 2755249 TI - [Verapamil-induced serum sickness]. PMID- 2755250 TI - [Estimate of the costs of osteoporotic fractures of the femur in Spain]. AB - To evaluate the economic impact of osteoporosis, the cost of acute attention to the osteoporotic hip fractures recorded in Barcelona during one year was investigated. The hospital records of 8637 beds (85.64% of the overall number in the city) were reviewed and the cases seen in inhabitants aged 45 years or more during 1984 were included. The cost, days of hospital admission, operations and orthopedic material were recorded. Data from 870 fractures were recovered. During the study period 1358 hip fractures took place in Barcelona, with 1269 +/- 21 (mean +/- SEM) operations, 31219 +/- 1550 (mean +/- SEM) days of hospital admission, and 408 +/- 40 (mean +/- SEM) prostheses. Their attention generated a cost amounting to 662.5 +/- 29.5 (mean +/- SEM) million pesetas. The cost of each fracture was 488200 +/- 331700 (mean +/- SD) pesetas, with a hospital stay of 23 +/- 17 (mean +/- SD) days. This represents, for the whole of Spain, 33298 +/- 1769 (mean +/- SEM) fractures, 31160 +/- 2154 (mean +/- SEM) operations, 767853 +/- 78314 (mean +/- SEM) hospital admission days and 10042 +/- 1530 (mean +/- SEM) prostheses every year. The yearly expenditure is 16295 +/- 1598 (mean +/ SEM) million pesetas (confidence interval of the estimation 95%). Thus, osteoporotic hip fracture results in a significant expenditure in this country. The enormous cost of the attention to osteoporosis and its complications warrants a greater effort for its prevention and care. PMID- 2755251 TI - [Changes in the activity of plasma renin and aldosterone induced by a pattern of increasing administration of zinc sulphate in normotensive individuals]. AB - The behavior of the renin-angiotensin-aldosterone system was evaluated in response to an increasing zinc intake. This oligoelement can modify the activity of the angiotensin I converting enzyme (ACE). Six healthy normotensive volunteers received 30 mg of zinc sulphate orally for 4 days and 600 mg for 4 additional days. On the first, fifth and ninth days plasma renin activity (PRA) and serum aldosterone were measured, and the possible changes in blood pressure were evaluated. PRA and aldosterone showed significant increases, with a stepwise distribution throughout the zinc overload. On the first day, PRA was 0.40 +/- 0.08 ng/ml/h; on the fifth day it was 0.80 +/- 0.21 ng/ml/h, and on the ninth day 1.39 +/- 0.34 ng/ml/h (1st-5th day; p less than 0.05; 1st-9th day: p less than 0.02). On the first day, the aldosterone levels were 81 +/- 17 pg/ml, on the fifth day they were 119 +/- 26 pg/ml, and on the ninth day 164 +/- 30 pg/ml (1st 5th day: nonsignificant difference; 1st-9th day: p less than 0.02). The values of arterial pressure did not change significantly after zinc overload. It is concluded that zinc overload can modify PRA and aldosterone levels, and that these changes are dose-related. PMID- 2755252 TI - [Pseudohemopathy caused by rhabdomyosarcoma]. AB - A 26-year-old male with a primary rhabdomyosarcoma of maxillary sinus is reported. The tumor was initially mistaken for an anaplastic Ki-1 positive anaplastic lymphoma in the histological preparation, owing to its high indifferentiation degree. After a smear study it was categorized as IEA, and chemotherapy of CHOP type was started; after two courses, local telecobalt therapy was given. After this was completed, the disease showed a progression, involving the bone marrow and resulting in clinical and cytological features consistent with acute leukemia. At that time we saw the patient for the first time. He is presently in complete remission after having started polychemotherapy of CVADIC type. After a commentary on the major study steps that led to the diagnosis, the crucial role of electron microscopy and, particularly, immunocytology for the correct identification of anaplastic tumors is emphasized. PMID- 2755253 TI - [Accidental hypothermia: the prognostic importance of early diagnosis]. PMID- 2755254 TI - [Regression of nephrotic syndrome in amyloidosis secondary to familial Mediterranean fever during maintenance therapy using colchicine]. PMID- 2755255 TI - [Central diabetes insipidus of pharmacologic origin?]. PMID- 2755256 TI - [Adverse effects of nifedipine and treatment dropouts]. PMID- 2755257 TI - [Detection of gestational diabetes with the 50-gram glucose test: prevalence and relationship with to factors]. AB - Prevalence of gestational diabetes was investigated in 222 pregnant women between the 24th and 28th weeks of gestation. A glucose screening test (GST) was performed with a 50 g glucose load, followed by a blood sample 1 hour later. Patients with glycemic levels greater than or equal to 140 mg/dl (7.8 mmol/l) 1 hour after the glucose administration were considered as having a positive GST and scheduled for a full oral glucose tolerance test (OGTT), which was interpreted according to O'Sullivan and Mahan criteria. Fifty-four patients had a positive GST, and 10 of them were diagnosed as having gestational diabetes mellitus. These figures indicate a gestational diabetes prevalence of 4.5% in general population and 18.5% in women selected by GST. The fetal weight index in patients with gestational diabetes was 1.13 +/- 0.10, whereas in normal women this index was significantly lower (p less than 0.01). Patients with positive GST and normal OGTT did not have an increased risk for fetal macrosomia. GST results were significantly higher in pregnant women with advanced age (greater than or equal to 35 years) and with late menarche (greater than or equal to 16 years), but did not vary according to maternal parity. Also, these results were significantly related with the number of risk factors for gestational diabetes encountered in a given patient, but not with any of them as examined alone, except for age. We conclude that GST performed in the 24th-28th weeks of gestation reveals 4.5% undetected gestational diabetes in our population. Certain maternal features (age, menarche, number of risk factors) influence on GST results. PMID- 2755258 TI - [Vascular hyperreactivity to vasopressin in mild essential arterial hypertension]. AB - The aim of the present study was to evaluate the hemodynamic effects of arginine vasopressin (AVP) infusion in essential hypertension. To this end, 9 hypertensive patients and 10 normotensive controls were evaluated. After one hour rest, AVP was infused at a dosage of 0.5 and 2 ng/(kg/min), in 20 minutes periods. After AVP infusion, mean arterial pressure increased only in hypertensive patients (from 125.8 +/- 7 to 131.8 +/- 7, p less than 0.01 and to 135.6 +/- 6 mmHg, p less than 0.01). Peripheral vascular resistance was significantly increased in both groups during AVP infusion, although the percent increase was higher in hypertensive patients during the last period of infusion (18.3 +/- 10 versus 4.6 +/- 4, p less than 0.05). Cardiac index decreased in both groups during infusion, although this reduction was significantly higher in hypertensive patients than in healthy controls in the last period of infusion (-8.16 +/- 6 versus -1.8 +/- 4%, p less than 0.05). These results confirm that in essential hypertension there is an exaggerated pressor response to AVP infusion, suggesting that it is due to an increased vascular response to this hormone. The compensatory reduction of cardiac output and the inhibition of sympathetic nervous activity mediated through baroreceptor reflexes do not apparently play a role in this pressor response. PMID- 2755259 TI - [Comparative study on the tolerance and efficacy of high doses of metoclopramide and clebopride in vomiting induced by cisplatin]. AB - Forty-one patients treated with cisplatin (100-120 mg/m2), alone or associated with vindesine (3 mg/m2), were included in a randomized crossover pilot study which compared 3 different doses of intravenous clebopride with intravenous metoclopramide. The patients were randomly assigned to receive clebopride in the first chemotherapy course in one of the three dose levels used (0.5 mg/kg, 21 patients; 0.75 mg/kg, 11 patients; 1 mg/kg, 10 patients) or metoclopramide (10 mg/kg). In the second course of the same chemotherapy the patients received the alternative antiemetic, and thus each patient was his own control. The total dose of both antiemetic drugs was infused in 5 intravenous fractions given every 2 hours. The antiemetic activity of clebopride was moderately lower to that of metoclopramide with the first two tested doses (overall doses of 0.5 and 0.75 mg/kg) and similar with the last dose (1 mg/kg). Clebopride was reasonably well tolerated at the used dosages, inducing sedation in 20% of cases (versus 24% with metoclopramide) and diarrhea in 37% (versus 20% with metoclopramide). Extrapyramidal reactions developed in 17% of the courses which included metoclopramide and in none including clebopride. This difference was statistically significant. PMID- 2755260 TI - [Bases of the treatment of acute poisoning]. PMID- 2755261 TI - [Neurosyphilis with normal cerebrospinal fluid: diagnostic difficulties]. PMID- 2755262 TI - [Chronic lymphadenitis secondary to aluminum silicate deposits]. PMID- 2755263 TI - [Heatstroke: apropos of 2 new cases]. PMID- 2755264 TI - [Deaths attributed to tobacco consumption in Spain. Correcting and updating the data]. PMID- 2755265 TI - [Listeria monocytogenes septicemia in acquired immunodeficiency syndrome]. PMID- 2755267 TI - Real-time 'computer-evaded' pseudo-holography of computed tomography images. AB - An off-line method of dynamic imaging has been developed to facilitate visualization of three-dimensional tomographic data during real-time manoeuvres. Stereo-pair projection of multiple contiguous cross-sectional images on a conventional 625 line 50 Hz television raster has been investigated and pseudo holograms have been displayed. A Cartesian stereo-pair projection model incorporating three degrees of rotational freedom and perspective has been developed. Computer simulations of the model have been conducted and the feasibility of adopting a simplified model has been examined. A condensed solution with two degrees of freedom, retaining partial perspective effects, has been simulated and analysed for worst-case errors. Reasonable projection accuracy has been demonstrated for small orientation angles. Specialized display hardware has been developed and a departure has been made from conventional picture element (pixel) display methodology. Elemental quadrilaterals (rho-pixels), varying in size, shape and screen position, have been considered as an alternative to static square pixels in a rigid matrix. Joystick-controlled rho pixel arrays have been implemented with parallelogram-shaped rho-pixels incorporated as a simplified case of quadrilateral projection. Dynamic stereo pair projections of 64 X 64 rho-pixel arrays have been generated from computed tomography (CT) images and the results of phantom studies on a four-plane system are discussed. PMID- 2755266 TI - Three-dimensional visualization of computerized tomography and laser scan data for the simulation of maxillo-facial surgery. AB - A system has been developed for the three-dimensional (3D) visualization of the face and skull using data obtained from a purpose-built no-contact laser scanning system and from a series of scans produced by X-ray computerized tomography. Features developed allow the simulation, planning and prediction of maxillo facial surgery. Realistic skeletal and facial images with a solid 3D appearance are produced from these two datasets using computer graphics techniques. The images can be sectioned for diagnostic purposes or parts can be repositioned for the simulation of surgery. 3D measurements can be made on the images for pre- and post-surgical analysis. An example of the clinical use of the system in the planning of surgery and the prediction of post-surgical facial appearance is given. PMID- 2755268 TI - Human-computer interaction and expert systems for three-dimensional studies of biomedical images. AB - Three-dimensional reconstruction of serial sections, observed by microscopy, is an important technique in medicine and biology. To view any part of a structure clearly, that part has to be identified and clearly highlighted in its relationship to other features in a structure. The identification process can be time consuming and tedious if many sections are involved, especially for routine applications, since human identification is required. In this paper we describe how image processing, together with other information on the shape and position of features relative to each other on any one section and throughout the structure, could be incorporated into an expert system and we also show how such a system could be designed. An important feature is the use of human-computer interaction to allow the system to evolve under the guidance of the biological or medical expert. An example of feature identification in a plant-parasitic nematode is used. PMID- 2755269 TI - Pseudo-shading technique in the two-dimensional domain: a post-processing algorithm for enhancing the Z-buffer of a three-dimensional binary image. AB - Three-dimensional (3D) medical graphics is becoming popular in clinical use on tomographic scanners. Research work in 3D reconstructive display of computerized tomography (CT) and magnetic resonance imaging (MRI) scans on conventional computers has produced many so-called pseudo-3D images. The quality of these images depends on the rendering algorithm, the coarseness of the digitized object, the number of grey levels and the image screen resolution. CT and MRI data are fundamentally voxel based and they produce images that are coarse because of the resolution of the data acquisition system. 3D images produced by the Z-buffer depth shading technique suffer loss of detail when complex objects with fine textural detail need to be displayed. Attempts have been made to improve the display of voxel objects, and existing techniques have shown the improvement possible using these post-processing algorithms. The improved rendering technique works on the Z-buffer image to generate a shaded image using a single light source in any direction. The effectiveness of the technique in generating a shaded image has been shown to be a useful means of presenting 3D information for clinical use. PMID- 2755270 TI - Using greyscale voxel databases for improved shading and segmentation. AB - Many different data representations are possible in computer graphics. Originally, in the medical field, simplified methods were used in order to reduce computation times on small computer systems. Currently a wider range of techniques is developing as costs of hardware continue to fall. In this paper we review a number of possible representations and explain the advantage of one that is greyscale, volumetric and random access. Different segmentation techniques can be used, as well as shading algorithms that give greatly improved appearances. A quantitative analysis of shading methods is derived in terms of the degree of sampling of the 'pseudo-normal' vectors that estimate the direction of the tangent to a surface. The application to a study of multiple sclerosis lesions in the brain using nuclear magnetic resonance data is shown. PMID- 2755271 TI - Pseudo 3-dimensional representation of biomedical images. 30 June 1988, London. Papers and abstracts. PMID- 2755272 TI - Direct vascular effects of 19-hydroxyandrostenedione. AB - A C19 steroid, 19-hydroxyandrostenedione (19-OHAD), an amplifier of the mineralocorticoid effects of aldosterone, is known to cause hypertension in rats during chronic administration. In the present study we examined the direct vasoconstrictive effects of 19-OHAD and aldosterone in vitro as a possible mechanism of their hypertensinogenic effects. Contractile responses of central ear arteries from normal male rabbits to either 19-OHAD or aldosterone were examined in Krebs' bicarbonate buffer. When given alone, neither 19-OHAD nor aldosterone consistently caused contraction of the arteries, nor did 19-OHAD amplify the contractile action of aldosterone to a detectable range. Pretreatment of the ear arteries with desipramine, an inhibitor of neuronal uptake (uptake 1) of norepinephrine (NE), resulted in significant concentration-dependent contraction by each steroid. This contraction was markedly attenuated by prazosin but not by yohimbine. Both steroids significantly potentiated the contractile reaction of the ear arteries to exogenous NE in a dose-related manner without pretreatment with desipramine, suggesting that 19-OHAD may increase vascular resistance through the inhibition of extraneuronal NE uptake (uptake 2). These results suggest that 19-OHAD is not an amplifier of aldosterone at the vascular site. PMID- 2755274 TI - Effects of the diterpene sclareol glycol on body temperature in rats. AB - The effects of the diterpene sclareol glycol (SG) of the labdane family on rectal body temperature in rats were studied. Sclareol glycol induced dose-dependent changes in temperature. At the lowest dose (5 mg/kg) SG produced a decrease followed by an increase in temperature; at the middle dose it produced a decrease and at the largest dose, an increase in rectal temperature. Sclareol glycol caused changes in apomorphine-induced hypothermia (at the low and middle doses it reversed hypothermia, and at the high dose hypothermia was enhanced). Sclareol glycol produced a dose-dependent reversal of reserpine-induced hypothermia. These results suggest that the diterpene sclareol glycol induces changes in core body temperature by interacting with dopamine (DA) receptors and with the second messenger system of 3',5'-AMP in the brain thermoregulatory areas. PMID- 2755273 TI - Detection of drug effects on neurons: protein synthesis inhibition by low doses of amphetamine. AB - The effects of in vivo administered amphetamine (4 and 15 mg/kg) on neuronal and unfractionated brain cortex protein synthesis were evaluated in albino rats. In vitro incubation of brain cortex prisms with 14C-leucine and bulk isolation of neuronal perikarya were performed 1 h after drug administration, and 14C was measured by liquid scintillation counting in hot TCA-insoluble fraction. Amphetamine 15 mg/kg significantly decreased protein synthesis in both fractions, neuronal protein synthesis being more inhibited than total cortex. A lower dose (4 mg/kg) significantly inhibited neuronal protein synthesis, even when it failed to affect total cortex protein synthesis. Results presented here show that neurons may be more sensitive than other brain cells to changes in body temperature. The usefulness of the procedure in the evaluation of drug effects is also considered. PMID- 2755275 TI - Study on the peroral absorption of the endekapeptide cyclosporine A. AB - The beagle dog was found to be a suitable model for pharmacokinetic and bioavailability studies of cyclosporine A (CsA). All pharmacokinetic parameters studied were in the same order of magnitude as those found in man. Three CsA peroral formulations in the form of capsules were compared with a commercially available P.O. solution (to be diluted for administration) and a solution for intravenous administration. Of the three experimental capsule formulations, one based on a microemulsion resulted in an extent of absolute and relative bioavailability not different from that of the available P.O. solution. The advantage, however, is that it is a capsule preparation, ready to swallow, and does not need any manipulation by the patient to dilute the solution. The other two capsule preparations, based on a Gelucire gel with sorption promoters and a microemulsion containing Azone, resulted in a lesser bioavailability than the solution. PMID- 2755276 TI - Maximum tolerated temperature in the rat tail: a broadly sensitive test of analgesic activity. AB - The methods most frequently employed for the study of analgesic activity of opiates are those based on thermal stimuli (hot-plate, tail-flick, TWR). These tests, however, are only sensitive for opiates which are pure agonists. In this work, we propose a modification of the TWR method capable of detecting analgesic activity in both agonist and agonist-antagonist opiates. In addition, non-opiate analgesics also show activity in this test. The ED50 (mg/kg, i.p.) of the substances studied, administered 30 min before commencement of the test, were as follows: buprenorphine: 0.02; methadone: 0.08; morphine: 1.9; pentazocine: 4.5; d propoxyphene: 5.5; codeine: 7.6; pethidine: 9.2; zomepirac: 20.1; suprofen: 138.0; acetylsalicylic acid: 453.4. There was a statistically significant linear correlation between the results obtained by the proposed method (MTT) and those of some of the most frequently used methods for the study of analgesic agents (writhing induced by phenylbenzoquinone, acetic acid, acetylcholine bromide, hot plate test and rat tail withdrawal test). The simplicity of the method makes it suitable for use in the battery of screening tests for analgesic activity of both narcotic and non-narcotic substances. PMID- 2755277 TI - A morphometrical method to estimate isoproterenol-induced infarct size in the rat. AB - A morphometrical method to quantify the geometrical distribution of ventricular necrosis induced in rat following the s.c. injection of isoproterenol was developed and tested. Each ventricle was divided into two portions, apical and basal, and then 10 microns thick sections of both portions were cut. Necrotic areas were detected with nitro blue tetrazolium. Total and necrotic areas were measured for each section. Thereafter, the total and necrotic volume were calculated assuming that the ventricles form a cone-like structure composed of successive frustum of a cone crowned by an apical cone. The study of volumes, necrotic and whole cardiac could be relevant for a more actual experimental comparison of the anti-ischemic drugs activity. Our results indicated that necrotic volume is unevenly distributed, especially at lower doses of isoproterenol treatment, being greater at the apical than at the basal portions of the ventricles. The importance of careful study of the ventricular apex is stressed. Potential sources of error in determining necrotic volume are discussed. PMID- 2755278 TI - Effect of cimetropium bromide and other antispasmodic compounds on in vitro guinea-pig gallbladder. AB - The effect of cimetropium bromide, a new antimuscarinic compound, on bethanechol- and electrically-induced contractions was studied on isolated guinea-pig gallbladder. Atropine and two other widely employed antispasmodics (i.e., rociverine and octylonium bromide) were employed as reference compounds. Cimetropium and atropine proved to be competitive antimuscarinics, their pA2 being 7.77 +/- 0.14 and 8.31 +/- 0.14, respectively. On the contrary, rociverine displayed a dual effect being a competitive antagonist at low (up to 10(-5) mol/l) and a mixed one at high (greater than 10(-5) mol/l) concentrations. When tested against bethanechol- and electrically-induced contractions, all the compounds, with the exception of octylonium bromide, showed a concentration dependent relaxant effect. In both experimental conditions, the potency of cimetropium was of the same order of magnitude as that of atropine and 150-200 times higher than that of rociverine. These data, together with the reported activity on human gallbladder in vivo and the well known involvement of cholinergic system in the control of gallbladder motility, could represent the rationale for the clinical use of cimetropium in the treatment of biliary colics as well as spasms of biliary tree. PMID- 2755280 TI - Effects of the diterpene sclareol glycol on convulsive seizures. AB - The effects of the diterpene sclareol glycol (SG) of the labdane family on convulsive seizures induced by pentylenetetrazole (PTZ), picrotoxin and bicuculline in mice were studied. Sclareol glycol potentiated convulsive seizures induced by PTZ (60 and 80 mg/kg) and antagonized the anticonvulsant effect of diazepam. At low doses, SG gave a protective effect against convulsions induced by picrotoxin and bicuculline, and prolonged the latency to convulsions. At larger doses, SG increased the intensity of convulsive seizures. Forskolin, a diterpene of the same family, evoked a protective effect against convulsions induced by bicuculline and prolonged the latency. PMID- 2755279 TI - S-adenosylmethionine inhibits collagen synthesis by human fibroblasts in vitro. AB - Previous studies have indicated that S-adenosylmethionine (SAMe), the precursor of methyl groups and thiols, exerts an anti-inflammatory activity. In order to clarify whether this molecule also has antifibrotic properties, we evaluated its pharmacological effects on human fibroblasts in vitro. Accordingly, fibroblasts between 5 and 10 subcultures were incubated for 24 h with different SAMe concentrations (from 0.005 to 626 microM). Fibroblast proliferation measured by incorporation of labeled thymidine was not affected by SAMe in the range of the tested concentrations. Moreover, cell viability assessed by trypan-blue exclusion test was greater than 98% in all cultures, without any difference between SAMe and control cultures. Collagen synthesis estimated by HPLC measurement of hydroxyproline in both media and cells was not modified by SAMe concentrations lower than 0.05 microM. On the other hand, SAMe concentrations higher than 0.05 microM significantly (p less than 0.01) reduced collagen synthesis as compared with untreated controls. This effect was not dose-dependent. In conclusion, this study indicates that SAMe addition to fibroblasts in the range of concentrations which can be found in vivo induces a marked decrease (about 50% of control value) in collagen synthesis with no adverse effects on cell proliferation and viability. These findings suggest further investigation of the potential antifibrotic role of SAMe. PMID- 2755281 TI - Percutaneous absorption of rosmarinic acid in the rat. AB - Rosmarinic acid (RA) is a nonsteroidal anti-inflammatory agent. The purpose of the study was to investigate the transdermal absorption of RA, its tissue distribution and absolute bioavailability. In ex vivo experiments, permeation of RA across excised rat skin was about 8 times higher from alcoholic solution than from water, indicating that ethanol may act as sorption promoter. The flux from water or alcoholic solution was 4.4 or 10 micrograms/cm2/h, and the tleg was 7.8 or 3.7 h, respectively. After I.V. administration, RA is best described by a 2 compartment open model; t1/2 = 1.8 h, t1/2 alpha = 0.07 h, V tau = 2.3 L/kg, V beta = 15.3 L/kg. Upon topical administration of RA in form of a W/O ointment (25 mg/kg, 50 cm2), the absolute bioavailability was 60%. 0.5 hours after I.V. administration, RA was detected and measured in brain, heart, liver, lung, muscle, spleen and bone tissue, showing the highest concentration in lung tissue (13 times the blood concentration), followed by spleen, heart and liver tissue. 4.5 hours (peak time) after topical administration of about 3 mg on the hind leg over 20 cm2, RA was measured in blood, skin, muscle and bone tissue. The percutaneous route of administration seems to be a promising one for the therapeutic use of RA as nonsteroidal anti-inflammatory agent. PMID- 2755282 TI - Brain histamine in Alzheimer's disease. AB - The concentration of histamine (HA) has been determined by high-performance liquid chromatography (HPLC) with fluorometric detection in 21 different regions of brains from patients with senile dementia of the Alzheimer type (SDAT) and subjects (CB) whose causes of death were not related to neuropsychiatric, neurological and/or neurodegenerative diseases. The highest levels of HA in the central nervous system (CNS) of both control (CB) and SDAT samples were found in the posterior hypothalamus (CB = 3.13 +/- 0.63 pmol/mg; SDAT = 7.75 +/- 1.43 pmol/mg, p less than 0.005), where the HA neurons are located, and in the anterior hypothalamus (CB = 1.77 +/- 0.33 pmol/mg; SDAT = 2.82 +/- 0.45 pmol/mg, p less than 0.005). The lowest HA levels were detected in the cerebellum (CB = 0.12 +/- 0.04 pmol/mg; SDAT = 0.24 +/- 0.09 pmol/mg, p less than 0.01) and medulla oblongata. HA levels were significantly higher in SDAT than in CB in the following areas: motor cortex (Brodmann's area 4) (A4), premotor cortex (A6), postcentral gyrus (A1,2), posterior parietal cortex (A5,7), superior temporal gyrus (A41,42), temporal pole (A38), primary and secondary visual cortices (A17,18), anterior and posterior regions of the hypothalamus, putamen, caudate nucleus, nucleus accumbens, thalamus, hippocampus, pons, medulla oblongata and cerebellum. No changes were seen in globus pallidus and corpus callosum. Since the origin of HA in the brain is dependent upon three main compartments (neuronal, mast cell, vascular smooth muscle), with approximately 60-80% of the total HA belonging to the neuronal pool, on the basis of neurochemical data we postulate that the increase in the levels of HA in SDAT might account for or be associated with alterations in neuroendocrine, cognitive, neurovascular and sleep wakefulness functions. PMID- 2755283 TI - An immunohistochemical study of the endolymphatic sac in patients with acoustic tumors. AB - Intraosseous endolymphatic sacs obtained from patients with acoustic neuromas who had undergone total labyrinthectomy during tumor removal were examined for the presence of T helper/inducer and T suppressor/cytotoxic lymphocytes, B lymphocytes, plasma cells, and macrophages. Immunoperoxidase staining of cryostat sections revealed the presence of T helper/inducer lymphocytes, T suppressor/cytotoxic lymphocytes, and macrophages. The number of B lymphocytes and plasma cells was much smaller than the number of T lymphocytes. The number of T suppressor/cytotoxic lymphocytes was higher than the number of T helper/inducer lymphocytes. This study supports the notion of local immune responsiveness in the human inner ear. This is the first immunohistochemical study to analyze lymphocyte subpopulations; specifically, to provide insight into T-cell function in the endolymphatic sac. PMID- 2755284 TI - Post-traumatic cholesteatoma. AB - Cholesteatoma can develop as a late complication of fracture of the temporal bone. The otologist must be wary of it since the growth of the cholesteatoma resulting from a temporal bone fracture can be undetected for years allowing for invasive and extensive growth. Three illustrative cases are presented. PMID- 2755285 TI - Wound healing: relationship of wound closing tension to tensile strength in rats. AB - A study was conducted to better define the relationship between closing tension and the resulting tensile strength of scars in incisional wounds. Five groups consisting of ten hairless rats were studied. Transverse wounds were created and closed on the back of each rat, with closing tension varied by excising amounts of skin in widths of 0 (control), 15, 30, 45, and 60 mm. The tensile strengths were determined at 28 days. Higher mean tensile strengths were demonstrated in the two groups requiring the highest closing tensions (45 mm and 60 mm of skin excision) with P = 0.0028 and P = 0.00016, respectively. A logarithmic relationship between closing tension and tensile strength was demonstrated using linear regression analysis with t = 6.18, p less than .0001, and R2 = .44. PMID- 2755286 TI - Adaptation to surgery for head and neck cancer. AB - We examined the postoperative adjustment of 45 patients who underwent surgery for cancers of the head and neck: 23 who had laryngeal cancer, 18 who had oral cavity/oropharyngeal cancers, and 4 who had cancers of other sites. Patients were assessed preoperatively, and at 3 months and 9 to 12 months postsurgery. Interviews and questionnaires were used to assess depression, body image, limitations, pain, financial problems, need for help at home, and social interaction. Results revealed that pain, fatigue, weakness, and loss of speech were major concerns. Pain and financial concerns were worst at 3 months and then improved. Physical limitations increased steadily with time. Depression was a major factor in patients with oral cavity and oropharyngeal cancers. Of note, patients who underwent postoperative radiation therapy had the most difficulty adapting to their illness and treatment, with persistent limitations in function and social isolation. The implications of these findings are discussed. PMID- 2755287 TI - Growth of the lateral surface of the temporal bone in children. AB - The adaptation of implantable auditory prostheses for use in children has raised questions concerning both what effect growth may have on the implant and what effect the implant may have on growth. The purpose of this study is to describe temporal bone lateral surface dimensions in children of different ages to draw inferences about growth rates. Using a surface projected grid and point calipers, 158 intact temporal bones from 103 individuals of known ages between birth and 20 years were measured at six points from a fixed reference. These specimens were located in the skeletal collections of the Smithsonian Institute's Museum of Natural History, the Medical Museum of Walter Reed Hospital at the Armed Forces Institute of Pathology, and the Cleveland Museum of Natural History. Linear regression analysis helped clarify a bimodal pattern of growth in which marked increases in dimension occur from birth to 4 years of age and much less change is seen from age 4 to 20 years. These data suggest that implantation in children under 4 years of age is subject to maximal growth effects. PMID- 2755288 TI - Aided auditory thresholds in children with postmeningitic deafness. AB - Postmeningitic hearing loss is often bilateral, profound, and rapid in onset. Children with postmeningitic hearing loss may be identified as potential candidates for cochlear implantation. The length of time required for a definitive trial with conventional amplification, which must precede a final decision regarding cochlear implant surgery, has been the subject of debate. Twenty-five children with bilateral severe-to-profound postmeningitic sensorineural hearing loss were fitted with appropriate amplification and results of serial-aided tests were analyzed to determine the degree of benefit and changes in aided thresholds over time. Twelve children gave aided responses that clearly indicated the presence of residual hearing and good aided benefit. Ten youngsters have responded consistently in the vibrotactile range when aided, thus receiving limited benefit from conventional amplification. Of particular interest are three children who initially exhibited limited or no auditory responses but who, after a period of 16 to 25 months, showed excellent benefit with binaural hearing aids. These children are all in total communication programs and have received good auditory training. Caution should be exercised when concluding that such a child does not benefit from amplification. PMID- 2755289 TI - Embolization in the treatment of epistaxis after failure of internal maxillary artery ligation. AB - Internal maxillary artery ligation is effective in treating epistaxis. Occasionally a patient may continue to hemorrhage after this procedure. Evaluation of postoperative angiograms reveals several factors accounting for the failure of internal maxillary artery ligation. These factors include incomplete ligation of vessels, alternative dominance of vessels, and reconstitution of flow through collaterals. Eleven such patients have been successfully treated with angiography and embolization. There was one complication of skin slough in the region of the columella. Embolization is a useful modality in the management of these difficult cases. PMID- 2755290 TI - Delayed diagnosis and treatment of acoustic neuroma. AB - The records of 25 patients who underwent excision of acoustic neuroma between 1980 and 1987 were reviewed. All patients originated from southern New England. Facial nerve function was preserved in 92% of all patients, and 42% of patients with tumors less than 2.0 cm retained residual hearing postoperatively. These rates compare favorably with those found in larger series. Our series demonstrated that 60% of patients complained of hearing loss for longer than 2 years prior to tumor diagnosis. The mean duration of hearing loss prior to diagnosis was 4.2 years. Although sophisticated diagnostic methods were generally available, early detection of tumors did not occur, despite the early onset of auditory symptoms. The emergence of sophisticated computer-assisted diagnostic tests and the development of technologically advanced operative methods have reduced operative morbidity, but interestingly, have had little influence on early tumor diagnosis. Late detection of acoustic neuroma in an otherwise medically sophisticated community suggests the need for improved awareness among patients and their primary care providers. Failure of early detection may occur more commonly than generally appreciated, despite the availability of technologically advanced methods of diagnosis. PMID- 2755291 TI - Replacement of upper esophagus: results with myocutaneous flap and with gastric transposition. AB - The authors reviewed 25 cases of pharyngoesophageal replacement. A tubed pectoralis major myocutaneous flap was employed in ten cases where an adequate distal resection margin could be obtained above the thoracic inlet. Total gastric transposition was used in 15 cases where resection extended into the mediastinum. The overall rates of complications (52%), postoperative mortality (20%), and satisfactory deglutition (80%) were similar for both operations and were superior to those achieved with reconstructive procedures previously used by the authors. The choice of method is influenced by the length of the pharyngoesophagus to be replaced and the general condition of the patient. Gastric transposition is a more versatile operation and is adaptable to replacement of the entire esophagus if necessary, while the tubed pectoralis major myocutaneous flap has proven particularly effective for the rehabilitation of elderly and severely debilitated patients. PMID- 2755292 TI - Cutaneous malignant melanoma of the head and neck. AB - A computer-aided analysis of 5,109 patients with malignant melanoma was performed. Patient population characteristics according to body site (head and neck, extremity, and trunk) were determined for the following parameters: sex, histologic type of melanoma, Clark's level, Breslow thickness, age, clinical status of regional nodes, presence or absence of ulceration, and recurrence. Head and neck melanomas accounted for 17% of the total population (N = 877). A detailed analysis of general population characteristics according to subsites within the head and neck region (ear, face, neck, nose, and scalp) was performed. Survival characteristics were determined for head and neck patients according to lymph node surgery, histologic type of tumor, and tumor thickness. The effect on survival of lymph node dissection (elective for stage I disease and therapeutic for stage II disease) was analyzed by univariate and multivariate methods. Elective lymph node dissection (ELND) was performed on 77 patients and 39 patients underwent therapeutic nodal dissection (TLND). Overall, survival was significantly improved following ELND as compared to TLND; however, multivariate analysis indicated the improved survival was related to variations of age within the population rather than the beneficial effect of lymph node surgery. Elective lymph node dissection did significantly reduce the incidence of recurrence for head and neck patients (p = 0.002). Since recurrence was demonstrated to be directly related to survival, the trend toward improved survival following ELND after 5 years was felt to be important. There was no difference in survival according to the histologic type of melanoma. PMID- 2755293 TI - Temporal and perceptual characteristics of tracheoesophageal voice. AB - This study compared the temporal and perceptual characteristics of tracheoesophageal voice produced in four different prosthetic/occlusion conditions: 1. using the Blom-Singer duckbill prosthesis and digital occlusion of the tracheostoma; 2. using the Blom-Singer duckbill prosthesis and valve occlusion of the tracheostoma; 3. using the Blom-Singer low-pressure prosthesis and digital occlusion of the tracheostoma; and 4. using the Blom-Singer low pressure prosthesis and valve occlusion of the tracheostoma. Characteristics of speech produced in each condition were also compared to those of normal speech. Results revealed significant differences between normal speech and tracheoesophageal speech (in all prosthetic/occlusion conditions) for several temporal and perceptual parameters. In addition, important trends were noted among tracheoesophageal prosthetic/occlusion conditions. PMID- 2755294 TI - Sleep-related laryngeal obstruction presenting as snoring or sleep apnea. AB - The difference between snoring (with or without sleep apnea) and laryngeal stridor resulting from laryngeal dysfunction may not be readily apparent. Two cases of Shy-Drager syndrome and one undiagnosed case in which laryngeal dysfunction was exacerbated by sleep are reported. Such dysfunction might create life-threatening situations for which emergency tracheostomy should be considered. The importance of differentiating stridor from snoring is discussed. PMID- 2755295 TI - Auditory perceptual problems in non-organic hearing disorder. AB - A series of 22 patients who presented with non-organic hearing disorder were examined for auditory perceptual problems. A test battery that examined eight areas of auditory perception revealed significant auditory perceptual problems in each of the 22 patients. The results indicate a view that differs from the traditional view of non-organic hearing disorder as either conscious feigning of a hearing disorder or an unconscious symptom of an unidentified emotional disorder. The information presented here indicates that specific auditory processing disorders could adversely affect patients' hearing and that auditory perceptual disorders could be diagnosed and treated. PMID- 2755296 TI - Chondrosarcoma of the epiglottis with regional and distant metastasis. AB - Chondrosarcoma of the epiglottis is extremely rare and there are no previously reported cases of this neoplasm with regional or distant metastases. The first case of this entity and its histopathologic considerations are presented. Accurate grading of this malignancy is essential, since a more poorly differentiated pathologic condition in these tumors indicates aggressive biologic properties consequently leading to frequent local recurrences and metastasis. This is evident in the present case in which, despite being free of local or regional recurrence for 3 years following a supraglottic laryngectomy and bilateral neck dissections, the patient developed pulmonary metastases. We support the use of conservative laryngeal surgery and modified neck dissections for this disease rather than partial resections or debulking procedures, since the histopathologic condition may not be fully recognized without microscopic analysis. PMID- 2755297 TI - Complications in nasal and sinus surgery. PMID- 2755298 TI - Microsomal delta 5 desaturation of eicosa-8,11,14-trienoic acid is activated by a cytosolic fraction. AB - delta 5 Desaturation of eicosa-8,11,14-trienoic acid to arachidonic acid was studied in rat liver microsomes. It was shown that delta 5 desaturation of fatty acids in vitro requires the participation of a peripheral component of cytosolic origin. Desaturation of 20:3n-6 to 20:4n-6 decreases in washed microsomes as they lose an adsorbed cytosolic fraction (CF), but the enzymatic activity can be recovered as a function of CF concentration in the incubation medium. Albumin does not substitute for CF. delta 5 Desaturation of 20:3n-6 is inhibited by arachidonic acid by a product inhibition effect, but CF prevents retroinhibition of delta 5-desaturase by 20:4n-6. This ability of CF is eliminated by preincubation of CF with 20:4n-6, but not with gamma-18:3n-6, the product of delta 6 desaturation of 18:2n-6, thus indicating that CF impairs the retroinhibitory effect of arachidonic acid on delta 5-desaturase in a specific manner. delta 6 Desaturation of linoleic acid to gamma-18:3n-6 is also activated by CF and retroinhibited by gamma-18:3n-6. CF activity on delta 6 desaturation is retained after preincubation with 20:4n-6, but it is lost after preincubation with gamma-18:3n-6. Activation of delta 6-desaturase by CF is associated with the removal of the reaction product in a specific manner. Chromatography of CF by Sephacryl S-200 separates two major subfractions which show different efficiency in reactivating delta 5- and delta 6-desaturase activities in washed microsomes. Therefore, CF may contain subfractions that can prevent delta 5- and delta 6 desaturase retroinhibition by apparently binding their respective reaction products specifically. PMID- 2755299 TI - Analysis of seed oils containing cyclopentenyl fatty acids by combined chromatographic procedures. AB - The fatty acids of seed oils of the Flacourtiaceae, Hydnocarpus anthelmintica, Caloncoba echinata and Taraktogenus kurzii, have been examined by a combination of capillary gas chromatography, silver ion high performance liquid chromatography and gas chromatography-mass spectrometry. In addition to the common range of cyclopentenyl fatty acids found in such oils, 13-cyclopent-2 enyltridec-4-enoic acid was a major component of H. anthelmintica and was identified by mass spectrometry as its picolinyl ester and dimethyldisulphide adduct. It has not previously been found in nature. In the other seed oils, the isolated double bond in the corresponding fatty acid was in position 6, as expected. Similarly, cis-4-hexadecenoic acid and C16 and C18 cyclopentyl fatty acids were identified for the first time in H. anthelmintica. Iso- and anteiso methylbranched fatty acids were present in trace amounts. PMID- 2755300 TI - Capillary gas chromatography and tandem mass spectrometry of paf-acether and analogs: absence of 1-O-alkyl-2-propionyl-sn-glycero-3-phosphocholine in human polymorphonuclear neutrophils. AB - Fast atom bombardment-tandem mass spectrometry was used to identify molecular species of paf-acether (paf) produced by human polymorphonuclear neutrophils. Using this biological material, normal phase high performance liquid chromatography was necessary prior to the fast atom bombardment-tandem mass spectrometry step. Gas liquid chromatography/electron capture detection after hydrolysis with phospholipase C and conversion to heptafluorobutyrate derivatives was used to confirm the results. The results indicated the presence of mainly 1-O hexadecyl/octadecyl-2-acetyl-sn-glycero-3-phosphocholine, acyl analogs of paf and only trace amounts of other alkyl analogs of paf. We did not detect the 2 propionyl analog of paf. Moreover, supplementation of human polymorphonuclear neutrophils with sodium propionate did not result in formation of the 2-propionyl analog of paf. PMID- 2755301 TI - Effect of marginal zinc deficiency on lipoprotein lipase activities in postheparin plasma, skeletal muscle and adipose tissues in the rat. AB - The activities of lipoprotein lipase in postheparin plasma, retroperitoneal adipose and gastrocnemius muscle tissues were determined in the rats fed 2.8 ppm of dietary zinc for eight weeks, as compared with pair-fed and ad libitum-fed rats given 30.8 ppm of zinc. The postheparin lipoprotein lipase activity, as determined by using a lipid emulsion labeled with [3H]triolein as the substrate, was significantly lower in the first group of rats, relative to that in the second and third groups. Tissue lipoprotein lipase activities were compared using the lipid emulsion and activator serum obtained from the zinc-deficient rats and the ad libitum-fed rats. The activator sera were devoid of very low density and low density lipoproteins, but enriched in high density lipoproteins. Muscle lipoprotein lipase activities were significantly lower when assayed with the activator serum from the zinc-deficient compared with the activities determined with the activator serum from the ad libitum-fed. Similarly, muscle lipoprotein lipase activities were lower in all groups when [3H]-triolein-labeled chylomicrons from the zinc-deficient were used as the substrate, compared with the activities determined using the chylomicrons from the ad libitum-fed. Lipoprotein lipase activities in the adipose tissues were not affected by the different sources of the activator sera and chylomicrons. The results strongly suggest that the decrease in postheparin lipoprotein lipase activity in zinc deficiency is not due to changes in tissue lipoprotein lipase enzyme per se, but to compositional alterations in chylomicrons and high density lipoprotein, particularly, with regard to C apolipoproteins, modulators of lipoprotein lipase activity. PMID- 2755302 TI - Alpha- and gamma-tocopherol levels in lipoproteins fractionated by affinity chromatography. AB - Alpha- and gamma-tocopherol levels of nine women were measured in whole serum and in serum lipoproteins separated by heparin affinity chromatography. Alpha tocopherol levels (mean +/- SD) in whole serum, low density plus very low density lipoproteins and high density lipoproteins were 10.8 +/- 2.7, 6.4 +/- 1.6 and 4.6 +/- 1.4 (micrograms/ml), respectively. Corresponding values (micrograms/ml) for gamma-tocopherol were 1.2 +/- 0.5, 0.7 +/- 0.3 and 0.6 +/- 0.2. Recoveries of serum alpha- and gamma-tocopherol from the heparin columns were 102 +/- 5% and 105 +/- 7%, respectively. Serum alpha-tocopherol was linearly correlated with components of high density lipoprotein (apolipoproteins, high density lipoprotein cholesterol), but not with serum total lipids or indices of low density lipoprotein, even though high density lipoprotein carried less than half of the serum alpha-tocopherol. However, serum gamma-tocopherol was highly correlated with indices of serum lipids, such as serum cholesterol (r = 0.92, p = 0.005). The coefficient for the correlation of low density lipoprotein (+ very low density lipoprotein) tocopherol with high density lipoprotein tocopherol was r = 0.66 (p = 0.06) for alpha-tocopherol and r = 0.84 (p = 0.004) for gamma tocopherol. These differences in the relationships of the two tocopherols to lipids and lipoproteins support the view that when the two tocopherols are present at normal dietary levels, gamma-tocopherol partitions between lipoproteins based on their relative lipid content, but a portion of the alpha tocopherol in high density lipoprotein is specifically bound. PMID- 2755303 TI - Fatty acid pattern of tissue phospholipids in copper and iron deficiencies. AB - Because copper and iron have been reported to be essential cofactors in delta 9 desaturation of fatty acids, the effects of different dietary intakes of copper and iron on tissue fatty acids were studied. Male Long-Evans rats (ten per group) were fed diets containing adequate, deficient or excess copper or iron. On day 42 of the dietary regimen, the animals were killed and tissues and blood were removed for analysis of metals and fatty acids of phospholipids. Compared with the copper-adequate rats, the copper-deficient rats showed increased 18:0 in liver and decreased 16:1 omega 7 in liver, heart and serum. There were no differences for 16:0 or 18:1 omega 9. Intake of excess copper did not cause an increase in products of delta 9 desaturation. Comparisons between iron-deficient and iron-adequate rats showed that iron deficiency increased 18:2 omega 6 in liver and serum and decreased 20:4 omega 6 in serum only. Relative percentages of 16:0, 18:0, 16:1 omega 7 and 18:1 omega 9 in liver and serum phospholipids were similar for both groups. Intake of excess iron caused a decrease in 18:2 omega 6; and 16:0 and 18:1 omega 9 were higher in the liver of the iron-excess group than the iron-deficient group. This study did not support the requirement for copper or iron in the delta 9 desaturation of fatty acids as expressed in phospholipids of liver, heart and serum. PMID- 2755304 TI - Dietary induction of cholesterol gallstones in hamsters from three different sources. AB - Cholesterol gallstones were produced in young male, golden Syrian hamsters, obtained from three different suppliers, by administering a nutritionally adequate, semipurified diet for periods of either 5 or 10 weeks. The major components of the lithogenic diet were casein, cornstarch, butterfat, corn oil and 0.3% cholesterol. The hamsters were obtained from Sesco, Harlan Sprague Dawley (Engle hamster) and Charles River (Lakeview hamster). There were profound differences among the three groups with respect to gallstone formation and cholesterol metabolism: The highest incidence of gallstones occurred in Sesco hamsters, 44.4% and 63.6% after 5 and 10 weeks on the lithogenic diet, respectively. In the Engle hamster, after a 5-week feeding, cholesterol crystals and gallstones were absent. When the feeding period was extended to 10 weeks, cholesterol gallstones were present in 45.5% of the animals. In the Lakeview hamsters, neither gallstones nor cholesterol crystals were found in the gallbladder after a 5-week period. After 10 weeks, cholesterol gallstones were found in only a single hamster. In all groups, the lithogenic diet produced large increases of liver, serum and biliary cholesterol concentrations and increased liver weights. When the animals were fed for 5 weeks, only the bile of Sesco hamsters became supersaturated. Supersaturated bile was induced in all groups after a 10-week feeding of the lithogenic diet with cholesterol saturation ranging from 1.47 to 1.97. These data indicate that it is possible to induce cholesterol gallstones in hamsters by means of a nutritionally adequate, semipurified diet of moderate cholesterol content.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2755305 TI - Polyunsaturated fatty acid changes suggesting a new enzymatic defect in Zellweger syndrome. AB - The fatty acid composition of red blood cells, fibroblasts, forebrain, liver and kidney were studied in a 3-month-old infant who died from Zellweger Syndrome, and the results were compared with those of age-matched controls. Besides a typical increase in the very long chain fatty acids 26:0 and 26:1 and a great reduction in the plasmalogen levels, confirming the diagnosis of Zellweger Syndrome, some striking changes in the polyunsaturated fatty acid patterns were discovered. The most important was a very drastic decrease in the values of 22:6 omega 3 and 22:5 omega 6, the two products of delta 4-desaturation. In the kidney, the level of 22:6 omega 3 fell below that of 26:0. Consequently, the ratio 26:0/22:6 omega 3 (and 26:1/22:6 omega 3) was most useful in emphasizing the fatty acid anomalies, especially in renal tissue, where the 26:0/22:6 omega 3 ratio increased to almost 200 times the normal values. Other significant, although less consistent fatty acid alterations were increases in 18:2 omega 6, 18:3 omega 6, 20:3 omega 6, 18:4 omega 3 and 20:4 omega 3, and a decrease in 20:4 omega 6 in some tissues. The existence is proposed of a new enzyme defect in peroxisomal disorders, involving the desaturase system of long chain polyunsaturated fatty acids. PMID- 2755306 TI - Fish oil prevents change in arachidonic acid and cholesterol content in rat caused by dietary cholesterol. AB - Rats were fed diets high in either saturated fat (beef tallow) or alpha-linolenic acid (linseed oil) or eicosapentaenoic and docosahexaenoic acids (fish oil) with or without 2% cholesterol supplementation. Consumption of linseed oil and fish oil diets for 28 days lowered arachidonic acid content of plasma, liver and heart phospholipids. Addition of 2% cholesterol to diets containing beef tallow or linseed oil lowered 20:4 omega 6 levels but failed to reduce 20:4 omega 6 levels when fed in combination with fish oil. Feeding omega 3 fatty acids lowered plasma cholesterol levels. Addition of 2% cholesterol to the beef tallow or linseed oil diet increased plasma cholesterol concentrations but not when fish oil was fed. Feeding the fish oil diet reduced the cholesterol content of liver, whereas feeding the linseed oil diet did not. Dietary cholesterol supplementation elevated the cholesterol concentration in liver in the order: linseed oil greater than beef tallow greater than fish oil (8.6-, 5.5-, 2.6-fold, respectively). Feeding fish oil and cholesterol apparently reduced 20:4 omega 6 levels in plasma and tissue lipids. Fish oil accentuates the 20:4 omega 6 lowering effect of dietary cholesterol and appears to prevent accumulation of cholesterol in plasma and tissue lipids under a high dietary load of cholesterol. PMID- 2755307 TI - The common occurrence of furan fatty acids in plants. AB - The observation that F-acids (1) occur in rat chow initiated a search for F-acids in human diet. We observed that the amount of F-acids with a pentyl side chain in alpha-position taken up with a one-day diet correlates well with the amount of excreted degradation products, the pentyl urofuran acids (2), (3) and (4). Therefore it can be concluded that F-acids with a pentyl side chain are not produced in the human body but are introduced through the diet. The origin of F acids carrying an alpha-propyl side chain is less clear. The amount of propyl urofuran acids (2) and (3) excreted in urine was found in one case out of three to be five times higher than the amount of F-acids carrying a propyl group in alpha-position taken up by the diet. Therefore, it can presently not be excluded that a portion of the propyl F-acids is produced by the body. F-acids found in human food are mainly introduced into the body by vegetables and fruits. F-acids were found also in birch leaves in considerable amounts, as well as in grasses, dandelion and clover leaves. Thus, we can conclude that F-acids are common constituents of plants. PMID- 2755308 TI - Oxidation of vitamin E in red cell membranes by fatty acids, hydroperoxides and selected oxidants. AB - Our laboratory previously reported that vitamin E (tocopherol) in human blood platelets was oxidized in vitro by various oxidants. This paper shows that diamide, superoxide, hydroperoxides and polyunsaturated fatty acids induce oxidation of tocopherols in red cell membranes. In contrast to platelets, red cell membrane tocopherol was oxidized by hydrogen peroxide and tertiary butyl hydroperoxide. Alpha tocopherolquinone was one of the products of oxidation. Among the fatty acids, the cis polyunsaturated acids were the most potent oxidizing agents with monounsaturated and trans compounds relatively ineffective. The oxidation is not a detergent effect of the fatty acids since neither the detergents Brij and Lubrol, when present in concentrations under 0.5 mM, nor sodium arachidonate (1.25 mM), could oxidize the membrane tocopherol. When red cell membrane samples were incubated with 0.5 mM arachidonate, 47 +/- 11% (S.D.) of the tocopherol lost was converted to tocopherolquinone. Unlike arachidonate, oxidants such as diamide, hydrogen peroxide and tertiary butylhydroperoxide are unable to oxidize all of the membrane tocopherol and produce less tocopherolquinone from oxidation (10-15%) under the experimental conditions of this study. Linoleic acid hydroperoxide is a much more potent oxidant and produces less quinone than arachidonate. The mechanisms of tocopherol oxidations induced by the various compounds seem to be different since the yields of quinone during oxidation vary with the nature of the oxidant. Tocopherol is consumed by oxidation as it protects the membrane from oxidant damage induced by compounds such as unsaturated fatty acids and hydroperoxides. PMID- 2755309 TI - Synergistic enhancement of the antiproliferative activity of cis diamminedichloroplatinum(II) by the ether lipid analogue BM41440, an inhibitor of protein kinase C. AB - The new phospholipid analogue 3-hexadecylmercapto-2-methoxy-methyl-propyl-1 phosphocholine inhibits the phospholipid-calcium-dependent protein kinase, partially purified from Walker carcinoma cells with a Ki value of 0.56 microM. The compound inhibits the phorbol ester stimulated phosphorylation of the ribosomal protein S6 indicating that the depression of Ca2+-phospholipid dependent protein kinase by the alkyl phospholipid also occurs in intact cells. The dose effect curve for the inhibition of cell proliferation by 3 hexadecylmercapto-2-methoxy-methyl-propyl-1-phosphocholine in Walker cells exhibits a close correlation to the dose effect curve for the depression of Ca2+ phospholipid-dependent protein kinase activity. Although alternative mechanisms cannot be excluded, the data suggest that the growth inhibitory activity of 3 hexadecylmercapto-2-methoxy-methyl-propyl-1-phosphocholine correlates with the inhibition of Ca2+-phospholipid-dependent protein kinase. The antiproliferative activity of 3-hexadecylmercapto-2-methoxy-methyl-propyl-1-phosphocholine is synergistically enhanced by cis-diamminedichloroplatinum(II). PMID- 2755310 TI - Quantification, characterization and fatty acid composition of lysophosphatidic acid in different rat tissues. AB - The amount and composition of lysophosphatidate present in different rat tissues have been estimated by an internal standard method in which a synthetic unnatural isomer (1-heptadecanoyl-rac-glycerol-3-phosphate) was added to the total lipid extracts, and the fatty acid composition of purified lysophosphatidate was determined. Lipids from tissues were extracted under acidic conditions, and the lysophosphatidate was purified by solvent partitions followed by thin-layer chromatography in multiple solvent systems. The purified lipid was shown to be 1 acyl-sn-glycerol-3-phosphate by chromatographic and chemical analysis, by its resistance to hydrolysis when treated with phospholipase A2 and also by its complete conversion to 1-acyl-sn-glycerol when treated with alkaline phosphatase. The fatty acid constituents of this lipid were determined by gas-liquid chromatography of the derived methyl esters. The concentrations (nmol/g of tissue) of lysophosphatidate in various tissues were: 86.2 +/- 4.2 in brain, 60.3 +/- 6.3 in liver, 46.4 +/- 6.5 in kidney, 30.6 +/- 5.0 in testis, 22.3 in heart and 19.3 in lung. Mostly (80%) saturated fatty acids were found to be present in this lyso lipid. A significantly high level of stearic acid was present in this lipid from all the tissues (50-60% in liver, kidney, brain and testis, and about 40% in heart and lung) compared to palmitic acid (10-15% in liver, kidney and brain and 25-30% in testis, heart and lung). The fatty acid compositions of phosphatidic acid, the putative product of lysophosphatidate acylation, from different tissues were also determined and palmitate was found to be the major saturated fatty acid.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2755311 TI - The essential fatty acid requirement for azoxymethane-induced intestinal carcinogenesis in rats. AB - The essential fatty acid requirement for the development of intestinal carcinogenesis was determined and compared to the overall essential fatty acid status of the animals as measured by the triene/tetraene ratio in the plasma, liver and colon. To induce tumors, male Sprague-Dawley rats were given two weekly injections (20 mg/kg body wt) of azoxymethane. Two weeks after the last injection, the rats were divided into groups of 25 and given one of six diets containing various levels of essential fatty acids (as linoleate). The diets contained 5% total fat and were prepared by mixing safflower oil (high essential fatty acids, beef fat (low essential fatty acids), and medium chain triglyceride oil (no essential fatty acids). One group of rats was fed a 20% beef fat diet. The range of essential fatty acids was from less than 0.03% to 1.28% (w/w). Twenty-six weeks after the first azoxymethane injection, the animals were killed and intestinal tumor incidence and multiplicity were determined. Samples of plasma, liver and colon were also taken for measurement of the triene/tetraene ratio by gas chromatography. Large bowel tumor incidence showed a dependence on the essential fatty acid content of the diet. The results were as follows: (percent essential fatty acids: percent tumor incidence) Group A (1.28: 72.4), Group B (0.60: 73.3), Group C (0.11: 55.2), Group D (0.08: 39.3), Group E (less than 0.03: 37.9) and Group F, which was fed 20% beef fat, (0.34: 88.5).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2755312 TI - The effect of dietary fish oil on muscle and adipose tissue lipoprotein lipase. AB - The activity of lipoprotein lipase (LPL) in the adipose tissue and skeletal muscle of rats fed glucose- or fructose-based diets containing fish oil, corn oil or tallow was examined. In addition, heart LPL activity was measured in rats fed a glucose-based diet containing either corn oil or fish oil. Adipose tissue LPL activity was unaffected by dietary fat. In both heart and skeletal muscle, LPL activity was higher in rats fed the fish oil diet. These results suggest that increased removal of triglyceride by muscle may contribute to the blood triglyceride lowering effect of dietary fish oil. PMID- 2755313 TI - Association of the intestinal brush-border membrane phospholipase A2 and lysophospholipase activities (phospholipase B) with a stalked membrane protein. AB - We have attempted to determine the size and membrane orientation of a recently described rat jejunal brush-border protein possessing phospholipase A2 and lysophospholipase activities (phospholipase B) (Pind, S. and Kuksis, A. [1988] Biochim, Biophys. Acta 938, 211-221). The phospholipase A2 and lysophospholipase activities were renatured following nonreducing sodium dodecyl sulphate polyacrylamide gel electrophoresis of the total membrane proteins and were shown to migrate as a component of a protein band having a relative molecular mass of 170 kDa. This band accounted for approximately 1% of the total Coomassie Blue staining proteins. Phospholipase B was also shown to be solubilized from the membranes, in an active form, by a proteolytic digestion with papain. Papain solubilization resulted in a loss of the hydrophobic properties observed for the intact phospholipase. These results suggest that the active site of the phospholipase projects from the luminal surface of the membrane vesicles. In support of this, phospholipase activity towards exogenous, detergent-solubilized phosphatidylcholine was demonstrated under conditions in which the membranes remained intact. We conclude that the phospholipase B has the characteristics of a stalked, brush-border membrane protein and may be considered as another digestive enzyme anchored in this membrane. PMID- 2755314 TI - Effect of pH on the affinity of phospholipids for cholesterol. AB - The ability of multilamellar vesicles of phosphatidylcholine and phosphatidylethanolamine in aqueous phase to prevent access to cholesterol by a nonpolar solvent was examined. Phosphatidylethanolamine vesicles. In mixed vesicles, cholesterol was retained in proportion to the amount of phosphatidylcholine. To alter the charge and hydration of head groups, pH was adjusted from 1.2 to 12.5. Above pH 8, both phosphatidylethanolamine and phosphatidylcholine retained sterol in a 1:1 molar ratio of phospholipid to cholesterol, regardless of acyl side chain composition. Between pH 2.0 and pH 8.0, sterol retention varied with type of head group and side chain. Lipids with 16-carbon saturated side chains retained more sterol than 18-carbon unsaturated or 12-carbon saturated side chains. Between pH 1.1 and 2.0, none of the phosphatidylethanolamines retained sterol, but long chain phosphatidylcholines, saturated or unsaturated, retained sterol in a 1:1 molar ratio of phospholipid to sterol. Short chain phosphatidylethanolamines and phosphatidylcholines retained 0 to 20% at the low- to mid-pH range. Size of multilamellar vesicles, measured by Doppler effect light scattering analysis, had no bearing on sterol retention. Sonication of vesicles, which increases surface curvature, increases the retention of sterol. Fluorescence polarization indicated that cholesterol does not interact with DPPC or DLPC side chains. The observations can be interpreted in terms of space requirements of head groups, including charge repulsion and hydration. Other factors, such as monovalent cation replacement by protons, juxtaposition of charged groups on vesicle surfaces and length and unsaturation of acyl side chains affect the affinity of phospholipids for cholesterol. PMID- 2755315 TI - Changes in lipid composition of liver microsomes and fatty acyl-CoA desaturase activities induced by medium chain triglyceride feeding. AB - Changes in fatty acid composition, microsomal delta 9- and delta 6-desaturase activities and liver contents of cholesterol and phospholipids were studied in rats fed medium chain triglyceride-supplemented diets. Weanling rats were divided into four groups and fed for three weeks a basal diet with different 10%-fat supplements: corn oil, medium chain triglyceride-corn oil, olive oil and medium chain triglyceride-olive oil. The highest relative content of saturated fatty acids corresponded to corn oil-fed animals. Both monounsaturated fatty acid content and delta 9-desaturase activity were higher in the animals fed olive oil diets than in corn oil-fed rats. The long chain polyunsaturated fatty acids of the n-3 series were increased in the olive oil and medium chain triglyceride olive oil-fed groups probably due to the lower linoleic/alpha-linolenic ratios found in these two diets. The cholesterol/phospholipid molar ratio was unaffected by diet and the unsaturation index was only slightly changed in the four groups. Thus, some mechanism may be operative under these conditions to maintain the homeostasis of the membrane. PMID- 2755317 TI - Molecular species of glycerophospholipids and sphingomyelins of human erythrocytes: improved method of analysis. AB - This study reports the application of modern methods of molecular species analysis in determination of the structure of both major and minor glycerophospholipids and sphingomyelins of human erythrocytes. Individual phospholipid classes were resolved from total lipid extracts by thin-layer chromatography. Diradylglycerols were released by phospholipase C and converted into trimethylsilyl ethers, which were resolved into the alkenylacyl, alkylacyl and diacylglycerol subclasses by normal phase high performance liquid chromatography. Molecular species of diradylglycerols and ceramides were quantitated according to carbon and double bond number by gas liquid chromatography using a fused silica capillary column wall-coated with bonded RTx 2330. The molecular species of ceramides were determined by GC/MS. The diradyl glycerophosphocholines contained 93.0% diacyl, 4.6% alkylacyl and 2.5% alkenylacyl, while the diradyl glycerophosphoethanolamines were made up of 48.8% diacyl, 47.8% alkenylacyl and 3.4% alkylacyl subclasses. Analysis of the molecular species showed that the long chain polyunsaturated acids were mainly combined with C16 in all diradyl GPC subclasses and in diacyl GPE, while in the alkylacyl and alkenylacyl GPE and in diacyl glycerophosphoinositol and diacyl glycerophosphoserine they were combined mainly with C18 saturated fatty chains. In addition to the C16 and C18 alkyl and alkenyl, the ether fractions also contained significant proportions of C20, C22 and C24 chains. The molecular species of the ceramide moieties of the SPH were made up largely of mono- and diunsaturated species. Over 200 molecular species were identified and quantitated in a representative sample of human red blood cells. PMID- 2755316 TI - Delta 6 and delta 5 desaturase activities in liver from obese Zucker rats at different ages. AB - delta 6 Desaturation of linoleic acid (18:2 n-6) and delta 5 desaturation of dihomo-gamma-linolenic acid (20:3 n-6) were measured in liver microsomes from genetically obese Zucker rats (fa/fa) and from their lean littermates (Fa/--). Both groups were fed a balanced commercial diet. The rats were 6, 9 and 12 weeks old, which corresponded to stages in their active growth period. The content of total fatty acids and n-6 polyunsaturated fatty acids in whole liver and liver microsomes was also determined in order to ascertain how the desaturase activities measured in vitro reflected regulation of essential fatty acid metabolism in vivo. Contrary to values obtained for delta 6 desaturation, delta 5 desaturation at nonsaturating substrate levels were lower in obese rats than in lean controls. In contrast, at saturating substrate level, the maximal delta 5 desaturase activities were the same in both phenotypes and they increased with age. Study of delta 5 desaturation kinetics (1/V vs 1/S) showed that Vm did not differ between 12-week-old obese and lean rats, whereas KM in obese rats was much lower than in controls, expressing the very low affinity of the enzyme for the substrate in obese animals. The fatty acid composition of liver lipids reflected the results of desaturase activities in vitro. In particular, the ratios 20:4 n 6/20:3 n-6 were lower in obese rats than in lean rats, which can be explained by the lower conversion of 20:3 n-6 into 20:4 n-6 by delta 5 desaturation.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2755318 TI - Molecular species of glycerophospholipids and sphingomyelins of human plasma: comparison to red blood cells. AB - In addition to diacyl glycerophosphocholine and sphingomyelin, human plasma also contains small amounts of other glycerophospholipids, which may have special metabolic function. The structure and origin of these minor plasma lipids has not been determined. Knowledge of the detailed composition of the phospholipids of red blood cells (Myher et al., Lipids 24, 1989) permits evaluation of one of the possible sources. This study reports the detailed analyses of plasma glycerophospholipids made in parallel to those of the erythrocyte lipids obtained from the same blood using HPLC and GLC methods. The proportions of the major phospholipid classes in the plasma and erythrocytes were similar to published values, including the essential absence of diradyl glycerophosphoserine from plasma. Plasma diradyl glycerophosphocholine contained 93.0% diacyl, 3.4% alkylkacyl and 3.6% alkenylacyl, whereas the diradyl glycerophosphoethanolamine consisted of 71.8% alkenylacyl, 19.9% diacyl and 8.3% alkylacyl subclasses. The diradyl glycerophosphoinositol was 100% diacyl. The content of the minor subclasses of plasma diradyl glycerophosphocholine is similar to that of the red cells, but the ether content of the diradyl glycerophosphoethanolamine is higher in plasma than in cells. The lipid ether subclasses of plasma glycerophospholipids also contained a higher proportion of the C20, C22 and C24 alkyl and alkenyl chains than those of the cells. Furthermore, the C16 and C18 containing species in diradyl glycerophosphoethanolamine subclasses varied with the nature of the polyunsaturated acid, whereas in diradyl glycerophosphocholine subclasses the polyunsaturated acids were combined with the C16 and C18 acids in equal proportions. The significant differences in the molecular species of glycerophospholipids and sphingomyelin between plasma and red cells would appear to limit any direct transfer or equilibration of their lipid components. PMID- 2755319 TI - Modulating influence of dietary lipid intake on the prostaglandin system in adult men. AB - We evaluated the effect of moderate dietary changes on the prostaglandin system by measuring the urinary excretion of 7 alpha-hydroxy-5,11-dioxo-tetranorprostane 1,16-dioic acid (PGE-M). In a crossover design, twenty-four free-living male subjects in good health (24 to 54 years of age) were fed two diets: (i) Regular (R) diet, 41% energy (en%) from fat, P/S 0.59, M/S 0.96; (ii) Experimental (E) diet, 19 en% from fat, P/S 1.31, M/S 1.48. Diet R contained 13.9 g/day of neutral detergent fiber (NDF) and about 600 mg/day of cholesterol per 3200 kcal; Diet E contained 35.5 g/day NDF and about 280 mg/day cholesterol. Each controlled-diet period lasted ten weeks. The menu cycle was 7 days, and all diets were calculated to provide adequate amounts of essential nutrients. The PGE-M excretion rates were determined in 24-hr urine by stable-isotope dilution gas chromatography-mass spectrometry in the selected ion-monitoring mode. Low-fat Diet E, with an intake of 6.6 en% from polyunsaturates, was associated with an average 14.2% reduction in PGE-M daily output, compared to high-fat Diet R with a 9.3 en% from polyunsaturates (P = 0.046). These results support the view that dietary lipid changes can significantly alter the in vivo production of E-series prostaglandins. We cannot conclude, however, if this apparent diet effect was brought about by the change in linoleate intake alone or was the result of complex biochemical interactions among individual fatty acids, both saturated and unsaturated. PMID- 2755321 TI - Increased plasma triglyceride secretion in EFA-deficient rats fed diets with or without saturated fat. AB - Metabolic responses to essential fatty acid-deficiency in rats include an increased rate of triglyceride secretion into the plasma, a large reduction in the HDL1 plasma lipoprotein concentration, and increased concentrations of liver triacylglycerols and cholesteryl esters. Because of differences in the types of EFA-deficient diets used, it is not clear whether these responses were solely due to the absence of EFA from the diet or whether saturated fat, or differences in acyl group chain length in this fat, might be responsible. Therefore, we fed rats diets differing only in amounts and kinds of fat, and measured triacylglycerol secretion rates and liver concentrations of triacylglycerols and cholesteryl esters, for comparison with our earlier measurements of plasma high density lipoprotein subpopulations in rats fed exactly the same diets. The purified diets contained either no fat, 5% by weight hydrogenated coconut oil, 5% hydrogenated cottonseed oil, or each of these three diets supplemented with 1% safflower oil, or 5% corn oil. We also fed some rats a nonpurified stock diet for comparison with literature reports. The present results indicate that the metabolic responses to essential fatty acid deficiency described above are definitely due to essential fatty acid-deficiency and not to the presence or chain length of acyl groups in saturated fat in the diet. PMID- 2755320 TI - The hepatocellular transport of sulfobromophthalein-glutathione by clofibrate treated, perfused rat liver. AB - The hypolipidemic drug clofibrate is known to affect the hepatic transport of various organic anions including bilirubin, fatty acids and sulfobromophthalein. Changes in the rate of metabolism and/or intracellular transport have been claimed responsible for the effect. To evaluate these possibilities, the transport of sulfobromophthalein-glutathione, a model compound that does not require metabolism for biliary excretion, was studied in perfused livers isolated from clofibrate-treated and control rats. Cytosolic fatty acid binding protein and glutathione S-transferase activity were also measured. Clofibrate treatment significantly increased liver weight; as a result glutathione S-transferase activity (toward 1-chloro-2,4-dinitrobenzene) fell if expressed per gram of liver (4560 +/- 420 (SE) vs 7010 +/- 260 nmoles/min for clofibrate treated and controls respectively, p less than 0.002), but was unchanged when expressed per total liver (60.8 +/- 6.5 vs 64.6 +/- 3.5 mumoles/min for clofibrate and controls p greater than 0.5). Irrespective of how it was expressed fatty acid binding protein was significantly increased by the drug treatment. Steady state sulfobromophthalein-glutathione removal velocity was saturable with increasing concentrations of sulfobromophthalein-glutathione in both control and clofibrate treated livers. Steady state extraction ratio, as well as Vmax and Km for removal, did not differ between the two groups. In keeping with other observations, these data collectively indicate that the hepatic steady state removal of nonmetabolized compounds is not affected by clofibrate.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2755322 TI - The precursors of fecapentaenes: purification and properties of a novel plasmalogen. AB - Fecapentaene-12 and fecapentaene-14 are genotoxic poly-unsaturated ether-lipids produced by the colonic microflora in humans and pigs. Although the fecapentaenes have been extensively characterized, little is known about the nature of the precursors from which they are produced. We purified one form of these precursors from feces of an individual who excreted high levels of fecapentaene-12 and its precursors. Purification was carried out by a series of extractions and precipitation in organic solvents followed by silica and amine high performance liquid chromatography. The purified precursor had identical UV spectral characteristics as the fecapentaenes indicating that it contained the same ether linked pentaenyl functional group. However, it was not mutagenic. The precursor was amphiphilic in nature, behaving like a synthetic "model" ether-phospholipid on silica and C18 thin layer chromatography. When incorporated into phosphatidylcholine micelles it could be hydrolyzed in vitro by a combination of lipase and phospholipase C to fecapentaene-12. Our findings indicate that the general structure of this precursor is that of a phospholipid, specifically a plasmalogen--the exact structures of which remain to be determined. PMID- 2755324 TI - Clinical computing. PMID- 2755323 TI - Black currant seed oil feeding and fatty acids in liver lipid classes of guinea pigs. AB - Guinea pigs were fed one of three diets containing 10% black currant seed oil (a source of gamma-linolenic (18:3 n-6) and stearidonic (18:4 n-3) acids), walnut oil or lard for 40 days. The fatty acid composition of liver triglycerides, free fatty acids, cholesteryl esters, phosphatidylinositol, phosphatidylserine, cardiolipin, phosphatidylcholine and phosphatidylethanolamine were determined. Dietary n-3 fatty acids found esterified in liver lipids had been desaturated and elongated to longer chain analogues, notably docosapentaenoic acid (22:5 n-3) and docosahexaenoic acid (22:6 n-3). When the diet contained low amounts of n-6 fatty acids, proportionately more of the n-3 fatty acids were transformed. Significantly more eicosapentaenoic acid (EPA) (20:5 n-3) was incorporated into triglycerides, cholesteryl esters, phosphatidylcholine and phosphatidylethanolamine of the black currant seed oil group compared with the walnut oil group. Feeding black currant seed oil resulted in significant increases of dihomogamma-linolenic acid (20:3 n-6) in all liver lipid classes examined, whereas the levels of arachidonic acid (20:4 n-6) remained relatively stable. The ratio dihomo-gamma-linolenic acid/arachidonic acid was significantly (2.5-fold in PI to 17-fold in cholesteryl esters) higher in all lipid classes from the black currant seed oil fed group. PMID- 2755325 TI - The soul of a new system: a modern parable. PMID- 2755326 TI - Role of computing in patient care in two hospitals. AB - This report describes two hospital-wide clinical computing systems that assist physicians, nurses, medical students, and other clinicians in the care of their patients. From any of the video-display terminals located throughout the hospitals (666 at Beth Israel Hospital and 1250 at Brigham and Women's Hospital, both in Boston), clinicians can obtain results from the clinical laboratories; read diagnostic reports from the clinical departments; view lists of medications used during hospitalization and prescriptions filled in the outpatient pharmacy; request delivery of a patient's chart; request consultation on approaches to therapy; perform bibliographic retrieval of the MEDLINE database; and read, write, retract, edit, and forward electronic mail. During a one-week study period, 1737 clinicians at Beth Israel Hospital used one or more of the options in the clinical information system 58,757 times. During the same week, 2262 clinicians at Brigham and Women's Hospital used one or more of their options 89,101 times. The large amount of use by clinicians, who could, if they so desired, rely on printed reports or telephone calls to obtain their clinical information, suggests that a reliable, comprehensive, and easy-to-use computer system can contribute substantially to the quality of patient care. PMID- 2755327 TI - Departmental and laboratory computing in two hospitals. AB - This report describes the departmental and laboratory use of integrated, hospital wide computing systems at Beth Israel and Brigham and Women's hospitals in Boston. The systems have an important role in the admitting, outpatient, and medical records departments; in the clinical departments (blood bank, cardiology, neurophysiology, pathology, radiology, and pharmacy); in the clinical laboratories; and at Brigham and Women's Hospital, in the financial departments. Information that is collected in the computers from these departments and laboratories is available for viewing by clinicians at terminals located throughout each hospital and is used in compiling charges for each patient's account. The programs are heavily used. During a one-week study period, 742 departmental and laboratory workers at Beth Israel Hospital filed or edited information in patients' computerized records 137,526 times. During the same week, 984 departmental and laboratory workers at Brigham and Women's Hospital filed or edited information 293,367 times. After the computing systems were introduced, the time required to collect unpaid bills decreased substantially at both hospitals. PMID- 2755328 TI - X-File: a program for maintaining a radiographic teaching file. AB - Software designed for entry, retrieval, and maintenance of radiographic case-file data on a microcomputer offers considerable help in maintaining such records in a radiology department. The case files are based on the Index for Roentgen Diagnoses, published by the AmericanCollege of Radiology. The terms and code numbers of the index are included in the software, so that the user need only enter the diagnostic term desired; the code numbers and exact terminology are assigned automatically. The software is written for an IBM-compatible microcomputer. Residents and staff radiologists have been using the program for the past two years to store and find both confirmed cases and other interesting cases. The system's capacity exceeds 70,000 entries on a 20-megabyte had disk. The program has five features not found in previous similar programs and not attainable with manual methods. PMID- 2755329 TI - Transmural metabolite distribution in regional myocardial ischemia as studied with 31P NMR. AB - Phosphorus-31 nuclear magnetic resonance (31P NMR) has been applied to study the canine heart prior to and during regional myocardial ischemia induced by partial flow reduction in the left anterior descending coronary artery (LAD). NMR data were acquired in a transmural fashion by restricting the signal to a column perpendicular to the heart wall using B0 gradients and obtaining spectroscopic spatial resolution along the third dimension using the B1 gradient and adiabatic excitation. With this approach, transmural spectra were accumulated in five separate voxels spanning the wall of the left ventricle from the epicardium to the endocardium. In the normal canine myocardium the levels of high-energy phosphates CP and ATP were relatively constant throughout the left ventricular wall, with only minor evidence of free inorganic phosphate in any of the transmural voxels. However, during sustained partial occlusion of the LAD, significant regional differences between the epi- and the endocardium were noted. The data demonstrate the importance of studying cardiac bioenergetics with transmural differentiation. PMID- 2755330 TI - Identification of a characteristic 31P NMR signal in acute experimental pancreatitis with the aid of 1H-31P correlated 2D measurements of intact pancreas. AB - Two-dimensional 1H-31P correlation spectroscopy and relaxation time measurements of intact diseased pancreas were performed in order to identify an unknown peak appearing at -0.18 +/- 0.04 ppm in a 31P NMR spectrum of taurocholate-induced experimental acute pancreatitis in rats. The signal was identified as a solubilized lecithin taurocholate complex. PMID- 2755331 TI - Spectroscopic imaging and spatial localization using adiabatic pulses and applications to detect transmural metabolite distribution in the canine heart. AB - Adiabatic pulses have been employed in spectroscopic imaging and relaxation rate measurements at 4.7 T to demonstrate the feasibility of obtaining spectroscopic data from the complete sensitive volume of a surface coil using the surface coil as a transmitter and receiver. With conventional B1 sensitive pulses, spectroscopic localization or imaging techniques, such as chemical-shift imaging, yield resonance intensities that are distorted severely as a function of space, and maximal signal is detected from a small region within the complete sensitive volume of the coil. With adiabatic pulses, however, this problem is eliminated completely. In addition, a new method of spatial localization is introduced. This method, referred to as FLAX-ISIS, is a derivative of longitudinally modulated Fourier series window and ISIS approaches and utilizes adiabatic inversion and excitation pulses. The method allows construction of localized spectra for multiple regions along the surface coil axis by postacquisition data manipulation of a single set of free induction decays. These techniques were applied to the study of the myocardium using an implanted surface coil in an instrumented closed chest canine model and in an open-chest preparation. The results demonstrate that one-dimensional techniques are adequate for transmural detection of metabolites provided signal origin is restricted to a column perpendicular to the left ventricle wall. PMID- 2755332 TI - Simultaneous multislice imaging (SIMUSIM) for improved cardiac imaging. AB - In conventional ECG gated multislice imaging of the heart, slice position and phase in the heart cycle are not independent parameters. This drawback is removed by simultaneous imaging of multiple slices. This paper describes a technique which is based on simultaneous excitation of several slices by multifrequency selective rf pulses. In comparison to conventional cardiac multislice imaging an improved quality of heart images is obtained, because more acquisitions are attributed to the MR signal of the slices. The gain in signal-to-noise ratio per measurement time increases with the square root of the number of slices investigated simultaneously. This is demonstrated using phantom experiments and cardiac images. PMID- 2755333 TI - Interleaved 31P NMR with transcutaneous nerve stimulation (TNS): a method of monitoring compliance-independent skeletal muscle metabolic response to exercise. AB - 31P NMR spectroscopy was used to monitor the metabolic response of the tibialis anterior muscle group to transcutaneous nerve stimulation of the peroneal nerve at a rate of 4 Hz for 5 min in human volunteers (n = 8). It is demonstrated that this technique can be used as a method of investigating effort-free and compensation-independent skeletal muscle exercise. PMID- 2755334 TI - Fluid shear and spin-echo images. AB - Because clinical studies have indicated that shear in fluids may be one of the major causes of magnetic resonance image artifacts, we imaged an apparatus that would separate the effects of shear from the plethora of other motion artifacts. The apparatus contained fluid between two concentric cylinders. To produce shear, we turned the outer cylinder. To produce motion without shear, we turned both cylinders as one. Shear rates near 200 s-1 (similar to those in large arteries) can cause pixel intensities either to increase 40% or decrease to background levels. Increases can occur when the velocities are nearly parallel to the phase encoding gradient. Decreases can occur when velocities are in the direction of the frequency gradient. The decreases are similar to those predicted from phase dispersion within a "voxel" so long as the voxel's phase warp does not exceed 2 pi. PMID- 2755335 TI - Characterization of fluid flow using low-spatial-resolution velocity spectra from NMR images. AB - Flow velocity distributions or spectra may be obtained by NMR imaging using an anisotropic three-dimensional Fourier transform pulse sequence in which the low resolution direction encodes perpendicular velocity. Velocity spectra from regions of interest covering the entire lumens of pipes in a flow phantom containing straight sections, a jet, and a constriction suggest that velocity spectra provide useful information even when the vessels are not spatially well resolved. The flow in the phantom was characterized and limited measurements were made. PMID- 2755336 TI - Spectral editing techniques for 31P NMR spectroscopy of blood. AB - Although the measurement of the pH of biological systems using the 31P NMR response of inorganic phosphate is well known, sometimes in blood absolute determination of the intensity and position of the Pi resonance is precluded by overlap from the doublet resonance of 2,3-diphosphoglycerate. Three techniques which overcome this problem by eliminating the doublet are described and their sensitivity to the experimental parameters is assessed. PMID- 2755337 TI - A perfusion system developed for 31P NMR study of melanoma cells at tissue-like density. AB - A perfusion culture system has been developed for 31P NMR study of human uveal melanoma metabolism by adapting the Vitafiber I cartridge system (Amicon). 31P NMR spectra collected weekly during periods of up to 10 weeks demonstrated increasing levels of phosphorus metabolites as the anchorage-dependent cells grew to tissue-like density. PMID- 2755338 TI - [Evaluation of the optical properties of video display terminals]. AB - Video display terminals (VDTs) pose to these operating then professionally risks resulting from optical properties of the screen, lighting conditions and organization of VDT workplaces. The latest Polish VDTs have been tested to determine their ultraviolet and infrared radiation, screen luminance depth and light reflection factors of the casing, key-buttons and documents serving as information sources. The ultraviolet and infrared radiation did not reach a health-hazardous level, however the light reflection factors were highly differentiated and showed unsuitable distribution inside the operator's visual field; the luminance pulsation of the screen exhibits a considerable depth. The findings promoted defining some rules of the proper use of VDTs. PMID- 2755339 TI - [Presence of potentially pathogenic bacteria and fungi in the cooling-lubricating emulsion used in the aluminum sheet rolling process]. AB - Microbiological tests of aluminium rolling water-oil emulsion reveal high level of contamination: relatively anaerobic bacteria 10(6)-10(8) cells/ml, fungi and yeasts 10(3)-10(4) cells/ml, and also anaerobic bacteria Desulfovibrie sp. reducing sulfates to hydrogen sulfide. In emulsion samples there were present bacterial strains potentially dangerous to health, belonging to the family Enterobacteriaceae, Vibrionaceae, Pseudomonadaceae, Bacillaceae. The fungi and yeasts found in the emulsion were identified as: Aspergillus sp., Penicillium sp., Cladosporium sp., Cephalosporium sp., Candida sp. The emulsion sprayed in aerosol in air of the mill was the infecting source for the workers. The emulsion was protected by a biocid and thus the growth of potentially pathogenic microorganisms was inhibited. PMID- 2755340 TI - [Lead level of the hair in persons occupationally exposed to it in selected work places]. AB - The concentration of lead was determined in the hair of 69 occupationally exposed and 55 non-exposed subjects. The mean lead content in the three selected occupationally exposed groups was 17.48, 29.03 and 25.74 micrograms/respectively, significant differences being found between some of them. The mean lead content in the hair of unexposed population was 4.20 micrograms/g. Statistical analysis of the results demonstrated a highly significant difference in mean lead levels between exposed and non-exposed groups. The subjects occupationally exposed to lead and its compounds exhibited no significant correlation between lead concentrations in hair and delta-aminolevulinic acid concentrations in urine. PMID- 2755343 TI - [A strategy for measuring air pollution in the work environment]. PMID- 2755341 TI - [Effect of work in coke-processing plants on the efficiency of selected cognitive processes]. AB - Reports demonstrating the usefulness of neurobehavioral methods in estimation of early results of work in exposure to toxic substances have been quite frequent recently. In this study 198 workers of coking plants (including 137 highly exposed--group I and 61 low or medium exposed--group II) and 50 non-exposed workers constituting the control group have undergone psychological examinations consisting of estimation of perception, short-time memory and learning capabilities. The obtained results give evidence of statistically significant visual and motorial disturbances in group I, as compared to the control group and group II. Also the findings in group II were statistically significantly worse than those in the control group (except learning capabilities). The abnormalities coincided with the results of neurological examination (including EEG) and correlated with the degree of BaP exposure. In this connection it is suggested that the exposed workers should be rotated in their working posts. PMID- 2755342 TI - [Limitation of hand function in workers with Dupuytren's contracture]. AB - A group of 72 physical workers with Dupuytren's contracture, subject to operation, was examined. Such advantages of early operative treatment as facility of surgery, shorter hospitalisation, shorter rehabilitation after operation, and quick return to previous occupation have been pointed out. PMID- 2755344 TI - [Reply to the letter of Dr. G. Szewczyk regarding his article "A strategy for measuring air pollution in the work environment" (Medycyna pracy, vol. 37 p. 369, 1986)]. PMID- 2755346 TI - Detection of the patient at risk for osteoporosis at the time of the menopause. PMID- 2755345 TI - Differential effect of long-term oestrogen therapy on trabecular and cortical bone. AB - The effect of long-term oestrogen therapy has been assessed in 40 oophorectomised women. Twenty-one of the women had received mestranol (mean 26 micrograms/day) and 19 received placebo tablets for a mean duration of 14 yr. A newly developed gamma-ray computed tomography (CT) scanner was used to measure trabecular and cortical bone separately in the distal radius. Bone density in the lumbar spine was measured using dual photon absorptiometry (DPA). Prevention against bone loss was demonstrated at all sites for the mestranol treated group (P less than 0.01). The deficit of radial trabecular bone (27%) was greater than that for radical cortical bone (14%). The deficit for the spine was intermediate (20%). One-year follow-up radial measurements showed a significant 1.2% increase (P less than 0.01) in cortical bone for the treated group. The DPA measurement was found to be best correlated (r = 0.80) with a mixed trabecular and cortical bone parameter in the radius. We conclude that the degree of bone loss at any site is dependent on the proportion of trabecular bone present. PMID- 2755347 TI - Health care access project. Explores one solution for the uninsured. PMID- 2755348 TI - Data show lack of insurance a serious problem. PMID- 2755349 TI - Three Michigan programs help unlock the door to health for the uninsured. PMID- 2755350 TI - MSMS legal counsel explains physician access to HCFA, MPRO records. PMID- 2755351 TI - MSMS offers retirement plan. PMID- 2755352 TI - Rep. David M. Gubow. Looking toward the future. PMID- 2755353 TI - Turning death into life. An organ recipient's story. PMID- 2755355 TI - Transfer of insurance coverage explained. PMID- 2755354 TI - Rackham Arthritis Research Unit article clarified. PMID- 2755356 TI - Hepatitis B. It's the most important health issue today. PMID- 2755357 TI - Child day-care programs. A must, says MSMS Committee on Concerns of Women Physicians. PMID- 2755358 TI - Understanding the power of effective communications. PMID- 2755359 TI - Michigan Society of Medical Assistants. An important resource for physicians. PMID- 2755360 TI - Socialized medicine. Are we ready for it? PMID- 2755361 TI - Consumers need to be educated about SIDS. PMID- 2755362 TI - Bindings of toxic shock syndrome toxin-1 and staphylococcal enterotoxins A, B, and C to rabbit spleen cells. AB - Toxic shock syndrome toxin-1 (TSST-1) and staphylococcal enterotoxins (SE) A, B, and C were studied on binding to rabbit spleen cells. The toxins showed remarkable mitogenic effects on the cells. Among them, SEA and TSST-1 had much stronger mitogenic activities than SEB and SEC. Binding study showed that labeled TSST-1 and SEA bound considerably to cells, but that labeled SEB or SEC was not observed to bind at a detectable level under the same conditions as TSST-1 and SEA. Competitive binding analysis between toxins to cells proved that TSST-1 and SEA clearly competed with each other in binding. Scatchard plots for TSST-1 and SEA in binding were linear at the doses used. The Scatchard analysis for TSST-1 and SEA gave a dissociation constant of 2.5 X 10(-9) M and 7.6 X 10(-8) M and the number of binding sites per cell of 5.3 X 10(3) and 1.0 X 10(5), respectively. PMID- 2755363 TI - Annual change in immunoglobulin G and M antibody levels to Toxoplasma gondii in human sera. AB - Sera collected from a Japanese population over 4 years at yearly intervals were examined for antibodies to Toxoplasma gondii by enzyme-linked immunosorbent assay (ELISA). Distributions of immunoglobulin (Ig) G antibody levels for 6 age groups consistently showed two antibody groups with constant mean ELISA values. Quantitative analysis of annual changes in IgG antibody levels for 1,366 pairs indicated increase of greater than or equal to 0.1 in 28 samples and decrease of greater than or equal to 0.1 in 58 samples, with the remaining 1,280 samples showing changes of less than 0.1. Mean ELISA values of samples with increase and decrease were 0.479 and 0.833, respectively, and the difference of 0.354 was similar to 0.412, that was the sum total of mean annual changes in samples with increase (0.228) and decrease (0.184). Increase of greater than or equal to 0.1 from the initial IgG antibody level of less than 0.1, which was considered as a serological evidence for newly acquired infection, was observed in 3 samples, but no increase was demonstrated in IgM antibody level. The changing pattern of IgG and IgM antibody levels in people during the initial and chronic phases of asymptomatic infections is discussed. PMID- 2755364 TI - Characterization of a strain of Mycoplasma hominis lacking 120 kDa membrane protein isolated from Vero cell culture. AB - A strain of Mycoplasma hominis lacking a major membrane protein of 120 kDa was isolated from a Vero cell culture. This strain showed very slow growth rate and formed nipple-less colonies on agar medium. PMID- 2755365 TI - Plasmid profiles of Mycobacterium avium complex isolated from swine. AB - Twenty strains of Mycobacterium avium complex (MAC) isolated from swine and five strains from humans were examined for drug susceptibility and plasmid content. Four strains of swine origin and two strains of human origin harbored plasmid DNAs differing in molecular weights. No relationship between plasmid contents and drug resistance was observed. Southern DNA-DNA hybridization showed that small plasmids from swine MAC strains were homologous to those from human origin at the nucleotide level. PMID- 2755366 TI - On the nature of growth and new growth based on experiments designed to reveal a structure and function for laboratory space. Part I. A synopsis of experimental results and discussion (thermodynamics aspects, transmission of cell radiations, the role of oxygen). AB - Experiments were designed to investigate the contribution of space existing outside the immediate range of chemical reactions of crystal growth and biological phenomena with special reference to growth. Results have been interpreted on the basis that space has both structure and function. Properties derived from the interpretation include action at a distance, memory and the ability to sustain matter in steady states which inter alia constitute patterns of growth. A throughflow (or dissipation) of space was shown necessary to sustain the pattern. Patterns so formed in biomatter can reproduce themselves as virtual images which can be rescued as real images which exhibit a remarkable fidelity of copy. The discussion enters contributions to the prime idea that space has structure and function by recource to modern ideas on non-linear thermodynamics, radiations between cells, quantum field theory and vortex theory, only the first two of which are treated in this paper. PMID- 2755367 TI - On the nature of growth and new growth based on experiments designed to reveal a structure and function for laboratory space. Part II. An approach to the structure of space through quantum field theory with examples of possible biological relevance. AB - A previous paper in this series described experiments and observations which could have been produced by properties derived from the quality of laboratory space. In particular, action at a distance was of commonplace occurrence. It was argued that support for this idea was forthcoming from two recent developments in physics, that of non-linear thermodynamics and that of quantum mechanics followed by quantum electrodynamics. The first permitted the concept of a formative or structuring role for energy permeating matter the second the concept of a structure and function for space. One of these functions was to provide for the creation of subatomic particles and thus of matter. This creativity is achieved from an origin in a non-observable world where the equations have no terms for distance or time. The demonstration of the insignificance of distance in the experiments reported using both crystal and biological growth was used to infer that events in this growth process were similarly preceeded by events in the non observable world. The implications of such an origin for growth and new growth are discussed. PMID- 2755368 TI - Stimulation of epipharyngeal receptors can produce significant bronchoconstriction or bronchodilation: dependence upon unilateral forced nostril breathing? AB - It is suggested that the disagreement in the literature on whether stimulation of epipharyngeal receptors produces bronchoconstriction or bronchodilation may be explicated by the factor of unilateral forced nostril breathing. PMID- 2755369 TI - Vasopressin inhibition via combined head-out water immersion and a prostaglandin E-1 precursor in the treatment of male reproductive failure due to chronic alcohol abuse. AB - Male reproductive failure and infertility are quite common in alcoholics. There are very high correlations between elevated vasopressin levels and male infertility on the one hand, and probable deficiencies of prostaglandin E1 which may raise levels of PGE2 and endorphins which, in turn, release vasopressin on the other. Since head-out water immersion rapidly decreases vasopressin levels, a suggested joint protocol of head-out water immersion and a prostaglandin E-1 precursor is proposed for male reproductive failure in alcoholics. PMID- 2755370 TI - Immune function and the chronic fatigue syndrome. PMID- 2755371 TI - Pathogenicity of Campylobacter pylori in the upper gastrointestinal tract- implications for modern therapy. PMID- 2755372 TI - Incidence and prevalence of insulin-dependent diabetes mellitus in the zero- to 19-years' age-group in Sydney. AB - A population-based register of cases of insulin-dependent diabetes mellitus in the zero- to 19-years' age-group was established in the Southern Metropolitan Health Region of Sydney. The aims of the register were to provide accurate incidence and prevalence data for comparison with those of studies from elsewhere in the world and to evaluate diabetes services, morbidity and compliance with self-care regimens. This article presents the incidence and prevalence data. In the Southern Metropolitan Health Region, the annual incidence of insulin dependent diabetes mellitus per 100,000 population who were aged zero to 19 years, rose from 10.3 cases in 1984 to 14.8 cases in 1987, and in the zero- to 14 years' age-group, it rose from 13.6 cases per 100,000 population in 1984 to 19.4 cases per 100,000 population in 1987; the increases were not statistically significant. The prevalence in the zero- to 19-years' age-group was 0.80 cases per 1000 population, and in the zero- to 14-years' age-group, it was 0.74 cases per 1000 population on February 1, 1986. Age-specific incidence rates were calculated for the years 1984-1987. Incidence peaks occurred at the ages of six years, 10 years and 12-13 years. PMID- 2755373 TI - Unsatisfactory nutritional parameters in non-insulin-dependent diabetes mellitus. AB - Four-day food records, body mass index and glycosylated hemoglobin levels were measured in 212 subjects with established non-insulin-dependent diabetes, who volunteered for a trial of educational programmes. Of these subjects, 79% were above their ideal body weights and 75% of subjects had a glycosylated haemoglobin level that was above the normal range. Ninety-five per cent of subjects reported a total fat intake greater than 30% of their total energy intake, and 80% of subjects reported total carbohydrate intake of less than 50% of their total energy intake. These results suggest that the current methods for the management of non-insulin-dependent diabetes do not achieve optimal long-term dietary results. PMID- 2755374 TI - The place of routine urine testing on admission to hospital. AB - An audit of routine urine testing by dipsticks at a large private provincial hospital analysed 2294 patient records. No result was recorded in 12% of records. Abnormal but expected results were obtained in 9% of cases. Of the 4% of unexpectedly abnormal results, in only one-third of patients was the attending practitioner aware of these results and, in fewer than one-fifth of the patients, were further diagnostic tests performed. In not one case was treatment altered. PMID- 2755375 TI - Attitudes to alcoholism in a Sydney teaching hospital. AB - The physical and psychosocial tolls that are attributable to alcohol are well documented. However, our community has been slow to respond to this serious problem. A survey of attitudes to alcoholism at a Sydney teaching hospital found an acceptance of the disease model and an acknowledgement of alcohol as Australia's main problem drug. The vast majority of respondents felt that the National Campaign against Drug Abuse had paid inadequate attention to alcohol. PMID- 2755376 TI - Recurrent fever in Sjogren's syndrome. PMID- 2755377 TI - Smoker's foot. PMID- 2755378 TI - Bacterial meningitis in children in the Northern Territory. PMID- 2755379 TI - Preventing and dealing with scientific fraud in Australia. PMID- 2755380 TI - Screening for cervical cancer. PMID- 2755381 TI - Worksite programme for the modification of cardiovascular risk factors. PMID- 2755382 TI - Inadvertent pregnancies in oral contraceptive users. PMID- 2755383 TI - [Biological limits of exposure: evolution of interpretative and methodologic criteria]. AB - Biological monitoring is an extremely efficient investigation tool in evaluation of exposure to exogenous substances, in both occupational and environmental settings. However, although biological tests have been widely acclaimed as the ideal approach to or as a completion of environmental measurements, they have had difficulty in becoming firmly established due to a number of limitations of various nature. Besides the numerous uncertainties in the set-up phase, which depend on the choice of indicators or criteria for their use, difficulties are still incurred in making a univocal interpretation of the results. These difficulties are due to the limited pharmaco-kinetic information available on the various substances and to the wide variability in individual biological response. The possibility of extrapolating Biological Exposure Limits (BELs) from the corresponding TLV-TWA, by means of calculations based on the experimental regressions observed between internal and external dose indices, has up to now been considered a dubious operation from a formal point of view and merely indicative for practical purposes. This paper examines the possibility of establishing BELs that are fixed taking account of the influence of the various biological variables, thus permitting a more correct, objective and generalised use of biological indicators in current practice. From the regression function and relative tolerance limits, intended as a range of values within which regression values can be expected to be found with a probability that can be fixed a priori, it is possible to calculate 3 BEL values for each environmental TLV-TWA concentration. The question of which of these different values should be selected as a BEL for practical purposes must be solved on the basis of a series of observations related to the type of investigation being performed and the context in which the results are to be used. It should be emphasized that each BEL value has its own particular sensitivity and specificity, i.e., the possibility of correctly classifying the exposure conditions in relation to the environmental values. If sensitivity and specificity values are known, it is possible to calculate the predictive value of the biological measurements compared to the environmental measurements; if numerical data on these parameters are available, account can be taken of the variability of the results in a rigourously scientific manner.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2755384 TI - [Biological monitoring of occupational exposure to airborne pollutants]. AB - Biological monitoring of inert substances requires knowledge of the mechanisms regulating respiratory absorption. The authors examine the influence of parameters such as work load, exposure duration and biotransformation on the respiratory absorption of inert airborne pollutants in the workplace. Attention is also given to the possibility of using biological thresholds or Biological Equivalent Limits (BELs). PMID- 2755385 TI - Electron microscopic evaluation of atmospheric dust. AB - For the determination of the health hazards to humans of inhaled dust particles, precise collection and evaluation techniques are needed. The sampling system has to be designed in order to obtain representative samples and has also to take into consideration the type of electron microscopy evaluation which will be applied. A convenient method is the collection of dust particles on conventional membrane filters (MF) or on Nuclepore polycarbonate filters (NPF); their characteristics are outlined. The preparation of filters is a decisive procedure, both for SEM (low magnification) and for TEM evaluation. The advantages and disadvantages of the two electron microscopic techniques are described and discussed. As an example of practical application, the results of ambient air fiber measurements in the cities of Dusseldorf and Duisburg, and in an urban site 50 km away from the nearest city for the period 1981-83 are reported. From these results, it seems possible to obtain useful and realistic informations on particulate air pollutants when using both electron microscopy techniques. PMID- 2755386 TI - [Refinement of the methods of diffractometric analysis in relation to the preparation surface exposed to X rays]. AB - The aim of the study was to assess the degree of X-ray diffractometric response using preparations having a surface exposed to X-rays other than 2 cm2, which is standard for sample-holders supplied with a goniometer, coupled to a commercially available analytic apparatus. Two samples of commercial talc were examined with dust size below 30 microns (and having different content of "respirable" or "alveolar" dust classes), as regards chlorate, talc and asbestos constituents and quartz. Twelve different experimental conditions of the preparations permitted X ray exposure of surfaces between 6.25 and 500 mm2. For the low angle positions it was possible to obtain a substantial improvement in the overall diffractometric response by increasing the surface of the preparations; however, in each case, a reduction in the surface produced, in addition to a better definition of the peaks, an increase in the diffracted intensities per unit of surface of the preparation; this is clearly related to the collection spectrum of the radiant energy of the incident beam in space, and leads to the possibility of reducing to an order of magnitude of milligrams the mass of samples that can still be submitted to qualitative and quantitative diffractometric analysis. PMID- 2755387 TI - [Fox tapeworm infections. How endangered is the human?]. PMID- 2755388 TI - [The so-called globus syndrome or "a bolus in the throat"]. PMID- 2755389 TI - [The role of population migration in the spread of opisthorchiasis from an Ob' Irtysh invasion focus]. AB - The first quantitative indicators of opisthorchiasis irradiation from the invasion focus at the social level are obtained. It was demonstrated that 114.000 out of 1 mln. people leaving the helminthiasis invasion focus had suffered from opisthorchiasis. Invasion irradiation may be limited by means of reduction of emigration from the area by improvement of working and living conditions and reduction of the invasion rate, which can be attained by creation of a system of immigrants' protection and activization of preventive measures and medical treatment of local population. PMID- 2755390 TI - [Assessment of the heminthologic situation along the route of the Irtysh Karaganda canal. Public health helminthologic and malacologic studies]. AB - Results of sanitary-helminthological study of soil and population density of the Opisthorchis first intermediate hosts--Mollusca--in the water bodies of the Irtysh-Karaganda canal area are presented. Mean number of soil samples containing Opisthorchis ova constituted 11.76 +/- 2.0% out of 255 samples analyzed; 1.7 +/- 0.14 ova per 100 g of soil; 22 out of 81 stations under study were populated by the Bithynia inflata and B. troscheli molluscs. 0.96 +/- 0.38% of Mollusca from water reservoir No 8 were Opisthorchis invaded, which indicated, along with invasion of fish and human population, revealed by previous studies, the agent's active circulation within the Shiderta invasion focus. PMID- 2755391 TI - [Ecologo-epidemiologic characteristics of echinococcosis in the Irkutsk region]. AB - Seroepidemiological screening of population of the Irkutsk region with regard to echinococciasis was preformed by RLA and RIHA. The last 26-year data on surgically confirmed echinococciasis cases were obtained at the local hospital. Relatively high invasion and disease rates were revealed in the forest-steppe natural areal complex population, the invasion agent circulating between dogs and sheep. Invasion and disease rates in taiga were low. Problems of low invasion foci tension are discussed. PMID- 2755392 TI - [The use of pesticides in disinfecting soil from ascaris eggs]. AB - Low-toxicity pesticides--polycarbazin and prometrin--are suggested for use in decontamination of helminths' invaded soils. Soils in the invasion foci and microfoci should be treated with pesticides dosed at 50 g/5 l of water per 1 m2, in autumn, after the crop, and in early spring after the snow melt, with respect to the periods of maximal accumulation of helminths' ova in soil and preparations' degradation period (about 6 months). PMID- 2755393 TI - [The effect of thiazon on helminth eggs in soil]. AB - Thiazon at the dosage of 200 g/m2 produces a total ovicidal effect on the eggs of Ascaris and Trichurus, laid on soil surface at 12-30-days exposition; at the depth of 5 cm the number of Ascaris eggs reduced by 40-85% and those of Trichurus -by 29-81%, whereas in the intact soil 100% eggs' viability preserved. The thiazon dosage rise up to 250 g/m2 increased also the efficacy of the treatment. PMID- 2755394 TI - [Assessment of run-off in pollution of bodies of water with diphyllobothriiidae eggs by hydrometeorologic indicators]. AB - Use of some hydrometheorological characteristics for assessing quantitative parameters of surface run-off in water reservoirs' areas is suggested. Conclusions concerning the potential threat of anthropogenic water pollution are drawn on the basis of above-mentioned indicators. PMID- 2755395 TI - [Prasiquantel treatment of patients under ambulatory conditions in an opisthorchiasis focus in the Komi-Permyak autonomous area]. AB - 90 Opisthorchis felineus invaded patients were subjected to prasiquantel treatment. Single doze of the drug (40 mg/kg) was administered under ambulatory conditions. Treatment efficacity 6 months after administration attained 85.9%. Side-effects were observed in 89.7% of patients, the neurotropic effects' rate being 85.4%. Lower side-effects' rate was established in case of prasiquantel administration with milk. Positive clinical effect of prasiquantel treatment was observed in 69.3% patients. PMID- 2755396 TI - [The effect of Opisthorchis invasion on the clinical course and outcome of abdominal typhoid. Indicators of non-specific resistance and phagocytosis in patients with abdominal typhoid combined with chronic opisthorchiasis]. AB - A number of non-specific resistance indices (complement, properdin, lysozyme, bactericidal activity of blood serum, phagocytosis indices) in Opisthorchis invaded abdominal typhoid patients as well as in acute and chronic carriers of Salmonella typhi was inferior to those of uninvaded patients (with the exception of bactericidal index). Complete recovery from opisthorchiasis stimulated the cessation of S. typhi elimination and increase in the level of some non-specific resistance factors. PMID- 2755397 TI - [The hypophyseo-thyroid system in psoriatic arthritis combined with chronic opisthorchiasis]. AB - Paper presents the data on the content of hypophysial-thyroid and hypophysial adrenal systems' hormones obtained by means of radioimmune assay, and the data of timecourse hepatoscintibiligraphy with Tc 99 m TCK-15 of 94 patients (first group -48 patients with psoriatic arthiritis combined with chronic opisthorchiasis; second group--46 pure psoriatic arthritis patients). Statistically significant increase in the content of triiodinethyronine, thyroxine, hypophysial thyreotropic hormone, corticotropic hormone and significant reduction of cortizol and aldosteron contents were observed in case of mixed pathology. Thyroid hormones' level was directly connected with hepatic and gallbladder disfunctions. The above-mentioned changes belong to pathogenetic mixed-pathology factors which should be taken into account in elaboration of best treatment methods. PMID- 2755398 TI - [Clinical and immunological indicators in patient with viral hepatitis A combined with ascariasis]. AB - The data obtained point to the aggravation of virus hepatitis A time-course in case of a mixed pathology. This may be due to the state of a certain immune deficiency characteristic of parasitic diseases, including helminthiasis. It is also possible that immune deficiency is an inevitable condition for helminths' existance in the host. This suggestion is supported by the fact of helminthic invasion of virus hepatitis patients. PMID- 2755399 TI - [Efficacy and tolerance of a nematocide used in treating enterobiasis]. AB - Paper presents the data on clinical assessment of parasitocidal effect and tolerance to the new helminthocide nemocide. 140 enterobiasis patients were subjected to nemocide treatment, including 29 hospital patients and 111 children treated under ambulatory conditions. Nemocide-tolerance proved to be satisfactory. Efficacy of hospital treatment attained 96.5 +/- 3.4%, while under ambulatory conditions it was 82.0 +/- 4.0%. PMID- 2755400 TI - [Clinical observation periods for diphyllobothriasis patients depending on the invasion period]. AB - Discrepancy between the terms of clinical observation and normalization of gastric functions was established on the basis of a time-course study of gastric secretory function in 189 diphylobothriasis patients examined before the treatment and 1-2, 5-6, 10-12 months after it. Recovery of the secretory function took less than 5-6 months in people recovered from short-term invasion (less than a year), while in patients recovered from long-term invasion (lasting more than a year) it took 10-12 months, and reduced secretory activity in the latter group was still observed in many cases 10-12 months after treatment. Results of the study may be used in optimization of terms and forms of clinical observation. PMID- 2755401 TI - [Immunochemical characteristics of echinococcal fluid used for preparing immunodiagnostic preparations]. AB - Protein content, antigenic activity, presence of enzymatic (carboxylesterase) activity and fractional content were determined by high performance liquid chromatography in 6 samples of echinococcal fluid from cysts isolated from sheep, cattle and pigs. Significant differences between the contents of above-mentioned characteristics in various echinococcal fluid samples were observed. The highest content of diagnostically valuable components was revealed in cysts isolated from sheeps' liver. Authors come to the conclusion on the necessity of choosing criteria of assessment of echinococcal fluid samples' fitness for echinococcosis diagnosis. PMID- 2755402 TI - [Isolation of antigens from Echinococcus granulousus cysts by gradual membrane filtration]. AB - High molecular fractions were obtained by gradual membrane diafiltration and their antigenic and enzymatic (carboxylesterase) activity were analyzed. Degree of the fractions' homogeneity was determined by high performance liquid chromatography. Active antigenic complexes were discovered in fractions with m. m. over 300.000 and 100.000 = 300.000. PMID- 2755403 TI - [Differences in surface antigens of three diphyllobothriidae species, detected by serologic methods]. AB - Immunochemical studies of somatic and surface extracts from D. dendriticum, D. ditremum and D. latum tape-worms demonstrated low specificity of somatic antigens of all three species and serological specificity of D. latum. D. dendriticum and D. ditremum, though serologically close, contained specific components demanding more precise extraction methods. PMID- 2755404 TI - [Morphometric and cytologic methods of assessing the host's immune response to invasion by Trichinella spiralis]. AB - Morphometric and cytological methods of assessment of the immune response of the host's lymphoid organs to invasion were assayed in experimental model of the white mice trichinelliasis. High informative value allowing to reveal the real processes, causing immune system's alterations in case of trichinelliasis as well as the terms and sequence of appearance of immune responses in various organs, were established. Authors suggested methodological approaches to morphometry use and its application in various cases of experimental and clinical pathology. PMID- 2755405 TI - [Biogenic amines and the nervous system of Opisthorchis felineus]. AB - Dopamine (0.08-0.25 micrograms/g of the tissue raw weight) and serotonin (0.13 0.31 micrograms/g of the tissue) were determined by spectrofluorimetry in the Opisthorchis tissue homogenate. Histochemical analysis (with glyoxylic acid) demonstrated distribution of biogenous amines in Trematode's nervous system. Fluorescence characteristic of catecholamines was found in 3 pairs of symmetrically situated cells in the anterior part of the worm and in a small number of relatively small assymmetric neurons in its posterior part. Similar fluorescence was observed in cephalic ganglia commissure, anterior and posterior nervous trunks, commissures and multiple fine fibrae. Flourescence characteristic of indolamine was seen in 5 pairs of symmetric neurons situated in the anterior part of the worm. Processes of these cells were observed from a close distance. PMID- 2755406 TI - [Results of malariometric study of the population of the Yemen Arab Republic in 1986]. PMID- 2755407 TI - [Biological activity of precozen I on Musca domestica and Aedes aegypti]. AB - Paper presents the results of the study of biological effect of precozen I- preparation with antijuvenile type of action on flies and mosquitoes. Parenteral administration resulted in reduced rate of imago hatching, alterations in female reproductive system, hereditary sterility. Treatment of flies' as well as mosquitoes' larvae caused various moult alterations: prologation of development stages, reduced chitinization. Multiple effects of precozen I on insects, characteristic both of hormonal preparations and chemosterilants, were observed. PMID- 2755408 TI - [Periods of seasonal activity of Aedes pullatus coquillett, 1904 in the Khibini mountains]. AB - Season of activity of Aedes pullatus Coq. mosquitos in the Khibini mountains (the Murmansk region) was divided into 5 periods basing on their behaviour as well as on ecological and physiological pecularities. Seasonal activity periods for different years vary from the 1-2nd decade of July to the 2-3rd decade of September. PMID- 2755409 TI - [Opisthorchiasis at left Dnieper watersheds]. AB - Present state of opisthorchosis infestation in the Dnieper watershed (rivers Vorskla, Psyol, Khorol, Sula, Seym, Snov, Desna water basins), situated in the Sumy, Chernigov, and Poltava regions of the Ukraine, is assessed. 7909 humans from 37 villages, 94 cats, 1134 carp fishes, 20013 mollusca and 30 soil samples were screened for the presence of Opisthorchis eggs. Opisthorchosis foci with an over 36% infection rate of population remain in the watersheds of the Dnieper left confluents (rivers Desna, Seym, Vorskla and Khorol). Infestation rate varies between various rivers as well as along one and the same river which is due to several ecological and social factors. Opisthorchis circulation is established at all the rivers but in most areas it didn't involve human population. Distribution pattern of human opisthorchosis in evidently focal and patchy which should be taken into account in the planning and implementation of opisthorchosis control measures. PMID- 2755410 TI - [Follow-up and prognosis of herpes simplex encephalitis. Observations on 57 patients between 1960 and 1987]. AB - A retrospective study of outcome in 57 herpes simplex encephalitis (HSE) patients treated between 1960 and 1987 is reported. HSE was confirmed by virus isolation or detection of intrathecal anti HSV synthesis. 24 patients did not receive antiviral therapy, 19 were vidarabine recipients and 14 were treated with acyclovir. Mortality was not correlated with sex or age but with the level of consciousness at onset of therapy. Acyclovir therapy was by far superior to vidarabine with respect both to mortality and neurologic sequelae after a mean follow-up period of 170 days. PMID- 2755411 TI - [Predictive value of a combined physiologic-therapeutic oriented score system in patients of intensive internal medicine]. AB - 171 consecutive patients of a medical intensive care unit (age 18 to 81 years, mortality 24.6%) who were treated in the ICU for at least 72 hours were investigated in order to test the hypothesis, that the combination of therapeutic scoring (TISS) and physiologic scoring (APS) may improve the prognostic significance of score systems and/or the severity of disease classification in critically ill patients. Discrimination of survivors and non-survivors of the combined score was comparable to the results of isolated scores. A higher weighting of the physiology parameters in the combined score did not improve its prognostic significance. On the other hand, only the combined score implicated a linear increase of mortality with increasing score point values. - We conclude, that the combined score system improves the severity of disease classification in critically ill medical patients. PMID- 2755412 TI - [Piretanide in chronic and acute decompensated heart failure. Effect on hemodynamics and vasoactive hormones]. AB - Eight patients with chronic heart failure classified as NYHA class II to III (group 1) and nine patients with acute decompensated heart failure classified as NYHA class IV (group 2) were treated with piretanide at a dosage of 12 mg administered intravenously. In both groups the level of prostaglandine PGE2 as well as plasma renine activity significantly increased prior to the onset of diuresis. The percentage increase was more pronounced in group 1 which had lower baseline values. With a time-lag, the norepinephrine plasma level also increased significantly. During the first 30 minutes there was only little effect on blood pressure, pulmonary artery pressure and cardiac output in patients with chronic heart failure (group 1). Only after 60 minutes there was a significant decrease in mean pulmonary artery pressure (from 39 +/- 17 to 33 +/- 18 mm Hg; p less than 0.05). In patients with acute decompensated heart failure (group 2) piretanide led to a significant reduction in mean pulmonary artery pressure (from 42 +/- 13 to 37 +/- 12 mm Hg; p less than 0.05) within 15 minutes after administration, i.e. even prior to the onset of diuresis. Thus, the administration of piretanide had a positive effect on hemodynamics in patients with chronic as well as in patients with acute decompensated heart failure. Significant improvement prior to diuresis onset, however, was only found in patients with acute decompensated heart failure. These effects may be explained by a stimulation of prostaglandines which promote vasodilation. They are increased by the diuresis.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2755413 TI - [Platelet activating factor produces platelet activating factor, comes to nothing]. PMID- 2755414 TI - Studies of ammonia loading: effects of rate of delivery and enhanced removal of NH4 on blood levels of ammonia and coma induction. AB - Using dose-response curves, the dose of NH4Ac inducing coma in one-half of the animals was increased by 60 to 80% after 1 mmol of arginine. The larger increase occurred in larger rats but was not proportional to the increase in weight. Incremental subcoma doses of NH4 raised the amount of NH4 required for inducing coma and the brain level of ammonia at the point of coma. After a portacaval shunt the results were similar, although lower doses of NH4 were required from the beginning. Blood ammonias after a loading dose (1.25 mmol) of NH4 were influenced by the duration of a preinfusion of NH4 and by the preinjection of various amino acids involved in the disposal of NH4 in the urea cycle. The amount of reduction in blood ammonia by ornithine and arginine compounds was less the longer the preinfusion of NH4. Blood ammonia was not lowered by glutamate at any time but was increased with longer preinfusion periods. Hepatectomy (Hx) reduced the removal of an NH4 load. After a modest load (0.85 mmol) of NH4, blood ammonia increased 5-fold, over that of sham-operated rats, with 70% Hx and 15-fold with 90% Hx. Ornithine reduced these blood ammonias by about 50%. Arginine had no effect. These studies indicate ways of reducing toxicity of NH4 and factors that predispose to or enhance toxicity. PMID- 2755416 TI - Regional comparison of the lumped constants of deoxyglucose and fluorodeoxyglucose. AB - We determined the regional relationships of the lumped constants for deoxyglucose (DG) and fluorodeoxyglucose (FDG). Awake male rats were given simultaneous intravenous injections of [14C]DG and [18F]FDG, and sacrificed after 45 min. The brains were removed and small pieces of cortical tissue were sampled by dissection. The remainder of the brains were frozen and sliced into 20-microns thick sections that were placed on coverslips and dried on a hot plate. Two sets of brain autoradiograms were prepared from the brain sections, one representing predominantly [14C] and the other [18F]. The autoradiograms were digitized, and after correcting for cross-contamination, tracer-concentration images of the DG and FDG were generated. Based on relative tracer concentrations in the tissue samples, the lumped constant of FDG was found to be 1.25 times that of DG, or 0.6. Using this value, images of glucose metabolism for the DG and FDG were generated from the tracer concentration images and compared. No significant regional differences were found, indicating that the relationship between the lumped constant of DG and that of FDG was stable throughout the normal brain. PMID- 2755415 TI - Dopamine and serotonin in rat striatum during in vivo hypoxic-hypoxia. AB - Dopamine and serotonin were determined in extracellular fluid of rat striatum by semiderivative in vivo voltammetry during normoxia and a single or repeated exposure to 15% O2 (i.e., mild hypoxia) or 12.5% O2 (i.e., moderate hypoxia). A single exposure to 15% oxygen increased extracellular dopamine 76%. With reintroduction of air to the animals, dopamine values returned to baseline. During a second episode of 15% oxygen, dopamine increased 63% and remained elevated even during a final exposure to air. On the other hand, serotonin was unaffected by 15% oxygen. Moderate hypoxia (12.5% oxygen) increased dopamine (79%) and serotonin (26%) and both remained elevated even after the initial reintroduction of air. These studies demonstrate that in vivo hypoxia increases rat striatal extracellular dopamine and, to a lesser extent, extracellular serotonin. Furthermore, after repeated, mild hypoxic episodes or moderate hypoxia, the increases in rat striatal extracellular dopamine and serotonin continue even during normoxia. These studies further support a role for dopamine and serotonin in hypoxic-induced changes in brain function. The hypoxic-induced elevation of these two neurotransmitters during normoxia may be important in the production of hypoxic/ischemic-induced cell damage. PMID- 2755417 TI - Maternal alcohol ingestion inhibits fetal glucose uptake and growth. AB - The distribution of maternally-derived glucose was determined in selected tissues of fetuses from ethanol-fed (EF) rats and from pair-fed (PF) and ad lib-fed (AF) controls. Maternal ethanol ingestion resulted in reduced fetal brain and liver weights and lower liver and lung glycogen levels compared to those of the PF or AF control groups. In addition, experimental fetuses exhibited reduced uptake of maternally-derived [3H] 2-deoxy-D-glucose (2-DG) by placenta and fetal brain. Fetal body, liver, lung, and brain weights correlated with fetal plasma 3H activity and with the fetal:maternal plasma 3H ratio, an indicator of the rate of placental glucose transfer. Brain weight correlated with 2-DG content per gram tissue weight. These observations suggest that reduced nutrient availability due to impaired placental transfer plays a role in the intrauterine growth retardation associated with maternal ethanol ingestion. PMID- 2755418 TI - Neuromorphological changes in mouse olfactory bulb after neonatal exposure to phenobarbital. AB - Heterogeneous Sabra mice pups were injected daily with 50 mg/kg phenobarbital (B50) or 40 mg/kg (B40) from postnatal day 2 (P2) to P21. Control litter mates (C) received vehicle injections. All animals were killed on P50 and their brains removed for histological analysis. The volumetric growth of the main olfactory bulb (MOB) was assessed in hematoxylin and eosin-stained serial sections cut in the sagittal plane. The volume of MOB was reduced 20 to 25% in barbiturate treated mice. The greatest reductions in volume were seen in the external layers of the bulb (20 to 28%). There were moderate reductions in the internal granular layer (IGL, 6 to 20%) and no reductions in the subependymal layer that contains the migrating and immature cells. The number of prenatally-formed mitral cell neurons was unaffected by the treatment while the number of the pre- and postnatally generated granule cells was significantly reduced in the B40 group. There were no treatment effects on the sizes or packing densities of the mitral or granule cells. Like the hippocampus and the cerebellum, the developing MOB is vulnerable to barbiturate-exposure. PMID- 2755419 TI - Effects of aluminum ingestion on spontaneous motor activity of mice. AB - Aluminum (Al) as aluminum lactate in a purified diet was fed to adult female Swiss-Webster mice over a six week period. Comparison groups were: controls (CON), 25 micrograms Al/g diet; low Al (LO), 500 micrograms Al/g diet; high Al (HI), 1000 micrograms Al/g diet; and pair fed (PF) 25 micrograms Al/g diet pair fed to HI group. Weights, food intake and toxic signs were recorded at 3-day intervals and activity levels were measured during a 24-hr session during week 5 using an automated apparatus. Food intake was not reduced overall in Al-treated groups but they demonstrated a cyclic pattern of food intake. Mean weight gain over the 6-week period in the HI (0.5 g) and PF(0.1 g) groups was somewhat less than that in the CON (2.3 g) and LO (2.0 g) groups. No neurotoxic signs were recorded in any group, but a dose dependent increase in localized fur loss was seen. Overall activity level was 20% lower in HI than CON groups, with vertical movement more affected than horizontal movement. HI mice were less active during the diurnal period of peak activity than CON mice and their activity periods were also somewhat shorter (130 vs. 200 min). Activity of LO and PF mice did not differ significantly from controls, although PF activity levels were more variable. These data demonstrate that short term feeding of aluminum at levels within an order of magnitude of estimated human intake can influence neurobehavioral function as indexed by motor activity. PMID- 2755420 TI - Aluminum produces age related behavioral toxicity in the rabbit. AB - Two- to 3.4-year-old, retired breeder, rabbits received repeated aluminum (Al) lactate or sodium (Na) lactate injections. All six rabbits receiving twenty 400 mumol Al/kg SC injections died, demonstrating much higher mortality than previously seen in younger rabbits. Subsequent rabbits receiving Al were dosed with 200 mumole/kg injections. Aluminum injections inhibited body weight gain. Renal function, as measured by creatinine clearance, in these rabbits was inferior to younger rabbits, perhaps contributing to the Al induced toxicity. Renal function decreased during Al injections suggesting a nephrotoxic effect of Al. Rabbits were tested for their ability to acquire, retain and extinguish a classically conditioned reflex, nictitating membrane extension. Rabbits which received Al acquired and retained the conditioned response less well than Na lactate injected rabbits. Impaired acquisition was evidenced by lower percent conditioned responses, more trials to 1 to 10 consecutive conditioned responses and longer conditioned response latencies. Aluminum injections produced significant elevations in tissue Al concentration in frontal gray and hippocampal brain as well as most peripheral tissues studied. Aluminum induced behavioral toxicity is greater in adult and aged rabbits than in young rabbits. Aged rabbits are more susceptible to Al induced mortality than adult or young rabbits. PMID- 2755421 TI - Relative cerebellar weight: a potential indicator of developmental neurotoxicity. AB - Overt malformations do not always accompany behavioral changes resulting from perinatal exposure to certain drugs. However, the central nervous system (CNS) is the anatomical substrate for behavior, and functional defects may be accompanied by more subtle, structural alterations of the brain. The purpose of this study was to determine if changes in the weights of certain brain regions occur in rats exposed prenatally and/or perinatally to propylthiouracil (PTU) which retards functional development of the brain. Pregnant rats were dosed with PTU during gestation and/or lactation, and on postnatal day 28, auditory startle responses were measured to determine if PTU altered functional development. The brains of all pups were then dissected into 10 separate regions, dried and individually weighed. Brain weights were expressed in absolute and relative (to total brain weight) terms. Pups that were exposed to PTU from days 10 to 21 of gestation grew normally, but their startle responses to auditory stimuli were significantly different (p less than 0.05) from controls. Thus, for the purpose of this experiment, PTU acted as a developmental neurotoxicant because it altered performance on a test of neuromuscular function without being overtly teratogenic. The weights of most brain regions in PTU-treated rats were statistically comparable to controls. However, relative cerebellar weight was significantly (p less than 0.05) different. Therefore, these data suggested that relative cerebellar weight might be used to predict functional defects that appear during development following prenatal or perinatal exposure to certain neurotoxicants. Although cerebellar weight and auditory startle responses were altered by PTU, this study does not establish a causal relationship between the anatomical and functional changes that occurred.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2755422 TI - Neuronal depletion of the amygdala resembles the learning deficits induced by low level lead exposure in rats. AB - The behavioral deficits observed after lead exposure have been related to limbic system dysfunction. In a previous study it was shown that the neurotoxicity of lead could not be explained by the damage of the hippocampus alone. The purpose of the present investigation was to use behavioral comparisons to test the hypothesis that the intrinsic neurons of several nuclei of the amygdala, where lead has been found to accumulate, can be a target of the effects of the metal as well. A group of rats were maternally and permanently exposed to lead (750 ppm in the diet as lead acetate). Another group of equally aged and housed rats, never experimentally exposed to lead, were injected ibotenic acid into the amygdala. All groups plus sham-operated and unoperated controls were tested in the open field, the radial arm maze, and a passive avoidance task. The results showed that lead exposure (both permanent and maternal) and amygdalectomy produced a) no effect on locomotor activity, b) impairments in the acquisition phase of the radial maze, and c) impairments in passive avoidance. These results suggest an involvement of the amygdala in the neurotoxic action of lead, but not as the only brain structure. The deficits in permanently lead-exposed rats are more pronounced than in only maternally-exposed animals suggesting a longlasting, but not totally irreversible effect of early lead exposure. PMID- 2755423 TI - Single toluene exposure and changes of response latency in shock avoidance performance. AB - The behavioral effects of a single exposure to toluene were investigated using shock avoidance performance. Rats were exposed to 2000, 4000, 6000, and 8000 ppm toluene vapor for 4 hr after they acquired shock avoidance learning. Then the effects of toluene on avoidance performance, locomotor activity, and response latencies (RLs) were simultaneously examined for 3 days. Shock avoidance responses were significantly decreased at concentrations of 4000, 6000, and 8000 ppm, but recovered 3-6 hr after the cessation of exposure. The 2000 ppm exposure had no effect on these responses. Locomotor activity was transiently increased at concentrations of 2000 ppm and 4000 ppm, but recovered after 6 hr. Both 6000 ppm and 8000 ppm exposure at first decreased locomotor activity but later increased it. There were biphasic effects, inhibition and excitation, on locomotor activity, and it took 1 day to recover from them. Response latencies were shortened at concentrations of 2000, 6000, and 8000 ppm. That was due to hyperactivity. However, 4000 ppm toluene exposure induced the prolongation of RLs, although ataxia or narcosis were not observed. It was suggested that certain higher nervous functions in the central nervous system (CNS) which controlled timing behavior might be confused. PMID- 2755424 TI - Effects of 2-methoxyethanol on fetal development, postnatal behavior, and embryonic intracellular pH of rats. AB - The industrial solvent 2-methoxyethanol (2ME) is a reproductive and developmental toxicant when administered by inhalation, gavage, and IP injection. The present research established that this solvent can produce teratogenicity in rats when administered in liquid diet. Groups of 10 Sprague-Dawley rats were given various percentages of 2ME in liquid diet on gestation days 7-18. Day 20 fetuses were examined for visceral or skeletal malformations. Concentrations above 0.025% 2ME (approximately 73 mg/kg/day) produced total embryo-mortality. Cardiovascular malformations were produced at lower levels. The teratogenic no-effect level was 0.006% 2ME (16 mg/kg). In a second experiment, groups of 12 Sprague-Dawley rats were given 0, 0.006 and 0.012% of 2ME as above. Litters were culled to 8 pups, and tested for auditory and tactile startle and conditioned lick suppression, and for performance in figure-8 activity and the Cincinnati water maze on postnatal days 48-65. The high dose of 2ME produced approximately 50% mortality in the offspring and increased the number of errors in the Cincinnati maze. No other behavioral effects were observed at either dose. An interaction study was conducted to determine if simultaneous exposure to 2ME and ethanol would reduce the teratogenicity of 2ME, but no reduction was observed. The hypothesis that 2ME acts by altering embryonic intracellular pH was tested by injecting 0.33 ml/kg of 2ME into rats on gestation day 13, and determining embryonic intracellular pH at 2, 4, 8, and 24 hours thereafter. There was an increase in pH at 4 hours, but not at later time points. Another group of rats was given 2ME along with amiloride, which blocks the sodium/hydrogen antiporter. The combined 2ME-amiloride exposure produced an incidence of cardiovascular malformations in fetuses twice that of 2ME alone. These studies confirmed the structural teratogenicity of 2ME even when given in liquid diet, as it was given for the first time in the present study. At nonteratogenic doses, developmental toxicity (e.g., postnatal deaths) persisted, but only limited evidence of behavioral teratogenicity was observed. The pH data are consistent with the concept that 2ME may alter embryonic intracellular pH at critical stages of organogenesis. PMID- 2755425 TI - Neurobehavioral effect of triadimefon, a triazole fungicide, in male and female rats. AB - Triadimefon is a widely used systemic fungicide, yet there is little published information on its effects in mammals. This study describes the effects of triadimefon in male and female rats using a functional observational battery (FOB), motor activity (measured in a figure-eight maze), and operant performance (responding under a fixed-interval 3-min schedule). For the FOB, Long-Evans hooded rats were tested immediately before dosing and 0.5, 4, 24, and 48 hr after IP dosing with either vehicle, 30, 100, or 300 mg/kg triadimefon. Prominent effects of triadimefon (100 and 300 mg/kg) included increased arousal, stereotypies involving repetitive sniffing, head bobbing, and pacing, and self mutilation. Dose-related handling-induced convulsions, changes in reflexes and sensory reactivity, hypothermia, and body weight loss were also significant findings. Doses of 30, 75 and 150 mg/kg triadimefon increased figure-eight maze activity whereas 300 mg/kg decreased activity. Habituation of activity during the session as well as the spatial distribution within the maze were also affected by triadimefon. Overall rates of responding maintained by fixed-interval milk reinforcement were increased at 30 and 56 mg/kg, and decreased at 100 and 200 mg/kg. Responding within the 3-min fixed-interval was also affected, with low rates normally occurring early in the interval markedly increased. These effects on operant performance were similar to those seen following d-amphetamine, and were attenuated by pretreatment with chlorpromazine (0.5 mg/kg). On many measures, female rats appeared to be somewhat more sensitive than males. Recovery was evident in some measures the day after dosing, but the effects of high doses (greater than or equal to 100 mg/kg) were typically prolonged (several days). Thus triadimefon produced a unique neurotoxic syndrome which is similar in many aspects to that produced by CNS stimulants. PMID- 2755426 TI - Long-term effects of prenatal phenytoin exposure on offspring behavior in rats. AB - Pregnant Sprague-Dawley CD rats were administered phenytoin by gavage on days 7 18 of gestation in doses of 0 or 200 mg/kg. The offspring were tested at various ages to determine the duration of postnatal dysfunction and its replicability and generality compared to previous experiments. Phenytoin offspring had increased newborn (5.2%) and preweaning (16.7%) mortality compared to controls (0% and 3.1%, respectively), and an 8.5% reduction in average body weight at 28-70 days. No weight differences were significant at other ages. Phenytoin offspring showed increased activity on multiple tests, swam slower in a straight channel, committed more errors and took more time in the Cincinnati water maze, startled less, and had longer latencies on the Morris hidden platform test. Among phenytoin offspring 42.3% exhibited the abnormal circling defect previously described (14,17). Consequently, data were reanalyzed in terms of circlers, noncirclers, and controls to determine the contribution of this effect to the dysfunctions observed. Circlers accounted for the differences in open-field activity, figure-8 ambulation, hole-board horizontal locomotion, straight channel swimming time, water maze retention errors, tactile prepulse startle inhibition, and some trials of the Morris test. Circlers and noncirclers differed from one another and from controls on measures of figure-8 rearing, water maze errors and times, and some trials of the Morris test, with circlers more affected than noncirclers. Circlers and noncirclers did not differ from one another, but both differed from controls, on measures of early locomotion, hole-board vertical activity, and unmodified startle amplitude. Circling was hypothesized to reflect an underlying vestibular defect, however, the data also support the view that phenytoin has effects beyond those accounted for by possible vestibular effects. PMID- 2755427 TI - Effect of nickel chloride on body temperature and behavioral thermoregulation in the rat. AB - This study was designed to assess the effects of acute nickel chloride administration on behavioral and autonomic thermoregulation in the rat. In one experiment, male rats of the Fischer 344 strain were injected with nickel chloride (IP) at dosages of 0 to 24.0 mg/kg and placed in an environmental chamber maintained at an ambient temperature (Ta) of 10 or 20 degrees C. Colonic temperature was measured 60 min postinjection. Nickel chloride caused a dose related decrease in colonic temperature, and the hypothermia was accentuated at the cooler Ta. In a second study, rats injected with 0, 6.0, 12.0, or 24.0 mg/kg nickel chloride were placed in a temperature gradient which allowed the rats to select their preferred thermal environment. Nickel chloride at dosages of 12.0 and 24.0 mg/kg caused a significant reduction in the selected Ta. At these dosages the rats were also significantly hypothermic at 60 min postinjection. In a third experiment, whole-body oxygen consumption (i.e., metabolic rate) was measured at Ta's of 10, 20, and 30 degrees C following a 12.0 mg/kg injection of nickel chloride. Nickel chloride caused an initial depression in metabolic rate and hypothermia at Ta's of 10 and 20 degrees C but not at 30 degrees C. In conclusion, (a) nickel chloride affects both behavioral and autonomic control of thermoregulation in the rat and appears to induce a regulated decrease in body temperature and (b) the behavioral thermoregulatory response of the rat is less sensitive to nickel chloride when compared to the mouse. PMID- 2755428 TI - Behavioral consequences of prenatal exposure to the organophosphate insecticide sumithion. AB - Prenatal administration of Sumithion 50 EC, an organophosphate insecticide, to CFY rats at 5, 10 and 15 mg/kg from days 7 to 15 of gestation, resulted in dose related decreases in open field activity and motor coordination in the offspring treated with the two higher doses. Long lasting alterations in the acquisition and extinction of a conditioned escape response, as well as increased social interactions were observed in the adult offspring. The results indicate a no effect level at 5 mg/kg under the experimental conditions in the present study. PMID- 2755429 TI - Why physicians are skeptical about 'quality' talk. PMID- 2755430 TI - The quantification of quality: the Cleveland Clinic approach. Interview by Richard L. Reece. PMID- 2755431 TI - A new breed of physician and a new brand of cost containment. Interview by Richard L. Reece. PMID- 2755432 TI - Reflections. PMID- 2755433 TI - Health care quality. How we measure, define, and refine it. PMID- 2755434 TI - 'Fishhook medicine' in Minnesota's resort towns. PMID- 2755435 TI - How will quality in health care be defined? PMID- 2755437 TI - The United Kingdom Central Council and the future of nursing education. PMID- 2755436 TI - The Adult Health Care Decisions Act. Duties of physicians and other health care providers. PMID- 2755438 TI - Instructional assignments and the recent collective bargaining agreement: effect on nursing education. AB - Nursing teachers employed in the community college nursing programmes in Ontario were discontent with their workloads. Along with other teachers in the community college setting, they went on strike in the fall of 1984. Attention was focused on the workload formulae. In 1986, a new contract was ratified for all the teachers in the community colleges in Ontario. What issues emerged? Discussion will focus on contract changes with respect to instructional assignments, the effects upon the nursing instructors and students, and finally the implications for the programme. PMID- 2755439 TI - Philosophical analysis and its value to the nurse teacher. AB - Philosophy is often regarded as a subject which is only of interest to those engaged in academic pursuits. This paper suggests that it can be of practical value to nurse teachers. Indeed never more so than today, with the current emphasis on change and decision making, be it in relation to curriculum development or the future of professional education. Change is occurring at such speed, that we have little time to ponder and, therefore, cannot afford 'faulty logic'. The article commences with a description of the processes involved in philosophical analysis, including linguistic and conceptual analysis, asking different types of questions and determining the validity of arguments. It goes on to consider why nurse teachers should adopt this approach and finally the necessity of its inclusion in curricula for basic nurse education. PMID- 2755440 TI - A qualitative analysis of examination questions set for students of nursing in Scotland. AB - The construction of essay-type questions for inclusion in nursing examination papers is a time consuming task for teachers. In this paper, the findings of the qualitative analysis of the examination systems in basic nursing education in Scotland are discussed, with specific reference to questions set in internal and external formal examinations. The form and type of questions which seemed to create difficulties for students are identified and discussed. Several issues are raised, including coverage of the syllabus content, the science base for nursing, and determining levels of question difficulty. The paper concludes with recommendations concerning the format of assessment, especially if the NBS were to delegate more responsibility to colleges and when the proposals on curriculum reform evisaged in Project 2000, are implemented. PMID- 2755441 TI - Individual stress and its relationship to termination of nurse training. AB - During interviews with 23 learners (student and pupil nurses) who left training as a response to stress, the following points were explored; knowledge of nursing before commencing training; reasons for wanting to nurse; situations which produced stress; the way in which individual stress responses were expressed; and methods for coping with stress. Clinical experiences had produced the most distress, related predominantly to negative attitudes of other nurses. Behavioural and physiological signs of stress were observed as well as psychological reactions such as worry. People had few adaptive coping strategies and received little support in their time of need. The majority expressed a desire to try nursing again. PMID- 2755442 TI - Anxiety in male nursing students at Kamuzu College of Nursing. AB - Anxiety is a usual and expected occurrence among nursing students. Male students are confronted with additional anxieties, especially in Malawi, due to role expectations for men. A 31-item questionnaire eliciting potentially anxiety provoking situations was presented to the 24 male nursing students at Kamuzu College of Nursing in Lilongwe, Malawi. The results of this small study suggest a high level of anxiety among these male students, and dissatisfaction about the information presented to them upon entering the Nursing Programme. The men felt particular stress about role differences between nurses and other male health workers. PMID- 2755443 TI - An investigation into whether nurse teachers take into account the individual learning styles of their students when formulating teaching strategies. AB - Many factors have an effect on ways students learn, but differences in learning styles may not be reflected in the way they are taught. A small study of the learning styles of 119 students and 13 nurse teachers was carried out as part of a Certificate of Education Course. In addition a short questionnaire was used to determine teachers preferred teaching styles. The data collected demonstrated that the groups sampled did not express a very strong preference for any one learning style, but for a combination of styles as did the teachers sampled. The author concludes that nurse teachers should examine more closely the reasons why they favour one strategy over another. This in turn should make learning more challenging and rewarding for the students and teachers. PMID- 2755444 TI - Learning from each other: peer teaching and learning in student nurse training. AB - From whom do student nurses learn practical skills? According to the small group of students questioned by the author they learn as much from fellow students as from staff nurses, and clinical teachers have little part in this type of learning. The author discusses this issue and asks whether teachers should be more involved in clinical practice. PMID- 2755445 TI - Teacher behaviour: a determinant of student self esteem. AB - This small scale piece of research was undertaken to establish whether there existed a relationship between teacher behaviour and the reported self esteem inventories of four students. Using a low inference category system for rating teacher behaviour the researcher's behaviour was observed and categorised by an independent rater. The students were asked to complete Coopersmith's (1967) modified self-esteem inventory both before and after each teaching session. Following the first teaching session, the remaining two, in terms of teacher behaviour, were experimentally manipulated. A repeated measures design was utilised, in order to reduce confounding variables in subjects. Results have been analysed using the 'T' test to calculate statistical significance between 'Pre' and 'Post' inventory scores of students. The paper clearly shows the need for the researcher to remain sensitive to experimental design when undertaking small scale research. PMID- 2755446 TI - Nursing education in South Africa. AB - Basic nursing education in South Africa has recently changed from a series of single registrations to a 4 year integrated programme. Diploma nursing education has also been moved into the mainstream of post-secondary education by the establishment of Nursing Colleges affiliated to Universities. These structural changes have put nursing education on a healthy footing, which should serve it well for the next decade. PMID- 2755447 TI - Rationing. PMID- 2755448 TI - Solving a wordy mass. PMID- 2755449 TI - Fetal echocardiography. Management of suspected congenital heart disease. AB - As prenatal ultrasound and echocardiographic imaging become more common-place, prenatal diagnosis of serious cardiac conditions becomes possible. A case report points out the importance of establishing a firm diagnosis before undertaking definitive treatment after birth. PMID- 2755451 TI - Listening to patients. PMID- 2755450 TI - Esophageal dilation. Six-year experience in a small community hospital. AB - The results of this review indicate esophageal strictures can be effectively and safely managed by dilation in the community hospital setting. PMID- 2755452 TI - "The healthy tan": a modern misnomer. PMID- 2755453 TI - Testing for drugs of abuse in urine. AB - Testing for drugs of abuse in the workplace forces the physician and laboratory into an adversarial role with the employee-patient. The author reviews the history of drug testing, current laboratory standards, and the legal controversies surrounding the testing of employees for drugs of abuse. PMID- 2755454 TI - Urine testing in impaired physicians. PMID- 2755455 TI - My philosophy of nursing. PMID- 2755456 TI - The effect of adenine nucleotides on the rate and fate of glutamine utilization by incubated mitochondria isolated from rat mesenteric lymph nodes. AB - The rate of glutamine utilization by isolated lymphocyte mitochondria is 21.4 nmol/min per mg protein, of which 72% is converted to glutamate. Addition of ATP, ADP or AMP increased the rate of glutamine utilization by 60%. Evidence is presented that this is due to a stimulation of oxoglutarate dehydrogenase activity by ADP: this may account for the stimulation of glutamine utilization by concanavalin A in lymphocyte. PMID- 2755457 TI - On the interactions of catalase with subcellular structure. AB - The interaction of mouse liver catalase with subcellular membranes was studied, and an ionic interaction with a variety of membranes, including those derived from the microsomes, was observed. The interaction with microsomal membranes was found to be abolished by pre-treatment of catalase with neuraminidase, indicating a functional significance for catalase-bound sialic acid. Catalase activity was found to be enhanced when bound to membranes, and evidence for a weak association of catalase with peroxisomal structure in mouse liver was also obtained. It is concluded that mouse liver catalase has a capacity to bind to a variety of subcellular membranes in vivo and that this interaction may be consistent with a general protective role for the enzyme, as well as being compatible with a model of peroxisomal biogenesis which involves the interaction of catalase with microsomal membranes. PMID- 2755459 TI - Developmental and steroid hormonal regulation of insulin-like growth factor II expression. AB - We have investigated the influence of steroid hormones on insulin-like growth factor II (IGF-II) expression. Hepatic IGF-II mRNA decreased gradually during postnatal development, reaching adult levels at 3 weeks of age. Treatment of 1 day-old rats for 4 days with 10 micrograms/day of the glucocorticoid dexamethasone (DEX) reduced IGF-II mRNA levels 10-fold in liver and inhibited body weight gain. Estradiol and testosterone did not affect IGF-II expression. A dose-response relationship between IGF-II mRNA levels and the different amounts of DEX injected was seen. IGF-II levels remained low after withdrawal of DEX, indicating an irreversible effect. Albumin expression was increased in newborn rat livers after DEX treatment. Our results suggest that glucocorticoids play an important role in the regulation of IGF-II expression. The mechanism for glucocorticoid-induced reduction of IGF-II mRNA is still unclear; however, our findings indicate that DEX inhibits IGF-II by causing premature differentiation of the liver. PMID- 2755458 TI - Molecular topography and secondary structure comparisons of botulinum neurotoxin types A, B and E. AB - Botulinum neurotoxin (NT) serotypes A, B and E differ in microstructure and biological activities. The three NTs were examined for secondary structure parameters (alpha-helix, beta-sheet, beta-turn and random coil content) on the basis of circular dichroism; degree of exposed Tyr residues (second derivative spectroscopy) and state of the Trp residues (fluorescence and fluorescence quantum yield). The proteins are high in beta-pleated sheet content (41-44%) and low in alpha-helical content (21-28%). About 30-36% of the amino acids are in random coils. The beta-sheet contents in the NTs are similar irrespective of their structural forms (i.e. single or dichain forms) or level of toxicity. About 84%, 58% and 61% of Tyr residues of types A, B, and E NT, respectively, were exposed to the solvent (pH 7.2 phosphate buffer). Although the fluorescence emission maximum of Trp residues of type B NT was most blue shifted (331 nm compared to 334 for types A and E NT, and 346 nm for free tryptophan) the fluorescence quantum yields of types A and B were similar and higher than type E. In general the NTs have similar secondary (low alpha-helix and high beta-sheets) and tertiary (exposed tyrosine residues and tryptophan fluorescence quantum yield) structures. Within this generalized picture there are significant differences which might be related to the differences in their biological activities. PMID- 2755460 TI - Proenkephalin gene expression in the primate uterus: regulation by estradiol in the endometrium. AB - Proenkephalin mRNA has previously been shown to be expressed in the rodent uterus with varying levels during the estrous cycle. To examine for the potential regulation of proenkephalin gene expression by steroid hormones in a primate displaying a menstrual cycle and to define the functional tissue within the uterus expressing this transcript, we have used Northern blot analysis of extracted RNA from isolated uterine tissue subtypes from normal adult rhesus macaques obtained during the menstrual cycle and from ovariectomized females under different physiological steroid hormone treatments. A strong band of proenkephalin mRNA of 1.3 kilobases was detected almost exclusively in the proliferative endometrium from monkeys in the follicular phase of the cycle. No proenkephalin mRNA was detected in secretory endometrium obtained from monkeys in the luteal phase. When ovariectomized macaques were implanted with silastic capsules of 17 beta-estradiol, proenkephalin mRNA was detected in the endometrium but not the myometrium of the estradiol-treated animals. No proenkephalin mRNA was detected in ovariectomized control animals. Under these conditions, we were unable to detect proenkephalin mRNA in ovariectomized macaques implanted with separate silastic capsules of 17 beta-estradiol and progesterone or in decidual tissue from early or late pregnancy. These results suggest that in the primate uterus 1) proenkephalin mRNA is expressed primarily in the endometrium of the uterus, 2) expression of the proenkephalin gene is regulated by 17 beta-estradiol in the endometrium, and 3) this effect of estradiol is antagonized by progesterone. PMID- 2755461 TI - Managing neonatal pain. PMID- 2755462 TI - A healthy, long life. PMID- 2755463 TI - Trichosporon beigelii infection in an immunocompromised host. AB - A case of Trichosporon beigelii infection in a patient with non-Hodgkins lymphoma that illustrates some of the associated diagnostic and chemotherapeutic problems, is described. Despite prolonged isolation of the yeast from blood cultures, the patient recovered from the infection after treatment with amphotericin B and flucytosine. Presenting features, diagnosis and monitoring of antifungal therapy in renal failure are discussed. PMID- 2755464 TI - Morphological anomalies of the spore forming structures in Aspergillus species. AB - Morphological anomalies of the spore forming structures in 13 thermotolerant strains of aspergilli were studied on two different media (Sabouraud glucose and Czapek-Dox agar) incubated at 28 degrees C, 38 degrees C and 45 degrees C. A few more casual observations in contaminant non-thermotolerant aspergilli were also analysed. A logical classification of these anomalies was given, depending on what part of spore forming structure was affected. Some of these anomalies have either never been described before or not yet reported, i.e. in five additional Aspergillus spp. The incidence and relationship to the culture medium and incubation temperature of these anomalies, as well as possible significance of our observations, were discussed. PMID- 2755465 TI - Colonization of a squamous cell carcinoma in the bovine horn core by Aspergillus terreus. AB - Aspergillus terreus, an opportunistic pathogen, was found to be associated with cancerous tissue of the horn core in a weak and old debilitated cow. The organism was isolated in pure and luxurient growth from a surgically operated specimen of the horn core, and was also demonstrated in the fresh mounts and PAS stained sections of the infected tissues. The isolate showed resistance to nystatin (100 micrograms) when tested by paper disk diffusion technique. This appears to be the first report on the occurrence of A. terreus in bovine squamous cell carcinoma of the horn core. PMID- 2755467 TI - Availability of zinc from germinated, fermented and autoclaved black-gram (Phaseolus mungo) in rats. AB - The availability of zinc in the autoclaved black-gram diet was better as compared to germinated, fermented and raw black-gram diets and this may be due to more destruction of phytate. PMID- 2755466 TI - [Topical application of a 0.1% ciclopiroxolamine solution for the treatment of pityriasis versicolor]. AB - 90 patients suffering from pityriasis versicolor used a 0.1% solution of ciclopiroxolamine for a topical four week treatment. 74% of the patients were cured clinically and mycologically after a four week-therapy. Following additional 4 weeks the responder rate rose to 86%. PMID- 2755468 TI - Estimation of the daily intake of cadmium which may be consumed by students 12-17 years old in secondary schools in the city of Havana. AB - In the present article we offer information regarding the estimated amounts of cadmium which may be consumed by 12,000 students 12 to 17 years old, who attend boarding secondary schools. The method of analysis used to determine cadmium is that reported by the Association of Official Analytical Chemists using atomic absorption spectrometry with air-acetylene flame. The estimated quantities of cadmium which these students may consume according to the offered foods are smaller than those recommended as provisional tolerable weekly intake by the Joint FAO/WHO Expert Committee on Food Additives. PMID- 2755469 TI - Fractionation and characterization of yeast proteins. AB - Fractional profile of proteins from baker's, brewer's, and alcoholic yeasts was studied, applying a consecutive treatment of commercial biomasses, with solutions with a gradient of ionic strength and pH. It was found that a large part (35-50%) of total proteins from investigated biomasses is extracted by means of 0.01 M KCl, pH 7.0, which together with proteins extracted by means of 0.65 M KCl, pH 9.5, makes the part of the easily extractable proteins (50-64% of the total protein amount). The remaining part of proteins is extracted by means of alkaline solutions only. The amino-acid composition of the isolated fractions indicated that they are suitable for usage as food product ingredients. PMID- 2755470 TI - Effect of roasting and autoclaving on phytic acid content of chickpea. AB - Chickpea cultivars CM-68, C-44, Kabuli, CM-72 and 6153 were analysed for phytic acid, phytate phosphorus and total phosphorus. The effect of roasting and autoclaving on these constituents of whole seed and cotyledons was determined. The data revealed that roasting and autoclaving significantly decreased (P less than 0.05) the phytic acid of chickpea cultivars. Phytic acid of whole seed was reduced to a range value of 16-60% and 16-64% by roasting and autoclaving respectively depending upon the cultivar. In the cotyledon, the phytic acid was reduced to a range value of 32-68% and 18-68% during roasting and autoclaving respectively. Similar effect of these treatments was observed in phytate phosphorus however, total phosphorus was little affected. PMID- 2755472 TI - Cut-price fingerprints. PMID- 2755471 TI - Effect of dietary sub-lethal doses of lima bean lectin on relative organ weights, pancreatic and intestinal trypsin (EC 3.4.21.4) and chymotrypsin (EC 3.4.21.1) in the rat. AB - The dietary implications of feeding sub-lethal doses of extracted and purified lectin from lima bean were assessed in weanling rats using changes in relative organ weights, pancreatic and intestinal trypsin and chymotrypsin activities as the response indices. Liver weights decreased significantly (p less than 0.05) while the heart showed a slight but non-significant increase in response to dietary lectin levels. The kidneys, pancreas and spleen were not significantly affected by dietary lectin. Although the activities of the pancreatic enzymes tended, for the most part, to decrease with increasing dietary lectin, such decreases were not significant when compared with the control. Intestinal trypsin and chymotrypsin activities were significantly (p less than 0.05) decreased in the small intestine while the activity values in both the large intestine and caecum were relatively unaffected. Activities of both enzymes showed significant (p less than 0.05) negative quadratic relationship with dietary lectin levels in the small intestine as judged by the magnitude of the R2, coefficients of multiple determination, of 0.77 and 0.76 for trypsin and chymotrypsin respectively. PMID- 2755473 TI - Soviet psychiatry. Grey marks from US group. PMID- 2755474 TI - Animal experiments. Taking advice from experts. PMID- 2755475 TI - Animal experiments. PMID- 2755476 TI - MIRAGE or no mirage? PMID- 2755477 TI - Biological light guides. PMID- 2755478 TI - Constraints on brain growth. PMID- 2755479 TI - Limits on bilingualism. AB - Speech, in any language, is continuous; speakers provide few reliable cues to the boundaries of words, phrases, or ther meaningful units. To understand speech, listeners must divide the continuous speech stream into portions that correspond to such units. This segmentation process is so basic to human language comprehension that psycholinguists long assumed that all speakers would do it in the same way. In previous research, however, we reported that segmentation routines can be language-specific: speakers of English do not. French has relatively clear syllable boundaries and syllable-based timing patterns, whereas English has relatively unclear syllable boundaries and stress-based timing; thus syllabic segmentation would work more efficiently in the comprehension of French than in the comprehension of English. Our present study suggests that at this level of language processing, there are limits to bilingualism: a bilingual speaker has one and only one basic language. PMID- 2755480 TI - Using fetal tissue. PMID- 2755481 TI - AIDS research. French group moves on two fronts. PMID- 2755482 TI - AIDS survey. No sex please, we're American. PMID- 2755483 TI - Schizophrenia. Genetic linkage revisited. PMID- 2755484 TI - Were Neanderthals the first humans to bury their dead? PMID- 2755485 TI - Daedalus. High performance. PMID- 2755486 TI - Fertility and cystic fibrosis. PMID- 2755487 TI - Mycoplasma control. PMID- 2755488 TI - Motion-deblurring in human vision. AB - If photographs are taken of moving objects at slow shutter speeds the images of the objects are blurred. In human vision, however, we are not normally conscious of blur from moving objects despite the fact that the temporal response of the photoreceptors is sluggish. It has been suggested that there are motion deblurring mechanisms specifically to aid the visual system in the analysis of the shape of retinally moving targets. Models of motion deblurring have been influenced by the finding that certain very precise spatial pattern discriminations are unaffected by motion. An example is vernier hyperacuity, in which the observer must detect the direction of offset between two lines with abutting ends. With a stationary stimulus, observers can detect a vernier cue of less than 10 arcsec and acuity is unaffected by retinal-image motion of up to 3 deg s-1 We confirm this finding, but provide evidence against any general deblurring mechanism by showing that another kind of hyperacuity, discrimination of the distance between two parallel lines (spatial interval acuity), is interfered with by motion. This argues against a general deblurring mechanism, such as a neural network 'shifter circuit', and we point out that the high level of vernier acuity for moving stimuli is susceptible to an alternative explanation. PMID- 2755489 TI - Exclusion of linkage to 5q11-13 in families with schizophrenia and other psychiatric disorders. AB - Recently a linkage study on five Icelandic and two English pedigrees has provided evidence for a dominant gene for schizophrenia on 5q11-13 (ref. 1). In that study, families with bipolar illness were not included. Using the same probes, two similar but independent investigations on one Swedish pedigree and on fifteen Scottish families excluded linkage to schizophrenia. To evaluate whether the susceptibility gene on 5q11-13 is a common cause of schizophrenia in other populations, we examined five affected North American pedigrees using probes to the D5S39, D5S76 and dihydrofolate reductase loci. Two families in the present series had cases of bipolar disorder. We found that linkage can be excluded by multipoint analysis. These results, taken together, suggest that the disease gene on 5q11-13 does not account for most cases of familial schizophrenia. PMID- 2755490 TI - Biotechnology licensing: Europe delays BST decision. PMID- 2755491 TI - Chernobyl fallout: continuing plans for evacuation. PMID- 2755492 TI - AIDS-contaminated blood: haemophiliacs to sue. PMID- 2755493 TI - Nuclear waste: billion dollar clean-up plan announced. PMID- 2755494 TI - Women in science: still a soft female touch for doctorates. PMID- 2755495 TI - Abbott and Hybritech settle dispute. PMID- 2755496 TI - Harvard fights first battle. PMID- 2755497 TI - Rival claims over DNA amplification. PMID- 2755498 TI - Epidemiology: nuclear overhaul. PMID- 2755499 TI - Leukaemia increase sets puzzle. PMID- 2755500 TI - Alaskan oil spill: survivors return to the wild. PMID- 2755502 TI - Animal experiments. PMID- 2755501 TI - Screwworm spread: African eradication plan threatened. PMID- 2755503 TI - Peer review. PMID- 2755504 TI - Aquatic viruses. And now, small is plentiful. PMID- 2755505 TI - DNA fingerprinting on trial. PMID- 2755506 TI - Mate choice on fallow deer leks. AB - Leks, on which males defend small clustered mating territories, may have evolved because of the unusual opportunities they provide for female choice of mating partners, and several studies of lek-breeding animals have demonstrated correlations between the mating success of males and their phenotype or behaviour. However, these could arise because (1) females select mates on the basis of male phenotypic traits; (2) males interfere with each other's mating attempts; or (3) females show preferences for particular mating territories, and larger or stronger males are more likely to win access to these territories. Here we report that when fallow bucks on a traditional lek were experimentally induced to change their territories, differences in the mating success of bucks persisted, whereas differences in the position of their territories relative to the centre of the lek did not. The observation that bucks rarely interfered with their neighbours' harems and females moved freely between bucks suggests that females choose their mates on the basis of male phenotype rather than territory type or location. In this population, the immediate factor affecting the movements of females between males was the size of a buck's harem. PMID- 2755507 TI - DNA phylogeny of the extinct marsupial wolf. AB - The phylogenetic affiliation of the extinct marsupial wolf (Thylacinus cynocephalus), which once was widespread in Australia, has been uncertain. On the basis of morphology, some systematists argue that the thylacine was most closely related to an extinct group of South American carnivorous marsupials, the borhyaenids, whereas others consider it to be closer to Australian carnivorous marsupials. Here we use direct sequencing by means of the polymerase chain reaction (PCR) to compare 219 bases of mitochondrial (mt) DNA from museum specimens of the marsupial wolf and representatives of six genera of extant marsupials. In agreement with the results of an antigenic study of albumin, our genetic data suggest that the marsupial wolf was more closely related to other Australian marsupial carnivores than to those of South America. Thus, the marsupial wolf represents an example of convergent morphological evolution to South American carnivorous marsupials as well as to true wolves. PMID- 2755508 TI - High abundance of viruses found in aquatic environments. AB - The concentration of bacteriophages in natural unpolluted waters is in general believed to be low, and they have therefore been considered ecologically unimportant. Using a new method for quantitative enumeration, we have found up to 2.5 x 10(8) virus particles per millilitre in natural waters. These concentrations indicate that virus infection may be an important factor in the ecological control of planktonic micro-organisms, and that viruses might mediate genetic exchange among bacteria in natural aquatic environments. PMID- 2755509 TI - Function of identified interneurons in the leech elucidated using neural networks trained by back-propagation. AB - Mechanical stimulation of the body surface of the leech causes a localized withdrawal from dorsal, ventral and lateral stimuli. The pathways from sensory to motor neurons in the reflex include at least one interneuron. We have identified a subset of interneurons contributing to the reflex by intracellular recording, and our analysis of interneuron input and output connections suggests a network in which most interneurons respond to more than one sensory input, most have effects on all motor neurons and in which each form of the behaviour is produced by appropriate and inappropriate effects of many interneurons. To determine whether interneurons of this type can account for the behaviour, or whether additional types are required, model networks were trained by back-propagation to reproduce the physiologically determined input-output function of the reflex. Quantitative comparisons of model and actual connection strengths show that model interneurons are similar to real ones. Consequently, the identified subset of interneurons could control local bending as part of a distributed processing network in which each form of the behaviour is produced by the appropriate and inappropriate effects of many interneurons. PMID- 2755510 TI - Division and differentiation of isolated CNS blast cells in microculture. AB - The mechanism of transformation of the overtly similar cells of the neural plate into the numerous and diverse cell types of the mature vertebrate central nervous system (CNS) can better be understood by studying the clonal development of isolated CNS precursor cells. Here I describe a culture system in which blast cells (cells capable of division) isolated from embryonic day 13.5-14.5 rat forebrain can divide and differentiate into a variety of clonal types. Most clones contain only neurons or glia; 22% contain both neurons and non-neuronal cells. For the division of blast cells, live conditioning cells need to be present indicating that environmental signals influence proliferation. Heterogeneous clones develop in homogeneous culture conditions, so factors intrinsic to the blast cells are probably important in determining the number and type of clonal progeny. PMID- 2755511 TI - Transcription factor IIIA induced bending of the Xenopus somatic 5S gene promoter. AB - Transcription factor IIIA (TFIIIA), the canonical zinc-finger protein, is a protein of relative molecular mass 39,000 (39K) that is required for transcription of 5S-ribosomal subunit genes in Xenopus. It binds in a sequence specific manner to the internal control region of the 5S gene (see Fig. 1) and facilitates transcription of the gene by RNA polymerase III. It also binds to the 5S gene product to form a 7S ribonucleoprotein particle. In oocytes the 7S particle acts as a storage form of the RNA to be utilized later in development. TFIIIA binds to DNA through its 30 K N-terminal domain, which contains nine zinc fingers. TFIIIA was the first protein described to have this type of DNA binding motif, but numerous other proteins have now been shown to have zinc-finger domains. A structure for a single zinc-finger from the yeast protein ADR1, was recently proposed based on two-dimensional NMR data (ref. 8), and a similar structure was proposed based on comparison with crystal structures of other metalloproteins. Although models for the interaction of TFIIIA with the 5S ribosomal gene DNA have been proposed, based on nuclease digestion and methylation interference data, little precise structural information is available for TFIIIA and the physical basis for the interaction of zinc-fingers with DNA is not understood. Using both circular permutation and circularization assays we provide convincing biochemical evidence that TFIIIA bends the DNA at the internal promoter of the 5S gene. PMID- 2755513 TI - Creating the North Carolina Physicians Health and Effectiveness Program. PMID- 2755512 TI - Thrombolytic therapy on the homefront. Intravenous urokinase in community hospitals. PMID- 2755514 TI - Will you help a troubled physician? The North Carolina Physicians Health and Effectiveness Program. PMID- 2755515 TI - Traumas of the past, problems of the present and fear of the future. Aftermaths of parental chemical dependency. PMID- 2755516 TI - Ethical guidelines for expert medical witnesses. PMID- 2755517 TI - Skin: the bare facts. PMID- 2755518 TI - Morphine: immediate release vs. controlled release. AB - One must ever focus, in the oncology patient, on the possible treatable etiologies of pain which might be amenable to radiotherapy, chemotherapy or surgery. The first goal is to accurately diagnose the source of the pain and then, only if other active intervention is unhelpful, administer analgesic therapy. The use of controlled-release morphine administered at regular 12-hour intervals offers an additional method of providing prolonged comfort with the associated overall improvement in quality of life of the cancer patient. PMID- 2755519 TI - To knock on poverty's door. The story of Evylyn D. PMID- 2755520 TI - Rocky Mountain spotted fever. PMID- 2755521 TI - Two comments on Dr. Weaver's editorial. PMID- 2755522 TI - [Life threatening exacerbations of COPD in children]. PMID- 2755523 TI - [Lens extraction, ambulatory surgery or hospitalization]. PMID- 2755524 TI - [Kinetics in toxicity studies]. PMID- 2755525 TI - [Cavernovenous leakage, a surgically treatable cause of erectile impotence]. AB - In 17 of 33 patients with proven organic erectile impotence, caverno-venous leakage was determined by dynamic cavernosography in conjunction with high flow rates to induce and maintain artificial erection. The normal values of dynamic cavernosography in 12 healthy males are presented as well. Of these 17 patients 12 (aged 26-51 yr) underwent surgical ligation or resection of the deep dorsal vein of the penis and ligation of ectopic veins if present. Potency was restored immediately postoperatively in 8 of these 12 patients. In 2 of the other 4 operated patients cohabitation was possible again only with auto-injections of papaverine. The short-term results are presented. PMID- 2755526 TI - [Diagnosis of laryngeal carcinoma using proton spin resonance tomography]. AB - Seventy-eight patients were investigated by magnetic resonance (MR) imaging using optimal scan parameters and a surface coil. Forty-two patients were also examined by computer tomography (CT). Sixteen patients underwent laryngectomy. MR imaging of cancerous tissue in the larynx, and particularly of non-invaded and invaded cartilages, was examined by comparing MR images with sliced surgical specimens. Pre-operative CT and MRI findings were evaluated by comparing them with postoperative histopathological findings. MR T1-weighted images demonstrate localisation and extent of cancerous tissue. With combined use of T1-weighted and proton-density images MR imaging is superior to CT for showing cartilage invasion. Unfortunately, gross movement artifacts, which resulted in non diagnostic images, occurred in 16% of the examinations. PMID- 2755527 TI - [Attitudes of pregnant women concerning testing for HIV infection]. AB - Since July 1987 pregnant women who attend the outpatient clinic of the University Hospital in Groningen are tested for HIV-infection after informed consent. Their opinion of this policy was examined by means of a questionnaire. This questionnaire was answered by a group of women who had delivered and by a group tested recently. Of these 95.9% and 89.8%, respectively, felt it would be desirable to test all pregnant women; 30% felt obliged to be tested. Informed consent was of importance according to 58.8%; 84.8% were worried about a risk of 1:10,000 of acquiring HIV-infection; 16.6% would still feel very anxious if this risk were 1:1,000,000. Many of the women were prepared to pay for testing, if this would reduce these risks. The results show a positive attitude to screening for HIV-infection. However, a restrained policy remains advisable as the prevalence is still low and screening is considered more or less obligatory by the women involved. PMID- 2755528 TI - [Macro-creatine kinase: not all increased CK-MB activity signifies a heart infarct]. AB - Assay of creatine kinase MB isoenzyme plays an important role in the diagnosis of acute myocardial infarction. An increase in CK-MB is frequently interpreted by the clinician as objective evidence of myocardial cell damage. However, increases of CK-MB may be found in several circumstances in which patients have not sustained an acute myocardial infarction. An important cause of elevated CK-MB values unrelated to acute MI is the presence of macro-creatine kinases in the patient's plasma. With immuno-inhibition procedures macro-CK is often measured as CK-MB, leading to falsely elevated CK-MB. In this paper macro-CKs, their clinical importance and their interference with CK-MB determination are discussed. PMID- 2755529 TI - [The effects of gastric acid inhibitors]. PMID- 2755530 TI - [Kidney tubule function disorders caused by acetic acid]. PMID- 2755531 TI - The physician as an expert witness. PMID- 2755532 TI - Physician's duty to breach a patient's confidentiality. PMID- 2755533 TI - Ex parte discussions between treating physicians and defense counsel in malpractice and personal injury suits. PMID- 2755534 TI - Tort claims against health care providers for breach of confidentiality. AB - In 1920, in the case of Simonsen v. Swenson, the Nebraska Supreme Court recognized in principle that a patient could file suit for money damages against his physician for the wrongful disclosure of confidential information. Since then a growing number of American states have allowed patients to bring such claims. In this article, the author discusses the nature of these breach-of-medical confidence claims and some of the problems which attend them. PMID- 2755535 TI - Doctor glut or doctor shortage. PMID- 2755536 TI - [Vestibulofugal projections to the lateral reticular nucleus of the cat medulla]. AB - Certain amount of neurons in vestibular nuclei were labelled after horseradish peroxidase injection in the medullar lateral reticular nucleus of cat. Such projections were strictly homolateral and formed by small and medium-size neurons localized mainly in the Deiters nucleus; their number was, probably, much less in comparison with the number of vestibulo-spinal units. Functional role of vestibular projections to the lateral reticular nucleus in the motor activity control is discussed. PMID- 2755537 TI - [Convergence of projections from various thalamic nuclei on the rat somatosensory cortex columns]. AB - The method of primuline fluorochrome retrograde transport was used to study sources of thalamo-cortical projections on a separate somatic cortical neuronal column connected with C3 vibrissae of albino rat. Labeled cells were found in 8 thalamic nuclei: tv, tvd, tpo, pf, rh, tvm, tvl, tr. The intensity of neuron staining and cell quantity and density varied in different nuclei. Hence their axon branching in the rat cortex was also different. The majority of intensively stained and densely packed cells have been observed in tv nucleus. The observed convergence of different thalamo-cortical inputs on single somatic cortex column explains heterogeneity in functional properties of the same column neurons and makes it possible for the column to form several neuronal assemblies with different functions. PMID- 2755538 TI - [Characteristics of the synaptic apparatus of the parietal associative cortex (area 5b) in the cat brain]. AB - An electron microscopic examination of the associative cerebral cortex (area 5b) in cat was performed. The average density of axonal terminal profiles in this area was 263 +/- 16 terminals per 1000 micron2 of the slice area. 75.5% of axonal terminals contained synaptic vesicles and had asymmetric or symmetric contacts with visible active zones. 8.4% of axonal terminals had contacts without visible active zones. 24.5% of axonal terminals contained synaptic vesicles, but had no visible contacts with neighbouring structures. 84.9% of axonal terminals contained round or slightly elongated vesicles, 7.8% --a mixture of round and elongated vesicles and 7.3%--thin elongated vesicles. Among the axonal terminals with visible synaptic contacts 46.6% were of the axo-spine type, 50%--of axo dendritic type and 3.4%--of axo-somatic type. 77% of axo-somatic terminals contained elongated vesicles and had symmetric contacts and 23% contained round vesicles and had asymmetric contacts. PMID- 2755539 TI - [Responses of neurons of an isolated cortical strip in a state of convulsive excitation to single electrical stimuli]. AB - Responses of isolated cortical slab neurons to single stimuli before, during and after the development of epileptiform state in a slab were investigated in experiments on immobilized and locally anaesthetized cats. It was shown that during the development of generalized seizure activity in an isolated cortical slab its neurons generate EPSP and paroxysmal depolarizing shifts (PDS) of the membrane potential (MP) accompanied by refractory periods. Refractory periods coincide with PDS plato and MP repolarizing shifts. During these shifts single electrical stimuli produce gradually transforming PDS. After cessation of the ictal activity neurons are still able to generate PDS to single stimuli for some time. It is suggested that the role of postsynaptic responses in genesis of the epileptiform activity is not the most important. Nonsynaptic factors are, probably, involved in its generation. PMID- 2755540 TI - [Nonlinear temporal summation of EPSP in mollusk neurons]. AB - Temporal summation of monosynaptic EPSPs produced by paired afferent stimuli was studied in the experiments on identified neurons of mollusc Planorbis corneus. Nonlinear properties of the summation were shown; there were three types of the summation: facilitation, depression and mixed type. It was shown that summation functions (characterizing the dependence of the ratio between the test and conditioning EPSP amplitudes and the value of the corresponding interstimulus++ interval) had some local extremum in most cases. The value of the interstimulus++ interval corresponding to this extremum was in correlation with single EPSP parameters. Possible localization of mechanisms responsible for the EPSP summation properties is discussed. PMID- 2755542 TI - [Changes in the electrical activity of spinal cord neurons of adrenalectomized rats under the effect of adrenal cortex hormones]. AB - Effect of dexamethasone and desoxycorticosterone on the electrical activity of neurons in dorsal and ventral horn of spinal cord evoked by sciatic nerve stimulation were studied in adrenalectomized rats as well as effect of the same hormones on the background activity of single cells in the dorsal horn. The results demonstrated that both hormones (dexamethasone and desoxycorticosterone) provided enhancement of the amplitude of the field potentials recorded from the dorsal half of the spinal cord and facilitation of the background neuronal discharges of the single cells under investigation. It was stated that gluco- and mineralocorticoid hormones exerted different effects on the activity of ventral horn neurons of the spinal cord: dexamethasone++ potentiated and desoxycorticosterone depressed the amplitudes of the field potentials recorded from the region of motoneurons. The presented data have shown the modulatory effects of neurosteroids on the electrical activity of the spinal cord neurons. PMID- 2755541 TI - [Effect of antibodies to glial glycolipid antigens on miniature end-plate potentials]. AB - Less than 4% of miniature end-plate potentials (MEPPs) in frog cutaneous-pectoral muscles, normal or exposed to nonimmune rabbit serum were atypical. These MEPPs were of normal amplitude, but their time course was nearly twice as slow as that of normal MEPPs. The exposure of muscles to rabbit anti-galactocerebroside serum induced more than three-fold increase in the fraction of atypically slow MEPPs. Inhibition of acetylcholinesterase caused an appearance of giant MEPPs, the fraction of slow MEPPs being unchanged. Possible mechanisms of increase in fraction of atypical slow MEPPs based on modification of the synaptic Schwann cell functioning are discussed. PMID- 2755543 TI - [Responses of visual cortex neurons in the rabbit to direct stimulation by a current of varying intensity]. AB - Responses of 47 visual cortical neurons to intracortical electrical stimulation by single biphasic pulses of increasing intensities in the range of 150-2700 microA were investigated. Analysis of response components of each single neuron has demonstrated that their thresholds are similar and those for different neurons vary from 150 to 600 microA. With an increase of the current intensity different neuronal responses type are revealed (concerning the number of impulses in different response phases). They are stable, gradual and selective responses. An increase of the current intensity induces a decrease of the proportion of stable responses (from 26% to 11%) and a slight increase in the proportion of selective responses (from 21% to 32%) in cases of more remote phases of the neuronal response. The fact that selective responses can be detected in all intervals of the analysis indicates, probably, that there are optimal current values for maximal neuronal responses. Elongation of the inhibitory pause takes place in all neurons investigated. The results may be of practical use in researches of human visual prosthesis. PMID- 2755544 TI - [Convergence of preganglionic fibers on neurons of the rabbit superior cervical ganglion]. AB - Responses of neurons of the rabbit superior cervical ganglion to stimulation of the fascicles of preganglionic fibres and tonic activity of these neurons were recorded with intracellular electrodes in vitro and in situ, respectively. Marked convergence of preganglionic fibres onto ganglion cells was found: 8.5 +/- 1.2 fibres, on the average, converged on each cell. It was found that each ganglionic neuron received two preganglionic inputs: single and multiple. The single input was formed by a single preganglionic fibre which evoked EPSP strong enough to trigger a postsynaptic spike. The multiple input was formed by two or more converging preganglionic fibres which could trigger a postsynaptic spike only through summation of the EPSPs they evoked. The interspike intervals for these two preganglionic inputs in tonic activity of neurons were described by distributions of different types: Gaussian and Poisonian ones. Those two distributions were typical of single and multiple inputs, respectively. PMID- 2755545 TI - [Effect of artificial polarization of the membrane on IPSP of neurons in the cat sensorimotor cortex]. AB - Inversion of the early component of IPSPs in neurons of the sensorimotor cortex by artificial hyperpolarization of the membrane was demonstrated in cats immobilized by myorelaxants in acute experiments. The late component of IPSP was not inverted. Amplitudes of the early component of IPSPs were decreased by the membrane depolarization while the late component was completely reduced. The input resistance of the membrane which decreased during the early component of IPSPs was restored to the initial level during the late component. PMID- 2755547 TI - [Changes in the ultrastructure of cortical synapses during exposure to associated neurochemical stimuli]. AB - Dependence of changes in the postsynaptic density, active zone and synaptic cleft on time relations between the administered associated stimuli was established. Locally applied glutamate and acetylcholine were used as the stimuli. PMID- 2755546 TI - [Effect of ischemia and recirculation on the ultrastructure of the ventral horns of the rabbit spinal cord and accumulation of calcium in motoneurons]. AB - The effect of 40-min ligation of the abdominal aorta and 60-min recirculation was investigated with the use of pyroantimonate. All the motoneurons were markedly damaged. Vacuolized mitochondria and basal membrane of capillaries contained calcium deposits. PMID- 2755548 TI - Serum cholesterol, its lipoprotein fractions among survivors of cerebrovascular disease. A case-control study. AB - A case-control study was conducted in 1983 on 210 cerebrovascular disease (CVD) patients identified from a retrospective cross-sectional door-to-door survey of four cities in the People's Republic of China. One hundred and eleven male (mean age 63.8 +/- 8.9 years) and 99 female (mean age 63.5 +/- 11.1 years) CVD survivors and controls matched for sex, age, race and area were selected. Total serum cholesterol, high-density lipoprotein and low-density lipoprotein cholesterol were measured to see if there were differences between lipids in survivors of CVD and their matched controls. There was a higher level of total cholesterol in cerebral thrombotic patients (n = 114) and a lower level of total cholesterol and high-density lipoprotein cholesterol in cerebral hemorrhagic patients (n = 35) than in controls, although the results were not statistically significant. The only higher level of total serum cholesterol that might be important was in the group of male thrombotic patients of age greater than 70 years (n = 22; nominal p value less than 0.05). The implication of this finding needs further clarification. PMID- 2755549 TI - Cerebral palsy in Tottori, Japan. Benefits and risks of progress in perinatal medicine. AB - From the changing incidence of cerebral palsy (CP) in the Tottori joint study, the absolute number of saved non-CP babies in the period 1955-1984 in the whole of Japan was calculated as about 33,000. The significant decrease of the incidence in the period 1955-1980 was mainly related to the advances made in perinatal medicine. In contrast, the recent reincrease is attributable to low birth-weight CP. As for the risk factors for quadriplegia or double hemiplegia of CP, maternal toxemia, low Apgar scores and neonatal abnormal signs were important. Diplegia and paraplegia were significantly correlated with low birth weight. Among the babies weighing below 2,000 g, there was a more than 40-fold increased risk of CP compared with that in the general population. As for the risk for low-birth-weight diplegic CP, the number of abnormal signs in the neonatal period is correlated with the brain damage. The next step in preventing perinatal brain damage might be to give more attention to fetal deprivation and to well-balanced and sensible neonatal care of risk babies. PMID- 2755550 TI - Patterns of mortality from hereditary ataxias in the United States, 1971 and 1973 1978. AB - Mortality rates for deaths 'due to' and 'with' hereditary ataxias are presented for the first time. Age-adjusted mortality rates were higher for whites than for nonwhites of either sex, and for men in both racial groups. Age-specific mortality rates for whites showed a peak for 'hereditary spinal ataxia' in the 20 29 age group. For the other types of ataxias they were low until age 40 and increased thereafter. Heart diseases were a frequent cause of death in people dying 'with' hereditary ataxias. The median survival (from birth) for hereditary spinal ataxia in whites was 35 years. PMID- 2755551 TI - Dietary changes in temporal relation to multiple sclerosis in the Faroe Islands: an evaluation of literary sources. AB - In order to generate additional hypotheses on a possible role of dietary factors in the etiology of multiple sclerosis, the ethnographic literature and other relevant sources from the Faroe Islands were reviewed. A transitory occurrence in the first half of the 20th century was evident for the extended consumption of oat products, of fulmars possibly infected with ornithosis virus, and of foodstuffs treated with wood smoke or smoke condensates. The hypothetical basis of these considerations must be emphasized. PMID- 2755552 TI - Increasing incidence of multiple sclerosis in South Lower Saxony, Germany. AB - In the epidemiological area of South Lower Saxony the prevalence of multiple sclerosis increased from 51/100,000 in 1969 to 99 in 1986. The mean annual incidence increased from 2.6 for the period from 1964-1974 to 4.6 for 1975-1985. This trend is significant (p = 0.0068). Diagnostic criteria, methods of case finding and analysis of the data remained stable. Minor necessary changes as for example due to new data protection laws and new handling of early cases by practising physicians can hardly explain this significant increase. In consideration of similar reports from all over the world biological exogenous factors are suspected but remain to be identified. PMID- 2755553 TI - Neuroepidemiological survey on Sicilian population. A feasibility study. AB - This research was designed as a pilot study in order to determine the feasibility and the reliability of a major door-to-door neuroepidemiological survey to be performed in the near future in 3 Sicilian towns with a total population of 30,000 inhabitants. 1,601 subjects were investigated by means of a questionnaire for the prevalence of stroke, epilepsy, parkinsonian syndromes, peripheral neuropathies, intracranial neoplasm and migraine. This preliminary study proved to be a good starting point, but some difficulties were identified in the questionnaire, in data collecting instruments and in diagnostic criteria. PMID- 2755554 TI - The effect of sleep fragmentation on sleep and performance in younger and older subjects. AB - Groups of 12 normal 55-70-year-old and young adult subjects had their sleep experimentally disturbed at a rate of approximately 14 times per hour to determine the residual effects of moderate sleep disturbance and to determine any differential impact as a function of age. Normal age-related changes in sleep were seen on baseline and recovery nights. In the second night of sleep disturbance, the older subjects had a smaller increase in total awakenings than young adults. Older subjects had a slower increase in auditory arousal threshold as sleep disturbance progressed. The older subjects also tended to have less performance deterioration on morning testing than did young adults, and this difference was significant for numbers of correctly completed addition problems. These evidences led to the conclusion that, while both age groups were sensitive to moderate sleep disturbance, the older individuals appeared somewhat less sensitive than the young adults. PMID- 2755555 TI - Effects of dietary restriction on radial-arm maze performance and flavor memory in aged rats. AB - Two groups of aged rats, a dietary restricted group fed approximately 10 g per day from 6 weeks of age and a group fed ad lib throughout their life span, were compared with a young adult group on an 8-arm radial maze and a flavor memory task. The young adult displayed efficient performance on the radial-arm maze within the 15 day test period. In contrast, both aged groups exhibited significantly poorer performance in the maze in comparison with the young adult group neither aged group differed from chance at the end of the 15 days. The flavor memory task required the animals to consume a novel flavor. Their loss of neophobia, as indexed by their subsequent consumption, was then taken as an indication of the extent to which they remembered the novel flavor and its effects. The young adult group lost their neophobia more rapidly than either of the aged groups, which did not appear to differ from each other. Taken together, this pattern of results indicates that dietary restriction does not protect animals from the memory loss observed in aged animals. PMID- 2755556 TI - Choline levels are increased in cerebrospinal fluid of Alzheimer patients. AB - We measured choline (Ch), acetylcholinesterase activity (AChE) and total protein in the cerebrospinal fluid (CSF) of 66 Alzheimer patients (ages 54-89 years) and 22 age-matched controls (ages 52-80 years), looking for markers of the well established cholinergic deficit and neuronal degeneration in Alzheimer disease (AD). Three or more lumbar punctures were performed in 21 patients over a span of 24 months in order to study the changes in these CSF components with disease progression. We found a statistically significant reduction in AChE and an increase in Ch with advancing dementia. These changes were not related to patient age. We suggest that the rise in CSF choline is related to neuronal membrane breakdown and reduced Ch uptake by cholinergic neurons. The reduction in CSF AChE is consistent with the depletion of cholinergic neurons in AD. PMID- 2755557 TI - The topography of nerve cell loss from the locus caeruleus in elderly persons. AB - A topographical analysis of nerve cell loss from the locus caeruleus in "mentally normal" old people shows cell loss to be uniformly diffuse throughout the whole nucleus with no preferential involvement of any one particular area. Such findings contrast with those of ours on Alzheimer's disease and suggest differing mechanisms underlying the cell loss of old age and Alzheimer's disease. Cell loss in Alzheimer's disease is thought to relate to primary pathogenetic events in terminal fields of cerebral cortex. In "normal" old age, cell loss may be determined by changes occurring at perikaryal level possibly in respect of the cytotoxic effects of noradrenaline degradation and neuromelanin accumulation. PMID- 2755558 TI - Changes in expression of a synaptic vesicle antigen in aging sympathetic neurons. AB - The effects of altering synaptic activity of sympathetic neurons on the expression of a synaptic vesicle protein (p65) were studied by deafferentation of the superior cervical ganglion (SCG) in adult and aged Fischer-344 rats. Levels of p65, an integral membrane protein of synaptic vesicles, were assayed by radioimmunoassay. After deafferentation, a transient increase in p65 levels is observed in the SCG of adult rats. In aged animals, the response to deafferentation is delayed and enhanced, and levels do not drop to values observed in operated adults. After SCG deafferentation, p65 levels in the iris, an SCG target, initially are depressed below control levels; p65 levels return to control values in adult animals after 14 days, but remain depressed in aged animals. In contrast, a transient increase in p65 levels is observed in the pineal of both adult and aged animals. These results suggest that while the aged sympathetic nervous system retains the ability to respond to alterations in synaptic activity, it is unable to reregulate once a response is initiated. PMID- 2755559 TI - Leg flexion conditioning in the rat: its advantages and disadvantages as a model system of age-related changes in associative learning. AB - Twelve- and 28-month-old Fischer 344 rats of both sexes received five 60-trial sessions of Pavlovian conditioning in which the CS was a 75 dB, 10,000 Hz tone, and the US was a 0.5-mA, 0.5-sec duration footshock. Right foreleg flexion was measured as the conditioned response (CR). Other animals received a random sequence of unpaired tones and footshock and served as pseudoconditioning control groups. Interstimulus intervals (ISIs) of 1.5 and 3.5 sec were studied. The longer ISI resulted in higher rates of responding in both the conditioning and pseudoconditioning groups. However, with the exception of the young males, all animals showed significantly higher levels of responding in the conditioning groups. Females also showed faster acquisition and higher levels of responding than males. A significant sex by age by sessions interaction occurred, suggesting that old males may be somewhat retarded in acquiring the leg flexion CR compared to the other groups of animals. Old males were also slower to reach a criterion of 5 successive CRs than either young males or young or old females. PMID- 2755560 TI - Advances in Alzheimer therapy: cholinesterase inhibitors. AB - After a decade of intense study of cholinergic therapies for Alzheimer's disease, three conditions in this field are apparent: 1) The potential that cholinergic agents will ameliorate the memory dysfunction of Alzheimer patients (as 1-dopa benefits Parkinson patients) is still a stimulus for research. 2) Cholinergic neuropharmacology and its impact on the therapy of memory disorders associated with cholinergic dysfunction needs to be further characterized and understood. 3) While there is still a search for a symptomatic treatment for AD, the path to find a treatment for the Alzheimer disease process must first pass through a phase of basic research to find the cause of Alzheimer's disease. At the meeting, there was an undercurrent of concern that the cholinergic deficit is too severe to be treated, that the cholinergic systems are too complex to respond to a pharmacologic therapy and that too many other systems are involved in Alzheimer's disease for a cholinergic treatment to be successful. However, this concern was balanced by the evidence of basic scientific experiments which indicate that the central cholinergic system mediating memory can be positively manipulated in animal lesion preparations and Alzheimer tissue. Also there were reports that improved pharmacological approaches and psychological measures are being developed. It appears that Alzheimer therapy is at the stage that cancer chemotherapy was 20 years ago: the promising agents cause nausea without producing clear effects but the basic laboratory studies strongly suggest that substantial benefits are possible and several agents have shown encouraging results. Meanwhile, patients and scientists are becoming increasingly interested in the field.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2755561 TI - The paradoxical stimulatory effect of morphine on LH secretion is dose-dependent and naloxone-reversible. AB - We previously observed that morphine stimulated luteinizing hormone (LH) secretion from ovariectomized rats when administered intravenously at a dose of 10 mg/kg body weight. The objectives of the present study were to determine: (1) if this paradoxical effect of morphine on LH secretion could be antagonized by naloxone; (2) whether beta-endorphin also stimulated LH secretion under similar conditions; (3) what influence, if any, the ovaries have on the expression of this opiate-induced LH secretion, and (4) whether this paradoxical effect of morphine extended to prolactin (PRL) secretion. An intravenous injection of morphine, 10 mg/kg body weight, to ovariectomized rats acutely increased both plasma LH and PRL concentrations. The LH and PRL responses were completely antagonized by the concurrent administration of the opiate antagonist naloxone (1 mg/kg body weight). In contrast, morphine suppressed LH concentrations and had no effect on PRL levels when injected at a dose of 1.0 mg/kg body weight. Intravenous injections of beta-endorphin, 1 mg/kg body weight, increased PRL concentrations to a level comparable to that observed following morphine, 10 mg/kg body weight, and produced a transient but insignificant inhibition of LH release. Intraventricular injections of much lower doses of beta-endorphin resulted in a dose-dependent suppression of LH release and a dose-dependent stimulation of PRL release in ovariectomized rats. Intravenous administrations of morphine (10 mg/kg), but not beta-endorphin (1 mg/kg), to normal female rats resulted in a 2-fold increase in LH concentrations similar to that observed in ovariectomized rats, whereas both treatments similarly increased PRL concentrations.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2755562 TI - Comparison of the nocturnal temporal profiles of N-acetyl-transferase and thyroxine 5'-deiodinase in rat pineal. AB - The nocturnal temporal patterns of pineal N-acetyltransferase (NAT) and type II thyroxine 5'-deiodinase (5'-D) were compared in the same animals. Both NAT and 5' D had a similar rise to a midnight zenith with the same lag period but 5'-D rose to its peak 1 h before NAT. The temporal profiles of decrease in enzyme activities were quite different, with 5'-D declining long before NAT. Acute light exposure caused a rapid dramatic decrease in NAT but not in 5'-D. These data suggest that different mechanisms are in involved in the decrease of these two enzyme activities. The role of the antecedent rise in 5'-D activity in the nocturnal rise of NAT activity is apparently minor at most, since pretreatment with iopanoic acid completely blocked the nocturnal rise in 5'-D but had no effect on the nocturnal rise in NAT nor on the acute fall in NAT from its midnight zenith after exposure to light. PMID- 2755563 TI - Effects of self-administered phencyclidine on regional uptake of 2-deoxy-D-[1 14C]glucose in brain. AB - Phencyclidine profoundly alters cerebral metabolism in the rat. This study explored whether cerebral metabolic effects of phencyclidine differed when the drug was self-administered by trained rats, compared with when it was given acutely to naive rats. The regional cerebral uptake of 2-deoxy-D-[1-(D14C] glucose (DG) was examined following two injections of phencyclidine (0.5 mg/kg/injection, i.v.) or saline in freely-moving, drug-experienced rats. Naive controls received phencyclidine or saline according to an identical dose regimen. In self-administering and naive rats, phencyclidine produced many of the same effects on uptake of DG, including the following: decreases in the habenula, inferior colliculus, sensory cortical areas and corresponding thalamic relay nuclei; and increases in limbic areas (entorhinal and retrosplenial cortices, subicular areas). Some regions (auditory and motor cortices, medial geniculate body, globus pallidus) showed different effects in self-administering and naive rats. Another study, in which rats were not self-administering phencyclidine, but had histories of treatment with drugs similar to those of the self-administering rats, indicated that chronic exposure to drug accounted for some of the differences. Furthermore, differences between the effects of phencyclidine in self-administering, versus non-self-administering rats with similar histories suggested that activity in some regions of the brain may relate to training in drug self-administration and/or behavior. PMID- 2755564 TI - Amygdala-kindling as a model for chronic efficacy studies on antiepileptic drugs: experiments with carbamazepine. AB - The anticonvulsant properties of carbamazepine were evaluated after single and multiple doses in the kindled amygdaloid seizure model in rats. Carbamazepine significantly reduced severity and duration of motor seizures and the duration of afterdischarges recorded from the stimulated amygdala after a single dose of 30 mg/kg (i.p.), but tolerance developed during chronic treatment of rats with three times daily intraperitoneal injection of 30 mg/kg of the drug for 2 weeks. Tolerance was also observed with respect to central side-effects (ataxia, muscle relaxation) of the treatment. Determinations of plasma levels confirmed previous studies in rats and other species in that concentrations of carbamazepine declined during chronic treatment, which may be related to autoinduction of the metabolism of the drug. Indeed, carbamazepine-10,11-epoxide, the major active metabolite of carbamazepine, could not be quantified in the plasma after the first dose but accumulated during chronic treatment, indicating an enhanced metabolism of the parent drug. As a consequence of decreasing concentrations of carbamazepine but increasing levels of the epoxide, the sum of concentrations of both compounds after 1 or 2 weeks of treatment did not differ from the concentration of unchanged carbamazepine initially determined. Determinations of the acute anticonvulsant potency in kindled rats indicated that carbamazepine 10,11-epoxide was about half as potent as the parent drug. In view of the anticonvulsant activity of carbamazepine-10,11-epoxide, the loss of anticonvulsant efficacy observed during chronic treatment with carbamazepine cannot be related solely to metabolic tolerance, i.e. due to enhanced metabolism of drug, but should also relate to functional tolerance, i.e. induced by central adaptation to the long-term presence of the drug and its metabolite. PMID- 2755565 TI - 5-Hydroxytryptamine depolarizes neonatal rat motorneurones through a receptor unrelated to an identified binding site. AB - Superfusion of hemisected lumbar spinal cord of the neonatal rat with solutions containing 10(-6) to 10(-3) M 5-hydroxytryptamine (5-HT) elicited depolarizations of graded amplitude which were recorded from motorneurons through a ventral root. Maximum responses (amplitude 1.0 +/- 0.1 mV, mean +/- SEM, n = 30) were evoked by 10(-4) M 5-HT. Repeated concentration-response curves could be determined from the same preparation. There was no involvement of 5-HT2 receptors in the depolarizing response to 5-HT, since neither ritanserin nor ICI 169, 369 showed any antagonist action. Amongst agents with activity at 5-HT1A sites, the selective 5-HT1A receptor agonist, 8-hydyroxy-2-(di-N-propylamino) tetralin (8-OH DPAT), neither mimicked the action of 5-HT nor antagonised it, while spiperone (10(-8)-10(-7 M) antagonised responses to 5-HT in a concentration-related manner. Responses to 10(-4) M noradrenaline, used as a control depolarizing agent, were unaffected by spiperone. The onset of blockade by spiperone was slow, 1 hr being required for equilibration of the tissue with antagonist. The blockade was surmountable by larger concentrations of 5-HT. Concentration-response curves to 5 HT were shifted to the right in an approximately parallel manner by spiperone. The dose ratios measured from these curves at the EC50 level, yielded an apparent pA2 of 8.24 +/- 0.14 (mean +/- SEM, n = 15), although the Schild plot of the data had a slope less than unity. The lack of activity of the selective 5-HT1B receptor agonist, RU 24969, and the 5-HT1B receptor antagonists, (+/-) cyanopindolol and quipazine, indicated that 5-HT1B receptors were not involved in the 5-HT response of motorneurones to 5-HT. Mesulergine, metergoline and cyproheptadine also antagonised responses of motorneurones to 5-HT, producing a surmountable blockade. Mesulergine (10(-8), 3 x 10(-8) and 10(-7) M caused a progressive rightward shift of the concentration-response curves, but 10(-7) M depressed the maximum response to 5-HT. Responses to noradrenaline were not affected by these concentrations of mesulergine. The apparent pA2 for blockade of 5-HT responses by mesulergine, calculated from experiments in which there was a parallel displacement of the concentration-response curves, was 8.75 +/- 0.11 (mean +/- SEM, n = 10).(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2755566 TI - Pharmacological evidence for the presence of cholecystokinin-containing neurones in the mesenteric nerves supplying the guinea-pig ileum. AB - In guanethidine-treated, capsaicin-desensitized segments of guinea-pig isolated ileum electrical stimulation of mesenteric nerves resulted in contractions reaching 10 to 30% of the maximal longitudinal spasm. These responses were abolished by tetrodotoxin or atropine, and were reduced by half by the selective cholecystokinin antagonist lorglumide. It is concluded that neuronal processes whose endings release cholecystokinin-like material within the gut wall run in the mesenteric nerves and contribute to the capsaicin-resistant contractile response by releasing endogenous acetylcholine. PMID- 2755567 TI - Confirmation by magnetic resonance imaging of Bell's cruciate paralysis in a young child with Chiari type I malformation and minor head trauma. AB - We report the case of a young girl who suffered bilateral upper extremity paralysis after minor head trauma. Her clinical picture, as well as radiographic evidence of a fracture at C1, led to the diagnosis of Bell's cruciate paralysis, caused by a small lesion in the rostral part of the pyramidal decussation. Magnetic resonance images showed, in addition to a Chiari Type I malformation, an abnormality in the medulla. All previous cases of cruciate paralysis lack both pathological and radiographic supporting evidence. PMID- 2755568 TI - Acute aortic thrombosis causing sudden paraplegia in a patient with known thoraco lumbar spinal metastasis: the diagnostic usefulness of magnetic resonance imaging. AB - Diagnosis and treatment of acute aortic thrombosis utilizing magnetic resonance imaging is reported. The patient had known thoracolumbar spinal metastases and sudden onset paraplegia. MRI critically shortened the time to emergent surgery and obviated the need for two invasive tests (myelogram and angiogram). PMID- 2755569 TI - Benign osteoblastoma of the parietal bone: case report. AB - A case of benign osteoblastoma of the parietal bone is presented. Attention is drawn first to the rarity of this tumor and second to the fact that the radiological and histopathological features of the tumor reported here lead us to suspect the presence of regressive features in its evolution. PMID- 2755570 TI - Primary spinal intramedullary malignant melanoma: case report. AB - A rare case of primary spinal intramedullary malignant melanoma at the T6 level in a 31-year-old man is presented. The tumor was partially removed, and neuroaxis irradiation up to 50 Gy was then administered. Subsequently, systemic interferon beta (specific activity, 2.0 X 10(8) IU/mg protein) therapy (total dose, 2.2 X 10(7) units) was begun. At the completion of these therapies, immunohistochemical analysis with monoclonal antibodies against melanoma-associated antigens confirmed the presence of melanoma cells in the cerebrospinal fluid (CSF). Chemotherapy with intrathecal administration of dacarbazine (dimethyltriazenoimidazole carboxamide, DTIC) was then initiated, to avoid the dissemination of tumor cells by the CSF. Periodic cytological examination of CSF for melanoma cells revealed a marked reduction in the number of tumor cells. Pharmacokinetic study showed that the disappearance of DTIC from the CSF was biphasic, with an initial half-life of 30 minutes and a terminal half-life of 5 hours. Follow-up examination by MRI 1 year after the operation did not disclose any significant increase in size of the residual tumor. Neither recurrence nor metastasis was observed. The pertinent literature on spinal cord melanoma is reviewed, and the usefulness of MRI and intrathecal chemotherapy with DTIC is discussed. PMID- 2755571 TI - Toward the ideal electrocorticography array. AB - Several features desirable in the design of electrocorticography arrays are listed. A new electrocorticography system is described and compared with types that are commercially available. This system offers several advantages over older systems and results in significant saving of time in the operating room. PMID- 2755572 TI - Sites of origin of primary intracerebral malignant lymphoma. AB - With the aim of finding characteristics pointing to the primary site, computed tomography examination from 9 patients with primary brain malignant lymphoma (non Hodgkin's lymphoma originating in the central nervous system, NHL-CNS) (5 single, 4 multiple lesions) were analyzed. The tumors were usually situated in the basal ganglia, corpus callosum, or cerebellum and were always in contact with either the ependyma of the ventricles or the subarachnoid space. Tumors with widespread infiltration of white matter surrounding the ventricles were characteristic of NHL-CNS. Microscopic examination of 3 autopsy cases revealed infiltration of the subependymal layer of the lateral ventricles and the third and fourth ventricles by lymphoma cells. The entire extent of the choroid plexus was invaded by tumor cells. There were multiple foci of similar cells invading the periventricular white matter. The subarachnoid space was filled with lymphoma cells. In many areas the Virchow-Robin spaces and pial-glial membranes were disrupted, and invasion of the underlying gray matter by tumor cells was seen. The ultrastructure of the blood vessels of NHL-CNS was compared with those in glial, nonglial, and metastatic brain tumors. The essential feature in NHL-CNS was fenestrated vessels. They resembled the blood vessels found in nonglial and metastatic brain tumors, but were distinctly different from those seen in glial tumors with nonfenestrated vessels. Although the following scheme in proposed with reservations, it could account for the sites of origin of NHL-CNS: lymphocytes located in the choroid plexus stroma or the subarachnoid space are activated, caused to proliferate, and finally become neoplastic.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2755573 TI - Pediatric Chiari malformations. PMID- 2755574 TI - Role of blood volume on eicosanoids in cerebrospinal fluid. PMID- 2755575 TI - Complications of intracranial pressure monitoring in trauma patients. AB - A retrospective review of 175 intracranial pressure (ICP) monitors placed in 140 trauma patients over a recent 3-year period showed a 10.3% infection rate. Factors that were related to the development of an ICP monitor-related infection included: 1) duration of monitoring; 2) requirement for serial monitors; and 3) concurrent infection at other sites. These findings are discussed in light of the related literature concerning ICP monitoring and recommendations made to decrease the incidence of infection-related complications. PMID- 2755576 TI - Coagulation and fibrinolysis in chronic subdural hematoma. AB - In 19 patients with chronic subdural hematoma, coagulation and fibrinolysis in venous blood taken at the time of surgery and in the hematoma contents aspirated from chronic subdural hematoma were studied. Compared with coagulation results for venous blood, the hematoma contents demonstrated marked prolongation of the recalcification time, prothrombin time, and activated partial thromboplastin time, and marked reduction of clotting factor V, the hepaplastin test, prothrombin, and fibrinogen. Antithrombin III was also decreased, and fibrinopeptide A was increased in the hematomas. Fibrinolytic results demonstrated that both plasminogen and alpha 2-plasmin inhibitor were decreased, and both fibrinopeptide B beta 15-42 and fibrin and fibrinogen degradation products were increased in the hematomas. These findings indicate excessive activation of the clotting system, thrombin generation, and increased fibrinolytic activity occurring in the hematomas. From these results, excessive activation of both the clotting and fibrinolytic systems is emphasized to be the possible etiological factor for the origin and development of chronic subdural hematoma. PMID- 2755577 TI - Anterior screw fixation of posteriorly displaced type II odontoid fractures. AB - Posteriorly displaced Type II odontoid fractures (Type II-P) are difficult to stabilize in an anatomic position with accepted methods of posterior atlantoaxial arthrodesis. Nine patients with Type II-P odontoid fractures with 4 to 15 mm displacement were treated with anterior odontoid screw stabilization. Seven of these patients had associated fractures or defects of the posterior arch of the first cervical vertebra (C1). Atlantoaxial posterior arthrodesis in these patients would not have been possible initially because of the lack of structural integrity of the posterior arch of C1. Two patients, later in the study, had no injury to the ring of C1. The odontoid fractures were stabilized with two 4.0-mm cancellous screws inserted through an anterior approach to the neck under fluoroscopic control with the skin incision at the C5 level. Preoperative reduction of the displaced odontoid process and immediate operative stability of the atlantoaxial complex were obtained in each case. No neurological complications related to the procedure occurred. Two patients died of causes unrelated to their cervical fracture surgery. The 7 patients who survived were followed for a minimum of 6 months. Fracture union and cervical stability were demonstrated in each of the surviving patients, without evidence of screw loosening or loss of fixation. Normal range of motion of the neck was documented at follow-up in all surviving patients. Although this series represents a limited experience with this treatment technique, anterior odontoid screw fixation has significant advantages over accepted methods of cervical stabilization for Type II-P odontoid fractures.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2755578 TI - Neurosurgical aspects of cerebral cryptococcosis. AB - Eleven patients with raised intracranial pressure caused by cerebral cryptococcosis developed complications requiring neurosurgical operations. Two patients were fully conscious on admission, and 9 had impaired consciousness, four of whom were comatose. Seven patients were found to have hydrocephalus only. Two patients had cerebral edema initially, and 2 had cystic lesions. One of the latter developed subdural effusion. All patients eventually developed progressive hydrocephalus requiring placement of a ventriculoperitoneal shunt. Four patients were initially treated by external ventricular drainage. When external ventricular drainage was used initially, there were no associated complications; however, there was a high incidence of complications (4 of 7 patients) when a ventriculoperitoneal shunt was placed as the initial treatment. Of the 11 patients, 10 (91%) survived; of these 9 (82%) made an excellent recovery and 7 (64%) returned to their original work. The patient who died had been receiving steroid therapy for hypopituitarism. PMID- 2755579 TI - Modification of a model for cerebral ischemia in the cat: a new method to occlude the middle cerebral artery. AB - A modified method of occluding the middle cerebral artery (MCA) by inserting a tiny copper wire into the lumen of the vessel to make a model for cerebral ischemia in the cat is described. Of 22 rats, 4 were controls and the remaining 18 were divided into two groups. Bipolar electrocoagulation was used in 9 cats and copper wire insertion was used in the other 9 to occlude the MCA through a transorbital approach. Two cats died after surgery and were excluded from this study. Of the 16 cats in two experimental groups, 13 of 14 showed hemiplegia and the other 2 were killed under anesthesia. Typical ischemic changes can be seen in the territory of the occluded MCA. Increased water content and decreased amplitude of somatosensory evoked potentials can be found in the ischemic hemisphere. Histochemical fluorescence study demonstrated that the sympathetic nerve fibers normally existing on the MCA can be completely destroyed by electrocoagulation but may remain intact with the copper wire method. This new method may have less influence on the vascular regulative function of the autonomic nervous system and be more similar to the pathological changes of cerebral infarction in man. We think our method can be useful for further research in cerebral ischemic disease and the regulative effects of the nervous system on brain vessels. PMID- 2755580 TI - Temporary vessel occlusion and barbiturate protection in cerebral aneurysm surgery. AB - In a review of 147 patients with intracranial aneurysms surgically treated by one surgeon (FAD) between 1980 and 1987, 36 selected patients received intraoperative barbiturate protection with sodium thiopental during temporary arterial occlusion. Thiopental doses of 5 to 15 mg/kg were used. Twenty-nine of 36 (81%) had ruptured aneurysms. Occlusion times ranged from 3 to 93 minutes, with a mean of 16.2 minutes. Seven patients had new neurological deficit in the immediate postoperative period, but in only two did these persist. Twenty-one patients (72%) with subarachnoid hemorrhage and 6 with incidental aneurysms made a good recovery. Of the 9 patients with significant permanent deficit, all but 2 were related to either the severity of the initial hemorrhage or to delayed vasospasm. In only one instance might temporary arterial occlusion have led to permanent neurological sequelae. Temporary arterial occlusion with barbiturate protection is a safe technique. For aneurysms that are more surgically complex, it allows for complete dissection of the aneurysm neck and identification and preservation of the surrounding vascular anatomy, while reducing the risk of intraoperative rupture and postoperative stroke. PMID- 2755581 TI - Astroblastomas: a pathological study of 23 tumors, with a postoperative follow-up in 13 patients. AB - Astroblastomas are rare, usually circumscribed, supratentorial tumors of young subjects and are characterized by a perivascular arrangement of the tumor cells. Their clinical behavior is unpredictable and their prognosis has been regarded as intermediate between that of astrocytomas and glioblastomas. A personal series of 23 astroblastomas was reviewed, adequate postoperative follow-up being available in 13 patients. Two distinct histological types were encountered: low-grade and high-grade. The low-grade type comprised tumors with better differentiated and more benign-appearing microscopical features. Five of the 8 patients with tumors of this type who were available for follow-up have survived from 3 to 20 years after treatment; in 1 patient the tumor converted into a fatal glioblastoma after 4 1/2 years. The high-grade type consisted of tumors with more anaplastic features. Three of the 4 patients with tumors of this type available for follow up died after 1 1/2 to 2 1/2 years, the astroblastomas in 2 of them having converted into a glioblastoma and a gliosarcoma, respectively. One patient, however, has had an unexpected length of postoperative survival of 11 1/2 years. The best clinical results were obtained after total or subtotal resection of the tumor, followed by radiotherapy. The role of chemotherapy is still uncertain. This form of glioma illustrates the discrepancies that may sometimes be apparent between histopathological features and length of postoperative survival. The prognosis is also further complicated by the potential of the astroblastoma to convert into a more malignant type of glioma. PMID- 2755582 TI - The efficacy of intravenous nimodipine in the treatment of focal cerebral ischemia in a primate model. AB - The clinical and pathological effects of nimodipine on cerebral infarction were investigated in 12 male baboons. In randomized/blind trials, six animals given intravenous nimodipine (2 micrograms/kg/min load, 1 microgram/kg/min maintenance) for 96 hours starting 50 minutes before 6-hour double-clip occlusion of the middle cerebral artery were compared to 6 control animals. Standardized neurological examinations were performed by examiners blinded to the animals' therapy on Day 7 and Day 14 after stroke. On Day 14 the animals were killed. The brains were studied pathologically, and the relative areas of infarction were quantified. Intracranial pressure was lower in nimodipine-treated animals; however, the range of intracranial pressure values in each group was broad. Two control animals with high intracranial pressure died. There were no deaths among the nimodipine-treated animals. The neurological scores on Days 7 (P less than or equal to 0.01) and 14 (P less than or equal to 0.05) were significantly different between the two groups. The nimodipine-treated animals had less clinical evidence of infarction compared to controls. Nimodipine-treated animals tended to have smaller areas of infarction; however, the difference between the two groups was not statistically significant. The infusion of nimodipine in the treatment of focal cerebral ischemia is safe and does not appear to aggravate the extent of infarction or to exacerbate intracranial hypertension. The clinical neurological evaluations indicate that nimodipine may improve or preserve neurological outcome after stroke. PMID- 2755583 TI - CSF TRAP: a procedure to improve laboratory testing with myelography. AB - CSF TRAP (Transport and Rapid Accessioning for Additional Procedures) is a procedure that provides storage of and rapid access to cerebrospinal fluid (CSF) specimens and allows clinicians to review initial findings before ordering low yield CSF studies. The cost-effectiveness of routinely using the CSF TRAP procedure with myelography is examined in a study group of 819 patients, 74% with disc diseases, spinal stenosis, spondylolisthesis, or pain syndromes, 10% with cancer, and 16% with neuropathies and miscellaneous conditions. Routine studies on CSF obtained during myelography provided little additional clinical information, except for patients with cancer (of 80 patients with cancer, the results of cytological examination of the CSF were positive in 12) and patients with multiple sclerosis, for whom oligoclonal band and IgG analysis provided supportive diagnostic data. The utilization of the CSF TRAP procedure with elimination of unnecessary culture and cytological studies on patients with disc diseases, spinal stenosis, spondylolisthesis, and pain syndromes, reduces myelographic CSF procedures by 20%, for a savings exceeding $14,000. The CSF TRAP procedure allows for a more cost-efficient analysis of CSF obtained using myelography, while providing fluid for analysis in patients with unexpected findings. PMID- 2755584 TI - Giant pediatric aneurysm treated with ligation of the middle cerebral artery with the Drake tourniquet and extracranial-intracranial bypass. AB - Saccular intracranial aneurysms occur infrequently in children, and the incidence of pediatric giant aneurysms is statistically in the same proportion as in adults. The management of these giant aneurysms can be treacherous. This paper presents a case of a 9-year-old boy with a giant aneurysm of the right middle cerebral artery that was successfully managed by ligation of the middle cerebral artery using a Drake tourniquet with the patient awake and by augmentation of the middle cerebral artery circulation with superficial temporal artery-middle cerebral artery anastomosis without excision of the lesion. PMID- 2755585 TI - Luxury perfusion syndrome confirmed by sequential studies of regional cerebral blood flow and volume after extracranial to intracranial bypass surgery: case report. AB - We report a case of luxury perfusion syndrome with temporary neurological deterioration after extracranial to intracranial bypass surgery. A preoperative computed tomographic scan showed no detectable infarct, and the measurement of regional cerebral blood flow showed severe depression of ipsilateral hemispheric perfusion. The patient developed temporary neurological deterioration after bypass surgery, with no recognizable pathological signs on postoperative computed tomographic and angiographic studies. Regional cerebral blood flow and volume were more elevated during the period of neurological deterioration than after the subsequent recovery. This strongly suggests that excessive blood flow directed into chronically ischemic brain through a graft may induce a luxury perfusion syndrome resulting in neurological deterioration. PMID- 2755586 TI - Treatment of acute traumatic internal carotid artery occlusion with extracranial to-intracranial arterial bypass: case report. AB - Ligation of the cervical internal carotid artery resulted in an acute neurological deficit in the dominant hemisphere of a 35-year-old man who suffered a penetrating injury to the neck. Regional cerebral hypoperfusion was suspected because the ischemic symptoms occurred while the patient was fully heparinized. Immediate institution of a barbiturate coma, volume expansion, and placement of a high-flow extracranial-intracranial arterial bypass graft led to rapid recovery of hemispheric function. High-flow extracranial-intracranial bypass grafts appear to be indicated for the treatment of symptomatic cerebral ischemia in selected cases of acute ligation or occlusion of the extracranial carotid artery. PMID- 2755587 TI - The growth of cerebral cavernous angiomas. AB - The natural history of cavernous angiomas is poorly understood, and their growth has rarely been documented. We report three cases of cavernous angiomas that grew to large size in 6 years, 2 years, and 2 months, respectively. An initial computed tomographic scan disclosed no abnormalities in one patient and demonstrated two "minimal" lesions in the other two. The mechanisms of growth of these lesions are discussed; subsequent hemorrhages and capsule formation played a major role in their enlargement. PMID- 2755588 TI - The effect of categorization on verbal memory after temporal lobectomy. AB - Epileptic patients with left or right temporal lobectomies were compared with normal subjects on a verbal memory task involving recall and recognition of categorized and uncategorized word lists. The left temporal group recalled significantly fewer words than the normal control subjects, and recognition performance was also poorer. The right temporal group did not differ significantly from the normal controls on recognition, although differences neared significance on recall. Categorization improved performance in all the groups. The left temporal patients improved if words were presented in order of category membership, but recalled less if category membership was randomized over order of presentation. PMID- 2755589 TI - Sequence ability in parkinsonians, patients with frontal lobe lesions and patients who have undergone unilateral temporal lobectomies. AB - Patients in the early stages of Parkinson's disease were compared with patients who had sustained damage specific to either the frontal or temporal lobes and normal controls on a number of sequencing tests. These tests involved the reproduction of sequences of hand gestures, sequences tapped out on blocks, and sequences of digits. Only the groups with frontal lobe lesions or right temporal lobectomies were impaired on any of these tasks, though no group was impaired on all of the sequencing tasks. PMID- 2755591 TI - Stop consonant production in isolated and repeated syllables in Parkinson's disease. AB - To determine if Parkinson's disease (PD) patients have increasing difficulty as speech tasks become longer or more complex, the timing and accuracy of isolated syllables and repeated sequences of syllables were studied. Acoustic measures of PD patient's syllables were similarly impaired relative to normal controls for both isolated and repeated syllable sequences. Listeners' identification scores were equally high for both types of productions. Unlike previous studies of other types of movements in PD, speech accuracy and timing does not deteriorate as items become longer or more complex. PMID- 2755590 TI - Hemispheric asymmetry of processing temporal aspects of repetitive movement in two patients with infarction involving the corpus callosum. AB - Two right-handed patients with infarction involving the forebrain commissural fibres produced irregular but rapid repetitive movements with their left hands while producing normal movements with their right hands as well as having normal oral expression. The abnormality was more conspicuous when producing slow tapping patterns. When required to reproduce rapid tapping patterns of around 5 beats/sec, one of the patients produced a comparatively regular tapping pattern. Thus, we believe that both hemispheres are equipped with the faculty to produce rapid repetitive patterns and that only the left hemisphere is responsible for the temporal processes involved in producing required repetitive patterns. PMID- 2755592 TI - Right posterior brain-damaged patients are poor at assessing the age of a face. AB - The ability to order unknown faces by age was investigated in right and left brain-damaged patients, divided into posterior and non-posterior groups on the basis of CT scan findings. A face recognition test and a figure ground discrimination test were also given. All three tests were affected by brain damage, but their sensitivity to the locus and side of lesion varied. While no hemispheric difference was found on the figure ground discrimination test, the face age test significantly discriminated patients with right posterior injury from any other brain-damaged group. The face recognition test occupied an intermediate position, with right posterior patients significantly impaired in comparison with right non-posterior patients and marginally impaired with respect to left posterior patients. Aphasia did not affect the performance of left brain damaged patients on any of the tests. The findings are interpreted as evidence that damage of the right posterior hemisphere areas disrupts the structural encoding of visual information. Four prosopagnosic patients were also tested. Only those showing signs of apperceptive agnosia failed on the face age test. PMID- 2755593 TI - Rates of forgetting in normal ageing: a comparison with dementia. AB - This paper examines the effect of normal ageing on the forgetting rate of visuo spatial material in a sample of 74 subjects, aged between 16 and 83. It finds that normal ageing produces a mild acquisition deficit as well as a significant increase in the forgetting rate; and it demonstrates that the relatively rapid rate of forgetting in the elderly cannot be accounted for by differences in the initial level of acquisition. The present result is contrasted with that obtained in studies of dementia and the Korsakoff syndrome, which have demonstrated a profound acquisition deficit but a normal forgetting rate once initial learning has been accomplished. Possible explanations of these differing patterns of results are briefly considered. PMID- 2755594 TI - Perceptual asymmetry in schizophrenia and affective disorder: implications from a right hemisphere task. AB - The patterns of perceptual asymmetry exhibited by normal, schizophrenic, and affectively-disordered subjects on a dichotic tonal discrimination task, were compared. Affectively-disordered subjects' performances differed significantly from those of normal subjects, with normals demonstrating the expected left ear advantage, and affectively-disordered subjects showing no lateral advantage. The performance of the schizophrenic subjects fell between those of the normal and affective groups along a laterality continuum, with paranoid schizophrenic subjects tending to show a larger left ear advantage than non-paranoid schizophrenic subjects. The results do not support the hypothesis that schizophrenic subjects inappropriately transfer processing of right hemisphere stimuli to the left hemisphere, but do suggest that subgroup distinctions may be relevant to hypotheses of lateralized dysfunction in schizophrenia. Further, the performance of the affective group supports previous findings of right hemisphere abnormalities in affective disorder. PMID- 2755595 TI - Shift of functional cerebral asymmetry during the menstrual cycle. AB - This study investigated whether for females, who are said to be less strongly lateralized for cognitive functions than men, hemispheric superiority might depend on the phase of the menstrual cycle. The results show that while asymmetry in lexical decisions did not change throughout the menstrual cycle, asymmetry in face perception decreased linearly from a large right hemisphere superiority during menstruation to a small left hemisphere superiority during the premenstrual phase. This is seen as being relevant not only for the discussion of sex differences in cerebral asymmetry but also for the concept of cerebral organization in general. PMID- 2755596 TI - Hemispheric contributions to drawing. AB - The drawings of 69 consecutive stroke patients with single cerebral lesions on CT and of 33 normal controls, were analyzed by two independent observers using a standardized scoring system. The drawings of left brain damaged subjects (LBD) were more impaired overall than those of right brain damaged subjects (RBD). RBD drawings displayed hemispatial neglect and impaired spatial relationships. LBD drawings were simplified and exhibited low level errors of execution. Lesion size correlated significantly with drawing impairment in RBD but not in LBD. No relationship between intrahemispheric lesion location and drawing quality was found. However, severity of hemiparesis correlated significantly with drawing impairment in LBD. Performance on a visuospatial perceptual task correlated better with overall drawing quality for RBD than for LBD. Our data suggest that neglect and a visuospatial deficit impair drawing in RBD while dominant hand paresis and a conceptual impairment which parallels comprehension impairment contribute to LBD drawing disability. PMID- 2755597 TI - Selective visual attention in Alzheimer's and Parkinson's patients: memory- and data-driven control. AB - An automated visual search experiment was carried out on patients with incipient Alzheimer's disease, non-demented Parkinsonians and healthy controls to test for selective attention control within the framework of the Norman and Bobrow (1975) model. The performances of the Parkinsonians and healthy controls were consistent with the predictions of this model but those of the Alzheimer patients were not. These patients appeared to be no longer sensitive to the facilitation supplied by the stimulus context and to spend most of their residual resources on achieving accuracy. The reduction of their attentional resources possibly interferes with the control of the speed-accuracy trade-off. PMID- 2755598 TI - Effects of cultural background and education on handedness. AB - A 5-item handedness questionnaire was given to 317 subjects in four different groups: (1) 51 Tucano (Amazonian jungle) adolescents (36 male, 15 female); (2) 66 Spanish-speaking adolescents (43 male, 23 female) with similar age and educational background to the Tucano group; (3) 100 urban subjects (50 male, 50 female) with a low educational level; and (4) 100 urban subjects (50 male, 50 female) with a high level of education. Hand preference scores were not affected by sex or educational level. The incidence of left-handedness was lower in the Tucano group than in the other groups, despite the fact that the Tucano culture is a highly permissive one. The two rural groups showed less extreme hand preferences than the urban groups, and the Tucano in particular were less likely to indicate extreme hand preferences on any of the items. These results indicate significant effects of culture and environment on declared hand preference, and may be pertinent to recent discussions of cerebral organization in illiterates. PMID- 2755599 TI - Spontaneous recovery of precise movement and of fixation of position of a limb following extirpation of the somatosensory area of the cortex in dogs. PMID- 2755600 TI - Organization of interneuronal interaction in the cerebral cortex of cats during training in the recognition of visual signals. PMID- 2755601 TI - Influence of a dominant focus, formed in the blink reflex center, on a local defensive reflex in the rabbit. PMID- 2755602 TI - Effect of cerebral neurite-stimulating protein on morphogenesis of organotypical culture of spinal ganglia. AB - We have extracted a cationic protein with a molecular weight of 15,000 kdalton from the hemispheres of rat and bovine brain. Addition of the protein to the nutrient medium of the organotypical culture of chick embryo spinal ganglia results in a considerable (2-2.5 fold) increase in the growth zone of the explants. The neurite-stimulating effect of the protein is observed at a concentration of 10 ng/ml. We observed an intensive longitudinal growth of neurites, an increase in their amount per unit area, a considerable intensification of ramification, and formation of strong anastomoses, numerous dense plexuses, and arcades. Fasciculi of neurites covered with glia are formed. The cerebral neurite-stimulating protein is evidently one of the neuron-growth factors regulating development of the nervous system in the body. PMID- 2755603 TI - Memory and noise immunity in the recognition of emotional state by voice in patients with local lesions of the brain. PMID- 2755604 TI - Psychophysiological characteristics of visual perception of schizophrenic patients with polarization of the occipital and frontal cortex. PMID- 2755605 TI - Effect of CSF from animals with damage to the motor cortex on compensation of motor disorders. PMID- 2755606 TI - Influence of glucose on polysensory properties of neurons of the ventromedial nucleus of the hypothalamus. AB - Using the method of intracellular pickup of neuronal activity, a high degree of convergence of impulses of various modalities onto the cells of the ventromedial nucleus of the hypothalamus was established in cats immobilized by means of diplacin dichloride. Great similarity was identified in the patterns of responses to somatic, visceral, light, and sound stimuli. With intravenous administration of glucose, 32% of the neurons studied increased their convergent capacity, 19% of the cells increased the frequency of spikes, and 23% changed the phase of the reaction. The excitatory type of reaction predominated in the responses of the cells investigated. PMID- 2755607 TI - Interzonal transcallosal connections of the auditory and parietal cortex. AB - Transcallosal evoked potentials arising in the parietal region in response to stimulation of the auditory cortex of the opposite hemisphere were investigated in acute experiments on cats immobilized by tubocurarine. Interzonal transcallosal responses were recorded over the whole surface of the parietal cortex and were of two types: positive-negative and negative-positive. Positive negative EP have a longer response latency and a greater total amplitude of both components. Negative-positive EP disappeared after division of the corpus callosum, whereas positive-negative responses were not significantly changed. Interzonal transcallosal potentials were characterized by the presence of functional interhemispheric asymmetry of individual shape. The right hemisphere was dominant with respect to average amplitude of the negative phase in negative positive responses. The amplitude of the early positive component was greater in the right hemisphere in males and in the left hemisphere in females. The late negative wave in animals of both sexes was greater in the right hemisphere. Late components of the EP had a significantly shorter peak latency in the dominant hemisphere. Characteristics of generation and interhemispheric asymmetry of auditory-parietal transcallosal responses are discussed and compared with visual parietal responses. PMID- 2755608 TI - Changes in reactivity of neurons of the visual cortex under influence of the posterolateral hypothalamus and the nuclei of the midbrain raphe. AB - An analysis of the influence of the posterolateral hypothalamus, which elicits positive reactions in behavioral testing, and of the midbrain raphe nuclei, on the plastic properties of the neurons of the visual cortex, was carried out in acute experimental conditions on diplacin-immobilized rabbits, based on a model of cortical trace processes. The different types of change in the reactivity of cortical cells under the influence of rhythmic sensory stimulation are described. The results of statistical analysis point to a dependence of hypothalamic and serotoninergic influences on the initial reaction of neurons to sensory stimulation. It is demonstrated that the plastic changes in the activity of cortical neurons reveal similar features under the influence both of the "positive" emotiogenic zone of the hypothalamus and of the midbrain raphe nuclei. Similar regularities are observed also in an analysis of the interaction of cortical neurons which were recorded in one microvolume identified by the method of cross-interval histograms. PMID- 2755609 TI - Organization of human higher cortical functions with different forms of reinforcement. PMID- 2755610 TI - [Cervical maturation. Physiologic aspects and pharmacologic implications]. AB - The latest theories on cervical maturation and the techniques of pharmacological induction of labour are summarised. The role of the prostaglandins is particularly stressed both from the physiological viewpoint and as drugs of choice for effective pharmacological induction of uterine cervix. Finally, the personal clinical protocol for the induction and management of labour is reviewed. PMID- 2755611 TI - [Re-epithelialization of ectropion by topical application of an amniotic membrane after long preservation]. AB - Treatment of ectropion of the portio presents numerous applicational problems, not least the psychological one of the woman who often refuses to carry out DTC because she considers it painful and it involves long periods of sexual inactivity. The possibility of using amniotic membranes to rapidly stimulate re epithelization of ectropion of the portion of dimensions greater than 0.5 cm is examined. PMID- 2755612 TI - Polyendocrine failure with hypogonadism. AB - Primary gonadal failure, in males with autoimmune endocrinopathies, rarely has been described. We present a unique case of transient hypergonadotropic hypogonadism in a male with type 2 polyglandular failure (Addison's disease and autoimmune hypothyroidism). PMID- 2755613 TI - Microbiological contamination of the ocean, and human health. PMID- 2755614 TI - Chronic confusional state. AB - An acute confusional state after infarction in the distribution of the right middle cerebral artery has been described. Patient recovery usually is excellent. Some patients, however, do not improve, resulting in a chronic confusional state. PMID- 2755615 TI - Financing medical education. AB - As more health care services are being diverted from hospitals to the ambulatory setting, funding for student and resident training in this setting becomes a problem. This paper details the causes of this problem and proposes some financial solutions. PMID- 2755616 TI - Ammonia encephalopathy. AB - Ureterosigmoidostomy can be complicated by pyelonephritis, renal calculi, hypokalemic hyperchloremic acidosis, and colonic neoplasia. It has been associated with the development of hyperammonemia and encephalopathy in patients with underlying liver disease. We report a rare case of hyperammonemic encephalopathy in a patient with normal liver function. PMID- 2755617 TI - [Excellence of service through excellence in education]. PMID- 2755618 TI - [Policy of the Minister of Health and Social Services for improving health and well-being in Quebec. 1]. PMID- 2755619 TI - [Local Community Service Centers--24-hour service, good evening!]. PMID- 2755620 TI - [The orally handicapped]. PMID- 2755621 TI - [When the nurse makes herself an advocate for youths]. PMID- 2755622 TI - [Being a nurse in a palliative care unit]. PMID- 2755623 TI - [The morning grooming, a preferred tool in intervention]. PMID- 2755624 TI - Violence toward the elderly. PMID- 2755625 TI - AIDS: the heart of the matter. PMID- 2755626 TI - AIDS: time to change. PMID- 2755627 TI - AIDS: universal precautions. A new approach for uncertain times. PMID- 2755628 TI - AIDS: lessons from overseas. PMID- 2755629 TI - Approaching AIDS. PMID- 2755630 TI - AIDS: further down the track. Learning from the Australian experience. PMID- 2755631 TI - AIDS: confronting prejudice. PMID- 2755632 TI - AIDS--a double perspective. PMID- 2755633 TI - The stress of grief. PMID- 2755634 TI - The shock of the new. PMID- 2755635 TI - Internal assessment. 1. PMID- 2755636 TI - Nursing registration: is the state exam necessary? PMID- 2755638 TI - Where are all the patients going? And who's looking after them? PMID- 2755637 TI - AIDS wrap. PMID- 2755639 TI - Manager's primer for developing inner resources. PMID- 2755640 TI - Of bandwagons and partnerships. PMID- 2755641 TI - Evolving quality assurance initiatives in home healthcare. PMID- 2755642 TI - Patient classification and staffing in ambulatory care. PMID- 2755643 TI - A vital link in continuity of care. PMID- 2755644 TI - Medicine vs. nursing, the RCT proposal. PMID- 2755645 TI - Nurses and the media. PMID- 2755646 TI - Hospital perceptions of job satisfaction. PMID- 2755647 TI - 12-hour shifts: panacea or problem? PMID- 2755649 TI - "Middle management" consolidation. PMID- 2755648 TI - Rewarding efficient OR/PACU utilization. PMID- 2755650 TI - Recruitment versus retention. PMID- 2755651 TI - [Immunoglobulins M, G and A as prognostic criteria of the treatment outcome in uveal melanoblastoma]. AB - The level of immunoglobulins M, G, A in 30 patients with uveal melanoblastomas has been compared with results after treatment, different cellular types of uveal melanomas before enucleation and in various terms after it. It was found that for prognosing the outcomes of tumors the determination of the level of immunoglobulins M and G proved to be informative. It becomes lower after combined treatment; higher in spindle cell melanomas, than in mixed and epithelioid ones; lower in the patients survived, than in cases with a lethal outcome. PMID- 2755652 TI - [The absolute light sensitivity of the visual analyzer in sailors during a 10 month commercial voyage]. AB - For the purpose of studying the influence of extreme conditions of a long-term voyage on the functional state of the visual analyser, light sensitivity was studied in 21 seamen. It is shown that adaptation mechanisms regulating light sensitivity have a phase tendency: phase is characterized by a rise of the level of light sensitivity within first 90-120 days of the voyage; phase II--by a gradual fall of the level of light sensitivity beginning from 120-140 days of the long-term voyage. The investigations performed allow to create an informative diagnostic test for a well-grounded therapy intended to widen adaptive possibilities of the system responsible for regulation of light sensitivity. PMID- 2755653 TI - [The results of a method of intraocular correction]. AB - At the present time, intraocular correction is the most optimal up-to-date method of medical and professional rehabilitation of patients with cataract and aphakia, ensuring high functional possibilities of the eye. Now above 300 models of intraocular lenses are known, and the searches continue to find the optimal one as well as its localization in the eye. Most of ophthalmologists consider the best site to be the posterior chamber. The paper analyses results after implantation of four intraocular lens models (anterior chamber, iris-clip, posterior chamber with fixation in the ciliary sulcus or in the lens capsule) in 157 patients, the follow-up period ranging from 3 months to 4 years. High visual acuity, 0.6-1.0 was achieved in 96.8% of patients. The observations have shown that, if stable position of the implant in the eye is achieved at the time of operation and if the patients are properly treated after implantation and followed up for a long-term period, the possibilities of severe complications in the eye are considerably reduced. PMID- 2755654 TI - [Effect of the ascorbic acid of the aqueous humor on the lipid peroxidation process in the eye in primary open-angle glaucoma]. AB - Investigations of aqueous humor in primary open-angle glaucoma have shown a change in its normal contents: decreased ascorbic acid in it and increased secondary products of lipid peroxidation. In patients with glaucoma of stages III and IV, a correlative relationship between them is recorded (r = -0.78). It is suggested that in the pathomechanism of increased intraocular pressure in primary glaucoma activation of the process of lipid peroxidation plays a role due to decreased concentration of ascorbic acid in the aqueous humor, being one of the most important components of antioxidative system of the eye. PMID- 2755655 TI - [Characteristics of the development of cataract models against a background of poisoning]. AB - Biomicroscopic studies of lenses of 300 rabbits subjected to the action of various cataractogenic factors have shown that a combined action of cataractogenic factors (3-aminotriazole and light) as well as of cataractogenic and syncataractogenic factors (carbon tetrachloride) possess a much stronger action, that the isolated effect of such factors, as light of high intensity and 3-aminotriazole. It is shown that under combined action of 3-aminotriazole and carbon tetrachloride ripe cataract develops by the 42nd week and under combined action of light, aminotriazole and carbon tetrachloride--by the 30th week. The isolated action of aminotriazole and light doesn't induce ripe cataract. Aminotriazole produces pronounced cataractous changes 50-60 weeks after administration, the light--80 weeks after the action. A conclusion is made that opacification of the lens is a result of complex causes with many factors and is conditioned not only by photochemical processes in the lens itself and disturbances in the processes of detoxification of free radicals in the tissues of the eye as a whole and in the lens, in particular, but also by changes in the antiradical status of the body as a whole. PMID- 2755656 TI - [Radial keratotomy as the method of choice in the optical correction of myopia and myopic astigmatism]. AB - The paper analyses literature data and personal observations concerning the usage of radial keratotomy as a method of choice for correction of myopia and myopic astigmatism. It is pointed out that till now some rather important aspects of the usage of this operation are not yet comprehensively elucidated. To these aspects belong contraindications to the operation, its late sequelae, peculiar manifestations of age pathology in the eyes after keratotomy and a number of other questions. The author considers that such patients should receive a rather detailed information on the possible complications and outcomes of the operation, in particular on those negative points which are already known. The traditional and surgical methods available in ophthalmology should be regarded not as alternative ones, but as supplementing each other, i.e. as methods of choice. PMID- 2755657 TI - [Steps to enhance the efficacy of the anterior measured keratotomy operation]. AB - Analysis of 5184 anterior measured keratotomies after the S. N. Fedorov's method performed at the Krasnoyarsk Interregional Centre of Ophthalmic microsurgery has shown coincidence of practical results with a computer prognosis in 80% of cases. It is shown that unsatisfactory refractive effect is directly related with irregular incisions of the cornea, its perforation and subsequent coarse scarring of the incisions. The authors have worked out a number of measures for optimization of the operation and treatment of persons with coarse scarring of the cornea in the postoperative period, which allows twice to reduce discrepancy between practical results of the operation and computer prognosis. PMID- 2755658 TI - [Diagnosis of anterior uveitis]. PMID- 2755659 TI - [Use of the preparation optimol in treating primary glaucoma]. PMID- 2755660 TI - [Initial open-angle glaucoma, its diagnosis, local and general drug treatment]. PMID- 2755661 TI - [Late results of transscleral hypotensive low-energy laser therapy of glaucoma]. AB - The paper discusses remote observations (within 5 years) over 64 patients (94 eyes) with open-angle glaucoma after transscleral hypotensive low-energy laser therapy. Before treatment, intraocular pressure was moderately increased in 63 eyes (67%), high--in 31 (33%). In 27 eyes with minimum, moderately expressed dystrophic changes in the anterior segment of the eye, a course of transscleral hypotensive low-energy laser therapy, 1-2 sessions, resulted in normalization of intraocular pressure and improvement of hydrodynamics, remaining stable within the whole period of observation. In 49 eyes with moderately expressed dystrophic changes in the anterior segment of the eye, a course of 3-5 sessions brought about normalization of intraocular pressure, remaining stable within 6-12 months, on the average. In 18 eyes with strongly expressed dystrophic changes in the anterior segment of the eye, a partial hypotensive effect was achieved and the patients were operated a month later. In patients with a normalized intraocular pressure, stabilization of visual functions (visual acuity and visual field) within the whole period of observation is also recorded. PMID- 2755662 TI - [Dynamics of visual function in glaucoma patients treated with various antiglaucoma preparations]. AB - A comparative study of the visual functions dynamics has been conducted in 81 glaucomatous patients (105 eyes) with normalized intraocular tension, treated by hypotensive preparations of various mechanisms of action. The groups of the patients were maximum identical by their characteristics. The follow-up period was 2 years. It was found that visual functions remain stable in patients treated by beta-blockers and their combination with pilocarpine, while, in patients treated by pilocarpine and alpha-stimulators the results were worse. The less effective were anticholinesterase preparations and combinations of pilocarpine with adrenaline. PMID- 2755663 TI - [Drug therapy of initial open-angle glaucoma]. AB - The paper analyses results of long-term general and local medicamentous treatment of 86 patients with open-angle initial glaucoma. The hypotensive preparations were miotics, sympathomimetics, beta-blockers, carbonic anhydrase inhibitors. Regulation of intraocular pressure by means of miotics was achieved in 30% of cases and by means of sympathomimetics--in 53%. The best hypotensive effect with a long-term regulation of intraocular pressure was achieved by means of beta blockers. In order to correct vascular disturbances, angioprotectors, cavinton, rheopolyglucin, 2 courses a year were used. A systematic, pathogenetically grounded medicamentous treatment of initial glaucoma allows to achieve stabilization of glaucomatous process in 88% of cases. PMID- 2755664 TI - [Efficacy of combined conservative treatment of patients with initial open-angle glaucoma]. AB - The effectiveness of complex treatment of patients with the initial stage of glaucoma has been studied in 100 patients, aged from 40 to 85 years. The complex treatment included instillations of pilocarpine, pilocarpine in combination with optimol into the conjunctival sac; the usage of agents improving microcirculation, trophicity, metabolic, oxidation-reduction processes in the body and antisclerotic preparations. The analysis of the results obtained has shown normalization of intraocular pressure in 77% and improvement of hydrodynamic indices in 78% as well as improvement of neurotrophic processes in 86% of patients. The rest of the patients required surgical intervention. PMID- 2755665 TI - [The importance of a new compression test in the diagnosis of preglaucoma and initial glaucoma]. AB - A new compression test with an especially constructed mechanic oculopressor allows to make both functional and tonometric measurements during the test. The method was used in 48 eyes of healthy persons and 196 eyes with advanced, initial glaucoma, preglaucoma and ocular hypertension. The results obtained have shown that the test is effective for detection of preglaucoma and ocular hypertension as well as for differential diagnosis of initial glaucoma and ophthalmic hypertension by the analysis of changes of the blind spot area, the time of restoration of its sizes to the initial state and dynamics of annular compression coefficients at the time of the test. PMID- 2755666 TI - [The causes of a decrease in eye function in open-angle glaucoma]. AB - On the grounds of the analysis of 123 case histories of patients with open-angle glaucoma, for the period of 5-20 years, as well as clinical and sectional observations, the authors make a conclusion that in a part of patients the cause of progression of glaucomatous process in normalized intraocular pressure is a descending atrophy of the optic nerve. It is connected with sclerotic changes in the internal carotid and ophthalmic arteries exerting pulsating pressure on intracranial portions of the optic tract (a "basal factor" of glaucoma). PMID- 2755667 TI - [Clinico-morphologic research on the initial stage of open-angle glaucoma in patients of various ages]. AB - The paper analyses results of clinical examination of patients with initial open angle glaucoma--44 eyes of patients under 44 years of age and 96 eyes of patients above 50--and those of morphologic studies of 16 biopsies of the drainage zone of the eyes obtained at sinusotrabeculectomy in young and elderly patients. A complex investigation of the initial stage of open-angle glaucoma has shown identical clinico-morphologic changes responsible for this form of the disease in patients at any age. This identity is manifested itself by similar hydro- and blood microcirculatory disturbances, changes in the anterior chamber angle structures differing only quantitatively in patients of various age. Some distinctive peculiarities in the course of open-angle glaucoma are also noted in persons of young age. Morphologic studies have revealed qualitative differences in glaucomatous patients of young age, such as specific structures of collagenous fibers peculiar to embryonic period. PMID- 2755668 TI - [The clinical picture and pathogenetic problems in low-pressure glaucoma]. AB - Dynamic examinations of 78 patients with a primary diagnosis of glaucoma with low intraocular pressure and 25 persons without disturbances in intraocular pressure regulation, using up-to-date adequate methods--ultrasound dopplerography, rheography, fluorescence angiography, electron tonography, as well as other traditional methods, allow to make a conclusion that glaucoma with low intraocular pressure is a variant of the development of a typical open-angle glaucoma complicated by involutional changes in the body in a form of chronic vascular deficiency (chronic ischemic neuropathy of the eye). Glaucoma with low pressure should be differentiated from ischemic neuropathy or its outcome. The criterium for a diagnosis of low pressure glaucoma is the presence of changes in hydrodynamic and their progression (intensification of retention in reduced level of intraocular fluid outflow), positive results of unloading tests. A term "primary open-angle glaucoma, chronic vascular deficiency" is proposed. PMID- 2755669 TI - [Surgical results of dissection of the superficial temporal artery in patients with preglaucoma and initial open-angle glaucoma]. AB - Results of superficial temporal artery dissection performed in 42 patients (44 eyes) with preglaucoma and initial open-angle glaucoma have shown no impairement of visual field, visual acuity, optic disc in the period from 0.5 to 1.5 years after it. The increased linear rate of bloodflow after the operation remained stable in 17 eyes of patients with preglaucoma and in 14 eyes of patients with glaucoma. Intraocular pressure became normalized in 20 and 19 eyes as well as intraocular fluid outflow in 14 and 13 eyes, respectively. In both groups there was a tendency to normalization of retinal functions and hydrodynamics of the eye. Thus, the operation produces improvement of regional bloodflow, tonographic and electrophysiologic indices. Its usage is considered to be reasonable, but, when determining indications to it, an individual approach is necessary. PMID- 2755670 TI - [Energy metabolic function in diabetic angioretinopathy]. AB - Electron-microscopic and ultrahistochemical investigations of biopsies of the conjunctiva as well as of iris and retina of 46 patients with diabetes mellitus have revealed disturbances in the ultrastructure, bioenergetics and activity of enzyme processes of the cell at different stages of diabetic angioretinopathy. The increase in activity of peroxide oxidation of lipids in progression of retinopathy is recorded. It is recommended to use antioxidants and agents increasing oxidation-reduction processes. PMID- 2755672 TI - Learning from medical students--Part I. PMID- 2755671 TI - [Transudative myopic maculopathy: pathogenetic validity and comparative effectiveness of laser interventions]. AB - The paper presents a retrospective (5-10 years) analysis of results of treatment in a group of patients (104 eyes) with "moist" myopic maculopathy and initial visual acuity from 0.04 to 0.3. Subretinal neovascular membranes were found in 59% of eyes. Localization of the membranes was subfoveolar in 48% of cases, parafoveolar--in 39%, extrafoveolar--in 13%, the size of them being to 300 micrometers in 28%, from 300 to 800--in 58%, more than 800--in 14% of cases. Comparative assessment of effectiveness of various kinds of laser coagulation, laser stimulation and conservative treatment has shown laser coagulation to be the most effective and pathogenetically substantiated method of treatment of neovascular membranes. The most resultant is laser coagulation by the type of "panmacular" in combination with radical laser coagulation of neovascular membranes (if they are present). The most radical is laser coagulation with preservation of a new point of gaze fixation, ensuring preservation of a rather high visual acuity, 0.3. Laser coagulation has a transient effect only in cases of myopic maculopathy without neovascular membranes. Conservative treatment is ineffective. Mechanisms of therapeutic action of laser coagulation and laser stimulation are discussed. PMID- 2755673 TI - Ethics--what is and what ought to be. PMID- 2755674 TI - Billing confusion. PMID- 2755675 TI - Medical schools to tap liberal arts pool. PMID- 2755676 TI - Are your CME programs as flimsy as the Emperor's new clothes? PMID- 2755677 TI - Developing and maintaining uniformity in the CME site-survey process, Part II. PMID- 2755678 TI - Differences in cancer mortality rates in Ohio communities with respect to uraniferous geology. AB - Populations in areas of uraniferous geology may be at risk from radon emissions. Twenty-eight municipalities were examined as to their location with respect to uraniferous geology. Communities with possible radon risk had higher rates for all cancers and cancer of the respiratory system, but differences were not statistically significant. Some possible reasons for the results are discussed. PMID- 2755679 TI - Clinical evaluation of a samarium/aluminum compound filter. AB - Rare earth compound filters, which offer reduced patient exposure during intraoral radiography, have not been clinically evaluated for their effect on diagnostic yield. This clinical study was conducted to compare the diagnostic yield of bitewing radiographs exposed with a conventional aluminum filter with matched bitewing radiographs exposed with a samarium/aluminum compound filter. One hundred sixty-three pairs of bitewing radiographs were read independently by two reviewers for absence or presence and depth of proximal carious lesions. Degree of agreement between films was assessed by means of the kappa statistic. Results showed good agreement between the radiographs exposed with each filter type. Thus, x-ray machines modified with a samarium/aluminum rare earth compound filter produce bitewing radiographs of comparable diagnostic yield and lower dose when compared with radiographs exposed with a conventional aluminum filter. PMID- 2755680 TI - The focal trough of the Autopan panoramic dental x-ray machine. AB - The focal trough of the Autopan machine was evaluated with a multiline test object. The width of the focal trough varied from 5.5 mm anteriorly to about 23 mm in the midramus area with 1.7 line pairs per millimeter of resolution. The focal trough covers most tooth position areas. The machine is capable of producing clinically acceptable radiographs in most clinic populations. PMID- 2755681 TI - Reevaluation of the Fexitron 845. AB - The concept of flash radiography resulted in the development of the Fexitron 845 in the 1960s. Limitations in the technology of screen films (calcium tungstate) at that time displaced the Fexitron as a useful adjunct for clinical dentistry. The recent introduction of the more efficient rare-earth screens requires a reevaluation of the Fexitron 845. This study retests the efficacy of the Fexitron 845 for clinical diagnosis. PMID- 2755682 TI - Missing endodontic reamer. PMID- 2755683 TI - Reamer in the maxillary antrum: a complication of periapical surgery. PMID- 2755684 TI - Discomalleolar and anterior malleolar ligaments: possible causes of middle ear damage during temporomandibular joint surgery. AB - Damage to structures within the middle ear during surgical manipulation of the temporomandibular joint (TMJ) has been reported. Two structures are proposed as possible intermediaries in this trauma: the discomalleolar ligament (DML), which passes from the malleus to the medial retrodiscal tissue of the TMJ, and the anterior malleolar ligament (AML), which connects the malleus with the lingula of the mandible via the sphenomandibular ligament (SML). It has been hypothesized that when tension is applied to the DML and/or AML, the resulting movement of the malleus could cause damage to the tympanic membrane and associated structures. The objective of this study was to determine whether tension applied to the DML and/or the AML could cause movement of the malleus. With the use of a superior medial approach through the middle cranial fossa, the ligaments connecting the malleus with the mandible were examined in 52 adult/human cadaveric half-heads. Tension applied directly to the SML resulted in movement of the malleus in three specimens. Similar tension applied to the DML did not cause movement of the malleus. Histologic evidence showed a continuity of fibers between the SML and AML. When the mandibular condyle was distracted inferiorly, tension was demonstrated in the SML. The results indicate that the AML via the SML has the potential to cause middle ear damage and is more likely to do so than the DML. PMID- 2755685 TI - Imaging orofacial tissues by magnetic resonance. AB - Magnetic resonance imaging was used to study the human orofacial complex. Two imaging methods, a fixed head coil and a surface coil, were used. Images from a database of 31 subjects revealed details of many structures including the masseter, temporal, medial and lateral pterygoid muscles, the teeth, articular condyles, and facial bones. A dentigerous cyst and a maxillary sinus "polyp" were also identified. Our study demonstrates the utility of this imaging modality in the identification and localization of soft tissue lesions. The strengths and weaknesses of the technique and its clinical potential are discussed. PMID- 2755686 TI - Bilateral coronoid hyperplasia. Report of a case. AB - A case of bilateral coronoid hyperplasia is presented. This is a developmental abnormality that occurs primarily in males and is characterized by progressive, asymptomatic limitation of mandibular movements. The condition is usually detected shortly after the age of puberty. A diagnosis is usually made on the basis of the history and the radiographic findings. Surgical removal of the elongated coronoid processes, along with good postoperative range-of-motion exercises, will restore full mandibular movement. PMID- 2755687 TI - Congenital hemifacial hypertrophy. Report of two cases. AB - Two cases of congenital hemifacial hypertrophy are described. To our knowledge, this is the first report of this syndrome in a black African population. Possible diagnostic problems are highlighted. PMID- 2755689 TI - Oral lichenoid dysplasia: a clinicopathologic analysis. AB - Three women had a diagnosis of oral lichen planus (OLP), which was made on the basis of clinical and histologic features. All three had persistent burning pain associated with large mucosal lesions. Changes in the color (red, red and white, white), configuration, and severity of the lesions were unpredictable and did not correlate well with topical corticosteroid therapy. Only one patient used tobacco (cigarettes)--this patient had recurrent oral candidiasis and was receiving multiple medications. One of the two nonsmokers was a denture wearer with a single episode of candidiasis. After 63, 32, and 56 (mean 50) months, carcinoma developed in all three. In retrospect, the initial biopsy specimens of two patients exhibited lichenoid dysplasia, whereas that of the third showed only lichenoid mucositis. Although speckled erythroplakia was the earliest clinical sign of a classic, nonregressing premalignant lesion, it already signaled the presence of invasive carcinoma. Some early epithelial dysplasias appear to have a robust inflammatory/immunologic response to the antigenically (but as yet not histologically) altered dysplastic epithelium and a high probability of at least temporary resolution. Mucosal erythema of obscure origin displaying spontaneous, usually temporary, partial to complete regression may be common to both purely inflammatory conditions like lichen planus and early epithelial dysplasia. We contend that some, if not most, cases of apparent malignant transformation of OLP likely represent red and white lesions that were dysplastic from their inception but that mimic OLP both clinically and histologically. PMID- 2755688 TI - Oral mucosal lesions: association with the presence of antibodies to the human immunodeficiency virus. AB - To assess the relationship between oral lesions and antibodies to the human immunodeficiency virus, oral examinations of 803 homosexual males were conducted at the time of serologic testing. Nineteen percent were HIV seropositive. Thirty percent of antibody-positive subjects had one or more oral lesion(s), as compared with 7% of antibody-negative subjects (p less than 0.001). The presence of oral lesions was significantly associated with HIV seropositivity: a subject was 5.7 times as likely to have serum antibodies if he had one or more oral lesions (95% confidence interval, 3.5 to 9.1; p less than 0.001). This significant association with HIV seropositivity was only partially explained by cigarette smoking (adjusted odds ratio 3.1; 1.4-6.8; less than 0.006). Specific conditions that were significantly associated with seropositivity included candidiasis, hairy leukoplakia, periodontal disease, and Kaposi's sarcoma. Other diseases identified included acute necrotizing ulcerative gingivitis, mucocutaneous ulcerations, and oral warts. Oral findings may occur earlier in the natural history of infection than previously reported. PMID- 2755690 TI - A case of benign cementoblastoma. AB - A rare case of benign cementoblastoma is reported. Active cementoblasts adding cementoid tissue were observed histologically by means of specific staining for unmineralized matrix of hard tissue. A polarizing microscope and an x-ray diffractometer were used to clarify the cementum-like tissue of benign cementoblastoma. The collagen bundles of tumor tissue showed irregular and random arrangements under polarized light. The qualitative analysis revealed that the mineralized component was composed of low-crystalline hydroxylapatite. PMID- 2755691 TI - "Aggressive" osteoblastoma of the maxilla. AB - A case of osteoblastoma in the maxilla of a 6-year-old boy is reported. The tumor was clinically characterized by locally aggressive behavior but histologically consisted of a relatively well-circumscribed mass of bone-producing epithelioid osteoblasts and occasional multinucleated osteoclasts characteristic of osteoblastoma. Radiographically the tumor appeared to penetrate the cortical plate. Because of the size of the lesion, its histologic features, and the clinical and radiographic impression of its being poorly confined, the diagnosis of "aggressive" osteoblastoma was rendered. The problem of differentiating between benign and aggressive forms of osteoblastoma is discussed. PMID- 2755692 TI - An evaluation of sealing ability of calcium hydroxide sealers. AB - Solid core filling material such as gutta-percha has been used to fill the root canal in conjunction with a sealer to prevent apical leakage. The purpose of this study was to compare apical seal of five different root canal sealers. Sixty roots of maxillary central incisors were cleansed and shaped and randomly assigned to one of six groups of ten roots each. The root canals were obturated with gutta-percha and one of the sealers by the lateral-vertical condensation technique. Groups I, II, III, IV, and V consisted of roots in which the canal was filled with gutta-percha along with either Roth's sealer, AH26, Sealapex, CRCS, or Nogenol sealer, respectively. Group VI was filled with gutta-percha and without sealer to serve as a control. The access opening was filled with amalgam. Each tooth was then placed in a capped vial containing 2 X 2 inch gauze pads saturated with distilled water, and the sealer was allowed to set at 37 degrees C in the humidor for 48 hours. The roots, except for the apical 2 mm, were coated with two layers of nail polish. The roots were stained with india ink, decalcified, dehydrated, and then placed in methylsalicylate to make them transparent. The leakage was measured with a filar micrometer eyepiece under a dissecting microscope. The mean apical leakage of six groups was as follows: I = 0.45 mm, II = 0.277 mm, III = 0.343 mm, IV = 0.263 mm, V = 0.336 mm, and VI = 2.310 mm. Results showed no significant difference in the apical seal produced by gutta-percha and the tested root canal sealers.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2755693 TI - The eruption of third molars in adults: a 10-year longitudinal study. AB - Among 829 participants of the Veterans Administration Dental Longitudinal Study examined over four triennial cycles, 97 persons (11.7%) had one or more unerupted third molars, for a total of 151 teeth, when the study was initiated. During the first 10 years of the study, 10 subjects had 14 unerupted third molars extracted, while in 10 persons 11 third molars erupted. Four of the latter persons each had one third molar removed subsequent to eruption. Three of the 11 erupted third molars were in functional occlusion. The position of 4 of the 11 "erupting" third molars appeared to remain unchanged relative to radiographic landmarks. Thus, their apparent clinical eruption may have been due to a reduction in the level of the gingival tissue in the area distal to the second molar tooth in association with periodontitis. The eruption of third molars in older adults appears to be a more frequent phenomenon than was previously recognized. Most erupting third molars had some associated pathologic condition, including caries and periodontitis. PMID- 2755694 TI - The role of a dental operating microscope in improved nonsurgical treatment of "calcified" canals. AB - Three cases illustrating successful nonsurgical treatment of "calcified" canals are presented. Careful round bur drilling through dense calcified deposits in the pulp chamber and into the canal may uncover a treatable apical canal remnant. The dental operating microscope (Dentiscope) is an invaluable aid. PMID- 2755695 TI - Bacterial growth inhibition produced by root canal sealer cements with a calcium hydroxide base. AB - Inhibition of growth of six bacterial strains produced by two root canal sealers with a calcium hydroxide base, CRCS and Sealapex sealers, is studied. The results are compared with those obtained with two zinc oxide eugenol sealers and one epoxy resin. The inhibition produced with the calcium hydroxide sealers is similar to that obtained with the other sealers. The component of paraformaldehyde in a sealer increases the inhibition significantly. PMID- 2755696 TI - [Changes and progress in surgical treatment of fractures of the pelvic ring and acetabulum]. AB - The diagnosis and treatment of pelvic fractures and dislocations demand that the pelvic girdle and the acetabulum be examined separately. Fractures of the pelvic girdle are present in more than 60% of cases but have to be stabilized only in 9%, in contrast to acetabular fractures, which need to be reduced and internally fixated in 55%. Combined fractures need surgical management in 66% of cases. Fractures of the pelvic girdle are best diagnosed by means of plain radiograms and computed tomograms to distinguish posterior instability. These techniques are the basis of the treatment plan for external or internal fixation. External fixation is an effective method from the aspect of hemorrhage control but not sufficient to avoid postoperative pain. Early open reduction and internal anterior and posterior fixation is the treatment of choice if good rehabilitation is to be achieved. Acetabular fractures occur mostly in young patients. Only accurate articular reduction of displaced fractures can bring about a good functional result, as this minimizes posttraumatic arthritis. Radiological evaluation is done with three standard views: 1. A. P. X-ray of the pelvis; 2. oblique view of the obturator; 3. oblique view of the ilium. When those are considered in combination with a CT scan, acetabular fractures can be classified. The Letournel classification is extremely important for reduction and fixation, as no one surgical approach has been found that is satisfactory for all acetabular fractures. Internal stabilization is provided with single screws and plates. PMID- 2755698 TI - [Progress and changes in the treatment of shaft fractures of the femur and tibia]. AB - The historical development of the treatment of shaft fractures is outlined. Nowadays there is a number of possibilities for the treatment of shaft fractures: conservative and surgical methods. Operative treatment can be done with screws and plates, with intramedullary or interlocking nailing, and with external fixators. The advantages and risks of the various methods are explained. We should now no longer ask what the best method is for any fracture, but rather what method will provide the best prospects of healing in a particular pattern of injury. PMID- 2755697 TI - [Changes and progress in the treatment of fractures of the coxal end of the femur]. AB - Consideration of technical developments, a review of the literature and of our own experience with 535 patients compared with nearly 20,000 patients of an ASIF population treated during the same period show that the indications for treatment of extra- and intracapsular fractures of the proximal femur have become much simpler. (1) Extracapsular fractures of the proximal femur fall into two groups: pertrochanteric fractures are fixed by means of the dynamic hip screw and intratrochanteric unstable fractures by means of either the dynamic hip screw (valgus type) or a 95 degrees condylar plate. (2) Intracapsular fractures are treated according to the patient's age group. In patients younger than 70 years femoral head preservation is achieved by compressing screw osteosyntheses, while in patients over 70 years head resection is performed an a total endoprothesis inserted. In patients with life expectation shorter than 3-5 years a femoral head prothesis is inserted. PMID- 2755699 TI - [Changes and progress in fracture treatment of the humeral shaft]. AB - Most humeral shaft fractures are treated by early functional mobilization (Sarmiento-Bracing). In some situations (short transverse fractures, old age of patients living alone, extreme obesity, social circumstances) operative fixation may be warranted in individual patients. There are, however, several absolute and urgent indications for operative fracture stabilization: fractures involving nerve or vessel injury, open fractures, multiple fractures on the ipsilateral arm, and delayed fracture healing. Osteosythesis with a dorsally placed femoral DC plate gives the best results. PMID- 2755700 TI - Autocrine interaction between TGF alpha and the EGF-receptor: quantitative requirements for induction of the malignant phenotype. AB - Alterations affecting the epidermal growth factor (EGF)/transforming growth factor alpha (TGF alpha)-responsive mitogenic pathway are frequently detected in malignancies. In particular, the EGF-receptor (EGFR) molecule has been found overexpressed in a number of human tumors, and TGF alpha is produced by a large array of tumor cells. Gene transfer experiments have previously demonstrated that expression of either TGF alpha or EGFR alone is not sufficient to induce the transformed phenotype in NIH3T3 cells. In this study we sought to investigate the biological effect of expression of TGF alpha and high levels of EGFR in this model system. We demonstrate that the gene for TGF alpha acts as a potent oncogene in NIH3T3 cells overexpressing EGFR (NIH-EGFR, greater than 10(6) EGFR). We further show that TGF alpha directly stimulates proliferation of the cell in which it is produced and provide evidence that the extracellular compartment of the transformed cell is the major site of interaction between TGF alpha and EGFR. Analysis of human tumor cell lines revealed a strong correlation between expression of TGF alpha and overexpression of EGFR. Moreover, high levels of EGF independent tyrosine phosphorylation of the EGFR were detected both in NIH-EGFR expressing TGF alpha and in high EGFR and TGF alpha coexpressing human tumor cell lines. Thus, the two events instituting the EGFR/TGF alpha autocrine loop responsible for transformation in vitro may play a role in the development of some human malignancies. PMID- 2755701 TI - Studies of the retinoblastoma gene in human sarcomas. AB - The retinoblastoma susceptibility gene, (RB), is a tumor suppressor gene which, when deleted is associated with the development of retinoblastoma. The observation that children with heritable retinoblastoma frequently develop second malignancies, principally sarcomas, led to the detection of similar RB gene deletions in some osteosarcomas. We studied 44 unselected sarcomas from patients with no antecedent retinoblastoma to determine the prevalence and nature of RB gene alterations. DNA and RNA were extracted from fresh tumors and analysed by Southern and Northern blotting. Three of nine osteosarcomas and 4 of 29 soft tissue sarcomas had deletions of the RB gene. Four of these were full-length, and three were partial deletions of the gene. RNA from 5 of the 7 deleted tumors was studied, and 4 cases completely lacked the RB transcript. Transcripts were found in 19 of 20 tumors with an apparently intact RB gene, and in all the normal tissues studied. An additional tumor lacked the RB transcript, but the gene appeared intact at the DNA level. In total, 8 of 38 sarcomas were found to have alterations of the RB gene. These data indicate that the RB gene is inactivated in a significant number of sarcomas unrelated to retinoblastoma, and that the potential role for the gene in the pathogenesis of human malignancy may not be limited to retinoblastoma. PMID- 2755702 TI - Metastatic conversion of factor-dependent lung fibroblasts (CCL39) requires over expression of oncogenes which induce high rate of autonomous replication. AB - Several classes of oncogenes were tested for their ability to confer cellular growth autonomy and the metastatic phenotype on CCL39 lung fibroblasts. v-sis as well as highly but not weakly expressed activated ras, v-fps and myc genes were susceptible to relieve CCL39 cells from their dependence on exogenous growth factors. However, based on growth rate estimations, ras and fps cells divided 2 to 3 times more rapidly than myc and sis cells in serum-free medium. All ras and fps cells produced pulmonary metastases in 60-100% of young nude mice, following subcutaneous or intravenous injection. Acquisition of factor-independent growth during in vivo passage was demonstrated in two instances. Animals developed either no or sporadic metastases after implantation of transfected cells expressing v-sis, normal Ha-ras, myc or no foreign oncogene. The results are consistent with the notion that the rate at which tumor cells can proliferate independently from growth factor stimulation is a good predictor of their metastatic potential. Oncogenes such as activated ras and fps appear more efficient than myc and sis to induce the metastatic conversion of preneoplastic CCL39 cells and to abrogate Go-arrest controls of division. PMID- 2755703 TI - Depression in chronically ill patients. PMID- 2755704 TI - Our bellwether for the 21st century--AIDS. PMID- 2755705 TI - The "window of negativity" of HIV antibody tests. PMID- 2755706 TI - Who dropped the ball on tort reform? PMID- 2755707 TI - Pressure pain thresholds in normal muscles: reliability, measurement effects, and topographic differences. AB - This project sought to determine measurement effects, topographic variability, and reliability of pressure pain thresholds (PPT) as an index of normal tenderness in the masseter and temporalis muscles of non-patient subjects. PPTs were measured using the ascending method of limits in 10 subjects. The PPT over 5 trials at each of 5 temporalis sites and 10 masseter sites was measured in 1 experiment. Interpretation of the data with repeated measures analysis of variance indicated that the PPT was significantly higher in the temporalis than in the masseter; additionally, the PPT at a tendon area was significantly higher than at the belly area. These differences should be considered in reducing unwanted variability in PPT measures, receptor distribution, and in inference based on patient examination. There were no differences in the PPT over 5 trials and, thus, no measurement effects. The mean of the first 2 trials at each site appeared to give a better estimate of the PPT than the data from either the first trial or second trial alone from that site. In a second experiment, the PPT was measured in 2 trials at each of 4 sites over 5 sessions. The between-session PPT across multiple sessions was reliable and without differences. PMID- 2755708 TI - Comparison of one technique of patient-controlled postoperative analgesia with intramuscular meperidine. AB - We have compared analgesic requirements, perceived pain, and self-assessment of 'health locus of control' for 72 h in 88 subjects after cholecystectomy, randomized to either a standard technique of self-administration of meperidine (patient-controlled analgesia, PCA) or to intramuscular injections on demand (i.m.). Multivariate analysis revealed no statistical differences between group scores for pain (over any 24 h period) and only minor differences in total meperidine administered. However, the PCA group received significantly less analgesic in the first 24 h (P less than 0.01) and described significantly more pain over the first 4 h (P less than 0.01). Assessment of 'health locus of control' did not show any marked changes. Analysis of patient questionnaires suggests more enthusiasm for patient-controlled analgesia, but in this study, it was difficult to clearly demonstrate any significant advantage for pain management or amount of opiate administered. PMID- 2755709 TI - Pain development and consumption of analgesics after oral surgery in relation to personality characteristics. AB - In the present study a survey has been performed of the pain development and analgesic intake in 100 patients following elective oral surgery of impacted third molars in relation to preoperative assessment of personality characteristics. Our results show that no sex differences existed preoperatively concerning personality characteristics, concerning postoperative pain development or analgesic consumption. Fourteen patients reported no pain at all and 40 patients did not use any analgesics in the postoperative period. We also found a good correlation between total sum of pain scores and analgesic intake. Patients undergoing surgery in the morning reported a lower total sum of pain scores, reported pain at fewer occasions and tended to require less analgesics than patients being subjected to surgery in the afternoon. The patients who reported a total sum of pain scores in the upper percentile during the postoperative period rated their general health worse, as rated on the General Health (GH) questionnaire, and used more analgesics than did patients in the lower percentile. Also, patients not using any analgesics reported less symptoms of distress according to the GH scale as compared to patients using analgesics. In general, however, less than 10% of the variance in postoperative pain and consumption of analgesics could be explained by the preoperative factors studied. PMID- 2755710 TI - The influence of physical and psychosocial factors on accuracy of memory for pain in chronic pain patients. AB - Pain patients' retrospective reports of pain are important to physicians and other health professionals in helping to decide on future treatment plans. Unfortunately patients' memory of pain can be inaccurate and subject to overestimation. This study examined variables which influenced accuracy of remembering pain in 93 chronic pain patients. The patients were initially evaluated by a physician and completed a comprehensive pain questionnaire and an SCL-90. All patients were asked to monitor their pain intensity every hour for 1 week. At the end of this period each patient was asked to estimate their average pain intensity ratings for 4 times during the day for the previous week. These estimations were compared with the actual mean pain ratings. Results showed that most patients tended to overestimate their pain intensity levels. Cervical and low back pain patients were found to be more accurate than headache and abdominal pain patients in remembering their pain. Patients who reported more emotional distress, who had conflicts at home, who were less active and who relied on medication tended to be the most inaccurate in remembering their pain. PMID- 2755711 TI - Comparison of verbal and visual analogue scales for measuring the intensity and unpleasantness of experimental pain. AB - Although the multidimensional nature of pain is now well recognized, there are, nevertheless, very few quantitative tests to measure the separate dimensions of pain and little data concerning their relative sensitivity. The present study compares 2 currently available methods, verbal descriptor and visual analogue scales. Eight subjects rated painful and near-painful heat stimuli by using visual analogue scales for intensity or unpleasantness and by choosing the most appropriate phrases from lists of intensity or unpleasantness descriptors. In the intensity dimension, the relationship between perception and stimulus temperature was essentially identical whether calculated from the visual analogue or verbal descriptor scales. However, data derived from the verbal descriptor scales revealed that subjects rated the painful temperatures as relatively more intense than unpleasant; this difference could not be detected using the visual analogue scales. These results confirm that both visual analogue and verbal descriptor techniques successfully quantify sensory intensity and affective aspects of pain, but that verbal descriptors may provide the more sensitive tool for separating intensity and unpleasantness. PMID- 2755712 TI - The cold pressor pain paradigm in children: feasibility of an intervention model (Part II). AB - The purpose of this study was to examine the feasibility of testing a psychological approach (hypnosis) to pain reduction in children using the cold pressor paradigm. Children's pain ratings at 10 sec intervals and duration of arm immersion (40 sec maximum) in 15 degrees C (n = 37) and 12 degrees C water (n = 29) were assessed in 6-12-year-old children during 2 baseline trials (alternating arms), followed by 2 more trials after randomization to a control or hypnosis treatment condition. Hypnosis was found to reduce pain significantly more than the control condition in both 15 degrees C and 12 degrees C water. Hypnotic susceptibility was not strongly related to hypnotic pain reduction. However, age was significant, with younger children showing higher pain ratings and early arm withdrawal rates and less response to hypnosis than older children. In 15 degrees C water, females had higher pain ratings and early withdrawal rates than males, but this sex discrepancy disappeared in 12 degrees C water. This study demonstrated the feasibility of the cold pressor paradigm for testing intervention strategies and its potential for enhancing our understanding of pain in children. PMID- 2755713 TI - Relief of persistent postamputation stump and phantom limb pain with intrathecal fentanyl. AB - Two patients with postamputation stump and phantom limb pain respectively responded favorably to intrathecal fentanyl which temporarily abolished the pain, normalized sensations and produced euphoria without supraspinal effects. One of the patients subsequently received intrathecal, extradural and intravenous fentanyl as well as intrathecal lidocaine. The neuraxial (intrathecal and epidural) fentanyl temporarily abolished the pain. Intravenous fentanyl and intrathecal lidocine were unable to reproduce this effect. Neuraxial fentanyl apparently produced its effects by a segmental spinal action. Spinal modulation of postamputation pain was important in these patients. PMID- 2755714 TI - [Features of blood lipid composition during emotional stress in rabbits with dyslipoproteinemia]. AB - Only the concentration of essential fatty acids increases in blood serum under the effect of emotional stress in intact rabbits. In experimental dyslipoproteinemia, emotional stress, besides increasing the amount of essential fatty acids also causes marked changes of lipid metabolism of an atherogenic character. The mechanisms of lipidemia activation and maintenance are discussed. PMID- 2755716 TI - [Lipid peroxidation as a mechanism of bioenergetic regulation in inflammation of the respiratory organs]. AB - Oxidative phosphorylation, the content of lipids, diene++ conjugates, and malonic dialdehyde, catalase activity in hepatic mitochondria, and antioxidative activity of the postmitochondrial fraction of the liver were studied during the development of inflammation of the lungs in rats (in periods of 3 days to 3 months). The metabolic condition of the mitochondria changes in these periods of the disease from limited hyperactive to inhibited hyperactive with diminution of oxidation and phosphorylation conjugation. This is attended by an increase of the relative content of lipids (increase of diene++ conjugate and decrease of malonic dialdehyde level). Changes of catalase activity correlate with the dynamics of changes of the phosphorylation coefficient. It is assumed that the regulation of bioenergetic processes is realized by modification of the mitochondrial membrane structures, increased utilization of lipids as a respiratory substrate, as well as by changes in the activity of the factors of lipid peroxidation control which may be regulators of oxidation and phosphorylation conjugation. PMID- 2755715 TI - [Comparative characteristics of the lipid composition of lipoproteins of the blood plasma and ascitic fluid in liver cirrhosis]. AB - Comparison of phospholipid content in different fractions of lipoproteins of the ascitic fluid and blood plasma showed selective accumulation of high density lipoproteins (HDLP) in the ascitic fluid. The ascitic fluid HDLP differed from blood plasma HDLP in a larger fraction of triglycerides and cholesterol oleate. No significant difference was revealed in the lipoprotein (LP) low density lipid spectrum in the two fluids. The very low density LP (VLDLP) of the ascitic fluid differed from blood plasma VLDLP by higher ratios of phosphatidylcholine (PC) (sphingomyelin and PC) unesterified cholesterol; the PC in VLDLP of the ascitic fluid had a relatively higher content of linoleic and oleic acids. It is suggested that the detected differences are associated with dynamic insufficiency of lymph drainage in portal hypertension, as the result of which LP of intestinal genesis, spreading in the interstitium of the wall of the small intestine, enter the abdominal cavity by bypassing the blood plasma. PMID- 2755718 TI - [Pulmonary surfactant in guinea pigs after toxic exposure to CCl4]. AB - The surface-active properties of lung surfactant were studied in 32 guinea pigs given CCl4 according to a schedule. The surface activity of the surfactant is inhibited in the experimental animals under the effect of hepatotrophic poison (CCl4) due to the disturbed metabolism of its phospholipids, which is a consequence of the diminished lipid-synthesizing function of the liver. Diminution of the surface-active properties of the lung surfactant and disturbance of its qualitative composition may be regarded as the cause of the development of extensive atelectases in the animals' lungs. PMID- 2755717 TI - [Changes in the pulmonary surfactant system and induced chemiluminescence of pulmonary washings after fasting and the effect of alpha-tocopherol on them]. AB - A complex of methods was used to study the pulmonary surfactant system and the intensity of induced chemoluminescence of pulmonary washings in rats after 4-week fasting and the effect produced on them by alpha-tocopherol. During fasting changes occurred in the values of surface activity of pulmonary washings, extracts, stability coefficient, and intensity of induced chemoluminescence; this was evidence of exhaustion of the intracellular surfactant reserve and intensification of lipid peroxidation. Administration of alpha-tocopherol during fasting reduced the disturbances in the pulmonary surfactant system of the animals and the degree of increased lipid peroxidation activity which indicates that the antioxidant protects the unsaturated fatty acids from oxidation. PMID- 2755719 TI - [Participation of the lungs in the absorption and liberation of biogenic amines in the postresuscitation period]. AB - After revival from a 10-minute clinical death caused by acute blood loss the transport of biogenic amines to the lungs in dogs did not increase for 3 hours. Their absorption by the lungs was replaced periodically by their liberation; both processes were intensified for serotonin but weakened for histamine. In 6-9 hours during the period of hypoperfusion and reduction of the transport of amines to the lungs the intensity of absorption and liberation of serotonin by the lungs were normalized, while these processes for histamine remained diminished. The content of biogenic amines in arterial blood reduced. Twenty-four hours later, under conditions of normalization of hemodynamics, the transport of histamine to the lungs and its concentration in blood were still reduced, while the transport and absorption of serotonin by the lungs, as well as its content in arterial blood, increased; this was attended by an increase in total pulmonary resistance and the development of moderate hypoxemia. Animals who died subsequently had a higher level of serotonin in arterial blood but a lower level of histamine. The role of the lungs in homeostasis of blood biogenic amines in the postresuscitation period is discussed. PMID- 2755720 TI - [Dynamics of venous blood return in normal conditions and in patients with obstructive lung disease]. AB - The venous blood flow in the jugular, cubital, and inferior cava veins was studied in 7 healthy individuals and in 22 patients with chronic obstructive bronchitis by means of bichamber Doppler ultrasonography and direct measurement of venous pressure. The diameter of the veins, blood flow rate, and venous pressure were found to be greatly determined by the intrathoracic pressure variations during the respiration cycle. It is suggested that distention of the peripheral veins, which is the commonly accepted sign of right-ventricular insufficiency, in patients with drastic bronchial obstruction is a consequence of disturbed mechanics of respiration, namely, increase of intrathoracic pressure during expiration, which impairs the return of venous blood to the right parts of the heart. PMID- 2755721 TI - [Diminution of the hypoxic effect of conjugate functions in skeletal muscles under the action of gamma-oxybutyric acid]. AB - The resistive, capacitive, and exchange function of vessels in hypoxia (8% O2) was studied on cat shank muscles isolated in relation to hemodynamics. The perfusion pressure reduced by 28%, the pre- and postcapillary resistance by 32 and 35%, the capillary hydrostatic pressure by 12%. The venous flow increased by 0.13 ml/100 g, the capillary filtration coefficient by 58%. Infusion of sodium salt of gamma-oxybutyric acid (GOBA) (10 mg/min) into the region caused lesser changes of parameters while the venous flow increased by 0.63/100 g. Combination of hypoxia and infusion of the agent stabilized precapillary resistance, capillary hydrostatic pressure, and venous flow within ranges close to the initial background, while the capillary filtration coefficient increased by 25%. Changes of perfusion pressure and postcapillary resistance were similar to those recorded under conditions of control hypoxia. The mechanisms of the effect of GOBA sodium salt on conjugate functions of vessels of the skeletal muscles in hypoxia are discussed. PMID- 2755722 TI - [Effect of hyperoxia on systemic hemodynamics, microcirculation, and oxygen regimen in rats in replacement of massive blood loss by albumin]. AB - Experiments were conducted on rats to study systemic hemodynamics, microcirculation, and oxygen regimen in the organism in replacement of massive blood loss with albumin solution in normo- and hyperoxia. The results suggest that in breathing oxygen conditions are created in the organism for fuller realization of the mechanism of compensatory increase of the minute circulation volume in replacement of blood loss by a blood substitute, as a result of which total oxygen consumption increases and microcirculation is restored more adequately. PMID- 2755723 TI - [Experimental therapy of thermal burns with biogenic peptide-containing preparations]. AB - The authors studied the therapeutic activity of biogenic peptide-containing preparations derived from microbial cell membrane fractions, solcoseryl, and plasma alcohol extract (PAE) in experimental thermal trauma. Treatment of the burnt animals with solcoseryl and PAE reduced mortality to 40-42%, accelerated the healing of the burn wound, restored the behavior status, and increased the intensity of oxygen consumption. This is evidence of the promising character of further studies of the biological activity and therapeutic properties of these preparations. PMID- 2755724 TI - [Depression of penicillin-evoked seizure discharges of cerebrospinal neurons by magnesium ions]. AB - In experiments on narcotized spinal cats perfusion of the lumbosacral segments of the spinal cord with penicillin (50 mmol/l) containing artificial cerebrospinal fluid led to the appearance of spontaneous negative small potentials in the dorsal roots and spontaneous repetitive bursts of impulses in the ventral roots of the perfused segments. The epileptogenic activity of penicillin was reduced or completely blocked if administration of the penicillin containing cerebrospinal fluid was preceded by 20-30 minute perfusion of the central canal of the lumbosacral segments with cerebrospinal fluid containing a high concentration of magnesium ions. PMID- 2755725 TI - [Effect of delta-sleep inducing peptide on electrical instability of the heart in emotional stress]. AB - The effect of the delta-sleep inducing peptide (DSIP) on disorders of the cardiac rhythm in emotional stress was studied in experiments on rabbits. DSIP (60 nmol/kg) diminished or arrested ventricular extrasystole occurring in experimental emotional stress. It was shown that the antiarrhythmic effect of DSIP is most manifest if it is injected just before exposure to the stress factors. DSIP injection induces increase of the thresholds of the occurrence of ventricular fibrillation and its precursors in intact animals. This can explain the high preventive effect of DSIP in stress. The acquired data on the antiarrhythmic effect of DSIP should be taken into consideration in elaborating preventive recommendations aimed at raising the organism's stability to stress factors. PMID- 2755726 TI - [Sympathetic innervation of the heart and long Q-T syndrome]. AB - The effect of stimulation of the right sympathetic augmenting nerve of the heart on myocardial electrical activity and central hemodynamic values was studied in experiments on intact and stellectomized dogs. Prevailing tonus of the right augmenting nerve resulting from its stimulation was attended by ischemic changes of the myocardium and moderate lengthening of the Q-T interval in intact dogs. Increased rate of cardiac contractions and rise of arterial pressure in stellectomized dogs as well as tachycardia occurring in them due to stimulation of the nerve bore evidence of increased sensitivity of beta-adrenoreceptors in the partly denervated heart. The authors show the role of asymmetry of the sympathetic nerve regulation, caused by unilateral stimulation of the augmenting nerve, in combination with changed sensitivity of the myocardial adrenergic receptors in the development of the lengthened Q-T interval syndrome. PMID- 2755727 TI - [Pharmacologic analysis of the sympathico-adrenal system in animals with alloxan diabetes]. AB - Activation of the hormonal link of the sympathico-adrenal system, reorganization in the organs of adrenoreception, and redistribution of monoamine oxidase activity are evidently directed towards creation of a definite substrate-hormonal background necessary for correcting hypoinsulinemia. PMID- 2755728 TI - [Tolerogenic effect of ovalbumin digestion products forming in the gastrointestinal tract of rats]. AB - The authors studied the tolerogenic effect of ovalbumin digestion products absorbed into the blood from the gastrointestinal tract of rats and injected intravenously into mice 24 hours before immunization of these animals with native protein. The preparation is a fraction with a molecular mass of no less than 6,000 daltons obtained by gel filtration of blood serum of ovalbumin fed rats on a column with Sephadex G-25. The titer of antibodies to ovalbumin determined by the passive hemagglutination test reduced on the 14th and 20th days after parenteral immunization with native ovalbumin. PMID- 2755729 TI - [Features of protein secretion by the rat liver in various stages of carbon tetrachloride or heliotrine poisoning]. AB - Rats were poisoned by carbon tetrachloride (50% oil solution; 0.5 ml/100 g; 12 injections) or by heliotrine (0.5 mg/100 g once a week; 10 injections). In periods of 3 to 12 months from the onset of poisoning, the liver was perfused in situ with Tyrode's solution and polyglucin for 5 hours. Protein was determined in the perfusate. In the first 3 hours of perfusion stimulation of protein synthesis was absent (basal secretion), then 500 mcg/l cortisol was added (stimulated protein secretion). Progressive decrease in basal and stimulated secretion of protein was encountered in heliotrine poisoning. In poisoning by carbon tetrachloride stimulated secretion decreases progressively, while basal secretion reduces in the initial stages of perfusion but begins to be activated by the 12th month after the onset of poisoning. PMID- 2755730 TI - [Role of xanthine oxidase in the genesis of acute pancreatitis]. AB - Experiments were conducted on 268 male albino rats with modeled acute pancreatitis to study the xanthine oxidase (XO) activity in the pancreatic tissue during intraperitoneal administration of stimulators of pancreatic exocrine function (pilocarpine) and inhibitors of enzyme activity (allopurinol). Pilocarpine (0.1 mg/kg) increased XO activity by 90-100% one-three hours after injection, which was due to increased synthesis of the enzyme. Allopurinol (500 mg/kg) inhibiting XO activity removes the XO activating effect of pilocarpine in the first two hours after injection. It was established that one of the tranquilizers of the 1,4-benzodiazepine series--seduxen (15 mg/kg) produces an inhibiting effect on XO activity and, like allopurinol, removes the XO activating effect of pilocarpine. Complete parallelism was also revealed between the dynamics of changes of XO activity in the pancreatic tissue and alpha-amylase in blood under the effect of the preparations studied. PMID- 2755731 TI - [General pathophysiology of the nervous system]. PMID- 2755732 TI - A pediatrician's view. PMID- 2755734 TI - A new understanding of consent in pediatric practice: consent, parental permission, and child assent. PMID- 2755733 TI - Ethical and legal issues relating to abortion in adolescence. PMID- 2755735 TI - When parents demand treatment. AB - In striving to provide quality medical care to the child and in serving as an educator and counselor to the family, the pediatrician can pursue several different decision making paths. The chosen path will depend on the pediatrician's medical knowledge and skill, but will also be influenced significantly by views of moral responsibility in medicine and attention to the emotional and social factors in the physician-patient encounter. PMID- 2755737 TI - A pediatrician's view. PMID- 2755736 TI - The HMO pediatrician as patient advocate. PMID- 2755738 TI - Acute pain in children. PMID- 2755739 TI - Unusual CNS and orbital metastases of neuroblastoma. AB - Although neuroblastoma is a common childhood malignancy with frequent metastatic disease, involvement of the CNS and eye are unusual findings. Recently, we encountered two such cases. One of the patients had undergone bone marrow transplantation. The long term effects of this treatment regarding behavior of the tumor and subsequent metastatic pattern have yet to be determined. The second patient presented with apparent congenital neuroblastoma. Both of these tumors were extremely aggressive in nature, and could represent variations of the usual metastatic pattern of neuroblastoma. PMID- 2755741 TI - Gas reduction of intussusception. AB - Efforts to improve the non-surgical management of childhood intussusception centre around (a) reassessment of selection criteria used to ensure as many children as possible have the advantage of hydrostatic reduction, and (b) improvements and modifications of enema technique to ensure successful and safe reductions without increased morbidity. Reports that pneumatic reduction was highly successful in treating childhood intussusception prompted the authors to evaluate this technique over an 18 month period using our previously reported technique of oxygen at 2 litres/minute and a pressure of 80 mm Hg. Pneumatic reduction was attempted in 114 of 129 consecutive cases of intussusception, and was successful in 85 (75%). Fifteen patients (8.6%) were considered unacceptable risks for gas reduction using our current selection criteria and had primary surgery. The overall success rate considering all cases of intussusception managed at our institution over this period was 66% (85/129). As with any form of hydrostatic reduction, pneumatic reduction of intussusception requires careful selection of patients, meticulous technique, and awareness of complications and their appropriate management. Because of its simplicity and improved success rate, pneumatic reduction has replaced traditional barium reduction at our institution. It may be that with further evaluation of selection criteria, higher pressures, and prolonged attempts that results will improve further. PMID- 2755740 TI - Contrast media in intussusception. AB - Pediatric radiologists in 40 children's hospitals in North America were interviewed to determine their choice of contrast media in the diagnosis and treatment of intussusception. The respondents indicated that barium was utilized in the vast majority of instances. Almost all indicated that they would proceed with barium enema even if there is unequivocal evidence of small bowel obstruction on the plain film examination. In over 14,000 cases of intussusception, there were 55 perforations, an incidence of approximately 1 in 250. The perforations in general were well tolerated, although there was one death. PMID- 2755743 TI - Three dimensional reconstruction in coronal synostosis: pre and post operative appearances. AB - Three dimensional computed tomography (CT) is a relatively new method of arranging the elements of CT slices into a morphological image with a multi dimensional appearance. It is of particular use in craniofacial deformities. The following report shows its use in the pre and post operative assessment of frontal skull deformity in three infants with coronal synostosis. PMID- 2755742 TI - The natural history of reflux in the lower pole of duplicated collecting systems: a controlled study. AB - Thirty two children with reflux into the lower pole of duplicated collecting systems, followed non-operatively for one to five years, were compared to a carefully selected control group of similar children who had reflux into a single collecting system. There were no significant differences between the two groups, either in the outcome of reflux or in the incidence of new renal scars. We conclude that reflux into the lower pole of a duplex kidney does not in itself constitute an indication for early surgical treatment. PMID- 2755744 TI - MRI study of lumbosacral lipoma in children. AB - The authors report 16 cases of lumbosacral lipoma in children studied by MRI. The exact position of the cord and its relationship to the lipoma were well demonstrated in all cases but one. There was as high incidence (25%) of syringomyelia in the terminal conus. Arnold Chiari malformation was never associated, which differentiates lumbosacral lipomas from myelomeningoceles. However, the nerve roots and their relationship to the lipoma were rarely visualized. Despite these drawbacks, MRI is the examination of choice if lumbosacral lipoma is suspected in children. PMID- 2755745 TI - Nonmedical personnel requirements for a pediatric radiology department. AB - The primary goal of a successful pediatric radiology department is to arrive at the correct clinical diagnosis as soon as possible. This responsibility is shared by radiologists, technologists, nurses, secretaries and clerks. The goal of this study was to determine the optimum number and type of nonmedical staff required to correctly and efficiently perform these examinations. The secondary purpose of our study was to evaluate the effectiveness of technologists, nurses, secretaries and clerks regarding: 1) patient waiting time, 2) performance of multiple examinations, 3) actual time for completion of examination(s), and 4) time required for the radiology report to be in the patient's medical history. Our study analyzed the number and type of radiological examinations performed for a variety of patients (emergency room patients, outpatients and inpatients) examined in the Radiology Department of Childrens Hospital of Los Angeles, a 345 bed metropolitan pediatric teaching hospital. The results of these evaluations will be discussed in this paper. Our data suggests that the time spent by the technologists in psychological support of the parents and the patient is inversely proportional to the time required to complete the test. Based on our study and the conclusions it presented, significant changes were implemented in our pediatric radiology department; specifically, the number of clerical positions was reduced from three to one with the use of computer-assisted check in and chart follow-up within the department. Childrens Hospital of Los Angeles is a 345-bed metropolitan pediatric teaching hospital affiliated with the USC School of Medicine.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2755746 TI - Cerebrospinal fluid pseudocyst presenting as a hepatic mass: a complication of ventriculoperitoneal shunt. AB - The case of a 3-year-old male child is reported who had a history of congenital hydrocephalus, treated by VP shunting. Severe complications with VP shunting are rare, but in this case the shunt had apparently perforated the liver, causing a pseudocyst to form and subsequent hepatomegaly. The shunt was revised surgically and the pseudocyst resected. PMID- 2755747 TI - Extralobar pulmonary sequestration presenting as intractable pleural effusion. AB - A pre-term baby girl presented at birth with respiratory distress and pleural effusion on the left. A soft tissue mass was found via lateral x-ray and CT scan; the mass proved to be extralobar pulmonary sequestration. PMID- 2755749 TI - Prominent transverse (Bowdler) bone spurs as a diagnostic clue in a case of neonatal hypophosphatasia without metaphyseal irregularity. AB - Transverse midshaft spurs allowed a diagnosis of hypophosphatasia in a newborn infant without metaphyseal irregularity. PMID- 2755748 TI - CT appearance of large sternoclavicular calcific masses in a teenager with chronic renal disease and secondary hyperparathyroidism, on hemodialysis maintenance. AB - The case of a 14-year-old teenager is reported who had large sternoclavicular masses. The young man had chronic renal disease due to chronic glomerulonephritis and had been on hemodialysis maintenance for many years. CT showed the masses to be lobulated with low attenuation septa. Metastatic calcification occurs in various systemic diseases. PMID- 2755750 TI - Michel dysplasia. Common cavity inner ear deformity. AB - A case is reported in whom there was a unilateral complete arrest of differentiation of the otocyst associated with an ipsilateral mild hemifacial hypoplasia and auricular abnormalities. The patient's tympanic membrane and VII nerve function were normal and a normal ossicular mass was identified on CT Scan. This case illustrates that development of the middle ear cavity (exclusive of structures on the medial wall), external ear canal and VII nerve can be independent of development of the inner ear and that a unilateral absence of otic capsule differentiation can take place without severe associated abnormalities. PMID- 2755751 TI - Non-surgical treatment of a congenital splenic cyst. PMID- 2755752 TI - Skeletal changes in fetal akinesia. PMID- 2755753 TI - Occurrence of childhood encephalitis: a population-based study. AB - The occurrence of childhood encephalitis was evaluated in a population-based study in an area with no arboviral infections. Ninety-five children were treated for encephalitis during 1973 to 1987, giving an annual incidence of 8.8/100,000 children younger than 16 years of age (95% confidence interval, 6.7 to 10.1). Based on virologic and serologic studies the most common etiologic agents were varicella (24 cases), mumps (8), herpes simplex (7) and measles (4). The etiology remained unknown in 37 children. No cases of encephalitis caused by mumps, measles or rubella were found in the population after 1982, when vaccination against these viruses was introduced. PMID- 2755754 TI - Medical management of fungal suppurative thrombosis of great central veins in a child. PMID- 2755755 TI - Nocardia transvalensis pneumonia in a child. PMID- 2755756 TI - The worm has turned: cysticercus to anisakis. PMID- 2755757 TI - Detection and recognition of auditory patterns. AB - The detection/recognition theorem (Starr, Metz, Lusted, & Goodenough, 1975) provides a signal detection theory prediction of an observer's ability to identify one of a set of possible signals on the basis of the observer's ability to detect whether any signal is presented. The present findings show that the theorem can be applied to complex auditory stimuli in a fashion that is not merely a trivial extension of the results obtained with simple auditory stimuli. PMID- 2755758 TI - Effects of uncertainty on melodic information processing. AB - In three experiments, musically trained and untrained adults listened to three repetitions of a 5-note melodic sequence followed by a final melody with either the same tune as those preceding it or differing in one position by one semitone. In Experiment 1, ability to recognize the final sequence was examined as a function of redundancy at the levels of musical structure in a sequence, contour complexity of transpositions in a trial, and trial context in a session. Within a sequence, tones were related as the major or augmented triad; within a trial, the four sequences began on successively higher notes (simple macrocontour) or on randomly selected notes (complex macrocontour); and within a session, trials were either blocked (all major or all augmented) or mixed (major and augmented randomly selected). Performance was superior for major melodies, for systematic transpositions within a trial (simple macrocontours), for blocked trials, and for musically trained listeners. In Experiment 2, we examined further the effect of macrocontour. Performance on simple macrocontours exceeded that on complex, and excluded the possibility that repetition of the 20-note sequences provided the entire benefit of systematic transposition in Experiment 1. The effect of musical structure (major/augmented) was also replicated. In Experiment 3, listeners provided structure ratings of ascending 20-note sequences from Experiment 2. Ratings on same trials were higher than those on corresponding different trials, in contrast to performance scores for augmented same and different trials in previous experiments. The concept of functional uncertainty was proposed to account for recognition difficulties on augmented same trials. The significant effects of redundancy on all the levels examined confirm the utility of the information-processing framework for the study of melodic sequence perception. PMID- 2755760 TI - The effects of auditory streaming on duplex perception. AB - When a formant transition and the remainder of a syllable are presented to subjects' opposite ears, most subjects perceive two simultaneous sounds: a syllable and a nonspeech chirp. It has been demonstrated that, when the remainder of the syllable (base) is kept unchanged, the identity of the perceived syllable will depend on the kind of transition presented at the opposite ear. This phenomenon, called duplex perception, has been interpreted as the result of the independent operation of two perceptual systems or modes, the phonetic and the auditory mode. In the present experiments, listeners were required to identify and discriminate such duplex syllables. In some conditions, the isolated transition was embedded in a temporal sequence of capturing transitions sent to the same ear. This streaming procedure significantly weakened the contribution of the transition to the perceived phonetic identity of the syllable. It is likely that the sequential integration of the isolated transition into a sequence of capturing transitions affected its fusion with the contralateral base. This finding contrasts with the idea that the auditory and phonetic processes are operating independently of each other. The capturing effect seems to be more consistent with the hypothesis that duplex perception occurs in the presence of conflicting cues for the segregation and the integration of the isolated transition with the base. PMID- 2755759 TI - Manual discrimination and identification of length by the finger-span method. AB - Experiments were conducted on length resolution for objects held between the thumb and fore-finger. The just noticeable difference in length measured in discrimination experiments is roughly 1 mm for reference lengths of 10 to 20 mm. It increases monotonically with reference length but violates Weber's law. Also, it decreases when the subject is permitted to maintain a constant finger span between trials; however, it tends to increase when the nondominant hand is used. As would be expected from studies of other stimulus dimensions in other sense modalities, resolution is considerably poorer in identification experiments than in discrimination experiments. For stimulus sets that cover a broad range (90 mm), the total information transfer is roughly 2 bits; for those that cover a relatively small range (18 mm), it is roughly 1 bit. The data are analyzed and interpreted using analysis techniques and models that have been used previously in studies of audition (e.g., Durlach & Braida, 1969). PMID- 2755761 TI - 2-D contour perception resulting from kinetic occlusion. AB - Kinetic occlusion, the progressive deletion or accretion of texture elements as one surface covers or uncovers another, has been shown to be an important source of information for determining depth order. In the present study, the importance of this information for 2-D contour perception was examined. In Experiment 1, subjects were asked to discriminate four different target shapes defined solely by kinetic occlusion. Discrimination increased with an increase in texture density and velocity, with density as the major factor. In Experiment 2, the targets were defined by static untextured regions as well as by kinetic occlusion. Overall, accuracy was similar to that found in Experiment 1, indicating that the presence of static information had little impact on accuracy. In Experiment 3, subjects were unable to discriminate among the four targets when presented with static versions of the displays used in Experiment 2. The results from these experiments indicate that kinetic occlusion can be used for discrimination of different 2-D shapes and that density has a more important role in determining accuracy than velocity. PMID- 2755762 TI - Teaching pigeons an abstract relational rule: insideness. AB - In 49 sessions, pigeons failed to learn to sort a collection of 80 stimuli composed of a closed curve and a dot, divided into two categories, according to whether the dot was or was not inside the curve. Next, the pigeons were successfully trained, first with the insides of the curves shown in bright red, then with a darker red, and finally with a black matching the background outside the curve. After this stepwise procedure, the pigeons displayed a limited ability to sort novel curves and dot locations according to whether the dot was or was not inside the curve. PMID- 2755763 TI - Speech perception by budgerigars (Melopsittacus undulatus): the voiced-voiceless distinction. AB - Discrimination of synthetic speech sounds from the bilabial, alveolar, and velar voice onset time (VOT) series was studied in 5 budgerigars. The birds were trained, using operant conditioning procedures, to detect changes in a repeating background of sound consisting of a synthetic speech token. Response latencies for detection were measured and were used to construct similarity matrices. Multidimensional scaling procedures were then used to produce spatial maps of these speech sounds, in which perceptual similarity was represented by spatial proximity. The results of these experiments suggest that budgerigars discriminate among synthetic speech sounds from these three VOT continua, especially between those from the bilabial and alveolar series, in a categorical fashion. PMID- 2755764 TI - Discriminability and dimensionality effects in visual search for featural conjunctions: a functional pop-out. AB - Treisman and Gelade's (1980) feature-integration theory of attention states that a scene must be serially scanned before the objects in it can be accurately perceived. Is serial scanning compatible with the speed observed in the perception of real-world scenes? Most real scenes consist of many more dimensions (color, size, shape, depth, etc.) than those generally found in search paradigms. Furthermore, real objects differ from each other along many of these dimensions. The present experiment assessed the influence of the total number of dimensions and target/distractor discriminability (the number of dimensions that suffice to separate a target from distractors) on search times for a conjunction of features. Search was always found to be serial. However, for the most discriminable targets, search rate was so fast that search times were in the same range as pop-out detection times. Apparently, greater discriminability enables subjects to direct attention at a faster rate and at only a fraction of the items in a scene. PMID- 2755765 TI - Magnitude estimation of warmth: intra- and intersubject variability. AB - Fifty-two subjects, both male and female, 18 to 62 years old, were asked to hold a metal bar maintained at different temperatures (33 degrees to 42 degrees C), and to estimate the magnitude of the resulting thermal sensation. On the average, the estimates were linearly related to the stimulus temperature, although most individual subjects either under- or overestimated middle-range values. Intersubject variability, which was twice as large as intrasubject variability, could not be accounted for by gender, age, or body-temperature differences. PMID- 2755766 TI - The acquisition of parafoveal word information in reading. AB - A somewhat counterintuitive finding has emerged from experiments that restrict the "window" of visual information available on a fixation during reading: fixation duration increases even though there is less information to process on a fixation. The two most likely explanations for this phenomenon are: (1) that the reader extracts abnormal information outside the window and this slows down processing; (2) that a restricted window does not allow a preview of a word before it is fixated, and hence identification of the word is slower when the word subsequently is fixated. In the present experiments, these two alternatives were tested. Conditions in which the size of the window alternated between fixations were compared with conditions in which the size of the window remained constant from fixation to fixation. This manipulation allowed us to separate effects due to restriction of the size of the window on the current fixation from preview benefits (which would be due to restriction of the size of the window on the prior fixation). Two experiments demonstrated clear beneficial effects on fixation duration due to receiving a preview of a word on the fixation prior to when it was fixated. In contrast, restriction of the size of the window had only marginal effects on the fixation on which that restriction occurred. In addition, a subsidiary analysis suggested that the benefit of previewing a word was influenced by its length; for short words, a preview primarily allowed the reader to skip the word more frequently, whereas for longer words, a preview primarily shortened the fixation time on the word when it was later fixated. PMID- 2755767 TI - Rhythm and "good endings": effects of temporal structure on tonality judgments. AB - The purpose of the present experiment was to investigate the influence of rhythmic structure on the perception of tonal relationships marking the end of a melody. Musically sophisticated listeners were asked to rate the degree of resolution in a set of folk tunes that varied in their tonal ending and temporal accent structure. The results indicated that melodies ending on the leading tone to-tonic progression were judged the most complete, while the least complete were those leaving a listener "hanging" by ending on the leading tone note. These ratings, however, were influenced by the temporal accent structure of a tune. The highest degree of resolution was observed for melodies that ended "on time" through an invariant pattern of temporal/melodic accents. Accent structures that led to endings occurring earlier or later than expected resulted in significantly lower resolution ratings. The present results illustrate the need to incorporate dynamic pattern influences into models of tonal perception. PMID- 2755768 TI - Perception of lowercase letters in peripheral vision: a discrimination matrix based on saccade latencies. PMID- 2755769 TI - Patch clamp experiments on nicotinic acetylcholine receptor-ion channels in bullfrog sympathetic ganglion cells. AB - Nicotinic acetylcholine-receptor ion channels (AChR channels) were studied in bullfrog sympathetic ganglion cells cultured for 1 day to 3 weeks, using a patch clamp technique. Microsuperfusion of ACh (2-10 microM) to the ganglion cell under the whole cell clamp produced an inward current at membrane potentials negative to -60 mV, which had a fast onset and decay. This rapid ACh-induced current was accompanied by a large current fluctuation, decreased and increased in amplitude by membrane depolarization and hyperpolarization, respectively, and blocked by d tubocurarine. Thus, this current must be induced by the nicotinic action of ACh, but not by a muscarinic effect to activate a slow cation-selective current. At depolarized levels more than -50 mV, ACh induced an additional inward current which was slow in time course, accompanied by no or decreased current fluctuation and increased in amplitude by membrane depolarization. Accordingly, this slow ACh induced current could result from the suppression of a voltage-dependent K+ current (M-current: Brown and Adams 1980) by the muscarinic action of ACh. Fluctuation analysis of the rapid ACh-induced current at potentials negative to 50 mV revealed the elementary conductance of 14 pS and a power spectral density distribution of the double Lorentzian function which yielded the time constants of 5.4 and 62.5 ms at -60 to -80 mV. The variance of either component was independent of the mean current. PMID- 2755770 TI - Cytosolic free calcium in single microdissected rat cortical collecting tubules. AB - Cytosolic free Ca2+ ([Ca2+]i) was measured in single fragments of rat cortical collecting tubule (CCT) by using fura-2 and a tubule superfusion device. Under basal conditions, i.e. with 1 mM of external Ca2+ ([Ca2+]o), the average steady state [Ca2+]i was 179 +/- 16 nM (n = 44 tubules). Random alterations of [Ca2+]o between 0 mM and 4 mM led to corresponding variations in steady state [Ca2+]i levels, which were linearly correlated with [Ca2+]o (average slope 93 +/- 34 nM [Ca2+]i per 1 mM [Ca2+]o for six tubules). In contrast, [Ca2+]i was little affected by decreasing external Na+ concentration. Cell membrane depolarization with 100 mM of external K+ induced a sustained drop in [Ca2+]i (21% as an average). The data suggest that steady state [Ca2+]i in CCT cells resulted from a non-saturable passive entry of calcium ions across cell membranes balanced with an active extrusion by calcium ATPase (pump and leak mechanism). The passive component cannot be accounted for either by Na+/Ca2+ exchangers nor by voltage dependent calcium channels; it is best explained by the presence of voltage independent calcium channels in cell membranes. PMID- 2755771 TI - Effects of 5-hydroxytryptamine (serotonin) and forskolin on intracellular free calcium in isolated and fura-2 loaded smooth-muscle cells from the anterior byssus retractor (catch) muscle of Mytilus edulis. AB - Effects of 5-hydroxytryptamine (5-HT) and forskolin on intracellular free calcium concentration [( Ca2+]i) were studied in suspensions of fura-2 loaded smooth muscle cells from the anterior byssus retractor 'catch' muscle of Mytilus edulis. The successive addition of 5 mM carbachol (CCh) and 100 mM KCl to the suspension evoked a transient elevation of [Ca2+]i from the resting value of 124 +/- 2.7 nM (mean +/- SE, n = 18) to 300-400 nM, which was associated with contraction. The change in [Ca2+]i induced CCh was concentration-dependent with the EC50 of 10(-5) M. The resting [Ca2+]i was unaffected by 10 microM 5-HT. The change in [Ca2+]i induced by 5 mM CCh was suppressed by 5-HT from 167 +/- 14.0 (n = 11) to 124 +/- 14.9 (n = 8) nM whereas that induced by 100 mM KCl was enhanced from 321 +/- 31.9 to 405 +/- 17.6 nM (n = 8). 5-HT applied during the decaying phase of the CCh response caused a rapid decline in [Ca2+]i. In both the responses to CCh and KCl, the falling phase was accelerated by 5-HT. 10 microM forskolin, a potent activator of adenylate cyclase, mimicked the effects of 5-HT as did a membrane permeant cyclic AMP analogue, 8-parachlorophenylthio cyclic AMP (cpt-cAMP). Application of 100 microM cpt-cAMP partially suppressed the Ca2+i response to CCh and enhanced that to KCl. D-Tubocurarine (500 microM) added during the decaying phase of the response induced by 100 microM CCh, caused a rapid decline in [Ca2+]i similar to that caused by both 5-HT and forskolin.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2755772 TI - Intracellular sorbitol content in isolated rat inner medullary collecting duct cells. Regulation by extracellular osmolarity. AB - In order to study the mechanisms involved in the regulation of renal inner medullary sorbitol content, collecting duct cells were isolated from rat inner medulla and the effect of extracellular osmolarity on sorbitol synthesis and sorbitol content was investigated. Cells isolated at 300 mosmol/l and incubated up to 24 h as primary cultures in 300 mosmol/l media or in media made 600 mosmol/l by the addition of 150 mM NaCl showed no difference in total synthesis. Intracellular sorbitol content was, however, 2.3-fold higher in the cells kept in the higher osmotic medium. Cells isolated at 600 mosmol/l released sorbitol about 8 times faster when transferred into hypoosmotic medium (300 mosmol/l) than when transferred into isoosmotic (600 mosmol/l) media. Cells exposed to hyperosmotic media (900 mosmol/l with NaCl) maintained a higher intracellular sorbitol content than cells incubated in isoosmotic media. Changes of intracellular sorbitol content could not be attributed entirely to cell lysis--as demonstrated by determination of cellular content of lactate and lactate dehydrogenase. The alteration in sorbitol membrane permeability was reversible and was only observed when poorly permeable solutes (such as NaCl and sucrose) were used for the experiments, changes in urea elicited no effect. It is proposed that rapid changes in membrane permeability to sorbitol play an important role in the adjustment of intracellular sorbitol concentration in inner medullary collecting duct cells to changes in extracellular osmolarity. PMID- 2755773 TI - Intracellular pH during secretion in the perfused rabbit mandibular salivary gland measured by 31P NMR spectroscopy. AB - Intracellular pH (pHi) was measured in the isolated, perfused rabbit mandibular salivary gland by 31P NMR spectroscopy. In the unstimulated gland perfused with HCO3-/CO2-buffered Ringer's solution, pHi was 7.27 +/- 0.01. Continuous stimulation with acetylcholine elicited dose- and time-dependent changes in pHi. 10(-6) mol/l acetylcholine caused a brief intracellular acidosis (-0.19 +/- 0.06 pH units) followed by an increase in pHi to a more alkaline steady-state value (7.33 +/- 0.02). In the absence of perfusate HCO3- or in the presence of 10(-4) mol/l DIDS (4,4'-diisothiocyanatostilbene-2,2'-disulphonic acid), the transient acidosis was abolished and pHi increased rapidly to give a sustained alkalosis (7.49 +/- 0.03 and 7.44 +/- 0.03 respectively). In the presence of 10(-3) mol/l amiloride, the response to acetylcholine was a rapid decrease in pHi to 7.02 +/- 0.02. The data suggest that, during perfusion with HCO3-/CO2- buffered solutions, stimulation with acetylcholine results in a transient loss of HCO3- from the acinar cells (causing a transient acidosis), and, independently, the activation of Na+-H+ exchange (causing a sustained alkalosis). In the unstimulated gland, DIDS and the HCO3- -free perfusate caused decreases in pHi to 7.12 +/- 0.02 and 7.04 +/- 0.01 respectively. In contrast, amiloride had little effect. The relatively high value of pHi maintained by the unstimulated gland is therefore probably not due to Na+-H+ exchange. PMID- 2755774 TI - Localization of transport compartments in turtle urinary bladder. AB - To characterize different transport compartments in the urinary bladder epithelium of postabsorptive turtles, the electrolyte composition of individual cells was determined using electron microprobe analysis. After blocking the transepithelial Na transport, the short-circuit current decreased from positive to negative values (from 26.5 +/- 17.7 to -3.9 +/- 2.9 after ouabain and from 25.4 +/- 17.2 to -8.0 +/- 5.1 microA/cm2 after amiloride). Whereas under control conditions the Na and K concentrations were similar in all cell types and the same was true for Cl in most of the cells, some cells exhibited very low Cl concentrations. The epithelial cells were subdivided according to their electrolyte composition into ouabain-sensitive and ouabain-insensitive ones. In the ouabain-sensitive cells, which made up the majority of epithelial cells and showed a relatively high Cl concentration (about 36 mmol/kg wet weight), the Na concentration increased after ouabain by about 90 mmol/kg wet weight and the K concentration decreased by a similar amount. Since these alterations could largely be prevented when amiloride was applied before ouabain, it is suggested that the granular and basal cells form a syncytial Na transport compartment similar to that in other multilayered epithelia. The ouabain-insensitive cells, in which almost no alteration in Na and K concentrations was observed after ouabain, were subdivided into a Cl-rich (34.6 +/- 7.6 mmol/kg wet weight) and a Cl-poor (12.0 +/- 5.6 mmol/kg wet weight) population. Since in these cells no large mucin granules were detectable, they are regarded as carbonic anhydrase rich cells involved in H and HCO3 transport. PMID- 2755776 TI - Vasoactive intestinal peptide stimulation of renal adenylate cyclase and antagonism by (4Cl-D-Phe6Leu17)VIP. AB - The effect of vasoactive intestinal peptide (VIP) and related peptides [glucagon, secretin, PHI 1-27 (peptide with N-terminal histidine and C-terminal isoleucine)] on renal adenylate cyclase (AC) has been determined in several species. The largest stimulation (4.1 +/- 0.5-fold basal) of AC by 1 mumol.l-1 VIP was observed in feline cortical plasma membranes. In rabbit and guinea-pig, VIP increased AC activity 1.5 +/- 0.3- and 1.8 +/- 0.3-fold respectively but glucagon had no such action. Conversely in the rat glucagon stimulated AC some 3-fold over basal activity whereas VIP had little effect. In dog, cat and mouse both peptides were effective in increasing AC activity. For cat, half-maximal stimulation of cortical plasma membrane AC by VIP was seen at 27.0 +/- 9.0 nmol.l-1 (SE N = 9 animals). VIP also increased AC activity in both outer (red) and inner (white) medulla. In feline cortical membranes VIP and PTH (parathyroid hormone) when added in combination were fully additive. However for VIP and glucagon in combination there was no cumulative increase in AC activity, indeed the resultant activity was less than that attained by VIP alone. The VIP analogue (4Cl-D Phe6Leu17)VIP at 10 mumol.l-1 produced a right shift in the VIP-dose response curve and increased the EC50 from 17.2 +/- 5.8 nmol.l-1 to 132.0 +/- 22.2 nmol.. 1 VIP (SE N = 4). There was no reduction in the maximum response elicited by VIP consistent with a competitive type of antagonism by this analogue. PHI-stimulated AC was also reduced by (4Cl-D-Phe6Leu17)VIP resulting in a similar right shift in the dose response curve.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2755775 TI - Ion transport and enteric nervous system (ENS) in rat rectal colon: mechanical stretch causes electrogenic Cl-secretion via plexus Meissner and amiloride sensitive electrogenic Na-absorption is not affected by intramural neurons. AB - The initial phase of in vitro experiments in Ussing-type chambers on large intestine is characterized by short-circuit currents (ISC) declining from high starting values to a lower plateau within 0.5 h. The origin of this "initial ISC transient" was investigated by ISC measurements on partially stripped segments of rat rectal colon. Transport was pre-stimulated in vivo by keeping animals in barbiturate-anesthesia for 5 h prior to tissue preparation. This procedure caused by endogenous aldosterone-liberation amiloride-sensitive Na-absorption to become the predominant electrogenic transport. The initial ISC-transient was abolished by tetrodotoxin (TTX, 1 microM), indicating a neuronal mediation of this phenomenon. In order to identify the transport which was subject to neuronal control, the amiloride-sensitive Na-absorption was measured during electrical field stimulation (bipolar rectangular pulses: 5 Hz, 1 ms, +/- 6 mA). There was no difference to unstimulated controls. In contrast, the initial ISC-transient was dependent on Cl in the bath following Michaelis-Menten-kinetics (KM = 20 mM) and could be prevented by 10 microM serosal bumetanide. Then, initial filling of the Ussing-chamber was imitated during the course of the experiment by removal and immediate re-addition of the bathing fluid. This procedure caused ISC-changes of similar appearance as the initial ISC-transient. To verify that indeed mechanical stretch is the sensory stimulus triggering the initial ISC-transient, the effect of small pressure oscillations was studied. This also produced an ISC transient which was TTX-sensitive and was abolished after removal of the submucosal plexus Meissner by total stripping.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2755777 TI - Oxygen supply of the blood-free perfused guinea-pig brain in normo- and hypothermia measured by the local distribution of oxygen pressure. AB - The O2 supply of the blood-free perfused brain cortex of the guinea pig was investigated by measuring polarographically the local distribution of tissue PO2 at 18 degrees C, 24 degrees C, and 37 degrees C. The perfusion was performed in situ, using a medium equilibrated by a gas mixture of 95% O2 and 5% CO2. Papaverine was added to prevent vasoconstriction during hypothermia. To avoid measuring artefacts thin micro electrodes with a small sharpened tip of ca. 4 microns in diameter were used and a special puncturing technique was applied. The experimental results indicate the presence of a large variation of local tissue PO2. Local mean PO2 increased up to a depth of 1000 microns, reached a plateau, and then decreased towards 3000 microns. This demonstrates that the O2 supply changes in dependence of the distance of the brain surface. This may partly be caused by the special vascularization pattern of the brain cortex. As it follows from the PO2 histograms, at 24 degrees C the tissue layer between 0-2000 microns (layer I) was well supplied with oxygen, whereas at the same time the layer between 2001-3000 microns (layer II) was hypoxic. At 37 degrees C, both layers were hypoxic, but layer III showed the more pronounced tissue hypoxia. To obtain a sufficient oxygen supply the temperature had to be reduced below 24 degrees C to sufficiently decrease tissue O2 consumption: at 18 degrees C, there was no sign of hypoxia any more. In comparison with the PO2 histogram of the tissue the PO2 histogram of the pial surface was shifted to higher PO2 values.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2755779 TI - [MR imaging of the bone marrow using short TI IR. Part 1--Normal and pathological intensity distribution of the bone marrow]. AB - Normal vertebral bone marrow intensity distribution and its alteration in various anemias were evaluated on short TI IR sequences. Material consists of 73 individuals, 48 normals and 25 anemic patients excluding neoplastic conditions. All normal and reactive hypercellular bone marrow revealed characteristic intensity distribution; marginal high intensity and central low intensity, corresponding well to normal distribution of red can yellow marrows and their physiological or reactive conversion between red and yellow marrows. Aplastic anemia did not reveal normal intensity distribution presumably due to autonomous condition. PMID- 2755778 TI - Synaptic potentials induced by postganglionic stimulations in cat bladder parasympathetic neurones. AB - Intracellular recording techniques were used to examine and compare synaptic potentials evoked by stimulating pre- and postganglionic nerve trunks in cat bladder parasympathetic ganglia. In the 76 ganglion cells examined, two types of responses were recorded on stimulating the postganglionic nerve: an antidromic action potential (type PostNS1; n = 30) or a fast excitatory postsynaptic potential (f-EPSP; type PostNS2; n = 46) which resulted in an orthodromic-like action potential. In some of the cells exhibiting a PostNS1 response (n = 19), a fast depolarization was superimposed on the antidromic spike. This depolarization was due to the synaptic activation of nicotinic receptors. In many of the cells exhibiting either PostNS1 or PostNS2 responses, repetitive stimulation of the postganglionic nerve induced a slow hyperpolarization. Applying nicotinic (hexamethonium, 0.5-1 mM) receptor muscarinic (atropine, 1 microM), alpha adrenergic (phentolamine, 1 microM) and purinergic (caffeine, 0.5-1 mM) receptor antagonists completely inhibited the tetanus-induced slow hyperpolarization in some cells (n = 5). In other cells (n = 15), a slow hyperpolarization persisted in the presence of these antagonists. These results indicate that stimulation of the postganglionic nerve trunk of cat bladder parasympathetic ganglia can elicit not only an antidromic action potential, but also synaptic potentials which are mediated by the activation of cholinergic (nicotinic and muscarinic), noradrenergic and purinergic receptors, as well as non-cholinergic, non-alpha adrenergic and non-purinergic synaptic potential. PMID- 2755780 TI - [MR imaging of the bone marrow using short TI IR. Part 2--Normal and pathological intensity distribution of the bone marrow]. AB - Bone marrow pathology of hematological neoplasms was evaluated using short TI IR sequences and T2 weighted STIR (IR 1500/100/40, IR 1500/100/80). Material consisted of 49 individuals including 10 leukemias, 5 myelofibroses and 30 multiple myelomas. On IR 1500/100/40, all cases revealed heterogenously or diffusely high intensity. On IR 1500/100/80, both of acute and chronic myelocytic leukemias revealed definite signal decrease, while chronic lymphocytic leukemia, myelofibrosis and multiple myeloma showed no obvious signal decrease. PMID- 2755781 TI - [Focal sparing around the gallbladder in fatty liver: an useful sign in the diagnosis of borderline cases by CT]. AB - The role of CT in the diagnosis of fatty liver is well established. CT has been proved to be a useful noninvasive tool for the demonstration of fatty infiltration of the liver. The characteristic finding is a diffuse decrease in the attenuation within the liver compared with that of the spleen. Commonly, fatty infiltration of the liver is generalized and both CT scans and sonograms can easily demonstrate changes related to this condition. Sometimes, fatty infiltration of the liver is focal and occasionally, it is generalized with focal sparing of the normal liver tissue creating some problems in the diagnosis. Recently, some reports have mentioned the appearance of a focal sparing area in the generalized fatty liver. We often found a high attenuation region around the gallbladder bed in the fatty liver patients on CT examination. There appears to be some relationship between the high density around the gallbladder area and the fatty liver. A retrospective study was undertaken to evaluate the relationship. In this paper, we presented the CT scans of 57 fatty liver cases and compared them with the CT scans of 50 normal patients to discuss the possible cause of the phenomenon and its usage in the diagnosis of the fatty liver. PMID- 2755782 TI - [Effect of various contrast media on platelet aggregation--an in vivo study]. AB - Recently, some radiologists using non-ionic contrast media for angiography have noted the increased tendency of thrombus formation in the injection syringe or angiographic catheter contaminated with blood. In vitro studies by some authors have shown that non-ionic contrast media had only a slight anticoagulative effect as compared with ionic contrast media. But the in vivo studies comparing the anticoagulative effect of both ionic and non-ionic contrast media have not been performed previously. We investigated the effect of non-ionic and ionic contrast media on platelet aggregation in 40 patients undergoing angiography. The in vivo study revealed a negligible influence of both non-ionic and ionic contrast media on systemic platelet aggregation. The dose of contrast media also showed no significant correlation with platelet aggregation. Our study suggests that the data from in vitro experiments cannot be extended to in vivo study as for the relationship between contrast media and their anticoagulant effect. PMID- 2755783 TI - [Percutaneous placement of the inferior vena caval filter--a clinical experience with the Gunther vena caval filter]. AB - A new inferior vena caval filter (Gunther vena caval filter) was used in seventeen patients with pulmonary embolism. The filter is a basket filter which consists of twelve stainless-steal wires, and can be inserted percutaneously through a 10 F angiographic catheter. The filter was easily and safely placed in every case. No significant complications were encountered. In a follow up period of up to twenty seven months, the filter was well tolerated. One patient had a recurrence of pulmonary embolism. The author believe that the filter will be suitable for prophylactic placement for pulmonary embolism, and it will take over another filters that require surgical venotomy. PMID- 2755784 TI - [Magnetic resonance imaging in lateral medullary (Wallenberg's) syndrome]. AB - Eight patients with a clinical diagnosis of lateral medullary (Wallenberg's) syndrome were studied with magnetic resonance imaging (MRI) at 1.5 Tesla. On T1 weighted axial images, small hypointense lesion (infarct) was demonstrated in the region of lateral medulla in 6 patients. Ipsilateral hemiatrophy of the medulla was revealed in one patient. In the remaining one patient, a thrombosed vertebral artery was disclosed. It was therefore concluded that MRI is useful diagnostic modality for Wallenberg's syndrome. PMID- 2755785 TI - [Diagnostic capability of digital radiography of the chest using scanning laser stimulated luminescence]. AB - Diagnostic capability of Fuji Computed Radiography (FCR) of the chest was compared to the conventional radiography (CoR) using regular film-screen system. FCR utilizes imaging plates of scanning laser stimulated luminescence. Visibility of 14 structures of the chest radiography was evaluated by 3 radiologists in 100 pairs of FCR and CoR which were taken at the same time with the same exposure factors. FCR was superior to CoR especially in observation of the mediastinum and areas behind the heart and diaphragm. The minor fissure was better seen on CoR. Superiority of FCR to CoR was thought to be mainly due to the processed image of FCR, and the so-called normal image of FCR had little diagnostic advantage. Simulated abnormal densities: nodular, alveolar, and interstitial densities with a chest phantom, were made, and detectability of alteration of these densities on FCR and CoR was evaluated by 19 radiologist, using ROC curve analysis. FCR and CoR revealed the similar diagnostic capability in nodular and interstitial densities. In alveolar densities, however, FCR was statistically inferior to CoR. Nineteen radiologists were divided into 3 groups by their experience in radiology, and comparison was made as to their diagnostic capability with FCR and CoR in the same manner as described above. There was no significant difference among the groups with FCR in either density pattern. PMID- 2755786 TI - [Cardiothoracic ratio and roentgenologic heart size as the indices of body fluid retention in uremics under hemodialysis]. AB - We evaluated the cardiothoracic ratio (CTR) and the roentgenologic heart size (RHS) as the indices of body fluid retention in 31 of uremic patients under hemodialysis. The maximum changes of the roentgenologic thoracic diameter, measured monthly for one year in 31 patients, varied from 10 to 68 mm. The average differences of RHS and CTR between maximum inspiration and forced inspiration in 18 healthy people were 1 mm (RHS) and 2.5% (CTR), respectively, and the change of roentgenologic thoracic diameter was 12 mm. The error of repeated CTR measurements in a period of one year could be estimated more than 2%. In 22 patients the body weight reduction of 1 kg corresponded to a 4 mm decrease of RHS (p less than 0.005) and 1.5% of CTR (p less than 0.05), respectively. In relation to the change of body fluid balance assessed by the change of body weight, RHS showed a higher correlation than CTR. These results could be attributed that RHS was hardly influenced by the respiration, whereas CTR was surprisingly affected. It is concluded that the measurement of RHS is more useful as an index of control of body fluid balance than CTR. PMID- 2755787 TI - [Quantitative evaluation of bone mineral contents of hand bone using CR technique]. AB - We evaluated the clinical applicability of a matrix compression technique on computed radiography (CR) data for quantitative measurements of bone mineral content of hand bones. Similar results were obtained compared to those obtained by the conventional microdensitometry (MD) technique. This CR technique which uses imaging plates should take the place of the normal MD technique due to the fact that it provides for the reduction of exposure dosage. PMID- 2755788 TI - [Pleural thickening associated with solitary pulmonary nodule: evaluation with thin-slice CT]. AB - Thin-slice CT was performed in 39 cases with a solitary pulmonary nodule abutting on the chest wall. Fifteen cases had bronchogenic carcinomas and the other 24 had benign non-neoplastic pulmonary nodules. CT findings were evaluated retrospectively paying special attention to the angle of the lesion with adjacent pleura, the homogeneity of the boundary between the lesion and the pleura, the configuration of the pleural thickening (broad or not, symmetric or not, tapering or not) and the visibility of the extrapleural fat plane. The broad, symmetric and tapering pleural thickening was seen in one of the 15 cases with a bronchogenic carcinoma and in 11 of the 24 cases with a benign non-neoplastic pulmonary nodule. Our result showed that the broad, symmetric and tapering pleural thickening might be indicative of benign pulmonary nodule. The authors concluded that thin-slice CT might be useful in the evaluation of the benignity of a solitary pulmonary nodule abutting on the chest wall. PMID- 2755789 TI - [Reference lines on diagnostic imagings of the head Part 1: Reference lines on cephalogram]. AB - The relationship between three major reference lines including Reid's base line (RBL), canthomeatal line (CML) and orbitomeatal line (OML), which pass the center of orbital margin and porion, was investigated in 141 cephalograms of normal healthy volunteers. The difference between CML and OML is so small (mean 1.0 degrees +/- S.D. 1.3 degrees) that these two lines are considered almost identical. It is said that RBL and CML meet about 10 degree, but present study shows the angle is about 13 approximately 14 degree. The relationship between these two major reference lines (RBL and CML) and the other four reference lines including nasion-clition line (NC), clition-basion line (CB), nasion-basion line (NB) and nasion-opisthion line (NO) is also evaluated. NO shows the most stable relationship to RBL (22.7 degrees +/- 2.1 degrees) and NB shows the most stable relationship to CML (15.0 +/- 2.1 degrees). PMID- 2755790 TI - [Reference lines on diagnostic imagings of the head. Part 2: Reference lines on MRI]. AB - Simple but accurate and useful methods to draw reference lines parallel to canthomeatal line (CML) and Reid's base line (RBL) on MRI are described in this paper. A line is drawn through the nasal root and the pontomedullary junction on a midsagittal MRI of the head. It is confirmed that this line is parallel to CML in 21 normal healthy volunteers and 33 patients who show no mass effect on the midsagittal image. It is also verified that a line through the nasal root and mesencephalon-pontine junction on the midsagittal image is parallel to RBL. PMID- 2755791 TI - [CT diagnosis of acute aortic dissection; clinical importance of acute aortic dissection with non-opacified false lumen]. AB - Sixteen (47.5%) of 35 patients with acute aortic dissection showed a non opacified crescent in the aorta on an initial contrast CT. Seven of these 16 patients underwent cineangiography soon after the initial CT, and in all 7 patients, neither an intimal tear nor an intimal flap was obtained. All but one of above 16 patients were followed by CT. Mean duration of follow-up was 9.6 months. In 10 of 15 patients with non-opacified false lumen, the false lumen remained non-opacified until the last examination. Moreover, in 6 of these 10 patients, the false lumen shrunk, and in the other 3, it disappeared completely on follow-up CT. On the other hand, in remaining 5 of these 15 patients who were initially diagnosed to have non-opacified false lumen, the false lumen became opacified and enlarged in size on follow-up CT performed in the first 14 weeks. Moreover, in 4 of these 5 patients, the false lumen became opacified in the only first 6 weeks. No matter how intensive care should be paid at least for the first 6 weeks, it seems that patients with aortic dissection which have non-opacified false lumen had good prognosis in comparison to patients with ordinary aortic dissections which have opacified false lumen. We believe aortic dissection with non-opacified false lumen may consist of two type of aortic dissection, one has no intimal tear, the other has some intimal tears and a thrombosed false lumen. In conclusion, CT is the most useful modality in diagnosing acute aortic dissection. The reasons are the incidence of acute aortic dissection with non opacified false lumen was high, patients with non-opacified false lumen had good prognosis, and it was difficult to diagnose aortic dissection with non-opacified false lumen by conventional cineangiography and/or DSA. PMID- 2755792 TI - [Computed tomography of calcaneal fractures--comparison with conventional radiography]. AB - Computed tomography (CT) and conventional radiography were compared in 52 calcaneal fractures. As for CT, direct coronal imagings were performed in all and direct axial imagings were added in 27 of them. Conventional radiography included lateral, axial, and Anthonsen (oblique) views. Overall CT detected 7 more of the incongruity of the posterior facet, 9 more of the bulging of the lateral wall, and 6 more of the fracture of the sustentaculum tali than conventional radiography. In addition the entrapment of the peroneal tendons between the calcaneal body and the fibular malleolus could be evaluated only with CT. These informations are indispensable for the proper treatment of the fractures and we conclude that CT is useful in evaluating calcaneal fractures. PMID- 2755793 TI - [MR imaging of orbital tumors]. AB - Nine cases of pathologically confirmed orbital tumors were evaluated with magnetic resonance imaging (MRI) at 0.5T. Seven cases were examined with orbit coil using 7-mm-thick sections and two cases were examined with head-coil using 10-mm-thick sections. All lesions were clearly demonstrated on T1-weighted images as low intensity. However, the lesions were indistinct on T2-weighted images because of low contrast between the lesions and surrounding orbital fat and artefact produced by eye movement. Two of three cases with meningioma examined with orbit-coil were clearly discriminated from the optic nerve. Meningioma in the remaining case examined with head-coil was discriminated from the optic nerve by administration of Gd-DTPA. Adenoma of the right lacrimal gland was shown as an enlarged gland on T1-weighted images. Pseudotumors (four cases) showed very low intensity on T1-weighted images. Three cases of four pseudotumors showed low intensity on T2-weighted images. Among them one was moderately low intensity, and histological examination of the lesion showed prominent fibrotic changes. Pseudotumor of the remaining case examined with the head-coil showed same intensity with fat on T2-weighted images. Intraorbital infiltrating foci of chronic lymphocytic leukemia showed low intensity with fat on T1-weighted images, and the same intensity with fat on T2-weighted images. MRI may be useful to discriminate pseudotumor with fibrotic changes (chronic inflammatory lesions) from lymphoma or leukemic infiltration. PMID- 2755794 TI - [Constructions of compensating screen of chest radiography and its clinical applications--evaluation of normal anatomical structures]. AB - We have constructed compensating screens which have different sensitivities for the pulmonary hilum and mediastinum in contrast to the lung. With these screens the regions of the mediastinal and retrocardiac areas are simultaneously displayed with optimal contrast on postero-anterior (PA) chest radiographs. The potential clinical use of compensating screens was evaluated in 67 patients for visibility of the anatomical structures in comparison with conventional screens. Confidence test was used to compare the detectability of the various anatomical structures of the chest. The chest radiographs obtained with compensating screens improved visibility of the anatomical structures including the tracheal bifurcation, right and left main bronchus, and paraesophageal line. PMID- 2755795 TI - [Usefulness of dual-energy digital radiography in detecting atlas and axis]. AB - Cranial dual-energy digital radiography was applied to three patients. The anatomy of the atlas and axis was clearly recognized without utilizing the open mouth view. We consider it a very effective technique when applied to the patient who experiences difficulty in opening the mouth, like severe traumatic or infantile patients. In addition, it is a useful examination for patients with suspected anomalies of cranio-vertebral junction. PMID- 2755796 TI - [Clinical results of thermoradiotherapy of locally advanced and recurrent breast cancers--comparison of results with radiotherapy alone]. AB - From August 1979 through January 1988, 23 breast cancer patients with 25 tumors supposed to be refractory to conventional treatment were treated by thermoradiotherapy. Of the 25 tumors, 10 were locally advanced primary tumors [Group 1], 4 locally advanced recurrent tumors after operation more than 5 cm in maximum diameter [Group 2], and 11 locally recurrent tumors after radiotherapy [Group 3]. The present study was not a formal randomised-trial, but a historical controlled study. The results were compared with tumors which were treated by radiation therapy alone between July 1962 and August 1979. The historical control groups comprised 11 tumors for Group 1, 17 for Group 2 and 19 for Group 3. Employing 4 types of heating devices (8, 13.56 MHz capacitive RF, 430, 2450 MHz microwave), hyperthermia was administered once or twice a week after irradiation, for 30-60 minutes per session, up to a total sessions of 2-9. Radiotherapy was delivered in fractions of 180 to 200 cGy per day, 5 days per week, up to 28-74.4 Gy in total, or in fraction of 400 cGy, two times per week, up to 28-60 Gy. Tumor temperatures were measured by inserting thermocouples into the tumors. The tumors that did not recur during follow-up of more than 3 months were regarded as locally controlled tumors, and the local control rate was calculated. The local control rate in Group 2 and the local response rate (CR + PRa) in Group 1 were higher than those of the historically controlled tumors. In Group 3, hyperthermia combined with lower total doses of irradiation showed a high local response rate similar to that by radiation therapy alone. Thus local hyperthermia in combination with radiation therapy seems to be more effective than radiotherapy alone for locally advanced and recurrent breast cancers. PMID- 2755797 TI - [Local hyperthermia using a device made of temperature-sensitive ferrite. The first report: temperature, output characteristics]. AB - The basic study of intracavitary and interstitial hyperthermia was made with the Soft-Heating Method. In this method, a hybrid device composed of non-magnetic metal ring and ferrite rod is used as a heater. Being exposed to external magnetic field, the device produces heat, and its temperature rises to the Curie Temperature of the ferrite rod with self-regulation. The accuracy of the regulation is +/- 0.2 degrees C near the Curie Temperature which can be set up almost freely. In addition to that, the frequency of magnetic field is not so high (20-50 KHz) that there is no damping nor reflection of the field in a human body. Therefore the system seems to be very useful for hyperthermia of deep seated tumor. In this paper, experimental discussion of the possibility of local hyperthermia by the system is made. From the results, it is concluded that the system will be applied to clinical uses. PMID- 2755798 TI - [Comparative studies on physical characteristics and clinical efficacy of conventional and digitized chest radiographs]. AB - Comparative studies were performed between digitized and conventional radiographs of the chest in terms of their physical characteristics and diagnostic efficacy. The purpose of these studies is to confirm the diagnostic capability of digitized image whether it can use for primary diagnosis in routine works. The results of two studies show good correlation each other. It is strongly suggested that the conventional chest radiographs should be digitized with 100 microns pixel in 12 bit density resolution. PMID- 2755800 TI - [Japanese reference man 1988-IV. Studies on the weight and size of internal organs of Normal Japanese]. AB - The weight and size of 12 main internal organs of Normal Japanese were measured at the Tokyo Medical Examiners Office, where the autopsies have been carried out on sudden death cases. This report selected, 5,600 cases with little or no pathological body change, from approximately 18,000 total autopsy cases, during the period of 1970-1980. The organs were divided into 23 groups according to age and sex. Mean value and standard deviation were calculated for each group, using a CDC-6600 scientific computer. The data in this report were compared with the data of 1952, when people were in starvation after termination of the World War II. At that time, several organs were decreased in weight by 8% in liver, 15-20% in kidney, heart, spleen and adrenal gland, respectively. However, pituitary gland showed an 18% increase while brain and thyroid showed almost the same value. Other organs measured were lung, liver, pancreas and testis. PMID- 2755799 TI - [Experimental studies on mechanisms and prevention of radiation pneumonitis]. AB - Radiation pneumonitis are well recognized as complications of radiotherapy for the thoracic malignancies. However, the pathogenesis of radiation pneumonitis has been poorly understood and prevention of it has not been developed. In this study, to define the mechanisms of radiation pneumonitis biologically, we measured lipid peroxides, the activities of glutathione peroxidase (GSH pex.), leukotriene C4 and D4 (LTC4 and LTD4) in the irradiated lungs of mice. Eight weeks old female ICR mice were sacrificed at various time periods (immediately after to 5 days) following the 10 Gy whole-body irradiation with 60Co gamma rays. The lipid peroxides and the activities of GSH pex. increased immediately after the irradiation, but returned to the control level 1 hour after the irradiation. And then, the lipid peroxides also increased from 1 day after the irradiation, while the activities of GSH pex. decreased below the control level. LTC4 and LTD4 in the irradiated lungs of mice were also significantly higher than those of non irradiated controls. Furthermore, we investigated effects of Coenzyme Q10 and Azelastine for the prevention of radiation pneumonitis. Lungs of ICR mice after 10 Gy whole-thorax irradiation treated with those drugs were compared with the control lungs pathologically. Intraperitoneal administration of those drugs decreased the damages for endothelium, such as vacuole formation and stripping off the basement membrane which were recognized by electron microscope. Based on these results, it was strongly suggested that initial damage of irradiated lungs might be induced by lipid peroxides and leukotrienes, and that Coenzyme Q10 and Azelastine could reduce radiation pneumonitis. PMID- 2755801 TI - Using nursing research. PMID- 2755802 TI - Nursing care of children. PMID- 2755803 TI - Use of research in clinical judgment. PMID- 2755804 TI - Nursing care of the elderly. PMID- 2755805 TI - Mental health nursing. PMID- 2755806 TI - Guidelines for evaluation of research for use in practice. PMID- 2755807 TI - Community health nursing. PMID- 2755809 TI - Nursing management. PMID- 2755808 TI - Health promotion and primary care nursing. PMID- 2755810 TI - Basic concepts, skills, and procedures. PMID- 2755811 TI - Maternity nursing. PMID- 2755812 TI - Using nursing research. Instructor's manual. PMID- 2755813 TI - Critiques of research on basic concepts, skills, and procedures. PMID- 2755815 TI - Critiques of research on nursing care of children. PMID- 2755814 TI - Critiques of research on maternity nursing. PMID- 2755816 TI - Critiques of research on nursing care of adults. PMID- 2755817 TI - Critiques of research on nursing care of the elderly. PMID- 2755818 TI - Critiques of research on mental health nursing. PMID- 2755819 TI - Critiques of research on community health nursing. PMID- 2755820 TI - Critiques of research on health promotion and primary care nursing. PMID- 2755821 TI - Critiques of research on nursing management. PMID- 2755822 TI - Foreign bodies. PMID- 2755823 TI - Fat chance. PMID- 2755824 TI - An invisible leash? PMID- 2755825 TI - Support your CNO. PMID- 2755826 TI - Leadership: rising to the challenge. PMID- 2755827 TI - Leadership: bridge-building. PMID- 2755828 TI - Leadership: take me to your leader. PMID- 2755829 TI - Lasting attachments. PMID- 2755830 TI - Hospices are for living. PMID- 2755832 TI - Power to women in partnership. PMID- 2755831 TI - Learning from the experts. PMID- 2755833 TI - Enrolled nurses. Pressure points. PMID- 2755834 TI - Code of conduct. One big headache. PMID- 2755835 TI - The interview. 1. Rules of the game. PMID- 2755836 TI - Students' attitudes towards AIDS. PMID- 2755837 TI - Patient safety in the intensive care unit. PMID- 2755838 TI - A patient with gas--induced brain damage. PMID- 2755839 TI - Learning to COPE. PMID- 2755840 TI - Teaching ethics. PMID- 2755842 TI - Suicide: the other victims. PMID- 2755843 TI - Suicide: those left wanting. PMID- 2755841 TI - Waiting for Griffiths. PMID- 2755844 TI - Suicide: how do we cope? PMID- 2755846 TI - Cultivate support workers. PMID- 2755845 TI - Enrolled nurses. The graveyard of ambition? PMID- 2755847 TI - The interview. 2. Games people play. PMID- 2755848 TI - Fit for nursing. The hazards of healthy eating. PMID- 2755850 TI - Journal of wound care society. PMID- 2755849 TI - Rape. A subject for the curriculum? PMID- 2755851 TI - The pressure sore debate. PMID- 2755852 TI - Breast self-examination program praised. PMID- 2755854 TI - Patient education SIG seeks input. PMID- 2755853 TI - Weight gain in breast cancer. PMID- 2755855 TI - Accidental acute exposure to fluorouracil. PMID- 2755856 TI - Creating a vision of hope: the challenge of palliative care. PMID- 2755857 TI - Putting creativity into practice. PMID- 2755858 TI - A longitudinal study of the adjustment of patients and husbands to breast cancer. AB - Although adjustment to breast cancer is an ongoing process, few studies have assessed the psychosocial adjustment of patients and husbands over an extended period of time. The purpose of this descriptive study was to compare the psychosocial adjustment of mastectomy patients and their husbands at three points in time: 3 days, 30 days, and 18 months post-surgery. Data were obtained from 41 mastectomy patients and their husbands (n = 82 subjects) at each time point. Three instruments with established reliability and validity were used to measure three components of psychosocial adjustment: the Affects Balance Scale (mood), the Brief Symptom Inventory (symptom distress), and the Psychosocial Adjustment to Illness Scale (role functioning). Repeated measures Analysis of Variance was used to compare changes in subjects' adjustment levels over time. Results indicated that while subjects' levels of mood and levels of role functioning improved over time, subjects' levels of distress did not improve over time. Distress levels reported by patients and husbands at 18 months were similar to levels reported at 3 days and 30 days post-surgery. The findings suggest that difficulties in psychosocial adjustment are not confined to the early phase of illness but persist over time for both patients and husbands. Nursing implications center on the importance of long-term, ongoing assessment. PMID- 2755859 TI - Effects of controlled-released morphine on quality of life for cancer pain. AB - Oncology nursing is concerned with pain relief and overall Quality of Life (QOL). The purpose of this study was to determine the effects of controlled-release morphine on QOL for patients with cancer. Eighty-three subjects were randomly assigned in a clinical trial of short-acting versus controlled-release analgesia (MS Contin, Purdue Frederick Co., Norwalk, CT). Data was collected in a repeated measures design every 2 weeks for 6 weeks yielding a total of 240 visits. Five instruments were used to assess QOL, pain, and functional status. Study findings indicate improved pain management with controlled-release MS Contin and important nursing implications for the management of analgesia-induced gastrointestinal symptoms. Through appropriate pain management with pain therapies such as controlled-release analgesia, nurses can greatly enhance QOL for the patient with cancer. PMID- 2755860 TI - Continuous infusion chemotherapy in the ambulatory setting: the nurse's role in patient selection and education. AB - Continuous infusion therapy (CIT) is an alternative to traditional intravenous bolus or brief infusion chemotherapy. The benefits of CIT are improved therapeutic index, reduced toxicity, and modification of drug resistance. CIT administered in the ambulatory setting fosters cost effectiveness and improved patient satisfaction. Nurses use their clinical skill and judgement to assess potential CIT patients prior to treatment for self-care ability and to prepare them for treatment. Topics to include in patient education are care of the vascular access device, introduction to CIT, toxicities and side effects of medication, pump operation, procedures for daily infusion monitoring, discontinuation of the infusion at home, and plans for follow-up. This article is a guide for the oncology nurse performing a pre-treatment assessment of an infusion candidate and planning patient education sessions. PMID- 2755861 TI - Group therapy for families facing a cancer crisis. AB - The impact of the cancer diagnosis and its effects on the lives of patients and family members can put a serious strain on intra-family relationships. This paper describes how to initiate, lead and analyze supportive group therapy meetings for families of individuals with cancer based on our experiences in conducting more than 600 group sessions over the last 12 years. We have found that most families can benefit from multiple-family therapy sessions and that highly-stressed families can benefit significantly from both multiple- and single-family therapy meetings. Discussed is the need for therapists to be alert to non-verbal as well as verbal communications of families and the need for different interacting techniques for each type of therapy group. The meetings aim to overcome family members' resistance to discussing the emotional distress caused by the disease and to encourage them to bring into the open conflicts from the past, anxieties about the present, and fantasies regarding the future. PMID- 2755862 TI - A study of burnout in nurses working in hospice and hospital oncology settings. AB - This study investigated whether nurses providing care for terminally ill patients experience burnout to different degrees based on the healthcare settings in which they work. The study also investigated the relationships among nurses experiencing burnout in these settings and six work-related variables hypothesized to relate to burnout. Fifty-seven nurses responded to three selected questionnaires. There was a significant difference between hospice nurses' burnout scores and those of hospital oncology nurses. Different work-related variables correlated with burnout for each group, with the exception of support in the workplace, which correlated significantly for both groups. Descriptive data suggest implications for future research. PMID- 2755864 TI - Managing ambulatory infusion systems. PMID- 2755863 TI - What you should know about radiation implant therapy to the head and neck. PMID- 2755865 TI - Challenges to conducting research with children with cancer. PMID- 2755866 TI - Lack of ocular changes with dimethyl sulfoxide therapy of scleroderma. AB - Eighty-four patients with scleroderma hand ulcers were treated 3 times daily for 3 months in a randomized, double-blind clinical trial by immersing their hands into bags of topical 70% dimethyl sulfoxide (DMSO), topical 2% DMSO, or 0.85% normal saline. Fifty-five of the patients completed the study, 46 of whom received blinded initial (0 days) and final (12 weeks) full ophthalmologic examinations. This evaluation included past ocular history, past drug history, family ocular history, pupillary examination, cycloplegic refraction, motility study, applanation tension, indirect dilated funduscopic examination, and slit lamp examination. No statistical difference in these ocular variables, including visual acuity, lenticular changes, and cataract development, were noted among the three groups, and in no patients were the DMSO-related lenticular changes reported in numerous animal studies found. The maximum theoretical dosage of DMSO administered was 2.6 g/kg/day, which is comparable to those used in the animal studies. PMID- 2755867 TI - Prospective surveillance of antibiotic-associated coagulopathy in 970 patients. AB - N-methyl-thio-tetrazole (NMTT) has been proposed as a causative factor in antibiotic-associated coagulopathy. To evaluate this hypothesis, a nationwide surveillance program was initiated to determine the relative frequency of antibiotic-associated coagulopathy and the importance of specific risk factors. A total of 970 patients were studied, with 491 being treated for infections and 479 receiving antimicrobial surgical prophylaxis. The NMTT-containing antibiotic cefotetan was compared with non-NMTT-containing antibiotics, for example, cefoxitin and cefazolin (prophylaxis only), and an aminoglycoside-antianaerobic (AG + AA) combination. Prothrombin time (PT) and partial thromboplastin time (PTT) were measured for each patient prior to the start of antibiotics and within 24-96 hours after the conclusion of drug administration. The patient population was relatively young [mean (SD) age 51.0 (20) yrs] with good nutritional status. The overall frequency of hypoprothrombinemia (4.5%) and bleeding (1.7%) was very low, and was highest with the use of AG + AA (p less than 0.05). No statistical differences were observed for the remaining antibiotic regimens in either the prophylaxis or treatment group. Logistic regression analysis identified treatment with the AG + AA combination, presence of liver disease, and renal dysfunction as factors associated with an increased risk of hypoprothrombinemia. In conclusion, this study suggests that the frequency of antibiotic-associated coagulopathy is low, regardless of antibiotic, in patients who are not critically ill and not malnourished. PMID- 2755868 TI - Brain angiotensin: critical role in the ongoing regulation of body fluid homeostasis and cardiovascular function. AB - The existence of an endogenous brain-angiotensin system and its association with cardiovascular and body water regulation has been recognized for over a decade. Nevertheless, the importance of the brain-angiotensin system to the instantaneous regulation of these processes has not been firmly established. A 5-minute intracerebroventricular (ICV) infusion of the angiotensin antagonist, [Sar1,Thr8] AII, effectively lowered the blood pressure in normotensive rats. Additionally, application of the selective aminopeptidase inhibitor, bestatin, given alone, resulted in a dramatic increase in blood pressure and a robust drinking response. Both effects were 100% blockable by [Sar1,Thr8]-AII pretreatment. Predictably, an aminopeptidase inhibitor, bestatin, greatly elongated the half-lives of AII and AIII in the cerebroventricles. Since neither of these treatments included the introduction of exogenous angiotensins, we have concluded that perturbations of the endogenous brain-angiotensin system are effective at rapidly influencing both cardiovascular and body fluid homeostasis, thus highlighting the paramount role played by brain angiotensin in their ongoing regulation. PMID- 2755869 TI - Quantitative autoradiographic localization of cholecystokinin receptors in rat and guinea pig brain using 125I-Bolton-Hunter-CCK8. AB - The autoradiographic localization of receptors for the brain-gut peptide cholecystokinin (CCK) has shown differences in receptor distribution between rat and guinea pig brain. However the full anatomical extent of the differences has not been determined quantitatively. In the present study, 125I-Bolton-Hunter-CCK8 (125I-BH-CCK8) was employed in a comparative quantitative autoradiographic analysis of the distribution of CCK receptors in these two species. The pharmacological profile of 125I-BH-CCK8 binding in guinea pig forebrain sections was comparable to those previously reported for rat and human. Statistically significant differences in receptor binding between rat and guinea pig occurred in olfactory bulb, caudate-putamen, amygdala, several cortical areas, ventromedial hypothalamus, cerebellum, and a number of midbrain and brainstem nuclei. The results of this study confirm the presence of extensive species specific variation in the distribution of CCK receptors, suggesting possible differences in the physiological roles of this peptide in different mammalian species. PMID- 2755870 TI - Centrally and peripherally administered bombesin decreases food intake in turkeys. AB - The effects of intracerebroventricular (ICV) and intravenous injections of bombesin (BBS) on food intake were investigated in turkeys. Adult turkey hens were injected ICV with 50 to 1000 ng of BBS. In addition, the effect of pretreatment with the BBS antagonist [d-Arg1, D-Phe5, D-Trp7,9, Leu11]-substance P was investigated. To determine if BBS also had a peripheral site of action, 0.5 to 8 micrograms/kg body weight of BBS was injected IV into turkey poults. The ICV and IV injections of BBS decreased food and water intake in a dose-dependent manner. The most efficacious doses when injected ICV for decreasing food and water intake were 1000 and 500 ng, respectively, whereas 8 micrograms/kg was most efficacious in decreasing food intake when administered IV. The satiating effect of ICV-injected BBS could be attenuated with pretreatment with the BBS antagonist. The results of these studies suggest that BBS acts to decrease food and water intake in both the periphery and the central nervous systems of turkeys. PMID- 2755871 TI - Dual effect of bombesin and gastrin releasing peptide on gastric emptying in conscious cats. AB - The effect of bombesin (BBS) and gastrin releasing peptide (GRP) on gastric emptying was studied in conscious cats. This effect was measured simultaneously with antral motility. Acid and pepsin secretions as well as blood hormonal peptide release were additionally measured. A dual effect was observed. First, BBS and GRP slowed gastric emptying of liquids, while antral motility was decreased, then after 60 minutes of continuous intravenous infusion, antral motility returned to basal values and gastric emptying effect reversed. The mechanism of this peculiar action is independent of gastrin, pancreatic polypeptide, somatostatin and motilin release and most probably connected with a cholinergic stimulation induced by the peptides, the late predominance of which counterbalances the inhibitory effect of bombesin-like peptides on antral motility. PMID- 2755872 TI - Identification and characterization of cyclo(His-Pro)-like immunoreactivity in amniotic fluid. AB - Amniotic fluid (AF) from 25 term pregnancies was analyzed for cyclo(His-Pro)-like immunoreactivity (CHP-LI). CHP-LI was detected in all AF samples and was indistinguishable from synthetic CHP by immunoidentity, by gel chromatography on Sephadex G-25, and by high pressure liquid chromatography. The mean concentration of CHP-LI in AF was 13,622 +/- 1288 pg/ml (+/- SE) and concentrations were not altered by maternal labor. Plasma concentrations of CHP-LI were similar in 4 pregnant and 4 control subjects [2260 +/- 432 pg/ml vs. 2162 +/- 419 pg/ml (+/- SE), respectively]. We conclude that 1) CHP-LI is readily detected in AF from term pregnancies and is indistinguishable from synthetic CHP, and 2) concentrations of CHP-LI in human AF are significantly higher than concentrations of maternal plasma CHP-LI, suggesting CHP AF originates by mechanisms other than diffusion from maternal plasma. PMID- 2755873 TI - Human glucagon and vasoactive intestinal polypeptide (VIP) stimulate free fatty acid release from human adipose tissue in vitro. AB - Glucagon, vasoactive intestinal polypeptide and secretin are strong stimulators of lipolysis in adipose tissue from laboratory animals. Yet, in human adipose tissue these data could not be confirmed under comparable experimental conditions. Using pH stat titration, an advanced in vitro test system for evaluating lipolysis, it was possible to demonstrate lipolytic activity for glucagon down to a concentration of 10(-8) mol/l. This is comparable to the minimal effective doses in rat adipose tissue and corresponds to the effect of equimolar concentrations of noradrenaline in man. Secretin with an amino acid sequence very similar to glucagon was not lipolytically active, while VIP stimulated free fatty acid release in a concentration of 10(-6) mol/l. Since the minimal effective dose of glucagon is only 30 times greater than the plasma levels a physiological significance of these finding may be suggested. The lipolytic activity of VIP seems to be only of pharmacological interest. PMID- 2755874 TI - Effects of guinea pig vasoactive intestinal peptide on the isolated perfused guinea pig heart. AB - The pharmacological effects of guinea pig vasoactive intestinal peptide (VIP) were studied in isolated perfused guinea pig hearts. Bolus injections of VIP produced a dose-dependent tachycardia that was not affected by atenolol. A decrease in amplitude of ventricular contractions occurred in response to all doses of VIP. This response was preceded by a small increase in amplitude in 3 of 6 hearts at the highest dose. VIP produced a decrease in perfusion pressure which was prominent after coronary tone was elevated with [Arg8]-vasopressin. The present findings support speculation that VIP may have a role in the regulation of heart rate and coronary blood flow. PMID- 2755876 TI - Structural identification, subcellular localization and secretion of bovine adrenomedullary neuromedin C [GRP-(18-27)]. AB - Bombesin-like immunoreactivity (BLI) was purified from acid (HCl) extracts of bovine adrenal medulla. High performance liquid chromatography (HPLC) on a mu Bondapak C18 column revealed the presence of five molecular forms of BLI, one coeluting with synthetic gastrin releasing peptide (GRP), the mammalian counterpart of amphibian bombesin, one coeluting with neuromedin C, one coeluting with neuromedin B and the two other ones coeluting with the oxidized forms of neuromedins B and C. The material corresponding to neuromedin C was purified to homogeneity and its amino acid composition and sequence corresponded to those expected for neuromedin C. HPLC analysis on an analytical SP-5PW column of subcellular extracts of bovine adrenal medulla indicated that neuromedin C is almost exclusively localized in secretory granules. The neuropeptide function of neuromedin C and/or other BLI peptides at this level was supported by the stimulatory effect of carbamylcholine (500 microM) on the release of BLI (4.5 fold increase over the basal release of 19 fmol/5 min) from perfused bovine adrenal glands. PMID- 2755875 TI - Melanin concentrating hormone (MCH): synthesis and bioactivity studies of MCH fragment analogues. AB - Nineteen analogues of melanin concentrating hormone (MCH) were synthesized and tested for their skin-lightening activities in the in vitro eel skin (Synbranchus marmoratus) bioassay. All the analogues synthesized were fragments of the native sequence: Asp-Thr-Met-Arg-Cys-Met-Val-Gly-Arg-Val-Tyr-Arg-Pro-Cys-Trp-Glu-Val with sequential elimination of substituents from both the carboxy- and amino termini. All the analogues that contained tryptophan in position 15 were found to be full agonists and equipotent to MCH. In the absence of Trp15, full agonist activity was maintained but potency was reduced ten-fold or more. The minimal fragment analogue possessing equipotency to the parent peptide, MCH, was the MCH(5-15) sequence. These observations coupled with results from work reported previously by our laboratories suggest the importance of the Trp15 residue for interaction with the MCH receptor in this assay system. PMID- 2755877 TI - Sauvagine/urotensin I-like immunoreactivity in the caudal neurosecretory system of a seawater fish Diplodus sargus L. in normal and hyposmotic milieu. AB - We report the presence of sauvagine/urotensin I-like immunoreactive (SV/UI-LI) elements in the caudal neurosecretory system of a teleost (Diplodus sargus L.) collected from aquaria tanks of the Aquaculture Center (Talassographic Institut of CNR) of Messina or maintained in an hyposmotic milieu for different periods. In normal specimens, SV/UI-LI material was recognizable in discrete or little amounts both in Dahlgren cell cytoplasm and in their axons that reach the urophysis. On the contrary, the specimens transferred in an hyposmotic milieu showed a fast and dramatic increase of immunoreactivity mainly in neurohemal endings of the urophysis. This suggests a physiological role of caudal neurosecretory products on osmoregulatory mechanisms. PMID- 2755878 TI - Supraspinal FMRFamide antagonizes morphine-induced horizontal, but not vertical, locomotor activity. AB - Morphine and the molluscan neuropeptide Phe-Met-Arg-Phe-NH2 (FMRFamide) were administered to mice alone or in combination intracerebroventricularly (ICV) and the effect on locomotor activity was measured. Morphine given alone (0.5 micrograms) significantly increased horizontal locomotor activity compared to vehicle-treated controls. FMRFamide at low doses (0.01-10 micrograms) had no effect of its own, but blocked the morphine-induced increase in horizontal locomotor activity. Unlike the opiate antagonist naloxone (1.0 micrograms), FMRFamide (up to 10 micrograms) had no effect on morphine-induced decrease in vertical activity. These data further support a role for FMRFamide as a modulator of opiate action, but comparison to naloxone suggests that FMRFamide might not act as a pure competitive antagonist of this opiate effect. PMID- 2755880 TI - Distribution of two distinct messenger ribonucleic acids encoding gastrin releasing peptide in rat brain. AB - There are two distinct mRNAs that encode the precursor to gastrin-releasing peptide (GRP) in rat brain. These two messages arise from separate transcription initiation sites located approximately 400 base pairs apart, which are presumably regulated by separate promoters. In the present study, we mapped the distribution of neurons containing GRP mRNAs by in situ hybridization using cRNA and synthetic DNA probes specific for the 1.5 kb GRP transcript and probes complementary to both the 1.5 kb and 1.1 kb transcripts. The distribution of neurons expressing GRP mRNA appears to be wider than that previously observed by immunohistochemical studies, suggesting an important functional role for this neuropeptide in a number of brain regions. We detected the 1.5 kb transcript only in cingulate cortex, Ammon's horn of the hippocampus and in subiculum. In contrast, the probe which hybridized to both GRP mRNAs labeled a broad range of brain areas, including those containing the 1.5 kb mRNA. These data suggest that the 1.5 kb mRNA encoding rat GRP is expressed only in specific parts of the limbic system, whereas the expression of the 1.1 kb GRP message is more widespread. PMID- 2755879 TI - Electrophysiological studies with new CCK analogs: correlation with binding affinity on B-type receptors. AB - The electrophysiological effects of Boc-D-Asp-Tyr(SO3H)-Nle-D-Lys-Trp-Nle-Asp-Phe NH2 (compound I) and Boc-gamma-D-Glu-Tyr(SO3H)-Nle-D-Lys-Trp-Nle-Asp-Phe-NH2 (compound II), two cyclic cholecystokinin analogs with high selectivity for CCK-B receptors, as well as the effects of the linear enzyme-resistant analog Boc [Nle28,Nle31]-CCK7 (BDNL), were compared with those of CCK8 using extracellular recordings in rat hippocampal slices in vitro. Bath applications of the three synthetic compounds resulted in concentration-dependent and reversible increases in single-unit activity. Comparison of equieffective concentrations yielded the following potency rank order: BDNL greater than CCK8 greater than compound II greater than compound I. There was a close correlation (r = .96, slope = 0.98) between the excitatory activities of the analogs and their potencies in displacing radiolabelled CCK8 from CCK-B receptors on rat brain membranes. PMID- 2755881 TI - Characterization of angiotensin II receptors in the rat fetus. AB - The presence of AII receptors during early and late embryonic development was studied by binding of 125I[Sar1, Ile8] AII to whole mouse blastocysts and membrane-rich fractions from rat conceptuses, 7 to 21 days in gestation. In early mouse embryos there was no detectable binding under a variety of experimental conditions. However, in late gestation rat fetuses, specific and high affinity binding was observed, with a concentration of sites similar in membranes from whole and eviscerated fetuses. Using less than 100 micrograms of membrane protein, binding was time and temperature dependent, maintaining equilibrium from 30 to 120 min at 23 degrees C and it was enhanced by addition of Mg+2 up to 5 mM, EGTA 2 mM and dithiothreitol up to 2.5 mM. Scatchard analysis of the binding data indicated Kd values ranging between 0.7 and 0.9 nM. Binding was first detectable at day 10 (14.3 +/- 2.3 fmol/mg), increasing to 104 +/- 16, 2,625 +/- 168, 5,993 +/- 152 and 5,902 +/- 92 by days 12, 15, 18, and 21 of gestational age, respectively. Since the functional significance of these binding sites depends on the availability of the agonist ligand, acid extracts from eviscerated 10-day-old fetuses were analyzed for the presence of AII. Measurement of AII by radioimmunoassay revealed immunoreactive AII-like material (845 pg/g of tissue), with an elution pattern identical to that of AII standard in a Sephadex G-50 column. This material was bioactive, as demonstrated by its ability to displace 125I[Sar1, Ile8]AII from adrenal glomerulosa membranes, an effect which was abolished by pretreatment of the extract with AII antibody.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2755882 TI - My patient, my friend. PMID- 2755883 TI - Detecting physical disorders in emotionally disturbed patients. AB - Comprehensive assessment of physical and emotional conditions in patients with functional complaints is important. Physical disorders are sometimes overlooked in mentally ill patients, resulting in a delay in diagnosis and possibly irreversible changes. Clues to physical causes of functional complaints include an atypical clinical presentation, behavior that is out of character, a lack of demonstrable secondary gain, and multiple target-organ symptoms. PMID- 2755884 TI - How to evaluate murmurs in children. PMID- 2755885 TI - Toothpick perforation mimicking jejunal lymphoma. PMID- 2755886 TI - Postanginal sepsis. A pain in the neck. AB - The primary care physician must be on the alert when a patient presents with a sore throat, signs of sepsis, and a rapidly deteriorating condition. Recognition of this distinct clinical presentation should lead to the diagnosis of postanginal sepsis. Once this diagnosis is suspected, therapy with an antibiotic that provides coverage against streptococci and anaerobes should be initiated promptly, and a drainable focus of infection should be excluded. PMID- 2755887 TI - Effects of genetic strain, slow versus rapid-feathering maternal genotype, and cage density on the performance of Single Comb White Leghorns. AB - Two hatches involving 11,158 pullets from 22 Single Comb White Leghorn strain crosses were used in these experiments: 13 from rapid-feathering (k+/-) and 9 from slow-feathering (K/-) dams, some of which shared common genetic backgrounds; and all from 5 homozygous k+ sire types. Birds were grown intermingled within hatch, and were subsequently caged in two laying houses, one with 30.5 cm x 40.6 cm cages and the other with 40.6 cm x 30.5-cm cages, at densities of three or four birds/cage. Data were collected by cage on hen-day rate of lay from 50% production to 52 wk of age; (HD%), number of eggs produced per hen housed (EHH), percentage mortality (%M) to 52 wk of age; 35-wk BW (BW35); egg weight (EW34), specific gravity (SG34), and percentage bloodspots (BS%34) at 34 wk of age. The effects of hatches or house (H), density (D), maternal feathering type (MFT), genetic strain within MFT (GS/MFT), bank level within house (BL/H), and all possible interactions were included in the analysis model. Hatch, house, and cage type were completely confounded, so no general conclusion can be made concerning the effects of the reverse and standard cages on performance. The H effects were significant for all traits except HD%. Cage D significantly affected all traits except SG34 and BS%34. Pullets housed at three/cage weighed 26 g less, produced 5.5 more eggs that were .3 g/egg lighter, laid at a 1.7% higher hen-day rate, and had 3.6 less %M from 20 to 52 wk of age than those housed at four/cage. The MFT significantly affected all traits except %M, SG34, and BS%34. The k+/- daughters from K/- dams weighed 34 g less, produced at a 2.8% lower HD%, laid 6.9 fewer eggs, which eggs averaged .6 g/egg less than the eggs from the k+/- daughters of the k+/- dams. Interactions were in general small and nonsignificant. However, the H x GS/MFT interactions were significant for HD%, EHH, BW35, %M, and EW34 (P less than .05); their significance is suggestive of the presence of genotype x environment interactions. PMID- 2755888 TI - Feeding time and body temperature interactions in broiler breeders. AB - Four groups of 70-wk-old broiler breeder females were fed once daily at 0600, 1000, 1400, and 1800 h to determine the effect of feeding time and eating on body temperature. The photoperiod was from 0430 to 1930 h. Four floor pens of 30 hens each were assigned per feeding time. Following a 9-day adjustment period, body temperature was determined, in series, by rectal probe of 5 birds/pen at 7 and 3 h prefeeding and 1, 5, 9, and 13 h postfeeding. Body temperature was increased .5 C at 1 h postfeeding in all groups and at 5 h postfeeding in the 0600-h fed group. The rate of feed consumption was fastest with afternoon feeding. Four 1-yr old broiler breeder males were implanted with an FM radio transmitter for monitoring body temperature and housed in an environmental control chamber. Body temperature was monitored when the birds were fed at 0600, 1000, 1400, and 1800 h. The chamber temperature cycled from 22.2 to 33.3 C (22.2 C: 2200 to 0800 h; 33.3 C: 1200 to 1600 h; 27.8 C: 0800 to 1200 h and 1600 to 2200 h). Lights were on from 0430 to 1930 h. Body temperature changes were also monitored under constant temperature (27.8 C) and light for birds fed ad libitum or at 1000 h. Body temperature increased as much as 1.5 C following feeding and reached a maximum at 5, 4, 3, and 2 h postfeeding at feeding times of 0600, 1000, 1400, and 1800 h, respectively. Males unable to feed displayed a significantly increased body temperature when they observed other birds eating. A specific body temperature response to feeding activity was observed only when males were fed once daily under constant environment. PMID- 2755889 TI - Water usage of broiler breeders. AB - Water usage of daily fed and skip-a-day-fed broiler pullets housed in cages was measured in two trials. Daily fed birds in both trials had free access to water. In Trial 1, skip-a-day-fed birds were restricted to 4 h water every day or only on feed days. In Trial 2, the skip-a-day-fed birds were water restricted 4 h either every day, only on feed days, or had free access to water. Skip-a-day-fed birds tended to drink more water on feed days than on off-feed days but amounts were significantly different only in Trial 2. Water intake of these skip-a-day fed birds on off-feed days was less than that of comparable birds fed on a daily basis with free access to water. Conversely, skip-a-day-fed birds drank more water on feed days than did daily fed birds (P less than .05) when both groups were given free access to water. Overall mean daily water consumption and spillage were unaffected by feeding or water restriction regimens. The main influence of skip-a-day feeding and water restriction appears to be on the pattern of water consumption and not on overall water usage. Daily feeding increased body weight gain relative to that of birds fed skip-a-day, although water restriction did not influence growth. Metabolizable energy derived from a feed was unaffected by feeding or water restriction regimens. PMID- 2755890 TI - Individual and combined toxicity of deoxynivalenol and T-2 toxin in broiler chicks. AB - Effects of feeding diets containing deoxynivalenol (DON)-contaminated wheat (16 mg DON/kg) and purified T-2 toxin at 4 mg/kg singly and in combination were characterized in male broiler chicks from 1 day to 3 wk of age. Total body weight gains and final body weights were significantly reduced by the DON/T-2 toxin combination but were not significantly affected by the toxins singly. The efficiency of feed utilization was reduced in chicks fed either of the diets containing DON-contaminated wheat. The incidence and severity of oral lesions induced by T-2 toxin was increased in the DON/T-2 toxin combination. Several parameters not altered by DON or T-2 toxin singly were significantly affected by the combination, indicating that the combination may pose a potentially greater problem to the poultry industry than either of the mycotoxins individually. PMID- 2755891 TI - Digestive tract clearance of broilers cooped or deprived of water. AB - Feed is withdrawn from broilers to facilitate digestive tract clearance before processing. This research examined the effects of cooping and water deprivation on contents of the digestive tract during feed withdrawal in two experiments. Broilers were reared to 48 days of age on litter in a windowless house. Corn soybean meal diets and water were provided ad libitum. In the first experiment, broilers were continuously fed before feed withdrawal. In the second experiment, broilers were placed on a meal-feeding regimen of 1.5 h on feed and 4.5 h off feed for 42 h prior to feed withdrawal. Withdrawal began at the end of a 1.5-h feeding period. At the time of feed withdrawal, broilers were cooped, left on litter without water, or left on litter with water available. At 2, 4, 6, and 8 h after withdrawal, ten broilers from each treatment were killed and the crop, proventriculus plus gizzard, and small intestine were removed. The weight of the contents of each segment was determined. Water deprivation did not change the weight of contents in any segment. Cooped broilers retained digesta in the crop and proventriculus plus gizzard for a longer time than broilers on litter. The combination of meal feeding and cooping soon after feed withdrawal greatly increased the quantity of digesta in the crop 8 h after feed withdrawal. Cooping should be delayed until the crop is empty. Meal feeding increases the time required to accomplish this. PMID- 2755892 TI - Characterization of resistance and immunity to Eimeria tenella among major histocompatibility complex B-F/B-G recombinant hosts. AB - The relative influence of the B-F vs. B-G chromosomal regions on innate resistance and immunity to Eimeria tenella was studied among six B-F/B-G recombinants, designated BR1, BR3, BR4, BR5, BR6, and BR8. In one experiment, resistance was studied among 340 F1 chicks each carrying the B17 allele derived from Line UCD.003 and therefore also heterozygous for one of the B recombinant haplotypes. In a second experiment, acquired immunity was studied among 161 F2 chicks each carrying one B17 allele and segregating for one of the recombinant alleles. In Experiment 1, F1 chicks of similar haplotypes, BR3 and BR4 (BF2-G23), gained significantly more weight than those with BR1 (BF24-G23) and BR5 (BF21 G19) following exposure to a single high dose of 25,000 oocysts, although no differences in lesion scores were detected among the six recombinants. Following exposure to a single low dose of 2,500 oocysts, F1 chicks BR3 and BR4 also gained significantly more weight and had significantly lower lesion scores than BR1 or BR5 F1 chicks. To study acquired immunity in the F2 homozygous chicks, five consecutive daily exposures of 500 oocysts were followed 21 days later by challenge with 10,000 oocysts. The BR5 (BF21-G19) and BR6 (BF21-G23) homozygous chicks, both carrying the B-F21 allele, showed significant protection in terms of reduced lesion scores. These results demonstrate that E. tenella parasitism manifests itself to varying degrees in chicken hosts possessing different recombinant major histocompatibility complex haplotypes. PMID- 2755893 TI - Metabolism of decoquinate in chickens and Japanese quail. AB - Thirty mature chicken hens and 40 mature Japanese quail hens were used in an experiment to compare pathways of decoquinate (DQ) excretion. Labelled DQ was injected into chickens (.5 microCi via wing vein puncture) and quail (.25 microCi via cardiac puncture) on Day 0. Blood was sampled at 0, 1.5, 3, 6, 9, 12, 24, and 48 h postinjection. Eggs and excreta of chickens and quail were collected for 28 and 14 days, respectively, and analyzed for 14C. Six chickens and eight quail were sacrificed prior to 14C-DQ injection and also on Days 1, 7, 14, and 34 or 32 postinjection. Samples of liver, heart, kidney, bile, skin, fat, and muscle were analyzed for 14C. Blood rapidly cleared 14C in both species, and the half-time of 14C excretion via excreta was more rapid in quail (.37 day) than in chickens (.92 day). Little 14C was found in the eggs of quail (.32% of dose) and chickens (.17% of dose). Quail appeared to excrete peak amounts of detectable 14C 1 day earlier (Day 4) than chickens (Day 5). Liver contained the greatest concentration of 14C on Day 1 in both species. By the end of the experiment, less than 1% of the dose remained in liver or other organs. Results indicate that chickens and quail metabolize 14C-DQ at comparable rates and by similar pathways. PMID- 2755894 TI - Effect of severity of early protein restriction on large turkey toms. 1. Performance characteristics and leg weakness. AB - The effect of early protein (Pr) nutrition on compensatory growth and leg weakness of turkey toms was studied. Four levels of dietary Pr [100, 80, 70, or 60% of National Research Council (NRC) recommendations in 1984] were fed ad libitum in isocaloric diets from 1 to 6 wk of age. Subsequently, the four treatment groups were fed a common diet within age periods according to NRC (1984) Pr levels. As the level of Pr decreased, body weight at 6 wk decreased (2.23, 1.94, 1.63, and 1.39 kg, respectively, P less than .005) and 1 to 6-wk feed:grain ratios increased. Weight gains from 6 to 20 wk of age were the same for all treatment groups. Thus, a significant carry-over effect of Pr on body weight was still evident at 20 wk of age (15.5, 15.2, 14.9, and 14.5 kg, respectively, P less than .005). Feed consumption decreased linearly through 16 wk of age as Pr decreased. Feed:gain ratios from 6 to 20 wk of age decreased (3.25, 3.20, 3.14, and 3.13, respectively, P less than .05), and Pr consumption:gain ratios from 1 to 20 wk decreased (.596, .551, .546, and .543, respectively, P less than .005) as the level of Pr decreased. However, the cumulative feed:gain ratio from 1 to 20 wk of age was not affected by Pr. The 60 or 70% level of dietary Pr resulted in 60% fewer toms with severe leg weakness at 18 wk of age than the 100% level of dietary Pr. Toms have limited ability for compensatory weight gain within the realimentation time allowed, regardless of the level of Pr fed from 1 to 6 wk. However, significant savings in dietary Pr and reduced leg weakness may be economically beneficial when Pr is restricted to 70% of the 1984 NRC recommendations during early growth. PMID- 2755895 TI - Effect of severity of early protein restriction on large turkey toms. 2. Carcass characteristics. AB - The effect of early protein (Pr) nutrition on the carcass characteristics of turkey toms was studied. Four levels of dietary protein [100, 80, 70, or 60% of National Research Council (NRC) recommendations in 1984] were fed as isocaloric diets ad libitum from 1 to 6 wk of age. Subsequently, the four treatment groups were fed according to NRC recommendations in 1984 to 20 wk of age. Toms from all treatment groups were sampled at 6, 12, and 20 wk of age, and New York-dressed carcasses were evaluated for chemical composition and yield of commercial cuts. Fat and DM content in the carcass increased, whereas ash and crude Pr content decreased as the toms aged. Yields of breast and back increased, drumsticks and wings decreased, and thighs did not change as the toms aged. At 6 wk, percentages of carcass Pr and ash were not affected by Pr, but fat increased linearly as the level of Pr decreased (P less than .005). Breast and thigh meat yields decreased, and skin yield increased as the level of Pr decreased. Yields of bone and other carcass parts were not influenced by Pr. At 12 and 20 wk, breast and thigh meat yields and chemical composition were restored to normal proportions, irrespective of early Pr nutrition. At 20 wk of age, only breast yield was significantly reduced by 60% Pr (P less than .05). The amount of dietary Pr consumed per carcass Pr gain decreased at all stages of growth as the level of Pr decreased. Early Pr had minimal effects on relative organ weights. Toms recover from the effects of early Pr restriction on carcass parts, but restriction to the 60% level may reduce breast meat yield. PMID- 2755896 TI - Effect of dietary aluminum on calcium and phosphorus metabolism and performance of laying hens. AB - The effect was studied of feeding dietary Al as aluminum sulfate on calcium and phosphorus metabolism and performance of Single Comb White Leghorn laying hens. In Trial 1, graded levels of Al (0, .05, .10, or .15%) were added to a corn soybean meal layer diet containing 3.3% Ca and .5% available P. Each diet was fed for 28 days to six groups of six individually caged hens. Adding .15% Al to the diet significantly (P less than .05) reduced feed intake, egg production, body weight, tibia breaking strength, and plasma inorganic P. In Trial 2, graded levels of Al (0, .1, .2, or .3%) were added to the basal diet. Each diet was fed to five or six individually caged hens for 42 days. Feeding .3% Al significantly (P less than .05) decreased plasma inorganic P in samples collected immediately following oviposition after 10 and 42 days of treatment. Plasma total Ca, tibia weight, and tibia breaking strength were unaffected by dietary treatments. Egg production and feed intake during Days 1 through 21, but not during Days 22 through 42, were significantly reduced by .3% Al. The results indicated that the addition of .3% Al to a laying hen diet has a negative effect on P metabolism and egg production. PMID- 2755897 TI - Riboflavin requirement of turkey poults fed a corn-soybean meal diet from 1 to 21 days of age. AB - Two battery experiments involving a total of 816 Nicholas Large White turkey poults were conducted to determine the riboflavin requirement from 1 to 21 days of age. In Experiment 1, 480 poults were assigned to six dietary treatments: 0, .6, 1.1, 1.7, 3.1, and 4.4 mg supplemental riboflavin/kg basal diet. The corn soybean meal basal diet was formulated to contain 28.5% crude protein. The vitamin premix was formulated to be devoid of riboflavin. The analyzed riboflavin content of the basal diet was 2.7 mg/kg feed. Ten replicates of eight birds per pen (four female and four male poults) were used per diet. In Experiment 2, 336 poults were assigned the same dietary treatments but with only seven replications. Using the broken line technique, it was determined that .79 +/- .03 mg supplemental riboflavin/kg diet or 3.5 mg riboflavin/kg diet was needed to maximize growth. However, in order to prevent leg paralysis, slightly more riboflavin appeared to be needed. PMID- 2755898 TI - Effect of dietary calcium and phosphorus levels on ultra-filterable calcium and dialyzable phosphorus in the laying hen. AB - Laying hens were fed diets containing combinations of 2.6 or 3.6% calcium and .45 or .75% total phosphorus. After receiving the diets for 2 wk, blood samples were collected during a 24-h period at 6-h intervals and total calcium, ultrafilterable calcium and dialyzable phosphorus was determined on blood plasma. Plasma total calcium was higher (P less than .05) in hens that received the diets containing the higher level of calcium (3.6%), but was not influenced by dietary phosphorus levels. Overall in the experiment, neither the dietary calcium nor phosphorus levels had significant effects on the plasma ultrafilterable calcium or dialyzable phosphorus. However, at 0600 and 1200 h, dialyzable phosphorus levels in plasma of hens fed the diet high in both calcium and phosphorus was significantly (P less than .05) greater than that in plasma from hens fed diets low in both calcium and phosphorus. The time that the blood sample was taken had a significant effect (P less than .05) on plasma total calcium, ultrafilterable calcium, and dialyzable phosphorus. PMID- 2755899 TI - Efficacy of fertilization in artificially inseminated turkey hens. AB - Research was conducted to develop an artificial insemination protocol optimizing the use of spermatozoa by turkey breeder hens. Large White turkey hens were inseminated on Days 14 and 17 postphotostimulation with 200 million spermatozoa from one male phenotype to fill the oviductal storage sites. Artificial inseminations were then performed weekly for 20 wk with different spermatozoa numbers of another male phenotype. Fertility and phenotype of each poult were determined at hatch to ascertain which insemination, initial or subsequent, was responsible for fertility. Inseminating weekly with 200 million viable spermatozoa cells resulted in better fertility but did not optimize the hen's utilization of spermatozoa from the initial inseminations. When fewer spermatozoa were inseminated weekly (50 million cells), more progeny were fertilized by spermatozoa already residing in the oviduct than would be expected. When the number of spermatozoa inseminated weekly was increased at intervals during a laying cycle, spermatozoa from the initial inseminations were utilized more efficiently, but fertility was depressed at times during the laying cycle. Gradually increasing weekly inseminated numbers of spermatozoa from 50 to 200 million viable cells/hen as the hens age results in nearly equivalent fertility to that resulting from insemination by 200 million cells each week. This represents a savings of 1.4 billion spermatozoa/hen over a 20-wk laying period. PMID- 2755900 TI - Direct effects of furosemide and amiloride on the perfused and ischaemic rat heart. AB - The present study was undertaken in order to assess direct effects of furosemide and furosemide plus amiloride upon the perfused and ischaemic isolated rat heart. Furosemide in concentrations ranging between 4-400 mg/l in the perfusate increased coronary flow in a concentration dependent manner. There was no evidence for a negative inotropic effect of furosemide. However, very high doses of furosemide (400 mg/l) decreased the post-ischaemic values of left ventricular developed pressure, coronary flow rate, adenosine triphosphate, creatine phosphate and potassium, and increased the myocardial content of calcium and sodium. Furosemide 4 mg/l and 40 mg/l had no effect on post-ischaemic parameters compared to the control group except that furosemide 40 mg/l increased the recovery of coronary flow. Although amiloride 13.3 mg/l alone did not affect post ischaemic recovery, the addition of this dose to furosemide 400 mg/l improved the post-ischaemic recovery of left ventricular developed pressure, coronary flow rate and adenosine triphosphate. The myocardial content of magnesium and potassium was higher indicating protection of amiloride by its magnesium- and potassium-sparing properties opposing ischaemic losses aggravated by the exposure to furosemide. PMID- 2755902 TI - Kinetics of reaction of cis-diamminedichloroplatinum(II) with DNA. AB - A method based on cation exchange chromatography was developed to determine the adducts formed in the reaction of cis-diamminedichloroplatinum(II) (cis-Pt) with DNA. DNA was incubated with various concentrations of cis-Pt for various periods of time, ethanol precipitated, and enzymatically digested to nucleosides and Pt containing oligonucleotides. The unmodified nucleosides were separated from the positively charged intra- and interstrand cis Pt adducts with a weak cation exchanger, CM-Sephadex C-25, and the adducts were further purified by HPLC. The main adduct was shown to be an intrastrand cross-link of cis-Pt bound to the N-7 atoms of two neighboring guanines. The minor adducts were intra- and interstrand cross-links of cis-Pt with adenine and guanine and an interstrand cross-link of cis-Pt with two guanines. At low levels of DNA-modification (cis-Pt:nucleotide = 1:50-1:1000) the intrastrand cross-link of cis-Pt with two guanines consisted of 60-70% of the total platination of DNA. At higher levels of DNA-modification (greater than 1:20), the amount of undigested products increased, indicating shielding of DNA by cis-Pt from nucleolytic enzymes. PMID- 2755903 TI - Uptake of gentamicin in foetal and newborn rats after a single intraperitoneal injection. AB - The aim of the present investigation has been to examine 1) the placental passage and uptake of gentamicin in foetal rat tissues and 2) uptake and organ distribution of this drug in neonatal rats with special reference to the kidney. After a single intraperitoneal injection of tritium-labelled gentamicin to the mother, we found a rapid passage of radioactivity across the rat placenta, but no pronounced tendency to accumulation in the foetus. After administration of 10 micrograms or 100 mg gentamicin per kg body weight to pregnant rats at day 11 or 13, respectively, of gestation, the maximal concentrations of the drug recovered in individual foetuses were 0.05 and 300 ng per mg wet weight. Ten and 90 min. after administration the uptake of gentamicin in the kidney cortex of the mother was 25 and 118 fold higher, respectively, than the corresponding uptake in the foetal kidney after 19 days of gestation. After a single intraperitoneal injection, gentamicin uptake in the kidney cortex of neonatal rats resembled that seen in adult animals, with a rapid initial phase followed by a relatively stable plateau, although the maximal uptake was only about 10% as large in the neonates. PMID- 2755901 TI - Adenosine triphosphate blocks opiate withdrawal symptoms in rats and mice. AB - The effect of adenosine triphosphate (ATP) on the expression of opiate withdrawal was examined using a chronic model of morphine-dependence. ATP was studied for its ability to modify or block jumping in morphine-abstinent mice. In mice administered 2 mg/kg ATP intravenously, the naloxone ED50 for withdrawal jumping increased by 11-fold in comparison to saline-treated mice. Nalaxone-precipitated morphine-withdrawal in the rats, has been shown to induce a specific pattern of intestinal hypermyoelectric activity and to increase the arterial blood pressure. Administration of ATP at dose of 1 and 2 mg/kg intravenously inhibited the induction of hypermyoelectric activity pattern in 80 and 100% of animals tested respectively. ATP also blocked the increase in mean arterial blood pressure seen during withdrawal in a dose-dependent fashion. Investigations were carried out to determine if blocking of the alpha 2-adrenoreceptors with yohimbine would result in an alteration in antiwithdrawal action of ATP. Yohimbine reversed the effect of ATP in blocking naloxone-precipitated withdrawal on the myoelectric activity of jejunum and colon, however, it failed to antagonize the effect of ATP on withdrawal jumping and to block the effect of ATP on the pressor response produced by naloxone in morphine-dependent animals. PMID- 2755904 TI - Inhibition of acute CNS-tolerance to hexobarbital and prolongation of hexobarbital anaesthesia by disulfiram treatment in rats. AB - In many studies disulfiram treatment has been found to prolong hexobarbital anaesthesia, but the underlying mechanisms have not been clarified. In the present study, the effect of disulfiram on the development of acute tolerance to hexobarbital was studied in 2 age groups of rats (80 and 130 days old). Acute tolerance was measured as the increase in the brain concentration of hexobarbital (in 4 brain regions) needed to keep the rats on a constant EEG-monitored anaesthetic level for 1 hr. The effects of disulfiram on the metabolism in vitro and elimination in vivo of hexobarbital were also measured. The results suggest that the prolonged hexobarbital anaesthesia found after disulfiram treatment was the result of an inhibition of at least two different mechanisms: (1) the ability of the brain to develop acute tolerance to hexobarbital, and (2) the metabolism of hexobarbital by the liver, the latter resulting in a decreased elimination of the anaesthetic from the brain. The impaired development of acute tolerance was apparent only in the older rats. The inhibition of hexobarbital metabolism was most obvious in the younger ones. PMID- 2755905 TI - Pinacidil uptake and effects in the isolated rabbit heart. AB - The myocardial accumulation of pinacidil showed one-compartment characteristics with a half-time of 1.11 min., whereas the disposition followed three-compartment kinetics with half-times for the relevant two redistributory and the terminal phases of 0.39, 1.51 and 5.44 min., respectively. At a steady-state drug concentration in the perfusate of 6.12 nmol ml-1, the average concentration of pinacidil in the myocardium was 20.6 nmol g-1. The accumulated amount could predictically be referred with 57% to a central and 31 and 12% to two peripheral (deeper) drug pools. The pharmacodynamic effects of pinacidil in the isolated perfused rabbit heart were studied at stepwise increasing concentrations from 0.15 to 100 microM. Coronary flowrate increased initially up to 24.5% at 1.5 microM pinacidil and then gradually decreased. Amplitude and velocity of contraction were both inhibited in a biphasic way up to 92.7 and 94.1%, respectively. Apparent dynamic steady states developed within 13-15 min. The computer-derived inhibitory Em-values related to the first phase were 49.2 and 52.4% and those related to the second phase were 111.7 and 108.3%, respectively. Heart frequency decreased monophasically and exhibited an inhibitory Em-value of 19.6%. Oxygen consumption decreased at pinacidil concentrations higher than 15 microM and the Em-value was 69.7%. The frequency-corrected QT-interval decreased biphasically and the related inhibitory Em-values were 8.6 and 58.7%. The QRS interval did not change and the PQ-interval only showed a minor increase at the highest pinacidil concentration. Our findings are compatible with the concept of pinacidil being a potassium channel opener. PMID- 2755906 TI - Muscarinic receptor density in the rat urinary bladder after unilateral denervation. PMID- 2755907 TI - Oral absorption of sodium pentobarbital and effects on gastrointestinal function. AB - An anaesthetic dose (40 mg/kg) of sodium pentobarbital (SP) was administered intragastrically to adult, fasted male rats at total dosing volumes of 1, 2, or 3 ml. Area under the plasma concentration-time curve did not differ for the various dosing volumes. During the initial (rapid) phase of gastric emptying all solutions containing drug appeared to empty at a faster rate than distilled water (2 ml). However, solutions containing drug emptied much more slowly than water during the terminal (slow) phase of gastric emptying. Drug solutions moved along the small intestine at approximately the same rate as distilled water. SP significantly lowered rectal temperature and slowed the propagation velocity of the migrating myoelectric complex (MMC) recorded from four serosal electrodes chronically implanted along the proximal small intestine. In addition, the drug significantly decreased the rate of MMC recurrence, extended the duration of MMC phases, and decreased slow wave frequency at all sites monitored. The results suggest that: 1) the relative oral bioavailability of sodium pentobarbital is not influenced by dosing volume within the range tested, 2) the various dosing volumes of SP tested moved through the gastrointestinal tract at an equal rate, and 3) orally administered SP significantly decreases the propagation velocity and periodicity of the MMC in the small intestine. PMID- 2755908 TI - Effects of immunosuppressive chemicals on lymphoid development in foetal thymus organ cultures. AB - A murine foetal thymus organ culture system was employed to screen a number of immunotoxic chemicals for direct thymus toxicity. The toxic effects caused by 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) and its congeners on the system used had previously been shown to be similar to those caused in vivo on lymphoid development. The most potent compound tested was the corticosteroid fluocinolone acetonide, which caused a 50% inhibition of lymphoid development (EC50) at a concentration of 5 x 10(-11) M. The EC50 of TCDD was around 5 x 10(-10) M while that of 4 beta-phorbol 12-myristate 13-acetate (TPA) was ca 10(-7) M. TCDD and its congeners are believed to act via binding to the Ah receptor. Other known or presumed ligands of this receptor, which are potent inducers of P1-450 (P-448) dependent polysubstrate monooxygenase activities, were considerably less toxic with EC50 levels varying between 10(-5) M (7,12-dimethylbenz(alpha-) antracene, alpha-naphthoflavone, benzo(alpha)pyrene) and 10(-4) M (beta-naphthoflavone and 3 methylcholantrene). Dinaphtho/2,3-b,5,6-b/dioxin and indolo/2,3-b/carbazole showed toxicity at 5 x 10(-6)-10(-5) M and 5 x 10(-5) M respectively. TCDD, TPA, and fluocinolone showed additive effects when added two by two in different combinations. Thus fluocinolone, known to counteract the toxicity and epidermal growth factor (EGF) cell-surface receptor-decreasing activity caused by TPA in other cell types, failed to decrease TPA toxicity in the thymus culture system. PMID- 2755909 TI - Tissue distribution of inducible aldehyde dehydrogenase activity in the rat after treatment with phenobarbital or methylcholanthrene. AB - Two genetically distinct substrains of the Wistar rat (RR and rr) were used to study the tissue distribution of the inducibility of aldehyde dehydrogenase (ALDH). The RR substrain is responsive to phenobarbital (PB), as far as the induction of the hepatic ALDH activity is concerned, whereas the rr substrain is deprived of this biochemical property. Both substrains, however, respond to treatment with methylcholanthrene (MC), exhibiting a uniform increase of the ALDH activity in the liver. It is known that PB and MC induce two different isozymes of the hepatic cytosol. The effect of PB (1 g/l in drinking water, for 12 days) on the inducibility of ALDH in extrahepatic tissues was examined in the RR substrain. On the contrary, MC was given (50 mg/kg x 4, intraperitoneally) to rr animals. The activity of ALDH was found to be induced by PB in the liver and the intestinal mucosa, when measured with NAD and propionaldehyde (P/NAD) or phenylacetaldehyde (Ph/NAD). An increase of the activity was also noticed when ALDH was measured with NADP and benzaldehyde (B/NADP). In rr animals, MC induced the B/NADP activity in the liver, the intestinal mucosa, the kidneys, the lungs, the spleen, the brain, the urinary bladder and the heart. The effect of MC on various tissues was less distinct, when ALDH was measured as P/NAD or Ph/NAD activity. It is concluded, that PB and MC not only induce different types of ALDH activity, but they also reveal differences in the tissue distribution of the inducibility of ALDH. PMID- 2755910 TI - Distribution of aluminium following intraperitoneal injection of aluminium lactate in the rat. AB - An animal experiment was performed to evaluate the absorption and distribution of aluminium in serum and tissues of normal rats. The animals were intraperitoneally injected with an aluminium lactate solution at a pH adjusted to 7.0. Before starting, a short preliminary study was carried out in order to verify the validity of the treatment with aluminium lactate instead of aluminium chloride at endogenous pH 3.4. Thirty-one rats were used in the main experiment, divided in four groups. In treated animals, the total Al-administered dose was 75.6 mg during 78 days of treatment. Furthermore, to evaluate the influence of the parathyroid hormone on Al absorption and/or distribution, 200 USP/rat of parathyroid hormone extract (PTH) were also administered during the last 5 days of the experiment. Aluminium content in serum, tibia, rib, brain, liver, muscle, kidney and spleen was determined. Calcium analysis in serum and bone was also performed. The highest concentrations of aluminium were found in liver and spleen, whereas the lowest level was found in the brain. The PTH effect on Al absorption was evident in brain and bone. PMID- 2755911 TI - Effect of diazoxide and hydralazine on intestinal transit and blood pressure in the rat. AB - This study examines the effects of diazoxide and hydralazine on gastrointestinal and vascular smooth muscle. The effect of the drugs administered individually and in combination was determined on small intestinal transit and blood pressure in adult male Sprague-Dawley rats. Both diazoxide and hydralazine produced dose dependent decreases in the ratio of intestinal transit to total length. Additionally, combinations of various doses of hydralazine and diazoxide produced a greater than simple summation of the inhibitory effects on intestinal transit. The combination of diazoxide and hydralazine produced only a simple additive effect on mean arterial pressure. PMID- 2755912 TI - Triazolam: adverse effects in relation to dosage. PMID- 2755913 TI - Histamine receptors in the smooth muscle of human internal mammary artery and saphenous vein. AB - The effects of histamine were characterized and compared in the vascular smooth muscle of two human isolated blood vessels, the human internal mammary artery (HIMA) and the human saphenous vein (HSV). Segments of these vessels were obtained during aortocoronary bypass surgery and their intimal surface was rubbed in order to eliminate any possible influence of the endothelium. Histamine contracted both types of vessels in a concentration-dependent manner and this effect was antagonized by the H1 receptor antagonists mepyramine and cicletanine. In the case of HIMA only this antagonism was found to be competitive (pA2 values of 9.3 and 7.7 for mepyramine and cicletanine, respectively). Histamine-induced contractions were not significantly affected by phentolamine (0.3 microM). In HSV, but not HIMA, indomethacin (5 microM) significantly depressed histamine induced contractions (by about 30%). In the presence of the H2 receptor antagonist cimetidine (10 microM), concentration-response curves of histamine induced contractions were significantly shifted to the left in both HIMA and HSV, suggesting the presence of H2 receptors mediating relaxation. HIMA and HSV precontracted by noradrenaline could be partially and concentration dependently relaxed by histamine, only in the presence of a H1 receptor antagonist. This relaxation was inhibited by cimetidine. The results show that in de endothelialized HIMA and HSV histamine induced mainly contraction which is sensitive to the H1 receptor antagonists. Only in HIMA, nevertheless, was competitive antagonism established. In addition, histamine-induced relaxation, antagonized by cimetidine, could be demonstrated in both precontracted vessels, indicating the presence of H2 receptors. PMID- 2755914 TI - Teratogenic effects of some calcium channel blocking agents in Xenopus embryos. AB - Xenopus embryos, treated for three days from the early cleavage stage with the calcium channel blocking drugs nifedipine, diltiazem, verapamil or nicardipine continue to develop in water. By the seventh day many developmental abnormalities appear, the most reproducible affecting the central nervous system, failure of forebrain development, synophthalmia and neural tube defect. Other anomalies include failure of mandibular growth and malrotation of the gut. Failure of water and electrolyte transport are indicated by severe oedema in some animals. The defects appear to relate to calcium ion antagonism, and provide a pharmacological model for some forms of teratogenesis in which large populations can be studied readily. PMID- 2755915 TI - Effects of toluene on protein synthesis and the interaction with ethanol in hepatocytes isolated from fed and fasted rats. AB - The effects of three different concentrations (about 10, 100 and 1000 microM) of toluene on protein synthesis were studied in hepatocytes isolated from fed and fasted rats after 60 and 120 min. of incubation. The interaction between ethanol (60 mM) and the low and high toluene concentrations were also tested. To measure protein synthesis, 14C-valine was used as the precursor amino acid. Total valine concentration was 2 mM to ensure near-constant specific radioactivity of precursor. Toluene concentrations were measured by head-space gas chromatography. Protein synthesis was unchanged in the presence of low toluene concentrations. Intermediate toluene concentration decreased protein synthesis by about 20% and high toluene concentration decreased protein synthesis by about 60%. Protein synthesis was similar in cells from fed and fasted rats. Ethanol alone inhibited protein synthesis by 20-30%, more in fasted than in fed rats. Toluene and ethanol in combination inhibited protein synthesis additively. The high toluene concentration with or without ethanol appeared to inhibit synthesis/secretion of export proteins in hepatocytes from fasted rats. In conclusion, our study indicates that toluene in relatively high concentrations inhibits general protein synthesis in isolated rat hepatocytes. Toluene and ethanol seems to inhibit protein synthesis additively. PMID- 2755916 TI - The effect of estramustine, nor-nitrogen mustard and tauromustine on macromolecular labelling in the human prostatic tumour cell line 1013L. AB - To further clarify the mode of action of estramustine, the influence on macromolecular synthesis in the human prostatic tumour cell line 1013L was investigated. Cell treatment with estramustine, nor-nitrogen mustard and tauromustine, followed by radioactive nucleotide and leucine incorporations, as a measure of RNA, DNA and protein labelling, were carried out. The initial effect of estramustine clearly differed from that obtained after treatment with nor nitrogen mustard and tauromustine. No inhibition of DNA synthesis was found whereas an inhibition of overall RNA synthesis was predominant. Adaption of an established RNA separation method was used in an indepth study of RNA labelling after estramustine treatment. An inhibition of 29S, 18S and 4-7S RNA was found after estramustine treatment, indicating disturbances in either RNA processing or RNA transport. The lack of 45S RNA labelling additionally indicates pre-ribosomal inhibition. PMID- 2755918 TI - Effects of kynurenic acid and ketamine on neonatal sleep in rats. AB - Kynurenic acid and ketamine are, besides non-specific actions, antagonists of excitatory acidic amino acids in the rat brain. At intraperitoneal doses of 300 mg/kg (1.6 mmol/l) and 5 mg/kg (18 mmol/l), respectively, they are equipotent antagonists of N-methyl-D-aspartate receptors. We studied the acute effects of ketamine and kynurenic acid, at these doses, on sleep patterns of rats during the second and third postnatal weeks with the so called static charge sensitive mattress (SCSB). Both kynurenic acid and ketamine decreased active sleep; ketamine additionally increased quiet state and kynurenic acid increased waking. The decrease in active sleep may be related to glutaminergic NMDA and serotonergic responses in the rat brain but non-specific actions and interactions with other transmitter systems are also involved. PMID- 2755917 TI - Chelation in metal intoxication. XXIX: Alpha-mercapto-beta-aryl acrylic acids as antidotes to mercury (II) toxicity. AB - alpha-Mercapto-beta-(2-furyl) acrylic acid (MFA), alpha-mercapto-beta-(phenyl) acrylic acid (MPA), alpha-mercapto-beta-(2-hydroxyphenyl) acrylic acid (MHA), alpha-mercapto-beta-(4-methoxyphenyl) acrylic acid (MMA), beta-1,2-phenylene di alpha-mercapto acrylic acid (1, 2-PDMA) and beta-1, 4-phenylene di-alpha-mercapto acrylic acid (1, 4-PDMA) enhanced faecal excretion and reduced liver, spleen and blood burden of inorganic mercury when administered (0.5 m mol/kg, in two split doses) 24 hr after Hg (II) (1 mg/kg) in rats. MFA, MPA, MHA, and MMA were also effective in lowering renal Hg mainly from the cytosol, without any significant increase in urinary excretion of Hg. The results indicate that all the mono mercapto acrylic acids including MFA were more effective than di-mercapto acrylic acids and act through the mechanism characteristic of thiol chelators, that is, mobilization of Hg as their complexes, contrary to the reported observation that MFA acts through the induction of metallothionein. PMID- 2755919 TI - Diltiazem enhances gentamicin nephrotoxicity in rats. AB - The effect of the calcium antagonist, diltiazem, was examined in gentamicin induced nephrotoxicity states in rats. Animals were injected for 5 days with diltiazem intraperitoneally (40 mg/kg/day), or gentamicin subcutaneously (100 mg/kg/day) or simultaneously with both preparations using the same doses. At the time of sacrifice, the urea and creatinine clearances, as well as urine osmolality were determined and the renal tissues were processed for examination by light microscopy. Gentamicin-injected rats demonstrated the typical pattern of aminoglycoside nephrotoxicity characterized by poliuric renal failure and necrosis of the proximal tubular epithelium. Rats injected with diltiazem revealed only mild depression of urine osmolality. There was no elevation of blood urea nitrogen and serum creatinine or depression of urea and creatinine clearances, and no focal tubular cell necrosis was detected. However, concomitant administration of both compounds considerably increased nephrotoxicity by according both histological indications and renal function measurements. Thus, we conclude that the combination of diltiazem and gentamicin must be used carefully in human clinical practice. PMID- 2755920 TI - Analysis of methyl mercury binding sites on tubulin subunits and microtubules. AB - We have studied the localization and affinity of methyl mercury hydroxide (MeHg) binding sites on microtubules. There is one class of binding sites for MeHg on tubulin, a high affinity class with fifteen sites. MeHg binds to tubulin stoichiometrically within microtubules, and does not induce microtubule disassembly at this low binding ratio. MeHg binds in microtubules either in the presence or absence of free tubulin subunits but free subunits act as uncompetitive inhibitors for MeHg binding to the polymer. These stoichiometric polymer surface binding sites for MeHg apparently do not interfere with subsequent polymerization, in contrast to the multiple sites in the free dimer whose occupation blocks subsequent assembly. In assembly cycles that follow MeHg binding to polymers, we continue to find MeHg bound to microtubules at substoichiometric ratios. Dimers with higher levels of MeHg binding are rendered assembly incompetent. These results show MeHg to have one class of binding site on tubulin, and the MeHg binding site, both to the polymer surface and to the free dimer, to be the same. PMID- 2755921 TI - Effects of acute morphine administration on noradrenaline turnover and metabolism in various brain parts of control and handled rats. AB - The main purpose of these experiments was to study whether the morphine-induced changes in cerebral noradrenaline (NA) turnover differ between various brain areas of male Wistar rats assessed by the alpha-methyl-p-tyrosine (alpha MT) induced NA depletion. The effects of repeated saline injections (20 days) on the morphine-induced changes in NA and also in free and sulphated 3-methoxy-4 hydroxyphenylethylene glycol (MOPEG) concentrations were studied. 5 to 40 mg/kg of morphine reduced the alpha MT-induced NA depletion in the cortical hemispheres, while 40 mg/kg of morphine enhanced it in the lower brain stem. 10 mg/kg of morphine lowered the NA concentration in limbic forebrain and hypothalamus and increased it in the cortical areas. It also elevated the MOPEG concentrations in all brain parts with the sole exception of sulphated MOPEG in the cortical hemispheres. Naltrexone antagonized the morphine-induced changes in NA turnover and MOPEG concentrations. The only significant handling-induced change was the elevation of NA concentrations in the hypothalamus. The increasing effect of morphine on the sulphated MOPEG concentration in the prefrontal cortex and the lower brain stem was attenuated in handled rats. In conclusion, these findings show that, the response of cortical NA neurones to acute morphine administration is retardation of turnover rather than activation which occurs most notably in the lower brain stem. Furthermore, the responses are modified by previous exposure of rats to handling. PMID- 2755922 TI - Effects of tetraethylthiuram disulfide on the toxicokinetics of cadmium in mice. AB - This study examines the effects of tetraethylthiuram disulfide (TTD; disulfiram, Antabuse) on the toxicokinetics in mice of 109Cd-labelled cadmium chloride, as determined by whole-body and organ gamma-counting. At the highest single dose of orally administered CdCl2, i.e. 70 mumol/kg, orally administered TTD enhanced the inhibitory effect of CdCl2 on intestinal motility and increased the fractional whole-body retention of the dose of cadmium chloride, indicating enhanced intestinal cadmium absorption. Also, TTD induced extensive changes in organ distribution of absorbed cadmium; the relative hepatic and testicular deposition was reduced, while the relative deposition in heart, spleen, lungs, brain and carcass was increased. In a prolonged exposure experiment where CdCl2 was added to the drinking water and TTD to the feed, TTD increased the intestinal absorption of cadmium by more than four-fold as compared to the controls. Further, decreased deposition was seen in the carcass and increased deposition in intestines and liver. In a third experiment, oral doses of TTD given twice weekly had no influence on the rate of excretion of aged cadmium depots, and also the organ distribution was unchanged. Thus, the effect of TTD on cadmium metabolism seems to be exerted only during intestinal absorption and the distribution phase immediately thereafter. PMID- 2755923 TI - Effects of macromolecular chelators on intestinal cadmium absorption in mice. AB - Suppression of absorption by macromolecular chelators have been successful with several metals. In this paper a series of immobilized chelators ranging from DTPA to S-containing soft bases have been synthetized and investigated for ability to suppress intestinal uptake of 109Cd2+ in mice. Dextran-0-ethyl-mercaptan, xanthates derived from polysaccharides and polyvinyl alcohol, dithiocarbamates of polyethylene imine and aminoethyl cellulose, and DTPA immobilized on aminopropyl silica were all ineffective. DTPA immobilized on aminoethyl cellulose even enhanced the intestinal uptake. The macromolecular chelators were without extensive effect on organ distribution of absorbed cadmium, except for dithiocarbamate immobilized on polyethylene imine, which enhanced the deposition of cadmium in several organs including the brain. Although the results are discouraging, they indicate that design and synthesis of immobilized vicinal dithio compounds may represent an avenue for development of non-absorbable chelators with high affinity for cadmium. PMID- 2755924 TI - Interaction between benzylpenicillin and thiopental in the central nervous system of the male rat. AB - The effect of benzylpenicillin (BPC) pretreatment on the kinetics and brain sensitivity for thiopental was studied in male rats using a previously developed electroencephalgrafic (EEG) threshold method. Thiopental was infused intravenously with constant infusion rate. The rats were killed by decapitation immediately after the first burst suppression of 1 sec. or more (the silent second) which was observed in the EEG-record during the infusion. Thiopental concentration in serum and in different brain regions was determined by a high pressure liquid chromatografic method. After pretreatment with 0.9 g/kg of BPC the dose of thiopental needed to induce the silent second was significantly reduced (-20 per cent) when compared with saline treated controls. The serum concentration was also reduced (-30 per cent) after this BPC pretreatment but the concentrations in the different brain regions were the same in both groups. After pretreatment with 1.2 g/kg of BPC almost all animals had convulsions, the dose needed to obtain the silent second was very much reduced and there were reduced concentrations of thiopental in the different brain regions. After both doses of BPC high negative correlations were found between BPC concentrations in brain tissue and thiopental concentrations in hippocampus and brainstem indicating an interaction between the drugs. The most probable site of this interaction is the organic acid transport system out of the CNS which could be used by both substances. Lipid solubility is not the only factor involved in the distribution of thiopental in the rat brain. PMID- 2755925 TI - No embryotoxic or teratogenic effect of dimethyl phthalate in rats after epicutaneous application. PMID- 2755926 TI - [Does medical education change behavior, attitude and knowledge in relation to smoking? A survey of medical students in the 1st and next to last year of study]. AB - Among the 831 students in the first and last-but-one year of medical studies, 21% were smokers, 4% occasional smokers, 63% non-smokers and 5% former smokers. There were no statistically significant difference in smoking habits between the first and fifth years of study. The different semesters did, however, reveal significant differences with respect to their evaluation of smoking as a health hazard, their knowledgability as to the causal effects of smoking in diverse diseases, the readiness of the doctors-to-be to counsel their patients to avoid smoking, self assessment of their knowledge about smoker counselling methods, their support for the ban on cigarette advertising, and further education in the field of smoker counselling. Significant difference were to be seen between smokers, former smokers and non-smokers with respect to their personal evaluation of their smoking habits over the next five years, the assessment of smoking as a hazard to health, and the subjective burdening of smoking, the question as to the example-setting and instructive role of the physician with respect to smoking, and the question of statutory measures affecting smoking. PMID- 2755927 TI - [Tumor-like courses in lung sarcoidosis (4 observations)]. AB - Case reports on 4 women operated on for suspected tumour. The diagnosis of sarcoidosis was confirmed histologically. The difficulties associated with the differential diagnosis are discussed and, the need for morphological clarification is emphasized. PMID- 2755928 TI - [Respiratory insufficiency in acute bronchiolitis in infancy]. AB - Forty-one infants with acute viral bronchiolitis were hospitalized in our paediatric intensive care unit during the seven year period from 1980 to 1987. In 14 out of 27 evaluated patients, Respiratory Syncitial Virus (RSV) was detected in the nasal secretions. Twenty-three children required only supportive care and monitoring. Eighteen infants had to be ventilated because of respiratory failure. The major indication for mechanical ventilation was an arterial or capillary pCO2 of more than 64 mmHg; other criteria were repeated apnoea, respiratory acidosis, and clinical deterioration. In all cases the type of the mechanical ventilation was an intermittent mandatory ventilation (IMV) with flow and time cycled respirators; muscle relaxation was not required in any case. The average duration of mechanical ventilation was 40 hours. All the children recovered uneventfully. These data suggest that even the most severe cases of acute bronchiolotis can be treated successfully, and that the mortality rate of this disease entity can be reduced to zero. PMID- 2755929 TI - [Pneumonia following bronchography]. AB - The extravasation of contrast medium into the alveoli during or following bronchography would appear to be associated with an increased complication rate. The histomorphological changes occurRing may vary in degree, and it may thus be difficult to differentiate such changes from those associated with other forms of pneumonia and pneumoconiosis. This paper reports on a case in which, using energy dispersive X-ray micro-analysis in the scanning electron microscope, the presence of contrast medium within a region of alveolar pneumonia was observed, thus enabling accurate establishment of the cause of this condition. PMID- 2755930 TI - Trypanosoma acomys (Wenyon, 1909): reproductive forms and course of parasitemia in the natural host Acomys cahirinus (Desmarest, 1819). AB - Trypanosoma acomys (Stercoraria, Trypanosomatidae) was studied in the laboratory bred spiny mouse Acomys cahirinus. Only trypomastigotes were found in peripheral blood, whereas the thymus of experimentally infected A. cahirinus showed amastigote syncytial reproductive forms whose nuclei of nuclei ranged from 2 to 128. These reproductive forms were detected 9-10 days after the i.p. injection of spiny mice with trypanosomes obtained from primary lung cultures. Transitional trypomastigote-like forms were observed in the thymus; no reproductive or diving forms were encountered in any other tissue, including blood. The course of the parasitemia in spiny mice inoculated i.p. with 1.2 x 10(6) parasites from 26- to 32-day-old cultures initiated from infected lungs was studied. A similar, characteristic pattern was observed in both male and female hosts. Four phases were recognized: latent, logarithmic, stationary, and decline. These phases ended on days 2, 14, 98, and 154 postinoculation, respectively. The decline phase was gradual and the parasites could not be detected by day 154 postinoculation. In contrast, inoculation from older cultures (35-50 days old) showed longer latent and logarithmic phases, a shorter stationary phase, and a sharp drop in parasite density during the decline phase; the parasites were not detected in the peripheral blood by 120 days postinoculation. PMID- 2755931 TI - Isolation and partial characterization of rhoptries and micronemes from Eimeria nieschulzi zoites (Sporozoa, Coccidia). AB - Homogenization and subcellular fractionation of sporozoites of Eimeria nieschulzi have allowed the recovery of highly enriched fractions of rhoptries and micronemes. The isolated organelles kept their in situ morphological characteristics. Their apparent densities in sucrose solutions were approximately 1.18 g/cm3 for rhoptries and 1.14 g/cm3 for micronemes. When subjected to sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE), the microneme fraction showed two major polypeptides at 220 and 94 kDa. The rhoptry fraction contained at least three predominant peptides at 200, 150, and 63 kDa. Micronemes were also isolated from third-generation merozoites of the same species; their characteristics were identical to those of the organelles isolated from sporozoites. PMID- 2755932 TI - Experimental transmission of two Myxobolus spp. developing bisporogeny via tubificid worms. AB - Spores of Myxobolus cotti El-Matbouli and Hoffmann 1987 and M. cerebralis Hofer 1903 (fresh or after 5 months in mud) are taken in by tubifex worms and develop in their gut epithelium cells into actinosporea of the genus Triactinomyxon. Triactinomyxon deriving from M. cotti differ distinctly from those derived from M. cerebralis in morphology and the number of sporozoites in the epispore. It could be shown that Triactinomyxon spores infect fish either via the water (bullhead, rainbow trout) or by feeding of infected tubifex (rainbow trout), developing into Myxobolus spores in central nervous tissue (bullhead) or cartilage (rainbow trout). Fresh or ripened spores of M. cotti and M. cerebralis were not infectious for bullheads or rainbow trout, respectively. The results of our experiments confirm the hypothesis that the life cycle of M. cotti and M. cerebralis includes an intermediate host and a metamorphosis into actinosporea of the genus Triactinomyxon. PMID- 2755933 TI - Kinetics of mast cells, eosinophils and phospholipase B activity in the spontaneous-cure response of two strains of mice (rapid and slow responder) to the cestode Hymenolepis nana. AB - Primary egg-derived infection of Hymenolepis nana (100 eggs) in BALB/c (rapid responder) and C3H (slow responder) mice resulted in increased levels of mucosal mast cells (MMCs), eosinophilia (bone marrow, peripheral, tissue) and phospholipase B activity. The response appeared to be similar in both strains used, with a slight difference in cellular accumulation but a significantly earlier response in BALB/c than in C3H mice. These findings suggest that the prolongation of H. nana infection in C3H mice may be related to the delayed appearance of MMCs and eosinophils, which triggers a slower generation of the intestinal inflammation response. The rapidity with which phospholipase B activity increased was strictly correlated with eosinophil tissue number; this further supports the hypothesis for a direct parallel between eosinophils and phospholipase B activity in infected tissue. PMID- 2755934 TI - Total and specific IgE in serum and cerebrospinal fluid of rats and guinea pigs infected with Angiostrongylus cantonensis. AB - The total and specific IgE response to Angiostrongylus cantonensis infection was evaluated according to host permissiveness. Total IgE levels measured by a double antibody radioimmunoassay (RIA) increased slowly in the permissive host (the rat), reaching a maximum between 4 and 8 weeks after infection. This maximum was earlier but significantly lower in the non-permissive host (the guinea pig). IgE antibodies specific for adult worms or L1 or L3 larvae of A. cantonensis were measured by a radioallergosorbent test (RAST). In the case of adult worms and L1 antigens, specific IgE antibody levels showed large variations in relation to the duration of infection in rats. In contrast to total IgE levels, the specific IgE response to L3 larvae was lower in rats than in guinea pigs in both the serum and cerebrospinal fluid (CSF). These results suggest variations in the total vs specific IgE response according to host permissiveness or non-permissiveness to A. cantonensis infection. These results are discussed in the context of the possible participation of IgE antibodies in immune defence. PMID- 2755936 TI - The experimental receptivity of Helicella (Helicella) itala and Cepaea nemoralis (Mollusca, Helicidae) to larvae of Muellerius sp. and Neostrongylus linearis (Nematoda, Protostrongylidae) from chamois (Rupicapra rupicapra). AB - Two batches of Helicella (H.) itala (adult specimen) and two of Cepaea nemoralis (adult and young specimens) were experimentally infected with larvae I (L-I) of Muellerius sp. and Neostrongylus linearis obtained from the lungs and faeces of Rupicapra rupicapra. In assess larval development, the number and percentage of the total number of larvae (L-I + L-II - L-III) per mollusc were studied, together with the number and percentage of L-III per snail and the days on which the different larval stages were reached. The development of Muellerius sp. and N. linearis was greater in larvae from faeces. For both species of molluscs, the values for the percentages of the total number of larvae and L-III were higher in N. linearis than in Muellerius sp., but there were no notable differences in the days on which the various larval stages were reached. Both nematodes achieved a greater degree of development in young specimens of C. nemoralis than in adults. Whether the larvae came from faeces or the lungs, H. (H.) itala was a better intermediate host than C. nemoralis for Muellerius sp. and N. linearis. PMID- 2755935 TI - Proteins of Nippostrongylus brasiliensis analyzed by immunoblotting. AB - Antigenic proteins were characterized by the immunoblotting technique with sera from rats and mice after infection as well as hyperimmune sera. The immune response of infected animals was mainly directed toward five proteins of adult worms (190, 118, 110, 98, and 52 kDa) and four proteins of the third larval stage (L3; 92, 78, 58, and 24 kDa). The immunoblots indicated that stage-specific proteins of the homogenates were recognized. Three stage-specific proteins of L3 larvae (150, 135, and 125 kDa) and three proteins typical to the adult worm (100, 82, and 67 kDa) were identified. The majority of the worm proteins elicited an IgG response. IgE synthesis was induced by living and dead parasites and was directed towards four proteins (190, 150, 125, and 98 kDa). Three proteins additionally induced an IgG or IgM antibody response. The immune response as shown by the immunoblotting technique seems to be directed towards (1) antigens that are present for the duration of an infection and (2) stage-specific antigens that are expressed for only a short time during the life cycle of the parasite. PMID- 2755937 TI - Occurrence of the cattle strain of Echinococcus granulosus in the German Democratic Republic. PMID- 2755938 TI - Stimulatory effect of monitor peptide and human pancreatic secretory trypsin inhibitor on pancreatic secretion and cholecystokinin release in conscious rats. AB - The stimulatory effects of monitor peptide (MP) that was recently purified from rat bile-pancreatic juice on cholecystokinin (CCK) release and pancreatic exocrine secretions were examined in the conscious rat. As the sequence of MP has some homology with human pancreatic secretory trypsin inhibitor (hPSTI), the effects of these two materials were compared with each other. Rats were prepared with external bile and pancreatic fistulae. Pancreatic juice diversion significantly increased pancreatic secretions, but the intraduodenal injection of MP (0.9 micrograms per rat) could further increase pancreatic secretions. The MP injection produced significantly higher plasma CCK concentrations than the injection of isotonic saline solution did. Trasylol was infused simultaneously with pancreatic juice diversion to completely eliminate residual luminal protease activities. The MP (0.9 micrograms per rat) still showed the stimulatory effect, but hPSTI did not show any stimulatory effect on pancreatic secretion. Plasma CCK concentrations produced by MP were significantly higher than those produced by hPSTI. It was concluded that MP has a strong species specificity and that MP could stimulate CCK release and pancreatic exocrine secretions, not only via inhibiting luminal protease activities but also probably with a direct effect. PMID- 2755939 TI - Enhanced membrane phospholipid metabolism in human pancreatic adenocarcinoma cell lines detected by low-resolution 1H nuclear magnetic resonance spectroscopy. AB - The low-resolution proton nuclear magnetic resonance (NMR) spectra of human pancreatic adenocarcinomas maintained in nude mice and in culture exhibit characteristic features. First, the high values of longitudinal (T1) and transverse (T2) relaxation times were attributed to disturbances in the exchange of ions and water molecules in cancerous cells. Second, a new peak situated at about 1.8 +/- 0.2 ppm from the peak of tissular water was observed. It was higher in spectra recorded from the proliferative peripheral zone of the tumor than from the central necrotic zone and was not observed in healthy control pancreatic tissue. Histological examination of the xenografts by transmission electron microscopy indicated intense phospholipid metabolism with marked development of the plasma membrane and the presence of numerous secretory granules, lysosomes, and multivesicular bodies in the cytoplasm. The new 1H NMR low-resolution peak was thought to reflect an increase in membrane viscosity stemming from alterations in the structure and metabolism of membrane phospholipids. Whatever its origin, the 1.8-ppm peak is a particular feature of cancerous pancreatic cells, which should be readily detectable by NMR in vivo. PMID- 2755940 TI - Comparison of gas clearance and radioactive microspheres for pancreatic blood flow measurement. AB - Measurement of pancreatic blood flow (PBF) is technically demanding. Although radiolabeled microspheres are considered the "gold standard" for PBF assessment, they have practical limitations. In the current study, H2 and xenon-133 gas clearance techniques were adapted to PBF measurement and compared to radiolabeled microsphere techniques. Simultaneous measurements of PBF were made using either hydrogen or xenon gas washout and radiolabeled microspheres. Measurements were made under basal, vasoconstricted (vasopressin 2U i.v. or nicotine 4 micrograms/kg/h) and stimulated (secretin 125 ng/kg/h or 2 U/kg i.v.) conditions (random order). Mean PBF was 26.9 +/- 5.3, 50.5 +/- 2.3 and 27.6 +/- 5.2 ml/min/100 g basally, 36.9 +/- 8.0, 90.1 +/- 18.9, and 81.7 +/- 14.5 ml/min/100 g in the stimulated state, and 24.2 +/- 7.8, 25.0 +/- 3.5, and 14.9 +/- 7.5 ml/min/100 g in the vasoconstricted state for hydrogen gas clearance, xenon gas clearance, and radiolabeled microspheres, respectively. The H2 clearance technique resulted in tissue trauma, was complicated by frequent electrode displacement, and correlated poorly (r2 = 0.36, p greater than 0.05) with microsphere values. In contrast, xenon clearance measurement had no apparent effect on the pancreas and correlated well (r2 = 0.83, p less than 0.01) with microsphere data. We conclude that xenon clearance offers an attractive, validated alternative to radiolabeled microspheres for measuring pancreatic blood flow. PMID- 2755941 TI - Fibroblast structure and function during regeneration from hormone-induced acute pancreatitis in the rat. AB - The regeneration of the rat exocrine pancreas from a hormone-induced pancreatitis was investigated. In a previous study it was shown that the [3H]thymidine labeling index of interstitial cells increases 20- to 30-fold on day 1.5 after the induction of pancreatitis. Here we show by electron microscopic autoradiography that 80% of the labeled interstitial cells are fibroblasts. Their replication, fine structure, and collagen biosynthesis was further investigated: By day 2.5 numerous mitotic figures were found, indicating an enhanced proliferative activity of fibroblasts at the early stage of pancreatic regeneration. The ultrastructural analysis revealed that many fibroblasts contain abundant cytoplasm with a well-developed rough endoplasmic reticulum, prominent Golgi complexes, and secretory granules filled with fibrillar material. In contrast, the pancreatic fibroblasts of saline-infused control animals were shown to be spindle-shaped and to contain only very little cytoplasmic organelles. The collagen biosynthesis was quantified by in vivo labeling with [3H]proline and quantification of [3H]hydroxyproline in pancreatic protein hydrolysates. The collagen biosynthesis of experimental pancreata was measured to be 15 times that of controls on days 1.5 and 2.5 after the induction of pancreatitis and to remain fourfold elevated on days 3.5 through 10.5. In pulse-chase experiments using [3H]proline as the labeled precursor for collagen, the newly synthesized collagen was shown to be degraded with a half-life of 35 h. We conclude that replication of pancreatic fibroblasts and collagen biosynthesis as well as collagen degradation play important roles in the early phase of pancreatic regeneration. PMID- 2755942 TI - Allopurinol stimulates pancreatic exocrine secretion in the dog. AB - The effects of allopurinol on the secretion of pancreatic juice were investigated both in live animals and in preparations of isolated, blood-perfused dog pancreas and were compared with those of secretin. An i.v. administration of allopurinol (3-10 mg/kg) caused a dose-dependent increase in the pancreatic secretion. The secretory responses to 3 and 10 mg/kg of allopurinol were approximately equal to those to 0.03 and 0.1 U/kg of secretin, respectively. An intra-arterial (i.a.) infusion of allopurinol (0.5-1.2 mg/min) also elicited dose-dependent increases in flow rates, bicarbonate concentrations, and outputs of pancreatic exocrine secretion, but protein concentrations were little affected by allopurinol. Similar results were obtained in the juice induced by an i.a. infusion of secretin (0.012-0.05 U/min). Both bicarbonate and protein concentrations in the juice obtained with allopurinol were almost the same as those obtained with secretin at a similar flow rate of pancreatic secretion. The secretory activities at 0.5, 1.0, and 1.2 mg/min of i.a. allopurinol infusion corresponded roughly to those at 0.012, 0.025, and 0.05 U/min of i.a. secretin infusion, respectively. Therefore, the secretory action of allopurinol was similar to that of secretin. The allopurinol-induced secretion was not modified by pretreatment with atropine sulfate, cimetidine, or sulpiride hydrochloride. These results suggest that allopurinol stimulates pancreatic secretion by acting directly on ductular cells of the dog pancreas. PMID- 2755943 TI - Influence of steroids on the exocrine pancreas: presence of laminated bodies in the acinar lumen following castration and adrenalectomy. AB - The influences of combined adrenalectomy and castration and of a replacement therapy with estradiol and glucocorticoids were examined in the rat pancreas. At the light microscope level, the surgical treatment changed the overall shape of the acini and caused widening of intralobular and interlobular spaces as well as partial depletion of zymogen granules. A significant reduction of the acinar lumen size was observed in castrated-adrenalectomized (CasX-AdreX) animals. This could be reversed by a replacement therapy with glucocorticoids. Moreover, triamcinolone even caused a significant lumen enlargement as compared to sham operated animals. Such an enlargement was not observed with dexamethasone. Both these glucocorticoids caused an increase in zymogen granule content of the acinar cell. At the ultrastructural level, hitherto undescribed type of precipitates was observed in the acinar lumen of CasX-AdreX rats. Precipitates that exhibited a laminated aspect were identified as luminal laminated bodies. The latter could have some interest from the etiological point of view of certain pancreatic diseases, such as cystic fibrosis and pancreatitis. Replacement therapy with estradiol did not affect the frequency of these precipitates, but glucocorticoid had a significantly inhibitory effect. From our observation, it is clear that some steroid exert a profound influence on the acinar cell and that a replacement therapy with glucocorticoids or estradiol do not totally restore the normal aspect of the pancreas acinar tissue. It suggests that some unknown factors from adrenals or testis are still required in addition to glucocorticoids and estrogens for the maintenance of the structural integrity of the gland. PMID- 2755944 TI - Thoracic complications of pancreatitis. AB - Pancreatitis may be associated with thoracic complications, notably chronic massive pleural effusion (CMPE) and, rarely, pseudocysts with mediastinal extension (PME) and enzymatic mediastinitis (EM). Our personal experience with 14 cases of thoracic complications (nine CMPE, two PME associated with pleural effusion, and three EM of 670 patients who underwent surgery; of these, 191 had acute and 479 had chronic pancreatitis) during 16 years (1970-1986) is reported. In the patients with CMPE, the initial symptoms were progressive dyspnea eventually associated with cough and chest pain. In the PME cases, there was dysphagia associated with left subscapular pain and left chest pain. The initial signs in the patients with EM were sudden dyspnea, cyanosis, retrosternal pain, tachycardia, and acute heart failure. A fistula between the pancreatic ductal system and the pleural cavity in seven of the nine patients with CMPE was demonstrated by intraoperative pancreatography and/or cystography. On the contrary, preoperative endoscopic pancreatography demonstrated the sinus tract in only three of the seven. In both cases of PME, computed tomography (CT) provided a correct diagnosis that was confirmed at surgery. In the patients with EM, the diagnosis was suggested by the clinical appearance and was confirmed by the chest roentgenogram and by CT. All patients had operations after varying periods of unsuccessful 2-4-week-long conservative treatment. One patient with infected ascites died postoperatively. There were no thoracic recurrences of pancreatic disease among the other patients at a 10-month-10-year follow-up observation after surgery. PMID- 2755945 TI - Alcohol-induced chronic pancreatitis in rats after temporary occlusion of biliopancreatic ducts with Ethibloc. AB - Chronic obstructive pancreatitis-like histological and biochemical alterations were provoked in male Wistar rats with Ethibloc occlusion of the common bile duct and the main pancreatic ducts. After the disappearance of the glue from the ducts, a gradual and almost total recovery was demonstrated during a 2-month observation period. About 12 g/kg of alcohol (20% vol/vol) given daily by gastric intubation and ad libitum intake inhibited the recovery of pancreatic weight and enzyme contents in the occluded rats, and within a 2-month period chronic calcifying-type pancreatitis became evident with some signs of remaining obstructive pancreatitis-like lesions. Cessation of alcohol administration after 2 months resulted in a recovery of pancreatic weight and enzyme contents, although morphological regeneration was less pronounced and calcification remained visible in some rats. A 50% raw soy flour diet provoked some further changes in the proportion of enzymes without any supplementary increases of pancreatic weight and protein content. This animal model of chronic pancreatitis demonstrates that chronic obstructive and calcifying pancreatitis can appear together and earlier if the etiological factors act in combination. Suppression of pancreatic regeneration by alcohol seems to be necessary to maintain chronic pancreatitis-like lesions and to develop calcification. PMID- 2755946 TI - Regulation of growth and differentiation in pancreatic cancer. Bethesda, Maryland, September 19 and 20, 1988. PMID- 2755947 TI - Inspection of three-dimensional structures of proteins with dynamical information from the normal mode analysis. AB - In this paper it is demonstrated that, to analyze structural data of proteins obtained from X-ray crystallography, the normal mode analysis in dihedral angle space can serve to supplement X-ray data as a useful system for gaining information on their dynamical as well as static structures. Especially, the following two subjects are discussed; first, the breakdown of the motions of a limited region in a polypeptide chain (e.g., an alpha-helix, a beta-strand or a loop) into internal and external motions reveals whether the region is flexible, or it is rigid but mobile when it has large fluctuations. Second, the correlation map between atomic motions serves to provide information for dividing the chain into segments, such as domains or modules, from a dynamical rather than from a geometrical point of view. It is shown that the modules proposed by M. Go appear distinctly in the correlation map as the regions in which clusters of atoms with positive correlation coefficients of their movements to each other exist. Furthermore, the modules are characterized by the negative correlation coefficients of the movements of the atoms in the clusters in a particular module to such movements in a different module. PMID- 2755948 TI - Sequence of caprine alpha s1-casein and characterization of those of its genetic variants which are synthesized at a high level, alpha s1-CnA, B and C. AB - The sequence of caprine alpha s1-casein (199 residues) was established. The peptide chain has the same length as, and shows a 88% degree of identity with, its bovine counterpart. With the ovine alpha s1-casein, the sequence of which was deduced from that of its mRNA, the degree of identity is 97%, counting as one difference a deletion of eight residues in the ovine protein. The differences between the three genetic variants associated with a high alpha s1-casein content in milk are simple substitutions. Variant alpha s1-CnA differs from variant alpha s1-CnB by two substitutions, 16 Leu (A)----Pro (B) and 77 Gln (A)----Glu (B), the latter inducing the appearance of a phosphate group on 75 Ser. Variant alpha s1 CnC differs from alpha s1-CnB by three substitutions, 8 His (B)----Ile (C), 100 Arg (B)----Lys (C) and 195 Thr (B)----Ala (C). The original type of caprine alpha s1-casein could be another hypothetical genetic variant, having the same electrophoretic mobility as alpha s1-CnB. PMID- 2755949 TI - The following protein sequences were reprinted from the: protein sequence database of the Protein Identification Resource (PIR). PMID- 2755950 TI - Sperm measures and reproductive success. Institute for Health Policy Analysis Forum on Science, Health and Environmental Risk Assessment. Proceedings of a workshop. Queenstown, Maryland, January 11-13, 1988. PMID- 2755951 TI - FDA procedures and policies to estimate risks of injury to the male reproductive system. AB - Two decades ago, the Food and Drug Administration (FDA) undertook a testing and research program to study and assess the mutagenic properties of so-called "Generally Recognized as Safe" (GRAS) substances which have a long history of use in food. Initially, the program employed three highly regarded mutagenicity tests; the host mediated assay, somatic cell cytogenetics, and the dominant lethal test. Only the latter measures male germ cell events. Eventually, research and testing results revealed major problems in the deployment of these tests for such purposes. A new approach involving a three tiered system was instituted in which the first tier was a relatively inexpensive pre-screen ostensibly capable of detecting any and all potential mutagens. For reasons of economy, this pre screen used micro-organisms. The objective of the second tier was to determine if substances positive in the first tier of tests would be mutagenic for higher organisms. Gene mutation in mammalian cells in culture, gene plus chromosomal mutation in Drosophila and heritable translocation in male mice were used for this purpose. The final tier was intended to assess the quantitative risk of mutation in mammals and depended entirely upon genetic studies in animals. Again, the heritable translocation test would be used as well as the specific locus test in mice. At the same time, efforts were made to refine and improve the usefulness of the dominant lethal and the heritable translocation test for toxicological purposes. More recently, studies have been undertaken to develop a practical test for nondisjunction in male germ cells. Currently, standard test requirements for food additive approval include only short-term in vitro mutagenicity tests.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2755952 TI - Association of sperm measures with reproductive outcome: National Toxicology Program studies in mice. AB - In reproductive assessment by continuous breeding (RACB) studies, a crossover mating trial was conducted if an adverse effect on fertility was detectable over an 18-week cohabitation period during which Swiss (CD-1) mice were continuously treated. Results of 25 RACB crossover mating studies conducted to determine the affected sex were compared with results of sperm morphology and vaginal cytology examinations (SMVCE) performed at the conclusion of each mating trial. SMVCE endpoints included epididymal sperm concentration, motility, and morphology, vaginal cytology, and male reproductive organ weights. In most studies, multiple SMVCE endpoints were adversely affected. With this group of chemicals, epididymis weight was sensitive and specific to male reproductive toxicants and nontoxicants, respectively. Sperm motility and testis weight were also highly sensitive to male reproductive toxicants. The above endpoints demonstrated the greatest statistical significance relative to other SMVCE parameters, and were highly associated with fertility measurements from breeding experiments. These characteristics suggest that some SMVCE endpoints are more useful for screening chemicals for potential male reproductive toxicity than others. Caution must be exercised, however, because the compounds used in these studies are not representative of all classes of chemicals, and chemicals not tested here may produce adverse reproductive effects by different mechanisms of action. The dose response effects of two glycol ethers evaluated in RACB, ethylene glycol monomethyl ether and ethylene glycol monoethyl ether, on reproductive outcome and SMVCE endpoints were examined in detail. Both caused adverse effects on testis weight and sperm head morphology, and these changes were associated with adverse effects on reproductive outcome. Until we have more experience with SMVCE and other screens, multiple endpoints should continue to be used for screening for reproductive toxicants. PMID- 2755953 TI - Predicting reproductive outcome from sperm measurements in Swiss (CD-1) mice. AB - Recent advances in the quantification of sperm characteristics, particularly by techniques of videomicrography, raise the problem of identifying a subset of sperm measurements that can accurately predict reduced reproductive performance in the presence of a reproductive toxicant. This paper discusses and illustrates, with sperm data from Swiss (CD-1) mice, three properties of sperm measurements in addition to the association with reproductive outcome that can be used as objective criteria to distinguish among potentially useful sperm characteristics. Identification of these properties was motivated by the need to single out sperm characteristics that would yield hypothesis tests with good power to distinguish groups with altered sperm characteristics from those with normal sperm characteristics. The list of desirable properties of sperm characteristics includes: a) MEASUREMENT: The most useful sperm characteristics will exhibit low measurement bias and high measurement precision. b) Distribution: Sperm characteristics that follow the class of normal distributions allow easy identification of the most powerful hypothesis testing procedures. c) Variation: Sperm characteristics that exhibit limited variation from individual to individual will make altered values easier to detect. d) Correlation: Sperm characteristics that exhibit a high correlation with reproductive outcome will be most useful. MEASUREMENTs of sperm concentration, sperm motility, and abnormal sperm were examined for each of these properties in Swiss (CD-1) mice. For control animals, evidence of measurement bias between labs and significant variation among studies within labs was found for each sperm characteristic, with measurements of abnormal sperm exhibiting the least bias. Sperm concentration and the natural logarithm of abnormal sperm appeared normally distributed. Individual to individual variation was substantial for sperm motility and sperm concentration, both of which required an approximately 30% decrease in mean to achieve good statistical power. In contrast, abnormal sperm required only a 4% increase in mean to achieve the same power. In spite of the measurement noise associated with these sperm characteristics, data from 25 experiments indicated good agreement between the results of hypothesis tests based on sperm characteristics and reproductive outcome as judged by fertility and the number of pups. The same conclusions reached for reproductive outcome were reached in 19 of 24 experiments for sperm motility, in 19 of 25 experiments for sperm concentration, and in 17 of 24 experiments for abnormal sperm. PMID- 2755954 TI - Calculation of the incidence of infertility in human populations from sperm measures using the two-distribution model. AB - A model, designated the two-distribution model, has been developed to estimate the incidence of human infertility based on alterations in sperm measures. Such alterations could be based on those obtained in populations exposed to a potential reproductive toxin or extrapolated from animal studies. The model requires distributions of sperm measures as input data; studies in which only averages and measures of variation are presented would not provide data bases useful for these calculations. To make the model more applicable and reliable, assumptions within the model need to be tested, additional data on distributions of sperm measures in defined human populations are needed, and possible extensions of the model need to be considered. PMID- 2755955 TI - Issues in the prediction of human reproductive success from semen characteristics. PMID- 2755956 TI - U.S. Environmental Protection Agency procedures and policies to estimate risk of injury to the male reproductive system. AB - Risk assessment, as defined by the National Academy of Sciences in 1983, is comprised by the following components: hazard identification, dose-response assessment, exposure assessment, and risk characterization. The U.S. Environmental Protection Agency (EPA) has developed risk assessment guidelines which follow the NAS format for Program Offices to follow in evaluating the potential adverse effects of environmental agents on humans. Guidelines have been published in the Federal Register on cancer, mutagenicity, developmental toxicity, chemical mixtures, and exposure. Proposed guidelines are expected to be published shortly on female and male reproductive toxicity. PMID- 2755957 TI - A study of the leaching of aluminium ions from drink containers. AB - Lacquered aluminium drink cans were filled with deionised water and buffers (pH 1 13) and stored at 20 + 2 degrees C for 60 days. The aluminium content of the solutions contained therein was assayed by atomic absorption spectroscopy at time intervals and the leaching of aluminium from the cans examined. The possible toxicological hazard of the addition of aluminium to the diet from this source is discussed. It is concluded that drinks packaged in aluminium cans do not present a significant risk to people with healthy kidneys. PMID- 2755958 TI - The volatiles of Chaerophyllum bulbosum L. ssp. bulbosum growing wild in Greece. AB - The analysis of the volatile fraction of Chaerophyllum bulbosum L. ssp. bulbosum (Apiaceae) growing wild in Greece, by capillary GC and GC-MS, demonstrated the presence of at least 34 constituents; 29 of which were identified, corresponding to 95% of the total. The following major components were found: apiol (37%), trimethyl-3,7,11-dodecatrien-1,6,10-ol-3 (8.5%), linalool (7.7%), myristicine (6.9%) and eugenol (5.8%). PMID- 2755959 TI - Application of NIRS to the quantity control of pharmaceuticals ketoprofen assay in different pharmaceutical formulae. AB - The possibility of using reflectance NIRS to assay 2-(benzoylphenyl)-propionic acid (Ketoprofen) in solid-state and gel preparations is investigated. The number of samples and amplitude of the percentage content distribution of the samples is examined in order to define the best possible calibration system. PMID- 2755960 TI - [Synthesis and antisecretory and anti-ulcer activity of new 4,6 diarylpyridazinones]. AB - It has been possible to prepare from 4,6-diaryl pyridazinones a series of derivatives substituted in the 2-position and having urea moiety via the addition of free amines into methylisocyanate. Their gastric anti-secretory and anti-ulcer activities were evaluated. The compounds with an N-2 ethyl chain on the pyridazinone ring (IVa, IVd, IVg) were the most active derivatives. PMID- 2755961 TI - [Mucoadhesive tablets for the buccal cavity]. PMID- 2755962 TI - Cadmium-induced hypertension in rats. AB - Chronic cadmium chloride (CdCl2, 0.5 and 1.0 mg/kg, i.p.) treatment in female albino rats for 2 weeks resulted in elevation of blood pressure. In chronic CdCl2 treated rats the pressor responses to different doses of noradrenaline, angiotensin II and depressor responses to acetylcholine and isoprenaline were unaltered. In rat hindquarter preparation there was elevation of perfusion pressure and the sensitivity of vascular bed to noradrenaline was increased in the CdCl2-induced hypertensive rats. Complete bilateral adrenalectomy or chemical sympathectomy or treatment with captopril did not prevent the development of CdCl2-induced hypertension. Treatment with verapamil (15 mg/kg/day, p.o.) or nifedipine (10 mg/kg/day, p.o.) for 2 weeks prevented the development of hypertension with chronic CdCl2 treatment. It is suggested that chronic treatment of rats with CdCl2 induces hypertension. It is possible that cadmium mimics the calcium ion for the induction of hypertension in rats. PMID- 2755963 TI - Effect of induced thyroid dysfunction upon uterine responsiveness in strips from pregnant and nonpregnant rats. AB - The influence of thyroid dysfunction on rat myometrial responsiveness to oxytocin, acetylcholine, CaCl2 and BaCl2 was assessed in uterine strips from pregnant and nonpregnant rats. In preparations obtained from hypothyroid nonpregnant rats, oxytocin and acetylcholine concentration-response curves were significantly displaced to the left, whereas myometrial strips from hyperthyroid nonpregnant rats were only supersensitive to acetylcholine. In relation to the pregnant state, T3 treatment caused an increased myometrial sensitivity to both oxytocin and acetylcholine. In this condition, concentration-response curves for oxytocin did not differ from nonpregnant control animals, whereas acetylcholine was about 300-fold more potent at the ED50 levels compared with those in nonpregnant animals. Either in pregnant or nonpregnant state, maximal responses and ED50 to BaCl2 did not differ. In addition, thyroid dysfunction did not modify the pattern of CaCl2-induced contractions in isolated myometrial strips from pregnant rats. This data extended to the myometrium, previous evidence in the literature indicating that thyroid dysfunction may affect uterine responsiveness to agonists. PMID- 2755964 TI - Brain and pituitary receptors for thyrotropin-releasing hormone in hypothyroid rats. AB - The effect of hypothyroidism on the thyrotropin-releasing hormone (TRH) receptors in several brain regions and pituitary of rats was determined. TRH receptors were labeled with 3H-(3-MeHis2)TRH (3H-MeTRH). Hypothyroidism was induced in male Sprague-Dawley rats by administering methimazole (0.05% w/v) in drinking water for 32 days. Rats serving as controls were given water without the methimazole. The development of a hypothyroid state was evidenced by significant decreases in colonic temperature, systolic blood pressure, heart rate and serum concentration of triiodothyronine (total T3), thyroxine and T3 uptake (T3U) as compared to control rats. The rate of gain in body weight of methimazole-treated rats was significantly lower than that of control rats. Binding of 3H-MeTRH at 2 nM concentration to membranes prepared from brain regions (striatum, hypothalamus, cortex, midbrain and pons plus medulla) of methimazole-treated and control rats did not differ. However, binding of 3H-MeTRH to pituitary membranes of methimazole-treated rats was significantly lower as compared to the pituitary of control rats. The results indicate that, in the rat, development of hypothyroidism is associated with down-regulation of pituitary TRH receptors but brain receptors remain unaffected. PMID- 2755965 TI - Comparison of the effects of castration and streptozotocin-induced diabetes mellitus on contractile responses of the rat vas deferens. AB - Contractile responses of androgen-sensitive smooth muscles such as the vas deferens and seminal vesicles are highly dependent upon the endocrine status of the animal. Although diabetes mellitus produces disturbances in reproductive function, including decreased serum androgen levels, the effects of diabetes on the contractile function of androgen-dependent urogenital smooth muscles have not been conclusively established. The present study compared the effects of streptozotocin-induced diabetes with those of castration on the contractile responses of rat vasa deferentia. Diabetes and castration produced significant decreases in serum testosterone levels, accompanied by significant decreases in vas deferens weights. Contractile responses of vasa deferentia from diabetic rats to carbachol, ATP, and phenylephrine were significantly increased, and responses to nerve stimulation were decreased. Similar results were obtained with vasa deferentia from castrated rats. Castration produced significant increases in contractile responses of vasa deferentia to carbachol and phenylephrine and decreased responses to nerve stimulation. The data suggest that both castration and diabetes produce a denervation-like supersensitivity which is specific for receptor-mediated processes. PMID- 2755966 TI - Effects of nisoldipine on coronary collateral perfusion and hemodynamics in chronically instrumented dogs. AB - The effect of a new dihydropyridine slow-channel calcium blocking agent, nisoldipine, on hemodynamics and myocardial blood flow in normal and collateral dependent areas distal to a chronic coronary artery occlusion were studied in chronically instrumented, conscious dogs. Nisoldipine produced significant and dose-related decreases in arterial blood pressure, an elevation of heart rate and large increases in coronary blood flow velocity. In dogs with an Ameroid constrictor previously implanted to enhance coronary collateral development, this agent produced large increases in perfusion distal to a chronic coronary artery occlusion. In addition, despite a reduction in arterial pressure, nisoldipine preserved renal cortical, intestinal and skeletal muscle blood flow while increasing tissue flow within liver and cerebral cortex. Thus, nisoldipine increases oxygen supply to collateral-dependent myocardium in the presence of reduced driving pressure for collateral perfusion. PMID- 2755967 TI - Skin temperature changes after irradiation with UVB or UVC: implications for the mechanism underlying ultraviolet erythema. AB - Measurement of the temperature change of skin exposed to ultraviolet radiation can be used to draw conclusions on the mechanism responsible for the development of ultraviolet erythema and on the question of which blood vessels are involved in the erythema. Under controlled environmental conditions we measured temperature change of skin areas, mainly on the back, irradiated with UVB (wavelengths between 280 nm and 315 nm) or UVC (wavelengths between 100 nm and 280 nm). Elevated skin temperature was measured after both types of irradiation. The influence of experimental conditions (ambient temperature, part of the body exposed to the radiation) was investigated. Ambient temperature did not influence the temperature difference measured significantly. The skin region used for the measurements did influence the results; temperature elevation after irradiation with UVC was markedly smaller on the forearm than on the back, for the same number of MED (minimal erythema dose; the dose required to elicit a just perceptible redness of the skin). The fact that temperature elevations were found after UVC and after UVB irradiations points to involvement of arteriolar vessels in UVC as well as UVB erythema. The arteriolar dilation found speaks for the concept that both types of erythema are caused by a vasoactive substance, probably diffusing from the epidermis to the dermal blood vessels. PMID- 2755968 TI - Complex dielectric constant of arginine-DNA and protamine-DNA aqueous systems at 10 GHz. AB - The complex dielectric constant of arginine and protamine from herring sperm (clupeine) and their complexes with herring sperm DNA was measured at 10 GHz in the temperature range -20 to +45 degrees C by a microwave cavity perturbation method. The experimental results were analysed in terms of a three-component equation (solute molecules, interfacial water and bulk water) to calculate the fractional volume of modified water and hence the specific hydration of the samples. A fourfold reduction of the specific hydration is observed for the clupeine molecule as compared to the free monomers. This is consistent with a folded conformation of the protein in solution. The specific hydration of the complex between clupeine and DNA is reduced by 50% with respect to the weighted average for the uncomplexed components. This result indicates an intimate contact between clupeine and DNA with exclusion of water molecules and is consistent with the highly condensed form of nucleoprotamines which is known in vivo. PMID- 2755969 TI - Tissue and phantom materials characterisation by scattering for in vivo XRF and mineralometric techniques. PMID- 2755970 TI - [French Society of Phlebology. Paris, 22 October 1988. Anesthesia and phlebology. Proceedings]. PMID- 2755971 TI - [Anesthesia and medical responsibility. Principles]. AB - Anaesthesia exposes the practitioner to the obligation of being answerable for his responsibility if he commits an error which leads directly to damage to the patient. He can be forced to pay compensation for the damage. Quite apart from this, there is also the unpleasant process of being called before a disciplinary hearing for "involuntary injury". Anaesthetic error. According to the criteria applied by the tribunals, the error can be personal, or resulting from errors committed by the auxiliaries involved by the doctor. He can also be considered responsible in cases of structural unsuitability in which he has, nevertheless, agreed to proceed. Application on phlebology. The omnivalent degree of Doctor of Medicine enables the phlebologist, as it does any other specialist doctor, to perform anaesthetics without restriction. The existence of "specialization" sanctioning special studies actually limits this right because of the rules of medico-legal responsibility. Consequences. If the choice of technique is completely open, it ought to be the one best adapted to the condition of the patient, and the practitioner ought to be in control of the situation. In every case, the patient ought to be informed of all risks and benefits. The anaesthetic cannot be performed by any person other than the practitioner or an anaesthetist nurse, in the presence of the practitioner. The surgery where this is performed must be equipped with all the apparatus necessary for good anaesthetic procedure, monitoring, and recuperation in case of patient distress. PMID- 2755972 TI - [The medicolegal implications of local anesthetics in phlebology]. PMID- 2755973 TI - [Comparative results of stripping under general anesthesia and under locoregional anesthesia (200 cases)]. AB - A study showing the improved results of operations on varices performed under local anaesthetic was based on 100 complete files of operations on varicose veins including crossectomy, long invaginated stripping and superficial phlebectomies (type Muller) carried out in one operation under general anaesthetic, and 100 identical files of operations performed under local anaesthetic. The fact that the result is more comfortable under local anaesthetic is especially to lengths of hospitalization, which mean that day surgery is preferable in 80% of cases, and also to the length of time off work which, statistically, can be reduced by local anaesthetic. Finally, the study of anatomic sequelae (varicosities and post operative neurological disorders) shows particularly that the development of varicosities during the operative period probably depends on oestroprogestative impregnation, and shows much more clearly that local anaesthetic facilitates the avoidance of lesion to the short saphenal nerve during the stripping, because of the pain signal triggered. PMID- 2755975 TI - [The risk of deep thrombosis due to intra-varicose injections. Why is it virtually non-existent?]. PMID- 2755974 TI - [Hemodilution and pain]. AB - The combination of the different chemical mediators likely to promote pain is often at the root of disturbances affecting both microcirculation and capillary permeability, as several studies have shown. These same disturbances are to be encountered in different types of illnesses in which pain dominates the clinical picture. Recent theoretical and experimental studies have also suggested that haemodilution might have beneficial effects on these rheological disorders. Three clinical observations (arteritis of the lower limbs, persistent post-phlebitic ulcer, myocardiac ischemia) demonstrate the therapeutic benefits of this technique, particularly regarding pain. PMID- 2755976 TI - [Differential diagnosis of vascular and radicular leg pains with special consideration given to the frequency of the coincidence of these 2 causes]. PMID- 2755977 TI - [The application of informatics to mercury gauge plethysmography]. AB - In this study, the authors present a computerized mercury-gauge plethysmography device. The electrical signals collected by the plethysmograph are sent to the computer where they are analyzed by a specially devised interpretation program. The graphs are flashed on the screen, the parameters are automatically and instantly calculated, and a printed-out medical report may be obtained at the end of the test. The various characteristics of the material and the program are presented. PMID- 2755978 TI - [A proposed classification of swollen legs]. AB - The subject of enlarged legs is vast and complex. Up to now there has been no organic classification of the clinical picture involved. The basic problem is that of the criterion on which to base the classification. Literature on this subject has opted for the pathogenic criterion because it seems to facilitate the formulation of a classification which is of use to the doctor. One possibility would be to divide the syndrome into vascular and non-vascular swollen legs. The first group could in turn be separated into macro-circulating and micro circulatory. The micro-circulatory forms can be primitive or secondary. Amongst the secondary micro-circulatory forms, two other groups can be singled out: secondary forms with local cause and secondary forms caused by organic pathology. However, there are clinical forms which are on the periphery of these different groups and these forms are subject to discussion regarding nosographic localization. PMID- 2755979 TI - [Phlebectomy using mini-incisions. A surgical technic or an alternative to sclerosis? Our experience with the first 100 surgical cases]. PMID- 2755980 TI - [A case of thromboangiitis obliterans in a young woman. A rarity and diagnostic difficulties]. AB - The diagnosis of thromboangiitis obliterans (Buerger's Disease) in a young patient can only be arrived at by means of a number of different arguments: clinical, biological and immunological, angiography, capillaroscopy especially if it concerns a young female patient; the rarity of TAO in a young woman ought to mean that scleroderma and lupus can be discounted; it also necessitates an annual clinical and paraclinical check-up. PMID- 2755982 TI - [Risks associated with the use of local anesthetics]. AB - Despite widespread use, accidents following the injection of a local anaesthetic are exceptional. Some peripheral nerve lesions have been described, in keeping with mechanical distension because of accidental intravenous injection, rather than because of the anaesthetizing product itself. Generally speaking, two aetiologies are to be underlined: allergy and toxicity. Allergy is exceptional with anaesthetics of the amine type, the only commercialized kind in this country. Some cases of cutaneous allergy and bronchospasm have been reported. The accident more to be feared is toxicity, which emerges in neurological symptoms (convulsions) then cardiac symptoms (rhythm disturbance, even cardiac arrest). These accidents are associated with the sudden presence of a high concentration of local anaesthetic in the blood, resulting from accidental intravenous injection, or, more rarely, excessive resorption of a strong dosage injected into a highly vascularized area. The stronger the anaesthetic, the more this type of accident is to be feared. These accidents can be avoided by means of the observation of a rigorous technique, careful checking of the patient after the injection, and readiness to start immediate and effective reanimation at the very onset of toxication symptoms. PMID- 2755981 TI - [Value of the Practitioner's Ambulatory Treatment in treating leg ulcers]. PMID- 2755983 TI - [Choice of an anesthetic technic for venous surgery of the lower limbs]. AB - The introduction of new anesthetic drugs and the option of administering anesthesia to outpatients for venous surgery of the lower limbs have modified the anesthesiologist's strategy. In addition, the final decision depends on the number of attending physicians (family doctor, phlebologist, surgeon, anesthesiologist, and of course, on the patient). The essential elements which determine the choice are: the methods preferred by the anesthesiologist, the patient's wishes, the duration, type and painful nature of the procedure. All types of anesthetic protocols may be employed. General anesthesia is often preferable because of its flexible administration and local anesthesia because it is simple to administer. Loco-regional anesthetics can be substituted for local types of anesthesia in bilateral surgical procedures but these are difficult to administer on an outpatient basis. Development of new drugs such as propofol is tending to give general anesthesia in outpatients an important role once again. PMID- 2755984 TI - [Objectives of consultation in anesthesia]. AB - Recently developed in France (1970), pre-anaesthetic consultation continues to gain in importance because of a number of considerations. Psychological considerations: Consultation provides information about the patient to be operated, wins the patient's co-operation for his/her preparation for operation, and takes some of the drama out of surgery and anaesthetic. Medical considerations: More complete pre-operative examination (discovery of hereditary defects, and current medication) carried out by means of a long and very methodical interrogation, difficult to do at the patient's bedside. The best and most accurate possible assessment of the anaesthetic risk will reduce per- and post-operative complications or at least reduce their effects by better prevention and preparation of the patient, notably in the case of patients with respiratory problems, following possible complementary examinations or other specialized consultations. Anaesthetic considerations: By means of the choice and discussion of an anaesthetic technique according to the patient's own wishes, the anaesthetic risk, the type of hospitalization, especially in ambulatory anaesthetic, when pre-anaesthetic consultation is indispensable. Care coordination: The anaesthetist doctor assumes a double role of clinician and coordinator with the surgical team, the other specialists, and especially the general practitioner whose work he will continue when the patient is hospitalized, and who will have a leading role in the pre-operative preparation of the patient, and the realization of complementary examinations often carried out at home. The consultation makes for a per-operative approach which is carried out earlier, is more complete and more humane. PMID- 2755985 TI - [Venous access in anesthesia and resuscitation]. AB - Veins are used not only in anaesthesia and reanimation, but also in the whole set of medical and surgical specializations, for blood-sampling, injecting, measuring and exploring. This study analyses the local, regional, and general complications arising from the puncture of the superficial and deep veins, their capacity for catheter insertion, and the medication or solutions injected. PMID- 2755986 TI - [Simulation of transcapillary exchange of liquids]. AB - The transcapillary exchanges of liquids between vascular and interstitial sections can be described with the help of a mathematical model describing variation in filtration, reabsorption, plasmatic flux and lymphatic flow in relation to the different active pressures, that is to say the arteriolar and venular pressures, the oncotic pressures of the proteins, and interstitial pressure. Also taking into account the modifications of the volemia in relation to blood loss and perfusions, modifications of the essential haemodynamic variables and diuresis, it is possible to reproduce various situations following the reduction in venous or lymphatic return, hypovolemia, and hypoproteinemia. The advantages in these simulations is demonstrated by the example of a blood depletion, compensated or otherwise, as follows: volemia, proteinemia, lymphatic flow. These simulations permit us to follow the sequence of events accompanying haemodilution, and to assess the qualities of a plasmatic substitute: oncotic strength, demi-vie, effect on the extravascular mobilisation of proteins. They also provide a reflexion tool permitting a better comprehension of transcapillary exchanges and the optimisation of strategies of vascular refill. PMID- 2755987 TI - Hydrogen generation from artificial sea water in a semiconductor septum electrochemical photovoltaic cell. AB - Visible light of the solar spectrum is directly converted to stored chemical energy of hydrogen from artificial sea water in a novel electrochemical photovoltaic cell. The principal element of the cell, modeled after the photosynthetic thylakoid membrane, is a semiconductor septum made of polycrystalline n-CdSe thin film deposited on nickel foil, which separates two aqueous solutions. Under short-circuit conditions, vigorous hydrogen evolution was seen at the Ni surface and continued as long as the cell was operated. The novel cell, the concept of which was derived from pigmented bilayer lipid membrane studies, is easy to construct, simple to operate, and appears to be a practical approach to the photochemical conversion and storage of solar energy. PMID- 2755988 TI - Radical processes in lipids. Selectivity of hydrogen abstraction from lipids by benzophenone triplet. AB - Laser photolysis techniques have been used to measure the reactivity of benzophenone triplet (3BZP) toward various fatty acids and two glycerides in benzene solution. Eight compounds varying both in number and in the configuration of olefinic bonds have been examined. It has been found that the rate constant for hydrogen abstraction from these compounds by 3BZP may be related to the number of secondary, allylic and doubly allylic hydrogens in each molecule by the equation: kH = [0.023[H sec] + 0.112[H allylic] + 1.78[H doubly allylic]] x 10(7) M-1s-1 PMID- 2755989 TI - A study of some polypyridylruthenium(II) complexes as DNA binders and photocleavage reagents. AB - The nature of the binding of several ruthenium polypyridyl complexes containing 2,2'-bipyridine (bipy), 4,4'-dimethyl-2,2'-bipyridine (DMB), 1,10-phenanthroline (phen), 4,7-diphenyl-1,10-phenanthroline (DPP), 2,2',2"-terpyridine (terpy), 2,2' biquinoline (biq), 1,4,5,8-tetraazaphenanthrene (TAP) and 1,4,5,8,9,12 hexaazatriphenylene (HAT), with calf thymus DNA, poly[d(A-T)] and poly[d(G-C)] were studied by absorption and emission spectroscopy, DNA melting techniques, and emission lifetime measurements. In low ionic strength phosphate buffer, spectroscopic changes and DNA stabilization depended on the polypyridyl ligands present, and indicated binding that varied from substantially electrostatic to intercalative. Ru(bipy)2(HAT)2+ and Ru(phen)3(2+), which bind by partial intercalation, also show a strong preference for poly[d(A-T)]. The emission quantum yields for most complexes were increased in the presence of DNA. An exception was Ru(TAP)3(2+) which has a markedly reduced emission quantum yield and lifetime in the presence of poly[d(G-C)] or CT-DNA, due to photoredox interaction with quanines. Emission decays of the complexes generally showed multiexponential behaviour. The ability of the ruthenium complexes to sensitise DNA cleavage was determined using pBR322 plasmid DNA. Ru(TAP)3(2+) is the most efficient sensitiser while uncharged complexes and complexes with very short lived excited states do not cleave DNA. PMID- 2755991 TI - Photo-CIDNP of the amino acids. AB - A photochemically induced dynamic nuclear polarisation (photo-CIDNP) study is presented of the amino acids that are polarisable with a flavin dye. These include derivatives of tryptophan, tyrosine, histidine, methylated lysines and methionine. The influence of pH, concentration and chemical modification on the magnitude of the CIDNP effect has been studied to obtain mechanistic information about the radical pair formation. The pH and concentration dependence of tyrosine and tryptophan polarisation could be accounted for quantitatively. The CIDNP evidence indicates that hydrogen-atom abstraction is important in generating radical pairs in the case of histidine and tyrosine, while electron transfer prevails in the case of tryptophan, the methylated lysines and methionine. PMID- 2755990 TI - Photointeraction of benzophenone triplet with lysozyme. AB - The quenching of the benzophenone triplet by lysozyme and its constituent amino acids in aqueous solutions have been studied. Native lysozyme quenches the benzophenone triplet with a high rate constant, 4 x 10(9) M-1 s-1. The quenching process takes place with production of significant amounts of free ketyl radicals, phi ketyl = 0.56, but with a very low benzophenone consumption yield (0.022). The consumption yield is considerably smaller than that observed for the free amino acids. This difference can be explained in terms of a dominant back hydrogen transfer to the protein in the disproportionation of the free radicals produced. Reduced and carboxymethylated lysozyme shows a higher quenching rate (7.8 x 10(9) M-1 s-1) and a larger benzophenone consumption yield (0.07). The deactivation of the benzophenone triplet by the native protein leads to its inactivation, with a quantum yield of 0.01. Tryptophan and arginine residues are destroyed with a quantum yield of 0.01. In the modified enzyme tyrosine and methionine groups are also consumed. PMID- 2755992 TI - In vitro photosensitization with a benzoporphyrin derivative. AB - Biophysical and photobiological properties of two benzoporphyrin derivatives were examined. These dyes exhibit substantial absorbance in the red, and are potent photosensitizers in vitro. After brief (0.5 h) incubations, phototoxicity was more closely correlated with membrane than with mitochondrial photodamage. Affinity of these dyes toward plasma lipoproteins are consistent with a mode of localization via the LDL-mediated mechanism utilized by the hematoporphyrin derived product, HPD. PMID- 2755993 TI - Fluorescence spectra in lung with porphyrin injection. AB - The fluorescence emission spectra from human bronchial mucosa and tumors, before and after injection of dihematoporphyrin ether/ester, have been measured with an optical multichannel analyzer from 500 to 750 nm. Fluorescence was excited with a violet krypton ion laser (average wavelength 410 nm). The autofluorescence spectra decrease monotonically with increasing wavelength except for a small broad peak near 600 nm. The spectra from tumor sites, after injection of the fluorescent porphyrin, exhibit the characteristic fluorescence emission at 630 and 690 nm, added to the autofluorescence spectrum. The spectra from control or nontumor sites are similar but the magnitude of the component due to the injected porphyrin is smaller than at a tumor site. The magnitude ratio of tumor to control site fluorescence depends on concentration of the porphyrin, tumor thickness, and time after injection. Autofluorescence degrades contrast and thus makes very thin tumors difficult to image. Subtraction of the autofluorescence background is desirable. PMID- 2755994 TI - Evaluation of sulfonated aluminum phthalocyanines for use in photochemotherapy. A study on the relative efficiencies of photoinactivation. AB - The cellular photosensitivity caused by aluminum phthalocyanines sulfonated to different degrees (AlPcSn) has been investigated. The phototoxic effect increased with decreasing number of sulfonate groups on the macrocycle, with the exception of AlPcS1 which was less phototoxic than AlPcS2 but more phototoxic than AlPcS3 and AlPcS4. The tendency of the AlPcSns to aggregate in our cellular system increased with increasing lipophilicity of the sensitizers. The aggregates had little or no photosensitizing activity. The low efficiency of cell inactivation caused by AlPcS1 can be explained by the highly aggregated state of this sensitizer in the cells. AlPcS2 and AlPcS3 induced a lower degree of cell inactivation per fluorescing quantum and per quantum absorbed by monomeric species than did AlPcS2 and AlPcS1. AlPcS4 and AlPcS3 are therefore suggested to be in different intracellular locations than AlPcS2 and AlPcS1. PMID- 2755995 TI - UV laser induced RNA-protein crosslinks and RNA chain breaks in tobacco mosaic virus RNA in situ. AB - The efficiency of RNA-protein crosslink and RNA chain break formation under nanosecond or picosecond UV-laser pulse irradiation of tobacco mosaic virus was determined. It was found that on high-intensity UV-laser irradiation the quantum yields of both reactions increase considerably as compared to the usual (low intensity) UV-irradiation. The RNA-protein crosslink quantum yield was found to be 1.8 x 10(-5) and 1.2 x 10(-4) and that of RNA chain breaks 1.7 x 10(-4) and 8.9 x 10(-4) for nanosecond and picosecond irradiation, respectively. PMID- 2755996 TI - Formation of purine photoproducts in a defined human DNA sequence. AB - The formation of DNA base damages by broad spectrum ultraviolet irradiation (250 400 nm) was investigated using a defined sequence of human DNA. The irradiated, 92 base pair, 3'-end of the human alphoid segment was incubated with an enzyme fraction purified from bacteriophage T4-infected E. coli. As previously reported, analysis of reaction products by sequencing gels showed enzymic incision of purine-containing photoproducts as well as pyrimidine cyclobutane photodimers. The purine-incising activity does not require metal ions and was unaffected by beta-mercaptoethanol or dithiothreitol. The formation of the purine photoproducts is independent of buffer; these lesions are produced by irradiation of DNA in Tris, Hepes or phosphate buffers. They are produced at biologically significant wavelengths between 260 to 300 nm. Only low levels were detected above or below this range. The formation of purine photoproducts is dose dependent with similar yields at some specific loci to pyrimidine dimers. These results suggest that purine-containing photoproducts could be of consequence in ultraviolet carcinogenesis. PMID- 2755997 TI - Singlet oxygen induces frank strand breaks as well as alkali- and piperidine labile sites in supercoiled plasmid DNA. AB - A covalently closed, circular, supercoiled plasmid was exposed to singlet oxygen by a separated-surface sensitizer. For each exposure, the quantity of single oxygen entering the DNA target solution was estimated by its oxidation of histidine. After singlet oxygen exposure, some DNA samples were treated to disclose occult lesions. Agarose gel electrophoresis was then used to resolve the unrelaxed supercoils from the relaxed circular and linear species, and all bands were quantitated fluorometrically. Exposure of supercoiled plasmid DNA to singlet oxygen induced frank DNA strand breaks, alkali-labile sites (pH 12.5, 90 degrees C, 30 min), and piperidine-labile sites (0.4 M, 60 degrees C, 30 min), all in a dose-dependent manner. Yields of alkali-labile and piperidine-labile sites ranged from one to four times the frank strand break yield. Replacement of buffered H2O by buffered D2O as the DNA solvent for singlet oxygen exposures increased DNA lesion yields by a factor of 2.6 (averaged over lesion classes). Our data for the detection of frank strand breaks is at variance with published results from studies in which singlet oxygen was derived from a thermolabile endoperoxide dissolved in the DNA solution. PMID- 2755998 TI - Biological UV-doses and the effect of an ozone layer depletion. AB - Effective UV-doses were calculated based on the integrated product of the biological action spectrum (the one proposed by IEC, which extends to 400 nm, was adopted) and the spectral irradiance. The calculations include absorption and scattering of UV-radiation in the atmosphere, both for normal ozone conditions as well as for a depleted ozone layer. For Scandinavian latitudes the effective annual UV-dose increases by approximately 4% per degrees of latitude towards the Equator. An ozone depletion of one percent increases the annual UV-dose by approximately 1% at 60 degrees N (increases slightly at lower latitudes). A large depletion of 50% over Scandinavia (60 degrees N) would give these countries an effective UV-dose similar to that obtained, with normal ozone conditions, at a latitude of 40 degrees N (California or the Mediterranean countries). The Antarctic ozone hole increases the annual UV-dose by 20 to 25% which is a similar increase as that attained by moving 5 to 6 degrees of latitude nearer the Equator. The annual UV-dose at higher latitudes is mainly determined by the summer values of ozone. Both the ozone values and the effective UV-doses vary from one year to another (within +/- 4%). No positive or negative trend is observed for Scandinavia from 1978 to 1988. PMID- 2755999 TI - Effect of photodynamic therapy on anti-tumor immune defenses: comparison of the photosensitizers hematoporphyrin derivative and chloro-aluminum sulfonated phthalocyanine. AB - The effects of the two photosensitizers chloroaluminum sulfonated phthalocyanine (ClAlSPc) and hematoporphyrin derivative (HpD) on the functional activities of macrophages and natural killer (NK) cells, two immunocyte populations implicated in the control of tumor development and spread, have been investigated. Murine peritoneal macrophages treated in vivo with ClAlSPc or HpD at 10 mg/kg body weight showed no impairment of Fc-mediated phagocytic capacity and only minor disturbances of in vitro tumoricidal/tumoristatic function. The NK cell activity of splenocytes obtained from photosensitizer-treated mice, assayed 24 or 48 h after i.v. injection of ClAlSPc or HpD at 10 mg/kg was unaffected compared to controls. However significant inhibition of NK activity was observed when splenocytes obtained from mice with or without subcutaneous Colo 26 tumors, treated with ClAlSPc plus laser therapy (675 nm) were used as effector cells. The results show that impairment of some anti-tumor activity can be observed in phthalocyanine treated or phthalocyanine + laser-treated animals but this relatively minor impairment may augur well for the use of systemic phthalocyanine administration in photodynamic therapy. PMID- 2756000 TI - Interaction of dibucaine.HCl local anesthetics with bacteriorhodopsin in purple membrane: a spectroscopic study. AB - Several spectroscopic techniques (absorption, emission, transient absorption and differential scanning calorimetry--DSC) were used to investigate the deprotonation of dibucaine.HCl in a hydrophobic environment, and the interaction sites and mechanisms of the local anesthetic dibucaine.HCl on bacteriorhodopsin (bR) in purple membrane. The important results are summarized as follows: (1) the visible absorption features of native (lambda max = 568 nm) and deionized (lambda max = 608 nm) bR are sensitive to the amount of dibucaine.HCl added; (2) the emission spectrum of dibucaine.HCl embedded in the retinal-free mutant bR is similar to that of dibucaine free base in Triton X-100 micellar solutions; (3) the phosphorescence emission of dibucaine at 77 K is completely quenched by bR and the fluorescence quenching rate for the incorporated dibucaine.HCl in bR was determined as kq = 4.09 x 10(13) M-1 s-1; (4) the incorporation of dibucaine.HCl in bR inhibits the slow component rate of formation of M412 and decreases the amount of M412 formation in the photochemical cycle of bR; and (5) the thermal stability of native bR was measured by DSC in the presence and absence of dibucaine and yielded an endothermic transition at 95.9 +/- 1.0 degrees C with 13.6 J/g (3.25 +/- 0.12 cal/g) of enthalpy changes. All observations suggest that the action site of the local anesthetic, dibucaine.HCl, is near or at the chromophore, i.e. the retinal Schiff base of bR. The anesthetic action on bR purple membrane is probably via a specific site binding, but not a conformational mechanism. PMID- 2756001 TI - Kinetic model of bacteriorhodopsin photocycle: pathway from M state to bR. AB - A model of the last parts of the bacteriorhodopsin (bR) photocycle is proposed on the basis of experimental data for the kinetic behavior of the 'O' intermediate during a temperature pulse in distilled water suspension. The model includes the previously proposed (but not well characterized) intermediate 'N' between the 'M' and 'O' states of bR. This intermediate exists in fast temperature-dependent quasi-stationary equilibrium with the red-shifted intermediate 'O' and has a maximum of absorption close to the bR spectrum. PMID- 2756002 TI - Photoinduced electron transfer across lipid bilayers containing magnesium octaethylporphyrin. AB - Both photoinitiated (thermodynamically downhill) and photodriven (thermodynamically uphill) electron transfer reactions across lipid bilayers are sensitized by magnesium octaethyl porphyrin (MgOEP). It is shown that the reaction mechanism is via reduction of photoexcited MgOEP at the reducing (ascorbate) side of the bilayer and the charge carrier is likely the neutral protonated MgOEP anion. The MgOEP cation (or its neutral form) does not contribute to charge passage across the bilayer even though it is readily formed at the acceptor (ferricyanide or methyl viologen) side of the membrane. Photoelectric measurements on planar bilayers show that the time constant for reduction of excited MgOEP is about 10 microseconds with 10 mM ascorbate. The membrane transport of the mediator appears to be rate limiting when the reaction is photoinitiated and the interfacial reaction appears to be limiting when the reaction is photodriven. The quantum yield of the process is about 0.1 in the latter case and about 0.02 in the former. The former yield is increased to about 0.15 in the presence of a redox mediator, duroquinone. In these systems, the magnesium porphyrin is both sensitizer and trans membrane redox mediator. PMID- 2756003 TI - Lux C, D and E genes of the Vibrio fischeri luminescence operon code for the reductase, transferase, and synthetase enzymes involved in aldehyde biosynthesis. AB - The lux C, D, and E genes of the Vibrio fischeri luminescence operon code for three polypeptides of 54, 33, and 42 kDa, respectively, which are required for synthesis of the aldehyde substrate for the luminescent reaction. These polypeptides have been identified in V. fischeri and V. harveyi as well as in recombinant E. coli harboring the cloned genes by specific acylation with [3H]fatty acid, showing that they are components of a fatty acid reductase system with reductase, synthetase and transferase activities. By using glycerol in the assay and/or extraction buffer and decreasing the reducing agent, the levels of the acylation of the 54 and 42 kDa polypeptides have been greatly increased. As a consequence, it was possible to demonstrate that the 54 kDa polypeptide coded by the lux C gene has reductase activity. In a subclone missing the lux E gene, the 42 kDa polypeptide was missing and the 54 kDa polypeptide could not be acylated in vitro with tetradecanoic acid (+ATP) and only to a low level in vivo indicating that the synthetase enzyme, responsible for fatty acid activation, is coded by the lux E gene. In vitro acylation with tetradecanoyl CoA of the 33 kDa polypeptide coupled with the specific cleavage of acyl-ACP only in E. coli extracts transformed with DNA containing the lux D gene, demonstrated that the lux D gene coded for the transferase enzyme. PMID- 2756004 TI - Naphthyl- and quinolylluciferin: green and red light emitting firefly luciferin analogues. AB - In the course of investigations on the possible involvement of the CIEEL (chemically initiated electron-exchange luminescence) mechanism in firefly bioluminescence, we have synthesized two novel firefly luciferin substrate analogues. D-Naphthylluciferin and D-quinolylluciferin were prepared by condensing D-cysteine with 2-cyano-6-hydroxynaphthalene and 2-cyano-6 hydroxyquinoline, respectively. These analogues are the first examples of bioluminescent substrates for firefly luciferase that do not contain a benzothiazole moiety. Firefly luciferase-catalyzed bioluminescence emission spectra revealed that compared to the normal yellow-green light of luciferin (lambda max = 559 nm), the emission from naphthylluciferin is significantly blue shifted (lambda max = 524 nm); whereas quinolylluciferin emits orange-red light (lambda max = 608 nm). The fluorescence emission spectra, reaction pH optima, relative light yields, light emission kinetics and KM values of the analogues also were measured and compared to those of luciferin. Neither of the analogues produced the characteristic flash kinetics observed for the natural substrate. Instead, slower rise times to peak emission intensity were recorded. It appears that the formation of an intermediate from the analogue adenylates prior to the addition of oxygen is responsible for the slow rise times. The synthetic substrate analogues described here should be useful for future mechanistic studies. PMID- 2756005 TI - Production of malonaldehyde from squalene, a major skin surface lipid, during UV irradiation. AB - Malonaldehyde (MA), a product of lipid peroxidation, is known to have a number of toxicological effects. Among skin surface components, squalene has been suggested as a significant source of MA following UV exposure. Irradiation of squalene coated on the inside surface of glass tubes served as a simple model to examine skin surface photochemistry. Malonaldehyde produced during UV-irradiation was reacted with methyl hydrazine to form N-methylpyrazole, which was then measured by gas chromatographic analysis. Ultraviolet A-irradiation produced low levels of MA from squalene, with a maximum of 1.0 nmol MA/mumol squalene near 6 h. Malonaldehyde production varied with the energy of irradiation, with levels of 176 nmol/mg squalene and 9 nmol/mg squalene produced after 3 h of irradiation with UVB and UVA, respectively. The thiobarbituric acid (TBA) assay for lipid peroxidation showed large overestimations of MA levels under all irradiation conditions tested. The TBA assay predicted the highest levels of MA with UVC but we did not detect any MA with our assay. PMID- 2756006 TI - Filling the talent pool. PMID- 2756007 TI - Use of animals for teaching and research at the University of the Witwatersrand, South Africa. PMID- 2756008 TI - Ovariectomy attenuates aggression by female rats cohabiting with sexually active sterile males. AB - Female rats were individually housed with a single castrated male with a testosterone implant that maintained sexual and aggressive behavior. At weekly intervals, the resident male was removed and an unfamiliar female intruder was introduced into the colony. Attacks, bites, on-top, and piloerection of the resident female toward the intruder were scored. Females whose level of aggression toward the intruder was substantial and stable were either ovariectomized or sham-ovariectomized. Aggression tests resumed 1 week postoperatively and continued for an additional 3 weeks. The results confirm that female cohabiting with a sterile male become aggressive. They also demonstrate that ovariectomy greatly attenuates but does not entirely abolish aggression toward an unfamiliar female intruder. The results appear to contribute to a growing body of evidence suggesting that the biological substrate and behavioral form of aggression by females housed with males (including that following parturition) is a hormone-dependent aggression which parallels testosterone dependent social aggression of males housed with females. PMID- 2756009 TI - Playback of female rat ultrasonic vocalizations during sexual behavior. AB - Both male and female rats emit ultrasonic vocalizations during mating. In an earlier study, female vocalizations were shown to be associated with female darting: when the female was devocalized, she increased her rate of darting. In a preliminary playback study, tape-recorded female ultrasounds were presented to devocalized females paired with intact males. Darting was reduced towards presurgical control levels. In this study, the playback experiment was replicated using a refined procedure to present female ultrasounds to the mating rats. Taped vocalizations were obtained from females, and were presented in a manner which more closely approximated the patterning of ultrasound production seen in the intact female. Each rat pair was tested three times: once prior to the devocalization of the female, and twice afterwards. In one postsurgical test, taped ultrasounds were presented during mating; in the other, tape hiss was presented. Several patterns of behavior increased in frequency when the female was devocalized relative to the control condition, but decreased when tape recorded ultrasounds were presented. These patterns included female darting and approaches towards the partner by both males and females. The darting results confirm and extend the findings of our earlier paper. Changes in approach behavior were not observed previously because the male was confined in the earlier study. This study contains the first direct evidence that female vocalizations affect the socio-sexual behavior of the male. PMID- 2756010 TI - The effect of embryonal amygdala grafts on the impairment of spatial working memory elicited in rats by kainate-induced amygdaloid damage. AB - The effect of epileptogenic lesion of amygdala on spatial working memory was examined in rats after unilateral (U, n = 9) or bilateral (B, n = 8) injection of 1 or 0.5 mu of 0.2% kainate into the amygdaloid complex. Another group of unilaterally lesioned rats (T, n = 9) received 8 days after kainate injection grafts of embryonal (E 20) amygdala into the damaged region. Twelve days after lesion the three experimental groups and an unoperated control group (C, n = 11) were trained during three weeks in the aversively motivated 8-arm radial water maze (RWM). Training decreased incidence of errors/8 choices from the initial 2.3 to 1.2 in the lesioned rats and to 0.4 in the controls. Transplantation did not enhance RWM acquisition but restored the symmetrical pattern of choices and normalized the emotionality of lesioned animals. Retraining the RWM task 3 months later revealed significant savings in the control group but not in the transplanted group. Histology showed in addition to large lesion at the injection site also distant lesions in the ipsilateral hippocampus, thalamus and neocortex and in the unilaterally injected rats also in the contralateral amygdala. Healthy, well integrated transplants found in 6 out of 9 transplanted rats reduced the incidence of remote lesions (particularly in the contralateral hemisphere). Performance of individual animals reflected the state of the transplant. It is concluded that the impairment of spatial working memory is due not only to destruction of amygdala but also to diffuse damage of the limbic system. The slowly developing seizure-induced distant lesions can be partly prevented by embryonal grafts. PMID- 2756011 TI - Meal associated changes in brown fat thermogenesis and glycogen. AB - Data indicate a close association between a decrease in feeding-induced brown adipose tissue (BAT) thermogenesis and an increase in food consumption. The present study examines the hypothesis that feeding-induced BAT thermogenesis, or feeding-induced changes in BAT glycogen, a mobile form of energy store and a correlate of BAT thermogenesis, may modulate feeding behavior. We report that propranolol, which completely abolished meal-induced BAT thermogenesis, did not evoke intake of a larger meal. Though BAT glycogen concentration is a sensitive measure of the state of feeding, on a meal to meal basis it does not correlate with hunger and satiety. Hence the hypothesis is not supported by the current data. We also report that meal-induced BAT hypertrophy and glycogen deposition can be dissociated from meal-induced BAT thermogenesis. PMID- 2756012 TI - Habituation of sympathetic-adrenal medullary responses following exposure to chronic intermittent stress. AB - Two experiments examined sympathetic-adrenal medullary responses of laboratory rats after exposure to a brief period of stressful stimulation daily for 26 consecutive days. In the first experiment, rats were exposed to restraint stress for 30 minutes per day and in the second experiment, rats were exposed to inescapable footshock for 10 minutes per day. For each experiment, handled controls were stressed acutely to provide a basis for comparison with chronically stressed animals. In both experiments, chronically stressed rats gained less weight than controls. Basal plasma levels of norepinephrine (NE) and epinephrine (EPI) were similar in control and chronically stressed rats. However, there was a substantial attenuation of the plasma catecholamine response to the 27th episode of restraint or footshock compared to acutely stressed controls. These findings indicate that sympathetic-adrenal medullary responses are dampened considerably in animals exposed to a highly predictable regimen of chronic intermittent stress. PMID- 2756013 TI - Energy intake of rats fed a cafeteria diet. AB - The proportion of lipid, carbohydrate and protein energy self-selected by male and female rats from a cafeteria diet has been studied for a 48-day period (36 day in female rats). The diet consisted in 12 different items and was offered daily, in excess and under otherwise standard conditions, to rats--caged in groups of three--from weaning to adulthood. Groups of control animals were studied in parallel and compared with the cafeteria groups. Cafeteria diet fed groups of rats ingested more energy and lowered their metabolic efficiency with age. Male rats ate more than females and increased their body weight even after female practically stopped growing. There was a wide variation in the aliments consumed each day by the cafeteria-fed rats. However, the proportion of lipid, protein and carbohydrate the rats ate remained constant. Male rats ingested more lipid than females. Carbohydrate consumption was constant in control and cafeteria fed groups of rats independently of sex. Protein consumption was higher in cafeteria rats than in controls, but the differences were not so important as with liquid. Fiber content of the cafeteria diet was lower than that of the control diet. The cafeteria diet selected by the rats was, thus, hypercaloric and hyperlipidic, with practically the same amount of carbohydrate than the control diet, slightly hyperproteic and, nevertheless, remarkably constant in its composition with respect to time. Cafeteria rats had a higher water intake than controls. All these trends were maintained despite the observed changes in the animals' tastes and their differential consumption of the ailments of the diet. PMID- 2756014 TI - Effects of repeated sleep deprivation in the dark- or light-period on sleep in rats. AB - This study was designed to examine the differences between sleep duration and EEG when sleep was restricted to the rest- or activity-phase for 5 successive days, achieved by repeated sleep deprivation in the dark (DSD) or light-period (LSD). In the DSD-experiment the percentages of the vigilance states were comparable to the level of the baseline light period. In LSD, the amounts of all sleep states increased substantially relative to baseline dark. The sleep episodes were lengthened in DSD and LSD. The duration of NREM-sleep and the sleep episodes remained longer in the light than in the dark, indicating circadian influences. In the first hours after sleep deprivation the delta activity during NREM-sleep was enhanced in LSD and to a lesser extent in DSD. This effect diminished over the consecutive days in both experiments. The EEG energy gained during sleep and its accumulation pattern on each day in DSD and LSD were strikingly similar, thereby reflecting a homeostatic process. After the sleep deprivation days, small changes were observed in the distribution of the vigilance states, the delta activity and EEG energy over the light- and dark-period. PMID- 2756015 TI - Adjustment to intermittent access in rats drinking saccharin: II. Adjustment of lapping rate. AB - Hungary rats were permitted to drink saccharin under conditions in which (a) the drinking spout was available continuously, or (b) it was withdrawn during alternate 30-sec periods. Rats adjust to such constraint by increasing their integrated lap rate (laps/min). We show that one way in which they do this is to lap at a higher rate within bursts of lapping. This faster lapping is not an artifact of forced interruptions and resumptions. It cannot only be maintained over a drinking session, but also initiated midway through the session if restricted access is imposed then. Therefore, the period of the lapping cycle can be adjusted, within limits, in response to situational constraints on access to the fluid. PMID- 2756016 TI - Hereditary nature of the pattern of the motor activity circadian rhythm in mice. AB - The inherited nature of the pattern of the daily motor activity function (MAF) has been studied using different families of the same strain of mice. The motor activity of 6 male mice, belonging to two different families (A and B was recorded during 54 days in LD conditions (12L:12D) using six inductive units. The register began the day just after weaning. A Fourier analysis was applied to motor activity data corresponding to observation periods of 24 hours. The daily power spectrum, with 20 harmonics, was calculated by obtaining the power content of each harmonic expressed as a percentage of the total power content of the MAF. A discriminant function based on the first fifteen harmonics was created to distinguish between the males of the two families. Then, the same discriminant function was applied to the daily power spectra of the progeny. It was also possible to differentiate among the mice (males and females) coming from fathers of family A and the mice coming from fathers of family B (p less than 0.02). This fact suggests that, in the power spectra of the progeny, there may be enough characteristic equal to that of their respective fathers and it further suggests that some characteristic of the MAF could have been inherited. PMID- 2756017 TI - Maternal behavior in normal and androgenized female rats: effect of age and experience. AB - The aim of the experiments presented here was to evaluate the influence of age and of previous maternal experience on care of pups in normal virgin and androgenized Wistar female rats. When sensitization occurred before they were 60 days old, androgenized females failed to develop consistent retrieving, probably because of excessive timidity (Experiments 1 and 2) whereas they were able to keep pups warm in their nests. During pup-toy choice tests (Experiment 2) young androgenized females displayed only erratic carrying of toys. On the other hand, 60-, 80- or 100-day-old androgenized females developed full maternal behavior like cyclic controls. In the third experiment, control and androgenized females exposed to pups when 60 days old, were reexposed when 95 days old. Androgenized females proved to be more sensitive to earlier exposure to pups than control females and showed significant reductions in latencies of emergence of maternal responses. PMID- 2756018 TI - Long-term memory for DRL: a comparison between weanling, adult and senescent rats. AB - Weanling (24-day-old), adult (3- and 7-month-old) and senescent rats (24-month old) were submitted for 10 days to a DRL 20 seconds schedule, at a pace of 4 sessions a day. After a 3 month interval, the subjects were tested for retention in an identical experimental setting. In training, the median Interresponse-Time (IRT) is directly related to the age of the subjects, whereas response rates are inversely related to it. Age-related differences subside at the end of training. In testing, adult rats improve their efficiency, whereas senescent and particularly former weanling rats do not catch up with training scores. These data are discussed in relationship with developmental variables in the temporal regulation of behavior, collateral activity, contextual and methodological variables in the study of memory. PMID- 2756019 TI - Effects of a gastric implant on body weight and gastrointestinal hormones in cafeteria diet obese rats. AB - In order to evaluate the effectiveness of a gastric implant in an animal model of dietary obesity, silicone implants (2.5 ml) were inserted into the stomachs of male rats maintained on a chow or "cafeteria" diet. At the time of implantation, the cafeteria fed rats weighed 14% more than chow fed controls. Overweight cafeteria fed animals lost weight in response to the gastric implant, whereas control chow fed animals did not. Both implant groups had significant increases in stomach weights in contrast to sham implant groups, but the increase was much less in the cafeteria diet group. The fasting plasma levels of the gastrointestinal hormones, gastrin and pancreatic polypeptide, and oxytocin (a marker of vagal afferent function) were measured by radioimmunoassay. Cafeteria fed sham or implanted animals had significantly higher fasting levels of plasma oxytocin and gastrin, and significantly lower plasma levels of pancreatic polypeptide than the chow fed groups. These studies demonstrate that the gastric implant has more effect on weight in overweight animals on a palatable mixed diet, perhaps related to both mechanical and neural factors. PMID- 2756020 TI - Level searching: a new assay of sexual motivation in the male rat. AB - Mendelson and Gorzalka recently described a bilevel chamber for the evaluation of rodent sexual behavior. In initial studies it was observed that during 5 min adaptation periods prior to the introduction of a sexually receptive female rat, male rats with prior sexual experience in these chambers would move from level to level in apparent search for the female rat. In Experiment 1, we examined the acquisition of this level searching behavior in male rats. Sexually active male rats were given access to either sexually receptive or nonreceptive female rats following a 5 min period alone in the bilevel chamber. Only male rats that pursued and copulated to ejaculation with sexually receptive females in the bilevel chamber significantly increased the number of their level to level movements in subsequent tests during the 5 min periods prior to the introduction of the female rat. In Experiment 2, male rats that had acquired asymptotic rates of level searching showed a significant attenuation of this behavior when the presentation of a female rat into the chamber was discontinued. These findings lead us to conclude that the increase in level to level movement by the male rat represents a sexually motivated search for the female rat. We suggest that the analysis of the acquisition, maintenance, and extinction of level searching behavior might serve as a simple assay of sexual motivation in the male rat. PMID- 2756021 TI - Avoidance and brightness discrimination conditioning in genetically different lines of rats. AB - Rats from an albino stock were selected for high (HAS) and low (LAS) avoidance scores measured in a shuttle-box. Learning performance of male rats was compared in three different tests: the shuttle-box, the pole jumping-box, and the Y chamber. It was shown that rats of the HAS line more rapidly acquired conditioned avoidance in the shuttle-box experiment and the pole-jumping experiment than LAS, whereas we could not detect any significant differences in brightness discrimination. In the open field test rats of the HAS line were more active in comparison to LAS's, measured in terms of higher ambulation scores. In conclusion, it is verified that the shuttle-box performance as well as pole jumping performance is highly determined by the emotional status of the animals and, moreover, that avoidance learning is based on mechanisms other than brightness discrimination learning. PMID- 2756022 TI - Continual monitoring of reaching in rat using magnetic induction law. AB - A method enabling the continual monitoring of movement has been developed based on the law of magnetic induction. The method was concretely applied in the handedness model of the rat. A sensing loop was implanted under the forearm skin of a rat. Electric voltage was induced by the movement of the sensing loop in a DC magnetic field. This voltage is proportional to the movement velocity and its polarity to the direction. The continuous character of the movement record allows convenient analysis and a more exact correlation with the bioelectric concomitants of the movement. PMID- 2756023 TI - Peak N160 of rat flash evoked potential: does it reflect habituation or sensitization? AB - Flash evoked potentials recorded from awake rats contain a negative peak occurring about 160 msec after the flash (N160). This peak has been associated with a specific level of arousal, and/or habituation by various authors. The current studies attempted to determine whether changes in N160 amplitude which accompany repeated testing reflect processes associated with sensitization or habituation. This paper describes experiments in Long-Evans hooded rats which demonstrate the effects of repeated testing, varying stimulus intensity, varying stimulus frequency, and discharging an alarm bell before and during a test session. Repeated testing produced increases in N160 amplitude which were greater at high than low stimulus intensities. Repeated exposure to the test chamber without flashing did not alter N160 amplitude, nor did altering stimulus rate within the range of 0.5 to 4.0 Hz. Discharging an alarm increased N160 amplitude. Taken together, the data suggest that amplitude of N160 more closely reflects sensitization to the stimulus than habituation to either the stimulus or any feature of the test situation. PMID- 2756024 TI - Change of female partner and postejaculatory performance of young and old rhesus males. AB - This study was undertaken to determine whether a change of female partner following ejaculation would reduce the postejaculatory interval (PEI). The male subjects were seven old (mean age 22.4 years) and five young (mean age 12.2 years) rhesus males (Macaca mulatta). The female subjects were four ovariectomized females rendered sexually receptive by treatment with estradiol benzoate. Introduction of a different female following ejaculation significantly reduced the PEI and latency to a second ejaculation in both young and old males. However, a different female did not reduce latencies to preejaculatory levels. The potential for enhanced sexual performance was retained in old rhesus males. PMID- 2756025 TI - Responses of fowls to an operant feeding procedure and its potential use for reducing randomness in meal occurrence. AB - Adult laying hens were tested with increasing and decreasing procurement costs (pecks at a disc) which allowed access to food for unlimited periods. This was done to observe changes in feeding behaviour, to see whether apparent randomness in meal occurrence can be reduced, and, if so, to identify an appropriate fixed ratio (FR) for incorporating in investigations of physiological correlates of hunger and satiety. Daily food intake stayed the same at all but the highest (160 pecks) FR. FR sizes were related negatively to total time feeding and meal frequency, and positively to intermeal interval length, meal size and rate of eating within meals. They were also related positively to meal length, but only weakly so. Frequency distributions of meal and interval lengths, and postprandial correlation coefficients, indicated that randomness in feeding did decline at higher FRs, and FR20 seems the most appropriate schedule for potential use in physiological experiments. PMID- 2756026 TI - The effect of increased adiposity on food intake of juvenile rats. AB - The regulation of feeding by body adiposity, as proposed by the lipostatic theory, has been well demonstrated in adult animals. However, mechanisms controlling long-term feeding in juvenile animals have not been well defined. In this study, increased adiposity was induced in young rats through oral gavage. Four-week-old rats were divided into three groups; ad lib feeding (100%-AL), tubefed 100% (100%-TF) or 150% (150%-TF) of ad lib intake. Animals were tube-fed these levels for one week. At the end of this period, one third of each group were killed and all remaining animals were returned to ad lib feeding for either 4 or 29 days later. During this recovery period, the 150%-TF group had significantly depressed food intakes for the first 4 days in comparison to the 100%-TF group. Afterwards, there were no significant differences between these two groups for the remainder of study. Overfeeding induced significant increases in total body fat in the 150%-TF group (24.8 grams) in comparison to the 100%-AL group (11.0 grams) and the 100%-TF group (14.0 grams). By day five of recovery, only the 150% group exhibited a significant loss of body fat. Total carcass protein and ash were not different between groups at any period. At day 29 of recovery, there were no treatment differences in carcass weight or fat content. Loss of body fat from the 150%-TF rats was associated with the decline in caloric intake. It appears that food intake is affected by relative adiposity during the dynamic phase of growth. PMID- 2756027 TI - Children's food intake following drinks sweetened with sucrose or aspartame: time course effects. AB - In two experiments, 2-5-year-old children's responsiveness to caloric density cues was examined. In a preloading protocol, consumption of fixed volumes of drinks (205 ml in Experiment 1; 150 ml in Experiment 2), sweetened with sucrose, aspartame, aspartame plus low glucose maltodextrin, or a water control, was followed by ad lib consumption from among a variety of foods. Caloric drinks had about 90 kcal in Experiment 1, 65 kcal in Experiment 2. The delay interval between the preload and the ad lib consumption was 0, 30 or 60 minutes. In Experiment 1, 24 4- and 5-year-old children participated in only one delay interval, while in Experiment 2, all 20 2- and 3-year-old children were seen in all conditions. Results revealed evidence of caloric compensation, but no evidence of preload x time delay interaction. In both experiments, aspartame also produced a significant suppression of intake relative to water, primarily due to the pattern at 30 min following the preload. Across conditions, the suppression following aspartame was usually significantly less than that produced by the caloric sweet drinks, providing evidence for postingestive effects. In Experiment 1, suppression of intake was related to the children's preferences for the foods, not to macronutrient content; consumption of nonpreferred foods was most suppressed. Consumption of sweetened drinks as long as 1 hour prior to eating suppressed food intake, and this common feeding practice may also reduce dietary variety. PMID- 2756028 TI - Feeding cycles entrain circadian rhythms of locomotor activity in CS mice but not in C57BL/6J mice. AB - The effects of periodic, restricted feeding (RF) for two hours at a fixed time of day on the circadian rhythms of locomotor activity were examined in CS and C57BL/6J mice, kept under continuous dim, red lights (LLdim). In C57BL/6J mice, free-running rhythms were not affected by an RF schedule, although anticipatory behavior prior to the food access period was observed. On the other hand, the free-running rhythms of CS mice did entrain to an RF schedule, exhibiting anticipatory behavior. The free-running rhythms of none of the control animals in either strain exhibited any effects resulting from the periodic disturbances occurring concurrently with the performance of RF. These results indicate that the circadian pacemaker couples with the food entrainable oscillator (FEO) in CS mice, but that such coupling may not exist, or may be very weak, in C57BL/6J mice. PMID- 2756029 TI - Wheel running, food intake, and body weight in male rats. AB - The acquisition of wheel running, its effects on food intake and body weight, and the effects of wheel deprivation, were examined in male rats. Running increased during the first 15 days of access, then plateaued. When wheels were unlocked after 10 days of deprivation, running was reduced, but quickly recovered to original levels. Animals first given wheel access 49 days into the study ran little, with no increase over days. Food intake dropped each time with wheel access, but recovered to control levels over 10-14 days. Wheel deprivation resulted in a temporary hyperphagia. With wheel access, weight initially dropped and was then maintained at a reduced percentage of homecage-housed animals. In male rats wheel access appears to have temporary effects on food intake, and long term effects on weight. Marked differences in the activity of same-age rats suggest that wheel running is in part a function of housing history. PMID- 2756031 TI - Exploratory behavior, reaction to novelty, and proactive memory in rats with temporo-entorhinal connections disrupted. AB - The parahippocampal cortex is ascribed a key function in mediating reciprocal connections between neocortical association areas and the hippocampal formation. Within this complex the lateral entorhinal cortex (LEC) seems to stand out as an important interface exerting modulating influence upon cognition and memory by way of its connections with the hippocampal formation and temporal cortex (TC), respectively. The purpose of the present study was to compare effects of TC/LEC disruptions in a novelty test with results previously obtained in the same test following lateral perforant path (LPP) disruptions. Further, effects of TC/LEC lesions on proactive memory were examined, since a profound impairment in retroactive memory has previously been found. Rats bearing TC/LEC lesions or LPP lesions behaved differently in the novelty test. It was also shown that the impairment in proactive memory was less severe than the one seen in retroactive memory following TC/LEC lesions. The results are discussed in terms of a highly integrative role of LEC. PMID- 2756030 TI - Contribution of amygdalar and lateral hypothalamic neurons to visual information processing of food and nonfood in monkey. AB - Visual information processing was investigated in the inferotemporal cortical (ITCx)-amygdalar (AM)-lateral hypothalamic (LHA) axis which contributes to food nonfood discrimination. Neuronal activity was recorded from monkey AM and LHA during discrimination of sensory stimuli including sight of food or nonfood. The task had four phases: control, visual, bar press, and ingestion. Of 710 AM neurons tested, 220 (31.0%) responded during visual phase: 48 to only visual stimulation, 13 (1.9%) to visual plus oral sensory stimulation, 142 (20.0%) to multimodal stimulation and 17 (2.4%) to one affectively significant item. Of 669 LHA neurons tested, 106 (15.8%) responded in the visual phase. Of 80 visual related neurons tested systematically, 33 (41.2%) responded selectively to the sight of any object predicting the availability of reward, and 47 (58.8%) responded nondifferentially to both food and nonfood. Many of AM neuron responses were graded according to the degree of affective significance of sensory stimuli (sensory-affective association), but responses of LHA food responsive neurons did not depend on the kind of reward indicated by the sensory stimuli (stimulus reinforcement association). Some AM and LHA food responses were modulated by extinction or reversal. Dynamic information processing in ITCx-AM-LHA axis was investigated by reversible deficits of bilateral ITCx or AM by cooling. ITCx cooling suppressed discrimination by vision responding AM neurons (8/17). AM cooling suppressed LHA responses to food (9/22). We suggest deep AM-LHA involvement in food-nonfood discrimination based on AM sensory-affective association and LHA stimulus-reinforcement association. PMID- 2756032 TI - Cholinergic regulation of female sexual behavior in rats demonstrated by manipulation of endogenous acetylcholine. AB - Infusions of the cholinesterase inhibitor, eserine, into the lateral ventricle of the brain facilitated lordosis in ovariectomized, estrogen primed female rats. Lordosis was also facilitated by infusions of 5 or 10 micrograms acetylcholine when this was accompanied by a low dose of eserine. Systemic treatment with the muscarinic antagonist, atropine (2 mg), completely blocked the facilitative effects of eserine and acetylcholine. In female rats made highly receptive by treatment with estrogen and progesterone, lordosis was inhibited by infusion of scopolamine into the lateral ventricles. These results agree with previous findings that sexual receptivity is regulated in part by endogenous cholinergic activity. PMID- 2756033 TI - Vomeronasal organ and social factors affect urine marking by male mice. AB - Adult CF-1 male mice cohabited for 15 days with three different females (EXPERIENCED) or remained physically isolated (INEXPERIENCED) prior to removal of their vomeronasal organs (VNX) or a SHAM procedure. Subjects were tested one month after surgery for urine marking in response to a stimulus male, a stimulus female, or no stimulus animal on the opposite side of a screened partition. VNX males exhibited a significant reduction in urine marking compared to SHAM males. EXPERIENCED VNX males deposited urine in amounts that were intermediate to SHAMs and INEXPERIENCED VNX males. These results suggest that deficits in urine marking behavior that result from loss of vomeronasal chemoreception may be ameliorated by prior sexual and/or social experience with females. PMID- 2756034 TI - Defensive burying behavior in maudsley reactive (MR/Har) and nonreactive (MNRA/Har) rats. AB - Based upon differences in open field and conflict behaviors, the MR/Har and MNRA/Har rat strains have been proposed as a genetically-based "animal model" for the study of emotionality and/or anxiety. The present study compared the MR/Har and MNRA/Har rat strains in the Defensive Burying paradigm. Prior to testing, female MR/Har and MNRA/Har rats were placed in a 40 X 30 X 40 cm Plexiglas chamber containing clay bedding material (5 cm deep) for 30 minute periods on each of four consecutive days. On the fifth day, a wire wrapped prod was placed at one end of the chamber. Rats were placed in the chamber singly and a 3 mA shock was delivered upon contact with the prod. Defensive Burying behavior (i.e., the moving of bedding material toward or over the prod) was recorded for each animal for 15 minutes postshock. There was no MR/Har versus MNRA/Har difference in the percent of animals exhibiting Defensive Burying, nor was there a MR/Har versus MNRA/Har difference in the latency to initiation or the duration of this behavior. Thus, these genetically-defined Maudsley rat strains do not appear to differ in all "animal models" for the study of anxiety or fear. PMID- 2756035 TI - Hyperalgesia following agonistic encounters in DBA/2 intruder mice is not associated with recuperative behaviours. AB - Recent findings concerning the time-course of opioid-mediated social conflict analgesia have revealed the existence of two distinct nociceptive phases. Analgesia lasting between 30-45 minutes postattack is evident in the early phase whilst hyperalgesia is observed in the late phase at around 70-75 min postattack. This pattern of nociception has similarities with that envisaged in the Perceptual-Defensive-Recuperative (PDR) model of fear and pain and is predictive of defense/fear reactions being seen whilst animals are analgesic with recuperative behaviours becoming evident in the hyperalgesic phase. Detailed ethological analysis was conducted on DBA/2 mice exposed to opioid-activating attack parameters in a resident-intruder paradigm and tested in the presence of a nonaggressive conspecific. During the analgesic phase, at 10 min postagonistic encounter, a profile was observed consisting largely of increased measures of static, self-directed, possibly recuperative, behaviours (immobile crouch and autogrooming). In contrast, during the hyperalgesic phase, at 70 minutes postencounter, there was evidence of increased environmental exploration, attending to and avoiding nonaggressive conspecifics but no increases in autogrooming or any other behaviours that could be viewed as being recuperative. It is concluded that under present test conditions, using DBA/2 mice exposed to opioid activating attack parameters, predictions based on the PDR model of fear and pain are not supported. PMID- 2756036 TI - Effects of antihistamines on centrifugal rotation-induced analgesia and conditioned flavor aversions. AB - Centrifugal rotation induces short lasting analgesia, as shown in tail flick tests conducted immediately afterwards, and apparently induces visceral upset that can support aversions for flavors ingested immediately beforehand, as indicated in later preference tests. Two experiments were performed with antihistamines to determine whether the analgesic and visceral effects of rotation were attributable to separate neurochemical systems. In each experiment four groups of rats were defined by factorial combination of UCS (rotation at 150 rpm vs. no rotation) and Drug (antihistamine vs. saline). In Experiment 1 the H1 blocker chlorpheniramine (20 mg/kg, IP) was found to be ineffective against analgesia and to block conditioned flavor aversions (CFAs). In Experiment 2 the H2 blocker cimetidine (100 mg/kg, IP) was found to have a nearly significant attenuating effect on analgesia and to have no effect on CFAs. The data support the idea that analgesia and visceral upset are attributable to separate mechanisms, both of which are activated by the same manipulations. PMID- 2756037 TI - Differential effects of paternal presence on pup survival in two species of dwarf hamster (Phodopus sungorus and Phodopus campbelli). AB - The effect of the presence or absence of the male, and of decreased ambient temperature (21 degrees C vs. 4 degrees C) on litter survival, pup survival and pup growth was measured from birth through day 18 after birth in Siberian (P. sungorus) and Djungarian (P. campbelli) hamsters. Siberian hamsters were not significantly affected by the experimental manipulations. In contrast, whereas 100% of litters and 95% of pups were successfully raised to weaning at 21 degrees C by paired Djungarian hamsters, survival fell to 47% when the mate was absent and even further, to 32%, when the ambient temperature was lowered. No significant differences in litter size or pup weight at birth were detected between species at the warmer temperature. However, P. sungorus pups gained weight significantly faster through day 12 after birth (while dependence upon the mother for food was absolute) than P. campbelli pups under all experimental conditions. Although the species are closely related, these data show that male Djungarian hamsters are essential to offspring survival under conditions where Siberian hamsters do not require conspecific help. Species differences in metabolism and thermoregulation may account for the differential pup survival. PMID- 2756038 TI - Taste-to-postingestive consequence conditioning: is the rise in sham feeding with repeated experience a learning phenomenon? AB - Although the progressive increase in intake with repeated sham feeding experience is assumed to reflect the extinction of learned satiety, the involvement of associative learning in this phenomenon has never been directly demonstrated. We show that: a) animals attenuate sham feeding on initial exposure only with foods tasting like those they have fed normally before, and b) latent inhibition, which retards the formation of CS-US associations in classical conditioning preparations, prevents the association of a taste with its postingestive consequences. These data suggest both that learning plays a role in the development of sham feeding and that associative linking of a food's taste with its postingestive consequences occurs during ingestion. The present results identify properties of taste-to-postingestive consequence conditioning and indicate how the sham feeding preparation can be used to identify the physiological events mediating this learning. PMID- 2756039 TI - Individual housing does not influence the adaptation of the pituitary-adrenal axis and other physiological variables to chronic stress in adult male rats. AB - Although the influence of housing conditions on the physiological response to stress has been extensively studied for several years, no attempts have been made to investigate the effect of this variable on the capacity for adaptation to chronic stress. To this end, adult male rats were housed either individually or in groups of four per cage and subjected to 2 hr of daily immobilization stress for 14 days. Housing did not influence any of the physiological variables measured either in unstressed or in stressed rats except the corticosterone response to stress which was higher in individually housed rats. Of the behavioral measures, individual housing significantly decreased defecation rate in the novel environment. Other behavioral measures were not influenced by housing. Chronic stress significantly reduced ambulation but no significant interaction between housing and chronic stress was observed. Taken together, these data indicate that a short period of individual housing did not affect the physiological and behavioral consequences of repeated exposure to chronic stress. PMID- 2756040 TI - Genetics and senescence. I. Age-related changes in activity and exploration in three inbred strains of mice. AB - Exploratory, locomotor and ambulatory activities were measured in nine independent groups of three inbred strains of mice (BALB/cBy, C57BL/6J and DBA/2J), at three different ages (150 days, 400 days and 750 days). The results show that for two of the three variables, the age-related changes present different patterns as a function of strain. The genetic and/or environmental correlates of the reactivity to aging may thus depend on the behavioral trait under study. PMID- 2756041 TI - Hyperphagia induced by pylorectomy in sheep. AB - In the hay-fed sheep, gastric (abomasal) contents are delivered continuously into the duodenal bulb at a mean flow rate of 210 ml per hour. The pylorus could behave as the site of origin of a feedback satiety signal by acting as a distal stomach sphincter limiting the abomasal emptying rate. This ability of the pyloric sphincter was confirmed by enhancement of abomasal outflow following either pylorectomy or pyloroplasty. In both cases, the subsequent reduction of the mean residence time of digesta in the abomasum was accompanied by an increase in the voluntary intake. The increase by 48% of food intake persisted several weeks after pylorectomy and was not only compensatory for the lower intake during recovery from surgery. Such an hyperphagia, obtained by removal of the ruminant herbivore pylorus, suggests the suppression at the antroduodenal junction level of a regulating factor affecting voluntary food intake by modulating the mean residence time of digesta in the abomasum. PMID- 2756042 TI - Effects of restricted feeding schedules on circadian organization in squirrel monkeys. AB - Free running circadian rhythms of motor activity, food-motivated lever-pressing, and either drinking (N = 7) or body temperature (N = 3) were recorded from 10 squirrel monkeys maintained in constant illumination with unlimited access to food. Food availability was then restricted to a single unsignaled 3-hour interval each day. The feeding schedule failed to entrain the activity rhythms of 8 monkeys, which continued to free-run. Drinking was almost completely synchronized by the schedule, while body temperature showed a feeding-induced rise superimposed on a free-running rhythm. Nonreinforced lever-pressing showed both a free-running component and a 24-hour component that anticipated the time of feeding. At the termination of the schedule, all recorded variables showed free-running rhythms, but in 3 animals the initial phase of the postschedule rhythms was advanced by several hours, suggesting relative coordination. Of the remaining 2 animals, one exhibited stable entrainment of all 3 recorded rhythms, while the other appeared to entrain temporarily to the feeding schedule. These results indicate that restricted feeding schedules are only a weak zeitgeber for the circadian pacemaker generating free-running rhythms in the squirrel monkey. Such schedules, however, may entrain a separate circadian system responsible for the timing of food-anticipatory changes in behavior and physiology. PMID- 2756043 TI - Sleep cyclicity in infants during the earliest postnatal weeks. AB - Cyclicity within sleep was investigated in 20 fullterm infants who were monitored in the home for 24-hour periods when they were 2-5 weeks old. Using a pressure sensitive mattress in the crib, analog signals from the baby's respiration and body movements were computer scored for: Quiet Sleep, Active Sleep, Active-Quiet Transitional Sleep, Sleep-Wake Transition, and Wakefulness. Sleep episodes with at least four recurrences of Quiet Sleep were analyzed for cyclicity. Significant cyclicity of Quiet Sleep was found in 49 of the 55 sleep episodes analyzed. The mean Quiet Sleep recurrence period was 63.2 minutes. Eighteen of the 20 infants exhibited cyclicity on one or more weeks. Thus, sleep during the neonatal period is generally characterized by the presence of cyclicity. Cyclicity was not related to other parameters of the sleep cycle, but was correlated with stability of state patterning over weeks. The results provide new evidence for neurobehavioral competence of the neonate in terms of sleep organization. PMID- 2756044 TI - Pyloroplasty does not disrupt liquid phase gastric emptying or CCK-induced satiety. AB - To assess the hypothesis that cholecystokinin (CCK) induces satiety by constricting the pylorus and inhibiting the rate of gastric emptying, we impaired pyloric function in 8 experimental animals using a Heincke-Mikulicz pyloroplasty procedure. Liquid phase gastric emptying was measured with a double-sampling procedure. We found that pyloroplasty did not disrupt the pattern of gastric emptying of saline or nutrient under control conditions. CCK also showed emptying in both pyloroplasty and control animals. Finally, pyloroplasty did not affect the ability of CCK to induce satiety. We provide functional and morphological evidence that the pyloroplasty procedure successfully impaired constriction of the pyloric sphincter. These findings suggest that the pylorus is not critical to the control of liquid phase emptying and, together with the absence of a pyloroplasty effect on CCK-induced satiety, seriously question the adequacy of the pyloric mediation hypothesis. PMID- 2756045 TI - Prenatal ethanol and stress in mice: 1. Pup behavioral development and maternal physiology. AB - On days 12 to 17 of pregnancy, B6D2F1 mice were pair-fed liquid diets containing either 25% ethanol-derived calories or an isocaloric amount of maltose-dextrin. During this period, half the mice in each dietary condition also underwent two daily one-hour periods of restraint stress. A fifth group, given lab chow and water ad lib, was left undisturbed throughout gestation. Neither treatment affected offspring body weight on days 22 or 32 postconception, but undernutrition produced by the pair feeding procedure reduced day 32 body weight in all groups relative to the ad lib-fed group. Both prenatal ethanol and pair feeding led to delayed neurobehavioral development on day 32, while prenatal stress significantly reduced the degree of developmental delay caused by these factors. In a second study, restraint stress significantly reduced blood alcohol concentrations in pregnant dams on day 15 of gestation while elevating plasma corticosterone concentrations, and this elevation was consistent regardless of the dietary condition of the dam. The pair feeding procedure also produced corticosterone elevations but the effect of ethanol was not significant. These results suggest that prenatal stress in the presence of other physiological insults may act to counter the actions of those insults. PMID- 2756046 TI - Prenatal ethanol and stress in mice: 2. Development and behavior of fostered offspring. AB - On days 12 to 17 of gestation, B6D2F2 mice were pair-fed liquid diets containing either 25% ethanol-derived calories or an isocaloric amount of maltose-dextrin. During this time, half the mice in each dietary condition also underwent two daily one-hour periods of restraint stress. All pups were fostered at birth to untreated mothers whose pups, in turn, were fostered to the treated mothers. Two additional groups of untreated dams were included, the pups in one group being fostered to other untreated dams while the rest remained with their biological mothers. Prenatal ethanol retarded neurobehavioral development on day 32 postconception and also decreased pup body weight at birth and at weaning, and brain weight on day 32 and at weaning. Prenatal stress decreased body weight at birth in the pair-fed controls only, increased open field activity at weaning and affected retention of a learned passive avoidance task. Undernutrition due to the pair feeding procedure decreased pup birth weight. There were a few effects on untreated pups fostered to treated dams, but these were marginal. These results do not support a role of stress-induced physiological changes in ethanol teratogenicity. PMID- 2756047 TI - Operant conditioning of response variability in male and female Wistar rats. AB - It has previously been suggested that some of the behavioral differences between the sexes in food motivated operant procedures may be a function of the fact that males are more likely than females to exhibit stereotyped behavior. If such is the case, then it might be expected that behavioral variability is more easily conditioned in females than in males. The present experiment was designed to investigate this notion. Male and female Wistar rats were trained to respond in a procedure in which response variability was explicitly reinforced. In this procedure subjects had continuous access to two response levers in the experimental chamber. In the first experimental condition, each sequence of four responses was followed by the presentation of a food pellet, if the sequence differed from the two sequences which preceded it (Lag 2). Time-out was presented when such was not the case. During time-out the levers were retracted from the chamber and all stimulus lights were extinguished for 4 sec. In subsequent experimental conditions, subjects had to produce four-response sequences which differed from the preceding four, eight and sixteen sequences respectively (Lag 4, 8, 16). Response sequences were classified by the number of switches between levers. Behavioral variability increased as the lag requirement was increased, showing that variability is a conditionable dimension of behavior. Differences between males and females were however not observed. These results thus contradict the previously reported finding that males exhibit more behavioral stereotypy than females. It is suggested that procedural variables may account for these seemingly contradictory findings. PMID- 2756048 TI - Interaction of adrenalectomy and fenfluramine treatment on body weight, food intake and brown adipose tissue. AB - Three experiments have examined the interaction of adrenalectomy and fenfluramine on food intake, body weight and the binding of guanosine-5'-diphosphate (GDP) to interscapular brown adipose tissue (IBAT). In the first experiment, GDP-binding by IBAT mitochondria from adrenalectomized or sham-operated animals was measured for 3 hr after one of 3 doses of fenfluramine. Fenfluramine stimulated GDP binding at lower doses in the adrenalectomized animals than in the controls. In the first chronic experiment, adrenalectomy prevented the restoration of normal food intake observed 8-10 days after the beginning of fenfluramine treatment. Adrenalectomy also increased weight loss and enhanced GDP binding to mitochondria from IBAT in rats treated with fenfluramine. In the second chronic experiment, the combination of fenfluramine and adrenalectomy led to a progressive weight loss, continuing hypophagia and stimulation of GDP-binding by IBAT, whereas rats treated with fenfluramine alone showed a recovery of food intake at a stabilized but lower body weight. These data are consistent with the hypothesis that adrenalectomy and fenfluramine disable two separate components of the food intake system and that when combined, produce a profound and persisting disturbance in energy or nutrient balance. PMID- 2756049 TI - Mouse pup urine as an infant signal. AB - Drops of urine from donors of different ages and sexes were applied to the anogenital regions of 19-day fetuses, killed by freezing, that ordinarily are weak in stimulating parental care. These fetuses were then presented to virgin, naive albino mice (Mus musculus). In Experiment 1, fetuses treated with urine of 6-day-old pups were more stimulating than fetuses treated with water. Differences in contact, picking-up, retrieval, licking and self grooming were significant. The sex of the donor revealed no effect. In Experiment 2, urine from 10-day-old pups was found to be more effective than urine from 4-day-old pups, with different effects on contact and retrieval. Urine from pups was also more effective than urine from adults, because of different effects on contact, picking-up, retrieval, licking and nest building. The effects of urine from adult virgin females differed less from those of pup urine than did the effects of urine from adult males. Compared with the latter the adult female urine had different effects on picking-up, licking and cannibalism. Speculations are made about an infant factor that might be still active in the urine of adult females. PMID- 2756050 TI - Virus infection as a stressor: influenza virus elevates plasma concentrations of corticosterone, and brain concentrations of MHPG and tryptophan. AB - Balb/c mice were infected with influenza virus PR8 (H1N1) by the intranasal route. At various subsequent times, brain samples were examined for their content of catecholamine and indoleamine metabolites, and plasma corticosterone was measured. Virus infection was associated with a progressive loss of body and thymus weights, and an increase in plasma corticosterone. Spleen weight initially increased then decreased. There were also increases in the cerebral content of free tryptophan throughout the brain, and of MHPG, a major catabolite of norepinephrine, especially prominent in the hypothalamus. Thus influenza virus can be regarded as a stressor because, like behavioral stressors, it activates the hypothalamic-pituitary-adrenal axis, and increases cerebral concentrations of tryptophan and norepinephrine catabolites. These changes resemble those observed following administration of sheep red blood cells and Newcastle disease virus, noninfectious activators of the immune system, suggesting that noradrenergic and HPA activation are common concomitants of antigenic stimulation. The mediator of these effects may be interleukin-1 released by activated macrophages. It should be noted that animals infected with viruses can be expected to exhibit stress like endocrine and neurochemical changes. PMID- 2756051 TI - Habituation of P300 to target stimuli. AB - Two experiments examined the effects on N100, N200, and P300 of 1) repeated target presentation, 2) interblock intervals, 3) knowledge of session end, and 4) reversal of targets and nontargets. In the first experiment, subjects (N = 40) performed an oddball task across six test blocks (35 targets per block). Statistical analyses showed that repeated target presentation resulted in P300 amplitude decreases (habituation) and P300 latency increases within and across test blocks (11.3 microV to 5.4 microV, 330 msec to 348 msec), and also resulted in N200 amplitude increases within blocks and N200 latency increases within and across blocks. Interblock intervals resulted in partial recovery of these habituation effects. Knowledge of session end increased P300 amplitude, while reversal of targets and nontargets had no effect. The latencies of N200 and P300 were positively correlated (r .55), while the amplitudes were not. The second experiment demonstrated P300 habituation at multiple scalp sites (Fz, Cz, Pz). Two factors that may relate to habituation of the P300 are decreased arousal level and degree of involvement in the task. PMID- 2756052 TI - Effect of electrical stimulation of "rewarding" areas of the hypothalamus on habituation and dishabituation to repeated mild cold exposures in C57BL/6J mice. AB - Four groups of 12-month-old C57BL/6J male mice had chronic electrodes implanted in the median forebrain bundle. In three groups the "rewarding" property of electrical stimulation was determined during a single 30-min session of self stimulation (ISS) before the beginning of the experiment. In the fourth group this test was postponed until the end of experiment. Every two weeks for 12 weeks all animals were subjected to repeated 3-hr cold stress tests consisting of partial physical restraint at an ambient temperature of 10 degrees C. The time interval between tests No. 3 and No. 4 was intentionally delayed up to four weeks. During the 4-week interval, animals of one of the groups tested for ISS remained in their home cages; mice of the second ISS-tested group received daily 30-min sessions of brain stimulation; and animals of the third ISS-tested group were placed daily for 30 min in the experimental chamber where they had been tested for ISS previously but received no brain stimulation. Animals of the fourth group, which were not tested for ISS prior to the experiment, also were placed daily in the experimental chamber without brain stimulation. Repeated cold testing resulted in improvement of cold tolerance (decrease of the rate of decline of colonic temperature during cold exposure) in the second and third tests relative to the first cold test in all groups (cold habituation).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2756053 TI - A theoretical model for perceived intensity in human taste and smell. II. Temporal integration and reaction times. AB - The theoretical model for perceived intensity in human taste and smell published previously was extended by incorporating the concept of signal detectability and temporal integration phenomena at low and high stimulus levels. The processes involved in human taste and smell perception are divided into three stages: a) An "internal meter" registers outside signals. Adaptation occurs at this stage. b) The meter is read for two possible purposes: to detect a weak signal or to estimate the signal's intensity. Both tasks require the smoothing of noise, which is accomplished by integration of the meter over time. c) The internal estimate is expressed through the use of a scaling method. PMID- 2756054 TI - Temporal integration and reaction times in human smell. AB - A model description of intensity perception in human taste and smell developed earlier has now been verified experimentally to determine parameter values for odorants. The final objective is to quantify and understand odour-odour interaction phenomena in e.g., masking, deo-perfumes and flavour enhancement. Five types of olfactometer experiments were carried out, viz. determination of thresholds, determination of reaction times, scaling of perceived intensity after 5 sec stimulation, scaling of perceived intensity of a fixed concentration at variable duration, and measurement of intensity/time relationships. Four subjects were used and the odorants cineole, geraniol and hexane. PMID- 2756055 TI - Strain, age, but not gender, influence ulcer severity induced by water-restraint stress. AB - Two ulcerogenic procedures, supine restraint (SR) and water restraint (WR) were compared. In Experiment 1, Fischer-344 (F344), Sprague-Dawley (S-D), Wistar, Long Evans (L-E), Spontaneously Hypertensive rats (SHR) and Wistar Kyoto normotensive (WKY) rats were exposed to SR and WR. WR produced more ulcers than SR. There was no difference in ulcer scores between WKY, F344 and L-E but these rats had significantly more ulcers as compared to SHR, Wistar and S-D rats. In Experiment 2, 4- and 16-month-old SHR, WKY and F344 rats were exposed to SR and WR. The older WKY rats had more ulcers than all other treatment groups. Experiment 3 revealed no significant differences between male and female rats exposed to either SR or WR. Body temperature (BT) scores obtained after restraint and after 2-hr postrestraint rest were only marginally related to ulcer severity. Rats exposed to WR had lower BT scores but the strain and age ulcer differences did not have corresponding BT differences. These studies revealed the following: the ulcer susceptibility of WKY rats; the WR technique is a useful ulcerogenic procedure; and hypothermia is a weak covariant to restraint-induced stress ulcer. PMID- 2756056 TI - The sweet taste in the calf. I. Chorda tympani proper nerve responses to taste stimulation of the tongue. AB - Electrophysiological recordings were obtained from the chorda tympani nerve in calves during stimulation with NaCl, quinine hydrochloride, citric acid, acesulfan-K, aspartame, fructose, galactose, glucose, glycine, lactose, maltose, monellin, Na-saccharin, sucrose, thaumatin, and xylitol. In cattle the chorda tympani innervates the posterior third of the tongue as well as the anterior part. It was found that the posterior receptive field generally responded better to sweet substances than the anterior. Glycine and Na-saccharin followed by xylitol were the most effective sweet stimuli. The monosaccharides elicited larger responses than the disaccharides. Aspartame gave a weak nerve response in 5 of 13 calves. Monellin and thaumatin elicited no change in chorda tympani nerve activity and did not crossadapt with any sweetener. No effects on citric acid responses were observed after application of miraculin. PMID- 2756057 TI - Effects of water temperature and flavoring on voluntary dehydration in men. AB - Effects of water temperature and flavoring on fluid consumption and body weight losses were studied in fourteen unacclimatized men (21-33 years) during 6 hr of treadmill exercise (4.8 km.hr-1, 5% grade for 30 min.hr-1) in a hot environment. Subjects consumed each of four beverages (15 degrees C water, 40 degrees C water, 15 degrees C flavored water, and 40 degrees C flavored water) on four nonconsecutive days. We identified two groups of individuals by body weight (BW) loss during the cool water trial: drinkers (D) who lost less than 2% initial BW (0.80 +/- 0.15%) and reluctant drinkers (RD) who lost more than 2% (2.53 +/- 0.12%). Although sweat losses were not different between the two groups, D consumed 31% more cool water than RD and experienced 68% less BW loss. Compared to the warm water trial, 6 hr consumption of cool water was significantly increased in both D (59%) and RD (141%) and BW loss was dramatically reduced in both groups. Flavoring significantly enhanced warm water consumption and reduced BW loss in RD only. Reduced consumption of warm water increased rectal temperature, heart rate and plasma osmolality in both groups. The results of this study indicate that either flavoring or cooling warm water will enhance fluid intake and reduce body weight deficits in men reluctant to drink. PMID- 2756059 TI - Vasopressin in dehydrated and rehydrated ponies. AB - Six pony mares deprived of water for 24 hours showed significant increases in plasma vasopressin (2.8 pg/ml) and osmolality (9 mosmol/kg). When water was made available the ponies drank rapidly (5 of 6 drank to satiety within 90 seconds) and corrected their fluid deficits precisely. Vasopressin did not return to predehydration levels until osmolality did after 15 minutes of access to water. The horse differs from rodents and humans, but is similar to pigs in that vasopressin levels do not fall before osmolality returns to normal. Oropharyngeal factors, therefore, may not be as important in vasopressin release in horses as in other species. PMID- 2756058 TI - Diverse effects of estradiol-17 beta: concurrent suppression of appetite, blood pressure and vascular reactivity in conscious, unrestrained animals. AB - Evidence from epidemiological and clinical investigations have suggested a relationship between estrogen-containing oral contraceptives and hypertension. The present series of studies, however, documents the ability of estradiol-17 beta, a natural ovarian estrogen, to lower resting blood pressure and pressor responses to norepinephrine in conscious, unrestrained guinea pigs. Arterial measurements were made of resting blood pressure and heart rate, plus pressor responses to intravenous infusions of 1.56 micrograms norepinephrine. Injection of 30 micrograms estradiol-17 beta reduced resting pressures up to 12% and pressor responses up to 20% in the interval from 12 to 48 hours postinjection. The estradiol treatment also significantly and reversibly lowered food intake, water intake, and body weight. These effects could be induced by either 3 or 30 micrograms of estradiol benzoate for up to 4 days if estradiol treatment was continued. Parallel studies indicated that NE-induced contractions of the isolated aorta were markedly reduced by pretreatment with estradiol. These studies indicate that natural ovarian estrogens may reduce blood pressure by reducing the contractility of the arterial smooth muscle. PMID- 2756060 TI - The use of hypothermia in surgical pinealectomy of the neonate rat. AB - A technique is described in which rat pups (5-7 days old) are induced into a state of suspended animation by placing them in the freezing compartment of a refrigerator at -20 degrees C for 8-10 minutes. This induces cessation of respiration and heart beat for 12-15 minutes. Surgical pinealectomy is undertaken during this period. Postoperation the animal is gradually warmed and restored to its dam. The effectiveness of pinealectomy was checked after some 400 days by measurement of plasma dark cycle melatonin levels using radioimmune assay. The method is reliable, robust and the results predictable, no melatonin being detectable 400 days after surgery. PMID- 2756061 TI - On the physiology of grooming in a pigtail macaque. AB - Several functions of social grooming have been proposed, including building affiliative bonds between group members, and reducing tension or anxiety. In this case study, heart rate (HR) of a single adult female pigtail macaque living in a social group was monitored in several behavioral contexts to examine the relationship between grooming and HR level, an indicator of autonomic nervous system activity. The subject was implanted as a part of another study with a multichannel telemetry system which monitored several physiological variables. Physiological and behavioral data were collected over a nine day period. Heart rate during agonistic interactions was significantly higher than during other categories of behavior, and sleep HR significantly lower. When the subject received grooming from others, HR was significantly lower than during self grooming or initiating grooming to others, as well as during other behaviors. HR showed significant declines during bouts of receiving groom (up to 20 bpm), but not during bouts of initiating or self grooming. Following aggression, HR decline was greatest while receiving grooming. There were also HR differences for methods of grooming: stroking but not other methods related to decreases in HR. PMID- 2756062 TI - Blood pressure during induction and termination of the dorsal immobility response. AB - Evidence has indicated that afferent baroreceptor input may play a role in the induction of the dorsal and tonic immobility responses, which are behaviorally similar, but involve opposite posture changes upon induction (i.e., upright versus inverted, respectively). Information is lacking on the topography of the blood pressure response during periods of dorsal immobility. The blood pressure response of the adult Wistar rat during induction and termination of dorsal immobility was compared to the blood pressure response during a condition which controlled for posture change. Each animal received two control trials, ten dorsal immobility trials and then two control trials in two successive sessions four and ten days after surgery. A precise second-by-second topographical analysis of the dorsal immobility response revealed a sharp rise in blood pressure at trial onset of 18.4 mmHg, followed by a return below pretrial levels and then subsequent recovery back to pretrial levels by the tenth-trial second. This level was maintained until the last five seconds of immobility when a rapid blood pressure elevation occurred. This terminating elevation correlated highly with the observation of large movement and probably reflected motor activity that eventually culminated in escape from immobility. The vertical posture change of the control condition, on the other hand, resulted in a gradual diminution of blood pressure, which implied that the initial blood pressure elevation during initiation of the dorsal immobility response could not be accounted for simply by posture change.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2756063 TI - [Study of the key concepts of Morita therapy--from the standpoint of clinical practice]. PMID- 2756064 TI - [A case of schizophrenia with paternalistic intervention]. PMID- 2756065 TI - [The present state of mental health services in the Tohoku District]. PMID- 2756066 TI - Feeling and facial efference: implications of the vascular theory of emotion. PMID- 2756067 TI - Visual search and stimulus similarity. PMID- 2756068 TI - Dynamic attending and responses to time. PMID- 2756069 TI - Second Workshop on Rhythm Perception and Production. Marburg, September 29 October 2, 1987. Selection of papers. PMID- 2756070 TI - A psychological pulse train: how young children use this cognitive framework to structure simple rhythms. AB - This paper examines the reproduction of both regular rhythms and irregular sequences by 5- and 7-year-old children, concentrating on the important role played by their organization around a pulse train. It is shown that: (a) the closer rhythms are to a regular beat the easier they are to reproduce and the greater are the improvements with age; (b) memory capacity is limited by the number of pulses around which the rhythm is organized rather than by the number of elements it contains; (c) all the children's productions contain two interval lengths that are in a ratio close to 1:2 and arranged in preferential sequences which we have called "stereotypes"; (d) arrhythmic sequences can only be reproduced if the intervals undergo a systematic distortion towards regularity. These results are interpreted in relation to a pulse-train hypothesis which states that on hearing a rhythm an "internal clock" or "time base" is evoked around which the rhythm is structured. PMID- 2756071 TI - The perception of expressive timing in music. AB - This paper is concerned with the perception of small-scale timing changes in musical sequences. The control and expressive function of these have been studied quite extensively from a production perspective, but not much is known about listeners' ability to detect them. A pilot study and two experiments are reported which investigate the detectability of different amounts of timing change in different sequential positions, different pitch contexts, and against the background of both metronomic and expressive comparisons. The results show that listeners are able to perceive as little as 20 ms lengthening in the context of notes lasting between 100 and 400 ms, and that this threshold appears not to be a function of base duration in this range. Sequential position and pitch structure influence the detectability of timing changes to a limited extent, for which some possible explanations are offered. A case is made for regarding timing in music as both a medium to convey structure and an object in its own right, suggesting that it may be perceptually organized in two different ways--as the consequence of a structural interpretation and as a directly registered quantity. PMID- 2756072 TI - Perceptual and motor factors in the imitation of simple temporal patterns. AB - This study investigated the relative importance of perceptual and motor factors in the imitation of simple temporal patterns. Previous research in which subjects tap out interval sequences using one finger has suggested that perceptual factors play an important role in response timing. Studies of bimanual tapping, in contrast, stress the importance of motor interactions between the two hands. In this experiment we compared the ability of subjects to tap out two-interval sequences using one finger, two fingers on one hand, and two fingers on opposite hands. The results showed almost identical performance under the three response conditions. It is suggested that the perceptual relations between intervals in a pattern were the main determinant of performance in this experiment. PMID- 2756073 TI - Human melatonin response to light at different times of the night. AB - Normal control subjects were examined on three separate occasions with light of sufficient intensity to suppress nocturnal plasma melatonin concentrations. One hour of light was given at each of the following times: (a) 2100-2200h; (b) midnight to 0100h; (c) 0400-0500h. Melatonin synthesis was just becoming apparent at 2100h. There was significant suppression of melatonin by light when given at midnight-0100h and 0400-0500h, but not when light was given at 2100-2200h. In each case following light, melatonin synthesis was shown to resume, even after light applied in the second half of the dark period (0400-0500h). A second experiment was undertaken to examine a possible "rebound" in melatonin levels following light given at 2100-2200h. Six further control subjects were exposed to light at this time, and plasma melatonin levels were measured until 0400h. No rebound in melatonin concentrations was observed. These results are compared with other studies of melatonin response to evening light exposure. PMID- 2756074 TI - Computerized brain tomography measures compared with spontaneous and suppressed plasma cortisol levels in major depression. AB - We determined brain density and ventricular measurements with computerized tomography (CT) in 33 depressed patients and compared the results with basal plasma cortisol and its suppressibility by dexamethasone. Mean plasma cortisol was positively related to elevated ventricular brain ratio (VBR). No association could be found between dexamethasone suppression test (DST) status and VBR or any other CT parameter. Elevated plasma cortisol levels and increased VBRs were positively correlated with total scores on the Brief Psychiatric Rating Scale, the Global Assessment Scale and the Bech-Rafaelsen Melancholia Scale, but they were not significantly correlated with total score on the Hamilton Anxiety Scale. PMID- 2756075 TI - Use of the dexamethasone suppression test in an inpatient setting: a replication and new findings. AB - The dexamethasone suppression test (DST) was administered to 131 depressed and 109 nondepressed psychiatric inpatients. The depressed patients were categorized according to DSM-III as minor depression, major depression without melancholia, and major depression with melancholia and/or with psychotic features. The nondepressed patients were stratified over several DSM-III subcategories. DST nonsuppression was nonspecific for major depression: the mean post-dexamethasone cortisol value and the number of nonsuppressors were not significantly different between the major depressives and the nondepressed psychiatric controls. Within the depressive sample the DST was a significant (p less than 0.01) discriminator between major and minor depression. Postdexamethasone plasma greater than or equal to 3.5 micrograms/dl at 0800h was the most sensitive (39%) and specific (94%) criterion; cortisol values at 1600h and 2300h showed no significant discriminating power for major vs. minor depression. The diagnostic utility of the DST thus appears to be limited to confirming the diagnosis of major depression, once the clinical diagnosis of depression is made. There was no significant influence of age or gender on postdexamethasone cortisol values. PMID- 2756076 TI - Premenopausal and postmenopausal women differ in their cardiovascular and neuroendocrine responses to behavioral stressors. AB - Middle-aged (45-51 years) women performed four tasks while their heart rate, blood pressure, and plasma catecholamines were measured. The tasks were serial subtraction, mirror image tracing, speech, and postural tilt. The speech task was considered to be particularly relevant to women because of its emphasis on social skills. Fifteen premenopausal women reported menstruating regularly and were tested in the early follicular phase. Sixteen postmenopausal women reported not menstruating for at least 12 months and their hormonal status was verified by serum levels of follicle-stimulating hormone. Results showed that postmenopausal women exhibited greater increases from baseline in heart rate during all tasks, relative to premenopausal women, with a particularly pronounced increase during the speech task. Postmenopausal women exhibited greater increases from baseline in systolic blood pressure and epinephrine, relative to premenopausal women, during the speech task only. Explanations for the stressor-specific effect of menopausal status were discussed. The results suggest that reproductive hormones may interact with stressor characteristics to determine middle-aged women's physiological responses to stress. PMID- 2756077 TI - Effects of conditioned stimulus fear-relevance and preexposure on expectancy and electrodermal measures of human Pavlovian conditioning. AB - The present research investigated the effects of fear-relevance of the conditioned stimulus (CS) and CS preexposure on human electrodermal conditioning and on a continuous measure of expectancy of the unconditioned stimulus (US). Both experiments employed 20 preexposure, 8 acquisition, and 8 extinction trials in a differential Pavlovian conditioning paradigm with shock as the US. In Experiment 1 (N = 48), electrodermal conditioning was retarded by CS preexposure, but was not influenced by fear-relevance of the CS. Expectancy of the US was retarded by preexposure only in the fear-relevant condition. In Experiment 2 (N = 48), the CS/US contingencies was embedded in a visual masking task. Preexposure retarded both electrodermal conditioning and US expectancy. Neither measure was influenced by fear-relevance of the CS. However, fewer subjects in the preexposure condition learned the CS/US relationship and those who did, did so on later trial than those in the no-preexposure condition. Thus, the results indicated clear retardation of conditioning as a result of preexposure, but no reliable effect of fear-relevance. PMID- 2756078 TI - Human brainstem auditory evoked potentials fail to provide evidence of efferent modulation of auditory input during attentional tasks. AB - Efferent modulation of auditory input at the level of the brainstem during attention-demanding tasks has been described in animal studies. Attempts to demonstrate these effects in humans have produced conflicting results, however. These studies are reviewed with particular reference to those animal experiments that have demonstrated peripheral effects. The human experiments have used a number of attentional conditions which have not been related either to each other or to the successful animal work. Two of the most important conditions in these studies--the use of an intermodal attention task and the manipulation of attentional states--have been examined rarely or not at all in the human research. Two experiments were conducted to investigate the possibility of attention-related effects on the human brainstem auditory evoked potential. These experiments were designed to examine experimental conditions common to both successful and unsuccessful attempts to demonstrate attention-driven efferent modulation at the periphery in humans. Also examined was the gradation of attention effects on efferent modulation demonstrated in animals but never studied in humans. No significant changes in either the latency or the amplitude of the brainstem auditory evoked potential were found in any of the attention demanding conditions. Results are discussed in terms of psychophysiological theories of attention. Also, the interpretation of the most recent animal work is questioned. PMID- 2756079 TI - The timing of bedtime and waketime decisions in free-running subjects. AB - Twelve "free-running" temporal isolation studies were performed using healthy human subjects aged 20-81 years (4 males, 8 females). Circadian rhythms were measured in subjective alertness (using a visual analogue scale technique) and rectal temperature. In all 12 subjects best fitting rhythm period were found to be shorter for rectal temperature (mean = 24.3 hours) than for subjective alertness (mean = 24.8 hours). Both rhythms were predictive of bedtime and waketime decisions. Bedtime decisions tended to cluster on the falling arm of the temperature and alertness cycles (modal times = 120 degrees (temperature) and 140 degrees (alertness) after acrophase); waketime decisions on the rising arm (modal times = 240 degrees (temperature) and 300 degrees (alertness) after acrophase). When this pattern was violated, sleep episodes were significantly more variable in length and disturbed by intruding wakefulness. PMID- 2756080 TI - Effects of smoking/nicotine on anxiety, heart rate, and lateralization of EEG during a stressful movie. AB - The effects of smoking cigarettes with differing FTC nicotine deliveries on anxiety and EEG activity were evaluated in 40 smokers who were compared with 40 non-smokers, matched for age and gender. Following smoking (sham-smoking in the case of the non-smokers), the participants viewed a stress-inducing movie. Smoking higher-nicotine delivery cigarettes during the movie, as compared to smoking low-nicotine control cigarettes, was associated with reductions in anxiety and right hemisphere activation, increased heart rate, and enhancement of the ratio of left-hemisphere parietal EEG activation to right-hemisphere activation. These results are interpreted as indicating that the anxiolytic effects of nicotine may be mediated by the right hemisphere. The EEG activity and emotional responses of non-smokers were more like those of smokers who smoked the lower-nicotine cigarettes than those of smokers of the higher-nicotine cigarettes. PMID- 2756081 TI - Electrodermal lability and visual information processing. AB - Individual differences in electrodermal lability have been related to performance in vigilance and reaction time tasks. The goal of the present study was to employ an "additive factors" approach to identify the stages of information processing that might underlie these effects. Nineteen labile and 17 stabile subjects performed a choice reaction time task in which a visual imperative stimulus was presented under two conditions of intensity (presumed to affect the speed of pre processing operations) X three conditions of degradation (which influences later encoding processes related to feature extraction). Measures of both reaction time and movement time were obtained. The major findings were: (a) labile subjects had faster reaction times than stabiles, and (b) lability interacted significantly with stimulus degradation. Labiles also tended (p less than .10) to have faster movement times. This pattern indicates that labiles and stabiles differ in the performance of later encoding operations, and possibly in the speed of motor processes as well. However, they do not appear to differ in the early pre processing of the simple physical attributes of a stimulus. PMID- 2756082 TI - Variations in period-analysed EEG asymmetry in REM and NREM sleep. AB - Monopolar EEG was recorded from lateral frontal and parietal sites with linked ear reference during sleep in 24 adults. Electrode placement followed the 10-20 International system. EEG was quantified using digital period analyses. The absolute difference in interhemispheric EEG parameters was compared for Stage 2, REM, and a slow wave sleep measure. The absolute difference measures reflect the degree of symmetry or asymmetry, regardless of the hemisphere of origin. Theta and delta activity in slow wave sleep was more asymmetrical than in either Stage 2 or REM. REM sleep was associated with the smallest asymmetries. These results do not support a right hemisphere REM, left hemisphere NREM relationship. Rather they suggest that REM sleep is associated with relative hemispheric symmetry whereas asymmetries are most prominent in slow wave sleep. Stage 2 sleep was significantly less asymmetrical than slow wave on a number of theta and delta measures. The significant differences between slow wave and Stage 2 sleep may denote functional differences within NREM sleep stages. PMID- 2756083 TI - Hostility patterns and cardiovascular reactivity to stress. AB - Sixty male subjects performed two challenging tasks while systolic blood pressure, diastolic blood pressure, and heart rate were monitored. They also completed the Cook and Medley Hostility Scale and measures of social support and mode of anger expression. Subgroups of subjects who differed in the patterns of their responses to the hostility items were identified via cluster analytic techniques. Exaggerated reactivity in systolic blood pressure to the two experimental tasks was exhibited by subjects in a subgroup who appear to have negative feelings toward people, but disavow these feelings and inhibit aggression so as not to alienate others. However, these individuals may have difficulty concealing their view of others and controlling their anger which, in turn, may erode their social support. PMID- 2756084 TI - Effects of a change in tone frequency on the habituated orienting response of the sleeping rat. AB - EEG arousal and heart rate responses to change in tone frequency following habituation training were studied during slow wave sleep in the rat. Rats were exposed to sequences of 12 tone pulses. Habituation stimuli (trials 1-7) had a frequency of 16 kHz. The frequency of the following (test) trials was changed to either 5, 12, 14, 22, or 40 kHz. Hearing level was held constant for all frequencies. Test trials were repeated five times to study rehabituation. The results indicate that heart rate deceleration is an indicator of the orienting reflex and its magnitude is a positive function of the amount of frequency change of the stimulus. Large frequency changes in either direction relative to the habituation frequency lead to re-evocation of the habituated EEG arousal and heart rate deceleration, with subsequent rehabituation. Small tone-frequency changes do not result in EEG arousal or heart rate deceleration responses that differ from the responses to the habituated frequency. Heart rate acceleration shows neither short-term habituation nor significant reaction to any of the test frequencies. PMID- 2756085 TI - Sleep on the night shift: 24-hour EEG monitoring of spontaneous sleep/wake behavior. AB - The present study sought to objectively describe the spontaneous sleep/wakefulness pattern of shift workers during a 24-hour period. Portable Medilog tape-recorders were used for ambulatory EEG monitoring of 25 male papermill workers (25-55 years) during days with night and afternoon work. The results showed that sleep after night work was two hours shorter than after afternoon work. The sleep reduction affected mainly Stage 2 and REM sleep while slow wave sleep was unchanged. In connection with night work 28% of the workers took a nap in the afternoon. These naps contained a large proportion of slow wave sleep and were, apparently, caused by the sleep deficit after the short main sleep period. The EEG recordings also revealed that 20% of the participants had sleep episodes during night work. These naps were as long as the afternoon naps, were experienced as "dozing offs" rather than naps, occurred at the time of the trough of the circadian wakefulness rhythm, and were concomitant with extreme subjective sleepiness and low rated work load. It was concluded that not only the sleep of shift workers was disturbed, but also the wakefulness--to the extent that sleepiness during night work sometimes reached a level where reasonable wakefulness could not be maintained. The latter observation is probably of special importance in work situations demanding a great responsibility for human lives or for great economic values. PMID- 2756086 TI - Psychophysiologic stress responsivity in type A and B female college students and community women. AB - Extreme Type A and Type B women (Jenkins Activity Survey) randomly assigned to low or high stress conditions of a forced choice reaction time task were monitored for heart rate (interbeat intervals), pulse transit time, skin conductance levels, and skin conductance responses during baseline, task, and recovery periods. Participants included 41 female undergraduates (student sample) and 58 women aged 25-65 years (community sample). Multivariate repeated measures analysis of variance indicated that among the students, Type As exposed to high stress had significantly higher skin conductance levels at baseline than did the Type As in low stress. During the reaction time stress task, student Type As in high versus low stress exhibited both higher heart rates and more skin conductance responses, although these effects did not occur for Type Bs. After covarying the baseline physiologic indices, results revealed that both heart rate and skin conductance levels were significantly higher for students in high versus low stress, but the Behavior Type X Stress interaction disappeared. In contrast, the Behavior Type X Stress interaction remained for skin conductance responses. Findings in the community sample showed only a nonsignificant trend for higher heart rate in high stress Type As than in low stress Type As. These results provide very weak evidence for a relationship in physiological indices between Type A behavior and stress in women across a broad age range. Implications are discussed with regard to sex differences in behavior type and possible interactions between behavior type and stress responsivity. PMID- 2756088 TI - Rubber dam isolation for Class V composite resin or glass ionomer restorations. PMID- 2756087 TI - Continuous recordings of impedance and phase angle during electrodermal reactions and the locus of impedance change. AB - The relatively few studies that use alternating current (AC) in exosomatic electrodermal recording techniques focus on tonic measurement but not on phasic measures. AC methods of phasic measurement, however, are most useful in testing electrical models of the electrodermal response. Problems arising from AC recording of fast electrodermal changes are discussed, and an appropriate measurement concept for continuous recording of impedance and phase angle is developed. This enables tonic values of both parameters to be offset in order to sufficiently amplify small changes. An AC frequency of 100 Hz was used in recording electrodermal activity in 10 subjects during an habituation series of 80dB 1000 Hz tones. Comparison of transformed curves showed that the main component of electrical changes accompanying electrodermal response is a shift in conductance while susceptance shows only small fluctuations. According to a widely accepted simple electrical model of skin, these results indicate that electrodermal responses take place mainly in the resistive element which parallels the capacitance associated with the stratum corneum, but that other components may be involved too. PMID- 2756089 TI - Chairside computer-aided direct ceramic inlays. PMID- 2756090 TI - The durability of acrylic complete denture bases in practice. PMID- 2756091 TI - An effectiveness study of a subgingival delivery system. PMID- 2756092 TI - Removable partial denture treatment in Poland. PMID- 2756093 TI - Chemical agents for removing intrinsic stains from vital teeth. II. Current techniques and their clinical application. PMID- 2756094 TI - Attrition and bone resorption--taking a long-term view. PMID- 2756095 TI - Enamel microabrasion: the technique. PMID- 2756096 TI - Safety study of a subgingival delivery system. PMID- 2756097 TI - Microflora in plaque from approximal posterior composite resin restorations. PMID- 2756098 TI - Corrosion of a nickel-chromium alloy by disinfectants. PMID- 2756099 TI - Citric acid burnishing of native radicular dentin: a scanning electron microscopic report. PMID- 2756100 TI - Histologic investigation on two titanium screw dental implants in humans. PMID- 2756101 TI - A quantitative histological study of strain-dependent differences in the effects of irradiation on mouse lung during the early phase. AB - Strain differences in the radiation response of mouse lung during the early phase (before 28 weeks postirradiation) were investigated histologically. The nine strains tested were divided into three groups on the basis of the nature of the edema present, the occurrence of hyaline membranes, and the presence of fibrosis. Group 1 mice, three C57 strains, developed hyaline membranes, focal fibrosis, and a protein-rich edema containing fibrin. Group 3, CBA and two C3H strains, had only a protein-poor edema with little fibrin and developed no visible fibrosis. Group 2 mice had both types of edema and small quantities of focal fibrosis. The degree of lung impairment in mice dying of respiratory insufficiency was assessed by scoring lung acini as nonfunctional or open and presumably functional. Over 70% of acini were nonfunctional as a result of airflow obstruction. This was considered sufficient to account for death. Carbon perfusion immediately before sacrifice indicated that all types of lesions were at least partially perfused with blood. Pleural effusions were found in some individuals of two strains. The proportion of nonfunctional acini was similar in mice of the same strain with and without effusions, which would not be expected if the effusions contributed appreciably to respiratory distress in the early phase. PMID- 2756102 TI - An assessment of the behavioral toxicity of high-energy iron particles compared to other qualities of radiation. AB - Conditioned taste aversion was used to evaluate the behavioral toxicity of exposure to high-energy iron particles (56Fe, 600 MeV/amu) in comparison to that of gamma photons (60Co), high-energy electrons, or fission neutrons. Exposure to high-energy iron particles (5-500 cGy) produced a dose-dependent taste aversion with a maximal effect achieved with a dose of 30 cGy. Gamma photons and electrons were the least effective stimuli for producing a conditioned taste aversion, with a maximal aversion obtained only after exposure to 500 cGy, while the effectiveness of fission neutrons was intermediate to that of photons and iron particles, and a maximal aversion was obtained with a dose of 100 cGy. In the second experiment, rats with lesions of the area postrema were exposed to iron particles (30 cGy), but failed to acquire a taste aversion. The results indicate that (1) high-energy iron particles are more toxic than other qualities of radiation and (2) similar mechanisms mediate the behavioral toxicity of gamma photons and high-energy iron particles. PMID- 2756103 TI - X-ray-induced mutations in cultured human thyroid cells. AB - Cultured human thyroid cells were X-irradiated in vitro and assayed for resistance to 6-thioguanine. The average mutant frequency was 1.69 +/- 1.34 X 10( 5) (mean +/- SD) in controls, 3.74 +/- 2.21 X 10(-5) in cells exposed to 1 Gy, and 7.19 +/- 5.37 X 10(-5) in cells exposed to 2 Gy. The positive association between mutant frequency and dose was statistically significant. The estimated mutation induction rate was 2.54 +/- 0.71 X 10(-5) per gray, which is in close agreement with published results for human skin fibroblasts and mammary epithelial cells. These results extend and confirm earlier reports that mutation induction rates for fibroblasts and epithelial cells after exposure to X rays are similar. PMID- 2756104 TI - Interaction of platinum(II) tetrachlorodianion (Fast Black)2 with superhelical DNA and with radiation in vitro and in vivo. AB - A new complex of tetrachloroplatinum(II) and the azoic diazo dye, Fast Black K, Pt(Fast Black)2, was made in an attempt to produce an uncharged molecule which could readily gain access into cells and could bring a high concentration of tetrachloroplatinum into the vicinity of the DNA. Even the lowest concentration of Pt(Fast Black)2 tested in the superhelical pBR322 plasmid DNA assay in vitro completely converted the superhelical DNA to the circular and linear forms by 24 h. When the cytotoxicity of the Pt(Fast Black)2 and Fast Black were tested in exponentially growing EMT6 cells. Pt(Fast Black)2 was slightly more toxic to normally oxygenated than to hypoxic cells at pH 7.40, but was far more toxic to cells at pH 6.45 with no difference based on cellular oxygenation. Fast Black was much less toxic than Pt(Fast Black)2 and its cytotoxicity was unaffected by pH. Pt(Fast Black)2 had a small radiosensitizing effect on hypoxic EMT6 cells with a dose-modifying factor of 1.3, but exposure to the drug entirely removed the shoulder region on the radiation survival curves for both the oxygenated and hypoxic cells. In contrast, Fast Black reduced the shoulder in hypoxic but not in oxygenated cells. When Pt(Fast Black)2 (500 mg/kg), Fast Black (300 mg/kg) (the maximally tolerated dose), or misonidazole (1 g/kg) were given intraperitoneally 15 min prior to irradiation of FSaIIC tumors with 0, 10, 20, or 30 Gy, Pt(Fast Black)2 alone caused a tumor growth delay of 6 days versus 3 days for Fast Black. With radiation, Pt(Fast Black)2 produced the greatest enhancement in tumor growth delay of the drugs tested, especially at the lowest (10 Gy) radiation dose (i.e., in the in vivo "shoulder region"). These results indicate that Pt(Fast Black)2 may be suitable for clinical development because it causes both significant direct cytotoxicity and enhancement of radiation killing. The fact that its cytotoxicity is markedly increased at an acidic pH and its radiation enhancing effects are greatest in combination with relatively low single-fraction radiation doses make it especially interesting. The cytotoxicity of Pt(Fast Black)2 may be influenced by the tumor environment, and the radiosensitizing properties appear well suited for use with radiation fraction sizes that are employed in the clinic. PMID- 2756105 TI - Inactivation of hypoxic cells by cisplatin and radiation at clinically relevant doses. AB - We have examined the effects of exposure to cisplatin (cis diamminedichloroplatinum(II] on the response of exponentially growing V79 cells to low (0-4 Gy) and high (up to 30 Gy) doses of X rays under hypoxic and aerobic conditions. Survival in both dose regions was assessed by clonogenic assays; the low-dose studies were facilitated by a Cell Analyser (B. Palcic and B. Jaggi, Int. J. Radiat. Biol. 50, 345-352 (1986]. The results show that cisplatin, like its isomer trans-DDP, exhibits greater interaction with low than with high radiation doses in hypoxic cells. This increased interaction could be seen even with subtoxic exposures to cisplatin as low as 1 mumol dm-3. In contrast, with cells irradiated in air in the presence of either complex, the interaction seen with high doses of radiation is completely lost or greatly diminished in the low radiation dose region. Further experiments showed that enhanced interaction of hypoxic cells with low doses of radiation could be equally effective with cisplatin pretreatments in air or in hypoxia, even if the cells are exposed to cisplatin only after irradiation. In experiments with nonproliferating plateau phase cultures, the same enhanced interaction was observed in the low-dose region. These results, for example enhancement ratios of 2.3 and 1.2 at low- and high-dose regions, respectively, for 5 mumol dm-3 cisplatin, are contrasted with those for nitroimidazoles which are better sensitizers in the high-dose region. PMID- 2756106 TI - A quantitative histological study of strain-dependent differences in the effects of irradiation on mouse lung during the intermediate and late phases. AB - Strain differences in the intermediate and late phases of the radiation response of mouse lung were investigated histologically. The proportion of lung impairment in mice at 28 and 52 weeks postirradiation and in mice dying of respiratory insufficiency was assessed by scoring lung acini as nonfunctional due to lesions which obstructed airflow, or open and presumably functional. The nine strains tested were divided into three groups on the basis of the late fibrotic response. Group 1 mice, three C57 strains, developed extensive contracted fibrosis and usually showed enough damage to explain late deaths. Group 2, SWR, A, and BALB/c strains, developed foci of contracted fibrosis. Group 3, CBA and two C3H strains, did not form fibrotic scars. Mice in Groups 2 and 3 that died with no pleural effusions appeared to have insufficient late lung damage to account for respiratory distress. Problems with pulmonary blood flow were indicated by evidence of loss of fine vasculature and right ventricular hypertrophy. In nondistressed, late-stage mice in Groups 2 and 3, loss of capillary perfusion in lung parenchyma free of obvious lesions was demonstrated by infusion of colloidal carbon. In one strain, A, an estimate of the proportion of nonperfused lung was made on distressed late-stage mice. Almost 50% of lung acini were nonfunctional as a result of nonperfusion, and an additional 9% of acini were nonfunctional due to lesions obstructing ventilation. It is suggested that nonperfusion of apparently normal lung acini is a major factor in late-phase deaths in those mouse strains which show little or no fibrosis. PMID- 2756107 TI - Enhancement of radiation-induced DNA double-strand breaks and micronuclei in human colon carcinoma cells by N-methylformamide. AB - The differentiation-inducing agent N-methylformamide (NMF) enhances the sensitivity of some cell lines to ionizing radiation. To elucidate the mechanism of NMF-mediated radiosensitization, we examined the effects of this agent on gamma-ray-induced DNA double-strand breaks and micronuclei in two cell lines, clone A (human colon carcinoma) and HCA-1 (murine hepatocarcinoma). Both cell lines form a better differentiated phenotype upon exposure to NMF, yet only clone A is radiosensitized. The neutral (pH 9.6) elution assay was used to evaluate the effects of this maturational agent on radiation-induced double-strand breaks in these cell lines. Exposure of HCA-1 cells to NMF had no effect on the level of DNA double-strand breaks induced by gamma rays. In clone A cells, however, exposure to NMF enhanced the initial formation of gamma-ray-induced double-strand breaks at each dose tested. The repair of double-strand breaks in both cell lines was not influenced by NMF. As a measure of chromosome fragmentation after irradiation, we evaluated micronuclei using the cytokinesis block method. Exposure to NMF had no effect on radiation-induced micronuclei formation in HCA-1 cells yet significantly enhanced the frequency of micronuclei induced by radiation in clone A cells. In clone A cells, the increases in radiation-induced double-strand breaks and micronuclei as a function of NMF exposure time reached maximums by approximately 72 h. These data suggest that NMF-mediated radiosensitization is the result of an increase in the initial level of radiation induced DNA double-strand breaks. PMID- 2756108 TI - Immunohistochemical quantitation of three collagen isotypes in perfused areas and nonperfused foci of the lungs of irradiated mice. AB - Collagen isotypes I, III, and IV were quantitated by video image analysis of fluorescent-antibody-stained lung tissue sections from control and irradiated C57L/J and BALB/c mice. The perfusion status of lungs was determined by injecting colloidal carbon into the hepatic vein immediately prior to sacrificing the animals. Well-perfused parenchymal regions turned black, whereas nonperfused areas remained pale. Previous histological studies indicated substantial differences in the types of lesions found in the lungs of these two strains. C57L/J mice develop extensive and persistent contracted fibrosis. In lung sections of C57L/J mice examined 28 weeks after a dose of 11 Gy X rays, all three collagen isotypes were significantly elevated to levels 37-51% higher than age matched control values in perfused regions of lung. In nonperfused areas, which had the histological appearance of contracted scar tissue, the three collagen isotype levels were further elevated to values 83-90% greater than controls. This finding suggests that in C57L/J mice, an elevation of each or all of the three collagen isotypes to levels approximately 45% greater than controls is consistent with continued pulmonary function during the intermediate phase of lung damage, whereas areas of parenchyma containing isotype levels in excess of 185% of control values coincide with functionally deficient regions. BALB/cCr//Alt. mice examined 28 weeks subsequent to 14.5 Gy X rays had a variety of visible lesion, most of which were nonperfused. In addition, one-quarter of nonperfused acini had no visible lesion. In perfused areas, the three isotypes were increased to 119 132% of control levels, with a further, significant (P less than 0.05) increase to 128-144% of control values in nonperfused parenchyma. Nonperfused areas were not characterized by contracted fibrosis; however, it would appear that the threshold level for collagen elevation associated with functional compromise during intermediate phase lies in the region of 130%. For BALB/c/J mice, 1 year after 9 Gy X rays, perfused areas of lung contained control levels of the three collagen isotypes, while nonperfused areas had isotype levels 119-131% of control values. Two of seven animals died at 41 weeks, but we were unable to ascertain collagen levels, since the lungs were not infused with colloidal carbon. PMID- 2756109 TI - Dose-response modeling of life shortening in a retrospective analysis of the combined data from the JANUS program at Argonne National Laboratory. AB - Life shortening was investigated in both sexes of the B6CF1 (C57BL/6 x BALB/c) mouse exposed to fission neutrons and 60Co gamma rays. Three basic exposure patterns for both neutrons and gamma rays were compared: single exposures, 24 equal once-weekly exposures, and 60 equal once-weekly exposures. Ten different dose-response models were fitted to the data for animals exposed to neutrons. The response variable used for all dose-response modeling was mean after-survival. A simple linear model adequately described the response to neutrons for females and males at doses less than or equal to 80 cGy. At higher neutron dose levels a linear-quadratic equation was required to describe the life-shortening response. An effect of exposure pattern was observed prior to the detection of curvature in the dose response for neutrons and emerged as a potentially significant factor at neutron doses in the range of 40-60 cGy. Augmentation of neutron injury with dose protraction was observed in both sexes and began at doses as low as 60 cGy. The life-shortening response for all animals exposed to gamma rays (22-1918 cGy) was linear and inversely dependent upon the protraction period (1 day, 24 weeks, 60 weeks). Depending on the exposure pattern used for the gamma-ray baseline, relative biological effectiveness (RBE) values ranged from 6 to 43. Augmentation, because it occurred only at higher levels of neutron exposure, had no influence on the estimation of RBEm. PMID- 2756111 TI - Protein degradation in CHL V79 cells during and after exposure to 43 degrees C. AB - Cellular protein degradation during and following hyperthermia should be altered due to increased enzymatic activity at elevated temperatures, inhibition of protein synthesis, and denaturation of proteins. We have previously demonstrated by differential scanning calorimetry that approximately 1-2% of total CHL V79 cellular protein denatures during a 10- to 15-min exposure to 43 degrees C (J. E. Lepock et al., J. Cell. Physiol. 137, 14-24 (1988)). Proteolysis was measured during and after exposure to 43 degrees C. The decay curves of the degradation of [3H]Leu-labeled proteins are fit well by a double exponential; however, each component is the sum of the decay curves of a large number of proteins, probably with a distribution of rates of degradation. At 37 degrees C a fast-decaying component (T1/2 congruent to 1.3 h), representing short-term proteins, and a slow decaying component (T1/2 congruent to 50 h), representing long-term proteins, are observed. At 43 degrees C the rate of degradation of the fast-decaying component is stimulated three- to fivefold (to T1/2 = 0.27-0.45 h). After return to 37 degrees C, the rate of degradation of the slow-decaying component is depressed twofold (to T1/2 = 109-141 h). The period of depression is dose dependent (i.e., time at 43 degrees C) and recovers at approximately the same time as resumption of protein synthesis and growth. Overall stimulation of degradation lasts for approximately 15 min at 43 degrees C and, coupled with an inhibition of synthesis, leads to the loss of at least a small percentage of total cellular protein. It is likely that the initial stimulated degradation is in part due to increased substrate in the form of denatured protein, further supporting the denaturation of proteins during hyperthermia. PMID- 2756110 TI - Alterations of neuronal nuclear matrix and chromatin structure after irradiation under aerobic and anoxic conditions. AB - This study was undertaken to determine if structural alterations of the bulk chromatin and the amount of protein associated with the nuclear matrix in cerebellar neurons depend on radiation dose and a cell's state of oxygenation. After irradiation with 2.5 to 25.0 Gy under both aerobic and anoxic conditions, the sensitivity of the neuronal chromatin to m. nuclease digestion increase linearly with dose up to about 5 Gy, beyond which there was no further increase. The same increase in accessibility of chromatin to micrococcal nuclease digestion was observed when neuronal nuclei were irradiated at 4 degrees C. Neuronal nuclei were stained with propidium iodide (PI) for DNA and with fluorescein isothiocyanate (FITC) for protein, both before and after complete digestion with DNase I, and analyzed by flow cytometry. There was no change in either the PI (P greater than 0.4) or the FITC (P greater than 0.9) fluorescence of undigested nuclei after irradiation. For the DNase I digested nuclei, the PI fluorescence was unchanged after irradiation (P greater than 0.4), but the FITC fluorescence increased significantly (P less than 0.02). This increase in the FITC fluorescence was linear with dose up to about 5 Gy, beyond which there was no further increase. The flow cytometry results from DNase I digested nuclei were identical for neurons irradiated under aerobic or anoxic conditions, indicating that this phenomenon is oxygen independent. This increase in FITC fluorescence after irradiation was inhibited at ice-cold temperatures and probably reflects an increase in protein content at the nuclear matrix that requires metabolism. This may explain our previously observed resistance of nuclear matrix-associated DNA to digestion by DNase I. This protein increase at the nuclear matrix appears to follow "saturation" kinetics identical to that previously reported for repair of DNA strand breaks in cerebellar neurons. However, the exact molecular nature of this process and its role in DNA repair or cell survival remains to be determined. PMID- 2756112 TI - Interaction between radiation and drug damage in mammalian cells. IV. Radiation response of adriamycin-resistant V79 cells. AB - Adriamycin-resistant variants derived from V79 Chinese hamster cells were examined for their radiation response properties. A stable resistant cell line (77A) demonstrated a significant reduction in the extrapolation number of the single-dose radiation survival curve. Second-step mutants from 77A cells exhibited a spectrum of radiation response states including decreased D0 values and large extrapolation numbers. A highly Adriamycin-resistant line (LZ) was found to be radiation sensitive with increased capacity for the accumulation of sublethal radiation injury. LZ cells are known to contain double-minute chromosomes and an amplified gene for the multidrug phenotype and to exhibit multidrug resistant properties. These cells require the presence of Adriamycin in their growth medium to maintain their pleiotropic characteristics. LZ cells became more resistant to radiation following reversion to an intermediate Adriamycin response as the consequence of growth in Adriamycin-free medium. Reverted cells also lost their large capacity for sublethal damage. It is suggested that detailed study of these mutants may provide insight into the identification of radiation-sensitive sites and their relationship to the genetic changes characterizing Adriamycin-resistant cell lines. PMID- 2756113 TI - The Auger electron dosimetry of indium-111 in mammalian cells in vitro. AB - Most of the radionuclides used in the formulation of radiopharmaceuticals emit Auger electrons when they undergo radioactive decay. The release of these low energy electrons at extracellular sites produces little direct damage to intracellular structures. However, many radiopharmaceuticals, or their metabolites, can be transported into the cell where the Auger electrons have the potential to damage nearby intracellular macromolecules, including DNA. In this preliminary study, chromosome damage, expressed as 60Co equivalent doses, and the effects on cell division following treatment with intracellular and extracellular 111In were measured in Chinese hamster V79 cells. The chromosome aberration yield in cells irradiated by intracellular 111In indicated that damage was induced at a rate of 7.2 X 10(-4) Gy/decay for levels of activity up to 0.075 Bq/cell and 4.5 X 10(4) and 2.9 X 10(4) Gy/decay for intermediate (0.204 Bq/cell) and high (0.389 Bq/cell) levels, respectively. Extracellular 111In-chloride produced damage at a rate of about 6.1 X 10(-12) Gy/decay. As little as 4.4 mBq/cell (about 4.4 X 10(3) Bq/ml of culture) of intracellular 111In was able to affect cell division, whereas extracellular 111In at 1.150 MBq/ml of culture had little effect. These data indicate that the Medical Internal Radiation Dose and International Committee on Radiation Units methods for organ dosimetry may underestimate the potential of intracellular Auger electron emitters to produce radiation damage. PMID- 2756114 TI - Quantitative measurement of radiation-induced base products in DNA using gas chromatography-mass spectrometry. AB - Gas chromatography-mass spectrometry with selected-ion monitoring was used to study radiation-induced damage to DNA. Quantitative analysis of modified purine and pyrimidine bases resulting from exposure to ionizing radiation using this technique is dependent upon the selection of appropriate internal standards and calibration of the mass spectrometer for its response to known quantities of the internal standards and the products of interest. The compounds 6-azathymine and 8 azaadenine were found to be suitable internal standards for quantitative measurement of base damage in DNA. For the purpose of calibration of the mass spectrometer. relative molar response factors for intense characteristic ions were determined for the trimethylsilyl derivatives of 5-hydroxyuracil, thymine glycol, and 5,6-dihydrothymine using 6-azathymine, and for the trimethylsilyl derivatives of 4,6-diamino-5-formamidopyrimidine, 8-hydroxyadenine, 2,6-diamino-4 hydroxy-5-formamidopyrimidine, and 8-hydroxyguanine using 8-azaadenine. Accurate measurement of the yield of radiation-induced modifications to the DNA bases is also dependent upon two chemical steps in which the purines and pyrimidines are released from the sugar-phosphate backbone and then derivatized to make them volatile for gas chromatography. The completeness of these reactions, in addition to assessing the stability of the modified DNA bases in acid and their trimethylsilylated derivatives over the time necessary to complete the experimental analysis was also examined. Application of this methodology to the measurement of radiation-induced base modification in heat-denatured, nitrous oxidesaturated aqueous solutions of DNA is presented. PMID- 2756115 TI - Comparison of recovery from potential mitotic abnormality in mitotically quiescent lens cells after X, neutron, and 56Fe irradiations. AB - After exposure to various doses of 250 kVp X radiation, 0.85 Me V fission spectrum neutrons, or 600 MeV/A iron (Fe) particles, mitotically quiescent rat lens cells showed no visible evidence of radiation injury. However, following the mitogenic stimulus of wounding, mitotic abnormalities became evident when responding cells entered mitosis. Latent damage and recovery therefrom were monitored at 3, 7, 14, and 28 days after irradiation. Following doses of 1 to 10 Gy of X radiation, the recovery rate, indicated by a decrease in abnormalities with time, was proportional to dose, and the dose-effect slope decreased exponentially with time. Virtually no recovery occurred during the 28 days after 1.25 to 2.25 Gy of fission neutron radiation. After doses of 0.5 to 3.0 Gy of Fe particles, an increased expression of mitotic damage or recovery than recovery occurred. As a consequence of the differing patterns in time for expression of damage or recovery following X rays and the high-LET radiations, the relative biological effectiveness (RBE) increased from 3.6 to 16 for neutrons and from 2 to 10 for Fe particles over the 28-day observation period. PMID- 2756117 TI - The radiation response of cells recovering after chronic hypoxia. AB - Experiments were performed to study the influence of hypoxic pretreatment on the radiation response of A431 human squamous carcinoma cells. Reaeration for 10 min after chronic hypoxia (greater than 2 h) was found to enhance the radiosensitivity of A431 cells, and the maximal effect was seen for those cells reaerated after 12 h of hypoxia. The radiosensitivity enhancement for reaerated cells after 12 h of hypoxia was maximized by 5 min after the return to aerobic conditions and reached the control level by 12 h of reaeration. This enhanced radiosensitive state was characterized by a reduced shoulder region and increased slope of the radiation dose-response curve for cells in both the exponential and plateau phases of growth. There was a slight increase in the number of G1 and decrease in the number of S and G2 + M cells for both exponential- and plateau phase cultures following 12 h hypoxic treatment. Although growth inhibition induced by 12 h of hypoxia was seen for cells in the exponential phase, there was no cell number change in the plateau-phase culture after hypoxia. Plating efficiency (PE) of cells in both growth phases was reduced by 30% after hypoxia. Furthermore, in the exponential-phase culture, the extent of reduction in PE after hypoxia was similar among cells in different phases of the cell cycle. Although S-phase cells in exponentially growing cultures were relatively more resistant to radiation than G1 and G2 + M cells, the cell age-response pattern was the same whether the cells had been aerobic or hypoxic before reaeration and irradiation. Furthermore, the enhancement ratio associated with reaeration after 12 h of hypoxia for these three subpopulations of cells was 1.3. Our results indicate that the increase in radiosensitivity due to reaeration after chronic hypoxia is unlikely to be related to the changes of cell cycle stage and growth phase during hypoxic treatment. PMID- 2756116 TI - Comparative effects of caffeine on radiation- and heat-induced alterations in cell cycle progression. AB - The effects of 3 mM caffeine on cell cycle progression of HeLa S3 cells exponentially and asynchronously growing in suspension culture were studied following exposure to 6.8 Gy gamma irradiation or 30 min at 45 degrees C hyperthermia. The stathmokinetic method, in which cells are grown in the presence of colcemid for the duration of experiment, in combination with two flow cytometric techniques, propidium iodide staining of DNA and acridine orange staining following acid denaturation of chromatin, were used to determine the fraction of cells in four cell cycle compartments, G1, S, G2, and M. Radiation and caffeine acted in a complementary manner, in which radiation reduced the caffeine-induced delays in cell cycle progression and caffeine prevented completely the radiation-induced accumulation of cells in G2 and mitotic delay. Heat and caffeine had additive effects on alterations in cell cycle progression. Cells containing spontaneous prematurely condensed chromatin were observed transiently immediately following heat exposure. These cells appeared to be in G2 and late S phase. PMID- 2756118 TI - Effect of inhaled alpha-emitting nuclides on mouse alveolar macrophages. AB - The effects of inhaled alpha emitters on the free cell population of the mouse lung were investigated up to 100 days after exposure. Groups of mice inhaled aerosols of 238PuO2, 239PuO2, or 241Am(NO3)3 to give alveolar deposits resulting in lung-averaged cumulative absorbed doses of about 20 Gy by the end of the study. Initially, with 238Pu most of the activity was associated with relatively few pulmonary alveolar macrophages (PAM), whereas with 241Am, all pulmonary alveolar macrophages were labeled and a substantial fraction was extracellular. The free cell population of the lung was sampled using bronchoalveolar lavage. The main parameters investigated were (a) the recovery and total numbers of free cells, including PAM, lymphocytes, and neutrophils; (b) the incidence of nuclear abnormalities in PAM (cells with more than one nucleus or with micronuclei); and (c) metabolic activation of PAM from measurements of their size and associated beta-glucuronidase activity. All three actinides produced depletions in total numbers of PAM, increased incidences of nuclear abnormalities, and metabolic activation of PAM, without a marked infiltration of inflammatory cells. Americium 241, which is distributed relatively uniformly in PAM, produced the most marked changes in that population and 238Pu, which gave the most inhomogeneous distribution of activity, produced the least. PMID- 2756119 TI - Mechanism of radiosensitization by halogenated pyrimidines: effect of BrdU on radiation induction of DNA and chromosome damage and its correlation with cell killing. AB - The effect of BrdU incorporation on cell radiosensitivity as well as on the induction of DNA double-strand breaks (DSB) and chromosome damage by radiation was studied in CHO cells. Induction of DNA DSB was measured by the nonunwinding filter elution technique and damage at the chromosome level was visualized and scored in G1 cells using the technique of premature chromosome condensation. The results indicated an increase in the radiosensitivity of cells grown in the presence of BrdU. Although sensitization was observed both in cells irradiated in the exponential phase and in cells irradiated in the plateau phase of growth, the degree of sensitization was greater in exponentially growing cells for the same degree of thymidine replacement by BrdU in the DNA. It is hypothesized that this indicates the possible importance of chromatin structure at the time of irradiation and/or the importance of chromatin conformation changes after irradiation in the expression of radiation-induced potentially lethal damage in cells containing BrdU. Incorporation of BrdU affected both the slope and the width of the shoulder of the survival curve and increased the induction of DNA and chromosome damage per unit absorbed dose. The increase observed in the slope of the survival curve was quantitatively similar to the increase observed in damage induction at the DNA and the chromosome level, suggesting a cause-effect relationship between these phenomena. Reduction in the width of the shoulder did not correlate with the increase in the induction of DNA and chromosome damage, suggesting that different phenomena, probably related to enhanced fixation of radiation-induced potentially lethal damage in cells containing BrdU, underlie its modulation. PMID- 2756120 TI - Influence of hyperthermia on gamma-ray-induced mutation in V79 cells. AB - Asynchronously growing V79 cells were assayed for mutation induction following exposure to hyperthermia either immediately before or after being irradiated with 60Co gamma rays. Hyperthermia exposures consisted of either 43.5 degrees C for 30 min or 45 degrees C for 10 min. Each of these heat treatments resulted in a survival level of 42%. For all sequences of combined treatment with hyperthermia and radiation, cell killing by gamma rays was enhanced. Mutation induction by gamma rays was enhanced when heat preceded gamma irradiation, but no increase was observed when heat was given after gamma exposures. Treatment at 45 degrees C for 10 min gave a higher yield in mutants at all gamma doses studied compared to treatment at 43.5 degrees C for 30 min. When heat-treated cells were incubated for different periods before being exposed to gamma rays, thermal enhancement of radiation killing was lost after 24 h. In contrast, only 5-6 h incubation was needed for loss of mutation induction enhancement. PMID- 2756121 TI - Neutral red uptake and clonogenic survival assays of the hyperthermic sensitization of tumor cells to tumor necrosis factor. AB - Vital dye uptake and postfixation dye assays have recently been used to examine the interaction between short-term (24-48 h) exposures to the monokine, tumor necrosis factor (TNF), and hyperthermic treatments with the finding that synergistic increases in cytotoxicity occurred. However, survival measured by these short-term dye assays is not necessarily closely related to eventual loss of clonogenic capacity. Treatment-induced growth delays, delayed cytotoxic effects, or perturbations of vital dye sequestration mechanisms could result in a different measurement of surviving fraction than given by a clonogenic assay. In this study we directly compared the neutral red vital dye uptake and clonogenic survival assays and confirmed in both assays that TNF-sensitive (L-929) and TNF resistant (EMT-6) phenotypes show greatly reduced survival when treated with combined recombinant human TNF (1.0-0.0005 micrograms/ml) and hyperthermia (1-2 h at 43 degrees C). Moreover, we confirmed that sensitization of the TNF-resistant EMT-6 cells was largely dependent on monokine treatment before hyperthermia and was reduced by the reverse sequence. The greatest sensitization of TNF-responsive L-929 cells also occurred when TNF treatment preceded heating. These results for clonogenic survival are consistent with the hypothesis that hyperthermia used in combination with TNF in vivo is more cytotoxic than TNF or hyperthermia separately. PMID- 2756122 TI - Cell cycle progression delay in conditioned medium does not play a role in the repair of X-ray damage in Chinese hamster V79 cells. AB - We tested our hypothesis that the lower survival of X-irradiated cells in growth medium (GM) relative to that in conditioned medium (CM) is due to differences in nutrient concentration levels rather than to differential effects on cell progression and growth. Chinese hamster V79 cells in log and unfed plateau phase, grown in Eagle's minimal essential medium (MEM) with 15% serum (100% GM), were irradiated. Before plating, cells were incubated in situ in various concentrations of MEM with serum (GM, normal cell progression) or MEM without serum or in CM (no cell progression). Cell survival was the lowest in 100% MEM with or without serum and increased with the decrease in MEM and serum concentrations, reaching a plateau in 40% MEM or 40% growth medium (40% MEM with 6% serum), similar to that in conditioned medium. Growth kinetics was the same in 40 and 100% growth medium, but the D0 of cells in 40% growth medium was higher than that of cells in 100% GM. Similarly, the D0 of cells in 40% MEM was higher than that of cells in 100% MEM, although cell progression was absent in both media. The radiation sensitivity of cells was the same in 40% GM with progression and in 40% MEM and CM with no progression. Cells in low-nutrient media were flatter than those in 100% MEM or GM. There was a correlation between the nutrient concentration in the medium postirradiation and the D0. This correlation was independent of the presence or absence of serum and thus independent of cell cycle progression. The cell morphology which is dependent on the nutrient concentration appears to influence the ability of a fraction of cells to repair their radiation damage. PMID- 2756123 TI - Promoter-enhanced neoplastic transformation after gamma-ray exposure at 10 cGy/day. AB - We have measured gamma-ray-induced neoplastic transformation in C3H10T1/2 mouse embryo cells irradiated at an average 10 cGy/day throughout the useful life span of these cells for transformation studies. At cumulative total doses of 50, 150, 300, and 450 cGy, samples of cells were assayed for cell survival and neoplastic transformation with or without the administration of 0.1 micrograms/ml of 12-O tetradecanoylphorbol-13-acetate (TPA) starting 24 h after the irradiation. The results indicate that, at a dose rate of 10 cGy/day, the rate of induction of neoplastic transformation is reduced by a factor of thirteen compared to that at 100 cGy/min. Still, frequencies above the background level are observed. These results are consistent with previous data which, at 144 cGy/day (0.1 cGy/min), showed that radiation-induced initiation events could be repaired during exposure, thus reducing the frequency of transformation from that observed at 100 cGy/min [A. Han et al., Cancer Res. 40, 3328-3332 (1980)]. Although the addition of TPA after the delivery of a particular dose at 10 cGy/day produced a significant increase in the frequency of neoplastic transformation, the degree of enhancement was less than after higher-dose-rate exposures [C.K. Hill et al., Radiat. Res. 109, 347-351 (1987)]. These results indicate that during 7 weeks of exposure, the repair of radiation-induced initiation was extensive but not complete, and suggest that a significant part of the damage persists which can be promoted by TPA. These observations support the inference that initiation and promotion are not tightly coupled and are probably independent processes. PMID- 2756124 TI - Plating efficiency as a function of time postirradiation: evidence for the delayed expression of lethal mutations. AB - The plating efficiency (PE) of a gamma-irradiated (7 Gy) human cell hybrid line (HeLa X skin fibroblast, designated as CGL1) has been measured as a function of time postirradiation and compared to that of unirradiated cells at similar cell densities and under the same growth conditions. The results indicate that following irradiation, the PE of the irradiated cells initially increases but never returns to that of unirradiated cells during the experimental period that we have examined. Furthermore, after a period of 9 to 10 days (equivalent to at least 10 cell doublings) postirradiation and plating, the PE of the irradiated cells begins to decrease and continues to do so over the next 5 days. A decrease does not occur in unirradiated cells until much later (i.e., Day 15) corresponding to at least 5 additional cell doublings. The data are discussed in terms of a delayed expression of lethal mutations. The possible impact of these observations on the estimation of radiation-induced transformation frequencies is also considered. PMID- 2756125 TI - [Use of contrast media in MR tomography of soft tissue sarcomas. Follow-up studies after multimodal therapy]. AB - The value of MRI was evaluated retrospectively in 32 patients with clinically confirmed soft tissue sarcomata. The results were compared with the clinical findings and with computed tomographic scans. All patients were examined for recurrent residual tumor, the majority after surgery, radiotherapy and/or chemotherapy. Regardless of the tumor site, MR was superior to CT or at least equivalent. The normal postoperative anatomy was well delineated. Discrimination of recurrent or residual masses from post-treatment fibrosis was good. Bone destruction, especially tumor-induced cortical erosion, was better defined with CT. MRI is an appealing modality for the diagnostic work-up and for the follow-up following treatment of thoracic and abdominal sarcomata in children. The use of Gd-DTPA meant T2-weighted image sequences of the chest and abdomen were unnecessary. PMID- 2756126 TI - [Computed tomography of complications of cholecystitis]. AB - In cases of acute cholecystitis, especially with cholecystolithiasis, the diagnosis is usually quickly made. In contrast, the symptoms in the presence of such complications as penetration, perforation and local abscess are often unspecific, and diagnostic procedures may be time-consuming, extending into weeks. One reason for this is the rareness of the entity. The same is true for emphysematous cholecystitis, although this presents with more acute symptoms. Computed tomography seems to be the most effective imaging method. Therefore, it should be used in cases of nonspecific problems in the upper abdomen. PMID- 2756127 TI - [Traumatic atlanto-occipital dislocation in conventional x-ray diagnosis]. AB - Different roentgenometric methods are discussed with reference to a case of atlanto-occipital dislocation (AOD). The most accurate information is provided by Lee's X-line method, which also allows differentiation of the three forms of this injury. As survival has been reported in cases of AOD, early conventional radiographic diagnosis is especially important. PMID- 2756128 TI - [An unusual abdominal accumulation of air]. PMID- 2756129 TI - Case study. Recurrent herpes labialis. PMID- 2756130 TI - On guard. PMID- 2756132 TI - Selecting implants. PMID- 2756131 TI - In the beginning. PMID- 2756133 TI - Handle with care. PMID- 2756134 TI - Case study. Recurrent aphthous ulcers. PMID- 2756135 TI - Breaking away from the old routine. PMID- 2756136 TI - Jump start. PMID- 2756137 TI - Case study. Candidiasis. PMID- 2756138 TI - Up front with infection control. PMID- 2756140 TI - Pioneer working for a bright future in dental hygiene. PMID- 2756139 TI - A good job is hard to find. PMID- 2756141 TI - Destructive disease. PMID- 2756142 TI - Altered state. PMID- 2756143 TI - Tracing the routes of disease transmission. PMID- 2756144 TI - Case study. Hairy leukoplakia. PMID- 2756145 TI - Tour of duty. PMID- 2756146 TI - Above it all. PMID- 2756147 TI - Instrument recirculation prevents infection transfers. PMID- 2756148 TI - Having your own business means hard work and long hours. PMID- 2756150 TI - Image-makers. PMID- 2756149 TI - Case study. Odontogenic keratocyst. PMID- 2756151 TI - Inside the walls. PMID- 2756152 TI - Options wide open with solo practice. PMID- 2756153 TI - Pre- and postjunctional actions of neuropeptide Y and related peptides. AB - The effects of neuropeptide Y (NPY) and related peptide fragments on blood pressure and vagal action at the heart were compared in the anaesthetized rat. A change in vagal action was taken as a measure of presynaptic activity and a change in blood pressure was taken as a measure of postsynaptic activity. NPY, NPY-(13-36), PYY-(13-36), des-Ser22-NPY-(13-36) and a stabilized 13-36 analogue of NPY (ANA NPY) all exerted pressor actions and attenuated vagal action at the heart. The maximum vagal inhibitory or presynaptic action in order of potency was NPY, ANA-NPY, PYY-(13-36) significantly greater than NPY-(13-36), des-Ser22-NPY (13-36). The order of potency for the half time of this effect was NPY, ANA-NPY significantly longer than PYY-(13-36) and NPY-(13-36), which were significantly longer than des Ser22-NPY-(13-36). For the pressor or postsynaptic effects, NPY increased blood pressure significantly more and for a longer duration than all the 13-36 fragments, which were not demonstrably different in this respect. These results are consistent with the proposal that there are two populations of NPY receptors. The C-terminal flanking peptide of NPY (CPON) and desamido-NPY had no effect on either vagal action at the heart or on blood pressure. PMID- 2756154 TI - Vasoactive intestinal peptide in the normal and inflamed feline gallbladder. AB - Intravenous infusion of vasoactive intestinal peptide (VIP) causes gallbladder mucosal fluid secretion by an action on epithelial cell receptors in the cat. Gallbladder fluid secretion is observed also in experimental cholecystitis and this secretion is abolished when the intramural gallbladder nerves are blocked. In the present study, immunoreactive VIP was detected in the gallbladder contents (29 +/- 5 (S.E.M.) pM) in the obstructed lumen of the gallbladder in cats with experimental cholecystitis and gallbladder mucosal fluid secretion, but not in the normal feline gallbladder. During luminal perfusion of the gallbladder in vivo, the calculated secretion of VIP into the gallbladder lumen in animals with experimental cholecystitis was significantly higher (0.31 +/- 0.08 (S.E.M.), pmol/h) than in controls (0.11 +/- 0.02 (S.E.M.), pmol/h) while plasma levels of VIP were similar. Recovery of exogenously administered VIP was similar in normal and inflamed gallbladders. The present results support the hypothesis that intramural VIP-releasing nerve fibers may be activated in cholecystitis. PMID- 2756155 TI - Isolation and characterization of bovine pancreastatin. AB - Bovine pancreastatin, a 47 amino acid residue peptide, was isolated from the pancreas and the pituitary gland using a chemical method which detects its C terminal glycine amide structure. The complete amino acid sequence of the pancreatic peptide is 74% homologous to that of porcine pancreastatin and is identical to bovine chromogranin A-(248-294), as deduced from its cDNA sequence. The sequence of the first 28 amino-terminal residues of the pituitary peptide was determined to be identical to the corresponding sequence of the pancreatic peptide. Since the pituitary peptide also contains the C-terminal glycine amide, it is therefore likely to be identical in structure to the pancreatic peptide. Thus, we conclude that bovine chromogranin A is the precursor of bovine pancreastatin. Synthetic bovine pancreastatin inhibited pancreatic exocrine secretion in a similar manner to porcine pancreastatin. PMID- 2756156 TI - The constitution and properties of phosphorylated and unphosphorylated C-terminal fragments of progastrin from dog and ferret antrum. AB - Antibodies to the extreme C-terminal tryptic (nona-) peptide fragment of porcine progastrin have been used in radioimmunoassay to identify progastrin fragments in dog, ferret and pig antral mucosa extracts and to monitor their purification. In addition to previously characterised phosphorylated and unphosphorylated C terminal tryptic peptides of porcine progastrin a minor form corresponding to the C-terminal octapeptide (i.e. des-Ser C-terminal nonapeptide) was isolated and characterised. The latter form together with phosphorylated and unphosphorylated forms of the nonapeptides were also isolated and chemically characterised from dog antrum, and the unphosphorylated nonapeptide was characterised from ferret antrum. The primary amino acid sequences of the dog, ferret and pig nonapeptides were identical. In ferret the unphosphorylated nonapeptide predominated, and in dog the phosphorylated form predominated; in pig both forms of the nonapeptide were well represented. Intact progastrin was identified in gel filtration eluates of extracts of all 3 species, but occurred only in relatively low concentrations. The nonapeptides did not stimulate acid secretion in the conscious gastric fistula rat and they did not modify the acid response to G17. Phosphorylation of progastrin-derived peptides is evidently well conserved across a range of species even though there appear to be differences in the relative proportions of phosphorylated and unphosphorylated forms. PMID- 2756157 TI - Omeprazole and ranitidine, antisecretagogues with different modes of action, are equally effective in causing hyperplasia of enterochromaffin-like cells in rat stomach. AB - Female rats were treated for 28 days with high doses of the gastric acid secretion inhibitors omeprazole and ranitidine. Omeprazole, which is long-acting, was given orally once daily. Ranitidine, which is short-acting, was given by continuous infusion (via osmotic minipumps, implanted subcutaneously). The aim was to produce a similar degree of acid inhibition with the two drugs. The inhibition of acid secretion over the day and night was more pronounced in the omeprazole-treated rats (maximal inhibition 100%, minimum 85%) than in those receiving ranitidine (mean 70%). In both groups, there was a great increase in plasma gastrin, somewhat greater after omeprazole than after ranitidine. The gastrin concentration in the antrum was almost doubled by both treatments and there was a moderate increase in the number of antral gastrin cells in the omeprazole-treated rats. The number of enterochromaffin-like (ECL) cells (per visual field) increased in the oxyntic mucosa to the same extent (greater than 100%) in the ranitidine- and omeprazole-treated rats. Apart from the gastrin cells in the antrum and the ECL cells in the corpus no other gastric endocrine cell type seemed to respond to treatments with antisecretagogues. We conclude that, regardless of the type of antisecretagogue used, effective and long-term suppression of gastric acid secretion results in sustained hypergastrinemia and increased number of ECL cells. Conceivably therefore, the ECL cell hyperplasia reflects the trophic effect of gastrin. PMID- 2756158 TI - The cardiovascular actions of centrally administered neuropeptide Y. AB - The cardiovascular actions of intracerebroventricular (i.c.v.) administration of neuropeptide Y (NPY) were examined in conscious, unrestrained rats. A prolonged decrease in heart rate (HR) and a fall in mean arterial pressure (MAP) were obtained following i.c.v. administration of NPY (1 and 10 micrograms). Passive immunization with an antiserum directed against NPY confirmed that the slowing of HR following i.c.v. administration of NPY was mediated via a central nervous mechanism and not from leakage of NPY out of the brain. Administration of NPY into different brain parenchymal regions identified a putative site of action in the rostral region of the solitary tract. The mechanism of the decrease in HR caused by centrally administered NPY was investigated by i.c.v. administration of NPY to animals that were pretreated with agents that altered autonomic tone. Administration of NPY to atropine-treated animals produced a reversal of the atropine-induced tachycardia, suggesting that the NPY-induced decrease in HR was not due to augmented vagal tone. However, administration of NPY to animals pretreated with propranolol did not significantly lower HR below that obtained with propranolol alone. These data suggest that i.c.v. administration of NPY may cause a decrease in cardiac sympathetic outflow. The effects of centrally administered NPY on baroreflex function were studied. The changes in HR caused by NPY did not significantly alter baroreflex set-point or gain. These studies provide evidence that NPY acted within a brainstem region to decrease sympathetic nervous outflow, resulting in a decrease in HR and MAP. PMID- 2756159 TI - [Evaluation of gallbladder emptying in patients with chronic liver disease by 99mTc-EHIDA hepatobiliary scintigraphy]. AB - Gallbladder emptying after intramuscular injection of cerulein was investigated by 99mTc-EHIDA hepatobiliary scintigraphy in 23 patients with biliary disease, 55 patients with chronic liver disease, and 21 normal controls. The mean gallbladder ejection fraction in patients with gallstones and liver cirrhosis was significantly reduced compared with normal controls. (gallstones: 56.3 +/- 21.3%, LC with gallstones: 50.8 +/- 29.6%, LC without gallstones: 55.9 +/- 26.7%, vs. normal controls: 74.4 +/- 12.9%, p less than 0.01). The mechanism for sluggish gallbladder emptying in liver cirrhosis is unknown, however impaired emptying with bile stasis provides a potential pathophysiologic basis for the high frequency of pigment stones. PMID- 2756160 TI - Relationship among iodine, bromine and chlorine concentrations in cow's milk in Japan. AB - In order to know the relationship among some elements in biological materials, iodine, bromine and chlorine concentrations in cow's milk samples in Japan were determined by the thermal neutron activation analysis using a low power research reactor and a Van de Graaff accelerator. The iodine contents in cow's milk samples ranged from 0.041 to 0.316 ppm with an average of 0.096 ppm. The bromine and chlorine in these samples ranged from 2.3 to 11.1 ppm and from 475 to 1650 ppm, respectively. The average concentration of the bromine was calculated to be 5.6 ppm and that of the chlorine was 853 ppm. The relationship among iodine, bromine and chlorine concentrations in cow's milk samples in Japan was studied with a regression analysis. It was suggested that the correlation has a power function as follows; Y = K(Z)-A where, Y is elemental concentration in ppm, Z is atomic weight [corrected] of element, A (= 7.4) is exponent and K (= 14.7) is a constant. PMID- 2756161 TI - [Fundamental studies, reference values and relationship to menstrual cycle of prolactin RIA BEAD II]. AB - We have tried fundamental studies, reference values and relationship to menstrual cycle on Prolactin RIA BEAD II kit which has a method of IRMA using monoclonal antibody. On clinical studies, we investigated change of serum prolactin level during the menstrual cycle and relationship to other hormones (LH, FSH, estradiol, progesterone). It was the result that prolactin level of follicular phase was lower than that of preovulatory phase and luteal phase. We conclude that change of prolactin level during the menstrual cycle is related with change of estradiol level. PMID- 2756163 TI - Evaluation of negative studies. PMID- 2756162 TI - The erosion of effective patent life--an international comparison. PMID- 2756164 TI - Are negative toxicological data suspect: an epilog. PMID- 2756165 TI - IARC and HHS lists of carcinogens: regulatory use based on misunderstanding of the scope and purpose of the lists. AB - In the last two decades there has been a tremendous increase in data on carcinogenic activity in experimental animals. While there have been few additions to the list of human carcinogens based on human data, the number of carcinogens based on animal data continues to increase unabated. The International Agency for Research on Cancer (IARC) list of carcinogens grew out of the IARC Monograph Series. The evidence classification system used to prepare the IARC lists in 1980, 1982, and 1988 is based on the sufficiency, i.e., strength, of the evidence of carcinogenic activity in one or more studies, not a full weight-of-the-evidence evaluation of all relevant data. Titles of categories of animal evidence referring to human risk potential were based on a presumption: "for practical purposes . . . as if." No evaluation was made of the predictive relevance of animal data to human risk. The IARC listing did not involve evaluation of potency or mechanism and was intended as a useful input but not as a basis for regulatory or legislative decisions. The Department of Health and Human Services (HHS) lists in the Annual Reports on Carcinogens are selected from the IARC lists and from reports of positive bioassay experiments conducted by the National Toxicology Program (NTP). The reports on the NTP bioassays relate to the strength of the evidence in each experiment and recognize that a "wider analysis" is necessary for determination of human risk. Because of a misunderstanding of the limited scope of the analysis involved, the IARC and HHS lists have recently been used as a basis for legislative and regulatory decisions. Examples of unanticipated use of the lists as triggers for regulatory and legislative decisions will be discussed. Some recommendations to mitigate the consequences of past unanticipated use of the lists and to prevent further misuse are discussed. PMID- 2756166 TI - New directions for regulating carcinogenic risks. PMID- 2756167 TI - Papers presented at the 4th annual meeting of the International Society of Regulatory Toxicology and Pharmacology. October 17-18, 1988, Baltimore, MD. PMID- 2756168 TI - Critical assessment of carcinogenic risk policy. AB - Fact. Cancer is a relatively common yet greatly feared disease. Belief. The concept that cancer is largely preventable is widely held by advocate groups, the press, and Congress. Belief. The concept that carcinogens at any level of exposure pose a significant cancer risk to human is widely believed by the public. Fact. In contrast to this belief, carcinogens are now known to be widespread in the environment and that virtually all substances are contaminated with carcinogens at some albiet low level. Fact. The solution to the ubiguitous presence of carcinogens cannot be solved by regulatory fiat. Fact. Often the only viable solution to regulating carcinogens is setting maximum levels of acceptable exposure (tolerances). Belief. In U.S. society, the process of establishing tolerances must be conducted in the open, providing adequate opportunity for public comment. Fact. The courts will sustain regulatory agency decisions about risks only if the administrative procedures used comply with the Administrative Procedures Act and if the technical methodology used is in good standing. Fact. For the method to be in good standing it cannot be a recent invention created after the fact to solve the issue at hand but must instead be a procedure that is claimed to be generally applicable to determining or estimating cancer risk. Belief. QRA should be an orderly procedure or process by which cancer risk estimations are conducted in an unbiased manner. As such it is fundamentally acceptable to the courts for resolving disputes. Fact. However, because QRA is dependent upon a large number of assumptions and because regulatory agencies feel compelled to act in a conservative, risk-adverse manner, risk estimates are often criticized for being over stated. Belief. To make risk estimates more realistic, data or facts must substitute for worst case assumptions. Fact. This process of substituting scientific facts for assumptions is occurring but it is expensive, time consuming, and not always possible. Nevertheless, it constitutes a major opportunity for improving the process by which risk estimates are made. PMID- 2756169 TI - Critical discussion of carcinogenic risk policy. PMID- 2756170 TI - Commentary on EPA carcinogen risk assessment guidelines. AB - EPA has indicated the Agency's Cancer Risk Assessment Guidelines are intended to be evergreen, i.e., subject to revision as advances are made in scientific understanding or difficulties are encountered. Several changes could be made in the Guidelines to better utilize advances in science, some of which EPA has already incorporated into risk assessment procedures, and also to alleviate difficulties encountered by the Agency. The hazard identification step of risk assessment should be more clearly defined, especially with respect to describing the best use of animal data to predict human hazard. The classification system for summarizing carcinogenic hazard should be expanded, and the titles revised, to better describe the varying degrees of knowledge concerning human carcinogenic hazard derived from experimental data. Current dose response estimation procedures should be supplemented to provide risk managers more perspective on human risk. Suggested additions are a central estimate of the upper bound of the dose response curve and a most plausible estimate of human response as a function of dose. The central estimate of the upper bound still includes the calculation of a statistical upper limit, but utilizes central estimates for some of the critical policy options. The most plausible estimate relies heavily on evaluation of the mechanism of carcinogenic activity and its implications for dose response estimation in humans. Thus, the outcome of dose response evaluation would include the current upper bound (worst case), a more central estimate of the upper bound, a most plausible estimate, and the lower bound. PMID- 2756171 TI - Mathematical models in quantitative assessment of carcinogenic risk. AB - Regulatory guidelines have specified default assumptions for the calculation of upper bounds on potential carcinogenic risk. These default "science policy" assumptions are used in the absence of more appropriate biological information, but can, in theory, be overridden by compound-specific data. As a screening tool, the standard LMS procedure provides a useful yardstick for regulators to compare hazard potential across compounds and across exposure scenarios. This standard methodology does not estimate actual risk, however. When specific compounds are being considered for detailed evaluation, methodology for more accurately estimating the true risk is often available. Pharmacokinetic models can be used to more accurately define the high-dose to low-dose extrapolation as well as to provide insight into across route and across species extrapolations. "More central" estimates of the upper bound on risk can be derived, or decision analysis techniques can be used to define the probability distribution of risk estimates, as the assumptions are changed. These data give the risk manager more information as to the relevance of the upper bound, and should be presented in any risk estimate to provide a richer demonstration as to the true risk. PMID- 2756172 TI - The risk of risk assessment. PMID- 2756173 TI - Epidemiology and the concept of causation in multifactorial diseases. AB - Unlike infectious diseases of the past, diseases prevalent in modern industrialized societies have multifactorial origins whose complexity so far has defied an integrated scientific understanding. Their epidemiologic investigation suffers from the conceptual inability of formulating plausible causal hypotheses that mimic a complex reality, and from the practical difficulties of running elaborate studies controlled for multifactorial confounders. Until biomedical research provides a satisfactory understanding of the complex mechanistic determinants of such diseases, epidemiology can only field reductionist causal hypotheses, leading to results of uncertain significance. Consensual but rationally weak criteria devised to extract inferences of causality from such results confirm the generic inadequacy of epidemiology in this area, and are unable to provide definitive scientific support to the perceived mandate for public health action. PMID- 2756174 TI - Comparative carcinogenicity of the PAHs as a basis for acceptable exposure levels (AELs) in drinking water. AB - The carcinogenicity of various polynuclear aromatic hydrocarbons (PAHs) has generally been demonstrated by their ability to act as complete carcinogens in the development of cancers in rodent skin tests. In order to develop proposed acceptable concentration levels for various PAHs in drinking water, we reviewed the studies that formed the basis for determining that these specific PAHs were carcinogenic in animals. We found that the relative potency of these PAHs varied over a range of many orders of magnitude. For example, the carcinogenic strength of benz[a]anthracene (BaA) is found to be about 1/2000th that of benzo[a]pyrene (BaP). We have used the calculated carcinogenic potency of the various PAHs relative to that of BaP as a means for proposing specific acceptable concentration levels in drinking water for each of the specific PAHs. BaP is the only carcinogenic PAH for which EPA has published an acceptable concentration level based on carcinogenicity. Based on the level EPA set for BaP (0.028 micrograms/liter), this methodology has provided for the specific PAHs a determination of proposed acceptable concentration levels quantitatively based on the same data that were used to qualitatively determine them to be animal carcinogens. We have proposed acceptable concentration levels for the carcinogenic PAHs in drinking water that range from 0.03 micrograms/liter for BaP to 6.5 micrograms/liter for BaA. We recommend that acceptable concentration levels for the various PAHs be based on their relative carcinogenic potencies rather than the EPA method of using the potency of only one specific PAH, BaP, to serve as the exposure level determinant for all PAHs. We further suggest that this methodology may be applicable to other classes of carcinogenic compounds. We have also found useful for the determination of acceptable concentration levels for the noncarcinogenic PAHs an analogous methodology based on the relative toxicities of the noncarcinogenic PAHs. PMID- 2756176 TI - [Neuro-AIDS: a multicenter neuroradiological study]. AB - The results are described of a retrospective multicentric CT/MR study of 141 neuro-AIDS patients (IV group CDC classification); 114 patients were drug addicted, 13 homosexual, 8 polytransfused, and 6 had other risk factors. The mean age was 29.6 years. The pathologic agent was identified in 47 cases by c.s. fluid examination, biopsy, autopsy or specific treatment response: it was HIV in 20 cases, toxoplasmosis in 11, cryptococcosis in 9, leishmaniasis, salmonella and papovavirus in single cases. In the follow up of 2 cases, a Kaposi's sarcoma and a primitive CNS lymphoma occurred. The main clinical features were AIDS-dementia complex (45% of cases) and focal neurologic manifestations (36%). The neuroradiological protocol consisted of 238 CT exams (97 controls), most of them with DDD (delayed double dose) technique, 7 MR exams (0.15 T) and 2 angiographies. CT findings were divided into 3 groups: negative (16%), atrophic (47%) and focal lesions (37%). In the first and second group, HIV and cryptococcal infections were the main pathologic agents. In the third group toxoplasma infections were discovered, and TB granulomas and other pathologic conditions, with ring-like or nodular enhancement, in cortical/cortico-medullary location. In follow-up patients a high tendency of evolution towards focal lesions was observed, even in negative cases. The DDD enhancement technique allowed in most cases both the demonstration of very small lesions and their grading. According to the literature CT, though a highly sensitive method, is inferior to MR imaging; however our experience in this field is currently insufficient. The specific diagnosis of pathologic agents of neuro-AIDS is difficult, due to the high number of opportunistic AIDS-related infections and neoplasms, with overlapping features: differential diagnostic criteria can be assessed only by comparing the clinical, microbiological, topographic, CT and MR findings. CT and MR exams are necessary to guide and monitor therapy and to plan stereotaxis biopsy. PMID- 2756175 TI - The potential for the use of cell proliferation studies in carcinogen risk assessment. AB - The use of observations on cellular proliferation in assessing the mechanism of action of certain factors in the genesis of tumors of the urinary bladder, forestomach, and intestine, or on the effects of dietary restriction, is illustrated. It is suggested that, particularly with nongenotoxic carcinogens, such studies may be of great use in risk assessment especially for those cases in which animals are exposed at very much higher levels of the test agent in the carcinogenesis bioassay than are humans as the result of the environmental or other use of the agent. PMID- 2756177 TI - [Optimization of the technic in the study of the upper abdomen using magnetic resonance. I. Artifact reduction]. AB - Complete motion artifact suppression is possible in abdominal MR imaging with the simple optimization of sequence parameters, with no need for special softwares. The authors have studied the influence of sequence parameters modification on the signal/noise relation and on the presence of motion artifacts. The tested parameters included Repetition Time (TR), 150 to 2000 ms, Echo Time (TE), 20 to 120 ms, and the number of acquisitions, 2 to 16. In T1-weighted sequences, the major advantages were offered by the short TR and short TE association, with many acquisitions. Optimal signal/noise relation and complete motion artifact suppression were thus obtained. In T2-weighted sequences, TE values had to be changed according to the desired contrast enhancement, and the number of acquisitions could not be increased to more than 2 in order to keep the acquisition time short. PMID- 2756178 TI - [Conventional radiography and digital radiography of the thorax: evaluation of anatomo-radiological parameters]. AB - We report the results of a comparative study of digital and conventional chest radiographs to detect normal anatomical structures of the thorax. A digital Toshiba unit (TCR 201) was used to examine 100 selected patients who were diagnosed with no chest pathologic conditions. The images in both modes were submitted for interpretation to five radiologists. The depiction of nine normal anatomical structures was more accurate on digital than on conventional radiographs. The mean confidence levels achieved in viewing digital images were higher than those obtained with conventional radiographs. This difference was statistically significant (p = 0.002). PMID- 2756179 TI - [Aseptic osteonecrosis of the femoral head in cancer patients with neuropathies caused by vincristine and vinblastine]. AB - Aseptic osteonecrosis has been described in many and dissimilar pathologic conditions--most frequently as the aftermath of fractures or dislocations; in falciform anemia, obesity, alcoholism; in diseases requiring constant and heavy corticosteroid therapy, and also following renal transplantation. Many of these pathologies, especially alcoholism, diabetes, uremia, and collagen vascular diseases, have a common denominator: peripheral neuropathy, which is believed to be a pathogenetic factor supporting osteonecrosis. The authors analyze 3 cases of aseptic osteonecrosis of the femoral head in cancer patients treated with vincristine and/or vinblastine. Since in these subjects severe and persistent neuropathy preceded the onset of osteonecrosis, a possible relationship is postulated between the vincristine/vinblastine treatment and the onset of femoral head osteonecrosis, through the pathogenetic mechanism of peripheral neuropathy. PMID- 2756180 TI - [The intravertebral vacuum phenomenon or gaseous dissection of the vertebral body]. AB - The intravertebral vacuum phenomenon is rather uncommon. It is determined by the collapse of the body of the vertebra with successive aspiration ex vacuo of gas (nitrogen) from the surrounding tissues, which collects under the endplates, causing them to appear disconnected. To date, the one who has reported the highest number of cases is Maldague, with sixty examples. Our report concerns four cases seen during the past five years. According to the most widely accepted pathogenetic theory, this phenomenon represents, together with vertebral collapse and increased bone density, a pathognomonic sign of ischemic osteonecrosis of the vertebrae, similar to osteonecrosis of the head of the thigh bone and, like this, favored by many different factors, such as old age, repeated traumas, alcoholism, rheumatoid arthritis, arteriosclerosis and corticosteroid therapy. PMID- 2756181 TI - [Double-contrast arthrography in meniscal pathology. Remarks on 1000 cases]. AB - The authors performed a statistical study on a series of 1000 patients examined with double-contrast fluoroscopically-guided knee arthrography. Arthrographic diagnoses were compared with the arthrotomic (500 patients), arthroscopic (350 patients) or clinical diagnoses of 150 patients with a follow-up of 6 months. In this series of patients with a history of "recurrent meniscal injury", arthrographic diagnoses were confirmed in a high percentage of cases, with 96.9% accuracy, 96.7% sensitivity for tears, and 98.6% specificity. On the basis of these results the authors suggest double-contrast arthrography as an examination of considerable value in the diagnosis of meniscal lesions, while in their opinion arthroscopy should be limited to questionable cases, to complex lesions with involvement of multiple articular structure and to the alterations clearly treatable by arthroscopy. PMID- 2756183 TI - [Percutaneous subtotal splenic embolization in thalassemia major. A 4-year follow up]. AB - Ten young patients affected with thalassemia major with hypersplenism were treated with subtotal percutaneous embolization. Percutaneous procedure was used to correct hypersplenism, while preserving a small portion of splenic parenchyma. Embolization was successful in 9 patients, and no significant complications were observed; in 1 patient arterial catheterization and splenic embolization were not possible due to splenic artery tortuosity. Post-procedural clinical course was characterized by intense pain, not always reduced by therapy. Hospitalization time was similar to that of surgical splenectomy. Effectiveness of percutaneous embolization was evaluated with splenic scintigraphy, clearance of erythrocytes marked with 99mTc and denatured with BMHP and with the analysis, both before and after percutaneous procedure, of the following 3 parameters: annual blood consumption, behavior of pre-transfusional hemoglobin, and transfusional pause. Six patients underwent a 4-year follow-up. In all cases scintigraphy showed the effectiveness of subtotal embolization, and clearance of erythrocytes appeared slower than before. As for clinics, an improvement was observed in transfusional parameters. The results from our series, though numerically limited, support the role of percutaneous splenic embolization as an alternative to surgical splenectomy in high risk patients or in patients who refuse surgery. PMID- 2756182 TI - [Galactographic features of the secreting breast]. AB - The authors report their experience in the galactographic study of 95 women with nipple discharge; 65 of them previously underwent both surgical and histological control. The galactographic features are classified according to predominant alterations: ductal ectasia, ductal stenosis, ductal amputation, solitary/multiple filling defects, ductal dystrophy, and irregular distribution of ductal branches. Histopathological findings (65 patients) appear to be related to nipple discharge types: thus, hematic secretion results pathognomonic for intracanalicular neoplasm (24/25), while serous and serous-hematic discharge (32/65) may be caused by any mammary pathologies. Galactography is therefore recommended, being sometimes the only reliable diagnostic method and allowing both topography and extension of the lesion to be demonstrated, which are necessary elements for planning adequate surgical treatment. PMID- 2756184 TI - [Surgical and radiotherapeutic treatment in stage I endometrial adenocarcinoma. Retrospective analysis of 218 patients]. AB - From April 1977 through April 1985, 218 stage I endometrial carcinomas were treated with radiosurgery or radiotherapy alone. Postoperative irradiation was external (60Co) in 131 and curietherapy in 27 patients. Twenty patients underwent preoperative curietherapy and 40 patients radiotherapy alone. Median follow-up was 5.6 years (range 3-11). The overall 5-year actuarial survival (Kaplan-Meier method) was 86.1% +/- 2.5. The 5-year D.F. actuarial survival was 95% +/- 4.9, 93.1% +/- 4.7, 88.4% +/- 2.9, respectively, for preoperative radiotherapy, postoperative curietherapy and postoperative external irradiation groups. The 5 year actuarial survival was 69.8% +/- 7.7 in the radiotherapy alone group. There was difference in survival among patients treated with radiotherapy alone as compared to those radiosurgically treated (P less than 0.001). Local and general recurrence rate was 8.2%; vaginal recurrences 2/218 (0.9%); pelvic recurrences 7/218 (3.3%); distant metastases 9/218 (4.1%). Overall side effects were observed in 20/218 patients (9.1%): grade I and II in 8.6% of cases, grade III in 0.9% of cases. The authors conclude that good results can be achieved with adjuvant radiotherapy both in high risk cases and in low risk cases, with minimal side effects. PMID- 2756185 TI - [Theoretical-experimental comparison of contrast in magnetic resonance]. AB - The intensity of MR signal depends on several parameters, such as proton density [N(H)], relaxation times (T1 and T2), repetition time (TR), and echo time (TE). A theoretical model describes this dependence, which is currently employed for image optimization. It allows the evaluation of image contrast once the tissue parameters are known. The above-mentioned theoretical model was tested with the use of CuSO4 samples at various concentrations for which T1 and T2 values were known from the literature. Our unit was an ESATOM MR 5000 which employed a 0.5 Tesla magnetic field. We used spin-echo sequences with TR = 500, 1000 ms and TE ranging from 50 to 150 ms. Signal intensity was measured both by direct access to the data matrix and with the use of the pixel intensity calculation program for regions of interest. The difference in the signals corresponding to the various samples were determined to evaluate the contrast. Our results are in strict agreement with those from the theoretical model. The latter can thus be employed for image optimization. PMID- 2756186 TI - [An original method in the axial radiological study of the femoro-patellar joint in the orthostatic active phase]. PMID- 2756187 TI - [Radical percutaneous treatment in a case of pseudoaneurysm of the gastroduodenal artery. Double embolization using Gianturco coils]. PMID- 2756188 TI - On the art of the abstract. PMID- 2756189 TI - Gd-DTPA enhanced high resolution MR imaging of pituitary adenomas. AB - Thirty-eight patients with surgically or biochemically confirmed pituitary adenomas were examined on a 1.5 T MRI system by means of spin echo technique with 3 mm slice thickness. T1 weighted sagittal and coronal sections were obtained before and after the administration of Gd-DTPA. Compared with the normal pituitary anterior lobe, 8% of the adenomas were hyperintense, 45% were isointense, 42% were hypointense and 5% were inhomogeneously intense. After Gd DTPA administration, 13% enhanced to a greater degree, 10% to the same, and 57% to a lesser degree than the normal pituitary tissue. Twenty percent showed inhomogeneous enhancement. In 10%, there was evidence of adenoma only in the enhanced images. The delineation of the adenoma from the cavernous sinus was improved from 47% in unenhanced scans to 91% after Gd-DTPA administration. PMID- 2756190 TI - Computed tomography and magnetic resonance imaging of the pericardium. AB - Computed tomography is an established modality for the evaluation of the pericardium. It is used to evaluate complicated pericardial effusions, pericardial thickening, calcific pericarditis, pericardial cysts, postoperative changes and primary and metastatic neoplasms of the pericardium. Magnetic resonance imaging is being used with increasing frequency in the evaluation of pericardial disease. It offers advantages over computed tomography, including a potential for tissue characterization, absence of ionizing radiation or need for intravenous contrast medium, and the ability to scan in any plane. Disadvantages include greater cost, longer examination times and the inability to identify calcification positively. PMID- 2756191 TI - The determination of death and the changing role of medical imaging. PMID- 2756192 TI - The clavicle: normal and abnormal. AB - The clavicle is an unusual long bone with many unique embryologic features. It is often involved in congenital and acquired disorders. Traumatic, inflammatory, neoplastic, metabolic and many other miscellaneous lesions may also affect the bone. Because of its ligamentous attachments and the presence of articulations at both ends, the clavicle can also be involved in arthritic diseases. This article illustrates the radiographic manifestations of many of the disorders of the clavicle that are commonly encountered in clinical practice. PMID- 2756193 TI - Penile prosthetic implants: a radiographic atlas. AB - This article provides an atlas of penile prosthetic implants currently in use. It is believed that an understanding of the structure and mechanism of these prostheses is essential to an accurate radiologic assessment of their integrity and to the recognition of the cause in cases of malfunction. PMID- 2756194 TI - Magnetic resonance imaging phase encoding: a pictorial essay. AB - A set of MRI images with various degrees of phase encoding were generated from the same raw data set. The resultant pictorial teaching aid is useful in developing an intuitive understanding of the mechanics and principles of phase encoding in two dimensional, Fourier transform magnetic resonance imaging. PMID- 2756195 TI - General case of the day. Pancreatic microcystic adenoma (benign serous cystadenoma). PMID- 2756196 TI - Pediatric case of the day. Tumoral calcinosis. PMID- 2756197 TI - Amalgam carveability. PMID- 2756198 TI - Restorative treatment in a clarinettist. PMID- 2756199 TI - [Abdominal pain and a hepatic mass in a young man]. PMID- 2756200 TI - [Clinical presentation of systemic lupus erythematosus as a massive pleural effusion with a mesothelial reaction]. PMID- 2756201 TI - [Dermatomyositis and hypernephroma]. PMID- 2756202 TI - [Fanconi syndrome caused by mercury chloride poisoning]. PMID- 2756203 TI - [Hypertensive crisis and hypertensive emergencies]. PMID- 2756204 TI - [Thrombolysis in acute myocardial infarction. When should it be done?]. PMID- 2756205 TI - [Unusual extra-intestinal manifestations in a patient with Crohn's colitis]. PMID- 2756206 TI - [Endocarditis due to Campylobacter jejuni and acquired immunodeficiency syndrome]. PMID- 2756207 TI - [Temporal arteritis: diagnostic considerations]. PMID- 2756209 TI - [Experience and evaluation of studies on the prevalence of nosocomial infections at a general hospital]. AB - From November 1986 to December 1987 we undertook 5 different counts of the prevalence of nosocomial infections (NI) in 4,572 patients (100% of the population). The following are the most important average values: NI overall, 14.4%, distributed as follows: urinary infections, 29.1%; surgical wounds, 21.6%; pneumonias 8.6%; phlebitis due to catheter insertion, 14.5%; and bacteremias, 5.2%. The most commonly found microorganisms were E. coli, S. aureus, Proteus mirabilis and Enterococcus. These studies reflect the need to decrease the prevalence of NI, mainly those coming from surgical wounds and from the urinary tract. These type counts are feasible with limited human resources. However, they are not appropriate for analyzing in detail the causes of the different types of NI nor in epidemic situations. PMID- 2756208 TI - [The spectrum of lymphadenopathy in HIV-positive patients. Prospective analysis of 45 cases]. AB - In the prospective analysis of 45 patients (intravenous drug addicts and homosexuals) with lymphadenopathy and positive HIV virus titers, including serology, immunological and histological lymph node studies, we examined the etiology and diagnostic results of the methods used. We found 19 cases with lymphoid follicular hyperplasia, 9 with lymph node tuberculosis, 7 with lymphoid depletion, 2 non-Hodgkin's lymphoma and one case with Hodgkin's disease. Routine serology did not provide more information concerning the lymphadenopathy and the immunological study showed a relationship, however not lineal, between the immunosuppression and the stage of HIV infection, while the histologic diagnosis did not, except in the cases with lymphoid depletion and non-Hodgkin's disease. In the asymptomatic patients (10 cases) biopsy results did not change the given treatment as well as the prognosis, thus, it could be eliminated in a routine study. Biopsy on occasions implied therapeutic management (lymph node tuberculosis) or a change in prognosis (lymphoma or lymphoid depletion) in symptomatic patients (35), therefore, it seems to de justified. Fine needle aspiration of the lymph nodes was harmless and safe and was shown to have good sensitivity (79%), thus, it can be recommended as a first elective diagnostic method for lymph node histology. PMID- 2756210 TI - [Analysis of the bacteriologic data obtained with a double-lumen distally-plugged telescopic catheter in the diagnosis of pulmonary infiltrates in patients on low mechanical ventilation]. AB - In order to assess the bacteriology of bronchial secretion samples, 40 patients in the intensive care unit who had developed fever and pulmonary infiltrates during mechanical ventilation have been studied. In each patient bronchial secretion samples were obtained by a double lumen distally-plugged telescopic catheter (DTC) inserted under direct view through the fiber bronchoscope (FB) as well as from simple bronchial aspiration (SBA) done simultaneously. A week later DTC and SBA were repeated. A statistically significant difference was found between the positive cultures obtained by SBA and those obtained by DTC (p less than 0.005). However, in 9 samples (14.27%) other microorganisms were isolated with DTC which were not detected by SBA and a lower number of colonizing microorganisms were found by DTC (p less than 0.05). The isolation of microorganisms by DTC allowed more precise management and moreover, a better clinical course was observed in those patients in whom chemotherapy was based on the data given by DTC. The relationship between the cultures obtained by DTC and the previous antibiotic treatment was statistically significant, finding a greater number of positive cultures when they were taken 2 hours after the last doses of the antibiotic. This relationship was not found in the cultures obtained with SBA. The most frequently isolated microorganisms were diverse types of Pseudomonas and Acinetobacter. No complication caused by the techniques arose. PMID- 2756211 TI - [2 cases of bilateral diaphragmatic paralysis]. AB - Bilateral diaphragmatic paralysis is characterized by severe dyspnea in decubitus, with or without known respiratory or cardiac disorders. In both patients clinical diagnosis was confirmed by measuring the transdiaphragmatic pressure which was approximately zero. The first patient, previous to the clinical onset, had an episode of gastroenteritis and later developed a pneumonia; in the second patient, clinical manifestations started after neck surgery and both the clinical and functional disorders recovered within the following eight months. PMID- 2756212 TI - [Uniform requirements for manuscripts: the new 3d edition]. PMID- 2756213 TI - [Uniform requirements for submitting manuscripts to biomedical journals. International Committee of Medical Journal Editors]. PMID- 2756214 TI - [Cervical mass and elevated alkaline phosphatase in a young man]. PMID- 2756215 TI - [Alcohol and endocrine pathology]. PMID- 2756217 TI - [Physical exercise and serum potassium in renal insufficiency]. AB - In order to study the effect of physical exercise on serum potassium in renal failure, twelve patients currently on chronic dialysis were subjected to physical exercise by means of an ergometric bicycle. The initial serum potassium was 5.2 +/- 0.6 mmol/l and after the performance of 3.304 +/- 1.583 kilopondimeters of total work, serum potassium was not modified: 5.5 +/- 0.6 mmol/l (p = NS). With regard to the parameters that regulate the intra-cellular distribution of serum potassium, physical exercise aggravated metabolic acidosis, decreasing the blood pH: from 7.33 +/- 0.05 to 7.23 +/- 0.08 (p less than 0.01) and plasma bicarbonate: from 19 +/- 3 mmol/l to 14 +/- 4 mmol/l (p less than 0.01); this was accompanied by a significant and percentage-wise similar increase in plasma epinephrine and norepinephrine. Patients with end-stage renal failure can perform moderate physical exercise, since this does not produce significant changes in serum potassium. PMID- 2756218 TI - [Fructosamine and glycosylated hemoglobin as parameters of hyperglycemia]. AB - We have determined the parameters fructosamine and A1 glycosylated hemoglobin, observing a good correlation between them. When analyzing both techniques, the determination of fructosamine proved to be more precise. Considering the significance of each of the tests, we conclude that these parameters cannot substitute for each other but are complementary and that the convenience of fructose determination can not invalidate the utility of determining the glycosylated hemoglobin. PMID- 2756216 TI - [Complications of acute pancreatitis. Frequency, moment of onset and multiplicity]. AB - One-hundred-six cases of acute pancreatitis have been prospectively studied in order to determine the characteristics of the complications that occur in severe acute pancreatitis (SAP). 19.81% of the patients developed SAP and 7.5% died. Chronic hepatitic disease was the only previous condition found with an increased frequency in SAP patients. We should point out that 90.5% of the patients developed more than one and 38% between 4 and 6 complications during their hospital stay. The most frequently occurring complication was encephalopathy (11.33%) followed by sepsis (8.49%), renal failure (8.49%) and respiratory failure (7.55%). The time of onset of each of the complications was quite variable, ranging from the first hospital day (shock) to the 29th (choledochal stenosis). The patients suffering shock and/or respiratory failure had a greater mortality rate. PMID- 2756219 TI - [Idiopathic anaphylaxis: presentation of 4 cases]. AB - Systemic anaphylaxis is a severe clinical picture, which may result in fatal consequences. It has been reported that in some cases, even after a complete study, the cause is unknown. We report on four clinical cases of anaphylaxis in which, after a detailed study, no etiological factor was found. At least one year later no case recurred. PMID- 2756220 TI - [Prevalence of antibodies against HIV in drug addicts and convicts]. AB - The presence of anti-HIV (human immunodeficiency virus) antibodies was determined in 325 subjects. The samples were taken from 138 convicts from Carabanchel and Ocana I jail, 162 parenteral drug addicts (PDA) from a center for rehabilitation of drug addicts (CR), and from 14 family members and 11 stable couples of these PDAs. There was a global seroprevalence of 61.23%, 56.9% in Carabanchel, 68.7% in Ocana I and 68.5% in the CR. When the results from the jailed convicts were analyzed according to risk factors, it was discovered that drug addiction was the most relevant since there was only a 29.4% of seropositivity in non PDAs with a statistically significant difference (p less than 0.01). This value was also higher than the seroprevalence found in the CR with a statistically significant difference (p less than 0.01). None of the family members of the CR were HIV positive. Two stable couples were positive in this sexual contact group. This article makes clear the important role of drug addiction in the dispersion of HIV infection in our midst. PMID- 2756221 TI - [Tumefaction of the hand in a young man]. PMID- 2756222 TI - [Hemoperitoneum as the first manifestation of hepatic regenerative nodular hyperplasia associated with Hodgkin's lymphoma]. PMID- 2756223 TI - [Oncogenic osteomalacia and Cushing's disease]. PMID- 2756224 TI - [Hashimoto's thyroiditis associated with systemic lupus erythematosus]. PMID- 2756225 TI - [Eosinophilic fasciitis]. PMID- 2756226 TI - [Improving the diagnostic efficacy of carcinoembryonic antigen (CEA) in gastric cancer by the simultaneous administration of Ca 72.4]. PMID- 2756227 TI - [Acromegaly and lung cancer]. PMID- 2756228 TI - [Hypogonadism and intermittent bitemporal hemianopsia as the first manifestation of an arachnoid or cerebral cyst]. PMID- 2756229 TI - [Histiocytosis with hemophagocytosis secondary to Brucella: study of 2 cases]. PMID- 2756230 TI - [Gingival hyperplasia associated with nifedipine]. PMID- 2756231 TI - [Abscess of the psoas muscle and pyomyositis caused by Staphylococcus aureus]. PMID- 2756232 TI - [Neither hepatic colic, nor a liver protection diet]. PMID- 2756233 TI - Endocrine therapy and growth regulation of breast cancer. PMID- 2756234 TI - Effects of steroids and their antagonists on breast cancer cells: therapeutic implications. PMID- 2756235 TI - Serum tyrosine kinase activity and neoplastic disease. PMID- 2756236 TI - Ribosomal protein S6 kinase and PKC in human mammary tumor cells. PMID- 2756237 TI - Modulation by estrogen and growth factors of transforming growth factor-alpha and epidermal growth factor receptor expression in normal and malignant human mammary epithelial cells. PMID- 2756239 TI - Genetic polymorphism of rabbit VHa region: a new allotype, a108. AB - We report a new rabbit IgVH allotype, designated a108, which was detected following studies of the progeny of a wild rabbit (Oryctolagus cuniculus) from Zembra Island (Tunisia). This allotype seems to be specific of this island, since it has not been detected in other wild rabbit populations (in Spain, Portugal or France). Its determinants are located on the Fd fragment of the immunoglobulin (Ig) heavy chain and it behaves like the product of an allele at the alpha locus. Allotype a108 was strongly related serologically to a1 and a107, and to a lesser extent to a101, a109 and a3 allotypes. We also detected determinants shared among the a1, a107, a108, a101 and a109 allotypes. These determinants were expressed by a large fraction of Ig molecules from rabbits of allotype a1, a107 and a108 and by a very small fraction of Ig from rabbits of allotype a101 and a109. PMID- 2756238 TI - Expression of VH11-gene family in hybridoma collections from peritoneum and spleen: differential correlation with BrMRBC reactivity. AB - Hybridoma collections from spleen or peritoneal cells of newborn or adult individuals were screened by RNA hybridization for expression of the VH11-gene family using a V-region probe VCP12, which encodes anti-BrMRBC antibodies. No VH11 expression was observed in hybridomas derived from newborn spleen cells in either BALB/c, NZB or (CBA/N x BALB/c) F1 mice (0/93). Adult NZB and BALB/c spleen cell collections contained only one hybridoma expressing VH11 (1/242). Interestingly, however, the VH11-positive hybridoma showed no anti-BrMRBC reactivity, while one anti-BrMRBC clone in the same collection expressed a Q52 VH gene. In contrast, hybridomas derived from peritoneal cells showed an absolute correlation between expression of VH11 genes and anti-BrMRBC reactivity (15/32). The high expression in the peritoneal cavity of such cells is likely the result of local positive selection. PMID- 2756240 TI - Comparison of in vitro and in vivo systems for propagation of Rift Valley fever virus from clinical specimens. AB - Several cell cultures and animals were compared for their relative sensitivity as primary isolation systems for Rift Valley fever virus (RVFV) and to determine if virulence characteristics of the isolates were altered in these systems. Eleven human sera from known cases of Rift Valley fever (RVF) were obtained from the 1987 epidemic in Mauritania and served as the source of virus for these studies. Sera were inoculated directly into cell cultures (Vero, C6/36 and DBS-FRhL-2) and animals (ICR suckling mice, Lak:LVG(SYR) hamsters and WF rats) concurrently. The cell lines provided a quick method to propagate, quantitate and identify these specimens without prior adaption. The isolates were highly virulent for suckling mice and hamsters, but not for WF rats, even after cell culture passage, which indicated that the Mauritanian isolates more closely resembled those strains from sub-Saharan Africa than those from the 1977-78 Egyptian epidemic. PMID- 2756241 TI - Rift Valley fever infection of rhesus monkeys: implications for rapid diagnosis of human disease. AB - Rhesus monkeys inoculated with Rift Valley fever (RVF) virus provide a model in which serial observations of serum viral antigen and antibodies can be made. In 9 non-fatal and 3 fatal infections, either antigen or IgM enzyme-linked immunosorbent assay (ELISA) antibodies were detected in every serum sample during the acute phase. Furthermore, viral nucleic acid could be detected by filter hybridization in most samples taken on days 1 to 3. Circulation of significant quantities of viral RNA provides an additional approach to the diagnosis and study of RVF. PMID- 2756242 TI - Effect of environmental temperature on the vector competence of Aedes fowleri for Rift Valley fever virus. AB - Studies were conducted to determine the effect of environmental temperature on the ability of Senegalese Aedes fowleri to transmit Rift Valley fever (RVF) virus. Temperatures tested included 17 degrees C, 28 degrees C and a cyclic (17 28 degrees C) regimen designed to mimic temperatures to which a mosquito might be exposed in October in southeastern Senegal. After per oral exposure, infection rates were similar (ca. 93%) for all three groups. However, RVF virus disseminated to the haemocoel more rapidly in mosquitoes held at higher temperatures, with peak dissemination rates (ca. 80%) reached at 11, 18 and greater than 42 days after the infectious blood meal for mosquitoes held at 28 degrees C, cyclic and 17 degrees C, respectively. Likewise, the time interval between ingestion of the viremic blood meal and the first transmission by bite was inversely related to environmental temperature, with the first transmission occurring at 11, 18 and 35 days for mosquitoes held at 28 degrees C, cyclic and 17 degrees C, respectively. After being transferred from 17 to 28 degrees C on days 7 or 14 after the infectious blood meal, mosquitoes rapidly developed a disseminated infection and transmitted virus by bite within 7 days. Environmental temperature significantly affected the vectorial capacity of A. fowleri for RVF virus, with transmission occurring earlier and at a higher rate in mosquitoes held at higher temperatures. PMID- 2756243 TI - On the processing of HIV-2 envelope glycoproteins. PMID- 2756244 TI - Doxorubicin-loaded nanoparticles: increased efficiency in murine hepatic metastases. AB - Free doxorubicin and doxorubicin associated with polyisohexlycyanoacrylate were tested for their therapeutic efficiency in hepatic metastasis-bearing mice. The metastases originated from the M 5076 reticulum cell sarcoma. Irrespective of the dose and the administration schedule, the reduction of the number of metastases was much larger with the doxorubicin-loaded nanoparticles than with free doxorubicin. This was clearly confirmed by histological examination. Although pharmacological and pharmacokinetic data indicated a strong capture of the nanoparticles by the hepatic issue, the mechanism of nanoparticle therapeutic efficiency remains unclear. PMID- 2756245 TI - Effects of physiological oxygen environment on drug-induced cell lethality of multicellular tumor spheroids from human lung cancer. AB - Advanced malignant tumors of certain histological types contain a hypoxic and necrotic core. Multicellular tumor spheroids (MTS) have the characteristics of chronically hypoxic cells in the center. We studied the effects of physiological oxygen environment on MTS growth and the cell lethality produced by doxorubicin (DXR) and cisplatin (DDP). MTS were made from 2 human lung cancer cell lines; PC 6 small cell and PC-10 squamous cell carcinoma, and grown for 2, 3 or 4 weeks; either in 5% CO2/air or 5% 02/5% CO2/90% N2. They were exposed to graded concentrations of DXR for 1 hr and cell lethality was determined by clonogenic assay. In the physiological oxygen environment MTS growth was retarded for both cell lines. PC-6 MTS grown in physiological oxygen environment were more sensitive to DXR than those developed in air. The differential sensitivity was most pronounced with the 2 week old MTS and gradually narrowed with increasing MTS size. In contrast, PC-10 MTS developed in the physiological oxygen environment were more resistant to DXR than those in air; the differences were again most pronounced in 2 week old MTS. There were little differences in cell kill effects of DDP, irrespective of cells being in monolayer or in MTS and growing in air or in physiological oxygen environment. These observations are consistent with the interpretation that cells in PC-6 MTS are scarcely affected by the physiological oxygen environment but easily affected by DXR, whereas cells in PC-10 MTS responded vice versa. PMID- 2756246 TI - Dissolution and stability of carmustine in the absence of ethanol. PMID- 2756248 TI - Aging brains: some observations. PMID- 2756247 TI - Differential tumor regression in patients with bilobar hepatic metastases and dual arterial supply: evidence supporting the advantage of intra-arterial over intravenous route of drug delivery. AB - Two patients with bilobar liver metastases were characterized by dual arterial blood supply to the liver. Treatment of both patients by the administration of chemotherapy, selectively via the arterial branches supplying the respective hepatic lobes bearing the metastases, resulted in differential tumor regression/progression. Thus, while the metastases borne by the arterially infused lobe regressed, the counterpart in the other (systemically infused) lobe showed marked progression. This phenomenon lends strong support to the notion that arterial infusion of chemotherapy in cases of regionally predominant (or confined) neoplastic disease, i.e., in the liver, is superior to the intravenous administration of similar drugs. PMID- 2756249 TI - Neurologic problems in the elderly. PMID- 2756250 TI - Aging, neurologic disability, and family caregiving. PMID- 2756251 TI - Looking and seeing with age-related neurologic disease and normal aging. PMID- 2756252 TI - Instability and falling in elderly patients. AB - Falls and instability in elderly patients may result from a single disease process or from the accumulated effect of multiple diseases and impairments. Therefore the first step in evaluating an elderly patient with a history of falling or instability is to identify single, potentially treatable diseases, such as normal pressure hydrocephalus, cervical spondylosis, or lumbar stenosis. The next step, regardless of whether or not a single disease process is identified, is to determine all factors possibly contributing to instability. This step involves a careful history and examination using the checklist approach already described. Careful recreation of the fall situation including location, activity engaged in, how the patient was feeling, and any environmental hazards present is an important part of the fall history. Re-creating the fall situation may provide important clues toward etiology as well as prevention. Interventions aimed at ameliorating identified impairments should be considered. Obviously, interventions need to be considered within the context of overall patient health and well-being rather than merely fall prevention. Fall preventive interventions may be medical, surgical, rehabilitative, or educational, or may involve environmental manipulations. Examples include surgery and good lighting for subjects with cataracts, adaptive footwear or surgery for patients with severe foot deformities, or physical therapy, appropriate walking aids, and raised seats for subjects with difficulty or unsteadiness in getting up. Instability and falling are not inevitable accompaniments of aging, but are problems that result from identifiable disabilities and impairments.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2756253 TI - Disorders of movement in aging. PMID- 2756254 TI - Urinary incontinence in the elderly. PMID- 2756255 TI - Neurophysiology of aging. PMID- 2756256 TI - Examination of the highest cerebral functions in the elderly. PMID- 2756257 TI - Examining the aging nervous system. PMID- 2756258 TI - [Surgical reconstruction possibilities in facial paralysis]. PMID- 2756259 TI - [The development in smoking habits in Canton Bern 1977 to 1987. Survey of smoking habits through regular x-ray screening in industry]. AB - The smoking habits of workers were registered on occasion of chest-x-ray screening over the eleven years period from 1977 to 1987 in Berne, Switzerland. In 1977 about 52% of the males were smoking. During the eleven years a decrease in prevalence of smoking can be observed in the male population. The decrease is more pronounced among older than among younger males. Young women smoke more frequently than older women. The prevalence has remained stable at about 28% in the female population between 1977 and 1987. These findings are in accordance with other Swiss studies and show that in Switzerland the preventive radiodiagnostic institutions are important vehicles for community oriented prevention and prevention research. PMID- 2756260 TI - [Health care needs, brain functional ability, social behavior and social attendant circumstances of elderly patients in community and institutionalized geriatric care in the city of Zurich]. AB - All aged persons being helped by community nursing-services, the house-helper service, the housekeeper service, or living in a home for the aged or in an apartment for seniors in a representative area of the city of Zurich are compared to all patients in nursing-homes of the city. This study included the size of social network measured by the number of different regular visitors, the number of different medications taken daily, the cognitive abilities measured by the Mini Mental Status, the activities of daily living and the social skills rated by the care-givers as well as the intensity of the care given. The groups were similar in age and sex-distribution but the nursing-home patients differed significantly in all other parameters from the others. In contrast, no significant differences could be found between persons receiving care in their homes and those in institutions for the aged. PMID- 2756261 TI - [A case from practice (141). Patient: Mr. Z. P., born 1927, electrician]. PMID- 2756262 TI - [Disseminated nocardiosis due to Nocardia brasiliensis in an ambulatory patient]. AB - We report the case of a 76-year-old man with generalized nocardiosis. The microbiologic pattern, the different clinical manifestations and the treatment of nocardiosis are discussed in general. In the particular case of our patient the disease manifested itself primarily as a subcutaneous abscess, a metastasis secondary to pulmonary nocardiosis. The disease was caused by a Nocardia brasiliensis, which is rarely seen in Europe and which does not usually cause a generalized form of nocardiosis. PMID- 2756263 TI - [Prognosis in ambulatory medicine. A lecture presented to Lausanne students in the framework of a course in general medicine]. PMID- 2756265 TI - [Treatment of ascites in liver cirrhosis]. PMID- 2756264 TI - [A case in practice: association of diarrhea and vision disorder in a 22-year-old man. Manuel Jose M., 1965, visits the doctor for diarrhea with vision disorder]. PMID- 2756267 TI - [Fever, productive cough, night sweats]. AB - A 43 year old male complained about fever, productive cough and nocturnal sweating. He was treated for pneumonia with antibiotics because of pulmonary infiltrate. Tomography revealed a large cavity with infiltrated border in the right inferior lobe. By means of bronchoscopy the diagnosis of bronchial tuberculosis was established. Mycobacterium tuberculosis was cultured. A comparison with previous radiographs suggested a duration of the disease of approximately 3 years. A combined chemotherapy with isoniazide, rifampicin and pyrazinamide resulted in rapid disappearance of symptoms and to regression of radiologic changes. The cavity persisted after 9 month of treatment. PMID- 2756266 TI - [Bacterial susceptibility to chemotherapeutic agents (Zurich, 1987)]. AB - This paper describes the frequency of susceptibility of Gram-positive and Gram negative bacteria against antibacterial agents. The data are based on all susceptibility tests performed at the Department of Medical Microbiology of the University of Zurich. The evaluation of the results from 1975 to 1987 shows that susceptibility against standard antimicrobial agents has not decreased in this period. These tables may be a valuable help for the physician in his decision for a "calculated chemotherapy". PMID- 2756268 TI - [When, how and why should an inflammatory dermatosis be biopsied?]. PMID- 2756269 TI - [Which are the nevomelanocytic nevi which should be excised?]. PMID- 2756270 TI - [Current treatment of psoriasis]. PMID- 2756271 TI - [Hospital or ambulatory delivery: there no longer is room for childbirth at home!]. PMID- 2756272 TI - [Percutaneous nucleotomy with discoscopy: experiences since 1979 and current possibilities]. PMID- 2756273 TI - [The therapeutic value of hysteroscopy in the treatment of uterine hemorrhage and infertility]. PMID- 2756274 TI - [Emergency care by the practitioner in injuries of the hand]. PMID- 2756275 TI - [Pancreatic abscess. Extraperitoneal drainage]. AB - The pancreatic abscess occurs in two to six per cent of patients with acute pancreatitis and in 40 to 50 per cent of whom develop the severe form of the disease. The postoperative morbidity rate is 85 to 90 per cent and the mortality rate is 30 to 50 per cent due to persistence or recurrence of infection. The anatomical location and dissemination of the pancreatic abscess allows an extraperitoneal approach. Twelve patients with pancreatic abscess are reported. Seven males and five females, with an average age of 36 years. Fever, abdominal pain, cutaneous hypersensitivity and palpable abdominal mass were the most frequent clinical signs. Most of them developed multiple organic failure, leukocytosis, hyperglycemia, increasing L.D.H. and alkaline phosphatase levels. The CAT scan was most useful to localize the abscess. About 83 per cent of patients had been operated on previously. The extraperitoneal surgical approach was anterior in 10 patients and posterior in two patients. Ten patients developed complications that resolved with conservative measures. Two patients (17%) died. Extraperitoneal drainage is a valid alternative to prevent peritoneal contamination and some other serious postoperative complications in the management of pancreatic abscess. PMID- 2756276 TI - [Retrospective evaluation of 500 endoscopic cholangiopancreatographies performed at the Instituto Nacional de la Nutricion "Salvador Zubiran"]. AB - We evaluated 500 endoscopic retrograde cholangiopancreatographies (ERCP) performed on 422 patients during a 5-year period in the Gastrointestinal Endoscopy Department, Instituto Nacional de la Nutricion Salvador Zubiran, Mexico, D.F. ERCP combines endoscopic and radiologic techniques in order to obtain high quality opacification of pancreatic and biliary ducts. The rate of success for cannulation was 90%; desired duct opacification was possible in 89%. The most frequent indication for ERCP was to establish the differential diagnosis for jaundice; biliary stones in the common bile duct was the most frequent diagnosis, followed by normal biliary ducts. Pancreatography was normal in 74% of patients. ERCP complications were detected in 5.6%; fever and transient pain was the most common complaint in 1.6%. Mortality attributable to the procedure was 0.8%. From histological corroboration of cases by surgery or postmortem studies, diagnostic sensitivity was 92%, specificity 76%, positive predictive value 96% and a prevalence of 89%. We conclude that ERCP is highly sensitive and specific in diagnosing bilio-pancreatic-duodenal disease. Our results are comparable to other's experiences published throughout the world. PMID- 2756277 TI - [Peri-choledochal varices. (Report of a case)]. AB - A case presentation of choledochal varices is published. Operative findings show extrahepatic portal hypertension, secondary to postoperative fibrosis and adhesions following cholecystectomy and choledochal stone extraction 15 and 3 years before this hospitalization. PMID- 2756278 TI - [Spontaneous drainage of a pancreatic abscess into the digestive tract]. AB - Pancreatic abscess is a serious complication of acute pancreatitis and the best treatment is surgical drainage, even when morbidity and mortality are high. We present a patient with a pancreatic abscess after cholecystectomy and bile duct drainage because of cholelithiasis and pancreatitis. The abscess was manifested by a palpable painful mass in the epigastrium, fever, leukocytosis, and confirmed by ultrasound. Through a nasogastric tube we drained necrotic and purulent material with gradual and complete recovery. This is the first case in our hospital in which a pancreatic abscess drained spontaneously into the digestive tract without requiring external drainage. PMID- 2756279 TI - [How to read medical journals. 2. To learn about a diagnostic test]. PMID- 2756280 TI - [Health directions. Nursing education in emergency care]. PMID- 2756281 TI - [Strategies for the future]. PMID- 2756282 TI - [Tokombere: a history of hope]. PMID- 2756283 TI - [In Holland, the nurse does everything...]. PMID- 2756284 TI - [In The Netherlands, the nurses have a hierarchy]. PMID- 2756285 TI - [Learning to work "elsewhere"]. PMID- 2756286 TI - [Can we prevent sudden death in the cardiac patient?]. PMID- 2756287 TI - ["The new quality" has arrived!]. PMID- 2756288 TI - [Nursing care in plastic surgery]. PMID- 2756289 TI - [Basic Nutrition (2)]. PMID- 2756290 TI - Care for the terminally ill. PMID- 2756291 TI - Hospice care of Rhode Island: past, present and future. PMID- 2756292 TI - Hospice care of Rhode Island: 1989. AB - Hospice care is an extension of primary care expressly designed to meet the human needs of the terminally ill patients and their families. Its nurses, volunteers, social workers, clergy and physicians, working collaboratively with the primary physician, seek to keep each patient free of pain, in a humane environment and to meet, where possible, immediate social needs. PMID- 2756293 TI - Reflections and remembrances. AB - Two brief and very personal essays written by practicing nurses in the Rhode Island community. These commentaries reflect their remembrances of the human dimensions of dying and the role of hospice in easing the accompanying burdens of anguish and grief. PMID- 2756294 TI - [How much, whom and what does the control ticket restrain?]. PMID- 2756296 TI - [How to promote health]. PMID- 2756295 TI - [A study on hip injuries]. PMID- 2756297 TI - [The social image of nursing. An opinion poll of the consumer]. PMID- 2756298 TI - [Surgical psychoprophylaxis in gynecology]. PMID- 2756299 TI - [Tuberculosis. A problem against which to fight]. PMID- 2756301 TI - [Continuing education. 38. Subject: the behavioral sciences. Topic: assessing the patient's mental state]. PMID- 2756300 TI - [Food habits and consumption (II). A survey conducted in Catalonia]. PMID- 2756302 TI - [Syndromes: from rapeseed oil to Bellvitge]. PMID- 2756303 TI - [Diseases of the upper aerodigestive tract and neck--clinical aspects and challenges for the radiologist]. AB - Based on the anatomy of the neck, some very characteristic inflammatory or tumorous diseases are demonstrated. The question is raised as to how far the radiologist can help the surgeon to estimate the extent e.g. of an abscess or a malignoma, so that the patient can receive the most adequate treatment. PMID- 2756304 TI - [Diseases of the aerodigestive tract and of the soft tissues of the neck. Comparison of MRI and CT]. AB - CT and MRT are compared with each other in examinations of the aerodigestive tract in 250 patients. MRT was found to be the method of highest sensitivity and specificity after intravenous administration of the contrast medium Gd-DTPA. Magnetic resonance tomography was found to be clearly superior to computed tomography on account of the 3-dimensional imaging possibilities, improved contrasting of soft parts, and freedom from artifacts. In space-occupying growths of the nasopharynx, oropharynx and hypopharynx, the primary use of MRT must be considered mandatory in diagnostic strategy planning. CT occupies the second rank and can be used for optimised visualisation of small osseous lesions and for digital subtraction angiography (DSA). The latter plays an important role in the analysis of selective vascular supply and in diagnosis before intraarterial chemotherapy. In respect of processed in the soft tissues of the neck, pathological lesions of the lymph nodes, vessels, soft parts and cervical processes are differentiated (n = 139). For the diagnosis of the entire neck region, magnetic resonance tomography with the additional use of the contrast medium Gd-DTPA proves to be the method with the highest rate of accuracy. In processes of the soft tissues, sonography can also be employed as a primary diagnostic tool. However, in certain localisations and lesions this method can only be used with certain restrictions. According to the present state of the art, computed tomography must be considered as a secondary procedure in the diagnosis of the neck region. PMID- 2756305 TI - [Comparison of sonography of the soft tissues of the neck with computerized tomography and magnetic resonance]. AB - Ultrasound B-scan, computed tomography and magnetic resonance imaging are currently used in the diagnosis of head and neck tumours. Screening of head and neck tumours should be performed by high resolution B-scan. Its high diagnostic sensitivity, minimal imaging artifacts, real-time recording and its minimal costs are outstanding features. CT is superior in imaging of bony structures; on the other hand, MR is superior in demonstrating site, border and topography of tumours and lymph nodes. Postoperative and/or post-irradiation follow-up of head and neck tumours should be done by sonography which allows differentiation of oedema, scars and tumour recurrence. The parapharyngoscopic sonography, echography, CT and MR can deliver different aspects in planning of neck surgery. An adequate diagnostic schedule is presented. PMID- 2756306 TI - [Possibilities in current radiotherapy of head and neck malignancies]. AB - Radio-oncology ranks highly in the treatment concept of tumours of the head and neck. Radiotherapy alone yields excellent rates of remission and cure with good cosmetic and functional results if applied in an early stage. Advanced tumours require the use of combined treatment modalities including surgery, radiotherapy and chemotherapy. The results of radiotherapy show a close relation to the applied dose in the target volume. This dose depends on the histology of the tumour, its localisation, its size, and the extent of involvement of lymph nodes. Radio-oncologically one can expect an increase in the rate of cure in higher tumour stages by the use of interstitial brachycurie therapy, intraoperative radiotherapy, hyperthermia and the employment of radiosensitisers of low toxicity. Close interdisciplinary cooperation is essential for achieving the best possible success of treatment. PMID- 2756307 TI - [Comparison of 2 positive and 1 negative oral contrast media for abdominal CT diagnosis]. AB - In a prospective randomised study three groups of 30 patients each were subjected to CT of the entire abdomen. The oral intestinal contrast media used were iodine solution (2%), barium suspension (1.5%) and paraffin emulsion (25%). The results were evaluated according to imaging, artifacts, ability to assess the intestinal wall, taste and side effects. All three contrast media are suitable for marking the gastrointestinal tract; paraffin shows advantages in the upper part of the tract and is the only medium that enables assessment of the wall, while causing the lowest rate of artifacts. Barium has a high acceptance and the best tolerance of all contrast agents. PMID- 2756308 TI - Omnipaque and Gastrografin in gastrointestinal follow-through examinations. AB - The non-ionic low-osmolar contrast medium Omnipaque was compared with the conventional ionic high-osmolar contrast medium Gastrografin in a randomized, double blind study comprising 71 consecutive gastrointestinal follow-through examinations performed because of suspected ileus or anastomosis control. The patients' reaction were confined to nausea, emesis and diarrhoe being very similar in both groups and related to the patients' illnesses. The taste of Gastrografin was more often judged unpleasant, but the difference was not significant. Omniplaque scored significantly better for contrast medium density and diagnostic visualisation in the small bowel, otherwise the differences were negligible. There were no significant differences in the transit time into the caecum. The high price of Omnipaque restricts its routine use. It may be diagnostically indicated in selected cases where greater accuracy in the delineation of pathologic anatomical details in the small bowel is desired. PMID- 2756309 TI - [A new concept for conventional x-ray diagnosis in intensive medicine]. AB - A modified examination concept to improve conventional x-ray diagnostics in a intensive-care unit is presented. This planning is based on the development of new technical components in the field of mobile diagnostics and the availability of improved basic materials that can certainly promote such a project. This is presently being installed in the Clinical Centre of the University of Gottingen and will be subjected to a critical cost/efficiency analysis during a run of one year. PMID- 2756310 TI - [Requirements in radiologic diagnosis from the internist-cardiology viewpoint]. AB - The article discusses the demands to be made on the various radiological methods in thoracic diagnostics in respect of their informative value for therapeutic consequences, as seen from the viewpoint of internal-cardiological intensive-care medicine. The importance of x-ray thoracic film in one or two planes is emphasised, with special reference to routine imaging. In consideration of the demonstration of essential pathological findings, routine chest x-ray film would be mandatory only the 40th year of age onwards and lateral projection from the 50th year. At any rate, about 50% of routine thorax x-rays in intensive-care wards show changes, the percentage being higher if there is a clinical suspicion of changes. Mention must be made of a so-called time phase lag between the x-ray thoracic findings and changed pulmonary arterial pressure. In diagnosis of pulmonary artery embolism the nuclear medicine methods are compared with pulmonary arterial angiography, taking sensitivity and specificity into account. 90% of pulmonary embolism show only non-specific changes in the chest x-ray. Together with these and perfusion scintigraphy a sensitivity of 98% can be attained, albeit with lower specificity, since perfusion angiography and angiography agree in only about 87% of the cases. The demands to be made on radiological diagnostics must be determined from case to case by the diagnostic effectivity in relation to the technical setup and cost. The cost aspect of the individual methods is of major importance when installing equipment in hospitals. PMID- 2756311 TI - [Thoracic diagnosis at the intensive care unit: digital radiography]. AB - Only few reports have been published so far on the clinical use of digital luminescence radiography (DLR). We report on 3.000 x-ray examinations of the thorax in the intensive-care ward performed by us since a suitable system (Philips PCR) had been installed in December 1987. The following advantages must be pointed out in respect of using DLR in thoracic diagnosis in the intensive care ward: No faulty exposures; the thorax can be x-rayed with the patient recumbent in bed, with lateral take: the image brightness in maintained at a constant level by histogram selection; electronic image processing and storage. Hence, DLR entails considerable improvement in x-ray diagnosis of intensive-care patients. PMID- 2756312 TI - [Bedside pictures and thorax-CT of intensive care patients]. AB - Computed tomography is a rare radiologic procedure in the intensive-care patient. This is due to the complicated procedure involved. Although x-ray film imaging in the supine patient has definitely improved in quality, computed tomography will continue to be used as the decisive method in cases that cannot be clarified completely, i.e. complex lesions, drainage, in the first examination of a polytraumatic patient, in the search for empyemas and abscesses, and in the clarification and identification of mediastinal processes. PMID- 2756314 TI - [Echocardiography in intensive care medicine]. PMID- 2756313 TI - [Acute pulmonary edema at the intensive care unit]. AB - 760 patients suffering from acute pulmonary oedema were treated between 1980 and 1986 at the Institute of Anaesthesiology of the Medical Academy in Wroclaw. The radiological image of the pulmonary oedema was sub-divided into three forms (hilar, hilar and perihilar, and hilar with massive plane-shaped infiltrates). In the treatment of acute pulmonary oedema in the intensive-care ward a thorough diagnostic programme is mandatory after the immediately necessary measures have been taken. PMID- 2756315 TI - [Results of autopsy examination of the knee cartilage of 120 patients dying in the hospital. II. The femoro-tibial joint]. AB - The authors have studied the autopsy results of both tibio-femoral joints in 120 patients: 57 women and 63 men, 112 of whom were over the age of 50. The condylar and tibial cartilages were classified into 5 categories: no lesion (0); slight fissure (I); severe fissure (II); slight deep ulceration (III); large ulceration (in more than 25 p. cent of the cartilage surface) exposing the sub-chondral bone (IV). In 120 patients, the 4 condyles in 58 patients (43.8 p. cent) and both tibio-femoral joints in 51 patients (42.5 p. cent) did not present any degenerative lesions beyond stage I. Stage III and IV cartilaginous lesions are rare before the age of 50. Their frequency suddenly increases after the ages of 70 in women and 80 in men. 44 p. cent of women and 31 p. cent of men presented tibio-femoral cartilaginous lesions of stages II or IV in at least one knee; 15.8 p. cent of women and 4.7 p. cent of men presented tibio-femoral lesions, stage IV, in at least one knee. In 58 p. cent of stage III and IV knee lesions, the menisci were abnormal: atrophic or torn. A menisco-chondrocalcinosis was found in 50 knees (20.8 p. cent of knees) of 28 patients (23.3 p. cent of patients). After the age of 60, the cartilaginous lesions were more severe and more extended in knees with menisco-chondrocalcinosis). PMID- 2756316 TI - [Diabetic cheiroarthropathy]. AB - Cheiroarthropathy is quite frequent in diabetics, but is only really specific at stage III, which is the most characteristic form. It is all the more frequent as the diabetes is old, but remains unrelated to sex, age and type of diabetes. The stiffening of the joint readily extends to other joints. The patients are moderately alerted in the absence of other associated pathologies: trigger finger, Dupuytren's disease, carpal tunnel syndrome. All these manifestations form the "diabetic hand", of which cheiroarthropathy is only one component. The need for an accurate analysis with the purpose of appropriate treatments, should be emphasized. The angiologic and histopathological study of patients with stage III cheiroarthropathy, enables us to demonstrate moderate abnormalities of the microcirculation, which are quite different from those encountered in sclerodermia. The etiopathogenesis of cheiroarthropathy remains mysterious and is probably related to an alteration of the collagen metabolism. One of the most interesting component is the association between cheiroarthropathy and the micro angiopathic complications of diabetes mellitus: cheiroarthropathy being the indicator of such diabetes. PMID- 2756317 TI - [Neuro-rheumatologic manifestations in patients infected with the AIDS virus]. AB - We are reporting 3 cases of lumbo-radiculalgia, simulating the usual picture of herniated disc, and revealing complications related to the virus of acquired human immunodeficiency (HIV). Rheumatologists must be aware of any atypical clinical signs in patients suffering from lumboradicular disease, and search for a HIV infection. PMID- 2756318 TI - [Systematic study of various tumoral markers in prevalent bone metastasis]. AB - In the presence of prevalent bone metastases, the precise histo-pathological diagnosis of the primary tumor is often difficult. The authors study the diagnostic value of systematic serum assay of a series of tumoral tracers (ACE, AFP, PAP and PSA, SCC, CA 19:9, CA 15:3, CA 125) which until now were used in evolutive and therapeutic monitoring. 34 patients were selected for this preliminary retrospective study (including 20 with a demonstrated histopathological diagnosis). 70 p. cent of prevalent bone metastases express a target tracer corresponding to the initial location. In some cases, an elevated tracer, because of its specificity, may bring about a diagnostic or therapeutic decision (always according to the context). No conclusion may currently be drawn in case of discordance between the anatomo-clinical context and the "profile" of the markers (1 case in our series). PMID- 2756319 TI - [Chronic intermittent dialysis and cervical spine involvement. A cross-sectional study of 55 cases]. PMID- 2756320 TI - [Foot root arthrosis]. PMID- 2756321 TI - [Vertebro-basilar vascular accident after manipulation of the cervical spine]. PMID- 2756322 TI - [Hypocalcemia induced in patients with Paget's disease by nasal salmon calcitonin. Effects of anti-calcitonin salmine antibodies]. PMID- 2756323 TI - [Evaluation of the hospital cost of femoral neck fractures]. PMID- 2756324 TI - [Streptococcal meningitis secondary to inoculation. 2 cases]. PMID- 2756325 TI - [Fractures caused by bone insufficiency of the femoral neck revealing a radiographic lesion of the hip. Value of MRI apropos of 2 cases]. PMID- 2756326 TI - [Frontal osteoid osteoma]. PMID- 2756327 TI - [Algodystrophia and malignant tumors]. PMID- 2756328 TI - Parathormone and calcitonin secretion in endemic goiter. AB - The investigations performed on 160 females of adult age with goiter and clinical signs of spasmophilia followed up the serum and urinary calcium and magnesium. The calcitonin and parathormone circulating levels were also determined. Although the levels of serum and urinary calcium and magnesium appear normal in adult subjects with simple goiter, decreased levels of the circulating parathormone were confirmed in most cases. The values of circulating calcitonin were within normal limits. The moderate hypoparathyroidism noted is an indication of the possible association of "parathyroid dystrophy" with endemic goiter. PMID- 2756329 TI - Unilateral exophthalmos through non-Hodgkinian malignant lymphoma. AB - A 57-year old male patient with unilateral exophthalmos was transferred to our hospital from an Ophthalmologic Clinic for suspicion of Graves' disease. Lateral skull X-ray showed the optic holes and orbits within normal limits. Orbital echography and CT scan revealed an intraorbital tumor which on histopathologic examination proved to be malignant lymphoma. PMID- 2756330 TI - Effect of pineal treatment on rat HDL-cholesterol under basal conditions and under stimulation with HCG. AB - The effect of the pineal extract and that of two fractions, f1 and f2, one above, the other 10,000 daltons obtained by ultrafiltration of the extract, on HDL cholesterol as well as on cholesterolemia and testosterone, under basal conditions and under exogenous HCG stimulation was followed up. Under basal conditions, the pineal extract induced a statistically significant decrease in the 3 biochemical indices, an effect which was also recorded with the two fractions, with the difference that the effect of f2 is more intense and significant as compared to f1, whereas the effect of the pineal extract appears more intense than that of the fractions. Under exogenous HCG stimulation, the pineal extract and less the fractions, partly inhibited the lowering effect of HCG on cholesterol and the rising effect of this hormone on testosterone. The role of the equilibrating agent of the pineal extract on HDL-cholesterol, cholesterolemia and testosterone, is discussed. PMID- 2756331 TI - Paediatric auditory brainstem response and pure-tone audiometry: threshold comparisons. A study of 142 difficult-to-test children. AB - Auditory brainstem response (ABR) thresholds have been determined in 142 anaesthetized 'difficult-to-test' children. The stimuli employed were 2-kHz tone bursts. Pneumatic otomicroscopy was carried out prior to the ABR assessment in all cases, and diagnostic myringotomy was performed when there was the slightest suspicion of abnormality. Long-term follow-up pure-tone audiograms were obtained in 56 patients. A comparison was made between ABR and pure-tone thresholds in the 2-4 kHz range both in healthy middle ears and in ears having middle ear effusion (MEE) at the time of ABR measurement. A correction factor for prediction of behavioural threshold from the ABR threshold both in healthy and in MEE ears is proposed. PMID- 2756332 TI - Speech recognition scores and ABR in cochlear impairment. AB - The relationship between the speech recognition scores (SRS) in noise and the auditory brain-stem evoked response (ABR) was examined in 7 males (age range: 40 to 60 yrs) with fairly similar audiograms but different SRS. The Spearman rank order correlation coefficient revealed a significant relationship between SRS and latencies of waves I and II of the ABR. The results are discussed in terms of neural degeneration and representation of speech stimuli in the auditory nerve. PMID- 2756333 TI - Patients' attitudes to the bone-anchored hearing aid. Results of a questionnaire study. AB - A questionnaire constructed to evaluate subjective patient opinions about a new bone-anchored hearing aid was sent to the first 65 patients who underwent this treatment. All 62 patients who were reached responded to the questions formulated according to the critical incident approach. 74% of the patients stated that they were very pleased with what they regarded as an improved sound transmission. 32% of the patients had noticed a qualitative improvement and the same percentage spontaneously commented on their improved cosmetic appearance with the new hearing aid. PMID- 2756334 TI - Effect of direction of pressure change on obtaining airtight seals in tympanometry. AB - To determine the effect of change in pressure direction on obtaining a seal during tympanometry, an ascending approach (-/+) was attempted when the traditional, descending approach (+/-) was unsuccessful in maintaining an airtight seal. Results revealed that a seal was achieved using the ascending direction in twelve ears when the descending method failed; in only four ears, neither method was successful. PMID- 2756335 TI - In vitro considerations in the production of dimensionally accurate earmoulds. II. The earmould material. AB - In the first part of this work, the accuracy of impression materials was studied. In the present paper, the dimensional accuracy of a range of hard and soft polymeric earmould materials was studied and found to be a function of choice of material, processing equipment, curing cycle, time after processing, and choice and storage time of impression material. It was noted that generally speaking the overall shrinkage of a two-stage specimen is approximately equal to the sum of the impression shrinkage plus processing shrinkage. Clinical trials are now being conducted to assess the real ear performance of earmoulds as a function of material accuracy and flexibility. PMID- 2756336 TI - Free-field sensitivity level of audiometric earphones to be used for speech audiometer calibration. AB - Speech audiometric test results strongly depend on the frequency response of the equipment used for speech transmission. For the comparison of data measured with different kinds of acoustic transducers, e.g. earphones and loudspeakers, a common reference basis for the specification of the frequency response of speech audiometers is therefore needed. The most obvious basis is the free sound field. In order to provide data for earphone specification in terms of the equivalent free-field response, which are to be included in an IEC standard on speech audiometers under preparation, comprehensive loudness comparison measurements with free progressive sound waves were performed on various audiometric earphones. When these data are used, calibration and testing of speech audiometers are as simple as in the case of puretone audiometers. PMID- 2756337 TI - Masked threshold changes associated with angular separation of noise and signal sources. AB - Threshold changes associated with separating a signal source and a masking white noise source from 0 degree to 90 degrees were determined for 0.5, 1 and 8 kHz pure tones and click trains. No changes occurred for the 0.5 and 1 kHz pure tones. Masked thresholds of 8 kHz pure tones and click trains decreased linearly by 9 and 13 dB respectively as angular separation was moved from 0 degree to 90 degrees. Changes in click train stimuli masked thresholds did not change significantly when the ear directed toward the masking source was occluded (11 dB drop at 90 degrees). The absence of changes at low frequencies and the similarity in magnitude of the changes in signals containing high frequency components with the responses to the monaural click trains, suggests that the threshold changes can be attributed to a head shadow effect. The casting of a sound shadow effectively lowers the noise level on the shielded side. These findings question the importance of cross-correlation techniques when detecting signals in noise. PMID- 2756338 TI - Skull simulator for direct bone conduction hearing devices. AB - The Bone-Anchored Hearing Aid (BAHA) is a direct bone conduction hearing device which has given patients with various middle ear disorders a significantly improved quality of life. As the BAHA has gained acceptance as a valuable contribution to the Swedish hearing aid rehabilitation program, the need for equipment which can perform objective frequency response measurements has grown. Such equipment is indispensable for carrying out quality assurance, service, and fitting evaluation. To meet the above-mentioned demands, the skull simulator TU 1000 has been developed. The dynamic behaviour of the skull simulator TU-1000 can be characterized as that of a rigid mass body with a weight significantly exceeding the weight corresponding to the dynamic mass of the transducer incorporated in the BAHA. The motions of the mass body are measured by an accelerometer the output signal of which is amplified by a precalibrated amplifier. The output signal is proportional to the output force level from the BAHA. The skull simulator TU-1000 is capable of measuring the output force level from the BAHA with high reliability for frequencies ranging from 100 Hz to 10 kHz. PMID- 2756339 TI - Are delayed evoked oto-acoustic emissions (DEOE) solely the outcome of an active intracochlear mechanism? AB - Post-mumps and post-measles hearing losses are a result of the destruction of Corti's organ. Both the basilar and the Reissner membranes are unimpaired. In 11 subjects with post-mumps (8 cases) and post-measles (3 cases) unilateral anacusis, DEOE with a mean amplitude lower than that of the contralateral normal ear with the same sensation level were observed with 0.5, 1 and 2 kHz tone-bursts and air conduction stimulation. These findings lend credit to the view that DEOE could in part be produced by a passive intracochlear mechanism, probably a consequence of the basilar membrane travelling wave induced by the displacement of the perilymph. In a normal ear, this passive mechanism could be superimposed by an active mechanism linked to the contractile activity of the outer hair cells (OHC) which modulates and increases the travelling wave depth. PMID- 2756340 TI - Affinity purification of IgG subclasses and the distribution of thyroid auto antibody reactivity in Hashimoto's thyroiditis. AB - To delineate accurately the IgG subclass distribution of thyroid auto-antibodies, sera from nine patients with Hashimoto's thyroiditis were fractionated into IgG subclasses by complete depletion of the other IgG subclasses on affinity columns. All IgG subclass fractions contained thyroglobulin and microsomal (or thyroid peroxidase) antibody activity, although when compared to the total serum concentrations of IgG subclasses, IgG4 antibodies were overrepresented. However, in contrast to recent studies, this particular subclass never predominated--IgG4 antibody levels being exceeded by those of the IgG1 and IgG2 subclasses; it seems likely that these differences relate to varying sensitivity for different subclasses in previously used assay methods. This pattern of subclass activity differed from that of tetanus toxoid antibodies, which were found in six subjects. There was no light chain restriction within any subclass, showing that the overproduction of IgG4 thyroid antibodies is not of monoclonal origin. The functional affinity of subclasses for both thyroid antigens varied between patients, but IgG2 subclass fractions showed the highest functional affinity in the majority of samples. We also found that IgG2 subclass thyroid antibodies were ineffective in eliciting antibody-dependent cell-mediated cytotoxicity, as distinct from the other three subclasses. Our results show that thyroid antibodies are less restricted in their IgG subclass distribution and patients are less heterogeneous than previously described. Moreover, IgG2 thyroid antibodies are quantitatively important and differ in relative functional affinity and effector function from IgG1 and IgG4 thyroid antibodies. PMID- 2756341 TI - Chemiluminescence of polymorphonuclear leukocytes and whole blood during acute bacterial infection. AB - The purpose of this study was to follow the changes in oxidative metabolism of polymorphonuclear leukocytes (PMN) and whole blood, during and after an acute bacterial infection, in otherwise healthy individuals, with the hypothesis that the majority of the subnormal activities found at clinical investigation of PMN functions in this respect, as part of the investigation of individuals with increased susceptibility to bacterial infections, is explained by subclinical infections or consequences of recent infections. 10 patients were followed from the day of admission and up to 80 days after the acute illness. Luminol- but not lucigenin-enhanced chemiluminescence (CL) of PMN was increased during the febrile period and normalized in parallel with normalization in body temperature. Both luminol- and lucigenin-enhanced CL were enhanced in whole blood during the period of fever. Subnormal activities of luminol- or lucigenin-enhanced CL were only seen sporadically. We conclude that the oxidative metabolism of PMN, as measured by lucigenin-enhanced CL, is virtually unaffected cause of the increased luminol enhanced CL during the acute illness is suggested to be due to the increase mobilization of myeloperoxidase. PMID- 2756342 TI - Pivmecillinam in long-term prophylaxis to girls with recurrent urinary tract infection. AB - Pivmecillinam in a single bed-time dose of 5-10 mg/kg was given as long-term prophylaxis to 20 girls with recurrent bacteriuria for a total of 228 months. Symptomatic recurrences occurred in 4 girls, i.e. 1.8 infections/100 months as compared to 17/100 months during the year preceding the study. The frequency of positive urine cultures during prophylaxis was 11%. 10 of the 15 isolates were enterococci, resistant to mecillinam. In rectal swabs examined for the presence of aerobic gram-negative bacteria, enterobacteria were isolated in 78% with a low rate of resistance to mecillinam (11%). Thus pivmecillinam offered effective protection against recurrent urinary tract infections, and did not tend to select resistant enterobacteria in the bowel, but allowed resistant enterococci to cause a few symptomatic infections. PMID- 2756343 TI - Serum IgG and IgA antibody responses to Campylobacter pylori in a group of healthy asymptomatic volunteers. AB - Sera from 17 healthy asymptomatic volunteers were tested for presence of IgG and IgA antibodies against Campylobacter pylori and correlated with endoscopic biopsy findings. Three volunteers infected with C. pylori had the highest IgG antibody titers of the group. None of 14 C. pylori free subjects had significant IgG antibody levels. IgA antibody titers were negative in all subjects regardless of state of infection, in contrast to control sera from symptomatic C. pylori infected patients who manifested high IgA antibody levels. PMID- 2756344 TI - Brucellosis in a child complicated with multiple brain abscesses. AB - A 4-year-old boy developed symptoms consistent with brucellosis and was treated with combined streptomycin and tetracycline. He had a high brucella agglutinin titer. However, he continued to have headache and papilledema. A brain CT revealed 6 large abscesses. Brucella melitensis was isolated from abscess material. The boy recovered completely after drainage therapy. PMID- 2756345 TI - Listeria monocytogenes septicemia associated with consumption of salted mushrooms. AB - Listeria monocytogenes septicemia in an 80-year-old man is described. On the day before clinical symptoms appeared the patient had eaten homemade salted mushrooms, rufous milkcap (Lactarius rufus Fr.). L. monocytogenes serotype 4b was isolated in blood cultures. The mushrooms which had been stored in cold for 5 months before consumption contained the same listeria serotype at a level of 10(6) CFU/g. Salt content (NaCl) of the mushrooms was 7.5%. Fever and diarrhea disappeared with penicillin therapy and the patient was discharged after 4 weeks in the hospital. PMID- 2756346 TI - HIV infection in a non-drug abusing prostitute population. PMID- 2756347 TI - A case of autochthonous malaria in Italy. PMID- 2756348 TI - Changing trends in antibiotic therapy: role of ciprofloxacin. PMID- 2756349 TI - Use of ciprofloxacin in patients undergoing transurethral prostatic surgery. AB - The efficacy of a short (Group I) and a prolonged (Group II) course with ciprofloxacin was assessed in patients undergoing transurethral prostatic resection and compared with that of controls without antibiotic (Group III). Both regimens significantly reduced the frequency of post-operative bacteriuria (p less than 0.01) and of severe infectious complications (p = 0.004) compared to the controls. Both regimens were equally effective in preventing peri-operative and post-operative acquisition of bacteriuria in patients without bacteriuria at surgery. In patients with bacteriuria before surgery, bacteriuria was found post operatively in 35% in Group I and in 9% in Group II (p = 0.012), but in 82% of the patients in Group III. Ciprofloxacin inhibited all but 7 of 176 bacterial strains at an MIC of less than or equal to 1 microgram/ml. Given orally, ciprofloxacin is a valuable alternative antimicrobial for use in conjunction with transurethral prostatic resection. A short course is sufficient for prophylaxis, and adequate therapy is achieved with a prolonged regimen. PMID- 2756350 TI - Influence of age on the pharmacokinetics of ciprofloxacin. AB - Data from 4 previously published reports on kinetics after oral ciprofloxacin administration are reviewed. Preliminary results from a study with oral and intravenous administration in elderly and young, healthy males are presented. The total clearance of ciprofloxacin is maintained in the elderly, while the renal clearance is reduced as a consequence of the age-related, physiological reduction of kidney functions. After oral administration there is, furthermore, an increased AUC and Cmax, which are explained by a higher bioavailability of an oral dose in the elderly (72.4%) as compared to young volunteers (58.4%). PMID- 2756351 TI - Does ciprofloxacin affect the inner ear? A preliminary report. AB - Ciprofloxacin, a 4-quinolone antibiotic was tested regarding its possible influence on the inner ear sensory epithelia. Adult guinea pigs were injected intraperitoneally with ciprofloxacin in a dosage of 25, 50, 100 and 150 mg/kg body weight per day. The animals in the high dosage ranges stopped eating and consequently lost weight quite rapidly. After sacrifice, the inner ear sensory epithelia were removed for ultrastructural analysis. The general outline of the vestibular sensory epithelia as well as the cochleae were normal. Mild changes in the sensory hairs of the third row of cochlear outer hair cells were noted in the specimens obtained from the high dose animals. These changes were discrete and did not resemble any previously known pattern of ototoxic damage. At present no data indicate that ciprofloxacin has a toxic effect on the inner ear. PMID- 2756352 TI - Effect of ciprofloxacin compared to gentamicin in the treatment of experimental intraabdominal infections in rats. AB - A reproducible experimental model of intraabdominal infections in rats has been developed in order to stimulate intraabdominal sepsis in patients. Preoperatively, the rats were fed with lean ground beef for two weeks in order to change the intestinal flora to one similar to that of humans. A 1-cm segment of ileum was isolated on its vascular pedicle. The intestine was then divided at each end of the segment and intestinal continuity was re-established by an end-to end anastomosis. The segment of ileum was then returned to the abdominal cavity. This experimental model was used to compare the efficacy of ciprofloxacin alone and in combination with clindamycin with the combination gentamicin and clindamycin in the treatment of intraabdominal infections. Eighty per cent of the untreated animals died within four days. Within six days, 30% of the animals receiving ciprofloxacin died. Animals treated with ciprofloxacin plus clindamycin or gentamicin plus clindamycin had a significantly decreased mortality and increased cure rates during the experimental period. Only 5% of these animals died. Thus the combination of ciprofloxacin and clindamycin seems to be as successful as gentamicin plus ciprofloxacin in the treatment of intraabdominal infections. PMID- 2756353 TI - A comparison of ciprofloxacin with doxycycline plus metronidazole in the treatment of acute pelvic inflammatory disease. AB - We studied the clinical and microbiological response to two treatment regimens in 36 patients with acute pelvic inflammatory disease (PID). All patients were hospitalized and underwent laparoscopy and endometrial biopsy. Cervical, endometrial, tubal and peritoneal cultures for Chlamydia trachomatis, Neisseria gonorrhoeae, genital mycoplasmas, facultative and anaerobic bacteria and Herpes simplex virus were obtained. The patients were randomly assigned to two treatment groups: 16 women received ciprofloxacin 200 mg b.i.d. iv. for two days, followed by oral administration with 750 mg b.i.d. to complete a 14-day course of treatment. Twenty women received the combination of doxycycline and metronidazole according to a similar scheme of administration. The response was evaluated with repeated clinical examinations, monitoring of the erythrocyte sedimentation rate and serum C-reactive protein concentration, and repeated microbial culture from the cervix. Ciprofloxacin treatment was successful in all nine patients with chlamydial or gonococcal PID and in six of seven with nonchlamydial nongonococcal PID. Doxycycline plus metronidazole regimen was successful in five of seven patients with chlamydial or gonococcal PID and in nine of 13 patients with nonchlamydial nongonococcal PID. Thus, the overall success rate was 94% (15 of 16) with ciprofloxacin and 70% (14 of 20) with doxycycline plus metronidazole. Our study suggests that ciprofloxacin is a promising new alternative for the treatment of acute PID. PMID- 2756354 TI - Comparison of efficacy and tolerance of intravenously and orally administered ciprofloxacin in cystic fibrosis patients with acute exacerbations of lung infection. AB - Twenty patients (17-27 yr) with cystic fibrosis were given ciprofloxacin at 30 pulmonary infectious exacerbations. All patients were chronically colonized with Pseudomonas aeruginosa. Twenty-five courses were completed, 13 orally (15 mg/kg b.i.d.) and 12 intravenously (4-6 mg/kg b.i.d.). Clinical efficacy was excellent or good in 85-90% of the courses and growth of P. aeruginosa was markedly reduced in 33-46%. Body weight and clinical score improved significantly. White blood cell count decreased and pulmonary function was improved. Reversible adverse effects, mainly rash and urticaria, appeared at seven occasions, five severe enough to cause interruption of treatment. Clinical efficacy and tolerance were better with oral than intravenous administration at the dosages used in this study. Excellent bioavailability provides additional basis for oral treatment with ciprofloxacin in cystic fibrosis patients. PMID- 2756355 TI - Antibiotic consumption in Sweden 1975 to 1987: changes in prescription patterns. AB - The antibiotic consumption in Sweden was evaluated during the period 1975 to 1987. Consumption was measured in terms of defined daily doses (DDDs), that is, the normally prescribed daily adult doses. During the study period the total consumption varied between 49 and 51 million DDD, indicating a considerable over use of antibiotics in Sweden. In the various groups of antibiotics, considerable fluctuations were seen. The cephalosporin use increased from 477000 DDDs 1975 to 1795000 DDDs in 1987, which can be explained by an increased use of cefaclor for treatment of respiratory tract infections and by the fact that cefuroxime is the dominant injectable antibiotic in Sweden. Markedly increased usage during the study period was also seen for erythromycin and penicillinase resistant penicillins. There were no obvious medical reasons for those increases. Among the folate inhibitors, sulphonamide usage has been almost completely abandoned during the period and the sulphonamides have been replaced by pivmecillinam, trimethoprim and, lately, norfloxacin for the treatment of urinary tract infections. Reduced usage was also seen for sulphonamide/trimethoprim combinations, probably due to an increased awareness of the risk for side effects to these antibiotics. During the entire period the use of tetracyclines, and especially doxycycline, was extensive--almost 10 million DDDs in 1987. The reason for that remains unclear but there are reasons to assume that these antibiotics are prescribed too frequently. PMID- 2756356 TI - Monitoring irrigating fluid absorption during transurethral resection of the prostate (TURP); a comparison between 1 and 2% ethanol as a tracer. AB - In a series of 35 transurethral resections of the prostate 1% ethanol was compared to 2% ethanol as a marker of the irrigating fluid. The ethanol concentration in the expired breath of the patient (EB-ethanol) correlated significantly to the irrigant absorption, as measured volumetrically, and to the change in the serum sodium concentration at 10-min intervals during the operation. The pattern of changes in EB-ethanol indicated whether the main part of the absorption entered through the intravenous or the extravascular route. With 1% ethanol added to the irrigating solution the absorption of 100-150 ml in 10 min could readily be detected. The sensitivity was twice as great with 2% ethanol; however, 1% ethanol is sufficient for routine procedures as it permits absorption to be detected long before it is large enough to produce a TUR syndrome. Monitoring ethanol in the expired breath provides the surgeon with an instrument to check that preventive steps against further absorption are effective. PMID- 2756358 TI - Viscoelastic properties of the normal human bladder. AB - Continuous and stepwise cystometry were performed through suprapubic catheters in 12 healthy young subjects in order to assess passive viscoelastic variables of the normal human bladder during the collection phase. Elastic contants increased non-linearly with bladder distension. Relative elastic modulus and relaxation time of the bladder wall increased or tended to increase with bladder distension and infusion rate. There was considerable interindividual variation in all variables suggesting that discrimination between normal and abnormal bladder wall viscoelasticity may be difficult in routine clinical practice. PMID- 2756357 TI - Prophylactic one-dose treatment with clindamycin and gentamicin in transurethral prostatic resection. A double-blind placebo controlled study. AB - One hundred and sixty-eight patients scheduled for transurethral prostatic resection were randomly assigned to treatment either with a combination of clindamycin and gentamycin or with placebo, administered preoperatively as a single bolus infusion. The patients were stratified into a group of 35 with preoperative bacteriuria, and a group of 133 with preoperative sterile urine. Postoperatively the frequency of bacteriuria and bacteriaemia, the maximum body temperature measured, the number of patients with antibiotic therapy instituted, and the duration of hospitalization were significantly lower in the treated than in the placebo group. This applied both to the group with preoperative sterile urine and to the group with preoperative bacteriuria. PMID- 2756359 TI - Extracorporeal shock wave lithotripsy in paediatric patients. AB - 24 children with urolithiasis of the upper urinary tract were treated by extracorporeal shock wave lithotripsy (ESWL). In all patients sufficient stone disintegration could be achieved by an average of 950 shock waves. Percutaneous nephrostomy was required for "Steinstrasse" ureteral obstruction in 2 cases. At discharge from hospital 16 children were considered stone-free. Follow-up showed 90% of the children to be stone-free without recurrence (mean 20 months). The necessary precautions considered, ESWL is the method of choice for treatment of urolithiasis of the upper urinary tract in children. The long term effects of ESWL on the juvenile kidney have yet to be observed. PMID- 2756360 TI - Tissue calcium in uraemia. AB - The content of calcium in the thoracic aorta, the heart and the kidney was determined in rats with moderate renal failure treated with 1.25 dihydroxycholecalciferol (1.25-DHCC) 100 ng/kg/day and Verapamil 20 mg/kg/day. In the aorta the content of calcium was significantly increased in uraemic rats and this increase was significantly augmented after administration of 1.25-DHCC. In the kidney no increase in calcium was seen in rats with uraemia, but treatment with 1.25-DHCC increased the calcium content significantly. This increase was not correlated to the serum calcium x phosphate product, which was almost normal. In the heart no changes in the content of calcium were observed. Verapamil did not influence the effect of 1.25-DHCC. It is concluded that administration of 1.25 DHCC per se may increase the content of calcium in the aorta and kidney in rats with moderate uraemia and possibly in this way sensitize the tissue to the development of tissue calcification. PMID- 2756361 TI - The effect of diclofenac sodium on renal function. AB - The effects of diclofenac sodium on the kidneys were studied during 4 1/2 hours in eight patients with normal renal function. Urinary output decreased within 10 min after the injection, and maximally by 80%. The renal plasma flow and the glomerular filtration rate initially diminished significantly, by 35%, but began to increase after only 2 hours. The dominant and persistent effect was reduction of free water clearance, with maximum fall from 5.9 to 0.08 ml/min after 2 1/2 hours. The long-lasting increased tubular reabsorption of water probably is important for the lowered intrapelvic pressure that is associated with good analgetic effect of diclofenac in ureteral colic. PMID- 2756362 TI - Spontaneous regression of cerebral and pulmonary metastases in renal cell carcinoma. AB - In a 57-year-old female with a metastatic renal cell carcinoma lung metastases decreased after nephrectomy. Simultaneously, she developed a 3 cm large brain metastases with clinical signs of hemiparesis. Palliation treatment consisted of a 6-week course of oral Dexamethasone. One year later the lung and brain metastases had regressed completely as evidenced by chest X-ray and cerebral computer tomography. The role of corticosteroid treatment for the spontaneous regression is discussed. PMID- 2756363 TI - Urethral strictures after transurethral bladder tumor resection. AB - The charts on 241 patients, consecutively undergoing a total of 2043 transurethral resections of bladder tumors and subsequent controls, were reviewed to find the incidence and possible causes of postoperative urethral stricture. The incidence of urethral stricture was 15% in males and 4% in females, but less than one-third were symptomatic. The strictures were found distally in the urethra in 83% of the patients and were treated with optical urethrotomy. Cumulated duration of postoperative catheterization was significantly longer and size of resectoscope used larger in patients with stricture. Repeated transurethral instrumentations may increase the risk of stricture development. PMID- 2756364 TI - Treatment of urinary incontinence with an implantable prosthesis. AB - Experiences with various types of implantable urinary incontinence prostheses based on two principles, passive compression of the urethra (Kaufman) or artificial dynamic sphincter (Scott) are recounted. The series consists of 40 patients, 3 women and 37 men. The cause of incontinence was transurethral resection of the prostate or open prostatectomy in 29 cases, radical prostatectomy in 3 cases, neurogenic bladder in 7 cases and urethroplasty in 1 case. The success rate with the Kaufman prosthesis was 50% and that with the Scott artificial sphincter 91% with an average follow-up of 2 years. Mechanical complications or infection requiring surgical intervention occurred in 42% cases. Careful patient selection and meticulous surgical technique are essential. The artificial urinary sphincter (type AMS 800) appears to be the best treatment modality for urethral sphincter deficiency. In the selected cases the Kaufman prosthesis still has a place for the treatment of elderly men with poor cortical and manual control, making them incapable of managing the AMS 800 prosthesis. PMID- 2756365 TI - Dilution of blood proteins due to irrigant absorption in transurethral prostatic resection. AB - The serum concentrations of albumin, transferrin, IgG, IgM and sodium, the blood haemoglobin concentration (B-Hb) and the blood loss were determined for 10-min periods in the course of 16 transurethral prostatic resections in which irrigant absorption of between 0.5 and 2.8 I had been measured volumetrically. The concentrations during resection, expressed as a percentage of those recorded just before induction of anaesthesia, were: B-Hb 89.2%, S-albumin 81.0%, S-transferrin 78.4%, S-IgG 81.0%, S-IgM 80.5% and S-Na 96.5%. The blood loss was the most important predictor of the decrease in B-Hb. The dilution of serum proteins was primarily due to hydration from crystalloid fluid given intravenously and from absorbed irrigating fluid; the most specific indicator of the degree of irrigant absorption was the serum sodium level. PMID- 2756366 TI - [Plant pesticides and ground water. Inventory, prevention and clean-up strategies. Bodies of Water and Plant Pesticides VI. 6th technical discussion. Berlin, 30 May-1 June 1988]. PMID- 2756367 TI - [Possibilities and limits of studies with C14-labeled herbicides for predicting the tendency of pesticides to wash out into the soil]. PMID- 2756368 TI - [The appearance of pesticides in groundwater in Bavaria]. PMID- 2756369 TI - [Pesticides and similar compounds in groundwater and drinking water: tendencies in analysis from the viewpoint of chemical study arrangements]. PMID- 2756370 TI - [The development of detection methods for pesticide groups--experiences from a water plant laboratory]. PMID- 2756371 TI - [The natural groundwater flow and a laboratory column for estimating groundwater pollution by pesticides]. PMID- 2756372 TI - [Pesticide use without groundwater and drinking water dangers--agricultural aspects]. PMID- 2756373 TI - [Important aspects of the protection of groundwater from pesticide residues- represented by the examples of chlortriazine, atrazine, simazine and terbutylazine]. PMID- 2756374 TI - A strategy for reducing the impact of pesticides on groundwater in the U.S. PMID- 2756375 TI - Pesticide residues in groundwater in The Netherlands: state of observations and future directions of research. AB - In the first stage of a programme of sampling and analysis for pesticide residues in groundwater in The Netherlands, the upper groundwater below four vulnerable soils was analysed for nearly 2,5 years in eight sampling rounds. Of 18 compounds analysed, including some metabolites, 1,3-dichloropropene, aldicarb, ethoprophos dinoseb, metamitron, atrazine, desethyl- and desisopropylatrazine, metolachlor and ethylenethioureum were repeatedly detected in the groundwater in concentrations above 0.1 micrograms.dm-3, the limit for pesticides in drinking water set by the EC. These observations were made below fields with potatoe-, maize- and bulb flower culture, all on low-humic to moderately humic sandy soils. No residues were found below a cracked light clay on a sandy subsoil. On the locations sampled evidence was found for complete in situ removal in the upper groundwater of 1,3-dichloropropene, high persistence of aldicarb residues and partial in situ degradation of dinoseb. PMID- 2756376 TI - [Pesticide use without groundwater and drinking water dangers--health protection aspects]. PMID- 2756377 TI - [Pesticide contamination in groundwater and drinking water--a review of Baden Wurttemberg]. PMID- 2756379 TI - [Pesticide use without groundwater and drinking water dangers--environmental aspects]. PMID- 2756378 TI - [The behavior of selected pesticides in groundwater close to the surface of heterogenic porous sediments]. PMID- 2756380 TI - [Pesticides in surface water, groundwater, and untreated water in Nordrhein Westfalen: measuring strategy, analysis and results]. PMID- 2756381 TI - [The demonstration by industry of future developments and the use of pesticides with special reference to necessary groundwater protection]. PMID- 2756382 TI - [Recognition of the water content of pesticides in water plants in West Germany]. PMID- 2756383 TI - [Herbicides in untreated and drinking water of a water supply enterprise- analysis and results]. PMID- 2756384 TI - [The behavior of selected pesticides in groundwater and drinking water areas]. PMID- 2756385 TI - [Ecodynamic processes in soil and groundwater conductors under the influence of pesticides]. PMID- 2756386 TI - Model for simulating the effects of management practices on pesticide concentrations in groundwater. AB - This manuscript describes the RUSTIC model and presents the results of an example application. RUSTIC links three subordinate models in order to predict pesticide fate and transport through the crop root zone, unsaturated zone, and saturated zone to drinking water wells: PRZM, VADOFT, and SAFTMOD. PRZM is a one dimensional finite-difference model which accounts for pesticide fate and transport in the crop root zone. This release of PRZM incorporates several features in addition to those simulated in the original PRZM code: specifically, soil temperature simulation, volatilization and vapor phase transport in soils, irrigation simulation and a method of characteristics (MOC) algorithm to eliminate numerical dispersion. PRZM is now capable of simulating fate and transport of the parent compound and up to two daughter species. VADOFT is a one dimensional finite-element code which solves the Richard's equation for flows in the unsaturated zone. The user may make use of constitutive relationships between pressure, water content, and hydraulic conductivity to solve the flow equations. VADOFT may also simulate the fate and transport of two parent and two daughter products. SAFTMOD is a two-dimensional finite-element model which simulates saturated solute flow and transport in either an X-Y or X-Z configuration. The codes are linked together with the aid of a flexible execution supervisor which allows the user to build models which are tailored to site-specific situations. In order to perform exposure assessments, the code is equipped with a Monte Carlo pre- and post-processor. The application of the model is to a potato field on Long Island, New York. The results indicate that RUSTIC is capable of realistically matching data observed in downgradient monitoring wells following 3 years of aldicarb application. PMID- 2756387 TI - [Pesticide approval practices and groundwater protection]. PMID- 2756388 TI - [The principle of foresight in protecting groundwater and drinking water from pesticide contamination]. PMID- 2756389 TI - [The granting of permission for exceptions to section 4 of the drinking water ordinance concerning pesticide contamination]. PMID- 2756390 TI - [The consequences of strict groundwater protection from pesticide contamination for agricultural businesses in Munsterland]. PMID- 2756391 TI - [Environmental hygiene concepts for avoiding groundwater and drinking water contamination by pesticides]. PMID- 2756392 TI - [Strategies for sanitizing an entry region]. PMID- 2756393 TI - [The estimation of pesticides in approved treatments in reference to drinking water contamination]. PMID- 2756394 TI - [Viewpoints of groundwater protection in the execution of plant protection laws]. PMID- 2756396 TI - [Annual meeting of Swiss Society of Gastroenterology. Montreux, 15-17 September 1988. Proceedings]. PMID- 2756395 TI - [Compilation of methods of pesticide detection in groundwater in relation to the permissible procedures--claims and reality]. PMID- 2756397 TI - [Long-term results following fundus plication and vagotomy in reflux disease. Complaints after 10-20 years]. AB - In 109 patients with primary reflux disease in whom combined fundoplication and vagotomy had been performed, the clinical results were evaluated by questionnaire 10-20 years (median 15.7 years) after operation. Indication for additional vagotomy was severe reflux disease and/or increased gastric acid output in 56 (A) and coexistent ulcer disease in 53 (B) patients. Vagotomy was truncular (with pyloroplasty) in 49, selective gastric (with pyloroplasty) in 50, and proximal gastric in 10 patients. Follow-up was available from 64 patients (59.6%). The results were as follows: 17.2% (A 19.4%, B 7.1%) had reflux symptoms, while 9.5% (A 11.4%, B 7.1%) needed medical antireflux therapy. Dysphagia was present in 28.2% (A 13.9%, B 35.7%), and gas-bloat in 54.7% (A 55.5%, B 53.6%). Typical postvagotomy symptoms were diarrhea in 23.5% (A 30.6%, B 14.3%) and dumping in 25.0% (A 22.2%, B 28.6%). Using the Visick classification criteria we found grade I and II in 73.4%, grade III in 17.2% and IV in 9.4%. Symptoms are frequent after fundoplication and vagotomy. The clinical result is more favourable in group B and for the combination of fundoplication with proximal gastric vagotomy. PMID- 2756398 TI - [Surgery in para-esophageal hiatal hernia: technic and results]. AB - 40 patients with paraesophageal hiatus hernia have undergone surgery over a period 25 years' period. Surgery consisted of gastropexy in 38 patients (ventral corpopexy in 32, fundophrenicopexy in 19), narrowing of the hiatus in 24 and fundoplication in 14. There was one operative death (2.5%). On follow-up 3 to 24 years later (mean 12.5 years) 17 of 20 patients (85%) have good or excellent results. 2 patients without additional antireflux surgery had to be reoperated later because of severe reflux disease (secondary fundoplication). 1 patient with gastropexy and fundoplication has recurrent reflux disease. X-ray studies in 18 patients showed recurrent paraesophageal hiatus hernia in 9 (50%). After operation for paraesophageal hiatus hernia a good clinical long-term result can be expected. To reduce the frequency of recurrent hernia, technical modifications should be considered. PMID- 2756399 TI - [Effects of anti-tissue immune sera on the contractile response of cells isolated from smooth muscle of the pyloric antrum]. AB - The effect of anti-tissue antisera on the contractile response of isolated smooth muscle cells from rabbit antrum has been investigated. Anti-stomach (SAE), anti colon (SAC) and anti-diencephale (SAD) antisera induced a dose-dependent contraction is isolated cells, whereas both non-immune serum and antisera obtained by immunization with other foetal tissues were ineffective. Proglumide, the well known gastrin antagonist, similarly inhibited both gastrin- and SAE, SAC, SAD antisera-induced contraction of isolated smooth muscle cells. PMID- 2756400 TI - [Therapy of pyogenic liver abscess]. AB - Between 1980 and 1986, 11 patients with pyogenic liver abscess were treated at the Department of Internal Medicine at the Kantonsspital St. Gallen. 2 patients underwent successful surgical drainage and 9 patients percutaneous needle aspiration or drainage. 7 were successfully treated while 2 required secondary surgical drainage. Our results suggest that percutaneous aspiration or drainage of pyogenic liver abscess should be tried before surgery is considered. PMID- 2756401 TI - [Partial gastrectomy and Roux-en-Y anastomosis in recurrence of reflux following fundus plication]. AB - Roux-en-Y reconstruction has been in use for several years as a reoperation for persistent esophagitis after fundoplication. The limited data in the literature appear to favour this approach. We have conducted a retrospective review of the records of 5 patients who have undergone this type of surgery for persistent reflux in the last four years. In 3 of these patients after fundoplication endoscopy showed grade IV esophagitis, grade III esophagitis in 1, and grade II esophagitis in 1. After Roux-en-Y reconstruction 1 endoscopy showed grade I esophagitis in 1 patient, and grade II esophagitis in 1. Three patients had no evidence of esophagitis and 1 patient was symptom-free and refused endoscopy. These results are in agreement with those in the literature. We conclude that Roux-en-Y diversion is a practicable reoperation after fundoplication and provides good results. PMID- 2756402 TI - [Surgical treatment of ulcerative proctocolitis with total colectomy, resection of rectal mucosa and continent reconstruction with a ileoanal pouch anastomosis]. AB - Between 1984 and 1988, 10 patients with ulcerative colitis underwent surgery involving total colectomy and ileoanal reconstruction with a J-pouch. In 8 of the 10 we selected the three-stage surgical procedure: 1. total colectomy, 2. proctomucosectomy, ileoanal pouch anastomosis and double path protective ileostomy, 3. ileostomy closure. In 2 patients colectomy and pouch-anal anastomosis were performed at the same time. In 3 of 10 patients postoperative complications occurred (1 pelvic abscess, 1 abdominal abscess, 1 ileus) after total colectomy. Complications after pouch-anal anastomosis occurred in 2 of 10 patients (1 abscess formation lateral to pouch, 1 entero-vaginal fistula). Follow up in all 6 patients in whom ileostomy closure had already been possible showed that an average of 16 months (2-44 months) after restoration of continuity 5 (of 6) patients were fully continent for stool and 1 woman patient was slightly incontinent for thin stool. With an average of 4.2 stool evacuations during the day and 1 defecation at night, all 6 patients expressed a high degree of satisfaction with the operative result. PMID- 2756403 TI - [Pathogenic heterogeneity of Barrett's ulcers. Apropos of 38 case reports]. AB - Barrett's ulcer is thought to develop in the columnar epithelium of Barrett's esophagus. In our series there is evidence that at least some Barrett's ulcers develop in squamous epithelium which may correspond to islets within Barrett's esophagus; in other cases Barrett's mucosa may surround a preexisting reflux induced ulcer and thus transform it into Barrett's ulcer. In some individual cases of Barrett's ulcer development of the ulcer primarily in the columnar epithelium could not be ruled out. These ulcers may be produced by local acid secretion, by acid or alkaline gastroesophageal reflux in patients with reduced resistance of the columnar epithelium. Exceptionally, Barrett's ulcer may result from local irritation by medication (pill-induced ulcer) or by nasogastric intubation. PMID- 2756404 TI - [Clinical aspects of acute pancreatitis]. AB - 55 patients with acute pancreatitis were treated at this institution between 1979 and 1984. The female/male ratio was 3:2. Biliary pancreatitis was found in 51%. In 15% alcohol was the cause, while in 34% the etiology remained unknown. The main symptoms were acute abdominal pain (100%), nausea and vomiting (51%), fever (35%), and peritoneal irritation (27%). Twenty-two patients were treated conservatively, while the remainder underwent surgery either in or after the acute phase of the disease. Hospital mortality was 0% for a Ranson Score up to 4.25% for 5/6 and 50% for greater than 6. PMID- 2756405 TI - [Prognostic significance of the Lauren classification of patients with stomach carcinoma. A statistical analysis of long-term results following gastrectomy]. AB - To evaluate the prognostic difference between the 2 major histological types of Lauren classification in gastric cancer, data on patients who underwent the same surgical procedure -- total gastrectomy -- were studied. 124 consecutive total gastrectomy cases treated from 1979 to 1986 were classified according to Lauren retrospectively into 2 groups, comprising 63 patients (50.8%) with intestinal type carcinoma and 61 in another group of diffuse (n = 44, 35.5%) or mixed type (n = 17, 13.7%) carcinoma. In regard to extent of total gastrectomy the two groups were comparable (splenectomy 50 times and compartment II lymphadenectomy 43 times in the intestinal type group, vs 49 and 39 times in the diffuse or mixed type group). The proportion of males (42 men, 21 women) and older patients (mean: 62 years) was greater in the intestinal type group than in the group of diffuse or mixed type carcinoma (34 men, 27 women, mean: 57 years). According to TNM stage no significant difference was observed in local tumor infiltration (pT stage), lymph node metastases (pN) and distal metastases (pM) between the two groups at the time of surgery. The stages of disease (UICC 1987) were similar in the two groups: Stage I: intestinal type 25.4% (16/63), diffuse or mixed type 23% (14/61), stage II: 19% (12/63) vs 14.7% (9/61), stage III: 14.3% (9/63) vs 19.7% (12/61), stage IV: 41.3% (26/63) vs 42.6% (26/61). The hospital mortality was 9.5% (6/63) in the intestinal-type group and 8.5% (5/61) in the group of diffuse or mixed carcinoma (no significant difference).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2756406 TI - [Pseudocyst and pancreatitis. Which factors are predictive of development?]. AB - Pseudocysts complicating the evolution of pancreatitis are being recognized with increasing frequency at the subclinical stage. The authors' retrospective study covering 55 cases of pseudocyst brings out 5 criteria for prediction of the evolution of the disease, which should facilitate decision-making with regard to therapy. PMID- 2756407 TI - [Cure of recurrent ascites in alcoholic hepatitis following transient placement of a LeVeen shunt]. AB - Three cases of severe alcoholic hepatitis associated with refractory ascites are reported. A LeVeen shunt was inserted which was effective and well tolerated. However, the shunt was removed in all 3 patients 8 months, 12 months and 9 years after insertion because of spontaneous migration (n = 2) or superior vena cava thrombosis (n = 1). At time of shunt removal all 3 patients had micronodular cirrhosis, but none had recurrent ascites during the 1-3 years of observation and despite the absence of diuretics. The eventual transient aspect of refractory ascites associated with alcoholic hepatitis is discussed, together with the potential beneficial and temporary role of LeVeen shunts in this condition. PMID- 2756408 TI - [Icterus due to carotene associated with iron deficiency anemia]. AB - We present 2 patients with carotenemia who also suffered from iron deficiency anemia. A causal relationship between the ingestion of excessive quantities of carrots and iron deficiency is postulated, since iron deficiency is known to be responsible for change of appetite (pica). A knowledge of this condition, which follows an indolent, reversible course, is necessary for the clinician mainly in view of the differential diagnostic aspects. PMID- 2756410 TI - Misprints. Seeking new methods for forensic DNA typing. PMID- 2756409 TI - Essay. Fetal research: the underlying issue. PMID- 2756411 TI - Big brother, Ph.D. Should scientists or bureaucrats form science's police force? PMID- 2756412 TI - Fifth AIDS Conference. Is HIV spreading at epidemic rates in the inner cities? PMID- 2756413 TI - Improving school health services staffing patterns. PMID- 2756414 TI - Sports medicine from the school nurse's point of view. PMID- 2756415 TI - Midtrimester amniocentesis: ten year experience in South Dakota. AB - Amniocentesis was begun as a clinical service by the Department of OB/GYN of the School of Medicine in 1978 through the Genetics Laboratory. The experience gained over the subsequent ten years and 1275 studies is detailed. An incidence of 2.9% abnormal karyotype to amniocentesis was found. Genetic counseling with regard to amniocentesis is recommended for women of 35 years or older with a positive family history. PMID- 2756416 TI - Risk management for physicians. Supreme Court invalidates minors' statute of limitations. PMID- 2756417 TI - The underrepresentation syndrome. PMID- 2756418 TI - Quick release of AIDS drugs. PMID- 2756419 TI - Drug availability is an issue for cancer patients, too. PMID- 2756421 TI - Gallo associate subject to investigation. PMID- 2756420 TI - Soviet psychiatry: real progress or just PR? PMID- 2756422 TI - Sleep researchers awake to possibilities. PMID- 2756423 TI - "Chemzymes" mimic biology in miniature. PMID- 2756424 TI - DNA typing is called flawed. PMID- 2756425 TI - Peptide binding and release by proteins implicated as catalysts of protein assembly. AB - Two members of the hsp70 family, termed hsc70 and BiP, have been implicated in promoting protein folding and assembly processes in the cytoplasm and the lumen of the endoplasmic reticulum, respectively. Short hydrophilic (8 to 25 residues) synthetic peptides have now been tested as possible mimics of polypeptide chain substrates to help define an enzymatic basis for these activities. Both BiP and hsc70 have specific peptide binding sites. Peptide binding elicits hydrolysis of adenosine triphosphate, with the subsequent release of bound peptide. PMID- 2756426 TI - Understanding the anomalous electrophoresis of bent DNA molecules: a reptation model. AB - In polyacrylamide gel electrophoresis, the retardation of DNA molecules containing regions of intrinsic curvature can be explained by a novel reptation model that includes the elastic free energy of the DNA chain. Computer simulations based on this model give results that reproduce the dependence of anomalous mobility on gel concentration, which is quantified by new experimental data on the mobilities of circularly permuted isomers of kinetoplast DNA fragments. Fitting of the data required allowing for the elasticity of the gel. PMID- 2756427 TI - Alaskan oil spill: health risks uncovered. PMID- 2756429 TI - Germany to ban embryo use. PMID- 2756430 TI - Should states regulate biotechnology? PMID- 2756428 TI - Fetal tissue transplants win U.K. approval. PMID- 2756431 TI - Circumcision may protect against the AIDS virus. PMID- 2756432 TI - Domain separation in the activation of glycogen phosphorylase a. AB - The crystal structure of glycogen phosphorylase a complexed with its substrates, orthophosphate and maltopentaose, has been determined and refined at a resolution of 2.8 angstroms. With oligosaccaride bound at the glycogen storage site, the phosphate ion binds at the catalytic site and causes the regulatory and catalytic domains to separate with the loss of stabilizing interactions between them. Homotropic cooperativity between the active sites of the allosteric dimer results from rearrangements in isologous contacts between symmetry-related helices in the subunit interface. The conformational changes in the core of the interface are correlated with those observed on covalent activation by phosphorylation at Ser14 (phosphorylase b----a). PMID- 2756433 TI - Sarcomas. PMID- 2756434 TI - Availability of pharmaceuticals in sub-Saharan Africa: roles of the public, private and church mission sectors. AB - Although the availability of pharmaceuticals is critical for both curative and preventive health care, drugs are, at best, sporadically available in governmental facilities in sub-Saharan Africa. The religious missions and private sectors are more successful than the public sector in obtaining and distributing drugs. The public sector operates under a myriad of constraints inherent in a bureaucracy; the religious missions have the advantages of better management and access to foreign currency; the private sector is innately efficient. Donor assistance to increase the availability of drugs in the public sector has included support for revolving drug funds, national drug services, the improvement of management techniques, and the local production of pharmaceuticals. None of these interventions has been notably successful. In 1987, UNICEF presented The Bamako Initiative--a proposal to launch an internationally-financed fund for essential drugs for sub-Saharan Africa. However, the proposal is unrealistic in anticipating that the requisite resources and/or hard currency can be raised to support the proposal. As the private sector is a more efficient distributor, it is recommended that the private sector be given responsibility for the distribution of drugs. Nonetheless, some governmental controls will be necessary to ensure that essential drugs are available at the least cost to the consumer. PMID- 2756435 TI - Healers, deities, saints and doctors: elements for the analysis of medical systems. AB - This article provides the basic elements for the discussion and analysis of medical systems and their inter-dependency, with special reference to Latin America and, in particular, to the Andean countries. In a culturally diverse and socially stratified population, such as in contemporary Latin America, medical systems constitute a social representation resulting from the historical relationship between autochtonous medical cultures and those from other latitudes. The impregnation of scientific and popular knowledge results not only in the incorporation (and often expropriation) of folk in professional or scientific medicine, but also in the increasing 'medicalisation' of popular and traditional therapeutic practices. The emergent 'popular' medical system draws from both the professional and folk models, and in its actual practice, integrates both popular beliefs and materia medica with elements drawn from popular religions and pre-Hispanic deities. The degree of competitiveness, co operation or 'integration' among medical systems depends mainly on the asymmetrical distribution of power and resources, and is conditioned by the population's behaviour in the management of disease. Existing pluralist systems of health care reveal a valuable array of survival strategies, which far outreach the proposals for integration called for by official sectors. On the other hand, knowledge derived from traditional medicine can contribute to the development of new models of clinical practice and to the expansion of the conventional epidemiological model. PMID- 2756436 TI - The psychosocial adjustment of patients and spouses to dialysis treatment. AB - Sixty-eight patients on hospital dialysis and their spouses were studied to compare their levels of adjustment and to examine gender differences. Two measures were used: BSI for psychological distress and PAIS for psychosocial adjustment to dialysis. High scores of psychological distress and adjustment problems were found both for patients and their spouses, with high correlations between the partners. Female patients and their husbands had higher scores than male patients and their wives respectively, and in some areas the husbands of female patients reported even more problems than the male patients. Clinical and theoretical conclusions are discussed. PMID- 2756437 TI - On the specificity of healing functions: a study of diagnosis in three faith healing institutions in Feira (Bahia, Brazil). AB - This essay examines three popular ethnomedical institutions in Brazil: faith healers, Protestant evangelicals, and the practitioners of one of the Japanese new religions. In particular, I compare the relative degrees of diagnostic specificity in their practices. Medical anthropologists have neglected the analysis of this aspect of practice, although I show in the present paper its utility for comparative work. Also, I show that diagnostic specificity is congruent with an ontological view of illness and an active role for the healer, while lack of diagnostic specificity is congruent with a very general form of therapy, such as is found in the Seicho-no-Ie religion. Traditional rezadores, in contrast, use a high degree of diagnostic specificity. PMID- 2756438 TI - The logic of a controversy: the case of Agent Orange in Australia. AB - Since 1979 the Vietnam Veterans' Association of Australia (VVAA) has claimed that exposure to the herbicide Agent Orange in Vietnam has adversely affected the health of Vietnam veterans and their families. A campaign for government recognition of diseases and disabilities caused by herbicide exposure led in 1983 to the appointment of the Evatt Royal Commission which, after a 2-year inquiry, comprehensively rejected the VVAA's claim. The Evatt Commission's findings have not been accepted by the VVAA and the claim continues to be defended, albeit in a highly qualified form. This controversy exemplifies the way in which a claim can attract public support, and persist despite rejections by Committees of Inquiry. An understanding of the reasons for the persistence of controversy requires an understanding of the logic of rejecting causal claims, the psychology of everyday inductive reasoning, and the interaction between politics and science. PMID- 2756439 TI - The public controversies of AIDS in Puerto Rico. AB - All articles using the word 'AIDS' that have appeared in the five major daily newspapers in Puerto Rico since 1982 were studied to analyze the way in which AIDS has been presented in the daily press. Virtually all of the articles regarding AIDS, at least those pertaining to Puerto Rico, presented controversies. These were of two kinds. Articles regarding prevalence, incidence, and sources of funding were presented as controversies between the two main political parties of the island. They can be considered extensions of other political arguments between the parties. Those regarding risk factors, prevention, and treatment were presented as controversies between representatives of the people, such as union leaders, and government officials. The victims of AIDS, the homosexuals, drug addicts and hemophiliacs, were generally left out of the controversies as participants. The controversies are generally nonmedical and nonscientific, suggesting that the public perceives insufficient interest on the part of medical and political leaders and is expropriating the problem. That the proposed solutions are directed more toward the victims than the causative organims is also characteristics of past epidemics. PMID- 2756440 TI - Sinking heart: a Punjabi communication of distress. AB - Within transcultural psychiatry there is a continuing debate between universalist and relativist positions. This debate focuses on the translation of Western psychiatric categories to non-Western languages and cultural contexts, and on the cross-cultural applicability of a Western model of human nature. This debate is of concern to medical practitioners and other primary carers who work with ethnic minority patients. The paper describes a syndrome of heart distress referred to as "sinking heart' by Punjabis living in Bedford, and it discusses how far this condition correlates with Western psychiatric categories. "Sinking heart' is an illness in which physical sensations in the heart or in the chest are experienced and these symptoms are thought to be caused by excessive heat, exhaustion, worry and/or social failure. The Punjabi model of "sinking heart' offers a culture bound explanation of somatic symptoms. It is based on culturally specific ideas about the person, the self and the heart and on the assumption that physical, emotional and social symptoms of pathology accompany each other. This model is compared with Western notions of depression and with medical models of heart distress, type A behaviour pattern and stress. The paper concludes that the Punjabi model of sinking heart does not exactly correspond to any of these. The sinking heart model bears closest resemblance to a Western model of stress. The similarity between these two models is in the form rather than in the content. PMID- 2756441 TI - Community and individual considerations in legislation and test policy regarding HIV-infection in the Nordic countries--a cross national comparative study. AB - The purpose of the study is to facilitate international co-operation and national development on AIDS-policy by describing and comparing the programmes on the control of AIDS in the five Nordic countries. This article is focusing especially on community and individual considerations in legislation and test policy regarding HIV-infection in relation to general testing, testing of special groups, registration, voluntariness and confidentiality. The data were collected in the period of April-December 1987 by a review of existing documental material, mailed questionnaires to key persons in the health agencies in each country and personal interviews with 60 representatives of relevant organisations and institutions. The analysis of the data demonstrate that all the Nordic countries are seeking compromises which try to satisfy individual as well as community needs, although with different weight attached to the elements involved. Compared with international recommendations, national AIDS-policies in the Nordic countries in some instances do not fully respect voluntariness and confidentiality. It is concluded that AIDS-policy should be studied in the context of national traditions concerning general health policy, individual rights and community protection. PMID- 2756442 TI - Do low levels of labour pain reflect low sensitivity to noxious stimulation? AB - In a study investigating factors affecting labour pain, 10 out of 97 subjects reported that they had never experienced any pain outwit childbirth. These subjects experienced comparatively low levels of pain within childbirth. They did not differ significantly from the majority of subjects on a large number of obstetric and psychological factors which normally affect pain in labour. It was suggested that these subjects were relatively insensitive to noxious stimulation, in that they do not experience pain when noxious stimulation is mild or moderate (as for example a consequence of menstruation, common accidents or ailments) and experience lower than average levels of pain when noxious stimulation is intense as in labour. Further investigation of such subjects is of theoretical interest and practical importance since it might allow for accurate prediction of pain levels in a proportion of parturants. PMID- 2756443 TI - [The effect of the x-ray contrast medium Amipaque on selected laboratory chemical and hematologic parameters of human blood taking into consideration electron microscopic studies]. PMID- 2756445 TI - [MRT anatomy of the retroperitoneal space]. PMID- 2756444 TI - [Percutaneous radiologic stent implantation in inoperable bile duct cancer using a new bile duct prosthesis]. PMID- 2756446 TI - [Immunoscintigraphy of a colorectal tumor recurrence using a 99mTc-labeled anti CEA-antibody]. PMID- 2756447 TI - [Results of scar keloid prevention using contact irradiation with strontium 90]. PMID- 2756449 TI - Occupational hand injuries. PMID- 2756448 TI - Computerization of clinic records: the resource utilization system for a sexually transmitted diseases clinic. AB - A computerized medical case record system, using manual entry into an IBM-AT personal computer, is described. The system was designed for simplicity, widespread acceptability by clinicians, and replacement of clerical procedures as well as for sophisticated data analysis. The major functions include regular production of a register of all clinic clients, summary of individual records for multiple attenders, listings of clients meeting designated criteria, and cross tabulations involving any three variables on the medical record. Despite greater requirements for data collection and analysis as well as clerical tasks involving data entry, introduction of the computerized system produced a net savings in cost of clerical activities in the first year of operation. PMID- 2756450 TI - [Vindesine, CCNU, high-dosage ara-C, and prednisolone (VINAP regimen) in the treatment of relapsing or refractory non-Hodgkin's lymphomas]. AB - Results of second line chemotherapy schedules to treat refractory lymphoma have usually been poor. In this study we have treated 21 patients with advanced non Hodgkin's lymphoma, usually heavily pretreated, with VINAP regimen. This original four drug chemotherapy combination included: Vindesine, 2 mg/m2 iv on days 1 and 2; CCNU, 40 mg/m2 oral on days 3 and 4; Cytosine arabinoside, 2.4 g/m2 iv on day 3 to 6 and methyl-Prednisolone, 80 mg/m2 on days 1 to 6. Sixteen patients (76%) showed response, including 5 (23%) who achieved a complete remission (CR). Eight patients achieved a partial remission (PR), and two patients obtained an objective response. Although the responses to VINAP regimen were dramatic and rapid in onset, usually they were of short duration except in cases of lymphosarcoma cell leukaemia. The median duration of response for patients with CR was 42 weeks and for PR 11 weeks. Toxicity was acceptable, including predictable myelosuppression, frequent mucositis and occasional polyneuritis. Neither central nervous problems nor conjunctivitis or dermatitis had been seen. PMID- 2756451 TI - [Moderate deficiency of Factor XII associated with postoperative deep venous thrombosis]. AB - The interrelationship between factor XII deficiency (Hageman trait) and thrombosis is well known. A case of moderate factor XII deficiency (activity, 30%) associated to deep vein thrombosis, which occurred in the popliteal region of the left lower limb after abdominal surgery, is reported. The deficit was found in 4 family members of the three generations studied, and all of them showed a close interrelationship between factor XII activity and kallikrein levels. Prolonged APTT was found in 3 of the 4 affected subjects. A multiallelic model is suggested to explain the genetic transmission of this impairment. PMID- 2756452 TI - [Concerning the organization of hemotherapy]. PMID- 2756453 TI - [Bone marrow necrosis and type L3 acute lymphoblastic leukemia. An infrequent association]. PMID- 2756454 TI - [Isolated involvement of the fibula as a diagnostic finding in multiple myeloma]. PMID- 2756455 TI - [Levels of antithrombin III and proteins C in the newborn infant]. AB - Antithrombin III and protein C levels were studied in cord blood from 91 babies born at term with weight adequate to their gestation age. No history of drug ingestion or any other cause of impaired blood coagulation in newborns was present in any of the mothers, and none of these had had thromboembolic diseases. Basic coagulation study and clinical status were normal in all the newborns. Antithrombin III was measured as antigen concentration and functional heparin cofactor, both values being similar (ratio: 0.97) and significantly lower than those of adults (p less than 0.001). Antigenic protein C was assayed by enzyme immunoassay, the value attained being also significantly lower than that of normal adults (p less than 0.001). Factor VII: C rates were assayed in order to establish the protein C/factor VII: C relationship, since this might be useful in detecting protein C deficiency due to the similar biological characteristics of both proteins. It was concluded that health normal newborns show decreased antithrombin III and protein C rates, probably due to lack of liver maturity. PMID- 2756456 TI - [Extramedullary blast crisis in chronic myeloid leukemia]. AB - Out of 113 cases of blastic crisis (BC) of Ph'-positive chronic myeloid leukaemia (CML), 13 had extramedullary involvement, this being the first BC manifestation in 5 instances. The median interval between extramedullary BC and bone marrow BC in these last was 2 months. Lymph nodes were the commonest extramedullary site of BC (8 cases), followed by osteoperiosteal and central nervous system (CNS). Lymph node BC occurred as generalised lymphadenopathy in most cases. Osteoperiosteal BC was seen as severe bone pain on osteolytic areas, whereas CNS blast crisis occurred as meningeal leukaemia in one case and chloroma in another. Lymphoid phenotype of blast cells was found in only 2 instances. The median survival of the patients after the onset of extramedullary involvement was 3 months. PMID- 2756457 TI - [Prognostic value of the changes in the DNA of blast cells from patients with acute lymphoblastic leukemia]. AB - The cytogenetic characteristics of 37 patients diagnosed of acute lymphoblastic leukaemia are presented. The studies were performed by cytofluorometry (CFM) after DNA staining with propidium iodide (34 cases) and/or chromosome identification with trypsin G bands (13 patients). Hyperdiploid DNA index was present in 15% of the patients, whereas none of them had hypodiploid DNA index. Abnormal karyotype was found in 69% of the evaluated cases. Good correlation was observed between the ploidy attained by CFM and by karyotyping cells. The highest percentage of aneuploidy corresponded to the L2 morphological subtype (55%), followed by L1 (36%). Structural alterations were the commonest in L2 variant, while numerical ones were commonest in the L1 variant. The 4 L1 patients with aneuploidy had the common immunophenotype, whereas the 6 aneuploidic patients of the L2 variant had common, early pre-B and undifferentiated immunophenotype. The actuarial survival of patients with diploid DNA index was 48.5% (IC 95%, 25-73%), whereas pseudodiploid patients have relapsed and died before 16 months from diagnosis (p less than 0.005). None of the patients with hyperdiploid DNA index and lacking structural alterations has relapsed. Patients with structural abnormalities have the poorest prognosis, while patients with hyperdiploid DNA index showed several favourable risk factors and are in the first complete remission. PMID- 2756458 TI - Management of desmoid tumors. AB - Desmoid tumors are rare, being less than 0.03 per cent of all neoplasms. Because of scarcity of data and relatively small numbers of patients, optimal treatment remains controversial. In this report, our experience with 36 patients evaluated and treated from 1960 to 1987 is analyzed. The most common primary site was the wall of the chest (ten); eight tumors originated in the abdominal wall. Nine patients had a history of previous trauma, and eight of these were women. Thirty two patients had wide local excision and two had amputations. Clear margins were obtained in only 22 patients despite an attempt at wide resection in all instances. With a mean follow-up period of 41 months and a median of 24 months, only one of 22 patients with negative histologic margins had recurrence of tumor. Among the 11 patients with positive margins, four received postoperative radiation therapy and two remain disease-free; of the seven remaining patients with positive margins, three had recurrences. One patient with unresectable disease was treated with tamoxifen with regression of tumor and remains alive 15 months later. These data suggest that the best treatment of desmoid tumors remains resection with a clear margin of normal tissue surrounding the tumor. Adjuvant radiotherapy did not appear to decrease the rate of local recurrence. PMID- 2756459 TI - Fibromyxoma of the bone. AB - Fourteen patients with fibromyxoma of the bone, a rare but relatively overlooked entity, are described. This tumor is different from a chondromyxoid fibroma in age distribution, clinical behavior and histologic appearance. Fibromyxoma occurs frequently in later life (after 50 years of age). It is usually not clinically aggressive and lacks the lobular pattern, chondroid matrix and cell variety of chondromyxoid fibroma. Secondary aneurysmal bone cysts developed in three patients. It behooves the pathologist to screen patients with aneurysmal bone cysts for evidence of pre-existing fibromyxoma, especially if the patient is less than 40 years of age. Treatment consists of curettage with or without cryosurgical procedures. Marginal excision may be necessary for an occasional aggressive lesion. PMID- 2756460 TI - Uterine incision and maternal morbidity after cesarean section for delivery of the very low birthweight fetus. AB - The maternal morbidity associated with the type of uterine incision used for the delivery of the very low birthweight (VLBW) fetus was examined. Maternal morbidity factors evaluated included the incidence of infection, bleeding, wound complications, estimated blood loss, blood transfusions, fever and days in hospital. Cesarean section was performed in 115 of 197 VLBW infants, with 31 low transverse and 84 vertical cesarean sections. There were no significant differences in antepartum, intrapartum or postpartum data between these two groups. Short term maternal morbidity was not increased with the use of vertical compared with low transverse cesarean section for the delivery of the VLBW fetus. PMID- 2756461 TI - Surgical treatment of anorectal fistula in patients with Crohn's disease. AB - Forty-seven patients with Crohn's disease were operated upon for fistula in ano during a 22 year period with an average follow-up time of 82 months. In 29 of the patients, the fistulotomy or fistulectomy wound healed primarily; in 37, a state of complete healing or minimal disability, sometimes after multiple fistulotomies, was achieved. Five patients required proctectomy, but the need for removal of the anorectum was not caused by surgical treatment of the fistula in any instance. Of the 31 patients who had a classical internal opening at the dentate line, 23 healed primarily after surgical treatment of the fistula, compared with only seven of 16 patients without such an internal opening. The 21 patients in whom the rectum was not involved and in whom there was a classical internal opening at the dentate line were an especially favorable group: 18 of these healed primarily after surgical treatment of the fistula, and although ten of them had one or more recurrences of the fistulas, 18 ultimately achieved a state of complete healing or minimal disability. We conclude that operative treatment of fistula in ano is a safe and effective modality in a carefully selected group of patients with Crohn's disease. PMID- 2756462 TI - Ovarian epithelial tumors of low malignant potential. AB - Forty-one patients with epithelial ovarian tumors of low malignant potential are discussed. Twenty-three patients presented with Stage I, four with Stage II and 14 with Stage III disease. All patients with Stage I disease were solely treated surgically. Twelve patients with Stage II and III disease also received postoperative chemotherapy. Four of ten patients had persistent disease at second look laparotomy. Chemotherapy was not used in six patients with Stage II and III disease when the tumor was considered to have been removed completely. Forty of the 41 patients are currently alive and free of disease at two to nine years of follow-up study. Vigorous and, at times, multiple surgical procedures remain the primary treatment of ovarian tumors of low malignant potential. PMID- 2756463 TI - Electrocardiographic guidance for percutaneous placement of central venous catheters. AB - A new technique is described for the percutaneous insertion of central venous catheters under direct ECG guidance, using the intraluminal column of saline solution as a transvenous electrode. This method is safe and allows the correct placement of the catheter tip in the superior vena cava, regardless of anatomic variations in the length of the central veins. It also identifies the aberrantly located catheter, thus preventing potential complications, such as irritation of the right ventricle by the catheter tip and extravascular infusion of solutes. PMID- 2756464 TI - Repair of the diaphragm with an external oblique muscle flap. AB - The technique for repair of large defects in the diaphragm by the use of an ipsilateral or contralateral flap from the external oblique abdominal muscle was successfully used during five hepatic resections and has been described herein. PMID- 2756465 TI - Managing the difficult pulmonary artery during completion pneumonectomy. AB - We describe two examples of successful management of a difficult PA. In the first, the posterior approach to the PA during completion pneumonectomy is demonstrated. In the second, the intrapericardial transection of the right PA is described when the tumor encroaches onto the right hilum. Maneuvers to ensure safe and continuous control of the PA have been previously described but never widely popularized or well illustrated. PMID- 2756466 TI - A modified percutaneous endoscopic gastrostomy. AB - We believe the procedure described herein overcomes the disadvantages of percutaneous endoscopic gastrostomy in that intraperitoneal leakage of gastric contents is prevented and injury to adjacent organs is obviated. At the same time, the desirable qualities of percutaneous endoscopic gastrostomy are retained. So far, the operation has been performed safely and quickly upon four patients who have had no morbidity or mortality. PMID- 2756467 TI - Dental health status in Latin-American preschool children in Malmo. AB - Seventy-three 3-6-year-old preschool children from Latin-American countries living in Malmo were examined in order to evaluate their oral health status. The children had on average 3.5 dmf teeth and 4.9 dmf surfaces. Forty-one per cent were caries-free. Oral hygiene was satisfactory in 25% of the children. Regarding dietary habits, 41% of the children had more than two unsuitable intakes per day. Night-time use of a nursing bottle with sugar-containing beverage was reported for 30%. The mean dmfs values differed significantly between children with and without S. mutans and lactobacilli in their saliva. Oral health status deviated markedly from the total group of 3-6-year-olds in Malmo, which might be explained by differences in cultural background and the ability to speak and understand Swedish. In conclusion, the Latin-American preschool children and their families should be regarded as a risk group for caries and gingivitis and consequently be subjected to special preventive dental care. PMID- 2756468 TI - Dental health, dental health knowledge and behaviour in 14-year-old children of Finnish immigrant families in the north of Sweden. AB - In this study, dental health in a group of Finnish teenagers from immigrant families is compared to that in a group of matched Swedish teenagers. Knowledge of dental disease and dental health behaviour is also compared. Seventy-seven Finnish and 85 Swedish 14-year-olds were examined for caries, gingivitis, calculus and presence of gingival pockets. They were interviewed about toothbrushing habits, use of fluorides and knowledge regarding dental health. A food habit history was taken. Data were collected concerning individual prophylaxis in the last 36 months. It was also noted whether or not the child met the selection criteria for inclusion in such a programme. The average D1FS (approximal initial lesions included) was 17.4 for the Finnish and 13.8 for the Swedish teenagers. The mean GBI% was 8.5 and 7.0 respectively. There were no statistically significant differences in toothbrushing or flossing frequency or use of fluorides. Between-meal eating of sucrose-containing products was more frequent in the Finnish group. Knowledge about gingivitis was equally good in the two groups, but knowledge about the etiology of dental caries was less good in the Finnish group. Although the Finnish teenagers had received almost twice as many hours of individual prophylaxis as the Swedish, 64% and 76% respectively of those fulfilling the selection criteria had not been offered this kind of pRophylaxis. For about 2/3 of the children in each group the individual prophylaxis given was considered adequate. PMID- 2756469 TI - [Management. Equally long in Troms?]. PMID- 2756470 TI - [Health services. Nursing homes--within or without the enterprise chain?]. PMID- 2756471 TI - [Management of rape. An open door for rape victims. Interview by Bjorn Arild Ostby]. PMID- 2756472 TI - [Central Health Authority: group management resolves conflicts?]. PMID- 2756473 TI - [A preparedness group for rape victims in Trondheim]. PMID- 2756474 TI - [Occupational health nursing. Do healthy men need nursing care?]. PMID- 2756475 TI - [Community health services. Community crisis team--a preventive effort]. PMID- 2756476 TI - [Hyperventilation in anxiety. Symptomatic treatment or symptoms as treatment?]. PMID- 2756477 TI - [Joint management with joint objectives]. PMID- 2756478 TI - [Management. It was a battle--background for the situation in the Troms Regional Hospital]. PMID- 2756479 TI - [Management. An end to "war in white"?]. PMID- 2756480 TI - [Management. When medicine is all--and the other way around...]. PMID- 2756482 TI - [Nursing education in Iceland]. PMID- 2756481 TI - [It is time that the Norwegian Nurses' Association commits itself internationally. Interview by Kjell Arne Bakke]. PMID- 2756483 TI - [Senile dementia. Discussion groups for relatives with demented elderly]. PMID- 2756485 TI - [Visions and reality]. PMID- 2756484 TI - [Health care Norway. Regulation of health care--systematic or haphazard?]. PMID- 2756486 TI - [Health education. An old tradition in new clothes. Interview by Bjorn Arild Ostby]. PMID- 2756487 TI - [Norwegian Nurses' Association's international activities. Assistance in women's rights among Palestinians]. PMID- 2756488 TI - 71st legislature produces bills that improve health care in Texas. AB - The 71st Texas Legislature adjourned May 29, ending what was an extremely successful session for the Texas Medical Association. During the 140-day session, TMA tracked more than 600 individual bills and secured passage of major legislation addressing rural health care, Medicaid enhancement, medical liability reform, and other measures to improve the quality of health care and the practice of medicine. TMA also was successful in blocking passage of legislation that might have lowered the quality of care. As this issue of Texas Medicine was going to press, Gov Bill Clements was threatening to veto the rural health care bill, House Bill 18. That issue was a possible agenda item for the special session Clements called for June 20. The special session was called specifically to deal with workers compensation reform, an issue the lawmakers failed to resolve during the regular session. This article, prepared by Ken Ortolon, public relations assistant, and the TMA Public Affairs staff, lists some of the issues TMA was involved in during the 71st session and their outcomes. PMID- 2756489 TI - Epidemiology of anencephaly in Texas, 1981-1986. AB - The incidence of anencephalic births among Texas residents for the period 1981 through 1986 is described. The annual incidence of this birth defect varied from 3.8 to 4.3 cases per 10,000 total births (live births and stillbirths). The highest mean annual incidence was found in East Texas and South Texas. Within all ethnic and racial groups studied, females had higher rates of anencephaly than males, and Spanish-surnamed residents had the highest incidence of this defect, with 5.0 cases per 10,000 live births. Mothers with three or more previous live births or a history of stillbirths were more likely to have anencephalic offspring than were those without these documented histories. Differences in the incidence of anencephalic births between Spanish-surnamed and non-Spanish surnamed whites were not explained by differences in parity. PMID- 2756490 TI - A physician's guide through the child and adolescent mental health system. AB - Despite the high prevalence of mental disorders among the child and adolescent population, a coherent, well-coordinated system for helping them has not developed. Primary care physicians are often frustrated in their attempts to find appropriate mental health services for child and adolescent patients, particularly if their families have limited resources to pay for care. This article gives an overview of the types of child and adolescent mental health services available in Texas, discusses entry requirements into various service systems, and offers practical advice to physicians on how to assist parents seeking care for their children. PMID- 2756491 TI - Toxoplasmosis of the brain and heart: autopsy report of a patient with AIDS. AB - Central nervous system (CNS) infection by Toxoplasma gondii is not uncommon in patients with acquired immunodeficiency syndrome (AIDS). Extraneural toxoplasmosis has been reported in the heart, lungs, testes, and skin of AIDS patients with concurrent CNS toxoplasmosis. Toxoplasma myocarditis is rare even in AIDS patients, except in Haitians. We report the case of a homosexual white man with positive HIV serology who presented with neurological complaints. A diagnosis of toxoplasmosis was not established before death, but at autopsy the patient had cerebral toxoplasmosis and Toxoplasma myocarditis. PMID- 2756492 TI - Up from the beach: medical waste disposal rules! AB - The recent incidents of floating debris, garbage, wood, and medical waste on our nation's beaches have focused public attention on waste management problems. The handling and disposal of solid waste remains a major unresolved national dilemma. Increased use of disposables by all consumers, including the medical profession, and the increasing costs of solid waste disposal options have aggravated the solid waste situation. Medical waste found on beaches in the summer of 1988 could have been generated by a number of sources, including illegal dumping; sewer overflow; storm water runoff; illegal drug users; and inadequate handling of solid waste at landfills and coastal transfer facilities, which receive waste from doctors' offices, laboratories, and even legitimate home users of syringes. As officials from New Jersey have determined, the beach garbage is no mystery. It's coming from you and me. In response to the perceived medical waste disposal problem, various state and federal agencies have adopted rules to regulate and control the disposal of medical waste. This article outlines the more significant rules that apply to medical waste. PMID- 2756493 TI - Doctor mom. PMID- 2756494 TI - Plan now for your child's college education. PMID- 2756495 TI - An uncertain life: demography in random environments. AB - This paper concisely reviews the demography of populations with random vital rates, highlights examples and techniques which yield insight into population dynamics, summarizes the state of significant applications of the theory, and points to open problems. The central picture in this theory is of a time-varying but statistically stationary equilibrium for population, sharply distinct from the notions of classical demography. The deepest biological insights from the theory reveal the temporal structure of life histories to be a rich arena for natural selection. PMID- 2756496 TI - Ethical problems with the use of animals in medical research and education: an introduction. PMID- 2756497 TI - Measuring merit in animal research. AB - Merit review of scientific projects involving laboratory animals is a central issue in the current debate over the ethics of animal experimentation. In this essay, I examine several conceptual, regulatory, and practical problems inherent in the merit review process. Contemporary challenges to the existing merit review system and suggestions for reform are also discussed. The essay concludes with comments on legal and political questions relevant to the future of merit assessment. PMID- 2756498 TI - Approving the use of animals in medical education. AB - Animals have been and will continue to be used in educational programs, but some concerns about the responsibility for assuring their proper care and humane use need to be discussed. Research animals have been regulated and monitored quite successfully by Institutional Animal Care and Use Committees (IACUC). These Committees are extending their responsibilities to cover animals used in educational programs. Three common roles of these IACUCs are described, including oversight, investigative and training responsibilities. Guidelines developed for faculty using animals at the University of Florida are presented and discussed. PMID- 2756499 TI - Using animals for the training of physicians and surgeons. AB - It is argued that cultural attitudes of a speciesist nature are background to the current practice of animal use in teaching medical students and residents. The scope of this activity is estimated, and educational theory is enlisted to suggest that many assumptions about the effectiveness of the practice are not valid. An assessment of one course used for ob-gyn training is presented. Since it is clear that animal suffering should be avoided when possible, the case is made that alternatives to animals may be used to replace animal use in much of current medical education. Medical educators should routinely question and offer adequate justification for any use of animals in medical education. PMID- 2756500 TI - The use of animals in medical education: a question of necessity vs. desirability. AB - An issue in current animal welfare ethics is the use of animals in medical education. At stake is the conflict of pain and suffering of the animals vs. the benefit to the students. The educator's role is to balance these two concepts. If the animals do suffer, this has to be justified by clearly establishing the necessity of their use. Neither this justification nor the methods for making the decision are clear. Addressed in this discussion are the arguments for and against animal use, alternatives, and proposals for the resolution of the controversy. PMID- 2756501 TI - The observing subject and psychophysiological research: an epistemological discourse. AB - Realizing that scientific knowledge was not based on a simple disclosure of reality, but was rather invented and developed in accordance with our own conceptions and prejudices, it should no longer be possible to consider matters as if they existed independently of us 'out there'. Taking as examples the notions of 'memory' and 'information' we try to elucidate the relevance this perspective has with respect to neuro- and psychophysiological research. PMID- 2756502 TI - Caring for decisionally incapacitated elderly. AB - Although treating the elderly occasion the same kinds of ethical issues as treating other patients, specific problems do arise when making decisions for persons, once competent, who no longer can express their values. I examine the problem of decisional incapacity and offer a critique of the principles, such as substituted judgment, and the instruments, such as advance directives, living wills, other instructional directives, as well as surrogate decision-makers. PMID- 2756504 TI - [The medical check-up]. PMID- 2756503 TI - The use of animals in medical education and research. AB - After noting why the issue of the use of animals in medical education and research needs to be addressed, this article briefly reviews the historical positions on the role of animals in society and describes in more detail the current positions in the wide spectrum of positions regarding the role of animals in society. The spectrum ranges from the extremes of the animal exploitation position to the animal liberation position with several more moderate positions in between these two extremes. Then the philosophical issue of the moral agency of animals is discussed in terms of an explication of the concept of rights and the concept of personhood. Further research is suggested concerning institutional policies regarding medical students who refuse to do physiology dog labs or other assignments which involve the suffering and/or death of animals. PMID- 2756505 TI - [Check-up examinations from the cardiologic viewpoint]. AB - The concept of the primary prevention of coronary disease is certainly widely accepted today and supports check-up visits of apparently healthy persons. The goals of check-up's viewed by the cardiologist are the detection of coronary risk factors and the identification of asymptomatic patients with coronary disease to initiate preventive measures. In some instances, a personal health problem forces the patient to a check-up visit. The major coronary risk factors of heredity, cigarette-smoking, hypercholesteremia, hypertension can be detected by taking the history, performing a physical examination and a blood-sampling for cholesterol. Additional investigations such as an ECG or an exercise-test are only indicated in symptomatic patients or in persons at high coronary risk. PMID- 2756506 TI - [The preoperative check-up, anesthesiologic aspects]. AB - A preoperative check-up has two main goals: first to detect concomitant disease beside the surgical problem that might influence anesthetic management. Second to assess treatment and the condition of the patient with stable concomitant disease. The patient should present in the best possible condition to anesthesia and operation. Disease of the cardiovascular system and the respiratory system are most commonly associated with increased anesthetic and surgical risk. Most abnormalities relevant to anesthesia are easily detected by history and physical examination. Routine preoperative screening tests (chest X-ray, ECG, hemoglobin, biochemistry) are of little value in detecting disease in younger people, although in patients over the age of 60 screening tests may be useful. PMID- 2756507 TI - [The gynecologic check-up]. AB - The feelings that come with the physiological changes, bring young women the awareness for the prophylactic intention of modern medicine. An example of the check-ups is the well accepted ante-natal clinic. The most frequent reason for a young woman to make an appointment with a gynaecologist is the wish to have some sort of contraception. This consultation often means the first chance for a pap smear to be carried out. With the onset of the climacteric is for those who have neglected their earlier screening examinations, the next reason to make an appointment. At this stage the doctor will discuss the possibilities of hormonal substitutive therapy. The need of early diagnosis of cancer should be stressed with regular examination in the following years. In gynaecology the screening tests with the aim of diagnosing precancerous conditions is only possible from the cervix. This being through vaginal cytology and colposcopy. For the early diagnosis of cancer attention to the at risk groups should be observed. Associated with the cervical, endometrial, ovarian, vulvar and breast cancers are phenotypical characteristics. Special attention should be given to the taking of the pap smear. Finally the current value of a mammography will be discussed. PMID- 2756508 TI - [Preventive medical examinations in infants, children and adolescents]. AB - Pediatric health care is one of the specialties in medicine for which prevention is the most traditional and most essential activity. In this brief review the office practice of Swiss pediatricians is discussed to give insight into the needs of children and their families concerning their health problems and the health services delivered in respect to check-ups and counseling. Age specific concerns and screenings are summarized. More special attention should be devoted to the health counseling for adolescents. PMID- 2756509 TI - [The dermatologic check-up]. AB - The aim of dermatologic check-up is the early diagnosis of asymptomatic potentially dangerous skin changes. An early melanoma may be cured by simple excision. Dermatologic signs in general medicine are very important. Paraneoplastic symptoms in patients with glucagonoma consist of the typical necrolytic migratory erythema. Acrokeratosis Bazex is seen in patients with larynx carcinoma and dermatomyositis or acanthosis nigricans may occur in patients with internal malignancy. Spider angioma, jaundice, changes in hair pattern and white nails may be cutaneous signs of liver disease or necrobiosis lipoidica may be found in diabetic patients. Renal transplants and patients with HIV infection should be submitted for a dermatological check-up every six months. In these people several malignant tumors are seen more often than in control people. PMID- 2756510 TI - [Check-ups from the urologic viewpoint]. AB - A medical check-up must comprise questions concerning not only the micturition but also the erection. Erectile dysfunction may lead to the detection of a hitherto undiagnosed diabetes or of arteriosclerotic lesions requiring treatment. The physical examination must include a digital rectal examination, in order to find a prostatic carcinoma in an early stage in which the radical operation most often will achieve disease free survival. PMID- 2756511 TI - Incidence of Mycoplasma hominis and Ureaplasma urealyticum infection in pregnant women and gynaecological patients; the effectivity of doxycycline therapy. AB - The authors report on the results of Mycoplasma hominis and Ureaplasma urealyticum cultivations performed within two and a half years in 1,421 pregnant women and gynaecological patients. Considering the obstetrical-gynaecological patients Mycoplasma hominis was identified in 7.25% and Ureaplasma urealyticum in 38.11% of cases. No significant difference was found in the incidence of Mycoplasma infection when comparing the results of cultivations of samples obtained from a clinically non-inflamed vagina or cervix with the results of cultivations of samples obtained from the female lower genital tract in the course of an inflammatory disease. In cases of endometritis, salpingitis or cophoritis Mycoplasma hominis could be isolated from the cervix significantly more frequently. The incidence of Mycoplasma hominis infection was also significantly higher in the examined 315 sterile women. The incidence of Mycoplasma hominis and Ureaplasma urealyticum infection did not differ when comparing the 267 symptom-free pregnant women to the other patients. The presence of the pathogenic organisms did not aggravate the unfavourable course of pregnancy. When examining the effectivity of Doxycycline capsule the drug proved to be effective in 78 patients for the treatment of genital Mycoplasma infections. PMID- 2756512 TI - Broncho-vaxom therapy for children with chronic bronchitis. AB - The authors report on a clinical study conducted in 1985/86 for evaluating the efficacy of Broncho-Vaxom in children with chronic bronchitis. They observed, during the Broncho-Vaxom therapy, a significant reduction in the number and severity of the acute episodes as well as the significant reduction of the use of antibiotics. They recommend the use of Broncho-Vaxom in chronic, recurrent respiratory infections. PMID- 2756513 TI - Usefulness of acid and gastric juice secretion decreasing action of cimetidine in anaesthesia for the prevention of aspiration. AB - The effect of Histodil injection on the amount and pH of the gastric juice has been examined in women undergoing caesarean section under intratracheal anaesthesis. According to the results cimetidine decreases the volume and acidity of gastric secretion to a significantly higher extent than the pretreatment with atropine as a single agent. Maximum effect may be expected within 60-90 minutes. With Cimetidine pretreatment the risk of aspiration and pneumonitis may be prevented. PMID- 2756514 TI - Clinical examinations with chinofungin spray and chinofungin powder. AB - Tolnaftate is effective in the local treatment of dermatophyte infections. It is recommended primarily in infections caused by Trichophyton rubrum, Trichophyton mentagrophytes, Epidermophyton floccosum, Microsporum canis and Malassezia furfur. It may be useful as an adjuvant local therapy in chronic dermatophyte infections treated with griseofulvin. PMID- 2756515 TI - [Efficacy and tolerability of cycletanine in aged patients with hypertension]. AB - Moderate arterial hypertension of the elderly has to be treated but the efficacy has to be progressive. Cicletanine has a pharmacokinetic profile well fitted to the therapy of this age group. The mechanism of action is characterized by synthesis of prostacyclin. A double blind prospective randomized study was conducted at two institutions on 132 patients aged more than 60, with diastolic arterial pressure over 95 mmHg and systolic over 160 mmHg. 62.9% of them were aged more than 75. The analysis of those two studies shows that the three groups with cicletanine (respectively 50, 100 and 150 mg per day) had a significant decrease of both pressures versus placebo. In the 50 mg group, 40% of arterial pressures were normalized after 3 months of treatment. There were no difference between 50 and 100 mg. There were no adverse drug reaction like falling down, day or night, or orthostatic hypotension. The biological tolerance, more particularly renal, was excellent with this dose of 50 mg a day. Cicletanine at the dose of 50 mg/day is a recommended treatment in arterial hypertension of the elderly. PMID- 2756516 TI - [Effects of nifuroxazide on fecal flora in healthy subjects]. AB - Effect of nifuroxazide on fecal flora was studied in 12 healthy volunteers receiving, in hazardous order and double-blind procedure, three six-days courses of treatment separated by eight-days spaces of time: the conventional dosage of 400 mg twice a day, a dosage of 1200 mg once a day, and placebo. Among six settled bacteriological index (wealth of the fecal flora, percentage of gram negative bacteria, numbers of E. coli, Enterococcus, Clostridium and Bacteroides), no significant variation was found by means of statistical study between D0, D2 and D7, nor between the three courses of treatment. Therefore nifuroxazide, even in high dosage, does not injure integrity of microbial intestinal ecosystem under so defined experimental conditions, similar with clinical conditions. PMID- 2756517 TI - [Pharmacokinetics of drugs in children]. AB - The pharmacokinetic parameters of a drug allow to define its posology. The large physiological modifications, which occur during the development of a child from birth to adolescence, can intensely modify some pharmacokinetic parameters of a drug and so increase its toxicity or inhibit its activity. In this review, pharmacokinetic consequential effects of child development are studied and discussed with regard to some examples. PMID- 2756518 TI - [General problems posed by prescription medications in children. Point of view of the clinician]. AB - Drug therapy for children arise many a problem for clinical practitioners as pediatric requirements are very specific. Adequate dosage according to various developmental stages (neonate, infant, child, adolescent), specific pediatric forms issued from clinical and pharmacokinetics trials in children, galenic drugs suitable for pediatric use without side effects especially for topical preparations, remodelling of adult forms into pediatric forms without loss of effectiveness are some of the main problems. Furthermore medication compliance and potential hazards connected to misuse of some "over the counter" drugs (antipyretics, vitamins, trace elements) delivered without medical prescription are underscored. PMID- 2756519 TI - [Difficulties in fixing the official dosage of drugs in children]. AB - In the French Pharmacopoeia there is a table of doses of drugs for pediatric use, which is to be hold as an official document. Some of the problems raised for establishing these doses are discussed in this paper: choice of age-ranges, selection of drugs, way of expressing doses, interest or not to indicate maximal doses, spread of these data to medical prescribers and pharmacists. PMID- 2756520 TI - [Drug surveillance in children]. AB - For the last decades, children have been the victims of severe and spectacular drug adverse reactions. Several risk factors explain the sensitivity and specificity of childhood to drug adverse effects. Newborn baby and infant are particularly affected. Three types of adverse effects which affect more specifically children, should be considered: a) Same effect as in adult but increase in intensity. b) Effects resulting from an interference with maturation and growth processes. c) Delayed reactions appearing a long time after drug exposition. Methods use to detect and collect drug adverse effects in children are not theoretically different from those used for adult patients except being more difficult to implement. A long term follow-up of adverse effects should be systematically organised for new drugs intend for children. PMID- 2756521 TI - [Problems posed by the adjusting of a dosage form of a drug for children]. AB - The safe use of drugs for pediatric patients is based upon good conditions of administration, in order to ensure accuracy and reproducibility of the dose received. But dosage adjustment often needs also a transformation of the galenic form, and that involves many risks or error. Some solutions are proposed in order to standardize the methods of drug adjustment for pediatric use. PMID- 2756522 TI - [Hepatitis during treatment with tamoxifen. Effects on the kinetics of epirubicin]. PMID- 2756524 TI - [Writing the clinical trial report]. AB - The clinical study report is a key document, representing as it does one of the elements of the drug registration file. The authors propose here a general design for a controlled trial which offers the advantage of a methodical approach covering most clinical study situations. PMID- 2756523 TI - [Pharmacokinetics of oral propafenone in patients with supraventricular arrhythmia]. AB - The efficacy of propafenone (P), a class IC antiarrhythmic drug with weak beta blocking properties was studied over a four day period in 10 patients with supraventricular arrhythmias (atrial fibrillation 7, flutter 1 and tachycardia 2). Group 1 included five patients (3M, 2F) who received 300 mg of P on days 1 and 4. Group 2 included five patients (4M, 1F) who received 600 mg on days 1 and 4. All the patients received 1200 mg/day on days 2 and 3. Pharmacokinetics parameters were calculated for the first and the final dosing. Half of the patients were converted to sinus rythm after a delay ranging from 12 to 55 h after the first dosing. The duration of arrhythmia was shorter and the left atrial diameter was significantly lower in the responder group than in the non responders. No relationship was observed between clinical efficacy and dose or plasma concentration of P. After the first administration of P, major interindividual variability in pharmacokinetic parameters was observed. Seven patients correspond to the extensive metabolizer phenotype with t1/2 el less than 10 h (mean: 5.4 +/- 2.2 SD). In this group t1/2 el increased from day 1 to day 4 and the AUC final/AUC initial ratio ranged between 4 to 17.5. Three patients showed the non-extensive metabolizer phenotype with t1/2 el ranging from 12.4 to 13.7 h and a moderate increase in AUC over chronic dosing. Adverse effects (cardiac conduction abnormalities, visual and digestive disturbances) were observed in the 3 oldest patients (70-73 yrs).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2756525 TI - [Topical ophthalmic drugs]. AB - Although satisfactory therapeutic results are obtained with usual topical opthalmic drugs, they present some inconveniences. Particularly, their biodisponibility is often poor, requiring the use of relatively important doses, and repeated applications. In order to avoid these difficulties, different systems more or less sophisticated, such as soluble inserts, impregnated lenses, liposomes or implantable pumps, have been conceived for topical application. However, although these systems seem to present certain advantages, none of them, commercialized or not, have been quite satisfactory. PMID- 2756526 TI - Variability in soman toxicity in the rat: correlation with biochemical and behavioral measures. AB - The inhibition of cholinesterase (ChE) activity in the central nervous system of the rat by the potent organophosphorus compound soman was examined. At soman doses greater than 55 micrograms/kg s.c. (0.5 LD50), there were: (1) dose-related inhibition of ChE activity in brain regions; (2) variability in the degree of ChE inhibition at each soman dose in each brain region; and (3) variability in the severity of signs of intoxication at each dose. These data suggest that measurements of ChE should be made directly or predicted individually in each animal for which the effects of soman are assessed. At the estimated ED50 soman dose for signs of intoxication (66 micrograms/kg s.c.), the remaining ChE activity in brain correlated poorly with ChE activity in plasma and red blood cells (R = 0.14-0.20), moderately with behavioral scores based on overt signs of intoxication (R = 0.63-0.94), and well with spinal cord ChE activity (R = 0.93 0.98). Finally, ChE activity in the thoracic and lumbosacral regions of spinal cord were not affected by headfocused microwave inactivation of brain enzymes, demonstrating that ChE activity in these regions of the cord can be used to predict the level of ChE inhibition in brain when direct measurement in brain is unfeasible. PMID- 2756527 TI - Biochemical responses of rat and mouse lung to inhaled nickel compounds. AB - Nickel subsulfide (Ni3S2), nickel sulfate (NiSO4), and nickel oxide (NiO) are encountered occupationally in the nickel refining and electroplating industries, with inhalation being a common route of exposure. The purposes of this study were to evaluate the biochemical responses of lungs of rats and mice exposed for 13 weeks to occupationally relevant aerosol concentrations of Ni3S2, NiSO4, and NiO, to correlate biochemical responses with histopathologic changes, and to rank the compounds by toxicity. Biochemical responses were measured in bronchoalveolar lavage fluid (BALF) recovered from lungs of exposed animals. Parameters evaluated in BALF were lactate dehydrogenase (LDH), beta-glucuronidase (BG), and total protein (TP). Total and differential cell counts were performed on cells recovered in BALF. All compounds produced an increase in LDH, BG, TP, and total nucleated cells, and an influx of neutrophils, indicating the presence of a cytotoxic and inflammatory response in the lungs of exposed rats and mice. Increases in BG were greater than increases in LDH and TP for both rats and mice. Chronic active inflammation, macrophage hyperplasia, and interstitial phagocytic cell infiltrates were observed histologically in rats and mice exposed to all compounds. Statistically significant increases in BG, TP, neutrophils, and macrophages correlated well with the degree of chronic active inflammation. Results indicated a toxicity ranking of NiSO4 greater than Ni3S2 greater than NiO, based on toxicities of the compounds at equivalent mg Ni/m3 exposure concentrations. PMID- 2756528 TI - Protective effect of flavonoids on drug-induced hepatotoxicity in vitro. AB - Primary cell cultures of neonatal hepatocytes were used to examine the protective effect of flavonoids in the presence of hepatotoxins. Catechin (CAT) and silybin (SIL) protected the hepatocytes against cell injury produced by erythromycin estolate (EE), amitriptyline (AT), nortriptyline (NT), and tert butylhydroperoxide (TBOOH). Leakage of lactate dehydrogenase (LDH), aspartate aminotransferase (AST) and alanine aminotransferase (ALT), as well as morphological parameters, were used as indices of hepatotoxicity. Hepatocytes were exposed to EE (1 X 10(-4) M and 2 X 10(-4) M), AT, NT, and TBOOH (1 X 10(-4) M and 1 X 10(-3) M) for a 2-h period. These hepatotoxins caused significant LDH, AST, and ALT leakage (P less than 0.05) when compared to untreated control groups. NT was less toxic than its parent compound, AT. Changes in morphology were evident after 1 h of treatment with the toxicants, including: vacuole formation, size deformation and cell necrosis. As the concentration of hepatotoxins was increased, the changes were more pronounced. Pretreatment of the cultures with either CAT or SIL resulted in less enzyme leakage and morphological alterations by the hepatotoxins. The results of this study suggest that CAT and SIL may act by stabilizing the plasma membrane against toxic insult. PMID- 2756529 TI - Perturbation of glutathione by a central action of morphine. AB - A series of studies were conducted in order to further characterize the previously reported effect of morphine to diminish hepatocellular concentrations of glutathione (GSH) in mice. Naive ICR mice administered morphine (i.p.) in doses up to 1000 mg/kg had diminished hepatic GSH concentrations, with a maximum depletion of approximately 50% occurring at doses of 250 mg/kg or greater. No such effect from an acute challenge with morphine was observed in morphine tolerant mice. The intracerebro-ventricular administration of the opioid receptor antagonist naltrexone (250 micrograms) completely blocked the hepatic GSH depression resulting from the systemic (i.p.) administration of morphine (100 mg/kg). When morphine (100 micrograms) was administered by the i.c.v. route, GSH concentrations in liver and plasma were significantly altered while heart and kidney were unchanged. Variable responses to i.c.v. morphine were obtained in spleen, stomach and lung. The depression of hepatic GSH was found not to be a consequence of morphine-induced hypoxia or hypothermia, and could not be attributed to intracellular oxidation of GSH. PMID- 2756530 TI - Muscle necrosis by N-methylated p-phenylenediamines in rats: structure-activity relationships and correlation with free-radical production in vitro. AB - Certain derivatives of p-phenylenediamine have been shown to cause necrosis of cardiac and skeletal muscle in rats; in vitro, such compounds are known to autoxidize to the corresponding radical cations, with concomitant formation of oxygen free-radicals. In the present study, the autoxidation rates of p phenylenediamine and its N-methyl, dimethyl, trimethyl and tetramethyl derivatives have been determined and compared with the severity of the muscle necrosis induced by each of these compounds in rats. A close correlation was observed between autoxidation rate in vitro and toxicity in vivo, suggesting that free-radical species may be involved in the initiation of the muscle damage caused by these substances. PMID- 2756531 TI - Retention and distribution of manganese in the mouse brain following acute exposure on postnatal day 0, 7, 14 or 42: an autoradiographic and gamma counting study. AB - The relationship between postnatal age at time of Mn exposure, and the retention and distribution of Mn in the brain of the mouse was studied using gamma counting and autoradiography. A single intraperitoneal dose of Mn2+ (11 micrograms/kg or 25 mg/kg) containing radioactive 54Mn was administered on postnatal day 0, 7, 14 or 42. Animals were then killed at various times post exposure (1-114 days) and retention and distribution determined. Maximum retention of Mn in the brain (calculated as a percentage of administered dose) occurred 43 days following exposure on day 0. For day 7, 14 or 42 the highest Mn retention was 24 h after exposure. Maximum retention was 2.9%, 3.5%, 2.5% or 0.3% respectively, Mn retention after 114 days was 0.4%, 0.3%, 0.3% or 0.04% respectively. For the carrier-added group maximum retention was lower with corresponding figures of 2.5%, 2.4%, 1.1% or 0.2% and retention after 114 days was also lower 0.1%, 0.06%, 0.05% or 0.01%. The autoradiography studies indicated that Mn was located in areas of the brain which had a high perikaryal density at the time of exposure and in the choroid plexus. High and low doses of Mn were similarly distributed and there was little change in distribution with time. PMID- 2756532 TI - Risk factors for stroke and other embolic events in patients with nonrheumatic atrial fibrillation. AB - Factors associated with stroke and other cardiac embolic events in subjects with nonrheumatic atrial fibrillation were examined in a retrospective study of 91 patients from a teaching hospital clinic. There were 28 first strokes during 355 person-years of follow-up (7.9 per 100 person-years). Patients who had experienced one or more previous events were approximately 2.3 times more likely to have a subsequent event (hazard ratio 2.3, 95% confidence interval 1.5-3.4) than patients who had experienced no events. A univariate analysis of factors associated with a first stroke of any cause or other embolic event showed that age of greater than 75 years (hazard ratio 2.5) and systolic blood pressure of greater than 160 mm Hg (hazard ratio 6.4) were significant factors. After adjusting for the effect of age and systolic blood pressure, previous events still carried an increased risk for subsequent events. Subject with nonrheumatic atrial fibrillation who have had one or more embolic events are at high risk of further emboli. They require special consideration when treatment is being planned. PMID- 2756533 TI - Leukoaraiosis and intracerebral hematoma. AB - We studied 33 consecutive patients with computed tomographic findings of decreased density in the periventricular white matter (leukoaraiosis). Computed tomograms in five (aged 56-75 years) of the 33 demonstrated intracerebral hematoma. The hemorrhages were situated in the thalamic area in four and in the parietotemporal area in one patient. These five patients were hypertensive and had signs characteristic of parenchymal hemorrhage. Three of the five patients had progressive dementia prior to the ictus, and two of the three also had a history of single or multiple strokes. There was no significant difference in the clinical findings of hematoma patients with or without leukoaraiosis. PMID- 2756534 TI - Prevention of chronic cerebral vasospasm in dogs with ibuprofen and high-dose methylprednisolone. AB - Severe chronic cerebral vasospasm was produced in dog basilar arteries by two injections, 2 days apart, of autologous blood into the cisterna magna of 25 dogs. Treatment with ibuprofen (n = 8) or high-dose methylprednisolone (n = 8) after the first injection of blood prevented or reduced angiographic vasospasm. Cerebrospinal fluid concentrations of prostaglandin E2, prostaglandin F2 alpha, 6 ketoprostaglandin F1 alpha (a metabolite of prostacyclin), and thromboxane B2 (a metabolite of thromboxane A2) were measured in both treated and untreated (n = 7) dogs. In untreated dogs, the level of prostaglandin E2 increased 94-fold by Day 8 after the first injection of blood and was strongly and positively correlated with the degree of angiographic vasospasm. Treatment with ibuprofen and high-dose methylprednisolone prevented or significantly reduced this increase in prostaglandin E2 concentration. Smaller increases in cerebrospinal fluid concentrations of thromboxane B2 and 6-ketoprostaglandin F1 alpha occurred after experimental subarachnoid hemorrhage; the magnitude of these increases was also reduced by ibuprofen or high-dose methylprednisolone treatment. In contrast, prostaglandin F2 alpha levels were not significantly altered during the study. These data show that enhanced prostaglandin E2 synthesis occurs during experimental subarachnoid hemorrhage, and the by-products generated in its synthesis may play a role in the pathogenesis of cerebral vasospasm. PMID- 2756535 TI - Correlation between cerebral blood flow and histologic changes in a new rat model of middle cerebral artery occlusion. AB - We describe a new focal ischemia model consisting of unilateral middle cerebral artery occlusion with a silicone rubber cylinder attached to a nylon surgical thread inserted through the internal carotid artery in rats. Recirculation was accomplished by pulling the thread out of the artery. We evaluated the reliability of this model and studied the influence of reperfusion of the brain by measuring regional cerebral blood flow in 30 rats and by using conventional neuropathologic methods after different periods of occlusion in 48 rats. The anterior neocortex and the lateral part of the caudate putamen, which were supplied by the occluded middle cerebral artery, were the regions most frequently damaged. After 1 hour of occlusion in five rats, in the cortex supplied by the occluded artery mean +/- SD blood flow was 0.19 +/- 0.08 ml/g/min (approximately 15% of that in the corresponding region of five sham-operated control rats), and mild scattered ischemic cell change was observed. Three (n = 5) or six (n = 5) hours of occlusion reduced blood flow more severely and caused severe ischemic cell changes in the cortex supplied by the occluded artery in proportion to the duration of ischemia. Characteristically, in five rats subjected to 3 hours of occlusion followed by 3 hours of recirculation, blood flow was restored and spongy edematous change was observed in the cortex supplied by the recirculated artery. This change resulted in hypoperfusion of the neighboring cortical region surrounding the recirculated area. Our model should be useful in various investigations of the influence of reperfusion on focal ischemic brain injury. PMID- 2756536 TI - Nimodipine does not improve neurologic outcome after 14 minutes of cardiac arrest in cats. AB - We tested the effects of nimodipine upon neurologic outcome in 31 cats subjected to 14 minutes of cardiac arrest followed by resuscitation. With the dose schedule used, nimodipine had no effect upon neurologic outcome or upon the percentage of ischemic neurons in frontal, hippocampal, occipital, or cerebellar brain sections. The electroencephalographic recovery pattern did not correlate with neurologic or pathologic findings. PMID- 2756537 TI - Comparison of intraluminally versus extraluminally administered nimodipine on serotonin-induced cerebral vascular responses in vitro and in situ. AB - The purpose of our study was to compare the ability of intraluminally and extraluminally administered nimodipine to inhibit serotonin-induced cerebral vascular responses in vitro and in situ. No difference was noted in the ability of nimodipine, whether administered intraluminally or extraluminally, to reduce the contractile response of extraluminally administered serotonin in a closed, pressurized, in vitro bovine middle cerebral artery preparation; histologic studies indicated that the tight endothelial junctions normally found in cerebral arteries remained intact in this preparation. In cats, pretreatment with nimodipine did not significantly reduce the ability of intracisternally injected serotonin to decrease cerebral blood flow; however, nimodipine did reduce the changes in cerebral artery diameter normally noted angiographically after serotonin injection. Although minor differences were noted between the intraluminal and extraluminal routes of administration of nimodipine in situ, in general the effects were comparable. PMID- 2756538 TI - Deafferentation versus cortical ischemia in a rabbit model of middle cerebral artery occlusion. AB - A two-site middle cerebral artery occlusion model in rabbits was developed. Platinum electrodes served for simultaneous recordings of regional cerebral blood flow, auditory evoked potentials, and electroencephalogram in the left and right auditory cortex and in the left medial geniculate body. Auditory evoked potentials and regional cerebral blood flow were also recorded in the subcortical white matter, and regional cerebral blood flow was recorded in the internal capsule. Distal segment occlusion of the middle cerebral artery caused severe cortical ischemia in four of 11 rabbits (Group I), accompanied by abolition of the auditory evoked potential in the left auditory cortex and white matter and severe reduction of the left electrocorticogram. Deep subcortical regions were affected either little or not at all. In the remaining seven rabbits (Group II) with only mild disturbance of cortical perfusion after distal middle cerebral artery occlusion, additional clamping of the proximal middle cerebral artery stem reduced thalamocortical tract blood flow and abolished cortical auditory evoked potentials. Spontaneous electrocorticogram was less affected in Group II than in Group I; thalamic regional cerebral blood flow and auditory evoked potentials were not altered. Histologically, ischemic lesions predominated in the cortex of Group I and in the subcortical structures of Group II rabbits. While correlated reductions in regional cerebral blood flow and auditory evoked potentials indicate effective cortical ischemia, the impairment of auditory evoked potentials in Group II rabbits must be due to cortical deafferentation by ischemia in the afferent tract. This model permits the investigation of the effects of predominantly cortical or subcortical ischemia in one functional system. PMID- 2756539 TI - Evidence of cortical reorganization in hemiparetic patients. AB - We studied the mechanisms underlying the recovery of motor function of the hand using a bidimensional xenon-133 inhalation technique to measure regional cerebral blood flow at rest and during the performance of a motor task (test condition). The regional cerebral blood flow patterns under rest and test conditions were compared in normal control and in stroke patients with either a cortico subcortical or a deep-seated lesion. Functional recovery appears to depend upon cortical reorganization involving both hemispheres, particularly in both parietal regions in the subgroup of patients with cortico-subcortical lesions. PMID- 2756540 TI - The ferret as an animal model in cerebrovascular research. AB - Clinical and pathologic observations have suggested analogies between the developing nervous system of ferrets (Mustela putorius furo) and those of more traditional animal models employed in stroke research. Experimental work has demonstrated advantages of the ferret as a model of visual development. We performed in vivo cerebral angiography and postmortem neurovascular dissection of latex-injected specimens of adult ferrets. The great vessels include a cervical arterial trunk that gives rise to both carotid arteries. The anatomy of the cranial arteries is similar to that of rabbits. No carotid rete mirabile is present. There are no intracranial anastomoses between the external and internal carotid systems. We present in vivo cerebral angiograms with pathologic correlation that demonstrate that ferrets may provide the same anatomic advantages as a rabbit model for the experimental study of cerebrovascular disease, with the additional advantage of a long extracranial cervical segment of the carotid artery, affording easier access to the intracranial vasculature. PMID- 2756541 TI - Effects of a new thyrotropin-releasing hormone analogue administered in rats 1 week after middle cerebral artery occlusion. AB - We observed the effects of a new thyrotropin-releasing hormone analogue, YM-14673 (N alpha-[[(S)-4-oxo-2-azetidinyl]carbonyl]-L-histidyl-L-prolinamide dihydrate) on behavioral changes in 26 rats subjected to middle cerebral artery occlusion. The administration of 0.1 mg/kg i.p. YM-14673 was started 1 week after occlusion and was repeated daily for 2 weeks. YM-14673 significantly accelerated the recovery of neurologic deficits and ameliorated the disturbance of passive avoidance learning. Thus, YM-14673 improved behavioral response in a model of chronic focal cerebral ischemia. The availability of a chronic middle cerebral artery occlusion model for the evaluation of drugs is also discussed. PMID- 2756542 TI - Moyamoya disease associated with polycystic kidney disease and eosinophilic granuloma. AB - Moyamoya disease has been associated with renal artery stenosis, cerebral hemorrhage, and multiple cranial traumas. We report a unique case of moyamoya disease associated with polycystic kidney disease and eosinophilic granuloma. Although the etiology of moyamoya disease is unknown, a familial pattern of occurrence has been documented. Of particular importance is its presentation with polycystic kidney disease, an autosomal dominant disease, suggesting a hereditary component to the etiology of this unusual vasculitic disease. PMID- 2756543 TI - Occlusion of the middle cerebral artery due to cysticercotic angiitis. AB - Three patients with cysticercosis developed a cerebral infarct secondary to the occlusion of the middle cerebral artery or its major branches. Histopathologic examination revealed a large subarachnoid cysticercus surrounding the occluded arteries in two patients and diffuse thickening of the leptomeninges in one. Blood vessels around the parasite showed inflammatory changes that caused either occlusive endarteritis or thrombosis due to disruption of the endothelium. Cysticercosis should be considered as a cause of occlusion of the major intracranial vessels, particularly in young patients living in areas where this disease is endemic. PMID- 2756544 TI - Spontaneous intracranial carotid artery dissection. AB - A previously healthy 46-year-old woman had the abrupt onset of aphasia and right hemiplegia from a large left-hemisphere infarct. At postmortem examination the cause of the infarct was dissection and occlusion of the intracranial carotid artery. No preexisting abnormality was found to account for the dissection. This uncommon cause of stroke and its pathogenesis are discussed. PMID- 2756545 TI - The unstable carotid plaque. PMID- 2756546 TI - The importance of brain temperature in cerebral ischemic injury. PMID- 2756547 TI - Possible complications of pentoxifylline in stroke. PMID- 2756548 TI - Granulocytes, platelet activating factor, and stroke. PMID- 2756549 TI - Hemorrhagic transformation of cardioembolic stroke. PMID- 2756550 TI - Determinants of early recurrence of cerebral infarction. The Stroke Data Bank. AB - We studied 1,273 patients with ischemic cerebral infarction who were entered into the Stroke Data Bank, a prospective, observational study involving four university hospitals and the Biometry and Field Studies Branch of the National Institute of Neurological Disorders and Stroke. Forty patients had noniatrogenic recurrent stroke within 30 days after the index cerebral infarction. Using life tables, the 30-day cumulative +/- SE risk of early recurrence for all infarctions was 3.3 +/- 0.4%. The risk of early recurrence was greatest for atherothrombotic infarction (7.9 +/- 2.2%, eight of 113 patients) and least for lacunar infarction (2.2 +/- 1.2%, eight of 337 patients). Both cardioembolic infarction (4.3 +/- 0.9%, 10 of 246 patients) and infarction of undetermined cause (3.0 +/- 0.5%, 14 of 508 patients) had intermediate risks. History of hypertension and diabetes mellitus, as well as diastolic hypertension and elevated blood sugar concentration at admission, were associated with early recurrence. Logistic regression analysis estimated the risk of early recurrence to be 8.56% in those with coexisting hypertension and a glucose concentration of 300 mg/dl versus 0.77% in the absence of these two abnormalities. Early recurrence was associated with longer median duration of initial hospital stay (27 vs. 14 days) and a higher 30-day case-fatality rate (20% vs. 7.4%). Increased weakness scores were associated with early recurrent stroke. Identification of the determinants of early recurrent stroke may lead to better secondary prevention and may help select high-risk patients for further study. PMID- 2756551 TI - How to find the perfect job. AB - 1. Accepting a job offer can either lead to career success or to dissatisfaction and high turnover. 2. The advantages and disadvantages of the offer must be weighed carefully, as well as those of the present job. 3. A carefully designed career plan with well-defined goals contributes to job satisfaction and facilitates the evaluation of offers. 4. A key component of a career program should be recognition of a nurse's needs and the program should be evaluated to determine if these needs are met. PMID- 2756552 TI - How to end the nursing shortage: solve the problems. PMID- 2756553 TI - Perioperative nursing: the neglected specialty. AB - 1. Changes in nursing curricula have caused two problems for perioperative nursing: it is difficult to recruit nurses since few understand the specialty, and there is a perception that the perioperative nurse is a handmaiden to the physician. 2. In ambulatory surgery settings, the perioperative nurse is often the only caregiver patients encounter; thus, patient care must be at the highest level possible. 3. Although associate and baccalaureate curricula offer few perioperative nursing experiences, future nurses must be recruited from these programs. 4. Many issues need to be addressed so that desirable programs for perioperative nurses can be developed. PMID- 2756554 TI - Selling the OR: strategies to compete in the marketplace. AB - 1. OR directors are expected to be successful business managers in addition to their usual management responsibilities. 2. To complete with other health-care facilities, it is essential to incorporate marketing as part of the management strategy. 3. Marketing includes developing the skill level of all staff members, including middle managers, staff nurses, and ancillary personnel. 4. OR directors must create a work environment where the physician and staff are partners in providing quality patient care. PMID- 2756555 TI - Pyridine nucleotide fluorometry in preserved porcine liver with fluorocarbon emulsion. AB - Oxidation-reduction changes in pyridine nucleotide fluorescence were investigated in perfused and preserved porcine liver. A fluorocarbon emulsion (FC-43) was administered to the perfusate as an oxygen carrier to obtain full oxidation level by portal perfusion at a physiological low flow rate. A satisfactory reading was obtained by portal perfusion with EuroCollins' solution containing 10% v/v FC-43 at a rate of 0.5 ml/min/g liver. The amplitude (R x A) and the changing velocity (R x V) from full oxidation to full reduction were determined in the resultant trace curve. Both R x A and R x V decreased in inverse proportion to the duration of preservation period (3, 6, 12 hr). Adenine nucleotide content, hepatic energy charge level, and ketone body ratio in the tissue were simultaneously measured, and they also decreased proportionally to the duration of preservation. There were close positive correlations between R x A and total adenine nucleotide concentration (r = 0.841, P less than 0.01), between R x V and energy charge (r = 0.787, P less than 0.01), and between R x V and tissue ketone body ratio (r = 0.881, P less than 0.01). These results suggest that pyridine nucleotide fluorometry can accurately follow the cellular function of isolated porcine liver by administration of FC-43 in perfusate. This fluorometry may also have potential application in evaluating viability of a large organ like the human liver graft. PMID- 2756557 TI - Central nervous system toxicity of cyclosporine in a rat model. AB - The central nervous system toxicity of cyclosporine, which is known to be neurotoxic clinically, was investigated in a rat model. Munich-Wistar rats were divided into 3 groups for a 2-week protocol. After baseline EEG and behavioral testing, group 1 (control) received a weight-adjusted volume of parenteral cyclosporine vehicle i.p., group 2 (low-dose) received 5 or 10 mg/kg/day i.p., and group 3 (high-dose) received 20 mg/kg/day i.p. Spontaneous behavior was observed, simple sensorimotor testing performed daily, and awake EEG's recorded 3 times per week. Four of 12 high-dose animals died during study, one after a witnessed tonic-clonic seizure, and two after recording of frankly epileptiform EEG's; there were no deaths in control or low-dose animals. Significant EEG abnormalities developed only at high-dose, with frankly epileptiform EEG's and/or seizures seen in 58 +/- 15% of these rats (P = 0.005, different from controls by life-table analysis). Although some high-dose animals demonstrated hyperirritability and dystonic posturing, behavioral changes were subtle, and animals were often still or rocking slightly during recording of frankly epileptiform EEG's. Walking latency and alley escape behaviors were delayed in high-dose rats, the latter correlating with abnormal EEG's. Serum urea nitrogens were mildly elevated in high-dose animals, but serum creatinine, electrolytes, bilirubin, body magnesium stores, and blood pressure remained normal in all groups. Kidneys showed only mild vacuolation histologically. The brain showed only very focal cortical injury sites related to electrode placement, which did not correlate with EEG changes or mortality. These results suggest that there may be a direct effect of cyclosporine on the central nervous system. This model system should prove useful in defining mechanisms of cyclosporine-related neurotoxicity. PMID- 2756556 TI - Differentiation between renal cortex and medulla in the response to hypotension using localized 31P magnetic resonance spectroscopy. AB - Experiments were designed to test the hypothesis that renal medulla is more sensitive to hypoxia than is the cortex. Using the one-dimensional phase encoding technique to perform 31phosphorus magnetic resonance spectroscopy in a perfused porcine kidney preparation, cortex and medulla were differentiated on the basis of the unique resonance at 3 ppm found only in medulla. Hypotension-induced hypoxia reduced total renal oxygen consumption by 60%, and urine flow by 44%. Nonlocalized 31P MRS spectra showed that [ATP]/[Pi] ratio fell by 40%, and intrarenal pH by 0.1 unit. Virtually all of these changes could be accounted for by changes in the renal cortex, where initial [ATP]/[Pi] was higher than in medulla (1.16 vs. 0.68). In medulla [ATP]/[Pi] fell only 29% (n.s. versus control) and pH remained unchanged during hypotension. Thus the cortex appears to be more sensitive to hypoxia in this preparation, and observations fail to support the proposed hypothesis. They are consistent, however, with the greater capacity of medulla for anaerobic glycolysis. Localized 31P MRS provides improved noninvasive metabolic assessment of cold-preserved kidneys. PMID- 2756558 TI - Structure-activity relationships of cyclosporines. Toxicity in cultured renal tubular epithelial cells. AB - Proximal (LLC-PK1) and distal (MDCK) renal epithelial cell cultures were used to investigate early biochemical changes in cellular metabolism following exposure to cyclosporine A (CsA). 3H-thymidine and 3H-leucine incorporation into the cells were used as indices of DNA and protein synthesis. The cells were exposed to concentrations of CsA ranging from 0.2 microgram/ml to 20 micrograms/ml. By 20 hr there was a decrease in the total cell count at concentrations of 10 and 20 micrograms/ml that was more pronounced by 5 days of exposure. At 5 days there was also a reduction in cell count at the lower concentrations of CsA. There was an initial increase in DNA and protein synthesis at 2 hr with inhibition of DNA synthesis evident by 20 hr. Protein synthesis was increased in the LLC-PK1 cells and decreased in the MDCK cells. At 5 days there was evidence of increased DNA and protein synthesis, most marked in the remaining viable cells exposed to the higher concentrations of CsA. Similar alterations in cellular metabolism were evident when the cells were exposed to the immunologically inert cyclosporine H (D-N-MeVal11-Cs). These studies demonstrate that cyclosporine produces alterations in cellular function as early as 2 hr after exposure to the drug. At the lower concentrations there is evidence of sublethal cellular toxicity and cellular regeneration. The toxicity appears to be related to the molecular structure of cyclosporine and its incorporation into cell membranes. We postulate that cyclosporine nephrotoxicity is the summation of several subtoxic alterations in cellular function the final expression of which is modified by other factors affecting renal function. PMID- 2756559 TI - Inflammatory myopathy in F1 hybrid mice with acute graft-versus-host reactions. AB - Polymyositis and myasthenia gravis-like syndromes have been seen in patients with GVH disease following bone marrow transplantation. We therefore investigated the histopathology of muscle in mice with acute graft-versus-host disease in order to determine whether these conditions are caused by injury from the GVH reaction itself or are due to radiation and drugs used to prepare the host for transplantation. GVH reactions were induced by intravenously infusing 50 x 50(6) lymph node and spleen cells from A/J-strain donors into (C57BL/6 x A/J)F1-hybrid recipients. These mice developed an active inflammatory myopathy beginning 15 days after engraftment. The inflammatory infiltrates were focal in distribution, initially around perimysial blood vessels, and later around muscle fibers. The infiltrating cell population was composed of lymphocytes, plasmacytoid cells, and macrophages. Muscle cell necrosis was observed and was temporally related to elevations in serum creatine kinase. Similar histologic changes were present in the myocardium. Our findings support the notion that muscle involvement in patients with GVH disease is caused by the disease itself. Myositis accompanying experimental GVH disease in mice may hold promise as a model of autoimmune inflammatory myopathy. PMID- 2756560 TI - Long-lasting dementia following brain grafting for the treatment of Parkinson's disease. PMID- 2756561 TI - Recovery of DNA from agarose gels using liquid nitrogen. PMID- 2756562 TI - An automated method for calcium phosphate-mediated gene transfer. PMID- 2756563 TI - [Estimation of the total mutagenic activity of the industrial environment at ferrous metallurgy enterprises]. AB - Complex cytogenetical and genetico-epidemiological examination has been conducted with workers of metallurgic industry. It is shown that a complex of factors of the blast-furnace and steel plants produces a 2-3 times higher cytogenetic effect in groups of workers as against the control level. A considerable increase in the level of intrauterine losses (the frequency of spontaneous abortions) is observed in the case of contact of father and mother with a complex of the industrial environment pollutants. PMID- 2756564 TI - [Features of hybridization of domestic hen and guinea fowl and structuro functional organization of hybrid chromosomes in comparison with original species]. AB - Hybridization of the domestic hen and the guinea fowl is accompanied by low fertility of eggs, high embryonic mortality of hybrid embryos and feti at various development stages and absolute sterility of the hybrid progeny. Cytological analysis of the hybrids obtained reveals heteromorphity of the 6th pair of their chromosomes although the character of the DNA synthesis in this pair is unchanged and is inherited from the initial species. A program of the DNA synthesis in the sexual chromosomes of hybrids differs from that in parents and seems to be one of the main causes of their sterility. PMID- 2756565 TI - [Quantitative estimation of the modification of mutagenic effect in experiments on mammals using a regression modification index]. AB - A regressive modification index (RMI = beta M - beta/beta.100) is suggested to quantitatively evaluate modification of the mutagenic effect in experiments on mammals. It is based on the correlation of regressive equation "dose mutagen- effects" coefficients beta M and beta in variants with and without modifier, respectively. Regressive modification indices of various doses of phenobarbital are calculated in experiments on rats with cyclophosphamide and fotrin. PMID- 2756566 TI - [Features of structural organization of mouse centrometric heterochromatin, detected during differential decondensation of chromosomes]. AB - The centromeric heterochromatin (CH) of mouse metaphase and interphase chromosomes has been shown to be practically devoid of the chromonemal and chromomeric levels of DNP organization. CH decondensation into DNP-fibrils caused by decreasing Ca2+-ions concentration is accomplished without formation of chromonemata and chromomeres. The peripheral regions of CH, immediately contacting the inner surface of kinetochores, display the highest stability towards the factors inducing the artificial decondensation. PMID- 2756567 TI - [Cell-by-cell flow cytometric analysis of chromosomes]. AB - The authors discuss various aspects of a recently developed method permitting a detailed flow cytometric analysis of the individual cell karyotypes such as instrumentation, histochemistry, data proceeding algorithms. Possible drawbacks of the method and the ways of their overcoming are considered. Results of analysis of the Chinese hamster cells are presented that illustrate the possibilities of the method, including the metaphase chromosome distribution according to their fluorescence intensity, the analysed cell distribution according to their chromosomes number, the table in which the individual cell karyotypes are distributed according to their fluorescence. The results obtained show that the developed method may be successfully used for investigating chromosomal iNstability and heterogeneity of the mammalian cells. PMID- 2756568 TI - [Change in the dry weight of hepatocytes during chronic intoxication of rats with CCl4]. AB - Dry weigHT of rat hepatocytes (DWH) was measured microinterferometrically during a chronic CCl4 intoxication. Following a long chronic intoxication of rats by hepatotropic poison results in the increase in DWH by 63%. The increase in the DWH due to CCl4 intoxication may be associated either with cell hypertrophy or with the cell polyploidy, depending on the test animal. Thus the trigger mechanisms of hypertrophy or polyploidy in cell population are not identical. It is supposed that the hypertrophy of hepatocytes accompanying liver cirrhosis is perhaps one of the mechanisms involved in the normal cell reparative reaction on the increased organ functioning. PMID- 2756569 TI - [The number and size of human ventricular cardiomyocytes and the number of nuclei in them]. AB - The study of isolated cardiomyocytes after alkaline dissociation allowed to reveal an individual variability of the absolute number and average volume of cells, as well as characteristics of these indices in the left and right ventricle myocardia of the dead adult patients' hearts. On the basis of the analysis of these indices and of other parameters of isolated cardiomyocytes, a possibility of hyperplasia of nuclei and of muscle cells themselves during their hypertrophy is discussed. PMID- 2756570 TI - [Stimulation of multiplication of chick embryo cultured cells after an increase in density of the cellular population]. AB - The secondary culture of chick embryo cells in 2-3 days after seeding was super inoculated with homologous cells. Suspended cells adhere and spread on the cell layer whereby the culture density increases quickly. After adhesion of exogenous cells to the layer the stimulation of cell proliferation takes place. This activation is not connected with methodical manipulations or with the influence of conditioned medium factors. The results suggest that the increase in cell number itself does not arrest cell multiplication. It is proposed that the known phenomenon of blocking cell proliferation in dense cultures cannot be attributed only to effects of high cell density. PMID- 2756571 TI - [The effect of picolinic acid and iron ions on the proliferation of SPEV cells]. AB - The effect of picolinic acid (PA) on SPEV cell proliferation is found to be different from that on normal and virus transformed NRC cells, and on spontaneously transformed CHO cells. It is shown that SPEV cells are arrested by PA at the end of G1-phase and at the beginning of S-phase and probably in G2 phase of the cell cycle. Ferrous ions remove the G1/S block induced by PA to permit the cell transfer through S-phase. On the one hand, PA chelates ferrous ions from the cells, and on the other one it inhibits the replicative DNA synthesis. It can be suggested that PA may arrest the SPEV cell growth affecting the iron-depend stable radical formation which is introduced into the active centre of ribonucleotiDE reduCTase. This results in the lower enzyme activity. PMID- 2756572 TI - [Interaction of aldolase with thin filaments within I-disks, isolated from skeletal muscles]. AB - Using electron microscopy and optical diffraction, Ca2+-dependent binding of a glycolytic enzyme (aldolase) to thin filaments of isolated skeletal muscle I disks have been revealed. On the micrographs of negatively stained I-disks the cross-striation determined by troponin-tropomyosin complex distribution has a period of about 38 nm. The width of troponin-tropomyosin stripes is 5-6 nm. On the optical diffraction patterns from isolated I-disks the meridional reflections measuring 38.5, 19.2, 12.8 nm are present. On the micrographs of isolated I disks, treated with aldolase in the absence of Ca2+ (1 mM EGTA) the width of periodic transverse stripes (period approximately 38 nm) increases from 5-6 nm to 25-28 nm due to the interaction of aldolase with thin filaments. On the optical diffraction patterns from I-disks treated with aldolase in the absence of Ca2+ (1 mM EGTA) the strong meridional reflection equal to 38.5 nm is present, while the reflections equal to 19.2 nm are absent. The optical diffraction patterns from I disks treated with aldolase in the presence of Ca2+ (greater than or equal to 10( 5) M) do not, as a rule, differ from those obtained from I-disks not treated with aldolase, i.e. they contain the three above reflections. The binding of aldolase to thin filaments in the absence of Ca2+ is the reason of disappearance of meridional reflections equal to 19.2 and 12.8 nm. PMID- 2756573 TI - [A decrease in the level of unscheduled DNA synthesis in preparations of irradiated rat hepatocyte nuclei under the effect of polyamines]. AB - The results obtained show the possibility of polyamine (spermine and spermidine) utilization to stabilize the nuclear chromatin and to protect it against nuclease degradation in the course of isolation of liver cell nuclei. Besides, the inhibition of the unscheduled DNA synthesis induced by nuclease incision and by gamma- or UV-radiation was demonstrated in the presence of polyamines. PMID- 2756574 TI - [The effect of caffeine on the duration of the mitotic phase cycle in CHO-K1 Chinese hamster cells, irradiated with x-rays]. AB - Alterations in the duration of mitotic cycle phases in X-irradiated Chinese hamster cells CHO K1 after caffeine (CF) treatment are studied. Delays in S- and G2-phases, induced by 1 and 5 Gr of X-irradiation, are partially or completely decreased by 1 mM or 5 mM CF, respectively. When CF is removed from the medium after irradiation, delays in S- and G2-phases are seen again, however long (0-12 hours) CF remains in the medium. The data obtained allow to suggest that since CF results in a radioresistant DNA synthesis, it may also postpone delays in S- and G2-phases, while cells are progressing through the cell cycle. PMID- 2756575 TI - [Thermolabile inhibiting proliferation of connective tissue cell activity from platelets]. AB - The action of a platelet extract (PE) and a heat-inactivated PE on 3T3 cells proliferation has been investigated. The heat-inactivated PE and platelet poor plasma (PPP) together can promote cell proliferation like fetal calf serum. At the same time PE inhibits proliferation of the cell culture stimulated by 5% fetal calf serum, whereas the heat-inactivated PE does not. Although the actions of 2% PE and 2% heat-inactivated PE on the cells incubated with PPP are equal, the stimulating effect of a 10% heat-inactivated PE is higher than that of a 10% PE. Thus, the inhibitor acts only at high concentrations. The role of the platelet-derived inhibitor in the limiting of extensive cell proliferation during vessel wall injury repair is discussed. PMID- 2756576 TI - [Diagnosis of gastritis caused by Campylobacter pylori. Presentation of 3 methods: bacteriology, histology and immunoblotting]. PMID- 2756577 TI - [Renal amylosis in Tunisian children. Apropos of 14 cases]. PMID- 2756578 TI - [Severity of reno-ureteral lithiasis in children (apropos of 100 cases]. PMID- 2756579 TI - [Consanguinity in the population of northern Tunisia]. PMID- 2756580 TI - [Thalassemia intermedia: apropos of 14 cases]. PMID- 2756581 TI - [Significance of the contribution of pizotifen in correcting appetite disorders and weight insufficiencies]. PMID- 2756582 TI - [Bladder tumors. An anatomo-clinical study of 178 cases]. PMID- 2756583 TI - [The cured tuberculosis patient and his problems (a study of 374 cases)]. PMID- 2756585 TI - [The association of nephrogenic diabetes insipidus and Gougerot-Sjogren syndrome: apropos of a case]. PMID- 2756584 TI - [Malignant non-Hodgkin's lymphoma of the abdomen in children]. PMID- 2756586 TI - [Thrombotic thrombocytopenic purpura: apropos of a case]. PMID- 2756587 TI - [Pulmonary arteriovenous fistula in a newborn infant with hereditary telangiectasis]. AB - A case of pulmonary arteriovenous fistula in a newborn baby suffering from hereditary teleangiectasis is described. 15% of patients with hereditary teleangiectasis develop pulmonary arteriovenous fistulas, most of which do not cause symptoms until adult life. Children with hereditary teleangiectasis should be followed regularly, because of the risk of developing vascular malformations, the most frequent locations being the nasal mucosa, the lungs and the gastrointestinal tract. PMID- 2756588 TI - [A clinically unexpected pheochromocytoma]. PMID- 2756589 TI - [Cholesterol examination--is it of any use?]. PMID- 2756591 TI - [The polymerase chain reaction--a new diagnostic tool]. PMID- 2756590 TI - [Herpesvirus and acute peripheral facial paresis]. PMID- 2756592 TI - [Inflammation and free oxygen radicals]. AB - When mammalian phagocytes encounter appropriate stimuli, highly reactive oxygen derived free radicals (superoxide and hydroxyl) and related species (hydrogen peroxide and hypochlorous acid) may be produced as a normal mechanism in the defence of the host against invading microorganisms. These radicals are destructive to most biological molecules and are responsible for much of the damage inflicted by phagocytes on both microorganisms and surrounding tissues at sites of infection or inflammation. Increasing evidence suggests that the generation of oxygen metabolites plays an important role not only for perpetuation of chronic inflammation, but also for the etiology of other health problems i.e. ageing, cancer, ischemia, and radiationinduced injuries. The extent of tissue damage in inflammation may partly be the result of the balance between free radicals generated and the antioxidant/radical scavenger protective defence systems. The implication of oxygen free radicals in inflammation and future directions are briefly discussed in the present overview. PMID- 2756593 TI - [Referral of non-traumatic emergencies treated during after-office hours, the Sukkertopp, in 1985]. AB - All of the emergencies of non-traumatic nature in the Sukkertop/Maniitsoq medical district in Greenland were registered during the year 1985. A total of 601 patients in which the sexes were equally represented were registered. Two thirds of these sought medical advice during the weekends, mainly between 10.00 and 17.00 hours. On weekdays, these patients came between 16.00 and 20.00 hours. The clientele involved was young and 1/4 were under the age of two years. 2.5% of these were admitted and 15% were followed up in the outpatient department. One fourth of the patients were given advice only and these consultations were interpreted as unnecessary. The disease pattern was distributed over 73 diagnoses and these could be summarized in 18 main groups. More than half of the consultations involved common, slightly infectious diseases and these were the reason for a two humped seasonal variation. It was considered that a number of the consultations occurred because of defective knowledge about health and these indicate a need for improved health information. Other conditions such as alterations in the structure of the health system, establishment of district health nursing and employment of the knowledge about variation in the pattern of consultations may lead to improved function in the health system. PMID- 2756594 TI - [Non-palpable tumors of the breast demonstrated by mammography]. AB - During the period 1.1.1985-28.2.1987, 114 mammographic markings with needles were undertaken on cancer-suspect, non-palpable tumours of the breast in 106 patients. In 27.2% of the cases, carcinomata were found and, in 16.7%, carcinoma in situ. Mammographic examination combined with needle marking is recommended as a diagnostic supplement to clinical examination. PMID- 2756595 TI - [Nd:YAG laser treatment of cancer of the esophagus and cardia]. AB - In 1988, Nd:YAG laser treatment was employed as palliative therapy for 23 patients with cancer of the oesophagus and cardia. After treatment, half of the patients could ingest light or normal diets and the ability to swallow improved in a total of 3/4 of the patients. Perforation of the oesophagus occurred in two patients and aspiration in two other patients. It is concluded that, in a great number of patients with inoperable cancer of the oesophagus and cardia, laser treatment is better than other palliative therapeutic measures. The indications are discussed. PMID- 2756596 TI - [Postoperative wound infections at a mixed surgical department. 1 year's registration employing a PC-based system]. AB - Operation wounds and surgical wound infections (S.W.I.) in the surgical department of Holbaek County Hospital were recorded over a period of one year. This registration was conducted in co-operation with the National Centre for Hospital Hygiene to test a standardised and simplified registration system and edb-programme, the Danop-Data system, developed to record S.W.I. on PC. 1.377 wounds and 45 S.W.I. were recorded. The overall infection rate was 3.3%. This compares favourably with rates reported in more extensive foreign investigations. There were significantly fewer infections during the second six months than during the first six month of the year. This was not due to changed conditions during the period of registration. The registration system and the edb-programme provide a satisfactory method of continuous surveillance of S.W.I. At the same time, the system itself proved very easy to use. PMID- 2756597 TI - [Registration of postoperative wound infections by ADB. A trial of the Danop program]. AB - The EDB programme, Danop, which was developed in cooperation with Statens Seruminstitut which is the central department for hospital hygeine in Denmark, was employed during the period 1.7.1987-30.6.1988 for consecutive registration of operative interventions and postoperative wound infection. During the period, 1,660 interventions were registered with a total frequency of infection of 3.5%; 2.6% of these in clean cases and 13.8% in infected cases. About one third of the infections were demonstrated by the general practitioners after discharge. In connection with introduction of registration, a considerable decrease in the number of postoperative wound infections occurred. It is decisive for the employability of the system that a reliable procedure for registration and return information is organized. The system is easy to use and functions well and does not require prior knowledge of edb and it provides excellent current control of and review of postoperative wound infections in one or more departments. PMID- 2756598 TI - [Adjustment to an ADB infection registration system at a surgical department]. PMID- 2756599 TI - [Examination of thrombocytes in patients with unstable angina pectoris]. PMID- 2756600 TI - [Malunion and growth disorders following fractures of the condylus radialis humeri in children]. AB - Basing on the results of 46 fractures of the lateral humeral condyle in children possible mal-unions and disturbances of growth after conservative and operative treatment are shown. Varus-tendency of the elbow axis was observated in 23% after conservative treatment of undisplaced fractures and in 37.5% after open reduction and Kirschner wiring of displaced fractures. Fish-tail deformity was seen both after conservative treatment and fixation with Kirschner wires; only open reduction and osteosynthesis with small-fragment screws could avoid this two disturbances of growth. One non-union was seen after conservative treatment. PMID- 2756602 TI - [Comparative study of arthroscopic and open meniscus surgery]. AB - In this paper we compared two groups of 80 patients each with meniscal tears. One group was treated by Arthrotomie and partial meniscectomie and the other group by an arthroscopic procedure also with partial meniscectomie. All patients were seen at a follow up between six and 18 months postoperatively. According to the Gaudernak scale we found in both groups 98% of very good and good results. The duration of hospitalisation and sickleave was reduced by 50% after the arthroscopic operation, which showed a significant difference. PMID- 2756601 TI - [Surgical treatment of forearm shaft fracture]. AB - Between 1977 and 1987 at trauma hospital in Salzburg 142 patients with shaft fractures in the middle third of forearm have been treated by open reduction (altogether 730 forearm fractures in the same period). Among other things post surgical complications are examined. Functional results and reported troubles of patients are demonstrated by 66 cases which have been reviewed. PMID- 2756603 TI - [A rare combination injury in Alpine skiing]. AB - This is a report on the incidence of associated osseos lesions in Achilles tendon ruptures. From 1967 to 1984 630 patients underwent treatment for closed Achilles tendon ruptures. In 49 cases (7.7%) associated osseos injuries were discovered. In 42 cases (6.6%) fractures of the malleolus medialis were found. Two patients with a rare combination (primarily treatment of osseos lesions, with delayed diagnosis of tendon rupture) deserve special attention. Concerning fractures of the lower leg with associated tendon rupture. Chronology and pattern of the injury are analyzed. PMID- 2756605 TI - [Perception of the attitude of physicians]. PMID- 2756604 TI - [Comparison of the value of magnetic resonance tomography and computerized tomography in the follow-up of augmentation-plasties with carbon fiber ligaments of the anterior cruciate ligament]. AB - 17 patients--treated with unidirectional carbon-fibre-ligaments augmentation for the anterior cruciate ligament--have been followed-up by MRI and CT. The question has been, whether both methods show comparable results. The interval between operation and follow-up has been 34 months in average (43 to 30). Significance was put on the probants bedding. MR-Imaging in two planes seems to be essential to show the artificial ligament's integrity in its extraarticular "over the top" position. Satisfying corresponding results could be found in MRI and CT. PMID- 2756606 TI - [Post-ligation syndrome: a follow-up of 556 cases, 5 to 8 years after tubal sterilization]. AB - Five to eight years later, we obtained an answer in 66.3% of 556 patients who had a sterilization between January 1978 and end of December 1981, in order to find any complication forming the so called Post-sterilization Syndrome. We traced back 80.6% of 62 patients who showed a genital pathology at the time of their surgery. We also could obtain an answer in 64.6% of 494 patients who had no apparent genital pathology at the time of their sterilization. We found that 12 patients of the first and 25 patients of the second group (10%) had suffered a major gynecological surgery since their sterilization. But in studying their records, we found that all their surgery was surgically indicated like for fibroids, prolapse, cervical cancer, etc. Three patients of the first and 16 patients of the second group (5%) showed bleeding problems which necessitated a D & C. In all, considering the age of the patients, there was no relationship between the sterilization and the rate of complications. PMID- 2756607 TI - [Chlamydia and coronary disease]. PMID- 2756608 TI - [Preliminary biopsy and preoperative chemotherapy: promising horizons]. PMID- 2756609 TI - Nephrectomy in situ: treatment of ureteral fistula due to progressive malignancy. AB - The authors report 2 patients with recurrent retroperitoneal neoplasms in whom ureteral fistulas were treated successfully by percutaneous transcatheter embolization of the renal artery with absolute ethanol. Angio-occlusive nephrectomy is suggested as an alternative to surgical nephrectomy in seriously ill and high-risk patients to preserve their quality of life. PMID- 2756610 TI - Forniceal rupture secondary to ureterocele and increased urine flow. AB - A case of a simple ureterocele presenting with spontaneous forniceal rupture is described. Rupture followed hypophysectomy for Cushing's disease and high urine outflow. This presentation has not been reported previously. PMID- 2756611 TI - Unusual tubular calcification of a nephrostomy tract. AB - Unusual tubular calcification occurred in the nephrostomy tract of a 30-year-old male, 6 months after percutaneous nephrostolithotomy. To our knowledge, this phenomena has not been previously reported. The main radiologic differential diagnoses are focal dystrophic calcification and vascular calcification. The etiology is unknown but may have been related to the patients' tendency to form renal calculi. The temporal sequence of events and the location of the nephrostomy catheter which correlated with the calcification suggests the correct diagnosis. PMID- 2756612 TI - Incidental extraction of double pigtail catheter during nephrostomy removal. AB - An unusual complication of nephrostomy removal is presented. A double pigtail catheter was trapped by the nephrostomy tube and accidentally extracted. Suggestions for preventing this complication are presented. PMID- 2756613 TI - Nephrogenic adenoma of the bladder: urographic spectrum. AB - Nephrogenic adenoma is a rare, proliferative response of urothelium to urinary infection or injury of the bladder mucosa. Histologically, the lesion resembles proximal tubules of the nephron. While it can occur throughout the urinary tract, it usually appears in the bladder, with diverse radiographic manifestations. Of 6 patients with nephrogenic adenoma of the bladder, 3 presented with masses in the bladder and 2 with irregularities of the bladder mucosa on urography, while 1 showed no focal urographic abnormalities. There were no distinctive radiographic features of nephrogenic adenoma that would allow it to be differentiated from tumor or other inflammatory lesions. Although it is considered benign, bladder involvement may be extensive and eradication of the tumor may be difficult. PMID- 2756614 TI - Microradiographic demonstration of human intrarenal microlymphatic pathways. AB - Renal lymphatics play a prominent role in physiological and pathologic states. However, intrarenal microlymphatic morphology has not been well established in humans. We have developed microangiographic techniques for studying microlymphatic morphology. Lymphatics were identified by location, presence of valves, and histologic characteristics in 4 patients (3 presented here and 1 reported previously), all of whom had congestive cardiac states. The renal lymphatics begin in the cortical interstitium near glomeruli and run adjacent to afferent arterioles and interlobular arteries. They drain into arcuate and interlobar vessels and then into hilar lymphatics. They also originate in and drain the medullary structures in the area of the vasa recta. Our study details the microlymphatic morphology in humans and confirms the similarity of human lymphatics to those studied extensively in pigs and dogs. PMID- 2756615 TI - MR and CT imaging of perirenal amyloidosis. AB - The radiographic findings of perirenal amyloidosis have not previously been described. A patient with multiple myeloma and primary amyloidosis (AL) with secondary hydronephrosis as examined on plain film, retrograde ureteropyelography, computed tomography, and magnetic resonance imaging is presented. This case illustrates perirenal amyloidosis and demonstrates the utility of CT and MRI in patient management and surgical treatment. PMID- 2756616 TI - [Isolation and characteristics of nutritional variants of streptococci of animal origin]. AB - Four strains of nutritionally variant streptococci (NVS) were isolated from the milk of mastitic cows and one strain from the lungs of a laboratory Norway rat which died from suppurative pneumonia. In primary cultivation NVS grew aerobically and anaerobically within 48-hour incubation at a temperature of 37 degrees C as minute nonhemolytic satellite colonies around a previously overlaid S. aureus strain or around other gram-positive and gram-negative bacteria. In the first subcultures NVS were growing in nutrient media enriched with 10% bovine serum and 5% staphylococcal filtrate, or 0.02% to 0.002% pyridoxal hydrochloride. All isolates did not grow in presence of 10%, 40% bile, and 6.5% of sodium chloride, neither did they grow at a temperature of 45 degrees C, they did not hydrolyze sodium hippurate, esculin, arginine, they did not produce levane and dextran from saccharose, they produced acid from mannitol, sorbitol, inulin, lactose, raffinose, trehalose, glucose, saccharose and maltose. Two strains produced acid from xylose and four strains from salicin. The strains isolated from mastitis did not have different biochemical properties from those isolated from a laboratory Norway rat with pneumonia. All strains of NVS were sensitive to chloramphenicol, ampicillin, gentamycin, lincomycin and cephalothin, four strains were sensitive to erythromycin and tyrosine, two to penicillin and one to streptomycin, oxytetracycline, chlortetracycline and novobiocin. All strains were resistant to neomycin, tetracycline, oxacillin and sulphonamides. The antigen prepared from the isolated strains by the method of Fuller did not react with any streptococcal group serum A-Z. PMID- 2756617 TI - [Immunologic skin tests in piglets]. AB - Immunological skin tests were carried out in 213 weanling piglets at the weight of 5 to 30 kg. Immediate hypersensitivity was evaluated by help of diagnostic allergens (mould, yeast and bacterial ones), delayed hypersensitivity by help of staphylococcus lysate, cellular immunity (tests de novo) by help of phytohemagglutinin and as common recall antigens were used tuberculin, toxoplasmin, candidic and tetanic antigen. The above substances were applied intradermally to the back of the piglets. For an evaluation of non-specific inflammatory response, sodium lauryl sulphate applied epicutaneously was used. The average reaction to diagnostic allergens (50 PNU in 0.05 ml) evaluated after 20 minutes was characterized as light dermal reactions (the papule size of 3-5 mm); in 22% of piglets moderate dermal reactions (the papule larger than 6 mm) to the diagnostic bacterial allergen (Staphylococcus aureus, Staphylococcus epidermidis) were determined. After an intradermal implantation of histamine (50 micrograms in 0.05 ml) the average size of the papule was 13 mm in 20 minutes. After the application of 0.1 ml of staphylococcus lysate (STAVA), the induration exceeding 10 mm was observed in 13% of piglets in 24 hours. After the application of phytohemagglutinin (100 micrograms in 0.1 ml), the induration exceeding 5 mm in 24 hours was determined in 93% of piglets and in 48 hours in 59% of piglets. Common recall antigens were applied at the volume of 0.1 ml. Forty-eight hours after the application no palpable induration was determined: in 91% of piglets after the application of tuberculin (2 TU PPD in 0.1 ml); in 75% of piglets after toxoplasmin (according to PNY 30-33-74); in 98% of piglets after candidic antigen (100 PNU in 0.1 ml) and in 86% of piglets after tetanic antigen implantations (0.03 Lf in 0.1 ml). The epicutaneously applied sodium lauryl sulphate (at 2.5% and 5% concentrations) caused no inflammatory dermal reactions (erythema or induration) after 24 hours. In piglets it is best to apply phytohemagglutinin for evaluating cellular immunity, staphylococcus lysate for evaluating delayed hypersensitivity to staphylococci and histamine for obtaining the information on a disposition of piglets to allergic diseases. PMID- 2756618 TI - [Activity of selected dehydrogenases and monoamine oxidases in the small intestine of gnotobiotic piglets infected with the coccidium Isospora suis]. AB - In the small intestine of 16 gnotobiotic piglets infected a day post partum (DPP) by Isospora suis coccidia the activities were studied of selected dehydrogenases and monoaminoxidase (O2 oxidoreductase, MAOx, EC 1.4.3.4.). The following dehydrogenases were investigated: succinate dehydrogenase (SDH, EC 1.3.99.1.), glycerol-3-phosphate dehydrogenase (glycerol-3-phosphate:menadion oxidoreductase, GPOX, EC 1.1.99.5.) and tetrazolium oxidoreductase (NADH, ES 1.6.99.3.). The activities of NADH and GPOX were found to decrease, a decrease being somewhat milder in MAOx, at a high infection dose of I. suis oocysts (750,000 oocysts), in comparison with the control, already on the first day after infection (DAI). The SDH levels did not change. In piglets infected by a low infection dose of I. suis oocysts a double marked decrease (negative to slightly positive finding) was recorded in the period from the third to the eighth day after infection (DAI). A similar pattern with a longer time interval between the decreases was observed in GPOX (4th to 11th day after infection). The findings of SDH and MAOx activities were different. The SDH activity is maintained at the same level (++) for the whole period of investigation and there occurs a decrease (+) only on the 9th day after infection, persisting until 11 DAI. The MAOx activity and its change correspond to the SDH activity; the difference being that in the second group the starting level is high ( ) and on the eleventh day after infection it is low or medium (0-++), in comparison with the standard. This variability is discernible from 8th DAI. PMID- 2756619 TI - [Level of heavy metals in the liver of sheep in experimental poisoning with copper oxide from industrial emissions]. AB - The life span and cumulation of heavy metals in the liver of 12 ewes of the Improved Wallachian breed were investigated in relation to feeding pollutants from a copper works. The total intake of copper, iron, zinc, arsenic, cadmium and lead was 466.8; 1253.93; 111.67; 34.75; 0.091; 2.13 mg per experimental animal/day, respectively. The average life span of ewes in the experimental group was 77 days. The difference between the first and the last animal which died from copper intoxication was 18 days. The concentration of copper in the liver of sheep who died from intoxication by this metal (2138.28 +/- 1090.96 mg. kg-1 in dry matter) was significantly higher (p less than 0.01) if compared with the control ewes (212.9 +/- 58.33 mg. .kg-1 in dry matter). In the course of observations no direct dependence between the concentration of copper in the liver and the life span of experimental animals was confirmed. The content of iron and zinc in the liver of experimental animals was within the reference range; the difference in zinc was statistically significant when compared with the control group (p less than 0.01). The intake of pollutants from the copper works increased significantly the concentration of arsenic and lead in the liver of experimental animals (p less than 0.01) if compared with the control group. The amount of cadmium in the liver of experimental ewes was 0.304 +/- 0.22 mg. .kg-1 and in the control ewes 0.285 +/- 0.10 mg.kg-1 in dry matter; no significant difference was determined at the same time. PMID- 2756620 TI - Changes in electrical resistance of the vaginal mucosa in prostaglandin-treated cows. AB - Ten Hereford x Friesian cows each received 1 mg fenprostalene by a single subcutaneous injection between days 5 and 16 of their ovarian cycles and the treatment was repeated 17 days later. The cows' ovarian cycles were monitored by daily plasma progesterone measurements, and the electrical resistance of their vaginal mucosae was also measured daily, with a Wallsmeta. Luteolysis occurred after 13 of the 20 injections of fenprostalene, and vaginal resistance measurements corresponded to changes in progesterone concentrations in 14 of the 20 potential luteolytic periods. Vaginal resistance measurements decreased in three cases where progesterone concentrations did not decrease (false positive results) and failed to decrease in three cases where progesterone concentrations did decrease (false negative results). PMID- 2756622 TI - Unusual reaction following overdose of xylazine in a mare. PMID- 2756621 TI - Influence of an OPRB on immunity to gastrointestinal nematodes: a field study. PMID- 2756623 TI - Responses to dinoprost in the bovine early post partum period. PMID- 2756624 TI - The efficacy of netobimin, 15 mg/kg, against Dicrocoelium dendriticum in sheep. PMID- 2756625 TI - Isolation of mycoplasmas from diseased seals. PMID- 2756626 TI - Acute disseminated toxoplasmosis in two captive lions (Panthera leo) in Nigeria. PMID- 2756627 TI - Bovine iritis. PMID- 2756628 TI - Castration and docking. PMID- 2756630 TI - Slaughterhouses. PMID- 2756629 TI - L hardjo and lambs receiving cow's colostrum. PMID- 2756631 TI - Vaccinating seals. PMID- 2756633 TI - Legislation for medicated animal feed. PMID- 2756632 TI - SerVet. PMID- 2756634 TI - Interaction between coccidia and Nematodirus battus in lambs on pasture. AB - Five thousand oocysts of each of two species of coccidia, Eimeria crandallis and E ovinoidalis or 30,000 infective larvae of Nematodirus battus, given as single infections to three- to five-week-old lambs, caused only transient diarrhoea and had no effect on growth. Lambs infected first with coccidia and two weeks later with N battus suffered severe diarrhoea, weight loss and some deaths. Simultaneous administration of the coccidia and the nematodes increased the clinical severity of the syndrome and increased the numbers of nematode eggs produced. PMID- 2756635 TI - Efficacy of a novel sustained release anthelmintic device in preventing parasitic gastroenteritis in first-season calves. AB - The efficacy of the first of a new generation of intraruminal devices for cattle, the morantel sustained release trilaminate, was assessed in two field trials. In each trial the animals were divided into a control group and a treated group. The device was administered to each calf before turn out in the spring and the reduction of gastrointestinal parasitism resulted in a substantial reduction in the level of pasture contamination with infective helminth larvae later in the season. Compared with the control calves the treated calves had a 94 per cent reduction of worm burdens acquired over the entire grazing season in the first trial, despite the controls being treated for clinical disease in September. In the second trial four anthelmintic treatments were administered to the control calves during the grazing season, but nevertheless a 64 per cent reduction of worm burdens in the treated group compared to the control group was recorded. The control of parasitic infection by the sustained-release devices resulted in mean weight gain advantages of 28.3 kg and 34.7 kg by the treated animals in the first and second trials respectively. PMID- 2756636 TI - Dangerous dogs. PMID- 2756637 TI - Chlamydia in ovine milk. PMID- 2756638 TI - Skeletal myopathy in rainbow trout fry/fingerlings. PMID- 2756639 TI - Veterinary profession in the EC. PMID- 2756640 TI - Continuing professional development in Scotland. PMID- 2756641 TI - Prescribing: harnessing public support. PMID- 2756642 TI - Veterinary attendance at driving trials. PMID- 2756643 TI - [Problems in the teaching of physiotherapy and health resort medicine to physicians]. PMID- 2756644 TI - [Climatic characteristics of the arid zone during the formation of the "afganets" wind]. AB - A statistical analysis has been performed of disturbances arising in meteorological parameters and atmospheric electrical field during various stages of "afganets" wind blowing (in the sun cycle XXI). PMID- 2756646 TI - [Graded physical loads as a method of preventing and treating maternal and fetal hypoxia in pregnant women with cardiovascular pathology]. AB - Graded muscular exercise is thought an efficient enough method of managing maternal and fetal hypoxia in pregnant women with cardiovascular disorders. Individually adjusted physical training allowed a 26% increase in resting values of maternal blood partial oxygen pressure and a 26% decrease in the number of infants born in severe asphyxia. PMID- 2756645 TI - [Use of a low-frequency magnetic field in the combined treatment of middle-aged and elderly patients with ischemic heart disease and osteochondrosis of the cervico-thoracic spine]. AB - The study performed by the authors into the effect of low-frequency magnetic field on coronary heart disease, cervical and thoracic osteochondrosis arising in senile and presenile patients showed the treatment to promote improvement of the heart autonomic regulation and attenuation of ischemic and vertebrogenic pain, to augment response to antiarrhythmic treatment in coronary patients with extrasystoles, to compensate for negatively inotropic effect of propranolol hydrochloride, to increase exercise tolerance. PMID- 2756648 TI - [Helium-neon laser radiation in the rehabilitation of fracture patients]. PMID- 2756647 TI - [The combined use of traditional acupuncture and microacupuncture therapy in treating bronchial asthma patients]. AB - The attacks of bacterial asthma in 100 patients were treated by standard acupuncture, microacupuncture and by combined use of the modalities. The comparative analysis revealed the highest efficiency for the combined treatment, the less for microacupuncture. The disease of moderate severity, light severity and that free of attacks should be treated, as the authors believe, with acupuncture plus microacupuncture, standard acupuncture, and microacupuncture, respectively. PMID- 2756649 TI - [The combined treatment of calcareous bursitis of the subdeltoid muscle and tendinitis of the supraspinous muscle]. PMID- 2756650 TI - [The use of a personal microcomputer in balneology]. PMID- 2756651 TI - [Sulfide ooze mud and sodium chloride baths in treating osteoarthrosis patients]. AB - Humoral immunity initially affected in patients with osteoarthrosis returns to normal under the influence of a multiple-modality treatment involving application of sulphide moor in combination with sodium chloride baths. PMID- 2756652 TI - [Effect of mud therapy on the links in the pathogenesis of rheumatoid arthritis in children and adolescents]. AB - One hundred and ninety-nine children aged 7-14 and 177 adolescents in remission and minimal manifestations of rheumatoid arthritis (RA) were examined before and after fangotherapy with allowance for activity of the process, age-related reactivity. The comparison involved sympathetic-adrenal function (by urine excretion of epinephrine and norepinephrine), specific and nonspecific immune reactivity (by the level of IgA, IgM, IgG, circulating immune complexes, T and B lymphocytes; RF titers, leukocyte migration inhibition test), platelet components of hemostasis (number of platelets, adhesion induced by ADP and epinephrine). PMID- 2756653 TI - [Effect of potable mineral waters with various chemical compositions on reparative processes of the mucosa of the gastroduodenal area]. AB - Examinations covered patients recovering after gastroduodenal ulcer exacerbation treated with oral mineral waters of different chemical composition. Drinking mineral water was found to stimulate trophic processes in gastroduodenal mucosa, more pronounced for waters of complex chemical composition, e. g. Moscow calcium magnesium-sodium sulfate water. PMID- 2756654 TI - [Combined treatment using brine in acute inflammatory diseases of the internal female genitalia]. AB - A new method of managing acute salpingitis using a combination of sacroabdominal electrophoresis with vaginal baths using the preparation "dry natural brine" is suggested. PMID- 2756655 TI - [Effect of the multiplicity of local microwave exposures on the immunohormonal indices of intact animals]. PMID- 2756656 TI - [Changes in the morphofunctional indices of the stomach in patients with chronic gastritis and an acid-forming deficiency under the influence of hydrocortisone ultraphonophoresis]. PMID- 2756657 TI - [Ultraphonophoresis of a heparin ointment in the therapy of postinjection and postoperative infiltrates]. PMID- 2756658 TI - [A method for preparing iodine and iodine bromide baths with the presence of molecular iodine]. PMID- 2756659 TI - [Hydrogen sulfide balneotherapy of patients with an anterior branch block of the left crus of the bundle of His]. PMID- 2756661 TI - [An improvement in the URR-1 unit for preparing an aqueous concentrate of radon]. PMID- 2756660 TI - [The potential of using measurements of body electrical conductivity in evaluating the therapeutic action of radon baths]. PMID- 2756662 TI - [The rendering of medical first aid to middle-aged and elderly patients]. PMID- 2756663 TI - [Arterial and venous hemodynamics in peptic ulcer and the preulcerous state]. AB - The method of tensometric universal occlusion plethysmography was used to determine the arterial and venous hemodynamics in 106 patients with ulcer disease and chronic gastroduodenitis with symptoms of ulcer disease. Reliable changes of the peripheral blood flow were revealed during exacerbations of the disease and clinico-morphological remission. The changes are caused by disorders in the system of regulation of the peripheral hemodynamics. PMID- 2756664 TI - [Digestive organ diseases in workers in contact with trinitrotoluene]. AB - The authors analyze the morbidity with temporary loss of working capacity due to diseases of the digestive organs in workers realizing technological explosions in the ore-mining and processing industry. The etiological role is shown of trinitrotoluene in the formation of really high levels of morbidity of the digestive organs. PMID- 2756665 TI - [Therapeutic and prophylactic measures in patients with dust-induced bronchitis complicated by pulmonary emphysema]. AB - Therapeutic-prophylactic measures in 60 patients were directed to remove the main pathogenetic mechanisms of development of lung emphysema (control of the obstructive syndrome, normalization of the sputum rheology, reduction of the protease level, restoration of the surfactant system activity). The efficacy of complex treatment (broncholytic agents, mucus regulators, protease inhibitors, etc.) depended largely on the necessity of active prophylactic medical care of patients with dust-induced bronchitis at early stages of the disease. PMID- 2756666 TI - [Hygienic problems in irrigating agricultural lands with sewage containing surface-active substances]. AB - Due to wide production and use of surface-active substances (SAS)-detergents in various branches of economy, they became spread chemical factors of environment. A scheme was worked out of possible migration of SAS in environmental objects in conditions of irrigation of agricultural land by sewage waters. It is suggested that detailed studies should be directed with the purpose of reducing of contamination of human environment. PMID- 2756667 TI - [Antileptospiral antibodies in the blood serum of donors]. AB - The authors investigated the content of antileptospiral antibodies in 930 blood sera of nonimmunized blood donors. It was established that high titers of antileptospiral antibodies are contained in 5.2% of practically healthy persons. PMID- 2756668 TI - [A method of evaluating the functional relation of separate signs of disease]. AB - An analysis of clinical data revealed a correlation between the relative frequency of joint appearance of changed signs and their functional relationship which is in contradiction to the value of the coefficient of stochastic link. Using an apparatus of the information theory the authors introduce a quantitative value of functional relationship between signs of the disease. A method is proposed of evaluation of the functional relationship between signs, the basis of which is calculation of the quantity of information contained in reports on the joint appearance of these signs in the disease. A formula was designed for calculating the coefficient of functional relationship. This method was approved on indices characterizing involvement of the pancreas in viral hepatitis. PMID- 2756669 TI - [The clinical picture and treatment of salmonellosis caused by rare Salmonella species]. AB - The clinical aspects, diagnosis and treatment of salmonellosis due to rare types of salmonellae were studied in 135 patients (males--58.5%, females--41.5%). The disease occurred sporadically with prevalence of the alimentary factor of infection without distinct seasonal characteristics. The gastroenterocolitic variant of the disease prevailed with signs of sigmoiditis, cholangiohepatitis, irritation of the peritoneum and involvement of the respiratory tract in some patients. The pathogens showed a high sensitivity to antibiotics. PMID- 2756670 TI - [Errors in the diagnosis of trichinelliasis]. PMID- 2756671 TI - [The use of indomethacin in acute intestinal infections]. AB - The dynamics of the level of prostaglandins E and F was studied in 45 patients with bacterial intestinal infections. It was established that during the acute period of the disease their content showed a significant increase. Inclusion of the indomethacin (a prostaglandin inhibitor) in the complex pathogenetic treatment of intestinal infections promotes early disappearance of pathological symptoms of the disease. PMID- 2756672 TI - [A case of transmission of the human immunodeficiency virus from a donor to recipients]. PMID- 2756673 TI - [Peptic ulcer recurrence after vagotomy]. AB - The authors studied the clinical aspects, indices of gastric secretion and basal level blood serum insulin, gastrin and parathormone in 83 patients with ulcer disease recurrence after vagotomy. All patients showed an active acidopeptic factor--sequel of ineffective and incomplete (in some patients) vagotomy as well as inadequate pyloroplasty. Provoking factors of ulcer disease recurrence may be stress, drugs, duodenogastric reflux, presence of ligatures after pyloroplasty. Surgical treatment is indicated in patients with surgical complications, repeatedly relapsing ulcers. Recurrences with moderate course are successfully treated by traditional means and the patients retain working capacity due to seasonal or all-year prophylaxis. PMID- 2756674 TI - [Peptic ulcer recurrence after selective proximal vagotomy]. AB - A study of the structure of recurrences of ulcer disease was made on the basis of long-term follow-up results in 257 patients with selective proximal vagotomies. Real (with the presence of an ulcer) and false (without ulcer) recurrences are distinguished. The clinical aspects of the course and diagnosis of real and false recurrences are described. The principles of prophylaxis and treatment of ulcer disease recurrences are outlined. PMID- 2756675 TI - [Chronic pancreatitis in patients with the postcholecystectomy syndrome]. AB - The authors report results of examination and treatment of 318 patients with chronic pancreatitis following cholecystectomy. Cholelithiasis is one of the most frequent etiological factors of development of pancreatitis. The incidence of pancreatitis showed a direct proportion to the duration of cholelithiasis before the operation. The treatment of these patients should be complex. Life-long prophylactic management is indicated in patients with pancreatic disorders. PMID- 2756676 TI - [Anatomico-functional changes of the duodenum and stomach in pancreatic cancer]. PMID- 2756677 TI - [Morphologic changes of the digestive organs during the development of kidney failure]. AB - Morphological changes in the organs of the gastrointestinal tract are caused by renal failure. They are reflected more in the small intestine and are accompanied by disturbance of the absorption process. The basis of these disorders are changes of the histoarchitecture of the absorbing surface of the small intestine. PMID- 2756678 TI - [A mathematical model for predicting the efficacy of glucocorticoid therapy of glomerulonephritis]. AB - A mathematical model is proposed for prediction of the efficacy of glucocorticoid therapy developed on the basis of the Bayes theorem and successive Wald's analysis. The model uses the retrospective values of the results of radioligand determination of the number of glucocorticoid receptor of lymphocytes and static renal scintigraphy. By means of the blind method the informative value of the mathematical model to predict the inefficacy of glucocorticoid therapy in nephrotic glomerulonephritis was 96%. A nomogram was developed. PMID- 2756679 TI - [Effect of glucocorticoids on immunological indices in patients with subacute thyroiditis]. AB - Use of glucocorticoid agents in 110 patients with subacute thyroiditis furthered normalization of the cellular, humoral immunity and unspecific defense factors. Clinical signs of the disease disappeared quicker than reduction of the severity of immune and autoimmune disorders evidencing protraction of the disease and necessity of prophylactic treatment and use of additional immunoregulating agents. PMID- 2756680 TI - [The prevalence of the initial forms of cerebrovascular and cardiovascular diseases and their risk factors among the rural population]. AB - An epidemiological analysis was carried out in 704 rural inhabitants. A significant incidence of cardiovascular diseases and their risk factors was found. The incidence of cerebrovascular pathology prevailed over the cardiac. With age hyperlipidemia increased, particularly in males. Therapeutic and prophylactic measures are discussed. PMID- 2756681 TI - [Prediction of the threshold power of a physical load in patients wih ischemic heart disease]. AB - To reduce time of physical loading (PL) without essential change of information value, an analysis was made of the hemodynamic and oxygen provision of PL during bicycle ergometry in 111 patients with IHD and 30 healthy persons. The authors worked out a method of determination of threshold power of PL without reaching signs of its inadequacy. The examination lasts not more than 10-15 minutes and may be carried out in out-patient conditions. PMID- 2756682 TI - [Dopamine in the combined treatment of heart failure in a patient with Abramov Fiedler myocarditis]. PMID- 2756683 TI - [Echocardiography in studying the indices of myocardial contractile function]. AB - In the assessment of most informative indices for studying the myocardial contractility based on electrocardiographic findings, 10 parameters at rest and at the peak of isoprenaline action (a positive inotropic agent) were estimated and analyzed. The study involved 30 apparently healthy people aged from 20 to 89 years. Using the method of major components, the initial information was condensed by excluding less informative characteristics. Eventually 4 parameters were selected which can be proposed for study of myocardial contractility by means of echocardiography: normalized systolic ejection rates for the first third of systolic ejection; percent of stroke volume ejected for the first third of systole; mean normalized velocity of circumferential fiber shortening; and peak rate of decrease of left ventricular dimension during systole. PMID- 2756684 TI - [Ambulatory treatment of hypertension patients using physical methods]. AB - Physical methods were used to treat patients with hypertensive disease (Stages I and II) in polyclinical conditions. Evaluation of clinical data and functional state of the cardiovascular system allowed to establish efficacy of these treatment methods and, thus, to recommend wider use of physiotherapy in the therapy of this group of patients with hypertensive disease. PMID- 2756685 TI - [The prevention of hypertension]. AB - The instability is shown of some types of hemodynamics in the course of 24 hours in healthy persons. Healthy persons with initial hyper- and normokinetic types of blood circulation are characterized by a disposition to inadequate reaction of the vascular tone in response to diurnal changes of the minute blood volume. Periodic elevation of the peripheral vascular resistance above permissible levels makes it necessary to carry out prophylactic measures against hypertensive disease. PMID- 2756686 TI - [Changes of the immunologic indices in patients with hypertension combined with obesity]. AB - A study of the immunological indices in patients with association of hypertensive disease and obesity revealed absolute and relative lymphocytosis, increased numbers of B-lymphocytes, immunoglobulins A, G, while the content of O lymphocytes and immunoglobulins M did not change essentially. Due to lymphocytosis, absence of immunodeficiency, obese patients should keep hypocaloric diet for short time as one of the main methods of obesity treatment. PMID- 2756687 TI - [The effect of spontaneous echo contrasting of the mitral regurgitation stream]. AB - The author demonstrates the phenomenon of spontaneous echo-contrasting of the left atrium caused by the regurgitation stream verified intraoperatively in a female patient with associated mitral disease. It is shown that this phenomenon appears due to asymmetric regurgitation stream and disturbed mechanism of movement of the mitral valve. PMID- 2756688 TI - [Supernumerary chorda of the left ventricle]. AB - Echocardiographic examination revealed in 184 (11%) of the 1680 persons an accessory chorda in the left cardiac ventricle (ACLV). It was found ACLV was often associated with paroxysms of cardiac of unclear etiology and ventricular fibrillation in myocardial infarction. The clinico-, phono-, electrocardiographic symptomatology and inheritability of ACLV are discussed. As defined by the authors the syndrome in ACLV includes: 1) cardialgia, 2) systolic murmur, 3) electrocardiographic syndrome of early ventricular repolarization, 4) paroxysms of cardiac fibrillation, 5) Predisposition to ventricular fibrillation in myocardial infarction. PMID- 2756689 TI - [The prevention of chrysotherapy complications in patients with rheumatoid arthritis]. AB - To prevent side-effects of chrysotherapy for rheumatoid arthritis the authors recommend a treatment scheme under corticosteroid protection. The proposed method was used in 56 patients with rheumatoid arthritis. Side-effects manifested in allergic eruptions were noted in 3 patients (5.35%) while in the control group of 34 patients who were treated by chrysotherapy according to the routine method complications were observed in 9 patients (26.47%). PMID- 2756690 TI - [Indices of the blood fibrinolytic system in osteoarthrosis and rheumatoid arthritis]. AB - The fibrinolytic system of the blood was studied in 46 patients with osteoarthrosis (OA) associated with reactive synovitis or without it, 44 patients with rheumatoid arthritis (RA) without visceral manifestations. It was found that a slowing of enzymatic, nonenzymatic and XIIa-dependent fibrinolysis is typical of RA but not of OA. Products of fibrin breaking in the general blood flow were absent in patients with OA but may be observed in RA. Increase of the level of fibrin monomers (FM) in the blood are observed in OA with reactive synovitis. The concentration of FM in the blood in RA and OA with reactive synovitis is an informative and dynamic sign of the activity of the inflammatory process and efficacy of treatment. PMID- 2756691 TI - [Sermion treatment of middle-aged and elderly patients with initial atherosclerotic encephalopathy]. AB - The authors report results of a clinico-physiological study of the efficacy of a vasoactive agent sermion in patients with initial atherosclerotic encephalopathy indicating a positive effect of course treatment with this agent on the main clinical manifestations of the disease, pulse blood filling, bioelectric activity of the brain, psychomotor rate, mental working capacity, mnemonic function. Considering the established age-related differences in the efficacy of the agent, it is expedient to recommend sermion for long-term employment in the elderly. One should be cautious in instituting the drug in persons suffering of raised intraocular pressure. PMID- 2756692 TI - [Iron metabolism in hereditary hemochromatosis]. AB - The characteristic features of iron metabolism in hereditary hemochromatosis are described. The patients showed an increase of serum iron, iron saturation of transferrin as well as serum ferritin and erythrocytes. Results of determination of isoferritins of the splenic and cardiac types revealed a biochemical heterogeneity of hereditary hemochromatosis. Methods of differential diagnosis of hereditary hemochromatosis, secondary hemochromatosis and chronic diseases of the liver are described. PMID- 2756693 TI - [The treatment of peptic ulcer]. AB - Problems are discussed on the differential pathogenetic treatment of patients with duodenal ulcer. Variants are singled out of the course of ulcer disease depending on the prevalence of clinical symptoms. The characteristic features of these symptoms are described and the most rational and individualized therapeutic complexes for each of these clinical variants are evaluated. PMID- 2756694 TI - [Immune system function and lipid peroxidation processes in protracted forms of pneumonia]. AB - The authors studied the characteristic features of cellular and humoral immunity as well as the intensity of free-radical lipid peroxidation in 74 patients with acute and protracted course of acute pneumonia. A close relationship was established between immune disorders at the level of the regulatory link and the activity of peroxidation of lipids during transformation of acute pneumonia into protracted. It is shown that the content of products of lipid peroxidation in erythrocytes during the first days of the disease may be a well-informative criterion reflecting the character of course of the inflammatory process in the lungs and adequate immune response. This may be used for the prognosis of protracted forms of pneumonia. PMID- 2756695 TI - [The pyrogenal test in assessing body immune reactivity in acute diseases of the respiratory organs]. AB - The authors studied the reaction of hypersensitivity of the delayed type to administration of pyrogenal in 94 patients with different acute diseases of the respiratory organs. Different changes of the pyrogenal test were accompanied by changes of leucocytosis, ESR, lymphocyte count, A, G, M immunoglobulins. An inverse relationship was found between the pyrogenal test and number of A and M immunoglobulins. The pyrogenal test may be used in outpatient conditions for preliminary evaluation of cellular immunity. PMID- 2756696 TI - [The use of enterosorption in treating patients with chronic asthmatic bronchitis]. AB - The author investigated the efficacy of using enterosorption in the treatment of patients with chronic asthmatic bronchitis. This method was used as monotherapy and in the complex with other pathogenetic agents. A positive dynamics was revealed of almost all indices of external respiration function with normalization of most of them. The severity of bronchospasm reduced. More effective was the use of enterosorption in the complex treatment. PMID- 2756697 TI - [Effect of antitubercular preparations on enzyme activity of erythrocytes]. AB - It was established experimentally that antituberculous agents (isoniazide, rifampicin, methazid, ethambutol, PAS) and their combination (isoniazide + rifampicin + PAS; isoniazide + PAS; methazid + PAS) inhibit erythrocytic glucoso 6-phosphate-dehydrogenase, glycerophosphate-dehydrogenase. This should be considered in instituting individual antituberculous therapy. PMID- 2756698 TI - [Phonopulmonography in examining the patient with pulmonary tuberculosis]. AB - The author used a new physiological method in the clinic of patients with pulmonary tuberculosis--photopulmonography, with the purpose of examination of the functional properties and pathological changes in the lungs. A study of 42 patients with different active forms of tuberculosis by this method permitted to evaluate the compensatory and adaptative capacities of pulmonary tissue, to determine the treatment efficacy. PMID- 2756700 TI - [The prevalence of disseminated sclerosis in the Carpathian region]. AB - The authors investigated the incidence of multiple sclerosis in the Carpathian region. It is concluded on the basis of a statistical analysis that the incidence of multiple sclerosis in this region is influenced by environmental factors. PMID- 2756699 TI - [Structural characteristics of the wall of the human pulmonary trunk in the prenatal period of ontogeny]. AB - A light and electron microscopic study of the pulmonary trunk of 243 human embryos and fetuses (6-40 weeks old) revealed a relationship of differentiation of vessel wall myocytes with fibrillogenesis. The latter shows in the early prenatal morphogenesis of the trunk wall an intensive course and in the time aspect leaves behind the terms of differentiation of myocytes from mesenchyma cells. PMID- 2756701 TI - [Basilar artery thrombosis as a complication of angiographic study in spontaneous subarachnoid hemorrhage]. PMID- 2756702 TI - [Mills' syndrome]. PMID- 2756703 TI - [Goodpasture's syndrome]. PMID- 2756704 TI - [Chordoma of the posterior mediastinum]. PMID- 2756705 TI - [Paget-Schroetter syndrome]. PMID- 2756706 TI - [The role of lipid peroxidation in the pathogenesis of ischemic heart disease in miners in deep coal mines]. PMID- 2756707 TI - Comparison of in vitro susceptibilities among gram-negative rods. AB - The activity of mezlocillin, azlocillin and piperacillin was compared using 100 clinical isolates of gram-negative rods. Overall piperacillin had the highest activity with 72 per cent sensitive strains; mezlocillin, 66 per cent, and azlocillin, 57 per cent. In the group of Pseudomonas aeruginosa, however, mezlocillin showed distinctly lower activity than both piperacillin and azlocillin. PMID- 2756708 TI - Sjogren's syndrome: implications for the primary care physician. AB - Sjogren's syndrome (SS) is a common immunologically-mediated disorder that will afflict a great proportion of our population in future years. The primary care physician undoubtedly will be confronted with such patients, many of whom will have complaints and findings not generally believed to be due to SS. In this communication, case reports of four patients with SS as well as a literature review are presented. Two patients had presentations that were classic for SS; however, the other two were diagnostic challenges. Emphasis is placed on the atypical and unusual way SS can present so that the primary care physician can more easily make the diagnosis and initiate therapy. PMID- 2756709 TI - Quality, accessibility and cost. PMID- 2756710 TI - Legal malocchio. PMID- 2756711 TI - Patient instruction questioned. PMID- 2756712 TI - Nutrition and AIDS. PMID- 2756713 TI - Effects of the fungicide prochloraz on xenobiotic metabolism in rainbow trout: in vivo induction. AB - 1. Rainbow trout were dosed with prochloraz by i.p. injection of sprayed food pellets. Cytochrome P-450, two P-450-dependent activities, and two conjugase activities were measured in vitro in microsomal or cytosolic fractions. 2. Prochloraz increased cytochrome P-450 in liver, intestine, and pyloric caeca: maximum response occurred at 30-100 mg/kg i.p. In cold conditions, this increase persisted for more than 8 days after injection. 3. Hepatic 7-ethoxycoumarin-O dealkylase (ECOD) and 7-ethoxyresorufin-O-dealkylase (EROD) were inhibited by prochloraz except in one assay in warm water where they increased. In intestine and pyloric caeca, ECOD and EROD were not detected, even when cytochrome P-450 was increased. 4. UDP-glucuronosyltransferase (1-naphthol as substrate) was unchanged or inhibited after prochloraz dosing. 5. Glutathione-S-transferase (o dinitrobenzene as substrate), was unchanged or inhibited by prochloraz. 6. The measured level of enzymic activities was the result of induction and inhibition by prochloraz residues. Variations in basal activities and perhaps in prochloraz interactions were due to temperature acclimatization. PMID- 2756714 TI - Differences in the metabolism of epicainide in rats and man. AB - 1. Epicainide is a new potent antiarrhythmic agent, metabolized differently in rats and man. 2. In rats, the aromatic part of the molecule (the two phenyl rings linked to the quaternary carbon atom) undergoes metabolic attack by the mono oxygenases. The hydroxy and methoxy-hydroxy metabolites are predominant and are excreted in urine and bile both as free and conjugated forms. 3. In contrast, the aromatic moiety of epicainide remains unchanged in man. It is the ethylpyrrolidine ring which is mainly attacked, resulting in the expected N deethylation, subsequent oxidation of the pyrrolidine moiety, and reduction or hydrolysis of the amide function. 4. A preliminary kinetic analysis of epicainide in man reveals a linear open 2-compartment model. The radioactivity recoveries confirm the absence of any accumulation of the drug in the organism. PMID- 2756715 TI - Alteration of hepatic carboxylesterase activity by soman: inhibition in vitro and enhancement in vivo. AB - 1. Hydrolysis of the drug esters procaine, chloramphenicol succinate, and prednisolone succinate was studied. Addition of soman to guinea pig liver microsomes caused a dose-dependent inhibition of hydrolysis of all three substrates; at the highest soman concentration (1 microM), ester hydrolysis was totally abolished. 2. Ester hydrolysis was also measured in liver microsomes from guinea pigs pretreated with soman at a low dose (10% of LD50) or at a high dose (90% of LD50) either 1 h or 12 h before killing. Plasma-cholinesterase activity was decreased in all pretreated animals. Liver carboxylesterase activity, measured with the three drug substrates and by hydrolysis of 4-nitrophenyl acetate was increased by all pretreatments. 3. This enhancing effect varies with the substrate and increases with dose of soman. The 12 h pretreatment produced a greater increase in activity than did the 1 h pretreatment. 4. These studies indicate that soman is a potent inhibitor of carboxylesterase activity in vitro but increases the activity of the liver enzyme when administered in vivo. PMID- 2756716 TI - The role of gut micro-organisms in the metabolism of deoxynivalenol administered to rats. AB - 1. Oral administration of deoxynivalenol (DON) to control rats resulted in the appearance of a de-epoxy metabolite in urine and faeces. 2. When DON was administered to rats treated with antibiotics to deplete their gut microflora there was very little excretion of radioactivity as the de-epoxy metabolite in faeces or urine. 3. Incubation of DON with a strictly anaerobic preparation of gut contents resulted in the progressive appearance of de-epoxy DON during a 24 h incubation period. 4. Incubation of DON with liver homogenate did not result in the appearance of the de-epoxy DON metabolite. 5. These results indicate that the presence of de-epoxy DON in rat excreta, following the oral administration of DON, is the result of metabolism by micro-organisms in the gut. PMID- 2756717 TI - Studies on the fate of flocoumafen in the Japanese quail (Coturnix coturnix japonica). AB - 1. 14C-Flocoumafen, administered to Japanese quail as a single oral or i.p. dose, was rapidly and extensively eliminated in excreta; most was eliminated within 24 h. Extensive metabolism of the rodenticide was seen, with at least 8 metabolites detected; unchanged flocoumafen comprised 9% dose. The elimination kinetics and metabolic profiles were qualitatively similar after oral and i.p. dosing. 2. The major metabolites (60% dose) were labile to beta-glucuronidase, liberating aglycones with identical chromatographic mobilities to those of the unchanged flocoumafen isomers. 3. Radioactivity was retained mostly in the liver; largely as unchanged flocoumafen associated with the mitochondrial and microsomal fractions. Elimination of radioactivity from most tissues was biphasic with an initially rapid depletion (5 days) followed by a slow terminal elimination phase. The elimination half life from liver was greater than 100 days. 4. Livers of quail receiving extended dietary exposure to flocoumafen at 5, 15 and 50 ppm had concentrations of flocoumafen (1.0 nmol/g) that were independent of dose, indicating a capacity-limited binding site. These hepatic concentrations were similar to those after a single oral dose and were also similar to those in rats. The data indicate the presence in quail liver of a saturable high affinity flocoumafin binding site with similar characteristics and capacity to that in the rat. 5. The selective toxicity of flocoumafen to rats (highly toxic) and quail (moderately toxic) appears to arise from differences in metabolism rather than from anticoagulant binding in the liver. When hepatic binding sites of rats are saturated anticoagulant action becomes lethal, whereas quail are able to survive and extensively metabolize the compound. PMID- 2756718 TI - The percutaneous fate of the rodenticide flocoumafen in the rat: role of non biliary intestinal excretion. AB - 1. Appreciable penetration of radioacticity occurred through rat skin following percutaneous administration of 14C-flocoumafen. At 7 days after dosing 12% of the administered radioactivity remained at the site of application, while 25% was located in the liver as unchanged flocoumafen. 2. Excretion of flocoumafen metabolites via the urine accounted for 10% dose over the 7 day experiment, this is some 30-fold greater than that seen after a single oral dose. 3. Unchanged flocoumafen comprised the major product detected in faeces. Biliary elimination was a very minor route of excretion and did not account for all of the unmodified flocoumafen present in faeces. 4. Considerable amounts of unchanged flocoumafen found associated with the contents of the large intestine after intraperitoneal administration to rats fitted with biliary fistulae indicates that, in the intact rat, flocoumafen enters the intestine by a non-biliary intestinal excretion mechanism. PMID- 2756719 TI - Metabolism of pentachlorophenol by fish. AB - 1. Interspecies variability in the metabolism of pentachlorophenol (PCP) was investigated by exposing rainbow trout, fathead minnows, sheepshead minnow, firemouth, and goldfish to water-borne 14C-PCP for 64 h. 2. The amounts of metabolites in bile and exposure water were species-dependent; all of the metabolites excreted into the water were sulphate conjugates while bile was enriched in glucuronide conjugates. 3. Biliary excretion accounted for less than 30% of the total PCP metabolites. 4. Biliary metabolites alone were a poor indication of the metabolites produced and of the major routes of elimination. PMID- 2756720 TI - Enterohepatic circulation of 2,4-dinitrobenzaldehyde, a mutagenic metabolite of 2,4-dinitrotoluene, in male Wistar rat. AB - 1. The major biliary metabolite of 2,4-dinitrotoluene (2,4-DNT) in male Wistar rat was 2,4-dinitrobenzyl alcohol glucuronide and the minor metabolites were 2,4 dinitrobenzyl alcohol, 2,4-dinitrobenzaldehyde, 2-acetylamino-4-nitrotoluene, 4 amino-2-nitro(2-amino-4-nitro)benzyl alcohol sulphate, 2,4-dinitrobenzoic acid, 2,4-diacetylaminobenzoic acid and 2-amino-4-nitrobenzoic acid. 2. 2,4 Dinitrobenzyl alcohol, 2,4-dinitrobenzaldehyde, 2,4-dinitrobenzyl alcohol glucuronide and 4-amino-2-nitro(2-amino-4-nitro)benzyl sulphate were excreted in the bile of male Wistar rat dosed with 2,4-dinitrobenzyl alcohol. 3. 2,4 Dinitrobenzaldehyde, 2,4-dinitrobenzyl alcohol, 2,4-dinitrobenzyl glucuronide, 4 amino-2-nitro(2-amino-4-nitro)benzyl alcohol sulphate and 2,4 diacetylaminobenzoic acid were excreted in the bile of male Wistar rat dosed with 2,4-dinitrobenzaldehyde. 4. These results indicate that the common biliary metabolites of 2,4-DNT, 2,4-dinitrobenzyl alcohol and 2,4-dinitrobenzaldehyde are 2,4-dinitrobenzyl alcohol and its glucuronide, and 2,4-dinitrobenzaldehyde, and suggest the enterohepatic circulation of 2,4-dinitrobenzaldehyde in the metabolism of 2,4-DNT. PMID- 2756721 TI - Pharmacokinetics of cromakalim--a new antihypertensive agent, in patients with mild essential hypertension. PMID- 2756722 TI - Comparative microsomal oxidation of febantel and its metabolite fenbendazole in various animal species. AB - A comparison has been made of the in vitro metabolism of febantel (FBT) with that of one of its pharmacologically active metabolites fenbendazole (FBZ) using microsomal preparations from liver of sheep, calf, horse, pig, rat, chicken and trout. The oxidation of FBT to the corresponding sulphoxide appeared to be far more rapid with the exception of the trout, than a similar reaction with FBZ. Indeed FBT was further metabolized in several species by cyclization and further oxidation. This observation could have toxicological significance in view of the greater tetratogenic effects of the metabolite oxfendazole. Reaction rates were most rapid in pigs and sheep. PMID- 2756723 TI - Antibiotic treatment of patients with primary bronchial cancer. AB - In the course of the retrospective evaluation of the case histories of 198 patients with documented primary lung cancer, the authors analysed the respiratory tract infections described in the case records and observed during clinical treatment. The bacterial flora of the patients and the sensitivity of the pathogens to antibiotics were examined. A comparison was performed between the antibiotic treatment and infectious complications of patients undergoing a cytostatic regimen and of those who were not administered cytostatic agents. The analysis of the data of bronchial cancer patients led to the conclusion that an adequately chosen and performed antibiotic treatment results in lower mortality due to respiratory tract infections than is described in the literature. PMID- 2756724 TI - [The frequency of bronchial carcinoma in 1,000 autopsies of cases of silicosis]. AB - In the present examination were analysed the anamneses, necropsies and x-ray photograms of 1,000 patients (743 men and 257 women), who died from silicosis in the Thuringian area. The analysis includes a period of 30 years. The material of examination comprises autopsies from 1954 to 1983. There were 45 lung cancers, found in 42 men and 3 women. A relation to smoking habit could not be examined. The lung cancer was mainly connected with a stadium of silicosis II. Only in 6 lung cancers there was a relation to the silicosis like a cicatrice cancer assumed. PMID- 2756725 TI - [Clinical studies of the effect of physical training therapy on oxygen absorption and pulmonary artery pressure in persons with chronic obstructive lung diseases]. AB - Twenty patients with chronic obstructive bronchitis were submitted to a 6-week rehabilitation program including bicycle training, breathing exercise, inhalation, massage, short wave therapy and others. Before and after 6-week training we investigated ventilatory and blood gas parameters and pulmonary artery pressure at rest and during exercise. There was no change in the oxygen uptake on the same exercise stage. We found an insignificant decrease of the pulmonary artery pressure at rest and during exercise. The physical training has no negative influence on the behaviour of pulmonary pressure. We stated a good effect of physical conditioning on the systemic circulation. The working capacity of all patients improved at the end of the training period. PMID- 2756726 TI - [The diagnosis of obstructed nasal breathing in clinical practice--a comparative study]. AB - One hundred patients were inspected after anamnesis by the mirror test by Glatzel, by anterior rhinoscopy, and anterior rhinomanometry in order to judge the passage of the nose. The results of the several parameters were compared on the base of an unitary scale. Fifty two percent of the patients had a full and 43% a partial conformity of the parameters. In 5% of all cases all parameters were divergent. The mirror test is available as screening method. The high expressiveness of rhinoscopy and rhinomanometry for the diagnosis of the restricted nasal breathing is explained. PMID- 2756727 TI - [Comparative cinematographic, endoscopic and functional studies of the preoperative estimation of the severity of tracheal stenoses]. AB - Structural tracheal stenoses have different functional effects according to degree, localization and extent of the stenosis. Further modifications are due to malacic components within the range of the stenosis or tracheal segments abutting on the stenosis. Nineteen patients with mainly cervical tracheal stenoses (12 patients) were investigated in order to examine if a functional X-ray-diagnostic procedure (X-ray-cinetracheobronchography--CTBG--of the central airways in several beam-directions during forced breathing, cough and Valsalva-maneuver after contrasting of the trachea and main-bronchi with powdered tantalum) yields an increase of findings in comparison with a static roentgenologic procedure (chest films p. a. and frontal; tomography) and an endoscopic examination. The judgement of the stenosis is made by measurement of the length and of the diameter compared with the normal trachea. Malacic components reveal themselves by changes of the stenosis-configuration during Valsalva-maneuver, forced breathing and strong coughing. In 11 of 19 patients there was evidence of a malacic stenosis-component and in 5 patients there was a mural weakness of abutting segments. In comparison with the endoscopic examination we found in 8 of 15 patients a diagnostic improvement by demonstration of unfixed stenotic compartments. Besides information about stenotic degree, configuration, localization and length, a CTBG offers the possibility of localizing and grading malacic stenotic components or of adjacent segments--provided that films are made in at least two planes. The application of CTBG in patients with tracheal stenosis is useful if there are signs of tracheomalacia or if the localization and the extent of the stenosis require a difficult reconstructive surgical intervention or if discrepancies between clinical aspect and stenosis-degree make it advisable to extend the field of diagnostic procedures. PMID- 2756728 TI - [Procedures in the course of subspecialization (pulmonology specialty--internists and pediatricians). Legal foundations]. PMID- 2756730 TI - Comparison of maximal postprandial serum cholylglycine concentration with the retention of 75Se-homotaurocholic acid in ileal dysfunction. AB - The retention of 75Se-homotaurocholic acid (75SeHCAT) was measured in 12 healthy controls and in 21 patients with Crohn's disease and compared with the maximum postprandial rise in the serum concentration of cholylglycine (CG) in order to detect bile acid malabsorption. The retention of 75SeHCAT was lowered in all patients with inflammation or resection of the terminal ileum over a length more than 20 cm. In 64% of these patients bile acid malabsorption could also be detected by the absence of a significant rise of the postprandial CG serum level but only if the loss of the ileal function exceeded 30 cm. Although less sensitive than the 75SeHCAT retention, the CG method is simpler to apply in terms of laboratory technology and does not involve exposure to radioactivity. The CG method appears to be of use to detect bile acid malabsorption in certain cases. In the case of negatively if still bile acid malabsorption is suspected more sensitive tests such as 75SeHCAT retention should be carried out to further evaluate bile acid malabsorption. PMID- 2756729 TI - [Effect of omega-3-fatty acids on biliary lipids and lithogenicity]. AB - Until now no studies are available about the influences of omega-3-fatty acids on biliary lipids in men. The effects of 1.5 g omega-3-fatty acids per day on biliary lipid concentration and composition were studied in 13 male healthy persons over six weeks. Biliary cholesterol concentration decreased from 5.4 +/- 0.53 mol% to 3.7 +/- 0.30 mol% (25%) statistically significant. Phospholipids and bile acids remained unchanged. Cholesterol saturation index (CSI) was lowered from 1.13 +/- 0.12 to 0.85 +/- 0.06 (p less than 0.05). Bile acid composition and conjugation rates were unchanged. No significant side effects could be observed. Substitution of omega-3-fatty acids induced in healthy male persons a decrease of biliary cholesterol and lithogenicity. PMID- 2756731 TI - [Prostaglandins and gallstones]. PMID- 2756732 TI - [Myocardial noradrenaline content: a factor not considered up to now for the prognosis of patients with dilated cardiomyopathy]. AB - To evaluate the prognosis of patients with idiopathic dilated cardiomyopathy (EF less than 50%) in 55 patients the myocardial catecholamine concentration, plasma catecholamine concentration, and left ventricular ejection fraction were determined. The follow-up time ranged from 7 to 47 months. At the time of follow up 10 of the 55 patients (group A) had died and three had undergone hearttransplantation. Group A patients had a significant lower EF (27 +/- 10 vs 36 +/- 9%, p less than 0.03), a lower myocardial norepinephrine (254 +/- 168 vs 579 +/- 416 pg/mg, p less than 0.007), higher plasma norepinephrine (640 +/- 333 vs 372 +/- 254 pg/ml, p less than 0.008) and plasma epinephrine (391 +/- 340 vs 116 +/- 81 pg/ml, p less than 0.006) in comparison to patients, who were still alive and not transplanted (group B). Survival was significantly lower in patients with an EF less than 30%, a plasma norepinephrine concentration greater than 350 pg/ml, a plasma epinephrine concentration greater than 125 pg/ml, and a myocardial norepinephrine content less than 400 pg/mg. Cox regression analysis revealed that the ratio of plasma vs myocardial norepinephrine was the best prognostic indicator for patients with an EF less than 30% and this ratio plus the plasma norepinephrine concentration were the best prognostic indicators for the whole group of patients. These data suggest that myocardial norepinephrine content is an important prognostic factor in patients with idiopathic dilated cardiomyopathy. PMID- 2756733 TI - [Heart valve surgery: an analysis of the causes and peri- and postoperative course]. AB - From a total of 1,152 consecutive patients with heart valve replacement (1964-87) 108 patients (9.4%) had to be reoperated. Mechanical valves had to be replaced (n = 89) mainly because of perivalvular leakage followed by prosthetic stenosis and dysfunction. The lowest reoperation rate was found with Bjork-Shiley prostheses (3.4%). Bioprostheses (reoperation rate 8.2%) had to be reoperated predominantly as a consequence of dysfunction. Ten years following implantation 30% of bioprostheses had to be replaced. Patients with reoperations demonstrated, in comparison to patients with singular valve replacement, no significant change in early mortality during the last 6 years (6.8% vs 5.4%). Furthermore, both patient groups revealed similar survival rates (10 years; 78% vs 76%) and improvement of life quality. However, non-lethal peri- and postoperative complication rates were higher in reoperated patients compared to patients with first valve replacement. PMID- 2756734 TI - [Incidence and concomitant factors of tricuspid valve insufficiency in patients with aortic and mitral valve diseases]. AB - Invasive data about the frequency and associated factors of tricuspid regurgitation in normals and in patients with aortic and mitral valve disease are still rare. Thus, right ventricular biplane angiograms (RAO/LAO projection), the mean pulmonary artery pressure and the presence of atrial fibrillation were analyzed with regard to tricuspid regurgitation in 30 normals and 165 patients with pure mitral regurgitation, mitral stenosis, aortic regurgitation, aortic stenosis, combined mitral valve disease or combined aortic valve disease. Patients with tricuspid stenosis or coronary artery disease were excluded. In 52 of the 195 patients tricuspid regurgitation was present. Tricuspid regurgitation occurred statistically more often in patients with mitral stenosis (33%), mitral regurgitation (48%) or combined mitral valve disease (68%) than in patients with aortic regurgitation (4%) or combined aortic valve disease (3%). In patients with aortic stenosis and in normals tricuspid regurgitation was not present. In patients with combined mitral valve disease, tricuspid regurgitation was more often present than in patients with pure mitral stenosis (p less than 0.002), despite comparable values of the mean pulmonary artery pressure, the right ventricular enddiastolic and endsystolic volume indexes, the right ventricular ejection fraction and the frequency of atrial fibrillation. Only in patients with pure mitral regurgitation tricuspid regurgitation was associated with an elevated mean pulmonary artery pressure (p less than 0.02). Differences in the right ventricular size and function did not occur between normals and patients with mitral or aortic valve disease. Therefore, the mean pulmonary artery pressure, atrial fibrillation and the size and function of the right ventricle are not major determinants for the occurrence of tricuspid regurgitation.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2756735 TI - [Function of the right ventricle in patients with mitral valve diseases]. AB - To investigate right ventricular function in mitral valve disease, biplane cineventriculograms of the right and left ventricle were performed in 96 patients 35 with mitral stenosis, 26 with mitral regurgitation, 12 with combined mitral valve disease, 14 with mitral stenosis and tricuspid regurgitation, and nine with mitral regurgitation and tricuspid regurgitation, compared to 18 normals (N). Right ventricular enddiastolic volume index was moderately elevated in patients with mitral stenosis and concomitant tricuspid regurgitation (111.6 +/- 35.3 ml/m2, no significance compared to N: 95.9 +/- 21.8 ml/m2) and with mitral regurgitation and tricuspid regurgitation (107.9 +/- 45.1 ml/m2, no significance compared to N). A reduced right ventricular ejection fraction (RVEF less than or equal to 50%) was found in 40 of the 96 patients. Right ventricular ejection fraction was frequently reduced in patients with mitral regurgitation and tricuspid regurgitation (46.7% +/- 15.1%) and significantly reduced in patients with combined mitral valve disease (45.0 +/- 17.6%, compared to N: 58.0 +/- 7.1%, p less than 0.01). No significant correlations were found between right ventricular ejection fraction and left ventricular enddiastolic volume or left ventricular ejection fraction in patients with mitral valve disease. Moreover, right ventricular ejection fraction did not correlate with systolic pulmonary artery pressure, mean pulmonary artery pressure or mean pulmonary capillary wedge pressure. Local wall motion (mean systolic shortening) was determined for the anterior, anteroapical, and inferior segment in the RAO-projection and for the right ventricular free wall in the LAO-projection. 63% of the patients (n = 25) with reduced right ventricular function (RVEF less than of equal to 50%) showed local wall motion abnormalities, preferably in the anterior segment of the RAO- projection (48%) and the right ventricular free wall (30%).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2756736 TI - [Influence of angiotensin-induced change in afterload on hemodynamics in mitral valve insufficiency. A 2-dimensional and color-coded Doppler echocardiography study]. AB - This study assesses the consequences of angiotensin I-induced afterload-stress on mitral regurgitation by two-dimensional and color-coded Doppler echocardiography. During continuous intravenous infusion of angiotensin I in increasing doses of 0.5, 2, and 4 micrograms/min, blood pressure increased significantly from 119 +/- 7/73 +/- 3 mm Hg up to 145 +/- 8/91 +/- 4 mm Hg (+22% resp. +25%; p less than 0.0001 resp. p less than 0.0001). Heart rate did not change significantly (84 +/- 2 min-1 resp. 88 +/- 4 min-1). The enddiastolic volume index, determined by two dimensional echocardiography, did not change significantly (104 +/- 10 ml/m2 resp. 112 +/- 3 ml/m2), the endsystolic volume index increased from 57 +/- 10 ml/m2 to 75 +/- 13 ml/m2 (+32%; p less than 0.01), the ejection fraction fell from 47 +/- 4% to 36 +/- 4% (p less than 0.001). In the RAO-equivalent view the maximal jet-length, determined by color-coded Doppler echocardiography, increased from 2.6 +/- 0.2 cm to 3.9 +/- 0.3 cm (+50%; p less than 0.001), the maximal jet area rose from 3.4 +/- 0.6 cm2 to 7.0 +/- 1.0 cm2 (+106%; p less than 0.001); in the parasternal long axis view the maximal jet-length increased from 2.3 +/- 0.2 cm to 3.5 +/- 0.3 cm (+52%; p less than 0.001), the maximal jet-area from 2.6 +/- 0.5 cm2 to 4.9 +/- 0.8 cm2 (+89%; p less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2756737 TI - [Myocardial damage following lightning injury]. AB - In a 27-year-old woman, struck by lightning behind the left ear, the ECG showed signs of an acute posterior-lateral myocardial infarction after 1 h of unconsciousness and loss of memory. Her serum enzymes were increased as is typical of myocardial infarction, but the patient did not complain of cardiac symptoms. Besides clear signs of lightning injury, the patient showed a hemorrhage throughout the left breast and transient pericardial effusion was observed by echocardiography. In the course of two months, the ECG revealed a regression to unspecific ST-T-deviations and serum enzymes became normal. TI-201 myocardial-scintigraphy (SPECT), done six days and two months after lightning injury, excluded reversible and irreversible perfusion defects. PMID- 2756738 TI - [Myocardial infarct with normal coronary angiogram]. AB - We report on a 50-year-old woman who was able to escape from the cellar which contained fermenting wine, whereas her husband died there. Immediately after the incident she developed an extended myocardial infarction of the anterior and septal wall in spite of an intravenous administration of streptokinase within 2 h. Four weeks later coronary angiography showed normal vessels. A spasm is assumed, favored by systemic hypoxia, CO2-overloading, and systemic adrenergic reaction. The postulated cause of the special localization of the spasm is an unknown individual local factor as in all other similar cases. PMID- 2756739 TI - Visualization of the Langerhans cells in the human vaginal epithelium by the L dopa histofluorescence method. AB - In this study we used the technique of L-DOPA histofluorescence for visualizing Langerhans cells in the human vaginal epithelium. Biopsy specimens were incubated with L-DOPA and sectioned by cryostat. The sections were exposed to formaldehyde vapour; during this passage, chemical conversion of L-DOPA into a strongly fluorescent compound occurred. Langerhans cells were clearly visualized in the vaginal epithelium; cell bodies and dendritic processes fluoresced sharply. The method is rapid and specific: it represents an useful tool for demonstrating Langerhans cells in the stratified squamous epithelium of vagina. PMID- 2756740 TI - [The structure of the arteries at the base of the brain in young and adult dwarf goats. 2. Age-associated changes]. AB - Age-associated changes in cerebral arteries of 6 years old pygmy goats were investigated quantitative-histologically. No atherosclerotic alterations could be observed. But age-related thickenings of the subendothelial lamina till to 7 microns were present. Beside a significant increases of the intima, also an increase of the media as also of some lumina could be seen. In relation to the increase of the arterial lumen, the increase of the media was more rapid. Apparently more intercellular substance is formed by the smooth muscle cell during age. These studies confirm only weak intimal thickenings of the cerebral arteries during ageing. They do not effect the blood supply of the brain. PMID- 2756741 TI - [Light microscopic studies of the intramural coronary arteries in the trabecula septomarginalis of the right heart ventricle of cattle, swine and dwarf goats]. AB - In the Trabecula septomarginalis (moderator band) of cattle, pig and pygmy goat regularly till to 6 arteries are found, which traverse from the interventricular septum to the M. papillaris magnus. At these intramural coronary arteries (diameter 100-800 microns)--without any exception--musculoelastic intimal thickenings are recognizable, which often may result in concentric luminal narrowings of a high degree. The genesis and importance of the specificities in the wall structure of the moderator band arteries are discussed in relation to the intramural coronary arteries of the ventricular wall and papillary muscle as an adaptational reaction of the vascular wall to the extraordinary stress of these small vessels. PMID- 2756742 TI - Sexual dimorphism in the cholinergic innervation of the hamster (Mesocricetus auratus) harderian glands. AB - We study the cholinergic innervation of the Harderian gland in male and female golden hamsters. There is a clear sexual dimorphism in the cholinergic innervation between both sexes. The Harderian gland from male animals contain much more nervous fibers with acetylcholinesterase (AChE) positive reaction than in female. The nervous fibers containing AChE activity are surrounding the acini and blood vessels. PMID- 2756743 TI - Ultrastructural localization of acetylcholinesterase in Axolotl brain capillaries. AB - The ultrastructural distribution of cholinesterases on the brain capillaries of Axolotl has been studied. The Axolotl brain contains branching, Anastomosing capillary network and capillary loops. The presence of acetylcholinesterases is seen on the basal lamina and in the spaces between the endothelial cells and the pericytes of both types of vessels. The role of this enzyme in the blood-brain barrier is discussed. PMID- 2756744 TI - Scanning electron microscopic observation on the distal part of the male urethra of the mouse. AB - In the proximal end of the navicular fossa, the stratified columnar epithelium lining the spongy part of the urethra abruptly changes into the stratified squamous one, presenting a sharp demarcation. It is considered that the junction between these 2 epithelia corresponds to the former site of the junction of the entoderm and ectoderm. The width of the microridges in the distal part of the navicular fossa was about doubled compared to that in the proximal part. It is suggested that the epithelium in the distal part is keratinized, while that in the proximal part is nonkeratinized. PMID- 2756745 TI - Pineal corpora arenacea produced by arachnoid cells in the bat Myotis blythi oxygnathus. AB - There are corpora arenacea among the cell layers of the arachnoid on the dorsal surface of the pineal organ of the bat (Myotis blythi oxygnathus). The pineal arachnoid consists of electron lucent cells connected by cell injunctions to flat sheets and sandwiched on both sides by electron-dense cell rows. Among the superficial cell layers, collagen fibrils form loose bundles. In the electron lucent cells, pinocytotic vesicles, rough surfaced endoplasmic reticulum, active Golgi areas and granular vesicles of various sizes can be found. Electron dense cells display fewer cytoplasmic organelles than the light ones. Lying between and below the hemispheres and cerebellum the pineal arachnoid does not contact the dura mater directly, therefore it continues on its both sides into arachnoid trabeculae. Corpora arenacea occur in lacunar enlargements of the arachnoid, first of all in the thickened dorsal portion of the pineal leptomeninx. The acervuli are insulated by collagen fibrils and exhibit concentric layers of various density. Needle-shaped structures resembling hydroxyapatite crystals were found in these concentric layers. There was no sign of formation of acervuli in the pinealocytes or elsewhere in the pineal nervous tissue proper. These findings confirm that view that corpora arenacea can be produced by the pineal arachnoid. The formation of acervuli is accompanied by secretory and resorptive phenomena of arachnoid cells. PMID- 2756746 TI - The blood circulation inside the spleen. I. The arterial blood vessels general distribution in the rat spleen. AB - As an attempt to investigate the different pathways followed by the blood into the spleen and to analyse their functional significance, a technique was used mainly based on the intraarterial perfusion of a Prussian blue "solution" added of some chemical mediators and vasoactive substances. Such technique provides results which may be analysed taking into account the effect of the anaesthetic used, that may influence the findings. From the anaesthetic used, the sulfuric ether and the barbital sodium produce vasoconstriction of the white pulp blood vessels, whereas the chlorpromazine-promethazine doesn't have this effect, and so the Prussian blue appears inside these vessels. The vasodilator drugs, such as succinonitrile and papaverine hydrochloride, show a general vasodilator effect on the splenic arterial system. Teh arterial vessels of the white and the red pulp, including those placed at the subcapsular areas, become enlarged; into the white pulp, either the central or the peripheral blood vessel plexus of the lymphatic follicle becomes evident. The latter readily constitutes the perifollicular and the pericolumnar plexus. The blood vessels of this plexus become permeable to the Prussian blue "solution" by the heparin sodium effect, and so the dye particles enter the marginal zone and the splenic sinuses. In addition, from the white pulp arteries arise 2 types of anastomotic arterioles which appear enlarged after succinonitrile treatment: The short anastomotic arterioles that crosses the marginal zone entering the red pulp near the white pulp; the long anastomotic arterioles which enter the red pulp and after a long course end up into or around a collector sinus. The addition of histamine dihydrochloride to the perfusion solutions shows a slight vasodilator effect mainly on the subcapsular penicillar arterioles, including the helicine arterioles. The adrenergic stimulation of the splenic blood vessels induces a generalized arterial constriction, except of the anastomotic arterioles, that becomes open; in such way, the blood pathway follows the course of the anastomotic arterioles and the collector arterioles also become constricted. The adrenergic vasoconstrictor effect is inhibited by the phenoxy benzamine hydrochloride. The addition of acetylcholine chloride, in the dosage, used, induces a generalized arterial vessel constriction, mainly of the perifollicular plexus. This effect is inhibited by atropine sulfate which, on the other hand, produces evident enlargement of the perifollicular and pericolumnar arterial plexus. PMID- 2756747 TI - Histochemical responses in the retina after acute blood loss. AB - Adult albino mice were bleed through the hearts by cardiac puncture under Nembutal anesthetic. 0.3 ml of blood was withdrawn form every animal. The retinae were then studied on a timed basis with succinic dehydrogenase histochemistry and alkaline phosphatase histochemistry. In control retinae, high SDH activities were localized in the inner segments, outer plexiform, inner plexiform, and ganglion cells layers and high alkaline phosphatase activities were localized in the ganglion cell layers and the vessels of the plexiform layers. Decrease in the enzymatic activities of both SDH and alkaline phosphatase in these layers were most evident 5h after bleeding. 9 to 24 h after bleeding, a compensatory increase was detected. 48 to 72 h after, the enzymatic activities decreased again. Reperfusion of experimental animals with 5% dextrose would increase the retinal enzymatic activities back to normal, even if the reperfusion was carried out as late as 48 h after bleeding. PMID- 2756748 TI - [Heart infarct--a turning point in life]. PMID- 2756749 TI - [Echocardiography--sound for mapping of the heart]. PMID- 2756750 TI - ["Troublesome relatives"]. PMID- 2756751 TI - [Pain relieve--morphine pump relieves pain and increases quality of life]. PMID- 2756752 TI - [Diabetes--diet--pregnancy. Generous with carbohydrates best for both mother and child]. PMID- 2756753 TI - [Liability case. Blood transfusion to the wrong patient]. PMID- 2756754 TI - ["You are as you live". Interview by Pelle Olsson]. PMID- 2756755 TI - [Vardfacket in Zimbabwe. Health care in the country--ways toward WHO's goal]. PMID- 2756756 TI - [Vardfacket in Zimbabwe. Wage differences split nurses apart]. PMID- 2756757 TI - [The first nursing care supplement]. PMID- 2756758 TI - [They come from 4 sections. We pull in the same direction!]. PMID- 2756760 TI - [Ethics as theater]. PMID- 2756759 TI - [The West Bank: here most trades protect businesses]. PMID- 2756761 TI - [Cytostatics program: safer work is the goal!]. PMID- 2756762 TI - [Course teaches women to argue about economics]. PMID- 2756763 TI - [Professional functions, education, wages--you member, think about it!]. PMID- 2756764 TI - [SHSTF requires from government: more places in 3-year education!]. PMID- 2756765 TI - [I admire myself!]. PMID- 2756766 TI - [Half the population is over 65 years old. Soon all of Sweden will look like Frostviken's gathering. Interview by Jan Thomasson]. PMID- 2756767 TI - [Vardfacket in Zimbabwe. Women exposed to the rupture between the old and the new]. PMID- 2756768 TI - [After the 88 agreement: new demands for wage policies with a budget without ceiling]. PMID- 2756770 TI - [Bet on primary health care--without giving us salary?]. PMID- 2756769 TI - [Wage policy in Bohus County: one must have members along]. PMID- 2756771 TI - [Ilska in anesthesia--"continued education should be worthwhile!"]. PMID- 2756772 TI - [Continued protest by physicians having Gundla as chief]. PMID- 2756773 TI - [A question of costs]. PMID- 2756774 TI - [Social Minister Sven Hulterstrom: physicians are not always the most suitable chiefs. Interview by Britta Nilsson]. PMID- 2756775 TI - [Vardfacket in Zimbabwe. They sew for their independence]. PMID- 2756776 TI - [A joint session of the Division of Medico-biological and Clinical Medicine Sciences of the USSR Academy of Medical Sciences, the USSR Ministry of Health, the Lithuanian SSR Ministry of Health, and the Academy of Sciences of the Lithuanian SSR on the problem of diabetes mellitus. 7-9 June 1988, Kaunas. Proceedings]. PMID- 2756777 TI - [Comparative clinico-immunologic and microcirculation studies in families of patients with type 1 diabetes mellitus and systemic lupus erythematosus]. AB - Presented are findings of comparative studies of the clinico-immunological parameters and the microcirculatory bed status in 17 DM I probands and 37 of their family members and in 17 SLE probands with 54 of their relatives. The DM I families were found to have DM and prediabetic cases, while among the SLE probands' families rheumatic and, less frequently, cardiovascular diseases prevailed. In the DM I probands' families, a significantly greater number of relatives were found to have rheumatoid factor, high IgG level, anti-DNA antibodies, and CIC (as compared to the SLE series). Both DM I and SLE groups demonstrated reduced efficacy of the cutaneous circulation as compared to norm; in the DM I relatives this disorder was more pronounced than in SLE relatives. The degree to which circulatory changes were pronounced was related to immunological disorders. PMID- 2756778 TI - [Diabetes mellitus in the Siberian region]. AB - The problem of diabetes mellitus in Siberia is of utmost medico-social importance. The patterns of diabetes and abnormal carbohydrate metabolism prevalence in the Siberian and, in particular, Northern regions are related to the significant population migration to these areas. A higher incidence of carbohydrate metabolism disorders and risk factors among the migrant compared to the native population is revealed. Evaluation of diabetes prevalence, morbidity, risk factors, and of the hormonal spectrum in the Siberian residents would allow for planning and implementing further preventive actions in the framework of the multifactor prophylaxis of chronic non-infectious diseases. PMID- 2756779 TI - [A program for the prevention of diabetes mellitus in Lithuania]. AB - The Programme on Diabetes Mellitus Control is a constituent part of Integrated Programme on Chronic Non-infectious Diseases Control. The epidemiological evidence has demonstrated the high prevalence of deranged carbohydrate metabolism in the republic. Registers of carbohydrate metabolism disorders were created for the children's population of the Republic and the adult population of Kaunas and two agricultural-industrial regions. A school for diabetic patients and the society 'Insula' were organised. The research-practical programme is implemented in stages. PMID- 2756780 TI - [Pregnancy and diabetes mellitus]. AB - The dynamics of the placental lactogenic hormone level, insulin requirements, and glycaemia during pregnancy was studied in diabetes I and II patients and diabetic pregnancies. Fructose amine and C-peptide levels in maternal and neonatal blood were measured in different diabetes types. The risk of diabetes I development in relation to the incidence of the HLA-system antigens was assessed. The need for a functional insulin therapy prior to and during pregnancy was substantiated. PMID- 2756781 TI - [Characteristics of the course of ischemic heart disease and diabetes mellitus occurring jointly]. AB - Findings of research into the specific course of ischaemic heart disease (IHD) concurrent with diabetes mellitus are analysed. Diabetic patients were found to have a more severe course of IHD after myocardial infarction, which was more often complicated with arrhythmias, cardiac failure, and unstable angina. The incidence of painless IHD after myocardial infarction was found to be twice higher in diabetics. A consistent relationship between the severity of diabetes and an increase in painless IHD incidence was noted. Diabetes was found to aggravate the IHD course irrespective of the patient's age. A correlation was observed between the severity of IHD and insulinaemia. Certain functional diagnosis methodologies are shown to be most informative in the differential diagnosis of IHD and diabetic cardiomyopathy. The high efficacy of a complex therapy including beta-blockers and angioprotectors in concurrent IHD and diabetes is demonstrated. PMID- 2756782 TI - [Skin lesions in diabetes mellitus]. AB - The characteristics of cutaneous manifestations in diabetes mellitus are presented. The clinical features of the skin lesions are described in relation to the severity of metabolic disorders. The clinical and biochemical features of Necrobiosis lipoidica, its classification and methods of treatment are detailed. PMID- 2756783 TI - [Optimization of insulin therapy in children with diabetes mellitus]. PMID- 2756784 TI - [The role of hyperbaric oxygenation in the complex treatment of patients with type 1 diabetes mellitus]. AB - The results of management of decompensated type I diabetes patients were evaluated. The first group (152 patients), in addition to the traditional therapy (diet No. 9, insulin), underwent hyperbaric oxygenation (10-15 sessions, 60 min exposure at 1.7 ATA). The second group (137 patients) underwent traditional therapy. The treatments' efficacy was compared according to the indices of the hormonal status, blood gas, cell metabolism, oxygen transport function of erythrocytes, and microcirculation status. The application of HBO in the complex management of severe DM allowed for early (12-19th day) compensation of carbohydrate metabolism, reduction of anti-insulin hormone level and of the total secretory activity of the sympathoadrenal system, stimulation of the residual pancreatic beta-cell function, and insulin dose reduction. HBO facilitated normalization of blood gas content, improvement of cell metabolism, oxygen transport, and microcirculation status. The traditional therapy resulted in less pronounced (or absent) positive changes in these indices which were manifest on the 25-27th day of treatment. PMID- 2756785 TI - [Biotechnical products in the treatment of diabetes mellitus]. PMID- 2756786 TI - [Experience in the surgical treatment of neovascular diabetic glaucoma]. AB - A new operation for neovascular glaucoma, filtrating vitrectomy, is described. The operation is based on creation of a permanent microfistula in the posterior chamber of the eye and simultaneous replacement of the viscous vitreous body with the isotonic saline. Filtrating vitrectomy was performed in 46 eyes with neovascular diabetic glaucoma. The intraocular pressure was normalized completely without medication in 70 per cent cases in the early postoperative period and in 66 per cent cases in the long term (12-39 months) period. PMID- 2756787 TI - [The radioecology of the grapevine. 1. The transfer of nuclear weapons fallout from the soil into wine]. AB - In a field investigation (1983-1985) comprising eight places of the most important viticultural regions in the Federal Republic of Germany, the contents of the radionuclides tritium (3H), carbon-14 (14C), strontium-90 (90Sr), and cesium-137 (137Cs) in air, soils, leaves of the vine, grapes and wine were measured and site-specific transfer factors were calculated. Data concerning soil parameters, climatic conditions, cultivation and vinification were collected. The tritium content of all samples was 10 Bq/l water of combustion, independent of location and year. The specific activity of 14C in the atmosphere and in biological material was 0.22 Bq/g carbon, independent of site and year. 90Sr contents of soils fluctuated between 0.7 and 3.5 Bq/kg dry matter. The mean content of leaves was 2 Bq/kg fresh material, of grapes 0.035 Bq/kg and of wine 0.008 Bq/l. 137Cs content of soils fluctuated between 1.3 and 7.9 Bq/kg dry matter. The mean content of leaves was 0.098 Bq/kg fresh material, of grapes 0.021 Bq/kg and of wine 0.0085 Bq/l. A relation between transfer of radionuclides and soil parameters and between the contents of grapes and wine was not recognizable. While cultivar-specific differences were not observed in grapes, red wines contained somewhat more 137Cs than white wines. Transfer factors soil grapes were 0.027 for 90Sr and 0.0057 for 137Cs. Site-specific influences such as soil parameters, climate, cultivation, vinification and differences between years led to a relatively small fluctuation of values. An influence of the nuclear power station Neckarwestheim has not been found in any of the radionuclides. PMID- 2756789 TI - [The mass media and our children]. PMID- 2756788 TI - Determination of residual 1,3-dichloro-2-propanol in protein hydrolysates by capillary gas chromatography. AB - This study describes a method for the quantitative determination of residual 1,3 dichloro-2-propanol in protein hydrolysates. The method is based on a continuous micro-steam distillation solvent extraction technique. The quantitative determination is performed by electron-capture gas chromatography using an "on column" injector and a fused silica capillary CP wax 52 CB column. The absolute detection limit for 1,3-dichloro-2-propanol in soy sauces is 10 pg and recoveries of 75.8% and 82.7% with a standard deviation of 4.0% and 2.5% are obtained for samples fortified in the range of 1 mg/kg and 0.1 mg/kg respectively. PMID- 2756790 TI - [The attitude of children of divorce to child custody, court hearings and visiting rights--a survey in Zurich]. AB - In a study conducted in Zurich, 1877 apprentices were asked to fill out one of two questionnaires on child custody, court hearings and visiting rights. The results reported in the present paper are based on the responses of the 338 youths (18%) whose parents were divorced. Of the youths included, 46.4% said the child's wishes should be the main criterion in custody decisions; 25.7% were in favor of joint custody and 39.1% opposed to it. The majority of the apprentices thought the child should be heard in court (lowest age recommended: 11 +/- 3.18 years). How often the subjects visited the parent who did not have custody depended on their age at the time of the divorce and whether their parents had remarried. PMID- 2756791 TI - [Relation of intelligence and the pathogenesis of various psychological disorders in children]. AB - In a study on 5- to 13-year-old children referred to a residential facility for psychiatric care we explored the interrelations between intelligence on the one hand and onset of manifest behavior problems and clinical diagnosis on the other. We controlled statistically for confounding effects of parental occupational status and the children's sex. There was a statistically significant association between type of disorder and level of intelligence. When intelligence was above average, neurotic and emotional disturbances as well as some other syndromes that are generally considered to have a good prognosis dominated. In contrast, average or below-average intelligence frequently coincided with more enduring types of syndromes such as conduct disorders. The level of correlation between age at onset and IQ depended on the type of disorder. For the children with neurotic/emotional syndromes or conduct disorders, the lower the IQ the earlier the age of onset and initial referral. But this did not hold for children with autism, hyperactivity or certain developmental disorders. The results are tentatively interpreted as supporting the position that cognitive competence acts as a protective factor in emotional development. PMID- 2756792 TI - [Results of the revision of the 1983 Hamburg-Wechsler Intelligence Test for Children in students with severe reading disorders]. AB - In connection with the current discussion about the use of the HAWIK-R in differential diagnosis, 20 children with severe reading retardation were tested with both the HAWIK and the HAWIK-R and the results compared, and 48 children with this disorder were tested with the HAWIK-R and divided into three groups by the amount of difference between verbal and performance scores. The results on the subtests of the HAWIK-R were grouped by the categories recommended by Titze and Tewes. In the first part of the study, the 20 reading retarded children scored lower on the HAWIK-R than on the HAWIK on the majority of subtests and also had much lower verbal, performance and full scale IQs. In the second part of the study, we found marked differences between the groups on most of the HAWIK-R subtests, especially between the groups where the verbal IQ was lower than the performance IQ and where the verbal IQ was higher than the performance IQ. With regard to the categories of subtests, the children with a lower verbal than performance IQ showed deficits attributable to poor learning skills, milieu and attention relatively frequently. On the other hand, the children with a higher verbal than performance IQ tended to have deficits in perceptuomotor skills and disorders of integrative brain functions. The problems involved in using the HAWIK-R for differential diagnosis are critically evaluated. If the HAWIK-R data are examined in detail and the child involved is observed carefully this test can provide useful information for setting up remediation programs for poor readers. PMID- 2756793 TI - [Early forms of compassion]. AB - The present study deals with the problem of whether early forms of compassion are already evident in the first year of life. For this purpose, tape recordings of other children crying were played as acoustic stimuli to 210 newborns and infants. Vocal and motor reactions were observed, and numerous measures were evaluated. It was found that a) children cry with another child from birth on; b) this responsive crying becomes less frequent as the child grows older; c) the motor reactions become increasingly differentiated; d) the responsive crying does not disappear entirely despite increasing cognitive abilities, although it is partly transformed into a more restrained reaction with a sad expression; e) hungry children react more strongly than satiated children, children with siblings more often than only children, and girls more often than boys; f) responsive crying to an indifferent acoustic stimulus was observed very rarely. This leads to the conclusion that early forms of compassion already exist in the first year of life. Two such forms are described. It is assumed that compassion is already present in a primitive form at birth, and is thus inborn. PMID- 2756794 TI - [Principle symptoms of delayed language development and behavioral disorders. 2 case studies on the topic of fragile X syndrome]. AB - Case reports of two boys (5 1/2 and 3 1/2 years old) with fragile X syndrome are presented. In both cases, the typical somatic signs were absent. On the other hand, the psychopathology, with delayed language development and behaviour problems (especially hyperactivity and autistic behavior), provided the indication for a chromosome analysis. Fragile X syndrome was diagnosed in both cases, but in case 2 two subsequent controls were negative. The conclusions are that a diagnosis of fragile X syndrome must be viewed with skepticism until it has been confirmed by a second chromosome analysis in another experienced laboratory and/or with a different laboratory method. In spite of the genetic etiology (case 1), a marked improvement in the symptoms was possible with an intensive remedial program. Hence the fragile X chromosome appears to predispose to certain psychopathological changes, and these changes are apparently strongly influenced by psychosocial factors. Awareness of the genetic diagnosis can have positive effects on a family's compliance concerning further therapeutic programs for the child. PMID- 2756795 TI - [Experiences with cage combinations for guinea pigs]. AB - Special cage units described in 1982 for guinea pigs have been used either as cages for small groups of breeding animals or for caging of growing animals. By using these cages the following advantages have been noted; the cage size can be adapted to number, age and body weight of the animals; aggression and panic are avoided by corners, walls and tunnels; economic use of breeding males by mating with more females. PMID- 2756796 TI - Serotonin and melatonin contents in the pineal glands from different stocks and strains of laboratory rats. AB - In the present study the pineal gland was examined in 2 outbred stocks and 6 inbred strains of rats some of which were pigmented to varying degrees, to see whether inbreeding affects the variability and whether differences exist between albino and pigmented rats. The animals were kept under 12 h light: 12 h darkness (12 L:12 D) and killed 7 h after the onset of light and darkness, respectively. The parameters examined were pineal protein content, serotonin and melatonin levels and hydroxyindole-O-methyltransferase (HIOMT) activity. All the parameters examined revealed interstrain differences, independently of whether the data were expressed per pineal or per mg protein. The variation coefficients for the various parameters were relatively high. They were mostly smaller when the data were expressed per pineal rather than per mg protein. No striking differences existed between the variation coefficients in inbred and outbred rats. When pineal size and the melatonin-related parameters expressed per pineal were used to assess the melatonin-synthesizing capacity of the pineal glands, it was found that the outbred Wistar and Sprague-Dawley rats and the inbred LEWIS-derived (LEW/Han) rats, all of which were albinos, had the most active pineals. Intermediate activity was noted in the hooded E3/Han and BDE/Han and the albino BDII/Han rats. The smallest and least active pineals were found in the totally pigmented BN/Han and DA/Han rats. The results taken together show that different stocks and strains exhibit significant differences in pineal size and melatonin forming capacity. Albino rats appear to have larger and more active pineals than pigmented rats. PMID- 2756797 TI - Application of a new, simple method for quantitative collection of 24-hour urines in small laboratory animals: determination of basal excretion of proteins, creatinine, urea, electrolytes, and of free steroids. AB - The application of a simple method for collection of 24-hour urines in laboratory animals is described and basal excretion values of urinary proteins, creatinine, urea, electrolytes and of free steroids (glucocorticosteroids, DHEA, progesterone, testosterone) in small laboratory animals like the Mongolian gerbil, rat, guinea pig and tree shrew were measured. The major advantage of this method is that cages are identical in size to animal's home cages, are easily constructed and cheap, and that dried and liquid portions of each 24-hour urine are quantitatively removed from aluminium sheets by a simple washing step. This facilitates the monitoring of changes of urinary excretion rates over longer time periods without stressing the animals by handling. PMID- 2756798 TI - Hardness of diet pellets and its influence on growth of pre-weaned and weaned mice. AB - The hardness of 3 commercial diet pellets for laboratory rats and mice was studied. Hardness was measured as the force (kp) required to crush a diet pellet. Between-batch variation, expressed as coefficient of variation, ranged between 12 and 70%. In one type of diet hardness of the pellets varied between 4 and 50 kp. Hardness did not change during storage for a period of 8 weeks. To investigate the effect of hardness on growth performance of young mice experimental diets were prepared with identical ingredient composition but with hardness of either 15 or 45 kp. Female mice provided with hard pellets (45 kp) were not able to raise their litters. Feeding the experimental diet as 15 kp pellets resulted in a slightly retarded growth when compared with the experimental diet in the form of meal. Weaned mice were fed with the experimental diet in 4 different forms: meal, 15 kp, 45-kp and ground 45-kp pellets. Male mice, unlike females, fed the 45-kp diet grew slower than their counterparts fed the other diet forms. It is concluded that batches of extremely hard pellets may be occasionally delivered, and that such diets have undesirable effects on performance of young mice. PMID- 2756799 TI - Intestinal "normalization" of germ-free rabbits with rabbit caecal microflora: effect of dosing regimens. AB - Hysterectomy-derived germ-free (GF) rabbits were given strictly anaerobic microflora obtained from the caecum of an antibiotic-decontaminated conventional rabbit. One group was given the caecal flora diluted in doe's milk. The second group received caecal flora without doe's milk and administration of the flora was repeated when the animals were given pelleted diet. Body weight and intestinal parameters determined in the two groups of rabbits were compared with values in rabbits conventionally raised with the doe. In GF rabbits given caecal flora, the values for most intestinal parameters were similar to values recorded in conventional animals. However colonization resistance to Escherichia coli was limited in GF rabbits given caecal flora diluted in doe's milk and severely impaired in GF rabbits given caecal flora without doe's milk, although relative caecal weight was normal. It is concluded that enteric microfloras should be preferably incorporated in doe's milk when dosed to GF rabbits to obtain acceptable gastrointestinal "normalization". PMID- 2756800 TI - Spontaneous tumours of the European hamster (Cricetus cricetus L.). AB - The incidence and spectrum of spontaneously occurring neoplasms was evaluated in 285 European hamsters (strain Mhh:EPH) ranging in age between 1 and 5 years. The mean lifespan of the 107 male and 135 female hamsters examined amounted to 122 and 135 weeks, respectively. The overall incidence of tumour-bearing animals was 51.2% (males: 57.9%, females: 47.2%). Malignant tumours were more frequent than benign neoplasms and affected more males than females. Neoplasms of the haematopoietic/lymphoreticular system were the most common tumours (males: 16.8%, females: 13.5%). In males, these were followed in a decreasing order of incidence by pheochromocytomas (15.9%), malignant schwannomas (8.4%) and tumours of the prostate (6.5%). In females, pheochromocytomas as well as granulosa cell tumours were the second commonest tumour types (6.2% each), followed by malignant schwannomas (5.1%). Other tumours did not exceed the 5% incidence level. Two unusual rare tumours were a locally invasive cementoblastoma arising in the maxilla and a carcinosarcoma of the skin with components of a squamous cell carcinoma and a neurofibrosarcoma. The results of the study are compared with data on the Syrian and Chinese hamster. PMID- 2756801 TI - The use of the DENTACRYL rapid (Spofa) resin for preparation of the rat tracheobronchial casts. AB - We have made tracheobronchial casts of the rat lungs using DENTACRYL Rapid (Spofa)--the synthetic methacrylic resin of Czechoslovak origin. The details of the method are fully described. The differences between preparations of the intact rat tracheobronchial trees and those of the rats after quartz instillation are illustrated. These differences are analogous to the commonly described changes in bronchograms. PMID- 2756802 TI - An analysis of the cyto- and myeloarchitectonic organization of trigeminal nucleus interpolaris in the rat. AB - The cyto- and myeloarchitectonic organization of trigeminal nucleus interpolaris (Vi) was examined in the rat using correlated Nissl- and myelin-stained sections. The caudal boundary of Vi is marked by a spatial overlap with the rostral pole of the medullary dorsal horn (MDH), where there is a dorsal and medial displacement of the substantia gelatinosa (SG, lamina II) layer of MDH. This spatial displacement was further documented using cytochrome-oxidase-reacted sections through the periobex region (POR) of the medulla, where the relatively unstained SG contrasts sharply with the intensely stained Vi neuropil. The rostral boundary of Vi is characterized partly by a distinct overlap with the caudal pole of the dorsomedial region (DM) of trigeminal nucleus oralis (Vo), and partly by a more gradual transition with ventral and lateral regions of Vo. The presence of the distinct MDH-Vi overlap is discussed in terms of its impact on the widespread contention that Vi is involved in the processing of dental pain afferents in the POR. Six separate and distinct regions of rat Vi can be distinguished on the basis of differences in their overall cyto- and myeloarchitecture: (1) a ventrolateral parvocellular region (vlVipc), which occupies the ventrolateral caudal half of Vi; (2) a ventrolateral magnocellular region (vlVimc), which occupies a similar region in the rostral half of the nucleus; (3) a border region (brVi), interposed between the spinal trigeminal tract (SVT) and vlVipc and vlVimc; (4) a dorsolateral region (dlVi), which lies predominantly in the rostral two-thirds of Vi subjacent to the dorsal half of SVT; (5) a dorsal cap region (dcVi), occupying the dorsomedial aspect of the nucleus throughout its entire rostrocaudal extent; and (6) an intermediate region (irVi), which lies immediately ventral to dcVi within the concavity formed by the medial borders of vlVipc and vlVimc. It is proposed that these cyto- and myeloarchitecturally distinct regions of Vi may largely represent functionally distinct regions, based on reported differences in the organization of afferent and efferent projections within the nucleus. PMID- 2756803 TI - The arbors of axons terminating in middle cortical layers of somatosensory area 3b in owl monkeys. AB - The arbors of single axons terminating predominantly in layer IV of the representation of the hand in area 3b of owl monkeys were reconstructed from serial brain sections after axons beneath the cortex were severed and horseradish peroxidase was injected into the white matter. In addition to dense terminations in layer IV, these labeled axons generally had branches extending into deeper layer III, and a few had very sparse terminations in layer VI. Terminal arbors ranged from 100 to 900 microns in diameter, and fine branches with synaptic boutons were unevenly distributed, typically grouped in a large central cluster and one or more smaller side clusters. The results are consistent with three broad conclusions: (1) Since the arbors are large relative to the details of the somatotopic map in area 3b, all regions within a single arbor may not be equally effective in activating cortical cells. (2) Spatially separate branches of single axons may relate to spatially separate modules of neurons of the same class in a manner that allows them to receive the same inputs. (3) Many of the somatotopic changes that have been reported in the hand representation as a result of nerve manipulations in adults could result from alterations in synaptic effectiveness within the arbors of single axons. PMID- 2756804 TI - Endoscopy as a diagnostic tool in inflammatory bowel disease. AB - Endoscopy has become an important technique for the evaluation of patients with inflammatory bowel disease. It is used for the diagnosis as well as for the follow up of the disease. The present article reviews different aspects of intestinal endoscopy with their specific indications in inflammatory bowel diseases (IBD). Furthermore some new endoscopic findings are shortly described. PMID- 2756805 TI - [Treatment of intra-abdominal sepsis and necrotizing pancreatitis with staged lavage using a Zipper]. AB - The mortality of generalised intra-abdominal sepsis and severe necrotising pancreatitis remains very high. The persistence of intra-abdominal septic foci leads to recurrent abscess formation, persistence of sepsis and development of multiple organ failure, ultimately leading to the death of the patient. Therefore we believe that a repeated and total elimination of all septic and necrotic material is the cornerstone of an adequate surgical therapy in these patients. We performed "staged lavage" with the aid of a Zipper in 24 patients (10 with intra abdominal sepsis and 14 with severe necrotising pancreatitis). Via the Zipper 98 relaparotomies were performed (mean 4.1 per patient). The high Apache II-scores (12 to 45, mean 24) illustrate the severity of disease in most of these patients. The expected in-hospital mortality-rate was 59% while in our series 7 patients died on a total of 24 (28%). PMID- 2756806 TI - [Perforation of the small intestine caused by an enterolith originating from a Meckel's diverticulum]. AB - Meckel's diverticulum is a rare pathological condition with an incidence about 2%. We are presenting here a rare case report of a perforation of the terminal ileum caused by enterolithiasis of a Meckel's diverticulum. This patient has had repeated sub-occlusive states which was improved under conservative medical treatment. The operative decision was justified on bases of the evidence of an abdominal lesion discovered on barium follow-through and abdominal CT-scan. PMID- 2756807 TI - [Anatomopathological criteria of progression in chronic idiopathic colitis]. AB - Idiopathic inflammatory colitis are diseases of remissions and exacerbations of various severity. The criteria of activity are based on a conjunction of clinical, radiologic, endoscopic and anatomopathological data. From the macroscopical point of view, they are different in ulcerative colitis and Crohn's disease. Ulcerative colitis is characterized by a diffuse and uniform mucosal inflammation; any biopsy outside an ulcerative area can be used to evaluate the inflammatory components which are in the acute phase (chronic active phase): oedema, vascular congestion and an inflammatory infiltrate composed of a mixture of lymphocytes, plasma cells and polymorphs with partial destruction of the glands (crypt abscesses). In the revolving phase, the inflammation regresses; the crypts are distorted, the crypt abscesses gradually disappear. In ulcerative colitis in remission, the inflammation vanishes but there is loss of parallelism and branching of the crypts. In Crohn's disease, the inflammation is often discontinuous and focal; biopsies must be taken from multiple sites. It is not rare to see a coincidence of lesions at different stages of activity. The criteria of activity are less reliable than in ulcerative colitis. Acute lesions present with oedema and infiltration of the lamina propria by polymorphs, neutrophils as well as eosinophils. Granulomas probably represent a particular reactional status. There features and number do not very significatively in the course of the disease. PMID- 2756808 TI - [Arteriography, lymphography, gammagraphy and computer tomography in the diagnosis of musculoskeletal tumors]. AB - The authors emphasize the importance of early and exact diagnosis of musculoskeletal tumours of the extremities and spine. This aim cannot be achieved by common biochemical, haematological and X-ray examinations. Therefore the authors recommend to use already during the initial examination of the patient a combination of classical roentgenography, arteriography, possibly lymphography, gammagraphy and computed tomography. The authors present a detailed account of experience with the application of the above diagnostic methods in 146 patients. On arteriograms of 37 patients dislocated main arteries were found 16 times, blood lakes 20 times. Lymphography revealed metastatic affection of regional lymph nodes in 21% of all patients, most frequently in bone reticulosarcoma and in synovial sarcoma. All-body gammagraphy helped to make the localization and assessment of size of the tumour more accurate, in two-thirds of the patients it was larger when visualized by this method than on native roentgenograms. In 3 of 14 Ewing sarcomas all-body gammagraphy revealed a polyostotic localization of the tumour. Computed tomography revealed the extent of infiltration and destruction of bone and soft tissues in pelvic and spinal tumours. PMID- 2756809 TI - [Reconstruction of open fractures of the leg associated with extensive loss of skin and soft tissues using muscular and cutaneo-muscular flaps]. AB - The author draws attention to the serious character of open fractures of the leg with extensive losses of the skin and soft tissues. He emphasizes the need of high standard primary surgical treatment and osteosynthesis of the fracture by external fixation device according to a therapeutic plan. To ensure an undisturbed consolidation of the fracture in indicated cases, the author implements the reconstruction of acute skin losses and soft tissue losses by a muscular flap of the m. soleus or m. tibialis ant. and by dermatomuscular flaps of the gastrocnemius muscle. Of 42 casualties with open fractures of the leg with losses of soft tissues the author made in 9 reconstructions of acute losses by muscular and dermatomuscular flaps. The author presents the documentation of two patients with open fractures of the leg who were treated by muscular and dermatomuscular flaps. PMID- 2756810 TI - [Use of Septopal in the treatment of bone infections]. AB - The authors evaluate a group of 29 patients where they used during treatment of a bone infection gentamicin pellets--Septopal Merck. The mean age of the patients was 46.6 years (9-75 years) the mean duration of the symptoms of inflammation before operation was 20 months. The prerequisite of successful application of Septopal is radical surgical treatment of the site of infection and provision of high standard soft tissue covering and assessment of the sensitivity of the aetiological agent to gentamicin. The most frequent causal agent of infection was Staphylococcus aureus in 48.3% and in combination with Gram-negative rods in 34.5%. In infections of total prostheses of joints one of the pathogenic agents was also Staphylococcus epidermidis. Healing per primam was recorded in 41% per secundam in 28%, in general, treatment was successful in 69%. By application of Septopal high local bactericide concentrations of gentamicin can be achieved for three months without threatening the patient with toxic side effects--local or general. The authors recommend, however, to remove it after cca 8 weeks. PMID- 2756811 TI - [The Immunoskintest]. AB - To evaluate the surgical risk before serious operations it is possible to use as one of the criteria a skin test the principle of which is an immunity reaction to a defined antigen injected strictly intradermally. It helps us to assess simply the state of immunological reactivity of the cellular type in a large number of persons of different age and thus to estimate to a certain extent the incidence of postoperative infectious complications. In a selected group of 68 patients who were hospitalized at the Orthopaedic Clinic in Plzen in 1987 the Immunoskintest was performed. The authors compare the incidence of infectious complications in different groups by the character of the disease, i.e. in a) planned operations in coxarthritis, b) in patients with injuries of the proximal part of the femur immediately after injury, c) in patients with injuries of the proximal part of the femur treated conservatively. The incidence of infectious complications is evaluated in conjunction with the results of the Immunoskintest. PMID- 2756812 TI - [Levels of C-reactive protein after surgery in fractures in children]. AB - The authors investigated the levels of C-reactive protein (CRP) after operations of fractures in the area of the elbow in children. Regardless whether antibiotics were administered preventively or not, there was a rise of CRP levels with a maximum on the third day after operation. By the 7th day CRP levels were normal. In the control group of children with mere manual reposition of the fracture of the wrist there was no significant rise of the CRP level. If the elevated CRP level persists after the 7th postoperative day, a local inflammatory complication is suspected. PMID- 2756813 TI - [Problems in admitting and eliminating children from sports training schools]. AB - The physical and mental load of children enlisted in the system of preparation for top sports is great. It is therefore essential to ensure very careful health care and also very strict criteria for enlistment of children to avoid pathological adaptation to the sports load. Specialized sports training of 14-18 hours per week may, in case of incorrect compensating activity, be the basis for the development of secondary changes. In the selection it is important to adhere to criteria pertaining to health, performance, function and development and to evaluate them in relation to the character of the sports discipline and preparation for attaining top performance. Based on six years' experience, it is possible to indicate for the purpose of orientation the risks of different sports for the locomotor system during ontogenesis. Cooperation of orthopaedists and specialists in sports medicine is the prerequisite of restricting possible negative sequelae of local and general overburdening. The conclusion must be always the synthesis of all examinations and conclusions must not be drawn from a single examination. The authors draw attention to mistakes in the evaluation by specialists as a result of lacking knowledge as regards the loading of the organism by training in these schools. PMID- 2756814 TI - [Randomized clinical studies in orthopedic surgery]. AB - The author describes the conditions and advantages of a prospective clinical investigation. He analyzes also the reasons why this type of investigation of the effectiveness of new surgical methods is used so little in orthopaedic surgery. PMID- 2756815 TI - [Early repositioning of fractures of the forearm, wrist, leg and navicular bone using an extension device attached to a bed]. AB - The author informs on the results of early reposition of fractures on an extension device on an emergency bed of the author's design which meets the demands laid on urgent, sparing and high quality reposition already in the out patient department, which is an advantage in particular in out-patient departments which are far from the hospital. Another advantage is, as apparent from results that reposition were successful in 273 (98.2%) of the patients despite the fact that they were made without an X-ray intensifier of the picture with a television screen. In all children and adults with fractures of the forearm, wrist, leg and navicular bone after clinical examination of the patient the X-ray pictures were made and checked only after application of a plaster bandage. The advantages of early reposition on the extension device should stimulate their use in all ambulances and in-patient departments where patients with above fractures are treated. PMID- 2756817 TI - [Comment on the article "Surgical treatment of acromioclavicular luxation"]. PMID- 2756816 TI - [Exarticulation of the knee joint--surgical and prosthetic aspects]. AB - The author present his experience with exarticulation in the knee joint and emphasizes its advantages, as compared with a long femoral stump and its importance for patients. He provides brief information on contemporary technical possibilities which make it possible to produce functionally and cosmetically more acceptable prostheses. PMID- 2756818 TI - Craniomandibular disorders in adult populations of West Bothnia, Sweden. AB - A randomly selected sample of 1992 adults (995 men and 997 women) representing four equally sized age groups of 25-, 35-, 50-, and 65-years-old inhabitants of West Bothnia were studied for prevalence of symptoms and clinical signs of mandibular dysfunction. Of the sample 79% completed a questionnaire and a clinical examination. The chewing inability increased with age. Recurrent headaches (once a week or more often) were reported to occur in 11% to 15% of the four age groups, and the duration of headaches was generally more than 2 years. Tooth-clenching, which was the most frequent oral parafunction, was reported significantly more often in women, whereas attrition was more severe in men. The commonest clinical finding was temporomandibular joint clicking, which varied between 13% and 35% in the different age groups. Crepitation was observed more often in women and increased with age. The jaw muscles were more frequently tender to palpation in women and the elderly. The mean maximal mouth opening capacity varied between 55 mm and 44 mm, decreasing with age, and was for the whole sample significantly higher among men. Since signs and symptoms of craniomandibular disorders were common findings in all age groups, routine dental examination should always include functional evaluation of the stomatognathic system. PMID- 2756819 TI - Dental caries, visible plaque, and gingival bleeding in young adult Danes in alternative dental programs. AB - From 16 to 19 years of age three groups of young adults received alternative dental programs on termination of the Public Child Dental Health Service (PCDHS) in different municipalities: public group, n = 386; mixed group, n = 161; and private group, n = 261. Dental caries status at the start of the study was assessed from the standard PCDHS records, and caries, plaque, and gingivitis were examined in an epidemiologic survey at the end. Caries experience at 16 years was 11.6 DMFS, highest in the mixed group and increased in all groups during the study. Initial placement in caries severity zones did not change. Visible plaque index (VPI) and gingival bleeding index (GBI) showed that plaque and gingival bleeding were present in most subjects, but rather few surfaces were affected. Association between gingival bleeding and non-use of dental services was found. Overall, it is concluded that none of the alternative programs differed from each other in having measurable effects on the oral health status. PMID- 2756820 TI - Dental treatment provided to young adult Danes enrolled in alternative dental programs during a 3-year period. AB - From age 16 to 19 years three groups of young adults received alternative dental programs on termination of the Public Child Dental Health Service (PCDHS) in different municipalities: public group, n = 386; mixed group, n = 161; and private group, n = 261. During the entire study information on dental service use by the participants was taken from the records and National Health Insurance files. All dental services were calculated relative to a standardized Dental Service Unit defined by the value of a dental examination. During the entire study a mean of 30.53 Dental Service Units were provided, corresponding to 10.18 per year. More than half were of a diagnostic preventive character, and well over one-fourth were fillings. Irrespective of dental program, differences in dental services were noted with regard to utilization of dental services and to initial caries status. Users with high caries experience also received more fillings, but fewer preventive services. No association was found between gingival status and dental services provided. PMID- 2756821 TI - The use of a visual analogue scale in observer assessment of postoperative swelling subsequent to third-molar surgery. AB - Postoperative swelling after mandibular third-molar surgery was evaluated in 40 patients. Three-dimensional metric measurement of swelling was compared with observer assessment of swelling from clinical examination, from pairs of en-face photographs, and from patient self-assessment, all using a 50-mm visual analogue scale (VAS) for registration. The photographs were evaluated by two groups of observers: general practitioners (n = 5) and oral surgeons (n = 5). The following conclusions were drawn: observer assessment of swelling from clinical examination and from judgement of photographs underestimates large swelling and slightly overestimates small or no swelling compared with objectively measured swelling. General practitioners and oral surgeons assess swelling from photographs almost identically, with a slight tendency for more underestimation of large swelling by the younger oral surgeons. A 50-mm VAS seems sufficiently reliable for assessment of swelling. PMID- 2756822 TI - Proceedings of the scientific session of the Collegium Oto-Rhino-Laryngologicum Amicitiae Sacrum. Hakone, October 23-26, 1988. PMID- 2756823 TI - VOR gain and phase in active head rotation tests of normal subjects and patients with peripheral labyrinthine lesions. AB - The gain and phase of the vestibulo-ocular reflex (VOR) were studied by active head rotation tests in normal subjects and in patients with unilateral or bilateral lesions of vestibular function. The examination was performed under two conditions: alert-in-dark and with spatially-fixed target. The results were evaluated using a simplified model of vestibular response. Under alert-in-dark condition, the VOR grain and phase deficits were observed on rotation to the affected side in patients with unilateral lesions and bilaterally in patients with bilateral lesions. Under spatially-fixed-target condition, these patients showed a decrease in gain at higher frequencies but no phase lag was observed. The principally new advantage was that not only VOR gain but also VOR phase could be quantified using this active head rotation test. Therefore, for diagnosing VOR dysfunction, this active head rotation test is more useful than the active head rotation tests previously reported. PMID- 2756824 TI - Posturography findings in workers exposed to industrial solvents. AB - Postural control was investigated by static posturography in 18 workers exposed to industrial solvents, 9 patients with psycho-organic syndrome due to industrial solvent exposure, and 52 controls. Both groups of exposed subjects showed larger sway areas with eyes open as well as closed, compared with the controls. No differences were found in the Romberg quotient (the relationship between sway areas with eyes closed/open). The correlation between static posturography and the otoneurological test battery was positive for the visual suppression test in the styrene group. In the industrial solvent group no significant correlations were found. The visual suppression test and some auditory tests were pathological in the exposed groups. The otoneurological test battery--especially the visual suppression test and static posturography--seems to contribute in the assessment of solvent related CNS lesions. PMID- 2756825 TI - Computer-aided three-dimensional reconstruction and measurement of semicircular canals and their cristae in man. AB - We studied the spatial relations of the semicircular canals (SCCs) and their cristae, by computer-aided three-dimensional reconstruction, a graphic method we developed. The angles between pairs of SCCs, between pairs of SCC cristae, and between a SCC and its crista were measured using histology sections of a normal temporal bone from a 14-year-old female. Angles between pairs of SCCs and pairs of cristae deviated 11.3 to 18.2 degrees and 4.8 to 18.0 degrees, respectively, from right angles and the long axis of each crista deviated 25.0 to 30.4 degrees from the line perpendicular to the plane of the corresponding SCC; thus none of these structures lies at a right angle to another. We believe these new anatomical findings will help in the clinical evaluation of SCC function. PMID- 2756826 TI - Walking through a human ear. AB - A computer animation system was developed to show the inside of a human ear as if the viewer were walking through it. A surface model of the human temporal bone was graphically reconstructed from serially sectioned celloidin specimens. In order to input the outline curves of ear structures, several reference marks were drilled into a celloidin block prior to sectioning. A sliding microtome was put on a worktable with a specially designed motor-driven drill. The machine made it possible to drill holes perpendicular to the plane to be used for serial sectioning. Superimposed outline curves and the reference marks were fed into a computer, and their shapes were altered by scaling, rotation, and translation before triangulation for surface coating. Parts of the structures of the ear were painted in different colours. PMID- 2756827 TI - Electrochemical composition of the cochlear fluids in the early experimental hydrops. Preliminary results. AB - The composition of endolymph and perilymph was studied in the guinea pig cochlea after 2 and 6 weeks of blockage of the vestibular aqueduct in an experimental model of hydrops. Compound action potential was monitored several times in the observation period. The endocochlear potential was measured and the endolymph was sampled at the first and third turns of the scala media. The Na, K, and Cl concentrations were determined in nanolitre aliquots of endolymph and of perilymph, the latter sampled from the basal scala vestibuli. After 2 weeks, no change in endolymphatic electrochemical composition was observed. After 6 weeks, endocochlear potential was decreased by 25% at both cochlear turns; K concentration was decreased in endolymph of the basal turn and Cl concentration was decreased in both turns; the calculated osmolality (Na + K + Cl) was decreased in both turns. These results indicate that the blockage of the vestibular aqueduct induced early auditory dysfunction whereas alterations of the electrochemical composition of endolymph occurred later after a time lag of more than 2 and less than 6 weeks. PMID- 2756828 TI - Stimulated otoacoustic emissions in children with sensorineural hearing loss. AB - Our previous studies of stimulated oto-acoustic emissions (OAEs) have revealed that the OAE threshold indicates the grade of inner ear impairment. The present study is a survey of OAE in children of school age. The mean OAE threshold values of 113 ears with normal hearing and 45 ears with functional deafness were 5.9 dB nHL and 6.2 dB nHL, respectively. In sensorineural loss the value was noted to increase according to its grade, classified into four groups, measuring 37.2 dB nHL in the group with severe loss higher than 91 dB. The findings suggest that the OAE threshold is useful for an indicator of inner ear function in children. There still remains the problem to be solved by a contrivance of noise removal for application of OAE to hearing tests in children of pre-school age. PMID- 2756829 TI - Computer-aided serial section reconstruction of nerve endings on the outer hair cells of the cochlea. Semithin sections vs. ultrathin sections. AB - Afferent and efferent nerve endings on several outer hair cells in different turns and rows of the guinea pig cochlea were three-dimensionally reconstructed from serial semithin sections or ultrathin sections by means of a new computer system. In the basal turn, a single afferent ending was sometimes isolated from the others and surrounded by efferent endings, suggesting that this type of afferent ending may have properties different from the others. The advantages and disadvantages of semithin sections and ultrathin sections in computer-aided reconstruction were discussed and it was concluded that the semithin section technique will be useful in reconstructions of specimens from a wide range, whereas the ultrathin section technique will be better for reproducing fine structures such as the distribution of cell organelles as well as synaptic membrane specializations. PMID- 2756830 TI - Three-dimensional observation of the spiral ganglion cell. Normal structure and pathological changes. AB - Spiral ganglia of guinea pig and mouse were investigated by scanning electron microscopy (SEM). The cochlea was freeze-fractured and then macerated with 0.1% OsO4 solution for 70-90 h (A-O-D-O method (1]. This allowed three-dimensional observation of the general view of the spiral ganglion and the intracellular structure. Two types of spiral ganglion cell, type I and type II, could be distinguished by the A-O-D-O method. Intracellular membranous structures such as mitochondria, endoplasmic reticulum (ER) and Golgi apparatus were also demonstrated stereoscopically. Furthermore, morphological changes in mouse spiral ganglion cells due to injection of Mycobacterium fortuitum were observed, using SEM. The degenerative process began as swelling of the mitochondria. When Schwann cell became affected, the myelin sheath disappeared and the ganglion cell border became indistinct. This degeneration developed rapidly, suggesting a direct influence of the bacteria on the ganglion cell. Various types of inclusion body with limiting membrane could be demonstrated stereoscopically. As Romand & Romand (4) suggested, these inclusion bodies may be remnants of cellular organellae or various type of lysosomes. PMID- 2756831 TI - Structural organization of the outer hair cell wall. AB - The lateral wall of the mammalian outer hair cell has specialized structures composed of "subplasma lamina" and "micropillars." These structures anchor the subsurface cisternae to the inner leaflet of the cell membrane. The micropillars are arranged in parallel arrays encircling the entire inner side of the outer hair cell. The subplasma lamina appears sheet-like with rows of indentations and ridges in parallel arrays or in grid patterns among the specimens prepared for scanning electron microscopy. It is interpreted that these indentations are formed by the loss of the micropillars due to the osmium digestion. It is suggested that the subplasma lamina and micropillars may provide a rigid structure of the cylindrical shape and also may be involved in the motile activity of the outer hair cell. PMID- 2756832 TI - Neuron-receptor cell interaction during development of the inner ear. A heterochronic ganglion study. PMID- 2756834 TI - Ageing of the vibratory tissue of human vocal folds. AB - Sixty-four human larynges ranging in age between 70 and 104 years were investigated histologically. The results were incorporated into our previous data for younger age groups. Discussion was focused on the mucosa around the vocal fold edge. The following tendencies were observed with ageing: (1) the membranous vocal fold shortens in males; (2) the mucosa thickens in females; (3) the cover of the vocal fold thickens in females; (4) edema develops in the superficial layer of the lamina propria in both sexes; (5) the intermediate layer of the lamina propria thins and its contour becomes deteriorated in males; (6) elastic fibers in the intermediate layer become less dense and atrophy in males; (7) the deep layer of the lamina propria thickens in males; (8) collagenous fibers in the deep layer become denser and fibrotic in males. The degree of these geriatric changes vary from individual to individual. PMID- 2756833 TI - Blood pressure and cochlear blood flow in the guinea pig. AB - The relationship between blood pressure and cochlear blood flow was investigated in 68 guinea pigs, using the vasoactive drugs angiotensin II, norepinephrine, phentolamine, isoproterenol, dobutamine, salbutamol, propranolol, bradykinin, papaverine, vinpocetine dilazep, and brovincamine. Cochlear blood flow increases markedly and proportionately to increases in blood pressure. By contrast, cochlear blood flow shows various responses toward a fall in blood pressure. In general, cochlear blood flow appears relatively resistant to blood pressure decrease. PMID- 2756835 TI - Stress and woundhealing of the cartilaginous nasal septum. AB - In the cartilaginous nasal septum of growing rabbits a stress is demonstrated, released by an incision perpendicular to the antero-posterior axis and rebuilt within a period of 3 weeks when the mechanical continuity of the septum is restored. The latter is the result of a process of woundhealing establishing a firm perichondrial side-to-side connection between the stumps. PMID- 2756836 TI - Experimental study of collagen as eardrum graft support in dogs. AB - This experimental study involving dogs tested type IV human collagen as a biomaterial for use in the tympanic membrane reconstruction. A loss of substance was induced for the two tympanic membranes, and a type IV collagen graft made to one side. The kinetics of receiver fibroblast colonisation of the graft, as well as in the case of resorption, were studied. Anatomopathological examination revealed the process of reconstitution. This animal study prepares the way for studies on man. PMID- 2756837 TI - Modified radical mastoidectomies as gas pockets. AB - An analysis of 45 adult ears which underwent a modified radical mastoidectomy showed: (a) in practically all these ears a variable amount of air was present behind the tympanic membrane; (b) this air was in continuation with the Eustachian tube; (c) two-thirds of the ears showed a collapse of part of the tympanic membrane--located predominantly in the posterior superior parts of the middle ear. These findings indicate that these atelectatic ears are gas pockets which are not closed, yet suffer from an imbalance of gas diffusion--from or into the middle ear. PMID- 2756838 TI - Morbidity of very young infants with and without acute otitis media. AB - Perinatal and other morbidity of 96 consecutive infants with acute otitis media (AOM) before the age of 3 months is compared with that of 96 birthday- and sex matched controls without AOM. Perinatal problems were found in 57 AOM infants and in 38 controls, prematurity and asphyxia being significantly (p less than 0.05) more common in the study group than in the controls. At the time of AOM, 51 infants had concurrent illnesses ('colds' excluded) or anomalies, while only 19 controls (p less than 0.001) showed any respective morbidity during their 3 months of life. While AOM infants frequently presented with other, especially respiratory, infections, the controls hardly ever did so. Symptomatology during otitis was varying, and frequently suggestive of respiratory problems other than AOM. Subsequent otitis morbidity of AOM infants was heavy, but other disease history was similar to that of the controls. The study stresses the importance of examining the ears in young infants presenting with any illness, and especially of a respiratory nature. PMID- 2756839 TI - Lermoyez's syndrome. A follow-up study in 12 patients. AB - Clinical studies were performed in 12 patients with the Lermoyez syndrome during a close follow-up of 2 to 31 years. The nature and temporal sequences of the symptoms of these patients are described. The incidence of Lermoyez's syndrome, as compared with Meniere's disease, is almost 18%. This is much higher than usually is assumed. In 6 out of 12 patients typical Meniere attacks were found besides their Lermoyez attacks. Almost every one of the 12 patients showed, besides the Lermoyez attacks, also hearing fluctuations without vertigo, and vertigo without hearing fluctuations. The type of vertigo was usually rotating, often with unsteadiness and in 3 patients dropping attacks were sometimes observed. The typical Lermoyez attack lasted several hours. The preceding hearing loss lasted for days to months. The hearing recovered after the attacks and remained stable for days to months. An improved hearing was noticed within some hours after the vertiginous attack in 9 out of 12 cases. Three patients noticed the hearing improvement already during the attack. In 8 out of 12 cases the disease became bilateral. PMID- 2756840 TI - Hearing preservation in acoustic neuroma surgery and postoperative audiological findings. AB - One hundred fifty-three cases of acoustic neuroma were treated surgically by the middle cranial fossa approach or extended middle cranial fossa approach. Attempts to preserve hearing were made in 30 cases with tumours extending 2.0 cm or less into the posterior fossa; successful hearing preservation was achieved in 12 cases. Among the 15 patients with preoperative hearing levels (HL) of 50 dB or lower and speech discrimination scores (SDS) of 50% or higher, hearing was preserved in 9 (60%) patients. A similar rate of hearing preservation was achieved among the patients with normal or near-normal hearing. Compared with those patients in whom hearing could not be preserved, those with hearing preservation had better HL, higher SDS, and less abnormal ABR findings preoperatively. Postoperatively, the HL and SDS deteriorated slightly. In addition, there was a marked prolongation of the IT5, and the incidence of absence of the stapedius reflex increased. Compared with the preoperative HL, the postoperative HL was unchanged in 5 cases; deteriorated temporarily and then improved in 5 cases; and deteriorated, though with hearing preserved, in 2 cases. Intraoperative monitoring was conducted by recording the ABR and VIII nerve compound action potentials and by electrocochleography. However, postoperative hearing could not always be predicted from the findings obtained at the end of the operation. PMID- 2756841 TI - Sodium concentration in saliva along the time course of experimental Coriolis sickness. AB - Procedures designed to evaluate the severity of motion sickness have included subjective reporting of changes in salivation. In order to increase objectivity, we studied the sodium concentration of saliva, which is directly related to the flow rate. Healthy adults with normal vestibular function underwent a modified Coriolis Sickness Susceptibility Index (CSSI) test, utilizing a staircase profile. Saliva was collected without interrupting the stimulus by means of cotton placed beneath the subject's tongue for one minute. Samples were obtained 5 min prior to stimulation, 30 and 45 min following stimulus onset, and/or upon reaching the "nausea II" endpoint. Saliva for analysis by atomic absorption spectrophotometry was obtained by centrifugation of the cotton. A significant difference in sodium concentration was found between the baseline and 30-min sample (p less than 0.01). Although the amount of salivation was rather variable, the pattern of changes in sodium concentration was similar in all experimental cases. PMID- 2756842 TI - Electrovestibulogram: first results in the guinea pig. AB - This paper describes a method of investigation of the peripheral vestibular system. Electrical stimulations (ES) are applied on the round window of chronically implanted guinea pigs, with and without vestibular stimulation (either per or post rotational accelerations). The whole nerve action potential recorded at the output of the internal auditory meatus, the difference between the two conditions, reveals the change in electrical excitability and thus presumably in discharge rate of vestibular fibres determined by rotational stimuli. This electrical vestibular action potential (EVAP) presents as a mainly monophasic potential with a peak latency to ES of about 0.3 ms. Right and left accelerations versus rest are shown to give responses with opposite polarity, reflecting the inhibitory and excitatory influences of these opposite accelerations, whereas the transfer function of EVAP versus acceleration amplitude appears roughly linear. These observations appear altogether coherent with published mechano-physiological data about individual discharge rates of canal fibres. Also relative amplitudes of acoustical and vestibular responses are in agreement with related number of fibres in the two systems. This EVAP could be the basis of a quantitative evaluation method for the vestibular system, the electrovestibulogram (EVG). PMID- 2756843 TI - Histamine and acetylcholine regulation of sympathetic nerve activity in guinea pig nasal mucosa. AB - The regulating effects of histamine and acetylcholine (Ach) in norepinephrine (NE) transmission in nasal mucosa were investigated by analyzing 3H-NE release from isolated guinea-pig tissues. In addition, localization of the histamine H1 receptor and the muscarinic acetylcholine receptor on the sympathetic nerve in the guinea-pig nasal mucosa were examined by quantitatively evaluating these receptors after the unilateral removal of the superior cervical ganglion. Ach inhibited electrically-stimulated 3H-NE release in a concentration-dependent manner, and this effect was blocked by atropine. Histamine inhibited electrically induced 3H-NE release at a concentration of 10(-5) M but enhanced it in concentration of 10(-3) M. Histamine increased the spontaneous release of 3H-NE in a dose-dependent manner, which was inhibited by pyrilamine (H1 antagonist) and excess Ach, but was not altered by cimetidine (H2 antagonist). These results suggest the following: 1) Local regulation of NE transmission in nasal mucosa involved excitatory H1 receptors, inhibitory H2 receptors and inhibitory muscarine receptors which can be facilitated by sensory stimulation with histamine. 2) Histamine regulation may vary with a balance between the excitatory and inhibitory effects. 3) Histamine in the high concentrations seen in cases of nasal allergy, may shift this balance causing increased NE release; at low concentrations, NE release is inhibited. In the second series of this study, we were unable to demonstrate a decreased number of either H1 or muscarine receptors on the side affected by unilateral cervical ganglia sympathectomy. PMID- 2756844 TI - Antioxidant enzymatic activities and resistance to oxidative stress in primary and subcultured rat astroglial cells. AB - The survival of neural tissues depends in part on the balance between the formation of free radicals due to oxidative metabolism and the transformation of the free radicals to non-toxic compounds. Serial subculture of rat glial cells as described here resulted in a decrease of the specific activities of several antioxidant enzymes and a glial specific marker for astrocytes. Thus, there was an increased susceptibility to oxidative stress in cultures by the third passage. These subcultured glial cell cultures may represent a useful model for the study of free radical induced neural damage that may be relevant to CNS trauma and aging. PMID- 2756845 TI - Selective effects of thyroid hormonal deprivation on growth and development of olfactory receptor sheet during the early postnatal period: a morphometric and cell count study in the rat. AB - Light microscopic numerical and morphometric studies were conducted on the olfactory epithelium of postnatal normal and hypothyroid rats. The normal rat olfactory epithelium undergoes marked growth and development during the suckling period (days 1-25): thickness, 50%; area, x 8, total number of olfactory neurons, basal and supporting cells, x 10, x 11 and x 8, respectively. The effects of thyroid hormonal deprivation on these proliferative postnatal growth changes were studied by adding PTU (n-propylthiouracil, a reversible antithyroid goitrogen) to the litter's drinking water from birth to weaning (day 25). The general architecture of naso-olfactory cavities as well as the histology and thickness of the olfactory epithelium were unaffected in the hypothyroid pups. However, the surface area of the olfactory receptor sheet was reduced by 40%, the reduction occurring throughout the cavity, though not uniformly. The total number of olfactory neurons, supporting and basal cells were reduced by 33, 45 and 47%, respectively. These results indicate that the postnatal vertical accretion of olfactory neurons occurring across the epithelial thickness is unaffected in the hypothyroid pups, while the horizontal proliferation of neurons accompanying the expansion of the sheet's surface area is markedly reduced. The results suggest differential effects of thyroid hormones on these modes of proliferative growth and imply further that in addition to possible direct effects, the influence of thyroid hormones on developmental growth of the olfactory epithelial sheets may be secondary to effects on the underlying submucosal connective tissue. PMID- 2756846 TI - Acetylcholinesterase in the development of chick dorsal root ganglia. AB - Acetylcholinesterase is expressed in chick dorsal root ganglia neurons very early in development. Since the physiological role of the enzyme in these cells is still obscure, it appeared of interest to investigate its modifications in the course of development. The specific activity of acetylcholinesterase in chick dorsal root ganglia increases, during in ovo development, from day E5 to day E13; after day E13 there is a decrease. Conversely, when acetylcholinesterase activity was expressed on a per ganglion basis, a continuous increase in the level of the enzyme until day E20 was observed. Acetylcholinesterase is a polymorphic enzyme and its molecular forms have different cellular localizations. Two globular forms, a tetramer (G4) and a dimer (G2), are present in the ganglia, as in chick brain. G4 is the major form at day E5, where it represents about 85% of the activity. This form shows a progressive decrease since day E8, and at day E20 exhibits activity levels similar to those of G2. It is known that acetylcholinesterase-producing cells are also able to release the enzyme in the extracellular space. We determined the release of acetylcholinesterase by cultured dorsal root ganglia neurons at various developmental stages: acetylcholinesterase release is significantly increased at day E20, as compared to younger stages, and 90% of the enzyme released is G4. PMID- 2756847 TI - Satellite cells in developing spinal ganglia. An immunohistochemical study. AB - The present immunohistochemical study investigates the presence and distribution of S-100-containing glial cells in the early stages of development in human spinal ganglia. From the earliest ages investigated immunoreactive cells could be detected in a continuous layer at the periphery as well as inside ganglionic rudiments in close relationship with neural elements, both at the light and ultrastructural levels. The possibility that these glial cells, exhibiting such a distinctive distribution, play a modulatory role on microenvironmental influences during maturation could be taken into account. Neither glial fibrillary acidic protein nor myelin basic protein could be detected at the ages investigated. PMID- 2756848 TI - The time course of hippocampal cholinergic innervation in the developing hypothyroid rat. A combined histochemical and biochemical study of acetylcholinesterase activity. AB - Development of cholinergic innervation in the hippocampal formation of normal and hypothyroid rats was studied by a combined biochemical and histochemical analysis of acetylcholinesterase (AChE) activity in normal and hypothyroid rats. The normal developmental pattern of cholinergic activity suggests an entrance of septal cholinergic fibers from the fimbria to different zones of the hippocampal formation mainly during the first postnatal week. By 10 days of age, the regional distribution of staining was similar to that in the adult. Thereafter, the intensity of staining increased without major changes in the laminar organization. As shown by closely related histochemical and biochemical findings, hypothyroidism led to a delay in the arrival of cholinergic afferences and a possible subsequent cholinergic hyperinnervation of the hippocampal formation in adulthood. These results are discussed taking into account the time course of structural development in the two synaptic compartments, namely the extrinsic septal neurons and intrinsic pyramidal and granule cells, in comparison with the development of thyroid function. PMID- 2756849 TI - The European spirit and the European Association of Neurosurgical Societies (EANS). PMID- 2756850 TI - Vein of Galen aneurysmal malformations. Report of 36 cases managed between 1982 and 1988. AB - The authors report a series of 36 vein of Galen aneurysmal malformations (VGM) diagnosed in the paediatric (78%) and adult (22%) populations that were referred to them for therapeutic management between 1982 and 1988. The clinical signs leading to the diagnosis were variable: 36% of systemic manifestations, 22% of neurological symptoms, 17% of hydrocephaly and 11% of intracranial haemorrhage. 30 angioarchitectural analyses could be obtained and allowed to classify these VGMs into 5 different types: 44% parenchymatous AVMs, 20% mural AVFs, 30% choroidal arteriovenous fistulas, 3% dural AVFs, 7% vein of Galen varices. This series demonstrates that the paediatric population is most sensitive to shunt effect whatever its type. Systemic manifestations and hydrocephaly are the most common signs encountered in the newborn and infants; whereas neurological signs and symptoms and haemorrhage belong mostly to the adult symptomatology. Because of the poor outcome of VGMs, all authors believe that these malformations have to be treated aggressively. However, we found contra-indications to be represented by pretherapeutic demonstration of cerebral tissue damage, or uncontrollable systemic failure, thus treatment is indicated to compensate for cardiac failure previously responding (even partially) to medical treatment. Secondly, appearance of sub-cortical calcifications, resistance to medication or clinical deterioration will also lead to urgent treatment. The endovascular method represents at present the best treatment with an overall low mortality (13%) and a 0% technical morbidity in children compared to the surgical one of (91% mortality in newborns and 38% in infants). The results achieved by embolization in this series were as follows: 27% satisfactory results with complete or almost complete occlusion of AV Shunt, 53% significant clinical improvement, 7% of patients were unchanged. The authors believe fundamentally that these patients (specially those belonging to the paediatric population) have to be treated in a centre where a paediatric intensive care unit, neurological, neurosurgical and surgical neuro-angiographic departments coexist, in order to assure the best possible management of these children. PMID- 2756851 TI - Translaminar screw fixation in lumbar spine pathology. Technical note. AB - Two technical variations of the method of translaminar screw fixation for unstable lumbar and lumbosacral segments are presented. Distraction-arthrodesis with intraarticular bone grafts allows definitive enlargement of narrowed foramina with consecutive root decompression as well as repositioning and intracanalicular decompression in cases of instability after lumbar disc surgery and in degenerative spondylolisthesis. Reconstruction of a hemilamina after hemilaminectomy and facet reduction allows reconstitution of the spinal canal and its posterior parts as well as direct treatment of intraforaminal pathology. PMID- 2756852 TI - An experimental study of the effect of nimodipine in primate subarachnoid haemorrhage. AB - Acute subarachnoid haemorrhage was produced in baboons by a transorbital vessel avulsion technique. Half the animals were pretreated with an intravenous infusion of the calcium antagonistic nimodipine, in a dosage comparable with clinical levels. The severity of the haemorrhage, as measured by changes in intracranial pressure, cerebral perfusion pressure, cerebral blood flow and reactivity, and evoked potentials, was not greater in the group receiving nimodipine. Changes in extracellular K+ and pH were much less marked in animals receiving nimodipine. It is suggested that nimodipine (a) has a protective effect at a cellular level against the ionic changes of ischaemia, (b) does not alter the mechanical severity of subarachnoid haemorrhage. PMID- 2756854 TI - Information in the clinical laboratory: computer-assisted organization and management. PMID- 2756855 TI - Desmoplastic fibroma. AB - This benign bone tumor is locally invasive and has a high rate of recurrence. Three-quarters of cases present before age 30. The characteristic plain film finding is a centrally located lytic lesion, usually in the metaphysis or metadiaphyseal region of a long bone. Treatment is surgical. PMID- 2756853 TI - Experimental transplantation gliomas in the adult cat brain. 3. Regional biochemistry. AB - Experimental brain tumours were produced in adult cats by stereotactic xenotransplantation of the rat glioma clone F98. Regional ATP, glucose and lactate were measured after 2-4 weeks on coronal cryostat sections by substrate induced bioluminescence, potassium content was imaged by the histochemical sodium cobaltinitrite method, and regional pH by incubating cryostat sections with the fluorescent pH-indicator umbelliferone. The regional biochemical alterations were correlated with magnetic resonance imaging and tissue water content. Biochemical changes were heterogeneous in tumours but exhibited a rather uniform pattern in peritumoural oedema. ATP was consistently reduced, glucose and lactate were increased and pH was more alkaline than in normal white matter. The decrease of ATP matched the increase of water, indicating that ATP decline represents fractional dilution in the oedematous tissue rather than break-down of energy metabolism. The increased lactate levels, therefore, may originate from the tumour and not from a metabolic disturbance in the peritumoural oedematous tissue. The implications of this interpretation for the pathogenesis of peritumoural oedema are discussed. PMID- 2756856 TI - Balloons as a cause of airway obstruction. AB - A balloon that bursts during inflation may result in foreign body obstruction of the upper respiratory tract. Retrieval may require a finger-sweep maneuver to dislodge the adherent material. Because balloon fragments are propelled rather than merely inhaled, the obstruction may be located deep in the airway. The clenched-teeth technique for balloon inflation can prevent this potentially fatal complication. PMID- 2756857 TI - A family practice approach to the pediatric prenatal visit. AB - Although recommended by many authorities, prenatal pediatric visits are not regularly scheduled. Thirty to 45 minutes should be allowed for review of the family background, obstetric history and psychosocial factors. The discussion should also include hospital concerns, as well as the practical and emotional aspects of returning home with a newborn. In addition, issues such as sleeping arrangements, safety, diapers and feeding should be addressed. PMID- 2756858 TI - Clinical trials for GLQ223 as a treatment for AIDS. PMID- 2756859 TI - AST vs. ALT. PMID- 2756860 TI - Preoperative evaluation of the elderly patient. PMID- 2756861 TI - Scuba diving and pregnancy. PMID- 2756862 TI - HTLV-I infection and the family physician. PMID- 2756863 TI - The response of the pulmonary surfactant-associated alkaline phosphatase following acute cadmium chloride inhalation. AB - In order to identify sensitive and specific biochemical indicators of pulmonary damages caused by industrial contaminants, male Long-Evans rats were exposed to a cadmium chloride (CdCl2) aerosol (5 mg Cd/m3; MMAD = 1.4 microns; SDg = 1.8) for 1 hr. The rats were sacrificed at 1, 4, 8, and 16 days after treatment. The response of the pulmonary surfactant (SF) system, which prevents alveolar collapse during expiration by lowering the surface tension at the air-liquid interface, was of particular interest. The effect of CdCl2 inhalation on the SF system was monitored by assaying the alkaline phosphatase (AKP) activity and phospholipid (PL) content in an enriched surface active SF fraction purified from bronchoalveolar lavages. The AKP activity of the SF fraction was markedly decreased (99%) on Day 1, indicating an inhibition of AKP by Cd. The PL content remained at control level while the total protein content was significantly increased (199%). On day 4, the high recovery of PL (207%) and AKP activities (639%) may reflect an increased secretion caused by Type II cell hyperplasia. By Day 8 these parameters returned to baseline levels. On Day 16 both the AKP activity and the PL content of the SF fraction were decreased significantly. Concurrently, the activities of the acid phosphatase and the B-N acetylglucosaminidase followed, but to a lesser extent, the response of the AKP activity on Days 1 and 4. They differed from AKP, however, in that their activities remained significantly elevated on Day 8 and in that they returned to baseline levels on Day 16.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2756864 TI - Reduction of airborne radioactive dust by means of a charged water spray. AB - An electrostatic precipitator based on charged water spray technology has been used in an underground uranium mine to control long-lived radioactive dust and short-lived aerosol concentration in a mine gallery where dust from a rock breaking/ore transportation operation was discharged. Two main sampling stations were established: one upstream of the dust precipitator and one downstream. In addition, dust samplers were placed at different locations between the dust discharge and the end of the mine gallery. Long-lived radioactive dust was measured using cascade impactors and nylon cyclone dust samplers, and measurement of the radioactivity on the samples was carried out by conventional methods. Radon and thoron progeny were estimated using standard techniques. Experiments were conducted under a variety of airflow conditions. A maximum radioactive dust reduction of about 40% (approximately 20% caused by gravitational settling) at a ventilation rate of 0.61 m3/sec was obtained as a result of the combined action of water scrubbing and electrostatic precipitation by the charged water spray electrostatic precipitator. This represents the optimum efficiency attained within the range of ventilation rates investigated. The dust reduction efficiency of the charged water spray decreased with increasing ventilation rate, i.e., decreasing air residence time, and hence, reduced dust cloud/charged water droplets mixing time. PMID- 2756865 TI - Current nitrogen dioxide exposures among railroad workers. AB - As part of a series of epidemiologic studies of the mortality patterns of railroad workers, various air contaminants were measured to characterize the workers' current exposures to diesel exhaust. Nitrogen dioxide (NO2), which is a constituent of diesel exhaust, was examined as one possible marker of diesel exposure. An adaptation of the Palmes personal passive sampler was used to measure the NO2 exposures of 477 U.S. railroad workers at four railroads. The range of NO2 exposures expressed as the arithmetic average +/- two standard errors for the five career job groups were as follows: signal maintainers, 16-24 parts per billion (ppb); clerks/dispatchers/station agents, 23-43 ppb; engineers/firers, 26-38 ppb; brakers/conductors, 50-74 ppb; and locomotive shop workers, 95-127 ppb. Variations among railroads and across seasons were not significant for most job groups. PMID- 2756866 TI - Fourier transform infrared (FTIR) spectroscopy for monitoring airborne gases and vapors of industrial hygiene concern. AB - There are few available analytical methods with which an industrial hygienist can perform near real-time identification and quantitation of gases and vapors in the workplace. At present, the instruments that come the closest to fulfilling this need are based on either Fourier transform infrared (FTIR) spectroscopy or mass spectroscopy (MS). In order to investigate the applicability of FTIR to the qualitative and quantitative analysis of gas and vapor emissions in the workplace, an investigation was carried out to choose optimal conditions that could maximize the signal from individual target analytes and minimize the potential for interference. In all cases, the limit of detection (LOD) of individual air contaminants was below the threshold limit value (TLV). PMID- 2756867 TI - Evaluation of the applicability of fourier transform infrared (FTIR) spectroscopy for quantitation of the components of airborne solvent vapors in air. AB - Monitoring of solvent vapors can be performed by a variety of methods. Recent studies by this research group have shown that Fourier transform infrared spectroscopy (FTIR) can be a useful method for monitoring mixtures of vapors in air. The use of FTIR for the quantitation of individual components in a stimulated 12-component paint solvent mixture is demonstrated, and optimal conditions for instruments use are detailed. The limit of detection (LOD) for each component is well below the threshold limit value (TLV), although there is a significant degradation of LOD in the mixture when compared to the values obtained for individual compounds. Accurate quantitation is obtained through the use of a least squares fit program. PMID- 2756868 TI - Workplace measurement of respirator effects using respiratory inductive plethysmography. AB - A useful system to study the cardiopulmonary effects of respirators in the workplace would be reliable, portable, and lightweight and would not encumber the nose or mouth or require modification to the respirator. Twenty men using such a system (which measured ventilatory parameters by respiratory inductive plethysmography [RIP]) were studied. The subjects all performed their usual jobs which involved some work with and some without a respirator. Twelve subjects used airline respirators and eight used air-purifying respirators. The RIP equipment measurements included respiratory frequency, tidal volume (VT), minute ventilation (V), and heart rate (HR). The RIP data from 20 other subjects was lost because of equipment malfunction, primarily lead separation in those whose jobs involved climbing around large workpieces. In general, the workers' cardiopulmonary parameters increased during respirator wear, probably because of a combination of factors, including the increased exercise of most respirator requiring tasks and the weight and heat stress associated with the respirator and protective clothing. When the ventilatory parameters with and without a respirator were compared at the same heart rates, no significant differences were noted in VT for the entire group. Respiratory frequency, however, and V increased with respirator wear. The effects of respirators alone were found to be commonly confounded in the workplace by changes in protective clothing, exercise requirements, and ambient heat stress. Further improvements in the portable RIP system are needed before it can be accepted as a reliable ventilatory measurement device in the workplace. PMID- 2756869 TI - Reaction of gallium arsenide with concentrated acids: formation of arsine. AB - Crystalline particles of gallium arsenide (GaAs) (approximately 2 microns in diameter) react with concentrated hydrochloric acid (HCl) (11.6 to 9 M) to form highly toxic arsine (AsH3) gas. None of the other strong acids that were investigated reacted with gallium arsenide to form AsH3. A spectrophotometric method, based on the reaction of AsH3 with silver diethyldithiocarbamate in a chloroform solution containing morpholine, was used to detect AsH3 gas dissolved in aqueous solutions and to determine the AsH3 gas that was liberated by the reaction of GaAs with HCl. Active sites on the gallium arsenide surface initiate the reaction that forms AsH3 gas. Absorption of oxygen or ions from solution on these active sites inhibits the formation of AsH3. PMID- 2756870 TI - Angiographic characteristics of the infarct-related coronary artery in patients with angina pectoris after myocardial infarction. AB - To elucidate the pathophysiology of angina pectoris after myocardial infarction, we analyzed the coronary stenoses in 45 subjects (28 men, 17 women, aged 33 to 67 years) with recent (less than or equal to 60 days) infarction, significant narrowing of only the infarct-related artery, and residual anterograde flow in this artery. Postinfarction angina was absent in 19 (group I) and present in 26 (group II). The groups were similar in age, left ventricular function, incidence with which each coronary artery was involved, as well as stenosis diameter (1.0 +/- 0.3 vs 0.9 +/- 0.4 mm [mean +/- standard deviation], respectively, difference not significant), stenosis area (0.9 +/- 0.4 vs 0.8 +/- 0.8 mm2, respectively, difference not significant), percent diameter narrowing (65 +/- 5 vs 66 +/- 9, respectively, difference not significant), and stenosis eccentricity. However, those with postinfarction angina had longer stenoses (group I, 4.3 +/- 1.4 mm; group II, 10.3 +/- 4.0 mm; p less than 0.001). Thus, patients with postinfarction angina and residual anterograde flow in the infarct artery may have angina due to a marked reduction in anterograde flow, caused by a long stenosis. There is no apparent relation between stenosis eccentricity and postinfarction angina. PMID- 2756871 TI - Usefulness of the severity and extent of reversible perfusion defects during thallium-dipyridamole imaging for cardiac risk assessment before noncardiac surgery. AB - Thallium-dipyridamole imaging is a very sensitive test for predicting cardiac events after noncardiac surgery, but it lacks specificity. To improve specificity, a semiquantitative scoring system was developed that combined dipyridamole-induced reversible left ventricular dilatation with scintigraphic indexes for severity and extent of reversible perfusion defects. Using this scoring system, patients were classified into low, intermediate and high risk subgroups. Thallium-dipyridamole imaging was performed in 66 patients before major general and vascular surgery. Thirty-nine patients classified as low risk (30 with normal scans and 9 with fixed defects) underwent surgery uneventfully. Surgery was cancelled in 6 patients with extensive thallium redistribution and coronary angiography was performed because of severe coronary artery disease in 5 and idiopathic dilated cardiomyopathy in 1. In the remaining 21 patients with thallium redistribution, a positive statistical correlation (p = 0.001) between scintigraphic indexes of severity and extent, and cardiac events was noted. Using cutoff values for the scintigraphic indexes, patients with reversible defects could be classified into intermediate and high risk subgroups. Only 1 of 11 patients at intermediate risk developed a complication, whereas 8 of 10 patients at high risk had a postoperative event (7 deaths and 1 myocardial infarction). Thus, using scintigraphic indexes for severity and extent, patients with reversible defects can be stratified into an intermediate risk subgroup that can safely undergo surgery and a high risk subgroup that requires coronary angiography. PMID- 2756872 TI - Exercise thallium-201 scintigraphy and prognosis in typical angina pectoris and negative exercise electrocardiography. AB - Patients with a history of typical angina but negative exercise electrocardiography represent a subgroup with an intermediate likelihood of having coronary artery disease and future cardiac events. A retrospective study of the prognostic utility of stress-redistribution thallium-201 scintigraphy was performed in 190 such patients. A second group of 203 patients with typical angina and a positive exercise electrocardiogram were analyzed for comparative scintigraphic purposes. The cardiac event rate for the 144 negative exercise electrocardiogram patients with normal thallium results was 5 vs 15% in the 46 patients with abnormal thallium results (p = 0.01). These patients were further stratified into high (14 to 18%), intermediate (9%) and low (less than 2%) risk groups for future cardiac events based on combining the thallium results with the percentage of maximal predicted heart rate achieved. A multivariate analysis revealed that an abnormal thallium result was the only significant correlate of future cardiac events. Mechanisms responsible for the discordant finding of a negative exercise electrocardiogram in patients with typical angina include (1) false-positive angina symptomatology in low prevalence coronary artery disease groups in whom the thallium test is negative, and (2) "electrocardiographically silent" ischemia in patients in whom the thallium test is positive. These findings reveal that thallium stress-redistribution scintigraphy can be used to stratify 1-year prognosis in this subgroup of patients with typical angina and negative exercise electrocardiograms. PMID- 2756873 TI - International application of a new probability algorithm for the diagnosis of coronary artery disease. AB - A new discriminant function model for estimating probabilities of angiographic coronary disease was tested for reliability and clinical utility in 3 patient test groups. This model, derived from the clinical and noninvasive test results of 303 patients undergoing angiography at the Cleveland Clinic in Cleveland, Ohio, was applied to a group of 425 patients undergoing angiography at the Hungarian Institute of Cardiology in Budapest, Hungary (disease prevalence 38%); 200 patients undergoing angiography at the Veterans Administration Medical Center in Long Beach, California (disease prevalence 75%); and 143 such patients from the University Hospitals in Zurich and Basel, Switzerland (disease prevalence 84%). The probabilities that resulted from the application of the Cleveland algorithm were compared with those derived by applying a Bayesian algorithm derived from published medical studies called CADENZA to the same 3 patient test groups. Both algorithms overpredicted the probability of disease at the Hungarian and American centers. Overprediction was more pronounced with the use of CADENZA (average overestimation 16 vs 10% and 11 vs 5%, p less than 0.001). In the Swiss group, the discriminant function underestimated (by 7%) and CADENZA slightly overestimated (by 2%) disease probability. Clinical utility, assessed as the percentage of patients correctly classified, was modestly superior for the new discriminant function as compared with CADENZA in the Hungarian group and similar in the American and Swiss groups. It was concluded that coronary disease probabilities derived from discriminant functions are reliable and clinically useful when applied to patients with chest pain syndromes and intermediate disease prevalence. PMID- 2756875 TI - Prognostic significance of ST potentials determined by body surface mapping in inferior wall acute myocardial infarction. AB - Electrocardiographic body surface mapping on admission to coronary care has been shown to predict prognosis in a previous study of 100 patients with inferior wall acute myocardial infarction (AMI). A further 98 patients with first inferior wall AMI were now studied by body surface mapping on admission to coronary care to confirm that both the spatial distribution or map pattern of ST-segment potentials and the precise measurement of the maxima and minima are of prognostic significance. Each ST-segment map was compared by correlation coefficient to the average map pattern of the 4 groups derived in a previous study and placed in the group with the highest correlation coefficient. Analysis of these groups against outcome confirmed that the group dominated by a large area of marked anterior ST depression was associated with a high rate of complications and a significantly lower survival free of coronary artery bypass grafting (p less than 0.01). Patients in this group had more extensive and severe coronary artery disease than patients in the other groups. Increasing values of maximal ST depression correlated with mortality and complication rates. The extent by which the magnitude of ST-segment depression exceeded the magnitude of ST-segment elevation correlated with mortality and incidence of left ventricular failure. The results confirm the findings of the original study. Body surface mapping is of prognostic significance in inferior wall AMI. PMID- 2756874 TI - Characteristics associated with early (less than or equal to 3 months) versus late (greater than 3 months to less than or equal to 3 years) mortality after acute myocardial infarction. AB - To define the independent variables predictive of early versus late mortality after acute myocardial infarction (AMI), 420 consecutive patients were studied and divided into 3 groups: the 45 patients who died within the initial 3 months (group 1), the 45 patients who died greater than 3 months and less than or equal to 3 years after AMI (group 2) and the 330 greater than 3-year survivors (group 3). The stepwise logistic discrimination method was applied to clinical and laboratory variables recorded during hospitalization to distinguish among the 3 groups. Six independent variables were found to be predictive of early mortality: left ventricular function score (chi-square 26.2; p less than 0.00001), ventricular fibrillation (chi-square 9.3; p = 0.002), bundle branch block (chi square 9.0; p = 0.003), history of previous AMI (chi-square 8.7; p = 0.003), age (chi-square 5.8; p = 0.02) and atrioventricular block (chi-square 3.8; p = 0.05). Three independent variables were found predictive of late mortality: age (chi square 13.8; p = 0.0002), anterior location of the AMI (chi-square 4.0; p = 0.04) and a low peak creatine kinase-MB level (chi-square 3.8; p = 0.05). Only 2 variables were able to distinguish between early and late nonsurvivors: peak creatine kinase-MB level (chi-square 8.7; p = 0.003) and ventricular fibrillation (chi-square 4.6; p = 0.03). Thus, the sets of independent risk factors for early and late mortality after AMI are substantially different--suggesting that differing mechanisms are responsible for outcome. PMID- 2756876 TI - Qualitative and quantitative comparison of amounts of narrowing by atherosclerotic plaques in the major epicardial coronary arteries at necropsy in sudden coronary death, transmural acute myocardial infarction, transmural healed myocardial infarction and unstable angina pectoris. AB - The amounts of narrowing of the 4 major (left main, left anterior descending, left circumflex and right) epicardial coronary arteries by atherosclerotic plaques were compared in 4 subsets of coronary patients. Of the 129 patients studied at necropsy, an average of 2.7 of the 4 arteries was narrowed greater than 75% in cross-sectional area at some point (0.7/4 in controls), and the group with unstable angina pectoris (3.2/4) had more narrowing than did the groups with sudden coronary death (2.8/4), acute myocardial infarction (2.7/4) and healed myocardial infarction (2.3/4). Each of the 4 major epicardial coronary arteries was divided into 5-mm long segments and a histologic section was prepared and stained by the Movat method of each of the 6,461 segments in the 129 patients and in the 1,849 segments in the 40 control subjects. In the 129 patients, 35% of the 5-mm segments were narrowed 75 to 100% in cross-sectional area (3% in controls) and the group with unstable angina had the highest percent (48%) of segments severely narrowed compared to the groups with sudden coronary death (36%), acute myocardial infarction (34%) and healed myocardial infarction (31%). Thus, of the 4 subsets of patients with fatal coronary artery disease studied at necropsy, those with unstable angina pectoris had the most severe and extensive coronary atherosclerosis. PMID- 2756877 TI - Conversion of sustained into nonsustained ventricular tachycardia during therapy assessment by programmed ventricular stimulation: criterion for a positive drug effect? AB - Serial electropharmacologic testing using up to 11 different antiarrhythmic drugs was performed in 130 consecutive patients (107 men, 23 women, ages 56 +/- 12) with inducible sustained ventricular tachycardia (VT). After 4 +/- 2.3 drug tests, complete suppression of VT inducibility (defined as less than 6 consecutive beats, mean 1.4 +/- 1.6) was achieved in 86 patients (66%), whereas in 44 patients (34%) nonsustained VTs (greater than or equal to 6 consecutive beats, less than 30 seconds in duration) were still inducible. There was no statistical difference between both groups regarding age, sex, underlying heart disease, ejection fraction or entry arrhythmia. After a mean follow-up period of 19 +/- 17 months, 24 patients (18%) had died, 8 (6%) suddenly. Eight patients (6%) experienced recurrent sustained VT. Symptomatic recurrences (sudden death or VT) occurred in 10 (11%) and 6 patients (13%, difference not significant), respectively. Probability of arrhythmia-free survival was comparable for patients with 0 to 5, 6 to 10, 11 to 15 and 16 to 32 inducible ventricular complexes with discharge medication. The negative predictive value of electropharmacologic drug testing was about 89%, irrespective of the maximal number of inducible complexes used for the definition of a negative test result. It is therefore concluded that conversion of sustained into nonsustained VT during therapy assessment by programmed ventricular stimulation indicates a positive drug effect. PMID- 2756878 TI - Random and nonrandom behavior of symptomatic paroxysmal atrial fibrillation. AB - Little is known about the behavior of symptomatic paroxysmal atrial fibrillation (AF). The nature of the process formed by the successive occurrences of this arrhythmia was studied in 8 patients with a history of symptomatic paroxysmal AF. Trans-telephonic monitoring of the electrocardiogram was used to document the cardiac rhythm during symptoms. Patients were followed while successive attacks of paroxysmal AF were documented. A minimum of 12 and a maximum of 26 consecutive episodes of symptomatic paroxysmal AF were recorded from the 8 patients during 66 to 332 days. Methods developed in industrial reliability theory were used to show that, for the overall group of 8 patients, the interevent times between successive occurrences of symptomatic AF were not independent. However, for a subgroup including 6 of the patients, the interevent times were independent and governed by an exponential probability distribution. Differences in observed behavior of symptomatic AF may relate to differences in underlying mechanism within patients. PMID- 2756879 TI - Comparison of the effects of pindolol and propranolol on exercise performance in young men with systemic hypertension. AB - To determine the effect of intrinsic sympathomimetic activity (ISA) on exercise performance during beta blockade, 12 hypertensive men were studied. The subjects underwent graded treadmill testing while taking pindolol (a beta blocker with ISA), propranolol (a beta blocker without ISA) and placebo, in a double-blind, crossover fashion. Blood pressure, heart rate, oxygen consumption (VO2), cardiac output and stroke volume were determined at 25, 45, 60 and 75% of each subject's VO2 max. Heart rate was significantly lower with pindolol compared with placebo at all stages of exercise, but significantly higher compared with propranolol at all stages of exercise except at 75% of VO2 max and at VO2 max (no significant differences between the 2 beta blockers were recorded at these stages). Mean arterial pressure was statistically equivalent with pindolol and propranolol at all stages of exercise and significantly lower while beta-blocked compared with placebo conditions at 45, 60 and 75% of VO2 max. Cardiac output and VO2 were statistically equivalent across all 3 treatments at all submaximal levels of exercise. It was concluded that, although heart rate was significantly higher with pindolol compared with propranolol at the 3 lower rates of work, cardiac output and VO2 were not different between the drugs, thus making little impact on exercise performance. PMID- 2756880 TI - Effect of exercise training in 60- to 69-year-old persons with essential hypertension. AB - This study sought to determine whether 9 months of low- or moderate-intensity exercise training could decrease blood pressure (BP) in hypertensive men and women (mean age 64 +/- 3 years). Patients underwent weekly BP evaluations for 1 month to ensure that they had persistently elevated BP and then completed a maximal treadmill exercise test to exclude those with overt coronary artery disease. The low- and moderate-intensity groups trained at 53 and 73% of maximal oxygen consumption (VO2 max), respectively; however, total caloric expenditure per week was similar in both groups. VO2 max did not increase in the low intensity group with training, but increased 28% in the moderate-intensity group. Diastolic BP decreased 11 to 12 mm Hg in both training groups. Systolic BP decreased 20 mm Hg in the low-intensity group with training, which was significantly greater than the change in the control and the moderate-intensity groups. Although systolic BP decreased 8 mm Hg in the moderate-intensity training group, this reduction was not significant. Training resulted in a somewhat lower cardiac output at rest in the low-intensity group, whereas total peripheral resistance decreased slightly in the moderate-intensity training group. Plasma and blood volumes, plasma renin levels and urinary sodium excretion did not change in either group with training. Both groups manifested lower plasma norepinephrine levels after training during standing rest, but not while supine. Thus, low-intensity training may lower BP as much or more than moderate-intensity training in older persons with essential hypertension, but the underlying mechanisms are unclear. PMID- 2756881 TI - Doppler evaluation of homograft valved conduits in children. AB - To assess the flow characteristics of homograft valved conduits in the immediate postoperative period, 69 children with 71 homograft conduits underwent 2 dimensional and Doppler echocardiographic examination at 1 to 40 days (mean 8) after surgery. Of the 71 conduits studied, 19 were aortic and 52 were pulmonary homograft valved conduits. Two aortic homograft valved conduits were inserted in the aortic position, whereas all remaining homografts were placed in the pulmonary position. On the immediate postoperative echocardiogram, 25 (35%) of the conduit valves had no regurgitation and 44 (62%) had 1+ (mild) regurgitation. Two pulmonary valved conduits (3%) in the pulmonary position had 2+ (moderate) regurgitation and right ventricular dimensions greater than 95% for body surface area. The peak velocity across the homograft valve was normal (less than 1.3 m/s) in 58 valves (82%). In the remaining 13 valves, peak velocity ranged from 1.4 to 2.6 m/s. No homograft valve had a peak velocity greater than 2.6 m/s in the immediate postoperative period. To assess the fate of homograft valved conduits in the intermediate-term follow-up period, 38 children with 38 conduits had a repeat echocardiogram at 6 to 25 months (mean 15 +/- 6) after surgery. Of the 38 conduits examined, 10 (26%) had no regurgitation, 25 (66%) had 1+ regurgitation and 3 (8%) had 2+ regurgitation. Progression of the amount of regurgitation occurred in 11 (29%) patients. At the follow-up examination, peak velocity was less than or equal to 1.4 m/s across 34 conduit valves, between 1.4 and 2.6 m/s across 3 valves and greater than 2.6 m/s across 1 valve.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2756882 TI - Correlation of intraabdominal fat accumulation and left ventricular performance in obesity. AB - The correlation of intraabdominal visceral fat accumulation and left ventricular performance was investigated in 37 obese patients who had 154 +/- 23% of ideal body weight. The left ventricle was studied noninvasively by means of echocardiography, whereas the distribution of body fat was determined by computed tomography. The end-diastolic left ventricular dimension and stroke volume were greater in obese patients than in non-obese control subjects. Not only the absolute values of these parameters, but also the diastolic left ventricular dimension index (calculated as end-diastolic dimension/cube root of body surface area) and stroke index were greater in obese patients. When the obese patients were divided into 2 groups according to the intraabdominal visceral fat area to subcutaneous fat area ratio (V/S) determined by computed tomography, the diastolic dimension index and the stroke index were significantly greater in visceral-type obesity (V/S greater than or equal to 0.4) than in subcutaneous type obesity (V/S less than 0.4) (43.2 +/- 2.9 vs 40.3 +/- 3.1 mm/m2/3, p less than 0.01 and 49.3 +/- 6.1 vs 40.3 +/- 5.6 ml/m2, respectively). Multiple regression analysis with independent variables of age, body weight, duration of obesity and V/S ratio showed that diastolic dimension index and stroke index significantly correlated with the V/S ratio. Thus, the alteration of cardiac function in obese patients is attributable not only to excess body weight and duration of obesity but also to intraabdominal fat accumulation. PMID- 2756883 TI - Improved sensitivity of color Doppler by SH U 454. AB - SH U 454, a suspension of galactose microparticles, provides microbubbles (97% less than 7 microns) in variable, reproducible concentrations. Its influence on color Doppler imaging was evaluated in a flow model study and in a clinical study. In the flow model, increasing attenuation (up to 11.4 dB/MHz) impaired the signal to noise ratio and decreased the sensitivity for detecting flow velocities. Thus, flow signals were obtained with flow velocities greater than 3 cm/s (0.1 dB/MHz), greater than 9 cm/s (5.7 dB/MHz) and greater than 17 cm/s (11.4 dB/MHz). After injection of SH U 454 (200 mg/ml), velocities down to 3 cm/s were detected even with high attenuation (11.4 dB/MHz). Color Doppler imaging was performed before and after intravenous injection of 2 ml, 3 ml and 4 ml of SH U 454 (200 mg/ml) in 22 adult patients, and the maximal color-coded areas of diastolic blood flow were determined in the right atrium and ventricle. In 19 of 22 patients, the displayed color-coded areas increased after injection of SH U 454. The diastolic blood flow was imaged on 14 +/- 8% (mean +/- 1 standard deviation) of the cross-sectional area of the right ventricle (4-chamber view) without SH U 454, compared with 39 +/- 15% with 3 ml of SH U 454 (p less than 0.001). For the right atrium, the area displayed by color Doppler increased from 9 +/- 13 to 62 +/- 25% (p less than 0.001). The variability of the measurements from patient to patient after injection of SH U 454 was 5.9 +/- 4% as compared with 10.7 +/- 6.9% without SH U 454 (p less than 0.05). These findings indicate that the intravenous injection of SH U 454 increases the sensitivity of color Doppler imaging for detection of blood flow by improving the signal to noise ratio. PMID- 2756884 TI - Usefulness of oral dipyridamole digital echocardiography for detecting coronary artery disease. PMID- 2756885 TI - Acute hemodynamic effects of adibendan, a new phosphodiesterase inhibitor, for severe congestive heart failure. PMID- 2756886 TI - Scanning electron microscopy of operatively excised severely regurgitant floppy mitral valves. PMID- 2756887 TI - Correlation of distance from subaortic membrane to base of the right aortic valve cusp and the development of aortic regurgitation in mild discrete subaortic stenosis. PMID- 2756888 TI - Circadian distribution in fatal pulmonary thromboembolism. PMID- 2756889 TI - Utility of precordial, epicardial and transesophageal two-dimensional echocardiography in the detection of intracardiac foreign bodies. PMID- 2756890 TI - Extensive multifocal myocardial infarcts from cloth emboli after replacement of mitral and aortic valves with cloth-covered, caged-ball prostheses. PMID- 2756891 TI - Denervation of the heart in congenital long QT and deafness. PMID- 2756892 TI - On the identity of "X" in so-called syndrome X. PMID- 2756893 TI - Treadmill exercise testing versus Holter monitoring for detecting myocardial ischemia. PMID- 2756894 TI - Type A behavior: its diagnosis, cardiovascular relation and the effect of its modification on recurrence of coronary artery disease. AB - A general review of type A behavior and its possible relation to clinical coronary artery disease, hypertension and migraine is given. The humoral and lipid derangements initiated by type A behavior are described as well as the possible pathophysiologic phenomena this behavior effects leading to accentuation and hastening of the onset of clinical coronary artery disease. The correct method of diagnosing type A behavior as well as methods of diminishing its intensity both in the coronary and still symptomless person are described. The significant decline in coronary morbidity and mortality in patients with coronary artery disease given type A behavior counseling is described. PMID- 2756895 TI - Relation between the ventriculographic silhouette and topography of thoracic potential in coronary artery disease. AB - The body surface potential map obtained within 30 days of cardiac catheterization was examined in 180 patients with coronary artery disease. Radii to the systolic and diastolic boundaries of the right anterior oblique ventriculogram were measured at 18 degrees intervals; isointegral voltages were tabulated for early and late halves of the QRS complex at 35 definitive electrode sites. Multivariate analysis showed all ray lengths depended on all 70 voltage values. Linear transformation matrices to predict ray length from voltage distribution were calculated for a training set which was successively expanded from 80 to 160 at increments of 20 patients. Training set expansion led to a progressive decrease in the error of reproduction of the ray lengths for patients outside the training set. There is a strong relation between ventriculographic contours in patients with coronary artery disease and body surface potential values during early and late QRS complexes. Even in simplified linear formulation, the relation is detectable throughout a large population despite interindividual variations in anatomic geometry. PMID- 2756896 TI - Electrocardiographic wave form and cardiac arrhythmias. AB - In addition to its established diagnostic uses, the electrocardiogram may be useful for predicting ventricular fibrillation and other arrhythmias. Non-uniform recovery of excitability, which is a factor in vulnerability, is the determinant of QRST deflection area, and regionally selective sampling by body surface electrocardiographic mapping may permit recognition of the locally disparate recovery related to fibrillation. Preliminary experimental and clinical studies support this possibility and suggest that the multipolar content of QRST area distributions on the body surface is a marker of vulnerability. PMID- 2756897 TI - Insight into a bad omen for white men: coronary artery disease--the Bogalusa Heart Study. AB - Clinical experience of diagnostic and interventional procedures, including cardiac surgery, indicates a greater prevalence of coronary heart disease in white men than in other race-gender groups. Studies of children and young adults in the Bogalusa Heart Study have provided evidence that might account for this race-gender contrast. A variety of anthropometric and metabolic parameters influencing serum lipid and lipoprotein levels places white boys and young white men selectively at high risk for the development of atherosclerotic coronary artery disease. Obesity and greater central body fat, subtle aberrations in carbohydrate-lipid metabolic relations and variability in sex hormone profiles appear to underlie a trend to adverse lipoprotein changes in white men. A lower high-density lipoprotein cholesterol level and apolipoprotein A-l at puberty and a dramatic increase of low-density lipoprotein cholesterol are seen in young white men; such adverse changes identify them to be at greater risk. It is noteworthy that children whose fathers had myocardial infarction tend to be white. These children also have relatively high ratios of apolipoprotein B/apolipoprotein A-l and apolipoprotein B/low-density lipoprotein cholesterol. Studies of risk factors in children emphasize their importance in the early natural history of coronary artery disease. These findings show the need for beginning prevention of adult heart disease in childhood. PMID- 2756898 TI - Changes by two-dimensional echocardiography in the myocardial appearance of patients with end-stage renal disease. AB - A retrospective study of the clinical and biochemical data of all patients with end-stage renal disease who underwent 2-dimensional echocardiography at Tulane Medical Center between 1982 and 1986 was performed. Complete echocardiographic data were available for comparison in 53 patients. Highly reflective echoes were judged to be present in the myocardium of 81% of the patients. This characteristic is described as a "glistening speckled appearance." Patients with this characteristic had significantly greater left ventricular mass index (p = 0.0021). PMID- 2756899 TI - Albumin uptake by renal lymphatics with and without obstruction of the renal vein. AB - Experiments involving injection of radio-iodinated albumin into the left renal arteries or left ureters of dogs indicate that the renal lymphatics are capable of a major contribution in returning to the circulation albumin (or other large molecules) escaping from renal capillaries. I131-albumin was injected into the jugular vein of controls or into the left renal artery or in retrograde manner into the left ureter of female dogs. Experimental groups included those with no obstruction, occlusion of left renal veins or left renal lymphatics, or both. Collections were made from the right femoral artery, both renal veins, thoracic duct and both ureters at frequent intervals for 2 to 4 hours. Data analysis included I131 concentration, specific activity, rate of recovery and selected ratios. After renal arterial injection, the percentage of I131 recovered in thoracic duct lymph of dogs without renal venous obstruction was 5 to 10 times that recovered in those that received injections into the jugular vein. In dogs with renal venous obstruction, recovery from the thoracic duct was 10 to 1,000 times that in control dogs. Most of the differences occurred during the first hour, after which time as recirculation and redistribution occurred the rates of appearance in thoracic duct lymph in each group were similar. The differences in the ratios of concentration in thoracic duct lymph to concentration in femoral arterial blood were also much greater when the renal vein was obstructed than in dogs with no obstruction. The greater return of albumin through the thoracic duct in those with impeded renal venous outflow was probably related to both sequestered concentration and increased intrarenal pressure.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2756900 TI - Pathologic anatomy of the dilated cardiomyopathies. AB - Dilated cardiomyopathies are characterized by systolic pump failure and by dilatation of the ventricular cavity. Thus, they differ from the other 2 main types of cardiomyopathies, namely, hypertrophic cardiomyopathy and restrictive/obliterative cardiomyopathy. The term dilated cardiomyopathy designates a number of heterogeneous syndromes: idiopathic dilated cardiomyopathy, alcoholic cardiomyopathy, postpartal cardiomyopathy, infantile cardiomyopathy with histiocytoid change in cardiac muscle cells, anthracycline cardiomyopathy, Keshan disease, and several ultrastructurally distinct abnormalities, some of which maybe familial. The pathologic features of these syndromes are reviewed in detail. PMID- 2756901 TI - A symposium: Pharmacologic and therapeutic aspects of urapidil. November 11, 1988, Amsterdam. Proceedings. PMID- 2756902 TI - Bidirectional closure of the rostral neuropore in the human embryo. AB - The length of each neuropore was measured in 23 human embryos of stages 10-12 (about 22-26 days), and the closure of the lips of the rostral neuropore was studied in 24 embryos of stage 11 (about 24 days), with particular reference to the terminal lip. Graphic reconstructions were prepared from two particularly suitable examples, and mitotic figures were plotted for one of these. The lengths of the rostral and caudal neuropores are basically similar, but the rostral opening closes 1 day earlier and more abruptly (within a few hours) than the caudal (which takes a day). Closure of the rostral neuropore in the human embryo is bidirectional, proceeding simultaneously from 1) midbrain and diencephalon 2 and 2) the telencephalic region adjacent to the chiasmatic plate. Species differences are emphasized. Closure at the terminal lip of the neuropore is by fusion of right and left neural folds, as occurs elsewhere during primary neurulation. The rostral end of the neural plate in the median plane is, in the human embryo, at the rostral limit of the chiasmatic plate. Histological differences, however, exist between closure at the terminal lip and that at the dorsal lip: the surface epithelium plays a more significant role at the terminal lip, and the seam is more visible and presumably stronger. In future anencephaly it has been found that fusion at the terminal lip may occur, although that at the dorsal lip is deficient. PMID- 2756903 TI - Renal anatomy of the manatee, Trichechus manatus, Linnaeus. AB - The manatee kidney is composed of several closely apposed lobes. These are formed by cortical folds (plicae corticales) that completely isolate the medullae, except where the medullae of adjacent lobes are partially fused. The cortex is continuous; its folds usually are separated, but only partially, by interlobar septa extending from the renal capsule. The cortex makes up approximately 57% of renal mass in adults and 68% in the calf. There are about 3 million glomeruli per kidney. The average is somewhat less than that expected of an adult eutherian of equal mass. The glomeruli, however, are large; they form 7.38% +/- 1.33 of cortical mass, which is above that for at least ten unrelated adult eutherians. The number of glomeruli per gram of cortex is considerably greater in the calf than in the adult. The medullae are about 43% of renal mass. The cortico medullary thickness ratio is 0.08 to 0.24. All terminal collecting ducts open at a crater (cratera cribrosa) of varying depth. Hair-pin loops occur at all levels of medulla, and apparently all loops bend at their thick segment. Cortical loops occur in the medullary rays. Vascular bundles were evident at the cortico medullary border and thin tubules extended into the medulla from the central ends of the medullary rays (cortical) in seven out of the nine kidneys. The renal pelvis is separated from the central ends of the cortical folds by delicate fascia through which pass the interlobar vessels. There are no fornices and no infundibula. The collagenous tissue of the pelvic wall extends across most of the pelvic surface of the outer medulla. PMID- 2756904 TI - Epithelial cytodifferentiation and extracellular matrix formation in enamel-free areas of the occlusal cusp during development of mouse molars: light and electron microscopic studies. AB - Mandibular first molars in mice ranging in age from 18 days prenatal to 5 days postnatal were used for light and electron microscopic examinations of the enamel free area (EFA) during development of the occlusal cusp (mesiobuccal cusp). Notable morphological changes in the inner enamel epithelium and the cells of the stratum intermedium were observed. At prenatal age of 18 days, the inner enamel epithelium of the EFA (EFA epithelium) was composed of a layer of columnar cells and covered by the cells of the stratum intermedium. Two days after birth, the EFA epithelium was made up largely of preameloblasts, with mitochondria located in the proximal side of the cells toward the stratum intermedium. The cells of the stratum intermedium were irregularly shaped, with wide intercellular spaces between them. At a postnatal age of 3 days, most of the EFA epithelial cells resembled maturation-stage ameloblasts, being short and columnar in shape and having nuclei located in their proximal side. Distal cell membranes were folded, and mitochondria were scattered throughout the cytoplasm. In 4-day-old mice, the EFA epithelium was found to be formed of short columnar or cuboidal cells with distinct intercellular spaces. The cells of the stratum intermedium could no longer be detected, and cells of the EFA epithelium could not be distinguished from those of the stellate reticulum. Odontoblasts of the EFA were arranged and polarized parallel to the basal lamina, and odontoblastic processes extended toward the cusp tip. The orientation of thin and thick collagen fibers within predentin and dentin was also parallel to the basal lamina. Even after dentin mineralization, disrupted basal lamina and long, aperiodic, fine fibrils were found between the epithelium and the dentin. Following the disappearance of the basal lamina and fine fibrils, stippled material and crystals appeared on the dentin surface. The mineralized matrix, which x-ray microanalytical energy peaks identified as containing calcium and phosphorus, was continuous with enamel in the distal slope of the cusp at the cusp tip. Thus, the inner enamel epithelium of the EFA differentiated into secretory cells capable of enamel-like matrix formation.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2756905 TI - Accessory cells in the gill epithelium of the freshwater rainbow trout Salmo gairdneri. AB - Two types of mitochondria-rich cells were identified in the gill epithelium of the freshwater-adapted rainbow trout, Salmo gairdneri, after selective impregnation of their tubular system with reduced osmium. A first type consisted of large cells with a poorly developed and loosely anastomosed tubular system; thus, that resembled the chloride cells commonly encountered in the gill epithelium of freshwater-adapted euryhaline fishes. A second type comprised smaller cells with an extensively developed and tightly anastomosed tubular system. These never reached the basal lamina of the gill epithelium and were adjacent to chloride cells, to which they were linked by shallow apical junctions (100-200 nm); thus, they resembled accessory cells, which are currently found in the gill epithelium of seawater-adapted fishes but are usually lacking in freshwater living fishes. Transfer of the freshwater-adapted trout into seawater induced the proliferation of the tubular system in the chloride cells and the formation of lateral plasma membrane interdigitations between accessory cells and the apical portion of the chloride cells. The length of the apical junction sealing off this extended intercellular space was reduced to 20-50 nm. The tubular system of the accessory cells was not modified. The extension of the tubular system in the chloride cells of the seawater-adapted fishes indicated that, as in most euryhaline fishes, these cells have a role in the adaptation of the rainbow trout to seawater. In contrast, the function of the presumptive accessory cells in freshwater trout remains to be established. PMID- 2756906 TI - Development of the stratified squamous epithelium of the human tympanic membrane and external canal: the origin of auditory epithelial migration. AB - The development of the stratified squamous epithelium of the tympanic membrane and external canal was studied in 167 embryonic, fetal, and postnatal human ears. It originates as a tube derived from the epithelium of the fundus of the primary external canal (zone 1). The tube is composed of a thin, flat epithelium on the medial side (zone 2), continuous with a thicker one (zone 3) on the lateral side; zone 3 thereafter merges with the external epithelium of the primary external canal (zone 4). Proliferative activity, as indicated by a thickened epithelium, with rete ridges in later fetal life, is present mainly in zones 1 and 3. Cornification at 18 weeks gestation is followed by clearing of keratinous debris to the exterior. Subsequently the canal widens, zone 1 now covering the pars flaccida region, a tongue-shaped area passing inferiorly from it and a part of the postero-superior deep canal adjacent to it; zone 2 covers the pars tensa and zone 3 most of the deep external canal. On the basis of the original embryonic growth, migratory epithelial movement throughout life is postulated to be generated in zone 1 by mitotic interposition and then to pass to zone 2. It then moves en masse through to zone 3, where unilateral progression by mitotic means takes the epithelium up to the cartilaginous canal. Such a pathway is approximately that seen in the marked, living eardrum and canal. PMID- 2756907 TI - The American Society for Clinical Nutrition as an academic society. PMID- 2756908 TI - Estimation of body composition from bioelectric impedance of body segments. AB - The hypothesis that body composition can be estimated accurately from measurements of the length and resistance of the body segments was tested. Weight; stature; whole-body resistance; and the resistances, lengths, and circumferences of the leg, trunk, and arm were measured for 135 white men and women aged 18-58 y. Fat-free mass (FFM) and percent body fat (%BF) were obtained from densitometry. The resistance of the whole body was determined almost entirely by the resistances of the arm and the leg. The accuracy of the prediction of FFM from arm length2/arm resistance and of %BF from weight x arm resistance/arm length2 was only marginally less than that obtained by using whole body measurements. Thus, measurements of the resistance and length of the arm can be used in place of the whole-body methods for estimating body composition from bioelectric impedance. PMID- 2756909 TI - A mathematical analysis of indirect calorimetry measurements in acutely ill patients. AB - Beside indirect calorimetry is generally accepted as reliable for evaluating energy expenditure (EE) and oxidation of carbohydrate (dCH) and fat (dF) in critically ill patients. Daily measurement of nitrogen excretion is usually included in the calculation of EE, dCH, and dF but it is difficult to perform in the clinical setting and is not necessary for accurate determination of EE. In this paper new equations, which are suitable for use with critically ill patients, are given for calculating EE, dCH, and dF without N-excretion measurements. With these equations the maximum errors for EE, dCH, and dF were 56, 179, and 306 kcal/d, respectively. The mean errors in 38 measurements of 26 critically ill patients were 27, 86, and 143 kcal/d, respectively. Measurement of EE by these equations is very accurate and suitable for both research and clinical use. Although the calculation of dCH and dF is much less precise, it can still given an indication of fuel utilization. PMID- 2756910 TI - Inhibitory effect of high caloric load of carbohydrates or lipids on human pancreatic secretions: a jejunal brake. AB - Effects of jejunal infusion of a saline solution, a protein meal, and a mixed protein and carbohydrate meal on biliopancreatic secretions were compared in six healthy volunteers. Protein infusion stimulated biliopancreatic secretions whereas carbohydrate infusion inhibited these secretions compared with saline infusion. The roles of lipid, carbohydrate, and caloric load on the inhibition of pancreatic secretions by jejunal infusion of nutrients was investigated in six other healthy volunteers. Carbohydrate, lipid, and the mixed meal inhibited pancreatic secretions whereas the carbohydrate solution was the only one that inhibited biliary secretion. These studies indicate that the mechanism of jejunal brake seems mainly related to the jejunal caloric load. In malabsorption or in the short bowel syndrome, a high caloric load or unabsorbed nutrients in the jejunum further inhibits pancreatic secretion, contributing to the loss of nutrients from the intestinal tract. PMID- 2756911 TI - Spontaneous meal patterns of humans: influence of the presence of other people. AB - Social influences on eating were investigated by paying 63 adult humans to maintain 7-d diaries of everything they ingested, time, subjective hunger, and number of people present. Meals eaten with others contained more carbohydrate, fat, protein, and total calories; had smaller deprivation ratios; and had larger satiety ratios than meals eaten alone. The number of people present was positively correlated with meal size even when meals eaten alone were excluded. Adding the number of people present as a factor in a multiple-regression prediction of meal size more than doubled the variance accounted for, without altering the influence of other predictors, suggesting that social factors are associated independently with an increase in meal size. Meal size was positively correlated with the postmeal interval for meals eaten alone but not for meals eaten with other people. This suggests that social factors increase amounts eaten and disrupt postprandial regulation. PMID- 2756912 TI - Effect of obesity on bioelectrical impedance. AB - The purpose of this study was to validate the use of bioelectrical impedance in assessing human body composition and to explore the use of this technique in obesity. Eighty-seven adults varying widely in body composition (range: 8.8-59.0% body fat) underwent measurement of bioelectrical impedance and underwater weighing (density). Fat-free mass determined from density (FFMd) was compared with FFM estimated from bioelectric impedance according to previously published regression equations. Correlation coefficients were high at all levels of body fat (0.94-0.99) but impedance equations overestimated FFM compared with FFMd in subjects greater than 42% body fat. This effect was greatest in subjects greater than 48% body fat and a regression equation was derived for determination of FFM for these subjects. These data confirm the excellent agreement between body composition determined from bioelectrical impedance and density but suggest that caution should be used in applying existing regression equations to very obese subjects. PMID- 2756913 TI - Energy supplementation in the last trimester of pregnancy in East Java, Indonesia: effect on breast-milk output. AB - Breast-milk output was measured in women who during the last trimester of pregnancy consumed a high- or low-energy supplement (53 and 55 women, respectively). Infant and mother pairs were enrolled at 2 or 6 wk postpartum. Test weighings were done four times at 8-wk intervals. Mean breast-milk output ranged from 682 to 744 g/d in the age period of 2 wk to 7 mo. There was no difference in milk output between the two experimental groups. In all cohorts, breast-feeding frequency influenced milk output positively. Only at age 18-22 wk did the mothers' prepregnancy or 4-wk postpartum body mass index play an additional role. The results confirm that breast-milk output of mildly undernourished women is comparable with that of well-nourished women. Short-term energy supplementation during pregnancy did not increase breast-milk output, probably because the sample studied was not at nutritional risk. PMID- 2756914 TI - Cardiovascular disease risk factors in free-living men: comparison of two prudent diets, one based on lactoovovegetarianism and the other allowing lean meat. AB - In general, vegetarians have lower serum lipids and blood pressures than omnivores have. We tested the blood pressure and serum lipid lowering effects of two fat-modified diets differing primarily in their source of protein. Twenty-six men were randomized in an incomplete block design to two of three diets: a high fat diet, a fat-modified lactoovovegetarian diet (LOV) and a diet in which 60% of plant protein in the LOV was replaced with lean meat (LM). Compared with the high fat diet both prudent diets significantly lowered blood pressure, serum total cholesterol (TC), and LDL cholesterol but significantly increased serum triglycerides. The LOV diet had a significantly greater cholesterol-lowering effect than did the LM diet (10% vs 5% decrease) but blood pressure reductions were similar. The partial substitution of lean meat for plant protein in a fat modified diet did not negate the overall cardiovascular-risk lowering of the lactoovovegetarian diet. PMID- 2756915 TI - Fatty acid composition of adipose tissue in humans: differences between subcutaneous sites. AB - We compared the fatty acid composition of adipose tissue from three different sites, one deep-seated site (perirenal) and two subcutaneous sites (abdominal and buttock), in 143 autopsied adult humans aged 24-61 y. The proportion of saturated fatty acids was highest in the perirenal adipose tissue and lowest in buttock adipose tissue. The proportions of monounsaturated fatty acids in the three sites were in the reverse order. Linoleic and linolenic acids were similar in the three adipose-tissue sites, an important finding for those concerned about the essential fatty acids, which are solely derived from the diet. The results clearly show that the fatty acid composition of the two subcutaneous fat depots differ significantly. We conclude that abdominal fat is more saturated than buttock fat. PMID- 2756916 TI - Predictive value of a short dietary questionnaire for changes in serum lipids in high-risk Utah families. AB - Dietary questionnaires and serum cholesterol, triglycerides, and high-density lipoprotein (HDL) cholesterol determinations were completed for 1239 subjects aged greater than or equal to 20 at each of two separate screenings. The mean time between screenings was 2.5 y. After correcting for potential confounding variables, reduction of a measure of dietary cholesterol and saturated fatty acids assessed by two simple questions was a significant independent predictor of reduction in total cholesterol in serum (p less than 0.005). Initial body mass index (BMI) and change in BMI were highly significant predictors of initial values and changes in total cholesterol, triglycerides, and HDL cholesterol in serum. Reduction of dietary saturated fatty acid and cholesterol was significantly correlated with initial serum cholesterol levels, which suggest that serum cholesterol screening may be an important motivating factor for dietary change. Important public health and research implications of these findings are discussed. PMID- 2756917 TI - Carnitine status of lactoovovegetarians and strict vegetarian adults and children. AB - Because carnitine is contained primarily in meats and dairy products, vegetarian diets provide a model for assessing the impact of prolonged low carnitine intake on carnitine status. Plasma carnitine concentrations and urinary carnitine excretion were measured in adults and children consuming a strict vegetarian, lactoovovegetarian, or mixed diet. In adults plasma carnitine concentration and urinary carnitine excretion of strict vegetarians and lactoovovegetarians were significantly lower than those in the mixed-diet group but were not different from each other. In children significant differences were found between all three diet groups for both plasma carnitine concentration and urinary carnitine excretion. The differences in plasma carnitine concentrations were greater in children than in adults, possibly reflecting the effects of growth and tissue deposition. Small differences between diet groups in adults do not suggest a nutritionally significant difference in carnitine status. Whether vegetarian children are at greater risk for overt deficiency is not answered. PMID- 2756919 TI - Serum vitamin A and retinol-binding protein in patients with insulin-dependent diabetes mellitus. AB - Serum concentrations of vitamins A and E and retinol-binding protein (RBP) were measured in 25 late adolescent and young adult patients with insulin-dependent diabetes mellitus. Their serum vitamin A levels were significantly lower than those of nondiabetic control subjects of comparable age. The serum concentrations of RBP were also significantly lower in the diabetic patients. The serum levels of vitamin A in the diabetic patients as well as in the control subjects showed a significant linear regression with serum concentrations of RBP. Unlike vitamin A, serum concentrations of vitamin E were not significantly different between the two groups of subjects. These findings suggest that the reduced serum vitamin A levels in the diabetic patients reflect reduced mobilization of vitamin A from the liver. PMID- 2756918 TI - Failure of dietary fat intake to promote fat oxidation: a factor favoring the development of obesity. AB - Seven young men spent three nights and 2 d in a respiration chamber where their rates of energy expenditure and substrate oxidation were continuously measured by indirect calorimetry. During the first 24 h they ingested a mixed maintenance diet containing 35% of calories as fat. An additional amount of 106 +/- 6 g fat/24 h (means +/- SD) was added to this diet during the following 36 h. The fat supplement (987 +/- 55 kcal/d) did not alter 24-h energy expenditure (2783 +/- 232 vs 2820 +/- 284 kcal/d) and failed to promote the use of fat as a metabolic fuel (fat oxidation 1032 +/- 205 vs 1042 +/- 205 kcal/d). The overall energy balance was closely correlated with the fat balance (r = 0.96, p less than 0.001) but not with the carbohydrate balance (r = -0.12, NS). These data indicate that substantial imbalances between intake and oxidation are much more likely for fat than for carbohydrate. PMID- 2756920 TI - Iron metabolism and vitamin A deficiency in children in northeast Thailand. AB - To investigate the association between vitamin A and iron metabolism, two studies were carried out: a cross-sectional study and an intervention trial. The cross sectional analysis was carried out in 1060 children aged 1-8 y. Multiple regression analysis was used to adjust for effects of age, gender, indices of the protein nutritional status, and infections. Retinol was significantly associated with hematocrit, serum Fe, transferrin, ferritin, and saturation of transferrin (%ST). To obtain further evidence as to whether this observed association is a causal one, an intervention trial was carried out. After collection of the baseline data of 300 children, 166 children with a hemoglobin concentration less than 7.5 mmol/L were selected. A random sub-sample of 78 children received vitamin A capsules; the other children served as control subjects. Two months after supplementation significant differences, adjusted for age, were found for retinol, retinol-binding protein, serum Fe, and %ST between the supplemented and the control group. After 4 mo none of the indices were found to be significantly different between the supplemented and the control group. Periodic massive doses of vitamin A may play a role in improving the Fe status as well. PMID- 2756921 TI - Plasma pyridoxal 5'-phosphate concentration and dietary vitamin B-6 intake in free-living, low-income elderly people. AB - Free-living, elderly persons (aged greater than or equal to 60 y, n = 198) were recruited to determine the effects of age, sex, health status, dietary vitamin B 6 intakes, and B-6 supplement use on plasma pyridoxal 5'-phosphate (PLP). Vitamin B-6 intakes were determined from 3-d diet records; supplementation was based on self-reported brand and frequency data. Fasting blood samples were analyzed for PLP. Subjects were primarily low-income Caucasians. There was no linear relationship between dietary vitamin B-6 intake, age, sex or health status, and PLP while accounting for supplemental vitamin B-6 use. PLP, however, was negatively correlated with age (p less than 0.001) in individuals with PLP values between 32 and 90 nmol/L. Vitamin B-6 status was low (PLP less than 32 nmol/L) in 32% of this elderly population (n = 198) and could be attributed to low dietary vitamin B-6 intakes and/or the presence of health problems reported to alter vitamin B-6 status. This research suggests that low vitamin B-6 status is prevalent in low-income, elderly persons, especially those with multiple health problems. PMID- 2756922 TI - Qinghaosu, dietary vitamin E, selenium, and cod-liver oil: effect on the susceptibility of mice to the malarial parasite Plasmodium yoelii. AB - Young female mice were fed torula-yeast-based diets deficient in vitamin E or selenium or supplemented with cod-liver oil to determine the effect of host antioxidant status on the therapeutic efficacy of the Chinese traditional antimalarial drug qinghaosu (QHS), a sesquiterpene endoperoxide. Vitamin E deficiency enhanced the antimalarial action of QHS against Plasmodium yoelii, both in terms of decreased parasitemia and improved survival but Se deficiency did not. A vitamin E-deficient diet containing 5% cod-liver oil had such strong antimalarial activity in itself that no additional therapeutic benefit of QHS could be demonstrated. Hematocrit values in parasitized mice treated with QHS or fed the cod-liver-oil-supplemented, vitamin E-deficient diet were normal. Nutritional manipulation of host antioxidant status may provide a promising prophylactic and/or therapeutic tool for the control of malaria. PMID- 2756923 TI - Aging: effect on hepatic metabolism and transport of folate in the rat. AB - Effects of aging on hepatic folate metabolism and transport were assessed in male Fisher 344 rats. Total serum and hepatic folate levels were measured. Hepatic folates were measured by high-performance liquid chromatography and by Lactobacillus casei assay. Transport of 5-methyltetrahydrofolate (5-CH3-H4PteGlu) was measured in isolated hepatocytes. Serum folate declined with aging; however, neither the total folate level nor the distribution of hepatic folate coenzymes was affected by the aging process. The level of liver folate monoglutamates was not significantly different in any group. The initial rate of uptake of 5-CH3 H4PteGlu was significantly decreased in hepatocytes from the 24-mo-old rats, as was the ability to concentrate this folate from the medium. Aged rats maintain apparently normal levels of hepatic folates despite decreased serum levels and decreased ability to take up folates, suggesting that membrane transport of folates may not be a limiting factor in hepatic folate assimilation. PMID- 2756924 TI - Characterization of retinyl beta-glucuronide in human blood. AB - Retinyl beta-glucuronide has been identified as a normal endogenous component of human blood, as have retinoyl beta-glucuronide and retinoic acid. The mean serum concentration of retinyl beta-glucuronide in adult volunteers (n = 6) was 6.8 +/- 4.0 nmol/L (means +/- SD) with a range from 1 to 11 nmol/L. Purified serum retinyl beta-glucuronide was characterized by the mass spectrum of its methylated trimethylsilyl derivative, by its hydrolysis by beta-glucuronidase, and by its chromatographic behavior in high-performance liquid chromatography systems. During a single day, concentrations of retinyl beta-glucuronide, retinoyl beta glucuronide, and retinoic acid varied approximately two-fold. PMID- 2756925 TI - Vitamin E status of northern Canadian newborns: relation of vitamin E to blood lipids. AB - Vitamin E status was determined in two groups of Canadian newborns: a northern group, mainly aboriginal (Indian and Inuit), and a southern group, mainly nonnative. Serum vitamin E, cholesterol, and triglyceride levels were measured in cord blood and ratios of vitamin E to both cholesterol (E:chol) and cholesterol plus triglyceride (E:chol + TG) were calculated. For the combined groups the mean serum concentration of vitamin E (8.71 +/- 2.45 mumol/L), cholesterol (1.77 +/- 0.46 mmol/L), and triglyceride (0.65 +/- 0.30 mmol/L) as well as the ratios E:chol (5.00 X 10(-3) +/- 1.26 X 10(-3) and E:chol + TG (3.60 X 10(-3) +/- 0.77 X 10(-3) were within normal limits. Significant north-south differences were found only in the mean triglyceride concentration, which was lower (p = 0.03), and E:chol + TG, which was higher (p = 0.002), in the northern than in the southern group. No differences attributable to differences in race were found. Only one infant, an Inuit in the northern group, was found to be deficient in vitamin E. PMID- 2756926 TI - Dose-response relationships regarding vitamin B-6 in elderly people: a nationwide nutritional survey (Dutch Nutritional Surveillance System). AB - The dietary intake and biochemical status of vitamin B-6 in 476 apparently healthy Dutch elderly people (aged 65-79 y), who were not using drugs known to affect vitamin B-6 metabolism, were evaluated. Intake of vitamin B-6 per gram protein was related to biochemical data, namely plasma pyridoxal 5'-phosphate (PLP) and cofactor stimulation of aspartate aminotransferase in erythrocytes (AST AC). Based on a cutoff point of 2.02 for AST-AC, approximately 9% of the elderly people not using vitamin B-6 supplements had a marginal vitamin B-6 status. About 7% were using vitamin B-6 supplements. Dietary intake of vitamin B-6 per gram protein was negatively related to AST-AC. Vitamin B-6 intakes per gram protein higher than 0.020 mg were necessary to ensure an AST-AC value less than 2.02. At high PLP values AST-AC hardly varied. The results seem to indicate a higher requirement of vitamin B-6 in elderly people than in younger adults. PMID- 2756927 TI - Hydrostatic weighing without head submersion in morbidly obese females. AB - This study tests the validity of hydrostatic weighing without head submersion (HWNS) for determining the body density (Db) of morbidly obese (MO) females. Eighty MO females who were able to perform traditional hydrostatic weighing at residual volume (HW) underwent four counterbalanced trials for each procedure (HW and HWNS) to determine Db. Residual volume was determined by oxygen dilution. Twenty subjects were randomly excluded from the experimental group (EG) and assigned to a cross-validation group (CV). Simple linear regression was performed on EG data (n = 60, means = 36.8 y, means % fat = 50.1) to predict Db from HWNS (Db = 0.569563 [Db HWNS] + 0.408621, SEE = 0.0066). Comparison of the predicted and actual Db for CV group yielded r = 0.69, SEE = 0.0066, E statistic = 0.0067, mean difference = 0.0013 kg/L. The SEE and E statistic for body fat were 3.31 and 3.39, respectively. Mean difference for percent fat was 0.66%. Results indicate that HWNS is a valid technique for assessing body composition in MO females. PMID- 2756928 TI - Maintenance energy needs for women as a function of body size and composition. PMID- 2756929 TI - Protein requirements of infants. PMID- 2756930 TI - Protein requirements of infants. PMID- 2756931 TI - Hypercalcemia of malignancy. PMID- 2756932 TI - Comparison of polyclonal and monoclonal antibodies in determination of glomerular deposits of hepatitis B virus antigens in hepatitis B virus-associated glomerulonephritides. AB - The nature of hepatitis B virus (HBV) antigens in HBV-associated glomerulonephritides was investigated in 7 hepatitis B surface antigen (HBsAg) carriers with membranous nephropathy, 16 HBsAg carriers with mesangial IgA nephropathy, and 1 HBsAg carrier with a mixed picture of membranous and IgA nephropathies. Consecutive frozen sections of renal biopsy specimens were stained with polyclonal and monoclonal antibodies against HBV antigens. Glomerular capillary deposits of HBeAg and HBcAg were detected in 66% and 57% of renal biopsies from HBsAg carriers with membranous nephropathy by monoclonal and polyclonal antibodies, respectively. The discrepancy in the immunofluorescence findings resulted from the cross-reactivity of the polyclonal anti-HBcAg antiserum because it contains both anti-HBcAg and anti-HBeAg activities. Mesangial deposits of HBsAg were detected in 40% and 21% of renal biopsies from HBsAg carriers with mesangial IgA nephropathy by polyclonal and monoclonal antibodies, respectively. The authors' study confirms that HBeAg is the predominant HBV antigen deposited in HBV-associated membranous nephropathy, and glomerular HBsAg deposits are detected in some HBsAg carrier with mesangial IgA nephropathy. Careful testing and evaluation of each antibody are necessary to prevent misinterpretation. PMID- 2756933 TI - Detection of messenger RNA in routinely processed tissue sections with biotinylated oligonucleotide probes. AB - In situ hybridization (ISH) with a radioactively 35S-labeled probe and a biotinylated oligonucleotide probe for human calcitonin was used to analyze eight cases of medullary thyroid carcinoma (MTC) in paraffin sections. Three of these cases were also studied with frozen tissue sections. The biotinylated probe readily detected calcitonin messenger RNA (mRNA) in routinely processed formalin fixed paraffin-embedded tissue section within 24 hours. Northern hybridization and other control studies demonstrated the specificity of the calcitonin probe. Biotinylated oligonucleotide probes for other mRNAs present in high abundance such as adrenocorticotroipic hormone (ACTH), prolactin, and growth hormone also detected the respective mRNAs in pituitary tissues. These result show that biotinylated oligonucleotide cDNA probes can be used to detect specific mRNAs present in large amounts in some endocrine cells and tumors by ISH. This approach offers an alternative that does not require the use of molecular cloning or radioactive probes for this investigative and diagnostic technique. PMID- 2756934 TI - 8;21 translocation in acute nonlymphocytic leukemia. Occurrence in M1 and M2 FAB subtypes. AB - Ten patients with acute nonlymphocytic leukemia (ANLL) and the 8;21 chromosome translocation were observed over an eight-year period. The mean age of the patients was 31, and nine achieved a complete remission. Six were classified as ANLL-M2, three as ANLL-M1, and one as borderline M1/M2. A missing sex chromosome was also observed in four of the ANLL-M2 patients but not in the three M1 patients. An increased number of dyspoietic myeloid cells and/or basophils was present in four patients in day 14 or 21 marrows after induction therapy, but this feature did not appear to adversely affect prognosis. Previous reports have stated that t(8;21) occurs almost exclusively in ANLL-M2. However, by revised French-American-British criteria for classification of ANLL, the M1 subtype may also be observed with significant frequency. PMID- 2756935 TI - A new ELISA method for the rapid quantification of Tamm-Horsfall protein in urine. AB - The authors present a simplified enzyme-linked immunosorbent assay (ELISA) technique for the quantitative measurement of urinary Tamm-Horsfall protein (THP). Microtiter plates are coated with THP and urine samples at various dilutions without the need for a capture antibody. The bound glycoprotein is then incubated with a monoclonal anti-THP antibody and an alkaline phosphatase conjugated anti-IgG antibody. The assay was validated and gave reproducible results over a wide range of absorbance values. The sensitivity of the assay for THP was 2-5 micrograms/L, the coefficient of variation between assays 7.5%, and the day-to-day variability 11.1% for THP concentrations between 6.25 and 200 micrograms/L. THP excretion was assayed in five volunteers over five days comparing THP concentration in spot urines and in 24-hour urine collections. PMID- 2756936 TI - A simple, automated functional assay for protein C. AB - Protein C is an important anticoagulant in circulating blood. The balance between the procoagulant and anticoagulant pathways determines whether a patient is at risk for thrombosis or hemorrhage, and low levels of protein C may result in thrombotic disease. It is important for clinical coagulation laboratories to measure protein C. For this purpose, a simple functional assay is needed. This article describes an automated assay for functional protein C with activation by copperhead venom. The authors have automated this assay for a centrifugal analyzer (COBAS Bio) and have proved the specificity of the assay by comparing values obtained amidolytically with those obtained with a radioimmunoassay for protein C. PMID- 2756937 TI - Positive direct antiglobulin test result in dialysis patients resulting from antiformaldehyde antibodies. AB - Patients on chronic hemodialysis who are treated with reusable dialyzers sterilized with formaldehyde are known to have antibodies develop with N-like specificity. These sera have been shown to also react with formaldehyde-treated N negative cells. This latter specificity has been referred to as antiformaldehyde (anti-Form). Because anti-Form develops presumably in response to formaldehyde treated cells that gain access to the patient's circulation, the authors reasoned that recipient anti-Form once established might be capable of binding to cells exposed to formaldehyde during dialysis, resulting in a positive direct antiglobulin test (DAT) result and an eluate reacting only with formaldehyde treated reagent cells. The authors studied 96 patients on chronic hemodialysis who were exposed to formaldehyde-sterilized equipment. Both anti-N-like and anti Form specificities were found. Anti-Form was detected in the serum of 16% of patients when tested against 0.37% (w/v) formaldehyde-treated cells. Nineteen percent of patients demonstrated a positive DAT result. The presence of a positive DAT result was significantly associated with the presence of anti-Form in the patient's serum (P less than 0.05). Red blood cell eluates from two patients with a positive IgG DAT result and serum anti-Form demonstrated anti Form in the eluate. Increasing the concentration of formaldehyde treatment of red blood cells resulted in increasing strength of reactions with anti-Form serum, suggesting that the sensitivity of serum and eluate testing could be modified by the method of cell preparation. As expected, the reactivity of anti-Form with formaldehyde-treated cells could not be neutralized by formaldehyde. The authors conclude that patients treated with formaldehyde-sterilized reusable dialysis equipment may on occasion have a positive DAT result and have an eluate that is nonreactive with the use of standard reagent cells but reactive with formaldehyde treated cells. PMID- 2756938 TI - Detection of hepatitis delta virus in serum and liver tissue by molecular hybridization. Validation of a rapid spot-hybridization technique. AB - Serologic tests for detection of delta hepatitis virus (HDV) antigen and antibody have recently been supplemented with a Northern blot hybridization assay for HDV RNA. However, this technique is cumbersome for analysis of multiple samples. In order to simplify detection of HDV RNA, the authors have tested a spot hybridization method with a new HDV cDNA probe. Their method has proved to be rapid, sensitive, and specific for HDV RNA even when less ultracentrifugation was used for recovering serum RNA. Results for HDV RNA were concordant by both spot and Northern blot hybridization in 12 serum samples from patients with known delta hepatitis, whereas in seven cases spot-hybridization was superior in detecting liver HDV RNA. The concordance between HDV RNA by spot hybridization and delta antigen was complete, whereas that between delta IgM (44% overall) or IgG (67% overall) was less strong. The authors' observations indicate that this new technology permits detection of HDV RNA with relative ease and could be applicable to the evaluation of large numbers of cases with delta hepatitis. PMID- 2756940 TI - Calling Dr. Kenney. PMID- 2756941 TI - Comments on software publication. PMID- 2756939 TI - Cat-scratch disease in a patient with AIDS. AB - A case of cat-scratch disease (CSD) in a patient with acquired immunodeficiency syndrome (AIDS) is reported. The lymph node pathologic characteristics were altered from those usually seen with CSD, showing clusters of vacuolated macrophages admixed with pycnotic nuclear debris instead of the usual suppurative granulomas. Evidence for the diagnosis was provided by Warthin-Starry stain and electron microscopic demonstration of the presumed CSD bacillus. Empiric treatment with antibiotics brought about clinical improvement. This case demonstrates the altered lymph node pathologic characteristics with CSD that may occur in a patient with AIDS. PMID- 2756942 TI - Protection for software authors. PMID- 2756943 TI - Review policy for papers concerning computer software. PMID- 2756944 TI - Computer reports--shareware library? PMID- 2756945 TI - Importance of flow cytometric (CFM) data as prognostic factors. PMID- 2756946 TI - Clinically useful limits (CUL) criteria best based on within-subject biologic variation. PMID- 2756947 TI - Research on predictability in cephalometry of the relationship of chin symphysis and nose-chin balance. AB - A sample of 120 untreated Caucasian adults was selected. All subjects were dental and skeletal Class I. The approach calls for the use of an original cephalometric method that is applied to the cutaneous profile by an esthetic curve extending from the nose to the chin. Statistical study of the sample confirms the existence of this cutaneous profile, regardless of facial type. This approach is proposed in combination with Sassouni's analysis to specify pogonion in the vertical and anteroposterior planes from which the vertical position of the chin (menton) may be deduced. PMID- 2756948 TI - Lingual orthodontics--its renaissance. AB - Lingual treatment has obvious advantages over labial treatment for the patient: no damage to labial or buccal surfaces of the teeth, no labial or buccal gingival hypertrophy or gingivitis, and better visualization of tooth alignment and facial contours. By the same token, lingual treatment has inherent disadvantages over labial treatment. Brackets are attached to very irregular and inconsistent lingual surfaces, which are not the surfaces to be aligned. Furthermore, lingual brackets are cantilevered a substantial distance from the labial surfaces, making the vertical height of the brackets vary with the torque angle of the labial surfaces and also making torquing adjustments affect not only the torque of the labial surfaces but also their heights. These factors make direct placement of preangulated, pretorqued brackets very inaccurate, especially on maxillary anterior teeth; mandibular anterior teeth are not so variable. More accurate indirect bracket placement with predictable and accurate indirect bonding procedures is resolving these disadvantages. It has been shown that a lingual appliance can have the same capacity to align the teeth as a labial appliance. The mere lingual placement of labial brackets, tubes, and arch wires with minor modifications has not proved to be a satisfactory solution. Rather, the designing of a completely new appliance system has been necessary to meet the mechanical requirements inherent in the lingual environment. This engineering challenge has basically been met with the Conceal occlusal-slot lingual system. Undoubtedly, refinements in the appliance system will be made as experience in its use expands ultimately to make lingual treatment as common as labial treatment. PMID- 2756949 TI - Relationships of changes in craniofacial morphology, head posture, and nasopharyngeal airway size following mandibular osteotomy. AB - The aim of the present study was to illustrate a possible relationship between changes in craniofacial morphology after mandibular osteotomy and changes in head posture and nasopharyngeal airway size. The material comprised standardized profile cephalograms of 52 patients with mandibular prognathism, all of whom underwent orthodontic adjustment before mandibular osteotomy. Mean age of the patients was 24.3 years; 12 men and 40 women participated in the study. The first profile radiograph of each patient was taken 1 day before surgical treatment in the natural head (mirror) position. All patients underwent mandibular surgery with a bilateral vertical ramus osteotomy. The cephalometric investigation was repeated approximately 1 year after the surgical procedure (means = 1.12 years). Craniofacial morphology was evaluated by 12 parameters describing sagittal and vertical jaw relationship. Head posture was evaluated by the craniocervical angulation and airway as nasopharyngeal airway size. Pearson's correlation analysis was used to evaluate the relationship between morphology, posture, and airway size before surgery and changes in these parameters after surgery. Before surgical treatment statistically significant correlations were found between posture and many morphologic variables, mostly mandibular. Small correlations were observed between posture and airway size, and airway size and morphology. After the surgical procedure, changes in posture were still related to changes in mandibular morphology, while other correlations between posture and morphology had been eliminated. Changes in nasopharyngeal airway size were not correlated to any changes in morphology, apart from maxillary prognathism, nor to changes in posture. The results indicated that mandibular morphology and function play a significant role in determining head posture. PMID- 2756950 TI - Stereophotogrammetric study of growth and development of the nose. AB - A total of 269 contour maps of the face were measured in three dimensions to study growth and development of the nose. The maps were derived from a mixed longitudinal study of 26 boys and 26 girls between the ages of 9 and 16 years, and were recorded annually. Various nasal parameters were measured to study growth of linear parameters and external nasal volume. Apart from dorsum of the nose between 9 and 11 years of age, all linear parameters were larger for boys by an amount increasing with age. The early growth in girls and late growth in boys suggested the presence of an adolescent growth spurt in the nose, which was confirmed by volumetric measurements. Developmentally the greatest change occurred in anteroposterior prominence of nasal tip in both sexes and the least change occurred in intercanthal width. PMID- 2756951 TI - Vertical dimensional changes of the lips in the North American black patient after four first-premolar extractions. AB - The purpose of this investigation was to evaluate the vertical dimensional changes of the lips in the North American black patient after four first-premolar extractions. A sample of 15 patients treated at the Orthodontic Clinic of Howard University College of Dentistry was selected. Pretreatment and posttreatment lateral cephalograms were traced on acetate tracing paper: landmarks of the skeletal and soft tissues were identified, and angular and linear measurements were made. Changes in the vertical dimensions of the lips used the Frankfort horizontal as a reference plane and changes in the horizontal dimensions of the lips used the pterygoid plane as a reference plane. Statistical significance was tested by means of two-tailed t tests and Pearson's r correlations. Findings indicated that retraction of the maxillary incisors correlated with an increase in upper lip depth, an increase in interlabial vertical dimension, and an increase in the inferomentolabial angle. The increase in interlabial vertical dimension correlated with an increase in the horizontal dimension of the upper lip relative to upper incisor retraction. This increase in interlabial vertical dimension relative to upper incisor retraction differed significantly from the results of the study by Jacobs1 on a sample of white patients treated with four first-premolar extractions. It is necessary to investigate this difference in future studies using larger sample sizes. PMID- 2756952 TI - The use of magnets to move molars distally. AB - Repelling magnets, which were anchored to a modified Nance appliance cemented on the first premolars, were activated against the maxillary first molars to move them distally. Eighty percent of the space created represented distal movement of the first molars. PMID- 2756953 TI - Uprighting of a deeply impacted mandibular second molar. PMID- 2756955 TI - Comments on ABO case report. PMID- 2756954 TI - Legal aspects of orthodontic practice: risk management concepts. Treatment records and the defensible case. PMID- 2756956 TI - Campylobacter pylori gastritis and peptic ulcer in children. PMID- 2756957 TI - Hyperuricosuria and microhematuria in childhood. PMID- 2756958 TI - Updating immunization status at discharge. PMID- 2756959 TI - Prevention of accidental extubations in newborns. PMID- 2756960 TI - Simultaneous transient hyperphosphatasemia in a set of twins. PMID- 2756961 TI - Very-low-birth-weight infants. PMID- 2756962 TI - Lack of associated renal anomalies in familial polythelia. PMID- 2756963 TI - Informed consent and the need for delegalization. PMID- 2756964 TI - Perinatal outcome of infants exposed to cocaine and/or heroin in utero. AB - While cocaine is now used much more frequently than heroin by women of childbearing age, we have found that a significant number of mothers have abused both drugs during their pregnancy. We studied 86 infants who were born to women with a history of cocaine and/or heroin use during pregnancy. The newborns were observed over a 5-day hospital period using a standardized abstinence scoring system and urine drug screening of both mother and infant. Of these, 35 had maternal and/or newborn urine test results that were positive for cocaine only (cocaine group), 14 that were positive for heroin only (heroin group), 17 that were positive for both cocaine and heroin (cocaine/heroin group), and 20 that were negative for both, although the mothers admitted to cocaine use during their pregnancy (cocaine history group). In approximately half of the mother/infant pairs, the results of the urine drug tests were discordant. Microcephaly and growth retardation occurred most frequently in the infants in the cocaine group (17% and 27%, respectively). Microcephaly was also found to be significant in the infants in the cocaine/heroin group. Signs of drug withdrawal occurred in all four drug-exposed groups. Mild withdrawal occurred in 26% of infants in the cocaine group, 21% of the infants in the heroin group, 47% of the infants in the cocaine/heroin group, and in 30% of the infants in the cocaine history group. Withdrawal requiring treatment occurred in 6% of the infants in the cocaine group, 14% of the infants in the heroin group, 35% of infants in the cocaine/heroin group, and 5% of the infants in the cocaine history group. The use of heroin with cocaine has a synergistic effect on the behavior of the newborn. PMID- 2756965 TI - Adolescents and condoms. Associations of beliefs with intentions to use. AB - Sexually active adolescents should use condoms to prevent the transmission of sexually transmitted diseases, including human immunodeficiency virus. This study examined, among male and female adolescents, which beliefs about condoms are associated with intentions to use them if they have coitus in the next year. Teenagers attending adolescent health clinics completed self-administered surveys. Although most adolescents knew that condoms prevent sexually transmitted diseases, an increasing belief in the preventive effects of condoms was not associated with an increased motivation to use them. Instead, other immediate, short-term consequences, such as the ease with which they can be used and discomfort associated with their use, were most strongly associated with adolescents' intentions to use condoms. To encourage condom use, messages from physicians and other health care professionals must focus on adolescents' beliefs that are most likely to encourage or inhibit use of condoms. Health considerations should not be the sole emphasis of such communications if the goal is to increase the use of condoms among sexually active adolescents. PMID- 2756966 TI - A model to determine the feasibility of a pediatric practice. AB - A major concern of urban and rural citizens of the United States is the availability of adequate pediatric health care in their community. Community leaders attempting to recruit health care providers and pediatricians considering locating their practice in a specific community need a method by which they can evaluate a community's potential for supporting a new primary care practice. A detailed survey was conducted in early 1988 of pediatric practices geographically dispersed throughout the state of Oklahoma. Data collected from the physicians and their administrative staff reflected the volume of office and hospital visits and practice costs over the prior 12 months. Using the capital costs and direct operating cost data with information obtained on the number of patient visits and revenue generated collected in this survey, we designed a model to project the economic feasibility of establishing a pediatric practice in a specific community. This model can be used to project the number of annual pediatric primary care visits a community can generate, the direct and indirect costs to establish and maintain a clinic, and the gross revenue and net income of the practice. PMID- 2756967 TI - The pediatric marketplace. AB - This study presents an overview of the demography of office-based pediatricians, trends in the patient population, and the growth of the pediatricians' market share of children seeking primary medical care. The following four factors bear directly on the present and future status of the office-based pediatric practice: (1) size of the office-based pediatrician population, (2) size of the pediatric patient population, (3) the frequency of patient visits, and (4) the pediatric market share. Results indicate that the pediatricians' market share of young children has continued to grow. However, the pediatricians' share of young children has not grown fast enough to offset an increase in the pediatrician population. Continued growth of the pediatric practice may depend on developing effective marketing strategies and providing more primary care to the adolescent population. PMID- 2756968 TI - Head injury training for pediatric residents. PMID- 2756969 TI - Sex steroids do not influence somatic growth in childhood. AB - The influence of sex steroids on somatic growth during childhood was evaluated by reviewing linear growth characteristics of 18 agonadal patients with normal sex chromosomes. None of the heights throughout childhood and before the onset of sex steroid therapy were below 2 SDs of the mean. Based on the normal z scores of these patients, we concluded that somatic growth throughout the childhood and prepubertal years is not sex-steroid dependent. PMID- 2756970 TI - Gastroesophageal reflux-induced hypoxemia in infants with apparent life threatening event(s). AB - To evaluate relationships between gastroesophageal reflux (GER) and the development and onset of apparent life-threatening event(s) (ALTE), 16 infants presenting with ALTE and 6 control subjects manifesting clinical GER alone were studied using prolonged, esophageal pH monitoring in conjunction with simultaneous pulse oximetry and transthoracic impedance pneumocardiography. Despite the absence of a clinical vomiting history in 14 of 16 patients with ALTE, the incidence of GER was similar in both groups (patients with ALTE vs control subjects, 95% vs 100%). Significant arterial oxygen desaturation (less than 90% for greater than 3 minutes) was monitored during 60 episodes in 14 of 16 infants with ALTE, compared with no episodes of reduced arterial oxygen saturation in control subjects. Fifty-four of 60 of these desaturation events commenced within 3.9 +/- 0.4 minutes (mean +/- SD) of onset of a drop in esophageal pH to less than 4.0. Linear regression analysis indicates a significant correlation between duration of esophageal acidification and length of individual hypoxemic episodes (r = .39). Pneumocardiograms were normal in all patients. These data suggest that unsuspected GER is common in infants presenting with ALTE and, in these patients, GER may be directly associated with reflex hypoxemic episodes. Prolonged intraesophageal pH monitoring, performed simultaneously with evaluation for apnea, should be considered in all infants presenting with ALTE. PMID- 2756972 TI - Picture of the month. PMID- 2756971 TI - Radiological case of the month. Esophageal obstruction and abscess formation secondary to impacted, eroding tiddlywink. PMID- 2756973 TI - Effect of pancreatic enzyme supplements on iron absorption. AB - Iron deficiency has been reported in one third of patients with cystic fibrosis. There are data that suggest that iron absorption is increased with exocrine pancreatic deficiency and that administration of pancreatic enzymes may impair oral iron absorption. We compared oral iron absorption over a 3-hour period in the presence and absence of exogenous pancreatic enzymes in 13 stable young-adult patients with cystic fibrosis and 9 age-matched control patients. Although none of the patients with cystic fibrosis had a hemoglobin level less than 119 g/L, serum ferritin levels were less than 25 micrograms/L in 5 of the 13 patients, and the mean corpuscular volume was significantly lower in the patient group (86.1 +/ 2.7 vs 90.9 +/- 5 fL). Baseline mean serum iron levels were higher in controls (18.9 +/- 5.9 mumol/L) than in patients (11.9 +/- 6.3 mumol/L). There was no difference in iron absorption in the absence of exogenous pancreatic enzymes. Significant impairment of iron absorption was detected in both patients with cystic fibrosis and controls after administration of a preparation of pancreatic enzymes. There was an inverse relationship between iron stores, as measured by serum ferritin, and iron absorption. These findings suggest that long-term consumption of pancreatic enzymes by patients with cystic fibrosis may contribute to iron deficiency. PMID- 2756974 TI - Risk of infectious complications in well-appearing children with transient neutropenia. AB - To determine whether well-appearing children found incidentally to be neutropenic are at risk for an infectious complication, 44 consecutive months of hematology laboratory records were reviewed. One hundred nineteen patients had medical record documentation regarding clinical course, serial white blood cell counts, and the absence of serious infections, chronic illnesses, or a family history known to be associated with neutropenia. The median duration of documented neutropenia was 13 days (range, 1 to 491 days). Infectious complications occurred in 4 of the 36 patients who had neutropenia for more than 30 days (2 with stomatitis, 1 with cellulitis, and 1 with pneumonia) but in none with shorter durations of neutropenia. There were no significant associations between the development of an infectious complication and either the initial absolute neutrophil count or the lowest documented absolute neutrophil count, nor was there a correlation between the initial absolute neutrophil count and the duration of neutropenia. These data indicate that infectious complications occur in otherwise well children with unexplained neutropenia that persists, but these infections are infrequent and usually are superficial. PMID- 2756975 TI - Pulmonary hypertension and asthma in two patients with congenital heart disease. AB - Reactive airway disease has only rarely been associated with pulmonary hypertension. We treated two patients with congenital heart disease and asthma who had increased pulmonary arterial pressure at cardiac catheterization. Pulmonary hypertension could not be explained solely by the cardiac lesion, nor by respiratory mechanical factors, as the patients did not have wheezing during the catheterization study. After long-term treatment with bronchodilators, corticosteroids, and oxygen, and coincident with improvement in the airway disease, there was catheterization-proved diminution of pulmonary hypertension. Whether asthma and pulmonary hypertension were causally linked is unknown, but further work seems indicated to elucidate the relationship between bronchoconstriction and pulmonary vasoconstriction. Furthermore, aggressive management of even mild reactive airway disease may be warranted in patients with pulmonary hypertension, regardless of apparent cause. PMID- 2756976 TI - Neonatal hyperbilirubinemia at high altitude. AB - A previous retrospective study showed an increased frequency of neonatal hyperbilirubinemia at high altitude in Colorado. In a prospective study we found that 39% of newborns at 3100 m altitude vs 16% at 1600 m exhibited hyperbilirubinemia, defined as a day 3 serum bilirubin level of 205 mumol/L or higher. Increased bilirubin production at 3100 m vs 1600 m was shown by increased levels of corrected carboxyhemoglobin. This finding was supported by increased erythropoietin and bilirubin values in cord blood and increased hematocrit values at day 3 among infants at 3100 m vs 1600 m. The sustained elevation in bilirubin for breast-fed vs formula-fed infants at 1600 m was observed for both feeding types at 3100 m. The findings suggested that there is a hematologic response to decreased oxygen availability at high altitude, resulting in increased bilirubin production accompanied by delayed bilirubin clearance. PMID- 2756977 TI - Irritable bowel syndrome: I. A practical approach. ACG Committee of FDA-Related Matters. American College of Gastroenterology. AB - An overview of current concepts of the irritable bowel syndrome has been presented. The definition, symptomatology, epidemiology, diagnosis, physical examination, and appropriate evaluation have been discussed. The role of emotional factors as triggering mechanisms has been analyzed. Succeeding papers will deal with clinical and experimental findings related to motor dysfunction in this disorder, nutritional factors related to the irritable syndrome, and a final paper discussing appropriate therapeutic approaches in IBS. PMID- 2756978 TI - Gastrointestinal symptoms in diabetic patients: lack of association with neuropathy. AB - Symptoms suggesting gastrointestinal motor dysfunction were determined in 114 diabetic subjects (type 1 and type 2) to see if they were most significantly related to diabetic neuropathy or to psychiatric illness. Presence of neuropathy was established using peripheral nerve conduction studies and objective tests of autonomic function. Affective and anxiety disorders were determined with a structured interview and standard diagnostic criteria. Symptoms were reported by the subsets of subjects with and without neuropathy, ranging in prevalence from 8% to 35%. Log-linear analysis indicated that each group of symptoms (upper gastrointestinal symptoms, altered bowel habits, and abdominal discomforts) was more significantly associated with psychiatric illness (p less than 0.01 for each) than with peripheral neuropathy (p greater than 0.2 for each). In this study, where anxiety and depression were prevalent, no symptom group was significantly associated with autonomic neuropathy once the effects of psychiatric illness on the analysis were taken into account (p greater than 0.2 for each). These findings suggest that gastrointestinal symptoms occurring in diabetic patients are poorly related to neuropathic complications and may often represent gastrointestinal syndromes commonly associated with psychiatric illness. PMID- 2756979 TI - Abdominal pain in hereditary angioedema: the role of acid hypersecretion. AB - Hereditary angioedema is a familial disorder characterized by recurrent episodes of soft tissue swelling and abdominal pain. Whereas most patients are successfully treated with androgenic steroids, some have abdominal pain unresponsive to therapy. To determine whether acid-peptic disease could account for the abdominal pain unresponsive to androgen therapy, we performed upper gastrointestinal endoscopy and determined basal acid output in 21 consecutive patients with hereditary angioedema and abdominal pain. Mean basal acid output of this group was 6.0 +/- 5.9 mEq/h, with five patients having gastric acid hypersecretion (defined as a basal acid output of greater than 10.0 mEq/h). The abdominal pain in 18 responded to stanozolol, whereas the pain in three patients did not change. Acid-peptic mucosal disease (esophagitis or duodenal ulcer) was present in these three patients with abdominal pain unresponsive to androgen therapy, all of whom had gastric acid hypersecretion (basal acid outputs of 13.7, 19.1, and 21.5 mEq/h, respectively). These three patients were treated with ranitidine but required increased doses to control their gastric acid hypersecretion, and to promote complete relief of abdominal pain and healing of their esophagitis or ulcer disease. These results indicate that there is a subset of patients with hereditary angioedema whose abdominal pain may be secondary to acid-peptic disease and gastric acid hypersecretion. Such individuals may require increased therapeutic doses of antisecretory medication to promote complete healing of esophagitis or ulcer disease. Basal acid output and upper gastrointestinal endoscopy are important determinants when evaluating abdominal pain in patients with hereditary angioedema that fails to respond to standard therapy. PMID- 2756980 TI - Anorectal manometry in active and quiescent ulcerative colitis. AB - Anorectal function was measured in 11 patients with active medically intractable ulcerative colitis, seven patients with quiescent ulcerative colitis, and 18 healthy subjects. The anal resting pressure, squeeze pressure, and ability to defecate a balloon were similar in all groups. Significantly lower rectal distention volumes were required for rectal sensation, critical volume, and to induce rectal contractility in patients with active disease compared to controls or patients with quiescent disease. Rectal compliance was significantly reduced in patients with active and quiescent disease. The increased rectal sensitivity and contractility in patients with active colitis appear to be related to active mucosal inflammation and ulceration. Episodes of mucosal inflammation may be responsible for chronic changes in the rectal wall resulting in fibrosis and decreased compliance in patients with quiescent disease. The frequency and urgency of defecation and the fecal incontinence may be due to a hypersensitive, hyperactive, and poorly compliant rectum. PMID- 2756981 TI - Large colorectal polyps: colonoscopy, pathology, and management. AB - Between 1984 and 1987, we reviewed all large (greater than or equal to 3.0 cm) colorectal polyps to determine the efficacy of colonoscopic polypectomy from both an oncologic and technical viewpoint. Forty-eight polyps greater than or equal to 3.0 cm were identified in 46 patients. Twenty polyps were entirely benign, 20 polyps contained noninvasive carcinoma, and invasive carcinoma was present in eight polyps. Four of the invasive cancers were associated with residual adenoma; the remaining four were polypoid carcinomas. Among the eight cases of invasive carcinoma, four had tumors that did not extend through the submucosa. Invasive cancer was more prevalent in left-side sessile lesions but was absent in all 10 right-sided polyps. Thirty-two polyps were removed by colonoscopic polypectomy. Four patients required colectomy after polypectomy for the following reasons: incomplete excision (N = 1), presence of invasive carcinoma at the resection margin (N = 1), and inability to define the level of carcinoma on pathologic examination (N = 2). Two polyps with cancer confined to the submucosa were successfully excised colonoscopically. Complications of polypectomy included three cases of minor hemorrhage. Sixteen polyps (the majority located in the right colon) were removed by primary surgical colectomy. We conclude that colonoscopic polypectomy is oncologically and technically successful for most large colorectal polyps. A minority of large polyps require colectomy because of incomplete removal or the presence of invasive cancer that is not curable with colonoscopic excision. PMID- 2756982 TI - Subtotal duodenopancreatectomy for pancreatic duct, distal bile duct and periampullary carcinoma: short- and long-term results. AB - Ninety patients with pancreatic duct, distal bile duct, and ampullary carcinoma underwent pancreatic resection. Following a standard policy of resection based on surgical findings, all the patients who had resection first underwent subtotal extended pancreatectomy (n = 68) and if they were considered not to fulfill the criteria for this operation, total pancreatectomy (n = 22). Thus, 68 of the 90 patients (72%) were managed with subtotal pancreatic resection irrespective whether they had ampullary, pancreatic duct, or distal common bile duct carcinoma. On the basis of our results, subtotal duodenopancreatectomy is regarded as the method of choice for many patients with pancreatic duct, distal bile duct, or ampullary carcinoma. PMID- 2756983 TI - Emptying of the intrathoracic stomach with and without pyloroplasty. AB - By radioisotope technique, we studied the emptying function of the vagotomized intrathoracic stomach after esophagectomy for carcinoma of the esophagus in 24 patients, and compared it with the preoperative emptying function. The patients were randomized into a control group (no pyloroplasty) and a study group (pyloroplasty). Gastric emptying was delayed in both groups, postoperatively; however, the delay was greater in the control group than in the study group. Therefore, vagotomy delays the emptying of the thoracic stomach, and this delay is not completely corrected by pyloroplasty. PMID- 2756984 TI - An experience with polyethylene balloons for pneumatic dilation in achalasia. AB - The Rigiflex achalasia dilator system was used to treat consecutively 24 patients with achalasia. The 30-mm balloon achieved a 70% satisfactory result, and the 35 mm balloon, 93%, including two patients who did not achieve a good response to the smaller balloon. No complications occurred. Dilation pressure, which averaged only 7 +/- 2 (SD) lb/inch2 (psi), was determined by insufflating 1-2 psi more than needed for complete gastroesophageal waist expansion at fluoroscopy. The mean lower esophageal sphincter pressure (LESP) of 39 +/- 11 (SD) mm decreased by 68% with the 35-mm balloon and 60% with the 30-mm. Solid food emptying by radionuclide scintiscan, which pretreatment averaged 62 +/- 36% (mean +/- SD) retention at 20 min, was highly variable both before and in response to dilation. A decrease in scintigraphy of less than 25% retention was present in two of three unsatisfactory treatment responses. A decrease of LESP of greater than 50% and scintigraphy greater than 25% corresponded well with a satisfactory response from the dilation. The excellent results obtained with this system, as well as the distinct advantages of durability, presence of three reliable sizes, and ease of use, make this an attractive alternative to other dilating systems in the treatment of achalasia. PMID- 2756985 TI - Lower esophageal sphincter dysfunction in diffuse esophageal spasm. AB - Although lower esophageal sphincter (LES) dysfunction has been reported in patients with diffuse esophageal spasm, recent changes in manometric criteria for spasm and for LES relaxation suggested a need for reassessment. Moreover, LES relaxation in reflux-associated spasm has not been reported previously. On clinical criteria and independent of manometric findings, 22 patients with spasm were assigned to either idiopathic (I-DES, N = 9) or reflux-associated spasm (R DES, N = 13) groups. Patients who underwent manometry for chest pain (C-NL, N = 10) or reflux (R-NL, N = 10) and had normal peristalsis served as control groups. Percent LES relaxation was significantly reduced in both spasm groups, and R-DES had significantly lower percent relaxation than I-DES. Post-deglutitive nadir sphincter pressure was significantly greater in R-DES than in I-DES. Duration of relaxation was normal in I-DES, but was significantly decreased in R-DES. This study indicates that 1) LES relaxation may be impaired in I-DES patients meeting current criteria for spasm, 2) the impairment in I-DES is primarily in "amplitude" of relaxation, i.e., percent relaxation and nadir pressure, but not duration, 3) LES relaxation may also be impaired in R-DES, and 4) the impairment in R-DES is to a greater degree than in I-DES patients and may be seen in both "amplitude" and duration of relaxation. This study shows that there is a spectrum of sphincter dysfunction in patients with esophageal spasm. It also suggests that there may be separate mechanisms for LES relaxation in R-DES patients, one with impaired relaxation and the other with near complete relaxation, "transient" or otherwise, to allow for reflux. PMID- 2756986 TI - The effect of alpha-interferon on the liver in a patient with hairy cell leukemia: light and electron microscopic studies. AB - A daily dose of 3 x 10(6) or 6 x 10(6) units of alpha-interferon was given during two 4- to 6-month periods to a 65-yr-old male patient with hairy cell leukemia, reducing splenomegaly and decreasing the number of hairy cells. Liver biopsy specimens taken during treatment revealed predominantly decreased hairy cell infiltration in the dilated sinusoids and enlarged or vacuolar nuclei of hepatocytes, compared with those in the liver before treatment. The ultrastructure of hepatocytes in specimens taken during treatment showed cytoplasmic vacuoles, weakly stained glycogen particles, and conspicuously decreased endoplasmic reticulum. Liver tests revealed decreased serum cholinesterase and total cholesterol levels in the early stage of treatment, low levels of total protein and albumin during treatment, and a very low value in the [13C]aminopyrine breath test. No clinical reports have been made on the decreased microsomal function during treatment with interferon. alpha-Interferon damaged the endoplasmic reticulum of hepatocytes, although it was effective for the reduction of hairy cells in the liver of hairy cell leukemia. PMID- 2756987 TI - Carcinoid tumors of the gallbladder with adenocarcinomatous differentiation: a morphologic and immunohistochemical study. AB - Two patients with gallbladder carcinoid tumors with adenocarcinomatous differentiation were examined. In both cases, the tumor contained argyrophilic granules and alcian blue-positive mucin. One contained argentaffin granules and the other showed PAS-positive mucin. Numerous membrane-bound electron-dense neurosecretory granules were demonstrated by ultrastructural study. Immunohistochemistry applied for the tumors clarified the epithelial, hormonal, and metaplastic character. Epithelial tumor markers, i.e., carcinoembryonic antigen (CEA) and epithelial membrane antigen (EMA), were positive in these tumors. The neuroendocrine nature was demonstrated by positive results of chromogranin A and neuron-specific enolase (NSE). Hormonal activities were not confirmed in the tumor cells. These results suggested that carcinoid tumors in the gallbladder have a multidirectional differentiation represented by a morphological continuum ranging from carcinoid to adenocarcinoma. PMID- 2756988 TI - Metronidazole-induced pancreatitis. AB - We present a case of a 22-yr-old female who developed acute pancreatitis coincident with metronidazole therapy, with documented recurrence when inadvertently rechallenged on two separate occasions. These episodes were unrelated to alcohol ingestion, gallbladder disease, or other known causes of pancreatitis. Only one other case of metronidazole-induced pancreatitis was found in the English literature. Known toxicities of metronidazole are discussed, as well as potential mechanisms by which metronidazole may have induced pancreatitis in our patient. Since metronidazole is used to treat a host of infectious and inflammatory conditions, its causal relationship with pancreatitis must be carefully considered. We suggest that metronidazole be discontinued when clinical or biochemical features of acute pancreatitis occur, once other known causes of pancreatitis have been excluded. PMID- 2756989 TI - Pancreatitis in the annulus of annular pancreas demonstrated by the combined use of computed tomography and endoscopic retrograde cholangiopancreatography. AB - Annular pancreas, an uncommon condition, is often hard to diagnose before operation. We report a case of annular pancreas with pancreatitis of the annulus that was diagnosed by the use of computed tomography followed by endoscopic retrograde cholangiopancreatography. An upper gastrointestinal series and duodenoscopy revealed stenosis of the second portion of the duodenum. Computed tomography revealed enlargement of the annulus of the pancreas. Two years later, follow-up computed tomography demonstrated calcifications of the annulus, although the remaining pancreas seemed to be normal. PMID- 2756990 TI - Systemic anaphylaxis during rectal manometry with a latex balloon. PMID- 2756991 TI - The association of fecal impaction and verapamil in a patient with scleroderma. PMID- 2756992 TI - Duodenoscopic sphincterotomy in patients with gallbladders in situ. PMID- 2756993 TI - Tales of the ampulla of Vater, III. PMID- 2756995 TI - Spontaneous bacterial peritonitis associated with ascites due to malignant lymphoma. PMID- 2756994 TI - Jejunal angiodysplasia presenting as intestinal perforation. PMID- 2756996 TI - Eosinophilic gastroenteritis associated with fissured mouth. PMID- 2756997 TI - Carcinoma of the stomach in a 24-year-old pregnant woman. PMID- 2756998 TI - Glucose polymer solution for diarrhea in ileostomates. PMID- 2756999 TI - Impaired erythrocyte NAD synthesis: a metabolic abnormality in thalassemia. AB - We have recently demonstrated that phosphoribosylpyrophosphate (PRPP) synthetase activity is decreased in RBC from individuals with thalassemia minor. Because NAD biosynthesis requires PRPP, the product of the PRPP synthetase reaction, we have investigated NAD synthesis in thalassemic RBC. NAD synthesis was measured in intact RBC both by following the accumulation of unlabeled NAD and by following the incorporation of 14C-nicotinic acid into NAD. Using both assay systems, we demonstrate that NAD synthesis is decreased significantly in thalassemic RBC compared to either normal or high reticulocyte red cells. Although this suggested that NAD content should be decreased in thalassemic RBC, no significant difference in NAD content was found among thalassemic, normal, or high reticulocyte red cells. Mechanisms for the lack of a significant decrease in NAD content in thalassemic RBC are discussed. These results indicate that NAD synthesis is impaired in thalassemic RBC possibly as a result of their decrease in PRPP synthetase activity. Our data provide evidence that thalassemic RBC have secondary metabolic abnormalities in addition to their primary defect in hemoglobin synthesis. PMID- 2757000 TI - Changes in hemostatic and fibrinolytic proteins in patients receiving L asparaginase therapy. AB - Hemostatic changes were evaluated in ten patients with acute lymphoblastic leukemia and lymphoma who received chemotherapy with L-asparaginase, vincristine, and prednisolone for 1 week. Following treatment, prothrombin time and activated partial thromboplastin time were significantly prolonged, while a marked decrease in fibrinogen levels was observed. The values for cross-linked fibrin degradation products, however, remained within normal limits during treatment, which excluded the possibility of disseminated intravascular coagulation. The concentrations of coagulation inhibitors (antithrombin III, protein C, and protein S), plasminogen, and alpha 2 antiplasmin also significantly decreased; however, levels of both tissue-type plasminogen activator and plasminogen activator inhibitor, which are synthesized in endothelial cells, increased during the treatment. Although a decrease was observed in concentrations of many coagulation factors, including subunits A and B of factor XIII, the activity and antigenicity of factor VII significantly increased following the treatment. From this study, we concluded that these hemostatic abnormalities caused by the administration of L asparaginase produced a labile condition that easily inclines to bleeding or thrombosis. PMID- 2757001 TI - Hb Warsaw (beta 42 Phe----Val): an unstable hemoglobin with decreased oxygen affinity. I. Hematologic and clinical expression. AB - Four members in two generations of a Polish-American family exhibited findings of congenital Heinz-body hemolytic anemia accompanied by cyanosis. Two of the affected family members have also developed severe pulmonary hypertension, with a fatal outcome in one of them. Blood from the affected individuals showed decreased oxygen affinity and contained elevated levels of methemoglobin. An unstable hemoglobin fraction underwent rapid precipitation following exposure of the red cell lysates to isopropyl alcohol or heat. This hemoglobin contained a newly identified abnormal beta chain with an amino acid substitution at the same position as that of Hb Hammersmith and Hb Bucuresti-Louisville. PMID- 2757002 TI - Flow cytometric evidence for minimal residual disease and cytological heterogeneities in acute lymphoblastic leukemia with severe hypodiploidy. AB - Two subpopulations of small and large leukemia cells and binucleated cells were present in the bone marrow of a 10-year-old girl with acute lymphoblastic leukemia (ALL). Cytogenetic studies showed some cells with a karyotype of 34,X, X,-2,-3,-4,-5,-7,-9,-13,-15,-16,-17,-20, and others with a karyotype that was exactly double the chromosome set in the cells with 34 chromosomes. Flow cytometric (FCM) examination of surface common ALL antigen (CALLA) and DNA content of the lymphoblasts led to the identification of the primary hypodiploid DNA stemline (DI = 0.72), which corresponds to the small-sized blasts, and the secondary hyperdiploid DNA stemline (DI = 1.44), which corresponds to the large sized blasts. Sequential bone marrow examinations with FCM and cytogenetics revealed the persistence of the primary hypodiploid clone during remission and their proliferation with chromosomal evolution at full relapse. These results suggest that more rational inductive therapy should be designed to achieve the favorable outcome of ALL with severe hypodiploidy and that FCM is a useful tool to monitor the minimal residual disease of this subgroup in ALL. PMID- 2757003 TI - Adult T-cell leukemia initially manifesting as facial diplegia. AB - We report an unusual case of adult T-cell leukemia (ATL) initially manifesting as facial palsy due to ATL meningitis, which was caused by lymphoid cells in the cerebrospinal fluid (CSF) with a different phenotype from those in the blood. A DNA southern blot analysis of the blood cells confirmed the diagnosis of ATL. The aberrant cells in the CSF contained nuclei with simple indentations and responded well to the initial chemotherapy, while leukemic cells in the blood showed lobulated or convoluted nuclei and were resistant to treatment. Flow cytometry performed before treatment demonstrated that the majority of the cells in the CSF were CD3+CD4+CD8-CD25+, consistent with ATL, whereas they expressed the CD45R antigen, which the blood ATL cells did not. These differences in the subphenotype, cell morphology, and responsiveness to treatment among the ATL cells in blood and CSF suggest that a single clone or subclone with heterogeneous nature was not generated, before the final development of ATL. PMID- 2757004 TI - Polymerase chain reaction amplification applied to the determination of beta-like globin gene cluster haplotypes. AB - We report here on the application of the polymerase chain reaction (PCR) technique for the determination of the beta-like gene cluster haplotypes. Seven fragments containing each one of the following polymorphic sites--Xmnl 5' to the G gamma gene, HindIII in the IVSII of G gamma and A gamma gene, HincII 3' and inside the gamma gene, Hinfl 5' of the beta gene, and HpaI 3' of the beta gene- are amplified using the PCR technique. Each amplified fragment is subsequently digested with the appropriate enzyme, analyzed by electrophoresis on agarose gel containing ethidium bromide, and visualized under ultraviolet light. This technique has the advantages of rapidity, safety, and cost-effectiveness. PMID- 2757005 TI - Idiopathic myelofibrosis terminating in erythroleukemia. AB - A 55-year-old woman with a one-year history of idiopathic myelofibrosis progressed to erythroleukemia. This is the first reported occurrence of erythroleukemia progression from idiopathic myelofibrosis. Certain patterns of leukemia transformation from myeloproliferative disorders are favored: Myeloblastic or myelomonocytic. The rare incidence of erythroblastic transformation is discussed. PMID- 2757006 TI - Bone marrow examination in pediatric patients. PMID- 2757007 TI - Effect of hydroxyurea on the rheological properties of sickle erythrocytes in vivo. AB - We have monitored the rheological effects of hydroxyurea (HU) on erythrocytes obtained from two patients with severe sickle cell anemia who were enrolled in a therapeutic trial of this drug. Erythrocyte membrane stability and whole cell and membrane deformability of red cells from treated and untreated patients and normal controls were determined in room air using an ektacytometer--a laser viscodiffractometer. The percentage of dense cells was quantitated by centrifugation on a discontinuous Stractan density gradient. F reticulocytes (FR), absolute F reticulocytes (AFR), and F cells (FC) were determined by single cell radial immunolgic assays. After 1 year of treatment with HU, there was a significant increase in the level of hemoglobin (Hb) F, FR, AFR, and FC. The degree of anemia remained the same, but there was significant increase in the mean cell volume (MCV) and a significant decrease in the mean corpuscular Hb concentration (MCHC). Whole cell deformability improved by twofold, but membrane stability remained within normal limits. The hydration status of sickle erythrocytes improved as was indicated by a change toward normal in gradient osmotic ektacytometry, an increase in RBC K+ content, a decrease in percent of dense cells, and a decrease in the MCHC. The data indicate that, in addition to its effect on the production of Hb, F, HU has a salutary effect on whole cell deformability and on the hydration status of sickle erythrocytes. Determination of the rheological properties of erythrocytes may be of value in monitoring the response to HU. PMID- 2757008 TI - Hemoglobin Athens-Georgia [alpha 2 beta 2 40(C6)Arg----Lys] in association with beta 0-thalassemia in Tunisia. AB - We describe an Hb Athens-Georgia (Hb A-Ga)/beta 0-thalassemia compound heterozygosity, found in a Tunisian patient. Oxygen binding studies of red cell suspensions of this patient, containing approximately 95% Hb A-Ga, revealed an almost normal oxygen affinity. Nevertheless, dilute solutions of Hb A-Ga showed an increased overall oxygen affinity and decreased heme-heme interaction. This could be explained by a tetrameric hemoglobin with normal oxygen binding properties but with increased dissociation into monomers or dimers, as a consequence of a structural abnormality within the alpha 1 beta 2 interface. Such an interpretation would explain the increased oxygen affinity reported in previous studies performed on heterozygous Hb A/Hb A-Ga patients. PMID- 2757009 TI - Ferrokinetic study of splenic erythropoiesis: relationships among clinical diagnosis, myelofibrosis, splenomegaly, and extramedullary erythropoiesis. AB - Splenic erythropoiesis was demonstrated by surface counting of 59Fe in 129 of 1,350 ferrokinetic studies performed over a 15 year period. These 129 studies were carried out in 108 patients, including 40 with chronic myelogenous leukemia (CML), 24 with agnogenic myeloid metaplasia (AMM), 18 with polycythemia vera (PV), six with a myelodysplastic syndrome, five with acute leukemia, three with prostate or breast carcinoma, two each with aplastic anemia or Hodgkin's disease, and one each with idiopathic thrombocythemia, multiple myeloma, chronic renal failure, or treated hypopituitarism. Splenomegaly was present in 83% of the studies and hepatomegaly in 72%. Grade II-III myelofibrosis was demonstrated in 62% of the cases. Hepatic erythropoiesis was present in 77% of the studies (only 38% in PV), and marrow erythropoiesis was undetectable in 33%. Total erythropoiesis was about twice normal (range 0.2 to 8 times normal) but was ineffective to varying degrees in 86% of the studies. Relationships between organomegaly, myelofibrosis, and extramedullary erythropoiesis, as well as differences among clinical disorders, are discussed. Differences observed between CML in chronic or blastic phase suggested that the erythroid cell line was involved in the proliferative process. It is concluded that splenic erythropoiesis 1) is encountered in a variety of clinical conditions; 2) is not necessarily associated with splenomegaly or myelofibrosis, even in the myeloproliferative disorders; 3) is part of a predominantly extramedullary (in the liver as well as in the spleen), expanded, and largely inefficient total erythropoiesis; and 4) can be evaluated in a semiquantitative manner by surface counting. PMID- 2757010 TI - Hodgkin disease in a patient with common variable immunodeficiency. AB - Extensive extralymphatic Hodgkin disease developed in a young man with common variable immunodeficiency manifested by hypogammaglobulinemia, recurrent sinopulmonary infections, and multiple autoimmune phenomena. Both humoral and cell-mediated immune dysfunction were present prior to treatment. After two cycles of chemotherapy, irreversible shock developed, and death occurred secondary to overwhelming infection in spite of prophylactic gammaglobulin replacement. The unusual features of this patient's case of extralymphatic Hodgkin disease in association with a primary immunodeficiency disorder have not been previously reported. PMID- 2757011 TI - Leukostasis: a phenomenon of prolymphocytic leukemia. AB - We are reporting a case of a patient with prolymphoctic leukemia complicated by fatal leukostasis. Multiple leukemic thrombi and leukoaggregates were demonstrated on postmortem examination in both the brain and lungs. This represents the first report pathologically documenting leukostasis in a chronic lymphoid malignancy. PMID- 2757012 TI - Bone marrow aplasia associated with proliferation of large granular lymphocytes and subsequent transformation to acute lymphoblastic leukemia. AB - Proliferation of large granular lymphocytes may be associated with neutropenia and, less frequently, thrombocytopenia. In this report, we describe a patient with severe aplastic anemia in the setting of a proliferation of cells with natural killer (NK) phenotype. We demonstrated evolution to acute lymphoblastic leukemia by cells of identical phenotype. PMID- 2757013 TI - Ovarian relapse in a young woman with acute lymphoblastic leukemia. PMID- 2757014 TI - Lymphoproliferative diseases and idiopathic myelofibrosis. PMID- 2757015 TI - Angiocentric immunoproliferative lesions. PMID- 2757016 TI - Platelet survival in patients with beta-thalassemia. AB - Thromboembolic events associated with significant morbidity and mortality have been observed in patients with beta-thalassemia major (TM). These include arterial as well as venous thrombosis and the development of early arteriosclerosis. To elucidate the possibility that TM patients may develop a hypercoagulable state we carried out a study of platelet kinetics on ten patients with TM and four patients with thalassemia intermedia (TI). Autologous platelets were labeled with indium-111-oxine, and the platelet lifespan (PLS) was determined. A significant shortening of PLS was observed in 13 out of 14 patients examined. The mean PLS (+/- 1 SD) in ten patients (8 TM, 2 TI) who underwent splenectomy was 107 +/- 36 hr (control splenectomized 248 + 51 hr) (P less than .001) and in four nonsplenectomized patients (2 TM, 2 TI) was 102 +/- 64 hr (control 224 + 23 hr) (P less than .01). The short PLS in addition to reported findings of increased circulating platelet aggregates and the decreased response of TM platelets to aggregating agents suggests in vivo platelet activation in thalassemic patients. PMID- 2757017 TI - Acinetobacter peritonitis during chronic peritoneal dialysis. AB - Among gram-negative bacilli isolated during peritonitis in chronic peritoneal dialysis (CPD), Pseudomonas species are most common but Acinetobacter species are nearly as frequent. A survey of more than 450 patient-years' experience with CPD revealed 23 episodes of Acinetobacter peritonitis (AP), making this the second most common form of gram-negative peritonitis. Concomitant break in sterile technique and exit-site/tunnel infection were infrequent. AP appeared as the first peritonitis episode in five cases and as the second in six cases, and the duration of CPD at the time of AP ranged from less than 1 to greater than 56 months. However, AP was noted to appear shortly after treatment of another peritonitis episode or shortly after CPD access placement, within 2 months in 11 cases (47%) and within 3 months in 14 cases (61%). Treatment with intraperitoneal antibiotics succeeded in 21 cases (91%) without CPD interruption or catheter removal, with tobramycin or gentamicin alone in 16 cases, and with combined aminoglycoside and penicillin or cephalosporin in six cases. In two cases intraperitoneal antibiotics alone were insufficient therapy: one case with concomitant tunnel infection and dialysate leak and one case with bacteremia while receiving corticosteroids. The time-dependent incidence of AP suggests opportunistic infection during a vulnerable period in the first 2 to 3 months following another peritonitis episode, but AP also appears amenable to intraperitoneal antibiotic therapy alone without interruption of the CPD routine in the majority of cases. PMID- 2757018 TI - Deferoxamine test and bone disease in dialysis patients with mild aluminum accumulation. AB - Aluminum bone disease is a frequent complication of dialysis patients. The deferoxamine (DFO) test has been advocated as a noninvasive procedure for the diagnosis of AI bone lesion. However most of these studies have been performed in symptomatic patients with significant AI bone disease. Whether this test may provide similar data at an earlier stage of AI toxicity is not known. The present study evaluates prospectively 28 patients with mild AI load. Patients studied ranged in age from 21 to 65 years; duration of dialysis was 5.6 +/- 3.2 years; deferoxamine, 40 mg/kg body weight, was infused at the end of dialysis. Serum AI was measured before DFO administration and before the next dialysis treatment. Bone biopsies were performed in all patients. Cortical bone AI was determined biochemically; trabecular and cortical bone AI were also determined histochemically. Mean basal serum AI (43.2 +/- 30.8 micrograms/L) and cortical bone AI (25.7 +/- 35.2 micrograms/g) were moderately increased. Basal serum AI correlated (r = 0.77) with the increment in serum AI after DFO infusion. After DFO, stainable trabecular and cortical bone AI correlated in a similar manner with both basal serum AI and increment in serum AI. Only biochemically determined cortical bone AI was not significantly related to basal serum AI. Nineteen of the 28 patients had evidence of osteitis fibrosa on bone biopsy. Stained AI surfaces but not trabecular AI were different in patients with low and patients with high bone formation rates. The bone findings, assessed as bone formation rates and resorption surfaces, did not correlate with biochemically or histochemically determined bone AI.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2757019 TI - Superimposed glomerular immune complexes in anti-glomerular basement membrane disease. AB - The association of anti-glomerular basement membrane (GBM) antibody-mediated glomerulonephritis and glomerular immune complexes is common and probably arises from a number of mechanisms. In the series, glomerular immune complexes were identified in 6 of 17 patients who initially presented with anti-GBM disease. In four cases, glomerular immune complexes were noted in renal biopsies obtained at clinical presentation; in the other two, they were first demonstrated seven and 28 months after presentation, when circulating anti-GBM antibody levels were undetectable. Circulating immune complexes were detected in only two of six patients, either 28 months before or 17 months after the demonstration of the glomerular membranous lesion. The association of glomerular immune complexes and anti-GBM disease may be coincidental with immunologically-unrelated immune complexes localizing in the GBM for physico-chemical reasons; or the presence of glomerular-bound anti-GBM antibodies may predispose to the deposition of molecules with particular affinity for these antibodies. One patient with glomerular immune complexes used heroin, which may be associated with immune complex formation and the development of glomerulonephritis; and one patient was subsequently thought to have systemic lupus erythematosus (SLE). An antecedent infection was found in two of the four patients who had glomerular complexes at presentation, but in only three of 13 with uncomplicated anti-GBM disease. Three of 6 patients with superimposed glomerular complexes had a history of exposure to organic solvents before the onset of disease, while none in the group with anti GBM disease alone had. PMID- 2757020 TI - Peritoneal dialysis-associated tuberculous peritonitis in an intravenous drug user with acquired immunodeficiency syndrome. AB - A rare case of tuberculous peritonitis in a continuous ambulatory peritoneal dialysis (CAPD) patient who has multiple risk factors for extrapulmonary disease due to Mycobacterium tuberculosis is presented. This patient' acute course was atypical with a predominance of neutrophils and low levels of protein in the peritoneal fluid. Obtaining the diagnosis of tuberculous peritonitis by acid-fast smear was also unusual, probably facilitated by centrifugation of large amounts of fluid. The patient was successfully treated without catheter removal. Tuberculosis should be considered in patients with culture-negative CAPD peritonitis. PMID- 2757021 TI - Hyperkalemia suppresses the renal adaptation to chronic respiratory acidosis. PMID- 2757022 TI - Peritonitis secondary to dialysis tubing contamination among patients undergoing continuous ambulatory peritoneal dialysis. AB - Patients were asked to report all dialysis system contaminations occurring from December 1985 through May 1988 to the home training facility. There were 74 instances of peritoneal dialysis system contamination, 20 of which resulted in peritonitis. Prophylactic antibiotics were used in 48 of 54 episodes not resulting in peritonitis. Three cultures yielded gram-positive organisms without clinical peritonitis becoming evident. Fourteen of the 20 episodes of peritonitis had received antibiotics prophylactically. System contaminations were classified into tears or holes of the catheter at the adapter on the Tenckhoff catheter or at the tubing connection to the dialysate bag and breaks of the connecting devices from either dialysis catheter to dialysis tubing or dialysis tubing to dialysate bag. System contaminations accounted for 20 of the 333 episodes of peritonitis that occurred during this time. Identifying system contamination is useful because prophylactic antibiotic therapy may prevent peritonitis. PMID- 2757023 TI - The effect of interdialytic interval on protein metabolism: evidence suggesting dialysis-induced catabolism. AB - While examining protein metabolism in hemodialysis patients, we noted that lengthening the interdialytic intervals from two to three days reduced the dialysate nitrogen waste excretion (D-N2; mg/min) and lowered the patient's protein catabolic rate (PCR; g/kg/d). D-N2 was measured in the spent dialysate and PCR derived from urea kinetics while patients maintained a constant dietary intake. In the basal state (B), D-N2 decreased from 5.43 to 4.32 mg/min when the interdialytic interval was increased from two to three days (P less than 0.001). Similarly, PCR was reduced from 0.96 to 0.82 g/kg/d when the interdialytic period was extended. The same phenomenon was observed when subjects were taking either thyroid hormone (T3) or ipodate (lp) to increase or decrease body metabolism. In the T3 period, D-N2 was 6.12 and 5.06 mg/min and PCR was 1.08 and 0.92 g/kg/d, respectively, when the interdialytic intervals were two and three days (P less than 0.001). During the lp period, N-D2 was 4.78 and 4.03 mg/min and PCR was 0.88 and 0.76 g/kg/d, respectively, for the two- and three-day intervals (P less than 0.05). These data are consistent with dialysis-related protein catabolism. It appears that the longer interdialytic interval allowed the body to shift to a more anabolic state. PMID- 2757024 TI - Recombinant human erythropoietin therapy: an overall approach to the anemia of chronic renal failure. Proceedings of symposia. December 11-13, 1988, San Antonio, Texas. PMID- 2757025 TI - Improvements in quality of life following treatment with r-HuEPO in anemic hemodialysis patients. AB - The quality of life was assessed in 37 maintenance hemodialysis patients during treatment with recombinant human erythropoietin (r-HuEPO; EPOGEN [epoetin alfa], AMGEN Inc, Thousand Oaks, CA) for correction of anemia. All patients experienced an increase in hematocrit level. The mean hematocrit level in the study population was 19.8% before therapy and 31.5% after therapy. Eighty-four percent of patients reported an increase in their sense of well-being. Better appetite was subjectively noted by 81% of patients. Improvements in sexual function (62%), socializing (70%), sleep (68%), and skin color (51%) were also noted. An increase in exercise capacity was reported by 78% of patients; objective measurements showed that the mean value of VO2max in a subgroup of 11 patients increased by 50% after treatment. The Karnofsky score calculated in 29 patients showed improvement in all patients except those aged greater than 70 years. The group mean Karnofsky score increased from 76 before to 86.6 after therapy, indicating that with r-HuEPO treatment subjects were able to exert themselves to perform ordinary activities. Before therapy 14 of the patients were unemployed; after therapy only two did not work. Those side effects that occurred, predominantly iron deficiencies, hypertension, and hyperkalemia, were controlled by appropriate clinical management. Treatment with r-HuEPO does improve the quality of life and ability to work of uremic patients and does not adversely affect their transplant potential. PMID- 2757026 TI - Iron management during recombinant human erythropoietin therapy. AB - Treatment with recombinant human erythropoietin (r-HuEPO; EPOGEN [epoetin alfa], AMGEN Inc, Thousand Oaks, CA) rapidly corrects the anemia associated with end stage renal disease during the acute phase of therapy and supports hematocrit levels throughout the maintenance phase. However, during the acute phase of therapy, iron deficiency will develop in most patients; it is therefore initially essential to monitor body iron stores monthly. A plasma ferritin level of less than 30 ng/mL or a transferrin saturation level of less than 20% confirms the diagnosis of iron deficiency. Microcytic, hypochromic red cell morphology appears only after prolonged iron deficiency due to inadequate monitoring and insufficient iron supplementation; alternatively, microcytosis in the presence of adequate iron stores suggests aluminum toxicity. In all patients except those with transfusional iron overload, prophylactic supplementation with ferrous sulfate (325 mg up to three times daily) is recommended. When oral supplements, which are poorly tolerated at high doses, are insufficient to meet the extraordinary needs resulting from r-HuEPO-induced erythropoiesis, intravenous iron dextran (500 to 1,000 mg administered in five to ten doses) may be required. During the maintenance phase of therapy, it may be necessary to continue iron supplementation to counteract ongoing loss of iron associated with blood loss through dialyzers and gastrointestinal bleeding. At the other extreme of iron balance, iron overload in transfusion-dependent patients, recent studies suggest that the ability of r-HuEPO to mobilize iron stores can be harnessed with therapeutic phlebotomy to reverse transfusional iron overload. PMID- 2757027 TI - Of mice, persons, and pigment. PMID- 2757028 TI - Genetic heterogeneity in Leber hereditary optic neuroretinopathy revealed by mitochondrial DNA polymorphism. AB - The presence or absence of a recently observed mitochondrial DNA (mtDNA) mutation associated with Leber hereditary optic neuroretinopathy (LHON) was tested in 19 Finnish families with cases of LHON. Leukocyte and muscle DNA from individuals with optic atrophy, microangiopathy, or normal fundi from maternal lineages were studied by Southern blot analysis, using mouse mtDNA as a hybridization probe. The mtDNA mutation, detected as SfaNI site polymorphism, was seen in 10 of the 19 families. In one family, the mutation was seen only in the two affected individuals, indicating recent origin for the mutation. Nine families and 28 maternally unrelated controls did not show the mutation. The results imply that alternative mtDNA mutations are associated with LHON and that this genetic heterogeneity may be the cause of the interfamilial variation in the clinical expression of LHON. In the families showing the SfaNI site mutation, the mutation was homoplasmic in all individuals irrespective of their disease status, suggesting that the intrafamilial variation in the clinical expression is not due to different ratios of mutant versus normal mtDNA. PMID- 2757029 TI - Analyzing the relationship between age at onset and risk to relatives. AB - Correlations in age at onset between relatives affect risk to relatives of a given age. Either an increase or a decrease in risk may be observed for a relative of a proband, according to whether there is a causal relationship between liability to disease and age at onset. Likelihood formulas are given for pairs of relatives under a number of different sampling schemes, and it is shown how data collected from relatives enable maximum-likelihood estimation of parameters of a linear model relating disease liability and age at onset. A genotype-environment extension of this model was fitted to data on age at onset for schizophrenia that were obtained from the National Academy of Sciences National Research Council Twin Registry. Age at onset is correlated between twins, but this correlation appears to be associated with factors that are separate from those which affect liability to disease. However, even this relatively large sample of twins is too small to draw firm conclusions about any causal relationship between disease liability and onset. PMID- 2757030 TI - Cardiovascular risk factors in a French-Canadian population: resolution of genetic and familial environmental effects on blood pressure by using extensive information on environmental correlates. AB - Genetic and environmental influences on systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean arterial blood pressure (MBP) were examined in 371 French-Canadian families by using path analysis. Familial environment was estimated with environmental indices constructed from as many as 14 (of a pool of more than 100) correlates of blood pressure (BP). Approximately 20% of the variance in BP can be accounted for by the composite index, and the types of variables and the direction of their effects vary as a function of age and of the multivariate context. Path analysis of the family data suggests that genetic heritability is relatively high in children (from 0.49 for SBP to 0.56 for MBP) but much smaller in adults (from 0.08 for DBP to 0.18 for SBP). The proportion of variability explained by familial environment is estimated to be the same in children and adults and is much higher than reported to date (from 0.30 for SBP to 0.42 for DBP). In addition, sibships share significant nontransmitted environmental effects, and there is no evidence to suggest specific maternal effects in the aggregation of BP. Two unique findings emerge from this study. First, unlike in most earlier studies, we were able to arrive at the same parsimonious model for each of the BP variables. Second, the familial environment accounts for a substantial proportion of the variability in BP, which has been considerably underestimated in earlier studies. PMID- 2757031 TI - Genetic analysis of HLA in the U.S. Schmiedenleut Hutterites. AB - The Hutterites are an Anabaptist population, highly inbred, with large family sizes and extensively documented pedigrees. As part of genetic-epidemiologic studies of the impact of HLA on fertility, HLA-A, -B, -C, -DR, and -DQ typing was performed on a total of 650 Schmiedenleut Hutterities in South Dakota. An extraordinary degree of homogeneity was found. HLA-A1, -A2, -A3, -A24, and -A26 accounted for 83%, HLA-B8, -B27, -B35, -B51, -Bw60, and -Bw62 for 75%, and HLA DR1, -DR2, -DR3, and -DR4 for 66% of the antigens at the respective HLA-A, -B, and -DR loci. All Hutterites characterized for HLA were descendants of no more than 78 ancestors. However, family analysis identified only 45 unique HLA haplotypes thought to reflect the original gene pool. Eight haplotypes were particularly frequent, accounting for nearly 50% of all observed haplotypes; four of these were consistent with a European ancestry. Coefficients measuring linkage disequilibrium were computed from haplotypes identified by family analysis. Overall, HLA analysis portrayed the Schmiedenleut Hutterities as a homogeneous and unique population, with disequilibrium among particular alleles and a spectrum of common and uncommon European haplotypes. PMID- 2757034 TI - Glasnost and Perestroika in human genetics. PMID- 2757032 TI - Assignment of human genes for phosphorylase kinase subunits alpha (PHKA) to Xq12 q13 and beta (PHKB) to 16q12-q13. AB - Phosphorylase kinase (PHK), the enzyme that activates glycogen phosphorylases in muscle, liver, and other tissues, is composed of four different subunits. Recently isolated rabbit muscle cDNAs for the larger two subunits, alpha and beta, have been used to map the location of their cognate sequences on human chromosomes. Southern blot analysis of rodent x human somatic cell hybrid panels, as well as in situ chromosomal hybridization, have provided evidence of single sites for both genes. The alpha subunit gene (PHKA) is located on the proximal long arm of the X chromosome in region Xq12-q13 near the locus for phosphoglycerate kinase (PGK1). X-linked mutations leading to PHK deficiency, known to exist in humans and mice, are likely to involve this locus. This hypothesis is consistent with the proximity of the Phk and Pgk-1 loci on the mouse X chromosome. In contrast, the beta subunit gene (PHKB) was found to be autosomal and was mapped to chromosome 16, region q12-q13 on the proximal long arm. Several different autosomally inherited forms of PHK deficiency for which the PHKB could be a candidate gene have been described in humans and rats. PMID- 2757035 TI - Funding and marketing of an investigational drug service. PMID- 2757036 TI - Involving quality review nurses in pharmacy-based drug-use evaluation program. PMID- 2757033 TI - Genomic organization of the human asparagine transfer RNA genes: localization to the U1 RNA gene and class I pseudogene repeat units. AB - Previously isolated human DNA clones containing asparagine transfer RNA (tRNAAsn) genes have been used to determine the genomic organization of this multigene family in man. One clone also contained a gene for U1 RNA, and so the organization of the two multigene families could be directly compared. The majority, and perhaps all, of the human tRNAAsn genes map to the same chromosome bands as do the U1 RNA true genes and class I pseudogenes located on the short and long arms, respectively, of chromosome 1. These two gene clusters were independently isolated using a somatic-cell hybrid minipanel, and use of repeat unit DNA polymorphisms showed that one tRNA gene clone maps to the short-arm gene cluster and the other to the long-arm gene cluster. Electron microscopy of heteroduplexes between these two clones showed duplex formation along the proposed region of overlap between them, indicating that the short- and long-arm gene clusters are structurally related. I suggest that the split into two distinct loci was facilitated by a pericentric chromosome inversion. This would have had the effect of positioning the genes currently on the long arm adjacent to the centromeric heterochromatin, perhaps resulting in a "position effect" on transcription of these genes. Restriction fragments of different sizes were found that were common to a majority of repeat units, depending on the restriction enzyme being used. Pulsed-field electrophoresis revealed that fragments of molecular weight of 180 kb were common to each unit (or multiples of units). These fragments also contained U1 RNA gene sequences. I therefore propose that these two gene families are closely linked on repeat units (or multiples of units) of 180 kb in size, which are probably organized in tandem arrays. PMID- 2757037 TI - Proper instruction for preparing and ingesting suspensions of K-Dur tablets in water. PMID- 2757038 TI - Concern about study design and statistical analyses in recent AJHP paper. PMID- 2757039 TI - Mifepristone commentary ignores abortion controversy. PMID- 2757040 TI - Dear Dr. Gans. PMID- 2757041 TI - Pharmacist-managed drug therapy in California hospitals. AB - To assess the effect of state legislation expanding the scope of pharmacy practice in health-care institutions, California hospitals were surveyed in 1982 and 1986 about pharmacists' regulation of drug therapy. Questionnaires were mailed to pharmacy directors at all hospitals in the state. The survey form explained that in pharmacist-regulated drug therapy, the pharmacist, under order or authorization of the prescriber, requests laboratory tests and initiates or adjusts drug dosage to obtain the desired therapeutic response; the questions were based on this definition. The response rates were 51.4% (292 of 568) in 1982 and 56.2% (329 of 585) in 1986. For the responding hospitals of most sizes and types, the percentage having pharmacist regulation of drug therapy increased; the largest increase was in the for-profit chain hospitals. In 1986, pharmacists were involved in regulating maintenance dosages in more than half of the responding hospitals (from 52% of hospitals with 50 or fewer beds to 86% of hospitals with 400-499 beds). The responses indicated that at least 50% of patients receiving aminoglycoside or warfarin therapy or total parenteral nutrition had their maintenance dosages regulated by pharmacists. The two surveys indicate that between 1982 and 1986 pharmacists became more involved in regulating drug therapy in California hospitals. PMID- 2757042 TI - Investigational drug practices in Michigan hospitals. AB - All 188 acute-care hospitals in Michigan with licensed pharmacies were surveyed to assess compliance with recommendations of ASHP, FDA, and the Joint Commission on Accreditation of Healthcare Organizations related to investigational drug use; other practice issues related to investigational drugs but not covered in those guidelines were also studied. Pharmacy directors were questioned about their practices for approving, prescribing, procuring, storing, and labeling investigational drugs; preparation, content, and use of investigational drug data sheets; record keeping; personnel issues; and other investigational drug services provided by the pharmacy department. The response rate was 84.5% (159 completed questionnaires returned), but only 44 respondents (27.7%) indicated that investigational drugs were currently used in their institutions. Written investigational drug policies and procedures were available in 116 (73.0%) of the responding pharmacy departments. Respondents currently handling investigational drugs had high rates of adherence for the following practice guidelines: preparation of data sheets (75.0%), storage (97.7%), monitoring of investigational drug use and stock levels (79.5%), and maintaining perpetual inventories (79.5%). Areas with relatively poor adherence rates included pharmacy department preparation of investigational drug patient-information sheets (20.5%), maintaining information within the pharmacy on minimum stock levels (53.9%), mode of shipment (30.8%), time to receive investigational drugs after order placed (38.5%), acceptance of nursing transcriptions of oral orders (56.8%), including "investigational drug" on the dispensing label (55.8%), and approval of data sheets by the investigator and the institutional review board (40.5% and 37.8%, respectively). Pharmacy departments, regardless of hospital size, should improve their adherence to ASHP, FDA, and Joint Commission guidelines for handling investigational drugs. PMID- 2757043 TI - Streamlining antimicrobial therapy through pharmacists' review of order sheets. AB - The impact of a pharmacy-conducted intervention program designed to contain costs by "streamlining" antimicrobial therapy is described. Streamlining of antimicrobial therapy may involve simplifying routes of administration, decreasing the dose or frequency of antimicrobial administration, or converting from multiple-agent therapy to single-agent therapy. Beginning on December 1, 1987, pharmacists at this university-affiliated teaching hospital used the antimicrobial order sheet (AOS) filled out by all prescribers of anti-infective agents to identify orders that were potential candidates for streamlining. Interventions involved a discussion between the pharmacist and prescriber in which the pharmacist specified the reasoning behind the recommended change. For each recommendation that was accepted by the prescriber, the cost savings per day was determined by subtracting the daily cost of the recommended streamlined therapy from the daily cost of the original "problem" therapy. Data collection continued until May 1, 1988. During that five-month period, 162 out of 173 pharmacist-initiated streamlining recommendations were accepted by prescribers, resulting in a total cost savings of $19,864. The average cost savings per intervention was $122.62. The most frequent intervention involved decreasing the frequency of i.v. administration, decreasing the dose, or both. The intervention that resulted in the greatest average cost savings involved simplifying the route of administration or discontinuing antimicrobial therapy entirely. The projected annual cost savings of this program is $47,700. By using information from AOSs to identify problem antimicrobial orders, pharmacists were able to recommend streamlining of antimicrobial therapies that resulted in an average cost savings of about $122 per intervention. PMID- 2757044 TI - Effects of bar coding on a pharmacy stock replenishment system. AB - A bar-code stock ordering system installed in the ambulatory-care pharmacy and sterile products area of a hospital pharmacy was compared with a manual paper system to quantify overall time demands and determine the error rate associated with each system. The bar-code system was implemented in the ambulatory-care pharmacy in November 1987 and in the sterile products area in January 1988. It consists of a Trakker 9440 transaction manager with a digital scanner; labels are printed with a dot matrix printer. Electronic scanning of bar-code labels and entry of the amount required using the key-pad on the transaction manager replaced use of a preprinted form for ordering items. With the bar-code system, ordering information is transferred electronically via cable to the pharmacy inventory computer; with the manual system, this information was input by a stockroom technician. To compare the systems, the work of technicians in the ambulatory-care pharmacy and sterile products area was evaluated before and after implementation of the bar-code system. The time requirements for information gathering and data transfer were recorded by direct observation; the prevalence of errors under each system was determined by comparing unprocessed ordering information with the corresponding computer-generated "pick lists" (itemized lists including the amount of each product ordered). Time consumed in extra trips to the stockroom to replace out-of-stock items was self-reported. Significantly less time was required to order stock and transfer data to the pharmacy inventory computer with the bar-code system than with the manual system.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2757045 TI - Appropriateness of metronidazole use in a teaching hospital. AB - The appropriateness of metronidazole use at a teaching hospital was determined by a retrospective audit. All orders for metronidazole received by the hospital pharmacy from December 26, 1986, to May 15, 1987, were identified, and the charts of the patients involved were reviewed to determine whether the drug's use was appropriate or inappropriate according to pre-established guidelines for indication, dose, dosage interval, and duration of therapy or prophylaxis. The oral route of administration was considered appropriate for patients who were taking other oral medications or who were on a diet of at least clear fluids. The acquisition cost of metronidazole from January to June 1987 was used to determine the potential cost avoidance that would result if (1) all types of inappropriate use were corrected, or (2) only the inappropriate route of administration were corrected. A total of 104 courses of therapy in 98 patients were evaluated, of which 76 were therapeutic and 28 were prophylactic. Of the 104 courses, 62% were found to be inappropriate by at least one of the criteria for appropriate use, excluding route of administration. Of the 893 doses of metronidazole administered by the i.v. route, 424 (47%) could have been given orally. A drug cost analysis revealed that $3954 (48% of the total hospital expenditure for metronidazole) could have been saved by substituting oral metronidazole for i.v. metronidazole when possible. If all criteria for appropriate use of metronidazole had been followed, $5977 could have been saved, which represents 71% of the current hospital expenditure for metronidazole.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2757046 TI - Justification and implementation of a cancer center pharmacy satellite. AB - The justification, establishment, and evaluation of a full-service cancer center pharmacy satellite for a university hospital are described. Providing efficient and effective pharmaceutical services was difficult because (1) the cancer center is housed in a freestanding building adjacent to the hospital and (2) there are special considerations inherent in the ordering and preparation of antineoplastic medications. Data collected and presented by the pharmacy, along with letters of support from nursing and medical staff, provided justification of the need to establish an oncology satellite pharmacy. The satellite, open 8.0 hours per day Monday through Friday, is primarily responsible for preparing antineoplastic agents and dispensing first doses of other intravenous and oral medications for the cancer center. Satellite staffing consists of 1.2 full-time-equivalent (FTE) pharmacists and 2.0 FTE technicians. A technician works in the satellite the same number of hours as the pharmacist but is also available to prepare antineoplastic drugs in the central pharmacy on weekends. Pharmacist activities also include providing drug and dosing information to the medical and nursing staff, as well as handling investigational drugs. The satellite pharmacy has decreased medication turnaround time by one-half and has improved pharmaceutical services to the nursing staff. PMID- 2757047 TI - Pharmacists' attitudes toward and use of cardiopulmonary resuscitation training received in pharmacy school. AB - Recent graduates of a pharmacy school were surveyed to determine their attitudes toward and use of cardiopulmonary resuscitation (CPR) and basic life support (BLS) training received as part of their pharmacy school instruction. Questionnaires were mailed to 215 pharmacists who had completed the mandatory CPR BLS training; only those who had practiced pharmacy for at least 6 of the previous 12 months were asked to respond. Usable questionnaires were received from 187 of the pharmacists surveyed. Of the respondents, 134 (72%) believed that the CPR-BLS program should continue to be mandatory for graduation; 131 (70%) believed their training to be of value in their current practices, and 174 (93%) believed it would be of value in the future. Nine (5%) of the pharmacists had actually performed CPR since their graduation. Pharmacists practicing in small and large hospitals were more likely to participate in CPR than pharmacists in medium-sized hospitals, and such participation was associated with the presence of decentralized and clinical pharmacy services. Recent pharmacy graduates who had received mandatory CPR-BLS training in school had positive attitudes about the value of this training in their professional practices. PMID- 2757048 TI - Stability of cisplatin and etoposide in intravenous admixtures. AB - The stability of various concentrations of etoposide and cisplatin in intravenous admixtures under various storage conditions was studied. Admixtures containing etoposide (200 and 400 micrograms/mL) with cisplatin (200 micrograms/mL) were prepared in 0.9% sodium chloride injection and in 5% dextrose and 0.45% sodium chloride injection. The admixtures were stored in either polyvinyl chloride bags or glass bottles. Mannitol and potassium chloride were added to selected admixtures. Half of the admixtures were protected from light, while the other half were exposed to fluorescent light. All admixtures were stored at room temperature. Samples were visually inspected and assayed for etoposide and cisplatin content by high-performance liquid chromatography within 15 minutes after admixture preparation and after 8, 24, and 48 hours of storage. Etoposide and cisplatin concentrations decreased less than 10% from the initial concentration after eight hours of storage. At 24 hours, the admixtures containing etoposide 400 micrograms/mL and cisplatin 200 micrograms/mL (with additives) in 0.9% sodium chloride injection precipitated. The decrease in etoposide concentrations during the first 24 hours in the rest of the admixtures was less than 10% of the initial concentration. The change in etoposide concentration was related to the type of i.v. solution and the presence of additives. After 24 hours, the change in cisplatin concentrations was less than 10% of the initial concentration, except in the admixtures that precipitated. For cisplatin, the presence of light was related to an increased loss of cisplatin concentration.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2757049 TI - Stability of morphine sulfate in portable pump reservoirs during storage and simulated administration. AB - The stability of four concentrations of morphine sulfate injection in prefilled reservoirs for portable infusion pumps was studied after storage for 30 days at refrigerated and room temperature and after a three-day simulated administration period at body temperature. Thirty-milliliter samples of morphine sulfate injections in four concentrations--1, 5, 15, and 25 mg/mL--were loaded into a pump reservoir. The reservoirs were stored in the dark at 5 degrees C and 25 degrees C for 30 days. Samples were taken from each reservoir immediately after loading and after 7, 14, and 30 days of storage. The reservoirs were then connected to portable infusion pumps, which were run for three days at a flow rate of 0.4 mL/hr at 37 degrees C. The last sample was collected at the end of the three-day period. Samples were assayed for morphine sulfate content by high performance liquid chromatography. The concentration of morphine sulfate increased up to 6% (for the 5-mg/mL sample) at refrigerated temperature and up to 16% (for the 15-mg/mL sample) at room temperature after 30 days' storage in the reservoirs. Evaporation of water from the reservoirs may have accounted for this phenomenon. No absolute relationship was found between the initial concentration of morphine sulfate and the percentage concentration increase after storage for 30 days. The change in morphine sulfate concentration before and after the three day pumping period was not significant. Injectable solutions of morphine sulfate in concentrations ranging from 1 to 25 mg/mL are stable when stored at refrigerated temperature for 30 days in a prefilled drug reservoir. PMID- 2757051 TI - Final report of the ASHP Task Force on Technical Personnel in Pharmacy. PMID- 2757052 TI - Trying to see the doctor: an American nightmare. PMID- 2757050 TI - Pharmacist's refusal to dispense diethylstilbestrol for contraceptive use. PMID- 2757053 TI - Evaluating health-care needs of the poor: a community-oriented approach. AB - PURPOSE: Concern has arisen over the provision of health care for the poor. In a project sponsored by a local community hospital, we conducted a telephone survey to determine unmet health-care needs of low-income families living in Orange County, California, and made recommendations to address those needs. METHODS: The survey assessed demographic characteristics and access to medical care of 652 adults and their families. RESULTS: In general, we found that the poor (incomes below 125% of the poverty level), the uninsured, and the Latino respondents had lower access measures than the nearly poor (incomes between 125% and 200% of the poverty level), insured, and Anglo subjects. However, insurance status was the strongest predictor of access in this low-income population. Important unmet health-care needs included prenatal care and preventive care. In response to our findings, the sponsoring hospital has instituted new health-care programs to help meet these needs. CONCLUSION: This community-oriented approach for improving problems of access to medical care for the poor may be appropriate for other localities. PMID- 2757054 TI - Effect of long-term normalization of serum complement levels on the course of lupus nephritis. AB - PURPOSE: We compared the long-term outcome of patients with lupus nephritis in whom normalization of complement levels (CH50) was sustained by adjustment of immunosuppressive therapy to those patients with persistently low complement levels despite similar immunosuppression in whom therapy was adjusted solely on the basis of clinical disease activity. PATIENTS AND METHODS: Thirty-nine female patients with lupus nephritis recruited from 1972 to 1979 were prospectively studied (mean follow-up, 116.7 +/- 11 months). Entry criteria included initial renal biopsy, low CH50, and elevated anti-DNA antibody levels. A second biopsy was performed in 24 patients after an interval of 40.6 +/- 5 months. Treatment was started with prednisone (1 mg/kg/day). Azathioprine at a dose of 1.5 to 2.0 mg/kg/day was added if complement was not normalized by prednisone alone. Twenty five of 39 patients had normal complement levels within six months (Group 1), and immunosuppressive therapy was tapered but continuously readjusted to the lowest dosage that preserved normal CH50 and maintained clinical remission. Eight of these 25 patients subsequently became persistently hypocomplementemic due to inadequate drug intake (Group 1B), whereas the complement levels continued to be controlled in the other 17 patients (Group 1A). Despite similar therapy, the remaining 14 patients did not achieve normalization of complement within the initial six months of therapy, and therefore future treatment decisions were based solely on clinical symptoms (Group 2). Renal pathologic lesions were classified according to World Health Organization criteria and a semi quantitative chronicity index. RESULTS: During the first six months, there were no significant differences in clinical or histologic features between patients in whom complement levels were controlled and patients in whom complement levels were not controlled. After a mean observation period of 10 years, however, patients with consistent normalization of complement (Group 1A) did much better than patients with only short-term complement control (Group 1B) or persistent hypocomplementemia (Group 2). Both groups with low complement levels had a similar outcome with significantly worse kidney and patient survival. Life-table analysis demonstrated that the differences in outcome between complement controlled and complement-uncontrolled groups became apparent only after five or more years of follow-up. Patients with a low chronicity score on initial biopsy whose complement level was controlled did uniformly well with no renal failure or death. (ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2757055 TI - Bleeding in outpatients treated with warfarin: relation to the prothrombin time and important remediable lesions. AB - PURPOSE: To determine the relation of bleeding to prothrombin times and important remediable lesions in outpatients treated with warfarin. PATIENTS AND METHODS: An inception cohort of 565 patients starting outpatient therapy with warfarin on discharge from a university hospital was assembled. Detailed records of outpatient prothrombin times were obtained for 103 of 130 case subjects with major or minor bleeding and for 117 control patients without bleeding. A nested case-control design was used to evaluate the association of bleeding with temporally related prothrombin times; odds ratios were estimated using multivariate logistic regression analysis to control for known predictors of major bleeding. The relation of bleeding to important remediable lesions was determined in all 130 cases of bleeding. RESULTS: For each 1.0 increase in the prothrombin time-to-control ratio, the odds ratio for major bleeding during the week after a prothrombin time measurement increased 80%; the odds ratio for minor bleeding increased 50%. These odds ratios were lower during the first month of therapy and higher thereafter. Bleeding was related to important remediable lesions in 49 of 130 cases (38%), but these lesions were unknown before bleeding in only 22 cases (17%). The mean prothrombin time rose sharply at the time of bleeding in patients without important remediable lesions, but not in patients with lesions. New, previously unknown lesions (including nine malignancies) were discovered in 20 of 59 case subjects (34%) with gastrointestinal bleeding or hematuria, but in only two of 71 case subjects (3%) with other bleeding (p less than 0.001). CONCLUSION: Our results provide a valid quantitative basis for estimating the odds of bleeding in relation to the prothrombin time and the yield of diagnostic evaluation in patients with bleeding. PMID- 2757056 TI - Noninvasive assessment of cardiomyopathy in normotensive diabetic patients between 20 and 50 years old. AB - PURPOSE: To further the understanding of diabetic heart disease, we tested the hypothesis that an asymptomatic group of normotensive diabetic patients between 20 and 50 years old had a restrictive cardiomyopathy independent of clinically significant coronary artery disease. PATIENTS AND METHODS: Quantitative two dimensional echocardiography and stress myocardial perfusion scintigraphy were performed to detect and characterize the cardiac abnormalities in this study group comprising 88 patients with rigorously classified diabetes and 65 volunteer control subjects. RESULTS: Diabetic patients were shown to have a mildly reduced left ventricular end-diastolic volume index: 50.1 +/- 8.2 and 52.1 +/- 14.7 mL/m2 for patients with type I and type II diabetes, respectively, versus 58.9 +/- 11.7 mL/m2 for control subjects. The left ventricular diastolic filling was also impaired in diabetic patients as reflected by a lower atrial emptying index: 0.73 +/- 0.24 and 0.76 +/- 0.3 for type I and type II diabetics, respectively, compared with 1.14 +/- 0.24 for control subjects. Exercise tolerance was normal in subjects with type I diabetes and slightly reduced in subjects with type II diabetes. Only one patient developed regional ischemia on thallium exercise testing. CONCLUSION: Using a comprehensive, noninvasive approach, we have shown that asymptomatic normotensive patients with type I or type II diabetes who were between 20 and 50 years old had a restrictive cardiomyopathy characterized by mildly reduced left ventricular end-diastolic volume and altered left ventricular compliance independent of critical coronary artery disease. PMID- 2757057 TI - Refractoriness to chemotherapy and poor survival related to abnormalities of chromosomes 17 and 7 in lymphoma. AB - PURPOSE: Lymphoma cells usually show cytogenetic abnormalities, but their relationship to prognosis has not been as extensively studied as in leukemia. A group of previously untreated cases of lymphoma with evaluable metaphases was examined for the association between cytogenetic abnormalities and clinical outcome. PATIENTS AND METHODS: The study consisted of 104 patients, from whom fresh tumor samples were obtained for cytogenetic tests. Because of the complexity of lymphoma karyotypes, the cases were divided into four patterns according to the type of abnormality of chromosome 17 or 7 present. Treatment of patients was given based on histologic grade and stage of disease. Response to treatment was evaluated according to previously described methods. RESULTS: Patients with true abnormalities of chromosome 17 or 7 (defined as those with either structural abnormalities of the short arm of these chromosomes or monosomy of these chromosomes with no associated unidentified markers) were observed to have an adverse prognosis. The overall response rate and tumor-related mortality were less favorable for patients with these cytogenetic abnormalities. By applying multivariate analysis, we found that this observation was independent of the effect of serum lactic dehydrogenase level, histologic grade, or tumor burden. CONCLUSION: True abnormalities of chromosome 17 or 7 in patients with lymphoma are associated with a poor response to chemotherapy, short time to treatment failure, and high tumor-related mortality rate. These findings raise the question of the potential involvement of some gene or oncogene, perhaps the p53 oncogene, which might impart a survival advantage to the malignant cells. PMID- 2757058 TI - New-onset seizures associated with human immunodeficiency virus infection: causation and clinical features in 100 cases. AB - PURPOSE: We attempt to define the significance and most common causes of new onset seizures in patients with human immunodeficiency virus (HIV) infection. In addition, we review the seizure type, neurologic examination, and other clinical features to better address diagnostic and management issues in these patients. PATIENTS AND METHODS: We reviewed 100 cases of new-onset seizures in HIV-infected patients who underwent complete evaluations at the University of California, San Francisco, hospitals. RESULTS: Seizures were the presenting symptom of HIV related illness in 18 patients, six of whom developed no other HIV-related illness until at least four months after the first seizure. Common causes in the 100 patients included mass lesions, HIV encephalopathy, and meningitis. No cause for the seizures was found in 23 patients despite a complete evaluation. An underlying cause was found in all patients with focal neurologic deficits but in only two of 24 who had normal results on an interictal neurologic examination. Focal ictal features were not predictive of cause. A cause was found in all 12 patients with status epilepticus or medically refractory seizures. A total of 12 of the 87 (14%) patients who received phenytoin developed a hypersensitivity reaction. Despite the brevity of follow-up in some patients, many patients, including those with no definable cause, had multiple seizures prior to the administration of anticonvulsants. CONCLUSION: The direct effects of HIV on the brain may be the single most common cause of seizures in this population. We favor treatment of a single seizure in patients with HIV infection. PMID- 2757059 TI - Characteristics of non-insulin-dependent diabetic patients with secondary failure to oral antidiabetic therapy. AB - PURPOSE: Secondary failure to treatment with oral antidiabetic agents frequently occurs in patients with non-insulin-dependent diabetes mellitus. In the search for causes of such failures, we examined patient- and disease-related factors in nonresponders and in responders to treatment with oral antidiabetic agents. PATIENTS AND METHODS: The study population consisted of three groups: (1) 34 nonresponders to treatment with sulfonylureas; (2) 25 patients who still responded to treatment with sulfonylureas; and (3) 10 age-matched healthy control subjects. In addition to patient-related factors such as adherence to diet and knowledge of diabetes, we examined insulin response to a test meal and hepatic and peripheral insulin sensitivity during a euglycemic insulin clamp in combination with indirect calorimetry and infusion of [3H-3-]glucose. RESULTS: Patient-related factors such as daily nutrient intake, activity score, knowledge of diabetes, and "stress level" were similar in both groups. However, nonresponders had a higher rate of basal hepatic glucose production (4.60 +/- 0.14 versus 3.63 +/- 0.26 mg/minute/kg of lean body weight; p less than 0.001), which was less suppressed by euglycemic hyperinsulinemia (about 100 microU/mL) than was that of the responders (p less than 0.001). In addition, total insulin stimulated glucose metabolism was reduced (5.07 +/- 0.22 versus 7.09 +/- 0.56 mg/kg.LBM.minute; p less than 0.001), and this was mainly accounted for by a reduction in non-oxidative glucose metabolism (glycogen synthesis and anaerobic glycolysis) (1.78 +/- 0.22 versus 3.54 +/- 0.49 mg/kg.LBM.minute; p less than 0.001). The severity of hepatic and peripheral insulin resistance correlated with the plasma glucose concentration but was unrelated to insulin secretion. In a multiple linear regression analysis, glucose overproduction in the liver (26.1%), impaired peripheral glucose metabolism (17.3%), and insulin deficiency (12.6%) could explain only 56% of the causes of secondary drug failure. CONCLUSION: Secondary failure to treatment with oral hypoglycemic agents is determined by the disease itself rather than by patient-related factors. Treatment of secondary drug failure should therefore aim at ameliorating both hepatic and peripheral insulin resistance. PMID- 2757060 TI - Persistence of neurosyphilis despite multiple treatment regimens. PMID- 2757061 TI - Murine typhus acquired during short-term urban travel. PMID- 2757062 TI - Fatal labetalol-induced hepatic injury. PMID- 2757063 TI - Warfarin resistance associated with nafcillin therapy. PMID- 2757064 TI - Wine poisoning as a source of lead intoxication. PMID- 2757065 TI - Spinal cord infarction resulting from cardiac catheterization. PMID- 2757066 TI - Sarcoid myositis with pseudohypertrophy. PMID- 2757067 TI - Pseudocrystalluria and pseudolipiduria. PMID- 2757068 TI - Coexistence of porphyria cutanea tarda and autoimmune hemolytic anemia. PMID- 2757069 TI - Amanita poisoning: treatment and role of liver transplantation. PMID- 2757070 TI - Human immunodeficiency virus-associated thrombocytopenic purpura. PMID- 2757071 TI - Aminoglycoside nephrotoxicity in obstructive jaundice: possible contribution by concomitantly administered corticosteroids. PMID- 2757072 TI - Familial cases of Berger's disease and anaphylactoid purpura: more frequent than previously thought. PMID- 2757073 TI - Nicotinic acid-associated myopathy. PMID- 2757074 TI - Cocaine-associated acute myoglobinuric renal failure. PMID- 2757075 TI - Possible role of Campylobacter pylori in idiopathic hyperammonemia. PMID- 2757076 TI - Primary lactic alkalosis. PMID- 2757077 TI - Different protein diets in renal failure: a self-controlled study. AB - The progression of renal failure on 2 different protein and phosphate diets was evaluated in 7 patients with chronic renal failure. We decided on three study periods for each patient: period A (low-protein diet: 0.6 g/kg of protein, 600 mg of phosphate) averaged 12 months; period B (normal protein diet: 0.9 g/kg of protein, 800 mg of phosphate) lasted 9 months; period C (low-protein diet as for period A) averaged 9 months. The slopes of 1/Scr were 0.003 (period A), -0.016 (period B) and 0.009 dl/mg/month (period C). The GFR (125I-iothalamate clearance) changed from 42.6 to 45.6 ml/min/1.73 m2 in period A, from 51.9 to 40.7 in period B and from 40.5 to 44.6 in period C. The results show changes in renal function when dietary protein and phosphate intakes exceeding 0.6 g/kg and 600 mg/day, respectively, are administered to patients with GFRs ranging from 24 to 66 ml/min. PMID- 2757079 TI - Hypercalcemia in patients with advanced chronic renal failure not yet requiring dialysis. AB - Six patients with progressive chronic renal failure not yet requiring dialysis and not consuming supplemental calcium or vitamin D developed hypercalcemia. Three had proven and 1 suspected tertiary hyperparathyroidism, 1 parathyroid carcinoma and 1 aplastic bone. None of the 3 patients who underwent bone biopsy had heavy bone aluminum staining. The patients with proven parathyroid-mediated hypercalcemia had marked elevation of C-terminal parathyroid hormone and alkaline phosphatase values and, when performed, radiographs consistent with osteitis fibrosa. When these findings are absent or the diagnosis is otherwise uncertain, a bone biopsy may provide a definitive diagnosis and guide management. PMID- 2757078 TI - Elevated bone aluminum and suppressed parathyroid hormone levels in hypercalcemic dialysis patients. AB - We studied 21 dialysis patients who became hypercalcemic without vitamin D or calcium therapy and compared them to 28 dialysis patients who were not hypercalcemic. In the hypercalcemic group, the mean ionized-calcium level was elevated compared to normal subjects (5.4 +/- 0.4 vs. 4.9 +/- 0.1; p less than 0.001), while the ionized-calcium level in the control dialysis patients was below normal (4.5 +/- 0.4 vs. 4.9 +/- 0.1; p less than 0.001). Bone biopsies were performed in all patients. Two thirds of the hypercalcemic patients had low turnover osteodystrophy (LTO, predominantly osteomalacia), a fraction significantly higher than in the control dialysis patients (13/21 vs. 8/28, respectively; p less than 0.05). The hypercalcemic patients with LTO had markedly elevated surface bone aluminum (63 +/- 24% of all trabecular surfaces). In contrast, the nonhypercalcemic dialysis patients with LTO and all patients with osteitis fibrosa had minimal surface bone aluminum. Hypercalcemic patients with osteitis fibrosa had a significantly lower mean N-terminal parathyroid hormone (PTH) value than did nonhypercalcemic patients with osteitis fibrosa (149 +/- 81 vs. 278 +/- 135 pg/ml, respectively; p less than 0.005). Both mean values were markedly elevated in comparison with those obtained in normal subjects (16 +/- 5 pg/ml). In contrast, patients with LTO, irrespective of the calcium level, had mean PTH values that were not significantly different from those of normal subjects. A PTH level greater than 100 pg/ml was 95% sensitive and 87% specific for osteitis fibrosa, as demonstrated by histomorphometry in nonhypercalcemic dialysis patients. However, this level was only 62% sensitive and 77% specific for a diagnosis of osteitis fibrosa in hypercalcemic dialysis patients.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2757080 TI - Determination of blood volume in nephrotic patients. AB - We assessed blood volume (BV) in 20 edematous patients with nephrotic syndrome and in 32 subjects without renal or other disease liable to induce BV variation. Two methods were chosen, one using 131I-albumin and the other 51Cr red blood cells. Among the 20 patients, 11 presented minimal-change lesions, and 9 had histological glomerular impairment. The BV was significantly higher when measured with 131I-albumin in both nephrotic patients and in controls. However, in patients with nephrotic syndrome, the values obtained from the measurement of BV by 131I-albumin showed an increase of only 1%. Comparison of BV values of nephrotic patients and controls showed that BV is equal or higher in two thirds and lower in one third, respectively. The same incidence of histological glomerular lesions was observed in both groups. In conclusion, this study demonstrates that the method using 131I-albumin to measure BV in nephrotic syndrome is reliable. BV is decreased in one third of the patients and is not related to the presence or absence of histological glomerular lesions. PMID- 2757081 TI - Brachiocephalic vein occlusion in a hemodialysis patient. PMID- 2757082 TI - Citrate anticoagulation for hemodialysis patients at risk of bleeding. PMID- 2757083 TI - Putting your patient-care philosophy to the test. PMID- 2757084 TI - Safeguarding the spirit of competition. PMID- 2757085 TI - When and how to extubate in the recovery room. PMID- 2757086 TI - Let's set the payment record straight. PMID- 2757087 TI - Psych nursing in a shelter for the homeless. PMID- 2757088 TI - Washington metro job focus. Capital attractions. PMID- 2757089 TI - Political strength: nursing's next frontier. PMID- 2757090 TI - The last nurse. PMID- 2757091 TI - Corneal topography of early keratoconus. AB - We used a corneal topography analysis system to evaluate nine eyes of seven patients in whom the diagnosis of keratoconus was suspected. There was no slit lamp evidence of the condition. In seven of nine eyes a cone was identified. Large amounts of corneal distortion were seen in selected patients even though they had excellent spectacle-corrected visual acuity and little or no distortion of the keratometer mires. These findings suggest that corneal topography analysis systems are useful in the detection and description of corneal irregularity in the early stages of keratoconus. The radial keratotomy surgeon should be aware that normal results on slit-lamp examination and normal keratometry and refractive data do not rule out the presence of early keratoconus. PMID- 2757092 TI - Familial congenital cornea guttata with anterior polar cataracts. AB - We examined 21 members of a family with a syndrome of cornea guttata and anterior polar cataracts. Twelve members had both ocular abnormalities. An affected woman underwent penetrating keratoplasty at age 28 years. Light microscopy of the corneal button showed changes consistent with cornea guttata and corneal edema. The combination of cornea guttata and anterior polar cataracts appears to form a well-defined ocular syndrome that is inherited in an autosomal dominant fashion. PMID- 2757093 TI - The effect of increased intraocular pressure on visual acuity and corneal curvature after radial keratotomy. AB - To detect the effect of increased intraocular pressure on visual acuity and corneal curvature after radial keratotomy, we measured these variables in the sitting and inverted positions in 18 patients who underwent radial keratotomy (Group 1) and compared their results with those from the unoperated on eyes of seven patients (Group 2). We also compared the results before and after inversion within each group. Intraocular pressure increased to approximately two times normal in each group. Significant improvement in visual acuity and reduction in central keratometry were noted only in Group 1. By multiple regression analysis, visual improvement correlated with the number of incisions but not the time since surgery. Our study provides evidence that increased intraocular pressure may account for transient changes in vision and corneal curvature after radial keratotomy. PMID- 2757094 TI - Test-retest variability in glaucomatous visual fields. AB - We measured test-retest variations in computerized visual fields from glaucomatous eyes. Fifty-one patients were tested four times within a four-week period; the severity of disease varied from incipient to advanced. We determined the dependence of threshold variability on defect depth and test point location. In areas of the visual field initially found to have moderate loss of sensitivity, variation in follow-up measurements ranged from normal sensitivity to absolute defect, with little dependence on distance from fixation. Conversely, large changes were considerably more unusual in locations initially showing normal or near-normal sensitivities, and variability was lowest in the most central portion of the field. Our findings suggest that differentiation between true progression and random variation will be facilitated if these factors are taken into account, as well as if comparisons are based on more than two tests. The complex nature of interest variation in glaucoma makes it natural to approach this problem with the help of computer-assisted analyses. PMID- 2757095 TI - Ocular surgery on patients receiving long-term warfarin therapy. AB - We analyzed data of 50 patients receiving long-term warfarin sodium therapy who underwent ocular surgery between 1982 and 1986. The frequency of hemorrhagic and thrombotic complications was compared in patients in whom anticoagulants were continued, those in whom the anticoagulants were discontinued in the perioperative period, and a group of matched control patients. There were six perioperative hemorrhagic complications in the warfarin-treated group (12%) compared to none in the control group. This difference was significant (P less than .03). However, no significant difference in hemorrhagic complications was seen between patients in whom warfarin sodium was continued and those in whom it was discontinued. PMID- 2757096 TI - Medial and lateral wall decompression for thyroid ophthalmopathy. AB - A two-wall decompression of the orbit, consisting of removal of the medial and lateral walls, was successful in eight patients with thyroid ophthalmopathy. The lateral wall was by removed by using the standard orbitotomy technique in addition to enlarging the space with a pneumatic burr, and the medial wall was removed through a direct medial canthal incision. Two patients had optic neuropathy, one had intermittent subluxation of the globe, and five had symptoms of exposure or increased pressure in the orbital area. In our eight patients, the two with optic neuropathy improved, the patient with subluxation of the globe became asymptomatic, and the other five had less exposure and were more comfortable. The amount of decompression ranged between 4 and 7 mm. The lacrimal sac was injured in one patient; temporary silicone intubation avoided any permanent sequela. PMID- 2757097 TI - Angiolymphoid hyperplasia with eosinophilia of the orbit associated with obstructive airway disease. AB - Two patients with angiolymphoid hyperplasia with eosinophilia isolated to the orbit had eyelid swelling, a superior orbital mass, and histories of intermittent obstructive airway disease. One patient later developed a transient peripheral blood eosinophilia as high as 36%. One lesion recurred 38 months postoperatively and responded to systemic corticosteroid therapy. PMID- 2757098 TI - Fibrovascular proliferation and retinal detachment after intravitreal injection of activated macrophages in the rabbit eye. AB - Injection of activated macrophages into the posterior vitreous of the rabbit induced vigorous fibrovascular proliferation over the optic disk and medullary rays, as demonstrated by 3H-thymidine autoradiography. One week after injection, endothelial cells and pericytes of the capillaries near the inner surface of the optic disk and rays were labeled; fibroblast-like cells, which were also labeled, migrated and formed vitreous strands. By the second week after injection, the fibrovascular tissue proliferated most actively, and traction medullary ray detachment and peripapillary retinal fold formation were observed. The cellular proliferation was accompanied by inflammatory cell infiltration. Glial cells within the optic disk, as well as retinal pigment epithelial cells beneath the detached retina, were labeled by 3H-thymidine. These results demonstrate that the fibrovascular proliferation originates from the vessel complex of the optic disk and medullary rays in this experimental model of retinal detachment. PMID- 2757099 TI - Decreasing frequency of enucleation in patients with retinoblastoma. AB - We reviewed our 15-year experience with the management of 324 cases of retinoblastoma. There has been a definite trend away from enucleation in both unilateral and bilateral cases during recent years. In cases of unilateral retinoblastoma, the affected eye was salvaged in 4% of cases (two of 49) during the five-year interval from 1974 through 1978, in 14% of cases (seven of 50) from 1979 through 1983, and in 25% of cases (20 of 80) from 1984 through 1988. In cases of bilateral retinoblastoma, both affected eyes were salvaged in 4% of cases (one of 24) from 1974 through 1978, in 18% of cases (nine of 50) from 1979 through 1983, and in 25% of cases (18 of 71) from 1984 through 1988. Earlier diagnosis of retinoblastoma and refinements in conservative methods of management are believed to be the main reasons for this trend away from enucleation. PMID- 2757100 TI - Interpreting automated perimetry. PMID- 2757101 TI - A new technique for optic disk analysis in patients with glaucoma. PMID- 2757102 TI - Ocular anomalies in abdominal muscle deficiency syndrome. PMID- 2757103 TI - A nationwide survey of the use of perfluoropropane and sulfur hexafluoride. PMID- 2757104 TI - Isolation of HIV-1 from vitreous humor. PMID- 2757105 TI - Isolated homonymous hemianopsia in the acquired immunodeficiency syndrome. PMID- 2757106 TI - An illuminated blade for vitreoretinal membrane dissection. PMID- 2757107 TI - Optic nerve head drusen and peripapillary central serous chorioretinopathy. PMID- 2757108 TI - L-shaped accessory sponge exoplant. PMID- 2757109 TI - Mandibulofacial dysostosis and cornea guttata. PMID- 2757110 TI - Daily refractive changes persisting after radial keratotomy. PMID- 2757111 TI - Orbital hemorrhage in a newborn. PMID- 2757112 TI - An alternative needle for frontalis suspension. PMID- 2757113 TI - Immunohistologic findings and results of treatment with cyclosporine in ligneous conjunctivitis. PMID- 2757115 TI - Leukocyte migration in synovial tissue. Leukocyte distribution, orientation, and migratory pattern after immune complex deposition in rabbit knee joints. AB - Complement-activating bovine serum albumin (BSA)-anti-BSA immune complexes (ICs) were injected into rabbit knee joint cavities; the contralateral control joint was injected with BSA together with normal rabbit serum. The migration of leukocytes from the synovial venules into the joint cavity was analyzed with light microscopy (LM), scanning (SEM) and transmission (TEM) electron microscopy. EM autoradiography was used to study the endocytosis of ICs by leukocytes. The shape, orientation, and distribution of migrating polymorphonuclear granulocytes (PMNGs) were analyzed by LM morphometry. PMNGs accumulated in the joints injected with ICs. The peak of the number of PMNGs in the synovial tissue was reached after 4 hours, in the joint cavity after 6 hours. PMNGs in the synovial tissue were concentrated in the intimal layer. Migrating PMNGs were polarized, as judged by the ratio between the long (D max) and short (D min) axes of the cells. There was a close association between the migrating PMNGs and the collagen fibers. The morphometric data showed that the nonflattened, cylindrically-shaped PMNGs were oriented along the collagen bundles, running parallel to the synovial surface, and did not migrate in the straight direction of a theoretic leukotactic gradient originating in the joint cavity after IC deposition. SEM and TEM showed that the PMNGs were aligned along the collagen fibers and interacted activity with the collagen by pseudopods and cytoplasmic projections. EM autoradiography showed that the PMNGs in the joint cavity had ingested 125I-labeled ICs and were degranulated. In contrast, the PMNGs within the synovial membrane did not show any signs of IC endocytosis or any apparent degranulation. Synovial type A cells were found to contain ICs. This study indicates that the response of PMNGs in IC induced synovitis consists of two distinct phases: an initial, mainly migratory phase in the synovial membrane where the PMNGs appear to use the collagen fibres as a climbing framework, and a second phase, in the joint cavity, characterized by PMNG metabolic activation, endocytosis of ICs, and degranulation. The apparent inability of PMNGs in the synovial membrane to ingest ICs and become degranulated might be due to not only concentration differences of ICs and leukotactic factors between the joint cavity and the synovial tissue but also might be related to the apparently active interaction with collagen. PMID- 2757114 TI - Xanthine oxidase activity in rat pulmonary artery endothelial cells and its alteration by activated neutrophils. AB - The possibility that endothelial cell-derived oxidants could contribute to neutrophil-mediated endothelial cell injury and cytotoxicity has been a subject of speculation. Rat pulmonary artery endothelial cells (RPAECs) were examined for the presence of xanthine oxidase (XO) activity, a well-known source of O2-. Using a sensitive assay based on measurements of radioactive xanthine conversion to uric acid by high performance liquid chromatography (HPLC), RPAEC extracts were found to contain both XO and xanthine dehydrogenase (XD) activities. Extracts from early passage cells have 55.3 +/- 11.7 (mean +/- SE) units/10(6) cells of total (XO + XD) activity, one unit of activity being defined as the conversion of 1% of substrate to product in 30 minutes of incubation. XO comprised 31.6 +/- 3.1% of this total activity. Addition of human neutrophils stimulated with phorbol myristate acetate (PMA) caused a rapid and dose-dependent increase in RPAEC XO activity from 31.6 +/- 3.1% to 71.7 +/- 4.8% of total without altering total (XO + XD) activity. The neutrophil dose-response curve for increase in XO paralleled closely the curve for neutrophil-mediated RPAEC cytotoxicity. The basal XO and XD activities and the neutrophil-induced increase in XO activity were inhibited by treating RPAECs with allopurinol, oxypurinol, and lodoxamide, which also inhibited cytotoxicity, but not by catalase, superoxide dismutase, or deferoxamine. Addition of H2O2 failed to cause an increase in RPAEC XO activity or XD to XO conversion. The results suggest that during neutrophil-mediated injury, rapid conversion of RPAEC XD to XO occurs, resulting in increased XO, catalyzed endogenous oxidant production, which may contribute to the oxidant burden in the killing mechanism initiated by activated neutrophils. Although the mechanism for conversion of XD to XO is uncertain, it appears that neutrophil derived H2O2 is not sufficient to cause this phenomenon. Furthermore, neither O2- nor chelatable iron is required for neutrophil-induced XD to XO conversion. Supernatant fluids from activated neutrophils failed to induce XD to XO conversion in RPAECs. This in vitro system provides an opportunity to define the cellular and molecular mechanisms underlying the in vivo phenomenon of XD to XO conversion associated with ischemic/reperfusion or inflammatory tissue injury. PMID- 2757116 TI - Purification of murine endothelial cell cultures by flow cytometry using fluorescein-labeled griffonia simplicifolia agglutinin. AB - Griffonia simplicifolia agglutinin (GSA) is a valuable histochemical tool in the identification of endothelium. In this study GSA labeled with fluorescein isothiocyanate (GSA-FITC) was used to purify cultures of murine cerebral microvascular endothelium. Cultures were stained with GSA-FITC, then sorted using a fluorescence-activated cell sorter (FACS). GSA-positive endothelial cells were collected, re-cultured, and subsequently re-analyzed by FACS using GSA-FITC. Cultures that initially contained 80 +/- 3 to 89 +/- 3% (X +/- SE) GSA-positive cells were purified to 98 +/- 1% positivity. Immunohistochemistry with an anti muscle-action antibody confirmed that FACS sorting of GSA-FITC-stained cells effectively removed contaminating smooth muscle cells from endothelial cell cultures. Viability, proliferation, and prostaglandin production of the cells was unaltered by lectin staining and FACS sorting. Thus, GSA-FITC can be used in conjunction with flow cytometry to enhance the purity of murine endothelial cell cultures without adversely affecting cell viability, growth, or metabolism. PMID- 2757117 TI - Cirrhosis of the liver induced by cupric nitrilotriacetate in Wistar rats. An experimental model of copper toxicosis. AB - Rats intraperitoneally injected with a daily dose of cupric nitrilotriacetate (Cu NTA), which contained 4 to 7 mg of copper/kg body weight, showed submassive liver necrosis, hemolytic anemia, and acute renal tubular necrosis at the beginning of the experiment and intermittently after 4 weeks of injections. All rats that survived over 8 weeks exhibited liver fibrosis with portal-portal, portal central, and central-central bridging. In all rats that survived over 16 weeks, micronodular cirrhosis of the liver or extensive liver fibrosis was observed. The copper content of the cirrhotic/fibrotic liver was above 250 micrograms/g dry weight. Electron-microscopic x-ray analysis at day 93 revealed that copper stored in secondary lysosomes was always accompanied by a proportional amount of sulfur (correlation coefficient, 0.98; P less than 0.005). An experimental model of copper toxicosis in terms of copper-induced cirrhosis of the liver was established with exogenous copper chelated by nitrilotriacetate. PMID- 2757119 TI - Structural changes in the megakaryocytes of patients infected with the human immune deficiency virus (HIV-1). AB - Although immune mechanisms are known to be partially responsible for the thrombocytopenia of patients infected with HIV-1, an understanding of the mechanism underlying this disorder is incomplete. A casual observation that bone marrow biopsies of HIV-infected individuals seem to exhibit an unusually large number of denuded megakaryocyte nuclei (DN-MK) prompted a study comparing MK of 20 HIV-seropositive individuals with those of 10 patients with HIV-negative idiopathic thrombocytopenic purpura and 10 hematologically normal subjects. In normal marrows the number of DN-MK average 2.1 +/- 0.5 SE per 10 low power field. In patients with ITP the average number was 6.5 +/- 1.4 SEM, whereas HIV-ITP marrows had an average of 42.5 +/- 3.7 SEM. Electron microscopy of AIDS megakaryocytes exhibited ballooning of the peripheral zone to an extent not seen by us in any other myelodysplastic syndromes. These observations support the concept that the pathophysiology affecting MK/platelets in HIV-infection should not be equated with the destructive process underlying other immune thrombocytopenias. PMID- 2757118 TI - Expression of the 35kDa and low molecular weight surfactant-associated proteins in the lungs of infants dying with respiratory distress syndrome. AB - Newborn respiratory distress syndrome (RDS) results from a deficiency of pulmonary surfactant. Surfactant has three ultrastructural forms: lamellar bodies, which, when secreted from Type II pneumocytes, transform into tubular myelin; tubular myelin in turn gives rise to the phospholipid monolayer at the air-fluid interface in the alveolus that constitutes functional surfactant. It has been shown previously that the lungs of infants dying from RDS lacked tubular myelin despite the presence of abundant lamellar bodies, whereas the lungs of control infants dying from other causes had both tubular myelin and lamellar bodies. An abnormality in the conversion of lamellar bodies to tubular myelin in RDS was proposed as a possible explanation for this finding. To evaluate the role of surfactant proteins (SPs) in this conversion, the authors re-examined the lungs of 11 RDS infants and 10 control infants for reactivity with antisera to high and low molecular weight SPs. In control infants, abundant intense staining with antisera to both types of SPs was found, but in the RDS lungs, staining was weaker than that in controls and less intense for high molecular weight compared to low molecular weight SPs. In lungs from patients with RDS, although staining increased with increasing gestational and post-natal ages, the intensity was less than control levels at all ages. The correlation of deficiency of SPs in RDS with lack of tubular myelin suggests that SPs may be involved in the conversion of normal lamellar bodies to tubular myelin and that the deficiency of SPs could explain the persistent respiratory distress in the presence of surfactant phospholipid synthesis. PMID- 2757120 TI - The role of fibronectin in the development of experimental amyloidosis. Evidence of immunohistochemical codistribution and binding property with serum amyloid protein A. AB - Azocasein-induced amyloid A (AA) amyloidosis in CBA/K1Jms mice was investigated to elucidate a preference of serum amyloid A (SAA) deposition in the spleen. By indirect immunofluorescence using anti-SAA/AA antibodies the initial deposition of SAA/AA was recognized in the marginal zone of spleen at 20 days after azocasein injection. Indirect immunofluorescence using anti-fibronectin antibodies also showed meshwork positivity in the corresponding area more intensely than that in controls. Immunoelectron microscopy using anti-SAA/AA revealed the presence of positively stained flocculent materials on cell surfaces of macrophages in the marginal area in addition to amyloid fibril. The tissue fibronectin rapidly increased in the spleen and maintained 10 times more than that of controls until the 20th day. Binding assay of SAA on frozen sections revealed the presence of SAA-binding substances in the perifollicular area. Affinity chromatographic assay showed fibronectin have a binding capacity to SAA1 and SAA2. By binding assay on the microtiter plate, SAA had more affinity to fibronectin than those of heparan sulfate, collagen type I, or serum amyloid P component. These results indicate that fibronectin plays an important role in the development of amyloidosis by working as a linking protein between SAA and the cell surface of macrophages. PMID- 2757122 TI - Comparison of rehabilitative knee braces. A biomechanical investigation. AB - A biomechanical comparison of eight popular commercially available rehabilitative knee braces was undertaken using a specially designed mechanical surrogate and computerized data acquisition system. Tests conducted included passive extension, valgus rotation, and anterior-posterior tibial translation. Most of the braces tested significantly reduced both translations and rotations compared to the unbraced limb under static test conditions. Braced versus braced performance varied and was found to depend upon a number of mechanical and design factors. PMID- 2757121 TI - Lymphatic filariasis. Brugia malayi infection in the ferret (Mustela putorius furo). PMID- 2757123 TI - Arthroscopic "second look" at the GORE-TEX ligament. AB - We performed an arthroscopic "second look" in 21 knees (20 patients) that had arthroscopic implantation of the GORE-TEX prosthesis for chronic ACL insufficiency. Arthroscopy was done on eight knees at the time of screw removal, eight for knee pain, two for giving way, and three for recurrent effusions. The degree of synovial joint reaction, graft synovial ingrowth, and graft rupture was graded. Microscopic examination was carried out on all biopsies of the GORE-TEX ligament. The average patient age was 30 years and the average time interval from original implantation to second look was 11 months. The GORE-TEX was intact in 11 knees, 10% ruptured in 6, and completely ruptured in 4. There was no correlation between number of GORE-TEX strands ruptured and synovial reaction. No particles of the graft were noted in the synovium if the implant was intact, but particles were noted with graft rupture. We conclude that the intact GORE-TEX ligament is an inert substance and does not cause significant joint reaction. Impingement in the intercondylar notch appeared to be the most common cause of graft failure. Further study is critical to determine the natural history of the GORE-TEX ligament and the knees' response to this prosthetic device. PMID- 2757124 TI - Healed meniscal tears in unstable knees. A long-term followup of seven years. AB - Peripheral vertical ruptures of the medial (N = 24) and the lateral (N = 4) meniscus were repaired in 28 patients (mean age, 27 years). They all had an ACL lesion, combined in 26 cases with a MCL tear. These injuries were reconstructed or sutured during the same session as the meniscus repairs. Approximately 1 year later, meniscal healing was proven arthroscopically in 20 and the other 8 had no clinical signs of meniscal rerupture. All patients were reexamined between 6 to 8 years after the initial repair. Instrumented stability testing, the Lysholm knee function score and an activity score (Tegner) were used. The patients' subjective evaluations were also recorded. In spite of the previous reconstruction, all knees were quite unstable (mean +5 mm increased laxity compared with the uninjured side). At followup, 3 of the 28 repaired menisci (11%) had reruptured in connection with a minor trauma during sports or daily activity. The knee function score averaged 88 points, the activity level dropped 2 steps compared with activities before injury (from 7 to 5). Twenty patients were satisfied with the results, 5 partly satisfied, and 3 not satisfied. A healed meniscal tear has a good chance of survival in an unstable knee. The most critical period of meniscal repair probably lies in the healing period just after surgery. PMID- 2757125 TI - Biomechanical evaluation of rotator cuff fixation methods. AB - Initial fixation strength and failure mode for various rotator cuff reattachment techniques (variations of the McLaughlin technique) were evaluated. Repair methods included standard suture (control), reinforced suture [expanded polytetrafluoroethylene (PTFE) patch and polydioxanone (PDS) tape augmentation] and stapling (nonarthroscopic and arthroscopic soft-tissue staples). The average strength of intact rotator cuff tissue (supraspinatus tendon) was also determined. The different rotator cuff repairs, including at least one control, were performed on fresh-frozen human cadaver shoulder pairs. Repairs were tested to failure in pure tension with the shoulder fixed in 60 degrees of abduction. Load and displacement data were normalized to controls, grouped according to failure modes, and statistically analyzed. The two basic failure modes observed were 1) bone failure, or suture tearing through the bone (indicating weak bone stock) and 2) tendon failure, or suture tearing of the rotator cuff. Gross comparisons between intact and repaired tendons indicated that the intact tendon was two to three times stronger than the repaired tendon. Based on the mode of failure and lack of increased strength after repair, the use of staples for cuff attachment is discouraged. PDS tape suture reinforcement did not increase fixation strength. In contrast, PTFE patch suture augmentation demonstrated statistically higher initial failure loads than did the control and was of specific benefit for shoulders with weak bone stock. PMID- 2757126 TI - The effect of knee braces on lateral impact loading of the knee. AB - Disruption of the medial supporting structures of the knee occurs commonly in contact sports such as American football and lacrosse. A limited number of clinical and laboratory studies currently document the effectiveness of bracing. The purpose of this project was to determine if commercially available bracing could be shown to produce objective evidence of medial stabilization of the knee. Our model involves the use of a cadaver lower extremity with a fixed foot and suspended femur with a free knee and a lateral impact load applied simulating a clipping injury. Force transducers were placed on the ACL and medial collateral ligament (MCL) and an electrogoniometer was attached to the extremity. The prophylactic braces studied had a limited capacity to protect the MCL from direct lateral stress with the knee in full extension. In flexion or with a change in direction of the load, the protective effect is greatly reduced. The functional braces had a capacity to limit abduction and rotational stresses on the MCL in flexion and extension. PMID- 2757127 TI - Electromyographic analysis of elbow function in tennis players. AB - Muscle activity about the elbow during tennis strokes in nine professional and collegiate level players was studied using indwelling EMG and high speed photography. Eight muscles were evaluated for the serve, forehand, and backhand strokes. The serve was divided into six stages and the ground strokes into four stages. EMG tracings were subjected to analog-to-digital conversion and a relative measure of quantity was obtained. Analysis of variance and Turkey tests were then done to assess statistical significance (P less than 0.05). The ground strokes showed low activity in all muscles tested during the preparation phase. During the acceleration phase, both the backhand and forehand showed a generalized increase in all muscle activity. Both strokes showed marked activity of the wrist extensors and, in addition, the forehand showed high activity in the brachialis and biceps. In the follow-through phase, there was a generalized decrease in muscle activity. The serve showed low activity in all muscles tested during the wind-up phase. The wrist extensors increased their activity in the cooking phase, with marked activity in late cooking. The pronator teres and the triceps showed increased activity in the acceleration phase. Follow-through phase showed low muscle activity except for the biceps, which increased in late follow through. In conclusion, the muscles of the elbow help stabilize the elbow as a unit during the ground strokes in these high level players. Power in the serve comes from increased activity in the triceps and pronator teres. The predominant activity of the wrist extensors in all strokes may be one explanation for predisposition to injury. PMID- 2757128 TI - Metabolic costs and heart rate responses to treadmill walking in water at different depths and temperatures. AB - Treadmill walking/jogging in water is a potentially useful therapeutic modality. Since energy costs of this activity are unknown, we compared oxygen consumption (VO2) of treadmill walking/jogging in water to a dry treadmill at speeds of 40.23 to 160.9 meters/min (m/m) in 13.4 m/m increments in 11 subjects. At speeds greater than or equal to 53.6 m/m, ankle depth, below knee, midthigh, and waist depth walking/jogging in water significantly elevated VO2 and heart rate (HR) above dry treadmill walking (P less than 0.05). At speeds greater than or equal to 134.1 m/m, VO2 of waist depth jogging was not significantly greater than dry jogging. These findings showed no gender specificity. Treadmill walking/jogging in waist depth water at temperatures of 30.5 degrees C and 36.1 degrees C was compared to dry treadmill walking in five subjects. The rate of increase of HR compared to VO2 was significantly greater at 30.5 degrees C than dry walking, and greater at 36.1 degrees C than 30.5 degrees C (P less than 0.05). Treadmill walking in water can double the oxygen cost of movement depending on the depth and speed, and the response to increasing speed is nonlinear. Water temperature affects the relationship of HR to VO2 at waist depth, suggesting that water temperature can add a significant thermal load to the cardiovascular system. Metabolic and cardiovascular demands of treadmill walking/jogging in water must be considered when using this modality since greater external work results at much lower speeds than on land. PMID- 2757129 TI - Nonsurgical treatment of ankle sprains using the modified Sarmiento brace. AB - The Sarmiento brace, originally designed by Dr. Augusto Sarmiento for treatment of tibial fractures, was used in this study as a nonsurgical treatment for ankle sprains. The brace allows sufficient immobilization of the ankle while leaving it accessible for local therapy. The fast relief of pain and early reeducation associated with our method permits a much more rapid resumption of normal physical activity. We have been using this method for 5 years and still remain firm believers in it. PMID- 2757130 TI - Quality assessment of athletic trainers. AB - This paper reports the first published assessment of the quality of services provided by athletic trainers. Medical coverage for the 1985 Junior Olympic Games was provided by certified athletic trainers (ATC), physicians, and other health care personnel. This study assessed the services of the 30 attending ATCs who managed 121 significant injuries. Standard injury information was collected by the ATCs and separately collected by their physicians. Nine months after the Games, phone interviews were conducted with the injured participants and assessment questionnaires were given to the attending physicians. Results revealed that young, injured, Junior Olympic participants generally did not inform their parents about their injuries or medical contact while at the Games. Athletes and physicians overwhelmingly agreed that they were positively impressed with the capabilities of the ATCs with whom they had contact. About 70% recovered from the symptoms and limitations of injury, as determined by the athlete, within the month following the Games. About 17% sustained some type of injury recurrence to the same body part, and at 9 months about 97% of the athletes had fully recovered from their injuries. These data not only indicate that athletic trainers can accurately identify minor athletic injury but signify the importance of long-term followup in our athletic populations. Multisport events, such as the Junior Olympic Games, impose considerable problems to a communication effort. The athletic trainer, as an ever-present figure in collegiate and professional circles, can be the central focus of an adequate communication effort regarding the patient care of other athletic populations. PMID- 2757131 TI - Personality, stress, and injuries in professional ballet dancers. AB - Twenty-nine soloist and principal dancers (mean age, 29.08 years) from America's two most celebrated ballet companies were administered questionnaires measuring personality (API), occupational stress (OES), strain (PSQ), and coping mechanisms (PRQ), and injury patterns. The results revealed that male dancers demonstrated significantly more negative personality traits and psychological distress than female dancers or men in the general population. In addition, physical stress and personality traits, characteristic of the "overachiever," distinguished injured dancers. It is suggested that classical ballet's emphasis on the ballerina may be at odds with a masculine identity in male dancers. Furthermore, the qualities that lead to success in this profession may contribute to injuries if carried to an extreme. PMID- 2757132 TI - Dynamic posterior shift test. An adjuvant in evaluation of posterior tibial subluxation. AB - The dynamic posterior shift test, a clinical method for evaluating both straight posterior instability and posterolateral rotatory instability, (PLRI), is a simple, dynamic, and reliable (reproducible) test that serves as an adjuvant to other clinical tests designed to evaluate an injury or insufficiency of posterior structures in the knee. The examiner maintains the hip at near 90 degrees of flexion to control rotation of the femur while slowly extending the knee passively. The hamstrings should be stretched to maintain their tightness. The tightened hamstrings assist gravity in subluxating the tibia posteriorly; they also provide dynamic axial loading to the joint as the knee is extended. In knees with posterior instability, the posteriorly subluxated tibia suddenly reduces as the knee joint nears full extension, and a jerk or "clunk" is felt by both the patient and the examiner. Thus, the patient's feeling of instability is reproduced by the test. We have used the dynamic posterior shift test for 5 years (as an adjuvant in our physical examination) to evaluate signs of posterior instability of the knee. Not only is the test reliable, but it is more definitive than other tests in evaluating straight posterior instability and PLRI. It is easy to perform and the results are reproducible. Because this test is dynamic rather than passive, it enhances the accuracy of evaluating posterior instability of the knee. PMID- 2757133 TI - Effect of standard and Aircast tennis elbow bands on integrated electromyography of forearm extensor musculature proximal to the bands. AB - Classic tennis elbow, or lateral epicondylitis, has been described as an overuse or misuse injury resulting in a tendinitis. The extensor carpi radialis brevis (ECRB) and extensor digitorum communis (EDC) have been implicated as primary culprits in this pathology. Tennis elbow has been treated using a constrictive band placed several centimeters distal to the origin of these two muscles. Aircast (Aircast Inc., Summit, NJ) has developed a new style of band that employs an air-filled bladder as the counterpressure element. This study tested the effect of both standard and Aircast bands on EMG activity of the EDC and ECRB proximal to the band compared to control values. Ten normal subjects, ranging in age from 20 to 43 years, were tested. Right upper extremities were tested in all cases. The subjects' forearms were stabilized in the CYBEX II forearm stabilization V-pad. The ECRB and EDC were then impaled with monopolar EMG needle electrodes. The CYBEX data were recorded using the HUMAC system and the EMG data were recorded and analyzed using the Cadwell 7400. EMG data were recorded at 80% of maximum voluntary isometric contraction (MVIC) with no band, the standard band, and the Aircast band. An analysis of variance (ANOVA) with repeated measures of integrated EMG (IEMG) and Duncan's multiple comparison tests revealed that the Aircast caused a significant reduction in IEMG of the ECRB and EDC when compared with control values and the standard band. The decrease in IEMG with the standard band was not statistically significant.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2757134 TI - Peroneal nerve entrapment in runners. AB - In a practice involving large groups of athletes, seven runners and one soccer player with peroneal nerve compression neuropathy secondary to exercise have been found. Running incited pain, numbness and tingling to varying degrees in all patients, and examination after running revealed muscle weakness and a positive percussion test as the nerve winds around the fibular neck. Nerve conduction velocity studies confirmed the diagnosis in the five patients on whom the test was performed; other studies served primarily to exclude other causes of pain. All patients were treated surgically by neurolysis of the peroneal nerve as it travels under the sharp fibrous edge of the peroneus longus origin. Seven of eight had excellent results and returned to their previous level of physical exertion without further symptoms. We think entrapment of the peroneal nerve at the fibular neck is a more common entity than previously recognized, and it should be considered in the differential diagnosis of exertional lateral leg pain. PMID- 2757135 TI - Atypical scapular fracture. A case report. PMID- 2757136 TI - An unusual cause of metatarsal pain in a young kendo player. PMID- 2757137 TI - Trends in the management of traumatic vertebral artery injuries. AB - From 1975 to 1988, 25 patients with a vertebral artery (VA) injury were treated. Admission neurologic status was intact in 14 patients (56 percent). Eight patients had deficits due to direct nerve or spinal cord injury, two patients had symptoms referable to vertebrobasilar ischemia, and one patient had a contralateral deficit due to an associated carotid artery injury. Twenty-two of 25 patients (88 percent) underwent diagnostic arteriography. Twelve patients (48 percent) with 9 occlusive and 3 minimal injuries were observed. Seven patients (28 percent), three with exsanguinating hemorrhage, were treated by operative exploration and VA ligation. Six patients (24 percent), two with a VA pseudoaneurysm and four with an arteriovenous fistula, were managed by percutaneous transcatheter embolization. The neurologic status was unchanged or improved in 22 patients (88 percent) at discharge. Two patients developed Horner's syndrome after VA ligation. Transient posterior circulation ischemia occurred in a single patient after percutaneous transcatheter embolization. There was no mortality. The majority of VA injuries are best managed by nonoperative methods. Untoward neurologic sequelae are rare. Operative intervention and VA ligation should be reserved for patients with active hemorrhage or large pseudoaneurysms and arteriovenous fistulas which cannot be embolized. PMID- 2757138 TI - Replacement of the abdominal aorta with a sutureless intraluminal ringed prosthesis. AB - To evaluate our experience with sutureless intraluminal ringed grafts in the abdominal aorta, we reviewed all patients who were managed with this device from 1980 to 1987. Thirty-one patients were identified with a mean follow-up time of 41 months. Three patients had suprarenal aneurysms and four had ruptured abdominal aneurysms. Average tube graft insertion time was 17 minutes and required 0.9 units of transfused blood. There were two postoperative deaths (6 percent), both secondary to myocardial infarction. None of the patients with ruptured or suprarenal aneurysms died. No patients had permanent renal or neurologic deficits, and no instances of postoperative bleeding, wound infection, pseudoaneurysm formation, or graft migration were encountered. The sutureless intraluminal graft can be implanted easily and quickly and is safe for use in the abdominal aorta. It is particularly helpful in the management of suprarenal or ruptured abdominal aneurysms, in which speed is important, and in effecting technically difficult anastomoses to friable aortic tissue. PMID- 2757139 TI - Open transmetatarsal amputation in the treatment of severe foot infections. AB - Severe forefoot infections may lead to limb loss, even if addressed aggressively. Infection or gangrene that compromises the plantar skin flap may preclude a standard transmetatarsal or midfoot amputation, thereby culminating in a below knee amputation. We report a series of forefoot infections with loss of the distal plantar skin. Open or guillotine amputation at the mid-metatarsal level led to a high rate of healing and a durable stump, provided that the level of infection did not extend beyond the metatarsal heads. Wound closure was obtained by wound contracture alone or by use of partial-thickness skin grafting. Rehabilitation was dependable. The association of diabetes mellitus or gangrene did not adversely affect outcome. Open transmetatarsal amputation is a safe surgical option preferable to midfoot or below-knee amputation for the treatment of severe forefoot infection that does not extend proximally beyond the metatarsal heads. PMID- 2757140 TI - Massive venous thrombosis of the extremities. AB - Massive venous thromboses of the extremities, although uncommon, are responsible for many of the long-term sequelae associated with venous disease. The charts of all patients with a diagnosis of iliofemoral venous thrombosis or subclavian vein thrombosis over a 6-year period were reviewed. There were 59 patients with iliofemoral venous thrombosis and 18 patients with subclavian vein thrombosis. Iliofemoral venous thromboses were three times more common, showed the classic leftsided predominance, and were more likely to be idiopathic. Subclavian vein thromboses showed no side or sex predilection and were due to anatomic abnormalities, intravenous lines, or radiation. Iliofemoral venous thrombosis showed poor response to lytic therapy, whereas subclavian vein thromboses were effectively lysed in those patients in whom it could be used. Massive venous thromboses of the extremities, although similar in presentation, have different characteristics depending upon the extremity affected. The cause, frequency, and response to treatment differ, which could ultimately influence outcome and the severity of postphlebitic symptoms. PMID- 2757141 TI - Compartment syndrome in combined arterial and venous injuries of the lower extremity. AB - In 9 of 45 patients treated for dual vascular injuries of the lower extremity, concomitant fasciotomies were performed at the time of initial surgery for associated soft tissue injury, fracture, or prolonged ischemia. Eight other patients developed compartment syndrome requiring delayed fasciotomy. In seven of them, vein was either ligated or the repaired vein became occluded. In the eighth patient, peripheral venous hypertension was caused by massive swelling of the thigh. In the laboratory, compartment pressure was monitored by wick catheter in 24 hind limbs of 12 dogs subjected to experimental conditions simulating vascular injuries and their management. There was a significant increase in compartment pressure in a group that simulated arterial and venous injuries managed by arterial repair and venous outflow obstruction. Based on our study, we suggest that obstruction to venous drainage and venous hypertension are major factors in the development of compartment syndrome in dual vascular injuries of the lower extremity. PMID- 2757142 TI - Femoral-tibial bypass for calcific arterial disease. AB - Overt calcification of the recipient artery and outflow bed has been regarded as a poor prognostic factor for femoral-distal arterial bypass patency and subsequent wound healing. In order to determine the short- and long-term limb salvage and graft patency rates achieved in these patients, the records of 35 patients undergoing 38 attempted femoral-tibial bypasses to a calcified recipient artery were reviewed. Two patients were unreconstructable at the time of surgery. Thirty-one of the 36 operations (86 percent) were performed using in situ saphenous vein bypass techniques, 3 were performed with polytetrafluoroethylene (PTFE), 1 with a composite sequential, and 1 with a composite vein graft. Immediate limb salvage was achieved in 31 of 36 limbs (86 percent). Five early below-knee amputations (14 percent) were required, two due to graft thromboses and three due to progressive foot necrosis despite patent grafts. One patient (3 percent) died secondary to sepsis. Three-year primary graft patency and limb salvage rates did not differ significantly from bypasses to noncalcified vessels. Femoral-distal bypass in the presence of overt calcific arterial disease may be successfully accomplished and offers an excellent prognosis for long-term graft patency and limb salvage. PMID- 2757143 TI - Management strategy of complex extremity injuries. AB - In this retrospective review of 37 patients with combined orthopedic and vascular injuries, our management strategy emphasized the prompt recognition of limb threat. Twenty-two patients had lower-extremity and 15 had upper-extremity injuries. No deaths occurred. Five delayed amputations were performed for limbs left denervated by associated soft tissue or neural injuries. No late vascular insufficiency was recorded in patients who underwent reconstruction with autogenous tissue. Whenever possible, the precise site of vascular injury was identified angiographically to help plan an approach that would provide adequate exposure for vessel repair as well as orthopedic stabilization. Vascular reconstruction typically preceded osseous stabilization. We conclude that improved outcome requires a coordinated multidisciplinary approach, expeditious limb revascularization, fasciotomy as indicated, rapid fixation of osseous injuries, and adequate soft tissue coverage of the underlying repair. PMID- 2757144 TI - The right retroperitoneal approach for abdominal aortic surgery. AB - Retroperitoneal exposure of the abdominal aorta is usually performed through a left flank incision. An alternative approach to the abdominal aorta is described utilizing a right flank incision. Indications for the use of the right retroperitoneal approach during surgery for aortic aneurysms include right renal artery stenosis, right iliac artery aneurysm, need for simultaneous cholecystectomy, multiple or recent intraabdominal procedures, and sigmoid colostomy. A series of 17 patients is presented to illustrate the utility of this approach. There was one operative death in an emergent patient; the cause of death was not related to the method of aortic exposure. The remaining patients recovered quickly. The anatomic advantages and limitations of this exposure are discussed. We believe that retroperitoneal aortic exposure is superior to midline transperitoneal exposure. Aortic exposure utilizing a right retroperitoneal approach is a useful option in the surgical armamentarium. PMID- 2757145 TI - Incidentally discovered adrenal masses. AB - It is becoming increasingly common to discover adrenal masses incidentally on radiologic imaging studies. Adrenal masses are also occasionally found unexpectedly during operation. Herein, we review 10 cases of incidentally discovered adrenal masses which illustrate the experience with the treatment of these lesions in the past 8 years. A management plan based on this experience and a review of previously published data are discussed. PMID- 2757146 TI - Peritoneovenous shunt for intractable ascites of hepatic, nephrogenic, and malignant causes. AB - A retrospective analysis of 54 patients with a peritoneovenous shunt inserted to control massive ascites refractory to conventional medical treatment is presented. The cause of ascites was hepatic in 29 patients (Group 1, 54 percent), malignant in 13 (Group 2, 24 percent), and nephrogenic in 12 (Group 3, 22 percent). The peritoneovenous shunt failed in 11 patients (20 percent): 6 in Group 1, 3 in Group 2, and 2 in Group 3. Shunt outflow obstruction (thrombosis) was the principal cause. Systemic sepsis in five patients and variceal hemorrhage in three were the factors responsible for most of the deaths (22 percent). Of the 42 patients who survived operation, the peritoneovenous shunt was effective in controlling the massive ascites in 37 (86 percent). Eight patients (15 percent), four with hepatic and four with nephrogenic ascites, survived 3 years or more without ascites. Removal of at least 50 to 70 percent of ascitic fluid at the time of shunt insertion was considered an important factor in decreasing morbidity and mortality. A peritoneovenous shunt can be effective for a long-term period in controlling massive ascites with an hepatic or nephrogenic cause in a selected group of patients; however, in patients with malignant ascites, although the benefit was substantial in half, the survival period did not exceed 6 months. PMID- 2757147 TI - Trauma and the neglected science of epidemiology. PMID- 2757148 TI - Choice and challenge in vascular surgery. PMID- 2757149 TI - Beneficial effects of banding on venous intimal-medial hyperplasia in arteriovenous loop grafts. AB - Local hemodynamics were modified in a canine arteriovenous loop graft model by placing a flow-limiting band on femoral polytetrafluoroethylene (PTFE) grafts. Banded and unbanded grafts were implanted in a paired fashion. Hemodynamic studies included Reynolds number and phonoangiography as measures of turbulence. Intimal-medial thickness was measured 8 weeks after implantation. Reduction of the volumetric flow rate by 50 percent resulted in significant changes in flow velocity, flow pulsatility, pressure, and turbulence at the venous anastomosis. Hyperplastic lesions developed in a reproducible manner at the venous anastomosis of the unbanded but not the banded grafts, as evidenced by combined intimal medial thickness measurements: unbanded grafts 0.68 +/- 0.13 mm (p less than 0.01 versus control), banded grafts 0.25 +/- 0.03 mm (p greater than 0.05 versus control). Stepwise regression analysis indicated Reynolds number had the best correlation with the development of hyperplasia (r = 0.915, p less than 0.005), this being the first time this correlation has been quantitatively determined. We conclude that flow disturbance or turbulence is a major factor in the development of venous intimal-medial hyperplasia in arteriovenous loop grafts. PMID- 2757150 TI - Hemodynamic performance of carotid artery shunts. AB - Although the use of shunts for carotid artery surgery remains controversial, the hemodynamics of the shunts currently available have not been carefully evaluated in vivo. We developed an animal model using contralateral carotid artery ligation, which produced ipsilateral carotid blood flows (640 +/- 44 ml/min) and internal carotid stump pressures (52 +/- 4 mm Hg) over a range commonly seen in carotid artery surgery. Seven shunts were tested and included Javid; 10F and 8F Brener; and 14F, 12F, 10F, and 8F Argyle shunts. The hemodynamic features evaluated for each shunt included maximum shunt flow, the pressure gradients occurring across each shunt, the increase in cerebral perfusion pressure over occlusion pressure associated with shunt placement, and the distal pressure pulse waveform. The larger diameter shunts were consistently better than the smaller diameter shunts. The correlation between shunt flow and the increase in distal pressure produced by shunt placement was high (r = 0.98, p less than 0.05), confirming that high flow rates maintained high perfusion pressure. By relating maximum shunt flow and the pressure gradient to the change in the pressure pulse contour for each shunt, it could be demonstrated that at the larger diameters, straight shunts displayed superior hemodynamic characteristics compared with tapered shunts, whereas at smaller diameters, tapered shunts were superior. PMID- 2757151 TI - Alkalinisation of bupivacaine for sciatic nerve blockade. AB - This double-blind study investigates the effect of pH adjustment of bupivacaine 0.5% with adrenaline 1:200,000 on block latency, duration of analgesia and systemic absorption of local anaesthetic after sciatic nerve blockade. Twenty four adult patients were randomly allocated into one of two groups: Group A (n = 12) received bupivacaine with adrenaline 1:200,000 (pH 3.9) 2 mg/kg, while Group B (n = 12) received alkalinised bupivacaine with adrenaline 1:200,000 (pH 6.4) 2 mg/kg. Increasing the pH of the local anaesthetic solution significantly reduced block latency from 25 minutes in Group A to 12.5 minutes in Group B (p less than 0.001) and prolonged the duration of useful analgesia from 14.1 hours to 18.3 hours (p less than 0.001). There was no significant difference in plasma bupivacaine levels between the two groups. The results indicate that alkalinisation of bupivacaine reduces time to onset and prolongs the duration of useful analgesia when used for sciatic nerve blockade, without significantly increasing systemic absorption. PMID- 2757152 TI - Changes in cardiac output during epidural anaesthesia for caesarean section. AB - Serial haemodynamic investigations were performed in 20 women who had epidural anaesthesia before elective Caesarean section. Cardiac output was measured by Doppler and cross-sectional echocardiography at the aortic valve. Measurements were performed after preloading the circulation with Ringer lactate solution (mean volume 805 ml) and then 10, 20, 30 and 40 minutes after administration of 0.5% bupivacaine. Preloading increased mean stroke volume from 84 to 94 ml and mean cardiac output from 7.01 to 7.70 litres/minute. Relative to basal values, mean arterial pressure decreased in all subjects after administration of bupivacaine (mean - 14%, range - 1 to - 33%). Five subjects were given ephedrine because of hypotension. In three of these subjects hypotension was associated with a marked decrease in cardiac output. No significant changes in arterial blood pressure or cardiac output were demonstrated relative to basal values in the remaining 15 subjects. Ephedrine induced consistent increases in blood pressure and cardiac output. PMID- 2757153 TI - Inheritance of low plasma cholinesterase activity in two families with a history of suxamethonium sensitivity. AB - An hypothesis advanced in 1970 concerning family inheritance of low enzymic activities of plasma cholinesterase has been substantiated. The recognition of three E1kE1s genotypes is reported in this family after investigation of a new generation. A second family with similar genetic characteristics is described. PMID- 2757154 TI - Atracurium overdose in a small infant. AB - An error in setting a syringe driver caused a 2.75 kg infant to receive 37 mg atracurium over 75 minutes. Clinically full recovery of muscle power had returned spontaneously 135 minutes after the infusion was stopped. The child suffered no ill effects. Assay of blood and urine for atracurium and laudanosine confirmed rapid clearance of the drug. PMID- 2757155 TI - Failure of repeated blood patch in the treatment of spinal headache. AB - The management of a persistent, incapacitating postdural puncture headache that required four consecutive autologous epidural blood patches is presented. Inadequate blood volumes, early patching and steroid in the epidural space are considered as possible causes of failure. Other associated problems and interventions are briefly discussed. PMID- 2757156 TI - A new dual function nerve stimulator. AB - The Duostim model TV02 is a new peripheral nerve stimulator designed both for nerve identification in the performance of regional anaesthesia and for monitoring neuromuscular blockade. The output pulses are unipolar and of adjustable constant current. The provision of single twitch (1 Hz and 1/15 Hz) train-of-four and tetanic stimuli, together with indication of the current delivered and the small size of the unit, facilitate its clinical use. Performance was assessed and found to be according to specification. PMID- 2757157 TI - The Malawi anaesthetic machine. Experience with a new type of anaesthetic apparatus for developing countries. AB - One year's experience with a new type of oxygen concentrator and anaesthetic machine, designed for anaesthesia in developing countries, is presented. The apparatus, its performance and problems are described and the author's suggested modifications to improve the original design are outlined. The apparatus, with these changes, represents a significant advance in oxygen availability for hospitals in developing countries as well as improving the anaesthetic capabilities. PMID- 2757158 TI - Serious morbidity attributable to anaesthesia. Considerations for prevention. AB - The types and frequency of complications attributable solely to anaesthesia, and which caused serious morbidity and substantial negative outcome, were examined in a prospective study of 7306 anaesthetics. The analysis demonstrated that severe complications and mortality attributable to anaesthesia occurred in 0.59% (1:170) and 0.04% (1:2500) of patients respectively. The data suggest that "high-risk' patients are more likely to be affected by errors and a substantial negative outcome than more healthy patients. We judged one-third of the anaesthesia related morbidity to be preventable. Anaesthetists are faced with an increasing number of patients who are at high risk, and who undergo increasingly extensive surgical interventions. Concomitant with the increasing complexity of care and increasing demands on the anaesthetists may be an expected increase in the incidence of errors. Recognition of the importance of human factors in morbidity and mortality attributable to anaesthesia is a necessary first step. PMID- 2757159 TI - Occupational exposure to nitrous oxide in four hospitals. AB - Diffusive samplers were used to measure the exposure of the anaesthetist, anaesthetic assistant and circulating nurse to nitrous oxide in every operating theatre of four Glasgow hospitals. Each theatre was surveyed over 1 or 2 weeks; samples were taken during every operating session. The exposures were in general surprisingly high. The anaesthetist's exposure was greater than ppm on about half the occasions. The study underlines the need for theatre ventilation systems and scavenging equipment to be properly maintained and for scavenging facilities to be used effectively. It is concluded that regular monitoring of staff exposures is required to check the effectiveness of antipollution measures. PMID- 2757160 TI - Anaphylaxis. PMID- 2757161 TI - The treatment of hyponatraemia. PMID- 2757162 TI - Malignant hyperthermia in the Wolf-Hirschhorn syndrome. PMID- 2757163 TI - Nifedipine and the pressor response to laryngoscopy. PMID- 2757165 TI - Cyst of epiglottis. PMID- 2757164 TI - Intranasal cocaine/adrenaline during halothane anaesthesia. PMID- 2757166 TI - Dose of bupivacaine. PMID- 2757167 TI - The oesophageal detector device: successful use in children. PMID- 2757168 TI - Profile-cuffed tracheal tubes and the Cardiff Cuff Controller. PMID- 2757169 TI - Cuff failure of PVC tracheal tubes. PMID- 2757170 TI - Epidural fentanyl at 4 degrees C for analgesia after epidural caesarean section. PMID- 2757171 TI - Inadvertent cause of dural tap. PMID- 2757172 TI - Inadvertent paravertebral block. PMID- 2757173 TI - Lignocaine 2% with adrenaline for epidural Caesarean section. PMID- 2757174 TI - Tachyphylaxis and epidural anaesthesia. PMID- 2757175 TI - The distribution of drugs administered using the Bier's technique. PMID- 2757176 TI - Further developments of the laryngeal mask. PMID- 2757177 TI - Laryngeal mask and patients with chronic respiratory disease. PMID- 2757178 TI - The use of ketamine in civilian and military surgery. PMID- 2757179 TI - Perished latex. PMID- 2757180 TI - Failure of rectal diclofenac to augment opioid analgesia. PMID- 2757181 TI - Potential hazard with Graseby PCAS. PMID- 2757182 TI - A method for the refinement of data arising from electrophoresis of biological fluids. AB - Gingival crevicular fluid (GCF) is being analyzed by sodium dodecyl sulfate/polyacrylamide gel electrophoresis (SDS/PAGE) in our laboratory. We wish to characterize the major protein species in GCF and to investigate their association with the progression of disease. Laser densitometry of SDS/PAGE provides estimates of log molecular weight (LMW) and relative abundance for each band in each sample. Our aim was to develop a method for the refinement of these data into clusters which could be treated as distinct protein species, whose relation to disease progression could be assessed. A reproducibility study showed that the estimated LMW would fall within 3% of the true LMW 95% of the time. The method clusters the estimated LMWs of each band in each sample so that clusters form at LMWs which occurred frequently. The data from each band in each sample are thus refined into cluster number and relative abundance. Application of the technique to data from the reproducibility study showed that clusters formed around the individual components in the mixture, with little misclassification. The technique was then applied to two data sets: from SDS/PAGE of 104 GCF samples from 74 adolescents without progressive periodontal disease, and from 2 patients suffering from advanced progressive disease. The clusters appeared accurately to reflect the appearance of the gels, and clear differences were observed between the two data sets. The method will enable changes in the composition of biological fluids to be associated with external factors such as disease status and should be widely applicable. PMID- 2757183 TI - Fractionation and analysis of mitochondria with polycarbonate membrane filters. AB - Polycarbonate membrane filters were used to fractionate mitochondrial populations depending on their aggregation or association with other subcellular structures. Isolated rat liver mitochondria penetrated through filters which have pore sizes larger than 1 micron. In contrast, mitochondria which were induced to aggregate in vitro by incubation at low pH were retained by the filters and thus could be separated from the single or small aggregates of mitochondria. Use of this membrane filtration method to analyze release of mitochondria from isolated hepatocytes showed that treatment with digitonin at concentrations only sufficient to lyse the plasma membrane did not release mitochondria. Homogenization or sonication following digitonin treatment released 25-50% of the mitochondria, but only a small fraction was intact. A high yield of intact mitochondria was released from digitonin-treated cells by a brief treatment with a low concentration of the proteolytic enzyme nagarse. Thus, this membrane filtration method provides a simple and rapid approach to analyze the extent of mitochondrial aggregation and association with other subcellular structures. PMID- 2757184 TI - Semimicrotitration device for cholinesterase assay. AB - A semimicrotitration device for reaction volumes of 0.5 to 2 ml and effective stirring of reaction solution or suspension is described. The principal part of the device is a combined glass electrode functioning as a reaction vessel (combined "cup"-glass electrode). Characteristics of the device are small volumes and great reliability. Nonspecific cholinesterase activities measured in rat plasma and liver tissue homogenates and compared with the activities of the same tissue and plasma samples measured radiometrically and spectrophotometrically illustrate the applicability of the device. The method is best suited for kinetic studies with multiple substrates of esterases, either in the soluble form or in tissue homogenates. PMID- 2757185 TI - Enzymatic method for measuring the absolute value of oxygen concentration. AB - An enzymatic method for measuring the absolute concentration of oxygen in aqueous solutions, using 4-hydroxybenzoate 3-monooxygenase and glucose oxidase, is described. The monooxygenase is used for quantitative oxidation of 4 hydroxybenzoate and NADPH with oxygen into 3,4-dihydroxybenzoate and NADP+; the amount of oxygen can be measured as the amount of NADPH decreased by the reaction. The monooxygenase reaction is performed in a syringe, a closed system. After the completion of the monooxygenase reaction, glucose oxidase is added to the assay solution to consume the oxygen from the atmosphere; this enables us to measure the NADPH concentration in the solution spectrophotometrically in an open system and to check the anaerobicity of closed systems. The oxygen concentrations at 25 degrees C of oxygen-saturated and air-saturated water were 1.10 and 0.23 mM, respectively. The value for argon-bubbled water was zero within the experimental error; this justifies the assay system. Thus, it is shown that a sample containing 8 microM-1.1 mM oxygen can be measured by this method. PMID- 2757186 TI - Rapid measurement of binding constants and heats of binding using a new titration calorimeter. AB - A new titration calorimeter is described and results are presented for the binding of cytidine 2'-monophosphate (2'CMP) to the active site of ribonuclease A. The instrument characteristics include very high sensitivity, rapid calorimetric response, and fast thermal equilibration. Convenient software is available for instrument operation, data collection, data reduction, and deconvolution to obtain least-squares estimates of binding parameters n, delta H degree, delta S degree, and the binding constant K. Sample through-put for the instrument is high, and under favorable conditions binding constants as large as 10(8) M-1 can be measured. The bovine ribonuclease A (RNase)/2'CMP system was studied over a 50-fold range of RNase concentration and at two different temperatures. The binding constants were in the 10(5) to 10(6) M-1 range, depending on conditions, and heats of binding ca. -15,000 cal/mol. Repeat determinations suggested errors of only a few percent in n, delta H degree, and K values over the most favorable concentration range. PMID- 2757187 TI - A microassay for the determination of iodide and its application to the measurement of the iodination of proteins and the catalytic activities of iodo compounds. AB - A microassay system based on the effect of the catalytic Sandell-Kolthoff reaction of iodide on the oxidation of arsenic(III) by cerium(IV) was developed to measure iodine-containing compounds. This rapid assay uses small quantities of reagents, is suitable for use with a photometric microplate reader, can test many samples simultaneously, and eliminates problems associated with the use of radiolabeled compounds to measure iodination. It can detect picogram quantities of iodide. We report the use of this assay to measure the conjugation of an iodine-containing hapten (iodinated Bolton-Hunter reagent, IBHR) to ovalbumin and human serum albumin. It has proven to be excellent for studying the relative molar catalytic activity of the iodine-containing compounds IBHR, thyroxine, 4 iodophenol, and lithium 3,4-diiodosalicylate. The interference by azide on the assay was investigated. PMID- 2757188 TI - Synthesis and characterization of 6-O-(N-heptylcarbamoyl)-methyl-alpha-D glucopyranoside, a new surfactant for membrane studies. AB - A new surfactant, 6-O-(N-heptylcarbamoyl)-methyl-alpha-D-glucopyranoside (HECAMEG, molar mass 335.38 g), was synthesized by a simple and low cost procedure from methyl-alpha-D-glucopyranoside. This surfactant is characterized by a high solubility in water (even at 0 degree C), ultraviolet light transparency in the region useful for protein detection, and a high critical micellar concentration (CMC = 19.5 mM), permitting fast elimination by dialysis. Furthermore, the surfactant is colorimetrically titratable by the anthrone technique and its weak interference in protein titration by the Lowry et al. procedure and the bicinchoninic method is easy to overcome. Two membrane proteins (NADH oxidase and succinate dehydrogenase) and a soluble enzyme (lactoperoxidase) retained full activity in the presence of HECAMEG below or above its CMC. The partial inhibition of beta-lactamase (soluble form) by HECAMEG above the CMC was probably only apparent and due to an interference of the surfactant with the substrate rather than a direct effect on the enzyme. HECAMEG was capable of extracting up to 75% of bacteriorhodopsin from the purple membrane of Halobacterium halobium in a nondenatured form as indicated by the spectral properties of the protein. It also solubilized spiralin from the Spiroplasma melliferum membrane with a great selectivity and efficiency, without detectable loss of antigenic properties. These data show that HECAMEG is a very mild surfactant, useful for membrane protein studies. PMID- 2757189 TI - A dye-photosensitized reaction that generates stable protein-protein crosslinks. AB - Irradiation of fibrinogen with visible light for 30 s in the presence of 1-1000 microM fluorescein was found to crosslink fibrinogen both inter- and intramolecularly. Optimum crosslinking was achieved at dye concentrations of around 100 microM and the amount of crosslinking was shown to increase with pH. Crosslinking was inhibited in the presence of 50 microM tryptophan or tyrosine and enhanced in the presence of 5 mM histidine. Twice as much crosslinking was found to take place under anaerobic conditions. These observations are consistent with a dye-photosensitized reaction following the hydrogen abstraction pathway. The subunits of eukaryotic ribosomes and those of phosphorylase a were also crosslinked by the method described. PMID- 2757190 TI - A least-squares computer method for the determination of the molecular ratio of conjugates between two different proteins from the results of the amino acid analysis. AB - A method for the determination of the composition of a conjugate between two different proteins by amino acid analysis followed by least-squares evaluation of the concentration ratio of the two components is presented. The method is based solely on calculations and avoids the use of labeled residues. A computer program, written in BASIC, is also presented to perform the calculations. PMID- 2757191 TI - Determination of mono-O-acetylated N-acetylneuraminic acids in human and rat sera by fluorometric high-performance liquid chromatography. AB - A simple, rapid, and highly sensitive fluorometric high-performance liquid chromatographic method for the determination of N-acetylneuraminic acid and its mono-O-acetyl derivatives in human and rat sera is described. The neuraminic acids, released by hydrolysis of serum in 2 M acetic acid, are converted with 1,2 diamino-4,5-methylenedioxybenzene, a fluorogenic reagent for alpha-keto acids, to highly fluorescent derivatives without the occurrence of O-acetyl migration and de-O-acetylation. The derivatives are separated isocratically within 25 min by reversed-phase chromatography using a TSK gel ODS-120T column. The limits of detection are 57-192 fmol in a 10-microliters injection volume at a signal-to noise ratio of 3. This sensitivity permits precise determination of the neuraminic acids in 5 microliters of human and rat sera. PMID- 2757192 TI - Large-scale purification of plasmid insert DNA sequences using low-percentage agarose exclusion chromatography. AB - Linear double-stranded DNA fragments ranging from 0.14 to 8.4 kbp have been fractionated on low-percentage agarose exclusion gels. Both Ultragel A2 (2% agarose) and Bio-Gel A150m (1% agarose) exclude DNA fragments greater than 900 bp, while the exclusion limit of Bio-Gel A50m (2% agarose) is about 350 bp. All gels result in moderate resolution of DNA fragments smaller than the exclusion limits; we generally observe nearly complete one-step separation of fragments that differ in size by a factor of 2. On the basis of these results, we have used these exclusion gels to routinely purify greater than 0.4 mg of plasmid insert DNA sequences in one step and over 2.5 mg with a single column, demonstrating that these gel matrices can be ideally suited for repeated rapid large-scale purification of plasmid inserts. In addition, this knowledge allows for a more rational design of plasmids in those cases where large-scale use of the insert DNA is required. PMID- 2757193 TI - Continuous photometric determination of endo-1,4-beta-D-glucanase (cellulase) activity using 4-methylumbelliferyl-beta-D-cellobioside as a substrate. AB - A very simple and sensitive procedure for the determination of the activity of highly purified endo-1,4-beta-glucanase from the microscopic fungus Trichoderma reesei using 4-methylumbelliferyl-beta-D-cellobioside has been developed. The HPLC study has shown that this substrate is cleaved by endo-1,4-beta-glucanase to form predominantly free 4-methylumbelliferone, Km and kcat being 1.25 mM and 7.9 s-1, respectively (30 degrees C, pH 5.0). The possibility of continuous photometric determination of the enzyme using the difference absorptivity coefficient of 1600 M-1 cm-1 at 350 nm has been demonstrated. PMID- 2757194 TI - A highly sensitive, mixed-phase assay for chloramphenicol acetyltransferase activity in transfected cells. AB - We describe a simple, rapid yet extremely sensitive assay for chloramphenicol acetyltransferase (CAT) activity in extracts from transfected eukaryotic cells. Using our modified reaction conditions and the mixed-phase assay, less than 0.000010 unit of CAT activity in transfected cells can be reliably detected. The mixed-phase assay is based on the inability of the polar [3H]-acetyl-Coenzyme A (CoA) substrate to partition out of a urea containing aqueous phase into the nonpolar scintillation fluor, while the [3H]chloramphenicol reaction products partition into the toluene scintillation fluor and are quantitated by scintillation counting. The increased sensitivity of this assay is due to the optimization of the acetyl-CoA concentration, to a urea-containing aqueous phase which lowers the assay background, and to the use of extract blanks. The mixed phase assay is simpler, is quantitative, uses less costly substrates, and is far more sensitive than the most widely used CAT assays, which require solvent extraction followed by thin-layer chromatography to separate the unreacted substrate from product. PMID- 2757195 TI - Nonlinearity in protein assays by the Coomassie blue dye-binding method. AB - The Coomassie brilliant blue (CBB) method for protein determination takes advantage of the fact that a low-pH red form of CBB reverts to a blue form when CBB binds to protein. The increase in absorbance at 595 nm of a protein-dye mixture compared to a blank containing only the dye reagent has been used to estimate the total amount of protein present in the sample mixture. A disadvantage of this method of protein determination is that the assay plot of absorbance at 595 nm versus total protein is not linear. PMID- 2757196 TI - Luminescent immunodetection of western-blotted proteins from coomassie-stained polyacrylamide gel. AB - Immunodetection with horseradish peroxidase-linked antibodies on Coomassie stained nitrocellulose blots can be performed efficiently and rapidly with the peroxidase substrate luminol. The luminescence produced is detected with radioautographic film. This procedure allows a direct identification of immunodetected bands of stained nitrocellulose sheets without using radiolabeled secondary antibodies. Because of its convenience and sensitivity, this method could be particularly suitable for purification of immunodetected proteins. PMID- 2757197 TI - Determination of the absolute configuration of the sugar residues of complex polysaccharides by circular dichroism spectroscopy. AB - Circular dichroism spectroscopy is used to determine the absolute configuration of the constituent sugar residues of bacterial polysaccharides from two strains of Streptococcus sanguis which are important receptors in bacterial coaggregation in the formation of dental plaque. A high-pressure liquid chromatographic method for carbohydrate analysis of glycoproteins, glycolipids, and polysaccharides has been extended to sugar chirality determination by collection of the eluted HPLC fractions and subsequent measurement of their circular dichroism spectra. The method involves methanolysis of the polysaccharide followed by formation of O benzoyl derivatives and HPLC on reverse-phase columns. Circular dichroism spectra of the collected derivatives in acetonitrile solution in the region 230 nm show large ellipticity bands resulting from "chiral exciton" interaction among the O benzoyl chromophores which are sensitive to the orientation of hydroxyl groups in the parent sugars. The sensitivity of the method is in the submicrogram range for the absolute configuration of single sugar residues. The circular dichroism of the intact polysaccharide in aqueous solution shows CD bands from the amide chromophore in the region 180 to 220 nm which are sensitive to the chirality of 2 acetamido sugar residues. PMID- 2757198 TI - A semiempirical model for the electrophoretic mobilities of peptides in free solution capillary electrophoresis. AB - In this study an attempt is made to explore the effect of a peptide's size, charge, and hydrophobicity on its electrophoretic mobility (mu) as measured by free-solution capillary electrophoresis with the aim of developing a semiempirical model which incorporates these effects. The effects of peptide size (which is measured by the number of amino acids in the polypeptide chain (n] and charge on mu are independently determined by experiment in a single solvent system and combined to give the relationship (formula; see text) where the constant 5.23 X 10(-4) is postulated to depend on the solvent system used. The form of Eq. [A.1] was confirmed, and the values of the constants 5.23 X 10(-4) and 2.47 X 10(-5) were determined, by measuring the electrophoretic mobilities of 40 peptides varying in size from 3 to 39 amino acids and varying in charge from 0.33 to 14.0. Furthermore, the effect of noncharged neutral amino acids on mobility was investigated and shown to be present, but only as a minor perturbation on the effects of size and charge. PMID- 2757199 TI - Analysis of pyridine dinucleotides in cultured rat hepatocytes by high performance liquid chromatography. AB - An isocratic reverse-phase high-performance liquid chromatography method for the separation and quantitation of total pyridine dinucleotides in hepatocyte cultures is described. Cells are extracted with cold 3 M perchloric acid or 0.5 N sodium hydroxide containing 50% (v/v) ethanol and 35% cesium chloride for the determination of the oxidized or reduced pyridine dinucleotides, respectively. Pyridine dinucleotides in the neutralized extracts were separated on an Excellopak ODS C18 (4.6 X 150 mm) column with 0.1 M potassium phosphate, pH 6.0, containing 3.75% methanol as the mobile phase. NAD+ and NADP+ were detected spectrophotometrically at 254 nm. The response was linear from 5 to 4000 pmol with recoveries of NAD+ and NADP+ of 98 and 101.1%, respectively. NADH and NADPH were monitored fluorometrically by activation at 370 nm and emission in the 400 700 nm range. The reduced pyridine dinucleotides had a linear response from 7.5 to 60 pmol with recoveries of NADH and NADPH of 99.4 and 101.3%, respectively. The coefficients of variation for all of the pyridine dinucleotide standards were less than 3.5%. PMID- 2757200 TI - Identification of Dictyostelium discoideum plasma membrane proteins by cell surface labeling and quantitative two-dimensional gel electrophoresis. AB - Plasma membrane proteins of the cellular slime mold Dictyostelium discoideum were characterized by two-dimensional polyacrylamide gel electrophoresis using a variety of labeling techniques and a microcomputer-based videodensitometer. Algorithms for the determination of molecular weights and isoelectric points were developed to aid in the comparison of polypeptides from different autoradiographs, Coomassie blue-stained gels, and Western blots. Cell homogenates were compared to plasma membranes isolated by a silica density perturbation technique and to cytoskeletons obtained by nonionic detergent extraction. Plasma membrane proteins were distinguished from subcellular contaminants by lactoperoxidase-catalyzed radioiodination, by selective labeling with N hydroxysuccinimidyl-2-iminobiotin, and by quantitatively determining the enrichments of individual polypeptides from gels of plasma membrane proteins relative to their counterparts in gels of total cell lysate proteins. In contrast to defining plasma membrane purity by measuring a representative marker enzyme activity, the quantitative two-dimensional gel analysis strategy presented allowed for a rigorous evaluation of the enrichments of all detectable polypeptides in the subcellular fraction. Quantitative two-dimensional gel analysis avoided problems encountered with marker enzyme activation or inhibition during subcellular fractionation as enrichments were based solely on polypeptide amounts. It was also capable of identifying a wider spectrum of plasma membrane proteins than any of the labeling techniques employed in this study. A high resolution two-dimensional gel catalog was generated containing information about plasma membrane protein orientation in the bilayer, association with the cytoskeleton, phosphorylation state, glycosylation state, copy number, isoelectric point, and molecular weight. PMID- 2757201 TI - Preparation of [35S]sulfobromophthalein of high specific activity. AB - Study of the hepatocyte transport mechanism of organic anions such as bilirubin and sulfobromophthalein has been limited by the relatively low specific activities of these ligands. [3H]Bilirubin and [35S]sulfobromophthalein have been available with specific activities of only approximately 100 mCi/mmol. We now report a relatively simple procedure to prepare [35S]sulfobromophthalein at a specific activity of approximately 3000 mCi/mmol. This compound is radiochemically pure and serves as a tracer for authentic sulfobromophthalein as judged by chromatography, hepatocyte uptake, metabolism, and biliary excretion. Use of this material as a photoaffinity probe and as a transported ligand may permit dissection and understanding of its transport mechanism. PMID- 2757202 TI - Modification of the drop dialysis technique for use with larger volume samples. AB - Desalting of nucleic acids by the drop dialysis method is limited by the fact that only small volume samples can be used due to the lack of sample containment on the membrane filters. A specially modified Styrafoam cup can be used as a membrane filter holder which serves to contain the sample, thus permitting dialysis of larger sample volumes. PMID- 2757203 TI - Calcium tartrate gel. AB - A method for preparation of a gel for chromatography has been developed. The adsorbent is calcium tartrate treated with potassium phosphate. By changing the temperature of synthesis (10-65 degrees C) and concentration of the salts (calcium chloride and sodium potassium tartrate) from 0.3 to 3.0 M, we have been able to prepare adsorbent crystals of definite sizes in the range 35-200 microns. In all cases, for synthesis of adsorbent, the Ca2+/K+Na+ ratio was greater than 1. After treatment of calcium tartrate crystals with 0.075-1.5 M potassium phosphate at 80-100 degrees C and pH 8.5-9.0, an appropriate chromatographic adsorbent was prepared. The chromatographic properties of calcium tartrate gel have been studied. The adsorbent permits flow rates of 25-150 ml/h, depending on the particle size. The capacity of calcium tartrate gel for binding BSA, RNA, and DNA was similar to that of Tiselius' hydroxyapatite (A. Tiselius, S. Hjerten, O. Levin (1956) Arch. Biochem. Biophys. 65, 132-155). The spheric shape of gel particles permits uniform and compact packing of adsorbent under the conditions of column chromatography. PMID- 2757204 TI - The separation of [32P]inositol phosphates by ion-pair chromatography: optimization of the method and biological applications. AB - We have developed an ion-pair reverse-phase HPLC method to measure inositol phosphates in 32P-labeled cells. The different chromatographic parameters were analyzed to optimize the resolution of the 32P-labeled metabolites. Analysis of inositol phosphates in biological samples was improved by a single charcoal pretreatment which eliminated interfering nucleotides without removing inositol phosphates. The kinetics of production of inositol phosphates in calcium activated erythrocytes, vasopressin-stimulated hepatocytes, and thrombin activated platelets were analyzed. Original data on the activation of phosphoinositide phospholipase C were obtained in intact erythrocytes by direct measurement of inositol (1,4,5)P3. Data from agonist-stimulated hepatocytes and platelets were consistent with those from previous studies. In conclusion, this technique offers many advantages over the methodologies currently employed involving anion-exchange chromatography and [3H]inositol labeling: (i) 32P labeling is less expensive and more efficient than 3H labeling and can be used with all types of cells without permeabilization treatments and (ii) ion-pair HPLC gives good resolution of inositol phosphates from nucleotides with shorter retention times, and long reequilibration periods are not required. PMID- 2757206 TI - Continuous liquid-phase piezoelectric biosensor for kinetic immunoassays. AB - The reactions of immunoglobulins with protein A and, subsequently, of antibodies to these immunoglobulins were continuously monitored by a piezoelectric biosensor. AT-cut crystals, with a fundamental resonant frequency of 10 MHz, were mounted in a Plexiglas holder, and one side was directly coated with protein A. Upon exposure to solutions containing rabbit or human IgG the resonant frequency was followed continuously and its decrease due to the binding of IgG to protein A observed. Subsequent addition of sheep antihuman IgG to the now immobilized human IgG caused a specific 3-fold further decrease in resonant frequency. We observed a frequency change of approximately 1 Hz fore each 10 ng of added immunoglobulin. Decreasing the pH to 3 released the bound IgG but not the protein A and permitted reuse of the crystal for further IgG binding. PMID- 2757205 TI - Application of free-solution capillary electrophoresis to the analytical scale separation of proteins and peptides. AB - The application of free solution capillary electrophoresis (FSCE) to the separation of protein and peptide mixtures is presented. Both qualitative and quantitative aspects of FSCE separations are considered. In addition, a brief introduction describing the separation principle behind FSCE separations and a discussion of electrophoretic mobility are included. The applications were chosen in order to highlight the selectivity of FSCE separations and to demonstrate applications of potential practical interest to the bioanalytical chemist. Comparison of FSCE relative to traditional analytical separation alternatives is stressed throughout. The examples are presented in three broad categories: protein separations, peptide separations, and the application of both to the analysis of recombinant protein products. In the first section, FSCE separations of peptide mixtures are presented which demonstrate the suitability of FSCE for the analysis of the purity of peptide samples, the homogeneity of peptide samples prior to sequencing, the identity of peptides by using electrophoretic mobility values, and the reduction of an intrachain disulfide bridge. In the second section, protein separations are presented that show the resolution of glycoproteins having the same primary structure and the separation of immune complexes from free unreacted antibody and antigen. In the final section, highly purified and well-characterized samples of biosynthetic human insulin (BHI), biosynthetic human growth hormone (hGH), and their derivatives were used to evaluate FSCE as a complement and/or alternative to conventional analytical separation techniques for the determination of purity and identity of biosynthetic human proteins. In addition, the quantitative aspects of FSCE analysis such as linearity of response, precision, and limit of detection were examined. PMID- 2757207 TI - Determination of total mercury in water and urine by a gold film sensor following Fenton's reagent digestion. AB - Fenton's reagent (Fe(II) + H2O2) is utilized for the digestion of environmental water samples and urine. Following the digestion, which converts organic forms of Hg to inorganic Hg(II), Hg(0) is liberated by borohydride reduction and measured by a conductometric gold film sensor. Quantitative recovery of Hg from samples spiked with mercuric chloride, methylmercury(II) chloride, and phenylmercury(II) acetate was attainable in the presence of naturally occurring suspended matter and humic and fulvic acids as well as 3% NaCl. The digestion is performed at moderate pH (3-4) and temperature (less than or equal to 50 degrees C) and does not use large amounts of any reagent. Excellent agreement is shown for reference water, wastewater, and urine standards. The limit of detection, facilitated by the low blank value, is 500 pg of Hg or 10 ng/L for a 50-mL sample. PMID- 2757208 TI - A "screened" electrostatic ion trap for enhanced mass resolution, mass accuracy, reproducibility, and upper mass limit in Fourier transform ion cyclotron resonance mass spectrometry. AB - Until now, it was thought that the optimal static electromagnetic ion trap for Fourier transform ion cyclotron resonance (FT-ICR) mass spectrometry should be designed to produce a quadrupolar electrical potential, for which the ion cyclotron frequency is independent of the ion's preexcitation location within the trap. However, a quadrupolar potential results in a transverse (to the magnetic field) electric field that increases linearly with distance from the center of the trap. That radially linear electric field shifts the observed ICR frequency, increases the ICR orbital radius, and ultimately limits the highest mass-to charge ratio ion that can be contained within the trap. In this paper, we propose a new static electromagnetic ion "trap" in which grounded screens placed just inside the usual "trapping" plates produce a good approximation to a "particle-in a-box" potential (rather than the quadrupolar "harmonic oscillator" potential). SIMION calculations confirm that the electric potential of the screened trap is near zero almost everywhere within the trap. For our screened orthorhombic (2.5 in. X 2 in. X 2 in.) trap, the experimental ICR frequency shift due to trapping voltage is reduced by a factor of approximately 100, and the experimental variation of ICR frequency with ICR radius is reduced by a factor of approximately 10 compared to a conventional (unscreened) 2-in. cubic ion trap.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2757209 TI - A thousand points of light: the Hadamard transform in chemical analysis and instrumentation. PMID- 2757210 TI - Determination of nitrite in drinking water and environmental samples by ion exclusion chromatography with electrochemical detection. AB - An extremely sensitive determination of nitrite in drinking water (tap water and underground water) and environmental samples (rain, lake water, and soil) was achieved by ion exclusion chromatography (IEC) with electrochemical (EC) detection. Potential interferences in the determination of nitrite by the standard spectrophotometric method or by the ion exchange chromatographic method with either conductivity detection or UV detection were eliminated. The detection limit was 0.1 ppb without preconcentration. No nitrite was observed from tap water or underground drinking water. The recoveries of nitrite added to tap water at 0.02, 0.1, and 1 ppm levels were between 96 and 104.5%. The average coefficient of variation was 4.7%. The recovery results were in good agreement with those obtained by the standard spectrophotometric method. Nitrite concentrations between 0.068 and 0.19 ppm were observed in rain within a week period. A greater variation, between 0.015 and 0.26 ppm, was observed in lake water. Amounts of 19.1 ppm and 0.50 ppm nitrite were observed from fertilized and unfertilized soil, respectively. PMID- 2757211 TI - Multicomponent fluorometric analysis using a fiber-optic probe. AB - Single-frequency phase-resolved fluorometry through single and bifurcated fiber optic probes is used to quantify mixtures of spectrally similar fluorophores. Correlation coefficients from correlation plots are greater than 0.98, and standard errors of estimate are less than 0.13 microM for 80 binary mixtures. Quantification of fluorophores at up to 10:1 molar ratios with lifetime separations of less than 200 ps is possible. The simultaneous quantification of the individual components of ternary and quaternary synthetic mixtures is demonstrated. Application of phase resolution to ambient light rejection is reported also. In this case, the emission spectrum of 10 nM Rhodamine 6G is easily obtained in the presence of a fluctuating, unmodulated background. PMID- 2757212 TI - Polymeric activated ester reagents for off-line and on-line derivatizations of amine nucleophiles in high-performance liquid chromatography with ultraviolet and fluorescence detection. AB - A novel polymeric activated ester reagent has been developed that improves final detectability and chromatographic performance in high-performance liquid chromatography (HPLC) for virtually all primary and secondary amines or amine analogues. This has involved the synthesis, characterization of final reagent, optimization of derivatization and separation conditions, and determination of analytical figures of merit. The polymeric reagent contained an activated ester linkage to the 9-fluorenyl group, which imparted ultraviolet (UV) and fluorescence (FL) detector properties to the final derivatives. Kinetic studies of these solid-phase (heterogeneous) reactions have been conducted, and specific rate constants were compared with those of the analogous solution reaction for the same substrates. Percent derivatizations have reached 90% and 70% for primary and secondary amines, respectively, under optimized conditions. High reaction reproducibility has been obtained by using the on-line approach, for more than 50 separate injections of the same amine substrate with a single solid-phase reactor. These solid-phase derivatizations have led to detection limits for typical amines in the low-parts-per-billion range. The final, overall methods can provide rapid, automatable, accurate, and precise detection and quantitation of primary/secondary amines and amine-like compounds in real-world sample matrices. As an illustrative example, amphetamine spiked in urine has been derivatized off line and on-line, with minimum sample preparation, and detected via HPLC-UV/FL with acceptable accuracy and precision. PMID- 2757213 TI - Chiral polymeric reagents for off-line and on-line derivatizations of enantiomers in high-performance liquid chromatography with ultraviolet and fluorescence detection: an enantiomer recognition approach. AB - Optically active and detector-sensitive polymeric reagents have been synthesized, loadings determined, derivatizations/separations/detection optimized, and applications to simple amines and amino alcohols described. Such reagents have been designed to contain different chiral centers, usually amino acids, leashed via an activated ester attachment to an insoluble, structurally rigid, organic polymer backbone. 9-Fluorenylmethyl (FMOC) moieties chemically bonded to the amino acids were used as ultraviolet (UV) and fluorescence (FL) sensitive detector probes to the final diastereomers of enantiomer substrates. Such diastereomers can be readily separated by isocratic or gradient elution normal phase methods. The kinetics for diastereomer formation have been determined, and final UV/FL responses for known mixtures of enantiomers have been compared to demonstrate overall validity of the method. Minimum detection limits, linearity of calibration plots, dual detector responses, and linear diode array spectra and absorbance ratios have also been demonstrated. In some cases, authentic standards have been prepared to calculate absolute percent derivatizations for specific enantiomer pairs. The overall approach permits, for the very first time, off-line or on-line precolumn derivatization for the formation of diastereomers having unique detector properties. It has been proven that the rates and rate constants for such formations are identical for at least those pairs of enantiomers studied. Separations are base-line or near-base-line, permitting accurate and precise quantitative determinations, by both UV and FL, of enantiomer/optical purity and chemical purity. PMID- 2757214 TI - Capillary zone electrophoresis with analyte velocity modulation. Application to refractive index detection. PMID- 2757215 TI - Color-coded genes. PMID- 2757216 TI - Computer chip speeds DNA analysis. PMID- 2757217 TI - The great fruit scares of 1989. PMID- 2757218 TI - Determination of chlortetracycline residues in tissues using high-performance liquid chromatography with fluorescence detection. AB - A method is described for the determination of chlortetracycline residues in tissue samples. The samples were extracted into a hydrochloric acid - glycine solution and the extracts concentrated and purified on cyclohexyl-bonded reversed phase cartridges. Any chlortetracycline present was converted to iso chlortetracycline at pH 12, which was then separated from interfering compounds on a reversed-phase polymeric column using high-performance liquid chromatography with fluorescence detection. The detection and determination limits of the assay were 20 and 50 ng g-1, respectively, making it suitable for statutory residue testing purposes. PMID- 2757219 TI - Simultaneous determination of fenamiphos, its sulphoxide and sulphone in water by high-performance liquid chromatography. AB - A method for the simultaneous determination of fenamiphos and its two metabolites, fenamiphos sulphoxide and fenamiphos sulphone, in water is described. The proposed method is based on the separation of the compounds on a silica gel column with ultraviolet detection and overcomes the problems of inadequate separation and possible decomposition associated with the gas chromatographic determination of these compounds. The application of the method to groundwaters showed that a minimum detection level of the order of 10 micrograms l-1 could be achieved easily with pre-concentration of the samples on Sep-Pak C18 disposable cartridges. PMID- 2757220 TI - Equilibrium constants and assay of benzodiazepines in acetic acid. AB - The over-all dissociation constants, in anhydrous acetic acid, of a series of benzodiazepines have been determined. A method is described for evaluating the formation constants of the perchlorate salts. From these values simple potentiometric and visual titration methods for the assay of benzodiazepines in acetic acid are described. PMID- 2757221 TI - Membrane filters for the concentration of trace elements in water: distribution of ion pairs between membrane filter and aqueous phases. AB - The sorption of ion pairs on membrane filters (MFs) has been studied by taking the membrane filter as one of the homogeneous phases. The sorbability of some ionic species and the sorption abilities of different types of MF were evaluated in terms of the sorption constant defined by Ksor,CA = [(C+,A-)f]/[C+][A-], where C+, A- and (C+,A-) refer to the cation, anion and the ion pair, respectively, and f refers to the filter phase. The values of Ksor,CA were determined for many combinations of ionic complexes of cobalt(III) with pyridylazophenols, either as cations or anions, and oppositely charged organic ions having different alkyl chain lengths, with MFs made of different materials: nitrocellulose (NC; Toyo Advantec), acetylcellulose (AC; Fuji Film), regenerated cellulose (RC; Toyo Advantec) and polyethersulphone (PS; Toyo Advantec). For a given cobalt complex ion, the value of log Ksor,CA increased linearly with the increasing number of carbons in the counter ion. Membrane filters made of different materials showed different sorption abilities, the order being NC greater than PS greater than RC greater than AC. It was shown that the surface area of the MF is of greater significance than the volume of the matrix of the MF in determining the sorption constant. PMID- 2757222 TI - Analysis of carbofuran residues in soil by the stopped-flow technique. AB - A simple method for the determination of carbofuran by the stopped-flow technique and which is suitable for its routine analysis in soil samples is reported. The method was based on the coupling reaction between carbofuran phenol (the hydrolysis product of carbofuran) and diazotised sulphanilic acid to form a coloured compound, the rate of formation of which was monitored spectrophotometrically. The calibration graph was linear in the range 1-40 micrograms ml-1 (RSD, 2%) and the method was highly selective. The average recovery of carbofuran was 96.5% from soil, and less than 0.5 micrograms g-1 could be detected. A procedure for the resolution of propoxur - carbofuran mixtures of mass ratios in the range 5:1-1:10 with a precision of ca 3% is also described. PMID- 2757223 TI - Simultaneous determination of benzodiazepines by ultraviolet--visible spectrophotometry in micellar media. AB - A method for the simultaneous determination of benzodiazepines in binary mixtures is proposed, based on the acid hydrolysis of benzodiazepines to benzophenones and the spectrophotometric determination of the latter in the presence of Nemol K 1030, a non-ionic surfactant condensate of ethylene oxide with nonylphenol. The experimental conditions for the hydrolysis of several benzodiazepines in sealed Pyrex tubes were determined. The addition of Nemol K 1030 to acidic solutions of benzophenones modified the positions of the absorption bands and made possible the simultaneous analysis of binary mixtures of benzodiazepines. PMID- 2757224 TI - Extractive spectrophotometric determination of some anti-inflammatory agents with methylene violet. AB - A fairly sensitive spectrophotometric method for the determination of ibuprofen, ketoprofen, piroxicam, diclofenac sodium, mefenamic acid or enfenamic acid in bulk samples and pharmaceutical preparations is described, based on the formation of a chloroform-soluble, coloured ion-association complex between the drug and Methylene Violet at pH 7.6. PMID- 2757225 TI - Voltammetric determination of chlorpromazine hydrochloride. AB - The electrochemical behaviour of chlorpromazine hydrochloride (CPZ-HCI) in sulphuric acid was investigated voltammetrically using ruthenium electrodes and it was subsequently determined by the same method. From the recorded voltammograms it was concluded that CPZ-HCI can be determined in the concentration range 2 x 10(-4)-8 x 10(-4) M (71-284. 3 micrograms ml-1). The proposed voltammetric method was applied to the determination of CPZ-HCI in tablets used for neuroleptic purposes in Turkey; the amount of effective compound was found to be within the ranges given for a pharmacopoeial procedure. PMID- 2757226 TI - Determination of selenium in fish flesh by hydride generation atomic absorption spectrometry. AB - Selenium was determined in freeze-dried fish flesh from perch, pike-perch and the fish flesh reference materials MA-A-2 No. 1174 and MA-B-3 No. 151 (both from the International Atomic Energy Agency) by hydride generation atomic absorption spectrometry. Four different decomposition procedures were tested. They yielded consistent results for the four specimens, but the certified concentration level of selenium in the reference material MA-A-2 was not reached. This indicated losses or the presence of very stable selenium-containing compounds in this fish flesh. Neutron activation analysis of the reference material, however, was in agreement with those results obtained. PMID- 2757227 TI - Gas chromatographic determination of ethyl 2-cyanoacrylate in the workplace environment. AB - Low levels of airborne ethyl 2-cyanoacrylate (ECA) were monitored by drawing air through sampling tubes containing Tenax GC. After desorption with acetone, ECA was quantified by gas chromatography using a thermionic specific detector in the nitrogen mode. Polymerised ECA was shown to yield ECA monomer under the conditions of gas chromatographic analysis. PMID- 2757228 TI - Thin-layer chromatographic scanner, spectrophotometric and high-performance liquid chromatographic methods for the determination of colchicine. AB - One high-performance liquid chromatographic (HPLC) and two thin-layer chromatographic (TLC) methods are proposed for the determination of colchicine in crude drugs and pharmaceutical preparations. The TLC scanner method is based on measurement of the absorbance of the separated colchicine spot; alternatively, after scraping the spot from the plate and elution the absorbance can be measured spectrophotometrically. The HPLC assay was carried out isocratically on a reversed-phase column using MeOH-H2O (60 + 40). The recoveries were 99.2 +/- 1.23, 99.1 +/- 1.12 and 99.1 +/- 2.01% for the TLC scanner, spectrophotometric and HPLC methods, respectively. The methods were shown to be sensitive and specific and can be used as an alternative to the pharmacopoeial methods having been applied to the determination of colchicine in corms of Merendera persica and in three pharmaceutical preparations. PMID- 2757229 TI - Kinetic and chemometric studies of the determination of creatinine using the Jaffe reaction. Part I. Kinetics of the reaction: analytical conclusions. AB - A kinetic-spectrophotometric study of the Jaffe reaction was carried out and the kinetic behaviour, calibration step and interfering effect of albumin on creatinine standard solutions were studied. It was concluded that there is a variation in the kinetic behaviour of the system when higher concentrations of creatinine, picrate or sodium hydroxide are tested. The experimental conditions for quantifying creatinine must be chosen so that the kinetic behaviour is the same in the dynamic concentration range. Changes in the absorbance (delta A) versus concentration equations were chosen as the most suitable for calibration graphs. It was also shown that creatinine results will have a proportional bias error if the interfering effect of albumin is not taken into consideration. PMID- 2757230 TI - Kinetic and chemometric studies of the determination of creatinine using the Jaffe reaction. Part 2. Application to human serum samples: kinetic behaviour and chemometric evaluation of the determination. AB - The kinetic behaviour of the reaction of alkaline picrate with creatinine in human serum samples was found to be similar to that for standard creatinine solutions containing albumin. A chemometric evaluation of the kinetic determination of creatinine using the Jaffe reaction was carried out. The analysis of variance (ANOVA) method applied to the delta A45,180 values, obtained from two replicates of three different serum samples over a period of 10 d, showed that the between-day and between-replicate variations added a component to the total variability, the residual error (delta R2) being 5 X 10(-5). A study of the accuracy of the determination was carried out by means of percentage recovery experiments, Youden's method and the standard additions method. Percentage recovery experiments showed that albumin has a marked effect on the results obtained. The application of Youden's method to four serum samples indicated that the method does not have a constant bias error, but, by applying the standard additions method it was concluded that the method has a proportional bias error. The recovery factor, defined as the ratio of the slope of the standard additions graph to that of the standard response graph, was also calculated for the four serum samples. The best values were obtained with different standard response graphs (7.7, 15.4 and 25.6 g l-1 of albumin) for each sample. A modification of the routine procedure used in clinical laboratories is proposed. This modification is based on the principles of the standard additions method and gives better results for creatinine content than those obtained with the routine procedure. PMID- 2757231 TI - Analysis of trifluralin and other dinitroaniline herbicide residues by zero-order and derivative ultraviolet spectrophotometry. AB - The utility of zero-order and first- and second-derivative ultraviolet (UV) spectrophotometry for the identification of benfluralin, trifluralin, isopropalin and oryzalin is discussed. These four herbicides were determined by zero-order and first-derivative UV spectrophotometry, with linear calibration graphs established between 50 and 100 concentration units and limits of detection ranging from 1 to 7 micrograms ml-1. The application of these techniques to the residue analysis of fortified soils and niebe and peanut leaves is described. Trifluralin residues were found to be 6.7, 8 and 1.7 micrograms ml-1 in samples of fortified soils, niebe leaves and peanut leaves, respectively. Isopropalin residues were found to range from 62 to 154 micrograms ml-1 in samples of fortified niebe leaves. PMID- 2757232 TI - Spectrophotometric determination of trace amounts of iron(III) with norfloxacin as complexing reagent. AB - The complexation of iron(III) with norfloxacin in acidic solution at 25 degrees C, at an ionic strength of about 0.3 M and a pH of 3.0 has been studied. The water-soluble complex formed, which exhibits an absorption maximum at 377 nm, was used for the spectrophotometric determination of trace amounts of iron(III). The molar absorptivity was 9.05 x 10(3) I mol-1 cm-1 and the Sandell sensitivity 6.2 ng cm-2 of iron(III) per 0.001 A. The formation constant (Kf) was determined spectrophotometrically and was found to be 4.0 x 10(8) at 25 degrees C. The calibration graph was rectilinear over the range 0.25-12.0 p.p.m. of iron(III) and the regression line equation was A = 0.163c - 0.00042 with a correlation coefficient of 0.9998 (n = 9). Common cations, except cerium (IV), did not interfere with the determination. The results obtained for the determination of iron(III) using the described procedure and the thiocyanate method were compared statistically by means of the Student t-test and no significant difference was found. PMID- 2757233 TI - Spectrophotometric determination of tannins in tea and beer samples with iron(III) and 1,10-phenanthroline as reagents. AB - A simple and accurate spectrophotometric method is proposed for the determination of tannins in tea and beer samples based on the reduction of iron(III) to iron(II) by tannins at 80 degrees C for 20 min. The iron(II) was then reacted with 1,10-phenanthroline at pH 4.4 to form a coloured complex. Background correction could be effected by precipitating the tannins in the sample solution twice with gelatin and kaolin. Absorbance measurements were made at 540 nm and the calibration graph was linear from 0 to 5.5 micrograms ml-1 of tannic acid with a slope of 0.213 A p.p.m.-1. The precision for the determination of tannins in a tea sample containing 9.45% of tannins was 1.8%. Most of the ingredients commonly found in tea and beer samples do not interfere with the determination. Several tea and beer samples were analysed for their tannin content using the proposed method. PMID- 2757234 TI - Application of adsorptive stripping voltammetry to the speciation and determination of iron(III) and total iron in wines. AB - An analytical procedure for the determination of iron(III) and total iron in wines based on adsorptive stripping voltammetry is described. Iron(III) was determined by using Solochrome Violet Red as chelating agent while catechol was used for the determination of the total iron content. Each chelate was adsorbed on the hanging mercury electrode and the reduction current of the accumulated chelate was measured. The results obtained from the application of this procedure to wine samples are discussed. PMID- 2757235 TI - Demonstration of sugar residues in the ultimobranchial tubule and thyroid C-cells of the rat using peroxidase labelled lectins. AB - The distribution of various sugars, that contribute to the composition of the carbohydrate components of the glycoprotein in the ultimobranchial tubule and the thyroid C-cells has been studied, using eight peroxidase-labelled lectins (Dolichos biblorus, Glycine max, Bauhinia purpurea, Helix pomatia, Arachis hipogaea, Ulex europaeus I, Limax flavus and Sophora japonica). The results obtained seem to show that there are receptors for Dolichos biflorus, Glycine max, Bauhinia purpurea, Helix pomatia, Arachis hipogaea, Ulex europaeus I and Limax flavus in the ultimobranchial tubule, suggesting the existence of N acetylgalactosamine, galactose, L-fucose and sialic acid. However, the C-cells show only a positive reaction with Ulex europaeus I indicating the existence of fucosyl residues in those cells. All these findings support the contention that the ultimobranchial body might contribute decisively not only to the formation of C-cells but also, partially, to the constitution of certain follicular cells. PMID- 2757236 TI - [Cellular specificity of lectin binding in the kidney of the quail (Coturnix coturnix japonica)]. AB - The goal of this study was to demonstrate the distribution of glycoproteins in the various segments of the Japanese quail nephron, using lectins labeled with HRP or FITC. Each one of the six labeled lectins had a characteristic distribution pattern along the nephron. The study shows that lectins are useful markers for certain nephron segments or for cell types in certain segments of the renal tubules. PNA marks the thin portion of the medullary loop, DBA marks the thick portion; it is thus possible to differentiate the nephron segments in the medullary cone of the kidney. Con A binds selectively with the epithelioid, granular cells of the tunica media of the vasa efferentia. The histochemical technic using labeled lectins makes it possible to identify certain renal structures that could not, or only with difficulty, be differentiated using conventional histology. Therefore, lectins as specific markers are gaining in importance for further studies of the morphology and physiology of the kidney. PMID- 2757237 TI - Studies on the ovarian development in zebu cattle (Bos indicus). AB - In a study of 71 female foetuses, gonadal blastema was observed at 1.5 cm crown rump length (CRL). Oogonial cells entered the meiotic prophase at 3.5-6.0 cm CRL, which was arrested at the dictyotene stage to produce primary oocytes which formed primordial follicles. Primordial follicles were observed at 6-8 cm CRL. All germinal cells were at dictyotene by 20-24 cm CRL and follicles developed to primary and secondary stages. Folliculogenesis dominated further ovarian development and reached a peak between 32 and 35 cm CRL. In seven of the 12 foetuses measuring between 41 and 72 cm CRL, many follicles were atretic and some luteinized. The luteal bodies were composed of hypertrophied theca and granulosa cells with homogeneous and eosinophilic cytoplasm. PMID- 2757238 TI - The tissue distribution of Ia- and IgM-positive cells in adult and newborn miniature pigs. AB - Distribution of Ia- and IgM-positive cells was compared in tissues of adult and newborn miniature pigs, using indirect immunoperoxidase and immunofluorescent techniques with monoclonal antibodies. The different distribution patterns were found mainly in adult jejunum and kidney. Both IgM- and Ia-staining were ascertained in the lamina propria between the Lieberkuhn crypts and in the lymphoid follicles of the jejunum. Moreover, IgM-positive cells were demonstrated in the crypts while Ia-reaction was seen in the lamina propria of the villi. In the kidney, IgM-staining was limited to the glomeruli. On the contrary, a distinct Ia-reaction was found mainly in intertubular structures. Small differences in IgM- and Ia-positive cell distribution were also noted in the mesenteric lymph nodes and in the spleen. Developmental changes of the adult distribution patterns (chiefly that of IgM-positive cells) were found in all tissues studied at 2 days of age. PMID- 2757239 TI - Cytological, immunocytochemical and ultrastructural study of GH cells of pars distalis adenohipophysaria of kids (Capra hircus). AB - Staining and histochemical methods, immunocytochemical and electron microscopy were used to individualize the somatotropic or GH cells in the adenohypophyseal pars distalis of the kid. They are found in a sagittal section throughout the pars distalis constituting 34% of the hypophyseal cell population. They are 12.37 micron in size and have as an ultrastructural characteristic secretory spherical granules of a large size (males, 391 nm and females, 427 nm) which are very electrodense. PMID- 2757241 TI - [Optical and scanning electron microscopic study of the structural development of the cecum and colon walls in the rabbit (Oryctolagus cuniculus L.) during the perinatal period]. AB - The study, through optical and scanning microscopy, of various developmental stages, from the 24th day of gestation to the 13th day after birth, shows a quick development of the structures of the caecal and colic mucosal layers to the adult forms, from the very first week of postnatal life. The distal part of the colon is full-grown before the other parts of the alimentary canal, and is particularly rich in mucous cells. The caecum is the place where an early lymphoid defense is provided, from the 30th day of gestation. PMID- 2757240 TI - Atresia of the right atrioventricular orifice with complete transposition of the great arteries in a horse. AB - The heart of a 6-week old Arabian filly with a history of poor health and exercise intolerance revealed at postmortem examination, multiple cardiac malformations which included atresia of the right atrioventricular orifice (tricuspid atresia, with associated atrial and ventricular septal defects), complete transposition of the great arteries, anomalous drainage of the venae cavae and coronary sinus into the left atrium, coarctation of the aorta, and a small but patent ductus arteriosus. The course of blood through the heart was suggested and discussed. PMID- 2757242 TI - Osteomorphological features of the appendicular skeleton of gazelles, genus Gazella Blainville 1816, bohor reedbuck, Redunca redunca (Pallas, 1767) and bushbuck, Tragelaphus scriptus (Pallas, 1766). AB - Examined the osteomorphological features of the appendicular skeleton of Grant's gazelle (Gazella granti), bohor reedbuck (Redunca redunca) and bushbuck (Tragelaphus scriptus). Osseous remains of these medium sized antelopes are often encountered in African late Quaternary archaeological sites, but their specific identification poses considerable problems to the archaeozoologist. A key has been developed to meet this recurrent problem and a number of diagnostic osteomorphological features, allowing a distinction between the bovids mentioned, are established. The osteomorphological characteristics, typical for Grant's gazelle have also been observed in the eight other extant African gazelles and in two Asian species, the goitred gazelle (Gazella subgutterosa) and the mountain gazelle (Gazella gazella). PMID- 2757243 TI - Correlation between bleeding times and platelet counts in women with preeclampsia undergoing cesarean section. AB - Platelet count and bleeding time and the correlation between these two variables in women with preeclampsia who received epidural or general anesthesia for cesarean section were evaluated. The study included 106 women with preeclampsia who were undergoing cesarean section and 94 healthy, term parturients receiving epidural anesthesia for labor analgesia or for cesarean section. Platelet counts were measured using an automated Coulter Counter, and bleeding times were measured using the modified Ivy bleeding time technique. Platelet count was significantly lower and bleeding time significantly prolonged in patients with preeclampsia compared with the control group (P less than 0.0001). In the preeclampsia group, eight patients (7.5%) had thrombocytopenia (platelet count less than 100,000/mm3), whereas in the control group, all women had a normal platelet count (greater than 150,000/mm3). All but one patient with thrombocytopenia had prolonged bleeding time. In addition, 34% of those women with severe preeclampsia and 13% with mild preeclampsia had prolonged bleeding time, although their platelet count was adequate. In the control group, 2% had abnormal bleeding time in the presence of a normal platelet count. There was good correlation between bleeding time and platelet count only when platelet count was lower than 100,000/mm3 (r = -0.76, P less than -0.02). PMID- 2757244 TI - Isoproterenol is an effective marker of intravenous injection in laboring women. AB - The purpose of this randomized, double-blind study was to determine if isoproterenol 5 micrograms iv produces a consistent, noticeable tachycardia in healthy, laboring women. Maternal heart rate, fetal heart rate, and uterine contractions were continuously recorded and maternal blood pressure was measured every minute for 10 min before and after each patient received either normal saline (NS group; n = 10) or isoproterenol 5 micrograms (ISO group; n = 10) iv. The data-collecting investigator and a nurse palpating the patient's radial artery determined which solution they thought had been administered. The authors analyzed the maternal heart rate tracings using baseline-to-peak (a greater than or equal to 25 beat/min maternal heart rate increase occurring within 120 s of drug injection and lasting greater than or equal to 15 s) and peak-to-peak (a greater than or equal to 10 beat/min increase in the maximum maternal heart rate during the 2-min postinjection over the maximum maternal heart rate during the 2 min preinjection) criteria for detection of an intravascular marker. Mean maternal heart rate in the ISO group was significantly higher than in the NS group 20, 30, 40, 50, and 60 s following the injection (P less than 0.01). The peak-to-peak criterion and the data-collecting investigator correctly classified all patients. Five ISO group patients were not identified by the baseline-to-peak criterion. The nurse palpating the mother's radial artery misidentified two patients. Systolic blood pressure was significantly higher in ISO group than in NS group patients 1 min (P less than 0.05) and 2 min (P less than 0.01) following drug injection. Diastolic and mean blood pressures did not change. No fetal distress occurred. Isoproterenol 5 micrograms is an effective marker of intravascular injection in laboring women; however, the safety and efficacy of epidural isoproterenol must be demonstrated in animals before isoproterenol can be incorporated in an epidural anesthesia test dose. PMID- 2757245 TI - Comparative ventilatory effects of intravenous versus fourth cerebroventricular infusions of morphine sulfate in the unanesthetized dog. AB - The ventilatory pharmacodynamics of morphine sulfate (MS) in the awake dog (n = 14) were investigated. Two routes of MS administration were employed: 1) 4 h continuous intravenous (iv) infusion (1 mg.kg-1 loading dose, 10 micrograms.kg 1.min-1 thereafter); and 2) fourth ventricle to cisterna magna perfusion (VCP) at increasing infusate morphine concentrations (0.1-100 micrograms.ml-1). The former was associated with a constant plasma and cisternal CSF (and presumably tissue) free morphine concentration. The latter produced, over 1 h at a constant infusate morphine delivery, a cisternal CSF free morphine concentration that leveled off by 30 min, little or no distribution of drug beyond superficial dorsal and superficial ventral brainstem tissue, and no detectable levels of morphine in plasma. When comparing the two routes of administration, ventilatory depression for a given cisternal free morphine level in the iv infusion studies was of a much greater magnitude than that seen in VCP experiments. Differences in the ventilatory patterns were also noted. Thus, iv delivery produced a decrease in tidal volume (VT) and no change or reduced respiratory frequency (f) with prolonged exposure. VCP delivery was also associated with reduction in VT but produced significant increases in f. An apparent maximal ventilatory depression with 1 h VCP administration was observed at morphine infusate levels of greater than 10 micrograms.ml-1, with higher infusate concentrations and extension of the perfusion period to 3 h producing no significant additional changes. Finally, VCP delivery of the mu-antagonist nalbuphine could only partially reverse the ventilatory depression accompanying iv morphine administration. These findings suggest that the ventilatory depression associated with iv morphine is a result of interactions with brain u-opiate receptors in superficial brainstem tissue and in deep brainstem and/or suprapontine tissue as well. PMID- 2757246 TI - An oil-based model of inhalation anesthetic uptake and elimination. AB - An oil-based model was developed as a physical simulation of inhalation anesthetic uptake and elimination. It provides an alternative to animal models in testing the performance of anesthesia equipment. A 7.5-1 water-filled manometer simulates pulmonary mechanics. Nitrogen and carbon dioxide flowing into the manometer simulate oxygen consumption and carbon dioxide production. Oil-filled chambers (180 ml and 900 ml) simulate the uptake and washout of halothane by the vessel-rich and muscle tissue groups. A 17.2-1 air-filled chamber simulates uptake by the lung group. Gas circulates through the chambers (3.7, 13.8, and 25 l/min) to simulate the transport of anesthetic to the tissues by the circulatory system. Results show that during induction and washout, the rate of rise in endtidal halothane fraction simulated by the model parallels that measured in patients. The model's end-tidal fraction changes correctly with changes in cardiac output and alveolar ventilation. The model has been used to test anesthetic controllers and to evaluate gas sensors, and should be useful in teaching principles underlying volatile anesthetic uptake. PMID- 2757247 TI - A pressure and volume-limited inflation syringe. AB - Excessive pressures generated in balloon-tipped pulmonary artery (PA) catheters, which have migrated distally, contribute to the morbidity and mortality associated with their use. A simple syringe modification is described by which additional dead space is added to the inflation syringe. The volume of injected gas is also increased to compensate for the dead space, thus ensuring correct balloon inflation. The added dead space acts as a compression chamber should normal balloon inflation be restricted (Safety Syringe). An additional modification is described in which the syringe nozzle is reduced to a pinhole, thus decreasing the rate of gas escape and lessening the possibility of rapid lateral impact of the balloon on the PA wall (Super Safety Syringe). The syringes were compared with a standard volume-limited syringe. Pressures were recorded at the intraluminal site of balloon contact in rigid tubes, live porcine PA, and human cadaver PA. The Safety Syringe consistently generated pressures of less than 975 mmHg, the lowest pressure at which human PA rupture has been demonstrated, under the most adverse simulated clinical conditions. The currently used volume-limited syringe generated a pressure of approximately 1500 mmHg when balloon inflation was restricted, and in one human cadaver PA, produced rupture. The pinhole modification of the Super Safety Syringe increased the time to generate maximum pressure from less than 0.25 s to about 1.5 s. PMID- 2757248 TI - Potentially lethal failure of the vapor exclusion system. PMID- 2757249 TI - Severe increase of intracranial pressure after deflation of a pneumatic tourniquet. PMID- 2757250 TI - Seizures during emergence from anesthesia. PMID- 2757251 TI - General anesthesia and hyperkalemic periodic paralysis. PMID- 2757252 TI - Continuous epidural lidocaine infusion in the parturient with paroxysmal ventricular tachycardia. PMID- 2757253 TI - A review of 25 patients with hereditary angioedema requiring surgery. PMID- 2757254 TI - Repair of coarctation of the aorta in a child after a modified Fontan's operation: anesthetic implications and management. PMID- 2757255 TI - Standards for oxygen analyzers. PMID- 2757256 TI - Bypassing the Diameter-Indexed Safety System. PMID- 2757257 TI - A complication of fiberoptic nasal tracheal intubation. PMID- 2757258 TI - An effect of temperature on anesthetic solubility and partial pressure: clinical importance. PMID- 2757259 TI - The lack of effect of succinylcholine on serum potassium in patients with Parkinson's disease. PMID- 2757260 TI - Source of specialized endotracheal tubes. PMID- 2757261 TI - Microvascular evaluation of the effects of nifedipine in vascular patients by laser-Doppler flowmetry. AB - Skin blood flow in the microcirculation of the distal foot was evaluated in patients with vascular disease and diabetes and compared with that in normal volunteers by use of laser-Doppler flowmetry. Resting flow (RF) and the flow on standing (SF) were measured in a room at constant temperature (20-22 degrees C). RF was significantly different in the five groups, being increased in patients with diabetes (in comparison with normal volunteers) and decreased in patients with intermittent claudication, rest pain, and ischemic limbs. The venoarteriolar reflex (in response to standing) was also decreased or abolished in diabetic and in all vascular patients. After treatment of all vascular patients with nifedipine (10 mg tid) for one week, there was a significant increase in RF in all patients. The venoarteriolar reflex was improved but still remained below the normal limit. In conclusion laser-Doppler flowmetry is useful both for differentiating classes of different vascular patients and for evaluating the microcirculatory changes induced by nifedepine. PMID- 2757262 TI - Variability and reproducibility of transcutaneous oxygen tension measurements in the assessment of peripheral vascular disease. AB - Transcutaneous oxygen tension (TcPO2) was measured according to a standard protocol in 43 limbs from 23 subjects, by use of oxygen-sensing electrodes attached to the chest (at a single site) or dorsum of the foot (at proximal and distal sites, located 1-2 cm apart). With the subjects supine, distal foot TcPO2 differed from proximal by an average of +/- 7.4 mmHg, and in 80% of all limbs the differences were between -6 mmHg and +15 mmHg. The two TcPO2's were subsequently combined to yield a single "average" value for each foot. TcPO2 measurements were repeated twenty-four to forty-eight hours later; in the supine position the change in "average" foot TcPO2 from the first to second measurement was +/- 6.9 mmHg, and in 80% of limbs the changes were between -11 mmHg and +9 mmHg. Similar reproducibility data were also obtained for ankle/brachial blood pressure indices (ABIs), chest TcPO2, and foot TcPO2 during three minutes of leg elevation at 30 degrees. The authors conclude that: (1) TcPO2 measurements from adjacent areas on the dorsum of the foot usually differ by 20-25% or less and (2) the short-term reproducibility of TcPO2 between studies is comparable to that for ABIs. PMID- 2757263 TI - Stress testing in patients with coronary spasm: comparison of those with and without fixed coronary artery disease. AB - Stress testing is one of the preferred noninvasive methods of identifying patients with coronary artery disease (CAD). Its value in patients with coronary artery spasm (CAS) is, however, difficult to ascertain. The authors studied 91 consecutive patients with angiographically documented CAS. All patients underwent a symptom-limited bicycle exercise test before coronary angiography. Eight patients (8.8%) showed ST-segment elevation during exercise; 37 (40.7%), ST segment depression; and 46 (50.5%), no changes. Thirty patients had normal coronary arteries; 19, one-vessel disease; 19, two-vessel disease; and 23, three vessel disease. Stress testing yielded abnormal results in 7 of 30 patients (23%) with no CAD and in 38 of 61 (62%) with fixed CAD (p less than 0.01). ST-segment response to exercise did not correlate with most clinical findings such as age, type of angina, duration of pain episodes, or the degree of disease activity. However, a significant correlation was found with the extent and severity of CAD. Absence of ST changes or ST-segment elevation did not differentiate those patients with or without CAD, but only 4 of 37 patients with ST-segment depression had no significant fixed lesions. In conclusion, half of the patients with CAS had a normal stress test. ST-segment elevation is an uncommon finding in these patients and does not reliably differentiate those with and without fixed CAD. The only relevant finding of stress testing in CAS patients is ST-segment depression, which strongly suggests the presence of underlying CAD. PMID- 2757264 TI - Increased arterial pulse wave reflections and pulsatile energy loss in acute hypertension. AB - Increased afterload is normally associated with hypertension. The work of the heart increases to overcome this load, but whether this is beneficial for pulse transmission has not been examined. Experimental measurements were obtained in induced acute hypertension in dogs. Results show that increased pulse wave reflections compound the increase in arterial blood pressure, and the increased work output by the left ventricle is compromised by the reduced efficiency of pulsatile energy transmission to organ vascular beds. PMID- 2757265 TI - Free calcium in rat papillary muscle at contraction assessed with Ca-selective microelectrodes. AB - Direct measurements of free intracellular calcium (Ca)i are needed for an understanding of the regulation of contractility. An on-line measurement of (Ca)i with Ca-selective microelectrodes in intact muscle strips provides a suitable means of investigating this problem, although considerable methodologic difficulties exist. Measurements of (Ca)i concentrations during muscle contraction have been carried out by different methods such as Ca-binding techniques and aequorin luminescence, but remain unsatisfying, since they were not performed on intact muscle strips. The authors' measurements were carried out with Ca-selective microelectrodes on rat papillary muscles (stretched to optimal length in a perfusion bath of 1.54 mL at 30 degrees C). The impalement of electrodes was considered adequate when the heights of Ca-electrode potential and membrane potential remained constant for more than twenty minutes. For provoking contractile responses, the authors replaced the normal Tyrode solution by a caffeine-containing contracture solution (content in mM: 0 NaCl [choline], 4 CaCl2, 30 KCl, 25 caffeine, 1.05 MgCl2). Ca-selective microelectrodes were calibrated before and after each measurement and only those impalements were taken as adequate that showed identical calibration curves before and after the experiment. They measured the (Ca)i at 20%, 50%, and 80% of maximal contractile force and obtained (Ca)i concentrations of 1.1 +/- 0.3 microM (at 20%), 3.6 +/- 1.2 microM (at 50%), and 11.8 +/- 0.27 microM (at 80%) (n = 6, +/- SEM). These results represent the fist on-line measurements of the myocardial (Ca)i concentrations with Ca++-selective microelectrodes in intact muscle strips during various degrees of contraction.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2757266 TI - Pulmonary hypertension in the CREST syndrome: variant of systemic sclerosis (scleroderma)--a case report. AB - The CREST syndrome (calcinosis, Raynaud's phenomenon, esophageal dysmotility, sclerodactyly, telangiectasia) is a variant but not a benign form of scleroderma. Pulmonary hypertension without pulmonary fibrosis appears to be more prevalent in the CREST than in scleroderma patients. Moreover, pulmonary hypertension in CREST may be rapidly progressive and a cause of sudden death from severe cor pulmonale. PMID- 2757267 TI - Cavernous lymphohemangioendothelioma of the right atrium--a case report. AB - The authors report a successful resection of a rare cystic tumor in the right atrium, discovered in an asymptomatic patient with atrial fibrillation. The cystic nature of the tumor was characterized by two-dimensional echocardiogram preoperatively. The site of attachment and movement of the tumor were clearly shown by cine computed tomography preoperatively. The tumor contained numerous endothelium-lined cavernous channels and groups of red blood cells. These features are distinctly different from those of other cystic tumors. PMID- 2757268 TI - DNA fingerprints of poultry. AB - Human minisatellite probes cross-hybridize to DNA of several species of poultry (chicken, duck, turkey and goose), and detect high levels of polymorphism. The resulting DNA fingerprints are individual specific, and allow the discrimination even between closely related birds. The pattern of poultry DNA fingerprints is different from that of humans and other animals, having a higher average proportion of large DNA fragments. Pedigree analysis revealed a low number of allelic pairs of variable DNA fragments, indicating that most of the alleles are unresolved in the DNA fingerprint or too small to be detected. The total number of detectable loci in broilers, using probe 33.6, was estimated as 62, of which 13 loci are on average scoreable and available for use. Poultry DNA fingerprints can be used for individual identification, linkage studies and as an aid in breeding programmes. PMID- 2757269 TI - Blood genetic marker studies of a sheep-goat hybrid and its back-cross offspring. AB - Blood samples from a female sheep-goat hybrid and its back-cross male offspring were tested for electrophoretic variants of plasma albumin, transferrin and esterase, and of red cell carbonic anhydrase, nucleoside phosphorylase, NADH diaphorase, 'X'-protein, superoxide dismutase, malic enzyme and haemoglobin. Red cells were also tested for blood group antigens. Both animals showed variants that could not be attributed to either sheep or goat alone, thus confirming previous chromosomal data that the female was a genuine sheep-goat hybrid. PMID- 2757270 TI - Additional studies of sheep haemopexin: genetic control, frequencies and postnatal development. AB - This study presents evidence that sheep haemopexin phenotypes are genetically controlled by three alleles, HpxA, HpxB1 and HpxB2, of a single autosomal locus. Frequencies of two alleles, HpxA and HpxB (HpxB encompasses two isoalleles, HpxB1 and HpxB2), were studied in eight sheep breeds in Czechoslovakia. The frequency of the HpxA allele was highest (ranging from 0.81 in Merino to 1.0 in East Friesian sheep). Qualitative and quantitative changes in haemopexin during postnatal development were studied by starch gel electrophoresis and rocket immunoelectrophoresis respectively. In electrophoresis, 1- or 2-day-old lambs had two very weak zones corresponding in mobility to two slower zones of adult animals. Later, the third more anodic zone appeared and gradually increased in intensity. In 1-month-old lambs the patterns were practically identical with those of adult animals. Using rocket immunoelectrophoresis, the level of haemopexin shortly after birth was practically zero. It rose sharply till the sixth day of life; then the level continued to rise slowly till about 1 month of age. The mean haemopexin level in adult sheep was 64.5 +/- 18.26 (SD) mg/100ml serum, ranging from 30.5 to 116.5 mg/100ml. PMID- 2757271 TI - Evidence for a third allele at the beta-lactoglobulin (beta-Lg) locus of sheep milk and its occurrence in different breeds. AB - Milk samples from 189 Merinoland Sheep, 145 Black Faced Mutton Sheep, 89 East Friesian Milk Sheep, 36 Rhon, 36 Pleven, 23 Tsigaja, 25 Black Razka and 86 Hungarian Merino X Pleven (F1) sheep were analysed by polyacrylamide gel electrophoresis under acid conditions and isoelectric focusing in ultrathin layer polyacrylamide gels with carrier ampholytes. Six different beta-lactoglobulin (beta-Lg) phenotypes (A, AB, B, AC, BC and C) were observed by both methods. The occurrence of three codominant alleles (beta-LgA, beta-LgB, beta-LgC) at an autosomal locus (beta-Lg) was supported by family and population data on genetic equilibrium. Differences in gene frequencies between the breeds were observed. PMID- 2757272 TI - Genetic relationships between 14 native Spanish breeds of goat. AB - The genetic distances separating 14 Spanish goat breeds are calculated from gene frequency data of 14 genetic blood markers (GSH, Ke, Hb, Dia, Ct, MDH, CA, X, NP, Alp, Am, Cp, Tf and Al). Working from the matrix of Nei's genetic distances we drew a dendrogram demonstrating a great genetic similarity among populations from Negra Serrana, Zamorana, Guadarrama, Retinta, Blanca Andaluza, Berciana and Pirenaica on one hand; and Canaria, Murciana, Blanca Celtiberica, Verata, Palmera, Malaguena and Granadina on the other. We discuss the similarities and differences within our classification using gene frequency data of the blood genetic markers studied, and classifications based chiefly on morphological and production data. PMID- 2757274 TI - A new allele of glucose phosphate isomerase in dogs. AB - A new variant of red cell glucose phosphate isomerase (GPI), designated GPI-C, was observed in the chow-chow breed of dog. GPI-C could be separated from the previously reported dog GPI variants (A and B), both by starch gel electrophoresis and by isoelectric focusing (pH 3-10). Family data supported the hypothesis that GPI-C is controlled by a third codominant allele (GPI C). GPI C occurred as a rare allele in the Dutch chow-chow population. PMID- 2757273 TI - Antibody responses to sheep erythrocytes for White Leghorn chickens differing in haplotypes of the major histocompatibility complex (B). AB - Lines of White Leghorn chickens were developed by selection for high (HA) or low (LA) antibody response to sheep red blood cells (SRBC) and then backcrossed to provide individuals segregating for haplotypes B13 and B21 of the major histocompatibility complex (MHC) within each selected line. Although antibody response to SRBC was consistently higher in background genome HA than LA, there was a significant interaction between background genome and MHC haplotypes. The interaction resulted from higher antibody response in B13/B21 individuals of line HA and in B21/B21 individuals of line LA. Thus, response to SRBC was dependent on particular haplotype combinations present at the MHC as well as the background genome in which they were expressed. PMID- 2757275 TI - Failure to find an association between ocular squamous cell carcinoma and class I antigens of the bovine major histocompatibility system. AB - We tested 53 cattle with ocular squamous cell carcinoma (cancer-eye) and 53 paired, matched controls for 25 class I antigens of the bovine major histocompatibility system. The most common antigen was W5 which was present in 40% of the animals with cancer-eye and 36% of the controls. There were no statistically significant differences in BoLA antigen frequency between cattle with and cattle without cancer-eye. PMID- 2757276 TI - Thrombolytic therapy in the emergency department: a new treatment modality for acute myocardial infarction. PMID- 2757277 TI - Evaluation of EMS management training offered during emergency medicine residency training. AB - Physician involvement in the provision of both direct and indirect medical control to emergency medical providers is critical to the effective operation of an emergency medical services (EMS) system. We conducted a survey of all accredited emergency medicine residency programs in the United States to determine the content of EMS instruction provided to these physicians-in training. The majority of programs provide an introduction to direct medical control, to EMS organizational structure, and the opportunity to participate in EMS-related research. Less than 65%, however, provide formal instruction in EMS risk management or quality assurance or the opportunity to observe policy-making bodies related to EMS. The importance placed on EMS during residency training is variable. EMS is the domain of emergency medicine, and adequate training of residents for these responsibilities is imperative. PMID- 2757278 TI - Comparison of five-view and three-view cervical spine series in the evaluation of patients with cervical trauma. AB - The three-view trauma series has been the standard screening examination for patients with cervical spine trauma. We conducted a prospective study to determine if the addition of supine oblique views to the three-view series would improve detection of fractures, subluxations, dislocations, or locked facets. All patients over a two-year period with suspected cervical spine injury had a five view series obtained (three-view series and supine oblique views), and selected high-risk patients underwent thin-section conventional tomography of the cervical spine. Films were interpreted separately by two radiologists and an emergency physician, and the tomography results were used as the gold standard for comparison. Thirty-three of 58 high-risk patients had one or more fractures, subluxation, or dislocation demonstrated on tomography. There were no fractures or dislocations detected on the five-view series that were not detected or suspected on the three-view series. In areas of the cervical spine reported to be better visualized by supine oblique views than three-view series, our results indicate that supine oblique views did not improve detection but did, in certain cases, allow more specific diagnosis of injuries. Our data do not support the routine use of supine oblique views in the initial radiographic evaluation of patients with cervical spine trauma. PMID- 2757279 TI - Exposure of emergency medicine personnel to ionizing radiation during cervical spine radiography. AB - We studied the potential hazard of ionizing radiation exposure to health care workers who routinely stabilize the necks of trauma patients during cervical spine radiography. A clinical trauma model was developed using an Alderson RANDO Phantom artificial torso to simulate an actual patient. A radiation monitor was placed where a health care worker's fingers, hands, arms, and thyroid gland would be, and standard cervical spine radiographs were taken. The exposures to the finger positions then were repeated with the monitor inside a 0.5 mm lead equivalent glove. The mean exposure to the finger for a single cross-table lateral radiograph was 174.5 mrem. The use of leaded gloves reduced this exposure to 0.3 mrem a 99.9% reduction). For a single series of lateral, anteroposterior, odontoid, and swimmer's views, the total mean measured unprotected exposure to the finger of the hand positioned nearest the radiographic tube was 681 mrem and the exposure to the finger of the opposite hand was 230 mrem. If these simulated exposures are indicative of actual patient situations, a health care worker who holds the head of a trauma patient four times each week with unshielded hands would receive more than twice the maximum allowable annual occupational radiation exposure to the extremities recommended by the National Council of Radiation Protection and Measurements. We conclude that health care workers who routinely stabilize the necks of trauma patients during cervical spine radiography may incur a radiation exposure risk and that 0.5-mm lead-equivalent gloves provide an effective barrier to ionizing radiation. PMID- 2757280 TI - A community survey of the potential use of thrombolytic agents for acute myocardial infarction. AB - We surveyed all patients admitted to nine community hospital coronary care units to determine what proportion could be candidates for thrombolytic therapy. During the 12-month study period, there were 4,115 admissions for possible acute myocardial infarction, and 1,076 (26%) had a discharge diagnosis of myocardial infarction. Patients with myocardial infarction had the following characteristics: 60% had ST elevation seen on the first ECG, 17% had ST depression without ST elevation, 75% were less than 75 years old, 75% had no contraindications to thrombolytic therapy, 78% arrived at hospital within six hours of onset of symptoms, and 94% arrived within 24 hours of symptoms. Criteria for administration of thrombolytic therapy can be grouped as restrictive (arrival within six hours of symptoms and ST elevation) or liberal (arrival within 24 hours of symptoms and ST elevation or ST depression). Applying these characteristics, 26% met restrictive criteria for treatment with thrombolytic therapy, and 36% met liberal criteria. Until liberal criteria (therapy up to 24 hours and ST depression) are convincingly shown to be of benefit, we believe clinicians should apply restrictive criteria to potential candidates for thrombolytic therapy. PMID- 2757281 TI - Comparison of intraosseous and intravenous routes of anticonvulsant administration in a porcine model. AB - During status epilepticus, rapid IV access for the administration of anticonvulsant drugs can be a very difficult and time-consuming procedure. Our study evaluated whether therapeutic serum levels of phenobarbital and phenytoin could be obtained by the intraosseous route. Twenty domestic swine weighing 10 to 20 kg were divided into two groups (ten each). In one group, phenobarbital 20 mg/kg was administered either intravenously (five) or intraosseously (five). The second group received phenytoin 15 mg/kg either intravenously (five) or intraosseously (five). All animals had samples for anticonvulsant levels drawn from an indwelling arterial cannula at one, three, five, seven, ten, 15, and 30 minutes after dosing. Anticonvulsant levels were found to be statistically significantly higher with IV administration (P less than .01). However, phenobarbital levels were therapeutic by the intraosseous route, while phenytoin levels were below the therapeutic range after the ten-minute interval. Bone marrow levels 45 minutes after infusion were 13.5 micrograms/mL (phenobarbital) and 11.5 micrograms/mL (phenytoin). Our study demonstrates that current IV dosing of phenobarbital 20 mg/kg given intraosseously obtains and maintains therapeutic serum levels. Phenytoin 15 mg/kg does not maintain therapeutic levels and cannot be recommended for intraosseous administration. PMID- 2757282 TI - Unrecognized endobronchial intubation of emergency patients. AB - Although intubation of emergency patients in the field is a routine measure, endotracheal tube misplacement remains a serious problem. Using radiologic criteria, the frequency of undetected endobronchial intubation by physicians was determined retrospectively in 100 (78 traumatized) field-intubated adult patients (72 men and 28 women; age, 18 to 90 years; mean age, 39.1 years) consecutively admitted to the University Hospital of Tuebingen, Tuebingen, Federal Republic of Germany, between January 1987 and February 1988. Position of tube tip relative to carina was evaluated on anteroposterior chest radiographs made on admission. Inadvertent endobronchial intubation was not recognized by the physician and the admitting anesthesiologist in 7% of the reviewed cases, and endotracheal positioning of the tube tip near the carina (2 or less cm) occurred in another 13%. While unilateral intubation is not immediately catastrophic, the resulting systemic hypoxemia and hypercapnia are aggravated by potential accompanying injury (eg, lung contusion, hematothorax, pneumothorax, shock, or cerebrocranial trauma), which can lead to secondary damage (eg, acute respiratory insufficiency, ischemic brain damage). Evaluation of the depth of tube insertion with the aid of common clinical techniques is particularly unreliable in the case of thoracic trauma, aspiration, or previously existing pulmonary disease. Suggested measures for prevention of endobronchial intubation are improved and intensified training of emergency staff to increase awareness of and prevent the catastrophic effects of endobronchial malposition of the tube tip, tube shortening before intubation, assessment of insertion depth by checking length scale on the tube, and avoidance of patient head and neck movement. PMID- 2757283 TI - Analysis of emergency department management of suspected bacterial meningitis. AB - Previous studies of emergency department management of bacterial meningitis have indicated that there are often long delays before initiation of antibiotics. The purpose of our study was to determine whether these delays were related to specific aspects of patient management. From 1981 through 1988, we retrospectively reviewed the medical records of 122 patients primarily evaluated in the ED and admitted for suspected bacterial meningitis at a university (55) and a community (67) hospital. The median time (interquartile range) from ED registration until initiation of antibiotics (time to antibiotics) was 3.0 hours (1.6 and 4.3 hours, respectively) (total range, 0.5 to 18 hours). The time to antibiotics was not significantly related to the time of ED registration. Ninety percent of the total time to antibiotics occurred after the initial physician encounter. Time to antibiotics was significantly (P less than .00005) longer for patients in whom computed tomography scan and/or laboratory analysis of cerebrospinal fluid preceded initiation of antibiotics compared with patients in whom antibiotic administration was not contingent on the results of these procedures (4.3 [3.2 and 6.0] versus 1.9 [1.2 and 3.4] hours, respectively). Also, time to antibiotics was significantly (P less than .00005) longer for patients in whom antibiotics were initiated on the ward as compared with in the ED (4.5 [3.5 and 6.8] versus 2.2 [1.4 and 3.5] hours, respectively). We conclude that long delays exist in the ED before initiation of antibiotics for cases of suspected bacterial meningitis, and that in general these delays appear to be physician generated and to a great extent potentially avoidable. PMID- 2757284 TI - A toxicity study of parenteral thiamine hydrochloride. AB - Thiamine deficiency is not uncommon in certain populations and clinical disease states such as Wernicke's encephalopathy or beriberi. Rapid parenteral repletion may be required, yet questions about the safety of IV thiamine have been raised because of reports of anaphylaxis. Our study was a prospective evaluation of the safety of thiamine hydrochloride given as a 100-mg IV bolus in 989 consecutive patients (1,070 doses). A total of 12 adverse reactions (1.1%) were reported. Minor reactions consisting of transient local irritation were seen in 11 patients (1.02%), and there was only one major reaction (0.093%) consisting of generalized pruritus. Thiamine hydrochloride may be administered intravenously without undue concern. Intradermal test doses before administration are not warranted unless patients have had previous allergic reactions. PMID- 2757285 TI - Preliminary observations on the effects of hyperbaric oxygen therapy on western diamondback rattlesnake (Crotalus atrox) venom poisoning in the rabbit model. AB - Intermittent hyperbaric oxygen therapy has been shown to reduce skeletal muscle necrosis in a compartment syndrome animal model. To study whether intermittent exposure to hyperbaric oxygen augments antivenin therapy in reducing muscle necrosis, we injected sublethal doses of Western Diamondback rattlesnake (Crotalus atrox) venom intramuscularly into the hind legs of New Zealand White rabbits. In this pilot study, the animals were divided into three treatment groups. The first group received one vial of antivenin intravenously, the second group received one vial of antivenin intravenously plus three hyperbaric oxygen treatments, and the third group received no treatments. There were no statistically significant differences among the groups. These preliminary observations suggest that muscle necrosis secondary to Crotalus atrox venom poisoning is not significantly altered either by Antivenin [Crotalidae] Polyvalent at the dose level we used or in combination with intermittent hyperbaric oxygen treatments in this rabbit model. PMID- 2757286 TI - Psychiatric screening in the emergency department: its effect on physician behavior. AB - The purpose of our prospective, controlled study was to determine whether providing the results of a psychiatric screening instrument, the General Health Questionnaire (GHQ), to emergency physicians would result in a change in the detection and management of patients with psychosocial problems. Five hundred ninety-nine emergency department patients were enrolled, 242 in the control and 357 in the intervention group. Noncritical patients, selected by presenting complaint, were given the GHQ to complete before physician evaluation; those whose GHQ scores were high (10 or higher) were identified as having a greater likelihood of having psychosocial problems. During the intervention phase, physicians were provided the patient's GHQ score before beginning their evaluation, as well as a specific mechanism for psychosocial referral. A significantly greater proportion of patients with high GHQ scores in both study groups were judged by physicians to have a psychiatric problem (P less than .0001). During the intervention phase, patients with high scores more frequently were assigned a psychiatric diagnosis (14.1% vs 7.7%) and received psychosocial referral (36.1% vs 5.7%). However, only the latter difference was statistically significant (P less than .0001). The majority (85.7%) of patients offered psychosocial referral accepted their referral. There was no difference in the number of laboratory tests ordered or medical/surgical referrals requested between patients in the control or intervention groups with high scores. Therefore, providing GHQ results to emergency physicians led to more frequent psychiatric diagnoses and psychosocial referrals of patients with high GHQ scores but did not alter their medical management. PMID- 2757287 TI - Injury profiles in pedestrian motor vehicle trauma. AB - One hundred fifteen consecutive pedestrians who were struck by motor vehicles were studied to determine the magnitude and patterns of the injuries sustained. The mortality rate was 22%, and 17 of 25 patients who died did so during the initial resuscitative efforts, primarily due to head, chest, and or abdominal injury. The average Injury Severity Score (ISS) among all patients was 20; however, it was significantly higher (46) in nonsurvivors. The majority of the victims were men (72%), and the average age of all patients was 35 years. As the patient's age increased, so did the likelihood of mortality, fractures, and prolonged hospital stay. Blood alcohol levels were measured in 85 patients, 65% of whom had detectable levels (mean, 0.25 mg/dL). There was no correlation between the presence of alcohol and mortality, ISS, head injury, or number of fractures. The most frequently injured organ system was musculoskeletal (77%), followed by head (34%), abdomen (21%), and chest (15%). The most common fractures seen were tibia-fibular (39), pelvis (35), and femur (31). Hospital stay averaged 11 days, and patients charges averaged $16,900. PMID- 2757288 TI - The development of a water rescue unit in an urban EMS system. AB - A river rescue unit was developed in Pittsburgh in March 1986. From its time of inception through December 31, 1987, the unit responded 572 times (325 times in 1987); this included 144 medical calls. Many of the other calls were police related, false alarms, routine patrols, or public service calls. We present a description of the service, type of training necessary, costs involved, and administrative aspects of running a marine emergency medical services system and its integration into an urban EMS system. PMID- 2757289 TI - Adolescent epidemic hysteria presenting as a mass casualty, toxic exposure incident. AB - Discussed is a case of explosive epidemic hysteria presenting as a mass casualty, toxic inhalation incident. Fifteen adolescent female students were triaged from a school of 700 persons exposed to sewer gas and arrived simultaneously at the emergency department complaining of a variety of nonspecific symptoms without physical findings. These symptoms quickly remitted with reassurance and dispersion of the group. Factors important in the recognition and treatment of epidemic hysteria are presented. PMID- 2757290 TI - 'No' when the family says 'go': resisting families' requests for futile CPR. PMID- 2757291 TI - General requirements for controlled clinical trials of antibiotic treatment of soft tissue lacerations. PMID- 2757292 TI - Emergency medicine--a new era. PMID- 2757293 TI - Evaluation of studies on the efficacy of paramedic treatment in acute myocardial infarction. PMID- 2757294 TI - Irrigation with acetic acid. PMID- 2757295 TI - DNR orders & living wills. PMID- 2757297 TI - In support of rational conceptualizations of schizophrenia. PMID- 2757296 TI - Porphyria in a young man. PMID- 2757298 TI - The need to test hypotheses about paranoid schizophrenia: reply to Clementz and Sweeney. PMID- 2757299 TI - Bias and fairness in the diagnosis of primary orgasmic dysfunction in women. PMID- 2757300 TI - [Duplex Doppler echography as a non-invasive method of evaluating cerebral blood flux, in full-term newborns, in the immediate neonatal period]. AB - The Doppler effect and its application on the human body is described as well as its specific use in pediatric age: cerebral blood flow, liver and renal transplants, vascular-renal and portal hypertension and characterization of mass, tissue and structure. The results of 107 studies with Doppler duplex echograph on 86 neonates are analysed. The anterior and posterior cerebral arteries were sounded. The parameters taken into consideration were ten maximum systolic velocity (VS), the final diastolic velocity (VD), Bada's pulsatility index (IP) and the morphology of the curve. In 35 normal newborns the results were: maximum systolic velocity 24.08 +/- 4.30 cm/s, the final diastolic velocity 8.77 +/- 1.86 cm/s, Bada's pulsatility index. In the caesarean born neonates in both forms of anaesthesia, and those born by EVA delivery (stimulation, suction and analgesia) slight increases were observed, in comparison with the normal newborn group, in the maximum systolic velocity and Bada's pulsatility index. PMID- 2757301 TI - [In vitro granulomonocytopoiesis during and after treatment of acute lymphoblastic leukemia in children]. AB - We studied the effects of antileukemic chemotherapy on the granulomonocytic precursors (CFU-GM) by the in vitro bone marrow culture method. Groups of study were: 1) 17 children with acute lymphoblastic leukemia in complete remission, under maintenance chemotherapy, and 2) 10 children who had finished the treatment. Both groups had the same treatment schedule. As a control group, we studied CFU-GM from 3 children without bone marrow lesion. The results show a diminution of the granulocyte-macrophage progenitor cells in individuals under treatment, compared with the control group, after a 14 days incubation period. The group of children out of treatment shows a higher number of progenitor cells after 7 days of incubation (mature progenitors), but number decreases after 14 days (immature progenitors). Therefore, we can deduce a toxic effect, direct or indirect, but probably sustained, of the chemotherapy on the granulomonocytic precursor cells. PMID- 2757302 TI - [Contact allergic dermatitis in childhood: 1972-1987]. AB - We have carried out retrospective study of 190 children with dermatitis, aged from 2 to 14 years old. 67 (35%) of these children showed positive patch-test reactions. Nickel sulphate (35%) was the first allergen. Form 1979, once mercury was introduced in the GEIDC standard series, it becomes the more common iatrogenic allergen in childhood in our country. Other allergens also responsible for the dermatitis were mercaptobenzothiazole (12%), cobalt (9%) and p phenylenediamine (7%). PMID- 2757303 TI - [Maturation of auditory evoked potentials in preterm newborns]. AB - Auditory evoked potentials were recorded in 25 babies with postconceptional age between 32 and 37 weeks without any risk factors for brainstem dysfunction. Waves I, III and V were constant while waves II and IV appeared more frequently with increasing gestation. The latency of waves I and III did not vary significantly in the period investigated while waves V significantly decreased its latency from 7.69 m in week 32 to 7.06 m in week 37 (p less than 0.01). I-V interwave interval or brainstem conduction time decreased from 5.59 m to 4.96 m over this period (p less than 0.01). PMID- 2757304 TI - [Splenic abscess after partial embolization]. PMID- 2757305 TI - [Isosexual precocious pseudopuberty caused by juvenile granulosa cell tumor]. PMID- 2757306 TI - [Cardiac tamponade resulting from a wound caused by compressed air gun]. PMID- 2757308 TI - [Trichobezoar in children. Apropos of 2 cases]. PMID- 2757307 TI - [Salt-losing tubulopathy secondary to urinary infection: a form of transitory pseudohypoaldosteronism]. PMID- 2757309 TI - [Drainage of a left subphrenic abscess through a percutaneous catheter in children]. PMID- 2757310 TI - [Congenital laterocervical teratoma]. PMID- 2757311 TI - Changes in therapeutic proteins caused by preparation techniques. PMID- 2757312 TI - Combined zidovudine and interferon-alpha therapy in patients with Kaposi sarcoma and the acquired immunodeficiency syndrome (AIDS) AB - STUDY OBJECTIVE: To evaluate the toxicity and potential clinical efficacy of combined therapy with zidovudine and interferon-alpha for patients with Kaposi sarcoma and the acquired immunodeficiency syndrome (AIDS). DESIGN: Nonrandomized, open trial study. SETTING: Outpatient clinic of a government referral-based research hospital. PATIENTS: Volunteer sample of 39 patients with human immunodeficiency virus (HIV) infection and Kaposi sarcoma. INTERVENTIONS: Patients received zidovudine, 250, 100, or 50 mg orally every 4 hours; 6 weeks after interferon-alpha was begun at a dose of 5 million U/d, and the dose was increased every 2 weeks until a maximum tolerated dose was determined. Patients then received the maximum tolerated dose of the combination for a minimum of 12 weeks before formal efficacy evaluations. MEASUREMENTS AND MAIN RESULTS: In the dose-escalation phase, the ability to tolerate interferon-alpha was clearly related to the zidovudine dose. Of the 13 patients receiving 250 mg of zidovudine, only 1 patient was able to tolerate at least 10 million U/d of interferon-alpha. Of the 12 patients receiving 100 mg of zidovudine, 8 tolerated 10 million U/d, 5 tolerated 15 million U/d, and none tolerated higher doses. Of the 12 patients receiving 50 mg of zidovudine, 8 tolerated 10 million U/d, 7 tolerated 15 million U/d, and 6 tolerated 20 million U/d or more. Dose-limiting toxicities included neutropenia (57%), fatigue (16%), thrombocytopenia (14%), and hepatic dysfunction (10%). Of the 22 patients who received a stable dose of both drugs for 12 weeks, 11 patients had a complete or partial tumor response and 8 showed an anti-HIV effect. Peak serum levels of interferon-alpha (32 to 250 U/mL) and zidovudine (0.40 to 3.85 microM) were in the ranges previously shown to be synergistic against HIV. CONCLUSIONS: Combination therapy with zidovudine and interferon-alpha can be administered to patients with HIV infection and Kaposi sarcoma in doses that effect antiviral and antitumor responses; it appears to have a potential role in managing such patients. PMID- 2757313 TI - Elevated serum lipids in hypogonadal men with and without hyperprolactinemia. AB - STUDY OBJECTIVE: To determine whether men with hypogonadism are at risk for hyperlipidemia. DESIGN: Case-control study. SETTING: Neuroendocrine clinical center of a referral-based university medical center. PATIENTS: Consecutive sample of 18 men with testosterone deficiency who had prolactin-secreting pituitary adenomas, 15 men with acquired secondary hypogonadism and normal prolactin levels, and 33 normal male controls. MEASUREMENTS AND MAIN RESULTS: We found a significant elevation in fasting cholesterol (6.23 +/- 0.28 mmol/L [mean +/- SE] compared with 5.17 +/- 0.13 mmol/L [241 +/- 11 mg/dL compared with 200 +/ 5 mg/dL], P less than 0.01), low density lipoprotein (LDL) cholesterol (4.11 +/- 0.23 mmol/L compared with 3.34 +/- 0.13 mmol/L [159 +/- 9 mg/dL compared with 129 +/- 5 mg/dL], P less than 0.05), and triglycerides (1.85 +/- 0.26 mmol/L compared with 1.11 +/- 0.07 mmol/L [164 +/- 23 mg/dL compared with 98 +/- 6 mg/dL], P less than 0.001) in men with hyperprolactinemia compared with controls. In the normoprolactinemic hypogonadal men, cholesterol (6.28 +/- 0.34 mmol/L [243 +/- 13 mg/dL], P less than 0.01), LDL cholesterol (4.34 +/- 0.34 mmol/L [168 +/- 13 mg/dL], P less than 0.01), and triglycerides (1.61 +/- 0.18 mmol/L [143 +/- 16 mg/dL], P less than 0.05) were also significantly higher than in the controls, and were the same as in the hyperprolactinemic men. High density lipoprotein (HDL) cholesterol did not differ among the three groups. CONCLUSIONS: Hypogonadism in men, with or without hyperprolactinemia, may be associated with elevation of fasting serum cholesterol, LDL cholesterol, and triglycerides compared with normal men. These data suggest that serum lipid levels should be evaluated in hypogonadal men. The presence of lipid abnormalities may affect the decision to treat testosterone deficiency in these patients. PMID- 2757314 TI - American College of Physicians Ethics Manual. Part 2: The physician and society; research; life-sustaining treatment; other issues. American College of Physicians. PMID- 2757315 TI - Acute asthma attack due to ophthalmic indomethacin. PMID- 2757316 TI - Human immunodeficiency virus (HIV) infection and hemolytic anemia. PMID- 2757317 TI - Cholesterol screening and coronary artery heart disease. PMID- 2757318 TI - CA19-9 and pancreatic cancer. PMID- 2757319 TI - Diabetic nephropathy: urinary albumin or total protein? PMID- 2757320 TI - Mortality in alcoholic hepatitis. PMID- 2757321 TI - Foreign medical graduates and board certification. PMID- 2757322 TI - Inhalation anaesthetics--exposure and control: a statistical comparison of personal exposures in operating theatres with and without anaesthetic gas scavenging. AB - Results are reported for air sampling surveys undertaken by the Health and Safety Executive (HSE) from 1980 to 1984 using diffusive samplers in 40 operating theatres and 18 recovery areas at 27 hospitals. For all personnel the geometric mean time-weighted average exposure to nitrous oxide in unscavenged theatres was 94 ppm and in scavenged theatres 32 ppm; the corresponding means for halothane were 1.7 and 0.7 ppm, respectively. Intermittent use of scavenging led to mean exposures between those found in scavenged and unscavenged conditions. Anaesthetists showed higher mean exposures than other staff in all conditions. Statistical analysis of the data demonstrates that mean exposures of operating theatre staff were significantly lower in scavenged than in unscavenged theatres. For most staff, exposure was also significantly lower in theatres using active scavenging systems compared with those using passive systems. The literature on the hazards of chronic exposure to inhalation anaesthetics and previous studies of exposure is also briefly reviewed. PMID- 2757323 TI - An investigation into the effects of breathing upon the aspiration efficiency of the human head. AB - A mathematical investigation is undertaken into the effects of the breathing pattern upon the aspiration efficiency of the human head. It is assumed that all the fluid inhaled by the head is subsequently exhaled and that the two stages of the breathing pattern last for an equal length of time. The particles are taken to be spherical and are assumed to be suspended without sedimentation in an ideal fluid which is flowing towards the head. A model for the head is proposed and the case of breathing through the mouth is studied. An analytical approach is adopted to determine the behaviour of the particles near the mouth, and the sampling efficiency of the head is investigated. Results are obtained for various situations, and comparisons are made with existing experimental results. It is shown that, in many cases, the effect of the breathing pattern is insignificant but for normal human breathing rates, it becomes significant as the velocity of the flow increases. PMID- 2757324 TI - Urinary fibres in occupational exposure to asbestos. AB - Urine samples from 10 workers from an asbestos cement factory and from a control group of 10 workers from a foundry, were obtained; drastic precautions were taken to avoid contamination. Each urinary mineral fibre was sized and identified by transmission electron microscopy. Results show that contamination problems encountered by other authors have been overcome and that the workers exposed to chrysotile appear to excrete more chrysotile fibres, but that this difference is not statistically significant. Possibly only a few of the exposed workers are significantly exposed to asbestos, the overall exposure level being very low. The degradability of chrysotile fibres in biological fluids or the retention of fibres in some organ could explain the lack of apparent correlation between exposure and urinary concentration. Unexpectedly high concentrations of crocidolite fibres of unknown origin were detected in both groups of workers. PMID- 2757325 TI - Exhaled breath analysis as a measure of workplace exposure to benzene ppm. AB - Exposures to benzene vapour were measured in a group of coal tar distillation workers and the concentration of benzene in the air that they exhaled was determined at the beginning of the following work period. Time-weighted average benzene concentrations were principally in the range 0.02-0.9 ppm. Benzene vapour was detectable in the breath of all subjects 16 h after exposure, and a progressive build-up over the working week was found. Nevertheless the relationship between exposure and concentration in exhaled breath was found to be poor. This suggests that at concentrations below about 1 ppm, the analysis of exhaled breath is not a reliable method of measuring previous exposure to benzene. PMID- 2757326 TI - Alveolar dust clearance capacity as determinant of individual susceptibility to asbestosis: new experimental observations. PMID- 2757327 TI - [Topical therapy with placental polydeoxyribonucleotide in cervical ectopy and ectropion]. AB - Twenty outpatients, aged 18-45 yrs, with cervical ectropion have been treated with vaginal suppositories of PDRN (a placental derivate). The drug has been given randomly in two preparations of 5 g and 10 g, however both containing the same amount of the active component (5 mg). The results show the effectiveness of the eutrophic and antiphlogistic action of both preparations, with a remarkable reduction of the leukorrhea. The patients preferred the vaginal suppositories of 5g both for the greater maniability and for the smaller vaginal discharge after the administration. The reduction of the excipients in the new vaginal tablets, besides improving the compliance of patients, brings about a longer contact of the drug with the vaginal walls, hence a better bioavailability of the active principle. PMID- 2757328 TI - [Prenatal diagnosis of congenital toxoplasmosis]. AB - Primary Toxoplasmosis is devoid of any consequences in the mother in most cases, while the fetus can suffer serious damages following transplacental passage of the parasite. This is probably due to its limited immunocompetence. 440 women have been seen for suspected primary infection during pregnancy: clinical and serological parameters excluded infection in 62% of the cases. In 168 cases primary infection was likely and they underwent therapy with Spiramycin 3 grams per day to prevent placental and fetal colonization: 53 cases were elected for invasive prenatal diagnosis. Amniotic fluid was obtained by amniocentesis and fetal blood by ultrasound guided cordocentesis and by fetoscopy: the samples were analyzed for specific anti Toxoplasma IgM and sent for isolation of the parasite. Diagnosis of fetal infection was made in 4 cases: 3 cases had specific IgM in cord blood, 1 case showed intracranial calcifications by ultrasound screening. Fetal infection rate is thus below 10% and prenatal diagnosis avoids unjustified interruption of pregnancies complicated by maternal toxoplasmic infection. PMID- 2757329 TI - [Immune deficiencies in children]. PMID- 2757330 TI - [Hypoplasia of cartilage and hair with combined immune deficiency]. AB - We report a case of cartilage-hair hypoplasia in a girl. The patient had short stature with short limbs and scalloped long bone metaphyses, sparse, poorly pigmented hair, and increased susceptibility to infections. Several features of this case deserve attention: neutropenia, probably due to an autoimmune mechanism, was an initial manifestation; the immune deficiency (defective B and T cell immunity, autoimmune manifestations) was severe, and cytomegalovirus infection possibly aggravated the immune deficiency and hormone abnormalities. Whereas this patient's short stature is becoming more marked, prophylaxis of infections and administration of immune globulins have effectively prevented complications for the last two years. PMID- 2757331 TI - [Neurologic manifestations in immune deficiencies]. AB - Immune deficiencies may be associated with central nervous system manifestations due to infections, to the cause of the immune deficiency, or to the treatments used. We provide several examples and emphasize the diagnostic strategy, that should be very systematic, and the intricate nature of the etiologies. PMID- 2757332 TI - [Materno-fetal infection by the human immunodeficiency virus (HIV)]. AB - Transmission of the HIV from mother to fetus is now virtually the only means by which children can be contaminated. Thirty to 40% of infants born to HIV seropositive mothers are infected. Nearly half of infected neonates develop AIDS within the first two or three years of life. Early diagnosis of HIV infection rests on recovery of the virus. Early administration of azidothymidine may reduce the severity of this infection that is occurring increasingly in France, where 30,000 to 40,000 women are HIV-seropositive. PMID- 2757333 TI - [Psychosocial problems posed by families having an infant infected with the HIV virus or with AIDS]. AB - Since the first cases of infantile AIDS, the "status" of the severely ill child and his or her family has changed. When faced with this "shameful" disease, transmitted by the mother to her child during pregnancy, parents feel compelled to hide their children's disease and to bear the tragic burden of emotional and social isolation. This fatal and untreatable disease, occurring as the result of an unconventional lifestyle, is responsible for progressive neurologic deterioration that makes the child unrecognizable. Sleep and feeding disorders make life unbearable. Emotional suffering and feelings of guilt result in highly specific behaviors that must be identified and understood in order to provide parents with appropriate support. Pediatricians lack the psychologic and sociologic training needed for managing some of these problems and should work with specialists in other fields, including social workers and psychologists, in order to evaluate the family's needs and take the appropriate therapeutic or preventive steps. PMID- 2757335 TI - [Radiotherapy of Kaposi's sarcoma in AIDS]. AB - Between June 1986 and August 1988, 129 patients with AIDS-related Kaposi's sarcoma were treated by cutaneous irradiation in our department. According to Mitsuyasu's staging, 25 patients (19%) were stage 1.76 (59%) stage II, no stage III was reported and 28 (22%) stage IV. Fifty four patients (42%) had previously presented with one or multiple opportunistic infections. Eighty six (66%) had previously received treatment: by interferon in 80 patients (62%) and/or Velbe in 40 (31%). Seventy six patients (59%) were treated by extensive cutaneous irradiation using 4 and/or 8 MeV electron beam energy and 53 patients (41%) by localized irradiation using 45 kV X-ray energy, 2.5 Gy/fraction, 4 times/week by split course 20 Gy then 10 Gy two weeks later. Only 111 patients were evaluable; 61% obtained complete remission and 33% partial remission after a mean period of 1.5 months (0.5-3 months). The overall tolerance was acceptable. The complications were epidermitis with some necrosis (8%), exudative epidermitis (26%) moderate epidermitis (63%) and slight reactions in 4%. The mean recurrence time was 5 1/2 months. PMID- 2757334 TI - [Curietherapy using a ruthenium and iridium disk in the treatment of choroid melanoma]. AB - Following the experience of the German authors, the treatment of choroidal melanoma with ruthenium 106 disk was introduced in Lyon. Between 1983 and 1988, 127 patients were treated. Results are analysed on a group of 84 patients followed 18 months and more. In 72 cases a reduction of thickness was noted. It was complete in 33 cases. Enucleation was performed in 10 patients due to no response or regrowth. In 3 cases the tumor was sterilized. Five patients died of metastases, and 73 are alive, 3 of them with liver metastases. An afterloading iridium template disk was used in 8 patients. 4 of them with a tumor thickness between 6.5 and 8 mm had a good response. Edema of the fovea was observed in 21% of cases, while cataracts were very unusual with Ru 106. An enucleation was performed in 6 patients because of a complication. A useful vision may be preserved in 60% of cases. The scleral tolerance dose is close to 1,500 Gy. These results are in agreement with those of the literature and are considered to be satisfactory for tumors not exceeding 5 to 6 mm in thickness. If the tumor is located close to the fovea or the papilla, and/or if the thickness is 8 mm or more, proton beam could be a good alternative. PMID- 2757336 TI - [A systematic radio-surgical combination in the treatment of sarcoma of soft tissues in adults. Results in 106 cases at the Centre Francois Baclesse]. AB - Based on a series of 143 cases of soft tissue sarcomas, including 106 cases treated curatively, the author stresses the importance of surgical resection with frozen section histological control, systematically combined with radiotherapy. Even when resection is complete, the frequency of loco-regional recurrences in all published series shows that neoplastic cells were already present around the resection site. Consequently, since 1972 at the Centre Francois Baclesse, whenever possible, surgery is preceded by concentrated regional irradiation (2 sessions of 6.50 Gy at 48 hour's interval) and postoperative complementary radiotherapy is always performed regardless of the quality of the resection 3 weeks after the preoperative irradiation. The dose is limited to a total of 50 Gy when the resection is complete and is increased to 60 to 70 Gy in the zones of doubtful or incomplete resection. This postoperative radiotherapy is associated with 5 injections of actinomycin D during the first sessions, but no adjuvant chemotherapy such as cyvadic is administered routinely. Under the conditions of treatment, the 5-year results obtained in 106 cases were as follows: local recurrences: 12.4%, metastases: 26%, survival rate: 76%. When the surgical resection was complete (62 cases), the 5-year local recurrence rate was 1.5% with 9% metastases and 92% survival. Metastases were related to factors of high malignancy which are beginning to be more clearly defined. These forms may benefit from intensive combination chemotherapy. PMID- 2757337 TI - [Calcified thrombus of the inferior vena cava. Apropos of a case]. AB - A case of calcified thrombus in the inferior vena cava discovered in child during the screening of a scoliosis is presented. Standard X-rays demonstrate the calcification and allow the diagnosis of calcified thrombus. Ultrasound, if necessary, can be performed. Pathogenesis remains at the present time unknown but congenital or hemodynamic factor are probable. Children are asymptomatic and no specific treatment is advised. PMID- 2757339 TI - [Elongation of the limbs]. PMID- 2757338 TI - [Aortic valvuloplasty in the elderly. Immediate and medium-term results]. AB - Between January 86 and February 88 we attempted percutaneous aortic valvuloplasty in 100 patients. 68 patients could be dilated with hemodynamic success: the aortic valve area increased from 0.52 +/- 0.17 cm2 to 0.78 +/- 0.27 cm2 (p less than 0.001). Cardiac output did not change significantly (4 +/- 1.1 l/mn). In the remaining 32 patients: 8 patients (8%) died in hospital and the morbidity rate was 11%: arterial injury (9), stroke (1) and major cardiac event (1). Sixty patients regarded as initial success were followed for 6 months: 3 patients (5%) died without cardiac events, functional improvement persisted in 41 patients (68%) and clinical failure was observed in 16 patients (27%): 4 patients died and in the remaining 12 patients, the recurrence of symptoms required medical treatment (5), surgery (5) or repeat percutaneous valvuloplasty (2). Echo-Doppler maximum aortic valve gradient was significantly less in improved patients (55 +/- 21 mmHg) than in deteriorated patients (78 +/- 36 mmHg) (p less than 0.02). One year after valvuloplasty: actuarial survival was 74 +/- 6%, clinical improvement was 53 +/- 7% and clinical recurrence was 41 +/- 7%. Thus percutaneous aortic valvuloplasty may be proposed only to non surgical patients. PMID- 2757340 TI - [Aspects of general surgery in humanitarian missions]. PMID- 2757341 TI - [Perforation of the cervical esophagus and hypopharynx complicating surgery by an anterior approach to the cervical spine]. AB - Difficult diagnostic and therapeutic problems are raised by perforations of the cervical oesophagus or hypopharynx in patients undergoing surgery to the cervical spine via an anterior approach. Based on their experience of three recent cases, the authors review the diagnostic approach, based on clinical examination and diatrizoate sodium oesophageal series, and propose conservative treatment consisting of surgical drainage with or without suture of the perforation and without removal of the osteosynthesis material, appropriate antibiotic therapy and hypercaloric enteral nutrition via nasogastric tube. The prevention of this complication is based on correct use of surgical retractors. PMID- 2757342 TI - [Immediate oesojejunal anastomosis after total gastrectomy in caustic necrosis]. AB - Eight patients underwent total gastrectomy for caustic ingestion. Oesophago jejunostomy was performed in the same surgical session. One patient died from hemorrhage. Only one of the 7 survivors had a benign anastomotic fistula. Five healed without any sequelae, 2 underwent colonoplasty 3 months later, because of a secondary oesophageal stenosis. We conclude that it is feasible, in certain unusual cases, to restore gastrointestinal continuity after total gastrectomy for caustic necrosis: moderate oesophageal lesions (stage I or II) and ingestion of a caustic product that cause few oesophageal damage (acids, liquid chlorine bleach, ...). PMID- 2757343 TI - [Value of elective cholecystectomy in children with homozygote sickle cell anemia. Apropos of 3 recent cases]. AB - Homozygous SS sickle cell anemia affects 0.25% of the population of the West Indies. Gallstones are frequently found in this blood disease and are the cause of recurrent abdominal pain, cholecystitis and dangerous infectious complications in these patients. These complications are difficult to distinguish from very frequent episodes of vaso-occlusive abdominal pain. Three cases in childhood sickle cell disease are reported. The authors believe that elective cholecystectomy is to be recommended (emergency cholecystectomy is associated with a high morbidity) as the children operated were improved by surgery, with resolution of abdominal pain. PMID- 2757344 TI - [Splenectomy in chronic idiopathic thrombopenic purpura in adults. Apropos of 49 cases]. AB - The authors reviewed the case files of 49 adult patients undergoing splenectomy for chronic idiopathic thrombocytopenic purpura at the Centre Henri Becquerel between 1970 and 1987. Although the postoperative course was straightforward in 83.7% of cases, one reoperation for subphrenic abscess was necessary and there was one postoperative death. Remission from thrombocytopenia was obtained in 87.5% of the patients, but only transiently in 8.5% of them. No preoperative predictive factors could be demonstrated. An early postoperative rise in the platelet count to more than 500 G/litre appears to ensure a good subsequent result. Secondary infectious complications are not exceptional and can be fatal (one death in our series); they require prophylaxis by anti-pneumococcal vaccination. The place of prophylactic antibiotic therapy has yet to be defined. PMID- 2757345 TI - [Splenectomy in Gaucher's disease. Apropos of 2 cases, one of which was preceded by embolization]. AB - Two cases of Gaucher's disease type I are reported Splenectomy was indicated because of hypersplenism and massive splenomegaly. In one case hypersplenism was treated with pre-operative selective embolization because of the volume of the spleen (20 kg). The embolization corrected the thrombopenia but not the size of the spleen. Four years after operation for case 1 and eight months for case two, there is an improvement in the clinical status. PMID- 2757346 TI - [Percutaneous injection of methyl-metacrylate in osteoporosis and severe vertebral osteolysis (Galibert's technic)]. AB - The authors present their preliminary experiences using methyl-metacrylate by percutaneous injection for the treatment of osteoporosis and osteolysis of the vertebral body and for vertebral angiomas. The injection of cement strengthens the vertebral body and prevents its collapse. The mixture used consist of 4.80 g of powder with 5 cm3 of monomer liquid. The technique is performed with radiological control under neuroleptanalgesia and a local anesthesia before insertion of the needle. This technique gives good results for the treatment of vertebral pain caused by osteoporosis or osteolysis. PMID- 2757347 TI - [Fractures of the base of the first metacarpus]. AB - The authors report a group of 73 cases of fractures of the base of the first metacarpal treated between 1974 and 1989. Fifty-three articular fractures (73%) and 20 non-articular fractures are described. Sixty-eight patients were treated surgically: 49 diverging pin insertions were used, 15 Lars Thoren technique, 5 rigid osteosyntheses with AO miniaturized material. Forty-two patients were seen again after one year or more. We classify the results as follows: very good: 29 (69%), good: 10 (24%), bad: 3 (7%). The relative simplicity, the reliability and the good results of the double diverging pin insertion lead the authors to apply this method in most fractures of the base of the first metacarpal, either articular or extra-articular. PMID- 2757348 TI - [Retroperitoneal perforation of duodenal ulcer responsible for abscess]. AB - The authors report a case of retroperitoneal perforation of a duodenal ulcer. This is a rare condition which is exceptionally responsible for abscess formation. If often has a poor prognosis. In the present case, the abscess was infrahepatic. The diagnosis of the origin of the abscess was established by radiological opacification via percutaneous puncture. Surgical drainage and irrigation performed via an extraperitoneal approach centered over the cavity, combined with triple-agent antibiotic therapy (penicillin, gentamicin, metronidazole) ensured collapse followed by sterilisation of the abscess cavity. The ulcer was cured by medical treatment. This case differs from the published case in terms of the diagnostic procedures classically used (upper gastrointestinal endoscopy and small bowel series), the infrahepatic site of the abscess and the extraperitoneal surgical treatment which avoided dissemination to the peritoneal cavity. PMID- 2757349 TI - [Post-infarction anterior septal rupture. Aspects of the IVC flux on bidimensional Doppler with color coding]. AB - In a case of anterior septal rupture complicating a transeptal myocardial infarction, the diagnosis of IVC is immediately confirmed by bidimensional Doppler with color coding. The abnormal flow and its three components are studied in multiple section planes. Incidences permitting the best visualization of the shunt are the longitudinal sections: left parasternal and apical-long axis. The parasternal short axis section only visualizes an abnormal intraventricular flow. Sweeping of the septum by caudal tilting of the probe, from an apical section of the 4 cavities, successively studies the three portions: left intraventricular, trans-septal, and right intraventricular of the abnormal flow. The size of the defect seems underestimated on bidimensional ultrasonograms as well as color Doppler. Speed, sensitivity and reliability of the color coded bidimensional Doppler, places it as the reference diagnostic test in this type of pathology. Catheterization still has a place in evaluating the severity of the shunt. PMID- 2757350 TI - [Hemodynamic effects of amrinone and comparison with dobutamine in patients with chronic respiratory insufficiency with pulmonary hypertension]. PMID- 2757351 TI - Clinical value of tumor markers. PMID- 2757352 TI - Combination and individual antitumor effects of hyperthermia, cisplatin, and selected dithiocarbamates. AB - The antitumor effects produced by combinations of cisplatin (Pt), substituted dithiocarbamates (dimethyldithiocarbamate [DmDTC] and sodium N-methyl-D-glucamine dithiocarbamate [NMGDTC]) and hyperthermia (H) were measured and compared to those produced by single agents alone in C3H/HeN mice bearing the transplantable radiation-induced fibrosarcoma, RIF-1, in one or both hind feet. The average tumor volumes of control and treatment groups were compared periodically after treatment with H. Combinations of H and Pt completely resolved established foot tumors in 10/13 mice. However, evidence of long-term nephrotoxicity and gastrointestinal (GI) toxicity became evident causing death of these mice within 120 to 122 days after tumor inoculation. Hyperthermia plus DmDTC resolved tumors in heated and non-heated feet in 3/8 mice, thus demonstrating both ipsilateral and contralateral anti-tumor activity. Furthermore, H-Pt-NMGDTC produced complete tumor resolution in 7/13 mice; these mice survived and were tumor-free 180 days post inoculation and autopsies revealed no appreciable nephro- or GI toxicity. In addition, 4/8 mice underwent complete tumor resolution in heated left feet plus dramatic retarding of tumor growth in unheated right feet (ipsilateral and contralateral anti-tumor effects). Five heat-treated left foot tumors resolved in the H-Pt-DmDTC group with one mouse demonstrating resolution of tumor in both feet. Advanced foot tumors were treated with H-DmDTC and H-Pt-DmDTC. Hyperthermia and Pt were administered on day 0 of the experiment and DmDTC on days 0 through 3; dramatic tumor shrinkage continued through day 6 for a total of 75 to 80 percent reduction of tumor volume in both groups. The concurrent administration of DmDTC or NMGDTC with H and Pt prevented or greatly reduced nephrotoxicity and GI toxicity in all experiments without retarding anti-tumor efficacy. PMID- 2757353 TI - Passive neonatal thrombocytopenia. A case study of factors predicting the response to i.v. IgG therapy. AB - A term male infant was noted at birth to have petechiae over the face and trunk and a platelet count of 3 x 10(9) per L. Maternal immune thrombocytopenia (ITP) was suspected from the clinical data and confirmed by the presence of antiplatelet antibody (both in the mother and infant) detected by recently described flow cytometry method. Initial treatment with exchange transfusions, platelet transfusions, steroids, failed to correct thrombocytopenia and, hence, seven doses of high-dose gamma globulin (IV-IgG) were given intravascularly. Initiation of IV-IgG was followed by stabilization of platelet counts with marked reduction in the need for platelet transfusions. In this case of passive ITP, the therapeutic efficiency of high dose IV-IgG seems to depend upon maintaining a certain critical level of serum IgG (which in turn may depend upon the serum antiplatelet antibody titers). PMID- 2757355 TI - Recent advances in clinical science. Abstracts of the 89th meeting of the Association of Clinical Scientists. May 11 to 14, 1989, Charlottesville, Virginia. PMID- 2757354 TI - Growth characteristics of cultured human proximal tubule cells exposed to aminoglycoside antibiotics. AB - It is well known that the nephrotoxic lesions that occur during aminoglycoside induced nephrotoxicity are both dose- and time-dependent. It was the purpose of this study to determine if a cell culture model based on the human proximal tubule would exhibit similar dose- and time-dependent relationships when exposed to aminoglycosides of various nephrotoxic potential. For this determination, the human proximal tubule (HPT) cells were exposed to increasing concentrations of streptomycin, kanamycin, gentamicin, and neomycin and monitored for cell growth and toxicity over an 18-day period of exposure. Both actively-dividing and resting cells were assessed with regard to aminoglycoside exposure. At high levels of aminoglycoside exposure, linear regression analysis disclosed that the rank order of toxicity of the aminoglycosides to be: neomycin greater than kanamycin greater than gentamicin greater than streptomycin. Both actively dividing and resting cultures of HPT cells displayed both dose- and time dependency with regard to toxicity and the ability of the cells to regenerate in the continued presence of aminoglycoside exposure. This pattern of dose- and time dependency was unique for each aminoglycoside and varied depending on the replicative state of the cells. With the exception of neomycin, clear evidence was obtained that toxicity and cell regeneration were occurring simultaneously throughout the time course of aminoglycoside exposure; the equilibrium between the two processes determining overall cell toxicity or regeneration. In addition, the HPT cells exposed to gentamicin displayed a unique pattern of toxicity and cell regeneration when compared to the other aminoglycosides tested, with gentamicin having an increased ability to stimulate cell proliferation. While the results obtained are in excellent agreement with that known from the clinical experience with the aminoglycosides, the dose- and time-dependency of the responses will require careful attention to growth state during employment in experimental protocols. PMID- 2757356 TI - Screening for thermostability and electrophoretic red blood cell sorbitol dehydrogenase (E.C.1.1.1.14) variants. AB - A screening for both thermostability and electrophoretic red blood cell sorbitol dehydrogenase (RBC-SORD) variants in blood donors was performed. SORD activity in standard conditions (unheated samples) in 274 individuals was 198 +/- 38.6 mIU/g Hb. The ratio of enzymatic activity after heating (H) to the activity in controls (C) before heating (H/C ratio) was 0.39 +/- 0.10. H/C ratios minor than 0.1 in 3 out of 274 blood donors and higher than 0.9 in 1 were observed. In 208 individuals, four electrophoretic phenotypes were observed: I) Three bands, named a, b and c, with cathodic mobility in 163 individuals (78.36%); II) Two bands a and c in 25 individuals (12.02%); III) Two bands b and c in 14 (6.73%); and IV) One band, c in 6 (2.88%). Studies carried out to characterize the three bands suggest that they are isozymes of the same locus with the observation of an interchange of the bands as a normal phenomena. PMID- 2757357 TI - [Nucleolus organizer region--centromere translocation]. AB - A karyotype 45,XX,-13,-15,+psudic (13;15)(p12.9;11.200) was observed in a young woman after two spontaneous miscarriages. After R-, C-, and NOR - banding - the rearranged element was shown to include: the long arm, the active centromere, and the NOR of chromosome 13, followed by the inactivated centromere, and the long arm of chromosome 15. PMID- 2757358 TI - Assignment of the GDH loci to human chromosomes 10q23 and Xq24 by in situ hybridization. AB - More precise localisations of the glutamate dehydrogenase gene (GLUD) to chromosome 10q23 and of the pseudogene GLUDP1 to X q24 are proposed. PMID- 2757359 TI - A case of the ring 20 syndrome. AB - A 4-year-old child with a ring 20 chromosome mosaicism, low grade developmental delay, and seizures is described. PMID- 2757360 TI - Partial trisomy 13q22----qter. A new case. AB - A newborn male patient with a partial trisomy 13q22----qter, derived from a maternal translocation (13;15)(q22;p11) is reported. This non-frequent chromosomal anomaly leads to a characteristic phenotype easily recognizable from other craniosynostosis syndromes, in which the cranial malformation is often associated with auricular and limb defects. This phenotype includes: cranial malformation, characteristic facies, mental and developmental retardation, urologic and genital anomalies, polydactily, abnormal muscular tonicity and convulsive status. Our patient, a "pure" partial trisomy, without other associated chromosomal anomaly, is compared with the published cases. PMID- 2757361 TI - A case of Alagille's syndrome with translocation (4;14) (q21;q21). AB - This paper reports a case of Alagille's syndrome, in association with a translocation 46,XY,t(4;14)(q21;21). The possible relationship between this autosomal dominant syndrome and the apparently balanced chromosomal rearrangement is discussed. PMID- 2757362 TI - Severe midline fusion defects in a newborn with 10q26----qter deletion. AB - In this report we describe a male newborn with a severe midline fusion syndrome associated with a "pure" distal 10q deletion (del(10)(q26.1----qter]. PMID- 2757363 TI - Pediplot: A computer-program for drawing pedigrees. AB - The paper describes a personal computer (PC) program PEDIPLOT for drawing genetic pedigrees. It is easy to use because the input file is created from index cards by a special program PEDI-BASE. The place in the pedigree is calculated from the parents id, which means the order of the persons in indifferent. It is possible to draw rectangular as well as circular pedigrees. PMID- 2757364 TI - Interstitial deletion of the long arm of chromosome 6. AB - A de novo interstitial deletion of 6q21 was observed in a male baby with moderate microcephaly, facial dysmorphism, and psychomotor retardation. In situ hybridization with a c-myb probe showed that the gene was conserved on the deleted chromosome. PMID- 2757365 TI - A study of yeasts during the delignification and fungal transformation of wood into cattle feed in Chilean rain forest. AB - In Chilean rain forest the presence and distribution of yeasts were studied during the fungal transformation of wood, producing a partially delignified material used as cattle feed ("huempe"). A total of 68 yeast species was reported, including a noticeable proportions of basidiomycetous and xylose assimilating strains, the latter related to the increased availability of this sugar in the decayed wood. The results of the mathematic comparison of taxonomic data of 327 strains showed a delimitation of sharp clusters corresponding to different species, including several new species described from this substrate, and genera, as Rhodotorula and Cryptococcus. At the initial stages of wood decay, characterized by the presence of Candida species, yeast diversity was low. The highest values were found in the medium stage of decay, used as feed, with an important presence of the genera Apiotrichum, Rhodotorula, Cryptococcus and Schizoblastosporion. After establishing a non-linear ordination from Euclidean distances between samples, based on yeast abundances, a relationship was observed between the populations developing at the different stages of wood decay by Ganoderma applanatum. A succession of yeast species was demonstrated during wood degradation by this white-rot fungus. PMID- 2757366 TI - Hyphal fusion during initial stages of trap formation in Arthrobotrys oligospora. AB - Hyphal fusion during initial stages of trap formation by Arthrobotrys oligospora was studied by video-enhanced contrast and electron microscopy. Trap initials grew perpendicularly to the parent hypha, then curved around and anastomosed with a peg that developed on the hypha. Trap initials usually developed 40-140 microns apart while the anastomosis occurred 20-25 microns from the initial. Vigorous cytoplasmic movements in trap initials and developed traps corresponded to intense staining with fluorescein diacetate (FDA) of these cells. In addition, bundles of microfilaments were seen in developing loops of traps. On fusion organelle migration took place from the tip cell of the trap into the peg. Later on a septum was formed at the site of fusion. PMID- 2757367 TI - A reevaluation of the genus Malassezia by means of genome comparison. AB - Results of a study of the genus Malassezia on the basis of genome characters confirm that two species should be maintained, M. furfur and M. pachydermatis. The two forms associated with skin disease, frequently referred to as Pityrosporum orbiculare and P. ovale, were found to be synonymous, the name M. furfur having priority. Malassezia pachydermatis, hitherto regarded as a strictly zoophilic species, may also be found on humans. PMID- 2757368 TI - Strain variation in Campylobacter pylori detected by numerical analysis of one dimensional electrophoretic protein patterns. AB - A total of 21 clinical isolates of Campylobacter pylori from Peru and the United Kingdom and two reference strains (from Australia), including the type strain (NCTC 11637T), were characterized by high resolution one-dimensional SDS polyacrylamide gel electrophoresis of cellular proteins. The protein patterns contained more than 40 discrete bands and the approximate molecular weights of the major bands were 22, 27, 46, 57, 60, 65 and 93 kD. The total patterns were used as the basis of numerical analysis. Most strains were clustered in four phenons at 91% similarity with the exception of six ungrouped strains. Overall similarity was high with all strains linked in the phenogram at greater than or equal to 81%. Variation among strains was attributable principally to qualitative and quantitative band differences in the 47 to 56 kD (hypervariable) region of the C. pylori protein profile. From the analysis, ten different electropherotypes (EP-types) were identified. We demonstrated that differences were detectable among isolates from widely separated geographical locations as well as from the same location, although multiple isolates from two Peruvian patients had the same electropherotype. Our results indicate that determination of protein profiles provides the basis of a reproducible method for characterization of C. pylori isolates. PMID- 2757369 TI - Aggregation of 27 oral bacteria by human whole saliva. Influence of culture medium, calcium, and bacterial cell concentration, and interference by autoaggregation. AB - Twenty-seven oral strains of the genera Actinomyces (5), Bacteroides (3), and Streptococcus (19) were tested for aggregation by human whole saliva, as well as the effect of culture medium, Ca-ions, and bacteria concentration thereupon. Of the media tested, GF-broth gave rise to less interference by autoaggregation or higher aggregation titers than BHI and TSB, and was used throughout this study. In most cases, Ca-ions (1 mM) only enhanced the rate of induced aggregation, whereas raising the bacteria concentration increased the rate of both induced- and autoaggregation. The final titers, ranging from 1-64, were hardly affected by these parameters, except those of S. rattus HG 59 and S. mutans HG 199, which were respectively increased and decreased by Ca-ions. Saliva-induced aggregation was observed for 21 strains of A. viscosus, A. naeslundii, A. israelii, B. gingivalis, B. intermedius, S. cricetus, S. mutans, S. rattus, S. sanguis, and S. sobrinus, mostly within 15 min to 3 h. Seventeen of these strains also showed autoaggregation, usually well after the onset of induced aggregation. Any potential induced aggregation of B. gingivalis HG 91 was always masked by autoaggregation, as well as that of the S. mutans strains under a particular set of conditions. The aggregation rate and titer varied considerably in a mutually unrelated and strain-dependent way. These microtiterplate data were matched by the 5 spectrophotometric patterns observed for saliva-bacterial interaction, which moreover, gave the better differentiation between induced and autoaggregation. In conclusion, most strains tested can show rapid saliva-induced aggregation in a strain-dependent way, yet strongly affected by the experimental conditions and interference from autoaggregation. PMID- 2757370 TI - Rhodospirillum centenum, sp. nov., a thermotolerant cyst-forming anoxygenic photosynthetic bacterium. AB - A novel non-sulfur purple photosynthetic bacterium, designated Rhodospirillum centenum, was isolated from an enrichment culture designed to favor growth of anoxygenic photosynthetic N2-fixing bacteria. R. centenum grows optimally at 40 42 degrees C and has the capacity to produce cytoplasmic 'R bodies', refractile structures not observed hitherto in photosynthetic prokaryotes. The bacterium is also unusual among photosynthetic bacteria in that it forms desiccation-resistant cysts when grown aerobically in darkness with butyrate as the sole carbon source. PMID- 2757371 TI - More monensin-sensitive, ammonia-producing bacteria from the rumen. AB - Two monensin-sensitive bacteria which utilized carbohydrates poorly and grew rapidly on amino acids were isolated from the bovine rumen. The short rods (strain SR) fermented arginine, serine, lysine, glutamine, and threonine rapidly (greater than 158 nmol/mg of protein per h) and grew faster on casein digest containing short peptides than on free amino acids ().34 versus 0.29 h(-1)). Gelatin hydrolysate, an amino acid source containing an abundance of long peptides, was unable to support growth or ammonia production, but there was a large increase in ammonia production if strain SR was cocultured with peptidase producing ruminal bacteria (Bacteroides ruminicola or Streptococcus bovis). Cocultures showed no synergism with short peptides. Strain SR washed out of continuous culture ().1 h(-1)) at pH 5.9. The irregularly shaped organisms (strain F) deaminated glutamine, histidine, glutamate, and serine rapidly (greater than 137 nmol/mg of protein per min) and grew faster on free amino acids than on short peptides ().43 versus 0.21 h(-1)). When strain F was provided with casein or gelatin hydrolysate and cocultured with peptidase-producing bacteria, there was a more than additive increase in ammonia production. Strain F grew in continuous culture (0.1 h(-1)) when the pH was as low as 5.3. The irregularly shaped cells and short rods were present at less than 10(9)/ml in vivo, but they ahd very high specific activities of ammonia production (greater than 310 nmol of ammonia/mg of protein per min) and could play an important role in ruminal amino acid fermentation. PMID- 2757372 TI - Fermentation products and plant cell wall-degrading enzymes produced by monocentric and polycentric anaerobic ruminal fungi. AB - Five anaerobic fungal isolates from the bovine rumen were grown on Coastal Bermuda grass (CBG) leaf blades and monitored over a 9-day period for substrate utilization, fermentation products, cellulase, and xylanase activities. Two of the fungal isolates showed monocentric growth patterns; one (isolate MC-1) had monoflagellated zoospores and morphologically resembled members of the genus Piromyces; the other (isolate MC-2) had multiflagellated zoospores and resembled members of the genus Neocallimastix. Three other isolates (PC-1, PC-2, and PC-3) exhibited polycentric growth and have not yet been described in the literature; these isolates were characterized by differences in morphology. All of the isolates degraded CBG to approximately the same extent (70% [dry weight]) in 9 days. Fermentation product accumulation was concurrent with substrate utilization. The major fermentation products for all isolates were formate, acetate, D-(-)-lactate, L-(+)-lactate, ethanol, carbon dioxide, and hydrogen. Succinate was produced by all cultures, with the exception of MC-1. Fermentation balances revealed different profiles for each isolate. As a group, monocentric isolates produced a greater ratio of oxidized to reduced products when grown on glucose or CBG than did the polycentric isolates, which produced a nearly equal ratio of these products. All isolates exhibited cellulolytic and xylanolytic activities, including endoglucanase, exoglucanase, beta-glucosidase, xylanase, and beta-xylosidase activities. Increasing enzyme activity correlated with the accumulation of fermentation products and substrate utilization. The optimum pH for the enzymatic activity of polycentric isolates was within a more narrow range (pH 6.4 to 7.0) than that of the monocentric isolates (pH 5.5 to 7.5). Activity toward cellulosic substrates was not detected until after the disappearance of reducing sugars. Xylanase activity was found to be five to seven times that of carboxymethyl cellulase activity for all cultures grown on CBG. PMID- 2757373 TI - Free-living pathogenic and nonpathogenic amoebae in Maryland soils. AB - Tests for potentially pathogenic amoebae were carried out on soil samples from the following sites: (i) farmlands fertilized with municipal sewage wastes, (ii) a stream receiving sewage effluent from a sludge lagoon, (iii) a ravine receiving storm runoff from a cattle farm, (iv) farmlands not fertilized with sewage wastes, and (v) a vegetated shoreline of a waterfront estate not used for farming or livestock production. Study sites were located on the eastern shore of Maryland, bordered to the north by Delaware and to the south by Virginia. Twenty four species of soil amoebae, including five potentially pathogenic Acanthamoeba species (members of the family Acanthamoebidae), were identified. All of the sites yielded two or more of the potential pathogens. PMID- 2757374 TI - Nickel transport by the thermophilic acetogen Acetogenium kivui. AB - Exogenous 63Ni was incorporated into carbon monoxide dehydrogenase when Acetogenium kivui ATCC 33488 was cultivated in the presence of 63NiCl2. The capacity for nickel (63NiCl2) transport was greatest with cells harvested from the mid- to late exponential phases of growth. Nickel transport was linear during the transport assay period and displayed saturation kinetics. The apparent Km and Vmax for nickel transport by H2-cultivated cells approximated 2.3 microM Ni and 670 pmol of Ni transported per min per mg (dry weight) of cells, respectively. The nickel transport system was not appreciably affected by the other divalent cations that were tested, and transported nickel was not readily exchangeable with exogenous nickel. Nickel transport was stimulated by glucose or H2 and was decreased by various metabolic inhibitors; however, nickel uptake by glucose- and H2-cultivated cells displayed differential sensitivities to ATPase inhibitors. PMID- 2757375 TI - Levels of bacteria, fungi, and endotoxin in bulk and aerosolized corn silage. AB - Three samples of silage taken from the surface of a silo and from depths of 20 and 45 cm in the silo were studied for identification of the potential agents causing symptoms of organic dust toxic syndrome. The samples were examined by dilution plating before and after aerosolization in an acoustical dust generator. Aerosol samples were collected by liquid impinger and filter cassettes. The samples were examined for total aerobic bacteria, anaerobic bacteria, gram negative bacteria, lactobacilli, listeriae, thermophilic actinomycetes, fungi, and endotoxin. Very high levels of total aerobic bacteria and fungi were found in the surface sample (up to 10(9) CFU/g in the bulk sample and up to 10(9) CFU/m3 after aerosolization), whereas the corresponding values from the deepest site were 100 to 50,000 times lower. Aspergillus fumigatus predominated among the fungi, whereas Bacillus and gram-negative organisms (Pseudomonas, Alcaligenes, Citrobacter, and Klebsiella species) prevailed among bacteria. Thermophilic actinomycetes occurred in numbers up to 10(7) CFU/g in the bulk samples, whereas anaerobic bacteria, lactobacilli, and listeriae were only few or absent. The concentration of endotoxin was high in the surface sample (up to 211.4 Endotoxin Units/mg) and about 200-fold lower in the sample from the deepest site. The results show that contact with dust from the surface of silage carries the risk of exposure to high concentrations of microorganisms, of which A. fumigatus and endotoxin-producing bacteria are the most probable disease agents. PMID- 2757376 TI - Enumeration of selected anaerobic bacterial groups in cecal and colonic contents of growing-finishing pigs. AB - Selected anaerobic bacterial groups in cecal and colonic contents of clinically healthy pigs fed a corn-soybean meal production diet were determined at sacrifice after 4, 8, and 11 weeks on feed, corresponding to intervals within the growing finishing growth period. By using ruminal fluid-based media, the densities of the culturable anaerobic population; the cellulolytic, pectin-fermenting, pectin hydrolyzing, xylan-fermenting; and the xylan-hydrolyzing, sulfate-reducing, and methanogenic bacterial populations were estimated. An analysis of variance was performed on these bacterial group variables to examine the effects of phase (weeks on feed), site (cecum or colon), or the interaction of phase with site. The population of total anaerobic bacteria was twice as dense in the colon as it was in the cecum (2 x 10(10) versus 1 x 10(10)/g [wet weight]; P = 0.001). The proportion of cellulolytic bacteria was lower at 4 weeks on feed than at 8 or 11 weeks (23 versus 32%; P = 0.026), while the proportion of pectin-fermenting bacteria depended on the interaction of phase with site (P = 0.021). The numbers of sulfate-reducing bacteria were significantly higher in the colon than in the cecum (6 x 10(7) versus 3 x 10(7); P = 0.014), as were methanogenic bacteria (19 x 10(7) versus 0.6 x 10(7); P = 0.0002). The remaining bacterial groups were stable with respect to phase and site. The results suggest that except for density differences, the microbial communities of the pig cecum and colon are similar in composition throughout the growing-finishing phase. PMID- 2757377 TI - Evidence for colonization and destruction of hinge ligaments in cultured juvenile Pacific oysters (Crassostrea gigas) by cytophaga-like bacteria. AB - Several strains of cytophaga-like gliding bacteria (CLB) were isolated as numerically dominant or codominant components of bacterial populations associated with proteinaceous hinge ligaments of cultured juvenile Pacific oysters, Crassostrea gigas. These bacteria were morphologically similar to long, flexible bacilli occurring within degenerative lesions in oyster hinge ligaments. Among bacteria isolated from hinge ligaments, only CLB strains were capable of sustained growth with hinge ligament matrix as the sole source of organic carbon and nitrogen. In vitro incubation of cuboidal portions of ligament resilium with ligament CLB resulted in bacterial proliferation on the surfaces and penetration deep into ligament matrices. Bacterial proliferation was accompanied by loss of resilium structural and mechanical integrity, including complete liquefaction, at incubation temperatures between 10 and 20 degrees C. The morphological, distributional, and degradative characteristics of CLB isolated from oyster hinge ligaments provide compelling, albeit indirect, evidence that CLB are the agents of a degenerative disease affecting juvenile cultured oysters. The motility, metabolic, and hydrolytic characteristics of hinge ligament CLB and the low moles percent G + C values (32.4 to 32.9) determined for three representative strains indicate that they are marine Cytophaga spp. PMID- 2757378 TI - Viability of Acanthamoeba cysts in ophthalmic solutions. AB - Acanthamoeba keratitis is a chronic infection of the human cornea. Many people who have this infection wear soft contact lenses. Usually lens wearers clean and maintain their lenses with various ophthalmic solutions including homemade saline. Recently it has been shown that homemade saline solutions play a role in lens contamination and thus in Acanthamoeba keratitis. We therefore evaluated the viability of cysts of three species of Acanthamoeba by exposing them for various time periods to saline, cleaning, and disinfectant solutions generally used to care for these lenses. We found that the viability of the cysts in saline solutions ranged from a minimum of 14 days to 90 days of exposure. In cleaning solutions, the survival times ranged from a minimum of 1 day to 90 days of exposure. Disinfectants, as expected, were the most effective of all tested solutions in killing Acanthamoeba cysts. The survival times ranged from 6 h to 14 days. None of these products were effective in destroying Acanthamoeba cysts in less than 6 h of exposure, which exceeds the suggested time that any given solution should be used for lens care. PMID- 2757379 TI - Cloning of two bacteriocin genes from a lactococcal bacteriocin plasmid. AB - Lactococcus lactis subsp. cremoris 9B4 plasmid p9B4-6 (60 kilobases [kb]), which specifies bacteriocin production and immunity, was analyzed with restriction endonucleases, and fragments of this plasmid were cloned into shuttle vectors based on the broad-host-range plasmid pWVO1. Two regions on p9B4-6 were identified which specify inhibitory activity on L. lactis indicator strains: one that could be confined to a 1.8-kb ScaI-ClaI fragment with low antagonistic activity and a 15-kb XbaI-SalI fragment specifying high antagonistic activity. The inhibitory substances produced by these two clones were sensitive to proteolysis. A 4-kb HindIII fragment derived from the 15-kb fragment strongly hybridized with the 1.8-kb fragment. The antagonistic activity specified by the 4 kb fragment was somewhat reduced as compared with that of the 15-kb fragment. A 1.3-kb ScaI-HindIII subfragment of the 4-kb fragment contained both the immunity and bacteriocin genes. Inhibition studies showed that the two bacteriocins had different specificities. PMID- 2757380 TI - C-ring cleavage of flavonoids by human intestinal bacteria. AB - Four hitherto undescribed Clostridium strains capable of cleaving the C ring of quercetin, kaempferol, and naringenin at C-3-C-4 were isolated from the fecal flora of humans. None of the strains cleaved catechin. C-ring fission occurred when the substrate was either in solution or in suspension. Mixed cultures of flavonoid-hydrolyzing bacteria, flavonoid-cleaving bacteria, and Escherichia coli, which was used to provide the anaerobic environment, rapidly metabolized rutin to 3,4-dihydroxyphenylacetic acid, indicating that the intestinal half-life of the biologically active aglycone is short. The cleaving strains shared many phenotypic characteristics, including their inability to ferment sugars, but they differed sufficiently to indicate that they represent different species. PMID- 2757381 TI - Viability of Giardia cysts suspended in lake, river, and tap water. AB - Numerous waterborne outbreaks of giardiasis have occurred since 1965, yet little or no information has been reported on the viability of Giardia cysts in different aquatic environments. We have studied the viability of Giardia muris cysts suspended in lake, river, and tap water, while also monitoring water temperature, dissolved oxygen, pH, and other water quality parameters. Fecal pellets containing G. muris cysts were placed in glass vials covered with filter paper and exposed to (i) lake water at 15 ft (ca. 4.6 m) and 30 ft (ca. 9.2 m), (ii) river water, (iii) tap water, and (iv) distilled water stored under laboratory conditions. At 3, 7, 14, 28, 56, and 84 days, two vials from each environment were removed, and cyst viability was determined by (i) fluorogenic dye exclusion, (ii) production of giardiasis in an animal, and (iii) cyst morphology by Nomarski microscopy. In the fall, the cysts suspended at 30 ft in lake water remained viable for up to 56 days whereas cysts stored at 15 ft were nonviable after day 28. The G. muris cysts exposed to river water remained viable up to 28 days as determined by the production of giardiasis in mice. G. muris cysts suspended in tap water showed no signs of viability after 14 days, while cysts serving as controls (exposed to refrigerated distilled water) remained viable for up to 56 days. In the winter, Giardia cysts suspended in either lake or river water were viable for 56 to 84 days whereas cysts exposed to tap water were nonviable by day 14.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2757382 TI - Molecular cloning of genes from Ruminococcus flavefaciens encoding xylanase and beta(1-3,1-4)glucanase activities. AB - Clones expressing activity against xylan or beta(1-3,1-4)glucan (lichenan) were isolated from a library of Ruminococcus flavefaciens 17 DNA made in bacteriophage lambda EMBL3. Hybridization analyses indicated the recovery of four separate genes encoding xylanases that showed no detectable associated carboxylmethylcellulase activity. One of these genes was associated with clones that also expressed beta(1-3,1-4)glucanase and beta-xylosidase activities. PMID- 2757383 TI - Characteristics and restriction analysis of the 4-chlorobiphenyl catabolic plasmid, pSS50. AB - The plasmid pSS50 is a 53-kilobase self-transmissible plasmid of broad host range that has been isolated from several Alcaligenes and Acinetobacter species. This plasmid has previously been shown to mediate the mineralization of 4 chlorobiphenyl to carbon dioxide and water. Physical characterization of this plasmid by restriction analysis indicates that most hexanucleotide cleavage sites are clustered in a 5-kilobase region, leaving large regions without restriction sites. The paucity of restriction sites is not due to DNA methylation. PMID- 2757384 TI - Growth of the syntrophic anaerobic acetogen, strain PA-1, with glucose or succinate as energy source. AB - Strain PA-1 (S. Barik, W.J. Brulla, and M.P. Bryant, Appl. Environ. Microbiol. 50:304-310, 1985) is an anaerobic, gram-negative rod that in pure culture decarboxylates succinate to propionate and that grows syntrophically as an acetogen with the H2 utilizer Methanospirillum hungatei if glucose, pyruvate, aspartate, or fumarate is provided. In pure culture, strain PA-1 grows optimally in a medium containing 5% ruminal fluid, 0.1% yeast extract, a 4:1 N2-CO2 gas phase, and 20 mM succinate. With the PA-1 plus M. hungatei coculture, good growth was obtained with 7.5 mM glucose and tryptophan could replace the yeast extract. Strain PA-1 in pure culture grew quite well in glucose medium if the large headspace was flushed intermittently with N2. Flushing with H2 inhibited this growth. PMID- 2757385 TI - Excretion of amino acids by 1,2,4-triazole-3-alanine-resistant mutants of Methanococcus voltae. AB - In contrast to wild-type cells, it was found that triazole-alanine-resistant mutants of Methanococcus voltae excreted histidine, proline, phenylalanine, and tyrosine in various combinations. These results suggest that a form of general amino acid biosynthetic control may operate in this methanogen. We also show that wild-type M. voltae excretes methionine. PMID- 2757386 TI - Effect of oxidative stress on membrane phospholipid and protein organization in human erythrocytes. AB - Membrane phospholipid and protein organization was studied in intact human erythrocytes exposed to phenylhydrazine, an oxidative agent inducer. The evaluation of the membrane phospholipid and protein organization was carried out in terms of asymmetric distribution across the membrane bilayer for the phospholipids, and in terms of accessibility of cleavable sites present on the outer membrane surface for the proteins. Treatment of phenylhydrazine-exposed erythrocytes either with bee venom phospholipase A2 or with trinitrobenzenesulfonic acid indicated that phosphatidylserine (PS), which is the only phospholipid not formally present on the outer leaflet of the membrane, was translocated to the outer surface of the cell membrane. The extent of this phenomenon was directly proportional to the concentration of the oxidant having a peak value at 0.1 mM. Phosphatidylcholine and phosphatidylethanolamine conserved their original distribution across the erythrocyte membrane throughout the study. The oxidant, at a dose which did not induce any modification of the sodium dodecyl sulfate-polyacrylamide gel electrophoresis cytoskeleton membrane protein pattern, did not provoke any alteration of the membrane protein surface architecture, although the translocation of PS to the membrane outer leaflet in intact erythrocytes was present. PMID- 2757387 TI - A selective inhibitor of N8-acetylspermidine deacetylation in mice and HeLa cells without effects on histone deacetylation. AB - The inhibitory effects of 7-[N-(3-aminopropyl)amino]heptan-2-one (APAH) on N8 acetylspermidine deacetylation were studied. In in vitro studies, APAH produced inhibition (apparent Ki of 0.18 microM) of N8-acetylspermidine deacetylation by the 100,000g supernatant fraction of rat liver. This apparent Ki was 60-fold less than the apparent Km (11 microM) for deacetylation of the substrate, N8 acetylspermidine, suggesting that APAH could be a potent, effective inhibitor in vivo. APAH was administered to mice by intraperitoneal injection at a dose of 200 mg/kg, and polyamine and acetylpolyamine levels in liver and spleen were measured. In tissues of control mice, N8-acetylspermidine was not detectable but increased to detectable levels 30-360 min after APAH treatment. These data are consistent with inhibition of the deacetylase by APAH. Increases in putrescine and N1-acetylspermidine levels occurred in liver after APAH treatment with increases in N1-acetylspermidine levels observed in spleen. In HeLa cells, a significant increase in N8-acetylspermidine was observed following 24 h exposure to 10 microM APAH while no change occurred in the acetylation level of HeLa cell histones. In contrast, 24 h exposure to 10 mM sodium butyrate produced no change in N8-acetylspermidine levels and an increase in the acetylation level of histones H4 and H2B. These results suggest that APAH has a relatively selective inhibitory effect on N8-acetylspermidine but not histone deacetylation. This is the first report of significant levels of N8-acetylspermidine in animal tissues and of the effects of in vivo inhibition of N8-acetylspermidine deacetylase. PMID- 2757388 TI - tert-butyl hydroperoxide-dependent microsomal release of iron and lipid peroxidation. I. Evidence for the reductive release of nonheme, nonferritin iron. AB - Rat liver microsomes were found to contain a small pool of nonheme, nonferritin iron. In the presence of ADP, low concentrations of tert-butyl hydroperoxide promoted the reductive release of nonheme, nonferritin iron, as evidenced by mobilization of bathophenanthroline-chelatable Fe2+. Iron release was inhibited by SKF 525-A and metyrapone, which are known to interfere with cytochrome P450 catalyzed reactions. Iron release was also inhibited by high concentrations of t BOOH, which caused rapid and extensive destruction of cytochrome P450. These observations suggested that iron release was catalyzed by cytochrome P450. Treatment of rats with phenobarbital (PB) caused simultaneous increase of cytochrome P450 and decrease of nonheme, nonferritin iron. The effects of PB were minimized by simultaneous administration of hematin, an inhibitor of heme synthesis, indicating that the nonheme iron was utilized for the synthesis of the heme iron of inducible cytochrome P450 isozymes. Consistently, microsomes from the liver of PB-treated rats were found to release low amounts of Fe2+, unless rats had also been treated with hematin to prevent utilization of nonheme, nonferritin iron for the synthesis of heme iron. PMID- 2757389 TI - tert-butyl hydroperoxide-dependent microsomal release of iron and lipid peroxidation. II. Evidence for the involvement of nonheme, nonferritin iron in lipid peroxidation. AB - In a previous study tert-butyl hydroperoxide (t-BOOH) was found to promote reductive release of nonheme, nonferritin iron from rat liver microsomes. The reaction was catalyzed by cytochrome P450 and was strictly contingent on the availability of ADP. In this study, t-BOOH was also found to promote microsomal lipid peroxidation, as evidenced by formation of malondialdehyde. t-BOOH dependent lipid peroxidation was stimulated by ADP, and four lines of evidence suggested that such stimulation was mediated by reductive release and subsequent redox cycling of nonheme, nonferritin iron. First, lipid peroxidation was stimulated by the same concentration of ADP that promoted iron release. Second, depletion of nonheme, nonferritin iron by pretreatment of rats with phenobarbital decreased the stimulation of lipid peroxidation by ADP. Third, the effect of ADP was maximal when the concentration of t-BOOH was adjusted to values that yielded maximum iron release. Fourth, the effect of ADP was abolished by bathophenanthroline, which is known to chelate ferrous iron in a redox inactive form. These results suggest that the reductive release of nonheme, nonferritin iron exacerbates the deleterious effects of t-BOOH on microsomal lipids. PMID- 2757390 TI - Regulation of alternative pathway activity in plant mitochondria: nonlinear relationship between electron flux and the redox poise of the quinone pool. AB - The dependence of respiratory flux via the alternative pathway on the redox poise of the ubiquinone (Q) pool was investigated in soybean cotyledon mitochondria. A marked nonlinear relationship was observed between Q-pool reduction level and O2 uptake via the alternative oxidase. Significant engagement of the alternative pathway was not apparent until Q-pool reduction level reached 35-40% but increased disproportionately on further reduction. Similar results were obtained with electron donation from either Complex 1 or Complex 2. Close agreement was obtained over a range of experimental conditions between the estimated contribution of the alternative pathway to total respiratory flux, as measured with salicylhydroxamic acid, and that predicted from the redox poise of the Q pool. These results are discussed in terms of existing models of the regulation of respiratory flux via the alternative pathway. PMID- 2757391 TI - A prothrombinase complex of mouse peritoneal macrophages. AB - Addition of prothrombin to mouse peritoneal macrophages in vitro resulted in the formation of a thrombin-like enzyme, as demonstrated by use of the luminogenic peptide substrate S-2621. The prothrombinase activity was sedimented by high speed centrifugation following homogenization of the cells and was abolished by treatment of the cells with the nonionic detergent Triton X-100 at 0.02% concentration. Moreover, the activity was drastically reduced by maintaining cultures in the presence of warfarin and, presumably due to competitive substrate inhibition, by adding S-2222, a chromogenic peptide substrate for Factor Xa. These findings suggest that prothrombin cleavage is catalyzed by Factor Xa at the macrophage surface. The generated thrombin was inhibited by antithrombin, and this reaction was accelerated by heparin with high affinity for antithrombin but not by the corresponding oligosaccharides composed of 8-14 monosaccharide units. Such oligosaccharides which are capable of accelerating the inactivation of Factor Xa by antithrombin, inhibited thrombin formation from prothrombin in the macrophage cultures, presumably by promoting inactivation by antithrombin of Factor Xa in a prothrombinase complex. Activation of the macrophage coagulation system, as proposed to occur in certain inflammatory conditions, thus may be modulated at various levels by heparin, or heparin oligosaccharides, released from mast cells. PMID- 2757392 TI - The structures of the asparagine-linked sugar chains of human apolipoprotein B 100. AB - The asparagine-linked sugar chains of human apolipoprotein B-100 were liberated from the polypeptide portion by hydrazinolysis followed by N-acetylation and NaB3H4 reduction. Their structures were elucidated by sequential exoglycosidase digestion in combination with methylation analysis after fractionation by paper electrophoresis and gel permeation chromatography. One neutral and two acidic fractions were obtained by paper electrophoresis in a molar ratio of 7:8:5. The neutral fraction contained high-mannose type oligosaccharides consisting of Man5GlcNAc2 to Man9GlcNAc2. The acidic fractions contained monosialylated and disialylated biantennary complex type oligosaccharides. As minor components in the monosialylated fraction, biantennary complex-type oligosaccharides which were absent one terminal galactose residue, monoantennary complex type, and hybrid type oligosaccharides were detected. Apolipoprotein B-100 was calculated to contain 5-6 mol of high-mannose type and 8-10 mol of complex type oligosaccharides per mole protein. PMID- 2757393 TI - Alterations in energy status by menadione metabolism in hepatocytes isolated from fasted and fed rats. AB - The biochemical mechanism of cytotoxicity, induced by the quinoid compound 2 methyl 1,4-naphthoquinone (menadione), was investigated in hepatocytes freshly isolated from fasted and fed rats. Hepatocytes from fasted rats were significantly more vulnerable to the toxicity of menadione than hepatocytes from fed rats. Menadione (150 microM) induced a 50% loss of viability of cells (LT50) from fasted rats after 55 min of incubation, whereas a LT50 of 80 min was observed after exposure of hepatocytes from fed rats to menadione. Glutathione and NADPH levels were rapidly depleted by menadione metabolism. This depletion was sustained during the incubation period. No significant differences were found in the time course and extent of the menadione-induced glutathione and NADPH depletion in hepatocytes of both nutritional states. Menadione also affected the energy status of the hepatocytes. The ATP content of cells from fasted rats decreased to 50% (AT50) within 18 min of exposure to menadione, whereas a 50% loss of ATP content of hepatocytes from fed rats was reached at 65 min. In contrast to depletion of glutathione and NADPH, the time course and extent of menadione-induced ATP depletion correlated well with the time of onset and rate of cell killing. Our results suggest that menadione metabolism may interfere with both mitochondrial and glycolytic ATP production. Depletion of ATP might be a critical step in menadione-induced cytotoxicity. PMID- 2757395 TI - The oxidation of methylglyoxal by mammalian pyruvate dehydrogenase. AB - Mammalian pyruvate dehydrogenase actively catalyzed the oxidation of methylglyoxal to acetyl-CoA. The reaction was fully enzymatic with an estimated Km of 1.89 mM. On the other hand, methylglyoxal was a competitive inhibitor of the enzyme for pyruvate, the Ki being in the 1 mM range. The reaction was inhibited in the presence of HgCl2. The reaction products were quantitatively identified as acetyl-CoA and formic acid. A mechanism for the reaction is proposed. PMID- 2757394 TI - Characterization and quantitation of fatty acids covalently bound to erythrocyte membrane proteins: anion transporter contains 1 mol of fatty acid thiol ester. AB - Human erythrocyte membranes which had been thoroughly extracted with organic solvents contained 20 nmol of fatty acids/mg dry wt. The major fatty acids were palmitic and stearic with their monoethenoic derivatives as minor constituents. No other fatty acids were detected. When solvent-extracted membranes were digested with Pronase about 90% of the original content of fatty acids was retained in the insoluble residue. Fatty acids were linked to membrane proteins through alkali-labile bonds of which 30% were of a thiol ester and the remainder of an O-ester type. This conclusion is based on differential liberation of fatty acids by hydroxylamine at pH 7.0 and pH 11.0. Two extracts of membranes enriched in peripheral proteins (bands 1, 2, 5 and 2.1, 4.1, 4.2, 6) were prepared and extracted with organic solvents but each contained about six times less fatty acids than the parent solvent-extracted membranes. Glycophorin A contains little if any covalently bound fatty acids. Anion transporter (band 3) contains about 1 mol of thiol ester of fatty acid. This accounts for about half of the thiol ester linked fatty acids in the parent solvent-extracted membranes. Most of the O-ester linked fatty acids are linked to an undisclosed membrane protein. PMID- 2757396 TI - Amino acid sequence of an inducible cysteine proteinase inhibitor (cystatin) from submandibular glands of isoproterenol-treated rats. AB - We have previously reported the purification of an inducible cysteine proteinase inhibitor from submandibular glands of isoproterenol-treated rats by sequential gel filtration and ion-exchange chromatography [G. S. Bedi (1989) Arch. Biochem. Biophys. 270, 335-343]. This inhibitor is not detected in normal rat tissues but is induced in submandibular glands following beta-adrenergic stimulation of rats. In this study the complete amino acid sequence and the position of disulfide bridges of the purified protein were determined by automated Edman degradation of the protein and its tryptic, chymotryptic, and Staphylococcus aureus V8 protease peptides and were as follows: (sequence; see text) Computer analysis revealed the presence of 40-50% sequence identity between inducible cysteine proteinase inhibitor and cystatins from human saliva, human cystatin C, bovine cystatins, and chicken cystatins, all members of Family 2 cystatins. The inhibitor has little sequence similarity with rat liver and epidermal cysteine proteinase inhibitors, which belong to Family 1 cystatins. PMID- 2757397 TI - A rabbit liver constitutive form of cytochrome P450 responsible for amphetamine deamination. AB - A cytochrome P450 isozyme responsible for amphetamine deamination was purified from hepatic microsomes of untreated rabbits. The purification procedures consisted of a set of column chromatographies with omega-aminooctyl-Sepharose 4B, DEAE-cellulose, CM-Sephadex C-50, and hydroxyapatite. The deamination activity was determined by measuring the formation of phenylacetone after derivatization to the p-nitrobenzyloxim by HPLC. This isozyme, which was designated P450APD, showed a monomeric molecular weight of 51,000 in sodium dodecyl sulfate polyacrylamide gel electrophoresis and exhibited an absorption maximum of reduced CO complex at 451 nm. On the basis of the specificity toward testosterone metabolism and the N-terminal amino acid sequence, P450APD was attributed to a member of P450 class IIC subfamily, which is identical or closely related to LM3b (D. R. Koop and M. J. Coon (1979) Biochem, Biophys, Res. Commun. 91, 1075-1081), form 3b (E. F. Johnson (1980) J. Biol. Chem. 255, 304-309), and other similar preparations. Antibody against the P450APD inhibited about 80% of the amphetamine deamination activity in rabbit hepatic microsomes as well as in the reconstitution system of this P450. The present results support that P450APD is the major P450 isozyme responsible for amphetamine deamination in rabbit liver. PMID- 2757398 TI - Heart tissue contains small and large aggregates of ferritin subunits. AB - Ferritin purified from horse heart and applied to nondenaturing polyacrylamide gel electrophoresis migrated as a single band that stained for both iron and protein. This ferritin contained almost equal amounts of fast- and slow sedimenting components of 58 S and 3-7 S, which could be separated on sucrose density gradients. Iron removal reduced the sedimentation coefficient of the fast sedimenting ferritin to 18 S, and sedimentation equilibrium gave a molecular weight 650,000, with some preparations containing ferritin of 500,000 molecular weight as well. Sedimentation rates of the 3 S and 7 S ferritins were not affected by iron removal, and sedimentation equilibrium data were consistent with Mr's 40,000 and 180,000, respectively. Preparations of ferritin extracted from horse spleen contained only 67 S (holo) or 16 S (apo) ferritin and no slow sedimenting species. When examined by sodium dodecyl sulfate-polyacrylamide gel electrophoresis, all of the ferritins contained the usual H and L subunits (23 and 20 kDa, respectively), but the slow-sedimenting (3 S and 7 S) heart apoferritins also contained appreciable quantities (ca 25%) of three larger subunits of 42, 55, and 65 kDa. All the subunits reacted positively in Western blots to polyclonal antibodies made against specially purified large heart or spleen ferritins containing only 20- and 23-kDa subunits. Similar results were obtained for ferritins from rat heart. The results indicate that mammalian heart tissue is peculiar not just in having an abnormally large iron-rich ferritin but also in having iron-poor ferritins of much lower molecular weight, partly composed of larger subunits. PMID- 2757399 TI - Biosynthesis of gallotannins: beta-glucogallin-dependent formation of 1,2,3,4,6 pentagalloylglucose by enzymatic galloylation of 1,2,3,6-tetragalloylglucose. AB - An acyltransferase was detected in young leaves of pedunculate oak (Quercus robur) that catalyzed the formation of 1,2,3,4,6-penta-O-galloyl-beta-D-glucose, the common precursor of gallotannins and the related ellagitannins. This enzyme depended on beta-glucogallin (1-O-galloyl-beta-D-glucose) as acyl donor; 1,2,3,6 tetra-O-galloyl-beta-D-glucose was specifically required as acceptor molecule, whereas no reaction occurred with the 1,2,4,6-isomer of this substrate. The partially purified enzyme (Mr 260,000) was stable between pH 5.0 and 6.5; highest activities were observed at pH 6.3 and 40 degrees C. Km values of 2.3 and 1.0 mM, respectively, were determined for the substrates beta-glucogallin and tetragalloylglucose. In accordance with stoichiometric studies, the systematic name "beta-glucogallin: 1,2,3,6-tetra-O-galloylglucose 4-O-galloyltransferase" is proposed for this new enzyme. PMID- 2757400 TI - Ferritin mRNA is found on bound as well as on free polyribosomes in rat heart. AB - Free and endoplasmic reticulum-bound polyribosomes from rat heart were examined for their ferritin mRNA content. A procedure for separation and purification of the two ribosome populations that produced good yields of homogeneous mono- and polyribosomes with no contaminating ultrastructures and gave distinctive sedimentation profiles in 15-50% sucrose gradients was developed. 14C-labeled free and bound polyribosomes added to heart preparations indicated that only 3% of free and 5.5% of bound polyribosomes cross-contaminated the bound and free fractions, respectively. RNA from both polyribosome populations hybridized with [32P]cDNA for rat ferritin. The extent of hybridization with mRNA from endoplasmic reticulum (ER)-derived polyribosomes was much greater than what could be accounted for by cross-contamination with free polyribosomes. This indicates that heart ferritin is synthesized not only on free polyribosomes for internal use in iron storage but also on ER-bound polyribosomes, where it may be destined for secretion into the plasma. PMID- 2757401 TI - Changes in antizyme-ornithine decarboxylase complexes in tissues of hormone treated rats. AB - The presence of antizyme-ornithine decarboxylase complex in thymus and kidney of rats was demonstrated using the method of Y Murakami et al. [(1985) Biochem. J. 225, 689-697]. A very small amount of complex was found in kidney of control rats, accounting for only 1-3% of total enzyme in the tissue, while in thymus, approximately one-third of the total ornithine decarboxylase in thymus occurred as an antizyme-enzyme complex. After treatment with dexamethasone, both free ornithine decarboxylase and antizyme-ornithine decarboxylase decreased in thymus, the free enzyme activity decreasing more rapidly. In kidney, the concentration of the antizyme-ornithine decarboxylase complex increased after dexamethasone treatment, but only after the induction of free enzyme activity had reached its peak and begun to decrease. The pattern of the changes in amount of antizyme ornithine decarboxylase complex after prolactin treatment differed from those observed in the dexamethasone-treated animals. In both kidney and thymus, the concentration of antizyme-ornithine decarboxylase complex increased concurrently with the induction of free enzyme activity. Both free and complexed ornithine decarboxylase had increased at 2.5 h after prolactin treatment and continued to increase to maximum specific activities at similar rates. In thymus, the amount of ornithine decarboxylase present as a complex reached 70% of the total in the tissue. In both thymus and kidney, the concentration of antizyme-ornithine decarboxylase complex decreased more slowly than did free enzyme activity. Free antizyme was observed only in thymus of dexamethasone-treated animals. The amount of measurable inhibitor was decreased if cycloheximide was given with dexamethasone. PMID- 2757402 TI - The development of expertise in dermatology. AB - To examine the development of expertise in dermatology, accuracy of diagnosis and response times of subjects at five levels of expertise were assessed. A total of 100 slides, 2 typical and 3 atypical slides from each of 20 common skin disorders, were presented to six subjects at each of the following levels: second year preclinical medical students, final year medical students, residents in family medicine, general practitioners, and dermatologists. Accuracy of diagnosis rose from 21% for medical students to 87% for dermatologists. Correct diagnosis was associated with a decrease in response time with expertise, whereas errors were associated with a dramatic increase in response time, and was slower than correct response times at all levels, suggesting that errors do not result predominantly from carelessness or speed. Typical slides accounted for a constant proportion of diagnostic errors at all higher levels of expertise, and experts continued to make a significant proportion of errors on slides shown to be relatively easy for residents. The results are shown to be at variance with any model that equates expertise with the mastery of complex rules, but they are consistent with models of expertise that propose that expertise is equated with a rapid "pattern-recognition" process, and errors result from unintended confusion with previous similar examples. PMID- 2757403 TI - Acquired perforating dermatosis. Evidence for combined transepidermal elimination of both collagen and elastic fibers. AB - Patients with renal disease or diabetes mellitus often have an acquired perforating disease of the skin develop that is characterized by hyperkeratotic papules with transepidermal elimination of degenerated material, including collagen or elastic fibers. There is disagreement regarding the most appropriate name for this disease. The pathologic process has been identified by various authors as reactive perforating collagenosis, elastosis perforans serpiginosa, perforating folliculitis, or Kyrle's disease. We have seen four patients with renal disease and/or diabetes whose skin biopsy specimens demonstrated combined transepidermal elimination of both collagen and elastic fibers. This finding is not characteristically seen in any of the previously defined perforating diseases. Since the histologic findings vary greatly in different lesions from different patients with renal disease, we recommend referring to this process as "acquired perforating dermatosis." It is best not to create a new category of perforating disease or to say that a given patient has one of the other four diseases based on random sampling of only a few lesions. PMID- 2757404 TI - Immune response to gamma-irradiated injectable human amnion and human skin collagens in the rat. AB - The immune response in rats to gamma-irradiated human amnion and human skin collagen was characterized through histologic and immunologic methods. Pepsin extracted human amnion collagen and skin collagen were purified and reconstituted. Implants of amnion collagen demonstrated greater persistence than skin collagen. For amnion collagen implants, no significant inflammatory response was found. Fibroblast and adipocyte ingrowth and neovascularization were present. Conversely, obvious inflammatory infiltration was evident in the skin collagen implants. Enzyme-linked immunosorbent assay results showed that anti-amnion collagen antibody levels were significantly lower than anti-skin collagen antibody levels against their respective implant materials. The ratios of type I to type III collagen are 56:44 and 95:5 for amnion collagen and skin collagen, respectively. These findings suggest that in this heterologous type system, type III collagen-rich amnion collagen preparations appear superior to skin collagen for soft-tissue augmentation. PMID- 2757405 TI - The microanatomical basis of facial frown lines. AB - We studied facial frown lines on cadaver skin. These wrinkles persisting after death were kept unmodified during the collecting procedure; some included the underlying bone. Their microanatomical basis lies in the hypodermis where trabeculae of the retinacula cutis are broader and much shorter underneath the wrinkle than in the surrounding skin. These trabeculae contain striated muscle cells. The hypertrophy of the extracellular matrix of the hypodermal septae is probably related to repetitive mechanical stimuli generated by the muscle cells. PMID- 2757406 TI - Merkel cell carcinoma. A successful treatment with tumor necrosis factor. AB - A Merkel cell carcinoma of the mandibular area in a 78-year-old woman was treated successfully by direct intratumoral administration of recombinant human tumor necrosis factor. The patient received 2.5 x 10(5) U/d of recombinant human tumor necrosis factor every other day. A total of six injections (total dose, 1.5 x 10(6) U, 0.52 mg of protein) were administered over a period of 12 days. Soon after the therapy ended, the lesion softened and decreased in size. After 1 month, only erythema was visible. The lesion had completely disappeared clinically and histologically 5 months after the local injection of recombinant human tumor necrosis factor. Neither recurrence nor metastasis has been observed for at least 12 months following the treatment. Recombinant human tumor necrosis factor is suggested to be effective for the treatment of Merkel cell carcinoma. PMID- 2757407 TI - Merkel cell carcinoma. AB - Merkel cell carcinoma is an unusual primary cutaneous tumor with an aggressive biologic nature. Following surgical treatment, 40% of patients have local recurrences develop, 55% have regional lymph node metastases develop, and 49% have distant metastases develop. We have treated four patients with Merkel cell carcinoma; only one of the four patients was alive and well after 2 years. Two patients died of metastatic disease, one at 11 months following initial treatment and one at 39 months. The fourth patient had a rapid recurrence following initial treatment and is currently in remission following chemotherapy for regional metastases. Recent reports indicate that chemotherapy may be helpful in treating patients with recurrent or metastatic Merkel cell carcinoma. PMID- 2757408 TI - Acute febrile neutrophilic dermatosis (Sweet's syndrome). Association with rheumatoid vasculitis. AB - A 58-year-old woman suffering from rheumatoid arthritis complicated by a leukocytoclastic vasculitis had an acute febrile neutrophilic dermatosis (Sweet's syndrome) develop immediately after worsening of her arthritic condition. This association supports the hypothesis that immunologic abnormality is involved in the pathogenesis of Sweet's syndrome and raises the question of a possible common pathogenic pathway between neutrophilic dermatoses and leukocytoclastic vasculitis. PMID- 2757409 TI - Rheumatoid neutrophilic dermatitis. AB - We recently examined a patient with severe rheumatoid arthritis who presented clinically with fixed urticaria-like plaques. Histologic examination revealed a dense neutrophilic dermal infiltrate without associated vasculitis. On clinical and histologic grounds, this case differs from other noninfectious neutrophilic inflammatory disorders. We present a case of rheumatoid neutrophilic dermatitis and review the salient features of this unique disorder. PMID- 2757410 TI - Factitial leg ulcers associated with an unusual sleep disorder. AB - A 19-year-old woman presented with a 14-month history of multiple, factitially induced, full-thickness leg ulcers. Nocturnal polysomnography with video monitoring revealed a short sleep latency and frequent sleep stage changes. Rapid eye movement sleep was absent. All stages of non-rapid eye movement sleep were associated with leg rubbing. After treatment that included avoidance of daytime naps and administration of chlorpromazine at bedtime, affect, daytime behavior, nocturnal sleep, and the ulcers improved markedly. To our knowledge, there are no reports of factitial dermatosis associated with disordered sleep. Our findings suggest that abnormal sleep may play a role in initiating or perpetuating factitial dermatoses. This case illustrates that polysomnography and video monitoring may be indicated in the evaluation of patients with factitial dermatoses. PMID- 2757411 TI - Progress in the perforating dermatoses. PMID- 2757412 TI - Plum-colored nodules in a patient with chronic myelogenous leukemia. Leukemia cutis in blast phase of CML. PMID- 2757413 TI - Springtime papules, plaques, and cheilitis. Polymorphous light eruption (PMLE) PMID- 2757414 TI - The ridgeback anomaly. PMID- 2757415 TI - Systemic sclerosis associated with multiple sclerosis. PMID- 2757416 TI - Congenital Horner's syndrome. PMID- 2757417 TI - Endothelium-derived relaxing factor and minoxidil: active mechanisms in hair growth. PMID- 2757418 TI - Ulcerogenic tumor syndrome of the pancreas associated with a nongastrin acid secretagogue. AB - Among 30 patients with islet cell neoplasms or hyperplasia who exhibited marked gastric acid hypersecretion and peptic ulceration and/or diarrhea, fasting plasma gastrin concentrations were less than 150 pg/ml in 11 patients, whereas the remaining 19 patients had hypergastrinemia. Plasma extracts from seven of these 11 patients were assayed for acid secretagogue activity in rats. All seven plasma extracts had secretagogue activity that was not found in the plasma extracts of ten patients with ordinary duodenal ulcer disease. Each of the tumor or pancreatic tissue extracts obtained from nine patients exhibited secretagogue activity in rats even though tissue gastrin content was 101.9 pmol (213.8 ng).g-1 or less. The secretagogue activity of the tumor extracts was confirmed in conscious gastric fistula dogs. The tumors' secretagogue activity, in contrast to gastrin, was destroyed by trypsin. It was eluted between porcine motilin and human gastrin I from a Sephadex G-50 (Pharmacia LKB Biotechnology, Inc., Piscataway, NJ) superfine column and was not retained by CM-cellulose, at pH 8.5. Its retention time during reverse phase HPLC on a C18 column also differed from those of G17 and G34. Thus, this secretagogue activity appeared mediated by a small, acidic peptide with a molecular size of about 2000 to 3000 daltons. The present study indicates that plasma and tumor extracts of these 11 patients contain a gastric acid secretagogue activity mediated by a nongastrin peptide. We suggest that what may be a distinct clinical entity associated with endocrine neoplasms of the pancreas should be considered in the face of excessive acid hypersecretion without fasting hypergastrinemia. PMID- 2757419 TI - Gastric cancer after peptic ulcer surgery. A historic prospective cohort investigation. AB - In a historical prospective cohort investigation of 4131 patients undergoing peptic ulcer surgery in 53 hospitals in the western part of Denmark from 1955 through 1960, the risk of subsequent gastric cancer development was studied. The patients were followed with regard to gastric cancer development until their death or the end of the year 1982 and the incidence of cancer in this cohort was compared to the incidence in the total population in the same region during the same period. A total of 46 gastric cancers were diagnosed versus 47 expected. Up to 15 years after operation the cancer risk was lower than expected. After 15 years the risk was higher than expected with a 2.1-fold higher incidence after 25 years for the total patient population. The highest risk was observed in male subjects undergoing a Billroth II subtotal gastrectomy with a 3.2 times increase in risk after 25 years. There was no difference between gastric and duodenal ulcer patients; and patients undergoing simple suture for a perforated ulcer showed no increase in cancer incidence. Patients with long-lasting symptoms had the same incidence as patients with briefer symptoms. These observations indicate that the operation per se and not the ulcer disease may be precancerous. PMID- 2757420 TI - Influence of site of origin and mucin production on survival in ampullary carcinoma. AB - We studied a series of 26 cases of carcinoma of the ampulla of Vater. There were 24 adenocarcinomas and two neuroendocrine tumors. Histologically the carcinomas could be divided into tumors arising from periampullary duodenal mucosa and those arising within the ampulla. True ampullary tumors had a significantly better 5 year survival rate (p = 0.028) than periampullary tumors. The type of mucin produced was investigated histochemically. Patients with true ampullary tumors producing predominantly sialomucins had a better prognosis than those with tumors secreting sulphated mucins (p = 0.045), but the numbers were small. We hypothesize that the most favorable type of ampullary carcinoma arises from biliary-type epithelium within the ampulla. PMID- 2757422 TI - The management of patients with suspected early postoperative small bowel obstruction. AB - A 10-year review of 101 patients sustaining an early postoperative small bowel obstruction within 30 days of celiotomy was carried out. Signs, symptoms, lab tests, and x-rays did not indicate which patients required operation. Twenty three patients were operated on for either failure to resolve their obstruction or because it was feared that ischemic bowel was present. In none of these patients, nor the 78 patients who resolved without reoperation, did dead bowel occur. Early postoperative small bowel obstruction was most often due to adhesions and inflammatory processes. Seven patients died (6.9%), three in the operated and four in the nonoperated group. Because ischemic bowel is very unlikely in patients with early postoperative small bowel obstruction, we advise 10 to 14 days of nasogastric suction initially; after this, improvement is unlikely without reoperation. PMID- 2757421 TI - Effect of thermal injury in the rat on transfer of IgA protein into bile. AB - Severe thermal injury is associated with bacterial sepsis; the intestine is considered a likely source of invasive organisms. Because IgA antibody in bile accounts for much of the specific immune defense of the upper intestinal tract in the rat, the effect of thermal injury on the quantity of IgA protein in bile was examined. Sprague-Dawley rats received a 20% to 30% body surface area burn under anesthesia. Eighteen hours later the common bile duct was cannulated and bile was collected for three hours. Total IgA protein in bile decreased 90% after thermal injury. The bile volume, the concentration of bile protein, and free secretory component did not change significantly. Although blood flow to the liver 18 hours after thermal injury was not changed, there was a significant reduction in total IgA concentration in the circulation; both monomeric (m-IgA) and polymeric IgA (p IgA) were decreased. This finding may explain, in part, the reduced concentration of IgA protein in bile. Although not examined in this study, decreased local hepatic synthesis and/or transport of p-IgA across the hepatocyte may also contribute to the reduced IgA levels in bile. PMID- 2757423 TI - Emergency subtotal colectomy. A new trend for treatment of obstructing carcinoma of the left colon. AB - During a 5-year period, 22 patients with obstructing carcinoma of the left colon were operated on in our department. All patients underwent emergency subtotal colectomy with primary ileocolonic or ileorectal anastomosis. The quality of life for patients undergoing subtotal colectomy is excellent. All patients enjoy an almost normal diet and those with an ileorectal anastomosis stabilize on two to three bowel movements per day. During a followup period of 65 months, four patients died from spread of their primary disease while two other patients died of unrelated causes. Sixteen patients are alive and free of disease. We consider subtotal colectomy the procedure of choice for patients with obstructing carcinoma of the left colon. PMID- 2757424 TI - Abdominal CT in children with neurologic impairment following blunt trauma. Abdominal CT in comatose children. AB - This paper examines the role of neurologic impairment as an indication for CT examination of the abdomen in children after blunt trauma. The clinical information and abdominal CT examinations of 482 consecutive children were reviewed prospectively for indications for abdominal CT and presence and severity of abdominal and chest injury. Children were divided into two groups determined by Glasgow Coma Scale (GCS): GCS less than 8, and greater than or equal to 8. The prevalence and severity of thoracoabdominal injury were higher in the neurologically impaired group. These children had a higher frequency of abdominal injury (GCS less than 8, 25 of 90 patients (27.8%) vs. GCS greater than or equal to 8, 70 of 392 patients (17.8%); p = 0.047 by Chi square test), injury to multiple abdominal organs (16.7% vs. 4.8%; p = 0.0002), chest injury (32.2% vs. 0.09%; p = 0.0001), and combined chest and abdominal injury (18.9% vs. 4.6%; p = 0.0001). In addition, the mortality rate in children with a GCS less than 8 was significantly higher (GCS less than 8, 24% vs. GCS greater than or equal to 8, 0.26%; p = 0.0001). Eleven children had a GCS less than 8 as the only indication for abdominal CT examination. All 11 children had a normal CT of the abdomen. Every child with abdominal injury on CT scan had specific abdominal signs suggestive of underlying injury. Three neurologically impaired children required abdominal surgery (3.3%) vs. 14 of 369 (3.8%) children with a GCS greater than or equal to 8; p = NS). We conclude that children with severe neurologic impairment are at higher risk for intraabdominal injury than those without coma, but that neurologic impairment without abdominal signs is a low-yield indication for abdominal CT examination. Abdominal CT scan should be reserved for children in whom there is a high clinical index of suspicion of significant abdominal trauma based on physical examination and the mechanism of injury. PMID- 2757425 TI - Detection of clustered gastrointestinal contractions in partial intestinal obstruction by surface vibration analysis. AB - Gastrointestinal contraction "clusters" with alternating quiescence occur in partial intestinal obstruction and are conventionally detected by intraluminal manometry. Surface Vibration Analysis (SVA), which is a noninvasive test, was evaluated in this study in experimental and clinical situations. In the experimental situation, former SVA was assessed against simultaneous manometry in two volunteers, in whom partial obstruction had been induced by intrajejunal balloon distension. Manometry showed typical contraction "clusters" with alternating quiescence, each of two to four minutes duration, in obstructed jejunum proximal to the balloon. The distal jejunum was inhibited. SVA showed a pattern of hyperactivity and quiescence corresponding to proximal jejunal activity. In the clinical situation, SVA recordings taken after a standard meal in nine patients with suspected chronic obstruction adhesive obstruction, (subsequently proven in seven patients and disproved in two), and 36 volunteers were compared. All patients with proved obstruction showed an SVA pattern of alternating hyperactivity and quiescence. This pattern was not observed in volunteers or nonobstructed patients. PMID- 2757426 TI - Nonpalpable breast lesion at biopsy: a detailed analysis of radiographic features. PMID- 2757427 TI - Long-acting analogue of somatostatin--SMS 201-995--is highly effective in the prevention of clinical symptoms related to the dumping syndrome. PMID- 2757428 TI - Increased incidence of cardiac contusion in patients with traumatic thoracic aortic rupture. PMID- 2757429 TI - Superlative results of burn treatment at the Shriners Burn Institute, Boston, Massachusetts from 1968 to 1986 in terms of mortality reduction. PMID- 2757430 TI - Sphincter-saving procedures for distal carcinoma of the rectum. PMID- 2757431 TI - About viability in valve grafts. PMID- 2757432 TI - Free radicals: the reperfusion Ninja. PMID- 2757433 TI - Viable and nonviable aortic homografts in the subcoronary position: a comparative study. AB - One hundred fifty-five freeze-dried, 63 frozen, and 337 Hanks'-antibiotic solution preserved or nutrient-antibiotic solution preserved homografts used for isolated aortic valve replacement have been followed for 1 to 20 years (mean, 5.3 years), a total of 2,931 patient-years of follow-up information. Overall survival, valve-related death, primary tissue failure, failure due to surgical technical error, infective endocarditis, and overall event-free survival have been assessed and compared. Overall survival 20 years after operation was 51.6% +/- 8.1% with a low incidence of sudden death. The method and length of preservation did not have any effect on the long-term performance or the mode of failure of the homografts. The rate of primary tissue failure was apparently higher with valves preserved in a solution containing calf serum, but the difference was not significant. It is concluded that long-term patient survival and quality of life after aortic valve replacement with a homograft are excellent. The current study, however, could not verify the existence of a significant difference between the three assessed methods of homograft preservation. Furthermore, it could not prove the importance of cellular viability or the existence of clinically significant immunological factors other than the calf serum content of the nutrient medium. PMID- 2757434 TI - Enhanced myocardial protection with adenosine. AB - This study was undertaken to investigate whether adenosine administered during cardioplegic arrest could enhance myocardial protection and improve recovery of function after ischemia. Isolated perfused rabbit hearts were subjected to 120 minutes of hypothermic (32 degrees C) multidose cardioplegia-induced ischemia. Control hearts (n = 23) received modified St. Thomas's cardioplegia, and the remaining hearts received cardioplegia with either 100 microM (n = 11), 200 microM (n = 11), or 400 microM (n = 11) adenosine. After ischemia and 45 minutes of reperfusion, left ventricular contractility was superior in all groups of adenosine-treated hearts compared with control hearts. Furthermore, there was a significant incremental increase in functional recovery with increasing dose of adenosine. Postischemic diastolic stiffness was significantly better in all adenosine groups compared with controls. No differences were noted in coronary flow or myocardial water content between adenosinetreated and control hearts. These data demonstrate that adenosine administered in these concentrations provides myocardial protection and improved recovery of both systolic and diastolic function after global ischemia, presumably metabolically by reducing depletion of adenosine triphosphate or enhancing repletion of adenosine triphosphate and enabling improved postischemic recovery. PMID- 2757435 TI - Correlates of survival in patients with postinfarction ventricular septal defect. AB - Prognostic indicators of survival in 42 consecutive patients (21 men and 21 women) with postinfarction ventricular septal defect were reviewed. Infarct location was anterior in 57%, inferior in 33%, and combined in 10%. The hospital mortality among 9 patients not receiving surgical therapy was 100%. Of the 33 surgically treated patients, 19 (58%) survived. Time from diagnosis to operation, ventricular function, and presence or absence of shock were analyzed in a logistic regression model to determine which factors carried independent prognostic value. Shock was independently predictive of operative mortality (p less than 0.01). Of additional variables examined, nonsurvivors were characterized by a shorter time from postinfarction ventricular septal defect to operation, a relatively higher incidence of inferior infarction, moderate right ventricular dysfunction and mild left ventricular dysfunction, and a lower right ventricular systolic pressure. Results of postmortem examination were available for 15 nonsurvivors. Quantitative analysis of percent ventricle infarcted revealed that in patients with inferior infarctions, a mean of 31% of the right ventricle was infarcted compared with 10% in patients with anterior infarction (p = 0.059). Kaplan-Meier survival estimates revealed 1-year survival of 70%, 5-year survival of 55%, and 10-year survival of 20%. Seventy percent of survivors were in New York Heart Association class I or II. These data show that, irrespective of ventricular function or timing of operation, the development of shock is the most important predictor of survival in postinfarction ventricular septal defect. The higher mortality in patients with inferior infarction may be associated with a greater degree of right ventricular infarction and consequent dysfunction. Finally, long-term survival and excellent functional recovery can be achieved in patients undergoing operation. PMID- 2757436 TI - Ten years' experience with the St. Jude Medical valve prosthesis. AB - Records of 1,298 consecutive patients who had received the St. Jude Medical prosthesis were reviewed (713 male and 585 female patients; mean age, 61.79 +/- 13.4 years). Early mortality was 5.7% (74 patients). Ninety-three percent complete follow-up was accomplished for the 1,224 patients who left the hospital (4,306.50 patient-years). One hundred ninety-two of these patients died, a late mortality of 16.9%. Sixty-four patients experienced thromboembolic episodes (17 major and 35 permanent). Twenty-four patients had anticoagulant-related bleeding, 4 had valve thrombosis, 7 had prosthetic valve endocarditis, 9 had paravalvular leak, and 10 underwent reoperation. There was no structural valve failure in this series. Twenty-two of the 118 patients who had valve-related complications died; another 15 patients died of sudden and unknown causes. Therefore, the total number of valve-related deaths was 37. Of those patients who survived, New York Heart Association functional class improved significantly (98% in classes II and III preoperatively and 96% in classes I and II postoperatively). Linearized rates for thromboembolism, valve thrombosis, and anticoagulant-related bleeding were 1.49% +/- 0.19%, 0.09% +/- 0.05%, and 0.56% +/- 0.11%/100 patient-years, respectively. The actuarial estimate of incidence free from all complications, operative death, and valve-related death was 66.9% +/- 8.2% at the end of 9 years. In spite of old age and advanced heart disease, the patients who received the St. Jude Medical prosthesis had very good results over a 10-year period. PMID- 2757437 TI - Transsternal radical thymectomy for myasthenia gravis: a 15-year review. AB - Thymectomy is an accepted therapeutic modality for patients with myasthenia gravis. The selection of patients for operation and the surgical approach are controversial. We reviewed 52 patients (aged 18 months to 82 years; mean age, 34 years) treated with transsternal radical thymectomy between 1972 and 1987. Patients were symptomatically staged according to the modified Osserman classification. There was one hospital death and postoperative follow-up was obtained on 51 patients. Improvement after thymectomy was observed in 3 of 11 patients (27%) in Osserman stage I, 16 of 25 patients (64%) in Osserman stage IIA, and 13 of 15 patients (86%) in combined Osserman stages IIB, III, and IV. Preoperative Osserman stage, patient sex, and thymic histology correlated with postoperative clinical response. Transsternal radical thymectomy is effective therapy for myasthenia gravis. Sustained improvement is obtained in patients with moderate and advanced disease. The majority of patients with ocular disease do not benefit from operation. PMID- 2757438 TI - Intralobar sequestration. A missed diagnosis. AB - Intralobar pulmonary sequestration is an uncommon but distinct clinical entity that may be the unrecognized cause of recurrent pulmonary infections. Between 1967 and 1987, 10 patients, ranging in age from 5 to 39 years, were found to have an intralobar sequestration. Nine patients (90%) had a history of recurrent pulmonary infections, chronic cough, and intermittent fevers. One patient was asymptomatic. Many patients had been treated with antibiotics on numerous occasions. The delay in diagnosis varied between 3 months and 7 years (mean delay, 1.5 years). The chest roentgenogram was abnormal in all patients. The intralobar sequestration was present in the left lower lobe in 7 patients and the right lower lobe in 3 patients. Bronchography was abnormal in 4 patients in whom it was done. Bronchoscopy was performed in 7 patients, but it was only helpful in excluding other diagnoses. Preoperative thoracic arteriography in 9 patients visualized the systemic arterial supply from the thoracic or abdominal aorta to the intralobar sequestration and helped prevent any catastrophic surgical bleeding. A lobectomy was performed in 9 patients and a segmentectomy in 1 patient without morbidity or mortality. In patients with recurrent infections in the same lower lobe, a high index of suspicion for an intralobar sequestration should prompt early diagnostic arteriography and, if confirmed, early operative intervention. PMID- 2757439 TI - Postoperative preservation of pulmonary function in patients with chronic empyema thoracis: a one-stage operation. AB - Twenty-two patients with chronic empyema thoracis underwent decortication. In 11 of them, simple decortication achieved sufficient reexpansion of the lung. In the other 11 patients, our new method was indicated because the pleural space was not closed completely by simple decortication. In our procedure, the parietal wall is collapsed, without rib resection, to contact the surface of the decorticated lung. All 11 patients had a one-stage cure. Two of these 11 patients had bronchopleural fistula. The preoperative and postoperative percentage of vital capacity, percentage of forced expiratory volume in 1 second, arterial oxygen tension, alveolar-arterial oxygen pressure difference, and xenon 133 radiospirometry revealed that pulmonary function was well preserved in patients treated by our method as well as in those undergoing simple decortication. The alveolar-arterial oxygen pressure difference during oxygen inhalation improved significantly (p less than 0.05) after operation compared with the preoperative values in both groups. From the pulmonary function studies, we conclude that our method achieves results comparable with those of simple decortication for the treatment of chronic empyema thoracis. Our procedure is indicated in patients for whom it is thought simple decortication will not lead to primary cure of empyema. PMID- 2757440 TI - Effect of surgical blood loss and volume replacement on antibiotic pharmacokinetics. AB - Antibiotic prophylaxis is used widely to prevent postoperative infection associated with cardiac operations. The influence of perioperative blood loss on antibiotic pharmacokinetics has not been well studied. Plasma cefazolin sodium samples from 8 patients undergoing a cardiac operation were collected postoperatively and analyzed. The results suggest that blood loss has a minimal effect on the elimination of cefazolin and that therapeutic concentrations are maintained without altering the dosage regimen. PMID- 2757441 TI - Eighteen to 37 hours' preservation of major organs using a new autoperfusion multiorgan preparation. AB - A new autoperfusion preparation was used to preserve six major organs simultaneously. In 7 Yorkshire white swine, the heart and lungs were separated and removed with the liver, pancreas, duodenum, and both kidneys en bloc while they were self-perfused. Fresh blood, glucose, electrolytes, heparin sodium, methylprednisolone, and a fat emulsion (Soyacal) were infused through the portal vein. No inotropic drugs were necessary. The organs survived for 18 to 37 hours (average survival, 24.6 +/- 2.7 hours [+/- standard error of the mean]). Aortic systolic pressure ranged from 78.5 +/- 5.5 to 98.7 +/- 11.8 mm Hg. Arterial oxygen tension ranged from 206 +/- 23 to 266 +/- 15 mm Hg and arterial carbon dioxide tension, from 20.1 +/- 2.7 to 32.1 +/- 4.9 mm Hg. Blood lactic acid levels decreased from 8.75 +/- 2.06 to 5.50 +/- 2.45 mmol/L at 24 hours. Urine output ranged from 25 to 82 mL/h. Blood urea nitrogen levels decreased from 9.17 +/- 0.59 to 4.67 +/- 1.08 mg/dL. Blood creatinine levels decreased from 1.34 +/- 0.10 to 0.57 +/- 0.22 mg/dL. Serum glutamicoxaloacetic transaminase levels increased from 73.4 +/- 26.3 to 194 +/- 179.5 U/L and serum glutamic-pyruvic transaminase levels, from 44.8 +/- 5.7 to 91 +/- 66.4 U/L. Red blood cell count ranged from 6.94 +/- 0.58 to 13.23 +/- 2.30 x 10(6)/microliters. Lung wet/dry weight ratios changed from 5.79 +/- 0.17 at the beginning to 6.25 +/- 0.16 at 24 hours. The technique for simultaneous multiorgan preservation presented here is simple, effective, and highly reproducible. This study appears to have produced one of the longest average survival times for autoperfusion. PMID- 2757442 TI - Tension pneumothorax during extracorporeal membrane oxygenation. AB - Life-threatening tension pneumothorax in neonates on extracorporeal membrane oxygenation (ECMO) has been associated with an increase in arterial oxygen tension and a decrease in peripheral perfusion, followed by a decrease in ECMO flow with progressive hemodynamic deterioration. To investigate this triad, chest tubes were placed bilaterally in 9 dogs to allow injection of air to produce tension pneumothorax. Six dogs were subsequently placed on standard venoarterial ECMO before the reinduction of tension pneumothorax. Measured values included arterial pulse pressure, inferior vena cava pressure, systemic arterial blood gases, peripheral arterial oxygen saturation, mixed venous oxygen saturation, and left heart cardiac output. Oxygen delivery was calculated from directly measured values. Each of the 6 dogs on ECMO demonstrated the triad of increased arterial oxygen tension (92 +/- 7 to 325 +/- 20 mm Hg; p less than 0.05), decreased peripheral perfusion (as evidenced by a decrease in pulse pressure from 55 +/- 4 to 31 +/- 5 mm Hg; p less than 0.05), and decreased mixed venous oxygen saturation (71% +/- 3% to 22% +/- 2% saturation; p less than 0.05) followed by a lower ECMO flow with progressive hemodynamic deterioration (oxygen delivery decreased from 285 +/- 11 to 111 +/- 12 mL/min; p less than 0.05). Aspiration of the intrathoracic air allowed return to baseline ECMO flow and hemodynamic stability in all dogs. The triad of increased arterial oxygen tension and decreased peripheral perfusion (as evidenced by a lower arterial pulse pressure and lower mixed venous oxygen saturation) followed by decreased ECMO flow with progressive hemodynamic deterioration consistently appears when tension pneumothorax occurs on ECMO. PMID- 2757443 TI - Mitral valve function after cryoablation of the posterior papillary muscle in the dog. AB - Extensive cryoablation of an arrhythmogenic left ventricular posterior papillary muscle associated with ventricular arrhythmias may affect mitral valve function. We studied the long-term effects of extensive cryoablation of the posterior papillary muscle and its ventricular attachment in 10 dogs. The dogs had hemodynamic, electrophysiological, and angiographic testing 1 month after operation. Seven dogs were then killed, and the hearts were examined at that time. Three dogs had repeat assessments 2 and 3 months after operation before they were killed. At 1 month, left ventricular angiography showed normal mitral valve function in all dogs. Pathological examination revealed that the posterior papillary muscle and its left ventricular attachment were replaced by a discrete dense, fibrous scar. The fibrous process involved the mitral valve in 2 dogs. At 3 months, pathological examination showed a marked fibrous scar with chondroid metaplasia and fibrous involvement of the mitral valve chordae and posterior leaflet in all 3 dogs. We conclude that extensive cryoablation of the posterior papillary muscle is not associated with long-term mitral valve dysfunction, and may be the best surgical technique to ablate an arrhythmogenic papillary muscle. PMID- 2757444 TI - Surgical management of aortopulmonary septal defect. AB - Fourteen patients with malseptation of the aortopulmonary trunk underwent operative repair from 1978 to 1988. Age ranged from 1 year to 35 years (mean age, 9.6 years). Five patients had type I, 6 had type II, and 3 had type III lesions. The hemodynamic disturbance in all patients was the consequence of a large left to-right shunt (mean pulmonary/systemic flow ratio, 2.38:1) with increased pulmonary vascular resistance (mean value, 4.47 units/m2). Our initial surgical experience with closure under cardiopulmonary bypass through the transaortic route in 3 patients and the transpulmonary approach in two patients resulted in 3 deaths. In the 9 subsequent patients, division and repair of the defect in the great vessels yielded uniformly good results. During follow-up, which ranged from 3 months to 2 years, all 11 survivors had good clinical improvement and none showed residual defects on restudy. Pulmonary artery pressure and pulmonary vascular resistance decreased in all patients except 1. PMID- 2757445 TI - Nd:YAG laser pleurodesis through thoracoscopy: new curative therapy in spontaneous pneumothorax. AB - From January 1986 to May 1987, 14 patients with spontaneous pneumothorax were treated in our department with a new endoscopic method using neodymium:yttrium aluminum-garnet laser photocoagulation through thoracoscopy. The 10 male and 4 female patients ranged in age from 14 to 59 years (mean age, 29 years). In all patients, the procedure was performed under general anesthesia. The thoracoscope was introduced through a 1- to 1.5-cm incision in the anterior axillary line of the fourth intercostal space. The fiber of the laser was advanced through the operative channel of the thoracoscope. In all patients, the bleb (or blebs) detected in the apex of the upper lobe was successfully coagulated with low-power laser pulses. Then the parietal pleura of the first five ribs was partially scarified to achieve pleurodesis. There were no side effects. Thirteen patients were successfully treated without recurrence (maximum follow-up, 29 months). We conclude that this new therapy can play an important role in select patients with spontaneous pneumothorax. PMID- 2757446 TI - Physiological changes during temporary occlusion of the superior vena cava in cynomolgus monkeys. AB - To evaluate the physiological changes that occur after temporary occlusion of the superior vena cava, we clamped the vena cava for one hour in 6 cynomolgus monkeys, monkeys with a venous system most resembling that of humans. The data from arterial blood gas analysis, ie, pH, arterial oxygen tension, arterial carbon dioxide tension, and HCO3-, were within normal limits during and after occlusion of the superior vena cava. Intracranial pressure was 8.6 +/- 0.8 mm Hg (mean +/- standard error) before occlusion and rose to 22.1 +/- 2.2 mm Hg during clamping. It decreased significantly to 17.7 +/- 1.9 mm Hg just before removal of the clamp and recovered to 8.6 +/- 0.9 mm Hg after the clamp was removed. Regional cerebral blood flow was 45 +/- 9 mL/min/100 g before clamping and decreased to 37 +/- 3 mL/min/100 g during clamping. It recovered to 47 +/- 5 mL/min/100 g after removal of the clamp. Cerebral perfusion pressure was within the margin of safety during clamping. Histological findings in the brain showed the effect of congestion in 1 monkey, but the change was slight. The electroencephalogram and electrocardiogram showed no abnormalities in this experiment. In conclusion, one-hour clamping of the superior vena cava with the azygos vein ligated was safe in 6 cynomolgus monkeys. We believe that in the clinical setting, one-hour occlusion of the superior vena cava would result in findings similar to those in this study, unless particular complications, such as arteriosclerosis or a cerebrovascular disorder, exist. PMID- 2757447 TI - Extracorporeal membrane oxygenation for postcardiotomy cardiogenic shock in children. AB - Size limitations and technical barriers prohibit the use of many conventional mechanical circulatory support systems for postcardiotomy ventricular dysfunction in pediatric populations. Extracorporeal membrane oxygenation (ECMO), frequently used to treat neonatal respiratory failure, can provide cardiac support and is effective treatment of postoperative myocardial failure in children. From 1981 to 1987, 10 patients aged 2 days to 5 years were maintained on ECMO for 15 to 144 hours (mean duration, 92 +/- 16 hours) after cardiotomy. Operative procedures included repair of tetralogy of Fallot (2 patients), closure of a ventricular septal defect (2), the Senning procedure for transposition of the great arteries (1 patient), repair of interrupted aortic arch with closure of a ventricular septal defect (1), repair of a partial atrioventricular septal defect (2), closure of a ventricular septal defect with excision of an anomalous muscle bundle (1), and the Fontan procedure (1). Venoarterial ECMO was established in all 10 children. Six patients underwent transthoracic right atrium-ascending aorta cannulation, 3 had right internal jugular vein-right common carotid artery cannulation through a cervical incision, and 1 had right internal jugular vein left axillary artery cannulation. Eight of the 10 patients were successfully weaned from ECMO, and 7 are long-term survivors. There were 3 deaths; 1 was caused by cardiac and acute renal failure complicated by sepsis two days after decannulation, another occurred 19 days after atrioventricular septal defect repair, and 1 was caused by massive pulmonary hemorrhage. Major hemorrhage developed in 3 patients while on ECMO; 2 required premature decannulation for mediastinal bleeding from operative sites and ultimately survived, and 1 died of respiratory failure as a result of endobronchial bleeding. We conclude that the use of ECMO in pediatric populations for transient postoperative ventricular dysfunction improves survival with limited overall morbidity. PMID- 2757449 TI - Amiodarone-induced pulmonary mass. AB - Amiodarone is an effective agent in the treatment of life-threatening ventricular arrhythmias. However, there are numerous side effects associated with this drug, including pulmonary toxicity. This report describes a pulmonary mass that developed in a patient receiving amiodarone and was initially thought to be a lung cancer. Complete resolution occurred after cessation of the drug. PMID- 2757448 TI - Myocardial preservation related to magnesium content of hyperkalemic cardioplegic solutions at 8 degrees C. AB - This study investigates whether the addition of magnesium to a hyperkalemic cardioplegic solution containing 0.1 mM ionized calcium improves myocardial preservation, and whether there is an optimal magnesium concentration in this solution. Isolated perfused rat hearts were arrested for two hours by this cardioplegic solution, which was fully oxygenated and infused at 8 degrees C every 15 minutes to simulate clinical conditions. The cardioplegic solution contained either 0, 2, 4, 8, 16, or 32 mM magnesium. At end-arrest, the myocardial creatine phosphate concentration (nanomoles per milligram of dry weight) was 20.7 +/- 2.1, 22.9 +/- 1.7, 24.8 +/- 2.0, 31.3 +/- 1.4, 33.1 +/- 1.8, and 31.6 +/- 0.8, respectively, in hearts given cardioplegic solution containing these magnesium concentrations. Thus, the concentration of creatine phosphate was significantly higher at end-arrest when the cardioplegic solution contained 8, 16, or 32 mM than 0 or 2 mM magnesium (p less than 0.002) or 4 mM magnesium (p less than 0.02), and highest with 16 mM magnesium. Also, creatine phosphate was more sensitive to the magnesium concentration of the cardioplegic solution than was end-arrest adenosine triphosphate levels, which did not differ among the experimental groups. Aortic flow, expressed as a percentage of prearrest aortic flow, was 60.3 +/- 5.0, 70.2 +/- 5.5, 71.6 +/- 4.4, 71.8 +/- 4.8, 81.0 +/- 5.0, and 71.8 +/- 5.3, respectively. The addition of magnesium to the cardioplegic solution improved recovery of aortic flow (p less than 0.05, 16 mM versus 0 mM magnesium). We conclude from these data that with deep myocardial hypothermia and at an ionized calcium concentration of 0.1 mM, the addition of magnesium, over a broad concentration range, improved preservation of myocardial creatine phosphate and, at a concentration of 16 mM, improved aortic flow. The optimal magnesium concentration in the cardioplegic solution was 16 mM. PMID- 2757450 TI - Mediastinal involvement by myxoid liposarcoma. AB - Metastatic involvement of the mediastinum by liposarcoma is uncommon, and clinical experience in its management is limited. A patient with liposarcoma of the lower extremity having a concomitant anterior mediastinal mass as the only manifestation of distant metastatic involvement is described. PMID- 2757451 TI - Late postoperative cardiac tamponade presenting as dysphagia. AB - A case of late cardiac tamponade seen with progressive dysphagia 15 days after aortic valve replacement is reported. The diagnosis was confirmed echocardiographically and successful pericardiocentesis was followed by immediate alleviation of the dysphagia. PMID- 2757452 TI - New clamp for intraoperative chest tube placement. AB - We describe an instrument designed specifically to avoid the pitfalls of intraoperative chest tube placement. PMID- 2757453 TI - The Society of Thoracic Surgeons ad hoc Committee on AIDS. Report to the membership. PMID- 2757455 TI - Reporting the results of heart valve operations. PMID- 2757454 TI - Central aortopulmonary shunt using Gore-Tex: the modified Davidson shunt? PMID- 2757456 TI - Effect of sperm motility on human in vitro fertilization. AB - Several sperm motility parameters in semen prepared by the swim-up technique were compared with IVF rates in 84 patients. The patients were either on clomiphene + human menopausal gonadotrophin or follicle stimulating hormone + human menopausal gonadotrophin stimulation regimens. Motility ratings were assessed both manually according to World Health Organization guidelines as well as computer-automated semen analysis (Cellsoft, Cryoresources, USA). Motility ratings of greater than or equal to 2 yielded significantly higher fertilization rates (78-82%) than ratings below 2 (20-23%) (p less than 0.001) for patients on both regimens. Velocity (41, 55, 78 microns/sec) and mean amplitude of lateral head displacement (1.96, 3.29, 4.91 microns) correlated significantly with and between manual ratings of 1, 2, and 3, respectively (r = 0.83; p less than 0.01). No significant differences were observed in linearity and beat/cross frequency between the manual ratings, although beat/cross frequencies tended to reduce linearly with increases in intensity of motility. The velocity of sperm motility has a significant effect on fertilization rates, and cut-off points of greater than or equal to 2 or greater than or equal to 50 microns/sec predict the actual potential and likely success of in vitro fertilization. These criteria on the swim-up semen should be used in the selection of patients admitted to IVF programs, and they justify the necessity of research investigations to improve motility in those patients with sluggish motility. PMID- 2757457 TI - Stimulation of motility and energy metabolism of spermatozoa from asthenozoospermic patients by 17 beta-estradiol. AB - Spermatozoa from nine asthenozoospermic patients were incubated for 3 h in Krebs Phosphate Ringer (KRP), supplemented or not with 17 beta-estradiol. 17 beta estradiol increased the mean velocity and maintained the percentage of motility during the first 2 h of incubation. Oxydative metabolism and intracellular ATP concentrations were enhanced, too, whereas glycolysis remained unchanged. PMID- 2757458 TI - Sleep deprivation and adaptive hormonal responses of healthy men. AB - To study the effects of sleep deprivation on the pituitary-testis axis physiology, we measured the circulating levels of follicle-stimulating hormone (FSH), luteinizing hormone (LH), prolactin (PRL), testosterone (T), androstanedione (A), dihydrotestosterone (DHT), estradiol (E2), and cortisol (C) in eight healthy men as follows: phase I (control), phase II (24-h restless period), phase III (48-h restless period), and phase IV (24-h recovery period). All samples were taken at 8:00 a.m. There was a significant decrease of T, A, DHT, and E2 in phase II but no decrease in FHS, LH, PRL, or C. In phase III there was no further decrease in any androgen, although E2 decreased along with the increase of PRL. In phase IV E2 and PRL tended to return to baseline values, and the androgens were very similar to the controls. FHS, LH, and C showed no change under the effects of phase III. These data extend the adaptive androgenic response and the association of the role of E2 and PRL to restricted or disturbed sleep in men. PMID- 2757459 TI - Suppression of lipid peroxidation in human spermatozoa by prostatic inhibin. AB - Loss of sperm motility owing to the production of hydrogen peroxide by lipid peroxidation is regulated by yet unidentified prostatic factor(s). Inhibinlike peptide (HSPI) of prostatic origin isolated from human seminal plasma and having a molecular weight of about 10,400 daltons was studied for its effect on ascorbate-induced lipid peroxidation in human spermatozoa. Dose-related suppression of lipid peroxidation occurred at a dose level of 0.25, 0.5, and 1.0 micrograms. HSPI may be one of the factors involved in the regulation of lipid peroxidation and therefore sperm motility. PMID- 2757460 TI - Effect of rapid dilution of semen on sperm-bound autoantibodies. AB - The effect of rapid dilution of autoantibody-positive semen on sperm-bound antibodies was studied in 12 male patients (0-100% IgA and 10-100% IgG). The direct immunobead test (IBT) and the sperm cervical mucus contact (SCMC) test were used to detect sperm-bound antibodies on spermatozoa before and after rapid dilution and swim up in HAM F-10 + 10% human blood serum. All patients tested had normal semen parameters. Sperm-bound antibodies detected after swim-up of semen samples ejaculated into 15 ml HAM F-10 + 10% serum (diluted) did not differ significantly from undiluted samples. Most values were lower (IBT and SCMC) but were not statistically significant. Sperm motility, forward progression, and morphology were statistically improved. Pregnancies resulting from washed semen (diluted) in combination with artificial insemination (AIH) or gamete intrafallopian tube transfer (GIFT) took place in spite of antibodies still present on the sperm membrane and can probably be attributed to improved semen quality, minimizing of ovum-sperm distance, and cervical mucus elimination. PMID- 2757461 TI - Effects of chronic treatment with verapamil on adrenoceptor-mediated contraction of rabbit aorta. AB - Rabbits received twice-a-day doses of verapamil for 8 days and, on day 9 they were sacrificed in order to test contractile responses of the aorta in vitro. Isolated rings of aorta received graded doses of KCl, norepinephrine and norepinephrine along with either phentolamine, phenoxybenzamine or additional (acute) verapamil. Treated rings (those from animals that received verapamil chronically) developed significantly less tension (E) in response to depolarizing doses of KCl, but the degree of developed tension was restored and, in fact, enhanced when the aortic tissue was tested after cold storage 24 hr later (day 10). Responses (E) to norepinephrine in verapamil-pretreated rings were less than in controls by amounts that correlated with the daily verapamil dose and these too were enhanced after cold storage for 24 hr. The equilibrium dissociation constant (KA) of norepinephrine for the alpha 1-adrenoceptor, determined by the method of partial receptor blockade, was increased (reduction in affinity) by amounts that also depended on the daily verapamil dose. In contrast to agonist affinity, phentolamine affinity, determined from Schild-plot analysis, was not different from controls, even for the highest daily dosage of verapamil. Stimulus effect curves were also the same in control and verapamil-pretreated groups, thus suggesting that the chronic treatment did not affect the basic contractile process distal to the receptor. Further, aortae from pretreated rabbits showed more depression to acute verapamil than was seen in controls and this depression in Emax could not be overcome with even high doses of norepinephrine. In addition to the known alpha-blocking and calcium channel blocking actions of verapamil, these data show that chronic verapamil affects norepinephrine, but not phentolamine-receptor affinity, thus suggesting that the chronic action of this calcium entry blocker may preferentially alter a site on the receptor to which norepinephrine binds. PMID- 2757462 TI - Comparative vasodilator effects of magnesium salts on rat mesenteric arterioles and venules. AB - In vivo studies were undertaken to investigate the comparative effects of different magnesium (Mg) salts (i.e., MgCl2, MgSO4, Mg acetate, Mg aspartate HCl) on arterioles (10-20 microns i.d.) and venules (15-30 microns i.d.) of the mesenteric circulation of the pentobarbitone-anesthetized rat. Perivascular administration of these Mg salts (topical doses = 0.1-100 mumoles) produced dose dependent vasodilatation (5-50% increases in lumen size) of arterioles and venules almost instantaneously. Arterioles were more sensitive than venules to topical MgCl2 and MgSO4 but not to either Mg aspartate HCl or Mg acetate. Intra arterial infusion of the Mg salts (1-40 mumoles/min, i.e., 5-400 mumol/kg/min for 20 min) at each dose produced vasodilatation, i.e. 10-80% increases in lumen size of mesenteric arterioles; doses above 10 mumoles/min sometimes produced bleeding from venules. Systemic i.v. infusion (1-40 mumoles/min) of all 4 Mg salts lowered systolic and diastolic arterial blood pressure dose-dependently; however, the degree or presence of vasodilatation noted in the microvessels was not always correlated with the falls in arterial blood pressure. Intravenous administration of the Mg salts resulted in dose-dependent elevation in plasma Mg (0.3-4.7 mg/dl, over control levels); increments in plasma Mg were noted as soon as 1 min after the start of the infusion. Plasma Mg levels wre higher with inorganic salts and peaked more rapidly. Large i.v. doses of Mg salts (i.e., greater than 20 mumoles/min) induced some bleeding from the venules which varied with the anion. Administration of a variety of pharmacological receptor antagonists and a cyclo oxygenase inhibitor did not interfere with vasodilatation of arterioles or venules induced by Mg salts. These results indicate that magnesium ions: 1) are vasodilators of intact microscopic mesenteric resistance and capacitance microvessels; and 2) bring about vasodilatation by direct actions on microvascular smooth muscle cells. In addition, our data indicate that the anion associated with Mg appears to exert significant influences on microvascular tone. PMID- 2757463 TI - Time course of the anticonvulsant action of clonazepam during ontogenesis in the rat. AB - A time course of the protective action of clonazepam against metrazol-induced seizures was studied in 612 rats aged 7, 12, 18, 25 and 90 days. Two doses of clonazepam (0.1 and/or 1 mg/kg) were used and metrazol (100 mg/kg in all but 18 day-old animals where 90 mg/kg were given) was administered s.c. from 30 min to 48 hr. Not all time intervals were examined in all age groups. Eight to 14 rats were used for each time interval, dose and age group. Both doses exhibited a clear-cut antimetrazol action at all developmental stages studied. The protective action lasted longest in the 2 youngest groups and shortened progressively with age. The lower dose of clonazepam always exhibited shorter duration of action than the 1 mg/kg dose. Both doses were more efficient against major than against minimal metrazol seizures in 18-day-old and older rats where minimal seizures could be reliably elicited by metrazol. PMID- 2757464 TI - Propylbenzilylcholine mustard discriminates between two subtypes of muscarinic cholinoceptors in guinea-pig taenia caecum. AB - A 10-min treatment of isolated guinea-pig taenia caecum with propylbenzilylcholine mustard (PrBCM; 3 x 10(-7) M) inhibited concentration response curves of 5 full agonists used. A 50-min treatment with PrBCM produced a further inhibition of their curves. However, a 90-min treatment with PrBCM had no further significant inhibitory effect on their curves. Concentration-response curves of 5 partial agonists were completely inhibited by the 50-min treatment with PrBCM (3 x 10(-7) M). The limiting effect of PrBCM observed on the concentration-response curves of the full agonists was not found on the curves of the partial agonists. These results suggest that there are 2 subtypes of muscarinic cholinoceptors, PrBCM-sensitive and -resistant muscarinic receptors, which are discriminated by PrBCM but not by atropine, pirenzepine or AF-DX 116. The pKA value (a negative logarithm of dissociation constant) of carbachol to PrBCM-sensitive receptors is smaller than that to PrBCM-resistant ones, suggesting that the full agonists may be more sensitive to PrBCM-resistant receptors than to PrBCM-sensitive ones. The partial agonists produced contractions of the taenia caecum predominantly through an activation of PrBCM sensitive receptors, while the full agonists contracted the taenia caecum through the interaction of two subtypes. The responses to nicotine and to electrical stimulation were inhibited by the 50-min treatment with PrBCM, suggesting that PrBCM-sensitive receptors might play a physiological role. PMID- 2757466 TI - Some aspects of the pharmacology and physiology of the Ascaris suum muscle. AB - Out of 11 agonists, including such agents as bradykinin, prostaglandin E2, eledoisin, only acetylcholine (Ach) caused the isolated exposed ascaris muscle to contract during treatment for 30 sec and at 10(-7) g/ml (or lower concentrations). The possibility of using this preparation for the identification and quantification of Ach in biological tissues and fluids was highlighted. Neostigmine, but not physostigmine, augmented Ach activity. This suggests that cholinesterases present in the ascaris muscle may be structurally dissimilar to those in the mammalian gut muscle. Several chemically unrelated antagonists showed anti-Ach activity in this preparation in a descending order: d tubocurarine (dtc) greater than mepyramine greater than atropine, decamethonium, succinylcholine greater than hexamethonium greater than piperazine. Neither adrenaline nor noradrenaline relaxed the ascaris muscle but gamma-aminobutyric acid (GABA) and, occasionally, piperazine caused immediate relaxation of the muscle. GABA was about 150 times more potent than piperazine in this regard. GABA also showed anti-Ach activity which was 0.8-3 times that of dtc. It is suggested that GABA is the inhibitory transmitter in the ascaris suum and that the anti-Ach activity of piperazine is due either to stimulation of GABA receptors and/or to nonspecific blockade of Ach receptors. PMID- 2757465 TI - Effects of aniracetam on one-trial passive avoidance tests and cholinergic neurons in discrete brain regions of rats. AB - Using rats in one-trial passive avoidance tests, the anti-amnesic effects of the nootropic drug aniracetam were investigated; moreover, the action of aniracetam upon the cholinergic system in the brain was studied. In one-trial passive avoidance tests, aniracetam prolonged significantly the retention time for 100 mg/kg, p.o. However, the retention-prolonging effect was diminished when the dose was increased to 300 mg/kg p.o. Investigation of the action of the drug upon the cholinergic system revealed that ACh and choline content in the corpus striatum was not increased by any doses of aniracetam. ACh content in the hippocampus was increased by doses of 100-300 mg/kg, p.o., but choline was not significantly increased by any doses, while in the cerebral cortex ACh content was significantly increased by a dose of 300 mg/kg, p.o. In addition, the decrease in hippocampal ACh and choline content following an injection of scopolamine was lessened by aniracetam 100 mg/kg, p.o. and 100-300 mg/kg, respectively. In order to elucidate the mechanism of these actions of aniracetam, the ACh-releasing action and changes in choline content of the extracellular spaces in the hippocampus were investigated, but no effects were observed. The results obtained indicate that aniracetam has an inhibitory effect upon scopolamine-induced amnesia. The mechanism of this effect may be an action upon the cholinergic system; therefore, some action with respect to the impairment of cholinergic neurotransmission in the hippocampus induced by scopolamine appears to be of particular importance. PMID- 2757467 TI - Release of [3H]- and endogenous GABA from slices of the rat medulla oblongata: modification by 3-mercaptopropionic acid, nipecotic acid and diaminobutyric acid. AB - Slices of the rat medulla oblongata were superfused and electrically stimulated. The amount of [3H]- and endogenous GABA was determined. There was a stimulus evoked release of [3H]- and endogenous GABA, which was Ca2+-dependent and tetrodotoxin-sensitive. 3-Mercaptopropionic acid (3-MP) reduced the release of endogenous GABA, whereas the release of [3H]-GABA was not affected by this agent. Nipecotic acid enhanced the spontaneous and stimulus-evoked release of both [3H]- and endogenous GABA. 3-MP, nipecotic acid and diaminobutyric acid modified the stimulus-evoked release of endogenous GABA from slices containing the rostral ventrolateral medulla, the caudal ventrolateral medulla or the nucleus tractus solitarii, regions responsible for blood pressure regulation. These results suggest that 3-MP inhibits the stimulus-evoked release of GABA without affecting its release process, whereas nipecotic acid enhances the release via its uptake inhibition action. PMID- 2757468 TI - Blood pressure and heart rate responses to intracerebroventricular infusion of sodium chloride solution in normotensive and hypertensive rats. AB - An increased central salt sensitivity is thought to be basically involved in hypertension. Therefore, in anaesthetized normotensive (Wistar, WKY) and hypertensive (SHR) rats, small amounts (10 microliters in 20 min) of both isotonic and hypertonic NaCl solutions (0.154 M, 0.3 M, 0.6 M and 1.0 M) were i.c.v. applied and blood pressure (BP) and heart rate (HR) responses registered. Central administration of hypertonic NaCl solution caused an elevation in BP and HR in both strains. The response magnitude was positively correlated to the NaCl concentration used. This increase could be interrupted by i.v. injection of a ganglionic blocker (tetraethylammoniumbromide). Despite of differences in time course, the magnitude of the BP and HR increases were much more elevated in SHR and WKY than in Wistar rats, suggesting strain differences. Considering the results obtained with 1.0 M NaCl solution, the following values were reached: in Wistar: delta syst. BP +15.7 mm Hg, delta HR +23.3 bpm; in WKY: delta syst. BP +40.2 mm Hg, delta HR +51.6 bpm; in SHR: delta syst. BP +46.0 mm Hg, delta HR +48.0 bpm. On the contrary, isotonic NaCl solution, when centrally applied, caused an elevation in HR (+25 bpm) and BP (delta syst. BP +6.2 mm Hg) only in SHR. These results support the idea that an exaggerated central sensitivity to sodium chloride may participate in hypertension. PMID- 2757469 TI - Effect of nisoldipine on the oxymyoglobin level of myocardial cells in hypoxic, perfused rat hearts. AB - The effect of nisoldipine on the oxygen balance in the hypoxic myocardial cells was studied. The isolated rat heart, driven at 300 beats/min, was perfused with Krebs-Henseleit solution equilibrated with a gas mixture containing 95% O2 + 5% CO2 (normoxic perfusion solution) at a constant flow rate (9 ml/min) according to the Langendorff's technique. The myocardial oxygenation level of myoglobin (reflecting intracellular oxygen tension) of the cells locating on the ventricular surface was continuously determined by means of an optical technique. Hypoxic perfusion (perfused with Krebs-Henseleit solution equilibrated with a gas mixture containing 30% O2 + 5% CO2 + 65% N2) decreased the oxymyoglobin level (MbO2), left ventricular pressure (LVP), and perfusion pressure (PP). Nisoldipine was infused into the aortic cannula for 10 min during the hypoxic perfusion. Larger doses of nisoldipine (282.9 and 141.5 nM expressed in terms of the final concentration in the perfusion solution) increased the MbO2 level and decreased LVP, without affecting PP. Smaller doses (70.7 and 35.4 nM) did not have a marked effect on these parameters. These results suggest that nisoldipine, in larger doses, improves the oxygen balance of the hypoxic myocardial cells, probably because of decrease in LVP hence oxygen demand, and that nisoldipine does not dilate further coronary vessels that have been dilated by hypoxia. PMID- 2757470 TI - Effects of niguldipine, a new dihydropyridine calcium antagonist, on regional blood flow, cardiac performance and myocardial metabolism in anaesthetized open chest dogs. AB - The haemodynamic and metabolic effects of niguldipine (0.01, 0.025 and 0.5 mumol/kg i.v.), a novel dihydropyridine calcium antagonist, were evaluated in 18 anaesthetized open-chest dogs. The following parameters were continuously measured: heart rate, arterial and pulmonary arterial blood pressure, left and right atrial pressure, left ventricular dp/dtmax, cardiac output, regional blood flow in the circumflex branch of the left coronary artery, and in 1 renal and 1 femoral artery. At predetermined intervals, contents of O2, CO2, H+ ions, glucose, lactate and free fatty acids were determined in blood drawn from the left atrium and a regional cardiac vein. Niguldipine induced a dose-dependent decrease in both systolic and diastolic arterial blood pressure, which led to an increase in heart rate and cardiac output. Mean left atrial pressure was markedly reduced by all doses. Coronary blood flow increased dose-dependently and persistently. Perfusion in the renal and femoral vascular beds also increased, but only transiently and to a lesser extent. Calculation of vascular conductances revealed a preferred vasodilating drug effect on the coronary vascular bed. Right atrial and systolic and diastolic pulmonary artery pressures were not noteworthy altered. Balances of metabolic substrates, O2, CO2 and H+ ions did not indicate any major drug effect of niguldipine on myocardial metabolism. PMID- 2757471 TI - [Intracranial granuloma as a late complication of subdural hematoma]. AB - Complications during subdural hematoma treatment are rare and usually occur soon after its evacuation. We present the clinicopathological and radiological findings of a granuloma that happened as late effect of the drainage of a subdural hematoma (1 year after). The presence of bone wax around the tumor and the finding of empty spaces intracytoplasmatic and extracellular surrounded by inflammatory cells suggest that the bone wax was the cause of the granulomatous process. PMID- 2757472 TI - [Epidemiologic study of alcoholism at the San Carlos University Hospital in Madrid]. AB - We studied the patients that were admitted to the Psychiatry Department of Hospital Clinico San Carlos in Madrid from 1977 to 1986, evaluating the prevalence of the abuse and/or alcohol dependence and its distribution by the sociodemographic variables of age and sex. Of a total of 9,425 patients, 772 had a diagnosis of alcoholism which represented and 8.1% of the admittances. The associations of alcoholism with other psychiatric pathologies was analyzed by means of the study of double diagnosis. A 15.5% of the alcoholic patients admitted between 1981-1986 had a second diagnosis. PMID- 2757474 TI - Temperature dependent pH-instability of some alpha-L-arabinofuranosidases. AB - In this paper are described alpha-L-arabinofuranosidases, partially purified from some moulds, with very high lability of their activity to weakly alkaline or neutral pH-values. This pH-lability strongly depends on temperature. The form of the inactivation curves suggests involvement of charge changes in this irreversible process. These enzymes may be useful for optimization of the tumor therapy concept described by Graffi (5). PMID- 2757473 TI - [Social change. The climacteric and depression]. AB - We study different socio-environmental factors in relationship with depression in the climacterium. Our sample are women who have been diagnostic of depression and are impatient in the Department of Psychiatry of University Hospital San Carlos. The isolation and the social and familiar changes are the most important events that happen to the women depressive climacteric. The Spanish women in climacteric age have lived in a cultural-educational environment focus toward a maternal role. Because of this her personality has development dependent and submission. PMID- 2757475 TI - Clinical hyperthermia, alone or with radiation therapy: results of a preliminary study on recurrences of cancers. AB - Authors present results obtained by hyperthermic treatment (alone or associated with radiation therapy) on 50 patients (with a total of 66 sites) treated between September 1983 and August 1986. All patients had recurrent or metastatic lesions of pretreated malignant tumors. Among these there were 19 breast adenocarcinomas, 33 squamous cell carcinomas of head and neck, 9 melanomas and 5 subcutaneous metastases of adenocarcinoma of the cervix, rectum and colon. The clinical protocol was: hyperthermia alone (43 degrees -45 degrees C for 30 minutes, bi weekly, for 4-5 weeks) or hyperthermia plus radiation therapy (4 Gy/fraction) for a total of 8-10 seances, in accordance with previous given doses of irradiation. In summary, complete response rates were 21.2% for head and neck tumors, and 51.5% for cutaneous or subcutaneous lesions. Results have also been analysed according to different prognostic variables related to tumor and treatment characteristics. These data are discussed. PMID- 2757476 TI - [Prognostic factors in laryngeal cancer]. AB - A retrospective analysis of 335 patients with laryngeal and hypopharyngeal cancer from the ENT-Hospital of the Wilhelm-Pieck-University Rostock, who died to December 1986, was made. Adjusted five-year survival rates were in glottic carcinoma 54.2 per cent and supraglottic carcinoma 42.9 per cent. This is significantly higher than in carcinoma of hypopharynx with 15.4 per cent. The following prognostic factors were important for the survival rates of the patients without consideration of the therapy of primary tumor: pTNM-stage, evidence and development of regional metastasis, enlarged stage of the primary tumor at the time of diagnosis; intercurrent diseases; development of distant metastasis and/or second carcinoma; localisation of tumor; primary therapy of regional lymph nodes. PMID- 2757477 TI - [Results of therapy of endometrial carcinoma and analysis of risk factors in comparison with a control group]. AB - Overall 1,021 patients with endometrial carcinoma were treated between 1965 and 1982 at the Department of Obstetrics and Gynecology and the Department of Radiology, Friedrich-Schiller-University, Jena. The 5-year-survival rate of all patients amounted to 63%. The 5-year-survival probability with primary surgery was 76.1%, with primary irradiation 34.4%. The frequency of risk factors in the patient group was compared with an age adjusted group of patients who underwent a D & C due to irregular bleeding of benign causes. Overweight and infertility were evaluated as significantly more frequent risk factors in cancer patients. There was no significant difference between the two groups concerning the factors hypertension, diabetes, heart-diseases, irregular bleeding and history of carcinoma in the family. PMID- 2757478 TI - Neuroimmunitary profile estimation in cerebrospinal fluid and its importance in childhood acute lymphoblastic leukaemia. AB - Immunoglobulin G (IgG) and albumin (Alb.) were measured in the cerebrospinal fluid (CSF) of 14 children with acute lymphoblastic leukaemia (ALL), with and without leukaemic infiltration of the central nervous system (CNS). The following indexes: (formula; see text) were calculated and used to express a protein profile of the CSF. This profile was found to be inflammatory-like in 10 children (71%) and normal in 4 (29%). The first two indexes, that reflect a local synthesis of IgG correlated significantly (r = 0.823; p less than 0.001). The follow-up made in five children showed a relationship between clinical course and local IgG synthesis. PMID- 2757479 TI - The organization of cancer care in Norway. PMID- 2757480 TI - Organization of cancer care in Belgium. PMID- 2757481 TI - Organization of cancer control in the USSR. PMID- 2757482 TI - End points and significance of reproducibility in pathology. PMID- 2757483 TI - Direct cocaine cardiotoxicity demonstrated by endomyocardial biopsy. AB - The morbidity and mortality associated with cocaine abuse has markedly increased in recent years. Although several articles indicate a possible connection of cocaine with coronary spasm and acute myocardial infarction, this study in seven patients with a history of cocaine abuse, who underwent endomyocardial biopsy, suggests that cocaine may cause direct toxicity to the myocardium. Myocardial specimens from five of seven patients showed multifocal myocyte necrosis, of which two specimens revealed focal myocarditis, while three specimens had changes consistent with dilated cardiomyopathy. Ultrastructurally, extensive loss of myofibrils and sarcoplasmic vacuolization were observed. It is postulated that the pathogenesis of acute cocaine-induced toxicity is direct destruction of myofibrils resulting in myocyte necrosis and that these changes may or may not be associated with interstitial inflammatory cell infiltrates. Long-term abuse of cocaine may lead to interstitial fibrosis and eventually congestive heart failure. PMID- 2757484 TI - Gastrointestinal autonomic nerve tumors. 'Plexosarcomas'. AB - Four plexosarcomas (gastrointestinal autonomic nerve tumors) characterized by light microscopic, immunocytochemical, and ultrastructural examination, including immunoelectron microscopy in one case, are described. The four neoplasms occurred in the small intestine (duodenum, two; jejunum, one; and ileum, one) and they had an aggressive course with either local or distant metastases. The light microscopic patterns varied from epithelioid and organoid to spindle cells, mimicking endocrine and sarcomatous neoplasms. Ultrastructurally, these tumors exhibited interdigitating cytoplasmic processes that contained scattered aggregates of membrane-bound granules varying in size from 100 to 300 nm intermixed with empty vesicles and numerous diffusely distributed intermediate filaments. Basal lamina covering cell surfaces, attachment plaques, and myofilaments, as expected in smooth-muscle tumors, were not identified, and diffusely distributed membrane-bound granules, as seen in paragangliomas and carcinoid tumors, were also absent. By immunocytochemistry, the tumors were intensely positive for vimentin and neuron-specific enolase and focally positive for neurofilaments and synaptophysin. In addition, three tumors were S100 protein positive and one stained for vasoactive intestinal peptide. Similar positive immunocytochemical reactions were identified in normal enteric plexus. It is essential to recognize plexosarcomas, which are invariably accompanied by aggressive clinical behavior, in spite of a seemingly benign, mitotically inactive light-microscopic appearance in most instances. Ultrastructural examination can readily separate plexosarcomas from paragangliomas and other sarcomatous and endocrine neoplasms. PMID- 2757485 TI - The fine structure of acquired immunodeficiency syndrome encephalopathy. AB - Involvement of the central nervous system with the human immunodeficiency virus is thought to underlie the clinical and pathologic features of acquired immunodeficiency syndrome (AIDS) encephalopathy. Although morphologic, immunocytochemical, and molecular data point to predominant human immunodeficiency virus infection of multinucleated and mononuclear macrophages, neuroglial and other cells are thought to be involved as well. Electron microscopic studies of biopsy tissue that might further define the neuropathologic changes have been limited. The opportunity to study well preserved biopsy tissue from a 38-year-old man with the acute onset of dementia and AIDS encephalopathy prompted this report. Human immunodeficiency virus was seen budding from the surface of multinucleated and mononuclear cells with morphologic features of macrophages; a rare astrocyte process showed evidence of viral infection as well. Macrophages were noted within the walls of blood vessels and in intimate contact with lymphocytes within the neuropil. Notably rare were tubuloreticular inclusions, interferon-related cytoplasmic structures commonly found in systemic endothelial cells and lymphocytes in AIDS. Their relative scarcity may signify reduced interferon production in AIDS encephalopathy. PMID- 2757486 TI - Image analysis microspectroscopy of senile plaque capillary amyloid in Alzheimer's disease. A preliminary study. AB - The relationship between cerebral amyloid and the microvasculature in senile plaques was studied with image analysis microspectroscopy. This imaging technique permitted topographic quantification of amyloid concentration within microscopic subregions of single senile plaques. The highest concentration of amyloid was measured at the walls of intraplaque capillaries. Spectroscopic images revealed a decreasing gradient of amyloid concentration with increasing distance from intraplaque capillaries. The concentration of amyloid in nonplaque capillaries was lower than that measured in capillaries within well-developed amyloid plaques. These findings support the premise that plaque amyloid deposition starts at the level of the capillary. PMID- 2757487 TI - Focal leptomeningeal rhabdomyomatosis of the posterior fossa. AB - We describe two infants with heterotopic skeletal muscle in the leptomeninges of the posterior fossa. In one case, the heterotopic muscle was accompanied by adipose tissue. Leptomeningeal rhabdomyomatosis may be more common than is apparent from the literature, since these lesions are missed if the meninges become denuded from the brain stem at autopsy or brain cutting. PMID- 2757488 TI - Morphogenesis of Michaelis-Gutmann bodies in cerebral malacoplakia. An ultrastructural study. AB - Malacoplakia was found in the brain biopsy specimen from the wall of a cystic lesion in a 4-month-old girl. Ultrastructural study of the Michaelis-Gutmann bodies revealed that the initial stage of calcification appeared to be the deposit of needle-shaped apatite crystals within intracytoplasmic membrane-bound vesicles of histiocytes. Accumulation of apatite crystals and coalescense of calcified vesicles resulted in the formation of large laminated calcospherules. Extracellular Michaelis-Gutmann bodies and apatite crystal-containing matrix vesicles were also noted. Calcified vesicles and the Michaelis-Gutmann bodies were not observed in the phagolysosomes. Bacteria and viral particles were not identified. These findings suggest that matrix and intracytoplasmic membrane bound vesicles play an important role in the initial stage of the formation of Michaelis-Gutmann bodies and that a mechanism other than bacterial or viral infection may be involved in cerebral malacoplakia. PMID- 2757489 TI - Focal neuronal gigantism and cerebral cortical thickening after therapeutic irradiation of the central nervous system. AB - An exceptional type of cortical dysplasia is described in the brain of a 32-year old woman who had received radiation therapy for a large pituitary adenoma 6 years before death. Markedly thickened gyri of the left inferior frontal, insular, and temporal cortex were found grossly. Microscopically, these gyri showed laminar disorganization and many unusually large and abnormally shaped ganglion cells. These neurons were heavily impregnated with silver preparations; were strongly reactive for neuron-specific enolase, synaptophysin, and neuronal cytoskeletal proteins (68- and 200-kd subunits of neurofilament protein, microtubule-associated protein 2, and tau); and ultrastructurally contained numerous perikaryal neurofilaments. Collectively, these findings suggest that the abnormally large, misshapen neurons contained excessive accumulations of cytoskeletal intermediate filaments. The present case and a similar one described in 1964 are the only two documented instances of neuronal gigantism apparently related to therapeutic irradiation of the brain. PMID- 2757490 TI - Pulmonary phospholipid accumulation distal to an obstructed bronchus. A morphologic study. AB - Alveolar proteinosis (AP) and postobstructive or endogenous lipid pneumonia (ELP) are two distinct morphologic types of phospholipid accumulation in the lung. In ELP, ultrastructurally amorphous fat accumulates in the cytoplasm of alveolar macrophages. In AP, lamellar surfactant bodies with an electron microscopic complex structure are stored within alveolar lumina. In contrast to ELP, AP has not been associated with bronchial obstruction. One case of postobstructive AP occurred distal to a central carcinoid tumor, and two cases of combined AP and ELP occurred next to a squamous cell carcinoma that obstructed a lobar bronchus. Results of histologic and ultrastructural studies were determined with regard to new insights into the physiology and biochemistry of pulmonary lipids. It was concluded that the morphology of accumulated fat in obstructed lung tissue may depend on local oxygen and carbon dioxide tensions. PMID- 2757491 TI - Pneumatosis cystoides intestinalis. Histological mucosal changes mimicking inflammatory bowel disease. AB - In 10 cases of pneumatosis cystoides intestinalis affecting the colon in adults, the overlying mucosa exhibited abnormal glandular architecture. The importance of this feature lies in the possible confusion histologically with inflammatory bowel disease, especially Crohn's disease. PMID- 2757492 TI - Immunocytochemical detection of lactoferrin in human gastric carcinomas and adenomas. AB - In gastric carcinomas, including 20 cases of intestinal type and 10 cases of diffuse type, in adenomas with mild to severe dysplasia (20 cases), and in hyperplastic polyps (10 cases), the presence of lactoferrin was investigated by immunohistochemistry. Incomplete or complete intestinal metaplasia or both and normal gastric mucosa were also tested. Preoperative hematocrit and serum iron levels (18 patients) were recorded. An evident reactivity for lactoferrin was encountered in intestinal type carcinomas, adenomas, and incomplete intestinal metaplasia, whereas diffuse-type carcinomas, hyperplastic polyps, and complete intestinal metaplasia were always unstained; mucous neck cells of the antrum and body were also positive for lactoferrin. The results are discussed in relation to the increased requirement of iron by neoplastic cells, although in gastric carcinomas serum iron levels appear to be unrelated to the immunohistochemical presence of lactoferrin. PMID- 2757493 TI - Iron-negative foci in siderotic macroregenerative nodules in human cirrhotic liver. A marker of incipient neoplastic lesions. AB - Resistance to iron accumulation is known as a phenotypic marker of neoplasia and preneoplasia in experimental hepatocarcinogenesis in rodents overloaded by iron. This study was aimed to evaluate whether such iron-free foci are present and valuable for identification of preneoplastic and incipient neoplastic lesions in human cirrhotic livers, especially within macroregenerative nodules in which hepatocellular carcinoma is known to arise. Iron-free foci were found in siderotic macroregenerative nodules in liver cirrhosis. These foci were classic and overt carcinoma or borderline lesions showing an expansive growth pattern. Borderline lesions were composed of hyperplastic or small basophilic hepatocytes with hyperchromasia and distinct nuclear membrane showing pseudoglandular, trabecular, compact, and scirrhous patterns. These data suggest that iron stain is valuable for identification of neoplastic or borderline lesions representing a transition from hyperplastic nodule to carcinoma in human liver cirrhosis. PMID- 2757494 TI - Histopathologic features of minute and small human gastric adenocarcinomas. AB - Thirty-four minute (less than 5 mm in the largest diameter) and 60 small (6 to 10 mm in the largest diameter) early gastric carcinomas (EGCs) were studied to assess the correlation between gross and histologic features. The characteristic macroscopic feature of many of the histologically differentiated, minute and small EGCs was a depression accompanied by a circumferential elevation of the adjacent noncancerous mucosa. The circumferential elevation was carefully studied histologically. On the other hand, most of the undifferentiated-type minute EGCs included a proliferation of the malignant cells affecting the lamina propria in the middle layer of the mucosa, leaving noncancerous glands and foveolae, and therefore presenting no specific macroscopic change. Most of the undifferentiated type small EGCs, however, manifested distinct depressions, with or without ulceration; these EGCs were histologically made up of a compact proliferation of carcinoma cells that destroyed both the foveolae and glands. These findings clearly showed the difficulty in detecting the undifferentiated type of minute EGCs and explained the increase in the frequency of the differentiated type in EGCs with a decrease of the size of clinically detectable EGCs. Topographic mapping of the EGCs revealed that the undifferentiated-type minute EGCs that occurred in the middle third of the stomach may well be overlooked. PMID- 2757495 TI - Significance of mucosal vs salivary gland changes in lip biopsies in the diagnosis of chronic graft-vs-host disease. AB - Lip biopsy is frequently utilized to diagnose and stage chronic graft-vs-host disease (cGVHD). However, the significance of mucosal (MU) vs salivary gland (SG) involvement as well as the minimal histologic changes necessary for diagnosis remain unclear. We evaluated 68 lip and oral mucosa biopsy specimens using published diagnostic criteria. Thirty-four specimens contained both MU and SG tissue. Both MU and SG were definitely involved in 13 patients while apparent false-negatives for MU of 20% (2/10) and SG of 11% (1/9) were observed. No clinical differences were noted among the patients with both MU-alone-, or SG alone-positive biopsy specimens. Patients with no evidence of cGVHD in either MU or SG showed significantly less other organ involvement than patients with positive evidence. Patients with minimal MU changes (rare dyskeratotic cells) were clinically indistinguishable from negative patients in terms of other organ involvement. However, 50% of the biopsy specimens with minimal MU involvement in which SG were present had definite GVHD in the SG. These data indicate that lip biopsy specimens must include both MU and SG tissue to rule out oral GVHD. Minimal MU changes are insufficient to diagnose oral cGVHD, although they do warrant close follow-up and a second biopsy if SG tissue is not present in the specimen. PMID- 2757497 TI - Post-cone biopsy traumatic neuroma of the uterine cervix. AB - Traumatic neuroma rarely occurs in the female genital tract and is probably the rarest complication of cone biopsy. A traumatic neuroma of the cervix found incidentally in the hysterectomy specimen of a 40-year-old woman who had previous conization for cervical squamous intraepithelial neoplasia grade 3 is presented. Significance of the finding is described. PMID- 2757496 TI - Nasal astrocytoma or nasal glial heterotopia? AB - This report describes a unique astrocytic lesion of the nasal cavity that was connected to a frontal lobe astrocytoma via the eroded cribriform plate. The nasal lesion probably resulted from downward extension of the cerebral astrocytoma. Other possibilities included coexistence of nasal glial heterotopia and intracerebral astrocytoma, and nasal glial heterotopia complicated by neoplastic transformation and intracranial extension. PMID- 2757498 TI - Enteritis cystica profunda in a patient with Crohn's disease. AB - Colitis cystica profunda is an uncommon but well-recognized condition affecting the colon. Involvement of the small bowel, enteritis cystica profunda, is extremely rare, and is characterized by mucus-filled cystic spaces frequently lined by demonstrable epithelium. The cystic spaces are located within the submucosa and muscularis propria. Isolated cases have been described in association with Peutz-Jeghers syndrome and Crohn's disease. We report a case of enteritis cystica profunda in a 31-year-old man with Crohn's disease. PMID- 2757499 TI - [Abstracts of papers presented at the annual session of the German Pharmaceutical Society. 11-12 March 1989, Blaubeuren. Analytical aspects in pharmacy]. PMID- 2757501 TI - Papers read before the 96th annual meeting of the Western Surgical Association. San Diego, Calif, November 14-16, 1988--Part II. PMID- 2757500 TI - Percutaneous transhepatic cholangiography and biliary decompression. Invasive, diagnostic, and therapeutic procedures with too high a price? AB - To investigate and/or treat the causes of jaundice, 221 patients underwent the following procedures over 7 years: percutaneous transhepatic cholangiography (PTC) alone (104 patients), PTC with external biliary drainage (69 patients), or PTC with external/internal biliary drainage (48 patients). Forty-nine procedure related complications occurred in 39 patients (18%). Three patients (1.5%) required an emergency operation for hepatic hemorrhage (2 patients) and a perforated gallbladder (1 patient). Two patients (1%) died as a direct result of the procedure secondary to hemorrhage (1 patient) and sepsis (1 patient). Preoperative biliary decompression, although technically (95%) and physiologically (82%) successful in the majority of patients, had no therapeutic benefit when compared (nonrandomized) with those patients without alleviation of jaundice prior to surgical intervention. PMID- 2757502 TI - The impact of in-house surgeons and operating room resuscitation on outcome of traumatic injuries. AB - As trauma systems develop, more patients can potentially benefit from immediate surgery. With in-house surgeons available, enthusiasm for direct transfer from the scene to the operating room (OR) has developed in many institutions. The purpose of this study was to define precisely which patients should be taken to the OR for resuscitation. Three hundred twenty-three patients were taken to the OR directly from the field during a 4-year period (6.9% of trauma activations). Indications included the following: (1) cardiac arrest--one vital sign present, (2) persistent hypotension despite field intravenous fluid, and (3) uncontrolled external hemorrhage. A board-certified surgeon and resuscitation team met the field transport team in the OR in all cases. Cardiopulmonary resuscitation for patients with blunt trauma was not accompanied by survival even with immediate surgery by a trained surgeon and it wastes valuable OR resources. Patients with prehospital hypotension unresponsive to fluid resuscitation indicate the need for rapid surgery. Patients with blunt injuries even with hypotension infrequently undergo operations in less than 20 minutes and can be resuscitated in traditional areas where better roentgenograms are obtained. Penetrating injuries to the chest and abdomen with hypotension are the primary indications for OR resuscitation. It can be anticipated with field communication and accompanied by enhanced survival. PMID- 2757503 TI - The reasons for failure in parathyroid operations. AB - Primary hyperparathyroidism occurs in about 1 in every 700 individuals. We analyzed our experience with 81 patients with persistent or recurrent hyperparathyroidism who were treated at the University of California, San Francisco, and the Veterans Administration Medical Center, San Francisco, from January 1979 through September 1988. In the 89 reoperations performed, the following six reasons or combination of reasons were responsible for the failed initial operation: (1) in 50 patients, there were multiple abnormal glands (30 hyperplastic and 20 second adenoma); (2) in 40 patients, the tumor was located in an ectopic position (22 mediastinal, 9 deep-seated cervical, 7 intrathyroidal, and 2 undescended); (3) in 17 patients, there were supernumerary parathyroid glands; (4) in 12 patients, the abnormal parathyroid glands were found in normal locations and the tumors were missed because of surgeon inexperience; (5) in 4 patients, failure was due to metastatic parathyroid cancer; and (6) in 4 patients, failure was due to errors on frozen section examinations. Preoperative localization studies usually identified the abnormal parathyroid tumor(s) prior to reoperations and were helpful in these patients. Knowledge of the reasons for failed parathyroid operations and the usual and unusual sites where parathyroid tumors are situated as well as a complete exploration should decrease the frequency of failed parathyroid operations. Localization studies are helpful for identifying these often elusive tumors. PMID- 2757504 TI - Biliary lithotripsy. Determination of stone fragmentation success and potential tissue injury in swine. AB - Application of extracorporeal shock wave lithotripsy to gallbladder stones was studied in 37 adult female swine. Twenty-two sows underwent cholecystostomy with implantation of human gallstones. In 20 animals, after a 10-day recovery period, extracorporeal shock wave lithotripsy, 2000 shocks (an amount determined in preliminary water bath studies to be effective), was performed. In 10 of these implanted swine, frequent focal point refocusing and biplanar ultrasonography were employed. Two animals served as operative controls. Fifteen other animals without gallstone implantation were studied for adverse effects of extracorporeal shock wave lithotripsy on tissue. These animals (unimplanted) received 5000 shocks; 7 animals were killed 1 to 4 days after treatment and the others were killed after 4 weeks. Biochemical tests (total bilirubin, alkaline phosphatase, lipase, amylase, alanine aminotransferase, and lactate dehydrogenase determinations) were performed on all animals at entry and every second or third day until they were killed. Successful fragmentation, defined as all residual gallstone fragments being less than or equal to 4 mm in greatest dimension, was achieved in 14 of 20 animals overall, but in 10 of 10 animals in which focal point refocusing had been used. Slight perivascular hemorrhage and minimal coagulation necrosis were seen histologically only in the liver parenchyma adjacent to the gallbladder bed. The remainder of the liver was grossly and histologically normal. No injuries to the colon, duodenum, common bile duct, or pancreas were observed. No alterations suggesting injury or altered function occurred in any of the biochemical tests. PMID- 2757505 TI - The treatment of achalasia. A current perspective. AB - We analyzed the course of 79 adult patients treated for achalasia between 1977 and 1988. Sixty-six patients (84%) had pneumatic dilatation as the primary therapy. Fifty-three patients (80%) had immediate improvement in swallowing. Three patients required immediate redilatation, 2 developed pulmonary aspiration, and 8 (12%) suffered esophageal perforation. Esophageal perforation was treated by closure plus Heller's myotomy in 3 patients, closure only in 3, chest tube in 1, and antibiotics and nasogastric suction in 1. At 4 years' follow-up, 50% of patients who had dilatation remained asymptomatic, 30% had symptoms of gastroesophageal reflux, and 20% had persistent dysphagia. Eight Heller myotomies were performed, with excellent results in 7 and 1 postoperative death from respiratory failure. Seven additional patients with disabling esophageal symptoms after multiple operations for achalasia were ultimately treated by esophagectomy (n = 5), hemigastrectomy and Roux-en-Y gastrojejunostomy (n = 1), and repeated myotomy (n = 1). All recovered and are able to eat solid food. Thus, our experience indicates that pneumatic dilatation remains unperfected (ie, the line between undertreatment and overtreatment is finer than generally recognized), and unless improvements can be made, the role for surgery may need to be reexpanded. PMID- 2757506 TI - Increased incidence of delayed gastric emptying in children with gastroesophageal reflux. A prospective evaluation. AB - Symptomatic gastroesophageal reflux is a common cause of failure to thrive, aspiration, and chronic pulmonary infection in infants. Gastric emptying was prospectively evaluated in 99 infants and children with symptomatic gastroesophageal reflux. Twenty-eight (28.2%) of 99 patients with gastroesophageal reflux had delayed gastric emptying. Twenty-one (75%) of the 28 patients underwent a concomitant gastric drainage procedure at the time of fundoplication. Seven had fundoplication alone and developed symptoms of early satiety, gas bloat, gagging, and pain postoperatively. Medical therapy was ineffective in these patients, and 5 improved after pyloroplasty. Delayed gastric emptying is common in patients with gastroesophageal reflux. These findings suggest that after fundoplication, symptoms of gagging, early satiety, and gas bloat syndrome may be related to delayed gastric emptying. This implies that a gastric emptying study should be performed preoperatively. PMID- 2757507 TI - The significance of the gastric secretory state in gastroesophageal reflux disease. AB - The gastric secretory status of 75 patients with abnormal esophageal exposure to gastric juice proved by 24-hour pH monitoring was measured to study the significance of gastric hypersecretion in gastroesophageal reflux disease. Gastric hypersecretion was a less-frequent finding than a mechanically defective sphincter (28% vs 72%, respectively). Forty-eight percent of patients with a normal sphincter, compared with 20% of those with a defective sphincter, were hypersecretors. In the presence of normal gastric secretion, complications occurred in 18% of those with a normal sphincter and 77% of those with a defective sphincter. In the presence of hypersecretion, the complication rate was 40% and 82%, respectively. These findings show that the development of reflux complications are related to a defective sphincter. Gastric hypersecretion in reflux patients with a normal sphincter is best treated by acid reduction using H2 blockers. Patients with a mechanically defective sphincter, regardless of their gastric secretory state, should have an antireflux procedure. PMID- 2757508 TI - Gastric surgery for morbid obesity. Complications and long-term weight control. AB - The efficacy of gastric surgery for morbid obesity has often been questioned because of incomplete long-term patient follow-up. Between 1977 and 1984, 537 consecutive patients received either a gastric bypass with a Roux-en-Y gastrojejunostomy, an unbanded gastrogastrostomy, or a vertical banded gastroplasty. The follow-up period was 5 years for all patients who underwent Roux-en-Y gastrojejunostomy and unbanded gastrogastrostomy and 3 years for all patients who underwent vertical banded gastroplasty. Only 5.8% of all patients were unavailable for this late follow-up. The unbanded gastrogastrostomy was not an effective weight-control operation. Both the Roux-en-Y gastrojejunostomy and vertical banded gastroplasty provided effective long-term weight control. Although the Roux-en-Y gastrojejunostomy gave slightly better weight control than the vertical banded gastroplasty, the more simple, safe, and physiological vertical banded gastroplasty is the procedure of choice for most patients with morbid obesity. PMID- 2757510 TI - The relationship of the abdominal aortic aneurysm to the tortuous internal carotid artery. Is there one? AB - During our investigation of the tortuous internal carotid artery in the presence of atherosclerosis, we noted a 44% incidence of abdominal aortic aneurysm. The incidence of abdominal aortic aneurysm in the adult population is 2% to 4%, and the incidence in a group of patients with carotid atherosclerosis has been reported to be 10%. This supports an association between the tortuous internal carotid artery and the abdominal aortic aneurysm independent of other risk factors. We found no significant difference in sex, age, or other atherosclerotic risk factors between those patients with and those without an abdominal aortic aneurysm. This suggests the possibility of weakness of the arterial wall as a cause of tortuous internal carotid artery and abdominal aortic aneurysm in this group of patients. Better histologic and biochemical definition of this possible weakness is warranted. From a clinical standpoint, we feel that the high association of the two conditions should not be ignored; patients found to have a tortuous internal carotid artery should be investigated and followed up carefully for the presence or subsequent development of aneurysmal degeneration of the aorta. PMID- 2757509 TI - Successful surgical treatment of idiopathic colonic dysmotility. The role of preoperative evaluation of coloanal motor function. AB - Identification of patients with severe idiopathic colonic dysmotility who would benefit from surgery can be difficult. Colonic transit studies and anorectal manometry were applied to 12 women with severe constipation before subtotal colectomy. Delayed transit was noted in all patients with most exhibiting left sided colonic arrest. Mean anal resting pressure and rectal capacity were similar to that in healthy controls. Pathologic examination results revealed decreased argyrophilic neurons in the colonic myenteric plexus. At 24 months postoperatively, all patients were satisfied with their results and mean (+/- SEM) weekly bowel movement frequency was 17 +/- 3 (compared with 0.8 +/- 0.2 preoperatively). Preoperative coloanal function studies therefore aid in the selection of patients who will be successfully treated by surgery. Subtotal colectomy with ileorectal anastomosis is the preferred operation because dysmotility can originate from either side of the colon. PMID- 2757511 TI - Venous reconstruction for iliofemoral venous occlusion facilitated by temporary arteriovenous shunt. Long-term results in nine patients. AB - In nine patients with iliofemoral venous occlusion, venous reconstructions using a temporary arteriovenous shunt were performed by open thromboendvenectomy with autogenous vein patch angioplasty in four, expanded polytetrafluoroethylene (ePTFE) bypass grafts (including two with external ring-supported ePTFE) in four, and Palma's procedure in one patient. There was an adequate function in the reconstructed venous segments in two of four who underwent thromboendvenectomy and in all four with ePTFE bypass grafting for nine months to 13 years after surgery. In those with a temporary arteriovenous shunt, prepared to maintain patency of the reconstructed venous segments, blood flow through the shunt exceeded 100 mL/min, determined by an electromagnetic flowmeter. Postoperative shunt closure was readily facilitated, using a looping technique and a 2-0 nylon. The increased blood flow through the graft made feasible by the temporary arteriovenous shunt enhanced the patency of the reconstructed venous graft and hence there was an improvement in the affected limb. PMID- 2757512 TI - Angioarchitectural classification of esophageal varices and paraesophageal veins in selective left gastric venography. AB - An improved radiographic classification of esophageal varices and paraesophageal veins was devised. Esophageal varices were divided into palisading and bar types. Paraesophageal veins were divided into intra-abdominal and thoracoabdominal types, with the latter being further subdivided into right-side-predominant and left-side-predominant types. The existence of the thoracoabdominal paraesophageal veins was significantly related to the preoperative endoscopic findings of the red sign and the form of the esophageal varices. Left-side-predominant paraesophageal veins were likely to drain the splanchnic blood flow to the hemiazygos vein. The largest grade of red sign was found in 88.9% of the patients with combination of bar type and intra-abdominal type and the largest form was in 88.9% of those with palisading and right-side thoracoabdominal types. The pressure gradients across the shunt were significantly lower in the right thoracoabdominal type than in others. Our study suggests that treatment be designed according to the vascular patterns of the lower esophagus. PMID- 2757513 TI - Iliac arterial transposition. AB - The surgical management of iliac arterial trauma remains a challenging problem with a perioperative mortality rate of 30%. The high mortality and postoperative complication rate is related to the hemorrhagic shock and multiple visceral injuries usually accompanying this vascular trauma. We feel prosthetic interposition grafts should be avoided in these frequently contaminated wounds. We use two approaches to iliac arterial transposition that restore vascular continuity following long-segment iliac injuries. These techniques eliminate the need for any interposition graft. They also reconstruct with native arterial tissue of similar diameter and vascular characteristics as the injured vessel. We advocate the use of iliac arterial transposition to manage iliac arterial injuries whenever it is anatomically feasible. PMID- 2757514 TI - Can the common bile duct drain into the fourth part of the duodenum? AB - An interesting case masqueraded as a case of the common bile duct entering the fourth part of the duodenum; this is an extremely rare anomaly. A review of the literature was performed. Surgeons should be cautioned about this anomaly with regard to operative procedures for treatment. PMID- 2757515 TI - Closed endarterectomy. Preferred operation for aortoiliac occlusive disease. AB - Closed endarterectomy using the LeVeen plaque cracker was performed on isolated, clamped segments of the unopened aorta, iliac, and femoral arteries. The results of this type of endarterectomy have been analyzed for 111 patients who were followed up from 2 1/2 to nine years. The five-year patency rate was 99%. After nine years, 96.5% of the vessels that underwent surgery remained functionally and radiographically patent. Closed endarterectomy is a substantial improvement over conventional open or half-closed endarterectomy. The closed endarterectomy takes less time, entails little or no blood loss, and is accomplished through a retroperitoneal approach. The aortofemoral bypass graft is inferior to the closed endarterectomy in morbidity, mortality, patency, and alleviation of impotence. Late complications with bypass grafts, using synthetic material, are more numerous and life-threatening. PMID- 2757516 TI - Migraineur, or migraineuse: a cheval of a different color? PMID- 2757517 TI - Permanent lithium-induced downbeating nystagmus. PMID- 2757518 TI - Warning headache in aneurysmal subarachnoid hemorrhage. PMID- 2757519 TI - Vascular dementia and dementia of Alzheimer-type cognition. PMID- 2757520 TI - Eye movements in acquired immunodeficiency syndrome. PMID- 2757521 TI - Polymyositislike syndromes in acquired immunodeficiency syndrome. PMID- 2757522 TI - Neurocysticercosis. PMID- 2757523 TI - Posterior cortical atrophy: a new clinical entity, or Alzheimer's disease? PMID- 2757524 TI - DNA synthesis in Alzheimer type II astrocytosis. The question of astrocytic proliferation and mitosis in experimentally induced hepatic encephalopathy. AB - Hepatic encephalopathy is associated with development of Alzheimer type II astrocytosis consisting of large, pale, frequently paired astrocytic nuclei. Previous studies have suggested that the paired forms are a manifestation of astrocytic proliferation and that the two nuclei of paired forms are in separate cells and have an equal (diploid) DNA complement. A model of hepatic encephalopathy can be produced using methionine sulfoximine to inhibit irreversibly the enzyme glutamine synthetase, resulting in elevated brain ammonia levels and development of Alzheimer type II astrocytosis. Using this model Sprague-Dawley rats were simultaneously injected with methionine sulfoximine 300 mg/kg and tritiated thymidine 15 mCi/kg. Autoradiography of cerebral sections from animals killed 18 to 36 hours after the injection revealed many heavily labeled cortical Alzheimer type II astrocytic nuclei. These findings are consistent with DNA synthesis and mitotic division of Alzheimer type II astrocytes. PMID- 2757525 TI - Brief loss of consciousness in bilateral carotid occlusive disease. AB - Loss of consciousness is rare in the absence of transient or persistent insult to the diencephalon or mesencephalon. We found three patients with severe atherosclerotic stenosis or occlusion of both internal carotid arteries who experienced brief loss of consciousness. Common characteristics were the absence of clinical or electroencephalographic seizure activities, significant cardiovascular disease, or a history suggestive of vasovagal syncope. Angiographically, the patients had widely patent vertebrobasilar circulation and collaterals from vertebrobasilar to carotid circulation. Episodic loss of consciousness disappeared after carotid endarterectomy. We concluded that bilateral hemispheric ischemia caused brief loss of consciousness, but selective focal ischemia in the subcortical structures superimposed on widespread bihemispheric ischemia may have been responsible. Since loss of consciousness is rare in carotid occlusive diseases, systemic and vertebrobasilar causes must be carefully ruled out in each instance. PMID- 2757526 TI - Hemiballism-hemichorea. Clinical and pharmacologic findings in 21 patients. AB - In this series of 21 patients with hemiballism-hemichorea we found an identifiable cause in all. Unlike most other studies in which stroke was the most important cause of the movement disorder, in almost half (10 of 21) of our patients some other cause was found. Hemiballism-hemichorea was often the presenting feature of underlying medical disease. Besides the subthalamic nucleus, other subcortical structures may be involved in the pathogenesis of this hemihyperkinesia. While the movement disorder often improves spontaneously or with pharmacologic therapy, the underlying disease may result in serious consequences. PMID- 2757527 TI - Neurophysiological evidence of auditory channel anomalies in developmental dysphasia. AB - Steady-state auditory evoked responses to frequency-modulated tones were obtained from normal children and two groups of children with developmental language disorders (developmental dysphasia). Children with predominantly expressive language impairment produced responses not different from normal children, while children with primary receptive language impairment produced responses that were markedly diminished, even absent. This occurred in recordings from either cerebral hemisphere and at mean frequency-modulation depths ranging from +/- 20 to +/- 100 Hz. Pathophysiology of auditory mechanisms concerned with frequency modulation analysis are particularly associated with receptive developmental language impairment and may underlie associated difficulties in speech perception. PMID- 2757528 TI - Chronic inflammatory demyelinating polyradiculoneuropathy. Clinical characteristics, course, and recommendations for diagnostic criteria. AB - Over a 10-year period, we followed up 60 patients (35 men and 25 women) with chronic inflammatory demyelinating polyradiculoneuropathy. Diagnosis was based on previously outlined criteria. Patients were treated in a uniform manner and the overwhelming majority, 56 (94.9%) of 59 treated patients, initially responded to immunosuppressive therapy. The time for initial improvement was 1.9 +/- 3.6 months while the time to reach a clinical plateau was 6.6 +/- 5.4 months. The course was monophasic in 32 patients (53.3%) and relapsing in 28 (46.6%). Despite the initial responsiveness, only 24 (40%) of 60 patients are in partial or complete remission, receiving no medication. Two patients died. We were unable to identify specific clinical or laboratory features at the time of diagnosis that predicted outcome. Our data analysis, along with previous reports, suggests that chronic inflammatory demyelinating polyradiculoneuropathy may be more heterogeneous than previously emphasized. In this light, we have proposed diagnostic criteria that allow for the heterogeneity but at the same time provide for a more consistent approach to better establish the natural history of this condition. PMID- 2757529 TI - Distributed anatomy of transcortical sensory aphasia. AB - We examined four patients with transcortical sensory aphasia and eight with milder language disturbances but with similar thalamic and/or temporo-occipital lesions. Specific attention was paid to differentiation of the computed tomographic lesion site of the milder cases from the transcortical sensory aphasia cases. The critical lesion for transcortical sensory aphasia in these patients involved pathways in the posterior periventricular white matter adjacent to the posterior temporal isthmus, pathways that are probably converging on the inferolateral temporo-occipital cortex. Analysis of the language function of these patients, of the influence of sensory modalities on language function, and of the interaction between semantic memory and semantic lexical functions suggests the existence of a specific brain system for semantic functions. This semantic system has a particular distributed anatomy. We propose that damage to this system may have a variety of clinical manifestations in language and in memory, depending on the exact lesion configuration. PMID- 2757530 TI - Neurosyphilis in acquired immunodeficiency syndrome. AB - In a retrospective study encompassing 42 months (January 1984 through July 1987), 12 patients were identified as having both neurosyphilis and acquired immunodeficiency syndrome. These patients constituted 44% of the entire group meeting rigorous diagnostic criteria for neurosyphilis and 1.5% of all patients hospitalized with acquired immunodeficiency syndrome. The typical patient with acquired immunodeficiency syndrome and neurosyphilis was young (mean age, 37 years) and male (83%). All had serological evidence of syphilis in both blood and cerebrospinal fluid. Syphilitic eye disease was surprisingly common in this group, occurring in 5 (42%). Four patients (33%) had been previously treated for syphilis. In 2, treatment for latent syphilis had been completed 3 and 5 months, respectively, before neurosyphilis was documented. Neurosyphilis is not uncommon in patients with acquired immunodeficiency syndrome in our population. In light of its diverse manifestations, syphilis should be considered in the differential diagnosis of any human immunodeficiency virus type 1-infected individual presenting with neurological, psychiatric, or ophthalmological disease. PMID- 2757531 TI - Prolongation of the P-300 latency associated with hydrogen sulfide exposure. AB - Three patients exposed to hydrogen sulfide developed persistent cognitive impairment, as suggested by the P-300 event-related potential and measured by neuropsychological testing. Routine neurological and physical examinations were unremarkable, although the patients were sufficiently impaired so as to be unable to work. The P-300 event-related potential and neuropsychological testing proved to be important in the detection of cognitive dysfunction following acute hydrogen sulfide exposure. The three patients with neurocognitive dysfunction were acutely exposed to hydrogen sulfide. The incidents occurred independently and under different circumstances. Each patient was evaluated at the Northern California Occupational Health Clinic, San Francisco, examined neurologically and neuropsychologically, and evaluated with a P-300 event-related potential. Each patient had persistent neurological symptoms, neuropsychological deficit, and abnormally prolonged P-300 latencies. PMID- 2757532 TI - Procedural memory during posttraumatic amnesia in survivors of severe closed head injury. Implications for rehabilitation. AB - To investigate the possibility that learning of skills (ie, procedural memory) is preserved during posttraumatic amnesia, 16 amnesic survivors of severe closed head injury and 16 control subjects were studied. Procedural learning tasks included mirror reading, mazes, and a pursuit rotor task that involved tracking a rotating target. Declarative memory was assessed by testing recognition of the words used in mirror reading and a questionnaire concerning details of the previous testing session. Learning was evaluated on 3 consecutive days and a fourth session was scheduled after resolution of posttraumatic amnesia. Despite stable impairment of declarative memory during posttraumatic amnesia, the performance of head-injured patients improved across sessions on all procedural tasks and showed transfer to testing after resolution of posttraumatic amnesia. PMID- 2757533 TI - Cerebral disconnection in multiple sclerosis. Relationship to atrophy of the corpus callosum. AB - Left ear suppression to dichotically presented verbal stimuli has been observed in patients with multiple sclerosis (MS). Rubens and coworkers have suggested that a disconnection of the auditory callosal pathways may account for this finding. To examine this proposal, we compared the performance of 28 MS patients with significant corpus callosum atrophy (CCA) on midsagittal magnetic resonance scans, 16 MS patients without significant CCA, and 64 demographically matched normal control subjects on two laterality tasks: verbal dichotic listening (consonant-vowel syllables) and tachistiscopic object-naming latency. Results indicated that left ear suppression was found only in the MS patients with CCA. Likewise, patients in the MS group with CCA were slow in responding to stimuli presented in the left visual field; this effect was not observed in patients without CCA. These findings support the hypothesis that efficiency of cross callosal information flow is reduced in MS patients with CCA. PMID- 2757534 TI - Sodium and water regulation in a patient with cerebral salt wasting. AB - Hyponatremia, in patients with central nervous system disease, can be attributable to impaired free water excretion (syndrome of inappropriate secretion of antidiuretic hormone) or to excessive sodium excretion (cerebral salt wasting). We present a patient with a parietal glioma and hyponatremia characterized by salt wasting and dehydration. Rehydration and sodium repletion corrected the sodium and volume deficits; withdrawal of supplemental sodium resulted in recurrence of dehydration and hyponatremia. We determined sodium and water balance and measured plasma atriopeptin, antidiuretic hormone, and aldosterone. Plasma atriopeptin ranged from 8 to 44 pg/mL (normal, less than 45 pg/mL); antidiuretic hormone was not elevated at 4 to 5 pg/mL, and aldosterone was slightly elevated at 1040.25 pmol/L. The concentrations of these hormones could not directly explain the natriuresis; interactions with neural or other humoral factors may be involved. In evaluating such patients, careful attention to sodium and water balance is important to guide appropriate therapy. PMID- 2757535 TI - The facial nerve in eyelid surgery. PMID- 2757537 TI - Importance of computer information systems. PMID- 2757536 TI - Modification of lacrimal probe facilitates silicone intubation. PMID- 2757538 TI - Corneal damage from improperly cleaned tonometer tips. PMID- 2757539 TI - Intact Bell's phenomenon in a patient with myasthenia gravis and upward gaze paresis. PMID- 2757540 TI - Unilateral arcus lipoides corneae with traumatic cyclodialysis in two patients. Case report. PMID- 2757541 TI - Idiopathic sclerochoroidal calcification. Case report. PMID- 2757542 TI - Initiation of amblyopia treatment in monocular congenital cataracts. PMID- 2757543 TI - How exposed are we? Is there a better way? PMID- 2757544 TI - Clinical risk factors for proliferative vitreoretinopathy. AB - We reviewed the records of all patients with rhegmatogenous retinal detachments examined and treated by a single surgeon (B.P.C.) at the University of Virginia, Charlottesville, between 1978 and 1984. Of the 607 eyes that satisfied the selection criteria, a preliminary chart review of outcomes found that 65 (10.7%) had proliferative vitreoretinopathy and 34 had macular puckers. From the remaining 508 eyes, 325 controls were randomly selected to match each case from within a time window. Thirty-six (55.4%) of the 65 patients with proliferative vitreoretinopathy had had unequivocal reattachment after a single procedure before the onset of proliferative vitreoretinopathy, and the only clearly identified technical difficulty that was significantly more common in the patients with proliferative vitreoretinopathy was the inability to identify a retinal break. Several other features of the rhegmatogenous retinal detachments that correlated with the development of postoperative proliferative vitreoretinopathy were identified, and stepwise discriminant analysis was used to ascertain which of these were more important. The strongest predictor was use of vitrectomy in management of the detachment. Following this in order of importance were the presence of preoperative proliferative vitreoretinopathy, preoperative choroidal detachment, and the amount of cryopexy required. Vitrectomy remained a strong predictor even when considered after adjustment for all other characteristics. These data suggest that proliferative vitreoretinopathy is not simply an iatrogenic disease, but it is more likely to occur in association with certain detachment features that either by themselves or through their management require prolongation of the retinal wound healing process. PMID- 2757545 TI - New and previously unidentified retinal breaks in eyes with recurrent retinal detachment with proliferative vitreoretinopathy. AB - The location of retinal breaks found on preoperative examination was studied in 68 eyes of 68 patients with recurrent retinal detachment and proliferative vitreoretinopathy. Twelve eyes had 23 open breaks that were known to exist previously, no open break was detected in 18 eyes, and 72 new or previously unidentified breaks were found in 41 eyes. Forty-seven (65.3%) of the 72 breaks were located on previous buckles, and 31 of these were on the posterior slope of the buckle. Twenty-nine (40.2%) of all new or previously unidentified breaks were on the border of a cryopexy-induced chorioretinal scar, and of these, 25 breaks (86%) were on the posterior slope of the buckle. Our results indicate that the retina that borders chorioretinal scars is vulnerable and prone to develop retinal tears secondary to traction from preretinal membranes. The vicinity of cryopexy-induced scars should be closely observed for retinal breaks in cases of recurrent retinal detachment with proliferative vitreoretinopathy. PMID- 2757546 TI - Epidemiology of ocular herpes simplex. Natural history in Rochester, Minn, 1950 through 1982. AB - In the period 1950 through 1982, there were 294 episodes of ocular herpes simplex virus infection in 151 residents of Rochester, Minn. Recurrence rates assessed by life-table methods after the first episode were 9.6% at 1 year, 22.9% at 2 years, and 63.2% at 20 years. Recurrence rates appeared to rise following repeated episodes. Ocular herpes simplex affecting both eyes at the same and/or different episodes was seen in 18 patients (11.9%). One fifth of patients had lid involvement alone, while a third had solely superficial corneal involvement. Deep corneal disease or uveitis was relatively uncommon. Therapy during the early period was varied, but significant complications were uncommon. Ninety percent of the eyes maintained visual acuity of 20/40 or better. The economic impact, measured in terms of days of active disease and physician visits, was substantial. PMID- 2757547 TI - Cigarette smoking and risk of nuclear cataracts. AB - The current study was undertaken to assess the relationship of smoking to the risk of lens opacities. The risk was evaluated separately for nuclear and cortical opacities and for both types together. We studied 838 watermen in Maryland by detailed ocular examination for the presence and severity of each cataract type. All subjects were interviewed regarding smoking history, and a cumulative smoking dose was calculated. The results suggest a significantly increased risk of pure nuclear opacities associated with cigarette smoking. The increase in smoking dose was associated with increasing severity of nuclear opacity. The risk of nuclear opacities increased with increasing cigarette dose and decreased if the subject had quit smoking. The effect of smoking was most striking in those less than 80 years old. No increased risk of nuclear opacities was observed with earlier age when smoking started, after adjusting for dose and cessation of smoking. Further investigations are warranted on the biochemical and physical damage to the nucleus of the lens from smoking cigarettes. PMID- 2757548 TI - Cryotherapy for trichiasis in trachoma. AB - Trichiasis secondary to trachoma was treated in 137 eyelids from 64 patients in Saudi Arabia. Cryotherapy with high-flow nitrous oxide was applied to the lid margin for 45 seconds in a freeze-thaw-freeze cycle. The success rate of treated eyelids was 56% after one treatment and increased to 90% after a second treatment. Hypopigmentation of the highly pigmented eyelids of the Saudi population was our most significant complication (8% of treated lids). Because cryotherapy is portable and cost-effective and can be administered by paramedical personnel, it is ideal for use in regions where trachoma is endemic. PMID- 2757549 TI - Ab interno sclerostomy with a high-powered argon endolaser. Clinicopathologic correlation. AB - A high-powered argon blue-green laser coupled to a 300-microns quartz fiberoptic probe was used to create an ab interno sclerostomy in a patient undergoing enucleation for a blind painful eye. Despite the presence of diffuse rubeosis, 360 degrees peripheral anterior synechiae, and superior conjunctival scarring, it was possible to create a full-thickness defect from the anterior chamber angle to the subconjunctival space without operative complications. Six laser applications were required using 8 W of power per pulse and 0.1-second pulse duration. The eye was enucleated immediately after the laser procedure, prepared for light microscopy, and sectioned serially. Histologic analysis demonstrated a patent fistula approximately 300 microns in diameter with sharp wound margins. Tissue damage was localized to within 150 microns of the sclerostomy. The overlying conjunctiva was intact. PMID- 2757550 TI - The use of fluorescein-conjugated lectins for visualizing atypical mycobacteria. AB - We investigated the feasibility of using fluorescein-conjugated lectins for visualizing and differentiating two species of atypical mycobacteria. Pure cultures of Mycobacterium fortuitum and Mycobacterium chelonei were established, as was an experimental model of infectious keratitis involving these two organisms. Samples from the pure cultures and corneal scrapings were placed on glass slides, fixed, and incubated with one of a panel of 22 fluorescein conjugated lectins. The slides were examined using an epifluorescence microscope. Fluorescein-conjugated concanavalin A brightly stained both species of atypical mycobacteria, in both the pure culture and experimental keratitis samples. Several additional fluorescein-conjugated lectins (wheat germ agglutinin, succinylated wheat germ agglutinin, Phaseolus vulgaris erythroagglutinin, and Psophocarpus tetragonolobus agglutinin) brightly stained M chelonei, but only moderately stained M fortuitum. These staining patterns are consistent with the known carbohydrate compositions of the cell walls of atypical mycobacteria and suggest that fluorescein-conjugated lectins may be useful for the visualization of these organisms in corneal infections. PMID- 2757551 TI - Spontaneous canine keratoconjunctivitis sicca. A useful model for human keratoconjunctivitis sicca: treatment with cyclosporine eye drops. AB - Thirty-six sequential cases of canine keratoconjunctivitis sicca (KCS) were treated with ophthalmic cyclosporine. The effects of topical cyclosporine were twofold: (1) cyclosporine increased tear production by 5 mm/min or greater in all cases of spontaneous KCS having an initial Schirmer's Tear Test value greater than 2 mm/min and in 59% of eyes with an initial Schirmer's Tear Test value of 0 to 2 mm/min, and (2) cyclosporine caused marked regression of chronic corneal neovascularization and granulation even in eyes in which lacrimation failed to improve. Additional benefits of topical cyclosporine were reduced mucopurulent conjunctivitis, rapid healing of nonhealing corneal ulcers, and reduced dependence on frequent topical treatments of KCS. Twelve normal beagles treated with topical cyclosporine also had a reversible increase in lacrimation compared with baseline or placebo control-treated dogs. PMID- 2757552 TI - Retinal reattachment by continuous vitreous insufflation. AB - Intraocular gas bubbles can occlude retinal breaks and lead to retinal reattachment, but inferior breaks can be difficult to occlude. We hypothesized that an automated air injector connected to the eye would progressively fill the vitreous cavity with a bubble and occlude all, even inferior, breaks. This technique, termed continuous vitreous insufflation, was applied in 30 eyes of 15 rabbits using an air pressure of 50 mm Hg. Thirteen study eyes underwent lensectomy, vitrectomy, and rhegmatogenous retinal detachment; 17 eyes did not. In each eye with a patent cannula, a bubble virtually filled the vitreous cavity within about 24 hours, and all detached retinas became reattached except those with large breaks. Because large bubbles should be effective in closing most breaks, continuous vitreous insufflation may enable high reattachment rates. Accordingly, this procedure may prove valuable in treating certain retinal detachments in humans, although there are obstacles to clinical application. PMID- 2757553 TI - Structural proteins of the neonatal and adult lamina cribrosa. AB - Optic nerve heads from three premature infants and six adults were studied immunohistochemically to compare the extracellular proteins in the lamina cribrosa of young and old human eyes. In both age groups, antibodies to the basement membrane components laminin and collagen type IV were associated with blood vessels and laminar beam margins. In the adult eyes, interstitial collagen types I and III were heavily distributed within the laminar beams. Antibodies to fibrillin, the microfibrillar portion of elastin, labeled discrete, heavy bands oriented longitudinally within these beams. The beams of the neonatal lamina cribrosa contained much less interstitial collagen, with a predominance of collagen type III. Neonatal elastic tissue bands were less numerous and distinct within the laminar beams. These biochemical differences between the young and old lamina cribrosa may, in part, explain different clinical behaviors of the optic nerve head in congenital and adult glaucoma. PMID- 2757554 TI - The extracellular matrix of the human optic nerve. AB - The nerve fibers of the optic nerve are enclosed and segmented by extracellular matrix. With immunostains, we localized collagen types I through VI, laminin, and fibronectin in frozen sections of the extracellular matrix of the prelaminar, laminar, and retrolaminar human optic nerve. The internal limiting lamina of the optic nerve has an extracellular composition similar to the thicker adjacent retinal internal limiting lamina. We confirmed that the lamina cribrosa contains type IV collagen and laminin, whereas the sclera does not. The septa of the retrolaminar optic nerve appear as vascular inward extensions of the pia mater. The glial tube that lines the optic nerve extends forward from the retrolaminar optic nerve through the lamina cribrosa to end anteriorly at the retinal pigment epithelium. It does not separate the optic nerve from the adjacent sensory retina. PMID- 2757555 TI - Accuracy and precision of keratometry, photokeratoscopy, and corneal modeling on calibrated steel balls. AB - Surgical manipulation of corneal shape requires an accurate and precise method of measuring anterior corneal curvature from apex to limbus. We evaluated the accuracy and precision of the Bausch & Lomb Keratometer, Kera Corneascope, and Computed Anatomy Corneal Modeling System by measuring comparable locations on four calibrated steel test balls. The Keratometer and Corneal Modeling System were more accurate and precise than the Corneascope. No statistically significant difference was found between the Keratometer and Corneal Modeling System with respect to accuracy or precision. In addition, the accuracy and precision of all 31 rings of the Corneal Modeling System were studied. Rings 2 through 26 were read accurately and precisely within +/- 0.25 diopter on three of the four balls. Values on the steepest ball were within +/- 0.37 diopter. PMID- 2757556 TI - Primary malignant melanoma of the lacrimal sac. PMID- 2757557 TI - Use of sodium hyaluronate for the repair of giant retinal tears. AB - Sodium hyaluronate (Healon) was used in conjunction with pars plana vitrectomy and scleral buckling to manage unilateral giant retinal tears of 180 degrees or more with severe folding in six consecutive cases. In each instance the retina was successfully flattened, and five of the six have remained so for at least one year. The technique enables the surgeon to unroll a retinal flap that is markedly inverted on itself and oppose it to the underlying retinal pigment epithelium. PMID- 2757558 TI - An alarm system to indicate air-fluid level in the irrigating bottle. AB - I have developed an alarm system to indicate the air-fluid level in the irrigating bottle. This system warns the operating personnel before complete loss of infusion fluid occurs. PMID- 2757559 TI - Clinical and histopathological considerations for the diagnosis and treatment of verrucous carcinoma of the larynx. AB - Verrucous carcinoma of the larynx is quite distinct from well-differentiated squamous cell carcinoma has a characteristic morphology and specific clinical behavior. It accounts for approximately 1%-2% of all laryngeal carcinomas. However, difficulties are encountered clinically in separating verrucous carcinomas from keratoses, verruca vulgaris and squamous cell carcinomas with a verrucous appearance. Between 1962 and 1982, 1504 patients with squamous cell carcinomas of the larynx were diagnosed and treated by staff physicians in the Department of Otolaryngology--Head and Neck Surgery, Washington University in St. Louis. Fifteen of these patients (1%) had verrucous carcinomas. These cases were studied in order to clarify any diagnostic problems, trace the biologic behavior of the tumors and report the results of the treatment used. Of these 15 patients, we were able to follow up 8. The latter had been treated only with surgery and none of them had received radiotherapy. One death occurred, but the patient died of other causes and remained free of cancer. Reports in the literature describe a high rate of recurrence of verrucous carcinomas following radiotherapy with occasional anaplastic transformation of tumors. No patients in our series developed a metastasis in the neck, indicating that neck dissection is not justified for patients with these neoplasms even though clinically enlarged neck nodes may be present. PMID- 2757560 TI - Prostaglandin content in human middle ear effusions. AB - The concentrations of prostaglandins (PGs) were measured by a radioimmunoassay in human middle ear effusions (MEEs) obtained from patients with otitis media with effusions. Each sample of MEE was divided into two groups: serous effusions and mucoid ones. The main PG in both the serous and mucoid effusions was TXB2 (375 and 857 pg/ml, respectively), followed by PGE2 (173 and 459 pg/ml, respectively). Smaller quantities of PGD2 (35 and 64 pg/ml, respectively), PGF2 alpha (139 and 183 pg/ml, respectively), and 6ketoPGF1 alpha (129 and 201 pg/ml, respectively) were also found in the MEEs. The amounts of each PG in the mucoid effusions were 2 or 3 times higher than those found in the serous effusions, while protein concentrations and the profile of these PGs in the MEEs were almost the same in the mucoid and serous groups. These results suggest that PGs may play an important role as a mediator of the inflammatory responses in the pathogenesis of MEEs. PMID- 2757561 TI - Pure-tone hearing thresholds in otologically healthy 5-year-old children in Finland. AB - We measured the pure-tone air and bone conduction hearing of 359 randomly selected otologically normal urban preschool children in Finland at the average age of 5.2 years. Children with otoscopically verified middle ear pathology or abnormal impedance audiometry were not included in this sample. The mean air conduction thresholds varied from 16.6 dB at 0.125 kHz to 6.6 dB at 2 kHz, and the mean bone conduction thresholds from 6.0 dB at 0.25 kHz to 0.7 dB at 4 kHz. The pure-tone average (of air conduction thresholds at 0.5, 1 and 2 kHz) of all the ears was 7.6 dB. The distribution of single air conduction hearing thresholds at the frequencies from 0.25 kHz to 4 kHz showed that 66%-75% were at the 5-10 dB level. PMID- 2757562 TI - Observations of cochlear blood flow dynamics using the laser Doppler flowmeter. AB - The cochlear blood flow of normal adult guinea pigs was measured by a laser Doppler flowmeter. The validity of this flowmeter was ascertained by its specificity for blood flow and its sensitivity to blood flow changes. Angiotensin II was infused into the animals and asphyxia was induced. The responses of the cochlear blood flow showed a close correlation with those of the systolic blood pressure. These results suggest a passive aspect in the physiology of cochlear blood circulation. On the other hand, there was a negative correlation between the responses of auricular skin blood flow and those of systolic blood pressure to a certain dose range of angiotensin II. To clarify the specific details of inner ear blood flow, further studies of the hemodynamics of the inner ear blood circulation should be continued under various experimental conditions. PMID- 2757563 TI - An immunohistochemical method for the study of aminoglycoside ototoxicity in the guinea pig cochlea using decalcified frozen sections. AB - An immunohistochemical technique with decalcified frozen sections was used to study aminoglycoside ototoxicity. Decalcified guinea pig cochleas were cut with a fine blade parallel to the plane of the modiolus to facilitate the penetration of inclusion material and the manipulation of frozen sections. Light microscopy was carried out and additional frozen sections were employed for an immuno-electron microscopic study. Twenty-four hours after a single transtympanic injection of 10 mg gentamicin, there was a definite distribution of the drug in only type I hair cells of the ampullae as well as in both inner and outer hair cells along the length of the cochlea. In those animals treated intraperitoneally with 200 mg/kg amikacin for 8 days, the drug was located in the outer hair cells of the cochlea, with a tendency to decrease from base to apex and in the inner hair cells towards the apex. PMID- 2757564 TI - Use of the subrenal capsule assay to measure antibody-dependent, cell-mediated cytotoxicity against head and neck tumors. AB - Experience with antibody-dependent, cell-mediated cytotoxicity (ADCC) has shown that antibody can increase the localization and killing capacity of lymphocytes. We tested the possibility of improving the activity of lymphokine-activated killer cells (LAK) on human tumor using the subrenal capsule assay in nude mice. The tumors were first grown in the renal capsule space and the effector cells injected later. In the model experiment we used M21 melanoma and monoclonal antibody against melanoma-associated antigen GD3. This antibody increases the tumor inhibitory activity of LAK cells from healthy donors in comparison to LAK alone. We have been able to prove the clinical relevance of such an approach. Tumor bioptic material from five tumor patients was tested with various monoclonal antibodies, following which the highly reactive antibodies were selected and incubated with the patient's LAK cells. Such pretreated LAK cells have a high growth-inhibitory effect on autologous tumor growing in the renal capsule space of the test mice. PMID- 2757565 TI - Encapsulated nerve corpuscles in the human tympanic membrane. AB - Encapsulated nerve endings were found in both the subepidermal connective tissue and the lamina propria of a human tympanic membrane. The structure of the corpuscles was round or oval and contained a number of axon terminals with mitochondria and Schwann cell processes. Amorphous materials were present in the intercellular space. These features appear to be advantageous in transmitting mechanical forces on the capsule to the axon terminals and are comparable to the function of a mechanoreceptor. Resultant changes in the shape and stiffness of the tympanic membrane as the result of its dislocation indicate similar changes in the pressure on the corpuscle. The arrangement of the sensory corpuscles suggests that they may play a role in detecting pressure changes in the middle ear cavity. PMID- 2757566 TI - [Cardiac involvement of alcoholics and the effect of total abstinence]. AB - Echocardiographic features of 221 alcoholics after total abstinence were investigated. At the time of admission, none demonstrated left ventricular (LV) enlargement. Noticeably, 26% patients out of the total showed LV wall thickening more than 1.4 cm in the interventricular septum. On the other hand, 19% of the alcoholics illustrated hypokinetic LV wall without chamber dilatation which was either less than 55% in ejection fraction or 30% in fractional shortening. Three months later, the LV wall thickness reduced significantly from 1.6 to 1.4 cm in average and the LV wall motion improved significantly from 27 to 31% in fractional shortening. In the cases with wall thickening, the change was well correlated with a decrease both in heart rate and in LV muscle volume, but not with a decrease in systemic blood pressure. No significant correlated factors could be detected in the hypokinetic cases. PMID- 2757568 TI - Neuropathological study of the nucleus basalis of meynert in alcoholic dementia. AB - Intellectual impairment and mental disorders occurring in association with long periods of alcohol abuse are often irreversible; those persons who have difficulty leading normal daily lives because of such disorders are considered to have alcoholic dementia. We investigated this condition from the standpoint of pathomorphology. The subjects were nine autopsy cases of alcoholic dementia; three alcoholic autopsy cases of about the same age level but without dementia were also studied as a control group. In these two groups, the nucleus basalis of Meynert in the substantia innominata was selected as fixed site and nerve cells were counted; strict anatomical measurements were performed on this fixed site, and every effort was made to minimized artifacts in each case. The nucleoli of the nerve cells at this site were calculated in a fixed area on the basis of a fixed magnification; this was repeated in serial sections, and the number of nerve cells on a fixed volume was thus obtained. The "t" distribution test within the two groups was investigated; a probability value of less than 0.05 was obtained and the null hypothesis abandoned. Mean values were found to be different. The results obtained were compared with those found in literature, and important findings concerning lesions in alcoholic dementia were noted. PMID- 2757567 TI - [Clinical study on alcoholic pancreatitis in alcoholics (especially in ERP findings)]. AB - The pancreatic functions (PFD test and 75g GTT), pancreatic enzymes (serum amylase, urine-amylase, serum-elastase I and serum-lipase), alcohol consumption histories, clinical symptoms, histological findings in the liver and ERP findings have been examined in 66 alcoholic patients. Fourty two out of 66 cases (64%) showed abnormal ERP findings which were compatible with chronic pancreatitis. But among these 42 cases, only 9 cases (21%) showed clinical symptoms such as epigastralgia, back pain, diarrhea and emaciation which suggest the existence of chronic pancreatitis. The degree of liver damage, alcohol consumption have no significant correlation with ERP findings. Furthermore, the severe alcoholic pancreatitis occurred in patients having mild liver injury more than those having severe liver injury such as cirrhosis. And the data of pancreatic functions and enzymes could not confirm ERP findings especially in patients with mild and moderate pancreatic injury when compared to normal ERP findings. We concluded that asymptomatic alcoholic pancreatitis occurred more frequently in painless alcoholic. It may be not suitable for only using the normal pancreatic functions test to diagnose the alcohol induced chronic pancreatitis. PMID- 2757569 TI - A study on death of alcoholics. AB - Out of 1,195 alcoholics treated in a psychiatric hospital during 1974-1986, 150 patients who died were examined. In 150 subjects, 86 natural deaths and 53 violent deaths were observed. Alcoholics who died from violent causes were hospitalized 10 years earlier and also died 10 years earlier than those of natural causes on the average. Furthermore, they failed more frequently to improve their drinking habits and their deaths tended to occur immediately after discharge. They were often single and of low economic status, and these social factors were considered to be closely related to their violent death. PMID- 2757570 TI - Vaginal delivery in first pregnancy following a primary caesarean section. AB - A retrospective study was performed on 131 women who had trial of scar in their first pregnancies following a primary caesarean section. The vaginal delivery rate was 81.7% and this rate was not significantly influenced by the indication for the previous caesarean section. It is advocated that patients for trial of scar should be selected on individual merits rather than on the nature of the indication for previous caesarean section. PMID- 2757571 TI - Cervical mucus prolactin levels in normal fertile and infertile women. AB - Cervical mucus and serum samples were obtained from 42 anovular women and 20 normal ovular fertile women (controls) for the determination of prolactin concentration by a solid phase radioimmunoassay. The former group was subgrouped into 14 galactorrhoeic (9 with oligohypomenorrhea and 5 with amenorrhea) and 28 non-galactorrhoeic (19 with oligohypomenorrhea and 9 with amenorrhea). The level of prolactin in cervical mucus of normally menstruating women was significantly higher than that of serum at P less than 0.0125 (11.68 +/- 0.77 ng/ml and 16.09 +/- 1.65 ng/ml, mean +/- SE, respectively). Serum prolactin level in galactorrhoeic amenorrhea cases was 8.2 times that of controls, while cervical mucus prolactin amounted to 32 times its control value. The rise of cervical mucus prolactin in cases of galactorrhea oligohypomenorrhea was 21 times its control value which is markedly higher than that of serum (1.9 times). The average rise of serum prolactin in the whole group of galactorrhea with abnormal menstrual function was about 4 times the control value, while the average rise of cervical mucus prolactin was about 41 times the corresponding control value. In the cases of galactorrhea with menstrual dysfunction, serum prolactin level may be normal in 50% of cases, while cervical mucus prolactin is strikingly elevated in 100% of cases. The possibility of pituitary adenoma should be considered if the level of serum or cervical mucus prolactin exceeds 100 ng/ml and 600 ng/ml respectively. The possible physiological role of cervical mucus prolactin and its source are discussed. PMID- 2757572 TI - A study of drug efficacy in the treatment of ovarian cancer. AB - One hundred and nine cases of common epithelial ovarian cancer treated in our department during the past decade were entered into this study, which dealt with direct therapeutic effects and prognosis, comparing the groups administered cisplatin with those administered other anticancer drugs. 1) In 38 patients with measurable lesions, high response rates were achieved through the administration of anticancer drugs containing cisplatin in both the primary cancer and recurrent cancer groups. 2) Preventive chemotherapy was performed in patients in whom complete surgery was achieved at the initial operation. No significant difference in prognosis was observed through the administration of cisplatin and other anticancer drugs. 3) In patients in whom reduction surgery was carried out to the maximum possible degree at the initial operation, an improvement in prognosis was observed through the administration of cisplatin. These results imply that a cisplatin-based regimen should be aggressively used, except in cases that underwent complete debulking surgery. PMID- 2757573 TI - Recurrent pancreatitis in the third trimester in 2 consecutive pregnancies--its relationship to liver histology: a case report. AB - A 20-year-old woman who had recurrent pancreatitis in the third trimester in 2 consecutive pregnancies was reported. Her liver histology was indistinguishable from acute fatty liver of pregnancy, although she showed no clinical signs. The relationship between idiopathic acute pancreatitis during pregnancy and acute fatty liver of pregnancy was discussed. PMID- 2757574 TI - Intrauterine insemination with washed capacitated sperm cells in the treatment of male factor, cervical factor and unexplained infertility. AB - One hundred and fourteen couples with long standing infertility due to male factor, cervical factor and unexplained infertility were admitted for therapeutic trials with intrauterine insemination of washed, capacitated husband's sperm cells between May 1986 to October 1987 at The Egyptian IVF-ET Center, Cairo, Egypt. Three hundred and sixty-four trials were done (an average of 3.19 trial per patient). Fifty-eight patients got pregnant (16% pregnancy rate per trial). This simple and noninvasive procedure can be considered as an alternative treatment for infertility due to male factor, cervical factor, and unexplained infertility. PMID- 2757575 TI - Grandmultiparity: a continuing problem in developing countries. AB - Four hundred and thirty-one grandmultiparae and 1,070 less parous women who delivered at Civil Hospital, Karachi over a 2-year period (Jan. 1982 to Dec. 1983) have been reviewed retrospectively. The purpose was to estimate the incidence of grandmultiparity at this hospital and compare the incidence of obstetric and medical complications in the grandmultiparae with the less parous women. A higher incidence of anaemia, spontaneous abortions, abruptio placentae, postpartum haemorrhage, spontaneous uterine rupture and fetal loss was found in the grandmultiparae compared with other parturients. The grandmultipara continues to be a "high-risk" obstetric problem. PMID- 2757576 TI - Contragestive effects of the antigestagenic agent, RU486, in rats and rabbits. AB - The contragestive effects of the antiprogesterone RU486 in pregnant rats and rabbits were investigated. Administrations of increasing doses of RU486 in intact or castrated pregnant rats induced abortion in a dose dependent manner. RU486 had less effect when administered on the 16th day of gestation. Antiestrogens (tamoxifen, clomiphene citrate), an inhibition of 3 beta-hydroxysteroid dehydrogenase (epostane) showed a synergistic effect when used in combination with RU486. A decrease in serum progesterone levels was observed after RU486 administration. A larger dose of RU486 was necessary to induce abortion in pregnant rabbits compared to rats. The maximum blood concentration was greater and the area under the plasma level curve was larger in rats than in rabbits following administration of RU486. PMID- 2757577 TI - Activity of peritoneal macrophages in endometriosis. AB - The mechanism of infertility in women with endometriosis is still largely unclear. It is thought that peritoneal macrophages increase in number in women with endometriosis and that the macrophages phagocytize sperm or the fertilized ovum, leading to infertility. We examined the levels of phagocytosis by peritoneal macrophages in patients with and without endometriosis using a flow cytometric assay. The level of phagocytosis in the control group was significantly lower than in the group with endometriosis. Quantitative results on the level of phagocytosis by peritoneal macrophages suggest that peritoneal macrophages are one of the factors contributing to infertility associated with endometriosis. PMID- 2757578 TI - The inhibitory effect of synthetic steroids on proestrous gonadotropin release in the rat. AB - This study was performed to evaluate the inhibitory effect of synthetic steroids on the hypothalamo-pituitary axis. Six synthetic steroids, used for contraception or other gynecologic indications, were injected to female rats on diestrus 2 (2 mg/kg, sc), and the animals were sacrificed in the afternoon of proestrus. Serum levels of LH, FSH and progesterone, the pituitary contents of LH and FSH, and LH RH in the median eminence were measured by radioimmunoassays. Among the synthetic steroids tested in this study, norethisterone, d-norgestrel, 3-keto-desogestrel and gestrinone completely blocked the gonadotropin surge on proestrus, showing stronger antigonadotropic activity than progesterone. Desogestrel did not affect proestrous gonadotropin release at this dose. The suppressive effect of danazol could be seen only in a larger dose (20 mg/kg). These findings reconfirmed previously reported results, which demonstrated that the hypothalamo-pituitary complex was a major site of action of these steroids. PMID- 2757579 TI - Localization and significance of fibronectin in peri-implantation mouse embryos. AB - This study was performed with the aim of clarifying differences in the localization of fibronectin between embryos developed in vivo and in vitro together with the significance of fibronectin in embryos at implantation. Localization of fibronectin in the embryos was first found in the inner cell mass of the early blastocyst in utero (in vivo group). In contrast, when embryos were cultured in vitro from the 2-cell to the blastocyst stage (in vitro group), fibronectin could not be observed in the late blastocyst. When the blastocysts developed either in vivo or in vitro were further culture for 3 days in Dulbecco's Modified Eagle Medium (D'MEM) containing 10% newborn calf serum, the in vitro implantation (trophoblastic outgrowth in vitro) rates were 90% and 37%, respectively. If the blastocysts developed in vivo were cultured in D'MEM alone, the in vitro implantation rate was as low 29%. However, if fibronectin was added to the D'MEM, instead of newborn calf serum, the in vitro implantation rates were improved. These results led to the conclusion that fibronectin is necessary for the implantation of blastocysts. PMID- 2757580 TI - Role of telereceptive and interoceptive (taste) cues in ingestional neophobia in chicks (Gallus domesticus). AB - Experiment 1 investigated the influence of telereceptive (visual) and interoceptive (taste) cues on neophobia by measuring the intakes of clear water and novel solutions of red-colored water, clear 4.0% vinegar, or red-colored 4.0% vinegar in chicks (Gallus domesticus) on 5 test days. Neophobia was reliably greater the more numerous the novel stimuli in testing (i.e., red-colored vinegar) but was similar in magnitude for novel visual and novel taste cues alone. In Experiment 2 chicks received zero, one, or five preexposures to red colored water or to clear 4.0% vinegar and were tested for neophobia to red colored 4.0% vinegar. Intake of red vinegar reliably increased with the number of preexposures. However, preexposure to red-colored water facilitated intake of red vinegar more than preexposure to clear 4.0% vinegar did. These results suggest that the familiarity of telereceptive (visual) stimuli attenuates the demonstration of taste neophobia. PMID- 2757581 TI - Age-dependent facilitation of taste-footshock conditioning by prior exposure to the training context. AB - Among adult rats, gustatory stimuli are easily associated with illness, but not with external unconditioned stimuli such as footshock. Recent evidence indicates, however, that this cue-to-consequence specificity may vary ontongenetically. The present studies examined the acquisition of an aversion to a taste paired with footshock in 5- and 15-day-old rats. Consistent with previous reports, 5-day-old rats avoided the taste that preceded footshock, while 15-day-old subjects did not express an aversion to the taste paired with footshock. Exposure to the training context for either 1 or 5 h prior to conditioning disrupted taste-footshock conditioning in the 5-day-old subjects. For the 15-day-old subjects, 1 h of pre conditioning exposure to the training context had no effect on conditioning, whereas a longer duration of preexposure promoted conditioning to the taste cue. The results suggest ontogenetic differences in stimulus selection. PMID- 2757582 TI - Perioral anesthesia disrupts maternal behavior during early lactation in Long Evans rats. AB - The role of perioral somatosensory stimulation from pups in maternal behavior was investigated in lactating Long-Evans rats (Rattus norvegicus) during early lactation by local anesthesia of the mystacial pads with lidocaine, which blocks conduction in the infraorbital nerve. It was concluded that (1) acute perioral anesthesia markedly inhibited pup retrieval when the subjects had no formal pretreatment retrieval experience. Further, these dams displayed little tolerance to the lidocaine treatment when they were tested repeatedly. (2) The severity of the effects of perioral anesthesia on retrieval was dependent upon prior experience and the testing situation. Following pretreatment retrieval experience, and in a test cage with dark and light compartments which provided a strong incentive to retrieve, 80% of lidocaine-injected dams did retrieve. However, retrieval efficiency was impaired by perioral anesthesia, largely due to increased time in contact with pups prior to each retrieval and to increased carrying time. (3) Perioral anesthesia also inhibited pup licking, but not self grooming, suggesting that the former, but not the latter, is largely under peripheral stimulus control and that deficits in maternal oral activities cannot be due to impairment of mouth opening and use. (4) The onset of nursing behavior was delayed until after the recovery of snout sensations and retrieval. This suggests that a maternal behavior not directly involving the mouth is nonetheless dependent upon the dam's receipt of perioral tactile input from pups. PMID- 2757583 TI - Undernutrition during suckling and latent learning ability of rehabilitated adult male rats. AB - The present report investigates the effects of early undernutrition on the latent learning ability of rehabilitated adult male rats in a simple maze task. Rats were undernourished during suckling by feeding their dams an 8% casein diet. Well nourished dams received a 25% casein diet during the same period. Rats were weaned at 21 days of age and nutritionally rehabilitated until they became adults, when behavioral task was conducted. Under a nonappetitive condition, rats were exposed either to an open field or to a maze apparatus. They were thereafter deprived of water and tested in the maze apparatus. Both well-nourished and undernourished rats that had been previously exposed to the maze performed better than those exposed to the open field. Nutritional treatment had no effect on performance of either the latent learning or of the open-field groups. These results suggest that rehabilitated adult rats are able to learn about the environment when no immediate reinforcement is involved. The discrepancy between our findings and results reported by others may be due to differences in task complexity and/or perhaps to the fact that nutritional rehabilitation also plays a role in reversing some of the deleterious effects of early undernutrition on learning ability of rats. PMID- 2757585 TI - Synaptic plasticity in the hypoglossal nucleus of female canaries: structural correlates of season, hemisphere, and testosterone treatment. AB - The caudal portion of the hypoglossal nucleus (nXIIts) contains the motor neurons that control the syrinx in songbirds. In canaries, song occurs seasonally, is principally produced by males, and appears to be produced predominantly by muscles on the left side of the syrinx. The present study measures the effect of seasonal change and manipulation of testosterone levels on synapse number and morphology in nXIIts in adult female canaries. We find that synapse density is lower in testosterone-treated birds than in control birds and lower in fall than in spring. The number of vesicles per presynaptic profile increases in the spring as a result of a general increase in this measure in all synapses. The number of vesicles per presynaptic profile also increases with testosterone treatment, primarily due to an increase in the proportion of synapses associated with unusually high vesicle counts. Together, these changes suggest that large reserves of neurotransmitter may be necessary to sustain singing. Several ultrastructural differences between hemispheres are found. Postsynaptic thickenings are longer, and postsynaptic processes are larger on the left side than on the right side. In the spring, there are more vesicles per synapse on the left than on the right, but this lateralization is reversed in the fall. Thus, lateralization of song production is associated with lateral asymmetries in synapse morphology. These hemispheric differences are relatively small, like those seen at the light microscope level, encouraging further consideration of peripheral as well as CNS sources of functional lateralization. The seasonal and testosterone-induced changes in synapse number and morphology may be components of the periodic reorganization of canary vocalization. PMID- 2757584 TI - Classical discrimination conditioning of the rabbit's eyelid response using pontine stimulation as a conditioned stimulus. AB - Classical discrimination conditioning of the nictitating membrane/eyelid response was performed on seven rabbits using stimulation of the pontine nuclei or middle cerebellar peduncle as the conditioned stimulus (CS) and an air puff as the unconditioned stimulus (US). The rabbits learned to discriminate between a CS paired with a US and delivered to one pontine nucleus (the CS+) and a CS presented alone and delivered to the contralateral pontine nucleus (the CS-). Subsequent reversal of the discrimination was also achieved when the CS+ and CS- stimulation sites were interchanged. The results are interpreted as support for the idea that essential plasticity for classical eyelid conditioning occurs efferent to the pontine nuclei, possibly in regions of the cerebellum. PMID- 2757586 TI - Nicotinic-dopaminergic relationships and radial-arm maze performance in rats. AB - Accurate performance on the radial-arm maze is dependent upon the integrity of nicotinic-cholinergic, muscarinic-cholinergic, and dopaminergic systems. Pharmacological blockade of these systems with mecamylamine, scopolamine, or haloperidol impairs choice accuracy in the maze. We have previously demonstrated that the performance deficit caused by muscarinic blockade is enhanced by coadministration of the nicotinic antagonist, mecamylamine, and is diminished by coadministration of the dopamine antagonist, haloperidol. In the present study, it was found that the choice accuracy deficit produced by nicotinic blockade is enhanced, not antagonized, by coadministration of haloperidol. Thus, although both nicotinic and muscarinic cholinergic systems are involved in radial-arm maze performance and antagonists of these receptors are additive in the deficits they cause, nicotinic and muscarinic interactions with dopaminergic systems are opposite in nature. PMID- 2757587 TI - Thermopreferendum of the rat: inter- and intra-subject variabilities. AB - The thermopreferendum of male hooded rats was studied in a temporal thermal gradient. The preferred ambient temperature was found to be approximately 19 degrees C. In addition to the thermopreferendum, three other physiological functions (resting body temperature, daily food intake, and daily ambulatory activity) were each measured in eight rats for 8 days. Overall variability of the thermopreferendum data was higher than that of body temperature and food intake data but lower than the variability of ambulatory activity data. Coefficients of inter- and intrasubject variabilities were computed for each of the four variables. Inter-subject variability was equivalent in all variables, but intrasubject variability was smaller for thermopreferendum and activity than for food intake and core temperature. The thermopreferendum of 19 degrees C is consistent with previously published results but inconsistent with the available data on the thermoneutral zone of the rat (27-28 degrees C). The cause of this inconsistency remains to be determined. PMID- 2757588 TI - Place avoidance learning and stress-induced analgesia in the attacked mouse: role of endogenous opioids. AB - In this study, mechanisms of pain inhibition (tail-flick test) and memory (place avoidance paradigm) were investigated in attacked, DBA/2 and C57BL/6, mice. During training, exposure of test animals to 10 or 30 bites by an aggressive, isolated ICR mouse situated in the dark half of a bright/dark conditioning box induced a significantly higher social conflict analgesia in DBA than in C57 mice. Naltrexone (0.5 and 2.0 mg/kg) reduced this response in DBA mice that received 30, but not 10, bites and was ineffective in C57 mice. This points to different, opioid versus naltrexone-insensitive nonopioid, analgesic mechanisms. During place choice testing in the same box 24 h later, DBA mice that had received 30, but not 10, bites showed a significant, naltrexone-reversible, avoidance of the attack place. No place avoidance learning was observed in C57 mice. The data provided unequivocal evidence that place avoidance learning was a result of associative conditioning, in that neither pairing nor social conflict per se significantly changed the preference for the dark side seen in experimentally naive DBA mice. Antagonism of place avoidance conditioning was observed regardless of whether testing was carried out in the drugged or undrugged state, excluding possible state-dependent effects as an explanation for the naltrexone induced impairment. Individual correlational analysis in saline-injected, attacked DBA mice revealed a negative relationship between the analgesic state immediately after training and the avoidance of attack place during testing. In summary, the results suggest strain-dependent analgesic and learning mechanisms and indicate that endogenous opioids released in attacked DBA mice support pain inhibition and modulate the memorization of attack place by their analgesic effects, as well as by mechanisms independent of pain inhibitory systems. PMID- 2757589 TI - Homogamous assortative mating among Puerto Rican families: intergenerational processes and the migration experience. AB - Homogamous assortative mating is examined in the context of intergenerational processes and the migration experience in two generations of Puerto Rican families in New York City: mothers and fathers in a parent generation (100 pairs) and their married child and the child's spouse in the child generation (100 pairs). The variables used to examine intergenerational processes and to assess homogamy are age, education, and the degree of acceptance of two Puerto Rican cultural values--familism and fatalism. The findings indicate clear and pervasive intergenerational differences and discontinuities but homogamous marital patterns in each generation. The sociocultural dislocations resulting from the migration experience from Puerto Rico to New York City do not impede the restitution of marital homogamy in the host society with respect to either general or culture specific variables. PMID- 2757590 TI - Sex differences in property crime in a Danish adoption cohort. AB - Sex differences in genetic and environmental influences on criminal behavior against property were studied in a birth cohort of 6129 male and 7065 female Danish adoptees and their biological and adoptive parents. Both genetic and environmental factors were found to contribute to variation in liability to property criminality, the relative proportions of variance explained being similar in males and females. Important shared- and nonshared-family environmental factors were present. In separate analyses of average liability toward property criminality, however, convicted females appeared to be more genetically predisposed than convicted males, a conclusion based on the finding that female property offenders were more likely than male offenders to have convicted biological (but adopted-away) offspring. On the other hand, property offending males and females did not appear to differ in their average shared family environmental liabilities, since conviction rates did not differ for adoptees of convicted adoptive mothers and fathers. Also, social class in the adoptive parents of convicted sons and daughters were comparable, further indicating that average shared-family environmental liabilities do not differ between the sexes. PMID- 2757591 TI - Genetic analysis of an avoidance-avoidance response in Mus domesticus. AB - Latency to leave a lighted platform and enter a novel chamber in which other mice had received shock was measured in 2592 mice from eight inbred strains and all 56 F1 crosses. An analysis of the diallel matrix indicated a clear genetic architecture, although genetic effects accounted for only 10% of the total phenotypic variance. Dominance favoring a slight delay in chamber entry suggested a selective advantage in spending a longer time on some elements in the behavioral chain involved in avoidance-avoidance responses. Inbred strains showed greater litter variance than F1 hybrids, suggesting greater developmental buffering of heterozygotes. Both the genetic architecture and the strain rankings differ from those typically found in open field and similar tests of locomotor activity. The results illustrate the problem of interpreting behavior genetic results in terms of proportions of total phenotypic variance and difficulties in generalizing to ancestral or other populations in an attempt to interpret genetic results in an evolutionary context when reliability is low. PMID- 2757592 TI - The B6.SW bilineal congenic sucrose octaacetate (SOA)-taster mice. AB - SWR/J inbred mice (Tasters) reliably avoid, whereas C57BL/6J inbred mice (Nontasters) are indifferent to, sucrose octaacetate (SOA) at certain concentrations. From these strains we have developed a set of bilineal congenic Taster mice. Approximately 4000 mice, from 2 isogenic and 12 segregating generations, were tested in a program designed to evaluate genetic models for SOA tasting during development of congenic strains. The criterion phenotype was avoidance or nonavoidance in preference tests of the bitter tastant SOA at concentrations of 10(-4) and 10(-5) M. Across the 12 segregating generations, the results were consistent with Mendelian expectations for a single autosomal locus with complete dominance of the Taster phenotype. The breeding program produced 12 replicate B6.SW lines containing the taster allele on the B6-Nontaster genomic background. The congenic Taster mice may facilitate a functional analysis of the sense of taste. PMID- 2757593 TI - Sucrose octaacetate tasting in a heterogeneous population of CFW mice. AB - Three experiments investigated the genetic underpinnings of the sucrose octaacetate (SOA) avoidance-indifference dimorphism that exists among outbred CFW mice. In the first experiment, results from 687 subjects across three generations of segregation were consistent with predictions from a single-autosomal, two allele model, with dominance for the avoidance (Taster) phenotype. In the second experiment, heterogeneous CFW Tasters and Nontasters were mated with SWR/J (Taster) and C57BL/6J (Nontaster) inbred mice. The SWR and CFW mice are both derived from Swiss mice, and the results were consistent with the possibility that the Taster animals share an allele which is identical by descent. The second and third experiments also investigated sensitivity to SOA across an extended range of concentrations. Nontaster CFWs avoided SOA at the near-saturation 10(-3) M concentration but did not avoid any weaker concentrations. Taster CFWs avoided all concentrations down to approximately 10(-6) M SOA. PMID- 2757594 TI - Behavioral and reproductive differences in mice as a function of inbreeding. AB - Twenty brother-sister pairs of mice were randomly selected from a genetically heterogeneous population of mice to begin a schedule of inbreeding that lasted for six generations (F = 0 to F = .732). We examined a number of indices of reproductive behavior and found that all declined as a function of inbreeding. Specifically, there was a consistent decline in the number of fertile matings, in the number of offspring that survived to weaning, and in the weight of the pups at the time of weaning (21 days of age). We also examined a number of behaviors with the following results: there was a systematic increase in the number of trials required to learn an active avoidance task and a consistent decrease in the number of trials required to extinguish this habit. We observed a statistically significant difference in the retention of a passive avoidance habit, but these results were quite variable and not consistent across generations of inbreeding. Finally, we observed that inbreeding had little effect on measures of locomotor behavior. PMID- 2757595 TI - Burrowing behavior in wild house mice: variation within and between populations. AB - Burrowing behavior was assessed on 120 lab-reared house mice (Mus domesticus) derived from five geographic populations representing a north-south cline along the east coast of the United States. Mice were placed individually into Plexiglas containers filled with sand and peat moss, and their burrows were excavated 24 h later. Seven measures were taken and reduced by principal-components analysis to two factors for further analysis. Marked differences existed within, but not between populations, and members of full-sib families built qualitatively and quantitatively similar burrows. The lack of a geographic cline and the apparent high heritability of burrowing behavior do not lend support to its use as a major thermoregulatory adaptation. PMID- 2757596 TI - Strain differences of the light-dark preference in inbred rats. AB - The present study examined strain differences in the light-dark preference among four strains of rats. The test was done in the home-cage situation under 12L:12D cycles. Data from four strains were compared: BN/Kyo, BDIX/Nem, Wistar/Nu, and F344/NSlc. These strains differed in the light-dark preference measured by the ratio of the time spent in the field area of the home cage during the light period. BN/Kyo and BDIX/Nem spent the most time (approx. 23%) in the field during the light period, while F344/NSlc spent the least time (approx. 5%). Wistar/Nu fell between the two (approx. 12%). PMID- 2757597 TI - Comment on Tambs' (1987) "No Genetic Effect on Variation in Field Dependence". PMID- 2757598 TI - No evidence for X linkage in rod-and-frame test (RFT) scores: an answer to Thomas. PMID- 2757599 TI - Immunohistological detection of H-2 antigens in vivo induced by IFN-beta in mouse brain tissues. AB - We describe the immunohistological detection of in vivo interferon-beta (IFN beta)-induced H-2 antigens in mouse brain tissues. Two injections of recombinant mouse interferon-beta (rIFN-beta) were given into the lateral ventricles. Following perfusion with periodate-lysine-paraformaldehyde (PLP) solution, microsliced brain sections were incubated with anti H-2 monoclonal antibody and these subjected to a streptavidin biotin immunohistochemistry technique. Expression of H-2 antigens was demonstrated on neurons, neuroglias and vascular endothelial cells in the hippocampus, cerebral cortex, corpus callosum and other regions of the brain as well as on ependymocytes in the choroid plexus. H-2 antigens were also diffusely distributed in the cytoplasm and axons. PMID- 2757600 TI - Postlarval muscle growth in fish: a DNA flow cytometric and morphometric analysis. AB - The mechanism of postlarval fish myotomal growth was investigated in trout (Salmo gairdneri) by means of morphometric and cytofluorometric analysis. The mechanism by which new fibres are added during postlarval growth (hyperplasia) is not fully understood. In histological cross sections these new fibres have a small diameter which give the muscle a "mosaic" appearance. One hypothesis suggested that they could be derived from the proliferative activity of satellite cells. DNA cytofluorometric analysis of nuclei suspensions obtained from trout white myotomal muscle during different developmental stages (eleutherembyronic; alevin; yearling and adult) showed a consistently low S-cytometric phase during all stage in which myofibres of small diameters were present. The percentage of such small fibres, determined by morphometric analysis, suggested that satellite cells are the proliferative population. In fact, their percentages, as determined by morphometric analysis in histological section, bear a linear relationship with the S-cytometric phase percent nuclei (R = 0.927). Only in adults (67 cm in size) there was a significant decrease in the S-cytometric phase. At this stage, in histological sections, the myotomal muscle no longer had a "mosaic" appearance because of the disappearance of the small fibres. It may, therefore, be supposed that in the cm 67 adult specimens, the proliferative population is entering the G0 phase. It is known, in fact, that muscle growth proceeds only by fibre hypertrophy in trout longer than 70 cm in length (Stickland, 1983). PMID- 2757601 TI - Congenital muscle fibre type disproportion: clinical, morphological and biochemical findings in children. AB - Muscle biopsies from quadriceps femoris muscle of normal subjects and subjects with symptoms of congenital myopathy, aged 1-3 years, were examined for morphological and biochemical differences. Four patients showed clinical signs of Congenital Fibre Type Disproportion (CFTD) as described originally by Brooke (1973), while the other cases showed only signs of hypotonia and diffuse weakness as described by Clancy et al. (1980). No morphological differences between patients with different clinical signs were found in any biopsy sample from the quadriceps femoris muscle, as regards fibre size; type I fibres were always smaller than type II fibres. The difference in fibre size was more than 15% in all cases, and the variability coefficient of the larger type II fibres was less than 250. Nevertheless, as regards fibre occurrence, two patients showed more type I fibres than type II fibres, four patients showed more type II fibres than type I fibres and one patient had a marked type II fibre predominance. Enzyme activities assayed in the crude mitochondrial fraction showed no abnormalities between normal subjects and patients. An increase in the activity of lactate dehydrogenase in the crude extract was found in all cases. PMID- 2757602 TI - Compared flow cytometric analysis of mitochondria using 10-n-nonyl acridine orange and rhodamine 123. AB - The use of the supravital mitochondrial-specific dye Rhodamine 123 (Rh 123) in combination with flow cytometry permits the monitoring of the changes in the mitochondrial transmembrane potential, reflecting the overall mitochondrial activity of the living cell. While this probe appears to be a potent tool for these studies, it also exhibits an important limit in the interpretation of the results: it cannot distinguish between an increase in mitochondrial activity without biogenesis and a modification of mitochondrial content. 10-n-Nonyl Acridine Orange chloride (NAO) constitutes another mitochondrial specific fluorochrome. In contrast with Rh 123, NAO accumulation in the cell does not seem to be driven by the proton-motrice force but does seem to be related to specific interactions with mitochondrial membrane proteins and/or lipids. In this work, the cytotoxicity of NAO, the kinetics of cellular uptake and the release of the dye have been determined using flow cytometry. The use of several ionophores or mitochondrial inhibitors has confirmed the independence of NAO uptake regarding mitochondrial transmembrane potential. NAO was also used to examine the changes in the mitochondrial compartment during the transfer of articular chondrocytes from cartilage to the culture conditions, where Rh 123 evidenced changes in mitochondrial activity and/or biogenesis, in order to know whether the use of probes with different specificity allows one to distinguish between mitochondrial activity and biogenesis. PMID- 2757603 TI - A qualitative and quantitative assay of dihydrofolate reductase in carrot cells resistant to methotrexate. AB - The cytochemical pattern and the quantitative assay of DHFR on Daucus carota cell lines sensitive and resistant to methotrexate (MTX) are described. Cytoplasmatic enzyme activity is evidenced as granules of formazan, final reaction product, in the majority of the cells. DHFR activity appears low in Daucus carota cells used as control while in carrot cells resistant to MTX is very high, an observation which parallels previous biochemical studies. These results are supported by quantitative data of DHFR content in a random cell population. A possible correlation between overproduction of DHFR and gene amplification in MTX resistant cells is discussed but the solution of this problem will depend on the availability of a dhfr plant probe. PMID- 2757604 TI - Adaptation of contractile proteins in human heart and skeletal muscles. AB - Sarcomeric muscles including the myocardium respond to increased workload with adaptation by differential gene expression and without cell division. This is characteristic for postmitotic tissues. We showed that a short period of high intensity endurance training induces a shift from fast myosin heavy (HC) and light (LC) chain isoforms towards the slow variety within histochemically typed fibres of human vastus lateralis muscle. In an intermediary state of transition both varieties of isoforms are co-expressed in one fibre. Likewise a shift from the fast myosin alpha-HC towards the slow beta-HC was observed in the atria of severely insufficient human hearts. Such a shift does not occur in the ventricular myocardium where the beta-isoform is expressed mainly. However, both ventricular myosin LC species do occur in the atrium while only the atrial LC-1 isoform appears in the ventricular muscle under increased workload. The expression of the myosin HC and LC isoforms is regulated independently of one another and tends to change towards the slow myosin type with its greater contraction economy. PMID- 2757605 TI - Energetical considerations related to calcium release from the sarcoplasmic reticulum in skeletal muscle. AB - During the initial phase of activation (about 5 ms) of 1 g of muscle about 200 nmol of Ca++ are released from the SR which results in a current of about 7.7 A. Because at least 90% of Ca++ is released at a gradient below 1000/1 a free energy of about 3 mJ is available. Based on a SR-surface of approximately 2 m2/g of muscle a maximal inside negative membrane potential of -87 mV and a specific membrane capacitance of 1 microF/cm2 only about 9 nmol of Ca++ can be released without charge compensation before the calcium equilibrium potential is reached. This means that a countercurrent must compensate for practically all the calcium released in order to maintain a substantial driving force during release. The energy derived from the amount of Ca++ and its gradient or the caloric value of ATP required for Ca++-uptake (100 nmol) sets an upper limit for specific membrane resistance of the SR in the range of 200 omega cm2. This value is compatible with clearly lower numbers deduced from measurements on membranes obtained by fusing SR vesicles with lipid bilayers and the concept that the SR functions as a current source rather than as a voltage source. However, this value is much lower than estimates of specific membrane resistance based on indirect measurements. PMID- 2757606 TI - Perhexiline increases calcium-activated force in skinned psoas fibres by raising calcium affinity of troponin-C. AB - We investigated the influence of the calcium-/calmodulin antagonist perhexiline on the calcium sensitivity of skinned muscle fibres from rabbit psoas muscle suspended in MgATP salt solution (pH 7.0; 20 degrees C). Perhexiline strongly sensitized the skinned fibres for calcium; thus the relationship between isometric force development and calcium ion concentration was shifted to the left in the presence of perhexiline. Similar results have been achieved with skinned fibres from pig cardiac (ventricular) muscle fibres. In skinned psoas we also determined the binding of Ca2+ to troponin-C by using the method developed by Guth and Potter (1987). Troponin-C labelled with DANZ (5-dimethyl aminonaphthalene-2-sulfonyl aziridine) was incorporated into skinned fibres after previous extraction of troponin-C. The fluorescence signal (at 460 nm) as well as force increased when the calcium ion concentration rose to pCa 5.7. Addition of perhexiline increased this force and the fluorescence signal indicating that the increase in calcium responsiveness of the contractile apparatus was, at least partly, due to an increase in calcium occupancy of troponin-C. PMID- 2757607 TI - Effect of external K on the block of the inward rectifier during hyperpolarization in guinea-pig ventricular myocytes by external Na. AB - The effect of changes of the external K concentration on the block of the inward rectifying K current during hyperpolarization in guinea-pig ventricular myocytes by external Na was investigated. The voltage-dependent block of iK1 by external Na ions is decreased when the external K concentration is lowered between 5.4 and 0.54 mM, but is not influenced when Ko is increased from 5.4 to 27 mM. The effect of lowering Ko can be described as a decrease of the rate of entry of blocking Na ions at lower external K. PMID- 2757609 TI - Activation and blocking effects of divalent cations on the calcium-dependent potassium channel of high conductance. AB - Using the patch-clamp technique the action of internal barium- and magnesium-ions on the calcium-dependent potassium channel in the membrane of vascular smooth muscle cells from the media layer of the human aorta was studied. Under symmetrical potassium conditions in excised inside-out patches bathed in the standard solution containing EGTA, the addition of barium as well as magnesium led to a concentration-dependent shift of the activation-curves to negative values of the membrane potential compared with the control, a block of single channel activity by barium, whereas no inhibitory effects by magnesium were registered. Thus, these results suggest that the process of channel activation of the calcium-dependent potassium channel of high conductance depends not merely on calcium but also on other divalent earthalkali ions. PMID- 2757608 TI - Membrane fluidity and kinetics of Ca2+-dependent potassium channels. AB - Patch-clamp technique and fluorescence polarization analysis were used to study the effect of lipids on the kinetic of Ca2+-dependent K+ channels and membrane fluidity. Cultured smooth muscle cells from human and rabbit aortas were used. 2 decenoic acid (DA) was applied to increase membrane fluidity and cholesterol (CHS) level was varied using mevinolin (MEV) and CHS-enriching medium. In the presence of 0.5 microM Ca2+ and 2 mM Mg2+ more than 40-fold elevation in the probability of the channels been open (Po) was observed under DA action. Treatment of cells with MEV leads to nearly 2 fold increase in membrane fluidity and to more than 4 times elevation of Po. The addition of CHS to the cell membrane resulted in a nearly 2 fold decrease in membrane fluidity and about 2 fold decrease in Po. The data suggest that lipid content affect the kinetics of Ca2+-activated K+ channels presumably due to changes in membrane fluidity. PMID- 2757610 TI - Sarcomere dynamics in isolated cardiac myocytes investigated by high-time resolution laser light diffractometry. AB - Unattached single cells of the guinea pig myocardium were illuminated with laser light. From the position of the mean of the first order diffraction line at a CCD sensor the sarcomere length was calculated with a time resolution of 1 ms. The maximum velocity of the sarcomere shortening was 2.15 +/- 0.87 microns/s (mean +/ S.E.). Nearly 20% of the cells investigated were found to shorten in a stepwise manner. The intensity profiles of these myocytes deviated from the Gaussian shape at the same time as "pauses" became visible. Therefore, this phenomenon might be due to Bragg effects which result from different sarcomere populations within stepwise shortening cardiac cells. PMID- 2757611 TI - Afterload dependence of cardiac contraction parameters. AB - In rabbits the afterload dependence of baroreflex inotropy was studied, based on the contraction parameters CI = (dP/dt/P)max and a systolic time interval RP. These were estimated 1. for stepwise aortic coarctation and 2. for aortic nerve stimulation under pressure clamp conditions. CI is enhanced by aortic pressure elevation whereas RP is shortened. Aortic nerve stimulation caused higher CI and RP effects at free-running pressure than under pressure clamp conditions. The RP effects are always smaller. For clamping at low holding pressures the CI effects are higher and vice versa, whereas the RP effects are nearly independent of pressure. These results show that baroreflex inotropy, generally, is influenced by concomitant afterload changes, but the CI parameter and its inotropic effect is more afterload-dependent than RP. PMID- 2757612 TI - Force-velocity relation and myosin isozymes of rat muscles. AB - The proportions of three myosin heavy chains in rat soleus and EDL are used to compute a triple linear regression which predicts correctly the maximal mechanical power and approximately the parameters b and a/Fo of the Hill's equations. PMID- 2757613 TI - Subunit composition of native myosin isoenzymes of some striated mammalian muscles. AB - Six "native" isomyosins of characteristic electrophoretic mobility are present in various proportions according to the muscle type (fast, slow or mixed). SM2 and SM1 contain MHC1; IM contains MHC2A; FM1, FM2 and FM3 contain MHC2A and MHC2B. SM2, SM1 and IM contain MLC1s; SM1, IM, FM2 and FM3 contain MLC1f; FM2 and FM1 contain MLC3f. The six isomyosins appear to separate on the base of their myosin light chain content. PMID- 2757614 TI - The influence of suspension hypokinesia on contractile properties of slow and fast twitch muscles of young growing and adult rats. AB - The influence of the lack of the gravity force on contractile properties of the slow-twitch soleus (SOL) and the fast-twitch extensor digitorum longus (EDL) muscles was investigated in 3 week or 6-month-old rats suspended by their tail. In both groups suspension hypokinesia (SH) lasting 3 weeks or longer leads to a marked decrease of the mass and of the mean cross-sectional area of the SOL. The SOL of suspended animals shows decreased contraction and half-relaxation times and a lower tension of the single twitch, a decreased maximum tetanic force output, an increased fusion frequency and a decreased tetanus-half-rise time. The force developed per unit cross-sectional area and the twitch-tetanus ratio are unchanged. The atrophy and the changes in contractile properties are more pronounced in young developing rats than in adult ones. The SOL of suspended young rats does not develop into a slow-twitch muscle and shows a posttetanic potentiation and a cooling potentiation of the single twitch, properties observed in fast-twitch muscles only. In comparison to controls SH has no influence on the wet weight, mean cross-sectional area, and contractile properties of the EDL of young or adult rats. The data presented here and supported by histochemical and biochemical results demonstrates the importance of the gravity force for slow twitch muscles especially during development. PMID- 2757615 TI - Behaviour of EMG-parameters and conduction velocity in contractions with different muscle temperatures. AB - In the study the effect of changing muscle temperature on EMG-parameters and muscular conduction velocity was investigated for ambient temperatures of 0, 10, 20, 30, 40 degrees C. With temperatures below 20 degrees C a striking diminution of EMG-amplitudes was observed despite nearly unchanged mechanical capability. The decrease in mean frequency of surface EMG was related directly to changes in conduction velocity during cooling of the muscle whereas in fatiguing muscle contractions the mean frequency seemed to be also affected by other mechanisms. PMID- 2757616 TI - Changes of the conduction velocity of isolated muscles induced by altered external potassium concentration. AB - The propagation of action potentials along fibre bundles of fast and slow twitch rat muscles was tested by means of two separated different electrodes. In spite of marked differences in contractile properties between fast and slow twitch bundles, the conduction velocity (c.v.) was found to be similar in all preparations at room temperature. At 35 degrees C the c.v. was 2.76 +/- 0.36 m.s 1 in SOL and 3.0 +/- 0.77 m.s-1 in EDL muscles, respectively. An elevation of the extracellular K+ from 5 to 10 mM caused a reduction of the c.v. by 20 - 40% in limb and sternomastoid muscles. The effect increased with higher K+ concentrations. Repeated tetanic stimulation also induced a decrease of the c.v. The opposite effect occurred in solution with reduced external K+. In O K+ solution the c.v. of fast twitch fibres increased by almost 50%. The results show that extracellular K+ interacts with processes of the regeneration of the action potential along the fibres. PMID- 2757617 TI - Changes of EMG activity patterns of extraocular muscles and the tonic control of eye position during the postnatal development of the rabbit. AB - The motor activity patterns of the rectus superior and obliquus superior extraocular muscles of the rabbit in response to static tilt stimulation were studied by electromyography in the unanaesthetized animal during postnatal development. During the first postnatal week the eye muscle activity showed a phasic pattern with continuous fluctuations of the activity level. The main postnatal decrease of the variability of EMG activity level occurs in the rabbit during the second week of life. Thereby, a constant tonic EMG activity of the extraocular muscles during static tilt stimulation was achieved from the third postnatal week onwards. The ability of stabilizing the eye position in space by this developmental process is an important prerequisite for the normal development of an effective visual orientation of the rabbit after the postnatal opening of the eyes. PMID- 2757618 TI - The contribution of single motor units of the biceps brachii muscle in man to the momentum in elbow flexion. AB - The attempt of evaluation of motor unit in vivo force in biceps brachii muscle in man shows a methodological important fact: On principle it is impossible to measure or to calculate the contribution of a single motor unit to the force output of a certain muscle. Most of the physiological data of motor units are indicated as forces measured in isolated muscles. The effect of a muscular action in joints is a momentum always. The way from muscular force to the momentum in the joint is a multidimensional and nonlinear one. Moreover some synergistic muscles act upon one joint in each case. Because we can't know their current contribution to the summarized momentum in the joint which can be measured only, it is impossible to estimate the percentage of the force of one muscle in the synergistic ensemble. It is not possible finally to calculate exactly the percentage of the single motor unit force inside one muscle, because we have motor units of different extend. An exact strategy for estimation of momenta is shown including the steps of uncertainty for calculation. PMID- 2757619 TI - Coordination processes in a human motoneuronal pool. AB - Using two leads of a multielectrode the EMG from biceps brachii muscle in man was recorded. The test-persons were ordered to produce a sustained isometric flexion force in the elbow joint which they could control optically. In the range of about 3-5% of maximum force it was possible to identify 2-5 active motor units under this condition. Cross interval histograms were calculated showing two types of coordination between two simultaneously active motor units: 1st, periods of relative phase-coordination in different extent. This means that cross-intervals are fluctuating in a small range for short time periods. An arbitrary subdivision of the fluctuation ranges and the time periods into different classes shows that about 20-35% of the total of the cross-intervals are coordinated by relative phase dependence. In these cases the ratio of the mean discharge rates is 1:1 approximately. 2nd, another type of relationship -f the motor units active at the same time we have called "frequency coordination". This means that the fluctuations of cross-intervals around the mean discharge rate ratio are smaller than the fluctuations of the discharges of both single units around their own mean value. In these cases, which are more frequent than phase-coordination (up to 50%), the ratios of the mean discharge rates are 1:1,2 and more. PMID- 2757620 TI - Decrease of motoneuron excitability during stretching of the human soleus. AB - Changes of motoneuron (MN) excitability was studied during the basic modalities of slow or static stretching of the human soleus muscle (Sol). Tendon (T) and Hofmann (H) reflexes were recorded during slow passive (assisted) stretching (SS). The H response was analysed in SS, in SS preceded by a maximal isometric contraction of the muscle or contraction-relaxation (CR) and during stretching of the muscle by contracting the antagonistic muscle (AC). The maximal joint mobilization during SS, CR and AC appears to be closely related to the decrease of the H response. It is suggested that the joint mobilization during slow stretching is closely controlled by the level of inhibition of the MN pool excitability, which lasts only as long as the stretching manoeuvre is maintained. PMID- 2757621 TI - On-line determination of anaerobic threshold with rms-EMG. AB - 1. On-line monitoring of surface rms-EMG for detecting the anaerobic threshold during a cycle ergometer test was evaluated and compared with blood lactate and ventilatory parameters in 12 healthy icehockey players. 2. Dislinearity of increase in blood lactate level, ventilatory parameters and myoelectrical activity was observed at the mean work level of 300 (range 270-330) watts in each case. 3. The linearity disappeared at the same time in the rms-EMG-load ratio in working quadriceps and gastrocnemius muscles while also in nonworking frontalis muscle a change in EMG level was noticed. 4. The break point in rms-EMG did not correlate with the changes in skin humidity and temperature. No change was observed in spectral properties of the myoelectrical signals. 5. The rms-EMG follow-up is easier to perform than measurements of blood lactate and ventilatory parameters in the determination of anaerobic threshold. PMID- 2757622 TI - Interindividual variability of isometric endurance with regard to the endurance performance limit for static work. AB - In literature there are doubts concerning the 15% MVC (maximal voluntary contraction) level and invariability of isometric endurance, as described by ROHMERT (1962) as a "biologische Konstante". Therefore, 3 experimental sets using different levels of relative loads from approximately 2.9% (individual weight of forearm) to 50% MVC and different holding times (up to 1 hr) were performed concerning elbow flexion and knee extension. Measurements of the times until exhaustion and muscular fatigue (EMG) underlined the great variability of the holding times and showed that the mean endurance performance limit for isometric exercise lies neither at the 15% MVC level nor can it be used as a "biologische Konstante". The muscle fibre composition is discussed as the main reason for the observed variability. PMID- 2757623 TI - Force, endurance time, and cardiovascular responses in voluntary isometric contractions of different muscle groups. AB - A study was made to reinvestigate the general validity of the force/endurance relation of isometric contractions. Relative force development, mean bioelectrical muscle activity and circulatory responses (blood pressure, interbeat interval) during isometric contractions of different muscle groups were compared. 6 men performed maximum isometric contractions of foot plantar- and dorsalflexors and hand flexors lasting 10 minutes. The hydrostatic blood pressure was varied by placing subject's arms and legs in two different positions, high and low. 9 Women performed plantarflexion and dorsalflexion with maximum strength and at constant load of 60% MVC to exhaustion. The results confirm that the force/endurance relationship during isometric exercise is not a biological constant, applicable for all muscles. The fibre composition of the muscle and the blood pressure varied by different hydrostatic components are discussed as factors causing differences in force/endurance relationship. PMID- 2757624 TI - Muscle force sensation changes during sustained voluntary contraction. PMID- 2757625 TI - Peripheral changes during muscle fatigue and their adaptation to training and disuse. AB - Muscle fatigue has been studied in the human adductor pollicis during electrically evoked (30 Hz) contractions. The peripheral electrical and mechanical changes were compared during sustained (60s) and intermittent (sixty ls) contractions separated by 2.0, 1.0 and 0.5s intervals. The results indicate that the mechanical failure is not closely related to the electrical changes and it is proposed that intracellular processes dominate the force deterioration during fatigue. This point of view is discussed on the basis of data recorded from control, trained and disused muscles, during standard fatigue tests. PMID- 2757626 TI - Temperature effects on mammalian muscle contraction. AB - Effects of temperature (range 37 degrees C to 8 degrees C) on isometric twitch and tetanic tensions of mammalian (rat) fast and slow muscles are re-examined. The twitch tension of a fast muscle increased in cooling it 20 degrees C but decreased on further cooling, whereas that of a slow muscle decreased monotonically with cooling. The cooling-potentiation in the fast muscle was evident within a week after birth but the cooling-depression in the slow muscle was not established until about the fourth week. The maximal tetanic tension in either muscle, and at all ages, decreased 10-20% in cooling to 25 degrees C but decreased more markedly in cooling below 20 degrees C; the tension at 10 degrees C was 40-50% of that at 35 degrees C. Preliminary observations made on fast muscle showed that the apparent stiffness/tension ratio was higher at low temperatures. It is postulated that the cooling depression of tetanic tension in mammalian muscle may be due to a direct effect on cross-bridges, whereas twitch tension variation may represent a net outcome of the same effect and the cooling increase in the calcium sensitivity of myofibrillar activation. PMID- 2757627 TI - Temperature effects on isometric contractions of slow and fast twitch muscles of various rodents--dependence on fibre type composition: a comparative study. AB - The influence of temperature (range 15-37 degrees C) on the isometric contractions of the slow twitch soleus (SOL) and the fast twitch extensor digitorum longus (EDL) muscles of mice, rats and guinea pigs were investigated in vitro. Cooling of the bathing solution prolonged the time parameters of single twitches and tetanic contractions in a non-linear manner in both muscle types of all animals. In muscles containing predominately fast twitch fibres like the EDL of all animals cooling was followed by an increase of the single twitch tension (cold potentiation) with a maximum of 160-180% at about 20 degrees C. The influence of a decrease of the temperature on the twitch tension was different in the SOL of the three animals. In SOL of mice (containing about 50% slow twitch fibres) the twitch tension was virtually unchanged, in SOL of rats (about 70% slow twitch fibres) a moderate cold depression and in SOL of guinea pigs (composed by slow twitch fibres only) a strong cold depression was observed. The maximum tetanic tension decreased progressively on cooling in all muscles and independently of their fibre type composition. Cooling increased the twitch tetanus-ratio in fast twitch and decreased it in pure slow twitch muscles. It is concluded that the temperature dependence of the single twitch and the twitch tetanus-ratio can be used as a physiological measure of the fibre type composition of a given muscle. PMID- 2757628 TI - Twitch and tetanic contraction of lamprey muscle exposed to fatty acid at different temperatures. AB - The effect of Na-octanoate (NaC8) on the development of twitch and tetanic tension of a striated muscle (m. longitudinalis linguae) of Lampetra fluviatilis was tested at different temperatures. The muscle exhibited posttetanic potentiation as well as cold potentiation similar to other poikilotherme animals. The sensitivity to NaC8 was higher than that of striated frog or rat muscles but similar to that of mammalian smooth or cardiac muscle preparations. A decrease of temperature remarkably reduced the effect of NaC8 on the tension development. Also the fatigue of muscles during tetanic stimulation was smaller if the temperature was lower. It seems that both the process of fatigue and the action of NaC8 are delayed by the cold. PMID- 2757629 TI - Developing skeletal muscle: the importance of the physical properties of water. AB - We are proposing that cellular water becomes organized through its interaction with the various macromolecular (particularly protein) matrices of the cell. And a physical consequence of this interaction results in an orderly exclusion of solutes from the aqueous cytoplasm. This orderly solute exclusion, dependent on physical properties of each solute, along with selective electrostatic adsorption of ions determine the total cellular solute concentration in mature cells. We are proposing further that during early postnatal development the water macromolecular interaction induces less order and high concentrations of sodium can occur. Finally, our current view of cell water may have been in Albert Szent Gyorgyi's mind when he stated in 1972 that: "Sixty years of research has taught me to look upon water as part and parcel of the living machinery, if not the hub of life. Water is the most extraordinary substance! Partically all its properties are anomalous, which enabled life to use it as building material for its machinery. Life is water dancing to the tune of solids". PMID- 2757630 TI - Threephasic contractions in mammalian myocardium. Isolation and identification of a late component. Implications for rested-state contractions. AB - More than 100 years after Bowditch's discovery of the "Treppe" phenomenon the mechanism of the striking rate and rhythm dependence of cardiac contraction is not unequivocally established. Beside sophisticated techniques biphasic contractions seemed to be a promising approach. There was soon a general agreement that the first component of biphasic contractions is activated by Ca released from the sarcoplasmic reticulum. About the second component prevails confusion: It does not directly reflect the Ca current, but is somehow related to that. In addition, involvement of Na-Ca exchange is supposed. We produced threephasic contractions by the use of isoproterenol (0.5-.4 microM) in guinea pig papillary muscle. Either by the application of ryanodine (1 microM) or after long periods of rest a ryanodine resistant late component of contraction could be isolated. On reducing the transmembrane Na gradient either by reducing [Na]o or by experimental manoeuvres expected to increase [Na]i. (.5 mM [K]o; 2-8 microM ouabain) this component was found to be increased. The evidence suggests that this component is substantially activated by Ca entering the cell via the sarcolemmal Na-Ca exchange. The ryanodine sensitive first component of threephasic contractions was found to be sensitive to caffeine, isoproterenol and changes in stimulation as well. These findings support the view that it may be generated by Ca induced Ca release from the sarcoplasmic reticulum. The pharmacological properties of the second and third ryanodine sensitive component and its dependence on the stimulation pattern were similar to those of the aftercontraction. They were found to be sensitive to procaine, verapamil, Mg, Ni and isoproterenol.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2757631 TI - The feeding with unsaturated fatty acids modifies the course of the isometric contraction of rabbit papillary muscle in hypoxia. AB - Alterations of cardiac membrane functions can be induced by lipid rich diets. As to this the influence of the admixture of cholesterol (group Ch) and rape oil (group R) to standard food during 12 weeks on the course of the isometric twitch of rabbit papillary muscles in normoxia and hypoxia was studied. In group R the rate of contraction and relaxation is enhanced. This points to alterations in the role of the sarcoplasmic reticulum (SR), most probably due to the incorporation of unsaturated fatty acids. During hypoxia at 4 mM Ca concentration the force is more decreased in group R than in the control group C, but the rate of the contraction remains higher. The relaxation is more impaired especially in the early phase. The load-length relation is shifted to the left. The influence of hypoxia in group Ch was similar to group C. The results are hints for the Ca overload of the cells, preferentially in group R. The SR function seems to be more damaged, f.i. by radicals reacting with unsaturated fatty acids and by Ca activated lipolyses. PMID- 2757632 TI - Paralysis of respiratory muscles and hypoxic ventilatory chemoreflex. AB - We investigated the hypothesis that if the chest and abdominal respiratory muscles are paralyzed, the stimulatory hypoxic ventilatory response (HVR) would be less. We compared the HVR in low cervical cord-transected tetraplegics and in normal subjects during unloaded and mechanically loaded breathing. The results demonstrated that the tetraplegics' HVR was unsuppressed, although they displayed a disturbance in load compensation. We conclude that the descending drive to respiratory muscle motoneurons is not germane for the proper operation of the hypoxic chemoreflex. PMID- 2757633 TI - Stimulation of tumor necrosis factor-induced human myelogenous leukemic cell differentiation by high molecular weight PSK subfraction. AB - The mouse macrophage-like cell line, J774.1, spontaneously released differentiation-inducing factor(s). When these cells were treated with a protein bound polysaccharide, PSK, significantly higher amounts of differentiation inducing activity were accumulated in the culture supernatant. PSK directly stimulated human myelogenous leukemic cell differentiation induced by J774.1 conditioned medium or by tumor necrosis factor. Among four subfractions of PSK, only the highest molecular weight fraction (MW greater than 200 kD) exerted such a stimulating effect. PMID- 2757634 TI - Decay of hexokinase during reticulocyte maturation: is oxidative damage a signal for destruction? AB - Proteolysis of hexokinase in cell-free systems prepared from rabbit reticulocytes has been shown previously to be ATP-dependent and apparently mediated by the ubiquitin system (Magnani et al. J. Biol.Chem.261, 8327-8333). We have investigated this phenomenon, but found no substantial loss of hexokinase in cell free systems prepared from fresh lysates. Storage of lysates at -20 degrees C or addition of a free radical generating system was required to demonstrate rapid ATP-dependent decay. It appears that initial oxidative damage to hexokinase does not abolish its activity but allows it to be recognized by an ATP-dependent proteolytic system. The relevance of this mechanism to in vivo degradation of hexokinase is discussed. PMID- 2757635 TI - Comparison of taurocholate accumulation in cultured hepatocytes of pig, rat and man. AB - Intracellular accumulation at 37 degrees C of 50 microM [14C]taurocholic acid by hepatocytes of pig and rat, cultured for 24 hours, and by human hepatocytes, cultured for 12 hours, reached equilibrium after an incubation time of 1 to 2 hours. Maximum capacity to accumulate taurocholate intracellularly was assessed in 3-hour incubations with increasing extracellular taurocholate concentrations. Accumulation capacity of pig and rat hepatocytes was saturated at 100 microM, while uptake by human hepatocytes slightly increased even further above this concentration. At extracellular concentrations of 100 to 500 microM, hepatocytes of these three species concentrated taurocholic acid intracellularly to between 13 and 17 nmol per mg cell protein, corresponding to an intracellular concentration which was 10-70 times higher than the added extracellular concentration. With proceeding culture age, accumulation capacity of rat and human hepatocytes declined steeply (-80% and -60%, respectively between the first and second culture day). In contrast, in cultured pig hepatocytes, this capacity was only 40% lower on the third day compared to the first day of culture. It is concluded that in cultured pig hepatocytes, the capacity to accumulate bile acids is retained for a longer time than in cultured rat and human hepatocytes. PMID- 2757636 TI - Purification and molecular properties of the toxin coded by Ustilago maydis virus P4. AB - The toxin from the P4 strain of Ustilago maydis was purified and characterized using a series of gel-filtration and ion-exchange columns. The apparent molecular weight of the purified toxin was estimated from gel electrophoresis to be 11.3 kd in the presence of 2-mercaptoethanol and 10.3 kd in the absence of 2 mercaptoethanol. Amino acid analysis indicated 12% basic amino acids, 14% acidic amino acids and 16% glycine. The toxin was also stable to filtration and repeated freezing at -20 degrees C and thawing. PMID- 2757637 TI - Multiple populations of deleted mitochondrial DNA detected by a novel gene amplification method. AB - A gene amplification method for detecting small populations of deleted mitochondrial DNA was used in analysis of skeletal muscle from a patient with ocular myopathy. Multiple populations of differently deleted mtDNA were detected in the patient muscle. The presence of deleted mtDNAs was further confirmed by comparison of the shift in the sizes of the amplified fragments with the shift in the positions of the primers used for the amplification, (the primer shift PCR method). Other methods, namely Southern blotting, enzymic activity measurement, and Western blotting, were inefficient at detecting the mitochondrial abnormality. These findings suggest that the primer shift PCR method could be valuable for accurate diagnosis of ocular myopathy associated with mtDNA deletion. PMID- 2757638 TI - Caldesmon has two calmodulin-binding domains. AB - Chicken gizzard caldesmon was cleaved with chymotrypsin or CNBr, and the calmodulin-binding fragments were isolated using an affinity column. Limited chymotryptic digestion gives rise to a 38 kDa calmodulin-binding fragment (CT40) as described previously (Szpacenko, A. & Dabrowska, R., FEBS Lett. 202, 182-186, 1986; Fujii, T., Imai, M., Rosenfeld, G. C. & Bryan, J., J. Biol. Chem. 261, 16155-16160, 1987; Yazawa, M., Yagi, K. & Sobue, K., J. Biochem. 102, 1065-1073, 1987). In the case of CNBr cleavage a 37 kDa calmodulin-binding fragment (CB40) was obtained. Both CT40 and CB40 contain a reactive thiol group, but these thiols are apparently in different environments as judged by the responses of attached fluorescent labels to calmodulin-binding. A comparison of the N-terminal sequences of CB40 and CT40 with the complete sequence of caldesmon shows that the two calmodulin-binding fragments in fact originate from different parts of the parent molecule. Thus there exist two calmodulin-binding sites in caldesmon, one in the N-terminal half and the other in the C-terminal half of the molecule. This is consistent with the recent finding that up to two calmodulin molecules can be crosslinked to each caldesmon molecule (Wang, C.-L.A., Biochem. Biophys. Res. Commun., 156, 1033-1038, 1988). PMID- 2757639 TI - The measurement and mass spectral identification of indole-3-pyruvate from tomato shoots. AB - Endogenous indole-3-pyruvate has been identified by full-scan combined gas chromatography-mass spectrometry and measured using gas chromatography with an electron capture detector. High specific-activity [5-3H]indole-3-pyruvate was synthesized from [5-3H]tryptophan and used as an internal standard. In order to allow purification of the labile indole-3-pyruvate it was stabilised by the formation in the crude extract of its pentafluorobenzyl oxime derivative. This derivative also allowed sensitive detection and measurement of indole-3-pyruvate in the picogram range using a gas chromatograph with an electron capture detector. Endogenous levels were found to be between 8-10 ng/g f.wt. of tomato shoots which is comparable to that of the indole-3-acetic acid pool size, 11 ng/g f.wt., in this tissue. PMID- 2757640 TI - Lifetime evidence for a weak lowest electronic transition in adenosine. AB - The fluorescence decay of adenosine in 1:1 glycol/water glass has been determined at 77K using narrow pulse (700 ps) laser excitation at 290 nm and fluorescence detection with a scanned narrow-gate (100 ps) fast sampler together with digital averaging. Data analysis by re-iterative non-linear least squares convolution shows the decay is best represented by the bi-exponential form I(t) = 0.59exp - t/1.2ns + 0.41 exp - t/7.0ns. This leads to intrinsic radiative lifetimes of 150 ns and 220 ns respectively and a combined oscillator strength of 1.5 x 10(-2). Compared with the overall oscillator strength of 0.29 for the entire first absorption band of adenosine this indicates that transitions to and from the lowest-lying state in this band are quite forbidden. This is not accounted for by current theoretical considerations. PMID- 2757642 TI - A novel strategy for unambiguous determination of inner esterification sites of ganglioside lactones. AB - A method is described which is suitable for protection of all free hydroxyl groups of a glycosphingolipid under conditions which will not cleave ester linkages, including inner ester linkages characteristic of ganglioside lactones. The protecting methoxyethoxymethyl group is stable in alkaline media, surviving permethylation procedures which introduce a methyl ether at all sites previously acylated. Hydrolysis, reduction, and acetylation then yield alditol acetate derivatives which can be analyzed by conventional GC-MS to locate the methyl ether groups. The method is used to locate the inner esterification site of GM3 lactone. PMID- 2757641 TI - Laminin A chain synthetic peptide which supports neurite outgrowth. AB - Neurons from peripheral and central nervous tissue as well as from established cell lines respond to low concentrations of laminin with rapid extension of axon like processes. Two sites on laminin have been identified which stimulate neurite outgrowth, the major site residing at the end of the long arm of laminin. Recently laminin has been cloned and sequenced allowing for synthetic peptides to be prepared and tested for biological activity. We report here that antisera against synthetic peptides corresponding to A and to B1 chain sequences at the end of the long arm can partially inhibit laminin-mediated neurite outgrowth. Further, we show that a 19 amino acid synthetic peptide (CSRARKQAASIKVAVSADR) from the long arm of the laminin A chain is capable of stimulating neuronal-like process formation to almost the same extent as laminin and competes with laminin for stimulation of neurite outgrowth. PMID- 2757643 TI - Molecular basis of beta (0)-thalassemia/HbE disease in Thailand. AB - The molecular basis of beta(0)-thalassemia/HbE disease in 30 Thai patients was investigated using DNA amplification and dot-blot hybridization with a number of allele specific oligonucleotide probes. The mutations identified were 17 cases of 4 base-pair deletion at codons 41-42, 4 cases of amber mutation at codon 17, and one case each of an ochre mutation at codon 35, a single base substitution at position 5 of IVS-1, and a single base substitution at position 654 of IVS-2. PMID- 2757644 TI - Rat liver type I iodothyronine deiodinase is not identical to protein disulfide isomerase. AB - This study was done to test the recent hypothesis (Boado et al. (1988) Biochem. Biophys. Res. Commun. 155, 1297-1304) that type I iodothyronine deiodinase (ID-I) is identical to protein disulfide isomerase (PDI). Autoradiograms of rat liver microsomal proteins, labeled with N-bromoacetyl-[125I]triiodothyronine (BrAc[125I]T3) and separated by SDS-PAGE, show predominantly 2 radioactive bands of Mr 27 and 56 kDa. Substrates and inhibitors of ID-I inhibited labeling of the 27 kDa band but not that of the 56 kDa band. Treatment of microsomes with trypsin abolished labeling of the 27 kDa protein and destroyed the activity of ID-I but did not prevent labeling of the 56 kDa protein. Following treatment of microsomes at pH 8.0-9.5 or with 0.05% deoxycholate (DOC) PDI content and labeling of the 56 kDa protein were strongly diminished but ID-I activity and labeling of the 27 kDa protein were not affected. The latter decreased in parallel after treatment at pH greater than or equal to 10. Rat pancreas microsomes contain high amounts of PDI but show no ID-I activity. Reaction of these microsomes with BrAc[125I]T3 results in extensive labeling of a 56 kDa protein but no labeling of a 27 kDa protein. Pure PDI (Mr 56 kDa) was readily labeled by BrAc[125I]T3 but showed no deiodinase activity. These results strongly suggest that the 27 kDa band represents (a subunit of) ID-I while the 56 kDa band represents PDI. From these and other data it is concluded that PDI and ID-I are not identical proteins. PMID- 2757645 TI - Mossbauer spectroscopy applied to the oxidized and semi-reduced states of the iron-molybdenum cofactor of nitrogenase. AB - Mossbauer parameters at 125K for both the oxidized and semi-reduced states of FeMoco isolated from the MoFe protein of Azotobacter vinelandii nitrogenase of delta/Fe = 0.32 and 0.37 mm/s and delta Eq = 0.84 and 0.71 mm/s, respectively, are reported. FeMoco(ox) fits the Debye model perfectly from 4.2-125K and has a S = 0 ground state. FeMoco(ox) apparently contains 10-20% FeMoco(s-r) and vice versa, possibly as a result of the spontaneous oxidation phenomenon. Quantitation of the spectra indicates a Fe:Mo ratio of 5 +/- 1:1 and the similar quadrupole splittings and isomer shifts suggest a similar environment for all iron atoms. PMID- 2757646 TI - Quantitative determination of kinins released by trypsin using enzyme-linked immunosorbent assay (ELISA) and identification by high-performance liquid chromatography (HPLC). AB - Rapid ELISA and HPLC procedures were developed for quantitation and identification of various natural kinins. Antibradykinin mouse monoclonal antibodies were used to determine kinin levels in the range of 20-200 ng. Bradykinin coupled to bovine serum albumin was used to coat the plates in a 3- to 4-hr ELISA. Synthetic kinin standards isoleucine-seryl-bradykinin (Ileu-Ser-BK), methionyl-lysyl-bradykinin (Met-Lys-BK), tyrosine-bradykinin (Tyr-BK) and bradykinin (BK) yielded almost identical curves with a mixture of A5 and D9 monoclonal antibodies. [Tyr5]-BK, [Tyr8]-BK and des-arginine9 bradykinin (des Arg9-BK) showed negligible amounts of cross-reactivity. ELISA-compatible trypsin digestion developed for release of kinins from plasma of normal humans, rats and turpentine-treated rats gave values of 3.2, 6.9 and 70 micrograms/ml plasma, respectively. High performance liquid chromatography methods were developed for complete resolution of kinins on a C-18 reversed phase mu-Bondapak column before and after derivatization with phenyl isothiocyanate (PITC). The simple PITC derivatization procedure yielded good quantitation above 20 pmol. The ELISA and HPLC methods were used in a complementary fashion to assay and identify kinins in biological fluids as well as during the course of kininogen purification. PMID- 2757647 TI - Physico-chemical properties of prostaglandins and related pharmacological compounds. A theoretical study on conformational related activity. AB - Thromboxane A2, prostaglandin H2, a series of chemically stable cyclic endoperoxide analogues (U 46619, U 44069, ONO 11113, 9, 11, diazo PGH2 and SQ 26655) and different isomers of SQ 26655 were analysed for their spatial configuration by conformational analysis in a simulated membrane-water interface environment with a "structure tree" procedure already described for prostaglandins, leukotrienes and lipoxins. The conformers derived from the structure tree and with a high probability of existence are presented. A new method allows one to visualize the surface charge density of the calculated molecules. The spatial configuration and the surface charge density of each molecule are compared to their known order of competition binding to the putative TXA2/PGH2 receptor of platelets. The conformational and charge density analysis merely shows that the different stereochemistry of these molecules lead to spatial conformation, that mimics (agonists), or that are far from (antagonists) the TXA2/PGH2 conformation. PMID- 2757648 TI - Lactamimides: a novel chemical class of calcium antagonists with diltiazem-like properties. AB - The effects of a series of lactamimides on [3H]d-cis-diltiazem binding to rat brain membranes, on [3H]nitrendipine binding to cardiac membranes, and on calcium induced contractions in depolarized guinea pig taenia and ileum preparations were examined. Several of the lactamimides examined displaced [3H]d-cis-diltiazem binding and antagonized, in a competitive fashion, calcium-induced contractions. Over the series of lactamimides, there was a highly significant, positive linear correlation (r = 0.87, P less than 0.001) between their potency to displace [3H]d cis-diltiazem and their potency to antagonize calcium-induced contractions in the depolarized taenia and ileum preparations. Of the lactamimides examined, MDL 16,582A [N-(2,2-diphenylpentyl)azacyclotridecan-2-imine. hydrochloride] had potency equivalent to d-cis-diltiazem with pA2 values of 7.27 and 7.38, respectively, against calcium-induced contractions in the guinea pig ileum. These lactamimides are a novel chemical class displaying diltiazem-like calcium antagonist properties. PMID- 2757649 TI - In vitro metabolism of azasqualene derivatives and their effects on aminopyrine N demethylase activity in rat liver microsomes. AB - The metabolism of squalene dimethylamine (I), a potent inhibitor of 2,3 oxidosqualene (SO) cyclase, and of sixteen other squalene derivatives was investigated in rat liver microsomes. N-oxidation was the only metabolic pathway observed, squalene dimethylamine N-oxide being the only metabolite isolated from incubation of I. The azasqualane and quaternary ammonium derivatives did not form N-oxides during their metabolism. The inhibition of aminopyrine N-demethylase activity was also studied and the IC50, for compound I, which shows weak competitive inhibition, was determined. At 1 mM concentration the other squalene derivatives showed a range of inhibition activity possibly due to their different lipophilicity. PMID- 2757650 TI - Inhibition of fatty acid biosynthesis by bezafibrate in different rat cells. AB - Bezafibrate is one of the main drugs used in the treatment of human hyperlipemic diseases. Its action on the biosynthesis of fatty acids has been studied and the following conclusions have been drawn: (1) Lipogenesis from glucose is inhibited in hepatocytes and adipocytes isolated from "refed" rats previously treated with bezafibrate. (2) Lipogenesis from glucose is inhibited by bezafibrate in hepatocytes and adipocytes isolated from "refed" rats. (3) Lipogenesis from glucose is also inhibited by bezafibrate in acini isolated from lactating rats. These results show that bezafibrate is an inhibitor of fatty acid synthesis. PMID- 2757651 TI - Ontogeny of the activity of alcohol dehydrogenase and aldehyde dehydrogenases in the liver and placenta of the guinea pig. AB - The objectives of this study were to elucidate the ontogeny of the activity of alcohol dehydrogenase (ADH), low Km aldehyde dehydrogenase (ALDH) and high Km ALDH in the liver and placenta of the guinea pig, and to determine the relationship between the relative activity of each enzyme in the guinea pig maternal-placental-fetal unit and the disposition of ethanol and its proximate metabolite, acetaldehyde. The enzyme activities were determined in maternal liver, fetal liver, and placenta of the guinea pig at 34, 50, 60 and 65 days of gestation (term, about 66 days), in the liver of the 2-day-old neonate, and in adult liver. There was low ADH activity in fetal liver and placenta throughout gestation and in neonatal liver. The fetal liver low Km ALDH activity increased progressively and, at 60 days of gestation, was similar to adult liver activity, as was also the case for neonatal liver enzyme activity. Placental low Km ALDH activity was less than adult liver activity throughout gestation. Fetal hepatic high Km ALDH activity increased during gestation, but was less than adult liver activity, as was also the case for neonatal liver enzyme activity. Placental high Km ALDH activity was low throughout gestation. For oral administration of 0.5 g ethanol/kg maternal body weight to pregnant guinea pigs at mid-gestation (34 days), the maternal blood and fetal body ethanol concentration-time curves were similar. Acetaldehyde was measurable in maternal blood and fetal body at similar concentrations, which were 100- to 1000-fold less than the respective ethanol concentrations. The major difference in the disposition of ethanol and acetaldehyde at near-term pregnancy, compared with mid-gestation, was the lack of measurable acetaldehyde in fetal blood. These results indicate that the guinea pig fetus throughout gestation has virtually no capacity to oxidize ethanol, and its duration of exposure to ethanol is regulated by maternal hepatic ADH catalyzed biotransformation of ethanol. The fetus, however, appears to have increasing low Km ALDH-dependent capacity to oxidize ethanol-derived acetaldehyde during development, and would appear to be increasingly protected from exposure to acetaldehyde as gestation progresses. PMID- 2757652 TI - Effect of inhibition of protein synthesis on cholestasis induced by taurolithocholate, lithocholate, and a manganese-bilirubin combination in the rat. AB - Taurolithocholate, lithocholate, and a manganese-bilirubin combination produced a rapid reduction in bile flow after i.v. injection in the rat. The effect was diminished or blocked completely by pretreating the animals with cycloheximide or ethionine, known inhibitors of protein synthesis. The injection sequence and time period between administration of the inhibitor of protein synthesis and the cholestatic agent influenced the degree to which they modulated the cholestatic effect. The results indicate that uninterrupted protein synthesis is required for the expression of maximal reduction of bile flow by taurolithocholate, lithocholate, and a manganese-bilirubin combination. PMID- 2757653 TI - Reduction of doxorubicin toxicity by methylene blue in cultured rat myocardial cells. PMID- 2757654 TI - [Synthesis and teratogenic action of n-hydroxythalidomide]. AB - N-Hydroxythalidomide (1d), a potential metabolite of thalidomide (1a), was synthesized from N-phthalyglutaminic acid anhydride (1b) and O-tetrahydropyraline hydroxylamine, followed by deprotection. The teratogenicity of 1d was studied using the Hen's-Egg-Test model which had been found applicable for 1a. 1d was more teratogenic to chicken embryos compared to 1a. The percentage of teratogenic malformations in the 1d groups was 28-46%, whereas the percentage in the 1a groups was 20-23%. The oxygen protected precursor N-hydroxythalidomide (1c) was less teratogenic (11-15%). PMID- 2757655 TI - (S)-emopamil, a novel calcium and serotonin antagonist for the treatment of cerebrovascular disorders. 1st communication: pharmacological profile. AB - (S)-Emopamil ((2S)-2-isopropyl-5-(methylphenethylamino)-2-phenylvaleronitril e hydrochloride) is a novel compound of the phenylalkylamine group of calcium antagonists. (S)-Emopamil was tested in comparison to verapamil and gallopamil for calcium and serotonin antagonism and for cerebroprotective activity in acute hypoxia/ischemia. In receptor binding studies with (S)-3H-devapamil, (S)-emopamil exhibited distinct affinity to the verapamil binding site of the calcium channel. In rat cerebrocortical membranes, its affinity (Ki = 38 nmol/l) equalled that of verapamil and gallopamil (Ki = 49 and 27 nmol/l, respectively), whereas it was somewhat weaker in guinea pig skeletal muscle membranes. Comparing (S)-emopamil to its (R)-enantiomer, there was no clear stereoselectivity. Additionally, (S) emopamil showed very high affinity to the cerebral serotonin S2 receptor; its Ki value (4.4 nmol/l) for 3H-ketanserin displacement being substantially lower than that of verapamil and gallopamil (Ki = 177 and 242 nmol/l, respectively). This feature is clearly stereoselective; (S)-emopamil's affinity was distinctly higher than that of the (R)-enantiomer (Ki = 58 nmol/l). The functional significance of (S)-emopamil's receptor affinity was tested in rat aortic strips. (S)-Emopamil's serotonin antagonistic efficacy (EC50 = 4.5 nmol/l) was an order of magnitude higher than that of verapamil and gallopamil. (S)-Emopamil has a less potent calcium antagonistic effect (EC50 = 270 nmol/l) on the aorta than verapamil and gallopamil (EC50 = 35 and 14 nmol/l, respectively). In isolated electrically driven (1 Hz) left atria of guinea pigs, (S)-emopamil inhibited contractile force at a much higher concentration (EC50 = 29 mumol/l) than verapamil and gallopamil (EC50 = 1.1 and 0.19 mumol/l, respectively).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2757656 TI - (S)-emopamil, a novel calcium and serotonin antagonist for the treatment of cerebrovascular disorders. 2nd communication: brain penetration, cerebral vascular and metabolic effects. AB - The cerebral availability of the phenylalkylamine calcium antagonist (S)-emopamil ((2S)-2-isopropyl-5-(methylphenethylamino)-2-phenylvaleronitril e hydrochloride), was investigated in the anesthetized rat by computing the quotient of brain activity and integrated plasma activity 75 min after intraperitoneal injection of the 14C-labeled substance. The relative cerebral concentration defined in this way amounted to 2.05 for emopamil, 0.11 for verapamil and 0.03 ml/g for gallopamil, corresponding to a ratio of 70:4:1. The cerebral uptake of the same substances during a single capillary passage following intracarotid injection was determined by using tritiated water as an internal standard. Relative to the water the following brain uptake indices were obtained: (S)-emopamil 110.3, gallopamil 45.3 and verapamil 40.6%. According to these figures, emopamil is clearly superior to verapamil and gallopamil both with regard to cerebral availability and blood-brain barrier permeability. The effect of emopamil enantiomers on local cerebral blood flow was studied autoradiographically in the artificially ventilated rat anesthetized with nitrous oxide. The test substances were infused intravenously over 30 min, the determination of local cerebral blood flow being carried out 10 min after the end of the infusion. The numerical evaluation included 40 brain structures. In the investigated regions the infusion of 3 and 6 mg/kg (S)-emopamil led to an average blood flow increase of 24 and 52%, respectively. In the latter experimental group the values for the 22 cerebral structures showing a statistically significant effect were between 128 and 208% of control. In contrast, the application of 6 mg/kg (R)-emopamil did not lead to a significant change in blood flow in any of the areas.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2757657 TI - (S)-emopamil, a novel calcium and serotonin antagonist for the treatment of cerebrovascular disorders. 3rd communication: effect on postischemic cerebral blood flow and metabolism, and ischemic neuronal cell death. AB - The effect of (S)-emopamil ((2S)-2-isopropyl-5-(methylphenethylamino)-2 phenylvaleronitril e hydrochloride) treatment on postischemic cerebral blood flow and metabolism was investigated in nitrous oxide anesthetized, artificially ventilated rats. Forebrain ischemia was induced and maintained for 20 min by lowering arterial blood pressure to approximately 40 mmHg and clamping both carotid arteries. Local cerebral blood flow and glucose utilization were evaluated autoradiographically in 34 cerebral regions. In the cerebral blood flow studies intravenous infusion of 0.1 mg/(kg min) (S)-emopamil was begun 5 min after the end of ischemia. Local cerebral blood flow was determined 60 min later using [14C]iodoantipyrine. When the animals were treated with saline only, postischemic blood flow of 22 affected forebrain areas fell on average to 42 +/- 13% of nonischemic control. Treatment with (S)-emopamil increased perfusion of the same areas in a region-dependent fashion by an average of 54 +/- 19%, resulting in 63 +/- 17% of control values. The rise of blood flow in structures not directly affected by ischemia amounted to 52 +/- 27% (134 +/- 23% of control). In the studies on cerebral metabolism, the experimental animals received a total of 6 mg/kg (S)-emopamil by slow intravenous infusion before and during the ischemic episode. Determination of local cerebral glucose utilization was initiated after 50 min of postischemic recirculation using [14C]deoxyglucose. In the placebo-treated experimental group average glucose utilization of 14 forebrain areas was significantly lower (74 +/- 9% of control) than in the nonischemic control group.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2757658 TI - The effect of cibenzoline on myocardial damages in dogs. AB - The antiarrhythmic and cardioprotective effects of cibenzoline (4,5-dihydro-2 (2,2-diphenylcyclopropyl)-1H-imidazole) were investigated. Nineteen adult mongrel dogs were divided into 2 groups; in the control group, physiological saline (25 ml) was administered, and 20 min after, the left anterior descending coronary artery (LAD) was occluded for 2 h; in the cibenzoline group, cibenzoline (2 mg/kg), was administered 10 min before 2 h LAD occlusion. Blood pressure and appearance of arrhythmias were monitored throughout the experiment. Two h after occlusion, mitochondria were prepared from both ischemic and non-ischemic areas in each group, and their functions were measured polarographically. Fractionation of myocardial tissue from both ischemic and non-ischemic areas was performed, and activities of lysosomal enzymes (N-acetyl-beta-glucosaminidase and beta glucuronidase) were measured in each fraction. Administration of cibenzoline significantly reduced the appearance of ventricular arrhythmias in association with ischemia. Cibenzoline did not change significantly blood pressure and heart rate. In the control group, mitochondrial dysfunction and leakage of lysosomal enzymes induced by 2 h occlusion were observed. Administration of cibenzoline maintained significantly mitochondrial function and prevented significantly leakage of lysosomal enzymes. These results indicated that cibenzoline has a cardioprotective as well as an antiarrhythmic effect on ischemic myocardium. PMID- 2757659 TI - Metabolism and excretion of 14C-tiropramide after single intravenous or peroral administration to the rat. AB - The study was performed with 14C-tiropramide hydrochloride, i.e. O-(2 diethylamino-ethyl)-N-benzoyl-[DL-(U-14C)tyrosyl]-dipropylamide+ ++ hydrochloride, with a specific activity of 466.16 microCi/mmol. For the study of pulmonary, urinary and fecal excretion the substance was administered in single intravenous (i.v.) doses of 4 mg/kg to 4 rats (2 males and 2 females) and in single peroral (p.o.) doses of 10 mg/kg to other 4 rats (2 males and 2 females). For the study of biliary excretion 4 mg/kg of 14C-tiropramide hydrochloride were administered in single i.v. doses to 4 rats (2 males and 2 females) anesthetized with urethane and the bile was collected from the choledocus in the 8 h following administration. The radioactivity in the expired CO2, urine feces and bile was measured by scintillometry. The radioactive substances were extracted, separated by TLC and identified by comparison of their Rf values with those of putative metabolites with known chemical structure. The following results were obtained. Radioactivity in the expired CO2: No radioactivity was found, either after i.v. or p.o. administration. Radioactivity in urine: In the 48 h after administration 37% of the i.v. administered radioactivity and 31% of the p.o. administered radioactivity was recovered in the urine. Six basic substances could be identified. In order of decreasing abundance these were CR 1166, CR 1098, tiropramide, CR 1034, CR 1919 and CR 1938. Radioactivity in feces: In the 120 h after administration 60% of the i.v. administered radioactivity and 56% of the p.o. administered radioactivity was recovered in the feces.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2757660 TI - [Penetration and action of edoxudine in vitro and in vivo]. AB - The penetration of 5-ethyl-2'-deoxyuridine (edoxudine, Aedurid) from gel base with and without the addition of urea and other adjuvant has been studied in an in vitro model using guinea pig skin. The formulation of 3% edoxudine gel with 5% urea showed the best results. In vivo experiments on hairless mice infected intracutaneously with herpes simplex virus type 1 also showed this formulation's good efficacy as compared to other formulations. PMID- 2757661 TI - Tumor inhibition by ferricenium complexes. Activity against some solid experimental tumors. AB - In the present study, the antitumor activity of some water-soluble ferricenium complexes [(C5H5)2Fe]+ X- (I, X- = [FeCl4]-; II, X- = 1/2[Cl3FeOFeCl3]2-; III, X- = [2,4,6-(NO2)3C6H2O]-; IV, X- = [CCl3COO]- 2CCl3COOH) was investigated against the solid, subcutanteously growing tumors sarcoma 180, B16 melanoma and colon 38 adenocarcinoma. Whereas, in the case of solid sarcoma 180, only marginal antitumor activity was observed for I-IV, the compounds effected growth inhibitions of solid B16 melanoma and colon 38 carcinoma by 35-60% and 50-73%, respectively, resulting in T/C ratios of 40-65% and 27-50%. In most tests, ferricenium trichloroacetate IV, followed by ferricenium mu-oxo bis(trichloroferrate) II, were characterized by best antitumor properties against the tumor models investigated. PMID- 2757662 TI - [The effect of the antiarrhythmic, prajmalium bitartrate, on human thrombocyte function]. AB - Studies of the in vitro effects of the antiarrhythmic drug prajmalium bitartrate (PBT, Neo-Gilurytmal) showed inhibitory effects on platelet aggregation and thromboxane production. PBT inhibited the primary and secondary phases of aggregation induced by adrenaline (epinephrine) or adenosine diphosphate (ADP). Platelet aggregation stimulated with collagen, platelet activating factor (PAF), and the thromboxane mimetic 9,11-azo-prostaglandin H2 (U 44064) was inhibited. The secondary phase of aggregation induced by ristocetin and aggregation caused by arachidonic acid (AA) were inhibited in samples from some donors (responders) but not in others (nonresponders). Platelet aggregation by the ionophore calcimycine (A 23187) was not inhibited, but small doses of calcimycine abolished the PBT-induced inhibition of aggregation caused by ADP. Thromboxane production of platelets with collagen of ADP was inhibited by higher concentrations of PBT, whereas AA-induced thromboxane synthesis remained unchanged. The observed antiplatelet activities of PBT are thought to result from calcium and sodium channel blocking properties of the drug. PMID- 2757663 TI - Pharmacokinetics and bioavailability of oral acetylcysteine in healthy volunteers. AB - The plasma pharmacokinetics of oral acetylcysteine(N-acetylcysteine, NAC) after the administration of single 600 mg and repeated 200 mg doses and the relative bioavailability of the two regimens were studied in 12 adult subjects. On two different occasions in a cross-over, balanced fashion the subjects were administered orally either a single dose of NAC 600 mg as effervescent tablets or 4 repeated doses of NAC as granules in sachets at the regimen of 200 mg t.i.d. Venous blood samples were obtained just before dosing and 20, 40 min, 1, 1.5, 2, 3, 4, 6, 8, 10 and 12 h after the administration of NAC 600 mg; with the 1st, the 2nd and the 4th doses of NAC 200 mg samples were taken just before dosing and after 20, 40 min, 1, 1.5, 2, 3, 4, 6 and 8 h, the last sampling after the 1st dose being the one before the 2nd dose. A detailed description of the assaying methods of NAC is given in the text. As indexes of bioavailability Cmax' tmax and AUC of NAC plasma concentrations were considered and MRT was taken as an estimate of its persistence in plasma. NAC was quickly absorbed without any significant difference in tmax among the doses. With the 600 mg dose Cmax' AUC and MRT were greater than with a single 200 mg dose; after summing up the values of these parameters for the 200 mg doses no significant differences were observed in comparison to the single 600 mg dose in Cmax and AUC, while MRT resulted significantly higher.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2757665 TI - Acute effects of two dosages of orally administered midazolam on psychomotor performance in healthy volunteers. AB - The acute effects of two doses of orally administered midazolam (Dormicum, 10 and 30 mg) which as a putative anaesthetic premedicant is clinically expected to provide valid effects already after acute dosing on sedation parameters, were evaluated vs placebo within a randomized double-blind 3-period crossover design in 12 healthy male volunteers. The washout period was 7 days. Objective sedation measures were obtained with the oculodynamic test (ODT), which is a multidimensional computerized psychological testing device. Cardiorespiratory parameters were simultaneously sampled throughout the ODT-sessions. Intradiurnal assessments were done at -30, +30, +90 and +180 min post-dose. Subjective side effects were recorded by spontaneous recall and by means of a symptom check list. With midazolam there was a dose-dependent increase of sedation in the ODT, which persisted for at least 3 h after intake. The subjective side effects fitted a sedative pattern with mild (10 mg) and marked (30 mg) impairment of vigilance. Cardiovascular and respiratory parameters were changed vs placebo. All subjects reported an anterograde amnesia after the 30-mg dose at about 3 or 5 h post-dose, which depicts a double-peaking time course in some subjects. The subjects ability to cooperate in the psychomotor test regimen was distinctly impaired after 30 mg of midazolam during daytime administration. PMID- 2757664 TI - [Absolute bioavailability of a special sustained-release acetylsalicylic acid formulation]. AB - Absolute Bioavailability of a Special Acetylsalicylic Acid Sustained Release Formulation. The absolute bioavailability of an acetylsalicylic acid (ASA) sustained release formulation (Contrheuma retard), containing 300 mg ASA as initial dose and 350 mg in a retard formulation, was determined in comparison to a standard ASA solution for intravenous administration in a two-treatment, two period cross-over trial with 6 healthy male volunteers by comparing the areas under the plasma-fluctuation-time curves of the primary metabolite. In addition, it was examined by comparison of the mean times after administration of both formulations, whether the test formulation meets the requirements of a sustained release formulation. The investigations led to the following results: The absolute bioavailability of the test formulation was 95%. The statistical comparison of the areas under the concentration-time courses allowed no decision (neither for equivalence nor difference). The maximal concentration of SA after intravenous administration of the standard formulation was reached after 0.4 h on an average and amounted to 62 micrograms/ml. After oral administration of the test formulation, a mean concentration maximum of 28 micrograms/ml was calculated, which had been reached after about 2 h. The differences are statistically significant. The mean time for SA was 6 h after the standard formulation, whereas after administration of the test compound, a mean of 11.5 h was calculated. 24 h following administration, the concentration of SA was 1.3 micrograms/ml after intravenous administration of the standard formulation and 5.5 micrograms/ml after administration of the test formulation. These differences, too, are statistically significant. From the comparison of the mean time for SA, a retard factor of 1.9 was calculated. PMID- 2757666 TI - Clinical application of a human-collagen fleece as haemostatic agent. AB - Local haemostatic agents have been employed for years in all surgical fields. Collagen has proved superior to other materials in terms of its haemostatic effect and good tolerability. A human-collagen fleece (Beristypt) is now available for the first time. A special manufacturing process excludes the possibility of human-pathogenic viruses being transmitted. The good clinical efficacy of human-collagen fleece for the indication haemostasis and the fact that it is easy to use, have been demonstrated in 63 operations in four surgical fields. Human-collagen fleece was well tolerated; no adverse effects were reported. The use of human-collagen fleece is a promising adjuvant method for improvement of surgical haemostasis. PMID- 2757667 TI - [The effect of recombinant human tumor necrosis factor alpha on malignant tumors in vivo. Physiopathologic basis for clinical oncology]. AB - Effects of Recombinant Human Tumor Necrosis Factor-alpha on Malignant Tumors in vivo/Pathophysiological fundamentals for clinical oncology. The impact of recombinant human tumor necrosis factor-alpha (rhTNF-alpha; 6.6.10(6) U/mg protein) on growth, metabolism and perfusion of isotransplanted rat tumors (DS carcinosarcomas) was investigated. Tumor growth was stimulated at low TNF doses (1 and 10 micrograms/kg), and significantly retarded at higher TNF dose levels (0.1 and 1.0 mg/kg). Growth changes were paralleled by variations in perfusion and metabolism. A reduced tumor blood flow enhanced the efficacy of a subsequent heat treatment. From these results, important implications for the clinical use of rhTNF-alpha are obvious (e.g., possible growth stimulation, timing of a combination therapy with other tumor treatment modalities). PMID- 2757668 TI - Stability in biological fluids and clearance of immunoliposomes. AB - The in vivo and in vitro stability of liposomes having covalently bound monoclonal antibodies (MAB) connected to their surface via a disulfide bridge (about 6 anti-melanoma MAB-molecules per liposome) in tissue fluids was investigated. These immunoliposomes were composed of equimolar amounts of hydrogenated soybean lecithin and cholesterol and had a mean diameter of 113 nm. The protein-lipid binding, change of vesicle size and the release of encapsulated carboxyfluorescein (CF) were estimated. After i.v. injection into mice, an initial protein cleavage of 21% occurred within 30 min p.a., followed by a slow elimination of intact MAB-liposomes from blood circulation (t50 = 2.2 h). These liposomes had a similar elimination rate as protein-free liposomes. The in vitro results after incubation of MAB-liposomes in blood, plasma, serum and tissue fluid were very similar with regard to the protein-lipid cleavage, but the time dependence was different. The CF-release in vitro was slower (about 1.5%/d) than the protein cleavage; the vesicle size of MAB-liposomes increased substantially in contrast to protein-free liposomes in serum during 4 days. PMID- 2757669 TI - Synthesis and muscarinic activity of a series of tertiary and quaternary N substituted guvacine esters structurally related to arecoline and arecaidine propargyl ester. AB - A series of tertiary and quaternary N-substituted guvacine (1,2,5,6-tetrahydro-3 carboxy-pyridine) methyl and propargyl esters have been synthesized and tested for muscarinic/antimuscarinic activity on rat ileum and electrically paced left atria. Arecoline and arecaidine propargyl ester (APE) as well as their corresponding N-demethyl derivatives, guvacoline (norarecoline) and guvacine propargyl ester, acted as full agonists at both atrial and ileal muscarinic receptors (range of pD2-values 6.09-8.07). However, in both preparations arecoline and APE were clearly more potent (up to 15-fold) than their N-demethyl analogues. Replacement of the N-methyl group in arecoline and APE by larger substituents (ethyl, n-propyl, n-butyl, benzyl, phenylethyl) as well as N methylation resulted in a decrease or even a complete loss of agonistic activity. In both organs, the propargyl esters usually showed higher potency than the corresponding methyl ester analogues. N-Ethylguvacine propargyl ester and APE methiodide displayed pronounced agonistic activity in the atria (pD2 approximately 6.5; intrinsic activity = 0.79 and 0.67, respectively) but behaved as competitive antagonists in the ileum (pA2 = 6.06 and 5.62, respectively). Beside the lower sensitivity to muscarinic agonists of the rat ileum as compared to rat atria, the cardioselective stimulant action of both agents may also be due to their ability to recognize structural differences between atrial M2 alpha and ileal M2 beta muscarinic receptor subtypes. PMID- 2757670 TI - The adrenergic properties of ring-brominated isoprenaline analogues. AB - The beta 1- and beta 2-adrenoceptor activity of the 2- and 6-ring-brominated analogues of isoprenaline were evaluated in vitro. The 2-bromo-substituted analogue exhibits a far greater activity on beta 1- and beta 2-receptors than the 6-bromo-substituted analogue. PMID- 2757671 TI - Effects of the antiparkinson drug budipine on EEG activity in unrestrained rats. AB - Rats were stereotactically implanted with electrodes into four brain areas (frontal cortex, hippocampus, striatum, and reticular formation) to allow registration of intracerebral field potentials. Connection of the electrodes to a microplug fixed to the skull of the animals allowed wireless transmission of the signals using a four-channel telemetric device. The potentials were subjected to a frequency analysis in real time, the power spectra obtained were segmented according to previous experience. Even in the low-dose range, budipine affected the power within these frequency bands: at 2 mg/kg i.p. in the hippocampus, at 4 mg/kg in the frontal cortex also. Power increases, observed mainly in the alpha-1 and beta-2 bands, became decreases in several bands when the dosage was raised to 8 mg/kg. Further power decreases, especially in the alpha-1 and beta-1 range, were observed after 12 mg/kg of budipine. It is notable that the reticular formation was affected only at the high dosage. The muscarinic anticholinergics biperiden and scopolamine provoked a pattern of electric brain activity changes which were to some extent similar to those obtained with the low dose of budipine, in terms of power increases the delta, alpha-1 and beta-2 frequencies in the hippocampus and frontal cortex. In the striatum and reticular formation, however, they were essentially different. Here the anticholinergics differed not only from budipine, but also from each other: biperiden caused decreases in theta and alpha-2 power comparable to the action of 2,3,4,5-tetrahydro-1-phenyl-1H-3 benzazepine-7,8-diol, a dopamine D1-agonist. Scopolamine, in contrast, displayed the familiar pattern of delta and alpha-1 increases in the striatum.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2757673 TI - Binding of the new calcium entry blocker nilvadipine to rat aortic and guinea pig left ventricular membranes. AB - The binding of 3H-nilvadipine to the vascular (rat aortic) and cardiac (guinea pig left ventricular) microsomes was reversible and saturable. The results of the competitive binding experiments showed that nilvadipine had a higher affinity (Kd: 1.5 +/- 0.2 nmol/l) for the vascular binding sites than did nifedipine (Kd: 10.7 +/- 0.8 nmol/l) and nicardipine (Kd: 6.9 +/- 2.0 nmol/l), while the affinity of nilvadipine for the cardiac binding sites (Kd: 3.8 +/- 0.4 nmol/l) was similar to that of nifedipine (Kd: 3.3 +/- 0.1 nmol/l) and nicardipine (Kd: 4.2 +/- 0.3 nmol/l). The time courses of dissociation of the unlabeled dihydropyridines from the vascular binding sites were investigated using 3H-nitrendipine. Nilvadipine and nicardipine dissociated more slowly from the binding sites than did nifedipine. These results suggest that the high potency, selectivity for the vascular smooth muscle and long duration of action of nilvadipine may be related to its binding properties. PMID- 2757672 TI - [The disposition of bornaprine hydrochloride in the rat. 2. The metabolism of exo epimers]. AB - The biotransformation of an epimeric form of the anticholinergic drug exo-2 phenyl-bicyclo-[2.2.1.]-heptane-2-carboxylic acid (4'-diethylaminopropyl)ester hydrochloride (bornaprine hydrochloride, Sormodren) was investigated after oral application in male Wistar rats. Main metabolite of the exo-isomer in the feces was the hydroxylated and sulfate-conjugated product, substitution having occurred at C(5) of the bicyclic ring in exo-position. As further metabolites, the sulfate conjugate in exo-position at C(6) and the N-desethyl derivatives of both were detectable. PMID- 2757674 TI - Distribution of tiropramide and metabolites after single intravenous or peroral administration of 14C-tiropramide to the rat. AB - The study was performed with 14C-tiropramide hydrochloride, i.e. O-(2 diethylamino-ethyl)-N-benzoyl-[DL-(U-14C)tyrosyl]-dipropylamide+ ++ hydrochloride, with a specific activity of 466.16 microCi/mmol. The substance was administered in single intravenous (i.v.) doses of 4 mg/kg to 16 rats (8 males and 8 females) and in single peroral (p.o.) doses of 10 mg/kg to other 16 rats (8 males and 8 females). The radioactivity in plasma, in several organs and tissues and in gastrointestinal contents was measured by scintillometry. After i.v. administration the radioactivity is rapidly found in all investigated organs and tissues and also in the stomach contents. The radioactivity is concentrated in the liver and kidney, and also in other organs, as the pancreas and the salivary glands. After 120 h the radioactivity is small in the organs but still appreciably present in the colon content. The radioactivity crosses the blood brain barrier. Deep compartments were not found. After p.o. administration the radioactivity is rapidly found in the organs and is particularly concentrated in the liver, showing a rapid absorption from the gastrointestinal tract. Besides the obvious higher concentration of radioactivity in the stomach and small intestine in the initial times after p.o. administration, the distribution and elimination pattern from the organs do not substantially differ from those found after i.v. administration. The distribution pattern found using the scintillographic method were confirmed by an autoradiographic study made on 12 non-pregnant rats (10 males and 2 females) and on 7 rats at the 13th day of pregnancy and 7 rats at the 18th day of pregnancy.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2757675 TI - On the mechanism of the pharmacological activity of the new nonsteroidal antiinflammatory agent 4'-acetamidophenyl-2-(5'-p-toluyl-1' methylpyrrole)acetate. AB - 4-Acetamidophenyl-2-(5'-p-toluyl-1'-methylpyrrole)acetate (AU 8001), a tolmetin derivative, prepared by esterification with paracetamol, showed antiinflammatory antirheumatic activity in animal models. This activity is believed to be largely due to the ability of the drug to inhibit the synthesis of prostaglandins. Furthermore, there is evidence that AU 8001 may also reduce the leucocyte immigration into inflamed tissues. Moreover, AU 8001 had no effects, after oral administration, on histamine- and 5-hydroxytryptamine-induced increase of vascular permeability or lysosome membrane stabilization. PMID- 2757676 TI - Effect of a natural flavonoid on gastric mucosal barrier. AB - The effects of 3,5,7-trihydroxy-2-(3,4-dihydroxyphenyl)-1-benzopyrylium chloride (IdB 1027) on the rat gastric mucosa were evaluated. IdB 1027 administered intragastrically at doses ranging from 100 to 400 mg/kg inhibited the fall in transmucosal potential difference and the increase in H+ back-diffusion induced by acetylsalicylic acid. Moreover, IdB 1027 at doses of 50 and 200 mg/kg by intragastric route increased the gastric bicarbonate secretion. These results suggest that the gastroprotective activity of IdB 1027 is mediated by an increase in the efficiency of gastric mucosal barrier. PMID- 2757677 TI - Interaction of enoxacin with theophylline in rats. AB - Enoxacin (ENX) has been reported to raise significantly plasma levels of theophylline (TP) in humans. In order to elucidate a mechanism of this interaction, in vivo and in vitro studies were carried out in rats. Concomitant dosing of ENX with TP significantly elongated plasma elimination half-life of TP, which led to a marked increase in the maximum plasma TP level after repeated administrations of both drugs. In rats treated with ENX, urinary excretion of unchanged TP increased and that of TP metabolites comparably decreased. The pharmacokinetic analysis showed that ENX did not change renal clearance of TP and these observed effects of ENX were attributed to reduced metabolic clearance of TP. In the in vitro studies by using liver microsomes, ENX reduced the magnitude of the type II difference spectral interaction of TP with cytochrome P-448 (P 448) and the formation of TP metabolites catalyzed by P-448. These results strongly suggest that the inhibition of the TP binding to the ferric iron of P 448 leads to that of the TP metabolism. The most essential site of ENX to inhibit the TP metabolism was found to be the 4'-nitrogen atom in the 7-piperazinyl group, and the stereochemical structure of ENX was suggested to be responsible for this inhibition. PMID- 2757678 TI - [Biocompatibility and mechanical strength of various dura mater preparations after intraperitoneal implantation in rats]. AB - Biocompatibility and mechanical strength of 3 different dura mater preparations were studied during 1, 2 and 4 weeks in a rat model. Two preparations produced by conventional methods did not markedly differ, whereas the third one, which had been freeze-dried after addition of glycerol, exhibited some special properties, showing higher mechanical strength throughout the whole period of implantation, and lower tendency to form adhesions, and inducing weaker leucocytic reaction. For certain surgical problems this soft, strong and compatible dura preparation could be an appropriate alternative. PMID- 2757679 TI - Metabolism of the calcium antagonist gallopamil in man. AB - The metabolism of gallopamil (5-[(3,4-dimethoxyphenyl)methylamino]-2-(3,4,5 trimethoxyphenyl) -2- isopropylvaleronitrile hydrochloride, Procorum, G) was studied after single administration (2 mg i.v., 50 mg p.o.) of unlabelled and labelled G (14G, 2H). TLC, HPLC, GLC, MS and RIA were used for assessment of G and its metabolites in plasma, urine and faeces. G clearance is almost completely metabolic, with only minimal excretion of unchanged drug. Metabolites represent most of the plasma radioactivity after p.o. administration. They are formed by N dealkylation and O-demethylation with subsequent N-formylation, or glucuronidation, respectively. Compound A, derived by loss of the 3,4 dimethoxyphenethyl moiety of G is the main metabolite in plasma and urine (about 20% of the dose). This metabolite is accompanied by its N-formyl derivative (C), by the N-demethylated compound (H) and the acid (F), formed by oxidative deamination of A. Only 3 unconjugated monphenoles from several O-demthylated products showed distinct plasma levels which were nevertheless lower than metabolite A. These metabolites had no relevance to the pharmacodynamic action. Conjugated monophenolic and diphenolic products represented the major part in plasma and were excreted predominantly via the bile: they represented almost the whole faecal metabolite fraction. Less than 1% of the dose was recovered unchanged in the urine. About 50% of the dose is excreted by urine and 40% by faeces. PMID- 2757680 TI - [Bioavailability and pharmacokinetics of a new nifedipine preparation in healthy volunteers]. AB - In the course of this trial the bioavailability and the essential pharmacokinetic parameters of a newly developed 10 mg nifedipine preparation were to be determined in comparison to a marketed reference preparation after single oral administration. For this purpose, the test and the reference preparation were examined in 16 healthy volunteers according to a randomized 2-way cross-over design (latin square), blood samples were withdrawn up to 16 h p.a. and plasma concentrations of nifedipine and NPO (primary metabolite of nifedipine) were quantified by a HPLC method. Both preparations led to mean maximum concentrations of nifedipine in plasma of 110 mg/ml about 0.5 h p.a.; the mean termial half lives were 1.8 h (test preparation) and 1.7 h (reference preparation). The data found for the metabolite NPO largely corresponded to those of the parent substance, thus equal metabolisation and adequate pharmaceutical quality of the two galenics may be presumed. Statistical comparison (ANOVA, Pratt-Wilcoxon test) did not reveal any significant differences between the test and reference preparation and, apart from a minor deviation, confidence intervals according to Westlake were sufficiently small, such that the two formulations may be considered bioequivalent. No differences of clinical relevance were detected between the two preparations in assay. The undesired side effects/concomitant symptoms known after nifedipine administration were observed. PMID- 2757681 TI - Lung tissue concentrations of ciprofloxacin following intravenous administration in patients. AB - Serum and corresponding lung tissue concentrations of ciprofloxacin (Ciprobay) were investigated in 25 patients undergoing open lung surgery for pulmonary malignancies. Drug levels were measured at various times (50-240 min) after completion of a single i.v. dose of 200 mg by bioassay and HPLC. Lung tissue concentrations peaked within one hour after dosing (bioassay: 3.2 micrograms/g, HPLC: 4.5 micrograms/g). Tissue levels exceeded corresponding serum level 3- to 4fold throughout the observation period. The results demonstrate excellent penetration properties of this new antimicrobial compound into lung tissue. Ciprofloxacin was concentrated in the lung and thus by far exceeded known minimum inhibitory concentrations for most nosocomial respiratory pathogens. PMID- 2757682 TI - Effect of cardiac rehabilitation on postprandial response to a high fat meal in patients with coronary artery disease. AB - Past studies have shown decreased lipemic responses to a high fat meal in healthy trained vs. untrained subjects. The purpose of this study was to characterize fasting lipid profiles and lipemic responses in 13 male cardiac patients (6 in cardiac rehabilitation (CR) and 7 controls (NONCR]. Body composition and dietary composition were assessed. Plasma total cholesterol (TC), HDL-cholesterol (HDL-C) and triglyceride (TG) were determined after a 12-h fast. Subjects consumed a high fat meal (60% of calories) and the lipemic response to the meal was assessed by determining plasma TG hourly for 8 h following the meal. CR had a lower percent body fat than NONCR (26% vs. 34%, P less than 0.05). CR consumed fewer calories from fat than NONCR (28% vs. 41%, P less than 0.05). There were no significant differences between groups in TC, HDL-C or TG, although the differences approached significance (P less than 0.10). CR had a lower TC/HDL-C ratio than NONCR (5.0 vs. 7.7, P less than 0.05). Lipemic responses between groups were similar. There was no significant difference in peak TG, time to peak TG, or area under the TG curve between CR and NONCR groups. Thus, subjects undergoing cardiac rehabilitation appear to have both a more favorable diet and fasting lipid profile than NONCR; however, both groups had a similar response to a high fat meal. PMID- 2757683 TI - Fat consumption and factor VII coagulant activity in middle-aged men. An association between a dietary and thrombogenic coronary risk factor. AB - Diet was measured by 5-day weighed inventory to search for an association between fat intake in the general population and factor VII coagulant activity (VIIc), a strong predictor of coronary heart disease. Of 275 men aged 40-59 years registered with a medical practice, 203 (74%) participated and 170 (62%) provided a satisfactory record. After allowance for the increase in fat intake with body size, a statistically significant and positive association was found between dietary fat and VIIc (r = 0.18; P less than 0.05). The correlation coefficient was increased to 0.24 when adjusted for the effect of day-to-day variability in individual fat intake, thereby providing an improved estimate of the true strength of association. The mean difference in VIIc of 12% of standard between men in the highest and lowest quarters of the distribution of fat intake was similar to that reported between men experiencing coronary heart disease and those remaining free. The results support previous experimental fat-feeding studies and suggest that a high fat diet has adverse consequences for blood coagulability and coronary thrombosis. PMID- 2757684 TI - Vasa vasorum in the carotid sinus of atherosclerotic monkeys: implications for baroreceptor function. AB - The carotid sinus is unusually susceptible to development of severe atherosclerotic lesions. The purposes of this study were to examine effects of atherosclerosis on blood flow through vasa vasorum in the carotid sinus and to examine responses to humoral stimuli. Blood flow to vasa in the carotid sinus was measured with microspheres in 8 normal and 9 atherosclerotic cynomolgus monkeys. Blood flow to vasa in intima-media (in ml/min per 100 g) was 0.5 +/- 0.3 (mean +/ SE) in normal and 21 +/- 5 in atherosclerotic monkeys (P less than 0.05). Flow to adventitial vasa was 37 +/- 5 in normal monkeys and 50 +/- 7 in atherosclerotic monkeys (P greater than 0.05). Infusion of phenylephrine did not affect blood flow in normal or atherosclerotic monkeys. Infusion of serotonin did not affect blood flow to vasa in normal monkeys, but decreased flow to vasa in both intima-media and adventitia of atherosclerotic monkeys. In normal media, histological examination demonstrated the presence of a few vasa vasorum, which penetrated from adventitia. In atherosclerotic monkeys, medial vasa were much more frequent. Thus, (1) atherosclerosis produces marked increases in blood flow through vasa in intima-media of the carotid sinus, probably as a consequence of proliferation of vasa, and (2) in atherosclerotic monkeys, vasa constrict in response to serotonin. Based on these findings, we speculate that when serotonin is released as platelets aggregate at plaques in the carotid artery, serotonin may be delivered through vasa to nerves in the carotid sinus and thereby affect baroreceptor function. PMID- 2757685 TI - Ganglioside content and composition of cells from normal and atherosclerotic human aorta. AB - The ganglioside content and composition of cells obtained by enzyme digestion of 2 layers of human aortic intima were investigated. Five gangliosides were identified in cells isolated from the external musculo-elastic intimal layer adjacent to the media: GM3, GM1, GD3, GD1a, and GT1b. The same gangliosides plus ganglioside Gx, the chromatographic mobility of which corresponded to the mobility of ganglioside GD1b from human brain, were found in cells from the internal elastic-hyperplastic intimal layer adjacent to the vessel lumen. In both layers, the major cellular ganglioside was GM3 which represented 60% of the total cellular ganglioside content. The ganglioside content was lower in cells obtained from fatty streaks compared to cells isolated from unaffected intima. The amount of di- and trisialogangliosides in atherosclerotic plaque cells was lower, and that of monosialogangliosides higher than in cells isolated from unaffected intima. The amount of GM3 was mainly responsible for the difference in the total ganglioside content of cells obtained from different lesion types. On the whole, cells from fatty streaks contained smaller amounts of total gangliosides, whereas cells from plaques had greater total ganglioside content, than cells from unaffected intima. PMID- 2757686 TI - Sequence of the salmon (Oncorhynchus keta) [corrected] preproinsulin gene. PMID- 2757687 TI - Risk of thyroid cancer after diagnostic doses of radioiodine. PMID- 2757688 TI - The physician and the dying patient. PMID- 2757689 TI - Nursing comes of age. PMID- 2757690 TI - Management of Displaced Extension-type Supracondylar Fractures of the Humerus in Children. PMID- 2757691 TI - A new approach to the treatment of pseudomembranous colitis? PMID- 2757692 TI - Another cause of cachexia. PMID- 2757693 TI - Friendship in general practice. PMID- 2757694 TI - Value of heart-synchronized ventilation during extracorporeal shock wave lithotripsy remains unproven. PMID- 2757695 TI - The [lactate]/[pyruvate] ratio and alcohol metabolism: experiments with naloxone in fasting normal male volunteers. AB - Naloxone administration to fasting normal male volunteers reverses the acute ethanol-induced increase in the blood [lactate]/[pyruvate] ratio, but fails to lower blood-ethanol concentration. The results are discussed in relation to factors affecting ethanol elimination and the mechanism of antagonism of acute alcohol intoxication by naloxone. PMID- 2757696 TI - Effect of diet on [lactate]/[pyruvate] ratios during alcohol metabolism in man. AB - Ten subjects received alcohol by intravenous infusion on two occasions, after five-day periods on high- or low-carbohydrate diets. Blood [lactate]/[pyruvate] ratios were significantly higher during fasting alcohol metabolism after the low carbohydrate, high-fat diet. The carbohydrate/fat balance in the diet may affect cytoplasmic-mitochondrial NADH transfer. Dietary composition may modify the metabolic changes caused by alcohol. PMID- 2757697 TI - Increase in synaptosomal acidic phospholipids after intermittent but not continuous ethanol exposure. AB - The aim of this study was to compare the effects of different ethanol administration procedures on synaptosomal concentrations of acidic phospholipids. The concentrations of phosphatidylinositol and phosphatidylserine were significantly increased after intermittent ethanol exposure for one week but were unaltered after one or three weeks of continuous ethanol administration. The results indicate the importance of drinking pattern for changes in synaptosomal acidic phospholipids. PMID- 2757698 TI - The North Carolina Alcoholism Research Authority, thirteenth annual symposium. March 2 and 3, 1989, Raleigh, NC. Papers and abstracts. PMID- 2757699 TI - Mechanisms of alcohol tolerance. AB - Functional tolerance to ethanol can be prolonged by administration of the neuropeptide arginine vasopressin (AVP), which acts at specific CNS receptors. AVP receptors in brain (lateral septum) have been shown to be localized, in part, presynaptically, and the mechanism of action of AVP may thus involve modulation of neurotransmitter release. AVP has also been found to increase the levels of mRNA for the cellular proto-oncogene, c-fos, in the septum and hippocampus. This response to AVP, which may be direct or indirect, may underlie the long-term neuroadaptive effects of the peptide. Studies with vasopressin antagonists have indicated a role for endogenous AVP in modulation of ethanol tolerance, and measurement of hypothalamic vasopressin mRNA by Northern blot analysis and in situ hybridization indicates that chronic ethanol ingestion may alter AVP synthesis. Tolerance to the aversive effects of ethanol has been postulated to influence alcohol drinking behavior in some individuals. Elucidation of the mechanism by which AVP affects ethanol tolerance may eventually lead to pharmacological means to modulate tolerance and, consequently, alcohol intake patterns. PMID- 2757701 TI - Alcohol. PMID- 2757700 TI - Alcoholism and depressive disorders: is cholinergic sensitivity a biological marker? AB - There is an overlap between alcoholism and depressive disorders. However, alcoholics tend to be resistant to the effect of cholinergic agonists, whereas depressives tend to be more sensitive. A recently developed animal model of depression which is more sensitive to cholinergic agonists is also more sensitive to the acute effects of ethanol. These consistent human and animal studies suggest that cholinergic challenges may be helpful in separating alcoholics from depressives. PMID- 2757702 TI - Low-alcohol drinks. PMID- 2757703 TI - [Osteoclastic type giant cell carcinoma of the breast]. AB - Five cases of mammary carcinoma with osteoclast-like giant cells are reported. This study as well as review of the literature underline characteristic features of this rare histological type of carcinoma: a round well-circumscribed dense nodule of benign appearance on mammograms in half of the cases; brown colour of tumour specimens; stromal hypervascularity; negativity of epithelial, vascular and most histiocytic immunohistochemical markers in giant cells; positivity of leucocyte common antigen and vimentin in giant cells. Giant cells most probably originate from the fusion of histiocytic type mononucleated stromal cells, but results of immunohistochemical stainings cannot actually bring formal arguments to support this hypothesis. PMID- 2757704 TI - [Histologic classification and prevalence of tumors of the central nervous system in infants. Study of 100 excision samples]. AB - In order to assess the epidemiological and histological distributions of brain tumors in infants under 2 years of age, 100 cases collected in the Neurosurgery Department of Hopital Necker-Enfants Malades in Paris during an 11 year period, were reviewed. Histopathological diagnoses were analyzed with special reference to age at the time of diagnosis, sex, topography and grading. Brain tumors were classified into 2 groups: under one year of age, and between 1 and 2 years of age. Certain neoplasms were reclassified after review of the slides. The male-to female ratio was 1.09:1 for the first group, and 1.25:1 for the second one. In the group of tumors diagnosed under 1 year of age, 60% were supratentorial, and 40% were infratentorial. The percentages reversed after 1 year of age in favor of those of the posterior fossa. The histopathological distribution of these tumors was assessed in the two groups according to Rorke's classification. The three most common histological types were astrocytoma (27% under 1 year versus 36% after 1 year), ependymoma (25% versus 16%) and medulloblastoma (14% in each group). There was a significantly higher prevalence of some types of tumors in the first year of life as compared with those diagnosed after one year.: ependymomas (25% versus 16%), primitive neuroectodermal tumors (PNET) other than medulloblastomas (9% versus 3.5%), choroid plexus tumors (9% versus 17%), and teratomas (5% versus 1.7%). Craniopharyngiomas (2%) and non-tumoral lesions (vascular malformations) (7%) had similar distributions in both groups. There was a preponderance of malignant tumors in the first year of life. Our study demonstrates that brain tumors diagnosed during the first year of life have characteristic and specific features in terms of topography, histopathological distribution and grading. PMID- 2757705 TI - [Primary lymphoma of the heart. Report of a case with immunohistochemical study]. AB - A case of primary cardiac lymphoma (PCL) is reported in a patient presenting with chest pains. This PCL was treated with surgery. The histology showed a large cell lymphoma. The immunohistochemical study demonstrated the B cell origin of this PCL. PMID- 2757706 TI - [Neurofibroma of the penis]. PMID- 2757707 TI - Relationship between premenstrual syndrome and dysmenorrhea. AB - PMS is a clustering of symptoms that occur in the luteal phase of the menstrual cycle, varying between 2 and 12 days before the onset of menses, and resolving within the first 24 hours of flow. Dysmenorrhea is a clustering of symptoms that occurs one to two days before menses, diminishing within two to four days into the flow. Clearly, the impact of the discomforts related to PMS and dysmenorrhea influence women's responses to their daily responsibilities. Findings suggest symptomatology during the premenstrual and menses phases are different entities and, therefore, require different types of intervention. PMID- 2757708 TI - Occupational medicine residency training programs. The role occupational health nurses play. AB - An experienced occupational health nurse with suitable academic qualifications is able to assist in providing a well-rounded education and teaching physicians to be effective members of occupational health teams. Nurses are involved in teaching occupational health to physicians in the academic and practicum phases of occupational medicine residency training programs. However, the involvement of nurses in training physicians is inconsistent among the accredited residencies. Most of the nurses involved in teaching occupational health to physicians are at least master's degree prepared. Nurses are involved in the didactic, clinical, and administrative components of the training programs. Though nurses are involved in residency training programs to an extent, the lack of consistent involvement limits the diversity of points of view and fosters an imbalance in the training of occupational medicine residents. PMID- 2757709 TI - Case study: mariner's TB. AB - Mycobacterium marinum causes tuberculosis in fish and shellfish and cutaneous lesions in humans. It is transmitted from fish to humans by inoculation. The case presented involved a nodule on the wrist and was misdiagnosed as arthritis; the nodule was excised. Symptoms of tuberculosis persisted over a 2-year period. This case study can be generalized to a population of workers in the seafood industry, water hobbyists, and fish and shellfish enthusiasts. Education and research is needed to inform and protect populations at high risk for this disease. PMID- 2757710 TI - Effectiveness of abdominal radiographs in visualizing chewable iron supplements following overdose. AB - The purpose of this study was to determine the clinical effectiveness of visualizing chewable and nonchewable iron supplements remaining in the gastrointestinal tract following an overdose. A 5-year retrospective review of 93 pediatric patients who had ingested potentially toxic amounts of an iron supplement found that 58% had abdominal radiographs taken. Fifty-five percent of these patients had ingested chewable multiple vitamins with iron and 40% had ingested nonchewable tablets. After radiographic review, radiopaque densities could be marginally visualized in only one case of ingestion of a chewable iron supplement. The mean serum iron level of patients who had ingested a chewable form of iron was 270 micrograms/dL. An in vitro study was performed to determine the radiopacity of various chewable multiple vitamins with iron. It was concluded that although chewable multiple vitamins with iron are radiopaque in vitro, clinical radiographic visualization is unlikely. PMID- 2757711 TI - Potentiation of cocaine toxicity with calcium channel blockers. AB - Three calcium channel blockers were studied for efficacy in preventing seizures and death from cocaine intoxication. Rats were first pretreated with a test drug then subjected to high dose intraperitoneal cocaine. In this model, control animals developed seizures within six minutes, followed by death within ten minutes. Animals that were pretreated with diltiazem, nifedipine, or verapamil developed seizures significantly faster than controls, and at specific doses the death rate was higher than in controls for all three drugs. The potentiation of seizures and death by 2 mg/kg nifedipine pretreatment was further shown by challenge with three different doses of cocaine. This study fails to demonstrate a protective effect and suggests augmentation of cocaine toxicity by pretreatment with the three currently available calcium channel blockers. Several mechanisms by which calcium channel blockers may augment cocaine-induced toxicity are discussed. PMID- 2757712 TI - Common clinical features as predictors of bacterial diarrhea in infants. AB - Identification of infants with bacterial diarrhea during the first year of life is important to limit potentially serious complications, but indications for stool leukocyte examination and culture are not well defined. The ability of three clinical features--temperature, history of blood in the stool, and stool frequency--to predict the presence of bacterial gastroenteritis was analyzed. Over a 1-year period, 108 (10.4%) bacterial pathogens were isolated from 1,035 infants aged less than 1 year with diarrhea. Bacterial culture was positive in 14.9% of cases from May to October, compared with 6.2% of cases from November to April. A history of blood in the stool was the best individual predictor with sensitivity of 39%, specificity of 88%, and a positive predictive value of 30%. Temperature greater than 39 degrees C had sensitivity of 34% and specificity of 85%; greater than or equal to 10 stools in 24 hours had sensitivity of 28% and specificity of 85%. Using combinations of factors, we identified (1) a group of patients at high risk for bacterial diarrhea (infants with two of the three factors studied); (2) a low-risk group (those with temperature less than or equal to 38 degrees C, less than 10 stools in 24 hours, and the absence of blood in the stool); and (3) a group at intermediate risk for bacterial diarrhea (all other patients). We recommend routine stool cultures for infants with a high-risk combination. Additional clinical and laboratory features, such as stool leukocytes, should be studied among patients in the intermediate-risk group. PMID- 2757713 TI - Neurological manifestations as the initial presentation of acute myelogenous leukemia. AB - This case report illustrates neurological deficits as an unusual presentation of acute myelogenous leukemia. Neurological deficits are rare early in this disease. Our patient presented with anorexia, malaise, headache, and multiple cranial nerve palsies. A high WBC count and abnormal peripheral smear led to the diagnosis of leukemia. This report demonstrates that, although rare, CNS symptoms may be the initial manifestation of leukemia. Blood dyscrasias should not be overlooked in patients with the acute onset of neurological symptoms. A complete blood count and differential should be obtained under those circumstances. PMID- 2757714 TI - Coronary artery spasm induced by intravenous epinephrine overdose. AB - A 27-year-old man was accidentally given 2 mg intravenous epinephrine instead of 2 mg naloxone. He immediately developed chest pain, nausea, and diaphoresis. An ECG taken shortly after the epinephrine administration showed widespread ischemia. Forty-five minutes later the tracing still showed an early repolarization pattern, but ST elevation was less marked and the patient was asymptomatic. Serum potassium was 3.2 mEq/L and serum catecholamines, drawn approximately 20 minutes after the epinephrine administration, were 10 times normal (dopamine, 173 ng/L; epinephrine, 1,628 ng/L; norepinephrine, 1,972 ng/L). There are seven other reports of intravenous epinephrine overdose in the English literature. Two of the previously reported cases had 12-lead ECGs within the first hour. In both there was evidence of transient ischemia similar to that observed in this case. Most of the patients had symptoms consistent with angina, and several developed pulmonary edema. These findings suggest that, in humans, large intravenous doses of epinephrine are likely to produce coronary artery spasm and may decrease coronary artery perfusion. PMID- 2757715 TI - 1988 annual report of the American Association of Poison Control Centers National Data Collection System. PMID- 2757716 TI - Academic civil rights. PMID- 2757718 TI - Emergency management assistance using computerized guidelines. PMID- 2757717 TI - Informed consent in prehospital research. PMID- 2757719 TI - Effects of cesarean delivery on parental depression, marital adjustment, and mother-infant interaction. AB - To further our understanding of the effects of cesarean delivery on maternal and paternal depression, marital adjustment, and mother-infant interaction during perinatal and three-month postpartum feeding, data were prospectively collected on 80 primiparous married women and their infants, and 76 of their husbands. There were 56 vaginal deliveries and 24 cesarean section deliveries. Data were collected by interview at the latter part of the second trimester and three months post-partum by examination of the mothers' and infants' medical records, and by observation of mother-infant feedings at two days and three months postpartum. The infants' birthweight, weeks of gestation, and Apgar scores at five minutes, maternal age at delivery, and maternal and child health index risk scores were not significantly different between the two groups. Mothers who had cesarean delivery had significantly higher labor index risk scores than those with vaginal birth. The mothers and fathers were not significantly different on levels of depression or marital adjustment prenatally or at three months postpartum. There were no significant differences in mother-infant behaviors during the feedings observed. That we found no differences after cesarean and vaginal delivery would support the theory that mothers respond to infants' behavioral repertoire and not to the mode of delivery. PMID- 2757720 TI - Commentary: does cesarean delivery affect the parents? PMID- 2757721 TI - Predictors of a positive childbirth experience. AB - Knowledge of childbirth, fears regarding pregnancy, locus of control, state anxiety, expectation of pain, and confidence in ability to control pain were examined as possible predictors of positive childbirth experience. Self-reports of these variables were collected from 30 primiparous women enrolled in prenatal courses, on three occasions: before the first class, after the last class, and 24 to 48 hours after delivery. The number of women completing postdelivery measures was 21. It was found that those who demonstrated greater knowledge of childbirth and higher confidence after classes subsequently reported a less painful childbirth. Of interest, those with higher levels of childbirth-related fear before classes reported experiencing less anxiety during labor and delivery. It was suggested that these women may have recognized and dealt with their concerns earlier. Psychologic factors that appear to be most predictive of a positive childbirth experience include knowledge, confidence, and anxiety. The present findings support the current emphasis in prenatal education on imparting knowledge, instilling confidence, and providing a forum for dealing with childbirth-related fears. PMID- 2757722 TI - An American experience of pregnancy and childbirth in Japan. AB - Birth practices in modern Japan differ markedly from those currently observed in the United States and the outcomes are among the best in the world. A fundamental question is whether such practices could be exported apart from the underlying system of cultural values. While autonomy is cherished in America, birth practices in Japan directly and indirectly reflect the values of order and harmony in social groups. Strict adherence to traditional gender roles is seen as promoting the social order. I used a participant-observer approach to study this phenomenon, teaching on a maternity nursing faculty in Japan for two years, providing childbirth counseling in the foreign community, touring various birth facilities, interviewing health professionals and Ministry of Health officials, and bearing my first child in that country. PMID- 2757723 TI - Substance exposed infants. PMID- 2757724 TI - Correlates of maternal-fetal attachment. PMID- 2757725 TI - [Optimization of the purification of human plasma fibronectin by double affinity chromatography using gelatin and heparin Trisacryl LS]. AB - The authors described an optimized method of preparation to obtain pure human plasma fibronectin. The new performances related to the chromatographic and concentration steps, where the saving of time is about 40% and the lyophilization step where the saving of energy is also about 40%. The final product is without any less of either physical and biological activities. The size of the columns, the volumes of the chromatographic supports (gelatin and heparin-Trisacryl LS) and the quantity of the treated plasma are very much important and also the quantities of the final product are very increased. PMID- 2757726 TI - [Prevention of the risk of contamination of native blood products by the human immunodeficiency virus (HIV)]. PMID- 2757727 TI - Memory and aging. Proceedings of a symposium. Lausanne, Switzerland, 3-4 June 1988. PMID- 2757728 TI - Memory processes and aging: a defect of automatic rather than controlled processes? AB - The effect of age (20-86) and/or cultural level is investigated from the point of view of Cognitive Psychology. The study was carried out with 75 subjects distributed into 5 age-ranges and 3 cultural levels. It involved the following memory tests: forced choice recognition of faces (Warrington, 1984) and of abstract paintings; Rey Figure; immediate free recall; final free recall; learning and retention of paired associates; learning with AB-AC-AB design to test for interference; Selective Reminding test of Buschke (1973); repeated free recall. Data where analysed, taking into account dozens of variables. As far as age is concerned, all the analyses converge toward the same conclusion: short term memory is not significantly affected by age, while a clear distinction appears between two kinds of secondary memory. Secondary memory involved in the course of learning or in the retention of learning is unaffected by age. By contrast, secondary memory involved in the retention of an initial or single confrontation with test material is very much affected by age. Age might, therefore, differentially affect two kinds of secondary memory. It is suggested that, contrary to the view of certain authors, age mainly affects automatic secondary memory, whereas voluntary, conscious, controlled and effortful secondary memory, which could require a greater amount of 'mental energy' or attentional resource, is relatively well preserved with age. PMID- 2757729 TI - Memory complaints in the elderly: a study of 367 community-dwelling individuals from 50 to 80 years old. AB - State of memory was evaluated by a Memory Clinic in 367 community-dwelling patients aged from 50 to 80. They performed an exhaustive subjective evaluation including: severity of memory complaint, social status, activity scale, subjective Memory score, Zung's anxiety and depression scales and Well Being Questionnaire. Objective memory performance was evaluated by a complete memory scanning leading to a Global Objective Memory Score. No relationship was found between severity of memory complaints and age, sex, educational level, marital status, living alone or in family, and memory tests performance. More severe complaints were reported in people with poor social network, negative stereotypes on aging, and poor affective status. A strong correlation was found between severity of memory complaints and scores in self-reporting depression questionnaire, even in people with low depression scores. PMID- 2757730 TI - Psychometric procedures for analysis of memory losses in the elderly. AB - This study aimed to assess and compare the discriminative validity of two psychometric procedures which have been proposed to investigate memory losses in elderly. The first one relies on the use of the serial position curve paradigm in a test of immediate memory, the second one being a single recognition task. These two procedures were applied to the five following groups of subjects: 95 young elderly normals, 33 elderly normals, 26 patients with mild senile dementia of the Alzheimer type (SDAT), 17 patients with moderate or moderately severe SDAT and 24 elderly depressed patients. Results from both psychometric procedures confirm the findings of previous studies and support the view that memory impairment associated with SDAT is qualitatively different from that observed in normal aging or in depression. They also suggest that memory loss in elderly depressed patients differs only quantitatively from that of normal controls. However the recognition task seems to have the best validity to qualitatively discriminate the patients with mild dementia from both the normal controls and the elderly depressed patients. PMID- 2757731 TI - Techniques for cognitive training of memory in age-associated memory impairment. PMID- 2757732 TI - Inclusion and exclusion clinical criteria to form homogeneous groups of patients in the therapeutic trials of a memory enhancing drug. PMID- 2757733 TI - A logical approach to the clinical assessment of cerebro-active drugs. PMID- 2757734 TI - Clinical trials in memory disorders: objectives and methodology. PMID- 2757735 TI - Methodology and statistical problems in the assessment of memory by rating scales. PMID- 2757736 TI - [Quantitation of manganese and vanadium levels in the lung of "normal" and occupationally exposed persons]. AB - Manganese and vanadium concentrations were measured in the lung and in hilus tissue of 30 non-exposed and 10 occupationally exposed patients. The analyses were performed by electrothermal atomic absorption spectrometry with Zeeman background compensation after wet oxidative digestion. The pulmonary tissue sampling of 30 non-exposed persons was carried out in terms of topographic anatomical criteria from different lung segments and lobes, resp. The manganese concentrations vary between 70 and 360 ng/g, and for vanadium between 9 and 40 ng/g in relation to wet weight. On the average manganese concentrations are 3 to 5 times higher compared to vanadium concentrations, 2 to 4 times higher values were detected in hilus tissue compared to the lung parenchyme. With regard to the topographic anatomy 1.1 to 1.5 higher manganese and vanadium concentrations have been found in the upper lung areas. In 10 of the occupationally exposed persons the sampling was taken from various segments as far as available. In some cases only one lung tissue sample could be analysed. Two former high-grade steel welders and eight former workers from a Norwegian nickel refinery have been investigated. Esp. the manganese concentrations in lung tissue of the welders raised by the factor 100. The manganese content in other occupationally exposed persons has also been increased in comparison to the normal group whereas the vanadium concentrations were - with one exception - in the normal range. Synoptically these results demonstrate that the determination of manganese and vanadium concentrations in the lung tissue might give additional information especially concerning a former occupational exposure. Such investigations can also be of interest when giving medical expertise opinion. PMID- 2757737 TI - [Fiber emissions from weathered asbestos cement products. 1. Fiber release in ambient air]. AB - Emissions of fibrous aerosols were measured on buildings with weathered and corroded asbestos-cement-plates (roofing and facade shingles) by means of an already published equipment and procedure. The measured emission factors for asbestos fibers longer than 5 microns were in the range of 10(6) to 10(8) fibers/m2.h. They depended on the type of the AC-plates as well as on their age and corrosion intensity. PMID- 2757738 TI - [Epidemiological surveys of formaldehyde and nitrogen dioxide levels in indoor air]. AB - The influence of HCHO and NO2 on clinical, haematological, immunological, sensory and lung function parameters were tested in 129 children out of 3 classes. As part of a biological monitoring programme formic acid content in urine was determined. Concentration of the pollutants in indoor air was measured by means of passive samples. PMID- 2757739 TI - [Octenidine dihydrochloride, properties of a new antimicrobial agent]. AB - The chemical, antimicrobial and toxicological properties of Octenidine dihydrochloride - a compound belonging to the bipyridines - are briefly described. Already low concentrations (0.1% and less) of the substance are bactericidally and fungicidally effective. It is remarkable that this effect is practically as strong against grampositive as against gram negative germs. The compound is not absorbed by the skin. A systemic effect cannot be observed upon oral application within large of dosage scales. As active component in antiseptics the remanent effect has particularly to be emphasized even against transient germs reaching the skin after disinfection. PMID- 2757740 TI - [Use of UV rays for the disinfection of water. III. UV sensitivity of Legionella pneumophila of different ages in cold and warm drinking water]. AB - In drinking water the sensitivity of L. pneumophila serogroup 1 type Philadelphia and L. pneumophila serogroup 5 type Dallas were studied with a flowthrough u.v. light treatment apparatus. By washing purified cells from broth cultures were used as inoculum directly ( = young cultures) or kept 2-3 weeks in drinking water in the dark ( = old cultures). A decrease of 99,9999% was found after u.v. treatment by 19 mWs/cm2 for young cultures and by 15 mWs/cm2 for old cultures. Reductions of 99,9999% were obtained by 16 mWs/cm2 in cold drinking water (13-16 degrees C) and by 13 mWs/cm2 in warm drinking water (45-47 degrees C). L. pneumophila serogroup 1 and L. pneumophila serogroup 5 show a very similar susceptibility to u.v.-irradiation. Reductions of 99,9999% were obtained by 14 mWs/cm2 and 15 mWs/cm2, respectively. Thus L. pneumophila-suspensions proved to be more sensitive to u.v.-irradiation than E. coli oder E. faecium in earlier experiments. PMID- 2757742 TI - [Electron microscopy of extracellular polymeric substances in activated sludge]. AB - Many problems arise with the TEM preparation of activated sludge flocs because the specimen material contains up to 98% of water. It is difficult to preserve the ultrastructure beyond dehydration and to make the polymers visible, which cannot be visualized with standard methods. The method presented here renders satisfying results. The important role of the exocellular polymers for the structure, size and density of flocs can be well illustrated. Furthermore many structure patterns could be found differing largely from each other but occurring regularly as structure elements. PMID- 2757741 TI - [Bacterial regrowth in drinking water. III. Reasons for regrowth with oligocarbotolerant bacteria]. AB - Investigations have been undertaken into the bacterial regrowth in a Zurich drinking water plant and over a distance of 12 km along the drinking water distribution system. This required installation of eleven chromium steel dead-end water pipes. Counts of oligocarbotolerant bacteria were carried out in 7 or 8 repetitions in fresh water and water left to stagnate for 7 and 14 days respectively (7,8). Additionally ten different biological, chemical and physical parameters were determined in the fresh water samples. Multiple linear regression analysis was used to determine what influence the different parameters had on the bacterial regrowth during stagnation. Two regression models were evaluated, one for the data obtained during treatment, and the other for the data obtained along the distribution system. In both models the content of DOC (Dissolved Organic Carbon) and the content of phosphate was correlated with the growth of oligocarbotolerant bacteria. Further, a relationship between the contents of organic matter and bacterial regrowth was discovered during two measuring series conducted in different seasons. The model of data obtained during treatment generated two additional parameters correlated with aftergrowth: Firstly the initial colony content, which probably resulted because the stagnation period was only half that of the model. Secondly, the oxygen content which resulted because of ozonization. Under the given test conditions the following parameters did not appear in the regression model (Cp-statistics according to Daniel and Wood, 5): AOC (Assimilatible Organic Carbon) and UV-absorption used for measuring organic matter, nitrate content, content of chlorine/chlorine dioxide, electrical conductivity, pH-values and the room temperature during the 14 days stagnation in the distribution system model. PMID- 2757743 TI - [Correlation of blood pressure and cadmium and lead content of the hair in nonsmoking males]. AB - In developed countries, hypertension represents one of the most frequent diseases and is one of the most important risk factors of arteriosclerotic vascular disease e.g. to myocardial infarction or cerebral apoplexy. The etiology of hypertension is unknown in about 90% of cases. The heavy metals cadmium and lead occur in increasing amounts in the human environment. Numerous epidemiological studies and investigations using experimental animals have dealt with the putative relationship between cadmium and lead, and hypertension. The results to date have been quite controversial; thus the issue appears to be unresolved at present. In the present study scalp hair samples were collected from 100 non smoking 30-to-50-year-old men. After washing, the samples were digested with a mixture of nitric and sulfuric acid in a teflon bomb and analyzed by flameless atomic absorption spectroscopy. For 90% of the test persons the cadmium hair values were in the range of 0 to 1400 micrograms/kg; the corresponding range for hair lead was 0 to 13,000 micrograms/kg. Correlation with diastolic or systolic blood pressure was neither found for cadmium or lead. The test persons with the highest cadmium or lead load were not hypertensive. Some factors should be considered when comparing the present results with those of other investigators reporting a positive correlation in the question under consideration. 1. Previous studies in man frequently did not sufficiently take smoking habits into account. This is essential, however, because, in addition to cadmium and lead, nicotine and carbon monoxide are also constituents of tobacco smoke and contribute to an increase in blood pressure. 2. Previous investigations generally employed blood samples, which is disadvantageous in comparison with the analysis of hair because blood samples do not reflect long-term exposition, which is important in the etiology of chronic diseases. Correlation between hypertension and levels of long term cadmium and lead exposure in man seem to be unlikely in light of the present results. Nevertheless, numerous potential effects should be considered to obtain further insight in the complex pathogenesis of hypertension. PMID- 2757744 TI - [Ionogenic liberation of mercury from dental amalgam in waste water and sludge]. AB - Reduction of mercury content in communal waste water and sludge is mandatory. The release rate of Hg from dental amalgam (gamma 2 Lux Alloy) in waste water was determined. The Hg-ionic rate was found to be as low as 0.004% of total mercury content in waste water. In addition, the concentration of Hg (4.39-8.20 mg/kg), Ag (73.35-84.03 mg/kg and Sn (22.51-61.30 mg/kg) in sludge was estimated under anaerobic conditions. Compared with legal limits for drinking water (1 microgram Hg/l) in the F.R.G. mercury loads of dental surgeries are far below threshold levels where toxicological effects are to be expected. PMID- 2757745 TI - Studies of the bacteriological water quality for the intakes of different water treatment plants in greater Cairo. AB - Water samples from the intakes of 10 water treatment plants at Greater Cairo were bacteriologically tested for total bacterial counts, total coliforms, fecal coliform and fecal streptococci during 1984-1986. The total bacterial count ranged between 10(4)-10(6), 10(3)-10(6), and 10(3)-10(5)/ml during 1984, 85, and 86 respectively. Total coliform density ranged between 0-10(3), 10- greater than 10(4), and 10(2)- greater than 10(4)/100 ml during 1984, 85, and 86 respectively. Although fecal streptococci density does not exceed 10(3)/100 ml in most cases, large numbers of samples are negative for fecal streptococci. By using fecal streptococci as an indicator it is possible to avoid interference between the total bacterial count and coliforms detection. It is important to gain a real judgment about the public health safety by testing the sample for both coliforms and fecal streptococci. PMID- 2757746 TI - Observations on the anaerobic membrane-filter technique for coliform counts in Nigerian surface waters. AB - The applicability of the anaerobic membrane filtration method to faecal coliform counts was tested on 88 water samples from the Port Harcourt area of the Rivers State of Nigeria. Seventy-eight streams/rivers and ten untreated distributive sources were analysed. High levels of suspended residues necessitated the filtration of 1-2 ml of the raw and 5-10 ml of diluted samples of the surface waters. Anaerobic incubation, overall, decreased the nonfaecal coliforms (NFCs) and faecal coliforms (FCs) by 69.32% and 48.86% respectively. Percent decrease of mean NFC and FC count in 21 streams sampled at random, was 8.85% and 20.88%, respectively. Results from a stream and a faecally polluted beach of a tidal river sampled periodically were variable. The NFCs and FCs decreases in the stream sample by 5.4% and 7.6% respectively were not significant. For the beach samples, the 9.8% reduction in NFCs was significant (p = 0.01), but the 4.19% increase in FCs was not. Seventy percent of the distributive samples gave zero FC counts. Anaerobic incubation reduced to zero FCs in 2 samples and NFCs in 5 samples. It is concluded that the advantages of anaerobic incubation are not commensurate with the increased expenditure which invariably is incurred in the routine analysis of these waters. PMID- 2757747 TI - Quantification of helminth eggs in waste water. AB - Agricultural use of waste water has been regulated mostly by its bacteriological quality. Recently the importance of parasitological criteria for waste water standards was recognized by establishing that waste water containing less than 1 intestinal Nematode egg per liter is released for unrestricted use of effluents. At present, most of the techniques borrowed from parasitological coprology are only qualitative. In this report different protocols for helminth egg quantitation were compared. Three flotation techniques (Janeckso-Urbanyi, Faust, Arther) and two sedimentation techniques (Bailenger, Ritchie) and their performances were evaluated. Although all the techniques were based on the same number of on the whole positive samples, significant differences were observed in both the number of species identified and in the type of egg preferentially concentrated. Among the flotation methods tested, the Janeckso-Urbanyi modality offers undeniable advantages in efficiency and in the variety of species concentrated, but it is relatively costly. Among the sedimentation techniques, the one described by Bailenger is relatively inexpensive and concentrates all the types of eggs normally found in waste water samples, except for the relatively rare Enterobius with globally satisfactory yields. PMID- 2757748 TI - Isolation and survival of gentamicin resistant Enterobacter aerogenes on finger tips of hospital personnel. AB - Enterobacter aerogenes was isolated from the finger tips of 13.3 percent of hospital personnel while they were working in the wards. Gentamicin resistant strains were isolated more frequently than gentamicin sensitive. Carriage rate of E. aerogenes was higher among nurses than other staff members. There was no correlation between antibiotic resistance, capsular serotypes and survival of these strains on finger tips. The property of prolonged survival on finger tips is chromosomal in nature and not mediated by conjugative or non-conjugative plasmids. PMID- 2757749 TI - [Medical waste. 1. Microbiologic studies of wastes of various specialties at a large and small hospital in comparison to housekeeping waste]. AB - Hospital wastes, similar to household refuse, from normal and high risk areas of a big and a smaller hospital were tested quantitatively and qualitatively for nosocomial infective agents. The results were compared with those of household refuse. 20-25 samples from care and operating wards were examined each for 3 months. The whole content of a waste bag was suspended without a preceding sorting. After this treatment the eluat was microbiologically examined. The results of the test proved that the germ concentration of the hospital waste was less or similar than that of household refuse. The median for gram negative rods in household refuse was e.g. 4 log10-steps higher than in wastes from operating wards. The statistical analysis confirmed these highly significant differences between the wastes from the high risk operating areas of the big and smaller hospital and the household refuse for all investigated bacteria groups. There are nearly no differences between the wastes from normal wards and from household refuse regarding germ concentration for different groups, e.g. gram negative rods or D-streptococci, and no higher germ concentration in any case. In conclusion hospital wastes must be disposed with special hygienic measures inside the hospital, outside the hospital they can be disposed together with household refuse. PMID- 2757750 TI - Nucleoside analogues: 8. Some isomers of B.3839, the original 5 fluorouracil/nitrosourea molecular combination, and their effect on colon, breast and lung tumours in mice. AB - This study describes the manipulation of secondary products arising from the synthesis of the prototypical molecular combination of 5-fluorouracil (5-FU) and chloroethylnitrosourea (CNU), B.3839, in order to investigate the effects produced by connecting the C-S-C-C-CNU chain to the 5-FU ring in different ways. The isolation of phthalimide precursors of these compounds and the transformation into CNUs is described. Anti-tumour activity of these molecular combinations against a series of experimental murine colon, lung and mammary tumours is presented. The spectrum of anti-tumour activity displayed is interesting but defies simple explanation without further detailed in vivo pharmacokinetic and metabolism studies in order to define optimal profiles for activity. PMID- 2757751 TI - Platinum complexes with a selective action on estrogen receptor-positive mammary tumors. AB - Four (1,3-diaminopropane)dichloroplatinum(II) complexes, linked to 5-hydroxy-2-(4 hydroxyphenyl)-3-methylindole by spacer groups of varying lengths, were synthesized and studied for their binding affinities for the calf uterine estrogen receptor. The RBA-values ranged from 1.0 to 4.4 (estradiol: RBA = 100). The endocrine activities of the complexes and their ligands, determined in the mouse uterine weight test, are low. All compounds entered comparative tests using estrogen receptor-positive and negative mammary tumors models. The receptor levels in these tumors were determined by a modified h.p.l.c. micro assay. In cell culture, a growth inhibiting effect was only observed in hormone-sensitive MCF-7 cells, but not in hormone-independent MDA-MB-231 cells. At 10(-6) molar, the cell number was generally decreased by 50%. In vivo, the growth of estrogen receptor-positive MXT mouse tumors was strongly inhibited whereas the hormone independent MXT mammary tumors showed only a minor response. The most active compound was the platinum complex with a xylidene spacer group (4d-PtCl2) showing a reduction of tumor weight of 84% after 6 weeks of treatment (3 x 20 mg/kg/week). One of the complexes (4c-PtCl2) and its ligand were tested for activity against the hormone sensitive DMBA-induced rat mammary carcinoma. The inhibitory effect of the complex was close to that of cisplatinum. In these experiments, no sign of toxicity was observed. The selective effect on estrogen receptor-positive tumors make an endocrine mode of action both for the complexes and their ligands likely. PMID- 2757752 TI - Structure of the intrastrand cis-[Pt(NH3)2(d(GpCpG))] adduct in a dodecanucleotide duplex: I. A 1H and 31P n.m.r. study. AB - The structure of an intrastrand cis-[Pt(NH3)2(d(GpCpG))] adduct in a dodecanucleotide duplex has been investigated by using ultraviolet absorption, circular dichroism, 1H and 31P n.m.r. The binding of cis-DDP does not inhibit the formation of a duplex but it induces a lowering of congruent to 26 degrees C of its melting temperature. A broadening of the 1H spectrum prevents an accurate analysis of the platination site. Nevertheless, by considering its thermal behavior and the number of imino protons a model of structure of the platinated duplex is proposed in which the central C.G. pair is disrupted and a neighboring C.G pair is very accessible or distorted. The environment of two phosphate groups is disturbed by the cis-DDP binding. PMID- 2757753 TI - Structure of the intrastrand cis-[Pt(NH3)2(d(GpCpG))] adduct in a dodecanucleotide duplex: II. A molecular mechanics modeling study. AB - Molecular mechanics modeling has been carried out for the intrastrand cis [Pt(NH3)2(d(pGpCpG))] adduct in a dodecanucleotide duplex. In a first step, an analysis of the conformation of a platinated trinucleotide shows the tendency of the two chelating guanines to take respectively anti-syn or syn-anti positions and the role of phosphate-platinum amino group interactions. In a second step, duplex structures are examined. The distortions induced by platination are especially analysed for kinked and unkinked forms of the dodecanucleotide. In all models the central C.G pair in the platination site is disrupted and the double helix is more disturbed on the 5' side of this site than on the 3' side. Most of the structural features arising from the modeling are in agreement with the conclusions of an n.m.r. study reported in the preceding paper. PMID- 2757754 TI - A comparison of dihydrofolate reductase activity in intact leukemia cells and squamous cell carcinoma. AB - This report examines the intracellular activity of dihydrofolate reductase using an in situ assay designed to measure enzymatic activity in intact cells. The rate of uptake of folic acid exceeded the rate of in situ dihydrofolate reductase activity suggesting that the reduction of folate to dihydrofolate, rather than transport, was the rate limiting step. In situ dihydrofolate reductase activity varied linearly with cell number. A comparison of the in situ activity revealed that a squamous cell carcinoma selected for methotrexate (MTX) resistant (SCC 15R) had 100 times greater dihydrofolate reductase (DHFR) activity than L1210 leukemia. In agreement with this finding, the in situ DHFR activity in SCC-15R cells was 50-fold less sensitive to the inhibitory effects of MTX than the L1210 in situ DHFR activity (IC50 = 1.1 x 10(-5) M and 2.4 x 10.7(-7) M respectively). The inhibition of in situ dihydrofolate reductase activity by MTX was found to correlate with the inhibition of growth, DNA synthesis (CdR incorporation) and in situ thymidylate synthase activity. PMID- 2757755 TI - Changes in endogenous urea recycling and the handling of renal urea in pregnant and lactating Sardi sheep kept on a constant feeding level. AB - The kinetics of endogenous urea were compared during the last month of pregnancy, lactation, and a nonpregnant, nonlactating control period in Sardi sheep kept on a constant feed level. Urea entry rate estimated by injections of [14C]urea rose by 36% during pregnancy. Renal urea excretion was reduced by 40% during pregnancy and by 28% during lactation. Consequently, fractional urea recycling was greater during pregnancy and, to some extent, during lactation than during the control period. In a second series of experiments, glomerular filtration rate increased by 48% and urea filtration rate rose by 17% during pregnancy. During lactation, both glomerular filtration rate and urea filtration rate were close to control levels. It appears that the decreased renal urea excretion during pregnancy and lactation was due mainly to increased tubular reabsorption of urea. Rumination time increased by 15% during pregnancy. Rumen ammonia concentration was elevated in both pregnant and lactating ewes above the control period level. The results suggest that Sardi sheep possess a high potential for the conservation of nitrogen during pregnancy and lactation periods. PMID- 2757756 TI - [Measurement of changes in parietal tonus of the abomasum in sheep]. AB - An inflatable bag of 250 ml at the pressure of 2 mm Hg inside the abomasal lumen was used to identify the abomasal smooth muscle tone. Reduced tone of the ovine abomasum was assessed, like for the fundic part of the canine stomach, in relation with the cyclic motor activity of the proximal duodenum. Opposite effects were obtained following parasympathomimetic drug injection versus peptides of the gastrin group, suggesting a high responsiveness of the abomasal smooth muscle tone to both neural and hormonal influences. PMID- 2757757 TI - Electromyographic activity and noradrenaline content of the rabbit oviduct under different hormonal states. AB - Spontaneous electromyographic (EMG) activity of the oviduct recorded in vivo in untreated, estrogen-treated, and progesterone-treated castrated rabbits was found to exhibit two main patterns: short spike bursts lasting 1-10 s and long trains of action potentials lasting several minutes, which constituted the major component of EMG activity. After estrogen treatment, both wet weight and noradrenaline (NA) content of the castrated rabbit oviduct were enhanced mainly at the ampullary-isthmic junction; long trains of discharges were significantly shorter (2.0-2.7 min vs 3.6-4.6 min) and appeared at more frequent intervals (9.8 12.2 min vs 14.2-22.6 min). After progesterone treatment, spontaneous EMG activity was not significantly different from that in untreated castrated rabbits (as was the NA content) except at the ampullary-isthmic junction. NA injection elicited a stimulatory response of the oviduct lasting 1-7 min in the three hormonal states. Phentolamine strongly depressed spontaneous EMG activity but the inhibition was more transient in castrated rabbits than in estrogen-treated and progesterone-treated animals. Propranolol had no effect on spontaneous EMG activity. These data and the high NA concentrations found in all parts of the isthmus support the hypothesis that adrenergic innervation plays a role in the organization of oviductal motility in the rabbit. PMID- 2757758 TI - Incidence of the circadian rhythm of the excretion pattern on acetate absorption and metabolism in the rabbit hind-gut. AB - Acetate absorption in the hind-gut of anaesthetized rabbits was evaluated by measuring variations in the concentration of acetate in caecocolonic loops and in arterial and venous plasma. In vivo metabolism in gut and liver tissues was studied using [1-14C]acetate. Interrelations between acetate absorption and metabolism and both phases of the excretory cycle of the rabbit were examined. The disappearance rate from the caecocolonic loop was quantitatively significant. The gut tissue metabolized acetate, and the intensity of utilization varied with the segment studied; the distal position of the large intestine showed by far the highest uptake of short-chain fatty acids (SCFAs). In addition, acetate absorption, like its metabolism in the hind-gut and liver tissues, differed in intensity according to the phase of the excretory cycle, i.e., both mechanisms were enhanced during hard faeces production. Radioactivity was found in free amino acids, organic acids and sugars. Irrespective of the location in the gut and the excretion pattern, acetate was rapidly converted into glutamate and aspartate; these nutrients were subsequently diverted towards either oxidative metabolism or biosyntheses (non essential free amino acids, proteins). PMID- 2757759 TI - Evidence for chicken GH as the only hypophyseal factor responsible for the stimulation of hepatic 5'-monodeiodination activity in the chick embryo. AB - The influence of an intravenous injection of chicken growth hormone (cGH), a total chicken pars distalis (PD) extract, and a PD extract depleted of cGH by immunoadsorption was studied in the 18-d-old chick embryo. Plasma concentrations of triiodothyronine (T3), thyroxine (T4), and hepatic 5'-monodeiodination (5'-D) activity were measured. An injection of total PD extract raised plasma T3, T4, and 5'-D activity, whereas a PD extract depleted of GH only increased plasma T4. The amount of cGH present in the PD extracts, as measured by homologous cGH radioimmunoassay, increased T3 and raised liver 5'-D, but had no effect on plasma T4. The effect on liver 5'-D was more pronounced with cGH than with a total PD extract, whereas the effect on plasma T3 was somewhat less pronounced. It was concluded that cGH increased the peripheral conversion of T4 into T3 in the chick embryo, whereas a PD extract depleted of cGH was purely thyrotropic. The PD extract also seemed to have 5'-D-suppressing activity. PMID- 2757760 TI - Iodine nutrition in ewes. 2. Effects of low to high iodine intake by ewes on the I content of biological fluids and plasma immunoglobulins G in newborn lambs. AB - 1. In two experiments samples of blood and organs were taken from newborn and young lambs born to five groups of ewes that received different dietary iodine (I) levels. Dietary I contents (mg/kg dry matter [DM]) in pregnancy and lactation, respectively, were: Experiment 1--0.36 and 0.26 for group C, 2.01 and 1.94 for group D; Experiment 2--0.13 and 0.12 for group A, 0.22 and 0.20 for group B, 10.77 and 8.88 for group E. 2. I intake of ewes had no effect on birthweight, body weight gain, or mortality between birth and wk 2 of life. No difference between the groups was recorded in the weights of brain, heart, lungs, and liver of lambs killed at birth. However, the weight of both the thyroid lobes in lambs from group E was lower than that of the other groups. The I content of the thyroid lobes of lambs from group A was 30-40% lower than that of the other groups. 3. The plasma inorganic iodine (PII) of lambs from birth to d42 of life was affected by ewe I intake, except for groups A and B, during the first 16 h of life. The PII of lambs increased with the I intake via milk in each group. The ratio of PII of lambs at birth/PII of ewes at d7 prepartum was 3.77, 2.96, 1.68, 1.39 and 8.62, respectively, for groups A, B, C, D and E. 4. The high I intake by group E ewes induced a higher plasma T4 concentration in lambs at birth. The decrease in plasma immunoglobulins G (IgG) recorded for the lambs in this group might be explained by this increase in plasma concentration. PMID- 2757761 TI - Effect of the sex-linked dwarf gene on thyrotrophic and somatotrophic axes in the chick embryo. AB - Plasma concentrations of thyroxine (T4), triiodothyronine (T3), reversed triiodothyronine (rT3), and insulin-like growth factors I and II (IGF-I, IGF-II) together with peripheral 5'-monodeiodination activity were measured in both normal and sex-linked dwarf embryos between day 14 of incubation and day 1 posthatch. Plasma T4 levels increased gradually during embryonic development while T3 concentrations remained low until day 20, when a sharp increase was observed. rT3 levels also increased from day 14 and dropped on day 20 when T3 levels started to increase. 5'-monodeiodination activity was high on day 14 of incubation, decreased thereafter, and showed an increase at the time of air sac penetration together with increased T3 levels. At this stage, differences between normal and dwarf embryos were observed; the latter had lower nonsignificant 5' Monodeiodination activity and lower (P less than 0.01) plasma T3 levels. Plasma IGF-II levels were high during the whole embryonic period studied. Dwarf embryos had lower (P less than 0.05) IGF-II levels at the time of hatching. IGF-I levels were high on days 14 and 16, declined afterwards, and started to increase again around hatching. With the exception of T3 and IGF-II levels, introduction of the dwarf gene did not cause major changes in the hormonal parameters studied. This may explain the identical body weight at hatching. PMID- 2757762 TI - Indirect effect of casein phosphopeptides on calcium absorption in rat ileum in vitro. AB - Casein phosphopeptides (CPP) are the phosphorylated fragments of bovine milk casein. They are believed to enhance intestinal absorption of calcium by their ability to form soluble complexes with calcium thereby inhibiting the precipitation of phosphate-calcium salts. In order to evaluate whether they also act in an additional direct manner on the intestinal mucosa, these peptides were added in a phosphate-free medium at a concentration of 1, 2, or 4 mg/ml on the mucosal side of rat ileum mounted in an Ussing chamber in vitro. No effect on the electrical parameters of the tissue was observed. The unidirectional mucosal-to serosal flux of calcium was significantly reduced in the presence of the peptides, without alteration in the serosal-to-mucosal flux. Jms was 51.71 +/- 2.67 microEq/h.cm2 for control vs. 19.23 +/- 3.95 in the presence of 4 mg/ml CPP. This effect was associated with a reduction in free calcium in the mucosal reservoir of the Ussing chamber, without modification of mucosal total calcium or of serosal total and free calcium. These results indicate that CPP did not directly act on rat ileum to enhance calcium absorption. These peptides bind calcium, and the CPP--calcium complex which was not efficiently absorbed remained on the mucosal side of the tissue. In these conditions, the physiological role of CPP on intestinal calcium absorption could be only an indirect luminal inhibition of the precipitation of phosphate-calcium salts. This effect remains to be clearly established. PMID- 2757763 TI - Effect of allopurinol or superoxide dismutase plus catalase on cardiovascular function after burn injury in the anaesthetized rat. AB - A scald burn injury was applied to 22-23 per cent of the body surface area of anaesthetized rats. The cardiac output was 38-60 per cent lower in the burn injury group than in the control group; heart rate and mean arterial blood pressure were only slightly affected, but burn injury caused a significant increase in total peripheral resistance. The involvement of oxygen-free radicals in this immediate fall in cardiac output was investigated. Pretreatment with a blocker of free radical production, allopurinol or the infusion of the free radical scavengers superoxide dismutase plus catalase caused no cardiovascular improvement, suggesting that oxygen free radicals are not involved in the fall in cardiac output after burn injury. Allopurinol treatment, however, prevented the rise in total peripheral resistance seen after burn injury. PMID- 2757764 TI - Burn injuries in Port Harcourt, Nigeria. AB - The pattern of burn injuries in Port Harcourt, Nigeria is presented for the first time. Ninety-two patients were studied and 43 (46.74 per cent) of them were children in the 0-5 years age range. Thirty-seven of the children in this group suffered from scalds and six from flame burns. Petrol fire was the commonest cause of flame burns. The overall mortality was 26.09 per cent and the majority of deaths occurred in burns covering over 50 per cent of the total body surface area. Improved parental supervision of children, in particular toddlers, a more reliable public power supply system, a ban on carrying petrol in open containers in the streets and public enlightenment campaigns are advocated by the authors as preventive measures. PMID- 2757765 TI - How to study the aetiology of burn injury: the epidemiological approach. AB - Effective prevention of burn injury should be based on sound aetiological knowledge. This article deals with epidemiological methods to study the incidence of burn injury as a function of its risk factors. Central methodological issues are comparability of baseline prognosis, comparability of measurements (of effects in cohort studies and of risk factors in case-control studies), and comparability of external circumstances. These principles are clarified with a number of fictitious examples of risk factors for burn injury. It is explained that in preventive trials comparability may be achieved by randomization, blinding and placebo intervention. The main tools in non-experimental studies are deliberate selection and multivariate analysis. Special attention is given to the definition of the source population and to reducing measurement incomparability in case-control studies. Some well-designed case-control studies following these principles might bring effective prevention of burn injury some steps nearer. PMID- 2757766 TI - Pilot study into the IgG1 and IgG2 subclass response to polyvalent Pseudomonas vaccine in burned adults. AB - The IgG1 and IgG2 subclass response to thermal injury has been measured in a group of eight burned adults who received a single intramuscular injection of 0.5 ml of polyvalent pseudomonas vaccine (PPV), within hours of burn injury. The response in three of these patients is compared with the response in three matched patients who did not receive the vaccine. This single dose regimen of PPV did not appear to stimulate the early production of IgG1 or IgG2 and if subclass deficiency contributes to the risk of sepsis or toxin-mediated disease, as previous workers have established (Schur et al., 1970; Oxelius et al., 1981), then there is no apparent benefit in active immunization to reduce the risk in the early postburn period. PMID- 2757767 TI - Delayed neurological sequelae of high-tension electrical burns. AB - Five patients showed delayed spinal cord damage following high-tension electrical injury. Early specialist care of this complication is necessary and is best carried out in burn units. Our experience shows that recovery may be complete or only partial. PMID- 2757768 TI - Repair of burns of the scrotum using a gracilis myocutaneous flap. AB - An unusual case of isolated burns of the scrotum reconstructed by a unilateral gracilis myocutaneous flap is reported because of its clinical rarity. PMID- 2757769 TI - Measuring pressure under burns pressure garments using the Oxford Pressure Monitor. AB - Pressure garments are used extensively in the treatment of hypertrophic scarring following burn injuries. The Oxford Pressure Monitor was used to measure garment scar interface pressure (mmHg) using a number of fabric types over various body parts. The results indicate a wide range of pressure values between different garments and body parts with the greatest pressures found over the dorsum of hands and feet. The problems of achieving 'optimal pressure' over hypertrophic scarring are discussed with emphasis on the need for more accurate measuring equipment. PMID- 2757770 TI - Assessment of topical therapy of the burn wound with silver sulphadiazine after its use for 15 years in a burn unit. AB - A comparative study of patients receiving or not receiving topical applications of 1 per cent silver sulphadiazine cream as treatment for burn wounds has shown that the drug is still effective in significantly reducing the amount of bacterial contamination of burn wounds, even after 15 years of use in our Burn Unit. Consequently the overall mortality due to burn wound sepsis has been decreased in this Burn Unit. PMID- 2757771 TI - [Intensive psychosensorial stimulation of malnourished children. I. Effects on psychomotor development and physical growth]. AB - Children under 18 months of age, with primary moderate and severe malnutrition, were treated by a multiprofessional team with an ambulatory system. The prospective effect of intensive psychosensorial stimulation over psychomotor development and physical growth was studied. Control (41 children) and experimental (55 children) groups were compared when the program started and successively followed up after 6 and 12 months. The experimental group were given intensive psychosensorial stimulation at home by their mothers. They were trained and periodically inspected by nurses. Both groups were matched by age, sex and birthweight. They all came from very poor families. Mean age when the program started was 10.4 months. Weight for age, weight for height, height for age (Standard NCHS), serum albumin, serum iron, transferrin saturation, TIBC were evaluated. Psychomotor development was evaluated with Rodriguez S. (EEDP) and Brunet Lezine scales. Both groups had similar increment in weight for age, weight for height, serum iron and transferrin saturation. No change was observed in height for age, serum albumin and TIBC. Psychomotor development improved more in the experimental group (p less than 0.01), coming to normal range in most children in that group. To conclude, intensive psychosensorial stimulation in malnourished children is not shown to improve physical growth but does improve psychomotor development (malnutrition, psychomotor development, physical growth, psychosensorial stimulation). PMID- 2757773 TI - [Intraesophageal pH in children with suspected reflux]. AB - We study 22 children with clinical symptoms of gastroesophageal reflux. The main manifestations were: frequent vomiting, failure to thrive and repetitive pneumonia. In all of them we perform barium esophagogram (SEGD) with fluoroscopy, esophageal manometry (EM) and a four hours intraesophageal pH measurement. Thirteen of the twenty two children present a pathologic reflux (ERGE); in 16 we found SEGD that show reflux; three of them had an abnormal EM, the other 13 were normal. Seven patients showed alteration of the intraesophageal pH measurement. In conclusion the intraesophageal pH measurement in short period of time (4 hours) is a good method in the diagnosis of patients with ERGE. PMID- 2757772 TI - [Autoantibodies in juvenile rheumatoid arthritis. Clinical and serologic study]. AB - Twenty five patients with juvenile rheumatoid arthritis were studied in order to define the frequency and kind of circulating autoantibodies in this entity, as well as, their relationship with the different disease subgroups and complications. Also the association of these autoantibodies with the activity stage of the illness was determined. There were 14 pauciarticular, 8 polyarticular and 3 systemic juvenile rheumatoid arthritis patients. Twelve have a flare of the disease and 13 were completely asymptomatic. Rheumatoid factor measured by the latex agglutination tests was positive in 6 children. These included 2 patients with pauciarticular disease, showing titers below 1:40 and 4 cases with polyarticular disease, showing titers above 1:320. One of these last patients developed and adult type rheumatoid arthritis during her evolution and was treated with D-penicillamine. The polyarticular but not the pauciarticular patients showed positive tests for rheumatoid factor by nephelometry. No definite association between these laboratory results and the activity of the disease was noted. Positive antinuclear antibodies by the indirect immunofluorescence test were found in 3 pauciarticular and one polyarticular patients. A predominant homogeneous staining was found with the mouse kidney substrate, whereas homogeneous and speckled patterns were noted with the homologous HEp-2 cells. One patient with persistent positive antinuclear antibodies revealed uveitis. Three of the 4 sera with positive antibodies by the indirect immunofluorescent test have also anti-nucleoprotein antibodies by the hemagglutination test with titers above 1:32.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2757774 TI - [Intellectual development and somatic growth in students suffering from malnutrition early in life]. AB - STUDY OBJECTIVE: To evaluate the Intellectual Quotient (IQ) and the somatic growth of school children which were malnourished in early life. DESIGN: Ex-post factum study of growth and IQ achievements, in children previously affected by malnutrition. SETTING: To get early indicators of growth and development handicaps in school age children, for stimulation programs after the disease. PATIENTS: Twenty eight school children, affected by malnutrition during the first two years of life, were selected from a Rehabilitation Center. INTERVENTION: The height and the IQ (WISC) of the children, were measured. Beside that, the following data were obtained from the records: the age, height, weight and developmental quotient (Gesell) during the malnutrition, the time spent in the treatment, and the body weight/height ratio at recovery and at the time of the study. MEASUREMENTS AND MAIN RESULTS: In 20 of the children, the height was below the 10th percentile; 12 of them were below the 3d percentile. Only 8 had IQ's from 90 to 110; in 10 children the IQ was below 80. There was a positive correlation (p = 0.05) among the height/weight ratio at rehabilitation and at the moment of the study. The IQ, related to the variables studied, was not statistical significant (p less than or equal to 0.05). PMID- 2757775 TI - [Fluoroangiographic study of the retina in healthy siblings of diabetic patients]. AB - There are still great incognites in the etiology and physiopathology of the so called chronic complications of diabetes mellitus. There are specially many questions about the origin of the diabetic microangiopathy which is the cause of several alterations like the diabetic retinopathy. Genetic, immunological and environmental factors have been involucrated in its development. In order to study the genetic involvement, in fifteen normal brothers and sisters of known diabetics type I a retina fluorangiographic study was performed. In all the cases the fluorangiography was normal suggesting that the genetic factors must coexist with the metabolic disturbance to produce retina vessels damage. PMID- 2757776 TI - [Parathion poisoning]. AB - This study shows our clinical and therapeutical experience in 48 cases of infant COFA intoxication admitted in the Intensive Care Unit of "Emilio Civit Children Hospital", Mendoza, Argentina in a periode of seven years. They were investigated to determine the presence of Parathion in blood and gastric washing with the sodium hydroxide qualitative method, and also cholinesterase was detected in blood with a colorimetric method (the monotest cholinesterase). Age range from one to ten years with predominance from 3 to 4 years; 27 were males and 21 females. In almost all the cases (90%) the toxic ingressed through several ways, and from 10 to 30 minutes appeared the characteristic signs: miosis and bronchorrhea. Clinically in 30 cases the intoxication was considered dangerous and mild in the others. The data obtained by laboratory techniques were diagnostic only in half of the cases. Atropine's sulphate was done to all cases until their recuperation, in doses from 2.5 mg to 20 mg. The evolution was highly satisfactory, only two died and two remained with seizures. Always had thanklessness and carelessness with the child from living together adults, who playing handle and waste the toxic. In two occasions the intoxication was familiar by contaminated food. PMID- 2757777 TI - [Effect of danazol on heterozygous c protein coagulation deficiency exacerbated by Salmonella typhi sepsis]. AB - The case of an 8-month-old male with heterozygous coagulation protein C deficiency is presented. Sepsis due to Salmonella typhi aggravated the protein C deficiency and resulted in arterial thrombosis of the distal third of the lower right limb. The patient was treated with both heparin and danazol, the levels of functional protein C increasing and the necrotic phenomenon resolving, thus making unnecessary amputation of the limb. The observation is discussed with the evidences of danazol being useful in the treatment of patients with protein C deficiency. PMID- 2757778 TI - [AEC syndrome: ankyloblepharon, ectodermal defect, cleft lip and palate (Hay Wells syndrome)]. AB - A 12 month-old female is described, with clinical features of AEC syndrome. This case is a novo mutation. Clinical diagnosis at an early age is emphasised to get a better management and genetic counseling. Also we review the literature. PMID- 2757779 TI - [Psychosocial problems of children with chronic disease]. AB - This presentation comprises: a) the study of psychosocial problems in children with chronic disease (1980-83); b) application and results of a "pluridimensional approach" model, designed to solve these conflicts (1982-88). Thirty-five children with end stage renal disease (ESRD) and 34 families were studied, as well as the members of the professional team. The methods of study were: conducted observations, projective tests, recording and analysis of psychotherapy (individual and familiar) and Balint sessions. The data were analized in the framework of psychoanalysis, theory of the systems and groups, etc. The results showed: depression, anguish and regression, interfering with rehabilitation, in the group of children. The problems worsening with greater length of the dialysis periods and with younger age of the patients. Poverty increases losses and guilty feelings decreasing the defensive and adaptive mechanisms. In the families, ESRD provoked migration, fragmentation, dynamic and structural dysfunctions and several inter and intrapersonal conflicts. In the professional team, tension, anxiety, compulsive and indiscriminate conducts were detected, as well as a great difficulty to communicate with the patients and their families. In an attempt to decrease these conflicts a pluridimensional approach was designed and applied in the patients, families and members of the professional team, with the aim of interrupt the pathologic interaction patterns and change them in therapeutic. This model included the practice of several independent and simultaneous psychological interventions, ergotherapy, recreative and occupational activities with the patients; group sessions for information, diagnostic interviews and psychotherapy with the families and Balint sessions with the professional team.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2757781 TI - [Several current challenges of education in pediatrics]. PMID- 2757780 TI - [Control of diarrheal diseases in Mexico and Latin America]. AB - Oral rehydration therapy (ORT), has been considered the major advance in the treatment of the diarrheal diseases, and has been the single most important factor in the decrease of mortality and decreased morbidity in childhood diarrheal. ORT, is not limited to the administration of oral rehydration solution; it also includes feeding techniques and community education and participation. In order to promote ORT, national programs have been developed and promoted in educational centers in strategic areas of the Latin America countries, where medical and paramedical staff attend. In Mexico there have been two national surveys to evaluate the ORT program. This policy has allowed for participating countries to reduce the cost of treatment of diarrheal disease. PMID- 2757782 TI - Responses of hippocampal formation neurons in the monkey related to delayed spatial response and object-place memory tasks. AB - The memory for where in the environment a particular visual stimulus has been seen is one of the types of memory relatively specifically impaired by hippocampal damage in primates including man. In order to investigate what processing might be performed by the hippocampus related to this type of memory, the activity of hippocampal neurons was recorded while monkeys performed an object-place memory task. In this task, the monkey was shown a sample stimulus in one position on a video screen, there was a delay of 2 s, and then the same or a different stimulus was shown in the same or in a different position. The monkey remembered the sample and its position, and if both matched the delayed stimulus, he licked to obtain fruit juice. Of the 600 neurons analysed in this task, 3.8% responded differently for the different spatial positions, with some of these responding differentially during the sample presentation, some in the delay period, and some in the match period. Thus some hippocampal neurons respond differently for stimuli shown in different positions in space, and some respond differently when the monkey is remembering different positions in space. In addition some of the neurons responded to a combination of object and place information, in that they responded only to a novel object in a particular place. These neuronal responses were not due to any response being made or prepared by the monkey, for information about which behavioral response was required was not available until the match stimulus was shown. This is the first demonstration that some hippocampal neurons in the primate have activity related to the spatial position of stimuli. The activity of these neurons was also measured in a delayed spatial response task, in which the monkey was shown a stimulus in one position, and, after a 2 s delay when two identical stimuli were shown, had to reach to touch the stimulus which was in the position in which it had previously been seen. It was found that the majority of the neurons which responded in the object place memory task did not respond in the delayed response task. Instead, a different population of neurons (5.7% of the total) responded in the delayed spatial response task, with differential left-right responses in the sample, delay, or match periods.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2757783 TI - Progressive degradation of serial grooming chains by descending decerebration. AB - Rule-governed behavioral chains occur predictably within the grooming sequences of rats. Descending levels of decerebration were used to identify the minimum brain substrate needed to generate the sequential structure of a chain that connects up to 25 actions into a stereotyped grooming pattern. Full brain transections in the coronal plane isolated the decerebrate brainstem of rats at one of 3 different levels: mesencephalic (above the midbrain), metencephalic (above the hindbrain), and myelencephalic (above the medulla oblongata). Complete chain sequences were produced successfully by higher decerebrates, demonstrating that brainstem circuitry suffices for the basic generation of this sequential pattern. The pattern of sequential degradation across lower transection levels was gradual and continuous, raising the possibility that the generating circuitry for this chain may not be localized at a single level within the brainstem but rather may be distributed across the hindbrain as a degenerate or parallel network. The competence of this network appears to be reduced merely in increments by descending transections. This possibility is compared to localized generator alternatives. PMID- 2757784 TI - Qualitative and quantitative analyses of hoarding in medial frontal cortex rats using a new behavioral paradigm. AB - The study demonstrates novel features of rat hoarding, patterns of recovery from medial frontal cortex damage that are behaviorally dependent, and new methodology for studying hoarding. Rats were placed in a covered cage connected to an alley at the end of which were food pellets varying in size between 20 and 500 mg. Food pellet size directed movements: small food pellets were swallowed immediately, medium sized pellets were held in the paws and eaten, and large pellets were carried back to the cage. After bilateral ablations of the medial frontal cortex, hoarding ceased immediately postoperatively and then partially recovered. Thereafter, food pellets were treated as being smaller than they actually were. The medial frontal cortex rats also hoarded fewer multiple pellets, had slower hoarding speeds, and showed reduced hoarding in 24-h hoarding tests. They were more responsive to illumination changes: as illumination was reduced and finally reversed between the hoarding alley and home cage, they, unlike control rats, reduced and then ceased hoarding. Equivalent change was not produced by eye patches. Damage to medial frontal cortex may change an animal's sensitivity to the many cues provided by the food, the environment, and previous experience in such a way that hoarding responses become increasingly controlled by the immediate, simple, stimulus features of the environment. PMID- 2757785 TI - Effects of local application of 5-HT into the median and dorsal raphe nuclei on male rat sexual and motor behavior. AB - The local application of 10 micrograms 5-hydroxytryptamine (5-HT) into the dorsal or median raphe nucleus was found to facilitate male rat sexual behavior, as evidenced by a decrease in time to ejaculation, and in number of intromissions preceding ejaculation. The application of a higher dose, 40 micrograms, at either site, inhibited the initiation of sexual behavior. There was a clear distinction between the motor effects observed after local application of 5-HT into the dorsal or the median raphe nuclei. Injections into the median raphe produced a dose-dependent increase, whereas injections into the dorsal raphe nucleus produced a dose-dependent decrease, in motor activity. Present results suggests an inhibitory and excitatory role of the median and the dorsal raphe serotonergic projections, respectively, as regards motor behavior, whereas projections from both nuclei appear to have an inhibitory role in the mediation of male rat sexual behavior. PMID- 2757786 TI - Adrenocorticoid receptor binding in the rat hippocampus: strain-dependent covariations with arousal and habituation to novelty. AB - In order to investigate whether the genotype-dependent behaviour of the Naples high-(NHE) and low-excitability (NLE) rat strains was modulated by differences in the capacity of hippocampal adrenocorticoid receptors, a correlative analysis was made among behavioural scores from exposure to a Lat-maze and in vitro [3H]corticosterone hippocampal binding capacity in these rats and in their random bred controls (NRB). As previously shown, NHE/NLE-rats differed markedly upon forced exposure to the maze, with the NRB group occupying an intermediate position. No differences were found in maximal binding capacity (Bmax) and dissociation constant (Kd), nor in the individual maximal binding capacity (IMBC) between the two strains, while both showed lower IMBC than NRB-rats. These results tend to exclude that the genetic differences in the behaviour of NHE/NLE rats are due to distinct patterns in the adrenocorticoid binding capacity in the hippocampus (HPC). Moreover, the intrastrain correlative analysis among IMBC (in the whole HPC and in its dorsal and ventral portion) and the behavioural scores showed that (1) motor and emotional correlates of 'arousal' to novelty were positively correlated in NLE and negatively in NHE-, but not in NRB-rats; (2) a consistent correlation was found with the intertrial activity decrement (long term habituation), which was negative in both strains, and it was positive in NRB rats. These complex co-variations are envisioned as possibly due to the differential modulatory components of the activation and inhibition of novelty induced arousal response. However, our findings support the hypothesized involvement of the HPC, where adrenocorticoid receptors are selectively concentrated, in the modulation of some adaptive behavioural responses. PMID- 2757787 TI - Abstracts of the general conference of the European Brain Behaviour Society. Zurich, Switzerland, September 7th-9th, 1988. PMID- 2757788 TI - Molecular mechanisms of hormone action. 40th Mosbacher Colloquium of the Gesellschaft fur Biologische Chemie. April 6th to 8th, 1989. Abstracts. PMID- 2757789 TI - Nucleotide sequence of a cDNA encoding rat protamine and the haploid expression of the gene during rat spermatogenesis. AB - The nucleotide sequence of a 342-base cDNA encoding the rat protamine has been determined. This insert, isolated from a rat testis cDNA library, encodes a polypeptide of 50 amino acids of which 29 are arginine 9 are cysteine and 2 are tyrosine. The insert contains the complete 3'-noncoding region of 170 bases and 18 bases of the 5'-noncoding region. Hybridization of the protamine cDNA with the RNA prepared from testes of prepubertal and sexually mature rats revealed that protamine mRNA is first detectable as a 600 nucleotide long molecule in the 35 day old testis containing around 15% of round spermatids but not in testis of younger animals. The RNA of 50-day old and sexually mature rats was found to contain a second protamine mRNA which is around 500 nucleotides in length. Hybridization of the protamine cDNA with the RNA of isolated spermatids of the mature testis resulted in 2 prominent hybridization signals (600 and 500 bp) while the faint signal obtained with the RNA of pachytene spermatocytes (600 bp) was found to be due to contamination of the cell preparation by spermatids. After digestion of the mRNAs with ribonuclease H a single hybridization band even smaller than 500 nucleotides was obtained. As demonstrated on testis sections the transcripts are confined to the central layers of the tubuli seminiferi corresponding to the spatial arrangement of corresponding to the spatial arrangement of postmeiotic cells. The results indicate that the protamine gene in the rat is postmeiotically expressed and that the mRNA undergoes post transcriptional processing that includes a reduction in molecular size with respect to the poly-(A)+ tail. PMID- 2757790 TI - The primary structure of pale-throated three-toed sloth (Bradypus tridactylus, Xenarthra) hemoglobin. AB - The hemoglobin of the Pale-Throated Three-Toed Sloth (Bradypus tridactylus, Xenarthra) was separated into two components (ratio 4:1) with identical amino acid analyses for the alpha- and beta-chains. The primary structures of both chains from the major component are given. They could be isolated by chromatography on carboxymethyl cellulose CM-52. The sequences have been determined by automatic Edman degradation of the native chains and their tryptic peptides. The comparison with human hemoglobin showed 27 substitutions in the alpha-chains and 33 in the beta-chains. In the alpha-chains one amino-acid exchange involves an alpha 1/beta 1-contact. In the beta-chains two heme- and four alpha 1/beta 1-contacts are substituted. The hemoglobin of the Sloth is compared to that of the Nine-Banded Armadillo (Dasypus novemcinctus), another representative of the order Xenerthra. PMID- 2757791 TI - The hemoglobins of the adult blackbird (Turdus merula, Passeriformes). The sequence of the major (HbA) and minor component (HbD). AB - The blood of the adult blackbird contains one major hemoglobin component (HbA = alpha A2, beta 2, ca. 80%) and one minor one (HbD = alpha D2 beta 2, ca. 20%). The Hb-components were separated by FPLC on a TSK SP-5 PW column, and eluted with a linear NaCl gradient, while the globin chains were purified on a cation exchange (CM-Cellulose). Tryptic peptides from the globin chains were separated by HPLC on an RP-2 Lichrosorb column. The complete amino acid sequence was determined by automatic Edman degradation, using film and gas phase methods. For the alpha A-, alpha D- and beta-chains, peptide alignment was carried out relative to the corresponding chains of the greylag goose (Anser anser). The close phylogenetic relationship between blackbird, tree sparrow and starling is verified by the hemoglobin sequence. The O2-affinities of the major and minor hemoglobin components of the blackbird are not yet known. Thus, the results were interpreted on the basis of primary structure. Substitutions of possible structural significance were examined with the help of molecular graphics/modelling. PMID- 2757792 TI - Isolation of the boar sperm acrosin peptide released during the conversion of alpha-form into beta-form. AB - The sperm proteinase acrosin occurs in several enzymatically active forms which differ from each other in molecular mass. The high-molecular-mass alpha-form (53 kDa) is converted into the low-molecular-mass beta-form (38 kDa) by auto proteolysis. As these two forms possess identical N-termini and identical A chains (light chains) the difference must reside in the C-terminal parts of their B-chains (heavy chains). It could be demonstrated by gel electrophoresis that on incubation of alpha-acrosin, in addition to beta-acrosin, a main degradation product of approx. 18 kDa was formed. This fragment was isolated by gel filtration chromatography. The amino-acid composition of the fragment corresponded to the difference between that of alpha-acrosin and of beta-acrosin, and showed a strikingly high proportion of proline. It is suggested that this hydrophobic segment from the C-terminal region of alpha-acrosin accounts for the special membrane-associating property of the enzyme. PMID- 2757793 TI - Pharmacokinetic and -dynamic investigations on HL60 cells with a new protoporphyrin dimethyl ester hematoporphyrin dimer. AB - Pharmacokinetic and -dynamic studies using a novel porphyrin dimer were performed in human line HL60 promyelocytic leukemia cells. Uptake of the dimer into leukemic cells was observed to occur at substantially lower concentrations in comparison to a previously described monomeric dihematoporphyrin ether-free hematoporphyrin derivative. Both dimer and monomer derivatives could be demonstrated to inhibit cell growth, with no remarkable quantitative differences being found in cell proliferation studies regarding [3H]-thymidine incorporation and assay for colony formation. Structurally, the new compound represents an unsymmetrically substituted diethyl ether having protoporphyrin dimethyl ester and hematoporphyrin as substituents. For this reason the compound was designated as protoporphyrin dimethyl ester hematoporphyrin ether. PMID- 2757794 TI - Lipopeptide derivatives of bacterial lipoprotein constitute potent immune adjuvants combined with or covalently coupled to antigen or hapten. AB - Lipopeptide analogues of the N-terminus of bacterial lipoprotein consisting of N palmitoyl-S-[2,3-bis(palmitoyloxy)-(2RS)-propyl]-(R)-cysteine (Pam3Cys) attached to one to five further amino acids [Pam3Cys-Ser-Ser-Asn-Ala, Pam3Cys-Ser-(Lys)4, Pam3Cys-Ala-Gly, and Pam3Cys-Ser] were investigated for biological activity. In vitro, the compounds proved to be potent activators for Balb/c splenocytes as determined by proliferation assays. When given in vivo in combination with SRBC, Pam3Cys-Ser and Pam3Cys-Ala-Gly acted as immunoadjuvants enhancing the antigen specific IgM response after 7, and the IgG response after 14 days. In combination with dinitrophenylated bovine serum albumin (BSA(Dnp)), especially the amphiphilic and water-soluble lipohexapeptide Pam3Cys-Ser-(Lys)4 constituted a potent immune adjuvant. The lipopeptide was able to fully replace Freund's complete adjuvant (FCS) enhancing both anti-Dnp IgM and IgG in Balb/c mice. The hapten Dnp was also coupled directly--or via the spacer molecule 1,6 diaminohexane (HMD)--to the synthetic lipopeptides. The chemically defined low molecular-mass conjugates obtained were capable of inducing anti-hapten-specific IgM and IgG without further adjuvants or carriers. The anti-hapten responses induced by these chemically uniform lipopeptide-hapten conjugates were, however, less pronounced than the response to the conventional heterogeneous hapten protein conjugate BSA(Dnp), and only a weak boost effect was observed. Our results show that defined lipopeptides are novel immunoadjuvants either combined with or covalently linked to antigens or haptens. PMID- 2757795 TI - [Isolation and structure determination of two peptides occurring in human seminal plasma]. AB - Two previously unknown peptides with a high amount of polar amino acids were isolated from human seminal plasma by a combination of dialysis, gel filtration, ion-exchange chromatography, and RP-HPLC. Their structures were determined by gas phase sequencing simultaneously considering the different peak intensities. PMID- 2757796 TI - Investigations on the function of creatine kinase in Ehrlich ascites tumor cells. AB - 1. Growth and viability of in vitro cultured Ehrlich ascites tumor cells are not significantly impaired by exogenous creatine up to 40mM. Retardation of cell growth by higher concentrations depends on cell density. 2. Ehrlich cells grown in the presence of high concentrations of creatine accumulate creatine phosphate to high levels (up to 23 nmol/10(6) cells in the presence of 40mM creatine). 3. A nearly complete interruption of glycolytic ATP production or inhibition of the oxidative ATP synthesis reduces the maximal creatine to about 40-50% of controls. 4. Studies on the intracellular distribution of creatine kinase have shown, that the enzyme is only associated with the mitochondrial fraction. Titration of isolated mitochondria with digitonin revealed that the activity is located in the inter-membrane space and partly bound to the outer site of the inner membrane. 5. By growth of Ehrlich cells in creatine-free medium it is possible to obtain "creatine phosphate-depleted" cells (creatine phosphate less than 10% of controls). The growth of creatine phosphate-depleted cells as compared to controls is significantly reduced under energetic stress situations. The protein synthesis of these cells after an energetic stress (lack of glucose and oxygen) is significantly reduced as compared to creatine phosphate containing cells. 6. It is concluded that in these cells creatine kinase/creatine phosphate is a thermodynamic buffer system and not part of an energy shuttle as is postulated for muscle cells. PMID- 2757797 TI - Synthesis of thiol-functionalized N-acetylmuramyl peptide congeners suitable for their conjugation to target molecules. AB - N-Acetylmuramyl-dipeptide and tripeptide derivatives containing at the C-terminus a masked thiol function, i.e. the S-tert-butylthiocysteamine residue, were synthesized via direct condensation of N-acetylmuramic acid with the peptide moiety using the dicyclohexylcarbodiimide/N-hydroxysuccinimide procedure. Reduction with tributylphosphine in aqueous organic media generates the free thiol function for a selective conjugation of these immunomodulants with target molecules via unsymmetrical disulfide bridging with a second thiol group by the sulfenohydrazide procedure or via thio-ether linkage by the addition to maleimido -or aziridine-derivatives. PMID- 2757798 TI - Strategy for selection of internal, low redundancy probes for identification of specific cDNA. AB - Internal peptide fragments containing tryptophan residues are useful predictors of coding sequence for selection of restriction enzyme fragments or synthetic oligonucleotides to use in isolation of a cDNA or genomic clone. We describe a strategy to identify such fragments which uses an on-line photodiode array spectrophotometric analysis of tryptic fragment elution from an HPLC system to select peptides for amino acid sequence analysis. We applied this information to the identification and subsequent isolation of a cDNA corresponding to bovine placental lactogen from a bovine placental cDNA library which contains numerous closely related gene products. PMID- 2757799 TI - Dietary NaCl loading enhances antihypertensive effect of guanabenz in spontaneously hypertensive rats. AB - Our previous studies demonstrated that high dietary NaCl intake causes increases in blood pressure and plasma norepinephrine (NE) levels and a decrease in NE release associated with local upregulation of alpha 2-adrenoceptor number in the anterior hypothalamic area (AHA) of NaCl-sensitive spontaneously hypertensive rats (SHR-S). Further, acute microinjection of clonidine into the AHA of SHR-S fed a high NaCl diet resulted in greater depressor and bradycardic responses than in SHR-S receiving a normal NaCl diet. The current study tested the hypothesis that the antihypertensive effect of chronic systemic administration of guanabenz (0.24 micrograms/kg/min, IV) is enhanced in SHR-S maintained on a high (8%) NaCl diet than in control rats on a normal (1% NaCl) diet. After two weeks on the diets, mean arterial pressure (MAP) and heart rate (HR) were measured and blood for NE and epinephrine (E) assay was collected from intra-arterial cannulas in conscious, unrestrained rats. The ratio of left ventricle and septum to body weight (LV + S/BW) was determined. Chronic infusion of guanabenz significantly decreased MAP (P less than .05), HR (P less than .01) and LV + S/BW (P less than .01) in 8% NaCl fed SHR-S, but not in 1% NaCl fed SHR-S (P greater than .1). Guanabenz tended to reduce plasma NE levels in 8% NaCl fed SHR-S (.1 greater than P greater than .05), but not in 1% NaCl fed rats (P greater than .1).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2757800 TI - Mesenteric artery contractile properties during dietary calcium manipulation in spontaneously hypertensive and Wistar Kyoto normotensive rats. AB - The hypothesis that elevated Ca2+ intake lowers blood pressure in the spontaneously hypertensive rat (SHR) by altering intrinsic contractile properties of vascular smooth muscle was tested. The effect of 0.5, 1, and 2% Ca2+ in the diet on systolic blood pressure, serum-ionized Ca2+, and contractile properties of mesenteric arteries isolated from SHR and normotensive Wistar-Kyoto (WKY) rats maintained on diets for 6 and 12 weeks was examined. Blood pressure was significantly elevated in SHR on 0.5% Ca2+ diets after both 6 and 12 weeks, as well as in WKY receiving 1% Ca2+. After six weeks on the diets for the SHR and 6 and 12 weeks for the WKY, serum-ionized Ca2+ was a function of the amount of Ca2+ in the diet. When contractile force generation in response tp KCl or norepinephrine was examined, small diet-related differences were detected, but no consistent linear effect associated with the level of Ca2+ in the diet was observed in either strain. When the sensitivity of the vessels to KCl and norepinephrine was examined, no effects of oral Ca2+ intake were detected. The results indicate that oral Ca2+ loading has modest effects on blood pressure at both 12 and 18 weeks of age in the SHR and WKY and in the younger rat, where Ca2+ intake modulates serum ionized Ca2+ levels. At no age does modification of Ca2+ intake have a consistent effect on mesenteric artery sensitivity or force generating ability in response to KCl or norepinephrine. These findings do not support the hypothesis that oral Ca2+ loading lowers blood pressure in the rat by altering intrinsic contractile properties of vascular smooth muscle. PMID- 2757801 TI - Urinary output of urodiolenone in essential hypertension. AB - Increased amounts of urodiolenone, an isomer of a phytoalexin, were found in the urine of 34% of patients with essential hypertension. Urodiolenone was also excreted in 70% of patients with neurocirculatory asthenia (hyperkinetic syndrome) and labile hypertension; very small quantities were found in normal subjects. When grapefruit juice, which is rich in urodiolenone, was offered to hypertensive subjects, urodiolenone excretion was much higher than the amount ingested, indicating that output was not due to precursors present in the diet. PMID- 2757802 TI - Withdrawal-induced antihypertensive effect of vasopressin in Doca-salt hypertension. AB - Arterial pressure and heart rate were recorded in three groups of conscious unrestrained rats before, during and after a three-hour intravenous infusion of arginine vasopressin (AVP; 20 ng/kg/min). Before infusion of AVP, basal arterial pressure was 152 +/- 3.2 mm Hg for the Doca-salt hypertensive group, 117 +/- 3.2 mm Hg for the uninephrectomized control group, and 111 +/- 2.1 mm Hg for the sham operated control group. The changes in arterial pressure at each of the time points during the three-hour infusion of AVP were not significantly different among the three groups. Cessation of the AVP infusion was associated with a dramatic and prolonged fall of arterial pressure below preinfusion basal levels in the Doca-salt hypertensive group: pressure was 58 +/- 5.0 mm Hg below basal levels within 60 minutes of stopping the infusion and was still 45 +/- 5.6 mm Hg below four hours later. Pressure in this group was 107 +/- 5.7 mm Hg five hours after stopping the infusion. In contrast, the fall in pressure in the two control groups was small. Five hours after stopping the infusion, pressure was 108 +/- 2.3 mm Hg in the uninephrectomized group and 102 +/- 1.7 mm Hg in the sham operated group. Thus, five hours after stopping the infusion, blood pressures among the three groups were not significantly different. The Doca-salt hypertensive group had been rendered normotensive.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2757803 TI - Blood pressure and hypothalamic norepinephrine and dopamine in calcium-deficient rats. AB - The influence of dietary calcium (Ca) on systolic blood pressure (BP) and hypothalamic norepinephrine (NE), dopamine (DA) and DA metabolites dihydroxyphenylacetic acid (DOPAC), and homovanillic acid (HVA) concentrations was investigated in male Sprague-Dawley rats raised on diets containing 0.005, 0.17, 1.4, and 2.8% Ca for eight weeks starting at four weeks of age. Blood pressure was significantly higher in the 0.005% Ca and lower in the 2.8% Ca group respectively, compared with the control (1.4% Ca) group. Hypothalamic NE and DA were lower only in the 0.005% Ca group. DOPAC concentration was higher in both Ca deficient and -excess groups. No change in HVA was observed in any group. Plasma Ca was reduced and parathyroid hormone (PTH) was increased in Ca-deficient groups, but plasma Ca and PTH were increased and decreased, respectively, (nondetectable) in the Ca-excess group. These results suggest that changes in BP due to altered dietary Ca metabolism may be due in part to altered adrenergic system, as well as to dietary-induced changes in calcium metabolism. PMID- 2757804 TI - The relation of norepinephrine to blood pressure is independent of acculturation in Western Samoan men. AB - The purpose of this study was to examine whether the relationships between the rates of urinary catecholamine excretion and blood pressure were similar in more traditionally living and more acculturated Western Samoan men. The men studied included 31 traditionally living villagers and 28 laborers, 33 sedentary workers, and 31 college students from Apia, the capital of Western Samoa. The results show that norepinephrine was associated with systolic pressure at midmorning, independent of fatness, age, activity, and degree of Westernization. These findings suggest that the relationships between catecholamines and blood pressure are unaffected by acculturation in Western Samoan men. PMID- 2757805 TI - Role of cadmium in hypertensive patients with renal parenchymal disease. AB - In our study we investigated 36 out-patients with renal disease; 22 of them were hypertensive. In all patients proteinuria was present (4.30 +/- 0.82 g protein/d) and renal involvement has been proved by renal biopsy. Blood cadmium in nonsmokers was significantly (P less than .05) lower than in smokers. Patients with renal hypertension showed a significantly higher (P less than .05) urine cadmium excretion/d (1.60 +/- 0.23 micrograms/d) compared to normotensives with a disease of the kidney (1.14 +/- 0.38 micrograms/d). Our results indicate that cadmium may be involved in the development of hypertension in patients with renal disease. PMID- 2757806 TI - Cerebral blood flow and its pathophysiology in hypertension. AB - In chronic hypertension, the lower limit of autoregulation of cerebral blood flow (CBF) is shifted towards high blood pressure with a consequent impairment of the tolerance to acute hypotension. Despite this, antihypertensive treatment in the great majority of patients prevents stroke and the risk for treatment-induced cerebral ischemia is only real in a limited number of clinical settings such as malignant hypertension, hypertension in the elderly, and hypertension associated with acute stroke. During long-term treatment adaptive hypertensive changes in CBF autoregulation may be reversible, especially in young patients. Drugs used for emergency lowering of blood pressure may be classified into four groups according to their effect on CBF and intracranial pressure: (1) drugs with no pharmacological action in the cerebral circulation; (2) cerebral vasodilators; (3) alpha-adrenergic and ganglionic blockers; and (4) angiotensin-converting enzyme (ACE) inhibitors. Oxygen saturation in the jugular venous blood is of the order of 60% to 70% and is considerably higher than in the coronary sinus. It is hypothesized that this oxygen reserve enables the brain better than the heart to take hemodynamic advantage of pressure lowering without risking tissue ischemia. This may explain why antihypertensive treatment prevents stroke but not myocardial infarction. Acute hypertensive encephalopathy is probably caused by failure of autoregulatory vasoconstriction with focal or generalized dilatation of small arteries and arterioles. This is associated with a high CBF, dysfunction of the blood-brain barrier, and the formation of brain edema that is thought to cause the clinical symptoms. PMID- 2757807 TI - Blood pressure-lipid connection. PMID- 2757809 TI - Hypotensive mechanisms of antihypertensives based on the water tank model. AB - Mechanisms of hypotensive action of antihypertensive drugs were theoretically considered using the water tank model on body fluid volume-blood pressure regulation. If a cock is attached to a tank with a base area corresponding to the reciprocal of total peripheral resistance (TPR) and water is poured into this tank at a rate corresponding to the amount of Na+ intake, then equilibrium should be achieved at a certain water level, volume, and output from the cock, which represent mean arterial pressure (MAP), cardiac output (CO), and urinary Na+ excretion rate. The height of the cock from the tank bottom and the size of the cock correspond to the x-intercept and slope of the renal function curve (pressure-natriuresis relationship). Vasodilators lowered the cock height and enlarged the base area (reduced TPR), resulting in an increase in the volume (CO). beta-Blockers not only lowered the height, but also decreased the size of the cock. Because they do not alter TPR (base area), CO (volume) must be reduced. Converting-enzyme inhibitors had the same effects on the height and size of the cock as beta-blockers, but enlarged the base area (reduced TPR), resulting in an increase in the volume (CO). Diuretics increased the cock size without affecting the cock height or the base area, resulting in a decrease in CO. The effects of antihypertensive drugs on the cock (kidney) seemed essential in their hypotensive action, similarly as abnormality of the renal function curve is essential in the genesis of hypertension. These analyses can illustrate schematically the hemodynamic changes induced by antihypertensive drugs. PMID- 2757808 TI - Does sodium intake modify red cell Na+ transporters in normal and hypertensive subjects? AB - Abnormalities in sodium transport in red blood cells (RBC) have been reported in hypertensive subjects. Uncertain from previous studies is whether the level of sodium intake per se might influence the level of these transporters. This study was designed to answer that question by evaluating the level of activity of three RBC sodium transporters in fourteen normotensive and twenty-six hypertensive subjects studied twice--once while in balance on a 10 mEq and once while in balance on a 200 mEq sodium intake. There was no significant difference in the maximal velocity (Vmax) of the sodium pump or the cell sodium and potassium content in normotensive or hypertensive subjects, nor did sodium intake influence these factors. Li-Na countertransport activity was significantly (P less than .01) higher in the hypertensive than in the normotensive subjects. However, sodium intake did not influence the Vmax of this transporter in either group. In contrast, sodium efflux through the Na-K-Cl cotransporter was significantly influenced (P less than .03) by the level of sodium intake, but only in the hypertensive subjects. On the high sodium intake, both the Km and the Vmax were significantly elevated (P less than .03) compared to their levels on the low sodium diet. Additionally, only on the high salt diet did hypertensives have significantly higher levels of activity than normotensives (P less than .03). Thus, Na-K-Cl cotransport activity is influenced by the level of sodium intake, suggesting that caution needs to be exercised in interpreting the level of activity of this transporter unless the level of sodium intake is fixed and known. PMID- 2757810 TI - A novel cell type in the parathyroid glands of spontaneously hypertensive rats. AB - Recently, we described a circulating hypertensive factor, present in the plasma of spontaneously hypertensive rats (SHR). This factor seems to be produced by the parathyroid gland but is not identical to parathyroid hormone (PTH). In view of these findings, we attempted to search for histological differences in parathyroid glands between SHR and normotensive Wistar-Kyoto (WKY) rats by light and electron microscopy. Novel cells, distinct from normal chief cells, were frequently found in parathyroid glands of SHR rats, whereas they were scarcely observed in WKY rats. Our findings suggest that the novel cells are involved in the development of hypertension in SHR rats. PMID- 2757812 TI - A glomerular defect in prehypertensive Dahl S rats, which limits their capacity to increase GFR. AB - There is a great need to discover traits that predict future human hypertension. Our previous studies found abnormal glomerular filtration rates (GFRs) in isolated kidneys of Dahl S rats. Such GFR alterations were sought in intact, low NaCl, prehypertensive Dahl S rats. Such Dahl S rats are genetically susceptible to NaCl hypertension but are normotensive on low NaCl. On .3% low NaCl, BP of 12 Dahl S rats averaged 138 mm Hg v 131 in 12 Dahl R rats (NS). Glomerular filtration rates under inactin anesthesia were measured during two 20-minute periods before a 20-minute amino acid infusion and also during three 20-minute periods after the amino acid infusion. Before the amino acid infusion, GFRs averaged 3.3 mL/min in S rats v 3.25 in R rats (NS). After the amino acid infusion, R rats showed a progressive rise in GFR: 4.7, 5.1 and 5.4 in three successive 20-minute periods. In these same three periods after amino acids, the S rats had GFRs of 3.8, 3.8, and 3.8. Thus R rats had an 81% increase of GFR after amino acids, whereas S rats increased only 18%, a 78% lower increase, P less than .001. The R rats had the normal rise of GFR in response to an amino acid load. Prehypertensive S rats had virtually no increase in GFR after the amino acid infusion. Even though both S & R rats had BPs well within the normal range, the ability to increase GFR after amino acid infusion was markedly impaired in prehypertensive S rats. This defect could possibly be used to predict future hypertension.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2757811 TI - 1,25 (OH)2 vitamin D3 modifies growth and contractile function of vascular smooth muscle of spontaneously hypertensive rats. AB - The effects of 1,25 (OH)2 vitamin D3 on growth of cultured vascular myocytes and on the contractile response of isolated resistance arteries to norepinephrine was examined using tissue derived from 12-week-old spontaneously hypertensive (SHR) and normotensive Wistar-Kyoto (WKY) rats. 1,25 (OH)2 vitamin D3 (214 pg/mL) stimulated the growth of superior mesenteric artery myocytes cultured from the SHR and increased the sensitivity of isolated mesenteric resistance arteries to norepinephrine. These effects were not observed in tissue of the WKY. It is concluded that 1,25 (OH)2 vitamin D3 modulates vascular growth and contractility in the SHR, but apparently not the WKY. Possible mechanisms of action are discussed. PMID- 2757813 TI - Altered agonist-activated 86Rb+ efflux from arteries in canine renal hypertension. AB - Basal rate constants for 86Rb+ efflux from renal arteries of renal hypertensive dogs were lower than those of control animals whereas no differences were found for coronary arteries. Norepinephrine produced parallel increases in efflux rate constants for hypertensive and control renal arteries, but serotonin produced smaller responses in hypertensive compared to control coronary arteries. PMID- 2757814 TI - [Dietary habits of school children: breakfast]. AB - An investigation on the dietary habits of 944 secondary school children from Alghero, with reference to breakfast consumption and composition, has shown that the percentage of students who eat nothing for breakfast is higher than that reported by other authors. Furthermore it has been noted that consumption decreases among grown up students. Milk and coffee is the most common type of nutriment and also bread and biscuits are well represented. Other types of food, such as jam, yogurt or butter, are instead rarely consumed. Therefore the average caloric intake is of about 400 Kcal. PMID- 2757816 TI - [Several properties of human red cells subjected to hypotonic dialysis and resealing to use them as vehicles for bioreactors]. AB - The morphological and metabolic properties of red blood cells submitted to the procedure of loading by hypotonic hemolysis and isotonic resealing were compared with the controls. No appreciable differences could be detected concerning glycolytic ability, the amount of glucose metabolized in the hexose monophosphate pathway and the concentrations of glycolytic intermediates of ATP and of 2,3-DPG. Instead the concentration of reduced glutathione and the MCV were slightly reduced. These manipulated erythrocytes can be used as potential bioreactors or as carriers of exogenous substances. PMID- 2757815 TI - [Construction of an apparatus for pulsed field electrophoresis for the analysis of high molecular weight DNA]. AB - An inexpensive apparatus for Pulsed Field Gel Electrophoresis constructed by the Authors, is described. According to our experimental condition it was found that this apparatus is capable to resolve DNA fragments in order of 50-1500 Kb. This range of analysis is adequate for the molecular studies adjacent regions of prokaryotes, primitive eukaryotes and mammals. PMID- 2757817 TI - Autoantibodies against spectrin in rats. AB - Purified, homologous spectrin, inner component of red blood cell (RBC) membrane, injected intraperitoneally in rats determines the appearance in the serum of precipitating autoantibodies against spectrin. These have been purified and characterized according to their classes and anti spectrin activity. Immunochemical and immunocytochemical tests, including immunoelectronmicroscopy (colloidal gold method) have been employed. They belong principally to IgG1 and IgG2a subclasses and react in electro-immunodiffusion and ELISA tests with purified spectrin showing a more elevated level of antibodies than that of control rats (normal and adjuvant treated). They also mark in immunoelectronmicroscopy assays purified RBC membranes. The ease in inducing precipitating anti spectrin autoantibodies, as resulted in many experiments, and the appearance, also in control rats, of anti spectrin antibodies, even if at a very low level, suggest they rise as consequence of an enhancement of a "natural" immunological system normally operating at low and controlled degree, presumably intervening in the elimination of effete or damaged RBCs. PMID- 2757819 TI - Functions of the corpus callosum: observations from callosotomy performed for intractable epilepsy. AB - The effects of complete and partial corpus callosotomy in 6 patients are reported. Only the 2 cases undergoing total callosotomy showed evidence of impaired interhemispheric sensory transfer, related to sectioning of the splenium. Only mild long-lasting neuropsychological deficits were detected. Post commissurotomy mutism and akinesia appeared in 4 cases, 2 with total, and 2 with partial anterior callosotomy. The short-and long-term effects of corpus callosotomy appear to be related to the extent of the section the creation of lesions during the surgical procedure, and a peculiar organization of cognitive functions in chronic epileptic patients. PMID- 2757818 TI - [Deep interscapular temperature and thermogenesis of brown fat during sleep]. AB - Deep interscapular temperature measured just below the brown fat lobes was studied in rats during sleep at two ambient temperatures (24 degrees C and 4 degrees C) before and after adaptation (9 days) to cold (4 degrees C). The results show that in the cold ambient deep interscapular temperature decreases during desynchronized sleep independently of adaptation. Such change in temperature is probably the result of the depression in sympathetic vasoconstrictor influences on heat exchangers producing blood and brown fat cooling in sequence during this stage of sleep. PMID- 2757820 TI - [Hematochemical parameters in calves before, during and after weaning to a regular diet]. AB - The Authors studied the changes of 17 blood parameters of calves before, during and after a traditional weaning. Concentrations of total protein, albumin, urea nitrogen, creatinine, glucose, cholesterol, triglycerides, alkaline phosphatase, total bilirubin and phosphorus were determined by an automated assay system; sodium, potassium and chloride by a flame photometer; calcium, magnesium, copper and zinc by an atomic absorption spectrophotometer. Observed changes can be referred to: 1) the change of the digestion (glucose); 2) the age of the subjects (alkaline phosphatase); 3) the increase of weight (creatinine); 4) the type of feeding (phosphorus, copper and zinc). Sodium, potassium, chloride, calcium and magnesium did not change during the weaning. PMID- 2757821 TI - [Interference of inflammation caused by polyester with the growth of Yoshida ascite hepatoma. IV. Modifications of the sedimentation profile of the hepatoma cells]. AB - It was previously shown that Yoshida's ascites-hepatoma cells (Y cells) intraperitoneally injected into rats carrying chronic inflammation caused by polyester thread rapidly disappear. In this paper the sedimentation rate in a continuous Percoll gradient at unit gravity (1 g) using the CELSEP apparatus (Sorvall), the mean diameter and volume of the Y cells harvested from the peritoneal cavity of untreated (NT) and polyester-treated (TM) animals were determined at 6-12-18-24 hours after the inoculum. At 6 hours a number of Y cells appeared enlarged both from TM and NT rats, while afterwards, and notably at 18 and 24 hours, their size was decreased and their sedimentation rate was reduced only in TM animals. It seems that the chronic inflammation causes alterations both in the size and in the density of the Y cells and probably one of the mechanisms of their death is through shrinkage and apoptosis. PMID- 2757822 TI - [Interference of inflammation caused by polyester with the development of Yoshida ascite hepatoma in rats. V. Study of cytotoxicity in vitro]. AB - It has been known for some years that rats developing a granulomatous inflammation following the intraperitoneal injection of fragments of a polyester suture thread (Mersilene, M) reject a graft of 10(8) Yoshida's ascites hepatoma cells, which on the contrary rapidly grow in M-uninjected animals, originating an ascites tumor and killing the rats in a few days. In this paper granulomatous (TM) and normal (control, C) small pieces of peritoneum (omentum, mesentery and parietal) have been cultivated for 15 h in Eagle-Dul becco's medium together with 10(5) 51Cr-labelled hepatoma cells: the release of the label, an index of cell lysis, was considerably higher in the TM cultures, suggesting a cytotoxic activity of some components of the granulomas. Differences have been observed in the amount of radioisotope released among the TM cultures, suggesting that the particular composition of the cell population may be relevant to the cytotoxicity versus the hepatoma cells. PMID- 2757823 TI - Preliminary observations on the fine structure of the medial preoptic nucleus in Coturnix japonica. AB - The organization of the sexually dimorphic medial preoptic nucleus of the Japanese quail was studied at ultrastructural level. The region was characterized by clusters of parvocellular neurons showing a rich supply of axo-somatic synapses and a peculiar distribution of synthetic (rough endoplasmic reticulum) and secretory (Golgi complexes) structures. Further analyses are required to relate these features with sex, hormonal status and sexual behaviour of quail. PMID- 2757824 TI - Prosopagnosia: a defect in visual configural processing. AB - A patient with severe, lasting prosopagnosia could not get an immediate overview of a face sufficiently specific for successful identification. He also failed completely in tasks of visual closure despite adequate performances on numerous other tests of visual perception and memory. We conclude that prosopagnosia represents a loss of visual "configural processing"--a learned skill enabling immediate identification of individual members of a class without conscious visuospatial analysis or remembering. Prosopagnosia and agnosic alexia represent two distinct defects of configural processing: Alexics cannot identify items with distinctive features that are themselves identifiable. Prosopagnosics cannot identify objects whose critical distinguishing features have no independent identities. PMID- 2757825 TI - Relationship between conjugate lateral eye movements, brain organization, and cognitive style. AB - The relationship between individual differences in conjugate lateral eye movements (CLEMs) and inferential reasoning was investigated in two experiments. Subjects were given inference tasks in sentence and pictorial form and were later tested for recognition of correct inferences as well as literal recognition of the acquisition items. In Experiment 2, for example, subjects were given logical syllogisms during acquisition. Theoretically, right-eye movement/left-hemispheric (REM/LH) subjects should have excelled at this highly logical task but no significant differences between eye-movement groups were found. However, support for previous research showing the moderating effects of gender on hemispheric activation (measured by CLEMs) and hemispheric competence came from the memory data of Experiment 2. These data indicated that male REM/LH subjects recognized more acquisition sentences than the other eye movement/gender groups. It was suggested CLEMs and other measures of hemispheric activation and competence, coupled with data collected using complex cognitive tasks, can eventually lead to explanatory brain models of cognitive processing. PMID- 2757826 TI - The case against the case against group studies. AB - We challenge the position that only the analysis of single patients can allow us to infer normal function from impaired performance. We claim that the focus on group vs. single case studies is unprofitable and that a more useful question is how best to form abstractions of relevance to cognitive theory. In this context, we consider issues concerning the category of "agrammatism." PMID- 2757827 TI - Patient classification in neuropsychological research. AB - In a number of papers we have been concerned with the type of inferences that are legitimate in "experiments of nature" where the experimenter does not and cannot control the modifications to the cognitive system that are introduced by brain damage. We have argued that in such cases very restrictive conditions must be met in order to be able to draw valid inferences about the structure of normal cognitive mechanisms. Two consequences of these conditions are (1) patient classification into syndrome types (e.g., phonological dysgraphia, agrammatism, and so forth) can play no useful role in research concerned with issues about the structure of normal cognitive functioning or its dissolution under conditions of brain damage; and (2) only single-patient studies allow valid inferences about the structure of cognitive mechanisms from the analysis of impaired performance. Zurif, Gardner, and Brownell (1989, Brain and Cognition, 10, 237-255) have taken exception to our conclusions and propose to show the limitations of our arguments. In this paper we respond to their criticisms. PMID- 2757828 TI - Tinted lenses and dyslexics--a controlled study. SPELD (S.A.) Tinted Lenses Study Group. AB - We have carried out a randomised prospective controlled trial of the effect of tinted lenses on the reading ability of 24 non-asthmatic dyslexic children aged between nine and twelve years. Reading ability was assessed using the Neale Analysis of Reading. After one school term, there was no significant difference in the change in reading age between treatment and control groups. After two school terms (approximately six months), only 11 children (44%) were still wearing the glasses. Of 381 suitable subjects for entry into the study, 208 were excluded because of a diagnosis of asthma (to avoid effects of medication on cerebral function). As a result, we may have excluded subjects who would have responded favourably to tinted lenses. PMID- 2757829 TI - Management and visual acuity results of monocular congenital cataracts and persistent hyperplastic primary vitreous. AB - Sixty-two patients, 48 with a diagnosis of persistent hyperplastic primary vitreous (PHPV) and 14 with monocular congenital cataract (MCC) are reported. Nineteen patients with a diagnosis of PHPV and all patients with MCC received surgery with attempted visual rehabilitation. Early age of surgery, prompt optical correction with contact lens and aggressive patching therapy are required for successful visual rehabilitation. Glaucoma, retinal or optic nerve pathology, surgery later than three months of age or combinations of these factors were associated with poor prognosis. Isolated microphthalmos was not correlated with poor prognosis. Binocular fixation pattern was used to monitor patching therapy. Optokinetic nystagmus, visual evoked potentials or forced preferential looking were not employed. Of the 33 patients who underwent surgery, 10 (30%) achieved good (greater than or equal to 20/50) visual acuity, 8 (24%) achieved fair (20/60 to 20/100) and 15 (46%) achieved poor vision. In selected patients with the diagnosis of PHPV or MCC, visual rehabilitation can be achieved. PMID- 2757830 TI - Cyclitic glaucoma. AB - A series of patients is presented showing the widely variable clinical behaviour of different groups of patients who share the common features of cyclitic glaucoma. These cyclitic glaucomas may be classified: 1. Glaucomatocyclitic crises: unilateral or bilateral. This condition presents acutely, almost always in males with a strong tendency to spontaneous resolution but a liability to subsequent recurrence. Some cases are slow to resolve and may recur frequently. 2. Heterochromic cyclitis: glaucoma infrequently complicates heterochromic cyclitis and then with only a mild rise in intraocular pressure (IOP). 3. Chronic cyclitis: unilateral or bilateral. This is more common in females often presenting with a high rise in IOP which may be difficult to control medically. An insidious form of chronic cyclitis occurs in middle-aged, blue-eyed females, often with sarcoid, and is likely to progress to profound visual loss if unrecognised. PMID- 2757831 TI - Alport's syndrome and the eye. AB - Alport's syndrome comprises hereditary deafness, nephritis and ocular abnormalities. The features of Alport's syndrome are illustrated by a family with Alport's syndrome and hereditary oesophageal leiomyomatosis. The evidence that Alport's syndrome is due to a widespread basement membrane disorder is noted. Treatment of anterior lenticonus, the principal ocular abnormality, by lensectomy and intraocular lens insertion is recommended. PMID- 2757832 TI - Neodymium: YAG laser vitreolysis for treatment and prophylaxis of cystoid macular oedema. AB - Eighteen eyes with vitreous strands adherent to the corneoscleral wound of previous cataract surgery were treated with neodymium: YAG laser to achieve vitreolysis. Twelve eyes were treated for management of cystoid macular oedema (CMO group) and six eyes were treated for prophylaxis of possible CMO (prophylactic group). In the CMO group, visual acuity improved two or more Snellen lines in 10 eyes (83.3%) and seven eyes had a post-laser visual acuity of 20/40 or better (one eye had a pre-treatment visual acuity of 20/40 or better). In the prophylactic group, visual acuity was either maintained at the pre treatment level or improved in five eyes (83.3%) eighteen months after laser treatment. This procedure was complicated by retinal detachment in one case and elevation of intraocular pressure over 10 mmHg in another case. PMID- 2757833 TI - A new method for continuous intraocular drug delivery. AB - A novel device for the continuous intraocular delivery of drugs is described. The active intraocular component of the device is made from hollow haemodialysis fibres. During operation, the drug to be administered diffuses from a small extraocular reservoir to the intraocular fibres, where it passes through the semipermeable walls and into the vitreous body. The delivery of gentamicin by the device into the vitreous body of the cat is compared with direct intraocular injection techniques. Characteristics of the process of drug delivery were influenced by the geometry and design of the device. A reservoir concentration of 10 g/L gentamicin sulphate in a device with four fibres, each 5 mm long, resulted in stable vitreal gentamicin levels of 104 to 128 mg/L at 10 hours. Intravitreal injection of 0.1 ml of a 10 g/L solution of gentamicin caused localised peaks of intravitreal gentamicin concentration in the range 1180 to 3296 mg/L, before falling to 356 to 665 mg/L at 10 hours. The device provides the opportunity of a more controlled and continuous drug delivery, thus avoiding the high localised concentrations that may occur with direct injection techniques in which the required dose is delivered as a bolus. Refinement of a device of this type may result in a clinically useful method of intraocular drug delivery for drugs which present a risk of localised retinal toxicity or require repetitive administration with conventional intraocular injection techniques. PMID- 2757834 TI - A new panfunduscopic lens: a +90D-Goldmann fundus lens combination. AB - A new panfunduscopic lens is made by combining a +90 D lens and Goldmann contact fundus lens. The optics involved is explained. PMID- 2757835 TI - Mycobacterium chelonae keratitis. AB - A case of Mycobacterium chelonae keratitis is described. As with any infective keratitis, appropriate treatment depends upon rapid and accurate microbiological assessment of corneal scraping. Acid-fast stains such as Ziehl-Nielson should be performed, particularly in chronic corneal ulcers, as only these stains will distinguish mycobacteria from the more common diphtheroid organisms. The mycobacterium chelonae organism was sensitive only to tetracyclines. PMID- 2757836 TI - Vernal keratoconjunctivitis in childhood. PMID- 2757837 TI - Surgical management of oculomotor nerve palsy. PMID- 2757838 TI - Radial keratotomy. PMID- 2757839 TI - Technetium-99m haemaccel: a new lymphoscintigraphic agent. AB - Haemaccel, a denatured gelatin polymer with average molecular weight of 35,000, was labeled with Tc-99m and evaluated in rats and rabbits. The labeling efficiency was consistently higher than 85%. Tc-99m haemaccel (200 microCi in 0.05 ml) was injected intradermally into the hind footpads of rats lightly anaesthetized with diethyl ether vapour. Using a gamma camera, static images of the anterior view were obtained at various time intervals after injection. The images obtained demonstrated good localization of Tc-99m haemaccel in regional lymph nodes. In rats, about 3% of the injected dose was trapped in the node, and 48% remained at the injection site at 4 h after injection. In rabbits, good quality images of lymph nodes and lymphatic channels of the hind legs were obtained within 15 min after intradermal injection of Tc-99m haemaccel. Tc-99m haemaccel showed fast migration from the injection site, good accumulation in the lymph nodes, and good visualization of lymphatic channels. Hence, it has a potential application in lymphoscintigraphy. PMID- 2757840 TI - Reversible acute unilateral diminished pulmonary ventilation and perfusion caused by a mucous plug. AB - A case of acute unilateral decreased pulmonary ventilation and perfusion caused by a mucous plug documented by bronchoscopy is presented, and the literature is reviewed. PMID- 2757841 TI - [Prognostic evaluation of severe brain damage by auditory brainstem evoked potentials (BAEPs)]. AB - Auditory brainstem evoked potentials (BAEPs) reflect activities of the brainstem auditory pathway and the influence of activities of structures surrounding the pathway. It is said that BAEPs are reliable in predicting the outcome of patients with severe brain damage. The author studied the relationship between initial BAEP findings, particularly interpeak latencies of waves I to V and waves III to V, and mortality as based on the cause of each disorder. BAEPs were sequentially recorded in 241 cases of various neurological diseases resulting in severe brain damage (GCS less than 8) during the first few days after onset. BAEPs were graded into four groups based on initial findings. Group A: all waves I to V were recorded (159 cases). Group B: waves IV & V absent (11 cases). Group C: either wave I or waves I & II only were recorded (28 cases), Group D: all waves absent. Prognosis in Group B & C was poor, only two patients surviving in a vegetative state. There were no survivors in Group D. The relationship in Group A between interpeak latencies (I-V ipl, III-V ipl) and prognosis is discussed. This group consisted of 41 cases subarachnoid hemorrhage, 29 cases hypertensive intracerebral hemorrhage, 5 cases severe cerebral infarction, 21 cases infratentorial cerebral vascular disease, 49 cases supratentorial severe head injury, and 14 cases infratentorial head injury. In deceased cases of subarachnoid hemorrhage and supratentorial head injury, there was significant prolongation of I-V ipl and III-V ipl over the mean latency of 20 normal subjects plus 2SD.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2757842 TI - [Pressure waves induced by electrical stimulation of upper pons and lower midbrain in dogs with experimental subarachnoid hemorrhage]. AB - Neurogenic mechanisms of pressure waves were investigated by means of electrical stimulation of the upper pons and the lower midbrain of 32 dogs in which subarachnoid hemorrhage had experimentally been made. The dogs were slightly anesthetized, immobilized and artificially respired. After subarachnoid infusion of red blood cells, continuous recordings of systemic blood pressure (SBP), intracranial pressure (ICP) and cerebral perfusion pressure (CPP) were made simultaneously. At the stage of increased ICP, pressure waves were induced by electrical stimulation of the upper pons and the lower midbrain from 6 to 12 mm rostral to external auditory meatus. Stimulation parameters, i.e., intensity, duration and frequency, were kept constant at 0.1 mA, 1 msec and 40-50 Hz, respectively, throughout experiments. The induced pressure waves were classified into three types: fast, slow and plateau waves. Fast waves had a duration of 10 30 sec, being associated with a marked increase in SBP. They were induced by stimulation of 41 points in various portions of the pontine and mesencephalic tegmentum. Slow waves had a duration of 30 sec to 3 min, being associated with no change or a decrease in SBP. They were induced by stimulation of 12 points in the rostral pontine reticular formation and the mesencephalic reticular formation. Plateau waves had a duration of 3 min or more, being associated with no change or a decrease in SBP. They were induced by stimulation of 2 points in the mesencephalic reticular formation 2 mm lateral to the red nucleus, where slow waves had been induced at the early stage.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2757843 TI - [Diaphragmatic pacing by electrical stimulation of the phrenic nerve--a case report]. AB - A four-year-old boy had traffic accident and was transferred to our hospital with cardiorespiratory arrest, on March 24, 1986. After resuscitation, quadriplegia and apnea were sustained. Computed tomography (CT) scan on the day of admission only demonstrated subarachnoid hemorrhage and plain roentgenograms of the skull and cervical spine showed no abnormalities. He opened his eyes to verbal order one week later, but apnea and quadriplegia sustained. CT scan obtained on that day demonstrated no abnormalities but roentgenogram of the cervical spine showed atlanto-axial dislocation. On May 26, 1986, he was treated with densectomy through transoral approach. Furthermore, on June 19, he underwent laminectomy of the atlas, partial craniectomy of the occipital bone, and posterior fusion with iliac bone graft. However, apnea continued, and bilateral diaphragmatic pacemaker (Avery Laboratory Inc.) was planed: On Sept. 18, platinum and silicone rubber electrodes were surgically implanted on the both phrenic nerves at the cervical portion. Each electrode was connected by lead wire and connector to a radio frequency receiver which was implanted in a subcutaneous abdominal pocket. An external transmitter supplied electrical power and information of the stimulation to the implanted receiver by radiofrequency across the skin. Pacing time was gradually prolonged and continuous pacing for four hours could be successfully gained by March, 1987. Pneumonia once occurred in the course of gradual prolongation of the pacing time. The ideal candidates for diaphragmatic pacing are patients with normal phrenic nerves, diaphragm, and lungs.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2757844 TI - [Clinical significance of sialic acid in the CSF; in relation to the malignancy and leptomeningeal dissemination]. AB - We examined the level of sialic acid in cerebrospinal fluid (CSF) in 20 patients with brain tumor, and 5 patients with non-neoplastic disease of central nervous system. CSF concentration of sialic acid in the patients with malignant and semi malignant or benign brain tumor was 5.26 +/- 2.39 mg/dl, and 1.82 +/- 1.61 mg/dl, respectively. In patients with non-neoplastic disease, it was 1.64 +/- 1.53 mg/dl. The difference between groups was statistically significant (p less than 0.005). In two patients with malignant brain tumor, the level of sialic acid was decreased by radiation therapy or intrathecal chemotherapy. In conclusion, CSF concentration of sialic acid was significant of diagnosis of brain tumor character of malignancy, and effect of therapy for CSF dissemination. PMID- 2757845 TI - [Evaluation of electrophysiological neuromonitoring in the diagnosis of brain death: Part III. Compressed spectral arrays]. AB - Electrophysiological neuromonitoring of compressed spectral array (CSA) EEG, brainstem auditory evoked potentials (BAEP) and short-latency somatosensory evoked potentials (SEP) can provide precise and immediate information concerning functional integrity of severe brain damage. We applied this neuromonitoring system in 185 cases of severe brain damage in order to evaluate its reliability in the diagnosis of brain death. This report considers the relationships between CSA and neurological, conventional EEG (CEEG), BAEP and SEP findings, and the significance of CSA in the assessment of brain death. CSA monitoring of 59 patients (37 brain-dead in group A and 22 non brain-dead in group B) was performed and analysed. Brain damage was caused by cerebrovascular insult in 31 cases, head injury in 25, meningitis in 2, dan anoxia in 1. Mean patient age was 49 (ages 5-84). There were no significant differences in causes and age distribution between the two groups. CSA monitoring, using 5 or 7 microV/mm, of two channels (Cz-A1 and Cz-A2) of EEG activity was performed. Power spectral analysis (0-16 Hz) was carried out at 10 to 120 second epochs. Automatic BAEP (54 patients) and/or SEP (33 patients) monitoring was performed simultaneously 10 to 30 minutes. CSA was classified into three patterns: 1) "Electrocerebral silence; ECS" revealed bilateral absence of the CSA power spectra for periods longer than 40 seconds. 2) "Biological activity; BA" showed continuous peaks of activity. 3) "Equivocal; EQ" pattern showed intermittent peaks of activity, and unilateral loss of power spectra or bilateral loss within 30 seconds. CSA findings indicated the loss of CSA "BA" pattern (LCBP) in 36 group A patients (17 "ECS" and 19 "EQ"). All but two revealing LCBP had satisfied the neurological criteria of brain death (deep coma, absent brainstem reflexes and apnea) during CSA monitoring. "BA" was always present in 22 group B and one group A patients had not fulfilled neurological criteria of brain death. The CEEG results of all group A patients demonstrating "ECS" of CSA were of the classification Hockaday grade Va or Vb. Four patients classified as grade IV b demonstrated "EQ" An examination of CSA and neurological brainstem function of 28 group A patients revealed LCBP preceded the loss of brainstem reflexes and apnea in 15 patients or was coincided with them in 13.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2757846 TI - China--a dental perspective. PMID- 2757847 TI - 'Patient safety in general anaesthesia'. PMID- 2757848 TI - 'The elimination of cross-infection in dental practice--a 5-year follow-up'. PMID- 2757849 TI - 'Audit--a cause for TMJ dysfunction'. PMID- 2757850 TI - 'Preventive dental care for toddlers'. PMID- 2757852 TI - 'Representation for all?'. PMID- 2757851 TI - 'White knight' into just 'honest broker'. PMID- 2757853 TI - 'Lip numbness--sometimes a sinister symptom'. PMID- 2757855 TI - Instant radiographs. PMID- 2757854 TI - Autoclavable handpieces--an update. PMID- 2757856 TI - Meaningless means. PMID- 2757857 TI - The immediate or delayed replacement of teeth by permucosal intra-osseous implants: the Tubingen implant system. Part 2: Surgical and restorative techniques. AB - The previous paper emphasised the importance of case selection in determining success in the use of the Tubingen implant system. Adherence to strict clinical techniques has an equally important influence on implant success and failure. This paper describes the surgical and restorative techniques involved in the use of the Tubingen implant and comments on the authors' initial experiences with this system. PMID- 2757858 TI - A profile of dentists working in the general and community dental services in Scotland in 1987. AB - A questionnaire was sent to a list of what was considered to be all (1726) practitioners in the General Dental Service (GDS) and Community Dental Service (CDS) in Scotland. The overall response rate was 72%. A comparison of certain characteristics of the respondents with those of the entire group of dentists who were sent questionnaires suggested that the respondents comprised an acceptable cross-section. Proportionally more females worked in the CDS than in the GDS and many of the differences between the general characteristics of practitioners in the two services appeared to reflect differences which are known to exist between the career patterns of male and female dental practitioners. Most respondents (84.7%) claimed to have attended a post-graduate course within the last 5 years, although only 33.4% claimed to have attended more than one course per year. Over three-quarters of the respondents (76.0%) claimed that they belonged to a professional society, whilst 98.5% stated that they regularly read a professional journal or practice newspaper of some description. PMID- 2757859 TI - Extremes in second molar eruption in two oriental patients. AB - Two cases are presented where the maxillary second molars were just erupting. The first was a Chinese boy of 8 years 2 months and the other, a Chinese boy of 17 years 4 months. These extremes in eruption time are unusual and do not appear to have been reported in the literature. PMID- 2757860 TI - Statistical analysis--the future. PMID- 2757861 TI - Appointment systems. AB - At the heart of any dental practice is the appointment book. There cannot be a practice which does not depend upon appointments, yet many dentists seem to be unaware that they can control their appointments system. Practitioners may adopt an existing system which may no longer be appropriate and receptionists can remain oblivious to the pressures and burdens systems impose upon the dentist. In the third of his articles on practice management, Michael Wilkinson considers the problem. PMID- 2757862 TI - Initial experience with a microprocessor controlled current based defibrillator. AB - Intramyocardial current flow is a critical factor in successful ventricular defibrillation. The main determinants of intramyocardial current flow during transthoracic countershock are the selected energy and the transthoracic impedance of the patient. To optimise the success of the first shock and to titrate energy dosage according to each patient's transthoracic impedance, a microprocessor controlled current based defibrillator was developed. It was compared with a conventional energy based protocol of 200 J (delivered energy), 200 J, then 360 J if required in 42 consecutive episodes of ventricular fibrillation in 33 men and seven women. The mean (SD) predicted transthoracic impedance was 69.9 (14.0) omega. First shock success with the standard protocol was 80.9%, and first or second shock success was 95.2%. The microprocessor controlled current based defibrillator automatically measured transthoracic impedance and calculated the energy required to develop a selected current in each patient. A current protocol of 30 A, 30 A, then 40 A, if required, was used in 29 men and 12 women with 41 episodes of ventricular fibrillation. Transthoracic impedance (mean 65.1 (15.9) omega) was similar to that in the energy protocol group and success rates for first shock (82.9%) and first or second shocks (97.5%) were also similar. The mean delivered energy per shock with the current based defibrillator for first or second shock success was significantly less (144.8 J) with the energy protocol (200 J). The mean peak current of successful shocks was also significantly reduced (29.0 v 31.9 A). A current based defibrillator titrates energy according to transthoracic impedance; it has a success rate comparable to conventional defibrillators but it delivers significantly less energy and current per shock. PMID- 2757863 TI - Central haemodynamic changes after a meal. AB - Eight healthy people (seven men and one woman, aged 19 to 31 years) were studied by radionuclide cardiography when supine before and 30 minutes after a standard meal (6300 kJ). Control investigations were performed on a different day within a week of the standard meal. There was a median increase in cardiac output of 62% that was attributable to a 17% increase in heart rate and a 41% increase in stroke volume. Blood pressure and concentrations of plasma catecholamines did not change. The median end diastolic and end systolic volumes of the left ventricle increased by 41% so that the left ventricular ejection fraction was unchanged. There were no significant changes during the control experiments. In healthy people a meal caused an appreciable increase in stroke volume and dilatation of the left ventricle. The activity of the sympathetic nervous system, as measured by plasma catecholamines, did not change much, and changes in blood volume alone did not seem to explain the haemodynamic response to the meal. PMID- 2757864 TI - The QT interval in atrial fibrillation. AB - The electrocardiogram was recorded for 100 seconds in 50 patients with atrial fibrillation to determine the relations between QT intervals and both the mean and instantaneous ventricular rates. The mean ventricular rate was 94 beats per minute with a mean QT interval of 357 ms. The mean QTc, corrected beat by beat with Bazett's formula, was 444 ms--longer than reported for sinus rhythm. Between subjects, the mean QT interval was linearly related to the mean RR interval, with a slope of +21%. Within all 50 recordings there was a statistically significant correlation between QT intervals and immediately preceding RR intervals, with an average slope of +7%. This within subject QT/RR interval slope was greater at faster mean ventricular rates. In atrial fibrillation, as in sinus rhythm, the QT interval is a function of both the mean ventricular rate and the instantaneous ventricular rate, with the mean ventricular rate predominating; a simple correction of QT intervals for heart rate is therefore inadequate. Comparison of uncorrected QT intervals with those of earlier published series of people in sinus rhythm, however, suggested that atrial fibrillation is associated with prolongation of the mean QT interval. PMID- 2757865 TI - Cold intolerance in patients with angina pectoris: effect of nifedipine and propranolol. AB - Fifteen patients with chronic stable angina pectoris and a history of reduced exercise tolerance in cold weather (cold intolerance) underwent symptom limited treadmill exercise tests at 20 degrees C and 0 degrees C in a specially constructed cold chamber while taking no antianginal medication. Their mean time to onset of angina (5.8 v 4.2 min), to 1 mm ST depression (5.1 v 3.8 min), and to peak exercise (7.4 v 5.7 min) was significantly shorter on exercise at 0 degrees C than at 20 degrees C. The double product of heart rate and systolic blood pressure at each of these end points was the same in both exercise tests. Eight of these patients were treated with nifedipine 10 mg three times a day for two weeks and then with propranolol 40 mg three times a day for another two weeks. Repeat exercise testing was performed at the end of each two week treatment period. The mean time (SD) to peak exercise at the end of the nifedipine treatment period was 9.1 (2.0) min at 20 degrees C and 8.5 (2.3) min at 0 degrees C. The double product at peak exercise was the same for both exercise tests. At the end of the propranolol treatment period the mean time to peak exercise was significantly less at 0 degrees C (7.8 (2.6) min) than at 20 degrees C (8.9 (2.4) min). The double product at peak exercise was the same for both exercise tests but was significantly less than that on nifedipine. Cold intolerance was shown in patients with a positive history by symptom limited treadmill exercise testing at 0 degrees C. It persisted when they were treated with propranolol, albeit to a lesser extent, but not when they were treated with nifedipine. PMID- 2757866 TI - Severe haemolysis after percutaneous closure of a ductus arteriosus (arterial duct). AB - Severe mechanical haemolysis occurred after transcatheter occlusion of a ductus arteriosus (arterial duct) by a Rashkind double umbrella prosthesis. Surgical removal of the device and ligation of the duct were required before haemolysis was abolished. PMID- 2757867 TI - Percutaneous transluminal balloon dilatation of the mitral valve in pregnancy. AB - Pregnancy can cause life threatening complications in women with mitral stenosis, and there is a substantial risk of fetal death if valvotomy under cardiopulmonary bypass is required. A patient is described in whom pulmonary oedema developed after delivery of her first child by caesarean section 13 months previously. Subsequent cardiac catheterisation showed severe mitral stenosis (valve area 0.96 cm2, valve gradient 12 mm Hg, pulmonary artery pressure 30/16 mm Hg). Before valvotomy could be performed the patient again became pregnant and presented in pulmonary oedema at twenty two weeks' gestation. Medical treatment was unsuccessful and she underwent percutaneous transluminal balloon dilatation of the mitral valve. This increased the valve area to 1.78 cm2 and reduced the transmitral gradient to 6 mm Hg. The procedure was uncomplicated, and she remained symptom free on no medication. She delivered vaginally at 37 weeks' gestation. Percutaneous transluminal balloon dilatation of the mitral valve is a safe and effective alternative to mitral valvotomy in pregnancy. PMID- 2757868 TI - Colour flow Doppler mapping in the assessment of prosthetic valve regurgitation. AB - Two hundred Carpentier-Edwards, Bjork-Shiley, and Starr-Edwards prostheses in 173 patients were examined. Sixteen (16%) in the aortic and 24 (25%) in the mitral position were associated with clinical signs of regurgitation. A phased array system (Hewlett-Packard A77020A) with a 2.5 MHz duplex and 1.9 MHz continuous wave transducer was used. Colour flow mapping showed trivial transvalvar regurgitation in 23 (53%) metal aortic prosthesis, and only nine (20%) metal mitral prostheses. This difference was probably attributable to shielding of the left atrium by the metal components. Colour mapping confirmed abnormal regurgitation in all aortic prostheses with early diastolic numbers, but regurgitation was also shown in 25 (29%) with no diastolic murmur. Abnormal mitral regurgitation was found in 13 (54%) patients with a pansystolic murmur, but also in six (8%) with no systolic murmur. Two patients, thought on clinical grounds to have mild mitral regurgitation, had unexpectedly large jets on colour flow mapping. About one in three prostheses had paraprosthetic leaks, 65 (79%) of which were small with a jet area less than 20% of the area of the receiving chamber. The development of new paraprosthetic leaks led to the diagnosis of bacterial endocarditis in two patients. In eight patients regurgitation was first diagnosed with continuous wave Doppler, but was afterwards shown with colour mapping and in a further 10 regurgitation could only be shown by continuous wave Doppler. Colour flow mapping was less sensitive than continuous wave Doppler in detecting regurgitation,but seemed able to distinguish normal transvalvar from paraprosthetic regurgitation. Further studies in the natural course of paraprosthetic leaks and a comparison of the transoesophageal and transthoracic approaches in the assessment of mitral prostheses are needed. PMID- 2757869 TI - When does the risk of acute coronary heart disease in ex-smokers fall to that in non-smokers? A retrospective study of patients admitted to hospital with a first episode of myocardial infarction or unstable angina. AB - Nine hundred and seventy eight patients admitted with a first myocardial infarction or episode of unstable angina were studied to determine for how long after they gave up smoking did the risk in ex-smokers continue to resemble those of current smokers. Logistic regression was used to calculate a score, based on a combination of age, cholesterol, and hypertension, that separated current smokers from lifetime non-smokers. When this function was applied to ex-smokers, only those who had given up at least 15 years before the attack had a risk factor profile similar to that of non-smokers. Those who had given up less than five years before the ischaemic attack had a significantly higher level of other risk factors than current smokers; those who had stopped for between five and 15 years had levels similar to those of current smokers. Ex-smokers are at higher risk of acute coronary disease for at least 15 years after stopping, but some immediate reduction in risk is possible. PMID- 2757870 TI - Assessing cardiac pumping capability by exercise testing and inotropic stimulation. AB - In heart failure both functional capacity and prognosis are primarily determined by the degree of pump dysfunction. Although data on haemodynamic function at rest may indicate impaired cardiac function, they do not assess the capacity of the heart to respond to stress. Maximal bicycle ergometry and incremental intravenous inotropic stimulation in 31 patients with moderately severe heart failure were evaluated as methods of stressing the heart to determine cardiac pumping capability, which is defined as the cardiac power obtained during maximal stimulation. There was good agreement between the cardiac pumping capabilities assessed by these two methods. Maximal cardiac power output was better than maximal cardiac output and left ventricular stroke work index in representing cardiac pumping capability, because it was less dependent on the type of stimulation used during evaluation. Inotropic challenge is at least as effective as exercise testing in assessing cardiac pumping capability in heart failure, and may be a better method in patients who find physical exercise difficult. PMID- 2757871 TI - Lack of correlation between intracavitary thrombosis detected by cross sectional echocardiography and systemic emboli in patients with dilated cardiomyopathy. AB - The correlation between intracavitary thrombosis detected by cross sectional echocardiography and systemic embolism was studied in 126 consecutive patients with idiopathic dilated cardiomyopathy who were examined from January 1980 to September 1987. A total of 1041 serial echocardiograms were obtained with 3.5 and 5 MHz transducers. The mean follow up period was 41.2 months. The survival rate was 88% at two years and 56% at five years. Echocardiography showed intracavitary thrombi in 14 (11.1%) patients; 13 were mural and 11 were localised at the apex of the left ventricle. Twelve patients (8.4%) had systemic emboli; this corresponded to an incidence of new embolic events of 1.4 for 100 patient-years. Patients with intracavitary thrombi or systemic emboli were treated with oral anticoagulants, as were nine in functional class IV of the New York Heart Association, for 61 patient-years. The cumulative observation period for the whole population study was 418 patient-years. None of the patients with intracavitary thrombosis had embolic complications and none of those with embolism had intracavitary thrombi. Rates of intracavitary thrombosis and systemic embolism in this series were low and there was no overlap between the two events. This may have been because the patients did not have severe dilated cardiomyopathy, because echocardiography did not detect all the thrombi, or because patients were treated with oral anticoagulants. The presence of intracardiac thrombosis detected by cross sectional echocardiography is not predictive of systemic embolism in patients with idiopathic dilated cardiomyopathy. Criteria for the use of the anticoagulant treatment remain largely empirical in these cases. PMID- 2757872 TI - Diurnal variation of pulmonary artery pressure in chronic heart failure. AB - Variation in pulmonary artery pressure has important consequences for the interpretation of isolated pressure measurements in patients with chronic heart failure. To investigate the nature of diurnal variation in pulmonary artery pressure in chronic heart failure, eight angina-free men (aged 50-72 years) with treated chronic heart failure caused by ischaemic heart disease underwent continuous ambulatory pulmonary artery pressure recording by a transducer tipped catheter. The mean (1 SD) daytime pulmonary artery pressure was 29.6 (5.0) mm Hg systolic and 13.7 (5.6) mm Hg diastolic. The mean change in pressure from day to night was +5.1 (3.2) mm Hg systolic and +3.8 (1.7) mm Hg diastolic; and the mean change from standing to lying +9.3 (2.3) mm Hg systolic and +6.4 (2.1) mm Hg diastolic. In six of the eight patients there was considerable rise in pulmonary artery pressure at night, but in the two patients with the most severe symptoms there was no nocturnal rise. In patients with chronic heart failure, nocturnal pulmonary artery pressure is not determined by postural change alone. But interpretation of isolated pulmonary artery pressure measurements must take the posture of the patient into account. PMID- 2757873 TI - Colour flow imaging in the diagnosis of multiple ventricular septal defects. AB - Thirty one patients with multiple ventricular septal defects were studied by cross sectional echocardiography, conventional pulsed and continuous wave Doppler, colour flow imaging, and left ventriculography to determine the relative diagnostic benefits and pitfalls of each technique. The patients studied had a wide range of congenital heart defects with 19 patients having isolated multiple ventricular septal defects, three with associated tetralogy of Fallot, five with double outlet right ventricle, three with complete transposition and ventricular septal defect, and one with a complete atrioventricular septal defect. In 23 patients the defects were inspected at operation. Cross sectional imaging with integrated pulsed and continuous wave Doppler correctly identified multiple defects in only 12 (39%) patients. In contrast, colour flow imaging was accurate in 24 (77%) patients and left ventriculography in 20 (65%) patients. When patients were subdivided on the basis of relative peak systolic ventricular pressures into restrictive defects (18 patients) and non-restrictive defects (13 patients) the diagnostic value of colour flow imaging was different for each group. Colour flow mapping correctly identified multiple ventricular septal defects in 16/18 (89%) patients with restrictive defects but only 8/13 (62%) with non-restrictive defects. The comparative diagnostic accuracy of left ventriculography was 15/18 (83%) in the restrictive group and 5/13 (38%) in the non-restrictive group. Colour flow imaging was the single investigative technique with the greatest diagnostic accuracy in the diagnosis of multiple ventricular septal defects. It failed to be consistently accurate in defined subgroups with non-restrictive defects as did left ventriculography. The greatest overall diagnostic accuracy in this series was obtained when both colour flow imaging and ventriculography techniques were used in combination in a complementary fashion. PMID- 2757874 TI - Assessment of the orifice diameter by a multigated pulsed Doppler system in children with congenital semilunar valve stenosis. AB - This study investigated whether the jet diameter measured by a multigated pulsed Doppler system could be used to assess the severity of valve disease in children with pulmonary (n = 11) or aortic (n = 4) valve stenosis. The results obtained were compared with those obtained at cineangiography and at operation. Multigated pulsed Doppler examination of a stenosed valve showed a region of relatively high velocities in the velocity profile (jet flow). There was good agreement between the diameter of the disturbed region on the Doppler echocardiogram and the diameter of the jet on the lateral angiocardiogram. In severe valve stenosis the agreement between the valve diameters measured by multigated pulsed Doppler and at operation was also good. In less severe valve stenosis Doppler measurements systematically underestimated the valve diameter at operation. It is likely that the functional opening of a semilunar valve is a more relevant estimate of the degree of stenosis than the anatomical measurement of the orifice. The findings of this study indicate that multigated pulsed Doppler systems are useful in the noninvasive diagnosis of stenotic valve disease. PMID- 2757875 TI - Findings at necropsy in the heart of a patient with anticardiolipin syndrome. AB - A 40 year old man with a history of myocardial infarction and hypertension presented with transient cerebral ischaemic attacks, aortic regurgitation, a raised erythrocyte sedimentation rate, and thrombocytopenia. The anticardiolipin syndrome was diagnosed and he was treated with prednisolone and warfarin. He died two years later after the development of acute heart failure. At necropsy his heart showed widespread arteriolar thrombosis without vasculitis, recanalised large vessel occlusion, and a "post-inflammatory" valvulitis of the aortic valve. PMID- 2757876 TI - Successful repair of an atrial septal defect associated with right to left shunting. AB - An atrial septal defect was successfully repaired in a young woman despite the presence of pulmonary hypertension and right to left shunting. Before repair both isoprenaline infusion and 100% inspired oxygen produced significant falls in pulmonary artery pressure and pulmonary vascular resistance. A lung biopsy specimen at operation indicated a considerable decrease in the concentration of parenchymal pulmonary arteries and an absence of intimal fibrosis or medial hypertrophy. Pulmonary artery banding performed in infancy, as part of the management of a ventricular septal defect, may have contributed to the underdevelopment of the pulmonary vascular tree. The reduced number of pulmonary arteries is a possible explanation for the pulmonary hypertension. PMID- 2757877 TI - Severe pulmonary hypertension in Ullrich-Noonan syndrome. AB - A 19 year old woman with Ullrich-Noonan syndrome presented with a six month history of progressive dyspnoea and cyanosis. Clinical features were suggestive of severe pulmonary hypertension. Cross sectional echocardiography showed pronounced right ventricular pressure overload with right ventricular hypertrophy. Cardiac catheterisation confirmed severe pulmonary hypertension. Attempts to reduce pulmonary artery pressure with calcium channel blockers were unsuccessful. The patient died shortly after investigation. Necropsy confirmed primary pulmonary hypertension. PMID- 2757878 TI - Pharmacokinetic and pharmacodynamic comparison of two doses of long acting propranolol (80 and 160 mg) in healthy subjects. AB - 1. The kinetics and dynamics of long acting propranolol 80 mg and 160 mg were examined after single oral doses to 12 healthy volunteers. 2. Long acting propranolol 160 mg produced a twofold increase in mean peak blood propranolol concentration and AUC compared with the lower dose. There was no difference in elimination half-life, bioavailability and mean residence time of propranolol between the two doses. 3. Resting pulse rate was decreased by long acting propranolol 160 mg but not by the lower dose. 4. Both preparations blocked exercise induced tachycardia during the entire observation period of 29 h. Percentage inhibition of exercise tachycardia was significant at all time points but long acting propranolol 160 mg exhibited a greater reduction at 24 h and 29 h. 5. Increase in systolic blood pressure during exercise was inhibited by both preparations during the entire observation period with no differences between them. 6. The doubling of the dose administered was reflected in blood concentrations but not in pharmacodynamic parameters. Few pharmacodynamic differences were found between the two doses. PMID- 2757879 TI - A comparison of the effects of flosequinan, a new vasodilator, and propranolol on sub-maximal exercise in healthy volunteers. AB - 1. The effects of steady state flosequinan, a new vasodilator, and propranolol, on glucose mobilisation, lipolysis and plasma potassium concentration during sub maximal exercise testing were investigated in a double-blind, randomised, three way crossover study in 12 healthy volunteers. 2. Plasma glucose, potassium and free fatty acid concentration during and after exercise on flosequinan were similar to those on placebo. Exercise heart rates were 7% (+9.2 beats min-1) higher on flosequinan compared with placebo (P less than 0.05). During exercise on propranolol plasma glucose concentrations were comparable with those on placebo but plasma potassium concentrations were higher (mean increase 0.26 mmol l-1, P less than 0.01) whereas free fatty acid concentrations were lower (mean decrease 0.10 mmol 1-1, P less than 0.01). As expected the heart rate on exercise was 25% less (-35 beats min-1) on propranolol (P less than 0.05). 3. These data suggest that, in contrast to propranolol, flosequinan does not adversely affect the mobilisation of the two major sources of energy during sub-maximal exercise. PMID- 2757880 TI - Evaluation of a long acting formulation of nicardipine in hypertension by clinic and home recorded blood pressures and Doppler aortovelography. AB - 1. A novel formulation of nicardipine (50% standard (short acting), 50% sustained release) was evaluated in mild hypertension in a double-blind, randomized, placebo-controlled study, using clinic measurements (Hawksley) augmented by home recorded blood pressures (Copal UA 251). 2. Nicardipine 60 mg twice daily for 28 days produced a highly significant reduction in sitting blood pressure compared with placebo both pre dose (mean difference 17/8 mm Hg) and 2 h post dose (mean difference 34/26 mm Hg). 3. Home recordings confirmed the hypotensive effect and also revealed a consistent 'peak' effect between 2-4 h after dosing (mean difference 32/22) mm Hg). 4. Doppler aortovelography at 2 h post-dose showed a significant increase in in stroke and minute distance (linear analogues of stroke volume and cardiac output respectively) compared with placebo. The increase in stroke distance was linearly related to change in plasma concentration of nicardipine. 5. Of the 14 patients enrolled in the study, nine experienced troublesome adverse effects on nicardipine (headaches, facial flushing, palpitations, ankle oedema) and two of these were unable to complete the study as a result. 6. This formulation of nicardipine, in the fixed dosage used in this study, is characterized by an effective antihypertensive action but also by an unacceptable adverse effect profile, presumably due to an excess of its 'short acting' component. PMID- 2757881 TI - The contribution of nisoldipine-induced changes in liver blood flow to its pharmacokinetics after oral administration. AB - 1. The pharmacokinetics of nisoldipine (10 mg) was assessed in 10 healthy subjects after single dose and multiple dose oral administration. Apparent liver blood flow was measured, using ICG before and during the absorption phase of nisoldipine. 2. Apparent liver blood flow was increased both on acute and short term administration of nisoldipine, basal flow being lower on multiple dosing than on acute administration (P less than 0.02). 3. A positive relationship was found between the increase in apparent liver blood flow during absorption of nisoldipine and the flow-dependent part of the total AUC of nisoldipine. 4. The findings of this study indicate that a variable liver blood flow response during the absorption phase of nisoldipine contributes to the pharmacokinetic variability of the drug, both on acute and multiple dose administration. PMID- 2757882 TI - Equivalence of conventional and sustained release oral dosage formulations of acetazolamide in primary open angle glaucoma. AB - 1. Outpatients with primary open angle glaucoma uncontrolled on single topical therapy with either pilocarpine or timolol were recruited for a stratified double dummy cross over trial. Once or twice daily sustained release acetazolamide (SRA) was compared with an identical regimen of conventional tablets (CA). 2. During the run in period the patients received 500 mg SRA once or twice daily as needed to control intraocular pressure (IOP). The dose was thereafter kept constant and patients were allocated randomly to 4 weeks treatment with CA followed by 4 weeks SRA or vice versa. IOP and venous plasma concentrations of acetazolamide were measured at weekly intervals. At the end of each 4 week course, patients were admitted for a 24 h profile of IOP and drug concentration measurements. 3. Thirty five patients were recruited, but eleven were withdrawn during the run in period largely because of adverse effects; these became less troublesome when it was decided to give the once daily dose at 22.00 h. Four were withdrawn during the cross over, two because of inadequate IOP control. Twenty completed the trial. 4. The morning plasma concentration of acetazolamide measured each week showed no tendency to accumulation during the study. The mean swing (maximum minus minimum) in plasma acetazolamide concentration during the 24 h profile was less (P less than 0.005) with the SR formulation (11.6 +/- 4.9; mg l-1) +/- s.d.) than with the conventional (15.5 +/- 4.7) but the mean concentrations over the 24 h profile were indistinguishable (P greater than 0.05; 9.7 +/- 3.8 and 8.6 +/- 2.8 respectively). 5. Satisfactory control of IOP (no more than one reading above 22 mmHg) was maintained despite the changes in formulation in all but two of the patients who entered the cross over study. No close relationship between IOP and plasma concentration of acetazolamide was found. The 24 h IOP profiles whilst receiving each of the formulations were indistinguishable; thus the smoothing of the plasma drug concentration profile achieved by the SR formulation did not reduce the amplitude of swings in IOP. Similarly, no difference was observed between the formulations with respect to adverse effects. 6. It is concluded that the SR and conventional formulations were equivalent with respect to mean plasma acetazolamide concentration, IOP control and adverse effects. The SR formulation did not show practical advantages over the conventional formulation which was equally effective even with dosage intervals of 12 or 24 h. PMID- 2757883 TI - Stereoselective metabolism of metoprolol in Caucasians and Nigerians- relationship to debrisoquine oxidation phenotype. AB - The relationship between debrisoquine oxidation phenotype and the stereoselective metabolism of metoprolol was investigated in populations of British Caucasians (n = 139) and Nigerian subjects (n = 117). The 0-8 h urinary S/R-metoprolol (S/R-M) ratio was related to the ability to metabolise metoprolol and debrisoquine in both ethnic groups. The median S/R-M ratio was significantly higher in Caucasians (1.27) than in Nigerians (1.10). In the Caucasian population poor metabolisers of debrisoquine had significantly lower S/R-M ratio (median = 0.84) than extensive metabolisers (median = 1.28). Bimodality in the frequency distribution of the S/R M ratio was not apparent in either ethnic group. PMID- 2757884 TI - Mephenytoin and sparteine oxidation: genetic polymorphisms in Denmark. AB - The oxidation of mephenytoin was polymorphic in 358 healthy Danish volunteers. The ratio between the chromatographic peak areas of (S)- and (R)-mephenytoin (S/R) in 12 h urine was less than or equal to 0.48 in 349 extensive metabolizers (EM) and greater than or equal to 1 in 9 (2.5%) poor metabolizers (PM). Concomitant intake of mephenytoin and sparteine and subsequent assay by gas chromatography had no influence on the test results (mephenytoin S/R ratio or sparteine metabolic ratio). Among ten parents and seven siblings to six unrelated PM of mephenytoin only one (1/17 = 5.9%) was a PM. The pedigrees were compatible with an autosomal recessive mode of inheritance. PMID- 2757885 TI - Effect of an inhaled mast cell stabiliser, N-acetyl-aspartyl-glutamate (Zy15109) on allergen-induced immediate bronchoconstriction. AB - We have studied the effect of a mast cell stabiliser, the magnesium salt of N acetyl aspartyl glutamic acid (NAAGA) on allergen-induced immediate bronchoconstriction in 12 atopic subjects. Inhaled NAAGA, at a dose of 60 mg thrice daily for 1 week, offered no protective effect on the airways against allergen challenge when compared with a matched placebo. The drug was well tolerated with no adverse effects observed. PMID- 2757886 TI - Pharmacokinetics of intravenous clomiphene isomers. PMID- 2757887 TI - Odorous urine in man after asparagus. PMID- 2757888 TI - Asparagus and malodorous urine. PMID- 2757889 TI - Ethics and law in clinical pharmacology. PMID- 2757890 TI - Self-medication in urban and rural Zimbabwean communities. AB - 1. A questionnaire examining the use of, and knowledge about over-the-counter (OTC) drugs was administered verbally to representatives from 200 urban and 200 rural households. Self-medication was common in both groups but there were more drugs present in rural (336 items) than urban homes (231 items) with the differences largely due to the more frequent presence of traditional medicines in rural homes. 2. Analgesics were the commonest items in the homes of both groups. A positive urine screening test for aspirin, chloroquine, or antibiotics was found in 25% of urban and 27% of rural samples tested. Respondents who elected to use an OTC drug for a particular symptom usually chose an appropriate drug. 3. Rural respondents were more likely to use traditional medicines particularly for the treatment of cough, abdominal pain, and diarrhoea. 4. Knowledge about dosages, the possibility of adverse reactions, and the seriousness of potential poisoning with OTC drugs was inadequate and needs to be corrected for more efficient self-medication. PMID- 2757891 TI - A study of the transport of lithium across the erythrocyte membrane in vivo and of the effects of the ion transport inhibitors digoxin and dipyridamole. AB - 1. We have given an oral load of lithium carbonate to healthy volunteers in order to investigate the transport of lithium across the erythrocyte membrane in vivo and the effects of known inhibitors of that transport. 2. Using this technique we have shown that pretreatment with either digoxin, an inhibitor of the sodium/potassium pump, or dipyridamole, an inhibitor of the anion transporter, does not alter the plasma or erythrocyte lithium concentration profiles, nor any of the pharmacokinetic variables derived from these data, and we conclude that these two transport pathways do not contribute significantly to the in vivo handling of lithium by erythrocytes. 3. We have also shown that erythrocyte lithium concentrations measured directly differ significantly from the predicted concentrations calculated using the two-compartment pharmacokinetic model which has been used in some earlier comparisons of in vitro and in vivo lithium handling. 4. We suggest that the in vivo administration of lithium carbonate may permit a specific measure of the in vivo activity of the sodium/sodium countertransport pathway. PMID- 2757892 TI - The potassium channel opening drug cromakalim produces arterioselective vasodilation in the upper limbs of healthy volunteers. AB - 1. The effect of the K+ channel opening drug cromakalim on forearm blood flow during direct infusion into the brachial artery, and on the size of noradrenaline preconstricted hand veins during infusion directly into the vein, was studied in eight healthy volunteers. 2. Cromakalim (0.01-10.0 micrograms min-1) produced a dose-dependent increase in blood flow in the infused forearm, from 5.4 +/- 2.5 to 15.1 +/- 7.3 ml 100 ml-1 forearm min-1 at 10 micrograms min-1 (P less than 0.001). The half-time of offset of its action was 30 min. There was no change in blood flow in the non-infused forearm. 3. There was no increase in the size of noradrenaline pre-constricted dorsal veins during local infusion of cromakalim (0.001-1.0 microgram min-1). Glyceryl trinitrate (0.4 microgram min-1) however, completely reversed the constriction to noradrenaline (P less than 0.001). 4. The clear arterioselectivity of cromakalim, as with other members of this new class of drug, accords with the dependency of venoconstriction on receptor-operated, rather than potential-operated mechanisms which are of importance in resistance vessels. With this haemodynamic profile cromakalim may prove of value in the treatment of arterial hypertension. PMID- 2757893 TI - Bioavailability of hydroxychloroquine tablets in healthy volunteers. AB - 1. Five healthy volunteers received, in a randomised crossover design study, a 155 mg oral tablet and an intravenous infusion of 155 mg racemic hydroxychloroquine (200 mg hydroxychloroquine sulphate) to assess the bioavailability of the commercially available tablet (Plaquenil, Winthrop Laboratories, Australia). 2. The terminal elimination half-life of hydroxychloroquine is more than 40 days, thus blood and urine samples were collected for 5 months following each dose to characterise adequately the terminal elimination phase and obtain accurate estimates of the areas under the concentration-time curves. 3. The mean (+/- s.d.) fraction of the oral dose absorbed, estimated from the blood and urine data, was 0.74 (+/- 0.13). A wide range of estimates of the fraction of the oral dose absorbed was calculated from the plasma data (0.41 - 1.53), reflecting the difficulties of accurate measurement of hydroxychloroquine in plasma. 4. A period of 6 months is required to achieve 96% of steady-state levels of hydroxychloroquine with the usual once daily, oral dosage regimen. Pharmacokinetic factors may thus be partly responsible for the delayed action of the drug in rheumatic conditions. 5. Haemodialysis will not aid in the case of oral overdose with hydroxychloroquine. Although the proportionate increase in clearance may be large, the increase in the fraction of the dose excreted will be negligible. The extensive sequestration of the drug by tissues limits effectiveness of haemodialysis. PMID- 2757894 TI - Inter-subject variability in the metabolism of proguanil to the active metabolite cycloguanil in man. AB - 1. The metabolism of proguanil to the active metabolite cycloguanil has been evaluated in 135 British Troops and 26 Kenyan schoolchildren. 2. Large inter subject variability was observed in both plasma and urinary concentrations of proguanil and cycloguanil after standard doses of drug. 3. Based on the ratio of proguanil to cycloguanil (P/C) in urine the British troops formed a non-normal distribution. 90% of the population formed a discrete distribution with P/C ranging from 0.5 to 9.0 while the remaining 10% were scattered throughout the distribution to an extreme value of 39. A similar pattern of variability was observed using P/C from a 6 h plasma sample. 4. This variability was due to differences in the ability of individuals to metabolise proguanil to cycloguanil. 5. Thirteen schoolchildren who had experienced malaria during prophylaxis with proguanil and thirteen matched controls each received proguanil (100 mg). We could not discriminate between the two groups based on P/C ratio in either a 6 h plasma or 0-6 h urine sample. PMID- 2757895 TI - Effects of alpha-interferon on theophylline pharmacokinetics and metabolism. AB - 1. The influence of alpha-interferon (Roferon-A) on the pharmacokinetics and metabolism of theophylline was studied in healthy adults. Roferon-A was administered as an intra-muscular injection (3 x 10(6) iu) once-a-day over 3 days. One week prior to and immediately after this course a single 20 min aminophylline infusion (4 mg kg-1) was given. 2. Blood samples for theophylline analysis were taken over 48 h. Urine was collected up to 72 h and assayed for theophylline and its major metabolites 3-methylxanthine, 1,3-dimethyluric acid and 1-methyluric acid. 3. Pharmacokinetic parameters for theophylline in plasma were calculated. From urinary excretion data the overall metabolic clearance of theophylline and clearances for formation of the metabolites were calculated. 4. After interferon administration, there was a significant increase of approximately 15% in the mean values of the terminal elimination half-life, area under the curve and mean residence time of theophylline in association with a similar decrease in plasma clearance (P less than 0.05). Formation clearances of the metabolites tended to be smaller after treatment, but only the change in the overall clearance of theophylline was significantly different (P less than 0.05). There was no systematic shift in the metabolic pattern of theophylline. 5. Additional investigations of the influence of the duration of alpha-interferon treatment are necessary before definite conclusions can be drawn about the mechanism and the clinical relevance of the described interaction. PMID- 2757896 TI - The effect of angiotensin II and noradrenaline alone and in combination on renal sodium excretion in man. AB - 1. The renin-angiotensin-aldosterone-system is important for the maintenance of sodium balance in man. Recent animal evidence suggests the angiotensin II can modulate the effect of the renal sympathetic nervous system on renal function. We have investigated the possible interaction of physiological doses of angiotensin II and noradrenaline on sodium excretion in man. 2. Seven normal volunteers were studied on four occasions during maximum water diuresis sustained by oral hydration. Samples were obtained during a baseline and four subsequent 20 min periods (A-E). Placebo or noradrenaline was infused over periods B-E, and angiotensin II infused over period C. 3. There was no change in systemic blood pressure, heart rate or creatinine clearance caused by infusion of either angiotensin II, noradrenaline or both in combination. 4. Noradrenaline alone caused a significant fall in absolute and fractional sodium excretion. Angiotensin II when infused with placebo caused a 37% fall in absolute sodium excretion and a 32% fall when infused with noradrenaline (no significant difference between the 2 days). Similar changes were seen for urinary flow and fractional sodium excretion. 5. We have therefore found no evidence to support a postsynaptic interaction of low doses of angiotensin II and noradrenaline on renal sodium excretion in man. PMID- 2757897 TI - A stereochemical investigation of the cytotoxicity of mianserin metabolites in vitro. AB - 1. The metabolism of the enantiomers of mianserin to stable, chemically reactive and cytotoxic metabolites by human liver microsomes has been investigated in vitro. 2. Both enantiomers were metabolised to three major oxidation products: 8 hydroxymianserin, desmethylmianserin and mianserin 2-oxide. Hydroxylation occurred more readily with the S-enantiomer, whereas desmethylmianserin was always the major metabolite of the R-enantiomer. 3. The generation of chemically reactive metabolites exhibited a marginal degree of stereoselectivity, as assessed by irreversible binding of drug to microsomal protein (S greater than or equal to R; P less than or equal to 0.05). 4. The formation of metabolites which were cytotoxic towards human mononuclear leucocytes was greater (P less than or equal to 0.001] for R(-)-mianserin than for S(+)-mianserin and showed a significant correlation with N-demethylation (r = 0.84, P less than or equal to 0.01). PMID- 2757898 TI - Differential effects of flurbiprofen and aspirin on acetazolamide disposition in humans. AB - The plasma concentration-time profile of acetazolamide (AZ) following an intravenous bolus dose (5 mg kg-1) was determined during control, aspirin and flurbiprofen (FLU) treatment periods. The unbound fraction of AZ in plasma increased three-fold in the presence of salicylate (SA) while, in contrast, FLU produced consistent, but statistically insignificant, increases in binding. SA caused a two-fold decrease in both unbound AZ renal clearance and apparent volume of distribution at steady-state, while FLU produced a small, but significant, increase only in the latter. The area under the concentration-time curve for AZ in erythrocytes was increased by about 40% during SA treatment while FLU had no effect. Our results suggest that on a pharmacokinetic basis FLU may be a safer nonsteroidal anti-inflammatory drug (NSAID) to co-administer with AZ. PMID- 2757899 TI - Pharmacokinetics of intravenous cilazaprilat in normal volunteers. AB - The pharmacokinetics of 1 mg, 2 mg and 4 mg of cilazaprilat administered intravenously were determined in a group of eight volunteers. The fall in plasma concentration was polyphasic. Elimination was predominantly by renal excretion of the unchanged drug. The mean renal clearance values following 1 mg, 2 mg and 4 mg doses were 5.3 +/- 0.5, 8.1 +/- 0.5, and 9.8 +/- 0.5 l h-1 and plasma clearances were 7.8 +/- 0.5, 10.4 +/- 0.5 and 11.8 +/- 0.6 l h-1, respectively. Thus, plasma and renal clearances were dose dependent. ACE inhibition was greater than 82% for the first 4 h and about 55% at 24 h, after all three doses. There were no significant haemodynamic effects at any dose. PMID- 2757900 TI - Vigabatrin: a new anti-epileptic. PMID- 2757901 TI - Vigabatrin in the treatment of epilepsy in children. AB - 1. This study presents the results of the preliminary screening of vigabatrin as add-on therapy in an open, non-controlled multicentre study in children with refractory epilepsy. 2. There were 135 children, with an age range of 2 months-12 years. Main seizure type was partial in 42%, generalized in 29%, Lennox-Gastaut syndrome in 19% and West syndrome in 10%. 3. Vigabatrin was added onto current antiepileptic treatment in an initially recommended dose of 40-80 mg kg-1 day-1. However, the doses were frequently increased when tolerance allowed it, and the final mean dose used was 87 mg kg-1 day-1 (27-600). 4. A 75% to 100% reduction in seizure frequency was observed in 25% of patients (11 patients became seizure free) and 50 to 75% decrease in a further 13%. Efficacy was better in partial seizures, with good to excellent results in 49% of patients. The use of high doses, above 100 mg kg-1 day, was not associated with greater efficacy in this preliminary study. 5. No side effects were reported in 79% of patients. Agitation and insomnia were observed in 8.8% and somnolence in 6%. Other adverse events included ataxia (2.2%), nausea (2.2%) and increased appetite (1%). A moderate and transient decrease in haemoglobin was reported in six patients from the same centre; these patients were all receiving very high doses of vigabatrin (250 to 600 mg kg-1 day-1). 6. Vigabatrin thus appears to be a safe antiepileptic drug that may be effective in the treatment of severe epilepsy in children. PMID- 2757902 TI - Vigabatrin in epilepsy in mentally retarded patients. AB - 1. The anticonvulsant potency of vigabatrin (gamma-vinyl GABA, GVG) was studied in an open trial in a group of 21 mentally handicapped patients with drug resistant epilepsy. 2. With this treatment one third of these patients had more than 50% reduction in seizure frequency. The anticonvulsant effect appeared during the first month of therapy and was maintained during a 7-month study. The side effects were mild: mainly tiredness, aggressiveness, and ataxia. Other anticonvulsant drugs remained at baseline levels during GVG therapy. GVG was not found to modulate EEG recordings. 3. According to our results, GVG is effective for treating intractable epilepsy in mentally handicapped patients. PMID- 2757903 TI - Efficacy and safety of vigabatrin in the long-term treatment of refractory epilepsy. AB - 1. The long term safety and efficacy of vigabatrin has been studied in 254 patients with refractory epilepsy (82% with partial seizures) in 23 different clinics in eight European countries. 2. This was an open multicentre study in which patients who had experienced a significant benefit from vigabatrin and had continued to take the drug for 1 year or longer were eligible for evaluation. The mean duration of therapy in the 254 patients was 22.7 months; 72 patients received vigabatrin for more than 2 years. 3. Patients were severely affected by epilepsy with a median monthly seizure frequency of 15.7 despite taking an average of 2.2 antiepileptic drugs. On vigabatrin, the median seizure frequency was about 35% of baseline, remaining stable over time despite a 10% reduction in the number of concurrent medications. 4. The lack of tachyphylaxis to the antiepileptic effect of vigabatrin is shown by the small number of patients who discontinued for insufficient efficacy (11%), two thirds of them during the first 6 months of follow-up. Maintenance of efficacy is also clearly demonstrated by analysis of 2 year and 3 year cohorts of patients. 5. Clinical and biological tolerability was excellent. There was a very low rate of drop out for adverse events (1.6%). Adverse events, mainly sedation, irritation and weight gain were mostly mild and transient. 75% of patients reported no adverse event at all. 6. Safety evaluation included serial neurological, ophthalmological and general examinations: no new abnormal clinical feature or adverse event emerged with long term therapy. PMID- 2757904 TI - Experimental studies of the influence of vigabatrin on the GABA system. AB - 1. Studies of the influence of clinically relevant concentrations of vigabatrin on GABA-transaminase and on the release of endogenous GABA were performed in selectively cultured astrocytes and neurons. In addition, the two stereoisomers of vigabatrin were investigated separately. 2. The results indicated a preferential inhibition of neuronal GABA-transaminase by vigabatrin. 3. Only the (S)-form of vigabatrin seems to inhibit GABA-transaminase. This finding corresponds to observations in epileptic animals that the (R)-form exhibits no anticonvulsant effect. 4. Resynthesis of GABA-transaminase, following withdrawal of vigabatrin showed that maximum enzyme activity was obtained within 6 days. This finding corresponds to the persistent effect after withdrawal of the drug in patients, observed in clinical trials. 5. At a concentration of 25 microM, vigabatrin caused a significant increase in the release of endogenous GABA from cultured GABAergic neurons. Although no data on brain levels of the drugs are currently available, judging from vigabatrin blood concentrations in man and from information of brain levels in animals, following chronic treatment, it is conceivable that a sufficiently high concentration of the drug in human brain is obtained to augment GABA release. PMID- 2757905 TI - Effect of food on the absorption of vigabatrin. AB - 1. This study, involving eight healthy volunteers, revealed that food intake does not have a clinically significant effect on vigabatrin kinetics. 2. Kinetics of vigabatrin in the fasting state showed low inter-individual variation. 3. The plasma concentration vs time profile followed a bi-exponential decline with a terminal half-life of 6.8 h and a relative bioavailability of 92% +/- 11%. 4. In the clinical setting, vigabatrin may be taken at times convenient for the patient. PMID- 2757906 TI - Interaction between vigabatrin and phenytoin. AB - 1. The study was designed to determine the mechanism by which vigabatrin causes a fall in plasma phenytoin concentrations when added to the drug therapy of eight epileptic patients. 2. Total plasma phenytoin concentration was measured before and at intervals during 5 weeks' treatment with vigabatrin. 3. Plasma protein binding of phenytoin, the urinary ratio of phenytoin to 5-(p-hydroxyphenyl)-5 phenylhydantoin, and antipyrine clearance were measured before and at the end of treatment period. 4. Mean plasma phenytoin concentration fell significantly by 23% during the fifth week. 5. No change was found in any of the other measures. 6. Although an interaction between phenytoin and vigabatrin has been confirmed, the mechanism has not been elucidated. PMID- 2757907 TI - The effect of vigabatrin on brain and platelet GABA-transaminase activities. AB - 1. The inhibition profiles of GABA-transaminase (GABA-T) in rat brain and platelet have been compared following a single intraperitoneal dose of vigabatrin. The inhibition profiles exhibit similarities. The inhibition produced by the drug is dose-dependent and, in the dose range used in man, the dose response curves are comparable. The pharmaco-dynamic effects of the drug (inhibition of central and peripheral GABA-T) remain after the drug has been eliminated from plasma. It is suggested that the measurement of rat platelet GABA T may be used as a non-invasive assessment of the efficacy of GABA-T inhibitors in the rat CNS. 2. Human blood platelet GABA-T was significantly inhibited by the administration of a single oral dose of vigabatrin. Chronic administration also produces a significant inhibition of platelet GABA-T. As with rats, the pharmacodynamic effects on the platelet enzyme remained after the drug had been eliminated from plasma. If the situation in man is assumed to parallel that found in the rat then measurement of platelet GABA-T inhibition could prove to be a useful indicator of central inhibition. PMID- 2757908 TI - Neuropathology of vigabatrin. AB - 1. Neuropathological changes in experimental animals have been observed with vigabatrin treatment in mice, rats and dogs. 2. These changes have comprised intramyelinic oedema which is reversible on cessation of treatment. 3. In human studies so far, no intramyelinic oedema has been noted. It is not clear whether humans will show the neurotoxicity observed in animals; close monitoring of patients is indicated. PMID- 2757909 TI - Effects of vigabatrin and of GABA on myelinated rat cerebellar cultures: preliminary data. AB - 1. The aim of this study was to evaluate the effect of high concentrations of vigabatrin (gamma-vinyl GABA) and of GABA on myelin of the central nervous system cultures. 2. Explants of rat cerebellum were cultured for 14-19 days in vitro on collagen-coated coverslips in Leighton tubes. They were exposed for up to 14 days to 500 nmol ml-1 vigabatrin or to 1000 nmol ml-1 GABA. 3. Qualitative and quantitative blind examination of living cultures and of Sudan black B-stained slides showed mild toxicity of both drugs for myelinated fibres. No clear-cut differences could be demonstrated between the two compounds, although vigabatrin seemed slightly more toxic than GABA at these doses. 4. In electron microscopy, no patent intramyelinic oedema nor primary demyelination were seen. On the contrary, some degenerating myelinated fibres and astrocytic gliosis were seen in both experimental conditions. The changes involved axons as well as myelin sheaths. 5. The toxicity of GABA and vigabatrin was surprisingly mild in this very sensitive model. PMID- 2757910 TI - Effects of vigabatrin on evoked potentials in dogs. AB - 1. The purpose of this study was to evaluate possible changes in brain morphology and evoked potentials associated with daily administration of 300 mg kg-1 vigabatrin in dogs. 2. Somatosensory evoked potentials (SEP) and auditory evoked potentials (AEP) were recorded at baseline and weekly for 12 weeks of treatment and every 2 weeks for 17 weeks of recovery. Morphology was assessed immediately after treatment for two treated dogs and after recovery for the remaining five treated and two control dogs. 3. Vigabatrin produced a significant slowing of the central transmission measure of the SEP with no alteration in the AEP. Vigabatrin was associated with microvacuolation in select regions of the brain including the fornix, septum, optic tract, hypothalamus, thalamus and cortex. In addition, some microglial proliferation was noted. 4. Changes in SEP and the microvacuolation fully recovered after 17 weeks of treatment. 5. The study confirms vigabatrin induced microvacuolation in the dog and suggests these changes are associated with functional slowing of conduction in the somatosensory pathways. PMID- 2757911 TI - Effects of vigabatrin on evoked potentials in epileptic patients. AB - 1. Somatosensory (SEP) brainstem auditory (BAEP) and visual (VEP) evoked potentials were determined before and after add-on administration of vigabatrin (GVG) in patients with epilepsy. 2. At pre-treatment assessment SEP and BAEP parameters were usually found to be within normal limits, while P100 latencies of the VEP were abnormally prolonged in a considerable proportion of patients. 3. In a double-blind, placebo-controlled trial in 22 patients GVG (1-3 g day-1 stratified according to body weight) given for 7 weeks did not modify any of the evoked potential parameters evaluated. 4. Eighteen patients were evaluated prospectively at regular intervals during long-term GVG (2-4 g day-1) therapy with a mean follow up of 24 months (range 13-42 months). SEP, BAEP and especially VEP parameters showed some interindividual variability, but the within patient variation was relatively small. No consistent important changes were seen in association with GVG, although a possible trend towards a shortening of BAEP latencies and P100 latencies was observed. 5. The relevance of these findings with respect to GVG safety is discussed. PMID- 2757912 TI - Effects of long term vigabatrin on somatosensory evoked potentials in epileptic patients. AB - 1. Vigabatrin has proved to be a very effective antiepileptic in clinical trials, with excellent long term tolerability. 2. The purpose of this study was to test the central nervous system (CNS) safety of the drug during long term clinical use, due to the existence of species-dependent intramyelinic oedema in animal toxicology studies. 3. Somatosensory evoked potentials were recorded repeatedly over a mean period of 11 months, in 54 adult patients with refractory epilepsy who received vigabatrin as add-on therapy to their current antiepileptic regime. 4. There was no suggestion throughout the study that vigabatrin could lead to a prolongation of neuronal conduction times within the CNS pathways. 5. The results are consistent with previous studies of somatosensory, visual and brainstem auditory evoked potentials in patients. In view of the results observed in the dog, where increases in central latencies of somatosensory evoked potentials were clearly apparent, these data provide strong reassurance about the neurological safety of vigabatrin in the treatment of epileptic patients. PMID- 2757913 TI - Changes in CSF and brain soluble proteins following vigabatrin treatment in rats. AB - 1. Following the discovery of vacuoles in the white matter of the brain of small animals treated with vigabatrin (GVG) it was decided to investigate possible reasons for the occurrence of these vacuoles and to explore the possibility of finding CSF markers which could be applicable for monitoring toxicity in humans. 2. An animal model was developed to study the changes of protein synthesis and to assay soluble brain proteins by isoelectric focusing and two-dimensional electrophoretic techniques. 3. Five groups of rats were treated either with 300 mg kg-1 day-1 GVG, 50 mg kg-1 GVG every other day, 300 mg kg-1 day-1 sodium valproate, 100 mg kg-1 day-1 sodium valproate or sham treated. 4. All animals were given the drug in a liquid full nutrient diet. The dietary intake of the different groups was adjusted to the group which showed the smallest dietary intake, to compensate for possible differences between groups due to nutritional factors. 5. The rats on 300 mg kg-1 day-1 GVG had a 30% reduction of body weight and a 6% reduction of their brain weight, compared with the lower GVG dose group, the two valproate groups and the sham treated group. 6. The synthesis of soluble proteins in the cerebral cortex, hippocampus and cerebellum was decreased in rats given GVG at 300 mg kg-1 day-1 and was increased in rats given valproate at 300 mg kg-1 day-1.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2757914 TI - Cerebrospinal fluid GABA and seizure control with vigabatrin. AB - 1. To evaluate the relationship between the clinical response and enhancement of GABAergic neurotransmission, for 6 months we administered vigabatrin (gamma-vinyl GABA, GVG) to 75 patients with complex partial epilepsy. Total GABA (TGABA), free GABA (FGABA), homocarnosine (HC), and GVG concentrations were measured in CSF of these patients before and during GVG treatment. 2. Over 50% reduction in seizures was found in 55% of the patients. Dose-reduction resulted in a relapse, i.e. the return of seizures. 3. At baseline TGABA, FGABA, and HC did not differ in responders and nonresponders. After GVG treatment, the TGABA and HC levels were lower in nonresponders (P less than 0.001), but the GVG and FGABA levels did not differ. The GVG dose reduction resulted in a concomitant decrease in TGABA, FGABA, HC and GVG (P less than 0.001). 4. According to our results GVG is an effective anticonvulsant drug in complex partial seizures. In nonresponders the poor anticonvulsant response may be related to the lower elevation of the CSF markers of GABAergic neuronal activity in this group compared with the responders. PMID- 2757915 TI - Myoglobin: an evaluation of its role as a marker of rhabdomyosarcomas. AB - Tumour markers now have an established role in tumour diagnosis and patient management. However, antibodies used to detect these tumour markers have in some instances proved unreliable, with a low rate of sensitivity and specificity. In this study we wished to evaluate the role of a commercial antibody to myoglobin as a marker of rhabdomyosarcomas. The purpose of this investigation was to assess the sensitivity and specificity of myoglobin antiserum as a marker of rhabdomyosarcomas. This was performed by reacting a large number of tumours (sarcomas, carcinomas and melanomas) with a polyclonal anti human myoglobin antiserum. Staining was demonstrated in 60% of rhabdomyosarcomas. Only two tumours from a total of 226 non-skeletal muscle tumours showed a positive reaction (0.88%). One was a leiomyosarcoma and the other had been classified as an undifferentiated sarcoma but a rhabdomyosarcoma was included in its differential diagnosis. It is of interest that both had been earlier irradiated. This antiserum was therefore a specific but not a very sensitive tumor marker. Its rate of staining of rhabdomyosarcomas is compared with the results in the literature. A great disparity is found and the reasons for this are discussed. PMID- 2757916 TI - Reassessment of the relationship between M-protein decrement and survival in multiple myeloma. AB - The relationship between percentage M-protein decrement and survival is assessed in 134 multiple myeloma patients. The correlation did not achieve statistical significance (P = 0.069). Multivariate analysis using the Cox proportional hazards model, including a number of previously recognised prognostic factors, showed only percentage M-protein decrement, creatinine and haemoglobin to be significantly correlated with survival. However, the R'-statistic for each of these variables was low, indicating that their prognostic power is weak. We conclude that neither the percentage M-protein decrement nor the response derived from it can be used as an accurate means of assessing the efficacy of treatment in myeloma. Mature survival data alone should be used for this purpose. PMID- 2757917 TI - Prognostic factors and classification in multiple myeloma. AB - Analyses of prognostic factors have allowed the design of staging systems in different haematological disorders. In a series of 220 patients with multiple myeloma, univariate analysis showed that nine parameters had a significant adverse effect on survival; poor performance status (Karnowsky scaling system less than 70%), infections before diagnosis, renal impairment (assessed either by creatinine clearance greater than 2 mg dl-1 or urea greater than 40 mg dl-1), serum calcium (greater than 10 mg dl-1), severe anaemia (less than 8.5 g dl-1), the presence of Bence-Jones proteinuria, failure to achieve complete remission, more than 40% plasma cells in bone marrow and a low paraprotein index (monoclonal component/% plasma cells: P less than 0.09). In addition, this index correlated significantly with all the other prognostic factors except performance status. The best combination of disease characteristics selected by means of the Cox regression proportional hazards method were performance status and creatinine levels. Additionally, by factor analysis of principal components we obtained a regression equation that included creatinine levels, haemoglobin, performance status and paraprotein index. Using this it was possible to separate the series of patients into three risk categories: A (65 patients), B (69 patients) and C (65 patients) with a median survival of 41, 24 and 12 months, respectively. The model provided similar results to those of the British Medical Research Council, whereas the staging systems proposed by Durie and Salmon, Merlin et al. and Carbone et al. had a lower discriminant value in our series. PMID- 2757918 TI - Risk factors for breast cancer by oestrogen receptor status: a population-based case-control study. AB - Data from a population-based case-control study conducted in Adelaide, South Australia, and involving 451 case-control pairs, were analysed to determine whether the associations of menstrual, reproductive, dietary and other factors with risk of breast cancer differed by oestrogen receptor (ER) status. Data on ER status were available for 380 cases. The proportion of tumours which were ER+ increased with age, and there was a higher proportion of ER+ tumours in post menopausal than in premenopausal women. Both oral contraceptive use (P = 0.055) and cigarette smoking (P = 0.047) were associated with increased (unadjusted) risk of ER- cancer, while having little association with risk of ER+ cancer. Most dietary factors had little association with risk of either cancer type, the main exception being the reduction in risk of ER- breast cancer with increasing beta carotene intake (P for trend = 0.017). In general, however, links with the factors examined were not strong enough to suggest different causal pathways for ER- and ER+ breast cancer. PMID- 2757919 TI - Microscopic distribution of misonidazole in mouse tissues. AB - Mice were injected with tritiated misonidazole (750 mg/kg-1), killed after 24h and the excised tissues prepared for autoradiography (ARG) to identify sites of accumulation. The previously reported high grain count associated with bound misonidazole metabolite(s) was observed in the liver. The ratio of grain count in the emulsion above the centrilobular hepatocytes to the count over connective tissue (stroma) was 12. A higher count ratio for 'target' cells to stroma was observed in the following cells/tissues: meibomian gland (ducts 110, acini 65), oesophagus (keratinised layer 60), incisor (enamel organ 17), nasal septum (subepithelial glands 13). For some of these tissues the explanation might appear to lie with localised hypoxia, but for others which were probably normoxic there is as yet no obvious reason for these findings. PMID- 2757920 TI - Influence of delay in diagnosis on prognosis in testicular teratoma. PMID- 2757921 TI - Competitive exclusion of clonal subpopulations in heterogeneous tumours after stromal injury. AB - Xenografted artificial heterogeneous tumours (AHTs) were created by admixing, in a ratio of 9:1 or 1:9, two clonal subpopulations (designated as clones A and D) obtained from a heterogeneous human colon adenocarcinoma. In unperturbed AHTs these percentages remain constant with increasing tumour size. At average volumes of 250 mm3, AHTs were X-irradiated (15 Gy) and changes in growth rate and composition assayed. A and D cells exhibited equivalent levels of survival after in vivo irradiation as determined by excision assay procedures. At about 2-3 weeks post-irradiation AHTs exhibited a significant enrichment of the majority population in both the 1:9 or 9:1 A:D AHTs. Additional studies were concomitantly performed to determine whether these changes were mostly a function of normal tissue damage or of parenchymal tumour cell killing. In these studies, the normal tissue only was irradiated, tumour cells were implanted one day after irradiation, and the composition of AHTs assayed as a function of time post irradiation. In these studies, similar shifts in composition with similar kinetics to that seen in the in situ irradiations were found. We therefore propose that these compositional shifts are mainly a reflection of radiation damage to the stromal microenvironment, which is consequently unable to support tumour growth adequately leading to competitive exclusion of the minority subpopulation. PMID- 2757922 TI - Growth and radiation sensitivity of the MLS human ovarian carcinoma cell line grown as multicellular spheroids and xenografted tumours. AB - The growth characteristics and the radiation sensitivity of multicellular spheroids of the MLS human ovarian carcinoma cell line grown in spinner culture in atmospheres of 5% CO2 in air or 5% CO2, 5% O2 and 90% N2 were studied and compared to that of MLS xenografted tumours. The spheroids grew exponentially with a volume-doubling time of approximately 24 h up to a diameter of approximately 580 microns and then the growth rate tapered off, more for spheroids grown at the low than at the high oxygen tension. Thirty days after initiation, the spheroid diameters were approximately 1,500 microns at the low and 2,100 microns at the high oxygen tension. The tumour volume-doubling times were approximately 8 days (V less than 200 mm3) and 17 days (V = 1,000-4,000 mm3). The histological appearance of the spheroids and the tumours was remarkably similar; both developed large central necrosis and both were composed of epithelial cells and showed pseudoglandular structures with lumen. The spheroids were slightly less differentiated than the tumours. The intrinsic, cellular radiation sensitivity was independent of whether the cells were grown in vitro as spheroids or in vivo as tumours, as revealed by irradiating single cells from dissociated spheroids and tumours under aerobic conditions and intact spheroids and tumours under hypoxic conditions. Studies of 1,600 microns spheroids grown in 5% CO2 in air showed that the intrinsic radiation sensitivity of the chronically hypoxic cells was the same as that of acutely hypoxic cells. The fraction of radiobiologically hypoxic cells under these conditions was approximately 15% and similar to those of 9% (V = 200 mm3) and 28% (V = 2,000 mm3) found for the tumours. Spheroids with diameter of 1,200 microns did not show survival curves parallel to those for acutely hypoxic cells, i.e. they did not contain a measurable fraction of clonogenic cells at complete radiobiological hypoxia. The final portion of their survival curves represented partially hypoxic cells; the OERs were 1.6 and 1.3 for spheroids grown at the high and the low oxygen tension, respectively. The considerable similarity between the spheroids and the tumours suggests that MLS spheroids constitute a valuable in vitro model for studies of human tumour radiation biology and related physiological processes. MLS spheroids may be particularly useful in studies of therapeutic consequences of partial radiobiological hypoxia since complete hypoxia and different levels of partial hypoxia can be studied separately by varying spheroid size and the oxygen tension in the culture medium. PMID- 2757923 TI - In vitro antagonism between cisplatin and vinca alkaloids. AB - The effects of the combination of cisplatin and other cytotoxic agents were studied in vitro. When A549 lung cancer cells were treated simultaneously with cisplatin and other cytotoxic agents, cisplatin additively increased the cytotoxic effects of etoposide, mitomycin C, adriamycin, 5-fluorouracil and 1 beta-D-arabinofuranosylcytosine, but antagonised those of vincristine, vindesine, vinblastine and podophyllotoxin. The antagonism between cisplatin and vincristine was also observed with HT29 colon cancer cells. NC65 renal carcinoma cells and A431 epidermoid carcinoma cells when these cells were simultaneously exposed to both agents. When A549 cells were exposed to cisplatin and vincristine sequentially, the antagonism between them was evident when cells were pretreated with cisplatin but not when treated in the opposite sequence. Therefore, when combination chemotherapy including cisplatin and vinca alkaloids is given, possible antagonism between them should be considered, especially in determining the schedule of drug administration. PMID- 2757924 TI - Fetal calf serum and retinoic acid affect proliferation and terminal differentiation of a rat rhabdomyosarcoma cell line (BA-HAN-1C). AB - We report on the establishment of a model for differentiation induction in sarcomas, using the clonal rhabdomyosarcoma cell line BA-HAN-1C. This rhabdomyosarcoma cell line is composed of morphologically undifferentiated mononuclear stem cells, some of which spontaneously fuse to form terminally differentiated multinuclear myotube-like giant cells. The deprivation of fetal calf serum (FCS) or the exposure to retinoic acid, respectively, resulted in a significant inhibition of proliferation (P less than 0.001) and a marked increase in cellular differentiation as shown by a significant increase in the number of myotube-like giant cells (P less than 0.001) and in the creatine kinase activity (P less than 0.05) used as a biochemical marker of differentiation. Furthermore, after exposure to retinoic acid about 30% of the mononuclear tumour cells exhibited morphological features of rhabdomyogenic differentiation, such as bundles of thick and thin myofilaments, which had never been observed in the mononuclear cells of untreated cultures. These results confirm that the inverse linkage between proliferation and differentiation known from embryonic myogenesis is preserved in our rhabdomyosarcoma cell line. The failure to induce terminal differentiation by exposure to retinoic acid in all the cells of our clonal cell line indicates that some tumour cells might epigenetically be blocked from responding to retinoic acid. The temporary growth retardation observed after FCS deprivation suggests that autocrine stimulation of proliferation may be operating in our cell line, too. PMID- 2757925 TI - Enhanced cytostatic activity of the sesquiterpene lactone eupatoriopicrin by glutathione depletion. AB - Eupatoriopicrin (EUP), a sesquiterpene lactone from Eupatorium cannabinum L., possesses cytostatic activity. This was demonstrated for FIO 26 cells in vitro with the aid of a clonogenic assay and in vivo by tumour growth delay in FIO 26 and Lewis lung tumour-bearing mice. In vitro the IC50 for 1 h exposure to EUP was 1.5 microgram ml-1 (4.1 nmol ml-1). This concentration depleted about 25% of its cellular GSH concentration. Pretreatment of FIO 26 cells with BSO, resulting in greater than 99%. GSH depletion, enhanced the cytotoxic effect of EUP. The dose enhancement factor at the level of 10% cell survival was 2.3. Growth inhibition of the Lewis lung carcinoma and the FIO 26 fibrosarcoma, solidly growing in C57Bl mice, was found after i.v. injection of 20 or 40 mg kg-1 EUP, at a tumour volume of about 500 microliters. Pretreatment with BSO at a dose of 4 mmol kg-1 i.p., 6 h before EUP administration, resulted in a significantly stronger growth delay of both tumours compared with EUP only. At the time of EUP treatment, cellular GSH in the tumours was reduced by BSO treatment to about 60%. It is concluded that EUP possesses antitumour activity in vivo and that chemosensitisation of EUP may be accomplished by pretreatment with BSO, indicating that endogenous GSH protects against the cytostatic action of EUP. PMID- 2757926 TI - The dedifferentiation of metastatic prostate carcinoma. AB - Two hundred consecutive staging lymphadenectomies with metastatic prostate adenocarcinoma and 100 consecutive autopsies with widely disseminated metastatic prostate adenocarcinoma were identified. The metastases from 41% of the staging lymphadenectomies were entirely differentiated (gland forming) and an additional 43% were predominantly (50% or more) differentiated. In contrast, the metastases from 70% of the autopsies were entirely undifferentiated (non-gland forming) and an additional 18% were predominantly undifferentiated. Further, five patients with completely or predominantly differentiated metastases in staging lymphadenectomies were found to have widespread completely or predominantly undifferentiated metastases at autopsy 4-7 years later. These findings suggest that dedifferentiation occurs within metastases and that dedifferentiation within metastases may be important in understanding the widespread dissemination of metastatic prostate carcinoma. PMID- 2757928 TI - Multiple infundibular tumours of the head and neck. AB - A condition of multiple benign and sometimes self-healing infundibular tumours of the skin is described. It effects the sun-exposed areas of the head and neck in Caucasians. The individual lesions consist of a cluster of thick pockets, representing in many details the supra-sebaceous portions of the follicular unit. Follicular poroma, tumours of the deeper part of the follicular infundibulum, virus warts, inverted follicular keratosis and prurigo nodules do not correspond adequately with the appearance described in the present series of six cases. PMID- 2757927 TI - Dietary factors and epithelial ovarian cancer. AB - Dietary data from a population-based case-control study of 172 epithelial ovarian cancer cases and 172 controls were analysed. A significant (P less than 0.01) dose-response relationship was found between intake of fat from animal sources and risk of ovarian cancer, but plant fat was not associated. Although the effect of animal fat was confounded by education, an adjusted odds ratio of 1.8 persisted for those in the upper quartile compared to the lower quartile of consumption (P for trend = 0.03). After adjustment for animal fat intake, calorific and protein intake had minimal effects on risk. Total vegetables were found to be somewhat protective, but the mechanism of action was unclear. Weight, height and relative weight (weight/height2) were not related to risk of ovarian cancer. PMID- 2757929 TI - An investigation into the incidence of auto-immune disorders in patients with localized morphoea. AB - Patients with localized morphoea have an increased incidence of auto-immune disorders, but this is not related to the age of onset, duration of disease nor the site or number of lesions. The patients have an increased incidence of tissue antibodies and these are more common when more than one lesion is present. The relatives of the patients have also been found to have an increased incidence of auto-immune disorders. These findings suggest an immunological basis for the disease and indicate that the patients should be investigated and followed up to detect the evidence of other auto-immune disorders. PMID- 2757930 TI - Familial keratoses of actinic distribution associated with internal malignancy and cellular hypersensitivity to UVA. AB - In members of a family there appeared to be an association between the development of cutaneous pigmented keratoses in sun-exposed sites, and the later evolution of internal malignancies, particularly carcinoma of the uterus. Affected individuals were not clinically photosensitive, but their fibroblasts demonstrated gross cytopathic changes, low survival indices and an increased frequency of DNA single strand breaks following exposure to long-wave ultraviolet radiation (UVA). These clinical and cellular features appear to identify an unrecognized syndrome that may not be uncommon. Recognition of this syndrome in a family may prevent certain malignancies developing in those affected. PMID- 2757931 TI - Non-symmetric subcutaneous lipomatosis associated with familial combined hyperlipidaemia. AB - A family with familial combined hyperlipidaemia in which affected members had nonsymmetric subcutaneous lipomatosis (NSSCL) is described. Affected members had high serum levels of total cholesterol, low density lipoprotein (LDL) cholesterol and high density lipoprotein (HDL) cholesterol. By contrast, family members without NSSCL had normal lipid levels. There was also a correlation between the degree of hyperlipidaemia and the amount of subcutaneous lipomas. The occurrence of hyperlipidaemia in family members with NSSCL suggests the existence of a genetic linkage between these two characteristics, but did not show any association with HLA haplotyping. To our knowledge this association between lipid abnormalities and NSSCL has not been previously reported. PMID- 2757932 TI - Cutaneous chylous reflux. AB - Two cases of cutaneous chylous reflux are described. Both patients had many translucent white vesicles from which milk-like fluid wept intermittently. Lymphangiogram revealed dilated, tortuous lymphatic vessels and dermal backflow. Electron microscopic studies showed an abnormal ultrastructure of the dilated lymphatics. PMID- 2757933 TI - Imported rickettsial African spotted fever in Japan. AB - A 45-year-old Japanese man developed a black eschar skin lesion and on the body, a number of erythematous seropapules 2 weeks after his return from South Africa. Within 24 h of treatment with minocycline he was afebrile and symptomatically much improved. Serological tests showed increased antibody titres to spotted fever group rickettsiae (SFGR). From the clinical and serological findings we consider this patient to be the first in Japan to have been infected with SFGR in Africa. PMID- 2757934 TI - Prurigo pigmentosa successfully treated with minocycline. AB - Five patients with prurigo pigmentosa were treated with 100-200 mg minocycline daily. The eruption and pruritus rapidly resolved within a few days or up to a week. There has been no recurrence after stopping medication and we conclude that minocycline is effective for prurigo pigmentosa and safer than dapsone. PMID- 2757935 TI - Premenstrual exacerbation of atopic dermatitis. PMID- 2757936 TI - Purpura and sepsis--rarer causes? PMID- 2757937 TI - Concomitant Becker's naevus and acanthosis nigricans. PMID- 2757938 TI - An investigation of circulating and in situ lymphocyte subsets and Langerhans cells in the skin and cervix of patients with chronic renal failure. AB - This study was designed to detect possible changes in the immunocytology of the human immune system in the skin, cervix and peripheral blood of patients with chronic renal failure (CRF) treated by conservative methods, haemodialysis (HD) and continuous ambulatory peritoneal dialysis (CAPD). In the skin, Langerhans cell numbers were reduced in CRF, CAPD and HD patients but in the cervix, Langerhans cells were reduced only in the CRF patients. There was a preponderance of T suppressor lymphocytes compared with T helper lymphocytes in the epidermis in the CRF and the CAPD groups. The presence of natural killer cells in the epidermis of the renal groups compared to controls was significant in the CRF and HD patients while the presence of T suppressor lymphocytes in the epidermis compared to controls was significant only in the CAPD patients. In the dermis, there was a mixed cellular infiltrate of T helper and T suppressor lymphocytes but with no subset attaining significance. The dermal infiltrate of T helper lymphocytes in all three groups of renal patients was significantly reduced compared to controls. In CRF patients, peripheral blood pan T cells, T helper and T suppressor lymphocytes and B lymphocytes were reduced, while T suppressor lymphocytes were reduced in both HD and CAPD patients, compared to controls. Though the results confirm alteration of the immunocytology of the skin, cervix and peripheral blood, we could not relate them to a clinical finding. PMID- 2757939 TI - UVA sunbeds: tanning, photoprotection, acute adverse effects and immunological changes. AB - The effects on 31 normal subjects following exposure to sunbeds containing UVA lamps with minimal UVB emission have been compared in a double-blind study with the effects on nine control subjects of a similar exposure course three times weekly for 4 weeks to sunbeds emitting visible light. On previously untanned areas, all those subjects on active treatment developed a mild tan; in tanned areas they all developed a moderate tan, while all control subjects developed a minimal to mild tan. The mean protection factor against later UVB-induced erythema was 3.2 +/- 0.3 after the active course and 1.6 +/- 0.2 among the controls. Significantly more frequent adverse cutaneous effects for active subjects were pruritus, erythema, freckling, burning sensation, dryness and polymorphic light eruption. Cutaneous Langerhans cell numbers, and blood CD3+ (pan T-cell) and CD4+ (helper T-cell) lymphocyte subsets were reduced in both active and control groups. CD8+ (cytotoxic/suppressor T-cell) counts were similarly but not significantly reduced in both groups. Pityrosporum yeast counts were significantly reduced in both groups. The changes found in both groups seem attributable to small amounts of UVB emission from both active and control lamps. PMID- 2757940 TI - Cutaneous reactive hyperaemia: racial differences induced by corticoid application. AB - The postocclusive hyperaemic reaction before and after a single 1 h application of a potent corticoid (clobetasol 0.05% in ointment) was recorded by means of laser Doppler velocimetry in order to elucidate different racial responses in skin vasoconstriction. Fourteen young male subjects entered the study (eight Caucasians, six Blacks). Reactive hyperaemia was recorded after 4 min of occlusion of the forearm blood flow. The following parameters of the hyperaemic reaction were investigated: area under the curve response, peak response, rise of blood flow slope to peak and decay of blood flow slope after peak. Different responses were recorded in the Black subjects after the vasoconstrictive stimulus compared to the Caucasians, namely: decreased area under the curve response (P less than 0.04); decreased peak response (P less than 0.01); decreased decay slope after peak blood flow (P less than 0.04). These data are consistent with a different reactivity of blood vessels in black skin and possibly not related to the transcutaneous penetration of the chemical compound. PMID- 2757941 TI - The short-term benefit and long-term failure of ultraviolet light in the treatment of venous leg ulcers. AB - Ultraviolet light has in the past been advocated for the treatment of venous leg ulcers on the assumption that it increases skin blood flow and reduces skin hypoxia. Our results show that UV light increases skin-oxygen tension of the lower leg and inhibits the normal vasoconstrictor response on standing. However, this effect is short lived and is followed after 2 days by a return of the vasoconstrictor reflex and a marked decrease in skin oxygenation which continues for at least 2 weeks. Since UV irradiation improves skin oxygenation for only 48 h, it cannot be recommended as a form of treatment for venous leg ulcers. PMID- 2757942 TI - The treatment of decorative tattoos with the carbon dioxide laser. AB - The carbon dioxide laser was used in the treatment of 51 patients with decorative tattoos. Sixty-eight treatments were performed under local anaesthesia. Morbidity from treatment was low. Results 6 months after treatment in 44 patients revealed excellent or good results in 24 patients and hypertrophic scarring in three patients. These results confirm the value of this laser in the treatment of tattoos and demonstrate the advantages of this therapy over other treatments currently employed. PMID- 2757943 TI - Darier's disease with peri-follicular depigmentation. AB - We report a case of Darier's disease presenting with widespread peri-follicular depigmentation. Histology revealed the features of Darier's disease in the depigmentated macules and an absence of melanocytes. PMID- 2757944 TI - Post-irradiation morphoea. AB - We present details of nine patients who developed morphoea after radiotherapy. In every patient morphoea began within the irradiated area and in four spread beyond it. We believe the irradiation triggered the morphoea despite the absence of any clear-cut relationship to dosage or severity of the acute reaction. Dermatologists and radiation oncologists should be aware that this condition may lead to the mistaken diagnosis of a local tumour recurrence. PMID- 2757945 TI - Naevoid psoriasis. AB - A six-year-old boy presented with an eruption comprising multiple psoriasiform plaques, arranged in linear bands distributed along the lines of Blaschko and confined to the left side of the body. We believe that the eruption is true psoriasis, occurring in an unusual naevoid distribution. The existence of a genuinely naevoid form of psoriasis has frequently been debated, and has tended to be discounted. We believe that we have encountered a child who has this condition. PMID- 2757946 TI - Skin necrosis in giant cell (temporal) arteritis: report of three cases. AB - Three elderly, female patients presented with scalp ulceration. One developed sudden blindness before the ulceration of the scalp. Biopsy from the ulcerated area in this patient did not show evidence of giant cell arteritis, but the two other patients had histological evidence of giant cell arteritis and one of these also became blind. PMID- 2757947 TI - Attempted passive transfer of a serum factor in chronic urticaria from human to monkey. PMID- 2757948 TI - Calmodulin and psoriasis. PMID- 2757949 TI - Dithranol-mediated, dose-dependent priming and activation of luminol-enhanced chemiluminescence responses of human neutrophils in vitro. AB - At concentrations of 10 micrograms/ml and greater, dithranol (anthralin) caused an intense, dose-related activation of luminol-enhanced chemiluminescence (LECL) of human neutrophils and also increased oxygen consumption by these cells. Activation of LECL, which was maximal with 40 micrograms/ml dithranol, occurred promptly, peaked at 3-5 min, then declined. Dithranol-mediated stimulation of LECL was inhibited by catalase and by the protein kinase C inhibitor, H-7. Neutrophils from individuals with chronic granulomatous disease were unresponsive to the pro-oxidative effects of dithranol. At concentrations of 2.5 micrograms/ml and less, dithranol did not directly activate the LECL responses of neutrophils. However pre-treatment of neutrophils with dithranol at concentrations of 0.5-2.5 micrograms/ml increased the LECL-responses of cells subsequently stimulated with calcium ionophore and opsonized zymosan. These observations demonstrate two distinct dose-related, pro-oxidative interactions of dithranol with human neutrophils: low-dose priming and high-dose activation of oxidant generation. Since phagocyte-derived reactive oxidants are immunosuppressive, these pro oxidative interactions of dithranol with human neutrophils may contribute to the pharmacotherapeutic mechanisms of this agent. PMID- 2757950 TI - Autoimmune progesterone dermatitis responding to Tamoxifen. AB - A case of autoimmune progesterone dermatitis is described. Exacerbation occurred premenstrually and after intramuscular and oral challenge with synthetic progesterone. The condition failed to respond to oestrogen, but there has been a marked improvement with the anti-oestrogen drug Tamoxifen. PMID- 2757951 TI - Polymorphonuclear leukocytes in psoriatic smokers. PMID- 2757952 TI - Benign papular acantholytic non-dyskeratotic eruption: a new paraneoplastic syndrome? PMID- 2757953 TI - Differential expression of Langerhans cells in the epidermis of patients with leprosy. AB - Eighteen patients with lepromatous leprosy (LL) showed a significant reduction (P less than 0.001) of Langerhans cells (LC) irrespective of whether the biopsies were obtained from involved (398 +/- 186) or healthy skin (304 +/- 98). The cells showed morphological changes consisting mainly of loss of dendritic processes. Twenty-four controls (age, sex and race matched) had a mean number of LC of 632 +/- 138. In tuberculoid patients (TT) significant differences were observed, depending on the site of biopsy. Nine biopsies from involved skin had 993 +/- 206 LC, whereas 11 from healthy skin had 448 +/- 96 (P less than 0.001). This difference was confirmed in six additional borderline tuberculoid (BT) and TT patients in whom biopsies were simultaneously obtained from involved (973 +/- 179) and uninvolved skin (498 +/- 99). In 10 patients with indeterminate leprosy the LC density did not differ from the control population (630 +/- 261). The expression of LC numbers in BT and TT patients may represent migration of these cells from healthy skin to involved areas or mobilization of a central pool. The low density found in LL patients could interfere with adequate presentation of mycobacterial antigens leading to tolerance. Alternatively the presence of T helper cells in TT infiltrates may produce factors that recruit LC; their absence in LL lesions may account for the decrease in LC expression. PMID- 2757954 TI - Identification of cross-reaction patterns in allergic contact dermatitis from topical corticosteroids. AB - Contact allergy to topical corticosteroids occurs more frequently than previously supposed. Cross-allergic phenomena are common. On the basis of a review of the literature and our own patch test data on 15 patients, we conclude that positive patchtests to corticosteroids occur approximately six to seven times more frequently in well-defined groups of structurally-related substances than between corticosteroids of different groups. An analogous substitution pattern on the steroid D-ring or the carbon side chain (C20, C21) seems to have a significant influence on the association of positive patchtest results. This is not the case for other structural variables, such as the presence of a double bond in the steroid A-ring or fluoride substitutions on the B-ring. The effect of other factors such as concomitant sensitization and steroid metabolism in the skin on the development of a corticosteroid polyallergy are analysed, and the specificity and sensitivity of cross-allergy phenomena are evaluated. These are important in the selection of a topical steroid in the future treatment of a corticosteroid sensitive patient. PMID- 2757955 TI - The effects of vitamin E deficiency on rat skin. AB - The effect of vitamin E deficiency on the levels of lipid peroxide and solubility of collagen was investigated in Wistar rats that were fed a vitamin E deficient diet for 3 and 6 months. The lipid peroxide content in the skin and subcutaneous tissue was markedly increased as compared with that of control rats on a normal diet. The lipid peroxide content in the tissues of rats deficient in vitamin E for 3 months, was greater than that found in those on the diet for 6 months. The effect of UV irradiation on the lipid peroxide content in the skin of control rats was not significant, but there was a marked difference in lipid peroxide content in those animals on a deficient diet. The amount of insoluble collagen in the skin of rats on a vitamin E deficient diet for 6 months was increased and by more than in those animals on the diet for 3 months. The amount of soluble collagen in the rats deficient in vitamin E for 6 months was markedly reduced when compared with those on the diet for 3 months. These results suggest that vitamin E deficiency promotes the peroxidation of lipids and accelerates the cross-linking of collagen in the skin. PMID- 2757956 TI - Interferon response to dipyridamole in lupus erythematosus patients. AB - Studies in patients with autoimmune disorders strongly support a role for interferon (IFN) in the disease process. In the present study we investigated the in vivo production of alpha-IFN in lupus erythematosus patients after stimulation with dipyridamole, recently characterized as an alpha-IFN inducer in mice and humans. Levels of IFN were measured in serum samples from 22 patients with systemic lupus erythematosus (SLE) and 12 patients with discoid lupus erythematosus (DLE) before and 24 h after dipyridamole administration. IFN activity was assayed on human and bovine cells in parallel. Initial serum concentrations of alpha-IFN in SLE patients were markedly elevated. The percentage of DLE positive responders to dipyridamole induction was about twice as high as that found for SLE. Studies of factors responsible for IFN production in lupus erythematosus might result in better understanding of the relationship between DLE and SLE. PMID- 2757957 TI - Topical psoralen photochemotherapy (PUVA) and superficial radiotherapy in the treatment of chronic hand eczema. AB - The therapeutic efficacy of conventional superficial radiotherapy and topical psoralen photochemotherapy (topical PUVA) administered over a 6 week period was compared in a double-blind study of 21 patients with chronic bilateral constitutional hand eczema. One hand was treated with conventional superficial radiotherapy and the other with topical 8-methoxy-psoralen and long-wave ultraviolet light (topical PUVA). Significantly better clinical improvement was seen in superficial radiotherapy treated hands over topical PUVA treated hands after 6 weeks of treatment, but this difference was not maintained at 9 or 18 weeks. There was no significant difference in symptom severity between the two treatments after 6 weeks, but superficial radiotherapy produced significantly more symptomatic improvement at 9 and 18 weeks. Superficial radiotherapy is a less time consuming procedure than topical PUVA and leads to more rapid improvement. PMID- 2757958 TI - Relapse rates in moderately severe chronic psoriasis treated with cyclosporin A. AB - Seventeen patients with chronic psoriasis were given cyclosporin A (CsA) 5 mg/kg per day. Twelve patients cleared within 3 months and their relapse rate, 41% at 6 months, was not significantly different from that previously reported with dithranol or PUVA. This pilot study also suggests that continuing CsA for up to 4 weeks after clinical clearance confers no advantage with regard to relapse. Significant adverse effects on renal function and blood pressure did not occur. PMID- 2757959 TI - Dietary manipulation in childhood atopic dermatitis. AB - The dietary habits of 73 children seen consecutively in a dermatology out-patient department were studied to ascertain the nature and frequency of dietary manipulation and to assess any potential hazards. Although most children had only mild flexural dermatitis, 71% had had significant alterations made to their diet before attendance at hospital. Almost all diets were unsupervised and only six children had seen a dietitian. Over half had been started on diets before any professional advice had been sought. Information on diet had come from media, books or magazines (51%), friends (32%), general practitioners (27%) and district nurses or health visitors (18%). The major dietary alterations included the exclusion of eggs, dairy products and food additives, and the use of soya and goat's milk. Under 10% of patients claimed benefit from these largely unsupervised diets. Harmful practices included the frequent use of unboiled, unpasteurized goat's milk, unmodified goat's milk in a baby of 4 months and the use of severely restricted diets. Three children (6%) in the diet group had been on diets which were considered by a hospital dietitian to be particularly dangerous. However, there was no evidence of growth retardation, failure to thrive or specific deficiency syndromes in the group we studied. Uncontrolled, unsupervised and often prolonged dietary alterations are commonplace in children with atopic dermatitis. This is a potentially serious health problem. PMID- 2757960 TI - Prognostic factors in chronic lymphocytic leukaemia: the importance of age, sex and response to treatment in survival. A report from the MRC CLL 1 trial. MRC Working Party on Leukaemia in Adults. AB - We report the analysis of prognostic factors in a cohort of 660 patients entered in the first Medical Research Council trial in chronic lymphocytic leukaemia (CLL) between 1978 and 1984. The majority (94%) of patients were aged 50 or over and the number of men (M) was almost twice that of women (F) with an M:F ratio of 1.8:1. The M:F ratio was lower, 1.5:1, in patients aged 70 or over. Stage A CLL was the most common, and stage C the least common, among women of all ages, in contrast to men for whom stage A only predominated in the older age group. As the majority of CLL patients are elderly we have examined the causes of death in great detail. 29% of deaths were unrelated to CLL, mainly other cancers (12%) and cardiovascular complications (16%). The majority of deaths in patients presenting with stages B and C were from CLL-related causes, whilst almost half of the deaths in patients presenting with stage A were not obviously related to CLL. Univariate analysis disclosed that the A, B, C staging system was the most important factor considered; stratified and multivariate analysis showed that age and response to treatment were the main prognostic factors after stage. Women always fared better than men and this was independent of stage and age. This and other features documented in the trial suggest a major biological difference between the sexes which has not been widely recognized. The significant influence of treatment response on patients' survival suggests that the search for better treatments in CLL may be rewarding. The improved median survival of stage C patients recorded in this trial, 41 months, compares favourably with previous reports and may have resulted from better treatment. PMID- 2757961 TI - Investigation of the CD10 (cALLA) negative acute lymphoblastic leukaemia: further description of a group with a poor prognosis. French Groupe d'Etude Immunologique des Leucemies. AB - The absence of CD10 (cALLA) in non-T non-B acute lymphoblastic leukaemia (ALL) is usually considered to be of adverse prognostic significance. From a large multicentre series of phenotyped ALL, we have identified a group of 23 non-T non B ALL where blast cells were CD10 negative and CD19 positive. Class II antigens were present in 80% and C19 in 70%. Eight patients had successful karyotype analysis at diagnosis, and an additional patient at first relapse. Seven of these karyotypes showed a (4;11) (q21;q23) translocation. Most of the patients (70%) were young females, and they often presented with organomegaly. Six patients were less than 1 year old. The white cell count was over 100 x 10(9)/l in 48% of the cases. The FAB type was L2 in 56% of the patients. The most striking features were the poor response to therapy and survival. Six patients never attained complete remission and nine patients relapsed, most of them during the first year after diagnosis. Allogeneic bone marrow transplantation was performed in three children, of whom two are still alive 2 years after diagnosis. This study emphasizes the prognostic value of immuno-phenotypic and karyotypic investigations of ALL. PMID- 2757962 TI - Surface marker expression in adult acute myeloid leukaemia: correlations with initial characteristics, morphology and response to therapy. AB - The clinical significance of surface markers was investigated in 145 cases of acute myeloid (AML) or undifferentiated leukaemia (AUL), using a panel of six monoclonal antibodies directed to NHL-30.5 antigen (expressed on poorly differentiated myeloid cells), CD13, CD14, CD15, CD33 and CD34 antigens. Expression of CD14 was correlated with higher leucocyte count, higher serum lactate dehydrogenase level and presentation with extramedullary disease. There was no strict correlation with the French-American-British classification. However, the expression of CD14 was associated with monocytic subtypes. CD15 was mainly expressed in M2 and M3 subtypes, and NHL-30.5 and CD34 antigens in AUL and M1 leukaemias. All patients were treated with the same intensive induction treatment. Staining by three antibodies had a prognostic value. The complete remission (CR) rates were 38% (26/68) in NHL-30.5-positive versus 75% (62/77) in NHL-30.5-negative cases (P less than 10(-5), 50% (37/74) in CD34-positive versus 72% (51/71) in CD34-negative cases (P = 0.007) and 70% (77/110) in CD15-positive versus 31% (11/35) in CD15-negative cases (P less than 10(-4). Expression of NHL 30.5 and CD34 antigen was associated with shorter survival (P less than 10(-3) and P less than 10(-2) respectively), whereas survival was longer in CD15 positive cases (P less than 10(-3). In multivariate analysis, expression of NHL 30.5 antigen, absence of CD15, and high LDH level were associated with poor survival. CR duration was not influenced by any of the factors studied, including antigen expression. These results suggest that leukaemias with less differentiated phenotype have a lower response rate to induction treatment. PMID- 2757963 TI - Interferon alpha-2b as treatment for Philadelphia-negative chronic myeloproliferative disorders with excessive thrombocytosis. AB - We treated 32 patients with Ph1-negative chronic myeloproliferative disorders (CMD) with excessive thrombocytosis with Interferon alpha-2b (IFN alpha-2b): 26 had essential thrombocythaemia, ET (18 previously untreated, eight pretreated); one thrombocythaemia after treatment for Hodgkin's disease (HD); two thrombocythaemia associated with non-Hodgkin's lymphoma (NHL); three stage II idiopathic myelofibrosis (IM). IFN was given at daily doses of 1-4 x 10(6) IU. Twenty-seven patients (84%) responded, 17 (53%) achieved complete haematologic response after a median time of 12 weeks, and 10 (31%) partial haematologic response. Median platelet levels declined in complete haematologic response patients from 1,190 to 335 x 10(9)/l. Normalization of megakaryocyte (MK) levels was observed in 8/17 complete haematologic response patients treated for 9-12 months, with decreased bone marrow (BM) cellularity. Side effects requiring dose reduction or discontinuation of treatment occurred in 28% of cases with IFN doses of 2 or 4 x 10(6) IU. After 1 year of continuous IFN treatment, responses were maintained with conventional chemotherapy or low-dose IFN. This study demonstrates that IFN has definite therapeutic activity in CMD with excessive thrombocytosis. This biological agent, either alone or in combination with other antineoplastic treatment, may represent a new therapeutic approach for these disorders. PMID- 2757964 TI - 18q21 rearrangement in diffuse large cell lymphoma: incidence and clinical significance. AB - Cytogenetic, molecular genetic and clinical information was collected for 102 cases of diffuse large cell lymphoma (DLCL) ascertained in a diagnostic laboratory over a 3-year period. Nineteen cases showed evidence of either a t(14;18) or a rearrangement of one of three genomic probes for breakpoints at 18q21. Clinical and histologic evidence of transformation from follicular lymphoma or chronic lymphocytic leukaemia was available in six cases. Except for age, prognostic clinical variables (LDH, stage, extranodal involvement) were similar between the 18q21 rearranged patients and DLCL patients without 18q21 rearrangement. At a median follow-up in excess of 2 years for both groups, there was no difference in overall survival between the 18q21 rearranged group compared to DLCL patients lacking this genetic abnormality. The median disease-free survival for the 18q21 rearranged group, however, was significantly shorter and survival in partial remission longer. The propensity for extended survival of the 18q21 rearranged DLCL patients with residual or recurrent disease resembled the clinical behaviour of nodular lymphoma patients with t(14;18). These results suggest that cytogenic or molecular genetic identification of a chromosome 18q21 translocation may be of prognostic significance in the analysis of treatment protocols for patients with DLCL. PMID- 2757965 TI - Immunochemical characterization of the new platelet alloantigen system Bra/Brb. AB - We report the immunochemical characterization of the new platelet-specific alloantigens Bra and Brb. Bra antibodies were from mothers of children with neonatal alloimmune thrombocytopenia (NAIT), and anti-Brb was found in the serum of a polytransfused patient. By radioimmunoprecipitation, anti-Bra and anti-Brb precipitated two proteins with apparent relative molecular masses in sodium dodecyl sulphate-polyacrylamide gel electrophoresis of 155,000 and 130,000 under non-reduced conditions, and of 165,000 and 148,000 under reduced conditions. In two-dimensional polyacrylamide gel electrophoresis, the two bands moved with isoelectric points ranging from 5.2 to 5.4 and from 4.5 to 4.7, respectively. These features fulfil previously defined criteria for platelet membrane glycoproteins (GP) Ia and IIa. The results were supported by data obtained by an assay employing monoclonal antibody (mab)-specific immobilization of platelet antigens (MAIPA). By this technique, Bra and Brb antigens could be immobilized by mabs specific for the GP Ia/IIa complex (mab Gi 14) or a mab specific for the very late antigen-2 (mab 12 F1), but not by a mab specific for GP IIb/IIIa complex (mab Gi3). Furthermore, platelets from a thrombasthenic patient with complete absence of GP IIb/IIIa expressed the Brb antigen normally as shown in MAIPA; this antigen could be immunoprecipitated with anti-Brb and was identical to that of normal platelets. This confirms that the antigens of the Br system are not associated with the GP IIb/IIIa complex. By direct binding studies using mabs Gi3 and Gi14, we calculated that 51,500 +/- 3900 molecules of anti-GP IIb/IIIa and 6,470 +/- 500 molecules of anti-GP Ia/IIa were bound per platelet at saturation. Our results provide evidence for the first platelet-specific alloantigen system residing on the GP Ia. The difficulty in detecting anti-Bra and anti-Brb by direct binding assays may be related to the small number of GP Ia/IIa complexes on platelets. PMID- 2757966 TI - Factor IX Kawachinagano: impaired function of the Gla-domain caused by attached propeptide region due to substitution of arginine by glutamine at position -4. AB - Factor IX Kawachinagano (KWC) is a mutant factor IX protein initially recognized in a patient with severe haemophilia B, who had 46% of normal factor IX antigen and no detectable clotting activity. Previous studies indicated that factor IX KWC was not activated by factor XIa in the presence of Ca ions. In the present study, we purified and analysed factor IX KWC at a structural level in an attempt to clarify the nature of the impaired reaction with factor XIa. Kinetic studies showed that activation of factor IX KWC by factor X activator from Russell's viper venom (RVV-X) was normal, whereas activation by factor XIa was defective. Amino acid sequence analysis of tryptic peptides and direct analysis of the NH2 terminal sequence of factor IX KWC demonstrated that this mutant factor IX retained the propeptide region of 18 amino acids due to a substitution of arginine-(-4) by glutamine. These data suggested that the Gla-domain of factor IX KWC was dysfunctional, although the total gamma-Gla content, measured by alkaline hydrolysis, was normal. We assumed that this attached propeptide region of the molecule directly interferes with the adjacent NH2-terminus and prevents the metal-induced conformational changes which are essential for biological activity of normal factor IX. PMID- 2757967 TI - Erythrocyte heterogeneity in sickle cell disease: effect of deoxygenation on intracellular polymer formation and rheology of sub-populations. AB - Erythrocytes from 12 patients with homozygous sickle cell disease in the steady state were fractionated on a Percoll-Stractan density gradient. Erythrocyte deformability was measured by initial-flow-rate filtration through pores of 5 microns diameter and erythrocyte polymer content was calculated as a function of oxygen saturation. Density fractionated sub-populations of sickle cells showed distinct rheological characteristics, the filterability of dense cells being impaired by minimal oxygen desaturation with the apparent formation of little or no intracellular polymer. Lighter cell fractions required a greater degree of deoxygenation and polymer formation to impair deformability, although this occurred prior to morphological sickling. Dense cells therefore exert a disproportionate effect on blood rheology in sickle cell disease and are likely to have an adverse rheological effect in vivo at arterial oxygen tension. PMID- 2757968 TI - Alteration of the mechanical properties of sickle cells by repetitive deoxygenation: role of calcium and the effects of calcium blockers. AB - The formation of dense, poorly deformable sickle cells was studied by subjecting pre-separated, less dense cells to repeated deoxygenation and reoxygenation for 15 h. In the presence of Ca (2 mmol/l), this process caused the number of irreversible sickled cells to increase five-fold, mean cell haemoglobin concentration to increase by 13% and cellular potassium to decrease by 22%. Also, red cell filterability through 5 microns filter pores was greatly worsened. These effects decreased but were not totally abolished when the extracellular Ca concentration was lowered to zero or 0.01 mmol/l. If a high K medium was used (135 mmol/l), cell swelling rather than shrinkage occurred. Swelling also occurred if ouabain was added to the incubation. The Ca-channel blockers nitrendipine and nisoldipine had different effects. Nitrendipine, in the range 10(-7) - 10(-5) mol/l, was partially protective against all the induced changes, but nisoldipine was not protective at 10(-8) or 10(-6) mol/l. Thus, deterioration in the properties of sickle cells appears to be linked to Ca-dependent potassium loss during repeated sickling and is inhibited by nitrendipine. PMID- 2757969 TI - Relationship between the nicotinamide adenine dinucleotide redox potential and the 2,3-diphosphoglycerate content in the erythrocyte in sickle cell disease. AB - The percentage of nicotinamide adenine dinucleotide (NAD) in the oxidized form [NAD+/(NAD+ and NADH); i.e. the NAD+/NADT ratio] is increased in the red cell (RBC) in sickle cell disease. We tested the hypothesis that the increased NAD+/NADT ratio was a determinant of the increased 2,3-diphosphoglycerate (DPG) content of the SCD RBC. Using normal subjects and individuals with sickle cell disease or autoimmune haemolytic anaemia (AIHA), we observed an inverse relationship between the packed cell volume (PCV) and the RBC DPG concentration (r = -0.69) and a direct relationship between the RBC NAD+/NADT ratio and the DPG concentration (r = 0.74). When the effect of the PCV on DPG was removed using analysis of covariance [DPGady(PCV)], the NAD+/NADT ratio had a significant relationship with the DPGadj(PCV) (r = 0.50, P less than 0.001). In in vitro incubation studies, increasing the NAD+/NADT ratio significantly increased the DPG content of both normal and AIHA RBC. Conversely, decreasing the NAD+/NADT ratio decreased the DPG content of normal, AIHA and SCD RBC. Thus, the increased DPG content in the SCD RBC appears to be due, in part, to the increased NAD+/NADT ratio and is not purely a physiologic response to decreased oxygen carrying capacity. PMID- 2757970 TI - Haemolytic anaemia in analpha-lipoproteinaemia (Tangier disease): morphological, biochemical, and biophysical properties of the red blood cell. AB - A patient with familial analpha-lipoproteinaemia (Tangier disease) was found to have stomatocytosis and haemolytic anaemia. The analysis of the red cell membrane constituents revealed a low cholesterol content (90 nmol/ml red cells, control 130 nmol/ml red cells), a decreased cholesterol/phospholipid ratio (0.54, control 0.78), high phosphatidylcholine (41.5%, control 30.6%) and low sphingomyelin (18.8%, control 27.6%). The electrophoretic membrane protein pattern was normal. Osmotic gradient ektacytometry and osmotic resistance showed a decreased surface/volume ratio, which caused an increased filtration resistance in 3 microns pores. The elasticity of the membrane was unchanged. Functional membrane properties were altered: the anion exchange rate was increased, whereas alkali cation fluxes were normal. The capacity to release vesicles was reduced. This case represented a new type of stomatocytosis. It contributes to the understanding of the role of cholesterol and phospholipids in the red cell membrane and biomembranes in general. PMID- 2757971 TI - Secondary erythrocytosis and sarcoidosis. PMID- 2757973 TI - B-cell acute lymphoblastic leukaemia (B-ALL) heterogeneity. PMID- 2757974 TI - Three cases of myelodysplastic-myeloproliferative disorder with abnormal chromatin clumping in granulocytes. PMID- 2757972 TI - A congenital dyserythropoietic anaemia variant presenting as hydrops fetalis. PMID- 2757975 TI - Prognostic value of the duration of post-induction neutropenia in acute myelogenous leukaemia. PMID- 2757976 TI - The expression of the transferrin-receptor parallels the state of proliferation in HL-60 cells. PMID- 2757977 TI - The obstetric vacuum extractor is the instrument of first choice for operative vaginal delivery. PMID- 2757978 TI - Prevention of ovarian cancer: a survey of the practice of prophylactic oophorectomy by fellows and members of the Royal College of Obstetricians and Gynaecologists. AB - A questionnaire designed to investigate attitudes to prophylactic oophorectomy was sent to 2817 fellows and members of the Royal college of Obstetricians and Gynaecologists. A total of 1142 replies was received from those who performed regular sessions of gynaecological surgery. The number of respondents who said they would usually remove apparently normal ovaries at the time of abdominal hysterectomy from premenopausal women in age groups 35-39, 40-44, 45-49 and over 49 years was 4 (0.4%), 27 (2%), 234 (20%) and 585 (51%) respectively, and from postmenopausal women 974 (85%). The majority of respondents said that (i) they would prescribe hormone replacement therapy in oophorectomized premenopausal women (82%); (ii) they did not consider unilateral oophorectomy to have a role in prevention of ovarian cancer (84%); and (iii) they routinely discussed the question of prophylactic oophorectomy with their patients before operation (65%). Only 128 (11%) of the respondents believed that greater than or equal to 10% of ovarian cancers in the UK could be prevented by prophylactic oophorectomy at the time of operation for benign disease, and 505 (44%) would perform prophylactic oophorectomy as a primary surgical procedure in women who had a strong family history of ovarian cancer. PMID- 2757979 TI - Survival of younger cervical carcinoma patients treated by radical radiotherapy in the west of Scotland 1964-1984. AB - Between 1964 and 1984, 2011 patients in the West of Scotland were treated by radical radiotherapy for carcinoma of cervix. In keeping with the rise in incidence amongst younger patients nationally, the number of women aged less than 35 years seen during the 20-year period has doubled. Younger women (aged less than 35 or less than 45) have a better prognosis mainly because more present with earlier disease. Stage for stage there has been no change in survival of women of all ages treated by identical radiotherapy during this period. The rise in mortality of younger patients from carcinoma of cervix may be due to the increased incidence of the condition rather than a more virulent form of the disease. PMID- 2757980 TI - Intraperitoneal radioimmunotherapy for ovarian cancer. AB - Twenty-eight patients with assessable residual ovarian cancer after cytoreductive surgery and chemotherapy received intraperitoneal I-131 labelled monoclonal antibodies. There was no response in eight patients with tumour nodules greater than 2 cm, a partial response in two of the 15 patients with tumour nodules less than 2 cm, and a complete response in three of the other five patients with positive peritoneal washings. A further six patients received Y-90 labelled monoclonal antibodies for residual ovarian cancer. There was no response in one patient with nodules greater than 2 cm, and a partial response in one of the other five patients with tumour nodules less than 2 cm. The non-specific radiation dose in the peritoneal cavity from the infused isotope was measured by lithium fluoride thermoluminescent dosimetry (TLD). The radiation dose received by the peritoneal serosa was less than 500 cGy and was not sufficient to account for the observed tumour response. Significant bone marrow suppression was observed with I-131 activities greater than 120 mCi and with Y-90 activities greater than 13 mCi. The haemopoietic bone marrow is the dose-limiting organ in patients receiving radioimmunotherapy. PMID- 2757981 TI - Audit of medical response to antenatal booking history. AB - A retrospective review of 600 obstetric case-notes, covering the years 1978 to 1984, was performed independently by two assessors. The medical response to 22 risk factors, recorded at booking by the midwife, was assessed. The medical staff recognized 69% of the risk factors recorded at booking and responded appropriately to 82% of these. The standard of care improved over the period studied. The accuracy of our conclusions was greatly enhanced by carrying out each assessment in duplicate with arbitration by a third assessor when necessary, and it is proposed that all audits of medical practice should themselves be audited in this way. PMID- 2757982 TI - Reactive fetal heart rate response to vibroacoustic stimulation in fetuses with low scalp blood pH. AB - Fetal vibroacoustic stimulation in fetuses with suspicious or ominous fetal heart rate traces in labour was followed by acid-base balance determination on fetal scalp blood within 30 min of the test. The mean fetal scalp blood pH values were significantly higher in fetuses that showed reactive responses with fetal heart rate acceleration compared with those who had no response or responded with a deceleration to the vibroacoustic stimulation (pH 7.30 and 7.22 respectively). However, acidotic scalp blood pH values (7.16 and 7.18) were found in two fetuses which had shown reactive responses both to vibroacoustic stimulation and pain stimuli with scalp blood sampling. PMID- 2757983 TI - Maternal perception of sound-provoked fetal movements in low-risk pregnancies during the third trimester. AB - Maternal perception of fetal movements after vibroacoustic stimulation (Servox) was studied longitudinally on 456 occasions in 90 low-risk pregnancies after 28 weeks gestation until delivery. A positive response to sound stimulation, recorded as a fetal movement by the mother, occurred on 444 (97%) occasions. Of the 12 negative responses eight occurred before 33 weeks showing a positive correlation with decreasing maturity. All the pregnancies had good outcomes. The low rate of false-positive tests (3%) adds support to the suggestion that this rapid test could play a role in the assessment of fetal well-being. PMID- 2757984 TI - Are leukotrienes involved in human uterine contractility? AB - The effects of leukotrienes (LT) on the contractility of human and rat myometrial strips in vitro were compared with the effects of prostaglandins (PGs) and oxytocin. Preparations of human myometrial membranes were investigated for the presence and characteristics of LTC4 receptors. Neither the peptido-leukotrienes (LTC4, LTD4, LTE4) nor LTB4 had any consistent effect, stimulatory or inhibitory, on human pregnant or non-pregnant myometrium, at doses up to 1.25 microM; nor did they have any effect in rat non-pregnant myometrium. As expected, PGE2, PGF2 alpha (0.3 microM) and oxytocin (5 nM) stimulated human pregnant myometrium. PGF2 alpha stimulated and PGE2 inhibited human non-pregnant myometrium but oxytocin had no effect; all three compounds stimulated rat non-pregnant myometrium. The binding of 3H-LTC4 to human myometrium was specific (LTC4 greater than LTD4 much greater than LTE4, LTB4, PGE2, PGF2 alpha, arachidonic acid) but of low affinity compared with the binding of 3H-PGE2 to the same membrane preparations. These data support the view that leukotrienes have little direct influence on myometrial contractility. PMID- 2757985 TI - Measuring low-grade albuminuria in pregnancy. PMID- 2757986 TI - Successful pregnancy after selective embolization of a post-molar vascular malformation. PMID- 2757987 TI - Malignant lymphoma presenting as initial symptom in the uterus. PMID- 2757988 TI - Simultaneous spontaneous and primary surgical repair of eyelids. AB - Fifteen patients with suspected malignant lesions of the lower eyelids or inner canthal region, needing large excisions, were managed as day cases with spontaneous repair and simultaneous subtotal primary surgical reconstruction under local anaesthesia. For lesions confined to the lower eyelid, only those patients requiring full-thickness margin-inclusive (FTMI) excisions of more than half the horizontal extent of the eyelid are included in this study-the largest excision being 21 x 6 mm. For malignant lesions of the inner canthus, only those patients needing moderate to large excision of inner canthal skin and orbicularis with simultaneous FTMI excision of the medial one-third (8 x 5 mm) of the upper as well as the lower eyelid are included. The 16th patient had traumatic loss of inner canthal tissue. The final cosmetic and functional results in all 16 patients were satisfactory and comparable with the results of competent and in toto primary surgical reconstructions. For large excisions at the inner canthus spontaneous with partial primary surgical repair allows the use of a less extensive and less elaborate surgical procedure that is within the capabilities of most ophthalmic surgeons. PMID- 2757989 TI - The Mersilene mesh sling--a new concept in ptosis surgery. AB - The use of a Mersilene mesh sling in brow suspension ptosis surgery is presented. Seventeen cases of severe blepharoptosis have been treated by means of this sling with favourable results. Materials used in brow suspension procedures are categorised and discussed, and it is concluded that the Mersilene sling is an alternative to those currently available for the management of severe blepharoptosis requiring brow suspension surgery. PMID- 2757991 TI - Retinal sensitivity in hereditary retinal degeneration in Abyssinian cats: electrophysiological similarities between man and cat. AB - The functional and electrophysiological similarities in the changes in the electroretinogram (ERG) of man and cat affected by hereditary retinal degenerative disease were studied. The results of a series of log intensity amplitude studies in a group of young affected Abyssinian cats were fitted to the Naka-Rushton relationship by means of a mathematical package on the University of London mainframe. The analysis showed that the amplitude of the maximum dark adapted b-wave was significantly reduced by the end of the period studied but that the value of k, a variable inversely equivalent to retinal sensitivity, was only slightly reduced by the retinal degenerative process. The electrophysiological findings thus are similar to those found in cases of human diffuse dominantly inherited retinitis pigmentosa. PMID- 2757990 TI - Separable evoked retinal and cortical potentials from each major visual pathway: preliminary results. AB - Single cell experiments in primates show that there are two major parallel pathways named after the lamination in the lateral geniculate nucleus. Each of these systems can be preferentially excited by appropriate stimuli. Here we report that in man the polarity of the evoked potentials both in retina and in cortex depends on which of these pathways is stimulated. The identification of the resulting waveforms is thereby simplified--a matter of practical importance. The fact that at retina and cortex there are characteristic potentials may reflect the different cell biology of the two pathways. PMID- 2757992 TI - Dynamic nature of posterior subcapsular cataract. AB - Posterior subcapsular cataracts were studied in 10 patients (19 eyes) and were photographed at four to 12 weeks intervals by the Oxford Retroillumination Camera. Changes in the fine structure of PSC may occur in as short a time as four weeks. Posterior subcapsular cataracts are shown to be in a state of flux and are not, as might be assumed, slowly but relentlessly progressive. This could imply the existence of a repair mechanism in the lens. PMID- 2757993 TI - Presumed ocular histoplasmosis syndrome and linear streak lesions. AB - Five cases of subretinal neovascular membranes in the macula associated with punched out chorioretinal scars and linear streaks were seen in five Dutch patients. Clinically the fundus lesions are consistent with those of presumed ocular histoplasmosis syndrome (POHS) seen in the United States of America. Cutaneous serological testing for histoplasmin reactivity was negative in the three patients tested. Of special interest is the presence of linear streaks in association with POHS. They have not been previously described in patients from Europe with this syndrome. PMID- 2757994 TI - Trachoma and blindness in the Nile Delta: current patterns and projections for the future in the rural Egyptian population. AB - A population based survey of trachoma and blindness was conducted in a rural Nile Delta hamlet. Trachoma remains hyperendemic in this region. Active trachoma was common among preschool children; over half had moderate to severe disease. Of residents 25 years old 90% had substantial conjunctival scarring. Severe conjunctival scarring was commoner among women (84%) than men (58%), and three quarters of older women had trichiasis/entropion compared with 57% of older men. Males and females had equivalent age specific rates of inflammatory disease. Blindness was associated with old age; 17% of residents aged 50 and over were blind. Estimates of blindness based on this survey and other surveys in Egypt indicate that blindness is still a serious public health problem in rural Egypt. The number of blind persons in Egypt will increase from an estimated 420,000 in 1980 to 868,000 by the year 2020. The current crude blindness rate of 1.8% is expected to increase to 2.3% in the year 2000 and to 3.2% in 2020. PMID- 2757995 TI - Magnetic resonance imaging of intraocular foreign bodies. AB - Magnetic resonance imaging was performed with a low field strength scanner (0.08 tesla) on 15 bovine eyes into which had been inserted various magnetic and non magnetic foreign bodies. The precise location of the foreign bodies was determined by dissection. Magnetic resonance imaging was accurate in locating 11 of the 13 non-magnetic foreign bodies in this study. In addition a further five bovine eyes containing 10- to 20-mm long steel needles were scanned and dissected. No ocular damage attributable to movement of the foreign bodies could be seen. PMID- 2757996 TI - Retinal detachment in Axenfeld-Rieger syndrome. AB - Three cases of the association between the Axenfeld-Rieger syndrome and retinal detachment in one family are described. Serious damage to the posterior segment of the eye in the Axenfeld-Rieger syndrome has not previously been reported. PMID- 2757997 TI - Effect of cataract extraction on the pupil response to mydriatics. AB - Pupil diameters in the dark, in the light, and after mydriasis with tropicamide+ phenylephrine have been measured in 25 patients before and six months after cataract surgery. The aphakic pupil showed reduced mobility as evidenced by a smaller diameter in the and a larger one in the light. In patients who had intracapsular extraction or extracapsular extraction with intraocular lens implantation the pupils dilated less well than preoperatively. The difference in response to mydriatics is of practical importance in the assessment and treatment of peripheral retinal disorders in aphakic and pseudophakic eyes. PMID- 2757998 TI - A film video processor for the viewing of fluorescein angiograms. AB - A new, commercially available, and inexpensive film video processor facilitates the viewing of fluorescein angiograms on video monitors. The negative film is inserted into a film carrier, read by a charge-coupled device solid state pickup device and presented as a negative or positive image on a black-and-white monitor with the help of a negative/positive conversion feature. Details of the angiogram are studied by zooming into any part of the image, which magnifies the image up to six times. Contrast and brightness adjustment on the video monitor allows examination of under- or overexposed angiograms. PMID- 2757999 TI - Validation of a photographic method of measuring corneal diameter. AB - A photographic method for measuring corneal diameter using the Medical-Nikkor f200 mm lens is described. Measurements were compared with those obtained by calipers (46 eyes of 25 patients) and by placing a ruler either near the eye (123 eyes of 64 patients) or on the nose (98 eyes of 55 patients). Over all we found good correlation between photographic and caliper measurements (r = 0.94). No significant correlation was found between photographic measurements and estimates made with the ruler either near the eye or on the nose (r = 0.65 and 0.31 respectively). Modifications to our system are suggested which may provide an accurate, simple, non-invasive method of measuring corneal diameter in ophthalmic clinics. PMID- 2758000 TI - Ceftriaxone diffusion from blood to aqueous humour in man. AB - Ceftriaxone penetrates into the aqueous humour in man. The interaction of indomethacin on the disposition of ceftriaxone appeared to be time-dependent. Indomethacin delayed ceftriaxone penetration into, but enhanced its persistence in, the aqueous humour, permitting a period of antibioprophylaxis covering the required time for surgical treatment. PMID- 2758001 TI - Eyelid swelling and erythema as the only signs of subperiosteal abscess. AB - On clinical grounds it is usually easy to distinguish between preseptal cellulitis, a cutaneous infection not threatening to vision, and orbital cellulitis, a potentially vision threatening infection of the orbital tissues generally arising from paranasal sinusitis. We recently cared for two patients with a clinical diagnosis of preseptal cellulitis who had CT scan evidence of subperiosteal abscess. Antibiotic therapy alone resulted in clinical resolution in each case. PMID- 2758002 TI - Risk factors for cataract. PMID- 2758003 TI - Perfluoropropane. PMID- 2758004 TI - Treatment of retinal embolus by photocoagulation. PMID- 2758005 TI - Energy balance in rats given chronic hormone treatment. 2. Effects of corticosterone. AB - 1. Sprague-Dawley rats were given corticosterone for 4 to 14 d either by subcutaneous injection (50 mg/kg body-weight per d) or as a higher dose in the diet (1 g/kg diet). Energy balance was calculated using the comparative carcass technique. 2. Corticosterone significantly suppressed growth rate by at least 50% (P less than 0.001 in all experiments). The reduction in growth was more marked in males than in females. 3. Hormone treatment significantly reduced metabolizable intake (kJ/d) in males but not in females. Expressed relative to either metabolic body size (kg body-weight0.75) or fat-free mass, metabolizable intake tended to be increased in the treated groups. 4. Energy expenditure, calculated as the difference between metabolizable intake and gain and expressed as kJ/d, did not differ between treated and control rats. Relative to either metabolic body size or fat-free mass, expenditure was consistently increased in treated rats. This change was statistically significant in five of the eight comparisons. 5. The corticosterone-treated rat is characterized by high energy intake and expenditure relative to its body size and growth rate. Alterations in the relative sizes of different lean tissues may contribute to these changes. PMID- 2758007 TI - Milk-substitutes comparable to rat's milk; their preparation, composition and impact on development and metabolism in the artificially reared rat. AB - 1. Procedures are described to prepare nutritionally adequate rat milk substitutes by modifying commercially available processed cow's milk, rich in carbohydrate and low in protein and fat compared with rat's milk. 2. Premilk formulas, prepared as intermediates in the preparation of rat milk-substitutes, are rich in protein but low in their concentration of fat, carbohydrate, and minerals when compared with rat's milk. 3. Premilks were supplemented with lactose, vitamins, minerals, fat as oil mixtures, certain amino acids and other constituents to yield rat milk-substitutes which resemble the known composition of rat's milk in their properties and composition. 4. Detailed analyses of the milk-substitutes show them to be comparable to rat's milk in energy content, pH, osmolarity, the concentration of the macronutrients, fat, protein and carbohydrate, and the major minerals. 5. Rat pups were artificially reared from postnatal day 4 or 5 until days 16-18 by fitting them with gastric cannulas through which the milk-substitutes could be infused automatically. 6. The nutritional impact of the milk-substitutes was assessed by a comparison of growth and metabolic characteristics for artificially reared rats with age-matched sucking rats reared by their mother. 7. Indices which were taken to be appropriate included (a) body-weight gain; (b) the concentration in blood of protein, amino acids, ketone bodies, carnitine, glucose, galactose, lactate, insulin, and the electrolytes calcium, sodium, potassium and chloride; (c) the turnover of glucose and 3-hydroxybutyrate; (d) the concentration in brain of protein, cholesterol, cerebroside sulphate and the activities of the enzymes pyruvate dehydrogenase (EC 1.2.4.1), 3-oxo-acid-CoA transferase (EC 2.8.3.5) and acetoacetyl-CoA ligase (EC 6.2.1.16). 8. The studies suggest that milk substitutes approximating to rat's milk in composition promote acceptable metabolism in the artificially reared rat pup. PMID- 2758006 TI - Plasma proteins in growing analbuminaemic rats fed on a diet of low-protein content. AB - 1. Analbuminaemic and Sprague-Dawley (control) rats were fed on low- (60 g/kg) protein and control (200 g protein/kg) diets ad lib. from weaning. Males and females were studied separately. Body-weight and plasma protein concentrations were determined at 10 d intervals from 25 to 75 d of age. Electrophoresis of plasma proteins was performed in samples from day 75. Extracellular fluid volume was measured at 10 d intervals from day 45 onwards. Colloid osmotic pressure was measured in plasma and interstitial fluid (wick technique) at the start and end of the trial. 2. Body-weight increased much less on the low-protein diet than on the normal diet in both strains and sexes. The growth retardation was slightly more pronounced in the male analbuminaemic rats than in the male Sprague-Dawley controls. 3. Plasma protein concentration increased during normal growth in all groups, particularly in the female analbuminaemic rats. This increase was reduced by the 60 g protein/kg diet in all groups, with the exception of the male analbuminaemic rats. 4. Differences in plasma colloid osmotic pressure were similar to those seen in plasma protein concentration. Interstitial colloid osmotic pressure was higher in the control rats than in the analbuminaemic ones. The interstitial colloid osmotic pressure increased during growth in the control but not in the analbuminaemic rats. The difference in interstitial colloid osmotic pressure between the strains was maintained during low-protein intake, but at a lower level than during normal protein intake. 5. Subtracting interstitial from plasma colloid osmotic pressure, resulted in a rather similar transcapillary oncotic gradient in the various groups at 75 d, both on the control protein diet (11-14 mmHg), and on the low-protein diet (9-11 mmHg). 6. All protein fractions were reduced to a similar extent by the low-protein diet in the control rats, whereas in the analbuminaemic rats protein fractions produced in the liver were more severely depressed. 7. Extracellular fluid volume as a percentage of body-weight was similar in all groups, and decreased with increasing age. 8. In conclusion, the analbuminaemic rats were able to maintain the transcapillary oncotic gradient on both diets by reducing the interstitial colloid osmotic pressure. Oedema was not observed. 9. Despite the absence of albumin, the protein-malnourished analbuminaemic rat is no more susceptible to hypoproteinaemia and oedema than its normal counterpart. PMID- 2758008 TI - Effects of dietary trans-fatty acids on reproductive performance of Wistar rats. AB - 1. Wistar rats were fed for three successive generations on a semi-purified diet, in which the fat was provided by butter, sunflower oil, rapeseed oil or hydrogenated vegetable fat, differing in the content of cis,cis-18:2 and trans 18:1 fatty acids. Effects of these fats on the composition of adipose tissue and reproductive performance were studied. Fatty acids were analysed using high performance liquid chromatography. 2. The fatty acid pattern of adipose tissue was closely related to dietary fat composition and, established in the first generation, did not change significantly in successive generations of rats. 3. Hydrogenated fat adversely affected litter size, sperm morphology and regularity of oestrous cycle, and prolonged the period of gestation in experimental animals. Differences observed between the generations were not significant. 4. Hydrogenated fat decreased the level of serum testosterone in males, but the differences observed in levels of serum progesterone in females were not apparently related to the dietary trans-fatty acids. PMID- 2758009 TI - Interaction of dietary protein, cholesterol and age on lipid metabolism of the rat. AB - 1. Male rats at 1 (young) and 9 months (adult) of age were fed on purified diets, supplemented with or without cholesterol, containing 200 g protein/kg (casein (CAS), whey protein (WHY) or soya-bean protein (SOY] for 4 weeks. 2. SOY exerted a hypocholesterolaemic effect in young rats regardless of dietary cholesterol, whereas in adult rats it was observed only when a cholesterol-enriched diet was given. WHY was also hypocholesterolaemic in rats of both ages given cholesterol. SOY tended to reduce the liver cholesterol both in young and adult rats. 3. The liver hydroxymethylglutaryl-CoA reductase (NADPH) (EC 1.1.1.34) activity tended to be lower in the vegetable-protein groups than in the animal-protein groups in young rats, but the age-related reduction was observed only in the latter groups. 4. There was no significant age-related difference in the activity of liver cholesterol 7 alpha-monooxygenase (EC 1.14.13.17) in response to diets. However, when cholesterol was given, activity tended to decrease with age. Rats given SOY excreted more faecal steroids than those given casein, particularly adult rats. 5. The fatty acid profile of phosphatidylcholine and the delta 6-desaturase activity of liver microsomes indicated the reduced desaturation of linoleate in the SOY and WHY groups compared with the CAS groups. 6. The results thus showed a complex interaction of protein type, cholesterol and age on cholesterol homeostasis. PMID- 2758010 TI - Longitudinal manganese and copper balances in young infants and preterm infants fed on breast-milk and adapted cow's milk formulas. AB - 1. Mn and Cu intake and retention in twenty full-term infants and six preterm infants were studied on the basis of 72 h balances. The age of the infants was 2 16 weeks and the gestational age of the preterm infants (triplets) 34 and 36 weeks. Three nutrition schemes were pursued: breast-fed, formula-fed with unsupplemented adapted formula and formula-fed with trace element supplementation. 2. The mean Mn concentration of all breast-milk samples (n 2339) was 6.2 micrograms/l. The two formulas had similar Mn concentrations (77 and 99 micrograms/l) but had different Fe, Cu (121 and 619 micrograms/l), Zn and I contents. The mean Cu concentration in mother's milk was 833 micrograms/l. 3. The following mean daily Mn intakes and retentions (micrograms/kg) respectively were measured: breast-fed full-term 1.06 (SD 0.43) and 0.43 (SD 0.65), formula-fed full-term 14.2 (SD 3.1) and 2.8 (SD 4.8), formula-fed preterm 15.0 (SD 2.2) and 0.06 (SD 5.87). The results for Cu were 114.5 (SD 22.3) and 88.0 (SD 46.5) micrograms/kg in breast-fed, 19.8 (SD 4.2) and 4.6 (-11.5-9.6) in the unsupplemented formula-fed and 106.4 (SD 18.9) and 55.5 (SD 20.3) in the supplemented formula full-term infant group. No significant influence of the trace element contents of the formulas on the relative retention of Mn or Cu was found. 4. Young preterm infants, and to some degree young full-term infants, often had negative Mn balances caused by a high faecal excretion. The formulas with a Mn concentration below 100 micrograms/l gave a sufficient supply of Mn. Preterm infants fed on the unsupplemented formula had a marginal Cu supply and their first balances were negative (-3.8 (SD 1.8) micrograms/kg). 5. In accordance with the estimated safe and adequate daily dietary intakes (recommended dietary allowances), formula-fed infants receive much more Mn than breast-fed infants and their absolute retention is higher. 6. Cu from breast-milk had a significantly better biological availability than that from cow's milk formula. If retentions similar to those in breast-fed infants are intended, we conclude, therefore, that cow's milk formula should be fortified with Cu up to a level of at least 600 micrograms/l. PMID- 2758011 TI - Effects of dietary iron deficiency and tungsten supplementation on 59Fe absorption and gastric retention from 59Fe compounds in rats. AB - 1. In vivo 59Fe absorption from intrinsically labelled Fe-containing fractions of liver and blood were measured in rats by intragastric dosing. All rats were fed on a low-Fe diet for 3 d before dosing in order to standardize the Fe status of the intestinal mucosal cells. 2. An increase in digestion time from 2 to 12 h increased 59Fe absorption (P less than 0.01) from all fractions except ferritin. 3. Fe-deficient rats when compared with essentially Fe-replete rats showed decreased gastric retention for all fractions, but increased 59Fe absorption over 2 h only from ferritin. Ferritin showed several unusual absorption characteristics. 4. Dietary tungsten supplementation of Fe-deficient rats reduced the ferroxidase activity of intestinal mucosal xanthine oxidase. In addition, gastric retention and 59Fe absorption (P less than 0.05) from all fractions were increased. PMID- 2758012 TI - Effect of change of diet on the mineral composition of rumen fluid, on magnesium metabolism and on water balance in sheep. AB - 1. The effects of four diets on water intake, rumen fluid outflow-rate, rumen pH and mineral metabolism were studied in wether sheep. The diets were barley and hay, flaked maize and hay, dried grass and frozen grass. 2. Experimental periods were of 12 d duration, and plasma magnesium concentrations were lower at the end of treatment periods when the grass diets were given and were significantly different (P less than 0.05) at 11.00 and 20.45 hours. Also, the concentration was significantly lower with the dried-grass diet than with the frozen-grass diet (P less than 0.05). 3. The concentration of Mg in rumen fluid centrifuged at 30,000 g (ultracentrifuged) varied with the diet. Maximum concentrations (tmax) were reached 4 h later on the grass diets than on the hay and concentrate diets. In the latter case tmax coincided with that for calcium, potassium, chloride and ammonia. At this time sodium and phosphate were at a minimum. The concentration of Mg in ultracentrifuged rumen fluid was negatively correlated (r -0.89) with pH, which was significantly higher (P less than 0.01) at all times on the grass diets. This relation was also reflected in the apparent availability of Mg. 4. Total water intake on the frozen grass was about twice that on the barley and hay diet. The outflow rate of liquid from the rumen was higher on the frozen grass than on the other three diets. 5. The proportion of absorbed Mg excreted in urine was significantly influenced by diet. PMID- 2758013 TI - Serum folates in young dairy heifers. AB - 1. In the first trial, hourly blood samples were drawn during the light period (06.30-20.30 hours) from thirty-four dairy heifers in two groups of different ages. 2. Concentrations of serum folates were 8.2 (SE 0.1) ng/ml at the age of 18.2 (SE 0.6) d and 14.8 (SE 0.2) ng/ml at 120.7 (SE 2.9) d (P less than or equal to 0.001). 3. In the second trial, forty heifers were randomly assigned to a factorial experiment where age (2 weeks v. 4 months) and quantity of pteroylmonoglutamic acid injected intramuscularly (2.5, 5.0, 10.0 and 20.0 mg) were the two factors studied. Blood samples were taken immediately before injection and on days 1, 2, 3, 4, 7 and 10 after the injection. 4. Serum folates reached a maximum on day 1 after the injection of pteroylmonoglutamic acid. The response to the injection was different for the two age groups (P less than or equal to 0.0002); concentration of serum folates for 2-week-old heifers markedly increased, while in 4-month-old heifers the effect of a supplement of pteroylmonoglutamic acid was less marked. 5. These results might indicate a need for pteroylmonoglutamic acid in young animals during the development of rumen function. PMID- 2758014 TI - Ascorbic acid concentration of human fetal tissues in relation to fetal size and gestational age. AB - 1. Studies were carried out on the distribution of ascorbic acid in human fetal tissues with the progress of gestation. 2. Fetuses and stillborn babies varying in gestational age from 12 to 38 weeks were obtained from various Baroda hospitals. Ascorbic acid levels were determined in selected tissues: brain, adrenal, liver, kidney, lung, heart and placenta. 3. Ascorbic acid concentration in the brain was higher than that in the adrenal at all gestational ages, suggesting the importance of this vitamin in brain development. The concentrations of this vitamin in liver, kidney, lung and placenta were comparable, but that in the heart tended to be lower. In all the tissues, there was a fall in ascorbic acid during late gestation. However, the levels in tissues of stillborn babies were higher than those reported for adults. PMID- 2758015 TI - Potentiation of atherosclerotic lesions in rabbits by a high dietary level of vitamin E. AB - 1. Two experiments were conducted to determine whether or not high dietary levels of vitamin E affect the development of atherosclerotic lesions in aortas of cholesterol-fed (5 g/kg diet) rabbits that were mechanically deendothelialized by balloon catheterization. 2. In the first experiment, the aortas of rabbits fed 2000 mg vitamin E/kg diet (i.e. 50-fold their nutritional requirement) for 8 weeks showed no gross morphological differences, either within or outside experimentally damaged areas, from those of rabbits fed the nutritionally adequate control level (40 mg/kg) of the vitamin. 3. In the second experiment, rabbits fed 10,000 mg vitamin E/kg diet (i.e. 250-fold requirement) for 14-15 weeks showed significantly greater endothelial loss and plaque formation at aortic sites outside of the mechanically damaged area than did controls. Plasma cholesterol levels were very high (9000-14,000 mg/l) and were not affected by dietary vitamin E level until 10-12 weeks when they were reduced moderately (18%). 4. It is concluded that very high levels of vitamin E can potentiate spontaneous atherosclerotic lesions, and it is suggested that this effect may depend on high cholesterol status. PMID- 2758016 TI - Effects of vitamin B6 deficiency and repletion on the uptake of steroid hormones into uterus slices and isolated liver cells of rats. AB - 1. In vitro, pyridoxal phosphate extracts steroid-hormone receptors from tight nuclear binding (Cidlowski & Thanassi, 1981); in vitamin B6-deficient rats there is increased and prolonged nuclear accumulation of oestradiol in the uterus and testosterone in the prostate, associated with enhanced biological responsiveness of these target tissues to steroid hormone action (Symes et al. 1984; Bowden et al. 1986). 2. Slices of uterus from vitamin B6-deficient rats accumulated more [3H]oestradiol than did tissue from repleted animals. Acute repletion with vitamin B6 (0.5-1 h before killing) further increased the uptake of the steroid. 3. Isolated hepatocytes from vitamin B6-deficient rats accumulated more [3H]dexamethasone than did cells from repleted animals. Pre-incubation of the hepatocytes with pyridoxal phosphate resulted in a further increase in the uptake of the steroid. 4. The results suggest that in addition to the putative role of pyridoxal phosphate in releasing steroid-hormone-receptor complexes from tight nuclear binding (Cidlowski & Thanassi, 1981), vitamin B6 deficiency may also increase the concentration of steroid-hormone receptors or enzymes and other steroid-binding proteins in target tissues. PMID- 2758017 TI - Metabolic changes during the menstrual cycle. AB - 1. Eight women maintained on a constant diet throughout a single menstrual cycle were studied for cyclical changes in body-weight, carbohydrate, fat and protein metabolism. 2. A cyclical variation in weight occurred with two phases corresponding to the time of ovulation and menstruation. 3. Creatinine and nitrogen excretion in the urine also tended to be higher in the luteal phase. 4. Analysis of gas exchange in a respiratory chamber for 24 h periods at intervals during the cycle suggested that carbohydrate utilization tended to be less in the early follicular phase. 5. Feeding with a mixed diet produced marked increases in carbohydrate utilization during the day with little change in fat utilization from the fasting state. Carbohydrate utilization was less when fasting at night and tended to be less when fed during the day in the early follicular phase of the menstrual cycle. 6. Weight changes were not readily ascribed to changes in colonic function, or in glycogen or body protein storage. PMID- 2758018 TI - The effect of a low-fat diet on luteal-phase prolactin and oestradiol concentrations and erythrocyte phospholipids in normal premenopausal women. AB - 1. Fifteen normal premenopausal women followed a low-fat diet for a period of 2 months. 2. Daily fat intake was reduced from 81 g on their customary diet to 36 g on the low-fat diet. A significant reduction in total energy intake and an increase in the dietary polyunsaturated fat: saturated fat ratio was also observed. There was a significant decline in body-weight, percentage body fat and total serum cholesterol, but no significant change in high-density-lipoprotein cholesterol. 3. Luteal-phase prolactin concentrations were not altered, but there was a significant decline in oestradiol concentrations on the low-fat diet. The proportion of erythrocyte inositol-phospholipid was increased on the low-fat diet and there was a significant increase in the 20:4 omega 6 (arachidonate) content of inositol-phospholipids. No significant changes in the content or fatty acid compositions of other phospholipid fractions were observed. 4. Further investigation of the effect of level and type of dietary fat on the content and fatty acid composition of membrane inositol-phospholipids are required. Long-term studies investigating the response of both prolactin and oestradiol to dietary fat reduction are also warranted. PMID- 2758019 TI - The effects of intake of lucerne (Medicago sativa L.) and orchard grass (Dactylis glomerata L.) hay on the motility of the forestomach and digesta flow at the abomaso-duodenal junction of the sheep. AB - 1. The relations between food intake, reticulo-ruminal motility and abomasal digesta outflow were investigated in ewes receiving lucerne (Medicago sativa) v. orchard grass (Dactylis glomerata) hay. Abomasal digesta outflow was recorded continuously by means of an electromagnetic flowmeter probe inserted into a duodenal T-shape cannula and the motility using strain-gauge force transducers. Volumes and turnover rates of both rumen and abomasal liquid phases were measured by CrEDTA dilution. 2. The voluntary intake of lucerne was higher (60%) than that of orchard grass hay, and paralleled by an increased abomasal outflow (65%) corresponding to an increased number of gushes of digesta through the flowmeter probe: 129/h instead of 78/h on orchard grass hay. Abomasal motor activity was enhanced (35%), and periods of regular spiking activity were seen passing along the duodenum at a higher velocity for the lucerne diet than for the orchard grass diet. The increased abomasal outflow with lucerne hay was associated with a higher reticulo-ruminal turnover rate, but not abomasal turnover rate. Abomasal, but not reticulo-ruminal volume, was increased (30%) when lucerne hay was fed ad lib. 3. The total number of reticulo-ruminal contractions was increased by 6.6% when the dry matter entering the duodenum was increased by 70.6%, suggesting the level of voluntary intake, rather than reticulo-ruminal motility, as a major factor governing abomasal outflow in sheep. 4. More frequent passages of digesta, unrelated to duodenal contractions, were recorded in ewes receiving lucerne compared with orchard grass. Both a higher viscosity of the contents due to the addition of guar gum and the impairment of antroduodenal motility by 5 hydroxytryptophan were able to reduce the flow rate of orchard grass digesta, but did not affect the higher flow rate of lucerne digesta. The findings suggest that the high abomasal outflow in sheep fed on lucerne ad lib. is related to a low viscosity of the contents that are propelled, even in the case of antral contractions of low magnitude. PMID- 2758020 TI - The effect of ruminal phosphate concentration on the absorption of calcium, phosphorus and magnesium from the reticulo-rumen of the sheep. AB - 1. The absorption rates of calcium, inorganic phosphate (Pi) and magnesium were determined from buffered solutions placed in the temporarily isolated and washed reticulo-rumen of conscious sheep. The basic composition of these solutions was similar to that found in supernatant fractions of ultracentrifuged rumen contents. 2. The Pi concentrations studied in these solutions were 2, 8.7, 14, 17.3 and 38 mmol/l. The initial concentration of Ca was 2.0 mmol/l and that of Mg was 2.5 mmol/l in all experiments. 3. Increasing the Pi concentration in the rumen solution from 2 to 38 mmol/l resulted in increases in the net absorption rates of both Ca and Pi, and a decrease in the potential difference across the wall of the rumen. 4. Similarly, increasing the Pi concentration from 2 to 17.3 mmol/l resulted in an increase in the net absorption rate of Mg from the rumen. 5. Mineral analysis of strained rumen fluid or a 30,000 g centrifugate of strained rumen fluid revealed a reduced Pi concentration in sheep fed on frozen spring grass as opposed to the pellet + hay diet. The values obtained were within the range studied. PMID- 2758021 TI - Distribution of bacteria in the rumen contents of dairy cows given a diet supplemented with soya-bean oil. AB - 1. Liquid-associated bacteria (LAB) were harvested from the liquid phase (LAB1) and from the solid phase of rumen contents after washing and manual shaking (LAB2). Solid-adherent bacteria (SAB) were recovered after washing and pummelling the total particles (SAB1). The distribution and the chemical composition of these three bacterial compartments were investigated in four dairy cows fitted with rumen fistulas. The animals received successively a diet consisting of one part hay and one part barley-based concentrate (diet C) and the same diet containing free soya-bean oil (79 g/kg dry matter (DM); diet So). 2. The efficiency of removal of SAB1 from total particles of rumen digesta collected 1 h after feeding, was calculated from the diaminopimelic acid content in particles and of the corresponding detached bacteria. It was 24% on diet C and 18% on diet So (P less than 0.05), using a combination of homogenizing and 'stomaching' treatments in saline (9 g sodium choloride/1) (reference treatment). For diets C and So respectively it was lowered by Tween in saline solution (1 g/l; 22.7 and 17.8%, not significant), but was increased when using a previous chilling (6 h at 4 degrees) of homogenized particles before stomaching in saline (28.8 and 24.7%, P less than 0.05) and in Tween 80 in saline (1 g/l; 26.6 and 20.8%, P less than 0.05). 3. The extent of removal of SAB1 from the solid fraction of rumen digesta by the reference treatment decreased with decreasing particle size; it was at the highest for particles retained on 4 and 2 mm sieves (62.1-82.1%) and still elevated for particles retained on 0.8, 0.4 and 0.1 mm sieves (41.3-57.9%). It was very much reduced for particles smaller than 0.1 mm (11.7-14.5%), suggesting the occurrence of favourable conditions for the adhesion of SAB firmly resistant to removal (SAB2). 4. The concentration of total SAB (SAB1 + SAB2) in particles collected 1 h after feeding was lower (P less than 0.05) in diet C (190 g/kg DM) than in diet So (234 g/kg DM). Values averaged 595-645 g/kg DM for particles smaller than 0.1 mm, but only 61 and 81-98 g/kg DM for particles retained on 4 and 0.4 mm sieves, and on a 0.1 mm sieve respectively.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2758022 TI - Inhibitory effects of sulphur compounds, copper and tungsten on nitrate reduction by mixed rumen micro-organisms. AB - 1. The inhibitory effects of inorganic and organic sulphur-containing compounds, copper and tungsten on nitrate reduction by mixed rumen micro-organisms were investigated in two in vitro studies. 2. Coarsely strained rumen fluid from nitrate-adapted (Expt 1) or non-adapted (Expt 2) Suffolk Down wethers maintained on lucerne (Medicago sativa) cubes was used as an inoculum. In Expt 1, anaerobic incubation was carried out for 24 h for each medium supplemented with 10 mM sodium nitrate and the following chemicals: 0, 1, 2, 3, 5, 8 and 10 mM-sodium sulphide, 1 and 10 mM-sodium sulphite, 1 and 10 mM-sodium sulphate, 1 and 10 mM-L cysteine, 1 and 10 mM-DL-methionine, 1 mM-sodium tungstate and 1 mM-copper sulphate. In Expt 2, 1 and 10 mM-Na2S, 1 and 10 mM-L-cysteine, 1 mM-Na2WO4, and 1 mM-CuSO4 were added to incubation media to test for chemical inhibition of microbial reduction of nitrate. 3. In Expt 1, the amount of nitrite formed decreased with increasing concentration of sulphide-S added. The additions of L cysteine, W and Cu suppressed nitrite formation in media from both nitrate adapted and non-adapted sheep. 4. In contrast to the effects of sulphide, L cysteine and W counteracted, to some degree, nitrate-induced reduction of volatile fatty acid (VFA) production. Addition of Cu to the media resulted in a further depression of VFA production. PMID- 2758023 TI - New Zealand meat as a source of omega 3 polyunsaturated fatty acids. PMID- 2758024 TI - Phosphatidylcholine biosynthesis in cultured glioma cells: evidence for channeling of intermediates. AB - The major pathway of choline (Cho) incorporation into phosphatidylcholine (PtdCho) in mammalian cells is sequential conversion of Cho to phosphocholine (PCho), cytidinediphosphate choline (CDP-Cho) and PtdCho. In intact cells, this sequence is usually demonstrated using radiolabeled Cho since PCho and CDP-Cho do not enter the cell intact. We have studied the incorporation of radiolabeled Cho, PCho and CDP-Cho into rat glioma (C6) cells following electropermeabilization. C6 cells were permeable as judged by [U-14C]sucrose and Erythrosin B uptake and more rapid incorporation of [1,2,3-3H]glycerol into cell lipids, and viable as assessed by uptake and incorporation of [methyl-3H]Cho, [1-14C]oleate and [1,2,3 3H]glycerol into complex lipids. Despite rapid incorporation of [methyl-3H]Cho into PtdCho in permeabilized cells, there was no incorporation of [methyl 14C]PCho or CDP-[methyl-14C]Cho into PtdCho. PCho (300 microM) and CDP-Cho (300 microM) failed to significantly reduce incorporation of 28 microM [methyl-3H]Cho into PtdCho. Radioactivity in PtdCho of cells prelabeled with [methyl-3H]Cho prior to permeabilization could be chased with 4 mM Cho but not with 4 mM PCho or 4 mM CDP-Cho. The water-soluble products of Cho metabolism--PCho, CDP-Cho and glycerophosphocholine--were retained at 37 degrees C in permeabilized cells compared with controls while there was uniform leakage from permeabilized cells at 4 degrees C. Hemicholinium-3, an inhibitor of high-affinity Cho transport, decreased [methyl-3H]Cho incorporation into PtdCho in permeabilized cells, as in controls, suggesting that even in permeabilized cells, Cho incorporation into PtdCho is linked to the transport system. We propose that individual steps of the cytidine pathway of PtdCho biosynthesis are functionally linked and that reaction intermediates are not freely diffusible within the cell but are channeled to PtdCho biosynthesis. PMID- 2758025 TI - Fluorescence studies on binding of amphiphilic drugs to isolated lamellar bodies: relevance to phospholipidosis. AB - Lysosomal phospholipid storage disorder in lung tissue was observed during chronic treatment with amphiphilic amine drugs. The prevailing and widely accepted mechanism of phospholipidosis is that amphiphilic drugs bind to phospholipids and make the phospholipids unsuitable substrates for the action of phospholipases. We investigated hydrophobic and hydrophilic binding of fifteen drugs to the phospholipid storage organelle, lung lamellar bodies, isolated from male Sprague-Dawley rats. Hydrophobic interactions were studied using 1,6 diphenyl-1,3,5-hexatriene as a fluorescent probe and hydrophilic binding was studied using 1-anilino-8-naphthalene sulfonate as a fluorescent probe. The binding parameters were calculated using Scatchard equations. Of the fifteen drugs used, nine drugs bound to the hydrophobic moiety of lamellar bodies. The order of binding capacities was promethazine greater than chloramphenicol greater than amiodarone = desethylamiodarone greater than promazine greater than chlorpromazine greater than trimipramine greater than propranolol greater than imipramine much greater than chlorphentermine, phentermine, chloroquine, chlorimipramine, cyclizine and chlorcyclizine. Two binding affinities were calculated for all the bound drugs. Binding affinities to hydrophilic sites of lamellar bodies were calculated in terms of emission coefficients for 1-anilino-8 naphthalene sulfonate in the presence of drugs. Hydrophilic binding was in the order chlorpromazine greater than chlorimipramine greater than promazine greater than trimipramine greater than imipramine greater than chlorcyclizine greater than propranolol greater than promethazine greater than chlorphentermine greater than cyclizine greater than phentermine greater than chloroquine much greater than chloramphenicol, amiodarone and desethylamiodarone. The binding affinities of chlorinated analogs were stronger to hydrophilic sites when compared to the parent compound. Amiodarone, which is known to induce pulmonary phospholipidosis and its major non-polar metabolite, desethylamiodarone, bound strongly to lamellar bodies. These two drugs also inhibit phospholipases in vitro. The drugs with weak phospholipidosis-inducing capacity and extensive in vivo metabolism, namely, imipramine, chlorpromazine and promazine, also bound strongly to lamellar bodies with hydrophilic as well as hydrophobic interactions. On the other hand, chloroquine, which is known to induce phospholipidosis and to inhibit phospholipases, did not bind to lamellar bodies. Two major conclusions could be drawn from this study: one is that the drug interactions with isolated lamellar bodies could be studied using membrane fluorescence probes, 1,6-diphenyl-1,3,5 hexatriene and 1-anilino-8-naphthalene sulfonate; second is that the amphiphilic drugs bind to lamellar bodies, as reported for phospholipid vesicles, and the binding of drugs to lamellar bodies could be correlated with their phospholipidosis-inducing capacity only if PMID- 2758026 TI - Dehydroxylation of a 7 beta-hydroxy-C27 plant sterol in rat liver. AB - (22R)-Cholest-5-ene-3 beta,7 alpha,22-triol and the isomeric (22R)-cholest-5-ene 3 beta,7 beta,2-triol were 7-dehydroxylated by rat liver microsomes, after addition of NAD+ to the incubations. The product from both sterols was identified as (22R)-22-hydroxycholesta-4,6-dien-3-one by gas chromatography-mass spectrometry. The overall conversion of the 7 alpha-compound had an apparent Vmax of 5 nmol/mg protein per h, about 3-times higher than that of the 7 beta-isomer. Km was about 0.018 mmol/l in both reactions. NAD+ was required for the 7 dehydroxylation to proceed, conceivably by serving as cofactor in formation of the intermediate 7 beta,2-dihydroxy-4-cholesten-3-one. EDTA had a stimulatory effect upon the product formation. 7 alpha-Dehydroxylation of the bile acid precursor 7 alpha-hydroxy-4-cholesten-3-one has been demonstrated in liver tissue, but a 7 beta-hydroxy-C27-steroid dehydroxylating enzyme has previously not been identified. The results are discussed in relation to the marked differences in effect on neoplastic growth by the two isomeric hydroxysterols. PMID- 2758027 TI - The transport of lipoprotein cholesterol into bile: a reassessment of kinetic studies in the experimental animal. AB - Studies were undertaken to assess the contribution of lipoprotein cholesterol to bile and to determine whether already-existent hepatic free cholesterol and the free cholesterol which is newly generated from the hydrolysis of hepatic cholesteryl esters are equally available for secretion into bile or constitute metabolically separate pools. Rats with a bile fistula were injected with an intravenous bolus of high-density lipoprotein recombinants containing free [14C]cholesterol and [3H]cholesteryl esters. Results showed (1) that bile free [14C]cholesterol secretion was a constant and linear proportion of the whole liver free [14C]cholesterol pool, (2) that secretion into bile of free [3H]cholesterol was in direct proportion to the rate of hydrolysis of hepatic [3H]cholesteryl esters, and (3) that rates of biliary cholesterol secretion were very similar when secretion was calculated using the specific activity of free [14C]cholesterol and free [3H]cholesterol in the entire liver to 'label' the precursor free cholesterol pool. Furthermore, rates of secretion that were calculated using either isotope closely approximated the mass of free cholesterol that was directly measured in bile. Results thus indicate that because of equilibration and extensive dilution by the large pool of already-existent free cholesterol, the transport of isotopic cholesterol from lipoproteins cannot be used to directly assess the contribution of lipoprotein cholesterol to the cholesterol that is secreted in bile. These studies further suggest that the totality of preformed free cholesterol in the liver is in metabolic equilibrium in one single kinetic pool and that all hepatic free cholesterol is potentially available for secretion into bile. PMID- 2758028 TI - Alkylthioacetic acid (3-thia fatty acids)--a new group of non-beta-oxidizable, peroxisome-inducing fatty acid analogues. I. A study on the structural requirements for proliferation of peroxisomes and mitochondria in rat liver. AB - The induction of peroxisome proliferation was examined in rat liver after administration of equal concentrations (1 mmol/kg body weight) of 1,10 bis(carboxymethylthiodecane) (BCMTD), 1-mono(carboxymethylthiotetradecane) (CMTTD), 1-mono(carboxymethylthiooctane) (CMTO), 1 mono(carboxyethylthiotetradecane) (CETTD), palmitic acid and hexadecanedioic acid (HDDA). BCMTD, a non-beta-oxidizable and non-omega-oxidizable sulphur-substituted fatty acid analogue was considerably more potent than CMTTD (only non-beta oxidizable) in inducing enlargement of the liver and increasing peroxisomal activities (monitored by peroxisomal beta-oxidation, palmitoyl-CoA hydrolase and catalase activities). Morphometric analysis of randomly selected hepatocytes revealed that BCMTD and CMTTD treatment increased the number and size of peroxisomes and the relative volume fraction of the peroxisomes. All these cellular responses were more marked with BCMTD than compared with CMTTD. CMTO, a non-beta-oxidizable fatty acid analogue containing a lower hydrophobic alkyl-end than CMTTD and CETTD (a beta-oxidizable fatty acid analogue), showed a slight increase (1.4-1.8-fold) of peroxisomal beta-oxidation and caused marginally morphological changes of peroxisomes compared with CMTTD and BCMTD. The most striking effect of the alkylthiopropionic acid (CETTD) was an enhancement of the hepatic triacylglycerol level. Palmitic acid and hexadecanedioic acid only marginally affected the peroxisomal activities, but no morphological changes of peroxisomes and fat droplets were observed. The presented data strongly suggest that a minimal structural requirement for a peroxisome proliferator may be (1) a carboxylic acid group linked to (2) a hydrophobic backbone which (3) cannot be beta-oxidized i.e., the fatty acid analogues have a sulphur atom in the beta position. It is also conceivable that blockage for omega-oxidation may potentiate the peroxisome-proliferating activities in as much as BCMTD was more potent than CMTTD. Two mitochondrial marker enzymes, carnitine palmitoyltransferase and succinate phenazine methosulphate oxidoreductase were differently affected after administration of the investigated compounds. Furthermore, BCMTD and CMTTD as well as HDDA treatments increased the number of mitochondria, but the mitochondria tended to be smaller. The overall results presented here indicate that the structural requirements for proliferation of mitochondria are not identical to those for proliferation of peroxisomes. PMID- 2758029 TI - Further studies on the mechanism of inhibition of intestinal chylomicron transport by Pluronic L-81. AB - This study explored further the hypothesis that intestinal cells have two pathways for producing large triacylglycerol-rich lipoprotein particles. The hydrophobic surfactant Pluronic L-81 (L-81) inhibits formation of chylomicrons (containing triacylglycerol synthesized from dietary fatty acids and monoacylglycerol, through the monoacylglycerol pathway), but not formation of very-low-density lipoproteins. L-81 does not inhibit lymphatic lipid transport during infusion of egg phosphatidylcholine, whose fatty acid is processed through the alpha-glycerol phosphate pathway and is transported in lymph in very-low density lipoproteins. Thus, the first part of this study tested whether L-81 cannot inhibit the alpha-glycerol phosphate pathway, and thus L-81 can only affect chylomicron lipid secretion. Intestinal lymph fistula rats were infused with a lipid emulsion containing [1-14C]oleic acid, but no monoacylglycerol, to ensure that the oleic acid will be channeled to the alpha-glycerol phosphate pathway. Experimental rats received 1 mg/h of L-81 in their emulsion whereas control rats lacked L-81. Lymphatic triacylglycerol output, measured both chemically and radioactively, was markedly suppressed in the experimental rats as compared to the controls. Thus, these data indicate that the reason why lipid transport was unaffected by L-81 when egg phosphatidylcholine was infused was not because of the pathway used for the resynthesis of triacylglycerol from phosphatidylcholine. In the second part of this study, we measured the appearance time for chylomicron (in control rats) and for very-low-density lipoprotein (in L 81-treated rats). The appearance time is defined as the time between placement of radioactive fatty acid into the intestinal lumen and the appearance of radioactive lipid in the central lacteal. The average appearance time for the control rats was 10.8 min, which was significantly shorter than the 16.2 min in the L-81-treated experimental rats. This difference in appearance time further supports the hypothesis that chylomicron and very-low-density lipoprotein are packaged separately in the enterocytes and only the formation of chylomicron is inhibited by L-81. PMID- 2758030 TI - Antioxidant activity of L-carnosine, a natural histidine-containing dipeptide in crystalline lens. AB - Lipid peroxidation was shown to be an initiatory cause of cataract development in some cases. It has been established that injection into the vitreous body of the rabbit eye of a suspension of liposomes prepared from phospholipids containing lipid peroxidation products induces the development of posterior subcapsular cataract. Such modelling of cataract is based on a type of clouding of the crystalline lens similar to that observed in cataract resulting from diffusion of toxic lipid peroxidation products from the retina to the lens through the vitreous body on degeneration of the photoreceptors. Saturated liposomes (prepared from dipalmitoylphosphatidylcholine) did not cause clouding of the lens, which demonstrated the peroxide mechanism of the genesis of this form of cataract. Clouding of the lens was accompanied by accumulation of fluorescing lipid peroxidation products in the vitreous body, aqueous humor and the lens and also by a fall in the concentration of reduced glutathione in the lens. The ability of L-carnosine (beta-alanyl-L-histidine) to interact directly with lipid peroxidation products suggested its anticataract properties. The effect of L carnosine on inhibiting or reversing the formation of cataract induced by the administration of lipid peroxidation products was discovered. This phenomenon appeared to be related with normalization of the peroxide metabolism parameters in the crystalline lens. In view of the data, an aqueous solution of L-carnosine is physiologically acceptable in effective nonsurgical treatment of cataracts. PMID- 2758031 TI - Distinct patterns in homooligomer tract sequence context in prokaryotic and eukaryotic DNA. AB - The distributions of the junction sequences of homooligomer tracts of various lengths have been examined in prokaryotic DNA sequences and compared with those of eukaryotes. The general trends in the nearest and next to nearest neighbors to the tracts are similar for both groups. In both prokaryotes and eukaryotes A/T runs are preferentially flanked on either the 5' or the 3' ends by A and/or T. G/C runs are preferentially flanked by G and/or C. There is discrimination against A/T runs flanked by G or C and G/C runs flanked by A or T. However, whereas the distribution of prokaryotic homooligomer tract junction sequences was quite homogeneous, large variations were observed in the 5-fold larger eukaryotic database, increasing in magnitude from tracts of length 2 to 3 to 4 base pairs long. Possible DNA conformational implications and in particular DNA curvature and packaging aspects of prokaryotes and eukaryotes are discussed. PMID- 2758032 TI - DNA damage and cytotoxicity of nitracrine in cultured HeLa cells. AB - The effects of nitracrine (1-nitro-9-(3,3-N,N-dimethylaminopropylamino)acridine on DNA of cultured HeLa cells were studied. DNA strand breakage and interstrand cross-linking as well as DNA-protein cross-linking were measured by means of an alkaline elution technique and were compared with the cytotoxic effect of the drug. Interstrand cross-links were not detectable in the concentration range that inhibited cell growth up to 99%. DNA single-strand breaks were found when cells were treated with highly cytotoxic doses of the drug. DNA breakage was not reparable and exhibited a tendency to increase during incubation after drug removal. The only chromatin lesion induced by sublethal doses of nitracrine were DNA-protein cross-links which persisted for 24 h after drug treatment. It is concluded that DNA breaks represent degraded DNA from dying cells, whereas DNA protein cross-links are specific cellular lesions, which may be responsible for the cell-killing effect of nitracrine. PMID- 2758033 TI - Nucleotide sequence of a wheat mitochondrial lysine tRNA gene. AB - We present the sequence of a wheat mitochondrial (mt) lysine tRNA gene (trnK UUU). This gene more closely resembles its E. coli counterpart than it does the corresponding gene in fungal or mammalian mtDNA. Hybridization experiments with a trnK-specific probe suggest that at least two copies of this tRNALys gene are present in the wheat mitochondrial genome. PMID- 2758034 TI - Xenobiotic microsomal epoxide hydrolase: 5' sequence of the human gene. AB - A cDNA for human microsomal epoxide hydrolase (mEH) was used to isolate genomic clones representing the 5' portion of the corresponding human gene. A total of 1034 bases of mEH gene sequence were obtained that included exon 1 and 5' flanking information. In contrast to the structure reported for the rat mEH gene (Falany et al. (1987) J. Biol. Chem. 262, 5924-5930), the human mEH gene lacked a CAAT box, but did contain a high-affinity CTF binding site at position -278 and an SV40 core enhancer element at position -525. TATA boxes were identified at positions -32 and -29 for the human and rat genes, respectively. Sequence comparisons between 5' flanking regions of the human and rat mEH genes demonstrated 47% homology, considerably less than the 83% conservation observed in the cDNA coding areas. Primer extension experiments localized the transcription initiation site of the human gene to a position 116 bases 5' from the analogous site in the rat mEH gene. PMID- 2758035 TI - Intracellular free calcium concentration in lymphocytes of patients with muscular dystrophies. AB - Intracellular free calcium concentration [( Ca2+]i) of human peripheral blood lymphocytes was determined by fluorescence spectroscopic measurements with quin2 in patients with different types of muscular dystrophy and in controls. The [Ca2+]i level in lymphocytes showed a significant increase in adult type (facioscapulohumeral and limb-girdle) muscular dystrophies, while it showed a decrease in Duchenne dystrophy as compared to the values of age- and sex-matched controls. The data obtained suggest an alteration in the effectiveness of the calcium pump in lymphocytes and may represent a sign of generalized membrane damage in these hereditary muscle diseases. PMID- 2758036 TI - Preferential uptake of cytotoxic porphyrins from hematoporphyrin derivative in murine L929 fibroblasts and Chinese hamster ovary K1 epithelial cells. AB - Photodynamically induced loss of clonogenicity of murine L929 fibroblasts and Chinese hamster ovary K1 epithelial cells was determined with two different assays. It appeared that the loss of clonogenicity was much higher when 20 cells/cm2 were incubated with hematoporphyrin derivative (HPD) and illuminated, than when confluent cell layers were incubated with the same amount of HPD and illuminated prior to plating out. This dependency of cell killing on the experimental protocol was also observed when protoporphyrin (90-95% pure) was used as photosensitizer, but not when the cells were photodynamically treated with rose bengal or exposed to mitomycin C. Further, when cell layers were incubated with the residual solution that remained after the previous incubation of a confluent cell layer with HPD, illumination of these layers appeared to be almost non-toxic, although the overall porphyrin concentration in the residual solution was only slightly lower than in HPD. These results indicate that the porphyrins, responsible for loss of clonogenicity, are present in relatively small amounts in HPD and unpurified protoporphyrin and are preferentially taken up by the cells. Although 2-aminoisobutyric acid transport and DNA synthesis are among the most photosensitive targets with HPD, photodynamic treatment of L929 cells with the residual solution did not result in inhibition of the transport system and DNA synthesis. In contrast, the K+ content of the cells still decreased considerably, when utilizing the porphyrins, remaining in the residual solution as sensitizer. This indicates that under the present experimental conditions the disturbance of the membrane barrier function does not contribute to loss of clonogenicity of these cells and, moreover, that the photodynamically induced K+ leakage is caused by a component of HPD other than inhibition of 2 aminoisobutyric acid transport and DNA synthesis. PMID- 2758037 TI - The effects of inhibition of heme synthesis on the intracellular localization of iron in rat reticulocytes. AB - These studies assessed the fate and localization of incoming iron in 6-8-day rat reticulocytes during inhibition of heme synthesis by succinylacetone. Succinylacetone inhibition of heme synthesis increased iron uptake by increasing the rate of receptor recycling without affecting receptor KD for transferrin, transferrin uptake, or total receptor number. Its net effect was to amplify the number of surface transferrin receptors by recruitment of receptors from an intracellular pool. Despite increased iron influx in inhibited cells, only 2-4% of total incoming iron was diverted into ferritin. The majority of incoming iron (65-80%) in succinylacetone-inhibited cells was recovered in the stroma, where ultrastructural and enzymic analyses revealed it to be accumulated mainly in mitochondria. Intramitochondrial iron (70-75%) was localized mainly in the inner membrane fraction. Removal of succinylacetone restored heme synthesis, utilizing iron accumulated within mitochondria for its support. Thus, inhibition of heme synthesis in rat reticulocytes results in accumulation of incoming iron in a functional mobile intramitochondrial precursor iron pool used directly for heme synthesis. Under normal conditions, there is no significant intracellular or intramitochondrial iron pool in reticulocytes, which are therefore dependent upon continuous delivery of transferrin-bound iron to maintain heme synthesis. Ferritin plays an insignificant role in iron metabolism of reticulocytes. PMID- 2758038 TI - Acid secretagogues induce Ca2+ mobilization coupled to K+ conductance activation in rat parietal cells in tissue culture. AB - Intracellular recordings from cultured parietal cells of the rat gastric fundus showed that carbachol, pentagastrin, histamine (in the presence of isobutylmethylxanthine; IBMX) and dibutyryl cyclic AMP induced hyperpolarizing responses which were sensitive to a K+ channel blocker, quinine. The Ca2+ ionophore, ionomycin, also induced a quinine-sensitive hyperpolarization. Deprivation of extracellular Ca2+ preferentially inhibited the hyperpolarizing responses to histamine (plus IBMX) and to dibutyryl cyclic AMP. Caffeine, oxalate and dantrolene sodium, which are known to affect Ca2+ transport in the endoplasmic reticulum, selectively inhibited the carbachol response. Mitochondrial inhibitors (KCN and carbonylcyanide p trifluoromethoxyphenylhydrazone) preferentially suppressed the gastrin response. Cytosolic Ca2+ measurements with fura-2 indicated that significant increases in the intracellular concentration of free Ca2+ were induced not only by Ca2+ mediated acid secretagogues (carbachol and gastrin), but also by a cyclic AMP mediated secretagogue (histamine plus IBMX). Dibutyryl cyclic AMP also increased cytosolic Ca2+ ions. It is concluded that stimulation of receptors to histamine, carbachol and gastrin gives rise to mobilization of Ca2+ ions into the cytoplasm from the different sources, thereby stimulating Ca2+-activated K+ channels in cultured rat parietal cells. PMID- 2758039 TI - A critical appraisal of the association between energy charge and cell damage. AB - The association between the energy charge and cellular damage caused by metabolic inhibitors was investigated in a cellular system of quiescent fibroblasts. The cell damage was assessed by the release of lactate dehydrogenase (LDH) which indicates a severe change of membrane integrity. Inhibition of glycolysis resulted in release of LDH when the energy charge decreased below 0.5 at an ATP level of 10% of the original level. If oxidative phosphorylation was inhibited, the energy charge decreased to 0.1-0.35 (dependent on the type of inhibitor) a long time before release of LDH, and no change occurred in the energy charge when release of LDH started. The ATP level was 0.5-2% of the original at this time. Even a decrease of the energy charge to 0.1 could be reversed to a normal level, and at the same time the morphological cellular changes were fully reversed and no release of LDH occurred. The conclusion is that no simple correlation between energy charge and cell survival exists. The different levels of ATP at which release of LDH started after inhibition of glycolysis and oxidative phosphorylation indicate a special role of glycolysis in maintaining the membrane function and integrity. This was emphasized by measuring the potassium loss of the cells which was much more marked after inhibition of glycolysis. PMID- 2758040 TI - Properties of several protein kinases that copurify with rat spinal cord neurofilaments. AB - Several protein kinases that copurify with neurofilaments (NF) were identified and each kinase was assessed for its ability to phosphorylate NF proteins. NFs were isolated using an axonal flotation procedure and the kinases were extracted from NFs with 0.8 M KCl. NF kinases were incubated with peptide substrates for selected protein kinases, [32P]ATP and protein kinase cofactors and inhibitors to characterize the kinases. Using peptide substrates, three types of kinase were identified, and a fourth was identified using NF protein as substrate. The first three kinases were the catalytic subunit of cAMP-dependent protein kinase, calcium-calmodulin dependent protein kinase II and a cofactor-independent kinase that phosphorylated prepro VIP sequence 156-170 and was inhibited by heparin. Using NF proteins as substrate, a fourth kinase was identified which was cofactor independent and was not inhibited by heparin. Neither cofactor-independent kinase was casein kinase II. NF proteins were phosphorylated in vitro on serine and threonine, primarily by the two cofactor-independent kinases. Using [alpha-32P]8 N3ATP for affinity labeling, one kinase of 43,800 Da was identified. Thus, in addition to cAMP-dependent protein kinase and calcium-calmodulin dependent protein kinase II, two kinases have been found which are primarily responsible for NF phosphorylation in vitro and are cofactor-independent. PMID- 2758041 TI - Phorbol myristate acetate activates protein kinase C, stimulates the phosphorylation of endogenous proteins and inhibits phosphate transport in mouse renal tubules. AB - Calcium-activated, phospholipid-dependent protein kinase (protein kinase C) has been implicated in the regulation of transport processes in a variety of tissues and cell lines. To establish whether protein kinase C participates in the regulation of renal phosphate transport, we examined the effect of phorbol myristate acetate (PMA), a potent activator of protein kinase C, on phosphate uptake in fresh preparations of mouse renal tubules, and we correlated the changes in transport activity with protein kinase C activation and phosphorylation of endogenous proteins. PMA inhibited Na+-dependent phosphate transport, elicited a rapid translocation of protein kinase C from the cytosolic to the particulate fraction and stimulated the phosphorylation of endogenous substrates in the cytosolic and brush border membrane fractions. Effects of PMA were maximal after a 10 min incubation of the tubules with the activator. 4 alpha Phorbol, an inert analogue of PMA, did not elicit any of these effects. The present results demonstrate a temporal correlation between inhibition of Na+ dependent phosphate transport, translocation and activation of protein kinase C, and phosphorylation of endogenous proteins in mouse renal tubules. These data suggest that protein kinase C may play a regulatory role in phosphate transport in mammalian kidney. PMID- 2758042 TI - Interactions between a new class of eukaryotic antimicrobial agents and isolated rat liver mitochondria. AB - Members of a newly discovered class of eukaryotic antimicrobial peptides are shown to release respiratory control in isolated rat-liver mitochondria. They also dissipate the membrane potential and inhibit respiration. The uncoupling activity of the peptides decreases with time probably due to the presence of proteases in the mitochondrial preparation. Quinine and Mg2+ reduce the activity of the peptides. The nature of the dependence of the respiratory rate on the concentration of added peptides suggests that they are active in a multimeric form, consistent with the formation of a channel across the inner mitochondrial membrane. The channel allows passage of sucrose. PMID- 2758043 TI - Interaction of alpha-lactalbumin with phospholipid vesicles as studied by photoactivated hydrophobic labeling. AB - The alpha-lactalbumin segment which penetrates into phosphatidylserine/phosphatidylethanolamine vesicle bilayer under acidic condition was photoactively labeled with 3-(trifluoromethyl)-3-(m [125I]iodophenyl)diazirine [( 125I]TID) which had been partitioned into the hydrophobic interior of the bilayer. The hydrophobically labeled amino acid residues were identified by trypsin digestion of the alpha-lactalbumin/vesicle complex, extraction and Edman degradation of the membrane embedded fragment. The results are consistent with a notion that the segment exists in the membrane as an alpha-helix and that only one surface of this alpha-helix is exposed to the hydrophobic interior of the bilayer. Possible models are: (a) a loop of tightly held alpha-helix penetrating deep into the bilayer and (b) the helix being located on the interface between bilayer and the aqueous solution. The time dependent [125I]TID labeling process revealed that the middle part of this segment goes into the bilayer first and is then followed by both ends. The penetration rate is comparable to that of the fusion of the lipid vesicles of the same composition by alpha-lactalbumin at the same pH, which further supports that the penetration is the cause of fusion. PMID- 2758044 TI - Dynamics and orientation of glycolipid headgroups by 2H-NMR: gentiobiose. AB - Deuterium nuclear magnetic resonance has been used to investigate the dynamics and determine the orientation of the headgroup of the glycolipid 1,2-di-O tetradecyl-3-O-(6-O-beta-D-glucopyranosyl-beta-D-glucopyranosyl )-sn- glycerol (beta-DTDGL), in aqueous multilamellar dispersions. In addition, its anomeric analog, having an alpha glucose-glycerol linkage, was prepared and examined. The lipids were labelled with deuterium at specific positions in the disaccharide moiety. Analysis of the deuterium quadrupolar splittings for the first glucose ring (glycerol-linked) gave segmental order parameters of 0.43 and 0.35 for the beta and alpha isomers, respectively. Both isomers had similar orientations of the sugar ring relative to the bilayer surface, as determined for lipid in the liquid-crystalline phase. 2H-NMR results for the lipid labelled at C-6' are consistent with a single conformation about the C-5'-C-6' bond of the first glucose residue, with a dihedral angle (O-5'-C-5'-C-6'-O-6') of -17 degrees. The results obtained for the second sugar ring suggest that two conformers may be present, which are in slow exchange on the 2H-NMR timescale. Measurements of longitudinal relaxation times, T1z, gave similar values for both sugar moieties in the headgroup, suggesting that the disaccharide does not exhibit the flexibility expected about the 1----6 linkage. Since T1z for 2H in these compounds decreases with increasing temperature and increases with magnetic field strength, the motion(s) dominating relaxation is in the long-correlation-time regime [omega 0 tau c)2 greater than 1). Thus, the gentiobiosyl headgroup undergoes the slowest motion of the glycolipid headgroups studied to date. PMID- 2758045 TI - Spontaneous transfer between phospholipid bilayers of dehydroergosterol, a fluorescent cholesterol analog. AB - The spontaneous interbilayer transfer of dehydroergosterol, a fluorescent cholesterol analog, was examined using small unilamellar phospholipid vesicles. The kinetic data were best fit by an equation of the form Aexp (-kt) + B. Qualitatively, the general trend of the half-time for transfer and the base values (B) obtained for dehydroergosterol resemble the corresponding values obtained in the earlier studies of cholesterol transfer. However, quantitative differences, which reflect the molecular structure of the sterol, were observed. Acrylamide quenching performed on the donor vesicles at different stages of the transfer indicated that a time-dependent organization of DHE within the vesicles occurs. PMID- 2758046 TI - Determination of the apparent functional molecular mass of the hepatocellular sodium-dependent taurocholate transporter by radiation inactivation. AB - The apparent target size of the sodium-dependent taurocholate transporter in basolateral rat liver plasma membrane vesicles, showing overshooting taurocholate uptake in the presence of sodium was estimated by radiation inactivation. Radiation at -105 to -120 degrees C and 2.5 Mrad/min causes a dose-dependent monoexponential reduction of the overshoot of taurocholate uptake in the presence of sodium. In contrast, taurocholate transport in the absence of sodium and taurocholate permeation at 4 degrees C remained totally unaffected by the radiation dose, indicating that the passive permeability of the membrane towards taurocholate remained unaffected. Radiation inactivation by high-energy electrons provides information about the size of the functional unit of the transporter in situ. The target size determined represents the size of the radiation-sensitive mass which is compact enough for significant energy transfer to occur within all parts of the transport system. The minimal function molecular mass was determined to be 170 kDa for the sodium-dependent taurocholate transporter. To prove the validity of radiation inactivation data four internal standard enzymes were tested under identical conditions. PMID- 2758047 TI - ATP-stimulated uptake of S-(2,4-dinitrophenyl)glutathione by plasma membrane vesicles from rat liver. AB - ATP-stimulated uptake of S-(2,4-dinitrophenyl)glutathione with a high activity of 0.35 nmol/min per mg protein is found in a rat liver plasma membrane vesicle preparation enriched in sinusoidal marker enzymes. Transport takes place into an osmotically active space. Vanadate and S-(azidophenacyl)glutathione inhibit transport, whereas Ca2+, EGTA and ouabain are without effect. PMID- 2758048 TI - Duramycin effects on the structure and function of heart mitochondria. I. Structural alterations and changes in membrane permeability. AB - The polypeptide antibiotic duramycin has been reported to interact specifically with two lipids: phosphatidylethanolamine (PE) and monogalactosyldiacylglycerol (Navarro et al. (1985) Biochemistry 24, 4645-4650). PE is a major component of mitochondrial membranes. Duramycin was used to examine the role of PE in maintenance of mitochondrial structure and membrane permeability properties with the following results: (1) Duramycin addition to isolated rat heart mitochondria produced abrupt organelle contraction which was followed, depending on composition of the suspending medium, by pronounced swelling. The most notable morphological effect of the antibiotic was ruffling or crenelation of the outer membrane, which resulted ultimately in its separation from the inner membrane. (2) Low concentrations (less than 5 microM) of the antibiotic selectively increased the permeability of the mitochondrial inner membrane to cations and small solutes. This effect was blocked by atractyloside, a highly specific inhibitor of the adenine nucleotide translocator, by palmitoyl coenzyme A, by N ethylmaleimide, and by AMP, ADP and ATP but not GDP or GTP, implicating the adenine nucleotide translocator in the selective permeability increase. (3) Higher concentrations of duramycin induced a more generalized permeability increase which was not subject to inhibition by compounds capable of interacting with the adenine nucleotide translocator. PMID- 2758049 TI - Enhanced hybridoma production by electrofusion in strongly hypo-osmolar solutions. AB - Electrofusion of mammalian cells in strongly hypo-osmolar media containing sorbitol, small amounts of divalent cations and albumin resulted in high yields of hybrids. The number of viable hybrids was higher than any value for chemically or electrically-mediated fusion reported in the literature. Optimum clone numbers were obtained for fusion of osmotically-stable subclones of murine myeloma cells with DNP-Hy-stimulated lymphocytes provided that the osmolarity of the fusion medium was as low as 75 mosmol/l. Similar results were obtained for fusion of osmotically stable subclones of myeloma cells with the murine hybridoma cell line G8. Due to the dramatic increase in volume the field strength of the breakdown pulse (leading to fusion of the dielectrophoretically aligned cells) has to be reduced, as predicted by theory. The efficacy of hypo-osmolar electrofusion allowed the use of very few cells (about 10(5) lymphocytes or G8 cells per fusion chamber). This figure is considerably smaller than that reported in the literature for iso-osmolar electrofusion. It is significant that, in contrast to iso-osmolar conditions, the fusion yield in hypo-osmolar electrofusion was reproducible over long periods of time and less dependent of variations between cultures. At suspension densities of about 10(6) cells per fusion chamber (normally used in iso-osmolar electrofusion) hypo-osmolar electrofusion of homogeneous cell suspensions resulted in the formation of many giant cells when the appropriate field conditions were applied. Similar high or, at some field strengths, even higher numbers of clones at low cell suspension density were obtained when G8 and myeloma cells were first exposed during the washing procedure to strongly hypo-osmolar media, but then transferred to iso osmolar solutions for electrofusion. Similar experiments with lymphocytes and myeloma cells failed because of destruction of many lymphocytes by the two osmotic shock steps in rapid succession. Volume distribution measurements of G8 and myeloma cells showed that after re-incubation of the osmotically pre-stressed cells the original volume distribution is largely, but not completely re established. This and other results indicate that osmotic pressure gradients and associated tensions in the membrane do not play a primary role in the initiation of the electrofusion process. The experiments suggest that due to the osmotic (pre-) stress the membrane permeability is slightly and uniformly increased presumably due to the dissolution of membrane- and cell-skeleton proteins. Obviously, this facilitates electrofusion in hypo-osmolar or subsequently in iso osmolar solutions. PMID- 2758050 TI - Phosphatidylcholine-cholesterol interactions: bilayers of heteroacid lipids containing linoleate lose calorimetric transitions at low cholesterol concentration. AB - Model membranes composed of cholesterol plus one of two phosphatidylcholines (PC), each containing a saturated and a dienoic acyl chain, have been studied by differential scanning calorimetry. The gel to liquid-crystalline phase transition temperature of 1-palmitoyl-2-linoleoyl PC was -19.5 degrees C and that of 1 stearoyl-2-linoleoyl PC was -13.7 degrees C. The addition of cholesterol to the phosphatidylcholines in aqueous dispersion resulted in the progressive removal of the phase transition as observed by differential scanning calorimetry. Per mole of sterol in the membrane, cholesterol was more effective at reducing the enthalpy change of the phase transitions of these bilayers containing dienoic phosphatidylcholines than it is in eliminating the transition of membranes made with other phospholipids that contain more saturated chains. No transitions in membranes made with palmitoyl-linoleoyl PC or stearoyl-linoleoyl PC could be detected calorimetrically when 17 mol% cholesterol was present. PMID- 2758051 TI - Cation transport in oxidant-stressed human erythrocytes: heightened N ethylmaleimide activation of passive K+ influx after mild peroxidation. AB - Normal and chronically dehydrated (hereditary xerocytosis) human red cells were subjected to mild peroxidative treatment (315 microM hydrogen peroxide (H2O2), 15 min) in the presence of azide. The subsequent expression of passive (ouabain resistant) K+ transport activities was analyzed by measurement of 86Rb+ influx. Peroxidation of normal red cells did not affect basal K+ transport activity, but the increment in K+ influx elicited by 0.5 mM N-ethylmaleimide (NEM) was increased 3-fold. The enhanced K+ influx was chloride-dependent, but only partially inhibited by 0.1 mM furosemide. Stimulated activity declined progressively after NEM activation, but could be restored by a second NEM treatment. Prior conversion of hemoglobin to the carbonmonoxy form abolished the response to peroxide, while 200 microM butylated hydroxytoluene (BHT) exerted only partial inhibition, suggesting that the effect of H2O2 requires interaction of activated, unstable hemoglobin species with the membrane, but that lipid peroxidation is not sufficient. Peroxidation following NEM treatment also enhanced NEM activation, indicating that enhancement does not require altered NEM reactions with stimulatory or inhibitory sites. Passive K+ transport in hereditary xerocytosis red cells was not activated by NEM, with or without H2O2 pretreatment. The results demonstrate that modest peroxidative damage to red cells can heighten the activation of a transport system that is thought to be capable of mediating net K+ efflux and volume reduction in cells that express it. Models are proposed in which the effects of NEM, H2O2, cell swelling and other factors are mediated by conformational changes in a postulated subpopulation of anion channel (Band 3) molecules that bind the K+ transporter. PMID- 2758052 TI - Techniques for isolation of brush-border and basolateral membrane vesicles from dog kidney cortex. AB - Two methods are reported for renal membrane preparation from the dog kidney cortex. One method is a simultaneous preparation of brush-border (BBMV) and basolateral (BLMV) membranes. Using readily available laboratory equipment, differential centrifugation produced a supernatant which was treated with Mg2+. The Mg2+ treatment produced a pellet (crude BLMV) which was added to Percoll and centrifuged to produce purified BLMV. The supernatant after Mg2+ treatment eventually yielded pure BBMV after additional Mg2+ precipitations. The second method used an acidic medium in conjunction with divalent-cation precipitation to prepare BBMV. Whichever method was used, BBMV and BLMV showed appropriate enzyme and transport activities. PMID- 2758054 TI - Low-conductance states of K+ channels in adult mouse skeletal muscle. AB - Single-channel currents were recorded from Ca2+-activated or ATP-sensitive K+ channels in inside-out membrane patches excised from isolated mouse toe muscles. In addition to the closed and fully open configurations, both types of channels may exhibit several intermediate low-conductance states which are clustered near multiples of elementary conductance units. The units are 1/8 or 1/6 of the channel conductance for Ca2+-activated channels and 1/4 or 1/3 for ATP-sensitive channels. Normally, low-conductance states are rare, but they occur more frequently directly after patch excision. An increased probability of low conductance states of ATP-sensitive K+ channels was also observed in the presence and during washout of the internal channel blocker adenine. The results suggest that Ca2+-activated and ATP-sensitive K+ channels are composed of several membrane pores with strong positive cooperativity among the elementary conductance units. PMID- 2758053 TI - Structural and functional characterization of major platelet membrane components derived by limited proteolysis of glycoprotein IIIa. AB - The authors isolated a product of proteolytic degradation of glycoprotein IIIa (GPIIIa) which is formed on the surface of human platelets during incubation with chymotrypsin and which was previously described as the 66 kDa platelet membrane component. This component migrated with an apparent Mr 62,400 in a non-reduced system of sodium dodecyl sulfate polyacrylamide gel electrophoresis. In a reduced system it yielded two major subunits migrating with apparent Mr 14,000-17,000 and 65,000. The low-molecular weight component began with the NH2-terminal sequence of GPIIIa (GPNICTTR...) and the larger component with residue 348 of GPIIIa (GKIRSKKA...) as deduced from a cDNA clone of this glycoprotein. The two subunits appeared to be linked by one or more S-S bridges supporting the contention that GPIIIa is a highly folded molecule on the platelet membrane. In contrast to GPIIIa, the '66 kDa component' did not bind to GRGDSPK-agarose, to fibrinogen agarose nor to insolubilized monoclonal antibody recognizing the GPIIb/IIIa complex. The exposure of fibrinogen receptors during the course of incubation of platelets with chymotrypsin preceded the formation of the '66 kDa component' characterized in this study. An intermediate product of GPIIIa proteolysis migrating with an apparent Mr 120,000 in a non-reduced system and Mr 80,000 in a reduced system was identified as a precursor of the '66 kDa component'. The '120 kDa component' was not retained on GRGDSPK-agarose or on fibrinogen-agarose but it was retained on insolubilized antibody recognizing the GPIIb/IIIa complex. Incubation of platelets with porcine pancreatic elastase or human granulocytic elastase resulted in the formation of similar proteolytic degradation fragments. PMID- 2758055 TI - Relationships between chemical structure and inhibition of epinephrine-induced human blood platelet aggregation. AB - The effect of structural features in a series of carbamoylpiperidine and nipecotoylpiperazine congeners on epinephrine-induced aggregation of human blood platelets is examined. Epinephrine-induced primary aggregation is effectively inhibited by the nipecotoylpiperazine derivatives (culminating at an IPA50 of 11.9 microM). While among nipecotoylpiperazine as well as carbamoylpiperidine congeners there are potent inhibitors of ADP-stimulated platelet function (cresting at an IA50 of 12.4 and 11.4 microM, respectively), the carbamoylpiperidine analogs are much less active (e.g., IPA50 of 298.1), or practically inactive, in impeding epinephrine-induced primary aggregation (PA). PMID- 2758056 TI - Interactions between earthworm hemolysins and sheep red blood cell membranes. AB - The hemolytic activity exhibited by the coelomic fluid of the Annelid Eisenia fetida andrei is mediated by two lipoproteins of mass 40 and 45 kDa, each of them capable of hemolysis. Such an activity is not inhibited by zymosan, inulin or lipopolysaccharide (LPS), nor by hydrazine or methylamine, suggesting that earthworm hemolysins are not related to C3 or C3b complement components. Among the membrane lipids tested (phosphatidylcholine, phosphatidylethanolamine, phosphatidylglycerol, sphingomyelin and cholesterol) only sphingomyelin inhibited hemolysis. The analysis of E.f. andrei proteins bound to sphingomyelin microvesicles, as well as to sheep red blood cell (SRBC) membranes, revealed a polymerization of E.f. andrei 40 kDa and/or 45 kDa hemolysins. Consequently, sphingomyelin appears a likely candidate for hemolytic complex receptor. Electron microscopy observations suggested that the polymerization causes an open channel through the lipid bilayer. As demonstrated using metal ions, heparin, chondroitin sulfate, poly(L-lysine) and protamine chloride, the mode of action of earthworm hemolytic complex is not analogous to that of C9 or perforine. PMID- 2758057 TI - Association of hemin with protein 4.1 as compared to spectrin and actin. AB - The interaction of hemin with protein 4.1 isolated from red cell membrane cytoskeleton has been studied. Spectrophotometric titration has shown one strong binding site and additional lower affinity sites for hemin. From fluorescence quenching data an association binding constant of 1.3 . 10(7) M-1 has been calculated for the primary site. The conformation of cytoskeletal proteins after hemin binding was followed by the use of far UV circular dichroism and compared to that of the serum hemin trap, albumin. The secondary structure of albumin was unchanged in the presence of high hemin concentrations. Both spectrin and actin lost their conformation upon hemin binding in a ligand-concentration and time dependent manner. Unlike spectrin and actin, the secondary structure of protein 4.1 appeared. The findings of this study suggest that protein 4.1 may serve as the cytoskeletal temporary sink for small amounts of membrane-intercalated hemin similarly to the function of albumin in the serum. However, an increased release of hemin under pathological conditions may cause hemin association with the cytoskeletal proteins and as a result the cell membrane is expected to be distorted. PMID- 2758058 TI - Effects of non-electrolyte molecules with anesthetic activity on the physical properties of DMPC multilamellar liposomes. AB - The effects of 13 non-electrolytes with moderate anesthetic potency on the order of DMPC liposomes were examined. Changes in order were monitored by steady-state fluorescence polarization techniques using 1,6-diphenyl-1,3,5-hexatriene (DPH) and 1-(4-trimethylammoniumphenyl)-6-phenyl-1,3,5-hexatriene (TMA-DPG). At 30 degrees C, all of the compounds tested decreased the DPH steady-state anisotropy (rs), with potencies highly correlated to their oil/water partition coefficients. However, only the most hydrophobic anesthetics decreased TMA-DPH RS. Some of the most hydrophilic compounds, including ethanol and urethane, actually increased TMA-DPH rs, suggestive of an increase in membrane order. The concept of selectivity was borrowed from partitioning theory and used to explain some effects on anesthetic potency of decreasing temperature to 18 degrees C. In the gel as opposed to the liquid crystalline phase, selectivity for decreasing membrane order (as monitored by DPH) markedly increased, suggesting that anesthetic partitioning and/or the site of anesthetic action was occurring in a more hydrophobic domain. The solute-independent difference (or capacity) between two membranes for perturbation was defined as membrane sensitivity. Sensitivity appeared to also decrease with decreasing temperature, despite the decrease in membrane partitioning. This effect is thought to result from the selective delivery of the anesthetic solute to the membrane interior and away from more hydrophilic domains where anesthetics may order membrane structure. PMID- 2758059 TI - Relationship of hemolysis buffer structure, pH and ionic strength to spontaneous contour smoothing of isolated erythrocyte membranes. AB - Isolated human erythrocyte membranes crenate when suspended in isotonic medium, but can use MgATP to reduce their net positive curvature, yielding smooth discs and cup forms that eventually undergo endocytosis. An earlier report from this laboratory (Patel, V.P. and Fairbanks, G. (1981) J. Cell Biol. 88, 430-440), has described a phenomenon of ATP-independent shape change in which ghosts prepared by hemolysis and washing in synthetic zwitterionic buffers crenated at 0 degree C, but underwent conversion to smooth discs and cups when warmed in the absence of MgATP. We have further explored the effect of the hemolysis condition on the requirement for ATP in ghost shape change. 25 hemolysis buffers were applied at 10 mM (pH 7.4, 0 degree C). Eight anionic buffers with relatively high ionic strength (e.g., phosphate and diethylmalonic acid (DMA] yielded ghosts requiring ATP for shape change, while two cationic buffers (Bistris and imidazole) and ten synthetic zwitterionic buffers (e.g., Tricine and Hepes) with lower ionic strength produced ghosts that smoothed spontaneously at 30 degrees C. Hemolysis at intermediate ionic strength yielded mixed populations in which spontaneous smoothing was expressed in all-or-none fashion. Maximal ATP-independent shape change was induced by hemolysis at pH 7.3-7.7, while ATP was required after hemolysis at pH less than or equal to 7.1 even when the ionic strength at hemolysis was low. Ghosts requiring ATP could be converted to ATP independence by washing at low ionic strength, but ATP independence could not be reversed readily by washing at high ionic strength. Exposure to low ionic strength at pH greater than 7.1 presumably changes membrane organization in a way that alters the temperature dependence of tensions within the bilayer or skeleton of the composite membrane. PMID- 2758060 TI - Neutron and X-ray diffraction structural analysis of phosphatidylinositol bilayers. AB - Phosphatidylinositol (PI) bilayers, squeezed together by applied osmotic pressures, were studied by both neutron diffraction and X-ray diffraction. The lamellar repeat period for PI bilayers decreased from 9.5 nm at an applied pressure of 1.1.10(6) dyn/cm2 (1.1 atm) to 5.4 nm at an applied pressure of 1.6.10(7) dyn/cm2 (16 atm). Further increases in applied pressure, up to 2.7.10(9) dyn/cm2 (2700 atm) reduced the repeat period by only about 0.3 nm, to 5.1 nm. Thus, a plot of applied pressure versus repeat period shows a sharp upward break for repeat periods less than about 5.4 nm. For repeat periods of less than 5.4 nm, analysis of neutron-scattering density profiles and electron density profiles indicates that the structure of the PI bilayers changes as the bilayers are dehydrated, even though there are only small changes in the repeat period. These structural changes are most likely due to removal of water from the headgroup regions of the bilayer. D2O/H2O exchange experiments show that, at an applied pressure of 2.8.10(7) dyn/cm2, water is located between adjacent PI headgroups in the plane of the bilayer. We conclude that, although electrostatics provide the dominant long-range repulsive interaction, hydration repulsion and steric hindrance between PI headgroups from apposing bilayers provide the major barriers for the close approach of adjacent PI bilayers for repeat periods less than 5.4 nm. This structural analysis also indicates that the phosphoinositol group extends from the plane of the bilayer into the fluid space between adjacent bilayers. This extended orientation for the headgroup is consistent with electrophoretic measurements on PI vesicles. PMID- 2758061 TI - Induction of fusion in aggregated and nonaggregated liposomes bearing cationic detergents. AB - The addition of polyanionic polymers such as poly(aspartic acid) (PASP), DNA or dextran sulfate to liposomes composed of phosphatidylcholine (PC) and cholesterol (CHOL) and bearing the quaternary ammonium detergent [[[(1,1,3,3 tetramethylbutyl)cresoxy]ethoxy]ethyl]dimethy lbe nzylammonium hydroxide (DEBDA[OH]) resulted in liposome aggregation and fusion. Liposome-liposome fusion was studied by using fluorescently labeled liposomes and fluorescence-dequenching (DQ) methods. Addition of monoanions, such as aspartate or acetate, to liposomes bearing DEBDA[OH] caused neither their aggregation nor liposome-liposome fusion. Aggregation of liposomes bearing DEBDA[OH] by the binding pair avidin-biotin did not result in their fusion. Fusion in such aggregated liposomes was observed by the addition of chaotropic anions, such as nitrate or thiocyanate, or by PASP. A variety of other quaternary ammonium detergents behaved similarly to DEBDA[OH] in their ability to confer fusogenic properties upon PC/chol liposomes. The relevance of these findings to the mechanism of liposome-liposome fusion is discussed. PMID- 2758062 TI - Age changes in the crystallinity of bone mineral and in the disorder of its crystal. AB - The crystallinity of bone mineral and disorder of the crystal at different ages were measured by the X-ray diffraction method of Ruland. Measurements were made on femoral mid-diaphyses of Wistar rat from 2 weeks to 1 year of age. For a given animal age, the crystallinity of bone mineral increases with age, while the overall disorder of the crystal does not vary within experimental accuracy. The increase in the crystallinity with age is attributed to an increase in crystallite size, a decrease in lattice imperfections, or a combination of both effects. It is suggested that lattice imperfections of the first kind more largely contributes to the disorder of bone mineral crystals than those of the second kind. PMID- 2758063 TI - Control of exogenous proteinases and their inhibitors at the macrophage cell surface. AB - The actions and availability of human neutrophil elastase and its protein inhibitor, Eglin, when co-incubated with macrophages were investigated. Eglin did not induce radical production by mouse peritoneal macrophages; nor were specific binding sites for Eglin detected on these cells. Mouse peritoneal macrophages could inactivate both elastase and Eglin extensively, when these targets were used at concentrations appropriate to the extravascular fluids. Two methods were used for assessing such inactivation: one, as in previous literature, only took account of molecules remaining in the supernatant after interaction with the cells; the other (lacking from most previous studies) took into account all target molecules, including those associated with the cells. From an analysis of both types of experiment, it was shown that the cell-derived inactivators were stable products, whose quantity was not significantly influenced by the induction of a macrophage oxidative burst and its associated free radicals. They were probably mainly proteinases and proteinase inhibitors. Thus, mouse peritoneal macrophages restrict the activity of proteinases and inhibitors by means of stable molecules, such as proteins. Other mononuclear phagocytes may use free radicals and oxidants more extensively in this respect. PMID- 2758064 TI - Characterization of corneal proteoglycans under vitamin A deficiency. AB - Comparison of in vivo radiolabeled corneal proteoglycans from vitamin A deficient, pair-fed control and normal rabbits by chromatographic and enzymatic methods, reveals subtle but reproducible changes in the proteoglycans present in the vitamin A deficient corneas relative to those of pair-fed and normal control corneas. Although the total amounts of [3H]leucine and [35S]sulfate incorporated in vivo into the proteoglycans per cornea are similar in the three types of cornea, the proteoglycan affinity for DEAE-Sepharose is different, with more of the vitamin A deficient proteoglycans requiring a higher NaCl concentration for elution. Analysis of in vivo labeled rabbit corneal proteoglycans reveals that in vitamin A deficient animals, relative to pair-fed controls, there is (1) an increase in the proteoglycans digested by chondroitinase AC indicative of decreased epimerization of glucuronic acid to iduronic acid; (2) an increase in the amount of keratan sulfate proteoglycan with high affinity for an anion exchange resin, consistent with a greater negative charge; (3) differences in proteoglycan affinities for octyl-Sepharose, reflecting differences in hydrophobicity; (4) increased susceptibility to proteolysis by trypsin; (5) no significant difference in sulfation. PMID- 2758065 TI - The influence of link protein stabilization on the viscometric properties of proteoglycan aggregate solutions. AB - The dynamic, steady-shear and transient shear flow properties of precisely prepared link-stable (s0 136, 66% aggregate) and link-free (s0 93, 59% aggregate) proteoglycan aggregate solutions at concentrations ranging from 10 to 50 mg/ml were determined using a cone-on-plate viscometer in a mechanical spectrometer. All proteoglycan solutions tested possessed: (1) linear viscoelastic properties - as measured by the dynamic complex modulus under small amplitude steady oscillatory conditions (1 less than or equal to omega less than or equal to 100 rad/s) - and (2) nonlinear shear-rate dependent apparent viscosities and primary normal stress difference under steady shearing conditions (0.25 less than or equal to gamma less than or equal to 250 s-1). Our transient flow data show that all proteoglycan aggregate solutions exhibited transient stress overshoot effects in shear stress and normal stress. From these steady and transient flow data, we conclude that link protein stabilized aggregates have significant effects on their dynamic and steady-shear properties as well as transient flow properties. The transient stress overshoot data provide a measure of the energy per unit volume of fluid required to overcome the proteoglycan networks in solution from a resting state. Thus we found that link-stable aggregates form much stronger networks than link-free aggregates. This is corroborated by the fact that link stable aggregates form more elastic (lower than delta) and stiffer (higher [G*]) networks than link-free aggregates. The complete spectrum of viscometric flow data is entirely compatible with the proposed role of link protein in adding structural stability to the proteoglycan-hyaluronate bond. In cartilage, the enhanced strength of the networks formed by link-stable aggregates may play an important role in determining the material properties of the tissue and thereby contribute to the functional capacity of cartilage in diarthrodial joints. PMID- 2758066 TI - Isoelectric focusing of apo- and holo-transcobalamin present in human blood. Identification of a protein complexing with transcobalamin. AB - By means of isoelectric focusing we studied the factors influencing the isoelectric point of transcobalamin. Upon binding of cobalamin, the transcobalamin isopeptides M, X and S increase their isoelectric points by 0.4 pH units. Serum protein different from gammaglobulin changes the isoelectric point of transcobalamin, but the attachment of the transcobalamin-cobalamin complex to its acceptor is unchanged. Transcobalamin bound to auto-antibodies shows a characteristic pattern upon isoelectric focusing. PMID- 2758067 TI - [Enzymatic properties of the isolated B-chain of human thrombin]. AB - The A- and B-chains have been isolated from the non-covalent complex of human thrombin A- and B-chains, using selective reduction of the interchain disulfide bridge. The B-chain thus isolated (de-A-thrombin) retains its conformation, which is close to the native one and thus differs considerably from the B-chain isolated from the fully reduced enzyme. Nevertheless, the proteolytic (in terms of fibrinogen clotting) and amidase activities of de-A-thrombin are markedly reduced as compared to the native enzyme and the non-covalent complex of A- and B chains. It is assumed that the A-chain of thrombin is necessary for normal functioning of the active site of thrombin localized in the B-chain. PMID- 2758068 TI - [Use of bacterial DNA-methylases for structuro-functional analysis of the eukaryotic genome]. AB - Bacterial DNA-methylases with known recognition sites (RS) were used as probes for structural-and-functional analysis of eukaryotic genome. Adenine and cytosine DNA-methylases recognizing 4 to 6-member unique and degenerative nucleotide sequences having a symmetrical and asymmetrical structure were used for probing. The use of a set of methylases enabled the selection of a probe that was the most sensitive for the given pathology. Thus, severe hypothyrosis was found to be associated with changes in the acceptor capacity of liver DNA in the heterologous++ methylation reaction as could be evidenced from testing by two probes, CCCC and GAATGC. In the cells of chicken liver hepatoma MC29, the acceptor capacity of DNA during GGA methylation appeared to be altered in the greatest degree. DNA-methylases with degenerative SR are weakly specific probes for the study of structural changes (methylation) of the animal genome. PMID- 2758069 TI - [Various research results on the role of carbohydrate groups in macroimmunoglobulins]. AB - Evidence on the role of carbohydrates in the structure and function of macroimmunoglobulin (IgM) was obtained. The principal functions are the increase of hydrophilicity and preservation of a definite conformation of the protein molecule which, in its turn, is necessary for the implementation of its biological function. The protection of tryptophan residues at the molecule surface against the contacts with the surrounding water is conditioned by the above properties. The functions of each of the five carbohydrate groups in the heavy chains of IgM are reviewed. PMID- 2758070 TI - [Properties of silver-containing rat ceruloplasmin]. AB - Ceruloplasmin (Cp) was isolated from the sera of albino rats fed with silver nitrate (60 mg/kg of body weight). The oxidase activity of the enzyme was sharply decreased, while its concentration in the blood (as assayed immunologically) was slightly lower than in controls. The drop in the oxidase activity was caused by the replacement of several coppers by silver ions in the Cp molecule. Ag-Cp contained about four silver atoms per 1 mole of protein, its spectrum lacking maxima at 450 and 610 nm that are typical of normal Cp. When subjected to PAAG electrophoresis, Ag-Cp displayed two bands, one of which (Ag-Cp2) had the anodic mobility of normal Cp. The other band (Ag-CpI) migrated at a slower rate. Both bands were separately subjected to SDS-PAAG electrophoresis which revealed the dissimilarities among the proteolytic fragment patterns of Ag-CpI, Ag-Cp2 and normal Cp. Both Ag-CpI and Ag-Cp2 contained peculiar fragments produced by spontaneous limited proteolysis of the native molecule. The binding of silver ions by Cp seems to alter significantly the molecule conformation, which may cause the exposure of new peptide bonds susceptible to proteolytic attack. Cp seems to participate in the binding and detoxication of heavy metals in mammals. PMID- 2758071 TI - [The lysosomal pathway of prolactin degradation in the mammary gland: kinetics of prolactin hydrolysis by cathepsin D and the peptides formed thereby]. AB - Some peculiarities of prolactin hydrolysis by rat mammary gland lysosomal proteinases were studied. It was demonstrated that at pH 3.0-3.7 the initial steps of prolactin hydrolysis are under control of cathepsin D. Cysteine cathepsins are responsible for the deep degradation of the peptides formed. The molecular mass of rat mammary gland cathepsin D as determined by chromatography on Sephadex G-100 is about 45 kDa. Using affinity chromatography on hemoglobin Sepharose 4B, cathepsin D was purified 300--320-fold. The purified enzyme rapidly hydrolyzes low concentrations of prolactin down to peptides with Mr less than 1 kDa. At substrate--enzyme concentration ratios above 3:1, the limited proteolysis of prolactin occurred. At early steps of prolactin hydrolysis the formation of two peptides (Mr approximately 10 kDa) takes place. Deeper degradation of sheep prolactin led to the formation of four peptides with molecular masses of 6630, 3020, 1880 and 1040 Da (data from SDS-PAGE electrophoresis). An analysis of structural peculiarities of prolactin from different animal species revealed that this hormone is protected from the damaging effect of exopeptidases. PMID- 2758072 TI - [Regulation of the activity of rabbit skeletal muscle phosphorylase kinase by glycogen]. AB - The effects of glycogen on the non-activated and activated forms of phosphorylase kinase were studied. It was found that in the presence of glycogen the activity of non-activated kinase at pH 6.8 and 8.2 and that of the activated (in the course of phosphorylation) form are enhanced. The degree of activation depends on glycogen concentration. At saturating concentrations, this enzyme activity increases 2-3-fold; the enzyme affinity for the protein substrate, phosphorylase b, also shows an increase. The polysaccharide has no effect on the activity of phosphorylase kinase stimulated by limited proteolysis. In the presence of glycogen, the rate of autocatalytic phosphorylation of the enzyme is increased. Glycogen stabilizes the enzyme activity upon dilution. The experimental results suggest that the polysaccharide directly affects the phosphorylase kinase molecule. The maximal binding was shown to occur at the enzyme/polysaccharide ratio of 1:10 (w/w) in the presence of Ca2+ and Mg2+. PMID- 2758073 TI - [Rate of microsomal protein metabolism in the mouse liver]. AB - NaH14CO3, a poorly reutilized biosynthesis precursor, was used to study the rate of whole microsomal protein degradation in mouse liver. The use of the precursors, however, does not prevent the reutilization of labeled amino acids on phenobarbital administration. To avoid reutilization, a new method has been developed. It was shown that phenobarbital injections have no effect on the degradation rate of the whole microsomal protein. The effect of amidopyrine, a monooxygenase microsomal system substrate, on the rate of whole microsomal protein degradation was examined. An experimental model was developed, in which the monooxygenase microsomal system substrate does not exhibit the properties of its inducer. Amidopyrine administration to mice simultaneously with phenobarbital induction has no effect on the degradation rate of the whole microsomal protein. PMID- 2758074 TI - [Study of phospholipase A2 specificity in substrate-containing structures having different supramolecular organization]. AB - The specificity of snake venom phospholipase A2(PLA2) towards a number of phospholipid (PL) substrates, e. g., phosphatidylcholine (PC), phosphatidylglycerol (PG), phosphatidylethanolamine (PE) and phosphatidylinositol (PI) organized in Triton X-100 mixed micelles, liposomes and proteoliposomes was studied. PC was shown to be more rapidly hydrolyzed in micelles. For other PLs, the rate of hydrolysis decreased in the following sequence: PC greater than PI greater than PE greater than PG. The incorporation into micelles of a non hydrolyzable by PLA2 sphinogomyelin which, similar to PC, has a choline group, resulted in an increase of PLA2 specificity towards PL that are known to be devoid of this group: PE greater than PI greater than PG greater than PC. Quite a different picture was observed in bilayer liposomal structures: PI congruent to PE greater than PC greater than PG. The incorporation of cytochrome P-450 into liposomes caused the acceleration of PE and PG hydrolysis. The course of the PLA2 catalyzed hydrolysis in model membrane structures seems to be governed primarily by the supramolecular organization and localization of the substrate in the bilayer, but not by its chemical structure. PMID- 2758075 TI - [Organization of enzymes on subcellular structures: relay at the surface]. AB - There is a large body of evidence that soluble cytoplasmic enzymes of eukaryotic cells, e.g., glycolytic enzymes and proteins of the translational machinery, are organized in some way in space and in time. The following features of such organization emerge from the experimental data: (1) metabolites are transferred between enzymes directly "from hand to hand" in short-living enzyme-enzyme complexes rather than by diffusion in aqueous media; (2) enzymes show a tendency to be absorbed on surfaces of subcellular structures, such as membranes, cytoskeleton and polyribosomes; (3) enzymes are desorbed from a surface of a subcellular structure after binding specific metabolites, i.e., substrates and/or products of the reactions catalyzed by these enzymes. These features are suggestive of a relay mechanism for the enzyme systems functioning in a cell; an enzyme adsorbed on a surface of a subcellular structure is desorbed after binding its substrate or in the course of the catalytic act. Within a complex with its product the enzyme diffuses into the environment, until it reaches the next enzyme adsorbed on the same surface; then a short-living enzyme-enzyme complex is formed, and a direct "from hand to hand" transfer of the metabolite takes place. As a result, the overall metabolic process appears to be localized near the surface. We termed this mechanism as a "relay at the surface". PMID- 2758076 TI - [Principles of the organization and functioning of the metabolon microcompartment]. AB - The approaches to the elucidation of principles of metabolon functioning and the applicability of concepts of "protein-machine" and "conjugated ionic hydrogen bond systems" are discussed. The term "metabolon" refers to a supramolecular complex of sequential metabolic enzymes and structural elements of the cell. It has been assumed that the metabolon microcompartment consists of separate units joined together by channels, in which the active and, possibly, allosteric sites of enzymes become approximated. PMID- 2758077 TI - [Pyridoxal phosphate-dependent enzymes of sulfur amino acid metabolism]. AB - Cystathionine beta-synthase and gamma-cystathionase, the two major enzymes of the transsulfuration pathway of methionine metabolism, are described. These enzymes are responsible for inborn errors, e.g., homocystinuria and cystathioninuria. The interaction of gamma-cystathionase with the cofactor, substrates and inhibitors of the general formula RONH2 containing structural fragments of substrates has been studied. A non-radioactive avidin-biotin system for the microdetection of gamma-cystathionase in dot blots has been developed. This system was applied for immunoscreening of a rat liver cDNA library in the prokaryotic expression vector lambda gt 11. PMID- 2758078 TI - [Molecular mechanisms of the regulation of phosphorylase kinase from skeletal muscles of mammals and birds]. AB - Red and white avian skeletal muscles (chicken and pigeon) contain the same alpha' isoenzyme of phosphorylase kinase. According to data from gradient polyacrylamide slab electrophoresis in the presence of SDS, the molecular masses of beta- and gamma-subunits of phosphorylase kinase from rabbit, chicken and pigeon muscles are not identical. Electron microscopy data suggest that the quaternary structure of chicken and pigeon phosphorylase kinase is of the same type. The alpha' isozyme of chicken and pigeon phosphorylase kinase is strongly activated by calmodulin and troponin C. Avian phosphorylase kinase is activated 2--3-fold by phosphorylation with cAMP-dependent protein kinase and by autophosphorylation. This activation is associated with the phosphorylation of both alpha'- and beta subunits. The affinity of pigeon phosphorylase kinase a for Ca2+ is 20 times as high as that of phosphorylase kinase b. PMID- 2758079 TI - [Phosphorylation of components of high molecular weight aminoacyl-tRNA-synthetase complex from the rabbit liver by associated casein kinase type I]. AB - The aminoacyl-tRNA synthetase complex from rabbit liver possesses an endogenous protein kinase activity. The associated protein kinase in the complex was defined as casein kinase I. Using FPLC, a fraction of the supramolecular complex with a high level of metabolic activity was isolated; this preparation was found to be enriched in the casein kinase activity. Incubation of this fraction with [gamma 32P] ATP leads to the intensive incorporation of labeled phosphate into 12 polypeptides of the complex, i.e., glutamyl-, isoleucyl-, leucyl-, methionyl-, lysyl-, arginyl- and aspartyl-tRNA synthetases. An addition of free homologous casein kinase I does not change the spectrum or level of phosphorylation of the complex substrates. The homologous casein kinase II phosphorylates polypeptides with Mr of 65, 43 and 20 kDa in the complex. PMID- 2758080 TI - [5-Alkyl(C19-C25) resorcinols as regulators of succinate and NAD-dependent substrate oxidation by mitochondria]. AB - The effect of 5-n-alkyl(C19-C25) resorcinols isolated from Azotobacter chroococcum on the oxidation of succinate and NAD-dependent substrates (glutamate, alpha-ketoglutarate, malate, pyruvate) by rat liver mitochondria was studied, using the polarographic technique. With succinate, the above resorcinol lipids activated to some extent the 2,4-dinitrophenol-decoupled mitochondrial respiration, but markedly suppressed it (up to 95%) in the presence of NAD dependent substrates. The activating and inhibiting effects correlated with the resorcinol lipid/mitochondrial proteins ratio and were observed, when the lipid concentration in the incubation mixture ranged from 2.4.10(-4) to 6.0.10(-4) M. The most striking inhibiting effect was observed with alpha-ketoglutarate as substrate. The results obtained suggest that 5-n-alkyl(C19-C25) resorcinols should be regarded as rotenone type regulators of cell respiration. PMID- 2758081 TI - Cerebral blood volumes in young rats with and without in situ saline flushing of cerebral vasculature. Implications for in vivo studies of brain substance uptake. AB - In recent studies of bilirubin encephalopathy, in situ flushing of the cerebral vessels has been used to clear blood from the brain. The effectiveness of such procedures has not been adequately documented. Herein young, male Sprague-Dawley rats were given about 750 KBq of 51Cr-labelled rat erythrocytes 3 min prior to sacrifice. There were four experimental groups: control, displacer (sulfisoxazole), hyperosmolality, and hypercarbia. Half of the rats in each group had the brain vasculature flushed in situ, while the remaining rat brains were not flushed. The brains were dissected into seven regions, and the radioactivity in the tissues was compared to that of blood drawn from the rats immediately before death. Significant amounts of blood (22-42%) remained after in situ flushing. Retention was significantly higher in the hyperosmolar animals, and significantly lower in the hypercarbic animals as compared to controls. Interregional differences in blood volumes per gram wet weight were significant without, but not with flushing. Similar observations were made using 125I-IgM as a marker for the plasma compartment. In studies of brain uptake of substances with high plasma concentrations, substance remaining within the cerebral vessels may contribute significantly to the apparent brain uptake values. PMID- 2758082 TI - Acute thermoregulatory responses of the immature rat to warming by low-level 2,450-MHz microwave radiation. AB - Rats were tested at 6-7 days of age to determine thermoregulatory responses to microwave exposure (2,450-MHz; continuous wave). Each animal was partially restrained in a cylindrical holder and irradiated at a power density of either 5 or 20 mW/cm2 [specific absorption rate = 0.60 (W/kg)/(mW/cm2)] at a cold ambient temperature (Ta). Following a 1-hour thermal equilibration period, each rat was monitored at 1-min intervals during 1-hour microwave exposure and 1-hour recovery periods. Colonic temperature (Tco), determined with a Vitek probe, and metabolic heat production (M), derived from measures of oxygen consumption, were sampled and recorded during these periods. Tco increased significantly above initial level at both power densities and reached a plateau after 45 min of microwave exposure. Tco doubled with a four-fold increase in microwave intensity. Prior to exposure, M was elevated in response to cold Ta and remained unchanged during exposure at 5 mW/cm2, but decreased 7.2 W/kg during exposure at 20 mW/cm2. The results indicate that the hypothermic rat pup can be effectively warmed by low level microwave irradiation and is capable of altering metabolism in response to such heating. PMID- 2758083 TI - Free and bound tryptophan in human milk during early lactation. AB - Total (protein-bound and free) and free tryptophan levels of breast milk were evaluated in 10 mothers of term infants on the 3rd, 4th, 5th, and 30th day of lactation. We found high levels of both total and free tryptophan in the colostrum. This variation in tryptophan content of breast milk may reflect the requirement of the human neonate. PMID- 2758084 TI - Effects of prenatal heat stress on postnatal growth, behavior and learning capacity in mice. AB - Pregnant ICR mice were immersed in water at 42 or 43 degrees C for 10 min once or twice daily on days 12 through 15 of gestation and the postnatal development of their offspring was observed. Postnatal weight gain of the offspring and their brain weight at 11 weeks of age were smaller than the values for control animals. As compared with controls, prenatally heated mice were less active in an open field and learned slower in a water-filled multiple T-maze and in a shuttle box. Thus, prenatal brief hyperthermia in mice was shown to suppress the body and brain growth during the postnatal period and adversely affect their emotionality and learning capacity. PMID- 2758085 TI - Maternal transfer of photoperiodic information in Siberian hamsters. II. The nature of the maternal signal, time of signal transfer, and the effect of the maternal signal on peripubertal reproductive development in the absence of photoperiodic input. AB - Peripubertal reproductive development of Siberian hamsters is controlled by maternally derived photoperiodic information and the ambient photoperiod present after weaning. Previous experiments suggested that the maternally derived information is transferred during gestation, not during lactation. Development was examined in several photoperiods following manipulation of gestational and lactational photoperiods; development was influenced by the gestational, but not lactational, photoperiod. Second, effects of the gestational photoperiod were observed in young reared in constant light (LL) from Day 15. Depriving the young of ambient photoperiodic information after Day 15 allows a more direct assessment of the signal received from their dams. Finally, melatonin injections to long-day dams, at certain times of day, caused transmission of a short-day signal to young, as evidenced by their development in LL and light-dark cycles. Thus, a maternally derived signal that is dependent on melatonin influences reproductive development of the young during gestation; the maternally directed pattern of development can subsequently be modified by the youngs' own response to ambient photoperiods after weaning. PMID- 2758086 TI - Melatonin mediates alternation of seasonality in Syrian hamsters. AB - The annual cycle of reproductive activity in the Syrian hamster, Mesocricetus auratus, is the result of interaction between seasonal changes in daylength (photoperiodism) and seasonal changes in responsiveness to daylength (seasonality). The present experiment was designed to investigate the role of the pineal gland and its hormone, melatonin, in the alternation of seasonality (scotosensitivity and scotorefractoriness). Male hamsters were maintained on short daylengths (10L:14D) to establish scotorefractoriness, and then they were transferred to long daylengths (14L:10D) for conversion to scotosensitivity (sensitive to short daylengths). Before transfer to long daylengths, some of the hamsters were pinealectomized and others were sham-operated or unoperated. Some of the pinealectomized hamsters received single daily melatonin or saline injections while on long daylengths. After 14 wk on long daylengths, the hamsters were transferred to short daylengths for 10 wk to test for conversion to scotosensitivity. Pinealectomized hamsters were given three daily melatonin injections while on short daylengths. Such treatment is known to promote gonadal regression in scotosensitive but not in scotorefractory hamsters. Examination of testes after the short daylength interval revealed that exposure of nonpinealectomized hamsters to long daylengths had reestablished scotosensitivity (regressed testes). Pinealectomized hamsters that received no melatonin replacement while on long daylengths remained scotorefractory (enlarged testes), whereas those that received single daily injections of melatonin during long daylengths were found to be scotosensitive. These results indicate that a daily pulse of melatonin during expsoure to long daylengths has an important role in reestablishing responsiveness (scotosensitivity) to short daylengths. PMID- 2758087 TI - Effect of epostane, ZK 98299, and ZK 98734 on the interruption of pregnancy in the rat. AB - The objective of these studies was to determine whether treatment of 10-day pregnant rats with a combination of epostane (a progesterone biosynthesis inhibitor) and either ZK 98299 or ZK 98734 (progesterone receptor antagonists) would result in additive or synergistic effects on the interruption of pregnancy. When these compounds were tested individually, the order of potency in interrupting pregnancy was ZK 98734 greater than ZK 98299 greater than epostane (50% effective doses 1.3, 4.0, and 35 mg/kg, respectively). Epostane and ZK 98299 were then tested in combination. When epostane was given either 4 h prior to or concurrently with ZK 98299, the combined drug treatment resulted in a significant additive increase in interceptive activity compared to when ZK 98299 was administered alone. In vitro binding studies showed that ZK 98299 and ZK 98734 bound to the rat uterine progesterone receptor in vitro with approximately equal affinity. ZK 98734 bound to the rat thymus glucocorticoid receptor and to the rat ventral prostate androgen receptor with a greater affinity than ZK 98299. The affinity of ZK 98299 for the rat uterine estrogen receptor was weak while the binding of ZK 98734 was not detectable. Thus, the in vitro receptor binding profiles observed were consistent with the known progesterone and glucocorticoid antagonist activities of ZK 98299 and ZK 98734. Overall these findings show that the interceptive activity of epostane and ZK 98299, agents that exert their interceptive activity via different molecular mechanisms, is additive in the 10 day pregnant rat. PMID- 2758088 TI - Progesterone altered amino acid accumulation by human endometrium in vitro. AB - When human endometrium is exposed to progesterone, the rate of amino acid incorporation into its protein pool is altered. Accumulation into specific proteins has been evaluated by one-dimensional polyacrylamide gel electrophoresis. Comparison of steroid-exposed and nonexposed tissue has revealed a change in the rate of radiolabeled amino acid uptake into a few stained protein bands. To further characterize the effect of progesterone on endometrial protein metabolism, we have examined the one-dimensional electrophoretic band that undergoes the greatest change in leucine accumulation using two-dimensional gel and monoclonal antibody technologies. The band of interest results from altered amino acid uptake into a single protein spot on two-dimensional gels. This particular protein has an approximate size of 50 kDa and pI of 5.8. It exists in a monomeric form under nondenaturing conditions. During organ culture of proliferative endometrium exposed to 0.1 micrograms/ml progesterone, there is a sixfold increase in the rate of methionine uptake into this protein. The rate of amino acid accumulation is maximal after 24 h of culture in medium containing progesterone. Partial purification provided a product enriched 120-fold for this specific protein and facilitated development of a monoclonal antibody that was used to identify the protein in several human tissues besides endometrium. Antibody-antigen complex could not be detected in medium from secretory endometrium, suggesting that this protein resides in the cytosol without being secreted by the tissue. PMID- 2758089 TI - Immunocytochemical evidence for the transfer of an oviductal antigen to the zona pellucida of hamster ova after ovulation. AB - The zona pellucida (ZP), a glycoprotein layer that encloses the mammalian oocyte, is formed during follicular development in the ovary, persists at the time of fertilization within the oviduct, and then surrounds the embryo until implantation in the uterus. Although the structure and chemical properties of the ZP have been extensively studied, the precise site of origin of the ZP remains a matter of controversy. Moreover, the mechanism of synthesis and secretion of the ZP constituents is not fully elucidated. We have recently developed monoclonal antibodies (MAbs) against oviductal ZP of the golden hamster. We have used one of these MAbs (an immunoglobulin G) and the protein A-gold technique to study the localization of the corresponding antigenic sites, and we report here their distribution in the oviduct and within the cumulus oophorus complex of the superovulated hamster. In the oviductal epithelium, immunolabeling was observed in non-ciliated secretory cells in structures involved in protein secretion. In the cumulus masses collected from the oviduct, the sites of immunoreactivity were localized exclusively in the ZP encompassing the oocyte. Gold particles were evenly distributed throughout the entire thickness of the ZP. Treatment of the cumulus masses with hyaluronidase prior to preparation of isolated oocytes for immunocytochemistry did not affect this uniformity. The ZP of the preovulatory oocytes in ovarian follicles was not labeled. Our study provides immunocytochemical evidence for the secretion of an oviductal antigen that becomes intimately associated with the ZP of the oocytes during their passage through the oviduct. PMID- 2758090 TI - Glucose inhibits development of hamster 8-cell embryos in vitro. AB - Relative preferences of energy substrates (glucose, pyruvate, and lactate) for in vitro development of hamster 8-cell embryos were investigated. Using protein-free modified Tyrode's medium (TLP-PVA) containing 10 mM lactate (L), 0.1 mM pyruvate (P), and amino acids (Phe, Ile, Met and Gln), we found that development of hamster 8-cell embryos to blastocysts was supported better in the absence of glucose than in medium containing (standard) 5 mM glucose (88.1% and 50%, respectively). Addition of even 0.25 mM glucose to the medium significantly inhibited blastocyst formation (54.1%). Medium T-PVA, containing 5 mM glucose as sole energy substrate (without pyruvate, lactate, and amino acids), very poorly supported embryo development (less than or equal to 7.9% blastocysts), but addition of 0.1 mM pyruvate enhanced blastocyst formation (52%). Elimination of pyruvate in TL-PVA medium containing 5 mM glucose and amino acids markedly reduced blastocyst formation by 4-fold (13.5%); the optimal pyruvate concentration was 0.2 mM. However, if the same medium was devoid of glucose, blastocyst formation was high both in the absence (71.1%) and presence (83.3%) of 0.1 mM pyruvate. Similarly, in glucose-free T-PVA medium, addition of either 10 mM lactate or amino acids supported 8-cell embryo development to blastocysts (61.7% and 60.5%, respectively) as opposed to 18.8% and 30.6%, respectively, in the presence of 5 mM glucose. This augmented development in the absence of glucose is suggested to the due to the efficient conversion of lactate to pyruvate and of amino acids to amphibolic intermediates and hence their utilization via the Krebs cycle.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2758092 TI - Flow cytometric quantification of rat spermatogenic cells after hypophysectomy and gonadotropin treatment. AB - DNA flow cytometry was evaluated as a tool to analyze stage-specific changes that occur in absolute cell numbers in the testes. Hypophysectomy was selected as a model system for perturbing testicular cell types, since the cytological sequelae of this treatment post-hypophysectomy in the rat are well documented in the literature. Rat spermatogenic cells in stages II-V, VII, and IX-XIII of the seminiferous epithelial cycle (as defined by Leblond and Clermont, 1952) were quantified in numbers per standard length of seminiferous tubule by DNA flow cytometry after hypophysectomy and subsequent gonadotropin treatment. In agreement with previous histological studies, we found that acrosome- and maturation-phase spermatids disappeared from the seminiferous epithelium after 17 days post-hypophysectomy, whereas meiosis and early spermiogenesis continued at least 164 days. The number of meiotic cells and round spermatids gradually decreased after hypophysectomy. Changes were observed as early as Day 6 post hypophysectomy. Treatment with human chorionic gonadotropin (hCG) alone maintained most cell numbers within normal limits, and follicle-stimulating hormone (FSH) was needed in addition to hCG to maintain the normal number of cells with the amount of DNA contained in primary spermatocytes and spermatogonia in G2/M-phase (4C) in stages IX-XIII and elongated spermatids (1C') in stages II V of the epithelial cycle. The absolute numbers of spermatogenic cells at different phases of maturation provide a useful reference for quantitative studies of spermatogenesis. Pathological changes in the seminiferous epithelium can be detected and quantified by DNA flow cytometry. PMID- 2758091 TI - Phosphate is required for inhibition by glucose of development of hamster 8-cell embryos in vitro. AB - The influence of sodium dihydrogen phosphate (Pi) and glucose on the development of hamster 8-cell embryos mediated by pyruvate (P) or amino acids (A) or lactate (L) was investigated using modified Tyrode's medium, TLP-PVA. When pyruvate was tested as the only energy substrate in medium TP-PVA for embryo development, blastocyst formation ranged from 81.3 to 90.9% whether or not the medium contained 0.35 mM Pi or 5 mM glucose; but, when these two compounds were present together, blastocyst formation fell to 51.8%. Similarly, in TA-PVA medium containing four amino acids: Phe, Ile, Met, and Gln), embryo development to blastocyst ranged from 74.1% to 90.4% whether or not the medium contained 0.35 mM Pi or 5 mM glucose; but, when these compounds were present together, blastocyst formation fell to 16.0%. In TL-PVA medium, 10 mM sodium lactate supported embryo development (84.4% blastocysts); the addition of 0.35 mM Pi decreased blastocyst development to 65.6%. However, addition of glucose to Pi-free TL-PVA medium did not decrease blastocyst formation (81.3%); when the medium contained 0.35 mM Pi, glucose curtailed blastocyst development to 7.5%. When glucose and Pi interactions were studied at different concentrations, glucose up to 1 mM was not inhibitory in Pi-free TL-PVA medium (74.3% blastocysts), but 0.25 mM glucose in the presence of 0.35 mM Pi markedly inhibited embryo development (7.7% blastocysts). Phosphate at a relatively high concentration (1 mM) was inhibitory (37.9% blastocysts), even in the absence of glucose.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2758093 TI - Changes in sperm surface membrane and luminal protein fluid content during epididymal transit in the boar. AB - The surface membrane protein of boar sperm and the proteins in the fluid surrounding the gametes were analyzed during epididymal transit. The present study demonstrated that sequential dramatic changes occur in protein composition of the sperm membrane and epididymal fluid during epididymal transit. The maturation process of the boar sperm surface was characterized by a complex sequential evolution of the composition and orientation of macromolecules in the sperm membrane. Epididymal maturation resulted in the progressive disappearance of most of the surface testicular compounds, which were either renewed or masked by new permanent or transient low molecular weight polypeptides on the boar sperm surface membrane. In the fluid surrounding the spermatozoa, composition of the luminal proteins was altered throughout the epididymal transit and several new compounds were characterized. Very few proteins were correlated either with blood plasma or sperm surface compounds. PMID- 2758094 TI - The concentration of pepsinogen C in human semen and the physiological activation of zymogen in the vagina. AB - The relationship between male infertility and the pepsinogen C content in semen has been investigated. The activation of the seminal pepsinogen C in the vagina has been studied under physiological conditions. Samples of semen from 48 vasectomized males and from 46 males of infertile couples were analyzed for pepsinogen C by radioimmunoassay. No correlation was found between the level of pepsinogen C and seminal characteristics, including sperm concentration, motility, and morphologic features. The mean concentration of pepsinogen C was 42.2 micrograms/ml; the first, second, and third quartile were 18.4, 29.6, and 57.6 micrograms/ml, respectively. No significant difference in the level of pepsinogen C was observed between semen of normal quality, semen of reduced quality, and semen with aspermia. Activation of pepsinogen C occurred within 3 h when semen was incubated at pH below 5.0 at 37 degrees C. Intravaginal activation was investigated in six experiments in which semen from two males was instilled in three females. In four experiments with two couples, post-coital activation was investigated. Pepsin C activity in vaginal fluid was detected an average of 3 h (range 2-5 h) and 5 h (4-7 h) after instillation or ejaculation, respectively. Vaginal pH had then been below 4.5 for approximately 1 h. Pepsin C activity was present in the vagina for more than 24 h thereafter. It is most likely that seminal pepsin C is without influence on the fertilizing spermatozoon. However, pepsin C may exert a local effect in the vagina by degrading seminal proteins, thus preventing an immunogenic response in females. PMID- 2758095 TI - Human cervical mucus and its interaction with sperm: a fine-structural view. AB - Cervical mucus is a glycoprotein gel whose biological functions depend upon its macromolecular architecture. Using freeze-substitution fixation techniques, we have used transmission electron microscopy to examine the fine structural aspects of mucus, before and after unidirectional physical shearing, and during its interaction with sperm. The microstructure of mucus that has not been directionally stretched consists of a homogenous pattern of interconnecting electron-dense elements. The thickness of the primary structural elements varies from 0.04 to 0.5 microns, giving the impression that the elements have fibrillar but also ribbon-like properties. This dimension is smaller than the sizes depicted by prior studies using scanning electron microscopy. Within the mucus interior, the interstitial distance between adjacent primary elements ranges from 0.5 to 0.8 microns, and is filled with a fibrous network of secondary structural elements. This interstitial dimension is also significantly smaller than that suggested by prior electron microscopic work. At the exterior borders of the mucus, the interstitial sizes are reduced. After physical stretching by forceps, the mucus microstructure undergoes a radical deformation. In some specimens, the primary structural elements become longitudinally aligned and are less interconnected, with compaction at the exterior mucus borders. In other specimens, the primary structural elements become laterally compressed along the longitudinal axis; within the regions of compression, the intrapore diameter is reduced to less than 0.1 microns. These compressed regions will often exclude spermatozoa. Individual sperm deform the local mucus microstructure. The mucus directly anterior to the sperm head is stretched, and the mucus adjacent to the bending flagellum is compressed on the forward side and stretched on the opposite side. PMID- 2758096 TI - Concentration of acrosome stabilizing factor (ASF) in rabbit epididymal fluid and species specificity of anti-ASF antibodies. AB - Rabbit Acrosome Stabilizing Factor (ASF) concentrations were measured by immunoradiometric assay (IRA) in lumenal fluids obtained by micropuncture from the caput epididymidis, corpus epididymidis, cauda epididymidis, and the vas deferens of the rabbit. ASF was below the limit of detection in caput epididymidal fluids. Average ASF concentrations (3 bucks) in the corpus epididymidis, cauda epididymidis, and vas deferens were 880, 3363, and 3236 micrograms/ml, respectively. The average level of ASF in the cauda epididymidal fluid (CEF) represents from 10 to 23% of the total protein and is at least tenfold more than the amount previously determined to effect complete decapacitation of rabbit sperm by an in vivo assay. The average ASF concentration in seminal plasma from two vasectomized males was 0.155 micrograms/ml, approximately 100,000-fold less than is present in CEF and 2000-fold less than is present in normal seminal plasma. CEFs or seminal plasma from 11 different species were screened by Western blotting using high titer anti-ASF polyclonal antibodies to detect ASF-like molecules in other species. Only rabbit ASF was recognized. PMID- 2758097 TI - The basalis of the primate endometrium: a bifunctional germinal compartment. AB - Radioautographic analysis of epithelial and stromal cell proliferation in the primate endometrial functionalis and basalis (rhesus monkey) has identified horizontal zonal patterns of mitotic activation and inhibition during natural menstrual cycles. At 1 h after a single i.v. injection of [3H]thymidine, mitotic activity in endometrial biopsies (hysterotomy) was determined on 9 days from the late proliferative to the late luteal phase (-2 days to + 14 days relative to the estrogen [E2]peak). Labeling indices (LIs) were determined within glandular segments of the 4 horizontal endometrial zones: Transient functionalis Zone I (luminal epithelium) and Zone II (uppermost gland); Germinal basalis: Zone III (middle gland) and Zone IV (basal gland). The size of the dividing epithelial populations (LI) differed zonally. During E2 dominance (-2 days to +3 days), the epithelial LIs of functionalis I (10 +/- 0.3%) and II (9.8 +/- 1.0%) were greater than those of basalis III (5.8 +/- 0.2%) and basalis IV (3.7 +/- 0.8%). During progesterone (P) dominance (+5 days to +14 days), epithelial mitosis was strongly inhibited in functionalis I (4.3 +/- 1.9%), functionalis II (0.8 +/- 0.2%), and basalis III (1.4 +/- 0.5%). Thus germinal basalis III was linked functionally with transient functionalis I and II by periovulatory uniformity in epithelial proliferation and postovulatory mitotic inhibition. A unique mitotic pattern set basalis IV apart from other zones by a steady rise in LI from 1% (-2 days) to 11% (+10 days). The LIs for stromal fibroblasts remained quite uniform in basalis IV but varied in other zones. Thus the postovulatory primate basalis was a distinct bipartite compartment in which the mitotic rate in basalis IV glandular epithelium increased steadily whereas that of basalis III was strongly inhibited. The remarkable enhancement of epithelial mitotic activity in basalis IV may reflect expansion of the stem-progenitor cell population for gestational growth or for post-menstrual regeneration. PMID- 2758098 TI - [Real-time analysis of orofacial movements using electromagnetic articulography]. AB - A real-time version of electromagnetic articulography is presented, which permits the recording of five positions of the articulators in the oro-facial system. Movements can be shown online on PC screen. Owing to its biological safety and ease of handling, the system is especially suitable for clinical applications. PMID- 2758099 TI - [Ability to remove pesticides in the production of dialysis water (1)]. AB - In many cases it can be demonstrated that the amount of plant protective and plant treatment substances (pesticides) in drinking water exceeds the permitted levels of the drinking water ordinance which will come into effect on October 1st, 1989. Since some of these components are of toxicological relevance, an investigation was done on how far pesticides are removed during conventional purification of dialysis water, and especially during reverse osmosis. The retention rates of a reverse osmosis plant for 14 different pesticides applied in different concentrations and compositions were determined. Almost all of the substances examined were retained with an effectiveness of 92-98%. The elimination efficiency did not depend on the initial concentration of the pesticides. After an initial phase of 50 h duration, the concentration in the treated water reached a constant value which no longer changed even after more than 700 h. In part 1 of this contribution at first the fundamentals of dyalisis water purification are reviewed and a selection of the pesticides to be investigated is carried out. In addition experimental set up and procedure are described. PMID- 2758100 TI - ["Elastic osteosynthesis" with autocompression plates of carbon fiber reinforced thermoplastic material]. AB - The problem of atrophic bone that occurs in osteosynthesis employing rigid plates is first depicted. Attempts at fabricating "simirigid" plates, which, however, have so far failed to gain any practical importance are then discussed. The reason for this seems to be that made of duroplastics cannot be molded during the operation and the thermoplastics do not have sufficient strength. The production of semirigid plates made of thermoplastic Polyethersulfon (PES), reinforced with 20% short carbon fibres, results in plates which are made moldable by heating in a small oven, white retaining sufficient static strength, although only limited fatigue strength. Biomechanical examinations revealed that with appropriate dimensioning of the plates, "elastic osteosynthesis" results in less loss of mechanical function of the stabilized bones, so that less atrophy of the bone may be expected. During more pronounced exercise loading, a reversible "springiness" of the fracture results, which might stimulate callus formation and improved stability. PMID- 2758101 TI - Disposition kinetics of Saccharomyces boulardii in man and rat. PMID- 2758102 TI - Pharmacokinetics of the angiotensin converting enzyme inhibitor benazepril.HCl (CGS 14 824 A) in healthy volunteers after single and repeated administration. AB - The pharmacokinetics of the new angiotensin converting enzyme (ACE) inhibitor benazepril.HCl were evaluated in healthy male volunteers. The single dose kinetics were established from data of 62 subjects receiving an oral 10 mg dose of the drug. The steady state kinetics were investigated in 15 subjects after once-daily oral doses of 5, 10 or 20 mg. The compound is a prodrug which, on absorption, is hydrolysed to the pharmacologically active metabolite benazeprilat. Thus, plasma concentrations and urinary excretion of parent compound and active metabolite were determined. Benazepril.HCl was rapidly absorbed (tmax = 0.5 h) and rapidly eliminated from plasma (t1/2 = 0.6 h). Only trace amounts were excreted unchanged in urine. The drug was rapidly metabolized to benazeprilat (tmax = 1.5 h). The elimination of the metabolite from plasma was biphasic. About 80 per cent of benazeprilat formed was eliminated within 24 h (t 1/2 = 2.7 h), whereas the terminal phase (t1/2 = 22.3 h) controlled a minor amount of elimination. About 17 per cent of dose was excreted in the 24-h urine as benazeprilat. The drug disposition did not change during repeated oral dosing and only small accumulation of the metabolite occurred. The accumulation ratio was 1.20 for AUC and 1.24 for urinary excretion. The effective half-life for accumulation was estimated at about 10-11 h. The comparison with other ACE inhibitors showed similarities but also marked differences with respect to the drug kinetics and excretion. PMID- 2758103 TI - Gastrointestinal, liver, and lung extraction ratio of acetaminophen in the rat after high dose administration. AB - The pharmacokinetics of acetaminophen was examined in rats after administration of a single dose of 200 mg kg-1 by the intra-arterial, intravenous, portal vein, and oral routes. Levels of acetaminophen and its two major metabolites, acetaminophen-glucuronide and acetaminophen-sulfate, were quantitated in plasma at various time points for about 5 h after drug administration. The relative contribution of the gastrointestinal tract, liver, and lung to the oral extraction ratio (first-pass effect after oral absorption) was determined. A mean oral extraction ratio of 0.49 was obtained. The mean relative extraction ratio of the gastrointestinal tract, liver, and lung were 0.52, 0.07, and 0, respectively, indicating a major contribution due to the gastrointestinal tract. This is in contrast to earlier studies which have indicated negligible contribution by the gastrointestinal tract to the oral first-pass effect when lower doses were utilized. These results suggest that the relative contribution of the gastrointestinal tract and liver to the oral first-pass effect of acetaminophen may be dose-dependent. PMID- 2758104 TI - Pharmacokinetic interactions between arbaprostil and aspirin in humans. AB - Arbaprostil is an orally active prostaglandin E2 analogue. It has been developed as a drug to treat ulcers induced by non-steroidal anti-inflammatory drugs. In this study, pharmacokinetic interactions between arbaprostil and aspirin were examined in humans after chronic doses of both drugs. Subjects received either arbaprostil (50 micrograms), aspirin (975 mg) or arbaprostil (50 micrograms) and aspirin (975 mg) four times a day for 6 days and one dose on 7th day. Blood and urine samples were collected after the last dose for 6 h. Pharmacokinetic parameters of arbaprostil, aspirin, and salicylate were determined. Coadministration of arbaprostil significantly lowered the area under curve (5.09 +/- 0.32 micrograms hml-1 vs 5.78 +/- 0.29 micrograms hml-1, mean +/- SE, p less than 0.05) and time (0.45 +/- 0.07 h vs 0.70 +/- 0.12 h, p less than 0.05) to reach maximal plasma concentration of aspirin (acetylsalicylate). The pharmacokinetics of salicylate were not changed by arbaprostil, nor were the pharmacokinetics of arbaprostil affected by aspirin. Coadministration of these two drugs did not appear to potentiate the side-effects of either drug. The results suggest that arbaprostil and aspirin may be administered together without clinically significant changes in pharmacokinetics or adverse side-effects. PMID- 2758105 TI - Pharmacokinetic interaction between diltiazem and amiodarone in the dog. AB - The pharmacokinetic interaction between diltiazem and amiodarone was investigated in dogs. In the presence of amiodarone, diltiazem's AUC values were significantly increased and its total body clearance and volume of distribution at steady-state significantly decreased. This study indicates that cardiac patients on combined diltiazem-amiodarone therapy may indeed be in a high risk situation in regards to the unexpectedly high blood levels of diltiazem induced: with the ultimate introduction of such side-effects as (1) the lowering of blood pressure, (2) A/V block, and (3) sinus node depression. Such cases would require immediate dosage adjustment. Assuming that the data obtained in this study can be extrapolated to humans, a patient's physiological parameters should be monitored at periodic intervals and, more importantly, the patient should report the first sign of any untoward effect. PMID- 2758106 TI - Abstracts. Seventh International Congress of Biorheology. Nancy, France, 18-23 June, 1989. PMID- 2758107 TI - Alpha-and beta-components of the popliteal efferent lymph flow response to intra arterial catecholamine infusions in the sheep. AB - Lymph flow and lymphatic pressure fluctuations were measured in cannulated popliteal efferent lymphatics of the sheep. Five-minute intra-arterial infusions of norepinephrine (0.4 microgram/kg/min) produced up to fivefold increases in lymph flow and lymphatic contraction frequency. This effect was blocked by the alpha-antagonist phentolamine but not by the beta-antagonist propranolol. Isoproterenol (0.4 microgram/kg/min i.a.) inhibited flow. This effect was antagonized by propranolol. Acetylcholine (0.4 microgram/kg/min) had little effect on lymph flow. Since norepinephrine and isoproterenol respectively stimulate and inhibit lymphatic pumping activity in vitro, it is proposed that the effects of these agents on lymph flow and lymphatic contraction frequency in vivo are best explained by direct modulatory actions on the lymphatic smooth muscle pump. PMID- 2758108 TI - Effects of pH and anion substitution on magnesium accumulation in rabbit aortic smooth muscle. AB - The effects of anion substitution, pH and extracellular Mg2+ concentration on 28Mg accumulation were examined in rabbit aortic smooth muscle. Accumulation of 28Mg (expressed as a 28Mg/Mg2+ ratio) was not changed when the concentration of added, nonradioactive MgCl2 was increased from 1.5 to 15.0 mM. The 28Mg efflux rate was increased by added MgCl2 (0.15, 0.5 or 1.5 mM) in a dose-related manner after a similar delay of 5-10 min. Addition of 1.5 mM MgCl2, MgSO4 or magnesium aspartate hydrochloride enhanced 28Mg efflux and inhibited accumulation of 28Mg to the same extent. An increase or decrease in extracellular pH correspondingly increased or decreased 28Mg accumulation. However, the 28Mg efflux rate was not altered when extracellular pH was decreased. Efflux of 28Mg was increased by added 1.5 mM MgCl2 at pH 7.4 but not at pH 5.8. Thus, the net uptake of Mg2+ appears to be proportional to the concentration of extracellular Mg2+ in rabbit aorta. Low external pH decreases 28Mg retention in rabbit aorta by inhibiting the uptake of 28Mg rather than by increasing 28Mg efflux. Effects of added Mg2+ on transmembrane movements of 28Mg are not altered by changes in the associated anion. Extracellular Mg2+ appears to enter the cell and exchange with an intracellularly located pool of 28Mg in the same manner, regardless of whether the accompanying anion is sulfate, chloride or monoaspartate hydrochloride. PMID- 2758109 TI - Glucose dependence of sequential norepinephrine contractions of vascular smooth muscle. AB - The effects of successive, norepinephrine (NE)-stimulated, contractions of porcine carotid artery intima-media strips as a function of recovery medium were studied. Recovery following NE stimulation required the presence of glucose in the bathing medium for subsequent force production in response to NE stimulation. Potassium stimulation following failed NE contractions produced maximal contractions. Phosphorous nuclear magnetic resonance studies under similar conditions indicated that the energy state of the tissue was not impaired during and after recovery from NE stimulation without glucose. This study shows that the phasic phase of norepinephrine-stimulated contractions is dependent on the availability of extracellular glucose during the poststimulation recovery period for successive NE contractions. PMID- 2758110 TI - Frequency of neuromuscular junctions on arteries of different dimensions in the rabbit, guinea pig and rat. AB - The medio-adventitial border of a variety of perfusion-fixed arteries of young adult rabbits, guinea pigs and rats has been studied in the electron microscope. The arterial media in the different vessels ranged from 2 to 25 cells thick. Neuromuscular junctions, defined as axon varicosities containing synaptic vesicles closely apposed to the outer surface of smooth muscle cells, with only a single layer of basal lamina intervening between axon and muscle membranes, were identified in all three species. Junctions were found in most vessels less than 1 mm in diameter with a frequency ranging from 8,000-150,000 junctions per square millimeter of smooth muscle surface, the number generally increasing with decreasing arterial diameter. These small arteries were mostly, but not exclusively, muscular rather than elastic. In large arteries, such as abdominal aortae and some elastic arteries lying close to the heart (e.g. the carotid), no junctions were found. In a few vessels, such as guinea pig basilar (muscular) and rat and guinea pig superior mesenteric (elastic) arteries, junctions were found infrequently (1,000-4,000/mm2). The data indicate that all muscular arteries in rats and guinea pigs, and most muscular arteries in rabbits, receive innervation in the form of sympathetic neuromuscular junctions. Whilst a few elastic vessels are sparsely innervated with junctions, some are surrounded by axon bundles containing vesicle-filled varicosities. The physiological significance of the latter is obscure. PMID- 2758112 TI - Treatment of stage III breast cancer. A panel discussion. AB - A major question in oncology today concerns the most appropriate therapy for locally advanced breast cancer. Realistic goals include effective local treatment and a prolonged disease-free interval for these patients, most of whom have incurable disease. Here, our panel discusses the roles of surgery, radiation therapy, chemotherapy, and hormonal therapy, and the proper sequencing of these modalities. PMID- 2758113 TI - Phytohaemagglutinin responsiveness of peripheral lymphocytes and survival in patients with primary breast cancer. AB - The response of peripheral blood lymphocytes from 153 breast cancer patients to the T-cell mitogen phytohaemagglutinin (PHA) was measured prior to surgery and patients assigned to either high (Hi/PHA) or low (Lo/PHA) PHA response groups. Patients were followed up for between 8 and 12 years, or until death. Clinical characteristics were similar in Hi/PHA and Lo/PHA groups. In the 96 patients who received no postoperative adjuvant therapy, overall and relapse-free survival was significantly longer in Hi/PHA than in Lo/PHA patients (p less than 0.005, and p less than 0.025 respectively); relative risk of death within 12 years was 0.52 and of relapse was 0.64. In 47 patients who were treated with radiotherapy postoperatively, there was no correlation between the PHA response and overall or relapse-free survival. The implications of these findings for the selection of breast cancer patients for adjuvant treatment following surgery are discussed. PMID- 2758114 TI - Hereditary breast cancer and possible risk of mammography. PMID- 2758111 TI - Exposure, susceptibility, and breast cancer risk: a hypothesis regarding exogenous carcinogens, breast tissue development, and social gradients, including black/white differences, in breast cancer incidence. AB - At present, known risk factors account for only one-third of breast cancer cases diagnosed in the United States. They explain an even smaller fraction of the ten fold variation in international breast cancer incidence rates. The low population attributable risk of these identified risk factors, plus the existence of phenomena that cannot be easily explained by current etiologic hypotheses (such as the higher rate of breast cancer among black as compared to white women under age 40 within the United States), suggests that unidentified risk factors contribute substantially to breast cancer causation. This paper summarizes evidence to propose that two socially-conditioned factors determine a society's breast cancer incidence and its social gradients in risk: 1) the extent of exposure to exogenous carcinogens, and 2) breast tissue susceptibility to these exposures. It is further hypothesized that breast tissue susceptibility is inversely related to breast tissue differentiation, and that socially-mediated reproductive patterns (involving both early-terminated and full-term pregnancies) affect susceptibility both by altering (via hormonally-mediated mechanisms) the number and ratio of undifferentiated and differentiated cells, and by stimulating the growth of initiated and transformed cells. This view is presented in contrast to hypotheses that propose exposure to endogenous hormones as the major determinant of breast cancer risk. PMID- 2758115 TI - The impact of the right to refuse treatment in a forensic patient population: six month review. AB - In December of 1987, the Wisconsin supreme court held that all involuntarily committed mental patients in the state had the right to refuse psychotropic medication unless a court held that they were incompetent to make treatment decisions. The authors studied the effects of this decision in a 165-bed forensic hospital over the first six months after implementation of the decision. They found that 29 percent of patients already on psychotropic medication initially refused further treatment as opposed to 75 percent of newly admitted patients. Of refusers, 32 percent eventually resumed taking medication voluntarily; courts overturned the refusals of all the 51 percent who maintained their refusals, after an average delay of over a month. The length of procedural delays actually increased over the six months of the study as the courts learned of the decision. The authors compare their findings with other reported studies of implementation of right to refuse treatment decisions and discuss differences between the right to refuse treatment for civilly and criminally committed patients. PMID- 2758116 TI - The psychiatrist's guide to right and wrong: Part III: Postpartum depression and the "appreciation" of wrongfulness. AB - Whether or not the psychiatrist testifies on the ultimate issue in insanity defense cases, it is critically important that he familiarize himself with the applicable legal standards and interpretations in order properly to relate his clinical findings to the relevant criteria for insanity and thereby enhance the probative value of his testimony. This is the third in a series of articles which attempts to explicate judicial and statutory standards of insanity and correlate them with the psychiatrist's findings of psychopathology. This article analyzes the Model Penal Code formulation of insanity, with special emphasis on the all important distinction between "know" and "appreciate." This formulation permits the defendant possessed of mere surface knowledge or cognition to be exculpated, requiring that he have a deeper affective appreciation of the legal and moral import of the conduct involved if he is to be held criminally responsible. The Model Penal Code approach more readily lends itself to application as a standard of responsibility in cases involving affective disorders. An important disorder within this group, postpartum depression, is discussed in the context of raising the insanity defense in a case of infanticide. PMID- 2758117 TI - The New York State Insanity Defense Reform Act of 1980: a legislative experiment. AB - Through a statistical analysis of major changes in postacquittal procedures of the Insanity Defense Reform Act of 1980 (IDRA 1980), the study reveals the Act's success in formalizing, regularizing, juridicizing, accelerating, and extending to all acquittees psychiatric examinations and review and release procedures. Although more persons are reviewed and released at postacquittal hearings than in the matched pre-1980 cohort, fewer enter nonsecure facilities at commitment or during first 18 months of hospitalization, and fewer are released at the six month review. After 18 months more acquittees remain inmates in secure facilities. Interviews with leading figures in the formulation and enactment of IDRA provide retrospective and prospective judgments on insanity defense reform issues. PMID- 2758118 TI - Effects of a state law on rates of restraint on a child and adolescent unit. AB - Rates of restraint and seclusion on a child and adolescent unit were evaluated before and after the implementation of a restrictive state law which was designed to reduce the monthly rates of restraint. Overall, the total number of hours in restraint, corrected for mean daily census, decreased significantly. The average number of patients in chemical restraint stayed about the same. There was a significant increase in number of patients, number of episodes, and hours of mechanical restraint as expected. Rates of seclusion dropped to zero as mandated. A new category of physical restraint was defined by law and was used to limited extent. PMID- 2758119 TI - Violence in geriatric patients with dementia. AB - Although the elderly have been studied as victims of violent behavior, there has been little investigation of this population as perpetrators of violence. Using the method of retrospective chart review, this study examines the issue of violence by geriatric patients with dementia who need acute psychiatric hospitalization. Of 52 patients, 44 percent engaged in physical attacks and/or fear-inducing behavior during the two weeks prior to admission, and 29 percent engaged in similar behavior within the first 72 hours of hospitalization. Married patients and those who lived with family were overrepresented in the group of violent patients. The authors discuss possible explanations and implications of these findings. PMID- 2758120 TI - Perceptions of ethical problems by forensic psychiatrists. AB - A survey was undertaken of the opinions of two groups of forensic psychiatrists to determine their views regarding forensic ethical issues. Although AAPL has made significant strides for our profession by adopting ethical guidelines, some important issues have not yet been addressed, as revealed by our survey. Included were items heretofore considered too "controversial" for incorporation into guidelines, as well as items from the APA ethical framework. All APA items were evaluated as addressing ethical problems. The majority of respondents also viewed most of the "controversial" items as confronting relevant ethical problems, thereby suggesting their inclusion, in some form, in the profession's guidelines. They also appeared to favor retention of many traditional medical ethical values when functioning as a forensic psychiatrist. Clear selective discrimination existed among differing death penalty facets. Since AAPL at present does not wish to conduct its own ethics hearings, the AAPL guidelines as well as the items supported in this paper's survey would best be translated into a form consistent with the APA framework. In this way, AAPL's guidelines and also the new suggested items could readily be coordinated within the APA framework and could play a role in the APA local district branch enforcement process. PMID- 2758122 TI - [9th Forum on Cancerology. Paris, 6-7 June 1989. Abstracts]. PMID- 2758121 TI - Defendants pleading insanity: an analysis of outcome. AB - The authors examined the cohort of all defendants pleading not guilty by reason of insanity over a 12-month period in Baltimore City's superior trial court. During that time, 143 of the 11,497 defendants indicted (1.2%) pled not criminally responsible. Fourteen of those defendants (10%) were subsequently found not guilty by reason of insanity. The authors found marked agreement between the prosecution and defense with only two cases leading to full trials where the issue of insanity was argued. The evaluating physician's opinion as to criminal responsibility and Axis I diagnosis, and the most serious underlying charge discriminated between those defendants found not guilty by reason of insanity and those defendants found guilty or not guilty by the court. Other demographic factors such as age, number of dependents, educational level, severity of illness, and criminal background did not discriminate between the two groups. PMID- 2758123 TI - Elevation of urinary N-acetyl-beta-D-glucosaminidase and beta-galactosidase activities in workers with long-term exposure to aromatic nitro-amino compounds. PMID- 2758124 TI - Some factors influencing cadmium-manganese interaction in adult rats. PMID- 2758125 TI - Zinc protection against cadmium effects on preimplantation mice embryos. PMID- 2758126 TI - Effect of linear alkyl benzene sulphonate on germination of spores of the aquatic fern Ceratopteris thalictroides. PMID- 2758127 TI - Evaluation of ATP photometer for toxicity testing using Microtox luminescent bacterial reagent. PMID- 2758128 TI - Histopathological changes induced by malathion in the gills of bluegill Lepomis macrochirus. PMID- 2758129 TI - Urinary excretion of sulfate and glucuronate conjugates in a free living population of adult males. PMID- 2758130 TI - Bioaccumulation and depuration of some trace metals in the mussel, Perna viridis (Linnaeus). PMID- 2758131 TI - Uptake and distribution of 203Hg by fish fingerlings, Cirrhina mrigala, exposed to linear alkyl benzene sulphonate. PMID- 2758132 TI - Effect of forced fasting on magnesium and manganese regulation in a terrestrial isopod, Porcellio spinicornis Say (Porcellionidae, Isopoda, Crustacea). PMID- 2758133 TI - Distribution of atrazine, simazine, alachlor, and metolachlor in soil profiles in Connecticut. PMID- 2758134 TI - Heavy metal toxicity to fiddler crabs, Uca annulipes latreille and Uca triangularis (Milne Edwards): respiration on exposure to copper, mercury, cadmium, and zinc. PMID- 2758135 TI - Rapid and simple method for identification of glufosinate-ammonium using paper chromatography. PMID- 2758136 TI - Analysis of tributyltin compounds in shellfish by using gas chromatography-mass spectrometry. PMID- 2758137 TI - Degradation of malathion by microorganisms isolated from industrial effluents. PMID- 2758138 TI - Pesticide degradation in model soil evaporation beds. PMID- 2758139 TI - Hydrolysis of methyl parathion in a flooded soil. PMID- 2758140 TI - Chemical characterization and toxicological assessment of kraft pulp mill fiber waste as a feedstuff for beef cattle. PMID- 2758141 TI - Effects of paraquat on parent generation female and F1 suckling mice using different treatment regimes. PMID- 2758142 TI - Strain difference in free p-cresol excretion in urine of rats exposed to toluene at sub-narcotic concentrations. PMID- 2758143 TI - Short-term toxicity of nine industrial chemicals. PMID- 2758144 TI - Effects of a low OP dose on seed/bead discrimination in the kangaroo rat, Dipodomys. PMID- 2758145 TI - The Addiction Research Unit of the Institute of Psychiatry, University of London- I. The work of the unit's drug and alcohol section, and general issues. PMID- 2758146 TI - Treatment for the addictions in a psychiatric setting. AB - The Alcoholism, Chemical Dependency and Compulsive Gambling Services at South Oaks Hospital (a 334-bed private psychiatric facility in Amityville, New York) are discussed. Psychodrama and other group methods are integral parts of the program the interdisciplinary treatment team, headed by a psychiatrist, includes addiction counsellors. Outpatient continuing care and self-help groups are stressed. PMID- 2758147 TI - Cleaning the people's home: recent developments in Sweden's addiction policy. AB - Legislation has recently been passed in the Swedish parliament to criminalize drug use and widen the powers of the authorities to take adult alcoholics and drug addicts into care. The arguments and debates that have led to these measures are described, drawing on official reports, legislative proposals and parliamentary proceedings. The Swedish attempt to create a drug-free society is linked with recent economic problems, a temperance tradition, and a strong cultural desire for order. These have contributed towards a climate which two pressure groups in particular have manipulated to their advantage. PMID- 2758148 TI - Alcohol advertising, consumption and abuse: a covariance-structural modelling look at Strickland's data. AB - Re-analysis employing covariance-structural models was conducted on Strickland's (1983) survey data on 772 drinking students from Grades 7, 9 and 11. These data bear on the relations among alcohol consumption, alcohol abuse, association with drinking peers and exposure to televised alcohol advertising. Whereas Strickland used a just-identified model which, therefore, could not be tested for goodness of fit, our re-analysis tested several alternative models, which could be contradicted by the data. One model did fit his data particularly well. Its major implications are as follows: (1) Symptomatic consumption, negative consequences and self-rated severity of alcohol-related problems apparently reflect a common underlying factor, namely alcohol abuse. (2) Use of alcohol to relieve distress and frequency of intoxication, however, appear not to reflect abuse, although frequent intoxication contributes substantially to it. (3). Alcohol advertising affects consumption directly and abuse indirectly, although peer association has far greater impact on both consumption and abuse. These findings are interpreted as lending little support to further restrictions on advertising. PMID- 2758149 TI - Alcohol taxes: do the poor pay more than the rich? AB - Concern has often been expressed that alcohol taxes bear more heavily on the poor than on the rich, especially if these taxes are based on quantity rather than price. However, surprisingly little is known about how the tax burden is distributed across different income groups. Utilizing survey data from 3010 respondents in New Zealand, this study calculates exactly how much alcohol tax was paid by respondents in different income groups and in different types of households. These results were applied to household expenditure survey data to estimate the incidence of alcohol taxes across different households. The results suggest that, although in dollar terms the wealthiest households paid about four times as much alcohol tax as the poorest households, when expressed as a percentage of income, alcohol taxes are distributed proportionally across the lower income brackets but decline towards the upper end of the income scale. These taxes accounted for less than 1% of household income for all income groups. Households with children generally paid less alcohol tax than households without children. It is concluded that alcohol taxes in New Zealand do not seriously conflict with the broader equity objectives of government policy. PMID- 2758150 TI - Low alcohol beers and wines: attitudes of problem drinkers to their use and their effect on craving. AB - Thirty-one inpatient and 67 expatient problem drinkers' use of low alcohol drinks and their attitudes towards them were assessed using questionnaire measures. Self ratings of craving for alcohol were made before and after exposure to and optional tasting of low alcohol drinks. Problem drinkers were found to have a generally favourable view of low alcohol drinks, and they claimed that use of these drinks did not contribute to relapse. However, craving for alcohol was found to be significantly raised over baseline after exposure to low alcohol drinks. A significant correlation was found between this increase in craving and severity of dependence as assessed by the SADQ. PMID- 2758151 TI - An epidemic of opium dependence among Asian refugees in Minnesota: characteristics and causes. AB - After several decades absence, opium smoking has reappeared in the U.S. Introduced by Indochinese refugees in the early 1980's, it has spread to several regions of the country. In this report the characteristics of refugee opium addicts is described. In addition, the factors contributing to a fertile situation for opium addiction are presented. Finally, implications of these findings and remedial recommendations are suggested. PMID- 2758152 TI - Measuring the heaviness of smoking: using self-reported time to the first cigarette of the day and number of cigarettes smoked per day. AB - Two simple self-report measures have been used to assess the heaviness of smoking, 'number of cigarettes per day' (CPD) and 'time to the first cigarette of the day' (TTF). Little attention, however, has been given to the precise method of scoring this information. Using biochemical indicators of heaviness of smoking (alveolar carbon monoxide and cotinine), we explore the optimum data transformations for regression analysis and categorical analysis. We suggest a four category scoring scheme for both time to the first cigarette of the day (less than or equal to 5, 6-30, 31-60 and 61+ min) and average daily consumption of cigarettes (1-10, 11-20, 21-30, 31+ cigarettes) as the most powerful and practical categorical scoring of these variables. Due to possible ceiling effects on biochemical measures, we suggest using logarithmic transformations of CPD or TTF for regression or correlation analyses. PMID- 2758153 TI - The reliability of the CIDI-SAM: a comprehensive substance abuse interview. AB - The CIDI-SAM is a fully-structured interview that ascertains DSM-III, DSM-III-R, Feighner, RDC and ICD-10 diagnoses for alcohol, tobacco and nine classes of psychoactive drugs. It was designed at the request of the WHO/ADAMHA Task Force on Psychiatric Assessment instruments to expand the substance abuse sections of the CIDI. Using a test-retest design, the diagnostic and item reliabilities of this instrument were tested in a sample of 39 patients in substance abuse treatment at three St. Louis treatment facilities. Kappa values and their 95% confidence intervals, and Yule's Y values are reported. The average kappa for DSM III substance disorders was 0.84, for DSM-III-R it was 0.82. We report, on the average, excellent kappa values for individual alcohol and drug symptoms. We also ascertained from the respondent's themselves the reasons why answers to specific questions might have been discordant. The findings from this unique 'discrepancy interview' are reported. PMID- 2758154 TI - Alcoholism: advice versus extended treatment. PMID- 2758155 TI - The parathyroid glands in the rat as seen by ultrathin step and serial sectioning. AB - Parathyroid cells exhibit ultrastructural heterogeneity. This has been interpreted as an indication that the cells are undergoing secretory cycles, varying in synthetic activity. By electron microscopy we examined step sections at 1 and 2 micron intervals and serial sections of parathyroids from normocalcemic rats of three different age groups. The secretory cells in all three age groups exhibit structural polarity: nuclei and secondary lysosomes are generally located towards the interstitial tissue, whereas the Golgi is confined mainly to regions in the interior of the cell sheets. Cell surfaces facing the interstitial tissue are smooth, whereas plasma membranes in the interior of the cell sheets form tortuous areas. Consequently, an individual cell profile may show quite different appearance depending on section level. Our results do not support the concept that the observed heterogeneity is necessarily due to differences in organelle contents between the cells. The present investigation thus offers an alternative explanation to the ultrastructural variability among secretory parathyroid cells in the rat. PMID- 2758156 TI - Early calcitonin hypersecretion and C cell hyperplasia in rats with high incidence of C cell tumors (Wag/Rij). AB - Wag/Rij rats, a Wistar-derived strain, develop on aging a spontaneous medullary thyroid carcinoma which shows many morphological similarities to the human neoplasm. Using biochemical and histological methods, we studied calcitonin secretion and C cell distribution in young and adult Wag/Rij rats, to characterize possible modifications in calcitonin synthesis and secretion as compared to the original Wistar strain. During the period investigated, the mean basal circulating levels of calcitonin of both sexes were not significantly different between the two strains, although the Wag/Rij rats tended to have higher values. After a calcium challenge, the circulating calcitonin levels increased normally in the Wag/Rij strain as compared to Wistar rats of the same ages. Histological observations of their thyroids revealed a significant C cell hyperplasia, along with a weak immunostaining in some of the cells, due to a lack of secretory granules. Thus, in addition to the ability of developing C cell tumours on aging, the Wag/Rij strain is characterized by an early C cell hyperplasia leading to an increase of calcitonin secretion after a provocative secretion test. PMID- 2758157 TI - The effect of substrate composition and condition on resorption by isolated osteoclasts. AB - Osteoclasts isolated from 10-day-old rabbits were studied in a cell culture system to obtain further insight into the possible mechanisms involved in the process of bone resorption. Osteoclasts were cultured on the surfaces of devitalized mammalian bones, a composite of polycrystalline synthetic hydroxyapatite and geological single crystal hydroxyapatite. The structural interaction of osteoclasts with these various substrates was morphologically characterized by using a scanning electron microscope. Viable osteoclasts were observed to adhere and extend pseudopodia and filopodia for all cases of calcium phosphate surfaces. However, actual resorbing process was only observed in devitalized bone surfaces. Resorption pits of various sizes were found in multiple series and showed a preference for mineral-exposed area over collagen exposed area. The difference observed between resorption of those areas of bone surface and the failure of osteoclasts to resorb non-tissue substrates are discussed in relation to current theories of the mechanisms of mineral dissolution and resorption in mammalian calcified tissues. PMID- 2758158 TI - Cartilage resorption and endochondral bone formation during the development of long bones in chick embryos. AB - Cartilage resorption during long bone development in the chick embryo varies in several crucial aspects from that in mammals. Cartilage does not calcify prior to resorption, the pattern of vascular tunnelling is not as regular as that in mammals and no distinct growth plate or secondary ossification centre is apparent. Primary cartilage resorption is preceded by diffusion of substances which produce a change in the cartilage matrix and necrosis of adjacent chondrocytes. Mononuclear phagocytes resorb the bulk of uncalcified cartilage, but resorption is slowed down by the formation of an osteoid band along the walls of the marrow tunnels. This prevents resorbing cells from gaining access to the cartilage matrix. If this osteoid band is in alignment with the trabecular structure, it may contribute to structural bone. In some areas chondrocytes transform into, or are replaced by, bone-producing cells and osteoid is observed within the chondrocyte lacunae. Some calcification of cartilage is observed after 16 days in ovo, but this is independent of cartilage resorption. Remnants of calcified cartilage frequently persist in the marrow cavity and multinucleated chondroclasts are required to resorb these remnants. PMID- 2758159 TI - Effects of 1 alpha-hydroxyvitamin D3 on various stages of predialysis renal bone disease. AB - Biochemical parameters of mineral metabolism and bone histomorphometric measurements--both static and dynamic--were studied in 27 to 29 patients with chronic renal failure before (T0) and after 3 months treatment (T3) with 1 alpha hydroxyvitamin D3 (1 alpha (OH)D3; average daily dose 0.55 micrograms). In none of the biopsies was a positive aluminum stain found. Fourteen patients had an osteoblast seams length (Ob.Pm) of less than 4% (Group I) and high osteoid parameters, whereas 13 patients (Group II, Ob.Pm greater than 4%) also had clear histological signs of hyperparathyroidism. Group II had lower creatinine clearance and serum calcium, but higher iPTH values. Treatment with 1 alpha (OH)D3 resulted in a substantial suppression of secondary hyperparathyroidism in Group II, with a fall in Ob.Pm, the cancellous bone perimeter occupied by tetracycline double label and osteoclast perimeter (Oc.Pm). In Group II treatment resulted in the development of a positive correlation between Ob.Pm and the number of osteoclasts (N.Oc). With treatment the (thionine) mineralization front rose in both groups, but osteoid seams length did not fall. When calculated for both groups together, before and after treatment serum calcium was negatively correlated with osteoid seams length, while a positive correlation was found with the mineralization front. This study provides an indication that, in progressive renal bone disease in which aluminum intoxication has been excluded, hyperosteoidosis precedes the development of secondary hyperparathyroidism. Furthermore, the study shows that treatment with 1 alpha (OH)D3 suppresses secondary hyperparathyroidism and results in a moderate increase of mineralization. PMID- 2758160 TI - X-ray microanalytical histochemistry of human circumpulpar and mantle dentine. AB - An X-ray microanalytical histochemistry study was carried out, on thick sections observed under scanning electron microscopy, of five freshly extracted human premolars and five molars. In particular the circumpulpar and mantle dentine were examined to determine levels of calcium, phosphorus and sulphur, the basic elements involved in the process of biomineralization. Semiquantitative analysis was subsequently performed after the appropriate ZAF (Z, atomic number; A, absorption; F, secondary fluorescence) correction. Ca/P mass ratio was found to be similar for both regions in molars and slightly higher in circumpulpar dentine in premolars implying that this parameter is independent of the processes of biomineralization in the two dentinal regions. In contrast, statistically significant differences were recorded in sulphur content upon comparing mantle and circumpulpar dentine between premolars and molars (P less than 0.02). If sulphur, which has been associated with sulphated glycosaminoglycans (GAGs) decreases as mineralization progresses it would therefore seem reasonable to posit sulphur-rich areas in both topographical regions of the matrix--more significant in premolars than molars--able to undergo subsequent mineralization if required. The possible application of these findings in remineralization therapies is suggested. PMID- 2758161 TI - Age-related changes in trabecular width and spacing in human iliac crest biopsies. AB - Age-related changes in trabecular width and spacing have been examined in iliac crest bone obtained from 96 normal subjects. The mean trabecular plate density and separation were calculated from values of trabecular bone volume and mean trabecular plate thickness. There was an age-related decrease in mean trabecular plate thickness with age in both sexes; this was statistically significant in males (P less than 0.02) but not in females. In females, there was a significant decrease in mean trabecular plate density (P less than 0.001) and increase in mean trabecular plate separation (P less than 0.001); similar but non-significant trends were observed in the males. These results demonstrate that trabecular thinning contributes to age-related bone loss in both sexes. Loss of trabeculae also occurs in both sexes, but to a greater extent in females than in males. PMID- 2758162 TI - Structural mechanisms of trabecular bone loss in man. AB - The relationship between trabecular thinning and loss of connectedness of the trabecular bone pattern has been studied in iliac crest bone samples from 89 normal subjects in order to determine the structural mechanisms underlying age related bone loss. Trabecular width and structure were quantitatively assessed using computerized techniques. Highly significant negative correlations were found between the mean trabecular plate thickness and number of free ends/mm2 both in males (r = -0.571) and in females (r = -0.667) (P less than 0.001). Mean trabecular plate thickness also showed significant negative correlations with other structural indices indicating reduced connectedness, whereas positive correlations were found with those indices representing preservation of connectedness. Examination of the relative frequency of trabecular widths less than 100 microns revealed that only 2-5% of the trabecular surface would be susceptible to erosion by a resorption cavity of normal depth. These results indicate that trabecular thinning and erosion are interdependent processes in age related bone loss. Since only a small percentage of the trabecular surface is susceptible to erosion, and resorption cavities normally occupy only 1-5% of the total trabecular surface, these findings imply that the site of activation of new BMUs may not be randomly distributed but may instead be preferentially located at sites of lower trabecular width. PMID- 2758163 TI - The sleep/wake cycle in 4- to 14-month old children: general aspects and sex differences. AB - The sleep/wake cycle of 39 children, 4 to 14 months of age was observed and recorded continuously (24 h per day) over a 4-month period, one full week per month, from November 1986 through February 1987. Total sleep time per day was analyzed for the different age groups and for the two sexes. A decrease in total sleep time is shown as a function of increasing age for the whole population. Analyzing boys and girls separately, a differential effect on total sleep time was demonstrated, girls tending to sleep more after 10 months of age. PMID- 2758164 TI - Potassium concentration influences the gating of K+ channels from sarcoplasmic reticulum. AB - Gating of K+ channels from the sarcoplasmic reticulum (SR) is influenced by the K+ concentration in the bathing solution. The probability of finding the channel open (Po) increases nonlinearly with the K+ concentration. The current two-state model which considers only voltage-dependent rate constants for the SR K+ channel should be reconsidered in the light of the present results. PMID- 2758165 TI - GABAergic fibers from substantia nigra pars reticulata modulate escape behavior induced by midbrain central gray stimulation. AB - Electrical stimulation of microinjection of GABA antagonists into the dorsal periaqueductal gray (DPAG) produces escape behavior. In order to determine whether the nigrocollicular gabaergic fibers exert some control over this behavior, rats bearing kainic acid lesion of the substantia nigra pars reticulata were submitted to microinjections of bicuculline or electrical stimulation of the DPAG at the escape threshold. Rats thus treated exhibited a significant decrease in the escape threshold while bicuculline increased the expression of flight behavior. These results suggest an inhibitory control of gabaergic fibers from the substantia nigra pars reticulata on aversive behavior induced by DPAG stimulation. PMID- 2758166 TI - Cardiovascular change in response to prolonged defense area stimulation in freely moving rats. AB - The mean blood pressure and heart rate of freely moving rats were directly recorded over a 1-min period of electrical stimulation of the periaqueductal gray with intensities that induced freezing behavior, intense flight or no behavioral changes. Blood pressure and heart rate increased only when flight was induced and only during the first 15 s of stimulation. These cardiovascular changes suggest that homeostatic mechanisms act during the defense reaction and are markedly inhibited only at the beginning of the stimuli that induce the flight response, this inhibition quickly undergoing attenuation. These data do not suggest that activation of defense area, per se, contributes to the development of primary hypertension. PMID- 2758167 TI - The visual cortex of the agouti (Dasyprocta aguti): architectonic subdivisions. AB - 1. We have studied the cytoarchitecture and myeloarchitecture of the agouti's cortical surface that can be activated by visual stimulation. Five architectonic subdivisions that correspond to distinctive visuotopic representations were characterized. 2. The largest portion of the visual cortex is occupied by area 17 which is situated lateral to the cingulate cortex, medial to area 18, posterior to the parietal cortex, and anterior to the agranular retrosplenial cortex. Additionally, four architectonic subdivisions in the extrastriate visual cortex were distinguished, i.e., from medial to lateral: area 18, area 19, anterior lateral area, and temporal posterior area. 3. Along the border of the extrastriate cortex a ring of nonvisual cortical fields was encountered encompassing parietal (somatic sensorial) cortex, temporal anterior and temporal intermediate (auditory) areas, a band of pre-rhinal cortex, and agranular retrosplenial cortex. PMID- 2758168 TI - Model studies of crotamine self-association. AB - 1. The self-association of crotamine in the concentration range from 10 to 40 micrograms/ml was studied at pH 6, 25 degrees C, and at low ionic strength by monitoring the effect of protein concentration on the absorbance at 196 nm. 2. Of the several mathematical models tested, an equilibrium between monomers and trimers with an association constant of 1.50 x 10(11) M-2 gives an adequate representation of the phenomenon. However, a non-ideal, two-stage model describing an equilibrium among monomers, dimers, and trimers gives the best fit of the experimental data. 3. The equilibrium constants found for dimerization and trimerization were 1.70 x 10(3) M-1 and 3.37 x 10(6) M-1, respectively. 4. This model was confirmed by polyacrylamide gel electrophoresis where a trimer band was separated from an interconverting monomer-dimer band. PMID- 2758169 TI - New findings on the purification and characterization of an anti-bothropic factor from Didelphis marsupialis (opossum) serum. AB - We have used DEAE-Sephacel and Sephacryl S-200 to separate protein fractions from Didelphis marsupialis serum capable of protecting mice from the lethal effect of Bothrops jararaca venom. The fractions separated were homogeneous by conventional electrophoresis using cellulose acetate and polyacrylamide; however, they were heterogeneous on PAGE-SDS, showing similar electrophoretic patterns with or without mercaptoethanol. The protein bands obtained were glycoproteins with a molecular weight of 42,000 to 58,000 Daltons. PMID- 2758170 TI - Thyroid peroxidase activity in human nodular goiters. AB - 1. Thyroid peroxidase (TPO, iodide-oxidation) activity was evaluated in nodular and paranodular tissue samples from 27 patients with nodular goiter (19 "cold" and 8 "hot" nodules), and compared to 11 diffuse toxic goiter and 9 normal thyroid tissue samples. 2. In terms of U/g digitonin solubilized protein, TPO activity was increased in hot nodules (P less than 0.05), although not as much as in diffuse toxic goiters (P less than 0.01). 3. The mean TPO activity of tissues paranodular to a cold nodule was not different from that of normal thyroids. 4. Both the highest and the lowest TPO activities were found in cold nodules, but their mean value did not differ from those of their paranodular tissues or normal thyroids. 5. Inter-tissue variability was significantly increased (P less than 0.01) in cold nodules and in tissues paranodular to a hot nodule. 6. These data show that heterogeneity both within and among tissues contributes to the wide range of TPO activity detected in nodular goiters. PMID- 2758171 TI - The protective effect of zinc on gastric ulceration caused by ethanol treatment. AB - 1. The present study was undertaken in order to demonstrate the protective action of zinc ions on the gastric mucosa of rats submitted to the ulcerogenic effect of ethanol. 2. Aqueous solutions of zinc sulfate (20 mg/kg) and/or ethanol/water (1:1, v/v) (10 ml/kg) were intragastrically administered to young adult rats. The fundus region of the stomach was submitted to scanning electron and light microscopy study. The control group received isotonic sodium sulfate by the same route. 3. The ulcerogenic action of ethanol was completely inhibited by intragastric pretreatment with zinc sulfate for 3 consecutive days. 4. The clinical use of zinc ions to protect the gastric mucosa merits consideration in the light of the present findings. PMID- 2758172 TI - Motor responses of the upper esophageal sphincter and body to intraluminal acid. AB - 1. It is known that contraction of the upper esophageal sphincter (UES) and secondary peristalsis protect the airway and clear the esophagus of refluxed gastric contents. However, the exact nature of the stimulus and the role of acid remain controversial. 2. Secondary peristalsis and UES responses were measured following the intraluminal infusion of 0.1 N hydrochloric acid and equiosmolar NaCl solutions in seven normal volunteers. The protocol consisted of three phases: infusion of increasing volumes (1, 3, 5 and 7 ml per min), infusion of a given volume (7 ml per min) at different stimulation sites and balloon distension. 3. At the proximal esophagus the UES response to both solutions was similar, rising from a basal resting pressure of 30 mmHg to 70 mmHg for both HCl (range 60-85 mmHg) and NaCl (55-85 mmHg). The magnitude of the response decreased as the distance from the UES increased. The level of response decreased to 40 mmHg for both NaCl and HCl (range 30-60 mmHg) at the distal esophagus. These responses were also volume dependent. When the solutions were infused at 7 ml/min into either the proximal or distal esophagus, the sphincter pressure increased with increased volume to 65 mmHg for HCl (range 50-85 mmHg) and 60 mmHg for NaCl (range 50-80 mmHg). Secondary peristalsis was also induced by the two solutions. The level of response again decreased as the distance from the UES increased. This response was also volume dependent. Esophageal distension by a balloon positioned 10 cm below the sphincter induced secondary peristalsis and sphincter response identical to those induced by the infusion of fluid. 4. These results indicate that the principal stimulus for recruitment of the esophageal motor clearance mechanism is intraluminal distension and not necessarily the pressure of intraluminal acid. PMID- 2758173 TI - Swimming escape learning in rats with telencephalic lesions. AB - Experiments were conducted to determine whether rats having unilateral or bilateral ablation of either the neocortex or telencephalon can learn to escape from a tank of water by climbing a platform. Hemi- or bilaterally decorticated rats were able to learn the swimming escape task, the same being observed for hemidetelencephalated rats. Fully detelencephalated rats, however, did not exhibit this capability. These results show that integrity of one of the cerebral hemispheres is necessary in order to allow swimming escape learning. PMID- 2758174 TI - Characterization of convulsions induced by a hexanic extract of Spilanthes acmella var. oleracea in rats. AB - To characterize the convulsions induced by a hexanic extract of Spilanthes acmella var. oleracea, male Wistar rats were injected ip with 50 to 150 mg/kg of the extract and EEG and behavior were observed for periods as long as 2 h. Following the lower doses (50 and 75 mg/kg) only minor behavioral changes such as grooming and wet dog shakes were observed. Higher doses (100 to 150 mg/kg) induced full tonic-clonic convulsions in a dose-dependent manner which were accompanied by typical electrographic seizures in the EEG. These results confirm that the hexane extract of Spilanthes acmella var. oleracea is able to induce generalized convulsions in rats and can be used as a tool in the development of new models of epilepsy. PMID- 2758175 TI - Erythro-lectin immuno test (Erythro-LIT) in the immunodiagnosis of neurocysticercosis. AB - 1. The effectiveness of the Erythro-Lectin Immuno Test (Erythro-LIT) to detect anticysticercus antibodies was tested using cerebrospinal fluid (CFS) from patients with neurocysticercosis. 2. Both Erythro-LIT and complement fixation (CF) were used to detect antibodies in 36 CSF samples from cysticercotic patients. Erythro-LIT detected anticysticercus antibodies in 35 CSF samples (97%) and CF in 26 (72%). The antibody titers ranged from 1:4 to 1:4096 for Erythro-LIT (mean geometric titer = 282.65) and 1:1 to 1:64 in CF (mean geometric titer = 7.92). 3. When greater than or equal to 1:16 Erythro-LIT titer was used as a significant diagnostic cut-off value, the sensitivity and specificity of Erythro LIT were 92% and 100%, respectively, for CFS. 4. The high sensitivity and specificity demonstrated here, together with the simplicity and low cost of the test, make the Erythro-LIT a potentially useful method for screening for specific antibodies in neurocysticercosis. PMID- 2758176 TI - Effect of vitamin E on red blood cell preservation. AB - The effect of exogenous vitamin E (2.1 mg/100 ml) was determined on the preservation of red blood cell integrity (PCV and RBC counts) during long-term storage. Cells from healthy human blood donors, normal rats and rats raised on a vitamin E-deficient diet were stored in CE medium at 4 degrees C for 40-60 days. The addition of vitamin E to the CE medium protected normal rat RBC and those from vitamin E-deficient animals to even a larger extent. Neither the PVC nor RBC count in human blood changed during storage for up to 60 days and no effect of exogenous vitamin E was demonstrable. PMID- 2758177 TI - Oscillations of cardiac rate induced by acetylcholine in the isolated guinea pig heart. AB - 1. The effects of acetylcholine (ACh) on cardiac rate (electrocardiogram), contractile force and coronary flow recorded simultaneously were investigated in isolated guinea pig hearts perfused with Locke solution by the method of Langendorff. 2. Bolus injections of 0.5-550 nmol ACh induced oscillations of cardiac rate. These changes were not directly related to the doses of ACh injected (chi 2 test, P greater than 0.05). 3. The presence of 10 microM physostigmine in the Locke solution increased the number of heart rate oscillations elicited by ACh. 4. The electrocardiogram showed that the heart rate oscillations were due to wandering pacemakers, such as slow or fast junctional rhythm, and slow or fast idioventricular rhythm, which were intermingled with sinus rhythm, A-V block or sinus bradycardia. 5. In most experiments, the increase in ventricular rate was associated with an increase in ventricular contractile force ("Bowditch Effect") and a simultaneous reduction of coronary flow. 6. The heart rate oscillations were not prevented by reserpine or blockade of nicotinic receptors (hexamethonium plus gallamine) but were prevented by blockade of muscarinic receptors with atropine. 7. We conclude that the heart rate oscillations induced by ACh are due to several electrophysiological mechanisms (automatism and/or conduction disturbances) related to activation of muscarinic receptors. PMID- 2758178 TI - Tracheal responsiveness to histamine, PAF-acether and acetylcholine in normal and actively ovalbumin-sensitized guinea pigs. AB - The contractile effects of histamine (His), PAF-acether (PAF) and acetylcholine (Ach) were analyzed in tracheal rings from normal and ovalbumin-sensitized (OAS) guinea pigs. Although maximal responses to all agonists were enhanced in preparations from OAS guinea pigs, only the EC50 of Ach was significantly decreased. Previous treatment with 1 microM indomethacin (IND) or 10 microM quinacrine (QUIN) markedly displaced the dose-response curves for Ach on OAS preparations to the left, whereas the EC50 of His was only increased by QUIN. PAF responses, however, were completely abolished by IND in preparations from both sensitized and unsensitized animals. These results indicate that ovalbumin sensitization significantly affects the tracheal response to Ach, His and PAF, an effect that appears to be mediated by arachidonic acid metabolites. PMID- 2758179 TI - Our silent enemy: ashes in our libraries. AB - SCHOLARS, SCIENTISTS, PHYSICIANS, OTHER HEALTH PROFESSIONALS, AND LIBRARIANS FACE A CRUCIAL DECISION TODAY: shall we nourish the biomedical archives as a viable and indispensable source of information, or shall we bury their ashes and lose a century or more of consequential scientific history? Biomedical books and journals published since the 1850s on self-destructing acidic paper are silently and insidiously scorching on our shelves. The associated risks for scientists and physicians are serious-incomplete assessment of past knowledge; unnecessary repetition of studies that have already led to conclusive results; delay in scientific advances when important concepts, techniques, instruments, and procedures are overlooked; faulty comparative analyses; or improper assignment of priority. The archives also disclose the nature of biomedical research, which builds on past knowledge, advances incrementally, and is strewn with missteps, frustrations, detours, inconsistencies, enigmas, and contradictions. The public's familiarity with the scientific process will avoid unrealistic expectations and will encourage support for research in health. But a proper historical perspective requires access to the biomedical archives. Since journals will apparently continue to be published on paper, it is folly to persist in the use of acidic paper and thus magnify for future librarians and preservationists the already Sisyphean and costly task of deacidifying their collections. Our plea for conversion to acid-free paper is accompanied by an equally strong appeal for more rigorous criteria for journal publication. The glut of journal articles-many superficial, redundant, mediocre, or otherwise flawed and some even fraudulent has overloaded our databases, complicated bibliographic research, and exacerbated the preservation problem. Before accepting articles, journal editors should ask: If it is not worth preserving, is it worth publishing?It is our responsibility to protect the integrity of our biomedical records against all threats. Authors should consider submitting manuscripts to journals that use acid-free paper, especially if they think, as most authors do, that they are writing for posterity. Librarians can refuse to purchase journals published on acidic paper, which they know will need restoration within a few decades and will thus help deplete their budgets. All of us can urge our government to devise a coordinated national conservation policy that will halt the destruction of a century of our historical record. The battle will not be easy, but the challenge beckons urgently. The choice is ours: we can answer the call, or we can deny scientists, physicians, and historians the records they need to expand human knowledge and improve health care. PMID- 2758180 TI - Preservation of the biomedical literature: an overview. AB - The National Library of Medicine began to preserve its collection many years ago. This article presents a brief review of NLM's early conservation and microfilming programs, and describes the current activities of the library's new Preservation Section. Also mentioned are the complementary efforts of NLM staff who are involved in research into electronic imaging and the campaign to increase the use of alkaline paper in medical and scientific publishing. Goals of the National Preservation Plan for the Biomedical Literature are summarized and a report on progress in implementing the plan is provided. Results of the preservation needs assessment described in the accompanying article by Kirkpatrick are briefly analyzed. Recent efforts of the Commission on Preservation and Access, the National Endowment for the Humanities, the Research Libraries Group, and several international associations are described in terms of their potential benefit to preservation of the biomedical literature. The need to monitor new preservation technologies and preserve materials in audiovisual and electronic formats is emphasized. It is argued that with enough coordination, cooperation, and willingness among health sciences libraries to share the costs, the goal of preserving all of the important biomedical literature can be accomplished. PMID- 2758181 TI - Preservation activities and needs in U.S. biomedical libraries: a status report. AB - A national sample of health sciences and other types of libraries having significant holdings of biomedical literature was studied to determine the status of library preservation programs. Findings pertaining to 134 basic health sciences libraries and to ninety-seven resource libraries in the Regional Medical Library Program network are reported and discussed. Basic health sciences libraries participating in the study were primarily hospital libraries; resource libraries were primarily academic health sciences center libraries. Findings include information on topics perceived to be of greatest need for staff training and for informational or educational materials; on levels of preservation activity, staffing, and funding; and on capabilities for participating in a national cooperative preservation program. Efforts to identify general and special biomedical collections of potential importance to a national preservation program met with limited success. PMID- 2758183 TI - Developing a preservation policy and procedure statement for a health sciences library. AB - The preconditions for creating a preservation policy document in a health sciences library are an existing preservation policy for the institution of which it is a part and administrative support for preservation. The assumption underlying preservation activity, from the formulation of general guidelines to the detail of operating procedure, is that collection development and preservation are complementary functions. Documentation of operational procedures in some detail should be a part of the statement. Since preservation activity cuts across functional library structures, all management staff should be involved in the planning process and be made aware of their responsibilities. The creation of a preservation policy statement will highlight unaddressed issues, procedural inadequacies, and differences in staff perceptions of priorities, but a written statement provides a framework for setting priorities and making decisions. PMID- 2758182 TI - Selection for preservation: considerations for the health sciences. AB - Just as no health sciences library can afford to collect every work on a subject, neither can any health sciences library afford to preserve every item that is added to its collection. In decision making for collection development, health sciences libraries apply a set of selection criteria. Those same criteria have direct application in selection for preservation decisions. This paper summarizes the literature of selection for preservation, describes the scholarly record of biomedicine, and presents criteria for selection for preservation decisions. The preservation priorities statement for microfilming of monographs and serials in the National Library of Medicine collection is included as an appendix. PMID- 2758184 TI - Besieged. PMID- 2758185 TI - Libraries and archives. PMID- 2758186 TI - Severe head injuries--Swedish style. PMID- 2758187 TI - Alcohol and other predictors of cognitive recovery after severe head injury. AB - The research examined the effects of alcohol and other variables on cognitive outcome after severe head injury. Alcohol consumption habitually and at the time of injury were strongly related, and both were related to age and educational level but not injury severity. Covariance analysis to remove the effects of age and education showed a reduction in the main effects, so that only alcohol consumption at injury was a significant predictor of memory, but not other cognitive areas late after injury. There were significant interactions between severity of injury (post-traumatic amnesia), and alcohol habitually or at time of injury, with increasing alcohol consumption increasing the size of the memory deficit. To have a short post-traumatic amnesia and have drunk heavily led to a worse memory score than that found in patients with a considerably longer post traumatic amnesia who had drunk lightly or not at all. PMID- 2758188 TI - Severe traumatic brain lesions in Sweden. Part I: Aspects of management in non neurosurgical clinics. AB - This paper reports a study of 587 consecutive patients treated for severe traumatic brain lesions (coma greater than 6 hours) during 1977-1984. Epidemiology, management and outcome were documented in 425 patients during the first part of the study (1977-1982) as a basis for future efforts at improvements. A total of 70-80 patients with severe head injuries were admitted annually to the Department of Neurosurgery in Lund and 88.6% of these patients were referred from 14 local hospitals, most of which are situated more than 50 km from Lund. Half of the patients were older than 40 years and 25% older than 60. Focal intracranial mass lesions were diagnosed in 64% of the patients. In the total study 41% of the patients were described as 'talk and deteriorate' and 13% as 'talk and die'. In 1983 a protocol for primary management was introduced in all local hospitals in the region. The management protocol caused a significant decrease (p less than or equal to 0.05) in the number of explorative craniotomies in local hospitals and a virtual disappearance of late surgical procedures (greater than 6 hours after injury). A fall was observed in the number of patients arriving at the Department of Neurosurgery with respiratory insufficiency. The study illustrates the epidemiology of severe head injuries in Sweden and the present state of management of these patients in non-neurosurgical departments. It is concluded that an overall outcome comparable to other reported series is also feasible in regions with a relatively sparse population and large geographical distances provided that strict recommendations for initial management are given to the local hospitals. PMID- 2758189 TI - Severe traumatic brain lesions in Sweden. Part 2: Impact of aggressive neurosurgical intensive care. AB - During a 6 year period (1977-1982), 425 patients were treated in the Department of Neurosurgery, University Hospital of Lund, for severe traumatic brain lesions (coma greater than 6 hours). From 1983 a more aggressive management protocol was introduced including early recording of intracranial pressure (ICP) and 162 patients were included in the study 1983-1984. A dangerous increase in ICP in spite of adequate surgical treatment and moderately controlled hyperventilation was the incentive for barbiturate coma therapy in selected patients. In the first part of the study overall mortality was 48% whereas 39% of the patients reached good recovery/moderate disability 6 months after injury. During the second part of the study the corresponding figures were 35% and 54%, respectively (in both cases p less than or equal to 0.01). In the group of patients with focal intracranial mass lesions mortality decreased from 59% to 46% (p less than or equal to 0.05) and good recovery/moderate disability increased from 30% to 42% (p less than or equal to 0.05). Improvement in outcome was even more pronounced in patients with no-mass lesions, mortality decreased from 30% to 12% and good recovery/moderate disability increased from 56% to 80% (p less than or equal to 0.05 and p less than or equal to 0.01, respectively). No change occurred in age distribution or in the types of intracranial lesions that could explain these improvements. It is concluded that aggressive neurosurgical intensive care significantly improves outcome in patients with severe traumatic brain lesions. PMID- 2758191 TI - Ten cases of head-injured, suicide-surviving adolescents: challenges for rehabilitation. AB - This paper describes ten adolescents who made unequivocal suicide attempts which resulted in near-death and brain damage. As predicted from studies of successful suicide, this group was mostly male, in late adolescence, and with histories of psychiatric difficulties. The fact that each had tried to commit suicide was avoided by the medical care facilities and by the families. The term 'accident' was customary. This paper makes suggestions for mental health clinicians who consult to head-injury rehabilitation teams treating such adolescents. Two cases are presented to highlight the findings and recommendations of this study. PMID- 2758190 TI - Severe traumatic brain lesions in Sweden. Part 3: Economic aspects of aggressive neurosurgical intensive care. AB - The present study had two main objectives: Firstly, to document the economic differences between 'ordinary' and 'aggressive' neurosurgical intensive care and secondly, to evaluate the medical benefits in relation to costs for different subgroups of head-injured patients. The study compares patients injured in traffic accidents and treated in the Department of Neurosurgery, University Hospital of Lund, during 1977-1978 (n = 67) with similar patients treated during 1983-1984 (n = 87) after introduction of more vigorous neurosurgical intensive care. The economic analysis was performed by means of the CRISE-method (Cost Related Index Score Evaluation) and all costs were related to the monetary value in 1984. Adoption of a program for 'aggressive' neurosurgical intensive care increased the costs per treated patient by about 46% (from 70.887 Swedish Crowns (SEK) to 103.452 SEK). Mortality decreased significantly after the change in intensive care and the cost per surviving patient remained virtually unaffected (131.928 SEK vs. 132.357 SEK). Further, after introduction of the 'aggressive' programme a larger proportion of the economic expenditures were spent on patients who ultimately recovered well. It is concluded that the increase in costs following introduction of a more vigorous intensive care programme in patients with severe traumatic brain lesions is very reasonable in relation to the documented medical benefits. PMID- 2758192 TI - Relationships among pre- and post-injury intelligence, length of coma and age in individuals with severe closed-head injuries. AB - Relationships among pre-injury ability, post-injury verbal intelligence, duration of coma and age were analysed in 34 closed-head injury patients, 7-28 years of age, whose coma lengths ranged from 5 to 180 days. The results obtained suggest that moderate to severe closed-head injury uniformly impairs verbal intellectual functioning without regard to premorbid status. Premorbid ability test scores had a markedly low correlation (0.04) with Wechsler Verbal IQs, obtained after patients had plateaued in intellectual recovery. Even when the effects of coma and age were controlled, the correlation was not significant. Mean post-injury IQs for patients grouped according to pre-injury intelligence (above average, average, below average) were all in the 80s. The findings do not support the prevailing assumption that the greater the premorbid ability, the greater the potential for intellectual recovery and the better the outcome. This study instead suggests that the higher the pre-injury IQ, the greater the IQ point loss. This has important implications for rehabilitation, counselling, discharge planning and follow-up. The greater the disparity between pre- and post-injury IQs, the more profound the loss and, hence, the greater the need for patient and family adjustments, coping and modifications of future personal, educational and vocational plans. PMID- 2758193 TI - Hypercalcaemia causing declining cognitive function in a head injured patient. AB - Although hypercalcaemia in young children or adolescents immobilized by fractures or spinal cord injury is well recognized, hypercalcaemia in adult immobilized patients is rare without a pre-existing bone disease. To our knowledge, hypercalcaemia in a head-injured, immobilized patient has not been previously reported. We report here a case where a previously normocalcaemic, immobilized, head-injured adult patient developed cognitive decline secondary to hypercalcaemia five months after injury, when transient interruption of enteral feedings led to mild dehydration. Indices of bone turnover were elevated and parathyroid hormone was appropriately suppressed. Possible predisposing factors in our patient included a severe degree of immobilization and a very high level of athletic activity prior to injury. Careful fluid management and specific monitoring of calcium levels, even several months post-injury, should be performed to avoid the added complications of hypercalcaemia in head-injured patients. PMID- 2758194 TI - The use of Sinemet and bromocriptine. PMID- 2758195 TI - A long-term view of hypospadias. AB - The long-term psychological and physical sequelae of hypospadias and its management were assessed in a study of 213 patients over the age of fifteen. A high level of adult dissatisfaction regarding the quality of their repairs both in terms of function and aesthetics, plus criticism of inadequate guidance, indicates the need for follow-up until at least mid-teens, and the choice of operations which produce a terminal meatus and more natural appearance. PMID- 2758196 TI - The reverse flow ulnar artery island flap: 42 clinical cases. AB - Based on anatomical and dye injection observations, since 1984 42 cases of hand tissue defects (due to injury or surgery) have been reconstructed using a reverse flow unlar artery forearm island flap. Of the 42 cases, aetiology has included extensive crushing (25 cases), electric saw injuries (7 cases), burn scars (4 cases) and tissue defects following tumour or chronic ulcer resection (6 cases). Only one flap developed necrosis. The survival rate was 97.6%, including 4 cases of distal marginal necrosis. This procedure, therefore, offers a useful alternative in the repair and reconstruction of extensive tissue defects in the hand, whether caused by accidental injury or by surgery. PMID- 2758197 TI - The anterolateral thigh flap; variations in its vascular pedicle. AB - The anterolateral thigh flap is based on the septocutaneous perforators of the lateral circumflex femoral artery. Little has been written about anomalies of its vascular pedicle. We report two variants of the pedicle vessel in eight patients in whom this flap was used, and absence of the perforators in five other cases in whom it was attempted. The anterolateral thigh flap has the advantages of thin and pliable skin, long and large pedicle, inconspicuous donor scar and the technical possibility of combination with fascia, sensory nerve and iliac bone. If the perforators are absent, a tensor fasciae latae musculocutaneous flap or anteromedial thigh flap is available with only minor changes of the flap outline. PMID- 2758198 TI - Modified gluteus maximus V-Y advancement flaps. AB - A modified method is presented for the closure of wounds using gluteus maximus V Y advancement flaps. Extra tissue is included in each flap by extending the corners of its advancing edge. The extra tissue is utilised to aid closure by using a combination of rotation and transposition in addition to advancement. This modification is illustrated and examples of its clinical use described. PMID- 2758199 TI - Functional implications of major surgery for intraoral cancer. AB - A group of 41 patients were questioned about functional problems and concern for appearance, experienced following major surgery for intraoral malignancy. Twenty five per cent of the group reported significant difficulties. Spouses reported a higher incidence of problems. The effects of primary tumour site and type of reconstruction on functional outcome are discussed. PMID- 2758200 TI - The transverse forked flap in columella reconstruction. AB - A single-staged transverse forked flap in columella reconstruction is described. This can be either unilateral or bilateral and an example of each is presented. PMID- 2758201 TI - Reconstruction of the alar groove. AB - The obliteration of a well-defined alar groove is common after nasal alar reconstruction. A method is described that can be used at the time of reconstruction to ensure the continued definition of the groove or to restore it in cases where it has been obliterated. The technique is based on the natural tendency of the skin to tube itself. Cheek skin is advanced beneath the posterior free edge of the reconstructed ala so that this edge now comes into contact with an epidermal surface. As this edge now tends to tube itself, a natural alar groove is produced. This method has been used successfully in six cases. PMID- 2758202 TI - A new method of auriculoplasty for protruding ears. AB - The paper describes a new method of correction of prominent ears which is based on mathematical preoperative planning of ear-to-skull distance. The antihelix is shaped by two dermosubcutaneous perichondrial flaps; the conchal spring is eased by means of a wedge-shaped cartilage excision in the area of the isthmus of the cartilage or the auricle, while residual protrusion of the lobule is corrected by a Z-plasty. This method was used to correct 233 protruding ears in 129 patients and better aesthetic results were obtained than those reported for other modern methods of corrective auriculoplasty. The advantages of the method are that it is radical, less traumatic than many others and eliminates any possibility of subjective errors in the preoperative planning of the ear-to-skull distance. PMID- 2758203 TI - The amniotic band disruption complex. The pathogenesis of oblique facial clefts; an experimental study in the foetal rat. AB - This paper reports the findings of an experimental foetal rat study which has shown that it is possible to produce facial clefts by stimulating the tethering and disruptive effects of amniotic bands. Of the 10 experimental foetuses, 9 (90%) survived the in utero surgery and are included in the present study. Facial and palatal clefts were produced in all 9 (100%) of these foetuses. PMID- 2758204 TI - The post-injury changes that occur in transected foetal nerves; an experimental study in the rat. AB - The findings of this experimental foetal rat study have shown that transection of the peripheral branches of the maxillary and facial nerves on the 18th day of gestation is followed by axonal degeneration and regeneration. Although these processes are similar to those which occur in the adult animal, they occur more rapidly in the foetus. In this study the regenerating axons had crossed the wound and entered the neural tubes of the distal nerve segments by 24 hours after injury. PMID- 2758206 TI - A comparison of immediate and delayed repair of peripheral nerves using freeze thawed autologous skeletal muscle grafts--in the rat. AB - A group of rats in which each animal received immediate repair of a transected sciatic nerve using freeze-thawed muscle autografts was compared with groups where repair was carried out after delays of 3, 5, 7, 14, 28 and 56 days following transection. All rats were studied 100 days after graft insertion. A delay of 56 days was found to be incompatible with useful recovery. In the groups studied after shorter delays, myelinated nerve fibre numbers and diameters were not found to differ significantly from those seen after immediate repair. There was, however, a significant reduction in the rate of remyelination of the fibres following a delay. The implications of this are discussed. PMID- 2758205 TI - An improved model for tissue expansion and flap research in the rabbit. AB - A pocket for tissue expander implantation in the rabbit is described at the level between the skin and the panniculus carnosus. The vascular anatomy of the undermined skin was studied with microangiography which showed a functional (sub)dermal plexus. Expanders were placed in seven rabbits and inflated daily over a period of 10 days. Blood flow in expanded skin, as measured with laser Doppler flowmetry, dropped with increasing inflation pressure. During the course of expansion, the intraluminal pressure returned to a baseline level within 24 hours after each inflation. It is concluded that an expander placed in the described layer in the rabbit causes considerable skin stretch and interferes with cutaneous blood supply and is therefore an improved model for tissue expansion in the human. PMID- 2758207 TI - How does sepsis promote thrombosis in microvascular anastomoses? AB - This study on 100 rats, divided into five equal groups, has shown that chronic distant sepsis promotes occlusion of microvascular anastomoses to a significantly greater extent than aseptic inflammation, transient bacteraemia and even local infection. This may be related to the significant increase in the number of platelets in the group with distant sepsis. PMID- 2758208 TI - Impedance monitoring for subcutaneous free flap transfers. AB - The assessment of thoracic blood flow by electrical impedance is a well established technique. In an application of this a small electrode array has been developed in which an alternating electric current is passed through a subcutaneous free flap and the induced voltage across a small volume measured. A graphical display of this changing voltage illustrates the pulsatile flow through the flap, allowing continuous assessment of perfusion on a beat by beat basis. The electrode array is such that it can be placed in close contact with muscle without interface problems and can assess its viability. It is non-invasive and easily removed. We have found this accurate, easily interpreted by inexperienced staff, and a considerable reassurance in the postoperative period. PMID- 2758209 TI - Surgical correction of complete bifid scrotum using subcutaneous pedicle flaps; a report of two cases. AB - A method of surgical correction for the separation and severe transposition of the scrotum associated with perineal hypospadias is reported. Although this is a rare congenital anomaly, we have treated two cases in the past 7 years. A technique has been devised by which the scrotum is divided into two subcutaneous pedicle flaps, enabling complete correction of the transposed penis and scrotum. PMID- 2758210 TI - Upper lip reconstruction: use of the free superficial temporal artery hair bearing flap. AB - The use of the superficial temporal artery hair-bearing flap applied to the repair of burn injuries to the upper lip of two male patients is described. It is a relatively simple method of providing tissue to the injured lip with advantages over traditional methods in that it is single-staged and provides the possibility for hair growth in the form of a camouflaging moustache. Donor site morbidity is minimal. When combined with additional reconstructive procedures in the multiply injured male face, it provides a reasonable expectation for the patient of an acceptable appearance. PMID- 2758211 TI - A compound radial artery forearm flap for the reconstruction of lip and chin defect. AB - This report presents a successful case of lip and chin reconstruction by a compound radial artery forearm free flap. This was a versatile source of tissue in the absence of local tissue for reconstruction. PMID- 2758212 TI - Delayed lymphocoele following neck dissection. PMID- 2758213 TI - Accidental reinnervation as a complication of latissimus dorsi free flap to the face and scalp. AB - Although direct nerve neurotization is well known, accidental full reinnervation of a major muscle following microvascular transfer has not previously been reported. Our patient, who presented with total scalp loss, was initially treated with simple skin grafts. Repeated breakdowns over the years necessitated the use of more durable cover. A free latissimus dorsi muscle flap achieved this objective. Two years post-transfer it became evident that the whole of the latissimus dorsi had become innervated, producing facial and scalp distortion when the patient smiled. Formal exploration and section of both neural trunks to the latissimus dorsi was necessary to abolish this bizarre grimace. PMID- 2758214 TI - Simplified microvascular clamps. AB - A simple method to produce an effective new pattern of microvascular clamp, which is easily assembled from inexpensive and widely available components, is presented. PMID- 2758215 TI - Abstracts of papers read at the annual scientific meeting of the Craniofacial Society of Great Britain. Oxford, 14-15 April 1988. PMID- 2758216 TI - Quality assurance (QA). PMID- 2758217 TI - Effect of aminophylline on cisplatin nephrotoxicity in the rat. AB - 1. The effect of the methylxanthine aminophylline on cisplatin (5 mg kg-1 i.v.) induced acute renal failure was investigated in the rat. Renal function was measured 5 days after cisplatin administration. 2. Cisplatin caused a polyuric acute renal failure. The creatinine clearance was significantly reduced. 3. Aminophylline (24 mg kg-1 12h-1) ameliorated the cisplatin nephrotoxicity when administered during the maintenance phase of acute tubular necrosis. However, it had no effect when only administered prophylactically before the cisplatin application. 4. Enprofylline (20 mg kg-1 4h-1 with dose adjustment), a methylxanthine lacking adenosine receptor antagonism in comparison to aminophylline, had no protective effect on cisplatin nephrotoxicity. 5. Adenosine is a renal vasoconstrictor and decreases glomerular filtration rate. Endogenous adenosine in the kidney is formed by degradation of ATP and is thought to be involved in various forms of acute renal failure. The results suggest that adenosine may be involved in the haemodynamic changes in the kidney induced by cisplatin. PMID- 2758218 TI - Vasoactive actions of local anaesthetics on human isolated umbilical veins and arteries. AB - 1. An in vitro study, using helical preparations of human umbilical arteries and veins obtained from healthy women at term pregnancy, was designed to determine: (a) whether three local anaesthetics commonly utilized in obstetric anaesthesia (bupivacaine, 2-chloroprocaine, and lignocaine) can induce contraction or relaxation of resting umbilical vessels; (b) whether these agents can induce contraction or relaxation of umbilical vessels which have been previously induced to contract by a known activator, potassium chloride (KCl); and (c) the relative potency of these agents as compared to KCl. 2. The results indicate that: (a) these local anaesthetics are vasoactive on human umbilical vascular smooth muscle; (b) bupivacaine induces contraction in over 90% of the resting vessels examined, while 2-chloroprocaine consistently causes relaxation and lignocaine causes a small degree of contraction in 40% of vessels examined; (c) bupivacaine causes further contraction (or potentiation) of KCl-contracted muscle in 50% of the vessels studied, while 2-chloroprocaine and lignocaine both induce relaxation of these contracted vessels. PMID- 2758219 TI - Effects of oxodipine on 45Ca movements and contractile responses in vascular smooth muscle. AB - 1. The inhibitory effects of oxodipine, a new dihydropyridine, were compared with those of nifedipine on contractile responses in rat isolated aortic strips and on spontaneous mechanical activity in portal vein segments. 2. In rat isolated aorta oxodipine (IC50 = 7.8 +/- 1.8 x 10(-9)M) and nifedipine (IC50 = 8.5 +/- 2.5 x 10( 9)M) dose-dependently inhibited the contractile responses induced by high K (80 mM), whereas responses to noradrenaline (NA, 10(-6)M) were only slightly affected (IC50 greater than 10(-7)M). These inhibitory actions were observed with both drugs added either before or after the induced contractions. 3. Contractile responses induced by addition of Ca to 0Ca high-K solution were also dose dependently inhibited by oxodipine (IC50 = 4.5 +/- 2.5 x 10(-9)M). However, oxodipine up to 10(-6)M did not modify the contractile responses obtained in strips incubated in 0Ca when Ca was added in the presence of NA. 4. Oxodipine and nifedipine also inhibited the development of spontaneous mechanical activity in portal vein segments. 5. Oxodipine inhibited 45Ca uptake stimulated by high K (I50 = 8.7 +/- 2.5 x 10(-9)M) or by NA (I50 greater than 10(-7)M). However, it did not modify 45Ca uptake and 45Ca efflux in resting strips or 45Ca efflux stimulated by NA. 6. These results indicate that the effects of oxodipine on vascular smooth muscle may be due to the blockade of Ca entry through potential- and receptor-operated channels; it was at least 10 times more selective for potential-operated channels. Oxodipine did not modify Ca entry through passive leak channels and NA-induced intracellular Ca release. PMID- 2758220 TI - Negative inotropic activity of antilaminin IgG: participation of cholinergic mechanisms. AB - 1. Antilaminin IgG decreased the dF/dt of mouse isolated atria and inhibited the mechanical effect of acetylcholine in a non-competitive fashion. 2. Inhibitors of nicotinic and muscarinic cholinoceptors impaired the negative inotropic action of antilaminin IgG in mouse isolated atria. Hemicholinium and tetrodotoxin also reduced the response while the antihistamine, pyrilamine was without effect. 3. These results suggest that antilaminin IgG modulates cholinergic function in mouse isolated atria. Possible mechanisms are discussed. PMID- 2758221 TI - Reduction of cephalic arteriovenous shunting by ergotamine is not mediated by 5 HT1-like or 5-HT2 receptors. AB - 1. The potent, antimigraine drug ergotamine has affinity for both 5-HT1 and 5-HT2 binding sites and constricts arteriovenous anastomoses. Since 5-HT also constricts arteriovenous anastomoses (mainly via 5-HT1-like receptors), this study investigates the involvement of 5-HT receptors in the ergotamine-induced reduction of arteriovenous shunting in the carotid circulation of the cat and pig. 2. In the cat, ergotamine (3, 10 and 30 micrograms kg-1, i.v.) reduced carotid blood flow, predominantly by a reduction in arteriovenous anastomotic blood flow. Pretreatment with ketanserin (0.5 mg kg-1, i.v.) or methiothepin (1 mg kg-1, i.v.) did not antagonize the effects of ergotamine. 3. In the pig, ergotamine (2.5, 5, 10 and 20 micrograms kg-1, i.v.) also reduced carotid blood flow and arteriovenous shunting, which was not affected by pretreatment with methiothepin (1 mg kg-1, i.v.). 4. These results suggest that the reduction by ergotamine in the shunting of carotid arterial blood via cephalic arteriovenous anastomoses is not mediated by 5-HT1-like or 5-HT2 receptors. PMID- 2758222 TI - Involvement of the protein kinase C system in calcium-force relationships in ferret aorta. AB - 1. Intracellular Ca2+-force relationships were investigated in ferret aortic smooth muscle by the simultaneous measurement of aequorin luminescence and isometric force. Complete calcium-force curves were constructed by plotting calibrated aequorin luminescence versus force, while intracellular [Ca2+] was made to change by increasing degrees of K+ depolarization or decreasing extracellular [Ca2+]. 2. The steady state calcium-force curve in response to K+ depolarization exhibited maximal force generation at an intracellular [Ca2+] of approximately 4 x 10(-7) M. Further increases in intracellular [Ca2+] did not yield additional increments in force. 3. Protein kinase C activation with the phorbol ester, 12-deoxyphorbol-13-isobutyrate 20 acetate (DPBA) produced contractions accompanied by no detectable increases in aequorin luminescence. DPBA significantly shifted the control [Ca2+]-force relationship leftward to lower intracellular [Ca2+] with an increase in the magnitude of maximal generated force. 4. In aorta maximally precontracted by K+ depolarization, the addition of DPBA resulted in a significant increase in force in the absence of further increases in intracellular [Ca2+]. Conversely, in muscles maximally precontracted with DPBA, responses to K+ depolarization resulted in subsequent increases in force in the presence of simultaneous sustained increases in intracellular [Ca2+]. 5. The relatively specific protein kinase C antagonist H-7 caused a significant decrease in intrinsic myogenic tone in the absence of any statistically significant decrease in intracellular [Ca2+]. 6. These results suggest that protein kinase C may be an important regulator of vascular smooth muscle contractility by: (1) providing a mechanism by which the apparent [Ca2+] sensitivity of the contractile apparatus during agonist-induced contractions is increased, and (2) maintaining intrinsic myogenic tone by a mechanism the [Ca2+] requirement of which is satisfied by the resting [Ca2+]i. PMID- 2758223 TI - Defibrotide reduces infarct size in a rabbit model of experimental myocardial ischaemia and reperfusion. AB - 1. Defibrotide, a single-stranded polydeoxyribonucleotide obtained from bovine lungs, has significant anti-thrombotic, pro-fibrinolytic and prostacyclin stimulating properties. 2. The present study was designed to evaluate the effects of defibrotide on infarct size and regional myocardial blood flow in a rabbit model of myocardial ischaemia and reperfusion. 3. Defibrotide (32 mg kg-1 bolus + 32 mg kg-1 h-1, i.v.) either with or without co-administration of indomethacin (5 mg kg-1 x 2, i.v.) was administered 5 min after occlusion of the left anterior lateral coronary artery and continued during the 60 min occlusion and subsequent 3 h reperfusion periods. 4. Defibrotide significantly attenuated the ischaemia induced ST-segment elevation and abolished the reperfusion-related changes (R wave reduction and Q-wave development) in the electrocardiogram. In addition, defibrotide significantly improved myocardial blood flow in normal and in ischaemic, but not in infarcted sections of the heart. The improvement in blood flow in normal perfused myocardium, but not in the ischaemic area was prevented by indomethacin. 5. Although the area at risk was similar in all animal groups studied, defibrotide treatment resulted in a 51% reduction of infarct size. Indomethacin treatment abolished the reduction of infarct size seen with defibrotide alone. 6. The data demonstrate a considerable cardioprotective effect of defibrotide in the reperfused ischaemic rabbit myocardium. This effect may be related, at least in part, to a stimulation of endogenous prostaglandin formation. Other possible mechanisms are discussed. PMID- 2758224 TI - The cardiovascular pharmacology of ICI 170777 ((6RS)-6-methyl-5-(pyrid-4-yl) 3H,6H-1,3,4- thiadiazin-2-one) a novel compound with positive inotropic and vasodilator effects. AB - 1. This paper describes the cardiovascular effects of ICI 170777, a novel compound which enhances cardiac contractility and causes arterial and venous dilatation. 2. The positive inotropic effects of ICI 170777 on the heart were demonstrated by an increase in left ventricular dP/dtmax in the anaesthetized and conscious dog, and by an increase in tension development in isolated papillary muscles from the cat. 3. In the anaesthetized dog, the positive inotropic effects of ICI 170777 and of isoprenaline were attenuated by atenolol (5 mg kg-1, i.v.). Atenolol displaced the dose-response curve to ICI 170777 to the right by 4 fold but displaced the isoprenaline dose-response curve to the right by 247 fold. In vitro, however, atenolol (10 microM) had no significant effect on the positive inotropic response to ICI 170777. In the ganglion-blocked anaesthetized dog, infusion of a low dose of ICI 170777 which had no effect on the basal left ventricular dP/dtmax, selectively potentiated the positive inotropic effects of isoprenaline. These results indicate that ICI 170777 has both a non-adrenoceptor mediated positive inotropic effect on the heart and also facilitates the beta adrenoceptor-mediated control of contractility. 4. In the denervated and perfused hind-limb of the dog, ICI 170777 reduced arterial perfusion pressure and increased limb circumference at a constant arterial flow and venous pressure. This indicates that ICI 170777 has direct dilator actions on both arterial and venous vessels. In this preparation, diazoxide exerted an arterial selective vasodilator effect and sodium nitroprusside was a relatively selective venous dilator. ICI 170777 exhibited a balanced arterial and venous dilator effect which was intermediate in profile between that of diazoxide and that of sodium nitroprusside. 5. In the conscious dog, low doses (2-5 mgkg -, orally) of ICI 170777 evoked an increase in left ventricular dP/dt,,, with no significant effect on heart rate or blood pressure. At a higher dose (10mg kg 1, orally) it also reduced blood pressure and caused a significant increase in heart rate. The duration of the positive inotropic effect of 5mg kg- (orally) of ICI 170777 was 10-12 hours. This response did not diminish following repeated administration of the compound. 6. The positive inotropic action and balanced arterial and venous dilator effect of ICI 170777 indicate that the compound may be useful in the treatment of congestive heart failure, a disorder that is characterized by decreased cardiac contractility and enhanced arterial and venous constrictor tone. PMID- 2758225 TI - Interference of WEB 2086 and BN 52021 with Paf-induced effects on guinea-pig trachea. AB - 1. The thienotriazolodiazepine WEB 2086 and the gingkolide BN52021 have been evaluated as antagonists of Paf-acether (Paf) by studying their effects on Paf induced relaxation and Paf-induced prostaglandin E2 (PGE2) production in histamine-contracted guinea-pig tracheal preparations. 2. Relaxation induced by Paf 4 microM in histamine-contracted guinea-pig tracheal preparations was 39.67 +/- 3.5% (n = 30). At the same concentration, Paf significantly increased PGE2 production from histamine-contracted guinea-pig tracheal preparations. 3. WEB 2086 inhibited in a dose-related manner (IC50 = 21.2 nM) the relaxant effect induced by Paf and, at 1 microM, suppressed Paf-induced release of PGE2. 4. BN 52021 100 microM inhibited to about 60% Paf-induced relaxation of histamine contracted guinea-pig tracheal preparations, but completely abolished Paf-induced increase in PGE2. 5. Both antagonists had no effects on relaxations induced by arachidonic acid 10 microM or PGE2 0.1-1 microM in histamine-contracted guinea pig tracheal preparations. 6. The results are consistent with the presence of specific Paf receptors in guinea-pig trachea and indicate that a relaxant prostanoid, namely PGE2, at least partially mediates Paf-induced relaxation in this experimental model. PMID- 2758226 TI - Effect of changing extracellular levels of magnesium on spontaneous activity and glutamate release in the mouse neocortical slice. AB - 1. The mouse neocortical slice preparation, maintained in a two compartment, grease gap bath, exhibits spontaneous depolarizing activity (with or without rhythmic after potentials) after perfusion with magnesium-free artificial cerebrospinal fluid. 2. If the magnesium concentration is decrementally lowered over an extended time period, then incrementally raised following a similar time course, the spontaneous depolarizing shift activity shows a hysteresis (with regard to both frequency and amplitude), the depolarizing shifts being more resistant to magnesium during the incremental period. 3. The amino acid content of the perfusing fluid was analysed by high performance liquid chromatography (h.p.l.c.). Although a basal efflux of 6 amino acids was quantifiable, only glutamate levels increased following superfusion of the preparation with magnesium-free, artificial cerebrospinal fluid. 4. Glutamate release increased to 266% of the resting release in the presence of magnesium within the first 12 min of the change into magnesium-free artificial cerebrospinal fluid. This increase in release preceded the onset of spontaneous depolarising activity. The release of glutamate remained elevated at 182% of control up to 60 min after perfusion with magnesium-free buffer, when depolarizing activity was well established. 5. A model is presented and discussed for the genesis and maintenance of the spontaneous depolarizing shifts. It is suggested that the maintenance of this spontaneous activity reflects a long term enhancement of neocortical neurone excitability which may be related to long term potentiation in the hippocampus. PMID- 2758227 TI - Secretion of acetylcholinesterase and butyrylcholinesterase from the guinea-pig isolated ileum. AB - 1. Strips of longitudinal muscle from guinea-pig ileum, retaining Auerbach's plexus, were superfused with oxygenated Krebs solution. Addition of 50 mM KCl led to a pronounced Ca2+-dependent increase in the activities of both acetylcholinesterase and non-specific cholinesterase (butyrylcholinesterase) in the perfusate but with no change in lactate dehydrogenase activity. 2. No release of acetylcholinesterase, either spontaneous or K+-evoked was observed in tissue freed of the nerve plexus, although release of butyrylcholinesterase still occurred. 3. Carbachol induced a marked Ca2+-dependent increase in the release of acetylcholinesterase but had no effect on the release of butyrylcholinesterase or lactate dehydrogenase. This carbachol-evoked increase in acetylcholinesterase release was blocked by hexamethonium but not by atropine. 4. Four readily soluble molecular forms of acetylcholinesterase and three soluble molecular forms of butyrylcholinesterase were present in innervated longitudinal muscle strips, but insignificant amounts of acetylcholinesterase were detected in denervated strips of muscle. Only one of the four molecular forms of acetylcholinesterase was recovered in the perfusates. 5. It is concluded that acetylcholinesterase is secreted from the nerves of Auerbach's plexus in response to depolarizing stimuli or to nicotinic cholinergic stimulation, while butyrylcholinesterase is secreted from non-neural elements, possibly the longitudinal muscle cells, of guinea-pig ileum in response to a depolarizing stimulus. PMID- 2758228 TI - Identification of M1 muscarinic receptors in pulmonary sympathetic nerves in the guinea-pig by use of pirenzepine. AB - 1. The effect of pirenzepine, a muscarinic antagonist considered to be selective for M1 receptors, was studied on bronchoconstriction and bradycardia elicited by preganglionic stimulation of the parasympathetic vagal nerves and by i.v. injections of acetylcholine (ACh) in anaesthetized guinea-pigs. 2. Pirenzepine was equipotent in the heart and lung as an antagonist of the effects of i.v. ACh at postjunctional muscarinic receptors. Doses of pirenzepine in excess of 1 mumol kg-1 abolished all muscarinic responses consistent with non-selective blockade of M3 receptors on airway smooth muscle and M2 receptors on atrial cells. 3. In the lung, low doses of pirenzepine (1-100 nmol kg-1) increased vagally-induced bronchoconstriction despite concurrent partial blockade of the postjunctional receptors. This suggests blockade of neuronal muscarinic receptors. 4. Propranolol (1 mg kg-1) increased control bronchoconstrictor responses elicited by ACh and vagal stimulation but did not alter the potency of pirenzepine for postjunctional receptors in heart or lung. However, pirenzepine-induced enhancement of vagally-induced bronchoconstriction was abolished by propranolol, suggesting that pirenzepine may be an antagonist for muscarinic receptors located in the sympathetic nerves innervating airway smooth muscle. 5. These results confirm that bronchoconstrictor stimuli indirectly initiate activation of an opposing sympathetic reflex in the guinea-pig lung. This response is facilitated by muscarinic receptors located in the sympathetic nervous pathway. 6. The high potency of pirenzepine for the neuronal receptors in the sympathetic nerves suggests that these are M1 receptors. In contrast, the parasympathetic nerves innervating airway smooth muscle in this species contain M2 receptors which inhibit neurotransmission. PMID- 2758229 TI - Effect of pirenzepine and gallamine on cardiac and pulmonary muscarinic receptors in the rabbit. AB - 1. The effect of muscarinic antagonists considered to be selective for M1 receptors (pirenzepine) and for M2 receptors (gallamine) were studied on bronchoconstriction and bradycardia elicited by stimulation of the vagal nerves and by i.v. acetylcholine (ACh) in anaesthetized rabbits. 2. Pirenzepine was equipotent as an antagonist of ACh-induced responses at postjunctional muscarinic receptors in the heart, lung and blood vessels, whereas gallamine was at least ten times less potent at pulmonary and vascular muscarinic receptors. Thus, gallamine never caused complete inhibition of bronchoconstrictor or hypotensive responses to i.v. ACh, whereas doses of pirenzepine in excess of 1 mumol kg-1 abolished all muscarinic responses. 3. In the lung, both antagonists inhibited bronchoconstriction caused by vagal stimulation and ACh-induced bronchoconstriction to the same extent (pirenzepine, mean ED50 65 +/- 22 and, 130 +/- 28 nmol kg-1 respectively; gallamine, ED50 greater than 10,000 nmol kg-1 for both responses). Enhancement of vagally-induced bronchoconstriction was never observed. 4. In the heart, however, both pirenzepine and gallamine were ten times less potent as antagonists of vagally-induced bradycardia than of ACh-induced bradycardia. This differential blockade was unaltered by propranolol (1 mg kg-1) pretreatment. 5. It is concluded that there is no evidence for M1 or M2 muscarinic receptors in the pulmonary innervation of the rabbit and the potency of the antagonists in abolishing in abolishing vagally-induced bronchoconstriction was consistent with blockade of M3 muscarinic receptors on airway smooth muscle. 6. The results suggest that M2 muscarinic receptors may exert an inhibitory effect on transmission in the parasympathetic nerves innervating the heart in the rabbit. Blockade of such neuronal receptors would increase transmitter output to the atrial cells and explain the low potency of both antagonists in abolishing vagally-induced bradycardia in the rabbit. PMID- 2758230 TI - Subclassification of atrial and intestinal muscarinic receptors of the rat- direct binding studies with agonists and antagonists. AB - 1. Although extensively investigated, the extent of differences between receptors mediating negative inotropic and chronotropic responses is still unclear. In the present study atrial and intestinal muscarinic receptors were identified by [3H] N-methyl-scopolamine ([3H]-NMS) binding and the affinities of some presumably inotropy- or chronotropy-selective agonists and several antagonists determined. 2. All the agonists tested showed similar affinity for right and left atrial receptors. Accepting an affinity difference of 0.4 log units as experimental error, none of the agonists tested was selective for either atrium. 3. Affinity differences of the cardioselective antagonists himbacine, AF-DX 116 and methoctramine and the M1-selective antagonist dicyclomine for right and left atrial muscarinic receptors were also minimal (less than 2 fold selective). When compared to intestinal receptors, AF-DX 116 was 3 to 4 fold, methoctramine 10 to 13 fold selective and himbacine and dicyclomine non-selective. 4. These data provide evidence for differences between atrial and intestinal but not between right and left atrial muscarinic receptors. PMID- 2758231 TI - Local opioid-sensitive afferent sensory neurones in the modulation of gastric damage induced by Paf. AB - 1. The role of local sensory neurones in modulating the extent of gastric mucosal damage induced by close-arterial infusion of platelet-activating factor (Paf 50 ng kg-1 min-1 for 10 min) has been investigated in the anaesthetized rat. 2. Local intra-arterial infusion of the neurotoxin, tetrodotoxin (TTX), substantially augmented the mucosal damage induced by Paf, as assessed by both macroscopic and histological techniques. 3. In rats pretreated with capsaicin 2 weeks prior to study, to induce a functional ablation of primary afferent neurones, gastric damage induced by Paf was significantly augmented. 4. Administration of morphine (0.75-3 mg kg-1 i.v.) or its peripherally acting quaternary analogue, N-methyl morphine (15 mg kg-1 i.v.), also significantly enhanced the gastric damage induced by Paf. 5. The potentiation by morphine of Paf-induced gastric damage was inhibited by administration of the opioid antagonists, naloxone (1 mg kg-1 i.v.) or the peripherally acting N-methyl nalorphine (3 mg kg-1 i.v.). 6. Administration of TTX or morphine alone, or pretreatment with capsaicin did not induce any detectable mucosal damage, suggesting that interference with local sensory neuronal activity itself does not directly induce mucosal disruption. 7. These results indicate that peripheral opiate-sensitive afferent sensory neurones play a physiological defensive role in the mucosa, attenuating the extent of gastric damage induced by Paf. PMID- 2758232 TI - Presynaptic muscarinic receptors inhibiting endogenous noradrenaline release in the portal vein of the freely moving rat. AB - 1. In the portal vein of the freely moving unanaesthetized rat, the existence of presynaptically located inhibitory muscarinic receptors was investigated by use of the muscarinic agonist methacholine (MCh) 2. Infusion of MCh (0.3 micrograms min-1) did not significantly inhibit the endogenous noradrenaline (NA) overflow in portal plasma. However, after inducing high intra-synaptic concentrations of NA by blocking the presynaptic alpha 2-adrenoceptors with yohimbine (1 mg kg-1), MCh (0.3 microgram min-1) was able to reduce the yohimbine-induced enhanced NA overflow by 38%. 3. The MCh-induced inhibition was almost completely abolished after blockade of the presynaptic muscarinic receptors with atropine (0.6 mg kg 1). 4. During electrical stimulation of the portal vein nervous plexus the evoked NA overflow was strongly inhibited (95%) during MCh-infusion (0.3 microgram min 1). Again atropine (0.6 mg kg-1) was able to reverse this inhibition. 5. These results show the existence of presynaptic muscarinic receptors inhibiting endogenous NA overflow from the portal vein nervous plexus under conditions of enhanced sympathetic activity in the freely moving rat. PMID- 2758233 TI - Ketamine-induced relaxation in intact and skinned smooth muscles of the rabbit ear artery. AB - 1. The effects of ketamine, an intravenous anaesthetic, on the rabbit ear artery were investigated by measuring the tension in intact and saponin-treated skinned smooth-muscle fibres. 2. Ketamine dose-dependently inhibited contractions of intact smooth-muscle fibres induced by high K+ solution and by noradrenaline (NA) or histamine in Krebs solution. This drug similarly attenuated both phasic and tonic contractions induced by high K+ solution. 3. Ketamine also inhibited NA- or histamine-induced contractions in Ca2+-free solution containing 2mM EGTA, but it did not affect the caffeine-induced contraction in this solution. 4. Because the pCa-tension relationship of saponin-treated skinned smooth-muscle fibres was not affected, it can be proposed that ketamine does not have an effect on the contractile proteins. 5. In the presence of 5mM NaN3, 20 microM inositol 1,4,5 trisphosphate (InsP3) or 25mM caffeine produced a contraction in skinned smooth muscle fibres after accumulation of Ca2+ by intracellular stores. Analysis of the InsP3- or caffeine-induced contractions indicates that ketamine does not have an effect on the Ca2+ accumulation into and Ca2+ release from the intracellular stores. 6. These results indicate that the relaxant effects produced by ketamine in the rabbit ear artery are not likely to be due to an intracellular action. The inhibitory effects of ketamine could be caused by a decrease of the Ca2+ influx through the plasma membrane or interference with the process of signal transduction between receptors on the plasma membrane and intracellular stores. PMID- 2758234 TI - Alterations of coronary vascular responses to noradrenaline, acetylcholine and isoprenaline during acute myocardial ischaemia in dogs. AB - 1. The reactivity of coronary arteries to noradrenaline (NA), acetylcholine (ACh) and isoprenaline (Iso) during acute myocardial ischaemia was studied in anaesthetized, open-chest dogs. 2. The left anterior descending coronary artery (LAD) was cannulated and perfused via an extracorporal circuit at constant flow. Ischaemia was produced by decreasing the perfusion blood flow of the LAD to 50% (moderate ischaemia) and 27% (severe ischemia) of normal. A dose of each agent which had no significant myocardial effects was chosen. Heart rate was held constant by ventricular pacing during ACh administration. 3. Under normal conditions, the infusion of NA, ACh and Iso into the LAD produced significant decreases in coronary vascular resistance (P less than 0.01). However, under either moderate or severe ischaemic conditions intracoronary NA resulted in a marked increase in coronary vascular resistance (P less than 0.01), which was completely blocked by phentolamine, an alpha-adrenoceptor blocker; intracoronary ACh and Iso did not have a significant effect on coronary vascular resistance (P greater than 0.05). 4. These results indicate that coronary arterial responsiveness to some intrinsic vasoactive substances, such as NA and ACh, is altered during acute myocardial ischaemia. This may be important in the pathophysiology of myocardial ischaemia. PMID- 2758235 TI - Platelet-activating factor (Paf) antagonist, WEB 2086, protects against Paf induced hypotension in Macaca fascicularis. AB - 1. The actions of intravenously administered platelet-activating factor (Paf) (0.1-3.33 nmol kg-1) and the effect of a recently described Paf antagonist, WEB 2086, were investigated in the anaesthetized open-chest monkey, Macaca fascicularis. 2. Paf dose-dependently reduced blood pressure, left ventricular pressure (LVP) and its first differential LV dP/dt. 3. Mean pulmonary artery pressure, recorded in three animals, was essentially unchanged by any dose of Paf. 4. WEB 2086 (0.22 mumol kg-1, i.v.) attenuated the Paf-induced changes in BP, LVP and LV dP/dt. The dose-response curve for fall in BP was shifted to the right by one order of magnitude. 5. Histamine-induced cardiovascular changes (systemic hypotension and tachycardia) were not affected by prior administration of WEB 2086. 6. WEB 2086 should be of value in assessing the role of Paf in pathophysiological conditions. PMID- 2758236 TI - The effect of relaxants working through different transduction mechanisms on the tonic contraction produced in rat aorta by 4 beta-phorbol dibutyrate. AB - 1. We have examined the effects of a range of smooth muscle relaxants on the maintained contractions produced in rat aortic rings by the protein kinase C activator, 4 beta-phorbol dibutyrate; these effects were compared with those on the contraction induced by the selective alpha 1-adrenoceptor agonist, methoxamine. The phorbol ester, at 0.3 microM, gave a sustained contraction which was, on average, of approximately the same magnitude as the maximum contraction produced by methoxamine, 10 microM. 2. The beta-adrenoceptor agonist, isoprenaline (0.01-1 microM) caused a dose-related relaxation of the methoxamine induced contraction but had no effect on the contraction induced by the phorbol ester. 3. An activator of adenylate cyclase, forskolin (0.01-1 microM) produced a dose-related relaxation of the methoxamine-induced contraction and at 0.01-10 microM caused relaxation of the contraction induced by the phorbol ester. Similar results were obtained with the potassium channel activator, cromakalim (0.001-10 microM). 4. An activator of guanylate cyclase, sodium nitroprusside (0.001-100 microM) caused a dose-related relaxation of both the methoxamine-induced and the phorbol ester-induced contraction, being more effective on the former than on the latter. Similar results were obtained with enprofylline (1-1000 microM). 5. Methoxamine (10 nM-100 microM), given cumulatively, caused a dose-related contractile response. Pretreatment with isoprenaline (1 microM), enprofylline (10 microM) and nicorandil (1 microM) resulted in partial decrease of the subsequent response to methoxamine, while nicorandil (10 microM), forskolin (1 microM), sodium nitroprusside (10 microM) and cromakalim (1 microM) totally abolished it. 6. The phorbol ester, given cumulatively, caused increasing contraction in the concentration range 30 nM-10 microM. Pretreatment with forskolin (1 microM), sodium nitroprusside (10 microM), isoprenaline (1 microM), enprofylline (10 microM), nicorandil (1 microM or 10 microM), or cromakalin (1 microM or 10 microM), resulted in partial decrease of the subsequent response to 4 beta phorbol dibutyrate. 7. These results are discussed in the light of the suggestion that protein kinase C may have a role in the 'latch-bridge' phase of smooth muscle contraction, and that inappropriate activation of protein kinase C may contribute to the pathogenesis of hypertension and other conditions involving vasospasm. PMID- 2758237 TI - Cholecystokinin-octapeptide constricts guinea-pig and human airways. AB - 1. Cholecystokinin-octapeptide (CCK-OP, 10(-10)-3 x 10(-6) M) produced a concentration-dependent contractile response in guinea-pig trachea which was enhanced by both the mechanical removal of the epithelium and by indomethacin (10(-5) M), with an EC50 of 6.18 +/- 0.10 x 10(-8) M. 2. Sub-threshold concentrations of CCK-OP, which did not alter the resting tone of the smooth muscle, did not alter responses produced to electrical field stimulation (EFS) or to vagal nerve stimulation in an intact tracheal tube preparation. Atropine (2 x 10(-6) M) did not alter the concentration-response curve to CCK-OP, indicating that CCK-OP contraction is not mediated by cholinergic mechanisms. 3. The inhibition of neutral endopeptidase (endopeptidase-24.11) by phosphoramidon (10( 5) M) gave a leftward shift in the CCK-OP concentration-response curve in tissues with intact epithelium obtained from normal animals, but had no effect in tissues denuded of epithelium or in tissues obtained from animals which had been actively sensitized and challenged with ovalbumin (OA). 4. CCK-OP-induced contractile responses were antagonized by the CCK-receptor antagonists dibutyryl cyclic guanosine monophosphate (pA2 = 4.3) and L-364,718 (pA2 = 9.6). 5. CCK-OP induced bronchoconstriction in large, but not small, human airways and was antagonized by the CCK-receptor antagonist L-364,718. CCK-OP had no effect on cholinergic neural responses elicited by EFS in human airways. PMID- 2758238 TI - The effect of Paf antagonists on bronchial hyperresponsiveness induced by Paf, propranolol or indomethacin. AB - 1. Intravenous administration of platelet activating factor, Paf (600 ng kg-1 h 1) to ventilated anaesthetised guinea-pigs induced bronchial hyperresponsiveness to i.v. acetylcholine. 2. Pretreatment of ventilated, anaesthetised guinea-pigs with the beta-adrenoceptor antagonist, propranolol, or the non-steroidal anti inflammatory drug, indomethacin, induced bronchial hyperresponsiveness to i.v. histamine. 3. Paf-induced bronchial hyperresponsiveness was significantly attenuated by pretreatment with three different Paf antagonists, CV-3988, BN 52021 and WEB 2086. 4. Pretreatment of guinea-pigs with CV-3988, BN 52021 or WEB 2086 at doses inhibiting Paf-induced bronchial hyperresponsiveness, had no significant effect on propranolol or indomethacin-induced bronchial hyperresponsiveness. 5. It is suggested that bronchial hyperresponsiveness induced by propranolol or indomethacin is not secondary to Paf release in the guinea-pig. PMID- 2758240 TI - The effect of arginine and nitric oxide on resistance blood vessels of the perfused rat kidney. AB - 1. The vasodilator effects of arginine, nitric oxide (NO), acetylcholine (ACh) and sodium nitroprusside (NP) in the noradrenaline-preconstricted ('high tone') perfused rat kidney have been examined. 2. L-Arginine (0.6-23 mumol) caused a biphasic change in renal perfusion pressure. D-Arginine (0.6-23 mumol) was without effect. The second vasodilator component was abolished and the first vasoconstrictor effect augmented following CHAPS-induced removal of the vascular endothelium suggesting that vasodilatation was endothelium-dependent. 3. L Arginine salts produced transient and dose-related vasodilatation. L-Arginine methylester was the most potent with an ED50 of 2.2 +/- 0.4 mumol (n = 6). The rank order of potency of the salts tested was: methylester greater than hydroxamate greater than chloride. L-Homoarginine chloride was also vasodilator (ED50, 12.0 +/- 1.3 mumol, n = 5). D-Arginine chloride was without effect at doses up to 170 mumol. Responses to L-arginine chloride were endothelium-derived relaxing factor (EDRF)-dependent being abolished by CHAPS (4.7 mg ml-1, 30 s) and significantly inhibited (greater than 70%) by gossypol (3 microM) and nordihydroguaiaretic acid (NDGA, 10 microM). 4. Vasodilatation due to NO was unaffected by CHAPS and gossypol treatment but inhibited by NDGA. NO was approximately 3 times less potent than ACh but 3000 times more potent than L arginine methylester. 5. Kidneys perfused for 1 h with Krebs solution containing L-arginine chloride (100 microM) or L-canavanine (50 microM) showed no change in sensitivity towards ACh or NP. Higher concentrations of L-arginine chloride (500 microM) or L-canavanine (150 microM) significantly reduced the response to both vasodilators 6. L-Arginine salts dilate resistance blood vessels of the perfused rat kidney by a mechanism which may involve the release of EDRF from vascular endothelial cells of the perfused rat kidney.. PMID- 2758239 TI - Effects of propafenone on electrical and mechanical activities of single ventricular myocytes isolated from guinea-pig hearts. AB - 1. The effects of propafenone on the transmembrane action potential and sarcomere shortening during twitch contraction were investigated in single ventricular myocytes isolated from guinea-pig hearts. 2. Propafenone at low concentrations (3 5 x 10(-7) M) slightly lengthened action potential duration (APD), but shortened it at higher concentrations. The shortening of APD was accompanied by an attenuation of sarcomere shortening during twitch contraction. 3. Propafenone (greater than 10(-6) M) caused a concentration-dependent decrease in the maximum upstroke velocity (Vmax) of the action potential. In the presence of propafenone (3 x 10(-6) M), trains of stimuli led to an exponential decline in Vmax. A time constant for the recovery of Vmax from the use-dependent block was 4.8 s. 4. In myocytes treated with propafenone (3 x 10(-6) M), the Vmax of test action potentials preceded by the conditioning clamp pulses to 0 mV was progressively decreased by increasing the duration of single clamp pulse or by increasing the number of multiple brief clamp pulses. 5. These findings suggest that propafenone has use-dependent inhibitory action on the sodium channel by binding to the channel during both activated and inactivated states, and that the unbinding rate is comparable to that of Class-I antiarrhythmic drugs with intermediate kinetics. Propafenone may also have an inhibitory action on calcium and potassium channels. PMID- 2758241 TI - The antiarrhythmic and cardiac electrophysiological effects of buprenorphine. AB - 1. The effects of buprenorphine, given intravenously, on the incidence and severity of early acute coronary artery occlusion-induced arrhythmias were examined in anaesthetised rats. The electrophysiological effects of buprenorphine were also examined in sheep Purkinje fibres and rat papillary muscles, superfused in vitro with either a normal or a hypoxic, hyperkalaemic and acidotic physiological salt solution (PSS). 2. In anaesthetised rats subjected to acute coronary artery occlusion, pretreatment with buprenorphine (1 mg kg-1 i.v.) markedly reduced the incidence of ventricular extra-systoles during the initial 30 min post-occlusion period. The incidence of ventricular fibrillation (VF) was also significantly reduced from 56% to 10%. 3. At the antiarrhythmic dose (1 mg kg -1), buprenorphine also attenuated the sudden fall in systemic arterial blood pressure induced by acute coronary artery ligation. 4. In normal sheep Purkinje fibres and rat papillary muscles, buprenorphine (10(-6)-10(-5) M) significantly reduced the action potential height and maximum rate of depolarisation of phase zero (MRD) and prolonged the duration of the action potential. 5. Superfusion of sheep Purkinje fibres and rat papillary muscles with a hypoxic, hyperkalaemic and acidotic PSS resulted in marked reductions in resting membrane potential, upstroke and duration of the action potential. 6. In the presence of the modified compared with normal PSS, buprenorphine reduced the action potential height and MRD of both sheep Purkinje fibres and rat papillary muscles to a greater extent, although its ability to prolong the action potential duration was attenuated. 7. The antiarrhythmic effects of buprenorphine observed in vivo may be explained by its direct cardiac electrophysiological effects. Buprenorphine might be useful in relieving pain and in reducing the severity of arrhythmias in the early stages of acute myocardial infarction. PMID- 2758242 TI - The involvement of lactate and calcium as mediators of the electrical and mechanical responses of the myocardium to conditions of simulated ischaemia. AB - 1. Rat isolated and superfused atria were exposed to a lactate-containing solution simulating the composition of extracellular fluid during myocardial ischaemia (SI). 2. Atria subjected to SI showed a decreased adenosine 5' triphosphate (ATP) content, a rise in diastolic tension, a diminished conduction velocity of action potentials and shortened refractory periods. All these changes were less pronounced during lactate-free SI. 3. Atria preloaded with calcium displayed exaggerated responses measured electrically and mechanically during exposure to SI, whereas atria previously depleted of calcium displayed diminished electrical and mechanical responses to SI. Neither calcium loading nor calcium depletion modified the SI-induced depletion of the atrial stores of ATP. 4. Sulphinpyrazone protected atria against all aspects of the response to SI, but failed to protect the muscle under conditions of lactate-free SI. It is concluded that during SI, sulphinpyrazone protects against a lactate-mediated inhibition of the glycolytic synthesis of ATP. 5. Flufenamate exaggerated all responses of the atria to SI. These deleterious actions were still observed during lactate-free SI. It is concluded that flufenamate inhibits the synthesis of ATP in the mitochondria. PMID- 2758243 TI - PC12 phaeochromocytoma cells contain an atypical muscarinic receptor binding site. AB - 1. Kinetic, saturation and competition binding studies were conducted on the muscarinic receptor binding site labelled by [3H]-N-methylscopolamine [( 3H]-NMS) in intact PC12 cells and cell membranes. Similar studies were conducted on M1 receptors of rat cortex labelled with [3H]-pirenzepine and M2 and M3 receptors present in rat heart and submaxillary gland respectively, and labelled with [3H] NMS. 2. The dissociation of [3H]-NMS from muscarinic receptors in PC12 cells was slower than dissociation from both M2 and M3 muscarinic receptors. 3. The Kd of [3H]-NMS in the PC12 cells was significantly lower than that obtained at the M2 and M3 receptor. 4. In competition studies the affinity data for pirenzepine, hexahydroadiphenine and 4-diphenylacetoxy-N-methylpiperidine methiodide were consistent with the presence of an M3 receptor in the PC12 cells. However, for AF DX 116, cyclohexylphenyl(2-piperidinoethyl)silanol and methoctramine affinity estimates in PC12 cells were 3-6 fold lower than at the M3 receptor. 5. On the basis of these data we conclude that the muscarinic receptor present in the PC12 cells differs from the M1, M2 and M3 subtypes already described. PMID- 2758244 TI - Phentolamine and structurally related compounds selectively antagonize the vascular actions of the K+ channel opener, cromromakalim. AB - 1. The effects of cromakalim, a novel vasodilator agent believed to open K+ channels, were studied in a range of large and small arteries in vitro. In dog isolated coronary artery, precontracted with U46619 (a thromboxane A2-mimetic), cromakalim caused concentration-dependent relaxation which could be inhibited by phentolamine (10-100 microM). 2. The ability of phentolamine to antagonize cromakalim was selective since it did not affect responses to a number of other vasodilators including isoprenaline, nitroprusside or nicorandil. 3. The effect of phentolamine was not related to its alpha-adrenoceptor blocking actions since other alpha-adrenoceptor antagonists (prazosin 10 microM, rauwolscine 10 microM and phenoxybenzamine 1 microM) failed to influence the action of cromakalim. 4. A number of compounds structurally related to phentolamine were also able to block the vaso-relaxant response to cromakalim in the dog isolated coronary artery. The rank order of potency was alinidine = phentolamine = ST91 greater than tramazoline = naphazoline. Clonidine and tolazoline were inactive. The most potent compounds (alinidine and phentolamine) were effective only at concentrations above 1 microM. 5. Electrophysiological studies, in which resting membrane potential and tension were measured simultaneously, were carried out on rat isolated femoral artery. Phentolamine (30 microM) antagonized both the vasorelaxation and hyperpolarization caused by cromakalim. 6. These results suggest that phentolamine and some structurally related compounds, may inhibit K+ channel opening, an action which would account for their ability to antagonize the actions of cromakalim. Such compounds may prove useful in determining the role of K+ channels in regulating vascular smooth muscle tone in vivo and in vitro. PMID- 2758245 TI - X-ray dual-photon absorptiometry: a new method for the measurement of bone density. AB - A recently introduced method (dual-photon X-ray absorptiometry, DEXA) capable of measuring skeletal density in man (at present in the spine and hips, but ultimately for the whole body) has been evaluated in terms of its ability to perform long-term assessment of bone density changes. The method, which uses X rays rather than gamma rays as its photon source, represents a significant improvement over present systems both in image quality and precision (reproducibility) of results, which is better than 1% in vivo. Scanning time is approximately halved compared with present techniques and the radiation dose is reduced by 25%. First data on long-term drift of results and effects of changes in patient composition (i.e. thickness and fat content) are given and show the new method to be superior to present radionuclide systems. It is likely that this new method will become the standard for bone density measurements. PMID- 2758246 TI - Total or partial percutaneous renal ablation in the treatment of renovascular hypertension: radiological and clinical aspects. AB - In 15 patients with renovascular hypertension, considered unsuitable for angioplasty or surgery, percutaneous renal ablation was performed by injection of ethanol into the renal vasculature. Partial or complete renal ablation was confirmed by follow-up intravenous pyelography or arteriography. Patients were followed-up for a mean of 24.8 months after therapy and blood pressure was improved in all patients with five being cured. This study shows that percutaneous renal ablation is a useful and successful method of therapy for renal hypertension, and that it should be considered in patients unsuitable for surgery or angioplasty. PMID- 2758247 TI - Fetal fat measurement by magnetic resonance imaging. AB - A method to assess the average percentage of fetal fat with respect to other fetal tissue is described. This method was then used to assess the percentage of fat in 13 normal fetuses who had a magnetic resonance imaging (MRI) examination late in pregnancy (38-41 weeks). The scans of a further 13 fetuses of diabetic mothers and one case of intrauterine growth retardation (IUGR), all of whom had MRI examinations in the last 3 years, were reviewed and similar calculations were carried out. Whilst the percentage fat range in the normal group was large, it was still possible to discern a difference between the normal, diabetic and IUGR cases. PMID- 2758248 TI - Use of a radon mould technique for skin cancer: results from the Peter MacCallum Cancer Institute (1975-1984). AB - During the period from 1975 to 1984, 642 patients had non-melanoma skin cancers (NMSC) treated by a radon mould technique following the principles of the Manchester system. The results of 77 out of 642 (12%) with histologically verified lesions are presented. The sites of the lesions were as follows: head and neck 25 (32%), upper limbs 38 (49%), lower limbs 13 (17%) and trunk one case only. The histological diagnosis was squamous cell carcinoma 48 (62%), basal cell carcinoma in 22 (29%) and other in seven (9%). There were nine out of 77 (12%) failures, four with persistent disease, which did not clear after initial treatment (and for whom the radon mould was an inappropriate choice of technique), and five (6%) recurrences after clearance of the initial lesion. There was a sharp rise in failures after 1979 when there was a change of radon supplier, but no calibration error was substantiated. It is clearly beneficial for institutions to cross-check the manufacturer's brachytherapy source data. There have been no further recurrences or any symptomatic late morbidity. This is a safe, effective and practical radiotherapeutic technique for superficial lesions (not exceeding a depth of 4 mm) in areas of poor radiation tolerance, and may obviate the need for a prolonged fractionated course of external-beam radiation in selected patients. Alternatives to radon are discussed. PMID- 2758249 TI - Microcomputer processing of film radiographs. AB - An inexpensive image processing system, assembled from commercially available components and driven by "in-house" software, was tested as a means of processing radiographs obtained in a radiology department. In this preliminary study, the main interest was to investigate, through subjective appraisal, the ability of the system to recover the image quality of poorly exposed radiographs. Subsidiary objectives were to obtain some information regarding the specification limits of the system and its components, as well as some quantitative estimate of its advantages for clinical diagnosis. The system was used to process a set of film radiographs of an anthropomorphic chest phantom, produced under conditions that were designed to provide a wide range of image qualities. Following this, four sets of randomly ordered processed and unprocessed images were formally assessed by a group of experienced observers. Consensus opinion from the group indicated that significant improvement could be obtained through simple image processing. Some radiographs regarded as unacceptable became, after processing, acceptable to viewers. PMID- 2758250 TI - A flexible image archiving system using a personal computer and optical disk. PMID- 2758251 TI - Primary malignant melanoma of the vagina. PMID- 2758252 TI - Neuroblastoma presenting with obstructive jaundice. PMID- 2758253 TI - Acute aorto-iliac thrombosis in a young man shown on unenhanced computed tomography. PMID- 2758254 TI - Case of the month. No way out. PMID- 2758255 TI - Radiocontrast agents are contact activators of coagulation. PMID- 2758256 TI - The cost of imaging procedures. PMID- 2758257 TI - Extending surgical audit: the assessment of postoperative outcome. PMID- 2758258 TI - Gastric cancer: a 25-year review. AB - Between 1957 and 1981, 31,716 cases of gastric cancer were registered in the West Midlands, UK. The age-standardized incidence has shown a decrease from 17.42 per 100,000 population during the first quinquennium to 15.30 per 100,000 in the last. There was an apparent increase in the proportion of proximal lesions with a decrease in the proportion of distal, antral cancers. The stage of disease at diagnosis remained constant with 79 per cent of patients having stage IV disease. Less than 1 per cent presented with stage I disease. As a result, the curative resection rate was 21 per cent. The operative mortality rates for curative partial gastrectomy and total gastrectomy were 13 and 29 per cent respectively. Surgeons undertaking more than nine total gastrectomies annually had an overall mean operative mortality rate of 22 per cent. Overall age-adjusted survival at 5 years was 5 per cent. Survival at 5 years for stage I, II and III disease was 72, 32 and 10 per cent respectively. There was a significant increase in survival time for those treated by curative resection between 1972 and 1981 compared with the previous decade. The implications for the management of gastric cancer are discussed. PMID- 2758259 TI - Technique for abdominal radical total gastrectomy. PMID- 2758260 TI - Arm morbidity within a trial of mastectomy and either nodal sample with selective radiotherapy or axillary clearance. AB - The aim of this study was to assess upper limb morbidity following treatment for operable breast cancer. Patients were randomized to either mastectomy and axillary clearance (40 women: 12 with axillary nodal metastasis and 28 without axillary metastasis) or mastectomy and axillary sampling (54 women). Adjuvant radiotherapy was delivered to those in whom the sample revealed axillary nodal metastasis (28 women) but not to those with no axillary nodal metastasis (26 women). A subjective assessment of the state of the arm was made using a standard questionnaire. Objective assessment included upper and forearm circumference, should joint mobility and assessment of power in the pectoralis muscle. The mean age was 56.8 years (range 33-77 years) and the mean elapsed time from treatment was 5.72 years (range 4.0-7.5 years). Subjective limb oedema was greatest in those who had axillary lymph node metastasis but there was no objective difference. Subjective joint mobility was reduced in the women who received radiotherapy and this was confirmed by objective assessment (P less than 0.05). The objective reduction in arm mobility was related to the treatment rather than the axillary lymph node status. There was no difference in power. In this study women receiving adjuvant radiotherapy had significantly reduced shoulder mobility. This may have implications for current conservation studies using adjuvant radiotherapy. PMID- 2758261 TI - Graft occlusion following aortofemoral bypass for peripheral ischaemia. AB - Over a 10-year period, 241 patients with non-aneurysmal aortoiliac disease underwent aortofemoral bypass to 476 limbs. Four patients (1.7 per cent) occluded their grafts within 30 days of surgery, while 25 (10.4 per cent) suffered late graft occlusion. Postoperative occlusions were associated with significant morbidity and only one patient avoided major limb amputation or death. Overall, 46 episodes of graft thrombosis involving 51 graft limbs were encountered, the most common underlying cause being pre-existing or progressive multilevel distal occlusive disease. The overall cumulative graft patency rates were 95 and 87 per cent at 1 and 5 years respectively. Cumulative 5-year patency was significantly higher in patients presenting with claudication (91 per cent) than in patients presenting with rest pain (77 per cent) or ulceration and/or gangrene (71 per cent). Patients with evidence of multilevel distal occlusive disease at the time of aortic surgery had a significantly higher incidence of occlusion compared with those in whom there was no significant distal disease. In 35 episodes of occlusion (76 per cent), surgery was undertaken to restore limb blood flow, being successful in all but one case, with the most commonly performed procedure being graft limb thrombectomy. Seven of 28 patients (25 per cent) ultimately required major limb amputation and three patients died as a direct consequence of graft thrombosis. PMID- 2758263 TI - Number and anatomical distribution of incompetent thigh perforating veins. AB - Although incompetent thigh perforating veins are considered to be a common cause of recurrence of varicose veins after high saphenous ligation, the number and distribution of such incompetent veins have not been reported. The aim of the study was to determine the number and anatomical distribution of incompetent thigh perforating veins. Sixty-five limbs in 48 patients with varicose veins who were found to have incompetent thigh perforating veins on ascending deep to superficial venography were studied. In 80 per cent of patients one incompetent thigh perforating vein was found and in 20 per cent more than one was found. Concomitant incompetent calf perforating veins were found in 92 per cent of the limbs studied. The incompetent thigh perforating veins were found to occur anywhere in the thigh, from the upper edge of the patella to a few centimetres below the saphenofemoral junction. The majority (71 per cent) were found in the middle third of the thigh. All incompetent thigh perforating veins were communicating with the long saphenous vein, including those in five patients with incomplete stripping. The surgeon should be aware of incompetent thigh perforating veins which may be multiple and occur at any site on the medial aspect of the thigh. PMID- 2758262 TI - Role of venous elasticity in the development of varicose veins. AB - A reduction in the 'elasticity' of the venous system has been proposed as a precursor of venous insufficiency, but the concept remains controversial. This study was designed to develop a method of assessing venous elasticity, and to use this method to investigate the aetiology of varicose veins. Simultaneous measurements of calf volume (determined using strain gauge plethysmography) and venous pressure (obtained via a dorsal foot vein) were made during venous occlusion plethysmography. The elastic modulus, K, defined as stress/strain when the veins are full, was calculated from the pressure/volume relationship. The elastic modulus was determined in 19 normal legs, 33 legs with superficial venous insufficiency, 16 legs with deep venous insufficiency, and 18 legs of a high risk group of volunteers or patients without varicose veins but with a strong history of factors associated with their development. The results showed a clear difference in elasticity between normal limbs and limbs with varicose veins, and also between normal limbs and high risk limbs. These results support the hypothesis that reduced elasticity has a role in the development of varicose veins and precedes the onset of valvular incompetence. PMID- 2758264 TI - Lower limb vein trauma: a long-term clinical and physiological assessment. AB - The aim of this study was to assess the long-term clinical and physiological sequelae of lower limb venous trauma in a civilian practice. Twenty-six patients who had undergone surgery for lower limb venous trauma (median elapsed time 19.5 months) underwent assessment. Injuries had been sustained to the external iliac, common femoral superficial femoral and popliteal veins in two, four, nine and eleven limbs respectively. Using clinical assessment, photoplethysmography recovery time, the presence of popliteal reflux and venographic evidence of thrombosis, the final outcome was graded as good, fair or poor. Fourteen patients had pedal oedema, including two with a postphlebitic limb. The overall photoplethysmography recovery time (mean and s.d.) was 20.6 (8.7) s in the injured and 32.1 (6.7) s in the non-injured limbs (P = 0.002). Patients with a venographically occluded vein had a shorter photoplethysmography recovery time than those in whom the vein was patent (13.4 (5.6) versus 21.6 (8.7) s; P = 0.07). Popliteal reflux was present in 12 injured limbs. Seven of 12 venograms performed on limbs with a vein repair had evidence of previous thrombosis. Vein ligation carried considerable morbidity and all end-to-end anastomoses initially failed. In retrospect, saphenous vein grafts were too narrow for the recipient veins and panel grafts might have been more appropriate. Overall 11 of 26 patients (42 per cent) had a poor result. The repair of choice is a saphenous vein patch for lesser injuries and a saphenous panel graft for major injuries. Vein ligation should be avoided unless another life-threatening injury demands priority. PMID- 2758265 TI - Acute ischaemia of the lower limb: the effect of centralizing vascular surgical services on morbidity and mortality. AB - Surgical audit data for two 5-year periods (1974-78 and 1983-87) have been compared in a Health Board Area to assess the impact of centralization of emergency vascular services on the treatment of the acutely ischaemic lower limb. Patient populations in each period were comparable. Mortality rates remained constant in both periods at approximately 30 per cent. A significant improvement in overall limb salvage was observed (from 54 to 67 per cent, P less than 0.05). Limb salvage in survivors was improved from 80 to 95 per cent (P less than 0.001) and was paralleled by an increase in the number of reconstructive vascular procedures performed. We concluded that the centralization of emergency vascular services has not led to a reduced risk of mortality but has been associated with improved limb salvage. PMID- 2758266 TI - Phenol cauterization for ingrowing toenails: a review of five years' experience. PMID- 2758268 TI - Quicker intraoperative colonic irrigation. PMID- 2758267 TI - Clinical results of colectomy for severe constipation. AB - Subtotal colectomy has been performed in 40 patients with severe constipation. Only one patient was male. Five patients (13 per cent) had a history of a serious psychiatric disorder. Twenty-six patients (65 per cent) could not expel a 100-ml air-filled balloon and 19 patients (48 per cent) had electromyographic evidence of abnormal puborectalis contraction during attempted defaecation before operation. Median preoperative passage of 50 radio-opaque markers over 5 days was 16 per cent. Sixteen patients had had a previous anorectal myectomy to exclude Hirschsprung's disease. Initial resections were subtotal colectomy and ileorectal anastomosis (n = 34), caecorectal (n = 5) or ileosigmoid (n = 1) anastomosis. Secondary operations included restorative proctocolectomy and ileal pouch-anal anastomosis (n = 6) and six patients eventually had an ileostomy. Median bowel frequency per week significantly increased after operation (0.3 (range 0-1) preoperatively to 21 (range 2-70) postoperatively, P less than 0.005), the percentage of patients with abdominal pain fell after operation from 93 to 39 per cent but symptoms of abdominal distension remained the same (86 per cent preoperatively and 82 per cent postoperatively). PMID- 2758269 TI - Ischaemic strictures in patients treated with a low anterior resection and perioperative radiotherapy for rectal carcinoma. AB - In five (6 per cent) of 78 consecutive patients treated with an anterior resection for rectal carcinoma, a stenosis of the sigmoid colon just above the anastomosis was observed. Four patients had received preoperative radiotherapy over a period of 1 week to a total dose of 25.5 Gy and one patient had received postoperative radiotherapy (60 Gy) over a total of 8 weeks. The length of the stenosis varied from 4 to 120 cm. Two patients subsequently underwent reoperation with an abdominoperineal resection and three patients with a Hartmann procedure. In all patients the inferior mesenteric artery had been ligated close to the aorta. It is proposed that the stenosis may have been due to insufficient circulation in the marginal artery. This insufficiency may have been aggravated by the irradiation, as the retained part of the sigmoid colon was partly included in the irradiation target. PMID- 2758271 TI - Management of infection after prosthetic abdominal rectopexy (Wells' procedure). AB - The management and results of treatment of eight cases of implant infection after a Wells' rectopexy for rectal prolapse are reported. Most infections presented within 3 months of the rectopexy. Fever, abdominal or pelvic pain, diarrhoea, and the passage of pus per rectum were common presenting features. Removal of the infected implant per rectum or per vaginum was successful in four of five attempts and is the recommended initial approach, particularly in cases occurring early after surgery. Despite removal of the implant early after rectopexy recurrent prolapse did not occur. PMID- 2758270 TI - Anorectal physiology validated: a repeatability study of the motor and sensory tests of anorectal function. AB - Sixteen subjects (mean (s.d.) age 50.7 (12.8) years, three men) were studied on two separate occasions by two experienced investigators in random order. A standard protocol of anatomical, manometric and electrophysiological assessments of anorectal motor and sensory function was followed. No significant differences were found between the results obtained by the two investigators in the measurements of perineal descent, anal canal length, and canal resting pressure and squeeze pressure, pudendal nerve terminal motor latency, single-fibre electromyography fibre density of the external anal sphincter, and thresholds of mucosal electrosensitivity. This study shows that the standard tests of anorectal sensorimotor function are repeatable by different investigators. In addition, it suggests that comparison of data obtained in different centres using these techniques is valid. PMID- 2758272 TI - Anal and ileal pouch manometric measurements before ileostomy closure are related to functional outcome after ileal pouch-anal anastomosis. AB - Anal canal length, and canal resting and squeeze pressures, ileal pouch capacity and pouch compliance were measured in 104 patients after ileal pouch-anal anastomosis but before ileostomy closure. The intention was to determine if such parameters were associated with late functional outcome after re-establishment of intestinal continuity. Functional outcome in terms of stool frequency (day and night), incontinence (day and night), perianal pad use, perianal skin irritation, and the use of constipating agents was assessed for all 104 patients 1 year or more (median 438 days) after ileostomy closure. A low mean anal sphincter resting pressure before ileostomy closure was associated with subsequent nocturnal incontinence (P less than 0.05) and, to a lesser extent, the need to use constipating agents (P = 0.08). Pouch compliance if low before ileostomy closure was associated with an increased frequency of nocturnal stool frequency after 1 year (P less than 0.05). Anal canal length, and sphincter squeeze pressure and pouch capacity before ileostomy closure were not related to subsequent functional outcome in these patients. PMID- 2758273 TI - External and internal anal sphincter responses to rectal distension in normal subjects and in patients with idiopathic faecal incontinence. AB - The responses of the external anal sphincter and the internal anal sphincter to rectal distension were studied in 18 female patients who had idiopathic faecal incontinence with perineal descent and 11 female control subjects, by measuring pressures at six sites within the anal canal and the electrical activity of the external sphincter. The pressure profile in the normal anal canal, at rest, was asymmetric with the highest pressure recorded in the outermost channels. Rectal distension caused a transient increase in the activity of the external sphincter, which was associated with an increase in anal pressure, particularly in the outermost two channels. This was followed by a symmetrical reduction in anal pressure throughout the anal canal, caused by relaxation of the internal sphincter and shortening of the high-pressure zone. Two patterns of response were observed in the patients with idiopathic incontinence. Twelve patients (group 1) showed normal anal relaxation, but the maximum anal pressures recorded during rectal distension or a conscious squeeze were abnormally low, suggesting weakness of the external anal sphincter. The remaining six subjects (group 2), who were older than the group 1 patients, had much lower resting pressures and showed only external sphincter contraction in response to rectal distension, with no obvious internal sphincter relaxation. However, the maximum pressures recorded during a conscious contraction of the external sphincter were lower in this group than in the normal control subjects. These results suggest that group 2 patients have impaired internal anal sphincter tone, as well as external anal sphincter weakness. This may explain why all except one of the group 2 patients, compared with only 17 per cent of group 1 patients, reported incontinence to both solids and liquids. PMID- 2758274 TI - Rehabilitation after lower limb amputation: a comparative study of above-knee, through-knee and Gritti-Stokes amputations. AB - A study of 169 unilateral amputees under three Disablement Services Centres was performed. The study comprised 88 above-knee, 54 through-knee and 27 Gritti Stokes amputations. Satisfactory rehabilitation occurred in 33 per cent of above knee, 62 per cent of through-knee and 44 per cent of Gritti-Stokes patients (56 per cent overall). The better rehabilitation of through-knee versus above-knee amputees (P less than 0.02) was also found in a group of patients matched for comparable age and duration of amputation as well as in a group of age-matched vascular amputees. Through-knee amputees relied significantly less on wheelchairs than above-knee (P = 0.016) and Gritti-Stokes (P = 0.05) amputees. The prosthesis used for the through-knee and Gritti-Stokes amputations was considered unsightly in 50 per cent of cases (versus 31 per cent for the above-knee prosthesis). The superior rehabilitation with through-knee amputations should prompt us to improve both our technique for this amputation and the prostheses currently available. A through-knee amputation should be performed in preference to an above-knee amputation in the case where either is surgically possible, and a below-knee amputation not feasible. PMID- 2758275 TI - Surgical Research Society abstracts. PMID- 2758276 TI - Early cholecystectomy after sphincterotomy for common bile duct lithiasis. PMID- 2758277 TI - Facial paralysis due to a benign parotid tumor. PMID- 2758278 TI - Acute lower limb ischemia. PMID- 2758279 TI - Heller's myotomy. PMID- 2758280 TI - Growth rates in hepatic metastases. PMID- 2758281 TI - Preoperative cardiac risk of aortic aneurysm surgery. PMID- 2758282 TI - Carotid body tumors. PMID- 2758283 TI - Amputation for peripheral vascular disease. PMID- 2758284 TI - Treatment of cancer of the colon. PMID- 2758285 TI - Inferior parietal lobule neurones related to eye and hand reach movements in rhesus monkey. AB - Analysis was made on neuronal responses of the inferior parietal lobule to visual, jump, or 'reach' behavioral paradigm in 2 awake, trained rhesus monkeys. Preconditioning and antidromic electrical stimulation of medial and oral pulvinar LP nuclei and the arcuate gyrus aided the study. The results reveal two reach cell categories: one with no definable visual sensitivity (NVHRN) and one with visual receptive field responsiveness (VHRN). The VHRN reach cell firing is characterized by an early component. As the latter was observed only when the monkey reached loci inside but not outside of the cell-receptive field, it was equated with the cell visual receptive field response. This component could be voided by preconditioning stimulation of medial pulvinar or LP, the latencies of the VHRN responses becoming longer and comparable to NVHRN. If the consequences of reaching were nulled in any of a few different ways, such as preventing the monkey from reaching, disenabling the panel key, or denying the reward, a reach cell biphasic firing response showed no change in the first burst, but the second burst was absent, suggesting the latter's relation to satiation. If a jump cell's visual responses enhanced by the 'jump' paradigm were negated by preconditioning stimulation, the saccadic eye movement that otherwise followed the enhanced signals was replaced by another saccade, different in direction and amplitude, as if of other frames of reference. It seems, therefore, that the inferior parietal lobe system subserves in two types of reach behaviour: one with and one without visual guidance, playing perhaps a role in selecting strategies such as the dynamic option to do away with the visual guidance, if circumstances demand. PMID- 2758286 TI - Visually guided eye and hand movements in man. AB - Reaction times of saccades and of hand movements to a single visual target were measured and correlated on a trial-by-trial basis. The absolute values of the reaction times and their correlations depend on whether the fixation point, from which both eye and pointing movement started, remained visible (overlap) or was turned off some time before the target appeared (gap). Under overlap conditions long reaction times were obtained exhibiting large scatter and high correlations. Under gap conditions short reaction times (including express saccades) occurred with a small scatter and almost no correlations. It is concluded that the preparation of the saccade must be completed before the corresponding pointing movement can be initiated but not vice versa. PMID- 2758287 TI - Sensory and motor functions of the superior parietal cortex of the monkey as revealed by single-neuron recordings. AB - From the literature on the functional role of the superior parietal cortex, it can be seen that this cortical area has been attributed both sensory and motor functions, as demonstrated by anatomical and lesion studies. Single-unit recordings in behaving monkeys have equally been interpreted as demonstrating these two functions. However, the results of recent experiments using this technique suggest that area 5 may function in the transformation of sensory activity into motor activity. PMID- 2758288 TI - Somatotopic representation in inferior area 6 of the macaque monkey. AB - On the basis of its cytoarchitectonic and enzymatic properties area 6 of the macaque monkey can be subdivided into two large sectors: a superior sector lying medial to the spur of the arcuate sulcus (superior area 6 or F2) and an inferior sector lying lateral to it (inferior area 6). Inferior area 6 is constituted by two enzymatic areas: F4 and F5. In this study we investigated the somatotopic organization of inferior area 6 and the adjacent area 4 combining single-neuron recording and intracortical electrical microstimulation. We found that two separate movement representations exist in this region. The caudal one corresponds to area F1 (primary motor cortex), the rostral one to inferior area 6. The two representations are mirror images one of the other with the axioproximal movements being adjacently located. In the rostral map the proximal movements are mostly located in F4, the distal movements in F5. Neuronal properties indicate that the rostral map has characteristics that are more complex than the caudal map. We propose that the rostral map is involved in transforming visual information in motor commands. F4 should be involved in the control of arm movements based on the location of the objects in respect to the body, whereas F5 should play a role in the control of grasping movements on the basis of the size of the stimuli. PMID- 2758289 TI - Preparation of visually cued arm movements in monkey. Involvement of inferior parietal cortex. AB - Single-unit activity was recorded in monkey inferior parietal lobule (IPL) during performance of a visually cued limb motor task. Many neurons in the IPL modulated their activity just after the visual cue was presented, similar to the neuronal activity observed in the premotor cortex in a previous experiment. It is suggested that IPL neurons are involved in preparation of visually cued limb movement. The present results are discussed in view of a possible role for IPL and premotor cortex in processing visual information for use by the primary motor area. PMID- 2758290 TI - Single-unit activity related to active localization of acoustic and visual stimuli in the frontal cortex of the rhesus monkey. AB - Single-unit recordings were made in monkey periarcuate regions during the performance of limb movement tasks. A large class of neurons is described that appear to be involved in active localization of both acoustic and visual stimuli. These neurons failed to respond to stimuli of either modalities except in tasks where the location of the stimulus served as the cue for direction of movement. PMID- 2758291 TI - Role of the dorsolateral prefrontal cortex in organizing visually guided behavior. AB - Unit activity was recorded in the prefrontal cortex of rhesus monkeys during performance of a delayed task with two motor responses, a saccade and an arm movement, to a complex pattern of auditory and visual stimuli. The peculiarity of the paradigm was that onset of the different sensory stimuli, orienting saccade and arm movement, were dissociated in time and occurred at prefixed time intervals. Two hundred and sixteen task-related units were recorded. The data show that the dorsolateral part of the prefrontal cortex plays a crucial role in temporal organization of visually guided behaviour. This cortical area contains the neural substrate of an encoding strategy for remembered or current events and objects in the behavioural surround that are not, as yet, foveated. This encoding mechanism subserves a particular cognitive process. Whether events or objects are, or are not, encoded depends on their significance for future behaviour. While foveation deletes their neural trace, it activates a class of cells that appear involved in the preparation of arm movements towards the foveated region. The destruction of these two complementary mechanisms would disrupt the organism's capacity to integrate temporally and spatially discontinuous information for performance of goal-directed acts. PMID- 2758292 TI - Role of the parietal cortex for sensorimotor transformation. Evidence from clinical observations. AB - Somatosensory and motor functions of both hands were examined in 10 patients with unilateral parietal cortex lesions as revealed by computerized tomography. Tests of elementary somatosensory functions comprised surface sensibility, vibration, and position sense. For evaluation of complex somatosensory functions, the recognition of surface textures and object forms was tested. Motor performance was examined by measuring force and position control as well as manipulative and explorative motor behaviour. All patients showed varying degrees of sensory disturbance. Although the patients had no or minor paresis, they all had motor deficits concerning force control, fine movements, and manipulation with the hand contralateral to the lesion. Patients with more posteriorly located parietal lesions revealed predominantly severe disturbances of complex sensibility, precision grip, manipulation, and explorative finger movements. The characteristic and consistent feature of the disturbed motor behaviour was the loss of the purposive nature of the motor acts which were no longer adequate for the tasks (tactile apraxia). Paresis or ataxia could not account for this deficits. PMID- 2758293 TI - Premotor programming and cortical processing in the cerebral cortex. Electrophysiological correlates of hemispheric dominance. AB - Slow brain potentials were averaged from 12-15 EEG records (t = DC or 5 s) before and during voluntary hand movements and writing, spatial vision, language, and calculation tasks without vocalization and with visual fixation. EOG and writing pressure or EMG were recorded simultaneously. Skilled actions caused largest negative potentials in the contralateral sensorimotor hand area. Left-sided lateralization or bilaterally equal surface-negative potential shifts appeared during language and calculation tasks in 90% of the right-handers and in 75% of the left-handers. Right-sided lateralizations occurred during the viewing of perspective Necker figures or random-dot stereograms in the large majority of all subjects. PMID- 2758294 TI - Changes in contingent-negative variation and reaction time related to precueing of direction and force of a forearm movement. AB - Scalp-recorded contingent-negative variation was analyzed in a reaction time paradigm with full, partial, or no prior information regarding two dimensions of a forearm response: direction (flexion/extension) and force level (weak/strong). Visual cues (light-emitting diodes) were used for the warning and response signals. The reaction time was shorter when direction, rather than force, was known in advance. Source derivation techniques revealed that the somatosensory arm area was more 'activated' by direction than force information, whereas the precentral cortex seemed to be more strongly influenced by force information. Partial advance information was sufficient to trigger preparatory activities specific for the revealed dimension of the ensuing movement. PMID- 2758295 TI - Limbic system, basal ganglia, and dopaminergic neurons. Executive and regulatory neurons and their role in the organization of behavior. AB - Mesencephalic dopaminergic neurons appear to be involved in the organization of the behavioral response. They seem to facilitate the functioning of the integrative structures they innervate and to have a coordinated functioning, thus regulating the information transfer between these structures. In the present paper these two aspects have been investigated by behavioral and neurochemical approaches. Experimental studies were focused on the dopaminergic innervation of the nucleus accumbens. PMID- 2758296 TI - Periventricular structures and the organization of affective states and their behavioural expression. AB - This paper reviews briefly a series of electrophysiological, neurochemical, and behavioural studies concerning the role by periventricular structures (periaqueductal gray and medial hypothalamus) in the generation of aversive affective states and in the organization of overt escape behaviours. PMID- 2758297 TI - Failure to perform visually triggered forelimb movements after unilateral nigrostriatal damage in monkeys. AB - Unilateral injections of 6-hydroxydopamine into the substantia nigra of monkeys disrupted the initiation of learned movements performed with the contralateral forelimb. Failure to respond was observed in two types of behavioral tasks. The one involved a hand movement directed towards a target and the other, hand withdrawal without any spatial requirements at the end of the movement. The results suggest that the ability to perform the required response was recovered more quickly in the case of the task involving visually controlled movement. PMID- 2758299 TI - Applying a model of saccadic prediction to patients' saccadic eye movements. AB - A mathematical model of eye tracking of periodic square wave target motion has previously been proposed. In this work the model was further studied with regard to saccadic response time to symmetrical square wave target motion in 6 patients with unilateral parietal lesions following cerebrovascular accidents. Three types of saccadic response time were noted. In patients with type I, saccades contralateral to the damaged hemisphere had similar characteristics to those found in ipsilateral direction, but with longer response time. In those with type II, the saccadic response time was about the same on movement in either direction for repetitive target cycle durations of 1.2 or 2.0 s. In patients with type III, the target motion could not be predicted, in either direction. PMID- 2758298 TI - Temporal characteristics of tapping responses in healthy subjects and in patients who sustained cerebrovascular accident. AB - Tapping responses were recorded in a group of patients who sustained lesions from cerebrovascular accidents and from an age-matched group of healthy subjects. In each experiment the stimuli were an auditory signal, a flash, or a light touch on the arm, delivered either at random intervals or at fixed time intervals of 1, 2, 3, or 4 s. The tapping response was done with each hand separately (first experiment) or with each hand alternately (second experiment). Healthy subjects, 'predicted' the stimuli (response time less than 150 ms), when the 'preferred' fixed time interval was used. One group of patients (n = 3), did not predict the stimuli at the preferred fixed intervals when tapping was done with the hand related to the involved hemisphere. The second group of patients (n = 3) did not predict the stimuli when tapping was done with either hand. PMID- 2758300 TI - Experimental bradykinesia in the monkey: speed control impairments after lesion of the substantia nigra. AB - Unilateral lesions of the substantia nigra were performed on baboons which had been previously trained to perform a visual pointing movement. The resulting motor impairment consisted of an increase in movement duration. This bradykinesia shows as a regular decrease in velocity. A possible change in mode of motor control caused by lesion of the SN is discussed. Partial exclusion of SN might bring about a shift from the feedforward to a feedback mode relaying more heavily on visual cues. PMID- 2758301 TI - Premotor cortex and the retrieval of movement. AB - It is argued that the premotor cortex plays a crucial role in the retrieval of movement. Monkeys with bilateral lesions in premotor cortex were found to be impaired at selecting between two movements on the basis of visual cues. This was true whether the visual cue was present at the time of response or was no longer visible. Yet other monkeys with bilateral lesions in dorsal premotor cortex had little difficulty in remembering a movement if they had just been forced to make it a few seconds earlier. It is suggested that the premotor cortex is involved in the process of translation from a visual or auditory cue to an associated movement. PMID- 2758302 TI - Sensory to motor transformation: pre-motor mechanisms. Proceedings of the European Brain and Behaviour Society. EBBS workshop. Zichron-Yaacov, Israel, May 26-29, 1986. PMID- 2758304 TI - Gradual specification of response amplitude in human tracking performance. AB - These experiments examine how human subjects use information from a target to trigger a response and to specify its trajectory. We first determined if response initiation is predicated on the prior specification of response amplitude by examining the latencies and trajectories of impulses of isometric elbow flexion aimed to one of three visual targets. We varied target predictability (simple versus choice), the urgency with which the response was required, and the level of practice. With practice, subjects could respond to unpredictable targets with the same latency as to predictable ones; the range of response amplitudes was, however, always constricted. This central tendency bias disappeared when subjects were allowed long latencies to respond to the target, suggesting that with urgency, subjects can respond before specification is complete. To determine the time course of specification, the subjects were trained to initiate force impulses in synchrony with the last of a series of predictable tones. They also attempted to match the amplitude of their force impulses to one of three unpredictable visual targets presented at randomly varying times (50-400 ms) prior to the synchronizing tone. At the shortest stimulus-response intervals, before target information could be processed, the amplitudes of responses to all targets were clustered around that of the middle-sized target. Then, as the stimulus-response interval increased, response amplitudes gradually converged upon their specific targets. Specification started at stimulus-response intervals of about 100 ms and extended until about 350 ms.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2758303 TI - Generation of reaching movements: plausibility and implications of the equilibrium trajectory hypothesis. AB - According to the 'equilibrium trajectory' hypothesis, the generation of multi joint arm movements by the CNS involves the gradual shifting of the hand equilibrium position between the movement end points. This work presents a model which suggests that reaching movements are explicitly planned in terms of spatially and temporally invariant hand equilibrium trajectories. Implementing the model in computer simulations, and using stiffness parameters which were measured during arm posture, arm trajectories were simulated and compared to measured trajectories. The success of the predicted behavior in capturing the fine kinematic details of measured movements supports the validity of the proposed model for biological trajectory control. PMID- 2758305 TI - Investigation of the dorsolateral basilar pontine grey of the alert monkey. AB - The dorsolateral basilar pontine grey is assumed to play an essential role in a cortico-ponto-cerebello-pontine pathway subserving smooth-pursuit eye movements. The dorsolateral basilar pontine grey interconnects those cerebral and cerebellar cortical areas known to be involved in the generation of smooth-pursuit eye movements. In the present study three categories of neurons presumably contributing to smooth pursuit eye movements were recorded: visual-only neurons, visual-tracking neurons, and neurons combining both properties. Preference for directions of visual stimulation could be either iso- or antidirectional. PMID- 2758306 TI - Sensory factors are insufficient to define the ocular saccade goal in complex visual fields. AB - In most normal visual search situations, the environment is filled with a variety of stimuli, and selection among possible saccade targets is necessary. Current theories of visuomotor mechanisms must take into account not only the classical 'retinal error' input signal, but also perceptual and decisional factors as well as task-specific strategies adopted by the subjects. Experiments are reported in which eye movements are recorded in tasks requiring ocular saccades to be made onto target letters indicated by a peripherally visible mark or embedded within lines of homogeneous background letters. The results show how nonsensory factors interact with visual determinants in the preparation of the exploratory saccades. Expectations concerning the visibility of the sought-for target influence the spatial and temporal parameters of the eye movement which will be executed. PMID- 2758307 TI - Use of target velocity in saccadic programming. AB - Previous studies indicate that in response to a step-ramp visual target movement, the saccade amplitude approximates target displacement 100 ms before saccade onset. This study examines whether the saccadic system takes target motion into consideration when computing saccadic amplitude, if target movement is seen by the subject before he is requested to make a saccade. In the first experiment, while the subject fixated at the target (laser dot) and maintained fixation, the target jumped to the left and moved to the right at a fixed velocity. At some predetermined site, the target jumped a step to the right and continued to move in that direction. After the target step, the subject had to make a saccade and follow target motion. In the second experiment, while the subject fixated at the target and maintained fixation, the target jumped to the right and up and moved down at a fixed velocity. At some predetermined site, an auditory signal was given, and the subject had to make a saccade and follow target motion. Results in both experiments showed that the eye position was statistically different from the target displacement at 100 ms before saccade onset, indicating that the saccadic system uses target velocity in computing saccade amplitude. PMID- 2758308 TI - A model for collicular efferent mechanisms underlying the generation of saccades. AB - A quantitative model for the generation of saccades is presented which is based on the accepted notion that saccade metrics are coded in the deeper layers of the superior colliculus by the population of recruited movement-related cells. The model has important features derived from electrophysiological data in the monkey: a nonhomogeneous and anisotropic afferent-mapping function relating the outside visual world to collicular coordinates and a dome-shaped activity profile in the deeper layers describing the spatial extent of the recruited movement related cell population. It is proposed that each cell generates a small movement contribution which is determined both by the neuron's location in the collicular map and its firing rate. The individual cell contributions are then added vectorially to yield the total saccade. The model can generate saccades to single visual stimuli in all directions and simulate electrical stimulation experiments. To account for some nonlinear properties of the saccadic system in the computation of saccade metrics, a nonlinear version of the linear summation model is discussed. PMID- 2758309 TI - Saccadic tracking of a periodic target motion in the cat. AB - Cats were tested for their ability to follow a dot target which periodically jumps horizontally from side to side. They can learn to perform saccadic tracking of various stimulus frequencies, and often they produce saccades predicting the target displacements. The preferred stimulus frequency for response to synchronize was in the 0.5-Hz range. Cats tend to undershoot the target. They also tend to adopt a strategy of locking predominantly to one direction of displacement, but they can be trained to reverse this preferred side or to lock to both sides. Saccades to the preferred side are more accurate, and longer and slower in comparison to saccades to the other side, thus demonstrating a velocity accuracy trade-off phenomenon in the cat responses. Saccadic characteristics as expressed by the main sequence are apparently a stable property independent of the stimulus frequency. PMID- 2758310 TI - Stereopsis impairment during smooth pursuit eye tracking. AB - Coherent motion of random dot pattern across a stationary stereograting at 1-5.5 deg/s causes an impairment in perceiving the stereograting which is associated with optokinetic nystagmus. This study was aimed towards understanding the cause of the impairment. We tested two alternative hypotheses: (1) that the impairment is caused by efferent-afferent interactions and (2) that it is due to a temporal integration process, the effect of which is expressed at the temporal resolution limit of the stereoscopic mechanism to disparity alternation. The first hypothesis was rejected on the basis of modified displays and experimental conditions which clearly showed that in these displays stereopsis was not impaired in the presence of optokinetic nystagmus. In testing the second hypothesis, we first determined, for the original display, the threshold values of spatial frequency and angular velocity at which stereopsis ceased. We found for these values spatial frequency x angular velocity = 7.2 cycles/s, i.e., a constant limiting alternation rate for all angular velocity values tested. The averaging effect at the critical alternation rate was demonstrated by bisecting the display, each part having a different disparity value. The perceived depth levels of the two parts were different and are in accordance with an averaging process explanation. It is, therefore, argued that the cause of the impairment is a temporal integration process which averages the alternating disparity values of the moving dots. PMID- 2758311 TI - The development of lateral-line receptors in Eigenmannia (Teleostei, Gymnotiformes). I. The mechanoreceptive lateral-line system. AB - The South American weakly electric fish of the genus Eigenmannia were induced to spawn by simulating the conditions of the rainy season. Whole animals were viewed using scanning electron microscopy, and skin from embryos and larvae of different ages was prepared for histological examination. Additional live fish were stained with vital dyes. Neuromasts develop within the epidermis and then rise to the surface, at which time a cupula is forming. The first neuromasts appear on the head, forming the temporal, mechanoreceptive lateral line, at 3.5 days after spawning, and 1 day later neuromasts appear on the trunk as a ventral trunk line. On day 8 all the cephalic neuromasts have appeared and a secondary, medial trunk line begins to form. A dorsal trunk line forms when the fish are juvenile. Eight neuromasts of the cephalic lines, 7 neuromasts of the medial trunk line and all neuromasts of the ventral and dorsal trunk lines remain at the surface and do not become enclosed in canals. The opercular neuromasts and 7 neuromasts of the ventral trunk line degenerate later. The formation of the head canals begins on day 17, whereas the canal of the medial trunk line starts to develop on day 25, and both head and trunk canal systems are completed by day 33. The mechanosensory system develops before the electrosensory system. Behavioral observations also indicate that the mechanoreceptive system is functional as early as day 5. PMID- 2758312 TI - The development of lateral-line receptors in Eigenmannia (Teleostei, Gymnotiformes). II. The electroreceptive lateral-line system. AB - Weakly electric fish of the genus Eigenmannia were induced to spawn in conditions simulating the tropical rainy season. The skin of embryos of different ages was prepared for histological examination, and whole animals were examined by various histological methods and scanning electron microscopy. It was found that the electrosensory system develops after the first mechanoreceptive lines have formed. The tuberous and ampullary organs initially form adjacent to the lines of the lateral-line system. The tuberous organs develop at a rate 5 times higher than that of the ampullary organs. The rate of development for both classes of electroreceptors is 4 times higher on the head than on the trunk. The first tuberous organs develop on the head at day 7 and on the trunk at day 8. They increase in number and size during the growth of the fish. The ampullary organs begin to form on the head and on the most rostral part of the trunk at day 8. They are deeply sunk into the corium and have the same number of receptor cells as in adults. There are both ampullary and tuberous organs within fields of receptors that are innervated by a single nerve branch. PMID- 2758313 TI - Sound localization, use of binaural cues and the superior olivary complex in pigs. AB - Noise localization thresholds and the ability to localize pure tones at 60 degrees separation were determined for three domestic pigs using a conditioned avoidance procedure. The average threshold for localizing a brief noise burst was 4.5 degrees which is much more accurate than the thresholds of other hoofed mammals, such as horses, cattle and goats. The ability of pigs to localize low frequency tones indicates that they can use the binaural phase-difference cue. However, they were unable to localize tones of 4 kHz and higher, indicating that, like other hoofed mammals, their ability to use binaural intensity cues is greatly restricted if not completely absent. An examination of the superior olivary complex of pigs revealed that in relative size, shape and cell density it is more like that of cats than that of other hoofed mammals. PMID- 2758314 TI - Hand preferences and whole (Galago senegalensis). AB - The hand preferences in prey capture and whole-body turning biases after prey capture were assessed in 10 lesser bushbabies (Galago senegalensis) in 8 conditions designed to manipulate posture, visibility of prey and angle of reaching. Each subject received 60 trials in each test condition for a total of 480 trials. Seven subjects had a left-hand preference in food reaching, three right and none were ambipreferent. Eight subjects had a left whole-body turning bias, one right and one had no bias. No correlation was found between reach preference and turning bias. Bipedal posture facilitated the use of the dominant hand, whereas other manipulated conditions did not have a significant effect on hand use. A neuraxial arousal system is postulated as mediator of the bipedal effect on hand use. PMID- 2758315 TI - Head orientation in pigeons: postural, locomotor and visual determinants. AB - We have determined the pigeon's head orientation for two postures and two locomotor activities that do not involve a specific visual stimulus. Using a high speed cine camera, we filmed four pigeons (Columba livia) while (1) flying, (2) walking, (3) perching and (4) standing on a flat surface. Under these conditions, the head orientation is relatively constant, allowing us to estimate the normal horizon of the visual field and thus the horizontal meridian of the retina. Measurements of the lateral semicircular canal showed that the canal is tilted slightly up with respect to the horizon in the head orientation determined by the film analysis. In contrast to their relatively stable head posture during locomotion, the pigeons consistently altered their head orientation when presented with seed targets, apparently to fixate each seed with a small portion of the visual field around the bill tip. PMID- 2758316 TI - Quantitative analysis of the retinal ganglion cell layer and optic nerve of the barn owl Tyto alba. AB - The visual capacity of the common barn owl (Tyto alba) was studied by quantitative analysis of the retina and optic nerve. Cell counts in the ganglion cell layer of the whole-mounted retina revealed a temporal area centralis with peak cell density of 12,500 cells/mm2 and a horizontal streak of high cell density extending from the area centralis into the nasal retina. Integration of the ganglion cell density map gave an estimated total of 1.4 million cells for the ganglion cell layer. Electron microscopy of a single, complete section of the optic nerve revealed a bimodal fiber diameter spectrum (modes at 0.3 and 0.9 microns; bin width = 0.2 microns), with diameters ranging from 0.15 microns (unmyelinated) to 6.05 microns (myelinated, sheath included). The total axon count for the optic nerve was estimated from sample counts to be about 680,000 axons (25% unmyelinated). Therefore, roughly half of the cells in the retinal ganglion cell layer do not send axons into the optic nerve. With certain assumptions, the data predict a visual spatial acuity for barn owls on the order of 8 cycles/degree, a value similar to the known behaviorally measured acuities of masked owls (10 cycles/degree) and domestic cats (6 cycles/degree). PMID- 2758317 TI - A nomenclature for the cortical sulcal features of the tammar wallaby, Macropus eugenii. AB - A number of authors have suggested different nomenclatures for the sulcal pattern of the cortex of species from the macropodid family. These nomenclatures were found to be inadequate. This study proposes a simple and comprehensive nomenclature for the sulcal features of the cortex in wallabies. Prior to choosing the nomenclature, the most consistent sulcal pattern of the cortex of wallabies was determined. Also taken into consideration were results from both physiological and cyto-architectonic studies. The nomenclature chosen for the sulci is based upon the cyto-architectonic region in which they are found or which they delineate. This nomenclature can also be applied to other species from the family Macropodidae and, probably, more generally to metatherian mammals. PMID- 2758318 TI - A cyto-architectonic study of the cortex of the tammar wallaby, Macropus eugenii. AB - This study gives a detailed account of the cyto-architectonic features of the cortex of a tammar wallaby, a member of the Macropodidae, a family of Australian metatherian mammals. With the aid of the physiological data and data from pathway studies, six different cortical regions - frontal, parietal, temporal, occipital, insular and cingulate - were identified based on their eutherian homologues. Each region is distinguished by its individual cyto-architectonic properties. The frontal region consists of six layers throughout. Layer I is extremely thick, and an agranular region was not seen. The parietal region contains six layers of which layer IV is very prominent due to its great thickness and high cell density. Layer V is also thick and is present throughout this region. The temporal region consists of two areas: a dorsal area, physiologically defined as auditory, and a ventral temporal area. The cyto-architectonic features of the dorsal temporal area are similar to those of the parietal region, but the thickness of the neocortical mantle is narrower than that in the parietal region. In the ventral temporal area, layer VI has a speckled appearance and the cells are arranged in horizontal rows. In the occipital region, layers III and IV are very thick and well differentiated, giving a striated appearance to this region. The insular region was identified ventral to the frontal region and consists of both agranular and granular areas. The cingulate region, mostly situated in the medial part of the cortex, lacks a layer IV. Midway along its rostrocaudal extent, cells in layer III stain deeply and are tightly packed, forming a band separating layers I and II from layers V and VI. Layer VI has a speckled appearance and its cells are oriented in horizontal rows. Most of the cortical cyto-architectonic features in wallabies are comparable to those in eutherian mammals. The cortex of the tammar apparently lacks the agranular region described within the motor cortex of a number of eutherian mammals. Nonetheless, the cyto architectonic features of the tammar are otherwise comparable to those of contemporary eutherian mammals. PMID- 2758319 TI - Endogenous opioid systems regulate growth of neural tumor cells in culture. AB - Endogenous opioid systems (i.e., opioids and opioid receptors) play a role in neural cancer. Using a tissue culture system of S20Y murine neuroblastoma to assess the effects of opioids on growth, [Met5]-enkephalin was the most potent compound to influence cell replication. With a median effective concentration of 10(-10) M, this peptide inhibited cell proliferation in a stereospecific and naloxone-reversible manner. [Met5]-Enkephalin depressed both DNA synthesis and mitosis. [Met5]-Enkephalin was detected in neuroblastoma cells by radioimmunoassay, and was found to increase in concentration in culture media over time, suggesting that these cells produced the peptide. Immunocytochemistry showed [Met5]-enkephalin-like activity in the cortical cytoplasm, but not the cell nucleus, of neuroblastoma cells. Binding of [3H]-[Met5]-enkephalin specific and saturable, and Scatchard analysis yielded a Kd of 1.2 +/- 0.1 nM and a binding capacity of 50.2 +/- 4.3 fmol/mg protein. [Met5]-Enkephalin also depressed the growth of N115 murine neuroblastoma, SK-N-MC human neuroblastoma, and HT-1080 human fibrosarcoma. These results indicate that [Met5]-enkephalin, a naturally occurring pentapeptide that is derived from proenkephalin A, is a potent inhibitor of cell growth. Since cancer cells produce [Met5]-enkephalin, and contain a binding site to this ligand, endogenous opioid systems appear to control cell proliferation by an autocrine mechanism. PMID- 2758320 TI - Inhibition by H-7 of the protein kinase C prevents formation of brain edema in Sprague-Dawley CFY rats. AB - The effect of the protein kinase C enzyme inhibitor H-7 was examined on the brain edema formation evoked by bilateral occlusion of the common carotid arteries in Sprague-Dawley rats of CFY strain. Brain edema was assessed by measurement of water and electrolyte contents of the brain. The results showed that pretreatment with H-7 reduced the extent of brain edema formation in a dose-dependent manner. The fact that H-7 treatment prevented the accumulation of water and certain electrolytes in the brain indicates that the protein kinase C may be activated not only in the neuronal structures but also in the microvessels during ischemia, which can lead directly or via certain calcium-mediated mechanisms to the opening of tight junctions resulting in the development of brain edema. PMID- 2758321 TI - Traumatic spinal cord injury in rabbits decreases intracellular free magnesium concentration as measured by 31P MRS. AB - The mechanisms by which traumatic injury to the central nervous system cause irreversible tissue damage remain speculative. Recent reports suggest that a decrease in tissue total and free Mg2+ concentration may be an important factor in the development of such injury after experimental brain trauma. Although total Mg changes have been reported following spinal cord trauma, no studies have examined spinal cord-free Mg2+. In the present study, we have used phosphorus magnetic resonance spectroscopy to determine intracellular free Mg2+ concentration and atomic absorption spectrophotometry to measure total tissue Mg concentration in rabbit spinal cord prior to and following impact trauma. We report that intracellular free Mg2+ concentration decreases from a pre-injury value of 0.80 +/- 0.12 mM (mean +/- S.E.M.) to 0.31 +/- 0.05 mM at 2 h post trauma. Following injury there was an associated decrease in total tissue Mg and K concentration, but no alterations in tissue Na or water content. PMID- 2758322 TI - Anticipatory changes of soleus H-reflex amplitude during execution process for heel raise from standing position. AB - Soleus (SOL) H-reflex amplitude changes before the EMG onset of that muscle were compared between simple plantar flexion (SPF) and heel raise from standing position (STM). Results indicated that (1) the SOL H-reflex amplitude decreased during the STM but not the SPF, (2) in the STM, anticipatory EMG activity in the antagonist tibialis anterior (TA) appeared before the EMG onset of the agonist (SOL) and the onset corresponded to the initiation of the decreasing SOL H reflex, and (3) EMG reaction time of the SOL in the STM was significantly longer than in the SPF. These results suggest that the decreasing SOL H-reflex amplitude is caused by the reciprocal inhibition originating from the postural synergy, the TA. The functional significance of the decreased SOL H-reflex amplitude might lead to a delay in the activation of focal musculature. PMID- 2758323 TI - Co-existence of vasoactive intestinal polypeptide (VIP)- and cholecystokinin (CCK)-like immunoreactivities in thalamocortical neuron in the ventrolateral nucleus of the rat. AB - Cholecystokinin (CCK)- and/or vasoactive intestinal polypeptide (VIP)-like immunoreactivity (LI) was seen in many thalamocortical VL neurons which were retrogradely labeled with wheat germ agglutinin-horseradish peroxidase (WGA-HRP) injected into the frontal cortex of the rat. VIP- or CCK-LI was observed in 70 80% or 50-60% of thalamocortical VL neurons, respectively. Almost all of thalamocortical VL neurons with CCK-LI exhibited VIP-LI. PMID- 2758324 TI - Transection or electrical stimulation of the hypoglossal nerve increases glial fibrillary acidic protein immunoreactivity in the hypoglossal nucleus. AB - Glial fibrillary acidic protein (GFAP) immunoreactivity within rat hypoglossal (XIIth) nuclei was examined 1-50 days following either unilateral nerve transection or modest electrical stimulation using indirect immunofluorescence and PAP immunohistochemistry. Both nerve transection and stimulation provoked an increase in the immunodetected GFAP within the XIIth nucleus. PMID- 2758325 TI - Neuronal damage in the rat hippocampus in a new model of repeated reversible transient cerebral ischemia. AB - The influence of the interval of the repeated reversible transient cerebral ischemia on the neuronal damage in the hippocampal CA1 sector was investigated in the rats using a 4-vessel occlusion (4-VO) model. A single 3-min 4-VO did not produce any significant neuronal damage in the hippocampal CA1 sector, whereas the rats subjected to three 3-min 4-VO at 1-h intervals revealed a very severe neuronal damage which was much more severe than that in the rats subjected to a single 9-min 4-VO. In contrast, the rats subjected to three 3-min 4-VO at 6-h intervals revealed only a mild neuronal damage. The degree of the neuronal damage in the rats subjected to three 3-min 4-VO at 5-min intervals was similar to that in the rats subjected to a single 9-min 4-VO. The present study indicates that even such a brief, non-lethal ischemia as 3-min 4-VO can produce a severe neuronal damage if it occurs repeatedly at 1-h intervals. PMID- 2758327 TI - Interphotoreceptor contacts at the inner segment level in primate retinas. AB - Just sclerad to the external limiting membrane of the retina of the monkey (M. fasciculata), short processes from some foveolal and foveal cone inner segments made dense contacts with each other and at the same level of peripheral human retina similar rod-cone and rod-rod contacts were observed. PMID- 2758326 TI - Stimulation of dopamine output from adrenal medullary cells by beta-endorphin and its C-terminal tetrapeptide (MPF). AB - The output of dopamine from cultures of rat adrenal medullary strips was increased by 71-120% when Lys-Lys-Gly-Glu (MPF), the C-terminal tetrapeptide sequence of human beta-endorphin, was added to the culture medium at 100 micrograms/ml concentration. Human beta-endorphin caused a 44% increase, but an N terminal fragment of its molecule and somatotrophin caused no increase. Results with analogs of MPF show that small structural change of the C-terminal Glu residue causes complete loss of activity. PMID- 2758328 TI - Inositol 1-phosphate formation in long-term potentiation and kindling. AB - Long-term potentiation (LTP) in the CA3 hippocampal subfield, elicited in vivo, produced significant increases in basal and in carbachol- and noradrenaline induced hydrolysis of phosphatidylinositol-4,5-biphosphate (PtdIns(4,5)P2) as measured by the accumulation of InsP1 in hippocampal slices in vitro. Kindling, however, resulted in significant decreases in basal and in carbachol- and noradrenaline-induced accumulation of InsP1 in hippocampal slices. N-Methyl-D aspartate (NMDA) receptors do not directly alter the hydrolysis of PtdIns(4,5)P2 in either LTP or kindling. These results demonstrate that LTP and kindling are associated with opposite alterations in efficacy of the main receptors mediating the hydrolysis of PtdIns(4,5)P2. PMID- 2758330 TI - Auditory and visual neurons in the cat's superior colliculus selective for the direction of apparent motion stimuli. AB - In the cat, cells of the superior colliculus (SC) and the tectofugal pathways of the visual system are highly selective for the direction of a moving visual stimulus. Deep layer units of SC in addition respond to auditory and somatosensory stimuli, but the proportion of such non-visual cells is usually found to be much lower than that of visual cells. We recorded the responses of 174 cells in the SC to sequentially presented, localized visual and/or auditory stimuli that produced the sensation of apparent motion to human observers. Controls using single LED flashes or tone pips or clicks at very long intervals that did not produce apparent motion were also used. We found both visual and auditory units that responded vigorously to the apparent motion stimuli and showed pronounced directional selectivity. However, in the auditory domain such units were rare and thus did not increase the proportion of auditory responses in SC substantially. Varying the interstimulus interval (ISI) of these stimuli, both visual and auditory, indicated that the mechanism of direction selectivity in these cells was suppression of the response in the 'non-preferred' direction rather than facilitation in the 'preferred' direction. With long ISI's of 200 ms or more, every single stimulus gave a discrete response peak of constant amplitude. For ISI's of 50 ms or less the discrete peaks merged to a continuous response. Maximal firing rate in the preferred direction remained the same as for longer ISI's, but was decreased for movement in the non-preferred directions. Very short ISI's (10 ms) produced little response in any direction.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2758329 TI - Increased blood pressure induced by central application of aminopeptidase inhibitors is angiotensinergic-dependent in normotensive and hypertensive rat strains. AB - Two aminopeptidase inhibitors, amastatin (AM) and bestatin (BE), were employed in 3 strains of rats, spontaneously hypertensive (SHR), Wistar-Kyoto (WKY), and Sprague-Dawley (SD), to investigate the central angiotensinergic system. The results indicate that intracerebroventricular (i.c.v.) injections of AM and BE induced pressor elevations in all 3 strains of rats. In order to test for the possibility of spillage into peripheral vasculature, members from all 3 strains were peripherally infused with AM, BE, or 0.15 NaCl via jugular vein catheters. The SHRs were significantly more responsive to the aminopeptidases than the normotensive strains, however their overall pressor responses were only 33% of those to i.c.v. infusion. Next, in order to test the notion that these aminopeptidase inhibitors are having their effect via the central angiotensinergic system, and not some other peptidergic system, the specific angiotensin receptor antagonist, Sar1, Thr8-AII (sarthran) was employed. Intracerebroventricular pretreatment with sarthran prevented subsequent pressor responses to i.c.v. AM and BE in members of all 3 strains, thereby suggesting that these aminopeptidase inhibitors are having their effect via the central angiotensinergic system. PMID- 2758331 TI - Somato-motor components of the pelvic and pudendal nerves of the female rat. AB - The efferent innervation of the pelvic and pudendal nerves was characterized in this study by identifying the muscles activated by electrical stimulation of the nerves distal to the point at which they bifurcate from the L6-S1 trunk. Pelvic nerve electrical stimulation produced EMG-monitored contraction of the ipsilateral ilio- and pubococcygeus muscles, which was abolished by cutting one ('muscular') branch of the bifurcated nerve. (This 'muscular' branch receives proprioceptive input activated by tail displacement, whereas the other, 'viscero cutaneous' branch receives sensory innervation from the midline perineal region.) Pudendal nerve electrical stimulation produced contraction of the coccygeus, external anal sphincter, and ischiocavernosus muscles. Movements of the orifice and wall of the vagina were directly visualized during electrical stimulation of the two nerves. Intravaginal pressure measured by balloon was increased by pelvic nerve stimulation and decreased by pudendal nerve stimulation. Reflexive contraction of the ilio- en pubococcygeus muscles was produced by mechanostimulation of the perineum, clitoral sheath and distal vagina. This response was abolished by gentle cervical mechanostimulation. One implication of this finding is that passage of the fetuses through the cervix during parturition may relax the ilio- and pubococcygeus muscles, thereby facilitating delivery. PMID- 2758332 TI - [Left ventricular function in patients with recent onset of type I diabetes mellitus]. AB - Left ventricular heart function was investigated by means of two dimensional (2D) echocardiography and pulsed Doppler (PD) echocardiography in 17 young consecutive patients aged 17-38 years (mean 26.6 y.) with type I diabetes mellitus of short duration (mean 5.5 y.) whose stress ECG showed no signs of ischemic heart disease and who had no other organic complications of diabetes. The series was compared with 13 healthy volunteers (mean age 25.5 y.). No differences were found between diabetics and controls in systolic function parameters (left ventricular fractional shortening, interventricular septum shortening, left ventricular posterior wall shortening, left ventricular endsystolic dimension) as established by 2D. The parameters of left ventricular diastolic filling (maximal velocity of the rapid filling period E, its maximal time and duration of the whole phase) were established by PD and computer assisted approach. These parameters were studied also during atrial systole A and the E/A ratio was determined. All findings were comparable in the group of diabetics and controls, with the only statistically significant difference (p less than 0.05) in the duration of A which was shortened in the diabetics. PMID- 2758333 TI - [Cardiac complication of mucoviscidosis]. AB - Over the years 1971 to 1988 autopsies of 33 children with the clinical diagnosis of mucoviscidosis were performed at the Institute of Pathology, Medical Faculty, Comenius University, Bratislava. In three cases pronounced changes were observed on the myocardium, predominantly on the left ventricle. Multifocal necrosis and fibrosis of the myocardium represent rare but severe changes occurring as a complication of mucoviscidosis in infancy. PMID- 2758334 TI - [Microcomputer-assisted system for photographing the movements of biological valve prostheses]. AB - The aim of the study was to develop a clinically usable system of photographic imaging of the movements of biological valve transplants and of evaluating temporal and spatial relationships. The system has been established by means of a microcomputer and associated peripheral electronic equipment so that there is no need to use a high-speed camera. Functioning of the system was verified by testing 37 aortal valve allotransplants and the Bjork Shiley mechanical valve prosthesis. PMID- 2758335 TI - [Toxicity of cisplatin with continuous infusion of 5-fluorouracil in neoadjuvant chemotherapy of carcinoma of the oral cavity]. AB - The intensity and dynamism of the toxicity of the neoadjuvant chemotherapy regimen utilizing cis-diaminodichloro-platinum (CDDP) with continuous 5-day infusion of 5-fluorouracil (5-FU) was recorded and analyzed during the treatment of 23 patients with histologically established epidermoid carcinoma of the oral cavity. The most frequent sign of toxicity was leukopenia and nausea/vomiting, both occurring in 78% of cases. Leukopenia was more frequent and serious than reported in other studies. On the contrary, nephrotoxicity was mild and less frequent (17%) compared to literary data. Diarrhea was associated with the administration of CDDP in 31%, minimal hair loss was recorded in 21% of cases. Other signs of toxicity were rare and mild. The degree of severity of toxicity was increasing with the number of treatment courses only with respect to hematologic parameters. No life-threatening complications were recorded. In seven cases continuous treatment had to be interrupted after three days due to leukopenia. With regard to toxicity, the applied treatment schedule (three courses) is fully acceptable, safe and suitable as neoadjuvant chemotherapy in the complex management of oral cavity carcinoma without the risk of delaying subsequent definitive treatment. PMID- 2758337 TI - [Value consciousness in the integrity of the personality]. AB - Personality as intact functional integrity, a set of individual conditions of practical relationships generated by natural and social development, implies a system of information items and their mental traces specific for man which in its controlled function is termed value consciousness. Its identification substance is primarily conceptual and its reality is mass-individual, of different levels, yet with an overall orientation on the development of its biological species, society, and itself, on the process whose dynamics and specific orientation has determined its development and maintenance. As the principle of a person, consciousness is a substantial manifestation of the endowment of active sociability and intelligence. Therefore its highest quality of cognizance and conscientiousness requires effective operation with key concepts of rational, internal, sufficiently reflected aspects of practice. Following the primordial basic trend of the development of human life to full selfrealization of mankind, i. e. unity of the species, society, and the principle of the individual, it eventually overcomes the emotional consumer attitude to the sense of life and makes a correct handling of life, relations, functions, and values possible. Its developed form has a decisive, quality providing value for interpersonal, social and historical relationships, cultural and control functions, with a marked everyday impact particularly on human medicine. PMID- 2758336 TI - [Present trends in sports medicine]. AB - Knowledge on the response and adaptation of the human organism to motor activity in dependence on age and sex is presented. In organizing substitute motor activities for the population, two lines have to be differentiated, i.e. programs of exercises for the maintenance of health and training for increasing physical fitness. Recent methods of functional diagnosis of aerobic and anaerobic abilities in the laboratory and in sports premises are described. Echocardiographic examination presents a contribution as it enables to study dynamically the adaptation of the heart to different motor activities. The authors formulate their standpoint concerning selection of locomotively talented youth as well as some specific health problems of top performance sports (immunological resistance, doping). PMID- 2758338 TI - [Surgery in pectus excavatum without fixation aids]. AB - Analysis of 40-year experience with operations for pectus excavatum over the period from 1950-1988 is presented. In a series of 177 children ten different surgical approaches were used in succession. Since 1975 operations were performed exclusively by the method according to Ravitch and Welch which does not apply any fixation splints. The procedure is substantiated by the pathologico-anatomical and metabolic causes of the origin and development of inborn deformities of the chest. The operation consists of several exact procedures on the muscles, cartilages, and sternum, which have to be carried out consistently. The important parts of the surgical procedure are described. Since 1975 the method was used in 28 children, with very good and good results in 92.8%. PMID- 2758339 TI - [Diagnosis and treatment of trauma of the heart and major vessels]. AB - 31 cases of trauma of the heart and major vessels were treated at our hospital from september 1959 to september 1987. There were 28 men and 3 women. Their age varied from 8 to 45 years. The injuries included cutting (26 cases), bullets (2 cases), and other types (3 cases). 27 of the patients were in shock and 15 had heart tamponade. 30 cases were treated surgically. Simple repair was performed in 27 and removal of foreign body was done in 3 patients. As a result, 29 patients completely recovered and 2 died. The authors emphasize the importance of timely diagnosis of the trauma, immediate operation and the choice of simple and suitable surgery. Rapid tracheal cannula anesthesia should be used and the operation should be performed through left antero-exterior thoracic incision. PMID- 2758340 TI - [Treatment of traumatic shortening of the legs in adults]. AB - Non-traumatic shortening of lower extremities can be lengthened by osteotomy, traction or bone grafting. In traumatic shortening, treatment is limited by several reasons and emphasis should be put on bone healing and preserving of loading and walking functions. The lengthening of lower extremities has some difficulties. Recently, we have adopted a method in which we transposed muscle skin flap to repair the stick-bone scar in the early stage, and performed traction with Hoffman extra-frame (when osteotomy is needed) in the mid-stage and bone grafting (with or without vascularity) in the late stage. From April 1984 to April 1986, seven patients were treated by this method. The result was satisfactory. In this article is discussed the pathologic characteristics of traumatic shortening of the lower extremities and the role of the gastrocnemius in repairing skin defect. PMID- 2758341 TI - [First-aid of serious trauma at the emergency room (an analysis of 144 cases)]. AB - From 1983 to 1987 there were 144 patients with serious trauma who were given first-aid in the emergency room of our hospital. Sixty of them died (41.7%). The mortality was 56% (1983-1984) and 29.8% (1985-1987) (P less than 0.05). Our experience included: 1. to perform intratracheal intubation or tracheostomy at once for decreasing the mortality of the comatose or asphyxial patients, 2. to transfuse large quantity of liquid quickly and enough quantity of blood for treating shock; 3. learn to be more familiar with multiple injury for reducing diagnostic mistake; 4. to provide with excellent medical services and raise the efficiency of first-aid for decreasing the mortality of serious trauma in the emergency room. PMID- 2758342 TI - [Pathological classification and clinical characteristics of primary glomerulonephritis in China: bioptic study of 1001 cases]. AB - The pathological classification and clinical characteristics of 1001 cases of primary glomerulonephritis seen in Jinling Hospital between 1980 and 1987 were analysed. It was found that the incidence of mesangial proliferative GN (including IgA nephropathy) ranks first. This was the commonest type in the cases of nephrotic syndrome, renal hypertension and chronic renal failure. On the other hand, minimal changes and membranous nephropathy, the usual types of GN causing nephrotic syndrome in Western literature are not so common in our series. It is suggested that Mesangial proliferative glomerulonephritis, especially IgA nephropathy, should be stressed as the chief type of GN that needs further research. PMID- 2758343 TI - [Ultrastructural and immunocytochemical studies of endocrine cells in the mucous membrane of the fetal gastric antrum]. PMID- 2758344 TI - [The third type of fracture healing]. AB - Based on experimental and clinical studies, it was found that when fracture was nearly reduced, the choice and device of internal or external fixation was optimal and was used rationally, and thus rigid fixation was provided at the early stage. When immediate movements of joints were possible, relatively elastic fixation under weight-bearing at the later stage was done and no influence on transmission of the load and no signs of bone resorption could be seen at fracture ends. The fracture was repaired directly by Haversian system remodeling with a little callus. It is then called the third optimal type of fracture healing which is different from either primary or secondary healing. Using this new concept to treat fractures of long bones, not only will the fracture unite rapidly and functions restore satisfactorily, but also the strength and the stiffness of the healing bone will be greater, complications including non-union and refracture etc can be decreased or avoided. PMID- 2758345 TI - [Analysis of radiotherapeutic effects on nasopharyngeal carcinoma extending beyond the nasopharynx with damage of the cranial nerve and destruction of the base of skull]. PMID- 2758346 TI - [HLA antigens in alopecia areata]. PMID- 2758347 TI - [Preparation and characteristics of human monoclonal antibody HMD4 against ovarian epithelial carcinoma]. PMID- 2758348 TI - [An experimental study of blast injury]. AB - This paper presents some aspects of the authors' experimental research on blast injury in the past two years. The main results are as follows: (1) A new designed 39 meter-long shock tube for biological test has been built in the laboratory. Its maximal overpressure values are 215 kPa (in open condition) and 505 kPa (in closed condition). It may meet the need for inflicting blast injuries with various degree of severity. (2) A study of the effect of simulating gun muzzle blast wave on sheep indicated that in the single explosion, the threshold overpressure values inflicting the injury of internal organs were: Lung-37.27 kPa, G-I tract-41.0 kPa; the upper respiratory tract-negative until 73 kPa, while in the multiple (20 times) explosions, they were 23.7, 23.7 and 41.4 kPa, respectively. (3) Using TEM, SEM and some other special techniques, such as morphometry, freeze-fracture technique, labelled lanthanum nitrate technique, etc, it was demonstrated that in the lung with blast injury there were significant pathological changes in pulmonary capillary endothelium, alveolar epithelium and their intercellular junctions with apparent increase of permeability. (4) It has been shown that parallel superficial stripelike hemorrhage typical for lung blast injury is "Intercostal marking" instead of "Rib marking". (5) A new type of material (foamy nickel) for protection against blast wave is presented. It was proved that the material can effectively weaken or eliminate the effect of blast wave on human body. PMID- 2758349 TI - An assessment of the value of quantitative and qualitative data collection techniques. PMID- 2758350 TI - Residential modules for vocational training; the Burwalls experience. PMID- 2758351 TI - Prevention orientated and consider marketing techniques to promote dental services. PMID- 2758352 TI - Radiation risks in dentistry. PMID- 2758353 TI - Suppression of the late asthmatic reaction by hyposensitization in asthmatic children allergic to house dust mite (Dermatophagoides pteronyssinus). AB - In this study, we wanted to test the hypothesis that hyposensitization (HS) abrogates the late asthmatic reaction (LAR). We therefore selected 15 asthmatic children (subjects) sensitized to house dust mite (HDM), as proven by positive prick tests and/or specific IgE via the RAST. All children demonstrated a positive bronchial provocation test (BPT) to HDM; 14 showed a dual asthmatic reaction and one child showed an isolated LAR. All children were treated with anti-asthmatic drugs and received HS. They were rechallenged after 1 yr of HS while their anti-asthmatic medication was not changed, except for beta-agonists which were used only for relief of symptoms. Two BPTs, with a mean interval of 6.4 months, were also performed in eight asthmatic children (controls), who did not receive HS. In the controls, the same reaction pattern was observed during both BPTs. In the subjects, the LAR completely resolved in 5/15 after 1 yr of HS (P = 0.04). Furthermore, as a group, the subjects showed a less severe LAR after 1 yr of HS (expressed as mean fall of FEV1) (P less than 0.0001). The PD20 of the immediate asthmatic reaction (IAR) was the same as before HS was started, but the IAR was also less severe after 1 yr of HS (expressed as mean fall of FEV1) (P = 0.028). From these observations it is concluded that, in asthmatic children, HS may resolve and/or reduce the severity of the LAR. Although the PD20 of the IAR is not changed, the severity of the IAR is also reduced after 1 yr of HS. PMID- 2758354 TI - Occupational allergy in an entomological research centre. II. Identification of IgE-binding proteins from developmental stages of the blowfly Lucilia cuprina and other species of adult flies. AB - Sera from 30 workers in an entomological research institute and from five Sydney asthmatics, all with serum IgE antibodies to sheep blowfly (Lucilia cuprina) antigens, were studied with the aim of identifying individual IgE-binding proteins in extracts of L. cuprina adult flies, larvae and eggs, and in extracts of related species of flies from the order Diptera. Using protein blotting, 21, 18 and nine different IgE-binding components were identified in extracts of L. cuprina adult flies, larvae and eggs, respectively. A component(s) of MW 67 kD found in all three developmental stages, showed the highest frequency of IgE binding; reacting, for example, with 70% of the sera tested with the adult fly extract. Some components were detected in only one of the three developmental stages. Investigations of possible allergenic cross-reactivity between L. cuprina and extracts from six other related species of flies revealed IgE-binding bands in each of the extracts as well as in an extract of Agrotis infusa, a cutworm not belonging to the order Diptera. One strongly reacting component of MW 20 kD was detected in extracts of five different fly species as well as in the A. infusa extract. The results suggested that allergenic cross-reactivity between some fly species exists, and may extend to taxonomically unrelated insect species. PMID- 2758355 TI - The relative risks of sensitivity to grass pollen, house dust mite and cat dander in the development of childhood asthma. AB - The associations between skin sensitivity to various common allergens and the development of childhood asthma were ascertained in a longitudinal study of a birth cohort of New Zealand children up to the age of 13 years. Of 714 children skin-tested, 45.8% were sensitive to at least one of 11 allergens, the most common responses being to rye grass pollen (32.5%), house dust mite (30.1%) and cat dander (13.3%). Allergen-specific relative risk analysis, controlled for the effect of sensitivity to other allergens, demonstrated that sensitivity to house dust mite and to cat dander were highly significant independent risk factors associated with the development of asthma (whether defined as recurrent typical respiratory symptoms, increased airway responsiveness, or the concurrent presence of both), whereas grass sensitivity was not a significant independent risk factor for asthma. PMID- 2758356 TI - Anaphylaxis produced by rubber glove contact. Case reports and immunological identification of the antigens involved. AB - A study was carried out on six subjects suffering from anaphylactic reactions including asthma, rhinoconjunctivitis, contact urticaria and hypotension following contact with rubber gloves. All of them showed skin sensitivity and serum specific IgE to various preparations of natural latex, and not to other chemicals used in glove manufacturing. Immunoblotting techniques demonstrated that at least four soluble polypeptides from natural latex had the ability to bind specific human IgE. The results suggested that natural latex proteins present in rubber gloves can cause severe specific hypersensitivity reactions. PMID- 2758357 TI - Food specific skin-test reactivity in atopic subjects. AB - It has been proposed that a permanent or transitory increase in gut permeability is an important facet in the development of food allergy. If this occurs, then individuals with a history of a specific food allergy should have a higher incidence of immunological reactivity to other food allergens as compared to food tolerant subjects. To test this hypothesis, we evaluated the prevalence of food specific IgE responses by skin-prick testing in 60 individuals. Subjects were classified by a history of food allergy (shrimp hypersensitivity) and atopic status. Prevalence of skin-prick test reactivity to shrimp and a panel of nine other food extracts was determined. Skin-test reactivity to shrimp was related both a history of shrimp sensitivity and atopic status. However, the prevalence of skin-test reactivity to other foods was not related to clinical history of shrimp allergy, although it was related to atopy. A subset of subjects with shrimp allergy had multiple positive skin reactions to many of the nine other foods. This reactivity was associated with a history of pulmonary symptoms following shrimp ingestion. In general our results do not support non-specific increases in gut permeability being important in the development of food allergy. PMID- 2758358 TI - The relationship between exposure to rats and antibody production in man: IgG antibody levels to rat urinary protein. AB - An ELISA procedure has been developed to measure specific IgG antibodies against rat urine. Using this method antibody levels in individuals with differing exposure levels to rat have been measured. Mean antibody titres in groups of workers regularly exposed to rats were higher than those in groups currently or totally non-exposed. However, only in the group of workers exposed and sensitized to rats were IgG levels significantly elevated. Despite this significant difference in mean antibody titres there was considerable overlap between individuals in each group, and there was no direct relationship between exposure to rats and levels of IgG anti-rat urine antibody. Our results suggest a stronger correlation between sensitization to rats and the levels of antigen-specific IgG antibodies. PMID- 2758359 TI - Inflammatory and immunological cell profiles in a rat model of conjunctival immediate hypersensitivity. AB - A modified model of conjunctival immediate hypersensitivity in the rat is described. The advantages of this model over previously reported rat models are that it does not require invasive challenges, pre-treatment with mucolytic agents to enhance antigen penetration, or the use of haptens, and is therefore more representative of the mode of allergen challenge seen in human hay fever conjunctivitis. This model has been shown to have both early and late-phase cellular responses but only early phase clinical signs. During the early phase of the response the tarsal region accommodates a massive neutrophil infiltration and the fornix-bulbar region participates to a greater extent during the late-phase reaction, with a significant eosinophil infiltration. The development of this model has allowed us to gain a clearer insight into the mechanisms involved during conjunctival immediate hypersensitivity in the rat; and the simplicity of this model makes it attractive to use in the evaluation of new drug therapies prior to their introduction into human clinical trials. PMID- 2758360 TI - Skin-prick test preparations of Dermatophagoides pteronyssinus for prediction of a positive response to provocation testing. AB - Skin-prick testing (SPT) with allergen is widely used in the investigation of respiratory disease, yet its relationship to the results of provocation testing of the nose or bronchus remains obscure. We have studied this relationship by determining the concentration of Dermatophagoides pteronyssinus extract and the associated weal size which resulted in the lowest 'false positive' (FP) and highest 'true positive' (TP) rates when compared to the results of bronchial and nasal provocation testing. Subjects studied included those with both positive and negative bronchial or nasal provocation tests. For each of a series of concentrations of D. pteronyssinus extract, standardized in relation to content of Der pI antigen, receiver operating characteristic (ROC) curves of TP against FP rates were constructed. Optimal diagnostic concentrations for SPT were 0.112 1.122 x 10(6) IU of Der pI ml-1. However, at the lower end of this range the optimum weal areas for a positive test with the D. pteronyssinus extract were very small (less than 5 mm2). More appropriate concentrations for use in clinical practice were 0.56-1.122 x 10(6) IU Der pI ml-1 since at these concentrations more easily measurable weal areas of 5-10 mm2 (2.6-3.6 mm diameter) were almost equally predictive of a positive provocation test. PMID- 2758361 TI - Immunological specificity of chloramine-T-induced IgE antibodies in serum from a sensitized worker. AB - A procedure for the preparation of chloramine-T (CT) conjugates used to assay IgE antibodies was developed using response surface methodology and serum from a subject occupationally exposed to the substance. The conjugates, synthesized by reacting CT with human serum albumin (HSA) and other protein carriers, were used as antigens in a radio-allergosorbent test (RAST). Human serum albumin was found to be a suitable carrier, although other protein carriers also gave specific IgE binding of a similar extent. The CT-HSA conjugates used in the RAST were characterized by high performance liquid chromatography, electrophoresis, immunodiffusion and ammonium sulphate precipitation. However, no strong correlation was seen between the ability of the conjugates to bind IgE and their physical or immuno-chemical properties. The hapten and carrier specificity of CT induced IgE antibodies in the subject's serum were studied by direct RAST and RAST inhibition. No existence of new antigenic determinants related to the carrier could be demonstrated. Although HSA as a carrier was altered immunochemically by CT, the IgE antibodies were found to be specific to hapten only. Chloramine-T-specific IgG antibodies could not be demonstrated in the subject's serum. PMID- 2758362 TI - Effects of maternal diet during late pregnancy and lactation on the development of atopic diseases in infants up to 18 months of age--in-vivo results. AB - One hundred and sixty-two women with respiratory allergy to animal danders and/or pollens were randomly allocated to a diet consisting of either a very low ingestion of hens' egg and cows' milk or a daily ingestion of one hens' egg and about 11 of cows' milk during the last 3 months of pregnancy. One hundred and sixty-three infants were followed prospectively up to 18 months of age when the cumulated incidence of atopic disease in each child was evaluated blindly. No significant differences in the distribution of atopic disease were found among the infants in relation to the maternal diet during late pregnancy. The numbers of skin-prick tests positive to ovalbumin, ovomucoid, beta-lactoglobulin and cows' milk were likewise not influenced by differences in the maternal diet during late pregnancy. Genetic factors rather than maternal diet during the perinatal period probably have a greater effect on the incidence of atopic diseases during early infancy. PMID- 2758363 TI - Bronchial provocation testing. PMID- 2758364 TI - Clinical significance of serum HDL cholesterol. PMID- 2758365 TI - Platelet activation. PMID- 2758366 TI - Role of reactive oxygen derived radicals in ischemic heart disease. PMID- 2758367 TI - One year mortality outcomes of all coronary and intensive care unit patients with acute myocardial infarction, unstable angina or other chest pain in Hamilton, Ontario, a city of 375,000 people. AB - Over a one year period (1979 to 1980) all cardiac admissions to the coronary care units (CCU) and all intensive care unit (ICU) overflow admissions in Hamilton, Ontario, a city of approximately 375,000 people, were documented. Mortality status was determined one year following admission. There were 2004 individuals with either acute myocardial infarction (810), unstable angina (811) or other chest pain (783) as their first CCU/ICU admitting diagnosis that year. Mortalities in-hospital and by one year were: acute myocardial infarction 17 and 27%, respectively; unstable angina 1.5 and 9.2%, respectively; and other chest pain 1.4 and 3.1%, respectively. Of one year mortality following acute myocardial infarction, 63% occurred during the initial hospitalization, whereas this figure was 16% for unstable angina. For acute myocardial infarction, female mortality was greater than male mortality overall and in all but one age category. Mortality following acute myocardial infarction and unstable angina was strongly related to age. Repeat CCU/ICU admission occurred in 24% of acute myocardial infarction, 28% of unstable angina and 15% of other chest pain, while a total of death or nonfatal CCU/ICU readmission occurred in 31% of acute myocardial infarction, 32% of unstable angina and 17% of other chest pain. PMID- 2758368 TI - Effects of manganese chloride, verapamil, and hypoxia on the rate-dependent increase in internal longitudinal resistance of rabbit myocardium. AB - The effects of high rates of stimulation on the internal longitudinal restivity (Ri) and conduction velocity (theta) were studied on rabbit papillary muscle preparations using a silicon-oil chamber. Increasing the rate from 75 to 150/min caused Ri to rise and theta to decrease. The maximum rate of depolarization and action potential duration were also decreased. At a rate of 300/min the effects were more pronounced. Blockade of the slow inward current (Isi) and of the Na-Ca exchange by MnCl2 (5 mmol/L) did not prevent rate-induced changes in these variable. Verapamil (0.02 mmol/L) was also ineffective. Hypoxia (PO2 = 5.3 kPa) at 75/min induced changes in Ri and theta which were similar to those recorded at 150/min under aerobic conditions. The effects of high rates of stimulation were potentiated under hypoxia. From the present results it is suggested that Isi and the Na-Ca exchange are not the main determinants of the rate-induced increase in Ri, which could be determined by other intracellular Ca-release mechanisms or by a decrease in myoplasmic pH. PMID- 2758369 TI - Mechanisms underlying the cardiovascular responses to intrathecal vasopressin administration in rats. AB - Vasopressinergic pathways within the spinal cord have been implicated in the control of cardiovascular function. This study was undertaken to determine the mechanisms whereby intrathecally administered arginine vasopressin (AVP) increases blood pressure and heart rate in anesthetized rats. The cardiovascular responses to intrathecal AVP administration were significantly attenuated after intravenous administration of the ganglionic blocking agent, chlorisondamine chloride, as were the pressor responses following alpha-adrenergic receptor blockade with phentolamine and the heart rate responses following beta-receptor blockade with propranolol. Intrathecal administration of the V1 vasopressin receptor antagonist d(CH2)5Tyr(Me)AVP completely blocked the cardiovascular responses to intrathecal AVP injections, but did not significantly alter the responses to intrathecal substance P injections. There was no evidence for the involvement of the renin-angiotensin system in the pressor responses to intrathecal AVP, as (i) an angiotensin II receptor blocking agent, [Sar1, Val5, Ala8]angiotensin, failed to significantly alter the responses to intrathecal AVP, and (ii) plasma renin levels did not change following administration of the peptide. Intrathecal injections of [3H]AVP suggest that only small amounts of the peptide may cross into the plasma during the time in which the cardiovascular variables are changing. These data provide evidence that intrathecally administered AVP discretely activates the sympathetic outflow to the heart and vasculature, and confirm the neurally mediated nature of the response. PMID- 2758370 TI - Some pharmacological activities of novel adenine-related compounds isolated from a marine sponge Agelas mauritiana. AB - Agelasimine A and agelasimine B, two novel compounds related to adenine, have been isolated from the orange sponge, Agelas mauritiana, and have been tested for a variety of biological activities. Both compounds inhibited proliferation of cultured L1210 leukemia cells at nanomolar concentrations with accumulation in the G1 stage of the cell cycle. However, no prolongation of life was observed in mice bearing P388 leukemia treated with these compounds. In the rat isolated aorta, micromolar concentrations of agelasimines were very effective in inhibiting contractions elicited by potassium chloride but had little or no effect on responses for prostaglandin F2 alpha and had modest effects on the responses to noradrenaline and significant effects on 5-hydroxytryptamine. Agelsamines A and B appeared to be equipotent in causing relaxation in rabbit jejunum and bovine coronary artery, and they also inhibited nucleoside transport into rabbit erythrocytes in micromolar concentrations. PMID- 2758371 TI - A reappraisal of protein turnover values in neonates fed human milk or formula. AB - We investigated the effect of human milk feeding on the nitrogen metabolism of appropriate-for-gestational age infants of birth weight 1.5-2.0 kg. Eight infants received pooled mature human milk. The remaining 20 were divided into two equal groups, who received one of two low-protein, milk-based formulae. The formulae were identical in composition except for the protein source, which was either casein- or whey-predominant. The three diet groups received similar total nitrogen (390 mg N.kg-1.d-1) and energy (500 kJ.kg-1.d-1) intakes. The human-milk fed group, however, received a significantly higher intake of nonprotein and urea nitrogen and a significantly lower true protein nitrogen. Nitrogen metabolism was studied using a modified constant infusion of [15N]glycine, mixed with the feeding every 2-3 h. Urine was collected in approximately 3-h aliquots and analysed for total ammonia and urea nitrogen. Excretion of the 15N label was measured in urinary urea and ammonia. No differences were seen between the three diet groups in total [15N]urea or [15N]ammonia urinary excretion. However, the concentration of 15N in urinary urea in the human-milk-fed group was lower than in the two formula-fed groups. This reduction in concentration appeared due to a higher dietary intake of urea among the human-milk-fed group, and the consequent dilution of the label in the urine. As a result, protein turnover rates calculated from the [15N]urea end product were artificially raised in the milk fed group, and were significantly higher than those in the formula groups.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2758372 TI - Analysis of the direct and indirect effects of adenosine on atrial and ventricular cardiac muscle. AB - The effects of adenosine were examined upon the tension developed by isolated paced left atria, left ventricular papillary muscles, and right ventricular strips, and upon the spontaneous rate of contraction of right atria of guinea pigs. Three aspects of the direct and indirect actions were examined: the direct effects upon resting developed tension and rate, the indirect activity when added to tissues prestimulated by isoprenaline, and the indirect activity upon isoprenaline concentration--response curves when added prior to exposure to isoprenaline. The direct effects on the atria were decreases in left atrial tension and right atrial rate. These responses were antagonized by 8 phenyltheophylline (8-PT) and therefore were due to stimulation of cell surface P1 purinoceptors. This antagonism was greater in the left atria than the right. The direct ventricular effects were, in contrast, increases in force of contraction, which were not antagonized by 8-PT. This positive inotropy was also unaffected by reserpine pretreatment of the guinea pigs and therefore not due to release of endogenous catecholamines. A possible intracellular effect of adenosine is discussed. Adenosine reduced the isoprenaline-prestimulated tension or rate in both atrial and ventricular tissues, and this indirect effect was susceptible to antagonism by 8-PT. In the presence of adenosine, concentration response curves of the left and right atria for isoprenaline were displaced to the right, and the maxima were reduced. In contrast, there was no antagonism of the papillary muscle curves to isoprenaline, but the maximum developed tension was elevated. The minimal inhibitory effects of adenosine in ventricular muscles and the high concentrations required are discussed in the context of a physiological role for endogenous adenosine in attenuating cardiac overstimulation by the sympathetic nervous system or endogenously released catecholamines. PMID- 2758373 TI - Inhibition of platelet-activating factor induced renal hemodynamic and tubular dysfunctions with L-655,240, a new thromboxane-prostaglandin endoperoxide antagonist. AB - The continuous infusion or bolus injection of the platelet-activating factor (PAF) is associated with profound hypotension, marked reductions of renal plasma flow, glomerular filtration, and urinary sodium excretion. All these effects are inhibited by blocking PAF receptors. To examine further the potential mediators of PAF on renal function, we utilized L-655,240 (6 mg/kg, intravenously), a thromboxane-prostaglandin endoperoxide antagonist, to study the systemic and renal response to PAF (0.8 micrograms/kg, intravenously) in the anesthetized dog, using clearance methodology. PAF decreased blood pressure from 115 +/- 7 to 54 +/ 4 mmHg (1 mmHg = 133.3 Pa), renal plasma flow from 105 +/- 6 to 74 +/- 56 mL/min, and glomerular filtration from 43 +/- 3 to 32 +/- 1 mL/min. PAF also reduced urine volume from 1.1 +/- 0.2 to 0.4 +/- 0.1 mL/min, and urinary sodium from 158 +/- 7 to 86 +/- 7 mu equiv./min. L-655,240 alone had no significant effect on blood pressure, renal plasma flow, and filtration rate, at any dose. However, the 6-mg/kg dose resulted in a slight elevation of diuresis, from 1.1 +/ 0.2 to 1.9 +/- 0.1 mL/min, and urinary sodium, from 134 +/- 13 to 212 +/- 19 mu equiv./min. All doses of L-655,240 blocked the effect of PAF on blood pressure. However, the two lower doses of this antagonist (1 and 3 mg/kg) failed to prevent the PAF-induced fall of renal plasma flow and filtration rate, and attenuated the effect on urinary sodium in a dose-dependent manner.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2758374 TI - Influence of platelet-activating factor on leukotriene D4-induced contractions of the guinea pig parenchymal strip. AB - Platelet-activating factor (PAF) and sulphidopeptide leukotrienes, such as leukotriene D4 (LTD4), are potent constrictors that are probably released simultaneously in a variety of inflammatory respiratory events. The purpose of the present study was to determine whether LTD4-induced contractions of guinea pig parenchymal lung strips (GPPS) are modified in the presence of PAF. The contractile responses of isolated GPPS to cumulative doses of LTD4, acetylcholine, histamine, and potassium chloride in the presence of PAF (0.1 nM, 0.1 microM) were compared with parallel controls. There was no significant alteration of the response to acetylcholine and potassium chloride and the PAF induced inhibition of the response to histamine, although significant, was not concentration dependent. In contrast, PAF in a concentration range from 0.1 nM to 1.0 microM caused a marked, concentration-dependent reduction of LTD4-induced contractions. Pretreatment with the PAF receptor antagonist, BN52021, prevented the attenuation of LTD4-induced contraction by PAF. The attenuation of LTD4 induced contraction by PAF was also prevented by pretreatment with indomethacin or with the thromboxane synthase inhibitor U63,557A, but not by pretreatment with the lipoxygenase inhibitors BW755c or nordihydroguaiaretic acid. Thus inhibition of LTD4-induced GPPS contraction by PAF is receptor dependent and probably secondary to thromboxane generation. The respiratory smooth muscle response to leukotrienes may be modified significantly by concomitant PAF release. PMID- 2758375 TI - Characterization of ion movements and their relationship to muscarinic receptor binding and excitation-contraction coupling in guinea pig ileal longitudinal smooth muscle. AB - The relationship between ion movements (sodium uptake and potassium release) and agonist-induced contractile responses or muscarinic receptor binding was investigated in the guinea pig ileal longitudinal muscle (GPLM). Sodium uptake and potassium release were agonist-dependent, concentration-dependent, and stereoselective, with the following rank order of maximum ion movement: muscarinic agonists greater than histamine greater than substance P = serotonin. Potassium depolarization did not initiate sodium uptake or potassium release. Sodium uptake was rapid and monophasic, preceding potassium release which was biphasic in nature. Full muscarinic agonists produced equal maximal increases in sodium uptake, while maximal potassium release varied for all muscarinic agonists and in addition differed from sodium uptake in the following ways: time course, stereoselectivity, sensitivity to calcium antagonists, modulation by the guanylyl nucleotide derivative, 5'-guanylylimidodiphosphate (Gpp(NH)p), and inhibition by muscarinic receptor blockade with benzilylcholine mustard. The calcium ionophores A23187 and ionomycin (SQ23377) did not produce any sodium uptake; A23187 but not ionomycin produced potassium release comparable to that evoked by muscarinic agonists. Ion movement in response to combinations of agonists were not additive. Muscarinic agonist binding as measured by competition for [3H]quinuclidinyl benzilate ([3H]QNB) binding, was best described by multiple sites and was regulated by Gpp(NH)p. Excellent correlations were observed between the dissociation constants for binding and sodium uptake, potassium release, and contraction. The best correlations were those between the pharmacologic responses and the high affinity binding site in the absence, and the low affinity site in the presence, of Gpp(NH)p, respectively. Furthermore, the potencies of muscarinic agonists to evoke ion movements and to inhibit [3H]QNB binding were similar, and from one to two orders of magnitude less than those for contraction. It is suggested that contraction and potassium release were mediated by the high affinity, and sodium uptake by the low and average affinity muscarinic agonist binding sites, respectively. These findings suggest an agonist-activated receptor effector coupling model in GPLM that leads to the activation of sodium uptake, potassium release, and subsequently, contraction. PMID- 2758377 TI - The role of thermogenesis in the regulation of energy balance. Symposium of the Canadian Federation of Biological Societies. Quebec, Quebec, Canada, June 18, 1988. PMID- 2758376 TI - The effects of midazolam on hippocampal dentate gyrus granule neurons from young and old Fischer 344 rats. AB - The effects of midazolam (3 nM) perfusion on the membrane and synaptic properties of dentate gyrus granule neurons were examined in hippocampal slices obtained from young adult (4-6 months) and old (24-26 months) Fischer 344 rats. In young neurons, midazolam perfusion resulted in a hyperpolarization of the resting membrane potential with no apparent change in the input resistance. Midazolam perfusion also produced a significant increase in the amplitude of the post-spike train afterhyperpolarization (AHP). In neurons obtained from old animals, midazolam perfusion also produced a hyperpolarization of the resting membrane potential but did not significantly change the AHP. These effects may result from altered calcium homeostasis in neurons of the aged brain, and suggest that at least some of the direct actions of benzodiazepines on mammalian central neurons are altered during aging. PMID- 2758378 TI - Brown adipose tissue, liver, and diet-induced thermogenesis in cafeteria diet-fed rats. AB - Diet-induced thermogenesis (DIT) in young rats overeating a "cafeteria" (CAF) diet of palatable human foods is characterized by a chronic, propranolol inhibitable elevation in resting metabolic rate (VO2) and is associated with various changes in brown adipose tissue (BAT) that have been taken as evidence for BAT as the effector of DIT. But direct evidence for participation of BAT in DIT has been lacking. By employing a nonocclusive cannula to sample the venous effluent of interscapular BAT (IBAT) for analysis of its O2 content and measuring tissue blood flow with microspheres, we accomplished direct determination (Fick principle) of the O2 consumption of BAT in conscious CAF rats. In comparison with normophagic controls fed chow, the CAF rats exhibited a 43% increase in metabolizable energy intake, reduced food efficiency, a 22% elevation in resting VO2 at 28 degrees C (thermoneutrality) or 24 degrees C (housing temperature), and characteristic changes in the properties of their BAT (e.g., increased mass, protein content and mitochondrial GDP binding). They also exhibited the greater metabolic response to exogenous noradrenaline characteristic of CAF rats and the near elimination by propranolol of their elevation in VO2. By the criterion of their elevated VO2, the CAF rats were exhibiting DIT at the time of the measurements of BAT blood flow and blood O2 levels. However, BAT O2 consumption was found to be no greater in the CAF rats than in the controls at either 28 or 24 degrees C. At 28 degrees C it accounted for less than 1% of whole body VO2; at 24 degrees C it increased to about 10% of overall VO2 in both diet groups.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2758379 TI - Disorders of pigmentation. PMID- 2758380 TI - Radiotherapy for malignant fistula to other tract. AB - Radiotherapy was applied to 14 esophageal carcinomas with respiratory tract fistulas using various treatment regimens. Closure of the fistulas was observed in four cases after irradiation at a daily dose of 1.5 Gy. The period of closure was transient in two cases but long-term in the other two. One long-term closure case underwent low-dose rate telecobalt therapy (LDRT)(1 Gy per hour, 7 Gy per day; a total dose of 28 Gy) as a boost. His cancer has been well controlled and he is still alive without recurrence at 74 months after fistula formation. PMID- 2758381 TI - Intraperitoneal recombinant interferon-alpha 2b for recurrent malignant ascites due to ovarian cancer. AB - Thirteen patients with malignant ascites due to recurrent ovarian cancer were treated with intraperitoneal interferon 2b (5 mu/m2 escalating to 15 mu/m2, administered twice weekly by indwelling intraperitoneal catheter). The study population included eight patients with ascites only and five patients with ascites plus tumor masses greater than 2 cm in diameter. Five of 13 responded to treatment. All the responses were seen in patients with ascites only. Although tumor mass was an important determinant of response there was also a correlation between clinical response and suppression of colony growth on soft agar after in vitro exposure of tumor cells to interferon-alpha (IFN alpha). The intraperitoneal use of IFN alpha should be explored further in tumors with a predominant intraperitoneal location and microimplantation growth pattern. PMID- 2758382 TI - Obesity and breast disease. The role of the female sex hormones. AB - An Australian study of 513 women evaluated associations between obesity and both benign and malignant breast disease, and in particular investigated the role of female sex hormones. Women who gained more than 10 kg from early womanhood had a two-fold increase in risk of developing breast cancer, whereas lean women had a greater risk of being treated for benign breast disease. Obese women with breast cancer were more likely to have Stage II tumors but there was no significant association between obesity and tumor size or estrogen and progesterone receptor status. Obesity was strongly associated with the proportions of nonprotein-bound and albumin-bound estradiol, and inversely associated with sex hormone binding globulin (SHBG) levels and the proportion of SHBG-bound estradiol. In addition, age at menarche was inversely associated, and age at menopause directly associated with recalled weight at those time periods. These data demonstrate weight gain as a risk factor for breast cancer, and suggest a possible mechanism supporting its development. PMID- 2758383 TI - An assessment of proliferative and enzyme activity in transitional mucosa adjacent to colonic cancer. AB - The mucosa within 2 cm of cancers of the large bowel (transitional mucosa) shows histologic and histochemical changes which may indicate premalignant change. In this study, the authors used specimens from resected colonic tissue to compare morphometric, proliferative, and enzyme markers in transitional mucosa with those in cancer tissue and with those in uninvolved mucosa at least 10 cm from the cancer. Proliferative activity was assessed using the Ki 67 monoclonal antibody technique whereas a variety of methods were used to determine enzyme activities in mucosal homogenates. When compared to uninvolved mucosa, crypts in transitional mucosa contained greater number of cells, were significantly deeper and wider and were more likely to be branched. However, crypts in transitional mucosa had a significantly lower labelling index using the Ki 67 technique and there was no evidence of a shift in the proliferative zone towards the bowel lumen. The activities of ornithine decarboxylase, thymidine kinase, alkaline phosphatase, and lactate dehydrogenase were similar in transitional and uninvolved mucosa. Cancer tissue showed significantly higher levels of activity for ornithine decarboxylase and lactate dehydrogenase. Transitional mucosa showed morphometric changes but there were no proliferative or enzyme markers to suggest a higher than expected risk for malignant change. PMID- 2758384 TI - Cytometric characterization and clinical course of breast cancer diagnosed in a population-based screening program. AB - A randomized controlled trial evaluating mammographic screening was started in two Swedish counties in 1977. In one of these, Ostergotland county, the authors performed static cytofluorometry on 161 cancers detected at the second and third screening rounds, 50 interval cancers, and 219 cancers appearing in the nonscreened control group during the same time period. The median follow-up time was 42 months. No difference in mean S-phase was found between screening and control group cancers, but interval cancers, appearing between two screenings, had increased mean S-phase levels (P = 0.01) compared to both of the other groups. A high S-phase fraction was associated with distant recurrence in both node-negative and node-positive tumors. Aneuploid tumors were more often found in the control group (67%) and among interval cancers (72%) than among screening detected cancers (55%, P = 0.02). In Cox's multivariate analysis, including all patients, the lymph node status, tumor size, estrogen receptor content, and S phase all contributed independent prognostic information about the clinical course. DNA ploidy predicted the outcome in simple but not in multivariate Cox's analysis. When analyzing screening-detected cancers separately, only the S-phase significantly predicted distant recurrence in multivariate analysis. In tumors with local recurrence, a high S-phase implicated an increased, although not statistically significant, risk for distant recurrence. Survival with metastatic disease was significantly influenced by the S-phase level (P = 0.002). The authors conclude that S-phase fraction provides valuable kinetic information related to the clinical outcome for all stages of the disease and serves as a prognostic factor in screened populations, which have tumors predominantly in early stages. PMID- 2758385 TI - Morphologic characteristics of pancreatic carcinoma with diabetes mellitus. AB - For 81 cases of resectable pancreatic carcinoma, the site of cancer origin, cancer histologic features, and hyperplasia in the noninvolved duct were studied in relation to diabetes. They were classified into the following three groups: (1) fasting blood sugar (FBS) of less than 120 mg/dl (Group A, 26 cases); (2) FBS of more than 120 mg/dl with less than 2-year history of diabetes (Group B, 38 cases); and (3) FBS of more than 120 mg/dl with more than a 2-year history of diabetes (Group C, 17 cases). Although neither tumor size nor tumor location differed between the three groups, both the highest resectability (47%) and the lowest rate (71%) of extrapancreatic invasion were seen in Group C. A pancreatic ductogram showed that the pattern of the main pancreatic duct was intact in 0% in Group C versus 35% in Group A (P less than 0.05). Histologically, papillary/well differentiated adenocarcinoma was present in 35% of Group A patients versus 61% of Group B and 71% of Group C patients (P less than 0.05). Papillary hyperplasia was present in the ducts of 27% of the patients in Group A; this was significantly lower than the other two groups. Atypical duct hyperplasia was present in 47% of Group C patients; this was significantly higher than in the other two groups. It appears that cells in the main pancreatic duct are vulnerable to hyperplastic and well-differentiated cancerous changes in patients with a history of diabetes of more than 2 years duration. PMID- 2758386 TI - Influence of early diagnosis on prognosis of recurrent breast cancer. AB - Between 1980 and 1986 676 patients with primary breast cancer were operated on with curative intention at the Department of Surgery, Hanusch Medical Center, Vienna, Austria. Of these, 133 had recurrences. The patients were closely followed at the Outpatient Clinic. The authors have retrospectively analyzed this patient collective to evaluate the impact of routine technical and laboratory chemical follow-up programs on the detection rate of subclinical distant metastases and improvement of prognosis. There was no difference in outcome in terms of survival after recurrence and overall survival between patients with detection or recurrence in the asymptomatic stage who received general antitumoral therapy immediately, and a second group whose therapy was initiated upon clinical manifestation. The authors discuss the results in view of the screening costs. They emphasize the potential of follow-up programs due to timely detection of local recurrence, and observation of the contralateral breast, as well as the psychological aspect of a stable doctor-patient relationship. PMID- 2758387 TI - Early colorectal carcinoma with special reference to its development de novo. AB - The growth type of early colorectal carcinoma was classified into two types. The first type is intramucosal polypoid growth (PG-Ca) and the second type nonpolypoid growth (NPG-Ca) which shows mainly massive infiltration of tumor cells below the submucosal layer. The incidence of adenoma-carcinoma sequence was 72 of 75 lesions (96.0%) in pedunculated polypoid carcinoma, and 61 of 71 lesions (85.9%) in sessile and broad-based polypoid carcinomas. Their average sizes were 15.0 and 18.7 mm, respectively. Submucosal invasive carcinoma (SM-Ca) showed a low incidence. They were detected as microscopical or scattered lesions with a few lymphatic and venous permeation. The NPG-Ca contained 32 lesions. Intramucosal carcinoma without adenoma showing slight depression consisted of ten lesions of which the average size was 5.1 mm. The other 22 lesions showed massive submucosal invasion with marked lymphatic and venous permeation. The average size was 10.3 mm being smaller than PG-Ca. Histologically, NPG-Ca was not accompanied with adenoma. The NPG-Ca arose from de novo carcinoma less than 10 mm in diameter and invaded into the submucosal layer. In advanced carcinoma, the PG-Ca showed a low incidence (21.8%), and almost all cases were of the NPG type (78.2%). The NPG advanced carcinomas increased in those over the size of 20 mm. It is concluded that nonpolypoid early colorectal carcinomas easily progress to advanced carcinoma, and de novo carcinoma occupied about 80% of colorectal carcinoma. PMID- 2758388 TI - Cervical adenocarcinoma in women with nasopharyngeal carcinoma (NPC). AB - Multiple primary cancers account for only 0.38% of all cases in the Singapore Cancer Registry. The close temporal association of nasopharyngeal carcinoma (NPC) in three Chinese women with uterine cervical adenocarcinoma was observed in our department within a 3-month period; one other case was extracted from the local literature. Although NPC is a common neoplasm in local Chinese women, uterine cervical adenocarcinomas comprise only 8% of cervical cancers locally. The close occurrence of these cancers does not seem to be related to the therapy used for cervical cancer and suggests that an association of the Epstein-Barr virus (EBV) with uterine cervical adenocarcinoma should be further investigated. PMID- 2758389 TI - Sacrococcygeal extradural ependymoma. AB - A case of lumbosacral extradural myxopapillary ependymoma is reported. The clinical, embryologic, and therapeutic features of this rare lesion are presented. The unusual entity is discussed in the light of previous experience with extradural ependymoma in the lumbosacral region. PMID- 2758390 TI - Cancer risk in male veterans utilizing the Veterans Administration medical system. AB - Age-specific incidence curves, cumulative rates, and relative risks were estimated for selected malignancies among male veterans utilizing the Veterans Administration (VA) medical system during 1970 to 1982. Relative risks for malignant tumors of the lung, bronchus, larynx, oral cavity, and esophagus in males using VA hospitals were approximately double the rates for men of the Surveillance, Epidemiology, and End Results (SEER) cancer registry, thereby supporting the existence of strong effects of chronic cigarette smoking and alcohol consumption on the development of neoplasms at these specific anatomic sites. Relative to the SEER male population, there were significant reductions in the cumulative rates of neoplasms of the colon (15%) and extrahepatic biliary tract (30%), no differences in the rates of cancer of the stomach, small intestine, or pancreas, and a 50% increase in the cumulative rate of liver cancer among the veterans. Rates of malignancies of the genitourinary tract were similar in the VA and SEER registries with the exception of cancer of the penis, for which the cumulative rate was 50% higher in the veterans. These results are consistent with an excess of specific risk exposures among male veterans using VA hospitals, viz., cigarette smoking, alcohol consumption, poor nutrition, and other factors related to low socioeconomic status. The ultimate utility of the VA tumor registry will depend upon its exploitation by epidemiologists to provide leads for etiologic research. PMID- 2758391 TI - Histologic changes in the urinary bladder in relation to cigarette smoking and use of artificial sweeteners. AB - A total of 6503 sections of urinary bladder epithelium from 282 subjects were examined in random order, and histologic alterations, particularly the number of cell rows and the presence and extent of cells with atypical nuclei, were recorded. Cases were either individuals who had never smoked or who had smoked cigarettes. Microscopic slides with cells having 50% or more atypical nuclei were found in 4.3% of those who had never smoked; 67.1% in those who had smoked less than 20 cigarettes a day; 82.3% in those who had smoked 20 to 39 cigarettes a day; and 88.4% of the 40 or more a day cigarette smokers. The percentage of slides with six or more cell rows in these groups were 4.8%, 52.2%, 62.5%, and 72.9%, respectively. The histologic findings in the urinary bladder in relation to smoking habits fully complement the epidemiologic studies showing a dose response of cigarette smoking and urinary bladder cancer. No relationship was found between changes in the urinary bladder epithelium and the use of artificial sweeteners. PMID- 2758392 TI - Acquisition of additional primary chromosome abnormalities in the course of karyotype evolution in a case of FAB-M2 acute leukemia. AB - Cytogenetic studies of bone marrow metaphases from a 17-year-old woman with acute myeloid leukemia revealed a leukemic clone characterized by the t(8;21)(q22;q22) characteristic of FAB-M2. The patient was treated and achieved transient remissions. On relapse, her leukemic clone had acquired, in addition to the t(8;21), the inv(16)(p13q22) characteristic of FAB-M4Eo and a 5q- of the type seen in various acute myeloid leukemias and myelodysplastic syndromes. This cell line persisted throughout the remainder of the patient's clinical course. There were no other clonal chromosome abnormalities observed. The observation of multiple chromosome mutations, usually regarded separately as primary, in a single leukemic clone is most unusual and raises questions about our concepts of the nature of primary acquired chromosome mutations in cancer. PMID- 2758393 TI - Chromosomal composition of malignant human gliomas through serial subcutaneous transplantation in athymic mice. AB - The karyotypes of seven human glioblastomas were followed through serial subcutaneous passage in athymic mice. One tumor maintained the same hypodiploid stemline as seen in the original biopsy. Three tumors that originally had near diploid stemlines showed an increase in stemline number to pseudodiploid or hyperdiploid due to gains of whole chromosomes. One tumor showed an entirely different karyotypic profile in the xenograft than had been demonstrated originally. Two tumors showed a shift from near-diploid stemlines to near tetraploid and near-pentaploid stemlines. Structural abnormalities, including double minutes, that were present originally were maintained in the xenografts, and acquisition of new marker types was rare. Five of the seven lines showed an increased growth rate with serial passage as measured by a shortening of tumor doubling time and decreased time to 1000-mg size. There was, however, no obvious relationship between this change in growth rate and the karyotypic or histologic pattern. These studies demonstrate that most subcutaneous xenografts derived from malignant human gliomas retain karyotypes similar to those seen originally, making these systems useful models for studying the biologic significance of the chromosomal abnormalities of these tumors. PMID- 2758394 TI - der(1)t(1;9): a specific chromosome abnormality in polycythemia vera? Cytogenetic and in situ hybridization studies. AB - Two patients with polycythemia vera and an extra der(1)t(1;9) chromosome are reported. In one patient this was found as the sole abnormality. The other patient originally presented with trisomy 9 but later developed an extra der(1) during the further course of the disease with disapperance of the extra chromosome 9. In situ hybridization studies on this latter patient proved that the centromere of chromosome 1 was involved in the formation of the derivative chromosome. PMID- 2758395 TI - Cytogenetics of childhood acute nonlymphocytic leukemia. AB - Interest in more precise subclassification of the acute leukemias by cytogenetic criteria led us to identify and characterize the full range of chromosomal abnormalities in 121 children with de novo acute nonlymphocytic leukemia (ANLL). Only 21% of the cases had normal karyotypes; 62% had consistent or recurrent alterations, most commonly inv(16) or del(16), t(8;21), t(15;17), t(9;11), t(11;V) or del(11), and -7 or 7q-; and 17% had miscellaneous, apparently random, clonal abnormalities. Statistically significant associations between chromosomal abnormalities and the morphologic/cytochemical subtypes of ANLL, defined by criteria of the French-American-British (FAB) cooperative group were demonstrated for the t(8;21) in M1 and M2 leukemia, t(15;17) in M3, t(9;11) in M5, and translocations involving 11q23 other than t(9;11) [t(11;V)] or del(11q) in M4 and M5. The chromosome 16 inversion was not restricted to the M4 subtype, as is generally reported, and was not uniformly associated with increased and/or abnormal marrow eosinophils. None of these 121 cases were characterized by the Philadelphia chromosome, nor did any have the t(6;9), t(16;16), or inv(3), which have been noted previously in this disease. In addition to confirming several recognized correlations between recurrent structural chromosome abnormalities and FAB subtypes, this study identified novel abnormalities that have not been reported by others. It also disclosed an unusual heterogeneity of chromosome 16 abnormalities with respect to their distribution among FAB subtypes, their association with marrow eosinophilia, and their participation with other chromosomes in translocations. PMID- 2758396 TI - Fragile site 1p13.1 in neuroblastoma patients. PMID- 2758397 TI - Nonrandom numerical chromosome aberrations (+8, +11, +17, +20) in infantile fibrosarcoma. PMID- 2758398 TI - Cytogenetic analysis of a mesenchymal hamartoma of the liver. AB - Cytogenetic analysis of a mesenchymal hamartoma of the liver in a 3-year-old child revealed a balanced translocation between chromosomes 15 and 19 as the sole chromosome change. PMID- 2758399 TI - Karyotypic evolution of human meningioma. Progression through malignancy. AB - Cytogenetic analysis of an untreated sarcomatous meningioma from a patient submitted to two surgeries separated by 1 year are reported. The material from the first surgery was mostly hypodiploid, with a modal chromosome number of 42. Alterations of chromosome 22 were found in 80.6% of the cells. Four chromosome markers were found involving chromosomes 1, 2, 6, and 22, and numerical alterations involving chromosomes 8, 9, 10, 13, 14, 15, 18, 19, 20, 21, and Y. Although the modal chromosome number of the material from the second surgery was 45 (17.9% of the cells), 43.1% of its cells were hyperdiploid, 73% of these being in the triploid-tetraploid range. Dicentric and ring chromosomes were very frequent. Alterations involving chromosome 22 were still present. There was a recurrent trisomy of chromosome 3. To our knowledge, this is the first cytogenetic description, with banding techniques, of a malignant meningioma. PMID- 2758400 TI - Spontaneous chromosome fragility in band 3q21, 11p11, or 11q13 of cultured bone marrow cells from two patients with hematologic disorders. AB - Chromatid gaps and breaks clustering to band 3q21, 11p11, or 11q13 were observed prior to chemotherapy in short-term cultured bone marrow cells from two patients with hematologic disorders, one with acute monoblastic leukemia having +8 as the sole karyotypic abnormality and the other with pernicious anemia having no chromosome abnormality. The mitogen-stimulated peripheral blood lymphocytes of both patients, however, yielded a negligible frequency of chromosome aberrations. Because of no notable history of clastogen exposure in these patients, the observed chromosome fragility is most probably spontaneous, which might be correlated with the patients' physiologic condition at examination, i.e., an unusually low level of folic acid or vitamin B12, both being involved in DNA synthesis. Although band 11q13 is known to contain a common fragile site, chromosome fragility in bands 3q21 and 11p11 has not yet been reported in either normal or neoplastic cells. The present findings appear to favor the in vivo expression of chromosome fragility. PMID- 2758401 TI - Synchronization of cultured retinoblastoma cells for high-resolution chromosomes showing up to 1000 bands. AB - A method that allows high-resolution cytogenetic analysis of retinoblastoma cells in primary culture and subpassages is described. This method is based on the addition of high concentrations of bromodeoxyuridine or thymidine to obtain chromosomes subsequently banded to show 600-1000 bands. The results are compared with the standard harvest after 24 hours or long-term culture, and with low temperature synchronization after long-term culture. After blocking with bromodeoxyuridine or thymidine, the chromosomes are significantly longer than after cold synchronization or after the unsynchronized techniques. When they are GTG, RHG, or GBG banded, more than 40% of the mitoses are in the earlier phases with chromosomes showing more than 600 bands per haploid set. This method significantly improves the general quality of retinoblastoma tumor cell chromosomes and increases diagnostic and prognostic accuracy. PMID- 2758402 TI - Mixed lineage leukemia with cytogenetically unrelated abnormal clones. AB - We present a case of acute leukemia with morphologic, cytochemical, and immunophenotypic markers indicating that the population of blasts have characteristics of lymphoid and myelomonocytic origin. The cytogenetic study revealed the following mosaic abnormal karyotype: 46XX,dup(1)(q21--- 32)/46,XX,dup(11)(q13----25)/47,XX,trip(11) (q13----25),+der(17)t(17;?) (q24;?). The two clones involving #11 are obviously related. It is reasonable to assume that the third clone is an evolutionary result of the second one. Because no cytogenetic similarities were found among the first clone and the other two, we suggest that this mixed leukemia was of biclonal origin. To our knowledge, acute leukemia with mixed lineage characteristics and with the simultaneous presence of cytogenetically unrelated clones has not previously been reported. PMID- 2758403 TI - Localization of the raf-1 protooncogene on chromosome 6 of the mouse. AB - The murine c-raf-1 gene was localized by in situ hybridization to 6C3, proximal to c-ki-ras-2 and distal to the Igk locus. The localization of this protooncogene may be relevant to the correlation of chromosome breakpoints in neoplastic disease. PMID- 2758404 TI - Jumping end-to-end dicentrics in a case of squamous cell carcinoma from a patient with xeroderma pigmentosum. AB - Cytogenetic studies of a skin squamous cell carcinoma from a xeroderma pigmentosum patient were performed at several passages. They show the existence of recurrent rearrangements: 53% were dicentrics, of which 67% were of the telomere-telomere type. The telomeric region of the long arm of chromosome 12 was the most involved (in 38% of dicentrics), followed by 22p. The origin of this type of jumping rearrangement and its possible role on cell proliferation are discussed. PMID- 2758405 TI - Radiation sensitivity of cell strains from families with genetic disorders predisposing to radiation-induced cancer. AB - This investigation was designed to test the hypothesis that skin fibroblasts from patients with genetic disorders characterized by hypersusceptibility to X-ray induced cancer are sensitive to the cytotoxic or clastogenic effects of X irradiation in vitro. Cell strains were established from 28 specifically ascertained patients from families with nevoid basal cell carcinoma syndrome, retinoblastoma, or other disorders apparently predisposing to radiation-induced cancer. These included 10 patients with a clear personal or family history of radiation-induced tumors. These cell strains were examined for the cytotoxic effects of X-irradiation in 3 distinct series of separate, blinded experiments, along with a group of 9 similarly coded cell bank controls. Cells from 11 of these patients and 6 controls were studied for sensitivity to X-ray-induced chromosomal aberrations. Seven of the 37 cell strains were moderately hypersensitive to radiation-induced cell killing; 2 of these were from patients with radiation-induced tumors and 1 was a cell bank control. These results suggest that such isolated cases of hypersensitivity probably do not relate to the underlying genetic disorder. Overall, the X-ray response of cells from affected individuals in this study showed no systematic difference from that of cells from nonaffected relatives or cell bank controls for either cytotoxicity or clastogenicity. PMID- 2758406 TI - Nuclear but not mitochondrial genome involvement in 3-methylcholanthrene-induced expression of tumorigenicity in mouse somatic cells. AB - The involvement of heritable modifications of mitochondrial DNA (mtDNA) in chemical carcinogenesis was examined by studies on the effects on tumorigenicity of interchange of mtDNA between 3-methylcholanthrene (MCA)-induced mouse tumor cells and nontumorigenic mouse cells by the cytoplast-to-cell fusion technique. The difference in propagating abilities of two types of mouse mtDNA, type 1 mtDNA of B10mtJ strain and type 2 mtDNA of C57BL/10 strain, was applied successfully for complete replacement of the host cell mtDNA by cytoplasmically transmitted mtDNA. Tumorigenicity was assayed in nude mice by inoculating 5 x 10(6) cells s.c. into the backs of the mice. The results showed that tumorigenicity was not induced in nontumorigenic cells by replacement of their mtDNA by that from MCA induced tumor cells. Moreover, the tumorigenicity of MCA-induced tumor cells was still expressed when their mtDNA was replaced by that from normal cells with a limited life span. These observations suggest that, even if MCA treatment causes heritable modifications of mtDNA, modified mtDNA cannot induce chemical carcinogenesis and that modifications of nuclear DNA alone are sufficient for the expression of tumorigenicity. PMID- 2758407 TI - Urinary excretion of N1-acetylspermidine and other acetylated and free polyamines in the 1,2-dimethylhydrazine model of experimental rat colon cancer. AB - 1,2-Dimethylhydrazine (DMH) is a potent procarcinogen with selectivity for the colon. Recently, it has been demonstrated that levels of N1-acetylspermidine were elevated 2-3-fold in colonic tumors induced by this agent compared to control tissues. To determine whether alterations in the urinary levels of this acetylated polyamine or other polyamines were useful biochemical markers for colon cancer in this experimental model, rats were given s.c. injections of DMH (20 mg/kg body weight/week) or diluent for 26 weeks. One week after the last injection, control and DMH-treated animals were placed in separate metabolic cages and their urine was collected for 24 h. The urinary levels (expressed as nmol/mg creatinine) of putrescine, spermidine, spermine, N1-acetylspermidine, and N8-acetylspermidine were then analyzed by high-performance liquid chromatography. Animals from each group were then sacrificed and their colons were examined for tumors. The results of these studies demonstrated that the urinary level of N1 acetylspermidine was an excellent biochemical marker for colonic tumors induced by DMH. At 18.3 nmol/mg creatinine, N1-acetylspermidine was 100% sensitive and specific for colon cancer. Moreover, urinary levels of N1-acetylspermidine were better for this purpose than the N1-acetylspermidine/N8-acetylspermidine molar ratio, a marker previously suggested to be more specific for certain cancers than free polyamines. PMID- 2758408 TI - Mechanisms of the in vivo resistance to adriamycin and modulation by calcium channel blockers in mice. AB - A sensitive fluorometric assay using Hoechst 33258 and a modified alkaline elution procedure were used to quantitate DNA single-strand breaks following an in vivo drug treatment of mice bearing P-388/S and P-388/R cells. After an i.p. treatment of mice with 1 to 20 mg/kg Adriamycin (DOX), the following differences between sensitive and resistant P-388 cells were observed: (a) at 2 h following drug treatment the net intracellular accumulation of Adriamycin in sensitive cells was 2- to 3-fold higher than resistant cells at all doses tested; (b) utilizing a therapeutic dose of DOX (10 mg/kg), the amount of single-strand breaks of DNA in sensitive and resistant cells was significantly different, K x 10(2) = 13.6 +/- 1.1 (SD) versus 3.6 +/- 0.9, respectively; (c) the 10 and 50% lethal doses for verapamil (VEP) were 10 and 23 mg/kg and for a tiapamil analogue, N-(3,4-dimethoxyphenethyl)-N-methyl-2-(2-naphthyl)-m-dithiane-2 propylam ine hydrochloride (DMDP), were 107 and 126 mg/kg, respectively; (d) while the in vivo intracellular accumulation and retention of DOX in sensitive cells were not affected by DMDP or VEP treatment, complete restoration of DOX accumulation and retention was achieved in resistant cells treated with well tolerated doses of DMDP of 30 and 60 mg/kg. In contrast, utilizing the optimally tolerated dose of VEP (5 mg/kg), only partial restoration of DOX accumulation and retention in resistant cells was achieved; (e) DMDP or VEP did not alter the high level of DNA single-strand breaks induced by DOX in sensitive cells; in resistant cells, however, an increase in single-strand breaks of DNA was observed following treatment with DOX in combination with DMDP and to a lesser extent with VEP; and (f) the rapid DNA repair in resistant cells was inhibited by DMDP but not by VEP. These data demonstrate that DMDP but not VEP can effectively restore the in vivo intracellular accumulation of DOX in resistant cells at achievable nontoxic plasma concentrations. Previous studies have demonstrated that the in vitro intracellular concentrations and retention of DOX by resistant cells can be restored by VEP. The results reported herein demonstrated that similar effects can be achieved, however, in vivo by using a new calcium channel blocker, DMDP, with less in vivo toxicity and more efficacy than VEP in restoring cellular drug concentration, retention, and repair of DNA damage in the resistant cells. PMID- 2758409 TI - Enhanced growth of an estrogen receptor-negative endometrial adenocarcinoma by estradiol in athymic mice. AB - The aim of this study was to investigate the effects of estradiol and tamoxifen (TAM) on the growth of human endometrial carcinomas in athymic mice. Tissues from primary tumors were implanted into estradiol-treated mice. In passage 2, animals were treated with (a) placebo, (b) estradiol, (c) estradiol plus TAM, and (d) TAM alone. The size of the tumors was measured weekly. Estrogen receptors (ER) were determined with the dextran-coated charcoal method and/or ER enzyme-linked immunoassay. Progesterone receptors were measured with the dextran-coated charcoal technique. Of 16 primary tumors, 2 grew in the athymic mice and were studied further. Tumor EL was positive for ER (145 fmol/mg protein) and progesterone receptors (993 fmol/mg protein). Tumor EL in passage 2 was not significantly stimulated by estradiol, but was stimulated by a combination of estradiol and TAM. Treatments (estradiol, estradiol plus TAM, or TAM) all increased tumor growth in passage 3. Tumor BR and a metastasis BR-MET were ER and progesterone receptor negative, applying dextran-coated charcoal, ER enzyme linked immunoassay, and immunocytochemistry. The BR and BR-MET cells contain the complete ER gene but do not express any measurable amounts of ER mRNA as quantitated by Northern blot analysis, using a complete ER complementary DNA probe. In all animal passages the growth rate was significantly higher in estradiol-treated mice compared with the control. TAM alone had some growth stimulatory effect, but much smaller than observed in the estradiol group. TAM inhibited estradiol-stimulated growth. These results suggest that estradiol and possibly TAM are capable of stimulating tumor growth in the athymic mice independently from ER, potentially through a host-mediated mechanism. PMID- 2758410 TI - Differential ability of antiestrogens to stimulate breast cancer cell (MCF-7) growth in vivo and in vitro. AB - We have previously described an MCF-7 breast cancer cell variant, MCF-7TAM, which is stimulated to grow in athymic mice by tamoxifen (TAM) (M. M. Gottardis and V. C. Jordan, Cancer Res., 48:5183-5187, 1988). Earlier experiments have shown that TAM exhibits some profound estrogen-like effects in mice whereas TAM is less estrogenic in the rat. The aim in these studies was to compare the ability of MCF 7TAM to grow in different host environments and to determine whether the TAM stimulated phenotype could be maintained in vitro. Ovariectomized athymic mice and rats were implanted with 1-mm3 pieces of MCF-7TAM tumor and treated with estradiol, TAM, or control silastic capsules. After 9 weeks of growth in either species, TAM or estradiol-treated groups both had sustained growth of MCF-7TAM compared with the control groups. To determine the effects of estradiol and TAM on immune function in athymic mice, splenocytes from treated or control athymic mice, challenged with poly(I:C), were assayed for natural killer (NK) cell activity against 51Cr-labeled YAC1 target cells. Both estradiol and TAM abolished lytic activity by 12 weeks of treatment. To evaluate the role of a decrease in NK cell activity in the host on growth of MCF-7TAM xenografts we compared the growth effects in athymic and NK-cell deficient, ovariectomized beige mice. TAM stimulated MCF-7TAM in both beige and athymic mice; however, the tumor grew more rapidly in control beige mice than in control athymic mice. This study demonstrated that TAM-stimulated growth could occur in vivo. However, TAM or 4 hydroxytamoxifen did not cause a stimulation of MCF-7TAM compared with wild-type MCF-7 cells when experiments were conducted in vitro. These studies demonstrate that a suppression immune function can facilitate the growth of MCF-7TAM in athymic animals. However, additional components of the host environment contribute to TAM-stimulated growth in vivo. PMID- 2758411 TI - Effect of treatment with aromatase inhibitor 4-hydroxandrostenedione on the nonhuman primate menstrual cycle. AB - 4-Hydroxyandrostenedione (4-OHA) is a potent inhibitor of rat ovarian and human placental aromatase activity as assessed in vitro and has been shown to suppress ovarian estrogen secretion in vivo in rats. The compound inhibited extragonadal aromatization in male rhesus monkeys and reduced plasma levels of estradiol in postmenopausal women with advanced, metastatic breast cancer. Furthermore, 4-OHA caused disease remission in these patients. Prior to using this compound in premenopausal patients, the present study was carried out to determine whether 4 OHA affects the menstrual cycle by inhibiting ovarian estrogen production in nonhuman primate species. Four baboons (Papio anabis) exhibiting regular menstrual cycles were studied. Blood samples were collected daily throughout a control menstrual cycle and during treatment with daily s.c. injections of 4-OHA. Menstruation was not observed in three of four animals during treatment and did not resume until cessation of 4-OHA administration. The midcycle surge of estradiol which averaged 411 pg/ml in the control menstrual cycle was reduced during 4-OHA treatment by a mean of 49% of control. Thereafter, with continued 4 OHA treatment, serum concentrations of estradiol were significantly reduced below the basal control level [75.3 +/- 5.6 (SE) pg/ml] and were very low or undetectable. Perineal turgescence, an index of estrogenicity, was inhibited by 4 OHA administration. The preovulatory surge of serum luteinizing hormone, which averaged 114 ng/ml during the control cycle, appeared normal in three of four animals following 12 to 14 days of 4-OHA administration, but no luteinizing hormone surge occurred with continued 4-OHA administration. The results indicate that, although 4-OHA reduces ovarian estrogen formation during the first cycle, treatment for a second consecutive cycle appears to be necessary for maximal suppression. PMID- 2758412 TI - Type IV collagen-mediated melanoma cell adhesion and migration: involvement of multiple, distinct domains of the collagen molecule. AB - Tumor cell metastasis involves a complex series of interdependent events, including repeated invasion of basement membranes. Studies from several laboratories have implicated tumor cell adhesion and migration in response to laminin as a major contributing factor in tumor cell invasion. The current studies address the direct role of type IV collagen in promoting tumor cell adhesion, spreading, and migration. The observations of type IV collagen-mediated cellular behavior are contrasted with cellular behavior on type I collagen. The highly metastatic K1735 M4 melanoma cell line adhered, spread, and migrated in response to type IV collagen in a concentration-dependent manner. Functional assays using well-defined proteolytic fragments of type IV collagen demonstrated that melanoma cells interact with multiple domains of this protein. Highly metastatic melanoma cells adhered, spread, and exhibited motile behavior in response to 0.2 to 200 nM concentrations of a purified pepsin-generated, triple helix-rich domain of type IV collagen. In contrast, cells adhered and spread but were essentially nonmotile in response to a purified major noncollagenous domain of the protein. In addition, de novo protein synthesis was required for cell adhesion to the major noncollagenous domain, whereas adhesion to the helical domain was less dependent upon de novo protein synthesis. Arg-Gly-Asp (RGD) related peptides were used to study the adhesion and spreading of melanoma cells on type IV collagen. The results demonstrated that a serine containing RGD related peptide (GRGDSP) has virtually no effect on melanoma cell adhesion on type IV collagen-coated substrata, whereas this peptide inhibited melanoma cell adhesion to fibronectin-coated substrata in a concentration-dependent manner. In contrast, when threonine was substituted for serine (GRGDTP), cell adhesion to type IV collagen was significantly (45%) inhibited. The threonine-containing peptide virtually eliminated cell adhesion on substrata coated with type I collagen. These data demonstrate that adhesion, spreading, and migration of melanoma cells on type IV collagen have a complex molecular basis which is partially dependent on RGD-related sequences. PMID- 2758414 TI - Antileukemic effects of deferoxamine on human myeloid leukemia cell lines. AB - Deferoxamine (DFO) possesses antiproliferative activity against mitogen stimulated lymphocytes, several tumor cell lines, and human leukemia and neuroblastoma cells. We have investigated its effects on the human myeloid leukemia lines HL-60, HEL, and U-937. In suspension culture, DFO causes a dose dependent inhibition of proliferation of each cell line, with maximal inhibition observed at concentrations greater than 20 microM. These effects were prevented by cotreatment with iron salts and were at least partially reversible by removal of DFO from the culture system or addition of iron before 48 h of DFO exposure. Similar results were obtained in methylcellulose cultures of leukemic cells, with complete abolition of cell aggregates at day 7 in concentrations of 20 microM DFO or higher. DFO treatment caused a dose- and time-related decrease in DNA synthesis as measured by [3H]thymidine uptake, which was also reversed by treatment with iron salts. DFO caused slight reduction in RNA synthesis and did not affect protein synthesis. DFO caused significant antiproliferative effects on three myeloid leukemia cell lines, associated with inhibition of DNA synthesis, with in vitro effects observed at concentrations attainable in vivo. Evaluation of the antileukemic properties of DFO should continue. PMID- 2758413 TI - Modulatory potency of the beta-galactoside-specific lectin from mistletoe extract (Iscador) on the host defense system in vivo in rabbits and patients. AB - Proprietary extract of mistletoe (Iscador) that has federal approval for clinical application can exhibit immunomodulatory capacity. However, the nature of this responsible substance has still remained elusive. To validate the hypothesis that specific lectin-carbohydrate interactions at least participate in eliciting immunomodulation, the modulatory efficiency of the major beta-galactoside specific mistletoe lectin (ML I) from the clinically applied extract on selected immunological parameters was monitored "in vivo" in rabbits. Injections of nontoxic doses of the purified lectin or even only of its carbohydrate-binding subunit (0.25-1.0 ng/kg) into rabbits yielded significant increases in natural killer cytotoxicity, frequency of large granular lymphocytes, and phagocytic activity of granulocytes. In the clinically relevant situation, changes in these parameters were also determined in cancer patients after extract (Iscador) injection s.c. as well as i.v., emphasizing the potential relevance of the lectin. Comparative analyses of the changes in the selected parameters following injection of extract with normal lectin content as well as of extract, selectively depleted of lectin, into healthy volunteers corroborated this inference. Lectin depletion by affinity chromatography was highly specific and did not affect any other substance in the extract. Remarkably, contamination by endotoxin has been rigorously excluded in each applied specimen. These results encourage detailed elucidation of lectin action on various parts of the tumor defense system "in vitro" with the long range goal of achieving progress in the treatment of cancer through immunological strategies, exploring selective mediatory lectin-carbohydrate interactions. PMID- 2758415 TI - Induction of HL-60 leukemia cell differentiation by the novel antifolate 5,10 dideazatetrahydrofolic acid. AB - The novel tetrahydrofolate, 5,10-dideazatetrahydrofolic acid (DDATHF), was designed as an inhibitor of folate metabolism at a site other than dihydrofolate reductase. DDATHF has been shown to inhibit glycinamide ribonucleotide transformylase, a folate-requiring enzyme that catalyzes the first of two one carbon transfer reactions in the de novo purine nucleotide biosynthetic pathway. Incubation of HL-60 promyelocytic leukemia cells with 5 x 10(-8) to 10(-5) M DDATHF resulted in a marked inhibition of growth after 48 h, with a complete cessation of cellular replication by day 4. Cell cycle analyses of DDATHF-treated HL-60 cells demonstrated an initial block in early S phase by day 3 followed by an accumulation of cells in the G1 and G2 + M phases of the cell cycle. Inhibition of growth was accompanied by a concentration-dependent increase in the percentage of mature myeloid cells that expressed nitroblue tetrazolium positivity, and a small increase in nonspecific esterase activity. Induction of differentiation and inhibition of growth by DDATHF were completely prevented by hypoxanthine and 5(4)-amino-4(5)-imidazole carboxamide, suggesting that depletion of intracellular purine nucleotide pools has an important role in the biological effects of this inhibitor. This possibility was confirmed by the finding that DDATHF caused a pronounced reduction in intracellular GTP and ATP levels within 2 h, with maximum decreases being observed by 24 h, a time interval which preceded the inhibition of cellular proliferation by this agent. Pyrimidine nucleoside triphosphate levels were markedly increased under these conditions. The findings indicate the importance of purine nucleotides to both the inhibition of growth and the induction of differentiation of HL-60 leukemia cells by DDATHF. PMID- 2758416 TI - Enhanced sensitivity of the rat hepatoma cell to the daunorubicin analogue 4 demethoxydaunorubicin associated with induction of DNA damage. AB - The H-35 rat hepatoma, a cell line which is relatively resistant to the classical anthracycline antibiotics such as Adriamycin [the concentration of drug which inhibits cell proliferation by 5090 (IC50) = 2.5 microM] and daunorubicin (IC50 of 0.5 microM), is markedly more sensitive to the 4-demethoxydaunorubicin derivative, idarubicin (IC50 of 0.025 microM). In contrast to daunorubicin, which has previously been shown to inhibit hepatoma cell proliferation in the absence of perceptible DNA cleavage, idarubicin induces concentration-dependent DNA damage which may account for its enhanced capacity to inhibit proliferation of the rat hepatoma. Free radical scavengers fail to interfere with inhibition of cell proliferation induced by idarubicin. Damage to the cell membrane or alterations in mitochondrial integrity do not appear to represent components of idarubicin toxicity in this tumor cell line. Inhibition of DNA synthesis by idarubicin parallels inhibition of cell growth; however, sensitivity of DNA synthesis to idarubicin is significantly less than that for cell proliferation (IC50 values of 0.5 microM and 0.025 microM, respectively). It is postulated that the antiproliferative effects of idarubicin in the H-35 rat hepatoma model may be a consequence of alterations in DNA integrity which ultimately result in the inhibition of cellular biosynthetic processes. PMID- 2758417 TI - Implications for therapy of drug-metabolizing enzymes in human colon cancer. AB - Human colonic tissue is exposed to a variety of toxic chemicals and potential carcinogens in the diet and the intestinal microenvironment. Colonic adenocarcinoma is commonly resistant to the cytotoxic effects of most chemotherapeutic drugs. We have examined drug metabolic and detoxification pathways in clinical specimens of colon carcinoma and normal adjacent mucosa from 17 patients. All elements of xenobiotic metabolism examined are present in these tissues, including cytochrome P-450-dependent enzymes, glutathione, and glutathione-utilizing enzymes. In comparison of tumor tissue to its respective normal mucosa specific alterations in the pathways affecting a number of chemotherapeutic agents were detected, including significantly higher glutathione, glutathione peroxidase, and anionic glutathione-S-transferase activity. These and other alterations found here could be the target of therapeutic maneuvers to enhance the efficacy of antineoplastic treatment of human colon cancer. PMID- 2758418 TI - Expression of five cathepsins in murine melanomas of varying metastatic potential and normal tissues. AB - The relative levels of mRNAs for cathepsins B, D, H, L, and S in eight normal murine tissues and three murine melanoma variants, B16-F1, B16-F10, and B16a, have been analyzed by RNA dot blot and densitometry. A direct correlation was observed between the levels of cathepsin B mRNA and the metastatic potentials of these three melanoma variants. The relative amount of cathepsin B mRNA in B16a, which is the melanoma variant with the highest metastatic potential, was at least 3 times greater than that found in any of the normal murine tissues surveyed. Similar results were obtained in analyses of either solid tumors or of cultures of tumor cells, confirming that the tumor cells themselves were the source for the elevated expression of cathepsin B mRNA. Northern blot analysis revealed the presence of three cathepsin B transcripts of 5.0, 4.0, and 2.2 kilobases in the melanoma variants, while only the 2.2-kilobase transcript was seen in the normal murine tissues. Concurrently with the mRNA analysis, enzyme assays for cathepsin B activity were also performed using synthetic peptide substrates. The assays revealed increased cathepsin B activities in the melanoma variants, corresponding well with the increased cathepsin B mRNA levels, and in addition demonstrated that all three of the melanoma variants secreted a latent form of cathepsin B into conditioned medium, which could be activated by limited proteolysis with pepsin. The levels of the latent enzyme released by the murine melanoma variants correlated well with the levels of cathepsin B mRNA and with the metastatic potentials as determined by spontaneous metastasis form a s.c. site. PMID- 2758419 TI - Radiation response of vulvar squamous cell carcinoma (UM-SCV-1A, UM-SCV-1B, UM SCV-2, and A-431) cells in vitro. AB - Standard therapy for squamous cell carcinoma (SCC) of the vulva consists of radical surgery and inguinal node dissection. Radiation therapy has been used for preoperative treatment in advanced cases to reduce the size of the tumor, and also as the only treatment in inoperable or recurrent disease. To study the inherent radiation sensitivity of vulvar carcinoma, we tested three new vulvar carcinoma cell lines and the long-established cell line A-431 by using a 96-well plate clonogenic assay, earlier shown by us to be suitable for survival studies of SCC. SCC and adenocarcinoma cell lines derived from other sites were used as a reference. Cells were irradiated with a 4-MeV linear accelerator at a dose rate of 2.0 Gy/min. The vulvar cell lines were found to be highly resistant to radiation with the average mean inactivation dose of 3.44 +/- 0.34 Gy as calculated from the area under the curve. The results were consistent in repeated experiments and for all cell lines. The average value for area under the curve was 1.79 +/- 0.30 for the other SCC lines tested. The values for area under the curve differed significantly (P less than 0.0001) between the vulvar lines and reference SCC lines. These results indicate that vulvar SCC cells in vitro express exceptional inherent radioresistance, and thus development of other forms of additional treatment would be more advantageous in advanced cases. PMID- 2758420 TI - Stimulated rat liver mitochondrial biogenesis after partial hepatectomy. AB - In order to elucidate the response of mitochondria to the increase in cellular energy demand after hepatectomy, we have examined the effects of partial hepatectomy and hepatic artery ligation on the energy-transducing system of rat liver mitochondria. Specific content of DNA in the mitochondria increased on the first day after the hepatectomy and reached 150% of the original value. Oxidative phosphorylation capacity of the mitochondria started to increase on the first postoperative day. In contrast, specific enzymic activities, specific cytochrome contents, and subunit contents of the energy-transducing complexes in the isolated mitochondria were significantly increased only from the second postoperative day. The ligation of the hepatic artery did not inhibit the amplification of the mitochondrial function. The immunostain for ubiquinol cytochrome c oxidoreductase was increased predominantly in the portal area of the hepatic lobules of the hepatectomized rats. These results suggest that enhancement of the mitochondrial oxidative phosphorylation system after hepatectomy is based on the increase of the amount of the complexes in the inner membrane, which is closely related to replication of mitochondrial DNA, and that the blood supply from the hepatic artery is not an important factor in the mitochondrial amplification in rats. PMID- 2758421 TI - Role of tobacco and alcoholic beverages in the etiology of cancer of the oral cavity/oropharynx in Torino, Italy. AB - A population-based case-control study of cancer of oral cavity-oropharynx was conducted in the city of Torino, Italy, between 1982 and 1984. One hundred twenty two cases (86 males and 36 females) and 606 controls (385 males and 221 females) were compared with respect to lifelong alcohol and tobacco consumption. A 4- to 6 fold increase in risk among subjects with medium or high tobacco consumption was observed, as well as a trend in increasing risk with duration and with earlier age at the start of smoking. Other findings included a sharp reduction in risk with cessation of smoking, no clear protective effect of usage of filter, no differences in risk according to color of tobacco, and a higher risk for cigar versus pipe/cigarette smokers. An effect of alcoholic beverages was found in subjects with an average daily consumption of 120 or more grams of alcohol, with a higher risk in beer drinkers. Among heavy consumers of alcohol and tobacco, risks of both oral and oropharyngeal cancer were very high. A positive association between oral cancer and low educational level, after adjustment for alcohol and tobacco, was found. Attributable risks for alcohol and tobacco in the population were 23% and 72% in men and 34% and 54% in women. PMID- 2758422 TI - A case-control study of large bowel cancer and hormone exposure in women. AB - Several lines of evidence indicate a potential role for hormonal or reproductive factors in the subsequent development of large bowel cancer in women. To evaluate the relationship between hormone exposure and large bowel cancer a case-control study was carried out in 18 Illinois hospitals. Female cases, ages 45-74 (n = 90), and controls (n = 208) were identified from an ongoing large bowel cancer study. Data were obtained from medical records, personal interviews, and a subsequent mail survey with a questionnaire specific to hormone usage. Menopausal estrogen use was found to be protective with respect to the subsequent development of large bowel cancer with an odds ratio of 0.6 (95% CI, 0.33-0.99). This effect remained after controlling individually for age at diagnosis, ever pregnant (yes/no), parity, age at first birth, hysterectomy with documented oophorectomy, cholecystectomy, and appendectomy. Simultaneous adjustment, using logistic regression, for age at diagnosis, parity, hysterectomy, and cholecystectomy resulted in an adjusted odds ratio for menopausal estrogen use and large bowel cancer of 0.5 (95% CI, 0.27-0.90). Subsite analysis revealed the protective effect to be strongest for the rectal cancer cases. These data support the hypothesis that exogenous hormones may alter the risk of large bowel cancer in women. PMID- 2758423 TI - Intracranial tumors in children in Denmark (1960-1984) PMID- 2758424 TI - Radiation-induced cerebral lesions in childhood. AB - Post-irradiation cerebral pathologies may appear in various forms from localized radiation necrosis to a plurifocal type or from local to diffuse vasculopathies. Contrary to the current prevalent opinion, these lesions are not rare in children since young nerve tissue is particularly sensitive to ionizing radiation. Given the seriousness of some of these lesions, the authors recommend careful evaluation of the risk involved in relation to the real necessity of administering irradiation therapy in childhood. PMID- 2758425 TI - Removal of tumors in the III ventricle using the lamina terminalis approach. Three cases of isolated growth of craniopharyngiomas in the III ventricle. AB - Tumors in the III ventricle were totally removed in three children using a route through the lamina terminalis. The cases are discussed on the basis of computed tomography and intraoperative findings. It seems that tumors 4 x 2 cm in size can be successfully removed via this relatively small opening if the neuroradiological findings and the probable histology (craniopharyngioma) provide secure evidence that the tumor site and growth matrix are located in the frontal and lower portion of the III ventricle. Besides the advantage of requiring no transparenchymal access, this quick axial (orthograde) approach exerts no pressure on the hypothalamus, a complication which cannot always be avoided with the transcallosal route or the route through the foramen of Monro. Furthermore, the immediate location of the tumor behind the usually protruding lamina terminalis permits a rapid operation without exploratory characteristics. The distance between the brain surface and the tumor with this procedure is 0 cm; however, it can be up to 9 cm, depending on the age of the patient, with other approaches. PMID- 2758426 TI - Selective posterior rhizotomy: a long-term follow-up study. AB - Fifty-one spastic children who had undergone selective posterior lumbar rhizotomy between 1981 and 1984 were re-examined to determine whether the gains achieved had persisted and to look at other aspects that had not previously been explored in detail. The reduction of tone was maintained in all cases, while motor function continued to improve in 42 cases. Functional gains were greatest in children operated on under the age of 8, but pleasing results were also achieved in older children. Forty-five children continued to receive physiotherapy, particular attention being paid to building up muscle strength. Sensory disturbances were minimal, and there was no evidence of spinal instability. Post rhizotomy orthopaedic surgery for fixed-joint contractures generally brought further improvement. Parents and older children were also questioned and almost all were enthusiastic about the outcome. Rhizotomy can be of considerable benefit to spastic children, but great care must be taken in the selection of suitable cases. PMID- 2758427 TI - Neurological and behavioral sequelae in children operated on for brain abscess. AB - In order to characterize neurological, intellectual and behavioral sequelae better after surgical treatment of brain abscess in childhood, 32 children were studied over a 10-year time span after treatment of a brain abscess. Depending on the clinical condition, surgical treatment consisted of simple aspiration through a burr hole or of total excision after craniotomy. There were only 3 postoperative deaths (9%). The scheduled time for long-term follow-up was 3 years after surgery. The patient assessment included information concerning the presence of seizures, accurate neurological examination, an EEG, and a battery of intellectual tests to evaluate the presence of behavioral-mental deficits. Late seizures developed in 7 of the 29 survivors. Five patients presented permanent hemiparesis after surgical treatment. It is noteworthy that the intellectual impairment observed was more severe in younger patients, while the behavioral disturbances were more marked in school-age children. PMID- 2758428 TI - Clinical outcome after head injury in children. AB - For at least 1 year we have done a follow-up on 178 children under the age of 18 years with head injuries treated between 1981 and 1987. The Brussel Coma Scale and the Glasgow Outcome Score were used to determine neurological deficits and patient outcome. In children with coma, there was good recovery or moderate disability in 71.4%, severe disability in 6.1%, and death in 22.5%. When all head injuries were taken into consideration, a satisfactory outcome was found in 84.3%, severe disability in 3.3%, and death in 12.4%. The outcome mainly depended on the initial coma grade, but the duration of coma or advanced age were also negative factors for outcome. In 14.8%, intracranial mass lesions showed no significant correlation with outcome. In contrast to adults, diffuse brain swelling had a satisfactory outcome in 85.1%. PMID- 2758429 TI - EEG findings in minor head trauma as a clue for indication to CT scan. AB - In order to investigate the role of EEG in minor head traumata in the pediatric age, EEG and CT scan findings were compared in a series of 103 consecutive cases of children hospitalized within 24 h after head trauma. The EEGs were classified as normal in 50 patients, borderline in 10 patients, and abnormal in 43 patients. CT scan showed contusion in 6 patients and extracerebral hematoma in 4. All cases of abnormal CT scans were reported for patients with frankly abnormal EEG findings. In contrast, no pathological findings were found in CT scans for patients with normal EEG. The data suggest that EEG findings can play a major role in the diagnostic workup of patients with minor head traumata. Specifically, in the case of asymptomatic patients with normal EEG findings, it is likely that the CT scan will also be normal. PMID- 2758430 TI - Growing skull fractures: progressive evolution of brain damage and effectiveness of surgical treatment. AB - The growing skull fracture of childhood is a well-known but variously interpreted syndrome. Attempts have been made to find different pathogeneses for clinical and pathological patterns that are really successive phases of a single process, arising from the interaction of three basic conditions: (1) head injury with a large gaping fracture; (2) corresponding dural tear; (3) occurrence nearly always in infancy (the first year of life or period of maximum brain growth). This combination of factors alters the normal distribution of the intracranial pressure vectors and the fracture behaves like a "neosuture" with abnormal growth of the skull on the injured side. Simultaneously, the ventricular system tends to deform, dilating and shifting towards the side of the fracture. Three cases, successfully treated at a very late stage, are described. The good surgical results confirm the validity of the surgical method and its underlying theoretical basis. PMID- 2758431 TI - Clinicoradiological and therapeutic considerations in severe diffuse traumatic brain injury in children. AB - Forty-one children with severe head injuries and diffuse brain lesions were selected from a consecutive series of 62 children in traumatic coma (21 focal mass lesions) and studied. According to the CT pattern, two main types of intracranial lesions were considered: diffuse axonal injury (DAI) and diffuse brain swelling (DBS). High mortality, due to secondary increases of intracranial pressure (ICP), correlated well with the patterns of severe DBS, absence of perimesencephalic cisterns, and obliteration of the ventricles. However, children with normal CTs, and/or obvious shearing injuries indicative of DAI, had favorable outcomes; there was no mortality if increased ICP was not present. We conclude that although there does not seem to be any routine indications for ICP monitoring in children with pure DAI, early ICP monitoring and aggressive management of increasing ICP should be considered in comatose children with DBS, especially when associated with subarachnoid hemorrhage and respiratory or circulatory failure. PMID- 2758432 TI - Cysts of the pineal gland. A new clinical entity to be distinguished from tumors of the pineal region. AB - Thirty-two cases of pineal cyst diagnosed by magnetic resonance imaging (MRI) were reviewed and are described. The pineal cyst was demonstrated to be an area with slightly less intensity than the surrounding tissue and with slightly greater intensity than the CSF on T1-weighted images. On the T2-weighted images this lesion was identified as a high-intensity area with smooth margins and was homogeneous in nature. In three cases presenting with headache, compression of the vein of Galen was identified, and compression of the quadrigeminal plate was demonstrated in five cases. No patients presented with both pineal and quadrigeminal lesions. Of the cases, 63% were not detected by CT scanning alone. There were two cases in which the cyst ruptured and collapsed spontaneously during follow-up. It is emphasized that the presence of this lesion, which was more frequent than previously expected, should be kept in mind when diagnosing pineal tumors and should not be misdiagnosed. Surgery should not be undertaken unless the lesion produces symptoms due to the compression of the quadrigeminal plate, aqueduct, or the vein of Galen. PMID- 2758433 TI - Long-term follow-up of children and juveniles with arachnoid cysts. AB - In the vast literature on intracranial arachnoid cysts, communication of long term follow-up is rare. Therefore, we studied the case histories of 60 children and juveniles operated on in our hospital since 1951. The most favorable cases were patients with temporal cysts: 93% recovered fully or with only slight deficits. In other locations (frontal, parietal, occipital, infratentorial), the percentages for a favorable course were lower. The reason cannot be attributed to the operation procedures. Independent of the surgical procedure, there were no postoperative deaths after 1969. Long-term follow-up revealed that, depending on the location of the arachnoid cyst, a high percentage (62%-93% of patients) had normal physical and social development with satisfactory quality of life. PMID- 2758434 TI - Hydrocephalus in Crouzon's syndrome. AB - We reviewed 42 cases of Crouzon's syndrome. There were 16 cases with ventricular dilation. We believe that shunt should be inserted after fronto-orbital advancement if there are persistent signs of raised intracranial pressure. However, in cases presenting with severe ventricular dilation and papilloedema, a shunt is inserted prior to fronto-orbital advancement. Medium- or high-pressure systems should be used. PMID- 2758435 TI - "Skull punch" for craniotomy in neonates and infants. AB - We have designed a new instrument that we have called a "skull punch" which is useful and safe for making a burr hole for a purely osteoplastic craniotomy in neonates and infants. The instrument is described in detail. PMID- 2758436 TI - [From society to man: the paradox of social medicine]. PMID- 2758437 TI - [Prognostic significance of clinical, ergometric and coronarographic data in patients soon after myocardial infarction]. AB - The relative prognostic value of the clinical evaluation (Clin), exercise testing (ET), and cardiac catheterization (Cath), was assessed in 167 consecutive patients who underwent these exams within 40 days after an acute myocardial infarction. Each patient was followed at least 24 months; 12 patients died and 59 presented major cardiac events (angina, reinfarction and death). All the parameters were analyzed by univariate and discriminant and Cox regression analysis. For purposes of analysis, the predictive power of 3 sets of variables was analyzed separately: Clin, Clin + ET, Clin + ET + Cath. In the prediction of major cardiac events, only previous myocardial infarction was selected among the Clin parameters by multivariate analysis while ST segment depression, maximal systolic blood pressure, exercise duration and, though less significantly, coronary artery disease extension were selected among the ET and Cath var. The percentage of patients correctly classified was very low using only the Clin variables (60%) and significantly improved when ET and, to a lesser degree, Cath were added (77% and 80%, respectively). Multivariate discriminant analysis selected, as significant predictors of cardiac death, digitalis therapy, appearance of bundle branch block, previous myocardial infarction and anterior location of the myocardial infarction among the Clin variables, while exercise duration and LV ejection fraction were selected among the ET and Cath variables, respectively. The predictive power of the Clin variables alone was only slightly improved by the use of ET and Cath as the percentage of patients correctly classified was 76%, 81% and 84% using only the Clin, the Clin + ET and the combination of the Clin + ET + Cath var, respectively. In conclusion, the variables associated with a depressed LV function are the best predictors of future death and cardiac events; coronary angiography can only slightly improve the specificity of the exercise testing in the prediction of major cardiac events. PMID- 2758438 TI - [Exercise electrocardiogram in the evaluation of coronary atherosclerosis: correlations between electrocardiographic signs of ischemia and a coronarographic study]. AB - We divided 51 patients (Group C) with stable effort angina into 2 groups: Group A of 30 patients without previous myocardial infarction, Group B of 21 patients with previous myocardial infarction. The aim of this study was to test the relation between some ECG signs of ischemia and coronary artery disease (CAD) severity and to propose a new simple angiographic score of CAD. The patients, after a pharmacological wash-out period, were submitted to a treadmill effort test and to a coronarography. Stenoses were quantified using a score system recently proposed in the literature and a new simple score obtained summing the coronary stenosis in percent. Significant correlations between the time to the onset of ischemia (TSI) and the recovery time (TR) with the CAD severity in Groups A, B, and C using both scores were observed. The total stress time and the new index obtained summing the total effort time and the time to the onset of ischemia were related to the severity of CAD in Groups A and C using both scores. The multivariate discriminant analysis suggested that the TSI is the most sensitive variable to predict CAD severity in our patients. A good correlation between the 2 scores was also observed. PMID- 2758439 TI - [Relations between pressure overload and early signs of cardiac involvement in arterial hypertension]. AB - In arterial hypertension the indexes of left ventricular hypertrophy are not related to resting blood pressure, whereas a positive association with exercise blood pressure has been observed. It has not been investigated a possible relationship between response to stress and left ventricular diastolic function, the latter being early involved in arterial hypertension even before the development of ventricular hypertrophy. The present study was aimed at assessing a possible relationship between blood pressure response to dynamic exercise and index of left ventricular mass, systolic and diastolic function in a group of untreated hypertensives. fourty hypertensives aged 16-56 years were studied, 27 with mild hypertension and 13 with moderate or severe hypertension. The control group consisted of 23 normotensive healthy subjects, aged 14-40 years. All the subjects underwent a maximum-graded bicycle exercise in the supine position and a M-mode echocardiogram under the B-mode drive. Average values of the indexes of ventricular hypertrophy and of systolic function were overlapping in the 3 groups. Significant differences were observed in the indexes of diastolic function; with regard to normatensive controls, hypertensive subjects showed an increase in isovolumic relaxation time and rapid filling time, a decrease of isovolumic and rapid filling rates and a reduction of mitral valve closing and opening velocities.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2758441 TI - [Amiodarone prophylaxis of ventricular tachycardia in ischemic cardiopathy]. AB - Sustained ventricular tachycardia (VT) in coronary heart disease (CHD) represents a major risk factor for sudden death. The Authors evaluated the prophylactic efficacy of the chronic administration of amiodarone (A) on this arrhythmia and simultaneously the trend of ventricular extrasystole during the antiarrhythmic treatment. Twenty-three patients were examined, 17 with post-infarction cardiopathy and 6 with mixed angina. They showed either 1 or more episodes (2 patients) of sustained VT involving hemodynamic difficulties. The ejection fraction (EF) ranged between 20 and 45% average (35.2 +/- 9). All patients underwent a basal 24 hour ECG 3 days after the VT cardioversion, and every 6 months. All subjects took A orally for a period ranging from 7 to 67 months (average 23.04 +/- 14) at the dose of 800 mg/day 7 for days, and then 200 or 400 mg/day according to the presence or absence of ventricular extrasystoles (VE) greater than or equal to 30/hr and/or Lown's class (L) greater than or equal to 3. No patients died suddenly during the follow-up; 6 of them died for causes other than arrhythmia. Four of them showed only 1 sustained VT relapse after a period of 6 to 11 months. Two of these 4 patients showed a persistent increase of the number of VE and L-class while, in the remaining 2 patients, the number of VE remained substantially unchanged.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2758440 TI - [Erythrocyte Li/Na countertransport and correlated variables in a randomized sample of population]. AB - A genetically determined alteration of the cell membrane sodium metabolism may play a role in the pathogenesis of essential hypertension. The most consistent finding in patients with essential hypertension is an increased red blood cell Li/Na exchange (countertransport). It is genetically determined but it is also associated to potentially confounding variables (body weight, race, age and so on). The present study investigates the relationship between red cell Li/Na countertransport and various potentially confounding variables in a random sample of the population. It shows that this membrane cation transport system is increased in males compared to females and significantly correlated to body mass index in males and to blood pressure, alcohol consumption and, negatively, to urinary calcium excretion in females. Since body weight and alcohol consumption are correlated to blood pressure in several epidemiological studies, it can be hypothesized that they influence blood pressure control through an alteration of the cell membrane sodium transport. PMID- 2758442 TI - [An electrophysiologic and electropharmacological study of functional properties of the bundle of Kent in Wolff-Parkinson-White syndrome]. AB - The aim of this report is to attempt a definition of functional properties of Kent bundle on the basis of electrophysiologic and electropharmacologic data obtained from 89 cases of Wolff-Parkinson-White syndrome selected among a total number of 114 consecutive cases of WPW syndrome that underwent electrophysiologic intracavitary study. In 36 cases anterograde (ant) and retrograde (retr) effective refractory period (ERP) of accessory pathway were evaluated with premature (atrial and ventricular) stimulation at the same driven cycle length. The ant-ERP was longer than retr-ERP in 28/36 patients, shorter in 5 and equal in 2. This strong discrepancy between ant- and retr- ERP suggests an important role of "impedance mismatch" in the activation of ventricular (or atrial) muscle through an anomalous muscular bundle. In 11 cases an intermittent pattern of ventricular preexcitation was observed; in all these patients an anterograde supernormal conduction through the accessory pathway was observed. This aspect could be related to the activation of ventricular muscle, beyond Kent bundle, in its supernormal phase of excitability, suggesting the critical role played by ventricular activation for the appearance of preexcitation. Isoproterenol, injected in 11 cases (1 among them with intermittent ventricular preexcitation in basal conditions), produced a reduction of ant-ERP in all these cases, in spite of its well known poor effect on refractoriness of myocardial fibers. Ajmaline, injected in 32 patients, was able to block ventricular preexcitation in 81% of the cases, in spite of its poor effect on refractoriness of normal tissues. It is very likely that the disappearance of ventricular preexcitation is in this instance expression of lack of ventricular excitation (distal to Kent bundle) consequent to a drug-induced reduction of membrane responsiveness of ventricular cells. In conclusion, all these aspects strongly suggest that the appearance of ventricular (or atrial) preexcitation could be related to the activation of ventricular (or atrial) muscle distal to Kent bundle, rather than to conduction through the Kent bundle itself. PMID- 2758443 TI - [Multiple coronary fistulas to the left ventricle. An unusual cause of myocardial ischemia]. AB - Diffuse communications between the left coronary artery and the left ventricular cavity were found in a 54-years-old man presenting with angina pectoris and reversible ischemia documented on stress Thallium scintigraphy. During atrial pacing the patient experienced chest pain which was accompanied by lactate production. Atenolol, but not nifedipine, did ameliorate the symptoms. The anatomical types and the embriogenesis of coronary microfistulas along with possible mechanisms of ischemia are discussed. PMID- 2758444 TI - Temporal reproducibility of diastolic filling parameters derived from Doppler left ventricular inflow time velocity curves. Studies in normal subjects. AB - Doppler left ventricular inflow time-velocity curves have been extensively used to evaluate left ventricular filling. The reproducibility of the technique, however, has been rarely assessed, its temporal variability being, presently, unknown. In order to define the temporal reproducibility of Doppler parameters of left ventricular filling, 10 normal subjects were studied at 3 different times (baseline, after 24 hours, and after 1 week). No parameter changed significantly during 1 week follow-up. When variability, however, was expressed as percent changes relative to baseline, values ranging from 5.7% to 25% were found, the largest variability being associated with acceleration-deceleration parameters (p less than 0.001). In conclusion temporal variability of parameters obtained from Doppler diastolic mitral time-velocity curves is acceptable in homogeneous groups of subjects. When the technique, however, is used for serial evaluation of ventricular filling in a single patient, the specific temporal variability of the parameter considered must be taken into account before any variation can be ascribed to real hemodynamic changes. PMID- 2758445 TI - [Effects of digitalis on the left ventricular filling phase in the normal and ischemic heart. Angiographic study in man]. AB - The effects of digitalis on the left ventricular diastolic phase are very scant. In order to gain a better insight into this problem, we measured the hemodynamic effects of an intravenous injection of K-strophantidin (0.005 mg/kg in a bolus given within 5-10 min) during the diastolic phase in 9 normal male subjects and in 9 male patients with coronary artery disease (CAD), maintaining a normal overall ejection fraction despite of the presence of some hypokinetic segments. Administration of K-strophantidin decreased significantly in normal controls the left ventricular volumes at 1/3, 1/2, 2/3 of the diastolic phase, whereas it did not produce significant change in CAD patients. Digitalis decreased the first and increased the second filling peak of the volumetric variable dV/dt in the normal controls, but not in the CAD patients. In the latter group the 2 peaks before digitalis administration were similar. The effects of digitalis on the dV/dt measured during the second filling peak were significantly different in the 2 groups. The increments of pressure in middle and end diastole in CAD patients were significantly greater than those observed in normal controls. Results of the present study suggest that digitalis has a negative influence on the left ventricular filling phase both in normal and CAD subjects. In fact digitalis modifies in normals the pattern of the left ventricular filling phase whereas it induces an untoward increase in the middle and end diastolic pressure in CAD patients. PMID- 2758446 TI - [Cardiologic aspects of carbon monoxide poisoning]. AB - Carbon monoxide poisoning causes tissue hypoxia because of reduced transfer and altered release of oxygen by hemoglobin. Considering many case histories, we realized that symptoms and clinical signs of acute poisoning are mostly neurologic: coma, headache, dizziness, vomiting. On the contrary, it seems that myocardium, the other organ which mostly requires O2, is attacked in a "silent way". ECG in 5 patients with accidental carbon monoxide poisoning underlined that cardiac rate increased (3 of them presented tachyarrhythmias by atrial fibrillation) and the presence of more or less important alteration of ventricular repolarization like "subendocardial lesion". Simple hyperbaric oxygen treatment determined the regression of the rhythm disorder and of the abnormalities of ventricular repolarization. The only patient who had not the restoration of sinus rhythm had chronic atrial fibrillation. PMID- 2758447 TI - [Effects of isosorbide-5-mononitrate on exercise capacity, prostacyclin synthesis, the renin-aldosterone axis and catecholamines in patients with cardiac insufficiency]. AB - Isosorbide-5-mononitrate (IS-5-MN) is an active metabolite of isosorbide dinitrate with a longer plasma half life. Aim of the study was the evaluation of the effects of 40 mg/day of IS-5-MN on exercise capacity in patients with heart failure NYHA class II. After 1 week of wash-out, 10 patients with heart failure NYHA Class II, assumed 20 mg bid for 3 weeks. Bicycle ergometer tests were performed before (A), at the end of therapy (B), and 1 week later (C); in phase B the stress test was performed after 6 hours from the last assumption of IS-5-MN. We measured 24 hour urinary 6K-PGF1 alpha, the stable metabolite of prostacyclin, basal plasma renin activity (PRA) and plasma aldosterone, exercise-release of epinephrine and norepinephrine at the end of each phase of the study. The treatment with IS-5-MN improved the exercise capacity sigma (Watt.min), A less than (B = C), (p less than 0.01), while delta of heart rate (HR) during exercise (basal HR - maximal exercise HR)/(Watt.min), decreased, A greater than (B = C), (p less than 0.008). Basal BP and HR did not change. This fact seems consistent with the hypothesis of a combined effect of nitrates on both the venular and the arteriolar districts. Basal PRA and aldosterone, and catecholamine release during exercise after IS-5-MN did not change, while only norepinephrine increased 1 week after the end of the therapy, (A = B) less than C, (p less than 0.05): 24 hour urinary 6-K-PGF1 alpha increased after IS-5-MN A less than (B = C), (p less than 0.05). The results indicate that medium-term IS-5-MN treatment increases exercise capacity in patients with heart failure NYHA class II and that the effect lasts for 1 week after nitrate withdrawal at least. Prostacyclin is probably involved in medium-term clinical effect of IS-5-MN. PMID- 2758448 TI - Myocardial ischemia during stroke: scintigraphic demonstration. AB - In a 74-year old female, admitted to the Acute Stroke Unit for a cerebral reversible ischemic attack, we investigated the occurrence of ischemic alterations on ECG, recorded during an acute relapse, using 99mTc (MIBI) myocardial scintigraphy. Scintigrams showed a transient anteroseptal and inferior hypoperfusion. This is the first direct demonstration of myocardial ischemia occurring during stroke. PMID- 2758449 TI - [Intracavitary cardiac metastasis of osteosarcoma: echocardiographic aspects]. AB - Osteosarcoma is a malignancy whose various sites of metastasis greatly modify its ultimate prognosis. In this study we present a case of a 15 years old girl affected by osteosarcoma of the left femur with cardiac metastasis in the right ventricular cavity. The echocardiogram made it possible the in vivo diagnosis. It is recommended that an echocardiographic study is performed routinely in patients affected by osteosarcoma. PMID- 2758450 TI - [Familial hyperlipoproteinemia and nationwide health programs]. AB - In the submitted paper contemporary mortality trends from cardiovascular diseases in Czechoslovakia are given. The author emphasizes the importance of hypercholesterolaemia and elevated LDL-cholesterol levels as the most significant risk factor for an enhanced development of atherosclerosis and for manifestation of ischaemic heart disease. In reflections on the necessity to initiate primary preventive measures the author emphasizes the importance of making use of genetic aspects when screening individuals and families suffering from familial hyperlipoproteinaemia in childhood and adult age. It is estimated that at least 5% of the entire population are affected. One of the serious aspects of the incidence of hypercholesterolaemia in the population of Czechoslovakia is that 50 or more per cent have cholesterol levels which are so high that even as an isolated risk factor they are a mild to high risk of ischaemic heart disease. The author gives an outline of a nation-wide strategy of primary preventive procedures and their incorporation into health practice. PMID- 2758451 TI - [Present possibilities of quantitative doppler echocardiography using pulsed and continuous technics. I. Evaluation of valvular defects and functioning of valvular prostheses]. AB - In the submitted review the authors demonstrate contemporary possibilities of pulsed and continuous Doppler technique in the evaluation of valvular defects and the function of valvular prostheses. In case of stenotic orifices it is in particular the assessment of the pressure gradient by means of a simplified Bernoulli equation and calculation of the area of the orifice from the hydrodynamic continuity equation. In defects associated with regurgitation it is possible to assess the regurgitation volume and from the latter the regurgitation fraction or to use morphological evaluation of the regurgitation curve. Evaluation of the function of valvular prostheses by Doppler examination provides information on the severity of the obstruction as well as on regurgitation. Comparison of the Doppler examination with haemodynamic values obtained directly reported in recent years by various authors, revealed very satisfactory agreement between the two methods. Basic quantification of haemodynamics by Doppler echocardiography should become part of every echocardiographic examination in clinical practice and should contribute to a more accurate indication of surgical treatment. PMID- 2758452 TI - [The dipyridamole echocardiography test combined with isometric loading in the diagnosis of ischemic heart disease]. AB - The authors compared the sensitivity of the simple dipyridamole test (DP test) and the dipyridamole test combined with an isometric load (DP + HG test). Evaluation by means of two-dimensional echocardiography was used. The sensitivity and specificity of the DP test, in case of a 50% or greater stenosis of one or several coronary arteries, as a criterion of classification of the group was 45% and 100%, as compared with 72% and 100% in the combined DP + HG test. The correct diagnosis was confirmed by a selective reference coronarographic findings in all patients. The electrocardiographic changes alone in both tests were positive for IHD only in 9 and 17% resp. Ergometry was more sensitive (44%) than electrocardiographically evaluated changes, using the mentioned intervention tests, but it did not attain the sensitivity of the echocardiographic evaluation. The work indicates that temporary changes of the regional kinetics evaluated by two-dimensional echocardiography are a highly specific manifestation of myocardial ischaemia which developed during a load, and these changes are detected sooner and more frequently than associated electrocardiographic changes. PMID- 2758453 TI - [Does coronary pathomorphology affect the anti-anginal and anti-ischemic effects of diltiazem in patients with chronic stable angina pectoris?]. AB - The authors compared by means of bicycle ergometry the effect of a single dose of 90 mg diltiazem (Dilzem Godecke Co.) and placebo in 31 patients with chronic stable angina pectoris grade II-III according to NYHA. These patients were divided into group A where the pathomorphology of the coronary circulation made the "steal phenomenon" possible and group B where there were no conditions for the "steal phenomenon". Diltiazem, as compared with placebo, increased significantly in both groups the total work output during ergometric examination, delayed significantly the onset of stenocardia and the time before the development of a 1 mm depression of the ST segment; in group A it significantly reduced the depression of the ST segment during the maximum equal load achieved with diltiazem and placebo; it significantly reduced the diastolic blood pressure at rest and during exercise, it significantly reduced the heart rate in group B during exercise. The differences in the action of diltiazem, as compared with placebo, between the two compared groups A and B were not significant in any of the investigated parameters. Administration of diltiazem had a very favourable anti-anginal and anti-ischaemic action in both groups of patients, regardless of the morphology of the coronary affection. PMID- 2758454 TI - [Treatment of familial hypercholesterolemia using Mevacor. Initial experience]. AB - 18 patients treated at a specialized consultation centre for disorders of fat metabolism were administered a new-generation hypolipidemic (preparation lovastatin-Mevacor) produced by Merck Sharp and Dohme, which inhibits intracellular synthesis of cholesterol. The study also discusses specific types of heterozygotes with familial hypercholesterolemia representing a homogeneous group of patients with maximum resistance to medication and dietary therapy. Mevacor was administered in increasing doses of 20.40 and 80 mg daily for a three month period. During therapy cholesterol and apolipoprotein B levels significantly decreased, the former from 10.13 to 7.19 mmol/l, the latter from 1.95 to 1.49 g/l. Protective HDL cholesterol significantly increased from 1.01 to 1.23 mmol/l without the triglyceride level indicating any significant change. The course of therapy did not result in any undesirable effects necessitating drug discontinuation. During the clinical testing the patients' weight remained unchanged. PMID- 2758456 TI - [What is the value and utility value of medical practice based on?]. AB - A collection of data acquired through study and experience are similar to computer software. Thus any part of data collection can be readily used at any given time. Similarly as software, they represent a value. Single acts of application, performed or expected to be performed, express the utility value. The paper describes value testing and recommends to use the term social utility value for value utilization. Both these factors should be used for determining the value of medical work (differentiated remuneration). PMID- 2758455 TI - [Biventricular thrombosis in dilated cardiomyopathy. Echocardiographic and pathophysiologic study of intra-cardiac thrombosis]. AB - The paper reports on the observations of biventricular intracardiac thrombosis in dilated cardiomyopathy. The diagnosis was made with the aid of two-dimensional echocardiography used as the method of choice in suspected intracardiac thrombosis. In the authors' opinion, the principal hemostatic disorder in intracardiac thrombosis in dilated cardiomyopathy can be caused by insufficient fibrinolysis whose degree of reduction was confirmed with stimulations tests, some of which were developed at the authors' department. Adequate treatment of intracardiac thrombosis in dilated cardiomyopathy is open to discussion. At present, apart from the standard therapy, the authors mainly suggest anti coagulation treatment as this can prevent embolization affecting the greater or lesser blood circulation. PMID- 2758457 TI - [Hyperglycemia, hyperinsulinism, atherosclerosis]. AB - The paper deals with a group of 117 patients with clearly defined clinical signs of atherosclerosis following myocardial infarction appearing in middle age, analyzes relationship between indicators of saccharide metabolism and cardiovascular morbidity within a ten-year period, and discusses its potential cause. Fasting levels taken at 120 minutes after the administration of glucose and the sum of the fasting level and three stimulated levels of blood sugar, or insulin (IRI), were compared with 54 controls as well as within the group of patients. Compared with the control group, the patients had glycemia levels elevated. In the group of patient with ischaemic heart disease (glycemia levels especially the sum but also glycemias at 120 min.) were elevated in persons with signs of ischaemic disease of lower extremities, with hypertension, in cases with increased serum triacylglyceroles, with increased energy intake (including fasting levels). The sum of insulin kept increasing in cases with familial disposition to atherosclerosis, with clinical progression of atherosclerosis over a period of 5 years (non-fatal reinfarctions). This had a highly significant correlation with linoleic acid in total serum lipids suggesting correlation with cardiovascular morbidity. This finding stresses the necessity of a comprehensive view of deviations in sacharide metabolism, especially as regards the relationship between elevated glycemia and cardiovascular morbidity, and between insulin and mortality-causing factors. PMID- 2758458 TI - [Hemoglobin glycosylation in prolonged hyperglycemic episodes. Interpretation of results using mathematical modeling]. AB - Using a mathematical model, the authors analyze the relationship between glycemia and glycated haemoglobin concentration (GHb). This relationship is more complex that it seems at first sight as GHb concentration in erythrocytes is the outcome of two processes: glucose binding to haemoglobin and continuous turnover of erythrocytes in blood. Old erythrocytes carry information on glycemia of longer duration than do the younger ones. The result is that hyperglycemias which occurred immediately before to GHb estimation have a greater effect on GHb concentration than those that occurred former. Due to the fact that behind a certain value of GHb different hyperglycemic periods can be hidden, the compensation of a patient with diabetes mellitus cannot be assessed only on the basis of GHb concentration. The assessment can only be made when using criteria which take into consideration glycemia, glycated plasmatic protein, and glycated haemoglobin values in a complex way. PMID- 2758459 TI - [HLA antigens in type II diabetics]. AB - The study examined the relationship between class I HLA antigens and type II diabetes with regard to insulin secretion and hyperlipoproteinemia. Out of 28 HLA antigens of A, B and C loci, 46 type II diabetics had statistically more significant HLA Cw1 - 15.9% as compared with 6.3% of the control group, the relative risk being 2.81. These patients were younger than the other diabetics but showed no difference in insulin secretion or hyperlipoproteinemia. Diabetics with HLA Cw4, just as patients after myocardial infarction with concomitant hyperlipoproteinemia, were also found frequently to have hyperlipoproteinemia (89 percentage cases as compared to 63% of the other diabetics). The findings may be indicative of potential genetic heterogeneity of type II diabetes. The paper stresses the necessity of establishing suitable genetic characters for early diagnosis of diabetes and its development. PMID- 2758460 TI - [Prolonged Q-T interval on the ECG at rest in type I diabetics with autonomic neuropathy]. AB - 86 type I diabetics and 60 healthy persons were examined. The diabetics were divided into two groups: patients with and without autonomous neuropathy. An analysis was made of heart rate, Q-T interval from 12-lead ECG at rest as well as of systolic pressure in each group of the patients. The diabetics with autonomous neuropathy had both systolic pressure and heart rate significantly higher and resting ECG Q-T interval longer than those of diabetics without autonomous neuropathy or than those found in healthy persons. These manifestations are most probably due to relative sympathicotonia in these patients. It results in increased left ventricular work and in a potential increase in arrhythmias which probably worsen the prognosis in diabetics with autonomous neuropathy. PMID- 2758461 TI - [The 2d generation of sulfonylurea antidiabetic agents]. AB - The author gives an account of oral sulphonyl urea antidiabetics of the second generation which are registered in Czechoslovakia. Their pharmacokinetic characteristics are given as the main differentiating sign for their different dosage in otherwise similar indications, contraindications and undesirable effects. PMID- 2758462 TI - [An unusual case of eliminating a man as the father of twins]. AB - The authors describe an uncommon case when despite the great eliminating capacity of the HLA system a man in this system was eliminated only from paternity of one twin; as to the other twin, surprisingly he was eliminated in the Hp serum system. PMID- 2758463 TI - The AU-rich sequences present in the introns of plant nuclear pre-mRNAs are required for splicing. AB - Plant cells do not in general process the introns of transcripts expressed from introduced vertebrate genes. By studying the processing of model introns in transfected plant protoplasts, we have investigated the special requirements for intron recognition by plant cells. Our results indicate that the requirements for intron recognition in plants are different from those of both metazoa and yeast. A synthetic intron of arbitrary sequence but incorporating splice site consensus sequences and a high proportion of U and A nucleotides, a characteristic feature of plant introns, was efficiently spliced in protoplasts. We have studied the effects of various sequence alterations and conclude that AU-rich sequences are necessary for intron recognition. In addition, we find that the criteria for branch site selection are relaxed, as they are in vertebrates, but a polypyrimidine tract is not necessary. PMID- 2758464 TI - Identification of a mammalian protein that binds specifically to DNA containing methylated CpGs. AB - The effects of DNA methylation on transcription and chromatin structure require that nuclear factors be able to distinguish methylated and nonmethylated DNA. We describe a methyl-CpG binding protein (MeCP) that complexes with a variety of unrelated DNA sequences when they are methylated at CpG. Fifteen or more symmetrically methylated CpG moieties per molecule are required for strong binding under our conditions. Competition experiments show that vertebrate DNAs bind to MeCP, whereas naturally nonmethylated genomes or cloned vertebrate genomes do not bind. Cross-linking experiments detect a 120 kd protein that correlates stringently with MeCP activity. Species and tissue comparisons show that MeCP is widely distributed in mammals except in embryonal carcinoma cell lines, which have very low levels. PMID- 2758465 TI - An in vitro system for the editing of apolipoprotein B mRNA. AB - A novel form of RNA editing generates two forms of apolipoprotein B (apo-B) mRNA by converting C at nucleotide 6666 to U or a U-like base. We have established an in vitro system for the editing of apo-B mRNA using synthetic RNAs and S100 extracts from rat hepatoma cells. Editing was detected by a sensitive primer extension assay and confirmed by DNA sequencing. The in vitro editing activity is specific and sensitive to proteinase K. Apo-B100 RNAs were synthesized in vitro from deletion mutants spanning nucleotide 6666. Synthetic RNAs containing 2383, 483, and 55 nucleotides of apo-B mRNA sequence were edited in vitro with similar efficiency, but an RNA containing 26 nucleotides was not edited. PMID- 2758466 TI - glp-1 and lin-12, genes implicated in distinct cell-cell interactions in C. elegans, encode similar transmembrane proteins. AB - Genomic DNA closely related in sequence to lin-12, a gene that specifies certain cell fates during C. elegans development, was isolated from a C. elegans library by low stringency hybridization. DNA sequencing of genomic and cDNA clones predicts the new sequence to encode an integral membrane protein that shares three repeated amino acid sequence motifs with the lin-12 product and the Drosophila Notch product: an epidermal growth factor-like motif, the "lin 12/Notch Repeat," and a motif present in two yeast gene products that have cell cycle dependent functions. Austin and Kimble (see accompanying paper) present evidence that this sequence corresponds to glp-1, a gene implicated in cell-cell interactions distinct from those involving lin-12. Possible implications of the predicted structure of the glp-1 product with respect to these cell-cell interactions are discussed. PMID- 2758467 TI - Transcript analysis of glp-1 and lin-12, homologous genes required for cell interactions during development of C. elegans. AB - The glp-1 and lin-12 genes mediate several cell interactions during C. elegans development. We have identified the glp-1 gene in a region about 20 kb from lin 12. In collaboration with Yochem and Greenwald (1989; see accompanying paper), we show that a sequence identified by its similarity to lin-12 is in fact glp-1. We find a single 4.4 kb glp-1 transcript and a distinct 4.6 kb lin-12 transcript. Expression of the glp-1 transcript during development differs from that of lin 12. As expected from genetic analyses, glp-1 RNA is primarily in the germline while lin-12 RNA is primarily in the soma. Unexpectedly, we find that glp-1 RNA is also expressed in larval somatic tissues and that lin-12 RNA is abundant in early embryos. We suggest that glp-1 and lin-12 may play broader roles in development than previously thought. PMID- 2758468 TI - Two structural genes on different chromosomes are required for encoding the major subunit of human red cell glucose-6-phosphate dehydrogenase. AB - Structural analysis revealed the existence of two types of subunits in human red cell glucose-6-phosphate dehydrogenase. The two subunits have the same COOH region consisting of 479 amino acid residues, but their NH2-terminal regions are different in size and sequence. The minor subunit can be fully encoded by the X linked G6PD cDNA, but the NH2-terminal region of the major subunit cannot. The cDNA and the gene for the NH2-terminal region of the major subunit were cloned and characterized. Southern blot hybridization indicated that the gene for the NH2-terminal region is on chromosome 6, not on the X chromosome. Northern blot hybridization demonstrated an existence of two separate mRNA components, one for the COOH-terminal region and the other for the NH2-terminal region. Two separate structural genes, the X-linked and chromosome 6-linked genes, must be coresponsible for encoding the single chain subunit. Either cross-translation of two mRNAs, or transpeptidation, or some other mechanism must be involved in the synthesis of human red cell G6PD. PMID- 2758469 TI - [Endocrine orbital diseases]. AB - The authors summarize their experience with so-called orbital compression which they performed in eight patients solely on account of endocrine orbitopathy. From the total number of twelve operations (four times bilateral) they evaluate the results as unsatisfactory. It is a palliative surgical procedure which gives subjective relief and after some time in some instances also functional results. Although this type of disease is not frequent, this method is practically the only solution. PMID- 2758470 TI - [Comparison of therapeutic results of clinical stage II laryngeal carcinoma treated with various methods and concurrent monitoring changes in cellular and humoral protection]. AB - The authors compare the dynamics of serum glycoproteins concurrently with monitoring of changes of cellular defence in patients with laryngeal carcinoma, IInd clinical stage. In 20 operated patients with subsequent radiotherapy [group A] better results were achieved as well as normalization of glycoproteins in the course of treatment. The immune response has in the early postoperative period a declining trend. Later in the course of radiotherapy the concentration of IgA and IgM globulins rises with the exception of IgG globulins the concentration of which declined below values of the initial concentrations. The activity of T lymphocytes did not change substantially during treatment, contrary to 19 patients treated by radiotherapy only [group B] where T lymphocytes declined by as much as 14.7%. Also the majority of glycoprotein concentrations remain reduced in group B at the end of the investigation [6 months] with a maximum drop after administration of half the radiation dose [with the exception of alpha 2 macroglobulin and the C3 component of complement]. The IgA and IgG globulin concentrations declined, IgM increased partly. The results correlate with the mortality: in the course of three years in group B 9 patients died, while in group A only three patients which suggests that combined treatment [surgical and radiotherapy] offer better chances of cure. PMID- 2758471 TI - [The importance of CT examination in the diagnosis and therapy of rhino-otogenic intracranial complications]. AB - Computed tomography in the diagnosis of rhino-otogenic intracranial inflammatory complications made it possible to reduce significantly the morbidity and mortality. It provides more reliable information, than hitherto used pretentious and invasive methods, on the development of inflammatory foci, the dynamics of their development, localization and extent. In correlation with the clinical course and laboratory findings it makes it possible to select an optimal time for operation and to select an optimal surgical approach, or in exceptional instances a conservative procedure. However, false negative findings may also be encountered. In those instances, with regard to the course and symptomatology of these complications, CT must be repeated or another diagnostic method must be selected. PMID- 2758472 TI - [Fixation of the malleus and incus]. AB - During the past five years at the ENT Clinic in Olomouc 15 incudomallear synostoses of inflammatory aetiology were observed; 10 times tympanotomy was found, performed in patients without an inflammatory history, fixation of the malleus, or fixation of the malleus and incus or fixation of the stapes and malleus. The authors demonstrate three typical cases, incl. preoperative and postoperative audiograms. As during operation the ossicles are mobilized and left in situ et in function or removed by milling and destroyed and replaced by a reconstruction, the authors demonstrate a primarily fixed malleus found accidentally in the skull from medieval excavations, and histological preparations of primary incudomallear synostosis from a macerated skull in the anatomical museum. PMID- 2758473 TI - [Personal experience with the difference limen in interrupted tones in differentiating between sensorineural and supracochlear hearing disorders]. AB - The authors assessed the differences of the limen of interrupted sounds (sounds which last 500 ms, between which there are intervals of 200 ms) in healthy subjects and in patients with sensory neural and supracochlear hearing disorders. Essentially the results are consistent with those of Schorn and Fastl (2) and they suggest that patients with supracochlear hearing disorders are able to differentiate only much greater differences in intensity (more than 4 dB) between sounds, as compared with patients with sensory neural hearing disorders. PMID- 2758474 TI - [The importance of auditory canal electrodes for improving BERA recording]. AB - During BERA examinations using common surface leads (forehead, mastoid process or ear lobe) wave I is not always distinct. Contrary to hitherto used methods (needle electrodes, small electrodes fixed by means of a cross-bar), the authors recommend to make wave I more distinct by use a surface electrode with a larger area (78 sq.mm). It is an open silver tube which, if necessary, is fixed in the osseous portion of the external auditory meatus by a PVC tube. Examination of 50 subjects revealed that the amplitude of wave I increased by using the electrode on an average more than four times, the thresholds of wave I in healthy subjects are practically identical as the thresholds of the V wave. The authors did not observe any effect on the thresholds and latencies of the V wave. The examined subjects tolerated the electrode well. PMID- 2758475 TI - [Personal experience with the sleep apnea syndrome]. AB - In three children aged 3, 9 and 10 years the syndrome of sleep apnea with typical manifestations of obstructive apnoeic episodes during sleep is described. In two instances the nocturnal periodic apnoeic spells were associated with marked varying hypoxemia, objectively recorded by continuous monitoring of the transcutaneous oxygen tension using a skin oximeter. In one child the cause of airway obstruction during sleep were hypertrophic tonsils and adenoid vegetation, in the other two children in the nocturnal apnoeic spells above all the functional component participated, expressed by increased relaxation of the oropharyngeal musculature during sleep. In the first child adenotonsillectomy was followed by immediate regression of all original symptoms, in the remaining two children therapeutic results were achieved only by removal of the slightly enlarged tonsils, while previous adenotomy did not have a favourable effect on the course of their disturbed sleep. Permanent regression of the apnoeic episodes after tonsillectomy was confirmed by records of a smooth level of the skin oxygen tension during sleep. This syndrome is more frequent than generally assumed and late establishment of the diagnosis may lead to the development of serious cardiopulmonary complications, irreversible neurogenic dysfunctions and psychosomatic retardation of the affected children. PMID- 2758476 TI - [The sleep apnea syndrome in children]. AB - The authors give an account of the causes of the sleep apnea syndrome in children (SAS). SAS, unless eliminated in time, may cause serious functional and organic disorders in the cardiopulmonary and central nervous system due to repeatedly occurring hypoxia for prolonged periods. The authors discuss therapeutic methods used for elimination of airway obstruction from which the children suffer during sleep. The authors' solution of SAS is a simple apparatus (registered as an invention), inserted into the child's mouth through which the child breathes during sleep. PMID- 2758477 TI - [Changes in cellular immunity in children with acute laryngitis]. AB - In 46 children with acute laryngitis the authors tested the state of cellular immunity in the acute stage and repeatedly during controls after 1-3-month intervals. They assessed the number of total T lymphocytes and active T lymphocytes, the number of B lymphocytes and by means of the test of blastic transformation they obtained information on the functional fitness of the T lymphocyte population. They revealed important changes in the state of the T lymphocyte population, i.e. quantitative as well as functional changes which persisted in 80% of the children 1 and a half months after the acute state. This finding must be considered the consequence of viral infection potentiated by corticoids which may be the cause of prolonged morbidity of these children. It is not advisable to admit these children to child communities. In case of repeated respiratory diseases it is recommended to make an immunological examination and apply immunomodulating therapy in immunodeficiencies. PMID- 2758478 TI - [The importance of a bronchoscopy examination in carcinoma of the esophagus]. AB - The authors analyze bronchoscopic findings in 47 patients with tumors of the oesophagus with regard to the operability of the tumour. In 33 patients the respiratory organs were not affected, in nine pressure changes were found, in two signs of infiltration, obvious overgrowth of the tumour in three patients. In patients with an oesophageal tumour and the simultaneous affection of the lower airways in the majority only palliative operations are indicated to ensure the patient's food intake. Tracheobronchoscopy helps to assess the extent of the disease and thus its operability. PMID- 2758479 TI - [Diagnosis of mycotic diseases of the esophagus]. AB - The author summarizes in his review contemporary data from the literature and his own experience on the problem of the diagnosis of mycotic oesophageal diseases. PMID- 2758480 TI - [Congenital nasal cysts and fistulae]. AB - Congenital nasal cysts and fistulae are relatively rare. Their localization is usually medial, sometimes lateral at sites of facial junctions during the embryonic period, either above or below the nasal bones. In a group of 16 children operated in the course of 25 years on account of a congenital nasal fistula or cyst the authors encountered in two instances junction of the fistula with the dura mater. According to the histological examination dermoids or epidermoids were involved. As the pressure of the cyst may cause usuration of bone and distension of the osseous nasal skeleton, it is recommended to operate as soon as possible. PMID- 2758481 TI - [Objective adjustment of hearing aids to hearing disorders]. AB - The aim of a functional prosthesis - a hearing aid - is to improve the comprehensibility of speech. The hearing aid is individually adjusted for the patient. Every deaf patient is subjected first to an extensive otolaryngological and audiological examination programme which comprises the recording of the case history, assessment of the ENT diagnosis, examinations of threshold and suprathreshold sound audiometry, verbal and sentence audiometry in a sound-proof chamber and in space. To set the most important parameters of hearing aids (frequency characteristics, intensification and dynamic range) directly on the patient's ear, in the ENT department of the health centre of the Uranium Industry in Pribram Rastronics equipment from Denmark is used which makes it possible to achieve optimal adjustment of hearing aids, using several calculations applied on an international scale. PMID- 2758482 TI - [Adjustment of hearing aids using a computer]. AB - There was developed the programme for the fitting of hearing-aids for minicomputer SHARP PC 1500. According to the audiometric investigation the programme enables to choose the SPPL (Saturation Sound Pressure Level), gain, compression and frequency range. The programme was proved in the fitting of hearing-aids to thirty subjects, mostly with sensorineural hearing impairment. The use of the computer is considered as the simplifying of this work to the audiological personal. PMID- 2758484 TI - Advisory Committee on Epidemiology. Resolutions. PMID- 2758483 TI - National Advisory Committee on Immunization (NACI). PMID- 2758486 TI - AIDS surveillance-worldwide. PMID- 2758485 TI - Survey of antimicrobial susceptibility of community isolates of Streptococcus pneumoniae in Ontario. PMID- 2758487 TI - [Let us cure our planet!]. AB - Ideas of the moral code of nuclear age selected from IPPNW sessions at the 8th World Congress (Montreal 1988) and the 4th Regional Rhineland Symposium (1988). The proclamation of these sessions was adopted also by the newly established Czechoslovak Medical Society for the prevention of nuclear war. PMID- 2758488 TI - [MODY type diabetes mellitus in children and adolescents]. AB - Nineteen diabetics aged 9 to 18 years with the MODY type were investigated, incl. their families, by the oGTT. Diabetes in the parents was nine times and in siblings four times more frequent than in families of adolescents with IDDM. In parents the manifest form predominated, in siblings PGT. Vertical transmission of diabetes in three consecutive generations was found only in the MODY type (in 35%). Diabetes with the MODY type and their diabetic siblings did not differ significantly as to their mild glucose intolerance (blood sugar level up to 13 mmol/l), and their mild diabetic phenotypes did not differ either. Similarly diabetics with IDDM and their diabetic siblings did not differ substantially as to their severe glucose intolerance (blood sugar level up to 21 mmol/l), and their severe diabetic phenotypes did not differ either. IRI levels revealed five times a hyperinsulinaemic and three times a normal insulinaemic response. Obese diabetics were treated with a reducing diet and physical activity. To non-obese diabetics, if the above procedure was not sufficiently successful, sulphonylurea preparation were also administered. During check-up examinations fasting values and values three hours after a meal lower than 6.1 mmol/l were required. In the course of a four- to ten-year follow up it did not change. Existence of the MODY type already macroangiopathic complications developed; in one diabetic the glucose tolerance improved, in the remainder it did not change. Existence of the MODY type already in adolescents justifies early detection in families with a cumulated incidence of NIDDM and prophylactic procedures ensuring euglycaemia in confirmed diabetics. PMID- 2758489 TI - [Use of prostanoids in the diagnosis and treatment of bronchial reactivity in children]. AB - The bronchoconstrictive effect of prostaglandin F2 alpha was investigated in 24 school children suffering from obstructive lung disease. In all the investigated substance was administered by 2-minute inhalation, consecutively in doses of 0.06 0.12-0.25 and 0.5 mg with subsequent evaluation of pulmonary functions 1, 3, 6 and 10 minutes following inhalation. The trial was terminated when a drop of values indicating obstruction of the bronchial system by 20%, as compared with initial values, was recorded. While in healthy children the resistance of the air current did increase even after a high concentration of the administered substance, a provocation concentration in the patients was achieved already with the dose of 0.06 mg. The bronchodilating effect of prostaglandin E2 administered in a dose of 0.05 mg in eight asthmatic patients was very intensive but short and disappeared within 3 minutes after administration. From a therapeutic aspect the tussigenic effect of prostaglandin E2 played a more important role. PMID- 2758490 TI - [The incidence of antibodies against collagen in patients with juvenile chronic arthritis]. AB - Using the ELISA method, the authors assessed titres of antibodies to collagen type I, II and III in serum of patients with juvenile chronic arthritis (JCA). The results were compared with antibody titres in patients with rheumatoid arthritis (RA). Elevated antibody titres to all collagen types were found, as compared with age-matched controls. The mean titres in patients with RA were higher than in the group with JCA. Investigation of a correlation between the collagen antibody titres and values of the sedimentation rate after one hour revealed a statistical relationship only in collagen type II in patients with RA. PMID- 2758491 TI - [Modern possibilities of orthodonto-surgical treatment of jaw anomalies in adolescents]. PMID- 2758493 TI - [Intractable epilepsy in children]. PMID- 2758492 TI - [Ebstein's anomaly of the tricuspid valve with the WPW syndrome]. AB - Case-history of a four-year-old boy with Ebstein's anomaly of the tricuspid valve with WPW syndrome. Severe tricuspid insufficiency and repeatedly occurring tachydysrhythmias soon led to cardiac decompensation and death before the intended cardiac operation. Non-invasive clinical, ECG, X-ray and ECHO examinations correlated with catheterization, electrophysiological and pathological findings. In addition to the dislocated, malformed tricuspid valve the septal cusp of which was fused with the ventricular septum the authors found another additional atrioventricular muscular connection between the lower part of the septum of the right atrium and right ventricle. PMID- 2758494 TI - [The physician and the computer. 30. Evaluation of time, different aspects of the same problem]. AB - The authors mention different ways in which a give problem can be described within the framework of the theory of sets, logic, mathematical analysis, statistic and cybernetics. As an example of the confrontation of the mentioned aspects they discuss different approaches to the evaluation of time as a variable -temporal logic, Markov chains, theory of catastrophes which play a part in medicine, in particular in prognostic considerations. These different aspects make possible solutions which may differ and their application depends in particular on the purpose for which they are intended. PMID- 2758495 TI - [C-reactive protein in the diagnosis of infections in neonates]. PMID- 2758496 TI - [Orthopedic problems in obese children and adolescents]. PMID- 2758497 TI - [Incidence of obesity in childhood urolithiasis]. PMID- 2758499 TI - [An organization model for pioneer rehabilitation camps of the Czechoslovak Red Cross for children with poor health]. PMID- 2758498 TI - [The work of the physician in nurseries]. PMID- 2758500 TI - [Organization of transportation of pathologic neonates in the South Bohemia Region]. PMID- 2758501 TI - [Analysis of the administrative activity of the pediatrician within the system of comprehensive care]. PMID- 2758502 TI - [Methods list no. 1 of the leading workers in pediatrics and pediatric and adolescent hygiene for a cooperative approach between workers in the pediatric therapeutic and preventive services and the health service in childhood institutions during routine health monitoring]. PMID- 2758503 TI - [Computer tomography and its use in orofacial oncology]. AB - The authors communicate their experience with the application of CT in the diagnosis of neoplasms in orofacial region. The examinations were done with the head CT apparatus of 2nd generation. Indications for this examination are defined in the following areas: 1) retromaxillary, 2) paranasal sinuses, 3) orbits, 4) parotid glands, 5) cranial base, 6) malformation diseases, 7) mandibular joint, 8) lower region of the face and neck, 9) cervical nodes, 10) tumours extensive in volume. The authors present an analysis of results of 63 examinations in 57 patients with tumorous diseases. PMID- 2758505 TI - [Initial experience with transabdominal chemical sympathectomy in arterial occlusive diseases of the lower extremities using directed computer tomography]. AB - Twenty transabdominal unilateral lumbar sympathectomies were performed by the Chiba needle under the control of computer tomography. The intervention was made for advanced occlusive disease of lower extremities, where a reconstruction surgery was not possible. In nine patients under evaluation, excellent effect was seen in two, marked effect in two others, uncertain one in another patient while four patients were without any gain. An alcoholic solution containing a local long-term acting anaesthetic and a contrast medium was used as a blocking agent. The method may be useful even in an advanced disease and extends the series of diapeutic methods. PMID- 2758504 TI - [Detection of changes using computer tomography in newly diagnosed type 2 diabetes]. AB - In 28 newly discovered diabetic patients of 2nd type (non-insulin-dependent diabetics), computer tomography was used to determine the density of pancreas and kidneys, densities of liver, spleen and blood in abdominal aorta and to follow the occurrence of further pathological changes in the above mentioned tissues. The results were correlated with laboratory findings. The following changers were found: decreased density of pancreas (29.4 H) and liver (49.1 H) and increased density of spleen (56.3 H) and blood in abdominal aorta (43.7 H). The decreased density of pancreas appears to be connected with disorder of lipoprotein metabolism. The decreased liver density was related to increased energy intake in the food and overweight, evaluated by the Broc's index. Other findings of computer tomography in the newly discovered diabetics of 2nd type (changes in the size of pancreas, kidney, kidney cyst, nephrolithiasis, sclerotic plaques on aorta) were not significant. PMID- 2758506 TI - [Treatment of the superior vena cava syndrome]. AB - The author describes the results of therapy in three groups of patients (128 patients altogether) with the superior vena cava syndrome caused by a tumorous disease. All the patients were treated by radiotherapy as a main method of therapy. (200 kV, filtration 2 mm Cu) in a daily fractionation 300 r on the surface by one field, in the second period (1974-1978) 55 patients were irradiated by 60Co cobalt from two opposite fields by daily fractionation of 170 180 rad into the focus and in the third period (1984-1986) 25 patients were irradiated by 60Co cobalt from two opposite fields in 3-4 introductory daily fractions 3.0 Gy into the focus and then in normal fractionation up to the total dose planned. Immediate results of the treatment--complete disappearance of the syndrome symptoms--were the best in the 3rd group, where a complete disappearance of the symptoms was observed in 84% of patients and a partial relief in 8%. In the first period a complete disappearance of symptoms was in 54% and a partial relief in 10% of patients. The corresponding values in the second period were 74% and 11% respectively. In evaluating the survival of patients, no significant differences were found. In the first period, 50% of patients survived 12 weeks, in the second period 16 weeks and in the third one 20 weeks. One-year survival was reached by two per cent of patients in the first period, four per cent in the second period and eight per cent in the third period. The paper discusses other therapeutic possibilities and approaches in the treatment of the superior vena cava syndrome. PMID- 2758507 TI - [Manual afterloading applicators for intracavitary brachytherapy]. AB - A technical description of uterovaginal and rectal applicator system of manual afterloading is described. A simple solution while using domestic materials covering the requirements of present-day brachytherapy. The applicators proved to be suitable for gamma radiation sources as well as for gamma-neutron radiation of 252Cf sources. PMID- 2758508 TI - Improving medical education in Sri Lanka. PMID- 2758509 TI - Halothane, the liver and the Sri Lankan anaesthetist. PMID- 2758510 TI - Case reports of Dipylidium caninum; a pet associated infection. AB - Two cases of Dipylidium caninum (dog tape worm) infection occurring in children are reported for the first time in Sri Lanka. The diagnosis and treatment with praziquantel, a new broad spectrum antiplatyhelmintic, are described. The importance of this pet associated infection is discussed with special reference to preventive measures. PMID- 2758511 TI - Loa loa in a Sri Lankan expatriate from Nigeria. AB - A worm was extracted from the subconjunctival space of the left eye in a 14-year old Sri Lankan girl, who returned to Sri Lanka in 1983 after spending six years in Nigeria. It was identified as a male Loa loa. A history of evanescent (Calabar) swellings was obtained. She also had significant eosinophilia. Microfilariae were not detected in the blood. This is the first case of Loa loa infection reported from Sri Lanka. PMID- 2758512 TI - Giant mycotic aneurysm of the thoracic aorta. AB - A giant mycotic aneurysm of the thoracic aorta, which is a rare presentation of infective endocarditis, is reported. PMID- 2758513 TI - Ascending paralysis in rabies. PMID- 2758514 TI - [Clinical method of evaluating declined intelligence with aging and its application in traditional Chinese medicine research]. AB - A practical program edited by BASIC was used in this test. The test included 7 indexes of fluid intelligence by using the method of talking between man and computer: speed of mental mathematic, digit-symbol, choice reaction time, counting visual number span, tracing reaction and recognition of meaningless figures. Through the principal component analysis and multiple stepwise regression techniques, the authors found out the mathematical model of the intelligence aging from 506 normal subjects and established a measuring system for the declined fluid intelligence and physiological age could be measured with the system. The correlation of the repetition of the test was 0.9528. This method was suitable for mental workers of 46-75 years old. The measured accuracy among the subjects of 50-70 years old was higher. The method was applied practically in clinical evaluation of the effects of traditional herbal medicines and Qigong on fluid intelligence with aging. Through the analysis of validity and reliability, it was proved that this method was suitable for geriatric research. PMID- 2758515 TI - [An analysis of blood cell pouring on the tongue surface in 3032 healthy persons]. AB - This paper deals with the utilizing laser frequency multiplexing technique and Doppler effect, successfully to build up LDB-1 type of laser microcirculation blood flow meter. It was used to carry on a determination for blood cell pouring amount on tongue surface in 3032 healthy persons. The results were shown as follows. The average tongue blood cell pouring amount of healthy persons was 4.74 +/- 0.50, in which the male was 4.82 +/- 0.50, and the female was 4.66 +/- 0.49. Apparently, there was a great difference between them (P less than 0.01). Following the increase of age, the tongue blood cell pouring amount was gradually decreased. The average blood cell pouring amount of a group of 1-9 years old was 6.14 +/- 0.79, of over 60 years old was 3.89 +/- 0.39 (P less than 0.01). In the light red tongue, the average tongue blood cell pouring amount was 4.95 +/- 0.93, which was considered to be the highest; in the purple tongue, it was 3.96 +/- 0.44 which was considered the lowest. The average pouring amount in the red tongue was 4.94 +/- 0.77, and in the light white tongue was 4.21 +/- 0.52. The more red the tongue showed, the greater the tongue blood cell pouring amount would be; whereas, the more purple the tongue showed, the lower the tongue blood cell pouring amount would be. It obviously indicated that the tongue blood cell pouring amount would be. It obviously indicated that the tongue blood cell pouring amount could correctly reflect the different tongue characters and tongue blood circulation condition. PMID- 2758516 TI - [Observation on the efficacy and its mechanism of desensitization treatment with acupoints in allergic asthma]. AB - Desensitize treatment of 117 cases of allergic asthma caused by allergens has been carried out using acupuncture points with the extract of the allergen (or allergens) in this paper. After first course of the treatment, the extract of allergen was taken again to make intradermal injection. Diameter of redness and swelling on the skin was significantly reduced in comparison with that before the treatment (P less than 0.01). These cases were followed up for more than 2-3 years. 24.79% of the cases was basically controlled; 19.66% significantly curative effect; 46.15% better. Comparison of curative difference of this group with the other two control groups was significant (P less than 0.01). Therefore, this method is of considerable clinical value and worth popular in the treatment of allergic asthma. PMID- 2758517 TI - [Prophylactic effects of Salvia miltiorrhizae and ligustrazine on experimental respiratory distress syndrome induced by oleic acid in rats]. AB - The prophylactic effects of Salvia miltiorrhizae and ligustrazine on experimental respiratory distress syndrome (RDS) in Wistar rats were observed and compared with the dexamethasone. Sixty-two male rats weighing 194.68 +/- 20.40 g (M +/- SD) were used in this experiment. The rats were randomly divided into five (A-E) groups. Group A was given normal saline 0.1 ml/kg alone and group B oleic acid 0.1 ml/kg; both were injected in tail vein, and the latter produced typical RDS. Group C, D, E were injected intraperitoneally with agents of dexamethasone 2 mg/kg, Salvia miltiorrhizae 1.5 g/kg, and ligustrazine 20mg/kg, respectively, 15 minutes before oleic acid intravenous injection. All of the animals were sacrificed quickly 6 hours after injections and lung tissues were taken and examined with light and electronic microscope. The results showed that all of these medicines could minimize the lesions caused by oleic acid. Lung/body index was reduced. Prophylactic effects of Salvia miltiorrhizae and ligustrazine were similar to dexamethasone. The authors considered that preventive use of Salvia miltiorrhizae or ligustrazine could protect the lung from the development of RDS. PMID- 2758518 TI - [A study of Laminaria digitata powder on experimental hyperlipoproteinemia and its hemorrheology]. AB - Twenty rabbits with experimental hyperlipoproteinemia were divided randomly into two groups. The first group was administered Laminaria digitata powder (1 g daily) for 14 days. Another was given only the routine menu. It was found that the Laminaria digitata had a significant effect of lowering total cholesterol, lipoprotein, especially triglyceride (P less than 0.01), meanwhile it could increase the level of HDL-c and HDL2-c. Also it could reduce relative blood viscosity, relative plasma viscosity, reductive viscosity and fibrinogen very significantly (P less than 0.01). However HDL3-c, hematocrit and index of erythrocytic deformability were not much influenced (P greater than 0.05). This experiment showed that there was a connection between the blood lipids and the concept of "Phlegm" in TCM. PMID- 2758519 TI - [An experimental study on the anti-senility effects of shou xing bu zhi]. AB - This paper presents the anti-senility effects of Shou Xing Bu Zhi (SXBZ. made of thirteen herbs: Polygonum multiflorum, Codonopsis silvestris, Astragalus membranaceus, Poria cocos, etc.) in mice. The mice were administered with the SXBZ orally at dosage of 10 g/kg daily for three months. The results showed that the lipofuscin of liver and brain tissues was significantly reduced in both young (1 month old) and adult (11 months) mice. Examination of lipid peroxidation of liver tissue revealed a marked decrease in adult mice. The lipid peroxidation of rat liver homogeneous was obviously inhibited after culturing with drug solutions (5.0 mg/0.1 ml), 37 degrees C for 90 minutes in vitro. In addition, the diminution of hydroxyproline of skin in both young and adult mice was observed. Results of this study indicated that the SXBZ was effective in slowing down aging. PMID- 2758520 TI - [Some easily corrected problems in the research design in traditional Chinese medicine]. PMID- 2758521 TI - [Clinical significance of metal elements analysis in herbals affecting the kidney]. PMID- 2758522 TI - Steady-state fluorescence anisotropy and multifrequency phase fluorometry on oxidized phosphatidylcholine vesicles. AB - Multilamellar liposomes, from mixtures of unoxidized (control) and singlet oxygen oxidized phosphatidylcholine, were studied by steady-state fluorescence anisotropy and multifrequency phase fluorometry using 1,6-diphenyl-1,3,5 hexatriene (DPH) as fluorescent probe. Lifetime fluorescence decay of the DPH labeled liposomes was analyzed either by a model of discrete exponential components and a model that assumes a continuous distribution of lifetime values. Increasing the oxidized phosphatidylcholine content in the liposomes, an increase of the membrane interior polarity and a decrease of membrane fluidity occurs which can be related to the hydroperoxide-lipids and double bonds conjugation, respectively. PMID- 2758523 TI - Mixed-chain phosphatidylcholine analogues modified in the choline moiety: preparation of isomerically pure phospholipids with bulky head groups and one acyl chain twice as long as the other. AB - Diacylphosphatidylcholines were synthesized with widely different acyl chain lengths and bulky head groups. Lysophosphatidylcholine was acylated at room temperature within 6 h with a 10-fold molar excess of fatty acid anhydride in dry, alcohol-free chloroform in the presence of 1.2 equivalents of 4 pyrrolidinopyridine as a catalyst, affording the mixed-acid phosphatidylcholines with widely different chain lengths in more than 90% yield and with less than 1% acyl migration. The syntheses of isomerically pure 1-stearoyl-2-decanoyl- and 1 stearoyl-2-undecenoyl(delta 10)-sn-glycero-3-phosphocholines C(18:0)/C(10:0)-PC and C(18:0)/C(11:1 delta 10)-PC, respectively), followed by conversion to various head-group analogues, are illustrated here. The transition peak widths at half height of the endotherms obtained by differential scanning calorimetry are consistent with very high isomeric purity. Phospholipase D from Streptomyces chromofuscus was used as a catalyst in the hydrolysis of C(18:0)/C(10:0-PC to give the corresponding phosphatidic acid in quantitative yield. The latter compound was condensed with 10 molar equivalents of various N,N,N trialkylammonium alkanols (as their p-toluenesulfonate or tetraphenylborate salt) in the presence of trichloroacetonitrile in dry pyridine under nitrogen atmosphere to yield the C(18:0)/C(10:0) phospholipids bearing modified head groups, which were purified by flash chromatography. PMID- 2758524 TI - Comparison of steady-state fluorescence polarization and urea permeability of phosphatidylcholine and phosphatidylsulfocholine liposomes as a function of sterol structure. AB - The well-known reduction in the permeability properties of liposomes of dimyristoylphosphatidylcholine (DMPC) by sterols has also been demonstrated for its sulfonium analog (DMPSC) in which the N+(CH3)3 group of choline is replaced by S+(CH3)2. We have now compared the effects of 25 mol% 24-methylenecholesterol and cholesterol on the initial rates of urea permeation into dipalmitoyl-PC (DPPC) and dipalmitoyl-PSC (DPPSC) liposomes above the gel-to-liquid-crystalline phase transition temperature and found a greater reduction with 24 methylenecholesterol/DPPSC than with cholesterol/DPPSC liposomes but little difference between the two sterols in DPPC liposomes. Fluorescence polarization studies, using diphenylhexatriene as a probe, show that polarization (P) values are considerably higher in DMPSC liposomes containing 20 and 30 mol% 24 methylenecholesterol than in DMPC liposomes containing 20 and 30 mol% cholesterol. Higher P values were also obtained in DMPSC liposomes containing other 24-alkyl-substituted sterols (beta-sitosterol, ergosterol and campesterol) than in DMPC liposomes containing the same sterols. Reduced permeability rates in PSC liposomes containing 24-alkyl-substituted sterols are correlated with higher polarization values, reflecting an increased degree of order and/or motion in these liposomes compared with liposomes from the corresponding PC. These results suggest that alkyl substitution at C-24 of the sterol molecule results in tighter interactions with the sulfonium analog of PC than with PC. PMID- 2758525 TI - Effect of membrane additives on vesicle fusion. AB - A large variety of alkyl derivatives were found to either slow or block the low temperature induced fusion of dipalmitoylphosphatidylcholine small unilamellar vesicles (DPPC SUV) when incorporated into the SUV bilayer at five mol%. Only corn oil was fusogenic. PMID- 2758526 TI - [Radiologic change of cartilage of the pelvis and the upper end of the femur during growth. Application to the surveillance of scolioses]. AB - We retrospectively studied the radiographic documents of seventy girls with bony age varying from nine to eighteen years old and divided in nine equal groups and seventy boys with bony age from ten to nineteen years old. We analyzed the AP pelvic X ray of each child focusing on cartilages and ossification centers of both pelvic bone and upper femoral extremity. The purpose of this study was to assess the dates of apparition and ossification of these ossification centers and the dates of fusion of cartilages. The iliac ossification center (epiphysaris nucleus ilii) appears lately at bony age of thirteen years and half for girls and fourteen years and half for boys. The triradiate cartilage closes the earliest from its medial to its lateral portion before the apparition of the iliac ossification center. This closing date corresponds to the beginning of growth acceleration. Therefore, the period of growth acceleration can be identified by an accurate analyse of the triradiate cartilage closure on a single AP pelvic X ray. PMID- 2758527 TI - [Operations for lengthening the upper limbs in children and adolescents]. AB - We report 16 cases of lengthening of the upper limb: 4 humerus, 12 ulna from 1976 to 1987. Humerus lengthening are progressive with Wagner apparatus. They gave lengthening from 7.5 to 12 cm. There were no important complication. Ulna lengthening were done in patients with multiple hereditary osteochondromes and hereditary multiple exostoses, to correct the deformities of the forearm, and prevent dislocation of the proximal radial head. Actually progressive lengthenings replace immediate ones with radial osteotomy. PMID- 2758528 TI - [Stable flexible nailing of fractures of both bones of the forearm in children]. AB - Flexible medullary nailing is a method of choice for fractures of the forearm in children. This technique is indicated when orthopaedic treatment has fallen, or for instable fracture. We reported forty four fractures of the forearm concerning children with an age ranged from 2.5 to 15 years. We obtained 38 good results (83.3%) and 6 complications (14.7%) which were related to growth disturbance, leading to limitation of pronation; in one case we obtained a rupture of extensor pollicis longus. PMID- 2758529 TI - [Intertrochanteric osteotomy of the femur in children under 5 years of age. A new osteosynthesis plate]. AB - Between 1980 and 1988, 70 varus inducing and varus derotation osteotomies of the upper end of femur were carried out in children. The osteotomies were maintained by a plate and screws developed by the author. This plate combines a bend to medialize the inferior fragment and screw perforations for easy positioning; it facilitates the procedure since the degree of varus correction depends completely on the shape of the plate. This firmly maintains the desired correction and reduces the amount of radiation received at subsequent controls. PMID- 2758530 TI - [Long-term evolution of esophago-gastric junctions surgically treated to correct gastro-esophageal reflux. 111 cases]. AB - One hundred eleven patients underwent a surgical procedure for correction of intractable gastroesophageal reflux. Twenty children were severely mentally retarded. The range of follow up was 6 months to 15 years. Upper gastro intestinal series was realised at tenth post-operative day for 111 children, then during the first year for 97 children, between the first and fifth year for 62 children and after the fifth year for 25 children. The first upper gastro intestinal control (at tenth day) was normal for 111 patients. Next controls revealed, usually during the first post-operative year, an esophago-gastric junction anomaly for 49 patients (44%). Most of them are light (41/111 = 37%): occasional reflux (9 children; more frequent without pyloroplasty) of little paraesophageal hernia (32 children; more frequent with closure of esophageal hiatus by two suture lines, with esophageal fixation on median arcuatum ligament or without esophageal fixation on esophageal hiatus); these light anomalies are symptom free and sometimes transitories. Rarely, anomalies are important (8/111 = 7%): big paraesophageal hernia of recurrence (more frequent with partial posterior fundoplication and in children severely mentally retarded); five patients were symptomatic and had to be reoperated. Also now, we don't use partial posterior fundoplication and in mentally retarded children we prefer a Collis procedure. PMID- 2758531 TI - [Postoperative recurrence of esophago-tracheal fistula. Significance of peroperative catheterization of the fistula with tracheoscopy. Apropos of 10 cases]. AB - Ten children with recurrent tracheo-oesophageal fistula have been treated over 13 years (1976-1988). Five patients were referred from other centers. The original pathology was oesophageal atresia in eight and two patients had a tracheo oesophageal fistula alone. Barium swallow demonstrated the recurrent fistula in only five of eight cases. In fact, the key examination is tracheoscopy providing that catheterisation of the fistula. The position of the catheter is verified radiologically. The difficulties of surgery in recurrent fistula are linked to the problem of locating the level of the fistula peroperatively. Without catheterisation of the fistula, there were one failure out of three cases (one dead). By contrast, in the seven cases where the fistula was catheterised, a successful outcome was always obtained. The failure of surgery for recurrent tracheo-oesophageal fistula is not linked to a technical problem of closure of the fistulous tract but to failure to localize the fistula adequately. PMID- 2758532 TI - [2 cases of exception to the law of Weigert and Meyer]. AB - The authors report two cases of uropathy with duplicated ureters where Weigert Meyer law was not respected: one reflux to the upper pole segment and one megauretere with reflux to the lower pole segment. These exceptions must be absolutely recognized before endoscopic subureteral injection of polytetrafluoroethylen. Only retrograde pyelography can clarify anatomic situation and pathologic ureteral orifice. Retrograde pyelography must be used if the slightest doubt hangs over pathologic duplex system. PMID- 2758533 TI - [Is velopharyngeal competence stable with growth in patients with cleft palate?]. AB - It is possible to have a good velopharyngeal closure at 8 years of age and slowly deteriorate to present with velopharyngeal incompetence (VPI) at adolescence? Authors disagree on this subject so we undertook a study to find the answer in our cleft palate population. One hundred and seventy-three patients born between 1968 and 1972 with a cleft palate or cleft lip and palate were reviewed. The appreciation of their velopharyngeal closure at 8 years of age, as rated in their chart, was classified as good (group I, 125 patients), borderline (group II, 17 patients) or incompetent (group III, 35 patients). All children in group I had a good velopharyngeal closure before the age of 8 years, some never presented any symptoms of incompetency (VPI) while other corrected this VPI before the age of 8. The group II included children presenting inconstant or mild symptoms of VPI. All patients in group III received a pharyngeal flap to correct their VPI and were not included in this follow up study. Groups I and II were recalled and 52 presented for a late clinical evaluation of their speech. Group I: 47 examined, 42 still competent, 5 incompetent: group II: 5 examined, 3 competent and 2 incompetent. It is interesting to note that in group I, all five deteriorations of the V-P competency was seen in patients who had shown some symptoms of VPI in early childhood. They had become competent spontaneously or with speech therapy, before age 8.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2758534 TI - [Cartilaginous tumors in children]. AB - For the last 15 years, 44 cartilaginous bone tumors had been treated in children aging from 2 to 15 years. 80% were chondromas, either isolated (27), or multiples in enchondromata (9). Treatment varied from simple biopsy to extensive excision with cancellous bone graft. Two of these patients experienced postoperative recurrence but have been cured by another surgical excision. One chondromyxoid fibroma of the big toe and 2 chondroblastomas of the femur had been treated by excision with no recurrence. Three young boys (mean age 5 years) who had a metachondromatosis with chondromas of the extremities had been treated with one recurrence. Two children had a chondrosarcoma and both of them died from lung metastasis. Surgical treatment is indicated for all these tumors and is discussed with our results for each of them. PMID- 2758535 TI - [Congenital pseudarthrosis of the legs and the Ilizarov method. Apropos of 4 cases]. AB - Four cases of congenital pseudarthrosis were treated by the Ilizarov method and consolidation obtained by 3.5 months in three patients who had all undergone several previous surgical procedures. Although the length of follow up is short (maximum 3.5 years) consolidation occurred quicker than by traditional methods. This technique also permitted both simultaneous correction of axial malalignment and leg lengthening. We think that this method has a place as a salvage procedure except where the distal fragment is very thin or dystrophic. PMID- 2758536 TI - The haemodynamic response to intubation: a perspective. PMID- 2758537 TI - Haemodynamic responses to laryngoscopy and tracheal intubation in geriatric patients: effects of fentanyl, lidocaine and thiopentone. AB - The haemodynamic responses to laryngoscopy and intubation after induction of anaesthesia with thiopentone alone or in combination with 1.5 mg.kg-1 lidocaine and/or 1.5 or 3.0 microgram.kg-1 fentanyl were measured in 150 patients over 64 years of age to determine whether lidocaine, fentanyl or both lidocaine and fentanyl attenuated the pressor response. Fentanyl reduced the rises in systolic, diastolic and mean arterial pressures, heart rate, and rate pressure product and lidocaine decreased the rises in arterial blood pressure and rate pressure product (P less than 0.05). Fentanyl decreased the incidence of marked fluctuations in haemodynamic variables, often seen in geriatric patients (P less than 0.05). The haemodynamic effects of lidocaine and fentanyl were independent of each other. Complications occurred in all groups. Lidocaine-treated patients had fewer cardiac dysrhythmias (P less than 0.05) and 34 per cent of them had tinnitus. Fentanyl-treated patients had a higher incidence of hypotension (P less than 0.05). Respiratory depression developed in only one per cent of the fentanyl treated patients. Both lidocaine and fentanyl are recommended adjuncts to induction of anaesthesia with thiopentone in geriatric patients. PMID- 2758538 TI - The effect of local anaesthetics on epinephrine absorption following rectal mucosal infiltration. AB - This study was undertaken to investigate the effects of lidocaine and bupivacaine on epinephrine absorption following rectal mucosal infiltration, to assess the cardiovascular and metabolic effects of the absorbed epinephrine and to compare the systemic absorption of the local anaesthetics employed. Three groups of five greyhounds received 1.5 micrograms.kg-1 of epinephrine 1:200,000 in lidocaine 0.5 per cent, bupivacaine 0.5 per cent or 0.9 per cent saline. Plasma epinephrine, lidocaine, bupivacaine, lactate, glucose and potassium concentrations were measured at 1, 2, 5, 10, 15 and 30 minutes following infiltration. Plasma epinephrine concentrations were significantly higher in the lidocaine group at one and two minutes following infiltration. Plasma bupivacaine concentrations were significantly higher than plasma lidocaine concentrations throughout the study period. There were no significant differences in metabolic or biochemical indices within or between the three groups. A local vasodilatory action of lidocaine may enhance epinephrine absorption. Differences in hepatic uptake and rate of metabolism may explain the increased plasma bupivacaine measured. Lidocaine may be the local anaesthetic of choice for ano-rectal procedures, especially when large volumes of local anaesthetic are being infiltrated. PMID- 2758539 TI - Cumulative dose-response curves for atracurium in patients with myasthenia gravis. AB - The potency of atracurium was determined in five patients with moderate to severe generalized myasthenia gravis undergoing thymectomy. Train-of-four stimulation was applied to the ulnar nerve and the force of contraction of the adductor pollicis was measured. Cumulative dose-response curves were obtained during thiopentone-nitrous oxide-fentanyl anaesthesia. The average time to complete the dose-response studies was 12.7 +/- 1.5 minutes. The ED50, ED90 and ED95 of atracurium were (mean +/- SEM) 0.07 +/- 0.01, 0.12 +/- 0.22, and 0.14 +/- 0.04 mg.kg-1, respectively. The time to 25 per cent first twitch recovery was 35 +/- 4 min following maximum blockade. Ten normal patients were studied in the same manner. Their ED50, ED90 and ED95 were 0.13 +/- 0.01, 0.21 +/- 0.02 and 0.24 +/- 0.03 mg.kg-1, respectively. These results demonstrated that, in patients with moderate to severe generalized myasthenia gravis, atracurium was 1.7-1.9 times as potent as in normal individuals. PMID- 2758540 TI - Atropine-neostigmine mixture: a dose-response study. AB - The dose-response relationship and the doses of atropine required to prevent neostigmine from lowering heart rates below baseline in 50 per cent (ED50) and 95 percent (ED95) of patients after antagonism of pancuronium-induced neuromuscular blockade were determined in 70 patients with neostigmine-atropine mixtures. Neostigmine 0.04 mg.kg-1 (group A, n = 35) or 0.06 mg.kg-1 (group B, n = 35) was randomly mixed with one of seven doses of atropine (ranging from 0.014 to 0.04 mg.kg-1) in group A and from 0.02 to 0.04 mg.kg-1 in group B), with dose-response curves for atropine being constructed for both groups 5 and 10 min after injection of the mixture. These dose-response curves were found to be parallel in both groups. The calculated ED50 and ED95 values of atropine were similar in both groups. The estimated ED50 doses of atropine in groups A and B at 5 min were 0.031 and 0.033 mg.kg-1 respectively, and at 10 min the ED50 doses were 0.037 and 0.037 mg.kg-1 respectively. The calculated ED95 doses of atropine in groups A and B at 5 min were 0.05 and 0.046 mg.kg-1, and at 10 min the ED95 doses were also similar, being 0.06 and 0.055 mg.kg-1 respectively. Under the conditions employed in this study it would seem that in order to prevent late reductions in heart rates, the appropriate doses of atropine when used with neostigmine should be greater than that commonly used. PMID- 2758541 TI - Complications during anaesthesia in patients with Duchenne's muscular dystrophy (a retrospective study) AB - The purpose of this retrospective study was to estimate the frequency and severity of anaesthetic complications in patients with Duchenne's muscular dystrophy (DMD). Forty-four boys with DMD were exposed to anaesthesia and surgery 84 times during a period of 22 years (1965-86). The procedures took place at 15 different hospitals. Retrospective examination of the case records showed: 19 cases with local analgesia without any complications, and 18 of 65 general anaesthetics with minor or more serious complications. In ten cases an increase in body temperature above 37.5 degrees C was seen, five had abdominal pain and dark-coloured urine after surgery, and three had a critical perioperative course with a resemblance to malignant hyperthermia. The complications were almost exclusively related to the use of succinylcholine. The use of succinylcholine was dispersed through all ages. Three out of the eight patients with severe complications occurred 1.5, 2.5 and 4 years before the neuromuscular disease was diagnosed. Thus an unusual course of anaesthesia in male children calls for further investigation. Although it has been stated before that succinylcholine is contraindicated in patients with Duchenne's muscular dystrophy, the drug continues to be used. PMID- 2758542 TI - Failure of a lidocaine test dose to identify subdural placement of an epidural catheter. AB - We report the failure of a test dose of 3 ml lidocaine 1.5 per cent with 15 micrograms epinephrine to identify subdural placement of an epidural catheter in a parturient. Thirty-five minutes after injection of 13 ml lidocaine 1.5 per cent, intended to provide epidural analgesia, the patient developed an extensive sensory neural blockade. Some motor control was maintained and sympathetic block was incomplete. Blood pressure and oxygenation were easily supported with optimum positioning, fluids, ephedrine and oxygen by mask. The patient remained alert. The duration of neural blockade was approximately two hours. The patient underwent a second epidural for labour analgesia that was uneventful. There were no sequelae. Subdural injections are uncommon and unpredictable in their occurrence. Test doses do not consistently identify misplaced catheters. A negative response to a test dose does not guarantee that extensive neural blockade will not occur during epidural analgesia. PMID- 2758543 TI - Clinical differences in spinal opioid efficacy. AB - The case report describes a patient who presented with two simultaneously occurring but distinct pain syndromes. Epidural morphine controlled the pain from the abdominoperineal resection, while the pain from a deep venous thrombosis was not masked. Such differential effects of epidural morphine on pain of varying origin supports physiological observations on the specificity of the site of action of spinal opioids. PMID- 2758544 TI - Severe hypotension from epidural meperidine in a high-risk patient after thoracotomy. AB - A sixty-eight-year-old female developed severe hypotension immediately after the administration of epidural meperidine for post-thoracotomy pain. Two preceding injections of epidural opiates had been uneventful. The cardiovascular collapse was difficult to reverse and may have contributed to the patient's subsequent death. Cardiovascular complications have not been reported frequently as a possible side effect of epidural opiate analgesia. PMID- 2758545 TI - Anaesthesia for caesarean section in patients with uncontrolled hyperthyroidism. AB - The anaesthetic management of two patients with uncontrolled hyperthyroidism requiring Caesarean section is described. The first patient was diagnosed as hyperthyroid during pregnancy but was resistant to medical management with propylthiouracil (PTU). At 38 weeks' gestation, after optimizing her heart rate with intravenous propranolol, she received an epidural anaesthetic for the Caesarean section. The baby had manifestations of hypothyroidism immediately after birth but later became hyperthyroid. The second patient's hyperthyroidism was well controlled but she stopped her medication one week before delivery. The Caesarean section was performed under general anaesthesia for fetal distress. The baby died in the neonatal period of extreme prematurity. The anaesthetic management of the hyperthyroid parturient is discussed. Preoperative control of hyperthyroidism, bearing in mind pregnancy and time constraints, is essential. The use of PTU, propranolol, iodine, and glucocorticoids is described in the preparation of the parturient. Fetal and neonatal effects of these drugs are discussed. PMID- 2758546 TI - Meperidine to control shivering associated with platelet transfusion reaction. AB - Shivering may be part of a febrile non-haemolytic reaction to blood product transfusion. Shivering can increase oxygen consumption up to 500 per cent which may be detrimental to patients with decreased myocardial reserve. A case is presented of a reaction to platelet transfusion characterized by shivering, tachycardia and hypertension in a patient with a recent myocardial infarction in whom the metabolic and haemodynamic effects were considered to be potentially disastrous. Intravenous injection of meperidine was rapidly effective in treating these changes. PMID- 2758547 TI - Dissection of ascending thoracic aorta complicated by cardiac tamponade. AB - Two cases of cardiac tamponade caused by dissections of the ascending thoracic aorta are described. Despite uneventful induction of anaesthesia one patient exsanguinated following sternotomy and release of pericardial tamponade as the resulting increase in blood pressure caused aortic rupture. The second patient was managed with femoral-femoral bypass, propranolol and vasodilators prior to sternotomy to avoid this complication, and he survived. The anaesthetic management of a patient with cardiac tamponade is directed towards maintaining cardiac filling pressures and contractility. When the tamponade is released the sudden increase in cardiac output and blood pressure may cause the already weakened aorta to rupture. PMID- 2758548 TI - Craniosynostosis: an assessment of blood loss and transfusion practices. AB - Assessment and accurate replacement of blood loss during primary craniosynostosis repair is difficult due to patient size and surgical technique. Eighty-five charts of all patients undergoing primary craniosynostosis repair over a 15-year period were reviewed to determine blood loss and to assess blood transfusion practices both intraoperatively and postoperatively. Blood loss was calculated on the basis of estimated red cell mass (ERCM). Blood transfusion management was considered appropriate if the postoperative or posttransfusion ERCM was within 15 per cent of the preoperative value. Isolated sagittal craniectomy was the most common operation performed (60 per cent). Mean blood loss for sagittal craniectomies was 24 per cent of estimated blood volume (EBV) or approximately 20 ml.kg-1 and for metopic craniectomies 42 per cent of EBV (P less than 0.05). Intraoperatively, 70 per cent of all patients were appropriately managed with respect to blood transfusion. Postoperatively only 29 per cent of patients receiving transfusions were transfused appropriately. At our institution, intraoperative blood transfusion practices are appropriate, but postoperative transfusions are frequently unnecessary. PMID- 2758549 TI - Anaesthesia and Rett syndrome: a case report. AB - Rett syndrome is a neurological disorder of females characterized by dementia, autism, movement disorders and an abnormality of respiratory control. A 14-year old girl with Rett Syndrome underwent spinal fusion surgery under general anaesthesia. No exacerbation of the respiratory control defect with surgery and anaesthesia was observed. Hypothermia, ongoing blood loss and a normal anion gap acidosis were encountered, but were not attributable to features of this disorder. PMID- 2758550 TI - Epidurals for labour, and fainting fathers. PMID- 2758551 TI - Prolonged bleeding from epidural catheterization. PMID- 2758552 TI - Combined spinal-epidural needle. PMID- 2758553 TI - PORCH test. PMID- 2758554 TI - The Montando laryngectomy tube. PMID- 2758555 TI - UKCCCR guidelines for the welfare of animals in experimental neoplasia. PMID- 2758556 TI - Flavone acetic acid (LM-975; NSC-347512) activation to cytotoxic species in vivo and in vitro. AB - Flavone acetic acid (FAA; LM 975; NSC 347512) is a new anticancer agent with unprecedented, broad antitumor activity in murine models. Although FAA is very effective in vivo against solid tumors, including colon 38 adenocarcinoma, it was not cytotoxic in vitro against colon 38 cells and human colon adenocarcinoma cells HCT116 at pharmacologically achievable concentrations and exposure times. For example, a concentration of 300 micrograms/ml for a 10-day exposure time was required to obtain less than 1 log cell kill. After the administration of an effective FAA dose (180 mg/kg, i.v.) to mice, plasma cytotoxicity against HCT116 cells attained a 2 log cell kill between 0.5 and 2 h, which decreased to 1 log cell kill at 4 h. No cytotoxicity was observed 6, 12 or 21 h after drug administration. The controls used comprised mouse plasma containing FAA concentrations similar to those assayed in the above plasma samples from in-vivo dosed mice. These spiked plasma were not cytotoxic, indicating that other cytotoxic species, formed in vivo, were responsible for the increased cytotoxicity. Mouse hepatocytes co-cultured with HCT116 cells increased FAA cytotoxicity to 1 log cell kill at 30-100 micrograms/ml. The addition of phenobarbital-induced mouse liver supernatant S-9000xg also markedly increased FAA cytotoxicity to a 2 log cell kill at 300 micrograms/ml. We conclude that FAA can be activated both in vivo and in vitro to cytotoxic species that are more active than the parent compound. PMID- 2758557 TI - Preclinical pharmacologic studies of the new antitumor agent carmethizole (NSC 602668) in the mouse and beagle dog. AB - The chemical breakdown of carmethizole [1-methyl-2-methylthio-4,5-bis (hydroxymethyl)imidazole-4',5'- bis(N-methylcarbamate)hydrochloride] and its pharmacokinetics in the mouse and beagle dog were studied. Carmethizole was relatively unstable in aqueous media, having a half-life of less than or equal to 1 h in 0.9% sodium chloride, human whole blood, human plasma, and dog urine at 37 degrees C. Its major breakdown product in 0.9% sodium chloride and pH 5.0 sodium phosphate buffer was carmethizole diol. When carmethizole was added to pH 7.0 or pH 9.0 sodium phosphate buffer, the major breakdown product was carmethizole diol 4'-monophosphate. Carmethizole reacted directly with glutathione at pH 8.0, forming a glutathione adduct of carmethizole monocarbamate. Elimination of the drug from the plasma of the beagle dog following i.v. bolus doses of 22.4 and 4.3 mg/kg was biphasic. At these doses the terminal half-life was 39 and 46 min, respectively, and the respective total body clearance was 4.6 and 7.7 ml/min per kg. The 22.4 mg/kg dose was lethal to the beagle dog by day 4. Elimination of carmethizole from the plasma of mice following an i.v. bolus dose of 115 mg/kg was monoexponential, with a half-life of 11.6 min and a total body plasma clearance of 43.6 ml/min per kg. When the drug was infused at 230 mg/kg over 8 h into mice, the total body clearance was 40.8 ml/min per kg. Following the i.v. bolus administration of carmethizole to mice, 30% of the total dose was excreted in urine over 3 h as carmethizole diol, 10%, as carmethizole diol-sulfate, 3.4%, as carmethizole 4'-monocarbamate, and 2.4%, as unchanged drug. PMID- 2758558 TI - Prediction of thioguanine-induced cytotoxicity by dual-parameter flow cytometric analysis. AB - A method is presented for the quantitative analysis of delayed cytokinetic effects resulting from the treatment of L1210 cells with 6-thioguanine (TG). By using dual-parameter (DNA/protein) flow cytometry, we could observe the accumulation of late S/G2/M cells with abnormally high green fluorescence (i.e., protein content), indicative of unbalanced growth. The use of mitotic cells from a pseudotetraploid line (HT29) as external markers for both red and green fluorescence facilitated highly reproducible measurement of the mean green fluorescence (GFLmean) of the arrested late S/G2/M population. We found that the dose dependence of the observed GFLmean values followed the same unusual biphasic pattern as did cytotoxicity in this cell line, indicating that this parameter might be a suitable means of predicting TG-induced toxicity in vivo. We propose that the low background expected for this kind of measurement would make it particularly appropriate for the analysis of clinical specimens (e.g., mononuclear bone marrow cells) from leukemic patients receiving thiopurines, to monitor (and, hopefully, predict) their response to treatment. PMID- 2758559 TI - Effects of two pyridinalalkyliminerhodium(I) complexes in mice bearing MCa mammary carcinoma. AB - The examination of the differential effects of two square-planar rhodium(I) complexes on primary tumor growth and on the formation of spontaneous and artificially (i.v. tumor injection) induced lung metastases of MCa mammary carcinoma suggests different mechanisms of action, depending on the chemical characteristics of the compound used. Of the two complexes used, cyclooctadiene(2 pyridinalmethylimine)Rh(I) chloride and cyclooctadiene(2 pyridinalisopropylimine)Rh(I) chloride, the former compound confirmed the antineoplastic action previously shown in the Lewis lung carcinoma model. The activity of this derivative on lung metastasis formation seems to be unrelated to a cytotoxic action for tumor cells localized in the lungs. More likely, it appears that modifications occurring at the primary tumor level, probably different from a tumor-cell-directed lethality, are responsible for the reduction of spontaneous lung metastasis formation observed in treated animals. The hyperplasia of the spleen induced in treated animals seems to suggest that this compound is endowed with properties typical for biological response modifiers. PMID- 2758560 TI - Absence of cross-resistance between two alkylating agents: BCNU vs bifunctional galactitol. AB - Dianhydrogalactitol (DAG) increased the life span of both BCNU-sensitive and resistant L1210 tumor-bearing mice. However, the BCNU-resistant strain showed slightly lower sensitivity against DAG, which could be overcome by an increase in drug dose of ca. 20%. The somewhat lower sensitivity was proportional to a slightly reduced DNA cross-linking formation induced by DAG in BCNU-resistant cells. The amount of DNA cross-links was determined by measurement of the 1,6 di(guaninyl)-galactitol content of DNA. The slight reduction in cross-links is not attributable to DNA repair but rather to other factors that seem to prevent the formation of DNA-drug adducts. The absence of cross-resistance is explained by different kinds of DNA damage caused by the two alkylating agents and the presumably different defense mechanisms developed by cells against these lesions. PMID- 2758561 TI - A phase I trial of trimetrexate glucuronate (NSC 352122) given every 3 weeks: clinical pharmacology and pharmacodynamics. AB - Trimetrexate glucuronate (TMTX), a non-classic folate antagonist, has been evaluated clinically on several schedules. We studied TMTX given as an i.v. bolus over 5-30 min every 3 weeks in 44 patients with advanced solid tumors; it was given at doses ranging from 20 to 275 mg/m2. The maximal tolerated dose (MTD) on this schedule is 220 mg/m2, which we also recommend as a starting dose for phase II studies in patients without extensive prior therapy. Because of wide individual differences in drug tolerance, dose escalation in 25% increments is recommended for non-toxic patients. The principal dose-limiting toxicity was myelosuppression, although in some patients a flu-like syndrome precluded dose escalation. Significant rash and mucositis also frequently occurred in toxic patients. TMTX plasma concentrations were measured after the first dose and the data were fit by two- or three-compartment mammillary pharmacokinetic models. The TMTX clearance rate was 36.5 +/- 21 ml/min per m2 and did not change with dose; non-linearities with increasing dose were apparent in the steady-state volume of distribution (Vss) and in the terminal disposition half-life (t1/2). The difference between pre-treatment and nadir leucocyte counts was correlated with TMTX dose (r = 0.58; P = 0.0006) and with the area under the concentration vs time curve (AUC) (r = 0.41; P = 0.02). Pre-treatment plasma albumin concentrations correlated weakly with the nadir white blood count (r = -0.36; P = 0.047). Optimal schedules for the administration of TMTX have not been established and phase II trials using both bolus and daily X 5 schedules are under way. PMID- 2758562 TI - Alternating six-drug combination chemotherapy induction for intermediate and high grade non-Hodgkin's lymphoma. AB - 31 patients with intermediate and high-grade non-Hodgkin lymphomas were treated by a six-drug alternating regime comprising four cycles of 200 mg/m2 i.v. methotrexate on days 8, 15, 28 and 35, 50 mg/m2 i.v. Adriamycin on day 1, 40 mg/m2 oral prednisolone on days 1-7 and 21-27, 120 mg/m2 i.v. etoposide on days 21-23, 600 mg/m2 i.v. cyclophosphamide on day 21 and 1.4 mg/m2 i.v. vincristine on day 1 (MAPECO). In all, 3 patients had stage I disease, 12 stage II, 6 stage III and 10 stage IV. Of 28 evaluable patients, 19 were complete responders (68%) and 9 were partial responders (32%); at 2 years, the actuarial relapse-free survival of the 19 patients achieving complete remission is 80%, and 5 patients remain in complete remission at 3 years. This is a preliminary report of an effective intensive regime with acceptable toxicity. PMID- 2758563 TI - The effect of dose on the bioavailability of oral etoposide: confirmation of a clinically relevant observation. AB - The effect of dose on the bioavailability of oral etoposide was investigated in ten patients with malignant mesothelioma who received single-agent etoposide as part of a phase II study. Etoposide pharmacokinetics were studied in each patient at oral dose levels of 100, 200, 300, 400 and 600 mg. At doses above 200 mg, the AUC and peak concentrations of etoposide were substantially lower than predictions based on the 100-mg dose. This study confirms previous observations that etoposide absorption is dose-dependent and that a mean bioavailability of approximately 50% cannot be assumed at total oral doses greater than 200 mg. PMID- 2758564 TI - Pharmacokinetic and pharmacodynamic studies with 4'-epi-doxorubicin in nasopharyngeal carcinoma patients. AB - The plasma pharmacokinetic profile of 4'-epidoxorubicin (epirubicin) was investigated in 28 patients with nasopharyngeal carcinoma (NPC) after single i.v. rapid infusions. All patients had normal liver and renal functions. Plasma concentrations of the parent compound were specifically determined by a high performance liquid chromatographic (HPLC) method, with UV detection at 254 nm. Plasma levels of the compound were fitted to a three-compartment open model; a triexponential decrease in plasma concentrations with a long terminal plasma half life (44.8 +/- 21.2 h) was observed in 27 patients. The respective mean (+/- SD) serum concentration at 72 h and the AUC, plasma clearance, and terminal elimination rate constant in complete responders were 7.67 +/- 1.98 ng/ml, 4,002 +/- 3,080 ng.h/ml, 26.6 +/- 12.9 l/h.m2, and 0.009 +/- 0.007 l/h, whereas those in nonresponders were 4.96 +/- 1.8 ng/ml, 1.88 +/- 652.8 ng.h/ml, 44.4 +/- 15 l/h.m2, and 0.017 +/- 0.006 l/h, respectively; these differences were significant (P less than 0.05). Epirubicin produced a 52% response rate, including 6 patients with a complete response, 8 with a partial response, 11 with no change, and 2 with progressive disease. No relationship could be found between the various pharmacokinetic parameters and either leukopenia, age, or sex. These observations strongly suggest that plasma clearance may be one of the determining factors affecting the response or nonresponse of NPC patients to epirubicin, and a dose adjustment according to plasma clearance would probably increase the response rate. PMID- 2758565 TI - Ifosfamide in the treatment of pediatric malignancies. 4th European Conference on Clinical Oncology and Cancer Nursing. Madrid, November 1987. Proceedings. PMID- 2758566 TI - A phase II study of ifosfamide in paediatric solid tumours. AB - A total of 20 children with recurrent or unresponsive tumours (10 Wilms' tumours, 3 rhabdomyosarcomas, 4 Ewing's sarcomas, 1 osteosarcoma, 1 hepatoblastoma, 1 hepatoma) were given ifosfamide as a 24-h infusion (5 g/m2), with mesna as a uroprotector. The number of courses ranged from 1 to 13 (median, 3), and the interval between them was 2-3 weeks. In all, 16 of these patients had previously received cyclophosphamide. Complete clinical responses (CRs) were seen in 3 cases (2 Wilms' tumours and 1 Ewing's sarcoma) and lasted 5, 7, and 9 months. Partial responses (PRs) were seen in 3 instances; mixed response or stable disease, in 4; and progressive disease, in 10. Treatment was well tolerated in most patients, with no cystitis or severe myelosuppression, but two children developed transient neurological symptoms and one became hypertensive. Nausea and vomiting were controlled by high-dose dexamethasone in most children. PMID- 2758567 TI - Childhood non-Hodgkin's lymphoma in Egypt: preliminary results of treatment with a new ifosfamide-containing regimen. AB - Pediatric non-Hodgkin's lymphoma (NHL) constitutes 16% of pediatric malignancies reported to the National Cancer Institute (NCI) in Cairo. Since July 1985, we have treated 39 previously untreated pediatric NHL cases younger than 16 years of age (mean, 7.6 years) with a new protocol consisting of alternating cycles: regimen A comprised cyclophosphamide, high-dose ara-C, Adriamycin and vincristine; regimen B consisted of ifosfamide, methotrexate and VP16, with intrathecal methotrexate. Diagnoses included 20 abdominal masses, 16 peripheral lymphadenopathies and 6 bony lesions. Histopathology according to the working formulation revealed 21 cases of small non-cleaved lymphoma, 6 lymphoblastic, 5 large-cell and 7 unclassified diffuse lymphomas. Responses were complete in 31 cases (82%) and partial in 4 cases (10%), and no response was obtained in 4 cases (8%). Overall survival was 82% in limited disease and 60% in extensive disease at 28+ months. This short-term ifosfamide-containing regimen proved its efficacy, with results matching those of other regimens used in the United States and Europe. PMID- 2758568 TI - Experience with ifosfamide in paediatric tumours. AB - Ifosfamide, alone or in combination, is used in a variety of childhood tumours. Soft-tissue sarcomas are especially sensitive, with a 78% actuarial survival. Hyperaminoaciduria and a brief transient decrease in the plasma level of certain amino acids are the earliest signs of tubular toxicity. PMID- 2758569 TI - Childhood dysgraphia. Part 2. A study of hand function. AB - Sixty-six children were studied who had presented to the paediatric neurology service over a 2-year period, because they were failing to make the expected progress in mainstream school. Their parents were interviewed with a structured questionnaire and the children had a full neurodevelopmental examination which included a detailed assessment of hand function. Thirty-nine per cent of the children had a specific dysgraphia and there was a male predominance. The different populations of affected children had distinguishing characteristics. A family history of written language skill difficulties was elicited for most of the children with a developmental spelling dysgraphia, but it was uncommon in the children with an acquired spelling dysgraphia or motor dysgraphia. Slow speech development occurred frequently in developmental and acquired spelling dysgraphic children. Mixed handedness was significantly commoner in dysgraphic children who had acquired problems (P less than 0.05), whereas handedness in the developmental groups was within the expected normal distribution. Aspects of hand function such as power of hand grip did not distinguish the dysgraphic children. However, children with a spelling or motor dysgraphia had speeds of motor performance on successive finger movements and rapid hand pats outwith the normal range. These simple tests are a useful way of examining pertinent handskill difficulties in dysgraphic children. PMID- 2758570 TI - Observations on a child with cerebral palsy and her twin sister made in an integrated nursery and at home. AB - Observations were made on two twins attending the same integrated nursery. One of the children had cerebral palsy while her sister developed normally. Similar observations were also made in the twins' home while they played with their mother. Comparisons were made between the behaviour and experience of the two children in the nursery and also between the home and the nursery. The child with cerebral palsy was non-ambulant and her interactions in the nursery were limited in both quality and quantity compared with her sister and with opportunities presented at home. Despite this both children enjoyed attending the nursery. It is proposed that integration needs to have structured and monitored support for ensuring that children with special needs benefit from mainstream education. PMID- 2758571 TI - Cocaine and pregnancy: clinical and toxicological implications for the neonate. AB - Recent studies show that the rate of cocaine use by pregnant women in the United States is much higher than realized hitherto, and an increasing number of infants are being born to cocaine-using mothers. In an ongoing research project to study the effects of cocaine on pregnancy outcome, we studied 70 infants born to cocaine-using women. These infants were matched to a drug-free comparison group selected from the population of the same hospital: children of pregnant women of a similar racial and socioeconomic distribution, but with no history or evidence of licit or illicit drug use during pregnancy. Cocaine-exposed infants had lower birth weight, shorter gestation, and a smaller head circumference than control infants. Cocaine-exposed infants also had neurobehavioral abnormalities at initial evaluation and a higher rate of perinatal complications. Toxicological evaluation of urines of neonates born to cocaine-using women showed that benzoylecgonine, a primary metabolite of cocaine, persisted in the urines for as long as 120 h after delivery. We discuss the role of the immature fetal and neonatal system in the clinical and toxicological outcome of the infant, and emphasize that further long-term studies of this will be needed. PMID- 2758572 TI - The use of GC/IR/MS for high-confidence identification of drugs. AB - We describe the use of a combined gas chromatographic/infrared/mass spectrometric system to identify some common, clinically important drugs. Sensitivity for the serially configured combined system is demonstrated to be in the low nanogram range for strong infrared-absorbing compounds. Linearity for cocaine in the infrared detector was shown to have a correlation coefficient of 0.9914. Vapor phase infrared spectra are shown to be very reproducible, which is important in identifying drugs such as the barbiturates. Finally, the two completely independent principles of infrared and mass spectral detection lend significant confidence to the correct identification of the various drugs from a single injection of sample. PMID- 2758573 TI - Analysis of supplemented vitamin K1(20) in serum microsamples by solid-phase extraction and narrow-bone HPLC with multichannel ultraviolet detection. AB - A sensitive method for the determination of vitamin K1(20) in serum microsamples (50 microL) has been developed, utilizing solid-phase extraction with C8 Bond Elut columns and reversed-phase narrow-bore high-performance liquid chromatography [2.1 mm (i.d.), column] with a nonaqueous eluent. Recovery from serum (49 ng/mL) was 76% (n = 2). Peak homogeneity was assessed by photodiode array detection with absorbance ratio, spectral normalization, and transformation to the first- and second-derivative chromatograms. Calibration data at 248 nm over two ranges (20-200 ng/mL, 200-4000 ng/mL) varied linearly with concentration and were suitable for studies of vitamin K1 supplementation. By comparison with conventional columns, sensitivity was increased twofold. PMID- 2758574 TI - The continuing need for quality assessment of cyclosporine measurement. AB - The returns from the United Kingdom Cyclosporin Quality Assessment Scheme were analyzed for the period June 1987 to August 1988. During this time the number of laboratories in the Scheme increased from 102 to 124 and the proportion of laboratories using nonspecific assay methods declined, as did the proportion of them measuring cyclosporine in plasma. Seven different methods were used to measure the drug in blood, and the seven methods gave seven different results when used to measure patients' samples. The results, from lowest to highest, differed by a factor of approximately 3.4. The within-assay coefficient of variation (CV) was acceptable for all methods, but the between-assay and between center CVs were poor. HPLC gave higher CVs than did the immunoassays. PMID- 2758575 TI - Specific routine determination of 3'-azido-3'-deoxythymidine (AZT) in plasma by partly automated liquid chromatography. AB - A simple isocratic HPLC method for determining azidothymidine (AZT) in serum and plasma of patients has been developed. The novel, specific, two-step, solid-phase extraction approach used for sample preparation gives a nearly quantitative recovery (95.3%) of AZT from the blood plasma matrix and requires only minimal handling of infectious clinical samples. Automatic "on-line" injection is achieved with an AASP system by switching a small cartridge, which retains the extracted analyte, into the HPLC stream. The overall HPLC procedure shows satisfying reproducibility with low standard deviation (CV: 2.1%). Because of the low detection limit (about 10 ng) and the possibility of concentrating AZT quantitatively in as much as 5 mL of plasma or serum, the method can be used in routine monitoring of AZT as well as in pharmacokinetic studies. Nevertheless, before establishing therapeutic drug monitoring for AZT, it still must be determined at what time after the last AZT dose blood specimens should be drawn for correct therapeutic interpretation of the concentration of AZT measured in blood. PMID- 2758576 TI - HPLC measurement of chlorophenoxy herbicides, bromoxynil, and ioxynil, in biological specimens to aid diagnosis of acute poisoning. AB - A simple high-performance liquid-chromatographic assay for eight chlorophenoxy (2,4-D and related compounds) and two benzonitrile (bromoxynil and ioxynil) herbicides has been developed to aid in the diagnosis of acute poisoning. Sample (whole blood, plasma/serum, urine, or tissue homogenate) or standard (100 microL) is vortex-mixed (ca. 5 s) with 20 microL of internal standard solution [1.00 g/L 2,4,5-TP in 0.02 mol/L Tris buffer, pH 9.6:methanol (1 + 1)]. Dilute (0.2 mL/L) hydrochloric acid in methanol, 200 microL, is added and the mixture is again vortex-mixed (30 s). After centrifugation (9950 X g, 2 min) a 10-20 microL portion of the supernate is analyzed on a 250 X 5 mm (i.d.) Spherisorb S5 Phenyl column, with aqueous potassium dihydrogen orthophosphate (50 mmol/L, pH 3.5) and acetonitrile (3 to 1 by vol) at a flow-rate of 1.8 mL/min as eluent. The method is capable of resolving the chlorophenoxy/benzonitrile mixtures (2,4-D/MCPP, 2,4 D/DCPP, 2,4-D/ioxynil, 2,4-D/MCPP/DCPP, 2,4-D/2,4,5-T, and MCPP/ioxynil) encountered in the U.K. The limit of detection (at 240 nm) is 20 mg/L (10 mg/L for bromoxynil and ioxynil). Intra-assay and interassay CVs were less than 5% and less than 8%, respectively, for all analytes. Plasma:whole blood distribution ratios ranged from ca. 1.7 for 2,4-DB to ca. 2.0 for 2,4-D, emphasizing that results of whole-blood measurements must be multiplied by a factor of ca. 2 for comparison with plasma/serum data. PMID- 2758577 TI - Therapeutic drug monitoring in the 1990s. PMID- 2758578 TI - Effect of counting errors on immunoassay precision. AB - Using mathematical analysis and computer simulation, we studied the effect of gamma scintillation counting error on two radioimmunoassays (RIAs) and an immunoradiometric assay (IRMA). To analyze the propagation of the counting errors into the estimation of analyte concentration, we empirically derived parameters for logit-log data-reduction models for assays of digoxin and triiodothyronine (RIAs) and ferritin (IRMA). The component of the analytical error attributable to counting variability, when expressed as a CV of the analyte concentration, decreased approximately linearly with the inverse of the square root of the maximum counts bound. Larger counting-error CVs were found at lower concentrations for both RIAs and the IRMA. Substantially smaller CVs for overall assay were found when the maximum counts bound progressively increased from 500 to 10,000 counts, but further increases in maximum bound counts resulted in little decrease in overall assay CV except when very low concentrations of analyte were being measured. Therefore, RIA and IRMA systems based in duplicate determinations having at least 10,000 maximum counts bound should have adequate precision, except possibly at very low concentrations. PMID- 2758579 TI - Antipyrine interferes with chemical determination of bromide in simultaneous estimation of total body water and extracellular water. AB - Antipyrine and bromide dilution are frequently used to estimate total body water and extracellular water volumes, respectively. We assessed a potential error with the simultaneous use of these methods. In vitro the bromide concentration of solutions measured by the gold chloride or rosaniline methods decreased linearly with increasing concentrations of antipyrine. With the gold chloride method, the "inhibitory" effect of antipyrine was more pronounced for solutions in plasma than in those in water. With the rosaniline method, the "inhibitory" effect was similar for water and plasma. Antipyrine had no effect on bromide concentration measured by fluorescein or fluorescence excitation methods. We conclude that antipyrine potentially affects the measurement of bromide space by certain colorimetric methods. The mean values of previously published data do not appear to have been affected by the technical problems described in this study, although these problems may account, at least in part, for the large variability of the results. PMID- 2758580 TI - Microplate measurement of urinary albumin and creatinine. AB - We describe microplate methods for measurement of human urinary albumin (HUA) by competitive enzyme-linked immunosorbant assay (ELISA) and creatinine with a modified commercial enzymatic kit. Incorporation of substrate mixing into the competitive ELISA changes the dynamic absorbance-concentration response, greatly simplifying calculations and improving sensitivity and accuracy. Measurement of creatinine in urine and plasma samples with a commercially available enzymatic kit modified for analysis by use of an inexpensive microplate reader produced values comparable in precision and accuracy to those obtained by an automated kinetic Jaffe method. PMID- 2758581 TI - Prostatic inhibin-like peptide quantified in urine of prostatic cancer patients by enzyme-linked immunosorbent assay. AB - This is a highly specific enzyme-linked immunosorbent assay (ELISA) for measuring prostatic inhibin-like peptide (PIP) in urine, in which we use penicillinase (EC 3.5.2.6) conjugated with PIP and, as solid phase, a polystyrene microtiter plate. We used this ELISA to measure PIP in 24-h urine specimens from men with prostatic cancer (PCa) and from age-matched controls. For prostatic cancer patients the mean +/- SEM urinary PIP of 36.1 +/- 5 micrograms/24 h was significantly (P less than 0.001) lower than the mean of 127.1 +/- 9 micrograms/24 h for the age matched controls. PIP values for 30 samples measured by both ELISA and RIA correlated well (r = 0.985). We could detect as little as 1.56 ng of PIP in a sample. Analytical recovery of added PIP ranged from 91% to 104%. Mean CVs were 8.9% within-assay and 12.7% between-assay. We believe that this ELISA will be useful in assessing the status of PIP in men with normal and diseased prostates and in examining the function of the hypothalamus-pituitary-prostate axis. PMID- 2758582 TI - Creatine kinase and lactate dehydrogenase isoenzymes in serum and tissues of patients with stomach adenocarcinoma. AB - Total activities of creatine kinase (EC 2.7.3.2; CK) and lactate dehydrogenase (EC 1.1.1.27; LD) and their isoenzymes were estimated in serum and tissue samples from patients with stomach adenocarcinomas who were to undergo gastric resection. Total CK activity (U/g protein) appeared to be markedly decreased in neoplastic stomach tissue. CK-BB was the predominant isoenzyme in both neoplastic and normal stomach tissues; however, the CK-BB/total CK ratio was increased in adenocarcinoma tissue. Macro CK type 1 was found in two neoplastic tissues and macro CK type 2 in 11. LD4 and LD5 isoenzymes were predominant in gastric tissues, but LD5 and the LD5/LD1 ratio were higher in adenocarcinoma tissue. At 24 h before surgery, CK-BB was demonstrated in sera of all patients and CK-MB in 69%. The CK-BB probably originated from neoplastic stomach tissue, which contains high CK activity, with BB isoenzyme predominating. After gastrectomy, CK and LD isoenzymes in sera were markedly increased by 24 h postsurgery. These alterations were attributed to release from damaged tissue during gastric resection. PMID- 2758583 TI - Use of a dual-precipitation procedure for measuring high-density lipoprotein 3 (HDL3) in normolipidemic serum. AB - We compared results by a dual-precipitation method (J Lipid Res 1982;23:1206-23) for measuring high-density lipoprotein 3 (HDL3) cholesterol with those by ultracentrifugation at d 1.125, using 56 fresh and 105 frozen-stored serum samples. For both methods, HDL2-cholesterol was calculated as the difference between total HDL-cholesterol and HDL3-cholesterol. In general, for pooled serum samples, agreement was closest with ultracentrifugation when we used a dextran sulfate concentration of 5.0 mg/L to precipitate the HDL2-rich fraction, although the optimal concentration varied from 3.0 to 6.8 mg/L for different pools. For individual samples, the values for HDL3 by dual precipitation averaged 12.8% lower than by ultracentrifugation. The coefficients of correlation between the two methods were HDL3, r = 0.70; and HDL2, r = 0.92. The dual-precipitation method reflected the expected sex-related differences in HDL2-cholesterol concentration and inverse relationship with triglyceride concentration. PMID- 2758584 TI - Determination of branched-chain amino acids and tyrosine in serum of patients with various hepatic diseases, and its clinical usefulness. AB - We developed an automated enzymatic method for determination of the branched chain amino acids (BCAAs; valine, isoleucine, leucine) and tyrosine in serum, and applied it to the clinical evaluation of patients with various hepatic diseases. Analytically, the test results were acceptably precise and reproducible, and correlated well with results obtained with an amino acid analyzer. Clinically, we found that a decrease in BCAAs, an increase in tyrosine, and the BCAAs/tyrosine ratio in serum paralleled the severity of hepatic parenchymal damage. We conclude that this enzymatic determination of BCAAs and tyrosine is simple and convenient enough for routine clinical laboratory use, and that the ratio of BCAAs/tyrosine obtained may be a good indicator of the severity of hepatic disorders. PMID- 2758585 TI - Determination of magnesium in granulocytes. AB - Determination of magnesium in mononuclear blood cells may provide useful information about intracellular magnesium. Mononuclear blood cell preparations are frequently contaminated with granulocytes. We determined the normal reference interval for magnesium content and concentration of granulocytes and compared it with magnesium in mononuclear blood cells. The mean granulocyte magnesium concentration and content were 6.95 (SD 1.25) mmol/L and 3.11 (SD 0.54) fmol per cell, respectively, vs 10.95 (SD 1.70) mmol/L and 3.27 (SD 0.46) fmol per cell in mononuclear cells. The concentration of magnesium in granulocytes was significantly less (P less than 0.001) than in mononuclear blood cells, but the magnesium contents were not significantly different. PMID- 2758586 TI - The between-run component of variation in internal quality control. AB - Design of control charts for the mean, the within-run component of variance, and the ratio of between-run to within-run components of variance is outlined. The between-run component of variation is the main source of imprecision for analytes determined by an enzymo- or radioimmunoassay principle; accordingly, explicit control of this component is especially relevant for these types of analytes. Power curves for typical situations are presented. I also show that a between-run component of variation puts an upper limit on the achievable power towards systematic errors. Therefore, when the between-run component of variation exceeds the within-run component, use of no more than about four controls per run is reasonable at a given concentration. PMID- 2758587 TI - Influence of matrix on concentrations of somatotropin measured in serum with commercial immunoradiometric assays. AB - Using immunoradiometric assays (IRMAs) from Hybritech Inc. (H) and Nichols Institute Diagnostics (ND), we measured somatotropin (human growth hormone, hGH) in serum samples obtained every 20 min for 24 h from 10 prepubertal subjects with short stature. Results obtained with the ND reagents were 2.74 times greater than those obtained with the H reagents (P = 0.00001, r = 0.94, SEE = 3.9, n = 720). We therefore compared the IRMAs with the standard hGH RIA from the National Institutes of Health (NIH) National Hormone and Pituitary Program, using the genetically engineered hGH preparations (from Genentech Inc.) 22-kDa hGH and methionated 20-kDa hGH. We also assayed human pituitary hGH (NIH, lot no. AFP 4793B). Each hGH preparation was diluted in three diluent buffer systems: horse serum from H and from ND, and human serum. The RIA and H-IRMA gave superimposable standard curves for all hGH preparations in each diluent. The methionated 20-kDa hGH was not detected in the H-assay. Use of human serum matrix in the ND-IRMA shifted the standard curve as compared with the horse-serum matrix, giving equivalent binding at lower concentrations; i.e., serum hGH was overestimated in samples assayed against standards diluted in horse serum. Quality-control materials (Ciba-Corning) yielded disparate results in all three assays, yet human serum pools containing hGH gave similar results in the H and the NIH assays, and higher values in ND. When a human serum standard was used in the ND assay, both IRMAs gave similar results to the RIA assay for human serum samples. Reference intervals for hGH should be determined by each analytical laboratory, to prevent misdiagnosis of patients. Furthermore, quality-control material should be of human origin, because commercially supplied quality-control material does not react the same as human serum in some hGH assays. PMID- 2758588 TI - Alkaline phosphatase isoenzymes in plasma in hyperthyroidism. AB - Alkaline phosphatase (ALP; EC 3.1.3.1) isoenzymes were measured in the plasma of 63 untreated hyperthyroid patients (the hyperthyroid group), 58 treated hyperthyroid patients, and 100 blood donors. Total, liver, and bone ALP activities were significantly higher in the hyperthyroid group than in the treated hyperthyroid group or the blood donors. Bone ALP was more frequently and more markedly abnormal than liver ALP. Intestinal ALP did not differ significantly between the groups. The hyperthyroid patient group had significantly higher plasma calcium concentrations and lower serum parathyrin concentrations than those of the treated hyperthyroid group. PMID- 2758589 TI - Re-evaluation of the diagnostic utility of serum total creatine kinase and creatine kinase-2 in myocardial infarction. AB - The diagnostic utility of total creatine kinase activity (I), creatine kinase-2 isoenzyme activity (II), and II as a percentage of I, was examined by receiver operating characteristic curve and likelihood ratio (LR) analyses in 310 persons admitted to the Coronary Care Unit (151 proven cases of myocardial infarction and 159 non-myocardial infarction controls), from whom blood was sampled at 6-h intervals for 48 h after the onset of chest pain. I was ineffective either as a "rule-in" or as a "rule-out" test within the first 6 h of the onset of chest pain; thereafter, it was an effective test. II was the most effective test during the entire 48-h period. III was more effective than I in the first 24-h period, but was less effective than I during the next 24-h period. The decision threshold for high test sensitivities varies with time over the entire 48-h period, but remains constant for high test specificities. It is essential to tabulate the LR(+) and LR(-) values for both test sensitivity and specificity at constant values to determine the utility of each test at each time interval for respectively ruling out or ruling in a diagnosis of myocardial infarction. PMID- 2758590 TI - Cobalamin-binding capacity of haptocorrin and transcobalamin: age-correlated reference intervals and values from patients. AB - Unsaturated cobalamin-binding capacity in plasma (P-UBBC) is determined by use of a silica gel (QUSO G32) to separate haptocorrin (P-ApoHC) and transcobalamin (P ApoTC). The method is sensitive and precise: detection limit 13 pmol/L, interassay coefficients of variation 3% for P-UBBC (mean = 1080 pmol/L), 4% for P ApoTC (mean = 700 pmol/L) (n = 30). Values for P-UBBC, P-ApoHC, P-ApoTC, and P TBBC (P-UBBC plus P-cobalamin) determined in a population study of 228 individuals, ages 21-87 years, did not differ by sex. These values increased with age, whereas the cobalamin saturation (P-cobalamin as percentage of P-TBBC) decreased with age. However, these changes were statistically significant but marginal and thus not clinically important. We therefore suggest using combined reference intervals (central 95 percentiles) for all age groups: 500-1200 pmol/L for P-UBBC, 90-275 pmol/L for P-ApoHC, 400-930 pmol/L for P-ApoTC, 850-1600 pmol/L for P-TBBC, and 20-50% for cobalamin saturation. Results for 277 inpatients show high P-ApoHC in myeloproliferative disorders or acute nonlymphatic leukemia, whereas P-ApoTC concentrations are high in some patients with lymphoproliferative disorders or autoimmune diseases. PMID- 2758591 TI - Sensitive, rapid assay of subforms of creatine kinase MB in plasma. AB - The subforms of creatine kinase (CK; EC 2.7.3.2) in plasma have received recent attention as potential markers for the early diagnosis of acute myocardial infarction. Because changes in CK-MM subforms are not specific for myocardial injury, we developed an assay, based on high-voltage electrophoresis, that is sufficiently sensitive to detect the CK-MB subforms at concentrations substantially below the upper limit of normal (14 U/L). The assay can detect 1.25 U of either MB subform per liter with a precision of 0.20 U/L and gives responses that vary linearly with activity concentration from 0.0 through 30.0 U/L, with an identical signal response for both subforms. When both subforms are present in a serum sample, the assay accurately measures both the relative percentage and the absolute quantity of each: assay activity/known activity was 1.03 for each subform at a total MB subform activity of 5.0 U/L (r = 0.98). Assay time is 25 min, and there is no loss of CK during electrophoresis. Thus, this system can be used to rapidly, sensitively, and precisely quantify the two CK-MB subforms at activities well within the normal reference interval. PMID- 2758592 TI - Elimination of caffeine interference in HPLC determination of urinary nicotine and cotinine. AB - We report an analytical reversed-phase liquid-chromatographic procedure for quantifying nicotine and cotinine in urine, taking into account the presence of interfering caffeine frequently encountered in such specimens. These analytes are extracted from the alkalinized urine with chloroform. After evaporation of the chloroform, the residue is dissolved in methanol and injected into a chromatographic C18 column. Extraction recoveries averaged 80% to 97%. Chromatographic conditions were investigated to obviate caffeine interference. The proposed eluent mobile phase is a polar mixture of water, acetonitrile, methanol, and a pH 4 acetoacetate buffer (65/2/29/4 by vol) adjusted to pH 4.30 +/- 0.02 with triethylamine. High resolution and linearity were obtained for each analyte up to a concentration of 200 mg/L. The minimum detectable amount of each compound was 20 ng per injection, corresponding to 10 micrograms per liter of urine. Correlation with results of gas-liquid chromatography was excellent (r = 0.99). This simple, rapid procedure allows routine screening of tobacco exposure with acceptable precision: within- and between-run coefficients of variation were less than 2% and less than 5%, respectively. PMID- 2758593 TI - Urinary organic acid excretion by babies born before 33 weeks of gestation. AB - Using analytical procedures that are widely used by laboratories investigating metabolic disorders, we investigated urinary organic acid excretion by premature neonates who were receiving the usual clinical care. Our purpose was to provide a basis for the diagnosis of inherited organic acid defects. We analyzed 127 random (untimed) urine samples collected weekly from 22 infants of 25-32 weeks of gestation (median, 28 weeks). A wide variety of organic acids was excreted. After oximation, they were extracted with ethyl acetate and diethyl ether, derivatized to trimethylsilyl forms, and analyzed by gas-liquid chromatography on a nonpolar fused silica capillary column, with mass spectrometry for identification. Profiles for individual babies varied markedly on different occasions, reflecting their metabolic status and bacterial activity in the gut. There was no significant ketonuria. Three metabolites identified for the first time in urine from normal neonates were 2,3-butanediol, 3-hydroxy-2-butanone (acetoin), and 4 hydroxy-3-methoxyphenyllactic acid. Significantly increased excretion of 4 hydroxyphenyllactic acid and other phenolic acids occurred during parenteral feeding. PMID- 2758595 TI - Fluorometric determination of magnesium in serum with 2-hydroxy-1-naphthaldehyde salicyloylhydrazone. AB - This simple, rapid, sensitive fluorometric method for determining magnesium is based on formation of a fluorescent complex of magnesium with 2-hydroxy-1 naphthaldehyde salicyloyl-hydrazone in alkaline ethanolic medium (lambda ex = 420 nm, lambda em = 460 nm). The detection limit of the method is 0.05 microgram/L (2 nmol/L) and the relative standard deviations (CVs) are 0.8%, 1.1%, and 2.5% at magnesium concentrations of 50, 5.0, and 0.50 microgram/L, respectively. The standard curve is linear from 0 to 250 micrograms/L (0-10 mumol/L). We investigated the chemistry of the reaction, and have applied the method to determine magnesium in 100-fold-diluted, otherwise untreated serum samples. Within-run CVs for the method were 1.7%, 1.1%, and 1.3% at mean magnesium concentrations of 15.7, 26.4, and 36.2 mg/L, respectively. Day-to-day CVs were 2.7%, and 3.6% at mean magnesium concentrations of 10.1 and 25.5 mg/L, respectively. Samples from 96 hospitalized patients in intensive-care units were analyzed by the proposed method (y) and by an automated colorimetric method involving Magon sulfonate reagent (x). Linear regression analysis of the results yielded: y = 1.01x - 0.04 (r = 0.982, Sxy = 0.90). PMID- 2758594 TI - A rapid micro-scale procedure for determination of the total lipid profile. AB - We describe a one-day micro-scale procedure for determining the total lipid profile. Only 0.55 mL of plasma is needed for complete quantification of total cholesterol (TC), triglyceride (TG), and all lipoproteins. After precipitation with dextran sulfate and magnesium, the high-density lipoprotein (HDL) fraction was separated by centrifugation in an Eppendorf microcentrifuge. Very-low-density lipoprotein (VLDL) was separated from low-density lipoprotein (LDL) plus HDL in a Beckman TL 100 ultracentrifuge. TC, TG, and cholesterol in different lipoprotein fractions were measured enzymatically in a Baker "Encore II" automated analyzer. CVs, both within-day and day-to-day, were less than 3% for TG and TC, and less than 5% for HDL-C determinations. CVs for LDL-C and VLDL-C were less than 7.5% and 15%, respectively. Results by our micromethods (n = 66) agreed well with those by the conventional methods used at the Northwest Lipid Research Center, which are standardized against the Reference Methods of the Centers for Disease Control. Coefficients of correlation between the two methods were 0.98 for TC, 1.0 for TG, 0.98 for HDL-C, 0.94 for LDL-C, and 0.96 for VLDL-C. Results of electrophoresis on agarose gel and radioactivity-recovery studies indicate that our micro-centrifugation and slicing procedures result in clean separation of VLDL from other lipoproteins. PMID- 2758597 TI - Loss of porphyrins from solution during analysis: effect of sample pH and matrix on porphyrin quantification in urine by "high-performance" liquid chromatography. AB - We report the effect of sample matrix and pH on quantification of porphyrins by HPLC with fluorimetric detection. For aqueous solutions of pH less than 2.5, HPLC peak heights of the porphyrins increased with decreasing pH, reaching a plateau at pH less than 1.0. This loss of porphyrins from solutions with pH greater than 1.0 appeared to be due to a combination of microprecipitation and aggregation effects. No such "pH effect" was observed for urine samples supplemented with mixed-porphyrin standards. Addition of trace amounts of albumin to aqueous solutions also decreased these pH-related losses. These findings suggest a porphyrin-protein interaction that prevents microprecipitation and aggregation processes. We conclude that standard solutions of porphyrins for HPLC analysis should be prepared in a urine matrix. If aqueous solutions are used, then the pH must be adjusted to less than 1.0. Urine samples from normal individuals require only adjustment of pH to less than 2 before analysis; however, porphyric urines requiring dilution should be prepared with porphyrin-free urine diluent. PMID- 2758596 TI - Radioimmunoassay of beta-microseminoprotein, a prostatic-secreted protein present in sera of both men and women. AB - We describe a simple radioimmunoassay of beta-microseminoprotein, one of the three most abundant secretory proteins of the prostate gland. The detection limit of the assay is 1 microgram/L, and its precision, expressed as the total coefficient of variation, is less than 10% for values between 10 and 150 micrograms/L. Using this assay, we found that beta-microseminoprotein immunoreactivity was present in sera from both sexes at about the same concentration. The protein detected had the same molecular size on gel chromatography as the protein isolated from seminal plasma, and dilution curves for the sera paralleled that for the pure protein. The findings suggest that beta microseminoprotein is present in serum of healthy subjects of both sexes and that it originates in tissue other than the prostate gland. The range of the serum concentration was 0-10.6 micrograms/L (median 4.1) for 51 healthy adult women and 1.1-14.7 micrograms/L (median 6.2) for 35 healthy adult men not older than 40 years. In males with prostatic cancer the concentration in serum was highly variable and often greatly increased. The concentration of beta microseminoprotein was correlated with that of creatinine in serum, suggesting that the protein is eliminated--at least partly--from the circulation by glomerular filtration. Little of the protein was present in the urine of women. In urine from men the concentration was high and variable, probably because of local contribution from the prostate gland to the urethral urine. PMID- 2758598 TI - Evaluation of the biotinylated (Blugene) vs 32P-labeled cDNA probes of beta glucocerebrosidase: relative sensitivities in genomic and other systems. AB - The sensitivity, rapidity, and ease of use of biotinylated (Blugene, Bethesda Research Laboratories) and 32P cDNA probes have been compared, the probe being the cDNA for beta-glucocerebrosidase (EC 3.1.2.45). With the Blugene kit I could detect 2 pg of biotinylated DNA on dot blots. However, under conditions of hybridization, the lower limit of detection for unlabeled cDNA (transblotted onto nitrocellulose) by its labeled counterpart was 5000-fold smaller (10 pg vs 50 ng) for the isotopically labeled probe. 32P- and Blugene-probes hybridized detectably with 0.5 and 10 micrograms, respectively, of transblotted EcoR 1-digested genomic DNA, making the radioactive method 20 times as sensitive. However, color development was complete within 30 min to 3 h, whereas radioautoradiography required 12 h to one week. Blugene was also safer, easy to use, and effective under appropriate conditions. The 32P method is expensive, hazardous, time consuming, and technically difficult. This nonisotopic procedure represents a desirable improvement in biotechnology. PMID- 2758599 TI - Electrothermal atomic absorption spectrometric determination of aluminum: elimination of serum matrix effects. AB - An improved electrothermal atomic absorption spectrometric method for determination of aluminum in serum is described. An ammonium hydroxide/sulfuric acid diluent is used to control matrix effects from serum constituents. Because serum produces no apparent matrix effects with this diluent, one can accurately calibrate the procedure with aqueous standards. PMID- 2758600 TI - Effect of lyophilization on results of five enzymatic methods for cholesterol. AB - We studied the effect of lyophilization of serum pools on the determination of cholesterol with the enzymatic methods used in five automated analyzers: SMAC (Technicon), the RA-1000 (Technicon), the aca (Du Pont), the TDx (Abbott), and the Ektachem 700P (Kodak). We prepared two serum pools: pool A (2.2 g/L) and pool B (1.9 g/L). We separated each pool into three groups for treatment by lyophilizing or freezing at -20 and -70 degrees C. We determined cholesterol by the above methods at regular intervals during the next 270 days. For all methods, the measured concentration of cholesterol was less for the lyophilized serum than for frozen (P less than 0.007 by the paired-sample t-test). After adjusting for the dilutional effects of reconstitution, the decrease in original value was 0.7% for the SMAC, 1.7% for the RA-1000, 5.7% for the Ektachem, 9.4% for the TDx, and 14.3% for the aca. Lyophilization of cholesterol standards or serum samples may hamper the effective standardization of enzymatic methods and may be a source of apparent inaccuracy (bias) among enzymatic methods. PMID- 2758601 TI - Multipoint kinetic method for simultaneously measuring the combined concentrations of acetoacetate-beta-hydroxybutyrate and lactate-pyruvate. AB - This is a multipoint kinetic method for simultaneously determining acetoacetate (AcAc) plus beta-hydroxybutyrate and lactate plus pyruvate in a single cuvette of the Multistat III centrifugal analyzer. In the first step, AcAc and pyruvate are completely reduced, using 3-hydroxybutyrate dehydrogenase (EC 1.1.1.30) and lactate dehydrogenase (EC 1.1.1.27) in the presence of excess NADH at pH 7.5, to beta-hydroxybutyrate and lactate, respectively. After dilution, the endogenous beta-hydroxybutyrate and lactate and that resulting from reduction are simultaneously oxidized by their respective dehydrogenases in the presence of excess NAD+ at pH 9.0. Adjustment of the relative enzyme concentrations allows simultaneous estimation of AcAc plus beta-hydroxybutyrate and lactate plus pyruvate by analyzing multipoint absorbance data, collected during the oxidation reaction, with use of a two-component linear-regression model. Total run-to-run CVs were 6.4% and 6.1% at 5 mmol/L beta-hydroxybutyrate and 5 mmol/L lactate, respectively. The method was designed to be useful for identifying the cause of an increased anion gap in serum. PMID- 2758602 TI - Two whole-blood multi-analyte analyzers evaluated. AB - We evaluated two multi-analyte analyzers, the NOVA Stat Profile 1 (SP 1) and the NOVA Stat Profile 5 (SP 5). The SP 1 measures pH, pCO2, pO2, sodium, potassium, ionized calcium, and hematocrit in heparinized whole blood; the SP 5 determines all these analytes, plus chloride (not evaluated because it was unavailable at the time this study was initiated) and glucose. Interassay precision for pH, pCO2, pO2, sodium, potassium, ionized calcium, and hematocrit (all on the SP 1) and glucose (on the SP 5) was excellent, the respective CVs (%) being: less than 0.006, 2.1, less than or equal to 3.0, less than or equal to 0.5, less than or equal to 1.7, less than or equal to 2.1, less than or equal to 3.9, and less than or equal to 1.2. Correlation with results obtained with Corning's Model 178, NOVA Biomedical's Model 6, Beckman's Astra 8, and Roche's Cobas-Bio was also excellent (r greater than 0.975 for all analytes, r for hematocrit 0.865). Temperature stability studies on whole-blood specimens maintained at 1 degree C indicated that results for all measured analytes were essentially uncharged for at least 2 h, except for potassium, which increased by 13% in 2 h. At 22 degrees C, values for pH, pCO2, pO2, and glucose changed significantly within 2 h. Advantages of the NOVA Stat Profile series include decreased specimen requirements (250 microL), analysis time (72-90 s), turnaround time (about 4.5 min), and overall cost of operation. PMID- 2758603 TI - Evaluation of Gilford chemistry control interference with the chloride method in the Beckman Synchron CX3 System analyzer: cumulative effect of bromide on chloride results. PMID- 2758604 TI - Enzymic measurement of total bile acids adapted to the Cobas Fara centrifugal analyzer. PMID- 2758605 TI - Increased laminin concentrations in serum in hyperthyroidism. PMID- 2758606 TI - Wako UV colorimetric pancreatic lipase assay with 1,2-dilinoleoylglycerol as substrate evaluated. PMID- 2758607 TI - Effect of oral citrate on calcium absorption after an oral load of calcium phosphate. PMID- 2758608 TI - False-positive urine amphetamine screen with ritodrine. PMID- 2758609 TI - Interference with measurement of intact parathyrin in serum from renal dialysis patients. PMID- 2758610 TI - Intra-individual variation of the electrophoretic serum protein fractions. PMID- 2758611 TI - Three nonisotopic methods for human choriogonadotropin evaluated. PMID- 2758612 TI - Rhabdomyolysis in a case of free-base cocaine ("crack") overdose. AB - This is the case of a 27-year-old black man who was admitted to Loyola University Medical Center after a one-time experience of smoking free-base ("crack") cocaine. Clinical manifestations of the resulting cocaine intoxication were rhabdomyolysis, acute renal failure, and transient liver failure. This patient came to our attention because of the striking alterations in his blood-chemistry values, which indicated acute tissue damage, and his remarkable recovery within 96 h. We discuss the dramatic changes in the laboratory findings and the clinical course of this patient. PMID- 2758613 TI - Bence Jones proteins in the urine of patients with multiple sclerosis. PMID- 2758614 TI - Calibration problems with the 125I immunoassay for measuring cyclosporin A. PMID- 2758615 TI - Effect of measurement wavelength on fructosamine results. PMID- 2758616 TI - Standardization of nomenclature in clinical chemistry. PMID- 2758617 TI - Acceptable analytical error: a different opinion. PMID- 2758618 TI - Serum separator tube problems in Hitachi 736/737 analyzers. PMID- 2758619 TI - Reliable measurement of circulating immune complex depends on stable, accurate reference material. PMID- 2758620 TI - The "Fecatwin Sensitive" test for fecal occult blood is not intended for use without testing positives with the FECA-EIA assay. PMID- 2758621 TI - Fructosamine and IgA: no correlation in non-diabetics. PMID- 2758622 TI - Effect of substrate concentration on erythrocyte transketolase assay. PMID- 2758623 TI - High prevalence of atrophic gastritis in the elderly: implications for health associated reference limits for cobalamin in serum. PMID- 2758624 TI - Measurement of magnesium in mononuclear blood cells. PMID- 2758625 TI - Microalbuminuria in diabetes mellitus: more on urine storage and accuracy of colorimetric assays. PMID- 2758626 TI - Serum and plasma compared for use in 19 common chemical tests performed in the Hitachi 737 analyzer. PMID- 2758627 TI - Investigation of protoporphyrin IX standard materials used in acid-extraction methods, and a proposed correction for the millimolar absorptivity of protoporphyrin IX. AB - Erythrocyte protoporphyrin (EP) has been used for more than 30 years as an indicator of lead intoxication, iron deficiency, and porphyrias. Recently, numerous analytical problems associated with various EP methods have been reported, including a lack of consensus among investigators regarding the best calibration material or analytical procedure. We investigated commercially available protoporphyrin IX (PPIX) standard materials and measured the millimolar absorptivity (m epsilon) of these materials, focusing on variables affecting the determination of their absorptivities. Among the five forms of PPIX available, PPIX dimethyl ester, when hydrolyzed to PPIX free acid, gave the most consistent and reproducible results. This work confirmed our earlier observations, made on more than 600 separate occasions during 12 years, that the m epsilon of PPIX free acid in 1.5 mol/L HCl at the Soret maximum is 297 +/- 1.3 L.mmol-1.cm-1, 19% higher than the arbitrary value of 241 L.mmol-1.cm-1 generally accepted by most investigators but based on unpublished data. We propose that the m epsilon of 297 L.mmol-1.cm-1 for PPIX be adopted and that PPIX dimethyl ester be used for the calibration of acid-extraction methods. A detailed protocol for the preparation and verification of PPIX from the dimethyl ester is available upon request. PMID- 2758628 TI - Radioimmunoassay of testosterone not bound to sex-steroid-binding protein in plasma. AB - To measure the concentration of testosterone (T) that is not bound to sex-steroid binding protein (SBP) in plasma, we quantified by radioimmunoassay the T in the supernates of plasma samples after precipitation with 50%-saturated ammonium sulfate. The concentrations of non-SBP-bound T. directly measured with this assay, correlated significantly (P less than 0.001) with those deduced from measurement of the percentage of non-SBP-bound T determined with [3H]T as tracer or from mathematical models according to the law of mass action. It also correlated significantly with the ratio of T to SBP and with the concentration of nonbound T. As determined with this assay, the mean concentration of non-SBP bound T in normal men was higher in young (4.67, SD 2.68 nmol/L; n = 30) than in older (greater than 40 years) subjects (2.48, SD 1.61 nmol/L; n = 35; P less than 0.001) and lower than normal in hyperthyroid (1.61, SD 0.91 nmol/L; P less than 0.01) or infertile men (3.28, SD 1.70 nmol/L; P less than 0.01). In women, non SBP-bound T was higher in hirsute patients (0.24, SD 0.11 nmol/L; P less than 0.01) and was lower during pregnancy (0.09, SD 0.05 nmol/L; P less than 0.05) than in normal women during the follicular phase (0.16, SD 0.07 nmol/L). We conclude that this direct measurement of non-SBP-bound T in plasma is suitable for routine use and represents a reliable index of androgenicity in human pathology, particularly when alterations of the binding capacity of SBP modify the concentrations of total T. PMID- 2758629 TI - Simultaneous liquid-chromatographic determination of some bronchodilators, anticonvulsants, chloramphenicol, and hypnotic agents, with Chromosorb P columns used for sample preparation. AB - We describe a simple liquid-chromatographic system for simultaneously measuring bronchodilators, anticonvulsants, hypnotics, and chloramphenicol. Use in therapeutic drug monitoring includes determination of theophylline, caffeine, chloramphenicol, ethosuximide, primidone, phenobarbital, phenacemide, phenytoin, mephenytoin, nirvanol, and carbamazepine and its bioactive metabolites within 13 min. In the "toxicology mode" theophylline, caffeine, barbital, butabarbital, pentobarbital, amobarbital, secobarbital, primidone, phenobarbital, methylprylon, glutethimide, methaqualone, phenytoin, mephenytoin, nirvanol, and carbamazepine and its bioactive metabolites are resolved within 17 min. A reversed-phase C8 column (5-microns particles) is used, with acetonitrile/water (20/80 by vol) as mobile phase. The drugs are extracted from 50 microL of serum with use of a Chromosorb P microcolumn and chloroform/isopropanol (6/1 by vol). The drugs are quantified by absorbance at 208 nm, with tolylphenobarbital as internal standard. Lower limits of detection varied from 0.05 to 0.1 mg/L, analytical recovery from 94% to 106%; CVs were less than 5.6% within run, less than 6.9% between runs. PMID- 2758630 TI - Quantification of urinary porphyrins by liquid chromatography after oxidation of porphyrinogens. AB - A quantitative "high-performance" liquid-chromatographic method is described for determining porphyrins in human urine. Porphyrinogens in urine are first converted to the corresponding porphyrins by oxidation with iodine. Uroporphyrin, hepatacarboxylic acid porphyrin, hexacarboxylic acid porphyrin, pentacarboxylic acid porphyrin, and coproporphyrin I and III isomers are then separated on a reversed-phase column and measured by fluorometry. Analysis for the six porphyrins is complete within 24 min, including reconditioning for the next sample. The detection limit (twice the signal/noise ratio) for each porphyrin was 1 nmol/L for urine (25 fmol per 50-microL injection). Mean analytical recovery of each porphyrin ranged from 85% to 91%, within-day CVs from 1.4% to 7.3%. Normal reference intervals for porphyrins were established by assaying urine samples from 75 healthy subjects. Significant sex-related differences in coproporphyrin I and III isomers were evident when the values were expressed as nanomoles per gram of creatinine. Coproporphyrin isomer ratio was estimated for utility in the diagnosis of porphyrinurias. PMID- 2758631 TI - Practical automation and interpretation of quantitative assays of antibodies to therapeutic proteins, illustrated with human growth hormone. AB - To quantify concentrations of anti-growth hormone antibody in less than 600 serum samples by radioimmunoassay, we devised a system ("BOLAC") to process data and to execute the curve-fitting program LIGAND-PC automatically with an IBM PC compatible computer. We fit data from each sample to four binding and one or two antibody binding sites. Total antibody concentration is then calculated from the model that is statistically "best". This process occasionally selects a two binding-site model that severely overestimates the antibody concentration. Errors of this kind are discarded by constraining the product of the second-site antibody's affinity and its concentration to exceed a minimum value (0.05). We evaluated the performance of the BOLAC system by assaying controls and by using computer simulations to demonstrate the high confidence levels attainable in estimation of antibody concentrations. Between-assay variability (CV) was less than 25%, and analytical recovery exceeded 90%. These figures are acceptable for an assay based on curve-fitting of competitive radioimmunoassay data, allowing clinically relevant assessments of antibody responses in patient's samples. The advantages of the BOLAC system include high throughput and the reporting of results in absolute units of affinities and concentrations. PMID- 2758632 TI - Aberrant lectin-binding activity of immunoglobulin G in serum from rheumatoid arthritis patients. AB - Structural studies of oligosaccharide chains of immunoglobulin G (IgG) in serum have revealed a specific galactosylation deficiency associated with rheumatoid arthritis (RA). Using a two-site lectin-immunofluorometric assay, I studied the interaction of IgG with immobilized lectins. Compared with control IgG, IgG purified from RA patients' sera bound up to 40-fold more strongly to immobilized Bandeiraea simplicifolia agglutinin II, a lectin that specifically binds agalacto forms of other glycoproteins. However, inhibition studies and treatment of IgG with glycosidase suggested that only a minor part of this binding was mediated by agalacto oligosaccharides of IgG. Furthermore, these IgG samples bound even more intensively to some other immobilized lectins, including Ricinus communis agglutinin (RCA). The binding to RCA was not inhibited by lactose, a hapten sugar of RCA, whereas other lectin species in solution effectively inhibited it. Compared with intact RA IgG, isolated F(ab')2 fragments displayed only low RCA binding activity. These results indicate the existence of a carbohydrate nondependent interaction between RA IgG and different plant lectins. With use of immobilized RCA, the lectin-immunofluorometric assay was rapid and reproducible for measuring the aberrant lectin-binding activity of IgG directly in diluted serum samples. PMID- 2758633 TI - Implications of probability analysis for interpreting results of leukocyte esterase and nitrite test strips. AB - We examined 288 urine samples, using test strips, sediment microscopy, and culture. The ability of the leukocyte esterase and nitrite test strips to detect or exclude urinary tract infection, as defined by a positive culture, was evaluated by probability analysis. We found that the diagnostic efficiency of the esterase-nitrite combination was similar to that of sediment microscopy. Moreover, once the strip test results had been obtained, little additional information was given by microscopy. The importance of estimating the prevalence, or pre-test probability, of infection before the test result is evaluated is emphasized. We conclude that, for detecting or excluding urinary-tract infection, microscopy can be replaced by the esterase and nitrite test strips. If the probability of infection predicted by the test strips is not high (or low) enough compared with medical decision limits, the samples should be cultured. PMID- 2758634 TI - Urinary excretion of transferrin by non-insulin-dependent diabetics: a marker for early complications? AB - We measured concentrations of transferrin (TRF, in micrograms), and creatinine (Cr, in millimoles) in samples of untimed urine from 53 healthy subjects and 157 non-insulin-dependent diabetic (NIDD) subjects. The urinary TRF/Cr ratio was significantly higher in the NIDD group (P less than 0.001). If NIDD subjects are grouped according to their Alb/Cr ratio into normal albuminuria (Group A, Alb/Cr less than 2.5 mg/mmol), microalbuminuria (Group B, Alb/Cr 2.5-26.8 mg/mmol), and macroalbuminuria (Group C, Alb/Cr greater than 26.8 mg/mmol), the TRF/Cr ratios in all three groups exceeded those for healthy controls. Moreover, this ratio was higher in Group B than in Group A and higher in Group C than in Group B. The value for TRF/Cr was clearly abnormal (i.e., exceeded the 95th percentile value found in healthy subjects) in 61%, 95%, and 100% of Group A, B, and C subjects, respectively. The TRF/Cr ratio was significantly higher in those NIDD subjects with clinical retinopathy, and it correlated with arterial pressure. Evidently, TRF/Cr may be increased early in NIDD subjects, and it may be a sensitive marker for detecting development of complications of diabetes. PMID- 2758635 TI - Decreased immunoreactivity and binding activity of corticosteroid-binding globulin in serum in septic shock. AB - To investigate the mechanism(s) responsible for the depletion of corticosteroid binding globulin (CBG) activity in serum in septic shock, we developed a radioimmunoassay (RIA) for human CBG, using a monospecific antiserum to human CBG raised in rabbits. CBG was purified from pooled human serum by precipitation with ammonium sulfate and successive affinity chromatography treatments on corticosterone-Sepharose and concanavalin A-Sepharose. Final purification was achieved by HPLC on a diethylaminoethyl-PW (polymer matrix) ion-exchange column. Typical standard curves established for the CBG immunoassay showed parallelism for pure CBG and serial dilutions of sera from patients with septic or nonseptic shock and from healthy controls. Measurements of CBG by RIA showed a significantly (P less than 0.001) lower CBG concentration in patients with septic shock (22.9 +/- 5.9 mg/L, mean +/- SD; n = 23) than in controls (39.9 +/- 6.5 mg/L, n = 21) or in patients with nonseptic shock (33.3 +/- 6.5 mg/L, n = 12). The correlation between the concentrations determined by RIA and the CBG binding capacity was significant (r = 0.619, P less than 0.001, n = 33). The electrophoretic mobility of CBG was similar in sera from septic shock patients and normal subjects (Rf = 0.52-0.56). This suggests that the depletion of the corticosteroid-binding activity in serum during septic shock is associated with a decreased amount of CBG. PMID- 2758636 TI - Estimation of true values in radioimmunoassays. AB - We tested the accuracy of radioimmunoassays for two hormones, progesterone and estradiol, in relation to the use of two different antisera in each assay and to the degree of purification from plasma before the assay was done. Each analyte was assayed either in a diethyl ether extract, in a zone eluted from a Sephadex LH-20 chromatographic column, or in fractions of a chromatographic zone (from Sephadex LH-20 or Celite) that passed a test of "radiochemical purity." Statistically indistinguishable results were obtained in the assay of radiochemically pure fractions of both analytes, irrespective of the antiserum used. In addition, one of the antisera from each hormone gave equivalent results in the radioimmunoassay of ether extracts, even with no preceding chromatography. We demonstrated in this way that results obtained with use of highly specific antisera may, after a single chromatography, but even without any chromatographic purification, be as nearly accurate and as closely reflect the true value as those obtained in the assay of radiochemically pure hormones, an assay that has a character of a reference method (as defined by the IFCC). PMID- 2758637 TI - Lipase activity measured in serum by a continuous-monitoring pH-Stat technique- an update. AB - Using recent knowledge regarding the roles of colipase, bile acids, Ca2+, and emulsifiers, we optimized a previously published pH-Stat method for lipase (EC 3.1.1.3) activity measurements. The recommended assay conditions are: olive oil/triolein, 100 mL/L; sodium glycocholate, 35 mmol/L; Ca2+, 8.5 mmol/L; and colipase, 6.0 mg/L. The sample volume is 0.10 mL, the reaction pH 9.0, the temperature 30 degrees C, and the concentration of titrant 15 mmol/L. Hydroxypropyl methylcellulose, 20 g/L, replaces acacia as emulsifier to avoid inhibition by excess Ca2+. The standard curve is linear to greater than 4566 U/L. The reference interval with olive oil as substrate is 30-235 U/L. Lipase activities with triolein substrate are 9.9% greater than with olive oil. Interference by pancreatic carboxylesterase (EC 3.1.1.1) activity is inhibited by incubating the sample with diisopropylfluorophosphate. Results correlate well with those by the optimized SingleVial method of Boehringer Mannheim Diagnostics (r = 0.997) and the immunochemical assay of Beckman Instruments, Inc. (r = 0.995). Correlation with the aca method (E.I. DuPont de Nemours & Company) is less satisfactory (r = 0.892), probably owing to lack of colipase in the latter method. PMID- 2758638 TI - Simple, sensitive assay of polyamines by high-performance liquid chromatography with electrochemical detection after post-column reaction with immobilized polyamine oxidase. AB - This simple, rapid liquid-chromatographic assay of urinary polyamines (putrescine, spermidine, spermine, and cadaverine) involves electrochemical detection with a post-column immobilized enzyme, polyamine oxidase (EC 1.4.3.6) from soybean seedlings. Polyamines are separated by isocratic ion-pairing reversed-phase chromatography, then enzymatically converted, with release of hydrogen peroxide, via the post-column reactor with immobilized polyamine oxidase; the hydrogen peroxide is detected by electrochemical oxidation on a platinum electrode. The detection limits for injected putrescine, spermidine, and spermine were 0.3, 0.5, 0.6, and 4 pmol, respectively, with linear ranges of two to three orders of magnitude. Reproducibility was also good, with CV values less than 7%. The efficiency of the immobilized enzyme column was not decreased after analysis of 300 urine samples. Putrescine and spermidine excretion in urine from patients with blood cancers and solid cancers was significantly increased. PMID- 2758639 TI - Sources of imprecision in laboratories screening for congenital hypothyroidism: analysis of nine years of performance data. AB - We evaluated sources of imprecision in screening assays for congenital hypothyroidism performed between 1979 and 1987 by more than 45 laboratories participating in the national Neonatal Screening Standardization Program offered by the Centers for Disease Control. Reported concentrations were available from approximately 70,000 enriched dried-blood spot samples for thyroxin and thyrotropin, the primary and secondary screening assays, respectively. The most important sources of variation in assayed concentrations are within-laboratory imprecision and the methods or kits used. The importance of each of these sources depends on the analyte and its concentration. In most cases, the greatest source of measurement variation is attributable to within-laboratory imprecision (coefficient of variation 13% to 26%); however, kits are the largest source of variation at the lower concentrations of thyroxin. For both analytes, the greatest relative imprecision occurred at the low concentration, which was within the critical range of the cutoff values for detection of presumptive positive specimens. Imprecision in this range increases the risk of misclassifications. Minimizing within-laboratory imprecision and differences among kits seems to be the best way to improve overall efficiency of screening laboratories. PMID- 2758640 TI - A 125I-radioimmunoassay for measuring androstenedione in serum and in blood-spot samples from neonates. AB - We developed a radioimmunoassay with a gamma-emitting radioligand to measure androstenedione in human serum and in dried blood-spot samples from newborns. Antisera were raised in rabbits against androstenedione linked to bovine serum albumin at positions 3, 6, or 11 on the steroid nucleus. Radioligands were prepared by linking [125I]iodohistamine at positions 3, 6, or 11. Linkages were through either carboxymethyloxime or hemisuccinate bridges. All label and antibody combinations were examined, and the most sensitive and specific combination (antiserum raised against androstenedione-3-carboxymethyloxime-bovine serum albumin with an androstenedione-carboxymethyloxime-[125I]iodohistamine label) was selected for full evaluation. We report the performance of these selected reagents in an immunoassay for androstenedione in both serum and dried blood-spot samples from neonates. We measured concentrations of androstenedione in serum under normal and pathological conditions such as congenital adrenal hyperplasia and polycystic ovarian disease. Diurnal variation in normal men was observed. Androstenedione was measured in blood spots from neonates born at term or prematurely, with respiratory distress syndrome, or with congenital adrenal hyperplasia. PMID- 2758641 TI - Myoglobinuria, hemoglobinuria, and acute renal failure. PMID- 2758642 TI - Accuracy and precision of analyses for total cholesterol as measured with the Reflotron cholesterol method. AB - We compared plasma cholesterol measurements made with the Boehringer Mannheim Reflotron reflectance photometric analyzer in 1298 capillary blood samples with measurements made in venous blood samples collected at the same time and analyzed in four standardized Lipid Research Clinics laboratories. The Reflotron measurements averaged 0.8% to 7.8% lower than the laboratory values. Correlations (r) between the two sets of measurements ranged from 0.92 to 0.96. In some samples, however, the Reflotron values differed from the laboratory values by greater than or equal to 12%; the cholesterol concentrations in these samples tended to be higher than in those for which better agreement was observed. The smaller negative biases were observed when test strips were used that were calibrated with reference to the Centers for Disease Control Reference Method for cholesterol. The agreement between sequential Reflotron values averaged less than or equal to 4.3%. There was an average difference of less than or equal to 1.0% between Reflotron measurements made in each of two sequential capillary blood samples taken from a single finger puncture. PMID- 2758643 TI - "Stat" measurements of L-lactate in whole blood and cerebrospinal fluid assessed. AB - A first-generation semi-automatic amperometric lactate analyzer (Yellow Springs Instrument Co.) was assessed for urgent ("stat"), rapid laboratory measurements in whole blood and cerebrospinal fluid. For whole blood, measured lactate concentration and hematocrit were linearly correlated. An improved equation is presented for estimating the concentration of lactate in plasma from measurements in whole blood. The 95% reference range for the concentration of lactate in paired samples of capillary and venous whole blood from 40 healthy laboratory adults was found to be 0.4-1.5 mmol/L and 0.3-1.5 mmol/L, respectively. The 95% ranges for lactate in whole blood from 24 uncomplicated vaginal deliveries at term were established for cord venous blood, 1.2-5.0 mmol/L; cord arterial blood, 1.6-5.5 mmol/L; and maternal venous blood, 1.7-6.6 mmol/L. The 95% paired ranges were established for 20 lumbar-anaesthetized urological patients without neurological disorders after induction of anaesthesia for venous whole blood and cerebrospinal fluid (venous blood, 0.5-1.3 mmol/L; cerebrospinal fluid, 1.1-2.4 mmol/L). PMID- 2758644 TI - Murine monoclonal antibody adsorbed onto vinylidene fluoride floccules used to eliminate antibody interference in "sandwich"-type immunoassays. AB - We have previously reported that human anti-mouse IgG antibody (HAMA) can cause false-positive and false-negative results in "sandwich"-type monoclonal antibody (MAb) assays. To eliminate HAMA interference in "sandwich"-type MAb assays, we investigated the use of MAb on solid-phase, vinylidene fluoride floccules, which we have previously used as a solid-phase second antibody for RIA. The simple procedure effectively removes greater than 95% of HAMA from the most positive serum we have obtained from patients hyperimmunized to murine MAb, and it allows for accurate quantification of carcinoembryonic antigen. The solid-phase complex, added to blood, effectively removes HAMA and (or) "HAMA-type" heterophilic antibody from the sera or plasma. PMID- 2758645 TI - Radioimmunoassay of 5-methoxytryptophol in plasma. AB - 5-Methoxytryptophol (ML) is synthesized by the pineal gland, but no radioimmunoassay has been described for its routine measurement in human plasma. We have developed and validated such an RIA. The assay is sensitive (detecting as little as 8 ng/L) and specific, and requires no extraction stage. A preliminary study of healthy volunteers showed an intra-individual variation in plasma ML that was independent of the sex of the subject and the time of daytime collection. Investigation of the 24-h pattern of ML in seven men revealed a low amplitude daily rhythm (P less than 0.03). Mean concentrations of ML between noon and midnight significantly exceeded those between 0030 and 1130 hours in each individual (P less than 0.05). This assay is practical and convenient, and it should greatly assist in investigation of factors affecting concentrations of ML in human plasma. PMID- 2758646 TI - Role of rapid immunoassays for urgent ("stat") determinations of creatine kinase isoenyme MB. AB - We compared the analytical performance of three immunoassays used to rapidly determine creatine kinase (EC 2.7.3.2; CK) isoenzyme MB in serum: Dade's "Stratus," Corning's "Magic Lite," and Hybritech's "Icon QSR CK-MB." Performance criteria included precision, analytical sensitivity, sample stability, and analytical and clinical correlation of results for serum samples taken from healthy individuals, patients with suspected and confirmed acute myocardial infarction, and patients after coronary artery bypass surgery. We also examined 31 samples taken from patients in the emergency room suspected of myocardial infarction, to evaluate the potential of these assays for early diagnosis. Although these assays differ in the manner in which CK-MB is measured, and therefore have different procedural requirements, we conclude that they are equivalent in overall assay performance. None of these assays, however, is sufficiently sensitive for early diagnosis of myocardial infarction; therefore, results cannot be used by cardiologists in deciding whether acute thrombolytic therapy should be given. Other management decisions, such as the optimal utilization of intensive-care bed space, may justify using these assays on a "stat" basis. PMID- 2758647 TI - Alterations in lactate dehydrogenase isoenzyme patterns after therapy with streptokinase or streptococcal infection. AB - Serum samples from patients receiving intravenous streptokinase were examined for evidence of interaction in vivo between streptokinase and lactate dehydrogenase (EC 1.1.1.27; LD). We found that this treatment produced a band of LD activity that remained at the electrophoretic origin of LD isoenzyme analysis. Treatment with tissue plasminogen activator produced no such band. The streptokinase-LD complex could be removed from serum by ultracentrifugation. It remained in the circulation for as long as 48 h after streptokinase infusion. A similar phenomenon was observed in a case of pneumococcal sepsis. Examination of supernates from both cultures of several species of Gram-positive cocci revealed interactions between human LD and Streptococcus groups A and C and also Streptococcus pneumoniae. Evidently streptokinase can form complexes with LD in vivo after either streptokinase therapy or infection, with consequent alteration of the LD isoenzyme pattern. PMID- 2758648 TI - Estimation of reference intervals for total protein in cerebrospinal fluid. AB - Protein in cerebrospinal fluid (CSF) was measured by a modified biuret procedure and in two automated instruments, the Du Pont aca and the Kodak Ektachem. The latter's dry-slide reagent was also evaluated for precision, linearity, and effect of potential interferents. In vitro, ampicillin and vancomycin increase the apparent value for CSF protein as measured with the Ektachem slides. We excluded patients with disorders of the central nervous system, and we estimated the central 95% percentile reference intervals for CSF protein for each of the three methods. We found no age or gender dependence of values. By the biuret procedure, the reference interval is 140 to 620 mg/L. PMID- 2758649 TI - Enzyme-linked immunosorbent assay for free thyroxin in human serum. AB - We describe a simple enzyme-linked immunosorbent assay (ELISA) in which microtiter plates are used for determining the free thyroxin concentration (FT4) in serum. Only commercially available chemicals and reagents are needed, including the antiserum. The working range is 1 to 60 ng/L. Turnaround time is about 4 h. Within-run coefficients of variation (CV) for FT4 concentrations of 9.0, 19.0, and 35.0 ng/L were less than 5%; between-run CVs were 10% to 11%. Results by a radioimmunoassay method for 150 sera correlated well (r = 0.922). PMID- 2758650 TI - Nitromethane interferes in assay of creatinine by the Jaffe reaction. AB - A patient who ingested a methanol/nitromethane mixture (model airplane fuel) showed an apparent plasma creatinine concentration of 8.0 mmol/L by the Jaffe reaction when the actual creatinine concentration, as measured by a specific enzymatic method, was 0.09 mmol/L. This effect was due to nitromethane in the plasma. Interference by nitromethane with the determination of creatinine by reaction with alkaline picrate (the Jaffe reaction) has not previously been reported. When nitromethane was added to plasma, the apparent creatinine measured was linearly related to the amount of nitromethane added. Comparison of spectral changes occurring during creatinine/picrate and nitromethane/picrate reactions show substantial similarity, suggesting a similar structure for the products. Although the findings are of interest for both their toxicological and analytical implications, the main interest lies with their suggestion of a model system for future investigation of the Jaffe reaction. PMID- 2758651 TI - Use of purified lyophilized human lactate dehydrogenase isoenzyme 5 in a study of measuring lactate dehydrogenase activity. AB - We examined the stability of human lactate dehydrogenase (EC 1.1.1.27) isoenzyme 5--purified to a specific activity of about 400 kU/g--when lyophilized in a buffered, stabilized matrix of bovine albumin. This isoenzyme was prepared with a final activity of about 500 U/L and stored at -20, 4, 20, 37, and 56 degrees C for as long as six months. This isoenzyme decayed with approximate first-order kinetics, with an estimated half-life at -20 degrees C of about 475 years. Stability of reconstituted samples stored at 20 or 4 degrees C was poor, suggesting that the reconstituted material should be used without delay; material stored at -20 degrees C showed excellent stability for 15 days. We propose that such preparations might be further investigated as standards for use in electrophoresis of lactate dehydrogenase isoenzymes. PMID- 2758652 TI - Normal biochemical and hematological values in New Zealand white rabbits. AB - Animal model systems are used extensively for experimental in vivo studies. When biochemical and hematological measurements are made, reference intervals for the animal species must be determined. Here, the subjects for our study were young adult male New Zealand White rabbits. Blood was sampled from 110 normal healthy rabbits. Biochemical and hematological blood variables were measured by methods available in our routine service laboratory, and we report the ranges. PMID- 2758653 TI - Four sensitive thyrotropin assays critically evaluated and compared. AB - We compared four sensitive procedures for thyrotropin (TSH)--Corning's Magic Lite, ElectroNucleonics' Delfia, Baxter's Stratus, Nichols' Allegro--for their ability to completely discriminate TSH concentrations in sera in euthyroidism, hyperthyroidism, and hypothyroidism. We evaluated the analytical and clinical performance of these procedures according to previously published criteria. All procedures we examined fulfilled the criterion stipulating less than 1% overlap between the assay variation at the lower normal range limit and the assay sensitivity. Both measurements were made with an interassay CV not exceeding 10% to 15%. All procedures produced results that correlated well for specimens with TSH concentrations of greater than 0.4 milli-int. unit/L, and all four procedures clearly distinguished hypothyroid from euthyroid subjects. In a hyperthyroid euthyroid comparison, three of the procedures, the Magic-Lite, Delfia, and Allegro, differentiated the two with 97% accuracy, the Stratus procedure with only 90% accuracy. The procedures appeared to differ even more in the measurement of TSH in serum of patients undergoing suppressive treatment with thyroid hormones and in hospitalized nonthyroidally ill patients. The observed differences among procedures were thought to be related in part to a matrix serum effect, which is accentuated in samples from hospitalized patients. PMID- 2758654 TI - Serum apo-aminotransferases reassociate equally well with pyridoxal 5'-phosphate in water or buffer. PMID- 2758655 TI - Evaluation of cholesterol measurement with the Beckman System 700 analyzer in the Centers for Disease Control-National Heart, Lung and Blood Institute Lipid Standardization Program. PMID- 2758656 TI - Response of allergic and normal persons to sulfiting agents in wine: determination of thiosulfate excretion in urine. PMID- 2758657 TI - Evaluation of the TDx and ADx methadone immunoassays. PMID- 2758658 TI - Reducing misdiagnosis of myocardial infarction. PMID- 2758659 TI - Normal reference values for creatine, creatinine, and carnitine are lower in vegetarians. PMID- 2758660 TI - Detergent enhances interference of urate in determinations of fructosamine. PMID- 2758661 TI - Underestimation of urinary glucose by an automated urine dipstick analyzer based on glucose oxidase with iodine as indicator chromogen. PMID- 2758662 TI - Minimum detection limits for thyrotropin assays. PMID- 2758663 TI - Improved urinary oxalate method for a centrifugal analyzer. PMID- 2758664 TI - Analysis for homogentisic acid by NMR spectrometry, to aid diagnosis of alkaptonuria. PMID- 2758665 TI - Melanin and other indole compounds do not cause false-positive cannabinoid assay results. PMID- 2758666 TI - Fibronectin levels in pregnancy and puerperium. AB - Fibronectin levels were serially assayed during the third trimester of pregnancy and puerperium in a group women with uncomplicated pregnancies, and two groups with mild/severe hypertensive disorders of pregnancy. The values were found increased in the complicated pregnancies, with extremely elevated levels in cases of severe preeclamptic fits. PMID- 2758667 TI - Vaginal administration of gemeprost for preoperative cervical dilatation in non pregnant patients. AB - The use of Gemeprost vaginal suppositories has been evaluated in a trial for induction of the cervical dilatation in non pregnant women. 30 voluntary patients, 22 nulliparous and 8 pluriparous, had to be subjected to biopsy of the endometrium; 24 were treated for the control of sterility and 6 for menstrual perimenopausal disorders. The biopsies of the sterility control were effected in the second half of the cycle, generally without having recourse to narcosis. A single Gemeprost pessary containing 1 mg of 16, 16-dimethyl-trans-delta 2 PGE1 methyl ester was intravaginal administered, deeply into the posterior fornix, 3 hours before the biopsy. The success rate was 86.66 (26 pts.) with an average dilatation of 5.38 H (Hegar) +/- 0.75 SD. For 4 patients (13.33%) having a dilatation less than 4 H, it was necessary to complete the dilatation mechanically. All the observed side effects presented a modest intensity: cephalalgia 6.6% (no. 2), gastralgia 3.3% (no. 1), vaginal burning 6.6% (no. 2). No significant variation of vital function parameters was recorded. In conclusion this type of preparation of the cervix has permitted us to achieve a more gradual dilatation and to prevent the traumata of the cervico-isthmic system due to forced mechanical dilatations by the exclusive use of Hegar's dilators. PMID- 2758668 TI - Cell-mediated immunity and condylomatosis. AB - Cell-mediated response in 60 patients affected by acuminated condylomas has been studied; this was investigated with aspecific in vivo tests (intradermal-reaction with tuberculin, trichophytin, candidine) and by in vitro tests (blood test with cell count, lymphocyte typing, serum proteins, serum immunoglobulin) and was compared with a control group. The results obtained confirm the hypothesis that condylomas acuminata usually occurs in patients with well-preserved cell-mediated immunity. PMID- 2758669 TI - Cyst of the breast diagnostic-therapeutic approach. AB - We examined 148 cases of breast cysts and evaluated their association with breast cancer by means of a diagnostic and therapeutic protocol aimed at simplifying control of cystic disease of the breast. PMID- 2758670 TI - Who is the expert? PMID- 2758671 TI - The effects of Le Fort I osteotomy with maxillary movement on articulation, resonance, and velopharyngeal function. AB - Articulation, resonance, and velopharyngeal function were evaluated before and after Le Fort I maxillary advancement in 16 patients (seven with cleft lip and palate, one with cleft lip only, and eight without clefts). On the postoperative evaluation, seven of 11 patients with preoperative articulation errors showed an improvement in articulation after surgery. Two patients without clefts showed slight changes in nasal resonance, and two patients (one with cleft lip and palate and one with cleft lip only) developed mild nasal emission. Nine patients showed diminished velopharyngeal contact during speech on videofluoroscopic studies. Compensatory changes in velopharyngeal function were also observed, which included velar stretching and lengthening and increased lateral pharyngeal wall movement. PMID- 2758672 TI - The psychosocial adjustment of pediatric craniofacial patients after surgery. AB - The postsurgical psychological status of 25 craniofacial patients, 6 through 16 years of age, was studied using self, teacher, and parent report measures. In contrast to earlier reports of more positive adjustment following corrective surgery, the present study identified several concerns for craniofacial patients, including low self-esteem, impaired peer relationships, and greater dependency on significant adults. Problems were more clearly identified using projective techniques rather than self-report measures. The findings suggest that many children having craniofacial surgery should have supportive psychotherapeutic services. Variables were explored relative to psychosocial functioning. Although few significant correlations were demonstrated, positive psychological adjustment was found to be related to greater physical attractiveness, lower parental stress, and younger age. PMID- 2758673 TI - Pathogenesis of cleft palate in Treacher Collins, Nager, and Miller syndromes. AB - Abnormalities of the secondary palate were studied in an animal model in which features of Treacher Collins syndrome (TCS) and Nager or Miller syndromes (both of which are facially similar to Treacher Collins, but include limb malformations) were induced by acute maternal exposure to 13-cis-retinoic acid (13-cis-RA, isotretinoin, Accutane). Previous work in our laboratory has illustrated that excessive cell death in the proximal aspect of the maxillary and mandibular prominences of the first visceral arch and in the apical ectodermal ridge of the limb bud probably accounts for the characteristic craniofacial and limb abnormalities observed (Sulik et al, 1987; Sulik and Dehart, 1988). The current study shows that maternal treatment with 400 mg per kilogram 13-cis-RA at 8 days 14 hours (8d14hr) or 9d6hr post fertilization results in abnormalities of the secondary palate that vary in incidence and severity. Following the earlier treatment time, 82 percent (68 of 74) of the 18d fetuses were affected, with, severely hypoplastic, unfused palatal shelves present in 34 percent (25 of 74). The less severely affected fetuses had malformations that involved primarily the posterior aspect of the palatal shelves. This malformation (foreshortening of the posterior portion of the palate) constituted the major developmental alteration that resulted from treatment at the later time, at which time a 52 percent (26 of 50) malformation incidence was seen. The change in pattern of malformations with treatment time is consistent with the changing pattern of programmed cell death, which was observed to occur in the first visceral arch. PMID- 2758674 TI - Reliability of flexible fiberoptic nasopharyngoscopy for evaluation of velopharyngeal function in a clinical population. AB - Flexible fiberoptic nasopharyngoscopy (FFN) has become a popular clinical tool for evaluating velopharyngeal function. The literature contains numerous reports of FFN methodology and findings. However, there are few published reports that address clinical rating and reporting schemes or that evaluate viewer reliability. This study was designed to evaluate the reliability of visual perceptual ratings of FFN video images for assessing velopharyngeal structure and function in a clinical population. Ninety-five videotaped clinical evaluations were presented to and judged by three expert raters and nine novice raters from the fields of speech pathology, otolaryngology, and plastic surgery, using a standard rating form. A clinical rating scheme was used for quantifying perceptual judgments of velopharyngeal activity. Results suggest that videotaped FFN evaluations may be rated reliably, that expert raters working as a group are more reliable than novice raters working individually, and that the 125 evaluations presented without feedback are insufficient to improve the novices' reliability. The combined auditory and visual perceptual evaluation inherent in FFN may be its most significant asset for both clinical and research applications. PMID- 2758675 TI - Voice perturbations of children with perceived nasality and hoarseness. AB - Cycle-to-cycle variations in voice fundamental frequency (jitter) and amplitude (shimmer) were derived by electroglottography for 10 children with velopharyngeal insufficiency (VPI). Jitter was found to be positively correlated with ratings of perceived nasality, whereas shimmer was found to be positively correlated with ratings of perceived hoarseness. Theoretic implications for a regulatory model of speech aerodynamics are discussed. Additionally, clinical applications, in terms of using electroglottography as a supplemental assessment procedure, are suggested. PMID- 2758676 TI - Animal experimentation: necessary or not? PMID- 2758677 TI - Science, politics, and morality. PMID- 2758678 TI - Proteinuria in sickle cell trait and disease: an electrophoretic analysis. AB - Using ultrafiltration and SDS-PAGE, abnormal urinary protein excretion was found in 25.4% of 189 persons with sickle cell disease and trait, but none of 72 controls. Based upon molecular weight of urinary proteins, underlying renal lesions were classified as glomerular, tubular, or both. Altered protein excretion appeared at an early age, was more abnormal in older subjects, and was related to the severity of sickle cell disease (SS greater than SC = S/beta Thal greater than AS). Since none of the subjects had yet developed clinically significant renal disease, SDS-PAGE may permit early detection of patients who require careful follow-up or aggressive therapy. PMID- 2758679 TI - Tetrahydrobiopterin metabolism in the streptozotocin induced diabetic state in rats. AB - Streptozotocin induced diabetes has been shown to have associated changes in the metabolism of tetrahydrobiopterin. De novo biosynthesis of tetrahydrobiopterin in the brain was reduced as was dihydropteridine reductase activity. Consequently there is a shift from fully reduced biopterins to more oxidised species. Both can cause reduced levels in the cofactor pool and may cause reduced levels of the associated neurotransmitters and neurological deficits. PMID- 2758680 TI - An improved formula for the judgement of intrathecally produced IgG in the presence of blood brain barrier damage. AB - In order to develop a better formula for discrimination between transsudated and intrathecally produced IgG, we studied the relation between cerebrospinal fluid (CSF) IgG, serum IgG, CSF albumin, and serum albumin for patients with blood brain barrier (BBB) damage. From this study we derived a new formula, IgG extended index = (CSF IgG/serum IgG)/(CSF albumin/serum albumin). Applying this index on 152 patients with BBB damage, but not expected intrathecal IgG synthesis, yielded 14 patients (9.2%) with increased (greater than 1.24) IgG extended index. In comparison, 'conventional' IgG index was increased in 34 of the patients (22%). The diagnostic sensitivity for 68 patients with multiple sclerosis (MS), did not differ significantly between the two formulas (81 and 87%, respectively). A formula for the estimation of 24 hours IgG production was also developed, but this formula was not better than IgG index. Children (0.5-16 yr) had similar IgG patterns as adults. PMID- 2758681 TI - Hydroxycholesterols in serum from hypercholesterolaemic patients with and without bile acid sequestrant therapy. AB - To assess the effect of bile acid sequestrant therapy on bile acid precursors in plasma, we determined hydroxycholesterols in serum from patients with primary hypercholesterolaemia. Compared with a group of 5 male and 12 female patients without any lipid-lowering drug therapy, which has normal to slightly elevated 7 alpha-hydroxycholesterol, normal 7 beta-hydroxycholesterol and high normal to elevated 26-hydroxycholesterol levels, a group of 5 male and 9 female patients, using colestipol had higher 7 alpha-hydroxycholesterol without overlap, and higher 7 beta-hydroxycholesterol levels, but similar levels of 26 hydroxycholesterol. In the latter group, the ratio between 7 alpha hydroxycholesterol and total cholesterol in serum was also higher without overlap. Both groups did not differ for age, body weight, body mass index and serum lipid levels. In the group of patients without lipid-lowering drug therapy, 7 alpha-hydroxycholesterol correlated positively with total and low densitylipoprotein cholesterol, 7 beta-hydroxycholesterol negatively with body weight and body mass index, and 26-hydroxycholesterol positively with body weight. In both groups, 7 alpha-hydroxycholesterol correlated positively with 7 beta-hydroxycholesterol. These results suggest that (1) bile acid sequestrants enhance bile acid synthesis via the 7 alpha-hydroxylation but not via the 26 hydroxylation pathway, (2) serum 7 alpha-hydroxycholesterol level and the ratio between this hydroxycholesterol and total cholesterol in serum might be suitable parameters to check intake of bile acid sequestrants irrespective of dose, and (3) 7 beta-hydroxycholesterol is unlikely to be the result of cholesterol auto oxidation in vitro. PMID- 2758682 TI - Serum human chorionic gonadotrophin levels in early pregnancy. AB - Serum hCG reference intervals for various gestational periods in normal pregnancies were determined using three commercial assays--two standardized against the WHO 2nd IS (Amersham Amerlex-M beta HCG RIA (AMX) and Abbott beta-HCG 15/15 (ABB] and one standardized against the WHO 1 IRP (Hybritech Tandem -E HCG (HYB]. Serial samples from patients with accurately determined gestational periods were analyzed. We correlated these assays to determine the validity of the common practice of interchanging values between assays using the same WHO standard and of converting 1st IRP values to 2nd IS values by a fixed factor. The slope of correlation between the two 2nd IS assays (AMX, ABB) was 1.43, r = 0.960; whereas between the 1 IRP assay (HYB) and the two 2nd IS assays the slopes were 1.67, r = 0.963 and 1.22, r = 0.971 for AMX and ABB, respectively. In a prospective study of 52 patients with normal pregnancies, serum beta-hCG values in 46% of samples taken at 28-35 days gestation fell below the lower limit of the reference curves supplied with the AMX kit. Ninety-two percent of samples were within the newly established intervals. These results indicate that supplier's reference limits may not be accurate; in addition, a common factor should not be used to convert values from one commercial kit to another. PMID- 2758683 TI - Detection of elevated amounts of urinary pseudouridine in cancer patients by use of a monoclonal antibody. AB - Preparation of anti-pseudouridine monoclonal antibodies (MoAbs) and their applications for the quantitation of urinary pseudouridine in cancer patients are described. Seven MoAbs were selected. Five MoAbs were specific for pseudouridine and two MoAbs were cross-reactive with uridine. The most specific antibody, APU 6, was used in an enzyme-linked immunosorbent assay (ELISA) to determine urinary pseudouridine. Sensitivity was in the picomole range and the accuracy was nearly equal to that of the high performance liquid chromatography (HPLC) assay. The amount of pseudouridine in the urine of 28 healthy donors was 31.17 +/- 9.94 nmol/mumol creatinine. In 55% (35/63) of patients with cancer, urinary pseudouridine was elevated above the normal mean + 2 SD (51.04 nmol/mumol creatinine). Particularly, all of the patients (15/15) with leukemia and lymphoma had elevated levels of pseudouridine. These results suggest that urinary pseudouridine might be useful as a marker for leukemia and lymphoma. PMID- 2758684 TI - The quantitation of human ventricular myosin light chain 1 in serum after myocardial necrosis and infarction. AB - To determine the clinical utility of human ventricular myosin light chain 1 (HVLC1) in the diagnosis of myocardial necrosis, we established a radioimmunoassay for serum HVLC1 using polyclonal antibodies raised against the purified human protein. HVLC1 levels were measured in sera from 110 control patients and 38 patients immediately after cardiovascular surgery and in serial specimens from 10 patients with uncomplicated myocardial infarctions. The HVLC1 assay was found to be equal in sensitivity for the first 48 hours to the CK-MB for myocardial necrosis after cardiovascular surgery and for myocardial infarction. In virtually all myocardial infarct patients, HVLC1 levels in sera rose within hours of the onset of chest pain. From thereon, two sub-trends were discerned. For many, the HVLC1 levels remain elevated for 9-12 days beyond. In some, the HVLC1 levels returned to normal levels 1-2 days after the initial rise, but became elevated again for the next 5-9 days. In either instance, the diagnosis of myocardial infarction was permitted as late as 10-12 days after the onset of chest pain which is in stark contrast to all conventionally used biochemical markers. PMID- 2758685 TI - A new approach for measuring the erythrocyte life span with a nonradioisotope. AB - The possibility of substituting a nonradioactive isotope of chromium for 51Cr was studied. Blood, from five dogs with varying erythrocyte life spans, was labeled with 50Cr and 51Cr and transfused autologously. Erythrocyte-bound 50Cr was determined by inductively coupled argon plasma mass spectrometry and 51Cr by measuring radioactivity. Erythrocyte life span determination derived from the two isotopes did not differ significantly. Our results suggest that 50Cr can provide a nonradioactive alternative to 51Cr for labeling erythrocytes for life span studies. PMID- 2758686 TI - Linkage between serum cholinesterase 2 (CHE2) and gamma-crystallin gene cluster (CRYG): assignment to chromosome 2. AB - Serum cholinesterase 2 (CHE2) was examined in a Danish material of normal families that has been tested earlier for 70-78 classical marker systems and 25 RFLP systems. DNA for RFLP typing was provided by transforming 16-year-old frozen lymphocytes. The frequency of allele CHE2*C5+ in the Danish population was found to be 0.0430. The highest lod score was between CHE2 and the gamma-crystallin gene cluster (CRYG) (zeta = 4.21 at theta = 0.00 in females). The scores were from a single family with 15 children. CHE2 may, accordingly, be assigned to the location of CRYG: chromosome 2, bands q33-q35. PMID- 2758687 TI - The de Lange syndrome. Report of 15 cases. AB - Fifteen cases of the de Lange syndrome are presented. Personal and family histories, clinical features, detailed radiological findings, laboratory data, chromosome studies and dermatoglyphic patterns are reported. A Negro patient and his autopsy findings are described. Radiological diagnostic features are stressed; in particular, the combined presence of a hypoplastic middle phalanx of the index fingers and variable short metatarsal appear to be two additional features which are diagnostically helpful. The etiology of the syndrome is unknown; however, there is some evidence to suggest a genetic basis. The literature is briefly reviewed. PMID- 2758688 TI - Chondrodysplasia punctata in an adult recognized as vitamin K antagonist embryopathy. AB - A 32-year-old man with disproportionate short stature and striking facial dysmorphism came to genetic counseling as his wife was expecting their first child. In early infancy he had been diagnosed as having chondrodysplasia punctata, later regarded to be the autosomal dominant hereditary form. The expectant father was therefore convinced of a high risk of recurrence and vacillated between thoughts of taking his own life and of having his wife's pregnancy terminated. When his history revealed recurrent thromboses in his mother, treated with anticoagulants during pregnancy, her medical records of 1953 were located, and they disclosed that she had been treated with phenprocoumon (Marcoumar) from the 8th to the 12th and from the 13th to the 15th weeks of pregnancy. The patient has since become the father of a healthy son. PMID- 2758689 TI - A case of de novo trisomy 12p syndrome. AB - A case of pure 12p trisomy was discovered in a 14-year-old boy during a cytogenetic survey of Egyptian students attending a school for mentally retarded children. The patient had a normal birth weight but later showed developmental delay. Clinical examination at 14 years of age revealed a high bulging forehead, broad and flat nasal bridge, large mouth with everted lower lip, folded upper ear helix with protuberant antihelix, pectus excavatum, undescended testes, flat feet, generalized hypotonia and moderate mental retardation. Chromosomes analyzed from blood lymphocytes showed an enlarged short arm with an additional band on one of the no. 12 chromosomes. The duplicated chromosomal material extended from 12pter----p12.2, including the LDH-B locus, which showed a gene-dosage effect. This extra chromosomal material arose de novo by tandem duplication. The parents' chromosomes were normal. PMID- 2758690 TI - Retinitis pigmentosa, hearing loss and vitiligo: report of two patients. AB - In this report we describe the association of retinitis pigmentosa, hearing loss and vitiligo in two non-related patients. The second patient developed, in addition, an axonal polyneuritis after the age of 30. Previous reports dealing with this unusual combination of symptoms are discussed. PMID- 2758691 TI - An idic(X) leads to a del(X) or vice versa? PMID- 2758692 TI - Inhibition of human natural killer activity by antiserum against vitamin D binding protein, a group-specific component (Gc). AB - An anti-Gc antiserum (anti-Gc) was prepared by immunizing rabbits with purified Gc, a major vitamin D-binding protein in human serum. Gc is expressed on the surfaces of a small proportion of resting T cells and almost all B cells are natural killer (NK) cells. We investigated the effects of anti-Gc on NK activity of normal peripheral blood lymphocytes. Both anti-Gc and purified IgG isolated from anti-Gc prominently inhibited human NK activity in vitro. Inhibition of anti Gc was dependent on the concentration of the antiserum employed. Competition assay showed that purified Gc significantly blocked the inhibitory effect of anti Gc. The inhibition of NK activity in the cells treated with anti-Gc was restored time-dependently by being cultured in anti-Gc free medium. Anti-Gc-treated NK cells retained their capacity to bind to target cells. These findings suggest that mGc is associated with the process of the NK cytolysis on the post-binding cytolytic phase. PMID- 2758694 TI - The specificity of anti-cardiolipin antibodies from syphilis patients and from patients with systemic lupus erythematosus. AB - In order to elucidate the fine specificity of anti-cardiolipin antibodies (ACA) in patients with SLE compared to patients with syphilis (SY) various inhibition experiments were performed. Seven SLE sera and eight SY sera positive for ACA were diluted and preincubated with either cardiolipin VDRL-antigen, mitochondial particles, dsDNA, ssDNA or dilution buffer. The sera were subsequently assayed for residual ACA activity of IgG or IgM class using a sensitive ELISA technique. Significant inhibition of IgM ACA activity in SLE sera was found with cardiolipin, VDRL-antigen and mitochondrial particles. Cardiolipin inhibited binding to a significantly higher extent than the other antigens. In SY sera significant inhibition of the IgM ACA activity was found with all antigens used. The strongest inhibition was seen using VDRL-antigen. Inhibition of IgG ACA activity could only be clearly estimated in SY sera where VDRL-antigen was found to be a much stronger inhibitor than the rest, purified cardiolipin being the weakest. Only two out of seven SLE sera were IgG ACA positive which made a clear conclusion impossible but a strong inhibitory capability of pure cardiolipin and a weaker inhibition with VDRL-antigen was found. This study disclosed a difference between SLE and SY sera showing strong reactivity of ACA in SLE sera with purified cardiolipin, contrasting to ACA in SY sera which predominantly reacted with cardiolipin in the liposome environment, as found in the VDRL antigen and in mitochondrial particles. PMID- 2758693 TI - Quantification of lupus anti-ribosome P antibodies using a recombinant P2 fusion protein and determination of the predicted amino acid sequence of the autoantigen in patients' mononuclear cells. AB - The cDNA encoding the ribosomal protein P2 antigen was cloned from a human cDNA library constructed in the lambda gt11 expression vector. A beta-galactosidase-P2 fusion protein was purified to near homogeneity and used to develop an ELISA which was highly specific for anti-P antibodies produced in murine and human SLE. The median concentration of human IgG anti-P antibodies in serum was estimated to be 100 micrograms/ml (range 6-450 micrograms/ml). Pre-incubation of human anti-P sera with a synthetic peptide, corresponding to the C-terminal 22 amino acids of P2, completely inhibited reactivity with the fusion protein in the ELISA. These findings confirm that lupus anti-P sera show a striking restriction in epitope specificity and indicate that the P2 fusion protein is a useful alternative to the synthetic peptide antigen for detection and quantification of anti-P antibodies. To investigate the possibility that anti-P antibodies were induced by 'altered-self', cDNA encoding P2 were also cloned from lupus patients and control mononuclear cells. The predicted amino acid sequences of the patients' P2 were identical to that of the normal controls indicating that a primary structural abnormality of the P2 autoantigen was unlikely. PMID- 2758695 TI - Serum opsonic capacity against Yersinia enterocolitica O:3 in yersiniosis patients with or without reactive arthritis. AB - The opsonic capacity of 45 sera from patients with reactive arthritis after Yersinia enterocolitica O:3 infection and of 45 matched sera from yersiniosis patients without post-infection complications was studied at 1-3 months, 5-8 months and 12-20 months after the onset of the infection. Antibody-mediated opsonization of virulence-plasmid-containing Y. enterocolitica O:3 was studied by measuring complement-fixation on opsonized bacteria and opsonophagocytic function of the polymorphonuclear leucocytes (PMN). The PMN response against bacteria pre opsonized by heat-inactivated sera was measured by using a chemiluminescence (CL) assay. The fixation of complement Clq and C3 on bacteria was determined by flow cytometry using fluorescein-conjugated Clq- and C3c-antisera. All the sera were strongly opsonic at the onset of the infection, and this capacity persisted in most of the patients still at the end of the follow-up. No difference was observed in complement-fixing capacity between the sera of the two groups, but the sera from arthritic patients showed stronger augmentation of PMN CL response at the early phase of the infection (P = 0.005 in the presence of complement, P = 0.04 in the absence of complement). These results suggest that enhanced opsonic capacity may play a role in the development of Yersinia-triggered reactive arthritis by leading to strong activation of the PMN and, consequently, to release of inflammatory mediators. PMID- 2758696 TI - 1,25-Dihydroxyvitamin D3, but not retinoic acid, induces the differentiation of U937 cells. AB - We have examined the effects of vitamin D3 metabolites and retinoic acid on the myelomonocyte cell line U937. Inhibition of proliferation, measured by incorporation of 125iodo-deoxyuridine was seen at 72 h with 1,25-(OH)2D3 but not 25(OH)D3 or 24, 25(OH)2D3 metabolites. CD14 molecules, not normally present on U937 cells, were induced on the cell surface. However, Class II major histocompatibility complex (MHC) molecules were not induced and Class I MHC molecules not increased in density as determined by flow cytometry. Retinoic acid inhibited proliferation but failed to induce CD14 molecules. These data suggest that both 1,25(OH)2D3 and retinoic acid act as an antiproliferation signal to U937 cells; only 1,25-(OH)2D3 induces the differentiation towards a more mature phenotype. PMID- 2758697 TI - Genetics of experimental lupus nephritis: non-H-2 factors determine susceptibility for renal involvement in murine chronic graft-versus-host disease. AB - Chronic graft-versus-host disease (GvHD) was induced in (C57BL/10 x DBA/2)F1 and (B10.S x DBA/2)F1 hybrids by injection of DBA/2 lymphocytes. All of the animals developed GvHD. Renal disease and proteinuria occurred in all of the (C57BL/10 x DBA/2)F1 hybrids, but only in 54% of the (B10.S x DBA/2)F1. The type of renal lesion was similar in all diseased animals of both strains, i.e., immune complex glomerulonephritis (ICGN) with deposition of antibodies and complement in glomeruli. To find out whether H-2 haplotype or other factors, such as non-H-2 linked genes, determine the susceptibility for renal involvement in GvHD, we produced (B10 x B10.S)F1 x DBA/2 mice, determined their H-2 genotype serologically, and separated them into H-2b/d and H-2s/d groups. These two groups did not differ with respect to susceptibility to renal disease in the course of GvHD, which indicates that H-2 is not the decisive genetic factor. We conclude that factors not linked with H-2 exert a major influence on susceptibility to GvHD-related renal disease in these mice. PMID- 2758698 TI - Chronic therapy with recombinant tumor necrosis factor-alpha in autoimmune NZB/NZW F1 mice. AB - We studied the effects of recombinant murine tumor necrosis factor-alpha (TNF alpha) on autoimmune disease in lupus-prone NZB/NZW F1 (B/W) mice. Treatment with TNF-alpha, begun after the onset of clinical disease, improved survival relative to control mice: at age 10 months, 92% of mice treated with TNF-alpha were alive compared with 42% of control mice (P less than 0.05). Administration of TNF-alpha delayed the progression of renal disease, but sustained therapy did not prevent the eventual development of severe nephritis. Despite the improvement in survival, treatment with TNF-alpha did not inhibit anti-dsDNA antibody production. However, it accelerated T lymphocytopenia and abolished natural killer cell activity. These observations suggest that TNF-alpha may retard murine lupus in B/W mice through effects on cellular rather than humoral mechanisms. Our findings also indicate that the beneficial effects of TNF-alpha cannot be sustained indefinitely by chronic therapy. PMID- 2758699 TI - Long-term follow-up of membranoproliferative glomerulonephritis type II and pregnancy: a case report. AB - A 24-year-old female was diagnosed as having membranoproliferative glomerulonephritis type II (or dense deposit disease), 11 years prior to becoming pregnant. The patient's first renal biopsy was performed 5 years after the onset of her renal symptoms. This biopsy was compared to a second renal biopsy taken just before the patient became pregnant. The second renal biopsy only showed a slight progression in the disease process. During the course of pregnancy, neither renal insufficiency nor hypertension were clinically evident. However, both an increase in proteinuria and a transient hypoalbuminemia were observed. The pregnancy, labor and delivery, and postpartum course for both the mother and child were without complications. Cases of membranoproliferative glomerulonephritis type I and pregnancy have been reported. However, to our knowledge, there are few reports documenting the outcome of pregnancy when a patient has membranoproliferative glomerulonephritis type II. We suggest that it is possible for a patient with membranoproliferative glomerulonephritis type II to have an uneventful pregnancy if she has neither hypertension nor renal insufficiency. PMID- 2758700 TI - Exercise performance of hemodialysis patients during short-term and prolonged exposure to altitude. AB - The work capacity of patients on maintenance hemodialysis is impaired even at normal inspiratory oxygen pressure. A further restriction can be expected when these patients are exposed to hypoxia at altitude, since most of the usual compensatory mechanisms required to adjust to this environment are impaired or even missing. We tested the tolerance of hemodialysis patients to hypoxia and measured work capacity, hematological, and cardiovascular parameters at rest and during incremental bicycle ergometry during 3-hour exposure to altitudes of 2,000 m and 3,000 m, and during 2 weeks of exposure to an altitude of 2,000 m and compared these data with prealtitude values or with data evaluated in a control group, respectively. In control tests the patients reached work loads at exercise termination of about 66% of age and sex-matched healthy controls, the reduction correlated well with the degree of anemia. During short-term altitude exposure to 2,000 m peak work performance remained unchanged in comparison to prealtitude tests, whereas at 3,000 m it was reduced by about 12%. During the 2-week stay at 2,000 m peak work loads increased significantly by 17% accompanied by an increase in peak oxygen uptake (+15%), blood lactate, heart rates (+10 min-1), and systolic blood pressure (+20 mmHg), whereas the diastolic pressure was comparable to prealtitude values. In another group of hemodialysis patients studied at low altitude under similar experimental conditions none of these parameters was changed. Our data show that during acute exposure to altitudes up to 2,000 m maximal work of hemodialysis patients is not reduced, but is restricted at altitudes higher than that.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2758701 TI - Enhancement of cyclosporin nephrotoxicity by diuretic therapy. PMID- 2758702 TI - Incidence and clinical signs of the upper calyx syndrome and its relation to orthostatic proteinuria--a retrospective study. PMID- 2758703 TI - Quantitation of glomerular angiotensin II receptors in IgA nephropathy. AB - Mesangial cells have receptors for angiotensin II (AII) and contract in its presence. All is known also to increase the uptake of macromolecules by the mesangium. As a first step towards the investigation of a possible role for local disturbances of the renin-angiotensin system (RAS) in immune mediated mesangial proliferative glomerulonephritis, glomerular All receptors have been quantitated retrospectively in biopsy tissue from 20 patients with IgA nephropathy for comparison with 16 biopsies that showed only minor abnormalities by light microscopy and negative immunofluorescence. An autoradiographic technique using 125I labelled [Sar1, Ile8] All facilitated the quantitation of All receptors in frozen tissue sections. Following exposure to the treated sections, x-ray film was analyzed by computerized micro-densitometry. The data obtained were optical densities of areas corresponding to the presence of glomeruli verified by reference to adjacent sections stained with periodic acid-Schiff (PAS). There was no significant difference between patients 0.67 +/- 0.16 (mean +/- SD) and controls 0.61 +/- 0.15. Among patients there was no statistically significant correlation of glomerular All receptor density with either the degree of mesangial proliferation or the extent of hyperplasia of the juxtaglomerular apparatus (JGA). There was no apparent relationship with hypertension. The absence of an increase in glomerular All receptors despite proliferation of the glomerular mesangium may represent a local down regulation in patients with IgA nephropathy. PMID- 2758704 TI - Plasma and synovial fluid lanthanides in rheumatoid arthritis: variations after intra-articular therapy. AB - Lanthanides (Ln), or rare earth elements, are detectable in trace amounts in organisms. Increased concentrations of Ln have been observed in rheumatoid arthritis (RA) in plasma (pl) and synovial fluid (Sf). We have evaluated pl and Sf concentrations of Ln (in particular La, Nd, Ce, Yb, Lu, Eu), in rheumatoid arthritis patients, before and after intra-articular steroid injection. Increased pl and Sf concentrations of Ln were confirmed in RA. No detectable synovial fluid concentrations of Ln were observed in healthy controls. A statistically significant Ln reduction (p less than 0.001) was observed in Sf 3 and 6 days after local steroid injection and in pl after 6 days. The decrease in Ln concentrations in Sf and pl, after antiphlogistic therapy, reflects the reduction of the inflammatory condition. PMID- 2758705 TI - Scintigraphic quantitation of splenic function in SLE: correlation with IgM levels in serum. AB - The relationship between quantitative splenic uptake of sulfur colloid and immunoglobulin M level in serum was studied in 15 patients with systemic lupus erythematosus (SLE). Splenic function correlated positively with IgM level (r = 0.58, p = 0.02) and inversely with antibody titre to n-DNA (r = -0.74, p = 0.003), and was reduced (p greater than 0.001) in patients with depressed IgM levels. IgM level in serum may be a useful correlate of splenic phagocytic function in SLE patients. PMID- 2758706 TI - Anti-histone antibodies in SLE and other autoimmune diseases. AB - The frequency of IgG and IgM anti-total histones and anti-histone subfractions were studied in 63 patients with SLE and 257 patients with other autoimmune conditions employing the ELISA. IgG anti-histone antibodies were found in 17 of 63 (25%) sera of lupus patients and in only 16 of 257 (6%) sera of patients with other autoimmune conditions. The latter incidence did not differ statistically from that of 115 healthy control subjects. Furthermore, the concomitant appearance of both IgG and IgM anti-histone antibodies was observed only in SLE patients. Anti-histone subfraction (H1, H2A, H2B, H3, H4) activity was determined in sera containing anti-total histone antibodies. There was a higher preponderance for antibodies to H1, H2A, H2B in SLE. We conclude that anti histone antibodies seem to be a marker for lupus and its variants (e.g. drug induced lupus) and should be routinely looked for in SLE patients. PMID- 2758707 TI - Morphometric study of salivary glands in primary Sjogren's syndrome. AB - The relationship between structural changes of the minor salivary glands with age was evaluated by morphometric analysis in twenty patients with primary Sjogren's syndrome (prim. SS) (Group I) and in twenty sex and age-matched normal subjects (Group II). No statistically significant differences were found in the acinar tissue, intralobular ducts (ILD) and fibrous tissue between the two Groups. In contrast, there was a 5-fold increase in the volume fraction of inflammatory cells in Group 1. In both Groups the percentage of fibrous tissue and ILD increases and the percentage of acinar tissue decreases linearly with age. In Group I the increase in the volume percentage of fibrous tissue and the decrease in the volume fraction of the acinar tissue were not related to the volume percentage of inflammatory cells. These results demonstrate that in prim. SS the acinar atrophy is not related to the inflammatory process but is an age-dependent phenomenon. PMID- 2758708 TI - Anti-56K: a novel, frequently occurring autoantibody specificity in connective tissue disease. AB - A novel frequently occurring autoantibody specificity in serum from connective tissue disease patients is described. The autoantibodies as detected by immunoblotting are directed against a 56,000 Dalton (56K) antigen, that after biochemical fractionation predominantly is found in the cytoplasmic fraction of various cell types and tissues. Attempts to localize the antigen more precisely were unsuccessful primarily because these antibodies do not produce a positive immunofluorescence pattern. The antigen in its native form is not associated with DNA or one of the common cytoplasmic or nuclear RNAs in the cell. Immunoprecipitation studies also showed that the protein is not closely associated with other proteins in a multi-component complex. Anti-56K antibodies are found in about 8% of patients with connective tissue disease, most commonly in patients with Sjogren's syndrome (14%). It is not found in patients with mixed connective tissue disease, polymyositis/dermatomyositis or scleroderma and rarely (less than 1%) in healthy control subjects. The fact that 22% of the anti-56K sera also contain La/SS-B antibodies support the idea that this antibody specificity might be characteristic for a subclass of Sjogren's syndrome patients. PMID- 2758709 TI - Mycobacterium fortuitum in systemic lupus erythematosus. AB - When she was five years old, this patient - aged 20 time of death - had had two diagnoses: Leri-Weill's disease and SLE. The latter led to uninterrupted use of systemic corticosteroids. Twelve months before death, multiple purulent bursitis were followed by cutaneous nodules. From the latter, but not from the former, Mycobacterium fortuitum was isolated. Our case is in agreement with what is generally accepted: this saprophyte organism becomes pathogenic in disseminated infections, only if the immune system deteriorates. PMID- 2758710 TI - Felty's syndrome without concomitant arthritis: a variant. AB - A young female patient who had documented seropositive rheumatoid arthritis and was treated consecutively with aspirin, diclofenac, and gold salts was admitted years later for severe neutropenia. On examination she had, in addition, fever, positive rheumatoid factor, reversible swan-neck deformity of the fingers but otherwise normal joint findings. The patient responded to prednisone therapy. This case would appear to be a most unusual variant of Felty's syndrome. PMID- 2758711 TI - Recurrent lupus pneumonitis with pulmonary hemorrhage in systemic lupus erythematosus associated with chronic thyroiditis and antithyroid hormone autoantibodies. AB - We describe a SLE patient with repeated lupus pneumonitis and pulmonary hemorrhage. The hemorrhagic episodes were considered to be related to thrombocytopenia and lupus pneumonitis, which have responded well to treatment with moderate doses of steroids and immunosuppressant. She was also found to be suffering from chronic thyroiditis (hypothyroidism) and was positive for anti thyroid hormone antibodies, which have not been reported before in the SLE patients with thyroid diseases. PMID- 2758713 TI - Thrombocytopenia in a case of Wegener's granulomatosis. PMID- 2758712 TI - Autoimmune disease in hairy-cell leukemia: systemic vasculitis and anticardiolipin syndrome. PMID- 2758714 TI - D-penicillamine (DPA)-induced anticentromere antibody (ACA) PMID- 2758715 TI - Vitiligo and polymyositis. PMID- 2758716 TI - The effect of in vivo and in vitro methotrexate on lymphocyte proliferation as measured by the uptake of tritiated thymidine and tritiated guanosine. A reply. PMID- 2758717 TI - Intracranial tumors. Vomiting as a presenting sign. A gastroenterologist's perspective. AB - Vomiting is seen as a symptom in patients with brain tumors, but it rarely leads to the diagnosis in the absence of a recognized neurologic deficit. Five patients were referred to a pediatric gastroenterologist for outpatient evaluation of persistent vomiting and were subsequently found to have an intracranial mass lesion. The paucity of neurologic findings and the absence of headaches in most of these patients caused the referring physicians to focus on the gastrointestinal tract and not the central nervous system as the cause of the patients' vomiting. The pathophysiology of vomiting and evaluation of these patients is discussed; recognizable patterns of vomiting in these patients are described. PMID- 2758718 TI - Initial treatment of cystic fibrosis. Frequency of transient bulging fontanel. AB - Four infants with newly diagnosed cystic fibrosis developed a bulging anterior fontanel within days of starting enzyme replacement treatment. In the same time period, 41 hospitalized patients less than 1 year of age were diagnosed as having cystic fibrosis and treated, suggesting that increased intracranial pressure is common in this setting (9.7%). The clinical course of the four infants was similar: the bulging fontanel became apparent 1-6 days after initiation of pancreatic enzyme replacement and resolved within 1 week in three patients and within 4 months in the other patient. Two patients became mildly irritable. Computed cranial tomography and lumbar puncture were done in three patients, with completely normal findings except elevated cerebrospinal fluid pressure in two infants. There was no apparent difference in this treatment or clinical course before diagnosis between the four infants who developed a transient bulging fontanel compared with the overall group of cystic fibrosis patients. PMID- 2758719 TI - Massive levothyroxine ingestion. Conservative management. AB - The clinical course of a 29-month-old girl who was referred for evaluation after ingesting ninety 0.2-mg tablets of levothyroxine is reported. Despite an initial thyroxine (T4) level of 282 micrograms/dl and a triiodothyronine (T3) level of 1,837 ng/dl at 48 hours postingestion, her symptoms were mild and included irritability, vomiting, tremor, and tachycardia. Treatment was limited to activated charcoal and propranolol. Thyroid hormone levels fell to normal by 13 days postingestion. The child's clinical course was benign. Even after massive acute ingestions of levothyroxine, children's symptoms are usually mild and may be controlled with propranolol. This conservative approach should be considered before expensive and potentially dangerous therapies are undertaken. PMID- 2758721 TI - A calendar of seizures for epileptic patients in institutions. PMID- 2758720 TI - Lead intoxication from lead-contaminated water used to reconstitute infant formula. AB - The lead found in drinking water can be a source of lead poisoning to young children, particularly those who consume large amounts of water. The authors describe a 13-month-old infant who was discovered to have plumbism during routine evaluation. The lead source was ultimately traced to the daily administration of powdered formula which was prepared with home tap water having a first-draw lead content of 130 parts per billion. This case suggests that whenever infants are fed powdered formula, consideration should be given to analysis of the home tap water for lead content. PMID- 2758722 TI - The drug lag: an update of new drug introductions in the United States and in the United Kingdom, 1977 through 1987. AB - This report updates previous studies that documented the existence of a significant lag between new drug introductions in the United Kingdom and in the United States. During the 11-year period from 1977 through 1987, the United Kingdom led the United States in the number of first introductions of new drugs (114 versus 41), in average lead time for mutually available drugs (60.7 versus 28.9 months), and in the number of exclusively available drugs (70 versus 54). Analysis by therapeutic category indicated large United Kingdom leads in the introduction of respiratory (5.1 years), cardiovascular (3.2 years), central nervous system (3.2 years), and anti-cancer (2.9 years) agents, and shorter leads for anesthetic and analgesic (2.0 years), gastrointestinal (2.0 years), endocrine (1.4 years), and anti-infective (0.8 years) agents. A comparison of the 5-year period from 1983 through 1987 with the previous 5-year period (1978 through 1982) showed no change in the length of the lag time (1.9 years for each period). These results indicate that the United States continues to lag behind the United Kingdom in the availability of new drugs. PMID- 2758723 TI - Understanding comparisons of drug introductions between the United States and the United Kingdom. PMID- 2758724 TI - Reply to "Understanding Comparisons of Drug Introductions Between the United States and the United Kingdom". PMID- 2758725 TI - Pharmacogenetics of acute azathioprine toxicity: relationship to thiopurine methyltransferase genetic polymorphism. AB - Azathioprine therapy can cause acute myelosuppression. Toxicity is in part caused by the incorporation of azathioprine-derived 6-thioguanine nucleotides (6-TGN) into deoxyribonucleic acid (DNA). The enzyme thiopurine methyltransferase (TPMT) plays an important role in azathioprine catabolism. TPMT activity is controlled by a common genetic polymorphism, and one in 300 subjects has very low enzyme activity. Azathioprine was withdrawn in five study patients because of acute myelosuppression. The duration of azathioprine treatment was 21 to 70 days (median, 28), and the daily oral dose was 1.0 to 2.5 mg/kg. Sixteen control patients who had been taking oral azathioprine (1.1 to 2.0 mg/kg daily for more than 6 months) with no history of myelosuppression were studied. All subjects had normal liver and kidney function. When compared with the control group, the five patients with myelosuppression had very low TPMT activities and abnormally high 6 TGN concentrations. Inherited low TPMT activity appears to be a major risk factor for acute azathioprine-induced myelosuppression. PMID- 2758726 TI - Time to stop counting the tablets? AB - We attempted to assess compliance using both a pharmacologic indicator (low-dose phenobarbital) and a return tablet count in 225 patients who were taking part in three separate studies. There were 216 patients (96%) who kept a follow-up appointment after 28 days; 161 patients appeared to have good compliance (90% to 109%) by return tablet count. Of these 161 patients, 51 (32%) had plasma phenobarbital concentrations (corrected for dose and weight) that were less than 90% of the lowest value previously found in normal volunteers, which suggested poorer compliance. When compared with the age-related volunteer values, 77 (48%) had values that were less than 90% of the lowest volunteer value. There were 6 of 10 patients with apparently excessive (greater than or equal to 110%) compliance by return tablet count and 4 of 12 who failed to return their container who also had phenobarbital concentrations that were less than 90% of the lowest volunteer value. We concluded that return tablet count grossly overestimates compliance. PMID- 2758727 TI - Cadralazine challenge in patients with previous hydralazine-induced lupus: a 6 month study. AB - The objective of this study was to investigate the effect of cadralazine in patients who had previously had hydralazine-induced lupus. There were 11 patients included in the study, 10 of whom were treated for 6 months with 15 or 20 mg cadralazine given once daily in combination with beta-blockers and diuretics. All patients had a history of hydralazine-induced lupus and were slow acetylators. None of the patients included in this study showed any current signs or symptoms of drug-induced lupus. No evidence of lupus-like symptoms or of immunologic laboratory abnormalities were found during the study period. Side effects associated with vasodilator therapy were noted in some patients but were transient and mild. We concluded that a cross-reaction between cadralazine and hydralazine does not seem likely to occur and that cadralazine, because of its chemical properties, probably will not give rise to drug-induced lupus. PMID- 2758728 TI - Zidovudine disposition in patients with severe renal impairment: influence of hemodialysis. AB - Pharmacokinetics of zidovudine (azidothymidine, AZT) was investigated after oral administration (200 mg) in 25 HIV seronegative subjects: 14 patients with severe renal impairment (creatinine clearance 6 to 31 ml/min), five hemodialyzed anuric patients, and six healthy subjects. Plasma and urine concentrations of zidovudine and its glucuronidated metabolite (GAZT) were measured simultaneously by HPLC assay. In healthy subjects, GAZT concentrations were higher than those of AZT; AUC values were 23.7 +/- 1.9 and 5.2 +/- 0.6 mumol.hr/L, respectively. Formation of GAZT rate-limits its elimination: GAZT half-life (t 1/2) parallels that of AZT, which is around 1 hour. In uremic patients, AZT concentrations were moderately increased (AUC = 11.7 +/- 1.1 mumol.hr/L), whereas t 1/2 and mean residence time (MRT) remain unchanged despite the decreased renal clearance (16 +/- 2 versus 220 +/- 58 ml/min) and decreased urinary excretion (1.6 +/- 0.3 versus 8.1 +/- 1.0% of the dose). In contrast, GAZT concentrations are markedly increased (AUC = 402.9 +/- 88.6 mumol.hr/L). As a consequence of the decreased renal clearance (27 +/- 3 versus 331 +/- 42 ml/min), elimination is the rate limiting step and t 1/2 is increased (8 +/- 2 versus 0.9 +/- 0.1 hr). Contribution of a 4-hour hemodialysis session to AZT elimination appears to be negligible, whereas elimination of GAZT is enhanced. On the sole basis of AZT pharmacokinetic data, no particular dose adjustment appears to be necessary in patients who have severe renal impairment (creatinine clearance between 10 and 30 ml/min). However, high levels of GAZT should be anticipated with the usual dosage regimen. PMID- 2758729 TI - Metoprolol and mephenytoin oxidation polymorphisms in Far Eastern Oriental subjects: Japanese versus mainland Chinese. AB - We examined genetically determined oxidation polymorphisms of metoprolol and mephenytoin in 200 unrelated, healthy Japanese subjects and in 98 mainland Chinese subjects simultaneously. This examination was done according to the respective reported phenotyping criteria by use of the urinary metabolic ratio of metoprolol and of the percentage of excretion of 4-hydroxymephenytoin 8 hours after dose administration. The frequencies of occurrence of poor metabolizers (PMs) in the Japanese versus the Chinese subjects were 0.5% versus 0% for metoprolol and 22.5% versus 17.4% for mephenytoin, respectively. There were no statistically significant differences in these frequencies between the two Oriental populations. However, Chinese extensive metabolizers (EMs) showed a significantly lower excretion of alpha-hydroxymetoprolol (p less than 0.01) and 4 hydroxymephenytoin (p less than 0.001) than that of Japanese EMs, and the mode of the distribution histogram of the Chinese EMs for the two test probes was skewed compared with that of the Japanese EMs. The findings indicate that the two Far Eastern Oriental subject groups have a lower frequency of PM phenotype of debrisoquin/sparteine-type oxidation and a greater incidence of PM phenotype of mephenytoin oxidation compared with the respective frequencies reported from white subjects. However, the explanation for the observation that the metabolic capacities of the test drugs differed between the EMs of the two populations who had a similar ethnic origin and who resided in the same geographic area remains obscure. PMID- 2758730 TI - Dose-effect and concentration-effect relationships of pinacidil and hydrochlorothiazide in hypertension. AB - To determine dose-effect and concentration-effect relationships in hypertension for pinacidil and hydrochlorothiazide when given alone and together, we conducted a randomized, double-blind, 4 X 3 factorial, modified fixed-dose multicenter trial. Three hundred and eighty-four patients with essential hypertension (supine diastolic blood pressure, 95 to 110 mm Hg) were assigned to one of 12 groups that received all combinations of four doses of pinacidil (0, 12.5, 25, and 37.5 mg, b.i.d.) with three doses of hydrochlorothiazide (0, 12.5, and 25 mg, b.i.d.). Significant dose- and concentration-effect relationships were seen for pinacidil and hydrochlorothiazide on diastolic blood pressure. For pinacidil, dose- and concentration-effect relationships were steeper after the dose than before the dose. A significant interaction with hydrochlorothiazide was noted such that, when combined with 12.5 mg hydrochlorothiazide, 12.5 mg pinacidil had near maximal effects on blood pressure at both peak and trough. Edema occurred in 47% of those who received 37.5 mg pinacidil monotherapy (19% discontinued). The administration of 12.5 mg pinacidil with 12.5 mg hydrochlorothiazide appears to be optimal for efficacy and safety. PMID- 2758731 TI - Effects of age on the serum concentration of alpha 1-acid glycoprotein and the binding of lidocaine in pediatric patients. AB - We determined the effect of age on the serum concentration of alpha 1-acid glycoprotein (alpha 1-AGP) in venous blood from 134 subjects who ranged in age from preterm neonates to 18-year-old adolescents. The mean (+/- SD) serum concentration of alpha 1-AGP, determined by radial immunodiffusion, increased significantly with age: the concentration found in neonates was less than that found in infants which, in turn, was less than that found in older children (p less than 0.001). In addition, we determined the effect of alpha 1-AGP on the free fraction of lidocaine in four groups of infants and children who received intravenous lidocaine (1.5 mg/kg). The percentage of free lidocaine correlated inversely and linearly with the serum alpha 1-AGP concentration (r2 = 0.617; p less than 0.001). The percentage of free lidocaine in the five neonates exceeded that in the older age groups. We conclude that the serum concentration of alpha 1 AGP increases while the free fraction of lidocaine decreases from early infancy to adolescence. PMID- 2758732 TI - Pharmacokinetics of nalbuphine in infants, young healthy volunteers, and elderly patients. AB - Nalbuphine is a new agonist and antagonist opioid analgesic agent that undergoes an important hepatic metabolism. In this study, we compared the pharmacokinetics of intravenous and oral nalbuphine in three groups of subjects: group I consisted of 14 children from 1 1/2 to 5 years of age (group IA) and from 5 through 8 1/2 years of age (group IB), group II consisted of 9 healthy male volunteers from 23 to 32 years of age, and group III consisted of 9 elderly patients from 65 to 90 years of age. All subjects and patients had normal hepatic and renal functions. The children received an intravenous injection of nalbuphine (0.2 mg/kg), and the subjects and patients in groups II and III received, at random, 10 mg intravenous injections and 30 mg oral doses of nalbuphine on two separate occasions. The distribution of nalbuphine was not modified with age. Elimination half-life (t1/2) was significantly shorter in group I (0.9 hour) than it was in group II (1.9 hours) and in group III (2.3 hours). Systemic clearance of nalbuphine decreased significantly with age. Absolute bioavailability of nalbuphine increased from F = 12% in group II to 46.3% in group III (p less than 0.01). These findings suggest that doses and rates of administration of nalbuphine should be adapted in younger patients and in elderly patients. PMID- 2758733 TI - Comparison between continuous and intermittent infusion regimens of cimetidine in ulcer patients. AB - The relative effectiveness of intermittent infusions and primed continuous infusions of cimetidine in the maintenance of intragastric pH greater than or equal to 4.0 was evaluated in a double-blind crossover trial in 26 patients who had active or healed gastroduodenal ulcers. During the intermittent phase, each patient received 300 mg cimetidine intravenously every 6 hours. During the continuous infusion phase, each patient was given a continuous infusion of 37.5 mg cimetidine per hour, preceded by a priming dose of 300 mg cimetidine that was given for 15 minutes. Intragastric pH was monitored continuously. During the last 12 hours of the study, the continuous infusion regimen provided 20% more time in which the pH was more [corrected] than 4.0 with 25% less medication than did the intermittent infusion regimen. PMID- 2758734 TI - Prevalence of diabetes mellitus in individuals heterozygous and homozygous for sickle cell anemia. AB - Colorimetric determinations of glycosylated Hb were carried out in a sample (n = 97) of sickle cell anemia patients, and in an age- and sex-matched group of individuals (n = 45) heterozygous for sickle cell anemia, from the Eastern Province of Saudi Arabia. A statistically significant increase in the value of glycosylated Hb was found in sickle cell trait (HbAS) group, when compared with those of sickle cell anemia (HbSS) and normal (HbAA) groups. Since glycosylated Hb is considered a valid indicator of long-term blood glucose, and assuming normal red blood cell survival in HbAS carriers, the increased value of glycosylated Hb may suggest that there exists a higher incidence of undiagnosed diabetes mellitus in individuals with heterozygous inheritance for sickle cell hemoglobin than homozygous sickle cell patients and normal individuals. The mechanism underlying this observation remains to be defined. PMID- 2758735 TI - Biochemical changes in cultured murine fibroblasts after treatment with hydrazinophthalazines. AB - Fibroblast cultures exposed to the drugs inducing a collagen-like syndrome (hydralazine and binazine) displayed growth inhibition and decrease in cellular protein content in a dose-dependent manner compared with control cultures. This was accompanied by the inhibitory effect of the drugs on DNA synthesis. The changes in the basic biochemical parameters of fibroblasts testify to the toxicity of hydrazinophthalazines in the connective tissue. PMID- 2758736 TI - Glycaemic control affects cellular sodium metabolism. AB - Total and amiloride sensitive leucocyte sodium influx in Media containing 10 mmol/l Na was studied directly using a triple isotope method for measuring initial 22Na uptake rates in 25 non insulin dependent diabetic subjects. Glycaemic control was assessed by glycated haemoglobin and fasting blood glucose. Although no significant relationship between Na flux and either plasma insulin or blood glucose could be found, glycated haemoglobin was significantly correlated with both total and amiloride sensitive flux. Glycaemic control must be considered in future work on cellular sodium metabolism. PMID- 2758738 TI - Trace elements in blood cells of diabetic subjects. AB - The majority of zinc, copper and magnesium is either intracellular or associated with the bones. It is therefore unlikely that the plasma concentration of these trace elements will reflect their whole body content. Blood cells might be more representative of lean tissue and are also easy to obtain. The concentration of zinc, copper and magnesium was measured in the leukocytes and hemoglobin of 42 subjects with non insulin dependent diabetes mellitus (NIDDM) and in 22 subjects with insulin dependent diabetes mellitus (IDDM) and was compared with that of 44 age-matched healthy volunteers. Zinc was found to be deficient in the serum (p less than 0.001), leukocyte (p less than 0.001) and hemoglobin (p less than 0.05) of the IDDM subjects, while copper and magnesium were increased in the serum, leukocytes and hemoglobin of the IDDM subjects (p less than 0.001). There was no zinc deficiency in the leukocytes of NIDD subjects. These results are opposite to the findings on zinc concentration in various tissue of animal models for IDDM and NIDDM and with our present knowledge on zinc status in IDDM and NIDDM subjects. Thus, we conclude that the concentration of zinc in blood cells of diabetic subjects might not reflect its concentration in various tissues. PMID- 2758737 TI - A longitudinal study of multimodal evoked potentials in diabetes mellitus. AB - Abnormal findings in visual (VEP), brainstem auditory (BAEP) and somatosensory (SEP) evoked potentials at early stages of Type 1 and Type 2 diabetes have recently been reported by our group. Our aim here was to perform a longitudinal study in diabetic patients at an early stage of the disease using a combined evoked potential analysis in order to evaluate the variation of neurological abnormalities over time. Nine Type 1 and 12 Type 2 diabetic patients were examined and a second recording was carried out after a mean interval of 15.7 months +/- 6.2 SD. VEP, BAEP and SEP were measured in all patients. At the first recording electrophysiological abnormalities, present in both Type 1 and Type 2 diabetes were more evident when a multimodal evaluation was used (44.4% and 66.7% respectively). The follow-up study showed that overall neurological abnormalities persisted in all those patients who had previously presented pathological values. Whereas the number of patients with pathological values remained unmodified, a tendency to progression, namely the number of nervous levels with electrophysiological abnormalities, was observed. Thus, our study confirms the appearance of anatomofunctional disorders in the central nervous system in short term diabetes, shows the persistence of neurological impairment in such patients and reveals a progressive segmental involvement at different nervous levels. PMID- 2758739 TI - Improved intestinal form and function in diabetic rats fed long-term with a polyunsaturated fatty acid diet. AB - Short-term (two weeks) feeding of isocaloric diets supplemented with polyunsaturated fatty acids (PUFA) is useful for the prevention or treatment of the enhanced uptake of glucose which occurs in rats with streptozotocin-induced diabetes, as compared with animals fed a diet supplemented with saturated fatty acids (SFA). The study was undertaken to compare the effects of long-term (seven weeks) feeding PUFA or SFA to diabetic rats. We have previously reported that diabetic animals fed PUFA had superior body weight gain, lower hemoglobin AlC values, lower plasma cholesterol and triglyceride levels, lower percentage decline in glucose (K value) following intravenous glucose tolerance testing, near-normal values of hepatic microsomal glucose-6-phosphatase activity and near normal concentrations of 18:2(6) and 20:4(6) in liver microsomal phosphatidylcholine and phosphatidylserine. However, jejunal and ileal uptake of varying concentrations of glucose were similar in the three diet groups. Thus, the potential long-term beneficial effects of feeding diets with a high PUFA/SFA ratio probably have their explanation in metabolic effects distant to their uptake by the intestine. PMID- 2758740 TI - The Knox lecture: radiology and the law. PMID- 2758741 TI - Percutaneous video angioscopy in peripheral vascular disease. AB - Percutaneous video angioscopy was performed using high resolution thin angioscopes in 12 peripheral arteries in 10 patients with peripheral vascular disease, to study the intraluminal appearance before and after dynamic, laser and conventional balloon angioplasty. Clear blood free views of the whole length of artery instrumented were obtained in 10 arteries with the remaining two arteries being partially visualised. The angioscopic appearances were compared to angiography. Clinically significant findings were detected in all the arteries by angioscopy that were not found by angiography. These included thrombus in the artery and vascular sheath, intimal flaps and fractured atheroma. The angioscopic findings helped to assess the effects of angioplasty in different types of occlusion. The findings demonstrate the potential of percutaneous angioscopy as an aid to percutaneous angioplasty as well as being a powerful diagnostic procedure. PMID- 2758742 TI - The influence of the lordotic projection on the interpretation of the chest radiograph. AB - The advantages of the lordotic projection, particularly in elucidating suspected pathology at the lung apex, are well known. However, the distortion and artefact of the images of thoracic structures produced by this projection can lead to diagnostic errors. In order to determine the differences in the images produced we compared 14 pairs of lordotic and standard chest radiographs, taken within 24 h of each other, in the same patients. The main artefacts seen in the lordotic views were apparent elevation of the diaphragm, poor visualisation of the lung bases, loss of definition of the aortic knuckle, and apparent widening of the superior mediastinum. These artefacts were greatly exaggerated when lordosis coexisted with pathology, or technical factors such as patient rotation or inadequate respiration. Caution should be exercised to avoid misinterpretation of lordotic films. PMID- 2758743 TI - Digital imaging of the newborn chest. AB - The study reports initial experience on utilising an area plate digital imaging system to obtain portable radiographic images on newborn infants. Initial results suggest that the system is a practical alternative to conventional portable radiography with potential advantages of decreasing the number of retake films and also of decreasing radiation dose. PMID- 2758744 TI - Clinical diagnosis from digital displays: preliminary findings of the St Mary's Evaluation Project. AB - Image quality is a fundamental issue in the introduction of picture archiving and communications systems (PACS), and one that has hitherto been eclipsed by other aspects of the considerable technological challenge facing scientists and manufacturers involved in its development. We conducted a formal evaluation of clinical radiological diagnosis from a commercially available PACS viewing station, using subperiosteal resorbtion in renal osteodystrophy as the test pathological diagnosis, with receiver operating characteristic (ROC) analysis of the results. We conclude that the displayed, digitised images were inferior to film using the apparatus tested and believe that careful, objective clinical evaluation of such systems is of paramount important. PMID- 2758745 TI - Radiological nomenclature in benign breast change. Breast Group of the Royal College of Radiologists. PMID- 2758746 TI - Radiologists and endoscopy: a survey of the attitudes and intentions of radiologists in training. AB - A postal survey of senior registrars in radiology in this country was carried out to assess attitudes towards radiologists taking part in endoscopy services. One hundred and ninety-six senior registrars from 37 training centres recognised by the Royal College of Radiologists completed the questionnaire (a response of 74%). Thirty-nine per cent of respondents had some practical experience of endoscopy before commencing training in radiology. Twenty-eight per cent of respondents declared a major interest in gastrointestinal radiology. Sixty four per cent felt that radiologists should perform endoscopy (87% in the case of those with a major interest in gastrointestinal radiology). Thirty-seven per cent were interested in providing, or participating in, an endoscopy service after obtaining a consultant post. Despite this level of interest, only 18% of respondents felt that they had adequate access to endoscopy training and only 3% were aware of the training recommendations of the British Society, of Gastroenterology. PMID- 2758747 TI - Radiological evidence for the polyp/cancer sequence in the colon. AB - Three cases of frank malignancy developing in pre-existing colonic polyps are presented. Although this sequence of events is well recognised, it is rarely demonstrated radiologically. The cases illustrate the importance of identifying and appropriately treating polypoid colonic lesions. PMID- 2758748 TI - The relationship between the radiological and clinical features in patients with Crohn's disease. AB - A study has been made of 93 Japanese patients with Crohn's disease who had not undergone bowel resection at the time of diagnosis during the years 1969 to 1983. Ninety had longitudinal ulcers or a cobblestone appearance or both of the small intestine or colon or both on double contrast barium examination. The incidence of longitudinal ulcers in the small intestine was significantly higher than in the colon (P less than 0.001). Conversely the incidence of cobblestoning was higher in the colon than in the small intestine (P = 0.065). In patients with longitudinal ulceration, there was significantly lower Crohn's disease activity index (CDAI), ESR, and C-reactive protein. Patients with cobblestoning had a significantly higher CDAI, ESR and C-reactive protein, and significantly lower values of albumin, cholesterol in serum, serum iron, haemoglobin, and relative body weight. Our findings indicate that cobblestoning closely correlates with the disease activity of Crohn's disease, and that longitudinal ulceration has a negative correlation. Moreover, our results suggest that the high incidence of cobblestoning and low incidence of longitudinal ulcers in the colon and the reverse in the small intestine reflects the fact that colonic involvement renders the disease more severe than small intestine involvement only. PMID- 2758749 TI - The interpretation of retrograde pancreatography in the elderly. AB - Endoscopic retrograde pancreatography is regarded as the most specific technique in the diagnosis of chronic pancreatitis. In the elderly the relevance of endoscopic retrograde pancreatography changes in establishing the diagnosis is disputed. The pancreatograms of 101 patients aged seventy-five years or more, who had endoscopic retrograde pancreatography for suspected biliary or pancreatic pathology, were reviewed. Only four patients subsequently proved to have unequivocal chronic pancreatitis. There was no significant difference in the size or contour of the main pancreatic duct, or in side branch changes between those patients presenting with common bile duct stones, incidental biliary pathology and pain of probable pancreatic origin. Three definite diagnostic criteria for the diagnosis of chronic pancreatitis emerged--duct obstruction with a stricture, gross irregularity of the main pancreatic duct and the presence of large cavities. PMID- 2758750 TI - Aspiration of high-density barium contrast medium causing acute pulmonary inflammation--report of two fatal cases in elderly women with disordered swallowing. AB - Two cases are reported in which accidental inhalation of barium contrast medium occurred owing to disordered swallowing in elderly women. In each case there was a pulmonary inflammatory reaction followed within a few hours by death. Experimental and clinical reports of barium inhalation are reviewed and the hazard of aspiration of high density barium preparations in elderly and debilitated patients with dysphagia is emphasised. It is concluded that particular care should be taken in the radiological examination of such patients, and a suggested method for performing a contrast swallow in those who are liable to aspirate is described. PMID- 2758751 TI - Staging of carcinoma of the uterine cervix: MRI-surgical correlation. AB - Forty-six patients with carcinoma of the uterine cervix were examined with spin echo magnetic resonance imaging (MRI) using a superconducting magnet operating at a field strength of 0.5 T. All subjects later underwent lymphadenectomy and, when appropriate, radical hysterectomy. Surgical-pathologic correlation was carried out in order to assess the accuracy of the imaging modality in the staging of the disease. In the detection of nodal involvement, the accuracy of MR was 76%. The accuracy in determination of tumour size approached 100%. In the assessment of parametrial and vaginal involvement, the accuracy was 85% and 100% respectively. PMID- 2758752 TI - Out-patient lumbar radiculography with iohexol. AB - A prospective study of 200 patients undergoing lumbar radiculography using 10 ml iohexol (240 mgI/ml) was undertaken to determine whether the procedure could be safely performed on an out-patient basis. No statistically significant differences in the incidence and severity of side-effects were found between the 99 out-patients and 101 in-patient controls. Three out-patients had to be kept in hospital at the end of the observation period and a further three out-patients were re-admitted to hospital because of severe side-effects. Out-patient lumbar radiculography is a safe procedure provided there is careful patient selection, adequate advice and easy access to medical help should problems arise following the examination. Adopting this practice considerably reduces the cost of lumbar radiculography and indirectly increases the availability of orthopaedic beds. PMID- 2758753 TI - Prolapsed thoracic intervertebral disc: the importance of CT assisted myelography. AB - We present six new cases of prolapsed thoracic intervertebral disc (PTIVD), and review the clinical and radiological features, particularly with regard to the role of computed tomography (CT) examination in the diagnosis and management. In patients with atypical lower limb pain, particularly when associated with sphincter disturbances, lumbar myelography is incomplete unless supplemented by an examination of the conus region and lower thoracic cord. The supplementary use of CT in suspected PTIVD is of considerable value to the surgeon in determining the size, position, and volume of the sequestration, and the extent of excavation of the spinal cord by prolapsed disc material. PMID- 2758754 TI - Three dimensional radiation therapy planning using light projection of CT scans. AB - A simple, quick, accurate method of transferring CT scan images on to radiotherapy planning films is described using a modified overhead projector with variable magnification properties. PMID- 2758755 TI - Causes of urinary tract dilatation. PMID- 2758756 TI - Magnetic resonance imaging of the knee. PMID- 2758757 TI - Critical analysis of the use of skeletal surveys in patients with chronic renal failure. PMID- 2758758 TI - The 57 mm thermal clearance probe: a non-invasive tool for measuring subcutaneous blood flow. AB - 1. The segmented thermal clearance probe is a non-invasive instrument which measures heat thermal clearance, a variable directly proportional to superficial blood flow, with a depth sensitivity theoretically proportional to the sensor diameter. We compared an 18 mm sensor and a recently developed 57 mm sensor with the reference technique of xenon washout. 2. The theoretical depth sensitivity of the sensors was assessed using Perspex spacers. Ninety-five per cent of sensitivity had been lost at the respective depths of 3.5 mm and 7.1 mm for the 18 mm and 57 mm sensors. 3. A comparison was made between heat thermal clearance reading and 133Xe decay curves using the two probes for 15 min after injection of 133Xe at 2 mm and 6 mm depths in the anterior thigh in 41 subjects. The 57 mm sensor showed similar correlation with xenon washout at 2 mm injection depth (r = 0.89) and 6 mm injection depth (r = 0.86), whereas the 18 mm sensor showed greater correlation at 2 mm (r = 0.92) than at 6 mm (r = 0.62). 4. The 57 mm sensor was compared with xenon washout at 6 mm in eight insulin-treated diabetic subjects. The relationship was similar to that in non-diabetic subjects (r = 0.79), with no significant difference in slope or intercept. 5. It is concluded that the 57 mm thermal clearance probe may be used to study blood flow at the depth of insulin injection (6 mm) in diabetic and non-diabetic subjects. PMID- 2758759 TI - Urinary kallikrein excretion during potassium chloride infusion in potassium adapted rats: effect of amiloride. AB - 1. Urinary kallikrein excretion in the anaesthetized rat was measured during intravenous KCl infusion in control and in K+-adapted rats. 2. The infusion of 0.1 mol/l KCl at 3.0 ml/h for 60 min in control rats resulted in a significant increase in urinary kallikrein excretion, associated with diuresis, natriuresis and kaliuresis. 3. When rats were offered 0.1 mol/l KCl to drink ad libitum for 14 days (K+-adaptation), the basal excretion of kallikrein was higher than in the control rats. In K+-adapted rats, intravenous infusion of 0.1 mol/l KCl resulted in significantly greater increase in urinary kallikrein excretion than in the control rats. 4. The Na+-channel blocker, amiloride (8.5 mg/kg body weight), significantly increased urinary kallikrein excretion immediately after injection in control and K+-adapted rats. However, in the subsequent 60 min, kallikrein excretion decreased markedly to values lower than those before injection of amiloride. 5. When amiloride was superimposed on a continuous 0.1 mol/l KCl infusion in K+-adapted rats, there was an immediate increase in kallikrein excretion. In the subsequent 20 min, kallikrein excretion decreased only to increase again in the next 40 min of KCl infusion. 6. Since amiloride injection reduces urinary kallikrein excretion in control and K+-adapted rats, the results suggest that urinary kallikrein excretion in the rat is through a mechanism(s) affected by amiloride. The high urinary kallikrein excretion and the greater response to KCl infusion in K+-adapted rats suggest that the K+-transport mechanism is more important than the mechanism affected by amiloride. PMID- 2758760 TI - Effects of plasma, tumour necrosis factor, endotoxin and dexamethasone on extracellular proteolysis by neutrophils from healthy subjects and patients with emphysema. AB - 1. Neutrophils from patients with chronic obstructive bronchitis and emphysema or age-matched control subjects were cultured on a substrate of 125I-fibronectin. The neutrophils from patients with lung disease digested significantly more fibronectin and released more elastase into the culture supernatant than did cells from control subjects. Preincubation of neutrophils from emphysematous patients with plasma from control subjects significantly inhibited fibronectin digestion by the patients' neutrophils by, on average, 10%. Preincubation of control subjects' neutrophils with plasma from emphysematous patients had no effect on fibronectin digestion. 2. Tumour necrosis factor increased fibronectin digestion in a dose-dependent manner when the cytokine was added to the adherent cells but not when preincubated with the polymorphonuclear leucocytes in suspension. Bacterial endotoxin in concentrations above 6 micrograms/ml significantly increased fibronectin digestion by neutrophils, but leukotriene B4, interferon-gamma and interleukin-1 alpha had no significant effects. 3. Dexamethasone inhibited fibronectin digestion by neutrophils in a dose-dependent manner, from 11% at 10(-10) mol/l to 68% at 10(-3) mol/l. PMID- 2758761 TI - Increase in proteinuria and reduction in number of anionic sites on the glomerular basement membrane in rabbits by infusion of human nephrotic plasma in vivo. AB - 1. Intraortic suprarenal infusion in vivo of New Zealand White rabbits with plasma from patients with the nephrotic syndrome reduced the number of anionic sites labelled by the cationic polymer polyethyleneimine in the lamina rara iterna to 14.0 +/- 2.7 per 1000 nm of lamina rara interna (mean +/- SD) compared with 18.7 +/- 2.1 (P less than 0.005) after infusion of plasma from normal subjects. 2. Proteinuria increased in all nine animals infused with nephrotic plasma and in two of seven infused with control plasma (P less than 0.01). The mean increase in proteinuria in the animals infused with nephrotic plasma was 246 mg/l (P less than 0.05), whereas in those infused with control plasma there was no increase. 3. We conclude that nephrotic plasma contains a factor(s) capable of neutralizing the charge of these anionic sites and concomitantly increasing proteinuria. PMID- 2758762 TI - Naloxone-reversible inhibition of gall-bladder mucosal fluid secretion in experimental cholecystitis in the cat by acetorphan, an enkephalinase inhibitor. AB - 1. Enkephalin immunoreactive nerve fibres have been demonstrated in the gall bladder of various mammals including man. In various tissues, enkephalins are partly degraded by a membrane metallo-endopeptidase, enkephalinase (EC 3.4.24.11). 2. Using 3H-labelled [D-Ala2,Leu5]enkephalin as a substrate, enkephalinase activity, immunoprecipitated by a monoclonal antibody directed against the rabbit kidney enzyme, was demonstrated in the feline gall bladder. Using the same antibody in 125I-labelled form, the peptidase was immunolocalized by autoradiography, mainly in the epithelium. 3. In experimental cholecystitis, elicited by implantation of human gall-stones into the cat gall bladder, the continuous fluid secretion into the lumen was inhibited by exogenous enkephalins. 4. Acetorphan, an enkephalinase inhibitor, was found to block fluid secretion by the inflamed gall bladder via a naloxone-sensitive mechanism, but not to affect fluid transport in the normal gall bladder. The drug also transiently contracted the gall bladder and increased bile outflow from the liver. 5. It is suggested that acetorphan, by reducing the degradation of endogenous enkephalins in the inflamed gall bladder, decreases fluid secretion by the epithelium and that enkephalinase inhibitors may find clinical applications in acute cholecystitis. PMID- 2758763 TI - Effect of phosphate-buffered sucrose flush solution upon the initial phase of ischaemic acute renal failure in the rat. AB - 1. Experiments were performed upon anaesthetized rats to investigate the effect upon the initial 4 h of ischaemic acute renal failure of intrarenal flush with phosphate buffer (PB), sucrose alone and phosphate-buffered sucrose (PBS) solutions of differing compositions. 2. Kidneys flushed with PB immediately before 45 min pedicle clamp ischaemia exhibited a post-ischaemic function similar to that of control, non-flushed kidneys: they were isosthenuric and non-oliguric with a clearance of inulin (Cin) depressed to 10% of the pre-ischaemic value. 3. Kidneys flushed with 50 mmol/l sucrose in saline before ischaemia became isosthenuric, oliguric and had a more severely depressed post-ischaemic Cin compared with non-flushed kidneys. 4. Kidneys flushed with PBS containing either 50 (PBS50) or 140 (PBS140) mmol/l sucrose at pH 7 became polyuric after ischaemia, produced concentrated urine and had Cin values significantly higher than control kidneys. 5. Raising the pH of the PBS50 to 7.4 resulted in isosthenuric, polyuric kidneys that had a post-ischaemic Cin not significantly different from that of the control group. 6. It is concluded that the severity of the initial phase of ischaemic acute renal failure was significantly reduced by intrarenal flush with a PBS solution of pH 7; flush with PB or sucrose alone had no protective action. PMID- 2758764 TI - Whole body protein turnover and resting metabolic rate in homozygous sickle cell disease. AB - 1. Whole body protein turnover and resting metabolic rate were measured in six adults with homozygous sickle cell disease (genotype HbSS) and in six normal adults (genotype HbAA) of similar age. 2. Turnover was measured with prime/intermittent oral doses of [15N]glycine over 18 h and resting energy expenditure was measured by indirect calorimetry. 3. In HbSS, nitrogen flux (0.9 +/- 0.08 g day-1), protein synthesis (6.0 +/- 0.5 g day-1 kg-1) and protein degradation (5.6 +/- 0.5 g day-1 kg-1) were significantly increased compared with HbAA nitrogen (flux 0.5 +/- 0.02 g day-1 kg-1, protein synthesis 3.2 +/- 0.2 g day-1 kg-1 and protein degradation 2.8 +/- 0.2 g day-1 kg-1). 4. Resting energy expenditure was significantly higher in HbSS compared with HbAA when expressed per unit of body weight (115 +/- 3 and 94 +/- 4 kJ day-1 kg-1, respectively) or weight 0.75(317 +/- 6 and 269 +/- 8 kJ day-1 kg-0.75, respectively). 5. The increase in protein turnover and energy expenditure suggest that patients with HbSS exist in a hypermetabolic state that requires greater dietary energy compared with HbAA. PMID- 2758765 TI - Role of thromboxane A2 as a mediator of platelet-activating-factor-induced aggregation of human platelets. AB - 1. At present it is unclear whether platelet-activating-factor (PAF)-induced aggregation is mediated by thromboxane. To obtain further information about this event we have compared the affects of aspirin on platelet aggregation and secretion induced by PAF and collagen. 2. Collagen and PAF induced aggregation and secretion in human platelets in a dose-related manner. 3. Aspirin inhibited the magnitude of both platelet aggregation and secretion induced by PAF and collagen, but the degree of inhibition was much greater for collagen. 4. Aspirin strongly inhibited the aggregation rate of collagen-induced platelet aggregation, but had no measurable effect on the rate of PAF-induced aggregation. 5. Inconsistencies reported in previous studies of the effect of aspirin on PAF induced platelet aggregation may be explained, in part, by the doses of PAF used and the method of inactivating cyclo-oxygenase (in vitro compared with in vivo). 6. Our results suggest that the initial events of PAF-induced aggregation are independent of thromboxane A2 formation and that thromboxane A2 plays only a minor role in the later phase of PAF-induced aggregation. PMID- 2758766 TI - Clinical sequelae and sacroiliac joint changes by computed tomography after recovery from septic sacroiliitis. AB - Nine cases of septic sacroiliitis were re-examined clinically and by CT after a follow-up period of 1.5-7 years. At the final check-up, six of the patients were asymptomatic, while pain could be provoked by palpation or compression in three cases. The sacroiliac joint CT findings were considered normal in two cases. Joint space narrowing, subchondral sclerosis, cysts, erosions, ankylosis and/or osteophytes were detected in seven cases. We conclude that recovery from septic sacroiliitis is good although destructive and degenerative changes often develop as sequelae of an osteolytic involvement. PMID- 2758767 TI - Prevention of glucocorticoid-induced osteopenia: effect of oral 25-hydroxyvitamin D and calcium. AB - Twenty-four patients (9 M and 15 F, age range 51-82) with polymyalgia rheumatica receiving 6-methylprednisolone for a period of 9 months (16 mg/daily/two weeks, 14 mg/daily/two weeks, 12 mg/daily/1 month, 10 mg/daily/1 month, 8 mg/daily/1 month, 6 mg/daily/1 month and 4 mg/daily for the last four months) were randomly assigned to receive either 250HD3 (35 mcg/day for 25 days/month) (Group A) or placebo (Group B) in a double-blind study. All patients also received 500 mg elemental calcium daily. Before and at 3, 6 and 9 months ESR, tenderness on palpation and subjective pain were evaluated. At the same times, mineral metabolism parameters (serum calcium, phosphorus, alkaline phosphatase, 24-h urinary calcium, phosphate and 24-h hydroxyproline excretion) and radial bone mineral content (BMC) were evaluated. Activity indexes (ESR and clinical parameters) improved in both groups. Furthermore, serum alkaline phosphatase and 24-h hydroxyproline excretion decreased significantly only in Group A, and BMC decreased significantly in Group B but rose slightly in Group A. No side effects were observed in any of the patients. PMID- 2758768 TI - The rheumatoid heel: its relationship to other disorders in the rheumatoid foot. AB - Four-hundred and eight rheumatoid feet are studied. The percentage of talalgia is 3.7%; for inferior exostosis it is 29.6%, and 30.8% for posterior exostosis. Posterior demineralisation is present in 12%, whereas for bony erosion it is 8.1%. Plantar spurs are very closely associated to flattened feet (p less than 0.0001). Likewise a very noticeable statistical association is noted between postero-superior calcaneitis and tarsal arthritis (p less than 0.0001), and calcaneitis was more frequent among marked valgus (p less than 0.001). These results are compared with findings of other works. Therapeutic consequences are evoked. PMID- 2758769 TI - Infra-red surface thermography. Evaluation of a new radiometry instrument for measuring skin temperature over joints. AB - A study is reported of the evaluation of a new portable, light-weight, infrared thermometer, for the measurement of the skin temperature over joints. A high degree of reproducibility was observed, but no increase in heat was found over selected rheumatoid joints. The instrument will prove useful in detecting temperature changes in disease states where the changes are considerable, and where the ambient temperature can be strictly controlled. PMID- 2758770 TI - Evening primrose oil and olive oil in treatment of rheumatoid arthritis. AB - The effects of 10 ml of evening primrose oil or olive oil, administered twice daily for 12 weeks, on clinical and laboratory signs and on plasma prostaglandins were studied in 18 patients with rheumatoid arthritis. The plasma concentration of PGE2 decreased and that of TxB2 increased in both treatment groups, but no significant improvement could be seen in either group. PMID- 2758771 TI - Posttraumatic anterior cruciate ligament insufficiency as a cause of osteoarthritis in a knee joint. AB - The purpose of the present investigation was to examine and describe the osteoarthritic changes that chronic, partial or complete anterior cruciate ligament (ACL) insufficiency causes to the knee joint. The most characteristic findings in 77 patients with average follow-up of eight years were osteophytes and subchondral sclerosis of femoral and tibial medial condyles, tibial eminence and patella, as well as narrowing of medial or lateral joint space. Only five patients (14%) in the group with partial, but 28 (70%) of those with complete insufficiency of the ACL suffered from a clear posttraumatic osteoarthritis of the injured knee. In complete tears, the total extent of these pathological changes per patient was fourfold compared to the patients with partial tear. It was concluded that chronic, posttraumatic insufficiency of the ACL causes characteristic osteoarthritic changes to the injured knee and that the amount of these changes seems to depend on the amount of the insufficiency. Therefore, a quick restoration of the static and dynamic stability of the injured knee must be the privilege of every knee injury patient in order to prevent the development of premature osteoarthritis. PMID- 2758772 TI - Outcome in patients hospitalised for psoriatic arthritis. AB - Forty patients hospitalised for treatment of psoriatic arthritis (PsA) were followed for a mean of 8.0 years. At the end of this time none had died and only 8% were in functional class IV. 90% received second-line therapy. There was a high incidence of skin rashes on gold but hydroxychloroquine was well tolerated. Patients with psoriatic arthritis had a better outcome than patients with rheumatoid arthritis treated with the same regime. PMID- 2758773 TI - Unusual arthritis: be on the alert for leprosy. AB - A 50-year-old Indonesian man presented with arthritis of the left ankle, wrist and hand joints and a diffusely swollen left hand and foot. A few months later granulomatous skin lesions developed and renewed physical examination revealed a paresis of the intrinsic muscles of the left hand and the left M. extensor hallucis longes and thickening of several peripheral nerves. The skin lesions appeared to be anesthetic. A diagnosis of borderline tuberculoid leprosy was made and treatment resulted in cure with permanent peripheral nerve damage. This case emphasizes the importance of early recognition and treatment of leprosy to prevent nerve damage. PMID- 2758774 TI - Reactive fibromatosis in pustulotic arthro-osteitis. AB - Sterno-costo-hyperostosis is an inflammatory rheumatic disease which is associated to pustulosis palmaris et plantaris. The origin of this disorder is unknown. We described the appearance as a "reactive" fibromatosis in connection with a hyperostosis of a clavicle, which could be demonstrated in a biopsy-probe and by NMR-technique. PMID- 2758776 TI - Cricoarytenoid arthritis may be a case of emergency. PMID- 2758775 TI - Anticardiolipin antibodies in Behcet's syndrome: a predictor of a more severe disease. AB - A high incidence of anticardiolipin antibodies were detected in 7 of 20 patients (35%) with Behcet's Syndrome. Three patients had IgG-ab, three had IgM-ab and one had both IgG and IgM antibodies. IgG-ACA was detected mainly in patients with ocular disease (30%) and one of them also has cerebral vascular disease. A lower incidence of ACA was found in the patients taking steroids compared with the ones taking other drugs. This work draws attention to the more severe disease present in patients with ACA and also the possibility of such tests become negative in patients taking immunosuppressive drugs. PMID- 2758777 TI - Bone remodelling in osteoporosis. AB - Bone remodelling, a highly regulated succession of events, is the temporal sequence of osteoclastic bone resorption and osteoblastic bone formation. Bone loss with age and in osteoporotic patients is due to a disequilibrium between both processus. Bone histomorphometry was the method used to measure these events. Its shows clearly that, with age, the quantity of bone formed in one remodelling unit (so called mean wall thickness) decreases. In osteoporotic women, compared to control women of the same age the amount of bone formed is also decreased. Concordant data on this point have been obtained in different laboratories. By contrast, the cellular mechanism underlying this decreased amount of bone formed is largely controversial: a decreased osteoblast recruitment or life span or capacity to synthesize collagen have been suggested. Bone loss with age is associated with an increase in the amount of bone resorbed. This observation is the result of an indirect measurement founded on the distance between trabeculae. As the decreased bone formation, this processus is exaggerated in postmenopausal osteoporosis. The respective importance of decreased bone formation and increased bone resorption is however difficult to assess. Some osteoporotic patients have increased bone resorption surfaces compared to control women on their bone biopsy; however, it does not seem that these patients form a definite subgroup of osteoporotic patients as the extent of resorption surfaces changes with time in an untreated osteoporotic. In conclusion, the observed changes in bone remodelling in osteoporotic post menopausal women are an exaggeration of those observed during ageing. These changes should be a basis for a coherent therapy of bone loss in osteoporotic patients. PMID- 2758778 TI - ADFR therapy in the prevention of bone loss after menopause. AB - Estrogens retard bone loss after menopause and constitute the most logical therapy for the prevention of postmenopausal osteoporosis. Estrogens are contraindicated in some circumstances and some postmenopausal women are unwilling to accept them. We have used ADFR therapy as an alternative in the prevention of postmenopausal bone loss. One hundred women in the early postmenopausal period (6 24 months since the last menses) were introduced into the study. 50 were treated with placebo and 50 were treated with ADFR therapy (phosphorus 1.5 gr/day during 3 days, followed by SCT 100 UI/day during 10 days and calcium 1 gr/day). After 77 days without any therapy we repeated the cycles every 3 months. Bone mass was evaluated at the beginning and at 3, 6, 12 and 18 months by dualphoton absorptionmetry lumbar spine. In the control group, the mean spinal BMD decreased 7.31% after 12 months and 6.16% after 18 months (p greater than 0.05). The ADFR group only had a mean spinal BMD decrease of 3.79% and 1.1% after 12 and 18 months respectively (NS). Bone loss was greater in control than in ADFR group after 12 and 18 months (p less than 0.05 at both times). We conclude that phosphorus and calcitonin like ADFR therapy may be a useful alternative to estrogen for the prevention of accelerated bone loss after menopause. PMID- 2758780 TI - MAB Meridional Advisory Board, 2nd International Workshop on Osteoporosis. Paris, December 2-3, 1988. Proceedings. PMID- 2758779 TI - The natural history of the osteoporotic vertebral fracture. AB - The clinical picture of the osteoporotic fractures of the spine presents an heterogeneity in their intensity and duration. In 210 cases of osteoporotics with acute pain and radiological evidence of spinal fracture we separate their clinical picture in two groups. In Type I (121 cases) pain is acute and severe, improving gradually; the vertebral wedging is obvious from the beginning and remain unchanged. The duration of this event exceeds 4-8 weeks. In Type II (89 cases) pain is less and of shorter duration, but after 6-16 weeks a new attack of acute pain presents. This picture can be repeated for 6-18 months. Radiologically the fracture is not clear during the first attack but wedging gradually developed during the next months. Bone density of the lumbar spine (DPA) was measured in all cases. Type I had a significantly lower BMC than Type II. We suggest that patients with unclear vertebral fractures, minor symptoms and relatively high bone mass must classified in Group II and deterioration can occur during the next months. Long term treatment and additional orthopaedic prevention is needed. In Group I a short term calcitonin treatment helps early relief and mobilization. PMID- 2758781 TI - The role of physical exercise in prevention and management of osteoporosis. AB - The effect of exercises on vertebral trabecular bone mineral content (BMC) was investigated in 24 women with osteoporosis (OP) diagnosed by Quantitative Computed Tomography (QCT). Two groups were formed: an exercise and a control group with no exercise. Subjects in the exercise group exercised for one hour, twice weekly for a period of 6 months under the supervision of a physical therapist. A home exercise program which included the same exercises used in the hospital plus walking for half an hour every day was also assigned. Initial lumbar X-ray films, values obtained from laboratory investigations, physical activity scores and spinal BMC measurements were compared with those obtained after 6 months. The increase in the level of physical activity in the exercise group after exercise therapy was found statistically significant (p less than 0.001). After the exercise period, BMC values showed a 4.76% increase whereas in the control group, a decrease of 2.7% was found. The results demonstrated the beneficial effect of exercise in the prevention and management of OP. PMID- 2758782 TI - Cost analysis of osteoporosis related to untreated menopause. AB - Menopausal osteoporosis has many consequences for women over 50. Its complications incur high treatment costs both for society and the patients themselves. Collection of the epidemiological data required for a cost analysis of menopause-related osteoporosis is not easy, but we have calculated the direct (i.e. purely medical) costs as follows: hip fractures: approximate number per annum in women over 50: 55,000, minimum hospital costs (treatment and rehabilitation): 3.5 bn FF; forearm fractures: approximate number per annum: 35,000, cost of out-patient treatment: 200 m FF; vertebral fractures: common, but generally unrecorded: estimated number 40,000-65,000 cost: unevaluated. The relative benefit of hormone therapy versus nontreatment may be used to calculate the cost of osteoporosis due to non treated menopause. In France, where currently only 5% women over 50 are treated, this cost is 2.2 bn FF. If 50% of women were treated, the savings from hormone therapy (in terms of osteoporosis treatment costs) could be 1.2 bn FF, a figure which must be weighed against a cost analysis of oestrogen therapy. PMID- 2758783 TI - Biomarks in secondary osteoporosis. AB - The existence of a metabolic disease in rheumatoid arthritis in distant zones of the active synovitis areas, remains controversial. Indeed, the variations found, by different authors, in PTH, in alkaline phosphatase and in serum and/or in the calcium urinary values, as well as in phosphate and hydroxyproline, have not clarified this problem, despite the demonstration by histomorphometry and by densitometrical methods, of a greater loss of the bone mass in rheumatoid arthritis. At the same time, metabolic changes in sexual hormones, primary or secondary, can modulate the immune response and interfere in the clinic expression of rheumatoid arthritis and also in the bone turnover. Therefore, the purpose of this study was to compare some parameters of the bone metabolism and of the hormonal condition, in women with rheumatoid arthritis, with and without corticotherapy and in an age-related control group. In Group RA (patients), we found relatively higher levels of phosphates, alkaline phosphatase and osteocalcin, just as in the nephrogenic c'AMP and the hydroxyproline/creatinine quotient. The blood levels of calcitonin, PTH, T3, T4, cortisol and estradiol did not show significant differences between the 2 groups, although they were lower in Group RA. On the contrary, the plasma levels of testosterone, of 4 androstenedione and DHEA.S were significantly reduced in patients with rheumatoid arthritis. These results are compatible with the existence of bone metabolic hyperactivity in rheumatoid arthritis, which can be related, directly or indirectly to the reduced androgens plasma levels, since these seem to play a protective role in auto-immune diseases and also on the bone metabolism.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2758784 TI - Before you see it, you see its parts: evidence for feature encoding and integration in preschool children and adults. AB - Preschool children and adults were compared in two experiments examining the basic issue of whether perceptual representations of objects are built-up from independent features along the dimensions of size and brightness. Experiment 1 was a visual search experiment. Subjects searched for targets which differed from distractors either by a single feature or by a conjunction of features. Results from preschoolers were comparable to those from adults, and were consistent with Treisman and Gelade's (1980, Cognitive Psychology, 12, 97-136) feature integration theory of attention. Their theory states that independent features are encoded in parallel and are later combined with a spatial attention mechanism. However, children's significantly steeper conjunctive search slope indicated a slower speed of feature integration. In Experiment 2, four mathematical models of pattern recognition were tested against classification task data. The findings from both age groups were again consistent with a model assuming that size and brightness features are initially registered, and then integrated. Moreover, the data from Experiment 2 imply that perceptual growth entails small changes in the discriminability of featural representations; however, both experiments show that the operations performed on these representations are the same developmentally. PMID- 2758785 TI - The phenomenology of spatial integration: data and models. AB - A briefly presented visual stimulus followed by darkness seems to persist beyond its physical offset. We are concerned here with the relation between two characteristics of this visible persistence: first, its phenomenological resemblance to the stimulus that spawned it and second, its usefulness as a basis for integrating visual stimuli that are separated in time. We describe two experiments using a task in which two halves of a visual stimulus were presented successively and observers reported how complete the stimulus appeared to be. Stimuli appeared less complete with increases in both the duration of the interval intervening between presentation of the two halves and the duration of the initially presented stimulus half. This data pattern is similar to that obtained in tasks in which spatial integration of two temporally disparate stimuli is necessary for correct responding. On the basis of this similarity, we argue that phenomenological appearance and ability to integrate stimuli over time are two facets of the same perceptual events. We describe a formal model to account for these and other data. PMID- 2758786 TI - Testing between the TRACE model and the fuzzy logical model of speech perception. AB - The TRACE model of speech perception (McClelland & Elman, 1986) is contrasted with a fuzzy logical model of perception (FLMP) (Oden & Massaro, 1978). The central question is how the models account for the influence of multiple sources of information on perceptual judgment. Although the two models can make somewhat similar predictions, the assumptions underlying the models are fundamentally different. The TRACE model is built around the concept of interactive activation, whereas the FLMP is structured in terms of the integration of independent sources of information. The models are tested against test results of an experiment involving the independent manipulation of bottom-up and top-down sources of information. Using a signal detection framework, sensitivity and bias measures of performance can be computed. The TRACE model predicts that top-down influences from the word level influence sensitivity at the phoneme level, whereas the FLMP does not. The empirical results of a study involving the influence of phonological context and segmental information on the perceptual recognition of a speech segment are best described without any assumed changes in sensitivity. To date, not only is a mechanism of interactive activation not necessary to describe speech perception, it is shown to be wrong when instantiated in the TRACE model. PMID- 2758787 TI - Guttman scale analysis of dental health attitudes and knowledge. AB - Indexes on attitudes and knowledge are very often used in community dentistry research. However, such indexes are seldom evaluated with respect to validity. In the social sciences, complicated and advanced scaling methods are widely used. One of the methods, The Guttman scaling, is a means of analyzing the underlying characteristics of several items in order to determine whether the scale is unidimensional and cumulative. The purpose of the present study was to develop and evaluate two Guttman scales: 1) attitudes to prevention of dental diseases and 2) knowledge about sugar and caries. The scales were evaluated on the basis of survey data on health behavior, dental attitudes and knowledge among parents of Danish children 6 years of age. A total of 193 parents (71% of original sample) responded to a postal questionnaire including questions on attitudes to prevention of dental diseases and knowledge about sugar and caries. In the analyses, the scales were evaluated according to standard criteria of scalability: Coefficient of Reproducibility, Minimal Marginal Reproducibility, and Coefficient of Scalability. The analyses showed that unidimensional and cumulative scale was indicated for attitudes to prevention while the scale on knowledge about sugar and caries failed on the criteria of validity. In community dentistry, future studies ought to be more concerned with the construction and testing of scaling models in order to provide valid analyses of dental health attitudes and knowledge. PMID- 2758788 TI - General method for analysing dentist-patient interaction. AB - The interaction between dentist and patient during dental treatment may influence the frequency of dental visits in the future because this interaction may increase the dental fear of the patient. To find the characteristics of the dentist's behavior that increase or decrease dental fear a statistical analysis of the interaction may be used. Data of such interactions are known as time series. Because it is highly probable that the behavior of an individual at two different points in time is autocorrelated a correct statistical analysis of the interaction between dentist and patient must take this possibility into account. A general statistical method is proposed that can take autocorrelations into account. The method is compared with a simpler method that may not deal adequately with autocorrelations. PMID- 2758789 TI - Assessment of dental anxiety in edentulous subjects. AB - In this investigation an anxiety scale was constructed to measure dental anxiety in full denture patients. Furthermore, the relationship of this anxiety scale with denture history, denture satisfaction, and personality traits was investigated. A group of 125 patients who were on a waiting list to have new dentures constructed participated in this study. The coefficient alpha value of the anxiety scale was 0.81. Significant correlations were found with number of years with complete dentures (r = -0.20), with denture complaints (r = 0.18-0.19) and with some personality traits (r = 0.21-0.32). Further research into the role of dental anxiety with respect to dental behaviour and dental satisfaction in edentulous populations seems useful. PMID- 2758790 TI - Second assessment of London children involved in a scheme of dental health education in infancy. AB - In the mid-1970's, a scheme was set up providing dental health education at home visits to mothers with young children. A free supply of fluoride supplements for their children was offered to mothers in two of the three groups taking part. In the 10th year, 126 of the children were examined for caries and gingivitis. Few statistically significant results were seen in this small sample remaining from the scheme, but trends for better dental health amongst children whose mothers had been visited at home had been seen in a previous assessment and were seen again here. PMID- 2758791 TI - Immediate and delayed effects of a dental health education film on periodontal knowledge, attitudes, and reported behavior of Dutch adolescents. AB - In a field experiment the immediate and delayed effects of a 20-min dental health film on periodontal knowledge, attitudes, and reported behavior were assessed. Subjects were 425 12-14-yr-old Dutch adolescents. There were 12 experimental classes and eight control classes, matched for type of school, class, and level of urbanization. Results showed a substantial knowledge gain for the experimental group. This effect was sustained over a period of 2 months. For six items the gain was over 40%. Results did show a marginal effect of the film for attitude scores but no effect for reported behavior, either immediate or delayed. The effect of the film on knowledge was partly determined by background variables such as type of school, level of urbanization, and subject's age. No such interaction effects were obtained for attitude and reported behavior. The conclusion must be that knowledge of dental health issues can be improved by relatively simple means, but to change attitudes and behavioral dental practices more is needed than a 20-min film. PMID- 2758792 TI - Correlation of manual dexterity and comprehension with oral hygiene and periodontal status in mentally handicapped adults. AB - Although there is relatively little information concerning the oral health of handicapped adults there is increasing evidence to suggest that their oral condition, particularly periodontal health, is poor. The present investigation involved assessment of 382 handicapped patients attending four different Adult Training Centres in Birmingham. The caries status, oral hygiene, and periodontal conditions were evaluated and the Community Periodontal Index of Treatment Need (CPITN) was calculated. In order to assess the manual dexterity and the comprehension of the trainees a standard test was devised. This consisted of timing each participant in carrying out simple instructions to pick up and position certain common objects. The results indicated high levels of plaque, calculus, and bleeding with a mean CPITN of 7.43. The mean time taken for the manual dexterity and comprehension test was 23.9 seconds with a range from 10 to 80 seconds, S.E.+/- 1.33. This compares with results from 34 "normal" adults of a mean time of 8.2 seconds +/- 1.8 with a range of 6 to 12 seconds. There was no significant correlation between the Manual Dexterity and Comprehension scores and the periodontal indices in the handicapped adults. PMID- 2758793 TI - Long-term effect of xylitol chewing gum on dental caries. AB - About 85% (n = 269) of the subjects who participated in the Ylivieska follow-up studies on the effect of xylitol chewing gum on dental caries during 1982-84 or 1982-85 were re-examined in 1987 for the analysis of possible long-term preventive effects. Further caries reduction was found 2 or 3 yr after the discontinuation of the use of xylitol. The effect was especially marked in girls; the reduction in caries increment in the post-use years was 60% for the 2-yr users, suggesting that more pronounced caries reduction was associated with the most regular use of xylitol. In teeth erupting during the first year of the use of xylitol gum the long-term preventive effect was greater than in other teeth. Several explanations are suggested: lasting effect of the microbiological changes in the mouth, bacterial colonization on newly erupted teeth by organisms other than S. mutans, and/or thorough maturation of the teeth under favorable physico chemical circumstances. The results suggest that the value of xylitol in caries prevention depends on the timing of the treatment in relation to the development of the dentition. PMID- 2758794 TI - Hearing of dentists in the long run: a 15-year follow-up study. AB - Pure tone audiograms from 68 dentists with a minimum of 10 yr in dental practice were taken in 1973 and a follow-up was carried out in 1988. The aim was to study whether the dental occupation carried a risk for hearing handicap or not. Allowance for age and sex was made by using the presbyacusis values of SPOOR as the reference. At the speech range of frequencies dentists did not differ from the reference. At higher frequencies of 4, 6, and 8 kHz dentists tended to have higher hearing thresholds than expected. At 6 kHz, both male and female dentists had highly significantly greater hearing thresholds than expected by the corresponding references in both the studies. This difference remained essentially similar over the follow-up period, indicating that dental drill noise was insufficient to cause continuous loss of hearing. While mild NIHL was very common and tended to appear earlier in male than in female dentists, there was in the long run no continuous loss of hearing in either sex other than that attributable to the natural development of presbyacusis. PMID- 2758795 TI - Periodontal conditions in 35-44-year-old factory workers in Shanghai. AB - A periodontal survey applying CPITN was carried out in almost 500 male and female factory workers, 35-44 yr of age, in Shanghai, P.R. China. Calculus and shallow pockets were most frequent. Deep pockets of 6 mm and over were seldom found. The mean number of missing teeth was only 2.7 (out of 32). Problems associated with third molars seem to provide the largest immediate oral health problem. PMID- 2758796 TI - Analysis of complicated, multidimensional data. PMID- 2758797 TI - pH regulation of calcium efflux by turtle liver mitochondria. AB - 1. Turtle liver mitochondria are capable of taking up calcium in a pattern similar to that described from rat liver mitochondria. 2. Turtle liver mitochondria also possess a system for calcium efflux which is extremely sensitive to changes in extramitochondrial pH. A decrease in extramitochondrial pH by addition of HCl or by gassing with CO2 caused a rapid release of calcium. 3. The profound changes in pH and pCO2 during deep diving likely affects Ca efflux from mitochondria in the turtle liver. PMID- 2758798 TI - Avidin traps biotin diffusing out of chicken egg yolk. AB - 1. The unequal distribution of biotin and biotin-binding proteins between the yolk and albumen of freshly laid chicken eggs provides the potential for time dependent redistribution of biotin that could affect egg quality, biotin availability, and hatchability. 2. Avidin-bound biotin was measured in albumen next to the shell and next to the yolk in eggs stored up to 23 days. 3. Biotin bound to biotin-binding proteins (BBP-I and BBP-II) was measured at the center and periphery of yolk from the same eggs. 4. After 11 days of storage, significant amounts of biotin from the yolk began to accumulate in the albumen adjacent to the yolk. 5. This transfer is attributed to a change in the vitelline membrane that permits diffusion of biotin, not BBP-I or BBP-II, out of the yolk. 6. The dynamics of this phenomenon suggest that in addition to its antimicrobial role, avidin may be involved in the utilization of biotin by the chick embryo. PMID- 2758799 TI - Species-dependent differences in ATP half-life of glucose deprived crystalline lens. AB - 1. Significant differences were detected by 31P NMR spectroscopic techniques in the intrinsic rate of ATP hydrolysis by crystalline lenses from adult Macaca mulatta, Saimiri sciureus, Felis catus, Sus, Canis familiaris, Cavia rodentia and Oryctalagis cuniculus during exogenous glucose deprivation. 2. These differences were not attributable to differences in endogenous glycogen stores, and appear instead to emanate from comparative species differences in lenticular enzyme activities. PMID- 2758800 TI - Formation of alanine and glutamine in chick (Gallus domesticus) skeletal muscle. AB - 1. Incubation of extensor digitorum communis muscles from fed chicks in the presence of plasma concentrations of branched-chain amino acids (BCAA) increased the formation of glutamate, glutamine and alanine. This effect was inhibited by 1.5 mM L-cycloserine. 2. 2-Oxoisocaproate (0.1 and 0.5 mM) increased the formation of leucine but decreased that of glutamate, glutamine and alanine. 3. NH4Cl (0.3 mM) increased the formation of glutamine, and decreased the release and intracellular concentrations of glutamate and alanine. 4. Our results demonstrate that alanine and glutamine are synthesized de novo in chick skeletal muscle and demonstrate the similarity in alanine and glutamine synthesis in skeletal muscle between the domestic fowl and mammals. PMID- 2758801 TI - The influence of polyunsaturated fatty acids on spermine inhibition of lipoperoxidation. Studies on liposomes prepared with microsomal and mitochondrial phospholipids of sea bass (Dicentrarchus labrax L.) and rat liver. AB - 1. Composition of phospholipids extracted from different organelles of European sea bass liver was determined and compared with that of phospholipids extracted from the same organelles of rat liver. 2. Spermine binding to the vesicles prepared from microsomal and mitochondrial phospholipids and their aggregation was studied: these parameters indicate that only the presence of acidic phospholipids and not their unsaturation was essential for polyamine action. 3. No correlation exists between polyunsaturated fatty acid and spermine inhibition of lipid peroxidation. In fact microsomal phospholipids, which have a low content of acidic phospholipids, and a prevalent presence of phosphatidylinositol, are not protected by spermine. 4. Mitochondrial phospholipids, which have high content of cardiolipin, elicit the capability of spermine to inhibit lipid peroxidation. PMID- 2758802 TI - Purification and regulatory properties of pigeon erythrocyte pyruvate kinase. AB - 1. Pigeon erythrocyte pyruvate kinase (PK) was purified 22,000 fold by successive column chromatography on Sephadex DEAE A-50 and Red Agarose. The resulting enzyme preparation had a specific activity of 815.3 U/mg protein and an overall yield of 18.5%. 2. The molecular weight, as determined by gel filtration on Sephadex G-200 was 152,000. 3. Isoelectric focusing in the pH range of 3-10 showed that pigeon erythrocyte contained at least 3 PK isozymes with isoelectric points of 5, 5.7 and 6. 4. The variation of activity of PK at various ADP and phosphoenolpyruvate (PEP) concentrations was studied. The Km values for ADP and PEP were 0.40 and 0.46 mM respectively. 5. The enzyme was activated by FDP, and inhibited by ATP, highly phosphorylated inositol derivatives and 2,3-DPG: 6. It was activated by K+ and Mg2+ ions. 7. Phosphorylated hexoses and Pi stimulated the activity of PK. 8. The regulatory role of PK of pigeon erythrocytes, which lack the typical 2,3-DPG bypass, is discussed. PMID- 2758803 TI - Co-occurrence of psychiatric disorders in child psychiatric patients and nonpatients: a circumplex model. AB - This study of 106 preadolescent psychiatric inpatients, 101 preadolescent psychiatric outpatients, and 101 preadolescent nonpatients examined the prevalence of psychiatric disorders and co-occurrence of psychiatric diagnoses. The inpatients and outpatients had significantly more co-occurring diagnoses than the nonpatients. For a given diagnosis there are varying frequencies of co occurring disorders. The similar structure and prevalence among co-occurring diagnoses in this sample of children fit a circumplex model in which variation among disorders appears to be continuous in the form of a closed circle. PMID- 2758804 TI - Correlates of suicide and violence risk 1: the suicide risk measure. AB - A measure of suicide risk was developed using items reported to discriminate suicidal patients from controls in various studies. The new self-report scale was administered to 82 outpatients, 157 inpatients, and 83 college students. Using total scores, significant differences were found between the college sample and the two patient samples. The scale also discriminated between patients who reported one or more past suicide attempts and those who reported none. An independent cross-validation showed that half of the items continued to discriminate between patient and control groups. Sensitivity and specificity estimates were also determined. The test does not attempt to predict a specific rare event, i.e., suicide. It attempts to describe the degree to which a given individual reveals a set of characteristics that are similar to a suicide prototype. PMID- 2758805 TI - Validity of record ratings of the Global Assessment Scale. AB - The Global Assessment Scale (GAS) is a comprehensive rating of psychiatric status that is usually based on face-to-face interviews. Validity has not been established for the use of the GAS when it is based on secondary sources of information about the patient, source of patient information, although secondary sources have been used for this purpose. The current study examined agreement between GAS ratings based on medical records and ratings based on face-to-face interviews. Results showed moderate agreement between the two sets of ratings, with the intraclass correlation-coefficient (ICC) equaling .62. Record-based (R) GAS ratings were upwardly biased and were restricted in range when compared with interview-based (I)-GAS ratings. A case-by-case analysis showed that the disagreement could be accounted for by inconsistent documentation of the degree of functional impairment in the most severely disturbed patients. We conclude the following: If R-GAS ratings are used, designs should be modified to adjust for probable overestimated functioning of the most severely disturbed patients. PMID- 2758806 TI - Familial psychiatric illness in chronic posttraumatic stress disorder. AB - One hundred and eight veterans with posttraumatic stress disorder (PTSD) were compared with 60 age-matched controls with regard to family history of psychiatric illness. Depressed controls had a higher morbidity risk (MR) for depression and generalized anxiety in siblings/parents and children, respectively. Patients with PTSD did not differ from alcoholics or nonpsychiatric controls on the basis of family history. PTSD was associated with greater familial anxiety when compared with controls who had experienced combat. When World War II and Vietnam veterans with PTSD were compared, a higher MR for alcohol and drug abuse was found in siblings/parents of Vietnam veterans, and a higher MR was found for other chronic psychiatric disorders in the children of Vietnam veterans. PMID- 2758807 TI - Variation in cognitive functioning in nonorganic psychiatric disorders. AB - Level of cognitive function is usually conceptualized as a feature of organic psychiatric disorders. Classically, its assessment is part of the mental status examination. Standardized tests, such as the Folstein battery, are used to screen for organic disorders by measuring level and possible impairment of cognitive function through the stipulation of cutoff points. However, contemporary definitions of psychiatric disorders do not embrace such a categorical view of cognitive function. It is important to measure the level of cognitive function in all types of psychiatric disorders in relation to demographic characteristics. Consequently, it is better to view cognitive function as a continuous variable. The Cognitive Function Inventory (CFI), which can also yield a Folstein score, was used to assess cognition in patients diagnosed as having nonorganic psychiatric disorders. A number of different parameters of cognitive function are examined. Differences associated with demographic background and type of disorder are reported. The implications of these results are discussed. PMID- 2758808 TI - Nutrition. A refined mess. PMID- 2758809 TI - The powerhouse of Powys. PMID- 2758810 TI - Outside view. Jack's story. PMID- 2758811 TI - Focus on Wales. Passport to Pwllheli. PMID- 2758812 TI - Birth day sadness. PMID- 2758813 TI - Nursing care. A challenge for the summer. PMID- 2758814 TI - Private care. Home ward bound? PMID- 2758815 TI - Community nurse profile. Friend to the family. PMID- 2758816 TI - Community nurse profile. Teacher, guide and advocate. PMID- 2758817 TI - Stoma care. A portable problem. PMID- 2758818 TI - Lyme disease. PMID- 2758819 TI - The epidemiology of Lyme disease in Connecticut. AB - The overall incidence for Lyme disease for Connecticut residents in 1988 was 22 per 100,000. The highest rates were among residents of New London (108 per 100,000) and Middlesex Counties (72 per 100,000), although the greatest increase in incidence between 1985 and 1988 occurred among residents of Fairfield County (2 per 100,000 in 1985, 14 per 100,000 in 1988). Lyme disease is a statewide problem; in 1988 cases were reported among residents of 104 of Connecticut's 169 towns and cities. The disease burden in some communities is high with case rates approaching 1% of the population per year. Data from 1977 and 1985 suggest a three- to eightfold increase during that period in the occurrence of Lyme disease in the communities near the mouth of the Connecticut River. Continued reporting of cases with supporting clinical information is needed to improve Lyme disease surveillance and establish disease trends. PMID- 2758820 TI - National surveillance of Lyme disease, 1987-1988. AB - In 1987 and 1988, 6876 Lyme disease cases from 43 states were reported to the Centers for Disease Control. The 4507 cases reported in 1988 was nearly double the case number reported in 1987, and ninefold the number reported in 1982, when a systematic system of national surveillance was established. The average annual incidence of reported Lyme disease in the United States in 1987-1988 was 1.4/100,000. New York led the nation in reported cases in 1988 with 57% of the cases reported nationally. Eight states, New York, New Jersey, Pennsylvania, Connecticut, Massachusetts, Rhode Island, Wisconsin, and Minnesota, reported 92% of the nation's cases. The state reporting the highest incidence rate in 1987-88 was Rhode Island, with 9.9 cases/100,000. Regionally, incidence rates were highest in Northeastern and Mid-Atlantic states, intermediate in North Central and Pacific states, lower in the Southeast, and lowest in the Great Plains and Mountains states. The seven remaining states in which Lyme disease has not been transmitted all lie west of the 100th meridian. PMID- 2758821 TI - A prospective study of tick bites in an endemic area for Lyme disease. PMID- 2758822 TI - Lyme disease and pregnancy. PMID- 2758823 TI - Lyme disease prevention--knowledge, beliefs, and behaviors among high school students in an endemic area. AB - We surveyed 153 high school students in an area highly-endemic for Lyme disease. All students were familiar with Lyme disease; 14 students reported having had the disease. Ninety per cent of students believed tick-avoidance behavior could prevent Lyme disease, but fewer than half reported practicing any preventive behaviors. Students who believed a specific behavior was preventive were 3-6 times more likely than others to practice that behavior. Schools in endemic areas should educate students about Lyme disease. PMID- 2758824 TI - A message to physicians. PMID- 2758825 TI - Sharing the task of Lyme disease. Public education. PMID- 2758826 TI - Legal implications of uncertainty in lyme disease. PMID- 2758827 TI - Ode to that dammini Ixodes. PMID- 2758828 TI - Practicing in Lyme disease territory. PMID- 2758829 TI - Lyme disease and antibiotic prophylaxis. PMID- 2758830 TI - Reinfection with Borrelia burgdorferi. PMID- 2758831 TI - Mycobacterium avium intracellulare as a marker of human immunodeficiency virus disease. AB - Between January 1981 and December 1986, 4,178 patients were cultured for mycobacteria at a community teaching hospital in Hartford. The number of patients with positive cultures totaled 278 (6.65%). Mycobacterium other than tuberculosis (MOTT) was isolated from 228 (82%). MOTT isolation increased yearly from 1.5% of the patients in 1981 to 14.5% of the patients in 1986. Mycobacterium avium intracellulare (MAI) was the most common MOTT species isolated (197/228). Fifty nine patients were under the age of 50, but 23 had predisposing factors for MOTT. Of the 36 who did not have an underlying condition, 25 had the human immunodeficiency virus (HIV). The isolation of MAI preceded the diagnosis of AIDS/ARC in nine patients, in 10 others it coincided with their diagnosis and in six it followed the diagnosis. Isolation of MAI in a patient under the age of 50 with no predisposing factors may suggest concommitant HIV disease. PMID- 2758832 TI - Antibiotic streamlining--scope, format, and benefits. PMID- 2758833 TI - Gianetti v Norwalk Hospital: Connecticut Supreme Court rules on hospital and medical staff member contractual relationship and judicial review of medical staff termination decisions. PMID- 2758834 TI - The oath, the art, the caring. PMID- 2758836 TI - The character of our mortality. PMID- 2758835 TI - Mandatory HIV testing in hospitals. PMID- 2758837 TI - Learning the art. PMID- 2758838 TI - What's wrong with general surgery training. PMID- 2758839 TI - Canada's medical care system. PMID- 2758840 TI - Menstrual patterns and progesterone circulating levels following different procedures of tubal occlusion. AB - This study was undertaken to assess the effects of different tubal occlusion procedures on ovarian function. Three groups of subjects randomized to tubal occlusion by laparoscopy and Yoon ring (24 subjects), minilaparotomy and Yoon ring (19 subjects) and minilaparotomy and Pomeroy (22 subjects), and one separate control group of 26 healthy subjects not using any form of contraception were studied in a prospective design. The characteristics of the menstrual patterns were studied for one year after sterilization. Determination of the circulating progesterone levels were made on days 15, 20 and 25 of menstrual cycles initiated 1, 3, 6 and 12 months following the tubal ligation. In the analysis of the bleeding pattern there was a statistically significant difference in the mean segment length and in the longest bleeding-free interval in the subjects who had been sterilized by minilaparotomy with Yoon ring, when compared to the other two study groups and to the control group. However, the magnitude of this difference in number of days was not considered clinically significant. There was no statistically significant difference in the percentage of ovulatory cycles within the study and the control groups, or when the results of the study groups were compared with each other or to the control group. PMID- 2758841 TI - The effect of the anti-progestin RU 486 on early pregnancy in the long-tailed macaque (Macaca fascicularis). AB - The efficacy of various doses of RU 486 in terminating pregnancy before and after the luteal-placental shift (LPS) in the long-tailed macaque (Macaca fascicularis) was assessed through sonographic examination and measurements of steroid hormones and their metabolites. Intramuscular injection of 1.0, 2.5, 12.5, or 25.0 mg/kg was administered either from gestational day (GD) 15-18 (Group 1; N = 11) or GD 23-26 (Group 2; N = 9). The timing of treatment was determined by the detection of the preovulatory estrogen peak via daily urinary estrone conjugate (E1C) measurements. In Group 1, a 90.9% pregnancy loss was observed (10/11); seven animals aborted during GD 15-20, two animals indicated early embryonic death with retained gestational sacs, one animal aborted on GD 56, and one pregnancy was maintained. In Group 2, an 88.9% pregnancy loss was observed (8/9); eight animals aborted between GD 26-29, and one pregnancy was unaffected. Hormone profiles appeared to fall secondarily to the loss of trophoblast function. These results indicate: (a) RU 486 was more effective after the LPS; and (b) the primary effect of RU 486 appeared to be at the level of the products of conception. PMID- 2758843 TI - Biological activity in the repopulating rat spermatocyte after the withdrawal of gossypol treatment: I. The activity for DNA synthesis. AB - Mature male rats were treated with gossypol for various lengths of time after which the treatment was stopped to allow the arrested spermatogonia to revive. Fifteen days after withdrawal of the drug treatment, the arrested spermatogonia entered into the meiotic division and then reached the pachytene stage. The meiotic cells derived from the arrested spermatogonia were the first generation of the differentiated germ cells after long-term gossypol treatment. Centrifugal elutriation technique was used to isolate the repopulating pachytene spermatocytes (RPS) or the control pachytene spermatocytes (CPS) from the rat testis with or without receiving gossypol pretreatment. In vitro culture condition for RPS and CPS was established for the synthesis of DNA by the measurement of 3H-thymidine incorporation. The activity for DNA synthesis in RPS was studied and compared to that of the CPS. It was concluded that after gossypol treatment for various times, the incorporation of 3H-thymidine into the cellular thymidine pool of RPS was not affected. However, the activity for DNA synthesis in RPS was significantly lower than that in the CPS. The synthetic activity for DNA was reduced by 14%, 26%, 42%, 40%, and 40% in the RPS for the gossypol pretreatment of 3, 4, 6, 7, and 8 weeks, respectively. PMID- 2758842 TI - 3H-ZK 98,734, a new 11 beta-aryl substituted antigestagen: binding characteristics to receptor and serum proteins. AB - Recently, in the laboratories of Schering in Germany a competitive progesterone antagonist, ZK 98,734, was synthetized, which is characterized by a similar antigestagenic activity as RU 38,486, synthezised by Roussel-Uclaf in France, as assessed by inhibition of nidation tests in rats and guinea pigs. However, this compound has a substantially lower antiglucocorticoid activity measured in cell culture systems than RU 38,486. The purpose of this study was to present a comparison of biochemical and physical properties of the complexes formed by the human uterine progesterone receptor with 3H-ZK 98,734 on one hand and with other well-established progestins on the other hand. ZK 98,734 competed in the same order of magnitude as progesterone or RU 38,486 for the 3H-R5020 binding site of progestin receptor, whereas R5020, Org 2058 or progesterone were unable to compete against 3H-ZK 98,734. This apparent contradiction could be explained by means of FPLC-chromatography and sucrose density centrifugation technique. FPLC chromatography with an anion exchange column (Mono Q, Pharmacia, Uppsala, Sweden) showed that 3H-ZK 98,734 forms at least two stable complexes with uterine cytosol, on one hand with serum albumin, which presents almost 90% of bound radioactivity, and on the other hand with the two native progestin receptor forms, corresponding to 4S and 8S receptor forms in sucrose density gradient analysis. Competition experiments in liver cytosol of adrenalectomized rats with increasing concentrations of unlabeled ligands other than dexamethasone showed that ZK 98,734, RU 38,486 and cortisol displaced 3H-dexamethasone efficiently from the binding sites in the cytosol. Furthermore, results concerning the specificity of 3H-cortisol binding to serum proteins in diluted pregnant serum demonstrated that ZK 98,734 did not compete with 3H-cortisol for serum binding. PMID- 2758844 TI - Biological activity in the repopulating rat spermatocyte after the withdrawal of gossypol treatment: II. The activity for the synthesis of cellular and nuclear basic proteins. AB - The synthesis of cellular and nuclear basic proteins in the first generation of the repopulated pachytene spermatocyte (RPS) and the control pachytene spermatocyte (CPS) was studied by the incorporation of 3H-arginine into proteins. After pretreatment with gossypol for various lengths of time, the synthetic activity for cellular protein in the RPS was slightly inhibited. In comparison to CPS, on the other hand, the inhibition ranged from 12% to 26% (for gossypol pretreatment from 3 to 12 weeks, respectively). However, the synthetic activity for nuclear basic protein in the RPS was drastically reduced in comparison to that of the CPS. The reduction ranged from 46% to 61% in RPS after receiving gossypol pretreatment for 3 to 12 weeks, respectively. Gel electrophoretic separation of the basic protein extracted from the pachytene cell indicated that the major basic proteins are nucleosomal linker and core proteins, i.e., histone H1, H2A,B, H3, and H4, and with a lesser amount of sperm-specific BP and X1 proteins. After gossypol treatment in the RPS, the synthesis of sperm-specific proteins (BP and X1) and core histones (H2A and H4) became drastically reduced. Finally, the effect of gossypol on the ratio of nuclear basic protein to DNA in RPS and the direct correlation of this ratio to nucleosomal spacing and chromatin structure are discussed. PMID- 2758845 TI - Audio-spatial deficits in humans: differential effects associated with left versus right hemisphere parietal damage. AB - In order to study auditory spatial localization in subjects with posterior damage involving the parietal lobe, we investigated their manual pointing performances to linguistic and white noise signals distributed over six sound sources situated in the anterior auditory field at ear level. The results showed: (1) A striking difference between patterns of deficits associated with right and left damage. In subjects with right damage, auditory localization deficits occurred in the horizontal plane, were manifested as restrictions in the peripheral left auditory hemifield and tended to be related to left visual neglect. In subjects with left damage, auditory localization deficits occurred in the entire auditory field in the horizontal as well as vertical planes, and they were particularly strong in the antero-frontal region. (2) One subject with right damage and visual neglect but no left auditory spatial restriction, showed deficits in the right hemifield where sound source location tended to be overestimated. This subject also showed a better discrimination of the origin of a white noise than of a linguistic signal. Results are discussed in terms of hemispheric asymmetries of function. PMID- 2758846 TI - Aesthetic preference and picture asymmetries. AB - Previous research has shown that when right-handed subjects prefer one orientation of a picture over its mirror image, the more interesting or important content is on the right. Location of content, however, is only one of a number of possible asymmetric aspects of picture composition. To determine whether the relationship between aesthetic preference and cerebral asymmetry is affected by the interaction of different aspects of asymmetric information in a slide, the present study examined both asymmetry of content and asymmetry of motion. The results indicated that asymmetry of both content and motion combined to influence orientation preferences of right-but not left-handers. Thus, at least two asymmetric components of picture composition interact with brain organization to influence aesthetic judgements. PMID- 2758847 TI - Autobiographical memory. Its impairment in amnesic syndromes. AB - Three groups of brain-damaged patients with severe anterograde episodic amnesia, manifest both ecologically and psychometrically, were tested with an autobiographical memory (ABM) inquiry for which age-education adjusted normal baselines were available. One group was made up of 19 patients in the early stages of Alzheimer's disease and the other of 12 "pure" amnesic patients, 6 of whom had focal diencephalic damage and 6 widespread brain damage. ABM information retrieval was severely impaired in 84% of the early-stage demented patients and in the "pure amnesics" with widespread brain damage, but much less in those with focal damage. No temporal gradient emerged in either group and confabulation was only a marginal factor. Poor performances of demented and nonfocal amnesics were attributed to inertness in the search process. PMID- 2758848 TI - Divided attention 5 to 10 years after severe closed head injury. AB - The ability to divide attention of persons who had sustained a severe Closed Head Injury 5 to 10 years before (chronic CHI patients), was examined in a dual-task experiment administered to 15 CHI patients and 34 control subjects. Both the patient group and the control group consisted of active licenced drivers at the time of the investigation. One task was a compensatory tracking task requiring lane tracking, a basic skill or car driving. The other task was a self-paced visual choice reaction time task. Single-task difficulty was individually adjusted by adaptive task procedures (on both tasks CHI patients reached significantly lower performance levels in single task conditions). With individual differences in single-task performance thus controlled, the ability to divide attention was found to be approximately equal in the chronic CHI patients and the control group. A surprising finding in this light, however, was the significant positive correlation between severity of injury (PTA duration) and divided attention costs in the patient group. PMID- 2758849 TI - Attentional shift towards the rightmost stimuli in patients with left visual neglect. AB - In a search task where four letters were displayed to the right of a central fixation point, right brain-damaged patients with visual neglect showed the fastest response when the target was at the rightmost position and progressively slower responses as it moved towards the center of the display. This finding confirms Kinsbourne's claim that in visual neglect an important role is played by the magnetic attraction that the extreme end of the right structured space exerts on the patient's attention. PMID- 2758850 TI - Selective preservation of oral spelling without semantics in a case of multi infarct dementia. AB - A 70 year old retired van driver, with a diagnosis of multi-infarct dementia, showed features associated with transcortical sensory aphasia, with excellent repetition, a severe anomia, poor semantic comprehension and fluent speech. He was able to spell orally words which he did not understand, as well as nonwords; he wrote to dictation only after first spelling the words orally. Some of his spellings provided evidence for a dissociation between semantics and the graphemic output lexicon, the application of sub-word rules and partial lexical knowledge. These findings are interpreted in terms of a cognitive neuropsychological model. PMID- 2758851 TI - Aetiological variation in the amnesic syndrome: comparisons using the Brown Peterson task. AB - This study examined the performance of temporal lobe and Korsakoff amnesic patients on two versions of the Brown-Peterson task. One version involved trials with distractor intervals ranging from three to 60 second. The other investigated the effects of massed versus distributed practice with a constant nine-second retention interval. Korsakoff patients produced significantly poorer performance on both versions of the task. Further analyses indicated that impaired Brown Peterson performance was correlated with frontal dysfunction but not with the severity of the memory deficit. Previous inconsistencies concerning the performance of amnesic patients on the Brown-Peterson task are considered. PMID- 2758852 TI - Neuropsychological follow-up of patients operated for aneurysms of anterior communicating artery. AB - The neuropsychological outcome of 43 patients operated for ACoA aneurysms was assessed with a battery of 15 tests, tapping a wide spectrum of cognitive abilities. As a group ACoA aneurysms patients were impaired on 8 tests, including the three assessing memory. When however, patients falling below the cut-off point determined in normal controls were considered, 42% of the sample was unimpaired and only 35% fell on two or more tests. The analysis of single cases showed that memory was often affected, but short-term memory even more than long term memory. In addition to the well known memory disorder, the patients showed a wide range of neuropsychological defects, including language and space functions. The hypotheses that could account for this broad-based neuropsychological impairment are discussed. PMID- 2758853 TI - Neuropsychological follow-up of patients operated for aneurysms of the middle cerebral artery and posterior communicating artery. AB - This study assessed with a neuropsychological battery the outcome of 27 patients operated on for an aneurysm of the Middle Cerebral Artery a mean of 35 months before, and of 27 patients operated for aneurysms of the Posterior Communicating Artery, a mean of 47 months before. Both groups showed a defective pattern of performance that was related to the hemispheric side of the aneurysm with left sided patients impaired on naming, verbal fluency and verbal short-term memory and right sided patients on both short-term and long-term spatial memory and discrimination of line orientation. In single cases, the scope of neuropsychological impairment was sometimes wider than that expected only on the basis of the competence of the affected hemisphere. PMID- 2758854 TI - Different dimensions of hand preference that relate to skilled and unskilled activities. AB - Hand preference is multidimensional with two major factors and a variable number of minor factors. In the present factor analyses of hand preference, there was no evidence to support Healey, Liederman and Geschwind's (1986) suggestion that hand preference dimensions can be distinguished on the basis of those requiring movement of the distal musculature (fingers and hand) and those requiring movement of the proximal. The first factor reported here relates to "skilled" activities. Hand preference for the use of tools and manipulation of other objects is strongly lateralized in self-professed right- and left-handers. "Less skilled" activities such as picking up objects load on a second and a third factor. Preference for picking up objects including very small ones and relatively heavy ones is much less lateralized, although there appears to be a distinction between activities that involve strength and those that do not. A fourth factor relates to the use of bats and axes, a bimanual activity. PMID- 2758855 TI - Focused and divided attention in Alzheimer's disease. AB - Visual search tasks were used to examine two aspects of selective attention (focused and divided attention) in normal young and older persons and in Alzheimer patients. Normal and demented subjects were equally efficient in using a color cue to selectively search only the relevant items in an array. Thus, focused attention abilities appear to be relatively unimpaired by Alzheimer's disease. By contrast, in comparison to normals, the search time of demented patients rose disproportionately as the number of items over which they had to distribute their attention was increased. This suggests that Alzheimer patients are less efficient than normals in dividing their attention. PMID- 2758856 TI - The effect of analytic versus holistic encoding instructions on hemispheric superiority. AB - A modification of the tachistoscopic letter detection task employed by Neisser (1963) was utilized to examine hemispheric differences in employing analytic and holistic processing strategies. Stimulus arrays designed to elicit either serial or parallel processing sets were presented to the right hemisphere-left visual field (RH-LVF) or to the left hemisphere-right visual field (LH-RVF). Subjects were explicitly directed to perform an analytic or holistic encoding process on both types of stimulus arrays. The serial array produced longer reaction times than the parallel array for both hemispheres. A RH-LVF reaction time advantage was found across both stimulus sets and instructions. In addition, an overall reaction time advantage was found for holistic instructions relative to analytic instructions, but this superiority was not effected by hemisphere or contextual stimuli. PMID- 2758857 TI - Commissurotomy subjects show lateralized difference between manual and oral responding. AB - This study investigates the influence of the mode of response on the right ear advantage in verbal dichotic testing. Four complete commissurotomy subjects were tested on an ascending digits tape with oral response and manual response by the dominant hand with the volume equal and raised in each ear. Oral response elicited right ear report in all tests under all conditions at all levels of task difficulty. Pointing and writing responses elicited left ear report when the volume was raised in the left ear and the number of digits to report was small. Right ear performance increased and left ear performance decreased as the number of digits to process increased. Results indicate that response modes differ significantly in the degree to which they engage the left hemisphere or to which they suppress the ipsilateral pathways within the left hemisphere. Use of an oral response may obscure the lateralized contribution of the cognitive activity under investigation. PMID- 2758858 TI - When a patient can write but not copy: report of a single case. AB - A dissociation between spared spontaneous and impaired writing on copy is described in a patient with severe limb and constructional apraxia. Visual perceptual abilities were normal as well as oral language and reading. The findings are discussed in the light of an information processing model of writing. PMID- 2758859 TI - Lyme disease. PMID- 2758860 TI - Dermatitis due to sulfites in home permanent preparations. Part II. AB - Irritant contact dermatitis to sulfite hair preparations most commonly occurs when users do not follow instructions. Allergic eczematous reactions are very rare; immediate urticarial reactions seem to occur principally in patients with asthma. Pretesting should be done in such patients in a physician's office where medication for the treatment of shock or asthma is available. PMID- 2758861 TI - Leg ulcers: getting skin to grow. AB - A variety of leg ulcers (venous and advanced rheumatoid ulcers and those caused by arterial insufficiency, radiation, and diabetes) and their treatment are discussed in light of techniques applied in the physician's office. PMID- 2758862 TI - The use of pulse methylprednisolone and chlorambucil in the treatment of Sweet's syndrome. AB - A patient with an unusual variant of Sweet's syndrome, in which the course of the disease was chronic and relapsing, was treated successfully with intravenous methylprednisolone (pulse therapy). Remission was then maintained with oral chlorambucil. PMID- 2758863 TI - Annular erythema in identical twins. AB - A case of superficial gyrate erythema that was indistinguishable from erythema annulare centrifugum occurred in identical twins. We propose to include a familial cause among the known causes of erythema annulare centrifugum rather than considering this a separate entity, "familial annular erythema." PMID- 2758864 TI - Angiolymphoid hyperplasia with eosinophilia: removal with carbon dioxide laser in a patient on chronic oral anticoagulants. AB - A patient with angiolymphoid hyperplasia with eosinophilia of the arm is described. In spite of anticoagulant therapy, successful surgical removal of the lesion was carried out with carbon dioxide laser excision and vaporization. PMID- 2758865 TI - Acute febrile neutrophilic dermatosis (Sweet's syndrome). AB - We describe a patient who displayed the classic features of acute febrile neutrophilic dermatosis (Sweet's syndrome): sudden onset of erythematous plaques, fever, arthritis, and characteristic histologic findings. Unusual findings in her case were the localization of the lesions mainly on the legs, absence of leukocytosis and preceding illness, and marked neutrophilic infiltration in the subcutis. In addition, the fever and eruption subsided on the day the results of pathologic examination were available, making any treatment unnecessary. The short course of the disease in this patient suggests the possibility of postponing steroid treatment for one week in all patients with acute febrile neutrophilic dermatosis. PMID- 2758866 TI - Verruciform xanthoma of the penis. AB - Verruciform xanthoma is a rare pathologic entity with a predilection for the oral mucosa. A case of verruciform xanthoma involving the penis, the second reported in this location, is presented. PMID- 2758867 TI - Effect of sublethal concentration of antibiotics on the adherence of Staphylococcus epidermidis to eukaryotic cells. AB - Adherence of Staphylococcus epidermidis to pharyngeal epithelial cells as measured by [3H]-leucine-labelled bacteria was found to be a simple, objective and highly reproducible technique. Sublethal concentrations of cephalothin, rifampicin and vancomycin significantly reduced the bacterial adherence to epithelial cells, the effect being most marked with 1/2 MIC. Cloxacillin increased the adherence for one strain while it decreased it for the second. The effect was dose-related and the maximum reduction was observed when bacteria were grown with an antibiotic overnight. PMID- 2758868 TI - Pitfalls in testing drug uptake by leukocytes using radiolabeled drugs and an explanation of conflicting results with clindamycin. AB - Although studies of drug uptake by leukocytes use similar methods, the results reported are sometimes vastly different. To determine the possible reasons for this, we studied neutrophil uptake of [3H]-clindamycin using the most frequently used density gradient centrifugation method and the volume probes 3H2O and [3H] polyethylene glycol. We found that the [3H]-clindamycin available to investigators had undergone radiolytic decomposition; thus, its microbiologic activity was only 20% of its original potency. By thin-layer chromatography and autoradiography, four extra label-bearing regions were observed with [3H] clindamycin. Results of neutrophil uptake studies have shown a drop of cellular:extracellular concentration ratios from 40:1 in 1981 to 10:1 in 1982 and 1987. PMID- 2758869 TI - New forms of multidrug therapy for the treatment of leprosy. First report for the practice on rifampicin + sulfamethoxazole-trimethoprim + protionamide and rifampicin + sulfamethoxazole-trimethoprim + isoniazid. AB - Since 1970, when the lifelong monotherapy with dapsone (DDS) in leprosy could be replaced by short-term combination therapy with rifampicin + isoniazid + protionamide + DDS (Isoprodian-RMP), chemotherapeutic research was faced with two problems: (1) to find alternative treatment regimens for cases of intolerance, and (2) to work out forms of therapy allowing a further reduction of the average treatment time of 2 years. The present paper describes the attempts made to find solutions to these problems. With two new combinations, alternatives have become available, and the average treatment time is shortened to 6 months. Both combinations are also effective in tuberculosis. PMID- 2758870 TI - Study on the relationship between pharmacokinetics and antibacterial activity: comparison between ceftriaxone and cefotaxime within the respiratory tract. AB - The aim of this research was to collect precise data on the antibacterial activity of ceftriaxone and cefotaxime in the respiratory tract. The diffusion into pulmonary tissue and bronchial secretion and the antibacterial activity of the two antibiotics were evaluated in vivo by means of the inhibitory quotient. Ceftriaxone administered at a dosage of 1 g (i.m.) every 24 h resulted in antibacterial levels against the sensitive pathogens over a period of 24 h after each dose. The antibacterial protection afforded by cefotaxime, given at the dosage of 1 g (i.m.) every 12 h, was not as marked and did not extend over the interval between two administrations. PMID- 2758871 TI - Penetration of imipenem into human pancreatic juice following single intravenous dose administration. AB - The penetration of imipenem into the human pancreatic juice following a single intravenous dose of 500 mg was investigated in five patients who had undergone pancreatic transplantation. With a special technique for segmental pancreatic transplantation it was possible to collect pure pancreatic juice at regular intervals. Simultaneous blood and pancreatic juice samples were collected immediately before drug administration and then at 0.5, 1, 1.5, 2.5, 3.5 and 5.5 h thereafter. The antibiotic concentrations were determined by the agar diffusion method. The mean peak level in serum was 24.6 +/- (SE) 2.6 mg/l and occurred 0.5 h after administration. The mean peak concentration in pancreatic juice was not reached until 1.5 h after administration, and the level was then 1.7 +/- (SE) 0.3 mg/l. Thereafter the levels in serum and pancreatic juice declined in parallel, and the concentration in pancreatic juice was then about 13% of that in serum. Although imipenem penetrates into the pancreatic juice at a very low degree, the concentrations exceeded the MIC values for many bacteria associated with pancreatic infections. Imipenem could therefore be an alternative as monotherapy in the treatment of pancreatic infections. PMID- 2758872 TI - Susceptibility of Acinetobacter calcoaceticus to antimicrobial drugs, alone and combined, with and without defibrinated human blood. AB - Twenty-five clinical isolates of Acinetobacter calcoaceticus were examined for susceptibility to 14 antimicrobial drugs. In terms of inhibitory and bactericidal activities, imipenem and polymyxin B were most active, followed by amikacin and ceftazidime. Four isolates were resistant against fluoroquinolones (ciprofloxacin, norfloxacin, ofloxacin). The isolates varied in susceptibility to aztreonam, cefotaxime, cotrimoxazole, gentamicin, mezlocillin, netilmicin and piperacillin. Fresh defibrinated human blood from 3 donors revealed similar killing kinetics against 8 selected isolates. In time-kill curve experiments, human blood enhanced the activity of amikacin more than that of ceftazidime, ciprofloxacin and imipenem against A. calcoaceticus. The combinations of amikacin + imipenem and amikacin + ceftazidime in the presence of human blood were effective against this microorganism. Human blood combined with ciprofloxacin + imipenem was more effective than blood with added ceftazidime + ciprofloxacin. PMID- 2758873 TI - Are sex differences in child motor activity level a function of sex differences in maturational status? AB - By virtue of being farther along a developmental path for motor activity level, girls may appear to be the less active sex when compared to less physically mature but same-aged boys. If so, observed sex differences in activity level may be an epiphenomenon of sex differences in maturity related declines in AL. To test this hypothesis and the associated premise that females would be more mature and less active than males, the customary activity levels and relative physical maturities of 83 5-8-year-olds were assessed. Relative maturity (percentage of estimated adult height attained) was negatively related to activity level, and girls were both less motorically active and more mature than boys. Though reduced in magnitude, the sex effect remained significant after maturity was added as a predictor of AL. Thus, sex differences are not due only to maturity differences but may be partially mediated by them. PMID- 2758874 TI - Effects of marijuana use during pregnancy on newborn cry. AB - The effects of maternal marijuana use on the newborn cry were studied in Jamaica, where it was possible to rule out confounding factors such as the use of other substances and demographic variables that have clouded previous studies and where higher dosages may make the effects more visible. The acoustic characteristics of the cries of 20 infants of marijuana users and 20 controls were analyzed. The cries of the infants of marijuana users were shorter, had a higher percentage of dysphonation, a higher and more variable fundamental frequency, and a lower first formant than controls. There was also a dose response relation between the first formant and marijuana use. We suggest that heavy marijuana use affects the neurophysiological integrity of the infant. PMID- 2758876 TI - Soothing pain-elicited distress in infants with swaddling and pacifiers. AB - The effectiveness of pacifiers and swaddling in reducing pain-induced distress was compared in 2-week-old infants who underwent heel-sticks and 2-month-old infants who received injections. Crying, state, and heart rate were measured on 32 infants at each age during baseline, the stress of heel-stick or injection, and during 3-min soothing intervention and postintervention periods. At 2 weeks, infants' HR levels and crying declined significantly more rapidly in the pacifier than in the swaddling condition. At 2 months, both conditions produced similar rates of decline in HR and crying. At both ages, infants in the pacifier group spent significantly more time in an alert state than did swaddled infants. Following termination of the intervention at both ages, HR and crying tended to rebound more in the pacifier than in the swaddling group. Swaddling and pacifiers thus reduce pain-elicited distress differently. PMID- 2758875 TI - On the importance of fundamental frequency and other acoustic features in cry perception and infant development. AB - This study examined acoustic correlates of adults' ratings of infants' cries. Parents and nonparents rated 12 spontaneous cries from young infants on 8 items describing the cries' aversiveness and on 9 semantic differential items. The results indicated that the duration, the amount of dysphonation, and proportion of energy in various frequency bands were highly correlated with adults' ratings. Further, the pattern of correlations between each of the 17 rating scale items and the acoustic attributes was virtually the same, suggesting that the items represented a single underlying dimension of perceived aversiveness. Finally, no differences were found between the results for parents and nonparents. General issues in the study of cry perception are discussed. PMID- 2758877 TI - Attractiveness of lactating females' breast odors to neonates. AB - A series of experiments investigated the responses of human infants to olfactory cues produced by lactating females. 2-week-old bottle-feeding girls oriented preferentially to the breast odor (odorized pad) of a nursing woman when paired with such odors from either a nonparturient female or axillary odors from the same lactating female. Responses to axillary odor from a lactating female did not differ from those to a clean (nonodorized) pad. These data indicate that breast odors from lactating females are especially attractive to female infants who are unfamiliar with the stimulus woman and who have had no prior breast-feeding experience. PMID- 2758878 TI - Smile production in older infants: the importance of a social recipient for the facial signal. AB - 2 studies tested the hypothesis that infant smile production depends on the availability of a social recipient for the facial signal, as well as on appropriate internal events. We examined the effects of attentive and inattentive, familiar and unfamiliar social objects on smile production in 1 1/2 year-old infants outside of social interactions. Like adults, these infants directed a majority of the smiles produced during nonsocial activity to an attentive social object. Overall smiling frequency was much lower when the only potential recipient (the mother) was inattentive, but the effect did not appear to be mediated by negative emotion. Only smiles directed to mother were reduced: nonsocial smiling (at the toys) was not sensitive to mother's inattention, and when an attentive, friendly stranger was present, she was accepted as a substitute target for social smiles. We conclude that an open channel of social communication promotes the outward expression of internal affect in infants. PMID- 2758879 TI - Effects of craniofacial deformity in infancy on the quality of mother-infant interactions. AB - Self-report and behavioral observation procedures were used to assess the quality of mothers' interactions with facially deformed infants. This assessment strategy also provided an opportunity to evaluate the hypothesis that parents of facially deformed infants may deny or be unaware of deficits in their relationships with these children. 10 mothers, 5 with unattractive/craniofacially deformed infants and 5 with normal infants, completed self-report measures of stress, social support, satisfaction with parenting, and general life satisfaction. Mother infant interactions were videotaped and rated on discrete and global behavioral measures. Results revealed that mothers of deformed infants rated their parental satisfaction and current life satisfaction more positively than did mothers of normal infants. However, these same mothers were observed to behave in a consistently less nurturant manner than mothers of normal children. These results suggest that infant facial deformity/unattractiveness may affect the quality of infant-caregiver interactions without parental awareness. PMID- 2758880 TI - Inhibited and uninhibited types of children. AB - An initial group of 100 children who were not selected a priori on any behavioral features were observed in laboratory settings at 14, 20, 32, and 48 months and their behaviors coded for inhibition and lack of inhibition to the unfamiliar. The children who had been extremely inhibited or uninhibited at both 14 and 20 months differed significantly at 4 years of age in behavior and cardiac acceleration to cognitive stress. However, for the entire sample, there was no significant relation between degree of inhibited behavior at 14 or 20 months, on the one hand, and inhibition at 4 years of age, on the other, nor any relation between behavior and heart rate acceleration. These results suggest that the constructs inhibited and uninhibited to the unfamiliar refer to children who fall at the extremes of a phenotypic continuum from shyness and restraint to sociability and affective spontaneity. PMID- 2758881 TI - Family ecology and child characteristics that predict young children's educational television viewing. AB - This study investigated how sociological variables, program access, family attributes, and child characteristics influence children's viewing of the most well-established educational television program in the United States--"Sesame Street." 2 cohorts were followed from ages 3 to 5 and 5 to 7, respectively. Each family kept a diary of television viewed during 5 1-week periods over 2 years. Interviews and testing sessions were conducted before and after the 2-year period. "Sesame Street" viewing increased from age 3 to a peak between the ages of 3 1/2 and 4; thereafter, viewing declined. This developmental change appeared to be a function of age-correlated life events and perceived age appropriateness of the program rather than of ontogenetic cognitive change. Individual differences were primarily a function of family ecology--opportunities to view and characteristics of other viewers--rather than of family demographics or individual child attributes. Maternal employment and the amount of time children attended child care or preschool were negatively related to viewing. The presence of older siblings reduced viewing; the presence of younger siblings increased it. Viewing was unrelated to parent education or occupational status, child gender, child's vocabulary level, involvement in television, or interest in print and other media. Parental encouragement to watch the program was positively related to viewing for 3-5-year-olds. PMID- 2758882 TI - Effects of public day-care: a longitudinal study. AB - 119 Swedish children were followed from their first year of life up to the age of 8. Most could be classified according to (a) type of day-care they had experienced during their first 7 years of life and (b) time of first entrance into day-care. At 8 years, the children were tested with aptitude tests and rated by their teachers on school performance and social and personal development. Hierarchical regression analyses and MANCOVAs were used in the statistical treatment. Time of entrance into day-care predicted children's cognitive and socioemotional development, controlling for sex and home background. Children with early day-care (entrance before the age of 1) were generally rated more favorably and performed better than children with late entrance or home care. There was a tendency for early center care to predict a more favorable outcome than other care. PMID- 2758883 TI - Children's inquiry strategies in referential communication and in the game of twenty questions. AB - Young listeners perform poorly on referential communication tasks because they respond to ambiguous messages by guessing rather than by seeking clarification. 2 experiments addressed the ability of 4-, 5-, and 7-year-old listeners to perform competently following training in the skill of asking categorical questions. Training was presented either in the context of a Listener task or a Twenty Questions task. As these tasks require common strategies of information seeking, it was predicted that training in one task context would lead to improved performance on that task and to generalization of skill to the untrained task. The hypothesis was supported, although there were age differences in the effectiveness of training and efficiency of strategy use. The implications of the results for children's developing communication abilities were discussed. PMID- 2758884 TI - Aggression between peers in early childhood: individual continuity and developmental change. AB - 43 children were observed in play with "best available friends" at 2 and again at 5 years of age. An arousing stimulus, an angry interaction between adults, was introduced during play sessions to increase the likelihood of elicitation of aggressive patterns. Dimensions of physical aggression at age 2 (e.g., object related aggression, bodily aggression) predicted dimensions of children's physical aggression at age 5. However, substantial sex differences in the stability of aggression were found. Among boys, the disposition to engage in physical aggression was highly stable, with correlations ranging as high as r = .76. Certain dimensions of physical aggression at age 2 were also positively associated with verbal aggression at age 5. Fewer and more modest correlations were found among girls. The frequency of aggression, particularly bodily aggression (e.g., hitting, pushing), initiations of aggression, and the average length of aggression episodes, decreased between 2 and 5 years of age. These results indicate that relative aggressiveness tends to remain stable despite declines in the frequency of aggressive behavior between 2 and 5 years of age. PMID- 2758885 TI - Children's knowledge of thematic and taxonomic relations at two years of age. AB - An interesting conflict exists in the developmental literature concerning the strength of thematic versus taxonomic associations. "Dog-doghouse" is a thematic match, while "dog-horse" is a taxonomic match. This study compared the ability of children to identify both types of associations at 2 points during the third year of life: 26 months (N = 15) and 34 months (N = 24). A reinforced match-to-sample technique was used in which half of the matches were thematic and the other half were taxonomic. Both age groups were able to identify thematic matches, although children near 3 years of age were able to recognize a wider range of thematic associations than children near 2 years of age. The 26-month-olds were unable to identify taxonomic matches that had no perceptual basis, but the 34-month-olds were successful at this task; the 34-month-olds appeared to have a more general understanding of categories that was less tied to perceptual features. PMID- 2758886 TI - Children's use of nonegocentric standards in judgments of functional size. AB - Dimensional adjectives are inherently relative in meaning, and so provide a test of children's ability to apply nonegocentric standards. The present research investigates children's ability to apply one kind of relative standard assessing the size of an object with regard to its intended use (a functional interpretation). In 3 experiments, children 3-5 years of age were asked to judge objects as "big" or "little" according to their function (e.g., a hat for a doll; a key for a door). Contrary to previous claims, the ability to use nonegocentric functional standards was present by age 3. However, 3-year-olds performed above chance only when their attention was directed to the relevant function, either by means of action (when actually shown how the objects fit together) or by means of language. In contrast, 4-year-olds performed well without additional action-based or linguistic cues. It is suggested that children have an implicit ordering in their interpretations of big and little, such that functional judgments are lower in priority than 2 other standards: normative (the size of an object is compared to a stored mental standard, e.g., a chihuahua is small for a dog) and perceptual (the size of an object is compared to another physically present object of the same type, e.g., a chihuahua 6 inches tall is big compared to a chihuahua 4 inches tall). Even 3-year-olds can make nonegocentric functional judgments of relative size, but the basis of the judgment must be unambiguous. PMID- 2758887 TI - Children's ability to make probability estimates: skills revealed through application of Anderson's functional measurement methodology. AB - Functional measurement methodology was used to assess children's attention to the total number of alternative outcomes as well as the number of target outcomes when making probability estimates. In Study 1, first-, third-, and fifth-grade children were given the task of estimating on a simple, continuous but nonnumeric scale the probability of drawing a particular color of jelly bean from a bag containing either 1, 2, or 3 jelly beans of that color, and either 6, 8, or 10 jelly beans total. In Study 2, first- through fifth-grade children were given the task of estimating the likelihood that a bug would fall on a pot containing a flower when presented displays of planters containing either 2, 3, 4, or 5 pots with flowers, and 6, 8, or 10 pots total. In both studies, the children were exposed to each of the combinations of numerator and denominator across 3 replications. The results indicate that all age groups attend to variations in the denominator as well as to variations in the numerator, and, furthermore, that they attend to the interaction between these variables. This finding contrasts sharply with research that requires children to choose which of 2 containers offers the greater chance of yielding a target item in a blind draw. It is suggested that children possess the skill to make accurate probability estimates, but they are unaware that these estimates should always be made and used when comparing the probability of an event across trials. The findings are discussed in relation to the broader issue of the limitations of the choice paradigm as a means of investigating children's thinking. PMID- 2758888 TI - Young children's attribution of action to beliefs and desires. AB - When and how children understand beliefs and desires is central to whether they are ever childhood realists and when they evidence a theory of mind. Adults typically construe human action as resulting from an actor's beliefs and desires, a mentalistic interpretation that represents a common and fundamental form of psychological explanation. We investigated children's ability to do likewise. In Experiment 1, 60 subjects were asked to explain why story characters performed simple actions, such as looking under a piano for a kitten. Both preschoolers and adults gave predominantly psychological explanations, attributing the actions to the actor's beliefs and desires. Even 3-year-olds attributed actions to beliefs and false beliefs, demonstrating an understanding of belief not evident in previous research. In Experiment 2, 24 3-year-olds were tested further on their understanding of false belief. They were given both false belief prediction and explanation tasks. Children performed well on explanation taks, attributing an anomalous action to the actor's false belief, even when they failed to predict correctly what action would follow from a false belief. We concluded that 3-year olds and adults share a fundamentally similar construal of human action in terms of beliefs and desires, even false beliefs. PMID- 2758889 TI - Pluralism in children's reasoning about social justice. AB - To determine if children construe the fairness of societal practices as dependent on the implicit contract or definition of a situation, first (M = 6.8 years), third (M = 8.8 years), and fifth (M = 11.0 years) graders were questioned about 3 situations: one emphasizing learning or mastery, a contest, and a test. For each situation, they judged the fairness, alterability of fairness, effectiveness, and harmfulness of 3 teaching or coaching practices: having more able individuals help the less able, having individuals compete publicly, and having them perform independently. Children judged the fairness and effectiveness of each practice differently for each situation. They also recognized that unfair practices could become fair with participant consensus or over time, and that the potential of a practice to cause harm differed depending upon the context. These results were comparable for educational and athletic activities. In these respects, children's conceptions of the fairness of societal practices resemble those of philosophers who advocate pluralistic conceptions of justice. PMID- 2758890 TI - The development of working memory in normally achieving and subtypes of learning disabled children. AB - Working memory has been proposed as an important component of reading and arithmetic skills. The development of working memory was studied in normally achieving and subtypes of learning disabled children. The performance of reading disabled (RD), arithmetic disabled (ARITHD), and attentional deficit disordered (ADD) children, age 7-13, was compared to normal achievers (NA) on 2 working memory tasks, 1 involving sentences and the other involving counting. There was a significant growth of working memory as a function of age. In addition, the RD children had significantly lower scores on both tasks. The ARITHD children had significantly lower scores only on the Working Memory--Counting task, and the ADD group had scores similar to the normally achieving children except at the youngest age level in the Working Memory--Sentences task. Thus, a reading disability appears to involve a generalized deficit in working memory. Children with an arithmetic disability do not have a generalized language deficit but have a specific working memory deficit in relation to processing numerical information. As children with ADD did not have deficits in these tasks, working memory may not have significant attentional components. An important component of the development of reading and computational arithmetic skills appears to be the growth of working memory for language and numerical information. PMID- 2758891 TI - Student/teacher relations and attitudes toward mathematics before and after the transition to junior high school. AB - In a longitudinal study of 1,301 students and the teachers they had for mathematics before and after the transition to junior high school, we assessed whether changes across the transition in students' perceptions of their teachers' supportiveness were related to changes in their valuing of mathematics. Using repeated-measures multivariate analysis of variance, we found that when students moved from elementary teachers they perceived to be low in support to junior high teachers they perceived to be high in support, the intrinsic value of math was enhanced, while students who moved from teachers they perceived to be high in support to teachers they perceived to be low in support experienced a sharp decline in both the intrinsic value and perceived usefulness and importance of math. For students' perceptions of the usefulness and importance of math there was an interaction with achievement level. Math values decreased more sharply during the first year of junior high for low-achieving students who moved from more supportive to less supportive teachers than for high-achieving students who experienced the same change. PMID- 2758892 TI - Modeling IQ change: evidence from the Texas Adoption Project. AB - An analysis of genetic and environmental contributions to intellectual change was carried out by means of a path model applied to IQ data from the Texas Adoption Project, an adoption study in which children were measured on 2 occasions approximately 10 years apart. Included in the model were assortative mating, selective placement, genotype-environment correlation, a measure of socioeconomic status, and alternative hypotheses about cross-generation environmental transmission and the persistence of a trait over time. Some form of environmental transmission across generations was necessary, but either of the 2 forms tested was sufficient. The data were best fit by considering persistence over time to occur at the level of the developed trait. The effect of both genes and family environment was significant at the time of the first measurement, but only the genes made an additional contribution between the first and the second, suggesting the necessity of revising some popular stereotypes about development. PMID- 2758893 TI - [Various strategies in the diagnosis and therapy of thyroid gland cancer. Results of a survey]. AB - In a questionnaire we compared generally adviced therapeutical and technical procedures in patients with thyroid carcinomas with the actually favorized strategy of the clinically active surgeons. At present, sonography and cytology are not favored as preoperative diagnostic tools by the questioned surgeons. Hemithyreoidectomy as primary procedure in suspicious nodules is performed only seldomly. In the treatment of thyroid carcinoma total thyroidectomy is the accepted procedure and the possibility of restricted radicality in the treatment of papillary thyroid carcinomas has gained wide acknowledgement. Most surgeons prefer to visualize the recurrent nerve and at least one or two parathyroid glands. Autotransplantation of parathyroid glands with insufficient blood supply is considered only seldomly. PMID- 2758894 TI - [Non-occlusive ischemia enteropathy. Diagnosis, therapy and prognosis]. AB - Reduced cardiac output is the pathogenetic cause of non-occlusive ischemic enteropathia. The abdominal symptoms develop latently and surgery prevalently ensues during the stage of intestinal wall necrosis or perambulating peritonitis. There is a lethality of 50-100% and 50% at this clinic. Prerequisites of early diagnosis are: anamnesis and clinical finding, - laboratory constellation, - sonography, - mesentericography. In early stages, conservative treatment by vasodilators is promising. The laparotomy, however, is indicated in most cases in order to identify necrosis or perforation and to allow surgery according to its stages. PMID- 2758895 TI - [Aggressive fibromatosis--a surgical problem disease]. AB - The aggressive fibromatosis is a surgical problem disease. Two remarkable cases serve as examples to demonstrate the aggressive forms of extraabdominal fibromatosis. There is a tendency to locally invasive destructive growth without metastasising at any time and a markedly high relapse rate after surgery, a tendency that showed up clearly in our patients, too. The very multivarious nomenclature points out that about histiogenesis, pathogenesis and benignity of this excrescence still exists great obscurity. We report on the pathology and clinic of an aggressive fibromatosis of the thyroid gland region and of a thoracal aggressive fibromatosis in the right shoulderblade-region. PMID- 2758896 TI - [The "musculus rectus preserving" subcostal incision]. PMID- 2758897 TI - [Granular cell tumor of the esophagus--a contribution to the differential diagnosis of esophageal neoplasms]. PMID- 2758899 TI - [Clinical application of magnetic resonance imaging in gynecology]. AB - Thirty-five women were examined with female pelvic magnetic resonance imaging (MRI). 5 cases demonstrated normal pelvis structures, 3 had physiological atrophic changes, and one had an underdeveloped uterus. The other 26 cases consisted of 8 leiomyoma of uterus, 11 ovarian benign tumor, 3 ovarian cancer, 2 cervical and 2 endometrial carcinoma. Images of normal uterus as well as those pathological conditions mentioned above were depicted, and compared with the operative findings. By means of MRI, we were able to demonstrate the origin of most of the pelvic masses, number, size and location of leiomyoma, myometrial penetration, parametrial extension and lymph node metastasis of endometrial carcinoma. Cervical malignancy could be accurately staged, and serous cyst was possibly distinguished from hemorrhagic cyst. However, one case of mucinous cystadenoma was misdiagnosed as dermoid cyst; one myoma, 1 cm in diameter, in same density as the uterine muscle was overlooked and one mesonephroma of 0.3 cm in diameter situated deep in the cervical fibrous tissue was not detected. PMID- 2758898 TI - [Clinical pathologic analysis of congenital malformations in 411 perinates: with 80 autopsy materials]. AB - 411 cases of malformed babies in 1960-1985 were analyzed, giving an incidence of 6.8%. The clinical data and autopsy materials showed that the order of occurrence of malformation in various systems was: nervous system, face and neck, muscle, bone and digestive system. Autopsy rate was 37.4% in this series. The ratio of malformed male babies to female was 1.3 to 1. 46.5% of the mothers with malformed baby were at age of 25-29 years and 66.2% delivered at 37 to 41 weeks of gestation. 69.3% of mothers with malformed baby had gestational complications 11 times as high as those delivering normal neonate in the same period (P less than 0.01). Of them hydramnion, premature rupture of membranes, oligoamnios, neonatal asphyxia were obviously higher than those pregnancies with normal baby (P less than 0.01). There is mainly discussed the clinical value of autopsy and the preventive measures in decreasing birth of malformed babies. PMID- 2758900 TI - [Intrapartum amnio-infusion in patients with oligohydramnios]. AB - Patients with oligohydramnios are at increased risk of developing fetal distress during labor, presumably as the result of umbilical cord compression. Intrapartum saline amnio-infusion for short-term amnionic fluid replacement was performed in a prospective randomized manner in 60 cases of oligohydramnios during period of 1 year. Patients receiving amnio-infusion had significantly lower incidence of neonatal asphyxia and less cesarean sections as compared with the controls. No neonatal nor maternal complication occurred. The effect of amnio-infusion was also confirmed by B type ultrasonic examination. These results suggested that intrapartum saline amnio-infusion might be a hopeful therapy for patients with oligohydramnios. PMID- 2758901 TI - [Lymphangiography in ovarian cancer]. AB - Lymphangiography (LAG) and retroperitoneal lymphadenectomy were performed in 30 patients with ovarian cancer from May 1985 to Oct. 1986. The results showed that preoperative radiologic-postoperative histologic correlation was 83.3%. There was no false negativity in lymphographic diagnosis of the pelvic node metastases but two false negatives in the para-aortic node. The single most reliable criterion for LAG diagnosis of metastases was a filling-defect in the nodes. The value of LAG as an aid in staging and planning therapy was discussed. PMID- 2758902 TI - [Experimental heterotransplantation of human ovarian tumors in nude mice]. AB - Human ovarian tumors tissue taken from four surgical specimen were transplanted subcutaneously into female nude mice. The primary tissue transplantations were all successful, and the mean survival time was 15 weeks. One of the four ovarian carcinomas has been successfully transplanted to the 9th passage. Time needed for each passage was 4-6 weeks. The transplanted tumors examined histologically, cytologically and by electro-microscope, resembled the original ovarian cancer. Immunohistochemical tests were positive. Chromosome number was subdiploid and aneuploid. PMID- 2758903 TI - [Research on the need to perform a second curettage of hydatidiform mole: analysis of 152 cases]. AB - Curettage, for the second time, has been performed almost routinely for patients after the first curettage for hydatidiform mole. Is it necessary? The histopathologic results of the second curettage specimens were investigated. It showed that residual molar tissue was found in only 3.3% of the second curettage specimens. So in our opinion, a second curettage, which will not only add to patients' suffering but also would prolong hospitalization time, should be performed only in cases strongly indicated. PMID- 2758904 TI - [Long-term observations on cervical carcinoma IIb patients with preoperative intra-arterial chemotherapy]. AB - Seventy-four cases of cervical carcinoma IIb were treated by radical surgery. Among them 38 patients had received additionally preoperative intra-arterial chemotherapy. The ten and five-year survival rate of those receiving preoperative intra-arterial chemotherapy were 62.5 and 73.3% respectively, while in the group without preoperative intra arterial chemotherapy, the ten and five-year survival rate were 21.4 and 38.9% respectively. The pathological picture of them were studied. The tissue destruction was found more severe and the cellular immune reactions around the tumor foci increased in cases receiving preoperative chemotherapy as compared with those without. The mechanism of tissue reactions related to chemotherapy was discussed. PMID- 2758905 TI - [Predicting pregnancy-induced hypertension by radial arterial pulse waves]. AB - This study was carried on several methods used in predicting of pregnancy induced hypertension (PIH). Radial arterial pulse wave was found to give a predictive rate up to 85.7%, higher than that by mean arterial pressure in the second trimester of pregnancy or roll-over test. Thereafter, addition of cardio parameters, peripheral resistance and pulse wave coefficient K value yielded more accurate predicting effect in 120 cases. By recognizing the subclinical phase and giving mothers to be advises on daily life we were able to decrease the incidence of PIH from 18.8% to 9.2%. PMID- 2758906 TI - [Scanning electron microscopy observations on the vascular casts of the placental chorion in normal pregnancy and pregnancy-induced hypertension]. AB - The method of vascular casting in human placental chorion for scanning electron microscopy (SEM) was described. Through SEM of the placental chorion in five normal pregnant cases and twenty-two pregnancy induce hypertension (PIH), the three-dimensional angioarchitecture of the placental chorion in normal pregnancy and PIH of different clinical classes were clarified. Increasing with the severity of PIH, the capillaries in the placental chorion became more and more attenuated and irregular in diameter, with their branches decreasing in number and the inner wall roughened. These capillary changes were found even in mild PIH. However, the pathological changes in the chorionic capillaries in moderate and severe cases treated beforehand with magnesium sulfate were much less than those in untreated cases. PMID- 2758907 TI - [Predictive and diagnostic value of fibronectin levels in pregnancy-induced hypertension]. AB - Serum fibronectin (FN) level was assayed using ELISA monoclonal antifibronectin antibody of 152 normal gravida tested in the second and third trimesters, 24 cases who showed higher serum FN (309 +/- 13 mg/l, means +/- s means) than the normal (163 +/- 4 mg/l) developed pregnancy induced hypertension (PIH) later on. The serum FN level of 30 PIH patients was significantly higher than that of 128 normal gravidae (P less than 0.01). A serum FN level of 255 mg/l is suggested as the critical value in predicting the occurrence of PIH. The sensitivity was 79.2%, the specificity 95.3%, the index of diagnosis 174.5%, the efficiency of diagnosis 92.8%, the positive predictive value 76.0%, and the negative predictive value 96.1%. PMID- 2758908 TI - [On pregnancies with previous uterine scar]. AB - Pregnancies with previous cesarean section and myomectomy uterine scar was studied in 161 cases. The rate of vaginal delivery was 9.4%; the rates of front wall placenta, adherent placenta, placenta previa and placenta percreta were 51.0%, 7.5%, 5.7% and 0.9% respectively. Postpartum hemorrhage increased in the later three groups. The rate of uterine rupture was 4.1% in the term pregnancies; puerperal morbidity 6.6%. All these pathological statuses bore on relation to the time elapse from uterine scar formation to recent pregnancy. There were no serious complications in 63 cases of induced early abortion and 31 late abortion. It is emphasised that the quality of the operation should be improved to provide good chances of success in trial labour later on and attention should be paid to abnormal implantation of the placenta as well as rupture of the uterine scars. PMID- 2758909 TI - [Improved cephalic version: a report of 669 cases]. AB - From October 1986 to March 1988, 669 women of 30-40 weeks gestation with breech presentation subjected to improved cephalic version were presented. Using the Doppler sound detector to screen out contraindication, external cephalic version and/or bimanual cephalic version were done one hour after oral administration of 4.8 mg Salbutamol (relaxant of uterine). 647 cases out of 669 gravidae (96.71%) turned out to be successful. This procedure seems to be a simple, save and effective may to lower the incidence of breech presentation and cesarean section rate as well as the perinatal mortality rate of breech presentations. PMID- 2758910 TI - [Status of iron nutrition in term pregnant women and their newborns]. AB - Haemoglobin (Hb), free erythrocyte protoporphyrin (FEP), ratio of FEP and Hb (FEP/Hb), serum ferritin (SF) packed red cell volume (PCV), serum iron (SI), total iron binding capacity (TIBC), transferrin saturation (TS) were evaluated in 170 healthy pregnant women and their full-term babies. The pregnant women were devided into normal and iron deficient groups. The status of iron nutrition of babies of normal mothers and mothers with iron deficiency anemia (IDA) was compared. It showed that the decreased value of PCV in late pregnancy was mainly related to IDA. While the values of SF, FEP/Hb and Hb were more sensitive for detecting pregnancy associated IDA, the values of FEP, FEP/Hb and Hb in babies of IDA mothers were significantly higher than those in babies of normal mothers. Maternal iron status bore no significant correlation with the iron store of their babies. However, Hb less than 11 g/L, FEP/Hb greater than 4.5 micrograms/g, FEP greater than 0.92 mumol/L or SF less than 50 micrograms/L in early pregnancy were indications for iron supplementation. PMID- 2758911 TI - [Biochemistry of neonatal cord blood following intrapartum glucose and oxytocin infusion]. AB - The effect of intrapartum glucose and oxytocin infusion on the biochemical values of umbilical cord blood including Na, K, Cl, Ca, P, glucose, BUN and osmolality was studied in 246 newborns. The newborns were divided into 4 groups: Group 1 consisted of 162 babies whose mothers did not receive any intravenous infusion. Group 2. 53 babies, Group 3. 16 babies and Group 4.15 babies whose mothers received infusion of oxytocin in glucose (5U/L). The total amounts of infusion were less than 500 ml in Group 2. 500ml in Group 3. 500-1,000 ml in Group 4. Group 3 were delivered with forceps. In comparison with Group 1, the serum K+ in Group 2 and Cl- values in Group 4 were lower while the glucose values were higher in Groups 2, 3 and 4 (highest in Group 3). The other values were not significantly different. PMID- 2758912 TI - [Clinical application of intrauterine insemination]. AB - Nineteen infertile couples were treated with intrauterine insemination (IUI) using husband's semen. Three women with asthenospermic husbands, one with unknown cause and one treated with a combination of induced ovulation and IUI conceived. Three healthy infants have been delivered up to now. The indications for IUI, the importance of proper preparation of semen, the technique of insemination and prediction of ovulation in IUI are discussed. PMID- 2758913 TI - [Value of endometrial aspiration cytology in assessing endometrial status]. AB - Cytologic findings of endometrial aspiration from 135 women was correlated with pathologic diagnosis of endometrium. The results indicate that different endometrial changes, such as hyperplasia, carcinoma and other malignant endometrial lesions, different phases of normal menstrual cycle and senile atrophy can be distinguished by endometrial cytology. The author suggests that aspiration cytology may serve as a supplement to the biopsy or curettage in the assessment of the status of the endometrium. PMID- 2758914 TI - [Endometrioid carcinoma of the ovary: clinicopathologic analysis in 87 cases]. AB - From Jan. 1972 through Dec. 1984, 87 cases of endometrioid carcinoma of ovary were treated in our hospital, accounting for 23.5% of all cases of epithelial ovarian cancer admitted during the same period. Histologically they could be subdivided into 4 types, i. e. endometrioid carcinoma, clear cell carcinoma, adenocanthoma, and adenosquamous carcinoma. The 5-year survival rates for each type of tumors were 51.2, 0, 100 and 0% respectively. The 5- and 10-year survival rates were 90.1 and 90.1% for stage I, patients, 23.3 and 23.3% for stage II, 4.6 and 0% for stage III, and nil for stage IV. For improving the survival rate and reducing the incidence of recurrence, postoperative long term hormonal therapy should be considered. PMID- 2758915 TI - [Light and electron microscopic observations on endodermal sinus tumor of the ovary]. AB - The results of light and electron microscopic studies of the endodermal sinus tumor of ovary are presented. Although histologic features of the tumors appeared to be much varied, ultrastructurally all tumor cell seemed to show changes essentially of the same nature. The histogenesis of endodermal sinus tumor production of AFP by the hyaline globule and the basement membrane-like substance present only in this type of tumor, are discussed. The results of the present study support the view that the tumor originate from the embryonal yolk sac cells. PMID- 2758916 TI - [Efficacy of CT omnipaque myelography in the demonstration of intraspinal space occupying diseases (report of 77 cases)]. AB - The value of omnipaque myelography and CT myelography in 77 cases of intraspinal space-occupying lesions (51 extramedullary and 26 intramedullary confirmed by operation) was reviewed. In 69 cases the preoperative diagnosis was accurate, but not in the other 8 cases. It is not advisable according to the authors' experience to have both myelography and postmyelography CT scan done for all intraspinal space-occupying lesions. For most of the extramedullary tumors, myelography alone proved to be adequate. For intramedullary lesions the information obtained from myelography was inconclusive and postmyelography CT scan as a supplementary procedure was necessary. PMID- 2758917 TI - [Angiocardiographic diagnosis of membranous ventricular septal aneurysm in childhood]. AB - 121 patients with isolated VSD were investigated by left ventriculography in long axial oblique projections at Xinhua hospital. In this group, 26 cases (21%) had conal septal defects, one (1%) had a muscular VSD and 94 (78%) membranous VSD. Among the 94 patients, 41 cases (44%) had membranous ventricular septal aneurysm. The angiocardiographic manifestations, pathology, associated left ventricular right atrial shunt of membranous septal aneurysm and the differential diagnosis were discussed. PMID- 2758918 TI - [CT diagnosis of neuron migration anomalies]. AB - CT findings of 17 patients with neuron migration anomalies, 5 with lissencephaly, 6 with schizencephaly and 6 with heterotopic gray matter were reviewed. Migratory anomalies are congenital malformations caused by insult to the neurons during the time of migration. CT is effective in detecting these malformations. PMID- 2758919 TI - [X-ray manifestations of trichinosis on chest radiograph (analysis of 15 cases)]. AB - This article reported the result of the chest radiographs of 14 patients with trichinosis, in regard to the X-ray manifestations, pathologic basis and clinical significance. The radiologic findings included hilar enlargement, exaggerated and fuzzy lung markings, and pulmonary patchy infiltrations of varying sizes as well as fine nodular shadows. The pathologic basis consisted of dilatation and congestion of pulmonary vessels and capillary beds and intrapulmonary hemorrhagic lesions. The pulmonary radiologic manifestations are helpful for estimating patient's prognosis. PMID- 2758921 TI - [CT diagnosis of coal workers' pneumoconiosis]. AB - In order to evaluate the usefulness of CT in CWP, 100 coal workers were examined with both chest radiograph and CT scan. Comparison was done, the result indicated that both modalities yielded similar sensitivity to simple CWP. The CT score of simple CWP correlated well with ILO classification and 1986 Chinese criteria for staging of pneumoconiosis, whereas in complicated CWP, the CT scan was significantly superior to chest radiograph. CT scan identified readily large opacities. It could detect large opacities in 40% of simple CWP diagnosed on the basis of chest radiograph. CT scan also identified more cavities and calcifications within large opacities. The CT attenuation values were less reliable. The authors were of the opinion that at present CT attenuation values is not recommended for routine evaluation of CWP. PMID- 2758920 TI - [Idiopathic unilateral hyperlucent lung (analysis of 11 cases)]. AB - 11 cases of idiopathic unilateral hyperlucent lung were reported: The clinical pictures and X-ray findings were analysed. The main X-ray changes were abnormal hyperlucency of the affected lung or lobe while the size of the hyperlucent lung was normal or smaller than the contralateral side. The hilar shadow and vascular markings fine and decreased During respiration, the volume of the affected lung remained constant but the mediastinum shifted to the affected side on inspiration and away from it on expiration. The affected lung retained its radiolucency on expiration. The broncho-pulmonary angiogram, lung CT scan and pulmonary vascular tomograph were studied. The clinical pictures, etiology, pathology, X-ray diagnosis and differential diagnosis were discussed. PMID- 2758922 TI - [Diabetic osteopathy (an analysis of 37 cases)]. AB - This paper reported the result of clinicoradiologic analysis of 37 patients with diabetic osteopathy. The site of predilection was the bony ends of the extremities, especially the foot (91.9%). The main clinical manifestation was the presence of a non-healing chronic ulcer, whereas diabetic gangrene of bone constituted the chief x-ray finding, which was characterized by osteolytic destruction at the bony ends of metatarsals and phalanges, with minimal periosteous reaction if any. The bony articular surfaces were usually preserved. The chief distinction to be made is osteomyelitis. The mechanism of diabetic osteopathy is most probably systemic metabolic disorders resulted from disturbance of carbohydrate metabolism with secondary neurovascular changes. Infection probably plays the role of enhancing effect in gangrene of bone. PMID- 2758923 TI - [X-ray diagnosis of multiple epiphyseal dysplasia (a report of 3 cases from the same family)]. AB - This is a case report of 3 cases from the same family with multiple epiphyseal dysplasia. The disease is an uncommon congenital dominant hereditary disease of the bone characterized by multiple and symmetrical skeletal involvement with retardation of epiphyseal development, accompanied by irregularity and shortening of toes and fingers and yet still maintaining the normal proportion between the trunk and extremities. The intelligence is not affected. In the adult patients, sloping of distal tibial articular surface associated with degenerative changes of both hip joints is a reliable diagnostic sign. The aforementioned X-ray signs are helpful to distinguish this condition from other chondrodysplasia diseases. PMID- 2758924 TI - [Complications of selective arteriography and arterial embolization]. AB - Of 541 patients with selective arteriography or arterial embolization there were 16 cases developing clinically significant complications, 9(1.6%) were related to arteriography, 2 of which were pronounced hematomas at the puncture site and 7 subintimal injections in various selected arteries. 7(11.6%) complications occurred in a total of 60 cases of arterial embolization, among which there were 1 accidental embolization of the brain, 5 unexpected ischemic changes resulting in even dry gangrene and 1 vascular injury by the embolizing substance. The causes and hazards as well as prevention and management of the complications were briefly discussed. PMID- 2758925 TI - [Diagnosis of pituitary microadenoma on coronal CT scan]. AB - 38 patients with functional microadenoma were investigated with high-resolution computed tomography and only coronal scan was done. All patients were documented with surgery and pathology. On coronal CT scan, the density, height and the shape of the pituitary gland, as well as the bony structure of the sellar floor could be displayed clearly. Our results indicated that these four criteria were reliable in the diagnosis of microadenoma. If coronal CT demonstrates a normal pituitary gland, in our opinion, it is not necessary to take other X-ray examinations. PMID- 2758926 TI - [Investigations on internal derangement of the temporomandibular joint by direct sagittal CT scanning]. AB - This paper reported the preliminary experience of direct sagittal CT of temporomandibular joint (TMJ) and its modalities of TMJ was made. By using a specially devised table, the bony structure and disc of TMJ can be well demonstrated. The major advantage of this technique is direct demonstration of the articular disc and a diagnosis of anteriorly displaced meniscus which is reducible or irreducible can thus be made. The application of CT in internal derangement of TMJ will open up new insight into the diagnosis and management of these patients. PMID- 2758927 TI - [A correlative study of 108 cases of lumbar disc herniation (plain X-ray film, myelography and operative findings)]. AB - This article presented the X-ray plain films and myelograms of 108 patients with lumbar disc herniation and comparative study was made with operative findings. The diagnostic accuracy was 92.8%. Hypertrophic changes with lipping at posterior margin of the vertebral body and narrowing of anterior part of disc space with widening of the posterior part were useful signs for localizing the herniated disc. The myelographic signs of pressure on dural sac and nerve roots were evaluated for its significance in localization of the lesion and differential diagnosis. The X-ray manifestations of L S1 herniation were described in detail. PMID- 2758928 TI - [Investigation on reduction of radiation dose and optimization of exposure parameters in radiography]. AB - Investigation and measurement of the radiation dose level of routine X-ray diagnostic examinations were carried out on the spot, the results were as follows: Radiation dose of routine radiography: chest 0.258-1.032 x 10(-4) c/kg (0.1-0.4R); spinal and abdomen 0.774-1.806 x 10(-4) c/kg (0.3-0.7R); skull 0.774 1.032 x 10(-4) c/kg (0.3-0.4R) and gastrointestinal study 2.58-7.74 x 10(-4) c/kg (1-3R). Experiments employing different kV and mAs, and radiation exposure on 12 18 mm A1 phantoms while measuring the radiation dose and film density showed that radiation dose can be substantially reduced by improving the quality of X-ray beam for instance with the routine radiographic parameters for the chest, if the voltage is increased by 20 kV, radiation dose can be reduced to 65% or an additional 2 mm A1 filter can also reduce the dose to 60-65%. PMID- 2758929 TI - [Omnipaque (iohexol) CT myelography (CTM) in the diagnosis of cervical spondylotic myelopathy--correlative study of conventional myelography (a report of 100 cases)]. AB - 100 cases of cervical spondylotic myelopathy were studied with both CTM and conventional myelography and the results were compared. It was shown that CTM possesses more advantages over its counterpart as follows: (1) CTM can demonstrate with a higher degree of accuracy the size and configuration of the spinal cord, its internal composition and cystic necrosis, can pick up more herniations, hard and soft, up to 16% (39/252) and better define the position left, middle and right of the protrusion. (2) CTM is capable of making a correct diagnosis of cervical myelopathy and cystic necrosis in the cord. Analysis also showed that the degree of changes of spinal cord seen on CTM correlation closely with severity of the clinical picture. Atrophy and cystic necrosis of the cord are important factors accounting for clinical deterioration and operative failure. PMID- 2758930 TI - [Preliminary investigation on dynamic CT scan of intracranial tumors]. AB - 74 patients with various intracranial tumors were studied by means of dynamic CT, among them 45 cases were confirmed by operation and pathology. In analyzing the time-density curve and the ratio of increase in CT number of the tumoral tissue to that in the arterial lumens (tissue-blood ratio, TBR), we found that: (1) Dynamic CT technique is safe and easy to perform suitable for out-patients; (2) The time-density curves in acoustic neurinoma, meningioma, glioma and metastatic tumors are different from each other because of difference in vascularity and the degree of B.B.B. breakdown. Meningioma curve shows a rapid rise to the peak followed by a subsequent plateau; (3) TBR at the peak time (TBRp) is useful as an index for tumor. Combined analysis of time-density curve and TBRp is helpful for tumor differentiation. PMID- 2758931 TI - [CT diagnosis in subcortical arteriosclerotic encephalopathy]. AB - 51 cases of subcortical arteriosclerotic encephalopathy (SAE) diagnosed by CT were reviewed, the diagnosis and differential diagnosis of CT in SAE were discussed. The pathologic basis of SAE is thought to be arteriosclerotic changes in small penetrating cerebral arteries, which cannot be seen directly by CT, however, the resulting histo-pathologic alterations which include widespread patchy areas of demyelination and small infarcts could be demonstrated on CT image. It is surmised by the authors that these changes in white matter seen on CT are responsible for clinical deterioration of the patients. PMID- 2758932 TI - [X-ray diagnosis of 128 cases of cerebral vascular malformations (AVM) with emphasis on analysis of cerebral angiogram]. AB - 128 cases of AVM studied by cerebroangiography were analysed. All were confirmed by operation and pathology. Based on the feeding arteries, draining veins and malformed vessels, the authors analysed the hemodynamics of AVM and divided them into six types. This classification will be of benefit to the surgeon. In this article the associated cerebral aneurysm and blood supply from meningeal arteries were also discussed. The CT findings of AVM as well as various diagnostic imaging methods used were described. PMID- 2758933 TI - [Radiologic diagnosis and differential diagnosis of fibrous dysplasia of the facial bones]. AB - A radiologic-pathologic correlative study was carried out on 43 cases with fibrous dysplasia of the facial bones with emphasis on basis for radiological diagnosis. The x-ray manifestations according to density changes are classified into three types: sclerotic, osteolytic and mixed. The lesion extends along the longitudinal axis in the mandible whereas in the maxilla, the lesion spreads in a diffuse pattern along the wall of the maxillary antrum with preservation of maxillary contour. The authors considered that fibrodysplasia and ossifying fibroma are different disease entities and should be distinguished by combination of clinical, radiologic and pathologic evidences. PMID- 2758934 TI - [Primary pericardial mesothelioma: a report of four cases]. AB - Pericardial mesothelioma is an uncommon variety of primary malignant cardio pericardial tumors. Four cases with pericardial mesothelioma proved by surgery and pathology are reported in this paper. The pathologic and clinical characteristics, and the imaging diagnosis of this entity are briefly discussed. PMID- 2758935 TI - [Clinical applications of selective bronchial arteriography and bronchial artery infusion]. AB - 32 cases (94 times) of selective bronchial arteriography (BAG) and bronchial artery infusion (BAI) were reported. The arteriographic manifestations in several diseases and the relationship between the arteriographic features and histological types of bronchial carcinoma were described. The clinical applications of BAG and BAI were briefly discussed. PMID- 2758936 TI - [Imaging diagnosis of cervical spondylosis]. AB - Myodil-myelographic manifestations of 60 cases of cervical spondylotic myelopathy and radiculopathy were analyzed. For better understanding the biomechanical disturbances of cervical spondylosis, CT scans of 26 cases of this disease were also investigated. Myelography and/or CT were considered necessary if surgical procedure was to be undertaken with anterior approach. Myodil myelography or CT could fulfill the diagnostic requirements for surgery if Non-ionic water-soluble contrast media or other new techniques were not available. PMID- 2758937 TI - Cell biology of tick/host interaction and disease transmission. Papers presented at the XVIII International Congress of Entomology [corrected]. 2-9 July 1988, Vancouver, British Columbia, Canada. PMID- 2758939 TI - Acquired resistance to ixodid ticks induced by tick cement antigen. AB - Antisera from guinea pigs made resistant to infestation with an ixodid tick of east and central Africa, Rhipicephalus appendiculatus, were used to identify the tick antigens they recognized by immunoblotting. Most of the antigens were found in tick salivary glands and in tick attachment cement. Antisera from R. appendiculatus-resistant guinea pigs also recognized some salivary-gland antigens in ticks of other species (R. pulchellus, R. evertsi, Amblyomma variegatum and A. gemma). Antibodies against the most strongly recognized R. appendiculatus antigen, a 20-kDa molecule, were only poorly reactive with similar-sized molecules in the other ticks. A 94-kDa antigen, which appeared to have broader cross-reactivity, was purified from R. appendiculatus attachment cement, and a monospecific rabbit serum was raised against it. This antiserum clearly recognized a molecule of similar molecular weight in R. pulchellus and R. evertsi. Intravenous inoculation of rabbits with the purified molecule elicited delayed-type hypersensitivity to the antigen. The hypersensitive rabbits demonstrated resistance to feeding of R. appendiculatus ticks but slight enhanced feeding of R. pulchellus ticks. These results are discussed with respect to their relevance for artificial induction of tick-feeding resistance. PMID- 2758938 TI - Characterization of ixodid tick salivary-gland gene products, using recombinant DNA technology. AB - Ticks secrete an array of lesion-maintenance factors into the host via the salivary glands while feeding, some of which elicit an immune response by the host that adversely affects the ability of the tick to feed and reproduce. Our approach to characterizing these factors has been to make expression libraries from mRNA of salivary glands (from unfed and 3-day-feeding Amblyomma americanum females) which will serve as sources of the genes (clones) that code for them. Thus far, we have detected 10 positive clones in primary screens using polyspecific antiserum from rabbits hyperimmunized to 3-day-feeding tick salivary glands. We also report making a cDNA library from whole unfed females, and a genomic library from whole unfed ticks, which will serve as additional sources of genetic information for characterizing salivary-gland secretory products. Immunoblots of salivary glands from A. americanum females feeding for various intervals (unfed, and 12, 48, 72, and 96 h) revealed the presence of several prominent polypeptides (90 & 45 kDa) when probed with the same rabbit antiserum that was used to screen the expression library. Ixodes dammini had several immunogens in common with A. americanum at 96 h (90, 45, 43 and 23 kDa). We plan to use monospecific antiserum raised to antigens detected in our immunoblots (e.g. 90 kDa) to further screen the expression libraries, in addition to using the polyspecific antiserum already in hand. We discuss the future use of the salivary-gland genes for characterizing secretory products which facilitate attachment to the host (cement) and maintain the lesion during the lengthy feeding interval. PMID- 2758940 TI - Relationship between feeding, mating, vitellogenin production and vitellogenesis in the tick Dermacentor variabilis. AB - Anti-vitellin IgG directed against Dermacentor variabilis egg vitellin was used in sodium dodecyl sulfate polyacrylamide (SDS-PAGE) gradient gel immunoblots to detect the presence of vitellin and its precursor, vitellogenin, in the organs of feeding adults and in the immature stages of this tick. Vitellin polypeptides were found in the egg, larvae, nymph, and in the unfed adult stages of both sexes. Vitellin polypeptides were first detected in the ovary of mated females during the rapid-engorgement feeding period. These polypeptides were also present in the ovaries of ovipositing females, unmated females fed for extended periods, and fed unmated females that were detached from the host and held for 12 h before dissection. The same anti-vitellin antibody was used in immunoblots to monitor the appearance of vitellogenin in the organs and hemolymph of female ticks. Immunoreactive peptides of vitellogenin were found in the fat body, midgut, and hemolymph of pre-rapid-engorging mated and unmated females. These polypeptides were not found in fed males nor in Malpighian tubes of feeding or ovipositing females. Our data supported the following conclusions: 1) presence of immunoreactive vitellogenin in the adult female fat body, hemolymph, and midgut was dependent upon feeding; 2) in mated feeding females, we could not detect the uptake of vitellogenin by the ovary until rapid engorgement; 3) in unmated females, vitellogenesis did not begin unless prolonged feeding occurred; and 4) during the early developmental stages of this tick, vitellin served as an embryonic nutrient reserve and as a reserve against starvation between feedings. PMID- 2758941 TI - Effects of aging on the anorectal sphincters and their innervation. AB - The effects of aging on the pelvic floor musculature and its innervation are described in 102 women and 19 men without colorectal or pelvic floor disease. In the women, a reduction in anorectal "squeeze" pressure was found in the fifth decade, but the resting anal pressure remained unchanged. This reduction in squeeze anal pressure was accompanied by an increase in the mean pudendal nerve terminal motor latency, indicating damage to this nerve, and increased perineal descent in the resting and straining positions. The fiber density, recorded by single fiber electromyography in the external anal sphincter muscle, a muscle innervated by the pudendal nerves, was increased in the sixth decade, indicating the later development of compensatory reinnervation in this muscle. The interrelation of aging, menopausal effects, and parity in these changes is difficult to define from currently available data, but the authors suggest, from other evidence, that menopausal effects may be relevant. PMID- 2758942 TI - The effect of packed cells and whole blood transfusions on survival after curative resection for colorectal carcinoma. AB - The effect of perioperative blood transfusions on survival after curative resection for colorectal carcinoma was studied retrospectively on 270 patients with special emphasis on whole blood transfusion. Eighty-six (32 percent) patients did not receive blood transfusions, whereas the remaining 110 (41 percent) received packed cells and 74 (27 percent) received at least 2 units of whole blood. The recurrence-free and overall 5-year survival rates for the transfused group were 58 and 57 percent, respectively, and for the non-transfused group, 78 and 72 percent, respectively. These differences were highly significant (log rank test, P less than 0.001). The recurrence-free and overall 5-year survival rates for patients who received only whole blood or a combination of whole blood and packed cells was 51 percent, and of those who received only packed cells was 63 percent. The difference was not statistically significant (log rank test, P = 0.08, P = 0.35). Administration of more than 6 units of blood is attended with a significantly worse 5-year disease-free survival rate than administration of a smaller volume. The survival was not decreased if 6 or more units of whole blood were given. The authors conclude that perioperative blood transfusions have a significant detrimental effect on survival after curative resection for colorectal carcinoma. This effect is not enhanced by whole blood transfusions. PMID- 2758943 TI - Multiple blood transfusions reduce the recurrence rate of Crohn's disease. AB - In order to determine whether perioperative blood transfusion affects the recurrence of Crohn's disease, the authors reviewed the records of 79 patients with Crohn's disease who underwent their initial intestinal resection at their institution. Recurrence of Crohn's disease was documented by radiographic studies, endoscopy, or laparotomy. During the hospital admission for resection, 45 patients received multiple red blood cell transfusions. Recurrence developed in 22 percent of these patients by 36 months, and the median time to recurrence was 35 months. In the 34 patients who did not receive multiple transfusions, recurrence was found in 44 percent by 36 months, and the median time to recurrence was 20 months. These differences are significant, using the Kaplan Meier analysis (P less than 0.04). Recurrence in patients with disease limited to the small bowel or to the colon was not significantly affected by the transfusion status. However, recurrence developed in only 10 percent of multiply transfused patients with ileocolic disease by 36 months, whereas recurrence developed in 45 percent of the patients who were not multiply transfused. (Significance, P = 0.057). The authors believe that the observed decreased rate of recurrence of Crohn's disease in patients receiving multiple perioperative transfusions may represent another example of clinically significant immunosuppression from blood transfusion. PMID- 2758944 TI - Perforation of the rectum and sigmoid colon during barium-enema examination. Management and prevention. AB - Perforation of the rectum or sigmoid colon complicated 5 of 2200 barium-enema examinations performed during a 4-year period. Three patients with rectal perforations manifested by air extravasation were successfully treated with intravenous antibiotics and complete bowel rest. Two patients with barium extravasation were treated with immediate operation and colostomy. All five patients recovered. Perforation was found to be associated with a rectal stricture due to ulcerative colitis, a rectal cancer, an incarcerated inguinal hernia, fulminant ulcerative colitis, and a normal colon in an elderly patient. To determine the pressure in the rectum that could potentially be generated during a barium-enema examination, the pressures created by a standard barium delivery set were measured, using 1-meter columns of water, 25 percent diatrizoate sodium (Hypaque), 20 percent barium, and 80 percent barium. The columns generated pressures of 70, 85, 95, and 120 mm Hg respectively. Squeezing the delivery bag increased the pressure 21 to 79 percent or a maximum of 55 mm Hg. Colorectal perforation during barium-enema examination that was not accompanied by barium extravasation could be successfully treated nonoperatively. The associated pathology and our studies of pressures generated during a barium enema examination allow us to suggest that the incidence of colorectal perforation during barium-enema radiography can be reduced by 1) performing proctoscopy prior to barium enema, 2) avoiding the use of the rectal balloon in patients with known rectal lesions, 3) avoiding barium studies in patients with active colitis, 4) avoiding generation of pressure greater than that created by a column of barium suspension of one meter, and 5) using a lower concentration of barium when possible. PMID- 2758945 TI - Rectoanal reflex induced by H2O thermal stimulation. AB - To obtain clear evidence of the rectoanal reflex, cold water was injected into the rectum. All patients with a normal reflex had a rectoanal reflex when the water was either 4 degrees C or 17 degrees C. The same reflex was seen when a balloon was used for distention. No reflex was evident when the water was 37 degrees C. At 27 degrees C or 45 degrees C, the reflex was evident occasionally. In patients with Hirschsprung's disease, the rectoanal reflex was absent with balloon distention, and when water at any temperature was injected. As cold water will induce the rectoanal reflex safely and without rectal distention, measurement of the reflex using cold water is useful when the presence or absence of the reflex is doubtful. The authors' results suggest that the receptor related to the reflex is neuronal in origin and not muscular, and that the receptor locates near the mucosa. PMID- 2758946 TI - Transanal extirpation for early rectal cancer. AB - Transanal extirpation was performed in 38 patients with adenocarcinoma of the rectum. In 17 patients (group I) the tumor extended into the submucosa only, and in 14 patients (group II) tumors extended into, but not through, the muscularis propria. There was a significant difference in local recurrence between groups I and II. None of the patients in group I and six of the patients (42.6 percent) in group II developed local recurrences (P = 0.02). The 5-year actuarial survival probability was 100 and 82.6 percent, respectively. Transanal extirpation is an alternative to transsphincteric and abdominoperineal resection in the treatment of early well or moderately well-differentiated cancer of the rectum. The surgical procedure is simple and has few complications; however, only tumors extending no deeper than the submucosa are suitable for this treatment. The operation should be followed by frequent sigmoidoscopies and rectal palpation. The procedure should be defined as an excisional biopsy until results from the histologic examination are presented. PMID- 2758947 TI - Traumatic cloaca. AB - Deep laceration of the perineum after an obstetric injury may result in a cloacal deformity of the anus and vagina, causing complete fecal incontinence. A surgical technique consisting of reconstruction of the perineal body (perineoplasty) with puborectalis interposition and overlapping external sphincteroplasty is described to correct the defect and restore continence. This procedure has been used on 43 patients in a 10-year period with excellent anatomic and physiologic results. PMID- 2758949 TI - Use of a disposable umbilical cord clamp in end colostomy. AB - A method is described in which a simple disposable plastic umbilical cord clamp replaces the traditional cumbersome instrument or expensive staples in the operation of end colostomy. PMID- 2758948 TI - Morphology and rheology of the rectum in patients with chronic idiopathic constipation. AB - To evaluate whether there is a relationship between the viscoelastic properties of the rectum and its surface, barium enema and rectal accommodation studies were performed under standard conditions in 46 subjects (25 adults, 21 children) with chronic idiopathic constipation. In adults, a significant correlation was found between rectal surface at barium enema and the minimum radius of rectal distention with a balloon necessary to higher wall tension changes (r = 0.68; P less than 0.01). In both adults (r = 0.48; P less than 0.05) and children (r = 0.57; P less than 0.01), negative correlations were found between the surface of the rectum and its elasticity. It is concluded that rectal accommodation studies produce data comparable to those of radiologic examinations and may therefore be used repetitively, and without fear of radiation, as follow-up studies on constipated patients. PMID- 2758950 TI - Abnormal nerve conduction in impotent patients with diabetes mellitus. AB - The etiology of impotence in the diabetic population has not been clearly defined. To assess this problem, 24 impotent diabetic subjects, 21 nonimpotent diabetic subjects, and 10 subjects with psychogenic impotence were compared with nocturnal monitoring of penile tumescence and rigidity, penile arterial blood flow, and nerve conduction of the pudendal nerve. There was no statistical difference in mean age or duration of diabetes among the various study groups. All diabetic subjects who presented with complaints of impotence had severe abnormalities on nocturnal erection monitoring. There was no significant difference in the mean penile brachial index between impotent and nonimpotent diabetic subjects (P = .335). In contrast, there was a significant difference in bulbocavernosus-reflex latency times (P less than .001) between impotent (mean latency 48.4 ms) and nonimpotent (mean latency 38.7 ms) diabetic subjects. This study strongly suggests that impotence in the diabetic population is secondary to functional abnormalities of pelvic nerves and that the bulbocavernosus-reflex latency time is an excellent diagnostic test for assessing function of pelvic nerves in the diabetic individual. PMID- 2758951 TI - Impaired glucose tolerance in the U.S. population. AB - Impaired glucose tolerance (IGT) constitutes two-thirds of all glucose intolerance in the United States and is a major risk factor for diabetes. Despite these findings, the clinical and epidemiological significance of IGT has not been well investigated. The Second National Health and Nutrition Examination Survey, a cross-sectional study in which 75-g 2-h oral glucose tolerance tests (OGTTs) were performed, has provided an opportunity to examine the characteristics of IGT in the U.S. population. Data from the survey have been extrapolated to represent all U.S. residents. The findings indicate that approximately 11.2% of Americans aged 20-74 yr have IGT compared to 6.6% with diabetes. Rates of IGT increased with age for White men and women and Black men but declined for Black women greater than 54 yr of age, possibly because greater obesity in Black women precipitated earlier conversion of IGT to diabetes. The distribution of 2-h glucose values showed IGT to be part of a continuum of glucose intolerance extending from normal to diabetes. Individuals with IGT had rates of risk factors for non-insulin dependent diabetes (age, plasma glucose, past obesity, family history of diabetes, physical inactivity) that were intermediate between those of individuals with normal glucose tolerance and those with diabetes, although current obesity was similar for IGT and diabetes. The proportion of people with medical histories of diabetes-related conditions did not differ between IGT and normal glucose tolerance. However, several cardiovascular findings were more prevalent in individuals with IGT than in those with normal glucose tolerance, including hypertension, serum cholesterol, angina, abnormal heart findings, and medical history of arteriosclerosis and stroke. Both obesity and reported family history of diabetes were associated with higher rates of IGT, with the effect of weight gain on the prevalence of IGT occurring at lower levels than for diabetes. PMID- 2758952 TI - Relative sweetness of fructose compared with sucrose in healthy and diabetic subjects. AB - Fructose is credited with some advantages over sucrose: it causes less of an increment in plasma glucose and insulin response, and the taste is sweeter. We reevaluated the latter property with a new methodology (the "up and down" method adapted from Dixon) in 33 healthy subjects, 17 insulin-dependent diabetes mellitus (IDDM) patients, and 12 non-insulin-dependent diabetes mellitus (NIDDM) patients. Sweetening potency was determined over 2-3 test sessions in each subject. Results are expressed in percent as the relative sweetness (R) of fructose (F) over sucrose (S), taken as reference. In the first set of experiments, with a 30-g/L sucrose-water solution at pH 7, we found that R values were similar for healthy subjects (102 +/- 8%) and diabetic subjects (106 +/- 7%) (P less than .05). No significant difference between IDDM and NIDDM patients was observed. In a second set of experiments, performed in healthy subjects only, R was increased in acid water (114%; P less than .01), in lemon juice (136%; P less than .001), in water at 2 degrees C (130%; P less than .001), and in coffee at 2 degrees C (120%; P less than .02); mean values were decreased in grapefruit juice (77%; P less than .001), in water at 43 degrees C (88%; P less than .01), and in coffee at 53 degrees C (87%; P less than .001). We found that the test methodology had a very satisfactory intrasubject reproducibility (coefficient of variation [C.V.] less than 8%) but a very wide intersubject variability (C.V. congruent to 32%).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2758953 TI - Evaluation of epidemiology and immunogenetics of IDDM in Spanish- and Portuguese heritage registries. A key to understanding the etiology of IDDM? Diabetes Epidemiology Research International Group. AB - There appears to be extraordinary international variation in the incidence of insulin-dependent diabetes mellitus (IDDM), the reasons for which are not known. By evaluating the incidence of IDDM in Spanish- and Portuguese-heritage populations, important insight into reasons for the major worldwide differences in IDDM risk may be gained. The limited data that are available for Hispanic populations suggest that there is at least a 10-fold difference in risk between individuals of Hispanic ancestry in Colorado and Mexicans in Mexico City. Standard methods for assessing IDDM incidence are needed to further elucidate the patterns of risk among populations of iberian heritage. Therefore, we propose that comparable IDDM registries be established in the Spanish- and Portuguese speaking world. Once registries are established, further investigation of the characteristics of IDDM among various populations (including seasonal distributions, sex differences, age at onset, and changing trends over time) may help explain the large international incidence differences among not only Spanish and Portuguese-heritage populations but also among all children. PMID- 2758954 TI - Different HLA haplotypes in Mexican Americans with IDDM. AB - The study of HLA histocompatibility antigens and insulin-dependent diabetes mellitus (IDDM) in non-White populations may provide a unique opportunity to more accurately define the diabetes susceptibility gene(s) located within the HLA region. To determine whether HLA haplotypes differ between ethnic groups, we compared 105 HLA haplotypes from 55 Mexican-American IDDM patients with 272 haplotypes from 136 IDDM patients of non-Hispanic White descent. The accurate determination of genotypes and haplotypes requires the study of family units. Therefore, all diabetic patients in this study were from studies of families having one or more siblings with IDDM. In the Mexican-American group, HLA-DR3 and -DR4 were the most common HLA-DR alleles and were present in comparable frequencies in the non-Hispanic White group (HLA-DR3, 27% of Mexican-American and 29% of non-Hispanic White haplotypes; DR4, 46% of Mexican-American and 43% of non Hispanic White haplotypes). However, the HLA-B/DR-containing haplotypes and haplotype frequencies differed between the two groups. Several common haplotypes (B8/DR3, B15/DR4) in the non-Hispanic White group occurred less frequently in the Mexican-American group. In contrast, uncommon haplotypes in the non-Hispanic White group comprised nearly 50% of the DR4-containing haplotypes (B35/DR4, B40/DR4, B44/DR4) in the Mexican-American group. Although both DR3- and DR4 haplotype frequencies differed significantly between the two groups, the relative frequency of DR3- but not DR4-containing haplotypes was similar in both ethnic groups. This adds to the evidence suggesting that different susceptibilities are provided by the haplotypes carrying the DR3 and DR4 alleles. PMID- 2758955 TI - Analysis of changes in eating behavior and weight loss in type II diabetic patients. Which behaviors to change. AB - To identify the behavior-change strategies that are most clearly related to weight loss, 106 patients with type II (non-insulin-dependent) diabetes completed the Eating Behavior Inventory (EBI) before and after participating in a behavioral weight-loss program and at 1-yr follow-up. The EBI is a standardized questionnaire that assesses behavioral strategies typically taught in a behavioral weight-loss program. Pretreatment scores on the EBI were not related to weight-loss outcome, but changes on the EBI in the direction of more frequent use of appropriate strategies were related to weight loss at both posttreatment and 1-yr follow-up. Specific strategies related to weight loss at both times were 1) eating foods that help in losing weight, 2) recording foods eaten, 3) refusing food offered by others, and 4) being able to stop eating when appropriate. However, few patients maintained frequent use of these strategies at follow-up. It is concluded that weight-loss programs should focus on the strategies most strongly related to weight loss and try to improve long-term use of these techniques. PMID- 2758956 TI - Management of diabetes in correctional institutions. PMID- 2758958 TI - Diabetes in correctional institutions. PMID- 2758957 TI - Epidemiology of IDDM. Is it needed? PMID- 2758959 TI - Low relative prevalence of IDDM in French West Indies. PMID- 2758960 TI - [Direct regulatory action of erythrocyte membranes on the production of erythropoiesis-modulating factor in spleen cells]. PMID- 2758961 TI - [Selectivity of the effect of laser radiation on biological tissues]. PMID- 2758962 TI - [7-Ketocholesterol inhibits secretion of very low density lipoproteins by cultured human and rabbit hepatocytes]. PMID- 2758963 TI - [Mesodermalizing factor from bovine amniotic fluid]. PMID- 2758964 TI - [Loss of electrolytes as a cause of insect dehydration after application of insecticides]. PMID- 2758965 TI - [Hydrolysis and absorption of carbohydrates in isolated and functioning pieces of rat small intestine in chronic experiments]. PMID- 2758966 TI - [Quantitative analysis of the development of neurons in embryonal tissue of the cerebral cortex, transplanted into the brain of adult rats in comparison with the development of neurons in the intact brain]. PMID- 2758967 TI - [The effect of DNA conformation of the interaction of glucocorticoid receptor complex with a glucocorticoid regulating gene]. PMID- 2758968 TI - [A sharp increase in the liver of a factor stimulating proliferation of fibroblasts in vitro in experimental cirrhosis]. PMID- 2758969 TI - [An alternative promotor of the esterase S gene of Drosophila virilis leads to the formation of unusual mRNA in cells of imaginal disks]. PMID- 2758970 TI - [Peptide Arg-Gly-Asp-Ser amplifies the functional activity of phagocytes, caused by adhesion and phorbol myristate acetate]. PMID- 2758971 TI - Maternal smoking during pregnancy affects children's vigilance performance. AB - Aspects of attentional behaviour in 4--7-year-olds, as assessed by auditory and visual vigilance tasks, were related to prenatal exposure to cigarettes. Data on 76--79 children born to healthy, white, predominantly middle-class women were analyzed using multiple regression techniques controlling for potentially confounding variables including postnatal second hand smoke exposure. Cigarette smoking during pregnancy was related to an increased activity level of the children during the tasks and increased errors of commission in the auditory task and, to a lesser degree, in the visual task. After controlling for confounding factors, the relationship between prenatal smoking and errors of omission did not retain significance. The combination of results suggest that the deficits in attention may reflect impulsive responding and increased overall activity. PMID- 2758972 TI - Effects of secobarbital on human aggressive and non-aggressive responding. AB - This study examined the effects of secobarbital on human aggressive responding in a controlled laboratory setting. Sixty minutes prior to experimental sessions, male subjects were administered either placebo or 50, 100 or 200 mg per 70 kg of body weight doses of secobarbital double-blind. During these sessions, subjects could press a button to accumulate points exchangeable for money (non-aggressive response) or press another button ostensibly to subtract points from a fictitious person (aggressive response). Aggressive responding was occasioned by subtracting points from the subject. Subjects were instructed that points were subtracted by another person. Aggressive responding was maintained by contingent presentation of periods free of point subtractions, i.e., provocations. Acute secobarbital administration produced dose-dependent decreases in non-aggressive responding, and increases in aggressive responding. PMID- 2758973 TI - Do persistent morphine effects involve interactions with the genome? AB - Male rats were administered morphine in a liquid diet until five days prior to mating with drug naive nulliparous female rats which received no treatment during gestation. The birth weight of resulting litters was significantly reduced. The preconceptionally morphine-treated offspring showed a 34.8% +/- 17.1% mortality during the first 8 days compared with 0% in the control group and their weight gain profile was decreased as compared with controls. A persistent effect of paternally administered morphine was seen in 90-day-old male offspring. A possible way to further enlighten the underlying mechanisms is proposed. PMID- 2758974 TI - Grief, alcohol dependence and women. AB - A comparison was made between similar age-grouped widows (N = 37) and non-widows (N = 85) who were admitted to an alcohol dependence unit for treatment. The widows reported excess drinking to have occurred less frequently in close relatives and more frequently in their late spouses as compared to the non widowed females. Widows also had significantly different referral patterns. The findings suggest that the widows of alcoholics who had unresolved marital conflicts, or who become socially isolated are more vulnerable to abnormal grief responses. Prospective studies are required to verify this pilot survey. PMID- 2758975 TI - Cardiovascular effects of ethanol in anaesthetized, conscious and pithed rats. AB - The influence of ethanol (2.0 g/kg p.o.) on heart rate and blood pressure in anaesthetized, conscious and pithed rats was studied. In anaesthetized rats we observed an increase in heart rate and a marked and very sudden decrease in blood pressure. In pithed rats blood pressure decreased more slowly than in anaesthetized and conscious animals and there were no changes in heart rate. These results show that the central nervous system may be responsible for the increase in heart rate and early phase of hypotension caused by acute ethanol administration. The slower decrease (up to 1 h) in blood pressure may be caused by central and different indirect peripheral mechanisms. PMID- 2758976 TI - The relationship of cerebral atrophy and T1 in alcoholics: an MRI study. AB - There was a significant correlation between two measures of cerebral atrophy (the ventricle to brain ratio and the relative cerebral volume) and T1 in 19 detoxified alcoholics. This provides further evidence that T1 is a marker of structural damage in alcoholics although the partial volume effect of CSF may contribute to this finding. This has implications for studies comparing alcoholics to normal controls and suggests that better ways of excluding CSF need to be found. PMID- 2758977 TI - Relationship between alcohol consumption and breast cancer morbidity rates in Western Australia, 1971--1984. AB - Per adult (greater than or equal to 15 years) consumption of beer, wine, spirits and absolute alcohol for a 14-year period (1971--1984) was related to female breast cancer morbidity rates in Western Australia. Mann-Whitney U-tests showed that during the 7 years of highest wine consumption the highest rates for breast cancer occurred for females aged 30--59 years, but for women over 60 years of age the result was insignificant. The findings are consistent with a number of previous studies which have shown a positive association between alcohol consumption and increased risk of breast cancer. PMID- 2758978 TI - Menstrual disturbances and fertility in chronic alcoholic women. AB - Data on menstrual pattern, gynecological disorders and infertility were obtained from 51 chronic alcoholic women aged 20--42 years attending an outpatient clinic for alcoholics, using 51 randomly drawn age-matched healthy women as controls. A higher variability (P less than 0.05) in the duration of both menstrual cycle and menstrual flow was recorded in the chronic alcoholic women during active alcoholism. A higher frequency (P less than 0.05) of menstrual disturbances (70% vs. 55%) and uterine curettages (38% vs. 16%) were found in the alcoholic women. The latter reported more abortions (63% vs. 28%, P less than 0.001) and miscarriages (23% vs. 8%, P less than 0.05) than controls, but due to a higher number of pregnancies in the alcoholic group the proportion of abortions and miscarriages did not differ significantly. No differences existed between the groups regarding frequency of difficult conception. Social classification had no independent influence on the results. The study shows that chronic alcoholic women are more prone to menstrual abnormalities and are at greater risk of gynecological interventions, while they do not seem to have reduced fertility. PMID- 2758979 TI - Ovine coccidiosis: studies on the pathogenicity of Eimeria ovinoidalis and E. crandallis in conventionally-reared lambs, including possible effects of passive immunity. AB - No pathogenic effect was detected in lambs when 10(4) oocyts of each species were inoculated before 72 h of age. At 4 weeks of age the combined inoculum caused diarrhoea and weight loss, the severity being roughly proportional to the size of the inoculum. Even 1000 oocysts of each species caused diarrhoea; the pathogenic effect was attributable mainly to E. ovinoidalis. Hyperimmunization of ewes during pregnancy (by repeated inoculation of massive doses of oocysts) reduced the effects of oocyst inoculation in their progeny. Levamisole administration during pregnancy increased the birthweight of lambs. PMID- 2758980 TI - Influence of magnesium gluconate on stress reactions in rats. AB - During the tests carried out with rats the organic complex magnesium gluconate was examined for its bioavailability and its stress-reducing properties after oral application. The increase of magnesium concentration in serum achieved by means of magnesium gluconate turned out to be higher than the increase of concentration due to the administration of magnesium chloride. Just like other organic magnesium complexes, magnesium gluconate, administered for three days via feed to rats under stress conditions of immobilization, the substance causes a significant reduction in the increase in catecholamine and corticosterone concentration in serum. Regarding the reduction of stress in rats, the optimal concentration in feed is between 500 and 1000 mg of magnesium as magnesium gluconate per kg. PMID- 2758981 TI - Fetotoxicity of some anticoccidial drugs in chickens. AB - Fetotoxic effects induced by three anticoccidial drugs: robenidine, salinomycin and arprinocid were elucidated in the chicken. Different doses of these drugs were inoculated in groups of embryonated chicken eggs by the yolk sac route. After inoculation, candling of the eggs was performed daily and embryonic or fetal mortalities were recorded. At 19 days old, alive fetuses were collected, weighed, measured and examined morphologically for abnormalities. A group of eggs was kept non-inoculated as a control and another was inoculated with the solvent of the tested drugs. Inoculation of 0.09-9.75 mg robenidine/egg, 0.06-6.75 mg salinomycin/egg or 0.08-8.25 mg arprinocid/egg into the yolk sac of 7 days old embryos caused a dose-dependent fetal death. Arprinocid was the most lethal to chicken fetuses, followed by salinomycin while robenidine was the least. Dead fetuses were usually haemorrhagic, dwarfish and friable. Surviving fetuses showed a dose-dependent reduction in body weight and length, insignificant decrease in leg and wing lengths as well as some developmental abnormalities. PMID- 2758982 TI - [The veterinarian and animal welfare]. AB - At no important point does the Animals Protection Statute mention the competence of Veterinarians, but the "competent Authority". Also, the Animal Epidemics Statute and the Federal Hunting Statute provide for the cooperation of the veterinarian, but not for his competence to make decisions. This situation is even being overlooked by the investigating authorities, when in the case of using animals for "sport" or other problematic events, questions of the animals psychology and ethology have to be dealt with. In the courts the remarks of non specialist qualified persons can lead to wrong decisions as can either unsuitable or wrong evidence. PMID- 2758983 TI - [Hemoglobinuria in a dairy herd. (A short report)]. AB - This paper reports about the occurrence of hemoglobinuria in a herd of grazing dairy cows. Laboratory findings of serum, liver, pasture and soil showed hypocuprosis in this herd. Copper supplementation results in clinical recovery. Possible pathogenetic relations between copper deficiency and hemolytic anaemia are discussed. PMID- 2758984 TI - [The frequency of individual methods of treatment for health disorders in north German dairy herds]. AB - Disease data were recorded in 143 north German dairy herds including cows of three breeds: Angler, German Red and White and German Black and White. The following disease complexes were analysed: retained placenta, sterility, mastitis, milk fever and claw disorders. Data recording was performed by the herdsman and included date and type of disease per cow and a note, by whom the medical therapy was conducted (veterinary or herdsman). A comparison of both, therapy performed by veterinary or by herdsman, indicated that 75% of all cases of mastitis, 48% of all claw disorders and 25% of all cases of retained placenta were treated by the herdsman, whereas concerning milk fever and sterility only 10 resp. 8% of all cases were treated by the herdsman. An analysis was performed to investigate which factors of region, farm and herd may be related to the extent, in which disorders are treated by the herdsman. The results indicated that region, housing system, herd size and herd milk (kg) and fat (%) were affecting at least two of the five parameters which were formed to describe the herdsman's willingness to conduct medical therapy himself. PMID- 2758985 TI - [Individual glycoside therapy using serum concentration determination in canine heart failure]. AB - 32 dogs with congestive heart failure without sufficient reaction to a standardized therapy with glycosides are treated with an individual glycoside dose. The therapy is controlled by the serum concentration of the cardiac glycoside. The influence of additional diseases and medications is demonstrated. Finally a rule for the evaluation of the therapeutic glycoside dose is given. PMID- 2758986 TI - [The humanitarian stunning of fowl for slaughter with microwaves (2450 MHz)]. AB - Chickens can be killed in less than one second by exposing their heads to microwave irradiation with a frequency of 2450 MHz. Positioning the head exactly is necessary. The only way to avoid this handling is the exposure of the whole body. But because of a particular high rate of absorption the wings are heated so that the meat is not edible any more. Before slaughtering the chickens are hung up headlong. This causes increased cardiac and respiratory frequencies while the blood pressure is not altered yet. This handling is a considerable stress. Animal prevention arguments suggest to prefer anaesthesia before hanging the chickens in the conveyor belt. PMID- 2758987 TI - [In vitro parameters for understanding the immunocompetence of chickens of different lineage. 1. The cytotoxicity of avian whole blood against Saccharomyces cells]. AB - A cytotoxicity test was performed as a parameter for the nonspecific defense capacity in chickens using blood and saccharomyces cells (SCT). The test has the special merit of frequent repetitions of the results by two parallel test arrangements. The results of individual animals were not altered during a period of 14 days, as well as relatively not being affected by actual day fluctuation as long as environmental changes or antigenic changes do not appear. The cytotoxic activity is due to cellular defense mechanisms, especially concerning the activity of granulocytes, thrombocytes and monocytes but not lymphocytes and erythrocytes. The lysozyme contents of plasma show a very space cytotoxic activity against saccharomyces cells. PMID- 2758988 TI - [The analysis of selected performance parameters following embryo transfer in the example of cattle]. AB - Gestation lengths and birth weight of calves from German Red Pied cows were used to analyse differences between embryo transplant offsprings (n = 76) and offsprings from natural pregnancy (n = 118). Furthermore differences were examined in milk traits between embryo transplant (n = 76) and not embryo transplant offsprings (n = 66) from the same dam (German Black Pied, n = 38). After embryo transfer gestation lengths was shorter, but only with a clear difference in first calving cows. Calves from embryo transfer had lower birth weights, because most of the time recipients are maiden. Even the age effect was taken into account, birth weights were about 1.5 kg lower for embryo transplant offsprings. For milk traits no significant differences could be ascertain between embryo transplant and not embryo transplant offsprings. With the exception of fat yield the estimated breeding values of the offsprings correspond to the expectations. PMID- 2758989 TI - [The effect of excessive artificial UV radiation on the measurement of blood parameters and phagocytosis in calves]. AB - 5 calves of an age of 33 days were exposed to UV-light (280-320 nm) for a time of 12 hours. The mean dose of radiation was 179 x 10(-10) J/h x m-2. The results show slight influences of overdosed radiation on hemoglobin content of the blood, from 105.1 g/l to 102.6 g/l. The mean content of hemoglobin in erythrocytes decreased: 364 g/l to 347 g/l. The total leucocytes decreased from 7.74 x 10(9)/1 to 7.08 x 10(9)/1 after exposition of 5 hours. The exposition increased lymphocytes (55.6% to 66.0%) and decreased neutrophils (43.6% to 33.8%). The relationship of lymphocytes to neutrophils extended even after radiation time of only 5 hours from 1.45 to 2.04. The phagocytotic activity increased after 5 hours of exposition. To the end of exposition (60 hours after observation) a decrease was observed. A correlation between doses of radiation and hematological changes was found after 12 hours of radiation in lymphocyte counts (r = 0.878) and neutrophil counts (r = -0.824) as well as in the relation of lymphocytes to neutrophils counts (r = 0.941) and in the index of phagocytosis (r = 0.804). PMID- 2758990 TI - Rotavirus as an aetiological agent of acute childhood diarrhoea in Ile-Ife, Nigeria. AB - Of the 456 urban children aged 14 days and 4 years examined for rotavirus in this study, 376 had diarrhoea while 80 were without diarrhoea and serve as control. Among the 376 diarrhoeic children, 57 (15.2%) had rotavirus while none of the 80 control children had the virus. Rotavirus was significantly higher (p less than 0.05) among the in-patients (19.8%) than in the out-patients (10.3%) and among children of 7-12 months compared with other aged groups. The majority of the children that had the rotavirus lived in areas without pipe-borne water and similarly belonged to the low-socio-economic level. It is therefore possible to deduce from this work that rotavirus is still a major aetiology of acute childhood diarrhoea in Nigeria and its incidence can be affected by hygienic practices, the environment and socio-economic level. PMID- 2758991 TI - Chronic renal failure in tropical Africa. AB - The high occurrence of end-stage renal disease among black Americans is a well established feature. Black Africans are also more affected by chronic renal diseases. This lethal condition may constitute a great challenge for nephrologists in the tropics where financial resources to fund dialysis treatment are very scarce. A realistic role for the tropical nephrologist is discussed. PMID- 2758992 TI - Hepatitis B and delta infection in Gabon: a seriological survey in a representative sample of the province of Haut-Ogooue. AB - Hepatitis B virus markers and antibodies to delta agent were studied in adult people (15-54 years) in the province of Haut-Ogooue (Gabon), randomly selected by cluster sampling technique. Of the 384 people, 37 (9.6%) were positive for HBsAg, of which 23 (62.2%) were positive for HBeAg; 246 (65.3%) had anti-HBs and 53 (13.8%) had anti-HBc as the only marker. Chronic carriage of HBV defined as presence of HBsAg or exclusive anti-HBc was observed in 90 people (32%). At least one of the HBV markers was found in 89% of the people. Women were more frequently positive than men. No difference in relation to age was observed. Anti-delta was found in 12 (3.5%) of the 341 people with HBV markers and 7/12 of these could be considered as chronic HBV carriers. PMID- 2758993 TI - The diagnostic value of lymphnode biopsies in Benin-City, Nigeria. AB - A total of 359 lymphnode biopsies (LNB) were done over 11-year period (1975-1985) at the University of Benin Teaching Hospital, Benin-City, Nigeria. The mean number of LNB per year is 32.64 and the percentage incidence of LNB per year is 9%. The commonest site of LNB is cervical (42.9%) and this is followed by the inguinal (36.2%). There is a high incidence of non-specific lymphadenitis (65.3%) in LNB from the inguinal region as opposed to 16.8% in LNB from the cervical region. Tuberculous lymphadenitis is the commonest single histopathological diagnosis from cervical LNB (37.6%). Most cases of non-specific lymphadentitis were diagnosed in the 0-20 year age group. Hodgkins disease (HD) was most common in the 21-40 year age group as opposed to non-Hodgkins lymphoma (NHL) in the 41 60 year age group. NHL is more commonly diagnosed histopathologically than HD. The poorly differentiated lymphocytic (35.4%) and the undifferentiated (29.0%) types of NHL are the commonest subtypes whereas the mixed cellularity subtype (50%) was the predominant type of HD. Most cases of NHL were of the diffuse type (90.3%) as opposed to the nodular type. The implications of these findings are discussed. PMID- 2758995 TI - Advances in gastroenterology. PMID- 2758994 TI - The malignant lymphomas in Benin City, Nigeria. AB - Forty-seven cases of adult non-Hodgkin's lymphoma (NHL) and Hodgkin's disease (HD) seen at the University of Benin Teaching Hospital between 1975 and 1987 have been analysed with respect to the presenting features, management and survival. There is a preponderance of males over females (4.4:1 for NHL and 9:1 for HD). NHL was commonly diagnosed in the 41-50 year age group and HD in the 21-30 year age bracket. Lymphadenopathy was observed in all patients at the time of presentation, mainly generalized (48.1%) in NHL and cervical (65%) in HD. The poorly differentiated lymphocytic (29.6%) and undifferentiated (22.2%) types of NHL and the mixed cellularity type (40%) of HD are the most frequent histopathological types. The COP regime was the most frequently used therapeutic regimen. The results of treatment were poor mainly because of late presentation, inadequate supply of drugs, the high default rate and relative lack of radiotherapeutic facilities. PMID- 2758996 TI - A study of knowledge, attitudes and practices (KAP) of a rural community on malaria and the mosquito vector. AB - A study of malaria on the Kano Plain, Kisumu District, Western Kenya, was carried out between April and August, 1985. The study included a knowledge, attitudes and practices (K.A.P.) survey on malaria illness and the mosquito vector. Overall knowledge about malaria illness was found to be good. However, treatment and prevention practices of malaria were found to be poor. Knowledge of the mosquito and its relationship to malaria was found to be high. Knowledge of methods of prevention of mosquito bites was also found to be high but actual use of the methods was low. Knowledge of traditional methods of prevention of mosquito bites was also found to be high. Actual use was again found to be low. PMID- 2758997 TI - [Changes in the distribution of negatively charged sites of the synaptosomal membrane in adult rats]. AB - Changes in the distribution of Anionic sites on the synaptosomal membrane of old rats were investigated by means of cationized ferritin. Synaptosomal fraction was isolated from the cerebral cortex of two groups of rats: a control group-rats aged 2 months and second group-rats aged 14 months. Some diminishing of density was established on anionic sites as well grouping in larger or smaller aggregates of the same sites on the membrane of some synaptosomes of old rats. PMID- 2758998 TI - [Age changes in the distribution of VIP-positive neurons in the rat auditory cortex]. AB - Using the methods of immunocytochemistry, we made a study on VIP-ergic neurons in the auditory cortex of young and aged rats. Comparing the results we observed considerable diminution in the number of VIP-positive neurons of aged animals in all cortical layers. PMID- 2758999 TI - [Immunohistochemical demonstration of changes in the distribution of glial fibrillary acidic proteins of the auditory cortex in aging rats]. AB - Changes in the distribution of glial fibrillary acid protein-positive astrocytes in the auditory cortex of aged rats were investigated by an immunocytochemical method. It was established that there was an increase of these glial cells in all layers of the cortex. Possible causes for these changes are discussed. PMID- 2759000 TI - [The effect of neonatal thymectomy on thrombocytopoesis in rats]. AB - The influence of neonatal thymectomy on the number of thrombocytes, bone-marrow megakaryocytes (MKC) and activity of plasa thrombocytopoietin(TP) was studied in male rats 60 days after the manipulation--under normal and extreme (acute thromobocytopenia) conditions. It was established that under normal conditions neonatal thymectomy (NT) diminished the number of thromobocytes, the percentage of incorporated 75 selenomethionine in newly formed thromobocytes, the total number of MKC and their single stages--I, II, III, IV. The activity of plasma TP was not changed in normally thymectomized rats under normal condition, while in comparison with sham thymectomized rats, while it was considerably higher in acute thrombocytopenia. It is concluded that NT in rats inhibits megakarytocytopoiesis and diminishes thromobocyteson on this basis. NT stimulates biogenesis of TP- a specific humoral regulator of thrombocytopoiesis under conditions of acute thrombocytopenia. PMID- 2759001 TI - [Manufacturing of K+-potassium microelectrodes for electroretinographic studies]. AB - A method for fabrication of K+-selective microelectrodes for the purposes of elecroretinogram investigations is described. Both one- and two-barrel types of microelectrodes are obtained. The microelectrodes fabricated possess high sensitivity and stability. The values of potassium in corpus vitreous of the frog Rana ridibunda are presented. PMID- 2759002 TI - [The effect of immobilization stress on primary humoral immune response in white rats]. AB - The influence of immobilization stress (24 h) was studied on the humoral immune response of white male rats of Wistar strain against thymus- dependent antigen(sheep erythrocytes). It was established that immunosuppression occurred during application of stress before immunization, while immunostimulation developed during application of the stress after immunization (during the effector phase of the immune response). These differences in the intensity of the immune response could be explained by the peculiarities of neuro-endocrine and immunologic changes in the tow variants of the experiment. PMID- 2759003 TI - [Assessment of local cerebral blood flow by the hydrogen clearance method. I]. AB - The effects of flunarizine and fezam on the local cerebral blood flow (LCBT) were examined by the hydrogen clearance with inhalation of hydrogen. The experiments were carried out on male nonbred cats under cetamine narcosis. The results showed that flunarizine (1 mg/kg i.v.) induced apparent enhancement of LCBF with 58% in comparison with the control values. The effect was read up to 60 min. The combined preparation fezam (100 mg/kg i.v.) caused considerable improvement of LCBF 30 min after inhalation with 63% in comparison with the control values. It is suggested that the observed effects are due to Ca-blocking action on cerebral vessels after flunarizine treatment as well as a reduction of cerebral-vascular resistance and influence on the metabolism after the combination fezam. PMID- 2759004 TI - [The effect of the calcium antagonists nimodipin, verapamil and diltiazem on local cerebral blood flow of the cortex and thalamus in cats]. AB - Experiments were carried out on 54 cats, anesthesized by ether and alpha chloralose (0, 1 g/kg of b. m.) and the influence of calcium antagonists nimodipin (0.01 and 0.03 mg/kg), verapamil (0.1 and 0.3 mg/kg) and diltiazem (0.1 and 0.3 mg/kg), administered intravenously by a femoral venous catheter, was investigated on th local cerebral blood flow in the cortex and thalamus by means of a thermistor thermoclearance technique. The cerebral blood flow was recorded in the sensomotor area of the cortex-and pulvinar thalami. The effect of these drugs was examined on arterial blood pressure in dynamics synchronously. Calcium antagonist nimodipin, verapamil and diltiazem increased cerebral blood flow and this effect was more manifested in the cortex than in the thalamus. The effect of nimodipin was considerably stronger on the cerebral blood flow in the cortex in comparison with verapamil and diltiazem. Verapamil and diltiazem showed approximately equal effect on cerebral blood flow in the cortex. Diltiazem increased cerebral local blood flow, but not-that of the thalamus. PMID- 2759005 TI - [The effect of calcium antagonists nimodipin, verapamil, diltiazem and flunarizin on local cerebral blood flow in rabbits in chronic experiments]. AB - The influence of calcium antagonists nimodipin (0.03 and 0.06 mg/kg), verapamil (0.3 and 0.6 mg/kg), diltiazem (0.3 and 0.6 mg/kg), flunarizin (0.3 and 0.6 mg/kg), administered by the ear vena, was studied on the local cerebral blood flow of the cortex of 9 rabbits by means of the method of hydrogen clearance with inhalation of hydrogen under the conditions of chronic experiments. Platinum microelectrodes with diameter of 100 microns and length of 2 mm were implanted in the frontal and sensomotor regions of the cerebral cortex a month before the onset of the experiments. Calcium antagonists nimodipin, verapamil, diltiazem and flunarizine increased the local blood flow in the cerebral cortex of rabbits under the conditions of chronic experiments. The effect of nimodipin and verapamil on the local blood flow of cerebral cortex was more manifested in comparison with the effect of flunarizin and diltiazem. Nimodipin and verapamil, on the one side, and flunarizin and diltiazem, on the other, had almost equal effect, which elevated the local blood flow in the cerebral cortex of rabbits under conditions of chronic experiments. PMID- 2759006 TI - [Degenerative changes of the myelin fibers of sciatic nerves in aged rats]. AB - Ischiadic nerves of 24-month old rats were examined by electron-microscopic technique. It was established that a large part of myelin fibres had degenerative changes, manifested at various degree. Axonal cylinder was atrophied even to complete disappearance. Myelin fibres endured degeneration, ending with sequestration and fragmentation. In part of the involved fibres the myelin sheaths preserved their intactness, but collapsed due to atrophy of the axon. PMID- 2759007 TI - [Stimulation of experimental conditioned reflex impotence and a new method of detecting an aphrodisic effect]. AB - Ten original apparatuses were constructed to examine aphrodisiac effect. For the purpose conditioned reflex impotence was induced in white male mice in advance. Using the new method for establishment of the aphrodisiac effect the values of ED50 of the preparations Yohimbin, Testosteronum dipropionicum, Tribestan, Captogon, Coffeinum n. benzoicum and Imipramin were estimated. The new method allows to differentiate aphrodisiac effect from psychostimulating and antidepressive action. The advantages of the new method are: objectivity, adequacy to human pathology and does not require constant observation of the experiment. PMID- 2759008 TI - [Light microscopic and ultrastructural study of the lower olivary complex in the pigeon (Columba livia)]. AB - The normal morphology of neurones and neuropile of the inferior olivary complex (LOC) in a pigeon (Columbia livia) was investigated by a light and electron microscope. The light microscopic analysis on the basis of the histological techniques of Vissl, Gldgi-Rio Hortega showed that olivary neurons had moderate mean dimensions and moderately branched dendrite tree, but single neurons with a model for dendrite branches were encountered similar to the second type of neurons in mammals. Axo-somatic synapses and synapses on the primary dendrites were comparatively small in number, observed by the electron microscope. Complex synaptic connections, similar to those of the mammals, were observed in the neuropile of LOC together with axo-dendrite synapses. The central part of glomerulo-like connections consisted of two-three dendrite profiles, connected sometimes with desmosomelike contacts. The presented results show that the morphological characteristics of olivary neurons of a pigeon are similar to those of mammals, although they are not so complex. PMID- 2759009 TI - [The dependence of the carcinogenic effect on the concentration of N nitrosodimethylamine in (CBA x C57Bl/6)F1 mice and noninbred mice]. AB - The relationship between the tumour frequency and nitrosodimethylamine (NDMA) concentration in drinking water was studied in the experiments involving 495 (CBA x C57Bl/6)F1 hybrid and 600 noninbred mice of both sex. At the NDMA concentrations of 0.04, 0.2, 1.0, 5.0 mg/l the tumour frequency was as follows: 21.6/26.2, 35.5/27.3, 57.4/56.4, 90.5/72.9% (20.0/20.0% in control) in hybrid mice; and 15.4/39.6, 18.2/43.5, 62.2/61.0, 76.5/87.5% (15.0/30.0% in control) in noninbred mice, respectively. In the given experiments the minimal effective NDMA concentration was 1.0 mg/l, and the maximal effective one--0.2 mg/l both for the hybrids and noninbred animals. The results of the research may be used for calculation of the MPC for NDMA. PMID- 2759010 TI - [Inhibiting effect of thymogen on the development of tumors of the esophagus and forestomach induced by N-nitrososarcosine ethyl ester in rats]. AB - Immunostimulating synthetic peptide thymogen being an analog of the thymus polypeptide drug thymalin was studied for its effect on carcinogenesis of the esophagus and forestomach in male rats. Rats received N-nitrososarcosine ethyl ester (NSEE) per os in the daily dose of 100 mg/kg of body weight during 8 weeks. After cessation of the carcinogen administration rats were treated with thymogen (the daily dose of 10 micrograms per rat) or immune-inactive polypeptide drug pulmolin from the alveolar tissue of lung (the daily dose of 0.5 mg per rat) during the following 32 weeks. Animals were killed 40 weeks after the experiment beginning. NSEE induced the esophagus and forestomach tumours, mainly papillomas and rarely carcinomas, practically in all rats, more than 5 tumours per rat, on the average. Thymogen decreased the tumour incidence by 12% and made tumour multiplicity 1.7 times as low. Pulmolin did not influence development of these tumours. PMID- 2759011 TI - [Genetic and oncologic characteristics of CBA/CaLacSto mice]. AB - 400 male and female CBA/CaLacSto mice were analyzed from the age of two months to their death. The spontaneous malignancy incidence of frequency in this line amounted to 76.3% with prevailing hepatomas (65%), neoplasms of lung, fat tissue. Homozygosity of CBA/CaLacSto mice was revealed in all the gene under test. PMID- 2759012 TI - [Purine compound transport and metabolism in the thymus and spleen lymphocytes of C3HA mice during the growth of hepatoma 22]. AB - The purine metabolism was studied in the thymus and spleen lymphocytes of C3HA mice during hepatoma 22 growth in comparison with the transport characteristics of hypoxanthine and inosine in lymphocytes. An increase in the transport of these metabolites from erythrocytes was observed in the early hepatoma growth period. It may be associated with a certain pattern in the dynamics of purine metabolic pool in the lymphocytes. The inverse relationship is found between the rates of hypoxanthine transport into thymocytes and its intracellular concentration. PMID- 2759013 TI - [The dependence of the clonogenic fibroblast proliferation of human bone marrow on the feeder]. AB - The proliferation of human bone marrow stromal fibroblasts depends on the growth factors. Xenogenic bone marrow cells, previously radiated in a dose of 3000 Gy, are shown to be a source of such factors. The human bone marrow cells contain both stimulators and inhibitors of the fibroblast proliferation. The inhibitory activity of the bone marrow cells increases with their concentration in explants. The optimal culture conditions are developed. The efficiency values of the fibroblast cloning in children and adults are presented and compared. PMID- 2759014 TI - [Effect of carminomycin on the enzyme systems of the metabolism of active forms of oxygen and on free-radical lipid oxidation in August rats with Walker carcinosarcoma 256]. AB - The influence of carminomycin (CM) on enzymic systems of metabolism of oxygen active forms, free radical lipid peroxidation and microviscosity of membrane lipids as well as toxic and antitumour action of CM were studied in normal and tumour-bearing rats. Detected responses of the system of superoxide anion- and H2O2 metabolism reflected the role of active oxygen forms in CM toxicity. The investigation results of the lipid peroxidation fluorescent products level and microsomal lipid phase microviscosity did not suppose stimulation of lipid peroxidation as key mechanism for CM toxic effects. Problems on the prevention and treatment of anthracyclines side effects are discussed. PMID- 2759015 TI - [Phosphorus-containing metabolites in the cells of anthracycline-resistant strains of leukemia P388]. AB - The method of 31P nuclear magnetic resonance has been used to study in vivo the level of phosphorus-containing metabolites in cells of two strains of murine leukemia P388 with the phenotype of the multidrug resistance and in cells of the parent strain. Cells of both resistant strains showed a depressed level of phosphomonoesters in comparison with the parent one. The influence of rubomycin and emoksil on the level of phosphorus-containing metabolites of drug-resistant and -sensitive strains has been evaluated. The drugs were established not to affect practically the pool of these metabolites of the resistant strains. Both drugs significantly increased the pool of phosphomonoesters in the parent strain cells. PMID- 2759016 TI - [Pharmacokinetic validation of the antitumor efficacy of aclarubicin administered by various routes in CBF1 mice with Ca 755 carcinoma]. AB - Aclarubicin was established to be more active against murine mammary gland carcinoma Ca 755 after its intravenous injection as compared to oral administration. Pharmacokinetics of aclarubicin and its biologically active metabolites MA 144 N1, MA 144 T1 and MA 144 M1 was studied by HPLC in the tumour tissues. Not only quantitative but also qualitative differences in the ratios of the unchanged antibiotic and its metabolites in tumour Ca 755 were detected after aclarubicin administration by these methods. Diverse therapeutic activity was shown to be due to these differences. PMID- 2759017 TI - [Description of bulimic behaviors]. AB - This report describes and comments the definitions which have been proposed for Bulimia nervosa in three recent classifications: DSM III, DSM III-R and ICD-10. PMID- 2759018 TI - [Assessment instruments for bulimia]. AB - Systematic assessment of bulimia, alike the clinical definition of the disorder, is still meager and lacks reliability. Development of new evaluation instruments is the focus of many current researches. This article will distinguish: rating scales specific of bulimia, for screening in epidemiological surveys and clinical practice, as well as for measure of the severity of the symptoms; structured interviews for evaluation of bulimic patients, for clinical and research use; eating disorders rating scales, already used for anorexia nervosa; other rating scales of interest with bulimic patients; and more possible evaluation methods. Finally, we will review assessment measures for use in treatment studies of bulimia. PMID- 2759019 TI - [Sweet bulimia, salty bulimia. Emotional profiles and weight status]. AB - In this study we precise eating and non specific symptomatology of 56 patients with DSM III bulimia syndrome. Results confirm our first hypotheses, particularly the distinction between sweety and salty bulimia and the heterogeneity of patients with this syndrome. We specially studied two types of clinical dimensions: emotional components and weight status. According to emotional profile, bulimics differ from other psychopathologic populations and present some particular features. Impulsivity is a characteristic of sweety bulimics, dysphoria and affective lability characterise salty ones. PMID- 2759020 TI - Did eucaryotic steroid receptors evolve from intracrine gene regulators? PMID- 2759021 TI - Testosterone induction of cellular proteins in cultured Sertoli cells from hypophysectomized rats and rats of different ages. AB - Testosterone is essential for the maintenance of spermatogenesis, and the Sertoli cell is thought to be an important target cell for the hormone in the seminiferous tubule. The direct response of Sertoli cells to testosterone in cell culture was studied by two-dimensional gel electrophoresis of radiolabeled cellular proteins. Changes in testosterone responsiveness with age and hormonal condition were studied by culturing Sertoli cells from 20- and 40-day-old normal rats and 40-day-old rats that had been hypophysectomized at 20 days of age. Two abundant proteins, numbered 1604 and 1605 for reference purposes, were consistently increased in response to testosterone treatment in all three sets of cultured Sertoli cells. Two other proteins, 1602 and 1603, were decreased with testosterone in all three Sertoli cell cultures. Densitometric scanning of the gels revealed changes in several proteins of low abundance (i.e. proteins that represent less than 0.2% of the total incorporated radioactivity on the gel) in response to testosterone. The majority of the changes in response to testosterone were in these low abundance proteins. Protein profiles from testosterone-treated cell cultures as well as control (no hormone) Sertoli cell cultures differed among the three groups of cells. This indicates that differences in Sertoli cell function in vivo due to age and hormonal condition are reflected in culture by protein profiles. PMID- 2759022 TI - High affinity binding and regulatory actions of dexamethasone-type I receptor complexes in mouse brain. AB - It is often implied that the various molecular, physiological, and behavioral responses to the glucocorticoid dexamethasone (DEX) are mediated in brain exclusively via the interactions of this synthetic steroid with the classical glucocorticoid (type II) receptor. The results reported in this study, however, suggest this generalization may, at least for the female mouse, be too restrictive. In the first experiment we compared the efficacy of the mineralocorticoid aldosterone (ALDO) with that of DEX to measure the classical mineralocorticoid (type I) receptor in brain cytosol. Since both of these steroids also bind to type II receptors, our assays included the type II receptor selective ligand, RU26988. Whereas the specific binding of ALDO to type I receptors was largely unaffected by a 10-fold increase in the concentration of RU26988 (50- vs. 500-fold excess), there was a dramatic reduction in the specific binding of DEX. In a follow-up experiment, Scatchard analyses were used to confirm the differential affinity of RU26988 for DEX- vs. ALDO-type I receptor binding sites and to reveal that the affinity of type I receptors for DEX (Kd approximately 0.83 nM) was nearly as high as it was for ALDO (Kd approximately 0.46 nM). A series of competition studies indicated that the competitive affinity (Kdc) of DEX for the ALDO-binding site was equivalent to the Kd computed in the saturation analyses, thus suggesting that the high affinity binding sites for DEX and ALDO on type I receptors may be equivalent or at least overlapping. The binding of DEX to these high affinity sites may prove to be important, since the systemic administration of this steroid was found to down-regulate both type I and type II receptors in a number of brain regions. Because coadministration of the type I receptor antagonist RU26752 was shown to block these actions on type I, but not type II receptors, the formation of the DEX-type I receptor complex appears to be required for DEX-induced type I receptor down-regulation. An analysis of the in vitro efficacy of ALDO- vs. DEX-type I receptor transformation suggests that whereas there is a significant increase in the binding of both complexes to DNA-cellulose after treatment with thiocyanate, there is also a dramatic decrease in the stability of DEX- but not ALDO-type I receptor binding. We contend that it is this decrease in binding stability that mediates the DEX induced down-regulation of type I receptors.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2759023 TI - Thyroid hormone regulation of hypothalamic immunoreactive thyrotropin. AB - Immunoreactive TSH (IR-TSH) has been identified in the hypothalamus and other brain areas in intact and hypophysectomized rats. To determine if thyroid hormones regulate IR-TSH in the rat brain, the effects of T3 and T4 on pituitary and hypothalamic IR-TSH content were studied in intact and hypophysectomized rats. Female rats received daily injections of T3 (0.1, 1.0, or 10 micrograms/100 g BW) or T4 (0.5, 2.5, or 5.0 micrograms/100 g BW) for 7 days. The chronic administration of T3 and T4 decreased the plasma concentration and pituitary content of IR-TSH in a dose-dependent manner. In intact rats, the administration of T3 did not affect the content of IR-TSH in the median eminence, ventral hypothalamus, or dorsal hypothalamus. In contrast, administration of T4 significantly increased the content of IR-TSH in the median eminence and ventral hypothalamus in a dose-dependent manner. Similarly, in hypophysectomized rats daily administration of T4 resulted in a dose-dependent increase in the concentration of IR-TSH in the median eminence and ventral hypothalamus. In hypophysectomized rats infusion of colchicine into the lateral ventricle, which blocks axonal transport, decreased the content of IR-TSH in the median eminence (631 +/- 59 vs. 439 +/- 36 microU/mg), increased the content of IR-TSH in the ventral hypothalamus (45 +/- 5 vs. 87 +/- 10 microU/mg), and blocked the T4 induced increase in IR-TSH in the median eminence. In intact rats, administration of iopanoic acid, which blocks the conversion of T4 to T3, decreased the content of IR-TSH in the median eminence (688 +/- 44 vs. 450 +/- 38 microU/mg) and ventral hypothalamus (103 +/- 16 vs. 70 +/- 5 microU/mg) and blocked the T4 induced increase in IR-TSH in the median eminence (1025 +/- 82 vs. 644 +/- 62 microU/mg) and ventral hypothalamus (229 +/- 23 vs. 117 +/- 11 microU/mg). These data indicate that TSH content in the median eminence and ventral hypothalamus is regulated by a thyroid hormone-sensitive mechanism which requires the local monodeiodination of T4 to T3. In addition, the effect of colchicine on the IR-TSH content in the median eminence and the T4-induced increase in brain IR-TSH are consistent with previous reports demonstrating that hypothalamic IR-TSH is regulated independently of pituitary and serum TSH. PMID- 2759024 TI - In vitro metabolism of 25-hydroxyvitamin D3 by human trophoblastic homogenates, mitochondria, and microsomes: lack of evidence for the presence of 25 hydroxyvitamin D3-1 alpha- and 24R-hydroxylases. AB - In vitro studies were performed to assess the ability of term human trophoblastic tissue to metabolize 25-hydroxyvitamin D3 (25OHD3) and to compare this metabolism to that occurring in porcine renal mitochondria and microsomes. Human trophoblastic homogenates, containing a NADPH-generating system, were able to produce 1,25-dihydroxyvitamin D3 [1,25-(OH)2D3] at a rate of 225 pg/mg protein.h, but did not produce detectable quantities (less than 20 pg/mg protein.h) of 24,25 dihydroxyvitamin D3 [24,25-(OH)2D3]. Similarly, mitochondria and microsomes isolated from term human trophoblastic tissue produced 1,25-(OH)2D3 [249 +/- 156 and 199 +/- 82 (mean +/- SD) pg/mg protein.h, respectively] in the presence of an NADPH-generating system, but failed to produce detectable quantities (less than 200 pg/mg protein.h) of 24,25-(OH)2D3. The production of 1,25-(OH)2D3 from the trophoblastic mitochondria and microsomes could be increased by adding 140,000 x g trophoblastic cytosol to the subcellular incubation tubes. This treatment had no effect on the production of 24,25-(OH)2D3. The component(s) present in trophoblastic cytosol responsible for the increased 1,25-(OH)2D3 production by trophoblastic mitochondria and microsomes was shown to be heat labile, trypsin resistant, and less than 1000 mol wt in size. Comparing characteristics of the porcine renal 1 alpha- and 24R-hydroxylase systems with those of the human trophoblastic system revealed that 1) 1,2-dianilinoethane and EDTA totally blocked synthesis of 1,25-(OH)2D3 in trophoblastic mitochondria and microsomes, but had no effect on the synthesis of 1,25-(OH)2D3 by renal mitochondria; and 2) ketoconazole greatly inhibited the synthesis of 1,25-(OH)2D3 and 24,25-(OH)2D3 by renal mitochondria, but had no effect on the production of 1,25-(OH)2D3 by trophoblastic mitochondria or microsomes. Finally, production of 24,25-(OH)2D3 could not be demonstrated in trophoblastic homogenates, mitochondria, or microsomes, while the production of this compound was readily evident in renal mitochondria, but not microsomes. The results of this study question the existence of the 25-hydroxyvitamin D3-1 alpha- and 24R-hydroxylase systems in the trophoblastic portion of the human placenta. This study also suggests that 1,25 (OH)2D3 can be produced in vitro by a mechanism other than enzymatic 1 alpha hydroxylation. The possibility exists that the mechanism involves the insertion of oxygen at the 1 position of 25-(OH)D3 by free radical chemistry. PMID- 2759025 TI - Thyroid and glucocorticoid hormone regulation of rat pituitary growth hormone messenger ribonucleic acid as revealed by in situ hybridization. AB - The effect of thyroid and glucocorticoid hormones on mRNA have been largely studied using tumor cell lines. To investigate the role of these hormones in vivo, we have used in situ hybridization techniques to study GH mRNA regulation in the rat pituitary. The amount of mRNA encoding for GH was dramatically reduced after 1 month of treatment with 6-N-propyl-2-tiouracil. However, daily injections of L-T4 for 10 days restored GH mRNA to control levels. Similarly, adrenalectomy decreased GH mRNA levels, and subsequent daily injections of dexamethasone for 1 and 5 days restored the levels of GH mRNA to those before adrenalectomy. Moreover, 6-N-propyl-2-tiouracil treatment in combination with adrenalectomy dramatically reduced pituitary levels of GH mRNA, which were increased by administration of both thyroid hormones and glucocorticoids. These results show that the effects of thyroid and glucocorticoid hormones on GH synthesis are largely mediated by the hypothalamus. Our results obtained in implanted pituitaries under the kidney capsula demonstrated that these two hormones also exert a smaller effect of GH mRNA directly at the pituitary level. PMID- 2759026 TI - Glucocorticoids impair bone resorptive activity and viability of osteoclasts disaggregated from neonatal rat long bones. AB - It is generally believed that glucocorticoids cause osteoporosis through a combination of decreased bone formation and increased bone resorption. However, the direct effect of glucocorticoids on osteoclasts has not been determined. We therefore tested the effects of hydrocortisone and dexamethasone on bone resorption by osteoclasts disaggregated from neonatal rat long bones. Hydrocortisone and dexamethasone caused a dose-dependent inhibition of osteoclastic bone resorption in the range 10(-7) to 10(-5) M, and 10(-9) to 10( 6) M, respectively, at concentrations likely to occur during therapy and disease. Inhibition of bone resorption was found to be associated with impaired osteoclast survival: osteoclast numbers were reduced to approximately 25% of control values by 10(-6) M hydrocortisone and 10(-7) M dexamethasone. Osteoclast cytotoxicity by glucocorticoids was completely antagonized by progesterone, which itself had no effect on osteoclast survival. Analysis of the time course of these inhibitory effects showed a nonsignificant reduction in survival by 6 h and marked inhibition of survival by 12 h. We could detect no specific changes in osteoclast morphology in association with this impaired viability. The relative potencies of the glucocorticoids for impairment of osteoclast viability was similar to their relative affinities for binding the glucocorticoid receptor, and this, together with inhibition by progesterone, suggests a receptor-mediated mechanism. Such a receptor-mediated cytotoxic action of glucocorticoids has only previously been reported with lymphoid cells. The sensitivity of osteoclasts to the lethal effects of glucocorticoids suggests that glucocorticoids may have a role in physiology as inhibitors of osteoclastic bone resorption. PMID- 2759027 TI - Peptide histidine isoleucinamide (PHI)-(1-27)-Gly as a new major form of PHI in the rat small intestine. AB - Three immunoreactive peptide histidine isoleucinamide (PHI) forms (I, II, and III) from a rat small intestinal extract were separated on a Fractogel column, using a specific RIA. Peak III was identified as rat PHI-(1-27)-NH2 based on its coelution with a synthetic standard and its amino acid sequence. Peak I was tentatively considered as PHI extended with the connecting peptide preexisting between PHI and vasoactive intestinal peptide in their common precursor, based on its apparent mol wt. Peak II was the most abundant form (based on immunoassay) and has not been described previously. It was purified to homogeneity by using a RIA throughout the first three chromatographic steps, then a fast RRA (on rat liver membranes) during the last three purification steps. This new PHI variant was identified as rat PHI-(1-27)-Gly, as judged by full sequencing amino acid analysis after C-terminal digestion by carboxypeptidase-Y and by coelution with synthetic rat PHI-(1-27)-Gly. PMID- 2759028 TI - Biological half-life and transfer of maternal corticosteroid-binding globulin to amniotic fluid in the rabbit. AB - Rabbit corticosteroid-binding globulin (CBG) from the serum of pregnant and nonpregnant females differs in terms of charge microheterogeneity, and both forms were, therefore, radiolabeled and injected iv into 23- to 27-day pregnant rabbits (n = 6) to assess their biological half-lives and possible transfer to the fetal compartment. After an initially rapid distribution phase, the serum half-lives of both forms of [125I]CBG were essentially identical (approximately 13 h) and did not vary at different gestational ages. There was also no difference in the transfer of either form of [125I]CBG from maternal to fetal compartments in any of the animals studied. Moreover, [125I]CBG showed no sign of degradation and retained its steroid-binding activity in fetal urine and amniotic fluid. Twenty two hours after administration of [125I]CBG to rabbits (n = 2) at 23 days gestation, its mean level in fetal urine (7 cpm/microliter) and amniotic fluid (2.5 cpm/microliter) was much higher than that in fetal blood (0.6 cpm/microliter). More importantly, the specific activities of [125I]CBG in fetal urine and amniotic fluid were comparable to that in maternal serum, and approximately 2 orders of magnitude higher than that in fetal serum. Taken together, these results suggest that CBG in fetal urine and amniotic fluid is largely of maternal origin, and that maternal CBG crosses the fetal kidney preferentially. PMID- 2759029 TI - Parathyroid hormone stimulates release of insulin-like growth factor-I (IGF-I) and IGF-II from neonatal mouse calvaria in organ culture. AB - Effects of increased bone resorption on release of insulin-like growth factor-I (IGF-I) and IGF-II into the osteoblast microenvironment were investigated using neonatal mouse calvaria organ cultures. Release of these growth factors from calvaria into serum-free medium was quantitated using a human IGF-I RIA and human IGF-II RRA. Untreated calvaria released several-fold more IGF-II than IGF-I. PTH (from 1-12 nM) stimulated a dose-dependent increase in the release of both growth factors that correlated with increased calcium release and was sustained for up to 6 days. IGF-I and IGF-II release were maximally stimulated 5- to 10-fold and 1.5- to 2-fold, respectively, compared to untreated control values. Calcitonin inhibited PTH-stimulated resorption, but had no effect on PTH stimulation of IGF I and IGF-II release, suggesting that PTH effects on IGF-I and IGF-II release were not dependent on resorption. Furthermore, the amounts of IGF-I and IGF-II released from calvaria during 6 days of culture were 5-fold more than the amounts of IGF-I and IGF-II present in the calvaria (bone plus cells) at the beginning of culture, suggesting that much of the IGF-I and IGF-II released was newly produced by calvaria cells. The results suggest that PTH directly stimulated calvarial osteoblasts to release IGF-I and IGF-II. Since IGF-I and IGF-II stimulate osteoblastic cell proliferation, the effect of PTH on the release of these and other growth factors may mediate coupling of bone formation to bone resorption. PMID- 2759030 TI - Variation in myometrial response to intravenous oxytocin administration at different times of the day in the pregnant rhesus monkey. AB - To assess a potential underlying rhythm in the sensitivity of the pregnant primate myometrium to oxytocin we infused five pregnant rhesus monkeys (gestational age, 121-142 days) with oxytocin at three different periods of the 24-h day, in the order night, afternoon, and morning, via the maternal inferior vena cava. Oxytocin was administered for 1 min every 5 min over 30 min at four doses 400, 800, 2000, and 4000 pg/min.kg. The response of the myometrium, evaluated as the number of contractions per pulse of oxytocin, was greatest in the early hours of darkness. Studies in three additional monkeys in which the order of the oxytocin challenge tests was changed, again showed that the response to oxytocin was greatest in the hours of darkness. We conclude that an underlying, as yet undefined, rhythm exists in the sensitivity of the pregnant primate myometrium to oxytocin at different times of the 24-h day. This change in myometrial sensitivity may be due to variation in one or more of the many potential regulatory sites of oxytocin's action at the cellular level. We hypothesize that this difference in myometrial sensitivity to oxytocin plays a role in the switch from myometrial contractures to contractions that occurs around the hours of darkness, e.g. postsurgery, during food withdrawal, and before delivery. PMID- 2759031 TI - Spermidine is necessary for, but not the only mediator of, linoleic acid stimulated alpha-casein accumulation in mouse mammary epithelial cells. AB - Mammary epithelial cells obtained from virgin mice were induced to accumulate alpha-casein in serum-free two-stage collagen gel culture with insulin, PRL, and linoleic acid. Omission of either PRL or linoleic acid drastically reduces alpha casein accumulation. Spermidine addition to insulin-containing medium in either the absence or presence of linoleic acid does not stimulate alpha-casein accumulation. We conclude from this that spermidine can not be the sole mediator of PRL action. Spermidine also will not replace linoleic acid for alpha-casein accumulation if the fatty acid is omitted from the culture medium and will not increase casein accumulation when supplemented into PRL- and linoleic acid containing medium; thus, it is not the sole mediator of linoleic acid action. However, the spermidine synthesis inhibitor methylglyoxal-(bis)-guanylhydrazone does inhibit alpha-casein accumulation in a concentration-dependent and spermidine-recoverable manner in cells stimulated by PRL and linoleic acid. We could not detect changes in polyamine levels in response to any of the medium supplements used in this investigation. Spermidine is, thus, at least a required comediator of the alpha-casein synthesis induction, although its role remains enigmatic. PMID- 2759032 TI - Effects of gonadectomy and treatment with gonadal steroids and luteinizing hormone secretion in hypogonadal male and female mice with preoptic area implants. AB - The ability of male and female hypogonadal (hpg) mice with preoptic area (POA) grafts to show negative feedback was studied. GnRH neurons within POA grafts send axons into the median eminence of the hpg host (HPG/POA), resulting in increased gonadotropin production and gonadal development in the mice that are genetically unable to produce GnRH. The present studies evaluated whether negative feedback, an aspect of normal reproductive function, is present in male and female HPG/POA mice. In normal male mice plasma LH was increased 1 or 5 months after castration and returned to baseline after testosterone propionate treatment. In contrast, no alterations in plasma LH were measured in similarly treated HPG/POA males. HPG/POA female mice were ovariectomized 6 weeks or 3 or 6 months after graft surgery and received sc 17 beta-estradiol (E2) implants 3 months later. Normal mice were studied when 6 weeks old and 8 months old (age-matched to HPG/POA mice ovariectomized 3 months after graft surgery). Further, to determine whether the mice were capable of positive feedback, 1 week after receiving E2 implants, mice in the 6-week and 3-month postgraft surgery groups were challenged with sequential administration of estradiol benzoate and progesterone. The significant increase in plasma LH after ovariectomy or decrease after E2 implant in normal female mice was not present in most HPG/POA female mice. Just 2 of the 24 HPG/POA females studied had increased plasma LH after gonadectomy, and in only 1 of these was plasma LH suppressed by E2 treatment. The ability of an individual HPG/POA mouse to show positive feedback did not predict the ability to show negative feedback, nor did the ability to show negative feedback predict positive feedback capability. Among the mice that failed to respond to ovariectomy with increased LH release were some that had elevated LH in response to steroid challenge or had spontaneously ovulated. On the other hand, neither mouse that had increased LH release after ovariectomy had shown positive feedback to a steroid challenge. Immunocytochemical evaluation revealed GnRH cells within the grafts and GnRH fiber innervation of the host's median eminence, but there was no correlation between numbers of GnRH cells or extent of innervation with the ability to show either negative or positive feedback, nor was the presence of vasoactive intestinal peptide cells within the grafts of predictive value. The failure of negative feedback in most of the HPG/POA mice tested may be due to the failure to establish as yet unidentified but essential afferents to the grafted GnRH cells and/or their axonal processes. PMID- 2759033 TI - Insulin-like growth factor I regulates type I procollagen messenger ribonucleic acid steady state levels in bone of rats. AB - RNA extracted from parietal bones of rats was analyzed for the abundance of type I procollagen mRNA by a dot hybridization assay using specific cDNA probes. Hypophysectomized rats, deficient in IGF I, have 4.1-fold lower steady state levels of mRNA encoding the alpha 1 chain of type I collagen when compared to normal rats of the same weight (120 g). Administration of recombinant human insulin-like growth factor I (IGF I) for 6 days restores bone collagen mRNA levels to normal, and a single sc injection of 100 micrograms IGF I results in a 1.9-fold increase of both alpha 1(I) and alpha 2 (I)chain mRNAs after 8 h. Studies with calvaria cells in primary culture and with a bone-derived cell line, PyMS, yielded similar results: IGF I treatment of these osteoblast-like cells for 24 h increased steady state levels of type I procollagen mRNAs. Thus, IGF I appears to contribute to osteoblast mRNA expression for both chains of type I collagen. PMID- 2759034 TI - The circadian variation of prolactin in fetal sheep is affected by the seasons. AB - Plasma PRL concentration shows a circadian variation in fetal and adult sheep. In the adult sheep the presence of this variation depends on the season. In this paper we investigated whether season affects the presence of the circadian variation of PRL in the fetal sheep. To that effect we measured plasma PRL concentration every 2 h for 24 h during summer, fall, and winter in three groups of fetal sheep whose gestational ages ranged from 125-133 days. Mean (+/- SEM) fetal plasma PRL concentrations were 352.8 +/- 65.0 ng/ml during summer (n = 6), 98.7 +/- 12.9 during fall (n = 8), and 10.5 +/- 2.6 during winter (n = 4). A 24-h variation of plasma PRL was detected during summer [PRL (ng/ml) = 352.8 + 85.2 cos 15 (t - 18.5); P = 0.007] and fall [PRL (ng/ml) = 98.7 + 26.6 cos 15 (t - 23.6); P = 0.041] but not during winter. The mesor and amplitude of the variation are higher in summer than in fall, and the acrophases differ by 5 h, taking place at dusk in summer and close to midnight in fall. These findings show that in fetal sheep, PRL responds to seasons in utero. The signal triggering this response is most likely photoperiod. PMID- 2759035 TI - Pancreastatin, a presumed product of chromogranin-A (secretory protein-I) processing, inhibits secretion from porcine parathyroid cells in culture. AB - Chromogranin-A, also referred to as secretory protein-I, is a 50K protein found in and secreted by endocrine cells, in which it is costored with the native hormone. Porcine chromogranin-A contains a sequence identical to pancreastatin, a 49-amino acid, C-terminally amidated peptide that has been isolated from porcine pancreas, suggesting that chromogranin-A is the precursor of pancreastatin. Pancreastatin has been found to be a potent inhibitor of glucose-stimulated insulin release. As it is possible that pancreastatin inhibits secretion from other chromogranin-A-containing tissues in which it may be formed, we tested its action on dispersed porcine parathyroid cells in culture. Secretion of chromogranin-A and PTH was up to 6-fold greater at 0.5 mM Ca2+ than at 3.0 mM Ca2+. Pancreastatin (1 nM) reduced the secretion of both chromogranin-A and PTH at 0.5 mM Ca2+ to approximately the levels found at 3.0 mM Ca2+, but did not affect secretion at 3.0 mM Ca2+. Pancreastatin (0.01-1.0 nM) inhibited secretion of chromogranin-A in a dose-dependent fashion. Preincubation of the cells with pancreastatin was not required for inhibition. Transfer of inhibited cells to medium without pancreastatin led to restoration of secretion within 90 min. Phorbol myristate acetate (1.6 microM) stimulated secretion of PTH and chromogranin-A at 3.0 mM Ca2+, but not at 0.5 mM Ca2+. Pancreastatin reversed this stimulation, demonstrating that its inhibition was independent of Ca2+ concentration. These results are consonant with pancreastatin playing a physiological role in modulation of secretion by the parathyroid and, by extension, other endocrine tissues. PMID- 2759036 TI - Differential effects of continuous versus intermittent administration of growth hormone to hypophysectomized female rats on serum lipoproteins and their apoproteins. AB - The effects of the plasma pattern of GH on serum and lipoprotein levels of total cholesterol, triglycerides, apolipoprotein A-I (apo A-I), apolipoprotein B 48/100 (apo B), and apolipoprotein E (apo E) were studied in hypophysectomized female Sprague-Dawley rats, which had been given replacement therapy with L-T4 and hydrocortisone. Bovine GH (1 mg/kg.day) was administered sc either continuously by means of osmotic minipumps or by two daily injections. Serum lipoproteins were separated by sequential ultracentrifugation into very low density lipoproteins [density (d) less than 1.006 g/ml], low density lipoproteins (LDL; d 1.006-1.063 g/ml) and high density lipoproteins (HDL; d 1.063-1.21 g/ml). The content of total cholesterol and triglycerides were then determined. Apo A-I, apo B, and apo E were isolated from rat serum and antibodies raised in rabbits. In serum and in lipoprotein fractions, the content of apo A-I, apo-B, and apo E were determined by electroimmunoassay. After hypophysectomy, there occurred a decrease in serum cholesterol and serum levels of apo A-I and apo E, in spite of replacement therapy with T4 and cortisone. Similar changes were also observed in HDL. In contrast, apo B, cholesterol, and triglycerides were increased in LDL. Estradiol treatment had no effect on these changes. Continuous infusion of GH resulted in an increase in cholesterol and apo E in serum and HDL to the levels of intact females. In contrast, GH given twice daily had no effect. Therefore, the sexually dimorphic secretion of GH may be important for the regulation of sex differences in apo E and HDL cholesterol levels. There were no consistent effects of GH treatment on the levels of apo A-I in serum or HDL, but GH treatment resulted in a decrease in apo B and triglycerides in both serum and LDL, regardless of the mode of administration. This suggests that GH regulates the serum and LDL levels of apo B and triglycerides independently of the secretory pattern. PMID- 2759037 TI - Essential fatty acid deficiency delays the onset of puberty in the female rat. AB - This study assessed the effect of a dietary deficiency in the essential fatty acids (EFA) linoleic and linolenic acids on the onset of female puberty. EFA deficiency was produced in female rats by means of a semipurified diet and was biochemically documented by analyzing serum and erythrocyte fatty acid levels of more than 30 fatty acids, including all members of the n-6 and n-3 series. Levels of linoleic acid (18:2 n-6) and all n-6 derivatives, particularly arachidonic acid, were strikingly reduced. A less pronounced but clear-cut decrease in n-3 fatty acids, including docosahexaenoic acid (22:6 n-3) was also found. The times of puberty and first ovulation, as assessed by the ages at vaginal opening and first diestrus, were significantly delayed in EFA-deficient rats. The mechanisms underlying this delay appear to reside at both hypothalamic and ovarian sites. Simulation of preovulatory plasma estradiol (E2) levels via implantation of E2 containing Silastic capsules evoked a LH surge 30 h later in control juvenile rats, but not in EFA-deficient animals, indicating a delay in the development of the hypothalamic component of E2-positive feedback in the latter group. This delay appears to be due at least in part to reduced prostaglandin E2 (PGE2) synthesis, as the ability of the neurotransmitter norepinephrine to induce PGE2 release from median eminence nerve terminals was markedly reduced in EFA deficient rats compared with that in controls. The decrease in hypothalamic PGE2 release was related to the EFA deficiency and not to reduced PG synthase activity, as determined by HPLC analysis of PG synthase products derived from exogenous [14C]arachidonic acid. Basal and hCG-stimulated PGE2 synthesis was also compromised in ovaries from EFA-deficient rats. Depressed gonadal function resulting from the EFA deficiency was further evidenced by a reduced gonadotropin receptor content, a blunted E2 response to hCG in vitro, and an increase in mean serum FSH levels. These results suggest that the delay in puberty resulting from EFA deficiency is due to a reduced availability of arachidonic acid for synthesis of bioactive metabolites. This results in delayed development of both the hypothalamic and ovarian components of the reproductive axis. PMID- 2759038 TI - Characterization of melanin-concentrating hormone from rat hypothalamus. AB - A melanin-concentrating hormone (MCH)-like peptide was isolated from rat hypothalamus by acid extraction, gel filtration chromatography, immunoaffinity chromatography using antiserum directed against salmon MCH, and two steps of HPLC using octadecyl columns. Several zones of immunoreactivity were isolated, and Edman degradation in a gas phase sequencer indicated that the amino acid sequence of all zones was identical. Rat hypothalamic MCH is a nonadecapeptide which differs from salmon MCH by an N-terminal extension of two amino acids and four additional substitutions. Rat MCH has the following primary structure: Asp-Phe Asp-Met-Leu-Arg-Cys-Met-Leu-Gly-Arg-Val-Tyr-Arg-Pro-Cys-Trp-Gln- Val. PMID- 2759039 TI - Activin-A, inhibin and transforming growth factor-beta modulate growth of two gonadal cell lines. AB - The proliferative and differentiating effects of the gonadal hormones inhibin and activin-A were examined on cell lines derived from the ovary and testis. Activin A was found to inhibit the growth of CHO-K1 (Chinese hamster ovary) cells in culture, with an IC50 of 3 ng/ml. The maximal response (50% inhibition) required 3 days of incubation in the presence of 40 ng/ml activin-A, and the inhibitory effect was accompanied by morphological changes. Inhibin (10 ng/ml) partially blocked the inhibition of growth by activin. Transforming growth factor-beta (TGF beta), which is structurally related to activin and inhibin, was a very potent inhibitor of the proliferation of CHO-K1 cells, with an IC50 of 0.2 ng/ml and a maximal effect (70% inhibition) at 2 ng/ml. The combination of high concentrations of both TGF beta and activin-A did not result in a greater inhibitory effect than that observed with TGF beta alone, suggesting an overlapping step in the mechanism of action for both factors. In contrast to the results with CHO-K1 cells, differential effects of activin-A and TGF beta were observed in R2C (rat Leydig cell testicular tumor) cells. Activin-A had only a slight effect on proliferation over a 4-day incubation, but inhibited progesterone accumulation ina concentration-dependent fashion within 12 h. TGF beta, on the other hand, was a potent inhibitor of both growth and steroidogenesis in R2C cells. These studies suggest that activin-A and inhibin may regulate proliferation as well as functions of gonadal cells. PMID- 2759041 TI - Adaptation of liver membrane somatogenic and lactogenic growth hormone (GH) binding to the spontaneous pulsation of GH secretion in the male rat. AB - The secretory pattern of GH is pulsatile in both man and experimental animals. The present study was undertaken to investigate the effect of the endogenous pulsatility of serum GH on the dynamics of plasma membrane GH binding sites. In order to characterize somatogenic and total specific binding, male rats 45 days old were decapitated at 15-min intervals, and rat liver membranes were prepared. Binding studies were done in parallel with and without excess ovine PRL, 1 microgram/tube. Removal of endogenous ligand was performed by exposing the membranes to 3 M MgCl2. A composite picture of serum GH showed relatively good synchronization of the secretory episodes among the animals. Peak levels of the spontaneous secretion pulse of rat GH were followed by an immediate decrease in free somatogenic binding. Two hours later the binding activity returned to presecretion levels, essentially resetting the cell for another cycle. The kinetics of desaturated somatogenic binding were similar. The occupancy of liver GH somatogenic binding sites was maximal at the time of peak serum GH. High levels of the endogenous hormone caused an immediate sharp down-regulation of lactogenic desaturated binding. Up-regulation of the binding sites occurred about 90 min later. Scatchard analysis showed that binding activity of the membranes was a result of the altered number of binding sites, while the binding affinity remained fairly constant. Thus, the centrally regulated GH secretion in the male rat is complemented by appropriate dynamics of the GH receptor turnover, which in turn recognizes individual pulses and allows individual pulse-related responses to occur. PMID- 2759040 TI - Aromatase cytochrome P450 and cholesterol side-chain cleavage cytochrome P450 in corpora lutea of pregnant rats: diverse regulation by peptide and steroid hormones. AB - In previous studies we have shown that aromatase cytochrome P450 (P450arom) mRNA and protein increase markedly in luteal tissue between days 10-19 of gestation, whereas cholesterol side-chain cleavage cytochrome P450 (P450scc) appears to be constitutively maintained regardless of hormonal changes occurring during pregnancy. To identify pituitary and placental hormones that regulate these two P450 enzymes in the rat corpus luteum, serum LH activity and pituitary PRL release were selectively inhibited by administration of LH antiserum (LH-Ab) or CB-154, respectively. Placental hormones were removed by hysterectomy. Hormonal activities were replaced by the administration of hCG, PRL, testosterone (T), or estradiol (E), given individually or in combination. Induction of aromatase mRNA transcripts (3.3, 2.6, and 1.9 kilobases) and protein (54,000 mol wt) between days 10-15 of gestation was blocked by either surgical hysterectomy or LH-Ab treatment. Hysterectomy on day 10 combined with CB-154 abolished not only aromatase mRNA, but also markedly reduced P450scc mRNA (2.0 kilobases) by day 12. Induction of aromatase was partially restored in the day 10-15 hysterectomized rats by treatment with PRL plus E (most effective), PRL plus T, or PRL alone, but not by either T or E alone. Similar results were observed 2 days after hysterectomy (day 12), except that hysterectomy alone caused a transient 3.5-fold increase in P450arom mRNA and protein, most likely due to a transient release of pituitary LH. Aromatase mRNA and protein were also increased in intact pregnant rats treated with hCG between days 10-12. However, no effect of hCG was observed before (days 8-10) or after (days 13-19) midgestation. Likewise, LH-Ab had no effect if given after day 13. Despite hormone-specific regulation of the content of aromatase protein, E biosynthesis in vitro was not strictly related to aromatase enzyme content. We conclude that aromatase mRNA and protein are maintained by PRL at a low level of expression in the first half of pregnancy, can be modulated by LH at midgestation, and are subsequently induced to high levels in the second half of gestation by placental factors (rat placental lactogen-1 and T) and the conversion of T to E in the corpus luteum. P450scc appears to be constitutively maintained. Thus, two P450 genes known to be regulated by LH/cAMP in the rat follicle are controlled by diverse peptide and steroid signal transduction mechanisms in the corpus luteum. PMID- 2759042 TI - The dynamics of somatogenic and lactogenic growth hormone binding: internalization to Golgi fractions in the male rat. AB - Rapid turnover of the GH receptor has previously been shown, and its turnover (t1/2) has been estimated to be 30-85 min. In a companion study, we found that lactogenic and somatogenic GH binding sites on rat liver membranes were down regulated immediately after an episode of GH secretion and reappeared at the plasma membrane in time for the next secretory surge of the hormone. In the present in vivo study, we followed the fate of the down-regulated membrane GH binding sites in the Golgi membranes. Male rats were killed at 1000, 1100, and 1200 h, and their livers were removed for preparation of Golgi membranes. Lactogenic and somatogenic [125I]human GH binding to Golgi membranes was measured. The results of the present study show that Golgi receptors are related to the endogenous pulsation of serum GH. After the GH surge, an increase in the capacity of the lactogenic and somatogenic receptors in the Golgi membranes takes place. Most of these receptors were occupied by ligand and represent, therefore, internalized receptors. Two hours after the GH secretory peak, the occupied receptors had disappeared from the Golgi membranes and appeared in the plasma membrane, suggesting that receptors were recycled to the plasma membrane, awaiting the next GH surge. The following model is proposed: A surge of GH secretion causes immediate down-regulation of the plasma membrane receptors to GH. The receptors that disappear from the plasma membrane are internalized to the Golgi complex. A fraction of the Golgi receptors is recycled to the membrane, along with newly synthesized receptors, awaiting the next GH pulse. PMID- 2759043 TI - Thyroxine, triiodothyronine, and reverse triiodothyronine processing in the cerebellum: autoradiographic studies in adult rats. AB - Well confirmed evidence has demonstrated that the cerebellum is an important target of thyroid hormone action during development. Moreover, the presence of nuclear receptors and strong 5'-deiodinase activity in cerebella of adult rats have suggested that this region may continue to respond to thyroid hormones during maturity. Recent autoradiographic observations have focused attention on the cerebellar granular layer, in that [125I]T3 administered iv to adult rats was found to be selectively and saturably concentrated there. To determine the specificity of iodothyronine localization in the granular layer, we have now compared film autoradiographic observations made after iv [125I]T4 and iv [125I]rT3 with those found after iv [125I]T3. The results demonstrated that, as in the case of the latter hormone, labeling within the cerebellar cortex after iv [125I]T4 was both selective and saturable. Moreover, except for a lag in time to resolution and a longer retention time, the distribution of cerebellar radioactivity after iv labeled T4 was qualitatively similar to that seen after iv [125I]T3. However, the ability of T4 to become differentially concentrated in the granular layer of cerebellum was absolutely dependent on its ability to be converted intracerebrally to T3. Thus, pretreatment with ipodate, which blocks brain 5'-deiodinase activity and, therefore, the intracerebral formation of T3 from T4, completely prevented cerebellar granular layer labeling after iv [125I]T4 even though it did not interfere with differential labeling of this region by iv delivered [125I]T3. In the same experiments, propylthiouracil, a potent peripheral, but not central, 5'-deiodinase inhibitor, had no qualitative effect on the distribution of either T4 or T3 in cerebellum. By contrast with the results obtained after administering labeled T3 or T4, brain labeling after iv delivered [125I]rT3 was found to be no different from that produced by markers of cerebral blood flow, which rapidly enter and leave the brain without becoming incorporated into brain cells. This was so even during treatment with propylthiouracil and ipodate, both of which markedly prolonged the normally brief residence time of this iodothyronine in serum and brain. Overall, the autoradiographic results served to highlight the importance of the morphological approach for investigating thyroid hormone action and metabolism in brain. They demonstrated that only T3, whether entering as such from the circulation or formed in situ from T4 (but neither T4 itself nor iv administered rT3) was strongly, selectively, and saturably concentrated in the cerebellar granular layer of adult rats.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2759044 TI - Cytosolic androgen receptors in the neuroendocrine tissues of the golden hamster: influence of photoperiod and melatonin treatment. AB - Hamsters exposed for eight weeks to short photoperiod (LD 10:14) or treated with melatonin in the late afternoon under long photoperiod (LD 14:10) had significantly higher number of cytosolic androgen receptors in the pituitaries, hypothalami and harderian glands, as compared to the long photoperiod (LD 14:10) exposed controls. The numerical value of the apparent Kd was two to three times lower in the hypothalami and pituitaries, but not in the harderian glands of the animals from these groups. These results indicate that alterations in receptor numbers and affinity constants may be responsible for the dramatic changes in the sensitivity of the hypothalamo-pituitary axis to the negative feedback actions of the gonadal steroids, observed under inhibitory photoperiods and that this effect could be duplicated by late afternoon melatonin treatment. PMID- 2759045 TI - Proceedings of a conference on the adrenal cortex. New Orleans, June 5-6, 1988. PMID- 2759046 TI - Steroidogenesis activator polypeptide may be a product of glucose regulated protein 78 (GRP78). AB - Cholesterol side-chain cleavage is sensitive to antibiotic inhibitors of protein synthesis, suggesting that a labile protein may play a regulatory role in this process. We have previously characterized such a factor--steroidogenesis activator polypeptide (SAP). Given the low molecular weight of SAP (Mr 3215), a SAP precursor has been sought. Using immunoblotting techniques with two polyclonal antisera directed against portions of the SAP sequence, a single protein of apparent Mr 82,000 (p82) can be detected in rat adrenocortical tissue. Our data suggest that adrenal p82 is most likely the widely-distributed minor heat shock protein, glucose regulated protein 78 (GRP78). The two proteins share biochemical attributes, including pI (5.2) and ATP affinity, and the reported amino acid sequences for SAP and for the carboxyl-terminal end of GRP78 are nearly identical. We propose that SAP is cleaved from GRP78--or a cognate protein -and that this proteolysis is regulated in a manner characteristic of steroidogenic tissues. PMID- 2759047 TI - 18, 19-Dihydroxycorticosterone: a new metabolite in human urine. AB - Urines of patients with primary aldosteronism were extracted, the extract repeatedly chromatographed with reversed phase HPLC. The fractions immunoactive against 18-hydroxycorticosterone antiserum and being more polar than the 18 hydroxycorticosterone were further purified, derivatized and investigated by GC/MS. In this manner the natural occurrence of the 18, 19 dihydroxycorticosterone, which was lately synthetized, in human urine was confirmed. PMID- 2759048 TI - The regulation of the 17-deoxy steroids in man. AB - One must consider the 17-DOS as a biosynthetic pathway with multiple regulatory factors. ACTH is its dominant regulator but in the absence of ACTH and in conditions where plasma renin activity is increased, this biosynthetic pathway maintains its sensitivity to exogenous ACTH. Suppression of the renin system delays the general recovery of aldosterone after the removal of an aldosterone producing adenoma but not of the 17-DOS: a pattern also showed after the removal of a DOC-producing adenoma. In addition to the possible role of the renin system there remain inexplicable situations in its regulation that cannot be explained by ACTH and renin. Our studies suggest that a non-renin, non-ACTH factor may influence the basal production of these steroids, and by its reduction, permits deviation of steroid substrate to cortisol production. This sequence may be operative in the "stress syndrome". Finally, one of the more interesting phenomenonologic patients who has been observed is a young male who has the biochemical findings and clinical signs of DOC excess with hypertension, hyperplasia, suppression of aldosterone and the RAS, and normal cortisol levels. All the 17-DOS are elevated and both adrenal veins have high concentrations. He represents excessive stimulation of this pathway by putative 17-deoxy regulator excess. The renin system is suppressed and ACTH levels are normal. Treatment with suppressive doses of glucocorticoid hormones diminishes the elevated 17-DOS and cortisol and ameliorates blood pressure. In summary, there seems to occur in clinical disorders and contrived experimental settings, suggestions that a non renin, non-ACTH factor can regulate the 17-DOS, absence can explain some of the unusual conditions described (Fig. 1). The 17-DOS, while a vestigial pathway, may still cause disease, and provide clues to central organization of the adreno cortical response to injury, stress, and disease. PMID- 2759049 TI - How can aldosterone act as a mineralocorticoid? PMID- 2759050 TI - Effect of clomiphene on nuclear estrogen receptor of the fallopian tube during ovum transport in rabbits. AB - The effect of clomiphene on nuclear estrogen receptors of the Fallopian tube during ovum transport in the rabbit has been studied. Nuclear binding capacity was observed in ampulla (A), ampullary-isthmic junction (AIJ), isthmus (I), uterine-isthmic junction (UIJ) and uterus (U). Receptor concentration decreased in all segments of the tube after administration of clomiphene in mated animals. The bindings are of high affinity and low capacity. Important alterations were observed during transport when compared to that of 14, 24, 34, 48, 72, 144 and 168 hr post-coitum (p.c). At 24 hr p.c binding increased only in I and decreased in A and AIJ. Retention of eggs at I at 24 hr p.c showed as increase in binding at I. Egg transport was accelerated and eggs reached prematurely in the uterus due to the influence of clomiphene. Binding in I remained constant from 48 hr p.c to 144 hr p.c but concurrently the binding level increased in U from 34 hr p.c. The elevation of nuclear estrogen receptor level was maximum at 24 hr p.c which coincided with increased plasma estrogen level. The result of such study showed that clomiphene depleted nuclear estrogen receptor complex in the fallopian tube before transfer to the uterus. Further, observation indicated that clomiphene acted directly on the rate of egg transport because of the variations in estrogen receptors during different time periods. Thus, clomiphene reduced the quantity of estrogen receptor i.e., insensitiveness to estrogen. The variations in estrogen binding to its receptor and plasma level at different post-coital periods are modulated by clomiphene resulting in the acceleration of egg transport and prevention of pregnancy. PMID- 2759051 TI - Recombinant DNA-derived human insulin-like growth factor II (hIGF-II) stimulates growth in hypophysectomized rats. AB - Sustained subcutaneous administration of recombinant DNA-derived insulin-like growth factor II to immature female hypophysectomized rats stimulated significant increases in body weight gain, tibial epiphyseal cartilage width, femur hydroxyproline concentrations and a significant decrease in serum urea nitrogen concentrations. Recombinant DNA-derived human growth hormone (Humatrope), administered in the same manner produced similar biological effects. The data support the contention that hIGF-II has anabolic effects when administered to hypophysectomized rats and may be a locally acting mediator of pituitary hormone actions. PMID- 2759052 TI - Carcinogen risk assessment. AB - A molecular biological rationale for the linear nonthreshold dose-response pattern for carcinogenesis is presented based on the mutagenic activation of oncogens as the basis of initiation. The approach assumes that the linear nonthreshold dose pattern at very low doses applies only to tissues that are promoted by intrinsic and extrinsic agents other than the one being modeled, and that risk is characterized on a relative rather than absolute basis in terms of aggregate tumor response. PMID- 2759053 TI - Effective strategies for population studies of acute air pollution health effects. AB - A series of field studies involving repetitive functional measurements in relatively small populations of healthy children and adults engaged in normal outdoor activities has shown that significant decrements in respiratory function are associated with exposures to ozone (O3) at concentrations below the national ambient air quality standard. The ability to detect such effects can be attributed, at least in part, to the study design criteria used, which emphasized maximization of signal-to-noise ratios. Locations were selected to ensure relatively high exposures to relatively uniformly distributed secondary pollutants, with minimal exposure to local sources of primary pollutants. Populations were selected that would be engaged in active recreation out of doors. Populations of healthy persons were used to minimize variability in baseline function. We found that the magnitude of the O3-associated decrements in respiratory function was dependent on the variability in sensitivity to O3 among the population, the minute ventilation during outdoor activity, and the duration of the outdoor exposure. We also concluded that the O3-associated responses were potentiated by the presence of other air pollutants. PMID- 2759054 TI - Comparative toxicity of ambient air pollutants: some aspects related to lung defense. AB - Clearance mechanisms are an integral part of pulmonary defense, serving to rid the lungs of inhaled particles that deposit upon airway surfaces. This is accomplished by mucociliary transport in conducting airways and to a large extent by alveolar macrophages in the respiratory region. This paper compares the effects of acute exposure to sulfuric acid (H2SO4), nitrogen dioxide (NO2), or ozone (O3) on mucociliary clearance in rabbits and on phagocytic activity of macrophages recovered by bronchopulmonary lavage from animals exposed in vivo. The possible toxicologic mechanisms underlying dysfunction of clearance mediated by these irritants is discussed in terms of response to a pure acid (H2SO4), a pure oxidant (O3), and a material (NO2) that is a direct oxidant but which may produce secondary oxidants and acids upon dissolution in lung fluids. PMID- 2759055 TI - Shortcomings in risk projection. PMID- 2759056 TI - Sun exposure and malignant melanoma among susceptible individuals. AB - The purpose of this case-control study was to identify susceptible subgroups, primarily based on pigmentary characteristics, at higher risk of developing melanoma when exposed to the sun. The study group, which was interviewed from 1979 to 1982, consisted of 289 consecutive patients with melanoma and 527 randomly selected controls without cancer. In general, the risk of melanoma associated with sun exposure was greater for individuals expected to be susceptible on the basis of poor ability to tan, but not other pigmentary traits. There were, in addition, some noteworthy interactions between age and sun exposure. Among subjects with poor tanning ability, the risk of melanoma associated with outdoor occupation was more than 3-fold [odds ratio (OR) = 3.3] compared to indoor occupation. In contrast, the analogous OR was much less elevated among subjects with a good ability to tan (OR = 1.5). Mixed indoor and outdoor job exposure was protective among good tanners (OR = 0.80), but not among poor tanners (OR = 1.5). A similar pattern was seen for recreational sun exposure and, when applying multiple logistic regression, for the patient's overall subjective assessment of his lifetime sun exposure. However, quantitative assessment of average hours of sun exposure did not prove to be a good indicator of melanoma risk, even among susceptible individuals. A history of severe sunburn with blistering was associated with nearly 3-fold risk among poor tanners (OR = 2.9) but was protective among good tanners (OR = 0.79). A history of nonmelanoma skin cancer or solar keratosis was a very strong risk factor (OR = 7.3), which, however, did not significantly differ in magnitude among susceptibility subgroups. PMID- 2759057 TI - Radiation epidemiology: old and new challenges. AB - Over the last 40 years the amount of knowledge about human radiation effects has increased dramatically. During that interval, radiation epidemiologists have documented a number of additional types of radiation-induced cancer and have established rough estimates of the magnitude of cancer risks. Nevertheless, we currently have inadequate knowledge about a number of factors that help define the magnitude of radiation risks. These include questions of estimating risk over the lifetime, shapes of dose-effect curves, magnitude of risks at low doses, potentiation between radiation and other agents, and the nature and role of host susceptibility factors. Data from various studies are used to illustrate these questions. PMID- 2759058 TI - DNA adducts of propylene oxide and acrylonitrile epoxide: hydrolytic deamination of 3-alkyl-dCyd to 3-alkyl-dUrd. AB - Propylene oxide (PO) and acrylonitrile epoxide (ANO) are 3-carbon epoxides that are direct-acting mutagens. PO is a rodent carcinogen, and ANO has been postulated to be the ultimate carcinogenic form of acrylonitrile (AN). We have studied the reactions of these agents with 2'-deoxynucleosides and in vitro with calf thymus DNA at pH 7.0 to 7.5 and 37 degrees C. PO was reacted with DNA for 10 hr and resulted in the formation of the following 2-hydroxypropyl (HP) adducts: N6-HP-dAdo (1 nmole/mg DNA), 3-HP-Ade (14 nmole/mg DNA), 7-HP-Gua (133 nmole/mg DNA) and 3-HP-dUrd (13 nmole/mg DNA). 3-HP-dUrd was formed after initial alkylation at N-3 of dCyd followed by conversion of the adjacent exocyclic imino group at C-4 to an oxygen (hydrolytic deamination) with the formation of a dUrd adduct. ANO was reacted for 3 hr with calf thymus DNA and yielded N6-(2-hydroxy-2 carboxyethyl-dAdo (N6-HOCE-dAdo) (2 nmole/mg DNA); 1, N6-etheno-dAdo (11 nmole/mg DNA); 7-(2-oxoethyl)-Gua (7-OXE-Gua) (110 nmole/mg DNA); 3-OXE-dThd (1 nmole/mg DNA); and 3-HOCE-dUrd (80 nmole/mg DNA). As with 3-HP-dUrd, 3-HOCE-dUrd resulted from hydrolytic deamination of an initially formed dCyd adduct. A mechanism is proposed for the conversion of 3-alkyl-dCyd to 3-alkyl-dUrd involving intramolecular catalysis by the OH group on the 3-carbon side chain of the adduct.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2759059 TI - Interspecies extrapolation in carcinogenesis: prediction between rats and mice. AB - Interspecies extrapolation in carcinogenesis is studied by evaluating prediction from rats to mice and from mice to rats. The Carcinogenic Potency Database, which includes 3500 cancer tests conducted in rats or mice on 955 compounds, is used for the analysis. About half of the chemicals tested for carcinogenicity are positive in at least one test, and this proportion is similar when rats and mice are considered separately. For 392 chemicals tested in both species, 76% of the rat carcinogens are positive in the mouse, and 70% of mouse carcinogens are positive in the rat. When compounds composed solely of chlorine, carbon, hydrogen, and, optionally, oxygen are excluded from the analysis, 75% of mouse carcinogens are positive in the rat. Overall concordance (the percentage positive in both species plus the percentage negative in both) is 76%. Three factors that affect prediction between rats and mice are discussed: chemical class, mutagenicity in the Salmonella assay, and the dose level at which a chemical is toxic. Prediction is more accurate for mutagens than non-mutagens and for substances that are toxic at low (versus only at high) doses. Species differences are not the result of failure in the bioassay to attain the maximum tolerated dose in the negative species or of more frequent testing in the positive species. An analysis of the predictive value of positivity for the 10 most common target sites indicates that most sites are good predictors of carcinogenicity at some site in the other species; the poorest predictors among these common sites are the rat urinary bladder and the mouse liver. PMID- 2759060 TI - The accumulation of nickel in human lungs. AB - Using data from published studies, lung concentrations of nickel were compare for persons with and without occupational exposure to nickel. As expected, the concentrations were much higher for persons with occupational exposure. To estimate the effects of nickel-containing tobacco smoke and nickel in the ambient air on the amount of nickel accumulated in lungs over time, a model was derived that took into account various variables related to the deposition of nickel in lungs. The model predicted nickel concentrations that were in the range of those of persons without known nickel exposure. Nickel is a suspected carcinogen and has been associated with an increased risk of respiratory tract cancer among nickel workers. However, before the nickel content of cigarettes can be implicated in the etiology of lung cancer, further studies are needed to evaluate the independent effects of smoking and exposure to nickel. PMID- 2759061 TI - The role of aluminum and age-dependent decline. PMID- 2759062 TI - Genetic risk induced by carbon-14 generated by nuclear explosions. PMID- 2759063 TI - Oncogene activation in experimental carcinogenesis: the role of carcinogen and tissue specificity. AB - Techniques of molecular biology have been used to determine the relationship of cellular oncogenes to mechanisms of experimental carcinogenesis. Model systems involving three direct-acting alkylating carcinogens, two organ sites, and two species have been employed to elucidate the relationships between carcinogenic etiology, tissue specificity, and activation of known and novel oncogenes. Dimethylcarbamyl chloride, a reactive acylating agent, induces tumors of both the rat nasal mucosa and mouse skin whose DNA is devoid of NIH 3T3 transforming activity. Beta-propiolactone-induced rat nasal carcinomas contain a novel oncogene, 6 to 9 kb in size, whereas a mouse skin carcinoma induced by this agent possesses an H-ras oncogene activated by a 61st codon A to T transversion mutation. The novel oncogene activated in rat nasal tumors induced by beta propiolactone is distinct from one found in methylmethane sulfonate-induced tumors. The implications of these findings for understanding how oncogenes fit into general mechanism of carcinogenesis are discussed. PMID- 2759064 TI - In vitro models of carcinogenesis: expression of recessive genes by chromosomal mutations. AB - There has been considerable recent interest in the mechanisms by which recessive mutations involving cancer genes may be expressed. We have developed an in vitro model to study this phenomenon in an endogenous autosomal gene in human cells. We have analyzed the molecular structural changes that lead to loss of heterozygosity at the thymidine kinase (tk) locus. The results indicate that expression of a recessive allele frequently occurs by loss of heterozygosity at that locus. Over 90% of spontaneous mutants at the tk locus arose by allele loss. The fraction of induced mutants that arose by this mechanism depended upon the inducing agent. Loss of the active tk allele was often accompanied by loss of linked genetic loci on the long arm of chromosome 17. These results suggest that large-scale chromosomal mutations resulting from events such as deletion or mitotic recombination may be an important mechanism for the expression of activated or mutated recessive genes in human cells. Such recessive mutations could involve oncogenes or other growth regulatory genes important in carcinogenesis. PMID- 2759065 TI - Effects of general anaesthesia with enflurane on antroduodenal motility, pH and gastric emptying rate in man. AB - Antroduodenal motility, pH and gastric emptying rate were investigated before, during and after general anaesthesia with enflurane in 11 patients undergoing elective surgery not involving the abdomen. Motility was measured by manometry and the gastric emptying rate by the rate of paracetamol absorption. During anaesthesia gastric emptying rate was delayed in nine patients. General anaesthesia with enflurane nearly abolished the motility in the antrum. The duration of successive interdigestive motor complexes was reduced (P less than 0.001) mainly be a reduction in Phase II (P less than 0.01). The frequency of contractions was unchanged in the duodenum during Phase II and decreased during Phase III (P less than 0.01). The amplitudes of contractions were unchanged in the proximal part of the duodenum and decreased in the distal part (P less than 0.01). General anaesthesia with enflurane increased the gastric pH per- and post operatively (P less than 0.01). Motility in the antrum was rapidly regained in the recovery period. General anaesthesia with enflurane seems to delay gastric emptying rate by affecting the motility in the gastric antrum. The acidity of the stomach contents is reduced. PMID- 2759066 TI - Inspired oxygen concentration during general anaesthesia for caesarean section. AB - The effects on maternal oxygen saturation, foetal wellbeing and umbilical blood gases were compared when parturients received either 30 or 50% oxygen prior to delivery by Caesarean section under general anaesthesia. Maternal arterial oxygen saturation was significantly increased in the group receiving 50% oxygen. There was no difference between the two groups in terms of Apgar score minus colour, time to sustained respiration or umbilical cord blood gas estimations. The use of 30% inspired oxygen during uncomplicated Caesarean section is advocated. PMID- 2759067 TI - Dihydrocodeine--a reversible cause of renal failure? AB - Two patients who developed severe narcosis and acute renal failure following therapeutic doses of dihydrocodeine are reported. The administration of naloxone produced an increase in respiratory minute volume and an improved level of consciousness. In addition, there was evidence of reversal of their renal failure with an increased urine output and creatinine clearance during the period of naloxone administration. Although the antidiuretic effect of opioids is well documented, opioids have not previously been incriminated in the aetiology of renal failure. The possible mechanism for this is discussed and the risks associated with the administration of dihydrocodeine to patients with renal failure or the elderly are emphasized. PMID- 2759068 TI - Effects of enflurane on ectopic automaticity induced by local injury. PMID- 2759069 TI - Changes in plasma volume and red cell formation after a marathon competition. AB - The purpose of this study was to investigate middle-term influences of a marathon race on plasma volume (PV) and red cell production. We performed the following measurements in the blood of 15 male athletes: haemoglobin ([Hb]), haematocrit (Hct), plasma protein concentration ([Prot]), plasma osmolality, sodium concentration ([Na+]), potassium concentration ([K+]), aldosterone concentration ([Aldo]), haptoglobin concentration ([Hpto]), and the reticulocyte count, as well as the calculation of relative changes in PV, 3 days before and on 3-consecutive days after a marathon race. By the 2nd day of recovery PV had increased by 16%. Plasma osmolality and [K+] remained constant, whereas [Na+] had decreased slightly 2 days after the competition and [Aldo] tended to be elevated 1 day after the competition. [Hpto] was low before and 1 day after the competition and increased on the following days. Reticulocyte count was unaffected 1 day after the race, but increased by 106% on the 2nd day and was still elevated after 3 days. The causes for higher post-marathon plasma volumes and reticulocyte counts could be in the complex variations in hormonal regulation, which have not yet been sufficiently investigated. PMID- 2759070 TI - The electromyographic DC potential as a correlate of muscular activity. AB - The present experiment was undertaken to demonstrate the effect of muscular force as well as duration of muscular work on the electromyographic (EMG) DC potential. Thirty subjects had to lift different weights by flexing the right forearm within a defined and constant setting for 20 s. The experimental variables were weight (0.5, 1, 2, and 3 kg) and time. The EMG was recorded from the belly of the right biceps brachii muscle in a quasi-unipolar manner and split into an integrated ac channel (IEMG) and a dc channel (DC-EMG). The average IEMG showed a ramp-like shape. Analysis showed a positive relationship for weight (p less than 0.0001) and time (p less than 0.0001) with the IEMG. The average shape of the DC-EMG showed a negative initiation potential, a monotonically increasing negative potential during contraction (contraction potential), a positively peaking off potential and a slow return to baseline (after potential). Analyses of variance demonstrated a significant (p less than 0.001) relationship of weight to the magnitude of the initiation and the termination potential. Regression analyses displayed an inverse relationship of time to the termination (p less than 0.01) and to the resolution potential (p less than 0.001). The DC-EMG showed higher peaks (initiation and termination potential) for heavier weights. For the termination and after potential less positive deflections were found with increasing time (fatigue). A control condition (isometric contraction) indicated that the initiation, contraction, and termination potential of the DC-EMG may also be related to aspects of the movement. Results suggest that the DC-EMG is a more complex measure of muscular activity than the IEMG. PMID- 2759071 TI - Forearm oxygen uptake during maximal forearm dynamic exercise. AB - This study was undertaken in an attempt to determine the maximal oxygen uptake in a small muscle group by measuring directly the oxygen expenditure of the forearm. Five healthy medical students volunteered. The subjects' maximal forearm work capacity was determined on a spring-loaded hand ergometer. Exercise was continued until exhaustion by pain or fatigue. Two weeks later intra-arterial and intravenous catheters were placed in the dominant arm. Blood samples for measurement of oxygen concentration were collected via the catheters. Forearm blood flow was measured by means of the indicator dilution technique. Oxygen uptake was determined according to the Fick principle. The forearm oxygen uptake attained at maximal work loads was a mean of 201 (SD +/- 56) mumol.min-1.100 ml 1. It was impossible at maximal exercise to discern a plateau of the oxygen uptake curve in relation to work output. It is suggested that a plateau in the oxygen uptake curve is not a useful criterion for maximal oxygen uptake in a small muscle group. Skeletal muscle may have an unused capacity for oxygen consumption even at maximal exercise intensity where muscle work cannot be continued due to muscle pain and fatigue. PMID- 2759072 TI - Human body temperature is inversely correlated with body mass. AB - Forty-two women and 18 men of mean age 54 years had their sub-lingual oral temperature measured hourly from 0700 h to 2300 h. Mean oral temperature (averaged over the 17 readings) was inversely correlated with body mass in the group as a whole (r = -0.44, df = 58, p = 0.0003). The women had significantly higher mean oral temperatures than the men, but the inverse relationship between mean oral temperature and body mass was still significant when the data from the women were analyzed separately (r = -0.37, df = 40, p = 0.013). The results suggest that in humans, mean body temperature is inversely related to body mass, irrespective of gender. PMID- 2759073 TI - Renal protein excretion after exercise in man. AB - Thirteen men were submitted to graded exhaustive cycle exercise to determine the kinetics of proteinuria in the recovery period. Venous blood samples were analysed for haematocrit, lactate, creatinine, total protein and albumin for 1 h following exercise. Urine samples were collected during a 3-h recovery period. Total protein, albumin, and creatinine levels were determined for these samples. Total protein and albumin urinary excretion increased to 581 and 315 micrograms min-1, respectively, at the end of the 1st h of recovery as compared to 42 and 15 micrograms.min-1 for resting values. Plasma volume returned to pre-exercise levels between 30 and 60 min after cessation of exercise, while urinary total protein and albumin content still remained above the resting values for the following 2 h. Both post-exercise urinary total protein and albumin excretion followed a logarithmic decline with the same half-life of 54 min, thus requiring about 4 h to regain resting values. The reduction of plasma volume and the degree of dehydration do not seem to be involved in the process. The present study indicates the delayed recovery of protein handling by the kidney, as compared with other biochemical parameters, and provides accurate information on the kinetics of post-exercise proteinuria. PMID- 2759074 TI - Effects of fluid, electrolyte and substrate ingestion on endurance capacity. AB - The availability of carbohydrate (CHO) as a substrate for the exercising muscles is known to be a limiting factor in the performance of prolonged cycle exercise, and provision of exogenous CHO in the form of glucose can increase endurance capacity. The present study examined the effects of ingestion of fluids and of CHO in different forms on exercise performance. Six male volunteers exercised to exhaustion on a cycle ergometer at a workload which required approximately 70% of Vo2max. After one preliminary trial, subjects performed this exercise test on six occasions, one week apart. Immediately before exercise, and at 10-min intervals throughout, subjects ingested 100 ml of one of the following: control (no drink), water, glucose syrup, fructose syrup, glucose-fructose syrup or a dilute glucose electrolyte solution. Each of the syrup solutions contained approximately 36 g CHO per 100 ml; the isotonic glucose-electrolyte solution contained 4 g glucose per 100 ml. A randomised Latin square order of administration of trials was employed. Expired air samples for determination of Vo2, respiratory exchange ratio and rate of CHO oxidation were collected at 15-min intervals. Venous blood samples were obtained before and after exercise. Subjects drinking the isotonic glucose-electrolyte solution exercised longer (90.8 (12.4) min, mean (SEM] than on the control test (70.2 (8.3) min; p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2759075 TI - Electrocardiographic aspects of skin diving. AB - Electrocardiographic (ECG) aspects of skin diving were monitored by means of continuous ECG recording in a pool 15 m deep. Ten regularly trained divers with different levels of experience divid a minimum of three consecutive times, holding their beath, reaching depths of 6 m, 9 m, and 12 or 15 m. The water temperature was 28 degrees C. During the ascending part of these dives, bradycardia was observed in all skin-divers. Minimal heart rate correlated negatively with the diver's experience (number of dives previously performed). In six divers cardiac arrhythmia was observed. Atrial arrhythmias were sometimes isolated occurrences, but more frequently they were multiple. Ventricular arrhythmias tended to be bigeminal. Apparently, forced expiration through the snorkel when surfacing precipitated these rhythmic disorders. PMID- 2759076 TI - Ratings of perceived exertion in individuals with varying fitness levels during walking and running. AB - It was the purpose of this investigation to: 1) compare the ratings of perceived exertion (RPEs) in high and low fit individuals when walking and running at comparable exercise intensities and 2) to determine if ventilation (VE) provides a central signal for RPEs. Nine high fit and nine low fit male subjects completed two exercise bouts on a treadmill, one uphill walking and the other level running. Workloads for each bout were set at 90% of each subject's ventilatory threshold (VT) as determined from a graded exercise test. Oxygen consumption (Vo2), heart rate (HR), and VE were all similar between the walk and run trials for the low fit subjects (P greater than 0.05). HR were found to be significantly greater during the walk trial vs. the run trial (P less than 0.05) for the high fit subjects, whereas, VE was significantly greater during the run trial. Oxygen consumption was similar for the high fit subjects during both trials (P greater than 0.05). During the walk and run trials, central (12.1 +/- 1.6 vs. 11.4 +/- 1.5), local (14.0 +/- 1.3 vs. 13.9 +/- 1.1) and overall (12.8 +/- 1.2 vs. 12.4 +/ 1.4) RPEs were not found to be significantly different for the low fit group (P greater than 0.05). In contrast, during the walk vs. the run trial there was a significant increase in central (10.7 +/- 2.0 vs. 9.2 +/- 1.9), local (11.5 +/- 2.0 vs. 9.8 +/- 1.8) and overall (11.2 +/- 2.4 vs. 9.6 +/- 2.3) RPEs for the high fit group (P less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2759077 TI - Fat energy use and plasma lipid changes associated with exercise intensity and temperature. AB - The effect of 60 min of exercise at two intensities (50 and 60% VO2max) and temperatures (0 and 22 degrees C) on changes (delta) in plasma lipids [triglycerides (TG), glycerol (GLY), total cholesterol (TC), and HDL-cholesterol (HDL-C)] was examined. Subjects were 10 men aged 27 +/- 7 years (VO2max = 3.81 +/ 0.45 1 min, % fat = 12.2% +/- 7.1%). VO2 and respiratory exchange ratio results indicated that total energy and fat energy use were similar at the two temperatures. Changes in plasma volume (%delta PV) were different (P less than 0.05) at the two temperatures (22 degrees C: -2.3% vs 0 degrees C: 1.1%). Combining the data at each temperature revealed that the increases in concentrations were greater (P less than 0.05) at 22 degrees C (delta TG = 0.22, delta GLY = 0.20, delta TC = 0.14, delta HDL-C = 0.05 mmol l-1) vs 0 degrees C (delta TG = 0.10, delta GLY = 0.12, delta TC = 0.05, delta HDL-C = 0.02 mmol l 1). Combining the data for each intensity revealed that the increases in concentration were greater (P less than 0.05) at 60% VO2max for delta TG and delta HDL-C. The 60% VO2max/22 degrees C bout produced greater changes (P less than 0.05) than all other bouts for delta TC and delta HDL-C (0.21 and 0.08 mmol l-1, respectively). Only delta TG and delta GLY were greater at 22 degrees C when adjusted for %delta PV. These metabolic and plasma lipid results indicate that cold exposure does not act synergistically with exercise to further stimulate fat metabolism. PMID- 2759078 TI - Effects of chlorpromazine on hypothalamic aminergic neurons and stress responses in moderate cold. AB - Guinea-pigs were treated with chlorpromazine or 0.9% NaCl and exposed to +4 degrees C or +23 degrees C for 2 h. Hypothalamic noradrenaline (NA), dopamine (DA), 5-hydroxytryptamine (5-HT), 3-methoxy-4-hydroxyphenylethylene-glycol (MHPG), homovanillinic acid (HVA) and 5-hydroxyindoleacetic acid (5-HIAA) were determined by high-performance liquid chromatography. Serum and urinary catecholamines, muscle and liver glycogen and blood glucose were also measured. Chlorpromazine caused deep hypothermia at this moderately cold temperature and slight hypothermia at room temperature. Cold increased the activity of noradrenergic and serotonergic neurons, as indicated by the increase in hypothalamic MHPG and 5-HIAA and also the MHPG:NA and 5-HIAA:5-HT ratios. A tendency towards drug-induced inhibition of hypothalamic serotonergic neurons was seen, although this was not significant. A drug-induced inhibition of noradrenergic neurons could not be ruled out. Increased drug-induced turnover of DA was observed in the cold, and a tendency in the same direction was seen at room temperature. Excretion of DA into the urine was induced by chlorpromazine. The hypothermic guinea-pigs had low serum catecholamines, indicating diminished sympathetic activity, but high urinary catechols, a sign of cold stress. PMID- 2759079 TI - Muscular sound and force relationship during isometric contraction in man. AB - The contracting muscle generates a low frequency sound detectable at the belly surface, ranging from 11 to 40 Hz. To study the relationship between the muscular sound and the intensity of the contraction a sound myogram (SMG) was recorded by a contact sensor from the biceps brachii of seven young healthy males performing 4-s isometric contractions from 10% to 100% of the maximal voluntary contraction (MVC), in 10% steps. Simultaneously, the electromyogram (EMG) was recorded as an index of muscle activity. SMG and EMG were integrated by conventional methods (iSMG and iEMG). The relationship between iSMG and iEMG vs MVC% is described by parabolic functions up to 80% and 100% MVC respectively. Beyond 80% MVC the iSMG decreases, being about half of its maximal value at 100% MVC. Our results indicate that the motor unit recruitment and firing rate affect the iSMG and iEMG in the same way up to 80% MVC. From 80% to 100% MVC the high motor units' discharge rate and the muscular stiffness together limit the pressure waves generated by the dimensional changes of the active fibres. The muscular sound seems to reflect the intramuscular visco-elastic characteristics and the motor unit activation pattern of a contracting muscle. PMID- 2759080 TI - Effect of exercise duration on lactate kinetics after short muscular exercise. AB - Arterial blood lactate concentrations were measured in six normal males before, during and after 3- and 6-min bicycle exercises performed at three different work rates. The lactate recovery curves were fitted to a bi-exponential time function consisting of a rapidly increasing and a slowly decreasing component, which supplied an accurate representation of the changes in lactate concentration. Variations in the parameters of this mathematical model have been studied as a function of the duration of exercise and of the work rate, showing a clear dependence on exercise duration such that increasing exercise length decreases the velocity constants of the fitted curves. In terms of the functional meaning which can be given to these constants, this result indicates that extending exercise duration from 3 to 6 min reduces the ability of the whole body to exchange and remove lactate. This effect did not qualitatively modify the one already described, which is due to increased work rates, but it shifted the ability to exchange and remove lactate towards lower values. The main conclusion of the study is that lactate kinetic data vary as a function of time during exercise. This inference must be accounted for in the interpretation of lactate data obtained during muscular exercise. PMID- 2759081 TI - Haemodynamic and hormonal responses to heat exposure in a Finnish sauna bath. AB - Eight healthy young men were studied during three periods of heat exposure in a Finnish sauna bath: at 80 degrees C dry bulb (80 D) and 100 degrees C dry bulb (100 D) temperatures until subjective discomfort, and in 80 degrees C dry heat, becoming humid (80 DH) until subjective exhaustion. Oral temperature increased 1.1 degrees C at 80 D, 1.9 degrees C at 100 D and 3.2 degrees C at 80 DH. Heart rate increased about 60% at 80 D, 90% at 100 D and 130% at 80 DH. Plasma noradrenaline increased about 100% at 80 D, 160% at 100 D and 310% at 80 DH. Adrenaline did not change. Plasma prolactin increased 2-fold at 80 D, 7-fold at 100 D and 10-fold at 80 DH. Blood concentrations of the beta-endorphin immunoreactivity at 100 D, adrenocorticotropic hormone (ACTH) at 100 D and 80 DH, growth hormone at 100 D and testosterone at 80 DH also increased, but cortisol at 80 D and 100 D decreased. The plasma prostaglandin E2 and serum thromboxane B2 levels did not change. Patterns related to heat exposure were observed for heart rate, plasma noradrenaline, ACTH and prolactin in the three study periods. PMID- 2759082 TI - Blood pressure and plasma catecholamine responses to various challenges during exercise-recovery in man. AB - The purpose of this study was to assess the effects of a 2 h cycle exercise (50% VO2max) on heart rate (HR) and blood pressure (BP), and on plasma epinephrine (E) and norepinephrine (NE) concentrations, during the recovery period in seven normotensive subjects. Measurements were made at rest in supine (20 min) and standing (10 min) positions, during isometric exercise (hand-grip, 3 min, 25% maximal voluntary, contraction), in response to a mild psychosocial challenge (Stroop conflicting color word task) and during a 5-min period of light exercise (42 +/- 3% VO2max). Data were compared to measurements taken on another occasion under similar experimental conditions, without a previous exercise bout (control). The results showed HR to be slightly elevated in all conditions following the exercise bout. However, diastolic and systolic BP during the recovery period following exercise were not significantly different from the values observed in the control situation. Plasma NE concentrations in supine position and in response to the various physiological and/or psychosocial challenges were similar in the control situation and during the recovery period following exercise. On the other hand plasma E (nmol.1-1) was about 50% lower at rest (0.11 +/- 0.03 vs 0.23 +/- 0.04) as well as in response to hand-grip (0.21 +/- 0.04 vs 0.41 +/- 0.20) and the Stroop-test (0.21 +/- 0.05 vs 0.41 +/- 0.15) following the exercise bout.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2759083 TI - The increased oxygen uptake upon immersion. The raised external pressure could be a causative factor. AB - The principal cause of the immediate transient elevation in ventilation (VE, L.min-1) and oxygen uptake (VO2, L.min-1), when a human subject is immersed in cold water is considered to be the stimulation of cutaneous cold receptors. The present study demonstrates that the initial VE and VO2 responses are comprised of a thermogenic and a hydrostatic component. The peak values in VE reached (mean +/ SD) 66.8 +/- 22.3, 53.9 +/- 38.1, 32.2 +/- 15.4, 22.5 +/- 3.6, 19.5 +/- 4.6 L.min-1 during the first minute of immersion in 10 degrees, 15 degrees, 20 degrees, 28 degrees and 40 degrees C water, respectively. Similarly, peaks (mean +/- SD) in VO2 of 1.22 +/- 0.25, 1.01 +/- 0.32, 0.98 +/- 0.39, 0.81 +/- 0.09, and 0.78 +/- 0.26 L.O2.min-1, were reached when subjects were immersed in 10 degrees, 15 degrees, 20 degrees, 28 degrees, and 40 degrees C water. It is concluded that the observed increases in VO2 during the first minute of immersion are partly due to the increased hydrostatic pressure causing a shift of venous blood towards the thoracic region, and a transient increase in the uptake of oxygen into the blood. PMID- 2759084 TI - Purification and characterization of spermidine N1-acetyltransferase from chick duodenum. AB - We have reported that spermidine N1-acetyltransferase has a larger role than ornithine decarboxylase in putrescine synthesis in chick duodenum induced by 1 alpha,25-dihydroxycholecalciferol (calcitriol) [Shinki, T., Kadofuku, T., Sato, T. and Suda, T. (1986) J. Biol. Chem. 261, 11712-11716]. In the present study, spermidine N1-acetyltransferase was purified from the duodenal cytosol of calcitriol-treated chicks to homogeneity judged by SDS/polyacrylamide gel electrophoresis. The purified enzyme converted spermidine only to N1-acetyl spermidine. The apparent molecular mass of the purified spermidine N1 acetyltransferase was found to be 36 kDa by gel filtration on Sephacryl S-200 and 18 kDa by SDS/polyacrylamide gel electrophoresis. When duodenal crude 105,000 x g extracts were directly applied to a Sephacryl S-200 column without prior purification, three peaks with spermidine N1-acetyltransferase activity appeared. The first peak was in the void volume, the second peak was in the fraction corresponding to an apparent molecular mass of 70 kDa, and the third peak was in the fraction corresponding to 36 kDa. These results suggest that spermidine N1 acetyltransferase exists as a dimer of the 18 kDa subunits and is stabilized in (a) form(s) bound to other components or proteins in intact cells. PMID- 2759085 TI - Effect of DNA conformation on the transcription of mitochondrial DNA. AB - The importance of the conformation of the DNA template for in vitro transcription experiments was investigated using a mitochondrial RNA polymerase preparation from Xenopus laevis oocyte mitochondria. A premature termination transcription assay has been devised and the levels of the formation of transcriptional complexes have been identified using agarose gel electrophoresis. It was found that accurate initiation of transcription from in vivo promoter sequences was enhanced by supercoiling and that the two mitochondrial DNA-binding proteins, previously characterized by us, inhibited the transcription of DNA as gauged by these assays. PMID- 2759087 TI - Direct and energy-transfer photolabelling of brain muscarinic acetylcholine receptors. AB - Efficient photolabelling of muscarinic acetylcholine receptors was obtained using either two aryldiazonium salts or an azido derivative. These probes did not discriminate between muscarinic binding subtypes or affinity states and became irreversibly bound to the receptor sites, in an entirely atropine-protectable manner, upon ultraviolet irradiation. The extent of labelling was dependent both on probe concentration and on time of irradiation and reached up to 80% of the receptor population, under optimal alkylating conditions. In contrast to the azido derivative, both diazonium salts behave as potent irreversible labels of muscarinic receptors, provided energy-transfer photolabelling conditions were followed. Such an indirect activation of diazonium ligands, through an energy transfer from photoexcited tryptophan residues, has been previously found to increase the site-specificity and the rate of labelling of other acetylcholine binding proteins. Analogies in the photolabelling process of acetylcholinesterase or of nicotinic and muscarinic receptors by the two diazonium salts are discussed. Altogether, these findings suggest that these new probes may be promising tools to investigate the location and the topography of the agonist antagonist binding domain on purified muscarinic receptors, through amino acid and/or sequence analyses of radioactive, photolabelled residues. PMID- 2759086 TI - Structural changes in oxidised low-density lipoproteins and of the effect of the anti-atherosclerotic drug probucol observed by synchrotron X-ray and neutron solution scattering. AB - The atherosclerotic properties of low-density lipoproteins (LDL) are thought to be strongly enhanced by oxidation. The lipid-lowering drug probucol reduces the susceptibility of LDL to oxidation. Synchrotron X-ray and high-flux neutron solution scattering curves were used to characterise the structural properties of human LDL, before and after modification by oxidation with Cu2+ and the addition of probucol, in order to evaluate these techniques. Analyses based on Guinier plots, simple two-shell spherical modelling, and the use of cubic splines and indirect transformation show that a 20-h incubation with Cu2+ ions (but not 6 h) causes some of the LDL to associate to form larger aggregated particles. Gel electrophoresis on Cu2+ -oxidised LDL shows a concomitant degradation of the apolipoprotein B-100 as well as the formation of high molecular mass forms. These experiments indicate that the apoprotein B-100 structure has been significantly disrupted by oxidation. The addition of probucol to LDL causes an increase in the polydispersity of LDL, as evidenced by small changes in the Guinier curves and some weakening of the minima in the X-ray scattering curves. No changes in the quasispherical shape of LDL are observed and gel electrophoresis indicates no changes. It is possible that probucol may exert its effect by increasing the range of sizes of LDL and that the lipid-lowering effect of probucol in vivo might be caused by the preferential catabolism of the higher molecular mass forms of LDL thus created. PMID- 2759088 TI - Kinetics of bilirubin oxidation catalysed by bilirubin oxidase in a water-in-oil microemulsion system. AB - 1. Bilirubin oxidase can catalyse the oxidation of its primary substrate, bilirubin, in a water-in-oil microemulsion, which consists of discrete nanometer diameter water droplets dispersed in a continuous water-immiscible oil medium. The droplets are stabilized by a monolayer of the surfactant, cetyltrimethylammonium bromide present at the oil/water interface. 2. Spectroscopic evidence is presented to show that bilirubin solubilized in this system is located mainly in the surfactant layer, in a form accessible to the enzyme molecule. 3. Studies are presented on the enzyme-catalysed rate of bilirubin oxidation in this system, as a function of temperature, pH, water content, and substrate and enzyme concentrations. 4. The main conclusions are that the enzyme can efficiently oxidise bilirubin in microemulsions of low water content. The reaction obeys Michaelis-Menten kinetics. The optimal pH for the catalysis is 8.0. The efficiency of catalysis decreases sharply as the water content increases. PMID- 2759089 TI - Cholesterol efflux from and high-density-lipoproteins binding to cultured bovine vascular endothelial cells are higher than with vascular smooth muscle cells. AB - Cholesterol metabolism was studied and compared in confluent cultures of adult bovine aortic endothelial and bovine aortic smooth muscle cells which were grown under similar conditions. The total cholesterol content/mg protein was only slightly higher in smooth muscle cells than in endothelial cells and upon exposure to [3H]cholesterol the maximal specific activity/mg protein obtained was similar in both cell types. Most (98%) of the incorporated [3H]cholesterol remained in the form of free cholesterol in both cell types, and provided a system for the study of cholesterol efflux. The role of high-density lipoproteins (HDL) and human serum in cholesterol influx and efflux, in both endothelial and smooth muscle cells, was studied. Net cholesterol transport in the cultures was calculated and net efflux was observed in both cell types. This was higher in endothelial than in smooth muscle cells and HDL was more efficient than human serum in promoting net cholesterol efflux. During the influx experiments, no conversion of [3H]cholesterol to [3H]cholesteryl ester was observed either in the cell layer or in the incubation medium. On the other hand, during efflux experiments when HDL but not human serum was the acceptor, some (about 6%) conversion of [3H]cholesterol to [3H]cholesteryl ester occurred in the incubation medium. 125I-HDL3 binding to endothelial and smooth muscle cells was studied and demonstrated saturation at a concentration of about 100 micrograms protein/ml for both cell types. However, endothelial cells bound about six times more 125I-HDL3 than smooth muscle cells. These studies indicate that vascular endothelial cells are more protected against cholesterol accumulation than vascular smooth muscle cells. The greater ability of endothelial cells to bind HDL complexes when compared with smooth muscle cells, and thereby to be more susceptible to HDL induced cholesterol efflux, may add a new mechanism through which endothelial cells protect the blood vessel from cholesterol accumulation. PMID- 2759090 TI - Intestinal-like alkaline phosphatase expressed in normal human adult kidney. AB - Human adult kidney was found to contain not only the 'tissue-unspecific alkaline phosphatase' but also another alkaline phosphatase isozyme. By use of monoclonal antibodies specific for human intestinal alkaline phosphatase, this kidney isozyme was purified to homogeneity by immunoaffinity chromatography. The structural and kinetic properties of the enzyme were compared with those of the other alkaline phosphatase isozymes expressed in normal human tissues, i.e. the placental, intestinal, meconial (fetal), liver and kidney isozymes. The new kidney isozyme was clearly different from both the tissue-unspecific and the adult intestinal alkaline phosphatase as regards isoelectric point, molecular mass and peptide maps after cyanogen bromide cleavage, but it was found to be identical to the meconial alkaline phosphatase. The results demonstrate simultaneous expression of two alkaline phosphatase isozymes in human kidney, one of which is normally related only to the fetal intestine. PMID- 2759091 TI - Structural characterization of the lipid A component of Bacteroides fragilis strain NCTC 9343 lipopolysaccharide. AB - The chemical structure of Bacteroides fragilis NCTC 9343 lipid A was characterized by using conventional chemical procedures, methylation analysis, and laser desorption mass spectrometry. It was found that B. fragilis lipid A consists of a beta-D-glucosaminyl-(1-6)-D-glucosaminyl-1-O-phosphate backbone whose hydroxyl groups in positions 4, 4' and 6' are free, the latter serving as the attachment site for the polysaccharide component in lipopolysaccharide. This backbone molecule carries up to of five molecules of ester- and amide-bound long chain non-hydroxylated and (R)-3-hydroxy fatty acids. With regard to the distribution on the fatty acids on the lipid A backbone, a considerable heterogeneity was revealed by laser desorption mass spectrometry. Despite this heterogeneity, a major species of B. fragilis lipid A could be defined in which the hydroxyl group at position 3' of the distal GlcN carries (R)-3 hydroxyhexadecanoic acid and the hydroxyl group at position 3 of the reducing GlcN is acylated by (R)-3-hydroxypentadecanoic acid. The amino group of the distal GlcN residue carries (R)-3-(13-methyltetradecanoyloxy)-15 methylhexadecanoic acid and that of the reducing GlcN group (R)-3 hydroxyhexadecanoic acid. The absence of ester-bound phosphate and ester-linked 3 acyloxyacyl groups, the presence of not more than five acyl residues and the predominance of fatty acids possessing 15-17 carbon atoms are unique features of B. fragilis lipid A which differentiate it from enterobacterial and other lipids A and which are likely to be related to its low endotoxic activity. PMID- 2759092 TI - The visualization by affinity electrophoresis of a specific association between the consecutive citric acid cycle enzymes fumarase and malate dehydrogenase. AB - Evidence is growing that the citric acid cycle, like many other metabolic pathways, might exist in vivo as a more or less tightly organized multi-enzyme cluster. The term 'metabolon' [Robinson, J. B. & Srere, P. A. (1985) J. Biol. Chem. 260, 10800-10805] was recently introduced to describe such a complex of sequential metabolic enzymes. We adopted the technique of affinity electrophoresis for the study of interactions between the cycle enzymes fumarase and malate dehydrogenase. This approach offers several advantages over our previously described affinity chromatographic technique [Beeckmans, S. & Kanarek, L. (1981) Eur. J. Biochem. 117, 527-535], one of which is the fact that the interaction can be directly visualized. The observed association is specific since both metabolically unrelated proteins and the cytoplasmic isoenzyme of malate dehydrogenase do not interact with fumarase. Several metabolites (citrate, isocitrate, 2-oxoglutarate, succinate, fumarate, malate, oxaloacetate, Pi, AMP, ADP, NAD+, NADH) were found not to affect the association between fumarase and mitochondrial malate dehydrogenase. Both ATP, Mg2+ -ATP and GTP disrupt the association when they are present at 1 mM concentrations. Lower non-physiological ATP concentrations do not, however, disturb the interaction. The presence of 1 mM ADP was found to abolish the disrupting effect of 1 mM ATP. The latter findings are suggestive of an interruption of the citric acid cycle at the level of fumarase under conditions of high energy load (i.e. high ATP/ADP ratios). PMID- 2759093 TI - The identification of lysosomal ganglioside sialidase in human cells. AB - In this report we present evidence for the existence of a lysosomal ganglioside sialidase. The sialidase activity was solubilized by sonication and stimulated by cholate. The absence of ganglioside sialidase activity in sialidosis patients indicates that lysosomal sialidase is active towards gangliosides and glycoproteins. The plasma membranes were associated with two types of ganglioside sialidase activities, one was enhanced by cholate while the other was partially inhibited by this detergent. PMID- 2759094 TI - Human H1 histones: conserved and varied sequence elements in two H1 subtype genes. AB - The genes coding for two different human H1 histones were isolated, and the primary structures were deduced from the nucleotide sequences. The genes differ from each other and from any other vertebrate H1 structure described until now. The differences occur mainly within the N- and C-terminal H1 domains, whereas the central part of the protein is highly conserved. Within the flanking domains, however, some sequence elements are shared by different H1 subtype genes. An octapeptide, which has been described in C-terminal domains of most H1 histones, is found in both H1 subtypes. The nucleotide sequences of the flanking portions of both H1 genes show conserved motifs at established regulatory sites, but otherwise these 3' and 5' noncoding sequences of both genes differ substantially. PMID- 2759096 TI - Biosynthesis of intestinal microvillar proteins. Low temperature arrests both processing and intracellular transport. AB - The effect of culture at 20 degrees C on biosynthesis of microvillar enzymes was studied in pig small intestinal mucosal explants. At this temperature, aminopeptidase N (EC 3.4.11.2) and sucrase-isomaltase (EC 3.2.1.48-10) both accumulated intracellularly, predominantly in their transient, high mannose glycosylated form characteristic of the newly synthesized enzymes prior to the molecular processing taking place in the Golgi complex. The general morphology of the enterocyte was unaffected by culture at low temperature except for the Golgi complex where the cisternae appeared condensed and surrounded by numerous vesicles of 50 to 55 nm. Both molecular processing and microvillar expression could be restored by shifting the temperature to 37 degrees C. Culture at low temperature did not induce any missorting of newly synthesized aminopeptidase N, but both molecular processing and microvillar expression only resumed at a slow rate after increasing the temperature, suggesting that reorganization of the Golgi complex is a time-requiring process. PMID- 2759095 TI - Effect of protein synthesis inhibitors on formation and degradation of tight junctions in HT 29 adenocarcinoma cells. AB - The human colon adenocarcinoma cell line HT 29 grows in DMEM virtually without tight junctions (TJ). Fascia occludens type TJ can be induced in these cells by treatment with a variety of proteases or with hypertonic ammonium sulfate solution. The induced formation of TJ is not affected by pretreatment of the cells with cycloheximide or puromycin. The induced TJ are almost completely degraded within 2 h at 37 degrees C both in the absence and presence of the inhibitors studied. With ammonium sulfate as the initial inducing agent, it was possible to induce a second round of TJ formation as early as 2 h after the initial treatment, i.e., immediately after the degradation of the TJ formed in the first round. The same result was obtained in cells treated with cycloheximide. Similar results were also obtained when TJ were initially induced by a very mild trypsin treatment. However, if the initial induction involved a more rigorous proteolytic treatment, the cells needed a recovery period of several h before TJ could be induced again. Under these conditions, recovery from the protease treatment was impaired by the addition of protein synthesis inhibitors at any time prior to complete recovery. It follows that proteolytic treatment of cells not only induces TJ formation but also destroys cell surface proteins which must be available for the formation of TJ strands. It seems possible that these proteins mediate cell adhesion events which may be a prerequisite for, but not a part of the actual TJ formation. PMID- 2759097 TI - Bacterium release into host cells of nitrogen-fixing soybean nodules: the symbiosome membrane comes from three sources. AB - The release process of bacteria into the cytoplasm of soybean nodule cells has been studied, and three functional zones of the infection thread are delineated. Zone 1 is found over the greatest length of very long infection threads. Zone 2 is a short region where membrane mobilization by exocytosis of endoplasmic reticulum (ER) into the infection-thread membrane takes place; the result is that much new membrane and wall degradation enzymes can be provided. In addition, de novo membrane formation takes place inside the infection thread in apposition to the bacterial outer membrane. Zone 3 is the endocytic region where both bacteria and infection-thread wall degradation vesicles are released into the host cytoplasm and constitute a second product of endocytosis at the infection thread tip. Evidence is presented indicating that the symbiosome membrane, even at its time of origin, is composed of membrane from three sources: the host infection thread membrane, ER, and de novo synthesis; the membrane formation that is so large for these purposes is probably carried out both from the ER directly and also through the Golgi-apparatus synthesis. Evidence is also given that the bacteria have lost their exopolysaccharide coatings before release into symbiosomes. PMID- 2759098 TI - Induction of random microtubule polymerization in cold and drug-treated PtK1 cells following hyperosmotic shock treatment. AB - The effects of hypertonic sucrose on spindle and interphase microtubule (MT) arrays of PtK1 cells were investigated by incubating cells in complete culture medium at 4 degrees or 37 degrees C, with or without hypertonic sucrose, nocodazole or vinblastine (VLB). Results from anti-tubulin immunofluorescence showed that sucrose-induced alterations of spindle morphology seen at 37 degrees C did not occur at cold temperatures, but cold-induced MT loss was diminished. Application of warm hypertonic sucrose following depolymerization of MTs by nocodazole or cold resulted in the formation of a "feltwork" of randomly oriented, short MTs throughout the cytoplasm. These results, and those obtained substituting VLB for nocodazole, suggest that the effects of sucrose depend on the cytoplasmic concentration of soluble tubulin and support the hypothesis that osmotic factors are involved in effects of hypertonic sucrose on MT organization. PMID- 2759099 TI - Chronic iron overload inhibits protein secretion by adult rat hepatocytes maintained in long-term primary culture. AB - Short-term pure cultures and long-term cocultures of adult rat hepatocytes with rat liver epithelial cells, presumably derived from primitive biliary cells, were used to define in vitro models of iron overloaded hepatocytes in order to understand the molecular mechanism responsible for liver damage occurring in patients with hemochromatosis. In vitro iron overload was obtained by daily addition of ferric nitrilotriacetate to the culture medium. A concentration of 20 microM ferric salt induced hepatocyte iron overload with minimal cytotoxicity as evaluated by cell viability, morphological changes of treated cells and cytosolic enzyme leakage into the culture medium. The effects of iron overload on protein biosynthesis and secretion were studied in both short-term pure cultures and long term cocultures of hepatocytes. The amounts of intracellular and newly synthesized proteins were never modified by the iron treatment. Furthermore, neither the relative amounts of transferrin and albumin mRNAs nor their translational products were altered by iron overload. Moreover, no change in the transferrin isomeric forms were observed in treated cells. In contrast, a prolonged exposure of cocultured hepatocytes to 20 microM ferric salt led to a significant decrease in the amount of proteins secreted in the medium. This decrease included the two major secreted proteins, namely albumin and transferrin, and probably all other secreted proteins. These results demonstrate that iron loading alters neither the total nor the liver specific protein synthesis activity of cultured hepatocytes. They suggest that chronic overload may impede the protein secretion process. PMID- 2759100 TI - Changes in the content and distribution of sialic acid on the basal surface of isoproterenol-stimulated mouse parotid acinar cells. AB - The presence, distribution and content of sialic acid on the cell surface in collagenase-dispersed acini obtained both from unstimulated as well as from in vivo isoproterenol-stimulated mouse parotid have been studied. To this end, sialic acid residues have been qualitatively and quantitatively analyzed by 1) cytochemical labeling by wheat germ agglutinin (WGA), 2) biochemical procedures and 3) isotopic labeling by [3H]WGA (WGA-N-[acetyl-3H]-acetylated). Electron microscopy revealed striking differences in the binding of ferritin-conjugated WGA at the basal, lateral and apical cell surface. Unstimulated acinar cells showed a heavy patch-distributed binding of ferritin-conjugate on the basal cell surface while it was homogeneous and very scarce on the lateral one and absent on the apical cell surface. During the first few hours after isoproterenol, the WGA binding sites at the basal cell surface became homogeneously distributed. This fact was coincident with a loss of about 60 to 70% both in the content of neuraminidase-releasable sialic acid and in the binding of [3H]WGA to the acinar surface. These findings suggest that the release of sialic acid as free residues, which has been involved in the isoproterenol-triggered cell proliferation inducing mechanism in the mouse parotid, would occur at the glycocalyx corresponding to the basal plasma membrane of the acinar cells. PMID- 2759101 TI - Organization of the vimentin system and its spatial relationship to the microtubule complex during the division of mammalian cells growing attached and in suspension. AB - We have used immunofluorescence staining with antibodies that detect vimentin, tubulin and the centrioles to compare the distributions of these respective antigens during the division of several suspension and attached cultured cells. Our observations demonstrate that 1) from distinct interphase organizations in suspension and attached cells, the vimentin system consistently rearranges with the onset of mitosis into a filamentous cage-like structure enclosing the spindle, 2) during cytokinesis, the polar centrosomes relocalize near the midbody in suspension cells while they remain at the pole opposite to it in attached cells, and 3) the vimentin cage is disintegrated and aggregated on each side of the midbody during cytokinesis in lymphoid cells but may be retained in other suspension cells. PMID- 2759102 TI - Cytoplasmic membrane systems involved in bacterium release into soybean nodule cells as studied with two Bradyrhizobium japonicum mutant strains. AB - Two Bradyrhizobium japonicum, Tn5-induced, mutant strains, ML126 and ML150, were studied. Both induce host cell division to form normal-sized nodules that do not fix nitrogen and whose cells have very few bacteroids (Bar-). Early-infection (15 days post infection) cells have much endoplasmic reticulum (ER), numerous Golgi bodies, and large vacuoles that are probably secondary lysosomes. Later the cytoplasm of the host cells of both are dominated by hundreds of vesicles containing only finely fibrous material and that appear to originate by the degradation of the cell walls of the infection threads; they have been named "infection-thread wall degradation vesicles" (IWDV). Phosphotungstic acid-chromic acid (PACA) staining of thin sections shows that IWDV membranes and the plasma membranes of both the cells and infection threads usually stain quite intensely, while the membranes of other cell organelles do not. The membranes of the few symbiosomes present in the mutants also stain with PACA. This evidence suggests that largely the host-cell plasma membrane gives rise to both the vesicle and symbiosome membranes in these mutants. In cells induced by both mutants, ER appears to be deficient, a finding suggesting that an ER-synthesis signal is involved in the normal release process, that ER synthesis is prerequisite to a normal volume of release, and that insufficient ER can impair symbiosome formation. In the mutant-induced infections, normal lysosomes develop and engulf both symbiosomes and cytoplasmic vesicles, but the retardation of this activity is the probable cause of the cytoplasm becoming overloaded with vesicles. PMID- 2759103 TI - Uptake and utilization of small organic molecules by Paramecium tetraurelia. AB - Several methods for the metabolic radiolabeling of proteins in axenically grown Paramecium tetraurelia were examined. Less than 5% of the initial radioactivity from exogenously supplied radiolabeled compounds was incorporated into cellular proteins under all conditions tested. The relatively low uptake rates of 14C labeled amino acids and other small organic compounds by the cells and the subsequent metabolism of these molecules producing radioactive CO2 under conditions of rapid culture growth suggested that the transport of most or all of these compounds may be limited to bulk transport in solution and possibly accounted for by the volume transported by food vacuoles. Active transport of these molecules against a concentration gradient via carrier-mediated mechanisms was not apparent. The low rate of amino acid uptake explains the inefficient in vivo radiolabeling of cellular proteins by radioactive amino acids. PMID- 2759104 TI - Catheter technique for ablation of accessory atrioventricular pathway: long-term results. AB - Catheter ablation of an accessory atrioventricular pathway was attempted in six patients with recurrent tachyarrhythmias resistant to medication (four to five trials). Localization of the accessory pathway was performed by potential recordings with an electrode catheter from the region of the tricuspid and mitral valve rings during orthodromic supraventricular tachycardia (n = 4), during sinus rhythm (n = 1), and during ventricular pacing (n = 1). Using this mapping technique, the site of earliest atrial or ventricular activation through the accessory pathway was localized in the anterior septal (n = 2), right free wall (n = 2), posterior septal (n = 2), or left free wall (n = 1) region of the atrioventricular valve rings. The shortest ventriculo-atrial (VA) and atrio ventricular (AV) intervals measured in the local electrograms ranged from VA = 45 70 ms, and AV = 45-65 ms, respectively. The accessory pathway responsible for the arrhythmia demonstrated exclusive retrograde (n = 4) or bidirectional (n = 2) conduction properties. A total of 13 direct-current transcatheter shocks (one to three per patient) of 20-200 J each were aimed at the site of the accessory pathway. Thereby, conduction through the accessory pathway was abolished (n = 5) or modified (n = 1) and the patients were freed from their syncope and disabling arrhythmias (follow-up: 4.6-5.9 years). The procedure was well tolerated without complications. Mapping-guided catheter ablation of accessory pathways is an effective treatment of refractory supraventricular tachyarrhythmias in selected patients. PMID- 2759105 TI - Effect of paced cycle length on sinus node effective refractory period before and after autonomic blockade in patients with sick sinus syndrome. AB - Effect of basic paced cycle length on sinus node effective refractory period was studied in 22 patients with sick sinus syndrome. Sinus node effective refractory period was measured using three different paced cycle lengths before and after pharmacologic autonomic blockade. Sinus node effective refractory period could be measured at one cycle length, at least, in 59% of the patients before blockade, however, it could be measured at two or more cycle lengths in only 18% of patients because of the chaotic response of sinus node against premature stimuli. It could be measured after pharmacologic autonomic blockade in 68% of the patients at two or more paced cycle lengths. On the other hand, the rest of the patients showed no measurable sinus node effective refractory period at any cycle length, for their sinus node effective refractory periods were shorter than their right atrial effective refractory periods. The comparison of sinus node effective refractory period at different paced cycle lengths was unsuccessful before pharmacologic autonomic blockade, while the refractory period was significantly prolonged as cycle length was shortened after blockade. We concluded that (1) sinus node effective refractory period in humans is prolonged as paced cycle length decreases, (2) the autonomic reflex is the major disturbing factor in measuring sinus node effective refractory period, and pharmacologic autonomic blockade can be usefully employed to eliminate a chaotic sinus nodal response, (3) when sinus node effective refractory period is shorter than right atrial effective refractory period, a shorter paced cycle length should be used for definite measurement of the former. PMID- 2759106 TI - Double balloon aortic valvotomy for rheumatic aortic stenosis; in vivo studies. AB - The manner in which aortic valve area increases after in vitro double balloon aortic valvotomy for severe rheumatic aortic stenosis has not been defined. We selected ten intact aortic valves excised at cardiac surgery from patients (mean age 45 +/- 10 years) with severe rheumatic aortic stenosis, with a valve area less than or equal to 1 cm2. In vitro double balloon aortic valvotomy was attempted on each valve using two Meditech 15 mm diameter balloon catheters. The balloon catheters were simultaneously inflated to 4 atm pressure for 10 s. Before and after balloon valvotomy the valve area was calculated with a conical sizer, and radiological studies were also performed to study the effect of balloon valvotomy on calcified aortic commissures. The mean valve area increased from 0.7 +/- 0.2 (mean +/- SD) to 1.1 +/- 0.2 cm2 (P less than or equal to 0.001) after balloon valvotomy, with a mean total commissural splitting for each aortic valve of 9.3 +/- 6 mm. Overall, 63% of the aortic commissures were split, splitting occurring in 81% of non-calcified commissures and 43% of calcified commissures. There was no leaflet tear or calcium fracture either macroscopically or radiologically. Commissural splitting of rheumatic aortic stenosis is the manner in which valve area is increased after double balloon aortic valvotomy. The inflated balloon catheters split not only non-calcified, but also calcified arotic commissures. The adequate commissural splitting achieved and consequent 57% increase in valve area indicate that the double balloon aortic valvotomy technique may become a palliative therapeutic procedure for patients with severe rheumatic aortic stenosis. PMID- 2759107 TI - Thoracic epidural anaesthesia in patients with unstable angina pectoris. AB - The effect of high thoracic epidural anaesthesia with intermittent epidural bolus injections of bupivacaine (2.5 or 5 mg ml-1) was studied in 28 patients with unstable angina pectoris. The majority of the patients had a history of previous acute myocardial infarction(s) and/or angina pectoris and severe coronary artery disease. All patients were treated with nitroglycerin infusion for greater than 24 h and were included in the study if they had chest pain, not caused by acute myocardial infarction, at bed rest or recurrent anginal pain at rest greater than 2 days after infarction. 4.4 +/- 0.3 ml of bupivacaine induced a blockade of the upper seven sympathetic segments (Th1-7) for 98 +/- 9 min. Heart rate decreased significantly from 70 +/- 3 to 64 +/- 3 beats min-1 while blood pressure was unaffected by thoracic epidural anaesthesia. In 27 patients (96%) the anaesthesia induced complete analgesia. Nitroglycerin infusion was discontinued definitely within 3 h in 26 patients (93%) and pain was thereafter controlled by means of thoracic epidural anaesthesia as the sole treatment in 23 patients (82%) and as the major treatment in 25 patients (89%). Twenty-one patients (75%) were fully mobilized and stabilized. Treatment with thoracic epidural anaesthesia lasted for 6.0 +/- 1.1 days. The number of daily epidural injections decreased significantly with time from 2.7 +/- 0.3 the first day to 0.9 +/- 0.3 the fourth day (P less than 0.01, n = 19). Two patients developed acute myocardial infarction during the anaesthesia treatment period, and one of these patients died.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2759108 TI - The effect of carotid sinus massage is independent of posture in patients with heart disease. AB - The influence of posture on the effect of carotid sinus massage (CSM) in patients with heart disease has not been systematically evaluated. In the present study CSM was performed in 80 patients (mean age 55 +/- 10 (SD) years) suffering from various cardiovascular diseases. Each subject had unilateral right- and left sided CSM performed in the supine and in the sitting position, while heart rate and systolic blood pressure were monitored. No statistically significant differences in the CSM-induced response in systolic blood pressure or heart rate were found between the two postures. In the supine position the drop in heart rate was significantly greater after right-sided than after left-sided CSM (P less than 0.05). In only one patient (1%) was a significant carotid sinus reflex evoked. The response was cardioinhibitory with asystole for 3700 ms during right sided, supine CSM. These results imply that posture does not influence the effect of CSM in patients suffering from heart disease. PMID- 2759109 TI - Quality of life five years after myocardial infarction. AB - In 539 patients 5 years after myocardial infarction (MI), quality of life and factors influencing life quality were studied. All patients originally participated in an early intervention trial with metoprolol. A cardiac follow-up questionnaire and the Nottingham Health Profile were answered by 82%. In the former, information about subjective symptoms, smoking, work and current medication was obtained; the latter described health-related quality of life in terms of energy, sleep, emotions, mobility, pain and social isolation. The rate of and the reasons for rehospitalization were registered in the patients' records. The MI patients reported a comparatively high quality of life. Compared with 'normal' population, a decrease was noted in energy, sleep and mobility, and in sex life, hobby-activity and holiday activity. A nonparametric multivariate analysis disclosed that dyspnoea, angina pectoris and anxiety were closely associated with decreased quality of life. In conclusion, 5 years after MI most patients seemed well-adjusted. Impaired quality of life was reported by patients suffering from angina pectoris, dyspnoea and emotional distress. No relationship was found between health-related quality of life and the beta blocker, metoprolol, which was the most frequently used drug. PMID- 2759110 TI - Fatal acute left ventricular outflow obstruction due to interventricular septal haematoma--diagnosis by transoesophageal echocardiography. AB - We describe a case of fatal left ventricular outflow obstruction detected by intraoperative transoesophageal echocardiography. This resulted from acute haematoma formation within the interventricular septum following internal mammary artery grafting to the left anterior descending coronary artery. This unusual case highlights the emerging role of transoesophageal echocardiography in the diagnosis and management of the complications of cardiac surgery. PMID- 2759111 TI - Haemorheologic studies in patients with reduced coronary vasodilator capacity but normal coronary angiogram (syndrome X). AB - The cause of syndrome X, i.e. typical angina, positive exercise test, normal coronary angiogram, normal resting cardiac function, but reduced coronary vasodilator capacity is still unknown. The purpose of the study was to investigate blood fluidity as a possible cause of syndrome X. Haematocrit, plasma viscosity, erythrocyte aggregation, and erythrocyte deformability were examined in 14 patients with syndrome X (group 1), 24 patients with typical angina, positive exercise test, but normal coronary vasodilator capacity (group 2), and 37 patients with atypical chest pain and normal coronary arteries (control group). Coronary vasodilator capacity was determined by the argon method. Compared with normals, patients with syndrome X showed an elevated plasma viscosity (1.31 +/- 0.05 mPas vs 1.26 +/- 0.04 mPas, 2P less than 0.01), an elevated erythrocyte photometric aggregation index (141 +/- 27% vs 100 +/- 23%, 2P less than 0.01) and a reduced erythrocyte filterability (0.51 +/- 0.12 vs 0.66 +/- 0.09, 2P less than 0.01). Significant differences in the haemorheologic parameters between group 1, group 2 and the control group, however, were not detected. Multiple regression analysis did not reveal a significant relationship between coronary vasodilator capacity and the haemorheologic parameters tested. The data suggest that the reduction in coronary vasodilator capacity in patients with syndrome X cannot be attributed to haemorheologic alterations. PMID- 2759112 TI - Natural history of single vessel disease. Risk of sudden coronary death in relation to coronary anatomy and arrhythmia profile. AB - 214 patients with single vessel disease were followed-up for 1-78 months (mean 48 months). Incidence of sudden death was studied in relation to coronary artery lesions, left ventricular wall motion and ventricular arrhythmias found during ambulatory ECG recording. Incidence of sudden death was 11% (16 of 144) in patients with lesions of the left anterior descending branch (LAD), 8% (4 of 55) in lesions of the right (RCA) and 7% (1 of 15) in those with lesions of the left circumflex (LCX) coronary artery. Coronary artery occlusion was associated with a significantly higher incidence of sudden death (15%, 18 of 123) than high-grade stenosis (3%, 3 of 91) (P less than 0.05). The risk of sudden death increased in patients with complex arrhythmias and occluded LAD or RCA (8 of 38, 21%; 2 of 12, 18%) compared with patients without complex arrhythmias (5 of 34, 15%; 1 of 18, 6%). One patient with LCX occlusion died suddenly. Our data show that the incidence of sudden death in relatively low in patients with single vessel disease. However, there is a high risk of sudden death in patients with LAD or RCA occlusion associated with akinetic left ventricular areas and complex arrhythmias. PMID- 2759113 TI - Non-invasive study of dual chamber pacing by pulsed Doppler. Prediction of the haemodynamic response by echocardiographic measurements. AB - The increase in stroke volume with DDD compared with VVI pacing was measured at rest using pulsed Doppler echocardiography in 23 patients at a pacing rate of 70 beats min-1. Stroke volume was assessed by measuring the velocity integral of the flow at the aortic annulus using the apical five-chamber window. Pulsed Doppler echocardiography allowed determination of the least and most favourable AV delay haemodynamically. TVI was also measured at each nominal value of AV delay. The percentage increase in stroke volume was determined in every patient changing from VVI to optimum DDD pacing and was used as a measurement of the 'sensitivity' to optimum DDD pacing; the mean increase was 27 +/- 19%. The increase in stroke volume accompanying the change from DDD pacing with the least favourable to the optimum AV delay was also measured, and used as a measurement of 'sensitivity' to changes in AV delay; the mean increase was 23.7 +/- 16.3%. Clinical and standard echocardiographic parameters were studied in order to determine which variable might best identify the patients more likely to benefit from DDD pacing, and to identify those more sensitive to the AV delay setting. With respect to sensitivity to DDD pacing, three echocardiographic variables were selected by linear discriminant analysis from 11 clinical and echocardiographic variables. These were, in order of importance, left ventricular systolic diameter (LVSD), left ventricular wall thickness (LVWT) and left atrial size (LAS) which allowed the prediction of a good or a bad response to optimal DDD pacing with an accuracy of 91.3%.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2759114 TI - Prognostic value of segmental contractility assessed by cross-sectional echocardiography in first acute myocardial infarction. AB - We prospectively studied 110 patients with a first acute myocardial infarction with cross-sectional echocardiography, between 7-10 days post-infarction, to assess the value of semiquantitative segmental contractility score for the first year post-AMI risk stratification. 87 patients had acceptable recordings (40 anterior and 47 inferior infarction). Twelve patients had severe complications (severe angina or heart failure, reinfarction or death) and 40 had non-severe complications. The total segmental score was higher in complicated than in non complicated patients. The score also differentiated angina from heart failure. The score of necrotic area was more discriminating than that of non-necrotic area. Discriminating power was higher in anterior than in inferior acute myocardial infarction. Thus we conclude that the semiquantitative assessment of segmental contractility by cross-sectional echocardiography is useful for risk stratification following acute infarction identifying severe complications, particularly heart failure, with better discrimination in anterior acute myocardial infarction. PMID- 2759115 TI - Contribution of cross-sectional echocardiography to the diagnosis of right ventricular dysplasia at the asymptomatic stage. AB - The value of cross-sectional echocardiography in the early diagnosis of right ventricular (RV) dysplasia in asymptomatic patients has been assessed. Criteria that defined RV dysfunction and structural abnormalities were developed from 38 normal subjects. Of 136 patients admitted into the study program, 40 (29.4%) had an echocardiogram suggestive of RV dysplasia using the following criteria: mild dilatation of the right ventricle (normal range defined as the 95% confidence limit of the values in the control group); localized bulge and dyskinesia of the infero-basal wall; structural changes of the moderator band; isolated enlargement of RV outflow tract; apical dyskinesia and trabecular disarrangement. Holter monitoring and a maximal exercise stress test at entry into the study and during the follow-up (mean 42, range 18-82 months) demonstrated serious ventricular arrhythmias, and RV endomyocardial biopsy confirmed the diagnosis of RV dysplasia in most of these patients, characterized by an electrical instability of RV myocardium (82.5%). During the follow-up, a marked enlargement of RV cavity appeared in three other patients, and RV endomyocardial biopsy demonstrated the typical findings in all patients. PMID- 2759116 TI - Diagnostic merits of exercise testing in females. AB - The diagnostic accuracy of conventional exercise electrocardiography was compared with exercise algorithms specifically aimed at application in females, with R wave and heart rate adjusted ST-segment changes, and with discriminant analysis. A symptom-limited bicycle exercise test was performed by 189 females without previous infarction with a normal electrocardiogram (ECG) at rest. Frank lead ECG was computer processed. ST-segment amplitudes in lead X were superior to measurements in lead Y, but their sensitivity amounted only to 50% at a specificity of 90%. Correction for R wave amplitude marginally increased sensitivity. It was confirmed that leads with inferiorly directed vectors such as standard leads II, III, aVF or Frank lead Y should not be used for diagnostic purposes in females. Exercise-induced increases in R-wave amplitude of at least 0.1 mV occurred in only 8% of females with coronary disease. Previously described discriminant function using attained heart rate, ST-segment depression and a sex dependent ST segment correction factor yielded a sensitivity of 60% at a specificity of 90%. Sensitivities of heart rate adjusted ST-segment changes and of a previously proposed discriminant function were greater than 70% at a specificity of 90%. It is concluded that the diagnostic yield of exercise testing in females can be improved by use of more sophisticated electrocardiographic and exercise variables. PMID- 2759117 TI - Energy requirement for early defibrillation. AB - The appropriate energy requirement for defibrillation of out-of-hospital ventricular fibrillation has been a matter of discussion. We analysed the effects of 360 J, 200 J or a combination of 200 and 360 J DC shocks given by ordinary manual defibrillators or semiautomatic defibrillators. 120 of 127 ventricular fibrillation episodes were converted by three or less 360 J DC shocks delivered by a manual defibrillator. All 28 ventricular fibrillation episodes were converted by an average of 1.9 DC shocks when 360 J were delivered by a semiautomatic defibrillator. 139 of 152 ventricular fibrillation episodes were converted by three or fewer 200 J DC shocks and 52 of 53 by 2 x 200 J followed, if needed, by 1 x 360 J DC shock delivered by the same semiautomatic defibrillator. Three or fewer 360 J DC shocks seems completely adequate for conversion of most episodes of out-of-hospital ventricular fibrillation. There is no difference in the result of defibrillation by manual and semiautomatic defibrillators. PMID- 2759118 TI - The time factor in resuscitation initiated by ambulance drivers. AB - This study is concerned with the value of basic CPR (manual ventilation and closed chest cardiac massage) initiated within 5 min in delaying brain damage after cardiac arrest in adult patients at ambient temperature. In 88 cases of cardiac arrest, basic CPR was initiated within 5 min of collapse by trained ambulance personnel. Basic CPR was continued during transport to the hospital in ambulances not equipped with defibrillators. Advanced CPR was instituted in all patients upon hospital arrival. All 11 patients eventually discharged from the hospital without apparent brain damage arrived at the hospital within 10 min of cardiac arrest. A significant number of patients arriving later could be resuscitated acutely but later died unconscious or were discharged with severe brain damage. We conclude that basic CPR, including bystander CPR initiated within 5 min of cardiac arrest is likely to be of long-term value only if definitive advanced life support can be provided within 10 min after the patient's collapse. PMID- 2759119 TI - The estimate of coronary incidence following different case finding procedures. AB - In the pool of two rural population groups made up of 1695 coronary-free men aged 40-59 years at entry and followed-up for 25 years, repeated field examination at 5, 10, 20 and 25 years after enrollment and mortality checking, allowed us to identify 256 first major coronary events (coronary deaths and definite myocardial infarction)--the basic procedure. An extra effort in data collection, involving checking hospital admissions and discharges, inquiries to general practitioners and some postal questionnaires, allowed us to identify 45 extra cases of non fatal myocardial infarction--the special procedure. The reported incidence of a first major coronary event in 25 years increased in this way by 17.8%, from 15.1% to 17.7%. The 45 cases identified by the special procedure were younger and had more favourable levels of risk factors than the other 256. However the coefficients of six risk factors estimated by the Cox model (age, mean blood pressure, serum cholesterol, cigarette consumption, forced expiratory volume and arcus senilis) were rather similar, and all were significant in the solution that included the cases identified by the basic procedure, compared to the solution that included cases identified by both procedures. PMID- 2759120 TI - Fatal outcome associated with autopsy proven myocardial bridging of the left anterior descending coronary artery. AB - Two patients with myocardial bridging of the left anterior descending coronary artery associated with myocardial infarction are described. One of them died from acute cerebral emboli related to cardiac thrombosis in a left ventricular aneurysm. The other died suddenly while sleeping. Both patients were found to have a very long myocardial bridging of the left anterior descending coronary artery as well as patches of fibrosis in the left anterior descending coronary artery territory. Marked left ventricular hypertrophy was also found in the patient who died suddenly. No other cardiac abnormality was observed in either patient. These cases, together with those previously reported, suggest that myocardial bridging of the left anterior descending coronary artery can no longer be considered a benign coronary anomaly. PMID- 2759121 TI - Inflammatory arteritis with reversible coronary localization in a 70-year-old woman. AB - Giant cell arteritis with coronary involvement is an uncommon event, often discovered at autopsy after a myocardial infarction. We report the case of a 70 year-old female with unstable angina pectoris persisting despite angioplasty and antianginal treatment, associated with chronically increased erythrocyte sedimentation rate. Temporal artery biopsy was negative but ophthalmic assessment showed sequelae of ischaemic optical neuritis. Response to prednisone therapy was striking, with complete disappearance of angina pectoris, normalization of erythrocyte sedimentation rate and decreased thallium uptake at scintigraphy. This is the first case of giant cell arteritis of the coronary arteries seen after attempted therapy with percutaneous transluminal coronary angioplasty. Such findings justify considering giant cell arteritis each time a case of coronary manifestations with increased erythrocyte sedimentation rate resists medical treatment, or recurs after coronary angioplasty. PMID- 2759122 TI - Serial cross-sectional echocardiographic detection of multiform floating right heart thromboemboli. A case report. AB - This report describes a case in which serial cross-sectional echocardiographic examinations allowed us to make the diagnosis and to follow anatomical evolution of pulmonary thromboemboli. Frequent (three times a day for seven days) echocardiographic surveillance of thromboemboli allowed us to assess the effectiveness of the therapeutic approach. PMID- 2759123 TI - An optimized synthesis of 18F-labelled 5-fluorouracil and a reevaluation of its use as a prognostic agent. AB - An optimized synthesis of 18F-labelled 5-fluorouracil (5-FU) is described. The biodynamics of this radiopharmaceutical were studied in nude mice bearing a 5-FU sensitive (colon 38 carcinoma) or a 5-FU resistant (R1-rhabdomyosarcoma) tumour. It was found that not the initial tumour uptake, but the efflux of the 18F activity from the tumour was correlated with the 5-FU sensitivity of the tumour. PMID- 2759124 TI - Quantitative thallium-201 scintigraphy after dipyridamole infusion combined with low level exercise in healthy volunteers. AB - To establish test specific normal limits for quantitative analysis of uptake and washout of 201Tl after dipyridamole infusion combined with low level exercise, 20 healthy volunteers were studied with low likelihood of coronary artery disease (CAD) assessed by a stepwise probability analysis based on age, sex, symptoms, resting electrocardiogram, and exercise electrocardiography. Likelihood of CAD in these volunteers was calculated as less than or equal to 1%. After dipyridamole infusion combined with low level exercise, one volunteer complained of headache; no other side effects were observed. There were no chest pain complaints. Maximal hemodynamic changes were achieved during the 6th and 7th min of the test. No ST segment depression was recorded. Visual analysis of the 201Tl scintigrams was normal in all volunteers. Mean regional washout at 4 h was 44.37% +/- 2.11%. The regional washout in the 70 degrees LAO view (46.65% +/- 1.10%) was significantly higher than in the anterior and 30 degrees LAO views (43.44% +/- 1.50% and 43.02% +/- 1.45%, respectively). Profiles of uptake and washout of 201Tl were different after dipyridamole infusion combined with low level exercise as compared to maximal exercise. Thus, in quantitative analysis of 201Tl scintigraphy after dipyridamole infusion in conjunction with low level exercise as applied in the present study, it is mandatory to use normal limits of uptake and washout of 201Tl derived from healthy volunteers who underwent the same combined protocol. PMID- 2759125 TI - The two-component stomach: effects of meal particle size on fundal and antral emptying. AB - Using a dual-headed gamma camera and a standardized egg test meal labeled with 99mTc-sulfur colloid, the quantitative emptying of the total, proximal and distal stomach in five normal subjects was characterized. The same egg meal was given to the volunteers in 3 different forms: homogenized, and as 2.5 mm and 5.0 mm cubes on 3 separate occasions for a total of 15 studies. For the total stomach emptying, the lag phase and half emptying time (T1/2) obtained using a power exponential model were significantly shorter for the homogenized test meal than for the 2.5 mm and 5.0 mm cubed egg particles; the lag phases were 29 +/- 19 min (mean +/- SD) vs 55 +/- 26 (P less than 0.05) and 64 +/- 24 min (P less than 0.01), the T1/2's were 71 +/- 30 min vs 91 +/- 26 (P less than 0.05) and 104 +/- 30 min (P less than 0.05), respectively. For the proximal stomach, no statistically significant difference was observed among the 3 test meals; the T1/2s for the homogenized, 2.5 mm and 5.0 mm cubed meals were 65 +/- 26 min, 53 +/- 18 min and 64 +/- 20 min, respectively. For the distal stomach, both the peak activity (%) and time to peak activity (min) were significantly higher for the 2.5 mm cubes (43%, 54 min) and the 5.0 mm cubes (38%, 60 min) than for the homogenized eggs (16.4%, 30 min) (P less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2759126 TI - Gastrointestinal scintiscanning: dosimetry. AB - Calculations of the dosimetry associated with orally administered 99mTc labeled cellulose fibres and 111In labeled plastic particles were performed for adult standard man using MIRD methodology. The applied gastrointestinal transit parameters of these radiopharmaceuticals probably reflect the ranges of these parameters, regarding nondigestible components used for gastrointestinal transit studies. However, the critical organ for both radiopharmaceuticals was the large intestine. PMID- 2759127 TI - The visualization of femoral vessels in delayed bone scans--a sign of arteriosclerosis? A comparison of 99mTc-MDP and 99mTc-DPD. AB - The activity of femoral vessels in delayed bone scans was evaluated visually in 237 consecutive patients and quantified in 40 female patients. In visual analysis the patients were randomly divided into three groups and in quantitative analysis into four groups of equal size. Two different MDP preparations and one DPD preparation were used as bone-seeking agents. With aging, the activity in femoral vessels increased with all agents in visual analysis, significantly with MDPs (P less than 0.001) between patients less than or equal to 60 years and greater than 60 years. In female patients with all agents a significant increase in femoral activity was found (P less than 0.001 with MDPs, P less than 0.05 with DPD). In patients greater than 60 years, the femoral uptake was significantly higher with MDP when compared with the DPD uptake (P less than 0.01 with MDP1, P less than 0.05 with MDP2). Between the MDPs no significant differences were found. In quantitative analysis the femoral vessel to soft tissue ratio was significantly higher in patients greater than 70 years when compared with patients less than or equal to 50 years with MDP. No difference was found with DPD. Histological examination of excised arteries of ten patients with intense femoral uptake of MDP showed arteriosclerosis and calcification in all cases. The findings suggest that the femoral visualization in delayed bone scans is probably related to arteriosclerosis and is not a non specific finding. There may be age-related differences in the distribution of MDP and DPD. PMID- 2759128 TI - The reproducibility of single photon absorptiometry in a clinical setting. AB - The reproducibility of single photon absorptiometry (SPA) results for detection of changes in bone mineral content (BMC) was evaluated in a clinical setting. During a period of 18 months with 4 different sources, the calibration scans of an aluminium standard had a variation of less than 1% unless the activity of the 125I source was low. The calibration procedure was performed weekly and this was sufficient to correct for drift of the system. The short term reproducibility in patients was assessed with 119 duplicate measurements made in direct succession. The best reproducibility (CV = 1.35%) was found for fat corrected BMC results expressed in g/cm, obtained at the site proximal to the 8 mm space between the radius and ulna. Analysis of all SPA scans made during 1 year (487 scans) showed a failure of the automatic procedure to detect the space of 8 mm between the forearm bones in 19 scans (3.9%). A space adjacent to the ulnar styloid was taken as the site for the first scan in these examinations. This problem may be recognized and corrected relatively easy. A significant correlation was found between BMC of the lower arm and BMC of the lumbar spine assessed with dual photon absorptiometry. However, the error of estimation of proximal BMC (SEE = 20.0%) and distal BMC (SEE = 19.4%) made these measurements of little value to predict BMC at the lumbar spine in individuals. The short term reproducibility in patients combined with the long term stability of the equipment in our clinical setting showed that SPA is a reliable technique to assess changes in bone mass at the lower arm of 4% between 2 measurements with a confidence level of 95%. PMID- 2759129 TI - Kinetics of indium-III-labeled eosinophils in two patients with eosinophilia. AB - The kinetics of IIIIn-labeled eosinophils was evaluated in two cases of eosinophilia by means of external and blood cell counting. In both cases, the labeled blood eosinophils decreased rapidly for a few h after injection and then increased progressively up to the 20th and the 12th h, respectively. The changes of radioactivity with time in the liver, spleen and lungs correlated with that in the blood eosinophils. However, in both cases radioactivity of the thoracic spine increased rapidly for a few h after injection of the labeled eosinophils and subsequently decreased. This result suggests that some of the eosinophils recirculate between the marginal pool of marrow and the intra vascular space. PMID- 2759130 TI - Study of the disposition kinetics of the N-oxide-derivative: a metabolite of picobenzide. AB - The disposition kinetics of the N-oxide of picobenzide were studied after administration to rabbits at a bolus dose of 30 mg/kg of picobenzide intravenously. The biotransformation process fits a first-order kinetic process, and the metabolite shows good access capacity to the peripheral compartment. The N-oxide of picobenzide was determined by D.P.P. and parametric estimation was performed by the SIMPLEX method as the search algorithm. PMID- 2759131 TI - Metabolism of isobutylnaphthyl acetic acid in rats: determination of the chemical structures of metabolites. AB - After oral and intravenous administration of radiolabelled isobutylnaphthyl acetic acid (INAA) to rats two metabolites were isolated from urine and plasma by HPLC. Field desorption, high resolution electron impact mass spectrometry as well as GC-MS after derivatization were used for structure elucidation and identification of the metabolites. The main biotransformation product in rat urine was found to be 5-(2'-hydroxy-2'-methyl-propyl)-1-naphthyl acetic acid (M1). The main metabolite in plasma was derived and was found to be 5-(2' carboxypropyl)-1-naphthyl acetic acid (M2). PMID- 2759132 TI - The metabolism and kinetics of 125I-labeled human intravenous IgG preparation (C 425) in rats and rabbits. I. Blood clearance, excretion into urine and feces, and brain uptake. AB - The metabolism of intravenous human IgG preparation (C-425) was studied by the use of 125I-C-425 in rats and rabbits after intravenous injection of the compound particularly with regard to changes in the levels of radioactive compound or metabolites in the blood as a function of time as well as levels excreted in urine and feces. Brain uptake index of 125I-C-425 was estimated by a slightly modified Oldendorf's method. 125I-Polyglobin was used as the control compound. The half-life of blood clearance of 125I-C-425 radioactivity after the 2nd day was about 8 days in rats and about 5 days in rabbits, respectively. Within a relatively short period of 1 hour, a rapid decrease of blood concentration of radioactivity was recorded. This was due to the transfer of labelled compound from blood into the extravascular compartment. A high concentration of radioactivity in the blood was maintained for one week after intravenous injection of the labelled compound in both rats and in rabbits. Most of the radioactive compound or metabolites were excreted in the urine and relatively little in feces. Excretion in urine of rats reached about 22% for 125I-C-425 and about 17% for 125I-Polyglobin. The excretion rate slowed down over 24 hours. The total recovery rates in rats were about 40% for 125I-C-425 and 125I-Polyglobin and about 55% in rabbits for both drugs. The permeability through the blood-brain barrier was found to be negligible for both drugs. PMID- 2759133 TI - The metabolism and kinetics of 125I-labeled intravenous human IgG preparation (C 425) in rats and rabbits. II. Excretion into bile, tissue distribution and placental permeability. AB - The metabolism and kinetics of unmodified human IgG (125I-C-425) was studied in rats and rabbits after intravenous injection with regard to changes as a function of time of radioactivity in the blood and other tissues, excretion into the bile and placental permeability. A microautoradiographic study on the cellular interaction between 125I-C-425 and rat tissues was also performed using 125I Polyglobin as the control drug. Results showed plasma radioactivity to be the highest followed by blood, lung, heart, kidney, bone marrow etc. in decreasing order. Tissues considered to contain larger amounts of blood, gave higher radioactivity values with some exceptions, such as the thyroid and skin. Biliary excretion within 72 hours was 7.57% for 125I-C-425 and 10.74% for 125I Polyglobin. In pregnant rats, relatively high radioactivity was counted in the ovarium, uterus and placenta, and radioactivity in the fetus and amniotic fluid approached that of uterus and placenta up to 72 hours, indicating that placental permeability was gradual. Microautoradiographic findings revealed no cellular interaction such as aggregate formation, between human IgG and rat tissues. Further study is needed to elucidate immunological interaction under pathological conditions. PMID- 2759134 TI - Effects of salbutamol on the absorption and disposition of sulphamethoxazole in adult volunteers. AB - On the basis of the reports that beta-adrenergic stimulation affects gastrointestinal motility in man as well as induces N-acetyltransferase in rat pineal gland, we decided to assess the effects of salbutamol pretreatment on the absorption as well as disposition of sulphamethoxazole (SMZ). After a control pharmacokinetic study of SMZ, each of six healthy volunteers took salbutamol at a dose of 4 mg four times daily for two weeks, and the kinetic study of SMZ was repeated after the morning dose on the fifteenth day. None of SMZ half-life, volume of distribution, renal and hepatic clearance rates was significantly altered. However, salbutamol pretreatment resulted in significant reduction in the absorption rate constant of SMZ from 1.168 +/- 0.509 h-1 (mean +/- S.D.) to 0.688 +/- 0.348 h-1 (P less than 0.025), and this was associated with prolongation of tmax from 3.00 +/- 1.69 h to 4.33 +/- 1.51 h (P less than 0.025). Cmax, however, was not correspondingly reduced probably as a result of significant increase in the extent of SMZ absorption from 611 +/- 108 mg to 749 +/- 78 mg (P less than 0.025). Our findings suggest that beta-adrenergic stimulation does not significantly induce human hepatic N-acetyltransferase enzyme. However, it does reduce the absorption rate as well as increase the extent of absorption of SMZ. PMID- 2759135 TI - Metabolism of [U-14C]-4-hydroxybutyric acid to intermediates of the tricarboxylic acid cycle in extracts of rat liver and kidney mitochondria. AB - The metabolism of [U-14C]-4-hydroxybutyric acid (GHB) was investigated in sonicates of mitochondria of rat heart, kidney and liver. The conversion of this precursor to 14C-organic acids was monitored and quantified by sequential liquid partition chromatography on hydrated columns of silicic acid using a concave upward gradient of 2-methylbutan-2-ol in chloroform. Sonicates of liver and kidney mitochondria, but not heart, readily converted [U-14C]-GHB to 14C organic acids via a pathway of conversion to 14C-succinic acid, followed by further metabolism through the tricarboxylic acid cycle. This conversion was facilitated by exogenous NAD+ and NADP+. No evidence for the beta-oxidation of GHB was obtained in any of the mitochondrial sonicates. Studies with exogenous non labelled succinic semialdehyde indicated that this compound was an intermediate in the conversion of GHB to succinic acid. PMID- 2759136 TI - Tissue distribution and excretion of radioactively labelled compounds in the Wistar rat after administration of [N-methyl-14C]-erythromycin A. AB - Tissue distribution and excretion of radioactively labelled compounds was studied in the Wistar rat after i.v. administration of [N-methyl-14C]-erythromycin A. Whole-body autoradiography and liquid scintillation counting was used to investigate the tissue localization of radioactivity in pregnant and non-pregnant rats. Tissue levels were maximal within 20 min, except for lachrymal glands, thymus and brain. Large amounts of radioactively labelled compounds, partly originating from active secretion, were present in the small intestine and caecum. Marked concentration of radioactively labelled compounds was also observed in the liver, spleen, lachrymal and salivary glands, lymph nodes, mammary glands, skin, bone marrow, and, to a lesser extent, in the lung, kidney and skeletal muscle. During six hours of experimental follow-up, plasma levels remained lower than corresponding tissue levels. At 1 h the radioactivity in fetuses was about three times lower than that in maternal blood. Within 48 h, more than 90% of the administered radioactivity was excreted. The amounts of radioactivity recovered in urine, faeces and expired air were about 19%, 48% and 24% respectively. After 48 h, 8% of the administered radioactivity was found in the carcass. PMID- 2759137 TI - Chloroquine disposition in hypersensitive and non-hypersensitive subjects and its significance in chloroquine-induced pruritus. AB - Twenty-one healthy Nigerian volunteers distributed into four groups participated in a study to determine the significance of chloroquine disposition in chloroquine-induced pruritus. It involved the administration of chloroquine with or without promethazine pre-administration to the subjects. Group I consisted of 8 chloroquine non-hypersensitive subjects receiving 2 tablets of chloroquine sulphate (300 mg base); Group II consisted of 5 chloroquine non-hypersensitive subjects receiving 2 tablets of chloroquine sulphate 30 minutes after 25 mg promethazine tablet pre-administration; Group III consisted of 5 chloroquine hypersensitive subjects treated as in Group II; Group IV consisted of 3 hypersensitive subjects treated as in Group I. Blood (5 ml) and urine samples were collected periodically for up to 6 days post-dose. The samples were analysed for chloroquine and some of its oxidation metabolites by a specific HPLC method. Probit plots of cumulative drug/metabolite ratios were done to determine if there is polymorphism in chloroquine metabolism. There was bimodality only in the distribution of chloroquine/monodesethylchloroquine ratios, suggesting polymorphism in the metabolic oxidation of chloroquine in these subjects. Higher levels of monodesethylchloroquine were obtained in Group IV subjects when compared with any of the other groups. The oral clearance rate, elimination half life, and volume distribution at steady state of chloroquine in the study groups were not significantly different (P greater than 0.05). In the absence of promethazine there appears to be an extensive metabolism of chloroquine in hypersensitive individuals to produce monodesethylchloroquine which probably determines the degree of pruritus experienced by an individual. PMID- 2759138 TI - Pharmacokinetic interaction in beagle dogs of antiplatelet drugs: acetylsalicylic acid, dipyridamole and calcium dobesilate. AB - In clinical practice, the co-administration of antiplatelet drugs, such as acetylsalicylic acid (ASA) and dipyridamole (DP) and calcium dobesilate, is often recommended in order to obtain secondary prophylaxis against certain ischaemic diseases. Therefore the possible pharmacokinetic interactions between these three drugs were studied after a single-dose in beagle dogs. The plasma concentrations of ASA, DP and CaDb were measured by HPLC. It was found that the DP and CaDb kinetics were unaffected by concurrent intake of ASA, DP or CaDb. However, concurrent DP or CaDb improved the bioavailability of ASA, particularly the increased Cmax and (AUC). PMID- 2759140 TI - Prevalence rate of cerebrovascular disease in the rural population of northwest Peloponnese, Greece. A direct epidemiological study. AB - In a direct (door-to-door) epidemiological study, the prevalence rate of cerebrovascular disease in the rural population of northwest Peloponnese, Greece, was found to be 995 strokes per 100,000 inhabitants over 20 years of age. This number is considerably lower than the prevalence rate (1,417 strokes per 100,000 inhabitants over 20 years of age) found in the urban population of the same county (Patras, Greece). PMID- 2759139 TI - Neurological deficits secondary to spinal deformities: their treatment and results in 13 patients. AB - We report the results of surgical treatment in 13 patients operated on for compression of the spinal cord secondary to kyphosis or kyphoscoliosis between 1977 and 1985. In every case, an anterior decompression of the cord by transthoracic or thoracoabdominal route was followed in the same operation by anterior stabilization. Posterior fusion with Harrington's instrumentation was performed 15-20 days later. Neurological recovery was complete in 8 patients (61.5%) and partial in 4 (30.7%), while 1 patient died (7.6%). We review the relevant published work. PMID- 2759141 TI - Reversible optic neuritis secondary to paranasal sinusitis. AB - Three patients are described in whom optic neuritis was presumably caused by concurrent sinus infection. Aggressive treatment of the underlying sinus condition led to prompt visual improvement. Although underrecognized in clinical neurology, paranasal sinusitis is an uncommon but treatable cause of optic neuritis. Shortcomings of conventional radiological investigations and inappropriate use of corticosteroids may contribute to initial misdiagnosis. PMID- 2759142 TI - Daytime serum myoglobin fluctuations in Steinert's disease. AB - Baseline and evening serum myoglobin levels have been measured in 14 patients with Steinert's myotonic dystrophy. Mean levels in the morning and after a day of habitual activities, were higher in the study group than in a control group of healthy males. Serum levels in dystrophic patients were higher in the evening determinations, especially in the working patient subgroup. It is concluded that the daily physical effort of a normal job, significantly increases the serum myoglobin levels in patients with Steinert's disease. PMID- 2759143 TI - Platelet scintigraphy in cerebrovascular diseases. AB - The benefit of platelet scintigraphy using 99mTc-phytate as a method to detect atherosclerotic lesions in extracranial neck vessels was tested on 143 patients. 29 patients had an abnormal scan of the neck vessels. The scintigraphic results were critically evaluated, taking clinical observations and the angiograms performed on 88 patients into consideration. Platelet scintigraphy can be useful as an additional examination in some patients. Generally, however, the value and reliability of platelet scintigraphy must be seen as insufficient, making further prospective studies with histological examinations imperative. PMID- 2759144 TI - Experimental chloroquine myopathy: morphological and biochemical studies. AB - Morphological and biochemical studies were performed on the soleus muscles of rats receiving a daily intraperitoneal injection of 50 mg chloroquine chloride (CQ) per kilogram of body weight. Light microscopy showed mild to moderate variations in fiber size, numerous dense membranous bodies and vacuoles. The vacuoles were ringed by material that was intensely basophilic in hematoxylin eosin preparations, resembling rimmed vacuoles in the muscle fibers of distal myopathy. Segmental degradation or necrosis was often observed. The 3H-leucine uptake by myofibrillar and soluble sarcoplasmic fractions in CQ-treated muscles was the same as in the controls. The significant increases in lysosomal (cathepsin B & L, B and D) proteases and thiol protease inhibitor occurred in the earlier stages of CQ-induced myopathy, when hardly any autophagic vacuoles or dense bodies were observable by light microscopy. We conclude that the over development of autophagic vacuoles and the significant increases in lysosomal protease activity in muscle tissues may be important in the development of the focal degradation and necrosis of CQ-treated muscles. PMID- 2759145 TI - An inhibitor of cellular cytotoxicity is present in multiple sclerosis. AB - A blocking factor is present in the serum of patients with multiple sclerosis (MS). It is able to inhibit a cellular cytotoxicity reaction in vitro. This substance has characteristics similar to those of the 'P4' protein described in pregnant women and patients bearing tumors. Its possible contribution to MS pathogenesis is discussed. PMID- 2759146 TI - Congenital muscular dystrophy with leukoencephalopathy. AB - Two patients with 'benign' congenital muscular dystrophy (CMD) have been observed for several years. Symptoms and signs of central nervous system (CNS) disease occurred at the age of 7 and 16 years, respectively. CNS involvement in CMD may be more common than generally recognized, slowly progressive and delayed in onset. The combination of congenital hypotonia, contractures, 'dystrophic' muscle biopsy changes and diffuse subcortical hypodensity on computed-tomographic scans seems unique and specific for CMD and of differential diagnostic significance. PMID- 2759147 TI - Paroxysmal electroencephalographic abnormalities genetically transmitted: one family description. AB - A 10-year-old girl came to our observation since a general rule-out electroencephalogram (EEG) had showed, in absence of any clinical manifestation, generalized and symmetrical 3 c/s spike-and-wave bursts, whose duration was longer than 3 s. The subject, only daughter born from her mother's first marriage, had no family history of neurological diseases; her physical and neuropsychological examinations were normal. A polysomnographic recording showed, during sleep, the same abnormalities observed during wakefulness. Also on this occasion, there were no related clinical manifestations. Subsequent recordings were performed on her 33-year-old mother and on two siblings, 3 and 2 years old, respectively, born from their mother's second marriage, all normal by physical and neuropsychological examinations, with no referral about clinical seizures. Among them, the 3-year-old sister showed asymptomatic left rolandic spikes, while the 2-year-old boy, whose EEG was firstly normal, displayed, 1 year later, a burst of generalized 3 c/s spike-and-wave paroxysmal activity on a 4-7 c/s background activity. The possible unitary genetic transmission of paroxysmal EEG abnormalities is discussed. PMID- 2759148 TI - Naftidrofuryl protects neurons against ischemic damage. AB - The effects of naftidrofuryl on postischemic neuronal damage and on local cerebral blood flow (LCBF) were examined in a rat model of forebrain ischemia (occlusion of carotid arteries and hypotension). Ischemia was induced for 10 min. LCBF was measured after 2 and 10 min of recirculation. A histological evaluation of cell loss in the hippocampal areas was performed 7 days after ischemia. Naftidrofuryl (10 mg/kg) was administered intraperitoneally 15 min before ischemia. The drug reduced the percentage of necrotic neurons in the CA1 and CA4 sector of the hippocampus, while the LCBF of these hippocampal sections was not significantly altered. Thus, naftidrofuryl is suggested to protect hippocampal neurons against ischemic damage mainly by a direct effect on brain parenchyma. PMID- 2759149 TI - Danazol and internal carotid artery thrombosis. AB - The case of a 47-year-old woman suffering from a CT-assessed ischemic right hemisphere stroke, which occurred after a 2-month treatment with danazol (a synthetic androgen), is reported. The patient's thrombocytosis in association with danazol treatment and its possible correlations with the thrombotic event are discussed. PMID- 2759150 TI - Prolonged latencies of the N2 and P3 of the auditory event-related potential in children at risk for schizophrenia. A preliminary report. AB - In previous studies investigating long latency components of the event-related potential (ERP), schizophrenic patients generally showed reduced P3 amplitudes and in some studies prolonged N2 or P3 latencies. As there is a higher risk of offspring of schizophrenics than of mentally healthy parents developing this disease, the present study was intended to clarify whether ERP components (in particular the N2 and P3) differ between these two groups of children. Twelve high-risk and 12 age-matched control children (aged 9-16 years) performed an auditory oddball task in order to assess late ERP components. This task required the subject to covertly count rare target tone pips (P = 0.2) irregularly interspersed among frequent standard tone pips (P = 0.8) in two series of 400 pips. ERPs were recorded from midline electrodes (Fz, Cz, Pz). The results indicated distinctly prolonged N2 and P3 latencies in ERPs to target stimuli in children of schizophrenic patients. These findings suggest a slowed target classification in these children. PMID- 2759151 TI - The role of short-term visuo-spatial memory in control of rapid multi-joint prehensive movements. AB - How memorized visuo-spatial information influences motor control and whether this information is able to replace the feedback processing in cases of visual deprivation was studied using an unrestrained finger- and hand-movement paradigm. Nineteen right-handed subjects were asked to grasp and lift a small block with the index finger and thumb of the right hand, as quickly as possible. The efficiency of motor performance was analysed by measuring the grasping time derived from tangential velocity profiles of the fingertips. The data revealed significantly shorter grasping times under continuous visual guidance than during blind grasping. Grasping times increased under conditions with stepwise prolongation of visual deprivation time prior to the movement onset. The results support the general concept that within the first seconds of visual deprivation, stored visuo-spatial information can partly compensate for the lack of continuous visual feedback. PMID- 2759152 TI - General dysplasia of the cerebral arteries with persistent primitive acoustic artery and giant aneurysm. AB - A case of cerebrovascular systemic dysplasia is presented. The anomalies were: persistent primitive acoustic artery, giant aneurysm of the left internal carotid artery, aneurysm of the basilar artery, and an arteriovenous fistula. A review of the literature shows that the association of multiple malformations of cerebral vessels with a persistent primitive acoustic artery has not previously been described. Impairment of embryonic development is suggested as the origin of the malformations. PMID- 2759153 TI - Optokinetic nystagmus in homonymous hemianopia due to a strictly occipital lesion. AB - Optokinetic nystagmus (OKN) was tested in 15 patients with unilateral strictly occipital brain lesions and complete homonymous hemianopia and compared with findings in a group of normal controls. Quantitative analysis of the results in the patients revealed a bilateral disorder of OKN. When the stimulus was moved in the direction opposite to the hemianopic field, there was a significant decrease in optokinetic gain, and the amplitude of nystagmus decreased. There was no correlation between OKN and size of the residual macular field. PMID- 2759154 TI - Bright white light does not improve narcoleptic symptoms. AB - Bright white light (500lx) for 4 h/day was applied to seven narcoleptic patients (age 47-65 years, mean 55 years). The effects of the light on the disturbed sleep wake cycle in narcoleptics were investigated by the measurement of the following parameters: (1) excessive daytime sleepiness and sustained attention (multiple sleep latency test); (2) rest-activity cycles; (3) self-ratings (mood, anxiety, tiredness); (4) urinary cycles of 6-OH melatonin sulphate and cortisol; (5) sleep EEG. Treatment with bright light showed neither objective nor subjective changes in the clinical symptoms of narcolepsy. While similar "dosage" light applications can phase shift human circadian rhythms and improve depression and hypersomnia in winter depression, it is not an appropriate treatment for narcolepsy. PMID- 2759156 TI - Work and psychiatric illness: the significance of the posthospitalization occupational environment for the course of psychiatric illnesses. AB - The value of the reintegration and rehabilitation of inpatients vocationally was studied. Certain of the vocational experiences (unemployment and stressful working conditions) of former psychiatric inpatients were examined, with attention being paid to their stabilizing or destabilizing effect on symptomatic behaviour. A cohort of 230 first-time admissions for treatment of various disorders were interviewed while hospitalized and 1 year later. A 20-item list prepared by INFAS was used for indexing stressful working conditions. Psychopathological states were assessed with the help of the Present State Examination of Wing et al. (1973). The results indicate that mentally ill persons (especially those with organic or affective disorders), when confronted with unemployment after discharge from hospital, will usually respond by developing new or worse syndromes. Stressful working conditions appear to have very different effects in schizophrenia and affective disorders, viz. deterioration and amelioration of psychopathological syndromes respectively. PMID- 2759155 TI - The effect of neuroendocrine secretion on brain morphology and EEG sleep in patients with eating disorders. AB - Neuroendocrine disturbances [low plasma levels of triiodothyronine (T3), high plasma concentrations of cortisol], morphological brain alterations [enlarged external cerebrospinal fluid (CSF) spaces, dilatation of the ventricles] and altered sleep patterns [fragmented sleep continuity, a reduction of slow wave sleep (SWS) or REM sleep] have been described in patients with anorexia nervosa and bulimia nervosa. The present study investigates to what degree these disturbances interact with each other. In ten anorexic and five bulimic patients cranial computed tomography (CT) to estimate the size of the CSF spaces, blood sampling to measure cortisol and T3 plasma concentrations, and all-night polysomnography were performed. In comparison with patients with normal CT scans, the patients displaying enlarged CSF spaces spent more time in SWS, and the duration of REM sleep was reduced. In the whole sample, a negative correlation was found between the amount of REM sleep and cortisol, whereas a positive association was found between the amount of REM sleep and the T3 level. In addition, the degree of brain shrinkage correlated positively with cortisol and negatively with T3. On the basis of these results, it can be assumed that in patients with eating disorders the disease process with its neuroendocrine alterations affects brain morphology as well as EEG sleep. PMID- 2759157 TI - The demand for extramural psychiatric intervention in a community-based service. AB - Using a psychiatric case register, patients who had extramural contacts with the South-Verona Community Psychiatric Service in 1983 (N = 549) were selected for this study and followed-up for 3 years, from the date of their first 1983 contact. Out of the total number of extramural contacts made in 3 years (N = 12,429) 16% were unplanned (drop-in) contacts. A linear-logistic model was used to investigate the joint effects of sociodemographic and clinical variables on the frequency of unplanned extramural contacts. The model to fit the data was complex, confirming that many interactions among the variables considered in the study significantly affect the probability of using the community services on an urgent or unplanned basis. PMID- 2759158 TI - Significance of MRI-confirmed atrophy of the cranial spinal cord in Friedreich's ataxia. AB - The severity of Friedreich's ataxia was graded in ten patients by clinical examination and in five by use of posturography. These data were compared with neuroradiology findings. CT-confirmed infratentorial atrophy occured only in advanced cases of Friedreich's ataxia; the correlation with the clinical score was poor. On mid-sagittal MRI planes the diameters of fourth ventricle, brain stem at the level of the inferior olive and spinal cord at the levels of the foramen magnum and C3 were measured. Patients with Friedreich's ataxia had significant MRI-confirmed atrophy of the cranial spinal cord as compared with a normal, age-matched control group. This was also observed in patients with Friedreich's ataxia in the early stages. A reliable correlation between atrophy of the cranial spinal cord and the clinical score, however, could again not be found. MRI exploration of the cranial spinal cord may be recommended as an additional diagnostic marker in Friedreich's ataxia. PMID- 2759159 TI - High dose chemo-radiotherapy for sensitive tumors: is sequential better than concurrent drug delivery? PMID- 2759160 TI - Phase II trial of methotrexate-FAM (m-FAM) in adenocarcinoma of unknown primary. AB - Nineteen patients with adenocarcinoma of unknown primary were treated with the m FAM regimen, consisting of methotrexate 50 mg/m2 days 0, 28; 5-fluorouracil 600 mg/m2 days 1, 8, 29, 36; Adriamycin 30 mg/m2 days 1, 29; and mitomycin-C 10 mg/m2 day 1. All drugs were recycled every 56 days. No complete responses were seen. Seven patients (37%) achieved partial remission for a median duration of 11 months. An additional nine patients (47%) had stable disease for a median duration of 6 months. Median survival for responders was 16 months and was 10 months for those with stable disease. Toxicity was acceptable. This Phase II study attempted to evaluate the clinical impact of the pharmacological modulation of 5-fluorouracil with methotrexate, the goal being improvement of the results of FAM alone in adenocarcinoma of unknown primary. However, the addition of methotrexate, at least in the schedule employed in this study, did not appear superior to FAM. PMID- 2759161 TI - PC12 pheochromocytoma and sympathetic nervous system derived trophic factors augment growth of neuroblastoma. AB - A trophic factor secreted by PC12 rat pheochromocytoma augments growth of C1300 neuroblastoma clonal lines S20, N18 and C46, but does not affect growth of the NIE 115 line. A trophic factor present in newborn sympathetic ganglia has the same biological effect on neuroblastoma cell lines. PC12 cells and sympathetic ganglia are both of neural crest origin; possibly both secrete the same trophic factor. PMID- 2759162 TI - Diagnostic value of mucin-like carcinoma-associated antigen (MCA) in breast cancer. AB - The diagnostic value of mucin-like carcinoma-associated antigen (MCA) was compared to that of carcinoembryonic antigen (CEA) and/or CA 15.3 in patients with breast cancer. A total of 368 patients with breast cancer were studied, of whom 253 were free of metastases, whereas 94 had either skeletal or visceral metastases or diffuse metastatic disease. The diagnostic sensitivity of MCA proved to be comparable to that of CA 15.3 and superior to that of CEA in patients with metastatic breast cancer. In contrast, the specificity of MCA was superior to that of CA 15.3. Finally, the diagnostic sensitivity of each of the tested tumour markers, i.e. MCA, CEA and CA 15.3, could be improved by their combined use. We conclude that MCA, either alone or in combination with CA 15.3 and CEA, can improve the monitoring of disease progression in patients with metastatic breast cancer. PMID- 2759163 TI - TCNU (LS 2667), a new active drug in the treatment of advanced colorectal cancer. EORTC Early Clinical Trials Group. AB - Fifty-seven patients with advanced measurable or evaluable colorectal cancer not previously treated with chemotherapy and tumor manifestations from colorectal cancer were treated with tauromustine (TCNU), a new nitrosourea with a therapeutic index against murine tumors better to or equal to that of the established nitrosoureas. The dose was 130 mg/m2 orally q 5 weeks. There were one CR and seven PR, for an overall response rate of 14%. Responding sites included the liver (one CR and two PR), lung (four PR) and lymph nodes (two PR). The median duration of response was 33+ weeks (21+ to 34 weeks). The main dose limiting toxicity was myelosuppression which seemed to be cumulative. Subjectively, the drug was well tolerated although most patients experienced nausea and vomiting for some hours. It is concluded that TCNU is a well tolerated compound with limited, but definite antitumor activity against colorectal cancer and that further studies in this disease could be of interest. PMID- 2759164 TI - Chemosensitization at reduced nitroimidazole concentrations by mixed-function compounds combining 2-nitroimidazole and chloroethylnitrosourea. AB - A mixed-function compound (I-278) combining 2-nitroimidazole and chloroethylnitrosourea has been shown to be greater than 2-fold more toxic to hypoxic HeLa-MR cells than to cells similarly exposed under aerobic conditions, consistent with chemosensitization of nitrosourea toxicity by the 2 nitroimidazole Misonidazole (MISO). However, in the case of I-278, the enhancement resulted from micromolar concentrations of 2-nitroimidazole as opposed to the millimolar quantities required for a similar enhancement by MISO. These experiments provide evidence (1) that the enhanced hypoxic toxicity of I 278 is not attributable to additional, independent hypoxic cell killing by the nitroimidazole group and (2) that the interaction between the two functions under hypoxic conditions results in increased crosslink formation typical of chemosensitization. The data strongly suggest that the chemosensitizing efficiency of nitroimidazoles can be dramatically improved by covalent linkage to a chloroethylating species. PMID- 2759165 TI - Phase II study of low dose aminoglutethimide 250 mg/day plus hydrocortisone in advanced postmenopausal breast cancer. AB - Low dose aminoglutethimide 125 mg twice daily plus hydrocortisone 20 mg twice daily was shown to produce oestrogen and androgen suppression in postmenopausal women. A phase II study was carried out in 101 patients with advanced postmenopausal breast cancer. Objective response rates were 4% CR and 21% PR. Fourteen per cent had disease stabilization for more than 6 months (SD). Soft tissue sites showed the best response. Responses occurred in previous tamoxifen failures (28%) including SD. Toxicity was less than reported for higher dose regimens or low dose aminoglutethimide without hydrocortisone, particularly nausea and drowsiness. Survival from first relapse and start of therapy was not significantly different between PR and SD. This dosage regimen appears of comparable efficacy to previously reported higher dosage regimens with reduced toxicity compared to low dose regimens without hydrocortisone. PMID- 2759166 TI - An EORTC Gastrointestinal Group phase II evaluation of epirubicin combined with ifosfamide in advanced adenocarcinoma of the pancreas. EORTC Gastrointestinal Group. PMID- 2759167 TI - Prolactin receptors (PRL-R) and breast cancer. PMID- 2759168 TI - Is alcohol intolerance in cancer patients explained by tumour production of alcohol dehydrogenase? PMID- 2759169 TI - Immunoglobulin diversification in bursal duct-ligated chickens. AB - The role of external antigen contact on immunoglobulin (Ig) diversification occurring in chicken bursal cells was evaluated. The entry of environmental antigens into the lumen of the bursa of Fabricius was prevented by ligating the bursal duct prior to hatching (BDL: bursal duct ligation). We used two dimensional gel electrophoresis to compare the heterogeneity of Ig molecules from bursa cells of normal and BDL chickens. We have found that Ig diversity obtained from BDL chickens' bursae in two-dimensional gel analysis was similar to that of control birds. Furthermore, by using two monoclonal anti-idiotype antibodies to study intrabursal Ig diversification we have shown that frequencies of the Cld-1 and Cld-2 idiotypes were also unaltered following bursal ligation. We conclude that primary B cell diversification in the bursa is independent of the external antigen flow from the bursal lumen. PMID- 2759170 TI - Mechanisms of phenylalanine-induced pressor effects in conscious rats. AB - Phenylalanine and tyrosine reportedly decrease blood pressure in conscious restrained rats. However, tyrosine has recently been found to increase blood pressure in anesthetized animals, questioning the generality of findings obtained in restrained animals. The present study therefore evaluated the effects of phenylalanine on mean arterial pressure (MAP) and heart rate (HR) in unrestrained, conscious rats. Phenylalanine (0.32-1.33 mmol/kg i.p.) increased MAP and decreased HR, effects that were antagonized by carbidopa and prazosin but not by desipramine. In addition, both DOPA and tyrosine (1.33 mmol/kg) increased MAP. In contrast, phenylalanine-induced increases in plasma concentrations of its indirectly acting sympathomimetic amine metabolite, phenethylamine, were small and temporally unrelated to the phenylalanine-induced MAP elevation, and desipramine inhibited MAP increases produced by exogenous phenethylamine. These observations indicate that phenylalanine increases MAP in conscious, unrestrained animals by augmenting peripheral catecholamine synthesis and release rather than by affecting phenethylamine bioavailability. PMID- 2759171 TI - Adenosine analogs inhibit gastric acid secretion. AB - The potencies with which four adenosine deaminase-resistant analogs of adenosine affected the volume, pH and acid output of basal gastric acid secretions were examined in unanesthetized rats with chronic indwelling gastric cannulas. All four adenosine receptor agonists, R-phenylisopropyladenosine (R-PIA), S phenylisopropyladenosine (S-PIA), N-ethylcarboxamide adenosine (NECA), and 2 chloroadenosine (CADO) significantly decreased gastric acid output in a dose dependent manner. The rank order of potency was NECA, R-PIA greater than CADO greater than S-PIA. NECA and R-PIA were approximately equipotent in reducing gastric acid output. The levels of gastric acid output tended to increase at the lowest doses of the agonists. NECA decreased the volume of gastric secretion, whereas R-PIA had no effect on volume, but significantly increased the pH of the secretions. Valid measurements of pH in NECA-treated rats were not always obtainable because of near total inhibition of gastric secretions. S-PIA did not significantly affect volume, but increased pH at the higher doses tested. CADO decreased volume, but did not affect pH. These results indicate that adenosine analogs regulate not only the hydrogen ion concentration, but also the volume of gastric secretions. PMID- 2759172 TI - Vessel reactivity and prejunctional modulatory changes in the portal vein of mature spontaneously hypertensive rats. AB - The prejunctional effects of 2-chloroadenosine on the contractile responses to perivascular nerve stimulation were studied in conjunction with vessel reactivity in portal veins from mature (45-60 weeks) spontaneously hypertensive rats (SHR) and age-matched Wistar-Kyoto (WKY) controls. It was found that the contractility of the portal veins to exogenous noradrenaline was enhanced in SHR, while the sensitivity to noradrenaline, as seen from the EC50 values, was not altered. Responses to perivascular nerve stimulation (supramaximal voltage, 0.7 ms pulse duration for 10 s) were also enhanced in spontaneously hypertensive rats compared to WKY controls at all frequencies of stimulation tested (2-64 Hz), although the sensitivity to perivascular nerve stimulation was not changed since a response of 50% of the maximal obtainable was achieved at 8 Hz in both SHR and WKY. However, no evidence for change in the level of prejunctional modulation of nerve stimulation responses or postjunctional modulation of noradrenaline responses by 2-chloroadenosine (0.1-100 microM) was found. In conclusion, in mature SHR, responses to perivascular nerve stimulation and exogenous noradrenaline were found to be enhanced compared to responses in WKY, although there was no difference in the modulatory action of 2-chloroadenosine between SHR and WKY. PMID- 2759173 TI - Inhibition of noradrenaline release in the pig coronary artery via a novel serotonin receptor. AB - In pig coronary artery preincubated with [3H]noradrenaline, the effects of serotonin (5-HT) receptor agonists and antagonists on the electrically evoked (0.66 Hz) tritium overflow were determined. Tritium overflow was inhibited by 5 HT, 5-aminotryptamine, N,N-dimethyl-5-hydroxytryptamine, 5-hydroxytryptamine, 5 methoxy-3(1,2,3,6-tetrahydropyridin-4-yl)-1H-indole (RU 24969) and tryptamine. The maximum inhibition obtainable with 5-HT was by about 35%, its pIC20 value was 7.85. 8-Hydroxy-di(n-propylamino)tetralin, urapidil, ipsapirone, 5 carboxamidotryptamine, 4-hydroxytryptamine, 5-methoxytryptamine and alpha-methyl 5-hydroxytryptamine did not decrease 3H overflow. The inhibitory effect of 5-HT was not antagonized by ketanserin, mesulergine, metitepine, propranolol, (3 alpha tropanyl)-1H-indole-3-carboxylic acid ester (ICS 205-930) and yohimbine. Additionally, it was not altered by indomethacin. We conclude from the present data that the sympathetic nerves of the pig coronary artery are endowed with inhibitory presynaptic 5-HT receptors which do not belong to the 5-HT1, 5-HT2 or 5-HT3 receptor type but seem to represent a so far unknown receptor class. PMID- 2759174 TI - Muscarinic receptor subtypes in human and guinea pig lung. AB - Muscarinic receptor subtypes in human and guinea pig lung membranes were characterised using selective muscarinic antagonists. Competition experiments were carried out against [3H](-)-quinuclidinyl benzilate binding at 25 degrees C in Tris-HCl buffer; non-specific binding was determined in the presence of 1 microM atropine. Of all the antagonists examined, only the M1-selective antagonist pirenzepine exhibited a heterogeneous binding profile (nH less than 1.0), best described by two-binding sites of high and low affinity. Binding of [3H]pirenzepine confirmed the presence of a high proportion of high affinity (M1) receptors (60% of total) in human peripheral lung. The high potency of M3 selective antagonists 4-diphenylacetoxy-N-methyl-piperidine methiodide (4-DAMP) and hexahydrosiladifenidol suggested the presence of M3 receptors, but the low potency of AF-DX 116 and methoctramine indicated that there was no significant population of M2 receptors present. The existence of muscarinic receptor subtypes in lung may have important clinical implication but their cellular localisation remains to be determined. PMID- 2759175 TI - Effects of the l isomer of fenfluramine on dopamine mechanisms in rat brain: further studies. AB - Experiments were carried out to gain additional evidence that l-fenfluramine reduces the dopamine-mediated effects in intact animals. l-Fenfluramine 5 and 10 mg/kg i.p. dose dependently raised the levels of homovanillic acid in the striatum and nucleus accumbens of rats 1 h after injection. The effect of 5 mg/kg l-fenfluramine disappeared and was actually reversed 4 and 8 h after injection. The effect of 10 mg/kg l-fenfluramine, administered 48 h after the last haloperidol dose, was completely antagonized in both striatum and nucleus accumbens of animals made tolerant to the effect of haloperidol on homovanillic acid levels (through repeated treatment with 1 mg/kg haloperidol i.p. twice daily for 11 days). Unlike haloperidol (0.25 mg/kg), l-fenfluramine in various doses (2.5-20 mg/kg i.p.) did not modify the levels of striatal 3-methoxytyramine or change the decrease induced by a s.c. injection of 0.5 mg/kg apomorphine. The effect of apomorphine was not antagonized by 10 or 20 mg/kg l-norfenfluramine, an active metabolite of l-fenfluramine but 20 mg/kg l-norfenfluramine significantly raised striatal 3-methoxytyramine levels. l-Fenfluramine 20 mg/kg (but not 10 mg/kg) significantly enhanced the output of striatal acetylcholine assessed by trans-striatal microdialysis, for 60 min after injection. Apomorphine 1 mg/kg i.p. completely antagonized the increase of acetylcholine caused by 1 mg/kg haloperidol or 20 mg/kg l-fenfluramine. The results confirm that the l isomer of fenfluramine produces effects on the responses to dopamine and acetylcholine similar to those of neuroleptics by a mechanism not involving direct blockade of receptors. PMID- 2759176 TI - Role of leukotrienes and platelet activating factor in acute gastric mucosal lesions in rats. AB - Leukotriene C4 (LTC4) and platelet activating-factor (PAF) were found to affect gastric microcirculation and mucosal integrity but their role in acute gastric damage has not been established. The present study with rats confirms that exogenous LTC4 (10 micrograms/kg.h s.c.) or PAF (10 micrograms/kg i.p.) alone caused only mild gastric mucosal injury but greatly augmented mucosal lesions produced by other irritants such as absolute ethanol, taurocholate, aspirin or stress. These acute lesions were accompanied by a significant increase in mucosal generation of LTC4, and the addition of PAF further increased it. Pretreatment with BN 52021, a PAF receptor antagonist, abolished PAF-induced gastric lesions and reduced LTC4 generation in tests with PAF plus ethanol. Nordihydroguaiaretic acid, an inhibitor of the lipoxygenase pathway, and FPL 55712, an LTC receptor antagonist, reduced dose dependently the extent of gastric damage in various models of gastric lesions. Again, these protective effects were accompanied by a reduction in mucosal LTC4 formation. In addition, the protection induced by nordihydroguaiaretic acid was reversed in part by the pretreatment with indomethacin, suggesting that it could be attributed to increased biosynthesis of protective PG. The results indicated that LTC4 biosynthesis is increased in various forms of gastric damage and that LTC4 may be involved in the pathogenesis of this damage. PMID- 2759177 TI - Ginkgolide B protects isolated hearts against arrhythmias induced by ischemia but not reperfusion. AB - The effect of ginkgolide B (BN 52021), a specific platelet-activating factor (PAF) antagonist, applied in doses of 1.5, 3.0, 6.0 X 10(-5) and 1.2 X 10(-4) mol/l, in comparison to that of metoprolol (10(-5) mol/l) and diltiazem (10(-7) mol/l), two widely used antiarrhythmic agents, on ischemia- and reperfusion induced arrhythmias and heart functions, such as heart rate (HR), coronary flow (CF), aortic flow (AF), left ventricular developed pressure (LVDP), its first derivative (LVdp/dtmax), and left ventricular end-diastolic pressure (LVEDP) in isolated working rat hearts was examined. BN 52021 caused a dose-related protection against dysrhythmias, such as ventricular fibrillation, ventricular tachycardia, and premature ventricular beats induced by ischemia (30 min ligation of the left anterior descending coronary artery). The antiarrhythmic effect of BN 52021 given in a dose of 6.0 X 10(-5) mol/l was comparable to that of diltiazem and superior to the activity of metoprolol. None of the drugs influenced reperfusion-induced rhythm disturbances. BN 52021 did not alter heart functions, while metoprolol reduced (LVEDP only, and diltiazem increased CF, decreased AF, LVDP, and LVdp/dtmax during regional ischemia, indicating a negative inotropic effect. The antiarrhythmic effect of BN 52021 appears to be related to an antagonism of an increase in slow calcium influx induced by PAF in myocardial cells. Similarly to the mechanism of action of established antiarrhythmic drugs, BN 52021 can presumably prevent the re-entry mechanism involved in the development of ischemia-induced rhythm disturbances. PMID- 2759178 TI - Central nervous system effects and behavioral interactions with ethanol of centrally administered dilazep and its metabolites in mice. AB - Dilazep (i.p.), a coronary vasodilator and an uptake inhibitor of adenosine, dose dependently potentiated acute ethanol-induced motor incoordination in mice. In view of peripheral cardiovascular depressive effects of dilazep, the effect of i.c.v. dilazep (25, 50 and 75 micrograms), and its metabolites, 1,4-bis(3 hydroxypropyl)perhydro-1,4-diazepine (BHPD) (15, 31 and 62 micrograms) and 1-[3 (3,4,5-trimethoxybenzoyloxy)propyl]perhydro-1,4-diazepine (TBPD) (62 and 125 micrograms) on ethanol-induced motor incoordination was studied. Dose-related potentiation of ethanol-induced motor incoordination was noted with dilazep and its metabolites. Whereas dilazep (i.p.) produced no apparent central nervous system (CNS) effects, by i.c.v. route, it caused CNS excitation including tonic clonic seizures. Adenosine uptake inhibition, Ca2+ entry blockade or direct activation of adenosine receptors was ruled out as the possible mechanism of seizures because dipyridamole, verapamil or N6-(2-phenylisopropyl)-adenosine (R PIA) administered i.c.v., while potentiating ethanol (i.p.)-induced motor incoordination did not produce seizures. The CNS excitation was minimal with BHPD and none with TBPD. Theophylline pretreatment partially blocked potentiation of ethanol-induced motor incoordination by dilazep and BHPD and not by TBPD. The data suggest dilazep-induced potentiation of ethanol-induced motor incoordination is partially due to central adenosine receptor mechanism and partly due to other yet unknown mechanism(s) and further supported our earlier reports about adenosine involvement in the CNS effects of ethanol. The data also suggest that dilazep (i.c.v.)-induced seizures are due to mechanism(s) other than adenosine uptake inhibition, Ca2+ entry blockade or direct adenosine receptor activation. PMID- 2759179 TI - 5-HT3 receptor binding sites are on capsaicin-sensitive fibres in the rat spinal cord. AB - Specific binding sites for [3H]zacopride were found in the dorsal part of the rat spinal cord, particularly in the superficial layers of the dorsal horn. These binding sites had the same pharmacological profile as 5-HT3 receptors in membranes from the rat entorhinal cortex or from NG 108-15 neuroblastoma-glioma cells. Administration of capsaicin (50 mg/kg s.c.) to neonatal rats to induce degeneration of unmyelinated primary sensory fibres resulted in a significant decrease in [3H]zacopride specific binding (-50%) in the dorsal zone of the spinal cord of 4 month-old rats. This decrease was as pronounced as the decrease in [3H]bremazocine and [3H]naloxone binding to opiate receptors. These data support the presynaptic location of 5-HT3 receptors, at least in part, on capsaicin-sensitive primary afferent fibres in the rat spinal cord. PMID- 2759180 TI - Interactive effects of peptidoleukotrienes and histamine on microvascular permeability and their involvement in experimental cutaneous and conjunctival immediate hypersensitivity. AB - The involvement of peptidoleukotrienes (LTs) in mediating the increase in microvascular permeability associated with experimental cutaneous immediate hypersensitivity was studied by examining the effect of SK&F 104353, a potent and selective LT-antagonist, on the response evoked by graded, intradermal injections of antigen. SK&F 104353, employed at doses that profoundly blocked LTC4, LTD4 and LTE4 responses, significantly reduced the response produced by experimental cutaneous immediate hypersensitivity. The response to the lowest antigen dose (0.1 microgram) was, however, entirely insusceptible to SK&F 104353. The effect of SK&F 104353 was also examined in combination with a pyrilamine-cimetidine dosing regimen sufficient to remove the histaminergic component of cutaneous immediate hypersensitivity. The non-histaminergic component associated with higher antigen doses (10 and 100 micrograms) was significantly reduced but not abolished by SK&F 104353; the non-histaminergic component associated with low antigen doses (0.1 and 1 microgram) was not susceptible to SK&F 104353. Thus, the increase in cutaneous microvascular permeability evoked by immediate hypersensitivity appears to comprise three components: (1) A histaminergic response apparent for all antigen doses; (2) a LT-mediated component which is manifest in response to high antigen doses; (3) a third, unidentified component that is present for the entire antigen dose-range but contributes less to the overall response when high antigen doses are used. A distinct non-histaminergic, non-leukotriene mediated component was not a feature of conjunctival immediate hypersensitivity. SK&F 104353 administered in combinatio with pyrilamine cimetidine virtually abolished the response with a small residual remaining only for the highest antigen dose. In further contrast to cutaneous immediate hypersensitivity, SK&F 104353 alone was comparatively ineffective in type 1 allergic conjunctivitis. This difference in susceptibility to SK&F 104353 appears to reflect the type of histamine-LTD4 interactive effect on microvascular permeability. Histamine and LTD4 were additive in terms of cutaneous microvascular permeability. In the conjunctiva, histamine and LTD4 appeared mutually exclusive in that the level of response produced by the combination tended not to exceed that of the single component which caused the greater effect. PMID- 2759181 TI - Amiloride inhibits 22Na uptake and [3H]QNB binding in rat submandibular cells. AB - Dispersed acini isolated by collagenase digestion of the rat submandibular gland were used to compare the effects of amiloride and furosemide on the uptake of the isotopic tracer 22Na and on the binding of [3H]quinuclidinyl benzylate ([3H]QNB). In mM concentrations, both inhibitors reduced 22Na uptake in resting cells 34 and 25-29%, respectively. Acetylcholine (1 microM) enhanced uptake 23% and this effect was reduced 45% by amiloride and 26% by furosemide. Amiloride inhibited the binding of [3H]QNB to crude membranes prepared from fresh submandibular glands in a dose-dependent fashion (IC50 = 8 x 10(-6) M). Furosemide (3 x 10(-8) to 10(-3) M) did not inhibit radioligand binding. Na influx into resting salivary acini thus appears to occur by both amiloride-sensitive and furosemide-sensitive transport systems. The similar inhibition by furosemide of unstimulated and stimulated uptake of 22Na suggests that acetylcholine does not significantly activate the cotransport system within the time frame (i.e., 2 min) of the experiments. Acetylcholine appears to activate an amiloride-sensitive Na/H antiport, but amiloride blocks cholinergic receptors and may thus affect Na transport by receptor blockade. Other actions of amiloride, such as its ability to penetrate into cells and to act as a weak base which alters intracellular pH, may also contribute to the inhibition of Na entry into salivary cells. PMID- 2759182 TI - Quinine potently blocks single K+ channels activated by dopamine D-2 receptors in rat corpus striatum neurons. AB - In single channel recordings from acutely dissociated neurons of the rat corpus striatum, a membrane K+ channel which is activated by dopamine D-2 receptors was blocked by nanomolar concentrations of quinine. An intermittent partial blockade was observed at 4-10 nM quinine, with a voltage dependence consistent with quinine binding to the channel near the extracellular surface of the membrane. A nearly complete blockade of channel current was observed at 100 nM quinine and above. Such concentrations are known to be too low to block various other ion channels, and may be attained in human brain at antimalarial dosages of quinine. Blockade of this channel by quinine may provide a useful experimental probe of dopaminergic function, as an alternative to D-2 receptor binding site blockade by neuroleptics. PMID- 2759183 TI - Lack of anticonvulsant tolerance with RU 32698 and Ro 17-1812. AB - Possible development of anticonvulsant tolerance to three benzodiazepine receptor ligands was assessed in mice using an i.v. infusion of pentylenetetrazol as the convulsive stimulus. Extensive tolerance developed rapidly in the case of diazepam (0.35 mg/kg b.d. or 1.5 mg/kg b.d.). No significant tolerance was seen with the imidazopyrimidine derivative RU 32698 (9 mg/kg b.d.) or the partial agonist benzodiazepine Ro 17-1812 (1 mg/kg b.d.) These results provide further support for the hypothesis that partial agonists at the benzodiazepine receptor induce less tolerance than full agonists. PMID- 2759184 TI - Carbamazepine, but not caffeine, is highly selective for adenosine A1 binding sites. PMID- 2759185 TI - The effect of epinephrine and benzalkonium chloride on cultured corneal endothelial and trabecular meshwork cells. AB - We evaluated the effect of dipivefrin hydrochloride, epinephrine hydrochloride, epinephrine borate and their respective vehicles with and without the preservative benzalkonium chloride, on the in vitro growth characteristics of human corneal keratocytes, endothelial cells and trabecular meshwork. Epinephrine hydrochloride and borate at low concentrations (0.0002%) significantly inhibited growth of both trabecular meshwork and corneal endothelial cells. Higher concentrations (0.02%) of these same drugs induced the same effect on the growth of keratocytes in vitro. Similar observations were made on the effect of dipivefrin hydrochloride on human corneal cells in vitro. Benzalkonium chloride alone was demonstrated to be responsible for the growth inhibitory effects on trabecular cells. The susceptibility of trabecular meshwork cells in culture to the commonly used ophthalmic preservative benzalkonium chloride is demonstrated. PMID- 2759186 TI - The effect of organ culture on human trabecular meshwork. AB - The effect of organ culture on the trabecular meshwork was studied in a series of human eyes using a perfusion culture system. One eye of a pair was cultured while the fellow eye was immediately fixed in glutaraldehyde. Culture periods ranged from 2 to 28 days, during which a mean intraocular pressure of 27 mmHg +/- 15 was maintained. The perfused culture medium appeared to leave the eye via Schlemm's canal and collector channels, mimicking the in vivo situation. The trabecular meshwork was well maintained with this system in 21 of 25 eyes. Cells remained in position on trabecular lamellae, cellular organelles usually remained normal, and the lamellae remained intact. Culture-induced changes were noted, with some cells developing intracytoplasmic lipid vacuoles and other cells developing swollen mitochondria. In addition, scattered focal cell necrosis was observed, most often in the uveal meshwork. Meshwork cellularity (nuclei:solid tissue) was determined with an image analysis system; there was an average cell loss of 20-40% in the cultured eyes as compared to their respective fellow control eyes. Overall, organ culture appears to maintain the human trabecular meshwork for at least 28 days, allowing controlled experimental studies to be performed. PMID- 2759187 TI - Differential binding of alpha-crystallins to bovine lens membrane. PMID- 2759188 TI - Loss of high-affinity membrane binding of bovine nuclear alpha-crystallin. PMID- 2759189 TI - The non-enzymic glycosylation of bovine lens proteins by glucosamine and its inhibition by aspirin, ibuprofen and glutathione. AB - Cataract is a long-term complication of diabetes mellitus. Diabetics have increased glucosamine levels and it is possible that the non-enzymic glycosylation of the lens structural proteins by glucosamine induces conformational changes in the lens that contribute to cataract formation. Aspirin and aspirin-like analgesics may protect against glycosylation. In this paper the binding of glucosamine to bovine lens proteins and the effects of aspirin, paracetamol and ibuprofen on this reaction were investigated. Significant binding of glucosamine to the lens proteins was found. Gel-chromatography indicated that beta H-crystallin was most reactive to the amino-sugar. Of the analgesics studied, aspirin was the most effective inhibitor of glycosylation, followed by the other anti-inflammatory drug, ibuprofen. Preincubation of the lens homogenate with aspirin was no more effective at decreasing binding of glucosamine than was simultaneous incubation with aspirin. Glutathione significantly inhibited glucosamine binding. Glucosamine is active in non-enzymic glycosylation but the reaction can be inhibited by agents thought to protect against cataract. PMID- 2759190 TI - The Gecko visual pigment: the dark exchange reaction and the effects of anions. AB - A dark reaction is known to occur in retinal extracts of the gecko (Gekko gekko), in which the natural 11-cis-chromophore of the 521-pigment is apparently replaced by adding 9-cis-retinal to form the 9-cis-photopigment. With chloride-deficient extracts the reaction involves some 70% of the 521-pigment. Anions like nitrate, azide, thiocyanate and cyanate that shift the spectrum toward the blue do not affect this 70% exchange. Anions like fluoride, iodide and sulfate likewise do not alter this magnitude of reaction. In contrast, chloride and bromide that induce a bathochromic spectral shift lead to a decrease in this dark replacement of the 11-cis chromophore. This protection is similar to the action of these two anions in antagonizing the pigment loss by NH2OH and by temperature, both occurring in the dark. Apparently, chloride and bromide alter the opsin conformation so as to stabilize and/or protect the Schiff's base linkage but nitrate, azide, thiocyanate and cyanate act at a different opsin site or by a different mechanism. PMID- 2759191 TI - Rhodopsin levels and retinal function in cats during recovery from vitamin A deficiency. AB - Extended vitamin A deficiency in the cat led to an abnormal appearance in the tapetal fundus with the formation of a dark brown streak centered on the area centralis. At this time rod sensitivity, as measured by the b-wave of the electroretinogram, was reduced by more than two log units; the level of rod visual pigment was reduced by about 90% throughout the paracentral retinal region and was essentially absent from the area centralis. Following oral supplementation with vitamin A there was a rapid partial recovery of both rhodopsin levels and rod sensitivity. Further recovery continued over more than 18 days to levels that were not substantially below normal. This recovery was absent from the area centralis, in which measured visual pigment levels remained very low. In supplemented cats, the brown color in the fundus faded but there remained a small hyper-reflective zone at the area centralis. Morphological examination of the central retina in a supplemented cat showed an outer nuclear layer reduced to one or two rows in the small zone with low rhodopsin levels. Cone but not rod photoreceptors were present in this zone and they appeared to lack outer segments. During recovery, the increase in rod sensitivity was approximately linearly related to the recovery of rhodopsin levels. Thus, in these conditions reduction in sensitivity resulting from previous vitamin A deficiency was limited by the ability of the photoreceptors to absorb incident quanta. The time course of the recovery of rhodopsin and sensitivity suggests that at least two processes were involved. The faster of these may be the regeneration of rhodopsin from existing opsin molecules in the outer segments, while the slower may depend on the renewal of the outer segments themselves. PMID- 2759192 TI - A study on the sequence of phototoxic effects of rose bengal using retinal pigment epithelial cells in vitro. AB - This paper describes a study on the sequence of the phototoxic effects of rose bengal (RB), a fluorescein derivative used as a vital stain in the diagnosis of certain external ocular diseases. Bovine melanotic RPE cells were grown in culture. These cells were labeled with [51Cr] and exposed to visible light in the presence of various concentrations of RB; the leakage of [51Cr] from the cells was used as a measure of cell lysis. Exposure to light of the cells with 0.3-10 microM RB induced approximately 13 to 43% cell lysis. The lysis progressively increased when the exposure time was varied from 10 to 30 min. A relatively short period of irradiation in the presence of RB was sufficient to produce sublytic cellular injury which could subsequently lead to complete cell lysis even in the absence of the photochemical treatment. The dark reaction was time-dependent, and reached a maximum for a given irradiation period. Our results thus show that there are two different processes that could eventually lead to the cell lysis: (a) a phototoxic effect which caused a sublytic damage and (b) a dark reaction that followed. PMID- 2759193 TI - Polyol pathway activity in streptozotocin-diabetic rat lens. AB - We have examined polyol pathway kinetics in the lenses of rats made diabetic with streptozotocin. At up to 11 days after diabetes induction, the lenses were isolated and subjected to 'pulse-chase' studies: the lenses were incubated with [13C]glucose and lens metabolism followed by [13C]nuclear magnetic resonance (NMR) spectroscopy. Proton NMR spectroscopy was also performed to measure the hexose monophosphate shunt (HMPS) activity. The results showed that (1) the activity of aldose reductase increased initially and decreased after 11 days of diabetes; (2) the fructose pool increased initially but started to decline after 3 days; (3) the HMPS activity increased nearly 40% immediately after diabetes induction; and (4) the turnover rates of glucose, alpha-glycerophosphate (GP), lactate, sorbitol, and fructose were 80.8 +/- 2.6, 10.1 +/- 1.4, 47.7 +/- 3.7, 7.9 +/- 0.9 and 5.2 +/- 2.2 nmol hr-1 lens-1 (34 mg wet weight lens-1), respectively. Up to 35% of lactate appeared to derive from the polyol pathway. Further, GP was rapidly metabolized, although its fate is currently unknown. These results reveal a far more complex pattern of glucose metabolism in the diabetic lens than that in lenses incubated in high glucose. PMID- 2759194 TI - Spontaneous tumors in NMRI mice from carcinogenicity studies. AB - Twelve carcinogenicity experiments in NMRI mice from two different breeders were started at three different locations between 1974 and 1979. Tumors occurring in untreated control mice were compiled on the basis of histopathological reports. Of the 629 male and 627 female mice at the beginning of the studies, 614 males and 591 females were evaluated. The remaining animals were unavailable due to autolysis. The histopathologic diagnoses were performed by a team of 5 pathologists. A total of 1,220 tumors was seen (585 in males and 635 in females), of which 527 were classified as malignant (218 in males and 309 in females). About 56% of all tumors were located in the lungs and lymphoreticular system (LRS). Average frequencies of primary tumors: lungs 28.7%, LRS 28.2%, ovaries 21.3%, uterus 4.6%, vascular tissue 4.5%, mammary glands 3.9%, liver 3.2%, Harderian glands 3.2%, testes 3.1%, adrenals 3.1%, stomach 2.9%, pituitary 2.2%, endocrine pancreas 1.2%, thyroid 1.0%, Cowper's glands 1.0% and various other organs having tumor frequencies of less than 1%. This wide spectrum of spontaneous tumors with comparatively low frequencies renders NMRI mice a suitable strain for carcinogenicity studies. Male animals exhibited strikingly more tumors of the lungs, liver, Harderian glands, adrenals, endocrine pancreas and intestine, while LRS and pituitary tumors were predominant in females. Some tumor frequencies seem to be influenced by different husbandry conditions and different stocks. However, even under nearly identical husbandry conditions, the general frequency of benign and/or malignant tumors and of particular tumors varied markedly from one study to the next. Differences in mortality among studies had no pronounced effect on the range of tumor frequencies. Due to this biological variability in animal material, an interpretation of tumor frequencies in carcinogenicity studies necessitates an in-depth knowledge of the variability of tumor data for this mouse strain under similar husbandry conditions. PMID- 2759195 TI - Glycogen accumulation in normal and irradiated minced muscle autografts on frog gastrocnemius. AB - Alterations induced in glycogen content and phosphorylase activity have been studied in normal and irradiated minced muscle autografts on frog gastrocnemius at days 1, 3, 5, 7, 10, 15 and 30 postgrafting. The changes observed in the glycogen content and phosphorylase activity conform to the degeneration and regeneration phases of muscle repair. An attempt has been made to explain the altered glycogen utilizing capacities of the frog skeletal muscle during its repair and regeneration. PMID- 2759196 TI - A new view of the arterial smooth muscle cells and autonomic nerve plexus by scanning electron microscopy in spontaneously hypertensive rats. AB - Mesenteric artery smooth muscle cells and their associated autonomic nerve plexus were simultaneously studied by scanning electron microscopy in 3-month-old spontaneously hypertensive rats. The adventitial surface of the outermost muscle layer revealed numerically more protrusions accompanied by a denser network of nerve fibers in spontaneously hypertensive rats vs normotensive Wistar-Kyoto rats. PMID- 2759197 TI - Histological and histometrical changes of liver damage in rats after treatment with ethanol and carbon tetrachloride. AB - A pretreatment of 30 to 52 weeks with a 10% (v/v) solution of ethanol did not bring about any distinct changes but increased the damaging effects on liver caused by an acute dose of carbon tetrachloride in rats. This was shown by the semiquantitative assessment of histological changes and by the measurement of hepatocyte nuclei. The results of both investigations are complementary to each other and show a correlation. PMID- 2759198 TI - Blood pressure and impairment of endothelium-dependent relaxation in spontaneously hypertensive rats. AB - Correlation between hypertension and impairment of endothelium-dependent relaxation was demonstrated using aortae from certain strains of rats with various levels of spontaneous hypertension. It was also observed that the impairment of endothelium-dependent relaxation is the secondary change due to hypertension, and the level and duration of hypertension is the determinant factor of the impairment. PMID- 2759199 TI - Extraadrenal adrenaline formation by two separate enzymes. AB - Adrenaline (A) is synthesized in the adrenal medullae by the enzyme phenylethanolamine-N-methyltransferase (PNMT). After surgical removal of the adrenal medullae tissue A levels ranged from 22% of control in the heart to 125% of control in the liver. Use of a novel assay to measure tissue A formation revealed that many tissues can synthesize A using PNMT and another enzyme that N methylates both noradrenaline and dopamine. These enzymes are non-neuronal, inducible and synthesize a major fraction of tissue and urine A. PMID- 2759200 TI - Depletion of hypothalamic norepinephrine reduces the fever induced by polyriboinosinic acid: polyribocytidylic acid (Poly I:Poly C) in rats. AB - Administration of either Poly I:Poly C (0.05-0.50 micrograms) or norepinephrine (2-8 micrograms) into the anterior hypothalamic area produced a dose-related fever in rats. The fever induced by Poly I:Poly C was attenuated after selective depletion of norepinephrine in the hypothalamus. However, selective depletion of hypothalamic norepinephrine did not affect the fever induced by intrahypothalamic norepinephrine. The data indicate that Poly I:Poly C may act to induce fever through the endogenous release of norepinephrine from the rat's hypothalamus. PMID- 2759201 TI - gamma-Aminobutyric acid uptake by rat kidney brush-border membrane vesicles. AB - Brush-border membrane vesicles (BBMV) from rat kidney cortex possessed two uptake systems for gamma-aminobutyric acid (GABA), a high affinity system (Km = 10.9 microM) and a low affinity system (Km = 1203 microM). Both uptake systems were inhibited by p-hydroxymercuribenzoic acid and ouabain, and by the action of neuraminidase, whereas the GABA analogs nipecotic acid, beta-alanine, 2,4 diaminobutyric acid and 4,5,6,7-tetrahydroisoxazolo-[4,5 c]-pyridin-3-ol had no effect on the GABA uptake activity. The BBMV uptake systems were clearly different from the GABA transport systems present in brain tissue. PMID- 2759202 TI - Antiproliferative effects of 4',5'-unsaturated adenine nucleosides on leukemia L1210 cells in vitro. AB - Several 4',5'-unsaturated adenine nucleosides were shown to have antiproliferative activity against L1210 leukemia cells in vitro. The active nucleosides were cytotoxic to the L1210 cells as demonstrated by Trypan Blue uptake. The cytotoxicity was not induced by alterations in the ribonucleoside and deoxyribonucleoside triphosphate levels of the L1210 cells. PMID- 2759203 TI - Interaction of salicylate and noise results in mortality of rats. AB - Survival as a function of salicylate dose and the intensity of environmental noise was investigated in 150 adult female pigmented rats. Rats were assigned to groups (n = 6/group) defined by combinations of salicylate levels from 0-(saline) to 300 mg/kg, injected subcutaneously, and noise levels from ambient noise to 98 dB SPL, presented daily for 10-h periods for up to 17 days. Mortality occurred in groups exposed to the higher combinations of salicylate and noise. PMID- 2759204 TI - Antiarrhythmic peptide has no direct cardiac actions. AB - The electrophysiologic, inotropic, and muscarinic effects of antiarrhythmic peptide (AAP) were examined in canine cardiac Purkinje fibers, ferret papillary muscle, and canine cardiac membranes, respectively. Aside from a prolongation of time to peak force in papillary muscle, no biologically significant effects of AAP could be determined in any preparation, suggesting that its antiarrhythmic effects are not mediated by direct membrane actions. PMID- 2759205 TI - Lesions in suprachiasmatic nuclei simulate effects of pinealectomy on prolactin release in ovariectomized and sulpiride-treated female rats. AB - Previous studies indicate that the pineal gland alters prolactin secretion, and it was suggested that at least part of the effect of the pineal hormone melatonin on prolactin release may be mediated by the hypothalamic structures. In this study, pinealectomy and lesions of the suprachiasmatic nuclei were found to alter serum levels of prolactin in the same direction, an effect that was counteracted by daily afternoon melatonin administration. Melatonin, but not other pineal indoles, also prevented sulpiride-induced prolactin secretion in pinealectomized or suprachiasmatic nuclei-lesioned and ovariectomized rats, which suggested that the pineal gland can modulate prolactin secretion by acting through a dopamine mechanism independent of hypothalamic suprachiasmatic structures. PMID- 2759206 TI - Gradient distribution pattern of muscarinic receptors in N1E 115 mouse neuroblastoma cells. AB - The distribution pattern of muscarinic receptors in N1E 115 mouse neuroblastoma cells after linear and non-linear gradient centrifugation was investigated. In untreated cells, at least two forms of the receptors, with different densities, were found. PMID- 2759207 TI - Increased susceptibility to lipid peroxidation in skeletal muscles of dystrophic hamsters. AB - The results showed that the total content of lipids, which could be peroxidized with Fe(2 +)/ascorbate stimulation in vitro, was 45.4% and 53.7% higher than normal in the dystrophic hamster muscle at the age of 1 and 3 months, respectively. Correspondingly, the susceptibility to lipid peroxidation (stimulated by ADP-chelated iron at 37 degrees C) was 38.6-74.3% higher in dystrophic muscles. The increases were not related to necrotic lesions and inflammation observed. The activities of glucose-6-phosphate dehydrogenase, glutathione reductase, thioredoxin reductase and catalase were increased in dystrophic muscles but those of superoxide dismutases and glutathione peroxidase were unaffected. PMID- 2759208 TI - In situ demonstration of the activity of 3 beta-hydroxysteroid dehydrogenase on steroid hormone secreting cells within the paraaortic lymph nodes of golden hamster. AB - The in situ activity of 3 beta-hydroxysteroid dehydrogenase was detected in clustered cells which showed steroid-producing morphology, within the capsule of the paraaortic lymph node. In light and electron microscopic studies, the positive reaction products were detected on intracapsular cell clusters. This result indicates that these unique cells may have a steroid secreting function within the lymph nodes. PMID- 2759209 TI - Effect of human serum on alkaline phosphatase induction in cultured human tumor cells. AB - The continuous cell lines T 24 and HT-29, derived from human bladder and colon carcinomas, produce term-placental and intestinal alkaline phosphatase, respectively. Growth in hyperosmolar medium or exposure to prednisolone or sodium butyrate induces increased enzyme levels, and combinations of inducers elicit synergistic activity increases. The effect of the inducing agents is strikingly diminished when cells are grown in the presence of high concentrations of human serum, and the synergistic increases are essentially abolished. Major human serum protein fractions do not affect alkaline phosphatase induction. PMID- 2759210 TI - Necessity of adjuvants for inducing effective antibody response to zona pellucida antigens. AB - Rhesus monkeys evoked a vigorous antibody response to a single heteroimmunization dose of zona pellucida antigens, when these were administered along with complete Freund's adjuvant. The antisera recognized all the three major porcine zona glycoprotein families and the animals were rendered amenorrheic after such immunization. Monkeys immunized with zona without adjuvant, however, failed to show any anti-zona antibody response and had normal menstrual cycles. Zona pellucida glycoproteins are thus not effective immunogens unless administered along with a powerful adjuvant. PMID- 2759211 TI - Suppression of phytohemagglutinin induced splenocyte proliferation during concurrent infection with Eimeria nieschulzi and Nippostrongylus brasiliensis. AB - Results suggest that infection with Eimeria nieschulzi (Protozoa) interferes with splenocyte proliferation induced by infection with Nippostrongylus brasiliensis (Nematoda). PMID- 2759212 TI - Age distribution of circulating alpha-interferon. AB - A sensitive radioimmunoassay showed that circulating alpha-interferon in the plasma of healthy individuals was low in children and reached the highest level in the young adult, then declined gradually with age. Circulating alpha interferon was 0.201 +/- 0.059 ng/ml in males (n = 19) and 0.184 +/- 0.076 ng/ml in females (n = 14) at ages 30-39 years old. It was noted that circulating alpha interferon was maintained up to a certain level even in elderly individuals. PMID- 2759213 TI - Cadmium effects and biochemical status in hamsters following acute exposure in late gestation. AB - A normally teratogenic dose of cadmium ions administered to hamsters late in gestation does not cross the placental barrier nor does it result in placental pathology. Our finding, which differs from data for other rodents, may be due to differences in the chemical status of cadmium in the placental cytosols. PMID- 2759215 TI - 9-Methyl-7-bromoeudistomin D, a potent inducer of calcium release from sarcoplasmic reticulum of skeletal muscle. AB - The Ca2+-releasing action of several derivatives of eudistomin D isolated from a marine tunicate was compared with that of caffeine. It was found that 9-methyl-7 bromoeudistomin D was approximately 1000 times more potent than caffeine in causing Ca2+ release from the sarcoplasmic reticulum. PMID- 2759214 TI - An immune response-dependent mechanism for the vertical transmission of an entomopathogen. AB - An exceptionally efficient mechanism for the vertical transmission of a parasitic gregarine is dependent on the insect host's immune response. Gametocysts of Ascogregarina chagasi on the genital accessory glands of adult female sand flies (Lutzomyia longipalpis) become encapsulated through hemocyte-mediated immune reactions. Oocysts of A. chagasi, ejected into the lumen of the glands owing to pressure exerted by this capsule, become glued to eggshells and are subsequently ingested by larvae. In L. longipalpis with an experimentally suppressed encapsulation reaction, fewer accessory glands contained oocysts of A. chagasi. PMID- 2759216 TI - Nonvoluntary sexual activity among adolescents. AB - Data from the 1987 round of the National Survey of Children indicate that seven percent of Americans aged 18-22 have experienced at least one episode of nonvoluntary sexual intercourse. Women were more likely than men to report having had such an experience, with just under half of all nonvoluntary experiences among women occurring before the age of 14. Multiple classification analysis reveals that white women who had lived apart from their parents before age 16, those who had been brought up in poverty, those who had had a physical, emotional or mental limitation when they were young, those whose parents had been heavy drinkers, those whose parents had used illegal drugs and those whose parents had smoked cigarettes when they themselves were teenagers were at significantly greater risk for experiencing sexual abuse. Six percent of young white women with no risk factors, nine percent of those with one, 26 percent of those with two, and 68 percent of those with three or more had been sexually abused before or during adolescence. PMID- 2759217 TI - The effectiveness of contingency-planning counseling. AB - A longitudinal study assessed the effectiveness of contingency-planning counselling on contraceptive use and pregnancy outcomes among patients at a family planning clinic. Of 914 women enrolled in the study, 502 received traditional family planning counseling that focused on the provision of information and the selection of a contraceptive method, and 412 received contingency-planning counseling, which provided additional attention to possible problems that might arise with contraceptive use and the particular method selected. Although contingency-planning counseling was favorably received by both patients and staff members, patients in the two groups did not differ significantly on most of the outcomes considered. The two counseling groups had remarkably similar rates of clinic continuation at both the six- and 12-month follow-ups and analogous patterns of contraceptive use. In an exception to this pattern, the six-month pregnancy rate was significantly reduced among contingency counseled patients who had ever been pregnant. However, the effectiveness of the intervention in reducing the likelihood of unintended pregnancy was short-lived: At 12 months, the pregnancy rate among ever-pregnant women was the same for traditionally counseled patients as for those receiving contingency-planning counseling. PMID- 2759218 TI - Analyzing teenage births by school district. PMID- 2759219 TI - The fight over Roe v. Wade: the Webster briefs. PMID- 2759220 TI - Still screening for pulmonary tuberculosis? PMID- 2759221 TI - Immediate and late asthmatic responses induced by exercise in patients with reversible airflow limitation. AB - The existence and prevalence of late asthmatic responses to exercise in patients is uncertain. We investigated whether the late falls of peak expiratory flow rate (PEFR) after exercise challenge were still significant after comparison with the corresponding clocktime PEFR on a control day. We examined 86 patients with reversible airflow limitation, 79 with asthma and 7 with chronic obstructive pulmonary disease (COPD), all under regular treatment with bronchodilators and/or anti-inflammatory agents. Patients were randomized for a control day and an exercise day and PEFR was recorded hourly. On the exercise day, each patient underwent an 8 minute bicycle ride at 90% of predicted heart-rate. An early and a late asthmatic response to exercise were considered to occur when PEFR decreased by 10% or more on the exercise day compared to the corresponding clocktime PEFR on the control day. Thirty-three patients (38%) had a 10% or greater fall of PEFR at 4 to 13 hours after exercise when PEFR was compared with the corresponding clocktime on a control day. Seven (8%) had an isolated late asthmatic response, and 26 (30%) had a dual asthmatic response. We conclude that true late asthmatic responses develop after exercise in a significant number of patients with well controlled reversible airflow limitation. PMID- 2759222 TI - Pretreatment with an inhaled alpha 1-adrenergic agonist, methoxamine, reduces exercise-induced asthma. AB - In order to assess the role of the bronchial circulation in the pathogenesis of exercise-induced asthma (EIA), we conducted a double-blind, randomized study of the effects of pretreatment with an inhaled alpha 1-adrenergic agonist, methoxamine (Mx), in nine asthmatic teenagers with known EIA. Exercise consisted of 5 min cycle ergometry at a submaximal, constant work-load, while the subjects breathed dry air at ambient temperature. Forced expiratory volume in one second (FEV1) was measured at baseline, 15 min after pretreatment of either Mx or saline, and serially after exercise. Mx significantly reduced the exercise induced fall of FEV1 without modifying baseline FEV1 in five of the eight subjects, had little or no effect in three and caused an acute asthmatic attack in the remaining subject. Mx has potent constrictor effects on both bronchial and vascular smooth muscles through stimulation of postjunctional alpha 1 adrenoceptors. Therefore, the protective effect of Mx on EIA may be attributed to vasoconstriction of tracheobronchial vessels opposing the hyperaemia and mucosal airway oedema that may cause, at least in part, the exercise-induced acute bronchial obstruction in EIA. Alternatively, Mx stimulates mucus, water and electrolyte secretion by airway epithelium and may, therefore, oppose the dehydration of airway surface that could be a causative factor of EIA. PMID- 2759223 TI - Levomepromazine (Nozinan) reduces nonspecific bronchial hyperreactivity in asthmatics. AB - Ten patients with bronchial asthma were challenged with histamine before and after receiving saline and active drug (levomepromazine or antazoline) (a total of six challenges). The antihistaminic effect of levomepromazine (25 mg) was found to be comparable to that of antazoline (100 mg), evaluated from skin prick tests. Prechallenge forced expiratory volume in one second (FEV1) was found to be larger after levomepromazine than after antazoline (p less than 0.05), indicating a direct bronchodilating effect. This increased threshold airway calibre may have influenced the results of challenge, but change in provocative concentration producing 20% fall (PC20) was not statistically significantly correlated to change in FEV1. Levomepromazine increased PC20 2-doubling concentration compared to antazoline (p less than 0.05). Variation was observed in two minutes' ventilation during tidal volume breathing challenge. However, there was no statistically significant variation in two minutes' ventilation during challenge after receiving levomepromazine or antazoline. It was concluded that levomepromazine possesses a bronchodilating capacity and reduces bronchial hyperreactivity. PMID- 2759224 TI - Amelioration of human neutrophil elastase-induced emphysema in hamsters by pretreatment with an oligopeptide chloromethyl ketone. AB - Human neutrophils are a likely source of elastase in the pathogenesis of human pulmonary emphysema. A study was undertaken to determine whether emphysema, induced in hamsters by intratracheal treatment with human neutrophil elastase (HNE), could be ameliorated by intratracheal instillation of succinyl-alanyl alanyl-prolyl-valine-chloromethyl ketone (CMK). One mg of CMK was given to hamsters 1 h before 300 or 360 micrograms HNE or 1 h or 4 h after 360 micrograms HNE. The animals were studied eight weeks after treatment. The CMK given 4 h after HNE did not ameliorate the emphysema. The CMK given 1 h before HNE, ameliorated the development of emphysema but not bronchial secretory cell metaplasia. A molar ratio of instilled CMK to HNE of 128 was required for 50% in vivo effectiveness in ameliorating emphysema. Clearance studies indicated that 6.9% of the instilled CMK could be lavaged from the lungs 1 h after instillation. Therefore, an 8.9 to 1 molar ratio of lavageable CMK to HNE, at the time of HNE instillation, resulted in 50% protection. Using an in vitro assay with 3H-elastin as substrate, a 3 to 1 molar ratio of CMK to HNE was required to inhibit 50% of the elastolytic activity; 14% of the activity remained with an 18 to 1 molar ratio of CMK to HNE. Study of the in vivo effectiveness of anti-elastases, given as pretreatment in ameliorating HNE-induced emphysema and secretory cell metaplasia, is a reasonable bioassay, which may be used as a step in evaluating such agents for possible use in the prevention of human disease. PMID- 2759225 TI - Endobronchial hamartoma removed by rigid bronchoscope. AB - An endobronchial hamartoma of the right lower lobe was discovered in a 60 yr old female patient. She had been diagnosed and treated for chronic intractable bronchial asthma for more than 10 yrs. The endobronchial hamartoma was successfully removed with a rigid bronchoscope. PMID- 2759226 TI - Inappropriate titles of abstracts. PMID- 2759227 TI - The TRH-related peptide pyroglutamyglutamylprolinamide is present in human semen. AB - We have recently identified a novel peptide in the rabbit prostate complex which cross-reacts with an antibody to thyrotrophin-releasing hormone (TRH) and has the structure pGlu-Glu-ProNH2. In the present study, high concentrations of a TRH related tripeptide and also a polypeptide (10-12 kDa) containing a TRH immunoreactive peptide at its C-terminus were detected in human semen. The low molecular mass TRH-like peptide and the immunoreactive fragment from the polypeptide were isolated from human semen and shown to have identical structures. Amino acid analysis suggested compositions Glx2, Pro1, and after mild acid hydrolysis, the same sequence, Glu-Glu-Pro, was established for the two peptides. Fast atom bombardment (FAB) mass spectrometry yielded a pseudomolecular ion (M + H)+ of 355.38 which was identical to that of the synthetic peptide pGlu Glu-ProNH2. The data demonstrate that human semen contains the TRH-like peptide pyroglutamylglutamylprolinamide and also a polypeptide terminating in the sequence Gln-Glu-ProNH2. PMID- 2759228 TI - Radiation inactivation analysis of the A1 adenosine receptor of rat brain. Decrease in radiation inactivation size in the presence of guanine nucleotide. AB - Radiation inactivation analysis of the binding of the A1 adenosine receptor antagonist, 8-cyclopentyl-1,3-dipropylxanthine to rat brain membranes yielded a radiation inactivation size of 58 kDa. In the presence of GTP gamma S this was reduced to 33 kDa, in good agreement with the size of the ligand-binding subunit detected after photoaffinity labelling. The data indicate that the structural association of A1 adenosine receptors with G-protein components is altered in situ in the presence of guanine nucleotides. PMID- 2759229 TI - Direct evidence that the kinase activity of protein kinase C is involved in transcriptional activation through a TPA-responsive element. AB - In order to examine the involvement of protein kinase C (PKC) in the transcriptional activation of genes by TPA (12-0-tetradecanoyl phorbol 13 acetate) we have constructed a series of PKC expression plasmids. Transient expression of an active fragment of PKC in rat fibroblasts resulted in the transcriptional activation of a TRE (TPA-responsive element)-CAT chimeric gene which contains various repetitions of collagenase TREs. These provide the first direct evidence that kinase activity of PKC is involved in TPA-induced transcriptional activation through TRE. PMID- 2759230 TI - Reply to comment. De bello physostigminico II (the physostigmine controversy). PMID- 2759231 TI - Tentative identification of RNA-dependent RNA polymerases of dsRNA viruses and their relationship to positive strand RNA viral polymerases. AB - Amino acid sequence stretches similar to the four most conserved segments of positive strand RNA viral RNA-dependent RNA polymerases have been identified in proteins of four dsRNA viruses belonging to three families, i.e. P2 protein of bacteriophage phi 6 (Cystoviridae), RNA 2 product of infectious bursa disease virus (Birnaviridae), lambda 3 protein of reovirus, and VP1 of bluetongue virus (Reoviridae). High statistical significance of the observed similarity was demonstrated, allowing identification of these proteins as likely candidates for RNA-dependent RNA polymerases. Based on these observations, and on the previously reported sequence similarity between the RNA polymerases of a yeast dsRNA virus and those of positive strand RNA viruses, a possible evolutionary relationship between the two virus classes is discussed. PMID- 2759232 TI - Direct activation of a protein kinase activity from rat lacrimal gland by PMA in a phospholipid-free system. AB - The analysis of the cytosolic fraction from rat exorbital lacrimal gland with DEAE-cellulose ion-exchange chromatography showed the presence of a peak of protein kinase activity which was dependent on the presence of phosphatidylserine and diolein as well as calcium. This activity showed the same properties as the previously reported protein kinase C (PKC). Moreover, we have shown for the first time that this kinase or a kinase that coeluted from the column with PKC could be activated by a phorbol ester, PMA, in a phospholipid-free system, i.e. in the absence of any cofactor of PKC. These findings emphasize the need for caution in the interpretation of experimental results obtained when using phorbol esters to probe for a role of PKC in many regulatory processes. PMID- 2759233 TI - Delta zero-thalassemia in cis of beta Knossos-globin gene. Normal structure transient expression of the delta-globin gene. AB - We have previously described the first homozygous cases of Hb Knossos in an Algerian family. The Hb A2 was completely absent, ascertaining the presence of a delta zero-thalassemia determinant in cis of the beta Knossos S gene. Here, we investigate the affected delta-globin gene. The complete DNA sequence of the gene and its 5' and 3' flanking regions was determined. Only two nucleotide changes were recorded: a C----T substitution at -199 and an AT insertion at -448 upstream from the cap site. To examine the involvement of these changes in gene function, the delta-gene was subcloned in an expression vector and introduced into COS cells. Analysis of RNA derived from these cells, using an S1 protection assay and dot-blot hybridization, revealed qualitatively and quantitatively normal transcription. The loss of delta-globin gene activity in vivo may be due to the alteration of a tissue-specific control. PMID- 2759234 TI - Alzheimer's disease: microtubule-associated proteins 2 (MAP 2) are not components of paired helical filaments. AB - In Alzheimer's disease, the most characteristic neuropathological changes are the formation of neurofibrillary tangles (NFT) and neuritic plaques (NP) characterized by the presence of bundles of paired helical filaments (PHF) that accumulate in the degenerating neurites and neuronal cell bodies. Although the protein composition of the PHF is ill-defined, a number of microtubule-associated proteins have been implicated in these lesions. Here we report results with an antiserum monospecific for the microtubule-associated protein MAP 2 which does not cross-react with any other microtubular protein. Immunostaining with this antibody of sections from an Alzheimer's brain show a strong reactivity with NFT but no reactivity at the level of the NP. On the other hand, immunostaining of Alzheimer's brain sections with another antibody specific for the microtubule associated protein tau shows strong staining of PHF on both NFT and NP. These findings confirm the presence of the tau proteins in the PHF and strongly suggest that MAP 2 may not be a main structural component of the PHF. Labelling of NFT with the anti-MAP 2 antiserum suggests a non-specific binding of MAP 2 to the PHF during the process of NFT formation. PMID- 2759235 TI - Gene structure of rat cathepsin H. AB - The gene structure of rat cathepsin H was determined. It comprises at least 12 exons of various lengths (32-433 bp) spanning in total more than 17.5 kbp. The gene structure does not correspond well to the functional unit of the proteinase. The region around the active site Cys residue, the most conserved region among cysteine proteinases, is split by an intron. This is a common characteristic among the gene structures of cysteine proteinases. PMID- 2759236 TI - Component X of mammalian pyruvate dehydrogenase complex: structural and functional relationship to the lipoate acetyltransferase (E2) component. AB - The lipoate acetyltransferase (E2, Mr 70,000) and protein X (Mr 51,000) subunits of the bovine pyruvate dehydrogenase multienzyme complex (PDC) core assembly are antigenically distinct polypeptides. However comparison of the N-terminal amino acid sequence of the E2 and X polypeptides reveals significant homology between the two components. Selective tryptic release of the 14C-labelled acetylated lipoyl domains of E2 and protein X from native PDC generates stable, radiolabelled 34 and 15 kDa fragments, respectively. Thus, in contrast to E2 which contains two tandemly-arranged lipoyl domains, protein X appears to contain only a single lipoyl domain located at its N-terminus. PMID- 2759238 TI - Covalent peptide transfer to cell membrane proteins (peptidyl transferase). AB - HL60 cells, rabbit peritoneal granulocytes or membrane preparations of these cells incorporate radioactivity when reacted with the radioactive peptide tuftsin [3H Pro3]-Thr-Lys-Pro-Arg. The radioactivity which is not diminished by repeated treatments with TCA and NaOH, is covalently bound to a membrane acceptor protein of 100 kDa. The peptide is not displaced by large concentrations of its constituent amino acids. The acceptor protein is resolved into one labeled peak by gel filtration on Sephadex G-200, Sephacryl S-300 and by SDS-PAGE. Digestion by trypsin and chymotrypsin results in the production of smaller fragments. PMID- 2759237 TI - Affinity purified tetanus toxin binds to isolated chromaffin granules and inhibits catecholamine release in digitonin-permeabilized chromaffin cells. AB - Tetanus toxin, a potent neurotoxin which blocks neurotransmitter release in the CNS, also inhibits Ca2+-induced catecholamine release from digitonin permeabilized, but not from intact bovine chromaffin cells. In searching for intracellular targets for the toxin we studied the binding of affinity-purified tetanus toxin to bovine adrenal chromaffin granules. Tetanus toxin bound in a neuraminidase-sensitive fashion to intact granules and to isolated granule membranes, as assayed biochemically and visualized by electron microscopic techniques. The binding characteristics of the toxin to chromaffin granule membranes are very similar to the binding of tetanus toxin to brain synaptosomal membranes. We suggest that the toxin-binding site is a glycoconjugate of the G1b type (a polysialoganglioside or a glycoprotein-proteoglycan) which is localized on the cytoplasmic face of the granule membrane and might directly be involved in exocytotic membrane fusion. PMID- 2759239 TI - The distribution of a dopamine D2 receptor mRNA in rat brain. AB - Based on the recently reported sequence of a dopamine D2 receptor cloned from rat brain, we prepared a series of cDNA probes to determine the distribution of mRNA encoding this receptor. Within the forebrain, D2 receptor mRNA is abundant in the caudate-putamen, accumbens nucleus and olfactory tubercle. Moderate to low levels of mRNA are observed in the medial habenular nucleus, diagonal band, lateral septal nucleus, claustrum, dorsal endopiriform nucleus, and entorhinal cortex. In the mesencephalon, D2 receptor mRNA is abundant within the substantia nigra, pars compacta, and the ventral tegmental area. Comparison of the distribution of the mRNA and ligand binding indicates that both presynaptic and postsynaptic D2 receptors of the nigrostriatal, mesolimbic and mesocortical pathways are derived from the same mRNA. PMID- 2759240 TI - Formylmethanofuran dehydrogenase from methanogenic bacteria, a molybdoenzyme. AB - Formylmethanofuran dehydrogenase, a key enzyme of methanogenesis, was purified 100-fold from methanol grown Methanosarcina barkeri to apparent homogeneity and a specific activity of 34 mumol.min-1.mg protein-1. Molybdenum was found to co migrate with the enzyme activity. The molybdenum content of purified preparations was 3-4 nmol per mg protein equal to 0.6-0.8 mol molybdenum per mol enzyme of apparent molecular mass 200 kDa. Evidence is presented that also formylmethanofuran dehydrogenase from H2/CO2 grown Methanobacterium thermoautotrophicum (strain Marburg) is a molybdoenzyme. PMID- 2759241 TI - Unspecific DNA binding of the DNA binding domain of the glucocorticoid receptor studied with flow linear dichroism. AB - The unspecific interaction between the DNA-binding domain of the human glucocorticoid receptor and DNA was studied using linear dichroism (LD) and circular dichroism (CD) spectroscopy. The amplitude of the LD signal was found to increase upon addition of protein at ionic strengths less than 60 nM Na+, indicating an increased persistence length of the complex compared to uncomplexed DNA. Analysis of the LD spectrum suggests that the binding does not involve intercalation of tyrosine residues. Evidence of saturation is found at a binding stoichiometry of approximately 5 DNA base pairs per protein monomer. PMID- 2759242 TI - Identification of Nsp100 as elongation factor 2 (EF-2). AB - The nerve growth factor-sensitive phosphoprotein from PC12 cells, previously designated Nsp100, has been shown to be elongation factor 2 (EF-2). The criteria used for this identification include: (i) similarity of N-terminal sequence; (ii) phosphorylation by the same kinase; (iii) ADP-ribosylation mediated by diphtheria toxin; (iv) comparable function in cell-free protein synthesis. According to these criteria, Nsp100 and EF-2 are identical and the kinase that phosphorylates Nsp100 in PC12 cells is calcium/calmodulin kinase III. PMID- 2759243 TI - Linker histone-DNA complexes: enhanced stability in the presence of aluminum lactate and implications for Alzheimer's disease. AB - The binding of human brain linker histone proteins to a radiolabelled human Alu repetitive element was examined by mobility shift assay. Analysis of the complexes formed from protein extracts of whole neocortical nuclei, under physiological conditions in vitro revealed that linker histone H1(0) has the highest affinity for the Alu DNA sequence. The linker histone-DNA complexes assembled in the presence of aluminum lactate were more resistant to sodium chloride-induced dissociation than those formed in the presence of sodium lactate. The enhanced stability of deoxyribonucleoprotein (DNP) complexes in the presence of the aluminum cation may be of significance in neurodegenerative conditions such as Alzheimer's disease where aluminum preferentially associates with DNA containing structures of the nucleus. PMID- 2759244 TI - Similarities between G-proteins in visual cells of Sepia and cattle. AB - In contrast to antisera against native transducin a polyclonal antiserum raised against heat-denatured bovine transducin crossreacts with the G-protein from Sepia visual cells. This antiserum recognizes a 44 kDa (G alpha) and a 36 kDa (G beta) protein band from Sepia photosensory membrane preparation. Furthermore we purified the antibody-binding G-protein from Sepia by binding it to light activated rhodopsin of Sepia and GTP-induced extraction, similar to the purification of bovine transducin. This G-protein is probably involved in the phototransduction process. The purified Sepia G-protein did bind to vertebrate photosensoric membrane upon illumination, but was not eluted by GTP-containing buffer solution. After extensive bleaching, the G-protein became soluble. PMID- 2759245 TI - The primary sequence of the PFK-1 inactivating zinc-binding protein as deduced from cDNA sequencing. Identity of the zinc-binding protein with rat parathymosin. AB - We have recently described the sequence of the Zn2+-binding domain (43 amino acid residues) of a newly detected Zn2+-binding protein which reversibly inactivates phosphofructokinase-1 in a Zn2+-dependent manner [(1986) J. Biol. Chem. 269, 5895 5900; (1988) Eur. J. Biochem. 177, 561-568]. Here, we describe the primary sequence of this protein based on a full-length cDNA. A sequence comparison reveals the identity of the Zn2+-binding protein with a protein called parathymosin-alpha. PMID- 2759246 TI - New chloride-activated aminopeptidase from human erythrocytes. AB - A new Cl- -activated aminopeptidase was purified from the cytosol of human erythrocytes as a single chain protein of an approx. Mr of 70,000 and pI of 5.1. The enzyme hydrolysed 2-naphthylamides of aliphatic, aromatic and basic L-amino acids, with a preference for the alanyl residue. It also hydrolysed di-, tri-, and some hydrophobic tetrapeptides. The inhibitors were bestatin, amastatin, Co2+, Zn2+, Mn2+, 4-hydroxymercuribenzoate and 1,10-phenanthroline. The activity of the enzyme, inhibited by 4-hydroxymercuribenzoate, was partially restored by the addition of sulfhydryl compounds. The presence of 0.2 M Cl- (Br-,F-) caused a several-fold increase in the isolated aminopeptidase activity. PMID- 2759247 TI - Cynosures or shibboleths? PMID- 2759248 TI - Significance of tumor invasion and lymph node involvement on the prognosis and selection for surgery of adenocarcinoma of the cardia. AB - Between 1970 and 1983, 66 patients with adenocarcinoma of the cardia underwent resection in our institute. Hospital mortality within 30 days of surgery was 18.2%. Overall hospital mortality irrespective of time was 27.3%. The 4-year survival rate for all patients excluding overall hospital mortality was 29%. There was a significant difference in cumulative survival between T2 (n = 29) and T3 tumours (n = 15) (P = 0.035). Comparison in this 44-patient group of cumulative survival of patients with negative nodes (N0, n = 13) and positive nodes (N+, n = 31) was also significant (P = 0.01). The application of tumor invasion and lymph node involvement as peri-operative parameters for the selection of patients for resection was evaluated in a retrospective study. Forty four patients were found eligible to be rearranged in a system using the following clinicopathological parameters: T = 3 versus T = 2 and N+ (positive nodes in N1 and/or N2 groups) versus N0. This system revealed no distinct group of patients who should be withheld from resection according to the criteria held in our institute. Resection provided excellent relief of dysphagia in most patients. The various findings are discussed, and further prospective studies will be needed. At present, in the absence of haematogenous metastases, we prefer surgical resection for all patients whose general condition allows major surgery. PMID- 2759249 TI - An immunohistological study of gastric cancer--with special reference to the expression of carbohydrate antigens and nuclear DNA ploidy patterns. AB - The expression of carbohydrate antigens specific to Span-1, CA 19.9, and SLEX in cancer tissues and nuclear DNA ploidy patterns were studied from tissue specimens of lesions excised from 137 patients with gastric cancer. The frequency of detection of each antigen was augmented with advanced invasion depth and progress in regional lymph node metastasis. In the cases which were positive for all three kinds of antigens, lymph node metastasis and lymphatic or venous invasion were detected with significantly higher frequencies than in the negative cases. The DNA histograms showed a DNA ploidy pattern of Type Ia or Ib in the cases negative for these antigens and a non-diploid or aneuploid pattern of Type II or III in many of the positive cases. These findings suggest that an immunohistological study of gastric cancer using monoclonal antibodies, combined with a nuclear DNA ploidy analysis, might be useful for understanding malignancy of the tumour. PMID- 2759250 TI - Variations in steroid receptor status with disease stage in breast cancer. AB - Oestrogen and progesterone receptor (ER and PgR) distribution in three clinical subgroups of 421 breast carcinomas was analysed. The groups comprised (1) early breast cancer (T1-2a, N0M0; n = 64); (2) untreated advanced fungating cancer (n = 27) and (3) advanced cancer relapsing after endocrine therapy (n = 29). Receptor distribution in each of the subgroups was compared to that of the total population. The advanced fungating group contained no ER--ve/PgR--ve tumours and the distribution was also significantly different from the total population (P less than 0.001 by Chi-squared test). The proportion of tumours in the total population that contained greater than 40 fmol/mg ER was 187/421 (44.4%). There was no significant difference between the early breast cancer group and the total population (P greater than 0.9). However, the proportion of tumours containing ER greater than 40 fmol/mg in the advanced fungating cancer group (16/27, 59.3%) was significantly higher than in the total population (P less than 0.01). This difference may be partially explained by the older age at presentation in this group. In the relapsed after endocrine therapy group only four of 29 (13.8%) contained ER greater than 40 fmol/mg which was significantly different from the total (P less than 0.001). There was a higher proportion of early breast cancers containing PgR greater than 40 fmol/mg than in the total population (P less than 0.001). There was no significant difference between PgR distribution in the advanced fungating and relapsed groups compared to the total population. The data suggest that patients presenting with advanced fungating cancer are more likely to respond to endocrine therapy than the population as a whole, and that in breast cancer that has relapsed following endocrine therapy receptor levels decrease with progression of the disease. PMID- 2759251 TI - Erythrocyte sedimentation rate as a prognostic factor in renal cell carcinoma. AB - In a follow-up study of 193 adult patients with renal cell carcinoma diagnosed in northern Norway 1974-1980, ESR as a prognostic factor was studied with the Cox regression model. In 71 patients (37%) metastatic disease was known at diagnosis. In patients without metastatic disease an elevated ESR greater than 15 mm/h and renal vein involvement were significant prognostic factors indicating short survival. Multivariate survival analyses of all patients showed the presence of metastatic disease and elevated ESR (greater than 15 and greater than 30 mm/h) as significant prognostic factors indicating high-risk patients. This study concludes that ESR deserves attention as a prognostic discriminator in renal cell carcinoma. PMID- 2759252 TI - Epithelioid sarcoma. AB - In a 9-year period we treated 11 patients with an epithelioid sarcoma. Most patients were young adults. The tumour affected mainly the distal upper extremity (hand and fingers: four patients; wrist and forearm: three patients); one patient had an epithelioid sarcoma of the knee. Trunk localizations were seen in two patients and one patient presented with a vulva localization. Treatment consisted of surgery, regional isolation perfusion with doxorubicin (Adriamycin) or melphalan, radiation therapy, systemic chemotherapy or a combination of these modalities. Radical surgery in eight patients resulted in only two local recurrences. Locoregional metastases occurred in five patients. In five patients a therapeutic lymph node dissection was performed, in all instances followed by extensive recurrent disease. Distant metastases were seen in seven patients and mainly affected the skeleton (6x) and the lungs (4x); in the majority of cases these metastases occurred within a year after excision of the primary. Remissions following regional or systemic chemotherapy were not observed. At the time of analysis seven patients had died as a result of their epithelioid sarcoma; two patients were still alive with tumour 18 and 27 months after diagnosis. Only two patients remained tumour free for 17 and 65 months respectively following radical surgery, postoperative radiation therapy and (in one case) adjuvant chemotherapy. It is concluded that epithelioid sarcoma is a rare but exceedingly aggressive tumour. Since early diagnosis can only be auspicious, familiarity with the clinical features is of great importance. PMID- 2759253 TI - Primary radiotherapy with surgery in reserve for advanced laryngeal carcinoma. Results and complications. AB - A retrospective study of a selected group of 58 patients with T3 and T4 squamous cell carcinomas of the larynx presenting between 1974 and 1984 was undertaken. These patients were treated primarily with radical radiotherapy and salvage surgery in reserve. The aim of this study was to examine survival, recurrence rate and the complications after salvage surgery. In 30 patients the tumor was classified as a T3 and in 28 as a T4. In 14 patients (24%) nodal disease in the neck was present prior to the radiotherapy. Follow-up in all patients continued for at least 3 years or until death. Nineteen patients (33%) developed locally recurrent tumor and five (9%) developed nodal metastases to the neck. The recurrence in almost every patient was detected within 2 years after completion of the irradiation. Thirty patients (52%) are alive of whom 29 have no evidence of disease. Of these 30 patients 22 (73%) have their larynx intact and functioning. The 5-year adjusted acturial survival for the whole group of patients is 73%, for the T3N0 group 87% and for the T4N0 group 75%. Patients with nodal disease responded poorly. After salvage surgery severe postoperative complications developed in 37% of the patients. There were no deaths following salvage surgery. PMID- 2759254 TI - Clinical experience with CA-50 in the serum of carcinoma patients. AB - A radioimmunoassay was used for the detection of the human carcinoma-associated antigen CA-50 in the serum of 60 normal subjects, 236 patients with benign disease and 482 patients with carcinomas of different type. Serum levels in all normal subjects and 220 of 236 patients (93%) with benign disease were below 17 units/ml, while 269 of 482 patients (56%) with carcinoma had CA-50 levels above 17 units/ml. This tumour marker may prove useful in the diagnosis and monitoring of patients with various carcinomas. PMID- 2759255 TI - Evaluation of the therapeutic use of radioactive monoclonal antibodies C242 and C215 in transplanted murine tumours. AB - The therapeutic roles of monoclonal antibodies C242 and C215 labelled with 131I were investigated in transplanted mammary carcinomas. Fragments (10 mg) of mammary tumour from (A x Pc) F1 hybrid mice were implanted subcutaneously in 72 mice of the same strain. Twelve mice were injected with 131I-C242 starting from day 12 following tumour implantation, and eight out of 12 survived for 60 days. By contrast all but one of 36 control mice died within the same time period (P less than 0.0001). Twelve mice were injected with 131I-C215. Seven out of the 12 were alive at 60 days whilst all but 1 of 36 control animals had died (P less than 0.0001). In this study targeted immunotherapy using 131I-labelled antibodies C242 and C215 inhibited tumour growth and prolonged survival. Measurements of tumour area showed a 27-39 percent reduction in the mice receiving the radiolabelled conjugates C242 and C215 (P less than 0.004 and P = 0.028 respectively). PMID- 2759256 TI - Tourniquet infusion chemotherapy of the lower extremities--clinical and pharmacokinetic results. AB - A prospective analysis of tourniquet infusion chemotherapy is reported. Twelve patients with recurrent malignant melanoma and one patient with Kaposi's sarcoma on the lower extremities were treated. An objective tumor response (CR + PR) was noted in 4/8 patients with DTIC and in 1/5 with Adriamycin. Stable disease was registered in 2/8 and 2/5 when respective drugs were used. No major side effects were observed. Pharmacolkinetical analysis of Adriamycin were performed in five patients after two to three treatments. The plasma concentration time-curves of Adriamycin were in most cases described by an open three-compartment model. The AUC (area under the curve) values for Adriamycin were 3.4 (median value 95% CI 2.9-5.1) times higher than for Adriamycinol. The reproducibility of the intra arterial techniques was established by the repeated pharmacokinetic analysis. This technique seems to give lower AUC (mg/m2) when compared with earlier published intravenous data. The results indicate that tourniquet infusion chemotherapy produces a reasonable response, and that further evaluation with other drugs and comparison with isolation hyperthermic drug perfusion will be of interest. PMID- 2759257 TI - Leiomyosarcoma of a lower limb presenting with multiple cranial nerve palsies. AB - Leiomyosarcoma is a relatively uncommon soft tissue sarcoma usually presenting as a mass at the primary site. It arises in the retroperitoneal region, in the cutaneous or subcutaneous tissue of the extremities or, less commonly, from a large vein. A case is described where a patient presented with unilateral third, fourth, and sixth cranial, and ophthalmic division of trigeminal nerve palsies in whom biopsy of a longstanding lower limb mass demonstrated leiomyosarcoma. The presentation of this type of pathology has not been described previously. PMID- 2759258 TI - Cervicofacial actinomycosis in a patient treated for tonsillar carcinoma. AB - A 50-year-old patient who underwent locoregional radiotherapy and surgery for a tonsillar carcinoma, developed osteomyelitis with Actinomyces israelii with fistulization in the treated area, during chemotherapy treatment. This rare complication is discussed. PMID- 2759259 TI - The scientific tour of China and Hong Kong by the British Association of Surgical Oncology. PMID- 2759260 TI - [Free methyl-methacrylate content of some dental acrylates]. AB - The authors have proved the presence of free monomer content in 0,26% with Superacryl Special, 0,29% with Superpont C-B, 0,8% with Kallocryl C and the Duracryl O from a metanol solution of samples taken by cutting. By means of soaking in water for three months the most dissolved free monomer was 0.002% from Superpont C-B and Kallocryl C, and 0.004% from Duracryl O. From Superacryl Special no MNA was dissolved in determinable quantity. PMID- 2759261 TI - [A parallelling instrument for intraoral use]. AB - The parallelling applience employable in situ in the mouth is suitable for examining the axis relations of abutment and post teeth and for checking the axis position of prepared trunks. The applience helps the exact intra-oral preparation of surfaces, grooves, shoulders, parapulpal and root channel bores, parallel or of given declination angle. PMID- 2759262 TI - [Dental x-ray pictures made by parallel and right-angle technics]. AB - The long cone and its belonging film holder-centralizing system made by the Kentzler-Kaschner Dental GmbH (Ellwangen-Jagst, GFR) is well suitable to the right-angle technique. The system can simply be adapted to a number of X-ray apparatus. These technique decreases the distortion, the magnification and the radiation dose, increases the contrast of the pictures. The pictures are well reproducable. PMID- 2759263 TI - [Electrophysiologic study of hippocampal projections to the neurosecretory cells of the supraoptic nucleus in rats]. AB - Impulse activity of antidromically identified neurosecretory cells of the hypothalamic supraoptic nucleus, evoked by stimulation of the ventral hippocampus, was studied. Short-latency excitatory phasic reactions were revealed and no inhibitory responses were found. The existence of excitatory synaptic inputs was found from the hippocampus to other neurons of the supraoptic nucleus and perinuclear zone. These inputs were predominant as compared with analogous projections to neurosecretory cells. Peculiarities of limbic-hypothalamic relationships are discussed in connection with the afferent control of the neurosecretory cell activity. PMID- 2759264 TI - [Relation of optokinetic nystagmus and the width of the visual field]. AB - Optokinetic nystagmus (OKN) was elicited in humans by a moving vertical grating wide 30-170 degrees. A large range of velocities (10-120 degrees/sec) and a constant spatial stimulus frequency (0.13 cycle/degree) were used. It has been shown that the qualitative and quantitative OKN parameters can be controlled by stimulus area width. The optimal OKN was found under conditions of the whole field stimulation. Progressive masking of the periphery caused a OKN reduction whose magnitude was fixed in different stimulus ranges. The elimination of central stimulation resulted in a complete OKN suppression. The role of the stimulation eccentricity and of the stationary edges in the observed OKN changes is discussed. The findings offer a possibility for a more precise evaluation of OK responses. PMID- 2759265 TI - [Secretion of lysozyme by blood neutrophils during physical exertion]. AB - The effect of physical exercise on the lysozyme release from the blood neutrophils was investigated. The lysozyme RIA was adopted to evaluate its concentration. The RIA main parameters developed on the basis of specific antiserum and 125I-lysozyme, were noted. Physical exercise increased the lysozyme concentration in plasma and decreased it in neutrophils. During 2-hr resting, the partial normalizing of the values occurred. The data obtained suggest the above effect of physical exercise on the neutrophil secretory function to be a mechanism of suppression of the functional neutrophil activity. PMID- 2759266 TI - [Blood flow dynamics in adjacent microvessels of the brain in hypertensive rats]. AB - Significant alterations in the blood flow velocity, its amplitude and oscillations were found in cerebral cortex's microvessels of 5-12 mu diameter in normotensive and spontaneously hypertensive rats. Associated alterations of the blood flow shifted by a few seconds, were found in adjacent vessels. These alterations seem to be due to hemodynamic readjustments in proximal parts of the vascular net. The absence of these alterations in adjacent vessels suggests no significant redistribution of the blood flow in resting in cerebral cortex's microvessels. PMID- 2759267 TI - [Joint functions of the gastrocnemius muscle's blood vessels in lesions of the ventral structures of the medulla oblongata]. AB - Following bilateral electrolytic or chemical lesion of the neurons in rostral portion of the medulla oblongata ventral parts, a decrease in systemic arterial pressure, heart rate, precapillary resistance and perfusion pressure, postcapillary resistance and capillary hydrostatic pressure, was observed in the m. gastrocnemius vessels in cats, the capillary filtration coefficient increasing at that. Following chemical lesion of the neurons in caudal portion of the medulla oblongata ventral parts, a biphasic change of the AP and vascular resistance was observed in the m. gastrocnemius: their decrease within first 5 min was followed by their increase within next 120 min, the capillary filtration coefficient being decreased whereas capillary hydrostatic pressure increasing. No changes in the regional vascular capacity were found. PMID- 2759268 TI - [Mechanisms of the regulation of the blood supply of the aortic wall]. AB - The monoamine-induced contraction as well as the ATP- and hypoxia-induced relaxation of the smooth muscles were recorded in isolated aortal paravasal arteries. The data obtained show that the muscles of paravasal arteries represent a regulation mechanism of the aorta wall blood supply. PMID- 2759269 TI - [Interrelations of macro- and microhemodynamics and lymph outflow in the cat liver during stimulation of the hepatic nerves]. AB - Sympathetic electric stimulation of the liver nerves increased hydrostatic pressure in sinusoids by 8-10% in cats. The sinusoidal filtration coefficient decreased, particularly at the stimulation frequency 10-20 Hz. No significant increase in the lymph outflow from the liver was revealed which suggested an absence of the fluid transfer from the sinusoids to extravascular space. The above changes occurred against the background of the constriction of arterial, portal and venous vessels, as well as a reduction of the liver capacity. Comparison of these shifts with analogous values in small intestine revealed that the microcirculation in excitation of sympathetic-adrenal system is more stable in liver than in small intestine. PMID- 2759270 TI - [The role of sensory components in reactions of the human respiratory system to increasing loads]. AB - In 13 healthy male subjects performing an increasing work on veloergometer in conditions of resistive respiratory loads, the moments of sensation of respiratory difficulties and refusal from the work, were recorded. The analysis of the respiratory system functions revealed that the respiratory discomfort occurred with increasing of the alveolar PCO2 up to a certain value and that the refusal occurred on a certain level of inspiratory activity. The subjects believed that the moment of refusal coincided with the complete exhaustion of the respiratory system reserves. Their lung ventilation, however, as well as inspiratory effort were far from reaching the maximal values obtained in special tests. Apparently, the sensory components of responses to the combination of muscular work with an increased resistance against breathing are of a defensive character and directed to the prevention of the exhaustion of the respiratory system functional reserves. PMID- 2759271 TI - [Peripheral control of the feeding behavior of fresh water mollusks]. AB - Appetitive and consummatory feeding behavior was shown to be initiated by stimulation of different loci. Feeding programs were different in their motor output frequency in P. corneus and L. stagnalis stagnalis. The maintenance of the feeding program was provided by sensory input. In contrast to the insect flight generator, the feeding neuronal program had no peripheral regulation system in freshwater snails, its feeding program being more autonomic from peripheral influences than the flight motor program in insects. PMID- 2759272 TI - [Age-related dynamics of the development of choline metabolism in calves]. PMID- 2759273 TI - [Regulation of the phases of slow-wave ureteral activity by sodium and calcium ions]. AB - The ionic nature of each of the two slow wave depolarization phases of cat's ureter pacemaker during i.a. perfusion of kidneys, was studied. An increase of the calcium ions concentration led to an increase in the second wave phase amplitude, lengthening of the first phase and a decrease in the wave generation frequency. A decrease of the sodium ion concentration also led to an increase in the oscillation frequency with a corresponding shortening of the first phase. In sodium-free solution, during a short interval of time slow wave generation was observed which represented usually the second wave component. But for the autooscillations to get steady, the presence of sodium ions in medium is necessary. The Na+/Ca++ system seems to participate in the generation of the first wave phase. PMID- 2759274 TI - [Effect of neuroses on dopamine metabolism in the brain of rats with various activities on the "open field" test]. PMID- 2759275 TI - [Changes in ion currents in electrically stimulated neuron membranes in snails after administration of phenamine derivatives]. PMID- 2759276 TI - [Characteristics of the volume of lymph flow in relation to the body weight of animals]. PMID- 2759277 TI - [A device for immobilization of the cat head in a chronic experiment]. PMID- 2759278 TI - [Interzonal transcallosal connections of the sensomotor cortex]. AB - Interzonal transcallosal EPs occurring in response to stimulation of visual or auditory cortex of opposite hemisphere, were recorded in the cat sensomotor cortex. Visual-motor EPs had mainly an initial positivity whereas audio-motor those were mainly initially negative. Latencies of the former EPs were longer. Negative--positive visual-motor EPs had a greater amplitude than their synphasic audio-motor ones. Initially positive EPs had a greater amplitude in stimulation of A1 rather than 19. The EPs revealed an interhemisphere asymmetry: audio-motor those were greater in the left hemisphere mainly in females. The specifics of the asymmetry seems to be due to an interzonal asymmetry of transcallosal flows of projectional and associative cortical areas. PMID- 2759280 TI - [The reaction of cat cervical spine interneurons to stimulation of the parietal zone of the cortex]. AB - Neuronal responses of the spinal cord cervical segment in cat to stimulation of parietal and pericruciate areas of the neocortex had very similar parameters. Mono- and polysynaptic connections of the parietal cortex with the cervical cord neurons were revealed. The two cortical areas were found to exert effects of interaction on the same particular neurons. Possible participation of parietal cortex in the motor control is discussed. PMID- 2759279 TI - [The effect of oxytocin and vasopressin on individual behavior and EEG-correlates of narcotic dependent rats in the "open field" test]. AB - A single intracerebral injection of oxytocin activated the behavior, increased the frequency and amount of hippocampal theta-rhythm whereas vasopressin elicited opposite effects during "open field" test in drug-dependent rats with implanted electrodes in different brain structures. PMID- 2759281 TI - [The effect of adenosine and its derivatives on the dynamics of delayed activity and the calmodulin level in various structures of the brain]. AB - The adenosine and A1-adenosine receptor agonists produced shifts of DC potential and decreased the calmodulin levels in the animal hypothalamus. PMID- 2759283 TI - [Characteristics of processes of excitation and inhibition of monosynaptic spinal reflexes after removal of the labyrinth]. AB - Some electrophysiological changes were found within 1.0-1.5 hrs after removal of the labyrinth. The amplitude of extensor monosynaptic reflexes decreased. Recurrent inhibition weakened, amplitude of flexor monosynaptic reflexes increased, presynaptic inhibition decreased and recurrent inhibition was reinforced. Functional role of spontaneous influences of the labyrinth removal involves not only the reinforcement of extensor motoneurons but an increasing and stabilizing of reciprocal inhibition, restriction and stabilizing of reciprocal inhibition, restriction of information inflow and amplifying of differences of excitatory levels between active and passive reflex pathways. PMID- 2759282 TI - [Microelectrophysiologic analysis of the representation of the vagal, splanchnic, sciatic nerves and sensomotor region of the cortex in the central nucleus of the amygdala]. AB - In anesthetized cats, a high degree of reactivity (82.2%) of neurons was found to visceral nerves and visceral stimulation (single shocks and 2, 5, 10, 20 Hz) in the central nucleus of amygdala. The majority of the neurons revealed tonic changes of spontaneous activity. A high degree (76.6%) of afferent convergence from somato-visceral systems and cortical area was found. PMID- 2759284 TI - [Characteristics of lengthy spiked tetanus of rat skeletal muscle]. AB - Prolonged unfused tetanuses of the rat m. gastrocnemius were investigated. An increase in the stimulation frequency raised the tension of unfused tetanuses, shortened the time of achievement of the maximum level, and accelerated the beginning of the third (economic) phase. After cooling the muscle to 24-25 degrees C, the unfused tetanuses developed yet during low frequency stimulation and the economic phase began sooner. PMID- 2759285 TI - [Neuromuscular excitation and pain sensitivity of rats with various levels of arterial pressure]. AB - Responses to electric shock stimulation were studied in spontaneously hypertensive (SHR) and normotensive (WKY) rats. Neuro-muscular excitability and the pain thresholds were higher in the SHR rats. The decrease in the pain sensitivity seemed to be connected with changes of neuro-muscular excitability in hypertensive animals. The SHR rats were more active in new environment. Weak electric shocks reduced motor activity in the SHR rats more than in the WKY rats. Strong electric shocks enhanced motor activity and eliminated the strain and sex differences. The painful electric stimulation elicited a more obvious jumping activity in the SHR rats and a more active vocalisation in the WKY rats. PMID- 2759286 TI - [Blood supply of skeletal muscles in reactive hyperemia]. AB - In 18 anesthetized cats, 60-sec occlusion of the m. gastrocnemius artery entailed a decrease in the muscle blood supply by 15-20 ml of the blood volume in the vessels whereas the post-occlusion increase in the blood flow restored the blood volume with 45% excess. The intravascular accumulation of the blood exerting a moderating effect upon the venous return while preserving the increased arterial inflow, can be regarded as an automatic way of limiting the hemodynamic excitation due to the postocclusion shifts and involved in systemic circulation. Papaverin interacts with the blood volume restoration and leads to insufficient restoration in the postocclusion period. This suggests that the postocclusion excessive restoration of the blood volume in muscle, as observed in control animals, can be due to an active vasodilatation of the capacitance portion of the intraorgan vascular bed. PMID- 2759287 TI - [Features of physiologic mechanisms regulating microcirculation in the cerebral cortex of birds and mammals]. AB - The responses of pial arteries to increased activity of the cerebral cortex as well as their innervation at various stages of phylogenic development, were studied with the aid of serial photomicrography with subsequent frame-to-frame analysis in adult rabbits and hens. Following the application of 0.5% isotonic strychnine solution to brain surface, the dilatation of all the segments of the pial artery ramifications was considerably more obvious in rabbits than in hens. The latencies of the vascular responses differed in a similar way. Histochemical studies revealed a considerably richer adren- and cholinergic innervation in rabbit pial arteries as compared with those of hens. The vascular responses and the neurogenic control of the pial arterial bed seem to become steadily refined, together with its anatomy, in the course of evolutionary development. PMID- 2759288 TI - [The effect of hypoxia on the fractionated composition of erythrocytes in rat peripheral blood]. AB - The spectrum of distribution of the rat peripheral blood erythrocytes alters during adaptation to altitude-induced hypoxia as well as under the effects of increasing concentrations of the serum lipid constituents, arterial and venous plasma factors of animals initially adapted to hypoxia, and that of 2,3-DPG. The pattern of erythrocyte distribution in the periphery seems to depend on the micromedium conditions created by organ metabolic specifics, as well as on erythrocyte intracellular factors, there- by optimizing the system of oxygen supply to organs and tissues. PMID- 2759289 TI - [Autoregulation and dilatory reserves of the rat coronary arteries upon limiting their motor activity]. AB - The influence of 6-hr immobilization stress on the autoregulation reserve of coronary vessels was studied in 45 isolated hearts of white female rats. The ability of coronary vessels to resist against intravascular pressure decreased in early post-stress period, the relationship between the coronary flow and the contractile activity being disturbed. The stress seems to decrease the basal tone of coronary vessels, thus leading to a superfusion and a decline in coronary reserve. PMID- 2759290 TI - [Features of contraction of various sections of the left ventricle of an intact heart upon the action of inotropic factors]. AB - In anesthetized dogs, the effects of adrenaline and CaCl2 were studied by means of measuring intramural tension in the left ventricle wall (LV) and in the apex. The inotropic effect involved an increase in the ratio between the velocity of the tension growth in isovolumic phase and the maximum tension of this contraction, the ratio increasing more slowly in the apex than in the LV. This can be due to that the inotropic factors induce a greater growth of intramural tension in the apex than in the LV. PMID- 2759291 TI - [The effect of a single firing stimulation of the vagus nerve on atrioventricular behavior of stimulation in the cat heart]. AB - Dromotropic vagal effect was shown to consist of a prolonged tonic component and a short-term one depending on the interval between the burst irritation of the vagus nerve and the P-wave of the ECG. PMID- 2759292 TI - [Changes in the catecholamine level and energy metabolism of the myocardium in rats during cold and emotional stress]. AB - The catecholamine content in adrenergic plexuses and the oxidative enzyme activity (succinate dehydrogenase, lactate dehydrogenase) during cold and emotional stress were studied histochemically in the rat myocardium. An acute short-term cooling led to an increase in the catecholamine fluorescence intensity and succinate dehydrogenase activity, whereas a short-term emotional stress resulted in a decrease in both these parameters. PMID- 2759293 TI - [The effect of amplitude and frequency of pulse oscillations of blood flow on resistive and metabolic function of skeletal muscle vessels in cats]. AB - The amplitude-frequency characteristics of the perfusion pressure, capillary hydrostatic pressure and the capillary filtration coefficient were nonlinear in acute experiments on cats. The shifts of the perfusion pressure and the capillary filtration coefficient could either increase or decrease depending on the range of the values of the amplitude and frequency of pulsing blood flow. The mean capillary hydrostatic pressure was also altering only in certain combinations of the pulsation amplitude and frequency. The maximal shifts of the hemodynamic parameters varied by the values of the amplitudes and frequencies at which they occurred. PMID- 2759294 TI - [The relation of lymph flow and microcirculation in the cat liver under the effect of serotonin and bradykinin]. AB - In experiments on cats with hemodynamically isolated and perfused wider constant flow liver it was shown that intraarterial or intraportal infusion of serotonin and bradykinin increased a transinusoidal fluid fransher and lymph formation in the region. The elevated franshes walls of maintained mainly by an increase on the permeability of the walls of exchange microvessels. Differences were revealed in the achions of serofouri and bradykinin upon liver's arterial and portal vessels, the sensitivity of portal vein to the drugs being which lesser than of the live artery. PMID- 2759295 TI - [Ionic dependence of hyperpolarized changes of the membrane potential of breast secretory cells]. AB - In lactating albino mice, an augmentation of the membrane potential of secretory cells and of transepithelial potential difference caused by oxytocin and acetylcholine, was shown to be accompanied by the fall of transepithelial electrical impedance. The calcium-dependent increase of the permeability of plasmatic membrane for K+ seems to be the main cause of the above responses. PMID- 2759297 TI - [A method of recording super-slow physiologic processes in the rabbit brain and lungs in a chronic experiment]. PMID- 2759296 TI - [Seasonal changes in adrenergic regulation of the contractile ability of the frog bladder]. PMID- 2759298 TI - [Analysis of changes in arterial tone in an experiment]. PMID- 2759299 TI - [Determination of the volume of extravascular fluid in the lungs by electroimpedance indicators]. PMID- 2759300 TI - [A heat physical model of thermoregulation in the rabbit]. PMID- 2759301 TI - Service vs education. PMID- 2759303 TI - Divorce: a pediatrician's view. PMID- 2759302 TI - The under-use of mammography. PMID- 2759304 TI - The early detection of chronic disease in Delaware. PMID- 2759305 TI - Health data needs. PMID- 2759306 TI - You get what you pay for. PMID- 2759307 TI - Who is the real expert? PMID- 2759308 TI - Another perspective on television. PMID- 2759309 TI - Psychological implications of provisional prostheses. AB - The use of provisional restorations in the practice of partial and complete prosthodontics affords the dentist a productive method of arriving at an effective and pleasing prosthesis for the patient. Similarly, it serves the patient as a means of maintenance during multidisciplinary care. It can provide immediate replacement of extracted teeth and serve as a guide for correcting pre existing conditions such as collapsed vertical dimension, related esthetic or facial collapse, centric occlusion, and changes caused by deterioration. After one or more visits, preliminary to the dental treatment plan, in which there has been an evaluation of the patient's physical, oral, and emotional condition, the dentist can arrive at a plan in which all factors may be considered and treatment directed appropriately. This article, in its limited approach, has attempted to emphasize the importance of knowing and understanding the patient's needs, which are not often clearly expressed by the patient. There must be adequate preparation of the patient to reduce or eliminate anxieties. Patient-practitioner discussions regarding procedures and realistic expectations are most helpful. A broad span of multidisciplinary dental treatment may well be served by the use of the transitional prosthesis, affording the dentist and patient adequate time for treatment, corrections, and optimal esthetics. PMID- 2759310 TI - Provisional restorations. PMID- 2759311 TI - Orthodontics. Provisional restorations and appliances. AB - Critical to optimal patient care is the proper sequencing of treatment for the integration of multidisciplinary procedures in solution of dental problems. Provisional restorations and appliances play a particularly critical role in management of adult mutilated or periodontally involved dentitions. They also play an important role for young patients with teeth lost through trauma or that are congenitally missing and require orthodontic therapy. Many restorative and periodontal problems cannot be corrected without orthodontic preparation of the dentition. Because orthodontic therapy is used to help create a therapeutic occlusion, this goal of therapy is important to describe. PMID- 2759313 TI - [Physical therapy possibilities in the treatment of collagen diseases]. AB - We report about the rank of physiotherapy in the treatment of connective tissue diseases with special emphasize on scleroderma. Based upon therapeutic aim physiotherapeutic approaches for lupus erythematosus, dermatomyositis, and scleroderma are pointed out. PMID- 2759312 TI - [Experiences with cinnamic acid esters as sunscreening agents]. AB - After incorporation in ointment bases and cosmetics usual in trade 2-Ethylhexyl-4 methoxycinnamat being known as skin compatible was investigated for light protection efficacy in determining the sun protection factor (SPF). Despite different penetration power into the stratum corneum we obtained low SPF from all tested oils. In emulsion bases as a rule the SPF corresponded to the concentration of the filter, respectively little lower values were found. Most of the SPF-values did not vary significantly, although the investigated preparations were different in emulsions-type, ingredients and additives. Formulations containing 2-Ethylhexyl-4-methoxycinnamat in bases being of pharmacopoeial quality are recommended as alternative for incompatible sun cosmetics and drugs. PMID- 2759314 TI - Penetration of lecithin from hydrocortisone-containing liposomes into human skin. PMID- 2759315 TI - The effect of liposomal incorporation of topically applied hydrocortisone on its serum concentration and urinary excretion. AB - We demonstrated previously, that hydrocortisone incorporated in the phospholipid bilayer of liposomes (liposomal hydrocortisone) shows an improved concentration time profile in the different skin layers after external application when compared with a conventional ointment. In the present work, it was investigated under in vivo conditions, whether or not the liposomal formulation also enhances the percutaneous absorption rate. The results obtained in guinea pigs clearly demonstrate a decrease in serum concentration and urinary excretion. Thus, hydrocortisone-loaded liposomes, when applied topically, act as a selective drug delivery system or "drug localizer" increasing the therapeutic efficacy and, simultaneously, decreasing adverse systemic effects. The significance of liposomal attenuative and potent glucocorticoids in topical treatment is discussed. PMID- 2759316 TI - [Multicenter reticulohistiocytosis. A contribution to clinical aspects and therapy]. AB - It is reported on a 48-year-old woman suffering from a multicentric reticulohistiocytosis. Most trouble in this case is caused by severe arthritis, which could not be stopped by various therapy schedules. The actual treatment is the combination of Prednisolone, Chloroquine, Ibuprofen and roentgenotherapy of the hands. PMID- 2759317 TI - [Comment on the contribution by R. Zimmermann and A. Mattheus: "Erythropoietic protoporphyria"]. PMID- 2759318 TI - Detection by nailfold capillary microscopy of early morphologic capillary changes in children with insulin dependent diabetes mellitus. AB - Nailfold capillary microscopy (NCM) is a non invasive method to investigate digital microcirculation. The NCM pattern of 70 children with diabetes (duration varying from less than one month to 18 years) and of 35 healthy children was studied. Several capillary loops anomalies were observed: haemorrhages, disorganisation, dystrophies, microaneurysms. The anomalies were more frequent in children with diabetes (61.4%) than in the controls (20%; p less than 0.001). Haemorrhages and nailbed disorganisation were seen in both groups. Dystrophies were found more frequently in the diabetic group (46%) than in the controls (17%; p less than 0.01). Microaneurysms were observed only in diabetic children (27%; p less than 0.001); they were present in 18.5% of the children with a diabetes duration of less than 2 years and their frequency did not increase with the duration of the disease. Sex ratio, age and HbA1c were not different between the diabetic children with or without microaneurysms. No relationship was found between retinal angiography and NCM detection of the microaneurysms. In conclusion, NCM is able to detect frequent anomalies of the digital microcirculation, especially microaneurysms, early in the course of diabetes in children. The follow up of this pediatric population will provide further information on the prognostic value of these lesions. PMID- 2759319 TI - Hypertension and diabetes: an hypothesis on the possible role of hyperglycemia. PMID- 2759320 TI - Trial of labour following prior section; a 5 year prospective study (1982-1987). AB - Between 1982 and 1987, 506 women previously delivered by Caesarean section were subjected to a trial of labour. Vaginal delivery was achieved in 78.6% with only 1 true rupture of the scar (0.2%). There were no intrapartum or neonatal deaths. Moreover, 7 of the 8 antepartum stillbirths were due to asphyxia, and, as the perinatal mortality rate for the study group was higher than for the overall population, the need for antenatal surveillance in previously sectioned patients is emphasized. Induction of labour was performed in 127 patients with 74.1% achieving vaginal delivery. Oxytocin was administered to 162 patients for either induction or augmentation of labour and 80.3% had a vaginal delivery, with 1 true rupture and 4 bloodless dehiscences. It is concluded that trial of labour following prior section is associated with little risk of true rupture, and with no added risk to the fetus. Our policy and management has helped maintain over the past 5 years an overall moderate Caesarean section rate (10-11%) with a low perinatal mortality rate. PMID- 2759321 TI - Hypertensive disorders of pregnancy in Greece. AB - Unique population data on the incidence of hypertension during pregnancy was obtained during the 1983 Greek National Perinatal Survey. Of the 9915 women delivering in April who had their blood pressures measured during pregnancy, only 3.0% had a diastolic pressure of over 90 mmHg. The data can be compared with 11.6% of 15,744 women delivering in the United Kingdom in one week of April 1970 and for whom data on antepartum blood pressures were available (p less than 0.0001). Corresponding rates for proteinuric pre-eclampsia were 0.7 and 3.1% (p less than 0.0001). In Greece, there was no consistent variation with parity but a strong trend with advancing maternal age. The perinatal mortality rate among pregnancies with diastolic pressures of 91 mmHg and more was 6%, three times the national rate. Such cross-cultural comparisons of hypertension in pregnancy form a valuable basis on which to develop hypotheses to explain the aetiology of this condition. PMID- 2759322 TI - The importance of 'lumbar lordosis measurement device' application during pregnancy, and post-partum isometric exercise. AB - In this study, we measured the lumbar lordosis of normal pregnant women throughout their pregnancies and studied the efficacy and importance of the postpartum isometric exercise. 40 healthy primigravid patients were randomly assigned to one of the control and exercise groups. The lumbar lordotic deviation increased significantly throughout the pregnancy (p less than 0.05). Second postpartum day values of lumbar lordotic deviation and depth decreased compared to the third trimester values (p less than 0.05). Sixth postpartum week values of lumbar lordotic deviation and depth were found to be increased when compared to the first trimester values in the control and exercise group (p less than 0.05). On the other hand, the sixth week values in the exercise group are significantly lower compared to the control group (p less than 0.05). For these measurements we have used a 'Lumbar Lordosis Measurement Device' which was constructed in our institute. Muscle testing showed that isometric exercise improves the functional status of the affected muscles during pregnancy. We therefore conclude that the usage of 'LLMD' during the follow-up examination of pregnant women is essential to evaluate the posture of the patients. Isometric exercise is very important in order to obtain a normal posture and muscle tonus postpartumly. PMID- 2759323 TI - Endometrial glandular haemosiderosis in homozygous beta-thalassaemia. AB - Female patients with beta-thalassaemia major usually suffer from hypogonadotropic hypogonadism associated with amenorrhea, anovulation and infertility, attributed to the deposition of haemosiderin in the pituitary gland as well as in the ovaries. Pregnancies are rare and, with few exceptions, occur mainly in patients with beta-thalassaemia intermedia. Our study presents histopathological evidence that deposition of haemosiderin occurs in the endometrial glandular epithelium of 3 patients with beta-thalassaemia major. This deposition is mainly evident in the apical part of these cells above the nuclei, and should be taken into consideration as a contributing factor to the infertility in these patients by altering endometrial receptivity for implantation. In 2 patients who received effective iron chelating treatment with desferrioxamine the endometrial haemosiderin deposits either disappeared (patient C.R.), or were significantly reduced (patient G.L.). PMID- 2759324 TI - Diagnostic procedures in vaginitis. AB - Ninety-seven vaginitis patients underwent a standardized direct method of examination. Bacterial vaginosis was found in 38.1%, Candida albicans in 24.7% and Trichomonas vaginalis in 13.4%. Low secretional pH values were never met in bacterial vaginosis and T. vaginalis cases. A fishy odor, present in bacterial vaginosis, was also found in almost half of the T. vaginalis cases. Endocervical bacteriological cultures are probably insufficient with respect to the detection of C. albicans and Gardnerella vaginalis. However, we found 12.4% Chlamydia trachomatis, which indicates that endocervical bacteriology may be indicated in vaginitis patients. PMID- 2759325 TI - Primary ovarian carcinoid tumor in combination with carcinoid heart disease; a case report. AB - Primary ovarian carcinoid tumors (POCT) with secondary carcinoid heart disease are rare, only 13 cases have been reported in the literature to date. In most instances POCT can be completely removed surgically contrary to primary carcinoid tumor of the gastro-intestinal tract. Laparoscopy may be helpful in localizing the tumor. We present a case in which the carcinoid heart lesions progressed despite total eradication of the carcinoid. PMID- 2759326 TI - The aetiology and clinical significance of the sinusoidal fetal heart-rate pattern; two case reports. AB - Two cases are presented in which sinusoidal heart-rate (SHR) patterns were recorded antenatally. In the first case the pattern was associated with severe maternal exertion and prolonged exposure to freezing temperatures. The pattern returned to normal within an hour of maternal recovery. The second case was associated with fetal death due to high-output cardiac failure associated with a large liver haemangioma. A hypothesis is proposed to link the aetiology for this heart-rate pattern which would explain these, and previously reported cases. PMID- 2759327 TI - Obstructive uropathy from endometriosis after hysterectomy and oophorectomy; two case reports. AB - Two patients with obstructive uropathy as a result of post menopausal endometriosis are reported. They both illustrate the potential problems of hormone replacement therapy after bilateral salpingo-oophorectomy and hysterectomy in patients who have had extensive endometriosis. It is suggested that in such patients the potential of reactivation of the disease with hormone replacement therapy should be recognised and ureteric involvement be excluded by intravenous urography or renograms. PMID- 2759328 TI - Biliverdin reductase activity in cattle, sheep, rabbits and rats. AB - 1. Biliverdin reductase (BVR) activity was measured in post-microsomal supernatants of livers of cattle, sheep, rabbits and rats. BVR activities in bovine and ovine livers were 4.7 and 5.0%, respectively, of rat liver activity. 2. The finding of BVR activity in ruminants is in contrast to a previous report and may be due to the use of a different assay system. 3. Lapine liver had the lowest BVR activity of only 0.37% of rat liver activity. 4. Increasing the available heme by phenylhydrazine administration did not induce increased hepatic or splenic BVR activity in rabbits. 5. Maximal BVR activities were attained using NADPH as cofactor at pH 8.7 in sheep and rabbits and at pH 8.4 in cattle. 6. Differing concentrations of bovine or human albumins enhanced or inhibited BVR activity quite differently in the various species. 7. The finding of a very low, but measurable BVR activity in lapine liver and spleen may explain, in part, why rabbits, unlike rats, cattle and sheep, excrete primarily biliverdin (70%) into bile. PMID- 2759329 TI - Antilipogenic but not lipolytic effects of recombinant DNA-derived bovine somatotropin treatment on ovine adipose tissue; variation with genetic type. AB - 1. Lambs from three breeds (East Friesland, Oxford and Texel) were treated with recombinant DNA-derived bovine somatotropin (BST) at 0.05, 0.10, 0.20 mg/kg per day and fat metabolism assessed in subcutaneous adipose tissue biopsy samples. 2. BST treatment decreased adipose cell volume, fatty acid synthesis and acylglycerol glycerol synthesis but did not alter lipolytic rates (basal or noradrenaline-stimulated). 3. Genetic type influenced metabolism in a number of ways, most notably East Friesland lambs had lower fatty acid esterification rates and responded poorly to BST in terms of reduced lipogenesis as compared to the Oxford and Texel lambs. 4. Blood urea concentration was decreased by BST treatment suggesting increased nitrogen retention. 5. These results emphasise the role of somatotropin as an inhibitor of adipose tissue lipogenesis but cast further doubt on a physiological role in regulating lipolysis. PMID- 2759330 TI - Tryptic digestion of bovine secretory IgA at elevated temperature and in urea. Isolation of SC domain 1 which is covalently bound to IgA dimer and binds non covalently to IgM. AB - 1. Tryptic cleavage sites in bovine secretory component (SC) which become inaccessible when SC is bound to IgA dimer remained inaccessible at 60 degrees C and in 4 M urea at 37 degrees C. 2. This suggests the presence of strong interactions compatible with published affinity constants of ca 10(8) M-1. 3. In 5 M urea at 37 degrees C further cleavage of bound SC did occur to produce a fragment consisting of domain 1 which was disulphide bridged to the IgA dimer. 4. Binding studies on the isolated fragment showed that domain 1 did not account for all the binding by SC. 5. Cleavage of the isolated fragment with iodosobenzoic produced a smaller fragment consisting of the n-terminal third of domain 1 (residues 1-35). This N-terminal fragment showed significant binding. PMID- 2759331 TI - Preparation of antibodies against xanthine oxidase from human milk. AB - 1. Human xanthine oxidase [XO; EC 1.2.3.2.] was isolated by a non-proteolytic method from fresh human milk. Final purification of the protein was achieved by hydroxyapatite chromatography. Most (less than 95%) of the enzyme was released in the 0.40 M phosphate fraction at pH 6.8. 2. The specific activity of this preparation was found to be 0.047 microM min-1 mg-1 with xanthine as substrate. 3. Sodium dodecyl sulfate (SDS)-polyacrylamide gel electrophoresis (PAGE) separated two subunits, each with a mol. wt approximately 122 kDa. 4. On non denaturing acrylamide gels both of these subunits exhibited oxidase-like activity with xanthine as substrate in the presence of nitroblue tetrazolium and molecular oxygen. 5. Immunoconjugates of XO were prepared by the keyhole limpet hemocyanin (KLH)- and glutaraldehyde-crosslinking techniques. 6. Polyclonal antibodies to XO were raised by i.m. injection of these conjugates into female New Zealand rabbits. 7. Western blot analysis using the semi-dry technique was employed to confirm the specificity of the antibody. PMID- 2759332 TI - Quantitation of microtubule-associated protein MAP-1B in brain and other tissues. AB - 1. The presence of microtubule-associated protein MAP-1B in all mammalian tissues tested, as well as in brain, has been demonstrated by immunoblotting using a monospecific polyclonal antibody. 2. The expression of brain MAP-1B is developmentally controlled, as it is less abundant in adult than in newborn rat brain, where it is a major microtubule assembly promoting factor. 3. The level of MAP-1B in tissues other than brain is lower than it is in brain; but the relative ratios of MAP-1B to tubulin are very similar in all tissues, thus differing from the observed for MAP-2 or tau. 4. The amount of MAP-1B in non-nervous tissues seems not to be under developmental control. 5. These results are consistent with a role for MAP-1B in the assembly of microtubules in most cells. PMID- 2759333 TI - Inhibitory effect of eugenol on Cu2+-catalyzed lipid peroxidation in human erythrocyte membranes. AB - 1. The effects of eugenol on lipid peroxidation catalyzed by hydrogen peroxide (H2O2) or benzoyl peroxide (BPO) in the presence of copper ions were studied in human erythrocyte membranes. 2. The production of hydroxyl radicals was suggested in the peroxidation system catalyzed by H2O2/Cu2+. 3. H2O2/Cu2+-dependent peroxidation was inhibited by eugenol in a concentration-dependent manner; peroxidation was inhibited 62% by 200 microM eugenol. 4. In the presence of eugenol, the peroxidation catalyzed by BPO/Cu2+ was inhibited in a concentration dependent manner, and more than 100 microM eugenol completely inhibited peroxidation. 5. The inhibitory effect of eugenol was non-competitive against Cu2+ in H2O2/Cu2+- and BPO/Cu2+-dependent peroxidation. 6. It is suggested that eugenol inhibits formation of hydroxyl radicals. PMID- 2759334 TI - Evidence for an interaction of lipoprotein lipase with artery wall proteoglycans. AB - 1. Artery wall proteoglycans-lipoprotein lipase binding characteristics were studied using bovine milk 125I-labelled lipoprotein lipase (LPL) and chondroitin sulphate-dermatan sulphate proteoglycans (PGs) purified from pig aorta. 2. The binding process was studied either by a soluble assay (gel filtration) or by an immobilized proteoglycan assay (ELISA). 3. The binding process was reversible, saturable and occurred at a stoichiometry 1:1. 4. The binding process involved ionic interactions between the positively charged groups of LPL and the negatively charged groups of PG carbohydrate chains. 5. The complex PG-LPL may lead to the production of remnant lipoproteins and, thereby, contribute to cholesteryl ester accumulation in the arterial wall. PMID- 2759335 TI - Phosphorylation of the human erythrocyte glucose transporter by protein kinase C: localization of the site of in vivo and in vitro phosphorylation. AB - 1. The human erythrocyte glucose transporter was phosphorylated in vitro by protein kinase C. 2. Tryptic cleavage of phosphorylated native transporter produced two major unphosphorylated membrane-embedded fragments weighing 23 and 19 kDa and released numerous water-soluble peptides. 3. Ion-exchange FPLC of the soluble tryptic peptides resolved the mixture into two phosphopeptide peaks. 4. Tryptic digestion of glucose transporter that was phosphorylated in vivo in response to phorbol esters produced soluble phosphopeptides that eluted at identical salt concentrations. 5. Proteolytic digestion and peptide mapping of the transporter revealed that the site(s) of phosphorylation lie within the large cytoplasmic domain that bisects the molecule. PMID- 2759336 TI - Summary of the 10th NIH-sponsored Testis Workshop held in Baltimore, MD, U.S.A., December 8-11, 1988. PMID- 2759338 TI - Prolactin (PRL) mRNA from human decidua differs from pituitary PRL mRNA but resembles the IM-9-P3 lymphoblast PRL transcript. AB - The expression of the human prolactin (hPRL) gene is normally restricted to the anterior pituitary and the decidualized endometrium of the uterus. The human B lymphoblastoid cell line IM-9-P3 ectopically expresses a PRL mRNA which is about 150 nucleotides larger than its pituitary counterpart even though the mature protein products appear identical. In the present study we show that human decidual and IM-9-P3 PRL mRNAs are similar in size, both being elongated relative to the pituitary transcript. The size difference persisted after removal of the 3' end poly(A) tract, whereas the PRL precursors synthesized in a cell-free translation system using mRNAs from the three tissues showed identical apparent molecular weights upon sodium dodecyl sulfate-polyacrylamide gel electrophoresis. The elongation could therefore not be attributed to differences in the protein coding region or in the degree of polyadenylation and is suggested to reside in the 5' untranslated region of the molecule. PMID- 2759337 TI - Effect of progesterone on the activity of occupied nuclear estrogen receptor in vitro. AB - In previous studies, we have demonstrated that progesterone administration in vivo can selectively alter estrogen receptor levels and distribution in the rat anterior pituitary. The present study represents an attempt to extend these observations to an in vitro model. Cytosolic and nuclear preparations of uterine homogenates from ovariectomized adult rats were shown to be capable of temperature-dependent estrogen-mediated receptor activation and translocation from cytosol to nuclei upon recombination. Addition of progesterone to isolated cytosol did not diminish estrogen receptor binding capacity over at least a 2 h period at 22 degrees C. Preincubation of the subcellular fractions with progesterone, followed by removal of free progesterone prior to cytosol-nuclear recombination, resulted in dramatic reduction in nuclear estrogen receptor activity. This action was equally apparent whether progesterone was introduced to the cytosolic or nuclear fraction, and was confined to the steroid-occupied subpopulation of nuclear receptors. The ability of this in vitro system to mimic the estrogen receptor-suppressive effect of progesterone provides a good model in which to analyze the biochemical basis for a direct estrogen-inhibitory effect of progesterone on estrogen action. PMID- 2759339 TI - Albumin, a biologically active protein acting on Leydig cells. AB - The objective of the present study was to characterize further the albumin fraction of rat testicular fluid (rTF), which can enhance luteinizing hormone (LH)-stimulated pregnenolone production by immature Leydig cells in vitro. Testicular fluid, obtained from 300 rat testes was fractionated by sequential ammonium sulfate precipitation, dye-affinity, anion-exchange chromatography, chromatofocussing and an additional heat treatment. The final fraction showed a single band when analyzed on a silver-stained sodium dodecyl sulfate polyacrylamide gel and isoelectric focussing gel. The protein had a molecular weight of 67 kDa, an isoelectric point of 5.0 and was identified as albumin after Western blotting using an antibody against rat serum albumin. Albumin in this fraction gave a dose-dependent (0.1-2% protein, w/v) increase in LH-induced pregnenolone production, up to 4-fold, and the increase in specific bioactivity when compared to rTF was 1.4-fold. Selective depletion of albumin from testicular fluid was used as another approach to confirm that albumin itself is the main biologically active component in rTF. rTF from mutant analbuminemic rats (albumin content 0.02 mg/ml) did not stimulate LH-induced steroid production in our assay, in contrast to rTF from normal rats (albumin content 40 mg/ml). Albumin fractions obtained from rat, bovine and human sera were also effective in stimulation of steroid production in the presence of LH, in contrast to chicken serum albumin which gave no stimulation. The stimulatory effect of albumin is not caused by bound fatty acids, nor by the presence of modified forms of albumin such as testibumin or the albumin-bilirubin complex. Our results indicate that Leydig cells are more active in steroid production when surrounded by high but physiological concentrations of albumin. PMID- 2759340 TI - The influence of dexamethasone on serum thyrotrophin and thyrotrophin synthesis in the rat. AB - Glucocorticoid hormones suppress circulating concentrations of thyrotrophin (TSH), but their effect on synthesis of TSH in the pituitary gland is unclear. We have examined the influence of the glucocorticoid dexamethasone on serum TSH, pituitary TSH content and TSH beta- and alpha-subunit mRNA concentrations in pituitary cytoplasm in both the euthyroid and hypothyroid rat, and following triiodothyronine (T3) treatment in the hypothyroid rat. The rise in serum TSH in hypothyroidism was attenuated in animals treated with dexamethasone; in addition the suppression of serum TSH 6 h after T3 administration to hypothyroid rats was enhanced by dexamethasone. In contrast to the changes in serum TSH, pituitary TSH content was unaffected by dexamethasone. Furthermore dexamethasone had no significant effect on changes in pituitary cytoplasmic TSH beta- and alpha subunit mRNA levels with thyroid status. These findings demonstrate that dexamethasone exerts differential effects on serum TSH levels and TSH biosynthesis which contrast with those of thyroid hormones. PMID- 2759341 TI - 25-Hydroxyvitamin D3 metabolism in mitochondria from primary renal cultures. AB - Previous in vitro studies concerning the renal metabolism of 25-hydroxyvitamin D3 (25(OH)D3) to form 1,25-dihydroxyvitamin D3 (1,25(OH)2D3) and 24,25R dihydroxyvitamin D3 (24,25(OH)2D3) have utilized intact cell systems. In reflecting upon the possible mechanisms by which hormonally induced changes in the production of 1,25(OH)2D3 and 24,25(OH)2D3 may be brought about, we asked whether altered mitochondrial hydroxylase activities can quantitatively account for changes in the total cellular output of these steroids. Our objective was to delineate between extramitochondrial processes (e.g. altered substrate delivery), and those events restricted to the renal mitochondria (altered hydroxylase activities). We have examined the effect of pretreating primary cultures of chick kidney cells with either 1,25(OH)2D3 or parathyroid hormone (PTH) on 25(OH)D3 hydroxylase activities present in subsequently isolated mitochondria. Pretreatment with 10(-7) M 1,25(OH)2D3 reduced 1 alpha-hydroxylase activity in both cells and mitochondria to approximately 60% of control values by 1 h, and to 25-30% by 2 h. The effect of PTH (10 ng/ml) in both mitochondrial and whole cell preparations was an approximate 40% increase in measured 1 alpha-hydroxylase activity. 10 microM forskolin (FSK) elicited an approximate 2-fold increase in 1,25(OH)2D3 production. Reciprocal effects were observed with respect to 24 hydroxylase activity in both whole cell and mitochondrial preparations in response to exogenous 1,25(OH)2D3, PTH, and FSK. The findings demonstrate that these hormones initiate intracellular events which lead directly to altered 25(OH)D3 1 alpha- and 24-hydroxylase activities within the renal mitochondria. PMID- 2759343 TI - Symposium on Continuous Cell Lines as Substrates for Biologicals. Arlington, Virginia, USA (Washington, D.C.), May 26-29, 1988. Proceedings. PMID- 2759342 TI - Effect of vanadate on protein phosphorylation and on acid phosphatase activity in the canine prostate. AB - To evaluate the possible role of intracellular phosphatases in the local regulation of prostatic functions, the effect of sodium orthovanadate (VO4), an inhibitor of phosphotyrosyl protein phosphatases, was studied on both protein phosphorylation and acid phosphatase activity. Secretory and non-secretory epithelial cells were isolated from normal and metaplastic prostates and incubated with [32P]phosphate in the presence and in the absence of VO4; the phosphoproteins were separated by electrophoresis and the gels were either directly submitted to autoradiography or after an alkali treatment to reveal those proteins enriched in phosphotyrosine. Prior to alkali treatment, several phosphoproteins were evidenced and in less than half of the cell preparations a slight increase in labeling intensity under vanadate (less than 75%) was observed in two phosphoproteins, p57 and p44. After alkali treatment: (1) the effect of VO4 on p57 remained in the order of 44-45% and it was restricted to less than half of non-secretory cell preparations; (2) its effect on p44 was intensified (134-207%) and observed in all cell types and in more than 80% of all preparations; and (3) in half of non-secretory cell preparations from metaplastic glands, an effect of VO4 on p35 (127%) became evident. In all instances, with normal and/or metaplastic prostates, protein phosphorylation activity, either total or alkali-resistant and in the presence or in the absence of VO4, was always higher in non-secretory epithelial cells as compared to secretory cells.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2759344 TI - Are continuous cell lines safe as substrates for human drugs and biologics? A case study with human growth hormone. AB - The development of a genetically engineered human growth hormone (hGH) preparation is described. The cell line used to produce hGH is a C127 mouse cell transformed with a bovine papilloma virus (BPV) vector. Master, Extended Production, and Working Cell Banks were established. Product is produced by culturing in growth medium, and purified using a series of chromatography and ultrafiltration steps. Extensive testing of cell banks, and bulk and finished product reveals that the cells used to produce hGH are phenotypically and genotypically stable and are free from contamination with adventitious agents. Levels of residual host cell DNA are well below accepted guidelines. Clinical data gathered in multicenter trials confirm the efficacy and safety of the product in the treatment of classic growth hormone deficiency. The regulatory history of human growth hormone in the U.S. is reviewed. PMID- 2759345 TI - A proposed European pharmacopeia monograph for continuous cell lines derived drugs. PMID- 2759346 TI - Utilization of human hematopoietic cell lines for the propagation and characterization of HBLV (human herpesvirus 6). AB - In 1986, we reported the discovery and isolation of a novel human herpesvirus (HBLV) from AIDS and other lymphoproliferative disorders. Because HBLV is distinct from other members of the herpesvirus family and can infect B- and T lymphocytes and other human cells (megakaryocytes and glioblastoma cells), we suggested human herpesvirus-6 (HHV-6) as the taxonomic designation for this virus. In cultures from patients' peripheral blood, the evidence of HBLV can be recognized from the appearance of short-lived giant cells (2-10%), which are large, refractile, and are often mono- and binucleated. As these cells degenerate, extracellular virus particles are found in the culture medium. HBLV can infect fresh mononuclear cells, established B- and T-lymphoblastoid cell lines, megakaryocytes and glioblastoma cell lines. HBLV infection can be detected by: a. morphological changes; b. indirect immunofluorescence assay, in situ hybridization, southern blot analysis, polymerase chain reaction amplification; and c. electron microscopy. Because of its wide cell tropism, HBLV DNA sequences have been detected in B-cell lymphomas and short term cultured cells from Sjogren's patients. Expression of HBLV RNA was also detected in sarcoidosis. The etiological role of HBLV in human tumors is unclear. While in vitro data may not necessarily apply to in vivo conditions, the infection of various cell lines from tumors and fresh mononuclear cells suggests HBLV involvement in a variety of diseases. PMID- 2759347 TI - Qualification of working cell banks for the Vero cell line to produce licensed human vaccines. AB - Since 1980, Merieux Institute has prepared on microcarriers four working cell banks from Vero Cells (137th p.) received from the ATCC in May 1979 (at 124th p.). The lots have been or are used for the production of rabies and inactivated poliomyelitis vaccines. Three lots were controlled according to WHO requirements described in the technical report 673, 1982. For the fourth lot, we have followed the WHO requirements corresponding to the technical report 745, 1987. All the tests required us to demonstrate: i) Safety and purity (tests in animals and eggs, sterility tests, cocultures with human cells and other electron microscopic observations). ii) The absence of tumorigenicity (tests in newborn rats treated with antihymocyte serum at the WBC level and on the cells propagated to at least 10 population doublings beyond the maximum passage level used for production. Assays of cell transformation with DNA from the Vero line in the standard 3T3 assay system). iii) Identity (isoenzyme technique). All were satisfactory. PMID- 2759348 TI - Cell banking and gene expression. Summary and conclusions. PMID- 2759349 TI - Status of WHO concerning continuous cell lines as substrates for the production of biologicals. PMID- 2759350 TI - Current experience with biological products produced in various continuous cell lines. Summary and conclusions. PMID- 2759351 TI - Tumorigenicity testing of various cell substrates for production of biologicals. AB - The data presented in this paper confirm earlier findings that the antithymocyte globulin (ATG) treated newborn Wistar rat is more sensitive than the nude mouse in allowing the metastatic potential of a cell substrate to be displayed. Several human neoplastic cell lines such as HeLa, FL, Hep-2, KB and WiDr cells as well as monkey kidney cell lines such as Vero and BSC-1 cells, which failed to metastasize in nude mice, formed metastases in ATG-treated newborn rats. Earlier studies on the tumorigenicity of Vero monkey kidney cells were extended to various passage levels of BSC-1 aneuploid and CV-1 diploid monkey kidney cells in order to establish the effect of prolonged in vitro culture on the oncogenic potential of African green monkey kidney cells. It was found that BSC-1 and CV-1 cells--like Vero cells--showed increased tumorigenicity in the rat model with increasing cell passage. Cells of all three cell lines passaged 146 to 257 times formed invasive adenocarcinomas in the muscle (inoculation site) of the animals. Considering the passage levels, at which the adenocarcinomas appeared and lung metastases were detected, the malignant potential was most pronounced in CV-1 cells, followed by Vero cells and was lowest in BSC-1 cells. Results obtained from the in vitro tumorigenicity assay of cell colony formation in soft agar confirmed the rat test results: increased cell passage of all three monkey kidney cell lines resulted in higher cell colony formation. The in vitro chick embryo skin culture assay was found unsuitable for the differentiation of various passage levels of these cell lines. PMID- 2759352 TI - Fast biosensor-based system for measuring total DNA in protein solutions. AB - We report the quantitation of picogram levels of DNA, with a fast, reproducible, and non-isotopic assay system. Two DNA binding proteins are used, one to link DNA in the sample to a membrane and the other to label DNA with an enzyme. Enzyme levels are quantitated with very high sensitivity, by monitoring surface potential changes with a proprietary biosensor, as the enzyme changes its local pH. With this configuration, the assay is generic, detecting the presence of any DNA in the sample; that is, there is no specific hybridization probe involved. The prototype system involves instrumentation, software, plastic disposables, and reagents. With a simple protocol, it allows the user to determine the DNA levels, in the range of 2 to 100 pg, concurrently in multiple samples, with standards, with a total processing time of less than one hour, after sample pretreatment. Representative data will be shown. Essentially the same material presented here appeared in a poster session at the 2nd Annual Symposium on Analytical Biotechnology, Baltimore, Maryland, May 1988. PMID- 2759353 TI - Polio and rabies vaccines produced in continuous cell lines: a reality for Vero cell line. AB - The Vero cell line was applied to the production of Enhanced-Inactivated Polio Vaccine (E-IPV), Oral Polio Vaccine (OPV) and Rabies Vaccine, also called Purified Vero Rabies Vaccine (PVRV) for humans. The cell line was expanded through the cell bank systems. Using a microcarrier culture technique, a large scale production combined with an efficient purification process was developed. An extensive study of purity and biological safety was applied to the cell line to validate several Manufacturer's Working Cell Banks. Special emphasis was laid on the absence of any virus in the cells or any trace of viral sequence included in the Vero cell genome. Sensitive tests were applied to check that residual cellular DNA was as low as possible per dose of vaccine. E-IPV was licensed in July 1982 and since 1983 more than 20 million doses have been inoculated into children, without any side-effects. The production capacity of this E-IPV is presently more than 60 million doses per year. For PVRV, the license was delivered in June 1985 and over 350,000 doses have been injected without any problem. For the OPV, 27 monovalent lots were produced, 9 lots for each serotype. The studies of RNA sequences in variable regions and viral proteins gave results similar to the OPV produced from primary monkey kidney cells. All the other tests, and especially the neurovirulence tests in live monkeys showed that the OPV produced in Vero cell lines was acceptable. Since the completion of clinical studies, the license has been pending. The quality of the Vero cell line, as produced and tested by the "Institut Merieux", combined with the safety afforded by the virus purification, has helped to prevent potential problems. PMID- 2759354 TI - Insect cells as substrates for biologicals. AB - Various methods for the growth of insect cells and the production of recombinant human beta-interferon (rHu beta-IFN) by insects cells, Spodoptera frugiperda, IPL Sf-21AE after infection with recombinant AcNPV are described. Using a suspension perfusion Biospin filter culture system, an IPL-Sf-21AE cell line was propagated in a semi-controlled environment. To obtain and maintain high cell densities and viabilities in this system, the culture medium for suspension methods was modified by supplementing with ZnSO4, ALCl3, methyl cellulose and Darvan #2. Using these improved conditions, multiple harvests of rHu beta-IFN were collected in the cell culture supernatant for downstream processing. PMID- 2759355 TI - Continuous cell lines as substrates for biologicals. Draft position paper. Pharmaceutical Manufacturer's Association. PMID- 2759356 TI - Detection and elimination of adventitious agents in continuous cell lines. AB - The National Veterinary Services Laboratories (NVSL) routinely monitors continuous cell lines (CCL's) used for veterinary biologicals and diagnostic virology. All veterinary biologicals produced in CCL's must follow the master seed concept which limits the use of the master seed CCL to up to 20 passages beyond the passage level characterized and deposited at NVSL. All CLL's are evaluated for the presence of adventitious agents such as mycoplasma, bovine viral diarrhea virus, and other bacteria and viruses. Previously, CCLs were evaluated for tumorigenicity by the Syrian hamster cheek pouch method; however, this procedure has now been eliminated. The adventitious agents most frequently detected in CCL's have been bovine viral diarrhea virus and mycoplasma. Our laboratory has consistently found that the source of bovine viral diarrhea contamination of CCLs has been the use of contaminated fetal bovine cell culture enrichment serum. Gamma irradiation at 2.5-3.5 megarads at -40 degrees C of carefully screened fetal bovine serum has been used in the Diagnostic Virology Laboratory for over 10 years. If the irradiated serum is used at a final concentration of 10 percent, there is no untoward effect on cell susceptibility for virus propagation or cell culture growth. Gamma irradiation has also been demonstrated to be a very efficient inactivator of mycoplasma. Specific conditions utilized by our laboratory to preserve fetal bovine serum cell culture growth factors while eliminating adventitious bovine viral diarrhea virus will be presented. PMID- 2759357 TI - Changes in sensitivity to the odor of androstenone during adolescence. AB - While it has been reported that most, if not all, very young children are able to detect the odor of 5 alpha-androst-16-en-3-one (androstenone), approximately 40 50% of human adults cannot detect its odor. The present study focused on changes in sensitivity to androstenone during adolescence, which may account for this discrepancy. Sensitivity to androstenone was determined in 247 subjects aged 6 to 50. There was a significant increase in the number of males anosmic to androstenone between 9-14 and 15-20 years of age, and a significant increase in threshold with age among males able to detect the odor. We infer that a smaller percentage of females than males becomes anosmic to the odor of androstenone during development, and those able to detect it apparently show a decrease in threshold with age. No age-related changes were observed in tests of pyridine or d,l-beta-phenylethylmethylethylcarbinol (PEMEC). PMID- 2759358 TI - Maternal and peer imprinting in mallard ducklings under experimentally simulated natural social conditions. AB - Previous studies revealed that if socially reared mallard ducklings actively follow a stuffed mallard (Anas platyrhynchos) hen, they later show a visual preference for the familiar mallard hen over an unfamiliar redhead (Aythya americana) hen. The present study determined that the experience of actively following the hen is essential to the induction of a visually controlled, species typical, maternal preference. Domestic mallard ducklings that had not been given the opportunity to follow the mallard hen were "passively" reared in social groups consisting of a stuffed mallard hen and seven same-aged siblings for either 24, 48, or 72 hr after hatching. These birds were largely unresponsive to the hen in a later choice test, even when they were passively exposed to the mallard hen for as long as 72 hr prior to testing. The question arose as to whether passive exposure to the ducklings induced a preference for them that interfered with establishment of maternal imprinting under these simulated natural nest conditions. Results indicated that socially reared ducklings do prefer stuffed ducklings to a stuffed mallard hen in a simultaneous choice test even when the hen is present and vocalizing during social rearing. Further, even ducklings reared individually with the mallard hen were unresponsive to her in the later choice test. That there is something special about the stimulation provided by ducklings was further demonstrated by the finding that stuffed ducklings were preferred over the mallard hen (1) when the social rearing situation precluded active physical interaction with live ducklings and (2) when reared with inanimate stuffed ducklings. Thus, the ineffectiveness of the stuffed mallard hen in inducing visual imprinting under simulated nesting conditions cannot be attributed to the fact that she was not alive or reciprocally interactive. The present results suggest that mallard ducklings do not become visually imprinted to their hen until after departure from the nest, that the visual component of maternal imprinting likely involves active following subsequent to nest departure, and that early in postnatal development siblings are more visually attractive than is the hen. PMID- 2759359 TI - Visual head extension: transitional head coordination in the pigeon squab (Columbia livia). AB - We describe a previously unreported visuomotor behavior of the developing pigeon squab, which we term "visual head extension." The behavior consists of extension and lowering of the head as the bird descends towards a surface or experiences the optical equivalent of such a descent. A peak in performance occurs 10 days after hatching. Evidence obtained shows that both vestibular and dynamic visual information can independently produce head extension. We go on to place the new behavioral response in the context of a dynamic, relational approach to perceptuomotor coordination, and outline the corresponding advantages of studying the single-limb, head-neck system in the pigeon. PMID- 2759360 TI - Development of antipredator responses in snakes: IV. Interspecific and intraspecific differences in habituation of defensive behavior. AB - Habituation of defensive attacks directed toward a threatening stimulus was investigated in neonatal garter snakes. The focus of the experiments was on differential effects of a simple experimental process in relation to species, litter, sex, and individual. In Experiment 1 newborn Thamnophis melanogaster from four liters and newborn Thamnophis butleri from three liters were given daily tests in which snakes were confronted with a nonmoving and moving human hand. Over five successive test days the T melanogaster neonates showed a decline in number of strikes directed toward the stimuli. When retested 10-13 days later the animals showed significant response recovery. Although some of the T? butleri newborns demonstrated significant habituation, there was no overall habituation of strike scores in this species. The T? melanogaster had high strike scores, more rapid habituation to moving than nonmoving stimuli, and significant liter differences in habituation rates. The T? melanogaster, but not the T? butleri neonates, showed significant habituation of flight responses over the five tests. In T? butleri, but not T? melanogaster, males were more prone to attack than were females. In both species there were large differences in both overall strike scores and habituation rates of individual newborn animals. In Experiment 2, T? melanogaster 2-months old, were tested for short-term habituation to either a moving or nonmoving stimulus for 10 successive tests on one day. Habituation of strikes was similar to both stimuli, but more animals confronted with the moving stimulus showed an initial increase in strikes, lending support to the dual process theory of habituation. As in Experiment 1, there were large individual differences in habituation rates. The results are discussed in terms of the ecological and methodological implications for developmental studies. PMID- 2759361 TI - Effect on the postprandial glycaemic level of the addition of water to a meal ingested by healthy subjects and type 2 (non-insulin-dependent) diabetic patients. AB - The effects on postprandial glycaemic reactions of adding a glass of water to a meal were studied in 7 healthy male subjects and 20 Type 2 (non-insulin dependent) diabetic patients for a period of up to 3 h. The subjects were served a meal of potatoes and meat, with or without 300 ml of water, in random order on two mornings after a 12-h fast. The diabetic patients were considered as well controlled or not well-controlled according to HbA1c and blood glucose fasting values. Water addition increased the peak blood glucose (p less than 0.02) and serum insulin (p less than 0.02) levels in healthy subjects, and the blood glucose concentration in well-controlled diabetic patients (p less than 0.02). The addition of water also increased the overall blood glucose response, calculated as the positive incremental area, in healthy subjects by 68 +/- 25% (p less than 0.02) and in well-controlled diabetic patients by 40 +/- 14% (p less than 0.01). In poorly-controlled diabetic patients, however, the addition of water did not display significant effects, probably due to the varying fasting glycaemia in these patients. Thus, altering the physical property of a meal by dilution with water can affect the physiological responses; the results are considered to be relevant for the on-going discussion concerning the use of physiological responses to foods as a basis for diet instructions to diabetic patients. PMID- 2759362 TI - Urinary albumin excretion in diabetic pregnancy. AB - We have analysed the results of urinary albumin excretion in timed overnight urine samples once every two weeks during pregnancy and post-natally in 25 non diabetic women and 14 women with Type 1 (insulin-dependent) diabetes who were Albustix negative and had urinary albumin excretion less than 15 micrograms.min-1 at conception. Urinary albumin excretion did not vary significantly in the first two trimesters in either group and at 28 weeks was 2.73 micrograms.min-1 (0.32 251.68) (median and range) in the diabetic women and 2.53 micrograms.min-1 (0.90 13.37) in control patients (not significant). During the third trimester urinary albumin excretion increased, and levels were significantly higher in diabetic patients from 36 weeks (9.37 (0.9-31.78) vs 3.52 (0.19-33.74) micrograms.min-1, p less than 0.01) until delivery. In both groups, urinary albumin excretion reached a peak within the week following delivery - diabetic 17.42 micrograms.min-1 (2.03 46.64), control subjects 16.29 micrograms.min-1 (1.53-35.56), but six weeks after delivery, levels were similar to those in early pregnancy. The effect of pregnancy on urinary albumin excretion in these diabetic women would appear to be an exaggeration of the normal pattern, with levels returning to normal post delivery. It is not possible to know if this has significance for future renal function, but it would be important to investigate this phenomenon in patients who already have raised urinary albumin excretion at conception. PMID- 2759363 TI - Somatostatin analogue administration prevents increase in kidney somatomedin C and initial renal growth in diabetic and uninephrectomized rats. AB - In a previous study we demonstrated that the kidney content of somatomedin C was maximal one to two days after uninephrectomy or induction of diabetes, and that insulin treatment prevented an increase in kidney somatomedin C as well as kidney growth in diabetic animals. In the present study we have examined the effect of a somatostatin analogue on kidney somatomedin C and initial renal growth in the two experimental situations. The kidney hypertrophy in untreated diabetic animals amounted to 23% four days after streptozotocin injection and followed an increase in kidney somatomedin C content of 60% reaching the maximum after 48 h. In young and old uninephrectomized rats kidney growth was 19% and 16% after four days. In young animals a prompt increase of 50% in kidney somatomedin C was seen as reaching the maximum after 24 h, while the somatomedin C content in kidneys from old animals was maximal after 48 h (increase of 58%) in good accordance with the slightly slower kidney growth. The new findings of the present study are that administration of a long-acting somatostatin analogue (Sandostatin) effectively prevented the obligatory increase in kidney somatomedin C content as well as kidney growth both in experimental diabetes and after uninephrectomy. It is noteworthy that Sandostatin administration did not alter the metabolic state in diabetic animals indicating that the inhibition of kidney hypertrophy could not be attributed to improved metabolic control. The results thus support the concept that somatomedin C is involved in initial diabetic and post-nephrectomy renal growth. PMID- 2759364 TI - Exercise-induced diastolic abnormalities in type 1 (insulin-dependent) diabetic patients without overt heart disease. PMID- 2759365 TI - Appearance of acinar-cell-specific mucin in prenatal mouse submandibular glands. AB - The appearance of an acinar-cell-specific mucin was studied during fetal mouse submandibular gland development. The mucin was first detected in stage 23 and was quantitated through birth by radioimmunoassay (RIA). Quantitation results showed that the mucin accumulation was biphasic. Results from Western blotting and radioimmunoassay indicated that the mucin from the prenatal glands was similar both antigenically and in size to the mucin isolated from adult mice. Observations from light microscopy revealed a continuing progression of complexity throughout prenatal development, indicative of morphogenesis characteristic of differentiating exocrine tissues. When sections from various stages were compared morphometrically, it became clear that the overall ratio of epithelial cells to mesenchymal cells increased nearly 6-fold throughout the prenatal stages observed. The study suggests that acinar cell development in the mouse submandibular gland passes through a protodifferentiated stage. The proportions of epithelial and mesenchymal cells in the submandibular gland and the sensitivity of the RIA indicate that the mucin per cell actually increased to detectable levels at the onset of protodifferentiation, and this increase does not reflect a change in the relative proportions of epithelial and mesenchymal cells. PMID- 2759366 TI - [The H-reflex and resistance to static loads]. PMID- 2759367 TI - [Interrelation of the sympatho-adrenal and hypothalamo-hypophyseo-adrenal system and sports results (correlation analysis)]. PMID- 2759369 TI - [Reflex regulation of circulation by baroreceptors of the carotid sinus in man]. PMID- 2759368 TI - [Criteria for evaluation and normative periodic motor activity of the upper section of the gastrointestinal tract]. PMID- 2759370 TI - [Change in central hemodynamics during a shift in the sleep stage in healthy persons and patients with ischemic heart disease]. PMID- 2759371 TI - [Cardiovascular dynamics as affected by ergometric optimal sequence (ERGOS)]. PMID- 2759372 TI - [Electrodes in polyelectroneurographic studies. II. Experimental assessment of characteristics of electrode potential difference of silver chloride electrodes]. PMID- 2759373 TI - [Analysis of the processes of synchronization of single discharges of remotely arranged neuronal ensembles]. PMID- 2759375 TI - [Relation of the cardiac rhythm response to a test of active orthostasis with characteristics of central hemodynamics]. PMID- 2759374 TI - [A method for comparing individual and group purposeful sensorimotor activity]. PMID- 2759376 TI - [Cerebral circulation during intense mental work]. PMID- 2759377 TI - [Transesophageal electrocardiostimulation as a test during assessment of coronary blood flow in patients with ischemic heart disease with hemodynamically significant stenoses of the coronary arteries]. PMID- 2759378 TI - [Omega-potential measurement in studying the functional status of healthy subjects with normal and hypertensive types of reaction to graded physical exertion]. PMID- 2759379 TI - [Peculiarities of rhythm-dependent characteristics of the myocardium during early signs of cardiac insufficiency]. PMID- 2759380 TI - [Suppression of the sympathetic component of the baroreceptor reflex in patients with arterial hypertension]. PMID- 2759381 TI - [Characteristics of the regulation of cardiac rhythm in schoolchildren 13-16 years of age during academic studies]. PMID- 2759382 TI - [Visual evoked potentials in amblyopia]. PMID- 2759383 TI - [Functional asymmetry of the brain in stuttering children during the perception of emotion]. PMID- 2759384 TI - [Characters used by the cerebral hemispheres during recognition of geometric images]. PMID- 2759385 TI - [Correlations between calciuria and systolic arterial pressure in young normotensive subjects with family history of hypertension]. AB - Many experimental evidences suggest an important role of calcium in the pathophysiology of essential hypertension; an increased calciuria could be a feature of these patients. Provocative tests, such as cold pressor test or aerobic exercise, have been proposed to be predictive for the occurrence of essential hypertension. Aim of this study has been to show a relation between sodium, calcium and potassium urinary excretion and blood pressure response to provocative tests in young normotensives with a positive parental history for essential hypertension. The subjects of the study were 59 young normotensive volunteers, 30 with a positive and 29 with a negative parental history for essential hypertension. All subjects underwent a cold pressor test and a maximal aerobic exercise on a bicycle ergometer; blood pressure and heart rate were recorded before, during and after the tests by means of an automatic device. An overnight urine collection allowed the evaluation of sodium, potassium and calcium excretion. There was no difference between the two groups as to blood pressure response to provocative tests or to urinary electrolyte excretion. Only in subjects with a positive parental history for essential hypertension there was linear correlation between calcium urinary excretion and systolic blood pressure, both baseline and exercise-induced. PMID- 2759386 TI - [Correlation between thyroid hypofunction and the presence of circulating antithyroid microsomal antibodies. A phenomenon in the aged, prevalent in women]. AB - The authors evaluated the existence of serum thyroid microsomal antibodies (anti TMS) and their correlation, if any, with thyroid function in a group of 120 consecutive patients, who seemed clinically worthy to be studied from that point of view, even if they were lacking of a previous laboratory framing. Present study shows a consistent prevalence (81.8%) of anti-TMS concentrations were not related with any hormone parameter of thyroid function. Instead, the prevalence of anti-TMS positive subjects get to 69% in the 39 over-65 aged patients (32 women) of survey, with a concordance between high anti-TMS concentration and hypothyroidism of 87.5% in the subgroup. In these elderly patients circulating anti-TMS and serum TSH were found directly correlated (p less than 0.001), whereas serum FT4 was found in inverse correlation with the same antibodies (p less than 0.01). The consistent share of hypothyroid-aging patients, although mild or subclinical but clearly related with immunological phenomena, cannot be overlooked. PMID- 2759387 TI - [Headache and "masked" depression]. PMID- 2759388 TI - [Complex ventricular arrhythmias in ischemic cardiopathy]. PMID- 2759389 TI - [A clinical case. Painful thoracic symptomatology of the constrictive type]. PMID- 2759390 TI - [Famotidine in the short and long term treatment of duodenal ulcer: clinical and physiopathologic study]. AB - The aim of this study was to evaluate the clinical efficacy of short and long term treatment with famotidine 40 mg/daily at bed time in duodenal ulcer disease. 45 patients with endoscopically proven active duodenal ulcer undertaken the study. Endoscopic evaluations were performed at 6 weeks, 3 and 6 months from the start of the study. The following parameters were evaluated: pepsinogen group I and gastrin levels in serum, pH, acid and neutral glycoprotein, N acetylneuraminic acid, pepsin in gastric juice collected during the upper gastrointestinal endoscopy. 6 weeks healing rate was 91.1%. After the third month of follow-up 14.2% of the patients presented an endoscopical proven episode of relapse. No relapses were observed at the end of the study (after 6 months of treatment). Acid glycoprotein, N- acetylneuraminic acid and pepsin concentrations significantly decreased after 6 weeks of treatment (p less than 0.0125, p less than 0.025, p less than 0.005 respectively), while serum levels of pepsinogen group I, gastrin and gastric pH increased (p less than 0.0005, p less than 0.005, p less than 0.025). After 6 months period of therapy, a significant increase of neutral glycoproteins (p less than 0.01) and a decrease of pepsin (p less than 0.005) and acid glycoproteins (p less than 0.01) was observed. On the contrary, gastric N- acetylneuraminic acid, pH, serum gastrin and pepsinogen group I presented the pre-trial values. IN CONCLUSION: 1) famotidine appears to be an effective and safe therapy for duodenal ulcer treatment; 2) it seems to act not only by inhibiting gastric acid secretion but also influencing some parameters related to the gastric mucosal barrier. PMID- 2759391 TI - [Natural history of dilated cardiomyopathy]. AB - Seventy-seven patients with dilated cardiomyopathy (50 M and 27 F, aged 38 +/- 16 yrs) were followed up until Dec 31, 1985. Haemodynamic investigation was performed in all cases, and all pressure and left ventricular quantitative angiography parameters were collected. In no case did the coronary angiogram show significant lesions. Mean values of haemodynamic parameters for surviving and deceased patients were compared. Forty-six patients survived and 28 died during the follow-up period. Although all patients had an enlarged left ventricle and depressed contractility, survivors had either greater pressure/end systolic volume ratio or a greater stress/end systolic volume ratio. Survival curves confirm a particularly severe prognosis for patients with Suga index less than 1 or stress to end systolic volume ratio less than 2.5. Mass to volume ratio seems to affect two-year but not late survival. NYHA class does not indicate early survival. In conclusion, left ventricular function is obviously related to prognosis in these patients, but it seems still difficult to assess life expectancy from these parameters alone. PMID- 2759392 TI - [Natural history of dilated cardiomyopathy]. PMID- 2759393 TI - [Echocardiographic analysis of the left ventricle in patients with type II diabetes mellitus]. AB - Left ventricular involvement in type II diabetes mellitus is poorly understood. We performed a cross-sectional, M-mode and pulsed Doppler echocardiographic study on 27 diabetic patients and 27 controls accurately matched for age, sex, weight and height. All subjects also underwent 24-hour non-invasive ambulatory blood pressure monitoring. Left ventricular wall thicknesses and dimensions in diastole and systole, left ventricular mass index (82.7 g/m2 vs 78.4 g/m2) and the echocardiographic indices of left ventricular contractility did not show any statistical differences between diabetics and controls. Clinic and 24-hour ambulatory blood pressure did not show important differences between diabetics and controls. Doppler parameters for transmitral flow velocity (including peak A and peak E velocity and their ratio, pressure half time and pressure half slope) were the same in diabetics and controls. A stepwise multivariate regression analysis showed a significant positive independent relationship of peak A/peak E ratio with age (peak A/peak E = 0.0087 + 0.20 x age; F = 18.7; p = 0.0001), but not with diabetes or glycosylated haemoglobin (Hb 1 AC). Compared with non diabetics, diabetics showed a slight increase in aortic peak flow velocity (0.83 m/sec vs. 0.70 m/sec; p = 0.011) and a very slight increase in peak aortic gradient. Peak aortic velocity showed a highly significant positive independent relation with the duration of diabetes (Vmax = 0.572 + 0.0028* diabetes duration (months); F = 92.6; p less than 0.0001), but not with age, systolic or diastolic blood pressure of HB 1 AC.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2759394 TI - [Type A behavior and psychological characteristics of hypertensive patients undergoing antihypertensive treatment]. AB - The aim of this study was to evaluate the presence of "type A" behaviour and possible psychological distress in 373 hypertensive patients. One-hundred and ninety-five males, 56.2 +/- 6.2 years old and one-hundred and seventy-eight females, 57.1 +/- 6.2 years old, coming from the IPPPSH and still under double blind treatment with or without a beta-blocker (oxprenolol 160 mg SR), were studied by means of the Jenkins Activity Survey form C and several tests from the Cognitive Behavioural Assessment Battery (CBA-2.0). Seventy-four point eight percent of the patients showed a "type A" pattern, and 25.5% were in the extreme predictive interval for coronary heart disease according to WCGS. "Type A" pattern was not influenced by variables such as age, sex, education, job or previous pharmacological treatment. The patients studied did not show any particular psychological distress at the psychometric evaluation. However, special social and cultural characteristics and different therapies influenced some symptoms, such as anxiety, depression and somatic lamentation. According to this study: "type A" behaviour seems to be a steady feature of the hypertensive patient; furthermore, it seems to be due to a "biological imprinting" which can be considered a cause of hypertension; psychological distress depends on a particular set of environmental stimuli. In the first case an accurate prevention is needed while, in the second case adequate pharmacological and/or psychological therapies are needed. PMID- 2759396 TI - Cardiac rehabilitation services in the U.S. PMID- 2759395 TI - [Electrocardiographic findings in a school-age population using a computerized system: calculation of standard norms for heart rate and PR, QRS, and QT intervals]. AB - We evaluated some ECG parameters (HR, P-R, Q-R-S, Q-T) in a healthy school-age population. One-thousand-eight-hundred and ninety children ranging in age from 5 to 12 coming from different zones of the city of Naples were studied. On physical examination all subjects were free from cardiac disease. A computerized ECG (Muse 12SL System Marquette) was performed on every subject. One-hundred and seventy four of the 1890 children were excluded from statistical analysis because of ectopic rhythm (junctional rhythm or wandering pacemaker) or poor quality of the recording. Of the 1716 children included in the study, 837 were male and 879 were female. The computerized ECG 12SL System Marquette registers an ECG record consisting of all 12 classical ECG leads acquired simultaneously over a 10 second period. Each individual complex can be analyzed in all leads by the computer. An interpretation using this extended record, along with an ECG record of conventional length, is presented to the physician for review. The first step in computerized ECG analysis is Q-R-S identification, then P wave identification, beat classification, rhythm analysis, morphology analysis, complex alignment and computation of median complex. All parameters were divided for sex and age and gathered into tables. The variability of P-R, Q-R-S, Q-T versus HR were also evaluated. The following conclusions were drawn: 1) Sex is a very important variable in the parameters examined. Males have a much slower HR, greater Q-R-S duration, and longer Q-T interval when compared to females. 2) As age increases, HR slowly decreases, while P-R, Q-R-S and Q-T intervals increase.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2759397 TI - [Electrocardiogram simulation. A theoretical model of ischemia]. AB - Using an electric circuit model, made of two segments formed of sections that behave electrically as subendocardial and subepicardial cells, we simulated myocardial ischemia in one of the two segments. The changes in the ST segment and in the T wave were obtained respectively by diminishing the intercellular potential from -90 mV to -60 mV and by shortening or prolonging the duration of action potentials. In order to simulate acute subendocardial, subepicardial and transmural ischemia, the potentials of the internal section, the outer section, and of both sections were diminished respectively. The ST segment appeared depressed both in the segment involved and in the undamaged one in subendocardial ischemia. In subepicardial ischemia it appeared elevated in the segment involved and was normal in the undamaged one. In transmural ischemia it was elevated in the segment with reduced potential and it was depressed in the undamaged segment. The depression of the ST segment in the undamaged part, both in subendocardial ischemia and in transmural ischemia, depends on the imbalance of the central point and therefore the whole subendocardial layer behaves electrically as if it really were ischemic. The T-wave changes in acute ischemia are in keeping with those of the ST segment. PMID- 2759398 TI - Endoscopic needle biopsy: a comparative study of forceps biopsy, two different types of needles, and salvage cytology in gastrointestinal cancer. AB - One of the goals of gastrointestinal endoscopy is to diagnose whether a lesion is malignant. The desire to improve the sensitivity of biopsy-sampling techniques prompted us to compare prospectively the reliability and accuracy of obtaining tissue by forceps biopsy, needle biopsy (21 gauge 13-mm long metal needles versus 18 gauge 20-mm long plastic needles), and salvage cytology in patients with endoscopically suspected malignancy. Samples were obtained in the order of needle biopsy (the order of metal and plastic needle biopsy was randomized), forceps biopsy, followed by salvage cytology. Needle biopsies were obtained by puncturing the lesion under direct vision while aspirating with a syringe. Twenty-three patients with gastrointestinal malignancy were studied (7 esophageal, 4 gastric, and 12 colonic). Forceps biopsies were positive in 18 of 23 (78%), missing 1 gastric and 4 colon malignancies. Metal needle biopsy was positive in 16 of 19 (84%), plastic needle biopsy in 17 of 22 (77%), and salvage cytology in 20 of 22 (91%). Accuracy was increased by a combination of techniques. Endoscopic needle biopsy is a simple and rapid method to evaluate lesions seen at endoscopy and is especially useful in evaluation of submucosal lesions. PMID- 2759399 TI - Effect of aging on the pancreatic ducts: a study based on endoscopic retrograde pancreatography. AB - Studies in the West have shown that with advancing age there is progressive atrophy and fibrosis of the pancreas. In addition, there is a gradual increase in diameter of the main pancreatic duct (MPD) with age. However, there is a discrepancy between the findings at autopsy and findings at endoscopic retrograde pancreatography (ERP). To examine this issue, ERP of subjects who were found not to show any abnormality of the biliary and pancreatic ducts were selected. They were divided by decade from 10 to 70 years and for statistical analysis into young (less than 40) and older (greater than or equal to 40) patients. There was no difference in length of the MPD between the two groups. However, the width of the MPD in the head was significantly greater in the older subjects (group 2; mean +/- SD = 3.78 +/- 0.97 mm) compared with those who were less than 40 years (group 1; 2.97 +/- 0.71 mm; p less than 0.001). Similarly, in the midbody the width of the MPD in group 2 (2.86 +/- 0.9 mm) was significantly greater compared with group 1 (2.36 +/- 0.51 mm; p less than 0.02). However, there was no difference in width of the MPD in the tail between the two groups. Length of the accessory pancreatic duct (APD) did not show any alteration with age but width was significantly greater in group 2 (1.94 +/- 0.69) compared with group 1 (1.49 +/- 0.51; p less than 0.05). No difference was observed in the length and width of the MPD or APD between male and female subjects of either group.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2759400 TI - Midazolam-associated alterations in cardiorespiratory function during colonoscopy. AB - Twenty patients undergoing clinically indicated elective colonoscopy were prospectively monitored noninvasively for alterations in cardiorespiratory function. Most of the patients were elderly and many had either cardiac or pulmonary disease. All subjects were premedicated with intramuscular meperidine and continuously monitored with ECG, blood pressure, earlobe pulse oximetry, nasal air flow by thermistor probe, and impedance pneumography. Any use of additional analgesic or sedative was determined by the endoscopist, who was blinded to the physiologic tracings, and dosages of medications given were titrated to each patient's tolerance of the procedures as assessed by the endoscopist. Seventeen patients (85%) required additional sedation with the benzodiazepine, midazolam. These patients exhibited frequent episodes of hypotension (reductions in mean arterial blood pressure of 23 +/- 12 mm Hg from baseline, means +/- SD) and respiratory depression (as noted by the greater number of apneas and arterial oxygen desaturation as low as 7.1 +/- 2% from baseline, means +/- SD). In addition, elderly patients and patients with an underlying history of cardiac or pulmonary disease had a greater incidence of potentially untoward cardiorespiratory events. PMID- 2759401 TI - Large bore percutaneous endoscopic gastrostomy using the Russell technique. PMID- 2759402 TI - Successful ablation of a large fibrovascular polyp of the esophagus by endoscopic Nd:YAG laser therapy. PMID- 2759403 TI - Biliary stenting in an infant with malignant obstructive jaundice. PMID- 2759404 TI - Bile duct cancer is not hopeless. PMID- 2759405 TI - Oral sedative/analgesic premedication for 60-cm fiberoptic sigmoidoscopy. PMID- 2759406 TI - Iatrogenic paraesophageal hernia after endoscopy. PMID- 2759407 TI - Gastric wall abscess drained at endoscopy. PMID- 2759408 TI - Colonoscopic extraction of a foreign body from the ileocecal valve. PMID- 2759409 TI - Effects of alpha-latrotoxin on the early developmental events of the sea urchin Paracentrotus lividus: a histochemical study. AB - The effects of the spider toxin alpha-latrotoxin (alpha-LTX) on gametes, zygotes, and early embryos of the sea urchin Paracentrotus lividus have been investigated by in vivo experiments and by histochemical studies of acetylcholinesterase (AChE) activity. Treatment of unfertilized eggs with nanomolar amounts (1 to 0.3 nmol/l) of alpha-LTX neither triggered cortical granule exocytosis, nor prevented the elevation of the fertilization layer by sperms. Instead, fertilized eggs exposed to alpha-LTX showed noticeable alterations in cell surface topography, including the appearance of prominent membrane-limited blebs. Moreover, the zygotes treated with 1 nmol/l alpha-LTX failed to cleave. The histochemical staining of treated zygotes revealed a very strong AChE activity in the cortical region, including blebs. An enzyme reaction was also found in the perivitellin space. Our results suggest the hypothesis that some alpha-LTX receptors may appear after fertilization, supporting the awareness that fertilized eggs display excitable cell features. PMID- 2759410 TI - Comparative study of the anatomy and laminar organization in the olfactory bulb of three orders of freshwater teleosts. AB - The anatomy and lamination of the olfactory bulb in Cyprinus carpio, Tinca tinca, Barbus bocagei (Fam. Cyprinidae, Or. Cypriniformes); Salmo gairdneri (Fam. Salmonidae, Or. Salmoniformes); and Gambusia affinis (Fam. Poeciliidae, Or. Cyprinodontiformes), all of them freshwater teleosts, are studied. These species show significative differences on the location, size, morphology, and lamination of their olfactory bulbs. The presence of a new stratum in the olfactory bulb of Salmo gairdneri and a completely different laminar organization in the olfactory bulb of Gambusia affinis are described for the first time. The anatomical and histological peculiarities of this structure in the orders studied could be the basis for different experimental approaches. PMID- 2759411 TI - Local approximation and its applications in statistics. AB - For the discrete and for the continuous case, the problem of evaluating the derivatives of a function f(x) in a given interval of x is solved by local approximation method. Examples of application of the resulting numerical procedures are quoted relating the estimation of smooth function and its derivative for measured values (of a growth process), internal regression, trend elimination of time series, Bernstein polynomial, and kernel estimation of a density function. PMID- 2759412 TI - [Periodic local approximation for the model free description of measurement courses of biorhythmic processes--demonstration example for the selection of smoothness parameters]. AB - Measured time series with known basic periodicity may be modelfreely evaluated by procedures of local adjusted approximation. Examples of motility time series recorded in chronobiological experiments in the seasonal course of a year demonstrate aspects of choosing values of the smoothing parameter and the resulting effects for the quantitative description of the measured variations as well as for their interpretation. PMID- 2759413 TI - [The superficial cerebral veins]. AB - Estimated were the number, the course, and the width of the superficial cerebral veins. The veins on the superolateral surface of the brain are the prefrontal superficial lateral superior, the precentral superficial lateral superior, the central superficial lateral superior, the parietal superficial lateral superior, and the occipital superficial lateral superior veins which drain to the superior sagittal sinus, to bridging veins, and to the falx cerebri. The veins which drain the lateral surface of the brain downwards are the middle superficial cerebral veins, the temporal inferior, occipital inferior, and anastomotic veins. The diameters of these veins were measured at the perforation of the arachnoid membrane and the diameters of the anastomotic veins on their narrowest area. On the medial side of the hemispheres, we divided in precentral superficial superior medial, central superficial medial, parietal superficial medial, occipital superficial medial dorsal veins of the corpus callosum, and internal occipital veins. On the basal surface of the hemispheres, we studied and described the uncal veins and the inferior hemispheric veins. Studied and discussed are also the bridging veins in the course of the inferior cerebral veins, the paracavernous sinuses, and the last course of the veins and their connections with the dura mater or the course inside the dura. Given are besides the numbers of these veins, the area of perforation of the arachnoid membrane, and their width and medical importance. PMID- 2759414 TI - Histochemical methods and their application in the science and diagnosis. Abstracts of papers presented at the third symposium and school. Varna, Bulgaria, September 22 to 26, 1988. PMID- 2759415 TI - Adrenergic innervation of the ureters, urinary bladder, and urethra in pigs. AB - Studies were conducted on 4 sexually mature and 4 immature pigs. Scraps of the ureters, urinary bladder, and urethra were cut with a freezing microtome. Fluorescence method of Torre and Surgeon (1976) was used to reveal the adrenergic innervation. It was found that the ureters were weakly supplied with the adrenergic nerves; most of the nerves were located in the muscular and submucosal membranes. Apex of the urinary bladder possessed the weakest innervation. More nerves were found in particular layers of the bladder corpus whereas bladder trigonum and cervix possessed numerous nerves. Adrenergic innervation of the urethra was similar to that of the urinary bladder's cervix. Adrenergic nerves were present in the serous and muscular membranes of both the urinary bladder and the urethra. Part of the nerve fibres was connected with blood vessels of the organs under study. PMID- 2759416 TI - Qualitative and quantitative changes in monoamine oxidase activity after acute third ventricle treatment of GABA, muscimol, and picrotoxin in rat. AB - The effect of acute IIIrd ventricle injection of GABA, muscimol, and picrotoxin on the activity of monoamine oxidase (MAO) has been investigated in serum and a few hypothalamic nuclei of the rat brain using biochemical, histochemical, and cytophotometric techniques. Biochemical estimation demonstrated a significant reduction in MAO enzyme activity after GABA and muscimol injection, whereas picrotoxin produced pronounced increase in the enzyme activity. Histochemical and cytophotometric studies confirmed the biochemical findings. Even in brain, GABA and muscimol inhibited and picrotoxin stimulated the MAO activity. From the above findings, it may be concluded that GABA, muscimol, and picrotoxin regulate the MAO activity, possible mechanisms for which are being discussed. PMID- 2759417 TI - Some morphological and histochemical studies on the intestinal tract of the Brazilian sloth (Bradypus tridactylus). AB - The intestinal of the 3-toed sloth, Bradypus tridactylus, was studied macroscopically, with light microscope and with histochemical methods for mucosubstances. Macroscopically, the inner surface of the duodenum shows longitudinal and circular folds. There is no caecum, nor appendix. The large intestine consists of a short colon and a large rectal pouch, which has a thick wall. The mucosa of the small intestine has long leaf-shaped villi covered with columnar epithelium having a well developed striated border, and the goblet cells are scattered among the columnar cells. An association between neutral and acidic mucosubstances was detected in the goblet cells. The duodenal (Brunner's) glands are confined exclusively in the lamina propria of the duodenum. No Paneth cells were observed in the crypt lining. Argyrophil and argentaffin cells were found in the entire length of the intestine. The large intestine does not possess villi, but many goblet cells were observed in its mucosa. PMID- 2759418 TI - Iron depletion alters surface-associated properties of Staphylococcus aureus and its association to human neutrophils in chemiluminescence. AB - Staphylococcus aureus NCTC 6571 was grown in iron-depleted tryptone soya broth (Fe-TSB) to approximate to in vivo conditions, and in iron-rich TSB (Fe + TSB). Low iron effected a crucial decrease in surface hydrophobicity (SH) and a lack of supernatant Protein A (PrA). Iron availability did not affect PrA detection in immunoblotting and it was identified as a 35.5 kDa antigen in this strain. Fe phenotypes lacked 34, 48 and 52 kDa antigens. In chemiluminescence, Fe-phenotypes appeared least vulnerable to phagocytosis despite opsonisation. PMID- 2759419 TI - Genetic definition of two functional elements in a bacteriophage T4 host-range "cassette". AB - Gene 37 of T4 encodes the major subunit of the distal half of the tail fiber. The distal tip of the fiber, comprised of the carboxy-terminal ends of two molecules of gene 37 product (gp37), carries the principal determinant of the phage host range. The gp37 carboxyl termini recognize the bacterial surface during infection, and, in addition, include a site required for interaction with the product of gp38 during distal half-fiber assembly. In the absence of interaction with gp38, gp37 polypeptides do not dimerize. Eleven temperature-sensitive mutants with defects located near the promoter-distal end of gene 37 were tested at nonpermissive temperatures for production of an antigen that is diagnostic of distal half-fiber assembly. Six of the mutations prevent distal half-fiber assembly. The other five allow assembly of distal half fibers, which combine with proximal half fibers and attach to phage particles, but the resulting phage do not adsorb to bacteria. These two classes of mutations define two adjacent but separate genetic regions, corresponding to two different functional domains in gp37. These two regions and the neighboring gene 38 comprise a functional unit that can be considered as a host-range "cassette," with features that are strikingly similar to corresponding functional units in other unrelated as well as related phages. PMID- 2759420 TI - Genetic variability for pathogenicity, isozyme, ribosomal DNA and colony color variants in populations of Rhynchosporium secalis. AB - Samples of Rhynchosporium secalis were collected from two experimental barley populations known to carry a diverse array of alleles for resistance to this fungal pathogen. Classification of 163 isolates for four putative isozyme systems, a colony color dimorphism and 20 ribosomal DNA restriction fragment length variants revealed 49 different multilocus phenotypes (haplotypes). The six most common haplotypes differed significantly in pathogenicity. Genetic analyses of the data indicated that effective population sizes of the fungus were very large, that the effects of genetic drift were small, and that negligible recombination occurred in the populations studied. Frequency dependent selection was suggested as an explanation for the maintenance of variation in pathogenicity in the fungus. PMID- 2759421 TI - The Caenorhabditis elegans gene sdc-2 controls sex determination and dosage compensation in XX animals. AB - We have identified a new X-linked gene, sdc-2, that controls the hermaphrodite (XX) modes of both sex determination and X chromosome dosage compensation in Caenorhabditis elegans. Mutations in sdc-2 cause phenotypes that appear to result from a shift of both the sex determination and dosage compensation processes in XX animals to the XO modes of expression. Twenty-eight independent sdc-2 mutations have no apparent effect in XO animals, but cause two distinct phenotypes in XX animals: masculinization, reflecting a defect in sex determination, and lethality or dumpiness, reflecting a disruption in dosage compensation. The dosage compensation defect can be demonstrated directly by showing that sdc-2 mutations cause elevated levels of several X-linked transcripts in XX but not XO animals. While the masculinization is blocked by mutations in sex determining genes required for male development (her-1 and fem 3), the lethality, dumpiness and overexpression of X-linked genes are not, indicating that the effect of sdc-2 mutations on sex determination and dosage compensation are ultimately implemented by two independent pathways. We propose a model in which sdc-2 is involved in the coordinate control of both sex determination and dosage compensation in XX animals and acts in the regulatory hierarchy at a step prior to the divergence of the two pathways. PMID- 2759423 TI - Ancient interlocus exon exchange in the history of the HLA-A locus. AB - The major histocompatibility complex (MHC) in humans and chimpanzees includes three classical class I loci, A, B and C, which encode glycoproteins expressed on the surface of all nucleated cells. There are also several nonclassical class I loci including E, which have more limited expression. By analyzing published sequences, we have shown that in exons 4 and 5, A locus alleles from both humans and chimpanzees are much more similar to E than to B or C alleles, whereas in exons 2 and 3 alleles from all three classical class I loci are much more similar to each other than any one is to E. We propose that some 20 million years ago, interlocus recombination led to the formation of a hybrid gene in which exons 2 and 3 were derived from the original A locus and exons 4 and 5 were derived from the E locus. The fact that such an ancient event can still be detected suggests that interlocus recombination is rare in the MHC and does not significantly contribute to MHC polymorphism, which is known to be extremely high. The present finding, however, supports Gilbert's idea that exons in a gene may occasionally be replaced by those from another gene in the evolutionary process. PMID- 2759422 TI - Recombinant inbred strain and interspecific backcross analysis of molecular markers flanking the murine agouti coat color locus. AB - Recombinant inbred strain and interspecific backcross mice were used to create a molecular genetic linkage map of the distal portion of mouse chromosome 2. The orientation and distance of the Ada, Emv-13, Emv-15, Hck-1, Il-1a, Pck-1, Psp, Src-1 and Svp-1 loci from the beta 2-microglobulin locus and the agouti locus were established. Our mapping results have provided the identification of molecular markers both proximal and distal to the agouti locus. The recombinants obtained provide valuable resources for determining the direction of chromosome walking experiments designed to clone sequences at the agouti locus. Comparisons between the mouse and human genome maps suggest that the human homolog of the agouti locus resides on human chromosome 20q. Three loci not present on mouse chromosome 2 were also identified and were provisionally named Psp-2, Hck-2 and Hck-3. The Psp-2 locus maps to mouse chromosome 14. The Hck-2 locus maps near the centromere of mouse chromosome 4 and may identify the Lyn locus. The Hck-3 locus maps near the distal end of mouse chromosome 4 and may identify the Lck locus. PMID- 2759424 TI - Allelic and genotypic composition of ancestral Spanish and colonial Californian gene pools of Avena barbata: evolutionary implications. AB - Spanish explorers and colonists inadvertently started a massive experiment in evolutionary genetics when they accidentally introduced Avena barbata to California from Spain during the seventeenth and eighteenth centuries. Assays of the Spanish and Californian gene pools of this species for 15 loci show that the present day Spanish gene pool, particularly that of Southwestern Spain, is identical or virtually identical to that of California for five loci and closely similar for nine loci. Despite their similar allelic and single-locus genotypic compositions, the present-day Spanish and Californian gene pools are differently structured on a multilocus genetic basis. Evolutionary implications of these results are discussed. PMID- 2759425 TI - Is knowing the age-order of alleles in a sample useful in testing for selective neutrality? AB - The most powerful, and most frequently used, test of selective neutrality, based on data consisting of observed allelic frequencies in a sample of genes at some locus, is the procedure of G. A. Watterson. This procedure uses the sample homozygosity F* as the test statistic, and in effect leads to rejection of the hypothesis of selective neutrality if the observed value of F* differs significantly from neutral theory expectations. The homozygosity statistic is invariant under relabeling of the alleles and thus cannot use any further information on the alleles which might be available. We present results which suggest that information concerning the age order of the alleles cannot be used to provide a more powerful testing procedure than that of Watterson. PMID- 2759426 TI - Can molecular imprinting explain heterozygote deficiency and hybrid vigor? AB - Molecular imprinting, the phenomenon of differential expressions of a gene based on whether it is paternally or maternally derived, has been noted in mice, humans, and other nonmammalian organisms. Effects of differential imprinting are important not only in the study of the manifestation of deleterious genes; they have important evolutionary implications as well. It is shown here that molecular imprinting may mimic observations that are often construed to be due to hybrid vigor and/or inbreeding depression. Furthermore, if a locus undergoes differential imprinting, it also yields observed genotypic proportions which mimic heterozygote deficiency in the population without the aid of natural selection. PMID- 2759427 TI - Genetic evidence for two t complex tail interaction (tct) loci in t haplotypes. AB - The t complex on chromosome 17 of the house mouse is an exceptional model for studying the genetic control of transmission ratio, gametogenesis, and embryogenesis. Partial haplotypes derived through rare recombination between a t haplotype and its wild-type homolog have been essential in the genetic analysis of these various properties of the t complex. A new partial t haplotype, which was derived from the complete tw71 haplotype and which is called tw71Jr1, was shown to have unexpected effects on tail length and unique recombination breakpoints. This haplotype, either when homozygous or when heterozygous with the progenitor tw71 haplotype, produced short-tailed rather than normal-tailed mice on certain genetic backgrounds. Genetic analysis of this exceptional haplotype showed that the recombination breakpoints were different from those leading to any other partial t haplotype. Based on this haplotype, a model is proposed that accounts for genetic interactions between the brachyury locus (T), the t complex tail interaction (tct) locus, and their wild-type homolog(s) that determine tail length. An important part of this model is the hypothesis that the tct locus, which enhances the tail-shortening effect of T mutations, is in fact at least two, genetically separable genes with different genetic activities. Genetic analysis of parental and recombinant haplotypes also suggests that intrachromosomal recombination involving an inverted duplicated segment can account for the variable orientation of loci within an inverted duplication on wild-type homologs of the t haplotype. PMID- 2759429 TI - Genetic correlations and maternal effect coefficients obtained from offspring parent regression. AB - Additive genetic variances and covariances of quantitative characters are necessary to predict the evolutionary response of the mean phenotype vector in a population to natural or artificial selection. Standard formulas for estimating these parameters, from the resemblance between relatives in one or two characters at a time, are biased by natural selection on the parents and by maternal effects. We show how these biases can be removed using a multivariate analysis of offspring-parent regressions. A dynamic model of maternal effects demonstrates that, in addition to the phenotypic variance-covariance matrix of the characters, sufficient parameters for predicting the response of the mean phenotype vector to weak selection are the additive genetic variance-covariance matrix and a set of causal coefficients for maternal effects. These can be simultaneously estimated from offspring-parent regressions alone, in some cases just from the daughter mother regressions, if all of the important selected and maternal characters have been measured and included in the analysis. PMID- 2759428 TI - Genetic polymorphism for human platelet thermostable phenol sulfotransferase (TS PST) activity. AB - Platelet TS PST basal activity and thermal stability were measured in blood samples from 237 individuals in 50 nuclear families. Significant correlations were found among first degree relatives, confirming the previously reported familial aggregation of TS PST basal activity and thermal stability. Commingling analysis of basal TS PST activity provided evidence for multiple component distributions, and after transformation to remove skewness, segregation analysis supported a major gene hypothesis. For TS PST thermal stability, commingling analysis also provided evidence for multiple component distributions. However, segregation analyses were equivocal with regard to the presence of a major gene for thermal stability, since support for a major gene model depended on skewness. Bivariate commingling analysis, which examined thermal stability by simultaneously considering basal activity and activity after heating, suggested that genotypes, as defined by the inferred component distributions for TS PST activity, differ in thermal stability. A three-allele model is proposed as one hypothesis that may account for the combined results of basal activity and thermal stability. The results of this study indicate that a major gene polymorphism in conjunction with polygenic inheritance plays an important role in the regulation of both level of activity and thermal stability of this important drug-metabolizing enzyme in humans. PMID- 2759430 TI - The effects of assortative mating and migration on cytonuclear associations in hybrid zones. AB - We examine the influence of nonrandom mating and immigration on the evolutionary dynamics of cytonuclear associations in hybrid zones. Recursion equations for allelic and genotypic cytonuclear disequilibria were generated under models of (1) migration alone, assuming hybrid zone matings are random with respect to cytonuclear genotype; and (2) migration in conjunction with refined epistatic mating, in which females of the pure parental species preferentially mate with conspecific males. Major results are as follows: (a) even the slightest migration removes the dependency of the final outcome on initial conditions, producing a unique equilibrium in which both pure parental genotypes are maintained in the hybrid zone; (b) in contrast to nuclear genes, the dynamics of cytoplasmic allele frequencies appear robust to changes in the assumed mating system, yet are particularly sensitive to gene flow; (c) continued immigration can generate permanent cytonuclear disequilibria, whether mating is random or assortative; and (d) the order of population censusing (before versus after reproduction by immigrants) can have a dramatic effect on the magnitude but not the pattern of cytonuclear disequilibria. Using the maximum likelihood method, the parameter space of migration rates and assortative mating rates was examined for best fit to observed cytonuclear disequilibria data in a hybrid population of Hyla tree frogs. An epistatic mating model with a total immigration rate of about 32% per generation produces equilibrium gene frequencies and cytonuclear disequilibria consistent with the empirical observations. PMID- 2759431 TI - Apparent negative interference due to variation in recombination frequencies. AB - Variation in recombination frequencies may lead to a bias in the estimated interference value in a linkage experiment. Depending on the pattern of variation, the bias may be toward negative interference or toward positive interference, even when there is positive interference at the cytological level. In this paper we have mainly concentrated on the case of negative interference. We use models to quantify this effect when data are derived from a backcross experiment or from the selfing of F1 individuals. The effect is quantitatively similar in the two cases. There is an upper limit to the size the bias may reach for every given level of recombination. Two reported cases of negative interference in Drosophila and cultivated barley fall within this possible parameter range, i.e., the observed negative interference values could--at least in principle--be due solely to a variation in the recombination frequencies in the experiments. PMID- 2759432 TI - Gene genealogy in three related populations: consistency probability between gene and population trees. AB - A genealogical relationship among genes at a locus (gene tree) sampled from three related populations was examined with special reference to population relatedness (population tree). A phylogenetically informative event in a gene tree constructed from nucleotide differences consists of interspecific coalescences of genes in each of which two genes sampled from different populations are descended from a common ancestor. The consistency probability between gene and population trees in which they are topologically identical was formulated in terms of interspecific coalescences. It was found that the consistency probability thus derived substantially increases as the sample size of genes increases, unless the divergence time of populations is very long compared to population sizes. Hence, there are cases where large samples at a locus are very useful in inferring a population tree. PMID- 2759433 TI - Inference from clines stabilized by frequency-dependent selection. AB - Frequency-dependent selection against rare forms can maintain clines. For weak selection, s, in simple linear models of frequency-dependence, single locus clines are stabilized with a maximum slope of between square root of s/square root of 8 sigma and square root of s/square root of 12 delta, where sigma is the dispersal distance. These clines are similar to those maintained by heterozygote disadvantage. Using computer simulations, the weak-selection analytical results are extended to higher selection pressures with up to three unlinked genes. Graphs are used to display the effect of selection, migration, dominance, and number of loci on cline widths, speeds of cline movements, two-way gametic correlations ("linkage disequilibria"), and heterozygote deficits. The effects of changing the order of reproduction, migration, and selection, are also briefly explored. Epistasis can also maintain tension zones. We show that epistatic selection is similar in its effects to frequency-dependent selection, except that the disequilibria produced in the zone will be higher for a given level of selection. If selection consists of a mixture of frequency-dependence and epistasis, as is likely in nature, the error made in estimating selection is usually less than twofold. From the graphs, selection and migration can be estimated using knowledge of the dominance and number of genes, of gene frequencies and of gametic correlations from a hybrid zone. PMID- 2759435 TI - [Cytogenetic effect of the radiosensitizing action of 5-bromo-2'-deoxyuridine on eukaryotic cells at various periods of the DNA synthesis phase]. AB - The effect of 5-bromo-2'-deoxyuridine (BUDR) radiosensitizing action on meristematic cells of wheat seedlings and human peripheral blood lymphocytes synchronized with 5-fluoro-2'-deoxyuridine at the G1-S boundary was revealed. This effect was only found in the beginning of the S phase. We show that it was conditioned by incorporation of BUDR into special early replicating DNA sequences which are specific for chromosomal mutagenesis. Using the molecular biology methods non-random distribution of 3H-BUDR in the early replicating wheat DNA sequences with different degree of repeating was found. PMID- 2759434 TI - Effects of mutation on selection limits in finite populations with multiple alleles. AB - The ultimate response to directional selection (i.e., the selection limit) under recurrent mutation is analyzed by a diffusion approximation for a population in which there are k possible alleles at a locus. The limit mainly depends on two scaled parameters S (= 4Ns sigma a) and theta (= 4Nu) and k, the number of alleles, where N is the effective population size, u is the mutation rate, s is the selection coefficient, and sigma 2a is the variance of allelic effects. When the selection pressure is weak (S less than or equal to 0.5), the limit is given approximately by 2S sigma a[1 - (1 + c2)/k]/(theta + 1) for additive effects of alleles, where c is the coefficient of variation of the mutation rates among alleles. For strong selection, other approximations are devised to analyze the limit in different parameter regions. The effect of mutation on selection limits largely relies on the potential of mutation to introduce new and better alleles into the population. This effect is, however, bounded under the present model. Unequal mutation rates among alleles tend to reduce the selection limit, and can have a substantial effect only for small numbers of alleles and weak selection. The selection limit decreases as the mutation rate increases. PMID- 2759436 TI - [Effect of color mutation on the function of the adrenal cortex in chronic feed stress in American mink]. AB - Effect of color mutations, headlund and aleutian, on the adrenocortical function was studied in American mink under stress conditions. The adrenocortical function was analysed in the course of gland's incubation in vitro. Natural environmental factors (sharp fall of temperature) and artificially limited feed served as stress factors. It was shown that minks heterozygous for color mutant alleles studied were more resistant to the stressors. This is associated with genetically mediated peculiarities of the action of hypophysial adrenocortical system which is characterized by more adequate reactivity towards stimuli acting. Thus, the effect of heterosis in minks heterozygous for color alleles may well be caused by their increased resistance to stress. PMID- 2759437 TI - [Quantitative analysis of chromosomal localization of two human cloned satellite DNA III sequences by in situ hybridization]. AB - Chromosomal location of two cloned human satellite DNA III sequences pPD9 and pPD18 has been studied in 30 individuals by in situ hybridization. Pericentromeric localization of the DNA subsets studied was found in practically all chromosomes of the set. The majority of label was observed over the pericentromeric region of chromosome 9 (38.3% for pPD18 clone and 26.2% for pPD9), the short arm of chromosome 15 (17.2% - the pPD9 clone and 10.6% - the pPD18 clone) and the distal part of the long arm of Y chromosome (19.6% - the pPD9 clone and 15.4% - the pPD18 clone). Besides significant interchromosomal differences, moderately pronounced interindividual differences were also detected in the number of grains over the regular sites of the chromosomal location. Pretreatment of slides with DA/DAPI induced differences in the results of quantitative analysis is described. PMID- 2759438 TI - [Significance of genetic factors in the etiopathogenesis of allergic diseases]. AB - It was established using the methods of genetic-mathematical analysis that the multifactorial model of heredity with uninterrupted distribution of liability is more adequate to the genetic system defining hereditary predisposition to allergoses. PMID- 2759439 TI - [Frequency of chromosome aberrations induced by mutagens of various functions in cells of the first division at various times of fixation]. AB - The dynamics of chromosome aberrations in human lymphocyte culture cells of the 1 st division after exposure in the G0 phase for 1h to functionally different alkylating mutagens - ethyleneimine derivatives (bifunctional phosphamide, threefunctional thiophosphamide, tetrafunctional dipine and pentafunctional photrin) was analysed. The frequency of chromosome aberrations was constant after exposure to "dicentric" mutagens (dipine, photrin) at all times of fixation, while under the action of "monocentric" mutagens (phosphamide, thiophosphamide) this declined significantly with increasing the duration of cultivation. The portion of aberrations of the chromatid remains unaltered in time, in case of both "dicentric" and "monocentric" mutagens, reaching 75% for "monocentric" and 50% for "dicentric" of the total number of chromosome aberrations. PMID- 2759440 TI - [Mechanism of action of interferon is linked to its ability to protect the cell from interstrand cross-linking of DNA, induced by 8-methoxypsoralen, activated by long-wave UV-light]. AB - Treatment of human lymphocytes in the G1 phase of mitotic cycle with human lymphoblastoid interferon (Ly-IFN) decreased the frequencies of chromosome aberrations induced by 8-methoxy-psoralen-induced interstrand cross-links. Anticlastogenic effect of Ly-IFN was accompanied by stimulation of unscheduled synthesis of DNA in the G2 phase of mitotic cycle, as shown by increased percent of labeled cells registered by 3H-thymidine autoradiography. The data obtained seem to indicate that the mechanism of Ly-IFN protection is connected with stimulation of postreplicative repair. PMID- 2759441 TI - [Genetics of partial trisomies. Trisomy 4p]. AB - Phenotypic picture for two cytogenetically different variants of trisomy 4p (with and without involvement of the proximal part of 4q) obtained on the data of Minsk Teratologic Center and on the review of 64 cases from the world literature is presented. Mathematical evaluation of intrapair, within- and interfamilial similarity, depending on a duplicated segment, is given. It is shown that phenotypic similarity among patients in case of duplicated distal segments 4p15(16)----pter is significantly greater, while as the size of trisomic segment increases, the similarity goes down. Significant excess of within- over interfamilial similarity is shown, the fact that may be ascribed to a greater similarity of the genofonds in the group of relatives. PMID- 2759442 TI - [Interspecies variability in the organization of repeated sequences of the genus Hordeum]. AB - Seven barley species have been compared for organization of repeated sequences. Quantitative variation of repeated DNA fractions is demonstrated, though the total amount of sequences (reassociation up to Cot=10) in most cases does not vary. The repeats are divided into four groups by the mode of interspecific variability, with the help of dot and blot hybridization of the genomes under study with cloned highly repeated sequences of Hordeum vulgare. The first group contains the pHv7161 family of the most conservative sequences. The second group comprises moderately changing repeats. The third group includes highly variable Hind III repeats of Hordeum genomes, and the fourth group is represented by pHv7191 family of repeats that are highly amplified in H. vulgare genome. Comparative analysis of content and organization of highly repeated sequences in genome helps to clarify phylogenetic relationships in the genus and can be used for prediction of successfullness of interspecific hybridization. PMID- 2759443 TI - [Genetico-neurochemical analysis of the role of brain catecholamines in population hierarchy in male laboratory mice]. AB - Comparative genetic analysis of social dominance in micropopulations of male mice as well as noradrenaline and dopamine levels in brain was carried out. The RT male mice had maximal level of social dominance and the greatest content of brain catecholamines. It is suggested that the capacity for social dominance may depend on the function of the central catecholamine neurons. This suggestion has been confirmed by the data obtained both for interstrain and intrastrain relations between social dominance and catecholamine levels. PMID- 2759444 TI - [Genetic epidemiology of schizophrenia in the population of Tomsk Oblast. Dependence of parameters of the occurrence of schizophrenia among relatives on the method of proband sample formation]. AB - The program of genetic-epidemiological study of schizophrenia in five districts of the Tomsk region is presented. According to standardized methods, 610 diagnosed patients (epidemiological register) were examined, 74.1% of them being at random registered as probands (452 families of the epidemiological sample). 229 probands of non-epidemiological sample were registered in psychiatric hospitals. Schizophrenia occurrence parameters among first-degree relatives of probands of the non-epidemiological sample were regularly overestimated, as compared to the epidemiological sample. The methodical sources of contradictions in clinico-genealogical studies are discussed; the conclusion about representativeness+ of the probands' epidemiological sample is made. PMID- 2759445 TI - [Influence of the X-chromosome on finger dermatoglyphic features in the Ukrainian population of Podolye]. AB - Results of twins' and families' investigations of 19 quantitative features of fingertip dermatoglyphic patterns are presented. A conclusion has been drawn that the determinants of most of them have X-linked loci. The data were analysed in the light of the Lyon's hypothesis used in modern methods of interpretation of family correlations. The results revealed some incorrectness of the postulate of the highest connection in sister--sister pairs in the case of X-linked loci. It was ascertained that the distribution of family correlations, according to skin relief quantitative features, depends upon ethnic peculiarities of a sample: the higher the frequency of whorls in the population, the greater the probability of receiving the picture expected to occur in case of X-linked loci. PMID- 2759446 TI - [Characteristics of the cis- and trans-positions of chromatids of human acrocentric chromosomes in extreme old age]. AB - Cis- and trans-positions of chromatid associations of human acrocentric chromosomes were examined at extreme old age. Lymphocyte cultures were prepared by the usual method, from peripheral blood of 9 subjects aged 80-90 years (analysis of 179 metaphases) and 7 subjects aged 20-48 years (analysis of 124 metaphases). The functional difference between stalks of the sister chromatids was found. In the subjects at the age 80-90 years satellite stalks of chromatids 1 (in all DNA strands thymidine was substituted by 5-BrdU) of the D chromosome in cis-position are included into associations with lower frequency, as compared with the satellite stalks of chromatids-2 (thymidine+ is only substituted by 5 BrdU in a half DNA strands of the chromosome). This apparently reflects variability of regulation of functional activity of satellite stalks of sister chromatids. PMID- 2759447 TI - [Genetico-demographic patterns of the prevalence of various forms of endogenous psychoses]. AB - Prevalence rates (PRs) for EFP (schizophrenic, schizoaffective and affective psychoses), with allowance for proband sex and age-of-onset data were studied in a subdivided population from the North-East of the European Region of the USSR. The population includes three subpopulations: a small old religious semi-isolate of Russians ("Rs"), aboriginal Komi people ("Ks")--an ethnic community of Ugro Finnish lineage, and a mixed group of migrants ("Ms") from various regions of the USSR. The latter is mainly an urban population, while the "Rs" and "Ks" are, on the whole, rural populations. The total PR for EFP was found to be 0.97% for the "Rs", 0.63% for the "Ks" and 0.35% for the "Ms", whereas PRs-0.85-1.15% in other parts of the USSR, mainly for "panmixed" populations in large towns. The lower PRs for EFP in the "Ms" is caused by a backmigration flow involving certain groups of patients; consequently, the mean liability for "Ms" offsprings (as a whole) should also be lower. On the other hand, the lower PRs for EFP in the "Ks" is caused by underpresentation of clinically mild cases of the mental disease (mainly, pseudoneurotic schizophrenia), especially among female patients, probably due to that the so affected persons are sufficiently adapted to the cultural traditions of this rural population. It was shown that in the "Rs" the total PR for "nuclear" and paranoid schizophrenia is 0.68% versus 0.25% in a "panmixed" population. The increase is most likely caused by the high inbreeding level in the "Rs" semi-isolate, and if this is correct, we may suppose that at least one or two recessive genes are involved in the liability to the most heavy forms of schizophrenia. On the other hand, in the "Ms" (as in other "panmixed" populations) positive assortative mating among hereditary-predisposed persons is a more significant factor influencing family transmission of EFP, since the correlation between probands and their spouses is rpp = 0.31 (p less than 0.001) in the "Ms", as compared to rpp = 0.19 (p less than 0.1) in the "Rs". Thus, our general conclusion is that neither the place of inhabitance nor the life mode are the causal factors for EFP, but rather some genetic factors, more accurately, certain sets of specific genes. PMID- 2759448 TI - [Correlation of genetic and demographic differences between populations of indigenous inhabitants of the Northeastern USSR]. AB - Correlative analysis is given for some demographic characteristics in populations of asiatic eskimos, coastal and reindeer chuckchies, Kamchatka koryaks and Chukotka evens. Summarized estimation of population differences for 7 demographic parameters is presented. Highly reliable correlation of genetic distinctions as defined for 17 polymorphic loci, and demographic differences between populations estimated for 7 parameters (r = 0.868, P less than 0.001) was found. The role of ecological factors in formation of genetic structure features and application of demographic characteristics, as possible indicator of ecological particularities of the given populations, is considered. PMID- 2759449 TI - Through a glass darkly: work by the new old. PMID- 2759450 TI - Is there a gray peril? Retirement politics in Florida. AB - Using data from Florida, the most significant destination for Sunbelt retirees, three hypotheses concerning the political impact of retirement migration on the Sunbelt were tested. Surveys of local government officials and socioeconomic data about local government regarding 103 municipalities and 62 counties suggested that aging persons, although politically active, are seldom involved in organized advocacy or political opposition to local policies that are largely beneficial to other interests. PMID- 2759451 TI - Quality of care and the burden of two cultures: when the world of the nurse's aide enters the world of the nursing home. AB - Using ethnographic data, the two worlds of the nurse's aides were examined, the world in which they live and the world in which they work. Because the institutional culture of the nursing home often adds to the adversity of their personal life, the nurse's aides move between the two milieus in a self perpetuating negative cycle. Aides carry to the bedside of elderly residents the affective and psychological burden these two worlds place on them. PMID- 2759452 TI - Physicians' mandatory reporting of elder abuse. AB - We evaluated physicians' responses to state elder abuse reporting statutes. Most statutes require reporting without providing for adequate investigation and service delivery. The Alabama Protective Services Act of 1976 is typical. Survey responses by Alabama physicians suggest that they have reservations about their ability to diagnose abuse, the operation of the law, and their willingness to report abuse. It appears that, in Alabama, mandatory reporting by itself is counterproductive because the statute fails to provide for adequate investigation and service delivery or to command knowledgeable compliance. PMID- 2759453 TI - Caregiving Hassles Scale: assessing the daily hassles of caring for a family member with dementia. AB - Examined was a scale designed to assess the daily hassles of caring for a family member with Alzheimer's Disease (AD). Primary caregivers to AD patients (N = 60) completed the Caregiving Hassles Scale on two occasions and reported on their well-being. The 42-item scale provides a reliable and psychometrically sound instrument for assessing hassles associated with assistance in basic ADL, assistance in instrumental ADL, care-recipients' cognitive status, care recipients' behavior, and caregivers' social network. PMID- 2759454 TI - Reliable assessment of cognitive impairment in dementia patients by family caregivers. AB - Caregivers (n = 53) of patients with mild to moderate dementia administered a modified version of a cognitive examination at home to their patients. Comparisons between caregiver-administered examinations and the associated clinical examinations revealed a high degree of interrater reliability that was not affected by age or level of education of the caregiver. Reliable assessment of cognitive functioning by caregivers can provide clinicians with an alternative method for monitoring cognitive function of dementia patients. PMID- 2759455 TI - Comprehensive geriatric care in a day hospital: a demonstration of the British model in the United States. AB - A geriatric day hospital (GDH) was developed in a community hospital to meet the complex medical and social needs of the frail elderly. A review of medical records (n = 273) and interviews with referring physicians (n = 42 on 96 patients) revealed that the GDH provided intensive outpatient care, geriatric assessment, rehabilitation, and an alternative to hospitalization. In all, 21% of physician-referred patients would have been hospitalized without the GDH, 7% would have had longer hospital stays, and care would have been deferred for 18%. PMID- 2759456 TI - The effect of training on medical students' responses to geriatric patient concerns: results of a linguistic analysis. AB - The results of a randomized, controlled study indicated that an experience-based educational intervention in which medical students interview volunteer nursing home residents significantly changed medical students' responses to two geriatric patient vignettes. Despite prevailing ageist biases, the intervention enhanced students' abilities to identify and respond therapeutically to hypothetical elderly patients' underlying expressions of concern and, furthermore, prepared students for patient-centered geriatric interviewing. The use of elderly volunteers to assist in practice interview sessions helps sensitize future physicians to the problems of aging and teaches them empathic communication skills. PMID- 2759457 TI - Quality of instructions on prescription drug labels: effects on memory and comprehension in young and old adults. AB - We examined both comprehension of and memory for information on prescription labels as a function of age, memory load, and study time across three experiments with young and old adults. We found that older adults consistently manifested poorer recall of prescription information than young adults; age effects occurred even when participants received unlimited study time; and both young and old adults had substantial difficulty comprehending drug information as it is presented from a pharmacy. PMID- 2759458 TI - Immigration, aging, and intergenerational relationships. AB - This study examined the intergenerational relationships and roles of older Salvadorans who have come to the United States in their later years. Although there were many similarities between these parents' roles in El Salvador and in the United States, fewer were employed and more had taken on childcare responsibilities. Although their children had a strong sense of filial obligation, the parents asked for little concrete assistance from the children. PMID- 2759459 TI - Caregiving and employment: results of an employee survey. AB - An employee survey (N = 3,658) revealed that 23% of 1,898 respondents were assisting an elderly person. Multivariate analyses indicated that these care providers, when compared to other employees, were more likely to experience interference between their jobs and family responsibilities and more likely to miss work. Respondents also identified a number of employer-sponsored programs and benefits that could make it easier for them to combine work and caregiving roles. PMID- 2759460 TI - Hurricane Elena and Pinellas County, Florida: some lessons learned from the largest evacuation of nursing home patients in history. AB - Prior planning for and problems associated with the evacuation of 1,860 nursing home patients in Pinellas County, Florida, due to Hurricane Elena in 1985 were studied through questionnaires administered to nursing home administrators and public documents. The most serious problems were transporting patients to shelters in a timely fashion, delayed passage of recalled staff through police checkpoints, and staff burnout. PMID- 2759461 TI - Emergency housing for frail older adults. AB - The emergency housing program described provides immediately available beds in private homes for homeless, impaired elderly adults. Clients receive 24-hour care for two to four weeks while permanent housing arrangements are made. Compared to traditional programs for the homeless, the emergency program saved money and provided more positive social support. A year later clients were significantly less likely to be institutionalized than were comparable nonparticipants. PMID- 2759462 TI - Breast self-examination and the older woman: field testing an educational approach. AB - The effectiveness of a theoretically based educational strategy was compared with a standard breast self-examination educational strategy. It was found that women in the experimental treatment group (n = 68) were significantly (p = .029) more likely to perform breast self-examination appropriately 3 months following instruction than women in the standard treatment comparison group (n = 66) after controlling for pretest scores and age. PMID- 2759463 TI - Perceptions of caregivers about special respite services for the elderly. AB - Questionnaires were circulated to 48 family members who had arranged for respite care for ill elderly relatives. Caregiver families used their respite for vacations, personal business, freedom from caregiving, and surgery. Eighteen (78%) wished to participate in respite again because they thought it the best available arrangement to maintain their mental health during caregiving. PMID- 2759464 TI - Wright State student reactions. PMID- 2759465 TI - Gold in gray or gray in gold? A public-private puzzle. PMID- 2759466 TI - Sexuality in Chaucer. PMID- 2759467 TI - [Problems of the reorganization of scientific research in public health]. PMID- 2759468 TI - [Characteristics of morbidity among sailors]. AB - A set of factors of ship's environment greatly affected the onset of diseases in sailors. By means of individual selective case sample it was found out that temporary disability rates in sailors were lower compared to the analogous maritime workers. There were derived prognostic regression equations of the number of work-loss days according to sailors' occupation, age and labour intensity. Economic effect of the realized measures and reduction of temporary disability rates annually constituted 34 rb per person. PMID- 2759469 TI - [Working conditions of female workers in the system of "Soiuzgostsirk" (the Soviet State Circus)]. AB - Labour activity of those engaged in the system of Soyuzgostsirk was analyzed. It was established that unsatisfactory sanitary and hygienic situation for members of the orchestra, workers taking care of animals and others, physical and neuroemotional load of gymnasts, acrobats and their assistants, induced uncomfortable work posture of conjurers and gymnasts were in some cases regarded as the main unfavourable occupational factors. The health state of the above professional groups was assessed. Preventive measures aimed at sanitation of labour conditions and decrease of disease rates were developed. PMID- 2759470 TI - [Carcinogenic and nonspecific harmful factors in the rubber industry]. AB - The hygienic analysis of working conditions at a rubber production plant revealed that measures aimed at the decrease of dust load of the preparatory process were not sufficient. High dust load was accompanied by unfavourable microclimatic conditions. The content of carcinogens, such as benz(a)--pyrene, acrylonitrile, and vinyl chloride on the average did not exceed MACs. Their highest concentrations exceeding MACs were detected in vulcanization and compaction bays. Preventive measures should be directed at reducing workers' exposure to carcinogens and nonspecific occupational damaging factors by means of automatization and hermetic sealing of the equipment along with the introduction of robotized systems. PMID- 2759471 TI - [Introduction of hygienic recommendations in the construction of health centers at the Iu.V. Andropov Novolipetsk metallurgical combine]. PMID- 2759472 TI - [Problem of the use of epoxide coating at a clothing factory]. PMID- 2759473 TI - [Current methods of determining the level of solvents in the air of the work area during production of ascorbic acid]. PMID- 2759474 TI - [Photometric determination of calcium-carboxymethylcellulose in the air of the work area]. PMID- 2759475 TI - [Occupational diseases in foreign countries in the 1980's]. PMID- 2759476 TI - [Effectiveness of hepatoprotective agents in experimental allyl alcohol poisoning]. PMID- 2759477 TI - [Experimental complex for studying the biological effect of exposure to ultrahigh frequency irradiation at a ship's radar station]. PMID- 2759478 TI - [Planning of working conditions and tasks in creating optimal standards of technology in coal mines]. AB - During the next 20 years normalization of occupational factors at Donbas mines should be ensured by technical reconstruction of mines on the basis of the development of new technological circuits, automatization and mechanization means, the means of collective protection, physiologic labour rationalization. PMID- 2759479 TI - [Determining physical and psychological occupational stress in women performing physical work on the basis of subjective evaluation]. PMID- 2759480 TI - Prolonged manometric recording of anorectal motor activity in ambulant human subjects: evidence of periodic activity. AB - Based on short recordings, the rectum has been shown to have contractions with a frequency of five to 10 cycles per minute and slow contractions at three cycles per minute. To define anorectal motility over a prolonged period of time, we have studied 12 healthy volunteers using a fine pressure sensitive anorectal probe. A total of 240 hours of recording was obtained. We observed three types of activity in the rectum: (i) runs of powerful phasic contractions with a frequency of two to three per minute, lasting for three to 10 minutes, and recurring to an interval of 92 (1.9) minutes (mean (SEM)) during the day and 56 (1.7) minutes (mean (SEM)) at night, (ii) isolated prolonged contractions lasting for 10-20 seconds and seen mainly during waking, and (iii) clusters of contractions occurring at a frequency of five to six per minute lasting for one to two minutes and seen predominantly during the postprandial period. These clusters of contractions resembled the discrete clustered contractions seen in the ileum, whereas the more powerful and prolonged runs of contractions resembled phase III activity in the small intestine. In contrast, the anal canal showed bursts of contractions which were not temporally related. Our data show that the rectum, like the upper gastrointestinal tract, exhibits periodic motor activity; it remains to be seen whether these two biorhythms are synchronous. PMID- 2759481 TI - Acid resistant lipase as replacement therapy in chronic pancreatic exocrine insufficiency: a study in dogs. AB - Conventional treatment of pancreatic steatorrhoea in man has been unsatisfactory because 90% of the lipase content of therapy is inactivated by acid in the stomach and large doses of replacement treatment are needed to provide adequate supplementation. An acid stable agent (fungal lipase) was investigated in the treatment of pancreatic deficiency steatorrhoea in 11 pancreatectomised dogs maintained on a fixed dietary intake of fat and treated with pancreatin or fungal lipase. Ten grams (60,000 U lipase) of pancreatin was compared with 400mg (4800 U lipase) of fungal lipase administered with each meal against a no treatment group. There was no significant difference in stool bulk and faecal fat excretion between pancreatin and lipase treated animals. Both groups showed a significant reduction in stool bulk and fat excretion when compared with the no treatment group (p less than 0.01). A markedly diminished treatment volume, in the form of fungal lipase, is as effective in controlling steatorrhoea as pancreatin and may prove to be a potentially valuable therapy for patients with pancreatic insufficiency. PMID- 2759482 TI - Acute thrombocytopenia after De-Nol. AB - We describe a case of severe acute thrombocytopenia in a 72 year old man treated with De-Nol for erosive biliary gastritis. PMID- 2759483 TI - Active chronic hepatitis and febrile panniculitis. AB - Two patients with autoimmune hepatitis B negative chronic hepatitis and febrile panniculitis are described. On each occasion the panniculitis responded to increasing the doses of prednisolone. PMID- 2759484 TI - Clinical response to the long acting somatostatin analogue SMS 201-995 in a child with congenital microvillus atrophy. AB - A 27 month old girl with congenital microvillus atrophy received two courses of SMS 201-995, a synthetic long acting analogue of native somatostatin, in an attempt to decrease profuse secretory diarrhoea. During the first trial at 13 months of age fluid and electrolytes administered by parenteral infusion were decreased as measured by water and faecal electrolyte losses. During the second trial of SMS 201-995 at 19 months fluid and electrolyte input were held constant for 14 days. Stool volume declined from 275 ml/kg to 161 ml/kg. Reductions in output of stool electrolytes (Na+, K+, Cl-) were accompanied by an increase in urine fluid output and increased excretion of urinary Na+. Subsequent administration of SMS 201-995 for a nine month period was not associated with adverse side effects or an impairment of growth velocity. These findings suggest that SMS 201-995 may be useful therapy in infants with high output diarrhoea as a result of congenital microvillus atrophy. PMID- 2759485 TI - Infusion of methyl tertiary butyl ether in bile ducts of rabbits. PMID- 2759486 TI - Maalox versus cimetidine. PMID- 2759487 TI - Value of DNA image cytometry in the prediction of malignant change in Barrett's oesophagus. AB - DNA image cytometry was performed on Feulgen stained sections from 91 biopsies obtained during prospective endoscopic surveillance of 55 patients with Barrett's oesophagus. Aneuploid cells were detected in specimens from six of these patients. Four subsequently developed dysplasia and adenocarcinoma but, in the other two, biopsies had been reported as showing specialised epithelium only, with no apparent dysplasia and no evidence of malignancy on clinical follow up to date. In two of the four patients who subsequently developed carcinoma, aneuploid cells were only found in biopsies showing overt dysplasia or carcinoma but in the two other patients aneuploid cells were present in biopsies taken early in the clinical course before any dysplasia had been identified on the original reports. The presence of aneuploid cells on cytometry of these 'benign' biopsies allowed us, on histological review, to identify areas of atypia which were interpreted as mild dysplasia. In this series aneuploidy was always associated with some morphological abnormality varying from mild dysplasia to frank carcinoma. Aneuploid cells were not shown in material from one patient who had an oesophagectomy for dysplasia or in biopsy material from four patients showing 'indefinite dysplasia'. DNA cytometry combines an objective assessment of epithelial atypia with the advantage of detecting rare cellular aneuploidy and the ability to correlate these events with morphology. It should assist in the more accurate diagnosis of dysplasia and prove useful in identifying those patients with Barrett's oesophagus who are at greater risk of subsequently developing malignancy. PMID- 2759488 TI - Serum pepsinogen I and IgG antibody to Campylobacter pylori in non-specific abdominal pain in childhood. AB - A consecutive series of 51 children (mean age 11 years) who presented with recurrent abdominal pain were investigated by upper gastrointestinal endoscopy including three antral biopsies for microscopy, culture and urease testing. Serum IgG, IgA, and IgM antibodies to Campylobacter pylori (C pylori) were measured by the ELISA technique. Serum pepsinogen I was also measured. Thirty two children showed histological evidence of gastritis. All had C pylori on microscopy and or culture. Nineteen children showed no histological gastritis nor evidence of C pylori on microscopy, culture and/or urease testing. The IgG and IgA antibody levels to C pylori were significantly higher in C pylori positive children than in the negative group (p less than 0.001). Serum pepsinogen I concentrations were also significantly higher in C pylori positive children than in negative (p less than 0.001). Measurement of IgG antibody levels, combined with serum pepsinogen I estimation, predict the presence of C pylori associated gastritis in children with a sensitivity and specificity of up to 95%. It may be used therefore to predict gastritis and even peptic ulceration in children presenting with non specific upper abdominal pain. PMID- 2759489 TI - Chronic gastritis and gastroduodenal ulcer: a case control study on risk of coexisting duodenal or gastric ulcer in patients with gastritis. AB - Chronic (atrophic) gastritis (AG) is common in active duodenal (DU) and gastric ulcer (GU) disease. In this case control study in consecutive prospective outpatients (571 cases and 1074 controls) who had undergone diagnostic upper gastrointestinal endoscopy and routine biopsies from both antral and body mucosa, we calculated the risk of coexisting active DU and/or GU in different gastritis of the antrum or body and according to grade (superficial gastritis, mild, moderate or severe atrophic gastritis). The risk of coexisting active gastroduodenal ulcer (ulcer in duodenum and/or stomach), as well as the risk of DU or GU, was dependent upon the presence and grade of gastritis in antrum and body mucosa. The risk of coexisting ulcer, as expressed as an age adjusted relative risk (RR) and calculated as odds ratio of gastritis in cases and controls, was significantly increased in the presence of superficial antral and body gastritis (RR = 8.5 (7.0-20.0) in men; RR = 5.8 (3.3-10.2) in women), as compared with the risk of ulcer in subjects with histologically normal mucosa (RR = 1). The risk of ulcer, and the risk of GU in particular, increased further with increasing severity of antral gastritis. In such patients with moderate or severe atrophic antral gastritis the RR of coexisting ulcer even exceeded 20 in men and 10 in women (RR = 25.6 (9.0-72.7) in men; RR = 11.7 (5.9-23.0) in women). On the other hand, the RR of ulcer, and the RR of DU in particular, was below 1 in the presence of atrophic gastritis in the gastric body, irrespective of the grade of gastritis in the antrum. We conclude that the type and grade of gastritis strongly predicts the risk of coexisting peptic ulcer, and that the risk of coexisting DU or GU increases with an increase in grade of AG of the antrum but decreases with an increase in grade of AG of the gastric body. PMID- 2759490 TI - Evaluation of the intrinsic innervation of the internal anal sphincter using electrical stimulation. AB - Stimulation of the rectal mucosa with a bipolar electrode leads to relaxation of the internal anal sphincter. Intraoperative studies in two subjects showed that transmission of the impulse was independent of extrinsic nerves and was interrupted by circular myotomy. Characteristics of the reflex were studied in 11 healthy women and 19 women with severe idiopathic constipation. One control subject and two patients did not tolerate the test. In the remainder the stimulus caused a clearly defined fall in internal sphincter pressure. The mean resting maximum anal canal pressure before stimulation was the same in both groups (90 (10) v 104 (7) cm H2O, p = 0.3, controls v patients). The threshold stimulus for relaxation (12 (2) v 14 (1) mamps, p = 0.5), the maximum percent fall in resting pressure (43 (7) v 46 (4)%, p = 0.7) and the lowest absolute resting pressure produced by stimulation (48 (13) v 49 (6) cm H2O, p = 0.9) were the same in both groups. The stimulus required to achieve maximum relaxation was significantly higher in the patient group (23 (3) v 32 (2) mamps, p = 0.012) suggesting abnormal intrinsic innervation of the sphincter in these patients. Electrical stimulation should not replace balloon distension for routine testing of the rectoanal reflex but it may be useful in quantitative studies. PMID- 2759491 TI - Differentiation of rat intestinal epithelial cells is induced by organotypic mesenchymal cells in vitro. AB - Stromal-epithelial interaction is a potent driving force in the developing intestinal mucosa which ensures tissue specific cellular differentiation. The mechanisms involved are relevant to tissue renewal in adult organs yet they have not been elucidated because of the lack of appropriate in vitro models. In this study, we have investigated the interaction between intestinal mesenchymal and epithelial cells at the cellular level in vitro. Fetal rat intestinal epithelial cell colonies explanted in vitro on the 15th day of gestation, which failed to mature in plain monocultures, were reassociated in coculture with three different types of mesenchyme:fetal skin, gastric and intestinal mesenchyme. Only fetal epithelial cells cocultured with intestinal (homologous) mesenchyme acquired definite signs of differentiation within three to six days. These primitive epithelial cells were shown by electronmicroscopy to become highly polarized, connected by tight junctions and covered with a regular brush border. Three brush border enzymes were strongly expressed in homologous cocultures and their activity was sensitive to dexamethasone. In contrast, fetal epithelial cells cocultured with skin or stomach derived mesenchyme under identical conditions failed to differentiate in vitro: they remained flat, unpolarised and expressed only low enzyme activity. The unique potential of the small intestinal mesenchyme to promote intestinal epithelial differentiation is discussed. PMID- 2759492 TI - Geographic differences in digoxin inactivation, a metabolic activity of the human anaerobic gut flora. AB - The inactivation of digoxin by conversion to reduced metabolites (digoxin reduction products, or DRP), a function of the anaerobic gut flora, was studied in normal volunteers from southern India and the United States. Digoxin was metabolised to DRP by 28 (13.7%) of 204 healthy south Indians in contrast to 67 (36.0%) of 186 New Yorkers (p less than 1 X 10(-6)). Only 1.0% of Indians compared with 14.0% of Americans excreted large amounts of metabolites (greater than 40% DRP) in the urine (p less than 1 X 10(-5)). Of 104 urban Indians, 23 (22.1%) were metabolisers, in contrast with five of 100 rural villagers (p less than 0.001). Within the urban group, digoxin metabolism correlated with education, frequency of animal protein intake, and most significantly, personal income. Organisms capable of reducing digoxin in vitro were found with similar frequencies in stool cultures from Indians and Americans. In the cultures of some subjects, DRP production was inhibited at lower dilutions but expressed at higher dilutions. We conclude that variations in drug metabolism between population groups may result from differences in the metabolic activity of the anaerobic gut flora probably mediated by environmentally determined factors. PMID- 2759494 TI - Gynaecological consultation in patients with the irritable bowel syndrome. AB - A 12 month follow up study to assess the impact of symptoms suggestive of irritable bowel syndrome in women presenting to gynaecology clinics with pelvic pain is reported. Of 71 women 37 (52%) had symptoms suggestive of irritable bowel syndrome at presentation. A firm gynaecological diagnosis was reached in only three (8%) women positive for irritable bowel syndrome compared with 15 (44%) without (p = 0.002). After 12 months 24 (65%) women with irritable bowel syndrome were still symptomatic compared with 11 (32%) without (p = 0.01). This study shows that women with irritable bowel syndrome frequently attend gynaecological clinics but rarely have gynaecological pathology and the prognosis is poor in terms of resolution of their pain. PMID- 2759493 TI - Crohn's disease: risk of recurrence and reoperation in a defined population. AB - Two hundred and ten patients with Crohn's disease (CD) were identified in an epidemiological survey of inflammatory bowel disease in the Leiden Health Care Region of the Netherlands. The survey included all patients with CD seen between 1979-1983. The duration of disease ranged from less than one year to 48 years. Of the 210 patients with CD, 118 (56%) underwent surgical resection. Sixty one had an ileocaecal resection, 14 a proctocolectomy, in seven cases as a two stage procedure; 12 a segmental colectomy with end-to-end anastomosis and eight a subtotal colectomy with ileostomy. Twenty-one of these 118 patients (18%) had recurrences requiring reoperation; in 11 because of recurrence at the anastomotic site. Life table analysis showed that after 10 years 17% of patients required further resection for recurrence and 8% for relapse. By 20 years the rate of recurrence had risen to 56%. Patients over the age of 30 at first resection were at 1.5 fold greater risk of requiring further surgery than younger patients. The initial site of disease played no role in recurrence and there was no evidence that preoperative disease duration, delay in diagnosis, or late surgery had any effect on recurrence rates. This is one of the few community based studies to measure recurrence and relapse. A balanced appraisal is that surgery is not permanently curative, but the need for further resection may be lower than previously suggested. PMID- 2759495 TI - Factors determining outcome in children with chronic constipation and faecal soiling. AB - To evaluate factors which might contribute to treatment failure in children with chronic constipation and soiling, we evaluated the history, physical findings, defecation dynamics, and anorectal function in 97 patients. We treated them with milk of magnesia, high fibre diet, and bowel training techniques and evaluated outcome at one year when 43% had recovered. Recovery rates were similar for boys and girls. Fifty seven per cent of the patients had not recovered. This group at the outset had more frequent soiling episodes, more severe constipation, were less likely to defecate water filled rectal balloons and to relax the external sphincter during defecation. In general girls had more severe constipation, abdominal pain, and a previous urinary tract infection than boys. Girls were more compliant during treatment and had less frequent soiling episodes at one year. Stepwise logistic regression showed that severe constipation, abnormal contraction of the external sphincter and pelvic floor during attempted defecation, and inability to defecate the 100 ml balloon in less than or equal to 1 min was significantly related to treatment failure. Defecation of smaller balloons, volumes for threshold of rectal sensation, critical volume and rectal contraction, and compliance with treatment could not predict treatment failure. PMID- 2759496 TI - The yolk nucleus in the freshwater teleost Garra gotyla gotyla (Gray). AB - The structure and functional significance of the yolk nucleus in Garra are described. The study shows that the yolk nucleus appears in the cytoplasm of the early perinucleolus stage of the oocyte. It is present as a deeply stained structure enclosed in a vesicle. It disappears in the yolk vesicle stage and vitellogenesis begins soon afterwards. This probably indicates that it plays a role in the initiation of vitellogenesis. When yolk formation starts, the yolk nucleus disappears; this also suggests that it is of functional significance in yolk synthesis. PMID- 2759497 TI - Determination of local variation of the thickness of the capillary basement membrane of the human placenta at term by a morphometric method. AB - Material was taken from exactly determined sites on five placentas to determine local variation of the thickness of the capillary basement membrane in the normal human placenta at term. The thickness of the capillary basement membrane was determined in electron micrographs by a morphometric method and the resultant values were processed statistically. The results and the method are both discussed. PMID- 2759498 TI - Mechanism of the reduction of Meckel's cartilage in man. AB - The mechanism of reduction of the anterior end of Meckel's cartilage was studied in human embryos, with the following findings: 1. Meckel's cartilage is surrounded, from the outside and from below, by newly formed mandibular bone over the extent of the insertion of the musculus mylohyoideus. 2. Blood vessels from the newly formed bone penetrate Meckel's cartilage and break it down in the same way as in enchondral ossification of cartilaginous models of other bones. 3. The anlagen of the musculus mylohyoideus and musculus genioglossus are at first inserted on Meckel's cartilage; further muscle fibres, formed on the under surface of the two muscles, are inserted on the newly formed bone of the rudimentary mandible. Parallel to this process, the fibres on the upper surface of the muscles, which were originally inserted on Meckel's cartilage, disappear. The two processes combined lead to transposition of the insertions of the two muscles from Meckel's cartilage to the mandible. 4. In the area of the resorbed Meckel's cartilage, a minimum number of bone trabeculae are formed at the time of its resorption. The space left by Meckel's cartilage is taken over chiefly by the primitive medullary cavity of the rudimentary mandible, medially to the canal for the nerve and blood vessels. PMID- 2759499 TI - Localization of 2-glucuronidase in the marginal sinus of rat spleen. AB - The study demonstrated lysosomal 2-glucuronidase activity localized in the marginal sinus epithelium of rat spleen. Immunologically, the marginal sinus is a key structure of the spleen and its enzymatic apparatus differs from that of the cells of the red pulp venous sinuses. The possible physiological significance of this finding is briefly discussed. PMID- 2759500 TI - The use of cytoenzymological changes in certain parasitic protozoans for screening the carcinogenicity of chemicals. AB - Cytoenzymological changes were observed in parasitic ciliates (Nyctotheroides puytoraci) and flagellates (Opalina sudafricana and Protoopalina sp.) after injection of their host, Bufo regularis, with a single dose of 0.5 mg beta naphthylamine (BNA) per toad. The experiment was carried out during the host's pre-breeding season. Trophozoites of the given parasites were examined 21 days after the injection. The localization of the mitochondria and the relative intensity of succinic dehydrogenase (SDH) and deoxyribonucleic acid (DNA) activity in the control and BNA-treated trophozoites were compared. The results could prove useful for screening the carcinogenicity of chemicals by means of these parasitic protozoans. PMID- 2759501 TI - Semi-automatic morphometric analysis of secretory granules in the cells of the rat adenohypophysis. AB - The authors carried out a morphometric analysis--using a semi-automatic system for image analysis--of the secretory granules in the cells of the Wistar rat adenohypophysis. They evaluated the mean diameter (CIRCLE D), maximum diameter (MAX D), the factor of circular form (PE FORM) and the harmonic factor of form (HAR FORM). They also computed the coefficient of correlation between CIRCLE D and PE FORM and the percentual distribution of the values according to mean diameter. PMID- 2759502 TI - Sonatox-induced impairment of ovarian activity in an exotic cichlid, Oreochromis mossambicus. AB - In a low dose and short chronic exposure, Sonatox (2,2,5-endo, 6-exo-8,9,10 heptachloroborane), a chlorinated insecticide, impaired ovarian activity in the fish Oreochromis mossambicus. The histological profile showed abnormalities of the different kinds of oocytes and their nuclei. Compared with the controls, a sharp drop in the proportion and diameter of the various oocytes was observed. Fish exposed to Sonatox had more atretic oocytes than were found in the controls. Percentual gonad weight in relation to body weight was also significantly reduced in treated fish (p less than 0.001). These changes are indicative of regression of the gonads after exposure to the insecticide. PMID- 2759503 TI - Age and growth studies of the Sphyraenidae family in the southeastern Mediterranean based on otolith measurements. PMID- 2759504 TI - Studies of the seminal receptacle of the crab Portunus sanguinolentus (Portunidae: Brachyura). AB - The seminal receptacle or spermatheca of Portunus sanguinolentus consists of two parts--an anterior glandular and a posterior chitinous part. The chitinous part continues as the oviduct, which opens on the sternite of the sixth thoracic segment. Significant morphological and histological differences were observed between the spermatheca, as well as the oviduct, of mated and unmated crabs. In mated crabs the spermatheca is much more bulging, owing to receipt of a copious supply of seminal products, and its cells are hyperactive. Further stages of ovarian development were observed as indicators of sequential changes in the spermatheca. The secretory cells gradually disintegrate by way of holocrine secretion; this results in cellular stratification and the formation of distinct furrows in the chitinous posterior part. PMID- 2759505 TI - Projections from the claustrum to the occipital cortex in the guinea pig. AB - The existence of ipsilateral claustrocortical projection to the occipital area Oc 2.2 (Wree et al. 1981) was demonstrated in four guinea pigs. The neurons labelled by retrogradely transported HRP were localized in the caudal half of the claustrum dorsale (in its dorsomedial and central part); small and medium-sized oval and multipolar neurons preponderated. PMID- 2759507 TI - Relationship between the saccus endolymphaticus and the fourth ventricle of the brain of the domestic fowl (Gallus gallus f. domestica). AB - The fine structure of the wall of the SE was determined exactly and its relationship to the cisternae (the evaginations of the roof of the fourth ventricle extending to the SE) was defined. The way in which the cisterna is formed was defined and the development of its fine structure was described by comparing serial sections from 19-day embryos and adult fowls. Like the SE, the cisternae are lodged in the angle between the cerebellum and the medulla oblongata, in the subarachnoid space. The terminal segment of the cisterna lies in the immediate vicinity of the mesenchymal epithelium bordering the basal labyrinth of the SE cells. Collagen trabeculae keep the SE and the cisternae suspended in the subarachnoid space. The cisternae and trabeculae are wrapped in mesenchymal epithelium. The cisterna is avascular and does not communicate with the SE. The cisterna is lined internally with simple squamous epithelium (modified neural epithelium of the roof of the fourth ventricle). The bodies of the cells bulge into the lumen of the cisterna in the region of localization of their nucleus. The epithelium is seated on a pronounced basal lamina. The surface turned towards the subarachnoid space is lined continuously with mesenchymal epithelium without a basal lamina. The cells of the cisternal epithelium are connected by tight junctions of the type of zonulae occludentes and desmosomes. The basal lamina is continuous and distinct. The mesenchymal epithelium of the subarachnoid space has no basal lamina, as on the subarachnoid surface of the SE, the cisternae, the trabeculae, the pia mater and the arachnoidea.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2759506 TI - Spinal ascending projections to the nucleus tractus spinalis nervi trigemini of the dog. AB - Seven dogs were subjected 30 min to ligation of the thoracic aorta and were then kept alive 6-7 days after the ligature had been removed. Their spinal cord and brain stem were treated by the Nauta-Gygax method and the extent and appearance of preterminal and terminal degeneration of certain ascending spinal systems were analysed. In the medulla oblongata region, marked degenerating fibres from the lower thoracic and lumbosacral cord segments were found in the nucleus tractus spinalis nervi trigemini. Preterminal and terminal degenerating fibres were visualized in the caudal part of the trigeminal nuclear complex. Comparison with the literature showed these to be previously unknown projections with a relationship to the nucleus tractus spinalis nervi trigemini. PMID- 2759508 TI - An X-ray, microanalytical and ultrastructural study of cadmium absorption and transport in rat liver. AB - Accumulation of cadmium in the liver was demonstrated by X-ray microanalysis in every type of experiment, i.e. after injecting Cd into the ligated intestine and after the peroral acute single and combined, subchronic and chronic administration of Cd. Half an hour after its injection, Cd was localized diffusely in the liver; one hour after injection its increased accumulation in the cells caused generalized changes in the endoplasmic reticulum, mitochondria and nuclei. In acute and chronic peroral tests, the hepatocytes of the intermedial and peripheral zone of the lobes were the main storage region. After an acute dose of Cd, the cells in the centrolobular zone were hydropic, or single cell necrosis developed; after the longer effect of combined doses the latter was manifested as centrolobular focal necrosis. Cd was not demonstrated in the lesions. Chronic administration did not lead to manifest severe degenerative changes in the liver. Accretions in the mitochondria and on the membranes of the endoplasmic reticulum were identified by means of X-ray analysis with cadmium peaks. Cadmium showed up clearly as L alpha- and L beta-lines at 3.135-3.320 keV. We presume that cadmium is bound in the ribosomes of the endoplasmic reticulum, as well as the mitochondria, and is released by the invagination of swelling mitochondria of the peripheral hepatocytes into Disse's spaces. PMID- 2759509 TI - Note on differentiation of the epithelium of the small intestine in human embryos. AB - We studied the development of the human embryonic intestine from the 6th to the 8th week of gestation (embryos with a crown-rump length of 16-25 mm). Semithin sections show that a smooth, simple intestinal lumen, which is often a mere slit, is elsewhere, in the same specimen, distinctly formed and in places is partly occluded by accumulations of cells of a somewhat different character from those of the actual intestinal lining. Whereas the epithelium proper is mainly high and pseudostratified, the cells which secondarily occlude the originally open intestinal lumen are smaller and are more cuboidal to polyhedric in shape. In the electron microscope, the cells of the primitive epithelium appear narrow and columnar, with an ovoid nucleus and a few nucleoli. The cytoplasm contains numerous mitochondria and a gradually developing granular endoplasmic reticulum and Golgi complex. These cells have small, irregular microvilli on their surface, but some have an almost straight surface without any microvilli. They display striking pinocytotic activity and contain a quantity of multivesicular bodies. Their cytoplasm further contains isolated osmiophilic granules and lysosomes and a small amount of glycogen. The accumulation of glycogen is typical of the more mature developmental stages. Cilia are a characteristic finding in embryos with a c-r length of 16-25 mm. There is only one cilium to a cell, but not all the cells have cilia. The cilia are relatively thick and not very long and they almost always grow in the centre of the cell surface. The apical surface of such cells is usually slightly or more deeply concave. Structurally, the ciliated cells closely resemble phylogenetically primitive entodermal collar cells (choanocytes). They are apparently a phylogenetically old type of cells, whose existence could have functional value, which appears for a time during ontogenetic development. The cilia may temporarily play a role in the movement of the intestinal fluid and thus coparticipate in resorption before the musculature of the intestinal wall has been formed. PMID- 2759510 TI - Histological studies of normal and mutant mouse embryo hearts (a glycogen content study). AB - Mutant tail-short (Ts/+) embryos are developmentally retarded compared with normal +/+ litter mates. The development of the heart of Ts/+ embryos is severely affected if the tail-short gene is transferred to a new genetic (50% A/Gr) background. The aim of the present study was to investigate the glycogen content of the sinus muscle, the cushion and the atrial and ventricular walls of the heart. In normal embryos the sinus muscle is well developed by the 15th day post coitum (d.p.c.) and is crowded with glycogen granules. In Ts/+ mutant embryos, on the other hand, the development of this muscle is retarded and it contains only a little, diffusely distributed glycogen. The atrial and ventricular walls of embryos with a normal heart are well trabeculated and contain a large quantity of glycogen granules, while in mutant embryos they are less well trabeculated and contain only a little glycogen in a diffuse of finely granular form. PMID- 2759511 TI - [Differential diagnosis of functional voice disorders]. AB - In phoniatrics the differential diagnosis of functional voice disorders is mainly based on the medical history of the patient, laryngoscopic and stroboscopic findings. On the one hand the typical laryngoscopic picture must be stressed, on the other hand the central significance of stroboscopy for the functional diagnosis of the larynx has to be mentioned. Only the detailed assessment of the stroboscopic signs and symptoms described by Schonharl allows a therapy-relevant differentiation between cause-related diagnosis and compensatory secondary symptoms with a necessary distinction of psychosomatic disorders. PMID- 2759512 TI - [Current status of stuttering therapy in preschool and school-age children in the Federal Republic of Germany: results of a questionnaire study among therapists and analysis of the literature]. AB - It is evident that no empirical research has been carried out within the preschool age-group of stuttering children and also that information on the subject published in international and especially in the Anglo-American literature has not received the attention of German therapists. Rather than concentrating upon the stuttering child's speech and language, they attempt to convey to the child a greater pleasure in speaking and in communicating; this may result in symptoms that could aggravate prognosis. More than half of the therapists maintain the same attitude toward school-age children. The review of the literature and the replies to the questionnaire show that German therapists require new orientation toward scientific investigation and new concepts in the treatment of stuttering preschool children. PMID- 2759513 TI - Distribution of the amplitude in the pathologic voice signal. PMID- 2759514 TI - Vowel duration and voice onset time for stressed and nonstressed syllables in stutterers under delayed auditory feedback condition. PMID- 2759515 TI - [Classification of glottal dysfunctions on the basis of electroglottography]. AB - The close relationship between the muscular tension at the level of the glottis and the glottal opening time, closing time, and open quotient encourages the use of these temporal measures as an aid in classifying functional dysphonias. The validity of a 'quasi-open quotient' (QOQ) derived from the electroglottogram was explored by means of a crescendo singing task at comfortable frequency. The pattern of QOQ change during the crescendo task was determined and the range of the variable measured. In normal speakers QOQ varied from 0.75 (at low vocal intensity) to 0.40 (at high intensity). In contrast, the range of QOQ values was significantly restricted in patients with hyper- and hypofunctional dysphonia. The electroglottographical curves were registered and documented by a computer system (IBM AT, Gould DASA). PMID- 2759516 TI - The evaluation of an ELISA for semen-specific 19-OH prostaglandin F1 alpha/F2 alpha using ex-casework swabs and stains. AB - The application of an enzyme-linked immunosorbent assay (ELISA) for 19-OH Prostaglandin F1 alpha/F2 alpha (19-OH PG F) to casework analysis of seminal contamination of swabs and stains is reported. The results are compared to those where the identification of semen was based on the presence of acid phosphatase and spermatozoa. Five hundred and one samples were analysed and there was good agreement between the results of ELISA and conventional methods. The determination of 19-OH PG F confirmed both the presence of semen where spermatozoa were absent and indicated semen was present when acid phosphatase and spermatozoa were both absent. The results indicate that 19-OH PG F represents a useful marker for the casework identification of semen and is particularly valuable where spermatozoa are absent. PMID- 2759517 TI - The mechanism of fatal cardiopulmonary injury caused by a blow from a golf club. AB - In the course of a scuffle, a youth of 18 years was struck a single blow across the chest with a golf club. He collapsed dead on the spot. At autopsy, a precisely located and highly distinctive patterned imprint abrasion of the precordial region was revealed providing an excellent match with the weapon. The heart showed multiple internal ruptures and there was a laceration of the lingula of the left lung. Injury to the chest wall was confined to the soft tissues, the rib cage and sternum being intact. We postulate a novel mechanism to explain the cardiac rupture. PMID- 2759518 TI - A method of human diaphorase locus 3 phenotyping in human semen by isoelectric focusing. AB - A rapid method for the separation of diaphorase (DIA 3) isozymes in the pH range 6-8 is presented. Isoelectric focusing (IEF) of DIA 3 on 0.2 mm thick polyacrylamide gels took 60 min at 5 degrees C. Separated bands are sharp and common phenotypes are readily distinguishable. The method combines high resolution, speed, reproducibility and reagent economy with simplicity. PMID- 2759519 TI - Detection of injuries in traumatic deaths. The significance of medico-legal autopsy. AB - A material of 218 medico-legal autopsies on persons with traumatic injuries was analysed. All these persons had been admitted to hospital. In 75 (34%) injuries had been missed in hospital. In 11 (5%) the overlooked injuries were the sole cause of death, while in 51 (23%) they were contributory. The missed injuries were found in all regions: 27% were moderate (AIS 2), 28% serious (AIS 3), 40% severe (AIS 4), and 5% critical (AIS 5). It is concluded that medico-legal autopsies are necessary for an exhaustive evaluation of traumatic deaths. They are of significance not only to legal security, but also to the social need for analysing injury mechanisms and the consequent possibility of preventive efforts. PMID- 2759520 TI - Injuries due to deliberate violence in areas of Argentina. I. The extent of violence. Copenhagen Study Group. AB - As part of a transcultural investigation of violent behaviour in Argentina and Denmark an analysis was made of the incidents involving deliberate violence as registered in the emergency wards of Hospital Fernandez and Hospital Pinero in Capital Federal Buenos Aires over a period of 13 and 17 months, respectively. In the two emergency wards a total of 281 victims of deliberate violence were observed corresponding to a rate of approximately 0.2/1000 per year in a mainly middle income area of the metropolis Buenos Aires, the catchment region of Hospital Fernandez, and 0.6/1000 per year in a mainly low income area of Buenos Aires, the catchment region of Hospital Pinero. Men aged 20-24 years and 40-49 years were found to be the most frequent victims of deliberate violence, 13% and 11%, respectively. Elderly women greater than or equal to 60 years of age were rarely found to be victims of deliberate violence (2%). Skilled and unskilled male workers were over-represented as victims of violence. Sixty-four percent of the victims were men and 29% women, 6% were boys and 0.7% girls less than or equal to 14 years of age. Twenty-one percent of the male victims and 5% of the female victims were alcohol intoxicated when arriving in the emergency ward. The incidents took place in restaurants or in the vicinity of restaurants for only 7% of the male victims, while 55% of male victims and 34% of female victims had been injured in the street, most often by non-acquainted men. Fifty-eight percent of the female victims had been subject to deliberate violence at home, in the majority of the cases beaten by their spouse. Twelve percent of the male victims and 8% of the female victims were estimated to be under the influence of drugs. The incidence of deliberate violence seems to be lower in Argentina than in Denmark. However, serious lesions appear to be considerably more frequent in male Argentinian victims compared to male Danish victims, maybe because the practice of seeking medical assistance is different in the two countries. The pattern of deliberate violence appears to be associated with socio-economic and cultural factors. Influence of alcohol does not appear to play a role that is comparable to the situation observed in Denmark. A considerably larger percentage of victims in Argentina than in Denmark had been injured in the street. PMID- 2759521 TI - Injuries due to deliberate violence in areas of Argentina. II. Lesions. Copenhagen Study Group. AB - As part of a transcultural investigation of violent behavior in Argentina and Denmark, the lesions from accidents involving deliberate violence registered in the emergency wards of Hospital Fernandez and Hospital Pinero in Capital Federal Buenos Aires over a period of 13 and 17 months, respectively, were studied. Among the 281 victims entering the two emergency wards blunt violence without use of instruments was most often reported to be the violation method. Frequently indicated violation instruments against the male victims were batons (18.7%), sharp instruments (17.7%), and firearms (17.7%), the corresponding figures for female victims being 9.6%, 8.4% and 4.8%. The use of firearms and batons was considerably more pronounced in Argentina than in Denmark, particularly against male victims. A total of 373 primary and secondary diagnoses were reported from the patients, the most frequent diagnoses being contusions and open wounds in the head/neck region. Forty-three percent of the diagnoses were related to the head/neck region, being the most frequently injured region and the trunk the second most frequently injured region (30%). The degree of predominance of lesions in the head/neck region was much less than in the Danish material. Injuries of internal organs of the trunk were considerably more frequent in Argentina than in Denmark. Eighty-five percent of the victims had moderate or less serious lesions when assessed on the basis of the scores in the Abbreviated Injury Scale (AIS), (score less than or equal to 2). The AIS scores of the lesions in female victims were on average only slightly higher than those recorded in the Danish study, while 16.1% of the male Argentinian victims had lesions scored greater than or equal to 3 compared to 1.8% in male Danish victims. The need for treatment and hospitalization was more pronounced than in the Danish study. It may be concluded that the frequency of serious cases of deliberate violence probably would decrease if more restrictive rules for the possessing of firearms were enacted and enforced. PMID- 2759522 TI - Cyanide, carboxyhemoglobin and blood acid-base state in animals exposed to combustion products of various combinations of acrylic fiber and gauze. AB - In order to examine the usefulness of blood cyanide concentrations as an indicator of whether or not a victim was alive at the start of a fire, blood cyanide concentrations were measured in the bodies that we autopsied in our institute between January 1986 and March, 1987. In the present study, bodies with advanced decomposition were excluded. Thirty-six bodies were included: cyanide as well as carboxyhemoglobin (COHb) were detected in four charred bodies found at the scene of a fire. On the other hand, cyanide was not detected in any of the remaining 30 bodies except in two cases suspected of having ingested a cyanide compound. Rats and rabbits were made to inhale the combustion products of various combinations of acrylic fiber (hydrogen cyanide generating material when heated) and gauze (carbon monoxide generating material when heated). The exposure to the combustion products was continued until death in the rat and until apnea in the rabbit. The concentration of hydrogen cyanide in the exposure chamber and that of blood cyanide, at the time the animal died, correlated with the amount of acrylic fiber heated. In addition to differences in blood COHb and cyanide concentrations, there were also differences in blood gas concentrations between the acrylic fiber and the gauze groups. When the rabbits were switched to room air after the occurrence of apnea, the blood gas value began to normalize. PMID- 2759523 TI - Diagnosis of pregnancy in bloodstains. Study of progesterone and luteinizing hormone levels. AB - The objective of this work is to establish the diagnostic efficiency of the determination of progesterone and luteinizing hormone in bloodstains on an absorbent surface. In a stain consisting of woman's blood, the establishment of pregnancy or birth may be significant in cases of criminal abortion or infanticide, or to determine the probable date of the events. A total of 61 women between the ages of 16 and 47 years were studied (mean age 29.54 years; S.D. 7.82). Subjects were distributed in three groups: pregnant women, women in labour and non-pregnant women. We found statistically significant differences in progesterone and LH levels between the non-pregnant group and pregnant women in labour in 24 and 48-h bloodstains. We found no statistically significant differences between progesterone and LH levels in pregnant women in 24, 48 and 72 h stains and at 6 and 7 days. We can conclude that progesterone and LH measurements in bloodstains at least 1 week old and probably much older can be very useful in establishing the diagnosis of pregnancy up until and including the time of birth. PMID- 2759524 TI - Application of 3-D computer graphics for facial reconstruction and comparison with sculpting techniques. AB - Facial reconstruction has until now been carried out by the sculpting technique. This method involves building a face with clay or other suitable material on to a skull or its cast, taking into account appropriate facial thickness measurements together with information provided by anthropologists such as approximate age, sex, race and other individual idiosyncrasies. A method for facial reconstruction is presented using 3-D computer graphics and is compared with the manual technique. The computer method involves initially digitising a skull using a laser scanner and video camera interfaced to a computer. A face, from a data bank which has previously digitised facial surfaces, is then placed over the skull in the form of a mask and the skin thickness is altered to conform with the underlying skull. The advantage of the computer method is its speed and flexibility. We have shown that the computer method for reconstructing a face is feasible and furthermore has the advantage over the manual technique of speed and flexibility. Nevertheless, the technique is far from perfect. Further facial thickness data needs collecting and the method requires evaluation using both known control skulls and later unknown remains. PMID- 2759525 TI - Inflammation in the lungs of infants dying suddenly. A comparative study from two countries. AB - An investigation of lung tissue samples from sudden unexpected infant deaths from the German Democratic Republic (G.D.R.) (n = 106) and Finland (n = 94) shows the German material to contain 54 cases (51%) with advanced inflammatory changes allowing a definite pathologico-anatomical diagnosis and explanation for the death, whereas there were only 19 such cases (20%) in the Finnish material. Slight changes indicating an inflammatory process but not allowing a definite diagnosis ("borderline cases") were seen in one fifth of the cases in both countries. Thus a greater proportion of the child deaths below the age of 1 year in Finland are real cot deaths than in the G.D.R. where signs of respiratory infection can be found more often. PMID- 2759526 TI - Blood alcohol in sudden and unexpected deaths. AB - Blood alcohol concentration was determined in 1672 sudden and unexpected natural and non-natural out-of-hospital deaths. The material covered all medicolegal autopsies in the province of Uusimaa which has a population of approximately 1.1 million inhabitants. In general, the prevalence of cases with alcohol in the blood at the time of death was high but varied considerably according to sex, age, and the cause and manner of death. The blood alcohol result was positive in 36% of the male and in 15% of the female material. In 59% of the alcohol-positive male and in 54% of the alcohol-positive female cases the actual concentrations were at least 1.5%. Acute use of alcohol was regarded as a significant condition contributing to death in 23% of the whole male and in 8% of the whole female material. These gross results and the details presented indicate that the acute use of excess alcohol is a factor contributing to non-natural but also to sudden and unexpected natural deaths to an extent that is not generally known. The results also emphasize that simple blood alcohol determination should be a routine procedure in the autopsy praxis of all sudden and unexpected natural and non-natural out-of-hospital deaths. PMID- 2759527 TI - [Ultrastructural findings in the cornea in xeroderma pigmentosum]. AB - Xeroderma pigmentosum is a very rare disease caused by an inherited defect in the DNA repair system. The cells are less able to repair defects caused by UV radiation, which results in early aging of the skin and the development of malignant skin tumors. Robins assumes that the eye is involved in 60% of the cases. In our patient we found a dense opacity of both corneas in addition to the typical lentiginous alteration of the skin. Therefore, a corneal transplantation was carried out on both eyes. The corneal buttons obtained by keratoplasty were examined by light, and transmission electron microscopy. We found massive alterations in the tissues of all corneal layers. PMID- 2759528 TI - [Deformation of the central corneal surface following use of hard and soft contact lenses]. AB - Use of a computer connected with a slit-lamp-video-camera detected changes in the cornea topography after wearing contact lenses on a daily basis. Also subtle surface changes were observed within the upper portion of the areas measured. These appeared to be spiral-shaped or cloudlike patterns as a result of wearing hard or soft contact lenses respectively. The changes observed appeared to have resulted from movement of the contact lens. However, this device has also been used to determine changes that are similar in early keratokonus. The computer can store data from 1600 sites on the surface; there sites are distributed over a 4 mm diameter area in the central cornea. On command the computer can display an image of the corneal surface. Images from hour 0 and 6 weeks later were compared to determine the topographic differences. The surface patterns observed after 6 weeks of wearing lenses appeared to be involve numerous small depressions. PMID- 2759529 TI - [Clinical experiences with a therapeutic collagen contact lens]. AB - In 43 eyes of 40 patients, the therapeutic effects of a self-dissolving hydrophilic collagen contact lens were investigated. Epithelial defects of any source, lamellar perforating corneal injuries, and trophic sterile corneal ulcers were defined as indications for the use of the lens. Collagen contact lenses were applied with biodegradation times of 6, 24, and 72 h. All patients tolerated the lens well, and no adverse reactions to the collagen material were observed. In all diseases where the lens was applied, re-epithelialization was found to be relatively fast. PMID- 2759530 TI - [Incidence of cystoid macular edema following cataract extraction]. AB - In a prospective study we research the incidence of cystoid macular edema following intracapsular cataract extraction with the Choyce-Mark-IX implantation method. The only eyes included in the study were those for which the operation had been uncomplicated. Fluorescence angiography was performed after 8 days, 6 weeks, 6 months and 1 year. The edema was graded accordingly: grades I-III. Cystoid macular edema of grade III was demonstrated in 4% after 6 weeks but not after 6 months and 1 year. After 1 year, grade II occurred in 2% and grade I in 15%, respectively. Visual acuity, however, was not impaired. PMID- 2759531 TI - [Biological parameters of so-called "senile cataracts"]. AB - With advancing age the weight of the lens of the eye tends to increase in both human beings and animals; simultaneously, the percentage of enzymes in the entire lens decreases. These phenomena can be explained by the fact that the enzymes are mostly located in the epithelium and superficial nucleate fibers of the lens. In addition, the central part of the lens, which steadily increases its volume and percentage of the weight of the whole lens over a lifetime, has relatively few or no enzymes at all. In the superficial layers the enzyme content adenosine triphosphate (ATP) and glutathione remains high even in old age, and the cation pump K+ greater than Na+ is still intact. This fact is also true in deep supranuclear cataracts and primary nuclear cataracts. In subcapsular cataracts, however, the ATP and glutathione content decreases rapidly and the cation pump is defect. PMID- 2759532 TI - [Scanning electron microscopy findings in explanted posterior chamber lenses]. AB - Five explanted posterior chamber lenses were examined under the scanning electron microscope to determine the changes. The intraocular time of the lenses was 1 week to 3 years. The polypropylene loops showed superficial cracks in all cases, but only in the curve and the insertion areas. The findings therefore indicated that the morphological changes are more likely caused by mechanical stress than by biological degradation alone. PMID- 2759533 TI - [Tonography and fluorophotometry in the clinical study of aqueous humor dynamics]. AB - We used Grant's tonography and fluorophotometry (the Jones and Maurice method) to study the aqueous humor dynamics in normal and glaucomatous eyes. The results of the two methods were compared. The mean facility and rate of aqueous flow in normal eyes were similar. In glaucomatous eyes the tonographic outflow facility (C-value) varied greatly, and the calculated rate of aqueous flow (F-value) also had a large standard deviation. To study the inflow rate, fluorophotometry is a more accurate method. Further calculation of uveoscleral flow and the "pseudofacility" from the tonographic F-value and fluorophotometric C-value was therefore of only limited accuracy. PMID- 2759534 TI - Juvenile retinal detachment as a complication of familial exudative vitreoretinopathy. AB - Retinal detachment occurred in 36 (20%) of 180 eyes of 90 individuals with familial exudative vitreoretinopathy (FEVR) from 17 families. FEVR can give rise to very different types of retinal detachment, such as rhegmatogenous retinal detachment, falciform retinal folds, PVR with formation of a retrolental membrane and exudative retinal detachment. All but one retinal detachment occurred before the age of 30. Traction from vitreous membranes seems to be the most important cause of retinal detachment; atrophy of the peripheral retina may contribute to the formation of retinal breaks. Subretinal exudation is a rare cause of FEVR retinal detachment. PMID- 2759535 TI - [Follow-up after enucleation in choroid melanoma]. AB - We report on 31 patients who underwent enucleation between 1976 and 1984 for uveal melanoma and had a mean follow-up of 107 months. There was no irradiation to the globe or orbit prior to enucleation, which was done under general anesthesia. Histology showed that: the average diameter of the tumors was 10.6 mm and the average height 6.2 mm. There were 3 cases of spindle-cell A-type tumors, 19 of spindle-cell B, 2 of mixed cell types, and 7 cases of mixed cell types with epithelioid cell dominance or epithelioid cell tumors. In September 1988, 9 patients (29%) had died as of a result of metastases from the melanoma; 4 patients who died were found to have another malignant tumor; 1 patient died due to cerebral apoplexia; 1 patient died 8 days after enucleation due to unknown causes. The survival curve was based on the Kaplan-Meier method. PMID- 2759536 TI - [Stability and flexibility of the lipid layer of the tear film and their pathologic changes in a biophysical experiment]. AB - In vitro experiments with meibomian gland secretion from healthy subjects, patients with keratoconjunctivitis sicca and meibomianitis were performed. In addition, patients of different age groups of both sexes were also tested. The biophysical experiments included continuous measurement of surface pressure and surface potential under compression and decompression conditions. Surface pressure was determined by a Wilhelmy type film balance; surface potential was determined using the vibrating plate method. In the age group up to 60 years, the surface potential of females, males and patients with keratoconjunctivitis sicca showed a characteristic peak of 200 mV under compression, which was fully reversible under decompression. Females, males and patients with keratoconjunctivitis sicca over 60 years of age showed changes in the surface potential under decompression which indicated that the secretion was unstable and inhomogeneons. Patients with meibomianitis presented characteristic changes of surface potential. Qualitative alteration of the secretion may be the corresponding interpretation. The above biophysical methods have been used for the first time under clinical aspects. PMID- 2759537 TI - [Predominance of crossed optic nerve fibers is a characteristic of albinism, but not of dissociated vertical deviation]. AB - We examined eight patients with dissociated vertical deviation (DVD) for evidence of misrouting in the visual pathway, using visually evoked potentials. Full-field monocular pattern-onset chequerboard stimulation was employed. The visually evoked potentials were recorded from both occipital lobes. Their differential activity during stimulation of the right eye was compared with that obtained during stimulation of the left eye. In contrast to an earlier report, a predominance of the crossed projection was not found in any of the DVD cases. The results in eight normal control subjects were similar, unlike our findings in eight albino patients (predominance of crossed projection: a relative positivity over the contralateral hemisphere about 100 ms after pattern-onset). Possible artifacts are discussed that may have led to the earlier assumption of misrouting in DVD patients. PMID- 2759538 TI - [Cat-scratch disease in children]. PMID- 2759539 TI - [Vaccine development. Obstacles in evaluating AIDS vaccines]. PMID- 2759540 TI - [AIDS prevention. Only a few practical recommendations]. PMID- 2759541 TI - [Osteoporosis: no reason for resignation. 5th International Study Group on Osteoporosis. Venedig, 21-23 April 1989]. PMID- 2759542 TI - [Changes in the manifestations of endogenous depression in advanced age]. AB - The psychopathology of 301 patients aged between 45 to 65 admitted to psychiatric hospitals because of endogenous depression between the years 1920 and 1982 was investigated and compared within 4 consecutive time periods. Among other things, an increase in physical and vegetative complaints, disturbances of vital feelings, feelings of guilt towards partner and family, as well as feelings of insufficiency and attempts of suicide was observed. Within the last decade, the duration of phases was considerably longer. Conflicts during prodromal periods of depression, particularly with regard to the partner, the family and the professional occupation were exceedingly more frequently. Historical influences such as a lifestyle orientation towards success, optimal health and wealth might be significant for this development. Pharmacotherapeutic factors will be discussed, and the necessity for further transsectional and longitudinal studies based on clear diagnostic criteria and exploratory techniques will be pointed out. PMID- 2759543 TI - [Neurocutaneous melanosis]. AB - The authors report on a patient of 33 years of age suffering from neurocutaneous melanosis in whom two years after excision of a naevus pigmentosus et pilosus giganteus cellular proliferation of the melanoblasts in the area of the soft meninges was seen. This process led to the death of the patient within a few weeks' time despite intensive therapeutic measures, the manifestation being that of a generalised space-occupying growth in the CNS. Neuroradiological techniques can objectify the clinical pattern of signs of this very rare disease and may possibly enable an early diagnosis. PMID- 2759544 TI - Beta-blockade with propranolol and hepatic artery blood flow in patients with cirrhosis. AB - In patients with cirrhosis and portal hypertension, propranolol administration reduces heart rate and cardiac output and diminishes portal pressure and collateral blood flow. However, there is little information on the possible effects of propranolol on hepatic artery blood flow. The present study addressed this question in 12 cirrhotic patients with end-to-side portacaval shunt, in whom all of the liver blood flow represents the hepatic artery blood flow. Hepatic artery blood flow (continuous infusion of indocyanine green), cardiac output (thermal dilution), heart rate and mean arterial pressure were measured before and 20 min after the intravenous infusion of 10 to 15 mg of propranolol. beta Adrenergic blockade caused a significant reduction of cardiac output (from 9.1 +/ 2.1 to 7.1 +/- 1.4 liters per min, p less than 0.001) (mean +/- S.D.) and heart rate (from 85 +/- 10 to 71 +/- 7 beats per min, p less than 0.001), and a significant increase of systemic vascular resistance (from 9.0 +/- 2.1 to 11.7 +/ 2.7 mmHg per liter per min, p less than 0.001), whereas mean arterial pressure did not change (77 vs. 78 mmHg). Propranolol significantly reduced hepatic artery blood flow (from 0.65 +/- 0.20 to 0.55 +/- 0.14 liters per min, p less than 0.01). However, reduction of hepatic artery blood flow (-12.9 +/- 7.3%) was significantly less than reduction of cardiac output (-21.1 +/- 5.2%, p less than 0.01). As a result, the fraction of the cardiac output delivered to the liver was significantly greater after propranolol (8.0 +/- 1.7%) than before (7.3 +/- 1.7%, p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2759545 TI - Effects of propylthiouracil and methimazole on splanchnic hemodynamics in awake and unrestrained rats. AB - The treatment of alcoholic liver disease with propylthiouracil is based on its effect of suppressing the ethanol-induced increase in hepatic oxygen consumption. It has been postulated that liver necrosis ensues when the increase in oxygen demand by the liver exceeds oxygen delivery to this organ. Data are now presented which show that propylthiouracil also increases portal blood flow in awake, unrestrained rats. Liver blood flow was determined using the labeled microsphere technique in rats at various intervals (0.25, 0.5, 1.0, 3.0, 6.0 and 24 hr) after oral propylthiouracil (50 mg per kg). Administration of propylthiouracil (dose range: 6.25 to 100.0 mg per kg) produced a dose-dependent increase in portal blood flow when given either orally or intraarterially. Maximal flows were obtained with 50 mg per kg (controls = 37.8 +/- 1.5, oral propylthiouracil = 50.7 +/- 2.2 ml.kg-1.min-1). This increase in portal blood flow was accompanied by a decrease in preportal vascular resistance (controls = 2.61 +/- 0.16; propylthiouracil, 50 mg per kg = 1.79 +/- 0.09 mmHg per ml.kg-1.min-1). These effects were correlated with the plasma concentrations of propylthiouracil (r = 0.67, n = 68, p less than or equal to 0.001). The effect of oral propylthiouracil (50 mg per kg) on portal blood flow started at 0.5 hr and lasted for 6 hr after administration, whereas total liver blood flow was increased for 3 hr. Oral propylthiouracil (50 mg per kg) for 5 days resulted in a 53% increase in thyroid weight, an 85% reduction in 125I thyroid uptake and a 74% decrease in serum thyroxine concentration.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2759546 TI - Lack of effects of isosorbide-5-mononitrate on hepatic hemodynamics in HBsAg positive cirrhosis. AB - We conducted a randomized controlled hemodynamic study to evaluate the effect of placebo and 20 mg isosorbide-5-mononitrate, a long-acting organic nitrate, in 19 patients with HBsAg-positive cirrhosis by the simultaneous measurement of portal venous pressure and wedged hepatic venous pressure. Baseline values for the two groups were similar. One hour after oral administration of 20 mg isosorbide-5 mononitrate in 10 patients, mean arterial pressure, mean pulmonary arterial pressure and pulmonary capillary wedge pressure significantly decreased from 92 +/- 13 (mean +/- S.D.) to 82 +/- 14 mmHg, from 12.9 +/- 4.5 to 9.3 +/- 2.4 mmHg and from 6.9 +/- 3.4 to 4.3 +/- 1.8 mmHg, respectively. However, both portal venous pressure gradient (from 18.1 +/- 3.6 to 17.5 +/- 3.0 mmHg) and hepatic venous pressure gradient (from 17.8 +/- 5.2 to 16.6 +/- 5.3 mmHg) remained unchanged during the study. In six patients who received 20 mg isosorbide-5 mononitrate twice daily for 7 days, hepatic venous pressure gradient remained unaltered as compared to basal and 1-hr values. There was no significant change in cardiac index, heart rate or systemic vascular resistance in either immediate (1-hr) or delayed (7-day) studies. Three patients (30%) developed mild headache or dizziness and two patients (20%) demonstrated systolic hypotension (less than mmHg) during the immediate study. This study shows that isosorbide-5-mononitrate appears to have no effect in treating portal hypertension in patients with HBsAg positive cirrhosis. In addition, the isosorbide-5-mononitrate may affect the systemic circulation more than the portal circulation. PMID- 2759547 TI - Hemodynamic and metabolic responses to leukotriene C4 in isolated perfused rat liver. AB - Responses of isolated perfused rat liver to leukotriene C4 were studied in order to assess the mechanisms involved in leukotriene-mediated liver injury. Infusion of leukotriene C4 (11 and 44 pmoles per min per gm liver weight) into the portal vein resulted in a rise in portal pressure, a decrease in oxygen consumption, an increase in hepatic glucose and lactate efflux and lactate/pyruvate ratio in the perfusate and a small decrease in bile flow. Isoproterenol (1 microM) counteracted the effects of leukotriene C4 on respiration and portal pressure, whereas bile flow and glucose efflux were reversibly stimulated. The same changes were observed upon withdrawal of leukotriene C4. The release of glucose was correlated with the increase in oxygen consumption upon both isoproterenol addition and withdrawal of leukotriene C4. These results are indicative of leukotriene C4-induced microcirculatory redistribution of perfusate flow. Since, in the presence of nitroprusside (50 microM), both the effects of leukotriene C4 and their reversal by isoproterenol were diminished, a vascular site of action can be assumed. Accordingly, the accompanying metabolic responses can be explained by gradual changes in oxygen supply to parts of the liver. Reversibility of the leukotriene C4 effects and lack of short-term impairment of viability of the isolated liver suggest that leukotriene-mediated liver injury is a long-term effect related to events subsequent to microcirculatory changes. PMID- 2759548 TI - Thiopental infusion in the treatment of intracranial hypertension complicating fulminant hepatic failure. AB - Intracranial hypertension complicating fulminant hepatic failure has a mortality in excess of 90% in the presence of renal failure if not rapidly responsive to mannitol and ultrafiltration. Based on data which suggest that barbiturates can be of value in controlling the intracranial hypertension of head injury, intravenous thiopental was assessed in 13 patients with fulminant hepatic failure. All had developed acute renal failure complicated by intracranial hypertension unresponsive to other modes of therapy and were likely by all published criteria to have little chance of survival. The dosage of thiopental was adjusted incrementally until intracranial pressure, measured by extradural transducers, fell to within normal limits or adverse hemodynamic changes occurred. The intracranial pressure was reduced, in each case, by 185 to 500 mg (median: 250 mg) thiopental given over 15 min, and in eight cases continuing infusion achieved stable normal intracranial pressure and cerebral perfusion pressure. Five of the patients made a complete recovery and there were only three deaths from intracranial hypertension. Side effects were few and included minor hypotension controlled by dose reduction. The response of otherwise intractable intracranial hypertension and the 38% survival rate was remarkable for a group of patients with such a poor prognosis. PMID- 2759549 TI - A simple animal model of hyperammonemia. AB - Rats were fed a standard diet or the standard diet supplemented with ammonium acetate (20% w/w) for up to 100 days. The effect of the ingestion of the high ammonium diet on some aspects of nitrogen metabolism in rats was studied. Ammonia levels in blood increased approximately 3-fold; in brain, liver and muscle the increases were 36, 34 and 50%, respectively. Urea levels in blood and urea excretion increased approximately 2-fold. There was no increase of carbamyl phosphate synthase. Liver glutamine synthase activity increased by 58% and glutamate dehydrogenase by 40%, whereas glutaminase was not affected. Glutamine content in brain was twice that of controls. This new animal model to study hyperammonemia offers several advantages over others: it is simpler, is bloodless, requires no animal manipulation and permits long-term studies. PMID- 2759550 TI - Detection of antibodies against hepatitis B virus polymerase antigen in hepatitis B virus-infected patients. AB - By the use of a truncated recombinant hepatitis B virus polymerase antigen, we have characterized a series of patient sera for anti-hepatitis B virus polymerase antibodies. Seven of 54 (13%) had antipolymerase antibodies detectable by Western blot analysis, and no close correlation was apparent between the disease status and patient's immune response against hepatitis B virus polymerase antigen. Our results indicate that serologic responses to the viral polymerase are demonstrable but suggest that such antibodies are not likely to be clinically useful as diagnostic or prognostic markers of infection. PMID- 2759551 TI - Mechanism of iron potentiation of hepatic uroporphyria: studies in cultured chick embryo liver cells. AB - Effects of iron were studied in cultured chick embryo liver cells to help elucidate the effect of hepatic iron in the human disease porphyria cutanea tarda and in toxic porphyria caused by chemicals. These cultures have proven useful because (a) phenobarbital and phenobarbital-like drugs induce a common form(s) of cytochrome P-450 (P-450-phenobarbital) in these cultures; (b) 20 methylcholanthrene and certain other polycyclic hydrocarbons induce a different form(s) (P-450-methylchol-anthrene), and (c) uroporphyria can be produced rapidly by exposure to suitable chemicals. In these cultures, treatment with iron alone did not produce porphyrin accumulation, and treatment with iron + 5 aminolevulinate caused accumulation of protoporphyrin, as did treatment with 5 aminolevulinate alone. However, treatment with phenobarbital-like drugs and iron, the latter at a concentration as low as 0.2 microM, led to accumulation of uro- and heptacarboxylporphyrins. Potentiation of uroporphyrin accumulation by iron began before there was a detectable synergistic increase in activity of 5 aminolevulinate synthase, the rate-controlling enzyme of heme synthesis. In contrast, treatment of cultures with 20-methylcholanthrene, in the presence or absence of iron, did not result in uroporphyrin accumulation or an increase in the activity of 5-aminolevulinate synthase. Uroporphyrinogen decarboxylase activity was unchanged by drug and iron treatments. Inhibitors of P-450 phenobarbital, SKF525A and piperonyl butoxide, as well as cadmium and cycloheximide prevented the porphyrin accumulation produced by glutethimide + iron, even though, except with cycloheximide, these substances further increased 5-aminolevulinate synthase activity. In vitro, uroporphyrin was oxidized autocatalytically by iron. In intact hepatocytes, even low concentrations of iron (0.2 to 20 microM), in the presence of a form of cytochrome P-450 induced by phenobarbital-like chemicals, produces uroporphyria primarily by enhancing uroporphyrinogen oxidation, not by inhibition of the decarboxylase. Induction of 5-aminolevulinate synthase amplifies the porphyrin overproduction. PMID- 2759552 TI - Sensitivity of human tissue heme oxygenase to a new synthetic metalloporphyrin. AB - Heme oxygenase, the rate-limiting enzyme for heme degradation, can be inhibited by several new synthetic metalloporphyrins. Under certain conditions, a depression in heme oxygenase activity has important clinical significance in the treatment of hyperbilirubinemia, and, in this regard, tin-protoporphyrin has been shown to decrease the production of bilirubin in vitro as well as in vivo. Similarly, our study was concerned with finding a new metalloporphyrin which will inhibit heme oxygenase. Many of the synthetic heme analogs that we analyzed were quite effective inhibitors of heme oxygenase, but the most powerful inhibitor was found to be zinc-deuteroporphyrin IX, 2,4-bisglycol. This metalloporphyrin almost completely inhibits liver heme oxygenase at concentrations as low as 0.5 microM. Its potency as an inhibitor was found to be greater than that of tin protoporphyrin; the Ki of zinc-deuteroporphyrin IX, 2,4-bisglycol was calculated to be 0.003 microM. In conclusion, we demonstrated that zinc-deuteroporphyrin IX, 2,4-bisglycol has potent inhibitory effects on human liver, kidney and brain heme oxygenase so that this metalloporphyrin can be considered as an alternative to tin-protoporphyrin in the treatment of hyperbilirubinemia. PMID- 2759553 TI - Spiders and capillaries. PMID- 2759554 TI - Myeloproliferative disorders in portal vein thrombosis in adults. PMID- 2759555 TI - Epithelial membrane antigen expression by the perineurial cell: further studies of peripheral nerve lesions. AB - We have previously shown that a range of anti-epithelial membrane antigen monoclonal antibodies show immunoreactivity with the perineurial fibroblast, both in normal nerves and within a range of common peripheral nerve tumours. We have extended these observations by studying a further collection of peripheral nerve lesions, including some which have previously been thought to have an origin from the perineurial cell. The results provide further evidence that these antibodies reliably stain perineurial cells and that in conjunction with antisera to S-100 protein and neurofilaments, the relative contributions of the perineurial fibroblast, Schwann cell and neurone can be assessed within a nerve-related tumour/lesion. The perineurial fibroblast is an important component of some peripheral nerve lesions. PMID- 2759556 TI - Endomyocardial biopsy pathology in insulin-dependent diabetic patients with abnormal ventricular function. AB - We have previously shown impaired ventricular function in asymptomatic middle aged type 1 (insulin-dependent) diabetic patients who had no evidence of coronary artery disease. The diabetic patients had normal coronary angiograms but reduced ventricular ejection fraction on exercise. To examine the possible contribution of small vessel disease to this functional abnormality, we compared endomyocardial biopsies from seven symptom-free type 1 diabetic patients with biopsies from seven age- and sex-matched non-diabetic subjects. Interstitial fibrosis was present in three diabetic patients, arteriolar hyalinization in three patients and arteriolar thickening was observed in five patients. Morphometry performed on electron micrographs showed no significant difference in the thickness of the capillary basal lamina between diabetics and controls. While the functional significance of the abnormalities on light microscopy is unclear, our findings indicate that the abnormality of cardiac function described in diabetes is not associated with thickening of the myocardial capillary basal lamina. PMID- 2759557 TI - Hamartomas of the spleen: a study of 20 biopsy cases. AB - Twenty hamartomas of the spleen were studied by histological, immuno- and enzyme histochemical methods. In all cases nodules of varying size resembling proliferation of splenic red pulp structures were present that exhibited considerable morphological variation with regard to plasmacytosis, extramedullary haematopoiesis and phagocytic activity of macrophages. Splenic red pulp structures could be identified by immuno- and enzyme-histochemical markers reacting with sinus endothelium, including Factor VIII related antigen, proteinase inhibitors and non-specific esterases. In conjunction with the absence of organized lymphoid tissue and of dendritic reticulum cells these studies allow the differentiation of splenic hamartomas from haemangiomas that may possess a deceptively similar morphological appearance. PMID- 2759558 TI - Prognostic factors in colonic cancer. AB - Prognostic variables in 251 'curative' specimens of colonic cancer were studied. Subjective variables--tumour type, grade of differentiation, character of invasive margin and lymphocytic infiltration--were associated with fair to excellent levels of inter-observer agreement. Variables found to be of prognostic significance by univariate analysis were subjected to Cox regression analysis. This was undertaken for all three observers and for a consensus grading. No case in which direct spread in continuity was limited to the bowel wall was associated with a cancer-related death; 63 such specimens were removed as a group with an excellent prognosis and did not require further stratification. In the remaining 188 cases, all showing extramural spread, only lymph node invasion, character of invasive margin and tumour type were independent prognostic variables. The model differs from that developed previously for rectal cancer and is superior to the Dukes classification. PMID- 2759559 TI - The prognostic significance of immunophenotype in high-grade non-Hodgkin's lymphoma. AB - The prognostic value of immunophenotyping lymphomas was assessed by studying 51 cases of high-grade non-Hodgkin's lymphoma for which long term clinical follow-up (14-28 years) was available. Using antibodies which identify T- and B-cell related antigens in formalin-fixed, paraffin-embedded material, 43 were shown to be of B-cell and eight of T-cell phenotype. In terms of survival, cases of high grade T-cell lymphoma fared significantly worse (P less than 0.05) than cases of high-grade B-cell subtype. These findings support the belief that T-cell lymphomas have a more aggressive clinical course than their B-cell counterparts. PMID- 2759560 TI - Diagnosis of acute myeloid leukaemia with the use of monoclonal anti-neutrophil elastase (NP57) reactive with routinely processed biopsy samples. AB - The reactivity of a monoclonal anti-neutrophil elastase antibody (NP57) with routinely processed biopsy samples from various acute leukaemias has been examined and compared with that of chloroacetate esterase and CD15 (hapten X), two other myeloid cell-associated markers detectable in paraffin sections. No staining was seen with these markers in 14 cases of acute lymphoblastic leukaemia. In contrast the neoplastic cells in 27 of 37 acute myeloid leukaemias were NP57 positive. Twenty of these were also positive for chloroacetate esterase, whereas CD15 was expressed in only six cases. These results indicate that detection of elastase with monoclonal NP57 forms a useful supplement to traditional methods for the histopathological diagnosis of acute myeloid leukaemias. PMID- 2759561 TI - Morphometric analysis of nuclear/cytoplasmic ratios in normal and perineoplastic vulvar skin. AB - Analysis of vulvar skin adjacent to squamous carcinoma has demonstrated abnormal deoxyribonucleic acid (DNA) content in histologically unremarkable specimens. Analysis of DNA by microdensitometry is time-consuming. Morphometric analysis by point counting was used to compare the nuclear/cytoplasmic ratios of normal vulvar skin and skin adjacent to malignancy. This showed elevated ratios in the latter specimens although there was no linear relationship to increasing ploidy. PMID- 2759562 TI - Malignant granular cell tumour of the neck: immunohistochemical and ultrastructural studies of a case. PMID- 2759563 TI - Basal cell carcinoma and chronic venous stasis. PMID- 2759564 TI - Chondrolipoma of the tongue. PMID- 2759565 TI - Violent behavior and length of hospitalization. PMID- 2759566 TI - Asylums, asphalt, and ethics. PMID- 2759567 TI - Psychiatric services to nursing homes: a liaison model. PMID- 2759568 TI - Public mental health funding in California, 1959 to 1989. AB - Actual expenditures for local mental health services in California from 1959 to 1989 are analyzed to determine trends in state funding of services. As the locus of authority for mental health services shifted from state to county governments, the relative share of state budget appropriations devoted to mental health steadily dwindled. Since 1973 the public mental health budget has declined by 11.8 percent, and in most years the percentage of state general funds allocated to mental health has decreased. Programs for the developmentally disabled, which are similar in scope and mission to those for the mentally ill but are both funded and directed by the state, have received consistently higher levels of funding. California's practice of decentralizing operating authority for mental health programs while retaining responsibility for funding is seen as detrimental to the quality of public mental health services. PMID- 2759569 TI - Comparative costs and impacts of Canadian and American payment systems for mental health services. AB - In attempts to contain mental health costs, administrators are increasingly using incentives, competition, and accounting strategies and are creating more complicated financing systems. Yet the costs of these strategies and their impacts on the efficacy and efficiency of mental health services have yet to be studied. The authors compare mental health payment systems in British Columbia and Oregon. In the Canadian system, the patient is isolated from payment, sources of revenue are consolidated at the provincial level, only one payment mechanism per service type is used, health care documentation is oriented more to clinical needs than to reimbursement, and more discretion is delegated to providers. As a result, Canadian overhead costs are substantially less than those in the U.S. Patients have universal access to medical services in the Canadian system, and providers in hospitals, agencies, and individual practices have high incomes with low overhead costs. PMID- 2759570 TI - Violent behavior and length of psychiatric hospitalization. AB - The relationship between violent behavior and length of hospitalization was studied in a retrospective chart review of 253 patients admitted to a university based acute inpatient unit. Violent behavior was defined as physical attacks on persons or fear-inducing behavior before admission or during initial hospitalization, and its value as a predictor of length of stay was assessed in multiple regression analyses that also included 20 demographic and clinical variables. Violence per se was not an important predictor of length of stay, but violence associated with a diagnosis of schizophrenia was an important predictor. Schizophrenic patients who physically attacked others shortly after admission were more likely to have an extended stay than other patients. The study demonstrates the importance of considering clinically meaningful patterns, such as the interaction between diagnosis and violent behavior, when predicting length of stay. PMID- 2759571 TI - How nursing staff respond to the label "borderline personality disorder". AB - The influence of the diagnostic labels "schizophrenia" and "borderline personality disorder" on the expressed empathy of psychiatric nursing staff was assessed by examining nurses' written responses to a series of hypothetical patient statements. Respondents were more likely to demonstrate affective involvement in response to the schizophrenic patients' statements and were more likely to offer belittling or contradicting responses to the statements of patients with borderline personality disorder. The results corroborate increasing concerns that the diagnosis of borderline personality disorder has become a pejorative label for difficult patients and suggest that staff may provide stereotypic responses and less empathic care to borderline patients than to other patients. PMID- 2759572 TI - Factors predicting utilization of acute psychiatric inpatient services by frequently hospitalized patients. AB - A three-month cohort of admissions (N = 300) to an acute psychiatric inpatient unit of a county general hospital was studied to identify factors that differentiate patients with multiple admissions over a 12-month period from those with only a single admission. Patients with more than one admission made up 32 percent of the cohort. Compared with single-admission patients, they were significantly more likely to be chronically unemployed and to have a diagnosis of schizophrenic or affective disorder. Regression analyses indicated that the number of prior psychiatric hospitalizations was the strongest predictor of both the number of hospitalizations and the number of days hospitalized; other significant predictors were a secondary diagnosis of personality disorder, chronic unemployment, self-referral, and being black. The findings indicate that many of the problems of multiple-admission patients are rooted in social disadvantage, and efforts to devise effective interventions should not focus on psychopathology alone. PMID- 2759573 TI - Community adjustment of chronic schizophrenic patients in urban and rural settings. AB - The influence of environmental conditions on the community adjustment of chronic schizophrenic patients who live in boarding homes and other residential facilities was studied using data from medical records and interviews with patients. Seventy-eight patients living in an urban area and 46 patients living in a rural area were included in the study. Compared with rural patients, urban patients were more likely to live in substandard dwellings, to receive less practical support from the home operator, and to report more incongruence with household members and aversive neighborhood conditions. Urban patients showed significantly more psychopathology, functioned more poorly in relationships with others, and had poorer global functioning than rural patients. Except for the physical condition of patients' dwellings, all the environmental conditions measured in the study were significantly associated with some measures of community adjustment regardless of geographic setting. PMID- 2759574 TI - Families of the seriously mentally ill and their satisfaction with services. AB - Family members of seriously mentally ill persons were interviewed to determine their satisfaction with services received through a countywide service system based on the community support program (CSP) model developed by the National Institute of Mental Health. Interviews with 56 family members indicated that a majority were dissatisfied with various aspects of the service system. Multiple regression analysis revealed that significant contributors to family satisfaction were sex of respondent, type of relationship to family member, age at onset of illness, and time since onset of illness. Interaction with a case manager, specifically interaction involving emotional support for families, was the strongest factor explaining family satisfaction. That finding confirms the central role of the case manager in the delivery of CSP services. PMID- 2759575 TI - Developing a unit for mentally retarded-mentally ill patients on the grounds of a state hospital. AB - For some time patients with the dual diagnosis of mental retardation and mental illness have been recognized as a distinct patient population, but development of programs meeting their special needs is slow. In October 1986 a Massachusetts state psychiatric facility opened a rehabilitative program for such patients in a separate 40-bed unit on the hospital grounds. All patients admitted to the Specialized Habilitative and Rehabilitative Environment (SHARE) program had long histories of institutionalization, and many had been treated with neuroleptic drugs for several years. Most patients now attend day programming, and a few have been able to move on to less restrictive environments. Patients' average neuroleptic dosage has been substantially reduced. This progress has been made in spite of such program-development problems as the need to change staff's long held perspectives about dual-diagnosis patients, lack of funding, and high staff turnover. PMID- 2759576 TI - Women who shoot themselves. PMID- 2759577 TI - Caregivers of mentally ill adults: a women's agenda. PMID- 2759578 TI - Weapon carrying among patients in a psychiatric emergency room. PMID- 2759579 TI - Use of telephone prompts at an inner-city outpatient clinic. PMID- 2759580 TI - Training volunteers to work with the chronic mentally ill in the community. AB - The psychiatric literature gives evidence supporting the use of volunteers in caring for chronic psychiatric patients in the community. Thorough training of volunteers can be expected to enhance the quality of care they provide and help them to maintain interest in their role. The ten-week training program described in this paper was designed to increase volunteers' knowledge of mental illness, improve the quality of care they provided, and stimulate interest in the volunteer role. Pre- and posttraining scores on a questionnaire indicated that volunteers' knowledge had increased. The volunteers rated most aspects of the training very highly and felt that the orientation had helped them meet their goals. Several volunteers indicated increased tolerance for the mentally ill. Many questions remain unanswered. For example, in the long run, what difference does such training make for the patients with whom the volunteers work? Will reluctant professionals be more willing to refer patients to volunteer-staffed programs if those volunteers have had intensive training? Is the training cost effective? We feel that the potential benefits of volunteers working with the chronic mentally ill in the community make this an important area for future research. PMID- 2759581 TI - Self-mutilation. PMID- 2759582 TI - Attitudes toward AIDS. PMID- 2759583 TI - Community support. PMID- 2759584 TI - Work in rehabilitation. PMID- 2759585 TI - Colorado Trust: cooperation key to rural survival. PMID- 2759586 TI - Leveraged buyout architect elected to top FAHS post. PMID- 2759587 TI - Are severity data an effective consumer tool? PMID- 2759589 TI - Teaching hospitals face high-tech catch-22. PMID- 2759588 TI - McCarthy outlines standards for health reform. PMID- 2759590 TI - It's time to define appropriate care. Interview by Mary Grayson. PMID- 2759591 TI - Media seek access to quality-of-care records. PMID- 2759592 TI - Jury research strengthens lawsuit defense. PMID- 2759593 TI - Smart consumers present a marketing challenge. PMID- 2759594 TI - Patient satisfaction levels decline slightly in 1989. PMID- 2759595 TI - Catholic systems unite to take on managed care. PMID- 2759596 TI - New guidelines help hospitals monitor ob/gyn care. PMID- 2759597 TI - Hospitals turn to low-risk MD marketing. PMID- 2759598 TI - State associations help hospitals douse smoking. PMID- 2759599 TI - Health fraud: insurance companies in hot pursuit. PMID- 2759600 TI - Hospital saves money by starting a captive. PMID- 2759601 TI - Information system employees see salaries grow. PMID- 2759602 TI - Off-limits policy guides recruitment practices. PMID- 2759603 TI - Employee drug tests are unreliable and intrusive. PMID- 2759605 TI - Personality types of women attending an STD clinic: correlation with keeping first review appointments. AB - One hundred and eighty new women patients attending a sexually transmitted disease (STD) clinic answered the Eysenck personality questionnaire (EPQ) which measures psychoticism, extraversion, neuroticism, and a tendency to "fake good". These personality scores were correlated with the patients' attendance or non attendance for their first review appointments. The results showed that the mean psychoticism scale scores of the 41 non-attenders was significantly higher than that of the 139 who kept their first appointment. This relation was confirmed using point biserial correlations. The mean scores of non-attenders on the other three EPQ scales were not significantly different from those of attenders, and none of the correlations between the other EPQ scales and this behavioural criterion was significant. The psychoticism scale is tentatively recommended for identifying women patients who may need special counselling about the importance of keeping their first review appointment. PMID- 2759604 TI - Ayre v Aylesbury cervical spatulas. AB - A single blind crossover study compared the traditional Ayre spatula with the new Aylesbury spatula. The study group consisted of all women attending the department of genitourinary medicine during a 16 month period. The same incidence (3.6%) of dyskaryotic smears was found using the Ayre spatula (74/2077) as the Aylesbury spatula (72/2003). The incidence of smears with endocervical cells, however, was significantly greater using the Aylesbury (33.4%) than the Ayre (20.4%) spatulas, despite there being no difference in the incidence of smears with epithelial abnormalities. Quantitative studies thus showed that the Aylesbury gave no more accurate results than the Ayre spatula. PMID- 2759606 TI - Labial adhesions after genital herpes infection. AB - A case of genital herpes complicated by persistent labial adhesions is reported. As far as we know, this is the second such complication of genital herpes to be reported from this side of the Atlantic and only the third case documented world wide. PMID- 2759607 TI - Meningovascular syphilis of the spinal cord presenting with incomplete Brown Sequard syndrome: case report. AB - A man aged 31 presented to hospital with acute onset of weakness in the legs, sensory loss, and disturbance of bladder and bowel function. Incomplete Brown Sequard syndrome secondary to meningovascular syphilis of the spinal cord was diagnosed after serological tests for syphilis gave positive results. His condition was probably caused by endarteritis of the arteria radicularis magna of Adamkiewicz. He was treated with procaine penicillin 1.8 MIU intramuscularly once a day and probenecid 0.5 g by mouth three times a day for 21 days followed by physiotherapy and rehabilitation. Considerable neurological recovery was expected. To our knowledge this association has not been reported previously in detail in an English publication. PMID- 2759608 TI - Primary syphilis of the eyelid: case report. AB - Primary syphilis of the palpebral conjunctiva of the lower eyelid is reported because it is rare, which makes its diagnosis difficult but important. PMID- 2759609 TI - Allergic reactions to rubber condoms. AB - With the increased use of condoms, contact dermatitis to rubber is being seen more often. To develop a rubber condom suitable for use by rubber sensitive people, a "hypoallergenic" condom, which is washed in ammonia to reduce the residues of rubber accelerators, has been manufactured. Fifty patients allergic to various rubber accelerators were patch tested with an ordinary condom and the new washed condom. Fifty patients undergoing routine patch test investigation who were not allergic to rubber were also tested as controls. Twenty two of the rubber sensitive patients had a positive reaction to the new rubber condom compared with four of the control patients. Washing rubber condoms in ammonia does not appear to reduce the residues of rubber accelerators sufficiently for their use by rubber sensitive people. A non-allergenic condom is required. PMID- 2759611 TI - Risk factors in the development of cervical intraepithelial neoplasia in women with vulval warts. PMID- 2759610 TI - AIDS prevention: free condoms from an STD clinic in Copenhagen. PMID- 2759612 TI - Low dose oral ofloxacin to treat gonorrhoea in Hong Kong. PMID- 2759613 TI - Severity of urethritis in Reiter's disease. PMID- 2759614 TI - Chlamydial infection: which antibiotic for patients with acute intermittent porphyria? PMID- 2759615 TI - Electron microscopy to differentiate intestinal spirochaetosis from other conditions. PMID- 2759616 TI - Trichomonal vaginitis refractory to conventional treatment. PMID- 2759617 TI - Mystery of the holey prepuce: delayed podophyllin skin damage? PMID- 2759618 TI - Econazole nitrate (150 mg) single dose vaginal pessary compared with clotrimazole (10%) single dose vaginal cream to treat women with vaginal candidiasis. PMID- 2759619 TI - Segregation of the E1j gene for plasma cholinesterase in family studies. AB - Four families are reported in which the E1j gene is segregating. Two E1jE1k and one E1jE1f genotypes have been recognised by genetic analysis. The biochemical characteristics of several E1j genotypes are presented. PMID- 2759620 TI - Genetic genealogical studies of 20 north Swedish families with the rare blood group p. AB - In the county of Vasterbotten in northern Sweden, a large number of individuals with the rare blood group p have been found. The ancestors of all known 31 cases were studied genealogically, and the data showed that about one half of all cases (15 out of 31 in 9 out of 20 families) could be traced to one gene source in the north-eastern part of the county in the middle of the 17th century. In two of the families the parents were first cousins and in three they were second cousins. In the 18th and 17th centuries genealogical connections between the parents were found in another 10 of the families. PMID- 2759621 TI - High frequency of the rapid isoniazid acetylator phenotype in Lagos (Nigeria). AB - The metabolism of isoniazid was investigated in 323 unrelated and healthy Nigerians in Lagos using a simple dosage and urinalysis procedure. The distribution was bimodal and the population frequency of rapid acetylators was 61.92%, a value higher than that for most Caucasian populations. Males and females were equally affected by the traits. Analysis of both the population and pedigree data showed that the slow acetylator phenotype is a recessive trait, and the gene frequency of the recessive allele as computed by maximum likelihood methods is 0.6175 +/- 0.022. The clinical implications of these findings are discussed. PMID- 2759622 TI - Plasma alpha 1B-glycoprotein allele frequencies in Finns and Swedish Lapps: evidence for a new alpha 1B allele. AB - A new allele (A1B*5) of human plasma alpha 1B-glycoprotein (alpha 1B) was reported. alpha 1B phenotyping was done by two-dimensional agarose gel (pH 5.4) horizontal polyacrylamide gel (pH 9.0) electrophoresis followed by protein staining. The alpha 1B phenotypes 1-1, 1-2, 1-5 and 2-2 were observed in Finns and phenotypes 1-1, 1-2, 1-5 and 2-5 in Swedish Lapps. The respective frequencies of A1B*1, A1B*2 and A1B*5 were 0.9575, 0.0350, 0.0075 in Finns and 0.8922, 0.0653, 0.0425 in Swedish Lapps. The Swedish Lapps showed a higher degree of alpha 1B polymorphism (polymorphism information content = 0.19) than other Caucasian populations that have been studied. PMID- 2759623 TI - Erythrocyte enzyme polymorphisms in the Kamboh caste of Patiala, Punjab. AB - Data are presented on six erythrocyte enzyme polymorphisms (ADA, GLO I, EsD, AK, AP, GPI) in the Kamboh, a scheduled caste inhabiting the Patiala district of the Indian state of Punjab. With their high ADA2 (18.5%), Pa (42.5%) and GPI3 (5.3%) and a rather low GLO1 (18.8%) frequencies, the Kamboh differ from all other populations of Punjab. PMID- 2759624 TI - Distribution of Gc subtypes in Aragon (north-east Spain). AB - Group-specific component (Gc) polymorphism was investigated in 559 individuals from Aragon. The gene frequencies were compared to those reported for other European populations. PMID- 2759625 TI - C7 polymorphism in Japanese: new allele C7*8. AB - The polymorphism of C7 was investigated in neuraminidase-treated sera from 513 unrelated Japanese individuals using isoelectric focusing followed by an electroimmunoblotting technique. Besides the common phenotypes 5 rare variants including 2 types of new variants were detected. The family analysis suggested the hereditary occurrence of a new allele C7*8. The allele frequencies were: C7*1 = 0.8314, C7*2 = 0.0926, C7*3 = 0.0380, C7*4 = 0.0331, C7*6 = 0.0010, and C7*8 = 0.0039. PMID- 2759626 TI - Alpha 2 HS-glycoprotein phenotype and allele distribution in continental Italy and Sardinia. AB - The genetic polymorphism of alpha 2 HS-glycoprotein (A2HS) was studied in continental Italy (Rome and L'Aquila) and in Sardinia (Cagliari). The two continental populations did not differ significantly in the A2HS gene distribution, whereas the Sardinian population showed an A2HS*1 frequency significantly higher than in continental Italy. PMID- 2759627 TI - Transferrin C subtype frequencies in the Finnish population. AB - Transferrin (Tf) C subtypes were determined in 419 unrelated adult Finns. The calculated gene frequencies were C1 = 0.738, C2 = 0.097 and C3 = 0.133. The Tf phenotypes in 150 mother-child pairs were in accordance with autosomal codominant inheritance. This material included a rare TfC allele product in three individuals, apparently the same in all cases. PMID- 2759628 TI - Human malic enzyme-2 polymorphism in the GDR. AB - Leukocyte malic enzyme-2 (ME2) phenotypes were studied in 313 blood samples from unselected subjects and in 241 human brain tissue samples (postmortem examinations) from the northern part of the GDR. The ME2(2) frequency was 0.34 and the same in blood and brain samples. The gene frequencies were in agreement with those previously reported for European populations. A study of 71 mother child pairs supported a genetic transmission by two alleles at an autosomal locus. PMID- 2759629 TI - Glutamate-pyruvate transaminase subtypes in Singapore ethnic groups. AB - Autopsy liver samples from 244 Chinese, 119 Malays and 136 Indians were screened for glutamate-pyruvate transaminase (GPT) subtypes by starch-gel electrophoresis and isoelectric focusing at pH 5-7. Altogether, ten phenotypes controlled by four alleles (GPT1, GPT2A, GPT2B and GPT3) were identified. There was no significant difference in the frequency of GPT alleles between the ethnic groups. The distribution of GPT types was in agreement with the Hardy-Weinberg equilibrium in all the ethnic groups. PMID- 2759630 TI - Biochemical variation in the Sunni Muslims of Pulwama district, Jammu and Kashmir. AB - Baseline data are presented on phenotype and gene frequency distributions of nine red-cell enzyme systems (ADA, AK, EsD, GLO I, PGM1, AP, GPI, PGM2, SOD) in the Sunni Muslims of Kashmir valley in the northernmost Indian border state of Jammu and Kashmir. PMID- 2759631 TI - Placental glucose dehydrogenase polymorphism in Japanese. AB - The polymorphism of glucose dehydrogenase (GDH) was investigated in 516 Japanese placentae. The allele frequencies were GDH*1 = 0.510, GDH*2 = 0.488 and GDH*3 = 0.002. GDH*3 appears to increase from Japan via Southeast Asia and India to Europe. PMID- 2759632 TI - Further studies of salivary polymorphisms in the Japanese population. AB - The distributions of the phenotype and gene frequencies of nine polymorphic systems in human parotid and whole saliva were studied in the Japanese population of the eastern part of Japan and compared with those of populations in other areas of Japan and other ethnic groups. The gene frequencies were: Pa+ = 0.214; Pb1 = 1.000; Pr1 = 0.753; Db+ = 0.035; PmF+ = 0.394; Ph+ = 0.028; PIF+ = 0.733; Amy1V = 0.011, and s-AcpA = 0.217. PMID- 2759633 TI - Estimating the error rate in DNA diagnosis with linked markers. AB - Recombination between the marker locus and disease locus introduces a risk of diagnostic error that must be considered when performing indirect diagnosis of monogenic disorders by means of a linked DNA polymorphism or another marker. A method is presented which improves the hitherto used estimates of the magnitude of this error. Principally, it makes use of the fact that recombination between marker and disease locus needs not necessarily increase the error rate; if it occurs twice or several times during the diagnostic process, the final diagnosis may be correct. PMID- 2759634 TI - Serum proteins and erythrocyte enzymes of populations in Iran. AB - The genetic polymorphisms of nine biochemical genetic markers were investigated in four populations (Turks, Kurds, Tehranis and Kermanis) living in the north east and south-east regions of Iran. Only one of the nine loci studied (acid phosphatase) showed significant gene frequency differences and for the C3 system the F allele frequencies in these populations were the lowest ever reported from Iran. PMID- 2759635 TI - C8A and C8B polymorphisms in Norwegians and Norwegian lapps. AB - C8 inheritance patterns in 364 mother-child pairs formed the basis for evaluation of the existence of silent alleles (null alleles) in the genes determining the two known polymorphic C8 systems. While evidence for such alleles was not found in C8A (alpha-gamma complex), two observations of null allele segregation in C8B (beta chain) indicate a C8BQ*0 allele frequency of about 0.07. Two population samples comprising 150 Lappish and 1,264 non-Lappish Norwegians were examined for phenotype distributions in C8A and C8B. The phenotype distributions were mainly in accordance with the expected Hardy-Weinberg distribution. The results for C8A indicated simple, codominant inheritance of two frequent and several rare alleles. Allele frequencies were similar in the two populations. The C8A B gene frequency in Norwegians was significantly lower than that in FRG and higher than that in Negroes. C8B allele frequencies were also calculated from gene counts in the population material, but with due corrections for the C8BQ*0 frequency observed in the mother-child material. PMID- 2759636 TI - HLA antigens among Chinese in Taiwan: association of Cw1 and Cw3 on the same haplotype. AB - HLA-A, B and C phenotypes and gene frequencies of Chinese living in Taiwan are presented. Cw1 and Cw3 were frequently found to segregate together on the same haplotype. PMID- 2759637 TI - Polymorphism of serum proteins (C3, BF, HP and TF) of six populations in Colombia. AB - Five hundred and eighty-five serum samples from six populations in Colombia (Baranoa, Choco, Uitoto Indians, Subachoque, Pasto and Urban Bogotan) were investigated for four genetic markers. For the HP, C3 and BF systems but not for TF there is a wide range of gene frequency variation and these differences are compared with those in the few previous studies. PMID- 2759638 TI - Genetic drift and natural selection in an isolated Zapotec-speaking community in the Valley of Oaxaca, southern Mexico. AB - Genetic drift and natural selection were analyzed in a genetically isolated Zapotec-speaking community in the Valley of Oaxaca, southern Mexico. Moderately intense genetic drift and selection potentials were found. Potential for drift was related to (1) the small effective size of the population, and (2) the exceptionally low number of migrants into the population. Potential for selection was due to (1) an unusually high variance in fertility, and (2) a high contribution of prereproductive mortality. Significant potential for genetic evolution was found due to genetic drift and natural selection. PMID- 2759639 TI - Modified asymmetric T-tube model to infer arterial wave reflection at the aortic root. AB - A modified version of the T-tube model was constructed to represent the systemic arterial loading system as "seen" by the left ventricle (LV). This model consisted of two uniform tubes connected in parallel. It differs from the original T-tube model in that the transmission paths have no frictional losses and are terminated with complex impedances, rather than simple resistors. To estimate model parameters (load and tube compliances, tube inertances, characteristic impedances, and peripheral resistances) we measured ascending aortic pressure and flow in a group of five open-chest, anesthetized dogs. Parameter estimates were obtained by fitting experimental pressure to the pressure predicted by the model from experimental flow. To check the reliability of the model, an additional experiment was performed where flow in the upper descending thoracic aorta was measured in addition to ascending aorta pressure and flow. The fit between the experiment and model predicted ascending aortic pressure was satisfactory in all six dogs. This pressure was always characterized by the presence of a prominent diastolic oscillation. Our model showed that this oscillation is due to reflections from the lower body, the effective reflection site being most probably located at the level of middle to low abdominal aorta. The effective reflection site located in the upper body is closer to the heart. The related reflected wave affects pressure in late systole. PMID- 2759640 TI - Bias and variability of diagnostic spectral parameters extracted from closing sounds produced by bioprosthetic valves implanted in the mitral position. AB - A method is proposed to estimate the bias and variability of eight diagnostic spectral parameters extracted from mitral closing sounds produced by bioprosthetic heart valves. These spectral parameters are: the frequency of the dominant (F1) and second dominant (F2) spectral peaks, the highest frequency of the spectrum found at -3 dB (F-3), -10 dB (F-10) and -20 dB (F-20) below the highest peak, the relative integrated area above -20 dB of the dominant peak (RIA20), the bandwidth at -3 dB of the dominant spectral peak (BW3), and the ratio of F1 divided by BW3 (Q1). The bias and variability of four spectral techniques were obtained by comparing parameters extracted from each technique with the parameters of a spectral "standard." This "standard" consisted of 19 normal mitral sound spectra computed analytically by evaluating the Z transform of a sum of decaying sinusoids on the unit circle. Truncation of the synthesized mitral signals and addition of random noise were used to simulate the physiological characteristics of the closing sounds. Results show that the fast Fourier transform method with rectangular window provides the best estimates of F1 and Q1, that the Steiglitz-McBride method with maximum entropy (pole-zero modeling with four poles and four zeros) can best evaluate F2, F-20, RIA20 and BW3, and that the all-pole modeling with covariance method (16 poles) is best suited to compute F-3. It was also shown that both the all-pole modeling and the Steiglitz-McBride methods can be used to estimate F-10. It is concluded that a single algorithm would not provide the best estimates of all spectral parameters. PMID- 2759641 TI - Tailored versus realistic geometry in the inverse problem of electrocardiography. AB - The stability and applicability of a previously developed inverse procedure for the noninvasive determination of the activation sequence of the human heart has been evaluated. In particular, the possibility of using a standard geometrical configuration representing the heart and the inhomogeneous volume conductor in this procedure has been tested. Results show that in order to obtain reliable inverse solutions, true "tailored" geometry should be used. PMID- 2759642 TI - Orderly stimulation of skeletal muscle 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, motor units conduction velocity, firing rate behavior 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- 2759643 TI - Comparison of finite-difference time-domain SAR calculations with measurements in a heterogeneous model of man. AB - A finite-difference time-domain technique was used to calculate the specific absorption rate (SAR) at various sites in a heterogeneous block model of man. The block model represented a close approximation to a full-scale heterogeneous phantom model. Both models were comprised of a skeleton, brain, lungs, and muscle. Measurements were conducted in the phantom model using an implantable electric-field probe and a computer-controlled data acquisition system. The calculation and measurement of SAR distributions were compared primarily in the head (including the neck) and chest. To obtain the necessary spatial resolution with the computer model, the head and neck were modeled with approximately 105,000 cells, while 86,000 cells were used to configure the chest. Planewave fields, polarized in the E orientation, were utilized to irradiate the models at an exposure frequency of 350 MHz. Reasonable correlation existed between the calculations and measurements. PMID- 2759644 TI - Performance degradation of the coherent averaging technique by a molding effect. AB - In coherent averaging, we show that when temporal alignment is performed by matched filtering, the SNR improvement may reach a stable limit after a certain number of averaged events. The source of this degradation lies in the noise that can be contained in the template of the matched filter. This effect depends on the SNR and the morphology of the signal and it can be reduced by a multipass averaging procedure or by a template updating technique. PMID- 2759645 TI - A simple remote-controlled power switch for internalized bioelectronic instrumentation. AB - This communication presents a remote-controlled power switch for extending the battery life of biomedical instruments implanted into animals or humans. The switching action is controlled externally to the implant by an inductive link between two coils, one contained in the implant and one external to the implant. The external coil sends an electromagnetic pulse to the implant, triggering a CMOS "D" flip-flop connected as a toggle switch--its state is toggled on or off upon receiving the external pulse. The standby current drain of the switch is about 4 nA. The remote triggering range is approximately 20-50 cm. Testing of the switch, surgically implanted as part of a telemetry transmitter, is also discussed. PMID- 2759646 TI - Microcomputer-based interactive tracking of blood cells at biomaterial surfaces. AB - A microcomputer-based system for analyzing the motion of human platelets and leukocytes at synthetic surfaces from a sequence of video frames on tape is described. The software is designed to provide convenient interaction with an operator to reduce the burden of manual analysis. In addition, the system computes and stores the cell movement data on disk for subsequent statistical analysis. Measurement include the number and nature of cell-to-surface collisions, residence times, and distances traveled. PMID- 2759647 TI - Fibrillation induced at powerline current levels. AB - Electrical fibrillation of the human heart results in many unfortunate deaths. Because little information is available on short duration high current fibrillation, current levels below 1 and 50 A were used to induce ventricular fibrillation in hogs. Application times ranged between 16 ms and 3 s. Fibrillation was only produced when currents were applied during the T-wave period of the cardiac cycle. However, only 50 percent of the current application during the T-wave caused fibrillation. The total body resistance of the hogs was also measured at the high voltages and currents. The average resistance for 90 current applications was 284 omega. Trends in the data show that the total resistance decreases for increasing voltage, for increasing electrode size, and for current applications following the first current application. PMID- 2759648 TI - Theoretical quantification of the effects of plastic wall thickness on phantom measurements in electromagnetic hyperthermia. AB - Phantom experiments are a staple of research and development in electromagnetic hyperthermia. Phantom containers and compartments are typically constructed from plastics which are readily available in a wide variety of thicknesses and material compositions. The perturbation effects of these plastics on the electric fields to be measured may be important, especially if one is trying to obtain quantitative results such as when comparing with a numerical model. This communication presents a theoretical investigation into the effects of plastic wall thickness on the computed electric field. Design curves are reported which aid in the selecting of an acceptable wall thickness given a maximum degree of wall perturbation that can be tolerated. Many other materials such as rubbers and polystyrenes also have electrical properties within the ranges considered herein; hence, the results should apply to a variety of commonly used phantom construction materials. PMID- 2759650 TI - [Campylobacter pylori]. PMID- 2759649 TI - Definition and notation of hemoglobin oxygen saturation. AB - Oxygen saturation (SO2) should not be confused with oxyhemoglobin fraction (FHbO2). As automated multiple wavelength photometers may yield both SO2 and FHbO2, care should be taken that only SO2 is used in checking the results of pulse oximeters. Arterial SO2 is the quantity aimed at by pulse oximeters. Although the accuracy of the measurement may be less than that of the analysis of an arterial blood sample in vitro, the measured quantity remains SO2. Using a special symbol, like SpO2, obscures this fact and should be discouraged. PMID- 2759651 TI - [Serodiagnosis of Campylobacter pylori]. AB - The colonization of gastric mucosa with Campylobacter pylori can be detected by serological methods. ELISA and immunoblot methods are currently being employed for detection of antibodies against Campylobacter pylori. In general, both tests will differentiate between Campylobacter pylori positive and Campylobacter pylori negative patients. However, 5-10% of persons with negative cultures for Campylobacter pylori have positive serological tests, but only very few patients with Campylobacter pylori associated with chronic gastritis have negative serological tests. This is true for tests detecting IgG and IgA antibodies. Tests for IgM antibodies have not been found to be useful. Immunoblot analyses have shown that detection of antibodies against a 100-120 KD antigen has a high specificity for Campylobacter pylori infection. In a small study we evaluated the possible use of serological testing for follow-up studies on patients after Campylobacter pylori therapy. We found that patients who became Campylobacter pylori negative after therapy showed a significant decline of serum IgG titers against Campylobacter pylori. PMID- 2759652 TI - [Campylobacter pylori: clinical correlations and prospective comparative studies of various diagnostic techniques]. AB - The diagnostic performance of two different urease tests and of histologic search after modified Giemsa staining to detect Campylobacter pylori (CP) colonization of the upper gastrointestinal tract was prospectively investigated in 215 esophagogastroduodenoscopies, by using a sensitive culture technique as reference. Single antral urease tests had a high specificity of 95-96%, but a limited sensitivity of 78-83%, which increased to 91-94%, when one antral and one additional body biopsy were submitted to the biochemical tests. Giemsa stains were very sensitive, but less specific. The rate of colonization was similar in antrum and body biopsies, and increased with age. There was a close association of Campylobacter pylori colonization with duodenal and to a lower degree with gastric ulcer disease, but especially with gastritic mucosal changes. CP was never detected in patients without gastritis. Therefore, submitting one antral and one body biopsy specimen to validated urease tests represents a sensitive (91 94%) and specific (93%) method to detect Campylobacter pylori colonization, which appears to be a diffuse phenomenon affecting antral and body mucosae with similar frequency. PMID- 2759653 TI - [Prophylaxis in travel (malaria)]. PMID- 2759654 TI - [Prospective, comparative study of a infrared spectroscopic blood culture system (Bactec NR-660)]. AB - The automatic Bactec NR-660 system was compared with a conventional blood culture system - Septi-Check, La Roche (RSC). Out of a total of 962 blood cultures 157 isolates were detected: 123 in RSC and 104 in Bactec 6A. If only clinical relevant strains were considered the isolation rate was nearly equal in both systems, being 75% in RSC and 77% in Bactec 6A, respectively. The RSC-system was more frequently contaminated (3.3% vs 1.0%). Positive blood cultures were detected 12 hrs earlier by the Bactec system. PMID- 2759655 TI - [Circadian rhythm of cellular and humoral immunologic parameters]. AB - From 8 o'clock AM to 6 o'clock PM every two hours in 22 healthy volunteers the following examinations were done: 1. lymphocyte transformation test using the mitogens PHA, Con A and PWM, 2. immunosuppressive activity of the serum on the mitogen-induced lymphocyte transformation, 3. determination of the serum levels of cortisol and human growth hormone (hgH). In the morning the mitogenic lymphocyte transformation was on the lowest and at 4 o'clock PM on the highest level. In opposite to this the immunosuppressive activity of the serum an the serum level of cortisol reached the highest level in the morning and decreased to the minimum at 4 resp. 6 o'clock PM. These findings can be interpreted at least for these parameters in the meaning of a reduced cellular and humoral immunity in the first part of the day, which is confirmed from further results in the literature. PMID- 2759656 TI - Retinoic acid protects Langerhans' cells from the effects of the tumour promotor 12-O-tetradecanoylphorbol 13-acetate. AB - Retinoic acid prevents the decrease in epidermal Langerhans' cell (LC) density which occurs upon application of the tumour promotor 12-O-tetradecanoylphorbol 13 acetate (TPA) to murine skin. This occurred very rapidly, after only 1 week, and was still observed after 4 weeks of treatment. Retinoic acid alone increased the LC density, indicating that it could affect LC density independently of TPA. The induction of a contact sensitivity response which was inhibited by prior treatment with TPA due to the low LC density was also protected by retinoic acid. The anti-carcinogenic activity of retinoic acid is partially the result of its ability to inhibit tumour promotion. The loss of LC may be one of the important steps in tumour promotion as this would allow developing tumours to escape immune destruction. Our studies suggest that the ability of retinoic acid to suppress tumour promotion may be in part by protecting local antigen-presenting cells, thus allowing an immune response to be generated against tumours. PMID- 2759657 TI - Defective hepatic handling of IgA immune aggregates by mice with experimental IgA nephropathy. AB - In an experimental model of IgA nephropathy induced in mice by chronic immunization with dextran, we tested the hypothesis that a defect in the hepatic handling of IgA could be an important determinant in the deposition of IgA in the mesangium. In mice injected with 1-16 doses of 1 mg of dextran (after a preimmunization period of 21 days) the blood clearance of IgA immune aggregates was significantly delayed in relation to control animals, becoming normal at 24 injections. This alteration seems specific since the clearance of IgG aggregates was normal. The percentage of isolated hepatocytes with Fc receptors for IgA decreased significantly over the whole period of dextran immunization. The binding rate of 125I-IgA aggregates to hepatocytes of mice with 24 dextran injections was twice lower than that of control animals. By contrast, the percentage of Kupffer cells with IgA receptors increased over ensuing dextran injections. A progressive increase in the IgA blood levels and in the percentage of mice with mesangial IgA deposits was seen along the period of study. At 24 injections most animals presented moderate to intense mesangial proliferation and abundant electron-dense deposits. On the whole, these data suggest that the early impairment in the liver IgA clearance capacity observed in these animals could facilitate the presence of circulating immune complexes (IC) and their deposition in the mesangium. The increase in serum IgA, seen thereafter, together with the normalization of the IgA clearance capacity, suggest that other pathophysiological mechanism(s) (e.g. in situ IC formation or IgA polymers deposition) must also be involved in this model of experimental IgA nephropathy. PMID- 2759658 TI - Flare-up reaction on murine contact hypersensitivity. I. Description of an experimental model: rechallenge system. AB - In this experiment, a 'rechallenge system' was established in BALB/c mice to study a local immunological reaction of contact hypersensitivity (CH). Briefly, mice were sensitized by a single painting with 25 microliters of 0.5% dinitrofluorobenzene (DNFB) on the shaved back skin on Day 0. On Day 5, they were challenged with 20 microliters of 0.2% DNFB on each left ear, and on Day 33 challenged again with either painting 20 microliters of 0.2% DNFB on their both ears or intravenous administration of 15 mg of dinitrobenzene sulphonic acid (DNBS). As the result, marked ear swelling was observed by the second challenge only on the first challenged site and these responses were clarified to be antigen specific. In in vitro experiments, it was shown that only the cells from the regional lymph node of the skin, which were previously elicited on challenge, were enhanced to proliferate by DNBS, which was added into the culture medium. These results suggest that there is a local immunological mechanism to respond to the specific antigen only on the site in which CH reaction has been elicited previously. The results from this 'rechallenge system' may help to explain some pathological mechanisms of such chronic diseases as fixed drug eruption or chronic contact dermatitis, which recur easily in skin lesions involved previously. PMID- 2759659 TI - The effect of the platelet-activating factor antagonist, BN 52021, on human natural killer cell-mediated cytotoxicity. AB - The influence of the platelet-activating factor (PAF) antagonist, BN 52021, on human natural killer (NK) cell cytotoxicity against K 562 target cells was determined. Cytotoxicity was measured by a short-term (4 hr) 51Cr-release assay. The cytotoxicity was significantly reduced in the presence of PAF antagonist at concentrations from 30 to 120 microM. This reduction of killing was not due to the impairment of binding of effector cells to target cells. Pretreatment of K 562 target cells with the PAF antagonist led to a greater inhibition of NK cell cytotoxicity compared with that observed when the effector cells were preincubated with BN 52021. Thus, the inhibition of cytotoxicity appears to be due to an effect of BN 52021 on target cells rather than on lymphocytes. Furthermore, the increase in NK activity induced by interferon was less pronounced when BN 52021 was added in the incubation medium. The natural cytotoxicity of platelet-depleted or large granular lymphocyte-enriched effector cell populations was inhibited by the PAF antagonist in a similar manner. The effect of BN 52021 appears to be related to its specific PAF antagonistic activity since a similar action on NK cells was noted with two other structurally unrelated PAF antagonists, BN 52111 and WEB 2086. In contrast, Ginkgolide J (BN 52024), which is structurally related to BN 52021 but lacks PAF antagonistic activity, was ineffective in inhibiting NK cell cytotoxicity. Finally, synthetic PAF induces a dose-dependent cytotoxic action on K 562 cells and this effect of the autacoid is inhibited by BN 52021. These observations provide indirect evidence that PAF could play a role in the mechanism(s) of NK cytotoxity. PMID- 2759660 TI - Hereford cattle protected against Boophilus microplus with antigens purified by immunoaffinity chromatography from larval and adult ticks. AB - Tick larvae (Boophilus microplus) were extracted, fractionated by gel filtration and ion-exchange chromatography, and the fractions assayed by enzyme-linked immunosorbent assay (ELISA) against sera from cattle immunized and protected by antigens from the mid-gut of adult ticks. Unfractionated, whole larval extracts and selected reactive components were used to vaccinate cattle; they decreased the number of ticks dropped after challenge, but the effect of treatment was not significant. Antigens purified from crude larval extracts by affinity chromatography, using immunoglobulin ligands from an immune steer vaccinated with tick mid-gut antigens, also failed to protect cattle. However, tick extracts from both larval and adult ticks, which were first separated into membrane-associated and soluble fractions and then purified by exposure to the affinity ligands, protected cattle greater than 80% against subsequent challenge with ticks. PMID- 2759661 TI - Local oral immunization with synthetic peptides induces a dual mucosal IgG and salivary IgA antibody response and prevents colonization of Streptococcus mutans. AB - A small cell surface antigen of Streptococcus mutans was partially sequenced and the amino terminal peptides of 11, 15 and 20 amino acid residues and a dimer of the 15 and 20 residues peptides were synthesized. The synthetic peptides (SP) were used in topical oral immunization of the gingivomucosal epithelium of macaque monkeys. Sequential examination for antibodies over a period of up to 30 weeks revealed that six applications of the linear or cyclized SP11 and a random SP11 induced negligible or very low antibody levels. In contrast, the SP17 (SP15 with added cysteine at each terminus), SP21 (SP20 with one cysteine) and the dimer (SP35) induced significant anti-SP as well as anti-native streptococcal antibodies in the gingival fluid and in saliva. The functional significance of this immune response was examined by studying its effect on oral colonization of S. mutans following feeding of a carbohydrate-rich diet. Whereas control animals, sham-immunized with a random SP of 11 residues, showed increased colonization of the teeth by S. mutans, there was no colonization or a significant reduction in colonization of animals immunized with the cyclized SP17, linear SP21 or dimerized SP35. These experiments suggest that local immunization with SP derived from the sequences of a streptococcal cell surface antigen induce a dual local immune response of gingival IgG and salivary IgA antibodies against the SP and native SA. These antibodies may be involved in preventing colonization of S. mutans, which is the principal agent in the development of dental caries. PMID- 2759662 TI - The kinetics of oral hyposensitization to a protein antigen are determined by immune status and the timing, dose and frequency of antigen administration. AB - We have investigated the immunological consequences of feeding a protein antigen to previously immunized animals. BALB/c mice were systemically primed with ovalbumin (OVA) in complete Freund's adjuvant (CFA) and fed with high (10 mg/g body weight), medium (1 mg/g body weight) or low (1 microgram/g body weight) doses of OVA once (Day 1, 7 or 14) or sequentially for 5 days (Days 1-5, 7-11, 14 18). The specific IgG antibody response was suppressed only by early feeds of high-dose OVA (Days 1-5). Medium-dose OVA fed on Day 14 or low-dose OVA fed at any stage after immunization enhanced the IgG antibody response. In contradistinction, systemic delayed-type hypersensitivity responses (DTH) were usually suppressed by early feeds of high or medium doses of OVA but never after feeding low-dose OVA. The results suggest that systemic DTH and IgG antibody responses to oral antigen are subject to different control mechanisms in previously primed animals. Such responses depend on the immune status of the animal and are controlled by antigen dose, time and frequency of feeding. The immunological effects observed are also demonstrable following adoptive transfer of spleen cells collected 14 days after multiple feeds of high-dose OVA to immunized mice. Our findings suggest that oral hyposensitization after systemic immunization is regulated by (suppressor) spleen cells which are activated by gut processed antigen. PMID- 2759663 TI - Molecular characterization of four intra-t mouse recombinants. AB - Recombination in the proximal region of mouse chromosome 17 is greatly reduced in heterozygotes carrying the wild-type and the t complex-type chromosomes. The reason for this is the presence of two non-overlapping inversions in the t complex. Rare crossing-over does, however, occur within the t complex of the t/+ heterozygotes. Here we characterize four such exceptional intra-t recombinants, tTu1 through tTu4. To map the positions of the genetic exchange in these four recombinants, we analyzed them with DNA probes specific for 16 loci distributed over the t complex. The analysis revealed that in three of the four recombinants, an equal crossing-over occurred in the short region between the two inversions, producing chromosomes carrying either the proximal inversion only (tTu1 and tTu4) or the distal inversion only (tTu2). In the fourth recombinant (tTu3), unequal crossing-over occurred within the proximal inversion between loci D17Leh119 and D17Leh66, producing a chromosome in which the region containing loci Tcp-1, T, and D17Tu5 has been duplicated. The duplication of the Brachyury locus leads to the suppression of the tail-shortening effect normally produced by the interaction of the dominant (T) and recessive (tct) alleles at this locus so that the T/tTu3 mice have normal tails. PMID- 2759664 TI - Antigenic properties of 36 new H-2 congenic strains and 4 independently derived strains, W10LT, DDD, BZH, and FM. PMID- 2759666 TI - Synergistic anticonvulsant action of diazepam & clonazepam with amino-oxyacetic acid against isoniazid-induced convulsions in rats. AB - The protective effect of two benzodiazepine compounds, diazepam and clonazepam was tested against isoniazid (INH)- induced convulsions in rats pretreated with the gamma-amino-butyric acid (GABA) transaminase inhibitor viz., aminooxyacetic acid (AOAA), and the result was compared with that produced by the two drugs independently. Rats treated 6 h and not 30 min previously with AOAA showed a dose dependent inhibition of INH-induced convulsions. In these animals both diazepam and clonazepam showed a greater protective effect than that produced by them alone. It is suggested from these findings that, even if their anticonvulsant mechanisms are distinct, with or without the involvement of GABA, AOAA and the benzodiazepine compounds seem to act synergistically against INH-induced convulsions. PMID- 2759665 TI - A rabbit class II MHC gene with strong similarities to HLA-DRA. PMID- 2759667 TI - Morphine-like activity of substituted amides & imides of [D-Ala2, Met5] enkephalin. AB - Six enkephalin analogues (N-substituted amides and imides of [D-Ala2, Met5] enkephalin) were synthesized and tested for opioid activity. All the compounds, except one i.e., compound IV, showed analgesic activity which was much higher than Met-enkephalin and morphine in mice and inhibited electrically induced contractions of isolated guineapig ileum, [D-Ala2, Met5]-enkephalin-morpholide and [D-Ala2, Met5]-enkephalin-beta-Ala-amide were the most potent analgesics and nearly 6 and 500 times as active as morphine and Met-enkephalin respectively. Both the compounds were equipotent on the guineapig ileum preparation, whereas the beta-Ala-amide was about twice as active as the morpholide in the electrically stimulated mouse vas deferens preparation. PMID- 2759668 TI - Alterations in testicular functions in patients of scrotal hydrocele. AB - Forty three randomly selected patients of scrotal hydrocele were investigated for alterations in functions of the testes. FSH and LH levels were raised in 50 and 75 per cent of patients respectively whereas testosterone level was found subnormal in 14 of the 28 patients in whom hormone profile was studied. LH and FSH levels also showed some relation with duration and size of the hydrocele. Similarly, sperm concentration and their motility was found affected by the duration of the disease. PMID- 2759669 TI - An in vitro assessment of the genotoxic potential of pan masalas. AB - An aqueous extract of pan masala was tested for its in vitro effects on Chinese hamster ovary (CHO) cells by utilizing parameters like sister chromatid exchange (SCE), cellular kinetics and chromosome aberration (CA) assay. The cytogenetic damage brought about by the extract was dose dependent. The increase in SCE values was highly significant (P less than 0.001) for all the three concentrations tested. The treatment delayed the cell cycle progression. Frequencies of chromosome aberrations were elevated for all the concentrations utilized, however, a significant rise was obtained only at the highest concentration of 50 microliters/ml. PMID- 2759670 TI - The role of fine needle aspiration cytology of breast lumps in the management of patients. AB - The accuracy of diagnosis with fine needle aspiration cytology (FNAC) was assessed in 3230 patients with breast lumps between 1978 and 1986. The results for sensitivity, specificity, positive predictive value and negative predictive value were 97.6, 99.4, 99.5 and 97.2 per cent respectively; the overall accuracy was 98.4 per cent. Results reveal that a positive cytologic report by an experienced cytopathologist need not wait for histologic confirmation and the patient can be given definitive treatment based on the cytology report. PMID- 2759671 TI - Immunological cross reactivity & paraspecificity of the scorpion Heterometrus bengalensis antivenom. AB - Immunological cross-reactivity and paraspecificity of scorpion H. bengalensis antivenom were studied to find out the intergeneric therapeutic relationship between the venom of other scorpions in West Bengal Buthus tamulus, Lychas laevifrons and Heterometrus swammerdami. Of these scorpions, Buthus tamulus and Lychas laevifrons failed to show any cross reactivity. However, H. swammerdami venom showed cross-reactivity with H. bengalensis antiserum as revealed from immunogeldiffusion and immunoelectrophoresis. This antiserum protected H. swammerdami venom-induced lethality in mice, blocked the contractile response in smooth muscles and antagonised the venom-induced neuromuscular blockade in rat phrenic nerve diaphragm and chick biventer cervicis. PMID- 2759672 TI - Effect of capsaicin on triglyceride accumulation & secretion in ethanol fed rats. AB - Rats fed capsaicin (0.15, 1.5 and 15 mg%) containing diets were able to counter by about 30 per cent of the hepatic lipid accumulation caused by a single dose administration of ethanol (6 g/kg body weight). The rate of triglyceride secretion in capsaicin fed animals from liver to plasma was also elevated as judged by Triton WR-1339 induced hypertriglyceridemia. The results suggest a possible mechanism by which capsaicin counters ethanol induced hepatic lipid accumulation in rats. PMID- 2759673 TI - Preliminary findings on skin conductance measures in schizophrenics & normal individuals in India. AB - Skin conductance measures were investigated during response paradigms, in 18 non medicated schizophrenics and 22 normal individuals. Basal, tonic and phasic skin conductance indices were studied in four experimental series consisting of auditory and visual stimuli differing in signal status. No differences were seen in skin conductance basal levels, tonic levels, phasic response or in the incidence of nonresponse in schizophrenics as compared to normal individuals. PMID- 2759674 TI - Thermosensitivity, a possible new locus involved in genetic hypertension. AB - Spontaneously hypertensive mice have been characterized as more sensitive to environmental heat than normotensive mice. A breeding program was therefore initiated to examine the possible genetic link between thermosensitivity and hypertension. Crossbreeding of spontaneously hypertensive mice with randomly bred normotensive mice produced F1 hybrids, which were then intercrossed to create a F2 population. Thermosensitivity was measured with a noninvasive method. The rate of body temperature increase was significantly (p less than 0.001) higher in the hypertensive mice (1.74 +/- 0.04 degrees C/min) compared with normal controls (1.13 +/- 0.03 degrees C/min). The frequency distribution of the rate of body temperature increase among the progenies was consistent with the hypothesis that a single gene locus determines the observed difference in thermosensitivity between normal and hypertensive mice. The allele that determines the rate of body temperature increase in normal mice was dominant in relation to the allele contributed by hypertensive mice. In the F2 population, a bimodal distribution determined two phenotypes: less than 1.40 degrees C/min and greater than 1.40 degrees C/min. A significant difference (p less than 0.01) in blood pressure of 11 mm Hg was observed between these two phenotypes. In addition, a positive correlation (p less than 0.01) was noted between the rate of body temperature increase and blood pressure in the F2 progeny. We conclude that there is possibly a single locus controlling thermosensitivity, which exhibits additive-dominance inheritance. Alleles of this particular trait segregate in part with an increment in blood pressure. The results support the possibility that the increased thermosensitivity seen in hypertensive mice is associated with one of the genes that contributes to their high blood pressure. PMID- 2759675 TI - Aortic compliance in human hypertension. AB - Aortic compliance in normotensive and hypertensive Chinese subjects undergoing diagnostic cardiac catheterization was compared by using a newly described method that allows for determination of the pressure dependence of compliance if one assumes a value for the exponential coefficient of the pressure-volume relation of the large arteries. Under baseline conditions in the normotensive and hypertensive groups at mean aortic pressures of 96.3 and 128.6 mm Hg, aortic compliance averaged 1.47 and 0.80 ml/mm Hg, respectively. Compliance in the hypertensive group at a diastolic pressure of 99.4 mm Hg (which was nearly equal to the mean normotensive pressure) was 1.072 ml/mm Hg--still significantly lower than in the normotensive group. During nitroprusside infusion, however, the compliances in the hypertensive group increased to levels equal to or greater those in the normotensive group. Thus, these data confirm that aortic compliance is lower in hypertensive than in normotensive humans. They further demonstrate that the lower compliance cannot be attributed entirely to the elevated blood pressure, suggesting that excess smooth muscle tone may be partly responsible. PMID- 2759676 TI - Intracellular vascular muscle Ca2+ modulation in genetic hypertension. AB - Distribution of intracellular free calcium concentration (Ca2+) was compared in spontaneously hypertensive rat (SHR) and Wistar-Kyoto (WKY) rat isolated vascular muscle cells at rest and during stimulation by K+ with Ca2+ agonist or antagonist. Ca2+ activity was quantitated at each point within vascular muscle cells loaded with fura-2 at fluorescence excitation wavelengths of 340, 360, and 380 nm, and fluorescence emission at 510 nm (all filters were +/- 5 nm) quantitated by a digital photon-counting camera. Measurements of fluorescence intensity ratio in central and subsarcolemmal areas showed that calcium release, in response to 30 or 100 mM K+ with Ca2+ agonist or during spontaneous contractions, was principally from sarcoplasmic reticulum. Addition of the Ca2+ agonist Sdz 202-791, S (+) stereoisomer (SdzS), caused a dose-dependent increase of Ca2+ in both SHR and WKY rats. Intracellular calcium release sites were defined by "hot spots" of high fluorescence intensity ratio in both central and peripheral regions of the sarcoplasm. The size and intensity of hot spots increased, and there was an initial transient activation of subsarcolemmal calcium pools in response to high K+ with 1 microM Ca2+ agonist. In contrast, treatment of the cells with the R (-) stereoisomer of Sdz 202-791 (SdzR), a Ca2+ antagonist, prevented the increase in Ca2+ and the increase in hot spot size by either K+ alone or with agonist. Antagonist decreased central core Ca2+ release and fragmented the subsarcolemmal hot spots.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2759677 TI - Calcium binding capacity of erythrocyte membrane in human hypertension. AB - The cell membrane calcium binding capacity of genetically hypertensive rats is reduced when measured in the presence of the submicromolar calcium concentrations proper of intracellular environment. The present work, performed as an ancillary study to an epidemiological survey on an entire population, aimed to investigate the existence of a similar abnormality in human hypertension. Calcium binding to the erythrocyte membrane was measured in clinically healthy normotensive (n = 12) and hypertensive individuals (n = 24). For this purpose, a filtration technique was used, based on the determination of 45Ca bound to the erythrocyte membrane in the presence of free calcium concentrations (40 nmol/l and 1 mumol/l), which are similar to those of the intracellular environment. The intra-assay technical error was determined on 35 duplicate samples and, when expressed as percent of the mean, was 24.1 at the 40 nmol/l concentration and 16.8 at the 1 mumol/l concentration. Membranes of untreated hypertensive patients, at both calcium concentrations, bound significantly less calcium than the control group. Treated and untreated hypertensive individuals had comparable values of membrane calcium binding capacity. Membranes of the treated hypertensive group bound less calcium than those of the normotensive group at both calcium concentrations, but the difference was statistically significant only in the presence of 40 nmol/l free calcium. A significant positive correlation was observed between the calcium binding capacity at 40 nmol/l concentration and that at 1 mumol/l in the treated and untreated hypertensive groups (r = 0.73 and 0.75, respectively; 0.51 for the normotensive group). These findings support the hypothesis that a cell membrane abnormality is detectable in some hypertensive patients.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2759678 TI - Elevated sympathetic nerve activity in borderline hypertensive humans. Evidence from direct intraneural recordings. AB - Reports of elevated plasma catecholamine levels and augmented responses to autonomic blockade suggest increased sympathetic tone in borderline hypertension. It is not known if this reflects greater sympathetic neural outflow. We directly recorded muscle sympathetic nerve activity (microneurography) in 15 normotensive and 12 borderline hypertensive age-matched men to determine whether borderline hypertensive individuals have elevated sympathetic nerve activity. Supine heart rate, blood pressure, plasma norepinephrine, and efferent muscle sympathetic nerve activity (peroneal nerve) were measured after 6 days of both low and high dietary sodium intake (10 and 400 meq sodium/24 hr). Sympathetic nerve activity was elevated significantly in borderline hypertensive individuals on both low (37 +/- 1 in borderline hypertensive individuals vs. 29 +/- 1 bursts/min in normotensive individuals; p less than 0.01) and high (25 + 1 in borderline hypertensive individuals vs. 16 +/- 1 bursts/min in normotensive individuals; p less than 0.01) sodium diets. The borderline hypertensive group had higher systolic (p less than 0.01) and diastolic (p less than 0.05) blood pressures independent of sodium intake. Across both groups, high sodium intake reduced muscle sympathetic nerve activity (p less than 0.001), plasma norepinephrine (p less than 0.001), diastolic blood pressure (p less than 0.02), heart rate (p less than 0.002), and increased weight (p less than 0.005). A significant (p less than 0.05) group-by-diet interaction was observed for plasma norepinephrine levels. Specifically, compared with the normotensive group, plasma norepinephrine levels in the borderline hypertensive group tended to be higher on low sodium diet (p = 0.08) and lower on high sodium diet (p = 0.23).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2759679 TI - Influence of hypertension on aortic atherosclerosis in the Watanabe rabbit. AB - The effects of one-kidney, one clip Goldblatt hypertension on aortic atherosclerosis have been studied in the Watanabe heritable hyperlipidemic (WHHL) rabbit. Renovascular surgery was performed on WHHL rabbits at 3 months of age, and the rabbits were followed for periods of 3-6 months. Aortic atherosclerosis was assessed by measurement of intimal surface involvement with atherosclerotic lesions, determination of aortic free and ester cholesterol content, and microscopic examination. Systolic blood pressure increased by approximately 40-60 mm Hg in the renovascular surgical group as compared with the sham-operated group, but body weight, heart rate, serum cholesterol, and serum triglyceride were unaffected. Aortic atherosclerosis was increased in the hypertensive rabbits, even after 2-3 months of hypertension. At 3 months after renovascular surgery, the aortic surface area covered by atherosclerotic disease averaged 77 +/- 4.4% in hypertensive as compared with 16 +/- 3.3 in control rabbits. At 6 months after surgery, the values were 62 +/- 8.2% and 30 +/- 5.3% in the hypertensive and control rabbits, respectively. The differences in surface involvement and cholesterol content as a result of hypertension were particularly prominent in the descending thoracic aorta. Atherosclerotic lesions in the descending thoracic and abdominal aortic regions of normotensive WHHL rabbits were localized primarily to the ostia of branch vessels, but in the hypertensive rabbits, the involvement was typically very diffuse. No major differences in the nature of atherosclerotic lesions of comparable size were apparent by light microscopy. The results indicate that hypertension accelerates atherogenesis in the WHHL rabbit and suggest that this model may be valuable for studying the mechanisms by which such acceleration is induced. PMID- 2759680 TI - Smoking accounts for adverse effect of antihypertensive medications on plasma lipids. A population-based study. AB - Mean plasma levels of total cholesterol, high density lipoprotein cholesterol, total-to-high density lipoprotein cholesterol ratio, and total triglycerides were determined in a representative sample of the adult Israeli Jewish population, excluding known diabetics and individuals with overt atherosclerotic morbidity (n = 1,153). Levels were compared in normotensive and untreated and treated hypertensive individuals by glucose tolerance category and smoking, after adjustment for sex, age, and body mass index. In the presence of normal glucose tolerance, lipid levels in the nonsmoking normotensive and treated hypertensive groups were similar, whereas in the smoking, treated hypertensive group, lipids were significantly affected, as indicated by the respective adjusted mean levels (mg/dl): total cholesterol, 219, 221, and 240; high density lipoprotein cholesterol, 45.0, 43.6, and 42.0; ratio, 5.2, 5.3, and 6.0; and triglycerides, 114, 107, and 144. In individuals with glucose intolerance, trends were the same with the exception of triglycerides, which were significantly elevated in the nonsmoking, treated hypertensive group also; the respective values were 217, 225, and 257 for total cholesterol; 45.1, 44.9, and 41.4 for high density lipoprotein cholesterol; 5.2, 5.5, and 6.8 for the ratio; and 133, 152, and 187 for triglycerides. Lipid disturbances in treated smokers were not due to heavier smoking or differences in dietary intake. We conclude that disturbance of plasma lipid profile in treated hypertensive individuals may be mainly due to an interaction with smoking, with an additional effect of glucose intolerance. PMID- 2759681 TI - Ethnic differences in blood pressure, pulse rate, and related characteristics in young adults. The CARDIA study. AB - This study examined ethnic differences in blood pressure and pulse rate in young adults to see whether the differences, if they exist, can be explained by differences in body mass index, lifestyle, psychological, and socioeconomic characteristics. Data used were from the baseline examination of the Coronary Artery Risk Development in (Young) Adults Study (CARDIA). CARDIA is a longitudinal study of lifestyle and evolution of cardiovascular disease risk factors in 5,116 young adults, black and white, men and women, aged 18-30 years, of varying socioeconomic status. Young black adults had higher mean systolic blood pressure and slightly higher mean diastolic blood pressure than young white adults. For both men and women, the blood pressure differences between blacks and whites tended to be greater for the age group 25-30 than for the age group 18-24 years. Among the variables studied, body mass index, duration of exercise on the treadmill, number of cigarettes smoked per day, and number of alcoholic drinks per week were consistently associated with blood pressure. The blood pressure differences were greatly reduced after adjusting for these variables. Black participants had lower mean pulse rate than white participants. The differences tended to be greater for the age group 18-24 than for the age group 25-30 years. Among the variables studied, only duration on treadmill and number of cigarettes smoked per day were consistently correlated with pulse rate. With adjustment for duration on treadmill, the differences in pulse rate increased. These results suggest that differences in ethnic pattern of blood pressures and pulse rate with age may be due in part to obesity, physical fitness, alcohol consumption, and cigarette smoking. PMID- 2759682 TI - Activation and release of enzymes and major basic protein from guinea pig eosinophil granulocytes induced by different inflammatory stimuli and other substances. A histochemical, biochemical, and electron microscopic study. AB - In order to investigate the availability and release of enzymes from eosinophilic granulocytes in response to a variety of stimuli, guinea pig peritoneal eosinophils were obtained after repeated intraperitoneal injections of freeze dried Trichinella spiralis larvae. The activities of the enzymes peroxidase, arylsulfatase B, beta-glucuronidase, aminopeptidase, histaminase, cytochrome c oxidase, acid phosphatase, adenosine triphosphatase and glucose 6-phosphatase, and the major basic protein (MBP) were studied histochemically and, in part, also biochemically. Eosinophils were incubated with the following substances: histamine, platelet activating factor, calcium ionophore, compound 48/80, leukotriene B4, prostaglandins E1, and E2, heparin, and eosinophil-chemotactic factors from neutrophils and lymphocytes. Eosinophils displayed a selective and stimulus-dependent enzyme and MBP reaction. Calcium ionophore and compound 48/80 provoked a release of cytotoxic major basic protein, partly associated with peroxidase release, while leukotriene B4 and eosinophil chemotactic factors caused histaminase and peroxidase release and activated leucinaminopeptidase. Heparin and calcium ionophore induced release of both MBP and histaminase. These data support the concept that eosinophils exhibit either inflammatory or cytotoxic, or antiinflammatory properties upon stimulation by various agents. PMID- 2759683 TI - Influence of monoclonal IgM cold agglutinins on adhesiveness, phagocytosis, and bactericidal activity on human granulocytes and monocytes. AB - Monoclonal IgM cold agglutinins (CA) bind and, in the presence of complement, are cytotoxic to various mammalian cells. The impact of these autoantibodies on functional capacity of phagocytes has not been studied until now. Herein we report that sera with monoclonal IgM anti-I and anti-i CA significantly reduce adhesiveness, phagocytosis, phagocytic index, and intracellular bactericidal activity of human peripheral blood polymorphonuclear cells (PMNs) at 37 degrees C and 24 degrees C. Anti-i CA were more active than anti-I. Sera with monoclonal IgMs without CA activity reduced the total number of ingested bacteria but otherwise had no effect on phagocytic functions. There was no difference in the degree of inhibition when anti-i and anti-I CA were tested against cord, maternal, and adult PMNs. Chromatographically purified a-I and a-i CA inhibited markedly phagocytosis in concentrations as low as 1 mg/ml. Phagocytic activity of peripheral blood monocytes was inhibited by CA at 18 degrees C but not at 24 degrees C or 37 degrees C. Pepsin digestion or reduction and alkylation of chromatographically pure IgM CA abolished completely their inhibitory activity. Thus, in physiological temperatures, monoclonal IgM cold agglutinins impair various phagocytic functions of human phagocytes. It may add to the susceptibility to infections in patients in which such autoantibodies are synthesized. PMID- 2759684 TI - Clinical signs of acute ocular inflammatory response to endotoxin are not altered by increasing antioxidant potency of intraocular fluids. AB - Plasma antioxidant activity is due in large part to the ferroxidase activity of the copper (Cu) transport protein, ceruloplasmin. Implantation of osmotic pumps containing copper into rabbits resulted in a doubling of Cu concentration, ferroxidase activity, and antioxidant activity in plasma. Blood-ocular barriers essentially prevent the entry of large molecules such as proteins from plasma into the intraocular fluid compartments. However, during ocular inflammation, when these barriers are disrupted, plasma proteins can enter. Twenty-four hours after the induction of ocular inflammation by intraocular injection of endotoxin, the Cu concentration and antioxidant activity of intraocular fluids from the Cu pump animals was twice that of control groups, reflecting the differences in plasma levels. This is the first direct demonstration that alterations in plasma levels of ceruloplasmin can influence the antioxidant potency of the extracellular fluids. Increased intraocular fluid antioxidant activity did not affect the acute anterior segment response to endotoxin. However, it is possible that the time course and resolution of the response is altered by changes in extracellular fluid antioxidant activity. This possibility is currently under investigation. PMID- 2759685 TI - Influence of acute pulmonary interstitial inflammation on kinetics of phagocytosis by alveolar macrophages. AB - The pulmonary alveolar macrophage (PAM) is central to lung cellular defenses and is a potential participant in lung injury, but little is known about the influence of the nature and anatomic pattern of acute lung injury on PAM function. To assess the relationship between ongoing pulmonary inflammation and PAM function, we evaluated PAM phagocytic kinetics in a model system of experimental interstitial adjuvant pneumonitis (EIAP) in calves. PAMs were obtained from lung one and seven days postinduction (dpi) of EIAP. Lesions were typical of EIAP, characterized by acute multifocal to coalescing exudative interstitial pneumonitis at 1 dpi, which progressed to granulomatous interstitial pneumonitis by 7 dpi. The total recoverable lung cells and percentage of neutrophils (PMNs) were elevated (P less than 0.01) from animals with EIAP at both 1 and 7 dpi, and there was a four-fold increase (P less than 0.01) in the PAM yield by 7 dpi. Linear regression equations revealed that a larger proportion of control PAMs were phagocytic than were PAMs from animals with EIAP. The mean initial phagocytic rates of PAM following acute lung injury were significantly elevated (P less than 0.05) over controls; this difference was concentration dependent and required a phagocytic bead stimulus concentration in excess of 12.5 x 10(6) beads/ml. PAMs from animals with EIAP had a greater maximum rate of phagocytosis (Vmax) and Km than control PAMs. PAMs from animals with EIAP had a slightly higher proportion of cells which phagocytosed multiple beads. Levels of beta-glucuronidase were elevated (P less than 0.02) in PAM from animals with EIAP at 7 dpi. The results document enhanced PAM phagocytic function in EIAP and differ from our previous experiments in which depressed PAM phagocytic indices were obtained in a model of virus-induced acute bronchiolitis and alveolitis. The functional activities of the PAMs thus appear to be modified by injury-specific events in the lung microenvironment which may, in part, reflect the nature and anatomic pattern of developing pulmonary inflammatory reactions. PMID- 2759686 TI - Effects of products from inflammatory pulmonary neutrophils on alveolar macrophage chemotaxis, spreading, and thymidine incorporation. AB - Since macrophages and neutrophils are found together in the alveolar region of the lung during alveolar inflammation, we assessed whether neutrophil products could influence three key functions of alveolar macrophages: chemotaxis, spreading, and thymidine incorporation. Neutrophils were obtained from the lungs of rats treated by intratracheal instillation of heat-killed Corynebacterium parvum and cultured overnight, alone or in the presence of zymosan, PMA, an inert particulate (titanium dioxide), or a toxic dust, (quartz). Supernatants were collected from these cells and a lysate, obtained by freeze-thawing neutrophils, was also used. Neutrophil supernatants caused a slight reduction in chemotaxis and a significant loss of ability to spread on glass which varied depending on the in vitro treatment of the neutrophils. In addition neutrophil supernatants also had a substantial effect in stimulating uptake of thymidine which was, once again, very dependent on the treatment of the neutrophils during preparation of the supernatants, with unstimulated and TiO2-treated neutrophils producing maximum stimulation. The increases in thymidine uptake were not matched by increased proliferation, suggesting that another signal may be necessary for expanison of alveolar macrophage numbers during alveolar inflammation. PMID- 2759687 TI - Relationship between intracellularly and extracellularly generated oxygen metabolites from primed polymorphonuclear leukocytes differs from that obtained from nonprimed cells. AB - The ability of primed human polymorphonuclear leukocytes (PMNLs) to respond metabolically to stimulation with formylmethionyl-leucyl-phenylalanine (FMLP) was investigated. Cells isolated from an aseptic inflammatory reaction and from patients with a severe bacterial infection as well as cells that had been treated with a bacterial lipopolysaccharide were investigated. When these cells were compared to peripheral blood cells isolated from healthy controls, they were found to be metabolically primed, i.e., the cells gave rise to an increased chemiluminescence response to subsequent stimulation with the peptide. It was also shown that proportionally more of the activity generated from the primed PMNL was of an intracellular origin compared with that obtained from nonprimed cells. The biological effects induced by radicals produced extracellularly and intracellularly are discussed. PMID- 2759688 TI - Formation and use of poly-L-histidine-catalase complexes: protection of cells from hydrogen peroxide-mediated injury. AB - Insoluble complexes of poly-L-histidine (polyhistidine) and catalase were prepared by mixing the two reactants together in solution at pH 5.5 and subsequently elevating the pH to approximately 7.0, at which point they precipitated. Complexes formed at optimal ratios of polyhistidine to catalase contained essentially all of the catalase present in the original solution. The catalase present in such complexes contained greater than 50% of the H2O2 inhibiting activity of the native catalase used to prepare the complexes. The insoluble complexes rapidly bound to viable endothelial cells and were resistant to removal by extensive washing. The presence of polyhistidine-catalase complexes on the cell surface protected the cells against injury mediated by H2O2 or activated polymorphonuclear leukocytes. These data show that polyhistidine catalase complexes can be prepared that have a high affinity for cells and that retain catalase activity. These complexes may be useful in treating inflammatory conditions in which it is necessary to maintain a high local concentration of inhibitor. PMID- 2759689 TI - Spoon vs bottle: a controlled evaluation of milk feeding in young infants. AB - Fifty infants under the age of six months who were on artificial milk and who had attended the hospital for diarrhea, were taken up for study. They were divided into two groups. In Group I (n = 25) infants were given milk by spoon and in Group II (n = 25) by bottle. Mothers were given education relevant to the method of feeding on an individual basis. Follow up over a period of 3 months showed a fall in the number of diarrheal episodes which was similar in the two groups. Maternal compliance was significantly better in the bottle-fed group where only one mother expressed a desire to change over to the use of cup and spoon. The weight gain was better in the bottle-fed group, the difference being statistically significant relevant to the weight gain in the second and third month and to the total weight gain in the three months period (t = 3.24, p less than 0.01; t = 2.03 p less than 0.05; and t = 2.24, p less than 0.05, respectively). PMID- 2759690 TI - Thigh circumference at birth as the best predictor of low birth weight babies. AB - The present study was undertaken to find out the best simple anthropometric parameter for identifying low birth weight babies (LBW). A total of 1000 newborn babies were subjected to anthropometry within 48 hours of life. Birth weight was significantly correlated (p less than 0.001) with thigh circumference (TC), mid arm circumference (MAC), chest circumference (CC), length (L) and head circumference (HC). However, the correlation was maximum for TC (r = 0.9201). All anthropometric indicators had a statistically significant sensitivity, specificity and predictive value (p less than 0.001) for identifying less than or equal to 2500 g birth weight babies. However, thigh circumference of less than or equal to 14.5 cm and less than or equal to 13.5 cm had the best sensitivity, specificity and predictive value for identifying babies with birth weight of less than or equal to 2500 g and less than or equal to 2000 g, respectively. TC at birth is a cheap, simple, quick and reliable indicator for predicting LBW babies. It may be used whenever weighing at birth is not feasible. PMID- 2759691 TI - Serum and hair zinc in Indian childhood cirrhosis. AB - Zinc levels in serum and hair were estimated in 32 cases of Indian Childhood Cirrhosis (ICC)--14 in Stage II and 18 in Stage III. Levels were compared with 20 cases of age matched healthy controls. Mean serum zinc level in ICC was 62.0 +/- 13.10 micrograms/dl as compared to 115.7 +/- 12.62 micrograms/dl in controls. The difference was statistically significant. Further, mean level of serum zinc (70.78 +/- 12.95 micrograms/dl) in Stage II was significantly higher than the level 55.88 +/- 8.16 micrograms/dl in Stage III, thereby showing an inverse relationship with the severity of the disease. Mean hair zinc level of 144.53 +/- 23.26 micrograms/g in ICC was much lower than that of 172.5 micrograms/g in controls. The study revealed an altered state of zinc nutrition in children with ICC. PMID- 2759692 TI - Hemostatic changes in neonates with anoxia and sepsis. AB - Hemostatic profile (prothrombin time (PT), thrombin time (TT), kaolin cephalin clotting time (KCCT), plasma fibrinogen, serum fibrin/fibrinogen degradation products (FDP) and platelet counts) was examined in 153 neonates with birth anoxia and 86 with sepsis. Remarkable hemostatic alterations occurred in neonates with severe anoxia and sepsis, while those with moderate anoxia exhibited minimal or no change. Vitamin K administration to anoxic babies showed no improvement in the hemostatic profile after 48-72 hours. The hemostatic alterations were presumably due to incipient disseminated intravascular coagulation (DIC). In spite of the marked coagulation changes, only 3 neonates with sepsis and none of the anoxic newborns presented with clinical bleeding indicating a well balanced hemostatic mechanism. PMID- 2759693 TI - Anterior fontanel size in hilly and non-hilly newborns in and around the district of Darjeeling. AB - The sizes of the anterior fontanel were measured for 110 hilly and 130 non-hilly newborns in and around the District of Darjeeling to observe for any significant difference. The mean size of the anterior fontanel for the hilly newborns was 3.35 +/- 1.07 cm and for the non-hilly newborns was 3.80 +/- 1.95 cm. There was a significant difference (p less than 0.05) between the hilly and non-hilly races. Percentile grids for the mean anterior fontanel size were calculated. This study may help to prepare a national standard for the anterior fontanel size. PMID- 2759694 TI - Is high protein milk beneficial for SGA-terms? AB - A three months longitudinal followup of SGA term babies was done for their response to feeding of high protein milk (3.1 g/100 ml) and they were compared with their breast fed counterparts. The formula fed infants had no advantage over the breast fed when weight was compared. However, blood urea and serum creatinine levels were higher in the formula fed infants, than the breast fed ones. The serum valine concentrations, indicative of protein nutritional status, increased with increasing postnatal age in all the infants. Formula fed had higher serum valine than breast fed ones. Serum phenylalanine and serum tyrosine levels, which may hamper CNS development, were higher in the formula fed infants than the breast fed ones. PMID- 2759695 TI - Bacterial flora in chronic tonsillitis. AB - A study of aerobic and anaerobic bacterial flora in chronic tonsillitis revealed a total of 59 isolates. Aerobic flora from the surface swab was found in 80%, from the core of the tonsil in 92% and from both the surface and the core in 68% of the cases. There were 30 aerobic isolates from the surface and 29 isolates from the core. Mixed flora were present from the surface and the core in 10 and 7 cases, respectively. Pathogens were seen in 36% of the cases from the surface and in 40% from the core. There was no significant difference in the nature of aerobic flora from the two sites. Anaerobic flora were cultured from the core only and were seen in 20% of cases. There were a total of 7 isolates. In 16% cases it was associated with aerobic flora. The common aerobes were Beta hemolytic streptococcus (16%) and Staphylococcus coagulase positive (12%) and common anaerobes were Peptostreptococcus (16%) and Veillonella parvula (4%). There was no consistent pattern of combination of aerobes and anaerobes in chronic tonsillitis. PMID- 2759696 TI - Intestinal obstruction due to Henoch-Schonlein purpura. PMID- 2759697 TI - Phytobezoar obstruction. PMID- 2759698 TI - Effect of nutritional supplementation on growth of infants with congenital heart diseases. PMID- 2759699 TI - Bartter's syndrome in newborn treated with indomethacin. PMID- 2759700 TI - Pouch colon syndrome. PMID- 2759701 TI - Familial congenital hypoplasia of depressor anguli oris muscle with congenital hepatic fibrosis. PMID- 2759702 TI - Wilson Mikity syndrome. PMID- 2759703 TI - Incomplete duplication of urethra (accessory urethra) in a male child. PMID- 2759704 TI - Motility disorders. PMID- 2759705 TI - Effects of magainins and cecropins on the sporogonic development of malaria parasites in mosquitoes. AB - Magainins and cecropins are families of peptides with broad antimicrobial and antiparasitic activities derived respectively from the skin of frogs or from giant silk moths. In insects, cecropins function as part of an inducible immune system against a number of bacterial infections. When injected into anopheline mosquitoes previously infected with a variety of Plasmodium species, both magainins and cecropins disrupt sporogonic development by aborting the normal development of oocysts; sporozoites are not formed and the vector cannot transmit the parasite to another host. It may be possible to induce effective transmission blocking immunity in the mosquito vector by the introduction and expression of genes coding for magainins, cecropins, or similarly acting parasiticidal peptides into the mosquito genome. PMID- 2759706 TI - Cloning and nucleotide sequence of the gene (trh) encoding the hemolysin related to the thermostable direct hemolysin of Vibrio parahaemolyticus. AB - Vibrio parahaemolyticus isolates derived from an outbreak of gastroenteritis in the Republic of Maldives did not have the genetic potential to produce the thermostable direct hemolysin, but one such isolate produced a hemolysin immunologically related to the thermostable direct hemolysin (T. Honda, Y. Ni, and T. Miwatani, Infect. Immun. 56:61-965, 1988). The Maldives isolates hybridized with the DNA probe for the gene encoding the thermostable direct hemolysin (the tdh gene) under reduced stringencies. A DNA fragment containing the probe-reactive nucleotide sequence was isolated from a selected strain and cloned into pBR322 in Escherichia coli. A clone producing the thermostable direct hemolysin-related hemolysin was obtained by screening with hemolysis assays and by an immunological assay. Nucleotide sequence analysis of the cloned DNA fragment revealed that the gene encoding the thermostable direct hemolysin related hemolysin (the trh gene), like the tdh gene, encoded the hemolysin subunit composed of 189 amino acid residues. The trh gene had significant nucleotide sequence homology with the tdh gene (68.4% with the tdh1 gene copy and 68.6% with the tdh2 gene copy). The amino acid sequences of the hemolysin subunits deduced from the nucleotide sequences of the trh gene and tdh gene were homologous (61.9% homology with the tdh1-encoded subunit and 63.0% homology with the tdh2-encoded subunit) and contained the two cysteine residues to form an intrachain bond at the same positions, and their possible conformations appeared to be similar as determined by hydrophobicity-hydrophilicity analysis and a secondary structure prediction. The trh and tdh genes may have had a common ancestor and may have evolved by single-base changes so that they maintained the fundamental architecture of the molecules. PMID- 2759709 TI - Transformation of the dermatophyte Trichophyton mentagrophytes to hygromycin B resistance. AB - A transformation system for the ringworm-producing dermatophyte Trichophyton mentagrophytes has been developed. The system employs the plasmid pHIS, which contains a bacterial hygromycin B phosphotransferase gene linked to Cochliobolus heterostrophus regulatory sequences (B. G. Turgeon, R. C. Garber, and O. C. Yoder, Mol. Cell. Biol. 7:3297-3305, 1987). This plasmid confers hygromycin B resistance to T. mentagrophytes. The DNA was stably integrated into the fungal genome, and the number and sites of integrations varied among transformants. Transformant clones were capable of infecting guinea pigs. This system opens the way for the molecular genetic analysis of the interaction of T. mentagrophytes with epithelial animal tissues. PMID- 2759710 TI - [Follow-up study of severely overweight adolescents 4 years following inpatient weight loss with a low calorie protein-carbohydrate diet]. AB - Very low calorie protein/carbohydrate diets have proved to be efficient and safe in the treatment of obesity in childhood and early adolescence. The follow-up study at issue shows that subsequent to short-term therapy no further reduction in weight is to be expected without adequate care following the diet. Between 1980 and 1983, 27 adolescent patients were treated for severe obesity (78.12% +/- 18.3% overweight, mean +/- s.e.m.) at the metabolic ward of the department of pediatrics, University of Vienna. The administration of a very low calorie protein/carbohydrate diet (VLCD) for 26 (+/- 7) days led to a considerable reduction in overweight (8.1 +/- 2.9 kg). On dismission the percentual overweight had decreased to 59.4 (+/- 24)%. After 4.4 (+/- 0.7) years the weight of 11 of the 27 patients could be controlled, 10 patients refused further cooperation and the remaining 6 could not be addressed. The body mass index (weight/height) had risen from 29.4 (+/- 1.2) to 43.0 (+/- 6.0) with 10 of 11 patients, corresponding to a percentual overweight of 88.2 (+/- 18.1)% at the follow-up date. Only one girl had reduced overweight by 45%, the BMI had fallen from 33.9 to 27.1. Furthermore, our data suggest that obesity induces a significant increase in blood pressure in adolescents. This rise is apparently independent of the age related increase in blood pressure and revertible by weight loss. The results we have to hand show that long-term weight reduction has only been achieved in 1 of 11 cases, with none of the adolescents having participated regularly in an outpatient after-care program.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2759707 TI - Nonionic block polymer surfactants modulate the humoral immune response against Streptococcus pneumoniae-derived hexasaccharide-protein conjugates. AB - Nonionic block polymer surfactants (NBPs) were tested for the capacity to stimulate the antibody response against hexasaccharide (HS), derived from Streptococcus pneumoniae type 3 capsular polysaccharide (S3PS), which was conjugated to proteins. The immune response was evaluated in the (CBA/N x BALB/c)F1 progeny, in which female mice are phenotypically normal whereas male mice carry an X-chromosome-linked immunodeficiency. NBPs L101, L121, 1101, and 1501 were able to increase anti-HS immunoglobulin M (IgM) and IgG levels in both normal and X-chromosome-linked immunodeficient mice (with up to 74-fold stimulation of antibody titers). Distribution of S3PS-specific antibodies over the various IgG isotypes was restricted after immunization with either HS-bovine serum albumin or HS-keyhole limpet hemocyanin (HS-KLH). Addition of NBPs (in particular 1501) resulted in a more diverse immune response with either antigen as judged by isotype distribution. Isoelectric focusing of individual sera and subsequent detection of S3PS-binding antibodies in these sera by immunochemical staining revealed a restricted number of different spectrotypes in the course of the immune response. Upon immunization of mice with HS-KLH, spectra of secreted antibodies were slightly more complex and more densely stained than after immunization with HS-bovine serum albumin. Furthermore, NBPs 1101 and 1501 appeared to be able to stimulate the secretion of antibodies, which were secreted only in small amounts without the use of NBPs. Different explanations for increased spectrotype diversity after immunization with KLH as the carrier and after administration of NBPs as the adjuvant are discussed. PMID- 2759708 TI - Somnogenic activity of O-acetylated and dimeric muramyl peptides. AB - Slow-wave sleep-promoting factors in brain and urine were identified as muramyl peptides (MPs), the building blocks of bacterial cell wall peptidoglycan. In this study, structural variations of MPs that occur naturally in bacterial peptidoglycan were investigated for somnogenic activity. Monomeric and dimeric MPs were isolated and purified from Neisseria gonorrhoeae and Actinomadura sp. strain R39. The structures of these MPs were verified by fast atom bombardment mass spectroscopy and tandem mass spectroscopy. After intracerebroventricular administration of MPs, electroencephalograms and brain temperatures of rabbits were recorded for 6 h and were analyzed to determine durations of slow-wave sleep, rapid-eye-movement sleep, and wakefulness. The 6-O acetylation of muramic acid enhanced the somnogenic effects of certain monomeric MPs relative to their non-O-acetylated (but otherwise identical) counterparts. Two monomeric MPs containing an unsubstituted amide (i.e., Iso-Gln) were inactive, thus confirming previous results showing that amidation of a variety of MPs can block somnogenic activity. Two peptide-cross-linked MP dimers tested had no effect on slow-wave sleep, although a third peptide-cross-linked MP containing a 1,6-anhydro muramyl end on one of its monomeric subunits, a structure that enhances somnogenic potency of un-cross-linked monomers, was somnogenic. Two dimers connected by glycosidic bonds and containing an Iso-Gln moiety were inactive. Two other glycosidically linked dimers that also contained an Iso-Gln moiety, but were of lower molecular weight, were somnogenic. In summary, 6-O acetylation of muramic acid in somnogenic MPs enhances activity, and as a class, peptide-linked dimeric MPs tend to be less active than their constituent monomers. PMID- 2759711 TI - Biological and immunological properties of Sugi basic protein-pullulan conjugate. I. Suppressive effect on IgE antibody production and on IgE-mediated reactions. AB - Sugi basic protein (SBP), a major allergen of Japanese cedar pollen, conjugated to pullulan acquires suppressive activities for IgE, but not for IgG antibody production, and for IgE-mediated PK reactions in a SBP-specific manner. When either normal or IgE anti-SBP antibody-producing mice were treated with the conjugate, IgE anti-SBP antibody levels scarcely increased even after immunization with SBP + alum. This suppression was shown to be SBP specific and IgE selective. The ability of SBP-pullulan conjugate to elicit PK reactions on passively sensitized rat skin was markedly reduced. Furthermore, the conjugate inhibited the reactions mediated by the IgE antibodies and native SBP when it was injected into the IgE antibody-sensitized sites 2 h prior to SBP challenge. The reduced ability of the conjugate to elicit PK reactions was not due to loss of antigenic determinants during the conjugation procedures because binding activity of the conjugate to anti-SBP antibodies was as strong as that of native SBP. These results indicate that SBP-pullulan conjugate may be useful for 'desensitization therapy' against the pollinosis. PMID- 2759712 TI - Lymphocyte analysis in a patient with X-linked agammaglobulinemia and isolated growth hormone deficiency after development of echovirus dermatomyositis and meningoencephalitis. AB - A previously described patient with X-linked agammaglobulinemia and growth hormone deficiency developed an echovirus-associated meningoencephalitis and dermatomyositis-like syndrome while being treated with intramuscular gamma globulin and human growth hormone. Initiation of high-dose intravenous gamma globulin resulted in resolution of the clinical symptoms and the patient has remained asymptomatic over the past 55 months. Lymphocyte phenotype analysis at the time of presentation with echovirus infection revealed an increase in CD2+, CD16+, HNK-1+ lymphocytes, a decrease in CD4+ T cells as well as absence of B cells. This elevation in the LGL/NK phenotype resolved with clinical improvement. In addition, there was evidence of lymphocyte activation following the development of echovirus infection (increase in HLA-DR expression and elevated serum IL-2 receptor levels) which resolved with clinical improvement. A muscle biopsy obtained during the period of the dermatomyositis-like syndrome demonstrated a CD8+ lymphocytic infiltrate very similar to the observations in classical dermatomyositis. Taken together, these findings suggest that growth hormone therapy in this patient failed to alter the humoral immunodeficiency. In addition, serum IL-2 receptor levels and lymphocyte phenotyping may be useful adjuncts for monitoring echovirus disease in immunodeficient patients. PMID- 2759713 TI - Immunoglobulin E response to pertussis toxin in whooping cough and after immunization with a whole-cell and an acellular pertussis vaccine. AB - Immunoglobulin E antibodies to pertussis toxin (PT-IgE) were demonstrated in 15 of 23 (65%) patients with culture-confirmed pertussis. In 6 individuals there was a low-grade PT-IgE response after 6-9 weeks of disease and in 9 a rapid PT-IgE response, appearing 1-3 weeks after onset of symptoms. The PT-IgE antibody levels in immunized individuals were higher than in the non immunized. Following primary immunization of 23 children with a monovalent whole-cell pertussis vaccine (Burroughs-Wellcome, UK) or with an acellular pertussis vaccine (JNIH-6, Biken, Japan) a late low-grade PT-IgE response was found in 8 (35%). In 7/10 children previously immunized with the JNIH-6, a booster injection 16 months later with the same vaccine resulted in a rapidly appearing PT-IgE antibody response. In contrast, none of 13 children initially immunized with the monovalent whole-cell vaccine and then boostered with either this vaccine or JNIH-6 had detectable PT IgE antibodies after the booster injection. The study shows that IgE-antibodies to pertussis toxin commonly appear in patients with whooping cough and that the kinetics and the magnitude of the response is influenced by previous exposure to the antigen. A PT-IgE response may also follow pertussis immunization. PMID- 2759714 TI - Disposition and immunogenicity of penicillin in the rabbit. AB - The immunogenicity, disposition and irreversible protein binding of benzylpenicillin (BP) were studied in male New Zealand White rabbits. There was an increase in IgG anti-benzylpenicilloyl (BPO) antibody activity, as detected by enzyme-linked immunosorbent assay (ELISA) following daily intramuscular administration (for 4 consecutive days) of BP (2.7 and 1.6 mmol/kg) freshly dissolved in 0.15 M NaCl. Antibody activity reached a maximum approximately 14 days after the last injection. There was a smaller immune response when a dose of 270 mumol/kg was administered. The specificity of the IgG antibody response for the BPO determinant was confirmed by inhibition of binding by BPO-aminocaproate. [3H]BP, administered intravenously to rabbits at a dose of 2.7 mmol/kg was rapidly cleared from plasma, and unchanged BP was not detected at 1 h. After 3 h, irreversible binding accounted for less than 0.004% of the dose bound per milliliter of plasma, and this represented all the radioactivity present in plasma at this time. Covalent binding of BP to plasma proteins, in vitro, after 3 h was of the same magnitude for rabbit, rat and human plasma. Therefore, BP can induce a specific antibody response in the rabbit in contrast to the lack of immunogenicity observed previously in the rat. PMID- 2759715 TI - Natural killer susceptibility of brain tumor cell lines inversely correlates with the degree of cell differentiation and not with the level of human histocompatibility antigen expression. AB - The purpose of this paper is to investigate the natural killer (NK) sensitivity of 15 cell lines derived from human brain tumors expressing different levels of major histocompatibility complex (MHC) antigens. Although it has recently been reported that NK susceptibility varies inversely with target cell class-I human leukocyte antigen (HLA) expression, our results show no correlation between class I HLA, class-II HLA or beta 2-microglobulin expression on target cells and NK sensitivity, whereas a significant inverse correlation between NK susceptibility and the degree of tumor cell differentiation has been found. Thus, poorly differentiated tumor cells are highly susceptible to NK lysis, whereas well differentiated ones are NK resistant. These results suggest that sensitivity to lysis by NK cells of cell lines derived from human brain tumors is primarily determined by the stage of differentiation and not by the level of MHC antigen expression on target cell. PMID- 2759716 TI - Dendritic cell accumulation in draining lymph nodes during the induction phase of contact allergy in mice. AB - Draining lymph node cells isolated from mice 24 h following topical exposure to a variety of contact-sensitizing chemicals, including the dinitrobenzene derivatives, 2,4-dinitrochlorobenzene and 2,4-dinitrothiocyanobenzene, contained increased numbers of dendritic cells (DCs). The increase in frequency of DCs was time-dependent and preceded significant changes in either lymph node cellularity or lymph node cell proliferative activity. The degree of DC accumulation was also influenced by the chemical used and the concentration employed for sensitization. In the context of contact allergy, the biological relevance of this phenomenon to the induction of hapten-specific responses is indicated by the fact that relatively small numbers of DC--enriched fractions of lymph node cells (comprising approximately 70% DCs), but not unfractionated or DC--depleted populations, transferred sensitization to naive animals. Moreover, using the skin sensitizing fluorochrome, fluorescein isothiocyanate, it was observed that 24 h following exposure the majority of lymph node cells bearing high concentrations of antigen were within the DC-rich fraction. PMID- 2759717 TI - Gliadin antibody production by small intestinal lymphocytes from patients with coeliac disease. AB - Small intestinal lymphocytes (SIL) were isolated from jejunal biopsies from 9 non coeliac controls, 6 treated and 5 untreated coeliac patients. Six-day cell culture supernatants were assayed for total IgG, IgM and IgA and specific anti casein and anti-gliadin antibodies by ELISA. SIL from the untreated patients secreted more total IgM and IgA than SIL from the treated patients and more total IgG, IgM and IgA than SIL from the controls. The untreated patients' cells secreted more specific anti-gliadin IgA than those from the treated patients and more anti-gliadin IgG, IgM and IgA than the controls. SIL from the untreated group released more anti-casein IgM than those from either the treated or control groups. There were no differences in total immunoglobulin, or specific anti casein or anti-gliadin antibody secretion by SIL from the treated and control groups. Comparison of immunoglobulin release from cells lysed prior to culture and that secreted both after 30-min and 6-day cultures showed that the majority of immunoglobulin had been synthesised in vitro and could not be accounted for by carry-over. PMID- 2759718 TI - Characterization of grass pollen-specific IgE, IgA, IgM classes and IgG subclasses in allergic patients. AB - Water-soluble grass pollen extracts (Dactylis glomerata) were separated by isoelectric focusing in a wide pH range (2-11) in agarose gel. After focusing, two successive gel prints were taken. The first one, on an ordinary nitrocellulose filter during 10 s, enabled the visualization of separated components of the pollen, after india ink staining. The second one, on a cyanogen bromide-activated nitrocellulose filter obtained after a 10-min transfer and saturation step, was incubated overnight with patient sera, and the specific antibodies bound to antigens or allergens were detected. The screening of different patient sera showed great variability in the antigen spectra. There was no obvious relationships between IgM and IgA antigen spectra as compared to IgE. Some association between IgE and IgG4 subclass was observed. PMID- 2759719 TI - In vitro sensitivity of immature human mast cells to chemotherapeutic agents. AB - Cells from the human immature mast cell line, HMC-1, were tested for their sensitivity to 11 chemotherapeutic agents by changes in viability and incorporation of tritiated thymidine ([3H]-thymidine) after 72 h of in vitro drug exposure. Doxorubicin hydrochloride and cytosine arabinoside were the most active agents against HMC-1 cells at the concentrations tested. Doxorubicin hydrochloride inhibited the incorporation of [3H]-thymidine and decreased the viability of HMC-1 cells by greater than 90% at a concentration of 0.06 microgram/ml. Cytosine arabinoside inhibited the incorporation of [3H]-thymidine and decreased the viability by greater than 95% at a concentration of 0.1 microgram/ml. A clone of HMC-1 cells, A4, with an enhanced percentage (70-80%) of metachromatically staining cells was equally sensitive to these two agents; however, A4 cells were more sensitive to vinblastine sulfate and less sensitive to methylprednisolone than was the parent cell line. Both HMC-1 cells and A4 cells showed approximately equal sensitivity to etoposide and to mitomycin. These results show that human mast cells are susceptible in vitro to a number of commonly used chemotherapeutic drugs. PMID- 2759720 TI - Inhibition by histamine of platelet-activating-factor-induced neutrophil chemotaxis in bronchial asthma. AB - Circulating human polymorphonuclear neutrophils are involved in asthma after their migration into the lung by local chemotactic factors. Investigation of the locomotion of neutrophils in Boyden chambers, showed that the chemotactic intensity of the platelet-activating factor (PAF) was similar in cells from healthy subjects and allergic asthmatics, although the optimal effect of the mediator was observed at 10(-6) M and 10(-8) M, respectively. Histamine had no direct chemoattractant effect on neutrophils but inhibited PAF-induced chemotaxis of neutrophils from healthy subjects and allergic asthmatics. This study provides additional evidence that neutrophils are involved in asthma, and points out the interaction between PAF and histamine in the migration of neutrophils to the lung. PMID- 2759721 TI - Effect of reduction and heat on the detection of house dust mite (Dermatophagoides pteronyssinus) allergen Der p I by protein blotting. AB - Employment of reducing conditions during sample preparation alters the mobility of the house dust mite (Dermatophagoides pteronyssinus) allergen Der p I as determined by sodium dodecylsulphate-poly-acrylamide gel electrophoresis (SDS PAGE) from an apparent MW of approximately 25 kD (unreduced) to an apparent MW of approximately 30 kD. Probing of nitrocellulose transfers with sera from subjects allergic to D. pteronyssinus showed that reduction of Der p I was accompanied by a substantial loss of IgE-antibody-binding capacity by this allergen. An important consequence of the effect of reduction on Der p I is that the electrophoretic mobility of this protein becomes very similar to a closely spaced pair of protein-staining bands, probably Der p III, of MWs 30-31 kD. These bands bind IgE antibodies strongly and with high frequency and exhibit the same electrophoretic mobilities under both reducing and non-reducing conditions. Thus, for the clear resolution of allergen Der p I from other IgE-binding components in the same MW region, including Der p III, house dust mite samples for analysis by SDS-PAGE and blotting should not be reduced. PMID- 2759722 TI - Changes in seasonal mortalities with improvement in home heating in England and Wales from 1964 to 1984. AB - Changes in summer (July-September) and winter (January-March) mortalities of people aged 70-74 in England and Wales from 1964 to 1984 were compared with possible causal factors. Summer mortalities were little affected by annual temperature or influenza epidemics and fell from 1972-1975 for all causes, coronary and respiratory causes, while cerebrovascular mortality fell more rapidly from that time. Cigarette consumption also fell from 1972-1975; falling consumptions of total fat from 1970 and saturated fat from 1972-1975 probably also contributed to the fall in arterial deaths, and likewise falls in prescription rates for tranquillisers and sedatives from 1976-1978 to the fall in respiratory deaths. From 1964 to 1984 use of central heating increased from 13% to 69% of households, domestic fuel consumption increased, and excess mortality in winter from respiratory disease declined by 69%, even relative to summer mortality and when adjusted for varying coldness of winters. The improvement was partly explained by a decline in influenza epidemics. By contrast, excess mortalities in winter from coronary and cerebrovascular disease, although rising in some early influenza epidemics, did not fall significantly as home heating improved. These thrombotic deaths together accounted for 56% of the total excess winter mortality by 1984. The findings support other indications that most of the excess mortality from arterial thrombosis in winter in England and Wales is due to brief excursions outdoors rather than to low indoor temperatures. PMID- 2759723 TI - Effects of wearing two different types of clothing on body temperatures during and after exercise. AB - The experiment was conducted to investigate the human thermoregulatory responses during rest, exercise and recovery at Ta 20 degrees C and 60% R.H. under the conditions of wearing two different types of clothing. Six healthy men wore two types of clothing: one covering the whole body area except the head (Type A, weight 1656 g), and the other covering only the trunk, upper arms and thighs (Type B, weight 996 g). The level of rectal temperature was kept significantly higher in Type B than in Type A during rest and recovery. The increased and decreased rates of rectal temperature during exercise and recovery were significantly greater in Type A than in Type B, respectively. These findings are discussed from the viewpoint of the differences of skin temperatures of the extremities between Type A and Type B. PMID- 2759724 TI - Effects of selective cooling of the facial area on physiological and metabolic output during graded maximal or prolonged submaximal exercise. AB - Physiological and metabolic output responses to facial cooling during a graded maximal exercise and a prolonged submaximal exercise lasting 30 min at 65% VO2 max were investigated in five male subjects. Pedalling on a cycle ergometer was performed both with and without facial cooling (10 degrees C, 4.6 m s-1). Facial cooling at the end of graded maximal exercise apparently had no effect on plasma lactate (LA), maximal oxygen consumption (VO2 max), maximal heart rate (HR max), rectal temperature (Tre), work-load, lactate threshold (LT), ventilatory threshold (VT) and onset of blood lactate accumulation (OBLA). However, the response to facial cooling after prolonged submaximal exercise is significantly different for heart rate and work-load. The results suggest that facial wind stimulation during maximal exercise does not produce a stress high enough to alter the metabolic and physiological responses. PMID- 2759725 TI - Plasma-cortisol levels in experimental heatstroke in dogs. AB - The effect of external heat-load, exercise and dehydration on dynamic changes in plasma cortisol during the development of heatstroke was investigated. Thirty three unanesthetized dogs were tested under two sets of climatic conditions: comfort conditions and hot-dry climatic conditions, half of them while exercising. Half of the dogs in each group were rehydrated. None of the dogs that were investigated at room temperature suffered heatstroke. Of the dogs exposed to high ambient temperature, all of the exercising, as well as five out of six non hydrated dogs and one rehydrated non-exercising dog suffered heatstroke. Significant dehydration (6%-7% of body weight), occurred only under high ambient temperature. Plasma cortisol levels of all dogs that suffered heatstroke rose conspicuously for at least 5 h and returned to normal levels 24 h later. Cortisol levels of dogs who did not experience heatstroke remained within the normal range. Cortisol levels correlated with the severity of the stress leading to heatstroke. High and rising levels of cortisol, several hours after body temperature returns to normal, may support the diagnosis of heatstroke. PMID- 2759726 TI - Effect of supplemental light on growth, prolactin, progesterone and luteinizing hormone in water buffalo (Bubalus bubalis). AB - Fifty non-pregnant Surti buffalo heifers aged between 17 and 42 months (n = 24, less than 24 months; n = 26, greater than 24 months) were randomly assigned to groups subject to either natural daylight +4 h supplemental light (n = 25) or natural day light (n = 25), to study changes in growth, serum prolactin (Prl), progesterone (P4) and luteinizing hormone (LH) to supplemental lighting. Ambient temperatures (T) and relative humidity (RH) generally were greater than 27 degrees C and less than 70% during the daytime, respectively. Light-supplemented heifers had 16.2 kg net body weight (BW) gain at 9 weeks compared to 20.8 kg for controls, but higher mean Prl after 6.5 weeks (P less than 0.01), and higher P4 (0.41 vs 0.19 ng/ml; P less than 0.06) than control heifers. Older heifers had 39.7% greater BW (P less than 0.01), but a net 4.3% BW gain compared to a 10.1% gain for younger heifers at 10 weeks. Older, light-supplemented heifers had higher mean P4 (0.63 vs 0.19 ng/ml; P less than 0.07) than the other groups. These weight and hormonal changes suggest that 4 h supplemental light can alter growth and endocrine function in buffaloes under similar planes of nutrition. While light supplementation did not have a positive effect on body weight during the 10 week study, body weight and endocrine changes due to supplemental light may be important factors for initiation of reproductive cyclicity. PMID- 2759727 TI - Abnormal DNA content in liver-cell dysplasia: a flow cytometric study. AB - To clarify the true nature of liver-cell dysplasia (LCD), a flow cytometric study has been performed. The DNA content of hepatocytes from 26 cases of cirrhosis with diffuse areas of LCD was investigated and compared to that of hepatocytes from 21 control patients with non-neoplastic and neoplastic liver conditions. Flow cytometric analysis was performed on propidium-stained nuclei from archival paraffin-embedded material. Analysis was directed to assessment of diploid as well as non-diploid peaks by calculation of DNA index (DI), using normal hepatocytes present in each sample as individual and specific references. Since only samples containing at least 10,000 nuclei were considered suitable for analysis, 4 of the 26 LCD cases were discarded. Eight of 22 LCD cases had an abnormal DNA content compared with 0/11 non-neoplastic cases (p less than 0.05) and 8/10 hepatocellular carcinomas (p less than 0.05). Non-neoplastic control cases displayed uniformly diploid stemlines whereas hepatocellular carcinomas had in 8/10 cases bimodal or trimodal populations. Thus, LCD is a heterogeneous lesion in terms of ploidy, and the abnormal DNA content observed in some cases supports its pre-neoplastic nature. PMID- 2759728 TI - Cancer incidence among spouses of patients with colorectal cancer. AB - The risk of colorectal cancer was examined among spouses of approximately 10,000 colorectal cancer patients. A total of 8,095 spouses were identified, and cancer cases in this cohort were sought in the Danish Cancer Registry. No excess risk was found for colorectal cancer as such. The data were also analyzed by subsite of the large bowel for the index cases and for the spouses, respectively. The estimated relative risks were in general close to unity, the only exception being the risk of right-sided colon cancer among husbands of index cases with left sided colon cancer, RR = 2.17 (p less than 0.05). The absence of excess risk was noted regardless of the duration of marriage. The risk of other cancers with a presumed etiology similar to that of colorectal cancer (cancer of the uterine corpus, breast, prostate and biliary tract) was also close to expected values. PMID- 2759729 TI - In situ oestrone synthesis in normal breast and breast tumour tissues: effect of treatment with 4-hydroxyandrostenedione. AB - An isotopic infusion technique has been used in an attempt to determine the contribution that local, in situ, oestrone synthesis makes to the oestrogen content of breast tumours. 3H-Androstenedione and 14C-oestrone were infused into women with advanced breast cancer for 12 hr before operation. At surgery, normal breast and breast tumour biopsy samples were obtained and 3H-androstenedione, 3H oestrone derived from 3H-androstenedione and 14C-oestrone were isolated and measured. DNA polymerase alpha activity, a marker of cellular proliferation, was also measured to examine whether local synthesis of oestrone exerted a biological effect. The study was repeated after patients had been treated with the aromatase inhibitor, 4-hydroxyandrostenedione, before undergoing further surgery for removal of their tumours. In 4/6 tumours examined, in situ synthesis of 3H oestrone from 3H-androstenedione accounted for the major part (84.3 +/- 9.0%) of the 3H-oestrone detected, while no significant in situ synthesis occurred in 2 other tumours. Although treatment with 4-hydroxyandrostenedione did not significantly alter the uptake of 3H-androstenedione or 14C-oestrone into breast tissues, in situ formation of 3H-oestrone was only detected in one tumour sample after treatment. DNA polymerase alpha activity decreased in 4/6 tumours after treatment with 4-hydroxyandrostenedione. Overall, however, there was no significant correlation between the level of 3H-oestrone formed in situ and DNA polymerase alpha activity (r = 0.38, NS). It is concluded that in some, but not all, breast tumours in situ formation of oestrone can make an important contribution to the oestrogen content of breast tumours. PMID- 2759730 TI - Sucrase-isomaltase expression and enterocytic ultrastructure of human colorectal tumors. AB - We report the relative frequency of sucrase-isomaltase (SI) antigen expression in human colonic adenocarcinoma (22/57), in peritumoral mucosa taken next to the tumor (31/41) or distant from it (29/42) as well as in 21/23 polyps. Our results are based on indirect immunofluorescence with a monoclonal antibody (MAb) specific for human intestinal SI. A regular and intense expression of SI occurred only in 6 tumor specimens. In the remaining 16 SI-positive tumor samples, labelling was heterogeneous, i.e., scattered over more or less extensive areas. A similar irregular staining pattern was also found in polyps and in peritumoral mucosa, irrespective of its distance from the tumor. Electron microscopic examination of 19 carcinomas mostly revealed altered brush-border membrane features, irrespective of histological SI staining pattern. Brush-border enzyme activities of sucrase, alkaline phosphatase and maltase showed no difference between tumor specimens and peritumoral mucosa, but aminopeptidase was depressed in the former. Sucrase activity was extremely low (mean values 1.1 to 1.8 mU/mg protein) and rose only exceptionally to 17.5 mU/mg prot. PMID- 2759731 TI - t(2;8) variant translocation in Burkitt's lymphoma: mapping of chromosomal breakpoints by in situ hybridization. AB - In 6 different Burkitt lymphoma cell lines with t(2;8) variant translocations (J1, LY66, LY91, BL21, BL64, JBL2) the breakpoints on chromosome 8q+ were mapped in relation to each other and to c-myc by in situ hybridization. The probes used were derived from chromosome 8q24 and comprised a c-myc probe, a probe located 48 kb downstream of c-myc, 3 probes adjacent to the chromosomal breakpoints of BL64, LY91 and JBL2, respectively, and 2 probes located in the 5' and 3' part of the thyroglobulin gene. The breakpoints of LY91 and JBL2 lie less than 200 kb and greater than 200 kb downstream of c-myc, whereas the distance to c-myc of the BL64 breakpoint and of the thyroglobulin probes is unknown. By recording the hybridization signals specific for these probes on chromosomes 2p- and 8q+ of each cell line it was possible to establish the order of breakpoints on band 8q24 relative to the c-myc and thyroglobulin genes as follows: centromere--c-myc--J1- BL64--BL21--LY91--JBL2--+ ++LY66--thyroglobulin--telomere. This information is essential for further mapping of this important chromosomal region. PMID- 2759732 TI - Tumor blood flow: the principal modulator of oxidative and glycolytic metabolism, and of the metabolic micromilieu of human tumor xenografts in vivo. AB - We have investigated therapeutically relevant pathophysiological parameters of human breast and lung cancer xenografts in nude rats. All lung cancers and one breast cancer exhibited rapid growth and high blood flow values paralleled by high metabolic rates. The tissue of these tumors was well oxygenated up to very advanced growth stages. Xenografts from other breast cancer cell lines grew much more slowly, were poorly perfused, and exhibited low metabolic rates. Here, tumor hypoxia and tissue acidosis were evident. These results indicate that significant differences in the metabolic micromilieu can be detected in human tumors; these are due to varying perfusion rates and may be partly responsible for failure to obtain tumor control in individual patients. PMID- 2759733 TI - Time-dependent toxicity of drugs used in cancer chemotherapy: separate and combined administration. AB - Time-dependent toxicity of 3 anti-cancer drugs was demonstrated in BALB/c mice. Cisplatinum, adriamycin and cyclophosphamide were injected at 4 different circadian stages, either together (combined injection) or separately, to different groups of mice. Toxicity was evaluated by body-weight changes, mortality and white blood cell counts. Maximal body-weight loss was caused by the administration of either Cisplatinum or the combination of all 3 drugs at 15.00 hr and 21.00 hr, i.e., 9 and 15 hr after light on (HALO). Only moderate body weight loss was induced when adriamycin was injected at 09.00 hr or at 21.00 hr (3 and 15 HALO). In contrast to Cisplatinum and adriamycin, cyclophosphamide induced no significant change in body weight when injected at either time. The highest level of mortality was caused by the injection of all 3 drugs together at 21.00 hr (15 HALO). No death occurred when drugs were administered separately. The rate of recovery (as assessed by weight regain) also exhibited dependence upon the time of drug administration and was the slowest after injections at 21.00 hr (15 HALO). It appears, therefore, that the time-dependence modes of toxicity and recovery (as assessed by body-weight change) are different. The decrease in white blood cell count also exhibited a time-dependence pattern which differed from that of weight loss and death. PMID- 2759734 TI - Characterization of cell lines derived from a multiply aneuploid human bladder transitional-cell carcinoma, UCRU-BL-13. AB - A series of cultured cell lines (designated UCRU-BL-13) has been established from different serial passages of a multiply aneuploid human bladder transitional-cell carcinoma xenografted in nude mice. Serial passage of the xenografts in vivo and of the cell lines in vitro was accompanied by shifts in the tumor ploidy, with dominance of different major peaks. Despite this, the expression of tumor markers remained constant, and consistent chromosomal markers were observed both in the 8th xenograft passage and in a subline in tissue culture established over a year apart. Chromosomal numbers reflected the predominant aneuploid peaks observed; consistent numerical and structural changes included a marker derived from chromosome 1, 8p-, -10, 11q+, and 17q+. The cell line derived from the initial xenograft comprised a mixture of transitional, adenocarcinoma and squamous carcinoma cells in early passage, but adenocarcinoma cells were absent from later passages. The lines expressed the B-blood-group antigen, histocompatibility antigens, receptors for transferrin and EGF, and reacted with a series of monoclonal antibodies (MAbs) directed to malignant human epithelial cell lines. These lines provide a model for studying the evolution of tumor heterogeneity and drug resistance in bladder carcinoma exhibiting multiple aneuploidy. PMID- 2759736 TI - Characterization of a newly established, TA-4-producing squamous carcinoma cell line derived from metastatic tongue carcinoma. AB - A human squamous carcinoma cell line was established from the pleural effusion of a patient with recurrent squamous carcinoma of the tongue. The cell line, designated HST-I, has been passaged 82 times over a period of 4 years. The cells have been shown by light and electron microscopy to be of the squamous epithelial type. Immuno-histochemical staining was positive for keratin. When these cells were transplanted into athymic nude mice, tumors developed at the site of inoculation, which on histological examination were shown to be well differentiated squamous carcinomas. Karyotypic analysis of cells from the cell line demonstrated an aneuploid human type with a modal chromosome number of 71, with both numerical and structural aberrations. HST-1 cells produce and secrete TA-4, a squamous-cell carcinoma-related antigen, in vitro in culture and in vivo in nude mice bearing the tumors produced by inoculation of cultured cells. Thus, the HST-1 cell line represents a new human tongue squamous carcinoma producing TA 4. This cell line appears useful for facilitating therapeutic investigations as well as biological studies on the association between cancerous growth and circulating TA-4 levels. PMID- 2759737 TI - Zn++ inhibits both tumor necrosis factor-mediated DNA fragmentation and cytolysis. AB - The cellular events involved in direct tumor-cell destruction by tumor necrosis factor (TNF) are still incompletely understood, but a role of endonucleases has been suggested. In the present study we have analyzed in detail the effect of Zn++, an inhibitor of endonucleases, on TNF-mediated DNA-fragmentation and on cytolysis in Actinomycin-D-pre-treated WEHII 64-S cells. Beginning 2 hr after addition of TNF, a rapid degradation of cellular DNA is observed, as evidenced by release of 3H-Thymidine (TdR) label from nuclei into cytoplasm. TNF-mediated lysis of WEHII64-S cells begins at 3 hr and reaches plateau levels at 7 hr. Addition of Zn++ to TNF-treated WEHII64 cells completely abrogates DNA fragmentation at ImM. Of greater importance is the fact that Zn++ treatment also completely blocks TNF-mediated cytolysis of the target cells. Concentrations between 0.1 and I mM ZnSO4 prevent cell death, as assessed by chromium-release and Trypan blue dye exclusion. In addition, ZnCl2, but not other divalent cations like CaCl2, MgSO4 and CuSO4 in the same concentration range, prevents cell death as well, demonstrating that the effect in fact is mediated by Zn++. Zn++ added 2 hr after TNF treatment, still effectively inhibits cell lysis, indicating that it acts at a late stage after binding of TNF to its receptor. Our data suggest that activation of endonucleases is not an accompanying effect but an essential step in TNF-mediated tumor-cell destruction. PMID- 2759735 TI - Comparison of therapeutic efficacy and host toxicity of two different 131I labelled antibodies and their fragments in the GW-39 colonic cancer xenograft model. AB - The in vivo uptake, therapeutic potential, and host toxicity were evaluated for both the intact IgG and F(ab')2 fragment of 2 murine monoclonal antibodies (MAbs) directed against either carcino-embryonic antigen (CEA), called NP-4, or colon specific antigen-p (CSAp), called Mu-9, in the GW-39 human colorectal carcinoma grown in the hamster cheek pouch. Mu-9 IgG and F(ab')2 were retained longer by the tumor than was the NP-4 IgG or F(ab')2, respectively. Localization of the two antibodies by micro-autoradiography revealed two distinct patterns. Mu-9 was seen densely around whole acini of tumor cells, whereas NP-4 was found around each individual cell, albeit less densely. The anti-tumor effects of 131I-labelled Mu 9 and NP-4 IgG were equal, but the therapeutic effectiveness of Mu-9 F(ab')2 was significantly higher than NP-4 F(ab')2, as measured by change in tumor size. A dose-dependent increase in host toxicity, as measured by change in body weight and change in peripheral white blood cells (p-WBCs), was observed with 0.5 to 3.0 mCi doses of 131I-IgG regardless of the MAb used. A 10-22% loss in body weight lasting 3-7 weeks and a 50-80% loss in pWBCs lasting 6-8 weeks were observed in these animals. In contrast, 3 x 2 mCi doses of 131I-NP-4 or Mu-9 F(ab')2 given at 3-day intervals, a schedule which was equally therapeutic to a single 2-mCi dose of 131I-IgG, resulted in only a 9% loss in body weight and a 50% loss in pWBCs that lasted only 1 week. This was followed by a complete recovery over the next 2 3 weeks. These data suggest that multiple doses of F(ab')2 can be as tumoricidal as a single dose of an intact MAb IgG, but significantly less toxic to the host. PMID- 2759738 TI - Sterically hindered analogues of diacylglycerols. Synthesis, binding to the phorbol ester receptor and metabolism in A549 human lung carcinoma cells. AB - The 5 following compounds were synthesized in order to investigate the relationship between structure and ability of glyceride-type molecules to bind to the phorbol ester receptor: one dioctanoyl cyclohexane-1,2,4-triol, 2 isomeric methyl analogues of 1,2-dioctanoyl-sn-glycerol (diC8), one dimethyl and one cyclohexyl analogue of diC8. Their ability to compete with 3H-labelled phorbol 12,13-dibutyrate [( 3H]PDBu) for specific binding sites in intact A549 human derived lung carcinoma cells and in a cytosolic cell extract was compared with that of diC8 and 12-O-tetradecanoylphorbol-13-acetate (TPA). The affinity of diC8 for the phorbol ester receptor was much weaker than that of TPA. The analogues in turn were less able than diC8 to compete with [3H]PDBu for receptor sites. Like diC8 and unlike TPA, the synthesized compounds inhibited cell growth only at those concentrations at which cytotoxicity was also apparent. DiC8 and its methyl and dimethyl derivates, but not the cyclohexyl derivative or the cyclohexanetriol diester, were metabolically removed from cellular incubates as measured by gas liquid chromatography. The results suggest that the binding of glyceride-type molecules to the phorbol ester receptor exhibits stringent specificity and that the design of novel potent agonists of phorbol esters might require the placement of the molecular features of diacylglycerols important for biological activity into a molecular framework which is more complicated than glycerol. PMID- 2759739 TI - Effect of immunization on HTLV-I infection in rabbits. AB - Two groups of 3 rabbits, each immunized with heat-inactivated HTLV-I or a synthetic env peptide (env175-196), developed antibodies to viral proteins including gp68 and gp46. These immunized rabbits were then challenged with a transfusion of blood from HTLV-I-infected rabbits of the opposite sex. After transfusion challenge, antibody titers further rose in both groups and antibodies to HTLV-I proteins p24 and p19 newly appeared in the env 175-196 group. In addition, 3 more rabbits were infused with hyperimmune rabbit anti-HTLV-I IgG and similarly challenged with virus-infected blood. Pre-challenge sera from these rabbits showed high anti-HTLV-I titers with antibodies to envelope and core proteins. Despite transfusion challenge, the antibody titers gradually declined to undetectable levels in all 3 rabbits over a period of 16 weeks. Virus isolation was attempted from peripheral lymphocytes harvested 1 to 6 months after challenge infection and cultured in the presence of interleukin-2 (IL-2). HTLV-I carrying lymphoid cell lines of recipient origin were established from all 6 rabbits given active immunization, whereas HTLV-I could not be isolated from any of the 3 rabbits given passive immunization. Absence of virus infection in the latter group was confirmed by negative blood transfusion assay to normal rabbits. These results indicate that hyperimmune IgG, but neither heat-inactivated HTLV-I nor env 175-196, were protective against HTLV-I infection induced by blood transfusion. PMID- 2759740 TI - Plasmacytoma induction in radiochimeras. AB - We have induced plasmacytomas (MPC) in BALB/c radiochimeras (RCh) repopulated with syngeneic hemopoietic cells carrying distinctive chromosomal markers. A group of 38 RCh that received 0.5 ml pristane, followed by Abelson virus infection 2-3 weeks later, developed 7 tumors (18.5%) of donor origin after a relatively short latency period (X = 83 +/- 8.3 days). In contrast, only 3 (2%) MPCs were observed in 149 RChs that received 0.5 ml pristane 3 times at monthly intervals. Two of them originated from host cells. Pristane-treated RChs developed a less extensive oil granuloma (OG), compared with pristane-treated intact mice. This may explain the low incidence of MPC in the former. Our findings also suggest that Abelson virus can overcome the postulated deficiency of OG. MPC induction in the pristane + Abelson-virus-treated RCh system will facilitate the further characterization of the MPC precursor cell and the localization of genetic resistance vs. susceptibility factors at the donor vs. host level. PMID- 2759741 TI - Relative tumorigenicities of hybrid cells with and without HSR-bearing chromosomes from a human melanoma cell line. AB - Some cell types within the human melanoma cell line MeWo contain homogeneously staining regions (HSRs) consisting of repetitive DNA sequences and ribosomal RNA (rRNA) genes derived from chromosome 15. To further examine the association between enhanced tumorigenicity and the presence of HSR-bearing chromosomes, hybrid cell lines were constructed by fusing X-HSR-containing MeWo cells with ouabain-resistant, HPRT-deficient Chinese hamster ovary cells and culturing in HAT medium containing ouabain. A hybrid containing the X-HSR chromosome and several MeWo chromosomes was more tumorigenic in BALB/c nude mice than derivative cells lacking the X-HSR and human chromosome 18. However, since this enhanced tumorigenicity could be due to sequences on either the X-HSR or chromosome 18, a second series of hybrids was constructed by micro-cell fusion. In this case, the tumorigenicity of hybrid cells containing 2 copies of the X-HSR as the only MeWo chromosome was similar to that of derivative cells lacking these chromosomes. Cytogenetic analysis revealed that the nucleolar organizer regions (NORs) on the HSR were inactive in the hybrid cells. Our data indicate that DNA sequences amplified on MeWo HSRs do not enhance tumorigenicity under experimental conditions in which rRNA genes are not expressed. As the only active NORs in MeWo HSR-containing cells are on the HSRs, we suggest that expression of these amplified rRNA genes is responsible for the selective growth advantage of these cell types in nude mice. Our data also indicate that the enhanced tumorigenicity of MeWo HSR-containing cells is not due to co-amplification of a dominant oncogene. PMID- 2759742 TI - Efficacy of two-route chemotherapy using cis-diamminedichloroplatinum(II) and its antidote, sodium thiosulfate, in combination with angiotensin II for rat liver tumor. AB - To improve the therapeutic effects of conventional TRC using i.a. CDDP plus simultaneous i.v. STS in a rat liver tumor, we made use of the AT-II-induced hypertension method, in combination with TRC. The decrease in tumor area (-15%), measured 8 days after the TRC using CDDP 12 mg/kg i.a. plus i.v. post administration (5 min later) of STS 1,264 mg/kg, was much greater than that (+ 13%) seen in the conventional TRC, but BUN level was elevated (44.9 mg/dl). AT-II (15 micrograms/kg) administered i.a. simultaneously with CDDP normalized the BUN level (20.3 mg/dl) and further decreased (-15% to -31%) the tumor area (modified TRC). The modified TRC also exhibited a higher anti-tumor effect than did CDDP 3 mg/kg with AT-II i.a. (5%) at a similar BUN level (22.2 mg/dl). Loss of body weight, decrease in WBC count and changes in serum transaminases of rats treated with the modified TRC were tolerable. The improved therapeutic effect of the modified TRC was explained as follows: during AT-II-induced hypertension, (I) CDDP delivery to the tumor was increased by 150% and (2) CDDP delivery to the kidney was decreased by 35%. The latter effect of AT-II made feasible the post administration of STS to CDDP. PMID- 2759743 TI - TAG-72 serum determination in early and advanced gastric cancer. PMID- 2759744 TI - Balloon dilatation of a porcine bioprosthetic valve in aortic position. AB - We describe a case of percutaneous balloon valvoplasty of a stenotic Hancock bioprosthesis in aortic position. The procedure reduced the peak systolic gradient from 110 to 25 mm Hg. The calculated area of the orifice increased from 0.59 to 1.07 cm2. A cineaortogram performed after the procedure showed trivial aortic regurgitation and the subsequent immediate course was uneventful. The mechanism of dilatation and the risks of the procedure are discussed. PMID- 2759745 TI - The combination of a left aortic arch, a right-sided descending thoracic aorta with a left-sided arterial duct. AB - A nine-year-old male child presented with a history of recurrent chest infections and breathlessness. On investigation, he was found to have a left aortic arch with a right-sided descending thoracic aorta along with a left-sided arterial duct. He also had mild aortic stenosis with regurgitation. The duct was successfully ligated under controlled hypotensive anesthesia through a left posterolateral thoracotomy. PMID- 2759746 TI - Congenital long QT syndrome inducing 2:1 atrioventricular block: early detection in fetal life. AB - A case is reported of congenital long QT interval associated with fixed 2:1 atrioventricular block. The bradycardia was detected at 16 weeks of gestational age. The atrioventricular block was due to an extremely delayed ventricular repolarization. Early detection of bradycardia in fetal life and the demonstration of a normal positive correlation between QT duration and ventricular rate suggest that, in this case, the syndrome may be due to an anomaly of the myocardial cells rather than to imbalance of the sympathetic nervous system. PMID- 2759747 TI - Rheumatic tricuspid stenosis without involvement of the mitral valve. AB - We describe a case of rheumatic tricuspid stenosis without involvement of the mitral valve. Rheumatic disease of the tricuspid valve is very rare in the absence of concomitant mitral valvar disease. We suggest that the closing pressure at the valve is not the only factor governing localization of the rheumatic process. PMID- 2759748 TI - Acute right ventricular infarction without infero-posterior left ventricular infarction. AB - Two cases of acute right ventricular infarction associated with acute extensive anterior myocardial infarction in the absence of inferior and/or posterior left ventricular infarction are presented. Such a combination is likely to occur from acute occlusion of the left anterior descending artery in the face of severe narrowing of the infundibular (conus) artery rather than from acute occlusion of the right coronary artery. PMID- 2759749 TI - Left pulmonary isomerism with normal arrangement of the heart and abdominal organs. Computed tomography of two adults. AB - The computed tomography and the three-dimensional reformatting of the thorax of two adults with left pulmonary isomerism demonstrated: two right-sided and two left-sided pulmonary lobes, bilateral hyparterial upper lobe bronchi, symmetrical main bronchi in one and slightly longer left in the other, normal atrial arrangement as identified by a broader right atrial appendage and the coronary sinus on computed tomograms. The arrangement of the heart and abdominal organs was normal. Computed tomography could be a direct non-invasive approach in identification of the arrangement of the heart and organs. PMID- 2759750 TI - Isolated episode of exercise-related ventricular fibrillation in a healthy athlete. AB - A 19-year-old man had a documented ventricular fibrillation during a football match. He was a top-level athlete, and after successful resuscitation, he was extensively studied. Electrolytic disturbances, long QT syndrome and nervous mechanisms were all ruled out. Right and left ventriculography, coronary angiograms, electrophysiologic study and endomyocardial biopsy all proved normal. A beta-blocker was empirically given in the absence of any reliable test to guide therapy more scientifically. PMID- 2759751 TI - Surgical pathology of mitral valves--the Indian scene. AB - Of the 75 cardiac valves excised at surgery over a 2 year period, 54 were mitral valves. Using simple morphological criteria along with clinical data, the valves were assigned to 2 major groups, rheumatic and non-rheumatic. The group with rheumatic disease accounted for 90% of cases. Mitral stenosis, incompetence and combined stenosis with incompetence were encountered with equal frequency (38, 38 and 24%). Mitral insufficiency of rheumatic etiology, no longer considered to be a major problem in the west, continues to be frequent in India. An increased incidence of mitral regurgitation in young females is an important feature noticed in this series. PMID- 2759752 TI - Lung function in simple complete transposition after intracardiac repair. AB - Pulmonary function was measured in 35 patients (mean age 11.6 years) with simple complete transposition 4.4 years after intracardiac repair. A disturbance in the lung function (greater than 2 SD from the normal value) was found in 88% of the patients. A marked increase in static recoil pressure (P less than 0.001) was most frequent (in 66%). Static lung compliance was only 75.1% of the predicted values. Values of mean vital and total lung capacity were decreased (P less than 0.01 and 0.001). Residual volume, the ratios of functional residual versus total lung capacity and residual volume versus total capacity were all increased. The signs of decreased patency of the airways were found in only 4 patients. A negative correlation was detected between the indices of lung stiffness and the age of assessment of lung function. A positive correlation was found between the ratios between functional residual and total capacity and pulmonary blood flow. No other correlation between lung function data and pulmonary arterial pressure or flow was proved. Increased lung stiffness, restriction of lung volume and hyperinflation could influence unfavorably the long-term results in successfully treated patients with simple complete transposition. PMID- 2759753 TI - Influence of echocardiography in pre-operative cardiac catheterization in congenital heart disease. AB - The influence of echocardiography on pre-operative cardiac catheterization was assessed in a retrospective analysis comparing two 12-month periods. Of 245 operations in 1983, 200 (82%) had pre-operative cardiac catheterization when two dimensional echocardiography only was used in the pre-operative assessment compared to 162 of 238 (68%) operations in July 1985-June 1986 when pulsed Doppler echocardiography also was used (P less than 0.001). Significant reductions in pre-operative cardiac catheterization were present in both open (87/87 vs 89/102, P less than 0.001) and closed (113/158 vs 73/136, P less than 0.005) heart procedures. The group with the most significant reduction in pre operative cardiac catheterization before open heart surgery were children with atrial septal defects; of the closed heart surgical groups, the greatest reductions were in patent ductus arteriosus, coarctation of the aorta and tetralogy of Fallot. Echocardiogram diagnostic errors occurred in 22/245 (9%) in 1983 compared to 9/238 (4%) in 1985/86 (P less than 0.05). Echocardiography has resulted in a significant reduction in pre-operative cardiac catheterization and has become more accurate in diagnosis. PMID- 2759754 TI - Unusual drainage of the inferior caval vein in left atrial isomerism. AB - Two of the 26 cases of left atrial isomerism in our clinical material had an unusual drainage of the inferior caval vein. In one, the inferior caval vein crossed from left to right infradiophragmatically and then drained into the right sided morphologically left atrium. In the second case, there was azygos continuation to both right and left superior caval veins. These variations have major surgical significance. PMID- 2759755 TI - The management of symptomatic neonates with suspected congenital heart disease using combined cross-sectional echocardiography and pulsed Doppler flow study as the definitive investigations. AB - We studied prospectively 140 consecutive symptomatic neonates with suspected congenital heart disease by combined cross-sectional and pulsed Doppler echocardiography. Using the sequential segmental approach, the anatomy at all cardiovascular junctions was clearly defined in 89 (64%) babies. Based on the non invasive investigations, 47 went to surgery while 42 babies were treated medically. The other 51 babies underwent further cardiac catheterisation. Of these, only 23 (16%) required diagnostic catheterisation prior to their management decision. The remaining 28 babies were catheterised for (1) angiographic measurement of anatomical structures (n = 12), (2) haemodynamic measurement (n = 1), and (3) balloon atrial septostomy (n = 15). One hundred and two babies had ultimate verification of their echocardiographic diagnoses. A total of 612 cardiovascular segments were identified. There were 33 (5%) echocardiographic errors, 23 of missed or uncertain diagnosis and 10 wrong interpretations. The diagnostic sensitivity and specificity for the combined non invasive technique were thus 96 and 98%, respectively. Only one death was attributed directly to an echocardiographic error. Hence when the clinical outcome was taken into consideration, 88 of the 89 neonates without an initial catheterisation were judged to be appropriately managed for their presentation. PMID- 2759756 TI - Prognostic index in prediction of mortality from infective endocarditis. AB - Out of 176 patients with infective endocarditis complicating rheumatic (120) and congenital heart disease (38), mortality occurred in 35 patients (19.9%). Presence of leukocytosis, heart failure, major embolisation and isolation of certain organisms including Staphylococci, beta-haemolytic Streptococci, Pseudomonas and Klebsiella were ominous with higher mortality rates compared with those when they were absent (P less than 0.02). Stepwise logistic multiple regression was then applied and the four most important independent variables were identified. A prognostic index for the prediction of mortality for infective endocarditis was then constructed by the summation of the regression coefficients. By applying this index, patients with infective endocarditis could be divided into subgroups with increasing proportional mortality from 5.8 to 83.3%. It provides an objective assessment of the risk patients with infective endocarditis, and a more reliable evaluation of benefit of any new treatment regimen, including cardiac surgery, during the acute stage. PMID- 2759757 TI - Clinical correlates of acute right ventricular infarction in acute inferior myocardial infarction. AB - Right ventricular infarction was diagnosed on the basis of ST-segment elevation greater than or equal to 1 mm in at least one right precordial lead (V3R-V6R) in 20 of 50 patients with first acute inferior myocardial infarction. Seventy five percent of these had ST elevation in 2 or more right precordial leads. Giddiness and hiccups were more common amongst such patients (P less than 0.05). Signs of right ventricular dysfunction-raised jugular venous pressure (65%), Kussmaull's sign (45%), hypotension (without cardiogenic shock, 40%) and right-sided third sound (25%) in the absence of clinical left ventricular failure, were noted in 65% of such patients. Eleven patients had 2 or more of the above signs. ST elevation in 2 or more right precordial leads was found in 10 of these 11 patients. A more complicated course in the hospital characterised by bradyarrhythmias, hypotension and cardiogenic shock, combined with a greater mortality was seen in such patients. We conclude that the bedside diagnosis of haemodynamically significant right ventricular infarction can be made on the basis of a combination of clinical signs and ST elevation in 2 or more right precordial leads, even in units not equipped for bedside haemodynamic monitoring, echocardiography and radionuclide studies. This should lead to a better identification and management of such patients. PMID- 2759758 TI - Quantitative analysis of the exercise tolerance test for determining the severity of coronary artery disease. AB - Results were compiled from the literature on the use of the exercise tolerance test to identify patients with severe coronary artery disease. Pooled estimates of sensitivity and specificity were derived for the ability of the exercise tolerance test to identify three-vessel or left main coronary artery disease. There was great variability among the studies examined in the estimated sensitivity and specificity of a given criterion for severe coronary artery disease. This variability could not be explained by reported variations in study design. The findings suggest that the accuracy of the exercise tolerance test and other tests cannot be properly interpreted without much greater detail presented in the literature on patient selection and test administration. PMID- 2759760 TI - Day case cardiac catheterisation using the Sones technique. AB - Cardiac catheterisation using the Sones technique was planned as a day case procedure in 855 of 1662 consecutive patients admitted for cardiac catheterisation. Of these, 810 (95%) were discharged the same day. Forty-five (5%) needed overnight hospitalization, 34 for reasons connected with the procedure and 11 for other reasons. No serious complications occurred and there were no deaths. The cost of day stay was approximately half that incurred using overnight stay. Thus, cardiac catheterisation using the Sones technique on a day case basis is safe and may produce significant cost efficiency. PMID- 2759759 TI - Unexpected sudden death during acute myocardial infarction: role of primary electromechanical dissociation. AB - The causes of death during the acute phase of myocardial infarction were studied in 128 patients. Forty-three of these, who had no clear signs of cardiocirculatory failure, were considered to be cases of sudden and unexpected death. Thirty-two of these patients (74%) had electromechanical dissociation, defined as a sudden disappearance of an effective arterial pressure in the presence of adequate electrocardiographic complexes. Twenty-three patients who had been given this diagnosis were males and 9 females; 53% presented with anterior infarction, 31% with infero-posterior infarction, 3.5% with both anterior and infero-posterior and 12.5% with non-Q wave infarction. A previous episode of infarction was recorded in 31.2% of patients with electromechanical dissociation. Autopsy was performed in 84 patients, 23 of whom died with electromechanical dissociation. Half of the latter cases revealed cardiac rupture (secondary electromechanical dissociation), whereas in the other half death was due to primary electromechanical dissociation. The study stresses the relatively high incidence of this cause of death and the need to differentiate between the two different forms. Although at present the pathophysiology of primary electromechanical dissociation is not completely understood, we believe that recurrence of global or local ischemia may play a more important role than cardiovascular inhibitory reflexes. PMID- 2759761 TI - Effect of arginine vasopressin on coronary and systemic hemodynamics in man. AB - Arginine vasopressin is a potent constrictor of isolated arterial segments in vitro. However, it is disputed whether, in vivo, arginine vasopressin acts as either a systemic or coronary vasoconstrictor. The purpose of this study was to determine the effect of arginine vasopressin on coronary and systemic vascular tone in man. Six patients undergoing routine diagnostic cardiac catheterization were studied. At angiography, all patients were found to have severe coronary artery disease. Cardiac and systemic pressures and coronary blood flow as well as serum arginine vasopressin and osmolality levels were measured before and after administration of hypertonic contrast dye and then following intravenous injection of an analog inhibitor of arginine vasopressin. At baseline, serum arginine vasopressin levels were within the normal range in all patients, but, following infusion of contrast dye, rose above physiological levels in 5 patients. In these latter patients, there were no significant changes in coronary and systemic hemodynamics between baseline (condition 1), following administration of contrast dye (condition 2) and 10 minutes after injection of arginine vasopressin inhibitor (condition 3). Mean coronary sinus blood flow (ml/min) and mean coronary vascular resistance (dyne.sec.cm-5) were 184 +/- 49 and 41,235 +/- 8275 during condition 1, 204 +/- 62 and 39,442 +/- 8781 during condition 2, and 192 +/- 75 and 44,930 +/- 11455 during condition 3. Mean arterial pressure (mm Hg) and mean systemic vascular resistance (dyne.sec.cm-5) during conditions 1, 2 and 3 were 105 +/- 12 and 1454 +/- 174, 114 +/- 21 and 1432 +/- 210, and 114 +/- 15 and 1436 +/- 147, respectively.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2759762 TI - Telescoping of alcoholism in women alcoholics. AB - The accelerated progression of alcoholism, or telescoping, was examined among women alcoholics. Three aspects of telescoping in women were examined: the age of onset of four landmark symptoms, the number of years between landmark symptoms, and the number of symptoms occurring within each interval between landmarks. Women alcoholics were found to report a significantly shorter interval between the age at which they first began experiencing alcohol-related problems and the time they sought treatment than did male alcoholics. PMID- 2759763 TI - The Gamblers Treatment Clinic of St. Vincent's North Richmond Community Mental Health Center: characteristics of the clients and outcome of treatment. AB - Data were analyzed from gamblers treated as outpatients: 128 for whom admission data were available and 88 for whom both admission and termination data were available. This group consisted mostly of White males. The average age of the clients was about 42 years. These clients were frequent and heavy bettors whose lives were deeply disrupted by gambling. The clients reported significantly less gambling at termination of treatment than they did at initiation. Improvements in social relations were reported at termination of treatment. There was some evidence that improvements in life-style were related to reports of less gambling at termination of treatment. PMID- 2759764 TI - Does endorsement of the disease concept of alcoholism predict humanitarian attitudes to alcoholics? AB - It has been widely assumed that the disease concept of alcoholism is a powerful vehicle for the promotion of humanitarian attitudes to alcoholics. However, Crawford and Heather have argued that individual differences in attitudes to alcoholics are liable to be a reflection of broader attitudes to deviancy rather than a function of endorsement/rejection of a disease conception. This argument was subjected to empirical scrutiny by means of a questionnaire distributed to 200 members of the public. The questionnaire (1) measured attitudes to four deviant groups--alcoholics, drug addicts, compulsive gamblers, and juvenile delinquents--and (2) recorded whether respondents endorsed or rejected a disease conception of these deviant conditions. Attitudes to the non-alcoholic deviant groups were better predictors of humanitarian attitudes to alcoholics than was endorsement of a disease conception of alcoholism. PMID- 2759765 TI - Host-parasite associations of Eimeria spp. (Apicomplexa:Eimeriidae) in kangaroos and wallabies of the genus Macropus (Marsupialia:Macropodidae). AB - Faecal samples from 514 kangaroos and wallabies representing 12 species of the genus Macropus were examined for oocysts of Eimeria spp. Six species of Eimeria were redescribed from their type hosts, and on the basis of finding homologous oocysts in the faeces of other Macropus spp., host ranges for these coccidia were extended. Eimeria hestermani Mykytowycz, 1964 is redescribed from M. giganteus (eastern grey kangaroo) and is described from M. fuliginosus (western grey kangaroo), M. rufogriseus (red-necked wallaby), M. dorsalis (black-striped wallaby), and M. eugenii (tammar wallaby). E. toganmainensis Mykytowycz, 1964 is redescribed from M. rufus (red kangaroo) and the host range is extended to M. giganteus, M. fuliginosus, M. rufogriseus and M. eugenii. E. wilcanniensis Mykytowycz, 1964 is redescribed from M. rufus, and the host range is extended to M. giganteus, M. fuliginosus and M. robustus (euro or wallaroo). E. macropodis Wenyon & Scott, 1925 is redescribed from M. rufogriseus, and is described from M. giganteus, M. fuliginosus, M. rufus, M. irma (western brush wallaby), M. parryi (whip-tailed wallaby), M. dorsalis, M. eugenii, and M. parma (parma wallaby). E. fausti Yakimoff & Matschoulsky, 1936, E. cunnamullensis Mykytowycz, 1964 and E. purchasei Mykytowycz, 1964 are synonymized with E. macropodis. E. marsupialium Yakimoff & Matschoulsky, 1936 is redescribed from M. giganteus, and from M. fuliginosus. E. gungahlinensis Mykytowycz, 1964 is redescribed from M. fuliginosus, and from M. giganteus. Seven new species of Eimeria are described. E. flindersi, new species, is described from M. eugenii, M. rufogriseus, and M. antilopinus (antilopine wallaroo). E. prionotemni, new species, is described from M. eugenii, M. parryi, M. rufogriseus, M. agilis (agile wallaby) and M. dorsalis. E. mykytowyczi, new species, is described from M. agilis, M. antilopinus, and M. parryi. E. parryi, new species, is described from M. parryi. E. yathongensis, new species, is described from M. fuliginosus and M. giganteus. E. parma, new species, is described from M. parma, and E. desmaresti, new species, is described from M. rufogriseus. E. kogoni Mykytowycz, 1964, and E. rufusi Prasad, 1960 are considered species inquirendae. The host-parasite associations of these coccidia, and of similar species of Eimeria in other genera of Macropodoid marsupials, are discussed in relation to the postulated phylogeny of the hosts. PMID- 2759766 TI - Non-specific resistance to Babesia divergens in the Mongolian gerbil (Meriones unguiculatus). AB - Inoculation of mature gerbils with BCG gave protection to subsequent infection with B. divergens when inoculated by the intracardiac and intraperitoneal routes, the latter showing a dose dependent relationship. BCG vaccination was most effective in immature gerbils (less than 4 weeks old), which are innately resistant to B. divergens. Vaccination of gerbils with killed Propionesbacterium acne and zymosan A failed to elicit a protective response, which contrasts conspicuously with rodent babesia studies. Incubation of B. divergens-infected gerbil blood with hydrogen peroxide produced parasite inhibition only at the highest concentration and treatment of parasitized gerbils with the oxidative radical inducer, alloxan monohydrate, gave equivocal results so it is evident that, unlike Plasmodium spp., B. divergens is not significantly susceptible to the action of reactive oxygen forms. PMID- 2759767 TI - Oesophagostomum radiatum: successful vaccination of calves with high molecular weight antigens. AB - Extracts of adult Oesophagostomum radiatum were resolved into four fractions by gel filtration chromatography on a Superose 12 column. ELISA assays on these four fractions showed that the antibodies produced by naturally infected calves predominantly reacted with the void volume fraction (VV). Three trials were conducted in which calves were vaccinated with the VV fraction of adult extract. When compared to untreated controls, vaccination with the VV of adult extract significantly (P less than 0.05) reduced worm establishment and faecal egg output after challenge infection relative to untreated controls. PMID- 2759768 TI - Additional Plasmodium species from Anolis lizards of Hispaniola and Panama. AB - Saurian malaria parasites in the Caribbean were previously represented by only two species, Plasmodium azurophilum and P. floridense. An additional three species of Plasmodium occur on Hispaniola which appear, because of morphometric and qualitative similarities, to be related to South and Middle American species: a subspecies of Plasmodium tropiduri in Anolis cybotes; a population of Plasmodium minasense anolisi in A. cybotes and A. distichus; and another parasite in A. distichus which is designated as a subspecies of a previously undescribed Plasmodium species in Anolis limifrons. Taxonomic descriptions based upon morphology of mature schizonts and gametocytes are given, the previously unknown parasites are described as new species/subspecies, and comparison is made with P. floridense which also occurs in their respective host species. A Fallisia species was also present but is not described. The increased diversity of Plasmodium parasites in Hispaniolan anoles is attributed to colonization of the island by four separate evolutionary lines of Anolis lizards, in comparison to fewer invasions of Jamaica and Puerto Rico, where only P. floridense and P. azurophilum are found. PMID- 2759769 TI - Sexual, seasonal and tissue variation in the encystment of Cotylurus variegatus metacercariae in perch, Perca fluviatilis. AB - All of the 267 perch sampled from Lough Neagh between 1981 and 1983 were infected with the metacercarial cysts of Cotylurus variegatus. Sites of infection were the swim-bladder, pericardium, septum transversum and, to a lesser extent, the visceral cavity. The swim-bladder, particularly the anterior portion, was the site of heaviest infection. Visceral cysts were found chiefly in female fish and this may be related to reduced immunological defence and/or thinner body wall during the breeding season. The number of cysts recorded was not related to host length, suggesting that further parasite invasion is offset by cyst mortality possibly as a result of the host immunological response to the parasite. Highest mean worm burden was recorded between May and June. This corresponded to increased water temperature necessary for development of eggs and the breeding season (April-June) of the perch. PMID- 2759770 TI - Experimental Haemonchus contortus infections in guinea pigs. AB - Approximately 40% of exsheathed Haemonchus contortus larvae administered to guinea pigs established in the stomach and developed into fourth stage larvae. Most worms were then lost between 5 and 7 days after infection and the guinea pigs were resistant to a second infection. Haemorrhage, oedema and infiltration with inflammatory cells, especially eosinophils, developed in the stomach wall of infected guinea pigs and reactive hyperplastic changes occurred in the gastric lymph node. H. contortus infection of guinea pigs has some potential as a model for study of the pathology, immunology and chemotherapy of gastric nematodiasis. PMID- 2759771 TI - Immunocytochemical demonstration of neuropeptides in the fish-gill parasite, Diclidophora merlangi (Monogenoidea). AB - Using the indirect immunofluorescence technique, immunoreactivity (IR) to three mammalian and one invertebrate regulatory peptide has been demonstrated in the nervous system of the monogenean gill parasite Diclidophora merlangi. IR to pancreatic polypeptide (PP), peptide tyrosine tyrosine (PYY) and FMRFamide was evident throughout central and peripheral nervous tissues, whereas vasoactive intestinal polypeptide (VIP)-IR was confined to a portion of the longitudinal ventral nerve cords. Staining patterns revealed the orthogonal arrangement of the nervous system consisting of paired cerebral ganglia, connecting post-pharyngeal commissure, three pairs of longitudinal nerve cords and associated neurones. PP IR, PYY-IR and FMRFamide-IR were intense throughout the central nervous system of the worm. A small plexus of nerve fibres and somata in each peduncle was immunoreactive for FMRFamide and provided innervation to each of the eight posterior clamps. In the peripheral nervous system, PP-IR, PYY-IR and FMRFamide IR occurred in an extensive nerve-net with fine, possibly sensory nerve endings in the tegument. PP-IR was also present in nerve fibres in the walls of the ootype, seminal vesicle and uterus. PYY- and FMRFamide-IRs, while evident in nerve fibres of the ootype wall, were also present in a distinct population of cells that encircles the ootype, and which are linked to it by fine cytoplasmic connectives. The majority of these somata were bipolar or multipolar. PYY-IR and FMRFamide-IR were also associated with nerve fibres and bipolar cells in the wall of the vitelline reservoir. Regulatory peptides would appear to play an integral role in neuronal functioning and egg development in D. merlangi. PMID- 2759772 TI - Selection for thiabendazole resistance in Ostertagia spp. by low efficiency anthelmintic treatment. AB - Thiabendazole (TBZ) treatment of grazing weaners infected with a predominantly susceptible strain of Ostertagia reduced worm burdens by 90%. The surviving sub population had a level of resistance four times greater than the original population when compared to similarly infected, but untreated, weaners. TBZ treated and control weaners were relocated to worm-free pasture so that the contamination on the plots grazed by TBZ treated weaners was from the survivors of the drench. The anthelmintic treated groups were subsequently managed under a two summer drench programme while control groups remained so throughout the experiment. Monitoring both parasite population size and the degree of resistance over the following 2 years indicated that after three anthelmintic treatments, resistance developed to a level where TBZ was ineffective. When compared to control groups, a mean reduction in population size of around 80% was maintained in the TBZ treated groups for 1 year. This difference, however, disappeared by the second year. A similar study over 1 year with a moderately TBZ resistant strain of Ostertagia indicated that TBZ treatment produced no significant reduction in population size but more than doubled the level of resistance. The study indicated the critical need for highly efficient anthelmintic treatment, particularly in situations where, through ecology or management, post treatment contamination is likely to contribute substantially to future generations of worms. PMID- 2759773 TI - A novel host-protective antigen from Trichostrongylus colubriformis. AB - The detergent-soluble fraction from Trichostrongylus colubriformis third-stage larvae contained a simple set of antigens, one of which (molecular weight 41,000) induced 43-51% protection in guinea pigs following immunization. Isolation and partial amino acid sequence analysis of this protective antigen showed it was parasite tropomyosin. PMID- 2759774 TI - Trixacarus caviae infection of guinea pigs with genetically determined differences in susceptibility to Trichostrongylus colubriformis infection. AB - Guinea pigs with genetically determined resistance or susceptibility to infection with the nematode parasite Trichostrongylus colubriformis were allowed to become infected with the sarcoptid mite Trixacarus caviae. Compared with nematode susceptible guinea pigs, nematode-resistant animals had larger populations of mites and developed a more severe dermatitis, with greater mast cell hyperplasia and many more infiltrating eosinophils. The results suggest that animals bred for resistance to one parasite may have greater susceptibility to other parasites. PMID- 2759775 TI - Effects of Echinostoma caproni infection on the lipid composition of Biomphalaria glabrata. PMID- 2759776 TI - Basilar skull fractures in children. AB - In this paper we are reporting a retrospective study of patients under 18 years of age managed at the Los Angeles County/University of Southern California Medical Center from January 1979 through December 1987 with the diagnosis of basilar skull fracture. Sixty-two patients with basilar skull fractures were admitted during that 7 1/2 year period. The most common etiology was pedestrain versus vehicle accidents (42%), followed by falls (27%), vehicle accidents (23%), and being hit by an object (8%). The most common physical findings were hemotympanum (58%) and bleeding in the ear canals (47%). Thirty-four percent of the patients complained of hearing loss. Cerebrospinal fluid otorrhea was noted in 16 patients (26%), while only 1 patient had cerebrospinal fluid rhinorrhea. Facial nerve paralysis was present in 8 patients (13%). Vestibular symptoms were rare. Sixty-three percent of the patients had the diagnosis confirmed by radiography. The clinical presentation, complications, management and outcome of basilar skull fractures in the pediatric population are discussed. PMID- 2759777 TI - Otitis media with effusion and habitual mouth breathing in Dutch preschool children. AB - Habitual mouth breathing (HMB) is defined as the habit of in- and exhaling (part of) the air through the mouth, when an individual is at rest and the nose is sufficiently free. It is postulated that HMB is a risk factor for otitis media with effusion (OME) in preschool children. The results are presented of a prospective cohort study on 253 3-year-old children, free from OME, with a follow up period of 3 months, to determine the role of HMB in the etiology of OME. The risk ratio for OME of habitual mouth breathers, compared to nose breathers, was found to be 2.4 (95% confidence interval (C.I.): 0.99-5.70). Moreover, there is a clear and significant linear trend in the proportion of OME in 3 breathing categories: nose breathing, intermediate and mouth breathing. This relation remains after correction for confounding. It is concluded that HMB is a risk factor for OME. It is estimated that about 20% of the incidence of OME is caused by HMB. The high incidence of OME means that HMB carries a great deal of impact. Suggestions are made for the prevention and treatment of HMB. PMID- 2759778 TI - Rhinomanometry in children. AB - During the period January 1982 to December 1985 nasal resistance (NR) was measured by computer-assisted 'head-out' plethysmography in 986 patients aged 4 18 years referred to the Airflow Laboratory at the Hospital for Sick Children, Toronto. Nasal resistance was found to decline with increasing age, and it was elevated in the presence of mucosal swelling, adenoid enlargement and other significant nasal pathology. Studies of variance on the equipment used indicated that in the assessment of NR results of the head-out volume displacement plethysmographic method of active posterior rhinometry were highly reproducible. PMID- 2759779 TI - Alveolar soft part sarcoma of the head and neck. A disease of children and young adults. AB - Alveolar soft part sarcoma (ASPS) is a rare malignancy of uncertain histologic origin that predominantly afflicts female children and young adults. Forty-three cases occurring in the head and neck have been identified, to which we add a case. The most frequent sites of occurrence in the head and neck are orbit and tongue. Treatment is universally surgical, with limited roles for adjuvant radiotherapy and chemotherapy. Representative populations of patients with orbital, non-orbital and extremity ASPS are compared statistically. Improved disease-free intervals in orbital ASPS vs non-orbital ASPS and head and neck ASPS vs extremity ASPS are documented. Debate exists regarding the histologic origin of ASPS. The additional case presented does not corroborate recent immunohistochemical studies suggesting myogenic origin. Nevertheless, the clinical pattern of disease offers additional support to the myogenic hypothesis of histologic origin. PMID- 2759780 TI - Rhinomanometry in the selection for adenoidectomy and its relation to preoperative radiology. AB - Recent work has shown that resolution of otitis media with effusion (OME) following adenoidectomy may be related to certain preoperative radiographic parameters. This study was performed to investigate the relationship between the total nasal resistance (TNR), adenoid volume and the radiographic palatal airway and adenoid depth in children with OME. Fifty-six children underwent anterior active rhinomanometry and 40 completed the investigation. There was a significant association between the Palatal Airway and the TNR, and in the 27 who subsequently underwent adenoidectomy this was nearly so with respect to adenoid volume and TNR. The relationship demonstrated was not strong enough for TNR to be of use in selection of children for adenoidectomy based on radiographic parameters. Rhinomanometry can be difficult and time-consuming to perform in children. In its present form it is unlikely to be of routine clinical use in this context. PMID- 2759781 TI - Screening for middle-ear disease in schools for hearing-impaired children. AB - The aim of the study was to determine the prevalence of middle-ear dysfunction in a group of hearing-impaired children attending schools for the deaf. Two groups of subjects between the ages of 4 and 16 years were selected. Group 1 consists of Caucasian and Group 2 of Negroid children. Otoscopic examinations, impedance and pure tone testing were performed on each child. The results indicated a prevalence of 43% failures on the impedance tests in the Caucasian group and 18% failures in the Negroid group. Chronic problems like perforations, otorrhoea, etc. were more common in Group 2. The results also suggest the existence of differences in the prevalence of middle-ear dysfunction between normal and hearing-impaired children. PMID- 2759782 TI - Congenital absence of the nose: a case report. AB - Congenital absence of the nose (arhinia, congenital nasal atresia) is a rare anomaly which is infrequently described in the literature. Herein we present a case of congenital absence of the nose recently evaluated and treated at Children's Hospital Medical Center (CHMC), Cincinnati, OH. CT and MRI studies were obtained. To our knowledge, no such radiographic evaluations have been described in patients with congenital absence of the nose. In addition to complete absence of the anterior soft tissues of the nose, thin anterior and thick posterior atretic plates were present. MRI was useful in defining the nature of the soft tissue mass which filled the single hypoplastic nasal cavity. The lip, alveolus, and palate were remarkably well developed. A thorough investigation revealed no other congenital defects. At 15 days of life, because of the airway support required and the associated feeding difficulties, a nasal airway was created using a combination of sublabial, transpalatal and percutaneous approaches. Frequent home dilation of the surgically created opening has been successful in maintaining nasal patency thus allowing the patient to go without continuous stenting. PMID- 2759783 TI - A swollen cheek, an unusual course of acute mastoiditis. AB - An acute mastoiditis can occasionally present as a swelling in front of the ear. An inflammation of the air cells of the mastoid cavity can spread, via the cells in the root of the zygomatic arch, to the soft tissues of the cheek. Unfamiliarity with this underlying cause of a swollen cheek can lead to delay of proper treatment with potential harm to the patient. This case presents such an uncommon form of mastoiditis in a 3-year-old boy; the failure to recognize the disease initially led to extensive osteomyelitis of the temporal bone. CT scanning was important in establishing the cause of the persistently severe condition of the boy, in spite of bilateral myringotomies and mastoidectomy on the right side. Destruction of bone from the zygomatic arch to the suture between temporal and occipital bone was shown. Extensive removal of diseased bone was achieved neurosurgically, thus leading to uneventful recovery. PMID- 2759784 TI - Tracheostomy in children--the Red Cross War Memorial Children's Hospital experience 1980-1985. AB - During the 6 years (1980-1985) at The Red Cross Children's Hospital 293 children required a tracheostomy during treatment of a variety of disorders. Of these children 44% were under 1 year of age. Indications are discussed of which the commonest was LTB. Of the 3500 children seen with laryngotracheobronchitis (LTB) 4.6% had a tracheostomy--28% of those requiring airway intervention. Overall 67% of the children were decannulated within 10 weeks and 92% within a year. For 56% one or more further procedures prior to decannulation were required, including 34 children who required a laryngotracheoplasty. Obstructing stomal granulation tissue had to be removed from 51 children and suprastomal collapse was a cause of decannulation failure in 52 children. Use of an expiratory valve as an aid to decannulation is discussed. Five children died of tracheostomy airway complications and 25 children of a medical disorder. One complication, laryngeal incompetence, was particularly associated with herpetic laryngeal ulceration. Staphylococcus aureus and Hemophilus influenzae were the main organisms cultured in the early weeks, with Pseudomonas and Streptococcus species predominating later. PMID- 2759785 TI - Transplantation of retinal epithelial cells. PMID- 2759786 TI - Cell loss in the aging retina. Relationship to lipofuscin accumulation and macular degeneration. AB - We examined the impact of aging on the numbers of photoreceptors and retinal pigment epithelium (RPE) cells, and the number of photoreceptors per RPE cell profile, in selected regions of 30 human eyes. The mean ratio of photoreceptors to RPE cell was higher in the macula than in the paramacula (P less than 0.01) or the equatorial area (P less than 0.001). We found evidence for an age-related loss of RPE in both whites (P less than 0.02) and blacks (P less than 0.0006), although the rate of loss in whites was significantly slower than in blacks. Photoreceptor loss in blacks was inversely correlated with age (P less than 0.04). In whites, however, photoreceptor loss was very significantly and directly correlated with lipofuscin concentration in the opposing RPE (P less than 0.0001) and unrelated to age. The disparity in the rates of photoreceptor and RPE cell loss produced, in older eyes, a higher ratio of photoreceptors per RPE cell profile. In the macula, the ratio for whites over 50 years of age was significantly higher (P less than 0.05) than that in blacks over 50. Our data suggest that the increased phagocytic and metabolic load on the RPE, which ultimately the macula causes a preferential age-related accumulation of lipofuscin in the RPE, which ultimately leads to photoreceptor death. This may prove a useful model of age-related macular degeneration and Stargardt's disease. PMID- 2759787 TI - The blood-retinal barrier in chloroquine retinopathy. AB - Chloroquine retinopathy can result in devastating loss of vision. To date, there are no effective and reliable methods of detecting the toxicity at an early stage when retinopathy may be reversible. Chloroquine is deposited in the retinal pigment epithelium, which forms part of the blood-retinal barrier (BRB). By vitreous fluorophotometry we have shown that there is breakdown of the BRB in chloroquine retinopathy. However, in asymptomatic patients who had received varying amounts of hydroxychloroquine (up to 1067 g), the BRB remained intact. PMID- 2759788 TI - S (blue) cone pathway vulnerability in retinitis pigmentosa, diabetes and glaucoma. AB - A variety of retinal disease lead to a decrease in the sensitivity of the S (blue) cone pathways. To determine the possible sites and mechanisms of this loss we compared the sensitivities of an S (blue/pi-1) and an M (green/pi-4) cone pathway in patients with retinal diseases that differ as to their primary locus of sensitivity loss. The sensitivities of an S and an M cone pathway were assessed in patients with retinitis pigmentosa, insulin-dependent diabetes mellitus and open-angle glaucoma using Stiles two-color increment threshold technique. A greater loss in sensitivity of an S than an M cone pathway was found for all three disease groups; however, the diabetic patients showed a more selective loss. The results suggest that multiple sites are involved and that the combined effects of metabolic abnormalities and hypoxia contribute to the selective loss. PMID- 2759789 TI - Changes in rod sensitivity through adulthood. AB - Absolute thresholds of 23 subjects 19-61 years of age were determined for three wavelengths at six retinal eccentricities in the horizontal meridian (2.5 degrees 30 degrees). The raw data were corrected for prereceptoral light losses that may be age-dependent. Lens density was estimated for each subject by comparing scotopic spectral sensitivity with the absorption spectrum of rhodopsin. Macular pigment density was estimated by comparing macular sensitivity with peripheral sensitivity. Average dark-adapted pupil size at each age was taken from published values. After correction for these prereceptoral light losses, changes in rod sensitivity with age were not significant at any retinal locus tested. PMID- 2759790 TI - Asymmetry of focal ERG in human macular region. AB - Electroretinograms (ERGs) were elicited by hemicircular (half-disc) stimuli to the upper, lower, temporal and nasal maculas of 26 normal subjects, and the amplitudes and implicit times of the ERGs from opposing macular regions were compared. The amplitudes of a-wave, b-wave and oscillatory potentials (OPs) were significantly larger in the upper macular region than in the lower macular region (P less than 0.05). The amplitudes of a- and b-waves did not differ significantly between temporal and nasal macular regions, but OPs showed enormous asymmetry, with significantly larger amplitudes in the temporal retina than in the nasal retina (P less than 0.001). The implicit times of a-waves, b-waves and OPs did not differ significantly between upper and lower retina, or between temporal and nasal retina. These findings aided analysis of the ERG of a patient with a retinal defect. PMID- 2759791 TI - Corneal repair following keratectomy. A comparison between conventional surgery and laser photoablation. AB - We have used the fluorescent dye dichlorotriazinyl aminofluorescein (DTAF) to demonstrate corneal remodeling following keratectomy in the rabbit. The dye was applied to the surface of 3.5 mm diameter anterior keratectomy wounds produced by either lamellar dissection or photoablation with an excimer laser (193 nm) to a depth of 15, 50 or 75 microns. Stromal wounds that had been ablated in 12 concentric steps to produce a graded profile with a central depth of 15 or 30 microns were also studied. The repair process was followed for periods of up to 6 months. These results were compared to wounds of similar dimensions in which an intrastromal keratectomy was performed and the anterior stromal surface replaced. Sections examined by fluorescence microscopy showed that connective tissue was deposited beneath the epithelium of all anterior keratectomy wounds irrespective of their mode of induction or depth. The deposition of this new tissue, and an associated thickening of the epithelium over the wound surface, appeared to be complete by 1 month and tended to restore the original surface contour. The synthesis of connective tissue, but not the hyperplasia of the epithelium, was reduced by local steroid treatment. In contrast, an intrastromal keratectomy only stimulated the deposition of small amounts of new connective tissue at the wound junction without as marked a thickening of the overlying epithelium. These observations emphasize the importance of the epithelium in moderating repair after stromal loss, and suggest that remodeling may result in corneal haze and a change in the desired refraction if refractive surgery is attempted by anterior keratectomy. PMID- 2759792 TI - Hyperthermic treatment of rabbit corneas. AB - Well defined heat doses (temperature X time) were applied to normal rabbit corneas in an effort to determine thermal tolerance, and to examine the effects of heat on this tissue. A purely conductive heater was chosen to minimize intraocular penetration, and avoid findings attributable to nonthermal effects of inductive sources. The etched element heater was sewn to 38 rabbit corneas. Thirty-six were treated to temperatures of 38, 45, 52 and/or 59 degrees centigrade for durations of 5, 15, or 45 min. Three eyes were treated at each time-temperature interval and sacrificed at either time 0, 1 day or 1 week follow up. Histologic examinations were performed on all corneas. A corneal haze was first noted at 45 degrees C X 45 minutes X 1 day follow-up. This correlated with a mild stromal edema on light microscopy. Higher thermal doses produced a spectrum of damage, with complete destruction of all keratocytes and endothelial cells at 59 degrees C X 45 min. At levels greater than 45 degrees C x 45 min, heat damage was noted to be increased at 24 hr followup. Some recovery was noted by 1 week follow-up, with the exception of the 59 degrees C X 15 or 45 min groups. These two heat doses induced a drop-out of cellular elements with evidence of disintegration and fragmentation of collagen fibrils. Conductive heating of up to 45 degrees C X 15 min appeared well tolerated by normal rabbit corneas. PMID- 2759793 TI - Dynamics of corneal epithelial healing after an alkali burn. A statistical analysis. AB - A precise definition of epithelial healing kinetics following chemical injury is necessary to aid the investigation of control mechanisms, potential therapeutic intervention and ophthalmic drug toxicity. Wound healing was studied photographically at frequent intervals in rabbits following 1N or 4N alkali burns. Planar wound areas were determined by computerized planimetry and transformed mathematically to curved surface data. The decrease in equivalent wound radius with time was computer-modelled using two linear and three nonlinear regressions. A periodic function was also investigated. Serial photographs showed that intermittent attrition of small areas of the migrating wound edge was a common confounding variable. Although excellent coefficients of determination were found for all models, the addition of nonlinear factors gave a small advantage. A mean lag phase of 3.96 and 6.52 hr occurred after 1N and 4N alkali burns, respectively; wound edge attrition was notably prevalent in early healing. Epithelial healing in the rabbit had a fundamental linear component, with mean epithelial migration rates of 76 and 80 microns/hr after 1N and 4N alkali burns, respectively, and which continued to closure. A quadratic nonlinear component was also suggested. No significant circadian component was detected. PMID- 2759794 TI - The morphology and function of healing cat corneal endothelium. AB - We mechanically damaged the entire corneal endothelium of one eye of each of ten cats and then examined both eyes by fluorophotometry and specular microscopy for 5 months. Six weeks after damage, when the corneas had cleared sufficiently to make accurate measurements, the mean endothelial permeability to carboxyfluorescein was increased 11% (P = 0.02) and the mean central corneal thickness was increased 11% (P = 0.05) in the damaged eyes. The mean endothelial pump rate was decreased 29% (P = 0.05), indicating that the increase in permeability was insufficient to explain the increase in thickness. The permeability returned to normal by 3 months and the pump rate by 5 months. Six weeks after damage, the mean endothelial cell size was increased 89% (P less than 0.01), the mean coefficient of variation of cell size was increased 200% (P less than 0.01), and the mean percentage of hexagonal cells was decreased 34% (P less than 0.01). By 5 months, the mean cell size had changed very little, and none of the three morphologic measurements had returned to normal. As in rabbits, the endothelial barrier in cats recovers before the pump after wounding. Unlike in rabbits, functional recovery in cats requires at least several months. Such prolonged functional recovery after endothelial trauma might also be expected in humans who, like cats and unlike rabbits, have little capacity for endothelial mitosis during healing. PMID- 2759795 TI - A system for long-term corneal perfusion. AB - Seventy-two human corneas were maintained in a perfusion system at 37 degrees C and 18 mm Hg intracameral pressure for 1 to 3 weeks. Corneal thickness, which was initially greater than normal because the enucleated eyes were kept at 4 degrees C before excision of the corneas, decreased slowly during the period of incubation. Endothelial removal or perfusion with ouabain (10(-4) M) induced irreversible stromal swelling. Cooling to 4 degrees C for 8 hr during perfusion caused stromal swelling that disappeared after rewarming to 37 degrees C; less stromal swelling occurred with cooling after 3 weeks of perfusion than after 3 days. No enlargement of central endothelial cells was noted in most corneas by serial specular microscopy. Electron microscopy demonstrated reversal of postmortem changes and maintenance of normal intracellular ultrastructure for 3 weeks. This system for long-term corneal perfusion will allow controlled studies of the effects of new methods of corneal preservation and other perturbations upon the corneal endothelium in situ. PMID- 2759796 TI - Neodymium-YAG transscleral cyclophotocoagulation. The role of pigmentation. AB - Using a rabbit model we investigated the role of pigmentation of the ciliary body in obtaining ciliodestruction by neodymium-YAG transscleral cyclophotocoagulation. There was marked destruction of the ciliary body in pigmented rabbit eyes, but no histologic effect was observed in albino rabbit eyes. These findings suggest that pigmentation of the ciliary body is important for obtaining the desired response from neodymium-YAG transscleral cyclophotocoagulation in rabbit eyes by our technique. Further study is necessary to define the role of pigmentation in human eyes in this treatment modality. PMID- 2759797 TI - Prostaglandin F2 alpha effects on intraocular pressure negatively correlate with FP-receptor stimulation. AB - According to the current working classification for prostanoid receptors, the prostaglandin F2 alpha-sensitive receptor (FP-receptor) may be identified by comparing the rank order of activity of prostaglandin F2 alpha (PGF2 alpha) and its analogues. In order to further understand the pharmacology of PGF2 alpha induced ocular hypotension, the intraocular pressure response to PGF2 alpha and selected analogues was compared with their rank order of activity in typical FP receptor preparations such as contraction of the cat iris sphincter and affinity for corporal luteal membrane binding sites. The rank order of potency for decreasing intraocular pressure was as follows: PGF2 alpha greater than PGF1 alpha greater than 16-phenoxytetranor PGF2 alpha greater than 17-phenyltrinor PGF2 alpha = fluprostenol (inactive). For cat iris sphincter contraction, the rank order of potency appears to be fluprostenol = 17-phenyltrinor PGF2 alpha greater than 16-phenoxytetranor PGF2 alpha = PGF2 alpha greater than PGF1 alpha. The rank order of potency for PGF2 alpha analogues in decreasing intraocular pressure appears to negatively correlate with the rank order for cat iris sphincter contraction and literature values for corporal luteal membrane binding. It is concluded that the ocular hypotensive effect of PGF2 alpha is not mediated by the FP-receptor. PMID- 2759798 TI - Dexamethasone induces specific proteins in human trabecular meshwork cells. AB - Previous studies have demonstrated the presence of high-affinity, glucocorticoid specific receptors in explants of human outflow tissue and in cultured trabecular meshwork. Glucocorticoid-induced responses of scleral fibroblasts and trabecular meshwork cells were evaluated in this study. Incubation of human trabecular meshwork (HTM) and scleral fibroblast (HS) cells with 10(-7) M dexamethasone (DEX) results in a 60% inhibition of prostaglandin production. The effects of glucocorticoid treatment on cellular and secreted proteins using [35S] methionine incorporation were evaluated. Treatment of HTM cells cultured from two normal individuals with DEX induced the expression of [35S] methionine-labelled cellular proteins of 35, 65 and 70 kD, and secreted proteins of 40, 90 and 100 kD. Under the same experimental conditions, a 70 kD molecular weight cellular protein was induced in the HS cells. There were no apparent DEX-induced alterations in HS secreted proteins. Since a functional common response to glucocorticoid treatment in both HS and HTM cells was inhibition of prostaglandin production, the dexamethasone-induced expression of the 70 kD protein in these cells may be related to this effect. Further studies are required to elucidate specific roles of the steroid-induced proteins in the effects of glucocorticoids on HTM and HS cells. PMID- 2759799 TI - Measurement error in assessing the size of posterior subcapsular cataracts from retroillumination photographs. AB - Twenty-six eyes with posterior subcapsular opacities of various sizes were photographed with the Neitz-Kawara Retroillumination camera. The outline of the opacity in a single photograph of each opacity was traced onto a transparent plastic overlay twice by two independent outliners. Two methods were used to estimate the area within the outlines of the opacities. In the first, a transparent overlay with a standard grid was used to count the number of boxes within the outlines. The second method used computer planimetry to estimate the area within the tracings. We estimated the measurement error associated with a single outlining of an opacity and the contribution of the measurement error to overall sample size requirements in studies comparing the mean areas of posterior subcapsular opacities. Variability in the measurement techniques contributed fewer than 20 additional subjects to overall sample size estimates, a small contribution to total sample size requirements in most studies. An outliner's inherent variability in outlining an opacity was a much larger contributor to the measurement error than was variability in assessing the area of the outline of the opacity. While within outliner variability was similar for the two persons outlining the opacities, there were systematic differences in the way the two traced the outlines. Variability from the use of separate photographs of the same opacity taken by different photographers was minimal. PMID- 2759800 TI - Human lens membrane cation permeability increases with age. AB - Parallel studies of the ionic balance and membrane permeability characteristics of normal human lenses were carried out in three countries (USA, England and Italy). Similar age-related changes were found in each laboratory. The lens membrane potential and resistance declined markedly with age while internal Na+ and free Ca2+ increased. There was a concomitant stimulation of Na+ and K+ transmembrane fluxes. These data indicate that in the ageing process there is an increasing contribution to membrane ion traffic from a channel, or channels, that permit Na+, K+ and Ca2+ to pass. The increase in permeability coincides exactly with the increase in optical density that occurs in the ageing human lens. PMID- 2759801 TI - Morphology and ultrastructure of human vitreous fibers. AB - Significant alterations in vitreous structure occur with aging and disease. There is controversy as to the nature of the normal structure of the vitreous and no studies have correlated macroscopic structure with ultrastructure in the same eyes. Twenty-eight fresh, untreated human eyes were examined after removal of the sclera, choroid and retina. Dark-field slit illumination of the whole vitreous revealed the presence of macroscopic fibrous structures. The fibers had an antero posterior orientation with anterior insertions at the vitreous base and posterior insertions in the premacular vitreous cortex. Transmission electron microscopy demonstrated the presence of collagen fibrils and no membraneous structures. Parallel collagen fibrils packed in bundles were also detected. Macroscopic vitreous fibers most likely result from alteration of the hyaluronic acid collagen complex with aggregation of collagen fibrils into bundles as seen on electron microscopy. Identifying the mechanisms underlying this process of fiber formation could clarify the pathogenesis of vitreous liquefaction and the pathophysiology of posterior vitreous detachment. PMID- 2759802 TI - Electrophoresis combined with immunologic identification of human tear proteins. AB - The protein content of normal human tears from five subjects was examined by molecular weight separation using SDS-polyacrylamide gel electrophoresis (PAGE) and by charge separation using agarose isoelectric focusing (IEF) gels. After separation, specific proteins were identified by immunoblot and immunofixation. Tear proteins examined included albumin, IgA, IgG, prealbumin, lactoferrin, lysozyme, secretory component and transferrin. These techniques required 1 to 14 microliters unconcentrated tears. We found SDS-PAGE superior to agarose IEF to examine total tear protein pattern, and silver stain almost ten-fold more sensitive than Coomassie blue stain. Immunologic staining markedly enhanced protein detection in all tear samples and appeared to offer the definitive method to probe for a specific protein in tears. In this study prealbumin and a portion of the IgG were present in normal tears at higher than expected molecular weight, suggesting they were present in complexed form. Prealbumin and secretory component staining showed marked variability between subjects. These techniques should be applicable to examine tear proteins in a variety of ocular disease states. PMID- 2759803 TI - Rapid adaptation of saccadic amplitude in humans and monkeys. AB - To study adaptive motor learning in the saccadic system we have used a psychophysical procedure that introduces a "visuomotor mismatch" between the retinal error signal (retinal distance between fovea and target image) and the motor error signal (movement required to accurately foveate the target). The saccadic system responds to this visuomotor mismatch by rapidly modifying the amplitude of the saccade. We will refer to this procedure as induced saccadic dysmetria. In our paradigm, the saccadic dysmetria is produced by electronically adding or subtracting a fraction of the eye position signal to adjust the target's position. Thus the original visual error signal that initiates the saccade no longer elicits an appropriately sized saccade; there is a mismatch between target step and saccade amplitude. We find that the human and nonhuman primate saccadic systems respond to this error by rapidly and adaptively adjusting the amplitude of saccades. Such adaptive adjustments are not the result of changes in saccade strategy but represent a genuine recalibration. We conclude that induced saccadic dysmetria provides us with a tool for the study of adaptive motor learning in the oculomotor system. It is hypothesized that the adaptive mechanism may use either or both of two signals: a visual error signal representing the retinal distance of the target from the fovea after the initial saccade and/or a motor error signal represented by the amplitude of the corrective saccade. PMID- 2759804 TI - Denervation of primate extraocular muscle. A unique pattern of structural alterations. AB - Extraocular muscles differ from most other skeletal muscles in terms of constituent fiber types and innervation pattern. The rules that govern fiber responses to various experimental interventions for most skeletal muscles, therefore, may not strictly apply to the extraocular muscles. In this study, denervation of the extraocular muscles of Cynomolgous monkeys, Macaca fascicularis, was accomplished by intracranial transection of the oculomotor nerve. Survival times of 3-167 days were allowed, and muscles were processed for analysis by light and electron microscopy. Short-term alterations involved all muscle fiber types and included retraction of neuromuscular junctions, mild myofibril disruption and inflammatory cell infiltration. Long-term morphopathological changes were most apparent in the orbital singly innervated fiber type and its global layer counterpart. These alterations consisted of dispersion of the mitochondrial aggregates which characterize this fiber type. Only occasional fibers (all types) exhibited severe vacuolar atrophy or myofilament breakdown despite the occurrence of only limited reinnervation. When extensive reinnervation did occur, the characteristic layered organization of the extraocular muscles was preserved and fiber type grouping was not apparent. Taken together, these findings indicate that the extraocular muscles exhibit a resilience to denervation beyond that observed for other skeletal musculature. PMID- 2759805 TI - An evaluation of the notification of birth form. AB - Data on 108 Notification of Birth Forms, from a total of 6 hospitals, have been compared with hospital case notes, for both accuracy and completeness. Items related to socio-demographic features of mothers were reliable. However, certain items related to past obstetric history, such as date of last birth and number of previous live births, were less than 90% reliable. Data on index pregnancy were poorest, with three items, first visit to doctor during pregnancy, first visit to hospital during pregnancy and rubella immune status all less than 75% reliable. Data from one hospital were of poorer quality than others, principally because the information on the form is not obtained directly from the mother. Data on forms related to travellers (N = 29) were also of poorer quality. PMID- 2759806 TI - Ulcerative enteritis--atypical features. AB - A 40 year old man with two month history of vomiting and weight loss, was found to have multiple strictures in his small bowel. Investigations outruled known causes of small bowel ulceration, and the flat bowel mucosa did not respond to a gluten free diet. Treatment with steroids conferred a temporary benefit, however, small bowel ulceration persisted. PMID- 2759807 TI - Area of residence and risk of cancer of the cervix uteri in Ireland. AB - A study of 85 women attending a national centre for treatment of invasive squamous cell carcinoma of the cervix uteri (SCC) and 85 age-matched female controls attending the same centre showed no significant difference for area of residence. A previously reported excess of rural women among cases was probably an artefact of sample selection. An increased risk for women resident in urban areas described in studies elsewhere is not apparent in the women studied and demographic features of the Irish population may influence this result. PMID- 2759808 TI - Diagnosing iron deficiency in a hospital population. AB - The iron status of four hundred and forty-seven hospital patients was studied in order to assess the efficiency of laboratory tests in diagnosing iron deficiency. One hundred and three patients (23%) were iron deficient on bone marrow examination. The laboratory tests had a low diagnostic efficiency, with either a low diagnostic rate or a high false positive rate. However, serum ferritin, despite a diagnostic rate of 25% did establish the diagnosis with near certainty, avoiding the need for invasive and costly investigations. Serum ferritin should be retained in the laboratory investigation of iron deficiency. Serum iron with iron binding capacity should be removed from the repertoir. PMID- 2759809 TI - A comparison of alprazolam with amitriptyline in the treatment of patients with neurotic or reactive depression. A report of a randomised, double blind study by a General Practitioner Working Party. AB - 104 patients suffering from neurotic or reactive depression were treated with either alprazolam or amitriptyline in randomised, double-blind fashion. Seventeen patients were either lost to follow-up or withdrawn before week 2 (13 due to side effects and 1 because she was feeling better). A further 7 patients did not comply with the protocol, giving a total of 24 patients whose data were not considered suitable for inclusion in the analysis of therapeutic assessments. Evaluation of the 80 patients (40 in each group) who completed at least 2 weeks of the 4-week study demonstrate that both treatments produced a statistically significant response rate. There was a more rapid effect in those patients who received amitriptyline, but there was no significant difference in response between the treatment groups after 4 weeks treatment. Analysis of safety and side effect data on 101 patients (50 treated with alprazolam and 51 with amitriptyline) shows no statistically significant difference in the overall number of side effects experienced in each group, although 11 of those patients who received amitriptyline withdrew because of adverse reactions before completing the study compared to 6 in the alprazolam group. These results suggest that alprazolam may be a useful treatment for patients with neurotic or reactive depression not requiring hospitalisation. PMID- 2759810 TI - Investigation of the possible effect of the Chernobyl accident on Irish mortality rates. AB - RADIOACTIVE fallout from the Chernobyl accident reached Ireland in May 1986 and caused serious concern with regard to its possible effects on health. Reports of a large scale American study claim an almost immediate effect of Chernobyl fallout in terms of increased mortality rates. A study of Irish mortality rates reported a substantial increase in numbers of deaths during the three months immediately post-Chernobyl. The present study investigates whether there is a statistically significant basis for the reported increase in mortality in Ireland. No discernible evidence was found for increased mortality rates in Ireland during 1986, following the Chernobyl accident. The initial report of increased mortality rates was based on provisional mortality registration statistics and not on actual day by day data. PMID- 2759811 TI - Suprasellar germinoma--occult presentation with hypothalamic failure 18 months before diagnosis. AB - Hormonal evidence of widespread hypothalamic failure, including diabetes insipidus, hyperprolactinaemia, growth failure, hypothyroidism, and adrenal failure, was present in a boy of 14 years. Investigation with computerised axial tomography (CT) and metrizamide encephalography failed to identify any anatomical abnormality at the time of presentation. However, 18 months later papilloedema was noted at which time a suprasellar mass and gross dilatation of the ventricular system were readily identified using CT and a germinoma was subsequently diagnosed and treated. In the light of this experience we recommend that when "idiopathic" hypothalamic failure is diagnosed, imaging procedures, including CT or nuclear magnetic resonance examinations, should be repeated on at least one occasion, after an interval of approximately 6 months. PMID- 2759812 TI - Oculopharyngeal muscular dystrophy in an Irish family. AB - Victor and his associates coined the term oculopharyngeal muscular dystrophy to describe a clinical syndrome characterised by dysphagia and ptosis. Subsequent authors have traced a large series in French Canadians to a single Quebec isolate and have emphasized that the condition is usually inherited as a dominant trait. In 1974 Fried reported two isolated cases in an Ashkenazi Jewish family of Hungarian extract in whom the condition was recessively inherited. In this paper we report an Irish family from North Cork with typical features of oculopharyngeal muscular dystrophy in whom the inheritance pattern is dominant with incomplete expression. In reporting such cases the ethnic and genetic heterogeneity of oculopharyngeal muscular dystrophy is highlighted. Case Report 1. A 68 year old farmer was admitted for investigation of recurrent chest infections. He complained of a 20 year history of progressive difficulty swallowing, productive cough and impaired vision. On examination he had a gaunt expressionless appearance with bilateral ptosis to mid pupillary level. Both right and left gag reflexes were noted to be reduced and sluggish, and on swallowing fluids were noted to regurgitate through his nostrils. Chest examination revealed the presence of bibasal coarse crepitations suggestive of aspiration. No further physical abnormalities were noted. On investigation, full blood count, urea, and electrolytes, liver function tests, sedimentation rate, thyroid function tests, muscle enzymes (PK, LDH) and electrocardiogram were normal. Chest radiograph confirmed aspiration. Tensilon test was negative. Oesophagoscopy outruled organic obstruction, and confirmed sluggish pharyngeal muscular activity. A clinical diagnosis of oculopharyngeal dystrophy was made on the basis of associated ptosis and dysphagia occurring in the presence of a supportive family history.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2759813 TI - Recent experience with intensive combination chemotherapy for treatment of childhood acute lymphoblastic leukaemia. AB - Forty-eight children with acute lymphoblastic leukaemia (ALL) who presented to the Oncology Department of Our Lady's Hospital for Sick Children, Crumlin, Dublin over a 52 month period were treated using a schedule modified from the BFM-81 protocol. All patients achieved remission within four weeks. With a minimum follow up period of 18 months, actuarial disease free survival was 68% and overall survival 75%. Mean hospital stay throughout the treatment period was 31 days. While these results represent an improvement in overall survival compared with historical controls, careful selection of risk categories will be the major aim of future studies so that more appropriate treatment can be instituted for high risk patients while minimising therapy for low risk disease. PMID- 2759814 TI - Testicular cancer, early diagnosis and management. PMID- 2759815 TI - Difficult intubations--anaesthetist's nightmare. PMID- 2759816 TI - The statistical ring of confidence. PMID- 2759817 TI - Insight into childhood blindness. PMID- 2759819 TI - Seat belts and accidents. PMID- 2759818 TI - To trip, to slip, perchance to tumble. PMID- 2759820 TI - Surgery in the treatment of varicose veins. AB - To identify variables which might influence the results of varicose vein surgery, a ten-year retrospective study was carried out on 612 patients undergoing varicose vein surgery. Patient symptomatology, type of venous insufficiency and operator experience were examined and correlated with the results of surgery. The female-to-male ratio was 2:1. The mean age was 47 years for women, 45 years for men. A family history of varicose veins was recorded in 74% of patients. A history of previous deep venous thrombosis was reported in 5% of cases, but in the sub-group of patients with stasis ulceration, the incidence was 9%. Cosmetic appearance was the commonest presenting complaint (54%), while ulceration was relatively infrequent (14%). There was moderate-to-marked improvement in 86% of cases at one year. This was sustained in 79% at three years, in 75% at five years and in 74% at ten years. There was no correlation between the type of venous insufficiency or the presenting complaint, and the result of surgery. Operator experience had the most significant effect on the outcome of surgery (P less than 0.001). Our findings indicate that varicose vein surgery offers most patients a satisfactory result. The only significant variable was operator experience. We strongly recommend closer supervision of junior staff performing this type of surgery, particularly as a large proportion of these patients (25% in this study) are operated on by the more junior staff. PMID- 2759821 TI - Radiographic changes in the ossific nucleus in congenital dislocation of the hip. AB - Twenty one patients with a delayed diagnosis of congenital dislocation of the hip were studied to assess the relevance of radiographic changes in the ossific nucleus of the proximal femur during the first year following treatment. All abnormal hips demonstrated sclerosis of the margins of the ossific nucleus with irregularity of its surface at three months following surgery. In nineteen patients a head within a head was identified. These common changes are interpreted as the radiographic appearance of a spherical growth disturbance line formed by the ossific nucleus. It is concluded that these radiographic changes which are often accepted as indicators of avascularity are of no detrimental significance in the absence of physeal injury. PMID- 2759822 TI - Ovarian cancer in a county hospital. AB - Forty two cases of ovarian cancer diagnosed and treated over a ten year period (1975-1985) are reviewed. The mean age at presentation was 59.3 years and mean parity 1.9. Abdominal pain and distension were the commonest clinical symptoms. Twenty three patients had total abdominal hysterectomy and bilateral salpingo oophorectomy with or without partial omentectomy. All patients had at least diagnostic laparotomy. There were no post-operative deaths. Thirty two patients had adjuvant chemotherapy. Two patients had false negative "Second Look" procedures. Histology in all cases was of epithelial origin. Survival at one year was 52.4% and 35.3% in those patients followed for five years. Good prognosis was related to extent of disease and surgical excision. Cisplatinum post-operative chemotherapy replaced other cytotoxic drugs in the latter years and it's use was associated with less morbidity and longer survival in patients with extensive disease than earlier regimes. We feel that national co-ordination in gynaecological oncology surveillance and treatment would be beneficial. PMID- 2759823 TI - Contraceptive practices of patients referred for colposcopy with an abnormal cervical smear. AB - This study examined the contraceptive practices of 100 patients referred for colposcopy because of an abnormal cervical smear. At presentation 49% were using oral contraception but 94% had taken the pill at some time. Eight of the 10 patients using barrier methods were relying on condoms: in at least seven of the eight cases an abnormal cervical smear preceded condom usage. Thus, the method of contraception used when cervical neoplasia develops may differ from the method used when the patient presents for colposcopy. Although consistent with previous studies suggesting that the incidence of cervical neoplasia is increased in women using oral contraception, the risk of neoplasia is more likely to be explained by the degree of exposure of the cervix to an infectious carcinogen or to the immunosuppressive effects of seminal plasma. We suggest that future studies of the epidemiology and natural history of cervical neoplasia should include a detailed contraceptive history. PMID- 2759824 TI - Changing patterns in childhood gastroenteritis. AB - A study was made of gastroenteritis and the causal organisms in children under 14 years admitted to a large Dublin isolation fever unit in 1987. The findings were compared with a similar study at the hospital in 1981. In 1621 admissions in 1987 (1770 in 1981), there was a significant drop in the incidence of E. coli (10.1% vs. 22.6% in 1981), Salmonella spp. (3.0% vs. 4.9%) and Shigella spp. (1.7% vs. 4.9%). Cryptosporidium was identified in 4% of cases in 1987, mainly from rural backgrounds. The peak incidence of total cases was in late winter compared with the 1981 peak in late summer/early autumn. The length of stay in hospital fell significantly (9.5 vs. 18.3 days). This change in the pattern of gastroenteritis in Ireland has already been described in other developed countries 15-20 years ago. PMID- 2759825 TI - Full blood count values in adolescents. AB - This paper presents full blood count values for Irish adolescents. The range of results is presented and normal values are suggested. Of particular interest are the low MCV and MCH values among male adolescents. This would suggest that iron deficiency is more common in this group than was hitherto appreciated. PMID- 2759826 TI - Iron deficiency in pre-menopausal females. AB - Of 20 women (pre-menopausal) with iron deficiency anaemia, only three felt that their periods were unduly heavy. However, on objective assessment of menstrual loss using the alkaline haematin method, the blood was found to be excessively heavy in 12 cases (296 +/- 45 mls per cycle: normal is 80 mls/cycle). The findings emphasise that women underestimate the extent of menorrhagia. PMID- 2759827 TI - Listeriosis: a community problem? AB - Three epidemiologically distinct cases of listeriosis, one perinatal and two adult, presented in hospital over a three day period. Clinical signs were non specific with pyrexia and respiratory distress. Diagnosis in all three was made by blood cultures. Such cases reflect the general increase in reporting of listeriosis and suggest that the condition is increasing in incidence in the community, most likely due to food contamination. Raw vegetables, milk, soft cheeses, pre-cooked and inadequately cooked meats have all been implicated. Regular public health inspection of foods and food storage facilities with increased public awareness of the hazards of inadequate cooking and storage of food are the most effective means of preventing listeriosis and its potentially disastrous consequences especially for pregnant women and immunosuppressed patients. PMID- 2759828 TI - Osteomalacia in the elderly: biochemical screening in general practice. AB - Two hundred and eighty two patients aged sixty-five or over were screened for biochemical evidence of osteomalacia using a modified metabolic bone index. 5.2% showed classical biochemical features of the disorder. As osteomalacia is an important but under-recognised condition in the elderly, this simple biochemical method may be suitable for general identification of patients at risk. PMID- 2759829 TI - The role of dipsticks in the diagnosis of urinary tract infection. AB - Dipsticks containing indicators for the presence of leucocytes (nephur test) and bacteria (nitrate test) were performed on 1134 urine samples obtained from children attending a Urinary Tract Infection Clinic. These dipstick results were compared with the results of standard leucocyte counts and culture of the same urines. The nitrite test was disappointing in diagnosing infection as it was positive in only 81.4% of urines with positive cultures. However, if it was combined with a nephur test only 3.9% of infections were missed. Conversely a positive nitrite test indicated with 91.3% accuracy that the urine was infected. Combined negative nephur and nitrite tests were 98.6% accurate in excluding urinary tract infection. PMID- 2759830 TI - Hepatitis B in a residential population with a mental handicap. AB - Hepatitis serology was used to assess the nature and extent of hepatitis B virus (HBV) infection in the population of a residential centre for people with a mental handicap comprising 56 with Down's Syndrome (DS) and 193 with other mental handicaps (OMH). Markers of HBV were present in 170 cases (68%), of which 25 (10%) were HBsAg positive and potential carriers and 145 IgG anti-HBc positive (58%) indicating exposure to but not necessarily immunity from the virus. Of 25 who were HBsAg positive five were HBeAg positive, 17 were anti-HBe positive, two were HBsAg positive only and one was anti-HBe plus IgM anti-HBc positive. Age and length of residence were significantly associated with HBsAg, IgG anti-HBc and total markers of infection but the degree of mental handicap was not and the DS/OMH ratio only with HBsAg. The results indicated widespread HBV infection, no acute disease cases, relatively few infectious cases and a pre-disposition of DS residents to retain HBsAg in their sera. Vaccination of staff and at risk residents is recommended. PMID- 2759831 TI - Medical services for the elderly. AB - The percentage of acute medical beds in Galway Regional Hospital, occupied by patients over 65 years old is more than 50%. This use of acute medical services by elderly, will increase over the next three decades, in line with population projections. Further development of the geriatric service, and more emphasis on training in geriatric medicine is necessary. PMID- 2759832 TI - New approaches to the prediction of the folding of membrane proteins with redox function. AB - A new method is elaborated for determining the hydropathy profile of membrane haemoproteins. The method is called membrane propensity for haemoproteins (MPH) and is based on the statistical analysis of the amino acid composition of the predicted transmembrane regions of cytochrome b from the bc1 and the b6f complexes. The accuracy of the MPH method in predicting the ends of the known transmembrane segments of the reaction center of Rhodopseudomonas viridis is higher than that obtained by hydropathy methods based on physico-chemical parameters. The MPH method is able to clearly exclude from the membrane polypeptides that are not consistently predicted to be transmembrane by other methods or techniques, for instance the region corresponding to helix IV of mitochondrial cytochrome b. A correlation has been found between the shape of the hydropathy profile of the transmembrane segments predicted by this new method and the known structure of the membrane-spanning helices of Rhodobacter reaction centers. From the above correlation it is proposed that the haem-coordinating domain of mitochondrial cytochrome b is folded in a novel structure, called "clepsydra domain", which is formed by distorted transmembrane helices packed in a waisted antiparallel bundle. PMID- 2759834 TI - Abstracts of papers presented at the meeting of the Sicilia Group of the Italian Biochemical Society. April 22-23, 1988, Milazzo. PMID- 2759833 TI - Abstracts of papers presented at the first meeting of marine biochemistry of the Italian Biochemical Society. April 9, 1988, Naples. PMID- 2759835 TI - Hospital utilization in cardiovascular disease. PMID- 2759836 TI - Effect of exercise on the kidney of aging mice. AB - Quantitative light microscopic and ultrastructural kidney changes were studied in young and old mice subjected to moderate exercise. While there was little or no change in the glomeruli of the young animals, the older age-group showed progressive and statistically significant mesangial sclerosis with obliteration of capillary lumina. Electron microscopy also showed electron dense deposits in both the mesangium and subendothelium. Kidney weight in the young mice subjected to exercise was decreased when compared with the controls, while old animals showed a higher kidney weight after 6 weeks of running exercise. Our results of progressive kidney changes in old exercising animals, together with previous studies on myocardial and skeletal muscle showing parallel changes, stress the need for careful clinical studies on the possible damage of these organs in older people who engage in jogging and heavy exercise. PMID- 2759837 TI - Effect of different degrees of hypoxia and reoxygenation on myocardial energetics. AB - We determined the effect of high-flow hypoxia and reoxygenation on myocardial function and O2 uptake. Isolated working rat hearts were subjected to a 30-min period of hypoxia (pO2 = 384, 296, 207 and 131 torr), followed by 30 min of reoxygenation (pO2 = 500 torr). Another group of normoxic hearts was exposed to 500 torr O2 for the same length of time. During hypoxia, lactate release increased, whereas O2 uptake (VO2), aortic flow (AF) and stroke volume decreased relative to the degree of hypoxia. In hearts subjected to a pO2 of 131 torr, coronary flow and VO2 declined to 40 and 15%, respectively, of the control values, without any AF. Reoxygenation of the hypoxic hearts after the hypoxia increased the depressed VO2 and AF relative to the previous degree of hypoxia. However, these values remained below those of the normoxic hearts, indicating persistent hypoxic injury. In a second series, we also measured the mechanical power (using aortic pressure) at three levels of inflow pO2: 500, 300 and 200 torr, and obtained good correlation between the mechanical power and both AF and VO2. Analysis of the O2 cost of production of AF showed a posthypoxic disengagement between VO2 and AF after exposure to O2 of 131 torr. The degree of hypoxia determines the amount of hypoxic damage and the ability of the heart to recover upon reoxygenation, and an accelerated injury occurs at severe hypoxia. PMID- 2759838 TI - Bioethics: secular philosophy, Jewish law and modern medicine. AB - The recent unprecedented expansion of scientific knowledge and the greater awareness and involvement of the public in medical matters, as well as additional causes described here, have impelled the development of a new form of bioethics over the past three decades. Jewish law and philosophy have always dealt with medical issues. In recent years, however, a voluminous body of literature devoted to Jewish medical ethics has developed. It covers all relevant issues and offers Jewish solutions to many complex problems arising from the recent scientific breakthroughs. This article analyzes the differences between Jewish and secular philosophies regarding fundamental moral theories relevant to modern medical ethics. PMID- 2759840 TI - Cyclosporin-A treatment for early insulin-dependent diabetes mellitus: first experience in Israel. PMID- 2759839 TI - Hemoglobin C-beta (0) thalassemia. PMID- 2759841 TI - Walk headache: an unusual manifestation of ischemic heart disease. AB - A 71 year old man sought neurological advice because for two years he had suffered from headache every time he made an effort. A treadmill stress test showed a relation between effort, headache and depression of ST segments on E.C.G. With isosorbide dinitrate and diltiazem, the manifestations improved. This suggests a referred head pain due to myocardial ischemia. PMID- 2759842 TI - Cognitive-behavioral therapy for migraine headaches: a minimal-therapist-contact approach versus a clinic-based approach. AB - The efficacy of a clinic-based cognitive-behavioral program for the treatment of common migraine was compared to the same approach using a minimal-therapist contact format by means of a randomized controlled trial. Forty-eight subjects between 18 and 50 years of age completed the program. Following four weeks of recording headache activity, subjects were randomly assigned to a waiting list control condition or to one of the two treatment conditions. Treatment was followed by four weeks of recording of headache activity immediately posttreatment and again six months later. Multivariate analysis of variance indicated that there was a significant reduction in headache frequency, duration and peak intensity following treatment for both treated groups. These reductions were maintained at six months follow-up. Treatment for the minimal-contact group was significantly more cost-effective than for the clinic group. PMID- 2759843 TI - Cognitive behavioral treatment of chronic headache: group versus individual treatment format. AB - Two hypotheses were tested in this study: (1) that a short course of cognitive behavioral therapy (CBT) is effective in the treatment of chronic headache; and (2) that group CT is as effective as individually administered CBT. Twenty-two chronic headache sufferers were randomly assigned to one of three treatment conditions: group administered CBT, individually administered CBT, or no treatment (wait list) control. Wait list subjects ultimately received treatment identical to that offered to subjects in the group treatment condition. Treatment outcome measures included the Brief Symptom Inventory, the McGill Pain Questionnaire, and several measures calculated from self-monitoring data. Tentative support was found for the hypothesis that CBT as provided in this study is effective in the treatment of chronic headache. There was no evidence that group versus individually treated subjects differed significantly on any of the measures used, although the small N and large variance among subjects limit us to preliminary conclusions for our findings. Clinical implications and suggestions for future research are discussed. PMID- 2759844 TI - Menstrual migraine and intermittent ergonovine therapy. AB - The treatment of patients suffering with menstrual migraine is sometimes a difficult and frustrating problem for the physician. As many menstrual migraine headaches are refractory to abortive therapy, prophylactic therapy is often needed. Ergonovine maleate, an ergot derivative with vasoconstrictive properties, has been used with some success in migraine headache patients. Forty patients who were treated with intermittent prophylactic ergonovine were studied over six months. The patients ranged in age from 22 to 40 years, and all suffered with menstrual migraine headaches which were refractory to abortive therapy. Each patient took ergonovine maleate 0.2 mg three to four times daily during menses and recorded headache occurrence and severity. After three months, 24 patients (60%) reported significantly less severe attacks, six patients (15%) reported less frequent headaches and 14 patients (35%) reported no improvement. After six months there was a decrease in effectiveness with 20 patients (50%) reporting significantly less severe headaches and two patients (5%) reporting less frequent headaches. This limited study suggests that ergonovine maleate may be of value in the treatment of difficult menstrual migraine patients. PMID- 2759845 TI - Ocular blood flow changes in cluster headache and chronic paroxysmal hemicrania. AB - Intraocular pressure and pulsatile ocular blood flow were recorded during and between attacks in patients suffering from cluster headache (n = 18) or chronic paroxysmal hemicrania (n = 7). Similarities, as well as significant differences, were observed between the two groups of patients, pointing to fundamental differences between the two disorders with regard to pathophysiology. Compared with healthy controls, the cluster headache patients demonstrated low pulsatile ocular blood flow values between attacks, with an increase to normal levels during pain. The chronic paroxysmal hemicrania patients, however, had normal values between attacks with a marked and significant increase to high values during attacks. PMID- 2759846 TI - Cluster headache and intercalated seizures in a young man: therapeutic effectiveness of flunarizine. AB - A young man suffering from both cluster headache and epilepsy is reported. Since the age of 37 he had recurrent generalized tonic-clonic seizures; one year later cluster headache attacks began. Neurological examination, standard laboratory tests and CT-scan were normal. The EEG showed medium-voltage sharp waves, not blocking upon eye opening, over the right parieto-temporal region. Flunarizine was added to his phenytoin therapy; it controlled both paroxysmal disorders. After six months, flunarizine was discontinued and during a one year follow-up the patient remained symptom-free. This calcium channel blocker can be regarded as an ideal drug in patients suffering from both cluster headache and epilepsy; it controls this headache syndrome and is a useful add-on to standard anti convulsant therapy. PMID- 2759847 TI - The vascular theory of migraine--resuscitated or more moribund? PMID- 2759848 TI - Re: The dark side--. PMID- 2759849 TI - Low brain magnesium in migraine. AB - Brain magnesium was measured in migraine patients and control subjects using in vivo 31-Phosphorus Nuclear Magnetic Resonance Spectroscopy. pMg and pH were calculated from the chemical shifts between Pi, PCr and ATP signals. Magnesium levels were low during a migraine attack without changes in pH. We hypothesize that low brain magnesium is an important factor in the mechanism of the migraine attack. PMID- 2759850 TI - Acute demyelination mimicking vascular hemicrania. AB - A 29-year-old woman presented with acute hemicrania, trigeminal neuropathy and posterior fossa dysfunction. The admission differential diagnosis included vertebral artery dissection, posterior circulation aneurysm, vascular malformation and brainstem infarction. However, radiographic and CSF studies indicated demyelination. Acute demyelination should be in the differential diagnosis of vascular hemicrania with signs of posterior fossa dysfunction. PMID- 2759851 TI - Drug-related headache. AB - A survey was made of 10,506 reports to the WHO Collaboration Centre for International Drug Monitoring from five countries concerning headache, migraine, aggravated migraine and intracranial hypertension associated with drugs. The ten drugs most frequently reported to be associated with headache were indomethacin, nifedipine, cimetidine, atenolol, trimethoprim-sulphamethoxazole, zimeldine, glyceryl trinitrate, isosorbide dinitrate, zomepirac and ranitidine. Regarding migraine, oral contraceptives were also among the most implicated drugs. Most reports of intracranial hypertension concerned tetracyclines, isotretinoin and trimethoprim-sulphamethoxazole. Vasodilatation and salt and water retention with subsequent redistribution of intracranial fluid seem to be common mechanisms underlying drug-related headache. For certain frequently reported drugs, however, the mechanisms of the headache are unknown. PMID- 2759852 TI - Pituitary adenoma presenting as painful intermittent third nerve palsy. AB - We report the case of a woman with short nocturnal attacks of peri- and retro orbital pain, diplopia, ptosis, rhinorrhea and lacrimation of five months evolution. Neurological examination was normal between attacks. The latter presented with partial third nerve palsy, which finally became complete and permanent. Brain CT showed a sellar and supraseller tumor with parasellar extension to the right side. We stress the atypical clinical presentation and evolution of this case, and discuss its pathophysiology. PMID- 2759853 TI - Reversal of cluster headache side following treatment of arteriovenous malformation. AB - We describe the case of a forty-four year old man who had typical right sided cluster headaches and an arteriovenous malformation supplied mainly by the right anterior cerebral artery. Following endovascular embolisation of this artery the AVM was supplied mainly by the left anterior cerebral artery. Subsequent headaches have always been on the left. Transcranial Doppler studies now suggested an increase of middle cerebral artery flow velocity. We suggest that the change in haemodynamics was responsible for the change in headache side. PMID- 2759854 TI - Couple therapy and chronic headache: a preliminary outcome study. AB - This brief report examines the factors that led to successful completion of couple therapy with 8 chronic headache patients and their spouses, as opposed to another 8 couples who dropped out of treatment. Overall, the couples who successfully completed therapy were in less strifeful marriages and were confronted with specific life change events as opposed to the couples who dropped out, who gave evidence of chronic marital difficulties. Family and couple therapy for chronic headache sufferers is recommended on a selective basis. PMID- 2759855 TI - [Sexually transmitted diseases and the transmission of HIV infection]. PMID- 2759856 TI - [Unusual manifestations of Lyme borreliosis. A contribution to the clinical spectrum of this disease group]. AB - Since the discovery that EM (erythema migrans), ACA (acrodermatitis chronica atrophicans) and BL (borrelial lymphocytoma) have an infectious etiology, these syndromes have been receiving particular attention. This report describes four patients whose dermatological symptoms did not at first indicate borreliosis. In all four cases serological antibody tests proved that they were caused by Borrelia burgdorferi. In two of these cases these findings were confirmed by bacterial cultures. The unusual skin symptoms, i.e. multiple disseminated erythema, erysipelas-like manifestations, swelling and discoloration of the eyelids and lichenoid papules, extend the known clinical spectrum of cutaneous borreliosis in Europe. PMID- 2759857 TI - [Hypervascularization syndrome of the penis following arterialization of the dorsal penile vein for erectile impotence]. AB - A hypervascularization syndrome following arterialization of the deep dorsal vein of the penis to amend venous erectile impotence is a rare cause of penile ulcers that has not previously been described in the dermatological literature. Arterialization is performed by installing a shunt from the inferior epigastric artery or a venous bypass from the femoral artery to the deep dorsal vein of the penis, resulting in a blockage of venous outflow and in retrograde inflow into the corpora cavernosa. Complications arise as a result of persistently elevated blood pressure in the deep venous system and the erectile tissue in 10-20% of cases and are most often linked to dilatation of the shunt: the consequences are enlargement and induration of the glans, hazard of phimosis and paraphimosis, pulsation of the penis, micturation difficulties and, ultimately, ulceration of the glans. Surgical reduction of the arterial inflow ("banding" of the shunt) is the only therapeutic procedure that reduces hypervascularization without compromising the newly gained erectile function. PMID- 2759858 TI - [Livido racemosa in detection of anti-phospholipid antibodies]. AB - Livedo reticularis and antiphospholipid antibodies have previously been found to be associated with a subgroup of patients with systemic lupus erythematosus. We present a case of livedo reticularis accompanied by antiphospholipid antibodies, in which no other signs of any systemic or cutaneous disease could be detected. PMID- 2759859 TI - [Brown hair and nail discoloration by water containing iron]. AB - A 24-year-old patient who was otherwise in good health noticed an increasing brown discoloration of all her nails and her previously fair hair 7 weeks before consultation. On investigation it could be found that the patient used water with a high iron content for washing. A high iron content was detected in the discolored parts of the hair. PMID- 2759860 TI - [Acquired reactive collagen disease in the adult: successful treatment with UV-B light]. AB - A 77-year-old patient with diabetes and progressive renal failure suffered from severe pruritus accompanied by umbilicated, keratotic papules corresponding clinically and histologically to reactive perforating collagenosis. UV-B light therapy considerably improved the pruritus and the skin lesions. PMID- 2759861 TI - [Crohn disease--initial manifestation in the oral and anogenital area]. AB - A case is reported of Crohn's disease in a 17-year-old patient. The initial manifestation was bipolar: the clinical features of macrocheilitis with swelling of the upper lip that had persisted for the last 6 months. The buccal tissue disclosed a cobblestone-appearance, combined with atypical fissures and rhagades in the anogenital region. Histopathological examination of lip and anogenital biopsy specimens revealed a granulomatous inflammatory reaction. Therefore, the clinical findings were interpreted as the primary manifestation of Crohn's disease. In the differential diagnosis Melkersson-Rosenthal's syndrome was also taken into consideration. PMID- 2759862 TI - [Alternative treatment of larva migrans]. PMID- 2759863 TI - [Current risk of HIV infection by blood transfusions]. PMID- 2759864 TI - [Comment on the response by C. Schirren to the inquiry from general practice: Definition of oligozoospermia]. PMID- 2759865 TI - [Comment on the contribution by F. Ehring: Regression of over 150 skin metastases of malignant melanoma by homeopathic complex therapy]. PMID- 2759866 TI - Long-term availability of Tc deposited on soil after accidental releases. AB - Considerable uncertainties are associated with the transfer of Tc from soil to plant. Mathematical models built to simulate that transfer generally use a single value derived from short-term experiments. Recent observations have, however, given a clear indication that the soil-to-plant transfer varies with time, depending on the biogeochemical cycling of this element. The long-term behavior of Tc in soils accidentally contaminated has been studied for 4 y in lysimeters exposed to natural climatic conditions. An important fraction of the deposit (70%) is rapidly removed from the 20-cm plow layer with a half-time of 54 +/- 2 d; the remaining fraction tends to persist in the soil for long periods of time (half-time = 30 +/- 16 y). Immediately after the deposit, the plant-to-soil concentration ratios are very high (about 400); they decrease to six 3 y after the contamination. The shape of the evolution of the contamination measured in grass after an accidental deposit is best-fitted to a sum of two exponential functions; the environmental half-times estimated for the two components are about 30 d and 2 to 3 y, respectively. PMID- 2759867 TI - Bioavailability of Tc incorporated in plant material. AB - The effective removal rate of radiopollutants from contaminated soil usually has been estimated by considering only the radioactive decay constant. This approximation, however, becomes a matter of concern when assessments are performed for long release periods, for long-lived radionuclides and for radionuclides exhibiting relatively high values of plant-to-soil concentration ratios. Previous results obtained for 99Tc showed that phenomena other than radioactive decay may be of importance in soil depletion and that uptake by plants, as well as mechanisms affecting the availability, must be taken into account. In agricultural practice, ignorance of these mechanisms may lead to inaccurate predictions of dose levels. Harvest losses have already been theoretically discussed, and removal constants of soil radioactivity from harvest and leaching have been estimated. Validation of the soil-plant model for Tc including these depletion processes is thus necessary, and minilysimeter experiments were conducted. Contaminated plant material was reincorporated into the soil and was allowed to undergo humification; plants were cultivated on these soils and their Tc uptake was studied. Results showed that an important part of the recycled, bioincorporated Tc is immediately and highly available to plants. The results are discussed within the framework of the plant-material degradation. PMID- 2759868 TI - Comparative metabolic behavior and interrelationships of Tc and S in soybean plants. AB - The comparative behavior of sulfur (S) and technetium (Tc) in soybean seedlings shows gross subcellular distributions to be similar for these oxyanions. More than 75% of the tissue-deposited Tc remains soluble and extractable. Differences in Tc fixation/incorporation were noted for the nuclear and chloroplast fractions of leaf and root cells. Pulse studies showed that soluble protein and nitrate reductase levels rose in response to Tc accumulation by sink leaves but not source leaves. In vitro assay of chloroplast-based S reduction and incorporation systems showed Tc to be reduced and incorporated into amino nitrogen-containing products. A hypothesis related to the metabolic behavior of Tc in plants is presented. PMID- 2759869 TI - Cytological effects of Tc on young soybean plants. AB - Soybean seedlings (Glycine max cv. Williams) were exposed for 24 to 67 h to 99TcO4- (Tc) at various concentrations in dilute culture solution. Reduced primary leaf midrib length was observed with 67-h exposures to greater than or equal to 6.0 mu M Tc. Cellular effects were consistently observed by a light microscope after 43-h or longer exposure to 6.6 microM Tc and higher concentrations. At lower Tc levels, abnormal cells were interspersed among cells of normal appearance. Abnormal cells displayed blockshaped nuclei which were more densely stained by Harris' hematoxylineosin Y than controls; such cells frequently demonstrated incipient plasmolysis. The number of affected cells increased with dose; both nuclei and cytoplasm demonstrated greater staining intensity and more severe plasmolysis at higher levels. At levels of greater than or equal to 13.2 Tc, cellular damage was extensive. Cells were reduced in size and were highly plasmolysed; cell walls were distorted, and intercellular spaces were reduced or became nonexistent. Mitotic activity was observed at Tc levels less than or equal to 9.9 microM. Observed Tc cellular effects are attributed principally to the alteration of membrane permeability characteristics. PMID- 2759870 TI - Toxicity of 99Tc: can it represent a risk to man? AB - The movement through the environment and the toxicity to plants of 99Tc have been studied. However, information is scanty on 99Tc toxicity to mammals even though this is the decisive criterion for assessing the consequences of releases of Tc. A critical tissue could be the thyroid because of its preferential accumulation of Tc and the developing organism because of its greater radiosensitivity; moreover, this toxicity might be enhanced under conditions of a low iodine (I) diet. These questions were studied in rats given large amounts of 99Tc in either a normal or an I-deficient diet for several months starting 2 wk before mating. Newborns were continued on these diets after weaning. The parameters determined were: occurrence of pregnancy and litter size, triiodothyronine and thyroxin in serum, uptake of 131I by the thyroid 24 h after injection, histology of the thyroid and concentration of Tc in tissues of the mothers and their decendants. Thyroid damage, as well as the effects on pregnancy, could be observed after amounts of 10 micrograms Tc g-1 food. Iodine deficiency only slightly influences the 99Tc toxicity. The chemical and radiological toxicity of 99Tc to rats is small. Consequently, it seems unlikely that contamination levels in the environment would ever reach levels that could lead to serious non-stochastic effects, even in the developing organism. PMID- 2759871 TI - Linear programming models for cost reimbursement. AB - Tamura, Lauer, and Sanborn (1985) reported a multiple regression approach to the problem of determining a cost reimbursement (rate-setting) formula for facilities providing long-term care (nursing homes). In this article we propose an alternative approach to this problem, using an absolute-error criterion instead of the least-squares criterion used in regression, with a variety of side constraints incorporated in the derivation of the formula. The mathematical tool for implementation of this approach is linear programming (LP). The article begins with a discussion of the desirable characteristics of a rate-setting formula. The development of a formula with these properties can be easily achieved, in terms of modeling as well as computation, using LP. Specifically, LP provides an efficient computational algorithm to minimize absolute error deviation, thus protecting rates from the effects of unusual observations in the data base. LP also offers modeling flexibility to impose a variety of policy controls. These features are not readily available if a least-squares criterion is used. Examples based on actual data are used to illustrate alternative LP models for rate setting. PMID- 2759872 TI - HMO growth and hospital expenses: a correction. PMID- 2759873 TI - [Lermoyez syndrome. Clinical aspects and follow-up]. AB - The clinical data and follow-up of five patients with Lermoyez syndrome are reported. Three of them presented with marked lesions of the cervical spine. Serological antibodies against nuclei and sarcolemma as well as against heart muscle and gastric cells were found. Tests of the sera against guinea pig cochlear tissue showed antinuclear antibodies in one patient and against basilar membrane structures in another. Three sera were negative despite positive heterologous finding. Therapy included infusions active on the inner ear, decompression of the saccus endolymphaticus in two cases and physiotherapy for the cervical spine. These achieved marked improvement or long term relief. The available literature supports the conclusions based on pathophysiological considerations of our results. We cannot postulate an independent immunopathogenesis for Lermoyez Syndrome, but we think that the immunological findings conform with the clinical and experimental data found in the literature. PMID- 2759874 TI - [Function-saving microsurgery in suboccipital removal of large acoustic neuromas]. AB - Various successful approaches are available for acoustic neurinoma surgery, permitting total tumor removal and preservation of cranial nerve function. In smaller and medium sized tumors excellent results can be achieved with respect to facial and cochlear nerve function using the transtemporal approach. For larger tumors similar results can be achieved by the suboccipital approach. The results of 45 completely removed large acoustic neurinomas all operated upon via the suboccipito-lateral approach with microsurgical techniques and neurophysiological monitoring are presented. The average tumor size, excluding the portion within the internal auditory canal was 3 cm. Anatomical preservation of the VIIth cranial nerve was achieved in nearly all cases. Satisfactory to excellent facial nerve function was preserved in 70% of all cases. Initial hearing was preserved in 29%. However delayed postoperative hearing loss was encountered in 13%. Therefore definite hearing preservation was achieved in 16% of the cases. Intraoperative monitoring, especially of auditory evoked potentials, was very helpful in achieving these functional results. PMID- 2759875 TI - [Functional results following surgical management of isolated orbital floor fractures (blow-out fractures)]. AB - Sixty five orbital floor fractures of varying degrees of severity were assessed retrospectively. The operative treatment was performed via the transorbital approach within 14 days of the trauma. Pre-operatively 26 patients had sensory disorders of the infraorbital nerve. Six months later the nerve had recovered fully or partially. Preoperatively 49 patients (74%) were found to have double vision. Six months after the operation 44 patients (90%) were either much better or the double vision could no longer be detected. Only 5 cases showed no improvement. In view of the poor results of non-operative therapy of orbital floor fractures, we recommend early operative treatment for blow out fractures. PMID- 2759876 TI - [Effect of warm air inhalation on the nasal ciliated epithelium]. AB - It is known from in-vitro-studies, that temperatures exceeding 45 degrees C can damage the function and structure of the nasal cilia irreversibly. We tested 30 healthy volunteers by inhalation therapy, exposed to moist vapor over a 10 min period. The ciliary function was assessed by vital cytological sampling, and included measurement of ciliary beat frequency. The beat frequency increased during inhalation therapy, but the number of viable ciliated cells did not change significantly. Thus warm air inhalation therapy does not damage the nasal ciliated epithelium, probably due to the air conditioning capacity of the nose. PMID- 2759877 TI - [Nursing record for maternal health care]. PMID- 2759878 TI - [Midwives as obvious developers of care in midwifery arts. Summary of presentation given at the Swedish Midwifery Society's study days in Stockholm, 15 16 March 1988]. PMID- 2759879 TI - Animal rights: a biological contradiction. PMID- 2759880 TI - Mandibular condylectomy in a horse. AB - Mandibular condylectomy was effective in improving mastication and stopping weight loss in a horse. The horse had a history of intermittent purulent drainage from a facial wound and unilateral ankylosis of the temporomandibular joint. PMID- 2759881 TI - Hypertrophic osteopathy in a pony with a pituitary adenoma. AB - Hypertrophic osteopathy was diagnosed in a pony that had no antemortem or postmortem evidence of an intrathoracic lesion. With a history of hirsutism in an aged pony, a pituitary adenoma was suspected, and evaluation of plasma cortisol and insulin values and their response to thyrotropin-releasing hormone supported the diagnosis. PMID- 2759883 TI - Bacterial culture of blood from critically ill dogs and cats: 100 cases (1985 1987). AB - Of 100 critically ill dogs and cats, 49 (39 dogs, 10 cats) had bacteremia. Gram negative bacilli were the most common isolates from the bloodstream of dogs with bacteremia (46%), and gram-positive cocci and anaerobic bacteria were isolated from 36% and 31% of positive cultures, respectively; 15% of positive cultures were polymicrobial. In cats, gram-negative bacilli (especially Salmonella enteritidis) and anaerobic bacteria were the most common isolates, and 30% of positive cultures were polymicrobial. Gram-positive cocci were not isolated from the blood-stream of cats. Odds ratios, adjusted for the combined effects of disease status (severe vs nonsevere), results of bacterial culture of blood result (positive vs negative), and species (dog vs cat) were calculated for mortality in animals in the study. In animals with bacteremia, severe disease increased the risk of death 11.6-fold, compared with the risk in animals with nonsevere disease. Bacteremia increased mortality 10-fold in animals with severe disease, compared with mortality in animals with severe disease without bacteremia. Animals with severe disease and bacteremia were 15.6 times more likely to die than were those with nonsevere disease and negative culture results. In animals with nonsevere disease, culture results (positive vs negative) were not related significantly to mortality. Disease status (severe vs nonsevere) in animals without bacteremia also was not significantly related to mortality. There was no significant difference in overall mortality in dogs, compared with that in cats.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2759882 TI - Prognostic factors for tumor remission and survival in dogs after surgery for primary lung tumor: 76 cases (1975-1985). AB - The association of various prognostic factors with remission and survival after the excision of lung tumors was evaluated in 76 dogs. Overall, the median survival time of treated dogs was 120 days; 72% had tumor that underwent remission (median duration of remission, 120 days). Dogs with tumors that underwent remission had significantly (P = 0.001) increased survival time (median, 330 days vs 28 days for dogs with tumors that did not undergo remission). The finding of normal-sized lymph nodes at the time of therapeutic thoracotomy was significantly (P = 0.001) correlated with increased remission probability (85.4% remission rate vs 43.6% in dogs with large lymph nodes). Use of various diagnostic methods to find normal regional lymph nodes before surgery indicated that such finding was significantly (P less than or equal to 0.01) correlated with increased remission duration (median remission duration, 365 days, vs 60 days for tumors in dogs with large lymph nodes), and the finding of normal lymph nodes at the time of surgery was significantly (P less than or equal to 0.01) correlated with increased survival time (median, 345 days, vs 60 days for dogs with large lymph nodes). PMID- 2759884 TI - Atresia coli in calves: 26 cases (1977-1987). AB - Atresia coli was identified in 26 calves. In calves with abdominal distension, progressive depression, and the absence of feces since birth, atresia coli should be suspected. Surgery was performed on 24 calves, involving decompression of the distended large intestine followed by colonic anastomosis. Nine calves were subsequently discharged; 3 of those calves reached breeding age. As an adult, 1 of the calves produced 5 offspring unaffected by atresia coli. Early postoperative mortality was associated with hypothermia, peritonitis, and ischemic necrosis of the large intestine. Calves with visible signs of peritonitis at surgery had a poor prognosis. Four calves had motility disturbances of the colon after surgery. These were characteristic of a functional obstruction and were unresponsive to treatment. Surgery was most successful in calves that were bright, alert, and ambulatory. PMID- 2759885 TI - Pharmacologic features of clindamycin in dogs and cats. PMID- 2759886 TI - What is your diagnosis? Dilatation of the cranial portion of the esophagus. PMID- 2759887 TI - What is your diagnosis? Partial herniation of the stomach and spleen through the left hemidiaphragm. PMID- 2759888 TI - More on skillful writing. PMID- 2759889 TI - Pronunciation of "veterinarian". PMID- 2759890 TI - To be or not to be an extremist. PMID- 2759891 TI - Peace Corps offers Third World experience. PMID- 2759892 TI - Reinventing the regulatory wheel. PMID- 2759893 TI - Veterinary practice in the 21st century. PMID- 2759895 TI - Dissolution of a veterinarian's marriage. PMID- 2759894 TI - On becoming a perfect student. PMID- 2759896 TI - ECG of the month. Sinus arrhythmia and second degree atrioventricular block. PMID- 2759897 TI - Colostral and serum IgG, IgA, and IgM concentrations in Standardbred mares and their foals at parturition. AB - Immunoglobulin G, IgM, and IgA concentrations were measured in serum collected from 36 Standardbred mares within 12 hours of foaling, in colostrum collected within 6 hours of foaling, and in serum collected from foals 24 to 48 hours after birth. In serum collected from mares after parturition, mean concentrations of IgG, IgM, and IgA were 2,463.9 +/- 1,337.3 mg/dl, 136.4 +/- 218 mg/dl, and 305.2 +/- 237.5 mg/dl, respectively. In serum from foals, mean concentrations of IgG, IgM, and IgA were 1,953.3 +/- 1,635 mg/dl, 33.8 +/- 30.4 mg/dl, and 58.4 +/- 42.2 mg/dl, respectively. In colostrum, mean concentrations of IgG, IgM, and IgA were 8,911.9 +/- 6,282.2 mg/dl, 957 +/- 1088.1 mg/dl, and 122.9 +/- 77.3 mg/dl, respectively. The IgG concentrations in foal serum were poorly correlated with IgG concentrations in colostrum (r = 0.462, P less than 0.01). Correlations of IgM or IgA concentrations in serum from foals with IgM or IgA concentrations in colostrum and correlations of IgG concentrations in serum from mares with those in colostrum were not significant (P less than 0.01). Of 36 foals, 1 (2.8%) had a serum IgG concentration less than 400 mg/dl. Of 36 foals monitored for 4 months, 6 developed infectious respiratory tract disease requiring antimicrobial therapy at ages varying from 55 to 113 days; these infections were probably not related to failure or partial failure of passive transfer of antibody. PMID- 2759898 TI - 4-Methylpyrazole as treatment for naturally acquired ethylene glycol intoxication in dogs. AB - Eight dogs with ethylene glycol intoxication were treated with 4-methylpyrazole, an alcohol dehydrogenase inhibitor. Dogs had clinical signs referable to ethylene glycol ingestion including ataxia, depression, vomiting, polyuria, and dehydration. Metabolic abnormalities included high anion gap metabolic acidosis, serum hyperosmolality, isosthenuria, and monohydrate and dihydrate calcium oxalate crystalluria. Serum and urine ethylene glycol concentrations were determined to confirm ingestion of ethylene glycol. A 50-mg/ml solution of 4 methylpyrazole in propylene glycol was administered iv as follows: initial treatment, 20 mg/kg of body weight; at 17 hours after admission, 15 mg/kg; at 25 hours after admission, 5 mg/kg. By 24 hours after admission, all dogs had clinical and metabolic improvement. Of the 8 dogs, 7 were released within 3 days of admission. Four of the 8 dogs returned for follow-up evaluation, at which time biochemical or hematologic abnormalities were not observed. PMID- 2759899 TI - Zinc-induced hemolytic anemia caused by ingestion of pennies by a pup. AB - A 4-month-old Pomeranian pup was examined because of anorexia, salivation, and persistent vomiting. Initial laboratory testing revealed marked hemolytic anemia with spherocytosis. Survey abdominal radiography revealed 4 metal objects which, when removed by gastrotomy, were identified as pennies. Of 4 pennies, 3 were minted since 1983 and were heavily pitted over the surface and rim. Partially digested pennies were composed of a copper-plated high zinc concentration alloy. Further laboratory testing indicated a marked increase in serum zinc concentration in the pup (28.8 mg/L), confirming metal toxicosis. Serum zinc concentrations decreased during recovery. PMID- 2759900 TI - Essential hypertension in a dog. AB - Severe hypertension was diagnosed in a dog that initially was referred for evaluation of visual deficits and retinal hemorrhage and eventually was donated for medical treatment of hypertension. Initial blood pressure measured by direct methods was markedly high (systolic, 275 mm of Hg; diastolic, 170 mm of Hg). Measures of renal function were within normal limits, with the exception of hypotonic urine. A test protocol was designed to exclude possible secondary causes of hypertension; negative results of such tests allowed the diagnosis of essential hypertension. The consistency of the hypertension and its response to medical control were studied for 5 years. Blood pressure while the dog was untreated during those years was 240 +/- 24 mm of Hg (systolic) and 146 +/- 14 mm of Hg (diastolic). Plasma renin activity was within normal limits, and the response of the renin-angiotensin system to varied salt intake was normal. The most effective medications used to lower blood pressure were propranolol and captopril, both of which were more effective than salt restriction alone. Five years after the diagnosis of hypertension, the dog was euthanatized because of chronic renal failure secondary to pyelonephritis. Hypertension was less severe as the condition progressed into chronic renal failure. Complete necropsy did not reveal an obvious cause of the hypertension, and histopathologic changes were limited to the cardiovascular system, eyes, and kidneys. PMID- 2759901 TI - Short colon in two cats and a dog. AB - Two cats and 1 dog were referred for evaluation of signs of large-intestinal dysfunction. In each instance, contrast radiography revealed an abnormally short, straight colon, with the cecum located in the left hemi-abdomen. Short colon did not appear to contribute specifically to the active disease processes found. The anomaly may develop owing to errors in the processes of elongation and rotation of the embryo's midgut. The clinical relevance of short colon is unknown, but the disorder may contribute to a history of chronic elimination of soft feces. PMID- 2759902 TI - Surgical correction of pectus excavatum, using external splintage in two dogs and a cat. AB - Two 4-week-old pups and a 7-week-old kitten with respiratory distress and pectus excavatum were treated by external application of a coaptation splint to the ventral aspect of the thorax. Sutures were placed percutaneously around the sternum and through predrilled holes in a piece of moldable splint material that had been contoured to fit a normal-shaped thorax. Correction of the sternal deformity and alleviation of respiratory distress were achieved in all 3 animals. Frontosagittal index and vertebral index were assessed before and after surgery. In all 3 animals, both indices were abnormal before surgery, but were within the normal range after surgery. PMID- 2759903 TI - CP-78,545, a new monocarboxylic acid ionophore antibiotic related to zincophorin and produced by a Streptomyces. AB - A new monocarboxylic acid ionophore antibiotic related to zincophorin, CP-78,545 (1), was found in the culture broth of Streptomyces sp. N731-45. CP-78,545 was extracted with organic solvents and purified by column chromatography. The metabolite, which is active in vitro against certain Gram-positive bacteria, as well as the anaerobe Treponema hyodysenteriae, and a coccidium Eimeria tenella, was isolated as a water insoluble magnesium salt (2) in 2:1 (ligand/metal) stoichiometry. The structure of CP-78,545 was elucidated by spectroscopic (NMR and MS) methods, and the relative stereochemistry was determined by single crystal X-ray analysis of the cadmium salt (3). CP-78,545, i.e., 24 dehydrozincophorin, is unique since its molecular backbone contains a terminal double bond previously not found in other polyether ionophores. PMID- 2759904 TI - WS-9659 A and B, novel testosterone 5 alpha-reductase inhibitors isolated from a Streptomyces. I. Taxonomy, fermentation, isolation, physico-chemical characteristics. AB - WS-9659 A and B, produced by Streptomyces sp. No. 9659, were extracted from cultured broth, purified by solvent extraction followed by chromatography on silica gel and then isolated as prisms (C22H24N2O, mp 161 approximately 162 degrees C, C22H23N2OCl, mp 152 approximately 153 degrees C). WS-9659 A and B have testosterone 5 alpha-reductase inhibitory activity. The IC50 values of WS-9659 A and B for partially purified rat prostate testosterone 5 alpha-reductase were 5.0 x 10(-7) M and 1.0 x 10(-5) M, respectively. PMID- 2759905 TI - WS-9659 A and B, novel testosterone 5 alpha-reductase inhibitors isolated from a Streptomyces. II. Structural elucidation of WS-9659 A and B. AB - On the basis of spectroscopic and chemical evidence, the structures of WS-9659 A and B isolated as inhibitors of testosterone 5 alpha-reductase from a Streptomyces have been established as 1 and 2, respectively. The reductase inhibitory activities of the derivatives 5 and 6, and degradation products 3 and 8 were considerably less active and substantially inactive, respectively. PMID- 2759906 TI - Structure-activity relationships in a series of piperazine-2,3-dione containing penicillins and cephalosporins. II. Derivatives substituted at N(4) of the piperazine ring. AB - The structure-activity relationships within a series of penicillins and cephalosporins containing an N(4)-substituted piperazine-2,3-dione moiety in the C(6)/C(7)-beta-side chain are discussed. PMID- 2759907 TI - 3-Methylpseudouridine as a fermentation product. AB - 3-Methylpseudouridine (beta isomer) has been identified in fermentation broths of Nocardia lactamdurans. It accumulates at quite high levels following the accumulation of extracellular uracil in strains exhibiting increased levels of de novo pyrimidine biosynthetic enzymes. It is labeled by exogenous uracil, and appears to result from an irreversible modification of one of the components of the elevated pyrimidine pool. Its methyl group is labeled efficiently by [methyl 14C]methionine. PMID- 2759908 TI - Cell-free biosynthesis of new cyclosporins. AB - An enzyme preparation, isolated from extracts of the fungus Beauveria nivea (previously designated Tolypocladium inflatum), is able to synthesize cyclosporins (Cy's) in vitro. At suboptimal temperature it was possible to yield about 50 micrograms of CyA per ml. The enzyme also produces several of the naturally occurring congeners of CyA, such as the Cy's B, C, D, G, M, O, Q, U and V and some of the analogues known to be produced by the fungus via precursor directed biosynthesis, like dihydro-CyA, [N-methyl-L-beta-cyclohexylalanine]CyA, [L-allylglycine]CyA and [D-serine]CyA. Furthermore, Cy's not obtainable by the fungus could be prepared by the enzyme system in the presence of the appropriate precursor amino acids; the synthesis of [N-methyl-(+)-2-amino-3-hydroxy-4,4 dimethyloctanoic acid]CyA, [L-norvaline, N-methyl-L-norvaline]CyA, [L-norvaline, N-methyl-L-norvaline]CyA, [L-allo-isoleucine, N-methyl-L-allo-isoleucine]CyA, [L allo-isoleucine]CyA, [D-2-aminobutyric acid]CyA and [beta-chloro-D-alanine]CyA could be established. The immunosuppressive effects of the new derivatives are discussed. PMID- 2759909 TI - Comparison of the effect of tautomycin and phorbol ester on protein kinase C in a cell-free system. AB - The effect of tautomycin (TM) on protein kinase C (PKC) was studied in a cell free system. TM, like phorbol dibutyrate (PDBu), enhanced both base-line and Ca2+/phospholipids-dependent protein kinase activity. However, PDBu but not TM increased the affinity of the enzyme for calcium ions (Ca2+), suggesting that TM is a new activator of PKC, distinct from PDBu. In the presence of 10 micrograms/ml phosphatidyl inositol, the activity of PKC reached maximum at 10( 3) M Ca2+ concentration when the other co-factors were absent. Both TM and PDBu increased the maximum level of PKC activity at the optimum concentration of Ca2+, suggesting that they interacted with the site of PKC which is distinct from the site where Ca2+ interacts. TM and PDBu did not activate the enzyme when protamine sulfate in place of histone III-S was used as a substrate, indicating that they activate PKC by affecting the regulatory domain of the enzyme. PMID- 2759910 TI - A new macromolecular antitumor antibiotic, C-1027. III. Antitumor activity. AB - C-1027, a new macromolecular antitumor antibiotic produced by Streptomyces globisporus C-1027, showed extremely potent cytotoxicity toward cultured cancer cells. Compared in terms of IC50 values, antibiotic C-1027 showed much more potent cytotoxicity than doxorubicin, mitomycin C and neocarzinostatin. Spermatogonial assay, a prescreen for anticancer drugs, was highly sensitive for detection of C-1027. At tolerable doses, C-1027 exhibited marked inhibition on a panel of transplantable tumors in mice, which included leukemia L1210, P388, ascites hepatoma H22, sarcoma 180 and melanoma Harding-Passey. PMID- 2759911 TI - New antitumor antibiotics, duocarmycins B1 and B2. PMID- 2759912 TI - Brine shrimp (Artemia salina) as a convenient bioassay for avermectin analogs. PMID- 2759913 TI - A new antibiotic, RK-699a. PMID- 2759914 TI - Syntheses and antitumor activities of 7-O-(3-amino-2,3,6-trideoxy-2-fluoro-alpha L-talopyranosyl)daunomvcinone and -adriamycinone. PMID- 2759915 TI - Syntheses and antitumor activities of 7-O-(6-deoxy-2-O-methyl-alpha-L talopyranosyl)-daunomycinone and -adriamycinone. PMID- 2759916 TI - Biosynthesis of the antibiotic okilactomycin. PMID- 2759917 TI - Structure and biosynthesis of a new antifungal antibiotic, phthoramycin. PMID- 2759918 TI - Antibacterial activity of catecholic piperacillin analogues. PMID- 2759919 TI - The enigma of streptomycin transport. PMID- 2759920 TI - The entry of antibiotics into human monocytes. AB - Effective therapy of infections due to facultative intracellular micro-organisms, which persist after ingestion by mononuclear phagocytic cells, requires the use of antibiotics with the ability to inactivate these intra-phagocytic bacteria. Since entry of antibiotics into mononuclear phagocytes is a pre-requisite for activity against such intracellular organisms, we have determined the uptake of 11 radiolabelled antibiotics by human peripheral blood monocytes. beta-Lactams (penicillin G, cefamandole and cefotaxime), gentamicin, and metronidazole had a limited ability to enter monocytes, achieving cellular concentrations which were equal to or less than extracellular levels (C/E less than or equal to 1). Imipenem, a novel beta-lactam antibiotic, rapidly bound to monocytes, but cell associated drug progressively declined during further incubation. Chloramphenicol, a lipid-soluble drug, and trimethoprim were concentrated three fold by human monocytes. In comparison with the other antibiotics, roxithromycin (C/E = 14), clindamycin (C/E = 6 to 7) and erythromycin propionate (C/E = 4 to 5) were markedly concentrated by human monocytes. In contrast to our findings in other phagocytes, there was no evidence that active membrane transport was involved in monocyte uptake of clindamycin, erythromycin and roxithromycin. We have demonstrated that several antibiotics are highly concentrated within human monocytes, and it will be important to evaluate the effects of this antibiotic uptake on various monocyte functions, including intra-phagocytic antibacterial activity. PMID- 2759921 TI - Clindamycin enhances murine delayed-type hypersensitivity and anti-candidal activity. AB - The contact sensitivity response of mice to dinitrofluorobenzene (DNFB), as determined by an epicutaneous painting and subsequent ear challenge assay, was enhanced by clindamycin administration. The optimal augmentation effect of clindamycin required its simultaneous administration at the time of DNFB skin sensitization. Clindamycin also was found to boost both in-vitro and in-vivo murine response to experimental infection with Candida lusitaniae. Intraperitoneal injection of 1-2 mg of the drug increased the clearance of yeast from organs after intravenous inoculation of mice. Clindamycin at concentrations of as low as 12.5 mg/l also increased the ability of cultured murine macrophages to kill the yeast without an increase in phagocytic activity. PMID- 2759922 TI - Comparative chemotherapeutic activity of new fluorinated 4-quinolones and standard agents against a variety of bacteria in a mouse infection model. AB - The new fluorinated 4-quinolones appear to represent orally effective alternatives to parenteral and oral agents currently in use. A number of new fluorinated 4-quinolones were compared in acute systemic mouse-infection models with various Gram-positive cocci (streptococci and staphylococci), Enterobacteriaceae and Pseudomonas aeruginosa. Also included were standard oral and parenteral antimicrobial agents. CI-934 was the most potent quinolone in infections induced by Streptococcus pyogenes and Str. pneumoniae. CI-934, ciprofloxacin, enoxacin, norfloxacin, ofloxacin and pefloxacin were as effective as or superior to standard oral agents currently utilized in infections induced by the Enterobacteriaceae and staphylococci. They were active against antibiotic susceptible strains and strains resistant to beta-lactams and gentamicin. Most were also quite potent against systemic P. aeruginosa mouse infections. These studies indicate good chemotherapeutic potential for the new generation fluorinated 4-quinolones in infections induced by the staphylococci, streptococci, Enterobacteriaceae and P. aeruginosa, including strains resistant to standard antimicrobial agents. PMID- 2759923 TI - Roxithromycin in the treatment of pneumonia. AB - An open multicentre study of the efficacy and side effects of roxithromycin, a new macrolide antibiotic, in the treatment of community acquired pneumonia was undertaken. The diagnosis was verified by transtracheal aspiration. Fifty-three patients were studied. In the 49 patients evaluable the clinical efficacy rate was 92% (95% confidence limits 84-100%). Only by measurement of the fall in serum C-reactive protein was it possible to detect a difference in response between pneumonia due to Streptococcus pneumoniae and Haemophilus influenzae. The drug was well tolerated clinically and laboratory abnormalities included transient eosinophilia and elevated liver enzymes in two patients. PMID- 2759924 TI - Efficacy and safety of low dose aztreonam in the treatment of moderate to severe gram-negative bacterial infections. AB - One hundred and fifty-three patients with moderate to severe infections due to Gram-negative bacteria, including septicaemia (60 cases), lower respiratory tract infection (32 cases), intra-abdominal infection (40 cases) and urinary tract infection (21 cases), were treated with aztreonam 1 g every 12 h. This dosage is lower than usual. Criteria for inclusion included documented Gram-negative bacterial infections, and assessment of the severity of the disease by a scoring system for both community and hospital acquired infections. No other antibiotic active against Gram-negative bacteria was allowed. In 71 patients, in whom Gram positive or anaerobic organisms were detected or suspected, additional agents effective against these organisms were administered. One hundred and forty-one patients (92.2%) were cured with a mean duration of treatment of 10.9 +/- 4.0 days. None of the Gram-negative bacteria initially isolated became resistant to aztreonam. Colonization, generally by a Gram-positive organism, was observed in 27 patients and superinfection in five. Aztreonam was well tolerated. This study suggests that a daily dosage of 2 g of aztreonam should be sufficient in the treatment of moderate to severe Gram-negative bacillary infections due to sensitive organisms. PMID- 2759925 TI - Treatment of typhoid fever with ofloxacin. AB - Ofloxacin, 300 mg 12-hourly, was given orally to 64 patients with typhoid fever, all with positive blood cultures. Almost 80% of the isolates were resistant to chloramphenicol, ampicillin and co-trimoxazole, but sensitive to ofloxacin and norfloxacin. Fever subsided within five days in most patients (mean 3.2 +/- 1.1), rates of clinical effectiveness and bacteriological cure both being 100%. Thirty patients were followed for 1-3 months after the completion of therapy with no occurrence of relapse. PMID- 2759926 TI - Bacteria highly resistant to trimethoprim. PMID- 2759927 TI - Ofloxacin penetration into bile and pancreatic juice. PMID- 2759928 TI - IDEA: infectious diseases eradication adviser. PMID- 2759929 TI - Ciprofloxacin, imipenem and rifampicin: in-vitro synergy of two and three drug combinations against Pseudomonas cepacia. AB - The in-vitro activity of ciprofloxacin, imipenem and rifampicin, singly, and in two and three drug combinations was evaluated against 16 isolates of Pseudomonas cepacia. All 16 isolates were resistant to rifampicin; nine isolates were susceptible to ciprofloxacin; six were susceptible and seven had intermediate susceptibility to imipenem. The imipenem and rifampicin combination was synergistic for one of 16, imipenem and ciprofloxacin synergistic for seven of 16 and the three antibiotic combination was synergistic for 12 of 16 isolates. The three antibiotic combination demonstrated synergism with two isolates which were resistant to all three drugs. Combinations of two and three antibiotics resulted in enhanced killing of P. cepacia in this in-vitro study. PMID- 2759930 TI - Comparative pharmacokinetic study between lenampicillin, bacampicillin and amoxycillin. AB - A cross-over study was performed comparing serum kinetics and urinary excretion in six healthy, fasting volunteers after ingestion of comparable amounts of lenampicillin, bacampicillin and amoxycillin. Venous blood samples and urine samples were taken at intervals for 6 and 12 h respectively post-tablet ingestion and assayed for free ampicillin or amoxycillin concentration with Bacillus subtilis as indicator organism. The most rapid Tmax and the highest Cmax were achieved with lenampicillin. The AUC was similar for lenampicillin, bacampicillin and amoxycillin as was the total percentage urinary recovery of antibiotic. Potential pharmacokinetic advantage of orally administered lenampicillin and bacampicillin compared to comparable doses of amoxycillin are higher peak serum concentrations (12.0 mg/l lenampicillin; 9.7 mg/l bacampicillin; 7.6 mg/l amoxycillin) and more rapid time to peak concentration (0.6 h lenampicillin; 0.7 h bacampicillin and 1.4 h amoxycillin). PMID- 2759931 TI - Determination of serum and bone concentrations of cephradine and cefuroxime by HPLC in patients undergoing hip and knee joint replacement surgery. AB - Bone and serum concentrations of cephradine and cefuroxime were measured by HPLC in 21 patients undergoing hip and knee joint replacement surgery. An intravenous dose of 750 mg of each cephalosporin was given to patients at induction of anaesthesia. The serum and bone concentrations of both compounds were similar in individual patients although there was considerable interpatient variation. The mean concentrations in the femoral head bone supernatant in hip replacements were 7.2 mg/kg of cephradine and 8.0 mg/kg of cefuroxime. In knee replacement the femoral condyle bone concentrations were 5.1 mg/kg of cephradine and 4.2 mg/kg of cefuroxime, and for tibial bone 5.6 and 4.6 mg/kg respectively. Both cephradine and cefuroxime diffuse well into bone giving bone concentrations effective against common pathogens such as Staphylococcus aureus and S. epidermidis. PMID- 2759932 TI - Comparative study of clindamycin, imipenem, oxacillin and vancomycin in the infected granuloma pouch model. AB - In a rat granuloma pouch model, Staphylococcus aureus infection was treated with clindamycin, oxacillin or vancomycin and Bacteroides fragilis infection with clindamycin or imipenem. The model simulates a subcutaneous abscess and has the advantage of permitting frequent sampling of exudate for bacterial counts and antibiotic levels in the same animal. In staphylococcal infection all drugs reduced the bacterial counts in the infected pouch by 1-1.7 log, with a significant effect lasting for 3 h after the last injection. A 1.06-1.4 log reduction lasted for 24 h with clindamycin and oxacillin, but there was only an 0.3 log reduction at 24 h with vancomycin. The ratio of the drug concentration in the infected pouch to the MIC was highest with clindamycin (2.3) compared to oxacillin (1.6) and vancomycin (0.8). With Bact. fragilis infection the bacterial counts dropped 1.5 log at 3 h after the last injection with clindamycin and imipenem. At 24 h the counts were reduced 1.0 log with clindamycin and 0.5 log with imipenem. The ratios of pouch fluid concentration to MIC was 7.6 and 4.08 for imipenem and clindamycin, respectively, at 3 h, and 1.0 and 2.3 for imipenem and clindamycin at 24 h. PMID- 2759933 TI - Extended spectrum cephalosporins and Clostridium difficile. AB - There is little information about how commonly the newer cephalosporins cause diarrhoea due to Clostridium difficile. In this study of 111 patients with C. difficile-associated diarrhoea, 106 had received antimicrobial agents in the four weeks before detection of C. difficile. The relative risk for each antimicrobial agent was greatest with clindamycin, followed by cefotaxime, cephamandole and ceftriaxone. There was no statistically significant difference in risk between the cephalosporins evaluated. Narrower spectrum penicillins, anti-pseudomonal penicillins and aminoglycosides were not potent inciting agents. PMID- 2759934 TI - Coupling between respiratory and stepping rhythms during locomotion in decerebrate cats. AB - To determine whether and how the strength of coupling between respiratory and stepping rhythms varies depending on locomotor patterns, correlation analysis was done of diaphragmatic and gastrocnemius muscle activities. In spontaneously breathing cats decerebrated at the precollicular-post-mammillary level, tonic electrical stimulation was delivered to the mesencephalic locomotor region to induce locomotion on a treadmill. Electromyograms were recorded from the left hemidiaphragm and the bilateral gastrocnemius muscles. Various locomotor patterns were elicited by changes in the belt speed of the treadmill and in the intensity of stimulation of the mesencephalic locomotor region. Cross-correlograms between diaphragmatic and gastrocnemius activities showed that coupling was absent or weak when the cats walked slowly. The strength of locomotor-respiratory coupling tended to increase as the mean stepping interval shortened. When the animals were galloping, the respiratory rhythm was entrained 1:1 with the stepping rhythm. This study showed that the strength of coupling between respiratory and stepping rhythms varied depending on the locomotor patterns elicited, especially on whether the animals were running. PMID- 2759935 TI - Adenine nucleotide degradation in human skeletal muscle during prolonged exercise. AB - Eight healthy men cycled at a work load corresponding to approximately 70% of maximal O2 uptake (VO2max) to fatigue (exercise I). Exercise to fatigue at the same work load was repeated after 75 min of rest (exercise II). Exercise duration averaged 65 and 21 min for exercise I and II, respectively. Muscle (quadriceps femoris) content of glycogen decreased from 492 +/- 27 to 92 +/- 20 (SE) mmol/kg dry wt and from 148 +/- 17 to 56 +/- 17 (SE) mmol/kg dry wt during exercise I and II, respectively. Muscle and blood lactate were only moderately increased during exercise. The total adenine nucleotide pool (TAN = ATP + ADP + AMP) decreased and inosine 5'-monophosphate (IMP) increased in the working muscle during both exercise I (P less than 0.001) and II (P less than 0.01). Muscle content of ammonia (NH3) increased four- and eight-fold during exercise I and II, respectively. The working legs released NH3, and plasma NH3 increased progressively during exercise. The release of NH3 at the end of exercise II was fivefold higher than that at the same time point in exercise I (P less than 0.001, exercise I vs. II). It is concluded that submaximal exercise to fatigue results in a breakdown of the TAN in the working muscle through deamination of AMP to IMP and NH3. The relatively low lactate levels demonstrate that acidosis is not a necessary prerequisite for activation of AMP deaminase. It is suggested that the higher average rate of AMP deamination during exercise II vs. exercise I is due to a relative impairment of ATP resynthesis caused by the low muscle glycogen level. PMID- 2759936 TI - Effect of cerebrospinal fluid hyperosmolality on sweating in the heat-stressed patas monkey. AB - Dehydration increases the osmolality of body fluids and decreases the rate of sweating during thermal stress. By localizing osmotic stimuli to central nervous system tissues, this study assessed the role of central stimulation on sweating in a heat-stressed nonhuman primate. Lenperone-tranquilized patas monkeys (Erythrocebus patas n = 5), exposed to 41 +/- 2 degrees C, were monitored for calf sweat rate, rectal and mean skin temperatures, oxygen consumption, and heart rate during infusions (255-413 microliters) of hypertonic artificial cerebrospinal fluid (ACSF) into the third cerebral ventricle. ACSF made hypertonic with NaCl to yield osmolalities of 800 and 1,000 mosmol/kgH2O significantly decreased sweat rate compared with control ACSF (285 mosmol/kgH2O), achieving maximal reductions during infusion of 37 and 53%, respectively. Rectal temperature significantly increased during the recovery period, reaching elevations of 0.69 and 0.72 degrees C, respectively, at 20 min postinfusion. In contrast, ACSF made hypertonic with sucrose (800 mosmol/kgH2O) failed to change sweat rate or rectal temperature during infusion in three animals. Thus, intracerebroventricular infusions of hypertonic ACSF mimicked dehydration-induced effects on thermoregulation. The reduction in heat loss during infusion appeared to depend on an elevation in cerebrospinal fluid [Na+] and not osmolality per se. PMID- 2759937 TI - Effects of CSF ANG II and AVP on sweating in the heat-stressed patas monkey. AB - Increasing cerebrospinal fluid [Na+] reduces sweat rate (msw) in the heat stressed patas monkey (Erythrocebus patas). This study determined the potential role of two neuropeptides, angiotensin II (ANG II) and arginine vasopressin (AVP), in mediating this response. Artificial cerebrospinal fluid, containing either ANG II or AVP, was infused into the third cerebral ventricle of lenperone tranquilized monkeys (n = 4) exposed to 41 +/- 2 degrees C. Solutions were infused at 16.5 microliters/min for 25 min (total vol approximately 413 microliters). ANG II (1.25, 2.5, 5, and 10 ng/microliters) tended to decrease .msw. However, during infusion, only the decline at 10 min associated with the 1.25-ng/microliters dose (26%) was different (P less than 0.004) from control. This dose elevated (P less than 0.004) core rectal temperature by 1.14 degrees C at 20 min postinfusion. In contrast, AVP (0.5 and 1.5 micrograms/microliters artificial cerebrospinal fluid) had no significant effect on .msw compared with control infusions. Both doses of AVP produced a slight but significant increase in rectal temperature of 0.14 and 0.22 degrees C, respectively, at 20 min postinfusion. In conclusion, the magnitude and time course of the change in .msw with central ANG II suggest that it does not act as the sole mediator of the decline in .msw observed with elevated cerebrospinal fluid [Na+]. The minimal effects produced by third ventricular AVP exclude this route as a means by which AVP could modulate .msw during dehydration. PMID- 2759938 TI - Use of doubly labeled water technique in soldiers training for jungle warfare. AB - The doubly labeled water method was used to estimate the energy expended by four members of an Australian Army platoon (34 soldiers) engaged in training for jungle warfare. Each subject received an oral isotope dose sufficient to raise isotope levels by 200-250 (18O) and 100-120 ppm (2H). The experimental period was 7 days. Concurrently, a factorial estimate of the energy expenditure of the platoon was conducted. Also, a food intake-energy balance study was conducted for the platoon. Mean daily energy expenditure by the doubly labeled water method was 4,750 kcal (range 4,152-5,394 kcal). The factorial estimate of mean daily energy expenditure was 4,535 kcal. Because of inherent inaccuracies in the food intake energy balance technique, we were able to conclude only that energy expenditure, as measured by this method, was greater than the estimated mean daily intake of 4,040 kcal. The doubly labeled water technique was well tolerated, is noninvasive, and appears to be suitable in a wide range of field applications. PMID- 2759939 TI - Some features of oscillatory flow in a model bifurcation. AB - Oscillatory flow in the lung is studied using an order-of-magnitude analysis and flow visualization experiments in a single bifurcation with lung-like geometry. The results are used to obtain a classification scheme that identifies three major flow regimes, distinguished on the basis of whether the flow is dominated by unsteadiness, viscous effects, or the effects of convective acceleration. The unsteady regime is found to exist for values of a dimensionless stroke length (L/a, i.e., stroke volume/local cross-sectional area) less than or equal to 3 and for values of a dimensionless frequency (alpha 2 = alpha 2 omega/nu, where alpha is airway radius, omega the oscillatory frequency, and nu the kinematic viscosity) less than or equal to 10 in basic agreement with previous studies. The viscous regime is found when alpha 2(L/a)(a/R)1/2 less than 10 and alpha 2 less than 10 where R is the local radius of curvature in the bifurcation; the convective regime is found when alpha 2(L/a)(a/R)1/2 greater than 10 and L/a greater than 3. This same approach yields scaling laws for the magnitude of secondary flow velocities and shows that the ratio of secondary-to-axial velocity is small everywhere outside of the convective regime where it scales with (a/R)1/2. Comparison of these results to related simple flows shows that many of the features observed can be attributed to the effects of curvature, suggesting that the influence of the flow divider and of area change may be of lesser importance than previously thought. PMID- 2759940 TI - Variability of responses across training levels to maximal treadmill exercise. AB - The variability of peak VO2 (ml/min, ml.kg-1.min-1), time on treadmill (TMILLTM), maximal heart rate (HRmax), respiratory exchange ratio at peak VO2 (Rmax), rate of respiration at peak VO2 (FREQ), and exercise-induced changes in plasma lactate concentration (LACDIF) was measured across three maximal treadmill runs in five highly trained, seven moderately trained, and five untrained males. No effect of training level on the variability of any of the parameters was found. Test-retest correlation coefficients for peak VO2 (r = 0.95, run 1 with run 2; r = 0.92, run 1 with run 3; r = 0.92, run 2 with run 3) were similar to previously reported values. Variance component distributions suggested that the underlying physiological mechanisms of response for peak VO2, TMILLTM, and HRmax were different from those of FREQ, Rmax, and LACDIF. Minimum detectable differences for peak VO2 (ml.kg-1.min-1, n = 5, minimum detectable within subject difference, 11.5%; minimum detectable among subject effects, 21.3%) indicated a need for careful attention to research design in future studies. PMID- 2759941 TI - Lung weight in vivo measured with computed tomography and rebreathing of soluble gases. AB - In nine anesthetized dogs, accuracy of noninvasive measurements of lung weight (W) and gas volume in vivo was determined from volume and density determined by computed tomography (CT) and by rebreathing helium and the soluble gases dimethyl ether (WDME) and acetylene (WC2H2). Reference standards were obtained from the postmortem scale weight of the frozen lungs (Wscale) and compared with the CT lung weights measured in the living dog (WCT-38) and the frozen carcass (WCT cold). WCT-cold did not significantly differ from Wscale [-2 +/- 9% (SD), P = 0.7]. WCT-cold was 10% greater than WCT-38 (0.10 greater than P greater than 0.05), suggesting an increase in lung weight despite immediately commencing freezing after death. WDME measured 64 +/- 6% and WC2H2 56 +/- 12% of WCT-38. Serial multiple measurements in three dogs over 14 wk showed a coefficient of variation (CV) of 10 +/- 2% for WDME, 18 +/- 2% for WC2H2, 4.1 +/- 0.9% for WCT, 2.6 +/- 0.8% for CT density, and 3.5 +/- 1.6% for functional residual capacity (FRC) by CT. FRC calculated from CT consistently underestimated FRC measured by rebreathing helium by 18 +/- 8% (P less than 0.005). This error, despite good agreement between WCT and Wscale, was explained by underestimation of CT total lung volume and overestimation of lung density by factors known to affect CT readings, such as partial volume effects, beam hardening, and limited number of input signals. These data show that CT scanning can provide serial measurement of the mass, density, and volume of the lungs with a CV in the order of 5%, but the rebreathing of soluble gases gives more than double this variability. Measurements of WDME performed on the same day had a CV of 3 +/- 1%, so that WDME provides a precise noninvasive means to measure lung weight in acute studies. PMID- 2759942 TI - Expression of airway contractile properties and acetylcholinesterase activity in swine. AB - We studied the effect of maturation on contractile properties of tracheal smooth muscle from seventeen 2-wk-old swine (2ws) and fifteen 10-wk-old swine (10ws) in situ and in vitro. The response to parasympathetic stimulation was studied in situ in isometrically fixed segments. Contraction was elicited at lower frequencies [half-maximal response to electrical stimulation (ES50) = 6.7 +/- 0.05 Hz] in 2ws than in 10ws (ES50 = 9.1 +/- 0.4 Hz; P less than 0.01). Despite substantial differences in morphometrically normalized cross-sectional area in 2ws (0.012 +/- 0.003 cm2) and 10ws (0.028 +/- 0.001 cm2; P less than 0.01), maximal active tension elicited by parasympathetic stimulation was similar (12.4 +/- 3.2 g/cm in 2ws vs. 13.3 +/- 2.3 g/cm in 10ws; P = NS). In separate in vitro studies in 25 tracheal smooth muscle strips from 10 swine, concentration-response curves generated with potassium-substituted Krebs solution (KCl) were similar in 2ws and 10ws. In 58 other strips (10 swine), maximal active force elicited with acetylcholine (ACh) in 2ws was significantly greater than for 10ws (P less than 0.001). Removal of the epithelium had no effect. However, cholinesterase inhibition with 10(-7) M physostigmine augmented the response to ACh in 10ws (P less than 0.02) but not 2ws. We demonstrate increased force generation and sensitivity to vagal stimulation in 2ws vs. 10ws, which corresponds to increased reactivity to ACh in vitro. The relative hyperresponsiveness in 2ws is specific for cholinergic response and is attenuated at least in part by maturation of the activity of acetylcholinesterase enzyme. PMID- 2759943 TI - Influence of respiratory drive on airway responses to excitation of lung C fibers. AB - To determine whether the responses of tracheal smooth muscle and the nasal vasculature to stimulation of lung C-fiber receptors depend on the level of respiratory drive, the effects of right atrial injection of capsaicin and phenyldiguanide were studied in chloralose-anesthetized, paralyzed, artificially ventilated cats. Studies were performed while the animals were hyperventilated to apnea and, in addition, when breathing was stimulated by inhalation of 7% CO2 or by N-methyl-D-aspartic acid (NMDA) applied to the ventral surface of the medulla. When the cats were hyperventilated to apnea with O2, injection of capsaicin into the right atrium increased tracheal tone and slightly raised nasal resistance. However, when the animals were ventilated with 7% CO2 in O2 or respiratory activity was stimulated by the application of NMDA, administration of capsaicin eliminated spontaneous phrenic nerve activity and caused an abrupt decrease in tracheal tone but still increased nasal resistance. Similar responses were also obtained with right atrial injection of phenyldiguanide. These results showed for the first time that in the cat the direction of the reflex effects on tracheal tone but not nasal resistance depends on the preexisting level of respiratory drive and on cholinergic activity to airway smooth muscle. PMID- 2759944 TI - Mechanical and metabolic alterations in rat diaphragm during electrical stimulation. AB - To investigate the hypothesis that the rate of fatigue development is not influenced by the absolute duration of contraction (train duration) and relaxation (off-phase of duty cycle) at constant duty cycle, strips of the diaphragm from 36 male adult rats (mean +/- SD wt 152 +/- 21 g) were stimulated directly for periods of 180, 250, and 320 ms at a constant duty cycle of 50%. The frequency of stimulation was adjusted to produce 40% of maximal tetanic tension at supramaximal voltages. After 30 min of stimulation, analysis of twitch characteristics between control and experimental groups indicated a prolongation of contraction time of 9% (P less than 0.05), an increase in relaxation time of 75% (P less than 0.05), and a decrease in twitch tension by 78% (P less than 0.05). Similarly, reductions (P less than 0.05) in isometric force output at high stimulation frequency (100 Hz) of 58% and at low frequency (20 Hz) of 67% were also noted. These changes were accompanied by an approximately 60% reduction in the maximal velocity of shortening. No difference was observed for any of the mechanical measures between experimental conditions. After 30-min stimulation, decreases of between 43 and 46% were noted for ATP (P less than 0.05) and increases of between three- and fourfold noted for IMP (P less than 0.05). No changes were found for either ADP or AMP. Total adenine nucleotide concentrations declined (P less than 0.05) an average of 24%. As with the mechanical data, no differences were found between the different stimulation conditions. It is concluded that for the conditions studied, fatigue mechanisms become manifest early in the stimulation period and are only minimally altered by the duration of specific contractions provided the relaxation period is of equal duration. PMID- 2759945 TI - Beta-adrenergic blockade alters whole-body leucine metabolism in humans. AB - This study examined the effects of a nonselective beta-blocking agent on whole body leucine metabolism in humans. Five normal, healthy subjects (4 male, 1 female) underwent a 6-h primed, constant-rate infusion of L-[1-13C]leucine after 5 days of twice daily oral use of 80 mg propranolol and a placebo. Leucine turnover was determined by tracer dilution and leucine oxidation by 13C enrichment of the expired CO2. Propranolol decreased the total daily energy expenditure from 1,945 +/- 177.5 to 1,619 +/- 92.5 kcal/day (P less than 0.05). A fasting associated decrease in blood glucose and an attenuated rise in free fatty acids and ketones were observed during beta-blockade. Propranolol also increased plasma leucine concentrations (73.1 +/- 8.7 to 103.4 +/- 7.3 mumol/l; P less than 0.05) and leucine oxidation (13.2 +/- 1.2 to 17.1 +/- 1.3 mumol.kg-1.h-1; P less than 0.05), although leucine turnover was not significantly altered (100.5 +/- 7.3 vs. 126.0 +/- 12.3 mumol.kg-1.h-1). In addition, the urinary urea nitrogen-to creatinine ratio was greater during propranolol administration (0.24 +/- 0.04 vs. 0.34 +/- 0.02 mol/g; P less than 0.05). These data suggest that the beta adrenergic system plays a role in the modulation of whole-body leucine metabolism in humans. Whether these changes are the result of a direct effect on skeletal muscle or an indirect effect mediated by altering the fuel supply to skeletal muscle cannot be discriminated by the present study. PMID- 2759946 TI - Variability of parenchymal expansion measured by computed tomography. AB - Computed tomography scans of isolated dog lung lobes at different lobe volumes were used to determine the variability of parenchymal tissue density and the variability of parenchymal volume changes on the scale of a voxel, a cube 1.5 mm on a side. The variability of tissue density increased with decreasing lobe volume. The variability of tissue density of neighboring voxels was positively correlated; the spatial correlation decreased exponentially with distance with an exponential scale of 0.3 cm. The ratio of the volume of the parenchyma within a voxel to its volume at total lobe capacity was calculated from the tissue density data at two lobe volumes. At a lobe volume of 40% total lobe capacity, the local fractional volumes were 0.42 +/- 0.12. The variability of ventilation that corresponds to this variability of fractional volume is large enough to explain the inefficiency of mixing in the isolated lobe and the slope of the alveolar plateau of nitrogen concentration in the expirate after a breath of oxygen. These results are consistent with data reported earlier on the variability of parenchymal volumes at a scale of 1-10 cm3. PMID- 2759947 TI - Chronic CO inhalation and carotid body catecholamines: testing of hypotheses. AB - The purpose of this study was twofold: one concerns carotid blood flow and tissue PO2 and the other the effect of chronic hypoxic hypoxia on enhanced catecholamine content. The rationale was that chronic CO inhalation would not mimic the effect of hypoxia on the carotid body if its tissue blood flow is sufficiently high to counteract the effect of CO on O2 delivery and, hence, on tissue PO2. The differential effects of CO on the carotid body and erythropoietin-producing tissue would also indicate that the effect of hypoxic hypoxia on the carotid body is the result of a direct action of a local low O2 stimulus rather than secondary to a systemic effect initiated by other O2-sensing tissues. To test these alternatives we studied the effects of chronic CO inhalation on carotid body catecholamine content and hematocrit in the rats, which were exposed to an inspired PCO of 0.4-0.5 Torr at an inspired PO2 of approximately 150 Torr for 22 days. The hematocrit of CO-exposed rats was 75 +/- 1.1% compared with 48 +/- 0.7% in controls. Dopamine and norepinephrine content of the carotid bodies (per pair) was 5.88 +/- 0.91 and 3.02 +/- 0.19 ng, respectively, in the CO-exposed rats compared with 6.20 +/- 1.0 and 3.29 +/- 0.6 ng, respectively, in the controls. Protein content of the carotid bodies (per pair) was 18.4 +/- 1.6 and 20.5 +/- 0.9 micrograms, respectively. Thus, despite a vigorous erythropoietic response, the CO-exposed rats failed to show any significant stimulation of carotid body in terms of the content of either catecholamine or protein. The results suggest that carotid body tissue PO2 is not compromised by moderate carboxyhemoglobinemia because of its high tissue blood flow and that the chronic effect of hypoxic hypoxia on carotid body is direct. PMID- 2759948 TI - Contrasts in muscle and myofibers of elite male and female bodybuilders. AB - Muscle cross-sectional area (CSA), fiber area, and fiber number were determined from the biceps brachii of eight elite male bodybuilders (MB) and five elite female bodybuilders (FB) who had similar training characteristics. Biceps CSA was obtained from computer tomographic scanning and corrected for noncontractile tissue. Biceps CSA was twofold greater in MB relative to FB and strongly correlated to lean body mass (R = 0.93). Biceps CSA expressed per kilogram lean body mass (LBM) or per centimeter body height (BH) was 35% greater in MB compared with FB. Most of the gender difference in muscle CSA was because of greater absolute mean fiber areas in MB (9,607 microns2) relative to FB (5,386 microns2); however, MB also had a significantly greater population of small type II fibers (less than 2,000 microns2) compared with FB. Type II fiber area/LBM averaged 1.6 fold greater in MB compared with FB; however, type I fiber area/LBM was similar between groups. Biceps CSA was positively correlated to fiber CSA (R = 0.75) and fiber number (R = 0.55). This suggests that adaptations to resistance training may be complex and involve fiber hypertrophy and fiber number (e.g., proliferation). Alternatively, since the muscle characteristics before training are not known, these apparent adaptations might be genetically determined attributes. PMID- 2759949 TI - Effect of sleep on nocturnal bronchoconstriction and ventilatory patterns in asthmatics. AB - To assess the effect of sleep on airflow resistance and patterns of ventilation in asthmatic patients with nocturnal worsening, 10 adult subjects (6 asthmatic patients with nocturnal worsening, 4 normal controls) were monitored overnight in the sleep laboratory on two separate occasions. During 1 night, subjects were allowed to sleep normally, whereas during the other night all sleep was prevented. The six asthmatic patients demonstrated progressive increases in lower airway resistance (Rla) on both nights, but the rate of increase was twofold greater (P less than 0.0001) during the sleep night compared with the sleep prevention night. However, overnight decrements in forced expired volume in 1 s (FEV1) were similar over the 2 nights. The asthmatic patients maintained their minute ventilation as Rla increased during sleep, demonstrating a stable tidal volume with a mild increase in respiratory frequency. We conclude that in asthmatic patients with nocturnal worsening 1) Rla increases and FEV1 falls overnight regardless of sleep state, 2) sleep enhances the observed overnight increases in Rla, and 3) sleep does not abolish compensatory ventilatory responses to spontaneously occurring bronchoconstriction. PMID- 2759950 TI - Measurement of sympathetic nerve activity in the unanesthetized rat. AB - A new system was developed in our laboratory to continuously monitor intra arterial pressure, heart rate, and sympathetic nerve activity in unanesthetized rats. The animals were prepared 24 h before the start of the experiments. Sympathoneural traffic was measured at the level of splanchnic nerve. The amplitude of the spikes recorded at this level was utilized to express sympathetic nerve activity. The amplitude of the residual electroneurogram signal present 30 min after the rats were killed was 32 +/- 2 mV (mean +/- SE; n = 11). For analysis, these background values were subtracted from values determined in vivo. The nerve we studied contains postganglionic fibers, since electrical activity decreased in response to ganglionic blockade with pentolinium (1.25 mg/min iv for 4 min). The amplitude of spikes fell by 43 +/- 4% (n = 4). Sympathetic nerve activity was highly reproducible at a 24-h interval (104 +/- 26 vs. 111 +/- 27 mV for the amplitude of spikes; n = 11). Dose-response curves to the alpha 1-stimulant methoxamine and to bradykinin were established in four rats. The increase in blood pressure induced by methoxamine caused a dose dependent fall in sympathetic nerve activity, whereas the blood pressure reduction resulting from bradykinin was associated with a dose-dependent activation of sympathetic drive. These data therefore indicate that it is possible with out system to accurately measure sympathetic nerve activity in the awake rat, together with intra-arterial pressure and heart rate. PMID- 2759951 TI - Reflex cardiovascular and ventilatory responses to increasing H+ activity in cat hindlimb muscle. AB - Static exercise increases arterial pressure, heart rate, and ventilation, effects which are believed in part to arise reflexly from a metabolic stimulus in the working muscle. In anesthetized cats, we tested the hypothesis that intra arterial injections of lactic and hydrochloric acid, which created levels of these substances in muscle similar to those seen during contraction, reflexly increased cardiovascular and ventilatory function. Hydrochloric acid (32 and 57 mM; 1 ml) injected into the arterial supply of the triceps surae decreased intramuscular pH from 7.26 +/- 0.05 to 7.17 +/- 0.05 (P less than 0.01) and reflexly increased arterial pressure (23 +/- 7 mmHg; P less than 0.01), heart rate (11 +/- 2 beats/min; P less than 0.001), and ventilation (187 +/- 72 ml/min; P less than 0.05). Static contraction of the triceps surae decreased intramuscular pH from 7.28 +/- 0.06 to 7.13 +/- 0.06 (P less than 0.01). Lactic acid was more potent in causing reflexes than was equimolar HCl. For example, lactic acid containing 4 mM lactate and 0.87 mM H+ reflexly increased arterial pressure, heart rate, and ventilation, whereas 0.87 mM HCl did not. Intra arterial sodium lactate (13 and 33 mM) at a neutral pH had no effect on these variables. We conclude that contraction-induced accumulation of H+, especially that arising from lactic acid, might provide a metabolic stimulus to evoke reflex autonomic effects. PMID- 2759952 TI - Ventilatory response to rowing and cycling in elite oarswomen. AB - Rowing is a unique exercise for humans, and the imposed biomechanical motion may alter both respiratory mechanics and timing. To investigate the ventilatory patterns of competitive rowers while rowing, we studied the pulmonary function of eight members of the University of Washington Women's Crew and one former member of the 1984 Women's Olympic Rowing Team on a rowing ergometer. Ventilatory performance of the oarswomen was compared both with their performance to exhaustion on a cycle ergometer and with the ventilatory response of six untrained controls on a rowing and a cycle ergometer. We found rowing elicited a higher ventilatory response in both the oarswomen and controls in submaximal and maximal work loads (P less than 0.001). Both oarswomen and controls had higher maximal breathing frequencies when rowing compared with cycling [rowers, 54.7 +/- 1.9 vs 49.8 +/- 0.09 (SE) breaths/min, P less than 0.05; and controls, 53.6 +/- 2.5 vs. 49.2 +/- 4.7, P less than 0.05] and lower maximal tidal volumes (rowers, 1.94 +/- 0.12 vs. 2.21 +/- 0.09 liters, P less than 0.01; controls, 1.59 +/- 0.09 vs. 1.68 +/- 0.19, difference not significant). Both oarswomen and controls were more hypocapnic while rowing compared with cycling (rowers, P less than 0.001; controls, P less than 0.02), although oarswomen were less hypocapnic while rowing than nonrowers (P less than 0.03). These results indicate that rowing causes hyperventilation with a higher breathing frequency and lower tidal volume. This alteration of pattern is possibly secondary to a change in mechanics, which possibly arises from the generation of high exercise ventilation in a variable seated position. PMID- 2759953 TI - Activation of masseter muscles with inspiratory resistance loading. AB - Closure of the jaw exerts traction on muscles that insert on the hyoid bone and that may stabilize or expand the pharyngeal airway. We postulated that the masseter muscles, which close the jaw, would be activated when the patency of the pharyngeal airway is threatened. We therefore measured electromyographic activation of the masseters during inspiratory resistance loading and compared it with activation of chin muscles and alae nasi in 10 normal subjects. We observed no masseter activation during quiet unloaded breathing, but as pharyngeal pressure became lower there was a significant increase in masseter activation in all subjects. The change in masseter activation relative to pharyngeal pressure was similar to that of chin muscles and alae nasi. Activation of the masseter preceded the fall in pharyngeal pressure as also occurred in the chin muscles and alae nasi. We conclude that the masseters are activated by inspiratory resistance loading and have respiratory activity similar to pharyngeal airway muscles. PMID- 2759954 TI - Thermal and metabolic responses to cold by men and by eumenorrheic and amenorrheic women. AB - Previous work has suggested that men (M) are more sensitive to cold stress than women. There have also been observations that suggest that amenorrheic women (AW) are less thermally responsive than eumenorrheic women (EW). We investigated the hypothesis that M, EW, and AW would have different responses to cold stress. The subjects (6/group) were tested four times: twice at rest for 60 min (5 and 22 degrees C) and twice in a progressive exercise test (5 and 22 degrees C). At rest at 22 degrees C AW had a lower O2 uptake (VO2) than M and lower rectal (Tre) and finger temperatures than EW. At rest at 5 degrees C both AW and EW had lower skin temperature (Tsk) than M, but there were no group differences in peripheral Tsk sites. M increased VO2 after 10 min and EW after 20 min of cold stress; however, AW did not increase metabolism until 60 min. In the two exercise tests Tre increased in proportion to relative work load; in the 5 degrees C test there was little evidence that exercise increased Tsk sites above rest levels. Few of the metabolic or thermal differences could be accounted for by body fatness, body surface area (BSA), or BSA/kg. The data support the hypothesis that M, EW, and AW have different responses to cold stress. PMID- 2759955 TI - Evidence for tissue diffusion limitation of VO2max in normal humans. AB - We recently found [at approximately 90% maximal O2 consumption (VO2max)] that as inspiratory PO2 (PIO2) was reduced, VO2 and mixed venous PO2 (PVO2) fell together along a straight line through the origin, suggesting tissue diffusion limitation of VO2max. To extend these observations to VO2max and directly examine effluent venous blood from muscle, six normal men cycled at VO2max while breathing air, 15% O2 and 12% O2 in random order on a single day. From femoral venous, mixed venous, and radial arterial samples, we measured PO2, PCO2, pH, and lactate and computed mean muscle capillary PO2 by Bohr integration between arterial (PaO2) and femoral venous PO2 (PfvO2). VO2 and CO2 production (VCO2) were measured by expired gas analysis, VO2max averaged 61.5 +/- 6.2 (air), 48.6 +/- 4.8 (15% O2), and 38.1 +/- 4.1 (12% O2) ml.kg-1.min-1. Corresponding values were 16.8 +/- 5.6, 14.4 +/- 5.0, and 12.0 +/- 5.0 Torr for PfVO2; 23.6 +/- 3.2, 19.1 +/- 4.2, and 16.2 +/- 3.5 Torr for PVO2; and 38.5 +/- 5.4, 30.3 +/- 4.1, and 24.5 +/- 3.6 Torr for muscle capillary PO2 (PmCO2). Each of the PO2 variables was linearly related to VO2max (r = 0.99 each), with an intercept not different from the origin. Similar results were obtained when the subjects were pushed to a work load 30 W higher to ensure that VO2max had been achieved. By extending our prior observations 1) to maximum VO2 and 2) by direct sampling of femoral venous blood, we conclude that tissue diffusion limitation of VO2max may be present in normal humans. In addition, since PVO2, PfVO2, and PmCO2 all linearly relate to VO2max, we suggest that whichever of these is most readily obtained is acceptable for further evaluation of the hypothesis. PMID- 2759956 TI - Accuracy of pulse oximetry to estimate HbO2 fraction of total Hb during exercise. AB - The accuracy of two pulse oximeters (Ohmeda 3700 and Biox IIa) was evaluated during cycle ergometer incremental exercise in 10 healthy subjects. The exercise protocol began at 30 W with the power output being increased 15 W.min-1 until volitional fatigue. Ear and finger probe pulse oximetry measurements of available hemoglobin (%Spo2) were compared with arterial oxyhemoglobin fraction of total hemoglobin (%HbO2) measured directly from arterial blood samples using a CO oximeter. To provide a wide range of %HbO2 values, four subjects exercised under hypoxic conditions [inspired partial pressure of O2 (PIo2) = 107 Torr], while the remaining six subjects exercised under normoxic conditions (PIo2 = 150 Torr). Because carboxyhemoglobin (HbCO) or methemoglobin (MetHb) is not measured by pulse oximeters, %HbO2 was corrected for HbCO and MetHb and expressed as percent arterial O2 saturation of available Hb (%Sao2). Small and insignificant differences (P greater than 0.05) existed between SpO2 (all 3 instruments) and %SaO2 at the lowest work rate and the highest power output achieved. Regression analyses of %SpO2 vs. %SaO2 produced correlation coefficients of r = 0.82 [standard error of the estimate [(SEE) = 1.79], r = 0.89 (SEE = 1.48), and r = 0.93 (SEE = 1.14) for the Biox IIa, Ohmeda 3700 (ear), and the Ohmeda 3700 (finger) pulse oximeters, respectively. We conclude that pulse oximetry, within the above limits of accuracy, is useful in estimating %SaO2 during exercise in healthy subjects. PMID- 2759957 TI - Effect of elevated vascular pressure transients on protein permeability in the lung. AB - Neurogenic pulmonary edema (NPE) may develop in individuals with head trauma or seizures and is generally thought to have a hydrostatic basis in the severe degree of pulmonary hypertension that occurs. Recently, it has been suggested that vascular pressures may rise to levels that damage the vessels, leaving the patient at risk for further edema development. The objective of this study was to determine if pulmonary vascular protein permeability is increased in a canine isolated perfused left lower lung lobe (LLL) preparation by pressure transients that may occur in NPE. Venous pressure (Pv) was transiently raised to values ranging from 8 to 102 Torr in 19 LLL. One Pv transient was studied per LLL. After Pv was returned to normal, the osmotic reflection coefficient (sigma d) for total proteins was determined by the hematocrit-protein double indicator technique. No reduction in sigma d was observed until microvascular pressure exceeded 70 Torr. The average sigma d for the 11 LLL in which the peak microvascular pressure was less than 70 Torr was 0.74 +/- 0.03 (SE). Above this level sigma d fell linearly with increasing Pv, with a value of 0.26 being observed after the highest Pv transient. These results suggest that protein permeability may increase in patients with NPE who develop very large increases in pulmonary vascular pressures but may not be a universal occurrence in this disorder. PMID- 2759958 TI - Respiratory adaptation to chronic hypercapnia in newborn rats. AB - We asked 1) whether newborn rats respond to chronic hypercapnia with a persistent increase in ventilation and 2) whether changes in lung mass were accompanying the respiratory adaptation to chronic hypercapnia, as previously observed during neonatal chronic hypoxia. Five litters of rats were kept in 7% CO2 (with 21% O2) from day 1 to 7 after birth (CO2exp) and compared with six litters of control rats growing in normocapnia-normoxia (C). Body weight was similar between the two groups. Ventilation, measured by flow plethysmography, increased in CO2exp from day 2 and remained steadily elevated, and at day 7 it almost doubled (174%) the C value because of the large increase in tidal volume and mean inspiratory flow (192 and 189%, respectively) with no changes in respiratory frequency. Two days after return to normocapnia, ventilation was still 33% higher than in C; at this time, acute exposure to hypercapnia increased ventilation relatively less in the CO2exp than in C because of a lower increase in tidal volume. Neither the lung weight-to-body weight nor the heart weight-to-body weight ratios increased in CO2exp. We conclude that 1) chronic hypercapnia in newborn rats induces a steady increase in ventilation, which persists at least 2 days after return to normocapnia with a reduction in the acute response to CO2, and 2) hyperventilation per se is not the cause of the increased lung mass observed during chronic neonatal hypoxia. PMID- 2759959 TI - Effect of pyocyanin and 1-hydroxyphenazine on in vivo tracheal mucus velocity. AB - Products of the bacterium Pseudomonas aeruginosa have been shown to slow the beating of human respiratory tract cilia in vitro. We have tested the effects of two of these compounds, pyocyanin and 1-hydroxyphenazine (given as a bolus dose dissolved in 2 microliters Ringer solution), on tracheal mucus velocity of radiolabeled erythrocytes in anesthetized guinea pigs. 1-Hydroxyphenazine (200 ng) caused a rapid slowing of tracheal mucus velocity (maximum fall 47% at 20 min) with recovery by 1 h. The effect of pyocyanin was slower in onset, 600 ng causing 60% reduction in tracheal mucus velocity at 3 h, and no recovery occurred. A combination of pyocyanin and 1-hydroxyphenazine produced an initial rapid slowing equivalent to the same dose of 1-hydroxyphenazine given alone, but the later slowing attributed to pyocyanin was greater than the same dose administered alone. This study demonstrates one mechanism by which products of P. aeruginosa may facilitate its colonization of the respiratory tract. PMID- 2759960 TI - Effects of hypoxia on metabolic rate of conscious adult cats during cold exposure. AB - Oxygen consumption (VO2) and shivering movements were recorded in adult, conscious cats in a thermoneutral (24-27 degrees C) and in a cold (3-8 degrees C) environment during normoxia, hypoxia, or hyperoxia for 55 min. In the cold environment, VO2 correlated with shivering index (SI) under conditions of normoxia or ambient hypoxia (FIO2 = 0.12). During normoxia, VO2 was 63% higher in the cold than the thermoneutral environment. Ambient hypoxia acutely reduced VO2 in cold and thermoneutral environments, the decrement being greater for the former than the latter. Similarly, the variation in VO2 for unit change in SI was greater in hypoxia than normoxic conditions, suggesting that hypoxia influenced nonshivering as well as shivering components of cold-induced VO2. Hypoxia induced by CO (FICO = 0.002) also reduced VO2 and SI, a result that is consistent with previous results indicating that carotid body chemoreceptors do not mediate the suppression of shivering by ambient hypoxia. Hyperoxia increased VO2 and SI in the cold, and the effects of both hypoxia and hyperoxia in the cold were antagonized by increasing FICO2 to 0.03. The results demonstrate that hypoxia suppresses VO2 in the cold by reducing the intensity of shivering and, probably, by an action on metabolic rate that is unrelated to cold-induced calorigenesis. PMID- 2759961 TI - Forearm metabolic asymmetry detected by 31P-NMR during submaximal exercise. AB - This study evaluated the relationship of skeletal muscle energy metabolism to forearm blood flow and muscle mass in the dominant (D) and nondominant (ND) forearms of normal subjects. 31P-Magnetic resonance spectroscopy was used to determine intracellular pH and the ratio of inorganic phosphate to phosphocreatine (Pi/PCr), an index of energy metabolism. Forearm blood flow and muscle mass were measured by venous occlusion plethysmography and magnetic resonance imaging, respectively. Metabolic measurements and flow were determined at rest and during submaximal exercise in both forearms. After a warm-up period, six normal right-handed male subjects performed 7.5 min of wrist flexion exercise in the magnet (1 contraction every 5 s), first with the ND forearm and then with the D forearm, at 23, 46, and 69 J/min. At rest, there were no differences between forearms in Pi/PCr or pH. However, at each work load the D forearm demonstrated significantly lower Pi/PCr and higher pH than the ND forearm. Blood flow was not significantly different between the forearms at rest or during exercise. Because these subjects were not engaged in unilateral arm training, we conclude that 1) Pi/PCr is lower and pH is higher in the D compared with the ND forearm in normal subjects during submaximal exercise, 2) these differences are independent of muscle mass and blood flow, and 3) the cumulative effect of long term, low-level daily activity provides an adequate training stimulus for muscular metabolic adaptations. PMID- 2759962 TI - Effects of pneumatic antishock garment inflation in normovolemic subjects. AB - This study examines the effects of inflation of pneumatic antishock garments (PASG) in 10 normovolemic men (mean age 44 +/- 6 yr) undergoing diagnostic catheterization. Seven subjects had normal heart function and no evidence of coronary artery disease (CAD); three patients had CAD. High-fidelity multisensor catheters were employed to simultaneously record right and left heart pressures before PASG inflation and after inflation to 40, 70, and 100 mmHg. A thermal dilution catheter was used to obtain pulmonary capillary wedge pressure and cardiac output. Counterpressure increases greater than or equal to 40 mmHg were associated with significant changes in left and right heart pressures. Right and left ventricular end-diastolic pressures increased 100% (P less than 0.01); mean pulmonary arterial and aortic pressures increased 77 and 25%, respectively (P less than 0.01); systemic vascular resistance increased 22% (P less than 0.05) and pulmonary vascular resistance did not change in normal subjects at maximum PASG inflation. Heart rate, cardiac output, and aortic and pulmonary arterial pulse pressures did not change during inflation in either group. Right and left ventricular end-diastolic pressures and pulmonary capillary wedge pressure were greater (P less than 0.05) in the CAD group compared with the normal subjects during PASG inflation. The data suggest that the primary mechanism whereby PASG inflation induces changes in central hemodynamics in normovolemic subjects is through an acute increase in left ventricular afterload. PASG changes in afterload and pulmonary capillary wedge pressure imply that these devices should be used with caution in patients with compromised cardiac function. PMID- 2759963 TI - O2- and pneumonia-induced lung injury. I. Pathological and morphometric studies. AB - The physiological, morphological, and morphometric findings of several lung injury models in baboons have been compared in the following six study groups: 1) initial injury with oleic acid followed by ventilation with 100% O2, 2) ventilation with 100% O2, 3) ventilation with 80% O2, 4) ventilation with 80% O2 followed by inoculation of Pseudomonas aeruginosa, 5) ventilation with 40% O2, and 6) normal nonventilated room-air-breathing animals. The animals were maintained for 11 days in an intensive care unit. Light microscopically, animals ventilated with 40 and 80% O2 showed mild lung injury, consisting mostly of an increase in alveolar macrophages in peribronchiolar sites and focal alveolar wall widening. The 100% O2-oleic acid, 100% O2, and 80% O2-Pseudomonas-treated baboons showed mixed exudative-reparative diffuse alveolar lesions. Ultrastructurally, the type II cells of these three groups had significantly altered morphology with aberrations of lamellar body configurations. Morphometric findings showed increases in type II and interstitial cells and decreases in type I and endothelial cells in these injured animals. A striking finding was that the physiological, morphological, and morphometric changes of an 80% O2-Pseudomonas insult was as injurious as 100% O2. This synergistic effect of hyperoxia and infection very likely reflects the most frequent evolution of adult respiratory distress syndrome in patients in intensive care units. PMID- 2759964 TI - O2- and pneumonia-induced lung injury. II. Properties of pulmonary surfactant. AB - Pulmonary surfactant was isolated from the lavage fluids of animals during the course of exposure to 100% O2, 80% O2, 40% O2, or 80% O2 plus 10(8) Pseudomonas aeruginosa instilled intratracheally and analyzed for its phospholipid composition. After 4-5 days of exposure to 100% O2, disaturated phophatidylcholine (DSPC) decreased to 87% of control, whereas the ratio of phosphatidylglycerol to phosphatidylinositol (PG/PI) was 37% of control. Longer periods of ventilation with 100% O2 resulted in DSPC falling to less than 40% of control. The injury was not reversed by reducing the O2 to 50%; rather, a progressive deterioration ensued. Acute respiratory failure (ARF) induced by 5 days of bacterial infection was very similar to that seen after 5 days of exposure to 100% O2. Ventilation with 80% O2 for 6 days resulted in smaller changes in DSPC but with differences in PG/PI comparable to those seen with 100% O2 or infection. We conclude that the ability of the type II cell to synthesize surfactant of normal composition is significantly impaired in these models of ARF. The earliest index of biochemical modification is the substantial change in PG/PI, which may be predictive of early lung injury. Further exacerbation of the injury could result in the reduction of DSPC content, with subsequent changes in lung mechanics and gas exchange. PMID- 2759965 TI - Time of application of negative pressure pulses and upper airway muscle activity. AB - Effect of upper airway pressure changes on thoracic inspiratory muscles has been shown to depend on the time of application during the breathing cycle. The present study was designed to investigate the importance of the time of application of upper airway negative pressure pulses on upper airway muscles. The upper airway was functionally isolated into a closed system in 24 anesthetized spontaneously breathing rabbits. Negative pressure pulses were applied in early (within the first 200 ms) and late (greater than or equal to 200 ms) inspiration, while electromyograms (EMG) of the diaphragm (Dia), genioglossus (GG), alae nasi (AN), and/or posterior cricoarytenoid (PCA) muscles were simultaneously monitored. When negative pressure pulse was applied in early inspiration, the increase in GG activity was greater [0.49 +/- 0.37 to 4.24 +/- 3.71 arbitrary units (AU)] than when negative pressure was applied in late inspiration (0.44 +/- 0.29 to 2.64 +/- 3.05 AU). Similarly, increased activation of AN (2.63 +/- 1.01 to 4.26 +/- 1.69 AU) and PCA (3.46 +/- 1.16 to 6.18 +/- 2.93 AU) was also observed with early inspiratory application of negative pressure pulses; minimal effects were seen in these muscles with late application. An inhibitory effect on respiratory timing consisting of a prolongation in inspiration (TI) and a decrease in peak Dia EMG/TI was observed as previously reported. These results indicate that the time of application of negative pressure during the breathing cycle is an important variable in determining the magnitude of the response of upper airway muscles.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2759966 TI - Analysis of bronchoconstrictor responses to platelet-activating factor in the cat. AB - Bronchoconstrictor responses to platelet-activating factor (PAF) were investigated in paralyzed, anesthetized, mechanically ventilated cats. Intravenous injections of PAF caused dose-dependent increases in lung resistance (RL) and decreases in dynamic compliance (Cdyn) and systemic arterial (aortic) pressure (PAO). The increases in RL and decreases in Cdyn in response to PAF were markedly reduced by sodium meclofenamate, a cyclooxygenase inhibitor, whereas the decreases in PAO were unchanged. Increases in RL and decreases in Cdyn but not PAO in response to PAF were reduced by SQ 29,548, a thromboxane (Tx) receptor blocking agent. CV 3988, a PAF receptor antagonist, reduced bronchoconstrictor and aortic depressor responses to PAF but had no effect on responses to the Tx mimic, U 46619, or to the prostaglandin precursor, arachidonic acid. The present studies suggest that bronchoconstrictor responses but not the hypotensive response to PAF are mediated in large part by the release of arachidonic acid from cell membrane phospholipids and the formation of cyclooxygenase products including TxA2. These data indicate that although airway and vasodepressor responses to PAF in the cat are mediated by different mechanisms, a similar PAF CV 3988-sensitive receptor is involved. PMID- 2759967 TI - Thermoregulation in hypergravity-acclimated rats. AB - To determine the effect of hypergravity acclimation on thermoregulation, core temperature (Tc), tail temperature (Tt), and O2 consumption (VO2) were measured in control rats (raised at 1 G) and in rats acclimated to 2.1 G. When the animals were exposed to a low ambient temperature of 9 degrees C, concurrently with a hypergravic field of 2.1 G, Tc of rats raised at 1 G fell markedly by approximately 6 degrees C (to 30.8 +/- 0.6 degrees C) while that of the rats raised at 2.1 G remained relatively constant (falling only approximately 1 degree C to 36.4 +/- 0.3 degrees C). Thus prior acclimation to a 2.1-G field enabled rats to maintain Tc when cold exposed in a 2.1-G field. To maintain Tc, thermogenic mechanisms were successfully activated in the 2.1-G-acclimated rats as shown by measurements of VO2. In contrast, VO2 measurements showed that rats reared at 1 G and then cold exposed at 2.1 G did not activate thermogenic mechanisms sufficiently to prevent a fall in Tc. In other experiments, rats acclimated to either 1 or 2.1 G were found to lack the ability to maintain their Tc when exposed to a 5.8-G field or when exposed to prolonged cold exposure at 1 G. Results are interpreted as showing that when placed in a 2.1-G field, rats acclimated to 2.1 G can more closely maintain their Tc near 37 degrees C when cold exposed than can rats acclimated to 1 G. However, this enhanced regulatory ability of 2.1-G-acclimated rats over 1.0-G-acclimated rats is restricted to 2.1 G fields and is not observed in 1.0- and 5.8-G fields. PMID- 2759968 TI - Fitting piecewise linear regression functions to biological responses. AB - An iterative approach was achieved for fitting piecewise linear functions to nonrectilinear responses of biological variables. This algorithm is used to estimate the parameters of the two (or more) regression functions and the separation point(s) (thresholds, sensitivities) by statistical approximation. Although it is often unknown whether the response of a biological variable is adequately described by one rectilinear regression function or by piecewise linear regression function(s) with separation point(s), an F test is proposed to determine whether one regression line is the optimal fitted function. A FORTRAN 77 program has been developed for estimating the optimal parameters and the coordinates of the separation point(s). A few sets of data illustrating this kind of problem in the analysis of thermoregulation, osmoregulation, and the neuronal responses are discussed. PMID- 2759970 TI - Surfactant subtypes of mice: metabolic relationships and conversion in vitro. AB - Mouse alveolar surfactant can be separated by equilibrium centrifugation on continuous sucrose gradients into three subtypes which we call "ultraheavy", "heavy", and "light" on the basis of their buoyant densities. We examined their metabolic relationship by in vivo labeling studies and by physical manipulation, cycling the surface area in vitro in an attempt to convert one subtype into another. Labeling studies indicated rapid quantitative progression of surfactant through ultraheavy, heavy, and light subtypes in sequence. To mimic the in vivo conversion of subtypes in vitro we "cycled" the surface area of surfactant in plastic tubes. Newly secreted surfactant obtained from incubated lungs, as well as surfactant obtained by alveolar lavage and lamellar bodies, exhibited conversion of material from heavier to lighter subtypes. The conversion between subtypes was quantal and was dependent on cycling, temperature, and time. We conclude that the three subtypes are discrete forms of alveolar surfactant that evolve from one into another. Cycling may provide a means to study the mechanisms of their interconversion in vitro. PMID- 2759969 TI - A PAF antagonist blocks antigen-induced airway hyperresponsiveness and inflammation in sheep. AB - We studied the effects of WEB-2086, a specific antagonist of platelet-activating factor (PAF), on the development of antigen-induced airway hyperresponsiveness and inflammation in sheep (n = 8). For these studies, airway responsiveness was determined from slopes of carbachol dose-response curves (DRC) performed at base line (prechallenge) and 2 h after Ascaris suum antigen challenges in the following three protocols: 1) antigen challenge alone (control trial), 2) WEB 2086 (1 mg/kg iv) given 30 min before antigen challenge (WEB pretreatment), and 3) WEB-2086 given 2 h after antigen challenge, immediately before the postchallenge DRC (WEB posttreatment). Airway inflammation was assessed by bronchoalveolar lavage (BAL) before antigen challenge and after the postchallenge DRC for each trial. A. suum challenge resulted in acute increases in specific lung resistance that were not different among the three trials. Antigen challenge (control trial) caused a 93% increase (P less than 0.05) in the slope of the carbachol DRC when compared with the prechallenge value. WEB pretreatment (1 mg/kg) reduced (P less than 0.05) this antigen-induced hyperresponsiveness, whereas pretreatment with a 3-mg/kg dose completely prevented it. WEB posttreatment was ineffective in blocking this hyperresponsiveness. BAL neutrophils increased after antigen challenge in the control trial and when WEB 2086 was given after antigen challenge (P less than 0.05). Pretreatment with WEB 2086 (1 or 3 mg/kg) prevented this neutrophilia. This study provides indirect evidence for antigen-induced PAF release in vivo and for a role of endogenous PAF in the modulation of airway responsiveness and airway inflammation after antigen induced bronchoconstriction in sheep. PMID- 2759971 TI - Pulmonary permeability in never-smokers between 21 and 67 yr of age. AB - During the last 5-10 years, measurements of pulmonary clearance (PCl) of aerosolized 99mTc-labeled diethylenetriamine pentaacetic acid (99mTC-DTPA) have become increasingly used as an index of pulmonary epithelial injury. The aim of this study was to apply a carefully defined procedure for measurements of PCl in healthy nonsmoking individuals and analyze whether sex, age, and height are clinically relevant confounders contributing to the range of interindividual variation. Measurements of regional ventilation (V) and perfusion (Q) were included to analyze whether these indexes are influenced by the same confounders. We studied 39 males and females between 21 and 67 yr of age. Average PCl of the lungs was 0.85 +/- 0.25%.min-1. There was a significant difference between PCl of the central and peripheral parts of the lungs (P less than 0.01). Regional V and Q were greater in the lower than in the upper halves of the lungs (P less than 0.01). There was no relation between PCl, V, or Q and the sex, age, and height of the individuals. It is concluded that when measuring PCl in adult individuals anthropometric measurements need not be considered. PMID- 2759972 TI - Surfactant metabolism in surfactant-treated preterm ventilated lambs. AB - Preterm lambs were delivered at 132 days gestational age, treated with 100 mg/kg radiolabeled natural sheep surfactant or Surfactant TA, and ventilated for times up to 24 h. Compared with an untreated group that developed respiratory failure by 5 h, both surfactant-treated groups had stable respiratory function to 24 h. Although only approximately 13% of the labeled surfactant phosphatidylcholine was recovered by alveolar wash at 24 h, there was no significant loss of the labeled phosphatidylcholine from the lungs. Labeled palmitic acid intravascularly injected at 1 h of age comparably labeled lung phosphatidylcholine in the three groups of lambs at 5 h; however, only approximately 0.5% of the labeled phosphatidylcholine was secreted to the air spaces of surfactant-treated lambs at 24 h. Labeled lysophosphatidylcholine given with the natural sheep surfactant was taken up by the lungs, converted to phosphatidylcholine with 30-40% efficiency, and resecreted to the air spaces, demonstrating recycling of a phospholipid. The large surfactant aggregates recovered from alveolar washes by centrifugation were surface active and contained approximately 76% of the air-space phosphatidylcholine in both surfactant-treated groups. Although clinical status was comparable, alveolar washes and surfactant subfractions from Surfactant TA treated lambs had better surface properties than did sheep surfactant-treated lambs. These studies identified no detrimental effects of surfactant treatments on endogenous surfactant metabolism and indicated that the surfactants used for treatments were recycled by the preterm ventilated lamb lung. PMID- 2759973 TI - Mechanism of enhanced cold tolerance by an ephedrine-caffeine mixture in humans. AB - The influence of a thermogenic mixture of ephedrine- (1 mg/kg) caffeine (2.5 mg/kg) on cold tolerance was investigated in nine healthy young male subjects during two seminude exposures to cold air (3 h at 10 degrees C). The drug ingestion reduced the total drop in core, mean skin, and mean body temperatures (P less than 0.01), thus producing significantly warmer final core, mean skin, and mean body temperatures compared with the placebo ingestion. The drug ingestion increased the total 3-h energy expenditure by 18.6% compared with that of the placebo ingestion in the cold (P less than 0.01). By means of the nonprotein respiratory exchange ratio to calculate the rates of substrate oxidation, it was found that the drug ingestion increased carbohydrate oxidation by as much as 41.7% above that of the placebo (P less than 0.05). In contrast, the drug mixture had no significant influence on lipid or protein metabolism. The results demonstrate that the ingestion of an ephedrine-caffeine mixture improves cold tolerance in humans by significantly increasing body temperatures in the cold. These improvements were not caused by an increased conservation of heat but by a greater energy expenditure, which appears to be dependent on an enhanced carbohydrate utilization. PMID- 2759974 TI - Mathematical analysis of running performance and world running records. AB - The objective of this study was to develop an empirical model relating human running performance to some characteristics of metabolic energy-yielding processes using A, the capacity of anaerobic metabolism (J/kg); MAP, the maximal aerobic power (W/kg); and E, the reduction in peak aerobic power with the natural logarithm of race duration T, when T greater than TMAP = 420 s. Accordingly, the model developed describes the average power output PT (W/kg) sustained over any T as PT = [S/T(1 - e-T/k2)] + 1/T integral of T O [BMR + B(1 - e-t/k1)]dt where S = A and B = MAP - BMR (basal metabolic rate) when T less than TMAP; and S = A + [Af ln(T/TMAP)] and B = (MAP - BMR) + [E ln(T/TMAP)] when T greater than TMAP; k1 = 30 s and k2 = 20 s are time constants describing the kinetics of aerobic and anaerobic metabolism, respectively, at the beginning of exercise; f is a constant describing the reduction in the amount of energy provided from anaerobic metabolism with increasing T; and t is the time from the onset of the race. This model accurately estimates actual power outputs sustained over a wide range of events, e.g., average absolute error between actual and estimated T for men's 1987 world records from 60 m to the marathon = 0.73%. In addition, satisfactory estimations of the metabolic characteristics of world-class male runners were made as follows: A = 1,658 J/kg; MAP = 83.5 ml O2.kg-1.min-1; 83.5% MAP sustained over the marathon distance. Application of the model to analysis of the evolution of A, MAP, and E, and of the progression of men's and women's world records over the years, is presented. PMID- 2759975 TI - Simultaneous acquisition of ECG, BCG, and blood pressure from chick embryos in the egg. AB - The applicability of the audiocartridge system to simultaneous measurements of the ballistic movements from multiple points of the egg was examined in late chick embryos. Despite direct contact between the cartridges and the egg, minute movements of the egg attributable to cardiac contractions of the embryo (ballistocardiogram, BCG) could be simultaneously detected from at least three points. The results showed that the amplitude of BCG waves was dependent on the site of detection, indicating that the BCG was a directional wave. The cartridge system for BCG measurement was incorporated in the electrocardiography and arterial catheterization to acquire simultaneously electrocardiogram (ECG), BCG, and blood pressure from the embryo confined in the egg. Isochronal comparison of these waves indicated that the ballistic movements of the embryo might be caused not only by the ventricular contraction but also by the atrial excitation, i.e., the BCG comprised waves appearing in the ventricular presystolic, contraction, and ejection periods. For wide changes in the heart rate, the approximate isometric ventricular contraction period remained almost constant. PMID- 2759976 TI - Metabolic activation of carotid body glomus cells by hypoxia. AB - The effects of low O2 on glucose consumption in the rabbit carotid body were studied using the in vitro 2-deoxyglucose technique. Metabolically active structures within the tissue were localized autoradiographically after freeze drying and vacuum fixation/embedding of selected incubated tissue samples. In 100% O2-equilibrated media, the mean basal glucose consumption calculated from the rate of 2-[1,2-3H]deoxy-D-glucose phosphorylation and its specific activity in the incubation media was 61 nmol.g tissue-1.min-1 in the carotid body and 42 nmol.g tissue-1.min-1 in parallel experiments with nodose ganglia. Low PO2 (20% O2-equilibrated media in vitro) increased glucose consumption in the carotid body by 44% but did not alter glucose metabolism of nodose ganglia. Autoradiographic data showed that preneural type I parenchymal cells are the principal site of glucose consumption in carotid chemosensory tissue. The mechanisms responsible for the hypoxia-induced increase in glucose consumption by the type I cells are discussed in relation to sensory transduction by the carotid body chemoreceptors. PMID- 2759977 TI - Measurement of alveolar pressure in closed-chest dogs during flow interruption. AB - We have developed a technique for installing alveolar capsules in dogs with intact chest wall, by exposing a region of parietal pleura between a pair of ribs and gluing the parietal and visceral pleura together around a small region of lung. This allows the direct measurement of alveolar pressure during spontaneous breathing. We measured alveolar pressure in normal dogs using this technique while suddenly interrupting flow at the trachea during passive expiration. Tracheal pressure exhibited a very rapid rise immediately on interruption that we showed to be composed of two distinct and roughly equal parts: one was the resistive pressure drop across the airways, and the other was a resistive pressure drop across tissues. By simultaneously measuring pleural pressure we showed that the tissues responsible were only in the chest wall and not in the lungs. PMID- 2759978 TI - Blood pressure changes during running in humans: the "beat" phenomenon. AB - In 20 runners the intra-arterial blood pressure changes determined by a long distance run and by a maximal bicycle ergometric test were recorded by means of the portable Oxford system. A peculiar pattern of the phasic waves was observed throughout the run: continuous rhythmic pulse pressure oscillations ranging in frequency between 4 and 28/min and unrelated to respiration were detected. The shape of these oscillations prompted us to investigate whether they were due to a "beat" phenomenon, that is, to the combined effect of two waves with a nearly equal frequency. To test this hypothesis, during the run 10 athletes carried a fluid-filled container around the chest. The pressure waves recorded in the container were added by computer to those recorded intra-arterially during bicycle ergometry. The resultant harmonic showed a pattern similar to that recorded in the athlete's radial artery during running. Conversely, by subtracting the pressure waves recorded in the container from those simultaneously recorded at the radial artery during running, nearly flat tracings were obtained. The source of the beat phenomenon has therefore been identified in the wave, which generates inside the aorta and the great vessels at each foot strike shock. PMID- 2759979 TI - Two-cytochrome metabolic model for carotid body PtiO2 and chemosensitivity changes after hemorrhage. AB - O2 microelectrode measurements were made in the cat carotid body (CB) at normal control blood pressures (C) and after hemorrhage (H) to reduce mean arterial blood pressure [C, 98.7 +/- 4.6 (SE) mmHg; H, 58.1 +/- 1.8; P less than 0.001; paired t test; n = 9 cats]. Mean tissue PO2 (PtiO2) was significantly lower (C, 78.4 +/- 3.0 Torr; H, 65.3 +/- 4.8; P less than 0.01). Except for two experiments with good autoregulation, the decrease in PtiO2 correlated with the reduction in blood pressure (r = 0.791, P less than 0.005). Measurements of O2 disappearance curves (DCs) and sinus nerve discharge (ND) were obtained after blood supply was occluded for 30-45 s (56 C DCs, 44 H DCs). Disappearance rates (dPO2/dt) were significantly slower after hemorrhage (C, -7.52 +/- 0.47 Torr/s; H, -6.60 +/- 0.44; P less than 0.01), decreasing by 0.656 Torr/s for each 10 Torr fall in PtiO2 (r = 0.626, P less than 0.05). Resting ND before occlusion increased during hypotension (11.6 +/- 2.9% of control, P less than 0.01) and correlated with the decrease in PtiO2 (r = -0.792, P less than 0.005). A computer simulation was performed for a two-cytochrome metabolic model with a second, low-O2-affinity oxidase in addition to normal oxidative metabolism. The effects of cat oxyhemoglobin and blood pH on the O2 DC measurement were also taken into account. The simulation for the two-cytochrome model was consistent with our experimental data and predicts reductions in blood flow and O2 metabolism with hypotension after hemorrhage that have similarities, as well as aspects that disagree, with previous reports in the literature. PMID- 2759980 TI - Skeletal muscle lipid peroxidation in exercised and food-restricted rats during aging. AB - The effects of chronic endurance exercise and food restriction on nonenzymatic lipid peroxidation (LP) of gastrocnemius muscle during aging were studied in male, Fischer 344 rats. One set of rats aged 6 and 18 mo were assigned to an exercise group (treadmill running) or an age-matched sedentary control group. After 6 mo (at the ages of 12 and 24 mo), LP and levels of alpha-tocopherol and its oxidized form, alpha-tocopheryl quinone, were measured. The extent of LP was determined in homogenates by measuring the content of thiobarbituric acid reactive substances. After homogenization, the muscles were immediately evaluated for basal LP and also incubated in the presence of oxidant stressors for 2 h to assess antioxidant capacity (AOC) and for 24 h to estimate total peroxidizable lipid (TPL). Basal LP was not affected by age or exercise. AOC was not affected by exercise at either age. However aging significantly decreased AOC and increased alpha-tocopheryl quinone in both sedentary and exercised groups. TPL was not affected by age, but was increased by exercise training (P less than 0.05). Another set of rats was divided into the following three groups at 3 mo of age: sedentary, fed ad libitum (S); sedentary, caloric restricted by alternate day feeding (R); and exercised by forced treadmill running (E). Two years later, when the rats were 27 mo of age, the extent of LP was assessed.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2759981 TI - Neutrophil kinetics in rabbits during infusion of zymosan-activated plasma. AB - Complement activation in vivo produces neutropenia and pulmonary sequestration of neutrophils (PMNs) whereas in vitro activation increases PMN adherence and decreases PMN deformability. The present study examined PMN kinetics in vivo to determine if this sequestration was specific to the lung. Venous or arterial injections of radiolabeled PMNs were given to animals receiving infusions of zymosan-activated plasma (ZAP) or saline, and the PMN distribution was evaluated 10 min later. In control animals, the relative size of the marginated and circulating PMN pools was similar after venous or arterial injection and regional PMN retention increased as blood velocity slowed. ZAP infusion produced threefold increases in PMNs within pulmonary capillaries after venous injection and PMN retention was independent of blood velocity. After arterial injection, ZAP infusion produced PMN sequestration in all organs. Rigid (glutaraldehyde-fixed) PMNs injected into control rabbits showed increased lung recoveries similar to those of fresh PMNs injected into ZAP-treated rabbits. We conclude that activation of the complement system causes PMN sequestration in both the pulmonary and the systemic microvasculature and that the decrease in PMN deformability that occurs with activation of the PMN may be important in the genesis of PMN sequestration. PMID- 2759982 TI - Regional hemodynamic responses to hypoxia and hypermetabolism in polycythemic dogs. AB - Normovolemic polycythemia did not improve the ability of either resting muscle or gut to maintain O2 uptake (VO2) during severe hypoxia because of the adverse effects of increased viscosity on blood flow to those regions. The present study tested whether increased metabolic demand would promote vasodilation sufficiently to overcome those effects. We measured whole body, muscle, and gut blood flow, O2 extraction, and VO2 in anesthetized dogs after increasing hematocrit to 65% and raising O2 demand with 2,4-dinitrophenol (n = 8). We also tested whether regional denervation (n = 8) and hypervolemia (n = 6) affected these responses. After raising hematocrit and metabolism, the dogs were ventilated with air, with 9% O2 91% N2, and again with air for 30-min periods. Reduced blood flow and increased O2 demand, caused by increased blood viscosity and 2,4-dinitrophenol, respectively, increased O2 extraction so that muscle VO2 was nearly supply limited in normoxia. Denervation showed that vasoconstriction had increased in gut and muscle with hypoxia onset but this was overcome after 15 min. By then, muscle was receiving a major portion of cardiac output, whereas gut showed little change. With hypervolemia cardiac output increased in hypoxia but neither gut nor muscle increased blood flow in those experiments. Because regional and whole body VO2 fell in all groups during hypoxia to the same extent found earlier in normocythemic dogs, any real benefit of polycythemia under the conditions of these experiments was dubious at best. PMID- 2759983 TI - Aflatoxins in domestic and imported foods and feeds. AB - Aflatoxins, metabolic products of the molds Aspergillus flavus and A. parasiticus, may occur in foods and feeds. These toxins cannot be entirely avoided or eliminated from foods or feeds by current agronomic and manufacturing processes and are considered unavoidable contaminants. To limit aflatoxin exposure, the U.S. Food and Drug Administration (FDA) has set action levels for these toxins in foods and feeds involved in interstate commerce. FDA continually monitors food and feed industries through compliance programs. This report summarizes data generated from compliance programs on aflatoxins for the fiscal year 1986. Commodities sampled included peanuts and peanut products, corn and corn products, tree nuts, cottonseed, milk, spices, manufactured products, and miscellaneous foods and feeds. Correlations were highest between aflatoxin contamination and geographical areas for corn/corn products and cottonseed/cottonseed meal. Higher incidences of aflatoxin contamination in corn and corn products designated for human consumption were observed in samples collected in the southeastern states (32 and 28%, respectively). A higher incidence of contamination was observed in corn designated for animal feed from Arkansas-Texas (74%) than from the southeastern states (47%). Only 3% of feed corn from corn belt states contained detectable aflatoxins. All aflatoxin contaminated cottonseed was collected in the Arizona-California area; 80% of cottonseed meal analyzed from this area also contained detectable levels of aflatoxins.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2759984 TI - Determination of enantiomeric purity of tranylcypromine sulfate by proton magnetic resonance spectroscopy with chiral lanthanide shift reagent. AB - Optimum experimental conditions were developed for determination of the optical purity of samples of tranylcypromine sulfate by proton magnetic resonance spectroscopy after complexation with the chiral lanthanide chelate Eu(hfc)3. At a substrate concentration of 0.25M (0.125M as sulfate) in CDCl3 and an Eu(hfc)3 to substrate molar ratio of 1, the methine proton geminal to the amino group in the cyclopropane ring showed the largest induced shift and largest enantiomeric induced shift difference. From the relative intensities of the resolved (+)-CH NH2 protons (15.77 ppm) and (-)-CH-NH2 proton (16.04 ppm), the enantiomeric purity and percentage compositions were readily calculated. The mean +/- SD recovery of (+)-tranylcypromine sulfate from synthetic enantiomeric mixtures was 101.02 +/- 2.59 (n = 6). PMID- 2759985 TI - Determination of diastereomeric purity of tranylcypromine sulfate by proton magnetic resonance spectroscopy with lanthanide shift reagent. AB - Use of proton nuclear magnetic resonance spectroscopy and the lanthanide shift reagent, Eu(hfc)3, resulted in a simple and reliable method for determination of the diastereomeric purity of trans-2-phenylcyclopropylamine sulfate (tranylcypromine sulfate). Eu(hfc)3 effectively simplified the complex overlapping pattern of the 5 non-equivalent phenyl protons to a virtually first order pattern. At a shift reagent to substrate molar ratio of 0.75, and a substrate concentration of 0.25M (as the free base) in CDCl3, the resonances for the cis- and trans-ortho-phenyl protons at 11.39 and 9.99 ppm, respectively, were sufficiently resolved to be of use in quantitative work. Analysis of synthetic diastereomeric mixtures of 2-phenylcyclopropylamine sulfate by the proposed method yielded results that were in close agreement with the expected values. The mean recovery (SD) of trans-diastereomer was 100.51% (0.40) (n = 6). Levels of less than 2% of cis-diastereomer were measurable in cis-trans mixtures. PMID- 2759986 TI - Simultaneous determination of oxytetracycline, tetracycline, and chlortetracycline in milk by liquid chromatography. AB - A simple, rapid procedure is described for the simultaneous quantification of 3 tetracycline drugs in bovine milk. Samples are prepared by dilution with an EDTA/phosphate buffer solution and filtration through a molecular weight cutoff filter. Analytes are concentrated on-column using a reverse-phase gradient elution system of oxalic acid, acetonitrile, and methanol. The limits of quantitation are approximately 15-50 ng/mL and the limits of detection are 10-20 ng/mL, depending on the compound. For oxytetracycline, over the range 50-1200 ng/mL, the average recovery and intralaboratory coefficient of variation were 97% and 4.1%, respectively. Over the same range, these parameters were, respectively, 97% and 5.0% for tetracycline, and 89% and 6.4% for chlortetracycline. The applicability of this procedure is demonstrated by separation and detection of incurred tetracycline residues in milk from treated animals. PMID- 2759987 TI - Liquid chromatographic-electrochemical detection screening procedure for six nitro-containing drugs in chicken tissues at low ppb level. AB - A screening procedure is described for the detection of furazolidone, nitrofurazone, aklomide, zoalene, nitromide, and sulfanitran residues in a single extract of chicken liver, breast, or thigh muscle at the low ppb level. The method includes extraction of tissue with chloroformethyl acetate-dimethyl sulfoxide (50 + 50 + 0.8), adsorption on neutral alumina, and subsequent elution of the residues with pH 6.0 phosphate buffer-methanol (1 + 1). Eluants are separated on a 25 cm, 5 microns C18 column with pH 6.0 phosphate buffer-methanol (57.5 + 42.5) as mobile phase. The drugs are detected with an electrochemical detector in the reductive mode at -0.8 V. Mean recoveries from all tissues ranged from 76.5% for nitrofurazone to 97.1% for zoalene. PMID- 2759988 TI - Liquid chromatographic determination of chloramphenicol residues in meat: interlaboratory study. AB - A liquid chromatographic (LC) method for the determination of chloramphenicol (CAP) residues in meat at the 10 microgram/kg level was tested in an interlaboratory study. The method used, based on aqueous extraction and sample cleanup with a cartridge containing Extrelut, was published earlier. A prestudy to familiarize collaborators with the method was performed before the actual interlaboratory precision study. The meat samples used in the precision study were prepared by diluting dosed chicken and pig muscle tissues with blank tissues from other species. Fourteen laboratories received 20 meat samples; 13 laboratories actually participated in the study. Two blank samples and 2 positive samples each of pig, calf, chicken, lamb, and cow meat were tested. The chloramphenicol concentrations in the positive samples ranged from 6.5 to 21 micrograms/kg. The overall mean reproducibility coefficient of variation was 17.9% after the results per laboratory were corrected for the mean recovery obtained within each sample series. The overall mean recovery was 55.1% with a coefficient of variation of 18.0% at the 10 micrograms/kg level. The limit of detection, based on chromatograms of blank samples, was estimated to be 1.5 micrograms/kg of chloramphenicol. No false positives or false negatives were observed in the concentration range tested; only 2 false positive results above the detection limit (1.7 and 6 micrograms/kg) on a total number of 60 blank analyses (3.3%) were observed. PMID- 2759989 TI - Determination of nicarbazin in chicken tissues by liquid chromatography and confirmation of identity by thermospray liquid chromatography/mass spectrometry. AB - A liquid chromatographic method is described for the quantitative measurement of nicarbazin in chicken liver, fat, muscle, and skin tissues. The 4,4' dinitrocarbanilide (DNC) portion of nicarbazin is extracted from tissues with ethyl acetate. After filtration and evaporation, the extract is purified by liquid-liquid partitioning with acetonitrile-hexane and alumina cartridge chromatography. DNC is separated and measured by reverse-phase liquid chromatography (RP-LC) with an octadecylsilyl (ODS) column and a UV detector set at 340 nm. The overall average recovery of DNC added to tissues was 83.4 +/- 3.1%. The lowest level validated in tissues by this procedure was 0.10 ppm. The limit of detection was estimated to be 0.020 ppm. This method provides a sensitive, selective, rapid, and reproducible alternative to existing purification, separation, and detection techniques, such as differential pulse polarography and colorimetry, for determination of nicarbazin in chicken tissues. Identity of DNC is confirmed by subjecting the purified extracts to thermospray LC/mass spectrometric analysis using negative-ion detection and selected ion monitoring. Three structural-indicating ions at m/z 302, 272, and 164 are monitored in the thermospray-mass spectrum which are characteristic of the DNC molecule. PMID- 2759990 TI - Liquid chromatographic determination and gas chromatographic-mass spectrometric confirmation of lasalocid sodium in bovine liver: interlaboratory study. AB - An analytical method has been developed that can reliably measure the metabolic marker residue of lasalocid. The method monitors this marker residue in food samples to ensure that the total residue of toxicological concern is not being exceeded. Interlaboratory studies of the liquid chromatographic determinative procedure and the gas chromatographic/mass spectrometric confirmatory procedure for lasalocid sodium at the 0.7 ppm level and higher were successful. PMID- 2759991 TI - Liquid chromatographic determination of lasalocid sodium in chicken skin: interlaboratory study. AB - The U.S. Food and Drug Administration (FDA) sponsored an interlaboratory study of a liquid chromatographic determinative procedure for lasalocid sodium in chicken skin with adhering fat. Four laboratories analyzed 35 dosed tissue samples and 82 fortified tissue samples containing lasalocid at levels ranging from 0.1 to 0.6 ppm. Samples were homogenized with acetonitrile, washed with hexane, and partitioned into the mobile phase prior to analysis liquid chromatography with fluorescence detection. The results of the interlaboratory study showed good reproducibility for fortified samples. Fortification levels, average recoveries, and interlaboratory percent coefficients of variation were as follows: 0.6 ppm, 0.57 ppm, and 9.7; 0.3 ppm, 0.25 ppm, and 9.1; and 0.15 ppm, 0.14 ppm, and 7.0, respectively. Data for analysis of the dosed tissue also showed good agreement among the laboratories. PMID- 2759992 TI - Determination of N-methylcarbamate pesticides in liver by liquid chromatography. AB - A liquid chromatographic (LC) method using a 2-step purification technique for the simultaneous determination of 10 carbamates in bovine, swine, and duck livers has been developed. Carbamates are extracted from liver samples with methylene chloride. After evaporation, the residues from the extract are dissolved in methylene chloride-cyclohexane (1 + 1) and cleaned up by gel permeation chromatography. The eluate containing carbamate residues is evaporated to dryness, reconstituted in methylene chloride, further purified by passing it through an aminopropyl Bond Elut extraction cartridge, and analyzed by liquid chromatography using post-column derivatization with orthophthalaldehyde and fluorescence detection. Excitation and emission are set at 340 and 418 nm, respectively. Liver samples for beef, pork, and duck were fortified with 5, 10, and 20 ppb of mixed carbamate standards. The average of 10 recoveries of 10 carbamates at all 3 levels of fortification was greater than 80% with coefficients of variation less than 17%. PMID- 2759993 TI - Microscopic detection and identification of various substitute vegetable tissues in ground horseradish. AB - Turnip root, parsnip root, potato tuber, and corn kernels have been used as adulterants in the preparation of horseradish sauce and horseradish powder. The diagnostic histological features of horseradish root and its known adulterants are described and illustrated as viewed through a polarizing microscope with cross polars and a first order red plate. A procedure which can be used to detect any of the known adulterants in horseradish is described. The adaptation of a previously reported semiquantitative method is also discussed. PMID- 2759994 TI - Amino acid rating method for evaluating protein adequacy of infant formulas. AB - Amino acid profiles and/or protein digestibility (by the rat balance method) were determined for various forms (powder, ready-to-use, liquid concentrate, etc.) of cow's milk- and soy-based infant formulas obtained from 4 manufacturers. The essential amino acid data of the formulas were compared with that of human milk for the calculation of amino acid scores (based on the single most limiting amino acid). The product of amino acid score and total protein (g/100 kcal) was then termed "amino acid rating." Amino acid scores for the milk- and soy-based formulas ranged from 59 to 90 and from 59 to 81%, respectively, due to deficiencies in sulfur amino acids and/or tryptophan. Because of significantly higher total protein contents (g/100 kcal) of soy- (2.65-3.68) and milk-based (2.20-2.95) infant formulas compared to human milk (1.5), the relative amino acid ratings (human milk = 100) for all infant formulas except 2 liquid concentrates (having values of 87%) were above 100%. Values for true digestibility of protein in milk- and soy-based formulas ranged from 87 to 97 and from 92 to 95%, respectively. When corrected for protein digestibility, the relative amino acid ratings for all the milk-based liquid concentrates were below 100% (77-98%). PMID- 2759995 TI - Microbiological survey of selected imported spices and associated fecal pellet specimens. AB - A microbiological survey was performed on 4 selected imported spices: black peppercorns, white peppercorns, coriander, and fennel seed. Aerobic plate count values ranged from 10(4) to 10(7) colony-forming units (CFU)/g for black and white peppercorns and from 10(3) to 10(5) CFU/g for coriander and fennel seed. Combined results of the 3-tube most probable number procedure and the API 20E kit indicated the presence of Escherichia coli in 4 test samples of black peppercorns, 1 test sample of white peppercorns, and 1 test sample of coriander. Two test samples of black peppercorns were positive for Salmonella contamination. Among the various Enterobacteriaceae isolated from the spices, Enterobacter cloacae and Klebsiella pneumoniae were found most frequently in all spice types. Of 18 mammalian and avian fecal pellets removed from the spices and analyzed microbiologically, E. coli was found in only 2 pellet specimens. There was no apparent relationship between the enteric microflora found in spices and those found in the fecal pellets. PMID- 2759996 TI - Simulation of aflatoxin testing plans for shelled peanuts in the United States and in the export market. AB - The 1987 United States aflatoxin testing plan for shelled peanuts was designed with a final accept level of 25 parts per billion (ppb) total aflatoxin. Some of the importers of U.S. peanuts use aflatoxin testing plans with accept levels lower than 25 ppb. For example, the accept level of a testing plan used in The Netherlands is 5 ppb B1 or 10 ppb total aflatoxin. Whenever export lots are re tested for aflatoxin by an importing country, some lots accepted in the United States will be rejected by the importing country's aflatoxin testing plan. Computer models were developed to determine the effects of decreasing the final accept level of the U.S. testing plan on the number of lots accepted and rejected in the United States and the number of exported lots accepted and rejected by The Netherlands testing plan. Decreasing the final accept level of the U.S. testing plan from 25 to 5 ppb increased the number of lots rejected in the United States by 371% while reducing the number of exported lots rejected by 51%. For every additional 8.3 lots rejected in the United States, one less export lot will be rejected. PMID- 2759997 TI - Gamma-ray spectroscopic determination of iodine-131 and cesium-137 in foods: two collaborative studies. AB - The AOAC method for iodine-131, cesium-137, and barium-140 in milk by gamma-ray spectroscopy (48.025-48.029) was extended to include other foods for the radionuclides iodine-131 and cesium-137. Two collaborative studies were performed to validate this extension. In the first study, a food sample containing 119 pCi 131I/kg and 53 pCi 137Cs/kg was sent to each of 45 laboratories for triplicate analyses. For 25 responses, the mean of the reported values was 123.8 pCi/kg for iodine-131, and for 27 responses, the mean was 53.4 pCi/kg for cesium-137. Repeatability (within-laboratory) standard deviations (Sr) for iodine-131 and cesium-137 were 4.6 and 3.7 pCi/kg, respectively. Reproducibility (among laboratories) standard deviations (SR) for iodine-131 and cesium-137 were 12.1 and 6.0 pCi/kg, respectively. In the second study, a food sample containing 25 pCi 131I/kg and 27 pCi 137Cs/kg was sent to each of 54 laboratories for triplicate analyses. For 21 responses, the mean of the reported values was 25.0 pCi/kg for iodine-131, and for 19 responses, the mean was 28.9 pCi/kg for cesium 137. Sr Values were 4.0 and 1.6 pCi/kg for iodine-131 and cesium-137, respectively, and SR values were 5.0 and 2.8 pCi/kg, respectively. The method extension was adopted official first action. PMID- 2759998 TI - Comparison evaluation of liquid chromatographic and bioassay methods of analysis for determination of paralytic shellfish poisons in shellfish tissues. AB - A liquid chromatographic (LC) method was compared with the AOAC mouse bioassay method (18.086-18.092) for determination of paralytic shellfish toxins in shellfish tissues. Shellfish samples were collected from Massachusetts coastal waters as part of a state surveillance program, and extracts of shellfish meat were analyzed for toxins by using both analytical methods. Overall correlation of the LC and bioassay methods is good (r = 0.943), but for samples with toxicities less than 100 micrograms saxitoxin/100 g shellfish meat, the correlation is significantly less (r = 0.531). Limits of detection are 10 micrograms saxitoxin/100 g shellfish meat and 40 micrograms saxitoxin/100 g shellfish meat for the LC and bioassay methods, respectively. Analytical capacity of the LC method is limited to 12 samples/person-day compared with 30 samples/person-day for the bioassay. Sampling capacity of the LC method could be increased by using a fluorescence detector with a wider response range, which would eliminate the need for dilution of concentrated samples. PMID- 2759999 TI - Determination of total vitamin C by ion exclusion chromatography with electrochemical detection. AB - A rapid and sensitive liquid chromatographic method for determination of total vitamin C in foods and beverages is described. Ascorbic acid and dehydroascorbic acid are extracted with sulfuric acid solution, and the dehydroascorbic acid in the extract is reduced to ascorbic acid by dithiothreitol at pH 7. The reduction is complete in 2 min at room temperature. The resulting total ascorbic acid is separated on an anion exclusion/high speed column with 20 mM sulfuric acid as eluant and detected amperometrically with a platinum electrode operating at +0.6 0.8 V vs Ag/AgCl reference electrode. Dithiothreitol (retention time, 3.2 min) does not interfere with the separation and detection of ascorbic acid (retention time, 1.3 min). The dehydroascorbic acid content can be estimated as the difference in ascorbic acid content measured with and without reduction by dithiothreitol. The completeness of the reduction was demonstrated by purposely allowing the oxidation of ascorbic acid in the food extract and determining the total vitamin C after reduction. The determinations of vitamin C content in selected foods and beverages were in good agreement with the expected values. Total analysis time for vitamin C is 10 min and the detection limit is 0.1 ng. The method is specific for vitamin C, and interference by other food constituents is minimal. PMID- 2760000 TI - Long-term continuation antidepressant treatment: a comparison study. AB - This retrospective study examined the clinical characteristics and the course of 26 patients with major affective disorders who repeatedly relapsed during or shortly after antidepressant tapering off at the usual 6-12-month intervals. The patients apparently required long-term antidepressant continuation therapy not preventive therapy, as they were unable to be successfully tapered off antidepressants over a mean of 36.6 months. In contrast with a group of 15 randomly selected patients with a more typical recurrent course of illness and successful tapers after 6-12 months of treatment, the long-term continuation therapy patients were younger, had a longer duration of depression before entering treatment, and were more likely to meet the DSM-III criteria for concomitant dysthymic, panic, or personality disorder or major depression with psychotic features. The findings suggest that secondary Axis I and Axis II diagnoses in antidepressant-responsive depressed patients are associated with the need for long-term continuation treatment. PMID- 2760001 TI - Panic disorder in the medically ill. AB - The authors describe five patients with concurrent panic disorder and medical illness. Panic disorder either caused worsening of the medical illness or was associated with continued physiologic symptoms that mimicked the symptoms of the medical illness after the illness had improved. In both cases, panic disorder was associated with high rates of medical utilization, increased patient suffering, and often costly medical tests. Accurate diagnosis and treatment decreased physiologic and psychiatric symptoms as well as medical utilization. PMID- 2760003 TI - Hyperthyroidism in a cocaine-dependent patient. AB - Although clinical manifestations of cocaine use are similar to the signs and symptoms of hyperthyroidism and research suggests that cocaine may affect the thyroid, no occurrences of cocaine-associated thyroid toxicity have been reported. The authors report a case of Graves' disease in a cocaine-dependent patient and propose that the patient's cocaine use may have precipitated thyroid toxicity. PMID- 2760002 TI - Catatonic signs in severe obsessive compulsive disorder. AB - Two cases of prolonged catatonic states that were part of severe obsessive compulsive disorder (OCD) are described. The catatonic symptoms failed to respond to neuroleptics but were ameliorated by conventional OCD treatments; clomipramine was used in one case, and behavior therapy in the other. Inclusion of severe OCD in the differential diagnosis of catatonia is discussed. PMID- 2760004 TI - Dose-dependent kinetics of trimipramine. PMID- 2760005 TI - Concurrent use of lithium and ECT. PMID- 2760006 TI - Hallervorden-Spatz disease. PMID- 2760007 TI - Nicotine gum use with nicotine addiction. PMID- 2760008 TI - Paranoia about paranoid personality research. PMID- 2760009 TI - Molecular cloning of a human apolipoprotein E variant: E5 (Glu3----Lys3). AB - Two types of apoE alleles from a genomic DNA library of a subject with the apoE2/E5 phenotype have been cloned. One of these alleles encodes an apoE isoprotein having cysteine, arginine, and cysteine at positions 112, 145, and 158 of mature apoE isoproteins, respectively, indicating an epsilon apoE2 allele. The other allele encodes a different isoprotein, having cysteine, arginine, and arginine at each of the above positions, respectively. In addition, this allele has a base substitution (G----A) which causes the substitution of lysine for glutamic acid at position 3 near the NH2-terminus of the mature apoE. This allele is a new variant, the epsilon apoE5 allele. PMID- 2760010 TI - Presence of 1-O-alk-1'-enyl-2-O-acetyl glycerophosphocholine (vinyl form of PAF) in perfused rat and guinea pig hearts. AB - 1-O-Alk-1'-enyl-2-O-acetyl-glycerophosphocholine (vinyl form of PAF) was found with PAF in perfused rat and guinea pig hearts. The main molecular species of the vinyl form of PAF, after separation by reverse phase HPLC, were identified as 1-O hexadec-, -octadec-, and -octadecen-1'-enyl-2-O-acetyl-GPCs (16:0, 18:0, and 18:1 vinyl forms of PAF) by mass spectrometry. The amounts of the predominant 16:0 species in rat and guinea pig hearts, respectively, were 46.4 and 22.5 ng per mg lipid-phosphorus of the original heart phospholipids. PMID- 2760012 TI - Production of optically active esters and alcohols from racemic alcohols by lipase-catalyzed stereoselective transesterification in non-aqueous reaction system. AB - Microbial lipase-catalyzed transesterification between vinyl acetate and (RS)-2 octanol or (RS)-1-phenylethanol was investigated in a reaction system without addition of aqueous or organic solvents. From a screening test with various lipases, it was found that the enzymes from Pseudomonas species could efficiently catalyze the reaction, and R-enantiomers of the racemic alcohols were preferentially esterified by them. Enantiomeric purities of the optically active alcohols (S) and esters (R) obtained from (RS)-1-phenylethanol by the stereoselective transesterification of these lipases were all more than 95%. PMID- 2760011 TI - Purification and properties of an aminopeptidase from Alaska pollack, Theragra chalcogramma, roe. AB - An aminopeptidase was isolated from a soluble fraction of Alaska pollack roe in the presence of 2-mercaptoethanol by fractionation with ammonium sulfate and column chromatography on DEAE-cellulose, hydroxyapatite, and Sephadex G-200. The molecular weight of the enzyme was estimated to be 125,000 and 105,000 by gel filtration and sodium dodecyl sulfate-polyacrylamide gel electrophoresis, respectively. The pH optimum and temperature optimum were 7.2 and 35 degrees C, respectively. The purified enzyme hydrolyzed various alpha-aminoacyl beta naphthylamides and cleaved L-Ala-beta-naphthylamide most rapidly. Both a sulfhydryl group and a divalent metal ion are essential for activity; however, the enzyme was inhibited when incubated with divalent metal ions. Puromycin, chelating agents, and thiol reagents were effective inhibitors. The enzyme was also inhibited by L-amino acids, in particular glutamic acid. Thus, the Alaska pollack roe aminopeptidase resembles soluble alanyl aminopeptidase [EC 3.4.11.14]. PMID- 2760013 TI - Restricted degradation of U6 RNA in a nuclear extract of Ehrlich ascites tumor cells. AB - A new nucleolytic activity that causes restricted digestion of U6 RNA was found in a nuclear extract of Ehrlich ascites tumor cells. This nucleolytic activity specifically degrades U6 RNA in the vicinity of its 3'-end with accumulation of a discrete sized degradation product of RNA of 90-95 nucleotides. Since this degradation product was not digested further by the nuclease under these conditions, this trimming of U6 RNA is supposed to be a biologically meaningful reaction. This nucleolytic activity required Mg2+, and was inhibited by Zn2+ or Ca2+. PMID- 2760014 TI - Control of influenza virus gene expression: quantitative analysis of each viral RNA species in infected cells. AB - We established a quantitative hybridization system by which three types of influenza virus RNAs (vRNA, mRNA, and cRNA) for the 8 genome segments were measured individually. As the hybridization probes, 32P-labeled RNAs of both plus and minus polarity were produced employing an SP-6 transcription system and used in a large molar excess, sufficient to overcome complementary RNAs present in the viral RNA samples. Employing the system, we studied the control of the synthesis of each viral RNA species in MDCK cells infected with A/Udorn/72 (H3N2). Our new observations were as follows. 1) Segment-specific transcription was observed at the primary transcription. 2) Replication of the virus genome began simultaneously for all segments. No delay was observed in the replication of the segments carrying late genes. 3) In addition to control at the transcriptional levels, the expression of viral late genes was regulated at some post transcriptional step(s). These results are not compatible with the concepts reported previously, and lead us to propose unique regulations operating on the expression of the viral late genes. PMID- 2760015 TI - pH dependence of the reaction rate of His 48 with p-bromophenacyl bromide and of the binding constant to Ca2+ of the monomeric forms of intact and alpha-NH2 modified phospholipases A2 from Trimeresurus flavoviridis. AB - The phospholipase A2 of Trimeresurus flavoviridis was found to show monomer-dimer equilibria. Under conditions where the enzyme exists predominantly in the monomeric form, the chemical reaction rate of p-bromophenacyl bromide (BPB) with the catalytic group, His 48, was studied at 25 degrees C and ionic strength 0.2 by measuring the residual enzymic activity using a fluorescent substrate, 1,2 bis[4-(1-pyreno)butanoyl]-sn-glycero-3-phosphorylcholine (diPBPC). The pH dependence curve of the reaction rate for the intact enzyme was practically the same as that for the modified enzyme, in which the N-terminal alpha-NH2 group had been selectively converted into an alpha-keto group. The pH-dependence curves were monophasic (sigmoidal) with a midpoint at pH 7.53, which corresponds to the pKa value of His 48. The pH dependences of the binding constants of Ca2+ to the intact and the alpha-NH2 modified enzymes were also studied at 25 degrees C and ionic strength 0.2 by measuring the changes in the tryptophyl fluorescence and/or aromatic CD spectra. The pH-dependence data for the modified enzyme were interpreted in terms of participation of Asp 49 (pKa 5.40) and His 48 (pKa 7.53), assuming that the protonation of Asp 49 competes with the Ca2+ binding. The pH dependence data for the intact enzyme were similarly interpreted in terms of participation of the alpha-NH2 group (pKa 9.40) in addition to that of Asp 49 (pKa 5.40) and His 48 (pKa 7.53).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2760016 TI - Tetrahymena HMG nonhistone chromosomal protein. Isolation and amino acid sequence lacking the N- and C-terminal domains of vertebrate HMG 1. AB - The complete amino acid sequence of a high mobility group (HMG) nonhistone chromosomal protein of the ciliated protozoan Tetrahymena pyriformis (GL strain) was determined. This protein was extracted with 0.5 M HClO4 together with histone H1 (molar ratio 1:1) from the whole histone extract, then purified by gel filtration and reverse-phase HPLC. The HMG protein showed a single electrophoretic band on SDS gel electrophoresis. The amino acid sequence was determined by Edman degradation of intact protein, BrCN fragments, and their staphylococcal protease and tryptic peptides. Thus the total sequence, consisting of 99 amino acid residues and having a molecular weight of 11,626, was completely determined. Phosphorus analysis of the tryptic peptides, containing serine or threonine, showed that this HMG protein was phosphorylated at two positions, each 6-7%, and contained 0.15 mol phosphate/mol protein. This Tetrahymena HMG is rather similar to the central part of vertebrate HMG 1 in terms of the amino acid sequence and the hydropathy profile. PMID- 2760017 TI - Association of apolipoprotein E with the low density lipoprotein receptor: demonstration of its co-operativity on lipid microemulsion particles. AB - When human apolipoprotein E (apoE), which forms a self-associated tetramer in an aqueous solution, bound to the surface of triolein/phosphatidylcholine microemulsion with a particle diameter of 26 nm, it became monomeric on the lipid particle surface without strong evidence for its accumulation on a particular particle that might be expected from its tetramer formation in the aqueous phase. ApoE in the form of the self-associated tetramer did not inhibit binding of human low density lipoprotein (LDL) to its receptor on cultured human skin fibroblast. LDL binding was inhibited only when apoE was bound to the lipid particle surface. The affinity of the apoE-containing lipid particle to the LDL receptor was of the same order as that of LDL on the basis of particle molarity when the surface of the particle was covered with apoE up to 40 to 50% of the saturation level. When the particle was covered more with apoE, the affinity increased by some 20 times. Since the surface of the lipid particle was saturated with 7 apoE molecules, the particle seemed to require to have at least 4 apoE molecules on its surface in order to obtain high binding affinity to LDL receptor. PMID- 2760018 TI - A deacylation enzyme for aculeacin A, a neutral lipopeptide antibiotic, from Actinoplanes utahensis: purification and characterization. AB - An enzyme, tentatively termed aculeacin A acylase, useful in preparing deacylated peptides which are used as starting material for semisynthetic antifungal antibiotics, was purified from the culture filtrate of Actinoplanes utahensis NRRL12052. The purification involved ultrafiltration and column chromatographies on DEAE-cellulose, hydroxyapatite, and Butyl-Toyopearl 650M. The purified enzyme was composed of two dissimilar subunits with molecular weights of 55,000 and 19,000. The subunits were dissociated in the presence of 0.1% SDS or 6 M guanidine hydrochloride; the dissociation accompanied loss of acylase activity. The enzyme was fully active at pH 7.0 and at 60 degrees C. Its pI was estimated to be above 10.25. The Km and Vmax for aculeacin A were 1.53 mM and 39.7 mumol/min/mg-protein, respectively. PMID- 2760019 TI - Amino acid sequences of ferredoxin isoproteins from radish roots. AB - Three ferredoxin isoproteins (R-Fd A, R-Fd B-1, and R-Fd B-2) were purified from white roots of radish (Raphanus sativus L. var. acantiformis cultivar Miyashige) and two isoproteins (L-Fd A and L-Fd B) from leaves. The amino acid sequences of three of them (L-Fd A, R-Fd B-1, and R-Fd B-2) were determined and compared with one another and with those of other higher plant ferredoxins so far studied. L-Fd A and R-Fd B-1 had heterogeneities at four and two amino acid sites, respectively. Two isoprotein (R-Fd B-1 and R-Fd B-2) were deduced to be expressed only in root tissue on the basis of sequence studies and amino acid compositions of all isoferredoxins isolated from the radish plant. The root ferredoxins sequenced in this study were similar to each other, but quite different from other higher plant ferredoxins, all of which were isolated from leaf tissue. The coupling activities of these ferredoxin isoproteins were measured in the NADP+ photoreduction system of radish chloroplasts and glutamate synthase [EC 1.4.7.1] systems isolated from radish leaf and root tissues. No distinctive physiological characteristics were observed among these isoferredoxins. PMID- 2760020 TI - Tryptic digestion of NADH dehydrogenase from alkalophilic Bacillus. AB - The alkalophile NADH dehydrogenase (NADH: 2,6-dichlorophenolindophenol oxidoreductase) [EC 1.6.99.3] consists of two identical subunits of 65 kDa, and each subunit contains the catalytic and liposome-binding regions. On treatment with trypsin, the polypeptide exhibiting the liposome-binding property in one of the subunits was digested to form an enzymatically active hetero-dimer (40 and 65 kDa), and then the polypeptide in the other subunit was digested to form an active homo-dimer (40 and 40 kDa). The hetero-dimer bound to liposomes, but the homo-dimer did not. Kinetic analysis showed that removal of one or two of the polypeptides in the enzyme slightly affects its kinetic parameters. For all the enzyme species, NAD inhibited competitively with respect to NADH and non competitively with respect to 2,6-dichlorophenolindophenol. The partially determined amino acid sequence of this alkalophile enzyme suggested that (i) a long random-coiled peptide (58 amino acid residues) or a portion of the peptide is located between the polypeptides with liposome-binding and catalytic properties, (ii) the polypeptide exhibiting liposome-binding property is in the amino terminal region of the enzyme, (iii) the amino acid sequences around the subtilisin and trypsin cleavage sites of the peptide are hydrophilic and on the surface of the protein molecule and therefore are susceptible to digestion, and (iv) the FAD-binding site is located near the amino terminal region of the catalytic region. PMID- 2760021 TI - Reaction mechanism of gramicidin S synthetase 1, phenylalanine racemase, of Bacillus brevis. AB - We have demonstrated that gramicidin S synthetase 1 (GS 1), phenylalanine racemase [EC 5.1.1.11], of Bacillus brevis catalyzes the exchange between a proton in the medium and alpha-hydrogen of phenylalanine in the course of the racemase reaction by using tritiated water or L-phenyl[2,3-3H]alanine. GS 1 from some gramicidin S non-producing mutants of B. brevis lacking phenylalanine racemase activity did not catalyze the tritium exchange reaction. The proton exchange between phenylalanine bound as thioester on the GS 1-phenylalanine complex and water in the medium was detected, but 5,5'-dithiobis(2-nitrobenzoic acid)-modified complex lacked both the proton exchange and phenylalanine racemase activity. It is suggested that a base group, probably a sulfhydryl group, on the enzyme functions as proton donor and acceptor during the phenylalanine racemase reaction. PMID- 2760022 TI - Covalent structure of a low-molecular-mass protein, meleagrin, present in a turkey (Meleagris gallopavo) ovomucoid preparation. AB - A low-molecular-mass protein, tentatively named meleagrin, was isolated from a commercial preparation of turkey (Meleagris gallopavo) ovomucoid. This 40-amino acid protein contains 3 disulfide bonds and high concentrations of aromatic residues (2 tryptophans and 3 tyrosines). It lacks threonine, methionine, phenylalanine, and arginine residues. The complete amino acid sequence was determined to be the following: less than Glu-Val-Leu-Lys-Tyr-Cys-Pro-Lys-Ile-Gly Tyr-Cys-Ser-Ser-Lys-Cys-Ser-Lys- Ala- Glu-Val-Trp-Ala-Tyr-Ser-Pro-Asp-Cys-Lys-Val His-Cys-Cys-Val-Pro-Ala-Asn- Gln-Lys - Trp. One of the three disulfide bonds exists between Cys12 and Cys28, and the two others links Cys32-Cys33 with Cys6 and Cys16. The amino acid sequence of meleagrin shows a strong homology to a similar basic protein, cygnin (Simpson, G.R. & Morgan, F.J. [1983] Int. J. Pep. Protein Res. 22, 476-481), of a rather distantly related aves, black swan (Cygnus atratus), suggesting some vital role of this protein in avian eggs. Similarity to a part (exon 9) of transferrins was also recognized. PMID- 2760024 TI - Requirements for the translational repression of ferritin transcripts in wheat germ extracts by a 90-kDa protein from rabbit liver. AB - A specific repressor of ferritin mRNA translation originally detected in rabbit reticulocyte lysates has now been purified to homogeneity from rabbit liver, as described in a companion paper (Walden, W. E., Patino, M. M., and Gaffield, L. (1989) J. Biol. Chem. 264, 13765-13769). This repressor is a 90-kDa protein that binds to a sequence in the 5'-untranslated region of ferritin mRNA. In this communication we describe the molecular features of a ferritin light chain transcript that are required for the repression of its translation by this protein. Addition of small amounts of the 90-kDa ferritin repressor protein (FRP) completely inhibited translation of ferritin transcripts in a wheat germ system. This repression did not require mRNA sequences contained in the 3'-untranslated region or in the majority of the ferritin coding region. In contrast, the first 130 nucleotides of the 5'-untranslated region, which contains the 28-nucleotide "iron responsive element" (IRE), was required for the repressive effect. Moreover, repression of full length transcripts was relieved by addition of a molar excess of a 92-nucleotide transcript of the 5'-untranslated region which also contained the IRE. These results suggest that no sequence information other than a portion of the 5'-untranslated region containing the IRE sequence is required for action of the 90-kDa FRP. In addition, a quantitative comparison of the repression of transcript with that of poly(A+) RNAs indicates that no post transcriptional modifications of the latter (other than cap addition) are involved in the action of the 90-kDa FRP. PMID- 2760023 TI - Comparative monolayer investigations of surface properties of negatively charged glycosphingolipids from vertebrates (gangliosides) and invertebrates (SGL-II, lipid IV). AB - The surface properties of four negatively charged glycosphingolipids from vertebrates, the sialo-glycosphingolipids (= gangliosides) GM1, GD1a, GT1b and a sulfo-glycosphingolipid (= sulfatide), and of the two negatively charged glycosphingolipids from lower invertebrates, the glucurono-glycosphingolipid Lipid IV and the aminophosphono-glycosphingolipid SGL-II were investigated in monolayers at the air/water interface. The molecular peculiarities under investigation were surface pressure (pi) and surface potential (delta V) which are described for Lipid IV and SGL-II for the first time. The surface pressure/area isotherms of all glycosphingolipids were typical of a liquid expanded monolayer and, with the exception of SGL-II, exhibited a phase transition to a liquid-condensed state at surface pressures above 20 mN/m. The surface potential/molecular area data found for gangliosides in the closely packed state at pi = 30 mN/m (GM1: delta V = -17 mV; GD1a: delta V = -35 mV; GT1b: delta V = -39 mV) showed only a slight influence of the additional number of negatively charged residues. For Lipid IV, the surface behavior was very similar to GM1 both possessing one negative group per molecule, whereas in SGL-II also the surface potential data (delta V = +173 mV) were different compared with GD1a both possessing two negative groups per molecule. The addition of Ca2+ condensed the monolayers of all glycolipids and increased the potential in the direction to more positive values, but these findings were less effective in SGL II films. On the basis of monolayer results presented here, in biological membranes of invertebrates especially Lipid IV might play a similar role as the ganglioside GM1 in vertebrate cells. PMID- 2760025 TI - Hamster fibroblasts defective in thrombin-induced mitogenesis. A selection for mutants in phosphatidylinositol metabolism and other functions. AB - Growth of Chinese hamster lung fibroblasts (CCL39) on thrombin as sole mitogen is dependent on phosphatidylinositol (PI) metabolism and activation of the Na+/H+ antiporter. By modifying a H+ suicide selection developed for the isolation of antiporter mutants in these cells, we enriched for and isolated CCL39 variants deficient in the thrombin mitogenic response (thrombin nongrowers). These mutants retain alternate mitogenic mechanisms and, hence, grow well on media containing serum. When challenged with thrombin, the mutants show decreased, increased, or unchanged levels of inositol phosphates produced as compared with wild type cells. One of the mutants (D1-6b) has decreased inositol phosphates production not only with thrombin but also with serotonin (5-hydroxytryptamine) and AlF4-, suggesting a defect distal to the thrombin receptors. Extracts of this mutant reveal marked decreased phospholipase C activity toward PI. From the different phenotypes of the thrombin nongrowers, it is clear that the selection is general and that mutants with various biochemical defects should lead to a better understanding of the PI cycle as well as of functions essential to mitogenesis. PMID- 2760026 TI - Sequence requirements for apolipoprotein B RNA editing in transfected rat hepatoma cells. AB - Apolipoprotein (apo) B mRNA undergoes a novel tissue-specific editing reaction, which replaces a genomically templated cytidine with uridine. This substitution converts codon 2153 from glutamine (CAA) in apo B100 mRNA to a stop codon (UAA) in apoB48 mRNA (Powell, L. M., Wallis, S. C., Pease, R. J., Edwards, Y. H., Knott, T. J., and Scott, J. (1987) Cell 50, 831-840). To examine sequences in the human apoB mRNA required for the editing reaction, a series of deletion mutants around the cytidine conversion site was prepared and transfected into a rat hepatoma cell line (McArdle 7777). This cell makes both apoB100 and apoB48. Editing was detected by a primer extension assay on cDNA that had been amplified by the polymerase chain reaction. RNAs of between 2385 and 26 nucleotides spanning the conversion site underwent similar levels of conversion. Editing was confirmed by cloning and sequencing of cDNA corresponding to the transfected RNAs. Conversion did not occur in transfected human hepatoblastoma (HepG2) or epithelial carcinoma (HeLa) cell lines, which do not make apoB48. These results verify that apoB48 is generated by a genuine tissue-specific RNA editing reaction and show that 26 nucleotides of apoB mRNA are sufficient for editing. PMID- 2760027 TI - Cleavage of parathyroid hormone in macrophage endosomes illustrates a novel pathway for intracellular processing of proteins. AB - Most ligands which are taken up by macrophages are transported to lysosomes where they are degraded to their constituents by a concert of acid hydrolases. This process requires a number of intracellular events which result in the transport of ligands from light density endosomes to the more dense lysosomes. In contrast, our studies have shown that macrophages may process some incoming ligands in endosomes (Diment, S., and Stahl, P. D. (1985) J. Biol. Chem. 260, 15311-15317) and that cathepsin D, an aspartyl protease, is localized in these organelles (Diment, S., Leech, M. S., and Stahl, P. D. (1988) J. Biol. Chem. 263, 6901 6907). Using rabbit alveolar macrophages, which can be subjected to subcellular fractionation, we have traced the intracellular transport and processing of bovine parathyroid hormone (PTH-(1-84]. We present evidence that macrophages internalize PTH-(1-84). Once in endosomes the hormone is cleaved to fragments which include a bioactive peptide, PTH-(1-34), and then the fragments are returned to the extracellular medium, without delivery to lysosomes. The entire cycle from initial binding to release of PTH-(1-34) is achieved within 10-15 min, a time period consistent with findings in vivo. Our data provide evidence for a novel route for processing of an endocytosed ligand. PMID- 2760028 TI - cDNA-derived amino acid sequence of the 86-kDa subunit of the Ku antigen. AB - The Ku antigen is a DNA-associated nuclear protein recognized by sera from patients with autoimmune diseases. It consists of two polypeptides of 86 and 70 kDa. cDNA clones encoding the 86-kDa subunit of the Ku antigen were isolated by probing lambda gt11 recombinant cDNA expression libraries with a monoclonal antibody specific for this protein. The amino acid sequence deduced from the cDNA comprises 732 amino acids and corresponds to a protein with molecular weight of 81.914. Nineteen residues at the NH2 terminus determined by protein sequencing corresponded to the sequence deduced from the cDNA. The predicted amino acid sequence contains a region with repeating leucine residues similar to the "leucine zipper" structure observed in the c-myc, v-myc, and c-fos oncogene products. The largest cDNA hybridized to 2.7- and 3.4-kilobase poly(A)+ mRNAs from HeLa cells. The cDNA clones expressed fusion proteins immunoreactive with the monoclonal antibody and sera from patients with autoimmune diseases. PMID- 2760029 TI - The interaction site for tamoxifen aziridine with the bovine estrogen receptor. AB - Calf uterine estrogen receptor was covalently labeled with [3H]tamoxifen aziridine during affinity chromatography purification. After carboxymethylation, affinity labeled receptor was digested with trypsin under limit conditions and the labeled peptides were fractionated by reversed-phase high performance liquid chromatography into one major and two minor components. Sequence analysis of the dominant labeled fragment indicated the facile cleavage of label during Edman degradation but identified two peptides, both derived from the extreme carboxyl terminus of the steroid-binding domain. The 17 residues of one peptide were fully conserved in all estrogen receptors. This fragment contained five nucleophilic amino acids and was considered as the more favored interaction site for tamoxifen aziridine. A corresponding region of the glucocorticoid receptor has recently been identified as one of three major contact sites for glucocorticoids (Carlstedt-Duke, J., Stromstedt, P.-E., Persson, B., Cederlund, E., Gustafsson, J.-A., and Jornvall, H. (1988) J. Biol. Chem. 263, 6842-6846). A comparison of amino acid physical characteristics in the hormone-binding domains of human estrogen and glucocorticoid receptors demonstrated an excellent structural correlation between the two regions and delineated elements in the estrogen receptor which may be directly involved in estradiol binding. PMID- 2760030 TI - Lipoproteins may provide fatty acids necessary for human lymphocyte proliferation by both low density lipoprotein receptor-dependent and -independent mechanisms. AB - Human lymphocytes respond optimally to mitogenic stimulation when cultured in serum-free medium supplemented with transferrin if fatty acids necessary for maximal proliferation are provided. Either lipoproteins or exogenous fatty acids support optimal lymphocyte responses. The current studies examined the role of cell surface receptors for low density lipoprotein (LDL) in the enhancement of lymphocyte proliferation. Support of lymphocyte growth by limiting concentrations of LDL was found to involve interaction of the lipoprotein with LDL receptors. Thus, modification of LDL by reductive methylation so as to inhibit receptor mediated interactions markedly decreased the capacity of LDL to enhance lymphocyte proliferation. Moreover, growth of lymphocytes obtained from patients with LDL receptor-negative homozygous familial hypercholesterolemia was minimal when cultures were supplemented with low concentrations of LDL (less than 10 micrograms cholesterol/ml). LDL also enhanced lymphocyte proliferation by a receptor-independent mechanism since high concentrations (greater than or equal to 50 micrograms cholesterol/ml) supported growth of both normal and familial hypercholesterolemia lymphocytes. In contrast, support of lymphocyte proliferation by high density lipoprotein (HDL) subclass 3 was completely independent of LDL receptors. Thus, HDL3 enhanced responses of both normal and familial hypercholesterolemia lymphocytes in an equivalent concentration dependent manner; this effect was not altered by reductive methylation of HDL3. One function of lipoproteins in this system may be the provision of fatty acids since oleic and linoleic acids enhanced DNA synthesis by both normal and familial hypercholesterolemia lymphocytes in the absence of lipoproteins. These results indicate that lipoproteins may provide fatty acids necessary for optimal proliferation of human lymphocytes by both LDL receptor-mediated and LDL receptor independent interactions. PMID- 2760031 TI - Characterization of a novel membrane glycoprotein involved in platelet activation. AB - When platelets bind certain specific ligands they are induced to secrete the contents of their cytoplasmic granules and to aggregate. Studies of the molecular events accompanying this vital physiological response have led to a greater understanding of cell activation in general since the pathways involved are common to a number of cell types. By contrast most of the information about the cell surface molecules that initiate signal transduction has emerged from work on T lymphocyte activation, a process essential to the initiation of the immune response. We have described an activation antigen on T lymphocytes that is involved in the differentiation of these cells. In the present report it is demonstrated that the antigen is expressed on the platelet membrane with about 1,200 copies/platelet. A monoclonal antibody detecting this antigen stimulates platelet secretion and aggregation with a half-maximal response at approximately 10(-8) M. Characterization of the antigen, termed PTA1, reveals a glycoprotein of Mr 67,000 showing extensive N-linked carbohydrate, much of which appears to be heavily sialated. The amino-terminal sequence of PTA1, EEVLWHTSVPFAEXMSLEXVYPSM, indicates that the protein has not previously been characterized. Preliminary investigation of the mechanism by which PTA1 mediates platelet activation suggests involvement of protein kinase C and the 47-kDa protein of platelets is rapidly phosphorylated upon antibody-mediated activation. During this process PTA1 is also phosphorylated, as it is following platelet activation by the other agonists, collagen, thrombin, and 12-O-tetradecanoylphorbol 13-acetate. These results provide the first example of a cell surface glycoprotein that is directly involved in both platelet and T lymphocyte activation. PMID- 2760032 TI - Molecular genetic analysis of the regulatory and catalytic domains of protein kinase C. AB - We have constructed the expression plasmids harboring protein kinase C (PKC) mutant cDNAs with a series of deletions in the PKC coding region. These plasmids were transfected into COS7 cells to characterize the PKC mutants. Immunoblot analysis using the anti-PKC antibody identified proteins with the Mr values expected from the PKC mutant cDNAs in the extracts from COS7 cells. The wild-type PKC, when expressed in COS7 cells, conferred increased phorbol ester binding activity on intact cells; but the PKC mutants with the deletion around the C1 region did not show this activity. The wild-type PKC showed protein kinase activity dependent on phospholipid, Ca2+, and phorbol ester, whereas these PKC mutants exhibited protein kinase activity independent of the activators in a cell free system. A PKC mutant cDNA with the deletion in the C2 region gave increased phorbol ester binding activity. Protein kinase activity of this mutant was much less dependent on Ca2+ compared with the wild-type PKC. A PKC mutant cDNA with the deletion in the C3 region conferred increased phorbol ester binding activity, but neither activator-dependent nor -independent protein kinase activity. These results indicate that elimination of the C1 region of PKC gives rise to constitutively active PKC independent of phospholipid, Ca2+, and phorbol ester and that the C1-C3 regions play distinct roles in the regulatory and catalytic function of PKC. In another series of experiments, transfection of some PKC mutant cDNAs with the deletions around the C1 region into Chinese hamster ovary and Jurkat cells activated the activator protein-1-binding element or the c-fos gene enhancer linked to the chloramphenicol acetyltransferase reporter gene in the absence of phorbol ester. Microinjection of these constructs into Xenopus oocytes induced initiation of germinal vesicle breakdown, indicating that they stimulated the PKC pathway in vivo. Thus, the phorbol ester-independent PKC mutant cDNAs could be a powerful tool to investigate the transmembrane signaling pathway mediated by PKC. PMID- 2760033 TI - Manganese-dependent peroxidase from Phanerochaete chrysosporium. Primary structure deduced from cDNA sequence. AB - A cDNA clone encoding a manganese-dependent peroxidase from the filamentous fungus Phanerochaete chrysosporium was isolated and characterized. The clone, lambda MP-1, was isolated by screening a lambda gt11 expression library with polyclonal antibodies raised against a purified manganese-dependent peroxidase (isozyme H4, pI 4.5). The lambda MP-1 cDNA sequence predicts a mature protein containing 358 amino acids with a molecular weight of 37,711 preceded by a leader peptide of 24 amino acid residues. The N-terminal amino acid sequence of a purified manganese-dependent peroxidase (H4) corresponds to the sequence deduced from the cDNA. Some homology (58% in nucleotide sequence and 65% in amino acid sequence) is observed between the manganese-dependent peroxidase and lignin peroxidase isozyme H8. The highest degree of similarity is observed near the enzyme active site. Residues essential for peroxidase activity, the distal and proximal histidines, can be identified in the amino acid sequence. Near these residues, homology is also observed with several other peroxidases. Northern blot analysis of poly(A)+ RNA from nitrogen-limited P. chrysosporium cultures indicates that the level of messenger RNA correlates with expression of the enzyme and its activity. This is consistent with the regulation of the enzyme being at the level of transcription. PMID- 2760034 TI - Epimerization of 3-hydroxyacyl-CoA esters in rat liver. Involvement of two 2 enoyl-CoA hydratases. AB - Interconversion of D- and L-isomers of 3-hydroxy-decanoyl-CoA was catalyzed by rat liver homogenate. Cation exchange chromatography followed by ammonium sulfate precipitation and PBE-94 chromatofocusing column was used to separate the peroxisomal bifunctional protein, the classic 2-enoyl-CoA hydratase (crotonase), and a novel 2-enoyl-CoA hydratase. Epimerization activity was lost during the last purification step. None of the above proteins was capable of catalyzing the epimerization by itself, but reconstitution was achieved by recombining crotonase and the novel 2-enoyl-CoA hydratase. Since hydration by the latter enzyme follows a different stereochemical course from that with crotonase, these two hydratases are distinguished as 2-enoyl-CoA hydratase 1 (crotonase) and 2-enoyl-CoA hydratase 2 (the novel hydratase). The data strongly suggested that epimerization in the rat liver proceeds via dehydration-hydration catalyzed by the two different hydratases. The intermediate of this two step mechanism appears to be trans-2-enoyl-CoA. PMID- 2760035 TI - Consensus sequences for early iodination and hormonogenesis in human thyroglobulin. AB - Thyroglobulin from a human goiter, containing four atoms of iodine/molecule (660,000 daltons), was iodinated with Na 125I and KI in vitro to achieve a net addition of either 2 or 7.8 atoms of iodine/molecule. After fractionation by high performance liquid chromatography, iodinated tryptic peptides from S cyanoethylated 125I-thyroglobulin were purified, sequenced, characterized by [125I]iodoamino acid distribution, and localized within thyroglobulins primary structure based upon the published cDNA sequence, (Malthiery, Y., and Lissitsky, S. (1987) Eur. J. Biochem. 165, 491-498). The addition of 2 atoms of iodine/molecule of thyroglobulin produced iodotyrosyls at five principal sites, with no 125I-hormone formation. The addition of 7.8 atoms iodinated the same sites more heavily, produced iodotyrosyls at 10 additional sites, and formed iodothyronines at 5 sites. After addition of 2 atoms of iodine, tyrosyl 24 and 11% of thyroglobulins 125I, while tyrosyl 2572 had 24%, but with 7.8 added atoms of iodine, tyrosyl 24 had more of the thyroglobulins [125I]iodothyronine (36 versus 26%). Since tyrosyls 149, 866, and 1466 were iodinated early but did not form the inner rings of iodothyronines, they are attractive candidates for donors of outer iodothyronyl rings. The sequences around the iodotyrosyls fall into three consensus groups, as follows: 1) Glu/Asp-Tyr, associated with synthesis of thyroxine (residues 24, 2572, and 1309), or iodotyrosine (residues 2586 and 991); 2) Ser/Thr-Tyr-Ser, associated with synthesis of iodothyronine (residue 2765) and iodotyrosine (1466 and 883); and 3) Glu-X-Tyr, 7 of the remaining 8 iodotyrosyls occur in this sequence, and we found iodine incorporation at each place this sequence appears in the thyroglobulin molecule. Iodine has been found at homologues of most of these sites in thyroglobulins of other species. We conclude that the primary structure of thyroglobulin, and particularly these consensus sequences, have a major role in the formation of thyroid hormones and their iodinated precursors. PMID- 2760036 TI - Primary structure and organization of the gene for a procaryotic, cell envelope located serine proteinase. AB - We have determined the complete nucleotide sequence of the gene for the cell envelope-located proteinase of Lactococcus lactis SK11. The gene contains a very AT-rich promoter region followed by the coding sequence of a protein of 1962 amino acids. Comparison of the NH2-terminal amino acid sequence of the mature proteinase and the expected primary translation product of the proteinase gene indicates that the enzyme is probably synthesized as a pre-pro-protein. This is confirmed by expression studies of the proteinase gene in Escherichia coli. The amino acid sequence of the proteinase shows significant homology to a number of serine proteinases of the subtilisin family. Compared with the related proteinase of L. lactis Wg2, the proteinase of L. lactis SK11 contains a 60-amino acids duplication and a total of 44-amino acid substitutions, some of which may account for the different cleavage specificity of both enzymes. Furthermore, a region was identified in the Lactococcus proteinase, which shows homology to the membrane anchoring domains of a number of proteins from other Gram-positive bacteria. PMID- 2760037 TI - Biosynthesis of ependymins from goldfish brain. AB - Ependymins beta and gamma constitute a novel family of secretory proteins in the extracellular fluid of goldfish brain. Here we demonstrate that at least two different transcripts exist in goldfish brain differing mainly in the length of their 3' noncoding regions but encoding very similar precursors for ependymins. Both precursors consist of 216 amino acid residues including two potential N glycosylation sites. Prepro-ependymin-I is the main but not the only precursor of ependymin beta, whereas prepro-ependymin-II is preferentially processed to ependymin gamma. This is in line with our results showing that both ependymins beta and gamma represent different glycoforms with very similar protein backbones. Additionally, we show that both ependymins share the same C-terminal ends indicating that ependymin gamma is not a proteolysis product of ependymin beta. We also demonstrate that processing at three internal pairs of basic residues does not occur in either ependymin. PMID- 2760038 TI - L-canavanine incorporation into vitellogenin and macromolecular conformation. AB - L-Canavanine is a potentially deleterious arginine antimetabolite whose toxicity is expressed in canavanine-sensitive organisms ranging from viruses to humans. Canavanine, a substrate for arginyl-tRNA synthetase, is incorporated into nascent polypeptide chains in place of arginine. This substitution results in the production of structurally aberrant, canavanyl proteins. Chemical, physical, and immunological studies of native and canavanine-containing vitellogenin obtained from female migratory locusts (Locusta migratoria migratorioides (Orthoptera] provide the first experimental evidence that canavanine can disrupt the tertiary and/or quaternary structure that yields the three-dimensional conformation unique to the protein. These findings enhance our understanding of the biochemical basis for canavanine's antimetabolic and potent insecticidal properties. PMID- 2760039 TI - In vivo phosphorylation and activation of ribosomal protein S6 kinases during Xenopus oocyte maturation. AB - Previous studies have shown that increased ribosomal protein S6 kinase activity in unfertilized Xenopus eggs can be resolved by DEAE-Sephacel chromatography into two peaks, designated S6 kinase I and S6 kinase II. We show here that antibody against bacterially expressed S6 kinase II cross-reacts with S6 kinase I. Both S6 kinases undergo marked phosphorylation when they are activated during oocyte maturation, and both become deactivated and dephosphorylated upon activation of eggs. Immunoblotting of extracts of oocytes reveals that all S6 kinase molecules undergo a decrease and increase in electrophoretic mobility upon activation and deactivation, respectively. The increase in electrophoretic mobility can be produced in vitro by incubation of activated S6 kinase with purified phosphatases. Phosphoamino acid analysis of S6 kinase II labeled in vivo during maturation reveals both phosphoserine and phosphothreonine, and phosphopeptide maps suggest that several kinases may phosphorylate and activate S6 kinase II in vivo. These results demonstrate that, during oocyte maturation and early development, S6 kinase activation and deactivation are regulated by phosphorylation and dephosphorylation, suggesting a probable mechanism for S6 kinase regulation in other mitogenically stimulated cells. PMID- 2760040 TI - Differential glucocorticoid regulation of collagen mRNAs in human dermal fibroblasts. Keloid-derived and fetal fibroblasts are refractory to down regulation. AB - Abnormal regulation of collagen synthesis has been observed in fibroblasts from keloids, benign collagenous tumors that develop as a result of an inherited defect in dermal wound healing. Hydrocortisone reduces the rate of collagen synthesis in fibroblasts from normal adult dermis and scars, but fails to down regulate collagen synthesis in keloid-derived fibroblasts. We show here that loss of glucocorticoid control of collagen synthesis in keloid cells is due to an inability of hydrocortisone to reduce the levels of types I, III, and V collagen mRNA, whereas it coordinately lowers these RNAs in normal adult cells. The defective regulatory mechanism is expressed only in fibroblasts from the lesion. Fibroblasts from uninvolved dermis respond normally to hydrocortisone. Not all glucocorticoid-modulated matrix proteins are abnormally regulated in this disorder; fibronectin mRNA is induced to a similar extent in normal and keloid cells. The failure of hydrocortisone to reduce collagen gene expression is also seen in fibroblasts from fetal dermis. We have reported similarities between keloid and fetal cells with regard to growth factor requirements and growth response to hydrocortisone. Thus, keloids may be due to the inappropriate expression of a pattern of growth and matrix production that is developmentally regulated. PMID- 2760041 TI - Characterization of two distinct positive cis-acting elements in the mouse alpha 1 (III) collagen promoter. AB - We have identified two distinct sequence elements in the mouse alpha 1(III) collagen promoter which are protected from DNase I digestion by the binding of factors present in crude nuclear extracts of NIH 3T3 fibroblasts. Small substitution mutations were introduced into these promoter elements and shown by the gel retardation (gel mobility shift) and DNase I protection assays to decrease or eliminate factor binding to the mutated element but not to the remaining wild-type element, indicating that two distinct factors recognize these separate promoter regions. Region A appears to bind a factor related to the Jun/AP-1 protein, whereas the factor binding to region B remains as yet unidentified. Mutagenesis of either region decreased the activity of the alpha 1(III) collagen promoter in DNA transfection assays by about 3-fold for the A region (located between - 122 and - 106) and about 5-fold for the B region (located between -83 and -61). These results indicate that regions A and B in the mouse alpha 1(III) collagen promoter are positive cis-regulatory elements, independently binding two distinct trans-activating factors. PMID- 2760042 TI - Purification of a glycosyl-phosphatidylinositol-specific phospholipase D from human plasma. AB - Mammalian plasma contains a phospholipase D, which is specific for the glycosyl phosphatidylinositol anchor found on many eukaryotic cell surface proteins (Davitz, M. A., Hereld, D., Shak, S., Krakow, J., Englund, P. T., and Nussenzweig, V. (1987) Science 238, 81-84; Low, M. G., and Prasad, A. R. S. (1988) Proc. Natl. Acad. Sci. U. S. A. 85, 980-984; Cardoso de Almeida, M. L., Turner, M. J., Stambuk, B. V., and Schenkman, S. (1988) Biochem. Biophys. Res. Commun. 150, 476-482). We have purified this phospholipase D to homogeneity by a four-step procedure involving a Mono Q and phenyl-5PW columns, followed by wheat germ lectin affinity chromatography and finally another Mono Q column. A 4,500 fold purification was achieved with a 5% yield. By sodium dodecyl sulfate polyacrylamide gel electrophoresis, the homogeneous enzyme has a Mr of 110,000 and appears to consist of a single polypeptide chain. It exhibits identical substrate specificity as compared with the crude preparation, is active over a broad pH range (4.0-8.5), inhibited by the thiol-blocking agent p chloromercuriphenylsulfonic acid and by 1,10-phenanthroline, and is partially heat-labile. PMID- 2760043 TI - A 14-kilodalton selenium-binding protein in mouse liver is fatty acid-binding protein. AB - In a previous study, we purified three selenium-binding proteins (molecular masses 56, 14, and 12 kDa) from mouse liver using column chromatography and sodium dodecyl sulfate-polyacrylamide gel electrophoresis. The aim of the present study was to determine the amino acid sequence of the 14-kDa protein thereby establishing any relationship with known proteins. Although the amino terminus of the 14-kDa protein was blocked, separate in situ digestions of the protein with endoproteinases Glu-c and Lys-c gave overlapping peptides that provided a continuous sequence of 93 amino acids. This sequence exhibited a 92.5% sequence homology with rat liver fatty acid-binding protein. In situ enzymatic digestion and partial sequencing of a 12-kDa selenium-binding protein revealed identical homology to the 14-kDa protein. The 14-kDa protein bound specifically to an oleate-affinity column from which the protein and 75Se coeluted. Delipidation or sodium dodecyl sulfate treatment failed to remove 75Se from the protein, indicating that the selenium moiety was tightly bound to the protein. These observations confirm that the mouse liver selenium-binding 14-kDa protein is a fatty acid-binding protein. The nature of the selenium linkage to the protein still needs to be explored. PMID- 2760044 TI - The role of selenium-dependent and selenium-independent glutathione peroxidases in the formation of prostaglandin F2 alpha. AB - In recent years, growing evidence suggests that glutathione peroxidases (GSH Pxs), both selenium-dependent GSH-Px (Se-GSH-Px) and selenium-independent GSH-Px (non-Se-GSH-Px) play an important role in the biosynthesis of prostaglandins and leukotrienes and in the regulation of key enzymes associated with the arachidonic acid cascade. The precise nature of their involvement in eicosanoid metabolism, however, is not yet completely understood. In the study reported here, we have systematically determined the catalytic efficiencies of Se-GSH-Px and non-Se-GSH Px toward prostaglandin (PG) G2 (PGG2) and PGH2. Se-GSH-Px exhibited high catalytic activity for the reduction of PGG2 as indicated by Km and Vmax values of 12 microM and 78 mumol/min/mg, respectively, whereas PGH2 was found to be a poor substrate, an indication that Se-GSH-Px reduces the hydroperoxide moiety but not the endoperoxide moiety of PGG2. The kinetic constants of Se-GSH-Px toward PGG2 were comparable to those determined for such classical substrates as H2O2 and cumene hydroperoxide. In contrast to Se-GSH-Px, non-Se-GSH-Px associated with cationic isozyme II of glutathione S-transferases (GSTs) from sheep lung cytosol was very active in the conversion of PGH2 to PGF2 alpha with a Vmax of 960 nmol/min/mg and a Km of 77 microM. This study shows that PGF2 alpha formation by non-Se-GSH-Px occurred in a GSH-dependent reduction of either PGG2 or PGH2. When PGG2 was used as the substrate for non-Se-GSH-Px, a novel intermediate compound appeared and was later identified by several methods of structural analysis as 15 hydroperoxy PGF2 alpha. Thus, the reductive cleavage of the endoperoxide occurs faster than the 15-hydroperoxide reduction allowing 15-hydroperoxy PGF2 alpha to accumulate briefly. A study of GSTs from several different tissues and species indicated that the transformation of PG endoperoxides to PGF2 alpha is catalyzed specifically by GST isozymes, which contain Ya size subunits. This specificity of GST isozymes in PG biosynthesis, coupled with their tissue-specific expression, may be a mechanism by which the body modulates the type of PGs produced in these tissues. Also, these results suggest a possible interaction of Se-GSH-Px and non Se-GSH-Px in the biosynthesis of PGF2 alpha. PMID- 2760045 TI - Activation of protein kinase C by naturally occurring ether-linked diglycerides. AB - Recent studies have demonstrated that ether-linked diglycerides are endogenous constituents of biologic tissues and accumulate during agonist stimulation (Daniel, L. W., Waite, M., and Wykle, R. L. (1986) J. Biol. Chem. 261, 9128-9132) and myocardial ischemia (Ford, D. A., and Gross, R. W. (1989) Circ. Res. 64, 173 177). Although protein kinase C previously had been thought to specifically require 1,2-diacyl-sn-glycerol (DAG) molecular species for activation, the present study demonstrates that purified rat brain protein kinase C is activated by naturally occurring ether-linked diglycerides (e.g. 1-O-hexadec-1'-enyl-2-octa dec-9'-enoyl-sn-glycerol and 1-O-hexadecyl-2-octa-dec-9'-enoyl-sn-glycerol) with a similar dose response curve to that for DAG molecular species. Although in vitro assays demonstrated that DAG could partially activate protein kinase C in the absence of free calcium, activation by ether-linked diglycerides required free calcium concentrations found only in stimulated cells (greater than 1 microM [Ca2+]free). To substantiate these findings the alpha and beta isoforms of protein kinase C from rat brain cortical grey matter were resolved by hydroxylapatite chromatography. Although the beta isoform of protein kinase C was substantially activated by DAG in the absence of free calcium, activation by ether-linked diglycerides had an absolute requirement for physiologic increments in free calcium ion found in stimulated cells. Since ether lipids are localized in specific subcellular membrane compartments, accumulate during several pathophysiologic perturbations and are effective activators of protein kinase C with separate and distinct calcium requirements in comparison to DAG, these results suggest that ether-linked diglycerides are important and potentially specific biologic activators of one or more isoforms of protein kinase C. PMID- 2760046 TI - Purification of a hepatic S6 kinase from cycloheximide-treated Rats. AB - Cycloheximide injection of rats results in the activation of a protein kinase that phosphorylates 40 S ribosomal protein S6. This Ca2+/cyclic nucleotide independent kinase exhibits chromatographic properties that are indistinguishable from the S6 kinase in H4 hepatoma cells whose activity is stimulated by insulin and growth factors and the S6 kinase that is activated during liver regeneration. The enzyme has been purified 50,000-fold to near homogeneity: a critical step in purification employs a peptide affinity column using a synthetic peptide corresponding to the carboxyl-terminal 32-amino acid residues of mouse liver S6, which encompasses all S6 phosphorylation sites. The purified enzyme is a 70,000 dalton polypeptide that is reactive with azido-ATP. In addition to 40 S ribosomal S6 and the synthetic peptide, the S6 kinase catalyzes rapid phosphorylation of a number of other protein substrates including histone H2b, glycogen synthase, and ATP citrate lyase; this last protein is phosphorylated by S6 kinase in vitro on the same serine residue that is phosphorylated in response to insulin and epidermal growth factor in intact hepatocytes. Moreover, the S6 kinase catalyzes the phosphorylation of a number of hepatic nonhistone nuclear proteins. This S6 kinase probably underlies the increased hepatic S6 phosphorylation observed after cycloheximide treatment, which in turn corresponds to the mitogen-activated S6 kinase. PMID- 2760047 TI - A library of oligosaccharide probes (neoglycolipids) from N-glycosylated proteins reveals that conglutinin binds to certain complex-type as well as high mannose type oligosaccharide chains. AB - This report describes the preparation of a library of oligosaccharide probes (neoglycolipids) from N-glycosylated proteins, characterization of the probes by liquid secondary ion mass spectrometry, and investigation of their reactions with 125I-labeled bovine serum conglutinin by chromatogram binding assays. The results, together with additional binding studies using neoglycolipids derived from purified complex type bi-, tri-, and tetraantennary oligosaccharides from urine, or their glycosidase-treated products, have shown that the combining specificity of conglutinin includes structures not only on high mannose-type oligosaccharides but also on hybrid- and complex-type chains. With high mannose type oligosaccharides there is increased reactivity from the Man5 to the Man8 structures, indicating a preference for the terminal Man alpha 1-2 sequence. With complex- and hybrid-type oligosaccharides, the requirements for binding are the presence of nonreducing terminal N-acetylglucosamine or mannose residues, but the presence of a bisecting N-acetylglucosamine residue may inhibit binding. From these results it is deduced that the reactivity of conglutinin with the complement glycopeptide iC3b rather than the intact glycoprotein C3 is due to the oligosaccharide accessibility rendered by proteolysis in the complement cascade. PMID- 2760048 TI - Cloning and expression of a smooth muscle caldesmon. AB - Caldesmon is a smooth muscle and nonmuscle regulatory protein that interacts with actin, myosin, tropomyosin, and calmodulin. Two overlapping clones, isolated from a chicken oviduct cDNA plasmid library and a chicken gizzard cDNA lambda NM1149 library, were used to generate a 4108-base pair sequence coding for one caldesmon. Expression of the coding sequence confirms this is one of the large smooth muscle caldesmons. The deduced protein molecular weight is 86.974, significantly less than the molecular weights estimated by sodium dodecyl sulfate gel electrophoresis. The protein has a high content of Gly, Lys, Arg, and Ala; there are two cysteine residues, one at either end of the molecule. Comparison with the Protein Identification Resource database demonstrates a similarity with a tropomyosin binding domain of troponin T, but none with any calmodulin or actin binding proteins. The center of the protein has an 8-fold repeat of a 13 amino acid sequence whose general motif is -Glu3-(Lys/Arg)2-Ala2-Glu2-(Lys/Arg)1-X (Lys/Arg)1-Ala1-, where X is Glu, Gln, or Ala. Comparison with peptide sequences from a chymotryptic fragment that binds actin and calmodulin places this domain on the C terminus of caldesmon adjacent to the troponin T similarity. A tentative map of the major binding domains is proposed on the basis of available data. PMID- 2760049 TI - Identification of a muscle-specific enhancer within the 5'-flanking region of the human myoglobin gene. AB - A 2-kilobase fragment from the 5'-flanking region of the human myoglobin gene extending from -2038 to +7 relative to the cap site regulates expression of a heterologous reporter gene in a cell-specific and developmentally regulated manner. Functional analyses of 5' and internal deletions indicate that sequences located between -261 and -205 are essential for muscle-specific expression in cooperation with the myoglobin core promoter. A 167-base pair fragment containing these sequences (-371 to -205) enhances expression from myoglobin core promoter elements in a manner that is independent of its orientation and position relative to the cap site. When linked to the herpes simplex virus thymidine kinase promoter, this 167-base pair fragment of the myoglobin gene also enhances expression in differentiated myotubes but not in undifferentiated myoblasts or fibroblasts. Nucleotide sequences within the region that is essential for enhancing activity (-261 to -205) are conserved in other mammalian myoglobin genes (seal, mouse) and resemble sequences within control regions of other genes that are expressed selectively in striated myocytes. These data indicate that the 5'-flanking region of the human myoglobin gene contains an enhancer-like element that is important for transcriptional activation during myocyte differentiation. PMID- 2760050 TI - The human alpha 2(XI) collagen (COL11A2) chain. Molecular cloning of cDNA and genomic DNA reveals characteristics of a fibrillar collagen with differences in genomic organization. AB - We have isolated three overlapping cDNA clones encoding the pro alpha 2(XI) collagen chain from a human chondrocyte cDNA library. Together, the cDNAs code for 257 uninterrupted Gly-X-Y triplets (almost 80% of the triple helical domain) and about 200 amino acid residues of the carboxyl telopeptide and carboxyl propeptide. The identification of the clones as pro alpha 2(XI) cDNAs was based on the complete identity between the amino acid sequences of three tryptic peptides derived from human alpha 2(XI) collagen and the cDNA-derived sequence. We have also sequenced six exons within a human genomic alpha 2(XI) cosmid clone. This sequence shows that although type XI collagen belongs to the fibril-forming class of collagens, there are substantial differences in exon sizes at the 3' end of the gene when comparing the alpha 2(XI) gene with those of human types I, II, and III collagens. Finally, pro alpha 2(XI) cDNA has been used as a probe to determine the location of the gene by in situ hybridization of chromosome spreads. The results demonstrate that the gene is located close to the region p212 on chromosome 6. Northern blot analysis shows that the gene is expressed in cartilage but not in adult liver, skin, and tendon. PMID- 2760051 TI - Two genes encode the major membrane-associated protein of methanol-induced peroxisomes from Candida boidinii. AB - A massive proliferation of peroxisomes occurs in the yeast Candida boidinii when methanol is utilized as the sole carbon source; these peroxisomes contain the enzymes which catalyze the initial steps of methanol utilization. The most abundant peroxisomal membrane-associated protein has an apparent molecular mass of 20 kDa and is termed PMP20. We report the isolation of two genes that encode very similar forms of PMP20; this is the first report of genes that encode proteins associated with peroxisomal membranes. Southern analysis demonstrates that the two genes are on different loci, although there are several homologous regions of both 5'- and 3'-untranslated sequence. One of the areas of 5' homology is within the untranslated region of the mRNA. Within the coding region there are 35 base differences between the two genes that are reflected in only five amino acid differences. The mRNAs representing both genes of PMP20 are induced in cells grown in methanol-containing medium and are below detection in cells grown in glucose. S1 nuclease protection analysis indicates that there is a 2.5-fold difference in mRNA expression between the two genes when induced. The predicted sequences of both PMP20 genes show the absence of a cleaved amino-terminal leader sequence and the presence of only 1 cysteine residue. In agreement with previous biochemical data suggesting a peripheral association of this protein with the membrane (Goodman, J. M., Maher, J., Silver, P. A., Pacifico, A., and Sanders, D. (1986) J. Biol. Chem. 261, 3464-3468), there are no obvious membrane spanning regions predicted in the sequences. Both PMP20 gene products contain the carboxyl terminal sequence AKL, similar to the putative SKL peroxisomal sorting sequence (Gould, S. J., Keller, G.-A., and Subramani, S. (1988) J. Cell Biol. 107, 897 905). PMID- 2760052 TI - Additional members of the rat liver lamin polypeptide family. Structural and immunological characterization. AB - In addition to lamins A, B, and C (Gerace, L., Blum, A., and Blobel, G. (1978) J. Cell Biol. 79, 546-566), the rat liver nuclear lamina has recently been shown to contain two higher molecular weight (70,000-75,000, pI 5.7-5.8) quantitatively less prominent nuclear polypeptides (Lehner, C.F., Kurer, V., Eppenberger, H. M., and Nigg, E. A. (1986) J. Biol. Chem. 261, 13293-13301). In the present study two dimensional tryptic peptide mapping and Western blotting with affinity-purified chicken and human sera have been utilized to examine the structural relationships and the tissue distribution of these quantitatively less prominent mammalian lamins (termed lamins D and E in this study). Lamins D and E have indistinguishable one- and two-dimensional proteolytic maps. Whereas the one dimensional proteolytic maps of lamins D and E show several degradation products which are of similar molecular mass to polypeptides seen in one-dimensional proteolytic maps of lamins A, B, and C, the two-dimensional tryptic maps of D and E are distinct from those of lamins A, B, and C, suggesting that lamins D and E are produced by transcription of one or more unique genes. Nonetheless, affinity purified anti-D/E antibodies (raised against lamin E) cross-react with lamin B, suggesting the presence of a shared epitope. Moreover, a human autoantibody cross reacts with all five lamins after affinity elution from any of the five, suggesting the presence of another epitope which is shared by all five polypeptides. All five lamins were undetectable in rodent epididymal sperm. In contrast, lamins D and E were readily detected in a variety of rat somatic tissues (liver, kidney, prostate, brain, heart) including lymphoid cells, a cell type depleted of lamins A and C. During mitogenic stimulation of lymphocytes, the signal for lamins A and C increased 5-fold, the signal for lamins D and E increased 2-fold, but the signal for lamin B remained unchanged, suggesting that levels of lamins D and E are regulated independently from those of the major lamins. PMID- 2760053 TI - Identification in turkey gizzard of an acidic protein related to the C-terminal portion of smooth muscle myosin light chain kinase. AB - The isolation of an acidic protein, pI 4.5, that is abundant in turkey gizzard is described. Its apparent molecular weight measured by electrophoretic procedures is 24,000. This protein is phosphorylated by the catalytic subunit of the cAMP dependent protein kinase and one phosphorylation site is indicated. From sequence determinations of tryptic peptides it is concluded that this protein is closely related to the C-terminal part of smooth muscle myosin light chain kinase. The initiation site for the protein is to the C-terminal side of the calmodulin binding site. From the sequence data an estimated molecular weight is 18,000. This protein is expressed independently, as indicated by a blocked N terminus, and is probably the translation product of the 2.7-kilobase RNA detected previously in chicken gizzard (Guerriero, V., Jr., Russo, M. A., Olson, N. J., Putkey, J. A., and Means, A. R. (1986) Biochemistry 25, 8372-8381). Because of its putative origin as the C-terminal end of smooth muscle myosin light chain kinase, it is termed "telokin" (from a combination of kinase and the Greek telos, "end"). PMID- 2760054 TI - Antithrombin activity of a peptide corresponding to residues 54-75 of heparin cofactor II. AB - Heparin cofactor II (HCII) is a highly specific serine proteinase inhibitor, which complexes covalently with thrombin in a reaction catalyzed by heparin and other polyanions. The molecular basis for the thrombin specificity may be explained by the identification here of a segment of HCII including residues 54 75 that binds to thrombin. A synthetic peptide, HCII(54-75), based on this segment of HCII, Gly-Glu-Glu-Asp-Asp-Asp-Tyr-Leu-Asp-Leu-Glu- Lys-Ile-Phe-Ala-Glu Asp-Asp-Asp-Tyr-Ile-Asp inhibited thrombin's cleavage of fibrinogen. Clotting activity of thrombin was inhibited 50% at a concentration of 28 microM. Polyacrylamide gel electrophoresis showed that HCII(54-75) inhibited thrombin's cleavage of both the A alpha and B beta polypeptides in fibrinogen. However, the peptide did not block thrombin's active site, as hydrolysis of chromogenic substrates was not inhibited. HCII(54-75) probably binds to the same site on thrombin as do carboxyl-terminal residues of hirudins, thrombin inhibitors of leeches. HCII(54-75) inhibited binding of thrombin to a synthetic peptide corresponding to residues 54-66 of hirudin PA, but the hirudin peptide was about 30-fold more potent in binding and clotting assays. Both synthetic peptides, as a result of their polyanionic character, might be expected to stimulate the reaction of HCII with thrombin. However, the hirudin-related peptide inhibited this reaction, suggesting that it blocked a site on thrombin required for interaction with HCII. HCII(54-75) had a net stimulatory effect on the thrombin HCII reaction as a consequence of its lower affinity for thrombin and greater negative charge relative to the hirudin-related peptide. These studies suggest that residues 54-75 of HCII interact with a noncatalytic binding site on thrombin and that this interaction contributes to efficient inhibition of thrombin by HCII. PMID- 2760055 TI - Isolation and characterization of the unusual lipopolysaccharide component, 2 amino-2-deoxy-2-N-(27-hydroxyoctacosanoyl)-3-O-(3-hydroxy- tetradecanoyl)-gluco hexuronic acid, and its de-O-acylation product from the free lipid A of Rhizobium trifolii ANU843. AB - Two new, unusual lipid A components have been isolated and characterized from the free lipid A of Rhizobium trifolii ANU843. 2-Amino-2-deoxy-2-N-(27 hydroxyoctacosanoyl)-3-O-(3-hydroxy- tetradecanoyl)-gluco-hexuronic acid and its de-O-acylation product were purified from the chloroform/methanol extract of a mild acid hydrolysate of the lipopolysaccharide by chromatography on C18 reverse phase columns and layers. The compositions of the two compounds were determined by releasing the acyl components by exhaustive acid-catalyzed methanolysis and identifying them as their methyl esters by gas chromatography and gas chromatography/mass spectrometry. The sugar component was identified by converting it to the alditol acetate derivative of glucosamine in a two-step reduction and identifying it as such by gas chromatography/mass spectrometry. The linkages of the fatty acyl components to the sugar residue and the configuration of the sugar component was confirmed by 1H and 13C NMR spectroscopy. The complete structures of the two compounds were further confirmed by fast atom bombardment mass spectrometry. It is still unsure whether the de-O-acylated derivative was formed from the di-acyl compound by de-O-acylation during acid hydrolysis. These structures represent the first report of 2-amino-2-deoxy-gluco-hexuronic acid in the free lipid A of a Gram-negative bacterium and confirms our earlier contention (Hollingsworth, R.I., and Carlson, R. W. (1989) J. Biol. Chem. 264, 9000-9303) of the involvement of 27-hydroxyoctacosanoic acid in the structure of the lipopolysaccharide of Rhizobium trifolii ANU843. PMID- 2760056 TI - Regulation of acetylcholinesterase synthesis and assembly by muscle activity. Effects of tetrodotoxin. AB - The abundance and distribution of acetylcholinesterase (AChE) oligomeric forms expressed in skeletal muscle is strongly dependent upon the activity state of the cells. In this study, we examined several stages of AChE biogenesis to determine which ones were regulated by muscle activity. Inhibiting spontaneous contraction of tissue-cultured quail myotubes with tetrodotoxin (TTX) reduces AChE activity by approximately 30% of the levels found in actively contracting cells. This decrease is due primarily to the loss of 20 S asymmetric (collagen-tailed) AChE from TTX-treated cultures and is reflected in reduced pool sizes for both cell surface and intracellular AChE molecules. Using monoclonal anti-AChE antibodies to immunoprecipitate and quantify isotopically labeled enzyme molecules, we show that AChE down-regulation by TTX is not mediated through changes in the rates of synthesis or degradation of AChE polypeptide chains. Newly synthesized AChE polypeptides acquire enzymatic activity at the same rate in TTX-treated cultures as in actively contracting cells, however, a larger percentage of catalytically active dimers and tetramers are secreted from TTX-treated cultures compared with controls. These results suggest that TTX-induced down-regulation of asymmetric AChE occurs at the level of assembly of globular AChE molecules with collagen like tail subunits in the Golgi apparatus, rather than through changes in the availability of catalytic subunits. Thus, post-translational mechanisms appear to play an important role in regulating the abundance and distribution of this important synaptic component in skeletal muscle. PMID- 2760057 TI - Methylation of microinjected isoaspartyl peptides in Xenopus oocytes. Competition with protein carboxyl methylation reactions. AB - Xenopus oocytes possess a highly conserved protein carboxyl methyltransferase postulated to function in the repair or metabolism of age-damaged protein aspartyl residues (O'Connor, C. M. (1987) J. Biol. Chem. 262, 10398-10403). Three hexapeptides of the general sequence Val-Tyr-Pro-isoAsp-X-Ala, in which isoAsp represents an L-isoaspartyl residue and X represents Gly, Ser, or Ala, are methylated with the same order of preference following their microinjection into oocytes as in a purified system containing bovine brain protein carboxyl methyltransferase and S-adenosyl-L-[methyl-3H]methionine. The affinities of the enzyme for the glycyl, seryl, and alanyl variants of the peptides in vitro are 4.25, 3.04, and 1.67 microM, respectively. A nonapeptide of the sequence Lys-Ala Ser-Ala-isoAsp-Leu-Ala-Lys-Tyr is a higher affinity substrate for the methyltransferase in vitro, characterized by a Km of 0.88 microM, but it is modified to a lesser extent in oocytes, partially because of its reduced stability in cytoplasm. The hexapeptide Val-Tyr-Pro-Asp-Gly-Ala, which contains an aspartyl residue in the usual stereoconfiguration, is not methylated either in vitro or in intact oocytes. Microinjection of any of the four isoaspartyl containing peptides greatly stimulates total carboxyl methylation in oocytes, with rate increases ranging from 19- to 51-fold after the injection of 30 pmol of peptide. The protein ovalbumin is also modified following its microinjection into oocytes to near its calculated methyl-accepting capacity. Each of the isoaspartyl peptides can act as a competitive inhibitor of ovalbumin methylation both in vitro and in microinjected oocytes. The inhibitory potencies of the peptides parallel their specific methyl-accepting activities. The results demonstrate that the oocyte may be a useful model for studying the significance of protein carboxyl methylation because of the large functional excess of methylation capacity and the fidelity of the reactions compared to those observed in purified systems. This excess capability may have physiological significance when structurally abnormal proteins accumulate as a result of cellular stress and or aging. PMID- 2760058 TI - Trifluoperazine stimulates the coordinate degradation of sphingomyelin and phosphatidylcholine in GH3 pituitary cells. AB - Prior studies demonstrated that 1,2-diacylglycerols stimulated degradation of the choline-containing phospholipids, phosphatidylcholine and sphingomyelin, in GH3 pituitary cells by a phospholipase A2 and a sphingomyelinase, respectively (Kolesnick, R. N. (1987) J. Biol. Chem. 262, 16759-16762). The present studies demonstrate that the phenothiazine trifluoperazine also stimulates degradation of these phospholipids. Trifluoperazine (25 microM) reduced phosphatidylcholine and sphingomyelin levels to 81 and 58% of control, respectively, after 30 min in cells labeled for 48 h with [3H] choline. Choline-containing metabolites were released specifically into the cytosolic fraction. The level of cytosolic phosphocholine, but not choline or CDP-choline, increased to 150% of control. These events were not mediated by inhibition of phosphatidylcholine synthesis. The level of 1,2-diacylglycerols, but not lysophosphatidylcholine or glycerol-3 phosphocholine, also increased. These data are most consistent with phosphatidylcholine degradation via a phospholipase C. Trifluoperazine-stimulated sphingomyelin degradation was accompanied by quantitative generation of ceramides consistent with activation of a sphingomyelinase. In contrast to trifluoperazine, choline-containing metabolites were released into the medium during stimulation by the 1,2-diacylglycerol 1,2-dioctanoyl-glycerol. Although both trifluoperazine and 1,2-dioctanoylglycerol increased ceramide levels, only 1,2-dioctanoylglycerol increased the sphingoid base level from 24 to 43 pmol/10(6) cells. Hence, trifluoperazine appears to deplete an intracellular pool of phosphatidylcholine and sphingomyelin by a different mechanism than 1,2-diacylglycerols. This is the first report of phenothiazine-induced degradation of choline-containing phospholipids. PMID- 2760059 TI - The chicken progesterone receptor A and B isoforms are products of an alternate translation initiation event. AB - The chicken progesterone receptor A and B proteins differ by an additional 128 amino acids located at the N terminus of the B protein. Using site-directed mutagenesis, we demonstrate that these two proteins arise by alternate initiation of translation from two in-phase AUG codons located on a single mRNA transcript. Both proteins are transcriptionally active in terms of their ability to activate a progesterone-responsive target gene. These results suggest a functional significance for evolutionary conservation of two forms of this steroid receptor. PMID- 2760060 TI - Molecular mechanism of basic calcium phosphate crystal-induced mitogenesis. Role of protein kinase C. AB - Synovial tissue hyperplasia in basic calcium phosphate deposition disease has been suggested to develop through the stimulation of cell growth by basic calcium phosphate (BCP) crystals deposited in joints. These crystals have been used in vitro to stimulate DNA synthesis in quiescent fibroblasts to experimentally study this proliferative disease. The stimulation of DNA synthesis, in density-arrested Balb/c 3T3 cells, by BCP crystals was inhibited after down-regulating protein kinase C activity with 12-O-tetradecanoyl-phorbol 13-acetate (TPA). No effect on platelet-derived growth factor (PDGF)-stimulated DNA synthesis was observed under the same conditions. The expression of c-myc and c-fos increased in response to BCP stimulation in a manner similar to the increase produced by stimulation with PDGF. The BCP stimulation of c-fos and c-myc messages was inhibited 60 and 90%, respectively, in TPA-pretreated, protein kinase C-down-regulated cells. The induction of these transcripts by PDGF was unaffected in cells pretreated with TPA. TPA was unable to stimulate c-fos and c-myc expression or DNA synthesis following protein kinase C down-regulation. Both PDGF and TPA stimulated phosphorylation of an 80-kDa protein, whereas BCP crystals had no effect on phosphorylation of this protein. The exposure of density-arrested Balb/c 3T3 cells to BCP crystals had no effect on high affinity epidermal growth factor receptor binding under conditions in which PDGF and TPA reduced epidermal growth factor binding. The data suggest that PDGF can act to stimulate c-fos and c-myc expression as well as DNA synthesis through a protein kinase C-independent pathway, whereas BCP crystals require at least endogenous levels of protein kinase C to stimulate these events. PMID- 2760061 TI - The arrangement of disulfide loops in human alpha 2-HS glycoprotein. Similarity to the disulfide bridge structures of cystatins and kininogens. AB - The complete disulfide loop structure of human alpha 2-HS glycoprotein has been elucidated. alpha 2-HS glycoprotein isolated from human plasma was found to be a two-chain protein composed of a heavy and a light chain. The heavy chain comprises the A-chain of alpha 2-HS glycoprotein (Yoshioka, Y., Gejyo, F., Marti, T., Rickli, E. E., Burgi, W., Offner, G. D., Troxler, R. F., and Schmid, K. (1986) J. Biol. Chem. 261, 1665-1676) and part of the connecting peptide which has been predicted from the corresponding cDNA sequence (Lee, C. C., Bowman, B. H., and Yang, F. (1987) Proc. Natl. Acad. Sci. U.S.A. 84, 4403-4407), whereas the light chain corresponds to the beta-chain of alpha 2-HS glycoprotein (Gejyo, F., Chang, J. L., Burgi, W., Schmid, K., Offner, G. D., Troxler, R. F., Van Halbeek, H., Dorland, L., Gerwig, G. J., Vliegenthart, J. F. G. (1983) J. Biol. Chem. 258, 4966-4971). Twelve half-cystine residues are present in the alpha 2-HS glycoprotein molecule, and 11 of them are positioned in the heavy chain and a single one in the light chain of the molecule; they form six disulfide bridges. The first and the last half-cystine residues of the amino acid sequence of alpha 2-HS glycoprotein are engaged in the formation of a loop spanning the extreme NH2 and COOH-terminal portions of the molecule, thereby connecting the heavy and light chains. The other 10 half-cystines residues are linked consecutively in the heavy chain and form five loops which span 4-19 amino acid residues. Among them are two pairs of loops which are characterized by mutual sequence homology. The particular arrangement of disulfide loops in alpha 2-HS glycoprotein is similar to the patterns of linearly arranged and tandemly repeated disulfide loops of cysteine proteinase inhibitors, i.e. the cystatins and the kininogens. It is concluded that alpha 2-HS glycoprotein represents a structural prototype of a novel family among the cystatin superfamily, characterized by the presence of two cystatin-like building blocks. Extensive similarity among the NH2-terminal sequences of alpha 2-HS glycoprotein and human histidine-rich glycoprotein suggest that the latter protein is another candidate protein of this new family. PMID- 2760062 TI - Mechanism of cleavage of apurinic sites by 9-aminoellipticine. AB - We have studied the kinetics of breakage of apurinic (AP) sites by the intercalating agent 9-aminoellipticine using fluorimetric methods with single (ss)- and double (ds)-stranded apurinic DNA. In order to understand the chemical process, high performance liquid chromatography was used to follow the reaction kinetics with the apurinic oligonucleotide model T(AP)T. The unstable intermediate, which is responsible for the beta-elimination step, is a Schiff base resulting from the interaction of the amino group of the aromatic amine with the aldehyde function of the deoxyribose moiety (AP site). Fluorescence occurs simultaneously with the breakage of both ss and ds DNA and of the oligonucleotide and arises from the formation of a conjugated double bond on the Schiff base through the beta-elimination reaction. In optimal conditions, the second order rate constant for the fluorescence build up is 15 x 10(3) min-1 M-1 for ds DNA and 0.105 x 10(3) min-1 M-1 for T(AP)T. The ability of 9-aminoellipticine to induce fluorescence and breakage of ss DNA and T(AP)T shows that intercalation is not essential for this reaction to occur. Nevertheless, the greater rate constant with DNA suggests that stacking is an important parameter for the reaction of the aromatic amine with the AP site. PMID- 2760063 TI - Thiol-mediated oxidation of nonphenolic lignin model compounds by manganese peroxidase of Phanerochaete chrysosporium. AB - In the presence of MnII, H2O2, and glutathione (GSH), manganese peroxidase oxidized veratryl alcohol (I) to veratraldehyde (IV). Anisyl alcohol (II) and benzyl alcohol (III) were also oxidized by this system to their corresponding aldehydes (V and VI). In the presence of GSH, chemically prepared MnIII or gamma irradiation also catalyzed the oxidation of I, II, and III to IV, V, and VI, respectively. GSH and dithiothreitol rapidly reduced MnIII to MnII in the absence of aromatic substrates and the dithiothreitol was oxidized to its disulfide (4,5 dihydroxyl-1,2-dithiane). These results indicate that the thiol is oxidized by enzyme-generated MnIII to a thiyl radical. The latter abstracts a hydrogen from the substrate, forming a benzylic radical which reacts with another thiyl radical to yield an intermediate which decomposes to the benzaldehyde product. In the presence of MnII, GSH, and H2O2, manganese peroxidase also oxidized 1-(4-ethoxy-3 methoxy-phenyl)-2-(4'-hydroxymethyl-2'-methoxyphenoxy)- 1,3-dihydroxypropane (XII) to yield vanillyl alcohol (VII), vanillin (VIII), 1-(4-ethoxy-3 methoxyphenyl)-1,3-dihydroxypropane (XVI), 1-(4-ethoxy-3-methoxyphenyl)-1-oxo-3 hydroxypropane (XIX), and several C alpha oxidized dimeric products. Abstraction of the C alpha (A ring) hydrogen of the dimer (XII) yields a benzylic radical, leading to C beta oxygen ether cleavage. The resultant intermediates yield the ketone (XIX) and vanillyl alcohol (VII) or vanillin (VIII). Alternatively, benzylic radical formation at the C' alpha position (B ring) leads to radical cleavage, yielding a quinone methide and a C beta radical, which yield vanillin and the 1,3-diol (XVI), respectively. In these reactions, MnIII oxidizes a thiol to a thiyl radical which subsequently abstracts a hydrogen from the substrate to form a benzylic radical. The latter undergoes nonenzymatic reactions to yield the final products. PMID- 2760064 TI - Properties of a novel D-stereospecific aminopeptidase from Ochrobactrum anthropi. AB - A novel aminopeptidase active toward D-amino acid-containing peptides, D-amino acid amides, and D-amino acid esters has been purified 2,800-fold to homogeneity from a bacterium Ochrobactrum anthropi SCRC C1-38, which had been isolated from soil. The enzyme has a molecular weight of about 122,000 and is composed of two identical subunits (Mr = 59,000). The optimal pH for activity was 8.0. It showed strict D-stereospecificity toward substrates including low molecular weight D amino acid amides such as D-alanine amide, D-alpha-aminobutyric acid amides, and D-serine amide; D-alanine N-alkylamides such as D-alanine-p-nitroanilide, D alanine benzylamide, and D-alanine n-butylamide; and peptides with a D-alanine at the NH2 terminus such as D-alanylglycine, D-alanylglycylglycine, D-alanyl-L alanyl-L-alanine, and D-alanine oligomers. Generally, the enzyme did not act on substrates composed of L-amino acid at the NH2 terminus, although it showed low stereospecificity only toward substrates such as the methyl esters of L-alanine, L-serine, and L-alanine-p-nitroanilide. Comparing the Km and Vmax values for the major substrates, it is clear that the enzyme prefers peptides to amino acid arylamides or amino acid amides. The enzyme was tentatively named as "D aminopeptidase." EDTA and divalent cations have no effect on the enzyme activity. The enzyme appears to be a thiol peptidase. PMID- 2760065 TI - Formation of isoaspartate at two distinct sites during in vitro aging of human growth hormone. AB - In vitro aging at pH 7.4, 37 degrees C causes natural sequence recombinant human growth hormone (rhGH), methionyl rhGH, and human pituitary growth hormone to become substrates for bovine brain protein carboxyl methyltransferase, an enzyme that modifies the "side chain" alpha-carboxyl group present at atypical isoaspartyl linkages. The substrate capacity of rhGH increased at a rate of 1.8 methyl-accepting sites/day/100 molecules of hormone. Reversed-phase high performance liquid chromatography (HPLC) of trypsin digests of aged rhGH revealed two altered peptides not present in digests of control rhGH. These two fragments, which had the amino acid compositions of residues 128-134 (Leu-Glu-Asp-Gly-Ser Pro-Arg) and 146-158 (Phe-Asp-Thr-Asn-Ser-His-Asn-Asp-Asp-Ala-Leu-Leu-Lys), contained the majority of the induced methylation sites, 22 and 58%, respectively. Isoaspartate can result from deamidation of asparagine or isomerization of aspartate. Isomerization of Asp-130, the only candidate site in 128-134, was corroborated by coelution of the altered fragment with the synthetic isoaspartyl peptide upon reversed-phase HPLC. Evidence is presented that the altered 146-158 fragment is a mixture of two peptides resulting from deamidation of Asn-149 to form 70-80% isoaspartate and 20-30% aspartate at this position. The position of isoaspartate in the altered 146-158 fragment was deduced from mass spectrometry, which indicated a single deamidated asparagine; from methylation stoichiometry, which indicated only one methylation site; and from automated Edman degradation, which showed an absence of asparagine and a low yield of aspartate at position 149. These results show that isoaspartate formation from both aspartate and asparagine is a significant, and possibly the major, source of spontaneous covalent alteration of rhGH and that enzymatic carboxyl methylation provides a powerful tool for assessing this type of modification. PMID- 2760066 TI - Chemical modification of chalcone isomerase by mercurials and tetrathionate. Evidence for a single cysteine residue in the active site. AB - Chalcone isomerase from soybean is inactivated by stoichiometric amounts of p mercuribenzoate or HgCl2. Spectral titration of the enzyme with p-mercuribenzoate indicates that a single thiol group is modified. Treatment of modified enzyme with KCN or thiols results in a complete restoration of enzyme activity demonstrating that the inactivation is not due to irreversible protein denaturation. A product of the enzymatic reaction, naringenin, provides complete kinetic protection against inactivation by both mercurials. The binding constant (33 microM) for naringenin determined from the concentration dependence of the protection agrees with the inhibition constant (34 microM) for naringenin as a competitive inhibitor of the catalytic reaction. This agreement demonstrates that the observed kinetic protection results from the specific binding of naringenin to the active site. Incubation of native chalcone isomerase with sodium tetrathionate (0.1 M) results in a slow time-dependent loss of enzymatic activity. The inactivation of chalcone isomerase by tetrathionate and N ethylmaleimide becomes very rapid in the presence of 6 M urea, indicating that the native tertiary structure is responsible for the low reactivity of the enzymatic thiol. The stoichiometric modification of reduced and denatured chalcone isomerase by [3H] N-ethylmaleimide indicates that the enzyme contains only a single cysteine residue and does not contain any disulfides. The evidence presented suggests that the only half-cystine residue in chalcone isomerase is located in the active site and thereby provides the first clue to the location of the active site in chalcone isomerase. PMID- 2760067 TI - cDNA clone and expression analysis of rodent fast and slow skeletal muscle troponin I mRNAs. AB - We have characterized the structure and expression of rodent mRNAs encoding the fast and slow skeletal muscle isoforms of the contractile regulatory protein, troponin I (TnIfast and TnIslow). TnIfast and TnIslow cDNA clones were isolated from mouse and rat muscle cDNA clone libraries and were used as isoform-specific probes in Northern blot and in situ hybridization studies. These studies showed that the TnIfast and TnIslow mRNAs are expressed in skeletal muscle, but not cardiac muscle or other tissues, and that they are differentially expressed in individual muscle fibers. Fiber typing on the basis of in situ hybridization analysis of TnI isoform mRNA content showed an excellent correlation with fiber type as assessed by myosin ATPase histochemistry. These results directly demonstrate that the differential expression of skeletal muscle TnI isoforms in the various classes of vertebrate striated muscle cells is based on gene regulatory mechanisms which control the abundances of specific TnI mRNAs in individual muscle cells. Both TnIfast and TnIslow mRNAs are expressed, at comparable levels, in differentiated cultures of rat L6 and mouse C2 muscle cell lines. Thus, although neuronal input has been shown to be an important factor in determining fast versus slow isoform-specific expression in skeletal muscle, both TnIfast and TnIslow genes can be expressed in muscle cells in the absence of nerve. Comparison of the deduced rodent TnI amino acid sequences with previously determined rabbit protein sequences showed that residues with potential fast/slow isoform-specific function are present in several discrete clusters, two of which are located near previously identified actin and troponin C binding sites. PMID- 2760068 TI - Placental prolactin-like protein A. Identification and characterization of two major glycoprotein species with antipeptide antibodies. AB - The purpose of this investigation was to develop immunologic probes to prolactin like protein A (PLP-A) that could be used to characterize the protein and its distribution in various tissues. Five oligopeptides corresponding to different regions of the predicted PLP-A amino acid sequence (peptides 1-13, 62-76, 101 114, 129-145, and 152-164) were chemically synthesized by solid phase methodology. The peptides were purified to homogeneity by reverse phase high pressure liquid chromatography and coupled to keyhole limpet hemocyanin. The peptide-keyhole limpet hemocyanin conjugates were used to immunize rabbits. Immune responses were monitored by enzyme-linked immunoassay. Reactivity of the antipeptide antisera with placental proteins was determined by immunoblotting and immunoprecipitation analyses. All of the peptides except peptide 1-13 yielded significant immune responses. Antisera to peptides 101-114, 129-145, and 152-164 each specifically recognized proteins of Mr 29,000 and 33,000 from cytosol preparations of rat placental tissue and showed limited or no cross-reactivity with other members of the prolactin-growth hormone family. Three experiments were performed to determine whether the Mr 29,000 and 33,000 species were glycosylated derivatives of an Mr 25,000 precursor. Treatment of placental cytosolic preparations with N-Glycanase prior to immunoblotting resulted in the identification of only an Mr 25,000 species. It was also determined that the Mr 29,000 and 33,000 species specifically bound to concanavalin A. Furthermore, tunicamycin shifted the synthesis of PLP-A by placental explants from the Mr 29,000 and 33,000 forms to the Mr 25,000 species. The Mr 29,000 and 33,000 species were identified in serum obtained from pregnant and fetal rats but not in serum from nonpregnant females or males. We conclude that PLP-A is expressed in rat placenta. An Mr 25,000 precursor (predicted from PLP-A cDNA and these results) is glycosylated to either the Mr 29,000 or 33,000 form, both of which predominate in placenta and in circulation. PMID- 2760069 TI - Quantification of aminofluorene adduct formation and repair in defined DNA sequences in mammalian cells using the UVRABC nuclease. AB - Using the UVRABC nuclease as a reagent coupled with DNA restriction and hybridization analysis we have developed a method to quantify N-acetoxy-2 acetylaminofluorene (NAAAF)-induced DNA damage in the coding and noncoding sequences of the dihydrofolate reductase (DHFR) gene in Chinese hamster ovary (CHO) cells. High performance liquid chromatography analysis shows that the only DNA adduct formed in NAAAF-treated CHO cells is N-(deoxyguanosine-C8-yl)-2 aminofluorene (dG-C8-AF). DNA sequencing analysis demonstrates that the UVRABC nuclease incises at all potential sites in which dG-C8-AF adduct may form in linear DNA fragments. We have found that the formation and removal of dG-C8-AF adducts in the coding and 3' downstream noncoding sequences of the DHFR domain are similar in cells treated with 10 microM NAAAF (3.1 adducts/14 kilobases); DNA adduct removal attains 70% for both sequences within 24 h. This result contrasts with that obtained for the repair of cyclobutane dipyrimidines in the DHFR gene, in which the repair efficiency is much higher in the coding region than in the 3' downstream noncoding region. Our results suggest that in CHO cells the repair pathway for aminofluorene DNA adducts is not the same as that for cyclobutane dipyrimidines. This new technique has the potential to detect a variety of chemical carcinogen induced DNA adducts at the gene level in cultured cells and in DNA isolated from animal tissues. PMID- 2760070 TI - Isolation and characterization of cDNA clones encoding embryonic and adult isoforms of rat cardiac troponin T. AB - We have previously reported that troponin T (TnT), a regulatory protein in muscle contraction, undergoes a switch from the larger, acidic embryonic form to the smaller, basic adult form during rat heart development (Jin, J.-P., and Lin, J.J. C. (1988) J. Biol. Chem. 263, 7309-7315). To investigate the significance and the molecular mechanism of this isoform switching, cDNA clones encoding rat cardiac TnT were obtained by screening a cDNA library constructed from young rat cardiac poly(A)+ RNAs using the expression vector lambda gt11. Clone RCT10 proved to be a full length clone containing 50 base pairs (bp) of 5'-untranslated sequence, 870 bp of coding sequence, and 196 bp plus poly(A) tail at the 3'-untranslated region. In the other cDNA clone (RCT11), the entire 3'-untranslated sequence and most of the coding sequence were identical with that of RCT10, but an additional 30-bp insert was present in the coding region from residues 18 to 27. This insertion sequence appeared to code for a fragment (EDWSEEEEDE) highly enriched in acidic amino acid residues. Thus, RCT11 might represent a clone encoding the embryonic isoform of rat cardiac TnT. S1 nuclease RNA mapping analysis using end labeled RCT11 cDNA probes confirmed that this region of the sequence is different in embryonic and adult isoform mRNAs. These results suggest that both embryonic and adult isoforms of rat cardiac TnT are generated from the same primary transcript by developmentally regulated alternative splicing. The amino acid sequence deduced from RCT10 cDNA exhibits 87%, 85%, and 72% homology with bovine, rabbit, and chicken cardiac TnTs, respectively, but less homology (57-59%) with the known skeletal TnTs from human, rat, rabbit, and chicken. Moreover, both the 5'- and the 3'-untranslated sequences of rat cardiac TnT mRNA are completely different from those reported for rat skeletal TnT mRNA, suggesting that rat cardiac TnT is coded from a gene distinct from the rat skeletal TnT gene. PMID- 2760071 TI - Differential regulation of phenylalanine ammonia-lyase genes during plant development and by environmental cues. AB - Phenylalanine ammonia-lyase (PAL) catalyzes the first reaction in the biosynthesis from phenylalanine of a wide variety of phenylpropanoid natural products including lignin, flavonoid pigments, and phytoalexins. In bean (Phaseolus vulgaris L.), PAL is encoded by a family of three genes. We show here by RNase protection with gene-specific probes that these genes are expressed differentially during development and in response to different environmental cues. While all three genes are expressed at high levels in roots, only PAL1 and PAL2 are expressed in shoots and only PAL1 is expressed in leaves. Strikingly, PAL2 is expressed at very high levels in petals, where PAL1 is only very weakly expressed and PAL3 is not expressed. All three genes are induced by mechanical wounding of hypocotyls, but fungal infection only activates PAL1 and PAL3. Illumination of etiolated hypocotyls activates PAL1 and PAL2 but not PAL3. Corresponding differential patterns of synthesis of specific PAL polypeptide isoforms were observed by two-dimensional gel electrophoretic analysis of in vitro translation products encoded by RNA isolated from hypocotyls stimulated by light, wounding, or infection. The specific isoforms encoded by transcripts of the three PAL genes were identified by inhibition of synthesis in vitro with gene specific anti-sense transcripts followed by comparative two-dimensional gel electrophoretic analysis of the pattern of translation products. These data indicate that selective expression of PAL genes encoding functional variants is governed by a complex set of regulatory networks for developmental and environmental control of phenylpropanoid biosynthesis. PMID- 2760072 TI - The assembly of regularly spaced nucleosomes in the Xenopus oocyte S-150 extract is accompanied by deacetylation of histone H4. AB - Histone proteins, which were assembled into chromatin using the Xenopus oocyte S 150 extract, were analyzed on acid-urea gels and Triton-acid-urea gels to determine their state of modification. We find that histone H4, which is present in a diacetylated form in the oocyte S-150, gradually loses its acetate groups as the DNA is packaged into chromatin. Thus, this process parallels the one observed in vivo during chromatin formation in growing eucaryotic cells. Histone H4 deacetylation in the oocyte S-150 is a DNA-dependent reaction. This reaction is blocked when butyrate (an inhibitor of histone deacetylase) is added at the onset of the chromatin assembly process. When butyrate is added at the end of the assembly process, no de novo acetylation of the nucleosomal histone H4 is observed. Chromatin with regularly spaced nucleosomes, displaying periodicities ranging from 160 to 220 base pairs, can be assembled in vitro with the oocyte S 150 (Rodriguez-Campos, A., Shimamura, A., and Worcel, A. (1989) J. Mol. Biol., in press). This chromatin may contain either deacetylated histone H4 when assembled under standard conditions or diacetylated H4 when assembled in the presence of butyrate. Both types of chromatin display identical structures upon digestion with nucleases. The potential applications of this system toward the study of the naturally occurring diacetylated histone H4 are discussed. PMID- 2760074 TI - Photolabeling of calmodulin with basic, amphiphilic alpha-helical peptides containing p-benzoylphenylalanine. AB - A novel photoreactive amino acid has been incorporated synthetically into two model peptides and the calmodulin-binding domain from myosin light chain kinase. Cross-linked photoadducts of each peptide with calmodulin have been prepared and digested by chemical and/or enzymatic methods to determine the site of label attachment. Depending on the position of the photoprobe in the peptide sequence, either Met-144 or Met-71 is photolabeled. These results are discussed in relation to the three-dimensional structure of calmodulin obtained crystallographically and the known solution properties of calmodulin. PMID- 2760075 TI - Protein kinase inhibitor-(6-22)-amide peptide analogs with standard and nonstandard amino acid substitutions for phenylalanine 10. Inhibition of cAMP dependent protein kinase. AB - The minimal structure in the heat-stable inhibitor protein of cAMP-dependent protein kinase required for a low nanomolar potency of inhibition is the peptide Thr6-Tyr-Ala-Asp-Phe-Ile-Ala-Ser-Gly-Arg-Thr-Gly-Arg-Arg-Asn-Ala-+ ++Ile22-NH2 (PKI-(6-22)-amide). While primary structural determinants for interaction with the protein kinase are distributed throughout the 17 residues of this peptide, we have previously shown that phenylalanine 10 in the NH2-terminal portion is a particularly important determinant for high affinity binding (Glass, D. B., Cheng, H.-C., Mende-Mueller, L., Reed, J., and Walsh, D. A. (1989) J. Biol. Chem. 264, 8802-8810). To investigate this requirement further, peptide analogs of PKI (6-22)-amide in which various natural and nonstandard amino acids are substituted for phenylalanine 10 have been synthesized and tested for inhibitory potency against the catalytic subunit of the protein kinase. Consistent with the importance of the hydrophobicity of phenylalanine, an alanine 10 substitution analog exhibited a 270-fold decrease in inhibitory potency, whereas the leucine 10 analog lost only 33-fold in activity as compared to the parent peptide PKI-(6 22)-amide. Peptides containing the spatial conformation analogs D-phenylalanine, homophenylalanine, or phenylglycine were 60-120-fold less potent than the parent peptide. Peptides containing various para-substituted phenylalanines at position 10 were only 5-11-fold less potent. One exception to this was (4' azidophenylalanine 10)PKI-(6-22)-amide, which was nearly equipotent with the parent inhibitor. The most potent analogs were those peptides containing highly aromatic residues at position 10. The 2'-thienylalanine 10, tryptophan (formyl) 10, tryptophan 10, and the 1'-naphthylalanine 10 analogs were 3-fold less potent, equipotent, slightly more potent, and 4-fold more potent than the parent peptide inhibitor, respectively. We conclude that phenylalanine 10 in PKI-(6-22)-amide, and presumably in the native protein inhibitor, interacts through specific hydrophobic and/or aromatic binding to a hydrophobic pocket or cleft near the active site of the protein kinase. PMID- 2760073 TI - Molecular cloning of a novel human leukemia-associated gene. Evidence of conservation in animal species. AB - We have recently described an 18-kilodalton polypeptide (p18) that is present in much greater abundance in acute leukemic blast cells (myeloid and lymphoid) than in resting or proliferating nonleukemic lymphoid cells or chronic lymphoid and myeloid leukemic cells. In this report we describe the cloning of two different sized full-length cDNAs that code for p18. The two cDNAs differ in their 3' noncoding regions as a result of alternative polyadenylation. Analysis of the complete nucleotide sequence and the corresponding amino acid sequence did not reveal significant homology to any previously described sequences. We show evidence that this gene is highly conserved in several animal species and low stringency hybridization studies suggest that the p18 gene may be a member of a family of partially homologous genes in the human genome. PMID- 2760076 TI - Intramedullary nailing with reaming to treat non-union of the tibia. AB - The records of fifty-one patients who were treated by intramedullary nailing with reaming for non-union of the tibia were retrospectively reviewed. The fractures had been treated initially by closed reduction and immobilization in a cast, external fixation followed by immobilization in a cast, fixation by pins incorporated in a plaster cast, minimum internal fixation and immobilization in a cast, dynamic compression plating, or intramedullary nailing with or without reaming. After the initial treatment had failed, intramedullary nailing with reaming was done to gain union. Although closed nailing of the tibia was preferred, in thirty-three patients, the site of the non-union was opened to improve alignment by performing an osteotomy or to remove failed hardware. Bone grafts from the iliac crest were used in ten patients, and a fibular ostectomy or osteotomy was done in thirty-three. Of thirty-four open fractures (fourteen grade I, seven grade II, and thirteen grade III), eight were infected at the time of intramedullary nailing. The average time of the diagnosis of a non-union was 9.6 months; the average length of follow-up after nailing was twenty months. In forty nine (96 per cent) of the fifty-one patients, tibial union occurred at an average of seven months postoperatively. Complications included persistent infection (three patients), acquired infection after intramedullary nailing with reaming (three patients), fracture of the nail that necessitated an additional operation (two patients), shortening of more than one centimeter (two patients), malrotation of more than 15 degrees (one patient), peroneal palsy (one patient), and amputation (one patient). When used to treat non-union of the tibia, intramedullary nailing with reaming can produce union as effectively as other alternatives, while enabling the patient to function more normally without external immobilization or walking aids. PMID- 2760077 TI - Prediction of properties of fracture callus by measurement of mineral density using micro-bone densitometry. AB - An experiment was designed to determine whether the material properties of fracture callus can be predicted by the measurement of mineral density. Rat tibiae that had a closed fracture were used to obtain uniform specimens of fracture callus at sequential stages of healing. An in vitro indentation test was done and tissue was biopsied, using a trephine, to determine the hardness and calcium content of a standardized area of callus tissue. The hardness of the callus was correlated with the mineral density of the local tissue, which initially had been measured non-invasively with single-photon-based micro-bone densitometry. The progress of differentiation and remodeling of callus was determined by comparative planimetric and microradiographic analyses of tissue. Determinations of density showed a linear correlation with concentrations of a hydroxyapatite equivalent solution (r = 0.997, p less than 0.001), with the ash weight of control specimens of cortical-trabecular bone (r = 0.998, p less than 0.001), and with the calcium content (micrograms per cubic millimeter) of the fracture callus (r = 0.854, p less than 0.001). The hardness of the callus had a non-linear relationship (r = 0.959, p less than 0.005) with the mineral density per volume of tissue, as measured by micro-bone densitometry. CLINICAL RELEVANCE: The appearance of fracture callus on conventional radiographs is an important clinical finding in the assessment of fracture-healing. It is, however, an unreliable predictor of the strength of the union of the fracture. Three dimensional imaging and quantification of bone mineral provide additional data about the quality and geometry of fracture callus. Our study showed that mineral content per unit of volume is a good index of hardness of the fracture callus. Thus, quantitative imaging may be useful clinically for monitoring fracture healing. PMID- 2760078 TI - The effect of alignment of the implant on fractures of the patella after condylar total knee arthroplasty. AB - The results in thirty-six knees that had a fracture of the patella after a total condylar arthroplasty were reviewed, and were analyzed according to the type of fracture and the alignment of the implant and the limb. Most of the fractures occurred two years or less after the initial operation. Fourteen knees were rated fair or poor and twenty-two, good or excellent. None of the thirty-six implants had been aligned in the neutral range. In sixteen knees, the alignment had a minor variation from the neutral range--that is, the knees were in minor malalignment. In general, these knees had the least severe fractures and the best over-all results. All had a good or excellent result except one, which was revised because of a loose patellar component. That knee was rated as fair at the latest follow-up. There was a major discrepancy in the alignment of twenty implants. These knees had more severe fractures and less satisfactory results than those in the other group. In two of these knees, the fracture was treated non-operatively; one had a good and the other, a poor result. Twelve of the remaining knees, which were treated surgically, were rated as fair or worse. Two knees that had revision of three components and restoration of alignment to the neutral range had an excellent result. The results of this study indicate that the alignment and fit of a component are important in determining the severity of a fracture of the patella after condylar total knee replacement and the long-term results after treatment of the fracture. PMID- 2760079 TI - Anteversion of the femur and idiopathic osteoarthrosis of the hip. AB - We studied the radiographs of 220 consecutive cadavera that were used for dissection by medical students over an eleven-year period. Anteversion of the femur was measured by a reproducible direct method after dissection of forty eight idiopathic osteoarthrotic hips and twenty control hips. We were unable to find a significant difference between the degree of anteversion of the neck of the femur in the two groups. PMID- 2760080 TI - Dural laceration occurring with burst fractures and associated laminar fractures. AB - The cases of sixty patients in whom a burst fracture of a thoracic or lumbar vertebral body had been treated with posterior instrumentation and arthrodesis less than two weeks after the injury were retrospectively reviewed. Thirty of the patients had an associated laminar fracture. Eleven of the thirty, all of whom had a lumbar fracture and a preoperative neurological deficit, were noted at operation to have dural laceration. In four of the patients who had dural laceration, neural elements were entrapped between the fragments from the laminar fracture. None of the remaining thirty patients who did not have a laminar fracture had dural laceration (p = 0.0002). Univariate and multivariate statistical analysis revealed no significant association of the dural laceration with the patients' age or sex, or with the radiographic characteristics of the spine. There was a significant association between dural laceration and neurological deficit (p = 0.0001). In our series, the presence of a preoperative neurological deficit in a patient who had a burst fracture and an associated laminar fracture was a sensitive (100 per cent) and specific (74 per cent) predictor of dural laceration. The presence of this fracture pattern and an associated neurological deficit also predicted a risk of dural laceration with entrapped neural elements. This information may influence decisions as to whether an anterior or a posterior surgical approach should be used in such patients. PMID- 2760081 TI - Salvage of non-union of supracondylar fracture of the humerus by total elbow arthroplasty. AB - Fourteen patients in whom open reduction and internal fixation could not be achieved satisfactorily had a total elbow arthroplasty for non-union of a supracondylar humeral fracture. All patients had an established non-union, and ten had had from one to four previous attempts at internal fixation. The average age at the time of operation was sixty-five years. The average duration of follow up was five years, with a minimum of two years. The average preoperative elbow score was 17 points, with both pain and functional disability present. The average postoperative score was 84 points; there were eight good or excellent results and three failures. The latter three patients had an additional operation: one each for dislocation, loosening of the humeral component, and deep infection. Salvage of supracondylar non-union by means of a total elbow arthroplasty is a technically demanding procedure. Strict indications for selection of patients must be followed. A semiconstrained implant is recommended, with preservation of the epicondyles and their muscular attachments in order to achieve balance of the soft tissues. PMID- 2760082 TI - Progression of scoliosis in Duchenne muscular dystrophy. AB - We reviewed the clinical charts and spinal radiographs of fifty-one boys who had Duchenne muscular dystrophy, had not had surgical treatment of the spine, and had been followed until death. All had scoliosis. None of the following variables was useful in predicting which curves would become severe: age when the patient initially walked, age when he ceased walking, age at onset of spinal collapse, surgical release of the iliotibial bands, or age at the time of death. Radiographs were made within eighteen months before death for thirty-three patients; in thirty-one of them, the final curve exceeded 40 degrees and in seventeen, 90 degrees. For the remaining eighteen patients, final radiographs were made more than eighteen months before death; at that time, eight of them already had a curve of more than 90 degrees. Although there was a relationship between extension of the lumbar spine and severity of scoliosis at the time of final follow-up, early maintenance of the lumbar spine in extension rarely prevented the development of a severe curve. For most of the patients who had a severe curve, sitting was difficult and was accompanied by breakdown of the skin and pain. When a patient's curve exceeded 35 degrees, the vital capacity usually was less than 40 per cent of the predicted normal value. Therefore, when walking becomes impossible for boys who have Duchenne muscular dystrophy, routine spinal arthrodesis should be considered. PMID- 2760083 TI - Coactivation of the hamstrings and quadriceps during extension of the knee. AB - The electromyographic activities of six muscles of the thigh were recorded, using bipolar surface electrodes, during active extension of the knee by six healthy men. The signal amplitudes were normalized to those recorded during isometric maximum voluntary contractions. Extension of the knee from 90 to 0 degrees (full extension) was performed at the rate of 10 degrees per second with the leg unimpeded and with weights of 1.8, 3.6, 5.4, or 7.2 kilograms attached to the ankle. The hamstrings were found to coactivate with the quadriceps during the terminal phase of extension. Coactivation of all three hamstrings was found to occur at joint angles of as much as 9 degrees, with the maximum at full extension of the knee and the strength of the signals ranging to as much as 20 per cent. The signals of all of the flexors and extensors increased with increasing loads on the ankle and, with the exception of the rectus femoris at 9 degrees of flexion, they also increased as the knee extended. The results of this study support the hypothesis that the hamstrings function synergistically with the anterior cruciate ligament to prevent the anterior tibial displacement that is produced by active contraction of the quadriceps in the terminal degrees of extension of the knee. This information is important for the physical conditioning of healthy individuals in preparation for athletic endeavors. Furthermore, if coactivation of the hamstrings with the quadriceps is mediated by sensors other than, or in addition to, those of the anterior cruciate ligament, then strengthening of the hamstrings appears to be an important adjunct to rehabilitation programs after repair or reconstruction of that ligament. PMID- 2760084 TI - Neurilemoma in the distal part of the thigh. A case report. PMID- 2760086 TI - A reappraisal of some professional attitudes in orthopaedic surgery. PMID- 2760085 TI - Cauda equina syndrome after surgical treatment of lumbar spinal stenosis with application of free autogenous fat graft. A report of two cases. PMID- 2760087 TI - Palmar shelf arthroplasty in the rheumatoid wrist. PMID- 2760088 TI - Amputation after tibial fracture: preservation of length by use of a neurovascular island (fillet) flap of the foot. PMID- 2760090 TI - The validity of survivorship analysis in total joint arthroplasty. PMID- 2760089 TI - Reflex sympathetic dystrophy of the knee. Treatment using continuous epidural anesthesia. PMID- 2760091 TI - Achilles' heel. PMID- 2760092 TI - Surgical or non-surgical treatment of acute rupture of the anterior cruciate ligament. A randomized study with long-term follow-up. AB - One hundred and eleven consecutive patients who had acute injuries to the knee that included rupture of the anterior cruciate ligament, as shown by physical examination with the patient under anesthesia and by diagnostic arthroscopy, were randomized to three treatment groups: simple repair of all injured structures, repair of all injured structures and augmentation of the anterior cruciate ligament with a strip of the iliotibial band, and repair of all injured structures except the anterior cruciate ligament. In all other respects, the knees were treated in an identical fashion. Of the 111 patients, 107 were re examined forty-five months or more after operation. At the most recent follow-up, the knees that had been treated by repair and augmentation of the anterior cruciate ligament were significantly more stable and had had significantly fewer subsequent meniscal tears. Sufficient instability to necessitate late reconstruction was also less frequent in the patients who had had an augmented repair. These patients had better function of the knee and a higher level of activity than the patients in the other two groups. Sixty-four per cent of these patients who had a rupture of the anterior cruciate also had a meniscal tear, and primary care was indicated for more than 50 per cent of the tears. Therefore, we believe that early arthroscopic examination is essential for patients who have an acute rupture of the anterior cruciate ligament. PMID- 2760093 TI - Instrumented Lachman tests for the evaluation of anterior laxity after reconstruction of the anterior cruciate ligament. AB - Using a KT-1000 arthrometer, in fifty subjects were measured the anterior ligamentous laxity in a knee in which the anterior cruciate ligament had been reconstructed and in the normal, contralateral knee. We also determined the anterior tibial displacement and anterior compliance, using the Lachman test. The subjects were divided into groups according to the type of autogenous intra articular substitute (either the central one-third of the patellar tendon or the semitendinosus tendon) that had been used for the anterior cruciate ligament and according to the duration of follow-up (range, twenty-four to 101 months). Lachman tests were performed, applying sixty-eight and ninety newtons of force, and indices for anterior compliance were calculated. Although significantly more anterior laxity was demonstrated with both sixty-eight and ninety newtons of force in the reconstructed knees than in the contralateral, normal knees (p less than 0.001), thirteen subjects, of whom eight lacked full extension of the reconstructed knee, had more anterior laxity in the normal knee. Analyses of variance showed no significant differences in the results of the Lachman tests as related to either the type of reconstruction or the length of postoperative follow-up. The results suggested that the two types of ligamentous substitute that were used in this study were equally efficient in limiting anterior tibial displacement, as demonstrated by the Lachman test. The study also demonstrated that the substitutes did not elongate significantly during the period of the study. PMID- 2760094 TI - Closed subarachnoid drainage for management of cerebrospinal fluid leakage after an operation on the spine. AB - A retrospective review was conducted to assess the effectiveness and safety of a temporary subarachnoid shunt to treat patients who have a leak of cerebrospinal fluid after a spinal operation. The shunt is percutaneously inserted in the lumbar spine and is removed after four days. This technique was used in nineteen patients over a ten-year period. Of the seventeen patients who had the shunt in place for the full four days, fourteen had resolution of the drainage of cerebrospinal fluid from the wound. One of two patients whose shunt was removed early also had a successful result. Eleven of the fifteen patients who were successfully treated were available for follow-up, and none had any adverse effects related to the original cerebrospinal-fluid leak or its treatment. The four patients who had a persistent leak were successfully treated with reoperation and direct repair of the dura. Eleven (58 per cent) of the nineteen patients had transient complaints of nausea and vomiting while being treated with subarachnoid drainage. Two of the nineteen patients had evidence of an intradural infection after placement of the catheter; the infection resolved in both patients after removal of the catheter and treatment with appropriate antibiotics. Closed subarachnoid drainage, when properly performed and monitored, is a reasonably effective and safe method for treating dural-cutaneous cerebrospinal-fluid leaks after a spinal operation. It may be considered as a non operative alternative to the standard procedure of reoperation and direct repair of the dura. A good result is still possible in patients in whom this technique fails and who eventually need surgical management. PMID- 2760095 TI - A fasciocutaneous transposition flap for coverage of defects of the lower extremity. AB - During a three-year period, eleven fasciocutaneous transposition flaps were used in ten patients to cover a defect in the lower extremity that was due to trauma or infection. The patients were subsequently evaluated with respect to survival of the flap, sensation in the flap, healing of the donor site, and postoperative morbidity. Two cases are presented for illustration. Coverage with a fasciocutaneous transposition flap proved to be safe and simple. This technique offers several advantages compared with reconstruction using microvascular free muscle transfer, and it may be preferable for many patients who have a defect distal to the knee. PMID- 2760096 TI - Experimental investigations into the carcinogenic effect of antitumor and immunosuppressive agents. AB - In a comprehensive experimental study on rats, the carcinogenicity of various therapeutically important antitumor drugs was investigated. The influences of strain, sex, dose and time of administration were systematically varied. The tested compounds showed remarkable differences in their carcinogenic potential. These differences were particularly obvious, not only when the total tumor rate was analyzed, but also when the distribution of tumor rates to the various localizations was considered (tumor spectrum). Three classes of carcinogenic substances were identified: (1) Substances showing a specific carcinogenicity: they lead to tumorogenesis primarily in organs or organ systems that, in the untreated control animals, remain virtually tumor-free for life. One example of such a substance is chlormethine. (2) Substances with non-specific carcinogenicity: they lead to an increase in tumors in organs that are also stricken in the control animals, however, to a clearly reduced extent. Oxazaphosphorine carcinogenicity is typical for this class. (3) Substances of mixed-type carcinogenicity: this group shows non-specific carcinogenicity, as well as a carcinogenic action with marked organ specificity. One example of this class is procarbazine. The antimetabolites tested were shown to be practically non-carcinogenic. Characteristic differences occurred between the two rat strains used in the investigation, Sprague-Dawley and BD II, with regard to the spontaneous tumor spectrum and the organ-related extent of carcinogenicity under the influence of the substances tested. In an experiment involving short-term application (up to 17% LD50, five times i.v. at 14-day intervals), the carcinogenic effects were substantially lower than in an experiment involving long-term application (up to 7% LD50, once a week for 52 weeks, i.v.), although the strain- and substance-specific characteristics in both experiments were rather similar. PMID- 2760097 TI - Sequential changes in growth kinetics and cellular phenotype during hepatocarcinogenesis. AB - Sequential changes in cell proliferation and cellular phenotype during hepatocarcinogenesis induced in rats with N-nitrosomorpholine were investigated by autoradiographic determination of the [3H]thymidine-labelling index in morphologically defined focal lesions and extrafocal hepatic tissue at different times between 4 and 48 weeks after withdrawal of the carcinogen (stop model). The labelling index was found to be significantly increased in all types of preneoplastic and neoplastic hepatic lesions as compared to both the liver tissue of untreated controls and the extrafocal parenchyma of N-nitrosomorpholine treated rats. However, the extent of the increase in labelling index differed in the phenotypically diverse types of preneoplastic and neoplastic lesions. There was a significant but relatively small increase in the labelling index in clear and acidophilic cell foci. A much stronger elevation of cell proliferation was characteristic of mixed and basophilic cell foci. The development of hepatocellular adenomas and carcinomas from preneoplastic hepatic foci was further characterized by an additional increase in cell proliferation. Each specific cellular phenotype was associated with a rather uniform proliferation rate, which remained elevated at all time points studied, suggesting that the rate of cell proliferation in the phenotypically diverse preneoplastic hepatic foci mainly reflects the intrinsic growth potential of the respective cellular phenotypes. The results support the concept that the predominant sequence of cellular changes in hepatocarcinogenesis induced by the stop model leads from the clear and acidophilic cell foci, storing glycogen in excess, through mixed and basophilic cell foci to hepatocellular adenomas and carcinomas. The fact that the labelling index of the extrafocal liver tissue of N-nitrosomorpholine-treated rats was also significantly higher than that of the normal parenchyma of untreated controls might indicate an involvement of extrafocal hepatocytes, in addition to that of foci of altered hepatocytes, in hepatocarcinogenesis. PMID- 2760098 TI - Genetic factors controlling inheritance of susceptibility to 1,2 dimethylhydrazine. AB - Reciprocal crosses were made between AKR/J, a 1,2-dimethylhydrazine (DMH) resistant mouse strain, and SWR/J, a sensitive strain. The F1 hybrids were tested with DMH and methylazoxymethanol (MAM), two colon carcinogens. Either DMH (20 mg/kg body weight) or MAM (35 mg/kg body weight), a metabolic derivative of DMH, was injected weekly for 10 weeks. In each group of 35 mice, 10 were injected with tritiated thymidine (25 microCi) 1 week after the sixth injection of DMH and MAM for the evaluation of proliferative characteristics and the number of foci of dysplasia occurring in 325 microns of distal colonic mucosa. At 27 weeks after the first injection of the carcinogen, the colons of remaining mice were opened longitudinally and the number of tumors enumerated. Compared with DMH-treated mice, the number of foci of dysplasia per mouse, the percentage of tumor-bearing mice, the number of tumors per animal, and the number of tumors per tumor-bearing animal induced by MAM were severalfold higher. This would suggest the presence of a gene(s) repressing metabolism of DMH to MAM. Moreover, differences in response to the carcinogens were observed between the sexes. In contrast to males, females treated with both DMH and MAM had significantly greater numbers of tumors per animal, tumors per tumor-bearing mice, and a greater proliferative response with extension of S-phase cells to the upper third and luminal surface of crypts. Among males, those with the XAKR/YSWR heritage appeared more resistant than XSWR/YAKR males, particularly in their response to MAM. A twofold difference in the number of foci of dysplasia per mouse, tumors per animal, and the number of tumors per tumor-bearing animals was seen. Analyses of the response to DMH and MAM by F1 reciprocal hybrids of the AKR and SWR strains have shown a complex inheritance pattern governing susceptibility to DMH. Resistance to the carcinogen is provided by at least two specific repressor genes, one governing metabolism of carcinogen from DMH to MAM, and the other controlled by gender. Genetic factors contributed by the AKR female appear to convey additional resistance to male progeny, suggesting more than one gender-related gene. PMID- 2760099 TI - In vivo short-term assays of repair and replication of rat liver DNA. AB - A short-term in vivo method for assay of repair and replication of rat liver DNA has been developed, by which possible hepatocarcinogens could be identified in a few days. F344 rats were treated orally with two genotoxic hepatocarcinogens, dimethylnitrosamine (DMN) and 2-acetylaminofluorene (2AAF), or a nongenotoxic hepatocarcinogen, carbon tetrachloride (CCl4). Then at suitable times after treatment, their hepatocytes were isolated by a two-step collagenase perfusion technique in situ and incubated with [3H]dThd with or without hydroxyurea, which inhibits DNA replication. Their nuclear DNA was then extracted and the incorporation of [3H]dThd into nuclear DNA was determined in a liquid scintillation counter. Unscheduled DNA synthesis (DNA repair), induced by DMN at doses of 2.5-10 mg/kg body weight and by 2AAF at doses of 12.5-50 mg/kg body weight, could be detected 2 h and 4 h after their administration as an increase of DNA synthesis of up to 5.8-fold and 6.0-fold, respectively, in the presence of hydroxyurea. Replicative DNA synthesis, induced by CCl4 at a dose of 200 mg/kg body weight, could be detected 48 h after its administration as a 23-fold increase of DNA synthesis in the absence of hydroxyurea and was inhibited approximately 97%-99% by hydroxyurea. Replicative DNA synthesis induced by 2AAF at a dose of 25 mg/kg body weight 16 h after its administration could be detected as a 6.8-fold increase of DNA synthesis in the absence of hydroxyurea. These results show that unscheduled and replicative DNA synthesis can be clearly distinguished by simultaneous measurements of the incorporation of [3H]dThd into nuclear DNA in the presence and absence of hydroxyurea. PMID- 2760100 TI - Immunohistochemical versus biochemical estrogen-receptor and progesterone receptor analysis: correlation with histological parameters. AB - Human breast carcinomas were evaluated for estrogen and progesterone receptors by immunohistochemistry using monoclonal anti-receptor antibodies (n = 267) and by cytosol steroid-binding assays (n = 212). The estrogen and progesterone receptor contents of the tumors correlated with histological features of differentiation, such as histological and nuclear grade, and with the amount of tumor necrosis and lymphoid infiltration. The correlation of immunohistochemically determined steroid receptor values with histological characteristics was somewhat better than that of biochemically assessed concentrations. PMID- 2760101 TI - Cellular and molecular pharmacology of 4'-epidoxorubicin in HeLa cells. Comparison with its parent drug, doxorubicin. AB - The effects on cellular DNA and cytotoxicity produced by doxorubicin (Dx) and its epimer 4'-epidoxorubicin (4'E-Dx) were investigated in cultured HeLa cells. 4'E Dx was 2.3 times more cytotoxic than Dx after 1 h of treatment, but the two anthracyclines were equally cytotoxic on longer-term (24 h) drug exposure. The different kinetics of cell lethality were related to pharmacodynamic differences between the two drugs. In fact, cellular uptake and efflux rates of 4'E-Dx were faster than those of Dx on 1 h of drug exposure but similar after 24 h of treatment. 4'E-Dx caused more protein-concealed strand breaks in DNA (single and double) than did Dx, despite a lower potency for free-radical formation. The degree of strand breakage by 4'E-Dx was not a linear function of exposure time and, in fact, the rate of strand-break induction declined continuously with time. In contrast, Dx caused an almost linear increase in DNA single-strand breaks with time during 1 h of drug exposure; this was apparently due to its slower uptake. There was little repair of the DNA single-strand breaks produced by Dx upon postincubation for 5 h in a drug-free medium, whereas DNA lesions caused by 4'E Dx were removed with a t1/2 of about 1.7 h. These findings underline the importance of the cellular pharmacokinetics of anthracyclines in relation to their cytotoxic and DNA-damaging effects. PMID- 2760102 TI - Enhanced activity of anticancer drugs in murine tumours by co-administration with 3-amino-pyrrolidine-2,5-dione-N-mustard derivative. AB - (R,S)3-(N,N-[bis-(2-chloroethyl)]-amino)-1-(2'-methoxyphenyl)- pyrrolidine-2,5 dione hydrochloride (I) has shown antitumor activity against P388 and L1210 leukaemias and Sarcoma 180 (ascites). The effect of (I), when co-administered with anticancer drugs, was studied in these murine tumours. Although co administration of (I) with methotrexate showed a significant increase of the activity against P388 and L1210 leukaemias and Sarcoma 180 (ascites), co administration of (I) with 5-fluorouracil, mitomycin C, adriamycin or vincristine did not exhibit any enhancing, synergistic or additive effect in the activity of these drugs. PMID- 2760103 TI - The levels and relations of prostaglandins in pregnant and non-pregnant tumor bearing mice. AB - Tissue levels of prostaglandins PGE1, PGE2, PGF1 alpha and PGF2 alpha were determined in muscle tissues of pregnant, and in tumor tissue of pregnant tumor bearing female syngeneic Balb/c mice bearing a transplanted methylcholanthrene induced fibrosarcoma. Tests were done on the 7th, 10th, and 15th days of tumor growth/pregnancy using a thin-layer chromatography method. The results showed significantly increased levels of prostaglandins in tumor-bearing animals as well as in pregnant tumor-bearing hosts when compared to controls. Changes in the levels of PGE1 in pregnant mice were the most prominent among all prostaglandins tested. In these animals, the mutual relations between prostaglandin subclasses were not affected. In tumor-bearing mice, especially those which were pregnant, the inversion of prostaglandins of the E series was observed. Tumor changed the levels of the E series prostaglandins in favour of PGE2. However, it did not change the relation between those of the F series. The levels of PGE2 were more expressed in pregnant tumor-bearing hosts than in their non-pregnant counterparts. This has led us to the conclusion that, besides the malignant tumor, the pregnancy itself also potentiates immunosuppression. Blocking of PGE2 production in tumor-bearing animals might have potential therapeutic implications. PMID- 2760104 TI - Growth of colorectal carcinoma cells: regulation in vitro by gastrin, pentagastrin and the gastrin-receptor antagonist proglumide. AB - The growth-regulating effects of pentagastrin, gastrin and the gastrin-receptor antagonist proglumide were investigated in three established cell lines derived from human colorectal carcinomas in vitro and after transplantation into nude mice. In vitro a significant increase of cell growth in the SW 403 cell line incubated with pentagastrin or gastrin was observed. In the Lovo cell line this effect was only detected after synchronization of cell growth. Pentagastrin and gastrin had no effect on the growth of the Ls 174 T cell line. Proglumide reduced cell proliferation in all three cell lines as well as in the L929S cell line derived from fibroblasts, which served as control. After transplantation into nude mice all tumor cell lines increased, Lovo and Ls 174 T as undifferentiated tumor, SW 403 as differentiated. Pentagastrin increased and proglumide decreased growth in SW 403 tumors, whereas no effect was observed on Ls 174 T and Lovo tumors. We therefore conclude that growth of some colorectal carcinomas is regulated by gastrin, but that the effect of proglumide is unspecific rather than related to blockage of gastrin receptors. The growth-regulating effect of gastrin could be due to tumor differentiation. PMID- 2760105 TI - Postendocytotic sorting of the ligand for the polymeric immunoglobulin receptor in Madin-Darby canine kidney cells. AB - The polymeric immunoglobulin receptor (pIg-R) is responsible for the receptor mediated transcytosis of polymeric immunoglobulins (IgA and IgM) across various epithelia. We have expressed the cDNA for the pIg-R in Madin-Darby canine kidney (MDCK) cells and found that this system mimics that found in vivo (Mostov, K. E., and D. L. Deitcher. 1986. Cell. 46:613-621). We have now investigated the postendocytotic pathway of the ligand for the pIg-R. After a 5-min internalization at the basolateral surface, approximately 45% of internalized ligand recycles to the basolateral medium and 30% is transcytosed to the apical medium. We have also examined why transcytosis of ligand is unidirectional, going only from basolateral to apical, but not from apical to basolateral. Several factors could explain this, such as proteolytic cleavage of the pIg-R at the apical surface, decreased apical endocytosis of ligand, or an intracellular sorting event. In this report, we show that the protease inhibitor, leupeptin, inhibits the cleavage of the pIg-R but does not alter the unidirectionality of transcytosis. In addition, we demonstrate that there is a significant amount of apical endocytosis of ligand (70% of that observed basolaterally). Finally, we demonstrate that apically endocytosed ligand can return only to the apical surface. Thus, once ligand reaches the apical surface, it is "trapped" and cannot return to the basolateral surface. We propose that the unidirectionality of transcytosis is the result of intracellular sorting, and that this results from a signal(s) present on the pIg-R. PMID- 2760106 TI - Structural changes induced in Ca2+-regulated myosin filaments by Ca2+ and ATP. AB - We have used electron microscopy and proteolytic susceptibility to study the structural basis of myosin-linked regulation in synthetic filaments of scallop striated muscle myosin. Using papain as a probe of the structure of the head-rod junction, we find that this region of myosin is approximately five times more susceptible to proteolytic attack under activating (ATP/high Ca2+) or rigor (no ATP) conditions than under relaxing conditions (ATP/low Ca2+). A similar result was obtained with native myosin filaments in a crude homogenate of scallop muscle. Proteolytic susceptibility under conditions in which ADP or adenosine 5' (beta, gamma-imidotriphosphate) (AMPPNP) replaced ATP was similar to that in the absence of nucleotide. Synthetic myosin filaments negatively stained under relaxing conditions showed a compact structure, in which the myosin cross-bridges were close to the filament backbone and well ordered, with a clear 14.5-nm axial repeat. Under activating or rigor conditions, the cross-bridges became clumped and disordered and frequently projected further from the filament backbone, as has been found with native filaments; when ADP or AMPPNP replaced ATP, the cross bridges were also disordered. We conclude (a) that Ca2+ and ATP affect the affinity of the myosin cross-bridges for the filament backbone or for each other; (b) that the changes observed in the myosin filaments reflect a property of the myosin molecules alone, and are unlikely to be an artifact of negative staining; and (c) that the ordered structure occurs only in the relaxed state, requiring both the presence of hydrolyzed ATP on the myosin heads and the absence of Ca2+. PMID- 2760107 TI - Substructure and accessory proteins in scallop myosin filaments. AB - Native myosin filaments from scallop striated muscle fray into subfilaments of approximately 100-A diameter when exposed to solutions of low ionic strength. The number of subfilaments appears to be five to seven (close to the sevenfold rotational symmetry of the native filament), and the subfilaments probably coil around one another. Synthetic filaments assembled from purified scallop myosin at roughly physiological ionic strength have diameters similar to those of native filaments, but are much longer. They too can be frayed into subfilaments at low ionic strength. Synthetic filaments share what may be an important regulatory property with native filaments: an order-disorder transition in the helical arrangement of myosin cross-bridges that is induced on activation by calcium, removal of nucleotide, or modification of a myosin head sulfhydryl. Some native filaments from scallop striated muscle carry short "end filaments" protruding from their tips, comparable to the structures associated with vertebrate striated muscle myosin filaments. Gell electrophoresis of scallop muscle homogenates reveals the presence of high molecular weight proteins that may include the invertebrate counterpart of titin, a component of the vertebrate end filament. Although the myosin molecule itself may contain much of the information required to direct its assembly, other factors acting in vivo, including interactions with accessory proteins, probably contribute to the assembly of a precisely defined thick filament during myofibrillogenesis. PMID- 2760108 TI - Purification and characterization of an Acanthamoeba nuclear actin-binding protein. AB - Immunolocalization of monoclonal antibodies to Acanthamoeba myosin I showed a cross-reactive protein in nuclei (Hagen, S. J., D. P. Kiehart, D. A. Kaiser, and T. D. Pollard. 1986. J. Cell Biol. 103:2121-2128). This protein is antigenically related to myosin I in that nine monoclonal antibodies and three polyclonal antibodies are cross-reactive. However, studies with affinity-purified antibodies and two-dimensional peptide maps show that the protein is not a proteolytic product of myosin I. We have used cell fractionation and column chromatography to purify this protein. It is a dimer of 34-kD polypeptides with a Stokes' radius of 4 nm. A polyclonal antisera generated against the purified protein confirms the nuclear localization seen with the cross-reactive monoclonal antibodies. The 34 kD protein binds actin filaments in an ATP-insensitive manner with a Kd of approximately 0.25 microM without cross-linking, severing, or capping. No ATPase activity was detected in the presence or absence of actin. It also binds to DNA. These unique properties suggest we have discovered a new class of actin-binding protein. We have given this protein the name NAB for "nuclear actin-binding" protein. PMID- 2760109 TI - Polewards microtubule flux in the mitotic spindle: evidence from photoactivation of fluorescence. AB - I have synthesized a novel derivative of carboxyfluorescein that is nonfluorescent, but can be converted to a fluorescent form by exposure to 365-nm light. This photoactivable, fluorescent probe was covalently attached to tubulin and microinjected into mitotic tissue culture cells, where it incorporated into functional spindles. To generate a fluorescent bar across the mitotic spindle, metaphase cells were irradiated with a slit microbeam. This bar decreased in intensity over the first minute, presumably due to turnover of nonkinetochore microtubules. The remaining fluorescent zones, now presumably restricted to kinetochore microtubules, moved polewards at 0.3-0.7 microns/min. This result provides strong evidence for polewards flux in kinetochore microtubules. In conjunction with earlier biotin-tubulin incorporation experiments (Mitchison, T. J., L. Evans, E. Schulze, and M. Kirschner. 1986. Cell. 45:515-527), I conclude that microtubules polymerize at kinetochores and depolymerize near the poles throughout metaphase. The significance of this observation for spindle structure and function is discussed. Local photoactivation of fluorescence should be a generally useful method for following molecular dynamics inside living cells. PMID- 2760110 TI - Acetylcholine receptor clusters of rat myotubes have at least three domains with distinctive cytoskeletal and membranous components. AB - Cultured rat myotubes develop high concentrations of acetylcholine receptors (AChR) in specialized areas of attachment to their substrate. We examined the ultrastructure of identified AChR clusters by quick-freeze, deep-etch, rotary replication or by thin sectioning of whole myotubes fixed in the presence of saponin and tannic acid to preserve the cytoskeleton. Our findings show that AChR clusters are composed of at least three distinct domains, differing in their cytoskeletal, intramembrane, and external components. At contact domains, the myotube's ventral membrane lacked AChR and lay within 10-15 nm of the substrate; electron-dense strands connected the two. The overlying cytoplasm contained bundles of parallel microfilaments passing above and through an irregular network of globular material, resembling the relationship of microfilament bundles to focal contacts already described in fibroblasts. Coated-membrane domains lay between the microfilament bundles and were overlain by cytoplasmic plaques of a regular network of polygons having associated coated pits. These plaques closely resembled the network of polymerized clathrin described in fibroblasts and macrophages. Coated membrane also lacked AChR and adhered to the substrate by electron-dense strands, but did not anchor microfilament bundles. The cytoplasm overlying AChR domains contained a complex network composed of at least two layers. The layer closest to the membrane consisted of protrusions from the cytoplasmic surface, some connected by fine filaments less than 5 nm in diameter. An overlying layer contained larger diameter filaments, some forming an anastomotic network reminiscent of the cortical cytoskeleton of erythrocytes. Longer filaments inserting into this network appeared identical to members of nearby microfilament bundles. The morphology of AChR domains supports the idea that AChR are immobilized by a network containing actin and spectrin. PMID- 2760111 TI - Three-dimensional structure of the nicotinic acetylcholine receptor and location of the major associated 43-kD cytoskeletal protein, determined at 22 A by low dose electron microscopy and x-ray diffraction to 12.5 A. AB - The three-dimensional structure of the nicotinic acetylcholine receptor (AChR) from Torpedo californica, crystallized both before and after removal of associated proteins, most notably the main 43-kD cytoskeletal protein that interacts both with AChR and actin, is determined to a resolution of 22 A. This is the first structural analysis where the 43-kD protein has been removed from the sample before crystallization. Thus, it provides the most reliable assessment of what constitutes the structure of the minimal five subunit AChR complex, and, by comparison with the native membrane, of the location of the 43-kD cytoskeletal protein. Image reconstruction of two-dimensional crystals includes information from electron images of up to +/- 52 degrees tilted specimens of latticed AChR. Hybrid density maps that include x-ray diffraction perpendicular to the membrane to 12.5 A resolution were used and eliminate some of the distortions introduced in maps based only on electron microscopic analyses. Comparison of the difference Fourier density maps between AChR with its normal complement of associated proteins, and without them shows that the main density, assigned to the actin binding 43-kD component is closely associated with the lipid bilayer as well as with the cytoplasmic domain of the AChR. It binds beside the AChR, not beneath it as suggested by others (C. Toyoshima and N. Unwin 1988. Nature [Lond.]. 336:237 240). There is good agreement between the volumes of density for structural components and expected volumes based on their molecular weight. Acetylcholine receptors aggregate in the absence of any cytoskeletal proteins, suggesting that the AChR alone is sufficient to encode and stabilize clustering, and perhaps to do so during synaptogenesis. The main 43-kD component may play a role in location and rate of association of AChR. We show that the disulfide bond that cross-links delta-delta chains of adjacent pentamers in about 80% of AChR, is not required to stabilize the lattice of AChR. Latticed tube structures are stable indefinitely. The lattices described here have 20% less volume of lipid than those originally obtained and characterized by J. Kistler and R. M. Stroud (1981. Proc. Natl. Acad. Sci. USA. 78:3678-3682), or those subsequently characterized by A. Brisson and P. N. T. Unwin (1984. J. Cell Biol. 99:1202-1211) and A. Brisson and P. N. T. Unwin (1985. Nature (Lond.). 315:474-477). PMID- 2760112 TI - Neuronal process outgrowth of human sensory neurons on monolayers of cells transfected with cDNAs for five human N-CAM isoforms. AB - Full length cDNAs for a variety of human N-CAM isoforms have been transfected into mouse L-cells and/or 3T3 cells. Three independent clones of each cell line that were shown to express human N-CAM were tested for their ability to support the morphological differentiation of sensory neurons. The cell surface expression of N-CAM isoforms, linked to the membrane directly by an integral transmembrane spanning domain or indirectly via covalent attachment to a glycosyl phosphatidylinositol moiety, were consistently found to be associated with a significant increase in the morphological differentiation of both human and rat dorsal root ganglion neurons. Modification of the extracellular structure of both classes of N-CAM, consequent to the expression of a glycosylated 37-amino acid sequence normally found expressed exclusively in muscle N-CAM isoforms did not obviously affect the ability of transfected cells to support increased neuronal differentiation. 3T3 cells that were transfected with a full length cDNA encoding a secreted N-CAM isoform, and that have previously been shown to secrete N-CAM into the growth media rather than link it to the membrane did not significantly differ from control cells in their ability to support neuronal differentiation. These data provide direct evidence for both transmembrane and lipid-linked N-CAM isoforms being components of the regulatory machinery that determines neuronal morphology and process outgrowth. PMID- 2760113 TI - Growth factors are released by mechanically wounded endothelial cells. AB - Growth factors may be required at sites of mechanical injury and normal wear and tear in vivo, suggesting that the direct action of mechanical forces on cells could lead to growth factor release. Scraping of cells from the tissue culture substratum at 37 degrees C was used to test this possibility. We show that scraping closely mimics in vitro both the transient plasma membrane wounds observed in cells subject to mechanical forces in vivo (McNeil, P. L., and S. Ito. 1989. Gastroenterology. 96:1238-1248) and the transient plasma membrane wounds shown here to occur in endothelial cells under normal culturing conditions. Scraping of endothelial cells from the culturing substratum released into the culture medium a potent growth-promoting activity for Swiss 3T3 fibroblasts. Growth-promoting activity was released rapidly (within 5 min) after scraping but was not subsequently degraded by the endothelial cells for at least 24 h thereafter. A greater quantity of growth-promoting activity was released by cells scraped 4 h after plating than by those scraped 4 or 7 d afterwards. Thus release is not due to scraping-induced disruption of extracellular matrix. Release was only partially cold inhibitable, was poorly correlated with the level of cell death induced by scraping, and did not occur when cells were killed with metabolic poisons. These results suggest that mechanical disruption of plasma membrane, either transient or permanent, is the essential event leading to release. A basic fibroblast growth factor-like molecule and not platelet-derived growth factor appears to be partially responsible for the growth-promoting activity. We conclude that one biologically relevant route of release of basic fibroblast growth factor, a molecule which lacks the signal peptide sequence for transport into the endoplasmic reticulum, could be directly through mechanically induced membrane disruptions of endothelial cells growing in vivo and in vitro. PMID- 2760114 TI - Basic fibroblast growth factor is an extracellular matrix component required for supporting the proliferation of vascular endothelial cells and the differentiation of PC12 cells. AB - Vascular endothelial cells (ECs) seeded sparsely on extracellular matrix (ECM) will proliferate in the absence of exogenous basic fibroblast growth factor (bFGF). This ECM will also stimulate neurite outgrowth in PC12 cells in the absence of exogenous growth factors. We have previously shown that bFGF is found in subendothelial ECM (Vlodavsky, I., J. Folkman, R. Sullivan, R. Fridman, R. Ishai-Michaeli, J. Sasse, and M. Klagsburn. 1987. Proc. Natl. Acad. Sci. USA. 84:2292-2296) and in basement membranes (Folkman, J., M. Klagsburn, J. Sasse, M. Wadzinski, D. Ingber, and I. Vlodavsky. 1988. Am. J. Pathol. 130:393-400). The actual requirement of ECM-associated bFGF for the growth of ECs and differentiation of PC12 cells was shown in two ways. First, polyclonal anti-bFGF antibodies added to subendothelial ECM inhibited both EC proliferation and PC12 neurite outgrowth. Secondly, PF-HR-9 cells, which do not synthesize bFGF and which produce an ECM not permissive for EC proliferation and PC12 neurite outgrowth, were transfected with bFGF cDNA. PF-HR-9 cells transfected with bFGF, but not with the dominant selectable marker SV2-neomycin, were found to express bFGF and to produce an ECM which did support both EC proliferation and PC12 differentiation. The ECM-mediated stimulatory effects were inhibited by anti-bFGF antibodies but not by anti-nerve growth factor antibodies or nonimmune rabbit IgG. These results indicate that bFGF associated with ECM is a required ECM component for ECM-mediated cell proliferation and differentiation. PMID- 2760117 TI - HPLC studies on the degradation profiles of glucose 5% solutions subjected to heat sterilization in a microprocessor-controlled autoclave. AB - A practically useful relationship between degradation and F0 at various temperatures is given. This may be of value for identifying the most suitable sterilization conditions for a number of glucose products and other pharmaceuticals. It was found that autoclaving at a high temperature to a low final F0 value gave the maximum product integrity. PMID- 2760115 TI - Expression and analysis of COOH-terminal deletions of the human thrombospondin molecule. AB - Thrombospondin (TSP) is a homotrimeric extracellular glycoprotein with a subunit molecular mass of 140 kD. The subunits have a modular or domain-like structure and are held together by interchain disulphide bonds. A number of domains have been identified including those for the binding of collagen, fibrinogen, and heparin. Due to the trimeric form of the TSP molecule, the various domains are trivalent in nature and this contributes to the ability of TSP to mediate cell substrate interactions. Indeed, TSP has recently been shown not only to promote cell adhesion but also to be intimately involved in cell growth and migration. The adhesive function of TSP is attributable to the "solid-phase" or matrix-bound form of the molecule. There is some evidence that the heparin-binding domain mediates incorporation of soluble TSP into the insoluble matrix form. The heparin binding domain of TSP is a compact globular amino-terminal moiety that contains two clusters of basic amino acids and a single intrachain disulphide bond. To delineate the role of the heparin-binding domain in matrix assembly and to define further the precise region of interchain disulphide bonding that results in trimer formation, we have expressed deleted forms of the cDNA encoding TSP in SV 40-transformed. African green monkey kidney cells. The proteins synthesized from the various deleted TSP cDNAs were examined for (a) secretion into the culture medium and incorporation into the extracellular matrix; (b) binding to heparin Sepharose; (c) immunoprecipitability by a conformation-specific monoclonal antibody; and (d) ability to form trimers. This analysis allowed us to draw the following conclusions. (a) A 218 amino acid NH2-terminal protein that preserves the intrachain disulphide bridge of the heparin-binding domain is capable of binding to heparin-Sepharose and incorporating into the extracellular matrix. (b) A shorter 164 amino acid NH2-terminal peptide that does not contain the intrachain disulphide bridge of the heparin-binding domain is neither able to bind to heparin-Sepharose nor able to incorporate into the extracellular matrix. (c) The region of interchain disulphide bridging necessary for trimer assembly resides within a cluster of seven cysteine residues immediately adjacent to the heparin-binding domain. PMID- 2760116 TI - Reappearance of an embryonic pattern of fibronectin splicing during wound healing in the adult rat. AB - The adhesive extracellular matrix glycoprotein fibronectin (FN) is thought to play an important role in the cell migration associated with wound healing. Immunolocalization studies show abundant FN in healing wounds; however, these studies cannot define the cellular site(s) of FN synthesis, nor do they distinguish the different and potentially functionally distinct forms of FN that can arise from alternative splicing of the primary gene transcript. To examine these questions of FN synthesis and splicing during wound healing, we have performed in situ hybridization with segment-specific probes on healing wounds in adult rat skin. We find that the FN gene is expressed at increased levels after wounding both in the cells at the base of the wound and in subjacent muscle and dermis lateral to the wound. Interestingly, however, the pattern of splicing of FN mRNA was different in these areas. In adjacent dermis and muscle, the splicing pattern remains identical with that seen in normal adult rat skin, with two of the three spliced segments (EIIIA and EIIIB) excluded from FN mRNA. In contrast, these two segments are included in the FN mRNA present in the cells at the base of the wound. As a result, the mRNA in this region is spliced in a pattern identical with that found during early embryogenesis. The finding that the pattern of FN splicing during wound healing resembles an embryonic pattern suggests that alternative splicing may be used during wound healing as a mechanism to generate forms of FN that may be functionally more appropriate for the cell migration and proliferation associated with tissue repair. PMID- 2760118 TI - Acetylation phenotyping of isoniazid using a simple and accurate high-performance liquid chromatography. AB - A simple, specific, accurate and reproducible method for the analysis of isoniazid and its major metabolite, N-acetylisoniazid in urine using high performance liquid chromatography (HPLC) is described. The assay is performed after extraction of isoniazid, N-acetylisoniazid and 5-(4-methylphenyl)-5 phenylhydantoin (internal standard) from urine using a mixture of chloroform:isopropanol (70:30, v/v) and eluted from a 5 microns C-18 reversed phase column at ambient temperature with a mobile phase consisting of 10 mM sodium acetate:methanol:acetonitrile (40:40:20, v/v) containing 10 mM dioctylsulphosuccinate sodium and adjusted to pH 2.9 with sulphuric acid (less than 1 ml), at a flow rate of 1 ml/min with u.v. detection at 266 nm. Quantification was achieved by the measurement of the peak height ratio, and the absolute recoveries ranged from 94 to 99%. Within-day coefficients of variation ranged from 2.81 to 4.54% for isoniazid and from 2.37 to 3.75% for N acetylisoniazid. Between-day CVs varied from 3.27 to 5.62% and from 2.5 to 4.91% for isoniazid and N-acetylisoniazid, respectively. Preliminary stability tests using a urine sample from a subject showed an increase in mean isoniazid concentration of about 25% after 1 month storage at -20 degrees C. The method was used for acetylation phenotyping of five individuals. PMID- 2760119 TI - Microbial contamination of cosmetics and personal care items in Egypt--body lotions and talcum powders. AB - We examined a total of 54 samples, including 18 body lotions and 36 talcum powders, for their total aerobic bacterial, coliform and fungal counts. We also carried out anaerobic bacterial counts for talcum powder as well as tests to detect some potentially hazardous bacteria in all tested samples. Talcum powders were more heavily contaminated with bacteria and fungi than body lotions. More than 40% of the tested body lotions contained no viable bacteria or less than 100 c.f.u./g. while all the talcum powders tested contained more than 100 c.f.u./g. Thirty per cent of the talcum powders were contaminated with 10(4) c.f.u./g. and none of the body lotions were contaminated to that extent. No coliforms were recovered from any of the body lotions, while 17% of the talcum powder examined contained coliforms in the range of 230-500 c.f.u./g. Staphylococcus spp. were detected in 18 samples of both talcum powders and body lotions, three of these Staphylococci were of the aureus type. Three samples of talcum powder contained E. coli, two samples contained Enterobacter agglomerans and one sample contained Citrobacter freundii. Seventy per cent of the body lotions showed no fungal counts, while 83% of the talcum powders examined were contaminated with fungi and most of the contaminated talcum powders contained more than 100 fungal cells/g. With regard to the anaerobic bacterial counts for talcum powders, 50% of the samples showed no counts while the other 50% contained less than 100 c.f.u./g. Four samples were contaminated with Clostridium perfringens, although C. tetani was not recovered from any of the samples. PMID- 2760120 TI - Population pharmacokinetic study of gentamicin and a Bayesian approach in patients with renal impairment. AB - A population pharmacokinetic study was conducted on a total of 70 patients receiving gentamicin therapy. The patients included those with normal renal function and those with varying degrees of renal impairment. The parameters studied were the apparent volume of distribution and the plasma clearance of gentamicin. The interindividual variability and the residual variability of those parameters in the different subpopulations were studied according to a statistical model that assumed log normal distribution. Use of the one-way ANOVA test revealed statistically significant differences (P = 0.004) in the population plasma clearance of gentamicin in patients below and above 50 years of age. A linear relationship was established between the plasma clearance of gentamicin and the creatinine clearance in those patients. At the same time, the coefficient of variation of the Clp increased progressively in patients with renal impairment, varying between 28.98% in patients with a ClCR greater than 100 ml/min and 76.53% in patients with a ClCR between 20 and 60 ml/min. The results obtained in the population study were later applied to drug monitoring in 23 patients with varying degrees of renal function and who received gentamicin therapy with different doses. The residual variability of the population allowed us to calculate a weighting factor (FF) between the experimental and the population data using Bayesian fitting. The weighting factor was 0.89 in patients with normal renal function and 0.80 in patients with renal impairment. Statistical comparison of the pharmacokinetic parameters obtained from the populational data, non-linear regression and the Bayesian method using revealed differences in the values for the apparent volume of distribution obtained with the two methods.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2760121 TI - Theophylline pharmacokinetics in patients with bronchopulmonary dysplasia. AB - Theophylline is commonly used to decrease airway resistance in patients with bronchopulmonary dysplasia (BPD). Little is known, however, about theophylline's pharmacokinetics in infants' with BPD. The objectives of this study were: (i) to examine the pharmacokinetics of theophylline; and (ii) to assess the intrapatient variation in theophylline serum concentration in BPD. Nineteen patients (gestational age: 27-33 weeks, postnatal age: 12-165 days) received 2-12 mg/kg/day theophylline. Multiple serum concentrations of theophylline were determined in each patient. Apparent clearance of theophylline ranged from 0.28 to 0.51 ml/min/kg. The steady-state trough serum concentration of theophylline ranged from 3.5 to 11.2 micrograms/ml. Based on our data, theophylline doses of 4 7 mg/kg/day may be required to achieve an average steady-state serum concentration of 10 micrograms/ml. Substantial intrapatient (twofold) variability was observed in theophylline concentrations normalized for dose during therapy. The data indicate that the theophylline serum concentration should be monitored for individualizing therapy in infants with BPD. PMID- 2760122 TI - Serum calcium levels in various lung diseases. AB - Calcium levels were determined in sera of patients suffering from various lung diseases. Healthy volunteers served as controls. Significant differences were found between the serum calcium levels of patients with active lung tuberculosis and those of controls (P less than 0.01). After treatment, serum calcium levels decrease to normal values in these patients. It was also found that there were significant differences in serum calcium levels of patients with primary lung carcinoma (P less than 0.01) and of patients with metastatic lung carcinoma as compared to controls (P less than 0.01). On the other hand, normal serum calcium levels were found in patients with pulmonary diseases with or without an infection. In conclusion, it seems likely that a combination of mechanisms plays a role in the pathogenesis of hypercalcaemia in pulmonary tuberculosis and primary and metastatic lung carcinoma. PMID- 2760123 TI - Commentary. Women and pharmacy--a view from the United States. PMID- 2760124 TI - Playing with pronouns in French maternal speech to prelingual infants. AB - Conventional and displaced uses of pronouns in maternal speech to refer to the baby were investigated in a developmental study of six mother-infant dyads using video-recordings of their free play at three, seven and ten months. These pronominal uses were analysed in a number of semantic contexts to determine how interactive situations influence the use of different types of pronouns. Results show that third- and first-person pronouns occur significantly more often in the semantic context of affect-oriented activities than in the semantic context of goal-directed activities. For second-person pronouns the results are the opposite. The contrast found between these two contexts, i.e. where the child is presented as the agent of a meaningful activity or not, shows how the place constructed for the baby as an interlocutor in maternal speech evolves with age. This study underlines the part the third person plays with its descriptive value in the acquisition of the system of pronouns. PMID- 2760125 TI - The validity of a parent report instrument of child language at twenty months. AB - When carefully assessed and analysed, parent report can provide a valuable overall evaluation of children's language at 20 months. Norming information and validity coefficients are presented here for a vocabulary checklist assessment included in the Early Language Inventory. Normative data are provided for fullterm, preterm, and precocious samples, including selected vocabulatory subsets that are indicative of early language learning style. The vocabulary checklist has substantial validity as indexed by correlations with the Bayley Scales of Infant Development and particularly with a language subscale derived from that test. PMID- 2760126 TI - How to make young children produce cleft sentences. AB - The present study focuses on the effects of contextual demands on the selection of a particular syntactic device, in asking whether French-speaking children from 4 to 10 years old will spontaneously produce it-cleft sentences if there is a functional necessity arising from the context. Taking into account recent studies that have specified the discourse function(s) served by this marked sentence form, it was hypothesized that the cleft formulation would be more likely than its uncleft counterpart whenever the child's intention was to contrast their own belief or knowledge with that of their addressee. The study showed this to be the case when the matter of the disagreement concerned the agent of an action: that situation elicited an overwhelming majority (from 80% to 97%) of cleft constructions, even from the youngest children. On the other hand, when the matter of the disagreement concerned the patient, there were only a few cleft constructions, even with the oldest children; contrastive stress on the object constituent was the predominant device employed for marking information in that situation. The high proportion of clefts in the Agent condition, and the high proportion of stressed object constituents in the Patient condition, both differ from previously reported data. These differences are discussed with reference to differences in task requirements and to differences between the prosodic constraints of French and English. PMID- 2760127 TI - The linguistic marking of agentivity and control in child language. AB - The present study examines the relationship between linguistic forms and the functions they serve in children's early talk about agentivity and control. The spontaneous linguistic productions of six children ranging between 1;8 and 2;8 served as the data base. Preliminary analyses of who the children referred to and what forms were used in subject position suggest that the children could be divided into two groups. Three children primarily referred to Self and relied on multiple Self reference forms in subject position, while the other children referred to both Self and Other and primarily used the Self reference form, I. A functional analysis was carried out to examine whether the seemingly interchangeable use of Self reference forms could be related to semantic and pragmatic patterns. The findings indicate that at a time before they regularly refer to others, the children systematically employed different Self reference forms to mark distinct perspectives on agency. PMID- 2760128 TI - The acquisition of polysynthesis. AB - Polysynthetic languages can present special extraction puzzles to children, due to the length of their words. A number of hypotheses concerning children's strategies for acquiring morphology, originally proposed on the basis of their approaches to somewhat simpler systems, are confirmed by observations of five children acquiring Mohawk. Among the Mohawk children, the earliest segmentation of words was phonological rather than morphological: stressed syllables, usually penultimate or antepenultimate, were extracted first. Ultimate syllables were then added, confirming the salience of the ends of words. During this time, distinctions expressed by adults in affixes were either omitted or expressed analytically. Acquisition then moved leftward by syllables. When most utterances were long enough to include pronominal prefixes as well as roots, morphological structure was apparently discovered. It is not surprising that the pronouns should trigger this awareness, since they are frequent, appearing with every verb and most nouns, they are functional, and they are semantically transparent. From this point on, the children acquired affixes primarily according to their utility and semantic transparency rather than their phonological shape or position. PMID- 2760129 TI - The acquisition of agglutinating languages: converging evidence from Tamil. AB - The acquisition of verb inflections in Tamil, an agglutinating language, was investigated in three 2-year-old children. The findings revealed a high percentage use of verb inflections indicating tense, aspect, modality, person, number and gender by all three children. Explanations for this early, almost error-free acquisition are discussed in terms of the facilitating properties of agglutinating languages. PMID- 2760130 TI - Form and function in the acquisition of Korean wh-questions. AB - In this paper the order in which wh-questions are acquired in the production and comprehension of two Korean children, aged 1;8-2;8 and 1;10-2;10, is analysed and compared with the available cross-linguistic data. Consistencies in acquisition order are hypothesized to be based on universals of cognitive development, which constrain the comprehension and production of wh-forms and influence the order in which mothers introduce them, and on functionally based similarities in the input of form/function pairs across children and languages. Discrepancies in acquisition order are attributed to differences in interactive style across caregivers and children, leading to different input frequencies of particular forms and individual children's selection of different forms for use. PMID- 2760131 TI - On children's uses of from, by and with in oblique noun phrases. AB - This study was designed to follow up children's early spontaneous uses of from to mark oblique agents by giving 40 children (aged 2;5-6;1), and 10 adults, grammatical and ungrammatical sentences containing from, with, and by to imitate and to repair. As predicted, children's imitations and repairs showed that (a) 2 year-olds produce from for agents, and with for instruments in imitation; and (b) as children get older, they shift to by for agents in their repairs, and keep from to mark locative sources. These findings support the hypothesis that when children first try to express oblique agents, before acquisition of conventional by, they choose from for this purpose because agents, as instigators of actions, are conceived of as the source of the action and its result. PMID- 2760132 TI - Acquisition of Pig Latin: a case study. AB - A boy's acquisition of Pig Latin was monitored throughout the year preceding first grade. Abilities underlying this game include the identification of words, deletion of the first syllabic onset (i.e. prevocalic consonants) of each word, blending of this onset and the suffix [ei] onto the word's end, and short-term memory for speech units. Performance improved over time as the underlying abilities developed. Meanwhile, various informative errors were made. Throughout most of the study, onsets that were correctly removed from a word's beginning were often added to its end incorrectly; unstressed function words were repeated intact and not transformed; and the first syllabic onset was overlooked when the syllable was unstressed. Because speech games like this one depend upon basic language skills, they can clarify aspects of ordinary language development. PMID- 2760133 TI - Nursery rhymes, phonological skills and reading. AB - Nursery rhymes are an almost universal part of young English-speaking children's lives. We have already established that there are strong links between children's early knowledge of nursery rhymes at 3;3 and their developing phonological skills over the next year and a quarter. Since such skills are known to be related to children's success in learning to read, this result suggests the hypothesis that acquaintance with nursery rhymes might also affect children's reading. We now report longitudinal data from a group of 64 children from the age of 3;4 to 6;3 which support this hypothesis. There is a strong relation between early knowledge of nursery rhymes and success in reading and spelling over the next three years even after differences in social background, I.Q and the children's phonological skills at the start of the project are taken into account. This raises the question of how nursery rhymes have such an effect. Our answer is that knowledge of nursery rhymes enhances children's phonological sensitivity which in turn helps them to learn to read. This paper presents further analyses which support the idea of this path from nursery rhymes to reading. Nursery rhymes are related to the child's subsequent sensitivity to rhyme and phonemes. Moreover the connection between knowledge of nursery rhymes and reading and spelling ability disappears when controls are made for differences in these subsequent phonological skills. PMID- 2760134 TI - Reversed-phase high-performance liquid chromatographic method for the quantification of 5-hydroxymethylfurfural as the major degradation product of glucose in infusion fluids. AB - Analysis of 5-hydroxymethylfurfural (5-HMF) is an important indicator of degradation in glucose infusion fluids. Current pharmacopoeial methods for analysis are insensitive and non-specific. A method is described here, incorporating an internal standard, to give a sensitive, accurate and precise method, suitable for use in the quality control of glucose infusion fluids, and with possible applications for the quantitative determination of 5-HMF in food and drink, bacterial cultures and hydrothermolysed wood. PMID- 2760135 TI - Normal-phase and reversed-phase liquid chromatographic techniques for the determination of dithranol and its degradation products. PMID- 2760136 TI - High-performance liquid chromatography as an alternative to microbiological measurements in the assay of tetracyclines. PMID- 2760137 TI - Separation of intravenous IgG containing albumin by high-performance size exclusion chromatography on TSKgel G3000SWXL. PMID- 2760138 TI - Identification of ADP-ribosylated histones by the combined use of high performance liquid chromatography and electrophoresis. AB - Reversed-phase high-performance liquid chromatography (HPLC) was employed for analysing mono- and oligo(ADP-ribosyl)ated histones. Under the chromatographic conditions described, the ADP-ribosylated histones showed similar retention times to the unmodified histones, although the molecular weight and the charge of the proteins are significantly altered by their modification. The simultaneous elution of unmodified and labelled modified histones was detected by two types of gel electrophoresis and by autoradiography. In addition, the HPLC fractions did not display overlapping ladders of the multiply modified histones, as is commonly seen in one-dimensional electrophoretic analyses of unfractionated material. Hence individual bands could be unambiguously assigned. After in vitro labelling of isolated rat liver nuclei, the following ADP-ribosylated and unmodified histones were identified by HPLC and gel electrophoresis: histone H1(0), four histone H1 subfractions, histone H2A.1, histone H2A.2, oxidized histone H2A.2, histone H2A.X, histone H2A.Z, histone H2B, three histone H3 variants and histone H4. PMID- 2760139 TI - Comparison of manual and exponentially modified gaussian based methods for the determination of the peak heights of selected-ion current profiles acquired in a mass spectral drug assay. PMID- 2760140 TI - Altered retention of derivatives of tele-methylimidazoleacetic acid in acid hydrolyzed samples of brain measured by capillary gas chromatography and mass spectrometry. PMID- 2760141 TI - Direct stereochemical resolution of enantiomeric amides via thin-layer chromatography on a covalently bonded chiral stationary phase. PMID- 2760142 TI - Simultaneous determination of nitrofuran derivatives in various animal substrates by high-performance liquid chromatography. PMID- 2760143 TI - Development of an analytical method for penicillin G in bovine milk by liquid chromatography with ultraviolet-visible detection and confirmation by mass spectrometric detection. AB - A liquid chromatographic (LC) method with ultraviolet-visible photodiode array (UV-VIS PDA) detection was developed to measure penicillin G in bovine milk. A liquid chromatographic-mass spectrometric (LC-MS) procedure was divised to confirm the LC method. The method involved diluting milk with a drug-releasing solvent consisting of acetonitrile-methanol-water and ultrafiltration through a 10,000 dalton cutoff filter. Penicillin G was separated from other components in the ultrafiltrate by ion-paired LC using a reversed-phase microbore column eluted with a 25% acetonitrile solution. The LC method was confirmed by thermospray LC MS. The detection limit for penicillin G determination in milk was estimated to be 10 ppb for LC with UV-VIS PDA and 100 ppb for LC-MS. PMID- 2760144 TI - Micro-method for the determination of roxithromycin in human plasma and urine by high-performance liquid chromatography using electrochemical detection. AB - A simple and sensitive high-performance liquid chromatographic micro-method for the determination of roxithromycin in human plasma and urine is described. A dichloromethane extract of the sample was chromatographed on a C18 reversed-phase column with acetonitrile-83 mM ammonium acetate-methanol (55:23:22, v/v) adjusted to pH 7.5 with acetic acid as the mobile phase. Roxithromycin and the internal standard, erythromycin, were detected by dual coulometric electrodes operated in the oxidative screen mode. The applied cell potential of the screen electrode was set at +0.7 V and the sample electrode at +0.9 V. The intra- and inter-assay coefficients of variation were less than or equal to 7.0%. The detection limit (signal-to-noise ratio = 3) was 0.1 microgram/ml for both plasma and urine. A study of drug stability during sample storage at 4, 20 and 37 degrees C showed no degradation of roxithromycin. The method is convenient for clinical monitoring and pharmacokinetic studies. PMID- 2760145 TI - Determination of the aminoglycoside antibiotics sisomicin and netilmicin in dried blood spots on filter discs, by high-performance liquid chromatography with pre column derivatization and fluorimetric detection. AB - A simple method for the determination of the aminoglycoside antibiotic sisomicin or its 1-N-ethyl derivative, netilmicin in whole blood, using dried blood spots (DBSs) on filter-paper punched discs has been developed. Sisomicin or netilmicin in the DBSs were recovered most effectively in 0.5 M Na2HPO4 using ultrasonication. The eluates from the DBSs were treated by ultrafiltration for deproteinization and subjected to pre-column fluorescent derivatization using o phthalaldehyde and beta-mercaptopropionic acid in 0.05 M KH2PO4-borate buffer (pH 9.0), followed by determination by reversed-phase high-performance liquid chromatography. The detection limits of sisomicin and netilmicin in the DBSs on punched discs (10.1 microliters of whole blood) were 0.053 and 0.50 micrograms per ml of whole blood, respectively (signal-to-noise ratio greater than or equal to 2). The method permits a simple collection of blood at the microlitre level and should prove particularly useful for monitoring sisomicin and netilmicin in blood at therapeutic levels in geriatric and paediatric patients. PMID- 2760146 TI - Analytical and preparative high-performance liquid chromatographic separation of the enantiomers of ifosfamide, cyclophosphamide and trofosfamide and their determination in plasma. AB - A high-performance liquid chromatography chiral stationary phase (HPLC-CSP) based upon cellulose-tris(3,5-dimethylphenylcarbamate), the OD-CSP, was used to stereochemically resolve three racemic anticancer drugs: ifosfamide (IFF), cyclophosphamide (CTX) and trofosfamide (TFF). The observed enantioselectivities (alpha) were 1.45 (IFF), 1.21 (CTX) and 1.10 (TFF). The OD-CSP was also used on a preparative scale to isolate the enantiomers of IFF with an optical purity greater than 97%. In addition, an analytical assay was developed for the determination of the enantiomeric composition of IFF and CTX in plasma using achiral-chiral coupled column chromatography. A racemic form of another CSP, the D,L-naphthylalanine-CSP, was used as the achiral pre-column. The sample clean-up prior to HPLC analysis was realized by liquid-liquid extraction with chloroform. The correlation coefficient was 0.987 for both standard curves (20-130 micrograms/ml) and the controls were within 10% of the real value. The analysis time for each serum sample was less than 30 min. PMID- 2760147 TI - Automated pre-column high-performance liquid chromatographic method for the investigation of adibendan metabolism. AB - An automated pre-column high-performance liquid chromatographic method has been developed for the isolation of adibendan and metabolites from biological fluids and for their simultaneous quantitative assay. High sensitivities were obtained by the use of a multiple-injection device allowing solid-phase extraction from several successive sample injections with enrichment of metabolite traces on the pre-column. Two metabolites in dog urine were identified as N-oxypyridine (M1) and 2-hydroxypyridine (M2) derivatives of adibendan, while the structure of M3 is still unknown. M1 and M2 are also metabolites in rats, rabbits and humans, and contribute to cardiovascular efficacy. The metabolic profiles were determined in plasma, urine and bile, as a function of dose, route of administration and sex, using radioactivity and ultraviolet detection of the eluates. PMID- 2760148 TI - Simultaneous determination of ranitidine and its metabolites in human plasma and urine by high-performance liquid chromatography. AB - A sensitive high-performance liquid chromatographic method was developed for the simultaneous determination of ranitidine and its metabolites, ranitidine N-oxide, ranitidine S-oxide and desmethylranitidine, in human plasma and urine. For the plasma analysis, 1-ml plasma samples spiked with phenylpyramidol as the internal standard were extracted at basic pH with acetonitrile-ethyl acetate (3:2, v/v). After evaporation and reconstitution, the samples were chromatographed on a cation-exchange column, with a mobile phase of 0.1 M sodium acetate buffer (pH 5) acetonitrile-tetrahydrofuran (56.5:36:7.5, v/v) and ultraviolet detection at 320 nm. The extraction recoveries were 99.8, 30.4, 74.2 and 80.2% and the detection limits were 5, 15, 10 and 4 ng/ml for ranitidine, ranitidine N-oxide, ranitidine S-oxide and desmethylranitidine, respectively. For the urine analysis, a simple deproteinization with an equal volume of acetonitrile was satisfactory for sample preparation. The applicability of this method for the pharmacokinetic study of ranitidine following oral administration was demonstrated. PMID- 2760149 TI - Inhibition of glucose utilization in uremia by hippurate: liquid chromatographic isolation and mass spectrometric and nuclear magnetic resonance spectroscopic identification. PMID- 2760150 TI - Determination of trimetazidine in biological fluids by gas chromatography-mass spectrometry. PMID- 2760151 TI - Determination of low concentrations of dibenzylamine in human plasma and urine by gas chromatography with a nitrogen-phosphorus detector. PMID- 2760152 TI - Radio-gas chromatography on wide-bore capillary columns equipped with a synchronized accumulating radioisotope detector. AB - A gas chromatographic system with wide-bore capillary columns and synchronized accumulating radioisotope detector (SARD) was developed. A direct injection method and constant-flow regulation were applied. The performance of wide-bore capillary columns was good and the correspondence of the resolution obtained with SARD and that with mass detection was excellent. It was proved that the apparatus could detect of the order of 1 pg of 3H-labelled substances (3.7 TBq/mmol) and compete in terms of sensitivity with gas chromatography-mass spectrometry. PMID- 2760153 TI - Sensitive high-performance liquid chromatographic determination of amiloride in human plasma by direct injection with pre-column enrichment. PMID- 2760154 TI - High-performance liquid chromatographic determination of m bis(chloroethyl)aminophenyl-L-alanine in plasma. PMID- 2760155 TI - Automated column liquid chromatographic determination of probucol in human serum and lipoprotein fractions. PMID- 2760156 TI - Assay for cloxacillin in human serum utilising high-performance liquid chromatography with ultraviolet detection. PMID- 2760157 TI - Application of analytical isotachophoresis in the study of platelet membrane proteins in patients with chronic myeloproliferative disorders. AB - The supernatants of dispase-treated platelets from normal persons and patients with myeloproliferative disorders were analysed by capillary isotachophoresis. The examined myeloproliferative disorders were three cases of chronic myelogeneous leukemia, one case of chronic neutrophilic leukemia, one case of essential thrombocythemia and one case of polycythemia vera. An additional peak was revealed in the samples from the patients with chronic myelogeneous leukemia. Platelets from the other three patients showed no additional bands. Isotachophoresis will be useful not only to analyse the superficial peptide on the cell membrane but also to define the peptide associated with malignant transformation. PMID- 2760158 TI - Determination of 3,4-methylenedioxyamphetamine and 3,4 methylenedioxymethamphetamine enantiomers in whole blood. AB - A method for the determination of the enantiomeric content of 3,4 methylenedioxyamphetamine (MDA) and 3,4-methylenedioxymethamphetamine (MDMA) in microsamples (200 microliters) of whole blood is described. The method involves liquid-liquid extraction of MDA and MDMA from blood and derivatization with the chiral reagent N-trifluoroacetyl-L-prolyl chloride. Separation, identification and quantitation of diastereomeric derivatives is by gas chromatography-mass spectrometry. The analytical range of the assay is from 0.12 ng to 48 ng injected on-column. Details for the synthesis of the enantiomers of MDMA are also provided. PMID- 2760159 TI - Determination of the GABAergic antidepressant drug fengabine and some of its metabolites in plasma by capillary gas chromatography with electron-capture detection. AB - A sensitive capillary gas chromatographic method was developed for the determination of fengabine (a GABAergic antidepressant drug) and some of its metabolites in plasma samples. The method involves a single and rapid liquid liquid extraction of the parent drug and metabolites from plasma buffered at pH 5, evaporation of the organic phase under nitrogen, derivatization to tert. butyldimethylsilyl ethers and esters and automatic gas chromatography on a fused silica, silicone-bonded capillary column coupled to an electron-capture detector. The detection limit for fengabine and other compounds is lower than 1 ng/ml in plasma; the method was successfully applied to pharmacokinetic and drug monitoring clinical studies and tested on more than 2000 biological samples and was found not to suffer from endogenous or exogenous interferences. PMID- 2760160 TI - Analysis of biogenic amines in the brain of the American cockroach (Periplaneta americana) by gas chromatography-negative ion chemical ionisation mass spectrometry. AB - Biogenic amines in the brain of the American cockroach have been identified and quantified by an extraction-derivatisation procedure involving their reaction with ditrifluoromethylbenzoyl chloride (DTFMB) in the aqueous phase followed by extraction into an organic solvent, hydrolysis of phenolic esters and conversion of free hydroxyl groups to trimethylsilyl (TMS) ethers and subsequent analysis by gas chromatography-negative ion chemical ionisation mass spectrometry. The molecular ion of these DTFMB-TMS derivatives carried most of the ion current which made the method highly specific and gave a potential limit of detection below the picogram level. This method establishes unequivocally that the principal amines in cockroach brain are tyramine, p-octopamine, dopamine, 5 hydroxytryptamine and noradrenaline. In contrast to mammalian nervous tissue, the other positional isomers of octopamine, together with the isomeric synephrines, are absent. PMID- 2760161 TI - Determination of inositol phosphates and other anions in rat brain. AB - Anion chromatography methods have been developed to determine the concentrations of inositol phosphates and other water-soluble metabolites in rat brain. The cerebral cortex, hippocampus, and striatum were analyzed by chemically suppressed conductivity detection. Animals were sacrificed by directed microwave irradiation for more accurate estimations of in vivo concentrations. The effects of different sample preparation methods are compared. Trichloroacetic acid, formic acid, and perchloric acid extraction result in lower recoveries of phosphocreatine and other anions than does homogenization with water followed by chloroform-methanol extraction. The effects of postdecapitative ischemia on metabolite concentrations are determined. These methods will be used to study the effects of pharmacological agents on inositol phosphates and should be broadly applicable to the analysis of a variety of biological systems. PMID- 2760162 TI - Quantitation of serological cross-reactivity between two geographical isolates of Oryctes baculovirus by a modified ELISA. AB - An assay was developed for quantitation of the antigenic relationship between viruses, by modification of the indirect ELISA. The principle of this method is to estimate the epitopes not shared between the related viruses, after titration of the antibodies specific to the common epitopes as in a blocking ELISA. In practice, varying concentrations of purified virus are preincubated with a fixed dilution of heterologous or homologous antiserum and the unbound antibodies present in the mixture are back titrated with virus particles bound to microtitre plates. The antigenic relationship is described in terms of differentiation index (DI) and total antigenic reactivity (TAR). This method has been used to quantitate cross-reactivity between two geographically different isolates of Oryctes baculovirus. PMID- 2760163 TI - Assessment of signs of influenza illness in the ferret model. AB - The ferret model of influenza A infection was evaluated to determine whether physical signs of influenza illness in addition to fever could be adequately followed. Ferrets were evaluated for nasal and systemic signs of influenza infection in a blinded, randomized protocol. Nasal signs were scored depending on the degree of nasal discharge and congestion. Systemic signs were evaluated on the basis of the activity level of ferrets. Nasal and systemic signs in ferrets challenged with influenza began to rise at peak virus shedding. This rise was coincident with the onset of the nasal inflammatory cell response. Nasal and systemic signs were statistically higher in challenged ferrets as compared with controls from 28 to 52 h after infection [P = 0.002 except at 28 h (P = 0.01)]. Despite precautions against influenza transmission, controls shed influenza virus associated with mild increases in nasal and systemic signs late in the course of the study. Our results suggest that severity of influenza illness can be adequately assessed in the ferret model using collective measurements of nasal and systemic signs, temperatures, and nasal cellular infiltration. PMID- 2760164 TI - Rapid isolation of double stranded RNA segments from disulphide crosslinked polyacrylamide gels. AB - A simple method was developed to isolate dsRNA segments from disulphide crosslinked polyacrylamide gels. The dsRNA preparations from the P4 killer virus strain 77 of Ustilago maydis containing 7 genomic segments with molecular sizes ranging from 0.36 to 6.7 kbp, the 20 kbp dsRNA associated with the '447' cytoplasmic male sterility in Vicia faba and the 23 kbp genomic dsRNA of citrus tristeza virus (CTV) were separated on disulphide crosslinked polyacrylamide gels. After UV visualisation, the dsRNA bands were excised from the gel and dissolved using 2-mercaptoethanol. The dsRNA were then purified from the solubilized fractions by specific adsorption on microgranular cellulose and elution with a small volume of water. The method is rapid, simple and convenient for the isolation of all the tested dsRNAs segments. PMID- 2760165 TI - Detection of the bunyavirus Germiston in VERO and Aedes albopictus C6/36 cells by in situ hybridization using cDNA and asymmetric RNA probes. AB - Using Germiston virus infected vertebrate (VERO) and invertebrate (Aedes albopictus C6/36) cells, paraformaldehyde-glutaraldehyde fixative allowed the best preservation of cellular morphology and the highest hybridization signals with cDNA and asymmetric RNA probes against the viral S segment. Asymmetric RNA probes always gave higher sensitivity and better specificity of in situ hybridization than the nick-translated symmetric DNA probe in both vertebrate and invertebrate cells. The study of Aedes albopictus C6/36 cells persistently infected with Germiston virus showed that only a small number of cells contained the S segment, and that the replication and transcription of the S segment took place in the cytoplasm of acutely and persistently infected cells. PMID- 2760166 TI - Replication of measles virus in the human plasma cell leukemia-derived LICR-LON HMy2 cell line. AB - Measles virus is usually grown in human or monkey fibroblast cells. We now show that LICR-LON-HMy2 (LL2) cells, a human plasma cell leukemia-derived line which grows in suspension culture, will permissively support replication of measles virus to an extent achievable with Vero cells. Sodium dodecyl sulphate polyacrylamide gel electrophoresis of measles virions produced by LL2 cells showed a polypeptide pattern typical of measles virus. As well, measles virus infected LL2 cells, like infected Vero cells, were found to secrete large amounts of virus hemagglutinin, but not other virus proteins. We thus conclude that LL2 cells can be effectively used to produce milligram amounts of measles virus and that virus-clarified culture medium from measles virus-infected LL2 cells is a potential source for purifying virus hemagglutinin. PMID- 2760167 TI - Resistance to bromocriptine in prolactinomas. AB - Bromocriptine therapy normalizes PRL secretion in most, but not all, patients with prolactinomas. This study was undertaken to determine the mechanism(s) responsible for bromocriptine resistance in patients with a PRL-secreting macroadenomas (n = 5) or microadenomas (n = 3). Their mean basal plasma PRL value was 807 +/- 220 (+/- SE) micrograms/L before treatment, and their nadir mean value was 354 +/- 129 micrograms/L during chronic therapy with 15-30 mg bromocriptine daily; four of the eight patients had an increase in tumor size during therapy. In cultures of prolactinoma cells from patients normally responsive to bromocriptine therapy (n = 10), considered as controls, 10(-9) mol/L bromocriptine inhibited PRL release by 71 +/- 6% (+/- SE), and the half inhibitory dose was 7 x 10(-11) mol/L. In contrast, in cultures of prolactinoma cells from five patients resistant to bromocriptine, PRL release was inhibited by only 3-42% at 10(-9) mol/L bromocriptine. This partial inhibition was reversed by a 100-fold excess of haloperidol. In contrast, the effects of other inhibitors of PRL release (10(-8) mol/L T3 and 10(-8) mol/L somatostatin) or of a stimulator (10(-8) mol/L angiotensin-II) on cells from resistant and normally responsive patients were similar. In cell membranes from five bromocriptine-responsive adenomas the density of dopaminergic binding sites, labeled by [3H] spiroperidol was 243 +/- 65 (+/- SE) fmol/mg protein. In adenomas from the eight patients resistant to bromocriptine therapy the density of [3H]spiroperidol-binding sites lower (145 +/- 31 fmol/mg protein). In adenomas from five resistant patients whose tumor had grown during therapy the density of binding sites was 25 +/- 3 fmol/mg protein, 10% of that in normally responsive patients. The effects of dopamine on adenylate cyclase activity also were different in the three groups of adenomas. Dopamine inhibited adenylate cyclase activity by 28.8 +/- 5.6% in five bromocriptine-responsive tumors and by 16.5 +/- 4.3% in adenomas from eight resistant patients. In contrast, in the five patients whose tumors grew during therapy dopamine paradoxically stimulated adenylate cyclase activity (+26.4 +/- 9.8%). There was a very good correlation between the density of dopaminergic binding sites and maximal inhibition of adenylate cyclase activity in bromocriptine-responsive prolactinoma patients (r = 0.90) and resistant patients who had no tumor growth during therapy (r = 0.94).(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2760168 TI - Pulsatile secretion of chorionic gonadotropin during the normal menstrual cycle. AB - Several groups of investigators have previously reported that small amounts of hCG are present in blood and urine of nonpregnant eugonadal women and men. We have developed highly sensitive and specific, two-monoclonal antibody, sandwich type assays which can quantify both hCG and LH in sera from postmenopausal women, women at all phases of the menstrual cycle, and men. Using these assays we have also reported that hCG is secreted in a pulsatile fashion in postmenopausal women, is stimulated by GnRH in both men and postmenopausal women, and is suppressed by a GnRH agonist in castrate men. Employing these same sandwich assays, we report herein that hCG is secreted in a pulsatile manner during the follicular and luteal phases of the normal menstrual cycle. During the follicular phase 0.68 +/- 09 (+/- SEM) pulses of hCG occurred each hour, while 0.62 +/- 0.08 pulses of LH occurred. Pulse durations during the follicular phase for hCG and LH, respectively, were 38.3 +/- 4.4 and 62.5 +/- 11.1 min (P less than or equal to 0.05). During the luteal phase there were 0.42 +/- 0.16 pulses/h of hCG and 0.38 +/- 0.08 pulses of LH (P greater than 0.05). Pulse durations were 22.3 +/- 7.5 and 126.4 +/- 19.0 min for hCG and LH, respectively (P less than 0.01). The t1/2 of hCG disappearance was 37.2 +/- 3.8 min during the follicular phase and 22.9 +/- 4.6 min during the luteal phase. The t1/2 values of LH were 82.9 +/- 5.7 and 67.5 +/- 5.12 min during follicular and luteal phases, respectively. The t1/2 of LH was greater than the t1/2 of hCG (P less than 0.01). We conclude that small amounts of hCG are secreted in a pulsatile manner during follicular and luteal phases of the human menstrual cycle. PMID- 2760169 TI - Serum triiodothyronine sulfate in man measured by radioimmunoassay. AB - In humans deiodination and perhaps glucuronidation are important pathways of thyroid hormone metabolism. In animals, sulfation plays an important role in T4 and especially in T3 metabolism, but little is known about sulfate conjugation of thyroid hormone in humans. In this study we used a specific T3 sulfate (T3S) RIA to address this question. Eight normal subjects were given oral T3 (1 microgram/day.kg BW) for 7 weeks. During the fifth week they also received propylthiouracil (PTU; four doses of 250 mg/day) for 2 days and during the seventh week iopanoic acid (IOP; 1 g/day) for 3 days. The mean pre-T3 serum iodothyronine values were: T4, 92 +/- 6 (+/- SE) nmol/L; rT3, 0.24 +/- 0.02 nmol/L; T3, 2.30 +/- 0.10 nmol/L; and T3S, less than 0.1 nmol/L (at or below the detection limit of the RIA). After 4 weeks of T3 administration the mean serum values were: T4, 39 +/- 6; rT3, 0.11 +/- 0.01; T3, 5.31 +/- 0.39; and T3S, 0.10 +/- 0.01 nmol/L. After 2 days of PTU administration, mean serum T4 increased to 48 +/- 7 (P less than 0.005), rT3 to 0.20 +/- 0.03 (P less than 0.025), and T3S to 0.13 +/- 0.01 nmol/L (P = NS), but serum T3 did not change (4.91 +/- 0.35 nmol/L). The effect of IOP was more pronounced; after its administration for 3 days the mean serum T4 was 49 +/- 8 (P less than 0.001), rT3 was 0.48 +/- 0.09 (P less than 0.005), and T3S was 0.29 +/- 0.04 nmol/L (P less than 0.005), and serum T3 decreased to 3.95 +/- 0.25 nmol/L (P less than 0.005). The T3S/T3 ratio was increased by PTU from 0.018 +/- 0.003 to 0.024 +/- 0.004 (P less than = NS) and by IOP to 0.055 +/- 0.007 (P less than 0.005). In conclusion, 1) serum T3S is virtually undetectable (less than 0.1 nmol/L) in normal subjects; 2) low serum T3S concentrations are detected in humans given T3; 3) serum T3S in T3-treated subjects is increased by inhibition of type I deiodinase activity with PTU and especially IOP; and 4) in comparison with previous estimates of the serum T3S/T3 ratio in rats, the low ratio in humans may indicate that sulfation is not an important mechanism of T3 metabolism in humans and/or the kinetics of plasma T3 and T3S differ in humans and rats. PMID- 2760170 TI - Postprandial gallbladder motility during long term treatment with the long-acting somatostatin analog SMS 201-995 in acromegaly. AB - The effects on gallbladder motility of long term treatment with the somatostatin analog SMS 201-995 (SMS) were studied in five patients with acromegaly treated for 6-32 months with 200-300 micrograms SMS daily. SMS (100 micrograms) or placebo was injected sc 45 min before a standard breakfast. Gallbladder volume (ultrasonography), plasma cholecystokinin (CCK), and pancreatic polypeptide (PP) were measured until 120 min after the meal. SMS completely suppressed the postprandial gallbladder contraction, despite a blunted, though still statistically significant, increase in plasma CCK from 1.6 +/- 0.2 pmol/L to an average of 3.7 +/- 1.7 pmol/L (P less than 0.01). The postprandial plasma PP peak after placebo was replaced by a slight but statistically significant decrease after SMS (P less than 0.05). A statistically significant correlation between the plasma CCK values and corresponding gallbladder volumes was seen only after placebo injection, not in the SMS study. We conclude that during long term treatment of acromegalics with SMS, an injection of 100 micrograms, sc, completely abolishes gallbladder contraction for at least 2 h after a standard breakfast, despite blunted, but still significant, CCK release. The data suggest a decreased sensitivity of the gallbladder to endogenous CCK during long term treatment with SMS. Careful control of patients with respect to the formation of gallstones is recommended. PMID- 2760171 TI - Alterations in the pulsatile properties of circulating growth hormone concentrations during puberty in boys. AB - To investigate the mechanisms subserving physiological alterations in circulating GH concentrations during puberty, we assessed the GH pulse characteristics of 60 24-h serum GH profiles obtained from healthy male volunteers of normal stature (aged 7-27 yr) whose physical development spanned the entire pubertal range. Subjects were divided into five study groups based on degree of sexual maturation. The mean 24-h concentration of GH was greater in late pubertal boys than in all other groups (P less than 0.001). This elevation primarily reflected a greater size, rather than number, of GH pulses, whether assessed as mean GH pulse area (P = 0.004 vs. all other groups), mean GH pulse amplitude (P = 0.001), or sum of the GH pulse areas (P less than 0.001). GH pulse frequency was indistinguishable among all groups (P greater than 0.05). However, circadian GH rhythms varied significantly in amplitude and mean values (but not in phase) throughout puberty. Plasma insulin-like growth factor-I levels were greatest in the late pubertal boys (1.98 +/- 0.15 U/mL) and remained elevated in the postpubertal group (1.44 +/- 0.18). The mean value for the adult men (0.74 +/- 0.06) was indistinguishable from that of prepubertal boys (0.90 +/- 0.13). In addition, all assessed characteristics of GH pulses and circadian rhythms in adults were equal to or less than corresponding values in prepubertal boys. We conclude that circulating GH concentrations transiently increase during mid- to late puberty in normal boys, primarily through augmentation of the size of GH pulses, but return to or below prepubertal levels during early adulthood. PMID- 2760172 TI - Hysteresis in the relationship between serum ionized calcium and intact parathyroid hormone during recovery from induced hyper- and hypocalcemia in normal humans. AB - We have used an immunoradiometric assay for intact PTH in conjunction with calcium and citrate infusions to study whether levels of intact PTH are responsive to reversal of the direction of change in ionized calcium in normal humans. Eleven normal subjects received graded infusions of citrate or calcium on separate days to produce linear rates of decrease or increase in calcium. After discontinuation of the infusions, the return of calcium toward baseline was followed. Six subjects were given an infusion of citrate after the calcium infusion to speed the recovery of calcium toward baseline. Citrate-induced hypocalcemia produced a rise in serum PTH levels from 28.1 +/- 3.6 to 69.4 +/- 4.8 ng/L as calcium fell from 1.26 +/- 0.01 to 1.06 +/- 0.02 mmol/L. As calcium returned toward baseline, PTH levels fell dramatically, reaching levels indistinguishable from baseline despite persistent hypocalcemia. Slopes of regression lines defining the PTH-calcium relationships during decreasing and increasing calcium levels were significantly different. Those subjects receiving a calcium infusion alone showed a prompt suppression of PTH levels. As calcium returned toward baseline after the infusion, a modest decline in calcium produced no significant change in the PTH-calcium relationship. When citrate was used to return calcium to baseline, PTH levels rose from 7.8 +/- 2.0 to 55.0 +/- 6.8 ng/L as calcium fell from 1.42 +/- 0.02 to 1.26 +/- 0.02 mmol/L and defined a regression relationship significantly different from the period of increasing calcium. Thus, a hysteretic relationship between ionized calcium and levels of intact PTH can be induced in normal humans by reversing the direction of change in calcium. Therefore, the role played by calcium concentration per se in controlling PTH secretion may be part of more complex and dynamic regulatory mechanisms. PMID- 2760173 TI - Presence of antibodies in the sera of patients with Graves' disease recognizing a 23 kilodalton fibroblast protein. AB - We examined whether antibodies (present in sera from patients with Graves' disease) might be directed against a connective tissue cellular component of the anatomical regions affected in the peripheral manifestations of that disease. Accordingly, we performed immunoblot analyses of cultured retroocular and pretibial fibroblasts. Retroocular connective tissue was obtained during orbital decompression surgery (n = 7) and at autopsy from normal individuals (n = 2). Pretibial skin biopsies were obtained from patients with pretibial dermopathy (n = 3) and at autopsy (n = 2). In addition, biopsies from other regions [extraocular muscle (n = 6), thyroid (n = 2), and abdominal skin (n = 3)] were also collected at surgery or autopsy. Serum samples were obtained from patients with severe Graves' ophthalmopathy (n = 31), hyperthyroid Graves' disease without overt ophthalmopathy (n = 13), nodular thyroid disease (n = 7), Hashimoto's thyroiditis (n = 7), rheumatoid arthritis (n = 5), and systemic lupus erythematosus (n = 3) and from normal individuals (n = 33). Electrophoresed fibroblast proteins were immunoblotted with 1:100 dilutions of sera using an antihuman immunoglobulin G-alkaline phosphatase conjugate. Antibodies against a 23kDa fibroblast protein were present in the sera from 24 of 44 (56%) of patients with Graves' disease with or without ophthalmopathy, 0 of 7 nodular thyroid disease, 0 of 7 Hashimoto's thyroiditis, 0 of 5 rheumatoid arthritis, 0 of 3 systemic lupus erythematosus, and 5 of 33 (15%) normal subjects. Significant differences in the observed frequency of antibodies existed between the Graves' disease group and the normal control group (P less than 0.01) or those patients with the other conditions (P less than 0.01). This 23kDa antigen was apparent in fibroblasts derived from individuals with Graves' disease as well as normal individuals and was present in fibroblasts from all anatomical sites studied. It was the sole protein uniquely recognized by sera from patients with Graves' disease. However, this serum reactivity did not appear to be related to the presence of clinically overt ophthalmopathy or pretibial dermopathy. Subcellular localization studies disclosed that the antigen was present in the supernatant but not the pellet resulting from a 100,000 x g centrifugation of whole cell sonicates. Antibodies against a 23kDa fibroblast protein are present in the majority of sera from patients with Graves' disease and rarely in sera from either normal individuals or those with other thyroid disorders or autoimmune diseases. Our results suggest the possibility that antibodies directed against this fibroblast antigen may be related to the developm PMID- 2760174 TI - Concurrent aortic and mitral valve echocardiography permits measurement of systolic time intervals as an index of peripheral tissue thyroid functional status. AB - Systolic time intervals (STI) were measured directly from concurrent aortic and mitral valve echocardiographic tracings in 127 subjects to assess their utility as an index of peripheral tissue thyroid functional status. The subjects were categorized according to clinical symptoms and the results of thyroid function tests into the following 7 study groups: normal subjects (n = 34), overt hyperthyroid subgroup I (n = 12), overt hyperthyroid subgroup II (n = 28), subclinical hyperthyroid (n = 15), subclinical hypothyroid (n = 22), overt hypothyroid subgroup II (n = 6), and overt hypothyroidism subgroup I (n = 10). Compared with normal subjects, overt hyperthyroid subgroup I patients had a significantly shortened mean isovolumetric contraction time (ICT), preejection period (PEP), and PEP/LVET (LVET = left ventricular ejection time; P less than or equal to 0.0005); the overt hypothyroid subgroup I patients also had significantly lengthened mean ICT (P less than or equal to 0.005), PEP, and PEP/LVET (P less than or equal to 0.0005). Compared with normal subjects, overt hyperthyroidism subgroup II patients also had a very significant shortening of ICT (P less than 0.0005) as well as a significantly shortened PEP and PEP/LVET (P less than or equal to 0.005), whereas subclinical hyperthyroid patients (with normal serum free T4 index and total T3, and suppressed TSH by immunoradiometric assay) also had ICT, PEP, and PEP/LVET STI values which were significantly shortened (P less than 0.05) values. Compared to normal subjects, the overt hypothyroid subgroup II patients (who were clinically asymptomatic with reduced serum free T4 index and elevated TSH) had a prolongation of ICT, PEP, and PEP/LVET (P less than or equal to 0.05), whereas the values in subclinical hypothyroid patients were similar to those in normal subjects. From these observations we conclude that in the absence of underlying heart disease, the echocardiographic method used is a rapid, reliable, and sensitive technique for determining STI and provides direct information on peripheral tissue thyroid functional status. PMID- 2760175 TI - The short term secretion pattern of human serum melatonin indicates apulsatile hormone release. AB - It is well known that many hormones are secreted in a pulsatile fashion. Changes in pulse frequency and/or amplitude can have severe physiological and pathological consequences. Attempts to assess the short term secretion pattern of the pineal hormone melatonin (MLT) provided inconsistent results. The development of objective statistic- and computer-based pulse detection programs and the advent of more precise and specific MLT assay systems during recent years prompted us to reexamine the short term secretion of the pineal hormone. We investigated 16 healthy volunteers (8 males and 8 females), aged 28.1 +/- 6.7 yr (mean +/- SD). Five-milliliter blood specimens were collected at 10-min intervals from 1900-0900 h (n = 8), 3-min intervals from 2300-0300 h (n = 4), 10-min intervals from 0800-2200 h (n = 2), and 3-min intervals from 1100-1500 (n = 2). The serum MLT concentration in each specimen was measured with a previously described RIA. The sensitivity of the assay varied between 3.0-7.5 pg (0.013 0.033 pmol) MLT/tube. The intrassay variance was assessed on 10 serum pools to which varying amounts of MLT had been added, covering the entire range of the standard curve; the coefficient of variance varied between 16.6-6.1%. The sequence of MLT levels in each subject was examined for the existence of pulses by visual inspection and by the computer programs Pulsar and Cluster. Apart from the circadian rhythm, the three methods did not reveal clear pulses but, rather, continuous release of the pineal hormone during the day and night. We conclude that the pineal hormone MLT is, in contrast to many other hormones, secreted in an apulsatile manner. Very frequent blood sampling may be unnecessary for full characterization of the secretion pattern without loss of information. In addition to the circadian pacemaker, the pineal does not appear to be under the control of the proposed hypothalamic or an intrinsic pulse generator. PMID- 2760176 TI - Measurement of thyrotropin in clinical and subclinical hyperthyroidism using a new chemiluminescent assay. AB - A new commercially available chemiluminescent TSH assay demonstrates an 8- to 10 fold increase in sensitivity over a sensitive immunoradiometric assay, allowing increased ability to distinguish partial from more complete thyrotroph suppression. Sera were analyzed from 145 patients who had TSH concentrations below 0.08 mU/L in the immunoradiometric assay. Most patients with overt hyperthyroidism had undetectable TSH concentrations in the chemiluminescent assay. Three groups of patients were identified, in which a large subgroup had undetectable values in the immunoradiometric assay and detectable values in the chemiluminescent assay (12 of 17 patients under treatment for hyperthyroidism who had recently normalized their serum thyroid hormone levels, 33 of 68 patients taking L-T4, and 4 of 8 patients with endogenous subclinical hyperthyroidism). In addition, several patients with undetectable basal and detectable TRH-stimulated TSH values in the immunoradiometric assay had detectable basal TSH values in the chemiluminescent assay. The utility of first generation TSH immunometric assays was their ability to distinguish hyperthyroidism from euthyroidism. The clinical utility of increasingly sensitive TSH assays will be to distinguish degrees of thyrotroph suppression in subclinical hyperthyroidism. PMID- 2760177 TI - Patterns of performance on the Fuld Object Memory Evaluation in elderly inpatients with depression or dementia. AB - The Fuld Object Memory Evaluation (Fuld, 1981) was administered to 80 elderly adults (aged 60 to 90 years) who were hospitalized for evaluation and treatment of primary degenerative dementia (PDD), other organic disorders (e.g., Parkinson's disease or multi-infarct dementia), or major depression. Although mean performance in each of the diagnostic groups was below normative levels reported by Fuld (1981), PDD patients performed significantly more poorly than those with depression or other organic disorders. Analysis of subscore patterns failed to support the hypothesis of a selective memory deficit in depression, and substantial overlap in scores was observed between the depressed group and patients with organic disorders other than PDD. Object Memory Evaluation performance was influenced by global mental status and secondary psychiatric diagnoses, but not by education, age, or physical health. PMID- 2760178 TI - WAIS-R test-retest reliability in a normal elderly sample. AB - We examined the 1-year test-retest reliability of WAIS-R Verbal, Performance, and Full-Scale IQs in a sample of 101 older normal individuals (mean age = 67.1). The respective Pearson rs were .86, .85, and .90. The median retest reliability coefficient for the WAIS-R subtests was .71. The test-retest reliability for the Verbal-Performance Discrepancy was .69. These data indicate that IQ scores are reliable in older normal individuals for this retest interval, but less confidence can be placed in the reliability of subtest scores and the Verbal Performance Discrepancy. PMID- 2760179 TI - Recognition memory span in mildly and moderately demented patients with Alzheimer's disease. AB - An abbreviated form of Moss et al.'s (1986) Recognition Span Test (RST) was administered to patients with mild or moderate dementia of the Alzheimer type (DAT) and to intact control (NC) subjects. Memory spans for verbal (i.e., words), spatial and configurational (i.e., faces) information were assessed. Delayed recall (15 s and 2 min) of the words used on the verbal recognition span was also determined. The results showed that both DAT patient groups were impaired on the three recognition tasks and that the spatial and verbal forms differentiated the mildly from the moderately demented patients. The mean overall recognition span scores (spatial + verbal + facial) differentiated between DAT patients and intact controls, with 37 of the 39 patients falling beyond the 95% confidence limits derived from the control subjects' scores. On verbal recall, both the mildly and moderately demented patients were severely impaired and evidenced a very rapid rate of forgetting between the 15-s and 2-min recall attempts. These findings suggest that the RST is not only highly sensitive to memory disorders in the early stages of DAT but also effective in discriminating among various stages of this disorder. PMID- 2760180 TI - Visual Continuous Recognition Memory in normal and closed-head-injured adolescents. AB - The Continuous Recognition Memory Test was administered to 46 normal adolescents and 91 closed-head-injured adolescents. Performance on the test varied significantly with severity of injury as measured by the Glasgow Coma Scale score and duration of impaired consciousness. The performance of adolescents with diffuse injury, right, left, or bilateral mass lesions did not differ significantly. The efficacy of the test for use with head-injured adolescents is demonstrated. PMID- 2760181 TI - Neuropsychological improvement versus practice effect following unilateral carotid endarterectomy in patients without stroke. AB - Patients who were admitted to hospital for a recent transient ischemic attack were entered into one of three groups based on medical and surgical characteristics; those with an abnormal neurological examination or a focal abnormality on CT Scan were omitted from the study. The two surgical groups (12 patients each) underwent either a left or right endarterectomy for a symptomatic atheroma of the ipsilateral carotid artery. The control group consisted of 12 patients who either demonstrated minor or nonexistent carotid abnormalities or a TIA distribution that was contralateral to what would otherwise have been a surgically treatable lesion. Patients were tested before surgery and again 6-8 weeks later with the WAIS, WMS, and other neuropsychological measures. Significant improvement on some measures at follow-up was strictly equivalent across all groups and was attributed to practice effects. PMID- 2760182 TI - Information processing speed in patients with multiple sclerosis. AB - We have recently proposed that the cognitive deficits of patients with multiple sclerosis (MS) share numerous characteristics associated with the syndrome of subcortical dementia. One such characteristic, slowness of mental processing, was evaluated in the present study. Thirty-six MS patients were compared to 26 normal controls of equivalent age, education, and verbal intelligence on the Sternberg memory scanning test. As anticipated, the motor-involved MS patients had an overall slower reaction time than did controls. Their scanning rate, a measure of pure cognitive speed, was also significantly slower than controls. These results suggest that MS patients exhibit a slowing of mental processing independent of motor involvement. PMID- 2760183 TI - A comparison of the WAIS and WAIS-R using T-score conversions that correct for age, education, and sex. AB - A newly developed T score conversion system that corrects Wechsler Adult Intelligence Scale (WAIS) and Wechsler Adult Intelligence Scale-Revised (WAIS-R) subtest and IQ scores for appropriate demographic variables was used to compare subjects' performance on the two versions of the instrument. Using 428 pairs of subjects matched on age, education, and sex, with one person in each pair having taken the WAIS and the other the WAIS-R, we found no significant differences in level or pattern of performance when analyses were performed on the T scores. This was in contrast to highly significant differences when uncorrected scaled scores and IQ values were compared. Therefore, the T score system appears to provide a tool which may help clinicians make more direct comparisons between the results obtained on the WAIS and WAIS-R. PMID- 2760184 TI - Developmental aspects of linguistic and mnestic abilities in normal children. AB - The Peabody Picture Vocabulary Test-Revised (PPVT-R), Boston Naming Test (BNT), Paired Associate Learning of the Wechsler Memory Scale (PAL), and verbal fluency tests were administered to 241 normal children aged 6-12 years. Normative data were compiled for the BNT, PAL, and verbal fluency tests. A Principal Components Factor Analysis with Varimax Rotation was conducted to determine whether the tests evaluated similar or differential functions. Three factors emerged, accounting for 67.7% of the variance: Factor 1 contained loadings from two semantic fluency measures (animals and food), Factor 2 contained the PPVT-R and the BNT, and Factor 3 contained two measures from the PAL (easy and hard associations). In children, the BNT relates more to word knowledge than to retrieval or fluency, and verbal memory appears to be relatively independent of these linguistic functions. PMID- 2760185 TI - Neuropsychological consequences of circulatory arrest with hypothermia--a case report. AB - This case study reports on the neuropsychological consequences of prolonged circulatory arrest with hypothermia and barbiturate "protection". Measurements performed during surgery showed a prolonged absence of EEG. The neuropsychological assessment revealed a remarkable preservation of function, with the exception of delayed verbal memory and performance on the Trial Making Test. The findings are discussed in relation to the safe duration of circulatory arrest and the protection afforded the brain by hypothermia and barbiturate. PMID- 2760186 TI - Selective Reminding Tests: a normative study of verbal learning in adults. AB - Verbal learning was assessed according to the Selective Reminding Test (SRT) in order to establish normative data and to provide a comparison with measures of immediate attention, verbal IQ, and verbal memory. The 392 subjects, stratified by sex (202 women, 190 men), age (4 groups: 16-70 years), and education (3 groups), were free of conflicting pathologies. Learning curves were established on centiles (75, 50, 25, 5). Sex differences favoring women were found in percent of finishers (those who reached criterion), and at all percentile levels of acquisition. Data were analyzed for group differences in performance on the SRT and related concurrent measures, but sex differences were not found on the VIQ or immediate attention tests. Also, assumptions of age and education stratification were not confirmed. However, those who completed the task were better able to form associational strategies than those who were unable to finish. The present data indicate that it is important to use detailed norms by gender and criterion level if clinical interpretations are to be valid. PMID- 2760187 TI - Is Wilson's disease a dementing condition? AB - A case presentation in this journal by Rosselli, Lorenzana, Lasselli and Vergara (1981) has raised the issue of intellectual deterioration in Wilson's Disease. Relevant findings in the recent literature are discussed. PMID- 2760188 TI - A response to Mapou. AB - Mapou (1988) has suggested that detection of brain damage has become an irrelevant task for neuropsychology, and that neuropsychological assessment should be used to generate profiles of cognitive function useful for sophisticated diagnosis and rehabilitation. While agreeing the latter considerations are important and germane, we affirm that the detection of brain damage remains an important task for neuropsychology. This affirmation is based on considerations of the nature of brain damage, the development and validation of neuropsychological tests, the utilization of neuropsychological assessment in current practice and the appropriate professional practice of clinical neuropsychology. PMID- 2760190 TI - Pressure sensitivity of active tension in glycerinated rabbit psoas muscle fibres: effects of ADP and phosphate. AB - The effect of changes in hydrostatic pressure (up to 10 MPa) on the maximally calcium-activated tension in glycerinated rabbit psoas fibres has been examined. The steady active tension was depressed by 0.8% per MPa pressure rise. This pressure sensitivity was enhanced by the pressure of millimolar phosphate and depressed by millimolar ADP. These results support the conclusions that increased pressure is perturbing a crossbridge event. The results are discussed in terms of a three state crossbridge model and are shown to be compatible with a pressure effect on the transition from an attached crossbridge state to a tension bearing state. This is compatible with the effects of pressure on the isolated proteins in solution. PMID- 2760189 TI - Caldesmon and the structure of smooth muscle thin filaments: immunolocalization of caldesmon on thin filaments. AB - Antibodies reacting with chicken gizzard caldesmon were used to determine the distribution of caldesmon on smooth muscle thin filaments. Antibodies developed against both the intact caldesmon molecule and a 40 kilodalton proteolytic fragment cause thin filaments to aggregate laterally. Aggregates produced with the latter antibody display regular periodic labelling with a repeat of approximately 38 nm, a distribution characteristic of proteins associated with tropomyosin on thin filaments. The stoichiometry of caldesmon on thin filaments has been critically reevaluated and alternative models of caldesmon distribution on thin filaments are proposed. PMID- 2760191 TI - The Seventeenth European Conference on Muscle and Motility. Abano Terme (Padova), Italy, 17-19 October 1988. Abstracts. PMID- 2760192 TI - Maximum rate of oxygen consumption and quantitative histochemistry of succinate dehydrogenase in single muscle fibres of Xenopus laevis. AB - Three different types of single living muscle fibre were dissected from the iliofibularis muscle of Xenopus laevis. The fibres were mounted in a glass chamber and their rate of oxygen consumption was determined as a function of twitch frequency at 20 degrees C. The rate of oxygen consumption increased with twitch frequency until it levelled off and reached a maximum. The maximum rate of oxygen consumption varied between fibres (0.019 to 0.161 nmol O2 s-1 mm-3) and was reached at different twitch frequencies (less than 0.2 to 5.7 stimuli s-1). After the determination of the maximum rate of oxygen consumption, the succinate dehydrogenase activity in cross sections of the fibre was determined by means of a quantitative histochemical method. A proportional relationship between the maximum rate of oxygen consumption and the succinate dehydrogenase activity was found. The maximum rate of oxygen consumption and the succinate dehydrogenase activity are also proportional to the volume density of mitochondria in the three fibre types reported by Smith and Ovalle (1973; J. Anat., Lond. 116, 1-24). It is concluded that quantitative histochemistry of succinate dehydrogenase reliably predicts the maximum rate of oxygen consumption of muscle fibres in Xenopus laevis and that the maximum rate of oxygen consumption of single muscle fibres is determined by the volume density of mitochondria. PMID- 2760193 TI - Abstracts of the 1988 annual meeting on muscle and cell motility physiology. Tokyo, November 28-29, 1988. PMID- 2760194 TI - Frequency, intensity, and duration as determinants of P300 from auditory stimuli. AB - The auditory event-related potential was assessed in two experiments that evaluated the effects of stimulus factors on P300 (P3) component amplitude and latency. The first experiment manipulated the frequency of the target stimuli (500, 1,000, 1,500, and 2,000 Hz) and standard stimuli (250 and 4,000 Hz) in different conditions. Both P3 amplitude and latency were affected by the target and standard tone combinations in specific ways. The second experiment varied the target tone intensity and duration factorially. P3 amplitude was unaffected by these variables, but peak latency was significantly shorter for the loudest and longest target stimuli. The findings indicate that variation in auditory stimulus parameters can produce small but reliable effects for P3 values, which should be considered when results are compared across studies. PMID- 2760195 TI - Third annual meeting of the American Academy of Clinical Neurophysiology. July 14 17, 1988, Boston, Massachusetts. Abstracts. PMID- 2760196 TI - Induction of preadipocyte differentiation by mature fat cells in the rat. AB - In this study we investigated the influence of mature adipocytes, derived from rat adipose tissue, on the replication and differentiation of preadipocytes in primary culture. Mature fat did not inhibit preadipocyte replication within the 6 d period studied. Preadipocyte differentiation, as assessed by both cytoplasmic lipid accretion and an increase in glycerophosphate dehydrogenase (GPDH) activity, was significantly stimulated by the presence of mature fat tissue or isolated adipocytes. The proportion of cells containing visible lipid droplets by oil red O staining was 47 +/- 10 to 58 +/- 10% (depending on the site of origin of the preadipocytes) when cocultured with mature fat compared with less than 1 to 2 +/- 1% when cultured in medium alone, while GPDH activity was 344 +/- 9 compared with 43 +/- 3 nM NADH/min per mg protein, respectively. This effect was not due to release of triacylglycerols from damaged adipocytes. Fatty acids added to the medium promoted lipid accumulation but did not stimulate a rise in GPDH activity. We concluded that mature adipocytes may release factor(s) that promote preadipocyte differentiation (and maturation). PMID- 2760197 TI - Hepatobiliary transport of glutathione and glutathione conjugate in rats with hereditary hyperbilirubinemia. AB - TR- mutant rats have an autosomal recessive mutation that is expressed as a severely impaired hepatobiliary secretion of organic anions like bilirubin (di)glucuronide and dibromosulphthalein (DBSP). In this paper, the hepatobiliary transport of glutathione and a glutathione conjugate was studied in normal Wistar rats and TR- rats. It was shown that glutathione is virtually absent from the bile of TR- rats. In the isolated, perfused liver the secretion of glutathione and the glutathione conjugate, dinitrophenyl-glutathione (GS-DNP), from hepatocyte to bile is severely impaired, whereas the sinusoidal secretion from liver to blood is not affected. The secretion of GS-DNP was also studied in isolated hepatocytes. The secretion of GS-DNP from cells isolated from TR- rat liver was significantly slower than from normal hepatocytes. Efflux of GS-DNP was a saturable process with respect to intracellular GS-DNP concentration: Vmax and Km for efflux from TR- cells was 498 nmol/min.g dry wt and 3.3 mM, respectively, as compared with 1514 nmol/min.g dry wt and 0.92 mM in normal hepatocytes. These results suggest that the canalicular transport system for glutathione and glutathione conjugates is severely impaired in TR- rats, whereas sinusoidal efflux is unaffected. Because the defect also comes to expression in isolated hepatocytes, efflux of GS-DNP from normal hepatocytes must predominantly be mediated by the canalicular transport mechanism, which is deficient in TR- rats. PMID- 2760198 TI - Finnish type of low density lipoprotein receptor gene mutation (FH-Helsinki) deletes exons encoding the carboxy-terminal part of the receptor and creates an internalization-defective phenotype. AB - A specific type of gene mutation affecting the LDL receptor has been found in many Finnish patients with familial hypercholesterolemia (FH). The mutant allele is characterized by a 9.5-kb deletion extending from intron 15 to exon 18. Molecular cloning and sequencing of a cDNA segment corresponding to the deleted allele indicated that the mutant receptor differs radically from the normal one because of loss of the domains encoded by exons 16, 17, and 18. The carboxy terminal portion of the normal receptor, comprising the amino acids 750-839, has been replaced by an unrelated stretch of 55 amino acids. The mutant allele was found to occur in 23 (50%) of 46 unrelated FH patients with an established functional defect in the LDL receptor. In cultured fibroblasts from the FH patients with the 9.5-kb deletion, both receptor-mediated binding and internalization of 125I-LDL were lower than normal, the former, on average, by 25%, and the latter, on average, by 50%. This combined functional defect probably results from both impaired attachment and impaired internalization of the mutated receptor. It remains to be investigated whether this Finnish type of LDL receptor gene mutation, here designated FH-Helsinki, occurs in other ethnic groups. PMID- 2760199 TI - Treadmill exercise promotes cyclic alterations in coronary blood flow in dogs with coronary artery stenoses and endothelial injury. AB - We have previously shown in anesthetized, open-chest dogs with coronary stenosis and endothelial injury that serotonin and/or thromboxane A2 (TXA2) receptor activation play a major role in the mediation of platelet-dependent, intermittent coronary occlusion. Using a similar model in awake, closed-chest dogs, we tested the following hypotheses: (a) treadmill exercise promotes the development of cyclic flow variations in dogs with coronary stenoses and endothelial injury; (b) ventricular pacing does not induce cyclic flow variations in the same dogs; and (c) TXA2 and/or serotonin are important mediators of exercise-induced cyclic flow variations in this model. The surgical preparation consisted of the application of a hard, flow-limiting constrictor and a Doppler ultrasonic flow probe around the left coronary artery of 11 dogs. Treadmill exercise resulted in the prompt development of cyclic flow variations in all 11 dogs. Ventricular pacing at rates as high as 170 beats/min induced cyclic flow variations in only one of five dogs. Exercise-induced cyclic flow variations were abolished by TXA2 and/or serotonin receptor antagonists in all but one dog. Thus, (a) treadmill exercise promotes the development of cyclic flow variations in dogs with coronary stenoses and endothelial injury; (b) ventricular pacing does not induce cyclic flow variations in most dogs in the same model; and (c) TXA2 and/or serotonin are important mediators of cyclic flow variations in this model. PMID- 2760200 TI - Dietary fish oil stimulates hepatic low density lipoprotein transport in the rat. AB - These studies were undertaken to examine the effect of fish oil, safflower oil, and hydrogenated coconut oil on the major processes that determine the concentration of low density lipoprotein (LDL) in plasma, i.e., the rate of LDL production and the rates of receptor-dependent and receptor-independent LDL uptake in the various organs of the body. When fed at the 20% level, fish oil reduced plasma LDL-cholesterol levels by 38% primarily by increasing LDL receptor activity in the liver. Dietary safflower oil also increased hepatic LDL receptor activity; however, since the rate of LDL production also increased, plasma LDL cholesterol levels remained essentially unchanged. Hydrogenated coconut oil had no effect on LDL receptor activity but increased the rate of LDL-cholesterol production causing plasma LDL-cholesterol levels to increase 46%. Dietary fish oil had no effect on the receptor-dependent transport of asialofetuin by the liver, suggesting that the effect of fish oil on hepatic LDL receptor activity was specific and not due to a generalized alteration in the physical properties of hepatic membranes. Finally, dietary fish oil increased hepatic cholesteryl ester levels and suppressed hepatic cholesterol synthesis rates, suggesting that the up-regulation of hepatic LDL receptor activity in these animals was not simply a response to diminished cholesterol availability in the liver. PMID- 2760201 TI - Lung fluid balance in lambs before and after premature birth. AB - The purpose of this study was to see if lung vascular protein permeability is greater in preterm lambs with respiratory distress than it is in lambs without lung disease. We measured pulmonary vascular pressures, lung lymph flow, and concentrations of protein in lymph and plasma of 10 chronically catheterized preterm lambs (gestation 133 +/- 1 d) for 2-4 h before and for 4-8 h after delivery by cesarean section. All lambs were treated with mechanical ventilation after birth and received a constant intravenous infusion of glucose-saline solution at an hourly rate of 10 ml/kg. Respiratory failure developed in six lambs, in which there was a sustained threefold postnatal increase in lung lymph flow and lymph protein flow, with an even greater increase in pleural liquid drainage. Concentrations of protein in lymph and pleural liquid were almost identical, averaging approximately 75% of the plasma protein concentration. In the four preterm lambs without lung disease, lymph flow and lymph protein flow were either near or below fetal values by 6-8 h after birth, and there was little or no pleural liquid drainage. Extravascular lung water averaged 7.3 +/- .8 g/g dry lung in lambs with respiratory failure compared to 4.8 +/- .5 g/g dry lung in lambs without lung disease. Thus, pulmonary edema with abnormal leakage of protein-rich liquid from the lung microcirculation into the interstitium is an important pathological feature of the respiratory disease that often occurs after premature birth. PMID- 2760202 TI - Motor unit regulation of mammalian pharyngeal dilator muscle activity. AB - The present study examined the cellular regulation of one of the pharyngeal dilator muscles, the geniohyoid, by assessing its motor unit (MU) behavior in anesthetized cats. During spontaneous breathing, MU that (a) were active during inspiration only (I-MU) and (b) were active during both inspiration and expiration (I/E-MU) were identified. I-MU had a later inspiratory onset time and a shorter duration of inspiratory firing than did I/E-MU (P less than 0.002 and P less than 0.0001, respectively). I-MU were usually quiescent whereas I/E-MU were usually active during the last 20% of inspiration. I/E-MU fired more rapidly (P less than 0.00001) and for relatively longer periods of time (P less than 0.00001) during inspiration than during expiration. End-expiratory airway occlusion (preventing lung expansion during inspiration) augmented the inspiratory activity of both I-MU and I/E-MU. Conversely, end-expiratory airway occlusion reduced the absolute and relative firing durations (P less than 0.002 and P less than 0.00002, respectively) and the firing frequency (P less than 0.001) of I/E-MU activity during expiration. These results indicate that (a) the complex pattern of pharyngeal dilator muscle activity is due to the integrated activity of a heterogeneous group of MU, (b) changes in the degree to which pharyngeal dilator muscles are active result from combinations of MU recruitment/decruitment and modulations of the frequency and duration of MU firing, and (c) gating of lung-volume afferent information occurs during the respiratory cycle. PMID- 2760203 TI - Reflex increase in blood pressure during the intracoronary administration of adenosine in man. AB - Infusion of adenosine (0.022-2.2 mg/min) into the left anterior descending (LAD) coronary artery of 26 patients produced a dose-dependent increase in blood pressure without a change in heart rate. At adenosine 2.2 mg/min, systolic pressure rose by 21.0 +/- 2.2 mmHg from 134 +/- 4.3 mmHg (P less than 0.001) and diastolic pressure increased by 10.4 +/- 1.1 mmHg from 76 +/- 1.9 mmHg (P less than 0.001). The rise in arterial pressure was associated with a 22 +/- 3.4% increase in systemic vascular resistance (P less than 0.01) and no change in cardiac output (-2.8 +/- 4.3%, P = NS). Plasma norepinephrine levels rose by 40 +/- 14% from 105 +/- 9 pg/ml (P less than 0.05) and epinephrine levels by 119 +/- 31% from 37 +/- 9 pg/ml (P less than 0.01). Right atrial infusion of adenosine produced insignificant hemodynamic effects, suggesting that systemic spillover of adenosine was not responsible for the observed effects. In 20 cardiac transplant patients with denervated hearts, LAD infusion of adenosine (2.2 mg/min) produced no change in systolic pressure (-0.1 +/- 1.6 mmHg from 139 +/- 3.4 mmHg, P = NS) and a decrement in diastolic pressure (-4.7 +/- 1.2 mmHg from 98 +/- 2.5 mmHg, P less than 0.01). Thus, infusion of adenosine into the LAD coronary artery causes a reflex increase in arterial pressure due to a rise in systemic vascular resistance, probably as a result of increased sympathetic discharge. This reflex pathway may be of importance in disease states such as myocardial ischemia, in which myocardial adenosine levels are elevated. PMID- 2760204 TI - Acquired congenital heart block. Pattern of maternal antibody response to biochemically defined antigens of the SSA/Ro-SSB/La system in neonatal lupus. AB - The molecular basis of autoantibody reactivity with components of the SSA/Ro SSB/La particle exhibited by sera of mothers of infants with severe and permanent manifestations of neonatal lupus (NLE) was investigated using immunoblotting and immunoprecipitation. The characteristics of NLE that were studied included congenital complete heart block (CCHB), second degree heart block, and hepatic fibrosis. Antibodies specific for one or more components of the SSA/Ro-SSB/La particle were found in sera from all 20 mothers of permanently affected infants. However, no antibody specific for a single peptide of this particle was common to all sera. Using tissue extracts from a human cell substrate, 80% of these sera had antibodies to one or more components of the SSA/Ro particle demonstrable by immunoblotting. The predominant antibody response in the NLE group was to the newly recognized 52-kD SSA/Ro peptide component. In contrast, antibodies to the 60-kD SSA/Ro component although present, were the least represented and not significantly increased in frequency among mothers of these infants, compared with a group of 31 mothers with autoimmune diseases such as systemic lupus erythromatosus (SLE) but who had healthy offspring. Antibodies directed to the 48 kD SSB/La antigen were demonstrated in 90% of the NLE mothers often accompanying antibodies against the 52-kD SSA/Ro component. The combination of antibodies to 48- and 52-kD structures was significantly increased in the NLE group, with an odds ratio of 35. The type of cell or tissue substrate was shown to influence detectability of antibodies. The 52-kD SSA/Ro peptide and the 48-kD SSB/La peptide were abundant in cardiac tissues from fetuses aged 18-24 wk, further supporting the possible relevance of these peptides to heart block. PMID- 2760205 TI - Evidence for a dominant gene that suppresses hypercholesterolemia in a family with defective low density lipoprotein receptors. AB - This paper describes an unusual kindred with familial hypercholesterolemia in which one-third of the relatives with a mutant LDL receptor gene have normal plasma cholesterol concentrations. The proband, a 9-yr-old boy with a plasma cholesterol value greater than 500 mg/dl, is homozygous for a point mutation that changes Ser156 to Leu in the LDL receptor. This substitution in the fourth repeat of the ligand binding domain slows the transport of the protein to the cell surface. The defective receptor cannot bind LDL, which contains apo B-100, but it does bind beta-migrating VLDL, which contains apo E in addition to apo B-100. Although the mother is heterozygous for this mutation, her LDL-cholesterol concentration is consistently in the 28th percentile for the population. Through direct examination of genomic DNA, we identified the mutant gene in heterozygous form in 17 of the mother's relatives, five of whom had normal LDL-cholesterol values. The pedigree was consistent with dominant transmission of a single gene that ameliorates or suppresses the hypercholesterolemic effect of the LDL receptor mutation. Through linkage analysis, we excluded the possibility that this suppressor gene was an allele at the LDL receptor locus. We also excluded the genes for the two ligands for the LDL receptor, apo B-100 and apo E. The existence of this putative suppressor gene may explain the occasional observation of normal LDL-cholesterol concentrations in heterozygotes for LDL receptor mutations. PMID- 2760206 TI - Evidence for metalloproteinase and metalloproteinase inhibitor imbalance in human osteoarthritic cartilage. AB - Cartilage specimens from tibial plateaus, obtained from 13 osteoarthritic (OA) patients and seven controls, were selected from three regions: zone A, center of fibrillated area; zone B, area adjacent to fibrillation, and zone C, remote region of plateau. Acid and neutral metalloproteinases and tissue inhibitor of metalloproteinase (TIMP) were extracted with 2 M guanidine. Methods were developed to selectively destroy either proteinases or TIMP to prevent cross reaction during assay. Acid and neutral proteinases were elevated approximately 150% in OA; TIMP was elevated approximately 50%. A positive correlation (r = 0.50) was found between acid and neutral proteinase activities in OA, but not in controls. Both proteinases were elevated two-to threefold in zones A, B, and C. However, the self-active form of the acid metalloproteinase was elevated only in zones A and B (200%); it correlated well with the Mankin scores, whereas the total activities did not. TIMP was elevated (50%) only in zones A and B. Both the proteinase levels and the Mankin score were elevated to a greater extent in the medial, than in the lateral, compartment. Titration of TIMP against the two metalloproteinases indicates that there is a small excess of inhibitor over enzymes in normal cartilage. In OA, TIMP does not increase to the same extent as the proteinases; the resultant excess of proteinases over TIMP may contribute to cartilage breakdown. PMID- 2760207 TI - Effects of hypoglycemia and prolonged fasting on insulin and glucagon gene expression. Studies with in situ hybridization. AB - In situ hybridization of proinsulin and proglucagon mRNA was performed in rat pancreas to assess prohormone gene expression during various glucopenic conditions. During a 4-d fast mean blood glucose declined by 48 mg/dl; proinsulin mRNA signal density remained normal while proglucagon mRNA signal density more than doubled. At the end of a continuous 12-d insulin infusion blood glucose averaged 53 +/- 12 mg/dl; proinsulin mRNA signal density declined to 30% of controls while proglucagon mRNA signal density more than doubled. In insulinoma bearing NEDH rats blood glucose averaged 34 +/- 3.5 mg/dl; the proinsulin mRNA signal was virtually undetectable and proglucagon mRNA signal density was more than twice the controls. There was no detectable change in either beta-cell area or islet number in rats subjected to fasting or insulin infusion, but in insulinoma-bearing rats beta cell area was markedly reduced. Thus compensation during 4 d of starvation involves an increase in glucagon gene expression without change in insulin gene expression or beta cell mass. In moderate insulin-induced hypoglycemia glucagon gene expression is increased and insulin gene expression decreased. In more profound insulinoma-induced hypoglycemia, in addition to the foregoing changes in hormone gene expression, there is a profound reduction in the number of insulin-expressing cells. PMID- 2760208 TI - Localization of transforming growth factor alpha and its receptor in gastric mucosal cells. Implications for a regulatory role in acid secretion and mucosal renewal. AB - Transforming growth factor alpha (TGF alpha) shares with epidermal growth factor (EGF) structural homology (35%), a common cell-surface membrane receptor (TGF alpha/EGF receptor), and a nearly identical spectrum of biological activity, including inhibition of gastric acid secretion. Herein, we report expression of TGF alpha mRNA in normal gastric mucosa of the adult guinea pig, rat, and dog. TGF alpha mRNA was also detected in matched surgically resected gastric mucosa and adjacent gastric carcinoma from 10 patients, and in gastric mucosa adjacent to a benign ulcer from an additional patient. TGF alpha protein was quantitated by radioimmunoassay and was present in tumor and adjacent mucosa. TGF alpha/EGF receptor mRNA was also detected in gastric mucosa from all species studied. Localization of TGF alpha and TGF alpha/EGF receptor mRNA expression was examined in samples of unfractionated guinea pig gastric mucosa and from chief cell enriched and parietal cell-enriched fractions. All samples exhibited TGF alpha and TGF alpha/EGF receptor expression. The TGF alpha signal was greatest in the parietal cell fraction (5.8-fold increase), but was also enhanced in the chief cell fraction (1.9-fold increase) relative to the unfractionated gastric mucosa. Like TGF alpha expression, TGF alpha/EGF receptor mRNA expression was most intense in the parietal cell-enriched fraction (7.8-fold increase), but was also increased in the chief cell-enriched fraction (2.7-fold increase) relative to the unfractionated guinea pig gastric mucosa. We conclude that TGF alpha and TGF alpha/EGF receptor genes are expressed in normal adult mammalian gastric mucosa. These findings, when interpreted in light of described actions of TGF alpha and EGF, provide evidence that local production of TGF alpha could play an important role in the regulation of acid secretion and mucosal renewal in the stomach. PMID- 2760209 TI - Molecular analysis of a female Lesch-Nyhan patient. AB - We report the identification of a female patient with the X-linked recessive Lesch-Nyhan syndrome (hypoxanthine phosphoribosyltransferase [HPRT] deficiency). Cytogenetic and carrier studies revealed structurally normal chromosomes for this patient and her parents and demonstrated that this mutation arose through a de novo gametic event. Comparison of this patient's DNA with the DNA of her parents revealed that a microdeletion, which occurred within a maternal gamete and involved the entire HPRT gene, was partially responsible for the disease in this patient. Somatic cell hybrids, generated to separate maternal and paternal X chromosomes, showed that expression of two additional X-linked enzymes, phosphoglycerate kinase and glucose-6-phosphate dehydrogenase, were expressed only in cells that contained the maternal X chromosome, suggesting the presence of a functionally inactive paternal X chromosome. Furthermore, comparison of methylation patterns within a region of the HPRT gene known to be important in gene regulation revealed differences between DNA from the father and the patient, in keeping with an active HPRT locus in the father and an inactive HPRT locus in the patient. Together these data indicate that nonrandom inactivation of the cytogenetically normal paternal X chromosome and a microdeletion of the HPRT gene on an active maternal X chromosome were responsible for the absence of HPRT in this patient. PMID- 2760210 TI - Platelet isoforms of platelet-derived growth factor stimulate fibroblasts to contract collagen matrices. AB - Fibroplasia and angiogenesis are essential components of tissue repair when substantial tissue has been lost at a site of injury. Platelets and monocyte/macrophages accumulate at these sites and release a variety of growth factors that are thought to initiate and sustain the repair. Often the involved tissue contracts, a process that can markedly reduce the amount of fibroplasia and angiogenesis necessary for the reestablishment of organ integrity. Such tissue contraction occurs over hours or days, a much slower time course than the rapid, reversible contraction of muscle tissue. Fibroblasts, which are rich in f actin bundles, appear to be responsible for wound contraction. However, the signals that stimulate contraction are not known. Using cultured fibroblasts, which are also rich in f-actin bundles, we demonstrate the platelet and monocyte isoforms of platelet-derived growth factor (PDGF; AB and BB) but not PDGF-AA, can stimulate fibroblasts to contract collagen matrix in a time course similar to that of wound contraction. In addition, PDGF appears to be the predominant fibroblast/collagen gel contraction activity released from platelets. Vasoactive agonists known to stimulate smooth and striated muscle contraction do not stimulate fibroblast-driven collagen gel contraction. PMID- 2760211 TI - The noncalcemic analogue of vitamin D, 22-oxacalcitriol, suppresses parathyroid hormone synthesis and secretion. AB - 1,25-Dihydroxyvitamin D (1,25-(OH)2D3) directly suppresses the secretion and synthesis of PTH in vivo and in cell culture. This compound has been used to treat secondary hyperparathyroidism associated with renal failure, but in some patients prolonged treatment with 1,25-(OH)2D3 results in hypercalcemia. An analogue of 1,25-(OH)2D3 with little or no calcemic activity, 22-oxacalcitriol (OCT), was recently developed. We confirmed this lack of calcemic activity by acute and chronic administration to normal rats. A single intraperitoneal injection of vehicle (propylene glycol), OCT, or 1,25-(OH)2D3 (1.0 micrograms/rat) increased calcium by 0.32, 0.30, and 1.40 mg/dl, respectively. When rats were given daily injections of vehicle or 0.5 micrograms of either 1,25 (OH)2D3 or OCT for 4 d, calcium did not change in the rats receiving vehicle or OCT, but increased from 8.4 to 11.4 mg/dl in the rats treated with 1,25-(OH)2D3. In primary cultures of bovine parathyroid cells, 10 nM OCT was as active as 10 nM 1,25-(OH)2D3, suppressing PTH release by 33%. This suppression is due, at least in part, to blocking of transcription of the PTH gene. Using a probe prepared by random prime labeling of an Msp I fragment of plasmid PTHm122, we found that a single 40-ng dose of OCT or 1,25-(OH)2D3 depressed PTH mRNA levels by 70-80% by 48 h when compared with vehicle. Thus, OCT is a very effective suppressor of PTH secretion with virtually no calcemic activity. This analogue may be a valuable tool for the treatment of secondary hyperparathyroidism. PMID- 2760212 TI - Activation of clones producing self-reactive antibodies by foreign antigen and antiidiotype antibody carrying the internal image of the antigen. AB - Because we found in previous work that a high fraction of antibodies exhibiting various specificities bound to glutamic acid 50-tyrosine50 homopolymer (GT) and expressed pGAT cross-reactive idiotype (IdX), we studied the activation of clones producing multireactive antibodies in 1-mo-old MRL/lpr and C3H/HeJ mice bearing VHJ haplotype. The activation of such clones was studied after mice were immunized with GT in CFA, HP20 (an anti-Id MAb carrying the internal image of GT in the D region), and a synthetic peptide corresponding to the D segment of HP20. Our results indicate that immunized mice produced both GT- and self-reactive antibodies. Study of the immunochemical properties of MAb showed that they exhibit multispecific properties and bind with similar-affinity constants to GT or self-antigens such as DNA, Smith antigen (Sm), and IgG2a. An important fraction of antibodies obtained from MRL/lpr mice immunized with HP20 expressed pGAT IdX and some of these antibodies share IdX expressed on anti-DNA, Sm, and rheumatoid factor (RFs) antibodies. The hybridomas producing multispecific autoantibodies use heavy-chain- (VH) and light-chain-variable region (VK) genes from various V gene families, suggesting that they do not derive from the pool of GAT precursors. Sequencing of VH and VK genes of two antibodies show that they can use closely related VHJ558, unmutated VK1, or different VK genes than those used by anti-GT antibodies. Our data demonstrate that clones producing antibodies binding to GT and self-antigens with similar-affinity constants can be activated by foreign or anti-Id antibodies carrying the internal image of the antigen or even by a synthetic peptide corresponding to the D segment of anti-Id antibodies. PMID- 2760213 TI - Effects of estrogen on low density lipoprotein metabolism in males. Short-term and long-term studies during hormonal treatment of prostatic carcinoma. AB - To characterize the effects of estrogen treatment on the metabolism of LDL we studied six males with metastatic prostatic carcinoma before and during the initiation of therapy; a repeated study was performed in five participants after 3-6 mo of treatment. The fractional catabolic rate (FCR) of autologous 125I-LDL was calculated both from elimination curves of plasma radioactivity and from urine/plasma (U/P) radioactivity ratios. Within 1-2 d of onset of estrogen therapy a more rapid decay of plasma radioactivity occurred, and FCR measured from U/P ratios increased by 20%. Concomitantly, LDL cholesterol levels decreased by 16%. After 3-6 mo of treatment FCR determined by both techniques was almost doubled, and LDL cholesterol was reduced by 34%. This occurred despite a 29% increase in the calculated synthesis rate of LDL. Tissue culture studies demonstrated that the receptor affinity of LDL isolated from patients on long term estrogen therapy was reduced. We conclude that a profound increase in LDL catabolism is induced through administration of pharmacological doses of estrogen in males, and hypothesize that this is the consequence of an increased expression of hepatic LDL receptors. This enhanced catabolism of LDL leaves LDL particles in plasma with lower affinity for the LDL receptor. PMID- 2760215 TI - Role of receptor cycling in the regulation of angiotensin II surface receptor number and angiotensin II uptake in rat vascular smooth muscle cells. AB - In vivo data on the factors controlling angiotensin II (AII) cell surface binding are conflicting. We studied the specific effects of AII on AII binding in rat mesenteric artery vascular smooth muscle cells in culture. Incubation with unlabeled AII at 21 degrees C resulted in time- and concentration-dependent decreases in AII surface binding at 4 degrees C, with a 30% reduction after exposure to 300 nM AII for 15 min. Reductions in cell surface binding were due to decrements in receptor number rather than changes in binding affinity. Loss of surface receptors was mediated by receptor internalization as maneuvers that blocked ligand internalization (cold temperature and phenylarsine oxide [PAO]) attenuated AII-induced loss of surface receptors. After removal of AII, recovery of surface binding was rapid (t1/2 = 15 min) and was mediated by reinsertion of a preexisting pool of receptors into the surface membrane rather than by new receptor synthesis. To determine the role of receptor cycling on AII-induced surface receptor loss, cells were incubated with the endosomal inhibitor chloroquine during exposure to AII at 21 degrees C. Incubation with AII plus chloroquine resulted in a 70% greater loss of surface binding than after incubation with AII alone. To determine the role of receptor cycling on uptake of ligand, cells were incubated with PAO or endosomal inhibitors during exposure to AII at 4 and 21 degrees C. Compared with buffer these agents did not alter AII uptake at 4 degrees C, but decreased uptake by 12-50% at 21 degrees C. These results indicate that after binding AII receptors cycle and that receptor cycling attenuates AII-induced losses of surface receptors and enhances ligand uptake by providing a continuous source of receptors to the cell surface. PMID- 2760214 TI - Estrogen-induced gallstone formation in males. Relation to changes in serum and biliary lipids during hormonal treatment of prostatic carcinoma. AB - To assess if and by which mechanisms pharmacological estrogen treatment induces gallstone disease, we examined patients with recently diagnosed prostatic cancer randomly allocated to estrogen therapy (n = 37) or orchidectomy (n = 35). According to gallbladder ultrasonography, after 1 yr new gallstones had developed in 5 of 28 estrogen-treated patients, compared with 0 of 26 orchidectomized patients (P = 0.03). Estrogen therapy for 3 mo increased the relative concentration of cholesterol and cholesterol saturation of bile by approximately 30% (n = 10). Serum LDL cholesterol was reduced by approximately 40%, and its relative change related inversely to that of bile cholesterol (Rs = -0.77). There were no changes in biliary or serum lipids after orchidectomy (n = 9). Secretion rates of biliary lipids were measured with a duodenal perfusion technique. Patients on chronic estrogen therapy (n = 5) had approximately 40% higher biliary excretion rates of cholesterol than age-matched controls (n = 7). Phospholipid secretion was also higher, but no difference in bile acid secretion was found. We conclude that an increased hepatic secretion of cholesterol results in increased cholesterol saturation of bile and an enhanced rate of gallstone formation during estrogen treatment. The changes in bile cholesterol seem to be related to the induced changes in serum lipoprotein metabolism. PMID- 2760216 TI - Immunohistochemical localization of low density lipoprotein receptors in adrenal gland, liver, and intestine. AB - The localization of LDL receptors in adrenal gland, liver, and intestine was studied using immunohistochemistry. The anti-LDL receptor antibody used was shown to be monospecific and did not react with striated muscle, a tissue which has a very low level of LDL receptors. Similarly, cerebral cortex showed only faint reactivity and that was to an area previously demonstrated to have LDL receptors. Adrenal gland was intensely reactive with the zona fasciculata, having a greater density of receptors than the zona reticularis. In normal liver, LDL receptors were present on the sinusoidal membranes and were sparse in the areas of hepatocyte-to-hepatocyte contact without an obvious portal to central gradient. LDL receptors were present throughout the intestine. In jejunum, staining was most intense at the base of the villus and extended up toward the villus tip. At the base of the villus, the receptor was primarily at the basal lateral membrane, but toward the villus tip, there was appreciable intracellular staining. Staining in crypts was more faint; in duodenum, staining in crypts equaled that in the villus region in intensity. In colon, there was intense staining throughout the epithelial cells. These results provide new information about the cellular and subcellular localization of LDL receptors and raise the interesting possibility that there is a role for LDL-derived cholesterol in new lipoprotein formation. PMID- 2760217 TI - Extrahepatic obstructive cholestasis reverses the bile salt secretory polarity of rat hepatocytes. AB - To elucidate the consequences of extrahepatic cholestasis on the structure and function of hepatocytes, we studied the effects of bile duct ligation on the turnover, surface distribution, and functional activity of the canalicular 100-kD bile salt transport protein (cBSTP). Basolateral (blLPM) and canalicular (cLPM) liver plasma membrane vesicles were purified to the same degree from normal and cholestatic rat livers and the membrane bound cBSTP identified and quantitated using polyclonal anti-cBSTP antibodies. Cholestasis of 50 h resulted in an increased release of cBSTP into bile, thereby decreasing its in vivo half-life from 65 to 25 h. Furthermore, a significant portion of cBSTP accumulated at the basolateral surface and in intracellular vesicles of cholestatic hepatocytes. This redistribution of cBSTP was functionally paralleled by decreased and increased electrogenic taurocholate anion transport in cLPM and blLPM vesicles, respectively. These results demonstrate that biliary obstruction causes a reversal of the bile salt secretory polarity of rat hepatocytes. The resulting increase in basolateral (sinusoidal) bile salt efflux might protect hepatocytes from too high an accumulation of toxic bile salts within the cell interior. PMID- 2760218 TI - Biochemical analysis of callus tissue in osteogenesis imperfecta type IV. Evidence for transient overmodification in collagen types I and III. AB - We analyzed tissue and cells from a stationary and a rapidly growing hyperplastic callus from a patient with osteogenesis imperfecta (OI) type IV and compared the results with those of compact bone and skin fibroblasts of an age-matched control. Collagen and protein contents per cell were low in the callus tissues and collagen I and III were overmodified as evidenced by an elevated level of hydroxylysine. The degree of lysyl hydroxylation was highest in those regions that appeared most immature by histological examination. Lysyl hydroxylation approached normal levels in collagen from the stationary callus and from the center of the growing callus. Overmodification of collagen was not seen in compact bone or cell cultures (neither skin fibroblasts nor callus cells) from the patient. Elevation of hydroxylysine in collagen from OI patients is generally attributed to mutations that delay triple helix formation. Our observations suggest that the varying degree of collagen modifications may occur in consequence of regulatory mechanisms during bone development and tissue repair. These mechanisms may be defective in some patients with OI as seen in this case with hyperplastic callus formation. PMID- 2760219 TI - Outcome of the acute glomerular injury in proliferative lupus nephritis. AB - Treatment with total lymphoid irradiation (TLI) and corticosteroids markedly reduced activity of systemic lupus erythematosis in 10 patients with diffuse proliferative lupus nephritis (DPLN) complicated by a nephrotic syndrome. Physiologic and morphometric techniques were used serially before, and 12 and 36 mo post-TLI to characterize the course of glomerular injury. Judged by a progressive reduction in the density of glomerular cells and immune deposits, glomerular inflammation subsided. A sustained reduction in the fractional clearance of albumin, IgG and uncharged dextrans of radius greater than 50 A, pointed to a parallel improvement in glomerular barrier size-selectivity. Corresponding changes in GFR were modest, however. A trend towards higher GFR at 12 mo was associated with a marked increase in the fraction of glomerular tuft area occupied by patent capillary loops as inflammatory changes receded. A late trend toward declining GFR beyond 12 mo was associated with progressive glomerulosclerosis, which affected 57% of all glomeruli globally by 36 mo post TLI. Judged by a parallel increase in volume by 59%, remaining, patent glomeruli had undergone a process of adaptive enlargement. We propose that an increasing fraction of glomeruli continues to undergo progressive sclerosis after DPLN has become quiescent, and that the prevailing GFR depends on the extent to which hypertrophied remnant glomeruli can compensate for the ensuing loss of filtration surface area. PMID- 2760220 TI - Renal bicarbonate reabsorption in the rat. III. Distal tubule perfusion study of load dependence and bicarbonate permeability. AB - Using continuous microperfusion techniques, we studied the load dependence of bicarbonate reabsorption along cortical distal tubules of the rat kidney and their bicarbonate permeability. Net bicarbonate transport was evaluated from changes in tracer inulin concentrations and total CO2 measurements by microcalorimetry. Bicarbonate permeability was estimated from the flux of total CO2 along known electrochemical gradients into bicarbonate-and chloride-free perfusion solution containing 10(-4) M acetazolamide. Transepithelial potential differences were measured with conventional glass microelectrodes. Significant net bicarbonate reabsorption occurred at luminal bicarbonate levels from 5 to 25 mM, and at perfusion rates from 5 to 30 nl/min. Bicarbonate reabsorption increased in a load-dependent manner, both during increments in luminal bicarbonate concentration or perfusion rate, reaching saturation at a load of 250 pmol/min with a maximal reabsorption rate of approximately 75 pmol/min.mm. Rate of bicarbonate reabsorption was flow dependent at luminal concentrations of 10 but not at 25 mM. During chronic metabolic alkalosis, maximal rates of reabsorption were significantly reduced to 33 pmol/min.mm. The bicarbonate permeability was 2.32 +/- 0.13 x 10(-5) cm/s in control rats, and 2.65 +/- 0.26 x 10(-5) cm/s in volume-expanded rats. Our data indicate that at physiological bicarbonate concentrations in the distal tubule passive bicarbonate fluxes account for only 16-21% of net fluxes. At high luminal bicarbonate concentrations, passive bicarbonate reabsorption contributes moderately to net reabsorption of this anion. PMID- 2760221 TI - RGDV peptide selectively inhibits platelet-dependent thrombus formation in vivo. Studies using a baboon model. AB - Since platelet hemostatic functions are mediated in part through the binding of adhesive proteins containing an RGD (Arg-Gly-Asp) recognition sequence, and since platelet reactions may be inhibited in vitro by RGD-containing peptides, we assessed in vivo the antithrombotic activity of RGDV (Arg-Gly-Asp-Val) tetrapeptide using a baboon thrombosis model. Thrombus formation was induced by a device consisting of a tubular segment coated with type I collagen, followed by two regions of expanded diameter exhibiting disturbed flow and stasis. The thrombogenic device was incorporated into femoral arteriovenous shunts under conditions of intermediate wall shear rate (100 s-1). Thrombus formation was measured by scintillation camera imaging of 111In-platelets and by counting of 125I-fibrinogen/fibrin. Thrombus that formed on the collagen substrate was rich in platelets, while thrombus formed in the disturbed flow regions was rich in fibrin and red cells. RGDV peptide was infused proximal to the thrombogenic device to maintain local plasma concentrations of 25, 50, and 100 microM. Infused RGDV decreased the accumulation of both platelets and fibrin on the collagen substrate in a dose-response manner. At the highest dose platelet and fibrin deposition after 40 min was reduced by greater than 80% (P less than 0.01). In the region of disturbed flow, RGDV (100 microM) reduced platelet deposition by 85% (P less than 0.01) but did not reduce the accumulation of fibrin (P less than 0.3). Similarly, the peptide inhibited the release of granular proteins from platelets associated with thrombus (platelet factor 4, beta-thromboglobulin; P less than 0.01), but did not prevent the appearance of fibrinopeptide A in circulating blood (P greater than 0.1). No systemic alterations in blood pressure, bleeding time, or platelet aggregation ex vivo were produced by locally infused RGDV. The antithrombotic effects of RGDV peptide disappeared within 5 min after discontinuing the infusion. In control studies infused RGEV (Arg-Gly-Glu Val, 100 microM) showed no antithrombotic activity. Thus, RGDV selectively blocks platelet-dependent thrombus formation in vivo. PMID- 2760222 TI - Use of mouse anti-rabies monoclonal antibodies in postexposure treatment of rabies. AB - Immunization of mice and hamsters with a cocktail of mouse MAbs specific for rabies virus nucleocapsid protein and glycoprotein protected animals not only when challenged with a lethal dose of rabies virus after immunization, but also in post-exposure situations. Hamsters treated with the MAb cocktail 3 h after virus inoculation were completely protected from lethal rabies virus infection, and 80% of the animals survived when the MAb cocktail was given 36 h after virus challenge. The potential usefulness of this MAb cocktail for the postexposure treatment of human rabies is discussed. PMID- 2760223 TI - Adenosine triphosphate turnover in humans. Decreased degradation during relative hyperphosphatemia. AB - The regulation of ATP metabolism by inorganic phosphate (Pi) was examined in five normal volunteers through measurements of ATP degradation during relative Pi depletion and repletion states. Relative Pi depletion was achieved through dietary restriction and phosphate binders, whereas a Pi-repleted state was produced by oral Pi supplementation. ATP was radioactively labeled by the infusion of [8(14)C]adenine. Fructose infusion was used to produce rapid ATP degradation during Pi depletion and repletion states. Baseline measurements indicated a significant decrease of Pi levels during phosphate depletion and no change in serum or urinary purines. Serum values of Pi declined 20 to 26% within 15 min after fructose infusion in all states. Urine measurements of ATP degradation products showed an eightfold increase within 15 min after fructose infusion in both Pi-depleted and -supplemented states. Urinary radioactive ATP degradation products were fourfold higher and urinary purine specific activity was more than threefold higher during Pi depletion as compared with Pi repletion. Our data indicate that there is decreased ATP degradation to purine end products during a relative phosphate repletion state as compared to a relative phosphate depletion state. These data show that ATP metabolism can be altered through manipulation of the relative Pi state in humans. PMID- 2760224 TI - An intracranial/extracranial approach for the surgical management of haemangiomas of the orbit and eyelid. AB - The authors propose a combined approach for the treatment of orbito-palpebral haemangiomas. Two cases are presented and discussed. Pre-operative evaluation included coronal, axial, and sagittal CT scans as well as a selective arteriogram. These studies assisted the planning of the surgical approach. An intracranial/extracranial surgical approach was used with ocular-palpebral dissection. Pre-operative arterial embolization was helpful in controlling perioperative blood loss. Precise excision of the masses was thus accomplished and functional and aesthetic reconstruction aided by the conservation of normal anatomical structures. PMID- 2760225 TI - Periorbital marginotomies: anatomy and applications. AB - The application of craniofacial techniques has led to a greater variety of methods for operative exposure. In the orbital region, the inferior marginotomy of Tessier is a valuable adjunct in the reconstruction of severe orbital floor fractures and their sequelae. This concept has been extended to the superior, lateral, and medial orbital rims to improve the exposure of the respective orbital wall. These marginotomies have been used for a variety of problems. There have been no complications related to the inclusion of a periorbital marginotomy, and its use in appropriate patients is strongly recommended. PMID- 2760226 TI - Zygomatico-maxillary fractures. Late results after traction-hook reduction. AB - A simple, closed method for zygomatico-maxillary fracture treatment is described i.e. replacement by the use of a traction bone-hook. After X-ray and clinical examination had excluded undisplaced fractures, blow out fractures and comminuted fractures, the postreduction stability was assessed peroperatively and again one week after. Sophisticated preoperative fracture-classifications predicting postoperative stability appeared redundant. In the present study, this procedure could be performed in 55.4% of the total fractures which needed to be reduced. At re-evaluation, two to eight years later, the results remained satisfactory. The method appeared, in addition to its simplicity, to require less complicated postoperative care and, therefore, a short hospitalization. PMID- 2760227 TI - Preserving the pterygoid plates in posterior repositioning of the LeFort I osteotomy. AB - The pterygoid plates have to be fractured and displaced to allow the maxilla to be repositioned posteriorly in the Le Fort I push-back osteotomy. A technique to reposition the maxilla posteriorly while preserving the pterygoid plates and the greater palatine neurovascular bundle is described. This technique reduces the risk of damaging the internal maxillary artery and the internal jugular vein which can lead to excessive haemorrhage. The disturbance to the Eustachian apparatus is also minimized. PMID- 2760228 TI - The myocutaneous platysma flap for the reconstruction of intraoral defects after radical tumour resection. AB - After performing 54 myocutaneous platysma flaps for reconstruction of intraoral defects following tumour surgery, the results, with reference to the postoperative outcome, are presented. Interest is focused on the anatomical basis of the flap's pedicle and its relevance for the indication of this method. PMID- 2760229 TI - Bacteriological sampling of postmortem rooms. AB - Thirty hospital and coroners' postmortem rooms in the West Midlands were visited over two years. The design, environmental facilities, and hygienic practices were investigated and air exchange rates were measured. Microbiological samples were taken from the environment and from gloves, hands, and protective clothing of staff. Glove punctures were also recorded and a plastic isolator evaluated. Bacterial counts in the air were low and related more to the number of people in the room than to the air exchange rate. There was little evidence of the production of aerosol containing bacteria, although splashing occurred while intestines were being washed out. Surfaces often remained contaminated with Gram negative bacilli after cleaning but numbers were considerably reduced on drying. Decontamination of instruments was satisfactory. A wide range of disinfectants and concentrations was used, but none showed evidence of contamination. Gloves were heavily contaminated after use, and occasionally the hands of the wearer after removal of the gloves. Washing the hands effectively removed residual transient organisms, irrespective of the agent used. The incidence of glove punctures was higher among technicians (38%) than pathologists (12%). The plastic isolator reduced smells and limited environmental contamination but visibility and acceptability were poor. The results of the study suggest that there is little evidence of risk of infection to staff, providing basic hygienic precautions are taken, but consideration should be given to the prevention of glove punctures. PMID- 2760231 TI - Creatine kinase activity in sickle cell disease. AB - Creatine kinase activity was measured in 28 patients in the steady state of sickle cell disease and ranged from 4-45 IU/l, comparable with that found in healthy adult caucasians. Creatine kinase activity was also measured in 14 patients admitted consecutively for the treatment of vaso-occlusive sickle cell crises. Creatine kinase activity remained within the normal range in eight of these 14 patients throughout their admission; none had muscle pain or a chest syndrome. In the remaining six, three with muscle pain and three with a chest syndrome, increased activity was found on one or more days. A further 17 patients with vaso-occlusive sickle cell crises, associated with muscle pain, were studied. Creatine kinase activity was significantly raised in all 17, the mean creatine kinase activity for men was 578.8 IU/l and 210.6 IU/l for women, with the highest values (up to 1790 IU/l) found in those who had exercised before admission. Measurement of creatine kinase activity may therefore be a useful marker of muscle perturbation due to sickling. PMID- 2760230 TI - Hepatitis B-DNA replication and histological patterns in liver biopsy specimens of chronic HBsAg positive patients with and without hepatitis delta virus superinfection. AB - The role of active hepatitis B virus (HBV) infection in chronic HBsAg positive hepatitis with and without hepatitis delta virus (HDV) superinfection was analysed in percutaneous liver biopsy specimens from 50 patients. Each specimen was divided into two--one part for histological evaluation and for the detection of HBcAg and delta antigen; the other part was tested for HBV-DNA using Southern blotting. Ten cases were of chronic lobular hepatitis, 10 of chronic persistent hepatitis, and 30 of chronic active hepatitis. Ten cases were delta antigen positive and showed high grade lobular activity but no evidence of HBV-DNA episomal forms or HBcAg reactivity. Twenty one cases showed HBV-DNA replicative intermediate forms; 19 had high grade lobular activity, which occurred in five cases without evidence of free viral DNA. Of the 21 biopsy specimens with HBV-DNA episomal forms, 14 were positive for HBcAg; only one of the 19 cases without detectable viral DNA was positive for such antigen. These data indicate that the presence of HBV or HDV active infection correlates with the histological finding of prominent lobular necrosis. Moreover, intrahepatic HBV-DNA seems to be a more sensitive marker than the presence of viral antigens for indicating HBV replication. PMID- 2760232 TI - Abnormal platelet aggregation in patients with Raynaud's phenomenon. AB - Platelet aggregation in vitro to several aggregating agents (serotonin (5-HT), adenosine diphosphate, adrenaline and collagen) was studied in 16 patients with primary and secondary Raynaud's phenomenon and compared with that in 13 normal volunteers. Platelets from patients with Raynaud's phenomenon had significantly greater responses to all the 5-HT concentrations tested (p less than 0.001 for 10 microM; p less than 0.01 for 1 microM; p less than 0.05 for 0.1 microM; p less than 0.02 for 0.025 microM) and to low doses of adenosine diphosphate (p less than 0.01 for 1 microM; p less than 0.02 for 0.5 microM) but normal responses to collagen, adrenaline, and high doses of adenosine diphosphate. Patients with secondary Raynaud's phenomenon were significantly more hypersensitive to 0.5 microM adenosine diphosphate than patients with primary Raynaud's phenomenon. In patients with secondary Raynaud's phenomenon there was a significant correlation between the extent of 5-HT aggregation and the duration of the disease. The finding that platelets from patients with Raynaud's phenomenon have enhanced responses to 5-HT and adenosine diphosphate, but normal responses to adrenaline and collagen, is consistent with a role for 5-HT in this disease. PMID- 2760233 TI - Evaluation of three Campylobacter pylori antigen preparations for screening sera from patients undergoing endoscopy. AB - A surface antigen (SA), acid glycine extract (AGE), and urease preparation (UP) were evaluated using sera from patients undergoing endoscopy and from subjects with gastric or duodenal ulcers. Sera were tested for the presence of IgG and IgA antibodies by a conventional indirect enzyme linked immunosorbent assay (ELISA). In patients with confirmed Campylobacter pylori associated gastritis, raised IgG antibody titres were indicated by absorbance values of greater than or equal to 500, greater than or equal to 500, and greater than or equal to 1500 for the SA, AGE, and UP, respectively. Corresponding values for the IgA assay were greater than or equal to 500, greater than or equal to 500, and greater than or equal to 1000. The specificity of the IgG assays were 94%, 92%, and 90% for the AGE, SA, and UP, respectively. In contrast, the UP was the most sensitive (97%); the other two antigen preparations gave values of 82%. In the IgA assay the UP showed the greatest specificity (90%) and sensitivity (90%). The predictive value for a true positive for the IgG assay was the same for all antigens (93%), whereas the UP gave a predictive value for a true negative of 96% compared with 79% for the other two antigen preparations. Of the patients with gastric or duodenal ulcers, raised antibody titres to SA were found in 72% (IgG) and 73% (IgA), to AGE in 75% (IgG) and 63% (IgA), and to UP in 77% (IgG) and 75% (IgA). The use of a urease antigen preparation to determine IgG antibody is recommended for screening patients undergoing endoscopy. PMID- 2760234 TI - Comparison of intralobar non-parenchyma, subcapsular non-parenchyma, and liver capsule thickness. AB - The intralobar and subcapsular areas of human liver were compared in terms of morphometry and morphology, and a correlation was made between the thickness of liver capsules and the amount of intralobar non-parenchyma in normal and diseased livers. Tissue was systematically sampled from 16 normal and 26 fibrotic livers taken at necropsy. The volume fraction of subcapsular and intralobar non parenchyma and the capsule thickness were determined by morphometry on histological sections. The volume fraction of intralobar non-parenchyma not only correlated well (tau = 0.7, p less than 0.001) with but was also equivalent in each case to the actual volume fraction of subcapsular non-parenchyma. Morphologically, the intralobar and subcapsular areas were remarkably similar. The volume fraction of intralobar non-parenchyma also correlated well (tau = 0.5, p less than 0.001) with capsule thickness. These results show that pathological changes in liver architecture were essentially similar in the intralobar and subcapsular areas and that capsule thickness reflected intralobar non-parenchymal changes. PMID- 2760236 TI - Detection of important abnormalities of the differential count using the Coulter STKR blood counter. AB - An assessment of the three part differential provided by the Coulter STKR blood counter showed good correlation when compared with an 800 cell manual differential. Satisfactory flagging of eosinophilia, basophilia, and the presence of immature cells was found. The use of variables derived from the STKR in conjunction with interpretive reporting and user-defined flagging enabled this department to reduce considerably the numbers of films requiring manual differential counts. PMID- 2760235 TI - Comparative study of iliac crest and proximal femur histomorphometry in normal patients. AB - The relation between the bone histomorphometric profile of the iliac crest and regions of the proximal femur was investigated. In the proximal femur four blocks were selected, representing the subchondral principal compressive (SPC) and tensile (SPT) regions, the zone near the medial cortex in the principal compressive region (MPC), and the zone medial to the greater trochanter (MGT). Undecalcified tissue sections stained by the von Kossa silver method and counterstained with haematoxylin and eosin were used for quantitation. The SPT region was most representative of the iliac bone profile, in particular the structural parameters of mineralised bone, trabecular thickness, and trabecular spacing and resorption surface. Most parameters in the regions studied showed inconsistent and variable results when compared with those of the iliac crest. There was only a weak association, therefore, between the histomorphometric parameters of the iliac crest and the proximal femur despite the appeal of the use of the iliac biopsy specimen as a simple clinical test. PMID- 2760237 TI - Prevalence of haematological anomalies in asymptomatic HIV infection. PMID- 2760238 TI - Survival of Campylobacter pylori in artificially contaminated milk. PMID- 2760239 TI - Ultrastructural localisation of urease in outer membrane and periplasm of Campylobacter pylori. PMID- 2760240 TI - Campylobacter pylori associated acute gastritis in a child. PMID- 2760241 TI - Automated measurement of plasma viscosity by capillary viscometer. PMID- 2760242 TI - Clinitec 200 as a screening test for bacteriuria. PMID- 2760243 TI - Shedding of oocysts of Cryptosporidium in immunocompetent patients. PMID- 2760244 TI - Nucleolar organizing regions in cervical squamous pathology. PMID- 2760245 TI - Use of nucleolar organiser regions (NOR's) for diagnosing gynaecological neoplasia. PMID- 2760246 TI - Effects of 6 months use of an antiseptic mouthrinse on supragingival dental plaque microflora. AB - This study was undertaken to determine whether long-term use (6-months) of an antiseptic mouthrinse (Listerine Antiseptic, Warner Lambert Co., Morris Plains, NJ, USA) led to an undesirable succession of oral pathogens or the emergence of resistant microbial forms. Supragingival plaque was collected from 83 subjects before treatment and after either 3 or 6 months use of either the active antiseptic or a 5% hydroalcohol control. Subjects rinsed with their assigned mouthrinse twice daily under supervision. The plaque samples were analyzed for microbial content by darkfield microscopy, culture on a series of nonselective and selective bacterial media, and by recognition of microbial forms by recognition of distinct colony on a nonselective medium. Statistical analysis of the results revealed no significant microbial shifts including no significant increases in presumptive oral pathogens, spirochetes, black-pigmented Bacteroides, Streptococcus mutans, or Candida albicans. Additionally, no detectable rise in either staphylococci or enteric bacteria, potential opportunistic pathogens, was observed. PMID- 2760247 TI - The effect of a topical non-steroidal anti-inflammatory drug on the development of experimental gingivitis in man. AB - 24 healthy volunteers abstained from tooth-cleaning for 17 days. Parameters of gingival health were recorded on days 1 and 17. On days 4, 6, 8, 11, 13 and 15, each volunteer randomly received, on a double-blind basis, 100 ml of 10 mM flurbiprofen solution in buffered preservative to one upper quadrant of the mouth. The contralateral quadrant received preservative only. Applications were made using a pulsed jet irrigating system. Gingivitis developed in all patients and there were no significant differences between the treatments for gingival index or pocket probing depths. When gingival health was re-established, 4 volunteers had a further 3 irrigations of flurbiprofen at intervals of 2 days. Plasma levels of flurbiprofen were determined after the 1st and 3rd irrigations. Assays showed that the drug was present in the plasma of all 4 subjects (range 0.2-0.7 micrograms/ml). Gingival health was re-established in 6 further volunteers from the original study. They then abstained from toothbrushing for 17 days, during which one maxillary quadrant was irrigated with the buffered preservative solution. The irrigations were made on the same basis as in the original study. Gingivitis again developed in these quadrants, although when the results were compared to the equivalent data from the first investigation, significantly greater median values for probing pocket depths and gingival indices were found in the latter study. Therefore, it appears that systemic absorption of flurbiprofen may have reduced the severity of the developing inflammatory lesions. PMID- 2760248 TI - Pulsated jet subgingival irrigation with 0.1% chlorhexidine, simplified oral hygiene and chronic periodontitis. AB - This study investigated the efficacy of a 0.1% chlorhexidine preparation as an aid to a basic oral hygiene programme comprising only baseline root and crown debridement, instruction in bass brushing without emphasis on interdental cleaning, and pulsated mono-jet subgingival irrigation. Baseline data for plaque index, papilla bleeding index and probeable pocket depth were similar in both test and control groups. Mean values for all 3 parameters were clearly lower in the chlorhexidine group, both at the end of the period of active treatment and up to 2 months thereafter. These differences were statistically significant for P1I at day 28, PBI at day 56 and PPD at days 56 and 84, but not at day 168. Proportionately more sites generally showed improvement in the chlorhexidine group at all times. It was concluded that 0.1% chlorhexidine significantly enhances the effects of the practical oral hygiene regime described. PMID- 2760249 TI - Effect of placement of occlusive membranes on root resorption and bone regeneration during healing of circumferential periodontal defects in dogs. AB - Previous studies indicate that root resorption is a frequent sequela to significant amounts of periodontal repair in animal models. A model was developed in labrador dogs to study periodontal wound healing in large circumferential defects in the absence of influence from the oral environment. A polytetrafluorethylene membrane of 1 micron pore size (GORE-TEX) was used to occlude cells from specific tissues from populating the healing dentin-connective tissue wound. 3 modalities were studied: (1) control, in which no membrane and therefore no cell occlusion was used, (2) flap occlusion, in which the internal surface of the flap was lined with the membrane preventing contribution of cells from the flap, (3) bone occlusion, in which the reduced alveolar bone was lined with the membrane preventing contribution from bone cells. Wound closure included total submergence of teeth and membranes. The membranes remained incorporated and no exposure of membranes or teeth occurred during the 3 months healing period. Histology revealed bone regrowth in all 3 treatment modalities. It is suggested that inductive elements in the connective tissue or dentin, or bone cells from periosteum were responsible for bone regrowth in the bone membrane treatment modality. No significant difference was seen for root resorption between the 3 treatment modalities. This study found that physical occlusion of cells from the inside of the surgical flap, or from the pre-existing bone, is not sufficient to prevent root resorption in periodontal wound healing. PMID- 2760250 TI - Studies on the effect of toothpaste rinses on plaque regrowth. (I). Influence of surfactants on chlorhexidine efficacy. AB - A number of compounds have been added to toothpastes to inhibit plaque regrowth. The inclusion of cationic antiseptics, such as chlorhexidine, poses formulation difficulties because of interactions with other ingredients particularly anionic detergents. More recently, Triclosan/zinc citrate formulations have been shown effective plaque inhibitors. The aim of this study was to compare a commercially available 0.2% Triclosan/0.5% zinc citrate toothpaste with a number of experimental 0.5% chlorhexidine/detergent toothpastes for effects on plaque regrowth over 4 days. Subjects rendered plaque free at each baseline rinsed twice a day with toothpaste slurries and disclosed plaque was scored at the end of each period. All toothpastes significantly reduced plaque by comparison with a control toothpaste, but were significantly less effective than a 0.2% chlorhexidine rinse. Some significant differences in favour of one chlorhexidine toothpaste were noted but these were small in magnitude. Whether the plaque inhibition obtained with Triclosan/zinc citrate toothpaste was greater than would be expected from other commercially available preparations cannot be determined from this study and is the subject of a further investigation. PMID- 2760251 TI - Studies on the effect of toothpaste rinses on plaque regrowth. (II). Triclosan with and without zinc citrate formulations. AB - Encouraging findings have been reported for the effects of Triclosan/zinc citrate toothpastes on plaque regrowth and in some studies gingival health. To date, commercially-available toothpastes contain 0.2% Triclosan with or without 0.5% zinc citrate. The aim of this study was to evaluate the effects on 4-day plaque regrowth, of a number of 0.2% Triclosan toothpastes with or without zinc citrate. All of the toothpastes contained varying levels of anionic detergent sodium lauryl sulphate and were compared with a commercially available toothpaste without Triclosan or zinc citrate and a 0.2% chlorhexidine mouthrinse. The toothpastes were used as slurry twice a day and plaque regrowth scored by area and the criteria of the debris index. Plaque inhibition was significantly greater with the chlorhexidine mouthrinse than with all of the toothpastes. There were no significant differences in plaque scores between any of the toothpastes. It would appear that at the concentration of 0.2% Triclosan with or without 0.5% zinc citrate provides little if any additional benefit to plaque inhibition to that produced by a conventional toothpaste containing sodium lauryl sulphate. PMID- 2760252 TI - Actinobacillus actinomycetemcomitans contamination of toothbrushes from patients harbouring the organism. AB - The main ecological niche of Actinobacillus actinomycetemcomitans (A.a.) seems to be the periodontal pocket, but it can also be isolated from supragingival plaque, buccal and tongue mucosa, or saliva. We examined toothbrushes from 21 patients, all identified as harbouring moderate to large numbers of A.a. in subgingival plaque, for contamination with this organism. 29% of the toothbrushes presented by our patients yielded detectable numbers of A.a. Immediately after toothbrushing this figure rose to 62%, but dropped to 50% after 1 h. Numbers of isolated A.a. on toothbrushes were weakly correlated with the degree of periodontal destruction, and significantly more numbers of A.a. on toothbrushes could be detected if the organism was found on mucous membranes or in saliva. There was no association with gingival inflammation, supragingival plaque nor mean numbers of isolated subgingival A.a. PMID- 2760253 TI - Enterohepatic circulation of drugs. PMID- 2760254 TI - The renal function and blood pressure effects of dilevalol in the normotensive and hypertensive elderly. AB - Dilevalol, the R-R optical isomer of labetalol, is a nonselective beta adrenergic blocking drug with selective beta-2 agonist properties. In a double-blind, crossover study the renal function effects of dilevalol were compared to placebo in 12 normotensive elderly volunteers before and after single dose administration. In addition, chronic treatment (greater than 4 weeks) effects of dilevalol were determined in eight elderly patients with mild to moderate essential hypertension. Renal function was determined by plasma disappearance curves from single injections of 99mTc-DTPA and 131I-orthohippurate. In both study populations renal function tests commenced two hours after dosing at expected peak plasma levels of dilevalol. Normotensive volunteers had an acute decrease in glomerular filtration rate of 10.3 ml/min, which was significant (P less than 0.05), while hypertensive patients had no change in glomerular filtration rate. There were no significant changes in other parameters of renal function measured. In the hypertensive elderly dilevalol treatment resulted in significant reductions, 18 and 19 mmHg respectively, of systolic (P less than 0.01) and diastolic (P less than 0.001) blood pressure. Heart rate was reduced by 5 beats per minute, and the change was not statistically significant. Dilevalol appears to be an excellent agent for treatment of hypertension in the elderly hypertensive patient, and does not change renal function when administered chronically to the hypertensive patient. Small but significant decrements in glomerular filtration rate occur with acute administration to normotensive volunteers. PMID- 2760255 TI - Acute hemodynamic responses to weightlessness in humans. AB - As NASA designs space flights requiring prolonged periods of weightlessness for a broader segment of the population, it will be important to know the acute and sustained effects of weightlessness on the cardiovascular system since this information will contribute to understanding of the clinical pharmacology of drugs administered in space. Due to operational constraints on space flights, earliest effects of weightlessness have not been documented. We examined hemodynamic responses of humans to transitions from acceleration to weightlessness during parabolic flight on NASA's KC-135 aircraft. Impedance cardiography data were collected over four sets of 8-10 parabolas, with a brief rest period between sets. Each parabola included a period of 1.8 Gz, then approximately 20 seconds of weightlessness, and finally a period of 1.6 Gz; the cycle repeated almost immediately for the remainder of the set. Subjects were semi-supine (Shuttle launch posture) for the first set, then randomly supine, sitting and standing for each subsequent set. Transition to weightlessness while standing produced decreased heart rate, increased thoracic fluid content, and increased stroke index. Surprisingly, the onset of weightlessness in the semi supine posture produced little evidence of a headward fluid shift. Heart rate, stroke index, and cardiac index are virtually unchanged after 20 seconds of weightlessness, and thoracic fluid content is slightly decreased. Semi-supine responses run counter to Shuttle crewmember reports of noticeable fluid shift after minutes to hours in orbit. Apparently, the headward fluid shift commences in the semi-supine posture before launch. is augmented by launch acceleration, but briefly interrupted immediately in orbit, then resumes and is completed over the next hours. PMID- 2760256 TI - Clinical utility of nifedipine and diltiazem plasma levels in patients with angina pectoris receiving monotherapy and combination treatment. AB - The clinical utility of nifedipine and diltiazem blood levels in patients with angina pectoris receiving monotherapy (N = 14) and combination treatment (N = 9) were assessed in a placebo run-in, double blind, randomized, crossover study. Compared to placebo, diltiazem (mean daily dose 360 mg), nifedipine (mean daily dose 90 mg) and combination diltiazem-nifedipine therapy (mean daily dose 55 mg of nifedipine, 360 mg of diltiazem) were associated with reductions in weekly angina attacks and nitroglycerin consumption. Although both drugs used as monotherapy and in combination were also associated with significant increments in exercise tolerance and other improved angina parameters, these changes were not related to the plasma levels of either drug. Nifedipine plasma levels were measured by gas chromatography and diltiazem plasma levels measured by reverse high-pressure liquid chromatography from specimens obtained 2-5 hours after the last previous dose, after 1, 2 and 3 weeks of treatment, and during baseline placebo and placebo washout periods. With combination therapy, there was no effect on the diltiazem plasma level compared to monotherapy. The significant decrease in the nifedipine dose in patients on combination therapy did not significantly change nifedipine plasma levels. Determinations of plasma levels of diltiazem and nifedipine in the management of patients is of no value in the management of patients with angina pectoris except for monitoring treatment compliance and overdosage. PMID- 2760257 TI - Clinical pharmacology of dilevalol (II). The pharmacokinetic, pharmacodynamic, and tolerance studies of dilevalol during repeated administration in healthy subjects. AB - Dilevalol (50 mg) was given orally twice daily for eight days in six healthy subjects. All parameters were obtained following 1st (on day 1) and 15th (on day 8) dosages. Blood samples for plasma drug concentrations were taken for a 12-hour (after 1st dosage) or a 24-hour (after 15th dosage) post-drug period. Blood pressure (BP) as well as heart rate (HR) at supine position, during 50 degrees tilting and during a submaximal exercise were measured after each dosage. The mean time to maximum concentration (tmax) was faster, and the mean area under the plasma concentration-time curve (AUC) was greater after 15th dosage than following 1st dosage. No significant differences were observed in the maximum plasma concentration (Cmax), the distribution half-life (t 1/2 alpha) or the elimination half-life (t 1/2 beta) between the two dosages. BP at supine position as well as during 50 degrees tilting decreased significantly after each dosage, and did not differ between 1st and 15th dosages. Postural changes in BP or HR during 50 degrees tilting were not induced following 1st or 15th dosage. The suppressing effects (%R) on an increase in HR during a submaximal exercise were significantly larger after 15th dosage than after 1st dosage. A significant correlation was observed between plasma dilevalol concentration and %R in HR. These data indicate that the hypotensive effect of dilevalol is not altered during the repeated administration of the drug for 8 days. However, the beta blocking activity of dilevalol might be enhanced during the repeated dosages, which is, in part, attributed to dosage-dependent elevation in plasma drug concentrations. PMID- 2760258 TI - Effect of quinolone antimicrobials on theophylline pharmacokinetics. AB - The purpose of the research was to ascertain the comparative differences of quinolone antibiotics on theophylline pharmacokinetics. Eight healthy male volunteers were randomly assigned to four treatments. Each was administered norfloxacin (NOR) 800 mg/d, ciprofloxacin (C) 1 g/d, nalidixic acid (NAL) 2 g/d and placebo (P) for 7 days. On the seventh day of each treatment, theophylline (5 mg/kg) iv was administered. The elimination half-life (T 1/2), total body clearance (CL) and volume of distribution at steady state (Vss) of theophylline were calculated using model-independent methods. ANOVA for repeated measures was used for data comparisons. The mean (SD) theophylline results were: CL l/kg/h- NOR .038 (.006), C .033 (.006), NAL .045 (.008), P .044 (.007); T 1/2 h--NOR 9.2 (1.8), C 10.6 (1.8), NAL 8.3 (1.8), P 7.5 (1.4). Theophylline Vss differences by treatment were not significant. NOR and C significantly decreased theophylline's clearance and the clearance change can be of clinical significance. PMID- 2760259 TI - Arithmetic versus harmonic mean values of elimination half-life: a study of triazolam. PMID- 2760260 TI - The influence of intravenous cimetidine dosage regimens on the disposition of theophylline. AB - The influence of the method of cimetidine administration on theophylline disposition was studied in nine healthy, cigarette smoking male volunteers. The treatment phases consisted of: A) theophylline alone, B) theophylline plus intermittent cimetidine therapy (300 mg IV every 6 hr), and C) theophylline in combination with continuous infusion cimetidine (50 mg/hr). Theophylline (4.8 mg/kg) was administered intravenously as aminophylline over 30 minutes during each treatment phase. During study phases B and C subjects received 48 hours of cimetidine therapy beginning 24 hours prior to theophylline dosing. Blood samples for determination of theophylline concentrations were collected serially over 24 hours. Serum theophylline concentrations were determined in duplicate using fluorescence polarization immunoassay (Abbott Diagnostic TDx). The average age of the subjects was 27.4 +/- 4.7 years, and the individual smoking histories ranged from 0.5 to 1.5 packs per day (average 0.89 +/- 0.33). The mean (+/- SD) body weight was 79.1 +/- 8.2 kg and all subjects were within 20% of their ideal body weight. Theophylline pharmacokinetic parameters were determined using noncompartmental analysis. ANOVA for repeated measures and Tukey's multiple comparison test were used for statistical analysis. The mean (+/- SD) theophylline clearance for each of the treatment groups was: 1.4 +/- 0.4, 1.2 +/- 0.3, and 1.2 +/- 0.2 ml/min/kg for phases A, B and C, respectively. Cimetidine decreased the clearance of theophylline, however, theophylline clearance was not statistically different between regimens B and C. Thus, the method of cimetidine administration (intermittent versus continuous infusion) did not influence the magnitude of the drug-drug interaction. PMID- 2760261 TI - Duration of retinogenesis: its relationship to retinal organization in two cricetine rodents. AB - The Mongolian gerbil (Meriones unguiculatus) has a prolonged period of development relative to other muroid rodents. We have explored the consequences of this relatively long period of maturation on retinal cell number and topography by comparing the duration and topography of neurogenesis in the gerbil retina with that of a closely related species which develops rapidly, the Syrian hamster (Mesocricetus auratus) (Sengelaub et al.: J. Comp. Neurol. 246:527-543, 1986). An analysis of thymidine-labeled retinas indicate that cells destined for the gerbil retinal ganglion cell layer are generated for at least 12 embryonic days, twice the duration in the hamster. The period of cell loss in the gerbil retinal ganglion cell layer extends for at least 14 postnatal days, more than twice as long as in the hamster. The gerbil retina is generated in a center-to periphery gradient for both retinal ganglion cells and displaced amacrine cells, while no such gradients are evident in the hamster retina. We conclude that the longer developmental period of the gerbil is associated with 1) a longer period of neurogenesis resulting in greater retinal cell number, 2) the expression of spatial gradients in neurogenesis, and 3) a larger eye at maturity. The last two factors, in part, may be related to the development of a highly differentiated area centralis and visual streak in the retina of this rodent. Unrelated to duration of growth, early differences in retinal shape between these two species contributes to the development of retinal topography. The gerbil, but not the hamster retina, is initially asymmetric, longer in its nasotemporal than its dorsoventral dimension. The gerbil retina then grows asymmetrically, producing a spherical retina, and coincident in time, a nasotemporally extended visual streak. PMID- 2760262 TI - Type B monoamine-oxidase-containing cells and fibers in the cat hypothalamus demonstrated by an improved enzyme histochemical method. AB - The present study, using a diaminobenzidine (DAB)-coupled peroxidation method, examined the distribution and morphological characteristics of neuronal structures containing type B monoamine oxidase (MAO-B) in the cat hypothalamus. Large and intensely stained, distinctive MAO-B-positive cells, multipolar and with long dendritic arbors, were principally distributed in the ventral hypothalamus extending from A7 to A12.5 of the Horsley-Clarke plane. These cells were located caudally in the ventral surface of the brain including the tuberomamillary nucleus (TM) and the region surrounding the mamillary nuclei. Rostrally, they were aggregated in the area surrounding the fornix, particularly in the lateral perifornical region, and dispersed in the anterior mamillary nucleus, lateral hypothalamic area (HLA), and the medial tip of the entopeduncular nucleus. The most rostral positive cell group was identified in a narrow space between the optic tract and the entopeduncular nucleus at the A12.5 level. In addition to these large cells, the present study disclosed the presence of "small" to "very small" MAO-B-positive cells in the area surrounding the mamillary recess and the lateral part of the caudal arcuate nucleus. Distinct MAO B-stained fibers were identified in all regions of the hypothalamus. A large number of thick labeled fibers were observed in the ventral hypothalamus including the TM and premamillary nucleus and posterior and lateral hypothalamic areas. A dense network of MAO-B-positive terminal-like fibers was observed in the dorsomedial nucleus where very small labeled cells were scattered. Many intensely stained thick and straight fibers were seen running ventrolaterally in the anterior part of the HLA and in the narrow space between the entopeduncular nucleus and optic tract. In the area of the tuber cinereum and the ventral part of the HLA, there were many positive fibers cut transversely, possibly projecting to the more anterior parts of the brain such as the diagonal band of Broca or septal nuclei. PMID- 2760263 TI - Organization of astrocytes in the visual pathways of the goldfish: an immunohistochemical study. AB - We have used antisera directed against glial cytoskeletal proteins to examine the distribution and organization of astrocytes in the visual pathways of the goldfish. We describe two different types of cells, which may be distinguished by their unique cytoskeletal proteins. Antibodies raised against a 48 Kd optic nerve protein react with stellate astrocytes in the optic nerve but virtually no glial cells in the brain (although blood vessels and the meninges in the brain were stained). The optic nerve astrocytes form a dense meshwork of processes through which the optic fibers pass. The intraorbital and intracranial segments of the nerve are divided into fascicles, each bounded by a glia limitans, which extend across the optic chiasm. Astroglial cells in the brain bind antibodies raised against a 50 Kd brain cytoskeletal protein. These antibodies show a very limited cross-reactivity with optic nerve cells. Brain astrocytes have filiform profiles and most appear to be deployed as radial glia. The glial fabric of the brain, as revealed by these antibodies, is far more loosely woven than that of the optic nerve. There is a sharp boundary between the two types of glial cells, immediately behind the optic chiasm. Glial processes in the optic tracts arise from cells in the preoptic area, whereas those in the optic tectum arise from cells that reside locally. In the optic tract, a glia limitans was often difficult to discern, whereas in the tectum one was always evident and composed of endfeet at the pial extremities of radial glial processes. These findings are discussed both in the context of previous observations by other workers as well as with regard to their possible functional implications. PMID- 2760264 TI - Biochemical and immunocytochemical characterization of olfactory marker protein in the rodent central nervous system. AB - Olfactory marker protein (OMP), previously thought to be expressed only by olfactory receptor neurons and their processes, was localized anatomically with immunocytochemical techniques to a number of brain regions in three rodent species, the mouse, rat, and hamster. In addition, the amount of antigen was quantified by radioimmunoassay (RIA) and characterized by an immunoblot procedure. In all three species the antigen could be detected immunocytochemically in the preoptic region and hypothalamus. The rat did not exhibit immunostaining in any other brain region. However, in the mouse neuronal labelling was observed throughout the neural axis, including cellular labelling in the bed nucleus of the anterior commissure, the median preoptic nucleus, the bed nucleus of the stria terminalis, the periventricular region, the anterior parvicellular subnucleus of the paraventricular nucleus, around the dorsomedial hypothalamic nucleus (pars compacta), the subincertal region, the arcuate nucleus, the anterior cortical nucleus of the amygdala, the suprageniculate nucleus, the lateral lemniscal nuclei, the lateraldorsal and lateralventral central gray, the posterior aspects of the commissural and marginal nuclei of the inferior colliculus, the paragenule nucleus, the A-5 region, the area postrema, the ventromedial nucleus of the solitary tract, area X, the spinal trigeminal nucleus (pars zonale), and superficial laminae of the spinal cord. The hamster displayed a different pattern of labelling including cells in the periventricular gray, the pontine reticular tegmental nucleus, the A-5 region, the medial vestibular complex, the prepositus hypoglossal nucleus, the parvicellular reticular nucleus, the lateral paragigantocellular nucleus, the raphe obscuras, the lateral reticular nucleus, and the lateral nucleus of the cerebellum. Immunostaining was seen in fibers within the red nucleus and within mossy fibers of the cerebellum. OMP levels could only be quantified by radioimmunoassay in the olfactory bulb of the three species and in the hamster cerebellum where they were 1/1,000 of those determined in the olfactory bulb. The authenticity of OMP measured in the RIA and detected immunocytochemically was verified by a double antibody immunoisolation/immunodetection procedure, which confirmed that the antigen being visualized had the molecular properties expected for OMP. In summary, these experiments demonstrate that authentic OMP exists in small groups of neurons in many areas of the central nervous system. PMID- 2760265 TI - Selective destruction of mossy fibers and granule cells with preservation of the GABAergic network in the inferior region of the rat hippocampus after colchicine treatment. AB - Lesions induced by colchicine injection into the rat hippocampus were investigated by means of electron microscopy and GABA immunocytochemistry. Granule cells were nearly completely destroyed 3 days after colchicine injection; since the necrosis of their axonal endings was delayed, an anterograde degeneration of the mossy fibers had probably taken place. The selectivity of the lesions was not limited to granule cells, for some pyramidal neurons in CA1 pyramidal layer were damaged. It was, however, striking to observe that throughout the hippocampal structure GABAergic neurons were spared from the effects of colchicine. For instance, GABAergic neurons were found in the vicinity of the completely destroyed granule cell layer. GABAergic neurons and terminals were also present in the CA3 region where the GABA-containing terminals formed a dense network of synapses with somata and dendrites of pyramidal cells. It was interesting to note that, consistent with previous studies, the GABAergic neurons in CA3 are innervated by mossy fibers. We conclude that after colchicine treatment the destruction of the granule cells was not associated with a lesion of the GABAergic network. This selective lesion provides a useful model with which to study the properties of CA3 neurons deprived of their major excitatory input but with an intact inhibitory network. PMID- 2760266 TI - Efferent connections of the dorsal cortex of the lizard Gekko gecko studied with Phaseolus vulgaris-leucoagglutinin. AB - The efferent connections from the dorsal cortex of the lizard Gekko gecko have been studied with the anterograde tracer Phaseolus vulgaris-leucoagglutinin. It appeared that the dorsal cortex is not a homogeneous structure as far as the efferent connections are concerned. All parts of the dorsal cortex project to the septum. All parts except the most medial project to the dorsal ventricular ridge, amygdala, nucleus periventricularis hypothalami, area lateralis hypothalami, and the anterior olfactory nucleus. The most medial part, in addition to the septal projections, is connected with the medial cortex and the contralateral medial and dorsal cortices. From the rostral part additional projections could be traced to the nucleus dorsolateralis hypothalami, nucleus ventromedialis thalami, nucleus dorsolateralis thalami, striatum, pallial thickening, medial cortex, nucleus olfactorius anterior, and the main and accessory olfactory bulbs. From the caudal part additional projections exist to the nucleus dorsomedialis thalami, nucleus accumbens, and the contralateral dorsal cortex. A system of intrinsic connections exists that can be subdivided into four subsystems, each of which subserves the interconnections within four subdivisions of the cortex: 1) the superficial medial part, 2) the deep medial part, 3) the caudal lateral and caudal intermediate parts, and 4) the rostral lateral and rostral intermediate parts. Connections between these four areas are scarce. From the present results the conclusion is drawn that the dorsal cortex of the lizard Gekko gecko has many hodological aspects in common with the ventral subiculum of mammals. The present results do not support the hypothesis that the dorsal cortex is the reptilian equivalent of the mammalian neocortex. PMID- 2760267 TI - Distribution and morphometric characteristics of oxytocin- and vasopressin immunoreactive neurons in the rabbit hypothalamus. AB - The distribution, morphological features, and morphometric characteristics of cell bodies producing oxytocin (OT) and vasopressin (AVP) were studied in the rabbit hypothalamus by means of a conventional immunoperoxidase method. The aim of the present study was to determine the existence or not of a species-specific OT-cell group that might be involved in the dense OT innervation of the intermediate lobe in the leporidae. No OT-cell group clearly distinct from the hypothalamic paraventricular (PVN) and supraoptic (SON) nuclei was found, even in colchicine-treated animals. Most immunoreactive perikarya were found within these nuclei. In addition, small AVP neurons occurred in the suprachiasmatic nucleus. In the SON, the predominant, tightly packed AVP cells occupied the ventral part of the nucleus, whereas OT neurons were dorsolaterally located. The PVN presented a loose organization without any obvious subdivision. OT cells, which predominated, occupied the medial part of the nucleus. The PVN had a prominent rostral anterobasal extension composed mainly of OT cells. Laterally to the nucleus, numerous large AVP neurons, with few and smaller OT cells, dispersed along the neurosecretory tract without forming definite cell clusters. AVP cell bodies had a rough granular aspect contrasting with the smooth and fine one of OT cells. Spinelike processes were rarely observed on the perikarya, except on large scattered AVP neurons, but frequently covered the proximal dendrites of both types of neurons. Throughout the hypothalamus, OT neurons had definitely smaller mean somal areas and were more homogeneous in size than AVP cells. PMID- 2760268 TI - Retinotopic organization within the lateral posterior complex of the cat. AB - Electrophysiological mapping methods were employed to systematically study the retinotopic organization within the cat's lateral posterior complex (LP). Visual responses were recorded in all the major subdivisions of the LP as well as in several adjoining cell groups. Specifically, separate representations of the visual field were identified for pulvinar, zones LP1-c, LP1-r, LPi, and LPm. Partial representations of the visual field were also evident in the geniculate wing, subdivisions of the lateral posterior shell, the inferior division of the posterior nuclear group, the suprageniculate nucleus, and the central lateral nucleus. Sufficient mapping observations were made to define the internal organization of major visual representations. Additionally, there was a very close correspondence between the mapping observations when they were compared with the cytoarchitectural criteria for recognizing functional cell groups (Updyke: J. Comp. Neurol. 219:143-181, '83). PMID- 2760269 TI - Development of the nerve fiber layer in the olfactory bulb of mouse embryos. AB - The purpose of this study was to provide an ultrastructural description of the development of the olfactory nerve fiber layer (ONL) in the olfactory bulbs of mouse embryos. The developmental age of each embryo was determined by means of the Theiler staging system. During stages 17 and 18, the olfactory axons grew through the mesenchyme toward the cerebral vesicle; they were accompanied by a group of electron-dense cells which were referred to as peripheral glial progenitor cells (GPCs) because they ensheathed the adjacent axons. In Theiler stage 19-21 embryos, the axons and the peripheral GPCs grew dorsocaudally along the external surface of the bulb primordium forming a presumptive ONL immediately superficial to its glia limitans. Through small breaks in this glia limitans, the axons, but not the peripheral GPCs, penetrated into the marginal zone of the bulb primordium. Even though by the first half of stage 21 there were only short stretches of glia limitans separating the presumptive ONL from the marginal zone, there was no intermingling of the perikarya between the two layers. A definitive ONL could be identified by the second half of Theiler stage 21, by which time the glia limitans of the bulb primordium had totally disappeared. However, up to Theiler stage 24 of development the only cells to be found in this definitive ONL were the peripheral GPCs. Although in Theiler stage 25 and 26 embryos there was an additional population of less-electron-dense GPCs within the definitive ONL, these cells were likely derived from the previous group of peripheral GPCs rather than from cells newly emigrated from the deeper layers of the developing bulb. This developmental data necessitated a reevaluation of the cell lineages of the two glial cell types that reside within the ONL of the adult olfactory bulb. PMID- 2760270 TI - Relationships between vitamin E status and erythrocyte stability in sheep. AB - Stability of erythrocytes from sheep with vitamin E deficiency (E-deficient) was compared by two haemolytic tests, one based on osmotic fragility in hypotonic saline and the other on detergent sensitivity in Tween 20. Relationships between haemolysis, plasma alpha-tocopherol concentration and creatine kinase (CK) activity were evaluated. E-deficient animals were clinically healthy but had elevated (greater than 1000 iu per 1) CK activities and low (less than 1 mumol per 1) alpha-tocopherol concentrations compared with control sheep (less than 500 iu per 1 and greater than 1.5 mumol per 1, respectively). Erythrocytes from E deficient sheep were markedly more susceptible to detergent treatment than those from controls, but osmotic fragility was similar in both groups. Detergent sensitivity was directly related to plasma alpha-tocopherol concentration and CK activity but not to erythrocyte glutathione peroxidase activity. Within 24 h of supplementation (300 mg alpha-tocopherol subcutaneously) of E-deficient sheep, plasma alpha-tocopherol concentrations were increased, CK activities decreased and erythrocyte susceptibility to detergent-induced haemolysis was significantly reduced. Concentrations of alpha-tocopherol returned rapidly (less than 3 days) to pre-supplement values, although decreased haemolytic responses persisted longer (greater than 7 days). Cells from E-deficient animals were protected against detergent-induced haemolysis by preincubation with alpha-tocopherol in vitro. The results indicate that detergent sensitivity of erythrocytes may provide the basis of a simple functional test for vitamin E deficiency in sheep. PMID- 2760271 TI - Reproductive abnormalities in canine fucosidosis. AB - Male English springer spaniel dogs affected with fucosidosis, a lysosomal storage disorder, were found to be infertile while females with the disease reproduced successfully. Ejaculates of semen collected from affected dogs had reduced total sperm output and morphologically abnormal spermatozoa. A high proportion of ejaculated spermatozoa had midpiece droplets, bent tails and poor motility. Severely vacuolated epididymal epithelial cells were observed by light microscopy. Electron microscopic examination revealed membrane-bound vacuoles of variable size containing scanty amounts of granular to fibrillar material in epididymal epithelial cells, smooth muscle, myoid cells and Sertoli cells. Male infertility is believed to result from lysosomal storage of fucosyl-linked substrates in cells of the reproductive system. The extensive lesions in the epididymis may have interfered with maturation and transport of spermatozoa. Also, deficiency of alpha-L-fucosidase activity could have impaired the shedding of cytoplasmic droplets from spermatozoa and altered the surface glycoprotein composition of the sperm during epididymal transit. PMID- 2760272 TI - Lysosomes in the pathogenesis of liver injury in chronic copper poisoned sheep: an ultrastructural and morphometric study. AB - Chronic copper poisoning was induced in sheep by oral dosing with CuSO4. The distribution of copper between hepatocytes was unequal and, with increasing liver copper concentration, isolated hepatocytes packed with electron-dense lysosomes were seen. These cells underwent degeneration and necrosis. During the pre haemolytic period, the concentration of Cu in the liver increased and the volume density, numerical density and mean volume of hepatocyte lysosomes increased in a linear fashion, indicating that there was proliferation as well as increase in the size of lysosomes. However, in animals killed during haemolysis, the numerical density had decreased but the volume density was little changed which indicates that lysosomal production may have diminished. It is postulated that the necrosis of hepatocytes packed with electron-dense lysosomes may be due to the accumulation of toxic amounts of copper in the cytosol, resulting from a reduced uptake of copper into the lysosomal system of these cells, and that the susceptibility of liver cells to Cu-induced damage may be increased if lysosome production is diminished. PMID- 2760273 TI - The roles of glucocorticosteroid and of fibrinolytic activity in the development of bilateral renal cortical necrosis in cycloheximide-treated mice challenged with a submicrogram dose of endotoxin. AB - Mice given cycloheximide and 0.2 microgram of endotoxin simultaneously developed ischaemic bilateral renal cortical necrosis as part of a fatal syndrome. Endotoxin given 2 h after cycloheximide, although fatal, failed to produce renal cortical necrosis. Investigation suggested that, following endotoxin challenge in cycloheximide-treated mice, the occurrence or non-occurrence of bilateral renal cortical necrosis was determined by the concentration of circulating glucocorticoids at the time of endotoxin challenge. Thus, below a certain, as yet undefined, glucocorticoid concentration, endotoxin does not cause renal cortical necrosis in cycloheximide-treated mice. Inhibition of the fibrinolytic system by epsilonaminocaproic acid (EACA) indicated that protection against renal cortical necrosis was directly mediated by increased fibrinolytic activity. Since this increased activity occurred during a period of profound cycloheximide-mediated inhibition of protein synthesis, it was postulated that pre-existing plasminogen activator was released from inhibition, and that this release could only occur when the glucocorticoid concentration fell below a certain critical value. PMID- 2760274 TI - Effect of gossypol on the thyroid in young rats. AB - The effect of gossypol on thyroid structure and function was examined. Groups of young male rats were subcutaneously injected daily with 0.2 ml gossypol acetic acid in doses of 1, 5, or 10 mg per kg body weight. Control rats were injected with vehicle only. At the end of the 15-day treatment, there was a dose-dependent decrease in the serum concentrations of thyroid hormones, i.e., free thyroxine, triiodothyronine, and reverse triiodothyronine. Histopathological examination revealed focal degeneration of thyroid follicles after a dose of 1 mg gossypol per kg body weight; widespread follicular atrophy occurred with 5 mg and 10 mg gossypol per kg body weight. The degenerating follicles were lined with discontinuous cuboidal or squamous follicular epithelium, some of which exfoliated into colloid. PMID- 2760275 TI - A comparison of rat femoral, sternebral and lumbar vertebral bone marrow fat content by subjective assessment and image analysis of histological sections. AB - A subjective assessment of the amount of fat within the available marrow space was made from histological sections of the femur, sternebrae and lumbar vertebrae in rats. The sternebrae and vertebrae showed considerably less variability than the femur. Comparison between subjective assessment and image analysis of femoral bone marrow fat showed that there is no great advantage to be gained from using the latter technique. It was concluded that evaluation of sternebral and vertebral bone marrow results in a more accurate assessment of fat content. PMID- 2760276 TI - Studies of the protective effect of different fractions of sera from pigs immune to Streptococcus suis type 2 infection. AB - Inoculation of mice with high doses of Streptococcus suis type 2 caused depression, anorexia, lethargy and sometimes death. This was prevented by prior inoculation of whole immune pig serum, the IgM and IgG fractions of immune pig serum and serum enriched with antibody to surface antigens. Clinical signs were not prevented by prior inoculation of pre-immune serum or serum depleted of antibody to surface antigens. Serum fractions that were protective in vivo were also opsonic in vitro. Western blot analysis identified two antigens of 44 and 78 kd that were recognized strongly by protective sera and a further four of 86, 94, 130 and 136 kd that were recognized less intensely. PMID- 2760277 TI - Fracture-associated osteogenic sarcoma and a mandibular osteoma in two goats. AB - An osteogenic sarcoma in association with a previously repaired fracture site and an osteoma were recorded in two aged Toggenburg and Toggenburg-cross goats. In one animal, five years after the surgical repair of a comminuted mid-shaft humeral fracture with an intramedullary pin, a sarcoma with osteoid production developed at the fracture site. A review of records revealed the previous occurrence of a mandibular osteoma inducing both subluxation of the temporal mandibular joint and contralateral mandibular deviation in a second animal. Such lesions are rarely documented in goats. PMID- 2760278 TI - An acute pleuropneumonia in a pig caused by Chromobacterium violaceum. AB - A 2.5-month-old, 30 kg Duroc pig died 10 days after showing clinical signs of dyspnoea and diarrhoea. Acute necrotizing and fibrinous pleuropneumonia with locally extensive lesions was found. Chromobacterium violaceum was isolated from pneumonic lung tissues and intratracheal inoculation of a pure culture into two SPF pigs reproduced lesions similar to those found in the natural infection. PMID- 2760279 TI - Leiomyoma of the tunica albuginea in a horse. AB - A leiomyoma of the left testicle was found in a 7-year-old Arabian stallion at routine castration. The neoplasm consisted of interlacing bundles of well differentiated, haphazardly arranged, smooth muscle cells attached superficially to the tunica albuginea. PMID- 2760280 TI - Multifocal bullous emphysema with concurrent bronchial hypoplasia in two aged Afghan hounds. AB - Multiple scattered foci of bullous emphysema were detected in the lungs of two aged Afghan Hounds. The affected parenchyma contained bronchi with rudimentary cartilage and small smooth muscle bundles. The bronchi were generally lined by cuboidal epithelium. The animals were generally asymptomatic throughout their entire lives. One, the female, developed dyspnoea and tachypnoea terminally, following the rupture of two bullae. PMID- 2760281 TI - Seminoma and parathyroid adenoma in a snow leopard (Panthera unica). AB - A seminoma and parathyroid adenoma were diagnosed in an aged snow leopard. The ultrastructural appearance of the seminoma was similar to that described in the dog and in man. The lack of significant amounts of rough endoplasmic reticulum, Golgi complexes and free ribosomes in the parathyroid adenoma suggested that it was non-functional. Parathyroid adenoma has not been previously described in a large wild feline. PMID- 2760282 TI - Avian colonic ion transport: effects of corticosterone and dexamethasone. AB - 1. Corticosterone, a natural corticosteroid hormone in birds, when injected into domestic fowl (Gallus domesticus) (2000 micrograms.kg-1, 4-5 h before experiment) increases both the basal Isc (short-circuit current) and amiloride-sensitive Isc as well as the PD across the colon in vitro. Dexamethasone, a synthetic analogue (650 micrograms.kg-1, 4-5 h before experiment) also increases the basal and amiloride-sensitive Isc as well as PD in these preparations. 2. In marked contrast, longer term injection or infusion of dexamethasone (650 micrograms.kg 1) for 3 or more days caused a decline in basal Isc and PD (the PD often reversed with the serosal side becoming electronegative) and a drop in resistance. However in these preparations, the amiloride-sensitive Isc was significantly elevated which could be accounted for by an increase in net Na flux. 3. No significant change occurs in net flux of Cl or K although unidirectional fluxes in both directions were increased for both ions in birds given dexamethasone for 3 days. 4. A disparity between the basal Isc and the amiloride-sensitive Isc appeared in these preparations from dexamethasone injected birds reflecting the transport of other ions, possibly HCO3- or H+. The possible role of corticosterone in mineral metabolism of birds is discussed. PMID- 2760283 TI - Blood viscosity in phocid seals: possible adaptations to diving. AB - 1. Mean corpuscular volume (MCV) and mean corpuscular hemoglobin concentration (MCHC) of phocid seal red blood cells (RBC) are elevated compared to those of most terrestrial mammalian species. The influence of these characteristics on blood flow was revealed by viscosity (VIS) measurements. 2. RBC morphology and VIS of whole blood from 7 harbor seals and 5 northern elephant seals were compared with blood of the domestic pig. Samples were analysed for RBC count, white blood cell (WBC) count, total plasma proteins, hematocrit (HCT), MCV and MCHC. Viscosity measurements were made at shear rates from 11.5 to 230.4 s-1 on a Wells-Brookfield cone-plate viscometer at 37 degrees C. 3. Mean values for HCT (%), MCV (micron 3) and MCHC (%) were, respectively: elephant seal: 57, 176, 44; harbour seal: 53, 105, 38; domestic pig: 28, 54, 34. Pig blood was reconstituted to match seal blood HCTs. VIS determinations showed that seal and pig blood conform to the general mammalian dependence of VIS upon shear rate and HCT. 4. Seal blood VIS was 28% (harbour seal) and 16% (elephant seal) less than pig blood VIS at low shear (P less than 0.05). Seal blood carried more hemoglobin per unit volume than did pig blood reconstituted to the same HCT. Fewer, larger RBC with higher MCHC, and hence elevated oxygen storage, accompanied by reduced VIS and reduced flow resistance near stasis suggests that this feature of phocid seal blood is an adaptation to circulatory redistribution during long dives. PMID- 2760284 TI - Characteristics of auditory brainstem responses in ground squirrels. AB - Auditory brainstem responses (ABRs) were characterized at 37 degrees C in ground squirrels (Citellus lateralis) which were implanted with recording screws to record ABRs, and a thermistor to record brain temperature. After two weeks ground squirrels were reanesthetized and tone pips and clicks were delivered through a TDH-49 headphone. Recorded ABRs were found to vary in a predictable manner as a function of stimulus frequency and intensity. At intensities above 50 dB SPL, ABRs could be recorded over the range tested (2-32 kHz). An 8 kHz tone pip was the best frequency for recording ABRs at the lowest stimulus intensities. Latencies decreased as stimulus frequencies increased from 4 kHz to 32 kHz. PMID- 2760285 TI - Auditory brainstem responses in ground squirrels arousing from hibernation. AB - Auditory brainstem responses (ABRs) were recorded in ground squirrels (Citellus lateralis) arousing from hibernation. Squirrels implanted with recording screws to record ABRs, and a thermistor to record brain temperature, were placed in a cold room at 9 degrees C on a 2L:22D light-dark cycle. Hibernating animals were moved from the cold room and ABRs recorded during arousal. The responses showed a gradual development of all brainstem peaks. At low temperatures there were very long latencies to the peaks. The amplitudes of the peaks increased (with fluctuations) as brain temperature increased. The data indicate that neural generators on the brainstem auditory pathway were all activated early in arousal. These results do not support the hypothesis that successive peaks appear and grow in amplitude only after previous peaks are fully developed. PMID- 2760286 TI - Comparative oxygen affinity of fish and mammalian myoglobins. AB - Myoglobins from rat, coho salmon (Oncorhynchus kisutch), buffalo sculpin (Enophrys bison) hearts, and yellowfin tuna (Thunnus albacares) red skeletal muscle were partially purified and their O2 binding affinities determined. Commercially prepared sperm whale myoglobin was employed as an internal standard. Tested at 20 degrees C, myoglobins from salmon and sculpin bound O2 with lower affinity than myoglobins from the rat or sperm whale. Oxygen binding studies at 12 degrees C and 37 degrees C suggest that this difference is adaptive, permitting myoglobins from cold-adapted fish to function at physiologically relevant temperatures. Taken together, purification and O2 binding data obtained in this study reveal a previously unrecognized diversity of myoglobin structure and function. PMID- 2760287 TI - Humoral factors released during trauma of Aplysia body wall. I. Body wall contraction, cardiac modulation, and central reflex suppression. AB - 1. Mechanical or electrical stimulation of isolated sections of body wall produced contractions that were graded with the intensity of the stimulus. Injury of body wall with shallow incisions produced extremely persistent contractions. 2. Long-lasting contraction of isolated body wall was also produced by brief application of "stimulated body wall wash" (SBW), sea water which was first washed through another section of body wall subjected to intense mechanical or electrical stimulation. Contractions were produced by SBW diluted to concentrations as low as 1% of the initial concentration. Contractions produced by prolonged application of SBW showed little fatigue, tachyphylaxis, or desensitization. 3. SBW caused contraction of isolated sections of body wall from all regions of the body, including tail, parapodia, siphon, purple gland, rhinophores, and anterior tentacles. SBW also caused contraction of isolated lateral columellar muscle and of the gill. 4. 30 mM CoCl2 blocked the release of contractile factors into electrically stimulated body wall and reduced but did not abolish contractile responses of unstimulated body wall to perfused SBW. SBW contractions were unchanged by disconnection of the perfused tissue to the CNS. 5. Hemolymph collected from the neck of an intact donor following strong electrical stimulation of the tail or excision of a parapodium ('stimulated hemolymphh, SHL) caused long-lasting contractions which were larger than those produced by control hemolymph (CHL) collected prior to stimulation of the donor. 6. Similarities between body wall contractions produced by SHL and by SBW, including their occurrence in 30 mM CoCl2, suggest that some of the contractile activity in SHL may be directly released from traumatized body wall. 7. SHL caused significantly greater cardioacceleration of the isolated heart than did CHL. Similarities between the cardioacceleration produced by SHL and by SBW suggest that a source of cardiac activity in SHL may be traumatized body wall. 8. SBW suppressed the gill-withdrawal reflex when applied selectively to the sheathed or desheathed abdominal ganglion. SBW-induced suppression was associated with significant reduction of evoked spike activity in identified gill motor neurons. SHL collected 1-2 h after noxious stimulation caused weak but significant suppression of the gill-withdrawal reflex when applied to the fully sheathed abdominal ganglion. PMID- 2760288 TI - Humoral factors released during trauma of Aplysia body wall. II. Effects of possible mediators. AB - 1. Preliminary, general chemical characteristics of substances in artificial sea water (ASW) washed through stimulated body wall (SBW) and in hemolymph taken from noxiously stimulated animals (SHL) were consistent with those of classical neurotransmitters, amino acids, and small- to medium-sized peptides. 2. 5 Hydroxytryptamine (5HT) and acetylcholine (ACh), unlike SBW and SHL, caused relaxation when perfused into isolated body wall. FMRFamide produced a biphasic response--brief contraction followed by prolonged relaxation. 3. Small cardioactive peptide (SCPB) caused body wall contractions similar to those produced by SBW and SHL, except that SCPB contractions displayed more desensitization and were completely blocked by 30 mM CoCl2. SCPB and SBW contractions were synergistic. 4. Dopamine caused persistent body wall contractions similar to those of SBW and SHL. Dopamine contractions were reduced but not blocked by 30 mM CoCl2. Unlike SBW activity, dopamine activity was reduced by alkalinization. 5. Glutamate and taurine produced strong but usually short-lasting body wall contractions. Adenosine, octopamine, arginine vasotocin, and cholecystokinin (CCK-8) caused weak or variable contractions. Met-enkephalin and somatostatin caused no obvious body wall responses. 6. When superfused over the fully sheathed abdominal ganglion, FMRFamide, met-enkephalin, glutamate, aspartate, and taurine reduced the magnitude of the gill-withdrawal reflex elicited by siphon nerve stimulation. 7. Taken together with earlier results, these data suggest a preliminary framework for trauma signal pathways. It is proposed that stress hormones (perhaps including FMRFamide, SCPs, 5HT, and dopamine) are released into hemolymph from neuroendocrine cells. Effective amounts of active intracellular solutes such as amino acids may also be released by extensive cellular rupture. Various humoral signals produce slow effects that contribute to hemostasis, balling up, increased cardiac output, and reflex suppression. PMID- 2760289 TI - Follicular cyst derived from hair matrix and outer root sheath. AB - A new follicular cyst was reported. The lower part of the cyst wall was composed of both basophilic and shadow cells as seen in pilomatricoma, whereas the upper part of the wall consisted of clear cells. Our case apparently derives from hair matrix and outer root sheath. PMID- 2760290 TI - Keratosis punctata of the palmar creases. PMID- 2760291 TI - Acantholytic dermatosis localized to the vulvocrural area. AB - This report describes 6 women with acantholytic lesions localized to the vulvocrural area. Clinically, multiple papules or solitary papules or plaques were situated on the labia majora or adjacent skin. None of the patients had similar abnormalities elsewhere on the body or family histories of similar eruptions. Two patients had concurrent candidal vaginitis. Microscopic findings consisted of acantholytic dyskeratosis resembling that observed in Darier's disease or acantholysis with minimal dyskeratosis similar to that seen in Hailey Hailey disease. In one patient, acantholytic dyskeratosis with a cup-like configuration resembled the microscopic appearance of warty dyskeratoma. Immunofluorescence microscopy was negative in one patient. Solitary lesions were cured by local excision, but the papular eruption of one patient was recalcitrant to therapy. The literature contains descriptions of eight additional women with comparable lesions. Acantholytic reactions localized to the vulvocrural area are not apparently rare and need to be distinguished from other acantholytic dermatoses that can affect this anatomic site. PMID- 2760292 TI - Proliferative fasciitis: ultrastructure and histogenesis. AB - The ultrastructure was studied of 2 cases of proliferative fasciitis (PF) which affected the fascia and subcutaneous fat. Two basic cell types were observed in the lesions: fibroblast-like, and giant cells. The fibroblast-like cells had myofibroblastic ultrastructural characteristics. The giant cells showed a well developed, rough endoplasmic reticulum, irregularly distributed filaments and clear lipid droplets in their cytoplasms. Ultrastructurally, the giant cells seemed to belong to a cellular line capable of synthesizing ground substances and extracellular fibers, but with a modified phenotype. A consistent feature was the presence of nodular aggregates of numerous proliferating perivascular cells. Transitional forms between perivascular, fibroblast-like, and giant cells were observed. Our hypothesis is that perivascular cells (activated pericytes) are the source of the fibroblast-like and giant cells in proliferative fasciitis. PMID- 2760293 TI - Subcutaneous fat necrosis of the newborn: light, ultrastructural and histochemical microscopic studies. AB - Multiple subcutaneous plaques and nodules appeared on the back and the dorsal proximal area of the extremities of a 9-day-old male infant after a complicated prenatal period necessitating cesarean section. The clinical and histological features were diagnostic of subcutaneous fat necrosis of the newborn. Light microscopy revealed adipocyte necrosis, a lymphohistiocytic infiltrate, and needle-shaped clefts within adipocytes and macrophages. Ultrastructurally, there were aggregations of electron-lucent spaces in the form of spindles and needles arranged in parallel within the altered adipocytes; macrophages surrounded these cells or their fragments and invaded the fat lobules. Enzyme histochemical staining, not previously reported in the literature, showed that acid phosphatase, leucine aminopeptidase, and indoxyl and non-specific esterases were present in the areas of fat necrosis. PMID- 2760294 TI - Release of cholesteryl esters by the mammary gland of the pre-partum cow. AB - In five cows that were regularly milked before parturition, cholesteryl esters were continuously released into the mammary fluid; their concentration in the fluid was initially high, but decreased a few days before parturition when mammary secretion of fluid and triglyceride was increasing. The composition of fatty acids in the cholesteryl esters of mammary fluid and in blood plasma was different, suggesting mammary synthesis of cholesteryl esters. PMID- 2760295 TI - Catecholamines, oxytocin and milk removal in dairy cows. AB - Experiments were designed to study the effects of catecholamines on oxytocin responses and milk removal in dairy cows. Adrenalin, noradrenalin, dopamine, isoproterenol (a beta-adrenoceptor agonist), phentolamine (an alpha-adrenergic blocker) and propranolol (a beta-adrenergic blocker) were infused intravenously. In addition, adrenalin was infused together with phentolamine and/or propranolol. Infusions started 8 min before milking and lasted until the end of milking. In some cases electroshocks (for 5 s) were applied immediately before milking in the absence and presence of phentolamine and propranolol. Adrenalin, noradrenalin and dopamine reduced milk removal, but only if administered in supraphysiological amounts. The effect of adrenalin and electroshocks on milk removal could be inhibited only partly by phentolamine. Inhibition of milk removal was not mediated by reduced oxytocin responses. Enhanced local release of catecholamines from sympathetic nerves was presumably responsible for lowered milk removal in response to electroshocks. Milk removal was facilitated during alpha-adrenergic blockade and during beta-adrenoceptor stimulation. PMID- 2760296 TI - Changes in the concentration of metabolites in milk from cows fed on diets supplemented with soyabean oil or fatty acids. AB - Cows were fed on diets supplemented with soyabean oil or soyabean fatty acids which in some cases were protected from rumen hydrogenation. The fat-containing diets reduced the output of short- and medium-chain fatty acids in milk. Associated with this fall in short- and medium-chain fatty acids was a decrease in the concentration of 2-oxoglutarate and an increase in that of isocitrate and citrate. Protection of polyunsaturated fat from rumen hydrogenation had no significant effect. Milk yields were unaffected by diet, but the variation in milk yield among cows correlated positively with the concentration of glucose in milk. PMID- 2760297 TI - Binding of zinc to bovine and human milk proteins. AB - Zn binding by whole bovine and human casein and by purified bovine caseins and whey proteins was investigated by equilibrium dialysis. Bovine alpha s1-casein had the greatest Zn-binding capacity (approximately 11 atoms Zn/mol). Protein aggregation was observed as Zn concentration was increased and the protein precipitated at a free Zn concentration of 1.7 mM. Zn binding increased with increasing pH in the range 5.4-7.0 and decreased with increasing ionic strength. Competition between Zn and Ca was observed for binding to alpha s1-casein indicating common binding sites for these two metals. Bovine beta-casein bound up to 8 atoms Zn/mol and precipitated at a free Zn concentration of approximately 2.5 mM, while kappa-casein bound 1-2 atoms Zn/mol. Whole bovine and human casein bound 5-8 atoms Zn/mol and precipitated at a free Zn concentration of approximately 2.0 mM. Scatchard plots for Zn binding to caseins showed upward convexity, possibly due to Zn-induced association of caseins. Apparent average association constants (Kapp) for all caseins were similar (log Kapp 3.0-3.2). Enzymic dephosphorylation of alpha s1- or whole bovine casein markedly reduced, but did not eliminate, Zn binding. Thus, phosphoserine residues appeared to be the primary Zn-binding sites in caseins. With the exception of bovine serum albumin, which bound over 8 atoms Zn/mol, the bovine whey proteins, beta lactoglobulin, alpha-lactalbumin and lactotransferrin, had little capacity for Zn binding. PMID- 2760298 TI - Zinc binding in bovine milk. AB - About 90% of the Zn in bovine skim milk was sedimented by ultracentrifugation at 100,000 g for 1 h. About half of the non-sedimentable Zn was non-dialysable, indicating that it was associated with protein, probably non-sedimented casein micelles. Casein micelles incorporated considerable amounts of Zn added to skim milk as ZnCl2, and at Zn concentrations greater than or equal to 16 mM coagulation of casein micelles occurred. Ca was displaced from casein micelles by increasing ZnCl2 concentration and approximately 40% of micellar Ca was displaced by 16 mM-ZnCl2. Micellar Zn, Ca and Pi were gradually rendered soluble as the pH of milk was lowered and at pH 4.6 greater than 95% of the Zn, Ca and Pi were non sedimentable. These changes were largely reversible by readjustment of the pH to 6.7. About 40% of the total Zn in skim milk was non-sedimentable at 0.2 mM-EDTA and most of the remainder was gradually rendered soluble by EDTA over the concentration range 1-50 mM. This indicates that there are two distinct micellar Zn fractions. No micellar Ca or Pi was solubilized at EDTA concentrations up to 1.0 mM, indicating that both colloidal calcium phosphate (CCP) and casein micelles remained intact under conditions where the more loosely bound micellar Zn fraction dissolved. Depletion of casein micelles of colloidal Ca and Pi by acidification and equilibrium dialysis resulted in removal of Zn, and in colloidal Pi-free milk non-dialysable Zn was reduced to 1.2 mg/l (approximately 32% of the original Zn). Thus, approximately 32% of the Zn in skim milk is directly bound to caseins, while approximately 63% is associated with CCP. Over 80% of the Zn in colloidal Pi-free milk was rendered soluble by 0.2 mM-EDTA, indicating that the casein-bound Zn is the loosely bound Zn fraction in casein micelles. A considerable fraction of the Zn in acid whey (pH 4.6) co-precipitated with Ca and Pi on raising the pH to 6.7 and heating for 2 h at 40 degrees C, indicating that insoluble Zn phosphate complexes form readily under these conditions. Studies on dialysis of milk against water, or dilution of milk or casein micelles with water, showed that CCP and its associated Zn is very stable and dissolves only very slowly at pH 6.6. The nature of Zn binding in casein micelles may help to explain the lower nutritional bioavailability of Zn in bovine milk and infant formulae compared with human milk. PMID- 2760299 TI - Tryptic phosphopeptides from whole casein. II. Physicochemical properties related to the solubilization of calcium. AB - Casein phosphopeptides (CPP) were produced by tryptic hydrolysis of sodium caseinate and further purified by precipitation and chromatography on QAE Sephadex A-25. Their physico-chemical properties were compared with the properties of an enzymically dephosphorylated equivalent preparation (DPP). Binding of Ca2+ to the peptides was measured using a Ca selective electrode and was found to increase with pH and to show 1/1 stoicheiometry Ca/Porg in CPP at pH 6.5 and 7.6. Klotz plots indicated equivalent binding sites at these two pH values, but some heterogeneity was seen at pH 3.5. In contrast, DPP did not bind significant amounts of Ca2+. CPP effectively inhibited the formation of insoluble calcium phosphates at different Ca/P ratios. The effective CPP concentration was 10 mg/l and complete stability of calcium phosphate solutions was obtained at about 100 mg/l. This stabilizing effect was dependent on the presence of organic P. PMID- 2760300 TI - Chemical characterization of bioactive peptides from in vivo digests of casein. AB - The in vivo formation of biologically active caseinopeptides was studied. It was proved that bioactive peptides were released in the small intestine of minipigs in the course of luminal digestion of diets containing bovine casein. An opioid peptide and a phosphopeptide were isolated from jejunal chyme and were chemically characterized. The opioid peptide has been identified as a fragment of beta casein (60-70). This peptide, named beta-casomorphin-11, displayed substantial opioid activity in an opiate receptor-binding assay. The caseinophosphopeptide has been shown to be a fragment of alpha s1-casein (66-74). Casein-derived phosphopeptides exhibit a potent ability to form soluble complexes with Ca and trace elements. Evidence exists that casomorphins and caseinophosphopeptides participate in the regulation of nutrient entry. PMID- 2760301 TI - Biologically active peptides of casein and lactotransferrin implicated in platelet function. AB - Casein and other milk proteins in maternal colostrum and milk, the earliest food of the newborn, should not only be considered as a nutritional supply but also as a source of biologically active peptides. Some of them isolated from casein and lactotransferrin were active on platelet function. They inhibited both aggregation of ADP-treated platelets and binding of [125I]fibrinogen to ADP treated platelets. Their behaviour was compared to that of fibrinogen peptides possessing similar effects: once more similarities between the milk and blood clotting phenomena could be observed. PMID- 2760302 TI - Opioid antagonist peptides derived from kappa-casein. AB - Opioid antagonists were sought in the fragments of kappa-casein which were obtained by chemical synthesis and enzymic digestion. A synthetic bovine kappa casein peptide (35-41), Tyr-Pro-Ser-Tyr-Gly-Leu-Asn (casoxin A) showed opioid antagonist activity at 200 microM in the guinea pig ileum assay. A synthetic peptide Tyr-Pro-Tyr-Tyr (casoxin B) which is found in bovine and human kappa casein, also showed opioid antagonist activity at 100 microM. Another opioid antagonist peptide (casoxin C) was isolated from tryptic digests of bovine kappa casein by reverse-phase HPLC. The structure of the peptide was Tyr-Ile-Pro-Ile Gln-Tyr-Val-Leu-Ser-Arg, which corresponded to kappa-casein (25-34). Casoxin C was active at 5 microM in the guinea pig ileum assay. Thus, bovine kappa-casein contains three potential opioid antagonist sequences. PMID- 2760303 TI - Enzymic dephosphorylation of bovine casein to improve acid clotting properties and digestibility for infant formula. AB - To improve acid clotting properties, enzymic dephosphorylation of caseins with calf intestinal alkaline phosphatase (CAP) or potato acid phosphatase (PAP) was investigated. Greater dephosphorylation was achieved using alpha s1- or beta casein as substrates, compared to whole casein or skim milk. Electrophoresis of PAP-modified caseins revealed bands with lower mobility and a multibanded pattern in the beta-casein region which was similar to that of human beta-casein. On the other hand, CAP modification produced electrophoretic bands having lower mobility of the beta-casein component, but with higher mobility in the alpha s1-casein component as well as increased net negative charge in the CAP-casein. PAP-casein formed a fine dispersion upon acidification to pH 4, with a microstructure similar to that of acidified human casein. Greater initial rates of hydrolysis by pepsin at pH 4 were observed for both CAP- and PAP-modified caseins, compared to bovine and human caseins. The rate and extent of hydrolysis remained high for CAP casein but tended to level off with PAP-casein during sequential digestion with pepsin and pancreatin. There may be advantages in the use of partial dephosphorylation to improve acid clotting and digestibility properties of bovine casein for infant feeding. PMID- 2760304 TI - A 1H-NMR study of bovine casein micelles; influence of pH, temperature and calcium ions on micellar structure. AB - The influence of pH, temperature and Ca depletion on bovine casein micelle suspensions in D2O containing simulated milk ultrafiltrate was studied by 1H-NMR spectroscopy. In the pH range of 5.8-7.5 the spectrum of the micelles showed very little pH dependence, indicating that no changes occurred in the dynamic behaviour of the proteins constituting the micelle. The NMR spectrum of casein micelles was strongly temperature dependent, particularly in the temperature range of 60-98 degrees C. Increase in temperature resulted in a strong increase in spectral intensity concomitant with changes in the spectral characteristics. In micelle suspensions these changes were reversible, and indicated that at elevated temperatures the rigid structure of the casein micelle started to melt, leading to an increased mobility of appreciable parts of the proteins in the micelle. Ca depletion of the casein micelles by addition of EDTA resulted in an increase in spectral intensity, which arose from the presence of casein components in the serum phase. The spectrum of these serum phase particles resembled closely the spectrum of a solution of total casein in simulated milk ultrafiltrate and was quite different from the spectrum of casein micelles. The implications of these results with respect to models of the structure of bovine casein micelles are discussed. PMID- 2760305 TI - Hydrophobic interactions in human casein micelle formation: beta-casein aggregation. AB - The association of non-phosphorylated (0-P) and fully phosphorylated (5-P) human beta-caseins was studied by fluorescence spectroscopy and laser light scattering. The tryptophan fluorescence intensity (FI) level increased between 20 and 35 degrees C, indicating a change in the environment of that residue. A similar transition occurred when ANS was used as a probe. Transition temperatures were slightly lower in 10 mM-CaCl2 but were not affected by an equivalent increase in ionic strength caused by NaCl. The magnitude of the FI change was less for the 5 P than the 0-P protein but was increased for both by CaCl2 addition. These FI data were characteristic of a conformational change and this was supported by fluorescence polarization which indicated that with CaCl2, tryptophan and ANS mobility increased at the transition temperature even though the extent of protein association also increased. Light scattering suggested that protein association proceeded with the primary formation of submicellar aggregates containing 20-30 monomers which then associated further to form particles of minimum micelle size (12-15 submicelles), and eventually larger. The temperature of precipitation of the 5-P form in the presence of CaCl2 was lower than the conformational transition and suggested that both hydrophobic interactions and Ca bridges between phosphate esters on adjacent molecules are important in micelle formation. PMID- 2760306 TI - Experiments on the heat-induced salt balance changes in cow's milk. AB - The heat-induced changes in salt balance between the colloidal phase of milk and its serum were studied using an ultrafiltration technique. Milk permeate was isolated at the heating temperature by means of a hollow fibre ultrafiltration cartridge coupled with a stainless steel heat exchanger unit. The milk samples initially at 4 degrees C were heated to 20, 40, 60, 80 or 90 degrees C. Ca, P, Mg and citrate contents of the permeates were determined. The decreases in Ca and P were proportional to the increase in temperature. Smaller losses in Mg and citrate were observed. An initial sharp decrease in concentration occurred within the first seconds of holding time and was followed by a slower and smaller decrease. The possible occurrence of a two-stage mechanism for the heat-induced salt precipitation is discussed. The precipitation of dicalcium phosphate is believed to occur together with some tricalcium citrate precipitation. PMID- 2760307 TI - Assessment of lipoprotein activators of skim milk lipoprotein lipase and the relationship between lipoprotein lipase activity and milk fat synthesis. AB - Bovine plasma and lipoproteins isolated by gel filtration chromatography were examined for their ability to activate skim milk lipoprotein lipase. Addition of equal amounts of protein from either triglyceride-rich lipoprotein, low density lipoprotein, high density lipoprotein or plasma to a lipoprotein lipase assay resulted in 6.0, 2.2, 2.5, or 1.1% hydrolysis of radiolabelled triglyceride emulsion. Lipoprotein lipase activity in skim milk was evaluated as an indicator of mammary lipid secretory capacity. Skim milk lipoprotein lipase activity was significantly lower immediately prepartum as compared with activity immediately postpartum (.2 vs. 5.4% of substrate hydrolyzed). Skim milk lipoprotein lipase was significantly higher during the final 12 d of lactation than in samples obtained 12 d after machine milking was terminated (5.6 vs. less than 1% of substrate hydrolyzed). Although skim milk lipoprotein lipase activity appeared positively related to mammary lipid secretory capacity during the time immediately surrounding initiation and cessation of copious milk production, activity between those periods was not correlated to milk fat percentage, milk fat yield, or stage of lactation. PMID- 2760308 TI - Effect of exogenous bovine somatotropin on mammary lipid metabolism and milk yield in lactating dairy cows. AB - Eight lactating Holstein cows were used to study the effect of bovine somatotropin on mammary lipid metabolism, milk production, and milk composition. Eight cows were injected with either excipient (n = 4) or 50 IU somatotropin/d (n = 4). A 2-wk adjustment period preceded a 10-d period when treatments were administered. On d 9, serial blood samples were collected from 2 to 5 h post injection to determine concentrations of somatotropin and metabolites in plasma. Mammary tissue biopsies were obtained 2 to 3 h after a.m. milking on d 10 to determine lipoprotein lipase activity and in vitro rates of acetate incorporation into fatty acids and acetate oxidation by mammary tissue slices. Activity of lipoprotein lipase in milk and mammary tissue and rate of acetate metabolism by mammary tissue were not affected by treatment. The following means for placebo and somatotropin, respectively, were: milk production (21.5 and 24.8 kg/d), milk fat (3.8 and 4.0%), and 4% FCM (20.7 and 25.1 kg/d). Plasma concentrations of somatotropin (3.0 and 43.4 ng/ml) and free fatty acids (105.6 and 219.5 mu eq/L) were significantly elevated with somatotropin. The injection of somatotropin into lactating dairy cows did not affect the mechanisms of fatty acid synthesis or metabolism evaluated in this study. PMID- 2760309 TI - Influence of varying protein and starch degradabilities on performance of lactating cows. AB - A milk production and digestibility trial with 32 cows (2 X 2 factorial with 8 cows per treatment) was conducted to test animal response to varying rumen degradation of dietary starch and protein. Four rations (barley-cottonseed, barley-brewers dried grains, milo-cottonseed, and milobrewers dried grains) were compared in early lactation cows fed 65% concentrate and 35% forage for 60 d. Digestibilities of starch were higher for barley than milo diets; whereas, those for organic matter were higher for cottonseed meal than brewers dried grains. Milk production was highest on barley-cottonseed with mean adjusted values of (kg/d): 37.4, 34.9, 34.2, and 34.6 for respective treatments. Dry matter intakes were not different among rations. Milk fat was higher on milo than barley with respective diets averaging (%): 3.1, 2.9, 3.4, and 3.6, and resulting in lowest FCM for the barley-brewers dried grains diet. Milk protein was not altered by treatment. These data suggest that responses to varying protein degradability can be altered by rate of starch breakdown in the rumen. PMID- 2760311 TI - Effect of ruminal protein degradation of blood meal and feather meal on the intestinal amino acid supply to lactating cows. AB - Four lactating cows fitted with ruminal cannulae and T-type cannulae in the proximal duodenum and terminal ileum were utilized to measure protein degradation in the rumen and amino acid flow to and absorption from the small intestine. Soybean meal, blood meal, feather meal, and a 50-50 combination of blood meal and feather meal provided 50% of the protein in diets that contained 50% grain mix, 40% corn silage, and 10% alfalfa pellets on a DM basis. Ruminal degradation of dietary CP was 53, 43, 32, and 37% for diets containing soybean meal, blood meal, feather meal, and the combination of meals. Cows fed the latter two diets also had lower ruminal NH3 concentrations and efficiency of bacterial protein synthesis compared to those fed the soybean meal diet. Total tract N digestibility was lower for diets containing feather meal (63.4%) and a combination of meals (66.3%) than the soybean meal diet (78.5%). Total amino acid flow to the duodenum was 19.3 and 15.6% higher for cows fed the feather meal and combined meal diets, respectively, compared with the soybean meal diet. Total amino acid absorption from the small intestine was higher as well as absorption of individual amino acids for the combined meal diet compared with the soybean meal diet. Absorption of individual amino acids, expressed as a percentage entering the duodenum, was lowest for the feather meal diet. Results from this study show that feeding a combination of blood meal and feather meal instead of soybean meal can increase intestinal supply and absorption of amino acids in dairy cattle. PMID- 2760310 TI - Long-term feeding of high zinc sulfate diets to lactating and gestating dairy cows. AB - Thirty dairy cows, fed a control diet consisting of silage and concentrates, were given either 0, 1000, or 2000 ppm of supplemental Zn (DM basis), from zinc sulfate monohydrate (ZnSO4.H2O) for most of a lactation. Feeding 2000 ppm Zn decreased milk yield and feed intake after several weeks. Some cows were affected more severely than others. Generally, primiparous animals were more tolerant of the high Zn diet than multiparous cows. Milk Zn was materially higher for cows fed 1000 ppm added Zn than controls. With 2000 ppm Zn, milk Zn was elevated further but returned to control values when the high Zn diet was discontinued. Plasma Zn was higher in cows fed supplemental Zn with the increase from 1000 to 2000 greater than that for the first addition. Plasma Cu was lower in cows feed 2000 ppm Zn but milk Cu was not reduced. Milk fat content was not affected, but protein and SNF were reduced by the 12th wk with the 2000 ppm Zn diet. There was no apparent effect on long-term health or performance after the cows were removed from the 2000 ppm Zn diet. Except for lower calf weights with 2000 ppm Zn, reproductive performance was not measurably affected by the dietary treatments. The 1000 ppm added Zn diet had no adverse effect on the cows in any parameter measured. PMID- 2760312 TI - Response of lactating jersey cows fed concentrate twice daily by computer or in a total mixed ration. AB - Two trials were conducted with 36 Jersey cows each to compare intake, production response, and relative economics of four concentrate management systems. Cows were assigned for 25 wk to concentrate fed: 1) for ad libitum consumption twice daily for 10 min, 2) twice daily according to production, 3) via computer feeder according to production, or 4) as part of a total mixed ration. Concentrate was fed at the rate of 1 kg/3.5 kg 4% FCM for treatments 2 and 3 and at the same rate, but to group average FCM, for treatment 4. Concentrate allotments were updated weekly. Cows were individually fed blended corn silage and whole cotton seed (84:16, DM basis) plus 2.2 kg alfalfa hay/d (Trial 2 only). Concentrate DM intake was 2.3 kg lower and forage DM intake 2.3 kg higher when cows were fed to production (treatments 2, 3, and 4). Milk production was highest in both trials for treatment 2. Fat test was lowest for twice daily ad libitum feeding with no differences found between other methods. Body weight change was similar across treatments and trials. Milk income was similar, fed costs higher, and income over feed cost lower for treatment 1 than for other methods in both trials. Three methods of feeding concentrate according to production were equally effective in maximizing profit. PMID- 2760313 TI - Diet digestibility and growth of holstein calves fed acidified milk replacers containing soy protein concentrate. AB - Three experiments were conducted to determine the effects of acidification of milk replacers containing soy protein concentrate on diet digestibility and growth of Holstein bull calves. In Experiment 1, six calves (6 wk old) were fed at 10% of BW/d either acidified milk replacer containing soy protein concentrate or untreated milk replacer containing soy protein concentrate. Replacers were reconstituted to 12.5% DM for 10-d adjustment and 4-d collection periods to determine digestibility and N balance. Digestibilities of DM, ether extract, and N were similar between treatments. Nitrogen retention and N retention as a percentage of that absorbed were higher for calves fed the acidified diet. In Experiment 2, 20 calves (1 wk old) were fed diets identical to those diets fed in Experiment 1 at 20% of BW/d for 4 wk. Calves were allowed to adjust to the diet for 5 d. Growth parameters were measured and amount of feed offered was adjusted weekly. Calves fed the untreated diet had higher daily weight gains, girth gains, height gains, and better feed utilization. In Experiment 3, 21 calves were fed either the aforementioned diets or a replacer based on milk proteins at 10% of BW/d (12.5% DM) for 4 wk. Growth parameters were measured and DM intakes were adjusted weekly. Growth and feed conversion were similar across diets. Replacers containing soy protein concentrate or large amounts of whey may need to be supplemented with additional methionine to maximize rate of gain. PMID- 2760314 TI - Field survey of clinical mastitis in low somatic cell count herds. AB - Nine commercial dairy herds, each with low herd milk somatic cell counts, were monitored for 1 yr to determine prevalence of intramammary infections and rates of clinical mastitis. Staphylococcus species was the bacterial group most frequently isolated from quarters at calving and at drying off. Environmental streptococci and coliform intramammary infections totaled less than 6% of quarters at both calving and at drying off. Staphylococcus aureus were isolated from less than 1% of quarters and Streptococcus agalactiae from 0% of quarters at both calving and drying off. A total of 646 clinical cases of mastitis were diagnosed in 548 quarters of 406 cows. Mean rate of clinical mastitis among herds was .457 clinical cases/305 cow-days. Rates of clinical mastitis ranged among herds from .273 to .748 clinical cases/305 cow-days. Coliforms and bacteriologically negative and environmental streptococci accounted for 82.3% of clinical cases. Rates of clinical mastitis and severity of clinical signs differed among herds, seasons of the year, parity groups, and stages of lactation. Rates of clinical mastitis were highest during summer, in first lactation cows, and during the first 7 d of lactation. PMID- 2760315 TI - Techniques for measuring blood flow in splanchnic tissues of cattle. AB - A useful approach of the study of nutrient absorption and metabolism is in vivo measurement of blood flow across portal-drained viscera and liver, and flux of bloodborne metabolites, successful application of the approach requires correct placement of chronic catheters in appropriate blood vessels. Additionally, catheters must stay patent long enough to allow the animal to recover from surgery and to complete an experimental protocol. This paper describes surgical techniques to install chronic catheters in mesenteric veins, the hepatic portal vein, and an hepatic vein of cattle. Techniques for access to arterial blood are described also. Materials, equipment, and supplies required for surgery, blood sampling, and blood flow determination are described. Commercial sources of supplies are suggested. Blood flow is measured by downstream dilution of para aminohippurate, which is infused into a mesenteric vein. Examples of blood flow data for three types of cattle are provided. PMID- 2760316 TI - Tall tales and other creations. PMID- 2760317 TI - In vitro acid production from starch and sucrose in saliva. AB - There was a wide range in the amounts of acid given by the assorted starch foods that were tested. In descending order, the amounts of acid formed were: boiled potato (2.50 +/- 0.10), "special wheat" bread (2.24 +/- 0.68), English muffin (2.19 +/- 0.00), raw potato (2.13 +/- 0.03), yellow cake (2.02 +/- 0.08), plain wheat flour (1.83 +/- 0.03), phosphate-enriched wheat flour (1.83 +/- 0.03), bagel (1.67 +/- 0.05), soft white bread (1.39 +/- 0.05), Italian bread (1.35 +/- 0.08), and pumpernickel bread (1.26 +/- 0.03). PMID- 2760318 TI - The glass ionomer rest-a-seal. AB - The "glass ionomer rest-a-seal" described is a restorative technique that minimizes removal of tooth structure and protects the glass ionomer from inherent property weaknesses. This technique would seem to have added benefits over the preventive resin restoration where pit-and-fissure decay involves dentin. Glass ionomer cements have become popular as materials with many desirable properties, including an adhesive nature and an ability to release fluoride to adjacent tooth structure. These materials are, however, technique-sensitive and proper application is critical for long-term success. Conservative treatment of pit- and fissure decay is often indicated. By utilization of the preventive resin restoration and now the glass ionomer rest-a-seal, practitioners can improve the long-term dental health of their patients. PMID- 2760320 TI - AIDS lawsuits pending. PMID- 2760319 TI - Dentin dysplasia type II: report of case. AB - Intrapulpal calcifications, in rare situations, may cause deformities and abnormalities of the roots of the teeth. Dentin Dysplasia Type II is a rare heritable dentin defect, of radiopaque foci resembling free pulp stones. This report describes the clinical and radiographic features of Dentin Dysplasia Type II in a fifteen-year-old girl. PMID- 2760321 TI - AIDS discrimination legislation introduced. PMID- 2760323 TI - The nursing process as a method for facilitating research. PMID- 2760322 TI - IAET strategic planning report: Chapter II. Trends in health policy, technology, and reimbursement. PMID- 2760324 TI - Physiologic changes and functional ability in the older patient: a challenge for the creative ET nurse. AB - In summary, older patients undergoing ostomy surgery require individual assessment of their functional abilities related to self-care. When deficits are identified it is the ET nurse who must respond with a creative, innovative approach that will assist the patient towards self-care, independence, and recovery. PMID- 2760325 TI - Standards of care. ET nursing practice. International Association for Enterostomal Therapy. PMID- 2760327 TI - [The mutagenic action of the DNA fragments of bovine adenovirus type 3 (BAV-3) containing early E1 (oncogene) and E4 regions]. AB - A study of mutagenic action of DNA fragments of bovine adenovirus type 3 (BAV-3), containing early E1 (oncogenic) and E4 regions has been carried out. Viral DNA was digested with Xba 1 restriction endonuclease. The mutagenic effect revealed itself by induction of resistance to 6-mercaptopurine in Chinese hamster cells. The data obtained suggest that the early regions E1 and E4 can cause mutagenic effect in mammalian cells. PMID- 2760326 TI - [The mechanism of the regulation of the sexual cycle in sheep]. AB - The application of a complex of vitamins and hormones at the ewes sexual rest is shown to ensure the manifestation of the complete sexual cycle fertility. These changes are preceded by increase in the albumen level, nucleic acids and the activity of aminotransferase in blood and tissues of the reproductive organs. The increase in metabolites concentration of the albumen exchange is resulted in the growth of the reproductive organs of ewes, the internal organs of fetuses, their weight and linear growth and the number of lambs per 100 ewes. The preliminary two injections of a vitamin complex and the following application of gestagenic and gonadotropic hormones proved to be more effective. PMID- 2760328 TI - [The biological action of highly dispersed metal powders]. PMID- 2760329 TI - [The effect of different antitumor preparations on the growth of a culture of the protozoan Crithidia oncopelti]. PMID- 2760330 TI - [A symmetry approach to electrocardiogram analysis]. AB - A qualitative characteristics of a symmetry of correlations in ECG parameters has been studied in experiments on rats with the adaptation syndrome and hypertonic patients (I-II stages). A geometrical model of cardiac cycle shaped as a rectangular triangle with temporal and amplitude ECG parameters as catheti. A total correlation between the ECG parameters is given: QT--QRS/QT--PQ.RR--PQ/RR- QRS = R--P/R--T = 1,309. In healthy individuals, the deviation from the ideal proportion constitutes less than 5%, and in patients with cardiovascular diseases, the deviations are substantial. PMID- 2760331 TI - [Electrophysiological analysis of the spectrum of the fibers of the lateral olfactory tract in rats in vitro]. AB - Total action potentials (AP) of lateral olfactory tract (LOT) have been studied on 200 um sections of olfactory cortex of rat brain. Over-threshold stimulation of a proximal end of LOT was accompanied by five waves at descending phase of AP. The increase in stimulation frequency from 1 to 3 to 10 Hz led to a decrease in amplitudes of all LOT AP components. The data obtained suggest that the composition of LOT fibers is heterogeneous. PMID- 2760332 TI - [The role of the parasympathetic nervous system in regulating the oxygen tension and regional blood flow in the digestive organs of rats]. AB - The input of parasympathetic region of vegetative nervous system in regulation of regional blood transfer and maintaining of oxygen balance in organs of rat digestive system has been estimated by measuring oxygen tension (pO2) and the rate of regional blood transfer (RBTR) in liver, gut, and small intestine after 1, 7, 14, 30, and 60 days after vagotomy. Vagotomy was shown to lead to the decrease of pO2 in liver (1, 14, 30 days), gut (1 day), and small intestine (7 and 30 days). At initial postoperation period (1 day), the decrease in pO2 is accompanied by the increase in RBTR (in gut and small intestine), and at late period, by the decrease of RBTR in liver. The correlation between the decrease in pO2 and the decrease in RBTR allows to conclude that the hypoxia developing in liver after vagotomy is of a circulatory nature. PMID- 2760333 TI - [The potential for enhancing the therapeutic efficacy of antitumor preparations]. AB - Joint introduction of cytostatic antitumor drugs and dogfish liver extract into animals with experimental tumors was shown to increase the efficacy of drugs as revealed by the increase in life span of experimental animals. PMID- 2760334 TI - [The biological activity of platinum and methionine complexes: the antitumor action and inhibition of root growth by complexes of differing compositions and structures]. AB - The effect of 21 methionine-platinum(II) and (IV) complexes on growth and division of cells in maize seedling roots has been studied. The studied complexes did not possess properties inherent in typical cytostatic compounds, e.g. cis dichlorodiammineplatinum (DDP). They inhibited root growth at higher concentrations as compared to DDP. In contrast to DDP, the studied complexes inhibited cell elongation to a similar or greater extent than cell division, did not prevent lateral root formation, and their inhibitory effect did not change with time. No correlation between the level of tumor growth inhibition and the pattern of root growth was observed. PMID- 2760336 TI - Abstracts of the scientific programs of the American College Health Association, sixty-seventh annual meeting. May 23-27, 1989, Washington. PMID- 2760335 TI - The mentally ill student on campus: theory and practice. AB - Traditional biases about the nature of mental illness and the mission of the academic environment have frequently shaped college policy and practice affecting mentally ill, suicidal, or chemically addicted students. Too often, removal of the student from campus has been seen as appropriate, therapeutically and educationally. The assumption that separating seriously disturbed students from the classroom is in the students' best interests is challenged by models of cognitive and emotional functioning that recognize the multifaceted nature of each. Such models affirm the salience of the student identity for the troubled student's sense of self and therapeutic prognosis. Creating an environment responsive to and supportive of the student in distress may also lead to significant educational benefits to the institution as a whole. Higher education has an opportunity to create work and study environments that meet broadly conceived ethical and educational goals. Experience with the Skidmore College Four Winds Hospital program demonstrates that few additional resources are needed to implement such policy and practice. PMID- 2760337 TI - Laboratory aspects of drug testing in athletics. PMID- 2760338 TI - Alcohol-related injuries and objective screening tests. PMID- 2760339 TI - Changing with the times. PMID- 2760340 TI - Accreditation of health services. PMID- 2760341 TI - College students and national health objectives for the year 2000: a summary report. PMID- 2760342 TI - Effectiveness of fluoride gel. PMID- 2760343 TI - The economic health of dentistry: past, present, and future. AB - Important changes in dentistry during the past two decades include a declining caries incidence, an increase in the number of dentists, greater competition for patients, and the spread of retail dentistry and alternative plans for financing and delivering dental services. Dire predictions about the effects of these changes often have not been based on facts. This article uses available data to examine the profession's economic prospects. PMID- 2760344 TI - Temporary paralysis of cranial nerves III, IV, and VI after a Gow-Gates injection. AB - A case of temporary complete paralysis of cranial nerves III, IV, and VI, after a Gow-Gates injection is reported. The proposed explanations for the mechanisms of occurrence are described. Although the Gow-Gates technique has many advantages, it is not without complications. To avoid such complications, it is important to take the following precautions when using the Gow-Gates technique: because of the proximity of the internal maxillary artery (accessory and middle meningeal) and the pterygoid plexus of veins, and because the anesthetic is injected quickly, it is paramount that careful aspiration be performed before administration of the local anesthesia; injections should be on or within 1 mm to 2 mm of the condylar neck. PMID- 2760345 TI - Nonsurgical management of ectopic teeth. AB - Four cases have been presented involving malpositioned premolars and molars that were brought into the arch. From the cases presented, it appears that aggressive surgical intervention to redirect ectopic premolars creates significant secondary problems. Interference with the bone surrounding the ectopic tooth may compromise the adjacent teeth and bone level. Pressure against the root of the impacted tooth may cause resorption. If the buccal or labial plate is removed, orthodontic movement will be impeded. Specific biochemical changes in bone are induced by the application of orthodontic forces. In these cases, creating space with coiled spring appliances resulted in remarkable reorientation and proper eruption of ectopic, impacted teeth. When surgical intervention is required in cases involving ectopic teeth, close collaboration between orthodontist and oral and maxillofacial surgeon is imperative to achieve successful results without negative sequelae. PMID- 2760346 TI - The efficacy of the rubber dam as a barrier to the spread of microorganisms during dental treatment. AB - This study evaluated the rubber dam as an infection control barrier during standard restorative procedures. Microbial collection was performed during preparation and placement of amalgam and composite resin restorations with and without the rubber dam, and during handpiece and air-water syringe spraying with and without the rubber dam. The results showed a significant reduction in microorganisms with the use of the rubber dam--70% to 88% and 95% to 99%, respectively; and 90% to 98% when all data were combined. These results indicate that using the rubber dam is a method of reducing microbial contamination at the primary source. Used with gloves, mask, and protective eyewear, the rubber dam provides an excellent barrier to the potential spread of infectious disease in the dental office. PMID- 2760347 TI - Periodontal probe use in general practice in Florida. AB - Use of the periodontal probe in 134 Florida dental practices was studied. Results indicated that 62% of the practices performed a complete recorded periodontal probing for new patients. Recall patients received a complete recorded periodontal probing in 57% of the practices at a mean frequency of 12.7 months. Selected site probing was performed in 22% of the offices as part of the new patient examination, and in 34% of the offices as part of the recall examination. In the examinations in 57% of the practices, changes in pocket depths were detected that could suggest changes in connective tissue levels. PMID- 2760348 TI - Asymptomatic expansion of the mandible. AB - Frequently, the first noticeable sign of an odontogenic myxoma is a slowly enlarging, painless expansion of the jaw. Spreading, loosening, and migration of teeth in the area commonly occur. In the early stages, the tumor is asymptomatic, and detection is made only by routine radiographs. Clinicians should be aware of the radiographic changes caused by this benign odontogenic tumor, and include it in their differential consideration of lesions presenting such changes in the jaws. A typical case of a fairly large odontogenic myxoma has been presented. The clinical, radiographic, and histological presentations have been discussed. The tumor was treated by en bloc resection with immediate bone and nerve reconstruction. The patient responded well to therapy and no tumors were found at the 1 year follow-up examination. PMID- 2760349 TI - Perspective on aging. PMID- 2760350 TI - ANSI/ADA specification no. 66 for dental glass ionomer cements. Council on Dental Materials, Instruments, and Equipment. PMID- 2760351 TI - Iron deficiency among active men. AB - Iron deficiency in active men is well documented. To assess the relative importance of dietary iron intake, iron absorption, and iron loss in the pathogenesis of this iron deficiency, we compared a group of iron-deficient athletes to a group with normal iron stores. Iron absorption was assessed by an iron tolerance test. Serum haptoglobin was used as a measure of hemolysis. The presence of hemoglobinuria reflected urinary iron loss. Iron intake was determined by a 3-day dietary record as well as a food frequency questionnaire. Results showed iron absorption to be inversely correlated with iron stores. Iron deficient athletes had higher absorption, suggesting a normal regulation mechanism. Major hemolysis (serum haptoglobin below 40 mg/dl) was found in 28% of subjects with no relationship to iron stores. No hemoglobinuria was detected after a usual training session. Iron intake was elevated in relation to high caloric intake, but iron intake in the form of meat was lower in iron-deficient athletes, as compared to those with normal or repleted iron stores. It is our opinion that inadequate iron intake is an important determinant of iron deficiency in athletes. PMID- 2760352 TI - Comparison of vitamin E levels in plasma, bronchoalveolar lavage, and lung tissues of adult pulmonary patients. AB - Plasma, bronchoalveolar lavage fluids (BAL), and lung parenchyma were analyzed for vitamin E and polyunsaturated fatty acid (PUFA) concentrations in three groups of patients routinely receiving oxygen therapy--two with adult respiratory distress syndrome (ARDS and SARDS), a third with pneumonia (PNEU), as well as a fourth group of patients receiving little or no oxygen therapy (OTHER). Only plasma alpha- and gamma-tocopherols were significantly lower in patients receiving oxygen therapy compared to those not requiring oxygen. Among diagnosis groups, PNEU patients exhibited highest levels of alpha-tocopherol in BAL, though all groups on oxygen had greater amounts of alpha-tocopheryl quinone in BAL as compared to those of the OTHER group. No significant differences in BAL measures were observed between oxygen and non-oxygen groups, however. No statistical tests on lung measures could be performed between these groups because of insufficient sampling for the OTHER group. A highly significant relationship was observed (r = +0.73, p less than 0.004) between plasma vitamin E and lung vitamin E when expressed in terms of PUFA, whereas no significant relationship was observed if plasma vitamin E and lung vitamin E levels were compared directly. No relationship was obtained for BAL alpha-tocopherol (expressed per number of cells) and lung alpha-tocopherol. These findings support previous reports that in an appropriate setting plasma vitamin E:PUFA ratios along with smoking status may be used to evaluate lung vitamin E levels when also expressed in terms of PUFA. PMID- 2760353 TI - The pattern of plasma volume changes in well-nourished and in food- or protein restricted pregnant rats. AB - Plasma volume and plasma protein were measured on days 5, 12, 19, and 21 of gestation in rats fed 25% casein either ad libitum or 55% food restricted, or fed 6% casein ad libitum (protein restricted). Both forms of undernutrition prevented the large increase in plasma volume observed in well-fed rats by day 19. The pattern of plasma volume change, with maximum mean values on day 19 (compared to the other measurement days), was not altered by undernutrition. Differences in plasma protein concentration or total circulating protein did not explain plasma volume changes. PMID- 2760355 TI - The glycemic index: variation between subjects and predictive difference. AB - It is not known whether the variability of the glycemic index (GI) in different subjects is due to within- or between-individual variation. In addition, it is not known how large a difference in GI between different meals is clinically important for individuals with diabetes. Therefore, insulin-dependent (IDDM) and non-insulin-dependent (NIDDM) diabetic subjects tested four foods, with each food taken by each subject on two separate occasions. For each food, most of the variation of absolute glycemic responses was due to differences between the subjects. However, when the results were expressed as the GI, there were no significant differences between the subjects, and most of the variation was due to within-individual variation. Using the within-individual variance, we estimated the so-called "predictive difference" of GI values. Its reliability was assessed by consideration of published data from eight studies where different mixed meals were taken by the same group of subjects. There were 37 cases where the difference between the GI of any two meals was greater than the predictive difference. Of these 37 pairs of meals, the GI correctly ranked the glycemic responses in 36 (97%). We conclude that GI values for the same food do not vary significantly between different individuals. For a subject with NIDDM a difference in GI of 34 will predict the ranking of glycemic responses of two meals with 95% probability. The corresponding value for a subject with IDDM is 50. PMID- 2760354 TI - Biphasic intrauterine growth in insulin-dependent diabetic pregnancies. AB - Early fetal growth delay (7-14 weeks of gestation) has been reported in insulin dependent diabetic (IDD) pregnancies and in several animal models. Macrosomia is a classic feature of the infant of the IDD mother. We hypothesized therefore that a biphasic pattern of fetal growth exists in IDD pregnancies. We compared fetal growth measurements [biparietal diameter (BPD) and abdominal circumference (AC)] obtained sonographically from 106 IDD pregnancies (Class B-RT) to similar data obtained from 117 normal, nondiabetic patients. The goals for diabetic glycemic control were: fasting blood sugar less than or equal to 100 mg/dl and postprandial blood sugar less than 140 mg/dl. From one to five ultrasonographic measurements were performed at varying gestational ages in all study patients. For data analysis, one examination from each pregnancy was randomly selected by computer. Gestational age (GA) was calculated from last menstrual period and corroborated by infant physical examination (Ballard score) at birth. BPD growth pattern was biphasic in the diabetic group, described by a cubic equation: BPD = 4.99 - 0.567GA + 0.037(GA)2 - 0.0005(GA)3, R2 = 0.935. Such a biphasic pattern did not exist in the control population [BPD = -3.0323 + 0.473(gestation) - ( 0.0040)(gestation)2, R2 = 0.9173]. Early growth delay was greater in fetuses that subsequently developed macrosomia (p less than 0.01). Similar results were found for AC measurements. We conclude that fetal growth delay occurs in the first half of the IDD pregnancy, followed by a phase of increased growth. The mechanism of the early growth delay is unclear. We speculate that early growth delay may be due to a "toxic" effect of glucose or other metabolite; and subsequent increased growth relates to fetal hyperinsulinism which develops from weeks 15 to 20 of gestation. PMID- 2760356 TI - Infant feeding formulas using coconut oil and the medium chain triglycerides. PMID- 2760357 TI - Survey of fatal anaphylactic reactions to imported fire ant stings. Report of the Fire Ant Subcommittee of the American Academy of Allergy and Immunology. AB - A physician questionnaire survey was conducted by the Fire Ant Subcommittee of the American Academy of Allergy and Immunology to document deaths caused by imported fire ant stings. From the 29,300 physicians surveyed, reports of 83 fatal and two near-fatal fire ant-sting reactions were received. Most anaphylactic deaths were reported from Florida (22) and Texas (19). After excluding duplicate reports, four confirmed deaths were documented in Alabama, 10 in Florida, two in Georgia, two in Louisiana, and 14 in Texas. PMID- 2760358 TI - Prospective observations on stopping prolonged venom immunotherapy. AB - After a decade spent establishing the safety, efficacy, and optimal techniques for venom immunotherapy, we have begun a series of studies to determine how long venom immunotherapy must be continued. In retrospective surveys, patients who had stopped venom immunotherapy after 1 to 2 years had a substantial risk (25%) of systemic sting reactions, but this was less than 50% of the risk in untreated patients. In this first prospective study, 30 patients elected to stop venom immunotherapy after at least 5 years of therapy. Skin test sensitivity had decreased significantly during therapy in 18/30 patients but remained clearly positive in 23/30 (seven patients became equivocal or negative). Serum venom specific IgE antibodies were at the lower limit of detection (1 ng/ml) in 11/30 patients. After stopping treatment, the mean serum venom-specific IgG antibody level declined from 5.5 +/- 0.6 micrograms/ml to 2.4 +/- 0.3 micrograms/ml by 9 months, which is the same as the mean venom IgG in untreated patients. After 12 months without therapy, live sting challenge caused no systemic reaction in 29 patients. The mean venom IgG level 1 month after the sting had risen significantly to 4.1 +/- 0.5 micrograms/ml, but there was no significant increase of venom IgE. These results suggest that prolonged venom immunotherapy leads to isotype-specific suppression of the venom IgE antibody response and may provide persistent clinical protection by mechanisms other than IgG blocking antibodies. The observations are to be interpreted very cautiously. Further investigations are needed to extend these observations in additional patients and for longer periods of time, and to examine possible mechanisms for this apparent loss of clinical reactivity. PMID- 2760359 TI - A comparison of six epicutaneous devices in the performance of immediate hypersensitivity skin testing. AB - Six devices commonly used for immediate hypersensitivity epicutaneous skin testing were compared with regard to precision and diagnostic accuracy. Fifteen subjects were tested on the back to 10 mg/ml of histamine phosphate and 50% glycerosaline by prick technique with a smallpox needle (SN), bifurcated needle (BN), Greer "pen" (GP), and blood lancet, and by puncture with the Morrow-Brown needle (MB) and Multi-Test (MT). Five devices were tested in quintuplicate to histamine and once to glycerosaline in each subject; with MT, five histamine and three glycerosaline sites were used. Analysis of the wheal areas obtained with SN, BN, GP, and MB demonstrated comparable degrees of precision (coefficient of variation). The precision of MT was less than the other devices (p less than 0.05). The blood lancet demonstrated intermediate precision. Twenty-two of 45 (49%) of the glycerosaline skin tests performed with MT were falsely positive, significantly more than the other devices (p = 0.0001). We conclude that MB, BN, GP, and SP are comparable devices for use in immediate hypersensitivity skin testing. The low precision and reliability of MT used for testing on the back would appear to make this device less than adequate for diagnostic or research studies. Its high rate of false positive reactions requires caution in interpretation of results when it is used in the clinical diagnosis of allergy. PMID- 2760360 TI - Asthma from childhood to adulthood--a follow-up study of 20 subjects with special reference to work capacity and pulmonary gas exchange. AB - Twenty men with a mean age of 24.9 years, who had moderate to severe asthma during childhood, underwent a follow-up examination of their physical fitness, working capacity, maximal oxygen uptake, and pulmonary function during and after physical work. Comparison was made with similar data obtained at the age of 10.9 years. The young men had a normal physical working capacity with a normal oxygen uptake of 3.65 +/- 0.56 L/min. The respiratory parameters and the arterial blood gases during work demonstrated values as in healthy individuals, and no differences between groups with mild and severe asthma during childhood were observed. The alveolar-arterial oxygen difference was normalized, compared to that at 10.9 years. Only a few subjects still had exercise-induced asthma with a postexercise fall of greater than 20% in FEV1 compared to childhood. The mean FEV1 values for the whole group after exercise were lowered and had not returned to the baseline level even after 20 minutes. Oxygen pressure (tension), arterial, measured during 20 minutes after work, demonstrated continuously decreasing values. This might reflect a persisting disturbance in the pulmonary ventilation perfusion relationship caused by the underlying asthma disease. PMID- 2760361 TI - Inhibition of the cutaneous response to antigen by a thromboxane-synthetase inhibitor (OKY-046) in allergic dogs. AB - We studied the effect of a selective thromboxane-synthetase inhibitor, sodium (E) 3-[4-(1-imidazolymethyl)-phenyl]-2-propanoate) (OKY-046) on the late-phase response to antigen in ragweed-sensitized dogs. Skin biopsies were performed before and 1, 6, and 24 hours after ragweed injection. OKY-046 was infused (100 micrograms.kg-1.min) from 1 hour before until 6 hours after intracutaneous ragweed in five dogs. The early clinical response to ragweed (wheal at 20 minutes) was not changed by OKY-046. A late-phase response (induration at 6 hours) was not observed in any of the OKY-046-treated dogs but was present at 6 hours in 4/5 dogs without OKY-046. Typical mast cells responded similarly in both groups with progressive degranulation during 24 hours. Maximal degranulation of atypical mast cells was delayed to 6 hours with OKY-046, whereas these cells responded completely at 1 hour without OKY-046. The inflammatory response to ragweed followed the same pattern in both groups, but the numbers of each cell type were decreased with OKY-046. With OKY-046, the cutaneous response to histamine was not changed significantly from baseline at 6 hours but was increased (p less than 0.05) at 24 hours, whereas without OKY-046, histamine response was significantly increased at 6 hours (p less than 0.001) and 24 hours (p less than 0.01). We conclude that OKY-046 alters the antigen-induced response of atypical mast cells, the subsequent cellular and clinical late-phase response, and prevents the increase in histamine response. PMID- 2760362 TI - Lung injury induced by short-term intermittent trimellitic anhydride (TMA) inhalation. AB - We have developed a rat model of lung injury with interstitial pneumonitis, lung hemorrhage, and a systemic and pulmonary immune response to trimellitic anhydride (TMA)-haptenized proteins induced by TMA inhalation for 10 days. The present studies explored the induction of lung injury induced by short-term intermittent TMA inhalation, a model more likely to simulate short-term industrial exposures during inadvertent spills of TMA. Sprague-Dawley rats inhaled TMA powder (500 micrograms/m3) on days 1, 5, and 10, and were necropsied on day 30, 18 hours after a 6-hour TMA-inhalation challenge on day 29. Rats were bled every second day and at necropsy. Serum IgG, IgA, and IgM antibody to trimellityl rat serum albumin was measured by ELISA. There was a rise in IgM and IgA antibody to trimellityl rat serum albumin starting at day 5 that peaked at day 20 with a decline in IgM by day 30. IgG antibody rose at day 7, peaked at day 20, and plateaued. The IgG antibody level was 10 times higher than the IgA or IgM level. In a second experiment, 18 rats were administered TMA-inhalation exposure on days 1, 5, and 10, and a TMA challenge on day 22. The number of hemorrhagic foci, lung weights, and lung-displacement volumes at necropsy on day 23 were highly correlated with IgG, IgA, and IgM serum-antibody levels. In a final experiment, rats developed a mean of 112 hemorrhagic foci per lung on day 30 after receiving only two TMA-inhalation exposures on days 1 and 5 with a rechallenge on day 29. (ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2760363 TI - Probable allergic reaction to casein hydrolysate formula. PMID- 2760364 TI - Benzalkonium chloride and bronchoconstriction. PMID- 2760365 TI - ADA testifies in support of nutrition monitoring. PMID- 2760366 TI - Culture and ecology in dietetics and nutrition. PMID- 2760367 TI - Food group contributions to nutrient intake in whites, blacks, and Mexican Americans in Texas. AB - The existence of three different ethnic groups, living within a defined geographic area in Texas and maintaining fairly distinct life-styles, provided an excellent opportunity to compare their dietary behaviors. Information about food consumption was obtained by 24-hour dietary recall from a group of 431 whites, blacks, and Mexican Americans residing in two counties in southeast Texas. Food group and subgroup contributions to 11 nutrients were calculated. The intake patterns of Mexican Americans demonstrated both an adherence to traditional or familiar Mexican food items, such as beans and tortillas, and a preference for foods not previously reported to be commonly consumed by that ethnic group, specifically beef. The current study provides a base of information necessary to implement dietary changes acceptable within the context of a particular culture's world view. Results revealed differences in food intake patterns that would be helpful in designing practical nutrition education programs specifically targeted toward these ethnic groups. For example, inadequate sources of nutrients were identified, as were sources of excess fat. PMID- 2760368 TI - A research model for relating job characteristics to job satisfaction of university foodservice employees. AB - The purpose of this study was to determine the relationship between job characteristics and job satisfaction and between demographic variables and job satisfaction for university foodservice employees. A three-part survey was developed which included the 30-item Job Characteristics Inventory, 6 items related to job satisfaction, and 7 demographic items. Separate written questionnaires were administered to 32 managerial and 147 non-managerial employees of a large state university foodservice department. The response rate was 98% (32 managers and 143 non-managers). The reliability for the instrument, as determined by Cronbach's alpha, was 0.88 for employees and 0.91 for supervisors. Multiple linear regression analyses were used to test research hypotheses at a significance level of p less than or equal to .05. There was a positive relationship between job characteristics (autonomy, task identity, feedback, variety, dealing with others, and friendship opportunities) and job satisfaction for both employees and supervisors. Feedback and dealing with others were the individual job characteristics that were significant. Only one job characteristic, dealing with others, was rated higher by managerial than by non managerial employees. There was no difference in job satisfaction by role (managerial vs. non-managerial) or demographic variables, except age for non managerial employees. Older, non-managerial employees tended to be more satisfied with their jobs than did younger employees. Dietitians and foodservice managers can use the findings for implementing job design strategies, such as job enrichment and job rotation, to improve employee satisfaction. PMID- 2760369 TI - Eating problems and nutritional status during hospital stay of patients with severe stroke. AB - Eating problems and nutritional status were studied in a consecutive series of patients who had had strokes. From this cohort, 32 subjects (mean age 73 years) with a hospital stay of 21 days or more are described. Eating problems were identified by direct participant observations of the patients' eating behavior, interviews on admission, inspections of the mouth, and discussions with the patients. Nutritional status was assessed by weight, triceps skinfold thickness (TSF), arm muscular circumference (AMC), plasma albumin, serum transferrin, and plasma prealbumin on admission and then weekly. Eating problems were identified in 27 patients. In a general linear hypothesis program, poor nutritional status 3 weeks after admission was found to be associated with (in decreasing order) low self-care performance, poor nutritional status on admission, male sex, intravenous energy-containing fluids, advanced age, paresis of the right arm, and eating problems. Factors other than eating problems seem to be important for undernutrition in patients with strokes during hospital stay. PMID- 2760370 TI - Impact of the Higgins Nutrition Intervention Program on birth weight: a within mother analysis. AB - A study was conducted to evaluate the impact of the Higgins Nutrition Intervention Program of individual nutritional assessment and rehabilitation on pregnancy outcome in a group of urban low-income women. Developed as an adjunct to routine prenatal care, the Higgins program utilizes an individualized approach to dietary treatment that combines an assessment of the risk profile for the presenting pregnancy with the application of specific nutritional rehabilitation allowances to compensate for the negative impact of diagnosed risks. This report presents results of analyses evaluating differences in birth outcomes between 552 sibling pairs; each mother had participated in the Higgins program during the pregnancy of the second-born, but not of the first-born, member of her pair. After adjustment for parity and sex, the intervention infants weighed an average of 107 gm more than their matched siblings at birth (p less than .01). The rate of low birth weight was 50% lower among the intervention infants than among their siblings (p less than .01); rates of intra-uterine growth retardation and perinatal mortality were also lower in the intervention group. The high risk of poor pregnancy outcome in this group of urban low-income women was reduced by the Higgins program. PMID- 2760371 TI - Blood-building foods in contemporary Chinese populations. AB - According to ancient Chinese medicine, "weak blood" is a yin condition that occurs during growth, pregnancy, the postpartum period, and old age. Treatment requires use of special foods that are "yang" in nature. This article investigated the use of such blood-building foods in seven contemporary Chinese populations throughout the world. Analysis of questionnaires from 379 respondents indicated that high-protein foods, such as pork liver and other meats, were recommended most often. Although these and other foods recommended were primarily yang, only 8.1% of respondents considered weak blood a "yin" condition. Comparison of 717 responses concerning foods that should be used to treat weak blood showed more similarities than differences between Chinese populations in different parts of the world. Strong adherence to cultural practices was also evident. Self-diagnosis and self-prescription are common modes of treating symptoms in the Chinese and other cultures. Knowledge of beneficial food-related health practices can enable practitioners to counsel their clients more effectively and to develop bilingual educational materials that incorporate familiar cultural practices. PMID- 2760372 TI - Voluntary consumption of a carbohydrate supplement by elite speed skaters. PMID- 2760373 TI - Survey of impact of social needs on Japan's dietetic education and practice. PMID- 2760374 TI - Patterns of infant feeding in a tri-ethnic population. PMID- 2760375 TI - Clinical evaluation of serum fructosamine in monitoring elderly outpatient diabetics. AB - Recently, new serum glycated protein assays (ie, serum fructosamine) have been developed. Fructosamine assays objectively monitor short-term glycemic control and, when used in conjunction with HgA1C, enhance the clinical information obtained and greatly aid in the clinical management of diabetes. Because they rely on glycation of serum proteins, the clinical utility of these assays in the elderly may be altered secondary to the hypoproteinemia that often is seen in these states. Therefore, we investigated the role of glycated serum proteins (ie, fructosamine level) in monitoring elderly diabetics over a 4-month period of observation. We found that the fasting blood glucose over the 4-month period correlated well with the serum fructosamine activity (r = 0.79, P less than .001) and HgA1C (r = 0.78, P less than .001). In addition, we found that the mean daily glucose, as determined by outpatient monitoring, correlated well to both the fructosamine activity (r = 0.66, P less than .001) and HgA1C (r = 0.74, P less than .001). We found no effect on the measurement of the fructosamine assay by the level of albumin seen in these patients. Our study suggests that serum fructosamine and HgA1C are equally effective in monitoring the elderly patient, as has been established in the younger diabetic, and no correction need be made in the fructosamine assay to compensate for variable serum protein levels seen clinically in the elderly. PMID- 2760376 TI - Vasopressin response to dehydration in Alzheimer's disease. AB - Alzheimer's disease is a progressive deterioration of neuropsychological functioning. One of the main neuropathological correlates of the disease is a drop-out of cholinergic neurons within the central nervous system. The neuropeptide that is responsible for water homeostasis and defense against dehydration, vasopressin, is also under direct cholinergic control. Several studies have suggested that in Alzheimer's disease there has been a trend toward lower vasopressin levels than in age-matched controls. In order to improve discrimination of normal from diminished vasopressin levels, nine subjects with Alzheimer's disease (mean age 65 +/- 2 years) and nine age- and sex-matched controls (68 +/- 3 years) underwent a mild provocative challenge of overnight fluid restriction. Individuals with Alzheimer's disease had a greater degree of dehydration, with overnight serum osmolality of 313 +/- 4 vs 300 +/- 3 Mosmol/kg, P = .01, and diminished "thirst" as measured by water ingested in one hour of ad libitum water intake. Eight of the nine with Alzheimer's disease had levels of vasopressin which, by extrapolation, appear to be subnormal for their serum osmolalities, whereas seven of the nine control subjects has vasopressin levels within or above the reference range (P less than .05). Elderly individuals with Alzheimer's disease may be at increased risk of dehydration during periods of fluid restriction due to the loss of normal physiological responses of "thirst" and vasopressin secretion. PMID- 2760377 TI - The EASI: a self-administered screening test for cognitive impairment in the elderly. AB - The Early Assessment Self Inventory (EASI), a rapid self-administered screening test for cognitive impairment in the elderly, was constructed to permit individuals to be assessed in a group or singly without examiner intervention. This paper-and-pencil device requires a fourth-grade reading level and makes minimal demands on literacy while assessing orientation, recent and remote memory, language, visual-construction, calculation, and attention. In the present study, the EASI was group-administered to 146 elderly persons attending senior centers and completed individually without examiner intervention by 19 outpatients at a memory disorders clinic. Participants were 60 to 95 years old with 5 to 18 years of education. The EASI demonstrated good internal consistency and test-retest reliability and was significantly correlated with the Mini-Mental State Exam and the Mattis Dementia Rating Scale, both widely used screening instruments. Neuropsychological measures of memory, attention, and verbal fluency correlated as well with the EASI as with the examiner-administered screening instruments, suggesting that the EASI may provide an efficient method of screening for cognitive impairment. PMID- 2760378 TI - Screening for cervical carcinoma in elderly women. Developed by the Clinical Practice Committee and approved by the American Geriatrics Society Board of Directors. PMID- 2760379 TI - Use of the Geriatric Depression Scale in dementia of the Alzheimer type. AB - The Geriatric Depression Scale (GDS) has been shown to be an effective screening test for depression in selected geriatric populations. However, it has not been evaluated as a screening test for depression among elderly adults with dementia of the Alzheimer type. Over a two-year period 283 patients were seen in a geriatric assessment center and were screened for depression using the Geriatric Depression Scale. They also received a clinical psychiatric diagnosis by one of two geropsychiatrists. Patients with a Clinical Dementia Rating (CDR) of 0 (cognitively intact) (n = 70) and those with mild Alzheimer's disease (CDR of 1) (n = 72) were selected for comparison. The data were analyzed using Receiver Operating Characteristic Curves (ROCs) in order to compare the utility of the Geriatric Depression Scale in these two groups. ROC curves, which plot sensitivity against false positives, have come into increasing use as a method of examining the clinical performance of tests. The area lying beneath the curve (AUC) can be estimated and used as a quantitative measure of test performance (equivalent to the Wilcoxon rank sum). In the intact group, the Geriatric Depression Scale produced a ROC curve with an AUC of 0.85 (percent score = 1), which is significant (z = 7.28, P less than .0001). In the group composed of those with Alzheimer's disease, the Geriatric Depression Scale yielded a ROC curve with an AUC of 0.66, which was not significantly different from chance (z = 1.92, P = NS). This study provides empirical evidence that while the Geriatric Depression Scale is an accurate screening test for depression in cognitively intact geriatric populations, it does not maintain its validity in populations that contain large numbers of patients with dementia of the Alzheimer type. PMID- 2760380 TI - Incidence of hypertension in an ambulatory elderly population. AB - Investigations of the natural history of blood pressure have generally evaluated mean systolic and diastolic pressure changes. While information, this information is not directly applicable to clinical practice settings, in which patients are usually classified as normotensive or hypertensive. We measured the actual incidence of hypertension, using two different definitions, in an ambulatory elderly population of 2,584 individuals over an 8-year period. Using the less stringent blood pressure definition (systolic blood pressure greater than 140 mmHg and diastolic blood pressure greater than or equal to 90 mmHg), 884 (34.2%) participants were normotensive and 1,700 (65.8%) were hypertensive at an initial screening. The average annual incidence of hypertension over the subsequent eight years was 13.2%, and life tables demonstrated a gradual risk of developing hypertension. The development of hypertension was not associated with gender or age; while older age groups had a greater chance of developing hypertension than younger, the difference did not reach statistical significance. PMID- 2760381 TI - Clinical aspects of pneumonia in the elderly veteran. AB - While atypical presentation of pneumonia in elderly patients is thought to be common, its incidence and factors predisposing to it are unknown. This study documents presenting symptoms of pneumonia in 48 patients, aged 65 or older, admitted to the medical service at a Veterans Administration Medical Center. Seventeen subjects (35%) had a classic constellation of symptoms which included both fever and cough. A chief complaint suggestive of pneumonia, defined as cough, fever, or shortness of breath, occurred in 27 subjects (56%). Five subjects (10%) had no symptoms suggestive of pneumonia even with a detailed history. Absence of a classic constellation of pneumonia symptoms correlated with advanced age (P = .0045), cognitive impairment at admission (P = .022), and baseline functional impairment (P = .028). Neither nutritional status as measured by serum albumin nor medical status as measured by number of medical problems and number of medications predicted an atypical presentation of pneumonia. Nineteen subjects (39%) did not have a documented fever, and 15 subjects (31%) did not have a leukocytosis. Absence of fever or leukocytosis did not correlate with age, number of medical problems, number of medications, cognitive status, functional status, or serum albumin. We conclude that a classic constellation of symptoms, signs and laboratory findings is frequently absent but some suggestive symptom is usually present in this population of elderly veterans with community-acquired pneumonia. Patients with advanced age, cognitive impairment at admission, and baseline functional impairment are most likely to have an atypical presentation of pneumonia. PMID- 2760382 TI - Digitalis in the elderly. PMID- 2760383 TI - Screening for breast cancer in elderly women. Developed by the Clinical Practice Committee and approved by the American Geriatrics Society Board of Directors. PMID- 2760384 TI - Cancer screening in the elderly. AB - Cancer screening in the elderly presents several unique challenges. There are no prospective trials of any cancer screening exam that have conclusively demonstrated efficacy in this age group. Any assessment of cancer screening in the elderly must include measuring an improvement in quality of life and functional status as well as decreased mortality from early cancer detection. Older patients usually prefer improved quality over quantity of life; they may be less interested in a trade-off of months or years of life in exchange for the side effects of cancer treatment. The elderly may need more home assistance during the treatment of the detected cancers; physicians should arrange for this. All of these variables must be included in studies of cancer screening in the elderly; the need for these studies is great. The following recommendations are probably the most reasonable in view of the currently inadequate knowledge base. Screening for breast cancer has demonstrated efficacy, with growing evidence for a cumulative effect from monthly breast self-examination, yearly breast examination by a physician, and yearly or biennial mammography. There may be no need to screen for cervical cancer in women after age 65 who have had regular Pap smear screening; however, older women who have never had Pap smears should have regular Pap smears for several years. Finally, because of the high frequency of colorectal and prostate cancers in the elderly, physicians should probably perform yearly rectal examinations with stool guaiac and regular sigmoidoscopy in this age group until definitive data support continuing or discontinuing these screening examinations. Physicians should educate their elderly patients to the importance of regular cancer screening and cancer risk-factor modification and should offer cancer screening examinations and counseling to elderly patients on a regularly scheduled basis. PMID- 2760385 TI - Fructosamine or glycated hemoglobin? PMID- 2760386 TI - On cancer screening in the elderly. PMID- 2760387 TI - Clinicians, academics, and "the exam". PMID- 2760388 TI - Hypersexual agitation in Alzheimer's disease. PMID- 2760389 TI - More on problems in nursing home care. PMID- 2760390 TI - To see or not to see: routine pupillary dilation. PMID- 2760391 TI - Functional model for eye protection program. PMID- 2760392 TI - Legal blindness in one eye. PMID- 2760394 TI - Contrast sensitivity function and mobility in elderly patients with macular degeneration. AB - Eleven control subjects, 64-79 years of age, and 10 subjects with macular degeneration, 70-82 years of age, were included in this study. Each participant was tested for visual acuity, spatial and temporal contrast sensitivity, and mobility in an unfamiliar environment. The course was designed with a pair of steps, ramps, and a level pathway. The subjects were timed and videotaped. The number of errors was recorded. Visual acuity and contrast sensitivity were significantly different between groups. The time to complete the course was significantly different between groups; however, the difference did not remain significant after age-adjustment. PMID- 2760393 TI - Life expectancy and diabetic retinopathy. PMID- 2760395 TI - One-week vs. 2-week hydrogel extended wear schedules. AB - Fifteen myopic patients wore 58% water content lenses for extended wear. The lens on one eye was removed weekly for 1 night and the lens on the other eye was removed only every 2 weeks. The patients were followed for 3 months. No significant difference in daytime corneal thickness was found between the two eyes at any visit. In comparing the corneal thickness the day before vs. the day after resuming lens wear, the mean thickness was no different for the 1-week schedule and tended to be slightly greater prior to removal for the 2-week schedule but not statistically different. There was no statistical difference in K-readings or corneal shape factor between the eyes. A mean increase in myopia was recorded, but it was only statistically significant for two visits for the 1 week wearing schedule eye. The number of positive biomicroscopic findings were slightly greater with the 2-week schedule. Two eyes developed corneal ulcers, one occurring on the 1-week schedule and one on the 2-week schedule. PMID- 2760396 TI - Neurophysiological correlates in a case of unilateral iris and chorioretinal coloboma. AB - This report details the case of an 11-year-old white male with a typical presentation of a unilateral iris and chorioretinal coloboma associated with multisystem disorders. The results of routine clinical and noninvasive neurophysiological tests are presented to demonstrate the anatomical and functional correlates of this striking and infrequently encountered ocular defect. PMID- 2760397 TI - Cavernous sinus syndrome from self-inflicted gunshot wound: case report and neuroanatomical correlation. AB - A case of total ophthalmoplegia is presented secondary to attempted suicide by firearm. The case demonstrates classic intermediate cavernous sinus syndrome signs. The neuroanatomy of the region, along with common parasellar syndromes, is reviewed. PMID- 2760398 TI - Panic attacks facilitating recall and mastery: implications for psychoanalytic technique. AB - A patient, during the course of a lengthy analysis, experienced several panic attacks. These regressive episodes, occurring only in the analytic setting, provided her with her special means for recalling and eventually mastering repressed elements of her life. This facilitating aspect of her disorganization, when identified and analyzed as such, helped deepen the patient's analytic experience. It was necessary for the analyst to define verbally and clarify her reconstructed past as it emerged as part of her panic state, transferentially, so that the patient could finally recognize, acknowledge, and understand hitherto hidden aspects of her life. The psychiatric literature in regard to panic states is briefly noted, as is the relevance of comparing the present almost exclusively organic, pharmacological orientation, with Freud's discussion of the "actual" or current neuroses of his day, almost a century ago. On the basis of this case report, the importance of understanding the content and meaning of the panic attack, by analytic means, is once again emphasized. PMID- 2760399 TI - Aspects of nonperverse scopophilia within an analysis. AB - This essay is intended to contribute to the increasing importance ascribed to scopophilia in modern psychoanalytic literature. The exceptional position of scopophilia is twofold: by virtue of its subdivisions, voyeurism and exhibitionism, it constitutes one of the two pairs of component drives recognized by Freund; and it informs one of the two major perceptual avenues that comprise communication in the analytic setting. A case is presented which shows how the psychic life of a female patient was dominated by a nonperverse scopophilia in a remarkable variety of ways, ranging from hyper-investment to inhibition and phobic curtailment. The case is equally noteworthy for the way in which these various phenomena were reenacted in the transference and in the particular visual character of the analytic scene; thus the patient's optical focal symbiosis and ophidiophobia are related to what I call the analyst's "retro presence." PMID- 2760401 TI - Understanding negative hallucination: toward a developmental classification of disturbances in reality awareness. AB - Negative hallucinations are explored from a psychodynamic viewpoint in four cases of neurosis. Next, shifting to the level of clinical theory, negative hallucinations are contrasted with five better-studied disturbances in reality awareness. It is noted that all six function as screen phenomena, and all occur in everyday contexts. These and other phenomenological issues lead to an assertion that negative hallucinations are regressive perceptual phenomena, similar in form to both preconscious perceptions and infantile amnesia. Finally, developmental considerations are used to derive a coherent hierarchy of disturbances in reality awareness. PMID- 2760400 TI - Psychoanalytic reconstructions and empirical data: reciprocal contributions. AB - Freud (1905, 1917, 1937) throughout his lifetime sought empirical scientific confirmation of the validity of his discoveries. In pursuit of this goal, he persistently emphasized the importance of establishing agreement between analytic reconstructions and the results of naturalistic child observation. The same objective lead Lichtenberg (1983), Emde (1981, 1985), and Stern (1985) to produce detailed evaluations of the impact of infant research findings on analytic developmental propositions. The present paper examines the relation among clinical reconstructions from an analysis developed through transference interpretations, empirical observations originating in the analytic patient's daughter's psychotherapy, and the results of empirical infant research that was being concurrently conducted by two of the authors. The findings from the clinical analysis of the mother, the psychotherapy of the daughter, and empirical infant research all converged on the same larger causative factor for the daughter's psychopathology--a type of maternal deprivation. Such a confluence of different sources of evidence, each identified by a different method of investigation, provides one kind of validation for psychoanalytic reconstructions, making it possible to provide that "satisfactory degree of certainty" which Freud (1937) called for in the attempt to integrate the patient's "psychic truth" with "actual" or historical truth. PMID- 2760402 TI - Fetishism in a woman. AB - Fetishism is generally considered to be a perversion occurring only in males. In this paper a clinical illustration of an adult woman with a fetishistic perversion is offered and considered within the context of the classic concept of fetishism originally described by Freud. Similarities and differences between male and female fetishism are discussed, with attention given to the greater complexity of the perversion as it occurs in a woman. The clinical example confirms the existence of fetishism in women and suggests that subtle forms of the perversion may go unnoticed and be more prevalent than previously realized. PMID- 2760403 TI - Pitfalls of a one-sided image of science: Adolf Grunbaum's Foundations of Psychoanalysis. AB - Adolf Grunbaum's (1984) The Foundations of Psychoanalysis has received extensive attention in psychoanalytic and philosophical circles. Aspects of Grunbaum's argument are reviewed and criticized. While his volume is an important contribution to the epistemological assessment of psychoanalysis, it reflects serious shortcomings in at least four areas: its treatment of the role of suggestion in the analytic enterprise, its scrutiny of the psychoanalytic genetic method, its appreciation of analytic methodology as actually practiced, and, above all, its predication on a unidimensional, positivistic vision of science. Alternative approaches to the philosophy of psychoanalysis are suggested. PMID- 2760404 TI - Comments on Charles Brenner's "Personal Chronicle". PMID- 2760405 TI - On the oceanic experience. PMID- 2760406 TI - Commentary on "Writing about Psychoanalysis". PMID- 2760407 TI - [Validity of prediction after standard implant and the implant calculated according to the SRK formula]. AB - The purpose of this study is to appreciate post-operative ametropia in pseudophakic patients (EEC and posterior chamber IOL). Two groups were implanted either with a standard 21 D IOL (group 1) or after calculation of implant power according to the SRK formula (group 2). Results show residual refractive errors over 2 D in 7% of case in group 2 and 22.3% of case in group 1. PMID- 2760408 TI - [Postoperative secondary divergent strabismus. Statistical analysis of 160 consecutive exotropias]. AB - Exotropias secondary to convergent squint surgery are fully different from primary exotropias. Their frequency appears to be largely variable according to the operative procedures. The computerized analysis of 160 consecutive exotropias reveals the compound nature of their motor impairments. In each case it is necessary to carry out a careful check up of various causal parameters, but the authors find they are not bound by simple correlations. In all cases an elongation reducing one or several muscles is noticed. Such anomalies are much more frequent and heavy than those observed in primary esotropias. Their iatrogenic origin is unquestionable. In 37% of the cases heavy capsular scars have been observed; their consequences on passive forces are obvious, but it is difficult to carry out their exact evaluation by the usual clinical tests. In that series the resulting surgical planning was made according to the various abnormal parameters had allowed the achievement of a good motor result in 89% of the cases. In 86% of the cases, only one additional operative procedure was necessary. PMID- 2760409 TI - [Deficits of the layer of retinal nerve fibers and glaucoma. Comparison with campimetry and control of the course]. AB - Photographic study of retinal nerve fiber layer try to show early defects in case of glaucoma or ocular hypertension. Among the recent techniques trying to indicate the first marks of glaucoma, this method appears easy, reproducible, objective, and uses a very common equipment. We describe the equipment and the technic used, and present the main physiological and pathological aspects. Our series includes 49 eyes (30 patients) and, for 30 among them (17 patients), a control of the evolution has been done within an average period of thirty months. In each case, visual field was studied, principally with the programs of early detection of glaucomatous damage available on the Octopus 2000 R (prog. No 31, 33 and G1). We explore and comment upon the results obtained by the confrontation between these exams. PMID- 2760410 TI - [Amebic keratitis: role of the rinsing solutions for corneal lenses using city water?]. PMID- 2760411 TI - [Treatment of preretinal retrohyaloidal hemorrhage: value of early argon laser photocoagulation]. AB - Within the first three or four days after occurrence of a premacular subhyaloidal hemorrhage, the posterior vitreous boundary layer may be lacerated by argon laser coagulation in such a way that the blood flows into the vitreous body, where it is absorbed within a few weeks. Older premacular hemorrhages under an intact vitreous boundary layer, typically green-white in color, have to be treated by more invasive vitreosurgical procedures. PMID- 2760413 TI - Effects of theophylline on human natural killer cells. AB - Theophylline has been shown previously to inhibit a number of cellular immune functions of granulocytes and T-lymphocytes. In the present report, we demonstrate that theophylline, in a dose-dependent fashion, suppresses human natural killer (NK) cell activity in vitro. To determine if theophylline produces quantitative or qualitative alterations in NK cells in vivo we quantitated peripheral blood NK cells with three monoclonal antibodies and FACS analysis and measured NK cytolytic activity in eight normal volunteers who took theophylline for eight days. No change was noted in the number of cytolytic activity of NK cells over the eight days of monitoring. We conclude that theophylline does not alter NK cells in vivo when given in therapeutic doses. PMID- 2760412 TI - Toxic and developmental effects of organophosphorus insecticides in embryos of the South African clawed frog. AB - Four organophosphorus insecticides and the active metabolites of two phosphorothionate insecticides were tested for their toxic and teratogenic effects on embryos of Xenopus laevis. All compounds caused dose-dependent developmental defects, such as abnormal pigmentation, abnormal gut development, notochordal defects and reduced growth. Malathion, malaoxon, parathion, and paraoxon produced severe defects, while monocrotophos and dicrotophos produced considerably milder defects. All compounds reduced NAD+ levels to a similar extent, regardless of the severity of the defects induced. Thus some commonly used organophosphorus insecticides and their metabolites are teratogenic to Xenopus embryos, but reduced NAD+ level does not appear to be important in causing the developmental defects. PMID- 2760414 TI - Monocyte locomotion in anergic chronic brucellosis patients: the in vivo effect of ascorbic acid. AB - In 14 patients suffering from relapsing chronic brucellosis who were anergic to brucella antigens, we have studied peripheral blood monocyte random migration and chemotaxis against non-specific and specific leukoattractants, as well as plasma and monocyte ascorbic acid levels. We found that all parameters studied, were significantly beneath normal, when compared to normal subjects. After the oral administration of ascorbic acid at a daily dose of 1gr for 15 consequetive days, random and directed migration against a non-specific stimulus (casein) returned to normal. Directed migration against disease associated leukoattractants (brucella melitensis and brucella abortus) antigens improved significantly, without reaching normal values. We concluded that ascorbic acid supplementation might partially restore peripheral, monocyte function and help the monocyte macrophage system to mount an effective immune response against chronicity of brucella infection. PMID- 2760415 TI - The effects of protein kinase inhibitors on lymphocyte blastogenesis and GVHD induced splenomegaly. AB - The activation of the protein kinase C (PKC) pathway plays an integral part in the proliferation of many cell types including lymphocytes. We report that the PKC inhibitor H-7 caused inhibition of three commonly studied blastogenic responses (Con A, LPS, and MLR) with the strongest suppression being detected in the MLR. In contrast, HA1004, a potent inhibitor of cyclic nucleotide-dependent protein kinases, did not alter the blastogenic response but occasionally caused augmentation. The phenothiazine compounds studied inhibited the Con A and, to a lesser extent, the LPS responses. One of the compounds, promethazine-HCl, was effective in vivo in inhibiting splenomegaly resulting from the induction of graft vs. host disease. Our studies support the involvement of PKC in lymphoid blastogenesis. They also suggest that agents that can inhibit PKC activity may be useful in inducing immunosuppression in vivo. PMID- 2760416 TI - Financial abuse of the elderly. Recognizing and acting on it. AB - 1. Within a trust situation, one party (the trustee) holds the title and control of property, but has a responsibility to use the property for the benefit of another (the beneficiary). 2. A durable power of attorney is a written document in which one person (the principal) has granted another person (the agent or attorney-in-fact) the authority to act for him and the delegation of authority continues even if the principal becomes incapacitated. 3. A representative payee is a person or organization who receives payment as a substitute for the beneficiary. 4. A joint tenancy is a form of co-ownership in which two or more persons hold a single interest in property and each co-owner has the right of survivorship. PMID- 2760417 TI - Loneliness. Easing the pain of the hospitalized elderly. AB - For the older adult, loneliness may contribute to deterioration in physical and mental health. Some factors that may contribute to loneliness in the older adult include the death of a spouse, loss of a pet, lack of visitors, physical incapacity, role changes, and relocation. In general, loneliness may be the result of events that typically occur as a part of the aging process. Nurses can decrease the incidence of loneliness in the older adult by ensuring access to visitors and facilitating involvement in usual activities. Assessment information that is needed to plan nursing care to decrease the incidence of loneliness includes data regarding the patient's cultural background; significant persons, objects, and activities; and previous hospitalization experiences. PMID- 2760418 TI - Remember when...? Using mnemonics to boost memory in the elderly. AB - Memory loss associated with normal aging is frequently confused with dementia. Self-perceived memory loss can lead to social withdrawal, which can contribute to an ongoing pattern of memory impairment. Memory instruction utilizing mnemonic techniques can lead to improvement in both memory and self-esteem in the elderly. A simple, four-session mnemonics instruction program can provide an effective intervention to assist older persons in coping with memory problems. PMID- 2760419 TI - Learning after graduation: are nurses taking advantage of the resources? AB - The vast majority of clients in long-term care facilities are elderly, but only half the RNs working with these clients had any specific training related to the elderly either before or after graduation. The majority of respondents preferred to attend educational offerings rather than read journal articles and felt it was beneficial to leave their facility to interact with peers from other agencies. A majority of the nurses read general interest nursing journals rather than ones specifically geared to gerontological nursing or geriatrics. Within an agency, time should be set aside for discussions and nurses should be encouraged to network outside the facility; guest staff nurses should also be encouraged to present new ideas. PMID- 2760420 TI - The demise of a gerontological nurse. PMID- 2760421 TI - The ping-pong ball effect of resident transfers: a nightmare for aging institutionalized persons. PMID- 2760422 TI - Back to the bedside. Teaching on nursing rounds. AB - 1. Teaching at the bedside provides the means for nursing students to begin their professional contacts with patients. 2. Teaching at the bedside should begin with selecting patients who illustrate specific problems and obtaining their consent. 3. Connoisseurship in clinical teaching means knowing and appreciating what is clinically significant at the bedside. 4. After teaching at the bedside, it is important to debrief students. PMID- 2760423 TI - Management of high-grade dysplasia in Barrett's esophagus. AB - When Barrett's esophagus is complicated by adenocarcinoma, surgery is indicated in appropriate patients. Until now, high-grade dysplasia in Barrett's esophagus has been managed in a similar fashion. We explore this approach and review reported cases of high-grade dysplasia to suggest guidelines for collection of data to make future clinical decisions more rational. PMID- 2760424 TI - When should we look for amebae in patients with inflammatory bowel disease? AB - Amebic colitis can mimick Crohn's disease of the colon and ulcerative colitis. Inflammatory bowel disease (IBD) patients can also be carriers of amebae. Since steroids can provoke amebic activity and even cause a fulminating colitis, it is necessary to determine that amebae do or do not exist. Furthermore, amebae can be easily eliminated by drug therapy but it is hard to eradicate IBD. Despite the above, diagnostic modalities for IBD are as effective as those for amebiasis, particularly for Crohn's disease with ileal involvement. Problems in differential diagnosis arise with IBD grossly limited to the colon. In these cases, false negative stool studies are increased by diarrhea and preparation for examinations, and both stool studies and serologies are compromised by steroids. If the clinical course of IBD is downhill, the clinician is justified in starting steroids even if evaluation for amebiasis incomplete. If, however, the index of suspicion is high, concomitant treatment with Metronidazole would be reasonable. PMID- 2760425 TI - "Going with the flow": a perspective on flow cytometry in gastroenterology. AB - In this perspective on the applications of flow cytometry in gastroenterology are described the use of flow cytometry in the study of normal physiology, in normal anatomy, and in premalignant and malignant conditions of the digestive tract. The basic principles and applications for cell counting, sorting, cell cycle analysis, and quantitation of cellular characteristics are addressed to emphasize the great potential and availability of flow cytometry. PMID- 2760426 TI - Strange bedfellows: duodenal ulcer and cancer of the stomach. AB - We have found only 308 cases of gastric cancer in patients with unoperated duodenal ulcer. We present seven men whose duodenal ulcer disease obscured the diagnosis of gastric cancer. We review the theoretical reasons that those with duodenal ulcer may be protected from gastric cancer, along with the current literature. PMID- 2760427 TI - Superior mesenteric artery syndrome. A follow-up study of 16 operated patients. AB - A series of 18 patients underwent surgery for upper abdominal symptoms and signs of superior mesenteric artery syndrome (SMAS). The diagnosis was made by simultaneous arteriography and barium meal. Findings at operation confirmed SMAS in every patient, and a duodenojejunostomy was performed. Duodenal and jejunal wall biopsy from 13 patients revealed normal myenteric and submucous plexuses. A follow-up study of 16 patients was performed after 7 years. At follow-up, the weight loss seen preoperatively had been corrected. However, symptoms were essentially similar to those found at the original examination. Only the frequency of the most distressing symptom, vomiting, was significantly decreased (p less than 0.05). The most striking features in the production of the "pincher mechanism" of the duodenum were found to be a short aortomesenteric distance together with sagittal parallelism between aorta and superior mesenteric artery. In conclusion, we recommend a conservative attitude in the treatment of SMAS. Surgical treatment with duodenojejunostomy may be indicated only if vomiting is a predominant symptom and proper conservative treatment has failed. PMID- 2760428 TI - Is operation always necessary for enterovesical fistulas in Crohn's disease? AB - We have followed 11 patients with Crohn's disease and enterovesical fistulas prospectively for up to 21 years. Seven patients underwent resection for complications other than the fistula; the fistula had been present up to 5 years in this group. Four patients have being followed medically for 1-21 years since a fistula was recognized. In no patient of either group has renal impairment developed. We suggest that enterovesical fistula by itself is not an indication for surgical intervention. PMID- 2760429 TI - Male infertility in inflammatory bowel disease. AB - We examined fertility in men with inflammatory bowel disease (IBD) to determine whether the reported deficit in pregnancies in their spouses was due to reduced reproductive capacity. The cases were 106 men with Crohn's disease and 62 with ulcerative colitis drawn from the rosters of North Carolina chapters of the National Foundation for Ileitis and Colitis. The 140 normal controls were neighbors identified by the cases. There were 186 pregnancies among the spouses of men with Crohn's disease, 110 among the ulcerative colitis group, and 300 among the controls. The mean number of pregnancies among the Crohn's disease patients (1.75 +/- 0.12) was significantly lower than the number for controls (2.14 +/- 0.11), p less than 0.02. The reduction in the mean number of pregnancies among patients with ulcerative colitis (1.77 +/- 0.18) was not significantly different from controls (p less than 0.07). Analysis of waiting time to conception showed that fecundability (the probability of pregnancy in a menstrual cycle) was not different in spouses of IBD patients and controls. We conclude that the overall reproductive capacity of men with IBD is not markedly diminished. PMID- 2760430 TI - Crohn's disease in the elderly. AB - We compared eleven patients in whom symptoms of Crohn's disease appeared at age greater than or equal to 65 with a younger group in whom symptoms had appeared earlier. Only 64% of the older patients were initially recognized as having Crohn's disease, as compared with 96% of the younger patients even though clinical characteristics and initial response to medical treatment were similar in both groups. A higher rate of complications occurred in the older group and follow-up data showed that they had higher mortality and a greater need for continuous treatment. We suggest that awareness of Crohn's disease in the elderly is less than in the young; the diagnosis is more often missed despite the similarity of the clinical features to those of younger patients. PMID- 2760431 TI - Effect of age on human gastric and small bowel motility. AB - To test the hypothesis that age alters fasting and postprandial antral and intestinal motility in humans, we studied 23 patients, aged 18-39 years (median 28), and 13 patients, aged 40-69 years (median 49). All were having gastrointestinal symptoms, but in none was there objective clinical, radiologic, or endoscopic features of bowel disease, and manometry of the stomach and proximal small bowel was normal. We quantitated certain parameters of fasting intestinal motility and postprandial antral and jejunal motility. There were no significant differences in the interval between interdigestive motor complexes (IMC), duration, propagation velocity, or maximum number of contractions during phase III of the IMC, or postprandial antral and jejunal motility indices. The postprandial indices show a very similar distribution in each decade. Thus, in selected patients with unexplained gastrointestinal symptoms but no objective features of gut disease, quantifiable gastric and small bowel motility parameters do not differ in the age groups 18-39 and 40-69 years. PMID- 2760432 TI - Marked hypergastrinemia in gastric outlet obstruction. AB - We report a 45-year-old woman with chronic peptic ulcer disease and multiple episodes of bowel obstruction, who was admitted with gastric outlet obstruction. Because of gastric hypersecretion, a diagnosis of Zollinger-Ellison syndrome was suspected and an initial serum gastrin of 1,251 pg/ml supported this diagnosis. Subsequent evaluation failed to reveal a gastrinoma. A repeat serum gastrin level after 14 days of continuous nasogastric decompression was 43 pg/ml, suggesting that the initial hypergastrinemia was due to antral distention. It is important to consider the possibility of gastric outlet obstruction as a stimulus for serum gastrins in the range previously considered diagnostic for the Zollinger-Ellison syndrome. PMID- 2760433 TI - Iron deficiency anemia in an athlete associated with Campylobacter pylori negative chronic gastritis. AB - A 14-year-old athletic boy with a 1-year history of decreased exercise tolerance presented with unexplained iron deficiency anemia. Panendoscopy, colonoscopy, and barium contrast studies of the gastrointestinal tract were normal. However, persistent uptake of radionuclide using a 99mtechnetium-sucralfate scan suggested inflammation localized to the stomach. Mucosal biopsies demonstrated acute and chronic gastritis that was not associated with the presence of Campylobacter pylori. PMID- 2760434 TI - D-lactate-associated encephalopathy after massive small-bowel resection. AB - D-Lactate-associated encephalopathy is a rare clinical syndrome characterized by dizziness, ataxia, confusion, headaches, memory loss, lethargy, and aggressiveness which may progress to frank but reversible coma. It occurs in patients with profound dysfunction of the short-bowel syndrome and is believed to result from massive carbohydrate malabsorption with resultant over-production of D-lactate and other organic anions by the colonic flora. Extremely elevated serum levels of D-lactate (but not L-lactate) confirm the diagnosis, but currently D lactate is not clearly established as the putative neurotoxin. We describe a patient who repeatedly developed D-lactate encephalopathy after surgical removal of nearly the entire jejunum and ileum. Markedly elevated D-lactate serum levels were documented during an encephalopathic episode. Potential pathophysiologic mechanisms and the treatment rationale are discussed. PMID- 2760435 TI - Jejunogastric intussusception diagnosis and management. AB - Jejunogastric intussusception is a rare complication following gastrojejunostomy, Bilroth II partial gastrectomy, and Roux-en-Y gastrojejunostomy. We report a recent patient with a retrograde gastrojejunal intussusception, the most common of the four anatomic variants of jejunogastric intussusception. It may present acutely as a surgical emergency with ischemic small bowel or chronically, with severe postprandial discomfort. Surgical correction is mandatory although controversy exists as to the most appropriate corrective procedure. PMID- 2760436 TI - Vena caval penetration by gastric ulcer: massive hemorrhage and embolization of gastric contents to lungs. AB - A 54-year-old man who died from acute upper gastrointestinal blood loss was found on postmortem examination to have a large amount of blood in the intestinal lumen from perforation of a gastric ulcer into the inferior vena cava. Gastric contents had also embolized into the pulmonary circulation. Most of the stomach was located posteriorly in the right thoracic cavity because of prior esophageal surgery, which had brought the posterior wall of the stomach in apposition to the anterior wall of the inferior vena cava. This is thought to be the first report of a gastric ulcer forming a fistula into the inferior vena cava, with food embolization to the lung. PMID- 2760437 TI - Recurrent cholangitis secondary to oriental cholangiohepatitis. AB - A Korean woman with a known mass in the left lobe of the liver and a normal gallbladder by ultrasound suffered recurrent cholangitis, which ultimately proved to be Oriental cholangiohepatitis. This disease, endemic to East Asia, has become widespread in the United States as immigration from that area has increased. The symptoms are identical to recurrent cholangitis associated with gallstones, but the natural history and definitive treatment are entirely different. The diagnosis should be suspected in patients with a history of parasitic infestation with Ascaris lumbricoides or Clonorchis sinensis or in those who have lived in an endemic area. PMID- 2760438 TI - Radiological diagnosis of inorganic lead poisoning. AB - A 43-year-old woman had abdominal pain and anemia due to inorganic lead poisoning. Plain abdominal x-ray films showed metallic densities within the lumen of the large bowel. The patient admitted that she used to chew the sheets of metallic lead enclosing wine bottle necks regularly. We report the case because of both the unusual radiographic findings and the exceptional source of lead intoxication. PMID- 2760439 TI - Spontaneous intramural dissection of the esophagus. PMID- 2760440 TI - Colonoscopic removal of a postoperative foreign body. PMID- 2760442 TI - Gay and lesbian youth: Part I. PMID- 2760441 TI - Transportation of gastric biopsies in a biphasic Campylobacter pylori media. PMID- 2760443 TI - Sappho was a right-on adolescent: growing up lesbian. AB - Beginning with the interaction between the coming-out process and adolescent development, this paper explores the young lesbian experience. The words and perceptions of over 20 young lesbians are used to depict the experience from their own points of view. PMID- 2760444 TI - The development of male prostitution activity among gay and bisexual adolescents. AB - The current research literature regarding male-juvenile prostitution activity is reviewed. An attempt is made to develop some theoretical understanding of the development of this activity among gay and bisexual adolescents. A predisposition, resulting from faulty psychosexual and psychosocial development, appears to make these boys vulnerable to the situational variables that they encounter. More severe disruptions in psychosexual and psychosocial development seem to result in more destructive and non-ego-enhancing prostitution activities. A clinical case study is presented which illustrates the development of this activity. Recommendations are made to help reduce the amount of self-destructive prostitution activity among male adolescents. PMID- 2760445 TI - Male prostitution and homosexual identity. AB - The documentary film on transvestites, The Queen, has a scene where a young man tells a friend about a recent job interview (Litvinoff, 1968). His friend asks, "Did you tell them you were a homosexual?" The young man, who did not get the job, answers, "No, they told me." What this interaction reflected was not just the fact of the young man's homosexuality, but the social fact: What it means to be homosexual in his culture and society. In this paper, I discuss the conduct of prostitution as one enactment of those meanings: Prostitution, as a social fact in the life of adolescent gay males, is understood by them to be linked with their homosexual identity. PMID- 2760446 TI - Gay youth and AIDS. AB - Gay male teenagers face considerable adversity during their "coming out" process due to the AIDS epidemic. They must decide whether to be tested for HIV-1 infection, whether to postpone sexual activity, how to select a partner, and which kinds of sexual practices to engage in. Gay youth often make such decisions based upon misinformation and faulty premises. This paper reviews what is known about gay youth and AIDS, and assesses their possible risk for HIV-1 infection. It is recommended that school and community-based health education programs be developed to teach gay and bisexual youth about safe sex. Moreover, research is needed into sociocultural variations among gay youth in order to develop appropriate and effective intervention strategies for AIDS risk reduction in this diverse population. PMID- 2760447 TI - Widening circles: an ethnographic profile of a youth group. AB - This article introduces work-in-progress on the ethnography of a gay and lesbian youth group in Chicago. The surrounding neighborhood is sketched and aspects of the supporting agency, within which the group functions, are described. Both are seen as contributing contexts for the "coming out" process here. The youth group is described in part, including the age, ethnicity, and related factors of its composition. Youth are found to be involved in a process of dual socialization entailing roles and knowledge in the gay and straight normative communities. PMID- 2760448 TI - Parental influences on the self-esteem of gay and lesbian youths: a reflected appraisals model. AB - Based on a population of 317 gay and lesbian youths, the current investigation explores the appropriateness of a reflected appraisals perspective in predicting the degree to which parental attitudes, as perceived by youth, affects their self esteem and comfortableness being gay. A lesbian was most comfortable with her sexual orientation if she also reported that her parents accepted her homosexuality; these variables did not, however, predict her level of self esteem. Among the gay males, parental acceptance predicted comfortable being gay if the parents were also perceived as important components of a youth's self worth; a male most comfortable with his sexual orientation had the highest level of self-esteem. Results are discussed in terms of: (a) sex of parent, (b) sex role development, (c) comparisons of gays and lesbians, and (d) research on gay and lesbian youth. PMID- 2760450 TI - Gay and lesbian youth: Part II. PMID- 2760449 TI - Lesbian and gay youth in England. AB - The experience of being gay and young has been seriously neglected in youth culture research and in youth service provision. This stems in part from the pervasiveness of both the heterosexual assumption and the sexual stigma. Since the advent of the gay movement, however, some modest research into gay youth has been conducted and some has been generated through the activity of gay organizations themselves. This paper reviews the experience and problems of being young and gay in Britain as revealed through three research studies. It outlines some key changes that have occurred during the 1980s, especially the emergence of gay youth organizations. It concludes by suggesting the diversity of the gay youth experience in England. PMID- 2760451 TI - Gay liberation and coming out in Mexico. AB - This article presents information on three sociocultural variables and relates it to gay liberation and the behavior of gay youth in Guadalajara, Mexico's second largest city. A detailed history of the gay liberation movement in Guadalajara is given because it provides an excellent example of the interaction of sociocultural variables and shows how different the outcome of liberation may be for gay people in Mexico. Brief life histories of the "coming out" of two Guadalajaran gay men further illustrate some of the unique ways in which gay identities change the lives of gay youth in Mexico. PMID- 2760452 TI - Growing up gay or lesbian in a multicultural context. AB - This study is an investigation of the influence of ethnicity on the relationships of gay and lesbian young people and their families. A framework for conceptualizing the influence of culture is presented. Modes of family responses are described and the conflicts involved in maintaining an ethnic identity, and a gay or lesbian identity, are discussed. Implications for researchers and practitioners are identified. PMID- 2760453 TI - To be 20 and homosexual in France today. AB - Being young and gay in Paris today poses a duality: The new generation of gay men and women have forgotten the historical consciousness of the gay liberation movement, yet their cultural identity and new way of life in a more modern France is a positive point. Thus, a new generation of gay young people growing up in a new cultural landscape and progressive attitudes of heterosexuals permit being optimistic. PMID- 2760454 TI - Gay youth in four cultures: a comparative study. AB - Young and older homosexual men in four countries (Sweden, Finland, Ireland, and Australia) were compared on a number of psychological, social, and psychometric indices to determine what differences existed between them, and the effect of culture on any such differences. Data show that there are greater differences between younger and older homosexual men as the culture appears more antihomosexual, and that younger homosexual men are less likely to accept their sexual orientation and more likely to accept myths surrounding homosexuality. Younger homosexual men were also more likely to have had gonorrhea (regardless of their number of sexual partners), to prefer receptive anal intercourse, and to have contacted partners by cruising. These data confirm that mental health consequences of antihomosexual environments are most negative where homosexuality is most severely stigmatized. PMID- 2760455 TI - Varying responses to hypotensive agents in different racial groups: black versus white differences. PMID- 2760456 TI - Proteinuria is an early marker in the development of progressive renal failure in hypertensive fawn-hooded rats. AB - Male spontaneously hypertensive fawn-hooded (FH) rats can be divided into two classes on the basis of their proteinuria. We investigated the relationship between early proteinuria and the impairment of renal function later in life. Urinary protein excretion (UpV), systolic blood pressure (SBP) and parameters of renal function were sequentially determined in male FH rats. A significant difference in UpV was already present from the age of 10 weeks. Class I rats excreted less protein than class II animals. Initially, the glomerular filtration rate (GFR) of class II animals was somewhat higher than that of class I rats, but from week 50 onwards a decrease in GFR of class II rats was noted and from then on rats died due to uraemia. The GFR of class I animals fell from week 75. The fall in GFR was preceded by a concomitant increase in UpV and SBP. The increase occurred earlier and the rate of increase was higher in class II rats. We conclude that a number of hypertensive FH rats die prematurely from end-stage renal failure. The presence of an increased UpV at an early age is an early marker for the development of renal failure. PMID- 2760457 TI - Effect of endogenous vasoconstrictors on maternal intramyometrial and fetal stem villous arteries in pre-eclampsia. AB - The contractile responses to various endogenous vasoactive agents were investigated in isolated human uteroplacental arteries from normotensive (NT) patients and patients with pre-eclampsia (PE) undergoing caesarian section. Tissue samples were obtained from the uterine incision and from macroscopically normal cotyledons. Vascular ring preparations of intramyometrial and stem villous arteries (length 1.0-1.3 mm, outer diameter 400-600 microns) were dissected and mounted in organ baths and isometric tension was recorded. Concentration-response relationships for vasopressin (VP), oxytocin (OX), angiotensin II (Ang II), noradrenaline (NA), 5-hydroxytryptamine (5-HT), prostaglandin F2 alpha (PGF2 alpha) and prostaglandin E2 (PGE2) were assessed. For each compound, the mean maximum contractile effect (Emax) and the drug concentration producing half maximal response (EC50) were determined. In intramyometrial arteries from NT and PE patients, VP, Ang II, NA, 5-HT and PGF2 alpha induced contraction while OX and PGE2 produced weak or no responses. Preparations from PE patients showed higher Emax values, while no differences in EC50 were found between the two groups. In fetal stem villous arteries, Ang II, 5-HT, PGF2 alpha and PGE2 induced contractions, while VP, NA and OX produced weak responses. No differences in Emax or EC50 values were found between the fetal vessels of PE and NT patients. No qualitative differences were demonstrated in response to the agents tested between the vessels (fetal and maternal) from NT women at term and PE patients. However, the results may reflect quantitative differences, suggesting increased contractility of maternal uteroplacental arteries from women with PE. PMID- 2760458 TI - The hypertensive effect of synthetic glucocorticoids in man: role of sodium and volume. AB - In previous studies, administration of adrenocorticotrophin (ACTH; 0.5 mg i.m. b.d. for 5 days) to normal subjects produced an adrenally dependent rise in blood pressure (BP) of some 20 mmHg, accompanied by an increase in cardiac output and an increase in plasma volume. The BP and metabolic effects of ACTH (increase in plasma glucose, fall in eosinophils, increase in body weight and urine sodium retention) were reproduced by infusion of the glucocorticoid (GC) cortisol at rates (6-8 mg/h) which reproduced the blood concentrations of the steroid achieved with ACTH administration. Oral administration (hydrocortisone 200 mg daily) produced similar changes qualitatively, although the cortisol concentrations and increase in pressure (12 mmHg) were less. Plasma volume was increased. To determine the role of urine sodium retention and plasma volume expansion in the hypertension, we gave synthetic steroids to six normal subjects for 5 days, at doses which were calculated to be similar for GC activity, but which had little or no mineralocorticoid (MC) activity. Prednisolone (40 mg/day), methylprednisolone (32 mg/day), triamcinolone (40 mg/day) and dexamethasone (8 mg/day) all produced equivalent GC effects (increase in plasma glucose, increase in total white cell count, fall in direct eosinophil count). There were no MC effects with any of the steroids. Body weight did not increase and urinary sodium excretion increased rather than decreased. Plasma volume (125I human serum albumin) and haematocrit were unchanged. BP rose with all four steroids: systolic BP rose by 13 mmHg with prednisolone, by 9 mmHg with methylprednisolone, by 10 mmHg with triamcinolone, and by 6 mmHg with dexamethasone. Diastolic BP increases were 8, 11, 8 and 7 mmHg, respectively. Thus, neither MC activity nor an increase in plasma volume is essential for steroids to induce an increase in blood pressure. Therefore, screening of synthetic GCs to minimize MC activity will not prevent hypertensive complications. PMID- 2760459 TI - Haemodynamic responses to conflict stress in borderline hypertensive rats. AB - Chronic exposure to a shock-shock conflict paradigm (2 h/day, 5 days/week for 12 weeks [1]) produces hypertension in the borderline hypertensive rat (BHR), a cross between the spontaneously hypertensive rat (SHR) and the Wistar-Kyoto rat (WKY). The purpose of the present study was to characterize the regional haemodynamic responses which take place during conflict-stress. A pulsed Doppler flowmeter and miniature probes implanted on the left renal and superior mesenteric arteries and the abdominal aorta were used to record changes in regional flow velocity. Recording of mean arterial pressure (MAP) allowed changes in regional resistance to be calculated. The first conflict session produced intense splanchnic and renal vasoconstriction and hindquarter vasodilation. Pressor responses were moderate. A second group of BHRs was studied during conflict sessions 17-18, prior to the development of hypertension. This group exhibited faster habituation to the stress than the group studied during the first conflict session: MAP and mesenteric resistance returned more rapidly towards pre-stress levels. Relative to naive control rats, this group exhibited a larger peak MAP and less tachycardia in response to a neutral stressor (air-jet stress) and a smaller reduction in renal resistance in response to ganglionic blockade. These data suggest that in this model, pressure load per se is moderate. More attention should be directed towards the role of trophic effects of the neurohumoral factors responsible for the pronounced constriction of splanchnic and renal vasculature in producing hypertension. PMID- 2760460 TI - The predictive role of systolic, diastolic and mean blood pressures on cardiovascular and all causes of death. AB - Systolic (SBP), diastolic (DBP) and mean [MBP = diastolic + 1/3 (systolic - diastolic)] blood pressures were compared as predictors of all causes of death (ALL) and of deaths from atherosclerotic cardiovascular disease (ACVD) in 2480 men, aged 40-59 years, belonging to three cohorts followed up for 20 years. Both univariate analysis, based on distribution of events in age-specific quintile classes of blood pressures, and multivariate analysis, based on the Cox proportional hazards model with five covariates as possible confounders, clearly showed the superiority of SBP over DBP in predicting fatal events; MBP played an intermediate role. PMID- 2760461 TI - Collagen-induced arthritis in Biozzi mice. Joint involvement is not correlated with collagen II IgG2a autoantibodies nor restricted to only H-2q and H-2r. AB - High (H) and low (L) immune responder "Biozzi" mice, obtained by four different selections, were investigated for their ability to develop collagen-induced arthritis. Both LI and LII lines--characterized by their low antibody responses to a wide variety of Ag--developed arthritis though they do not bear the susceptible H-2q and H-2r haplotypes. Out of the two lines (HI and HII) selected for their high antibody responses and bearing H-2q, only one (HI) developed arthritis. Both the lines with amplified high or low antibody responses (HG and LG), and the lines differing in the levels of cell-mediated immunity (Hpha and Lpha), failed to develop arthritis. Collagen II autoantibodies were found in all the lines: the responses being high (HI and HG), low (LI, LII and LG), or intermediate (HII, Hpha and Lpha). The level of IgG2a autoantibodies, presumed to be the most pathogenic, was low in two (HI and LII) of the three arthritic lines, and was high in the unaffected HG line. These results show that this arthritis is not solely restricted to H-2q and H-2r haplotypes, and argue against a correlation between collagen autoantibody levels and disease incidence. PMID- 2760462 TI - Association between anti-Sm and anti-ribosomal P protein autoantibodies in human systemic lupus erythematosus and MRL/lpr mice. AB - Anti-Sm and anti-ribosomal P protein antibodies show a high degree of specificity for the disease SLE. To determine whether a relationship between these two autoantibodies existed, the frequency of anti-P was determined in sera with and without anti-Sm activity. Of sera from lupus patients with anti-Sm 18/65 (28%), and 6/55 (11%) of sera without anti-Sm had anti-P as determined by an ELISA using a recombinant P2-beta-galactosidase fusion protein as Ag (p less than 0.05). The levels of anti-P were significantly higher in sera containing anti-Sm (0.37 +/- 0.45) than in sera without anti-Sm antibodies (0.18 +/- 0.20) (p less than 0.01). Similarly, a significantly higher proportion of anti-P positivity was found in autoimmune MRL/Mp-lpr/lpr mice positive for anti-Sm (11/53 = 21%) compared to age and sex-matched mice without anti-Sm (3/53 = 6%) (p less than 0.05). The IgG subclass distributions for anti-Sm and anti-P antibodies were similar in the MRL mice (IgG2a greater than IgG2b greater than IgG3 greater than IgG1). The association did not reflect polyclonal B cell activation in a proportion of MRL mice because no significant differences were observed in anti-DNA, antichromatin or total serum IgG levels in mice with and without anti-Sm or, in mice positive for both anti-P and anti-Sm compared to mice positive for anti-Sm alone. Cross inhibition experiments excluded the possibility that the Sm and P protein Ag shared a common epitope. Longitudinal measurement of anti-P and anti-Sm antibody levels by ELISA in three mice indicated that both antibodies first appeared at about 3 to 4 mo of age and fluctuated two- to threefold over 3 to 8 mo with independent peaks of activity. Recent observations regarding a relationship between anti-Sm and autoantibodies to other ribosomal proteins suggest that the association may be explained by an immune response to epitopes coassociated on the ribosome. PMID- 2760463 TI - Mastoparan, a wasp venom peptide, identifies two discrete mechanisms for elevating cytosolic calcium and inositol trisphosphates in human polymorphonuclear leukocytes. AB - Mastoparan, a tetradecapeptide toxin from wasp venom stimulates secretion in mast cells and enhances GTPase activity of several purified guanine nucleotide regulatory proteins (G proteins). This suggests that this toxin may effect cellular functions through activation of G proteins. In this report, we probed the effects of mastoparan on cytosolic calcium concentration ([Ca2+]i) and inositol trisphosphate (IP3) formation in human polymorphonuclear leukocytes (PMN). At noncytotoxic concentrations up to 35 microM, mastoparan induced a dose dependent elevation in [Ca2+]i in PMN, as determined by the fluoroprobe Fura 2. The increase in [Ca2+]i was attained through two discrete processes involving an initial rapid and transient calcium rise followed by a slower sustained increase. The initial but not the second [Ca2+]i increase was absent in PMN pretreated with pertussis toxin. The second but not the first [Ca2+]i rise required external calcium. The kinetics of [Ca2+]i changes and dependency on extracellular calcium induced by mastoparan correlated with the production of IP3. Pertussis toxin inhibited only the initial phase of IP3 production. The ability of pertussis toxin to ADP-ribosylate Gi-like proteins in PMN membrane was potentiated in the presence of mastoparan. Thus, mastoparan activates phospholipase C in PMN through two independent mechanisms. The first pathway is similar to that induced by chemoattractant receptors in that the rapid and transient activation of phospholipase C is dependent on a pertussis toxin-sensitive Gi protein. The second pathway is delayed, sustained, insensitive to pertussis toxin, and requires extracellular calcium. PMID- 2760464 TI - Application of flow cytometric measurement of surface IgG in kinetic analysis of monoclonal antibody synthesis and secretion by murine hybridoma cells. AB - The kinetics of antibody synthesis and secretion from a murine hybridoma cell line were studied using measurements of total cell-associated IgG, surface IgG, and IgG secreted into the medium. Kinetic analysis of IgG secretion demonstrates approximately constant secretion rate per viable cell over the entire batch cultivation. A correlation was observed (r2 = 0.74) between mean surface immunofluorescence and the total cell-associated IgG determined by ELISA of detergent-extracted cell lysates. No correlation was found between specific secretion rate and mean surface IgG level estimated by immunofluorescence flow cytometry measurements. Material balances on cellular IgG demonstrated that about 7% of the antibody which was synthesized during exponential batch growth was not released to the growth medium. Distributions of single-cell surface antibody content showed two subpopulations, one with very low surface IgG. The fraction of the population with low surface IgG increased throughout a batch cultivation. PMID- 2760465 TI - A simple method for the biochemical purification of Ro/SS-A antigen. AB - In the present study, Ro/SS-A antigen has been isolated from human spleen by a two-step procedure. In the first step most of the non-antigenic material was removed by means of ammonium sulphate precipitation and ion exchange chromatography. The final purification was obtained by passing the Ro/SS-A containing fractions twice through a Mono Q ion exchange fast protein liquid chromatography (FPLC) column. The purified antigen showed identical immunoreactivity with crude material on CIE and was composed of two polypeptides with a molecular weight of approximately 60,000 and 55,000 respectively on SDS PAGE, both reacting on Western blotting with a panel of anti-Ro/SS-A antisera. This system permits milligrams of highly purified antigen to be obtained from grams of human spleen. PMID- 2760467 TI - An enzyme-linked immunosorbent assay (ELISA) for urinary growth hormone suitable for use in the routine laboratory. The Wessex Growth Study. AB - An avidin-biotin enzyme-linked immunoassay was developed to measure human growth hormone (hGH) in urine. The assay was validated in terms of sensitivity, specificity and reproducibility. Parallelism was demonstrated between the standard curve (4-500 pg/ml) and serially concentrated urine. There was no interference from 125 ng/ml of adrenocorticotrophin, follicle stimulating hormone, luteinising hormone, prolactin or thyroid stimulating hormone. Recovery of exogenous human growth hormone in urine ranged from 91 to 103%. Intra- and interassay variations were less than 10% and sensitivity was 1.4 pg/ml. Application to timed overnight urine samples from both normal and short children or from acromegalic patients suggests the assay may be useful for simple, non invasive assessment of growth hormone secretion. Moreover, use of standard laboratory equipment and commercially available components, together with the avoidance of radioisotopes, facilitate its use as a routine screening assay. PMID- 2760466 TI - Generation of a sheep x mouse heterohybridoma cell line (1C6.3a6T.1D7) and evaluation of its use in the production of ovine monoclonal antibodies. AB - A stable aminopterin-sensitive sheep X mouse heterohybridoma cell line (1C6.3a6T.1D7) for use in the generation of sheep monoclonal antibodies is described. The line was first constructed by fusing the mouse myeloma line, NSO, to normal sheep lymphocytes obtained from the efferent lymphatic vessel of a cannulated popliteal lymph node. The line was rendered sensitive to aminopterin through a combination of irradiation and treatment with the anti-metabolite drug 6-thioguanine. Characterisation of the cloned cell line showed that it did not secrete sheep immunoglobulin (Ig) molecules, express Ig on the surface membrane, or express normal sheep B or T cell surface markers. The 1C6.3a6T.1D7 line has remained stable in tissue culture for over 2 years, showing no signs of reversion to aminopterin resistance. The 1C6.3a6T.1D7 cells have been used as fusion partners with lymphocytes from antigen primed sheep to generate sheep monoclonal antibodies to human chorionic gonadotropin (hCG) or a synthetic peptide analogue of the VP1 capsid protein of foot and mouth disease virus (FMDV). To optimise the efficiency of heterohybridoma generation, comparisons were made of peripheral blood, efferent lymph or excised lymph nodes as sources of antigen-stimulated lymphocytes for fusion. The results showed that lymphocytes prepared from either efferent lymph or lymph node on the fourth day following antigenic stimulation gave similar high fusion efficiencies, and both were vastly superior to peripheral blood lymphocytes. Results were also obtained which showed that the blast cells present in lymphoid tissues due to antigenic stimulation were the major cell types involved in the generation of viable antibody-secreting sheep X sheep X mouse heterohybridomas. PMID- 2760468 TI - Optimal conditions for the generation of monoclonal antibodies using primary immunisation of mouse splenocytes in vitro under serum-free conditions. AB - We have further optimised the serum-free in vitro immunisation system described by Ossendorp et al. (J. Immunol. Methods 91, 257, 1986) for the generation of hybridomas secreting specific antibodies. Thyroglobulin and the hapten 2-phenyl-5 oxazolone coupled to chicken serum albumin were used as antigens. For an optimal outgrowth of antigen-specific B cells the presence of T cells, thymocyte conditioned medium and antigen are required. The addition of supernatant from EL 4 cells (stimulated by phorbolmyristate acetate) inhibits the outgrowth of antigen-specific B cells. Using six-well plates with a surface area of 10 cm2 per well, an optimal IgM response was obtained when 10(7) splenocytes in a total volume of 2 ml/well were cultured for 3 days in the presence of antigen and thymocyte-conditioned medium. Increasing the concentration of cells whilst maintaining a constant surface area resulted in a decreased response. PMID- 2760469 TI - Differential oligoclonal band patterns on polyvinyldifluoride membranes. AB - We report a novel observation which has been reproducibly noted whilst studying immunoglobulin G binding to antigen immobilized on polyvinyldifluoride membranes. In some samples we have observed a difference between the pattern of oligoclonal bands on the front surface when compared to the reverse side of the membrane. We postulate that this observation results from differing affinities of the specific antibody binding to the antigen immobilised on the membrane. High affinity antibody will bind to antigen on the surface of the membrane next to the gel, while lower affinity antibody appears to diffuse through to the reverse side of the membrane. PMID- 2760470 TI - Non-specific cell binding characteristics of para-magnetic polystyrene microspheres used for antibody-mediated cell selection. AB - The binding of cells to paramagnetic polystyrene microbeads in the absence of coupling antibodies was measured. Cells from normal bone marrow, from an acute lymphoblastic leukemia (ALL) cell line or from a neuroblastoma cell line, were labeled with the fluorochrome Hoechst 33342 and incubated with microbeads by rotation at 4 degrees C. Following this incubation, the microbeads with all attached cells were collected using an externally applied magnetic field and visualized by microscopic examination under ultraviolet illumination. The incubation variables included the protein content of the medium, and the period of rotation. Normal bone marrow was found to adhere sparingly to the microbeads; less than 1.0% of the total nucleated cell population was recovered with the beads, whereas greater than 5% of the ALL cells and greater than 30% of the neuroblastoma cells were found to bind non-specifically to the microspheres. Neither changes in the protein concentration of the medium or in the incubation period significantly altered the non-specific binding of the cell types examined. It is thus apparent that the use of these microspheres for positive selection of cells, such as the collection of hematopoietic stem cells for transplantation, would be compromised by a sizeable non-specific interaction. Modification of the surface of the microspheres to substantially reduce this interaction will be necessary before efforts at positive selection using the magnetic microspheres can be fruitful. PMID- 2760471 TI - Enhancement of immunoblot staining using a mixed chromogenic substrate. PMID- 2760472 TI - Separation of active and inactive forms of the third component of human complement, C3, by fast protein liquid chromatography (FPLC). AB - C3(H2O), an inactive form of C3 present to a variable extent in most C3 preparations, has been isolated in 40 min from previously purified C3 using FPLC ion exchange chromatography on a Mono Q column. As many as six peaks were obtained from some C3 preparations, corresponding to different molecular forms of the protein. One of these peaks consisted of a molecular form of C3 with intact alpha and beta chains, a free sulfhydryl group but no hemolytic activity and was identified as C3(H2O). C3(H2O) eluted as a homogeneous peak well resolved from native C3, C3b, high molecular weight aggregates and small degradation fragments. The same C3(H2O) peak was generated from native C3 by repeated freeze-thaw cycles or NH2OH treatment. C3(H2O) alpha chain appeared as a doublet about 2 kDa heavier than native C3 alpha chain in low cross-linked gels. Two forms of C3b could be separated on the Mono S column, both able to form the C3 convertase. The present report describes a very fast method to resolve and isolate to homogeneity C3(H2O) and native C3 from C3 preparations. Both molecular forms of C3 are very suitable for studies of the initial and amplification C3 convertases of the alternative pathway of complement. PMID- 2760473 TI - An enzyme-linked immunosorbent assay (ELISA) for the measurement of serum antibodies to growth hormone. The Wessex Growth Study. AB - A solid-phase enzyme-linked immunosorbent assay for measuring antibodies to growth hormone (GH) was developed, with occasional use and long shelf-life in mind. With coating protein concentration optimised, the standard curve was linear over a 25-fold range of concentration. The interassay coefficient of variation ranged from 14.4% to 9.3%. The specificity of the assay was confirmed by the substitution of insulin for GH as coating protein and by preabsorption of sera with GH coupled covalently to Sepharose beads. There was no binding signal with insulin and absorption was dose dependent, maximum (greater than 80% complete) with 2 x 10(4) micrograms GH/ml undiluted serum. The assay was simple to perform, cheap and reliable. PMID- 2760474 TI - Loss of antigens from immunoblotting membranes. AB - Immunoblotting of PAGE-separated proteins is widely used. After electrophoretically transferring proteins from PAGE gels, sites on the membrane which are unoccupied are blocked or quenched with excess protein. The sensitivity of the immunoblotting technique is in part dependent on the amount of antigen associated with the membrane. We have investigated the loss of blotted proteins during blocking of various membranes with milk. Transblotted proteins are lost from nitrocellulose membranes (NC) (0.45 microns) in proportion to the amount of milk in the blocking solution and loss increases with time. When 5% milk was used as the blocking solution the amount lost was about 10% within 1 h and approached 25% at 24 h. This loss was nonselective and involved blotted antigens of a wide range of Mr. This time- and concentration-dependent relationship for the loss of transblotted proteins was tested with four immunoblotting membranes: Immobilon-P (Millipore), NitroPlus-2000 (MSI), and NC (0.2 microns and 0.45 microns pore size). NC (0.2 microns) gave the best results with the lowest percentage loss at 1 h (less than 5%). We recommend using NC (0.2 microns) and blocking with 0.5% milk for 30 min to minimize the loss of antigens from immunoblotting membranes. PMID- 2760475 TI - A miniaturised method for immunoglobulin allotype serology. AB - A modification of the classic haemagglutination inhibition method for immunoglobulin allotyping is described which employs reagent volumes of 2 microliters compared with the 25 microliter volumes commonly used in other serological allotyping methods. No loss of sensitivity or specificity was associated with the miniaturised method when compared to the standard tile technique. This method simplifies the large scale phenotyping and screening of sera and permits considerable savings of valuable reagents to be made. PMID- 2760476 TI - Comparison of fluorochrome-labeled and 51Cr-labeled targets for natural killer cytotoxicity assay. AB - An alternative method for measuring in vitro cellular cytotoxicity has been developed utilizing the carboxyfluorescein derivative 2',7'-bis(carboxyethyl)-5,6 carboxyfluorescein (BCECF) as the target cell label. Target cells labeled with the fluorescent dye are incubated with effector cells, if killing of targets occurs, BCEDF is released analogous to 51Cr release. Measurement of specific lysis in this assay is based on the direct measurement of dye retained by the remaining viable target cells using the Pandex FCA. In paired experiments we have compared the fluorochrome assay to the standard 51Cr release assay in measuring porcine natural killer cytotoxicity. The target labeling time with BCECF is 30 min as opposed to 1 h with 51Cr; and there is no significant dye reincorporation after release. The optimal target number per incubation well for the BCECF assay is 5 X 10(3) cells. In both the BCECF and 51Cr release assays, maximum percent specific lysis is reached after 3-4 h incubation. By 2 h incubation, the BCECF assay reaches the maximum seen with 51Cr and in a 4 h assay the maximum NK activity measured with BCECF labeled targets is always higher than that measured with 51Cr-labeled targets. In paired experiments, we have shown the reproducibility of the BCECF assay and that the BCECF assay measures NK enhancement by NK enhancing monoclonal antibody and inhibition by NK inhibiting monoclonal antibody as good as the 51Cr release assay, if not better. In conclusion, the BCECF assay is a reliable and reproducible measure of in vitro cellular cytotoxicity, eliminates the use of radioisotopes and is cost efficient. PMID- 2760477 TI - MicroELISA method for the determination of thymosin beta 9 discriminating between thymosin beta 9 and the structurally closely related thymosin beta 4. AB - In order to obtain specific antibodies against thymosin beta 9 showing minimal cross-reactivity with the highly homologous peptide thymosin beta 4, the N terminal fragment 1-14 of thymosin beta 9 was used for immunization. These antibodies have been tested in a competitive ELISA and show less than 1% cross reactivity with thymosin beta 4. On the other hand, antibodies raised against the native thymosin beta 9 (1-14) cross-react 35% with thymosin beta 4. Specific antibodies against thymosin beta 9 are important for studying the concentration and localization of thymosin beta 9 in thymus and other bovine tissues because thymosin beta 9 is always accompanied by thymosin beta 4. Using N-terminal fragments of thymosin beta 4-like peptides may be a general approach for obtaining specific antibodies since this part of sequence is less conserved in thymosin beta 4-like peptides. PMID- 2760478 TI - Rapid isolation and characterization of native mouse complement components C3 and C5. AB - A rapid, 1 day procedure for the purification of mouse complement factors C3 and C5 is described. The method is based on fractionated precipitation by polyethylene glycol 6000, followed by Mono Q anion exchange chromatography on a system for fast protein liquid chromatography (FPLC). For C3 isolation, an additional FPLC separation step using Superose 12 (gel filtration) was used. C3 was purified 71-fold with a yield of 32% as measured by biological activity; the preparation contained no detectable contaminants as judged by SDS-PAGE. A comparable procedure for the isolation of C5 resulted in a preparation with a considerable contamination which could be easily removed by affinity chromatography using antibodies directed against these contaminants. With this combined procedure C5 was purified 536-fold with a yield of 28% based on biological activity. SDS-polyacrylamide gel electrophoresis revealed that mouse C3 and C5 had apparent Mrs of 170,000 and 190,000, respectively. Under reducing conditions the alpha and beta chains showed Mrs of 107,000 and 62,000 for C3, and 104,000 and 85,000 for C5. PMID- 2760479 TI - Prevalence of respiratory syncytial virus subgroups over six consecutive outbreaks: 1981-1987. AB - Indirect immunofluorescence with strain-specific monoclonal antibodies was used to determine the phenotype of respiratory syncytial virus (RSV) isolates obtained from infants hospitalized in greater Boston over six successive outbreaks from 1981 to 1987. Of 981 isolates, 591 (60%) were classified as subgroup A and 383 (39%) as subgroup B. The prevalence of subgroups varied both between and within yearly outbreaks. In 1983-84 and 1984-85, both subgroups circulated concurrently and in almost equal proportions; in 1981-82, 1982-83, and 1985-86 subgroup A was dominant, accounting for 93% of all RSV isolates; and in 1986-87 subgroup B accounted for 89% of all RSV isolates. In some outbreaks both geographic and temporal clustering of subgroups occurred. No major differences in age, gender, or frequency of nosocomially acquired RSV between infants infected with either subgroup were seen, either overall or between or within yearly outbreaks. An expanded panel of monoclonal antibodies revealed further heterogeneity among subgroup A isolates. Comparison of these results with similar studies from other geographic locations indicated that the pattern of RSV subgroup prevalence is a localized phenomenon. PMID- 2760480 TI - Efficacy of inactivated influenza A virus (H3N2) vaccines grown in mammalian cells or embryonated eggs. AB - Influenza virus (H3N2) host cell variants isolated from a single infected individual were compared for their protective efficacies when used as formalin inactivated purified whole virus vaccines in ferrets. A/Mem/12/85 virus grown in embryonated chicken eggs (egg-grown), which differs from A/Mem/12/85 grown in mammalian Madin-Darby canine kidney cells (MDCK-grown) by a single amino acid substitution in the hemagglutinin molecule, was shown to be distinguishable by immune ferret serum. Ferrets were immunized intramuscularly with intact inactivated MDCK- or egg-grown virus and were subsequently challenged with infectious virus grown in either host cell type. MDCK-grown-virus vaccine induced higher mean serum hemagglutination-inhibiting (HAI) and neutralizing antibody titers than did egg-grown-virus vaccine and induced superior protection of ferrets against subsequent challenge with infectious virus grown in either host cell type. These results suggest that human influenza viruses that are antigenically and structurally similar to viruses grown in mammalian cells may be more efficacious as vaccines than some variants selected in eggs. PMID- 2760481 TI - Protection against infection with Vibrio cholerae by passive transfer of monoclonal antibodies to outer membrane antigens. AB - Ten monoclonal antibodies (MAbs), produced by hybridomas obtained through the cell fusion of mouse myeloma cells and spleen cells from mice immunized with outer membrane antigens of Vibrio cholerae, were mixed with suspensions of V. cholerae and administered orally to infant rabbits. Six of these MAbs, each one recognizing a different outer membrane antigen, did not confer protection from fatal V. cholerae infection. Four MAbs that reacted with the 18-kDa antigen, also called the cholera protective antigen, were highly protective against infection with V. cholerae. PMID- 2760482 TI - Enzyme-linked immunosorbent assay for the diagnosis of clinical and subclinical melioidosis. AB - An enzyme-linked immunosorbent assay (ELISA) for the detection of specific IgG and IgM antibody to Pseudomonas pseudomallei was developed. The IgG-ELISA was compared with the indirect fluorescence assay for IgG antibody (IgG-IFA) and the indirect hemagglutination (IHA) test in studies with serum specimens from persons from endemic areas for melioidosis and from persons from nonendemic areas of Australia. The sensitivity and specificity of the IgG-ELISA were 90% and 99%, respectively, comparable to those obtained with the IgG-IFA. The IgG-ELISA was more sensitive than the IHA test (74%) and was more suitable than the IgG-IFA as a serologic screening test for melioidosis. The IgM-ELISA was compared with the IgM-IFA as a marker of disease stage in patients with melioidosis. There was good diagnostic agreement between the tests; 92% of patients with active disease gave IgM-ELISA titers greater than or equal to 1:5,120 and 93% of patients with subclinical melioidosis had IgM-ELISA titers less than or equal to 1:1,280. Of the overlap group of patients with a borderline IgM-ELISA titer of 1:2,560, approximately 33% were clinical cases. An uncommon disease stage consisting of a self-limited, short-term, flu-like, pyrexial illness accompanied by elevated serum IgM-ELISA titers (greater than or equal to 1:5,120) was seen in a small number of patients residing in endemic Australia. PMID- 2760483 TI - Impaired clearance of aerosolized Legionella pneumophila in corticosteroid treated rats: a model of Legionnaires' disease in the compromised host. AB - To develop a model of legionnaires' disease in a host with defective cell mediated immunity, rats were treated with subcutaneous cortisone acetate and exposed to aerosolized Legionella pneumophila. Bacterial clearance, histopathology, cell recovery by bronchoalveolar lavage, serology, and splenocyte blastogenesis to heat-killed L. pneumophila were studied in cortisone-treated rats and normal controls. Corticosteroid administration resulted in a dosage related defect in the clearance of L. pneumophila. Cortisone-treated animals had a diffuse, progressive pneumonitis, but the influx of neutrophils to the lung, the serum antibody response, and the sensitization of splenocytes to L. pneumophila were not impaired by corticosteroids. The marked lymphocyte depletion observed in cortisone-treated animals may have contributed to defective expression of cell-mediated immunity. This model may be useful in further studies of the pathogenesis and treatment of legionellosis in the compromised host. PMID- 2760484 TI - Heterogeneity among isolates of rapidly growing mycobacteria responsible for infections following augmentation mammaplasty despite case clustering in Texas and other southern coastal states. AB - Thirty-seven cases of rapidly growing mycobacterial wound infections following augmentation mammaplasty were identified between 1979 and 1988. The infections were usually unilateral and had a narrow geographic distribution: almost 60% were from Texas and 92% from five southern coastal states. In Texas a seasonal incidence was observed; 45% of all previously reported and current patients had undergone mammaplasty in April, May, or June. Although these findings suggested a possible common source, analysis of 35 available isolates revealed 19 different phenotype patterns. Five different taxonomic groups were represented, although most isolates (70%) were Mycobacterium fortuitum biovar fortuitum. Plasmid bands were identified in 10 of 15 strains studied, with nine different profiles. An additional 11 cases of breast infection due to rapidly growing mycobacteria not associated with augmentation were also identified, of which nine came from the same states that contributed mammaplasty cases. Rapidly growing mycobacterial infections of the breast are endemic in Texas and other southern coastal states, and the heterogeneity of the isolates suggests that most cases are unrelated. PMID- 2760485 TI - An outbreak of giardiasis in a nursing home with evidence for multiple modes of transmission. AB - During a 6-w period from 20 April through 7 June 1986, an outbreak of giardiasis occurred in residents and employees of a nursing home and children participating in day care at the nursing home. Eighty-eight cases of giardiasis (defined by presence of clinical symptoms or results of stool examination) were identified from groups associated with the nursing home including 35 in nursing home residents, 15 in children in day care, and 38 in employees (including kitchen staff and child care providers). Multiple modes of transmission of Giardia lamblia, including food-borne and person-to-person transmission, occurred for these groups. Evidence of transmission by food included a significant association between sandwich consumption and illness in nursing home staff (P = .04) and a significant lack of illness among nursing home residents who consumed only a pureed diet (P = .007), where all food items are cooked before serving. The primary case among the food handlers, whose illness began in mid-April, had an infected child in the day care center. Person-to-person transmission is supported by a significant association between illness and physical contact with children from the day care facility through an "adopted grandparent" program (P = .03). This is the first reported outbreak of giardiasis in a nursing home, and these findings have implications for disease control in other facilities that combine child day care and care of the elderly. PMID- 2760486 TI - Prophylactic zidovudine after occupational exposure to the human immunodeficiency virus: an interim analysis. AB - Note from Dr. Merle A. Sande--Health care workers are at risk of acquiring human immunodeficiency virus (HIV) infection subsequent to accidental sticks with needles contaminated with blood from infected patients. The risk is small but real. Postexposure management is critically important, but few solid data are available. Can zidovudine (AZT, azidothymidine) prevent infection? How soon after exposure must the drug be given? At what dosage? For how long? Two leading authorities were asked to discuss this problem and to offer recommendations. Both have developed programs in their institutions, Dr. David K. Henderson at the Warren Grant Magnuson Clinical Center at the National Institutes of Health and Dr. Julie L. Gerberding at the University of California, San Francisco. PMID- 2760487 TI - Evidence that Chlamydia pneumoniae, strain TWAR, is not sexually transmitted. AB - Serum specimens from 230 sexually active women were tested for antibodies to Chlamydia trachomatis and Chlamydia pneumoniae. The women were randomly selected as controls in a population-based case-control study for ectopic pregnancy. A total of 123 had antibody to C. pneumoniae and 39 had antibody to C. trachomatis. There was an association between prevalence of antibody to C. trachomatis and an increasing number of lifetime sexual partners, early age at first intercourse, and a history of gonorrheal infection. The prevalence of antibody to C. pneumoniae was not related to any of these factors. These results provide evidence that the two human species of Chlamydia have a different mode of transmission and that C. pneumoniae is not sexually transmitted. PMID- 2760488 TI - Correlation of infecting serovar and local inflammation in genital chlamydial infections. AB - The relationship between acute inflammation and serovar of Chlamydia trachomatis was evaluated in patients with genital chlamydial infection who attended a sexually transmitted diseases clinic. Polymorphonuclear leukocytes (PMNLS) were enumerated on Gram's-stained smears of endourethral contents in men; cervicitis was scored by visual observation of the endocervix in women. Isolates were serotyped with a monoclonal antibody-based radioimmunoassay. The distribution of serovars in 99 women did not differ in the presence or absence of cervicitis or concurrent gonorrhea. An overall difference (P = .037) was observed when serovar distributions in men with less than or equal to 3 PMNLs (n = 42), greater than or equal to 10 PMNLs (n = 41), and gonococcal urethritis (n = 42) were compared. Follow-up pairwise comparisons revealed that men with less than or equal to 3 PMNLs had fewer isolates of serovars F and G than did men with greater than or equal to 10 PMNLs (P less than .05). No strong overall association was observed between inflammation and serovar. PMID- 2760489 TI - Clinical features of peritoneal tuberculosis. PMID- 2760490 TI - Lameness and asymptomatic Borrelia burgdorferi seropositivity in dogs. PMID- 2760491 TI - Interpretation of data regarding the protection afforded by serum, IgG, or IgM antibodies after immunization with the rough mutant R595 of Salmonella minnesota. PMID- 2760492 TI - Analysis of North American and European isolates of Borrelia burgdorferi with antiserum to a recombinant antigen. PMID- 2760493 TI - Concomitant human infection due to Rickettsia conorii and Coxiella burnetii. PMID- 2760494 TI - Invasive trichosporonosis in a patient with the acquired immunodeficiency syndrome. PMID- 2760495 TI - Isolation of human immunodeficiency virus from genital ulcers in Nairobi prostitutes. AB - Recent epidemiologic studies have implicated genital/anorectal ulcer disease as an important cofactor for acquisition and transmission of human immunodeficiency virus (HIV) during sexual intercourse. To better understand the mechanism for the association between genital ulcers and HIV, exudates from 62 genital ulcers of 56 HIV-seropositive prostitutes in Nairobi (Kenya) were cultured for HIV. Twenty-six ulcer cultures could not be evaluated for the presence of HIV because of bacterial or fungal contamination. HIV was isolated from 4 (11%) of the 36 remaining uncontaminated ulcer cultures (2 introital, 1 vaginal, and 1 cervical) from 4 separate women. HIV was isolated from the cervical os from only 2 of the 4 women. HIV p24 antigen was detected in exudate from 1 of the 4 culture-positive ulcers and 0 of 32 culture-negative ulcers. Genital ulcers in seropositive patients should be regarded as potential sources of HIV, which could be important in transmission of HIV during intercourse. Public health measures aimed at controlling sexually transmitted genital ulcer diseases should be an integral part of acquired immunodeficiency syndrome (AIDS) prevention programs. PMID- 2760496 TI - Antibodies to human immunodeficiency virus in vaginal secretions of heterosexual women. AB - To study the local immune response to human immunodeficiency virus type 1 (HIV-1) in women infected by or exposed to HIV-1, 75 women were studied: 15 were IgG seropositive but clinically asymptomatic, 15 had acquired immune deficiency syndrome (AIDS), 15 were IgG-seronegative with seropositive husbands, and 30 were healthy seronegative women who were selected as controls. Serum samples and vaginal secretions were tested for antibodies to HIV-1 IgG and IgA by Western blot analysis. Antibodies of the IgG and IgA classes were detected in serum samples and vaginal secretions from healthy seropositive women and from women with AIDS. Local IgG antibodies to all viral proteins were detected by Western blot tests. Genital IgA antibodies were mainly directed to the core proteins p18 and p25, the p68 reverse transcriptase, and the gp160 and gp41 glycoproteins; IgA antibodies to the glycoprotein gp120 were rarely recovered. Antibodies of both the IgG and IgA classes in genital secretions were directed to all viral proteins, including surface glycoproteins, and could play a role in limiting the virus infectivity on normal mucosa. PMID- 2760497 TI - Role of gastric colonization in nosocomial infections and endotoxemia: a prospective study in neurosurgical patients on mechanical ventilation. AB - The role of gastric microbial colonization in nosocomial infections and endotoxemia was investigated prospectively in 40 neurosurgical patients requiring mechanical ventilation for greater than 48 h. Each was studied up to 7 d. Swabs from the nose and oropharynx were cultured at admission, and aspirates from the stomach and trachea were cultured daily until enteral alimentation was started. Patients were evaluated every second day for endotoxemia and coagulation activation. Of 153 gastric aspirates, 66.7% contained microorganisms at a mean quantity of 10(7) cfu/ml. Nosocomial pneumonia occurred in 15 patients, septicemia in 5, and meningitis in 1. The stomach was the evident source of infection in only 1 patient with pneumonia. Of 140 plasma samples, 12 (8.6%) from 10 patients showed detectable endotoxin levels, but there was no association between endotoxemia or coagulation activation and the presence of microorganisms in the stomach. The stomach was not an important source for nosocomial infections or endotoxemia, even in patients with high gastric pH. PMID- 2760498 TI - Clinical and immunologic significance of cholera-like toxin and cytotoxin production by Campylobacter species in patients with acute inflammatory diarrhea in the USA. AB - The humoral immune response to both Campylobacter jejuni cell surface antigens and to potential toxins of the organism was studied in 64 adults with inflammatory diarrhea. In an enzyme-linked immunosorbent assay (ELISA) for surface antigens, 17 (71%) of 24 persons with Campylobacter enteritis showed seroconversion in more than one immunoglobulin class, versus only 2 (5%) of 40 patients with non-Campylobacter enteritis. In a GM1, ganglioside-based ELISA for detecting serum IgG to cholera-like enterotoxin, only one patient studied showed seroconversion to the enterotoxin. Of 22 Campylobacter isolates studied for production of cholera-like toxin, none of the supernatants from the Campylobacter strains were positive. Supernatants were also tested for enterotoxin and cytotoxic activity on Chinese hamster ovary cells; all isolates were negative for enterotoxin activity. In contrast, cytotoxin was produced by 7 (32%) isolates but was usually low-level and was not neutralized by patient's serum. These findings indicate that production of cholera-like toxin and cytotoxin by Campylobacter strains in the United States occurs in few strains and that host immune response is absent; their biologic significance in the pathogenesis of Campylobacter infections remains unclear. PMID- 2760499 TI - Treatment of experimental Pseudomonas aeruginosa pneumonia with a human IgM monoclonal antibody. AB - A human IgM monoclonal antibody (MA-1C1) to Fisher immunotype 3 Pseudomonas aeruginosa lipopolysaccharide antigen was evaluated for in vivo activity in a guinea pig model of experimental pneumonia. Pharmacokinetics of MA-1C1 were compared in infected and noninfected animals. Intravenous bolus infusion of MA 1C1, 1 mg/kg, resulted in peak serum antibody concentrations of 3.8 +/- 0.08 and 3.7 +/- 0.05 micrograms/ml in infected and noninfected animals, respectively. Serum half-lives were 25 and 22 h in infected and noninfected groups. Treatment with a single intravenous infusion of MA-1C1 improved survival from pneumonia and was effective over a broad dose range (0.1-2.5 mg/kg). Cumulative survivals were 18 of 47 in the MA-1C1 group and 0 of 31 in controls (P less than .001). Treatment with MA-1C1 also resulted in fewer positive blood cultures 12 h after infection (P = .04). Although MA-1C1 penetrated into inflamed bronchial fluids, local concentrations were only 5% of the concentrations achieved in serum. Thus, MA-1C1 seems to provide significant therapeutic activity against experimental P. aeruginosa pneumonia by preventing dissemination of infection from the lung. PMID- 2760500 TI - Adherence of the Lyme disease spirochete to glial cells and cells of glial origin. AB - Lyme disease, a tick-borne spirochetosis caused by Borrelia burgdorferi, produces protean neurologic manifestations, yet its neuropathogenesis is poorly understood. The affinity of the spirochete for cells of primary rat brain cultures and of the C6 glioma cell line was studied. B. burgdorferi adhered to both types of cells in a dose-dependent manner and exhibited an affinity for an extracellular matrix produced by the primary and by glioma cell cultures. Adherence of the spirochetes to the glial components of the primary brain culture could be an early event in the production of neurological injury; its affinity for cells could be the reason for its infrequent isolation from cerebrospinal fluid. PMID- 2760501 TI - Comparison of tissular disposition of pentamidine mesylate in the rat after aerosol or parenteral administration. AB - The tissular distribution of pentamidine mesylate (4 mg/kg as free base) after intravenous, intramuscular, and aerosol administration in healthy rats was examined. Pentamidine levels in the plasma, lungs, liver, kidneys, and other organs were determined by high-performance liquid chromatography. Pentamidine was undetectable in the plasma after day 5. At day 1, the injected groups had high concentrations of the drug in the kidneys (32-34 micrograms/g) and spleen with much lower concentrations in the lungs and the liver (3.12-5.70 micrograms/g and 1.64-2.19 micrograms/g, respectively). Aerosol delivery of pentamidine produced negligible extrapulmonary drug levels (3.29 micrograms/g in kidneys at day 1) and high sustained pulmonary levels throughout the 60 d of the study (range 5.42 19.62 micrograms/g). The half-time of elimination was longer in the lungs and kidneys (29-45 d) than in the liver (1.4-7.0 d) regardless of the mode of administration. PMID- 2760502 TI - Trichinosis in the Canadian Arctic: report of five outbreaks and a new clinical syndrome. AB - Trichinosis is a serious but understudied medical problem in the Arctic. Forty nine consecutive cases in the Inuit population of northeastern Canada are described. Most developed the disease after eating raw walrus, and the clinical presentation of most of these cases differed from previously reported descriptions of classic trichinosis due to Trichinella spiralis. Unlike the classic syndrome of a brief period of diarrhea followed by fever, myalgia, muscle weakness, and edema, the most common presentation in these cases was a prolonged diarrhea without fever and with brief muscle symptoms. High peripheral eosinophilia, high Trichinella antibody serotiters, and little direct or indirect evidence of muscle invasion in many of those with the chronic diarrheal presentation suggest a new clinical syndrome due to a different species of Trichinella seen in the Arctic or to reinfection with Trichinella. PMID- 2760503 TI - Onchocerca volvulus recombinant antigen: physical characterization and clinical correlates with serum reactivity. AB - An Onchocerca volvulus cDNA clone expressing epitopes found in adult and larval parasites, designated lambda RAL-2, was derived from a 1,000-base message present in adult O. volvulus, which encodes a protein with an apparent molecular weight of 17,000. This protein does not appear to be extensively posttranslationally modified. Serum samples from 52 individuals exposed to O. volvulus were examined for antibodies recognizing the lambda RAL-2 recombinant antigen; 77% produced such antibodies. In addition, individuals producing antibodies recognizing the recombinant antigen were significantly less likely to develop some aspects of ocular pathology associated with O. volvulus infection than were individuals who did not do so. These results suggest that recombinant antigens such as that produced by lambda RAL-2 may be useful in attempts to understand the mechanism of O. volvulus-induced ocular pathology. PMID- 2760504 TI - Immunoelectron microscopic localization of fibronectin in adherence of Staphylococcus aureus to cultured bovine endothelial cells. AB - Fibronectin binds to Staphylococcus aureus and may have a role in mediating its adherence to host tissue. Fibronectin was localized ultrastructurally on S. aureus in suspension and in interactions with cultured bovine endothelial cells. Probes were constructed by adsorbing fibronectin or its antibodies to colloidal gold beads (FN-Au or aFN-Au, respectively). Sites of fibronectin binding to S. aureus were demonstrated by reacting FN-Au with S. aureus in suspension. Transmission electron microscopy showed that FN-Au localized uniformly over the surface of S. aureus in suspension; most localized within 65 nm of the cell wall. The distribution of aFN-Au on S. aureus adherent to endothelial cells was concentrated in areas between S. aureus and endothelial cells. Areas of S. aureus not facing endothelial cells bound few aFN-Au. This suggests that the fibronectin labeled by aFN-Au in areas between S. aureus and endothelial cells was involved in adherence of the S. aureus, consistent with a role for fibronectin in endocarditis. PMID- 2760505 TI - B19 parvovirus replicates in erythroid leukemic cells in vitro. PMID- 2760506 TI - Hematogeneous osteitis due to Yersinia enterocolitica. PMID- 2760507 TI - Cefotetan and coagulopathy. PMID- 2760508 TI - Sulfadiazine revisited. PMID- 2760509 TI - An open study of the pyrimethamine-clindamycin combination in AIDS patients with brain toxoplasmosis. PMID- 2760510 TI - Presence of Loa loa microfilariae in ascitic fluid. PMID- 2760511 TI - Association of visceral leishmaniasis and human immunodeficiency virus infections. PMID- 2760512 TI - Effects of synthetic human gastrin-releasing peptide on pancreatic exocrine secretion and release of pancreatic polypeptide in conscious rats. AB - The effects of a newly synthesized peptide, human gastrin-releasing peptide (hGRP), on the pancreatic exocrine secretion and the release of pancreatic polypeptide (PP) were examined in the conscious rat. Plasma PP concentrations were determined by a recently established specific radioimmunoassay for rat PP. Amounts of 0.18, 0.35, and 3.5 nmol/kg/h hGRP significantly stimulated both pancreatic exocrine secretion and 0.35 nmol/kg/h of hGRP increased PP release. Simultaneously infused proglumide (300 mg/kg/h) did not affect either pancreatic exocrine secretion or PP release. However, simultaneous infusion of atropine (100 micrograms/kg/h) slightly inhibited PP release, but did not restrict the incremental response of pancreatic protein secretion to hGRP. These results suggest that hGRP directly stimulates pancreatic exocrine secretion and PP release. PMID- 2760513 TI - A comparison of pancreatitis induced by high or low pressure injections of enzymes into the canine pancreatic duct. AB - Purified pancreatic enzymes produced a substantial inflammatory response in the canine pancreas when injected under low pressure (40-60 cm). When high pressures in the range of 140 mm Hg were employed, the severity of the inflammatory response was considerably increased, and systemic hypotension and portal hypertension were common findings. The latter circulatory changes appeared to be related to a large load of enzyme-rich fluid absorbed predominantly by the venous route, and, to a lesser degree, by the lymphatics draining the interstitium of the gland. High pressure infusion appears to introduce variables that increase the intensity of the pathologic changes in the pancreas and the portal and systemic circulations. Infusion pressures within the range of physiologic probability appear to result in a lesion with less injection artifact. Studies involving experimental pancreatitis should take these factors into account, particularly when hemodynamic changes are an important consideration. PMID- 2760514 TI - Acute pancreatitis in a patient treated for alcoholic hepatitis. The hypothesis of supranormal ecbolic stimulation of the pancreon. AB - A 33-yr-old white woman treated for alcoholic hepatitis developed acute pancreatitis during her hospital stay. At autopsy, two major pathological processes were found: alcoholic cirrhosis and chronic pancreatitis. In both, there was evidence of an acute episode, i.e., acute alcoholic hepatitis and acute hemorrhagic pancreatitis superimposed on the chronic alcoholic lesions. The sequence of events would indicate that the acute pancreatic pathology was precipitated by supranormal ecbolic stimulation of the acinar segment of the "pancreon" units, triggered as a result of a high protein and fat diet. PMID- 2760515 TI - Carcinoma of the ear: retrospective analysis of 61 patients. AB - Malignant tumours of the ear canal and middle ear retain a poor prognosis despite the development of increasingly radical procedures. We report the combined experience of 61 patients presenting to our hospital over the past 30 years with this condition. Radiotherapy was the preferred initial treatment in almost all patients. Early surgical treatment by local resection just before or just after radiotherapy and radical mastoidectomy produced disease free survival for two to 20 years in 59 per cent (16 of 27) patients. Long term survival was achieved in 50 per cent of patients with carcinoma of the external auditory meatus and only 24 per cent of those with middle ear carcinoma. Salvage surgery produced a variable degree and duration of palliation but few survivors. Little was gained in the quality of life by petrosectomy. PMID- 2760516 TI - Attitudes to tympanometry. AB - A postal questionnaire revealed the widest possible spectrum of opinion regarding tympanometry. The reasons are discussed. PMID- 2760517 TI - Sublabial rhinotomy with septal transfixion as an approach to the nasal fossa, paranasal sinuses and nasopharynx. AB - A sublabial incision with septal transfixion and mid-face degloving is described as an approach to the nasal cavity, paranasal sinuses and nasopharynx. A brief history of the development of the technique is given. The results of nine cases are presented. These cases have had good tumour clearance, excellent cosmetic results and the minimum of complications. The sublabial approach is most useful in children and women, particularly those with intermediate grade tumours. The advantages of the approach compared to the lateral rhinotomy incision include: superior access to the floor of the nose, inferior turbinate and anterior nasal septum; access to both sides of the nasal septum and the absence of a facial scar. The limitations of the sublabial technique are the poor access to frontal sinus and the cribriform plate. PMID- 2760518 TI - Prevention of post-operative intra-nasal adhesions (a new material). AB - A new material, the wax paper enveloping the Fucidin gauze which is routinely used to pack the nose post-operatively, was utilized in 120 cases considered as 'high-risk' for the formation of post-operative nasal adhesions. This proved to be an inexpensive, simple and effective method when the prevention of the formation of nasal adhesions was the primary goal. PMID- 2760519 TI - Ophthalmic considerations in fronto-ethmoidal mucocoeles. AB - The pre- and post-operative ophthalmic consequences of fronto-ethmoidal mucocoeles are considered in a prospective series of 22 patients. Proptosis, lateral and inferior displacement, diplopia and restriction of ocular mobility were the commonest presenting problems. Following external fronto-ethmoidectomy, proptosis and displacement resolved completely in the majority of patients. One third of patients experienced a transient exacerbation of diplopia but this resolved in most patients. Persistent diplopia occurred in seven patients and required medical correction in four and surgery in one. This was due in all cases to underaction of the superior oblique muscle and probably to backward displacement of the trochlea which may be avoided by careful surgical re attachment. PMID- 2760520 TI - A modified incision for the trans-septal trans-sphenoidal approach to the pituitary. AB - The role of the otorhinolaryngologist in trans-septal trans-sphenoidal approach to hypophysectomy when undertaken conjointly with the neurosurgeon is to provide excellent and rapid exposure for the necessary neurosurgical manipulation. For the past two years at the King Fahd Hospital of the University in Al-Khobar, Saudi Arabia, a modified incision for the trans-septal trans-sphenoidal approach to the skull base around the area of the sella turcica has been undertaken in eight cases. This incision may offer a good alternative to the standard hemi transfixation incision. PMID- 2760521 TI - Two-stage temporalis flap reconstruction for facial paralysis. AB - Treatment of the paralyzed face remains a challenging surgical problem. When facial nerve damage is irreparable or facial nerve grafting has failed, static and dynamic techniques must be considered. A two-staged modification of the dynamic muscle transfer using ipsilateral temporalis muscle is described. Initially, a free temporalis fascia graft, harvested from the contralateral scalp, is placed around the oral commissure of the paralyzed side of the face through an incision in the nasolabial crease. Several weeks later, an ipsilateral temporalis muscle and fascia transfer is made to the anterior face and attached to the previously placed fascia graft. Oral commissure grafting, as a first step, provides for a secure anchoring point for the temporalis flap, and achieves a more satisfactory correction of the oral commissure. PMID- 2760522 TI - Cough as the sole manifestation of airway hyperreactivity. AB - The authors report 18 patients who presented to the ENT department with isolated cough, which had begun one month to 14 years previously. As the ENT examination was negative, the patients were referred to the Department of General Medicine where a bronchial reactivity test with acetylcholine was found to be positive, leading to a diagnosis of airway hyperreactivity. The group was predominantly female (15/18) and atopy was rare; indeed, only one patient, who had a history of allergic rhinitis, was found to be atopic. Bronchodilators and inhaled steroids cured or helped the cough in 16/18 patients. When a patient presents with chronic cough without other respiratory symptoms it is important to consider a diagnosis of airway hyperreactivity and to confirm this with a challenge test of bronchoconstriction. PMID- 2760523 TI - Osteoma of the ear canal presenting with headache. AB - Osteoma of external auditory canal is a rare benign tumour. Usually it is found incidentally and often symptomless. Here we have a case of osteoma arising from the anterior wall of the bony external auditory canal, causing ipsilateral temporal headache which was relieved by removal of tumour. PMID- 2760524 TI - Bilateral facial nerve palsy following secretory otitis media. AB - Facial nerve palsy is a known complication of acute suppurative otitis media. Cases of facial nerve palsy following secretory otitis media have not been reported in the world literature. We report a case of bilateral facial nerve palsy following secretory otitis media. PMID- 2760525 TI - Second primary tumour following retinoblastoma. AB - Reported is a child who at the age of 18 months had presented with a left retinoblastoma. The lesion had involved the optic nerve (Stage IV), and was successfully treated by enucleation and radiotherapy. The radiation field did not include the mandible or the submandibular triangle. He was followed up until he left the area aged 11 years. He represented aged 12 years with a progressive swelling of the left submandibular gland. Histology of the surgically excised submandibular gland revealed a mucoepidermoid carcinoma of the submandibular gland. This case highlights the need for continual surveillance in survivors of retinoblastoma, as second primary tumours occur both within and outside of previous radiation fields. The clinical association between retinoblastoma and mucoepidermoid carcinoma of the submandibular gland has not been previously reported. PMID- 2760526 TI - Carcinoma of the laryngeal saccule: a novel biopsy technique to make a difficult diagnosis. AB - Tumours of the laryngeal ventricle and saccule are rare and difficult to diagnose endoscopically. We present a case in which the tumour remained confined within the saccule, and describe how the problem of obtaining a positive biopsy was overcome. PMID- 2760527 TI - Carcinoma of the pharyngeal pouch. AB - The condition of carcinoma arising in a pharyngeal pouch is rare. It has been described in relation to long standing pouches and in pouches previously treated by the Dohlman's operation. Three additional cases of carcinoma of the pharyngeal pouch are described. PMID- 2760528 TI - Pharyngeal paralysis due to botulinum toxin injection. AB - Botulinum toxin injection is now recognized as an effective treatment for spasmodic torticollis. Complications of this increasingly popular method of treatment include mild and transient dysphagia, with or without dysphonia, lasting up to four weeks. Two cases of paralysis of vocal cord contralateral to the injected sternomastoid have also been reported. A case of severe dysphagia lasting six weeks associated with ipsilateral vocal cord palsy following botulinum toxin injection is presented. The probable mechanism for these complications is discussed. PMID- 2760529 TI - Atypical thyroglossal duct cyst. AB - Thyroglossal duct cysts most frequently present in childhood as a painless midline swelling of the neck. Uncommonly, these embryonal remnant cysts present clinically in adult life. The majority of adults with thyroglossal duct cysts present with a swelling at the level of the thyrohyoid membrane. On rare occasions, a thyroglossal duct cyst can present with more sinister symptoms, such as hoarseness, dysphagia and dyspnoea. On these occasions, the pre-operative clinical and investigative diagnosis remains in doubt until histology is available. PMID- 2760530 TI - Intravagal parathyroid adenoma. AB - An extremely rare case of intravagal parathyroid adenoma is presented. The tumour caused fusiform swelling of the left vagus nerve was shelled out. Post operatively the left recurrent nerve palsy was recovered in the two months. Serum calcium level returned to normal on the tenth day after the surgical operation without symptoms of hypocalcaemia. PMID- 2760531 TI - Agenesis of the cervical internal carotid artery. AB - Total or segmental agenesis of the internal carotid artery is a rare anomaly. The cervical portion of the internal carotid artery was absent in the right side of the patient who was carried out radical surgery due to recurrent oropharyngeal cancer. Post-operative venous digital subtraction angiography revealed that the remaining intracranial portion of the internal carotid artery was normally patent and supplied blood flow via ipsilateral external carotid artery. Otolaryngologist Head and Neck surgeon should know such a vascular anomaly and avoid a disastrous result on dividing the external carotid artery. PMID- 2760532 TI - Spontaneous external carotid artery occlusion. AB - The case of a 64-year-old man who presented with severe left sided facial pain and cyanosis of the left ear, preauricular region and tongue is described. Digital subtraction angiography confirmed complete occlusion of the left external carotid artery. The patient was anticoagulated and his symptoms resolved over the following month, presumably due to improvement of collateral blood supply to the ischaemic areas. The literature on the clinical manifestations of external carotid ischaemia is reviewed and the relationship between facial pain, internal and external carotid atherosclerosis is emphasised. PMID- 2760533 TI - Management of achalasia and laryngo-tracheal compression. AB - A case of severe airway obstruction due to laryngo-tracheal compression associated with achalasia is presented. Local anaesthetic tracheostomy has an important role in some cases. PMID- 2760534 TI - Regulating the clinical uses of fetal tissue. A proposal for legislation. PMID- 2760535 TI - The sinking of the "captain of the ship". Reexamining the vicarious liability of an operating surgeon for the negligence of assisting hospital personnel. PMID- 2760536 TI - Recognizing property interests in bodily tissues. A need for legislative guidance. PMID- 2760537 TI - Differentiation of human hematopoietic cells increases expression of a gene transferred by a retroviral vector. AB - To study expression of a retroviral vector in human hematopoietic lineages, two established human hematopoietic cell lines (HL60 and K562) and a human adherent stromal cell line (KM101) were infected with the vector pZIP-SV(X). Expression of the transferred neomycin resistance gene (neor) of pZIP-SV(X) was evaluated as the ability of the cells to form colonies (greater than 50 cells) in an agar assay in the presence of the neomycin analogue, G418. After infection, all three cell lines produced colonies resistant to G418. The level of neor mRNA in separate colonies was analyzed by Northern blot analysis. The neor gene transferred by the vector pZIP-SV(X) was expressed in both human hematopoietic and stromal cell lines. In addition, primary adherent human stromal cells infected with pZIP-SV(X) grew in the presence of G418. To determine if differentiation of hematopoietic cells affects expression of the retroviral vector, HL60 cells infected with pZIP-SV(X) were induced to differentiate, and the level of neor mRNA measured. The amount of neor mRNA increased when HL60 cells were induced to differentiate along the granulocytic pathway. Conversely, when HL60 cells were induced toward monocytoid differentiation (TPA), the level of neor mRNA did not significantly increase. We conclude that the neor gene transferred by a retroviral vector, pZIP-SV(X), is functionally expressed. In addition, expression of the transferred neor gene is regulated during myeloid differentiation of HL60 cells. PMID- 2760538 TI - Rat bone marrow and monocyte cultures: influence of culture time and lymphokines on the expression of macrophage differentiation antigens. AB - A set of seven monoclonal antibodies (moabs) has been shown to discriminate in situ between distinct subpopulations of macrophages in the rat. It is still controversial if this heterogeneity is caused by the existence of different lineages or by differentiation of a common precursor. In both cases, the differentiation process might be regulated by microenvironmental factors. The present study examines the expression of the macrophage markers recognized by the seven ED-moabs in bone marrow and monocyte cultures. Furthermore, the impact of culture time and stimulating factors on the antigen expression in these cultures was tested. The expression of the ED3 antigen is highly inducible in bone marrow cultures. Factors that might be responsible for the increased ED3 expression are investigated. This strong ED3 expression by bone marrow-derived macrophages is nearly absent by monocyte-derived macrophages. This implies that the ability to express ED3 is blocked before the macrophage precursor cells enter the circulation to become monocytes. The ED2 expression cannot be induced under the tested circumstances bone marrow macrophages in vivo do not express these antigens. In culture, these macrophages stain positive for these markers already after the first day of culturing. The other three antigens are expressed on all macrophages under all tested circumstances. PMID- 2760539 TI - Chenodeoxycholic acid normalizes elevated lipoprotein secretion and catabolism in cerebrotendinous xanthomatosis. AB - Cerebrotendinous xanthomatosis (CTX) is a rare inherited lipid storage disease caused by a defect in bile acid synthesis in which cholesterol and its product cholestanol are deposited in neurological and vascular tissue. Therapy with chenodeoxycholic acid but not with the 7 beta-epimeric ursodeoxycholic acid is usually successful. In an untreated patient, total and low density lipoprotein (LDL) cholesterol were found to be low (134 +/- 11 and 78 +/- 8 mg/dl, respectively). The production rate (PR) and fractional catabolic rate (FCR) of very low density (VLDL) apolipoprotein B (apoB) were, however, both markedly increased (34.7 mg/kg per day and 13.7 pools/day, respectively vs. 15.1 +/- 5.0 mg/kg per day and 6.2 +/- 3.8 pools/day in controls) while the PR and FCR of LDL apoB were moderately elevated (16.3 mg/kg per day and 0.65 pools/day, respectively vs. 12.9 +/- 1.2 mg/kg per day and 0.52 +/- 0.10 pools/day in controls). After 1 month of 750 mg/day of chenodeoxycholic acid, the FCR and PR of both VLDL and LDL apoB became normal while total plasma cholesterol increased significantly to 145 +/- 18 mg/dl. In a second patient who had been receiving 750 mg/day of chenodeoxycholic acid for 6 months lipoprotein kinetics were normal. These parameters did not change when the subject was switched to 750 mg/day ursodeoxycholic acid. We postulate that cholesterol biosynthesis in CTX is derepressed by a diminished hepatic pool of chenodeoxycholic acid and that the elevated secretion of apoB is a response to the increased rate of cholesterol production. PMID- 2760540 TI - Low density lipoprotein heterogeneity in the cebus monkey. AB - In studies of cebus monkey plasma lipoproteins, we have used an ultracentrifugally generated density gradient to isolate two distinct species of low density lipoproteins (LDL). Compositional analyses revealed that each of the ultracentrifugally isolated fractions was enriched in cholesteryl esters and contained a single apolipoprotein which in terms of its mobility on SDS gels corresponded to apolipoprotein B-100, the major apolipoprotein of human LDL. Hydrodynamic measurements carried out in the analytical ultracentrifuge showed that F1.20 values were 30.0 for LDL1 and 23.5 for LDL2. In a solution of density 1.0069 g/ml, the sedimentation rates were 5.9 and 7.2 S for LDL1 and LDL2, respectively. In addition to sedimentation velocity data, we describe a new approach for using these same data to obtain calculated values for molecular weight. The hydrated densities calculated for the two fractions were 1.033 and 1.045 g/ml and calculated molecular weights were 3.08 million for LDL1 and 2.42 million for LDL2. Hydrated density values were in excellent agreement with those calculated from compositional data. Electron microscopy data showed that LDL1 had a larger mean diameter of 26.7 nm than LDL2 which had a diameter of 19.3 nm. Native gel electrophoretic analyses of the two LDL fractions in 3.5% acrylamide showed that, consistent with its size, LDL1 had slower mobility than LDL2. PMID- 2760541 TI - Effects of monosulfate esters of taurochenodeoxycholate on bile flow and biliary lipids in hamsters. AB - The effect of the 3 alpha- and 7 alpha-monosulfate esters of taurochenodeoxycholate on bile flow and biliary lipids was compared to the effect of unsulfated taurochenodeoxycholate. Test bile salts were infused directly into the portal circulation through a catheter introduced into the splenic pulp. Recovery of unsulfated and sulfated bile salts was complete; no biotransformation of any of the administered compounds was noted. Equivalent choleresis was noted in response to administration of each of the test bile salts. Of particular interest, the biliary cholesterol and phospholipid content was tightly linked to biliary bile salt monosulfates; the slope of the line describing the relationship between bile salts and lipids was similar to that for the unsulfated bile salt. The critical micellar concentration of the 3 alpha- and 7 alpha-monosulfate esters was 19 mM and 18 mM, respectively. Sulfation of taurochenodeoxycholate, therefore, does not impair its bile secretory function. Despite a higher critical micellar concentration, biliary lipid excretion with monosulfate esters is equivalent to that seen with unsulfated bile salt. The role of hydrophobic/hydrophilic balance in the promotion of biliary lipid excretion may need to be redefined. PMID- 2760542 TI - CL 277,082: a novel inhibitor of ACAT-catalyzed cholesterol esterification and cholesterol absorption. AB - CL 277,082 (I) was found to be a potent inhibitor of acyl CoA:cholesterol acyltransferase (ACAT, EC 2.3.1.26) in microsomes from a variety of tissues with IC50 values of 0.14 microM for intestinal mucosal microsomes, 0.74 microM for liver, and 1.18 microM for rat adrenal. I was also shown to inhibit ACAT in cultured smooth muscle cells (IC50 = 0.8 microM) and was found to be specific in inhibiting cholesterol esterification since it did not inhibit fatty acid incorporation into triglycerides or phospholipids. Also, other cholesterol esterifying enzymes such as lecithin:cholesterol acyltransferase (LCAT) and pancreatic cholesterol esterase were not inhibited by I, nor was esterification of retinol by acyl CoA:retinol acyltransferase (ARAT) from intestinal mucosal microsomes inhibited. I was a potent inhibitor of cholesterol absorption in cholesterol-fed rats by markedly inhibiting increases in liver and serum cholesterol concentration (ED50 = 5.2 mg/kg per day) while increasing the excretion of neutral 14C-labeled sterol in the feces. PMID- 2760543 TI - Elevation of liver diacylglycerols and molecular species of diacylglycerols in rats fed a lipogenic diet. AB - The concentration of diacylglycerols in rat liver was measured by a newly developed procedure that entailed a) freeze-clamping of the liver in situ, b) lipid extraction with dimyristoylglycerol as an internal standard, c) thin-layer chromatography, and d) gas-liquid chromatography. Molecular species of diacylglycerol and total diacylglycerols were quantified. The average level of diacylglycerol in livers of chow-fed rats was 102 micrograms/g wet wt, equivalent to about 180 nmol/g wet wt. A high-carbohydrate fat-free diet, known to increase the rate of fatty acid synthesis, greatly increased the liver diacylglycerol concentration relative to the level observed in rats fed laboratory chow. Diacylglycerol molecular species that contained 16-carbon fatty acids were most markedly elevated. Liver triacylglycerol, free cholesterol, and esterified cholesterol were concurrently increased. Molecular species of triacylglycerols and cholesteryl esters that contained 16-carbon fatty acids were elevated to the greatest degree. The concentrations of total triacylglycerol and cholesteryl esters exhibited a high correlation in the livers of all animals studied, suggesting their coexistence in metabolic pools, predominantly the cores of lipid droplets and newly assembled very low density lipoprotein particles. The correlation of liver diacylglycerol and triacylglycerol contents in the chow-fed rats suggests that the diacylglycerol concentration may be a rate-determining factor in triacylglycerol synthesis when diacylglycerol levels are in the observed range of 70-150 micrograms/g wet wt. In conclusion, when the rates of fatty acid synthesis and hence triacylglycerol synthesis are increased in the liver, the steady state concentrations of diacylglycerols are also elevated.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2760544 TI - Deoxycholate 7 alpha-hydroxylase in the hamster: substrate specificity and effect of phenobarbital. AB - In a recent publication, we reported that deoxycholic acid is 7 alpha hydroxylated to yield glycocholate or taurocholate in vivo in the hamster (1987. Kuroki et al. Hepatology. 7: 229-234). In order to explore the possibility that amidation of free deoxycholic acid precedes the 7 alpha-hydroxylation, we assayed 7 alpha-hydroxylase activities of free and conjugated deoxycholates in vitro. 7 alpha-Hydroxylase activities of glycodeoxycholate and taurodeoxycholate were 720 +/- 132 and 640 +/- 160 pmol/mg.min-1, respectively. Activity of 7 alpha hydroxylation of free deoxycholate was very low (60 +/- 20 pmol/mg.min-1). After treatment with phenobarbital in a dose of 100 mg/kg per day for 6 days, 7 alpha hydroxylase activities of conjugated deoxycholates were decreased significantly (40%, P less than 0.01, n = 8), whereas that of free deoxycholate was not significantly changed. In the rat, 7 alpha-hydroxylase activities of conjugated deoxycholates were induced significantly (45% increase, P less than 0.05, n = 5) by phenobarbital treatment in sharp contrast to the hamster. There were significant correlations between the 7 alpha-hydroxylase activity of taurodeoxycholate and that of glycodeoxycholate both in the hamster and in the rat (hamsters: n = 16, r = 0.98, P less than 0.01; rats: n = 10, r = 0.82, P less than 0.01). These studies suggested that deoxycholic acid is 7 alpha-hydroxylated after amidation with glycine or taurine in vivo and that the same enzyme may well catalyze the 7 alpha-hydroxylation of glycodeoxycholate and taurodeoxycholate in the hamster.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2760545 TI - Quantitative estimation of the hydrophilic-hydrophobic balance of mixed bile salt solutions. AB - This paper describes the derivation of a bile salt monomeric hydrophobicity index that quantitatively defines the composite hydrophilic-hydrophobic balance of a mixture of bile salts. The index is based on the logarithms of bile salt capacity factors determined using reversed phase high performance liquid chromatography (HPLC) (stationary phase octadecyl silane; mobile phase methanol-water 70:30 w/w, ionic strength 0.15). It has been standardized arbitrarily to set indices of taurocholate and taurolithocholate to 0 and 1, respectively. Indices of tauroursodeoxycholate, taurohyodeoxycholate, taurochenodeoxycholate, and taurodeoxycholate were found to be -0.47, -0.35, +0.46, and +0.59, respectively. Whereas capacity factors and hydrophobicity indices of taurine-conjugated bile salts were constant for pH 2.8-9.0, the hydrophilic-hydrophobic balance of glycine-conjugated and unconjugated bile salts was strongly influenced by pH. At alkaline pH (greater than 8.5), hydrophobicity indices of fully ionized unconjugated (n = 4) and glycine-conjugated (n = 6) bile salts differed by only 0.14 +/- 0.02 and 0.05 +/- 0.01, respectively, from those of the corresponding taurine conjugates. At acid pH (less than 3.5) the hydrophobicity indices of four unconjugated bile acids (protonated form) exceeded those of the corresponding salts (ionized form) by 0.76 +/- 0.04; indices of six glycine-conjugated bile acids exceeded those of the corresponding salts by only 0.26 +/- 0.03. Capacity factors of the salt forms of cholate and its conjugates increased dramatically with increasing ionic strength of the mobile phase; retention of the protonated forms (cholic and glycocholic acids) was only minimally influenced by ionic strength. Thus the difference in hydrophilic-hydrophobic balance between a bile acid and its corresponding salt decreases with increasing ionic strength. Examples are given of calculation of hydrophobicity indices for biliary bile salts (fully ionized) from four species under conditions of intact enterohepatic circulation. Mean values, from least to most hydrophobic, were: rat (-0.31) less than dog (0.11) less than hamster (0.22) less than human (0.32). This study provides a rational basis for calculating the hydrophilic-hydrophobic balance of mixed bile salt solutions over a broad range of pH. PMID- 2760546 TI - Identification of the major metabolite of 12-HETE produced by renal tubular epithelial cells. AB - The identification and polarity of release of the major metabolite of 12-HETE produced by cultured canine renal tubular epithelial cells was determined. When incubated with 1.0 microM [3H]12-HETE for 1 h, cultured Madin Darby Canine Kidney (MDCK) cells converted 35% of the radiolabeled 12-HETE to a more polar metabolite. Following high performance liquid chromatography isolation and chemical derivatization, gas-liquid chromatography combined with mass spectrometry was used to identify the compound as 8-hydroxyhexadecatrienoic acid [16:3(8-OH)]. The electron impact mass spectrum of the hydrogenated derivative contained major ions at m/z = 215 and 245, corresponding to cleavage on either side of the trimethylsilyl group, and chemical ionization with NH3 yielded a major ion at m/z = 359, corresponding to the protonated molecular weight of the methyl ester. Incubation with 25 mM alpha-naphthoflavone, 20 microM nordihydroguaiaretic acid, and 0.1 mM 4-pentenoic acid failed to inhibit the formation 16:3 (8-OH), suggesting that the formation of 16:3 (8-OH) is not mediated by the cytochrome P-450, lipoxygenase, or mitochondrial beta-oxidation pathways. When grown on fibronectin-treated polycarbonate filters, MDCK cells released the 16:3 (8-OH) in both the apical and basolateral directions, irrespective of which side the 12-HETE was encountered. These results demonstrate the conversion of 12-HETE to a 16-carbon monohydroxy derivative by renal tubular epithelium and suggest that this product can be released to either the potential urinary space or the kidney parenchyma and renal microcirculation. PMID- 2760547 TI - Studies on acyl-coenzyme A: cholesterol acyltransferase activity in human liver microsomes. AB - The aim of the present study was to characterize the acyl-coenzyme A: cholesterol acyltransferase (ACAT) activity in human liver microsomes. Liver biopsies were obtained from patients undergoing elective cholecystectomy under highly standardized conditions. In 34 patients the enzyme activity of the microsomal fraction averaged 6.6 +/- 0.7 (mean +/- SEM) pmol.min-1.mg protein-1 in the absence of exogenous cholesterol. Freezing of the liver biopsy in liquid nitrogen increased the enzyme activity five- to sixfold. Similarly, freezing of the microsomal fraction prepared from unfrozen liver tissue increased the enzyme activity about twofold. These results may help to explain previous disparate results reported in the literature. The enhanced ACAT activity obtained by freezing was at least partly explained by a transfer of unesterified cholesterol to the microsomal fraction and possibly also by making the substrate(s) more available to the enzyme. Preincubation of the microsomal fraction, prepared from unfrozen liver tissue, with unlabeled cholesterol increased the enzyme activity about fivefold. This finding indicates that hepatic ACAT in humans can also utilize exogenous cholesterol as substrate. Addition of cholesterol to frozen microsomes prepared from unfrozen liver tissue increased the ACAT activity two- to threefold, whereas addition of cholesterol to microsomes prepared from frozen liver tissue did not further increase the enzyme activity. No evidence supporting the concept that ACAT is activated-inactivated by phosphorylation dephosphorylation could be obtained by assaying the enzyme under conditions similar to those during which the human HMG-CoA reductase is inactivated activated. PMID- 2760548 TI - Sodium dodecyl sulfate-glycerol polyacrylamide slab gel electrophoresis for the resolution of apolipoproteins. AB - We describe the resolution of the plasma apolipoproteins with molecular weights from 8,800 to greater than 550,000, using a 3.5% sodium dodecyl sulfate-glycerol polyacrylamide slab gel system. The simplicity of this system and the resolution of proteins over a broad range of molecular weights will make it particularly useful in investigations of apolipoprotein composition of plasma lipoproteins. PMID- 2760549 TI - Separation of phosphatidylinositols and other phospholipids by two-step one dimensional thin-layer chromatography. AB - A quick and efficient thin-layer chromatographic procedure is described for the separation of phosphatidylinositol-4,5-bisphosphate, phosphatidylinositol-4 monophosphate, phosphatidylinositol, phosphatidylcholine, phosphatidic acid, and phosphatidylethanolamine. The method involves development of the phospholipids successively in two different solvent systems but in the same direction. The method is simple, reproducible, and gives good resolution of the six different phospholipids tested. About 8-10 32P-labeled phospholipids isolated from rat hepatocytes were separated by this method; the six mentioned above were identified. Thus, the technique has potential application for both qualitative and quantitative analysis of phospholipid mixtures, such as the phosphoinositides, in cell or tissue extracts. PMID- 2760550 TI - Characterization of sarcosylsarcoursodeoxycholic acid formed during the synthesis of sarcoursodeoxycholic acid. AB - This report describes the isolation of sarcosylsarcosine conjugate of ursodeoxycholic acid (UDCA) formed during the synthesis of sarcoUDCA by the mixed anhydride method. The compound was characterized by its chemical ionization mass spectrum. The diamino acid conjugate was formed only when the free amino acid was used for conjugation. This was confirmed by the isolation of glycylglycoUDCA during the conjugation of UDCA with free glycine but not with glycine ethyl ester hydrochloride. Pure sarcoUDCA was prepared by conjugation of UDCA with sarocisine methyl ester hydrochloride while sarcoUDCA on further reaction with the protected sarcosine derivative gave pure sarcosylsarcoUDCA in 52% yield. PMID- 2760552 TI - Right ventricular infarction. The evolution of ST-segment elevation and Q wave in right chest leads. AB - ST-segment elevation in right chest leads V3R-V7R and Q wave in V3R was measured early (1-4 hours) and late (18-24 hours) after the onset of infarction in six patients. The patients died within 9 days of infarction, and autopsy demonstrated more than 50% necrosis of the right ventricle (inclusion criterion). Abnormal ST elevation was recorded in all patients in the early and late electrocardiograms, but mean ST elevation decreased significantly between these recordings. ST elevation greater than or equal to 1 mm was recorded in all patients in the early electrocardiogram but was present in only three (50%) in the second electrocardiogram. The number of leads exhibiting abnormal ST elevation decreased from 27 (90%) to 24 (80%) (NS), and those exhibiting ST elevation greater than or equal to 1 mm decreased from 24 (80%) to 15 (50%), (p less than 0.05). Q wave in V3R was present in both electrocardiograms in three patients. Evolution of Q wave was seen in only one patient, whereas two patients were without Q wave in both electrocardiograms. These results indicate that ST elevation in V3R-V7R may vanish within the initial 24 hours despite large right ventricular infarction. Furthermore, Q wave in V3R may evolve very early after the onset of right ventricular infarction. PMID- 2760551 TI - High performance thin-layer chromatography and densitometry of synaptic plasma membrane lipids. AB - Previously, it has been shown that phospholipids, cholesterol, and glycolipids could be quantitated using the same high performance thin-layer chromatography (HPTLC) method. Here we examined that method in terms of linearity of standards in the nanogram range, recovery of nonacidic and acidic lipids after Sephadex column chromatography, and quantitation of lipids in mouse synaptic plasma membranes (SPM) where lipid content is low. Nonacidic and acidic fractions were separated by Sephadex column chromatography, applied to plates using contact spotting, chromatographed, visualized with cupric acetate, and quantitated using in situ densitometry. Recovery of nonacidic and acidic fractions off the columns was determined with radiolabeled phospholipids. Standards for each lipid class were linear in the nanogram range. Quantitation of SPM lipid classes could be made with as little as 1.5 micrograms of total lipid. Recovery of the nonacidic fraction after Sephadex column chromatography was approximately 100% whereas the acidic fraction was approximately 91%. Phospholipids, cholesterol, and glycolipids could be determined in nanogram amounts using the same method. This method is an efficient method for examining different lipid classes and in samples where lipid content is low. PMID- 2760553 TI - Effect of exercise protocol and lead selection on the accuracy of heart rate adjusted indices of ST-segment depression for detection of three-vessel coronary artery disease. AB - To assess the effect of exercise protocol and number of monitoring leads on the ability of the ST/HR slope and delta ST/HR index to identify three-vessel coronary artery disease, the exercise ECGs of 50 patients who had coronary arteriography were reviewed. Test performance of the ST/HR slope using the Cornell exercise protocol with 13 leads was compared with performance obtained from the standard 12 leads and from sets of only 3 leads, as well as with test outcome using Bruce protocol equivalent stages with multiple-lead sets. ST/HR slopes could be calculated in 100% of patients using data from the Cornell protocol, but in only 80% of patients using the Bruce protocol with 13 leads (chi 2 = 8.1, p less than 0.005) and 54% of patients using the Bruce protocol with 3 leads (chi 2 = 21.0, p less than 0.001). With the Cornell protocol and 13 leads, an ST/HR slope partition of 6.0 microV/bpm identified three-vessel disease with a sensitivity of 96%, specificity of 58%, and overall test accuracy of 76%. At matched specificity, the Bruce protocol 13-lead ST/HR slope partition of 5.0 microV/bpm had a sensitivity of only 48% and overall test accuracy of 53% for three-vessel disease in those patients with calculable test outcomes (each p less than 0.01). Receiver operating characteristic curve analysis confirmed the superior performance of data acquired with the Cornell protocol and demonstrated no significant loss of Cornell ST/HR slope performance calculated from fewer monitored leads. Performance of the delta ST/HR index was similar with 3 leads and with 13 leads.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2760554 TI - Analysis of the hypoplastic right ventricle utilizing electrocardiographic body surface potential mapping (BSPM). AB - The authors present electrocardiographic body surface potential maps (BSPMs) of 11 patients with hypoplastic right ventricle (HRV) of three types: type I, HRV with pulmonary atresia; type II, HRV with tricuspid atresia; and type III, HRV with tricuspid artesia and transposition of the great arteries. The BSPMs of all 11 patients demonstrated evidence for epicardial right ventricular breakthrough, indicating conduction through an intact right bundle branch and Purkinje system. Nonetheless, the BSPMs strongly suggested profound morphological, probably embryological, differences among the right ventricles of the three groups. The four patients with type I HRV had no evidence for conduction abnormality. The five patients with type II, HRV however, had very marked conduction abnormality. In four of these five, the standard ECG and VCG had initial forces suggesting left lateral wall myocardial infarction. The BSPMs showed no evidence for infarction but demonstrated very complicated slow initial activation, explaining why the initial QRS vector was to the right and posterior before extending leftward. In addition, in all five the initial positive potentials were unusually inferior and the initial negative potentials unusually superior. After the evidence for epicardial right ventricular breakthrough, the positive and negative potentials rapidly changed positions so that the positive potentials were unusually superior and the negative potentials unusually inferior, consistent with the BSPM of endocardial cushion defects. In four of these five there was marked delay of total ventricular activation time. Of the two patients with type III HRV, one had an initial QRS similar to that of type II. Neither had rapid change of inferior and superior positive and negative potentials after right ventricular breakthrough, and both had intraventricular slowing, one with partial left bundle branch block. PMID- 2760555 TI - Recurrent resemblance in potential topography at different instants during ventricular depolarization and repolarization. Normal conduction contrasted with left bundle branch block and paced beats. AB - During ventricular activation and recovery, potential distribution may be exquisitely reproduced on instantaneous maps separated in time by many milliseconds. The timing and duration of these periods of strong resemblance (absolute r = 0.80 over 142 thoracic reference sites) may provide useful insight into the underlying patterns of the spread of activation and resumption of the repolarized state. This study examined 80 normal volunteers, 35 patients with left bundle branch block (LBBB), and 41 patients with permanent pacemakers. Normal subjects showed three basic patterns of recurrent surface map resemblance: (1) positive correlation between maps in early QRS and those throughout ST-T, but with greatest focus in late ST-T; (2) negative correlation between maps in early QRS and late QRS; and (3) negative correlation between maps in late QRS and early ST-T. These findings may be hypothetically attributed to the retention or recreation of similar relationships between the anatomic distributions of resting versus active or plateau versus repolarizing cells on the endocardial and epicardial surfaces, respectively. On the other hand, patients with LBBB and pacemakers were distinctly different in the timing and frequency of sustained resemblances. In these two states, there was sustained or continuing resemblance (positive correlation) between successive maps throughout QRS and again between successive maps through ST-T. In addition, the surface map pattern found throughout ST-T consistently appeared as the negative correlate of the preceding pattern that had dominated QRS. PMID- 2760556 TI - Cardiac refractoriness. Age-dependence in normal subjects. AB - The effects of age on cardiac electrophysiologic measurements were assessed in 30 subjects between the ages of 18 and 73 years and free of structural heart disease. Occult heart disease was excluded by a normal treadmill exercise tolerance test, a rest and exercise radionuclide angiogram, and/or a cardiac catheterization. Effective and functional refractory periods of right atrium, right ventricle, and atrioventricular node were assessed. The relationship between these measurements and age was examined using linear regression. There were significant correlations between age and atrial effective and functional refractory periods, atrioventricular effective refractory period, and ventricular effective and functional refractory periods. Other electrophysiologic measures showed no such relationship with age. PMID- 2760557 TI - Mechanisms of atypical atrioventricular Wenckebach periodicity. A theoretical model derived from the concepts of inhomogeneous excitability and electrotonically mediated conduction. AB - To explain the mechanisms of atypical atrioventricular (AV) Wenckebach periodicity, a model of the AV node was theoretically derived from the concepts of "inhomogeneous excitability" and "electrotonically mediated conduction." The theoretical model of the AV node has the following characteristics: (1) increased vagal tone depresses excitability in the AV node, (2) depressed excitability in the AV node is inhomogeneous in both transverse and longitudinal directions, and (3) electrotonically mediated conduction occurs across inexcitable gaps in the AV node. Many features in atypical AV Wenckebach periodicity are explained by the use of this model. Delayed AV conduction is caused mostly by electrotonically mediated conduction across a much-depressed region in the AV node, and thereafter AV conduction is blocked at the same region, resulting in the occurrence of an AV Wenckebach period with gradual lengthening of PR intervals. Occasionally, longitudinal dissociaton and concealed reentry in the AV node occur in the part below (distal to) the above depressed region, resulting in the occurrence of an AV Wenckebach period with sudden marked lengthening of a PR interval. The sinus impulse following such suddenly delayed AV conduction is usually blocked in the AV node as the result of concealed reentry of the preceding impulse. PMID- 2760558 TI - REM sleep and bradyarrhythmia episodes in rats. AB - The relationship between rapid eye movement (REM) phasic events and bradyarrhythmia was investigated in five male Wistar rats. ECGs, EEGs (frontal cortex and dorsal hippocampus), and electrooculograms were monitored continuously for 6 days. Sleep states were classified as alertness, slow-wave sleep, or paradoxical sleep, and the frequency of the REM burst was measured to evaluate the REM density. Bradyarrhythmias, such as SA block or AV block, were observed in each rat and were divided into two groups: group A, bradyarrhythmias with a duration greater than 5 sec; and group B, duration less than 5 sec. For a period of 33 days, the five rats showed alertness, slow-wave sleep, and paradoxical sleep 6,481, 6,483, and 1,523 times; bradyarrhythmia incidents in each sleep stage were 0.35%, 0.03%, and 22.4%, respectively. The incidence of bradyarrhythmia episodes increased with REM density, and 78.5% of the episodes appeared related to the REM bursts. The latency between the REM bursts and bradyarrhythmia was as follows: type A bradyarrhythmias, 2.17 +/- 0.41 sec; type B, 3.78 +/- 0.63 sec. These results suggest close association of bradyarrhythmia occurrence with REM phasic events. PMID- 2760559 TI - Transthoracic defibrillation threshold of sine and trapezoidal waveforms in defibrillation. AB - The transthoracic defibrillation threshold of trapezoidal (2.5-, 5-, 10-, 15-, 20 , 40-, and 55-msec duration) and damped sine waveforms were established in groups of anesthetized greyhounds. Of the seven trapezoidal waveforms, the threshold current was lowest for the 20-msec pulse but was not significantly different for the 5-20-msec pulses (p greater than 0.05). The threshold delivered energy was not significantly different for the 2.5-20-msec waveforms. The 40- and 55-msec pulses had significantly greater delivered energies than the shorter pulses (p less than 0.01). The transthoracic defibrillation threshold of two trapezoidal (5 and 20-msec) and three damped sine waves (Lown, Edmark, and Belfast) showed that the threshold transthoracic current and energy were not significantly different for the 5-msec trapezoid and three sine waves (p greater than 0.05). The threshold transthoracic energy for the 20-msec trapezoid was significantly greater than that of the four other waveforms. The threshold current for the 20 msec trapezoid was significantly less than that of the Belfast and Edmark waveforms only. Thus, none of the three damped sine waveforms was superior, with the 5-msec trapezoid producing similar results. Although the 20-msec trapezoid had the lowest threshold current, it had the highest delivery energy. PMID- 2760561 TI - Selected abstracts from the fifteenth International Congress on Electrocardiology. PMID- 2760560 TI - Trifascicular block with asynchronous intraventricular recovery and "supernormal" AV conduction. AB - The authors present a case of trifascicular block: complete right bundle branch block, tachycardia-dependent left anterior hemiblock, and bradycardia-dependent left posterior hemiblock. There is, in addition, a complicating independent AV junctional rhythm that is in most instances not affected by the conducted sinus impulses. Occasionally, however, this focus is discharged by very early sinus impulses that are unexpectedly conducted to the ventricles (a manifestation of "supernormal" conduction). A complex electrocardiographic pattern results from the interplay of the aforementioned mechanisms. PMID- 2760562 TI - Age-related differences in short-term retention of separable elements of an odor aversion. AB - The rate of forgetting over short intervals was tested in preweanling rats, 8, 12, or 18 days postnatal, using procedures that may have analytical advantages over other tests of short-term retention. Separate tests of retention were conducted for the simple occurrence of an odor and for the occurrence of an odor paired with a mild footshock. Forgetting of odors with either of two histories, incidental or target, was more rapid the younger the preweanling, over intervals of less than an hour. There was some indication of more rapid forgetting for incidental than target odors. Finally, although exposure to a CS- (an odor not paired with footshock) was necessary for conditioning of the CS+ (an odor paired with footshock) in rats 8 or 12 days of age, exposure to a CS- had no influence on conditioning of the CS+ in preweanlings 18 days of age. The age-related differences in forgetting over intervals less than an hour long suggest that substantial age-related differences in forgetting can occur that, it is likely, are not accounted for by differential growth. PMID- 2760563 TI - Discrimination of duration ratios. AB - Trained pigeons to make discriminations on the basis of the ratio of two stimulus durations. A red light of one duration was followed by a green light of a different duration, with 900 red-green pairs intermixed over trials. A choice followed the red-green pair; a response to a green side key was reinforced if the red-green ratio was less than a criterion ratio, and a response to a red side key was reinforced if the ratio exceeded the criterion. Reinforcement depended on whether red or green was longer under the basic condition; in other conditions, however, reinforcement depended on whether one duration was two or four times longer than the other. Sensitivity was similar across conditions, for the basic shorter-longer rule, and for the more complex rule of one duration as two or four times the other. Most choices were made on the basis of the ratio relation between the two durations and according to Weber's law. These results extend the findings of Dreyfus, Fetterman, Smith, and Stubbs (1988), and provide a new methodology for psychophysical scaling with animals. PMID- 2760565 TI - Peroxisomes and peroxisomal disorders. April 18 to 19, 1988, Vienna. Abstracts. PMID- 2760564 TI - Characterisation of a carboxypeptidase in human serum distinct from carboxypeptidase N. AB - Arginine carboxypeptidase activity in human serum, measured with the hippuryl-L arginine substrate, is about three times higher than in human plasma. This difference is much smaller when hippuryl-L-lysine is used as the substrate. When fresh serum is incubated at 30 degrees C, the arginine and lysine carboxypeptidase activity decreases until a stable activity, close to the plasma activity, is reached. This stable carboxypeptidase activity is attributed to carboxypeptidase N. The unstable carboxypeptidase differs from carboxypeptidase N in pH-optimum, esterase activity, substrate specificity, Co2+-activation and dithiotreitol activation. Blood cells are not responsible for the release of this enzyme during coagulation. No activator of carboxypeptidase N was detectable in human serum. Ion-exchange chromatography on DEAE-cellulose confirms the presence of two different molecular forms of arginine carboxypeptidase activity. PMID- 2760566 TI - Plasmalogen biosynthesis in the diagnosis of peroxisomal disorders. AB - Fibroblasts of patients suffering from peroxisomal disorders such as chondrodysplasia punctata (rhizomelic type), neonatal adrenoleukodystrophy, Zellweger syndrome and control fibroblasts were used for the evaluation of a procedure suitable for pre- and postnatal diagnosis. This technique is based on the detection of impaired peroxisomal plasmalogen synthesis by means of a double substrate, double labelling technique using 14C-labelled hexadecanol and 3H labelled hexadecylglycerol as precursors for peroxisomal and microsomal plasmalogen synthesis. Pathological cells are characterized by a decreased utilization of hexadecanol, thus resulting in an increased 3H/14C ratio within plasmalogens. Sensitivity and reproducibility of this method were improved by changing both the chromatographic conditions and the calculation of the diagnostic parameters. PMID- 2760567 TI - Peroxisomal oxidation of pipecolic acid in the rat. AB - Postnuclear fractions from rat liver and kidney oxidize L-pipecolic acid, a by product of lysine catabolism, in a hydrogen peroxide-producing reaction. This pipecolate oxidase2) activity is enhanced in preparations from animals treated with clofibrate and thyroxine, substances known to act as peroxisome proliferators and inducers of the peroxisomal fatty acid beta-oxidation. The enzymatic activity co-purified with the peroxisomal marker fatty acyl-CoA oxidase2) rather than with the mitochondrial marker glycerol-3-phosphate dehydrogenase2). Thus the degradation of L-pipecolic acid may start in the rat with a peroxisomal oxidase comparable to other hydrogen peroxide-producing oxidases found in peroxisomes. These findings provide indirect evidence that the marked hyperpipecolinaemia described in a group of human genetic disorders connected with peroxisomal defects such as Zellweger syndrome might be due to the absence of peroxisomal L-pipecolate oxidase. PMID- 2760568 TI - External quality assessment of absorbance measurements on spectral and spectral line photometers. AB - From 1984-1987, 12 quality control surveys on photometric measurements were carried out in 600-800 laboratories. The participants measured the photometric absorbance of the control samples at 4 wavelengths of the mercury spectrum: 334.1 nm, 365.4 nm, 404.7 nm and 546.1 nm. The medians of the results were without exception lower than the target values, but only very few of them deviated more than 1%. The dispersion of the values did not follow a normal distribution. Two thirds of the values were concentrated within a very small range, while about 10% lay outside the 2- to 3-fold range. It was found that longer wavelengths resulted in a smaller dispersion of readings than shorter ones. Furthermore, precision showed a significant dependency on the absorbance readings of the samples, on the one hand, and on the different photometers, on the other. PMID- 2760569 TI - Efficacy and safety of a polyester leukocyte removal filter for whole blood and red cell concentrate filtration. AB - Patients receiving multiple whole blood transfusions often experience adverse clinical symptoms caused by leukocytes. In the present study, the efficacy and safety of a polyester filter for leukocytes (Sepacell R-500) was evaluated. Donor units of whole blood and red cell concentrate stored for varying lengths of time were filtered. Emphasis was placed on humoral parameters indicative of release and/or activation reactions of granulocytes (neutral proteinase elastase, lysozyme, aggregation, chemiluminescence) and erythrocytes (lactate dehydrogenase, plasma haemoglobin). Nonspecific adsorption effects were investigated by plasma protein determinations (albumin, alpha 2-macroglobulin). A complete blood cell count as well as values of haemoglobin and haematocrit were determined. Sepacell R-500 proved to be a highly efficient filter to the leukocyte depletion of blood. Our results of erythrocyte and granulocyte related humoral parameters provided no significant evidence of filtration mediated activation or releasing reactions of clinical consequence. PMID- 2760570 TI - Effect of sensory input from the tongue on jaw movement in normal feeding in the opossum. AB - Opossums were presented with solid and liquid foods. The movements of the jaw and tongue were recorded cineradiographically together with recordings of the EMG activity in muscles opening the jaw and moving the base of the tongue (hyoid). The jaw opening in each cycle was in two stages--01 and 02; 01 had a constant amplitude irrespective of the food ingested. Ingestion of liquid (which involved continuous accumulation of a liquid bolus in the valleculae prior to swallowing) was associated with cycles of oral movement in which 02 was small; tongue retraction was associated with this opening. In contrast, solid and semisolid food ingestion was associated with large angles of jaw opening in 02 that also coincided with the tongue retraction. In this latter case a characteristic pattern of EMG activity, in which all the muscles moving the hyoid were simultaneously active, was added to the pattern seen in lapping; this additional activity had an EMG pattern that was consistent with a jaw opening reflex. The findings contrast with other reports that the jaw opening reflex is suppressed in mastication. Experimentally induced tongue contact with a variety of solid surfaces during lapping (an activity involving accumulation of a liquid bolus in the valleculae) induced neither increased jaw opening nor the additional EMG pattern. However, in situations when there was no bolus in the valleculae, additional jaw opening activity was elicited when the tongue contracted solids intra- or extra-orally. It is suggested that the ability of sensory input, from the anterior tongue, to elicit a jaw opening reflex and to change the type of jaw/tongue cycle was dependent upon the extent of bolus accumulation in the valleculae and therefore indirectly upon the consistency of the food. PMID- 2760571 TI - High-molecular-weight serine proteinase from lobster muscle that degrades myofibrillar proteins. AB - A latent alkaline serine proteinase (ASP) has been extracted from the soluble fraction of lobster claw and abdominal muscles. The enzyme, which was irreversibly activated 30- to 40-fold by brief (2-3 min) heating at 60 degrees C, had an optimal caseinolytic activity at pH 7.75. Its molecular weight was estimated to be 740,000 by gel filtration chromatography. Serine protease inhibitors (diisopropylfluorophosphate, phenylmethanesulfonyl fluoride, soybean trypsin inhibitor, aprotinin, benzamidine, and chloromethyl ketones) suppressed ASP activity 22 to 70%. In addition, sulfhydryl-blocking reagents and hemin inhibited activity 69 to 100%; leupeptin and E-64, however, did not. Pepstatin A, ethylenediaminetetraacetate, and adenosine triphosphate were without effect. These results suggest that the lobster ASP is a serine proteinase that contains one or more sulfhydryl groups essential for catalysis. ASP was stimulated by dithiothreitol and inhibited by CaCl2 and oleic and linoleic acids. The enzyme was partially activated by low concentrations of sodium dodecyl sulfate; 0.05% produced activities 13% of that of preparations heated at 60 degrees C. Neither poly-L-lysine, urea, dimethylsulfoxide, oleic acid, linoleic acid, nor N ethylmaleimide activated the enzyme. The ASP degraded most myofibrillar proteins, but showed a preferential hydrolysis of paramyosin, troponin-I and -C, and myosin alpha light chain. PMID- 2760572 TI - Rapid postembryonic development of a cricket flight muscle. AB - The metathoracic dorsal longitudinal muscle (DLM) of the cricket Teleogryllus oceanicus differentiated and developed rapidly over the last nymphal instar. Within eight days, the muscle mass increased by a factor of 15 and the relative volume of mitochondria quadrupled, while the relative amounts of myofibril and sarcoplasmic reticulum decreased. Tracheoblasts began to invade the muscle fibers immediately before the adult molt. Muscle mass continued to increase until four days after the adult molt, but the relative volumes of the ultrastructural components did not change. Within two weeks following the adult molt, the muscles in some of the animals began to degenerate. PMID- 2760573 TI - Control of growth and ultrastructural maturation of a cricket flight muscle. AB - The metathoracic dorsal longitudinal muscle (DLM) in the cricket Teleogryllus oceanicus increased in mass and rapidly acquired interfibrillar tracheoles and an increased proportion of mitochondria around the time of the adult molt. Both neural input and juvenile hormone levels were investigated as possible factors controlling this rapid maturation. Motor axons to the muscle were cut early in the last nymphal instar, and muscle growth slowed but ultrastructural maturation continued; the percentage of muscle volume occupied by mitochondria tripled and tracheoblasts invaded the fibers in both the denervated and contralateral innervated muscles. Newly molted last instar nymphs were treated with methoprene, a juvenile hormone analog, and examined four days following the next molt. Muscle growth was slowed but not stopped. Both mitochondrial proliferation and tracheoblast formation were completely blocked by hormone treatment. This study shows that both neural input and low levels of juvenile hormone are required for muscle growth. However, ultrastructural maturation seems to depend exclusively on low levels of juvenile hormone. PMID- 2760574 TI - Daily variation in maternal and fetal weight gain in mice and hamsters. AB - Daily variation in maternal and fetal weight gain was measured in hamsters (Mesocricetus auratus) and in mice (Mus musculus, C57Bl) with free access to food or under restricted feeding schedules. Pregnant hamsters with free access to food and water were weighed twice a day and fetuses were collected twice a day from 10.5 to 14.5 days after fertilization. In three experiments, pregnant mice were given free access to food and water or were allowed food for 12 hours a day or for 6 hours a day. Pregnant mice were weighed twice a day and in the restricted feeding experiments, fetuses were collected every 6 hours from 12.0 to 14.5 days after fertilization. Pregnant mice and hamsters with free access to food showed a daily rhythm in weight gain with greater gain at night. There was no evidence of a daily rhythm in the weight gain with greater gain at night. There was no evidence of a daily rhythm in the weight gain of hamster fetuses. Mouse fetuses showed greater weight gain during two 6-hour intervals each day, the second half of each night and the second half of each day. The 12-hour variation was seen in both wet and dry fetal weight. A 24-hour rhythm in fetal growth was previously described in rats (Barr: Teratology, 7:283-288, 1973). Results in rats and mice indicate that fetal growth is modulated on a daily basis. The different periodicity observed in rats and mice might be related to the different ages of the fetuses examined. PMID- 2760575 TI - In vitro technique for studying garter snake (Thamnophis sp.) development. AB - Garter snake (Thamnophis sp.) embryos of different embryonic ages were explanted from pregnant females and grown in vitro for up to 35 days. The culture medium consisted of Eagle's Minimum Essential Medium with various organic and inorganic supplements and antibiotics. Cultured embryos were injected with tritiated thymidine, sacrificed, and processed for autoradiographic examination. The in vitro technique allowed direct visualization of external morphologic changes over time, which followed a timetable similar to that of embryos growing in vivo. This technique also allowed easier manipulation of embryos for determination of embryonic stage and for injection of tritiated thymidine. This is the first report of long-term culture of snake embryos which adds to the limited number of reptilian embryos that have been studied in vitro. PMID- 2760576 TI - Pineal sensitivity to nighttime swimming stress changes during the active season in Richardson's ground squirrels (Spermophilus richardsonii). AB - Melatonin synthesis in the pineal gland, which is primarily regulated by the environmental lighting regime, can also be influenced by other factors that elicit modifications in sympathetic tone. The objectives of this study were to determine if forced swimming alters the normal pattern of melatonin production in the pineal gland of the Richardson's ground squirrel (Spermophilus richardsonii). In early June, the squirrels were forced to swim for 10 min during the photophase or during the scotophase. In mid-July squirrels swam only during the scotophase. Animals were sacrificed 15, 30, or 60 min after the onset of swimming. Activities of pineal N-acetyltransferase (NAT) and hydroxyindole-O-methyltransferase (HIOMT) were assessed by radioenzyme assay, and pineal melatonin content was measured by radioimmunoassay. Daytime swimming elicited no major changes in enzyme activity or pineal melatonin. In June, swimming at night prevented the normal rises in NAT activity and pineal melatonin seen in nonswimming controls. In contrast, the pineals of squirrels that were tested 6 weeks later in mid-July did not appear to be as sensitive to nighttime swimming, as there were only minor differences in both NAT activity and melatonin content compared to controls. These results demonstrate that forced nighttime swimming, unlike several other aversive stimuli, can evoke changes in the normal pattern of pineal melatonin production in this species. Furthermore, the pineal's response to such stimuli may not be stable over the course of the active season. PMID- 2760577 TI - Cross-fertilization between Syrian and Chinese hamsters. AB - The role of the zona pellucida in the specificity of fertilization was studied by cross-inseminations between Syrian (Golden) and Chinese hamster gametes. Cumulus enclosed eggs from both Syrian and Chinese hamsters were placed together in one dish and inseminated with spermatozoa from either one or the other species. Fertilization always took place between gametes of homologous species. Chinese hamster spermatozoa failed to bind to the zona pellucida of Syrian hamster eggs; hence, fertilization was never observed. However, Chinese hamster spermatozoa could fertilize zona-free Syrian hamster eggs. In the reciprocal cross, a large number of Syrian hamster spermatozoa could bind to and penetrate the zonae of Chinese hamster eggs. However, fusion of Syrian hamster spermatozoa with the vitellus of zona-intact Chinese hamster eggs was never observed. After removal of the zona pellucida, only a small percentage (31%) of Syrian hamster spermatozoa could fuse with Chinese hamster vitelli. Thus, in these species, the mechanisms of interspecific gamete recognition and the prevention of interspecies fertilization seem to differ according to the direction of the cross. In Syrian hamster eggs, the block to interspecies fertilization seems to exist at the level of the zona pellucida, while in Chinese hamster eggs the block is at the level of the egg plasma membrane. The implications of these results in analyses of the genetics of spermatozoa, the molecular basis of sperm-egg recognition, and mechanisms of reproductive isolation leading to speciation, are discussed. PMID- 2760578 TI - Cytochalasin D-induced triploidy in the mouse. AB - Previous attempts to obtain digynic triploid mouse development in vivo have either been entirely or only marginally successful, generally with the production of heteroploid rather than triploid conceptuses. We report that when a single intraperitoneal injection of 15 micrograms of cytochalasin D is given to recently mated female mice during a restricted period following ovulation induced by exogenous gonadotrophins, between 14 and 18% of conceptuses isolated on the 10th day of gestation had a triploid chromosome constitution. Triploidy was only induced in those eggs that were exposed to cytochalasin D when they were passing through a critical phase of the second meiotic division corresponding to the time when the second polar body was about to be extruded. Exposure to this agent either before or after this critical period only results in the development of normal diploid conceptuses. When females were mated to males carrying an easily recognisable paternally derived 'marker' chromosome, convincing cytogenetic evidence was obtained that only digynic triploidy was induced. No examples of diandric triploidy were recognised when conceptuses were analysed on the 10th day of gestation. The technique described therefore represents a simple and direct means of inducing digynic triploid mouse conceptuses whose development potential may be compared directly with that of their normal diploid littermates. PMID- 2760579 TI - Induction of the acrosome reaction in goat spermatozoa in simple physiological salt solution. AB - The present study was carried out to determine whether K+, Mg2+, PO4(3-), and HCO3- in a medium are necessary for inducing the acrosome reaction in ejaculated goat spermatozoa. Washed goat spermatozoa were resuspended in K-1 medium, containing NaCl, KCl, CaCl2, MgCl2, NaH2PO4, and NaHCO3; in K-2 medium, containing NaCl, CaCl2, NaH2PO4, and NaHCO3; in K-3 medium, containing NaCl, CaCl2, and NaHCO3; and in K-4 medium, containing only NaCl and CaCl2, followed by preincubation in a sealed glass tube at 39.5 degrees C for 1, 2, or 3 h. The sperm acrosome reaction was evaluated by the trypan blue-Giemsa method and hamster test. The results were essentially the same in all cases. Following preincubation for 1 h, however, the percentage of acrosome-reacted spermatozoa, the proportion of zona-free hamster eggs penetrated by spermatozoa, and the average number of spermatozoa in the vitellus of these penetrated eggs were low; all values indicated a significant increase with preincubation for 2 and 3 h. The presence of K+, Mg2+, PO4(3-), and HCO3- in the medium thus does not appear necessary for inducing the acrosome reaction in goat spermatozoa, since they can undergo the reaction during preincubation in a simple physiological salt solution containing only NaCl and CaCl2 when preincubated in sealed glass tubes at 39.5 degrees C. PMID- 2760580 TI - Sudden death by inhalation of cyclopropane. AB - This paper reports the case of a 22-year-old white male who was found dead in a storage room as a result of a fatal ingestion of cyclopropane. Cyclopropane is a sweet-smelling, irritating gas. Autopsy findings revealed congestion and hemorrhagic edema of the lungs, congestion of the trachea, and early autolysis. Cyclopropane was determined by headspace gas chromatography and mass spectrometry. To our knowledge, this is the first reported fatality involving cyclopropane. PMID- 2760581 TI - Phenol: tissue distribution in a fatality. AB - A case is reported where phenol, a disinfectant, was ingested and resulted in the death of a 40-year-old white female. Concentrations of phenol were determined in blood (130 mg/L), urine (47 mg/L), bile (187 mg/L), brain (486 mg/kg), kidney (331 mg/kg), muscle (204 mg/kg), liver (228 mg/kg), and stomach content (668 mg) and compared to other cases reported in the literature. PMID- 2760582 TI - Hypersensitivity myocarditis and hepatitis associated with imipramine and its metabolite, desipramine. AB - We present two cases of myocarditis and hepatitis with histologic characteristics of hypersensitivity-mediated drug reactions associated with imipramine and its metabolite, desipramine. In one case, death was directly attributed to myocarditis; in the second case, the patient died of an acute myocardial infarct, but myocarditis may have played a contributory role. One patient was taking imipramine, and therapeutic concentrations of imipramine and desipramine were documented in postmortem blood. The other patient was receiving desipramine documented by in-patient hospital medication records. Both cases had liver lesions associated in the medical literature with adverse drug reaction to imipramine. Although myocarditis has been previously associated with amitriptyline, these cases appear to be the first reported in association with imipramine/desipramine. The fact that one patient was taking only desipramine suggests that it may be the offending agent. PMID- 2760583 TI - DNA testing not ready for court?! A tale of two surveys. PMID- 2760584 TI - Discussion of "Bite Mark Impressions: A Review of Techniques and Materials". PMID- 2760585 TI - Addendum on "Cocaine in a Pregnant Woman". PMID- 2760586 TI - Effect of hyperthermia on breath-alcohol analysis. AB - Mild hyperthermia to the extent of a 2.5 degrees C increase above normal body temperature was produced by immersion of ethanol-intoxicated subjects in a warm water bath. Hyperthermia did not influence the blood-alcohol decay curve of the subjects. Hyperthermia did cause a significant distortion of the breath-alcohol decay curve, up to as much as a 23% increase above blood-alcohol concentration. The magnitude of this distortion effect was calculated to be a 8.62% increase in breath-alcohol concentration over blood-alcohol concentration for each degree C increase in core body temperature. The forensic relevance of these results is that further support is given to previous recommendations that temperature monitoring be included in procedures for breath-alcohol analysis. This leads to the recommendation that mouth temperature be measured before breath sampling to screen for abnormal body temperature and to allow for potential use of a "temperature correction factor." This modification to existing analytical procedures would optimize the reliability of breath-ethanol analysis for prediction of blood-ethanol concentration. PMID- 2760587 TI - Observations on the specificity of breath-alcohol analyzers used for clinical and medicolegal purposes. AB - This paper deals with the application of three kinds of breath-alcohol analyzer for clinical and medicolegal purposes. The limited specificity for analyzing ethanol in expired breath has given misleading information with potential serious consequences. Three different methods of alcohol analysis are reported: semiconductor sensing (Alcotest 7310), electrochemical fuel cell (Alcolmeter SM 1), and infrared (IR) absorptiometry (IR Intoximeter 3000). Methanol could not be distinguished from ethanol with any of these breath-test instruments. When nonspecific techniques of ethanol analysis are used, the results must be considered with caution when interfering substances expelled in breath cannot be excluded. PMID- 2760588 TI - Comparison of drug abuse in different military populations. AB - Quantitative analytical data, generated at the Navy Drug Screening Laboratory, Great Lakes, Illinois, expressed as percent confirmed positives for four drugs of abuse (marijuana metabolite, cocaine metabolite, amphetamines, and opiates) are summarized and compared according to their population of origin. The four populations of interest included U.S. Navy and Marine Corps recruits and service school members. Conformed positive urines for marijuana showed a small but significant decline (p less than 0.001) from about 1.2% confirmed positive among U.S. Navy recruits entering service school commands in 1984 to 0.9% among Navy service school members in 1988 and from 2.0% among U.S. Marine Corps recruits entering service schools in 1984 to 0.8% among Marine Corps service school members in 1988. Navy and Marine Corps recruits showed a significantly higher (p less than 0.001) confirmed positive use rate (6.1 and 3.3%, respectively) compared to service school members, perhaps reflecting their recent civilian use pattern. The relatively high confirmed positive cocaine rate among all groups may have reflected an increasing trend in all populations, confirming a similar trend in high school and other civilian populations. Generally, the frequency of confirmed positive urines with amphetamines and opiates, based upon the findings at the Navy Drug Screening Laboratory at Great Lakes, has been static except for an apparent recent increase in amphetamine use in 1988. The decline in confirmed positive drug urinalyses among service school members from both the Navy and Marine Corps indicated that perhaps education and maturity had a positive effect upon their behavior. PMID- 2760589 TI - Teaching forensic psychiatry to medical students. AB - Are separate courses on forensic psychiatry available for medical students? During the 1985 to 1986 academic year, the authors surveyed all U.S. medical schools to identify courses on forensic/legal psychiatry. A minority of schools included separate courses or practicums on forensic psychiatry or mental health law. In a follow-up telephone survey, instructors of each of these courses were interviewed. Information was obtained on format of course, duration, discipline of instructor or instructors, topics covered, reading materials, institutional settings, and the number of students who took the course. The results are discussed and compared with earlier surveys. PMID- 2760590 TI - Do sex offenders minimize psychiatric symptoms? AB - With increasing frequency, forensic psychiatrists are called upon to evaluate sex offenders for the courts and criminal justice system. While many clinicians have observed that denial of paraphilia is common in sex offenders, few studies have examined whether this population has severe psychopathology other than paraphilia. Similarly, little is known about whether sex offenders minimize or deny symptoms of psychopathology when undergoing psychiatric evaluations. To study these questions, the authors administered the Minnesota Multiphasic Personality Inventory (MMPI) to 36 sex offenders, comparing the degree to which they minimized or denied psychopathology, dividing subjects among two dimensions: (a) whether they admitted to, or denied, paraphilia, and (b) whether or not they faced legal charges for sex offense. Results indicated that, first, patients who denied paraphilia were significantly more likely to minimize psychopathology than were those who admitted to paraphilia (P less than 0.05); second, patients who faced no legal charges showed significantly more psychopathology than did those who faced charges (P less than 0.05); and third, the most frequent forms of psychopathology were antisocial attitudes, depressive features, somatization, and thought disorder. These findings suggest that many sex offenders may experience, and deny, widespread and severe psychiatric symptoms in addition to their sexual disorders. PMID- 2760591 TI - Canid modification of human remains: implications for time-since-death estimations. AB - Time-since-death estimations are usually based on physical decomposition of the corpse, insect succession, and contextual associations. The rates of change and succession are based on decomposition studies, most of which control access of scavengers to the corpse; however, many naturally exposed corpses are subject to scavenger modification. These modifications change the rate of decomposition, the pattern of insect succession, and the context of associations, thus altering estimations of time since death. A controlled feeding study with captive wolves and road-killed deer is pertinent to understanding canid scavenging and how scavenging may alter postmortem changes. During feeding, the wolves commonly dismember and devour the deer in a predictable sequence. Although there are some variations in the usual sequence, the carcass is always moved, and skeletal elements are separated, diminished in size and scattered. Scavenging must, therefore, be considered in estimating time since death. PMID- 2760592 TI - Descriptive morphological features of the nose--an assessment of their importance for plastic reconstruction. AB - On a series of lateral radiographs of 154 males and 199 females from Vienna, Austria, 3 qualitative morphological features of the external nose were recorded. Their relationship to craniometric dimensions, age, and the contour of the nasal bones was tested using Wilks' stepwise discriminant analyses. All tests gave significant results at the 1% probability level, but, overall, correct assignment of the features to their categories did not exceed 61%. Although height dimensions were used for discrimination in females, the prominence of the nasal bones and age appeared to be the most important discriminating variables in both sexes. Analyses further revealed that the nasal bridge and the direction of the nasal septum are highly correlated, whereas the tip of the nose seemed to be independent; this may reflect the dependence of the latter on exogenous influences, especially nutrition. It was demonstrated that the profile line of the external nose does not follow its underlying bony structures, that is, the profile line of the nasal bones. Thus, the present study showed that obtaining soft tissue thicknesses alone is not sufficient for successful facial reconstruction, but that a more holistic approach should be used to elucidate the relationships between soft tissue cover and the underlying hyaline and bony structures. PMID- 2760593 TI - Determination of C3 phenotype in dried bloodstains using isoelectric focusing. AB - Fresh whole blood and bloodstains were analyzed by isoelectric focusing (IEF) to determine the C3 phenotype of the blood donor. Three common phenotypes exist as a result of two autosomal alleles. The three phenotypes can be identified in fresh serum or in serum samples which had been stored at -20 degrees C for more than a year. Bloodstains maintained in a desiccator at 25 or at 37 degrees C retained the native form of C3 which could be detected for at least two weeks. Beyond two weeks of storage, stains became difficult to phenotype due to decreased banding intensity. Bloodstains aged longer than one month could not be phenotyped. C3 could not be detected in human semen by the serological methods employed. PMID- 2760594 TI - Validity testing of commercial urine cocaine metabolite assays: III. Evaluation of an enzyme-linked immunosorbent assay (ELISA) for detection of cocaine and cocaine metabolite. AB - A validity assessment study was performed on the Genetic Diagnostic Enzyme Immunoassay test kit, a new enzyme-linked immunosorbent assay (GDC ELISA) for detection of cocaine and cocaine metabolite in urine. A set of 290 urine specimens, comprised of clinical cocaine urines collected from 5 male subjects who had received single doses of intravenous cocaine, drug-free urines spiked with cocaine, cocaine metabolites, cocaine isomers, and other drugs of abuse, were assayed by GDC ELISA. The results were compared with results by gas chromatography/mass spectrometry (GC/MS) assay for benzoylecgonine. Concordance was high between the GDC ELISA assay and GC/MS and with results reported earlier for other commercial assays. Detection times and specificity of the GDC ELISA antibody were most similar to those of the Abuscreen radioimmunoassay for cocaine metabolite. Overall, the assay produced no false negative or false positive results and appeared to be a reliable screening test for detection of cocaine and benzoylecgonine in human urine. PMID- 2760595 TI - The Computer-Assisted Postmortem Identification (CAPMI) system: sorting algorithm improvements. AB - Refinements to the original Computer-Assisted Postmortem Identification (CAPMI) software algorithms and general data handling were suggested as a result of observations made following the Gander plane crash of 1985. The presence of highly fragmented and scattered remains following most plane crashes suggested that changes to procedure might improve CAPMI performance for use in these types of disasters. A total of 162 ante- and postmortem dental records which had been used successfully to identify victims of the Gander disaster were coded for anonymity and used for this investigation. Changes in data construction and management were made to CAPMI, according to concepts which were thought might improve system performance, and tested. Although most tested techniques improved CAPMI performance, the data suggested that replacement of "virgin" chartings with "data unknown" results in improved performance of CAPMI largely independent of other factors. Of 162 possible record matches, the original algorithm successfully listed the true record match in the top 20 possibilities 74% of the time; the tested variations on the original algorithm yielded results across a range of 38 to 83% successes, with most techniques performing better than the original algorithm. Results of this investigation have been incorporated into improved CAPMI procedures and software. PMID- 2760596 TI - Relationship and chronology of depression, agoraphobia, and panic disorder in the general population. AB - The comorbidity of disorders and chronology of first symptoms of depression, agoraphobia, and panic disorder were investigated. The Diagnostic Interview Schedule was administered to 3258 household residents. Strong associations were shown among all three disorders. However, the comorbidity of agoraphobia and panic disorder seemed to be accounted for by the relationship of both disorders with depression. The mean age at appearance of first symptoms was earlier for agoraphobia (low teens) than for depression or panic disorder (both about age 20). The results do not support the view that panic disorder is an integral component of agoraphobia, but rather that it is more closely associated with depression. The fact that agoraphobia precedes depression casts doubt on the thesis that depression is primary to anxiety disorders. Interpretation should, however, be viewed with caution because of the retrospective nature of the diagnostic instrument. PMID- 2760597 TI - Alliance and outcome in late-life depression. AB - Older adults who met criteria for major depressive disorder were randomly assigned to behavioral, cognitive, or brief dynamic therapy. Symptoms were equally reduced across the three treatment conditions. Early in treatment, alliance ratings were obtained from both therapists and patients and were related to outcome. We calculated one therapist alliance composite score and five patient alliance factor scores. In general, no agreement was found between therapists' and patients' judgments of alliance. Levels of alliance were found to be not significantly different across the three treatment conditions. For the sample as a whole, only the patient factor of Patient Commitment was found to be associated with depressive symptoms after treatment, with the strongest findings in the cognitive therapy condition. The Patient Commitment factor uniquely contributed to outcome over and above the contribution of initial symptomatology and symptomatic change at midpoint in therapy. Expected trends of association with outcome were observed for the therapist alliance composite score in brief dynamic therapy and for the patient factor of Patient Working Capacity in both cognitive and brief dynamic therapy. Findings are discussed in terms of their theoretical and clinical implications. PMID- 2760598 TI - Replicated factor structure of the Beck Depression Inventory. AB - The factor structure of the Beck Depression Inventory (BDI) was examined in an initial sample of 407 patients and replicated in a sample of 370 patients, using principal components analysis and varimax rotation. The entire sample was 98% male, with ages ranging from 22 to 88 years. The incidence of alcoholism was 72%, and the incidence of major mental illnesses was 17%. The stable dominant first factor (cognitive) accounted for 67 to 81% of the common variance, with a correlation of .94 between the factor loadings in the initial and replication analyses. The unstable second factor (vegetative) accounted for 15% to 19% of the common variance, with a correlation of .58 in item loadings. Consequently, the BDI appears to measure the cognitive aspects of depressive severity in a global fashion, as Beck originally intended. Approximately half of the items contribute very little useful predictive information. The fact that BDI total scores are not strongly related to the traditional vegetative symptoms of depression used in psychiatry is an artifact of the original method used to construct the test and is not a statement about the fundamental characteristics of depression. PMID- 2760599 TI - Optical differences in cases of multiple personality disorder. AB - Nine patients diagnosed with multiple personality disorder (MPD) and nine control subjects role-playing MPD were given complete ophthalmological examinations to test whether the MPD subjects would show greater variability in visual functioning across alter personalities than would control subjects role-playing MPD. An analysis of variability of eight optical measures in four prominent areas of vision was performed by comparing two covariance matrices for equality. The test on the equality of the two covariance matrices showed that the two groups were significantly different (p less than .05). That is, MPD subjects had significantly more variability in visual functioning across alter personalities than did control subjects. Because the test of equality of the two covariance matrices rejected the null hypothesis, univariate analyses of variance were performed on the eight individual ophthalmological measures that comprised the matrix. The results of these analyses showed that MPD subjects had significantly more variability across alter personalities than did their control counterparts on measures of visual acuity with correction, visual acuity without correction, visual fields, manifest refraction, and eye muscle balance. The data were also analyzed for clinical significance. Blind ratings of the data were performed by comparing the results of the individual dependent measures across the alter personalities of individual MPD and control subjects according to established ophthalmological criteria. The ratings for clinical significance showed that the MPD subjects had 4.5 times the average number of changes in optical functioning between alter personalities of the control subjects, with a mean of 2.56 clinically significant changes for the MPD subjects and .55 clinically significant changes for the control subjects. This difference was also statistically significant (p less than .01). PMID- 2760600 TI - Differences between multiple personality disorder and other diagnostic groups on structured interview. AB - The Dissociative Disorders Interview Schedule was administered to 20 subjects with multiple personality disorder, 20 with schizophrenia, 20 with panic disorder, and 20 with eating disorders. The findings showed that multiple personality can be differentiated from the other groups on variables such as history of physical abuse, sexual abuse, substance abuse, sleepwalking, childhood imaginary playmates, secondary features of multiple personality and extrasensory and supernatural experiences. Those with multiple personality also differ from the other groups on DSM-III criteria for multiple personality, psychogenic amnesia, and psychogenic fugue. The groups did not differ on the number of subjects who had had a major depressive episode. PMID- 2760601 TI - The family resemblance hypothesis applied to psychiatric classification. AB - The prototype model, an alternative to the classical view of classification theory, has recently been advocated for the study of the personality disorders. A central assumption of the prototype model is the family resemblance hypothesis. This hypothesis states that the more features of a category that a patient possesses, the more prototypical the patient is of the category. In previous research, results from applying this hypothesis to psychiatric classification have been mixed. The present study investigates the family resemblance hypothesis by examining the relationship between diagnostic agreement and the number of features in personality disorder cases. PMID- 2760602 TI - gamma Aminobutyric acid uptake, release, and effect on 36Cl--influx in bovine pineal gland. AB - Two apparent affinities for Na+-dependent, 3H-GABA uptake were found in bovine pineal fragments in vitro i.e., a high affinity uptake (Km = 37 +/- 5 microM) and a low affinity uptake (Km = 435 +/- 50 microM). GABA or the neuronal and glial GABA uptake inhibitor nipecotic acid was significantly more effective than the inhibitor of the GABA glial uptake beta-alanine to decrease pineal 3H-GABA uptake. High K+ concentration release 3H-GABA in superfused bovine pineals, no differences in 3H-GABA release among fragments taken from medial, proximal or distal pineal regions being apparent. Superfusion of pineal fragments in the absence of Ca2+ but in the presence of EGTA, Mg2+ or verapamil decreased significantly 3H-GABA release induced by K+. In every case a Ca2+-independent pineal GABA release was found. Preincubation with GABA or nipecotic acid, but not with beta-alanine, blunted subsequent 3H-GABA release. GABA increased 36Cl- influx in pineal homogenates, an effect blocked by picrotoxin. Incubation of pineal homogenates in the presence of aminooxyacetic acid decreased Vmax of glutamic acid decarboxylase, without modifying its Km. These results are compatible with a transmitter or modulator role of GABA in bovine pineal gland. PMID- 2760604 TI - Cholecystokinin binding sites in the rat forebrain: effects of acute and chronic methamphetamine administration. AB - Using the in vitro quantitative receptor autoradiographical technique, changes in the binding parameters of [propionyl-3H] propionylated CCK-8 [( 3H]pCCK-8) binding sites in the rat forebrain were investigated following acute and chronic administration of methamphetamine (MAP). The (Kd)app values of [3H]pCCK-8 binding sites in the frontal medial cortex and anterior cingulate cortex were significantly reduced after a single injection of 4mg/kg MAP. On the other hand, chronic treatment (14 days) with MAP at this dose significantly decreased the Bmax value of [3H]pCCK-8 binding sites in the anterior cingulate cortex accompanied by supersensitivity of locomotor effects to MAP. These findings suggest that dopamine (DA) neurons in these two regions are functionally related to intrinsic CCK-containing cortical neurons, and that CCK subsensitivity, perhaps due to an alteration in DA transmission, is involved in MAP sensitization. These findings may be relevant to the DA hypothesis of schizophrenia. PMID- 2760603 TI - The field-stimulated vas deferens of the streptozotocin-diabetic mouse: effects of prazosin, alpha, beta-methylene ATP, and variation of stimulation parameters. AB - The question of diabetic neuropathy was studied in the field-stimulated isolated vas deferens of the mouse. The animals were treated with either buffer or streptozotocin (170 mg/kg i.v.) 2 or 4 weeks, respectively, beforehand. Stimulus response relationships were tested by variation of frequency (VF) at constant pulse width and by variation of pulse width (VP) at constant frequency. The adrenergic twitch component was eliminated by prazosin (1 microM) and the purinergic component by alpha, beta-methylene ATP (MeATP, 10 microM). The diabetes did not alter the muscular contractility (tested with KCl) and left the twitch-inhibiting effects of prazosin and MeATP unchanged, thereby revealing no difference in susceptibility between noradrenergic and purinergic mechanisms. However, in diabetic vasa, the maximal effectiveness of stimulation was decreased with VF but not VP, whereas the sensitivity of intramural neurons (50% effective frequency or pulse width, respectively) was unchanged with VF and reduced with VP. This may suggest that the diabetic neuron release less transmitter (VF), which can be compensated for by the activation of less sensitive neurons (VP). Actually, the uptake of 3H-noradrenaline into the (4 weeks-) diabetic vas was normal but the stimulation-induced fractional release of tritium was decreased by 26%. It is concluded that a sympathetic neuropathy occurred in the vas deferens of the streptozotocin-diabetic mouse. PMID- 2760605 TI - [3H] GBR 12935 binding to the dopamine uptake site in post-mortem brain tissue in schizophrenia. AB - Specific [3H] GBR 12935 binding was performed on striatal tissue (caudate nucleus) obtained post-mortem from brains of schizophrenic patients and matched controls. Scatchard analysis of left and right hemisphere caudate tissue was performed on each individual subject. Kd and Bmax values were obtained by linear regression analysis of Scatchard plots. The results indicated no change in either the density or the affinity of the dopamine uptake site between schizophrenics and controls. Comparison of left and right hemisphere data also failed to demonstrate any asymmetry in the populations of dopamine uptake sites in both groups studied. The results do not support the hypothesis of a functional alteration of presynaptic dopamine systems in the caudate nucleus in schizophrenia. PMID- 2760607 TI - Sensitivity of ocellar interneurons of the honeybee to constant and temporally modulated light. AB - Sinusoidally modulated and discrete light pulses, the parameters of which approximated natural light conditions, were used to determine the response characteristics of ocellar first-order interneurons of the worker honeybee (Apis mellifera carnica). Large ocellar interneurons which terminate within the brain (LB neurons) were recorded from intracellularly and were identified visually after dye injection. Absolute sensitivity of LB neurons to light flashes ranges from 4 X 10(9) quanta/cm2s (Q) for MOC1,7 neurons to 1 X 10(12) Q for MOC3,4. The slope of the response-intensity (R/I) functions, which were calculated for intensities between 2 X 10(9) and 4 X 10(13) Q, varies in different types of LB neurons. The strongest response is given by one group of median ocellar neurons. With constant light around 10(13) Q, most LB neurons exhibit oscillatory hyperpolarizations which, upon increasing the stimulus to even higher intensities (10(14)-10(15) Q), gradually evolve to a hyperpolarized plateau. The frequency of these oscillatory voltage fluctuations increases with the rate of modulation of the stimulating light and reaches maximum values at 5-15 Hz modulation frequency. Two groups of MOC neurons follow sinusoidally modulated light up to 32 +/- 8 Hz (n = 5) and 29 +/- 6 Hz (n = 3), respectively, whereas lateral ocellar neurons cut off at 17 +/- 5 Hz (n = 4). The possible role of LB neurons is discussed. They may be inactivated when the bee is flying in bright sunlight. PMID- 2760606 TI - Chronic immobilization stress: evidence for decreases of 5-hydroxy-tryptamine immunoreactivity and for increases of glucocorticoid receptor immunoreactivity in various brain regions of the male rat. AB - Male rats were exposed to severe 14 day immobilization stress. Body weight, body temperature, food and water intake, behavioral parameters, and serum corticosterone levels were measured during and after the stress period. On the 7th day after cessation of stress the experimental animals together with the control rats were taken to immunocytochemical analysis involving morphometry and microdensitometry of tyrosine hydroxylase (TH), 5-hydroxytryptamine (5-HT), various neuropeptide, and glucocorticoid receptor (GR) immunoreactivities (IRs) in a large number of regions of the central nervous system. In addition, adrenocorticotropic hormone (ACTH) IR was analyzed in the pituitary gland. Seven days following cessation of the chronic stress food intake, total locomotion and forward locomotion had been restored to normal. Serum corticosterone levels appeared to remain increased even 6 days following cessation of the chronic immobilization stress, probably caused by increased release of ACTH. Paraventricular corticotropin releasing hormone (CRF) IR was negatively correlated with the pituitary ACTH IR, indicating that the increase in ACTH release was produced by an increased release of CRF from the hypothalamus. The major immunocytochemical change observed 7 days after cessation of stress was a disappearance of 5-HT IR in the 5-HT cell groups B1, B2, B3, and B7. 5-HT IR in nerve terminals was only affected in the dorsal horn, where 5-HT IR was increased in the substantia gelatinosa. GR IR was found to be significantly increased in monoaminergic cell groups: serotoninergic B7, dopaminergic A12, and noradrenergic A1, A2, and A6. A trend for a reduction of TH IR was observed in nigral DA cells associated with significant reductions in TH IR in striatal DA nerve terminals. Finally, increases in 5-HT and substance P (SP) IR were found in the nerve terminals of the substantia gelatinosa of the cervical spinal cord in the stress group. In the present experimental model evidence has been obtained for a maintained activation of the hypothalamic-pituitary-adrenal axis as evaluated 7 days after cessation of severe chronic immobilization stress. The reduction of 5 HT IR in various 5-HT cell groups indicates a reduction of 5-HT synthesis, which may also be associated with reduced 5-HT release from the nerve terminals, since no depletion was observed in terminal regions and in one case an increase in 5-HT IR was noted (substantia gelatinosa).(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2760608 TI - Characterization of protein-linked glycoconjugates produced by identified neurons of Aplysia californica. AB - The biosynthetic capabilities of individual neurons of the abdominal ganglion of the marine mollusc Aplysia californica have been analyzed after intrasomatic injection of 3H-monosaccharides. Glycopeptides prepared from the metabolically labeled cells were fractionated using serial lectin affinity and gel filtration chromatography. The fractionation procedure yielded eight populations of glycopeptides, and comparison of two different neurons (R2 and R14) showed that the quantity of the individual species produced is cell-dependent. Structural analysis indicated that the glycoconjugates produced by the Aplysia neuron constitute both O- and N-linked structures as well as an unusual class of oligosaccharide whose linkage to protein is unknown. The O-linked units are small and consist only of N-acetylglucosamine or N-acetylgalactosamine attached to protein. High-mannose-type asparagine-linked units are produced by the neurons, and some of these appear to be processed to biantennary complex-type units that bind to lentil lectin-agarose. Overall, although the Aplysia neurons produce oligosaccharides of a nature similar to that produced by higher eucaryotes, the N and O-linked structures produced by the neurons do not achieve the complexity of the comparable structures produced by mammalian cells. The results provide a basis for further studies aimed at understanding the role of glycoconjugates in the development of the nervous system. PMID- 2760609 TI - Identification of protein-bound oligosaccharides on the surface of growth cones that bind to muscle cells. AB - In the accompanying paper (Gabel, Den, and Ambron, in press) it was shown that eight populations of glycopeptides are synthesized by single neurons of Aplysia californica. To see which glycopeptides might mediate interactions with target cells, we first identified glycopeptides that are transported selectively to synapses and growth cones. The giant neuron R2 was injected intrasomatically with 3H-glucosamine. Twenty-four hours later, 3H-glycopeptides in the axon and cell body were isolated and resolved by serial lectin affinity chromatography. Of the eight populations, the biantennary-type glycopeptides (GPbi) and those that bind to WGA (GPwga) were preferentially associated with rapidly transported glycoproteins. In contrast, the glycopeptide that consists of N-acetylglucosamine O-linked to ser/thr was mostly retained in the cell body. GPbi and GPwga were also preferentially transported to growth cones. Analyses of RUQ cells, exposed to 3H-glucosamine in vitro for 36 h showed an enrichment of GPbi and GPwga at the growth cone relative to the cell body. The disposition of the various glycopeptides in growing neurons was also examined using FITC lectins. FITC coupled WGA, Vicia vellosa, and lentil lectin showed extensive staining of the cell body, but only WGA stained the growth cones. To investigate if GPwga interacts specifically with target cells, these glycopeptides were isolated from the neurons of 180 abdominal ganglia. GPwga, other Aplysia glycopeptides, and glycopeptides prepared from ovalbumin were coupled separately to fluorescent spheres. The spheres were then added to muscle cells isolated from the auricle of the heart, which is innervated by many neurons from the ganglion. While spheres coupled to GPwga bound to the muscle cell surface, the other glycopeptides did not. These results indicate that glycopeptides class GPwga, found among rapidly transported glycoproteins and on the growth cone surface, is able to bind to muscle cells and may therefore play some role in neuron-target interactions. PMID- 2760610 TI - Respecification of larval proleg motoneurons during metamorphosis of the tobacco hornworm, Manduca sexta: segmental dependence and hormonal regulation. AB - The principal locomotory appendages of the Manduca sexta caterpillar, the prolegs, are present on the third through sixth abdominal segments (anal prolegs located on the terminal segment were not included in this study). Previous studies have characterized some of the proleg retractor muscles and their motoneurons. In the present study we identified additional proleg motoneurons and their putative homologs in the non-proleg-bearing segments. One of the motoneurons present in the proleg-bearing segments is absent in the non-proleg bearing segments. At pupation the prolegs are lost, their muscles degenerate, and some of their motoneurons regress structurally. Subsequently, subsets of the proleg motoneurons and their homologs in other segments die in a segment-specific pattern. This is the first report of segment-specific motoneurons, and of segment specific death of identified motoneurons, in Manduca. During adult development the surviving proleg motoneurons innervate the tergosternal muscle (TSM) and grow bilateral dendritic arbors. Dendritic growth is completed by about the 12th of the 18 days of adult development. Following adult emergence all but one of the respecified proleg motoneurons dies. The hormonal dependence of dendritic outgrowth was tested by isolating abdomens to eliminate the ecdysteroid-secreting glands in the thorax. Between the second and fifth days after pupation the motoneurons became progressively more competent to undergo dendritic outgrowth following abdomen isolation. The extent of dendritic outgrowth paralleled the degree of morphological development attained by isolated abdomens. It is concluded that ecdysteroids are required for motoneuron outgrowth, but our findings suggest that, unless an abdominal source of ecdysteroids exists in pupae, a relatively small exposure may be sufficient. PMID- 2760611 TI - Giant fiber activation of flight muscles in Drosophila: asynchrony in latency of wing depressor fibers. AB - In Drosophila, brain stimulation of the giant fiber pathway brings about highly stereotyped electrical responses in target muscles involved in the escape response. Both the order of muscle response and the latency of that response are predictable in wild-type flies. The neuronal circuit to the targets is well defined and has been used in the analysis of a number of mutant phenotypes, including induced anomalies in temperature-sensitive (ts) mutations such as shibire (shi). It has been assumed that the stereotyped response includes simultaneous activation of all six fibers of the wing depressor muscle, DLM, resulting in equal latencies for all fibers. We report here a small, but distinct, inherent difference in latency between two sets of DLM fibers in a proportion of two wild-type strains as well as in a strain carrying the ts mutation shi. This difference may occur on one or both sides of an individual, is stable over time, and persists when the motor axon is stimulated peripherally. These results, due to the circuit leading to the target, suggest that the difference in latency arises peripherally. In flies reared at the shi permissive temperature (22 degrees C), the difference is more common in shi than in wild type flies; however, in shi flies reared at 18 degrees C, the prevalence resembles that of wild-type flies. This indicates a subtle expression of the shi defect even at the presumed permissive temperature of 22 degrees C. The difference in latency is similar to that induced in shi flies whose development is affected by pupal heat pulse. Thus, correct interpretation of differences in latency, e.g., in shi/wild-type mosaic flies or in flies with mutations affecting the GF pathway, requires recognition of the inherent asynchrony that can occur between DLM fibers. PMID- 2760612 TI - Calcium environment in encrusting deposits from urinary catheters investigated by interpretation of EXAFS spectra. AB - Extended x-ray absorption fine structure (EXAFS) spectra were recorded, above the K absorption edge of Ca, from 10 encrusted urinary (Foley) catheters obtained from 10 different patients. The presence of poorly crystalline apatite was demonstrated in all the deposits, even though this phase could not be detected in the x-ray powder diffraction patterns of most samples because of the obscuring effect of struvite, which was also present. Furthermore, the EXAFS spectra could be interpreted to yield quantitative information on the average short-range structure surrounding the Ca2+ ions in the poorly crystalline apatite. PMID- 2760613 TI - Kinetic studies of mobilization of copper(II) from human serum albumin with chelating agents. AB - The kinetics of the mobilizing reactions of five chelating agents for human serum albumin (HSA)-bound copper(II) [Cu(II)] have been studied spectrophotometrically. The decreasing sequence of reaction rate has been determined to be EDTA greater than DTPA greater than EGTA greater than NTA greater than IDA. A group of mathematical models were established to define the mechanisms of the competitive reactions between low-molecular-weight ligand and macromolecular ligand. All reactions of the five chelating agents follow a process involving the intermediate ternary complexes: (formula; see text) The reactions of DTPA and EDTA were found to be different from those of EGTA, NTA, and IDA. In the former cases, the reactions are likely following an overlapping mechanism in which the rate constant k1 was closed to k2. The reactions involving the other three chelators are different in k1 much greater than k2. PMID- 2760614 TI - Characteristics of sorbitol uptake in rat glial primary cultures. AB - Uptake of [U-14C]sorbitol was studied in astrogliarich rat primary cultures. Initial rate of sorbitol uptake is proportional to sorbitol concentration between 20 microM and 400 mM. Sorbitol transport is not inhibited by glucose, fructose, and a variety of structurally related polyols, or by cytochalasin B, an inhibitor of glucose transport. Phloretin, phlorizin, filipin, and n-hexanol, all compounds that alter the properties of biological membranes, and the sulfhydryl reagent p chloromercuribenzoate inhibit sorbitol uptake to various degrees. Variation in the concentrations of extracellular Na+ and K+ does not affect transfer of sorbitol across the cell membrane. It is concluded that sorbitol is taken up into glial cells by a diffusion process, not involving a carrier and probably not through the lipid bilayer, but through a proteinaceous channel-like structure. PMID- 2760615 TI - Occurrence in brain lysosomes of a sialidase active on ganglioside. AB - A lysosomal preparation, obtained from brain homogenate of 17-day-old C57BL mice by centrifugation on a self-generating Percoll linear density gradient, showed relative specific activity (RSA) values for typical lysosomal enzymes of 40-120 and for mitochondria, plasma membrane, and cytosol markers of much lower than 1, a result indicating a high degree of homogeneity. The lysosomal preparation contained a sialidase activity that was assayed radiometrically with ganglioside [3H]GD1a and fluorimetrically with 4-methylumbelliferyl-1-alpha-D-N acetylneuraminic acid (MUB-NeuAc). The properties of the lysosomal enzyme were compared with those of the plasma membrane-bound sialidase contained in a purified synaptosomal plasma membrane fraction that was prepared from the same homogenate and assayed with the same substrates. The optimal pH was 4.2 for the lysosomal and 5.1 for the plasma membrane-bound enzyme. The apparent Km values for GD1a and MUB-NeuAc were 1.5 X 10(-5) and 4.2 X 10(-5) M, respectively, for the lysosomal enzyme and 2.7 X 10(-4) and 6.3 X 10(-5) M for the plasma membrane bound one. Triton X-100 had a predominantly inhibitory effect on the lysosomal enzyme, whereas it strongly activated the plasma membrane-bound one. The lysosomal enzyme was highly unstable on storage and freezing and thawing cycles, whereas the plasma membrane-bound one was substantially stable. The RSA value of the lysosomal sialidase in the lysosomal fraction closely resembled that of authentic lysosomal enzymes, whereas the RSA value of plasma membrane-bound sialidase in the plasma membrane fraction was very similar to that of typical plasma membrane markers.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2760616 TI - A selective increase in particulate superoxide dismutase activity in parkinsonian substantia nigra. AB - The total activity of superoxide dismutase (SOD) and cytosolic and particulate activity of SOD in human substantia nigra and cerebellum were measured by a spectrophotometric method based on the ability of SOD to inhibit the autoxidation of adrenaline. The cytosolic and particulate isoenzymes of SOD were differentiated by the inclusion of potassium cyanide which selectively inhibits cytosolic copper/zinc-dependent SOD activity. In autopsied human brains, there was no difference in total SOD activity, or the activity of SOD in cytosol in substantia nigra of patients dying with Parkinson's disease compared to age matched controls. However, the activity of the particulate form of SOD was higher in the parkinsonian substantia nigra compared to control tissue. In the cerebellum there was no difference in the total, cytosolic, or particulate activity of SOD between parkinsonian patients and age-matched controls. Increased activity of SOD in particulate fraction may be a protective response to elevated levels of toxic free radicals in the parkinsonian substantia nigra. Alternatively, increased SOD activity may induce cell death through the accumulation of hydrogen peroxide. PMID- 2760617 TI - Ganglioside composition in human meningiomas. AB - The ganglioside composition in meningioma specimens from 20 patients was analyzed to find potential meningioma-associated structures. The characterization was performed by immunological staining with specific monoclonal antibodies to ganglioside antigens and fast atom bombardment-mass spectrometry. The major gangliosides were GM3 and GD3, and most of the meningioma specimens could be divided into a "GM3-rich" or a "GD3-rich" group. Gangliosides of the gangliotetraose series were represented by GM1, GD1a, GD1b, and GT1b, which were found in minor amounts in all the specimens. The ratios of GM1/GD1a and GD1a/GD1b differed from that in normal brain, and therefore existence of this series could not be explained by contamination with brain material. Ganglioside 3'-isoLM1, found in human malignant glioma, could not be detected in any meningioma specimen. PMID- 2760618 TI - Identification of adenosine receptor in rat pineal gland: evidence for A-2 selectivity. AB - We have examined the binding of the adenosine agonist radioligands [3H]cyclohexyladenosine [( 3H]CHA), R-N6-[3H]phenylisopropyladenosine [( 3H]R PIA), and 5'-N-ethylcarboxamido[3H]adenosine [( 3H]NECA) to membranes prepared from rat pineal gland. The results showed that the A-1-selective ligands (CHA and R-PIA) had less than or equal to 10% specific binding. By contrast, [3H]NECA, a nonselective A-1/A-2 ligand, gave 72% specific binding of the total binding. This specific binding was insensitive to cyclopentyladenosine (50 nM) or R-PIA (50 microM). To characterize this binding, we used the N-ethylmaleimide pretreatment method. Under these conditions, this binding was of high affinity with a KD of 51 +/- 10 nM and an apparent Bmax of 1,060 +/- 239 fmol/mg of protein. Specific binding was unaffected by the presence of MgCl2 (10 mM) but was sensitive to guanylylimidodiphosphate (100 microM) (-25%), a result suggesting the involvement of an N-protein mechanism in the coupling of the adenosine receptor labeled by [3H]NECA to other components of the receptor complex. The rank of activity of adenosine analogues in displacing specific [3H]NECA binding was NECA greater than 2-chloroadenosine greater than S-adenosyl-L-homocysteine greater than CHA. Binding was also displaced by 3-isobutyl-1-methylxanthine (IC50 = 23.6 microM). These findings are consistent with the selective labeling by [3H]NECA of an A-2 type adenosine receptor in rat pineal membranes. PMID- 2760619 TI - Polyclonal antisera to the individual neurofilament triplet proteins: a characterization using ELISA and immunoblotting. AB - In this article, the preparation and characterization of polyclonal rabbit antisera against the individual polypeptides of bovine neurofilament (68, 150, and 200 kilodaltons) is described. Selected antisera against the 68- and 150 kilodalton neurofilament polypeptides were specific for the corresponding antigen in homogenates of bovine, rat, and human brain as judged by immunoblots. The antisera against the 200-kilodalton neurofilament polypeptide cross-reacted to some extent with the 150-kilodalton neurofilament polypeptide, especially with the human antigen. The most specific antisera were used to develop an enzyme linked immunosorbent assay (ELISA), and the cross-reactivities between the antisera and the different bovine and rat neurofilament polypeptides were determined. Contrary to the results in the immunoblots, the antiserum against the 200-kilodalton neurofilament polypeptide was subunit-specific, as was the 150 kilodalton antiserum. The 68-kilodalton antiserum displayed a minute cross reactivity against bovine 150- and 200-kilodalton neurofilaments, but it cross reacted somewhat more with the rat 150- and 200-kilodalton antigens. Even so, the subunit specificity of the antisera is high enough to enable the development of a quantitative ELISA for determination of the individual bovine or rat neurofilament polypeptides in a mixture. This study is the necessary preparation for such an assay. PMID- 2760620 TI - Postnatal development of cholecystokinin-like immunoreactivity and its mRNA level in rat brain regions. AB - Developmental changes of preprocholecystokinin mRNA (CCK mRNA) and cholecystokinin-like immunoreactivity (CCK-LI) were examined in rat brain regions (frontal cortex, colliculi, hippocampus, striatum, and cerebellum) using RNA dot blot assays with cholecystokinin (CCK) cDNA and radioimmunoassay, respectively. The CCK-LI levels in all regions examined were very low at birth. Excluding the cerebellum, the levels in these regions increased postnatally and reached adult values at 28 days of age. In contrast to CCK-LI, CCK mRNA levels changed dramatically during development. A considerable amount of CCK mRNA was detected in the frontal cortex and hippocampus at birth. The changes in the level of CCK mRNA in the frontal cortex and colliculi paralleled those of CCK-LI, including a rapid increase from 7 to 14 days of age. The synthesis of CCK mRNA preceded the appearance of CCK-LI. CCK mRNA levels in the hippocampus and striatum exhibited a transient increase, with a peak at 14 days of age. In the adult brain, the CCK mRNA levels were high in the frontal cortex, moderate in the hippocampus and colliculi, and low in the striatum. The cerebellum contained only a negligible amount of CCK mRNA during development. The relatively high level of CCK-LI compared with the low level of CCK mRNA in the striatum supports the idea that most of the striatal CCK-LI is supplied from extrastriatal regions.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2760621 TI - Antioxidant enzymes and related trace elements in aging brain capillaries and choroid plexus. AB - The activities of superoxide dismutase (SOD), glutathione peroxidase, glutathione reductase, and catalase were measured in isolated brain capillaries, choroid plexus, cerebrum, and cerebellum from rats of 2, 6, 12, and 24 months. The contents of copper, zinc, and manganese were determined in capillaries, cerebrum, and cerebellum, and the profile of fatty acids was studied in brain capillaries. In brain capillaries, the activities of glutathione peroxidase and glutathione reductase did not change with age. The activities of the two enzymes increased in cerebrum and cerebellum. In choroid plexus, glutathione peroxidase activity increased, but glutathione reductase activity remained unchanged. Catalase activity in brain capillaries declined, whereas in choroid plexus, cerebrum, and cerebellum, it did not change. The activities of the three enzymes were significantly higher in brain capillaries and choroid plexus than in cerebrum and cerebellum. SOD activity increased in the four tissues. Copper content in the capillaries increased initially and then levelled off, whereas it continued to increase in cerebrum and cerebellum. Zinc increased in brain capillaries, but did not vary in cerebrum and cerebellum. Manganese content remained constant in all tissues studied. The percent of saturated fatty acids in brain capillaries did not change with age, whereas those of mono- and polyunsaturated fatty acids increased and decreased, respectively. The possibility that a deficiency of enzymes protective against free radicals causes blood-brain barrier and blood cerebrospinal fluid barrier degeneration is ruled out. PMID- 2760622 TI - Developmental changes in the calcium dependency of gamma-aminobutyric acid release from isolated growth cones: correlation with growth cone morphology. AB - We have investigated the development of Ca2+-dependent gamma-[3H]aminobutyric acid [( 3H]GABA) release in superfused growth cone fractions isolated from rats between the postnatal ages of 1 and 11 days. We have compared this release with the overall morphology of the subcellular fractions, and identified those structures taking up [3H]GABA by electron microscopical autoradiography. In fractions isolated from rats between 1 and 5 days, K+-evoked [3H]GABA release was completely independent of extracellular Ca2+. After 5 days a Ca2+ dependency appeared, which increased with age, such that by 10 days approximately 50% of the K+-evoked release was Ca2+ dependent. Electron microscopical analysis showed that, at all ages, large numbers of GABAergic growth cones were present in the subcellular fractions. Up to postnatal day 5, the growth cones were synaptic vesicle sparse but, after this age, increasing numbers of synaptic vesicle containing growth cones were seen. These results suggest that during maturation of GABAergic growth cones into synapses there is, initially, a mechanism for release that is independent of extracellular Ca2+ and that the appearance of a Ca2+-dependent [3H]GABA release from growth cones correlates with the appearance of synaptic vesicles. PMID- 2760623 TI - tele-Methylhistamine levels and histamine turnover in nuclei of the rat hypothalamus and amygdala. AB - An HPLC method using fluorescence detection for the determination of tele methylhistamine (t-MH) was improved to a sensitivity level which enabled the detection of 0.05 pmol of tissue t-MH. The t-MH contents and the histamine turnover rates in various nuclei of the rat hypothalamus and amygdala were subsequently measured. The histamine turnover rates were estimated from pargyline induced t-MH accumulation. Both the t-MH levels and the histamine turnover rates were shown to be relatively high in the nuclei dorsomedialis and premammillaris ventralis of the hypothalamus, and also in the nucleus medialis of the amygdala. The steady-state t-MH levels in various nuclei of the hypothalamus and amygdala correlated well with the histamine turnover rates in these nuclei. PMID- 2760624 TI - Purification and characterisation of cerebellins from human and porcine cerebellum. AB - The primary human and porcine structure of the novel neuropeptide cerebellin is unknown. These peptides were, therefore, isolated by a combination of ion exchange and reverse-phase chromatography using a specific radioimmunoassay against rat cerebellin. The sequences of the peptides were deduced by mass spectrometry (for both human and porcine cerebellins) and gas-phase Edman degradation (for porcine cerebellin). In both species, two molecular forms were identified. In the human, the major form corresponded to the pentadecamer [des Ser1]-cerebellin (approximately 95% of the total) and the minor form, to the hexadecamer peptide. In the pig, however, both molecular forms were present in approximately equal amounts. The finding that the sequences of human and porcine cerebellin are identical to that of the rat suggests that strong evolutionary pressure has acted to conserve this sequence. PMID- 2760625 TI - Newly synthesized dopamine as the precursor for norepinephrine synthesis in bovine adrenomedullary chromaffin cells. AB - The precursor pool of dopamine for norepinephrine synthesis was investigated in cultured bovine adrenomedullary chromaffin cells incubated with [14C]tyrosine. Under conditions where the intracellular [14C]tyrosine specific activity was constant and [14C]dopamine synthesis was maximal, [14C]dopamine and [14C]norepinephrine accumulated over time, and the total intracellular dopamine content more than doubled within 120 min. When [14C]norepinephrine synthesis was calculated at different times based on the specific activity of [14C]dopamine, this rate was approximately equal to the rate of [14C]dopamine synthesis and was, thus, inconsistent with the observed dopamine accumulation. However, the rate of [14C]norepinephrine synthesis based on the [14C]tyrosine specific activity accounted for the dopamine accumulation, an observation suggesting that newly synthesized dopamine, i.e., dopamine with a specific activity equivalent to that of its precursor, [14C]tyrosine, is preferentially utilized for norepinephrine synthesis. Further studies showed that the subcellular distribution of [14C]dopamine was identical to that of norepinephrine and epinephrine and that the accumulated [14C]dopamine could be converted to norepinephrine within the chromaffin vesicle if dopamine uptake was blocked. Taken together, these results suggest that a small intravesicular dopamine pool, rapidly replenished by newly synthesized dopamine, serves as the substrate for dopamine beta-hydroxylase. Several mechanisms to account for this observation are discussed. PMID- 2760626 TI - Investigations on the incorporation of a tritiated ganglioside, GM1, in the injured and intact sciatic nerves of the rat. AB - Following injury of their left sciatic nerves by means of a standardized procedure, male rats received intravenous injections of a tritiated ganglioside. GM1, on different days during the process of regeneration. The rats were killed at two different times after the injection and the concentrations of the total radioactivity, nonvolatile radioactivity, and labelled GM1 were estimated in six segments of the crushed and intact sciatic nerves. The segments of the damaged nerves showed higher concentrations of radioactivity and a higher content of GM1 than the corresponding segments of the contralateral nerves. Within the immediate area of the lesion the highest levels were found on the 3rd and 6th days after the injury; the segments distal from the lesion showed the highest levels of activity on days 9 and 12. The nerve segments proximal to the site of the injury showed a low rate of radioactivity incorporation. The higher concentrations of [3H]GM1 in damaged nerves as well as the rate of incorporation as a function of time indicate that exogenous gangliosides may be involved in the processes of regeneration and have a bearing on the latter. PMID- 2760627 TI - Clinical concentrations of volatile anesthetics reduce depolarization-evoked release of [3H]norepinephrine, but not [3H]acetylcholine, from rat cerebral cortex. AB - We compared the potencies of halothane, enflurane, and methoxyflurane in producing unconsciousness in vivo and in inhibiting the release of [3H]norepinephrine and [3H]acetylcholine in vitro. Rats were anesthetized with various concentrations of each anesthetic, and responsiveness was determined by a hemostat tail pinch. Slices of cerebral cortex were equilibrated with similar concentrations of each agent in vitro, and potassium-evoked release of [3H]norepinephrine and [3H]acetylcholine was determined. For both studies, brain concentrations of the anesthetics were determined by heptane extraction and gas chromatography. Using this method, we found that brain concentrations of all three agents which caused unconsciousness in vivo also reduced depolarization evoked release of [3H]norepinephrine by approximately 30% in vitro. The release of [3H]acetylcholine was unaffected by similar concentrations of these anesthetics. Such selective interference with stimulus-secretion coupling in central noradrenergic, and possibly other, neurons might contribute to the depressant actions of volatile anesthetics. The differential effects on norepinephrine and acetylcholine release also suggest differences in the mechanisms by which these two transmitters are released. PMID- 2760628 TI - Isolated light chain of tetanus toxin inhibits exocytosis: studies in digitonin permeabilized cells. AB - Previous work indicates that the heavy chain of tetanus toxin is responsible for the binding of the toxin to the neuronal membrane and its subsequent internalization. In the present study, the light chain of tetanus toxin mimicked the holotoxin in inhibiting Ca2+-dependent secretion of [3H]norepinephrine from digitonin-permeabilized adrenal chromaffin cells. Preincubation of tetanus toxin with monoclonal antibodies to the light chain prevented the inhibition by tetanus toxin. Preincubation of tetanus toxin with nonimmune ascites fluid or with monoclonal antibodies directed against the C fragment (the C-terminal of the heavy chain) or the heavy-chain portion of the B fragment did not prevent inhibition by tetanus toxin. The data indicate that the light chain is responsible for the intracellular blockade of exocytosis. PMID- 2760629 TI - Changes in polyamine concentrations in amygdaloid-kindled rats. AB - Concentrations of the polyamines putrescine, spermidine, and spermine were investigated in the left and right amygdala and in the remaining cerebrum, in which kindling was induced by repeated application of electrical stimulation of the left amygdala of rats. In kindled rats, the concentrations of spermidine and spermine increased slightly, but elevations did not reach significant levels in any brain regions. The most profound increase was detected in the putrescine concentration in all parts of the cerebrum 1-8 h after the final stimulation. These results suggest that the increases in concentrations of polyamines, particularly of putrescine, are involved in the pathogenesis of amygdaloid kindling. PMID- 2760630 TI - Muscle glucose-6-phosphate dehydrogenase deficiency. AB - Muscle glucose-6-phosphate dehydrogenase (G6PD) deficiency is described in four clinically heterogeneous patients: an athlete who developed myoglobinuria after physical exercise; a 7-year-old, mildly mentally retarded boy, who had episodes of dark urine and high creatine kinase; and two brothers of Sardinian origin, the elder showing moderate exercise intolerance. Histochemical and biochemical studies showed a lack of G6PD activity in muscle biopsy specimens as well as in erythrocytes. G6PD characterization in erythrocytes classified these mutant enzymes as Mediterranean variant in all the patients. The deficiency was confirmed in the patients' myotubes and skin fibroblasts, where residual activity was present. Electrophoretic studies in tissue culture extracts showed that the residual muscle enzyme migrated as a single electrophoretic band like normal human muscle G6PD. PMID- 2760631 TI - Influence of nimodipine on cerebral blood flow in human cerebral ischaemia. AB - Cerebral blood flow (CBF) was measured by xenon-133 inhalation and single photon emission computerized tomography (SPECT) in 7 patients with acute cerebral ischaemia prior to and 30 min after intravenous infusion of nimodipine (1 mg). Neurological examination, CT and CBF study were performed no later than 6 h after the onset of symptoms. Regional perfusion abnormalities were seen in all patients when the CT scan was still normal. Follow-up CT revealed low-density areas roughly corresponding to the core of the perfusion defect. Nimodipine infusion significantly decreased the mean arterial blood pressure (P less than 0.01), while PaCO2 and clinical symptoms remained unchanged. A significant CBF improvement (P less than 0.05) after nimodipine was seen in the border zone of the ischaemic infarct but not in the core of the lesion or in the unaffected contralateral hemisphere. PMID- 2760632 TI - Is Parkinson's disease of early onset a separate disease entity? AB - Two groups of patients suffering from Parkinson's disease were studied. The first group consisted of 23 patients with an onset age before 40 years; in the second group of 21 patients the onset was after age 50. The clinical findings and the course of the disease were very similar in each group. In spite of a longer disease duration in the patients with early onset of the disease there was no difference in motor impairment; the younger patients did better in mental testing and they were taking less dopaminergic medication. These differences are thought to be due to the age difference rather than to the existence of different disease entities. In the early onset group more familial cases (mostly affecting siblings) were found than in the older ones. The points in favour of there being a hereditary subgroup of early onset Parkinson's disease or of environmental factors causing the disease are reviewed. PMID- 2760633 TI - Diagnostic specificity of sensory and motor nerve conduction variables in early detection of carpal tunnel syndrome. AB - In the carpal tunnel syndrome (CTS) sensory nerve conduction is more sensitive than motor conduction. However, 8%-25% of the sensory distal latencies in symptomatic hands may still be normal. A systematic study was made of the median, ulnar and radial orthodromic nerve conduction velocities (SNCV) stimulating each of the fingers separately. Four SNCVs from the median nerve, two SNCVs from the ulnar nerve and one from the radial nerve were obtained, and the ratio of the median to radial SNCV and the ratios of the median and ulnar SNCVs were estimated. The significance of these parameters in the diagnosis of the CTS was studied, and a rapid technique for the screening of nerve entrapment in the initial stages of the disease is proposed. Three hundred and seventy-five symptomatic hands were examined. Seventy-five hands showed normal distal latency, in which cases, however, the SNCV of the ring finger was always outside the normal range, while the SNCVs of the thumb, index and middle fingers were abnormal in 64%, 80% and 92% of cases respectively. The amplitudes of the sensory responses were the least sensitive of the parameters studied. Our results suggest that a study of the median nerve digital branch to the ring finger may be of value in providing an easily performed and rapid technique for screening an early median nerve entrapment at the wrist. PMID- 2760635 TI - Measurement of tendon reflexes by surface electromyography in normal subjects. AB - A simple method for measuring the tendon reflexes was developed. A manually operated, electronic reflex hammer was applied that enabled measurement of the strength of tendon taps. Reflex responses were recorded by surface electromyography. Stimulus-response relations and latencies of tendon reflexes in the biceps, triceps, quadriceps and triceps surae were examined in 40 healthy subjects. A characteristic relation between stimulus strength and response amplitude was found which could be described by an empirical function. Latencies of both arm and leg reflexes were linearly related to the height of the subjects. Variations of reflex amplitudes within and between subjects were comparable with previous results obtained with more complicated techniques. Although repeatability of measurement of the amplitude is limited by the variability of reflexes, significant agreement was found between repeated measurements. Most reflex amplitudes were diminished during repeated examination after a short interval. Both measurement and clinical examination showed the frequent occurrence of left-right asymmetry of reflex amplitudes. These left-right differences were reproducible to a significant degree on repeated measurements after more than 2 years. PMID- 2760634 TI - Treatment of idiopathic parkinsonism with L-dopa in the absence and presence of decarboxylase inhibitors: effects on plasma levels of L-dopa, dopa decarboxylase, catecholamines and 3-O-methyl-dopa. AB - The effect of levodopa (L-dopa), alone or in combination with a peripheral decarboxylase inhibitor (PDI), on plasma levels of aromatic-L-amino acid decarboxylase (ALAAD, = dopa decarboxylase), L-dopa, 3-O-methyl-dopa (3-OMD), dopamine (DA), noradrenaline, adrenaline and dopamine beta-hydroxylase has been studied. In healthy subjects and in patients with parkinsonism plasma ALAAD level fell after administration of L-dopa + benserazide, but returned to previous levels within 90 min. In a cross-sectional study blood was obtained, 2 h after dosing, from 104 patients with idiopathic parkinsonism, divided into four groups: no L-dopa treatment (group 1), L-dopa alone (group 2), L-dopa + benserazide (Madopar) (group 3) and L-dopa + carbidopa (Sinemet) (group 4). Plasma ALAAD, which was normal in groups 1 and 2, was increased 3-fold in groups 3 and 4, indicating that there was induction of ALAAD by the co-administration of PDI. Despite this induction of ALAAD, in groups 3 and 4, with half the daily L-dopa dose compared with group 2, plasma L-dopa and 3-OMD levels were 5 times higher, while plasma DA levels were not different. The DA/L-dopa ratio was decreased 5 fold in group 2 and 16-fold in groups 3 and 4 as compared with group 1. Neither 3 OMD levels nor 3-OMD/L-dopa ratios correlated with the occurrence of on-off fluctuations. In a longitudinal study of three patients started on Madopar treatment the induction of plasma ALAAD was found to occur gradually over 3-4 weeks. Further detailed pharmacokinetic studies in plasma and cerebrospinal fluid are required in order to elucidate whether the ALAAD induction by PDI may be related to the loss of clinical efficacy of combination therapy in some patients and how it is related to end-of-dose deterioration and on-off phenomena. PMID- 2760637 TI - Complete bilateral internal ophthalmoplegia as sole clinical sign of botulism: confirmation of diagnosis by single fibre electromyography. AB - A case of complete bilateral internal ophthalmoplegia as the sole clinical sign of botulism is reported. Diagnosis was immediately confirmed by single-fibre electromyography (SFEMG), which revealed abnormally high blocking (14.3%), contrasting with moderately increased jitter (mean consecutive difference in the extensor digitorum communis muscle, 43.9 microseconds). After giving equine botulinum antitoxin and simultaneous forced emptying of the bowels, ocular symptoms completely disappeared within 2 days. Six days, 5 weeks and 6 months after the first SFEMG study, the jitter was still abnormal, even becoming more so with time. Blocking, however, was only rarely observed in the follow-up studies. It is concluded that SFEMG may serve as a useful and sensitive method for the rapid diagnosis of botulinum intoxication, even in cases where no clinical signs of general muscular weakness are apparent. PMID- 2760636 TI - Total, anti-viral, and anti-myelin IgG subclass reactivity in inflammatory diseases of the central nervous system. AB - Total IgG subclass levels, anti-viral, anti-myelin basic protein (anti-MBP), and anti-ganglioside 1 (anti-GM1) IgG subclass levels were measured in 6 patients with herpes simplex virus encephalitis (HSVE), 16 with borreliosis, 8 with other bacterial infections, 12 with multiple sclerosis (MS), 13 with subacute sclerosing panencephalitis (SSPE), 5 with glioblastoma and 12 controls. Total IgG1 levels were elevated in cerebrospinal fluid (CSF) from all patient groups (but not in the controls), IgG2 in bacterial infections, IgG3 in HSVE and borreliosis and IgG4 in some SSPE patients. The anti-viral (anti-measles, varicella zoster virus and rubella) IgG antibodies in MS were restricted to IgG1, anti-measles IgG to IgG1 and sometimes IgG4 in SSPE, anti-borrelia IgG to IgG1, IgG2 and IgG3. In contrast to anti-viral antibodies, anti-MBP and GM1 antibodies belonged to IgG1, IgG3 or IgG4 in MS. The nature of the immunological activation appears to be reflected in the subclass patterns elicited in the central nervous system. Different IgG subclass patterns in infectious diseases and MS suggest a difference between antigen-specific and non-specific B-cell activation. PMID- 2760638 TI - Reversible emetine-induced myopathy with ECG abnormalities: a toxic myopathy. AB - A young anorexic woman is described with a history of progressive muscle weakness following chronic ingestion of syrup of ipecac that was used in an attempt at weight control. Electrocardiogram (ECG) showed T-wave inversion in all leads and prolongation of the Q-T interval. Electromyography was abnormal. Muscle biopsy revealed a randomized, generalized, predominantly type-2 fibre atrophy and structural alterations in oxidative enzyme stains, such as targetoid and moth eaten fibres. A few necrotic cells were actively phagocytosed. Electron microscopy revealed severe sarcomeric abnormalities with Z-line streaming, myofibrillar disorganization and increased lysosomal activity. After discontinuation of ipecac syrup, the patient noted a gradual improvement in her condition. The ECG became normal. Emetine and related drug-induced myopathies are uncommon but are of experimental interest because of their effects on mitochondria and the light they shed on autophagic mechanisms in muscle. PMID- 2760640 TI - Inhibition of carnitine palmitoyltransferase (CPT) by chlorpromazine in muscle of patients with CPT deficiency. PMID- 2760639 TI - The heart in polymyositis-dermatomyositis. AB - Fourteen patients with polymyositis-dermatomyositis (PM-DM) underwent prospective cardiac assessment with non-invasive techniques. One patient had electrocardiographic evidence of Long-Ganong-Levine syndrome with multiple supraventricular premature beats. Echocardiographically one patient had late systolic prolapse of the posterior mitral leaflet and another had paradoxical movements of the interventricular septum. The study suggests that cardiac involvement is infrequent in PM-DM. PMID- 2760641 TI - Sparing of the perineal muscles in muscular dystrophies. PMID- 2760642 TI - Spinal arteriovenous malformations and fistulae: clinical, neuroradiological and neurophysiological findings. AB - Twenty-six patients with myelographic signs suggestive of a spinal arteriovenous malformation (AVM) were examined neurologically and neurophysiologically. By selective spinal angiography it was possible to differentiate between dural arteriovenous fistulae (dAVF 20 patients) and intradural AVMs (iAVM, 6 patients). Initial complaints were nonspecific and variable, mainly consisting of sensory disorders and muscle weakness. Later, patients suffered involvement of both the upper and lower motor neurons. There was a high percentage of lower motor neuron lesions (95%), especially in dAVF patients, which were mostly of widespread distribution and included several myotomes. Electrophysiological examination regularly revealed lower neuron involvement, frequently with pathological spontaneous activity in several myotomes, pathological sensory-evoked potentials after tibial nerve stimulation, but normal sensory conduction velocities of the sural nerve, indicating sparing of the sensory ganglion. Frequently there was a discrepancy between the localization of the dural fistula or angioma and the spinal level responsible for clinical symptoms. This suggests that it may be the inadequacy of the venous drainage system to cope with the blood volume rather than the AV-shunt that is responsible for the symptoms. An early diagnosis is essential, as removal of the shunt before there has been progression to severe neurological deficits (paraplegia) is the only way to ensure a satisfactory outcome. PMID- 2760643 TI - Stroke related to cerebral amyloid angiopathy: the significance of systemic vascular disease. AB - A retrospective postmortem analysis of 25 cases of cerebral amyloid angiopathy (CAA) in the setting of Alzheimer's disease or senile dementia of the Alzheimer type (AD/SDAT) is reported. Seven patients experienced clinically significant cerebral infarcts or hemorrhages or both. There was no statistically significant difference in the incidence of infarcts or hemorrhages in hypertensive and nonhypertensive patients. Hypertension does not appear to be an additional risk factor in the causation of cerebral infarct or hemorrhage associated with CAA in the setting of AD/SDAT. Just over half of patients with CAA and significant ischemic and/or hemorrhagic brain lesions showed atherosclerosis of the circle of Willis, sometimes in the context of severe disseminated atheromatous disease. PMID- 2760644 TI - Diffuse "encephalitic" cerebral toxoplasmosis in AIDS. Report of four cases. AB - Four patients with AIDS presented with a rapidly fatal global neurological illness. CT did not show any focal lesion and gross post mortem examination of the brain was normal in three of the four cases. Microscopic examination revealed numerous widespread microglial nodules in the brain parenchyma, most containing central toxoplama cysts or free tachyzoites. Such diffuse, non-necrotic, "encephalitic" forms of cerebral toxoplasmosis appear unique to AIDS and, to our knowledge, have not been documented previously. They represent a treatable, often misdiagnosed cause of diffuse neurological involvement in AIDS patients. PMID- 2760645 TI - Autonomic neuropathy in diabetics: comparison of cardiovascular tests, neurography, and cerebral refractory period of somatosensory evoked potentials. AB - Circulatory regulation tests--postural heart rate response (PHRR), Valsalva ratio, and reaction to sustained muscle exercise--, sural nerve neurography and cerebral refractory period (CRP) of median nerve evoked potentials were measured in 17 diabetic inpatients and correlated with their clinical signs of autonomic neuropathy (AN) and sensorimotor polyneuropathy (SN). Non-diabetic inpatients (without cardiovascular or related nervous disease) served as controls. The data of the diabetics and non-diabetic age- and sex-matched inpatients were significantly different for the PHHR measured by the 30:15 ratio, sural nerve conduction velocity and sural nerve refractory period, and CRP. The results correlated with the corresponding anamnestic signs. The PHRR showed abnormal values much more frequently than the sural nerve neurography or the CRP. No correlation was found between the signs of AN and those of SN or CRP. This stresses the need for a circulatory regulation test (preferably PHRR) in any diabetic when planning narcosis, as only these AN tests can reliably predict an increased cardiovascular risk in individual patients. PMID- 2760646 TI - Skeletal muscle CK-B activity in neurogenic muscular atrophies. AB - Creatine kinase isoenzymes were determined in skeletal muscle biopsy specimens of 34 patients suffering from neurogenic muscular atrophies. The findings were compared: (1) with those of 38 control muscle samples and (2) with those in 41 muscular dystrophies and other myopathic conditions. The measurements were made by electrophoretic separation and elution of the isoenzymes and by immunoinhibition assay. The results showed that the total and specific CK activity were significantly decreased (P less than 0.005) in neurogenic atrophies in contrast to myopathic conditions where no differences from control levels were observed. This decrease was due to a decrease of the CK-M subunit activity, while the CK-B subunit was elevated. The muscle CK-MB activity was considerably elevated in muscular dystrophies (P less than 0.02) and myositis (P less than 0.001), but it was also slightly elevated in neurogenic conditions. The similarity of the muscle CK isoenzyme pattern in neurogenic atrophies and myotonic dystrophy was noted. These findings could possibly reflect considerable difference in the regeneration process of neurogenic atrophies and muscular dystrophies. PMID- 2760647 TI - Neurogenic muscle hypertrophy. Report of two cases. AB - Muscle hypertrophy is rare in denervating diseases. A patient with calf enlargement associated with L5-S1 radiculopathy and another with thenar, hypothenar, forearm and calf muscle hypertrophy in the course of chronic relapsing inflammatory demyelinating polyneuropathy are described. Gastrocnemius muscle biopsy revealed both type I and type II fibre hypertrophy in the former case and predominant type I fibre hypertrophy in the latter. Passive stretching and abnormal spontaneous muscular activity might have played a role in the origin of hypertrophy in both patients, but a satisfactory explanation for denervation hypertrophy has yet to be provided. PMID- 2760648 TI - A case of Vogt-Koyanagi-Harada syndrome in a patient affected by Hodgkin's disease. AB - The Vogt-Koyanagi-Harada (VKH) syndrome, a disease of unknown origin, characterized by inflammation of the uveal tract, retina and meninges, was observed in a patient with Hodgkin's disease (HD) who had been treated with chemotherapy and radiotherapy. Ten years later the patient developed a cluster of neurological symptoms and signs (fever, pain, bilateral hypoacousia, dizziness, uveitis and psychiatric disorder) which were initially interpreted as a relapse of HD. The diagnosis of VKH syndrome was thereafter suspected from the clinical findings, response to therapy and further evolution. During the follow-up (14 months) the patient showed a varying course; hypoacousia remained unaltered while uveitis recurred and only a partial improvement was obtained by immunosuppressive therapy. PMID- 2760649 TI - Locked-in state in Borrelia burgdorferi meningitis. AB - The case is reported of a 28-year-old woman with persistent tetraplegia following acute meningitis due to Borrelia burgdorferi infection. The patient developed erythema chronicum migrans before radicular pain occurred in the upper extremities. The poor clinical outcome was suggestive of pontine infarction due to vasculitis of branches of the basilar artery. PMID- 2760652 TI - Pregnancy and epilepsy. AB - In a prospective study, 30 pregnant epileptic patients were followed through their pregnancy to determine the effect of seizures on pregnancy and its outcome and the effect of pregnancy on seizures. An attempt was made to correlate the serum hormone and anticonvulsant drug levels with seizure frequency, complications of pregnancy, occurrence of status epilepticus and teratogenicity. In 14 patients seizure frequency increased, in 15 it remained unchanged and in 1 patient it decreased. There were 2 spontaneous abortions, 2 patients had status epilepticus and 1 offspring of a patient had a ventricular septal defect. This patient was receiving carbamazepine and diphenylhydantoin. Patients with increased seizures frequency had significantly higher oestrogen levels, lower level of progesterone and lower level of anticonvulsant drugs as compared with those with no change in seizures. Patients who had abortions and those who developed status epilepticus had high serum oestrogen levels. PMID- 2760653 TI - Increased suicide rate in cancer patients. A cohort study based on the Swedish Cancer-Environment Register. AB - Using the Swedish Cancer-Environment Register, 424,127 cancer patients were followed in the national cause-of-death register with the aim of analyzing the suicide rate among cancer patients compared with the general population. The overall Standardized Mortality Ratio (SMR) in suicide was 1.9 (95% confidence interval 1.8-2.1) for males and 1.6 (1.5-1.8) for females. The suicide rate was highest during the first year after cancer diagnosis, with an SMR of 16.0 (13.5 18.9) in males and 15.4 (11.2-20.6) in females. There were no substantial differences in suicide rate between different sites of tumor, although higher suicide rates were observed in patients with cancer in the lungs and upper airways (both sexes) and with gastro-intestinal tumors (males). Our results corroborate previous findings of an increased suicide rate among cancer patients, and indicate a need for further attention to social and psychological aspects of the care and treatment of cancer patients. PMID- 2760651 TI - Multiple sclerosis, sleep latencies and HLA antigens. AB - The role of HLA antigens, and HLA-DR2 in particular, in the determination of mean sleep onset latencies (MSOLs) in multiple sclerosis (MS) was studied. It has been suggested that this antigen may play a part in the reduction of MSOLs, since nearly 100% of patients suffering from narcolepsy are DR2-positive. A multiple sleep latency test was performed in 37 patients suffering from MS without spontaneous complaints of sleep disturbances and who were typed for HLA-A, B, C, DR and DQ. The MSOL was reduced in a total of 21 patients, in only 7 of 15 DR2 positive patients and in 12 of 21 DQw1-positive patients. However, it was reduced in 13 of 16 B8- or B14-positive patients. In contrast with this, in the absence of an early sleep onset (MSOL greater than 30 min), no HLA antigens were found to be over-represented when considered individually; only those patients positive for a group of cross-reacting HLA antigens (B5, B15, B18, B21 or B35) had an MSOL greater than 30 min. These results suggest that the genes which code for the DR2 or DQw1 antigens, which are present in nearly 100% of narcoleptics, are not solely responsible for the appearance of an early sleep onset in MS. PMID- 2760650 TI - Myoclonus and adult coeliac disease. AB - A 56-year-old woman with coeliac disease developed myoclonus of cortical origin and palatal myoclonus with lesions of subcortical white matter on magnetic resonance imaging. Myoclonus can thus be a prominent feature of coeliac disease encephalopathy. A slight vitamin E deficiency was found but does not satisfactorily explain this myoclonic encephalopathy, which remains of unknown origin. PMID- 2760654 TI - Survival of children diagnosed with acute lymphoblastic leukemia in 1977-82 in Connecticut. AB - There was no evidence for an increase in survival among all all cases (N = 104) diagnosed between 1977-82 with acute lymphoblastic leukemia (ALL) at age less than 15 years and reported to the population-based Connecticut Tumor Registry (CTR). Hazard rates were consistently higher in males vs females during the second year after diagnosis, especially in males diagnosed after 1977-78. Registry data on prognostic factors, including white blood cell (WBC) count at diagnosis and Down's syndrome (DS), and initial treatment were used to interpret survival data by sex and year of diagnosis. A statistically significant sex difference in 4-year survival among cases diagnosed in 1979-80 was related to an unusually high survival rate (i.e. 100%) in females and the occurrence of two male DS cases. Further studies are needed on sex-specific survival rates among ALL cases diagnosed after 1977-78 in population-based cancer registries, which could be improved by more complete collection of data on immunophenotype and validation of data on relapses. PMID- 2760655 TI - Vitamin C status and other nutritional indices in patients with stroke and other acute illnesses: a case-control study. AB - Sixty-three patients with acute thrombotic stroke were compared with 47 age and sex-matched patients admitted concurrently with acute ischaemic cardiac pain and a further 44 with acute noncardiovascular illnesses. Overall the stroke patients scored highest on a questionnaire designed to estimate mean daily intake of vitamin C before hospital admission. There were problems with this retrospective dietary assessment, however, and the diet scores of the 27 stroke patients able to answer the questionnaire themselves fell between those of the other two groups. There were no significant differences between the three patient groups in plasma ascorbic acid or uric acid levels, but plasma magnesium and albumin levels were higher in the stroke patients. These findings were similar for patients aged over and under 70 but intergroup differences in magnesium and albumin levels were more marked in the elderly. These results do not support the postulated inverse relationship between vitamin C status and the risk of stroke. PMID- 2760656 TI - Sample size requirements for prospective studies, with examples for coronary heart disease. AB - Methods of determining the required number of disease cases for estimation of relative odds in prospective studies are evaluated, with examples from coronary heart disease. Data from a British prospective study of coronary heart disease are used in simulation exercises to assess the reliability of estimation formulae for both continuous and categorical risk factors. For continuous risk factors, a univariate formula based on estimation of the standardized relative odds (Whittemore A. S. JAMA 1981; 76: 27-32 [1]), gives reliable estimation of the required number of disease cases, provided the risk factor has a near normal distribution. An extension of the formula to adjustment for other risk factors, was less satisfactory, perhaps because of departures from multivariate normality. For categorical risk factors, an adaption of a univariate method for case control studies (Smith PG, Day NE. Int J Epidemiol 1984; 13: 356-365 [2]), gives reliable estimates of the number of cases required. However, this depends on approximate prior knowledge of the relative odds. In general, prospective studies of coronary heart disease risk factors should aim for at least 400 cases to enable sufficient accuracy of estimation. PMID- 2760657 TI - Diagnosis deferred--the clinical spectrum of diagnostic uncertainty. AB - This study attempts to define the term "Diagnosis Deferred" (DD) and determine its natural history and outcome. It is suggested that such a "non-diagnosis" should be used when the clinical and laboratory picture cannot be explained by any known disease entity after a minimum of 5 days hospitalization. During a 9 year period (1972-1980) 250 patients (1.8%) were identified as warranting the term DD from a total of 14,098 admissions to a department of Internal Medicine. Their average stay in hospital was 11.5 days. There was no sex difference between the patients, whose average age was 42.8 +/- 17.6 years (mean +/- SD; range 14 93). Three complaints predominated: joint pains (21.6%), abdominal pain (20.4%) and chest pain (16.8%). In 103 of the patients, there was follow-up information until the diagnosis was made or for at least 24 months (average 53.0 +/- 40.0 months, range 2-186). These patients were representative of the original cohort in both age, sex and classification of symptoms. Forty-three patients (42%) were subsequently diagnosed. 58% of these patients were diagnosed as a result of a change in or appearance of a clinical symptom during the follow-up period. "The survival of diagnostic uncertainty" in 50% of the patients was 84.5 months (7 years) with a range of 2-13 years. This time was significantly shorter for chest pain than for abdominal pain (33 months vs 87 months) (p = 0.003). In patients with "Diagnosis Deferred", a diagnosis was reached in 42%; in 22% the symptoms disappeared leaving 36% undiagnosed, and a continuing clinical challenge. PMID- 2760658 TI - The use of attributable fraction in the design and interpretation of epidemiologic studies. AB - Because of the etiologic heterogeneity present in many diseases and the interaction among causal factors in the development of disease, relative risks relating any one exposure to a disease may be low, especially in the presence of common exposures. Nevertheless, in the design of epidemiologic studies, arbitrary values of relative risks are often used to determine the sample size required to detect an association between a particular exposure and a disease outcome. Such an approach may not yield adequate statistical power to detect an association. In this commentary, the authors point out the value of using the attributable fraction to determine an appropriate value of relative risk to use for sample size calculations. The approach is particularly useful in cluster investigations where the magnitude of the expected attributable fraction can be readily estimated from the observed and expected rates of disease. Specification of an attributable fraction is also useful in the design of case-control studies of etiologically heterogeneous diseases, especially when common exposures are suspected. Finally, the relationship among attributable fraction, relative risk and exposure frequency is valuable in interpreting results of an epidemiologic study and gaining insight into the differences in relative risk estimates found in various studies. PMID- 2760659 TI - Friendly control bias. PMID- 2760660 TI - Screening for cervical cancer. PMID- 2760661 TI - Improving the sensitivity of the Barthel Index for stroke rehabilitation. AB - The Barthel Index is considered to be the best of the ADL measurement scales. However, there are some scales that are more sensitive to small changes in functional independence than the Barthel Index. The sensitivity of the Barthel Index can be improved by expanding the number of categories used to record improvement in each ADL function. Suggested changes to the scoring of the Barthel Index, and guidelines for determining the level of independence are presented. These modifications and guidelines were applied in the assessment of 258 first stroke patients referred for inpatient comprehensive rehabilitation in Brisbane, Australia during 1984 calendar year. The modified scoring of the Barthel Index achieved greater sensitivity and improved reliability than the original version, without causing additional difficulty or affecting the implementation time. The internal consistency reliability coefficient for the modified scoring of the Barthel Index was 0.90, compared to 0.87 for the original scoring. PMID- 2760662 TI - The bleeding severity index: validation and comparison to other methods for classifying bleeding complications of medical therapy. AB - Reports of bleeding complications of medical therapy should be based on valid methods of classification, but the reproducibility of existing methods has not been tested. Therefore, we prospectively studied three methods to classify the severity of bleeding: a purely subjective implicit method, a previously published explicit method using brief criteria, and the bleeding severity index, which is a new explicit method using detailed criteria about the amount, rate, and consequences of bleeding. Three physicians independently reviewed abstracts of 168 patients treated with anticoagulants. The proportion of cases classified as major bleeding varied widely when the implicit method was used (2, 14 and 39%), less when the old explicit method was used (28, 40 and 47%), and not at all when the new bleeding severity index was used (20, 20 and 20%). Intraobserver agreement was excellent for both explicit methods (kappa greater than or equal to 0.95). However, interobserver agreement was better for the bleeding severity index (kappa = 0.87) than for the old explicit method (kappa = 0.69) or the implicit method (kappa = 0.39). We conclude that the classification of bleeding complications of medical therapy depends on the method used. In comparison to older methods, the bleeding severity index is highly reproducible and should be tested more widely to determine whether it can be applied to the burgeoning clinical research in anticoagulation and thrombolysis. PMID- 2760663 TI - Gender and ethnic differences in the health practices of the elderly poor. AB - Gender and ethnic differences in personal health practices were examined with a sample of 1021 Medicaid recipients aged 65 years and older. Six different health practices were examined including smoking, drinking, weight control, exercise, and social networks. Although gender differences were noted with respect to all of the health practices examined, neither men nor women were consistently favored in adhering to desired health practices. Perhaps most importantly, women were more apt than men to refrain from smoking and drinking which have been strongly linked to major health consequences. Ethnicity was also a factor in all of the health practices examined. Whereas Hispanic and Black elderly were very similar to White elderly, Asian elderly generally adhered to more desired health practices than did either Whites, Blacks, or Hispanics. The implications of these findings could benefit health promotion programs for the elderly. PMID- 2760664 TI - Blood pressure trends associated with changes in height and weight from early adolescence to young adulthood. AB - In children, blood pressure is more closely related to height and indices of maturation than to age. This study extends observations on the relationship between height, weight, maturation and blood pressure during early adolescence into young adulthood. Standardized measurements of blood pressure, height, and weight were initially obtained in all 14-15 year old adolescents (N = 304) in a rural Kentucky school system. Measurements were repeated 5 and 8 years later. Adolescents with relatively high blood pressures continued to have higher blood pressures as young adults. Increases in systolic and diastolic blood pressure over time were related to increases of relative weight in both sexes (p less than 0.0001 and p less than 0.005, respectively), and in males increases of systolic blood pressure were related to increases of height (p less than 0.005). However, males who attained their full height at younger ages had higher blood pressures both during adolescence and subsequently, as young adults. Thus blood pressure of young adults is related to blood pressure in adolescence, relative weight and change in relative weight since adolescence, and in males to age of maturation as determined by the age at which adult height is attained. PMID- 2760665 TI - Framingham study data and "established wisdom" about cigarette smoking and coronary heart disease. AB - With the Framingham Heart Study widely recognized as the most comprehensive, sustained investigation of the precursors of coronary heart disease (CHD), an examination was made of its manifold published data on the relationship of cigarette smoking to CHD and the results were compared with the "conventional wisdom" about cigarette smoking and CHD as projected by the Surgeon General. The analysis of data in the Framingham Heart Study shows that its results are inconsistent with the Surgeon General's views about cigarette smoking and coronary heart disease. The inconsistencies refer to (1) the magnitude of the association between cigarette smoking and CHD; (2) the relative incidence of CHD in "heavy" smokers and nonsmokers; (3) the independent effect of cigarette smoking on CHD; (4) the increasing risk of developing CHD with duration of cigarette smoking; (5) the effect of smoking cessation; and (6) the association between cigarette smoking and CHD in women. PMID- 2760666 TI - Bias due to conjunctiva hue and the clinical assessment of anemia. AB - The influence of conjunctiva hue on the clinical evaluation of anemia was tested by three educated non-clinicians, trained for such a purpose, in 219 healthy ambulatory subjects. Over 27% of conjunctivae were classified as pink and 72.8% as reddish; the three observers agreed on 8.2% of the pink and on 49.8% of the reddish. Anemia (hemoglobin below 10.0 g/dl) was detected in 5.4% of the subjects with pink hue, and in 3.4% of subjects with reddish hue. Between 39.7 and 62.2% of the subjects with pink conjunctiva were misclassified as anemic by at least one worker, and between 20.0 and 50.0% of those with reddish conjunctiva were misclassified as not anemic. Overall agreement on conjunctiva hue for the 219 worker pairs ranged from 69.0 to 75.0%; the three kappa coefficients were between 0.27 and 0.34. The importance of conjunctiva hue variation will depend on the objective of the assessment and on the availability of laboratory tests. Bias due to conjunctiva hue should be stressed when clinicians and field personnel are under training. PMID- 2760667 TI - Prothrombin time ratio and other factors associated with bleeding in patients treated with warfarin. AB - We previously showed that the risk of major hemorrhage in patients with venous thromboembolism treated with warfarin was strongly related to duration of anticoagulant therapy. We here report the results of a more detailed analysis of factors other than duration of warfarin therapy associated with the risk of hemorrhage in these patients. Almost 7% of patients had a major hemorrhage on warfarin and an additional 23.7% had at least one minor bleeding episode. Age, female sex, and congestive heart failure were associated with small increases in the risk of major hemorrhage but not with the risk of minor bleeding. A prothrombin time ratio greater than 2.5 was associated with a fourteen-fold increase in the risk of a major hemorrhage (95% CI 5.1, 42.7), but major hemorrhages occurred in patients on warfarin at all measured values of the prothrombin time ratio. Taken together with the findings from our previous analysis, the study suggests that prevention of bleeding in patients on warfarin would best be accomplished by minimizing the duration of warfarin therapy, by scrupulous monitoring of the prothrombin time ratio, and by considering the "therapeutic range" for the prothrombin time ratio to be somewhat less than 2.0 2.5. PMID- 2760668 TI - Psychological distress after initial treatment for breast cancer: a comparison of partial and total mastectomy. AB - This study of the relation between type of mastectomy and psychological distress was based on all newly diagnosed breast cancer patients with localized or regional disease who were surgically treated in seven Quebec City hospitals in 1984. Among 235 eligible patients, 227 (96%) participated in a home interview 3 months after diagnosis and 205 of these women gave a second interview approximately 15 months later. The Psychiatric Symptom Index (PSI) was used to measure the severity of symptoms of psychological distress. At 3 months, 38.8% of partial mastectomy patients had high PSI scores compared to 25.8% of women treated by total mastectomy (OR = 1.8, p = 0.044). Fifteen months later, percentages with high scores were identical, 35.1%, in the two treatment groups. Age appeared to modify the surgery-distress relation. These results suggest that partial mastectomy does not protect against psychological distress after breast cancer. Moreover, they highlight the importance of adequate preparation and support for all breast cancer patients, regardless of type of initial surgery. PMID- 2760669 TI - A controlled study of ischemic stroke risk in migraine patients. AB - To help resolve the uncertain relationship between migraine headache and ischemic stoke, we performed a hospital-based, case-control study. Eighty-nine cases ages 15-65 with a head computed tomography (CT) scan supported diagnosis of ischemic stroke were matched to 178 control subjects. Using information obtained by telephone interview, the patients were placed into three categories according to explicit criteria: classic migraine; common migraine; and no migraine headache. Overall, the association between migraine and ischemic stroke is significantly increased only in patients with classic migraine [odds ratio (OR) = 2.6, 95% confidence interval (CI) 1.1-6.6]. In addition, classic migraine does not appear to increase ischemic stroke when hypertension, diabetes or smoking are present; however, when these other risk factors are absent, classic migraine is strongly and significantly associated with the risk of ischemic stroke [no hypertension, OR = 5.7 (95% CI 1.6-20.2); no diabetes, OR = 3.4 (95% CI 1.2-9.3); non-smoker OR = 4.3 (95% CI 1.2-15.0)]. Since none of the migraine patients in our study had a migrainous stroke, an underlying disorder other than prolonged vasospasm may be responsible for the observed increased risk. Our data suggest that classic migraine may be a marker for patients at increased risk for ischemic stroke unrelated to a migraine attack. PMID- 2760670 TI - Weight and mortality in Finnish men. AB - Mortality rates of 22,995 Finnish men aged 25 and over followed up for a median of 12 years were analyzed in relation to body mass index (BMI) at the initial examination. All-cause mortality followed a "U"-shaped distribution, being greatest for the thinnest and fattest men at all ages, or about 1.5-fold for those with BMI less than 19.0 kg/m2 and BMI greater than or equal to 34.0 kg/m2, as compared with men of normal weight (BMI 22.0-24.9 kg/m2). Mortality from cardiovascular diseases (CVD) increased with increasing BMI beyond the normal range. This depended mostly on the association of BMI with the biological risk factors of CVD. Mortality rates from CVD were also elevated among thin men under age 55, which could not be explained by the effect of the biological variables. Mortality rates from non-cardiovascular diseases, including cancers were inversely related to BMI among men of all ages. The high overall mortality of thin men was partly but not entirely attributable to smoking, low social class and antecedent disease. We conclude that both thinness and overweight are detrimental to longevity, but through differing mechanisms and disease patterns. PMID- 2760671 TI - Medicine and the media. PMID- 2760672 TI - Toward improved tracking of childhood blood pressure: another use for vertex corrected blood pressure measurements. PMID- 2760673 TI - Improving work group decision-making effectiveness. AB - Many of the decisions in complex health care organizations are made by small work groups. Nurse administrators often lead or are highly involved in these groups, where reaching quality decisions is a critical goal. This paper examines research and information from the communications field, presenting a model for making decisions in small groups. The author identifies common pitfalls of decision making groups and presents strategies for problem solving and improved decision making. PMID- 2760674 TI - Staff nurse attitudes and the development of a nursing research program. PMID- 2760675 TI - A computerized system for staffing, billing and productivity measurement. AB - Nursing administrators are developing methods to identify nursing department costs and revenue. A patient classification system driven by computerized nurses notes was developed at LDS Hospital as part of the hospital information system. This system is used to determine appropriate staffing on all nursing units and to bill patients directly for nursing care. The data is also used to measure nursing department productivity. PMID- 2760676 TI - Patient classification system evaluation: Part 2, System selection and implementation. 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 (JONA, June) presented 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- 2760677 TI - Exercise may evoke rather than reduce stress. PMID- 2760678 TI - Perception of opportunity and job attitudes. PMID- 2760679 TI - Redesigning hospital nursing practice: the Professionally Advanced Care Team (ProACT) model, Part 1. AB - Nurse executives must lead in proactively managing care delivery in the face of an increasingly severe nursing shortage. Failure to do so invites the imposition of untenable "solutions" by outside parties. Much has been written about the magnitude and causes of the current nursing shortage. This article focuses on alternative practice models as a viable solution. Part 1 examines similarities and differences among existing models and describes the Robert Wood Johnson University Hospital ProACT model. Part 2 will discuss the process of developing and implementing this alternative nursing practice and care delivery model. PMID- 2760681 TI - Certification should be required for hiring/promotion. PMID- 2760680 TI - Legal implications of institutional standards for nurses. PMID- 2760682 TI - Certification should not be required for hiring/promotion. PMID- 2760683 TI - Fine architecture of the splenic terminal vascular bed as revealed by arterial and venous pressure-loading perfusion fixation. AB - The three-dimensional fine architecture of the red pulp of human and animal spleens, which as fixed by a modified version of the arterial and venous pressure loading perfusion fixation (AVPL perfusion fixation) method, is demonstrated by scanning and transmission electron microscopy. In the human spleen, changes in splenomegalias associated with hereditary spherocytosis and chronic portal hypertension are also introduced in addition to the normal architecture of the red pulp of spleens removed from patients with stomach cancer. The AVPL perfusion fixation of these spleens clearly visualized complicated three-dimensional fine architecture of the red pulp and provided much important information on in situ morphology and dynamic change of the terminal vascular bed, including venous pressure-dependent size change of the stomata and three-dimensional shapes of the capillary terminal, with positive proof of their opening into the cordal reticular tissue. In studies of the spleen associated with portal hypertension, the AVPL perfusion fixation is considered a necessary technique for analysis of the structural deviation closely relating to a very high venous pressure. PMID- 2760684 TI - Application of an ultrahigh-resolution scanning electron microscope (UHS-T1) to biological specimens. AB - In 1985 we developed an ultrahigh-resolution scanning electron microscope with a resolution of 0.5 nm. It is equipped with a field emission gun and an objective lens with a very short focal length. In this study we report a survey of some different preparation techniques and biological specimens using the new scanning electron microscope. Intracellular structures such as cell organelles were observed surprisingly sharper than those observed by ordinary scanning electron microscopes. However, at magnifications over 250,000 x, platinum particles could be discerned as scattered pebbles on the surface of all structures in coated materials. Using an uncoated but conductively stained specimen, we successfully observed ribosomes on a rough endoplasmic reticulum at a direct magnification of 1 million. In these images some protrusions were recognized on the ribosomes. Ferritin and immunoglobulin G were used as samples of biological macromolecules. These samples were observed without metal coating and conductive staining. The ferritin particles appeared as rounded bodies without any substructure on the surface and immunoglobulin G as complexes of three-unit bodies. In the latter the central body might correspond to the Fc fragment and two side ones to Fab fragments. We assume that ultrahigh-resolution scanning electron microscopy is an effective means for observation of the cell fine structures and biological macromolecules. It will open a new research field in biomedicine. PMID- 2760685 TI - Aclar film in biological electron mircoscopy. PMID- 2760686 TI - Fixation and EM visualization of single peeled mammalian skeletal muscle fibers. PMID- 2760687 TI - Three-dimensional morphometrical study of dendritic spines of the granule cell in the rat dentate gyrus with HVEM stereo images. AB - Number, length, and diameters of dendritic spines of the granule cell in the dorsal leaf of the rat dentate gyrus were measured by using high-voltage electron microscope stereo images of 5-micron-thick Golgi preparations with the aid of a three-dimensional image analyzer system. Spine densities of 2.02 +/- 0.28, 2.28 +/- 0.33, and 3.36 +/- 0.35 per 1 micron at distal, middle, and proximal portions of the dendrite were obtained. These values were about 1.6-fold of the previous light microscopical report. Mean three-dimensional spine length were 1.244 +/- 0.506 micron, 1.262 +/- 0.563 micron, and 1.254 +/- 0.584 micron at distal, middle, and proximal portions, respectively, which were about 1.4 times longer than those measured in two dimensions. By using measured morphometrical parameters of spines such as lengths, diameters, and population densities, total spine surface areas of 2.401 micron 2, 2.806 micron 2, and 4.180 micron 2 per 1 micron of the dendrite at distal, middle, and proximal portions, respectively, were obtained. The total surface area of dendrite was about doubled by the addition of the spines at each dendritic portion. The advantageous features and the problems of the present method are discussed. PMID- 2760688 TI - Ultrastructural features of the AIDS virus (HIV) and its morphogenesis. AB - HIV particles were usually seen on the surface of established lymphoid cells derived from AIDS patients or on CEM cells infected with HIV, and sometimes in cytoplasmic vacuoles. The virus particles were formed by a budding process from the plasma membrane of an infected cell. The budding particles were of a doughnut form. Various profiles of virus particles were seen extracellularly: type 1 had a bar-shaped, electron-dense core, type 2 had a central and type 3 an eccentric electron-dense round core, type 4 was doughnut-shaped, and type 5 had a layered core. However, projection patterns of the AIDS virus model suggested that type 1, 2 and 3 particles are similar. Therefore, the AIDS virus may be one of three main types: with or without a dense core, and with a layered core. It is thought that a particle with a layered core and a doughnut-type particle may be immature viruses. PMID- 2760689 TI - Branched-chain alpha-ketoacids and related acids in thiamin-deprived rats. AB - We showed elevated plasma levels of branched-chain amino acids, alpha-ketoacids, alpha-hydroxyacids in thiamin-deprived rats, which had decreased liver thiamin levels (2.4% of control) after 4 weeks of feeding of thiamin-deficient diet. The ratios of mean levels of these acids in thiamin-deficient rats to those in control rats were as follows: total branched-chain amino acids 1.6; total branched-chain alpha-ketoacids 2.7; total branched-chain alpha-hydroxyacids 3.6; pyruvic acid 1.6. The plasma level of total branched-chain alpha-hydroxyacids was correlated to liver thiamin concentration (r = -0.67, p less than 0.01), but those of the other two acids were not correlated. Although the increased levels of branched-chain acids in thiamin-deprived rats were less remarkable than those of ill patients with maple syrup urine disease, they reflect the reportedly decreased branched-chain alpha-ketoacid dehydrogenase activities (about 40% of control), and we discussed whether the toxic effects of individual branched-chain acid could be demonstrated by its administration to the thiamin-deprived rats. PMID- 2760690 TI - Determination of vitamin B6 derivatives in foods and biological materials by reversed-phase HPLC. AB - Through use of a simplified analyzing system, seven vitamin B6 derivatives were determined with a satisfactory sensitivity and precision. This system consisted of a single reversed-phase ODS column with a fluorescence detector employing an isocratic solvent system. Each vitamin B6 derivative in some foods and biological materials was determined, based on the measurement of the integrated peak area. The data obtained by this method were compared with those obtained from a bioassay by Saccharomyces uvarum ATCC 9080, after acid hydrolysis of these materials. PMID- 2760691 TI - The effect of riboflavin deficiency on cerebrum and cerebellum of developing rat brain. AB - After 21-day-old weanling rats were maintained on diets deficient in riboflavin the weights of their brains were 19.8% less than those of rats on control diets. In riboflavin deficiency, the myelin lipids, cerebrosides, and sphingomyelin, as well as phosphatidylethanolamine, a significant component of the myelin membrane, were considerably reduced in proportion. It is considered that riboflavin plays some role in the metabolism of essential fatty acids in brain lipids and the pathological effect of its deficiency is similar to that of essential fatty acid deficiency, causing a fast impairment to brain development and maturation. PMID- 2760692 TI - Comparisons of urinary creatinine, skeletal muscle mass, and indices of muscle protein catabolism in rats fed ad libitum, with restricted food intake, and deprived of food. AB - Urinary excretions of creatinine (CR) and 3-methylhistidine (3-MeHis), and skeletal muscle mass (SKM) were measured in rats (male, Wistar, weighing about 290 g) fed a 20% casein diet ad libitum, rats restricted to 70% of the food intake of the ad libitum group, and rats deprived of food for 20 days. At the same time, catabolic rates of muscle protein derived from 3-MeHis/CR, 3-MeHis/BW, and 3-MeHis/SKM were compared. The CR/SKM ratio in the energy-restricted group was similar to the ad libitum group, while the ratio was higher in the food deprived group than in the other two groups. This means that CR excretion was promoted per unit of skeletal muscle mass by food deprivation. These results indicate that CR excretion can be an index for SKM under the condition of energy restriction, but not under the condition of food deprivation. The present data also suggest that it is possible to use the 3-MeHis/CR ratio instead of 3 MeHis/SKM which is the most reliable index of the three indices, under the condition of mild energy restriction. In food deprivation, however, the 3 MeHis/CR data tended to underestimate the catabolic rate of muscle protein compared with the 3-MeHis/SKM data. The 3-MeHis/BW data was similar to the 3 MeHis/SKM with all dietary conditions. The catabolic rate of muscle protein was constant or decreased very slightly under ad libitum feeding, decreased slightly in energy restriction, and increased drastically with food deprivation. PMID- 2760693 TI - A simple field test for assessing salt balance in heat-stressed miners. AB - A simple colorimetric test for urinary chloride (Fantus test) corrected for urine specific gravity (measured by refractometry) enabled 24-hour urinary sodium excretion rates to be predicted accurately from a single spot sample of urine. In 29 acclimatized miners working in an environment in excess of 40 degrees C, salt conserving mechanisms, involving renin and aldosterone, were not active until the urinary sodium excretion rate fell below 50 mmol/24 h. A predicted sodium excretion rate greater than 50 mmol/24 h indicates that dietary sodium supplementation is not necessary. PMID- 2760695 TI - Health insurance claims as a source of morbidity data. Du Pont Company's experience. PMID- 2760694 TI - Locations of fatal work injuries in the United States: 1980 to 1985. AB - Surveillance of injury at work is beset with problems of method and definition. As a result, national agencies have widely varying estimates of the number of fatal work injuries in the United States. One plausible method for identifying fatal work injuries is to use the Place of Injury variable, which is entered on all US death certificates but is not encoded by the National Center for Health Statistics. To use this method, one would assume that work injuries largely occur at "typical work sites," ie, places coded as industrial, farm, and mine and quarry. Data to test this method were derived from the National Traumatic Occupational Fatality data base maintained by the National Institute for Occupational Safety and Health. Analysis of this data base showed that work related fatal injuries mostly occur in places where many non-work-related injuries also occur. Only about one third of fatal work injuries took place at locations coded as industrial, farm, and mine and quarry. As a method for identifying fatal work injuries, the Place of Injury variable appears to have little value. PMID- 2760696 TI - Bedside case presentations: why patients like them but learners don't. AB - STUDY OBJECTIVE: To determine current attitudes of patients, medical students, housestaff, and clinical faculty toward bedside case presentations. DESIGN: Survey using multiple-choice questionnaire and open comments for students, housestaff, and faculty, and a structured interview of patients. SETTING: Major teaching hospitals on the campus of a midwestern medical school, staffed by full time faculty. PARTICIPANTS: 136 medical students, 58 housestaff, 66 faculty, and 73 patients. MEASUREMENTS AND MAIN RESULTS: 85% of patients liked the case presentation discussion at the bedside, but 95% of both students and housestaff felt more comfortable with such discussion away from the patient. Attending faculty were about evenly divided in preference, with the younger staff preferring the conference room setting. Most patients (88%) opposed rounds in the hallway. Duration of rounds of one to two hours was felt desirable by most, but 50% of students preferred a duration of less than one hour. For length of new patient case presentation, 60% of learners again favored brevity, less than 5 minutes. CONCLUSIONS: Bedside rounds are an opportunity to sharpen diagnostic skills and to demonstrate the art of medicine. They are undervalued by learners and younger faculty but appreciated by patients. The authors recommend that faculty improve bedside rounds by assessing team members' educational needs, by cultivating sensitivity and respect for the needs of all parties, and by assuring pertinence and brevity of bedside discussion. PMID- 2760697 TI - Assessing quality of a diagnostic test evaluation. AB - OBJECTIVE: To develop a standardized scale for assessing the quality of a diagnostic test evaluation. DESIGN: Fourteen participants with formal and practical experience in evaluating diagnostic tests formed a consensus panel. Panel members identified and weighted questions that should be addressed when assessing the quality of a diagnostic test evaluation. SETTING: General internal medicine division at an academic medical center. RESULTS: A 19-item weighted scale was developed. It prioritizes and addresses issues such as description of the proposed purpose of the test; appropriate selection and description of the study population; appropriate performance and description of the diagnostic test; appropriate selection and performance of the reference standard; and adequate presentation of test characteristics. CONCLUSIONS: The scale is proposed as a useful instrument for readers, investigators, reviewers, and editors, because it represents an updated synthesis of important criteria to consider when evaluating diagnostic tests. It can also be used to rate quantitatively the quality of diagnostic test evaluations. PMID- 2760698 TI - Physician recognition of ophthalmoscopic signs of open-angle glaucoma: effect of an educational program. AB - OBJECTIVE: To evaluate a short educational intervention instructing primary care physicians in the recognition of glaucomatous changes of the optic disc. DESIGN: Comparison of performances on a pretest and a posttest consisting of fundus slides in color. SETTING: Educational conferences at two university-affiliated teaching hospitals and one staff-model health maintenance organization. SUBJECTS: Thirty-six internal medicine residents and ten practicing internists. INTERVENTION: A 20-minute slide/narration educational program, which covered diagnostic criteria for open-angle glaucoma, normal and abnormal optic disc anatomy, and funduscopic signs of open-angle glaucoma. MEASUREMENTS AND MAIN RESULTS: Following the intervention, residents showed improved sensitivity (0.76 to 0.88, p = 0.007), specificity (0.65 to 0.88, p less than 0.001), and accuracy (0.71 to 0.88, p less than 0.001). Internists showed similar increments in sensitivity, specificity, and accuracy: 0.67 to 0.86 (p = 0.01), 0.59 to 0.84 (p = 0.01), and 0.63 to 0.85 (p = 0.002), respectively. CONCLUSION: A brief educational intervention can result in meaningful improvement in physician diagnostic accuracy in recognizing ophthalmoscopic signs of open-angle glaucoma. PMID- 2760699 TI - The autopsy: its role in the evaluation of patient care. AB - OBJECTIVE: To determine whether autopsies improve the detection of major clinical errors. DESIGN: Retrospective chart review of all deaths for a 30-month period to detect major clinical errors when a correct diagnosis and institution of proper therapy would have prolonged the patient's life, with comparison of autopsied patients with those without an autopsy. SETTING: Small government hospital inpatient medical service. PATIENTS: 335 consecutive deaths with 141 [42%] autopsies. MAIN RESULTS: Review of the clinical records of cases without autopsy led to the discovery of only two major clinical errors [1%], whereas 19 major clinical errors [13%] were detected in autopsy cases. Three of the 19 errors in autopsy patients would have been detected by chart review alone. Thirteen of the 19 clinical errors in autopsied patients were related to infections that were missed or were not treated appropriately because of misdiagnosis. CONCLUSION: Autopsies continue to reveal unanticipated and important information that is essential for internal medicine residency training and for the evaluation of the quality of medical care. PMID- 2760700 TI - The content of internal medicine residency training and its relevance to the practice of medicine: implications for primary care curricula. AB - Using survey items from Kern et al. (1985), 192 former residents rated their preparation in, and the importance of, three content areas of their residency training ("basic skill and knowledge areas," "allied medical disciplines," and "areas related to the practice of medicine"). Mean ratings replicated those reported by Kern et al. (r = 0.70 to 0.97, p less than 0.004). Using additional data about current practice patterns, ratings by general internists were compared with ratings by subspecialists. Both groups identified basic skill and knowledge areas as most important and felt that many areas related to practice management had been underemphasized. Most allied medical disciplines, however, were more important to generalists. Exposure to non-internal medicine areas seems important for residents considering subspecialization. However, all residents may benefit from increased emphasis on basic clinical skills and practice management. Program directors may want to address these issues, given the recent decline in applications to internal medicine programs. PMID- 2760701 TI - Gender differences in the clinical competence of residents in internal medicine. AB - OBJECTIVE: To study the differences between cognitive and noncognitive skills of men and those of women entering internal medicine. DESIGN: Comparison of program directors' ratings of overall clinical competence and its specific components and pass rates for men and women taking the Certifying Examinations in Internal Medicine in 1984-1987. PARTICIPANTS: 14,340 U.S. and Canadian graduates taking the Certifying Examinations of the American Board of Internal Medicine for the first time in 1984-1987. MEASUREMENTS/RESULTS: Average program directors' ratings of overall competence were 6.70-6.78 for men and 6.60-6.71 for women. The greatest differences in ratings of specific components of competence were in the areas of medical knowledge and procedural skills, where men were rated higher than women, and humanistic qualities, where women were rated higher than men. Pass rates were stable over the four years of the study, and ranged from 85 to 86% for men and from 79 to 81% for women. Men consistently performed slightly better than women regardless of the type of residency or quality of medical school attended. CONCLUSIONS: Small but consistent differences were found in the performances of men and those of women completing training in Internal Medicine as measured by program directors' ratings and ABIM Certifying Examination performances. PMID- 2760702 TI - The public's health care paradigm is shifting: medicine must swing with it. PMID- 2760703 TI - A strategy to define the role of the primary care physician in occupational and environmental medicine. AB - Although occupational medicine has its own unique knowledge, skills, and organizational base, it exists in a cultural, social, and organizational environment that is common to other institutions in our culture. It is therefore possible that the task of introducing the practice of occupational medicine into primary care can be made easier by examining the experience of those who have already attempted to introduce preventive Cardiology Academic Award provides a potential paradigm for enlisting a cadre of 10 to 25 innovative primary care physicians who would begin to develop actual practice models and disseminate their findings about the implementation of occupational medicine in primary care. Introducing preventive cardiology into primary care has required that multiple barriers be overcome; it is not unreasonable to expect that occupational medicine will face many of the same barriers. However, if these barriers can be successfully overcome at the experimental sites, the result will be a group of primary care practices that can be used as models for the expansion of occupational medicine to primary care in general. PMID- 2760704 TI - The context of the paradigm shift. PMID- 2760705 TI - Shifting or expanding medical paradigm? PMID- 2760706 TI - The language of patient care. PMID- 2760707 TI - Systolic blood pressure as a prognostic factor in acute pulmonary edema. PMID- 2760708 TI - Normative judgments and personal preferences. PMID- 2760709 TI - Job performance and prescription vs. non-prescription drugs. PMID- 2760711 TI - Modern approaches to blood pressure measurements: patient education. IVth Swiss Hypertension Workshop. 15-17 September 1988, Stein am Rhein, Switzerland. Proceedings. PMID- 2760710 TI - Why a family doctor? PMID- 2760712 TI - Computer-assisted shared care: the Aberdeen Blood Pressure Clinic. AB - A computer-assisted shared-care follow-up system, the patient record system, was used to follow up more than 3300 patients referred for assessment of hypertension. The patients are being followed up in collaboration with more than 250 general practitioners either in the hospital or in general practice, according to the assessment at each visit. The follow-up incorporates measures to control blood pressure below arbitrary target levels. Clinically important information is shared between doctors and between doctors and patients in order to highlight patients at risk, poor control of blood pressure, drug-host and drug drug interactions and adverse reactions and to optimize the process and outcome of care. PMID- 2760713 TI - The need for a standardized protocol for validating non-invasive ambulatory blood pressure measuring devices. AB - Increasing interest in ambulatory blood pressure measurement has resulted in the proliferation of non-invasive measurement systems. This paper discusses the problems associated with validation of these systems. There is an urgent requirement for a standardized protocol for validation of ambulatory systems which is practicable, universally applicable and which is acceptable to investigators, publishing houses and the manufacturing industry. PMID- 2760714 TI - Technical possibilities and limits of indirect automatic twenty-four-hour blood pressure devices. AB - Automatic 24-h indirect ambulatory monitoring of blood pressure and heart rate was performed in 758 patients. The blood pressure profiles of 1105 subjects were evaluated for 5 years using seven different monitors: Pill (Del Mar Avionics), PHYSIOPORT (Natic), Accutracker (Oxford), BDS (Medizintechnik), SL 5200, SL 90202 and SL 90207 (Spacelabs). The monitors were equipped with auscultatory and/or oscillometric devices, provided accurate readings and were repeatedly used up to eight times in some patients. Up to 100 data points per 24 h provided circadian blood pressure profiles for over 91% of the patients in clinical and non-clinical situations. Early identification of borderline hypertensives at risk and detailed information on the efficacy of different antihypertensive regimens may in part justify the high costs of the monitors. Although sleep disturbance continued in more than 24% of investigated patients, the new lighter, quieter monitors (e.g. SL 90207, 380 g) were well received by patients and nurses. In the future, simultaneous registration with 24-h ECG may help in identifying the effects of different antihypertensive therapies on blood pressure variability and rhythmicity of the heart rate. PMID- 2760715 TI - Can secondary hypertension be identified by twenty-four-hour ambulatory pressure monitoring? AB - Circadian blood pressure rhythms were examined in subjects exhibiting various forms of secondary and essential hypertension and in normotensive subjects with and without renal disease. Indirect ambulatory blood pressure recordings were performed in 284 subjects for 24 h. In contrast to patients with essential hypertension and to normotensive healthy subjects, the circadian fluctuations of blood pressure were reduced in secondary hypertensives and in normotensive renal patients. In renal hypertensives, these alterations in the diurnal blood pressure variations were dependent on the degree of renal failure. Calculations based on comparisons of the mean sleeping and mean daytime blood pressures identified 89.8% of the essential hypertensives and 72.5% of the patients with secondary hypertension. A large proportion of the patients with secondary hypertension had very high blood pressure levels during sleep, in many cases even exceeding the daytime levels. Thus, 24-h ambulatory blood pressure curves from patients with secondary and essential hypertension can be distinguished from each other. In secondary hypertension, blood pressure monitoring during both day and night is particularly useful for evaluating frequently severe nocturnal hypertension, which may require particular treatment. PMID- 2760716 TI - Standardized stress testing in the cardiovascular laboratory: has it any bearing on ambulatory blood pressure values? AB - We examined 77 males (mean age 45 years; mean casual blood pressure 139/94 mmHg; no secondary hypertension) to evaluate the relationship between cardiovascular measures from standardized stress testing (mental arithmetic, cold pressor test) in the laboratory and 24-h ambulatory recordings of blood pressure and the heart rate. The basic relationship between laboratory and ambulatory recordings was calculated by correlating the mean of our laboratory values with 24-h mean ambulatory values. Laboratory readings of baseline and stress systolic blood pressure, diastolic blood pressure and the heart rate correlated significantly (P less than 0.05) with ambulatory recordings of 24-h means and short-period means (e.g. baseline systolic blood pressure with work mean, r = 0.33; with mean, r = 0.33). However, the correlations were no closer than the basic relationship between laboratory examinations and ambulatory recordings (r = 0.41 for systolic blood pressure; r = 0.46 for diastolic blood pressure; r = 0.43 for heart rate). There was no specifically close correlation between laboratory baseline and the corresponding ambulatory rest phase (evening, sleep) or between laboratory stress values and ambulatory phases of high demand (work mean). Reactivity measures in the laboratory (stress values-baseline values) were correlated to measures of variability in ambulatory recordings (standard deviation; coefficient of variation; maximum, minimum value; range), but, again, there was no specific effect separating similar from non-similar phases. We conclude that laboratory measures have no specific bearing on ambulatory blood pressure and heart rate measures. PMID- 2760717 TI - Blood pressure self-measurement in normotensive and hypertensive patients. AB - In this study casual blood pressure was compared with home blood pressure measurement in 41 normotensive, 39 hypertensive and 21 borderline hypertensive subjects. The average casual readings for the whole group were 8.6 mmHg higher for systolic and 4.0 mmHg higher for diastolic pressures than self-determined values. Casual and home-registered blood pressures showed a highly significant relationship (P less than 0.001) for both systolic and diastolic blood pressure readings. In the distribution of self-measured diastolic blood pressure readings, normotensive subjects rarely (5%) showed values higher than 90 mmHg, whereas hypertensive subjects had a relatively high percentage of diastolic readings above that level (55%). The results confirm previous reports of lower self determined than casual blood pressure values. However, the high correlation between these two methods of blood pressure measurement indicates that in general there is a quantitative rather than a qualitative difference between casual and self-registered blood pressures. Finally, self-registered diastolic values exceeding 90 mmHg may be interpreted as hypertensive. PMID- 2760718 TI - Comparison of parameters for assessing blood pressure and heart rate variability from non-invasive twenty-four-hour blood pressure monitoring. AB - Cardiovascular psychophysiologists often express variability in successive data as the root of the mean squared successive differences. Other parameters of variability, such as the standard deviation and the coefficient of variation, are largely determined by slow (such as circadian) rhythms or linear trends. When the parameters of variability in blood pressure data are calculated each hour over an increasing period of time (to simulate the termination of the blood pressure monitoring after a variable duration), standard deviations and coefficients of variation increase due to the decrease in blood pressure levels at evening and night, but the root of the mean squared successive differences does not. The advantage of using the root of the mean squared successive differences as a parameter of blood pressure variability is shown in data from 147 outpatients with 10784 blood pressure readings. PMID- 2760719 TI - Education of the hypertensive patient: the Ann Arbor approach. AB - A patient education booklet was developed, based on patient behaviours identified as necessary for the control of hypertension. Use of the booklet increased patients' knowledge and helped to establish the desired behaviours. There were no adverse psychological effects on the subjects. Long-term usefulness of the booklet was assessed in 148 patients, whose motivation increased without increased anxiety. We conclude that educationally sound instructional materials complement the medical management of hypertension. PMID- 2760720 TI - Patient education in hypertension: five essential steps. AB - Greater medical education of patients requires individualized strategies with improved efficacy and effectiveness. We present a model for interactive patient education that has grown from our clinical work with patients who have multiple cardiovascular risk factors. The model distinguishes five stages in the process of a patient's health behavioural change (awareness, intention, trial, implementation and maintenance), and it links each stage with one of five different types of educational intervention (information exchange, negotiating readiness to change, building instrumental skills, developing coping behaviour and enhancing social support). The model provides the framework for a structured approach to more useful and efficient patient education which defines specific tasks and skills to be taught, learned and practised in a systematic and consistent manner. PMID- 2760721 TI - Educating nurses in blood pressure measurement and hypertension control. AB - Today, self-measurement of blood pressure is seen as the optimal goal in improving the compliance of the hypertensive patient, but it can only be reached by using well trained medical staff. In this, the role of nurses is particularly vital. We administered a questionnaire to 77 nurses and 146 doctors to determine their levels of knowledge concerning blood pressure measurement techniques and pitfalls, and definition of hypertension. The general knowledge of both groups was insufficient. Whereas doctors showed greater medical knowledge, nurses were better at the techniques. Both were equally deficient in defining hypertension. We therefore set up a short course (3h) in blood pressure measurement to evaluate knowledge and provide further training. The course consisted of a pretest, a short training programme and a post-training test. Post-training test results showed an average improvement in defining hypertension from 5% to 85%. We conclude that short-term training courses in blood pressure measurement are needed for nurses and doctors, particularly young doctors. We also need more coverage in the medical press to stimulate interest in this vital topic. PMID- 2760722 TI - Structure from two orthographic views of rigid motion. AB - We study the inference of rigid three-dimensional interpretations for the structure and motion of four or more moving points from but two orthographic views of the points. We develop an algorithm to determine whether image data are compatible with a rigid interpretation. As a corollary of this result we find that the measure of false targets (roughly, nonrigid objects that appear rigid) is zero. We find that if the two views have at least one rigid interpretation, then in fact there is a canonical one-parameter family of rigid interpretations; we show how to compute this family, and we describe precisely how the rigid interpretations vary within it. Since only two views are used, this analysis is relevant also to stereo vision. PMID- 2760723 TI - Computational structure of a biological motion-detection system as revealed by local detector analysis in the fly's nervous system. AB - The computations performed by individual movement detectors are analyzed by intracellularly recording from an identified direction-selective motion-sensitive interneuron in the fly's brain and by comparing these results with model predictions based on movement detectors of the correlation type. Three main conclusions were drawn with respect to the movement-detection system of the fly: (1) The essential nonlinear interaction between the two movement-detector input channels can be characterized formally by a mathematically almost perfect multiplication process. (2) Even at high contrasts no significant nonlinearities seem to distort the time course of the movement-detector input signals. (3) The movement detectors of the fly are not perfectly antisymmetrical; i.e., they respond with different time courses and amplitudes to motion in their preferred and null directions. As a consequence of this property, the motion detectors can respond to some degree to stationary patterns whose brightness is modulated in time. Moreover, the direction selectivity, i.e., the relative difference of the responses to motion in the preferred and null directions, depends on the contrast and on the spatial-frequency content of the stimulus pattern. PMID- 2760724 TI - Independent processing of suprathreshold spatial gratings as a function of their separation in spatial frequency. AB - Experiments were done to examine the minimum separation with respect to spatial frequency required for two superimposed gratings to be processed independently in the visual system. The contrasts of all stimuli were well above the detection threshold. The lack of independent processing was measured by the observers' failure to see both gratings as separate sinusoids; changes in the apparent contrast or spatial frequency of one grating when the other was present; and changes in the ability to discriminate small differences in the contrast or spatial frequency of one grating when the second grating was present. All measures point to a lack of independent processing when the gratings differ by less than 2 octaves. When they differ by more than 2 octaves, they are seen as separate, apparent spatial frequency is not altered systematically, and discrimination performance essentially is unaffected. However, the apparent contrast of the high-frequency grating varies, depending on whether its bars are seen against the bright bars or against the dark bars of the low-frequency grating. PMID- 2760725 TI - Motion interference in speed discrimination. AB - Human speed discrimination can be degraded by additional stimuli in close spatial and temporal proximity to the designated test target. In these experiments, observers judged the relative asynchrony between a pair of briefly flashed dots: speed discrimination for two-dot apparent motion. The addition of two irrelevant (interfering) flashed dots to the stimulus, which produces accelerating apparent motion, impaired speed discrimination. We call this impairment motion interference; adjacent stimuli are not processed independently by the motion system. Motion interference is time selective; interfering dots simultaneous with the target dots do not impair speed discrimination, nor do interfering dots that precede or follow the target by 200 msec or more. Motion interference was observed even when the interfering dots were as far away as 1 deg from the test pair. Similar effects were observed with a smoothly moving test target and with interfering stimuli composed only of high spatial frequencies. A multiple independent-channel model containing several parallel motion-energy detectors with different receptive-field sizes is considered and rejected. We conclude that speed discrimination depends on a time-selective combination of local motion signals from many detectors. These aggregate detectors combine information from local subunits, degrading information about acceleration. PMID- 2760726 TI - Avascular necrosis of the mandibular condyle: fact or fantasy. PMID- 2760727 TI - Correlation of clinical, radiographic, and arthroscopic findings in internal derangements of the TMJ. AB - Arthroscopic, clinical, and imaging observations were compared in 80 temporomandibular joints with suspected internal derangements. Rating scales were developed for assessment of the key arthroscopic findings of "roofing," vascularity, redundancy, articular surface condition, adhesions, and disc function. Clinical and imaging findings were correlated with the rated arthroscopic findings. The degree of roofing was found to have a significant relationship to disc quality and function. Arthroscopy completed the diagnostic picture in these cases and provided detailed information on the joints that was not elicited from clinical findings or imaging studies. PMID- 2760728 TI - The skeletal stability of Le Fort I downfracture osteotomies with rigid fixation. AB - Twenty subjects receiving Le Fort I downfracture osteotomies stabilized with rigid fixation were studied for relapse. The analysis was based on longitudinal cephalometric radiographs taken within 2 weeks presurgically, 1 week postsurgically, and after a minimum period of 6 months postsurgically. Vertical and sagittal changes in the maxilla were evaluated in reference to the Frankfort horizontal plane. It was found that the mean postsurgical relapse was minimal and not significant. It was smaller than that reported for patients who had received stabilization of the maxilla with intraosseous and maxillomandibular wiring. It was concluded that the rigid fixation technique is dependable and yields stable postsurgical results in the maxilla. PMID- 2760729 TI - A lateral cephalometric analysis of nasal morphology following Le Fort I osteotomy applying photometric analysis techniques. AB - Fifty patients who had undergone Le Fort I maxillary osteotomies were studied. Cephalograms were available preoperatively and at least 6 months postoperatively. Soft-tissue analysis of the nasal profile was done employing three angles commonly used in the photometric analysis performed for rhinoplasty: nasal tip projection angle, columellar angle, and supratip break angle. Maxillary movement was assessed in two ways: 1) horizontal and vertical component vectors of A-point movement were calculated, and 2) maxillary rotation, defined as the change in the angle of a line drawn from the anterior nasal spine to the posterior nasal spine relative to the anterior cranial base, was calculated. The component vectors of A point movement and maxillary rotation were then used as predictor variables for change in the soft-tissue angles in a multiple-regression analysis. A weak correlation was found between A-point movement in both the horizontal and vertical dimensions and the nasal tip projection angle. When A-point was moved in an anterior and superior direction, the nasal tip rotated up. The converse was true with movement in the posterior and inferior direction. Only A-point movement in the horizontal dimension had a significant relationship with columellar angle. When A-point was moved in an anterior direction, columellar angle increased. This study shows that prediction of the soft-tissue profile of the nose following maxillary surgery is difficult. PMID- 2760730 TI - Presence of nerve cell bodies in the lingual nerve in the third molar area. AB - The microanatomy of the lingual nerve in the third molar area was studied. Twenty two pairs of lingual nerves were dissected from human cadavers. The area of each nerve adjacent to the third molar was identified, cut, serially sectioned, and stained with hematoxylin and eosin. Nerve cell bodies were found within the structure of 40 of the 44 individual nerves (90.91%). There were two patterns of organization of the nerve cell bodies: isolated nerve cell bodies and ganglion like clusters of nerve cell bodies. Because of the proximity of the submandibular ganglion, it can be inferred that these cell bodies are parasympathetic in function. The presence of nerve cell bodies in the lingual nerve in the third molar region could have possible clinical ramifications. PMID- 2760731 TI - Arterial oxygen desaturation in adult dental patients receiving conscious sedation. AB - Forty-six adults undergoing dental procedures were monitored with a pulse oximeter for hypoxemia. Thirty-six patients received various amounts and combinations of central nervous system depressant drugs (barbiturates, sedatives, and narcotics) in addition to local anesthetics to produce a state of conscious sedation. Twenty-eight patients in the latter group received supplemental oxygen. Ten subjects served as a control group and received only local anesthesia without supplemental oxygen. Continuous monitoring by pulse oximetry revealed 151 episodes of mild, 132 of moderate, and 33 of severe arterial oxygen desaturation, although clinical signs of hypoxemia were absent. Patients with a body mass index greater than 30 or those with a smoking history greater than 30 pack-years were particularly prone to arterial oxygen desaturation. PMID- 2760732 TI - Masseter muscle adaptation following surgical correction of vertical maxillary excess. AB - This study was designed to examine the adaptive response of the human masseter muscle following surgical correction of abnormal facial form. Biopsies of the deep surface of the anterior superficial masseter muscle were obtained from five patients demonstrating vertical maxillary excess (VME), one at the time of corrective surgery, and a second at a long-term postoperative time interval (mean, 8 months). Control biopsies were also obtained from five individuals (three cadavers and two patients) with normal dentofacial morphology. A standard regimen of histologic and histochemical staining was used to classify individual muscle fibers as either type 1, type 2, or intermediate. In both VME patients and normal subjects type 1 fibers predominated, with the control group displaying a higher percentage (50% vs. 43%). On the average, type 1 fibers also had the largest areas. Following surgery there was an increase in type 2 fibers (30% vs. 52%). Two patients receiving maxillary surgery only exhibited either no change in mean fiber area or only a slight increase. The three remaining patients who underwent concomitant maxillary and mandibular surgery all showed a significant decrease in mean fiber area. Two persons in the latter group also showed features consistent with a denervation-reinnervation process. The results of this study indicate that the human masseter responds to surgical manipulation of the jaws in a histochemically demonstrable manner, with the nature and magnitude of the response associated with the particular surgical procedure(s) performed. PMID- 2760733 TI - Local subcutaneous atrophy following arthroscopy of the TMJ. AB - A case of subcutaneous atrophy associated with use of corticosteroids following an arthroscopic procedure of the temporomandibular joint is presented. PMID- 2760734 TI - Metastatic tumors to the jaws: a report of seven cases. PMID- 2760735 TI - An erupted odontoma: case report. PMID- 2760736 TI - Biosynthetic response of cartilage explants to dynamic compression. AB - The biosynthetic response of calf articular cartilage explants to dynamic compression was examined over a wide range of amplitudes, waveforms, and frequencies. Glycosaminoglycan synthesis was assessed by 35S-sulfate incorporation, and amino acid uptake and protein synthesis were assessed by 3H proline incorporation. Two culture chambers were designed to allow uniaxial radially unconfined compression and mechanical testing of cartilage disks: one chamber was used inside a standard incubator; the other was used with a mechanical spectrometer and allowed load and displacement to be monitored during compression. Dynamic stiffness measurements of 3-mm diameter disks identified a characteristic frequency [0.001 Hz (cycles/sec)] that separated low- and high frequency regimes in which different flow and deformation phenomena predominated; e.g., at 0.0001-0.0001 Hz, significant fluid was exuded from cartilage disks, whereas at 0.01-1 Hz, hydrostratic pressure increased within disks. At the higher frequencies, oscillatory strains of only approximately 1-5% stimulated 3H-proline and 35S-sulfate incorporation by approximately 20-40%. In contrast, at the lower frequencies (a) compressions of less than 5% had no effect, consistent with the dosimetry of biosynthetic inhibition by static compression (approximately 25% compression caused a approximately 20% inhibition of radiolabel incorporation), and (b) higher amplitudes (cycling between disk thicknesses of 1.25 and 0.88-1.00 mm) stimulated 3S-sulfate incorporation by approximately 20-40%, consistent with the kinetics of response to a single 2-h compression and release. None of the compression protocols was associated with detectable alterations in (e.g., compression-induced depletion of) total glycosaminoglycan content. This study provides a framework for identifying both the physical and biological mechanisms by which dynamic compression can modulate chondrocyte biosynthesis. In addition, the culture and compression methodology potentially allows in vitro evaluation of clinical strategies of continuous passive motion therapy to stimulate cartilage remodeling. PMID- 2760737 TI - Cellular turnover at the chondro-osseous junction of growth plate cartilage: analysis by serial sections at the light microscopical level. AB - In the distal hypertrophic cell zone of growth plate cartilage, the penetration of metaphyseal vascular endothelial cells is into the noncalcified territorial and pericellular matrices. Cellular mechanisms that promote metaphyseal vascularization are understood poorly, partly because no study has addressed the question of the time sequence of cellular interactions at the chondro-osseous junction. The purpose of the present study is to make predictions about the relative and the real time duration of cellular events during vascular invasion, including an analysis of the time sequence of death of the terminal hypertrophic chondrocyte. The data from serial section analysis at the light microscopical level of tetracycline-labeled growth plates indicate that death of the terminal hypertrophic chondrocyte occurs in discrete morphological stages characterized by rapid cellular condensation followed, within minutes, by endothelial cell penetration into the vacated lacuna. Cellular condensation lasts approximately 45 min or 18% of the time a cell spends as a terminal chondrocyte. The data also demonstrate that chondrocytic death occurs prior to invasion by vascular endothelial cells and that the chondrocytic lacuna remains empty for as long as 15 min before an endothelial cell or blood vascular cell fills the space. PMID- 2760738 TI - Effect of aging on tensile mechanical properties of the rabbit distal femoral growth plate. AB - Tensile tests to failure were performed on the distal femoral growth plate of rabbits. The measured tensile forces, together with animal weight and dimensional measurements of the femur, were used to develop a noninvasive method of predicting growth failure loads and to examine the effects of age on the tensile strength of the growth plate. Growth plate failure load correlated with rabbit weight, (r = 0.93), femoral length, (r = 0.91), and contoured growth plate surface area, (r = 0.74). Regression analysis for these relationships allowed for failure load prediction if animal weight, femoral length, or growth plate surface area was known. Nominal stress (failure load/surface area) was calculated and correlated with animal weight (age) for each distal femoral growth plate utilizing two surface area estimating techniques: growth plate surface contour and growth plate cross-sectional enlargement. A strong association was found with either technique. The growth and maturation of growth plate cartilage is of major importance in pediatric orthopaedics. This study demonstrate that the age dependent increases in tensile mechanical properties of the growth plate do not result merely from growth plate enlrgement or conformational changes. The changing tensile mechanical properties of the growth plate may explain why transphyseal distraction used clinically has produced varied and somewhat unpredictable results. Our study suggests that dose-response investigations are needed to define safe and optimal transphyseal distraction tensions before further clinical application is pursued. PMID- 2760739 TI - Regeneration of growth plate cartilage induced in the neonatal rat hindlimb by reamputation. AB - Following primary hindlimb amputations dividing the lower femur or the central tibiofibula, the neonatal rat innately regenerates the distal growth plate(s) with a frequency of about 20-30%. One or two reamputation procedures were performed in an effort to increase the frequency of physeal regeneration, noting that such procedures, and related forms of tissue stimulation, have been repeatedly shown to induce regenerative growth at limb amputation sites of some amphibians that display little innate regenerative capacity. The present reamputation sequences divided the skeletal stump through the cartilaginous mass arising at its distal end. Following first reamputation an approximate three fold increase in the frequency of growth plate cartilage regeneration was observed at transfemoral and transtibiofibular sites. Only after second reamputation, however, did tibiofibular physeal cartilage regeneration equal in frequency that observed after first reamputation through the lower femur. Ectopic growth plate cell architecture was identified in cartilaginous extensions arising from the side of the distal femoral shaft, and also within the regrown secondary cartilage body, which unites the lower tibia and fibula in the shank of the rat. Moreover, among 3 of 11 femoral amputees that had sustained reamputations, regrowth of the distal femoral condylar mass and profile were achieved to varying degrees. It is concluded that a regimen of reamputation, known to induce regenerative growth in the amphibian limb, also induces skeletal regneration in the mammalian limb, and lead to the appearance of ectopic growth plate cell architecture at adjacent sites. PMID- 2760740 TI - Effect of hyaluronic acid/chondroitin sulfate on healing of full-thickness tendon lacerations in rabbits. AB - Viscoat, a high-molecular-weight, highly purified hyaluronic acid (HA) and chondroitin sulfate (CS) compound, was instilled around rabbit plantaris tendon following full-thickness laceration and surgical repair. After 3 weeks of immobilization, no significant difference in adhesion strength or tensile strength of the healing tendons existed between Viscoat-treated tendons and controls. This contradicts previous studies which suggest that hyaluronic acid reduces postoperative tendon adhesions. Further studies examining tendon adhesions after less severe degrees of tendon injury and using direct, quantitative measurement techniques are warranted to demonstrate whether HA has a beneficial effect on tendon healing. PMID- 2760741 TI - Effects of intercostal nerve resection on the longitudinal rib growth in the growing rabbit. AB - Two, three, or four intercostal nerves with their vasoconstrictive sympathetic fibers were resected on the right side of 15 growing rabbits. Animals submitted to sham operations and intact animals formed two control groups. A scintigraphic study with 99mTc-methylene diphosphonate, performed on the test group 2 months after the resection, showed a significantly greater uptake of the isotope on the right than on the left costochondral junctions (p less than 0.05). Three months later the difference was still larger. There was no such significant difference in the rabbits of the two reference groups. In the rabbits of both these groups, the right and left ribs of each pair were almost equal in length. Of the denervated ribs of the rabbits composing the test group, the right ribs increased in length to a greater extent than the corresponding left ribs. The difference was statistically significant (p less than 0.05). As a consequence of this left right difference in length, mild thoracic scoliosis convex to the left developed 2 months after the resection. The total weight and volume of the denervated right ribs increased significantly more than those of the corresponding control left ribs (p less than 0.05), but their mineral content per unit of weight or volume showed no significant difference. PMID- 2760742 TI - The effect of ascorbic acid on the metabolism of rat calvarial bone cells in vitro. AB - Addition of 50 micrograms/ml sodium ascorbate to confluent cultures of isolated rat calvarium bone cells resulted in a 21% increase in DNA production, a 50-60% increase in incorporation of [14C]proline into collagenous and noncollagenous proteins, and a 200% increase in alkaline phosphatase activity; under identical conditions, [35S]sulfate incorporation into proteoglycans (glycosaminoglycans) was not affected. These results suggest that ascorbate may be important in maintaining or stimulating the osteogenic phenotype of normal bone cells. PMID- 2760743 TI - Axial rotation component of thoracic scoliosis. AB - The axial rotation (rotation about a vertical axis) of the vertebrae, of the ribs, and of the back surface are components of the deformity recognized clinically as the "rib hump" in thoracic scoliosis. Relationships of these rotations to the lateral deviation and lateral curvature of the spine were studied in 40 patients with idiopathic scoliosis. Stereoradiographs of the spine and rib cage were used to measure three components of axial rotation: rotation of the vertebrae, of the rib cage, and of the plane of maximum curvature of the spine. Stereotopographs of the back surface were digitized to measure the axial rotation of the back surface. In individual patients, there were high correlations of all components of axial rotation at each spinal level with the corresponding vertebral lateral deviation from the spinal axis. By regression analyses of the maximum values of each rotation in each curve, the rotation of the apex vertebra was found to be generally of lesser magnitude than the rotation of the plane of maximum curvature of the spine and in an opposite sense in kyphotic curves. The rib cage rotation was generally of lesser magnitude than the vertebra rotation, and the back surface rotation was less than both of these skeletal rotations. Vertebra rotation correlated most closely with lateral deviation of the spine. Simple segmental coupling of axial rotation and lateral bending could not be responsible for this axial rotation. PMID- 2760744 TI - Biomechanics of the rabbit cervical spine as a function of component transection. AB - The rabbit cervical spine in the form of the functional spinal unit was tested in a manner analogous to that used to study human functional spinal units. Anatomies and biomechanical similarities and differences with the human were demonstrated. The rabbit cervical spine failed abruptly after a well-defined series of anterior or posterior segmental injuries. However, up to the failure point, the rabbit cervical spine exhibited an increased range of motion after each segmental injury. The results of this study were used to develop an in vivo model for the study of spinal injury in subsequent projects. PMID- 2760745 TI - Temporal biomechanics of posterior cervical spine injuries in vivo in a rabbit model. AB - There are numerous clinical and biomechanical criteria for determination of acute spinal instability. No data, however, exist on the biomechanical behavior of the injured, untreated spine during the healing period. Using a rabbit model, this study was designed to quantify changes in the mechanical properties of the injured spine over time. Sixteen rabbits were assigned to four injury groups: Injury 1 (C4-5 supra/intraspinous ligament transection), Injury 2 (C4 laminectomy), or Injury 3 (C4 laminectomy, plus bilateral facet capsular ligament transection). The fourth injury group was Sham (posterior exposure of C4-5, no spinal injury). Preinjury range of motion was determined by standardized flexion extension radiographs on all animals. Postinjury flexion-extension radiographs were taken at 4, 8, and 12 weeks. At the end of 12 weeks, animals were killed. Mean range of motion at C4-5 for all injury groups decreased from preinjury values. The greatest decrease was for the most severe injury. At 8 weeks, the range of motion for this injury was less than half of the preinjury level and increased to 62% of the preinjury level at 12 weeks. PMID- 2760746 TI - The effect of surface and internal electrodes on the gait of children with cerebral palsy, spastic diplegic type. AB - The purpose of this study was to determine whether surface and internal fine-wire electromyography electrodes had an effect on gait. The subjects for the experiments were 38 children with the spastic diplegic type of cerebral palsy. The children were filmed using the high-speed cinematographic technique while they walked (a) with no electrodes (unencumbered), (b) with only surface electrodes, and (c) with internal electrodes. Single stance time, step length, cadence, and walking velocity were compared with analysis of variance and Bonferroni t tests. The results included a significant decrease in cadence (-6.3% of unencumbered walking; p less than 0.05) when comparing walking with surface electrodes with walking without any electrodes. The internal electrodes caused significant decreases from normal walking in the following parameters: step length for both the measured leg (-18.6%; p less than 0.005) and the nonmeasured leg (-18.0%; p less than 0.005), cadence (-7.9%; p less than 0.02), and walking velocity (-23.5%; p less than 0.005). Internal electrodes caused significant decreases as compared with surface electrodes in the step length for both the measured leg (15.7%; p less than 0.01) and the nonmeasured leg (15.6%; p less than 0.005) and walking velocity (19.7%; p less than 0.005). Single stance phase did not change significantly in any of the comparisons. It appears that the addition of the surface electrode apparatus does change the normal gait of a subject, causing a large decrease in cadence. The measurement of gait with internal electrodes causes further change in gait, resulting in large decreases in step length and walking velocity.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2760747 TI - Transverse stability of the carpus. An analytical study. AB - The stabilizing structures of the transverse carpal arch were studied utilizing an analytical model based on a rigid body spring model theory. This method was used to calculate the relative motion between carpal bones, the distribution of compressive forces in the intercarpal joints, and the tensions in the ligaments under simulated dorsopalmar compression. The contribution of each ligament against the effect of compression was determined by removing ligaments from the model. A multivariate analysis of variance disclosed that sectioning the flexor retinaculum alone does not significantly modify the distribution of forces in ligaments and joints (p = 0.33), and decreases dorsopalmar carpal stiffness by only 7.8%. In contrast, isolated removal of the palmar hamate-capitate ligament causes a pronounced weakening of the carpal structure, from an average of 232 to 131 N/mm (p less than 0.01). If the flexor retinaculum is removed in addition to releasing one palmar intercarpal ligament, a gross instability of the carpal arch is created. PMID- 2760748 TI - Density changes at the proximal tibia after medial meniscectomy. AB - Trabecular bone density changes at the proximal tibia were studied after total and partial meniscectomy using quantitative computerized tomography. Thirty-seven medially meniscectomized patients (5- and 10-year follow-up) and 10 control persons were included. In the partially and the totally meniscectomized knees, the area of maximal density in the medial tibial condyle was displaced approximately 4 mm in a posteromedial direction relative to the position in the intact knees. In both partially and totally meniscectomized knees, the density in the region of tibiofemoral contact in the medial tibial condyle was higher compared with the density in the same region in the contralateral intact knees. This difference was of the same order in the 5- and 10-year follow-up groups. The density difference between the meniscectomized and the intact knees in the region of tibiofemoral contact in the medial condyle was significantly higher in totally than in partially meniscectomized patients. It is concluded that not only total but also partial medial meniscectomy is followed by density changes, occurring within the first 5 years after meniscectomy. The results emphasize the importance of the utmost conservatism in surgery on the meniscus. PMID- 2760749 TI - Hardness, an indicator of the mechanical competence of cancellous bone. AB - Hardness and calcium content in compact bone are strongly related. Variation in Young's modulus is produced mainly by variations in mineralisation. Therefore, there should be a relationship between hardness and Young's modulus. We demonstrate this. The calcium content of cancellous bone and adjacent compact bone in several species shows little difference, the cancellous bone having approximately 10% less calcium. The hardness of cancellous bone in Bos is approximately 12% less than that of adjacent compact bone, and the calcium is approximately 2% less. These lines of evidence make it unlikely that the Young modulus of cancellous bone material is much different from that of compact bone. Similar evidence suggests that the yield stress of cancellous bone is similar to that of adjacent compact bone. PMID- 2760750 TI - Proliferative and synthetic response of bovine growth plate chondrocytes to various capacitively coupled electrical fields. AB - In vitro monolayer cultures of growth plate chondrocytes isolated from newborn calf costochondral junctions were subjected to capacitively coupled electrical fields for 48 h. In part A, the electrical signal was a 60-kHz sine wave applied at different voltages so as to produce electrical fields at the pericellular level of 7, 20, 50, and 126 mV/cm. Incorporations of [3H]thymidine and [35S]sulfate were assayed to determine the effect of the above fields on cells proliferation and matrix synthesis, respectively. Proliferation was increased by 47% in the 20 mV/cm field whereas the same field decreased [35S]sulfate incorporation by 21%. These changes were significant at p less than 0.05 in both instances. In part B, the 20 mV/cm field was applied in a pulsed fashion to produce daily duty cycles of 100, 25, 2, and 0.25%. Incorporation of [3H]thymidine, [35S]sulfate, and [14C]proline per DNA were assayed. Results indicated that the 100, 25, and 0.25% percent duty cycles showed significantly (p less than 0.01-0.05) increased proliferation, whereas the 0.25% signal (5 ms on/495 ms off for 6 h/day) significantly decreased [14C]proline incorporation. We conclude that the biologic response of cells in vitro is signal specific, and that the total amount of electrical energy required to stimulate the growth plate chondrocyte to increased proliferation is very small since the total time the 0.25% duty cycle signal was only 3.6 min of a 24-h period. PMID- 2760751 TI - Effects of streptozocin-induced diabetes on rat bone. PMID- 2760752 TI - The frequency of alcoholism and alcohol related brain disorders in various regions of Oslo city. An autopsy study. AB - The autopsy materials from the 5-year period 1983-1987 from Ulleval and Aker Hospitals in Oslo were reviewed. All cases with alcoholism were recorded and the histological sections were re-examined with regard to the presence of Wernicke's encephalopathy and alcoholic cerebellar atrophy. The two materials were compared statistically in order to see whether any difference in the frequency of alcoholism and alcohol related brain disorders could be demonstrated between the geographic areas served by these two hospitals. The study revealed a significantly higher percentage of alcoholics in the Aker material which also had a higher proportion of alcoholics with cerebellar atrophy and Wernicke's encephalopathy, although not significant for the latter condition. These results indicate that alcoholism is particularly frequent in the north-eastern part of Oslo city and that this region also has a relatively high proportion of heavy drinkers. PMID- 2760753 TI - Cholesterol assays in the Seralyzer instrument. AB - We evaluated the Seralyzer instrument for the assay of serum cholesterol and compared it to the Kodak Ektachem method. The Seralyzer showed good accuracy in the analysis of cholesterol in Abell-Kendall-verified serum pools, and the bias from the expected value was small in all cases but one. The Seralyzer exhibited CVs of less than 5% in all cases and good comparison with the Ektachem method. The Seralyzer is easy to use; however, some training in the proper pipetting technique is necessary. The Seralyzer meets medical needs criteria of total error greater than 5% from the true cholesterol value. PMID- 2760754 TI - Dual diagnosis: clinical and research perspectives. PMID- 2760755 TI - Substance abuse prognosis with an additional psychiatric diagnosis: understanding the relationship. AB - Patients with alcohol and other substance abuse problems have poorer prognoses if there is a concomitant psychiatric diagnosis. However, because severity of psychiatric problems contributes more than the specific psychiatric diagnosis to prognosis, the nature of the interaction between substance abuse treatment outcome and an accompanying psychiatric diagnosis can be questioned. In this article an attempt is made to understand the poor-prognosis-with-psychiatric diagnosis interaction through a literature review and an analysis of various problem areas that clients bring to substance abuse treatment. Problem areas were measured with a variety of instruments. The results show that groups that vary in severity of psychiatric problems also differ in severity of problems in other areas. As there is no doubt that such dual diagnosis patients pose a considerable treatment challenge, the implications of these findings for theoretical consideration and treatment planning are discussed. PMID- 2760756 TI - Neurocognitive impairment: the unrecognized component of dual diagnosis in substance abuse treatment. AB - Brief neuropsychological tests were administered to an inpatient substance abuse population to (1) evaluate the status of neurocognitive functioning at admission, (2) assess changes that may occur during the treatment program, and (3) compare various testing devices for clinical application in this setting. Patients entering a 14-day inpatient substance abuse unit were tested within a few days of admission with the Neurobehavioral Cognitive Status Examination (NCSE), the screening test for the Luria-Nebraska Neuropsychological Battery, and the Trail Making Test. Impaired neurocognitive performance was observed in approximately two-thirds of patients; the most frequently compromised areas of functioning involved attention and memory, calculation, abstraction, ability to follow complex commands, and visuospatial skills. Readministration of the NCSE prior to discharge detected a statistically significant improvement in attentional abilities, and a tendency toward improvement for verbal comprehension and abstraction. Discussion of these findings addresses several issues: (1) the frequency and degree of impairment in this population; (2) the observed variability of cognitive functioning; (3) the question of clinical improvement in neurocognitive functioning observed during a program of this length; and (4) a preference for the NCSE in this setting. The authors argue for the routine neuropsychological assessment of substance abusers, and discuss the above issues in terms of their implications for treatment at both the individual and programmatic level. Discussion of two cases illustrates the application of the NCSE, and the effect of finding organic impairment on staff attitudes and treatment issues. PMID- 2760757 TI - Dual diagnosis patients in the urban psychiatric emergency room. AB - Substance abuse among the mentally ill has become increasingly prominent. This article describes the problems presented by dual diagnosis patients in the urban, publicly funded, psychiatric emergency room. When such patients become acutely ill, neither the public health system nor the mental health clinician is adequately prepared to provide care. The inability to effectively treat these patients has become strikingly clear in recent years. In 1986, the Psychiatric Emergency Service at San Francisco General Hospital began to overflow with patients who required overnight stays. The intoxicated substance abusers with acute psychiatric complaints were the most difficult to manage clinically and administratively. Suggestions are offered for innovative approaches to this group of public patients: dual training of clinicians, flexible treatment programs prepared to deal with the whole person, and public funding that reflects patients' needs rather than clinicians' preferences. PMID- 2760758 TI - Bonded phase adsorption/thin-layer chromatography testing for marihuana metabolites. PMID- 2760759 TI - Susceptibility of Eimeria bovis and Toxoplasma gondii to oxygen intermediates and a new mathematical model for parasite killing. AB - Eimeria bovis and Toxoplasma gondii differ in their susceptibility to macrophages activated by lymphokines. Interferon-gamma can activate macrophages to totally inhibit E. bovis sporozoite development, whereas growth of T. gondii tachyzoites in macrophages is not totally affected. The susceptibility of these parasites to oxygen intermediates and their ability to evade the oxidative burst by macrophages were investigated in cell-free systems. Using a logistic model to assess growth inhibition, T. gondii growth was impaired by 50% at 10(-4.25) M (56 microM) H2O2, with 30 min as the optimum time for measuring inhibition. Preliminary results indicate that T. gondii follows mode-one and mode-two killing with relation to time after exposure to H2O2, implying a role for OH. and the induction of a DNA repair mechanism. The same model was used to assess inhibition of E. bovis growth that was more susceptible, being inhibited to 50% by 10(-5) M (10 microM) H2O2. Both parasites were susceptible to the effects of xanthine xanthine oxidase that releases a full complement of oxygen intermediates (H2O2, OH., (1)O2, and O2-). Adding quenchers or scavengers to the system confirmed that T. gondii was susceptible to products of the interaction of O2- and H2O2 (OH. and (1)O2), and that E. bovis sporozoites were at least partially susceptible to H2O2 and O2-, but extremely susceptible to OH.. These data were supported by studies on scavenging enzymes present in the parasites. Toxoplasma gondii was rich in superoxide dismutase (SOD), catalase, and glutathione peroxidase (GPO), and E. bovis had less catalase and SOD.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2760760 TI - Evidence for genetic control of nematode egg-shedding rates in calves. AB - Differences in nematode fecal egg counts from 167 purebred Angus calves born in 1986 and 133 born in 1987 that had been naturally exposed to infection on pasture were analyzed for sire effects. The calves were sired by 26 different bulls, all of which were related. Differences among fecal egg counts were attributable to sires (P less than 0.0002), to age of the calf (P less than 0.0007), to age of dam (P less than 0.05), and to collection year (P less than 0.0001). No variation in fecal egg count was attributable to calf sex (P greater than 0.23). After accounting for the effects of year, age of calf, and age of dam, heritability was estimated to be 29% (SE = 18%). It was concluded that a paternal contribution to the genome of each calf played an important role in determining average fecal egg output of the sire group. With heritability at 29%, selection against higher fecal egg counts or selection for lower fecal egg counts would be expected to produce measurable genetic change in a population. PMID- 2760761 TI - Colpocephalum holzenthali n. sp. (Mallophaga: Menoponidae) from the barred forest falcon Micrastur ruficollis (Falconidae) in Peru. AB - Colpocephalum holzenthali, a new species of chewing louse, is described from a series of lice collected in Peru from Micrastur ruficollis zonothorax, the barred forest-falcon. Colpocephalum holzenthali is most similar to members of the Colpocephalum polybori species group. PMID- 2760762 TI - Coccidian parasites (Apicomplexa: Eimeriidae) from insectivores. VII. Six new species from the hairy-tailed mole, Parascalops breweri. AB - Sixteen hairy-tailed moles, Parascalops breweri, collected from the northeastern U.S.A. were examined for coccidian oocysts; all were infected with multiple species of coccidia and 3 genera were represented. Two cyclosporans, 2 eimerians, and 2 isosporans are described as new species. Sporulated oocysts of Cyclospora ashtabulensis n. sp. are subspheroid to ellipsoid, 18 X 14 (14-23 X 11-19) microns, and sporocysts are ovoid, 12 X 7 (8-14 X 5-9) microns; C. ashtabulensis was found in 7 of 16 (44%) moles. Sporulated oocysts of Cyclospora parascalopi n. sp. are spheroid, 17 X 14 (13-20 X 11-20) microns, and sporocysts are ovoid, 11 X 7 (8-14 X 5-8) microns; C. parascalopi was found in 8 of 16 (50%) moles. Sporulated oocysts of Eimeria aethiospora n. sp. are subspheroid to ellipsoid, 19 X 13 (15-24 X 10-16) microns, and sporocysts are ovoid, 11 X 6 (8-13 X 4-7) microns; E. aethiospora was found in 4 of 16 (25%) moles. Sporulated oocysts of Eimeria titthus n. sp. are subspheroid, 16 X 14 (13-19 X 11-17) microns, and sporocysts are ellipsoid, 11 X 6 (9-13 X 4-7) microns; E. titthus was found in 4 of 16 (25%) moles. Sporulated oocysts of Isospora ashtabulensis n. sp. are ellipsoid, 20 X 14 (16-24 X 10-18) microns, and sporocysts are ovoid, 10 X 7 (7 14 X 5-10) microns; I. ashtabulensis was found in 5 of 16 (31%) moles.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2760763 TI - Coccidian parasites (Apicomplexa: Eimeriidae) from insectivores. VIII. Four new species from the star-nosed mole, Condylura cristata. AB - Twenty-four star-nosed moles, Condylura cristata, collected from the northeastern United States (Maine, Massachusetts, Ohio, Vermont) were examined for coccidian oocysts. All of the moles were infected with from 1 to 4 species of coccidia representing 2 eimerian and 3 isosporan spp., but oocysts of only 4 of these species were present in sufficient numbers for detailed study; these are described as new. Sporulated oocysts of Eimeria condylurae n. sp. were subspheroid, 17.7 x 15.7 (17-23 x 14-21) microns, with sporocysts ellipsoid, 11.7 x 5.6 (11-14 x 5-6) microns; E. condylurae was found in 3 of 24 (12.5%) moles. Sporulated oocysts of Isospora condylurae n. sp. were ellipsoid, 19.4 x 9.3 (17 21 x 8-11) microns, with sporocysts ovoid, 11.7 x 5.8 (11-13 x 5-7) microns; I. condylurae was found in 12 of 24 (50%) moles. Sporulated oocysts of Isospora cristatae n. sp. were ellipsoid, 15.7 x 10.1 (13-18 x 9-13) microns, with sporocysts ovoid, 11.0 x 5.7 (10-12 x 5-7) microns; I. cristatae was found in 19 of 24 (79%) moles. Sporulated oocysts of Isospora lamoillensis n. sp. were ellipsoid, tapering at both ends, 21.6 x 13.0 (19-23 x 11-14) microns, with sporocysts spindle-shaped, 14.9 x 7.7 (14-16 x 7-8) microns; I. lamoillensis was found in 2 of 24 (8%) moles. Although the second eimerian seen was in 7 of the 24 (29%) moles from Massachusetts, Ohio, and Vermont, there were not enough sporulated oocysts to study in detail to warrant a new species description.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2760764 TI - Gastropod intermediate hosts of Parelaphostrongylus tenuis (Nematoda: Metastrongyloidea) from northwestern Indiana. AB - Thirteen species of terrestrial gastropods from the Kingsbury State Fish and Wildlife Area, Indiana, were examined for the presence of third-stage larvae (L3s) of the meningeal worm, Parelaphostrongylus tenuis, during the summers of 1987 and 1988. Three (Deroceras laeve, Discus cronkhitei, and unidentified species of Cochlicopa [= Cionella]) were infected. Prevalence of infection was low, 1.1% and 2.7% in 1987 and 1988, respectively. The highest prevalence was 5.5% in Cochlicopa spp.; however, most of the larvae from this host were recently molted second-stage larvae (L2s). Attempts to identify foci of infection based on vegetation cover, soil pH, and replaceable calcium levels in the soil were unsuccessful. This is the first report of P. tenuis from Indiana. PMID- 2760765 TI - Development of Trypanoplasma borreli (Mastigophora: Kinetoplastida) in the leech vector Piscicola geometra and its infectivity for the common carp, Cyprinus carpio. AB - The development of Trypanoplasma borreli in the crop of the leech vector Piscicola geometra was characterized by significant changes in morphology. Immediately after ingestion by the leech, stumpy-shaped T. borreli predominated and numerous dividing specimens were found. This led to long and slender trypanoplasms near the end of the infection. The infection was terminated with complete digestion of the blood stored in the crop of the leech. The longest period of infection observed was 11 days. Trypanoplasma borreli was found only in the crop of the leech. At any time during the infection, T. borreli isolated from P. geometra cause a parasitemia when inoculated into parasite-free carp. There was no difference in morphology or infectivity among T. borreli isolated from various crop regions of P. geometra. PMID- 2760766 TI - Postembryonic development of Wohlfahrtia magnifica (Schiner, 1862) (Diptera: Sarcophagidae). AB - A description of the larval development of Wohlfahrtia magnifica (Schiner, 1862) is given. An interpretation of the morphological development correlated with functional and adaptive aspects of myiasis-causing flies is also included. A detailed analysis of morphological changes that occurred in W. magnifica larvae during postembryonic development is carried out. These changes happen in 2 larval interinstars, I-II and II-III, in which several structures such as anterior and posterior peritremes and cephalopharyngeal skeleton play an important role. The possible functions of these structures are considered. We also describe the first instar in W. magnifica to differentiate it from that belonging to Sarcophaga species, paying special attention to disposition of the cephalopharyngeal skeleton, anterior peritremes, and spinulation on the last 3 segments. Several structures, not described previously in Sarcophagidae, were observed: modified spines of the buccal and peritremal cavities, peritremal tubercles, and modified spines on the ventral surface. Changes occurring in these structures during larval development are described. Their probable role in the taxonomy of the genus Wohlfahrtia and their application to Nearctic species belonging to this genus, Wohlfahrtia vigil and Wohlfahrtia opaca, are also discussed. PMID- 2760767 TI - Dot-enzyme-linked immunosorbent assay (dot-ELISA) for the rapid diagnosis of human fascioliasis. AB - A dot-enzyme-linked immunosorbent assay (dot-ELISA) was developed as a fast and field applicable antibody detection tool for the diagnosis of human fascioliasis. The assay is performed using partially purified antigens from a species of Fasciola at 180 ng protein/dot (2 microliters) and serum samples at 1:20 dilution (1 microliter). Dot-ELISA results completely agreed with those of micro-ELISA. Antigen-coated nitrocellulose sheets stored for 3 mo at -20 C showed results identical to fresh sheets. Sera from patients with fascioliasis (n = 30) and other parasitic or viral infections (n = 120) were compared with sera from healthy controls (n = 14). Ninety samples can be tested within 90 min. The sensitivity, specificity, and speed of the assay may justify its use in laboratory and field studies. PMID- 2760768 TI - The dispersion of Echinococcus granulosus in the intestine of dogs. AB - We studied the dispersion of adult Echinococcus granulosus in the intestine of experimentally infected dogs at 2 scales of habitat use. On a coarse scale, worms were found most frequently in the anterior third of the small intestine. On a fine scale, clumps or aggregations, typically of 4-5 worms in an area of 12 mm2, occurred throughout the anterior two-thirds of the intestine. The most likely proximate cause of aggregative behavior is attraction between individual worms. There are at least 2 equally plausible ultimate causes of the behavior: to enhance cross-fertilization and to improve the quality of the environment. Restriction of worms to the anterior small intestine may be a consequence of aggregative behavior on a finer scale or a response to different proximate and ultimate factors. PMID- 2760769 TI - Changes in numbers and growth of Ligula intestinalis in the spottail shiner (Notropis hudsonius), and their roles in transmission. AB - Eighteen species of fishes were collected during the open water (1985-1987) and winter seasons (1985-1986) from Dauphin Lake, Manitoba, Canada (51 degrees 17'N, 99 degrees 48'W) and examined for plerocercoids of Ligula intestinalis (L.). Plerocercoids were most prevalent (5.3%) in spottail shiners (Notropis hudsonius), the major fish host for Ligula in Dauphin Lake. Detailed analysis of the spottail shiner-Ligula host-parasite system revealed that the number of plerocercoids differed between years and among habitats but there was no statistically significant seasonal pattern; recruitment of new worms was highest in young fish and decreased with age, and infected spottails had reduced gonad development. Analysis of host and parasite growth revealed that the soma of male spottails infected with Ligula weighed more but had a reduced growth rate. Growth rate of females was unaffected by Ligula but somatic weight was slightly increased. This appears to be related to the greater metabolic stress on infected males. Based on increased mean somatic weight and skewness of the weight distribution for infected fish, we propose that infected spottails are subjected to size-selective mortality. Some of the contradictions in the literature may be attributed to underestimated prevalence due to increased numbers of spawning fish in the spring, mixed age-classes of Ligula in separate age-classes of fish, and differential effects on growth due to infection in male versus female hosts. PMID- 2760770 TI - The effects of single and repeated inoculations of various larval doses on Strongyloides ratti burden and distribution in rats. AB - The changes in worm burden, distribution, length, and fecundity after and during single and repeated inoculations of 10, 50, or 500 larvae of Strongyloides ratti were examined in rats. Worm burden after a single inoculation of a higher larval dose reduced rapidly. Repeated inoculations of lower larval doses at weekly intervals led to a delayed peak and slower reduction of worm burden; the repeated inoculations of 10 larvae did not induce worm expulsion for at least 7 wk. In repeated inoculations at 3-wk intervals, a primary inoculation of 500 larvae induced strong resistance to reinfection at week 3, whereas no resistance was induced until week 6 in rats receiving repeated inoculations of 10 or 50 larvae. Similar dose-dependent reductions in worm length and fecundity were observed in single and repeated inoculations, and the reductions began earlier than worm expulsion. Intestinal migration of worms from the upper small intestine to the large intestine was observed during the course of single and repeated inoculations. Earlier and clearer migration was observed in rats receiving higher doses. These findings indicate that in S. ratti infection, the changes of worm burden, distribution, length, and fecundity are dependent on the inoculated larval dose. PMID- 2760771 TI - Experimental Dirofilaria immitis-associated glomerulonephritis induced in part by in situ formation of immune complexes in the glomerular capillary wall. AB - Eight dogs were immunized with an aqueous-soluble extract of adult Dirofilaria immitis. Subsequent to at least 7-fold increases in antibody titer, the left renal artery of each dog was infused with 6 mg of D. immitis antigen. Fourteen days after infusion, the left kidney was compared to the right kidney and preinfusion biopsies. All dogs developed glomerular lesions in the left kidney characterized by 1 or more of the following: mesangial cell proliferation, neutrophil infiltration, increased periodic acid-Schiff-positive staining of the mesangium and glomerular basement membrane (GBM), fibrin deposition, and thickening of the GBM. Left kidney glomerular immunofluorescence was positive in 7 of the 8 dogs using polyclonal antisera for canine IgG and C3 in a linear or fine granular pattern. Ultrastructural lesions were present in the left kidney of all dogs and consisted of irregular GBM thickening, intramembranous and mesangial electron-dense deposits, and mesangial and endothelial cell proliferation. Antibodies directed against D. immitis antigen were demonstrated in all kidney eluates from the left kidney. The right kidneys of 3 of the dogs developed lesions; however, in comparison to the left kidney, the lesions in the right kidneys were inconsistent, mild, and focal. The histologic findings in the left kidney were similar to those observed in dogs with naturally occurring D. immitis infections. In sham-immunized control dogs, renal arterial infusion of D. immitis antigen did not cause consistent immune complex glomerulonephritis; however, antigen adherence to glomerular capillary walls was observed by immunofluorescent microscopy.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2760772 TI - The phylogeny of the cercomeria (Platyhelminthes: Rhabdocoela) and general evolutionary principles. AB - The unified theory of evolution is an expansion of Darwinian theory that asserts that evolution is driven by entropic accumulation of genetic information that is constrained and organized primarily by the genealogical effects of phylogenetic history and developmental integration, and secondarily by ecological effects, or natural selection in its classical mode. Phylogenetic systematic analysis of the 8 major groups of parasitic rhabdocoelous platyhelminths permits empirical macroevolutionary evaluation of these postulates. Of the 131 characters considered, 127 are phylogenetically constrained, and 4 show evidence of 1 case of convergence each. Data from different developmental stages are phylogenetically congruent, despite differences in ecology among those stages. Ecological diversification, indicated by phylogenetic association of definitive hosts and parasites, and by changes in ecological components of life cycle patterns, is more conservative evolutionarily than diversification in developmental patterns, indicated by the appearance of unique larval stages, asexual proliferation of larvae, polyembryony, and heterochronic changes. These observations support the macroevolutionary postulates of the unified theory. PMID- 2760773 TI - Phylogenetic relationships among genera of the Tetrabothriidae (Eucestoda). AB - Cladistic analysis of the generic-level relationships within the family Tetrabothriidae was conducted. A single cladogram resulted from evaluation of 28 homologous transformation series representing 41 character states. The genus Tetrabothrius was recognized as plesiomorphic followed by Chaetophallus and Trigonocotyle. The latter was considered as the sister group for the remaining tetrabothriid genera of marine mammals. Anophryocephalus, Strobilocephalus, and Priapocephalus are among the most highly derived genera and are postulated as having close evolutionary affinities. Comparisons to previous explicit hypotheses for relationships among the genera indicated the present analysis was the most efficient phylogenetic statement (consistency index = 85.4%) for the 28 attributes evaluated. The recognition of Tetrabothrius as primitive and a natural grouping of Anophryocephalus, Strobilocephalus, and Priapocephalus in part confirmed results of previous studies of the Tetrabothriidae. PMID- 2760774 TI - Fine structure of Perkinsus atlanticus n. sp. (Apicomplexa, Perkinsea) parasite of the clam Ruditapes decussatus from Portugal. AB - A new apicomplexan species, Perkinsus atlanticus, is described from gill filaments of the clam Ruditapes decussatus (Bivalvia) from Portugal, where it causes great mortality. The zoospores differ from those of other species of Perkinsus in size and shape, dimensions, insertion of the 2 flagella, and in the identity of the host. On the other hand, the life cycle stages showed some ultrastructural differences compared with Perkinsus marinus, the only species previously studied in detail. When the clams were parasitized heavily, ultrastructurally similar life cycle stages were found in foot and mantle tissues. PMID- 2760775 TI - Occurrence of Cryptosporidium in home daycare centers in west-central Colorado. AB - Thirty white middle-class 5 yr olds from home daycare centers were examined for Cryptosporidium. Five fecal samples were collected from each child, over a 3-wk period, concentrated by sedimentation, and stained by a modified acid-fast technique. Nine children were positive (30%), 6 of these were asymptomatic (5 of these were under 2 yr old). Two girls and 1 boy, under 2 yr old, had mild diarrhea within 3 wk prior to fecal collection. PMID- 2760776 TI - Evidence for selective incorporation of host immunoglobulin by strobilocerci of Taenia taeniaeformis. AB - Strobilocerci of Taenia taeniaeformis were obtained from laboratory rats 90 days after experimental infection. Cyst fluid, whole parasite homogenate, and rat serum each were fractionated by SDS-PAGE, immobilized on nitrocellulose by western blot, and probed with conjugated goat anti-rat IgG. Reactive bands with relative mobilities corresponding to rat IgG were found in all 3 samples. Additional bands in cyst fluid and parasite homogenate may represent enzymatic degradation of IgG. The pattern of reactive bands in the homogenate discounts the nonspecific adsorption of host molecules onto the tegument and suggests selective incorporation of serum proteins. The presence of an IgG-like molecule of atypical molecular weight is consistent with either molecular mimicry or enzymatic cleavage of IgG bound to the tegument. The relevance of serum protein utilization by the parasite to evasion of the host immune response is discussed. PMID- 2760777 TI - Eimeria lancasterensis (Apicomplexa: Eimeriidae) from the eastern fox squirrel, Sciurus niger (Rodentia: Sciuridae), in north-central Texas. AB - Eimeria lancasterensis Joseph, 1969, is reported for the first time from the feces of 10 of 11 (91%) eastern fox squirrels, Sciurus niger ludovicianus, in Dallas and Johnson counties, Texas. Oocyst measurements were similar to those reported previously from the eastern gray squirrel, Sciurus carolinensis carolinensis, in Massachusetts. Except for our observation of a substieda body, oocyst morphology was identical to the original description of E. lancasterensis. PMID- 2760778 TI - Lack of correlation between in vitro and in vivo activation of complement in mice by infective Trichinella spiralis larvae. AB - Very little is known about the role played by complement in vivo during Trichinella spiralis infections, although previous reports indicate that it binds readily to the surfaces of muscle stages of the parasite in vitro. In order to study the binding of complement to muscle-stage larvae in vivo, larvae were recovered from BALB-c inbred, NFR/N inbred, and Swiss white outbred mice from 20 to 95 days postinfection. The presence of C3 was examined by direct immunofluorescence and leucocyte- and erythrocyte-adherence tests. Complement was found on a few larvae from the outbred strain and only rarely on larvae from the 2 inbred strains. Histological sections prepared from inbred strains and used in immunofluorescence tests to study in situ complement activation and binding were negative. Larvae from all 3 mouse strains bound complement 100% of the time when it was added to the worms in vitro. The results indicate that extrapolation from in vitro to in vivo activation and binding of complement to T. spiralis larvae may not be valid. PMID- 2760779 TI - Preparation and in vitro activity of liposome encapsulated opioids. AB - Four opiate molecules: morphine, naloxone, meperidine and codeine have been encapsulated in liposomes. The encapsulation efficiency has been studied as a function of the following parameters: liposome preparation method, lipid composition and opioid molecule hydrophobicity. The most important parameter as far as the entrapment efficiency is concerned is the liposome preparation method. The opioid activity of these molecules in vitro (Guinea Pig Ileum preparation) has been determined. No differences in the IC50 values could be found between encapsulated and free drug molecules. PMID- 2760780 TI - Application of encapsulated enzyme as a continuous packed-bed reactor. AB - In the previous report, microencapsulation of lipase employing a (w/o)/w multiple phase emulsion technique, with 2:1 polystyrene (PS)-SBR mixture being used as a wall material, was proposed. Catalysis of the encapsulated enzyme was investigated, and the hydrolysis of triacetin (triglyceride of acetic acid) was successfully simulated by the reaction model based upon the Michaelis-Menten mechanism. Other factors affecting the mechanism such as the mass-transfer resistance of the substrate molecules through the wall and the decrease in pH due to the formation of acetic acid were also taken into consideration. In this report, the particular microcapsules were applied to the continuous tubular reactor system, essentially a packed column reactor, and longevity and mechanical strength of the microcapsules were fully demonstrated. The reaction model derived for a well-stirred batch reactor was also applicable to simulate the behaviour in the packed-column reactor as it was proved that there is no mass transfer resistance between the reactant stream and the surface of microcapsules. The observed data agreed quite well with the calculated values. Similarity of the behaviours of catalysis observed between two reactor systems was thoroughly confirmed. No leakage of the enzyme was detected after repeated usage over the duration of a few months, the temperature being maintained in the range between 293 and 323 K, and pH reset after each operation. Commercial feasibility of the microcapsules for the enzyme catalysis with substrates, small enough to permeate through the wall, was established by these fundamental investigations. PMID- 2760781 TI - Artificial liposomes as a model for studying the lipid peroxidation effect of p phenylene diamine. AB - The effect of p-phenylene diamine on the peroxidation of liposomized samples of lecithin and peanut oil was studied under optimal conditions. The p-phenylene diamine was found to affect the formation of thiobarbituric acid reactive products of lipid peroxidation and the efficacy of various free radical scavengers. PMID- 2760782 TI - Microencapsulation of emulsified oil droplets by in-situ vinyl polymerization. AB - This paper reports on the preparation and evaluation of microcapsules formed by the polymerization of methyl methacrylate in the presence of an oil/water emulsion. The oil phase was composed of an alkane (n-decane or hexadecane) and the oil/water emulsions were stabilized by a variety of emulsifiers. Both oil soluble and water-soluble initiators were used and the monomer was introduced by either dissolving it in the oil or by feeding it through the water. The primary objective of the work was to study the effects of both formulation and process variables on the morphological characteristics of the polymer/oil composite particle. Our experimental findings indicate that it is not a trivial task to assure that the polymer is formed at the interface in such a way that it envelopes the oil droplet. It was found that the type of emulsifier used is crucial in determining the success of the encapsulation process. PMID- 2760783 TI - Preparation and characterization of poly(styrene) microcapsules containing corrosion inhibitors. AB - A technique has been developed to view cross-sections of microcapsules prepared by a multiple emulsion method. Poly(styrene) microcapsules were prepared by emulsifying an aqueous solution containing sodium dichromate, a corrosion inhibitor, into an organic solution containing dissolved poly(styrene). This water-in-oil emulsion was added to an aqueous solution with stirring to form a water-in-oil-in-water emulsion. The organic solvent was removed under reduced pressure resulting in polystyrene walled microcapsules containing aqueous sodium dichromate. The microcapsules were embedded in an agarose gel and sliced for examination by transmission electron microscopy. The cross-sections clearly identified a core surrounded by a sponge-like polymeric wall. The microcapsules were also examined by scanning electron microscopy. These photomicrographs showed a smooth, continuous external wall structure. PMID- 2760784 TI - Preparation and characterization of lactic/glycolic acid polymers and copolymers. AB - A range of poly(L-lactic acid) [L-PLA], poly(DL-lactic acid) [DL-PLA], polyglycolic acid [PGA] polymers and PLA-PGA copolymers were synthesized from lactide and glycolide. The effect of lactide type, catalyst concentration, reaction time and reaction temperature was studied. Intrinsic viscosity determination, gel permeation chromatography, laser light scattering, nuclear magnetic resonance and differential scanning calorimetry were used to characterize the polymers formed. It was impossible to determine the molecular weight of most PGA samples due to lack of solubility. The consequences of the results with regard to the production and storage of microencapsulated and related products are discussed. PMID- 2760785 TI - Liposomal pulmonary drug delivery. I. In vivo disposition of atropine base in solution and liposomal form following endotracheal instillation to the rabbit lung. AB - The potential of liposomes as carriers for local pulmonary drug delivery was investigated in the rabbit. Atropine base, a model compound for lipophilic drugs, was encapsulated in neutral MLVs and sprayed at the bifurcation of the trachea. Drug concentrations determined in the lung indicated liposomal encapsulation provided higher drug concentrations within pulmonary tissue for a more prolonged period of time as compared to the solution form. Comparison of drug levels in plasma and appearance of drug in urine demonstrated more rapid systemic absorption and elimination of 'free' drug. Greater accessibility of drug in solution to the systemic circulation was reflected in higher atropine concentrations in all internal organs studied. Liposome encapsulation favourably altered the disposition of atropine base when locally administered to the rabbit lung. PMID- 2760786 TI - Neural misdirection in congenital ocular fibrosis syndrome: implications and pathogenesis. AB - A child with congenital ocular fibrosis syndrome and oculocutaneous albinism displayed two distinct neural misdirection syndromes: synergistic divergence and Marcus Gunn jaw winking. This and other reported cases of misdirected innervation in patients with congenital fibrosis syndrome suggest that normal neuronal connections fail to become established early in development and that lack of innervation may underlie the pathologic features of the disorder. The prevailing concept of congenital fibrosis syndrome as a primary myopathy should be reconsidered. PMID- 2760787 TI - Botulinum toxin injection into the superior rectus muscle of the non-dominant eye for dissociated vertical deviation. AB - A variety of surgical procedures on the superior rectus muscles have been proposed as a remedy for Dissociated Vertical Deviation (DVD); Botulinum toxin (Oculinum) has been one such suggestion as a surgical alternative. We selected five older patients with DVD whose age placed them beyond a risk of amblyopia to evaluate Oculinum injection into the superior rectus muscle as therapy for DVD. The patients achieved a reduction from the mean value of 20 prism diopters to the mean value of less than 5 pd hypertropia at 172 weeks following injection. Our study suggests that Oculinum is effective in treating DVD, but caution should be exercised because transient ptosis invariably accompanies injection. PMID- 2760788 TI - Ophthalmic findings in classical galactosemia--a screened population. AB - Classical galactosemia due to a deficiency of galactose-1-phosphate-uridyl transferase, is an autosomal recessive disorder of galactose metabolism with an incidence in Ireland of one in 30,000 births. It can result in cataract formation through the accumulation of galactitol within the lens. Seventeen children with transferase deficient galactosemia were studied. Early diagnosis followed by a galactose-free diet and tight biochemical control prevented cataract formation in 13 cases after a mean follow-up of 6.3 years. Cataracts did not regress in all patients commenced on diet by 6 weeks but early treatment prevented progression. The ophthalmologist may play an important role in the monitoring of patients with this disease as the recognition of new lens opacities by slit-lamp biomicroscopy may be the most sensitive initial index of inadequate biochemical control. PMID- 2760789 TI - Acquired monofixation syndrome. AB - Monofixation syndrome is a well documented sensory abnormality occurring in patients with childhood-onset strabismus. We report the development of monofixation syndrome in six adults with strabismus. It is proposed that constant strabismus, which precludes and prevents bifixation, can result in the development of monofixation syndrome if the strabismic deviation is not corrected promptly. PMID- 2760790 TI - Study of chart designs and optotypes for preschool vision screening--I. Comparability of chart designs. AB - Design variations in children's distance vision screening charts contribute to inconsistencies noted in preschool vision screening programs. This study compares children's distance visual acuity on two chart designs: logarithm of the minimal angle of resolution (LOGMAR) vs a chart of 'standard' design. In theory, the LOGMAR chart offers the advantages of improved precision in measuring inter patient differences and greater consistency of follow-up measurements. Our findings indicate the following: 1) the ability to complete a test depends upon the child's age, not on chart design; 2) isolation of symbols is required more frequently for the LOGMAR charts than for the standard charts; and 3) on average, children have slightly poorer visual acuity scores on LOGMAR charts than on standard charts. PMID- 2760791 TI - Neuroretinitis in childhood. AB - We report the clinical features and results of laboratory testing of seven children with neuroretinitis, diagnosed on the basis of reduced visual acuity, relative afferent pupillary defect, and distinctive appearance of the fundi. Disc swelling was segmental in five patients with unilateral disease and diffuse in two patients with bilateral disease. Retinal infiltrates were transiently present in two patients. Swelling of the optic disc and peripapillary retina, along with the inflammatory vitritis resolved by 2 to 6 weeks but macular exudates persisted for 3 to 12 months. Two patients developed optic atrophy with permanent visual loss and two patients had visual acuity reduction detected only under low contrast conditions. Cat-scratch disease was implicated as the cause of the neuroretinitis in two patients; the etiology of the remaining cases was not established. PMID- 2760792 TI - Proceedings of the 19th Symposium on Drug Metabolism and Action. October 27-28, 1988, Osaka. Abstracts. PMID- 2760793 TI - Salivary excretion of 5-fluorouracil (5-FU). IV. Dependency of saliva/plasma concentration ratio and salivary clearance on plasma concentration of 5-FU during constant-rate intravenous infusion in rats. AB - Salivary excretion profiles of 5-fluorouracil (5-FU) were investigated following simultaneous bolus intravenous injection of a loading dose and constant-rate intravenous infusion of a maintenance dose of at one of three dose levels in rats. By stimulating salivation with pilocarpine infused intravenously, mandibular (M) and parotid (Pr) saliva samples were periodically collected separately via cannulas inserted into the ducts. Simultaneously, salivary pH and salivary flow rate were determined. (1) There was a good correlation between plasma concentration and each of the saliva concentrations of 5-FU with regard to the pooled data of the three doses (p less than 0.01). (2) A gland type difference between M and Pr in the saliva/plasma concentration ratio (S/P ratio) of 5-FU was observed. This difference seemed to result from that in salivary pH. These findings were similar to the results following bolus intravenous administration of 5-FU in rats. (3) The fluctuations of the S/P ratio and salivary clearance of 5-FU were smaller than those following the bolus intravenous administration. (4) The S/P ratio and salivary clearance were larger at higher dose and higher plasma concentration of 5-FU. It was confirmed that non linear kinetics might be involved in the salivary excretion of 5-FU in rats, and it was speculated that 5-FU excreted into primary saliva might be reabsorbed partly through some saturable process. PMID- 2760794 TI - The metabolism and excretion of trimethadione in patients with percutaneous transhepatic biliary drainage and renal dysfunction. AB - The metabolism and excretion of trimethadione (TMO) following an oral dose of 4 mg/kg has been examined in patients with percutaneous transhepatic biliary drainage (PTBD) and renal dysfunction. Biliary excretion as the total amount of TMO and its metabolite, dimethadione (DMO) was 2.0% of the dose during 0 to 48 h after TMO administration in patients with PTBD. Total urinary excretion (0-48 h) was 2.8% and 3.0% of the dose in healthy volunteers and patients with renal dysfunction, respectively. The serum DMO/TMO ratio at 4 h after oral dosing in patients of PTBD and renal dysfunction was not significantly changed in comparison with the ratio reported previously in healthy volunteers. The elimination half-life of TMO was also not altered in patients with PTBD in comparison with that reported previously in volunteers. These results suggest that metabolism and urinary and biliary excretion of TMO are not changed in patients with PTBD and renal dysfunction. PMID- 2760795 TI - 7-ethenyloxycoumarin as a new substrate for fluorophotometric assay of hepatic microsomal epoxidizing activities. AB - 7-Ethenyloxycoumarin (7-vinyloxycoumarin, VOC) was metabolized by rat liver microsomes in the presence of a reduced nicotinamide adenine dinucleotide phosphate-generating system to 7-hydroxycoumarin (HOC) and glycolaldehyde via the unstable epoxide, 7-(epoxyethoxy)coumarin, as an obligatory intermediate which had a half life of 5.4 min in 0.1 M phosphate buffer, pH 7.4, at 37 degrees C. The epoxide of VOC accumulated in the microsomal incubation mixture in the presence of the epoxide hydrolase inhibitor, 3,3,3-trichloropropene 1,2-oxide, was isolated and identified. HOC and glycolaldehyde were auto-decomposition products of the putative highly unstable intermediate, 7-(1',2' dihydroxyethoxy)coumarin, mostly formed by microsomal epoxide hydrolase from the epoxide. Direct fluorophotometry of HOC made it possible to determine epoxidizing activities of very small quantities of the microsomes from untreated rat liver (greater than or equal to 5 micrograms protein). VOC was epoxidizied by rat liver microsomal cytochrome P-450, inducible by 3-methylcholanthrene (3-MC) and phenobarbital (PB), and the microsomal epoxidation reactions were inhibited by IgG preparations raised against the major cytochrome P-450 components isolated from 3-MC- and PB-pretreated rat liver microsomes. In the untreated, 3-MC- and PB pretreated rat liver microsomes, at least two monooxygenase components with different affinity were strongly suggested by a kinetic study, carried out using the antibodies, to be involved in the epoxidation of VOC. PMID- 2760796 TI - Evaluation of anti-allergic effects of 1-substituted 2-n-butyl-methylenedioxy indenes. AB - The effects of ten 1-substituted 2-n-butyl-5,6-methylenedioxyindenes on mice and guinea pigs were investigated for their allergic reactions in the development of a new anti-allergic drug. Anti-allergic effects were determined by testing the effect of agents on passive cutaneous anaphylaxis (PCA) in mice and Schultz-Dale reaction in guinea pig tracheal muscle. 2-Butyl-1-[N-methyl-N-[2-(N',N' dimethylamino) ethyl]amino]5,6- methylenedioxyindene (1) indicated the most potent anti-allergic activity. Since our previous experiments indicated that 2-n butyl 3-dimethyl amino-5,6-methylenedioxyindene (MDI-A) and its derivatives showed a potent anti-allergic effect by interfering with the calcium (Ca) movement in the allergic reaction in guinea pigs, the effect of 1 and MDI-A on allergic reaction and Ca-induced contraction of tracheal muscle in these animals were compared. The present data indicate the superiority of 1 in both reactions. PMID- 2760797 TI - Facilitated transport of benzylpenicillin through the blood-brain barrier in rats. AB - The unidirectional influx of benzylpenicillin through the blood-brain barrier was examined with an in situ rat brain perfusion technique using purified [3H]benzylpenicillin. The major transport system of benzylpenicillin through the blood-brain barrier was via a saturable process with a one-half saturation concentration of approximately 8-30 microM. This transport system was significantly inhibited by probenecid (100 microM) and ceftriaxone (2 mM), indicating that the transport system may be shared by some organic anions including third generation cephalosporin antibiotics. These findings suggest that concomitant administration of beta-lactam antibiotics could produce a drug interaction to alter the drug penetration into the central nervous system. PMID- 2760798 TI - Managing chronic illness: parents with a ventilator--dependent child. AB - Ventilator-dependent children are surviving longer and increasing in number. This qualitative study was undertaken to describe the impact of a ventilator-dependent child on 10 families and to describe the management styles used by the parents. In five families, the child remained hospitalized due to the disability while in the other five the child primarily lived at home. Three major themes in managing were elicited: barriers, resources, and parenting. Parents believed they should try to normalize their child's experiences, that interactions with health care professionals required negotiation and assertiveness, and that they needed some support person(s) outside of the family. PMID- 2760799 TI - Effects of preadmission preparation on compliance with home care instructions. AB - This study was conducted to test the effects of preadmission preparation on parent and child psychological upset at the time of tonsillectomy surgery, on child postsurgery behavior, and on parental compliance with home care instructions. Forty children aged 3 to 11 years who underwent tonsillectomy on an outpatient basis were studied. No significant differences were found in parent and child behaviors of those people in the preparation group compared with those in the nonpreparation group. Parental reports of home care revealed that the majority of parents did not follow at least one half of the physicians' home care instructions. The findings of the study indicate the need to further examine factors associated with parental compliance with home care instructions. PMID- 2760800 TI - Newborn infants' preference for sterile water versus five--percent glucose and water. AB - This study examined whether normal newborn infants had a preference for 5% glucose and water or sterile water for their first feedings. An ex post factor design was used with 215 normal newborns to test five null hypotheses. The infants' preference for 5% glucose and water was significant at the P less than 0.00001 level. Size significantly influenced intake; larger infants consumed more fluids regardless of type. Race, gestational age, and gender had no statistically significant effects on amount of intake. Further research is needed to validate whether the time at which the solution is offered and the presence of rooting reflexes are associated with the amount of solution an infant will consume. PMID- 2760801 TI - Family adaptation during a pediatric intensive care hospitalization. AB - The purpose of this study was to investigate characteristics of families, specifically their adaptability, cohesion, and coping mechanisms during a child's intensive care hospitalization. The sample consisted of 30 families with children hospitalized in a pediatric intensive care unit. The Family Adaptability and Cohesion Evaluation Scales (FACES-III) and the Family Crisis-Oriented Personal Evaluation Scales (F-COPES) were used to collect data. Results indicate that the families were, as a whole, healthy in their levels of functioning; their dimensions of adaptability and cohesion were balanced. The families studied utilized a variety of coping mechanisms, and specific characteristics were identified that enabled the families to adjust to the child's intensive care hospitalization. PMID- 2760802 TI - A study of pediatric home ventilator management: medical, psychosocial, and financial aspects. AB - This study was conducted to assess whether one program of home ventilator management met the medical, financial, and psychosocial needs of children and their families. The sample consisted of 15 children with home ventilator assistance. Data were collected by chart review, parental telephone interviews, and comparison of home and hospital costs from itemized bills. Results indicated that, in comparison to prolonged hospitalization, home ventilator management is medically safe, with a significant reduction (78%) in overall cost. This study also revealed psychosocial benefits and deficiencies associated with the home care of ventilator-assisted children and their families. The results suggest interventions for nurses in the discharge preparation and follow-up care of ventilator-assisted children and their families. PMID- 2760803 TI - Readability: a critical instrumentation consideration. PMID- 2760804 TI - Our need to give. PMID- 2760805 TI - Perceived distributions of the characteristics of in-group and out-group members: empirical evidence and a computer simulation. AB - This research studied 2 properties of perceived distributions of the characteristics of social category members: the probability of differentiating (making distinctions) among category members and the perceived variability (variance) of category members. The results of 4 experiments supported the hypothesis that greater familiarity with a social group leads to greater perceived differentiation and variability regarding that group. In-group members formed more differentiated and variable distributions for groups defined by age and more differentiated distributions for groups defined by nationality. For gender (where students were roughly equally familiar with people of both genders), no in-group--out-group differences occurred. Also, students perceived greater differentiation and variability among classmates over the course of a semester. To explain these results, we developed PDIST, a multiple exemplar model that assumes that people form perceived distributions by activating a set of category exemplars and then judging the relative likelihoods of different feature values on the basis of the relative activation strengths of these feature values. The results of a computer simulation experiment indicated that PDIST is sufficient to explain the results of our 4 experiments. According to the perceived distributions formed by PDIST, increasing familiarity leads to greater differentiation and variability, has a concave impact, and has greater impact on differentiation than on variability. PMID- 2760806 TI - Personality and conditioning: a test of four models. AB - Four experiments were conducted to test hypotheses derived from 4 alternative models of individual differences in instrumental conditioning. A standard go--no go discrimination learning task was used in each of the 4 experiments. The results indicate that individual differences in performance of this discrimination are more consistently and strongly associated with impulsivity and anxiety than with extraversion and neuroticism. In each of the experiments, high anxiety hindered the learning of a go--no-go discrimination more among high impulsive Ss than among low impulsive Ss, and in 2 of the experiments high anxiety actually facilitated learning among low impulsive Ss. These findings are incompatible with Eysenck's and Gray's hypotheses regarding extraversion but are not inconsistent with Newman's. Aspects of these results do support Spence's and Gray's models of anxiety and instrumental conditioning. However, both of these models were contradicted by other trends in the data. A modification of Gray's model of impulsivity and anxiety that emphasizes the role of expectancies was proposed to fit these data. PMID- 2760807 TI - Constructive thinking: a broad coping variable with specific components. AB - The structure of constructive thinking and the development of an instrument for measuring it, the Constructive Thinking Inventory (CTI), were discussed. Scales were derived from a factor analysis of an item domain of people's everyday automatic thinking. When the CTI and other tests were factor analyzed, separate intellective and nonintellective factors were found, with the CTI loading more strongly on the nonintellective factor than any other test. Only measures of IQ loaded on the intellective factor. The global constructive thinking scale correlated significantly with success in work, love, social relationships, and in maintaining emotional and physical well-being, but not with academic achievement, the only criterion with which the measures of IQ correlated strongly. The patterns of correlations between the CTI scales and the various criteria as well as the factor analysis demonstrated that the construct of constructive thinking is differentiated as well as integrated. PMID- 2760808 TI - Cognitive person variables in the delay of gratification of older children at risk. AB - The components of self-regulation were analyzed, extending the self-imposed delay of gratification paradigm to older children with social adjustment problems. Delay behavior was related to a network of conceptually relevant cognitive person variables, consisting of attention deployment strategies during delay, knowledge of delay rules, and intelligence. A positive relationship was demonstrated between concurrent indexes of intelligence, attention deployment, and actual delay time. Moreover, attention deployment, measured as an individual differences variable during the delay process, had a direct, positive effect on delay behavior. Specifically, as the duration of delay and the frustration of the situation increased, children who spent a higher proportion of the time distracting themselves from the tempting elements of the delay situation were able to delay longer. The effect of attention deployment on delay behavior was significant even when age, intelligence, and delay rule knowledge were controlled. Likewise, delay rule knowledge significantly predicted delay time, even when age, attention deployment, and intelligence were controlled. PMID- 2760809 TI - [Studies on the synthesis of antiulcer agents. IV. Synthesis and antiulcer activity of dihydrobenzofuranone derivatives]. AB - The derivatives of 3-[3-oxospiro[benzofuran-2(3H),1'-cyclopropan]-5-yl]acrylic acid were synthesized and tested for antiulcer activities. As a result, 1-[3-[3 oxospiro[benzofuran-2(3H),1'-cyclopropan]-5- yl]acryloyl]piperidine(3t) and 4-[3 [3-oxospiro[benzofuran-2(3H),1'-cyclopropan]-5- yl]acryloyl]morpholine(3u) exhibited potent antiulcer activities. PMID- 2760810 TI - [Studies on the synthesis of antiulcer agents. V. Synthesis and antiulcer activity of dihydrobenzofuranone derivatives]. AB - In the preceding paper, we reported that 1-[3-[3-oxospiro[benzofuran-2(3H),1' cyclopropan]-5- yl]acryloyl]piperidine(1a) and 4-[3-[3-oxospiro[benzofuran 2(3H),1'-cyclopropan]-5- yl]acryloyl]morpholine(1b) have potent antiulcer activities. In this paper, propionic acid derivatives (2,3) and oxyacetic acid derivatives (4, 5, 10) were prepared by converting the acryloyl moiety into propionyl and oxyacetyl groups, and tested for antiulcer activities. As a result, [3-oxospiro[benzofuran-2(3H),1'-cyclopropan]5-yloxy]-a cetamide(4j) exhibited significant antiulcer activities. PMID- 2760811 TI - [Studies on the constituents of trichosanthes root. I. Constituents of roots of Trichosanthes kirilowii Maxim. var. japonicum Kitam]. AB - From the fresh roots of Trichosanthes kirilowii Maxim. var. japonicum Kitam., the following substances were identified: methyl palmitate, palmitic acid, suberic acid, alpha-spinasterol, stigmast-7-en-3 beta-ol, alpha-spinasterol 3-O-beta-D glucopyranoside, stigmast-7-en-3 beta-ol 3-O-beta-D-glucopyranoside, bryonolic acid, cucurbitacin B, cucurbitacin D, vomifoliol, ethyl alpha-L-arabinofranoside and D-glucose. The bitter taste of Trichosanthes Root was considered to be due to cucurbitacin B and D. PMID- 2760812 TI - [Studies on the constituents of trichosanthes root. II. Constituents of roots of Trichosanthes cucumeroides Maxim]. AB - From the fresh roots of Trichosanthes cucumeroides Maxim., three new triterpenoid glycosides with a bitter taste were obtained together with methyl palmitate, palmitic acid, alpha-spinasterol, stigmast-7-en-3 beta-ol, alpha-spinasterol 3-O beta-D-glucopyranoside, stigmast-7-en-3 beta-ol 3-O-beta-D-glucopyranoside and vanillic acid. On the basis of the results of spectral and chemical investigations, these glycosides were characterized as 25-O-beta-D-glucopyranosyl 11-oxocucurbit-5-ene-3 beta,24(R), 25-triol 3-O-alpha-L-rhamnopyranosyl-(1----2) beta-D-glucopyranosyl-(1----2)-beta -D- glucopyranoside, 25-O-beta-D-(6-O-acetyl) glucopyranosyl-11-oxocucurbit-5-ene-3 beta,24(R), 25-triol 3-O-alpha-L rhamnopyranosyl-(1----2)-beta-D-glucopyranosyl(1----2)- beta-D-glucopyranoside and 11-oxocucurbit-5-ene-3 beta,24(R), 25-triol 3-O-alpha-L-rhamnopyranosyl-(1--- 2)-beta-D-glucopyranosyl-(1----2)- beta-D-glucopyranoside. PMID- 2760813 TI - [Studies on the constituents of trichosanthes root. III. Constituents of roots of Trichosanthes bracteata Voigt]. AB - From the fresh roots of Trichosanthes bracteata Voigt., the following substances were identified: methyl palmitate, palmitic acid, suberic acid, alpha spinasterol, stigmast-7-en-3 beta-ol, alpha-spinasterol 3-O-beta-D glucopyranoside, stigmast-7-en-3 beta-ol 3-O-beta-D-glucopyranoside, glyceryl 1 palmitate, glyceryl 1-stearate, bryonolic acid, cucurbitacin B, isocucurbitacin B, 3-epi-isocucurbitacin B, 23,24-dihydrocucurbitacin B, 23,24 dihydroisocucurbitacin B, 23,24-dihydro-3-epi-isocucurbitacin B, cucurbitacin D, isocucurbitacin D and D-glucose. This root contains more than 6 times cucurbitacin of the root of T. kirilowii Maxim. var. japonicum Kitam. PMID- 2760814 TI - [Seasonal fluctuation of flavonol glycosides in Epimedium species]. AB - The seasonal fluctuation of flavonol glycosides in the leaves of Epimedium grandiflorum var. thunbergianum, E. cremeum and E. sempervirens (Berberidaceae) was investigated. The total content of glycosides was shown in the highest quantity at the flowering time, and as the leaves mature it has become stable amount with a little decrease. The suitable period for the harvest of Epimedium leaves was concluded to be two or three months after the flowering time. PMID- 2760815 TI - [Acid-base fractionation of lipophilic components in human urine and their high performance liquid chromatography equipped with multichannel ultraviolet detector: an application to xanthine derivatives]. AB - Column extraction technique was applied to acid-base fractionation of urinary lipophilic components. The acidified urine was retained on an extraction column packed with diatomaceous earth granules. Extraction solvent passed through the column was introduced directly into alkaline columns to fractionate strong and weak acidic components, the former being trapped on sodium hydrogen carbonate and the latter on sodium hydroxide column. Neutral components were eluted out without any chemical interaction with the support reagents. Acidic components retained in the column were recovered after acidified with acetic acid. Each fraction thus obtained was analyzed by silica gel high performance liquid chromatography equipped with a multi-channel ultraviolet detector using a solvent system consisted of 0.2% distilled water, 0.2% acetic acid, 15% ethanol and appropriate volume of n-hexane. Thus the comparative chromatographic studies of these three fractions became very easy. In our experiment, urinary components were extracted and chromatographed in the order of their partition coefficients. The method was applied to xanthine derivatives after the administration of caffeine tablets to a healthy volunteer. PMID- 2760816 TI - Comparative bioavailability of a new commercial tablet formulation and two lots of a reference formulation of haloperidol. AB - The bioavailability of a new tablet formulation (5 mg) of haloperidol was estimated relative to two lots of a reference product. Twenty-eight healthy male volunteers completed all three phases in that they received the test (T) and the two reference formulations (R1 and R2) in a balanced three-way crossover design. Using a sensitive HPLC method, plasma concentrations of haloperidol and reduced haloperidol were monitored over a period of 96 h following administration of each formulation. Haloperidol was measurable in the plasma of all the volunteers, whereas reduced haloperidol was measurable in only 6 out of 28 volunteers following each administration. Therefore, the assessment of bioequivalence in this study is based on haloperidol data only. The maximum plasma concentration (Cmax), time to Cmax (tmax), and area under the curve up to the last measurable concentration (AUCot) or infinity (AUCo infinity) were compared by analyses of variance and found not to be significantly different across the formulations. The relative bioavailability based on T:R1 or T:R2 ratios of AUCo infinity, AUCot, and Cmax was, in each case, within the acceptable range of 100 +/- 20%. Also, the relative bioavailability of R1 compared with R2 was within 100 +/- 20% in terms of the above bioavailability parameters. Except for tmax, all other pharmacokinetic parameters showed wide intersubject variation. PMID- 2760817 TI - Relationship between concentration and anticonvulsant effect of phenytoin against electroshock-induced seizures in rats: comparison of sampling sites for concentration determinations. AB - The purpose of this investigation was to determine the optimum sampling site for phenytoin concentration measurements in the context of pharmacodynamic studies of the anticonvulsant effect of phenytoin. Determination of drug concentrations in the serum, serum water, brain, and cerebrospinal fluid (CSF) of rats as a function of time after iv injection of a 6-mg/kg dose revealed a significant disequilibrium between brain and serum water for 15 min and between CSF and serum water for 5 min after injection. The concentrations of phenytoin in serum water 1 min after injection of 3 mg/kg (0.371 +/- 0.054 microgram/mL) and 45 min after injection of 8 mg/kg (0.399 +/- 0.049 microgram/mL) were not significantly different, but drug concentrations in the CSF and brain were appreciably higher after the latter dose. There was no protection against electroshock-induced seizures 1 min after the 3-mg/kg dose, but there was complete protection 45 min after the 8-mg/kg dose. At 15 min after drug injection, phenytoin concentrations in CSF and serum water were essentially identical over a wide concentration range. Fifty female Lewis rats weighing approximately 225 g, that consistently exhibited maximal electroshock-induced seizures in three preliminary trials on separate days, received 1, 2, 4, 6, or 8 mg/kg of phenytoin by iv injection. Electroshock was applied 15 min later, the percentage of animals protected from seizure by each dose was determined, and drug concentrations in serum, serum water, brain, and CSF were measured by gas chromatography. The relationship between anticonvulsant activity and drug concentration could be described by a Hill-type equation.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2760818 TI - Hepatic drug clearance in children: studies with indocyanine green as a model substrate. AB - For several drugs metabolized by the liver, higher dosages (mg/kg body weight) are required in children to attain serum concentrations comparable to those in adults. Indocyanine green (ICG), a commonly used model substrate for hepatic elimination of high intrinsic clearance drugs, has been extensively evaluated in adults but not in children. We evaluated the disposition of ICG in 115 children with leukemia and nine healthy adult volunteers. The mean (SD) ICG plasma clearance (CLp) for all 115 children (age 0.9-17.8 years) was significantly greater (p = 0.0006) than for adults [14.8 (7.8) versus 10.6 (2.4) mL/min/kg]. When clearances from only children less than 10 years of age (N = 85) were compared with those from adults, the difference was even greater [15.6 (7.3) versus 10.6 (2.4) mL/min/kg; p = 0.0001]. However, when ICG CLp was normalized to body surface area, values for children did not differ significantly from adults [378 (204) versus 422 (102) mL/min/m2]. These data provide insight as to why dosage (mg/kg) requirements of certain drugs are higher in children. PMID- 2760819 TI - Concurrent determination of hepatic bioavailability of salicylamide by three techniques in the dog. AB - Three methods of measuring hepatic first-pass metabolism of salicylamide in dogs that had undergone portacaval transposition were compared. The drug in both its radiolabeled (0.74 MBq) and unlabeled (20 mg/kg) forms was infused concurrently into forelimb and hindlimb veins, respectively. Because of the transposition, drug from the hindlimb is subject to first-pass metabolism in the liver. Bioavailability is a complementary measure of the extent of this metabolism. The three methods of determining bioavailability were continuous withdrawal of blood to determine the ratio of the areas under the plasma concentration versus time curves, ratio of specific activities in plasma after all the drug had been administered, and the conventional method, measurement of the ratio of areas determined from sequential plasma concentrations. The three techniques were found to give virtually identical values for bioavailability. Each method has its own advantages, limitations, and possible applications. The continuous withdrawal technique is potentially most applicable for drugs with short half-lives. The ratio of specific activities may be the preferred method for drugs with long half lives. The conventional method is limited by the number of samples needed, but is potentially useful under those conditions in which data following test and intravenous routes of administration are available. PMID- 2760820 TI - Cytotoxic effects of methionine alkyl esters and amides in normal and neoplastic cell lines. AB - Homologous series of L-methionine alkyl ester hydrochlorides and tosylates were synthesized and evaluated for in vitro growth inhibitory activity in Meth A sarcoma. Cytotoxicity, as determined by [3H]thymidine incorporation, was found to be directly proportional to alkyl chain length and surface tension lowering activity. L-Methionine decyl and dodecyl ester hydrochlorides possessed optimum cytotoxic activity (IC50 = 29, 28 microM) which was not reversible by the addition of L-methionine. Surface tension of a 50 microM solution of the decyl and dodecyl ester hydrochlorides were 35.4 and 32.7 dyn/cm, respectively. The corresponding decyl and dodecyl ester tosylates and amide hydrochlorides were less active. The N-t-butoxycarbonyl analogues were essentially inactive, demonstrating the necessity of an unsubstituted and/or potentially cationic amino group. Methionine dependence characteristics and cytotoxicity were also determined for three human (IMR-90, LX-1, MCF7) and four additional murine (L1210, L5178Y, 3T3, SV-T2) cell lines. The human cell lines Meth A, LX-1, and SV T2 were found to be methionine independent. The LX-1 tumor cell line and the SV T2 transformed line exhibited two to four times more sensitivity to the cytotoxic and cytolytic properties of the decyl and dodecyl ester hydrochlorides than their normal counterparts. The dodecyl amide hydrochloride derivative demonstrated enhanced cytotoxic activity in vivo relative to the corresponding ester, possibly due to decreased metabolic hydrolysis. PMID- 2760821 TI - Effect of viscosity on the pharmacokinetics and biological response to intranasal desmopressin. AB - The effect of viscosity on the nasal absorption and biological response to desmopressin was studied in humans. Nasal solutions of desmopressin with and without the addition of 0.25% (w/v) methylcellulose were administered by a precompression nasal spray pump to 10 volunteers. Plasma levels of desmopressin were assayed by radioimmunoassay and the biological response was measured by determination of the antihemophilia factors (Factor VIII and von Willebrand factor). The results showed that the addition of methylcellulose produced a more sustained and slower absorption, with a longer time to maximum plasma concentration (tmax). However, the areas under the plasma concentration-time curve were not different, indicating a similar total bioavailability. The biological response showed a similar effect. Peak Factor VIII activity was not different, but the presence of methylcellulose produced a slower onset of activity. These findings indicate that although the addition of a viscous agent to nasal formulations may produce a more sustained effect, it delays the onset of activity and no enhancement is achieved in the total bioavailability. PMID- 2760822 TI - Ethanol and water sorption into stratum corneum and model systems. AB - Sorption of ethanol and water into stratum corneum, delipidized stratum corneum, and triolein as a simple model lipid was investigated. Optima in ethanol sorption and flux are related to dehydration of keratins. There was no optimum for solubility in triolein; a linear cosolvency is observed with ethanol:triolein mixtures. A model is proposed which qualitatively predicts the key features of ethanol-enhanced skin permeation on the basis of these solubility phenomena and a constant diffusion coefficient. PMID- 2760823 TI - Blood clearance and organ distribution of intravenously administered polymethacrylic nanoparticles in mice. AB - Polymethacrylic nanospheres (mean diameter 0.25-0.30 microns), prepared by aqueous emulsion copolymerization, were developed as a new site-specific drug delivery system. The nanoparticles were labeled either with indium-111 or iodine 125, and after a single iv injection of labeled particles into mice, their blood clearance and organ distribution were analyzed. A rapid clearance of 111In labeled nanoparticles from the blood circulation to the mononuclear phagocyte system (MPS) was visualized using external scintigraphic imaging. From 10 to 60 min, radioactivity measurements in blood and organs (liver, spleen, kidneys, lungs, heart) showed that the 125I-labeled nanospheres were rapidly removed from the bloodstream (distribution half-life approximately 3-5 min) and mainly deposited in the liver (60% of the administered dose, 10 min after administration). Up to 1 h, radioactivity in heart and lungs remained insignificant, while in the kidneys, radioactivity levels increased from 8 to 11%. PMID- 2760824 TI - Solubilities and solid state properties of the sodium salts of drugs. AB - The solubilities in water of a number of sodium salts of weakly acidic drugs were determined. The compounds examined included barbiturates, sulfonamides, and hydantoins. When the logarithm of the aqueous solubilities of the salts were plotted against their melting points, an inverse relationship was observed; however, a good correlation was not immediately apparent. Further studies were conducted on the solid phases of the drugs after equilibration with water, using calorimetric, spectrophotometric, and gravimetric methods. In many cases, hydrate formation was evident and, for some compounds, the stoichiometric amount of water in the crystal was different before and after equilibration with water. Multivariate analysis of the data indicated that the logarithms of the molar solubilities were inversely related to both the melting points and the stoichiometric amounts of water in the crystal hydrates, but were unrelated to the polarity of the corresponding acid forms of the drugs. Therefore, for the sodium salts of these drugs, the solubility is primarily controlled by the properties of the solid phase which exists in equilibrium with the solution phase. PMID- 2760825 TI - Technetium-99m radiochemical assay by rapid filtration: a superior alternative to chromatography. AB - A new method for simultaneously measuring radiochemical purity and estimated lung trapping of colloidal technetium-99m (99mTc) radiopharmaceuticals is described. The method employs a small filtration device comprised of two stacked membrane filters, differing in membrane composition and in pore size, situated over a filtrate collection vial. Specifically, an 8-microns pore polycarbonate membrane filter is situated above a 0.22-microns pore mixed-cellulose-esters membrane filter. For assay, a diluted aliquot of radiopharmaceutical is passed through the filtration device. Technetium-99m radioactivity on the membranes and in the vial is then measured. The polycarbonate filter traps and quantitates lung-capillary occluding particles. The mixed-cellulose-esters filter traps and quantitates radiocolloid particles irrespective of relative size. The filtrate contains free pertechnetate. Within 4 min, this method yields results that compare well with those achieved by conventional techniques. The method works equally well for large colloidal particles [( 99mTc]stannous colloid), intermediate-size particles [( 99mTc]sulfur colloid), and small-size particles [( 99mTc] antimony trisulfide colloid). PMID- 2760826 TI - Calcium ion sequestration by N-acylamino acids within the rectal membrane and the enhancement of the rectal absorption of sodium ampicillin in rats. AB - The present study reports the contribution of the calcium ion sequestration capacity of N-acylamino acids, used as absorption promoters, to their absorption promoting action. Different extents of enhanced rectal absorption of sodium ampicillin by N-acylamino acids were well explained by the predicted amount of calcium ion sequestrated by N-acylamino acids existing in the rectal membranes. The amount of N-acylamino acids that penetrated into the rectal membrane was predicted by the product of the Rm value and the dose of N-acylamino acids. Thus, in the present study, it was demonstrated that the extent of the promoting effect of adjuvants at various doses on the membrane permeability may be predicted by multiplying the calcium ion sequestration capacity obtained in vitro by the lipophilicity and the dose applied to the rectal lumen of adjuvants. PMID- 2760828 TI - Preliminary studies of the development of a direct compression cellulose excipient from bagasse. AB - Bagasse is an unused by-product in cane sugar manufacture. Bagasse from sugar cane manually harvested in Indonesia was transformed to pulp by mechanical means and repeated autoclaving in 1.4% NaOH. It was then subjected to cycles of bleaching with hypochlorite and acid hydrolysis with 2.5 M HCl to produce 'microcrystalline' cellulose (MCC). Extraction of waxes by petroleum ether was necessary in order to improve the disintegration properties of tablets made from this material, DICEB III. When the bagasse-derived cellulose was reconstituted by recombining different proportions of selected sieve cuts to have a similar sieve size distribution as the commercially available MCC, Avicel PH102, it was found that the latter and DICEB III also had similar crystallinity as measured by X-ray powder diffraction (degree of crystallinity 2.8 +/- 0.2). The crystallinity and flow index were also relatively insensitive to most of the changes in the manufacturing procedure, indicating that the production process was quite robust. Directly compressed tablets were made containing 50 mg of caffeine and 500 mg of either Avicel PH102 or DICEB III to approximately the same hardness (11.6 +/- 1.1 and 13.7 +/- 0.5 kPa, respectively). They displayed similar satisfactory disintegration and dissolution behavior. However, DICEB III required greater compaction pressures than Avicel PH102, perhaps because the former was not spray dried to give spherical agglomerates of particles of uniform size as the commercial product. Rather, DICEB III consisted mainly of single irregular particles. Further work is required to improve the new excipient and to explore if the bagasse from mechanically harvested sugar cane (often contaminated by soil) could also be used for production of MCC. PMID- 2760827 TI - Serum protein binding of lomefloxacin, a new antimicrobial agent, and its related quinolones. AB - The serum protein binding of lomefloxacin (LFLX), a new quinolone (pyridonecarboxylic acid), and its related analogues was studied by an ultrafiltration technique. The extent of binding of quinolones was independent of the concentration of quinolones below 100 micrograms/mL in rat serum; but, above this concentration, the binding decreased with increased drug concentration in the case of nalidixic acid and analogue 3. The extent of binding in rat serum differed widely among the quinolones examined [i.e., from 15% (norfloxacin) to 84% (nalidixic acid) at concentrations of 0.4-10.0 micrograms/mL]. Lomefloxacin was bound to serum proteins to the extent of 28.1, 20.1, and 20.6% in the sera of rats, dogs, and humans, respectively. The binding of nalidixic acid with rat serum albumin, which was very similar to that in rat serum, was concentration dependent. Some quinolone derivatives with a piperazinyl group or a relatively large-sized substituent at the 7-position exhibited a percentage unbound of approximately 70-80%, while some derivatives with small-sized substituents gave a low percentage unbound of 20-30%. This suggests that there is a steric effect of the substituents at the 7-position of quinolones on their binding characteristics with serum proteins. The results of the present study indicate that quinolones bind mainly with albumin among serum proteins and that the remarkable difference of the extent of binding of quinolone analogues is related to the size of the substituent at the 7-position of the molecule, possibly due to its steric effect. PMID- 2760829 TI - Simultaneous high-performance liquid chromatography assay of two metabolites of 6 chloro-2-pyridylmethyl nitrate, a new antianginal drug, and its application to a pharmacokinetic study in rats. AB - An HPLC technique has been developed for the simultaneous determination of 6 chloro-2-pyridine methanol (5) and 6-chloro-2-pyridinecarboxylic acid (3), two metabolites of 6-chloro-2-pyridylmethyl nitrate, a new antianginal drug, in rat plasma. The plasma sample was placed on a Bond Elut C18 column and the compounds were eluted with 250 microL of the mobile phase. A 50-150-microL aliquot was injected onto the HPLC column. No interfering substances were observed in the plasma of a normal rat. The calibration curves for both 5 and 3 were linear from 0.1 to 50 micrograms/mL. However, the quantitative detection of the two additional metabolites, N-(6-chloro-2-pyridylcarbonyl)-glycine (1) and N-acetyl-S (6-chloro-2-pyridylmethyl)-L-cysteine (2) was not satisfactory. The metabolic pathway of 6-chloro-2-pyridylmethyl nitrate in vivo was studied in male rats which were dosed separately with 6-chloro-2-pyridylmethyl nitrate, 5, and 3. After intravenous injection of 6-chloro-2-pyridylmethyl nitrate, the unchanged drug was determined by a GC method that was also developed by us and reported in another paper. 6-Chloro-2-pyridylmethyl nitrate was rapidly metabolized, and the metabolites were detected as early as 1 min after 6-chloro-2-pyridylmethyl nitrate administration. The parent compound then declined rapidly and 3 formation was confirmed in the rat plasma. 6-Chloro-2-pyridylmethyl nitrate is extensively metabolized to 3 via 5 formation, and 3 is the main metabolite in rat plasma. PMID- 2760830 TI - Sodium chloride equivalents, cryoscopic properties, and hemolytic effects of certain medicinals in aqueous solution. V: Supplemental values. PMID- 2760831 TI - Relationships between first-order and Michaelis-Menten kinetics. PMID- 2760832 TI - Kaposi's sarcoma of the foot. A review and report of 156 cases. AB - The authors identify the incidence of Kaposi's sarcoma in the foot, and discuss the increasing incidence of AIDS-related cases, and the increasing chance of mortality when this lesion is seen in patients under the age of 50. PMID- 2760833 TI - Z-bunionectomy with internal screw fixation. AB - A new procedure for the correction of hallux valgus was performed on 39 patients (66 feet). The follow-up period averaged 29 months, with a range of 24 to 32 months. The new procedure is a horizontally directed displacement Z-osteotomy in the head and shaft region of the first metatarsal. Rigid internal fixation is obtained with 3.5 or 2.7-mm bone screws. The surgeons' satisfaction rate of 79% compares favorably with the patients' complete satisfaction rate of 85%. PMID- 2760834 TI - Neutral position casting techniques. Results of a survey. AB - The authors conducted a study to identify the nuances and frequencies of use for various neutral casting techniques. This was accomplished through a survey questionnaire that was sent to 300 podiatric physicians and 48 orthotic laboratories selected at random. To the best of the authors' knowledge, this has not been done previously. Survey results indicated that a difference of opinion exists among respondents in identifying critical factors in neutral position casting. PMID- 2760835 TI - Recalcitrant heel pain. Traumatic fibrosis versus heel neuroma. AB - In 1977, Davidson et al wrote an article entitled "Heel Neuroma." Since that time there has been a strong debate on whether the heel neuroma actually exists. The authors present a study of 14 patients presenting with recalcitrant heel pain. Each patient underwent surgical excision of a plantar heel mass. Two patients had bilateral procedures. Preoperative findings are compared with postoperative results. All of the patients experienced at least 75% relief, and the overall satisfaction rate was 79%. PMID- 2760836 TI - Texas informed consent experience. A model for the nation. PMID- 2760837 TI - Exposure of rats to inhalational anesthetics alters the hepatobiliary clearance of cholephilic xenobiotics. AB - Several recent studies indicate that anesthesia-induced alteration of UDP glucuronic acid concentrations can affect the rate of xenobiotic glucuronidation by UDP-glucuronosyltransferases. Other data demonstrate that the biliary excretion of several cholephilic drugs is depressed in rats anesthetized with diethyl ether. The present study has examined the effect of 2% halothane, 1.5% isoflurane, 2% enflurane and 3% sevoflurane on the clearance and biliary excretion of acetaminophen, digoxin, phenol red and phenol-3,6-dibromphthalein disulfonate. All volatile anesthetics reduced hepatic UDP-glucuronic acid concentrations 50 to 75%. Biliary excretion of acetaminophen as well as the glucuronide and sulfate conjugates was depressed by all anesthetics for about 1 hr, whereas biliary excretion of the glutathione conjugate was increased during this time. Although total clearance, elimination half-life and steady-state volume of distribution were not altered, biliary clearance of acetaminophen was decreased by 39 to 50%. Formation of the glucuronide conjugate of phenol red and its biliary excretion were depressed by all volatile anesthetics; however, total clearance was increased by 15 to 25% during isoflurane or sevoflurane anesthesia. Total clearance and steady-state volume of distribution of digoxin were decreased only in rats exposed to halothane. There were no changes in biliary excretion. Urinary clearance of digoxin was increased by all volatile anesthetics, whereas biliary clearance was decreased by halothane and enflurane. Biliary excretion, clearance and volume of distribution of phenol-3,6-dibromphthalein disulfonate were not altered by the anesthetics. These data indicate that the hepatobiliary elimination of the glucuronidated metabolites is reduced in rats exposed to volatile anesthetics. PMID- 2760838 TI - Adenosine-angiotensin II interactions. Part II. The role of adenosine in regulating angiotensin II-induced changes in heart rate and aldosterone release. AB - The purpose of the present study was to determine whether endogenous adenosine (ADO) participates in angiotensin II (AII)-induced decreases in heart rate (HR) and regulates AII-induced aldosterone (ALDO) release. To test these hypotheses we investigated: 1) the effects of ADO and AII on base-line HR and ALDO levels; 2) the effects of ADO on AII-induced bradycardia and AII-induced increases in ALDO levels; 3) the effects of ADO receptor antagonists [caffeine and/or 1,3-dipropyl 8-p-sulfophenylxanthine (DPSPX)] on AII-induced bradycardia and AII-induced increases in ALDO levels; and 4) the effects of ADO receptor hypersensitivity on AII-induced bradycardia. In the latter experiments, the animals were rendered hypersensitive to the bradycardic effects of ADO by administering caffeine for 1 week then abruptly withdrawing caffeine 18 hr before the experiment, i.e., caffeine withdrawal. Intravenous infusions of either ADO or AII decreased base line HR and ADO reduced the bradycardic response to AII. Intravenous infusions of DPSPX attenuated and caffeine withdrawal potentiated AII-induced bradycardia without modifying AII-induced increases in arterial blood pressure. AII increased and ADO did not alter base-line plasma ALDO levels; however, ADO attenuated by 50% AII-induced increases in ALDO levels. Neither DPSPX nor caffeine altered the ability of AII to increase plasma ALDO levels. These results indicate that although ADO has the potential to modulate AII-induced increases in plasma ALDO concentrations, endogenous ADO does not regulate the effects of AII on plasma ALDO levels under the conditions of these studies. However, endogenous ADO, in some way, contributes substantially to AII-induced bradycardia. PMID- 2760839 TI - Acute opioid physical dependence in humans: effect of varying the morphine naloxone interval. I. AB - Acute opioid physical dependence refers to the withdrawal symptoms precipitated by an opioid antagonist administered after a single dose or short-term infusion of an opioid agonist. This phenomenon is particularly interesting given that the abstinence syndrome has generally been thought to develop only after chronic exposure to opioid agonists. The purpose of this study was to determine the minimum time after agonist administration when antagonist-precipitated withdrawal could be observed. Naloxone (10 mg/70 kg) was administered i.m. either 0, 15, 45 or 90 min after single i.m. injections of morphine (18 mg/70 kg) in five nondependent male opiate users. Physiological and subjective report measures revealed no effect of morphine or naloxone at the 0 and 15 min morphine-naloxone interval conditions; however, before the naloxone challenge 45 and 90 min post morphine, agonist effects (e.g., miosis, respiratory depression and good drug effect subjective ratings) were clearly evident. Naloxone reversed these effects to premorphine levels and simultaneously precipitated subjective symptoms and observer rated signs of opiate withdrawal. Thus, this study showed that antagonist-precipitated withdrawal in humans was first observed 45 min after agonist administration. Further, the onset of naloxone-precipitated withdrawal effects closely paralleled the onset of morphine agonist effects. The results of this study suggest that adaptational changes underlying the development of physical dependence begin within minutes after acute exposure to an opiate. PMID- 2760840 TI - Role of brain tyrosine availability in mediating differences in ethanol sensitivity in long-sleep and short-sleep mice. AB - Long-sleep (LS) and short-sleep (SS) mice, bred for differences in initial sensitivity to ethanol, were found to differ considerably in the effect of ethanol on brain tyrosine levels. Brain tyrosine levels are decreased in both lines of mice over a 120-min period after ethanol, but the onset of the decrease occurs earlier (15 min vs. 60 min) and the extent of the decrease is greater (39% vs. 18%) in LS mice. This phenomenon is apparently related to the greater central nervous system ethanol sensitivity of LS mice, inasmuch as prior administration of tyrosine will prevent the ethanol-induced decrease in brain tyrosine levels and result in a decrease in the ethanol-induced sleep times of LS mice. An earlier study suggested a relationship between decreased catecholamine turnover in certain brain regions of LS mice and their greater ethanol sensitivity. The present observation that tyrosine pretreatment prevents or attenuates these ethanol-induced decreases in catecholamine turnover, while ethanol sensitivity is reduced, provides additional support for this apparent relationship. If the mice are pretreated with agents (large neutral amino acids) that lower brain tyrosine, the ethanol sensitivity (sleep times) increases in both lines of mice. The increased sensitivity is associated with marked decreases in brain region catecholamine turnover in both the LS and SS mice. These results are consistent with a role for catecholamine neuronal systems in mediating some of the intoxicating actions of ethanol, in general, and the differences in LS/SS ethanol sensitivity in particular. PMID- 2760841 TI - Multiple in vitro interactions with and differential in vivo regulation of muscarinic receptor subtypes by tetrahydroaminoacridine. AB - Tetrahydroaminoacridine (THA) is known to be a potent centrally acting cholinesterase inhibitor. In this report, the effects of THA in vivo and in vitro on the binding of muscarinic agonists and antagonists to putative M1 and M2 receptor subtypes were assessed in rat brain membranes. THA competitively inhibited labeled agonist and antagonist binding to membranes prepared from M1 and M2 enriched brain regions. The dissociation of radiolabeled antagonists from muscarinic receptors was decelerated markedly by THA. The half-time for dissociation of [3H]oxotremorine-M from the high affinity state of M1 and M2 receptors was unaffected by THA. Chronic THA administration resulted in a selective down regulation in the number of M1 receptors assayed directly with the M1-selective antagonist, [3H]pirenzepine. The decrease in the binding capacity of [3H]pirenzepine was correlated positively with the duration of drug treatment. Saturation analysis of [3H]pirenzepine binding confirmed that this loss in binding capacity was due to a reduction in the number of binding sites and not an altered affinity of the receptor for [3H]pirenzepine. Carbachol-[3H]pirenzepine competition revealed no change in the ratio of high and low affinity agonist states of the M1 receptor with chronic THA administration. In vivo studies demonstrate further that the total number of muscarinic receptors was decreased significantly, whereas putative M2 receptors, measured directly with the agonist [3H]oxotremorine-M or estimated by pirenzepine-[3H]quinuclidinyl benzilate competition, were unchanged. Thus, THA exhibits multiple actions at primary and secondary recognition sites on putative M1 and M2 subclasses of muscarinic receptors. The results suggest further that the clinical pharmacology of THA may represent a composite efficacy of THA at multiple sites on cholinergic synapses. PMID- 2760842 TI - BRL 34915 (Cromakalim) stimulation of 42K efflux from rabbit arteries is modulated by calcium. AB - BRL 34915 (Cromakalim) is a novel benzopyran that has anti-hypertensive actions. Contractile and 42K efflux responses to BRL 34915 were measured in blood vessels from the rabbit to determine whether Ca-dependent K-channels [K(Ca)] were involved. BRL 34915 increased 42K efflux from all blood vessels tested with an EC50 of 0.2 to 0.7 microM in the superior mesenteric artery (SMA). BRL 34915 also inhibited norepinephrine (NE)-stimulated 42K efflux (96%) and contraction (50%) in SMA with IC50 values (0.2-0.3 microM) which were similar to the EC50. Comparison of two vascular sites showed that the portal mesenteric vein required 10-fold higher BRL 34915 to achieve a 42K response equivalent to the maximal effect on SMA, yet the maximum response to NE was 4-fold greater in portal vein than SMA. The 42K efflux stimulated by BRL 34915 exhibited a significant decrement with time. Ca-removal increased the magnitude and stability of the BRL 34915 response in SMA and femoral arteries, whereas reapplication of Ca in the presence of BRL 34915 caused the 42K efflux to decrease rapidly. These effects of Ca were not altered by nisoldipine (NIS). The 42K efflux stimulated by BRL 34915 and by K-depolarization was additive when applied in combination in SMA. BRL 34915 had no effect on the NIS-inhibited 42K efflux (a Ca-dependent component) during K-depolarization. It is concluded that BRL 34915 acts on K-channels which differ significantly from the known properties of K(Ca)-channels and that BRL 34915 indirectly inhibits NE stimulation of contraction and K(Ca)-channels by hyperpolarizing the smooth muscle membrane. PMID- 2760843 TI - Regional O2 consumption and coronary flow during beta adrenoceptor stimulation in reperfused canine myocardium. AB - This study was performed to assess the ability of a reperfused region to increase its flow and O2 consumption upon inotropic stimulation. Isoproterenol (5 micrograms/kg/min) was infused i.v. during the reperfusion phase (4 hr) after 2 hr of the left anterior descending coronary artery occlusion in anesthetized open chest dogs (n = 7). The response was compared to a similar untreated reperfused group (n = 8). Coronary blood flow was obtained with labeled microspheres. Arterial and venous O2 saturations were determined microspectrophotometrically. During reperfusion and isoproterenol infusion, significantly higher heart rate (226 +/- 48 beats/min), maximum positive derivative of left ventricular pressure (3132 +/- 838 mm Hg/sec) and systolic aortic blood pressure (162 +/- 16 mm Hg) were recorded compared to reperfusion in the control group (133 +/- 22, 1615 +/- 184 and 124 +/- 30, respectively). In the control group, coronary blood flow to the reperfused areas decreased from preocclusion values of 85 +/- 22 and 95 +/- 43 to 63 +/- 45 and 47 +/- 31 ml/min/100 g for the subepicardium and subendocardium, respectively. O2 extraction was increased significantly in the reperfused region and O2 consumption was similar to that in the nonoccluded area. The corresponding flow values in the treated group at the end of the reperfusion period were 272 +/- 142 and 183 +/- 150 ml/min/100 g, respectively. With isoproterenol, the O2 extraction was not greater than in the nonoccluded area and the O2 consumption increased about 3-fold in comparison to the control group, although the increase in the reperfused subendocardium was less.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2760844 TI - Muscarinic modulation of endogenous acetylcholine release in rat neostriatal slices. AB - Some classical and nonclassical muscarinic agents were tested for their effects on potassium-evoked acetylcholine (ACh) release from rat neostriatal slices. Release was monitored by measuring endogenous ACh when acetylcholinesterase (AChE) was inhibited with physostigmine (30 microM) or by measuring endogenous choline when AChE activity was left intact. The classical antagonist, atropine (0.1-2 microM), induced an increase in release whether AChE activity was inhibited or intact. The putative M-1 selective antagonist, pirenzepine, had minimal effects over a broad concentration range (2-200 microM) and induced an increase in ACh release only when AChE activity was inhibited. The classical agonist, oxotremorine (10-100 microM) decreased effectively ACh release (by 22 35%), but only when AChE activity was intact. The oxotremorine analog, oxotremorine-M, was apparently more potent than oxotremorine, but also decreased ACh release (by 24-41%) only when AChE activity was intact. Another oxotremorine analog, BM-5, behaved more like a muscarinic antagonist in its effects on neostriatal ACh release, and the highest concentration tested (100 microM) increased release (by 47%) when AChE activity was left intact. As in many other cholinergic systems, the agonists tested in this study were not selective in their action on ACh release modulation in the rat neostriatum. The antagonists, however, were more selective in their action, i.e., pirenzepine was relatively ineffective, and on the basis of this selective action, it can be concluded that modulation of endogenous ACh release in the rat neostriatum is mediated by a M-2 muscarinic receptor subtype. PMID- 2760845 TI - Contribution of the intestine to the first-pass metabolism of felodipine in the rat. AB - The systemic availability of intraduodenally (i.d.) administered felodipine in the rat is about 10%. The purpose of this study was to determine to what extent intestinal metabolism contributes to the first-pass elimination of felodipine in the rat. Four different types of experiments were performed. 1) [3H]Felodipine was given i.v. and i.p.; 2) the uptake of i.p. administered [3H]felodipine by the lymph was studied for 3 hr after dosing; 3) portal blood was collected quantitatively for 40 min after i.d. administration of [3H]felodipine; and 4) the in vitro metabolism of felodipine was studied in intestinal cell suspensions. The mean bioavailability of the i.p. dose was approximately 48%. The uptake via the lymph was negligible as an insignificant amount of the radioactive i.p. dose was recovered in lymph from a main lymph vessel in the peritoneal cavity. An average of 21 +/- 12% of given radioactive dose was recovered in portal blood during the first 40 min after i.d. dosing. The recovered radioactivity was to 40 to 70% due to felodipine and 9 to 16% was due to dehydro-felodipine. These results indicate that substantial first-pass elimination occurs in the intestine of the rat. Further support for gastrointestinal metabolism of felodipine in the rat was obtained from incubations with intestinal cells. PMID- 2760847 TI - Effect of S-8666 on urinary Ca++ excretion in rats. AB - The effect of a novel uricosuric diuretic, S-8666, on urinary excretion of Ca++ was investigated in conscious rats. S-8666 acts mainly on the thick ascending limb of Henle's loop. Oral administration of S-8666 (3.2-316 mg/kg), furosemide (10-316 mg/kg) and trichlormethiazide (TCM; 0.01-10 mg/kg) caused natriuresis in a dose-dependent manner. However, the dose-response relationships for Ca++ and Na+ excretion differed slightly among these drugs. Na+ excretion was enhanced to the same extent by both S-8666 and furosemide, whereas Ca++ excretion induced by S-8666 was much smaller than that induced by furosemide. In the TCM group, there was no correlation between urinary excretion of Na+ and Ca++, but this was, if anything, a negative correlation. In the furosemide group, there was a highly significant positive correlation between these parameters with the slope of the regression line being 0.30 (g/Eq). In the S-8666 group, there was positive correlation between these parameters, but the slope of the regression line (0.13) was significantly lower than that in the furosemide group. The pattern of urinary Ca++ excretion as normalized by Na+ in the S-8666 group was intermediate between those of the TCM and furosemide groups. These results are compatible with the hypothesis that S-8666 has an additional site of action which is common to that of thiazide diuretics. PMID- 2760846 TI - Correlation between the inhibitory effect on catecholaminergic ventrolateral medullary neurons and the hypotension evoked by clonidine: a voltammetric approach. AB - Neuronal activity was monitored in vivo by differential voltammetry, an electrochemical technique measuring the metabolism of catecholamines. This technique was used to determine the influence of low doses of clonidine (starting from 2 micrograms/kg i.v.) on the activity of the catecholaminergic neurons of the nucleus reticularis lateralis region, site of its hypotensive action, and of the locus ceruleus, which is involved in its sedative effect. There was a correlation between the hypotensive effect of low doses of clonidine (2, 5 and 10 micrograms/kg i.v.) and the decrease of the neuronal metabolic activity within the ventrolateral medulla, whereas only higher doses of clonidine (50 micrograms/kg i.v.) decreased the metabolic activity in the locus ceruleus. Thus, we demonstrate in vivo differences in sensitivity toward the same drug of two different neuronal structures that are involved in the regulation of the cardiovascular and wakefulness functions, respectively. The present study also shows that clonidine has a preferential action on a medulla oblongata region that contains imidazoline-preferring receptors, namely the nucleus reticularis lateralis region, rather than on the locus ceruleus region, that contains mainly alpha-2 adrenoceptors. PMID- 2760848 TI - Additive diuretic effect of S-8666 during furosemide-induced diuresis in rats. AB - In order to verify that the novel uricosuric loop-acting diuretic S-8666 has an additional site of action in the distal tubule, we investigated the additive diuretic effect of S-8666 during furosemide-induced diuresis in rats. Intravenous bolus injection of S-8666 (3-30 mg/kg) and trichlormethiazide (TCM) (1-10 mg/kg) caused dose-dependent increases in Na+ excretion during furosemide-induced diuresis (primary, 10 mg/kg i.v.; sustaining, 10 mg/kg/hr i.v.), whereas injection of furosemide (5 mg/kg) did not. Ca++ excretion was decreased by injection of each drug. A significant reduction in Ca++/Na+ was observed at all doses of S-8666 and TCM. Additional natriuretic and hypocalciuric effects were lower in the S-8666 than in the TCM group. From these observations we conclude that: 1) S-8666 has a natriuretic effect which is additive to that of furosemide; 2) S-8666 attenuates the calciuric effect of furosemide; and, 3) S-8666 may have an additional site of action in the distal tubule. PMID- 2760849 TI - Hepatoprotective effects of cystathionine against acetaminophen-induced necrosis. AB - The hepatoprotective effects of cystathionine, as a prodrug of cysteine release, were examined in rodents. When cystathionine (100 mg/kg) was administered i.p. in rats, it was eliminated from rat serum with a biological half-life of 1.19 +/- 0.23 hr. Subsequent to the decrease of serum cystathionine, the concentration of cyst(e)ine increased up to 14.5 +/- 1.2 mg/l, and then decreased with a half-life of 4.12 +/- 0.82 hr. The concomitant administration of taurine (100 mg/kg) did not change the half-life of cystathionine (1.42 +/- 0.33 hr), but significantly increased the half-life of cyst(e)ine (19.1 +/- 0.56 hr). This effect of taurine was also observed when cysteine (100 mg/kg) was administered to rats. The liver injury was induced by the i.p. injection of acetaminophen (5.0 mmol/kg). The mortality rates, serum alanine and aspartate aminotransferase activities and the histological analysis of the livers, which were obtained from living mice, were examined 22 hr after the injections. Two administrations of cystathionine (5.0 mmol/kg x 2), one at 20 min before and one 20 min after the acetaminophen injection, prevented the acetaminophen-induced hepatic necrosis, completely. The coadministration of taurine increased the hepatoprotective activity of cystathionine, even at the low dosages (0.18 and 0.55 mmol/kg x 2). Moreover, the treatments using cystathionine, with and without taurine, restored the hepatic glutathione levels to 2.27 +/- 0.23 and 1.80 +/- 0.27 mumol/g, respectively. These levels had been depleted by acetaminophen injection to 0.96 +/- 0.18 mumol/g, 2 hr after the injection. Propargylglycine, an inhibitor of cystathionase, abolished the hepatoprotective effects of cystathionine, although it could not affect the action of cysteine.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2760850 TI - Transport of methotrexate by the in vitro isolated rabbit proximal tubule. AB - The tubular transport of [3H]methotrexate was studied in isolated nonperfused and perfused superficial proximal tubular segments of rabbit kidneys. Reabsorption represented only 5% of perfused methotrexate, and appeared to be mostly of passive nature inasmuch as it was not modified by reducing the temperature or by ouabain. Cellular accumulation in nonperfused segments and secretion in perfused tubules were highest in the S2 segment and lower in the S3 and S1 segments. Secretion against a bath-to-lumen concentration gradient was observed only in S2 segments (with a maximum methotrexate secretory rate of 478 +/- 48 fmol/mm.min and an apparent Km of transport of 363 +/- 32 microM), and was inhibited by probenecid and folate. The low capacity for methotrexate secretion may be explained by a low capacity of transport across the basolateral membrane of the proximal cell as methotrexate was accumulated only to a low extent in nonperfused tubules (tissue water to medium concentration ratio of 8.2 +/- 1 in S2 segments). During secretion a small amount of methotrexate was metabolized; the nature of the metabolite(s) remains to be defined. PMID- 2760851 TI - Dimethylation of the activator ICI 169,369 results in a high-affinity partial deactivator, ICI 170,809, of the arterial 5-hydroxytryptamine2 receptor system. AB - We investigated the mode of action of the potent antagonist ICI 170,809 in the 5 hydroxytryptamine (5-HT)2 receptor system of arterial smooth muscle. We used isolated preparations from rat tail artery and calf coronary artery with the endothelium rubbed off. In tail artery ICI 170,809 (0.3-30 nM) antagonized surmountably and nearly competitively the contractile effects of 5-HT (pKB = 10.0) and partially prevented the depression of 5-HT-induced contractions caused by methysergide. Increasing methysergide concentrations gradually prevented the protective effect of ICI 170,809. The combination of 30 nM ICI 170,809 with 300 nM of its demethylated analog ICI 169,369 (pKB = 8.8) caused surmountable blockade of the effects of 5-HT as expected from competition of the three drugs for the same receptor. In calf coronary artery ICI 170,809 (1-100 nM) reduced the maximum contractile response to 5-HT by 35% and caused competitive antagonism (pKB = 10.4) of the remaining 65% of the responses to 5-HT. ICI 169,369 (100 nM) completely prevented the depression of the maximum response to 5-HT caused by ICI 170,809. Methysergide (3 nM) depressed the maximum response to 5-HT by 65 and 30% in the absence and presence of ICI 170,809. The results are consistent with the existence of two interconvertible states R in equilibrium R' of the 5-HT2 receptor. The equilibrium of R in equilibrium R' is shifted toward R' by methysergide greater than ICI 170,809 much greater than ICI 169,369. PMID- 2760852 TI - Inflammatory paradental cysts in the globulomaxillary region. AB - Cysts located in the maxilla between the roots of an erupted lateral incisor and a canine were studied. Radicular cysts were excluded by the prerequisite of a positive pulp vitality test in both adjacent teeth, and odontogenic keratocysts were excluded by histologic examination. In the period from 1971-1987, 8 cysts were found which fulfilled the criteria for inclusion. The average age of the patients was 18.8 yr. All cysts were lined by a hyperplastic non-keratinized stratified squamous epithelium and there was always a heavy infiltrate of inflammatory cells in the connective tissue. The clinical and histologic features were similar to those previously reported for inflammatory paradental cysts (IPC) in the mandible. Therefore, it seems justified to suggest that some of the previously described globulomaxillary cysts are in fact IPCs. PMID- 2760853 TI - Amelogenesis imperfecta: a scanning electron microscopic and microradiographic study. AB - The aim of the present study was to use scanning electron microscopy (SEM) to visualize the morphology of the enamel surface in 12 primary teeth from children with amelogenesis imperfecta (AI). The observations were correlated to genetic, clinical and microradiographic data from the same teeth and to non-affected control teeth. SEM showed similar disturbances in teeth with a clinical predominance of hypoplasias and in teeth with a predominance of hypomineralization. In the microradiographs the enamel of most teeth showed both hypoplasias and areas of hypomineralization, independently of the predominant clinical manifestation. In the one boy with an X-linked inheritance pattern, both SEM and microradiography showed the morphology of the enamel to be unique in the present study. In the other teeth, similar manifestations were found in cases with AI as an AD trait and in the sporadic cases. PMID- 2760854 TI - Histopathology of the interactions between alveolar bone and impacted dental germs in osteopetrotic op/op rats. AB - Osteopetrosis, a general increase in bone density, is well-known as an autosomal recessive disease in several mammalian species. Compared with normal littermates, the osteopetrotic rats suffered from a complete failure of tooth eruption. Histologic and microradiographic studies show that the molars and the incisors developed a progressive ankylosis, the bone invades the germs and finally dissociates them. As early as the first days after birth, the incisors and the first molars are affected by the osteopetrotic process while the second and the third molars remain untouched. The periodontal membrane of the incisors is rapidly invaded by the osteopetrotic bone trabeculae. After the eleventh day, the process reached all molars. The germs were overlaid by an occlusal unresorbed bone. The formation of the gebernacular canal appeared to be independent of the prefunctional eruption. PMID- 2760855 TI - Scoring irradiation mucositis in head and neck cancer patients. AB - Irradiation mucositis is defined as an inflammatory-like process of the oropharyngeal mucosa following therapeutic irradiation of patients who have head and neck cancer. Clinically, it is a serious side effect because severe mucositis can cause generalized problems (weight loss, nasogastric tube feedings) and interferes with the well-being of the patient seriously. Grading mucositis is important for the evaluation of preventive and therapeutic measures. The object of this study was to develop a scoring method based on local mucositis signs only. Four clinical local signs of mucositis were used in this score: white discoloration, erythema, pseudomembranes and ulceration. Mucositis of the oral cavity was calculated during conventional irradiation protocol for 8 distinguishable areas using the 4 signs and their extent. A prospective evaluation of this method in 15 irradiated head and neck cancer patients displayed an S-curve reflecting a symptomless first irradiation week, followed by a rapid and steady increase of white discoloration, erythema and pseudomembranes during the second and third week. Oral candidiasis, generalized symptoms such as weight loss and the highest mucositis scores were seen after 3 weeks irradiation. The novel mucositis scoring method may be of value in studying the effect of hygiene programs, topical application of disinfectants or antibiotics on oral mucositis. PMID- 2760856 TI - Paget's disease of bone with involvement of the dental pulp. AB - A case of Paget's disease of bone in a 65-yr-old woman is described with partial obliteration of the pulps of teeth in the affected mandible. This hard tissue had the typical mosaic pattern of bone or cementum seen in that condition. PMID- 2760857 TI - Veterans Administration Cooperative Studies Project No. 147. Part IX: A comparison of the mechanical properties of several alternative metal ceramic alloys cast in clinical and research laboratories. AB - Comparison of mechanical properties of five metal ceramic alloys cast in clinical and research laboratories resulted in significant differences. Tested alloys included one Au-Pd (control), one Pd-Ag, and three Ni-Cr. Mechanical properties included strength, elongation, and microhardness. Tensile bars were torch cast simultaneously with restorations in the clinical laboratory and induction cast by using a preformed design in the research laboratory. Mechanical properties of most alloys showed larger variations when cast in the clinical laboratory. In the clinical laboratory the Au-Pd alloy showed significantly higher values for all properties. One Ni-Cr alloy was not significantly affected by environment for all properties. The remaining alloys were significantly affected for some properties by environment. The different laboratories had no greater or lesser effect on the base metals as a group than on the noble metals. Variation in handling, spruing, casting, and specimen size may account for some of the differences between laboratories. PMID- 2760858 TI - A preliminary study of the effects of tooth guidance on working-side condylar movement. AB - Clinical observations have indicated that lateral working-side tooth contacts can produce a posterior shift of the working-side condyle, resulting in pain in the temporomandibular joint. This study examined the influence of lateral retrusive and lateral protrusive tooth guidance on the movements of working condyles of the lateral pole. Four patients with lateral retrusive natural tooth contacts and four patients with lateral protrusive natural tooth contacts were studied. Movement of the lateral pole of the working condyle was recorded under the following conditions: (1) natural teeth in contact, (2) wearing of a mandibular acrylic resin splint that created lateral protrusive or lateral retrusive tooth guidance, and (3) a central bearing screw and bearing plate separating the teeth. The results indicated that the condition of the patient's temporomandibular joints was a crucial factor in consistency of condylar tracings. Condylar tracings from patients with temporomandibular joint condyle-disk lacking coordination were inconsistent and unreproducible. Consistent, reproducible tracings for patients without condyle-disk disorders indicated that lateral retrusive guidance can cause a more posterior pathway of the lateral pole of the working condyle than lateral protrusive guidance. Future studies are necessary to establish the relationship between lateral tooth guidance and temporomandibular disorders. PMID- 2760859 TI - An evaluation of the film thickness of resin luting agents. AB - Acid-etched cast metal resin-bonded retainers require resin luting agents with film thicknesses similar to dental cements to allow complete seating of frameworks without the need for post-bonding adjustments. Conventional cements, restorative resins, and resin cements were compared in terms of film thickness by using the American Dental Association Specification No. 8 for zinc phosphate cement. Most of the resin luting agents had film thicknesses of 20 to 40 microns. Working time was seen to affect film thickness. The particle size of one resin was also examined under scanning electron micrograph. PMID- 2760860 TI - The effect of complete dentures on head posture. AB - This study investigated possible changes in head posture after insertion of complete dentures in patients who had been edentulous for at least 6 months. The craniovertical angle was measured with a plastic ruler and protractor assembly, which was aligned with dots made on the skin over the zygomatic arch. Readings were made before denture insertion, immediately after insertion, and 15 and 30 minutes later. Two-way ANOVA was used to analyze the results. When the predenture insertion values were included, statistically significant changes (p less than 0.01) in head posture were found. However, when the predenture values were excluded, no statistically significant differences were found. The results support the conclusions that head posture is significantly altered immediately after insertion of dentures in edentulous patients but within the next 30 minutes there is no statistically significant alteration in head posture. PMID- 2760861 TI - Dimensional changes at the posterior border of baseplates made from a visible light-activated composite resin. AB - Dimensional changes of 50 baseplates made of Triad visible light-cured resin were measured before and after curing, placement in water, and drying on the laboratory bench. Results showed that the resin shrinks but improves on storage in water. For persons sensitized to monomer, no free monomer is present in the material. Therefore, Triad resin offers an alternative to conventional self curing resins often used to make baseplates. PMID- 2760862 TI - Technique for superimposing a color slide onto a facial cast to sculpt a facial prosthesis. AB - A precise and uncomplicated technique for superimposing a color slide onto a facial cast for sculpting a facial prosthesis of the periorbital region is described. This technique allows making a facial impression with the eye closed. The superimposed slide in full-face and profile views provide a natural appearance to the facial cast. Properly selected dental and photographic materials are essential to the success of this imaginative procedure. PMID- 2760863 TI - Comparison of weight reduction in different designs of solid and hollow obturator prostheses. AB - Seven types of the partially edentulous maxillectomy arches based on Aramany's classification were designed to evaluate the weight reduction of hollow obturator prostheses. Six obturator prostheses were made for each type of maxillary defect, three of the solid type and three of the hollow type. The weight of each of the 42 obturator prostheses was measured and all of the data were collected and statistically analyzed. The results showed that the hollow obturator prostheses had significantly increased weight reduction, from 6.55% to 33.06% depending on the size of the defect. PMID- 2760864 TI - Functional loading of the dentition during mastication. AB - A method is described whereby the electrical activity in the masseter muscles is used as an index of chewing force. By using the kinesiograph, it was possible to determine the interrelationship of the phases of the chewing cycle and to measure the duration of each phase. On the basis of a pilot study of 10 dentate subjects and two complete denture wearers, it appears that, although the magnitude of the applied load is reduced in denture wearers, this is to some extent compensated for by an increase in the time it is applied. The results also suggest that a greater force is applied to the supporting mucoperiosteum when inverted cusp teeth are used in the construction of the dentures. PMID- 2760866 TI - Distribution of occlusal contacts in maximum intercuspation. AB - This study describes the use of the T-Scan system to record and analyze tooth contact data by calculating time moment statistics in the sagittal and transverse axes of the occlusal plane and reports the results of this method to analyze the occlusion of 93 normal subjects. Results confirm the findings of previous investigators and indicate that in a normal dentition there is a tendency for bilateral equality of the tooth contacts about the sagittal axis and that the center of effort for tooth contacts anteroposteriorly is located in the region of the first molar and is symmetrical bilaterally. Because of the rapid and accurate ability of the T-Scan system to identify the distribution of the tooth contacts, it shows great promise as a clinical diagnostic screening device for occlusion. PMID- 2760865 TI - A comparative electromyographic study of the lateral pterygoid muscle and arthrography in patients with temporomandibular joint disturbance syndrome sounds. AB - To explore the relationships among dysfunction of the two heads of the lateral pterygoid muscle, temporomandibular joint (TMJ) internal derangement, and the mechanism of TMJ sounds, a comparative study was undertaken with electromyography of the two heads of the muscle and arthrography in 38 patients with temporomandibular joint disturbance syndrome sounds. Results suggested that the electromyograph shows various characteristics of dysfunction, when compared with the electromyograph of normal adults, that are significantly relevant to temporomandibular joint internal derangement, especially anterior disk displacement with reduction and without reduction. The mechanism of the sounds was further explained on the basis of the observation of this study. Summing up the data, the authors propose that the dysfunction of the superior head of the muscle is one cause of temporomandibular anterior disk displacement. PMID- 2760867 TI - Risk takers. PMID- 2760868 TI - Transcutaneous oximetry measurement in the PACU. PMID- 2760869 TI - Is it feasible to track infections in an ambulatory surgery center? PMID- 2760870 TI - Mr Adam's questions. PMID- 2760871 TI - Meeting the challenge: economic realities for nurses. PMID- 2760872 TI - Changes in phospholipids, cholesterol and protein content of oviduct fluid of cows during the oestrous cycle. AB - The oviducts of 4 cows were cannulated and oviduct fluid was collected daily from the exteriorized cannulas for a total of 5 oestrous cycles. Daily serum samples were assayed for oestradiol-17 beta and progesterone to monitor the oestrous cycle. Data for each cycle were compared for oviduct fluid collected during the non-luteal phase (serum progesterone less than or equal to 1.5 ng/ml) and the luteal phase (serum progesterone greater than 1.5 ng/ml). During the non-luteal phase oviduct fluid volume was higher and the osmolality was lower than during the luteal phase. Total protein, cholesterol and phospholipid secreted daily was greater during the non-luteal phase. Cholesterol and protein concentrations were generally lower during the non-luteal phase, but phospholipid concentrations were generally higher. About 40% of the phospholipid in oviduct fluid was phosphatidylcholine and lysophosphatidylcholine, while phosphatidylinositol and lysophosphatidylinositol accounted for 20%. The ratio of 1-acyl-phospholipid to diacylphospholipid increased during the non-luteal phase. An increased cholesterol to phospholipid ratio, and a decreased cholesterol to protein ratio in oviduct fluid also were associated with the non-luteal phase. Changes in the lipid composition of oviduct fluid during the oestrous cycle may play a role in the preparation of gametes for fertilization. PMID- 2760873 TI - Gossypol-induced modifications in the microenvironment of rat epididymal spermatozoa. AB - Gossypol acetic acid (20, 25 or 30 mg/kg/day orally for 5 weeks) decreased epididymal weight in adult Sprague-Dawley rats but the epididymal concentrations of proteins, lactate dehydrogenase and acid phosphatase were unchanged. The concentrations of carnitine, inositol and potassium in epididymal fluid were decreased in a dose-related manner. These modifications were not due to disturbances of Leydig and Sertoli cell functions which were normal. We suggest that the reduction in epididymal secretion results from a decrease in the number of spermatozoa rather than from a direct action of gossypol on the epididymal epithelium. PMID- 2760874 TI - Short-day melatonin pattern advances puberty in seasonally breeding rhesus monkeys (Macaca mulatta). AB - Prepubertal, spring-born females (Group H: N = 5) living outdoors were given a daily injection of melatonin (0.70 microgram/kg, s.c.) late in the afternoon to produce a short-day melatonin pattern equivalent to a night of approximately 14 h. The dose of melatonin produced serum concentrations of melatonin which simply extended, within the 24 h day, the normal endogenous nighttime elevation (80-100 pg/ml). The study was started in March when the females were 23 months of age and continued through January. Parameters of sexual maturation for this group were compared to those of untreated, age-matched females (Group C: N = 5) which also lived outdoors under changing environmental conditions. Melatonin treatment significantly advanced age at first perineal swelling (23.9 +/- 0.5 vs 30.5 +/- 0.2 months) and menarche (26.2 +/- 0.9 vs 31.2 +/- 2.4 months). Since all of the females were spring-born, these events occurred earlier in the year in Group H females (swelling: April vs October; menarche: June vs November). Furthermore, 4/5 Group H females exhibited first ovulation in December at 31.8 +/- 0.3 months. None of the Group C females ovulated during their 2nd year, but all did so the next breeding season at 43.5 +/- 0.3 months. All first ovulations in females had luteal-phase progesterone concentrations elevated for at least 12 days with peaks greater than 3.0 ng/ml. Body weights were similar between groups until the post menarchial interval when weight gain was greater in the melatonin-treated females. A similar pattern of group differences also was observed for serum concentrations of growth hormone and somatomedin-C. In addition, prolactin concentrations were seasonally elevated during the summer months in both groups, but concentrations fell to nadir values by August in Group H females and remained elevated until October in Group C animals. These results suggest that, in adolescent females housed outdoors, exposure to a short-day melatonin pattern permits sexual maturation to be initiated at an earlier age, allowing first ovulation to occur in the months immediately after menarche. A long-day melatonin pattern, typically experienced by females at this developmental age, may actually delay the initiation of maturational events until the subsequent fall months. PMID- 2760875 TI - The production of and sensitivity to cues that delay puberty and prolong subsequent oestrous cycles in female mice are influenced by prior intrauterine position. AB - Four experiments were conducted with CF-1 house mice (Mus domesticus) to examine the relationship between a female's prior intrauterine position (2M = between 2 male fetuses, 1M = next to one male fetus, 0M = not next to a male fetus) and the timing of puberty and length of subsequent oestrous cycles under a variety of housing conditions. The results of Exp. 1 confirmed that the presence of males was required for females to enter puberty and exhibit regular oestrous cycles, regardless of prior intrauterine position. When housed individually after weaning either with a male in the cage or separated by a wire mesh partition, 0M-females ovulated and mated at a younger age and had shorter post-pubertal oestrous cycles than did 2M-females (1M-females were intermediate between 0M- and 2M-females). Other females were also housed after weaning with a male or separated by a wire mesh partition from a male in a variety of social environments (4 0M-females and 1 2M-female, 4 2M-females and 1 0M-female, 5 1M-females, 3 0M-females and 3 2M females). The objective of these different housing conditions was to determine whether prior intrauterine position influenced the transmission of and/or sensitivity to cues that delay puberty and prolong subsequent oestrous cycles. Relative to 2M-females, 0M-females both produced more potent cues and were more sensitive to the cues (again, 1M-females were intermediate between 0M- and 2M females). Specifically, in the presence of other females, puberty was delayed and post-pubertal oestrous cycles were prolonged to the greatest extent in 0M females. Prior intrauterine position is therefore a source of individual variation in the production of and sensitivity to cues that modulate the timing of puberty and the length of subsequent oestrous cycles in female mice. The findings suggest that prenatally-androgenized 2M-females may have a reproductive advantage over other females at high population densities. PMID- 2760876 TI - Genotypic effects on gonadal size in fetal mice. AB - Fetal gonadal size was measured on Days 13, 16 and 19 of gestation in the C57BL/6ByEss (B) and BALB/cByEss (C) inbred strains, their two reciprocal F1 hybrids (CXB and BXC) and in the CXBD and CXBE recombinant inbred lines. At Day 13, CXB F1 fetuses, with C57 fathers and BALB mothers, had significantly larger testes and ovaries than did fetuses of the other 5 stocks. On Day 16, BALB fetuses had significantly larger testes than did C57, while at Day 19 C57 fetuses had significantly larger testes than did BALB fetuses. The CXB and BXC F1 fetuses had significantly larger testes than did mice of the two parental strains on Days 16 and 19, even though the mothers of all 4 kinds of fetus came from the same two inbred strains. C57 and BALB mice did not differ significantly in ovarian size, but had significantly smaller ovaries than did mice of the other genotypes on Days 16 and 19. CXBD mice had the largest ovaries, followed by those of the F1 hybrids. Ovarian size in CXBE mice was similar to that in the CXB hybrids. There were strong maternal effects on gonad size on Days 13 and 19 of gestation. The genes that influenced fetal testicular and ovarian growth appeared to differ from those expressed post-natally at 30 and 60 days. PMID- 2760877 TI - Effects of asynchrony on rabbit blastocyst development. AB - The development of synchronously and asynchronously transferred rabbit morulae (recovered at Day 3 p.c.) and blastocysts (recovered at Day 4 p.c.) was investigated before the anticipated time of implantation. The results obtained with various techniques (evaluation of gross morphology, measurement of diameter, thymidine incorporation, light and electron microscopy) led basically to the same conclusions. Embryos being asynchronously transferred to the uterus of recipient rabbits survived, at least in terms of certain cellular functions like cell proliferation, for more than 2 days. Development, however, was clearly retarded and ultrastructural examination revealed substantial cell damage. Some blastocysts showed, even after 3 days, normal growth and cell proliferation indicating considerable differences between individuals in the ability to compensate for suboptimal developmental conditions before implantation. In general, this ability was greater in the transferred Day-3 morulae than in the Day-4 blastocysts. Embryonic growth and the ability to dissolve the zona pellucida, to synthesize crystalloid bodies and to differentiate extraembryonic endoderm indicated the maintenance of some developmental functions under asynchronous conditions. Blastocyst development was influenced by the progestational stage of the recipient. At 1 day after transfer into asynchronous older uteri, blastocyst diameters were larger and cell proliferation was increased compared with all other groups, suggesting an attempt of the blastocyst to adjust to the more advanced maternal milieu. Development in asynchronous younger uteri was delayed. No comparable differences in development were found in cultured embryos for which the media had been supplemented with flushings from the same progestational uterine stages as used for transfer. Thymidine incorporation in cultured embryos did not differ between the various supplements (P greater than 0.05) and was generally lower than in chronologically aged asynchronously transferred embryos (P less than 0.05 for Day-3 and P less than 0.001 or P greater than 0.05 for Day-4 embryos). PMID- 2760878 TI - Donor and recipient genotype and heterosis effects on survival and prenatal growth of transferred mouse embryos. AB - Reciprocal embryo transfers amongst two inbred strains (C3HeB/FeJ and SWR/J) and their F1 cross (C3SWF1) were used to examine donor and recipient genotype and heterosis effects on survival and prenatal growth of mouse embryos. Among inbred strains, significant recipient genotype effects were detected for both embryo survival (P less than 0.01) and prenatal growth (P less than 0.05), while no donor genotype effects were observed. The recipient effect on overall embryo survival was due to a higher proportion of C3H recipients maintaining pregnancy to term than SWR recipients (P less than 0.01), rather than survival within litters. Irrespective of their own genotype, embryos developing in C3H uteri achieved larger body weights (P less than 0.01) and longer tail lengths (P less than 0.05) at birth than did embryos developing in SWR uteri. Recipient heterosis was not significant, while donor heterosis was significant for prenatal growth traits (P less than 0.001). PMID- 2760879 TI - Effects of sera, hormones and granulosa cells added to culture medium for in vitro maturation, fertilization, cleavage and development of bovine oocytes. AB - Sera (fetal calf serum: FCS; and oestrous cow serum: ECS), hormones (2.5 FSH micrograms/ml + 5 micrograms LH/ml + 1 microgram oestradiol/ml) and granulosa cells (5 x 10(6)/ml) were added to culture medium to determine the frequencies of in-vitro maturation, fertilization, cleavage (2- to 8-cell) and development into blastocysts of bovine follicular oocytes. The maturation rates after 24 h in culture were not significantly different among the three factors tested (56-72%). The fertilization rates were significantly affected by serum type and the addition of granulosa cells. FCS gave significantly higher rates of fertilization (57-71%) than did ECS (34-52%), but the proportions of polyspermic fertilization were significantly higher in the former (8-19%) than in the latter (2-3%). The addition of hormones did not affect fertilization, cleavage and development. Neither type of serum affected cleavage and development. The highest rates of blastocyst formation were obtained when granulosa cells alone were added (FCS, 17%; ECS, 16%). The cell numbers of the blastocysts obtained were 100-150, similar to those of blastocysts developed in vivo. Transfer of 6 blastocysts to 3 cows resulted in 1 pregnancy. The present results indicate that the co-culture with granulosa cells is the most important factor for in-vitro fertilization to development into blastocysts of bovine oocytes matured in vitro. PMID- 2760880 TI - Protein synthesis and degradation in non-cultured and in-vitro cultured rabbit blastocysts. AB - In 'pulse-chase' experiments synthesis and half-lives of leucine-labelled proteins were determined in rabbit blastocysts. Embryos were either non-cultured controls or were cultured for 24 h or 48 h in Ham's F-10 medium supplemented with homologous serum or uterine flushings. In control blastocysts protein synthesis increased by a factor of 10 between Day 4 and Day 5. Half-lives of newly synthesized proteins were 32 h in Day-4 and 99 h in Day-5 control blastocysts. In vitro culture of Day-4 blastocysts led to dramatically shortened half-lives, amounting to 6-10 h. Blastocysts developing in uterine flushing-supplemented media differed significantly from those cultured in serum-supplemented media. Protein synthesis was enhanced and protein degradation was normal for culture times up to 24 h. These results demonstrate (1) that half-lives of proteins in rabbit blastocysts increase with advancing embryonic age, and (2) that a characteristic feature of the altered metabolism of cultured blastocysts is a dramatically accelerated protein degradation, which (3) can be prevented for some time by supplementation of the culture medium with uterine secretions. PMID- 2760881 TI - Growth factor activity in luminal fluids from the male reproductive tract of the ram, rat, tammar wallaby (Macropus eugenii) and Japanese quail (Coturnix coturnix japonica). AB - Growth factor activity in luminal fluids from the male reproductive tract was assayed by measuring the stimulation of [3H]thymidine incorporation into BALB/c 3T3 fibroblasts. The potency of fluids from the rete testis of the rat, ram, tammar wallaby and Japanese quail was much the same. However, about 90% of the activity in fluid from the rete testis of the rat and tammar was lost during its passage through the epididymis. PMID- 2760882 TI - Functional and morphological characteristics of the first corpus luteum formed after parturition in ewes. AB - The ability of sheep luteal cells from the first corpus luteum formed after parturition (Group F) to secrete progesterone in the presence or absence of LH was compared with that of luteal cells obtained from normal cyclic ewes (Group C). Luteal concentrations of receptors for LH and prostaglandins (PG) F-2 alpha (PGF-2 alpha) and the cellular composition of corpora lutea from Groups F and C were also compared. Luteal cells from Group F secreted less progesterone in either the presence or absence of LH (P less than 0.01). There was no difference in the number of receptors for LH or PGF-2 alpha per luteal cell between Groups F and C (P greater than 0.1), nor was there a difference in the number of large or small steroidogenic luteal cells (P greater than 0.1). It was concluded that, if short-lived corpora lutea are insensitive to gonadotrophins, this response is not mediated by decreased numbers of receptors for LH. In addition, if the first corpus luteum formed post partum in ewes is more sensitive to the luteolytic effects of PGF-2 alpha, this effect is not mediated by an increased number of receptors for PGF-2 alpha or an increased proportion of PGF-2 alpha-sensitive large luteal cells. PMID- 2760883 TI - Synthesis of polypeptides by the cervix of the baboon (Papio anubis). AB - Administration of oestradiol to ovariectomized baboons caused the epithelium of the cervix to differentiate into tall columnar cells that were ciliated or secretory. Administration of progesterone in the presence or absence of oestradiol altered the appearance of the lining epithelium, suggesting a decrease in secretory activity. Fluorographs of media from cultures of tissue from steroid treated animals reflected changes in polypeptide biosynthesis which correlated with the morphological observations: 6 polypeptides (Mr 88,000-37,000; pI 5.5 6.0) were observed in all treatment groups and, except for relative changes in intensity, these polypeptides were electrophoretically similar to those synthesized by the endometrium. A new group of low molecular weight polypeptides (Mr 23,000-20,000, pI greater than 8.0-5.5) and a basic protein (Mr 160,000) were synthesized and released in the oestradiol-dominated animal. These polypeptides were distinct to the cervical mucosa since they were not observed in the endometrium or oviduct. Progesterone suppressed the synthesis of the low molecular weight acidic polypeptides (Mr 23,000-20,000; pI 6.1-5.5) but maintained the synthesis of the basic polypeptides (Mr 23,000-20,000; pI greater than 8). Treatment with progesterone +/- oestradiol did not appear to induce the synthesis of any new major polypeptides in the cervical epithelium. These results suggest that oestradiol induces the synthesis of a group of cervix-specific polypeptides and progesterone antagonizes the action of oestradiol in the baboon cervix. PMID- 2760884 TI - Effect of oestradiol delivered from a perioviducal device on ovum transport in mice. AB - Silastic devices impregnated with oestradiol and blank devices were placed around both oviducts and around skeletal muscle bundles in the forelegs to attain local and systematic delivery, respectively. Another group of mice received an oestradiol-impregnated device around one oviduct and a blank device in the contralateral oviduct. Implantation of blank devices around the oviducts and in the forelegs did not alter ovum transport. Devices impregnated with oestradiol placed around both oviducts produced a dose-dependent delay of ovum transport, which was more pronounced than the effect of devices located in the forelegs. Oviducts receiving an oestradiol-loaded device had a larger retention of ova than did the contralateral oviducts receiving a blank device. These results demonstrate a direct action of oestradiol upon the oviduct to delay ovum transport in the mouse. PMID- 2760885 TI - Sperm binding to the pig zona pellucida and inhibition of binding by solubilized components of the zona pellucida. AB - An assay to determine the binding of pig spermatozoa to the zona pellucida (ZP) of pig oocytes was developed using conditions compatible with in-vitro fertilization of pig eggs and with pig sperm penetration of zona-free hamster ova. These conditions were used to define which of the pig oocyte ZP components were involved in sperm binding by a competitive inhibition approach. Assay variables that were optimized included: the method of sperm preparation; sperm preincubation time; sperm-oocyte coincubation time; sperm concentration and temperature; and methods for the separation of free from oocyte-bound spermatozoa. Inclusion of solubilized ZP in the sperm preincubation medium inhibited sperm binding approximately 50%. Both the 55K and 90K components inhibited sperm binding although the 55K component was more effective. The two polypeptides derived from chemical deglycosylation of the 55K families did not inhibit sperm binding. Of several monoclonal antibodies to the ZP components tested, only one directed against the 55K alpha glycoprotein family inhibited sperm binding. Sperm binding to pig oocyte ZP is therefore dependent on the carbohydrate moiety of the glycoproteins and appears to involve more than a single ZP glycoprotein. PMID- 2760886 TI - Penetration of bovine follicular oocytes by frozen-thawed spermatozoa in the presence of caffeine and heparin. AB - Bovine follicular oocytes matured in culture were inseminated with frozen-thawed spermatozoa which were either preincubated for 5-5.5 h or not preincubated in a medium with caffeine (5 mM) and heparin (10 micrograms/ml). When the oocytes with cumulus and corona cells were inseminated, spermatozoa started to penetrate oocytes 3 h later regardless of whether spermatozoa were preincubated or not. However, a significantly higher proportion of oocytes was penetrated by preincubated than non-preincubated spermatozoa. When the oocytes were freed from cumulus and corona cells, penetration was observed to start 1 h after insemination and there were no differences in penetration rates 1-5 h after insemination between preincubated and non-preincubated spermatozoa. This study demonstrates that capacitation and the acrosome reaction of bovine spermatozoa can be induced within 1 h in a medium containing both caffeine and heparin when denuded oocytes are inseminated. PMID- 2760887 TI - Histochemical study of superoxide dismutase in the ovary of the rat during the oestrous cycle. AB - Superoxide dismutase, an enzyme which causes the dismutation of superoxide free radical anions to generate hydrogen peroxide, has been localized in the rat ovary. The negative-staining method was used to provide photo-induced reduction of nitro-blue tetrazolium in cryostat sections of rat ovaries for histochemical localization of superoxide dismutase. Superoxide dismutase was found in growing follicles, the membrane granulosa of Graafian follicles, ovulated follicles and blood vessels. It is suggested that superoxide dismutase may play a role in regulating follicular development, ovulation and luteal functions. PMID- 2760888 TI - Correlation of plasma progesterone concentrations to ovarian H-type lipase activity during pseudopregnancy in the rat. AB - Conditions for extraction and assay of hepatic type (H-type) lipase from rat ovaries were studied. An alkaline buffer with protease inhibitors and detergents gave the most efficient extraction. The specificity of the assays was ascertained using antiserum to H-type lipase from heparin perfusates of rat livers. H-type lipase activity was determined in ovarian compartments during pseudopregnancy (1 13 days) as well as during the ensuing period of luteal regression (Day 17). The activity was low in the luteal compartment immediately after ovulation, increased 6-fold to a maximum between Day 5 and Day 8 and then decreased again. This is similar to previously known changes in blood flow. There was a significant correlation between luteal H-type lipase activity and plasma progesterone regardless of luteal age. In contrast, neither the activity in the remainder of the ovary nor the activity in plasma changed during the luteal phase or correlated to plasma progesterone. Injection of heparin at the height of the luteal cycle (Day 8) caused a pronounced decrease in luteal lipase and in plasma progesterone. These studies suggest that the H-type lipase activity has an important role in luteal steroidogenesis, probably to facilitate uptake of cholesterol from lipoproteins. PMID- 2760889 TI - In-vitro induction of capacitation of fresh and frozen spermatozoa of the Siberian tiger (Panthera tigris). AB - Electroejaculates from 5 tigers were split and half of each was assayed fresh while the remainder was frozen and thawed before being assayed. Preincubation time, temperature and removal of seminal plasma were evaluated for their effect on in-vitro capacitation. Ability of spermatozoa to penetrate oocytes, as measured by the zona-free hamster egg-sperm penetration assay (SPA), was used as verification of capacitation. Results of the experiments with fresh semen indicate that: (1) preincubation time affects the fertilizability of tiger spermatozoa with 2 h appearing optimal, (2) a preincubation temperature of 37 degrees C results in significantly higher penetration rates than does a 22 degrees C treatment, and (3) tiger seminal plasma does not appear to contain decapacitation factors, as has been reported for several other species. Frozen semen experiments indicate that (1) frozen-thawed tiger spermatozoa must be removed from the environment of the semen extender before capacitation can take place, and (2) the freeze-thaw procedure results in a shortening of the required capacitation time. PMID- 2760890 TI - A study of the early morphological changes initiated in the uterine luminal epithelium by substances (oil and carrageenan) which induce the decidual cell reaction in mice. AB - Oil, carrageenan or saline were injected into the uteri of ovariectomized mice treated with hormones on schedules which would sensitize, partly sensitize or not sensitize the uterus to an intraluminal decidual stimulus. The uterine epithelium was examined histologically at various times over the succeeding 5 h. Saline did not produce any morphological change whereas almost immediately after the injection of oil or carrageenan epithelial cell death was apparent in the uterus, regardless of hormone treatment. Within 45 min the dead cells had been removed and the epithelium was re-established. Oil droplets were still present in the uterus after 5 h and these were able to stimulate a decidual reaction in partly sensitized animals when oestrogen was administered 18-44 h after the oil instillation, well after the re-establishment of the epithelium. It is suggested that the early transient cell death in the uterine epithelium is not responsible for triggering the decidual reaction but that it is the contact of the oil droplet with an intact epithelium which triggers the response when the hormonal conditions so allow. PMID- 2760891 TI - Successful pregnancies after transfer of embryos recovered from ewes induced to ovulate 24-29 days post partum. AB - After lambing in late November, oestrus and ovulation were induced by using a CIDR device and PMSG in early weaned (N = 13) or lactating (N = 14) Border Leicester x Scottish Blackface ewes between 23 and 29 days after parturition. Ewes were intrauterine inseminated under laparoscopic visualization 54-55 h after CIDR-device withdrawal and eggs recovered on Day 3 of the cycle. Ovum recovery and fertilization rates were higher in lactating than in early weaned ewes, with fertilization being achieved as early as 24 days post partum in both groups. Of the 7 early weaned and 11 lactating ewes yielding eggs, fertilization occurred in 4 and 7 ewes respectively. A total of 20 embryos were transferred to the normal uterine environment of 15 recipient ewes in which the interval from parturition was greater than 150 days. Pregnancies were successfully established in 9 recipient ewes, resulting in the birth of 10 viable lambs. Prolactin concentrations were significantly higher (P less than 0.001) in lactating than in early weaned ewes throughout the study. Nevertheless, normal luteal function (as assessed by daily progesterone concentrations) was exhibited by 12 of 14 lactating and 8 of 13 early weaned ewes. Two post-partum donors in which the corpora lutea completely failed to secrete progesterone yielded fertilized eggs which developed to term when transferred to a normal uterine environment. The results show that sheep oocytes can be fertilized using laparoscopic intrauterine insemination as early as 24 days after parturition and that the resulting embryos are viable when recovered on Day 3 after oestrus and transferred to a normal uterine environment. PMID- 2760892 TI - Qualitative and quantitative changes in protein synthesis occur at the 8-16-cell stage of embryogenesis in the cow. AB - Cow oocytes and preimplantation embryos were cultured in medium containing radiolabelled methionine and the proteins synthesized were analysed by one dimensional electrophoresis and fluorography. Marked changes in the pattern of synthesis were observed at the 8-16-cell stage of development. Quantitatively, a gradual decrease in the rate of protein synthesis occurred between the zygote and 8-cell stage and then the rate increased progressively to the blastocyst stage. Incorporation of radiolabelled uridine into RNA was first detected at the 16-cell stage. Taken together, these results suggest that protein synthesis is programmed by maternal mRNA up to the 8-cell stage but switches to mRNA derived from the zygote genome between the 8- and 16-cell stage. PMID- 2760893 TI - Decreased sperm survivability in subfertile Delaware roosters as indicated by comparative and competitive fertilization. AB - Duration of fertility following intravaginal and intramagnal insemination of hens with viable spermatozoa from subfertile Delaware roosters was compared with that obtained with spermatozoa from fertile Leghorns and subfertile Wyandotte roosters. In contrast to results with Leghorn and Wyandotte birds, duration of fertility was not increased following intramagnal insemination of spermatozoa from Delaware birds. Competitive fertilization also demonstrated that duration of fertility was less than expected in the spermatozoa from Delaware birds. Heritable subfertility in Wyandotte and Delaware roosters therefore appears to be attributable to distinct sperm defects. PMID- 2760894 TI - An improved culture medium supports development of random-bred 1-cell mouse embryos in vitro. AB - One-cell CF-1 x B6SJLF1/J embryos, which usually exhibit a 2-cell block to development in vitro, have been cultured to the blastocyst stage using CZB medium and a glucose washing procedure. CZB medium is a further modification of modified BMOC-2 containing an increased lactate/pyruvate ratio of 116, 1 mM-glutamine and 0.1 mM-EDTA but lacking glucose. Continuous culture of one-cell embryos in CZB medium allowed 83% of embryos to develop beyond the 2-cell stage of which 63% were morulae at 72 h of culture, but blastocysts did not develop. However, washing embryos into CZB medium containing glucose after 48 h of culture (3-4 cell stage) was sufficient to allow development to proceed, with 48% of embryos reaching the blastocyst stage by 96 h of culture. Exposure of embryos to glucose was only necessary from the 3-4-cell stage through the early morula stage since washing back into medium CZB without glucose at 72 h of culture still promoted the development of 50% of embryos to the blastocyst stage. The presence of glucose in this medium for the first 48 h of culture (1-cell to 4-cell stage) was detrimental to embryo development. Glutamine, however, exerted a beneficial effect on embryo development from the 1-cell to the 4-cell stage although its presence was not required for development to proceed during the final 48 h of culture. Blastocysts which developed under optimum conditions contained an average of 33.7 total cells. The in-vitro development of 1-cell embryos beyond the 2-cell stage in response to the removal of glucose and the addition of glutamine to the culture medium suggests that glucose may block some essential metabolic process, and that glutamine may be a preferred energy substrate during early development for these mouse embryos. PMID- 2760895 TI - Angiogenic activity of maternal and fetal placental tissues of ewes throughout gestation. AB - In Study 1, explants of caruncular and intercaruncular endometrium and fetal membrane were collected from ewes (5-6/day) on Days 11-13, 16-18 and 21-23 after mating and Days 10-12 after oestrus, and incubated for 24 h. Explant-conditioned media were evaluated for their effects on endothelial cell proliferation. Both caruncular and intercaruncular endometrium secreted factor(s) which stimulated endothelial cell proliferation, and which appeared to be greater than 100 x 10(3) Mr and heat-labile. In Study 2, conditioned media from explant incubations of caruncular and intercaruncular endometrium, cotyledon and intercotyledonary fetal membrane obtained from ewes (6-7/day) on Days 40, 65, 90, 115 and 140 after mating were evaluated for their effects on endothelial cell proliferation. Caruncular and intercaruncular endometrium and intercotyledonary fetal membrane secreted factor(s) which inhibited endothelial cell proliferation. Media from cotyledonary explants tended to stimulate endothelial cell proliferation on Day 115. Conditioned media from cotyledonary explants obtained from 3 additional ewes at Day 120 of gestation stimulated endothelial cell proliferation, and this activity also appeared to be greater than 100 x 10(3) Mr. Placental angiogenesis in ewes therefore appears to be modulated by both maternal and fetal placental tissues via stimulatory and inhibitory factors. PMID- 2760896 TI - Effects of prolactin on conceptus survival and uterine secretory activity in pigs. AB - Hypoprolactinaemia was induced by bromocriptine (CB154; 100 mg/day) which decreased circulating prolactin by 40% (P less than 0.06), but did not affect conceptus survival at Day 25 when administered on Days 10-16 when compared to saline:ethanol-treated control gilts. Bromocriptine or vehicle was administered to cyclic gilts on Days 10-11, oestradiol valerate was injected on Day 11 and uterine flushings were collected on Day 12. Total recoverable protein and uteroferrin in uterine flushings were not affected by treatment. However, leucine aminopeptidase activity (P less than 0.02) and total recoverable Ca2+, Na+, K+ and Cl- (P less than 0.05) were decreased in uterine flushings of gilts that received bromocriptine, suggesting that hypoprolactinaemia decreased general secretory activity of the endometrial epithelium and modulated ionic changes, respectively, in the uterine environment of pigs. Subcutaneous administration of pig prolactin (1 mg/12 h) increased (P less than 0.001) serum prolactin 4.5-fold. The interaction between hyperprolactinaemia and progesterone, without oestrogen, on components of uterine flushings were determined using gilts that received progesterone (200 mg/day) and prolactin or saline on Days 4-14 after ovariectomy on Day 4. On Day 15, there were no differences (P greater than 0.05) in any of the uterine secretory components measured. Hyperprolactinaemia (1 mg pig prolactin on Days 6-11) enhanced overall uterine secretory response on Day 12 to oestradiol (5 mg) administered on Day 11 compared to gilts that received 1 ml saline on Days 6-11 of the oestrous cycle. Total recoverable protein and leucine aminopeptidase activity were greater (P less than 0.05) for oestradiol-treated gilts, but effects of prolactin were not significant. Total recoverable glucose (P less than 0.01), PGF-2 alpha (P less than 0.02), uteroferrin (P less than 0.01) and specific activity of uteroferrin (P less than 0.001) were increased by prolactin and oestradiol, but not oestradiol alone. Calcium (P less than 0.05), chloride (P less than 0.05) and potassium (P less than 0.01) were increased in response to oestradiol. These results indicate an interaction between oestradiol and prolactin, but not progesterone and prolactin, which enhances secretion of some products of the pig uterine endometrium. PMID- 2760897 TI - Human oocyte-cumulus complexes stimulate the human acrosome reaction. AB - Oocyte-cumulus complexes were obtained, after induced ovulation, from infertile patients participating in an in-vitro fertilization programme. About 6 h after retrieval and depending on the expansion of the cumulus, 100,000 motile spermatozoa, prepared by a migration-centrifugation method, were added. After 14 18 h incubation at 37 degrees C, oocytes were examined for signs of fertilization (pronuclei and polar body formation) and then removed; spermatozoa remaining in the incubation medium were fixed for transmission electron microscopy. To provide an adequate number of cells for observation, spermatozoa from a minimum of 3-5 oocytes from the same patient were pooled. When sufficient spermatozoa were available after insemination, the remainder of the suspension was incubated at 37 degrees C and fixed along with the corresponding oocyte-incubated sample. In all, 32 sperm samples were assessed and fertilized oocytes were obtained with 29 of these. In the 24 samples in which greater than 100 spermatozoa (mean of 192) could be assessed, 32% of spermatozoa had initiated or completed the acrosome reaction. In the 15 of these 24 samples for which oocyte-free controls were available, 31% of cells were reacting or reacted, compared with 15% of cells (P less than 0.001) in the controls. In the remaining 8 samples, incubated with oocyte-cumulus complexes, less than 100 but greater than or equal to 20 spermatozoa (mean of 42) were assessed and again 32% of spermatozoa were reacted.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2760899 TI - An immunological cryo-ultrastructural study of a sequential appearance of proteins in placental binucleate cells in early pregnancy in the cow. AB - Using the most sensitive immunocytochemical method available, on ultrathin frozen sections, the results in this paper demonstrate that bovine placental lactogen (bPL) is present in the earliest fetal binucleate cells found at 21 days post coitum in the trophectoderm. A second protein, the SBU-3 antigen, which is absent in the early stages of pregnancy appears abruptly in the binucleate cell granules at 30 days post coitum coincident with the start of villus development. Subsequently, the granules contain both bPL and the SBU-3 antigen. This sequential production of unlike proteins indicates that the binucleate cell has different functions depending on the stage of pregnancy and has important roles to play both at implantation and in villus development. PMID- 2760898 TI - Cigarette smoking and human sperm quality assessed by laser-Doppler spectroscopy and DNA flow cytometry. AB - The sperm qualities of 350 men under fertility investigation were compared in relation to their smoking habits. The sperm variables included number, motility, morphology and vitality. Sperm motility was assessed objectively by laser-Doppler spectroscopy. In a randomly selected group, sperm samples were subjected to flow cytometry to assess the levels of DNA condensation. No significant differences (Kruskal-Wallis' test) in any aspect of sperm quality including DNA distribution could be demonstrated between non-smokers, moderate smokers (1-14 cigarettes/day) and heavy smokers (15-40 cigarettes/day). This was true when the data were pooled and when oligozoospermic/hypozoospermic ejaculates (1-39 x 10(6)/ml) and asthenozoospermic ejaculates (less than 25% of sperm cells with progressive movement) were analysed separately. The distribution of non-smokers, moderate and heavy smokers was the same in groups of men with normal sperm quality as those with impaired quality. The present study does not provide support for the contention that smoking has deleterious effects on sperm quality, at least using conventional parameters. PMID- 2760900 TI - Effects of clomiphene citrate on ovarian function in hypophysectomized rats. AB - On Days 28-30 of age, hypophysectomized rats were treated with oestradiol-17 beta (0.1 mg/day) and/or clomiphene citrate (0.1 mg/day). Subsequent treatment with PMSG (10 i.u., on Day 31) and hCG (10 i.u., on Day 33) was identical for all animals. Rats were killed on Day 34. Treatment with oestradiol-17 beta alone resulted in ovulations of 45.1 +/- 5.5 oocytes/rat (mean +/- s.e.m.). There were no ovulations among animals treated with clomiphene citrate alone but treatment with oestradiol-17 beta and clomiphene citrate resulted in a significant (P less than 0.05) reduction (23.1 +/- 7.6 oocytes/rat) in ovulatory response. Similarly, ovarian weights and serum progesterone concentrations were highest in the oestradiol-17 beta-treated rats, intermediate in those given oestradiol plus clomiphene citrate and the lowest in rats receiving clomiphene citrate alone. We suggest that clomiphene citrate exerts direct ovarian antiovulatory and oestrogen antagonist actions. PMID- 2760901 TI - Isolation of rat gonocytes by velocity sedimentation at unit gravity. AB - A method for obtaining enriched populations of gonocytes from rat embryos at 18 days p.c. has been developed. Single cell suspensions with high cell yield and good viability of the cells were obtained by a collagenase/trypsin digestion of the testes. Cells were separated on the basis of size by the Staput technique of velocity sedimentation at unit gravity. Populations of 600,000 gonocytes (70-75% purity), sedimenting at about 12 mm/h, could be obtained from 30-35 fetal rats within 8 h after killing. Purities were determined by Nomarski microscopy and verified in fixed preparations and by Coulter volume measurements. PMID- 2760903 TI - Abstracts. 4th International Congress of Reproductive Immunology. Kiel, F.R.G., 26-29 July 1989. PMID- 2760902 TI - Viable spermatozoa in the bladder after electroejaculation of lion-tailed macaques (Macaca silenus). AB - The bladder of 6 lion-tailed macaques was emptied and flushed with sterile saline. TALP-Hepes buffer was infused and the animals were electroejaculated. After electroejaculation, the semen quality was determined in the ejaculate and the bladder infusate. Of the 15 ejaculates analysed, a mean (+/- s.e.m.) sperm count of 133.8 (+/- 30.7) x 10(6) with 69.5 (+/- 6.0)% motility was obtained in the infusate as compared to the sperm count of 72.4 (+/- 38.6) x 10(6) with significantly lower (47.7 +/- 5.8%) motility in the ejaculate. PMID- 2760904 TI - Production and characterization of monoclonal antibodies against the H-Y antigen. AB - Monoclonal antibodies against the H-Y antigen were produced using spleen cells from female C57BL/6 mice hyperimmunized with cells from syngeneic males. Anti-H-Y positive clones were detected by enzyme immunoassays. Supernatant fluids from Daudi cell cultures and testicular cell preparations taken from mice, rabbits or calves served as presumptive sources of H-Y antigen. In addition, testis supernatant from genetically sterile mice was used. Male specificity was ascertained by the fact that the antibodies could be absorbed with spleen cells from male but not from female mice. Binding of the antibodies to H-Y antigen on the surface of male and female cells, obtained from a number of tissues and species, was confirmed by an indirect immunofluorescence assay. Several monoclonal antibodies appeared to be positive in all assays tested, suggesting that the molecule conferring the H-Y antigenicity lacks species-specificity and appears to be identical for soluble and membrane-bound H-Y antigen. PMID- 2760905 TI - Background (spontaneous) immunoglobulin production in the murine small intestine before and after weaning. AB - The ontogeny of the murine intestinal B-cell compartment before and after weaning was studied by quantitative analysis of immunoglobulin-secreting cells (Ig-SC) in the small intestine (SI). Before weaning, few Ig-SC were detected in the SI, whereas spleen and bone marrow already contained many Ig-SC. The number of Ig-SC in the SI started to increase immediately after weaning. Comparing early-weaned mice with non-weaned mice of the same age clearly demonstrated that weaning brought on the development of Ig-SC in the SI. The influence of a gut flora on the number of Ig-SC in the SI was examined by comparing the number of Ig-SC in the SI of conventionally housed, specific pathogen free (SPF) and germ-free mice. A bacterial flora was apparently needed for the normal development of Ig-SC in the SI. Comparing mice containing an aerobic Gram-negative bacterial flora with mice containing only an anaerobic Gram-positive bacterial flora demonstrated that the type of bacterial flora is relatively unimportant. No evidence was found that circulating maternal antibodies suppressed the development of the "spontaneous" intestinal and systemic B cell response. The results show that bacterial colonization of the intestine plays a pivotal role in the development of the Ig SC compartment in the SI. PMID- 2760906 TI - A comparison of anti-type II collagen antibody titres and isotype profiles in pregnant and virgin DBA/1 mice with collagen-induced arthritis. AB - In order to discover whether changes in the nature of the humoral response to type II collagen occur during pregnancy we compared, by enzyme-linked immunosorbent assay (ELISA), the anti-type II collagen antibody titres and isotype profiles of pregnant and virgin DBA/1 mice immunized with type II collagen. Significant reductions in the mean clinical scores and anti-collagen antibody titres were observed during late pregnancy. Titres of all of the anti collagen isotypes tended to be lower in pregnant than non-pregnant mice, although only in the case of IgG3 was there a significant difference between the two groups. We conclude that while pregnancy may cause changes to the isotype distribution of anti-collagen antibodies it is not possible on the basis of this study to relate such changes to the remission of arthritis observed during pregnancy. PMID- 2760907 TI - Hypertension screening in a Hungarian town. AB - In conjunction with a radiological tuberculosis project, a hypertension screening programme was carried out in 1984 on 13,772 people (74% of the eligible adult population) in the Hungarian town of Csongrad. In the younger age groups the blood pressure was found to be higher amongst men, whilst in older groups the women had higher blood pressures. By the WHO criteria, systolic hypertension was detected in one-third of the population and diastolic hypertension in one-sixth. Of the hypertensive patients detected, 34% were previously unaware of their diagnosis. The prevalence of hypertension was elevated particularly amongst obese persons and in the sub-group of physical (blue collar) workers aged over 60 years. There was a significant correlation between alcohol consumption and both systolic and diastolic blood pressures. Hypertension was found in 29.9% of heavy drinkers but in only 20.5% of moderate drinkers or total abstainers. PMID- 2760908 TI - Dietary fatty acid supplementation alters stress reactivity and performance in man. AB - Certain dietary polyunsaturated fatty acids, gamma linolenic (18:3n-6) and eicosapentaenoic (20:5n-3) acid, attenuate cardiovascular reactivity to stress in rats. To study their effects on cardiovascular reactivity to acute stress in man, 30 men were randomly assigned to one of three groups and given 28 day supplements of borage oil (containing 18:3n-6), fish oil (containing 20:5n-3), or olive oil (placebo). Reactivity to the Stroop colour-word conflict test was assessed prior to and following treatment. Borage oil alone attenuated blood pressure and heart rate responses to stress, increased skin temperature, and improved task performance. These data suggest that diet may be used to alter stress reactivity in man. PMID- 2760909 TI - Linoleic acid supplementation, membrane lipids and leucocyte sodium transport in normotensive humans. AB - Ten normotensive subjects had their omnivore diet supplemented with increasing doses of linoleic acid in the form of safflower seed oil in order to examine the effects of this polyunsaturated fat upon leucocyte sodium transport. Increasing the dose ingested to the limits of tolerance produced a significant decrease in ouabain resistant sodium efflux (P less than 0.05) but no significant change in total or ouabain-sensitive sodium extrusion. Intraleucocytic sodium content was correlated with erythrocyte membrane oleic acid % (r = 0.368, P less than 0.05); leucocyte ouabain resistant flux was correlated with oleic acid % (r = 0.453, P less than 0.01) and linoleic acid % (r = -0.319, P less than 0.05). No such associations were observed with ouabain sensitive sodium extrusion. No changes in body weight or urinary electrolyte excretion were observed. It is concluded that, at physiological concentrations, membrane linoleic acid content influences transmembrane sodium fluxes but not through modulation of sodium pump activity. Furthermore, the beneficial effect of this dietary manoeuvre, observed previously with small increments of safflower seed oil, was not seen in this experiment so the hypotensive activity of this manipulation must be regarded as limited. PMID- 2760910 TI - Non-resectable phaeochromocytoma: long term follow-up. AB - A forty-two year old woman presented with hypertension, trembling, sweating, visual impairment, headache and weight loss. A right adrenal phaeochromocytoma was diagnosed. The tumour could not be resected because it encircled the inferior vena cava. She was treated at first with phenoxybenzamine and propranolol and later with phenoxybenzamine and labetalol. She has remained normo-tensive and free of signs of adrenergic hyperactivity for 11 years. We suggest that pharmacological treatment alone is a valid alternative in cases of phaeochromocytoma who are at high surgical risk or where the tumour is not resectable. PMID- 2760911 TI - Reduced sodium chloride intake normalises blood pressure distribution. AB - The blood pressure distribution of 172 healthy normotensive subjects aged 3-77 years receiving diets containing different amounts of sodium are presented. On their usual intake of sodium (154 +/- 63 mmol Na+/day) and after two weeks on a high sodium intake (201 +/- 92 mmol Na+/day) supine systolic and supine diastolic blood pressure distribution were positively skewed to the right. After two weeks on a reduced sodium diet (77 +/- 37 mmol Na+/day) the blood pressure distribution was normal. An incremental effect of sodium on diastolic blood pressure occurred in 22% of the subjects. The fall in blood pressure on the reduced sodium diet in these 'sodium sensitive' subjects reduced the mean blood pressure level, which was associated with 'normalisation' of the blood pressure distribution. PMID- 2760912 TI - A comparison of immunoblot and DNA restriction patterns in characterising methicillin-resistant isolates of Staphylococcus aureus. AB - The ability of EcoR1 restriction enzyme fragmentation patterns and of immunoblotting to differentiate methicillin-resistant isolates of Staphylococcus aureus were compared. All isolates examined were typable by both methods and the reproducibility of each was excellent. Immunoblotting differentiated eight types and DNA restriction patterns four. The former technique was of value in characterising methicillin-resistant isolates of S. aureus and controlling an outbreak due to them. PMID- 2760913 TI - A novel luminometer for rapid antimicrobial susceptibility tests on gram-positive cocci by ATP bioluminescence. AB - The susceptibility of 130 clinical isolates of gram-positive cocci to a wide range of antimicrobial agents was assessed by ATP bioluminescence in a 4-h test. ATP assays were performed on a novel luminometer, the Amerlite Analyser, which measures luminescence from microtitration trays. For most organisms tested, there was good correlation (greater than 90%) with conventional MIC values estimated on 18-h cultures. However, a problem was found with detection of penicillin resistance in Staphylococcus aureus by the ATP method, 13% of strains showing major disagreement. Methicillin resistance of S. aureus was shown reliably for most strains (94%) by ATP assay, provided they were incubated at 30 degrees C. The Amerlite Analyser offers the potential for the development of a semi automated antimicrobial susceptibility test, with a significant reduction in reagent costs when compared with previously described bioluminescence protocols. PMID- 2760914 TI - Nonhuman primate models for AIDS. San Antonio, Texas, November 16-18, 1988. Proceedings. PMID- 2760915 TI - Use of Old World monkeys for acquired immunodeficiency syndrome research. AB - Mangabeys, macaques, and baboons persistently infected with human immunodeficiency virus (HIV)-2 NIH-DZ demonstrated no signs of immunodeficiency disease after 6-11 months following seroconversion. Thus Old World monkeys provide an animal model to investigate the effects of passive immunization (anti HIV-2 antibodies) on HIV infection in primates. PMID- 2760916 TI - Use of infectious molecular clones of simian immunodeficiency virus for pathogenesis studies. AB - Three infectious molecular clones of SIVmac and one of HIV-2 exhibit remarkable variation in their biological properties despite similarities in genome organization and sequence relatedness. Cloned viruses differed in their ability to grow in various cultured cells, in their ability to infect macaques, and in the location of the env stop codon. Sequences from the 3' end predict that at least three of the four clones do not have an intact, functional nef gene. All four cloned viruses yield infectious virus in HUT-78 and all four cloned viruses are cytopathic. PMID- 2760917 TI - Human immunodeficiency virus (HIV) from experimentally infected chimpanzees: isolation and characterization. AB - Human immunodeficiency virus-1 (HIV-1) isolates obtained from chimpanzees that had undergone various immunosuppressive treatments were characterized by growth on various primary cells and cell lines as well as by restriction endonuclease analysis. Viruses recovered from animals inoculated with uncloned HIV showed genetic variation from the original inoculum, whereas viruses isolated from an animal infected with a molecular clone of HIV did not. In some cases, virus recovery was possible only after enrichment for CD4+ cells by panning, inoculation with a chimpanzee cytomegalovirus, or a combination of these procedures. These findings indicate a role for viral and host cofactors in the control of virus replication and suggest explanations for the absence of clinical manifestations in HIV-infected chimpanzees. PMID- 2760918 TI - The biology of human immunodeficiency virus-1 IIIB infection in the chimpanzee: in vivo and in vitro correlations. AB - Human immunodeficiency virus (HIV)-1 IIIB infection of chimpanzees leads to a compartmentalized, nonpathogenic in vivo and in vitro relationship with the virus. The absence of an acquired immunodeficiency syndrome (AIDS)-like disease in over 100 chimpanzees persistently infected may be related to some or all of the findings reported here. Further characterizing these possible host adapative mechanisms may be critical in both understanding pathogenesis, as well as elucidating novel mechanisms for therapeutic and/or the preventive strategies for AIDS in humans. PMID- 2760919 TI - Blood-pressure responses during social interaction in high- and low-cynically hostile males. AB - The Cook and Medley Hostility (Ho) Scale has been found to predict the development of coronary heart disease, coronary death, and death from other causes. Enhanced physiological responsiveness among high-Ho subjects may represent a link between hostility and health. The present study examined the systolic and diastolic blood-pressure (SBP, DBP) and heart-rate (HR) responses of high- and low-Ho undergraduate males while they presented their position and listened to their partner's opposing position in a current events discussion task. Compared to low-Ho subjects, the high-Ho group displayed larger SBP and DBP responses. These results and others suggest that cynical hostility is associated with greater physiological responses to interpersonal stressors. PMID- 2760920 TI - Coping style, cognitive hardiness, and health status. AB - This study investigates the effects of coping style and cognitive hardiness on physical and psychological health status. Measures of coping styles (intrusive positive thoughts, intrusive negative thoughts, avoidance, problem-focused coping), cognitive hardiness, stress, health habits, psychological distress, and physical illness were collected for 194 professional employees. Multiple regression analyses revealed that intrusive negative thoughts and avoidance coping approaches significantly contributed to predictions of psychological distress and physical illness outcomes, respectively. Cognitive hardiness significantly contributed to predictions of psychological distress but not physical illness outcomes. Health habits were significantly related to both measures of health status. Two coping approaches, intrusive positive thoughts and problem-focused coping, did not significantly contribute to predictions of either physical or psychological health status. PMID- 2760921 TI - Evolution and transcription of old world monkey globin genes. AB - Although apparently inactive in the whole animal, the delta globin genes from three species of Old World monkey (rhesus, baboon and green monkey) are all functional in an in vitro transcription assay. Their activities in vitro are similar to that of the functional human delta gene. A fourth monkey gene, from the colobus monkey, is transcribed approximately fivefold less efficiently than the others. This reduced in vitro activity results from a 20 base-pair deletion, which removes the normal site of mRNA initiation. When the deletion is repaired by site-directed mutagenesis, transcriptional activity increases to the level observed for the other delta genes. We also report the complete nucleotide sequences of the colobus beta, colobus delta, and rhesus delta genes. Sequence comparisons show that the delta and beta genes in the same species have not exchanged genetic information since the divergence of the human and monkey lineages. Phylogenetic analysis of these sequences affirms that the Old World monkey delta genes are evolving more rapidly than their functional counterparts. Moreover, the rate of replacement substitutions has risen to equal that of non coding DNA, as expected for genes no longer under selective constraint. PMID- 2760922 TI - Isolation of an active gene encoding human hnRNP protein A1. Evidence for alternative splicing. AB - Heterogeneous nuclear ribonucleoprotein (hnRNP) core protein A1 is a major component of mammalian hnRNP 40 S particles. We describe the structure of an active A1 gene and report on the partial characterization of the A1 gene family. About 30 A1-specific sequences are present per haploid human genome: 15 such sequences were isolated from a human genomic DNA library. Many corresponded to pseudogenes of the processed type but by applying a selection for actively transcribed regions we isolated an active A1 gene. The gene spans a region of 4.6 x 10(3) base-pairs and it is split into ten exons that encode the 320 amino acid residues of the protein. The amino acid sequence derived from the exon sequences is identical with that deduced from cDNA and reported for the protein. One intron exactly separates the two structural domains that constitute the protein. Each of the two RNA-binding domains in protein A1 is encoded by one exon. Experimental evidence indicates that the A1 gene can encode for more than one protein by alternative splicing. The gene is preceded by a strong promoter that contains at least two CCAAT boxes and two possible Sp1 binding sites, but it lacks a TATA box. PMID- 2760924 TI - String analysis and energy minimization in the partition of DNA sequences. AB - Two approaches to the understanding of biological sequences are confronted. While the recognition of particular signals in sequences relies on complex physical interactions, the problem is often analysed in terms of the presence or absence of literal motifs (strings) in the sequence. We present here a test-case for evaluating the potential of this approach. We classify DNA sequences as positive or negative depending on whether they contain a single melted domain in the middle of the sequence, which is a global physical property. Two sets of positive "biological" sequences were generated by a computer simulation of evolutionary divergence along the branches of a phylogenetic tree, under the constraint that each intermediate sequence be positive. These two sets and a set of random positive sequences were subjected to pattern analysis. The observed local patterns were used to construct expert systems to discriminate positive from negative sequences. The experts achieved 79% to 90% success on random positive sequences and up to 99% on the biological sets, while making less than 2% errors on negative sequences. Thus, the global constraints imposed on sequences by a physical process may generate local patterns that are sufficient to predict, with a reasonable probability, the behaviour of the sequences. However, rather large sets of biological sequences are required to generate patterns free of illegitimate constraints. Furthermore, depending upon the initial sequence, the sets of sequences generated on a phylogenetic tree may be amenable or refractory to string analysis, while obeying identical physical constraints. Our study clarifies the relationship between experts' errors on positive and negative sequences, and the contributions of legitimate and illegitimate patterns to these errors. The test-case appears suitable both for further investigations of problems in the theory of sequence evolution and for further testing of pattern analysis techniques. PMID- 2760923 TI - Nucleotide sequence and complementation studies of the gene 10 region of bacteriophage T3. AB - The nucleotide sequence of bacteriophage T3 gene 10 and surrounding regulatory elements has been determined and compared to the analogous region of bacteriophage T7. T3 genes 9, 10 and 11 have been shown to complement T7 mutants. The DNA sequences of T3 and T7 gene 10A are homologous, as are the amino acid sequences of the respective products. The translational shift to the -1 frame is predicted to occur at the same position in gene 10 of T3 and T7, though different nucleotide sequences are probably responsible. The resulting gp10B products have completely different C termini. PMID- 2760925 TI - Comparative studies of ribulose-1,5-biphosphate carboxylase/oxygenase from Alcaligenes eutrophus H16 cells, in the active and CABP-inhibited forms. AB - RuBisCO (D-ribulose-1,5-biphosphate carboxylase/oxygenase; EC 4.1.1.39) has been isolated from the autotrophic hydrogen-oxidizing bacterium Alcaligenes eutrophus H16. Combining photon correlation and sedimentation analysis transport parameters of the enzyme were investigated in the active, (E.CO2.Mg2+) as a ternary complex, and inactive state, (E.CO2.Mg2+.CABP) as a quaternary complex, where RuBisCO is complexed with the transition state analogue CABP (2-C-carboxy-D-arabinitol-1,5 biphosphate). Within experimental error, no difference has been detected between the diffusion and sedimentation coefficients (D020,w = 2.72(+/- 0.07) x 10(-7) cm2 s-1, s020,w = 17.8(+/- 0.5)S) of active and CABP-complexed enzyme thus leading to the conclusion that the molecule, at least in solution, does not assume a different conformation when complexed with CABP. PMID- 2760926 TI - Position of Mercenaria regulatory light-chain Cys50 site on the surface of myosin visualized by electron microscopy. AB - Mercenaria regulatory light-chains, specifically labelled at cysteine 50 with N iodoacetyl-N'-biotinylhexylenediamine, were rebound to regulatory light-chain denuded scallop myosin, and the hybrid myosin formed was decorated with avidin. These hybrid myosins were visualized by rotary-shadowing electron microscopy. Three distinct images of avidin-decorated hybrid myosin molecules were obtained. These comprise singly decorated molecules, where the avidin is bound symmetrically or asymmetrically with respect to the two heads of myosin, in addition to "figures-of-five", where two myosin molecules associate with a centrally placed avidin molecule. Analysis of these images indicates that the Mercenaria regulatory light-chain Cys50 site is located 15 to 35 A from the head rod junction when the light-chain is bound in situ to myosin. Implications with respect to head topology and probe studies are discussed. PMID- 2760927 TI - Crystallization of human leukocyte elastase with its inhibitor Pro44-eglin c. AB - Human leukocyte elastase has been crystallized in complex with recombinant Pro44 eglin c in the orthorhombic space group P2(1)2(1)2(1). The cell constants are a = 126.1 A, b = 127.8 A, c = 69.4 A, alpha = beta = gamma = 90 degrees. The crystals diffract to at least 2.5 A resolution and are suitable for crystallographic structure analysis. PMID- 2760928 TI - Weights for data related by a tree. AB - How can one characterize a set of data collected from different biological species, or indeed any set of data related by an evolutionary tree? The structure imposed by the tree implies that the data are not independent, and for most applications this should be taken into account. We describe strategies for weighting the data that circumvent some of the problems of dependency. PMID- 2760929 TI - Structure and function of the nun gene and the immunity region of the lambdoid phage HK022. AB - The immunity region of the lambdoid phage, HK022, has been sequenced. The HK022 repressor gene, its cognate operators and promoters, and several early phage genes can be discerned. The overall design of the immunity region resembles that of other lambdoid phages. The location of the HK022 nun gene, whose product excludes superinfecting lambda by terminating transcription at (or near) the lambda nut sites, is analogous to that of gene N in lambda. nun is preceded by sequences similar to the lambda nut sites and the lambda pL promoter and is followed by several transcription termination signals. Despite these similarities, Nun is required neither for the lytic nor the lysogenic pathway of phage development. Again, unlike N, Nun is expressed in a prophage, perhaps from a promoter other than pL. We suggest that Nun and N have diverged in evolution and now perform different functions for their respective phages. Although Nun and N compete at the lambda nut sites and interact with the same host Nus proteins, they are only distantly related in predicted amino acid sequence. The presence of transcription terminators in the pL operon suggests that the expression of the HK022 early functions, like those of lambda, entails an antitermination mechanism. However, Nun does not appear to be an essential component of this mechanism. Our most economic model is that the HK022 nutL sequence suppresses pL operon terminators in the absence of a phage-encoded antitermination protein. Striking homologies between the HK022 nutL sequence and related sequences in the Escherichia coli rrn operons support this notion. Alternatively, a phage antitermination gene may be located outside the pL operon. PMID- 2760930 TI - Accelerated poly(A) loss on alpha-tubulin mRNAs during protein synthesis inhibition in Chlamydomonas. AB - Detachment of flagella in Chlamydomonas reinhardii stimulates a rapid accumulation of tubulin mRNAs. The induced tubulin mRNAs are normally rapidly degraded following flagellar regeneration, but inhibition of protein synthesis with cycloheximide prevents their degradation. alpha-Tubulin poly(A) tail lengths were measured during normal accumulation and degradation, and in cycloheximide treated cells. To measure alpha-tubulin mRNA poly(A) chain lengths with high resolution, specific 3' fragments of alpha 1- and alpha 2-tubulin mRNAs, generated by RNase H digestion of mRNA-oligonucleotide hybrids, were sized by Northern analysis. Both alpha-tubulin mRNAs have a newly synthesized poly(A) chain of about 110 adenylate residues. The poly(A) tails shorten with time, and show an average length of 40 to 60 adenylate residues by 90 minutes after deflagellation, at which time induced alpha-tubulin mRNA is being rapidly degraded. Poly(A) loss is significantly accelerated in cycloheximide-treated cells, and this loss is not attributible simply to the longer time the stabilized molecules spend in the cytoplasm. A large fraction of alpha-tubulin mRNA accumulates as mRNA with very short poly(A) tails (less than 10 residues) in the presence of cycloheximide, indicating that deadenylated alpha-tubulin mRNAs can be stable in vivo, at least in the absence of protein synthesis. The rate and extent of poly(A) loss in cycloheximide are greater for alpha 2-tubulin mRNA than for alpha 1-tubulin mRNA. This difference cannot be attributed to differential ribosome loading. This finding is interesting in that the two mRNAs are very similar in sequence with the exception of their 3' untranslated regions. PMID- 2760931 TI - Two-dimensional structure of plant light-harvesting complex at 3.7 A [corrected] resolution by electron crystallography. AB - The structure of the light-harvesting chlorophyll a/b-protein complex has been determined at 3.7 A resolution in projection by electron diffraction, electron microscopy and image analysis. Diffraction patterns and high-resolution spotscan images of two-dimensional crystals stabilized with tannin were recorded at low temperature. Phases of structure factors were obtained directly by image processing, after correction of the images for lattice distortions, defocus and beam tilt. Amplitudes were measured by electron diffraction. The projection map shows the detailed structure of the trimeric complex, suggesting the positions of two domains of potential structural and functional homology, of one membrane spanning alpha-helix approximately perpendicular to the membrane plane and of several tightly bound lipid molecules. PMID- 2760932 TI - Binding of oxygen and carbon monoxide to the hemocyanin from the spiny lobster. AB - A high precision, two-dimensional study of oxygen and carbon monoxide binding to Panulirus interruptus hemocyanin has been carried out. Global data analysis of three types of experiments, probing the molecule in its various states of CO and O2 ligation, revealed the entire hexamer to be the basic allosteric unit involved in a two-state mechanism. The co-operativity and linkage of the two ligands are presented in terms of derivative Hill plot surfaces extended along co-ordinates of CO and O2 activities giving a detailed and comprehensive view of the binding behavior. Among the findings is an apparent high co-operativity of carbon monoxide binding at high oxygen activity. The results are discussed in view of a general mechanism for co-operative behavior found in larger hemocyanin aggregates concerning "nested" allosteric interactions. PMID- 2760933 TI - Antibody against the amino terminus of alpha-actin inhibits actomyosin interactions in the presence of ATP. AB - Actomyosin interactions in the presence of ATP were examined by using site specific antibodies directed against the first seven N-terminal residues on skeletal alpha-actin. Fab fragments of these antibodies (S alpha N Fab) inhibited effectively the actin-activated ATPase of myosin subfragment 1 (S-1) at both 5 and 25 degrees C. Binding experiments carried out in the presence of ATP at 5 degrees C revealed that the catalytic inhibition was related to the inhibition of S-1 binding to actin by Fab. At equimolar ratios of Fab to actin, the binding of S-1 to actin and the activated ATPase were inhibited by 75 and 82%, respectively. These results, when contrasted with the small effect of Fab on rigor actomyosin binding, suggest ATP-induced changes at the interface of actin and myosin. PMID- 2760934 TI - Preliminary X-ray crystallographic study of lysozyme produced by Streptomyces globisporus. AB - Lysozyme from Streptomyces globisporus has been crystallized in a form suitable for X-ray structure analysis using ammonium sulfate as a precipitant. The crystals are hexagonal, space group P6(1)22 (P6(5)22) with unit cell dimensions: a = b = 129 A, c = 143 A. There are three or four molecules per asymmetric unit. The crystals diffract X-rays to at least 3.0 A resolution. PMID- 2760935 TI - Demographic and seasonal influences on human serum pesticide residue levels. AB - This study was intended to characterize more fully the distribution of serum concentrations of 16 pesticide residues with regard to key demographic and seasonal variables in a subsample of persons from the Second National Health and Nutrition Examination Survey between the ages of 12 and 74 yr old. Blood sera in 2-ml aliquots were analyzed, and the results were confirmed for 5994 persons. Almost all participants (99.5%) had p,p'-dichlorodiphenyldichloroethylene (p,p' DDE) concentrations greater than or equal to 1 ppb, ranging as high as 378.6 ppb. For the other pesticide residues, only beta-benzene hexachloride (beta-BHC) (quantified in 17.2% of the sera), dieldrin (10.6%), and another DDT-related residue, p,p'-dichlorodiphenyltrichloroethane (p,p'-DDT) (35.7%) were found at quantifiable levels in more than 10% of the serum specimens. Of the remaining analytes, hexachlorobenzene (HCB), trans-nonachlor (TNC), and heptachlor epoxide (HE) were found at quantifiable concentrations in 1-10% of the specimens, whereas o,p'-DDT, o,p'-DDE, p,p'-DDD, mirex, alpha-BHC, gamma-BHC, heptachlor, delta-BHC, and aldrin were found in less than 1% of the serum specimens. Results showed that increasing age, residing on a farm, or being a male conferred increased risks of exposure to most of the pesticide residues, independent of all other demographic and seasonal factors. In a pattern less consistent across the different pesticide residues and for fewer of the pesticides, persons who lived below the national poverty level, were nonwhite, resided in the South or West, or were examined in the spring or winter also seemed to have an increased likelihood of having quantifiable serum levels. PMID- 2760936 TI - Isolation and characterization of fly ash from rat lung tissue. AB - Inhaled fly ash may be leached by lung fluids, making potentially toxic trace elements in the fly ash bioavailable. We studied the composition and morphology of fly ash particles recovered from lungs of rats exposed to fly ash from a power plant burning pulverized eastern coal. Animals were sacrificed 1, 3, 6, and 12 mo after the commencement of the 4-wk exposures. Particles isolated from lungs of exposed animals, control fly ash samples, and samples recovered from control lungs spiked with fly ash were characterized by computer-controlled scanning electron microscopy (CCSEM) and thin window energy dispersive X-ray spectroscopy (EDS). EDS spectra of fly ash and ashed lung residues were distinct. Thus, fly ash particles could be distinguished from ashed lung residues. A majority of the fly ash particles recovered from lungs of exposed animals had similar morphology and composition to the exposure material. However, the number of silicon-rich particles decreased with time. After 6 mo, about 1% by number of the particles had been transformed, producing numerous "needles" associated with residues of fly ash particles. Particles that looked like diatoms were observed. This demonstrated that the sample preparation procedures used did not destroy delicate structures. Fly ash particles from a spiked control lung subjected to the same separation procedures did not have these structures. The structures may be the result of leaching of particles by lung fluids, which suggests that the glassy matrix components of fly ash particles may be bioavailable. PMID- 2760937 TI - A semiautomatic image analyzer for cell counts in monolayers. I. Construction, experimental procedure, and precision obtained. AB - A simple, flexible, low-cost image analyzer system is presented for determination of the total number of cells and the number of viable cells in monolayers of nonconfluent cells. Viable cells were identified and counted using an immunofluorescence method using fluorescein diacetate. Alveolar macrophages from rabbits were used. The different possible counting procedures that could be performed are analyzed. The precision of the method of estimating the cell numbers is indicated by a coefficient of variation of 5%. The experimental procedure is given for a short-term toxicological in vitro test in which the semiautomatic counting procedures can be performed within 1.5 h. PMID- 2760938 TI - A semiautomatic image analyzer for cell counts in monolayers. II. Application to toxicity estimation and comparisons between two cell-viability markers, fluorescein diacetate and lactate dehydrogenase. AB - By using an image-analyzer system, toxicological effects of different substances on nonconfluent cells in monolayers can be assessed. The total number of cells and the number of viable cells are semiautomatically counted. Fluorescein diacetate is used as the viability marker. The method was tested by using monolayers of alveolar macrophages from rabbits exposed to manganese dioxide particles. A dose-response curve was obtained from a series of experiments in which the response at a certain dose level can be obtained from cell-counting procedures of the duration of 1 h. The method can be used as a short-term test, testing potentially toxic substances including cytostatic drugs where the viability should be determined. Another example is further given of the use of this technique. The results obtained from it are compared with estimates of the percentage of viable cells assessed by extracellular lactate dehydrogenase from nonexposed and manganese dioxide particle-exposed monolayers of rabbit alveolar macrophages. The two methods both account well for the theoretical relation when the lactate dehydrogenase activity values are corrected for an inactivation of this enzyme with time. PMID- 2760939 TI - A semiautomatic image analyzer for cell counts in monolayers. III. Statistical considerations. AB - The image-analyzing system described in the companion paper (Thoren and Lanke, 1989) is considered from a statistical point of view. Special attention is given to the following applications: simple cell counts, viability estimation, and toxicity estimation. Different estimators are considered, their variances are discussed, and it is shown how to compute standard errors in different situations. PMID- 2760940 TI - Influence of laminin on the responsiveness of early chick embryo neural tube neurons to nerve growth factor. AB - Dissociated neurons from the neural tube containing the trigeminal motor nucleus from early chick embryos were cultured on laminin or collagen-polyornithine substrates, with and without nerve growth factor (NGF). Control cultures were grown in similar conditions with cytochrome-C. It was found that neuronal survival was not affected by NGF or cytochrome-C, but it was enhanced by laminin. The expression of neuritic processes, however, was significantly enhanced in the presence of NGF on both laminin and collagen-polyornithine surfaces, with the greatest number of neurons producing processes seen in the laminin-plus-NGF group. The length of processes was similarly enhanced by laminin and by NGF. Cytochrome-C did not influence any of these measures. The results indicate that while laminin potentiates the NGF effect on these early neuronal populations, NGF in conjunction with other substrata can have similar, though less dramatic, effects. These results, together with prior evidence of NGF receptors and specific NGF retrograde transport, suggest that this growth factor may play a significant role in the normal ontogeny of early motoneuron populations. PMID- 2760941 TI - Glucose transport in primary cultured neurons. AB - In this study, we have examined glucose uptake and its regulation by insulin in primary cultured neurons. Glucose transport was assessed by measuring the initial rate of uptake of 3H-2-deoxyglucose, a glucose analog that is transported and phosphorylated but not further metabolized. The uptake of 2-deoxyglucose was saturable; measurements of the intracellular concentration of 2-deoxyglucose and 2-deoxyglucose-6-phosphate revealed that hexokinase activity rather than membrane transport is the rate-limiting step for glucose uptake. Insulin had no effect on 2-deoxyglucose uptake at low (0.2 mM) or high (20 mM) concentrations of substrate. The order of potency of other hexoses to competitively inhibit the accumulation of 2-deoxyglucose was D-glucose (0.2 mM) = D-mannose (0.2 mM) greater than 3-0-methylglucose (9 mM) greater than D-galactose (90 mM). Cytochalasin B was a potent inhibitor of 2-deoxyglucose uptake (IC50 = 500 nM) and phloretin was more potent than ploridzin in inhibiting uptake. The structure of glucose transporters was examined by photoaffinity labeling using 3H cytochalasin B and by immunologic detection using antibodies raised against the human erythrocyte transporter. 3H-cytochalasin B labeled two proteins of 55 kDa and 43 kDa and the antibody recognized primarily a 43 kDa protein. The subcellular distribution of glucose transporters, estimated by measuring the number of specific cytochalasin B binding sites in subfractions of neuronal homogenates, showed 3.62 pmol/mg protein in the 11,000g pellet and 1.34 pmol/mg protein in the 200,000g pellet. IN CONCLUSION: 1) Neuronal glucose transport is not acutely regulated by insulin. 2) The kinetics of 2-deoxyglucose uptake into neurons are determined largely by hexokinase activity rather than membrane transport. 3) The apparent molecular weight of neuronal glucose transporters is similar to transporters in other tissues. 4) The number of glucose transporters per milligram of protein is relatively low in neurons compared to other tissues. PMID- 2760942 TI - Chicken NGF and non-NGF trophic factor synthesis and release by sciatic nerves in vitro. AB - The time course of production and release of nerve growth factor (NGF) and non NGF neuronotrophic factors for sympathetic neurons by chicken and rat sciatic nerves in culture was examined. These tissues actively synthesize and release neuronotrophic activity as metabolically poisoning nerves with azide dramatically reduced the amount of trophic activity released into the culture medium. The sustained release of this activity also was shown to be dependent on the presence of low-molecular-weight dialysable molecules present in foetal calf serum and amniotic fluid from day 11 chicken embryos. Affinity-purified antimouse NGF antibodies were used to show that sciatic nerves in culture release both NGF and non-NGF trophic factors. These antibodies inhibited all bioactivity of both mouse NGF and of a partially purified preparation of chicken NGF. Immunoblot studies confirm that the antibodies recognize both rodent and avian NGF. Excess antibody inhibited only about 50% of the trophic activity in media conditioned over rat or chicken nerves for the first 24 hr. Relatively similar amounts of this non-NGF trophic activity were released throughout 6 days in culture, and this trophic activity kept sympathetic neurons alive in culture in the absence of NGF for more than 4 days. NGF levels were quantified with a two-site enzyme-linked immunoassay and found to parallel changes in NGF bioactivity. Rat nerves released increasing amounts of NGF with time in culture. Whole chicken sciatic nerves, however, released decreasing amounts of NGF with time in culture, but when these nerves were desheathed by removal of the epineurium and attached tissue, the pattern of NGF release was similar to that observed in the smaller rat sciatic nerves. These studies therefore characterize antibodies recognizing chicken NGF, demonstrate that peripheral nerve tissue synthesize trophic factors other than NGF, and identify factors that influence NGF synthesis. PMID- 2760943 TI - Nerve regulation of class I and class II-asymmetric forms of acetylcholinesterase in rat skeletal muscles. AB - Two classes of collagen-tailed, asymmetric forms (A-forms) of acetylcholinesterase (AChE) have been described in skeletal muscles of vertebrates. They are distinguished by their different solubilization requirements: class I A-forms are solubilized in the presence of high salt, whereas class II A-forms require in addition a chelating agent for solubilization. We report here that class II A-forms are less sensitive to nerve section than are class I A-forms. The latter form decreases faster and to a lower level of activity after denervation. The decay of both AChE classes is more rapidly in short-stump nerves than in long ones. The effect of nerve section on class II A-forms appears to be dependent on the particular muscle group being studied. Both classes of A-forms reappear after muscle reinnervation, but the class I A-forms recovered earlier. More interestingly, both classes of A-forms increase in normally innervated skeletal muscles after contralateral nerve injury. In this case, however, the class II A-forms change first. Muscular disuse induced by contralateral tenotomy is also followed by a rise in class II A-forms. Our results, showing differences in response and flexibility in the changes of the two classes of A-forms in several experimental conditions, represent a relevant contribution to the understanding of the regulation and functional role of the asymmetric forms of AChE in vertebrate skeletal muscles. PMID- 2760944 TI - Intracerebroventricular administration of bombesin inhibits biliary and gastric secretion in the rat. AB - The effect of intracerebroventricular (ICV) bombesin on bile and gastric acid secretion was examined in the rat. ICV bombesin (10 micrograms in 10 microliters) inhibited basal biliary volume by 27% and bile bicarbonate by 52% of control values, while gastric acid secretion was decreased by 75%. These results provide evidence for central mechanisms for the control of gastrointestinal function. PMID- 2760945 TI - Consensus residues at the acetylcholine binding site of cholinergic proteins. AB - The nicotinic (nAcChR) and muscarinic (mAcCh) acetylcholine receptors and acetylcholinesterase (AcChEase) are structurally unrelated but share a common functional property: interaction with acetylcholine (AcCh). Alignment of the probable AcCh binding site regions of the nAcChR and mAcChR protein sequences revealed the presence of ten nearly identically spaced consensus residues, six of which contain potentially ligand-interactive side chains. Important elements of the consensus residues also were found in one unique sequence region of the AcChEases. Alignments among the two receptors and AcChEase outside the apparent binding region were rare, and the consensus AcCh binding residues were largely substituted in the homologous proteins, which do not bind AcCh. The consensus residues include two possible anionic subsite Asp residues and a Ser that may hydrogen bond to the AcCh carbonyl in the receptors. These residues correspond to positions Asp-166, Ser-173, and Asp-200 in the neuromuscular nAcChR; Asp-71, Ser 78, and Asp-105 in the M1 mAcChR; and Asp-93 and Asp-128 in Torpedo AcChEase. No corresponding consensus Ser is found in the AcChEase sequence; this is expected because of a downstream esterase active-site Ser-200 (Torpedo). A receptor conserved and disulfide-linked Cys corresponding to neuromuscular nAcChR residue 193 and M1 mAcChR residue 97 may be important in energy transduction associated with agonist-mediated events. The presence of additional binding-site aromatic residues that may form a hydrophobic environment near the anionic subsite are aligned within, but not between, the three cholinergic protein groups. These observations target specific regions and residues within these proteins for structure-function studies of the cholinergic binding domain. PMID- 2760946 TI - Papers from the annual meeting of the Trauma Association of Canada. September 21 24, 1988, Ottawa. PMID- 2760947 TI - Isoproterenol inhibits the increase in microvascular membrane permeability produced by bradykinin. AB - Bradykinin (BRADY) is hypothesized to cause the "capillary leak" syndrome in patients with sepsis, trauma, and burns. Our purpose was to determine if isoproterenol (ISO) reversed a BRADY-produced accelerated loss of intravascular fluid and protein into the interstitium of skin. An increase in microvascular permeability in canine hind paw skin was sustained by a continuous femoral artery infusion of BRADY (0.2 micrograms/kg/min). After 2 hours of BRADY, skin lymph flow (LYM FLOW microliters/min) increased nine-fold and skin lymph-to-plasma total protein concentration ratio (RTP) was substantially increased. Mean blood flow in the femoral arteries was increased four-fold by the BRADY infusion. After 2 hours of BRADY-induced increased permeability, five of the ten dogs were started on intravenous ISO (2 micrograms/min continuously) which increased heart rate from 182 +/- 15 to 222 +/- 11 beats/min. ISO reversed the increase in RTP produced by the BRADY. After 8 hours of BRADY, there was less tissue albumin in the dogs given ISO (14.5 +/- 2.0 vs. 29.5 +/- 6.6 mg/gram dry wgt, p less than 0.05 unpaired t-test). ISO can reverse the sustained increase in skin microvascular permeability produced by BRADY. PMID- 2760948 TI - Toxic factors in the red blood cell membrane. AB - The toxic effects of hemolysed RBCs have been studied for more than 100 years, but the specific factors involved have not been identified. This study focused on phosphatidylethanolamine (PE) and phosphatidylserine (PS), two aminophospholipids that normally reside on the cytoplasmic side of the red cell membrane. An in vitro experiment with murine peritoneal exudate macrophages showed that PE and PS: a) stimulated the production of H2O2, complement factor C3a, prostacyclin, and thromboxane at a dose of 5 micrograms/ml; b) produced cell injury, evidenced by release of lipid peroxides, LDH, and by morphologic changes on phase-contrast and electron microscopy at a dose of 50 micrograms/ml; and c) caused cell death in 50-66% of cells at a dose of 100 micrograms/ml. An in vivo experiment showed that PE and PS injected intravenously into various groups of rabbits: a) caused only transient hypotension at a dose of 0.05 mg/kg body weight; b) caused significant hypotension, cardiac arrhythmias, bronchospasm, activation of intravascular coagulation, complement, platelets, and leukocytes with release of histamine, serotonin, and thromboxane at a dose of 0.10 mg/kg; and c) caused cardiac arrest and death at a dose of 0.30 mg/kg. In contrast, the phospholipids of the outer cell membrane (phosphatidylcholine and phosphatidylinositol) caused minimal toxicity in vitro and none in vivo. PMID- 2760949 TI - Prospective MAST study in 911 patients. AB - Nine hundred eleven patients with systolic blood pressures less than or equal to 90 mm Hg were randomized to MAST and No-MAST groups, and all taken to a single Level I Trauma Center. Epidemiologic analysis of etiology, age, race, sex, Trauma Scores, and Injury Severity Scores revealed the two groups to be statistically identical. Seven hundred eighty-four patients were analyzed in detail. The principal injury location was thorax in 41%, abdomen in 32%, extremity in 16%, head in 7%, and neck in 4%. In patients with head and extremity wounds, the mortality rate was clearly not a function of MAST use. In the chest, abdomen, and neck, MAST did not improve survival. Although the total prehospital time was 35.8 + 10.4 minutes for MAST patients and 32.5 +/- 10.7 minutes for No-MAST patients, 70% of patients with MAST had prehospital times greater than 30 minutes compared to 55% of the No-MAST patients. When the prehospital time was greater than 30 minutes, 31% of the MAST patients died, compared to 21% of the No-MAST patients. MAST application adversely affected the outcome most significantly for patients with cardiac and thoracic vascular injury. The overall mortality of 31% in the MAST group, compared to 25% in the No-MAST group was statistically significant (p = 0.05). PMID- 2760950 TI - Compartment syndrome: a quantitative study of high-energy phosphorus compounds using 31P-magnetic resonance spectroscopy. AB - The purpose of this study was to quantitate the intracellular high-energy phosphate compounds during 6 hours of tissue ischemia in the anterior tibial compartment of beagles subjected to an induced traumatized compartment syndrome. The goal of this work was to provide clinicians with objective criteria to augment clinical judgment regarding surgical intervention in the impending compartment syndrome. A beagle model was utilized in which the Delta pressure (difference between the mean arterial pressure and compartment pressure) could be controlled. The model, in conjunction with 31P-magnetic resonance spectroscopy (MRS), allowed a measure of high-energy phosphate compounds and pH in the compartment at various Delta pressures. The extent of ischemic metabolic insult in the compartment was then quantitated. Our data suggest the following: 1) lower Delta pressures result in a proportionally greater drop in the intracellular phosphocreatine ratio and pH; 2) at lower Delta pressures, there is proportionally greater decline in the percentage recovery post-fasciotomy; 3) blood pressure is extremely important and periods of hypotension may result in increased muscle damage at lower compartment pressures. PMID- 2760951 TI - Pediatric trauma: need for surgical management. AB - A recent proposal by some pediatricians is that they be primarily responsible for resuscitation and triage of injured children with surgical care being initiated only through consultation. To assess the need for operative intervention, a consecutive series of 376 children less than 15 years of age admitted to a regional trauma center was examined, in which 194 children had 254 operations. Mortality was 7.2%. Twenty-two children who presented with persistent hemodynamic instability (sys. BP less than 90 mm Hg) had a mortality of 73%. Children were divided into three severity groups based on the Revised Trauma Score (RTS). Of the severely injured children (RTS less than or equal to 6), 79% required emergent operative intervention; 42% and 14%, respectively, required emergent operation in the moderately (6 less than RTS less than 12) and minimally (RTS = 12) injured groups. The need for operative management is great, even in "minimally" injured children. PMID- 2760952 TI - Nonunion of the clavicle and thoracic outlet syndrome. AB - Fifteen adult patients with clavicular nonunions were evaluated over a 10-year period. Fourteen of these patients were treated initially with a "figure-of eight" clavicle strap. Seven presented with narrowing of the costoclavicular space, and symptoms of intermittent brachial plexus impingement or thoracic outlet syndrome. Two of these resulted from resection of the mid-portion of the clavicle with subsequent impingement from hypertrophy of the lateral stump. Most commonly, hypertrophic nonunion of the clavicle caused the thoracic outlet syndrome, frequently many months after the initial injury. This delayed onset led to diagnostic confusion with other causes of radiating upper extremity pain, including cervical disc disease. Treatment of the adult clavicle fracture is different from that of the child with potential for greater functional impairment. The "figure-of-eight" harness frequently does not provide pain relief or adequate reduction of the fracture. If an acutely displaced fracture in an adult cannot be reduced and held by closed casting technique, open reduction and internal fixation may occasionally be indicated. We have found transcortical fixation by locking Knowles pins to be effective for treating hypertrophic nonunions, as well as for unreducible acute fractures. Atrophic nonunions require plate fixation and autologous grafting. Nonunion of the clavicle has been among the most responsive of nonunions in our experience, since all fractures treated by adequate reduction and fixation healed promptly.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2760953 TI - Treatment of acute postoperative anemia with recombinant human erythropoietin. AB - Risks inherent in the administration of blood products have increased efforts to avoid homologous transfusion. Although this has increased interest in autologous transfusion and intraoperative salvage, little attention has been focused on efforts to enhance endogenous erythropoiesis as a method of minimizing exposure to homologous blood. Recombinant human erythropoietin (rHuEPO) has been shown to enhance erythropoiesis. The purpose of this study is to evaluate the effect of rHuEPO, administered postoperatively, on a model of acute blood loss. Eleven adult male baboons were randomized into two groups. All animals underwent a laparotomy and an exchange transfusion, with 6% hetastarch, to a final hematocrit of 15%. Group I (N = 6) received 1,000 units/kg of recombinant human erythropoietin daily for the first 14 postoperative days. Group II (N = 5) received an equivalent volume of placebo. All animals were given supplemental vitamin B12, folate and 200% of shed iron, as iron dextran IV, after exchange transfusion. Response was observed for a period of 35 days. All animals survived the protocol. There were no adverse reactions to rHuEPO or surgical complications. The hematocrits were similar between groups at baseline and after exchange transfusion. The maximal rate of erythropoiesis was significantly faster in the rHuEPO group (2.1 vs. 1.3%/day; p less than 0.01). The time required to return to hematocrits of 30% (9.9 vs. 17.4 days, p less than 0.001) and to baseline hematocrits (11.9 vs. 32.1 days, p less than 0.01) were both significantly shorter in the rHuEPO group. The data show that rHuEPO accelerates the recovery from anemia in the postoperative setting. Acceleration of erythropoiesis represents another alternative to homologous transfusion.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2760954 TI - Intra-abdominal sepsis following liver trauma. AB - Of 330 consecutive patients with liver trauma having a celiotomy over a 5-year period, 295 (89%) survived more than 72 hours. Of these 295, 35 (12%) developed sepsis, and 11 (31%) of these septic patients died. The sources of the sepsis in 30 of these patients included: abdominal abscesses--23, pneumonia or empyema- seven, acalculous cholecystitis--two, gangrene of right colon--two, and thigh abscess--one. In five other patients, the source of the sepsis was not found, even at autopsy. The mortality rate in the 30 patients with one or more identifiable foci of infection was 23%. In contrast, when the source of the sepsis could not be found, the mortality rate was 80% (4/5) (p less than 0.05). Factors associated with an increased incidence of abdominal abscess included: splenectomy, 75% (3/4); liver packs, 63% (5/8); 20+ units of blood, 57% (8/14); Class IV-V liver injury, 35% (8/23); 10-19 units of blood, 25% (7/28); colon injury, 19% (7/36); and open (Penrose) drainage of the abdomen, 11% (23/213). None of 82 patients without drains developed an intra-abdominal abscess. Thus early control of an identifiable source of infection provides the best results with sepsis following liver trauma. The most effective method for preventing intra-abdominal abscesses appears to be avoidance of drains in mild (Class I-II) liver injuries. The use of a closed system in the most severe injuries is still controversial and needs to be addressed in a prospective trial. PMID- 2760955 TI - Multiple-level noncontiguous spinal fractures. AB - Double-level noncontiguous spinal injury is a more common occurrence than generally appreciated. A large number of these patients have neurological injury. Because these injuries occur in patients who meet the criteria for categorization as multiple trauma patients, we feel that a complete radiographic survey of the spine must be accomplished in the emergency room in any situation where clinical assessment is impaired. Treatment must be individualized with the same guidelines for treatment as for the isolated injury in the majority of circumstances. PMID- 2760956 TI - Macrophage activation decreases macrophage prostaglandin E2 release in experimental trauma. AB - Prostaglandin E2 (PGE2) derived from macrophages following trauma may contribute to trauma-induced immunosuppression. This study evaluated the effect of glucan, a macrophage-activating agent, on macrophage PGE2 release in a murine trauma model. ICR/HSD mice were administered D5W, glucan pre-trauma, or glucan post-trauma, and subjected to hindlimb crush and amputation injury. Splenic macrophages were isolated 24 hours following trauma, cultured (24 hrs), and macrophage PGE2 levels were determined. In-vitro marrow proliferation was assessed as a measure of immune function. Crush-amputation injury increased (184%) macrophage PGE2 release. In contrast, glucan administration (pre or post) reduced PGE2 levels in macrophage supernatants (71% and 85%, respectively). A 52% decrease in in-vitro bone marrow proliferation was observed following trauma. Glucan pre- or post trauma eliminated the suppression of bone marrow proliferation. In conclusion, macrophage-activating immunomodulators may exert beneficial effects following trauma by: 1) reducing macrophage PGE2 synthesis and release; and 2) reducing traumatic suppression of bone marrow proliferation. PMID- 2760957 TI - Preinjury psychopathology in trauma patients. AB - One hundred patients admitted to a Level I trauma center were interviewed using the Langner 22-item index of psychiatric symptoms to evaluate pre-existing psychological pathology. The medical chart was also examined for any type of note or evidence of psychiatric consultation efforts by the surgical attending staff. There were 74 males and 26 females in the sample, with a mean age of 33 years. Types of injuries included blunt trauma in 71% and penetrating trauma in 29% of the group, respectively. Eight per cent of these injuries were self inflicted. The mean Injury Severity Score was 17. Alcoholic intoxication was documented in 49%. We found that severe psychopathology as defined by the Langner Index was present in 88% of those admitted with penetrating trauma, in 47% of those admitted with blunt trauma, and in 75% of the intoxicated group. In only 14% of the sample was psychopathology documented in the chart by the attending staff. Preinjury psychopathology in trauma patients was commonly present and seemed to be most highly associated with penetrating trauma and alcohol use. PMID- 2760958 TI - Evaluation of computed tomography and diagnostic peritoneal lavage in blunt abdominal trauma. AB - Three hundred one hemodynamically stable patients with equivocal abdominal examinations following blunt abdominal trauma had a CT scan followed by DPL. Both studies were negative in 194 patients (71.6%) and positive in 51 patients (27.1%). Seven of the 51 patients (13.7%) had an additional significant injury at operation that was not seen on the CT scan. Nineteen patients had a negative CT scan, a positive DPL, and a significant injury confirmed at celiotomy. In this group of 19 patients, the CT failed to identify seven splenic, three hepatic, and three small bowel injuries. There were two complications attributed to DPL. Three patients had a false negative DPL. Diagnostic peritoneal lavage continues to be a reliable study (sensitivity--95.9%, specificity--99%, accuracy--98.2%). The CT scan is not as sensitive (sensitivity--74.3%, p less than 0.001; specificity- 99.5%, accuracy--92.6%). It is concluded that selective use of both procedures is appropriate as long as one recognizes the inherent limitations of each. PMID- 2760959 TI - Injury and cost comparison of restrained and unrestrained motor vehicle crash victims. AB - The use of active motor vehicle restraints is a topic of current public and legislative debate. To better define the effects of restraint systems on injury severity, the following study was undertaken. Parametric statistical tests were used for data analyses. For a 6-month period beginning February 1, 1987, all motor vehicle crash victims treated in the emergency unit were entered into the study (n = 613). There were 290 unrestrained subjects (UR), 254 restrained subjects (R), and 69 were excluded because restraint usage information was unobtainable. Unrestrained victims were younger (mean age, UR = 28, R = 32; p less than 0.05), and were more often male (UR = 65%, R = 51%; p less than 0.05). Hospitalization was more frequently required for unrestrained crash victims (UR = 59%, R = 26%; p less than 0.05). Length of hospital stay (LOS), including ICU confinement, was also extended (mean LOS, UR = 13, R = 10), but this difference did not reach statistical significance. Injury Severity Scores (ISS) and Abbreviated Injury Scales (AIS) were tabulated and compared. Mean ISS was significantly higher for unrestrained victims (UR = 8.28, R = 4.44; p less than 0.05), and a higher proportion of unrestrained victims had scores greater than 15 (UR = 20%, R = 7%; p less than 0.05). Mean AIS was higher in all regions, although the difference did not consistently reach statistical significance.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2760960 TI - Disseminated intravascular coagulation associated with spinal cord laceration: a case report. AB - A 31-year-old man was thrown from his motorcycle, sustaining a thoracolumbar fracture and cervical spine fracture with no evidence of neurologic function below L1. At the time of spinal fusion, there was diffuse bleeding from the soft tissues. Visualization of the thoracolumbar fraction revealed separation of the laminae with a dural tear and extruding spinal cord tissue. Laboratory evaluation identified abnormal clotting studies intraoperatively and postoperatively. We postulate that release of potent spinal cord thromboplastins into the systemic circulation may elicit a coagulopathy, as has been recognized following craniocerebral trauma. PMID- 2760961 TI - Studies on the calcium antagonistic action of tetrandrine: X VI. Hemodynamic effects of tetrandrine on conscious rats. AB - Hemodynamic study of tetrandrine (Tet) in conscious rats showed that 15 mg/kg i.v. lowered BP, LVSP, +/- dp/dtmax, and (dP/dt)P-1. The degree of diminutions was nearly equal to that of BP during the initial period, while the LVEDP was elevated. But all these parameters (except -dp/dtmax) recovered gradually and earlier than BP, and LVEDP decreased to a level slightly lower than that of control. These results indicate that the hypotensive action of Tet is mainly due to its inhibition of cardiac contractility at the early period, but due to vasodilatation in the later stage. The HR was slowed down abruptly followed by a reflex acceleration, and than a gradual but sustained decrease in HR supervened with i.v. Tet. When large dose (40 mg/kg) of Tet i.v. caused a cardiac standstill with the R wave of ECG persisting for a few minutes, it means that an excitation contraction decoupling occurred as that found on isolated myocardial preparation treated with verapamil and Tet. PMID- 2760962 TI - Uptake and metabolism of retinol in isolated cells of germinal epithelium in vitro. AB - Retinyl esters were quantitatively the most significant product formed in short term incubations of isolated rat germinal cells administered 3H-retinol. 3H retinyl palmitate was found to be the single most abundant metabolite accounting for approximately 80% of the total label 2 h after administration of 3H-retinol bound to bovine serum albumin. Differences were found in the relative activity of retinol uptake and metabolism between the various subpopulations of germinal cells separated by the staput sedimentation technique. The strongest correlation was between the magnitude of 3H-retinyl palmitate synthesis and the distribution of round spermatids. Large pachytene spermatocytes also appeared to correlate with 3H-retinyl palmitate synthesis although this correlation was ambiguous due to the presence of a small population of Sertoli cells and spermatogonia in these fractions. The concentration of cellular 3H-retinol was more than 10 fold greater in germinal cells administered 3H-retinol bound to bovine serum albumin than when 3H-retinol bound to serum retinol-binding protein was administered, and likewise the concentration of cellular 3H-retinyl palmitate was approximately 30 fold higher. In comparison to germinal cells, Sertoli cells administered 3H-retinol bound to serum retinol-binding protein incorporated 20 fold more 3H-retinol and synthesized more 3H-retinyl palmitate. However, both germinal cells and Sertoli cells were found to have incorporated similar concentrations of total label when administered 3H-retinol bound to bovine serum albumin. (ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2760963 TI - The effect of high cholesterol, high fat diet on rabbit plasma beta-VLDL and its interaction with macrophage. AB - Rabbits were fed on 1% cholesterol and 10% rape seed oil (group A) or lard (group B). Plasma cholesterol and triglyceride level of group A was strikingly lower than that of group B. No difference was found in the lipid composition of beta VLDLs between both groups. However, apo E content of beta-VLDL from group A was higher and apo B (higher molecular weight) was lower than that of group B respectively. beta-VLDL of group A caused greater accumulation of cholesterol in mouse peritoneal macrophage than that of group B. Therefore, we assume that the good effect of poly-unsaturated fatty acid on atherosclerosis results not from decreasing accumulation of cholesterol in macrophages but from enhancing elimination of beta-VLDL by the liver. PMID- 2760964 TI - The role of lipoprotein lipase in metabolism of normolipidemic very low density lipoprotein by macrophages. AB - It was demonstrated by using lipoprotein lipase (LPL) inhibitor benzene boronic acid (BBA) that LPL played a major role in the accumulation of triglycerides (TG) in mouse peritoneal macrophages exposed to rabbit normal very low density lipoproteins (N-VLDL). There wwere less free fatty acids (FFA) and much more N VLDL-TG left in the media containing BBA than in the controls. TG accumulation in the cells was greatly diminished or even prohibited by BBA. Thus, we obtained direct evidence that LPL played a more important role than the receptor did in the uptake of N-VLDL-TG by mouse macrophages. The mechanisms of LPL action were discussed. PMID- 2760965 TI - Toxicological studies on the organophosphorous insecticide methyl-ISP. AB - Methyl-ISP, a newly developed organophosphorous insecticide, is used in China to treat and protect plants from pest infestation. Our studies demonstrated that methyl-ISP is metabolized rapidly in rat and mouse. Its toxicity was low, no obvious accumulative toxicity, chronic toxicity, teratogenicity, mutagenicity, reproductive toxicity or delayed neurotoxicity could be observed. It is therefore concluded that methyl-ISP is relatively safe to animals and human subjects. methyl-ISP is now employed to replace the other commonly used insecticide hexachlorobenzene (666) in agriculture. A preliminary study was performed to elucidate the mechanism of intoxication at subcellular levels. PMID- 2760966 TI - A preliminary study on expression and significance of pre-S1 protein in liver tissue of patients with HBV infection. AB - Rabbit antiserum to Pre-S1 protein was used to establish peroxidase antiperoxidase (PAP) and avidin-biotin-peroxidase complex (ABC) immunohistochemical techniques for detection of Pre-S1 protein in paraffin embedded liver tissue. Pre-S1 protein could be expressed in hepatocyte cytoplasm and on membrane in some cases with chronic viral hepatitis, cirrhosis and hepatocellular carcinoma (HCC), and its expression was intimately associated with HBsAg, HBcAg in liver and HBV DNA in serum, indicating that pre-S1 protein may represent the essential component of hepatitis B virus (HBV) and also serve as one of the markers of HBV infection. The incidence of Pre-S1 protein was slightly lower in nontumorous liver of HCC than in other cases and Pre-S1 protein could not be detected in tumorous tissue of HCC suggesting that expression of pre-S1 protein may be suppressed in HCC cases. PMID- 2760968 TI - Extreme elevation of the erythrocyte sedimentation rate in patients admitted to a general medical ward in Harare, Zimbabwe. AB - A prospective, 1-year study was performed to determine the causes of an ESR greater than or equal to 100 in patients admitted to a general medical ward in Harare, Zimbabwe. An ESR greater than or equal to 100 was found in 101 (12%) patients. Infection (46 patients) was the commonest cause, followed by malignancy (25), connective tissue disease (17), renal disease (8) and liver disease (5). The frequency of an ESR greater than or equal to 100 in these diagnostic groups was infection (28%), malignancy (44%), connective tissue disease (71%), renal disease (30%) and liver disease (24%). Pneumonia was the commonest infection diagnosed and the commonest cause of a markedly elevated ESR. Although myeloma was only the second commonest malignancy diagnosed it was the commonest malignancy causing an ESR greater than or equal to 100. In the largest group, infection, there was a significantly increased mortality in patients with an ESR greater than or equal to 100. PMID- 2760967 TI - Human cryptosporidiosis in the Arabian Gulf: first report of infections in children in Kuwait. AB - During a 3-month pilot study, we identified ten children with cryptosporidiosis; they all presented with diarrhoea, most also with fever, vomiting and dehydration. For diagnosis, the formalin-acetate concentrate of the stool, and direct smears were stained for oocysts in safranin-methylene blue (S-MB). The negative staining of oocysts in trichrome-stained specimens was indicative and was confirmed by destaining and restaining in S-MB. Constraints contributing to the absence of reports from the Arabian Gulf were the lack of awareness of Cryptosporidium sp. as a cause of diarrhoea in children, inappropriate laboratory diagnostic techniques and, possibly, the initial referral of patients to polyclinics where mild cases may go undetected. Contaminated drinking water and close contact with domestic animals are possible modes of transmission of Cryptosporidium sp. but further studies are recommended to confirm this. PMID- 2760969 TI - Soil-transmitted helminthiases among inhabitants of an oil-palm plantation in West Malaysia. AB - A total of 819 Indian inhabitants (from 6 months to over 60 years of age) in an oil-palm plantation in West Malaysia was examined for soil-transmitted helminthiases using the brine flotation and Kato thick smear techniques. Half (51.0%) of the inhabitants were found to be infected (33.9% had Ascaris lumbricoides; 36.4% had Trichuris trichiura and 15.6% had Necator americanus). Soil-transmitted helminthiases (both single and mixed infections) were significantly more common among children and young adults from 6 months to 20 years of age where 67.1% (range: 64.7-70.3%) of this age group were infected. The infection rate declined to about 25% or less among elderly people over 50 years of age. Trichuris trichiura was the commonest helminth observed--both as single and mixed infections--and Trichuris mixed with Ascaris was the commonest type of double infection reported. However, there were no significant differences in the distribution of the types of single and double infections among inhabitants of different age groups, nor were there any significant differences in the distribution of soil-transmitted helminthiases among male and female inhabitants. The socioeconomic, environmental and cultural factors contributing to persistently high rates of infection with soil-transmitted helminths among plantation inhabitants are discussed. PMID- 2760970 TI - Clinical experience with enteric fever in The Gambia, West Africa 1981-1986. AB - The clinical experience with enteric fever in The Gambia over a 5-year period is presented. It remains a common cause of septicaemic illness, but the mortality rate is lower than previously reported from West Africa. PMID- 2760971 TI - Focal neurological signs in cerebral malaria accounted for by preceding neurological damage. AB - In 1987 at Port Moresby General Hospital, Papua New Guinea, two out of 103 adults with a final diagnosis of cerebral malaria had focal neurological signs noted on admission. In both cases the focal signs could be explained by documented prior neurological disease with residual focal damage. Focal neurological signs in patients presenting with malaria should prompt careful investigation to exclude other active neurological disease. Where no additional diagnosis is evident a history of past neurological damage may become apparent to explain the focal nature of the malaria presentation. PMID- 2760972 TI - Choosing and using a microcomputer for tropical epidemiology. I. Preliminary considerations. AB - Practical considerations involved in ascertaining data processing requirements, starting with the protocol of an epidemiological study, are discussed. These include assessments of both hardware and software requirements. Throughout the paper special emphasis is placed on the problems of conducting an epidemiological study in a tropical environment, with minimal infrastructural, logistic and expert support. The requirements of a hypothetical study protocol are used as an example. This paper covers aspects of data processing required in preparing a project proposal; its sequel considers getting the project under way. PMID- 2760973 TI - A case of post-partum toxic shock syndrome presenting in an African patient. AB - A classic case of post-partum toxic shock syndrome with a possible mother-infant pair involvement is presented. Its low incidence in Africa as well as a probable source of infection is discussed. PMID- 2760975 TI - Transverse myelitis and hepatitis in varicella. AB - We describe a case with several grave complications of varicella rarely encountered in previously healthy young individuals. PMID- 2760974 TI - Gastric emptying of oral rehydration solutions in acute cholera. AB - Gastric emptying of rice powder electrolyte solution and of glucose electrolyte solution was measured by a marker dilution double sampling technique in 14 and in 16 adult patients respectively after intravenous rehydration during an attack of acute cholera. Six patients who received rice powder electrolyte solution and seven who received glucose electrolyte solution re-attended for a repeat study with the same test meal 16 days later, when fully recovered from cholera. No differences in gastric emptying patterns of the two electrolyte solutions were observed, either in the acute or in the recovered patients. Similarly, gastric emptying of both solutions was rapid during acute cholera and comparable to that observed in recovered patients. This study indicates that gastric emptying is not impaired in acute cholera and that the rate of emptying of oral rehydration solutions is adequate to account for their observed clinical efficacy in fast purging patients with acute cholera. PMID- 2760976 TI - Adenovirus L1 52- and 55-kilodalton proteins are required for assembly of virions. AB - A variant of adenovirus type 5 that contained a mutation within the L1 52- and 55 kilodalton (52/55K) protein-coding region was isolated. The mutant, termed ts369, produced L1 52/55K proteins with a two-amino-acid substitution and was temperature sensitive. Temperature-shift experiments indicated that the ts369 defect was late in the viral growth cycle. DNA replication and synthesis of late proteins occurred normally in ts369-infected cells at the nonpermissive temperature, but mature virions were not produced. Rather, capsidlike particles associated with the left-terminal region of the viral chromosome accumulated. These incomplete particles could not be chased into mature virions when the infected cells were shifted to the permissive temperature. However, previously synthesized proteins could be assembled into virions in the presence of a protein synthesis inhibitor upon shiftdown from the nonpermissive temperature, suggesting that the inactivation of the L1 52/55K proteins was reversible. These results indicate that the adenovirus L1 52/55K proteins play a role in the assembly of infectious virus particles. PMID- 2760978 TI - Identification of two murine loci homologous to the v-cbl oncogene. AB - The virally transduced oncogene v-cbl transforms fibroblasts in vitro and induces early B-cell-lineage lymphomas in vivo. A series of probes derived from a molecular clone of v-cbl were used to map related sequences in the mouse genome. Analyses of Chinese hamster x mouse somatic-cell hybrids showed that two related genes, cbl-1 and cbl-2, were located on chromosomes 6 and 9, respectively. Restriction enzyme studies of DNA from hybrid cells containing either chromosome 6 or 9 suggested that cbl-1 resembles v-cbl and may be a processed gene, whereas cbl-2 has a complex genomic structure. Analyses of Mus domesticus/M. spretus interspecific backcross mice showed that Cbl-1 maps between the immunoglobulin kappa light chain and T-cell receptor beta chain loci and that Cbl-2 is tightly linked to Thy-1. PMID- 2760977 TI - Interactions of minute virus of mice and adenovirus with host nucleoli. AB - Biochemical evidence is presented that both minute virus of mice (MVM) and adenovirus interact with the nucleolus during lytic growth and that MVM can also target specific changes involving nucleolar components in adenovirus-infected cells. These virus-nucleolus interactions were studied by analysis of intranuclear compartmentalization of both viral DNAs and host nucleolar proteins: (i) MVM in mouse cells (its normal host) replicates its DNA in the host nucleoli; (ii) specific nucleolar proteins as well as small nuclear ribonucleoprotein antigens are recompartmentalized to multiple intranuclear foci in adenovirus infected HeLa cells; and (iii) when adenovirus helps MVM DNA replication in a nonpermissive human cell (HeLa), the MVM DNA is also recompartmentalized for synthesis. The data suggest mechanisms for disruption of nucleolar function common to oncogenic or oncolytic virus lytic growth and cell transformation. PMID- 2760979 TI - Persistent human immunodeficiency virus type 1 infection of monoblastoid cells leads to accumulation of self-integrated viral DNA and to production of defective virions. AB - Cell-free virus preparations from persistently infected monoblastoid cells (HU937) become progressively less infectious during long-term passage. This effect is specific for cell lines derived from U937 and is not observed in persistently infected T-cell lines. Reduced infectivity is correlated with accumulation of unusual, high-molecular-weight, extrachromosomal forms of the human immunodeficiency virus type 1 (HIV-1) DNA. These DNA molecules contain multiple copies of the viral genome, and their structures are highly variable. Of 17 subclones of the HU937 cell line, 15 unique restriction fragment patterns were observed for the HIV-1 viral DNA. Structural analysis of these viral DNA species indicated that they were formed by sequential rounds of long terminal repeat mediated integration of one circular DNA form into preexisting monomeric or multimeric structures. These viral DNA structures are termed nested self integrates. Once formed, self-integrates prove to be stable and can be maintained for several months in culture. The unusual structures of HIV-1 DNA in persistently infected monoblastoid cells attest to an alternative to the accepted retrovirus life cycle. The self-integrated viral DNA species reported here may explain some aspects of the mechanism controlling establishment and maintenance of persistent HIV-1 infection in cells of the monocyte/macrophage lineage. PMID- 2760980 TI - Temporal aspects of DNA and RNA synthesis during human immunodeficiency virus infection: evidence for differential gene expression. AB - The kinetics of retroviral DNA and RNA synthesis are parameters vital to understanding viral growth, especially for human immunodeficiency virus (HIV), which encodes several of its own regulatory genes. We have established a single cycle growth condition for HIV in H9 cells, a human CD4+ lymphocyte line. The full-length viral linear DNA is first detectable by 4 h postinfection. During a one-step growth of HIV, amounts of viral DNA gradually increase until 8 to 12 h postinfection and then decrease. The copy number of unintegrated viral DNA is not extraordinarily high even at its peak. Most strikingly, there is a temporal program of RNA accumulation: the earliest RNA is greatly enriched in the 2 kilobase subgenomic mRNA species, while the level of 9.2-kilobase RNA which is both genomic RNA and mRNA remains low until after 24 h of infection. Virus production begins at about 24 h postinfection. Thus, viral DNA synthesis is as rapid as for other retroviruses, but viral RNA synthesis involves temporal alteration in the species that accumulate, presumably as a consequence of viral regulatory genes. PMID- 2760981 TI - Separation of primary structural components conferring autoregulation, transactivation, and DNA-binding properties to the herpes simplex virus transcriptional regulatory protein ICP4. AB - A truncated ICP4 peptide which contains the amino-terminal 774 amino acids of the 1,298-amino-acid polypeptide is proficient for DNA binding, autoregulation, and transactivation of some viral genes (N. A. DeLuca and P. A. Schaffer, J. Virol. 62:732-743, 1988) and hence exhibits many of the properties characteristic of intact ICP4. To define the primary sequence important for the activities inherent in the amino-terminal half of the ICP4 molecule, insertional and deletion mutagenesis of the sequences encoding these residues were conducted. The DNA binding activity of the molecule as assayed by the association with a consensus binding site was sensitive to insertional mutagenesis in two closely linked regions of the molecule. One region between amino acids 445 and 487 is critical for DNA binding and may contain a helix-turn-helix motif. The second region between amino acids 263 and 338 reduces the binding activity to a consensus binding site. When analyzed in the viral background, the DNA-binding activity of a peptide containing an insertion at amino acid 338 to a consensus binding site was reduced while the association with an alternative sequence was eliminated, suggesting a possible mechanism by which ICP4 may recognize a broader range of sequence elements. Mutations which eliminated DNA binding also eliminated or reduced both transactivation and autoregulation, supporting the requirement for DNA binding for these activities. Peptides that retained the deduced DNA-binding domain but lacked amino acids 143 through 210 retained the ability to associate with the consensus site and autoregulatory activity but were deficient for transactivation, demonstrating that the structural requirements for transactivation are greater than those required for autoregulation. PMID- 2760983 TI - Nucleocapsid mass and capsomer protein stoichiometry in equine herpesvirus 1: scanning transmission electron microscopic study. AB - The Brookhaven scanning transmission electron microscope was employed to measure the masses of two nucleocapsid species (of light and intermediate densities) of equine herpesvirus 1. These were found to be 196.7 +/- 9.2 and 229.0 +/- 9.5 megadaltons (MDa), respectively. Biochemical assays showed that neither nucleocapsid contained any significant amount of DNA (less than 0.2% [wt/wt]). Taking into account data on protein composition, we conclude that the difference between their masses is essentially contributed by viral protein 22 (46 kDa), which is an integral component of the maturable intermediate nucleocapsid but not of the abortive light nucleocapsid. In view of earlier ultrastructural information on capsomer symmetry, our mass determinations are consistent only with the 150 hexavalent capsomers being hexamers of the 148-kDa major capsid protein. PMID- 2760982 TI - DNA binding and gene regulation by the herpes simplex virus type 1 protein ICP4 and involvement of the TATA element. AB - We report the results of fine mapping the sequences responsible for negative regulation of immediate-early (IE) gene 3 by its own gene product, ICP4. Affinity purified ICP4 binds the transcriptional start site of IE gene 3 and protein protein interactions induce a secondary mobility shift that footprints exactly as the primary complex. Since these DNA-protein complexes contain ICP4, it is likely that the two differ only in stoichiometry of protein. Additional data show that the DNA-binding domain recognized by ICP4 can be embedded as a cassette in foreign DNA and that native ICP4 will recognize and bind the resulting DNA. In two different immediate-early promoters, the ICP4 binding site can be located either 3' or 5' of the TATA box; however, the ICP4 site is rotationally displaced from the transcription factor IID (TFIID) site by a roughly one-half helical turn, suggesting that ICP4 and TFIID are on the opposite helical face when bound at their respective sites. In the IE1 and IE3 promoters, binding of ICP4 causes an alteration in the helical geometry of the minor groove of the TATA region as visualized by copper footprinting. In contrast, TATA hypersensitivity was not detected in the glycoprotein D promoter (an early gene promoter containing the ICP4 site separated from TATA by eight helical turns) or in an artificial IE3 promoter construct in which the TATA-A4 separation was increased from 2.5 to roughly 5 helical turns. Such stereospecific and distance-dependent conformational alterations in the TATA box under the influence of ICP4 binding may be important in the repression of immediate-early genes. PMID- 2760984 TI - A single-amino-acid substitution eliminates the stringent carbohydrate requirement for intracellular transport of a viral glycoprotein. AB - In this report, we have investigated the contribution of primary sequence to the carbohydrate requirement for intracellular transport of two closely related glycoproteins, the G proteins of the San Juan and Orsay strains of vesicular stomatitis virus. We used site-directed mutagenesis of the coding sequence to eliminate the two consensus sites for glycosylation in the Orsay G protein. Whereas the nonglycosylated San Juan G protein required at least one of its two asparagine-linked oligosaccharides for transport to the plasma membrane at 37 degrees C, a fraction of the Orsay G protein was transported without carbohydrate. Of the 10 amino acid differences between these two proteins, residue 172 (tyrosine in San Juan, aspartic acid in Orsay) played the major role in determining the stringency for the carbohydrate requirement. The rates at which the glycosylated and nonglycosylated Orsay G proteins were transported to the cell surface were the same, although a smaller fraction of the nonglycosylated protein was transported. These results suggest that the carbohydrate does not promote intracellular transport directly but influences a polypeptide folding or oligomerization step which is critical for transport. PMID- 2760985 TI - Only a minor fraction of plasma membrane-associated large T antigen in simian virus 40-transformed mouse tumor cells (mKSA) is exposed on the cell surface. AB - The bulk of simian virus 40 (SV40) large T antigen in SV40-infected and transformed cells localizes within the cell nucleus, while a minor fraction specifically associates with the plasma membrane (PM) and is exposed on the cell surface. PM-associated large T seems to span the lipid bilayer but, on the other hand, does not display typical features of a transmembrane protein. To further characterize the postulated transmembrane orientation of large T, we asked whether all large T molecules associated with the plasma membrane indeed are exposed on the cell surface. We compared the amount of cell surface-exposed large T, determined on living cells by a sensitive 3H-protein A-binding assay and by external immunoprecipitation, with that of total PM-associated large T extracted from isolated PM. We demonstrate that in mKSA cells (SV40-transformed BALB/c mouse fibroblasts), total PM-associated large T accounted for a substantial portion (ca. 2%) of total cellular large T. However, only 0.1 to 0.2% of it could be detected on the cell surface. Thus, only a minor fraction of PM-associated large T (less than 10%) is exposed on the surface of these cells. Interior PM associated large T is stably associated with the plasma membrane, while the small fraction of surface-exposed large T is rapidly released from the cell surface. PMID- 2760986 TI - Association of a cellular heat shock protein with simian virus 40 large T antigen in transformed cells. AB - The viral oncoprotein of simian virus 40, large T antigen (T-ag), is essential for viral replication and cellular transformation. To understand the mechanisms by which T-ag mediates its multifunctional properties, it is important to identify the cellular targets with which it interacts. A cellular protein of 73 kilodaltons (p73) which specifically associates with T-ag in simian virus 40 transformed BALB/c 3T3E cells has been identified. The binding of p73 to T-ag was demonstrated by coimmunoprecipitation analyses using polyclonal and monoclonal antibodies specific for T-ag. The interaction of p73 with T-ag was independent of T-ag complex formation with the cellular protein p53. Partial V8 protease cleavage maps for p73 and the cellular heat shock protein hsp70 were identical. Immunoblot analyses indicated that p73 complexed to T-ag was antigenically related to hsp70. T-ag deletion mutants were constructed that remove internal, amino-terminal, and carboxy-terminal sequences. These mutants mapped the p73 binding domain to the amino terminus of T-ag. The specific dissociation of p73 from the p73/T-ag complex was mediated by ATP; GTP, CTP, and UTP were also utilized as substrates. These characteristics suggest that p73 may be a member of the hsp70 family of heat shock proteins. The biologic significance of p73/T-ag complex formation has yet to be determined. PMID- 2760987 TI - Hepatitis B virus transcript produced by RNA splicing. AB - A new hepatitis B virus (HBV) transcript of about 2.2 kilobases was identified in HBV DNA-transfected human hepatoma cells. The 5' terminus of this viral RNA appears to map at one or more of the precore initiation sites, contains a deletion of 1,223 bases corresponding to the last codon of the core gene to the middle of the surface antigen gene, and terminates at the 3' polyadenylation site used by the other known HBV RNAs. The junction region of the deleted sequences showed the conserved splice donor and acceptor GT-AG sequences. Moreover, when a mutant HBV DNA in which the splice acceptor site was changed from AG to CG was transfected into human hepatoma cells, no 2.2-kilobase RNA was detected, further suggesting that this RNA represents a spliced transcript. The core gene, although an amino acid shorter, still encoded a functional viral core protein in complementation experiments. Sequence analysis of the cDNA of the 2.2-kilobase RNA suggests that this transcript can potentially encode a new protein that comprises the reverse transcriptase domain of HBV. However, genetic analysis using a transient DNA transfection system suggests that the gene product(s) of this transcript is not essential for viral replication. The function of this transcript remains to be studied. PMID- 2760988 TI - Developmental regulation of hepatitis B surface antigen expression in two lines of hepatitis B virus transgenic mice. AB - Two lines of hepatitis B virus (HBV) transgenic mice, designated G7 and G26, show preferential expression of the 2.1-kilobase hepatitis B surface antigen (HBsAg) RNA transcript in liver and kidney tissues (R. D. Burk, J. A. DeLoia, M. K. ElAwady, and J. D. Gearhart, J. Virol 62:649-654, 1988). This transcript was first identified in transgenic mice at gestational day 14 and was detected at similar or increased levels through birth and early development. However, in contrast to 2.1-kilobase HBsAg mRNA levels, HBsAg protein levels in serum decreased shortly after birth. Thereafter, serum HBsAg increased 100-fold to adult levels, with a corresponding 5- to 10-fold increase in HBsAg mRNA levels. In addition, adult males have higher levels of HBsAg in serum than females. HBsAg in serum in males was reduced approximately 50% by surgical castration and was restored to near-normal levels by testosterone supplementation. Since both transgenic lines show similar patterns of gene expression, we suggest that HBsAg gene expression is determined by viral regulatory elements in response to host factors. Whether tissue specificity, developmental regulation, and sexual dimorphism of expression of the exogenous HBV sequences were determined by single or multiple HBV regulatory elements remains to be determined. PMID- 2760989 TI - Identification of a sequence required for efficient packaging of human immunodeficiency virus type 1 RNA into virions. AB - Sequences required for efficient packaging of human immunodeficiency virus type 1 (HIV-1) genome RNA into virus particles were identified. Deletion of 19 base pairs between the 5' long terminal repeat and the gag gene initiation codon of HIV-1 resulted in a virus markedly attenuated for replication in human T lymphocytes. The mutant virus was characterized by nearly wild-type ability to encode viral proteins and to produce virion particles. The mutant virions exhibited a significant reduction in the content of HIV-1-specific RNA. These results identify an important component of the HIV-1 packaging signal. PMID- 2760990 TI - Phenotypic hiding: the carryover of mutations in RNA viruses as shown by detection of mar mutants in influenza virus. AB - When influenza virus monoclonal antibody-resistant (mar) mutants are selected by incubation in vitro with excess antibody, 90 to 99% of the mutants are not detectable. This observation may be explained by encapsidation of mar mutant RNAs within phenotypically wild-type envelopes. This phenotypic hiding can be revealed by selection of mar mutants in vivo after virus uncoating. Using experimental procedures appropriate to detect all viable mar mutants in a virus population, we determined precisely the mutation rates to the mar genotype by the fluctuation test for two nonoverlapping monoclonal antibodies. PMID- 2760991 TI - Effects of long terminal repeat mutations on human immunodeficiency virus type 1 replication. AB - The effects of deletions within three functional regions of the long terminal repeat of human immunodeficiency virus type 1 upon the ability of the long terminal repeat to direct production of the chloramphenicol acetyltransferase gene product and upon the ability of viruses that carry the mutations to replicate in human cell lines was investigated. The results show that the enhancer and TATAA sequences were required for efficient virus replication. Deletion of the negative regulatory element (NRE) yielded a virus that replicated more rapidly than did an otherwise isogeneic NRE-positive virus. The suppressive effect of the NRE did not depend upon the negative regulatory gene (nef), as both NRE-positive and NRE-negative viruses were defective for nef. We conclude that factors specified by the cell interact with the NRE sequences to retard human immunodeficiency virus type 1 replication. PMID- 2760992 TI - Experience in diagnosis and treatment of impotence caused by cavernosal leak syndrome. AB - To delineate neural, arterial, and venous components contributing to impotence, we used a previously described noninvasive screening sequence combined with stimulation of artificial erection with papaverine injection, selective pudendal arteriography (SPA), and dynamic cavernosography (DC). Among 572 men with impotence, age range 17 to 78 years (average age 54.8 years), 26 men with potential cavernosal leaks in absence of other factors were identified; 16 underwent DC; among these five had normal cavernous venous drainage. Eight men with abnormal cavernosal venous drainage required cavernous infusion flow rates higher than 120 ml/min to obtain erection and higher than 40 ml/min to maintain erection. Radiographic studies showed cavernosal leakage in all eight patients. Eight men, ages 39 to 61 years, underwent surgical ablation of abnormal cavernosal venous drainage. Among these, five men have had excellent results for up to 3 years. One failure was related to unrecognized penile arterial disease later shown by SPA. In two men small doses of papaverine now induce erection. We now recommend SPA before DC to rule out an arterial abnormality. Accurate identification of factors contributing to erectile failure is critical for successful treatment; in this experience candidates for correction of cavernosal leak syndrome were uncommon. PMID- 2760993 TI - Efficacy of corticosteroids in suppression of intimal hyperplasia. AB - The effect of steroids and immunosuppression on the development of intimal hyperplasia was studied in 24 New Zealand white rabbits. Staged bilateral arteriotomy and stripping of intima of the common carotid artery was performed by means of a 2F balloon catheter under 700 mm Hg of pressure. At 3 months, after the control side artery was harvested (N = 24), the rabbits were assigned to three groups of eight animals each: (1) dexamethasone 0.1 mg/kg, (2) cyclophosphamide (Cytoxan) 1 mg/kg, or (3) azathioprine 1 mg/kg intramuscularly. The animals were treated on the day before the contralateral intimal stripping and then were treated six times a week for 8 weeks; the vessels were harvested at 3 months. Twelve-week patency rates were 62.5% in the control group, 83.3% in the dexamethasone group, 100% in the Cytoxan group, and only 33.3% in the azathioprine group. The ratio of the luminal area to the area enclosed by the internal elastic lamina was used as an index of intimal hyperplasia, with a higher ratio indicating less intimal thickening. This ratio of the patient vessels was 0.74 +/- 0.14 (N = 15) for the controls, 0.79 +/- 0.11 (N = 6) for the Cytoxan group, and 0.91 +/- 0.06 (N = 5, p less than 0.05) for the dexamethasone group, which is statistically significant by means of analysis of variance. Occluded vessels had evidence of organized thrombus without any intimal hyperplasia. The decrease in intimal hyperplasia seen in the steroid group suggests a potential role for steroids in small vessel revascularization, but further studies are required. PMID- 2760994 TI - Recognition and management of Budd-Chiari syndrome: report of one hundred cases. AB - Budd-Chiari syndrome is an unusual form of portal hypertension caused by occlusion of the hepatic venous outflow, and it is often confused with portal hypertension caused by liver cirrhosis. Its prognosis is poor, and optimal therapy remains to be established. This is a report of 100 confirmed cases of this syndrome treated from December 1982 to March 1988 at two vascular centers in China. Sixty-two male and 38 female patients, 15 to 62 years of age (mean age, 32.6 years) were treated. Seventy-six patients had intractable ascites, 56 had esophageal varices, and 22 had upper gastrointestinal bleeding. There were 37 cases of membranous obstruction, 57 cases of occlusion of the inferior vena cava above the confluence of the hepatic veins, and 6 cases of occlusion of the hepatic veins. Eighty-one patients were operated on. Operative mortality rate was 8.6% (7/81). Follow-up from 2 to 66 months revealed that 58 of the patients operated on (72%) had good results, whereas 11 of 19 (58%) patients treated nonoperatively died within 2 months after admission. On the basis of these data we conclude that the operative procedure must be tailored to the cause and underlying pathologic characteristics. Mesoatrial shunting is the operation of choice for patients with occlusion of the retrohepatic inferior vena cava and hepatic veins, and inferior vena cava--atrial shunting is the operation of choice for patients with occlusion of the inferior vena cava and patency of the hepatic veins. Membranotomy is used for patients with inferior vena cava webbing, and mesocaval shunting is used for patients with intrahepatic venous occlusion only.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2760995 TI - Risk factors in a community experience with carotid endarterectomy. AB - Experience with 1035 carotid endarterectomies in a single community over a 2-year period was analyzed. Twenty-two surgeons working in six hospitals were involved. All surgeons had full-time or part-time appointments at the University of Rochester, 18 had special interest in vascular surgery, and eight had obtained a certificate of qualification in vascular surgery. Mortality rate was 1.4% (14 deaths), with additional permanent, nonfatal, neurologic morbidity of 3.4%. Mortality and morbidity were independent of surgeon, caseload, or hospital. Age and prior history of myocardial infarction influenced the incidence of postoperative myocardial infarction but not the incidence of death or neurologic morbidity. Factors that increased the risk of postoperative death or neurologic complication included hypertension; contralateral carotid disease as manifested by stroke, endarterectomy, or occlusion; whether the patient was a woman; and symptoms of crescendo ischemia. Lack of preoperative neurologic symptoms was correlated with decreased risk of myocardial infarction and neurologic complications. Overall mortality and neurologic morbidity associated with operation for "asymptomatic stenosis" was 3.1% (seven of 222 cases). However, the incidence of contralateral carotid disease was high in the patients in the asymptomatic group (60%), and all complications in this group occurred in patients with prior contralateral carotid endarterectomy or occlusion (p less than 0.05). PMID- 2760996 TI - Chronic pseudoaneurysm of the popliteal artery after blunt trauma. AB - Blunt trauma to the popliteal artery usually results in acute arterial damage that requires urgent repair. Most blunt trauma to the popliteal artery is associated with skeletal injuries. We report a patient who had a chronic pseudoaneurysm of the popliteal artery 10 years after minor blunt trauma to the popliteal fossa. The cause of the pseudoaneurysm and suggestions for the early recognition of these arterial injuries are discussed. PMID- 2760997 TI - Disruption of the proximal anastomosis of axillobifemoral grafts: two case reports. AB - The use of axillobifemoral grafting in the treatment of infected aortic prostheses or in the treatment of patients at high risk for aortoiliac occlusive disease has become a widely accepted treatment modality. Few complications involving the proximal anastomosis have been reported. The present report describes two patients who suffered proximal anastomotic dehiscence several weeks after surgery when they fully extended and raised the affected arm. PMID- 2760999 TI - Exposed synthetic vascular grafts of the groin: graft preservation by means of a tensor fasciae latae flap. PMID- 2760998 TI - Traumatic iliofemoral arterial injury: an association with high anterior acetabular fractures. AB - Two patients with documented anteroposterior compression injuries to the pelvis sustained concomitant injury to the iliofemoral artery and fracture of the acetabulum involving the high anterior column (the portion of the ilium forming the anterior component of the acetabulum). In a series of 800 major pelvic fractures similar arterial injuries have not occurred in association with other documented mechanisms. A high index of suspicion for iliofemoral artery injuries should be held by the clinician treating patients with acetabular fractures of the high anterior column sustained from anteroposterior compressive forces. PMID- 2761000 TI - Intraoperative digital real-time fluoroscopic arteriography for distal infrapopliteal arterial reconstruction. PMID- 2761001 TI - Endovascular surgery: the new challenge. PMID- 2761002 TI - In the words of a vascular surgeon. PMID- 2761003 TI - Is the preferential use of polytetrafluoroethylene grafts for femoropopliteal bypass justified? PMID- 2761004 TI - Responsibilities of vascular surgeons to study and control the field of endovascular surgery. PMID- 2761005 TI - Mortality of harbor seal pups at different sites in the inland waters of Washington. AB - We examined the mortality rates and causes of death of harbor seal (Phoca vitulina) pups in three regions of the inland waters of Washington (USA) in 1984. One hundred eight pups were collected during 239 searches of the shoreline areas near harbor seal haulout sites or through public reports. Minimum neonatal (up to 1 mo after birth) mortality rates at these regions ranged from 12% to 26% of the pups born. Neonatal mortality was highest in the Strait of Juan de Fuca; 33 of the estimated 105 (31%) pups born at the primary site died. Causes of death varied by location. In southern Puget Sound predation by coyotes (Canis latrans) was the primary cause of death, accounting for eight of 43 (19%) of the dead pups examined; starvation was the next most common cause of death. Mortality at study sites in the Strait of Juan de Fuca was related to premature parturition; 19 of 49 (39%) of the pups found dead were born prematurely. Nine species of bacteria were identified in samples taken from 42 pups; Proteus sp. and Escherichia coli were the most common. PMID- 2761006 TI - Reversal by tolazoline hydrochloride of xylazine hydrochloride-ketamine hydrochloride immobilizations in free-ranging desert mule deer. AB - We captured 10 free-ranging desert mule deer (Odocoileus hemionus crooki) (five males and five females) by net-gun from a helicopter and immobilized them with xylazine hydrochloride (HCl) (100 mg) and ketamine HCl (300 to 400 mg) injected intramuscularly. Arousal and ambulation times were 13.9 +/- 4.2 and 14.3 +/- 4.2 min in eight deer injected intravenously with tolazoline HCl (3.0 mg/kg). We observed a curvilinear relationship (R = 0.50, P less than 0.01) between rectal temperature and time after induction of anesthesia. Mean peak temperature (41.4 C) occurred at 23.7 +/- 3.2 min postinduction and was greater (P less than 0.01) than the mean temperature measured initially (40.8 C). Heart and respiratory rates (108 beats/min and 75 breaths/min) were elevated prior to immobilization. Mean heart rate increased (P less than 0.05) from 90 +/- 9 beats/min in anesthetized deer to 120 +/- 13 beats/min after tolazoline HCl injection. A 20% capture-related mortality rate suggests this combination of physical and chemical capture has serious limitations. Captive deer permitted to recover from xylazine HCl-ketamine HCl immobilization without a reversal agent were able to walk in 290 +/- 79 min. PMID- 2761008 TI - Brain cholinesterase activity of nestling great egrets, snowy egrets and black crowned night-herons. AB - inhibition of brain cholinesterase (ChE) activity in birds is often used to diagnose exposure or death from organophosphorus or carbamate pesticides. Brain ChE activity in the young of altricial species increases with age; however, this relationship has only been demonstrated in the European starling (Sturnus vulgaris). Brain ChE activity of nestling great egrets (Casmerodius albus) collected from a colony in Texas (USA) increased significantly with age and did not differ among individuals from different nests. Brain ChE activity of nestling snowy egrets (Egretta thula) and black-crowned night-herons (Nycticorax nycticorax) collected in one colony each from Rhode Island, Texas and California (USA) also increased significantly with age and did not differ among individuals from different nests or colonies. This study further demonstrates that age must be considered when evaluating exposure of nestling altricial birds to ChE inhibitors. PMID- 2761007 TI - Use of Telazol to immobilize female northern sea lions (Eumetopias jubatus) in Alaska. AB - Twenty-nine female northern sea lions (Eumetopias jubatus) were immobilized using Telazol in dosages ranging from 1.8 to 8.1 mg/kg. Best results were achieved with Telazol dosages ranging between 1.8 and 2.5 mg/kg which resulted in smooth induction and recovery. Optimal injection location was in the muscle mass of the lower back and hip. Dosages greater than 3.5 mg/kg resulted in a tendency toward hypothermia. Six mortalities occurred which were partially caused by the location of drug injection and perhaps the high dosage. PMID- 2761009 TI - Plasma and erythrocyte cholinesterase values for the common long-nosed armadillo, Dasypus novemcinctus. AB - Plasma and erythrocyte cholinesterase activities were determined for 40 free living and 12 captive common long-nosed armadillos (Dasypus novemcinctus) in order to establish normal values for monitoring pesticide exposure. Plasma cholinesterase activity ranged from 105 to 549 U/liter with no sexual or seasonal differences. Plasma values from captive animals were significantly lower than those from wild armadillos. Erythrocyte cholinesterase activity ranged from 2,915 to 15,126 U/liter with no differences detected between captive and wild animals or between sexes. However, erythrocyte cholinesterase values varied seasonally. Erythrocyte and plasma cholinesterase activities were not significantly correlated. Packed cell volume ranged from 24 to 51% and did not vary significantly between captive and wild samples, between sexes or among seasons. However, both whole blood and erythrocyte cholinesterase activities showed significant negative correlations with packed cell volume. Controlled experiments are needed to find the factors responsible for the statistically significant difference between plasma cholinesterase activities of captive and wild armadillos. The seasonal variation in erythrocyte cholinesterase activity and the negative correlation between erythrocyte cholinesterase activity and packed cell volume can be explained by an hypothesis that relates the variation in erythrocyte cholinesterase activity to variation in erythrocyte turnover rate. Future work should involve experiments to test this hypothesis. PMID- 2761010 TI - Fusobacterium necrophorum and Actinomyces pyogenes associated facial and mandibular abscesses in blue duiker. AB - Anaerobic and aerobic cultures of facial and mandibular abscesses were made from 12 blue duiker (Cephalophus monticola fusicolor) housed at the Deer and Duiker Research Facility of the Pennsylvania State University (USA). Increases in concentrations of total protein and serum globulin occurred in all cases. Actinomyces pyogenes was isolated from nine animals. Fusobacterium necrophorum was present in eight and Bacteroides sp. was found in seven animals; other genera of isolated bacteria included: Streptococcus (from two animals), Lactobacillus (one), Staphylococcus (one) and Actinomyces (two). Eight (67%) of affected animals were less than or equal to 2 yr of age. Facial soft tissues and mandibles were the tissues most often affected. Tissues within the oral cavity were not affected at the time of presentation. A common finding, not reported in other host species with necrobacillosis, was the presence of nondestructive mandibular proliferation. PMID- 2761011 TI - Efficacy of triclabendazole against fascioloidiasis (Fascioloides magna) in naturally infected white-tailed deer (Odocoileus virginianus). AB - The efficacy of triclabendazole was evaluated in the treatment of naturally acquired Fascioloides magna infections in white-tailed deer (Odocoileus virginianus). Twenty white-tailed deer were captured on the Welder Wildlife Refuge (Sinton, San Patricio County, Texas, USA) and maintained in a 64 x 64 m deer enclosure. Ten deer were given a 5% suspension of triclabendazole orally at a dosage of 10 mg/kg body weight and 10 deer were given a placebo. Three wk later the deer were euthanized and examined for parasites. At necropsy 19 deer were infected. All specimens of F. magna from the tissues of the triclabendazole treated deer were dead or severely affected by the drug as indicated by changes in their size, color, movement and texture relative to those from control deer. The drug was considered 100% effective against this parasite. Adverse reactions of the deer to the drug were not observed. PMID- 2761012 TI - Leukoencephalomalacia in a white-tailed deer from North Carolina. AB - Leukoencephalomalacia similar to equine leukoencephalomalacia occurred in a white tailed deer (Odocoileus virginianus) from North Carolina. The deer was recumbent and stuporous when presented for examination. It was believed that the disease resulted from ingestion of moldy field corn, infected with Fusarium moniliforme. PMID- 2761013 TI - A survey for Yersinia pseudotuberculosis in migratory birds in coastal Japan. AB - Yersinia pseudotuberculosis was isolated from three specimens of two species of birds, the black-faced bunting (Emberiza spodocephala) and pied wagtail (Motacilla alba), of 528 specimens of birds examined from coastal regions in Japan. The two isolated strains of Y. pseudotuberculosis were identified as serovar 4b and serovar 3. This is the first isolation of Y. pseudotuberculosis from birds in Japan. Yersinia enterocolitica was isolated from three specimens of the pied wagtail, one specimen of the reed bunting (Emberiza schoeniclus) and one specimen of the rustic bunting (Emberiza rustica). Yersinia frederiksenii was isolated from two specimens of the gray-rumped sandpiper (Heteroscelus brevipes). Yersinia intermedia was isolated from one specimen of the pied wagtail. PMID- 2761014 TI - Parasitic infection of the seahorse (Hippocampus erectus)--a case report. AB - This report details the development of a microsporidan infection in a colony of seahorses (Hippocampus erectus) caused by Glugea heraldi. Of 76 animals imported from Florida Bay (USA), two survived. A myxosporidan (Sphaeromyxa sp.) and an unidentified nematode infection were also diagnosed in the same colony, but these infections were not considered important, causative factors in the mortalities. PMID- 2761015 TI - Prevalence of larval Anisakis simplex in pen-reared and wild-caught salmon (Salmonidae) from Puget Sound, Washington. AB - The abundance of parasites of public health significance in pen-reared salmon and wild-caught salmon was compared. Two hundred eighty-seven salmon from Puget Sound, Washington, were examined for third-stage larvae of Anisakis simplex. Of these fish, 237 Atlantic salmon (Salmo salar), coho salmon (Oncorhynchus kisutch) and chinook salmon (O. tshawytscha) were reared in commercial salmon pens and 50 sockeye salmon (O. nerka) were caught during their spawning migration. All wild caught salmon were found to be infected with larval A. simplex; conversely, all pen-reared fishes lacked such infections. Edible musculature of wild salmon were infected with 581 (87%) nematode larvae. Of other salmon parasites known to infect humans, one Diphyllobothrium sp. plerocercoid was collected from each of three of the 50 wild-caught salmon. The study showed that farmed salmon may increase the margin of safety for consumers of raw seafood. PMID- 2761016 TI - Parasitic enteritis in superb lyrebirds (Menura novaehollandiae). AB - Ten free-living superb lyrebirds (Menura novaehollandiae) from forest habitat in southern Victoria, Australia were examined at necropsy over a 10 yr period. The acanthocephalan Plagiorhynchus menurae was identified in two lyrebirds from forest habitat in southern Victoria, Australia. There was necrotic enteritis in the duodenum associated with the acanthocephalans, with secondary bacterial involvement. The lesions probably resulted in the observed emaciation and debilitation of the birds. Probably the forest-floor habitat and insect diet of lyrebirds exposes them to these infections. PMID- 2761017 TI - Helminths of California quail (Callipepla californica) and mountain quail (Oreortyx pictus) in western Oregon. AB - Eighty California quail (Callipepla californica), collected from the E. E. Wilson Wildlife Area near Monmouth, Oregon (USA) during a 22 mo period, were examined for gastrointestinal helminths. Eight birds were infected with three species of nematodes, Heterakis isolonche, Dispharynx nasuta, and Capillaria sp., and two species of cestodes, Rhabdometra odiosa and Davainea sp. Except for D. nasuta, prevalence did not exceed 5% despite mesic conditions in the collection area. Two mountain quail (Oreortyx pictus) were collected from Lane County, Oregon (USA), near Blue River Reservoir; both were infected with the nematode Trichostrongylus tenuis. PMID- 2761018 TI - Physaloptera retusa (Nematoda, Physalopteridae) in naturally infected sagebrush lizards, Sceloporus graciosus (Iguanidae). AB - Of 292 adult sagebrush lizards (Sceloporus graciosus) examined for the stomach nematode, Physaloptera retusa, 81 (28%) were infected. Attached nematodes caused erosive inflammatory foci in the stomach mucosa. Early lesions were U-shaped. Degenerating gastric glands occurred in the adjacent mucosa. Healed lesions were fibrous connective tissue scars; regenerating gastric glands occurred at the periphery. There were no externally visible signs of infection. PMID- 2761019 TI - Knemidokoptes mutans (Acari: Knemidocoptidae) in a great-horned owl (Bubo virginianus). AB - A routine examination of a captive juvenile great-horned owl (Bubo virginianus) revealed bilateral proliferative papillary hyperkeratosis on the feet. Microscopic examination of skin scrapings produced numerous mites identified as Knemidokoptes mutans. This is the first record of this parasite in a great-horned owl. A single dose of ivermectin (200 micrograms/kg) was effective in treatment of this infection. PMID- 2761020 TI - Locations of moose in northwestern Canada with hair loss probably caused by the winter tick, Dermacentor albipictus (Acari: Ixodidae). AB - Five hundred two trappers representing 389 registered traplines in northern Alberta, northern British Columbia, Northwest Territories and Yukon Territory (Canada) responded to a questionnaire on the occurrence of hair loss and the winter tick (Dermacentor albipictus) on moose (Alces alces). Results suggested that winter ticks may occur as far as 62 degrees N. Several sightings of moose with presumed tick-induced hair loss near Kluane Lake, Yukon Territory, suggest the possibility of introduction of this serious pest into the moose population in Alaska. PMID- 2761021 TI - Rectal temperatures of immobilized, snare-trapped black bears in Great Dismal Swamp. AB - Rectal temperature was determined for 84 black bears (Ursus americanus) during 99 handlings in Great Dismal Swamp, Virginia and North Carolina (USA). All bears had been trapped with cable snares and immobilized with a 2:1 ketamine hydrochloridexylazine hydrochloride mixture. Temperatures were significantly greater in males and varied significantly by season. Immobilized bears began panting at rectal temperatures greater than 42.0 C. One death occurred at 43.0 C. We recommended cooling measures on black bears at rectal temperatures of greater than or equal to 40.0 C. PMID- 2761022 TI - Carfentanil and overwinter survival in bison: the alternative hypothesis. PMID- 2761023 TI - Magazines to leaf through while waiting ought not to contain any (tobacco) leaves. PMID- 2761024 TI - Periodicals without tobacco advertising. PMID- 2761025 TI - From the Centers for Disease Control. Chronic obstructive pulmonary disease mortality--United States, 1986. PMID- 2761026 TI - From the Centers for Disease Control. State-specific smoking-attributable chronic obstructive pulmonary disease mortality--United States, 1986. PMID- 2761027 TI - Child molestation and pedophilia. PMID- 2761028 TI - Think 'trismus-pseudocamptodactyly,' say 'Dutch-Kentucky.' But 'Dutch-Kennedy'? PMID- 2761029 TI - Nasotracheal intubation in the presence of facial fractures. PMID- 2761030 TI - Downhill skiing: impressive to the impressionable. PMID- 2761031 TI - Precautions for intranasal corticosteroid injection. PMID- 2761032 TI - Modeling the spread of HIV. PMID- 2761033 TI - Intravenous drug users and human immunodeficiency virus testing and counseling. PMID- 2761034 TI - The role of physician-owned insurance companies in the detection and deterrence of negligence. AB - This study presents evidence that physician-owned insurance companies and their physician members play an important role in the detection and deterrence of negligent behavior. A survey of physician-owned companies indicates that 94% involve their physicians in one or more aspects of the underwriting process. About 60% involve their members in assessing the competence of physicians who have been sued and in advising the underwriters on decisions concerning both continued insurability and the conditions of insurance. During 1985, a total of 0.66% of the physicians in physician-owned companies had their insurance terminated or were forced to give up their coverage because of negligence-prone behavior. An additional 0.7% of active policyholders were subject to restrictions on practice or other medical sanctions and 1.8% to surcharges and deductibles. Thus, disciplinary actions were in place against 3.2% of insured physicians whose performance was viewed as in some way substandard. The findings indicate that the physician-owned companies are effective agents in identifying negligence-prone behavior, and suggest that these companies also play an important role in deterring substandard performance. PMID- 2761035 TI - End-tidal carbon dioxide monitoring during cardiopulmonary resuscitation. A prognostic indicator for survival. AB - The effectiveness of ongoing cardiopulmonary resuscitation efforts is difficult to evaluate. Recent studies suggest that carbon dioxide excretion may be a useful noninvasive indicator of resuscitation from cardiac arrest. A prospective clinical study was done to determine whether end-tidal carbon dioxide monitoring during cardiopulmonary resuscitation could be used as a prognostic indicator of resuscitation and survival. Thirty-five cardiac arrests in 34 patients were monitored with capnometry during cardiopulmonary resuscitation during a 1-year period. Nine patients who were successfully resuscitated had higher average end tidal carbon dioxide partial pressures during cardiopulmonary resuscitation than 26 patients who could not be resuscitated (15 +/- 4 vs 7 +/- 5 mm Hg). The 3 patients who survived to leave the hospital had a higher average end-tidal carbon dioxide partial pressure than the 32 nonsurvivors (17 +/- 6 vs 8 +/- 5 mm Hg). All 9 patients who were successfully resuscitated had an average end-tidal carbon dioxide partial pressure of 10 mm Hg or greater. No patient with an average end tidal carbon dioxide partial pressure of less than 10 mm Hg was resuscitated. Data from this prospective clinical trial indicate that findings from end-tidal carbon dioxide monitoring during cardiopulmonary resuscitation are correlated with resuscitation from and survival of cardiac arrest. PMID- 2761036 TI - Health and mental health problems of homeless men and women in Baltimore. AB - A study of homeless people in Baltimore, Md, focused on their health and other characteristics, with special emphasis on their needs for services. In the first stage, 298 men and 230 women were randomly selected from the missions, shelters, and jail in Baltimore to respond to a baseline interview that provided extensive sociodemographic and health-related data. In the second stage, a subsample of 203 subjects was randomly selected from the baseline survey respondents to have systematic psychiatric and physical examinations. Data are presented from both stages. Data from the first stage demonstrate, among other things, the high levels of disaffiliation of this population and their heavy involvement in substance abuse. Data from the clinical examinations demonstrate the high prevalence of mental illnesses and other psychiatric disorders and of a wide range of physical disorders and confirm the high prevalence of alcohol abuse disorders. The high rates of comorbidity of these conditions is demonstrated and data are provided on the subjects' needs for mental health and substance abuse services. PMID- 2761037 TI - Radiology/case of the month. Posterior mediastinal mass in a black patient with back pain. PMID- 2761039 TI - Physicians looking at themselves. PMID- 2761038 TI - Are we comfortable with homelessness? PMID- 2761040 TI - Introducing the 'Resident Forum'. PMID- 2761041 TI - A piece of my mind. Family medicine. PMID- 2761042 TI - Confronting the rarest AIDS infection, a young man makes a cry from the heart. PMID- 2761043 TI - Medical education in the United States, 1988-1989. PMID- 2761044 TI - Undergraduate medical education. AB - The number of applicants to US medical schools continued to decline, while the number of accepted applicants increased slightly. From 1987-1988 to 1988-1989 academic years, the number of first-year medical students (including repeaters) who were white non-Hispanic males decreased 2.5%, the number of black non Hispanic males decreased 6.3%, and the number of Asians or Pacific Islander males increased 10.3%. During the same period, the number of first-year students who were white non-Hispanic females decreased 0.8%, the number of black non-Hispanic females decreased 4.8%, and the number of Asians or Pacific Islander females increased 13.7%. Women constituted one third of the entering class in the 1988 1989 academic year. During the past 5 years, the ratio of full-time medical school faculty to medical students increased from 0.88 to 1.08. About 4.8% of budgeted full-time faculty positions were unfilled, down from 5% in the 1987-1988 academic year. However, in the 1988-1989 academic year, more than 5% of positions were unfilled in microbiology, anesthesiology, dermatology, family medicine, neurology, obstetrics-gynecology, ophthalmology, orthopedics, pediatrics, and surgery. Many schools are showing signs of adopting new curricular approaches. A majority of medical schools have implemented many recommendations of the GPEP Report, at least at some level. Problem-based learning is present in the curriculum of 82% of schools, mainly as an experience in one or a few courses. In about two-thirds of schools, computer-based instruction is a formal part of one or more courses or laboratories. Thus, the medical schools appear to be addressing the challenges presented by the changing environment of medical education. PMID- 2761045 TI - US medical school finances. PMID- 2761046 TI - Graduate medical education in the United States. AB - The annual surveys of residency programs on which this report is based have had a higher than 90% response rate for the past 5 years. The count of available residency positions is a fluid entity and seems to be dependent on many factors, including funding and the number of qualified candidates seen by program directors. The number of GY-1 positions has not changed significantly during the past 3 years. The number of reported unfilled positions, including GY-1 unfilled positions, has increased each year since 1985. The total number of residents on duty decreased slightly in 1988. This decrease may be due to a lower response rate. The number of new entry residents (GY-1) has been decreasing since 1985. Thirty-nine percent of residents were training in family practice, internal medicine, or pediatrics. The number and percent of women in residency programs have remained steady. The percentage of FMG residents decreased slightly to 15.3% in 1988. The number of black non-Hispanic residents decreased in 1988, and the percentage of all residents who are black decreased slightly. The number of graduates of osteopathic medical schools in ACGME programs has increased 39% since 1986. The number of institutions involved in graduate medical education has not changed significantly during the past 3 years, although the number of institutions that are not hospitals has increased since 1983. Ninety-five percent of all types of institutions have some type of affiliation with a US medical school. PMID- 2761047 TI - Allied health education and accreditation. PMID- 2761048 TI - New evidence may expand indications for chemotherapy in breast cancer. PMID- 2761050 TI - Breast cancer screening guidelines agreed on by AMA, other medically related organizations. PMID- 2761049 TI - Not everyone agrees with new mammographic screening guidelines designed to end confusion. PMID- 2761051 TI - From the Centers for Disease Control. Weight-loss regimens among overweight adults--Behavioral Risk Factor Surveillance System, 1987. PMID- 2761052 TI - From the Centers for Disease Control. Chronic disease reports: deaths from lung cancer--United States, 1986. PMID- 2761053 TI - Drug testing of athletes: test the team's pooled urine. PMID- 2761054 TI - Transplantation of abdominal viscera. PMID- 2761055 TI - Physician need. PMID- 2761056 TI - Autopsy and diagnosing SIDS. PMID- 2761057 TI - Smoking wastes a good Parisienne. PMID- 2761058 TI - China and population control. PMID- 2761059 TI - Gastric restrictive surgery. PMID- 2761060 TI - Depression as a risk for cancer morbidity and mortality in a nationally representative sample. AB - The relative risks for cancer morbidity and mortality associated with depressive symptoms were examined using data from the National Health and Nutrition Examination Survey I Epidemiologic Follow-up Study. The Center for Epidemiologic Studies Depression scale and the depression subscale from the General Well-being Schedule were used as predictors in this 10-year follow-up study of a nationally representative sample. No significant risk for cancer morbidity or mortality was associated with depressive symptoms with or without adjustment for age, sex, marital status, smoking, family history of cancer, hypertension, and serum cholesterol level. These data were also reanalyzed for subjects aged 55 years or older who were retraced by a second follow-up. Neither measure of depressive symptoms was a significant risk for cancer death during the 15-year follow-up interval. These results call into question the causal connection between depressive symptoms and cancer morbidity and mortality. PMID- 2761061 TI - Intravenous magnesium sulfate for the treatment of acute asthma in the emergency department. AB - Conventional nebulized beta-agonist therapy has met with disappointing results in an increasing number of moderate to severe asthmatics who may be characterized as "poor responders." Thirty-eight patients suffering from acute exacerbations of moderate to severe asthma were treated in an emergency department with an intravenous infusion of saline placebo or 1.2 g of magnesium sulfate after conventional beta-agonist therapy failed to produce significant improvement in peak expiratory flow rate. Nineteen patients were randomized into each of two groups in a placebo-controlled, double-blind clinical trial. The treatment group demonstrated an increase in peak expiratory flow rate from 225 to 297 L/min as compared with 208 to 216 L/min seen in the placebo group. In addition, the number admitted vs discharged was significantly better for the treatment group (7 vs 12) than the placebo group (15 vs 4). Intravenous magnesium sulfate may represent a beneficial adjunct therapy in patients with moderate to severe asthma who show little improvement with beta-agonists. PMID- 2761062 TI - Humanism and the art of medicine. Our commitment to care. PMID- 2761063 TI - Depressive symptoms and risk of cancer. PMID- 2761064 TI - A piece of my mind. So long, coffee shop. PMID- 2761065 TI - Diagnostic and therapeutic technology assessment. Traveler's diarrhea. PMID- 2761066 TI - Intravenous fat emulsion (intralipid) delays gastric emptying, but does not cause gastroesophageal reflux in healthy volunteers. AB - The impact of overnight intravenous lipid emulsion (ILE) infusion on upper gastrointestinal tract physiology was assessed in 10 healthy volunteers. No changes in lower esophageal sphincter pressure (before infusion: 28 +/- 4 mm Hg; after infusion 20.5 +/- 3; p:NS), plasma concentrations of gastrointestinal hormones (gastrin: preprandial before/after lipids: 14 +/- 2.1/13 +/- 1.4 pM; postprandial before/after lipids: 28 +/- 2.7/30 +/- 3.4 pM, CCK: preprandial before/after lipids: 69 +/- 10/64 +/- 10 pM; postprandial before/after lipids: 96 +/- 11/95 +/- 12 pM; neurotensin: levels less than 6 pM in all samples; somatostatin levels undetectable in all samples) nor on pathologic gastroesophageal reflux episodes (% of time of pH less than 4, before/after lipids: 0.6 +/- 0.4/0.15 +/- 0.09), were found (p = NS). In contrast, technetium gastric emptying studies showed a significant delay when comparing pre- and post lipid infusion values (37 +/- 4/54 +/- 4%) (p greater than 0.005). The mechanism of this effect remains unexplained. PMID- 2761067 TI - Vitamin prescriptions on a hospital general medical ward: result of a drug utilization review. AB - Records of 103 consecutive admissions to a general medical ward over 4 months in a Veterans Administration Medical Center were reviewed. Assessment was made of nutritional status and potential need for supplemental vitamin therapy based upon predetermined criteria. Thirty-five of the 103 patients received one or more vitamin supplements. No patient received unnecessary vitamins as defined by our criteria. However, 48 patients had indications for vitamin supplementation, but did not receive any. Analysis of data by indication for vitamin therapy revealed 125 indications for vitamin therapy in 83 patients. Of the 125 indications 54 were treated appropriately, but there were no vitamin prescriptions in 71 indicated instances. We conclude that indicated vitamin supplementation may be underutilized in hospitalized general medical patients. PMID- 2761068 TI - Comparison of urinary urea nitrogen excretion and measured energy expenditure in spinal cord injury and nonsteroid-treated severe head trauma patients. AB - Severe head trauma patients (HT) exhibit markedly elevated energy expenditure and 24-hr urinary urea nitrogen excretion (UUN) values. The objective of this study was to compare seven spinal cord injured patients (SCI) to seven HT for changes in UUN and measured energy expenditure (MEE) over the first 18 days following injury. Energy expenditure was measured by indirect calorimetry and compared to values predicted by the Harris Benedict Equation (PEE). There were six quadriplegics and one paraplegic in the SCI group. HT patients had peak Glasgow Coma Scale scores of 3 to 10 for the first 24 hr postinjury. Patients were studied prospectively and matched for age, sex, and admitting weight Week 1 following the injury, SCI had mean UUN values of 0.18 +/- 0.04 g/kg/day vs 0.18 +/- 0.01 for HT patients. The mean MEE/PEE ratio was 0.56 for the SCI and 1.4 for HT (p less than 0.01). Over the entire study period the mean UUN value for SCI was 0.23 +/- 0.03 g/kg vs 0.21 +/- 0.01 for HT. The mean MEE/PEE ratio for SCI was 0.94 while HT remained elevated at 1.5 (p less than 0.05). Although the UUN was comparable in SCI vs HT, there was a significant difference in MEE/PEE between the groups. The elevation in UUN observed in SCI is not due to a hypermetabolic state. This suggests that different mechanisms promote the increased nitrogen excretion observed in these two populations. PMID- 2761069 TI - Fat intake is low in cystic fibrosis despite unrestricted dietary practices. AB - A prospective study of caloric intake and specific nutrient composition was performed in 64 cystic fibrosis patients aged 0.3 to 18 yr. Linear regressions and multiple stepwise regressions revealed no significant correlations between any individual dietary parameter and age, height, weight, percentile of weight or height, Shwachman Score, and pulmonary parameters. The caloric intake varied widely in individual patients and in different age groups. Despite unrestrictive dietary practices, the fat intake (33.7% +/- 8) was below that recommended for these linoleate deficient patients. PMID- 2761070 TI - Perforation by central venous catheters: a new testament to an old test. AB - Perforation by central venous catheters into the extravascular space is a rare complication of central venous lines that may explain new onset shortness of breath in hospitalized patients. We found that lowering bottles containing infusate and looking for return of venous blood is a highly specific test for this problem. Using Bayes' Theorem we calculated that for prior probabilities of catheter perforation of 0.01 and 0.05, corresponding posterior probabilities ranged from 0.1 to 0.15 and 0.35 to 0.49 respectively. This test should be used in all patients with new shortness of breath who have central venous catheters. PMID- 2761071 TI - A modified method of vascular access system implantation using the subclavian vein. AB - A new method of implanting vascular access systems using the Arrow Percutaneous Sheath Introducer Kit is described. The surgeon who frequently inserts these systems may find this technique to be a useful alternative in those patients in whom cutdowns were unsuccessful or in whom the percutaneous technique with a peel away sheath is found to be difficult. PMID- 2761072 TI - Left ventricular systolic and diastolic time intervals in familial amyloid polyneuropathy. AB - To determine left ventricular (LV) systolic and diastolic properties in patients with familial amyloid polyneuropathy (FAP), we analyzed simultaneous recordings of the electrocardiogram, phonocardiogram, carotid arterial pulse, and apex cardiogram in 14 patients and 21 normal subjects. LV systolic and diastolic time intervals were measured. Correlations between the intervals and neurologic disabilities, duration of illness, and age were examined. We found that in patients with FAP, 1) LV relaxation was impaired, especially in early diastole, whereas systolic function was generally preserved, 2) abnormal LV relaxation could be seen before the development of both clinically identifiable heart disease and the abnormalities in systolic function, 3) indexes of LV systolic function and relaxation decreased in parallel with the progress of the disease, duration of illness, and age, and 4) electromechanical delay was markedly increased. PMID- 2761073 TI - Combined effects of hypoxia and elimination of glucose on resting and postextrasystolic potentiated contractions of papillary muscle of guinea pigs. AB - We studied the combined effects of hypoxia and the absence of glucose on postextrasystolic potentiated and resting contractions in papillary muscle of guinea pigs. Postextrasystolic potentiations (PESPs) were evoked following trains of 40 externally applied continuous stimulations. During hypoxia resting (regular) contractions decreased to about 25% of baseline tension at 30 degrees C, whereas postextrasystolic potentiated contractions decreased to about 35% of baseline measurement of postextrasystolic potentiated contraction. In contrast, with reoxygenation, PESPs recovered quickly while resting contractions recovered gradually. Caffeine abolished the potentiation of post-extrasystolic contraction not only in normoxia but also in hypoxia. We speculate that calcium release from the sarcoplasmic reticulum (SR) is attributable to PESP for the most part, and that the trans-sarcolemmal calcium influx generally contributes to the steady state tensions developed by continuous stimulations. In addition, it seems that PESP works in a ischemic heart to compensate for the decreased tension during hypoxia as a potentiation by a premature ventricular contraction. Trans sarcolemmal calcium influx might be affected more easily than the SR calcium release, by a combination of hypoxia and the absence of glucose, that is, the sarcolemma may be more susceptible to hypoxic injury than the SR. PMID- 2761074 TI - Central baroreflex regulation by the renal nerves in anesthetized rats. AB - To determine whether the renal nerves affect central baroreflex regulation, the aortic depressor nerve (ADN) was stimulated electrically, while blood pressure, heart rate, and splanchnic nerve activity were recorded in renal denervated and sham-operated rats anesthetized with urethane. Tail cuff systolic pressure fell 6 days after renal denervation, but mean blood pressure recorded after anesthetizing with urethane did not differ between renal denervated and sham operated rats. Urinary sodium excretion was greater in renal denervated than in sham-operated rats. ADN stimulation produced frequency-dependent falls in blood pressure accompanied by inhibitions of sympathetic nerve activity and heart rate. Depressor and sympathetic inhibitory responses to ADN stimulation were significantly smaller in renal denervated than in sham-operated rats. These findings suggest that the renal nerves can regulate baroreflexes centrally. PMID- 2761075 TI - A case of successful coronary artery bypass grafting in a patient with angina pectoris and hypothyroidism. AB - There is a clinical dilemma in the treatment of patients with hypothyroidism and coronary artery disease; excess thyroid hormone administration may exacerbate anginal symptoms, and yet inadequate thyroid replacement may induce congestive heart failure. A case of successful coronary artery bypass grafting in a patient with angina pectoris and hypothyroidism is described in this paper. A 55 year-old woman with this complication initially received thyroid replacement therapy under strict monitoring. Forty days after the start of the thyroid replacement therapy, serum levels of thyroid hormone had reached the normal range, and then coronary artery bypass grafting was successfully performed. She recovered without any complications, and is now free from chest pain in spite of thyroid replacement therapy. PMID- 2761077 TI - [On learning pleasures and apprehension of expectant mothers]. PMID- 2761076 TI - A patient with an arteriovenous fistula between the internal mammary artery and the pulmonary artery. AB - A case of arteriovenous fistula between the internal mammary artery and the pulmonary artery was presented. In a recent review of the literature only 19 cases of this abnormality were described. In most instances, patients had continuous precordial murmur that might be confused with a patent ductus arteriosus. Definitive diagnosis was enabled by selective angiography. PMID- 2761078 TI - [Reflection on the midwifery practice]. PMID- 2761079 TI - [My personal experience in nursing and the development of deep affection for the profession]. PMID- 2761080 TI - [Process of understanding obstetrical nursing]. PMID- 2761081 TI - [A turning point in midwifery practice: the importance of the experience in the third year]. PMID- 2761082 TI - [Reflection on my 15 years in obstetrical nursing]. PMID- 2761083 TI - [32 years as a midwife with no regrets in the choice of the profession]. PMID- 2761084 TI - [Learning from teachers and patients: an experience by an obstetrician]. PMID- 2761085 TI - [Suggestions to the requirements of future midwives]. PMID- 2761086 TI - [Diagnosis in neonatology. 1. Examination of newborn infants]. PMID- 2761087 TI - [Application of NST (non-stress test) to detect low risk class 3]. PMID- 2761088 TI - [Learning through a difficult interaction with a pregnant schizophrenic patient]. PMID- 2761090 TI - [Mechanism triggering symptoms. 4. Emaciation]. PMID- 2761089 TI - [An essay by a midwife. A busy schedule of a working mother and wife supported by the family and colleagues]. PMID- 2761092 TI - [Memorable episodes in nursing. 4. A patient's self expression in seemingly selfish behaviors]. PMID- 2761091 TI - [A transient psychiatric syndrome in a young girl with a head injury: differentiation from a split personality]. PMID- 2761093 TI - [Advice to new nurses: attitude in reporting to a new station for the first time]. PMID- 2761094 TI - [Advice to new nurses: wider views and viewpoints through on-site-training and self-studies]. PMID- 2761095 TI - [Advice to new nurses: buildup of experiences in clinical practice]. PMID- 2761096 TI - [Advice to new nurses: description of my own experiences]. PMID- 2761097 TI - [An interview with Ms. Ann Walker Hardee, president of a home nursing agency in Texas]. PMID- 2761099 TI - [The importance of eating to man: an observation on eating]. PMID- 2761098 TI - [Evaluation of methods of taking aged patients' body temperature: comparison between the determination at the arm pit and at the abdomen (inside the diaper)]. PMID- 2761100 TI - [Nursing of a terminal patient: interactions with the patient and her family who were aware of the condition]. PMID- 2761101 TI - [Approach to a patient in the terminal stage of cancer: an innovation in the prevention of a bedsore]. PMID- 2761102 TI - [Ms. Watt's theories on patients. 13. Motivation]. PMID- 2761103 TI - [Nursing theory. 39. On King's nursing theory. 2. The dynamic interaction system]. PMID- 2761104 TI - [Encouragement of a nurse at a clinical scene]. PMID- 2761105 TI - [Welfare and medical care in an aging society. Trusting relationship in care giving]. PMID- 2761106 TI - [Report on the Colombian Medical Project. 4. To live in a foreign land]. PMID- 2761107 TI - [Profile of a nurse: Ms. Jean P. Ruxton studying humor, health, and survival of cancer patients]. PMID- 2761109 TI - [Focal points in modern medicine. 33. Comprehensive care of patients with kidney diseases]. PMID- 2761108 TI - [Understanding modern nursing in 100 words]. PMID- 2761110 TI - Electron microscopic observation of preretinal membranes. AB - In this report, membranes removed during vitrectomy were observed by various methods of electron microscopy to determine their three-dimensional structure and the mechanism of the contraction of preretinal membranes. The vitreous side surface of the preretinal membranes was covered by two types of flat cells, cells with long, extended processes and cells in a pavement arrangement. The lamellae of the flat cells in the internal structures of the preretinal membranes were also observed. In each lamella, the cells appeared to have a connection with each other and formed networks. The retinal side surface of the preretinal membranes was smooth and acellular. The glycerinated preretinal membranes were exposed to ATP and Mg2+, which induced the contraction of the component cells of the preretinal membranes. When the cells on the vitreous side surface of the preretinal membranes contracted, the intercellular connections among them appeared to be preserved. PMID- 2761111 TI - Choroidal vascular repair following orange dye laser photocoagulation. AB - In order to evaluate the effect of laser photocoagulation on choroidal vessels, moderate laser burns were performed on monkey fundi with a dye orange beam (595 nm) at various intervals for a period of 60 days. After photocoagulation, choroidal vascular casts were prepared by injection of Mercox resin into the carotid arteries, and then observed by scanning electron microscopy. Immediately after photocoagulation, filling defects of the choriocapillaris and medium-sized choroidal vessels were seen in all lesions. By three to five days, restoration of the choroidal microcirculation in the laser lesions had begun. At seven to ten days, filling defects of the choriocapillaris had gradually become undemarcated. By 2 weeks, the sites of the former filling defects were occupied by a loose network of capillaries. At 60 days, the laser lesions had been entirely replaced by newly formed choriocapillaris, composed of narrower lumina and showing a more irregular lobular pattern than normal choriocapillaris. PMID- 2761112 TI - Diagnosis and management of massive vitreous hemorrhage caused by retinal tear. AB - Fourteen cases of massive vitreous hemorrhage caused by a retinal tear, the cause having been confirmed during closed vitrectomy, were studied retrospectively. In the 3 cases with no retinal detachment and in the 6 cases with partial but not extensive retinal detachment at the time of surgery, the electroretinogram (ERG), visual evoked response (VER) and electrically evoked response (EER) were recordable preoperatively. After surgery the retina was attached in all 9 cases, but later redetached in one case. The visual acuity improved in 8 of the 9 cases. In the 5 cases with subtotal or total retinal detachment at the time of surgery, the ERG was nonrecordable preoperatively in all 5 cases, while the VER and EER were recordable in 4 cases. After surgery the retina was reattached in 3 of the 5 cases, but later redetached in one case. Visual acuity improved in only 2 of the 5 cases. When a retinal tear is suspected to be present, surgical intervention should not be delayed in cases of massive vitreous hemorrhage which does not clear after initial bilateral patching and bed rest. Ultrasonographic and electrophysiological tests help establish the diagnosis and prognosis. PMID- 2761113 TI - Localization of 3H-proline, 35S-sulfate and 3H-glucosamine in rat cornea following epithelial removal: epithelio-stromal interaction. AB - Localization of 3H-proline, 35S-sulfate and 3H-glucosamine was studied by autoradiography in the rat cornea following the removal of the epithelium. The three labeling chemicals were injected into the anterior chamber of rats, one chemical in each rat, 24 hours after the removal of the epithelium. Animals were sacrificed at various intervals up to 7 days after the injection. The silver grains of 35S-sulfate incorporated into the re-covered epithelium gradually shifted into the stroma. On the other hand, the 3H-glucosamine tended to move toward the epithelial cell membrane and the superficial layer of the epithelium. The 3H-proline incorporated in the epithelium remained in the cells without movement. These results suggest that the 35S-sulfate in the epithelium shifted into the stroma as 35S-phosphoadenosine-phosphosulfate [35S-PAPS] before sulfation of glycoconjugates occurred in the epithelium. A large amount of 3H glucosamine was utilized as a component of low-sulfated glycoconjugates in the epithelial cell membrane and other cell-coating substances. PMID- 2761114 TI - Measurement of vitreous oxygen tension in human eyes. AB - The vitreous oxygen tension in the human vitreous body was measured using a polarographic oxygen electrode during vitreous surgery. To the best of the authors' knowledge, this is the first time these measurements have been taken in the human eye. The vitreous oxygen tensions in the anterior peripheral vitreous body, central vitreous body, and posterior vitreous body were 16.7 +/- 3.7 mmHg (mean +/- SD, n = 9), 15.9 +/- 2.8 mmHg and 19.9 +/- 4.8 mmHg, respectively. The preretinal oxygen tensions over the detached retina and detached macula were 30.0 +/- 4.8 mmHg (n = 5) and 15.3 +/- 2.1 mmHg (n = 3), respectively, with the latter significantly lower than the former (P less than 0.01). In one case, after inhalation of 100% oxygen the oxygen tension over the retinal scar resulting from cryoretinopexy in a previous retinal detachment surgery increased remarkably to 160 mmHg. PMID- 2761115 TI - Calcium-induced opacification of rat lens beta-crystallin solution: its susceptibility to H2O2 oxidation. AB - Isolation of alpha, beta and gamma-crystallin solutions from rat lens soluble fraction was carried out by DEAE-cellulose ion-exchange column chromatography, and the effects of H2O2 on calcium-induced opacification of these solutions was examined. The alpha-crystallin solution became turbid in the presence of 1-10 mM calcium ions, and the turbidity increased with increasing calcium concentrations. The opacification level of the alpha-crystallin solution was not affected by 200 microM H2O2 treatment for 24 hours. On the other hand, the calcium-induced turbidity of a solution of beta-crystallin not treated with H2O2 was about one third that of the alpha-crystallin, but by the H2O2 oxidation, its calcium induced opacification was remarkably accelerated beyond the opacification level of the alpha-crystallin. The gamma-crystallin solution was made turbid by the H2O2 oxidation, but its turbidity was changed little by the addition of calcium ions. From the above results, it is suggested that the H2O2 acceleration of calcium-induced opacification of whole soluble lens protein solution previously reported might be mainly due to the aggregation properties of beta-crystallin. Furthermore, it is proposed that in the whole soluble lens protein, the calcium induced aggregation of alpha-crystallin might be kept at almost the same low level whether the H2O2 treatment is done or not, and that the beta-crystallin might be more susceptible to H2O2 than the alpha- and gamma-crystallins. PMID- 2761116 TI - Scleral spur and ciliary muscle in man and monkey. AB - The development of the human scleral spur and the role of the scleral spur in human and monkey eyes were studied by measuring the height of the scleral spur, the thickness of the uveal meshwork and the thickness of the longitudinal ciliary muscle. In an attempt to study how the tension of the ciliary muscle is transmitted to the inner wall of the Schlemm's canal, interconnections within the trabecular meshwork were also studied. The results indicate that after 40 weeks of gestation there is little or no further change with aging in the height of the scleral spur but there is a change in shape. The scleral spur is much less developed in monkey eyes than in human eyes. The corneoscleral meshwork predominates over the uveal meshwork in most human eyes while in monkey eyes the situation is the opposite. In man the thickness of the meridional part of the ciliary muscle attached to the scleral spur varies greatly in eyes with a well developed scleral spur. Interconnecting trabecular beams composed of elastic-like fiber were observed in the uveal and corneoscleral meshwork, as well as in the juxtacanalicular meshwork, extending to the cells of the inner wall of the Schlemm's canal. These findings and the dense structure of the scleral spur suggest that in monkey eyes, and at least in some human eyes, contraction of the ciliary muscle causes unfolding of the trabecular meshwork, not so much through the movement of the scleral spur as by movement of the interconnecting trabecular beams and fibers. One important role of the scleral spur is probably to keep the corneoscleral meshwork open when the ciliary muscle relaxes, and another is to enable inward-forward movement of the circular part of the ciliary muscle by pulling the posterior tip of the ciliary muscle anteriorly when the ciliary muscle contracts. A rigid scleral spur is an advantage for these two functions. PMID- 2761117 TI - Aqueous flare intensity and age. AB - The influence of aging on the blood-aqueous barrier function was assessed by measuring aqueous flare intensity in 203 normal eyes of healthy human subjects aged 20 to 79 years, using the recently developed laser flare-cell meter. The flare intensity correlated well with age (r = 0.502, Spearman r = 0.503, P = 0.00), and the intensity values in the subjects with their ages in the 6th, 7th and 8th decade were significantly higher than the values in the subjects in their 3rd decade (P less than 0.01). PMID- 2761118 TI - Assay of S-antigen immunoreactivity in mammalian retinas in relation to age, ocular dimension and retinal degeneration. AB - The immunoreactivity of S-antigen was assayed in the developing and adult retinas of a variety of mammals, including man. An electroimmunoassay was used with bovine S-antigen (in Triton X-100) as a standard and rabbit antiserum to this antigen was used for precipitation. In the newborn mouse, rat and rabbit retina no S-antigen was detected. During the second to fifth postnatal week a rapid increase in the immunoreactivity of this protein was found, which ran largely parallel to the development of photoreceptors and the increase in retinal rhodopsin content. In the rat, rabbit and guinea pig the adult level of retinal S antigen remained constant for a long period of life. In many mammalian species the amount of retinal S-antigen immunoreactivity appeared to increase proportionally to the square of the radius of the eye globe, which is closely related to the retinal surface area. Possible implications of this relationship are discussed. Specific anatomical and morphological characteristics of the eye and its tissues, rods/cones ratio, retinal degeneration and anomalous crossreactivity of S-antigens cause deviations from the relationship. For the S antigen content of adult human retina a value of 950 micrograms was found if purified human S-antigen was used as a standard. Very low values were found in the retina of a mouse strain homozygous for retinal degeneration-slow. PMID- 2761119 TI - The fine surface architecture of the primate ciliary body with special regard to the pars plana. AB - The fine surface architecture of the pars plana of the ciliary body was studied by scanning electron microscopy (SEM) in young and adult primate eyes following the removal of zonular fibers by hydrolysis with hydrochloric acid. In the young eye, the internal surface of the pars plana was characterized by a series of meridional ridges and grooves and, in the posterior region, by conspicuous surface invaginations on the ridges. In the adult eye, the meridional ridges in the anterior pars plana were smaller than in the young eyes and in a varying configuration, and the meridional grooves among the ridges were wide. In the mid pars plana, spine-like architectures were observed leaning parallel to each other toward the lens, along the course of the zonular fibers. In the posterior pars plana, the internal surface exhibited a reticularly multilayered appearance with interstices of various sizes. In incompletely digested specimens, the zonular bundles were found to dissociate into fan-shaped off-shoots, and were observed entering the meridional grooves and the surface invaginations on the ridges. The procedure used in the present study was considered to be highly useful for SEM observation of the surface morphology of the ciliary body. PMID- 2761120 TI - Metabolic cold acclimation after repetitive intermittent cold exposure in rat. AB - Repetitive intermittent cold exposure (5 degrees C, 6 h/day, 4 weeks) (ICE) resulted in the same cold adaptability as assessed by an enhanced cold tolerance (less drop of colonic temperature at -5 degrees C) and nonshivering thermogenesis (NST) (greater noradrenaline-induced heat production) as that elicited by continuous cold exposure (5 degrees C, 4 weeks) (CA) in rats. Although shorter intermittent (5 degrees C, 2 h/day, 4 weeks) (ICE-2 hr) as well as shorter continuous (5 degrees C, 1 week) (CA-1 wk) cold exposure effected an improved cold adaptability, the magnitude of cold tolerance and NST was smaller as compared with that in CA and ICE. The cold deacclimation process as reflected on the decreased NST did not differ between CA and ICE. Food intake was less in ICE than CA, while increase in body weight during the acclimation period was greater in the former. Increase in adrenal weight was greater in CA than ICE, but plasma corticosterone level did not differ among warm controls (WC), CA, and ICE in resting state (after 18-20 h at warm control temperature of 25 degrees C). Weights of interscapular and dorsocervical brown adipose tissue (BAT) increased to the same degree in CA and ICE. Plasma glucagon level in resting state did not differ among groups, while BAT glucagon levels significantly increased in CA and ICE, but they were higher in dorsocervical site than interscapular site in all acclimated states. Acute cold exposure (-5 degrees C, 15 min) caused increases in plasma corticosterone, glucagon levels, and in BAT glucagon levels in all acclimated groups. The extent of increase was significantly less for plasma glucagon in CA, while plasma corticosterone increased similarly in all groups. These results indicate that repetitive short-term cold exposure could elicit the same cold adaptability as that induced by continuous exposure, but requiring only one-fourth of the time of continuous cold exposure. Moreover, it is suggested that glucagon is involved in both CA and ICE, but the same extent of cold adaptability can be obtained in the less energy-requiring and less stressful state in ICE. PMID- 2761121 TI - Climatic adaptation in thermogenesis and thermal insulation in wood mice (Apodemus argenteus). AB - Wood mice (Apodemus argenteus) were trapped live at three different altitudes (below 1,000, 1,900, and 2,400 m) during a 1-year period (Feb. 1984-Jan. 1985). After remaining at the trapped locations for 10-14 days, they were transferred into a climatic chamber at an altitude of 610 m. Oxygen consumption (VO2) and colonic temperature (Tco) were measured at chamber temperatures (Ta) of five steps (30, 20, 10, 0, and -10 degrees C) in freely moving conditions. In response to Ta of 0 degrees C for the mice trapped in winter when their mean local habitat temperature (Te) were lower than 0 degrees C, there was a significant inverse correlation between VO2 and Te (r = -0.70, p less than 0.001) whereas no significant correlation (r = 0.23) was observed in the mice trapped in other seasons when Te was higher than 0 degrees C. The correlation between Tco and Te was significant (r = -0.66, p less than 0.001) over the entire range of Te. The pelt weight of the mice trapped at Te higher than 0 degrees C had a significant inverse correlation with Te (r = -0.65, p less than 0.001), but not in the mice trapped at Te lower than 0 degrees C. After measurement of VO2 and Tco at Ta of 0 degrees C, the mice who had lived in colder habitats (below 0 degrees C) showed 0% mortality, whereas the mortality of the populations which had lived in warmer habitats was 13%. These results suggest that, in wood mice, adaptation to severe cold is established by an enhanced thermogenesis and by an increased insulation of the pelt in moderate cold. PMID- 2761122 TI - Effects of bicarbonate ingestion on the respiratory compensation threshold and maximal exercise performance. AB - Six males performed cycle ergometer exercise on two occasions in random order. Each exercise was preceded by a 2-h period in which matched capsules were administered orally, containing either starch (C) or NaHCO3 (E) in a dose of a 0.2 g.kg-1 body wt; pre-exercise blood pH and [HCO3-] were 7.34 +/- 0.01 and 23.7 +/- 0.5 mM (mean +/- S.E.) for the C study, and 7.41 +/- 0.01 and 28.6 +/- 1.3 mM for the E study (p less than 0.001 and p less than 0.01, respectively). Exercise was continuous and maintained for 10 min at 40% of maximal oxygen uptake (40% VO2max), followed by 15 min at 12 W above the respiratory compensation threshold ([+RCT]) which was determined by the increase of the ventilatory equivalent for carbon dioxide (VE.VCO2(-1)), and for as long as possible at 95% VO2max. Endurance time at 95% VO2max was significantly longer in E than in C (2.98 +/- 0.64 min vs. 2.00 +/- 0.44 min, p less than 0.05). The rate of increase in arterialized venous lactate (LA) was higher in E than in C from rest to exercise at [+RCT], while there was no significant difference in the hydrogen ions ([H+]). Consequently, [H+].LA-1 (nM.mM-1) was significantly lower in E than in C. The change of VE.VCO2(-1) was shifted downward in E compared to C during exercise with the lowest value being observed at the same exercise stage. These results suggest that the respiratory responses to exercise are not affected by the higher level of [HCO3-] induced by NaHCO3 ingestion, and appear to reflect the net change of plasma [HCO3-] or [H+]. Also, induced metabolic acidosis has little effect on [H+] appearance in blood. PMID- 2761123 TI - Inhibition of nerve conduction by electromagnetic induction of the frog sciatic nerve-gastrocnemius muscle preparation. AB - The effect of electromagnetic induction (EMI) on impulse conduction and muscle contraction was studied in isolated sciatic nerve-gastrocnemius muscle preparation of the frog. Electrical stimulation (ES) of the sciatic nerve, at 0.5 Hz with 0.6 V (supramaximal) and 1-ms pulse duration, produced twitch contractions (3.5 +/- 0.4 g tension, mean +/- S.E., n = 8 frogs), which were reduced or blocked by EMI, applied to the nerve via an induction coil, from a d.c. source of 1.5-4 V, at a frequency of 100 min-1, for 2- to 4-min duration. Recovery of the blocked twitches was obtained within 4-5 min, after the cessation of the EMI and washing out the preparation in Ringer solution. The inhibition of the twitch tension by EMI was compared to that produced by an effective concentration of a local anaesthetic, lignocaine (1 microM), which is known to block conduction, by blocking ionic fluxes across the nerve membrane. It is possible that EMI also interferes with the ionic fluxes, and in prolonged duration, may produce changes in the myelin sheath (or the Schwann cells) of the nerve membrane. A comparison of ES with EMI was made, and it was concluded that EMI inhibited electrically induced neuromuscular transmission at the frog neuromuscular junction. PMID- 2761124 TI - Noradrenaline-induced changes in rat brown adipose tissue glucagon. AB - Brown adipose tissue (BAT) glucagon level was higher in cold-acclimated rats (CA) than in warm controls (WC). Noradrenaline (NA) injection increased BAT glucagon levels in both WC and CA with increases in plasma glucagon levels. The magnitude of increase was significantly greater in CA for plasma glucagon, while it did not differ for BAT between groups. However, BAT glucagon was kept at a higher level in CA after NA injection than in WC. PMID- 2761125 TI - A simple and rapid purification procedure for the preparation of tetramethylrhodamine-labeled antibodies. AB - A conjugate preparation of antibody (Fab) and tetramethylrhodamine (TMR) generally adsorbs free TMR which is very difficult to remove because of its strong hydrophobic binding. On the basis of criteria such as sodium dodecyl sulfate (SDS) gel electrophoresis and staining of the plasma membrane of live cells, we found that simple extraction with n-butyl alcohol or iso-amyl alcohol could remove the contaminating free dye. The procedure is especially useful when one needs to prepare conjugates with low nonspecific binding for the study of lateral diffusion of cell membrane-associated antigens. PMID- 2761126 TI - New mathematical modelling of blood lactate kinetics during ramp mode exercise in man. AB - The lactate (LA) kinetics of the whole body in exercise was described using the two-compartment model in consideration of the underlying physiological mechanism, and LA kinetics during the ramp mode exercise was analyzed. The estimated pattern of the glycolytic energy supply showed the progressive increase concurrently with the onset of ramp mode exercise and this pattern was just like a ramp phenomenon. Based on this result, it is proposed that blood LA kinetics during ramp exercise should be described mathematically as a continuous model, called "2nd-order model." PMID- 2761127 TI - Modulation of eicosanoid-induced contraction of mouse and rat blood vessels by gingerols. AB - The effects of the active principles of crude ginger (a traditional Sino-Japanese medicine), the gingerols, on the contractile responses to eicosanoids were compared using isolated mouse and rat blood vessels. Leukotrienes (LT) C4 and D4, a thromboxane (TX) A2 derivative (U-46619), prostaglandins (PG) F2 alpha, PGI2 Na, PGE2, the stable PGI2 derivative TRK-100, and PGD2 induced contraction in longitudinal segments of mouse mesenteric veins in that order of potency. Exogenous arachidonic acid and PGE1 did not cause contraction. The mesenteric veins also contracted in response to noradrenaline (NA) and phenylephrine (PhE), but not to clonidine. The gingerols alone relaxed the muscle transiently and then augmented the response to PGF2 alpha, PGE2, PGI2-Na, and TRK-100, but suppressed the response to PGD2, U-46619, LTC4, LTD4, NA and PhE. (+/-)-[6]-Gingerol also potentiated the PGF2 alpha-induced contraction in longitudinal segments of rat mesenteric vein and vena cava, but inhibited it in circular segments of rat aorta and longitudinal segments of mouse mesenteric arteries. These results showed that (+/-)-[6]- and (+/-)-[8]-gingerols potentiated the contraction induced by prostanoids (except PGD2) and inhibited that produced by PGD2, TXA2, and LT, suggesting the modulation of eicosanoids-induced responses by (+/-)-[6]- or (+/-) [8]-gingerol. PMID- 2761128 TI - Glutathione S-transferases and chloroform toxicity in streptozotocin-induced diabetic rats. AB - The glutathione S-transferase activity in liver and kidney cytosol was significantly decreased in short term diabetes induced with streptozotocin, whereas no decrease in the transferase was observed in phenobarbital-treated diabetic rats. Toxicity of chloroform was potentiated in streptozotocin- or phenobarbital-treated rats. The decrease in liver cytosolic and microsomal glutathione S-transferase activity was observed in long term diabetic rats, and only microsomal transferase activity was restored by insulin treatment. There was no release of glutathione S-transferases into the serum in the diabetic rats, and the transferases were not inhibited by streptozotocin in vitro. These results showed that glutathione S-transferase activity decreased during diabetes, and this decrease may contribute to altering drug metabolism and toxicity in diabetes. PMID- 2761129 TI - Mechanisms of action of eperisone on isolated dog saphenous arteries and veins. AB - Effects of eperisone, an antispasmodic in skeletal muscle, were investigated in helical strips of dog saphenous artery and vein. Eperisone relaxed saphenous arteries and veins previously contracted with norepinephrine, serotonin, acetylcholine, K+, or Ba2+; but in contrast, it produced contractions in the blood vessels contracted with prostaglandin (PG) F2 alpha. Treatment with eperisone attenuated the contractions induced by norepinephrine and serotonin in the arteries and those by clonidine and phenylephrine in the veins. Eperisone inhibited angiotensin II-induced relaxations, mediated possibly by endogenous PGI2, but did not alter relaxations caused by exogenous PGI2. Treatment with eperisone (10(-5) M) potentiated the contractile response to electrical stimulation of adrenergic nerves; the potentiating effect was suppressed by yohimbine. The eperisone-induced contraction in PGF2 alpha-contracted arteries was inhibited by treatment with indomethacin or aspirin, although cyclooxygenase activity was not inhibited by eperisone. These results may indicate that eperisone blocks postjunctional alpha 1- and alpha 2-adrenergic, muscarinic, serotonergic receptors and prejunctional alpha 2 adrenoceptors and reduces PGI2 synthesis via a mechanism other than cyclooxygenase inhibition. PMID- 2761130 TI - Studies on oxacephem antibiotics: comparison of the effects of 1-oxa and 1-thia cephalosporins on blood coagulation activities and vitamin K metabolism in rats. AB - Oxacephem antibiotics have been developed to increase the antibacterial activity of cephem antibiotics, but the effect of 1-oxygen replacement of cephem antibiotics on blood coagulation activities is not yet known. Therefore, latamoxef (LMOX), flomoxef (FMOX) and their 1-S congeners were examined for their effects on prothrombin time, activated partial thromboplastin time, plasma prothrombin and Factor VII levels, plasma and liver descarboxyprothrombin (PIVKA II) levels, and liver microsomal vitamin K epoxide reductase activities in rats kept on a vitamin K-deficient diet. Under the vitamin-deficient states, LMOX, FMOX and their 1-S congeners inhibited the vitamin K epoxide reductase, although the effect of FMOX or its congener was much less than that of LMOX, and they decreased the blood clotting activities in rats fed a vitamin K-deficient diet. However, no difference was found in these effects between LMOX and its 1-S congener or between FMOX and its 1-S congener. This result suggests that the 1 oxygen replacement of cephem antibiotics is not responsible for the hypoprothrombinemic effect of the antibiotics. PMID- 2761131 TI - Acute effect of amitriptyline, phenobarbital or cobaltous chloride on delta aminolevulinic acid synthetase, heme oxygenase and microsomal heme content and drug metabolism in rat liver. AB - Cobaltous chloride (CoCl2) caused very marked decreases of cytochrome P-450, b5 and total heme contents and an increase of heme oxygenase activity. On the contrary, phenobarbital (PB) increased hepatic drug-metabolizing enzymes, but the total heme content remained unchanged. On the other hand, amitriptyline (AMT) caused a marked increase of delta-aminolevulinic acid (delta-ALA) synthetase activity at 12 and 24 hr. In addition, the contents of total heme and cytochrome b5 and the activities of aminopyrine (AM) N-demethylase and aniline (AN) hydroxylase at 24 hr were also increased by AMT, whereas cytochrome P-450 content did not change. This may be explained by the fact that AMT would increase hepatic heme synthesis through the prolonged induction of delta-ALA synthetase, but it may not cause an increase in cytochrome P-450 heme because there are increases in the contents of cytochrome b5 and total heme. PMID- 2761132 TI - Chronic effects of imipramine and lithium on 5-HT receptor subtypes in rat frontal cortex, hippocampus and choroid plexus: quantitative receptor autoradiographic analysis. AB - The effects of chronic treatment with imipramine or lithium on serotonin (5-HT) receptor subtypes were analyzed in the frontal cortex, hippocampus and choroid plexus of rat brain by quantitative receptor autoradiographic procedures, using radioligands [3H]-5-HT, [3H]-8-hydroxy-2-(di-n-propylamino)tetralin ([3H]-8-OH DPAT), [125I]-iodocyanopindolol ([125I]-CYP), [3H]-mesulergine and [125I]-7-amino 8-iodo-ketanserin ([125I]-ketanserin) or [3H]-spiperone. Chronic i.p. administration of imipramine (20 mg/kg/day for 21 days) decreased the densities of 5-HT1, 5-HT1A, 5-HT1C and 5-HT2 sites in the frontal cortex, hippocampus and choroid plexus. Lithium (2 mEq/kg/day for 21 days) also decreased the densities of 5-HT1, 5-HT1C and 5-HT2 sites in the frontal cortex, and the densities of those including 5-HT1A sites in the hippocampus and choroid plexus. Imipramine and lithium very markedly decreased the density of 5-HT1C sites in the choroid plexus. We propose that methods employing quantitative receptor autoradiographic analysis can be used to characterize and understand the local effects of these drugs on 5-HT receptor subtypes. PMID- 2761133 TI - Effects of central nervous system-acting drugs on urinary bladder contraction in unanesthetized rats. AB - We studied the effects of drugs on urinary bladder contraction in unanesthetized (UA) rats using the same method as that previously employed to investigate similar effects in urethane and alpha-chloralose-anesthetized (A) rats. The surgical procedure was performed under halothane anesthesia, and after the recovery, the rats were restricted in a Ballman cage during the experiment. The pattern of the cystometrogram obtained in UA rats was very similar to that in A rats, and almost the same pattern was maintained for at least three hours. Baclofen (10 mg/kg, i.p.), morphine (10 mg/kg, i.p.) and pentobarbital (20 mg/kg, i.p.) completely inhibited the bladder contraction at doses only double those at which the same drugs inhibited the bladder contraction in A rats when i.v. injected. When the bladder pressure rose almost to the level of the peak pressure existing before injection of these drugs, the instilled solution leaked from the penis. On the other hand, even after injection of diazepam (5 mg/kg, i.p.) at a dose five times greater than the minimum amount necessary for complete inhibition of bladder contraction in A rats, the bladder contraction accompanying micturition continued in UA rats. It appears that the inhibitory effect of diazepam on bladder contraction in rats is potentiated by anesthesia. PMID- 2761134 TI - 2-cyclohexene-1-one-induced hyperglycemia in the mice. AB - 2-Cyclohexene-1-one (CHX) dose-dependently caused the elevation of blood glucose levels in both fed and fasted mice. Adrenalectomy considerably prevented the elevated blood glucose with CHX, and plasma adrenaline assays revealed about a three- to fifteen-fold rise after CHX treatment. These findings indicate that the CHX-induced hyperglycemia may be largely mediated by adrenaline released from the adrenal medulla. PMID- 2761135 TI - Effects of opioid peptides administered in conscious rats on the changes in blood adrenaline levels caused by immobilization stress. AB - Effects of several opioid peptides administered in the lateral cerebroventricle on the changes in blood adrenaline (AD) levels were examined at 10, 20 and 30 min after the start of immobilization in conscious rats. beta-Endorphin, (D-Ala2)-Met enkephalinamide, morphiceptin and (D-Ala2, D-Leu5)-enkephalinamide produced significantly lower elevations of AD than the control, and the effect was enhanced by naloxone. The effect of dynorphin, however, was almost the same as that of the control. PMID- 2761136 TI - Healing process of acetic acid-induced gastric ulcer and gastric mucosal prostaglandin E generation level in rats. AB - The prostaglandin E (PGE) generation level (PGE level) in the gastric mucosa was investigated in relation to the healing and relapse of acetic acid-induced gastric ulcers in the rat. The PGE level around ulcers showed higher levels after ulcer induction and decreased during the ulcer diminishing period. Thereafter, the PGE levels showed an inclination to increase during the ulcer exacerbation period. In reulcerated rats, PGE levels were significantly higher. In conclusion, a high level of PGE may indicate an ulcer exacerbation state. PMID- 2761137 TI - Blood LH level and induced ovulation after hCG and PMSG treatment in ovarian quiescent cattle. AB - Ovarian quiescent cattle bearing follicle with palpable size were treated with single intramuscular injection of 750-6,000 IU of human chorionic gonadotrophin (hCG) in 13 cases and 1,000-2,000 IU of pregnant mare serum gonadotrophin (PMSG) in 5 cases. Changes of blood luteinizing hormone (LH) level, estrus and ovulation after the treatments were examined. After the hCG treatment LH level became slightly high from 0.2-0.6 ng/ml of pre-treatment to 0.3-1.9 ng/ml of post treatment and maintained the level up to ovulation without the ovulatory LH surge. Ovulation was induced about 36 hr after the treatment in 12 cases. The ovulations were all silent ovulations. After the PMSG treatment LH level became slightly high from 0.6 ng/ml of pre-treatment to 1.3 ng/ml of post-treatment and the level lasted until the ovulatory LH surge. The ovulatory LH surge occurred about 39 hr after the PMSG treatment in 4 cases with a peak of about 32 ng/ml. Ovulation was induced about 74 hr after the treatment in all 5 cases. Four cases showed estrus but one in which the LH surge could not be confirmed did silent estrus preceding the induced ovulations. It was demonstrated that hCG induced ovulation without the LH surge but PMSG induced the ovulatory LH surge and the subsequent ovulation in ovarian quiescent cattle. PMID- 2761138 TI - Early organogenesis of the caprine stomach. AB - Early organogenesis of the caprine stomach was studied in a series of 11 embryos ranging from 6.5 mm neck-rump length (NRL) to 13.3 mm crown-rump length (CRL). In embryos with 6.5-6.7 mm NRL, a part of the primordial proper esophagus extended to the dorsal side of the primordial stomach. The primordial proper esophagus and its extension were lined with a simple epithelium and stained dark brown with Con A III, while the primordial stomach was weakly stained. In embryo with 7.3 mm NRL, the esophageal extension was separated from the proper esophagus by constriction, and became a primordial forestomach situated in an area outside the omental sac. In embryos with 8.3 mm NRL-10.7 mm CRL, primordial forestomach and primordial stomach were united and formed a spindle shaped primordial ruminant stomach with foregut rotation. The primordial ruminant stomach was similar to the primordial simple stomach except that it was more flattened laterally with the convex at the area of 'lesser curvature'. Primordial rumen, omasum and abomasum appeared from the spindle shaped primordial ruminant stomach in an embryo with 12.9 mm CRL. In an embryo with 13.3 mm CRL, primordial reticulum originated from an area between the primordial rumen and omasum. PMID- 2761139 TI - An appropriate ingestion volume of oral sulfa drug suspension in pigs. AB - The influence of ingested volume of a sulfa drug suspension, sodium sulfamonomethoxine (SMMNa), on the oral pharmacokinetics was studied in pigs, with regard to bioavailability and gastric emptying. Eighteen pigs, weighing 30 70 kg, were used. Phenol red solution was used for the evaluation of gastric emptying study. SMMNa suspension was used for pharmacokinetic study. Both of these fluids were administered by natural swallowing. Three experimental groups were constructed: G-I; 5 ml/kg of the test fluids to starved animals, G-II; 5 ml/kg of the test fluids to fed animals and G-III; 20 ml/kg of the fluids to fed animals. The glucose glycine electrolyte solution (GGES) was used as the vehicle for both the compounds. Six pigs, having duodenal cannula, were used for the study of gastric emptying. The gastric emptying rate was rapid in G-I, relatively rapid in G-III, and slow and variable in G-II. In agreement with the result of gastric emptying study, the values of Cmax and tmax were high and rapid in G-I, relatively high and rapid in G-III, and low and slow in G-II. Accordingly, the voluminous ingestion of drug suspension can facilitate the gastric emptying, in turn may make the oral absorption of the drug rapid-and-uniform. The 20 ml/kg volume of sulfa drug suspension may practically be recommended for the oral administration in pigs. PMID- 2761140 TI - An adhesion-hemadsorption inhibition test for the detection of serum antibody to Mycoplasma gallisepticum. AB - A simple adhesion-hemadsorption inhibition (AHAI) test was developed for the detection of antibodies to Mycoplasma gallisepticum in the chicken sera. The AHAI antibody was detected simultaneously with HI antibody from sera of chickens intratracheally inoculated with viable cells of M. gallisepticum. A good correlation between HI and AHAI antibody titers was obtained with 382 (84.7%) of 451 sera from chickens reared on farms spontaneously contaminated with M. gallisepticum, whereas the remainder, 69 sera, was positive for HI but negative for AHAI test. It was not apparent whether the latters exhibited a non-specific reaction or the discrepancy was due to the lower sensitivity of AHAI reaction. The AHAI test does not require a great amount of antigen, special reagents or instruments, or pre-absorption treatment of test sera, and, therefore, it may serve as a simple serological test for detecting antibodies to M. gallisepticum. PMID- 2761141 TI - Effects of prostaglandin F2 alpha-analogue administration on luteal function, implantation of embryos and maintenance of pregnancy in bitches. AB - The present experiment was carried out to clarify the effect of administration of the prostaglandin F2 alpha (PGF2 alpha)-analogue on the luteal function and the maintenance of pregnancy in bitches. Fifty-one bitches received a single inoculation of PGF2 alpha-analogue by intramuscular injection. The effect of this agent was observed by monitoring progesterone (P) levels and the state of the uterus by laparotomy, the occurrence of abortion, and the state of parturition. As a result, when bitches were administered with 100-400 micrograms at the beginning of the luteal phase, the decrease in the P level was temporary. In bitches inoculated with 100-800 micrograms of PGF2 alpha-analogue at the functional luteal stage, the P level began to decrease as early as on the following day after injection. In those treated with 100-200 micrograms of PGF2 alpha-analogue at 10-15 days of pregnancy, pregnancy was maintained in 3 of 5 bitches that had received the treatment at day 10, while in the remaining two, all embryos died after implantation. In those that had received the same treatment at day 15, only 2 of 7 maintained pregnancy. Pregnancy was interrupted in eight bitches treated with doses of 100-200 micrograms at days 25-45. In four bitches treated with doses of 100-200 micrograms at day 55, premature birth was induced after 30-44 hr. In conclusion, regression of the corpus luteum, abortion, and premature birth were induced in bitches treated with 100-200 micrograms at each stage, except the beginning of the luteal phase and of the pregnancy. PMID- 2761142 TI - Mycobacterium avium infection through the alimentary tract in mice. AB - Intestinal infection by Mycobacterium avium was investigated in C57BL/6 and BALB/c mouse strains. Single intragastric administration of a massive dose (10(8] or multiple administration of a lower dose (10(7), 10 times) established infection principally in the mesenteric lymph-node (MLN); a continuous or intermittent fecal excretion of the bacilli was detected by 6-8 weeks after the administration. Based on three criteria--isolation of the organisms from the MLN and from feces, and detection of acid-fast bacilli in sections of the MLN--germ free (GF) BALB/c mice exhibited clearer dose-effect relations than the flora bearing (FB) counterparts. After intragastric administration, the organisms were probably trapped in the Peyer's patch and then transferred to the MLN at an early period (by 4-7 days), persistent infection thus being established in the MLN. Systemic involvement evolved both in athymic and euthymic mice after a prolonged period of time (more than 40 weeks) showing far more severe involvement in the former regardless of the presence of floral organisms. PMID- 2761143 TI - Pharmacokinetics of quinidine sulfate in dairy cattle. AB - Pharmacokinetic profile and therapeutic range of plasma quinidine concentration were determined in dairy Holstein cows. Plasma half-life of intravenous quinidine was 1.28 +/- 0.492 (0.41-1.65) hr. The pattern of plasma quinidine transition after oral administration varied greatly among individuals. Total body clearance was 58.7 +/- 24.49 ml/min/kg, although renal quinidine clearance was 0.76 +/- 0.441 ml/min/kg. Therefore, the involvement of some extrarenal organ as the main site of excretion was suspected. Seven cows, diagnosed as atrial fibrillation or ventricular premature contraction, were orally administered with quinidine at various dosages. They showed plasma concentration of 2.3 +/- 1.59 mg/l when therapeutic effect was observed. Clinical signs of intoxication were observed at plasma quinidine concentrations over 10 mg/l. These results suggest the difficulty with the maintenance of effective plasma quinidine concentration by an oral or a single intravenous administration, and thus it is concluded that use of quinidine for treatment arrhythmic cows must be carefully done in order to avoid possible intoxication. PMID- 2761144 TI - Effects of ligation of the ductus deferens on the fowl epididymal region. AB - The effects of ligation of the ductus deferens on the epididymis in the fowl were studied histochemically and immunohistochemically to reveal the mechanisms of sperm disposal. At one week post-ligation, the lumina of the rete testes (RT) and the efferent ductules (ED) were distended and filled with densely accumulated spermatozoa. Macrophages and foreign-body giant cells were aggregated in and around the accumulations. The epithelium regressed in the initial portion of the RT with the invasion of fibroblasts and heterophiles into the lumen. The other part of the epithelium was penetrated by many spermatozoa. Numerous lymphocytes and plasma cells infiltrated into the interstitium. At 4 weeks, larger number of spermatozoa agglutinated in the lumen, and large masses of foamy cells and proliferated connective tissue protruded into the lumen. At 8 weeks, large masses of foamy cells were noted. The connecting ductules or the epididymal duct showed no marked changes after ligation. The epithelium of the ED showed weaker or no acid phosphatase activity after ligation. Immunoglobulin G-containing cells increased in number in the interstitium. These results showed that ligation of the ductus deferens in the fowl causes granuloma in the RT and ED, and that epithelial cells, macrophages and granuloma are engaged in the removal of spermatozoa. The participation of antibody is suggested in the sperm disposal processes. PMID- 2761145 TI - Contribution of leucocytes to the origin of lactate dehydrogenase isozymes in milk of bovine mastitis. AB - The isozyme patterns of lactate dehydrogenase (LDH) of bovine milks are different in normal (LDH1 is predominant) and mastitic milks. We surveyed LDH isozymes of mastitic milks, and found that the isozyme patterns could be separated into two groups, mastitic milk A (higher proportions of LDH1,2 and lower proportions of LDH3-5) and mastitic milk B (relative decrease of LDH1 and increase of LDH2-5, particularly LDH3-5). To elucidate the origin of LDH isozymes in the mastitic milks, the isozyme patterns of granulocytes, monocytes, platelets and lymphocytes (T and B cells) were examined. The patterns of granulocytes and lymphocytes were similar to those of mastitic milks A and B, respectively. Sodium dodecyl sulfate polyacrylamide gel electrophoresis also showed the presence of marker proteins of granulocytes and lymphocytes in mastitic milks A and B, respectively. These results suggested that granulocytes and lymphocytes at least partly contributed to the origin of LDH isozymes in the mastitic milks. PMID- 2761146 TI - Influence of immune treatments against Dirofilaria immitis infection in dogs. AB - Mongrel dogs were inoculated with two kinds of antigenic substances. The first was a phosphate buffered saline extract of whole Dirofilaria immitis mixed with aluminum hydroxide gel (group 1), and the second was an orally administered live Metastrongylus apri infective larvae (L3) (group 2). Both groups were then infected with D. immitis L3. Indirect hemagglutination (IHA) tests showed that the antibody was produced by these inoculations before the infection was introduced, even in dogs inoculated with M. apri. This suggests a cross reactivity between D. immitis and M. apri. The initial passive cutaneous anaphylaxis (PCA) antibody production was markedly delayed by about 70 days in group 2 compared with the production in the infected control dogs (group 3). The appearance of microfilaremia was also delayed by about one month in group 2 compared with that in the above control group. All dogs were sacrificed after the termination of the observation and worms recovered from the right ventricle and pulmonary arteries were counted and measured. The results indicated that immunization resulting from the homologous worm-somatic antigen might accelerate the growth of the infected larvae, whereas immunization resulting from the heterologous worm antigen, but cross-reactive to D. immitis, might disadvantageously affect the growth. PMID- 2761147 TI - The establishment of a clinical diagnostic method of the visual evoked potentials (VEPs) in the cat: the effects of recording electrode positions, stimulus intensity and the level of anesthesia. AB - The establishment of characteristic wave pattern of visual evoked potentials (VEPs) in the cat was attempted in order to be aid for clinical veterinary practitioners with the evaluation of visual dysfunction. 1) The position where the largest response of the VEPs was detected was close to the midline of the occipital area in normal cats. 2) The VEPs consisted of three components with latencies within 100 msec after flash stimulus. 3) Flash stimuli of higher illumination produced VEPs of shorter latencies and increased amplitude. Intensity of more than 0.6 J was necessary to obtain stable VEP patterns. 4) The latencies of VEPs hardly changed with time course under pentobarbital anesthesia, although they showed a fluctuant variation. PMID- 2761148 TI - Induction of twinning in dairy or crossbred heifers by ipsilateral frozen embryo transfer. AB - Induction of twinning by ipsilateral nonsurgical transfer of frozen two or demi embryos was attempted in 129 virgin dairy or crossbred heifers that had been kept under a stable in our station (group-1), mountain field (group-2) and private farm (group-3) conditions. Ninety seven heifers (75%) were diagnosed pregnant by rectal palpation at 35 to 60 days of gestation; 86 heifers produced 37 sets of twins and 49 single calves. Pregnancy rate of group-1 was lower compared to those of groups-2 and -3 (63%, 88%, 78%, respectively). Abortion and mortality rates of group-3 were significantly lower (P less than 0.05) than those of groups-1 and -2 (8% and 6%, 12% and 16%, 18% and 24%). Twin calves had a lower birth weight (P less than 0.05) than singles. But there was no significant difference in weight between singles and twin calves at 270-330 days of age. Dystocia and difficult delivery were not observed in females producing twins. The incidence of retained placentas in twin calving cows (17%) was higher than that of single calving cows (2%). The interval to conceive postpartum was longer in twin calving cows (95 +/- 41 days) than in single calving cows (87 +/- 26 days). Gestation length was 5.0 days shorter for twin calving cows (P less than 0.05). PMID- 2761149 TI - Transport of spermatozoa in the reproductive tract of the bitch: observations through uterine fistula. AB - Using unilateral uterine fistulas, the time required for spermatozoa to reach the end of the fistula after natural mating, artificial insemination (AI) in a normal standing posture (NP), and AI standing on the head (SH) was investigated in each of three stages of estrus. Conceptivity in these bitches was also investigated. Five experimental bitches were tested during a total of 8 estrous periods. The results are as follows; the time required for spermatozoa to reach the end of the fistula was almost the same in the early and middle stages, i.e., 30 sec to 1 min after natural mating and SH and less than 2 min for half the bitches in NP, although no intrauterine transport could be observed in the other half. In most cases of mating during the late stage no spermatozoa were found after any of the 3 methods of insemination. Five animals became pregnant in these experiments, but the other three failed to conceive. The implantation of fertilized ova occurred also in the fistulated uterine horn in all cases of pregnancy. PMID- 2761150 TI - Quantitative and morphological studies on the influence of zinc deficiency on the liver of pregnant rats. AB - The effect of zinc deficiency on trace metals in the liver, spleen, kidney, pancreas and duodenum was investigated in the control and zinc-deficient rats at 17 days and 20 days of pregnancy. Zinc-deficient rats fell into limosis after 5 days of pregnancy. The contents of zinc, iron, copper and manganese in the maternal tissues were measured by colorimetry with 5NPPF. The morphological changes of the liver were observed by light and electron microscopy. The contents of zinc in the pancreas and duodenum were less in the zinc-deficient group than in the control at both 17 days and 20 days of pregnancy. The contents of the copper and manganese in the liver, kidney, pancreas, duodenum and spleen, however, were not significantly different from the control. The contents of iron in the liver, spleen and kidney in the deficient group increased greatly at 17 days and 20 days of pregnancy compared with the control group. The combination rate of transferrin with iron also increased significantly in the deficient group. Staining with Berlin blue or Turnbull's blue showed intense reaction to iron around the interlobular connective tissue of the liver in the zinc deficient group at 20 days of pregnancy. Ultrastructurally, the liver of the zinc-deficient rats showed the decrease of glycogen granules and increase of lipid-like granules and lysosomes with various sizes and electron densities. These findings suggest that zinc deficiency causes the increase of iron contents in the various organs during pregnancy, and that there is an intimate interrelationship between zinc and iron in the metabolism of iron during pregnancy. PMID- 2761151 TI - Influence of autonomic nervous activity on variations in the R-R intervals in adult goats. AB - We used a heart rate memory apparatus to measure 2047 successive R-R intervals with an accuracy of 10 msec in adult goats. For 100 successive stationary R-R intervals out of the 2047 intervals, the R-R intervals sequence was recorded graphically and the means and standard deviations (SD) were calculated. The magnitude of the variation in the R-R intervals was represented by the SD. The usefulness of the analysis of R-R intervals as an indicator of autonomic nervous activity was determined. The diagram of 100 successive R-R intervals at rest showed a conspicuous periodic fluctuation. After the administration of atropine, atropine plus propranolol or after feeding, the R-R intervals were markedly shortened and the variations in the R-R intervals were abolished. After the administration of propranolol only, the R-R intervals were prolonged and the amplitude of the fluctuations in the R-R intervals was conspicuously increased. The respiration curve and the variation in the R-R intervals at rest fluctuated in periodic synchrony. A positive correlation between the mean and the SD of the R-R intervals was highly significant. This indicates that the variations in the R R intervals in the adult goats are closely related to autonomic nervous activity and that the analysis of the R-R intervals is suitable for the noninvasive assessment of autonomic nervous activity. PMID- 2761152 TI - Implication of coprophagy in pathogenesis of chicken botulism. AB - Oral administration of 1 x 10(7) viable spores of Clostridium botulinum type C killed the chickens kept on a board floor to allow them coprophagy, whereas the same dose of the spores failed to develop symptoms in those kept on a wire-net floor not to allow them coprophagy. Type C toxin was detected in the cecal droppings of the chickens of both the groups after feeding the spores and also in serum of symptomatic as well as asymptomatic chickens kept on a board floor. Thus, coprophagy, by which chickens ingest type C toxin (C1 L toxin) and the bacterial cells, seems to be a prerequisite for development of chicken botulism. PMID- 2761153 TI - Identification of feline herpesvirus type 1-hemagglutinin. AB - The crude hemagglutinin of feline herpesvirus type 1 (FHV-1), solubilized from infected fcwf-4 cells by detergents, was partially purified by three kinds of chromatographic methods. Lectin-affinity chromatography showed the hemagglutination (HA) activity in fractions, which was bound to Concanavalin A sepharose and then eluted by alpha-methyl D-mannoside, suggesting that the hemagglutinin might include a glycoprotein. Ion-exchange and gel-exclusion chromatographies were also capable of purifying the detergent-soluble crude hemagglutinin. When peak HA fractions, which were obtained from each of the three procedures, were analyzed by sodium dodecyl sulfate-polyacrylamide gel electrophoresis, the gel-exclusion chromatography was the most effective method. Electrophoreic analysis also showed only one band of 59,000 (59K) molecular weight protein, which was commonly observed in the three partially purified hemagglutinins with silver staining. In addition, the 59K protein band was clearly recognized in immunoblot analysis of the infected cell lysates using infected cat serum. These observations suggest that the FHV-1 detergent-soluble hemagglutinin from infected fcwf-4 cells may be closely related to a 59K immunogenic glycoprotein. PMID- 2761154 TI - Evidence for transuterine migration of embryos in the domestic cat. AB - A total of 169 pregnant cats presented for ovariohysterectomy were examined for the number of corpora lutea (CL) and the number of fetuses per uterine horn. The implantation rate and the frequency of occurrence of transuterine migration of embryos were calculated. The average number of CL was 5.6 +/- 1.9 (mean +/- SD; range, 2-11), the average number of fetuses was 4.5 +/- 1.4 (range, 1-8) and the average implantation rate was 84 +/- 20%. Transuterine migration occurred in 69/169 cats (40.8%). In animals with a 100% implantation rate, transuterine migration occurred in 50/84 cats (59.5%). The number of embryos that migrated ranged from 1-3 per animal and embryos moved from the uterine horn ipsilateral to the ovary with the larger number of CL in 66/69 cats (95.7%). As a result of transuterine migration, the difference in the number of fetuses between uterine horns as compared with the difference in the number of CL between ovaries was smaller in 54 casts (78.3%), unchanged in 8 cats (11.6%) and larger in 7 cats (10.1%). These results indicate that cats tend to equalize the number of fetuses between uterine horns by transuterine migration of embryos. PMID- 2761155 TI - Clinical studies on bovine autumnal conjunctivitis in Japan. PMID- 2761156 TI - Membrane fluidity of equine, bovine and canine lymphocytes during stimulation with concanavalin A. PMID- 2761157 TI - In vitro cultivation of newly excysted metacercariae of Japanese Fasciola sp. PMID- 2761158 TI - Effect of high temperature and humidity in the periovulatory phase on swine ovarian function. PMID- 2761159 TI - Effect of dihydroheptaprenol on nitroblue tetrazolium reduction by swine alveolar macrophages. PMID- 2761160 TI - Adenomatous papilloma of the uterine tube (oviduct) fimbriae in a dog. PMID- 2761161 TI - Age dependency of hematological values and concentrations of serum biochemical constituents in normal beagles from 1 to 14 years of age. PMID- 2761163 TI - The calamity of so-long life. PMID- 2761162 TI - Superoxide dismutase, glutathione peroxidase, and catalase activities in equine erythrocytes. PMID- 2761164 TI - When manners matter most. PMID- 2761165 TI - Therapy of multiple sclerosis. PMID- 2761166 TI - Multiple sclerosis presenting as an intramedullary cervical cord tumor. AB - We report a case of a 21-year-old white woman with a three-week history of rapidly progressive paresis and paresthesias of her extremities presenting as an intramedullary cervical cord lesion. Computer-assisted tomography and magnetic resonance imaging demonstrated a normal brain with a cervical cord enlargement suggestive of a primary spinal cord tumor. Her neurological deficits progressed despite dexamethasone; hence, laminectomy was performed with open biopsy of the cord lesion. The pathological specimens were sent to the Mayo Clinic and Kansas University for cell-type determination, due to their bizarre morphology. Both institutions concluded the biopsy specimens were demyelinated axonal plaques consistent with multiple sclerosis. This case illustrates that demyelinating disease can mimic spinal cord tumor, even with MRI scanning. Multiple sclerosis is a chronic demyelinating disease of the central nervous system. The clinical diagnosis requires documentation of lesions occurring on more than one occasion and at more than one site in the central nervous system. To improve the accuracy of the diagnosis of multiple sclerosis, spinal fluid analysis, visual and auditory evoked responses and radiologic imaging have been proposed. We report a patient with multiple sclerosis who presented with symptoms and physical findings suggesting a primary cervical cord tumor. Localized enlargement of the cervical cord was documented on magnetic resonance imaging. This is the first reported description of histopathologically confirmed spinal cord demyelination presenting as an intramedullary cervical cord tumor. PMID- 2761167 TI - Use of a special binaural hearing test to detect multiple sclerosis. PMID- 2761168 TI - Criteria for cardiac catheterization. PMID- 2761170 TI - An anonymous heroine. PMID- 2761169 TI - Nurses: heroes in action. PMID- 2761171 TI - [The current status and place of open surgery in treating urolithiasis]. AB - Within the concept of treatment of urinary calculosis, open surgery still occupies a firm place. At present, however, the indications for open surgical interventions have been considerably narrowed, and only a small group of patients with urinary calculosis are subject of open surgery, which requires experienced operators and special instruments for optimally sparing performance of the operation. Often intraoperative echography makes useless the application of intraoperative hypothermia and intraoperative X-ray diagnosis. PMID- 2761172 TI - [Fiber gastroscopy in the diagnosis of gastroduodenal diseases and of primary cancer of the gastric stump in particular]. AB - Data available in the literature are adduced and personal experience recorded with 5930 fiber gastroscopies, leading to the conclusion that fiber gastroscopy is a valuable method for diagnosis of diseases of the upper part of the gastrointestinal tract. Some aspects of primary cancer of the gastric residue and its inevitable accompanying pathology--the gastroduodenal reflux--are discussed, analyzing 313 fiber gastroscopies of patients, who had undergone in the past gastric resection for benign diseases. The authors adduce motives for the need of periodic fiber gastroscopic control of operated patients, aimed at early prophylaxis of primary cancer of the gastric residue. The need of regular medical control on these patients is also emphasized. PMID- 2761173 TI - [Inflammatory processes of the breast]. AB - Results are reported of a statistical study of the inflammatory processes in the mammary gland, based on data of the biopsy files at the Department of Pathology of the Research Medico-Biological Institute in Sofia for the period 1981-1985. Among 1498 biopsy specimens examined during this period, there were 27 cases of mastitis (1.8 per cent: 5 acute mastitis, 12 chronic diffuse, 10 granulomatous (one of them tuberculous), 2 lipogranulomas and 7 foreign type granulomas. Mean patient age was 45 years. Recognition of nonspecific inflammatory processes in the mammary gland is no problem for the experienced pathologist. Of major important is the evaluation of granulomas with the presence of necrosis, epithelioid and Langhans type giant cells for early diagnosis of such grave disease, as tuberculosis. PMID- 2761174 TI - [Acute obstruction of the mesenteric vessels--a diagnostic and therapeutic problem]. AB - Analysis was made of 175 patients treated for acute obstruction of the mesenteric vessels. The incidence was higher in males (male/female ratio = 2.5/l) and in winter--62 per cent of the cases. An the basis of thorough analysis of the most common diseases responsible for thrombus formation and thromboembolism and the basic symptoms in the clinical picture, ad ot table was elaborated for early diagnosis of acute obstruction of mesenterial vessels, enabling to take quick decision even without angiography. The level of obstruction in 57 per cent of the patients was in the stem of the mesenterial arteries; conclusion is hence made that, when possible, only reconstructive vascular operation associated or not with intestinal resection, will lead to permanent cure. Of all 175 patients in this series, 81 (46.5 per cent) were operated and 68 of them (83.9 per cent) died; only 13 survived (16 per cent). All of the unoperated 94 patients (53.5 per cent) died. Hence, a total of 162 patients died (92.6 per cent) and 13 survived (7.4 per cent). PMID- 2761175 TI - [Early adhesive ileus]. AB - For a period of eight years 158 patients with adhesive ileus, 23 of whom (14.6 per cent) with early adhesive ileus, have been treated at the surgical clinics of the Pazardzhik branch of the Higher Medical Institute in Plovdiv. Most frequently intestinal obstruction occurred after appendectomy--43.5 per cent of the cases. In 69.6 per cent of the patients it developed until the end of the second week. In five patients conservative treatment was effective. The other 18 patients were operated, with case fatality rate 16.7 per cent. PMID- 2761176 TI - [Surgical treatment of decubital wounds in the trochanteric area]. AB - A technique for operative treatment of decubital wounds in the trochanteric area is described. Skin-muscle flap from m. tensor fasciae latae is used. The characteristics of this type of wounds--significant bacterial invasion, involvement of trochanter major in the inflammatory process and well developed fibrous capsule--are taken into consideration. M. tensor fasciae latae is used as being most suitable for covering such defects. The stages of the operation are consecutively described: planning of the operation, cavity tamponade with gauze plug with suture ligatures, total excision, resection of trochanter major in case of inflammatory changes and formation and transposition of the skin-muscle flap. PMID- 2761177 TI - [Our experience in treating sub crustam skin burns]. AB - Alcoholic solution of chlorhexidine and methylene blue was used in 64 patients for local treatment of burned skin surfaces. The wounds healed under the crust, formed from denatured and desiccated fibrin coats and necrotic tissues. The two antiseptic agents (chlorhexidine and methylene blue) provided long-term antibacterial effect. The results were encouraging; epithelialization of rather deep burns was shortened by 4 or 5 days. PMID- 2761178 TI - [The effects of epidural analgesia on humoral immunity in patients undergoing transurethral resection]. PMID- 2761179 TI - [Anesthesia by percutaneous technics]. PMID- 2761180 TI - [Postoperative sclerosis of the bladder neck in men]. AB - Postoperative sclerosis of the bladder neck is an operative complication after removal of prostate adenoma. It was originally described by the American urologist Danslow in 1918. Personal experience is recorded in the diagnosis and treatment of 43 patients with postoperative sclerosis of the bladder neck for a period of four years. They have been treated at the Department of Urology of the Medical Academy in Sofia. Some basic methods of diagnosis of postoperative sclerosis of the bladder neck are discussed; transurethral methods of treatment- TUR and TUI--are considered the methods of choice. The postoperative results are based on the patients' complaints, on the amount of residual urine and on uroflowmetry. PMID- 2761181 TI - [The results in 7 cases of Marion's operation]. PMID- 2761182 TI - [1-step endoscopic laser papillosphincterotomy with endoscopic biliary drainage]. AB - Two patients with obstructive jaundice are presented. They had cancer of the large duodenal papilla and choledocholithiasis with edema and deformity of the papilla. Endoscopic laser papillosphincterotomy with "Nd-YAG" laser and one-step endoscopic biliary drainage--endoprosthesis of the common bile duct and naso labial drainage, respectively--were performed. The importance of laser papillotomy in patients, in whom electropapillotomy can not be accomplished or will not give satisfactory results, is emphasized. Analysis is made of the periodic medical literature on this problem. Report is made for the first time on combining two endoscopic methods--laser photocoagulation and endoprosthesis in benign and in malignant stenoses of the papilla, realized in one act. PMID- 2761183 TI - [Reconstruction of large facial and neck defects with skin-muscle flaps]. AB - Operative interventions for malignant neoplasms and other large tumors in the facial-maxillary area produce large defects, which require reconstruction for functional and esthetic purposes. Arterialized skin-muscle flaps furnish reliable opportunities for reconstructions, as they are more resistant to the unfavourable conditions after radiation treatment and have functional and esthetic advantages over skin plasty and the plasty with Filatov's stem. Three patients with malignant neoplasms in the facial-maxillary area are reported. Reconstruction was accomplished with skin-muscle flaps m.latissimus dorsi and m.pectoralis major. PMID- 2761184 TI - [A case of chemical burns of the tracheobronchial tree in childhood]. AB - A rare case of chemical burn of the tracheobronchial tree with powdered NaOH in a child is reported. In the course of the disease there were several periods of acute respiratory failure (ARF), requiring respiratory resuscitation with intubation, mechanical ventilation, aspiration and kinesitherapy. The chemical burn was followed by several hours of imaginary well-being, but subsequently pulmonary edema developed. On the fifth day obstruction of the air passages by secretions and mucosal hyperemia led again to acute respiratory failure. On the 15. day bleeding from the mucosa of the respiratory and gastrointestinal tracts developed, which incited again ARF. Such periodic deteriorations, leading to ARF after chemical burns, have been reported in the literature. They require recurrent respiratory resuscitation of different degree and form. Knowledge of these period in the pathologic process, leading to ARF and the adequate respiratory resuscitation are prerequisite for a favourable outcome of the morbid process. PMID- 2761185 TI - [Acute hemorrhagic-necrotic pancreatitis complicated by perforation of the choledochus]. PMID- 2761186 TI - [Myxoliposarcoma on the abdominal cavity]. PMID- 2761187 TI - [Carcinoma of the bifurcation of the common hepatic duct]. PMID- 2761188 TI - [Radiotherapy in (localized) non-Hodgkin's lymphoma of the orbit]. AB - Orbital NHLs are rare and manifest themselves primarily in localized stages. The value of radiotherapy is discussed, reviewing retrospectively the treatment results obtained in 41 patients irradiated for orbital NHL between 1958 and 1966. All were histologically verified. There were 15 lymphomas of low and nine of high malignancy according to the Kiel classification. Among the 17 remaining patients, 15 cases had been classified as reticulum cell sarcoma and two as lymphosarcoma. Fourteen cases were in stage IE, 19 in stage IIE, and eight in stage IIIE/IVE. After surgical biopsy (n = 25) or resection (n = 5), megavoltage irradiation was delivered in conventional fractionation from 20 Gy up to a total dose of 50 Gy. During the last decade treatment has been based on CT scans and corresponding computer assisted treatment planning. Clinically, complete remission was achieved in 13 out of 14 patients (93%) with stage IE, in 17 out of 19 patients (90%) with stage IIE, and in five out of eight patients (63%) with stage IIIE/IVE. The nonrecurrence rate is 65% (10 out of 14) for stage IE and 75% (13 out of 17) for stage IIE after a mean follow-up time of 36 months. As regards lymphomas of low and high malignancy, the nonrecurrence rate is 89% and 43% respectively. Recurrence (n = 8) and dissemination (n = 6) occurred only twice more than two years after radiotherapy had been discontinued. The incidence of side effects was low. Two patients developed a "dry eye." In two eyes the lens had to be removed because of progressive cataract. Radiotherapy with individual treatment planning based on CT scans is the curative treatment of choice fo localized orbital NHL. PMID- 2761189 TI - [BVDU therapy in herpes corneae]. AB - The authors report on the results of therapy with 0.1% BVDU eye drops in a pilot study involving 80 patients suffering from stellate, dendritic, and geographic keratitis. Tolerance of this drug was very good. Healing occurred in 66 patients (82.5%) within 14 days. In these patients re-epithelialization was complete after an average of 5.4 days. In 13 patients (16.3%) the lesion took more than 14 days to heal (mean 18.2 days). The therapy must therefore be considered as having failed in these cases. In one patient (1.2%) the treatment had to be discontinued, as his condition deteriorated during treatment with BVDU. PMID- 2761190 TI - [The effect of lens haptics on postoperative anterior chamber depth in PMMA posterior chamber lenses]. AB - In two groups of patients with two different posterior chamber intraocular lenses, very different correlations were found between postoperative and calculated anterior chamber depth, and between postoperative anterior chamber depth and axial length. Since it has long been known that there are positive correlations between anterior chamber depth and axial length in phakic patients, while on the other hand (according to many authors) these correlations seem to disappear in pseudophakic patients, and since the present authors found these positive correlations only in patients with one type of implant, they ascribe these differences between similar implants to the geometric configurations of the lens loops. In lenses with modified J-loop designs the optical zone might be dislocated backward when the lens is compressed, while lenses with C-shaped seem to suffer only minimal dislocation or none at all. The importance of this phenomenon in relation to individually different diameters of the eye and different localizations of lens loops, depending on implant technique, are discussed. PMID- 2761191 TI - [Pallor of the optic papilla--an early sign of glaucoma. A clinical controlled study of optic disk pallor and papillar cupping in glaucoma simplex, ocular hypertension and normal eyes with the optic nerve head analyzer]. AB - Double examinations of 99 eyes (34 healthy, 12 with ocular hypertension, 53 with primary open-angle glaucoma) were performed with the Optic Nerve Head Analyzer to evaluate whether an increase in disk pallor or in the cup-disk ratio (CDR) is the earlier sign of glaucoma. In eyes with primary open-angle glaucoma the CDR and the mean optic disk pallor value are significantly higher than in healthy eyes. There is no significant difference in the CDR of patients with ocular hypertension as compared to normals. However, the mean pallor value is significantly higher in eyes with ocular hypertension than in healthy eyes. Therefore, an increase in pallor may precede a significant increase in the CDR or detectable visual field defects. PMID- 2761192 TI - [The retinal nerve fiber layer in normal eyes and in glaucoma. I. Semiquantitative data of 398 eyes with glaucoma]. AB - Atrophy of the optic nerve is associated with changes of the retinal fiber layer (RNFL). Using red-free photographs the authors examined the RNFL of 398 eyes with chronic primary open-angle glaucoma and compared it with the RNFL of 234 normal eyes. The glaucoma group was divided into five stages and the fundus into four sectors. Differences between the normal and glaucoma eyes were: (1) The sequence of the sectors, with regard to the best visibility of the retinal nerve fiber bundles, was changed. In the normal eyes the nerve fiber bundles were most often best visible in the inferior temporal sector, followed by the superior temporal sector, the temporal horizontal area and finally the nasal region. In the glaucoma group the nerve fiber bundles were significantly more often best detectable in the superior temporal sector and the temporal horizontal area. (2) The degree of visibility of the retinal nerve fibers decreased significantly with increasing glaucoma stage. (3) Localized defects were seen in 15% of the eyes with glaucoma and none of the normal eyes. The specificity of this qualitative parameter was, therefore, 100%. The defects were found most often in the superior and inferior temporal regions. These differences between normal and glaucomatous eyes were also significant for the first glaucoma stage of this study. The localization of the foveola below the optic disk center (0.53 +/- 0.34 mm in the glaucoma group and 0.55 +/- 0.29 mm in the normal eyes) was not significantly different. PMID- 2761193 TI - [Damage to the corneal endothelium following exposure to sulfur hexafluoride gas]. AB - Damage to the corneal endothelium caused by sulfur hexafluoride was analyzed in 14 rabbits. Fourteen eyes were used for testing, while the other 14 served as controls. Three stages of endothelial reaction resulting from long-term contact with sulfur hexafluoride were established by morphologic and morphometric analyses. The first stage - acute necrosis of the endothelial cells - covers all stages of destruction up to total obliteration in the exposed area of the endothelium, which is clearly demarcated from the rest of the endothelium. The second, repair stage, begins as early as 24 hours after the operation and includes the diverse forms of endothelial cell spread, transformations of the hexagonal endothelial cells, and endothelial cell migration with polymorphia and formation of rosettes. The third, proliferative phase of the endothelial cell reaction follows directly after the second phase and is characterized by the production of more giant cells, the production of giant rosettes, compaction of cell membranes and filling of the intercellular space with amorphous substances. The results of this research are of major practical relevance, since they show that a 40/60% sulfur hexafluoride/air mixture cannot be regarded as inert. PMID- 2761194 TI - [Acanthamoeba keratitis--a too seldom diagnosed disease?]. AB - Acanthamoeba keratitis has become a difficult diagnostic and management problem in contact lens patients over the last few years. A young female contact lens wearer presented with a long history of painful central corneal ulcer. The suspected diagnosis of Acanthamoeba keratitis could only be confirmed by histology and electron microscopy following penetrating keratoplasty. Special stains of scrapings and culture of material on special media failed to establish the diagnosis. This rare (or underdiagnosed?) infection must be considered in the differential diagnosis of keratitis following contact lens wear. PMID- 2761195 TI - [Acute psychosis caused by poisoning with cyclopentolate]. AB - The authors report on a 17-year-old female patient who suffered an acute psychotic attack after local application of cyclopentolate 1.0% in both eyes. The literature is reviewed with regard to systemic side effects of local application of cyclopentolate. Toxicity of cyclopentolate may be found in every age group even if tolerated without side effects before and it has no specificity for patients with certain (especially brain) diseases. The rapid short-term cycloplegic effect and the rare cases of systemic toxicity support the authors opinion that cyclopentolate is a very useful and well-tolerated diagnostic substance. PMID- 2761196 TI - [An alternative measuring procedure to the simultaneous prism cover test]. AB - The simultaneous prism cover test is frequently used for measuring a manifest squint angle. In this paper an alternative method for measuring a manifest squint angle is described. While a subject fixes on a fixation object in near or far position, one eye illuminated from below with a collimated visible light beam. The light source is mounted on a holder which can be rotated around a vertical axis. The examiner observes the light reflexes of the anterior surface of the cornea and the posterior surface of the lens in the patients pupil and turns the holder until the images lie on a vertical line. In this case the direction of the incident light beam, which is determined by the position of the holder, and the direction of the optical axis of the eye coincide. For example, by measuring before and after covering, the difference in the measured light directions is the manifest squint angle, as determined by the simultaneous prism cover test. PMID- 2761197 TI - [Nursing care of the aged. II. Rehabilitation nursing for the early stage of hemiplegia]. PMID- 2761199 TI - [Airway management]. PMID- 2761198 TI - [Intermittent i.v. therapy with heparin lock]. PMID- 2761200 TI - [Rehumanizing maternal-child nursing]. PMID- 2761201 TI - [A case study of postoperative nursing care of a patient with subdural hematoma]. PMID- 2761202 TI - [Nursing care of the aged. II. Early stage nursing intervention of the cerebrovascular accident elderly patient]. PMID- 2761203 TI - [A study on the public health status for industrial safety at Kwang Ju Gun, Sun Nam City in Korea]. PMID- 2761204 TI - [Elderly health problems. Management and solutions]. PMID- 2761205 TI - [Objectives and tasks of projects of the medical laboratory in space "Medilab"]. AB - This paper discusses goals and objectives of the Soviet project to build a space medical laboratory "Medilab". Special attention is given to the design, structure and mathematical support of the dedicated biomedical laboratory. PMID- 2761206 TI - [Information interaction of the man-aircraft system as a problem in aviation medicine]. AB - The importance of psychophysiological optimization of information interaction in the man--flying vehicle system is discussed having in view maintenance of good health and enhancement of efficiency and reliability of pilots. Several examples are presented that show the necessity of taking into consideration psychophysiological mechanisms, which regulate pilot's activities, in order to develop modified methods of information presentation and display. PMID- 2761207 TI - [The first experience using soft contact lenses during long-term space flights]. AB - During a long-term flight on Salyut-7 and Mir orbital stations a contact lens was used for the first time in order to correct mild ametropia of one of the crew members. He used a soft contact lens for 5 hrs on flight days 10, 30, 45 and 60. As a result, acuity of vision of the treated eye increased to 1.5. This study showed that contact lenses can be employed in space flight. PMID- 2761208 TI - [Reaction of the cardiovascular system to static load after changes in body position]. AB - Cardiovascular responses of healthy male subjects to static loading in the horizontal, orthostatic and antiorthostatic positions were investigated. The body position was found to affect significantly both the sign and magnitude of circulation parameters. It was also shown that static loading tolerance was lower in the orthostatic than in the antiorthostatic position. It was hypothesized that the complex mechanism of adaptation to static loading involves purely physical factors (obstruction of small arterial vessels and blood discharge from veins of the strained muscle), central, intermediate and local reflex mechanisms. Resistance vessels play a predominant role in limiting systemic arterial pressure in the orthostatic position. Of greated importance in the horizontal position is venous blood pooling limiting its return to the heart. Rearrangement in hemodynamics during static loading is accompanied by an increase in the effective coronary blood flow which is the greatest in the orthostatic position. PMID- 2761209 TI - [Measurement of the temperature of deep-seated tissues in healthy men during hypokinesia]. AB - During a head-down tilt (-5 degrees) study, in which 10 healthy male subjects took part, their body temperature variations were investigated. Skin temperature was measured using and electrothermometer with a point sensor-thermistor and core temperature was measured using a radiothermometer at the wavelength 20 cm. The study showed that the distribution profile of core temperature was close to that of skin temperature: the lowest temperatures were characteristic of the limbs and the highest of the chest, stomach and head. During head-down tilt variations in core temperatures were different from those of skin temperature. As a result, the temperature gradient between the skin and core layers increased by bed-rest day 50. In the subjects who regularly exercised during bed rest the gradient grew because their skin temperature fell while in the subjects who did not exercise the gradient increased due to both factors, i.e. skin temperature decrease and core temperature increase. PMID- 2761210 TI - [Morphometric analysis of aortic endothelium and serum lipoproteins in rats during readaptation after 15-day hypokinesia]. AB - On hypokinesia day 15, the serum concentration of beta-lipoproteins increased and that of alpha-lipoproteins decreased, and the aortic endothelium was damaged. During the recovery period, the amount of pre-beta-lipoproteins was normal. After hypokinesia the concentration of alpha-lipoproteins increased and returned to normal by the 10th day while that of beta-lipoproteins remained lower for a long time. During the recovery period the number of endothelial cells showing karyopyknosis and karyolysis was increased. At later recovery-periods, the surface area of endothelial cells and their cytoplasm increased and the nucleus/plasma ratio decreased. However, lesions in the structure of the endothelial layer were less expressed than during hypokinesia. In the recovery period, the number of binuclear cells and the number of mitoses grew suggesting greater activity of regeneratory processes. PMID- 2761211 TI - [Physiologic reactions to electric stimulation of the labyrinth]. AB - Physiological responses to electric stimulation of the skin projections of labyrinths on the outer ear were investigated. The experiments were carried out on 56 test subjects using electric current in the range of 20 microA to 1.5 mA with the frequency 0.2-0.5 Hz. Thresholds for the emergence of autonomic, somatomotor and sensory manifestations were detected. It was found that autonomic reactions may develop independently of somatomotor responses. It is postulated that autonomic, motor and sensory reactions to electric stimulation of labyrinths constitute a combined response which is of afferent vestibular and skin origin. PMID- 2761212 TI - [Possibility of the development of decompression sickness during testing of G suits]. AB - This paper presents the results of 1179 altitude chamber tests of special suits performed by 193 subjects. The probability of altitude decompression disease observed during 29 experiments (2.5%) in 26 test subjects (13.4%) is calculated. The safety of decompression tables is evaluated as applied to the pressure 14-43 kPa after oxygen breathing for 0.25-2 hrs at sea level or for 1-6 hrs at 40 kPa. PMID- 2761213 TI - [Changes in the maximum permissible supersaturation coefficient in altitude decompression]. AB - This paper presents experimental data obtained during 383 altitude chambers tests in which 70 subjects participated. The purpose of the tests was to verify experimentally the safety of altitude decompression regimens that simulated transition from the orbital station atmosphere at a normal barometric pressure to the space suit oxygen atmosphere at a lowered pressure. The results help better understand correlations between the maximal allowable super-saturation coefficient and total postdecompression pressure. PMID- 2761214 TI - [Dynamics of acid-base equilibrium of the blood in humans a long-term exposure to an atmosphere containing acetic acid vapors]. AB - Two experimental series, each of 20 days in duration, were carried out using 8 healthy test subjects, aged 25 to 44 years. The purpose of the experiments was to identify the effect of two different concentrations of acetic acid vapors in an enclosed environment on blood acid-base equilibrium and gases. In both experimental series ambient temperature was increased to 33 degrees C during the last three days of exposure in order to better evaluate the acetic acid vapor effect. The most significant changes in acid-base equilibrium were detected when the vapor concentration amounted to 25 mg/m3. PMID- 2761215 TI - [Recording of intrathoracic pressure in animal experiments]. PMID- 2761216 TI - [Use of hydrogen peroxide and lead oxide for purification of urea-contaminated water]. PMID- 2761217 TI - [Intensification of the process of formaldehyde synthesis as the first stage in producing carbohydrates from wastes]. PMID- 2761218 TI - [Analysis of the informative value of the amplitude and time characteristics of early diastolic complex on the differential thoracic rheogram]. PMID- 2761219 TI - [Cytologic study of spermatogenesis in rats exposed to hypergravitation]. PMID- 2761220 TI - [Comparison of 2 methods of evaluating the paired function of the otolithic apparatus in man]. PMID- 2761221 TI - [Effect of long-term anti-orthostatic hypokinesia on tissue sensitivity to glucocorticoids]. PMID- 2761222 TI - [Mathematical analysis of a concept of the functioning of the cupula of semicircular canals]. PMID- 2761223 TI - A new method of sampling ascitic fluid from rats. AB - A new method of sampling ascitic fluid from rats over a period of at least 8 h in a reliable and easy way is described. The objective was to determine drug concentrations in ascitic fluid after intraperitoneal chemotherapy. Two silicon tubes were implanted into the abdominal cavity, one for drug administration and regulation of pressure, the other enabled ascitic fluid to be withdrawn. PMID- 2761224 TI - CBXC: a set of recombinant inbred strains between CBA/Ca and BALB/c. AB - A new set of nine recombinant inbred strains designated CBXC-1 to CBXC-9 has been developed from a cross between CBA/Ca female and BALB/c male mice. All of the strains have been brother x sister mated for more than 20 generations, and have been characterized at eight electrophoretic, one immunological and two coat colour loci at which the progenitor strains differ. This set of strains should be useful in investigating the genetics of any characters which differ between the two progenitor strains. PMID- 2761225 TI - Use of cage space by guineapigs. AB - Cage space requirements for laboratory animals have been established by Government Regulation and Recommendations. In order to test the adequacy of these space allocations, the use of cage floor area by breeding groups of guineapigs was studied. A computer-coupled video tracking system capable of imaging in low light intensity as well as total darkness was used to determine the average per cent occupancy by guineapigs in all portions of a cage over 12-h light and dark cycles. Simultaneous time synchronized slow motion video recordings permitted an analysis of activity to be coordinated with cage use data. Results of the study revealed that breeding groups of guineapigs utilize the periphery of the cage almost to the total exclusion of the centre of the cage. Approximately 75-85% of all occupancy in both the day and evening hours occurred in 47% of the cage floor area located along the periphery. Analysis of video recordings revealed that the animals remained active throughout the day and night with no prolonged period of quiescence that could be associated with sleep. Results of this study suggest that while guidelines for housing guineapigs based on area allocation per animal can be formulated and are easy to administer, they cannot be supported by the behavioural characteristics of these animals or careful quantitation of their pattern of cage space utilization. PMID- 2761226 TI - Cage design reduces emotionality in mice. AB - To see if a more natural cage design would alter the reactivity of laboratory mice, 192 mice were reared in cages with (1) no dividers, (2) five vertical dividers, (3) nine vertical dividers, or (4) nine vertical dividers and one horizontal platform. The mice preferred the most complex cages, and on almost all measures they were less emotional when reared in the more complex cages. Results suggest that a more natural housing environment would lead to healthier animals. PMID- 2761228 TI - Evaluation of inbred germ-free Fischer 344 albino rats as an experimental model for oral candidiasis. AB - Inbred germ-free Fischer 344 albino rats were evaluated as models for experimental candidiasis in order to investigate bacterial interaction with Candida albicans. Female rats were exposed to C. albicans in their drinking water and killed at intervals from 2 to 22 days after initial contact with the contaminant. C. albicans was cultured from their mouths from day 2 but from day 12 the number of colonies decreased. From day 2 to 9 all rats showed oral histological signs of candidal infestation, but after 9 days the number declined to 3 out of 9 at 22 days. The dorsal surface of the tongue was the best histological indicator of candidal infestation. All the rats had tongue lesions from day 4 to 9, and from day 6 there was also a concomitant localized loss of filiform papillae. The number of rats with all forms of tongue involvement also decreased after 9 days with only 3 out of 9 affected at 22 days. It is concluded that Fischer 344 inbred germ-free rats can be used on a limited scale as a model for candidiasis and bacterial interaction with C. albicans, the dorsal surface of the tongue would be the best site for studying candidal experimental lesions and it is probable that better results can be achieved with complete standardization of contamination and preparation procedures. PMID- 2761227 TI - Ear tag induced Staphylococcus infection in mice. AB - Mice used in a 2-year oral toxicity study developed a progressive, moist dermatitis. The initial lesions were seen around the ears in which metal identification tags had been placed and usually progressed to include the skin of the neck and shoulder. Clinically, the mice were pruritic, lost weight, had rough coats, and became moribund. The predominant finding at necropsy was pale brown kidneys with irregular granular surfaces. Histologically, there was inflammation and focal-to-diffuse necrosis in the visceral organs and affected skin. The predominant organism isolated from the skin, kidneys and heart blood was Staphylococcus aureus. This bacterium is a common inhabitant of the skin of conventionally housed mice and its isolation from the kidneys and blood suggested that the portal of entry was the wound caused by the insertion of the metal ear tag. PMID- 2761229 TI - Naturally occurring erysipelas in rats. AB - Erysipelothrix rhusiopathiae was isolated from the main limb joints of two Sprague Dawley rats affected by spontaneous lesions of chronic fibrinopurulent polyarthritis, endocarditis and mycocarditis. PMID- 2761230 TI - Efficacy of a commercial bacterin in protecting strain 13 guineapigs against Bordetella bronchiseptica pneumonia. AB - Bordetella bronchiseptica is known to be endemic in many guineapig (Cavia porcellus) colonies, and periodically is the aetiological agent of fatal epizootics of bronchopneumonia. A commercial, non-adjuvant B. bronchiseptica bacterin, which is approved for use in canines, was evaluated for induction of a protective immune response in Strain 13/N guineapigs against an airborne challenge of virulent B. bronchispeptica in small-particle aerosol. Seronegative animals were vaccinated on days 0 and 21 with intramuscular injections of 0.2 ml of bacterin. Humoral antibody titres of the vaccinated animals, as determined by ELISA, ranged from 128-1024 on day 49. On day 30 following the second dose of bacterin (study day 51), 12 vaccinated and 12 PBS sham-vaccinated animals were exposed to an inhaled dose of 4.3 x 10(5) CFU of B. bronchiseptica (325 LD50). Vaccinated, challenged animals remained clinically normal, although each guineapig did develop a localized upper respiratory infection. The rate of weight gain as well as rectal temperature of these animals were analogous to those exhibited by the control groups. Examination of 4 of the vaccinated, challenged animals on day 7 after exposure showed bacteria present in moderate to high numbers in the larynx and trachea but only minimally detectable in the lungs; by 30 days after exposure, the numbers of bacteria in the larynx and trachea were diminished, with none being detected in the lungs. Pathological alterations induced by B. bronchiseptica were not detected at either day 7 or day 30 after challenge in any of the vaccinated, challenged animals. Protection induced in Strain 13/N guineapigs by the commercial canine bacterin was sufficient to preclude the development of pulmonary disease, even in animals presented with a massive challenge of virulent bacteria in a small-particle aerosol. PMID- 2761231 TI - A method for catheterization, harnessing and chronic infusion of undisturbed chickens. AB - A system was designed to facilitate the chronic infusion and/or serial blood sampling of rapidly growing, meat-type chickens with little or no stress to the bird. Techniques for surgically preparing an indwelling catheter, fabricating a harness system to protect this catheter, utilizing a miniature fluid swivel to provide free movement and infusing solutions via a programmable pump are described. PMID- 2761232 TI - A mask system for halothane anesthesia of guinea pigs. PMID- 2761233 TI - Duration and patterns of transmission of Theiler's mouse encephalomyelitis virus infection. AB - The duration and patterns of Theiler's murine encephalomyelitis virus (TMEV) transmission were studied in eight index mice inoculated orally. Transmission was monitored by testing for seroconversion to TMEV in sentinel mice in direct contact with index mice and in other sentinel mice in contact with bedding soiled by index mice. For the first 14 weeks after inoculation, two contact sentinels were housed with each index mouse for 1 week, then replaced with two new sentinels. For the remaining 16 weeks, contact sentinels were changed monthly. All index mice transmitted TMEV continuously (weekly) for 4 to 9 weeks. Thereafter, six index mice transmitted virus intermittently. All index mice ceased transmitting TMEV 7 to 22 weeks post-inoculation. Results obtained from sentinel mice in contact with bedding soiled by index mice were 86% concordant with those using contact sentinel mice. Seven index mice were treated with cyclophosphamide or hydrocortisone 30 weeks post-inoculation. One cyclophosphamide treated mouse reinitiated virus shedding. PMID- 2761234 TI - The effects of cage size and pair housing on exercise of beagle dogs. AB - One of the requirements of the 1985 amendments to the Animal Welfare Act is the establishment of an exercise program for dogs. Assumptions have been made by some that larger cages or the presence of a companion animal will motivate exercise. To examine how cage size, pair housing and human contact affect exercise, a study was conducted using a computerized video-data acquisition system that measured distance traveled and time spent moving in 1 x 1 m, (single only) and 1 x 2 m (single and paired) and 1 x 1.5 m cage (paired only) cages. Male beagle dogs (n = 6) housed singly in the 1 m2 cage traveled an average of 55 m/hr spending only 8% (57 min) of the 12 h photo period in motion. When the cage size was doubled, the average distance traveled decreased to 13 m/hr and the time spent moving increased to 11% (77 min/day). When dogs were pair housed in a regulation size cage, the average distance traveled decreased to 8.6 m/hr and they spent less than 6% of the day in exercising (42 min/12 hrs). The greatest amount of exercise was seen when dogs were housed as a pair in a cage less than recommended size (an average of 109 m/hr and 8.8 min/hr). Therefore, these data indicate that larger cages or pair housing in regulation size cages have little or no effect on the activity of purpose bred male beagle dogs. There was, however, a direct correlation between activity, time and distance, and the presence of humans in the animal room.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2761235 TI - Alternative diets for maintaining and rearing cephalopods in captivity. AB - The requirement of live marine prey for cephalopod mariculture has restricted its practicality for inland research laboratories, commercial enterprises and home aquarists. We evaluated acceptability and resultant growth on: (a) frozen marine shrimps, (b) live and frozen marine polychaete worms, (c) live and frozen marine crabs, (d) frozen marine fishes, (e) live adult brine shrimp, (f) live freshwater fish and (g) live freshwater crayfish. The diets were presented for periods of 2 to 11 weeks to octopuses, cuttlefishes or squids and in most trials the results were compared to animals fed control diets of live marine shrimps, crabs or fish. Overall, frozen marine shrimp proved to be the best alternative diet tested. Adult Octopus maya on frozen marine shrimp diets grew as well as those on control diets at 2.8% body weight per day (%/d) compared to 2.0%/d on live freshwater crayfish, 1.4%/d on live marine polychaete worms and 0.8%/d on live freshwater fish (Tilapia sp.). Juvenile Octopus maya and Octopus bimaculoides also grew comparably to controls when fed frozen marine shrimps; growth rates ranged from near 3.0%/d at 3 months of age to nearly 2.5%/d at 6 months of age. Thus, these alternatives are acceptable as the octopuses end their exponential growth phase at an age of 3 - 5 months. Attempts to rear O. maya hatchlings and juveniles (up to 1 month of age) on dead foods resulted in high mortality and slow or negative growth. No live or dead alternative diet has been found yet that will promote good growth and survival in hatchling octopuses. Hatchling F3 generation Sepia officinalis (the European cuttlefish) were reared for 6 weeks exclusively on adult brine shrimp (Artemia salina).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2761236 TI - Mammary gland growth and response to hormones in mastomys compared with mice. AB - Mammary gland growth with or without hormone manipulation was examined in virgin mastomys (Praomys (mastomys) natalensis) and compared with C3H/He mice having a low mammary tumor incidence. Mammary glands of mastomys consisted mostly of duct systems even at 720 days of age, whereas conspicuous formation of normal end-buds and preneoplastic hyperplastic alveolar nodules were seen in the glands of mice after 180 days of age. Mammary glands of mastomys showed a higher response to estrogen or progesterone rather than prolactin, which is much different from other rodents. PMID- 2761237 TI - A new anesthetic agent for use in the gerbil. AB - Gerbils have been neglected in published reports on anesthesia. This study compared several dosages of Telazol used for anesthesia in the gerbil. Each group of animals injected with Telazol was evaluated for onset and duration of anesthesia and analgesia. Results showed Telazol to be a safe anesthetic and when dosed at 60 mg/kg to be suitable for major surgical procedures. Lower dosages of Telazol, in contrast, provided immobility and analgesia suitable for less nocioceptive and noninvasive experimental manipulations. Dosages of Telazol required for surgical depth of analgesia and anesthesia were accompanied by a prolonged recovery time. Gerbils should be monitored closely to insure a safe recovery when using the higher dosages. PMID- 2761238 TI - The effects of single caging on chimpanzee behavior. PMID- 2761239 TI - A simple method for the concurrent stimulation of skeletal muscle in several animals. PMID- 2761240 TI - Long-term catheterization of the rat ureter. PMID- 2761241 TI - Effect of dietary fat on milk protein secretion of lactating rats. PMID- 2761242 TI - Interstitial cell adenoma in a ferret. PMID- 2761243 TI - Multiple spontaneous lesions in an aged spider monkey. PMID- 2761244 TI - Acute pancreatitis in a five-year-old male. AB - Acute pancreatitis should be considered in all children presenting with acute abdominal complaints. A complete history should be obtained with emphasis on recent trauma, infections, current medications, and the presence of any systemic diseases. Simple laboratory studies and non-invasive imaging techniques can usually confirm the clinical suspicion. Most cases of interstitial pancreatitis resolve uneventfully but hemorrhagic pancreatitis carries a significant mortality risk. PMID- 2761245 TI - Marfan syndrome in the parturient. AB - Early recognition of the Marfan Syndrome and knowledge of its potentially lethal complications facilitates successful treatment of these individuals. It is through a joint effort by many specialist physicians such as the obstetrician, cardiologist, and anesthesiologist that these patients can be managed safely through pregnancy, labor, and delivery. PMID- 2761246 TI - Ticks, tetracycline, and backyard terrorism. PMID- 2761247 TI - Cryptococcal meningitis manifested as transient ischemic attacks. PMID- 2761248 TI - Cylindrical battery ingestion: a case of endoscopic retrieval. PMID- 2761249 TI - Tularemia and atypical lymphocytosis. PMID- 2761250 TI - Granular cell tumor of the esophagus. PMID- 2761251 TI - Stroke in an adolescent. PMID- 2761252 TI - How to review your own contracts. PMID- 2761254 TI - Spreading the risk. PMID- 2761253 TI - Managing HIV infection in your clinical practice. PMID- 2761255 TI - Somethin' he et, no doubt. PMID- 2761256 TI - Whatever happened to Prudence? PMID- 2761257 TI - Effects of the antioestrogen, ICI 164,384, on oestrogen induced RNAs in MCF-7 cells. AB - The effects of ICI 164,384 on the expression of six oestrogen-regulated RNAs (pNR 1, pNR-2, pNR-13, pNR-17, pNR-25 and pNR-100) and the 46 kDa secreted protein were measured in MCF-7 cells. In marked contrast to tamoxifen, an antioestrogen commonly used in the treatment of breast cancer, ICI 164,384 administered alone had little or no effect on the RNAs or protein. ICI 164,384 completely inhibited the induction of the RNAs and 46 kDa protein by oestradiol. Although ICI 164,384 has an affinity for the human oestrogen receptor only slightly less than that of oestradiol, half maximal inhibition of oestradiol action was attained with between a 50 and 150-fold molar excess of ICI 164,384. The pNR-1 RNA is induced by tamoxifen but this induction was abolished by ICI 164,384. Thus, ICI 164,384 acts as a potent antioestrogen for the regulation of the expression of specific oestrogen-responsive genes in human breast cancer cells. PMID- 2761258 TI - The presence of a hitherto undefined high-capacity androgen binding macromolecule in human ovarian cancer tissue. AB - Sex hormone binding globulin (SHBG) is known to interfere in the quantitation of androgen receptors (AR) if dihydrotestosterone (DHT) is used. We used a monoclonal antibody to remove SHBG from cytosol. In cytosol of benign prostatic hyperplastic (BPH) tissue low capacity binding for DHT, but not for R1881, was found after removal of SHBG. AR were detected in 18 of 20 ovarian cancer cytosols. In the two AR-negative cases, non-saturable binding for DHT, testosterone and R1881 was observed. Incubation with anti-SHBG did not change this. An hitherto undefined androgen binding macromolecule(s), with high-capacity binding for natural and synthetic androgens, but not for estrogen and progesterone, seems to be present in these ovarian cancer tissues. The functionality of these androgen binding macromolecules in ovarian cancer is yet to be demonstrated. PMID- 2761259 TI - 2-Bromo- and 16-bromo-estrogens and related compounds: potential inhibitors for both estradiol 2- and 16 alpha-hydroxylases in rat liver microsomes. AB - Kinetic studies of inhibition of estradiol 2- and 16 alpha-hydroxylase activities in male rat liver microsomes with 2-bromoestrogens, 4-bromo-estrone (4-BrE1), 16 alpha- and 16 beta-bromoestrones and 16 beta-acetylthioestrone (16-AcSE1) were carried out. 2-Bromoestrogens and 4-BrE1 nonspecifically blocked the two enzyme activities in a competitive manner, and 2-bromo-estradiol (2-BrE2) was the most potent inhibitor for the two hydroxylases among the 2- and 4-bromo steroids. Kinetic data, the apparent Ki's for the inhibitors and the apparent Km's for the substrate E2 in the assay, demonstrate that the A-ring bromo steroids are potent inhibitors for the two enzymes (Ki/Km ranging from 0.28 to 0.48 for the 2 hydroxylation and ranging from 0.26 to 0.49 for the 16 alpha-hydroxylation). In contrast, 16-bromoestrones and 16-AcSE1 non-competitively inhibited the 2 hydroxylation (Ki = ca. 70 microM) while the other was competitively blocked by them (Ki/Km ranging from 0.24 to 0.30). These 16-substituted steroids were very potent inhibitors for the 16 alpha-hydroxylase rather than the 2-hydroxylase and preferentially blocked the former. PMID- 2761260 TI - 18-Substituted progesterone derivatives as inhibitors of aldosterone biosynthesis. AB - The synthesis of new progesterone derivatives substituted at the 18 methyl group is described. These compounds are designed as 18-monooxygenase, cytochrome P-450 dependent potential kcat inhibitors. Preliminary results on the in vitro biological investigation of these modified progesterones are presented. PMID- 2761261 TI - Tamoxifen decreases the estradiol induced progesterone receptors by interfering with nuclear estrogen receptor accumulation. AB - The retention time of the estrogen receptor in the nucleus of target cells after antiestrogen treatment has been shown to be longer than after estradiol. This paper describes the accumulation of nuclear estrogen receptors and the obtention of estrogenic responses (i.e. synthesis of cytosolic progesterone receptors and DNA) in the rat uterus after tamoxifen treatment in the presence or absence of estradiol. One-week ovariectomized adult rats were implanted with a silicone elastomer capsule containing corn oil or 25 micrograms estradiol/capsule (0 h). 48 h after implantation rats were injected with corn oil or 2 mg tamoxifen/kg and decapitated at 72, 96 or 120 h after implantation. In parallel experiments the implants were removed just before the injections of tamoxifen or oil. Tamoxifen injected into rats implanted with oil increased both the occupied nuclear receptors and the progesterone receptors at 96 h. In rats implanted with estradiol, tamoxifen did not increase the occupied nuclear receptors and decreased the levels of progesterone receptor and DNA at 96 h. In rats whose estradiol implants were removed at 48 h tamoxifen did not change the level of occupied nuclear receptors at 72 h but it increased them abruptly at 96 and 120 h. In these rats progesterone receptors decreased at 72 h but they increased at 96 and 120 h, and DNA decreased at 120 h to a lower level than before implantation. The results suggest that when estradiol is acting, tamoxifen is not able to increase the level of occupied estrogen receptor and it acts as an antiestrogen by decreasing the high level of progesterone receptors previously induced by estradiol. When estradiol is not acting tamoxifen behaves as a partial estrogen agonist by inducing progesterone receptors. However, the antiestrogenic action of tamoxifen on the rat uterus DNA does not seem to be affected by estradiol. PMID- 2761262 TI - Testosterone metabolism in neuroendocrine organs in male rats under atrazine and deethylatrazine influence. AB - The inhibitory influence of atrazine and deethylatrazine on testosterone metabolism in male rat anterior pituitary and hypothalamus were studied under in vivo and in vitro experimental conditions. In vivo strong influence of atrazine (12 mg/100 g by wt. daily during 7 days) on 5 alpha-R, 3 alpha- and 17 beta-HSD activities was detected in the anterior pituitary. This dose provokes a significant increase in the weight of the pituitary gland, with hyperemia and hypertrophy of chromophobic cells with vacuolar degeneration. In vivo treatment of male rats with the same dose of deethylatrazine markedly inhibited 5 alpha-R activity in the anterior pituitary. The rate of 5 alpha-R activity inhibition in the anterior pituitary was the same after in vivo treatment with atrazine (37.3%) as with deethylatrazine (33.9%). This could suggest that the mechanism of inhibition of deethylatrazine is similar to that of atrazine. In vitro atrazine or deethylatrazine addition into the incubation medium significantly (P less than 0.01) inhibited 5 alpha-R, 3 alpha- and 17 beta-HSD activities in the anterior pituitary. The inhibition of 5 alpha-R activity was marked more by atrazine than deethylatrazine, while 3 alpha- and 17 beta-HSD activities were inhibited at the same rate. In vivo treatment with the same dose of atrazine or deethylatrazine (12 mg/100 g by wt daily 7 days) significantly inhibited (P less than 0.01) 5 alpha-R and 17 beta-HSD at the male rat hypothalamic level. 3 alpha-HSD activity inhibition was not significant for either compound. The in vitro addition of deethylatrazine was much more effective (P less than 0.01) in inhibiting 5 alpha R, 3 alpha- and 17 beta-HSD in male rat hypothalamus than atrazine. In spite of this, deethylatrazine seems to be less toxic in in vivo experiments due to its higher polarity and faster biodegradation. PMID- 2761263 TI - Estradiol and testosterone metabolism and production in men with prostatic cancer. AB - We recently observed a familial influence on the plasma concentration of sex steroids and the metabolic clearance in men with prostatic cancer. We have now determined, by isotope dilution techniques, the blood estradiol and testosterone production and clearance rates in men with prostatic cancer and in unrelated controls. Thirty-eight men had a diagnosis of prostatic cancer before the age of 63, and 22 controls matched for age were randomly selected from the general population. None of the patients or controls had received endocrine therapy. The plasma content of testosterone, dihydrotestosterone, estrone, estradiol, 3 alpha androstanediol glucuronide, dehydroepiandrosterone sulfate, sex-hormone binding globulin, apparent free testosterone concentration, follicle stimulating hormone and luteinizing hormone were not significantly different between the groups. The metabolic clearance and production rates of testosterone were significantly (P = 0.008 and P = 0.013, respectively) higher in patients [447 +/- 26 L/day/body surface area(m2) and 2.21 +/- 0.17 mg/day/m2, n = 38] than in controls [346 +/- 20 L/day/m2 and 1.70 +/- 0.11 mg/day/m2, n = 22]. The PR and MCR of estradiol were not significantly different between patients with prostatic cancer (n = 19) and controls (n = 12). These results indicate that men with prostatic cancer have elevated clearance and production rates of testosterone without an alteration of estradiol production or clearance. PMID- 2761265 TI - Specificity of steroid binding to testicular microsomal cytochrome P-450. Relation of steroid structure to type-I spectral responses after correction for hydrophobic association with the membrane. AB - On the basis of the concept that steroids accumulate in the lipid phase of endoplasmic reticulum membranes and approach the active sites of steroidogenic cytochromes P-450 from a hydrophobic environment, we describe a procedure that allows calculation of spectral dissociation constants Ks for steroid interaction with testicular microsomal cytochrome P-450 after correction for hydrophobic association of ligand with the membrane. Maximal type-I spectral responses, apparent Ks, and partition into microsomal lipids were determined for 36 steroids, and corrected Ks values were derived from these primary data. Partition coefficients range from 60 to 62,000, and corrected Ks range from 60 microM to 25 mM steroid concentration in the lipid phase. Full spectral properties depend on a side-chain (1-3 carbon atoms) at the C17-position which may be hydrophobic or may bear a 20-oxo or 20 beta-hydroxy, but not a 20 alpha-hydroxy group. Binding constants are especially sensitive towards modifications of ring A structure (aromatization or 5 beta-, but not 5 alpha-reduction) and of the side-chain length. Androgens, with the exception of those bearing a 17 beta-acetoxy or 17 beta-propionyloxy group, are poorly accommodated by this cytochrome P-450. PMID- 2761264 TI - 125I-ligand for progesterone receptor: 17 alpha-(6'-iodohex-1'-ynyl)-19 nortestosterone. AB - Progesterone receptor (PgR) is known to be a significant indicator of hormone dependency of a breast tumor and also an important prognostic factor for recurrence and survival. Relatively low specific activity of tritium-labeled ligands makes it difficult to detect the presence of PgR in very small specimens and in specimens with low PgR content. We therefore undertook the synthesis of a radioiodinated progestin. We have synthesized unlabeled 17 alpha-(omega-haloalk 1'-ynyl)-19-nortestosterones with 4, 6, and 8 carbon side chains; these have high affinity for PgR and clear potential for conversion to a 125I form. Since the six carbon side chain analogue had the highest relative PgR affinity (38% of the affinity of R5020, using PgR from T47D human breast cancer cells), it was selected for preparation of the 125I form by radiohalogen exchange of a omega bromoalkynyl precursor with carrier-free Na125I. This new ligand was found by Scatchard analysis to have a Kd of 0.47 nM, as compared with [3H]R5020 at 0.22 nM and [3H]progesterone at 2.0 nM. (For affinity studies, all ligands were diluted in dimethylformamide and added to PgR-containing T47D cytosol to give a final DMF concentration of 4%, in order to prevent R5020 and the test compounds from binding nonspecifically to proteins and glass/plasticware.) The new 125I-ligand showed very little instability when stored in ethanol at approximately 10 degrees C even for several months. Thus, 17 alpha-(6'-[125I]iodohex-1'-ynyl)-19 nortestosterone should prove to be a useful ligand for high sensitivity PgR assays. PMID- 2761266 TI - Quantification of estrogen- and progesterone receptors from cryostat sectioned human tumor tissue: comparison of ligand binding and immunocytochemical assays. AB - We have recently described an assay procedure to measure estrogen and progesterone receptors in extracts from frozen sections by a ligand binding assay. With this methodological approach it is now possible to perform comparative experiments not only to DCC/Scatchard analyses from different tissue blocks, but also to immunocytochemical determinations in identical tissue blocks: (1) When receptor quantities measured by the two biochemical methods were compared, a high correlation of estrogen receptor content was found between determinations in supernatants from frozen sections and DCC/Scatchard analyses. A slightly poorer correlation in the comparison of the ligand binding assays was obtained for the progesterone receptor. (2) The percentage of tumor cells stainable by immunocytochemistry for estrogen and progesterone receptors could hardly be correlated to the receptor concentrations (fmol/mg) measured quantitatively by the two ligand binding assays. (3) As the final result tumor specimen could be grouped into classes of receptor status according to the presence or absence of a nuclear stain in immunocytochemical assays or according to receptor concentrations above or below distinct threshold which were fixed at 20 fmol/mg for Scatchard analyses of both receptor species, 20 fmol/mg for estrogen- and 40 fmol/mg for progestin receptors for the assay with sections. In this diagnostical consideration the concordance of both biochemical methods to the immunocytochemical assessment was high for estrogen and less pronounced for progesterone receptors. (4) In some breast cancer specimen analyzed biochemically an unspecific progestin binding component could be detected superimposed on the progesterone receptor peak after isoelectric focusing. PMID- 2761267 TI - Effect of androgen pretreatments at adulthood on androgen-induced proliferative response of seminal vesicles in neonatally castrated mice. AB - Male mice were castrated on days 0 and 60 after birth. The majority of the neonatally castrated mice were pretreated with androgen; the mice were given daily injections of testosterone propionate (TP; 4 or 8 micrograms/g body wt) for 20 or 30 days starting from day 60. Daily injections of TP (4 micrograms/g body wt) to examine androgen-induced proliferation were started from day 30 or 60 after the end of TP pretreatments or from day 60 after castration; on various days after starting TP injections, the weight and the incorporation of 5 [125I]iodo-2'-deoxyuridine into the whole seminal vesicles were determined as indices for proliferation. The seminal vesicles of neonatally castrated adult mice were characterized by long duration of androgen-induced proliferation (greater than 20 days) with a low peak (neonatal castration type), whereas the seminal vesicles of adult castrated mice were characterized by short duration of proliferation (10 days) with a high peak (adult castration type). In neonatally castrated adult mice, the neonatal castration type of androgen-induced proliferation was changed largely to the adult castration type when pretreatment with 8 micrograms/g body wt of TP had been given for 30 days. However, this effect gradually disappeared when the mice had been pretreated with decreasing amounts of TP for a shorter period. The present findings suggest that the defect in the androgen-induced proliferative response of mouse seminal vesicles induced by the absence of neonatal and prepubertal testicular androgens can be compensated by androgens given in adulthood, if enough androgen is given for a sufficiently long time. PMID- 2761268 TI - Effect of alcohol on the interaction of cortisol with plasma proteins, glucocorticoid receptors and erythrocytes. AB - Alcohol ingestion stimulates glucocorticoid secretion in animals and normal men. It is generally believed that this effect is mediated through the pituitary adrenal axis. To investigate its mechanism, we focussed on the effects of ethanol on cortisol binding to plasma proteins and to glucocorticoid receptors, and on cortisol uptake by erythrocytes. Addition of ethanol (up to 800 mg/dl) decreased cortisol binding to albumin and corticosteroid-binding globulin (CBG), causing an increase in the plasma unbound component. Ethanol also decreased cortisol binding to glucocorticoid receptors in normal human peripheral lymphocytes. The uptake of cortisol by erythrocytes was not affected at ethanol concentrations as high as 2000 mg/dl. These results provide new insight to ethanol effects in vivo. The stimulatory effect of ethanol on the pituitary-adrenal axis appears to be attributable in part to a relative ineffectiveness of cortisol in cortisol responsive cells consequent to ethanol's ability to diminish cortisol binding to glucocorticoid receptors. A compensatory increase in ACTH secretion in response to the relative hypoglucocorticoid state perceived by corticotrophs would result in maintenance of elevated plasma unbound cortisol and cytosol cortisol levels. We conclude that altered interactions of cortisol with its receptors and transport proteins could be pathophysiological components of the changes in adrenocortical function induced by ethanol ingestion. PMID- 2761269 TI - Low aromatase activity and gene expression in human fetal testes. AB - Because of previous indications that estradiol (E2) plays a role in the regulation of testicular testosterone (T) production in some species, the production of E2 and aromatase gene expression in human fetal testes were investigated. Testicular minces from 14 fetuses (fetal age 15-23 weeks) were incubated with and without 200 ng/ml highly purified hCG, and the production of E2 and T was measured by RIA. Basal T production was high at 15-18 weeks of gestation and decreased thereafter. Estradiol production was low in all testes. Aromatase mRNA (P-450 arom messenger ribonucleic acid) was not detectable in fetal testicular tissues when studied by Northern and dot blot techniques. Placenta and fetal liver expressed aromatase mRNA, but fetal ovary contained only miniscule amounts. HCG significantly stimulated the production of both T and E2 in the testes of older fetuses (19-23 weeks), but the testicular E2 production of the youngest fetuses (15-18 weeks) did not increase significantly after hCG stimulation. These results indicate that aromatase activity and gene expression are very low in human fetal testes. These findings suggest that E2 may not play a major role in testicular T production in the human fetus. PMID- 2761271 TI - Microbial transformations of steroids--III. Transformation of progesterone by Sepedonium ampullosporum. AB - The 16 alpha-steroid hydroxylating fungus Sepedonium ampullosporum (CMI strain 203 033) transformed progesterone into 16 alpha-hydroxyprogesterone and four other major metabolites which have not been reported previously for this organism, 6 beta-hydroxyprogesterone, 17 alpha-hydroxyprogesterone, 16 alpha hydroxyandrostenedione and 16-oxotestosterone (16-ketotestosterone). Among the minor metabolites we have been able to identify 15 alpha-hydroxyprogesterone. This compound has not been reported for S. ampullosporum. The conditions used for transformation had comparatively little effect on the relative proportions of products formed, 16 alpha-hydroxyprogesterone always being the predominant metabolite, but had a major effect on the total yields of metabolites isolatable. These findings suggest that one or more constitutive enzyme systems were responsible for the transformations. PMID- 2761270 TI - The equivocal presence of nuclear androgen binding proteins in mammalian spermatids and spermatozoa. AB - The presence of nuclear androgen binding proteins measured by nuclear androgen exchange in rat spermatids and spermatozoa was re-examined. Specific binding was observed to be related to less dense contaminating particles when sonicated testes were fractionated by isopcynic centrifugation through a 40-61% Nycodenz linear gradient. No specific binding was observed in a pure preparation of epididymal spermatozoa collected by retrograde perfusion of the cauda epididymidis, even when a nuclear exchange assay of superior sensitivity was used. Contamination could easily be induced by adding prostatic tissue to epididymal spermatozoa prior to sonication. Despite this strong evidence that the measure of nuclear androgen receptors by nuclear exchange in germ cells is artefactual, the persistence of high endogenous concentrations of 5 alpha dihydrotestosterone and 5 alpha-diols (but not testosterone) in spermatozoa of castrated rats argues for the opposite conclusion. PMID- 2761272 TI - Normal saline vs. heparin lock flush solution: one institution's findings. PMID- 2761273 TI - A prescription for caring. PMID- 2761274 TI - Food and fluid as extraordinary care? PMID- 2761275 TI - 1000 cases of mumps treated with ear needling on Pingjian point (MA-T2). AB - 1. Acupuncture on Pingjian point has specific therapeutic effect for mumps. During the treatment, only one point is selected, the manipulation is simple, the therapeutic course is short and the effect is satisfactory. The method is worth popularizing. 2. The point should be taken accurately. The insertion of the needle should be quick and no retention of the needle is needed. The needle should be sterilized carefully to prevent infection. PMID- 2761276 TI - Clinical observations in 185 cases of ligament and tendon injuries treated by the method of dissipating blood stasis and promoting the meridian. PMID- 2761277 TI - Clinical observation on treatment of renal function damage due to chronic nephritis with blood circulation invigorating and blood stasis reducing regimen. PMID- 2761278 TI - An observation on the treatment of 34 cases of vascular headache with head acupuncture therapy. PMID- 2761279 TI - Follow-up observation on the therapeutic effects and remote reactions of artemisinin (Qinghaosu) and artemether in treating malaria in pregnant woman. PMID- 2761280 TI - 52 cases of external humeral epicondylitis treated by acupuncture and moxibustion. PMID- 2761281 TI - Experience on 60 cases of Sjogren's syndrome diagnosed and treated with traditional Chinese medicine. PMID- 2761282 TI - Observations on clinical therapeutic effect in treating soft tissue injuries by acupuncture, with pain threshold and electromyography as parameters. AB - 360 observations were made on 120 cases of soft tissue injury divided into groups. 1. Among the 100 patients in the acupuncture treatment group, 300 observations were made; among the 20 controls there were 60 observations. The effective rate in the acupuncture treatment group was 85.00%; in the control group it was 41.67%, a very significant difference (P less than 0.01). 2. Relationship between therapeutic course and effect. The effective rate for the first course was 74.00%; it was 90.50% when more than two courses were given, a very significant difference (P less than 0.01) indicating the marked effect of acupuncture treatment. 3. Based on the therapeutic theory of TCM syndrome differentiation and reinforcement method in the asthenia state, and reducing method in asthenia state, different manipulations were used for asthenia-heat and asthenia-cold types with good clinical results. There was no significant difference (P greater than 0.05) between the effective rate in these two types, pointing up the significance of the TCM syndrome differentiation theory in clinical acupuncture. 4. There was very significant difference (P less than 0.01) in the degree of pressed pain on the patient's tender spot before and after acupuncture treatment, also (P less than 0.01 and P less than 0.001 respectively) in the EMG amplitude on the affected side of the lumbar area before and after acupuncture treatment during light and heavy force in extension action of back muscles. Acupuncture treatment on soft tissue disease based on TCM syndrome differentiation theory is thus shown to be effective. PMID- 2761283 TI - Treatment of obstructive emphysema accompanied by edema with lung-ventilating and diuresis regimen--a dynamic observation of P (A-a) O2. PMID- 2761284 TI - An experimental study by single blind method on the anti-obesity effect of Xiaopangmei. AB - To evaluate the anti-obesity effect of Xiaopangmei, an experimental study by single method in three groups of rats was done. The first group were fed with Xiaopangmei-01, the second group with a placebo, and the third group were controls. As compared with the control and the placebo groups, the rats that had been fed Xiaopangmei for six weeks showed body weight, food intake, weight of epididymis fat pad and the intestinal absorption of glucose all significantly decreased. The swimming tolerance test showed they swam longer than the other two groups. No significant difference was found between the three groups in the growth and development indices such as body length, length of femur and tibia, weight of heart, lungs, spleen, kidneys, stomach, small intestines, gastrocnemius muscle, and adrenal glands. No side effects were found on the liver and kidney. The secretion of insulin was inhibited after the swimming tolerance test and the gastrocnemius muscle test was similar for all three groups of rats. We concluded that Xiaopangmei is an effective anti-obesity drug. PMID- 2761285 TI - Effect of electroacupuncture on brain enkephalins content at different times in rats. AB - The basic level of methionin-enkephalin (MEK) in rat medulla oblongata plus pons was the highest at 05:00 o'clock and the lowest at 23:00. In both hypothalamus and striatum at 05:00 it was higher than at 11:00, 17:00 and 23:00. In both hippocampus and midbrain at 05:00 and 23:00 it was higher than those at 11:00 and 17:00. In the cortex it was higher at 05:00 than at 11:00 and 17:00. The basic level of leucine enkephalin (LEK) in the medulla oblongata plus pons was the highest at 11:00 and the lowest at 17:00 and 23:00. Electroacupuncture (EA) at 05:00 increased the MEK content in the medulla oblongata plus pons and the LEK level in the hypothalamus. It decreased the MEK content in the hypothalamus and the LEK level in the cortex; EA at 11:00 produced decreases of MEK concentrations in the medulla oblongata plus pons and the midbrain and increases of MEK content in the cortex, hypothalamus and striatum. At 17:00 it increased the MEK level in the hypothalamus and the LEK content in the hippocampus. At 23:00 it reduced the levels of MEK and LEK in the hippocampus. The results suggest that there are very marked circadian rhythms in the MEK basic levels of the six discrete brain regions observed and the LEK of the medulla oblongata plus pons; EA at different times produces different effects on brain MEK and LEK levels. PMID- 2761286 TI - Studies on Yin-deficiency. PMID- 2761287 TI - Clinical observation on acupuncture therapy for cerebral hemorrhage. PMID- 2761288 TI - Immunological phenotypic pattern of acute lymphoblastic leukaemia in Egypt. AB - We have performed immunophenotyping studies on 186 untreated cases of acute lymphoblastic leukemia (ALL) in an Egyptian population, using panels of monoclonal antibodies (mAb) and an avidin-biotin-immunoperoxidase detection system. Sixty-two of these cases were tested with a panel of mAb directed against the T-cell markers CD2, CD4, CD8, B-cell markers CD20, kappa and lambda, the common ALL antigen (common ALLa) and class II HLA antigens. The remaining 124 cases were also tested with additional markers of T- and B-cell precursors, namely CD7 and CD19. The common leukocyte antigen, T200, was used to exclude nonhemopoietic neoplasms. Cases that remained unclassifiable were further tested with a wider panel of T-cell markers, including CD1, CD2, CD3 and CD5. In some cases multiple mAb directed against the same antigens were used. The relative frequencies of common ALL and B ALL were calculated from the total number of cases and were found to be 39.2% and 3.2%, respectively. The proportions of T cell and null leukemias were calculated from the better characterized subgroup of 124 cases, and were found to be 50% and 4.8%, respectively. In our series, the age distribution of common ALL revealed a peak at 2-5 yr, but this was partially obscured in the entire series by the high proportion of T-cell cases, which had an age peak between 4 and 12 yr of age. Our results demonstrate marked differences in the phenotypic pattern of ALL in Egypt compared to Western Countries, the predominant finding being a relative excess of T-cell ALL and a paucity of common ALL cases. At present it is not clear whether this results from an increased incidence of T-cell ALL or a decreased incidence of common ALL. PMID- 2761289 TI - Cytogenetic studies on the adult T-cell leukemia in Japan. AB - Cytogenetic studies were performed on 16 patients with ATL seen in Northern Kyushu island; nine were patients with acute type leukemia, one with crisis type and five with lymphoma type. The serum antibody for HTLV-1 (ATLA) was positive in all patients and the phenotype of ATL cells were ERFC+, OKT3+, OKT4+, OKT6-, OKT8 , OKT10+, OKla1+/- and Tac+. Abnormal findings of chromosomes were observed in 15 patients. Thirteen patients were in near diploid range. One patient was in triploid range and one patient was in tetraploid range. The polyploid karyotypes were found only in lymphoma type patients. Trisomy 3 and trisomy 7 were observed each in three patients with acute type of ATL. The most frequent abnormal rearrangement was observed in the long arm of chromosome 6 and the break occurred at band 6q15 and 6q21 each in four patients in this series. PMID- 2761290 TI - Alteration of intracellular actin levels induced by phorboldiester in human HL-60 leukemia cells susceptible or resistant to differentiation, and the effects of protein kinase inhibitors. AB - During monocyte-macrophage differentiation of HL-60 cells by 12-O-tetradecanoyl phorbol 13-acetate, the intracellular globular(G)-actin and polymerized(F)-actin increased 3-fold and 1.7-fold, respectively. Time course studies showed that these changes of actin levels were nearly coincident with the development of macrophage characteristics, including adhesiveness, positive reactivity against OKM-1 antibody and elevated lysozyme activity. When exposed to 5 nM TPA, these different properties of differentiation were detectable as early as 12 h after TPA treatment and reached a maximum by 24 h. Phosphorylation of 17 K and 27 K proteins, induced by TPA, occurred early (within 30 min) during TPA-induced differentiation. On the other hand, HL-60R cells, which are resistant to TPA in terms of the development of adhesiveness and differentiation, showed no change in both G- and F-actin levels, after the TPA treatment. TPA did not induce phosphorylation of these proteins in the HL-60R cells. In the presence of the protein kinase inhibitors, 1-(5-isoquinolinesulfonyl)-2-methylpiperazine dihydrochloride (H-7, 20 microM) and staurosporine (10 nM), the increase in actin levels induced by TPA was inhibited as well as other later evidence of differentiation. These results suggest that the phosphorylation of specific proteins is closely associated with the process of differentiation of HL-60 cells into macrophages. PMID- 2761291 TI - Differential sensitivity to (dl)-5-methyltetrahydrofolate of normal CFU-GM and HL 60 cells. AB - We studied the effect of (dl)-5-methyltetrahydrofolate on clonogenic growth of HL 60 cells in comparison with human normal CFU-GM. Seven normal bone marrow samples were tested for CFU-GM assay with or without (dl)-mTHF at concentrations ranging from 1.25 X 10(-4) to 5 X 10(-4) M. (dl)-mTHF only slightly affected CFU-GM formation, while, at the same concentrations, it showed a dose related inhibition of HL-60 colony formation, up to a complete arrest of growth at the doses of 5 X 10(-4) and 1 X 10(-3) M. The same impairment of proliferation was observed in liquid culture. These results are in keeping with reported observations, describing a different membrane system mediating "folate" transport in normal and leukemic cells. PMID- 2761292 TI - The effects of thymidine on deoxyribonucleotide pool levels, cytotoxicity and mutation induction in Friend mouse erythroleukaemia cells. AB - The ability of excess thymidine (10(-6)-10(-3) M) to enhance the frequency of 6 thioguanine (6-TG) resistant cell mutants and 2,6-diaminopurine (DAP) resistant cell mutants in Friend mouse erythroleukaemia cells, clone 707, was investigated. A significant increase in mutant frequency for both markers was observed at the higher (10(-4) and 10(-3) M) thymidine treatments. Measurements of deoxyribonucleoside triphosphate pool sizes in the cells revealed a dramatic elevation of the deoxythymidine triphosphate and deoxyguanosine triphosphate pools, an increase in the deoxyadenosine triphosphate pool and an almost complete disappearance of the deoxycytidine triphosphate pool at the higher thymidine treatments. This complemented the mutagenesis data. These results support the view that increases in mutant frequency may take place following perturbations in DNA precursor pools through a resultant decrease in the fidelity of DNA synthesis. Measurements of deoxyribonucleoside triphosphate pools were also carried out on clone 707 Friend cells and a thymidine kinase-deficient subclone, 707 BUF. The thymidine kinase-deficient subclone had significantly reduced deoxythymidine triphosphate and deoxyguanosine triphosphate pools relative to those observed in-clone 707 cells. The previously observed mutagen hypersensitivity in thymidine kinase-deficient Friend cells may result through pool imbalance rendering DNA excision repair error prone. PMID- 2761293 TI - Quantitative morphological aspects of granulocytic differentiation induced in HL 60 cells by dimethylsulfoxide and retinoic acid. AB - HL-60 cells differentiate to mature granulocytes when cultured with DMSO or retinoic acid. These two drugs can induce different expression of phenotypic or functional properties in these cells. The morphological characteristics of the differentiation sequences elicited by these two drugs have been therefore evaluated by a quantitative cytological analysis technique using a SAMBA 200 cell image processor. The maturation sequences induced by DMSO or retinoic acid differed mainly in nuclear geometry and cytoplasmic granules expression. Multivariate statistical analyses of data reveal that DMSO and retinoic acid elicited granulocytic maturation through two separate morphological pathways which can be individualized as early as 24 hr after differentiation induction. Image processing may therefore offer an interesting tool for studying new drugs with differentiation potential in chemotherapy. PMID- 2761294 TI - An attempt to select pseudonormal revertants of Friend erythroleukaemia cells using cytochalasin B. AB - Treatment of Friend erythroleukaemia cells with cytochalasin B (CB) resulted in multinucleation and loss of viability characteristic of a virus-transformed cell line. In an attempt to isolate pseudonormal revertants of this cell line mutagenized cultures were exposed to CB and surviving clones isolated. Many of these were found to be mutants resistant to the growth inhibitory effects of CB. The proportion of such mutants was reduced by simultaneous selection in CB and cytosine arabinoside. Of 699 clones examined none consistently exhibited reduced levels of multinucleation in the presence of CB. The inability of CB to select for revertants displaying a phenotype closer to normal cells is discussed. PMID- 2761295 TI - Considerations in the quantitative analysis of autoradiograms from 2-dimensional gels. AB - Two-dimensional (2-D) gel electrophoresis has been used in conjunction with autoradiography and computerized optical densitometry for quantitating specific protein synthesis. However, accurate quantitation of 2-D autoradiograms requires the prior assessment of such parameters as linearity, reciprocity, and reproducibility. The present study was performed to determine the contribution of each of these to the dissimilation of beta-emission and autoradiographic density, and of density and protein synthesis. Various aliquot volumes of a single complex protein specimen labeled with 35S-amino acids were subjected to 2-D gel electrophoresis, and these gels were serially exposed at graded intervals. The peak densities and volumes of the 111 visualized spots were used to examine the above parameters. In our computerized scanning system, the peak density is a more accurate and reproducible parameter of optical density than is spot volume. Approximately 30% of the dynamic range of peak density is non-linear; quantitation of spots above or below the linear range leads to inaccuracies in quantitation. In addition, the phenomenon of reciprocity, which states that density is directly proportional to exposure (beta-emission of 35S x time), is shown to fail as aliquot volume, or mass of 35S increases. The implications of reciprocity failure to accurate quantitation are discussed. Finally, the sources of variance in autoradiographic analysis were examined, by assessing the intra scan, intra-gel run, and inter-gel run coefficients of variation. The results of this study show that autoradiographic densitometry is an effective method for quantitation of 2-D gels, but linearity, reciprocity, and reproducibility must be assessed prior to its experimental use. Restrictions of such use are suggested. PMID- 2761296 TI - Determination of polyamines by precolumn derivatization with 9-fluorenylmethyl chloroformate and reverse-phase high-performance liquid chromatography. AB - A high-performance liquid chromatography (HPLC) method for the determination of picomole levels of polyamines (putrescine, spermidine, and spermine) is described. Amino groups in polyamines react with 9-fluorenylmethyl chloroformate (FMOC) to form stable and highly fluorescent derivatives which can be separated and quantitatively estimated by HPLC in about 12 min. The mean relative elution times (n = 14) for putrescine, spermidine and spermine are 4.21 +/- 0.02, 10.09 +/- 0.02 and 11.19 +/- 0.04 min, respectively. The method has been applied to determine polyamine concentration in rat dorsal root ganglia (DRG) without interference with endogenous amino acids. Polyamine content of individual rat DRG has been calculated and the values are as follows: putrescine, 36.8 +/- 2.01, spermidine, 1652 +/- 131.0 and spermine 388.5 +/- 38.4 pmol/DRG. Information on polyamine concentrations in DRG may be useful in understanding the mechanism of action of toxic chemicals on nervous system. PMID- 2761297 TI - A graphics-oriented personal computer-based microscope charting system for neuroanatomical and neurochemical studies. AB - This report describes a computerized microscope charting system based on the IBM personal computer or compatible. Stepping motors are used to control the movement of the microscope stage and to encode its position by hand manipulation of a joystick. Tissue section contours and the location of cells labeled with various compounds are stored by the computer, plotted at any magnification and manipulated into composites created from several charted sections. The system has many advantages: (1) it is based on an industry standardized computer that is affordable and familiar; (2) compact and commercially available stepping motor microprocessors control the stage movement. These controllers increase reliability, simplify implementation, and increase efficiency by relieving the computer of time consuming control tasks; (3) the system has an interactive graphics interface allowing the operator to view the image during data collection. Regions of the graphics display can be enlarged during the charting process to provide higher resolution and increased accuracy; (4) finally, the digitized data are stored at 0.5 micron resolution and can be routed directly to a multi-pen plotter or exported to a computer-aided design (CAD) program to generate a publication-quality montage composed of several computerized chartings. The system provides a useful tool for the acquisition and qualitative analysis of data representing stained cells or chemical markers in tissue. The modular design, together with data storage at high resolution, allows for potential analytical enhancements involving planimetric, stereologic and 3-D serial section reconstruction. PMID- 2761298 TI - A hybrid patch clamp amplifier. AB - The current-to-voltage convertor used in patch clamping is analyzed for noise generation and the major noise sources determined. A hybrid patch clamp amplifier design is theoretically analyzed. Here it is shown that by differentiation and recombining of signals the original input signal can be reconstructed. Several circuits of this design are described and their performance compared. The optimal signal detection obtained for a 1 ms current pulse width with a signal-to-noise ratio of 1 is 0.025 pA. In these circuits, high frequency attenuation is readily accomplished with a single control. In addition, compensation for the transients which occur with step control voltages is effectively accomplished. With this circuitry, it is shown that for most patch clamp situations, the minimum pulse width and current which can be detected is determined by the patch clamp seal resistance. PMID- 2761300 TI - Vibrating glass stylets: tools for precise microsurgery on cuticular structures. AB - Precisely localized lesions in cuticular structures of insects can be produced by fine glass rods, vibrating transversally at frequencies above 100 kHz. The oscillating edge of the glass rod scrapes off the chitinous material at minimal elastic deformation during treatment. The achieved roughness height is in the 0.1 micron range. The method is most fruitfully applied to insect sensilla. Studies of central projections of sensory nerves (degeneration; cobalt staining) profit from the new chance of eliminating selected single sensilla in close vicinity to others which are to remain intact. This can barely be achieved with conventional fine scissors. PMID- 2761299 TI - A fluorometric assay for acetylcholine with picomole sensitivity. AB - A sensitive fluorogenic assay for acetylcholine is described. The assay is based upon the reactions: (1) hydrolysis of acetylcholine to choline and acetate, catalyzed by acetylcholinesterase. (2) Oxidation of choline to betaine and hydrogen peroxide by choline oxidase. (3) Oxidation of p-hydroxyphenylacetic acid by hydrogen peroxide to a fluorescent product, catalyzed by peroxidase. With a sensitivity comparable to chemiluminescence procedures, the assay should find application to those situations requiring the persistence of a fluorescence signal or the necessity of assaying small volumes. PMID- 2761302 TI - [Nursing of patients with gastric and duodenal ulcer: physiopathology, diagnosis, and treatment of gastric and duodenal ulcer]. PMID- 2761301 TI - Constant current source for iontophoresis. AB - A simple, battery-powered current source is described that is suitable for the iontophoresis of axonal tracing substances, such as Phaseolus vulgaris leucoagglutinin. Unlike the previous designs that form the basis of most commonly used iontophoretic devices, this circuit does not use operational amplifiers to provide controlled current. Instead, a pair of bipolar transistors that can be selected to provide a compliance of many hundreds of volts form the regulating circuitry. PMID- 2761303 TI - [Nursing process for patients with gastric and duodenal ulcer]. PMID- 2761304 TI - [Nursing of a patient with duodenal ulcer following gastrectomy]. PMID- 2761305 TI - [Nursing of a patient with stomach ulcer following a gastrectomy]. PMID- 2761306 TI - [Bacterial contamination of fingers through contact with nasal secretions]. PMID- 2761307 TI - [Changes in the skin temperature during cleansing the back with a hot cloth]. PMID- 2761308 TI - [Nursing of a pessimistic patient facing a poor postoperative prognosis]. PMID- 2761310 TI - [Physiopathology of muscular dystrophy]. PMID- 2761309 TI - [Nursing of patients with diseases of the digestive system]. PMID- 2761311 TI - [Questions on nursing technics: changes in patients' postures]. PMID- 2761312 TI - [Significance of life and illness in nursing]. PMID- 2761313 TI - [Errors in nursing: casual use of everyday expressions such as "please wait a minute" and "it is all right"]. PMID- 2761314 TI - [Overcoming the shortcomings of nursing records]. PMID- 2761315 TI - [A letter from a nursing student studying in Hawaii]. PMID- 2761316 TI - [Nursing experience through interactions with patients: passing of a patient surrounded by her family members]. PMID- 2761317 TI - Effects of recombinant human tumor necrosis factor on the self-renewal capacity of leukemia blast progenitors in acute myeloblastic leukemia. AB - The effects of human recombinant tumor necrosis factor type alpha (rTNF alpha) on the blast progenitors from 14 acute myeloblastic leukemia (AML) patients and 1 chronic myelogenous leukemia patient in blastic crisis were studied in methylcellulose and suspension cultures. Blast progenitors renew themselves and/or undergo terminal divisions. Plating efficiency of primary colony formation (PE1) in methylcellulose, which is considered to reflect the terminal divisions of blast progenitors, was suppressed by rTFN alpha in a dose-dependent manner in all cases. Plating efficiency of secondary colony formation (PE2) and the recovery of clonogenic cells in suspension culture, which are considered to reflect the self-renewal capacity of blast progenitors, were also suppressed by rTNF alpha in a dose-dependent manner in almost all cases. rTNF alpha also inhibited both PE2 and clonogenic cells in suspension culture, even in relapsed AML patients who were very refractory to intensive chemotherapies. The results demonstrate that rTNF alpha inhibits not only terminal divisions but also the self-renewal capacity of leukemic blast progenitors. The finding that rTNF alpha suppressed the self-renewal capacity of leukemic blast progenitors proposes the utility of rTNF alpha to AML therapy. PMID- 2761318 TI - Cerebro-spinal fluid thymidine kinase in acute leukemia. PMID- 2761319 TI - [Effect of cadmium on C-14-glucose uptake by Staphylococcus aureus]. AB - The aim of the study was to evaluate an influence of Cd++ on 14C-glucose uptake by two strains of S. aureus resistant and sensitive to cadmium in 0.1 M phosphate buffer, pH 7.0. Uptake of this sugar in both strains is an active process in which energy comes from oxidation of endogenous substrates, what was shown in aerobic condition, anaerobic condition at temperatures of 37 degrees C and 4 degrees C, and with p-CMB and CCCP. In the resistant strains Cd++ at 10 microM concentration did not inhibit endogenous respiration, 14C-glucose uptake and its oxidation. This is due to presence of energy-dependent system of 2H+/Cd++ antiport coded by cadA genes located on penicillinase pII17810 plasmid, which eliminated Cd++ from bacterial cell. In the case of plasmid free variant deprived of this system, Cd++ is retained in cytoplasm and blocks endogenous respiration uptake, and oxidation of glucose. PMID- 2761320 TI - [Biochemical and serologic characteristics of Campylobacter jejuni/coli strains causing diarrhea in children]. AB - One hundred strains of Campylobacter jejuni/coli isolated from faeces of children with diarrhoea were characterised. Frequency of isolation of these microorganisms from faeces of children with enterocolitis symptoms was evaluated. In this group Campylobacter jejuni/coli constituted 11.4% of all isolates, being the dominant etiologic agent of these infections. Biotype pattern of 100 Campylobacter jejuni/coli strains was determined. Biotype I C.jejuni prevailed and C. coli constituted as much as 35% of all isolated strains. All isolated strains were characterised serologically according to typing scheme of Lior. Seventy four strains were typed and 22 were untypable, out of which four were rough. Two new serotypes were isolated: LIO 71 and LIO 72, LIO 4 and LIO 72 serotypes were the most frequently isolated. Frequency of isolation of Campylobacter jejuni/coli strains were also determined in the period from january 1985 to august 1987. PMID- 2761321 TI - [Surgical treatment of lymphedema]. PMID- 2761322 TI - [Results of microsurgical lymphovenous anastomoses in lymphedema--report of 110 cases]. AB - Between 1980 and 1986, 110 patients with lymphedema of the extremities (n = 98), male and female external genitalia (n = 9), breast (n = 2), and face (n = 1) were treated microsurgically. Microsurgery for primary (n = 6) and secondary (n = 104) lymphedema at present consists of anastomosis between collective lymphatics and veins. Ninety-eight patients with lymphedema of the extremities were followed-up for 26 months. The immediate and long-term results have been very satisfactory. Excellent and good results were obtained in 76.5%. An average reduction in circumference of the affected limb of 6.2 cm and an average reduction of excess volume of 59.2 +/- 29.5% (representing 703 +/- 850 ml) were obtained. These results prove that by standardized technique the microlymphaticovenous anastomoses can produce a good therapeutic result. On the basis of our clinical experience in treating lymphedema by microlymphaticovenous anastomoses, we believe that the anastomoses should be performed early and their number should be sufficiently high. Indications, types of procedures and advantages of the operation are presented. PMID- 2761323 TI - [Diagnosis of infection in surgery of the locomotor system with Tc-99m-HMPAO leukocyte scintigraphy]. AB - 70 patients with confirmed (23 patients) or suspected (47 patients) bacterial infection in the skeleton following diseases, injuries or operations in orthopedic surgery were investigated using Tc-99m-HMPAO leucocyte scintigraphy in order to evaluate the accuracy of this procedure. Infections could be detected correctly in 37 of 70 patients (right positives) while 28 patients had negative scans corresponding to the clinical course (right negatives). One false negative finding was observed. Five patients with clinically suspected infection had a focal uptake in the WBC-scan and were not operated subsequently. They range as false positive results, although they belong to a special group (Infection: Yes Operation: No [IYON]-group). In the assessment of the Tc-99m-HMPAO-WBC-scan there was a senstivity of 97.1%, specificity of 82.9% and an overall accuracy of 90%. The method is suitable for detection of early and late infection as well as chronic or hematogenous osteomyelitis in the locomotor system. This means an important contribution in diagnosis of infection determining further operative or conservative treatment. PMID- 2761324 TI - Definition of carcinoma of the gastric cardia. AB - This study concerns the definition of carcinoma of the gastric cardia. The topography of the esophagogastric mucosal junction (mucosal EGJ) was investigated with an endoscope in 182 patients who were free of hiatal hernias, ulcers, and neoplasms in the esophagus and stomach. The relationship between the EGJ and the cardiac gland area was then examined histologically in 56 resected specimens containing intact EGJs and cardia gland areas. Furthermore the cancerous center was determined; the shortest distance between the cancerous center and the EGJ and the amount of esophageal invasion were measured in 102 resected carcinomas located close to the junction; the carcinomas contained the EGJ and were good enough for pathohistological examination. The EGJ was located 0.5 - 1.0 cm proximal to the His angle (the gastric cardia) in radiological and endoscopic examinations. Histologically the cardiac gland area was found to straddle the EGJ at a range of about 1 cm proximal and 2 cm distal to the junction. Among the upper stomach carcinomas, most of the tumors (87.5%) whose center was located within 2 cm from the EGJ invaded the esophagus. In conclusion, carcinoma of the gastric cardia is defined as a lesion with its center located within 1 cm proximal and 2 cm distal to the EGJ. PMID- 2761325 TI - [Vascular anatomy of the anorectal transition]. AB - Based on selective dye injection studies, the regions of supply of the 3 rectal arteries have been defined. The cranial portion of the rectum receives its blood supply from the superior rectal artery, the inferior rectal artery supplies the entire rectal wall in a fan-shaped configuration up to the dentate line. A wedge shaped portion of the muscularis in the proximal distribution of the inferior rectal artery receives a relatively reduced supply. The middle rectal artery can supply a variable portion of the muscularis which is usually supplied by the distal superior rectal artery. Intramural anastomoses between these regions exist only between the superior and inferior rectal arteries at the level of the dentate line in the submucosa. PMID- 2761326 TI - [Treatment of iatrogenic esophageal perforation]. PMID- 2761327 TI - Er:YAG laser ablation of tissue: effect of pulse duration and tissue type on thermal damage. AB - The thermal damage caused by 2.94-micron Er:YAG laser ablation of skin, cornea, aorta, and bone was quantified. The zone of residual thermal damage produced by normal-spiking-mode pulses (pulse duration approximately 200 microseconds) and Q switched pulses (pulse duration approximately 90 ns) was compared. Normal-spiking mode pulses typically leave 10-50 microns of collagen damage at the smooth wall of the incisions; however, at the highest fluences (approximately 80J/cm2) tears were produced in cornea and aorta and as much as 100 microns of damaged collagen is found at the incision edge. Q-switched pulses caused less thermal damage, typically 5-10 microns of damage in all tissues. PMID- 2761328 TI - Er:YAG laser ablation of tissue: measurement of ablation rates. AB - The ablation of both soft and hard tissue using the normal-spiking-mode Er:YAG laser has been quantified by measuring the number of pulses needed to perforate a measured thickness of tissue. Bone is readily ablated by 2.94 microns radiation; however, at per pulse fluences greater than 20 J/cm2, plasma formation decreases ablation efficiency. At low fluence, desiccation can prevent efficient ablation of bone. The ablation efficiency for aorta and skin is higher than for bone. The ablation efficiency, 540 micrograms/J, and the ablation depth per pulse, greater than 400 microns, for skin are too high to be readily explained by simple models of ablation and thus provide evidence for a more complex explosive removal process. PMID- 2761329 TI - Experimental studies of the application of the Er:YAG laser on dental hard substances: I. Measurement of the ablation rate. AB - Up to now lasers have not achieved any practical importance in dentistry for drilling teeth because of considerable damage to the surrounding tissue. We studied the application of pulsed 2.94 microns Er:YAG laser radiation in vitro on extracted teeth to remove enamel, dentin, and carious lesions. The depth and diameter of laser-drilled holes were measured as a function of pulse number and radiant exposure. The tissue removal is very effective both for dentin and enamel. PMID- 2761330 TI - Laser dentistry: a new application of excimer laser in root canal therapy. AB - We report the first study of the application of excimer lasers in dentistry for the treatment of dental root canals. High-energy ultraviolet (UV) radiation emitted by an XeCl excimer laser (308 nm) and delivered through suitable optical fibers can be used to remove residual organic tissue from the canals. To this aim, UV ablation thresholds of dental tissues have been measured, showing a preferential etching of infiltrated dentin in respect to healthy dentin, at laser fluences of 0.5-1.5 J/cm2. This technique has been tested on extracted tooth samples, simulating a clinical procedure. Fibers of decreasing core diameters have been used to treat different sections of the root canal down to its apical portion, resulting in an effective, easy, and fast cleaning action. Possible advantages of excimer laser clinical applications in respect to usual procedures are also discussed. PMID- 2761331 TI - Laser dentistry: root canal diagnostic technique based on ultraviolet-induced fluorescence spectroscopy. AB - A diagnostic technique to detect residual tissues at different levels of the root canal during an endodontic treatment is presented. The diagnostic system is based on ultraviolet-induced fluorescence spectroscopy and uses suitable optical fibers for local delivery of excitation light and to collect back fluorescence spectra. Spectra of root canal tissues have been obtained from split teeth by labeling with a fluorescent solution. Residual tissue can be discriminated in respect to healthy dentin because of their different spectral responses: the spectral shape of the first response shows a clear peak at 530 nm because of a selective absorption of the fluorescent dye, whereas for the second response, the spectral curve monotonically increases toward ultraviolet wave-lengths with no particular structure. This technique has been tested on unsplit teeth simulating operative conditions. A compact spectroscopic system has been devised that can be easily integrated in an excimer laser system to perform residual tissue detection during laser cleaning of the canals. PMID- 2761332 TI - Mid-infrared erbium:YAG laser ablation of bone: the effect of laser osteotomy on bone healing. AB - A comparative study was undertaken in rabbit tibiae to assess the healing of bone in response to osteotomies by a mid-infrared erbium: YAG (2.94 microns) laser or a mechanical saw. Laser parameters necessary for osteotomy were shown to produce deep cuts with sharp edges and no gross charring or burning of adjacent bone. However, it was noted histologically that there was a delay in healing of the laser osteotomies as compared to saw osteotomies. This delay was caused by a microscopic zone of damage to bone adjacent to the laser cuts. It is concluded that, although the erbium: YAG laser may be a useful tool in orthopaedic surgery to ablate bone, under the conditions used in this study, there will be a delay in the healing process after laser osteotomy. PMID- 2761333 TI - Reflectance during pulsed holmium laser irradiation of tissue. AB - Although generally ignored in considerations of laser ablation of tissue, reflectance of laser light from tissue during laser-induced ablation is a potentially important factor in determining ablation efficiency because it determines the amount of laser light coupled into the target. To determine the significance of reflectance changes induced by laser irradiation, we examined the reflectance of liver samples during pulsed holmium laser ablation by placing the target at one focus of an ellipsoidal reflector and a detector at the other focus. The temporal behavior, total reflectance, and effect of multiple pulses were examined. Tissue reflectance as large as 50% was observed during holmium laser irradiation but depended upon laser radiant exposure and number of laser pulses. These measurements suggest that changes in the optical properties of the target during ablation are important and should be considered in detailed modeling of the ablation process. PMID- 2761334 TI - Visible action spectrum for melanin-specific selective photothermolysis. AB - The skin of black and albino guinea pigs was irradiated with single, 750 nsec long laser pulses at 435, 488, 530, and 560 nm in order to determine an action spectrum for the gross threshold response of immediate epidermal whitening. In addition, the immediate and delayed gross and histologic changes induced at, above, and below the threshold radiant exposures at all four wavelengths were studied. The action spectrum in the black guinea pigs was consistent with the reported absorption spectrum of DOPA-melanin. Histologically, there was epidermal damage immediately after radiant exposures at and above threshold at all four wavelengths. In addition, radiant exposures greater than threshold caused an immediate decrease in stainable epidermal pigment that was most marked at 435 and 488 nm. The healing response was also wavelength- and dose-dependent. Seven days after above-threshold exposures, there was little epidermal pigment in the 435 nm specimens. As wavelength increased, there was progressively more pigment, and in the 560 nm specimens, the epidermal pigment was equivalent to that seen in nonirradiated black guinea pig control specimens. Seven days after subthreshold radiant exposures, there was increased epidermal pigmentation and melanocytes at all four wavelengths. This was the most pronounced in the 435 nm specimens. There was no observable epidermal damage in albino guinea pig skin. PMID- 2761335 TI - Comparative study of the "point-by-point technique" and the "scanning technique" for laser treatment of port-wine stain. AB - Photocoagulation using the argon laser has been proven to be an effective method for the treatment of port-wine stains (PWS). However, it is very difficult to reproduce the parameters of laser treatment. This leads to inaccurate energy dosages secondary to the difference in treatment patterns. The aim of this study was to compare the conventional point-by-point technique (PT) for PWS treatment against a new scanning technique (ST) using a device called "Hexascan" (PREIN & Partners, Ferney-Voltaire, France). A total of 249 patients (171 females and 78 males) using the argon laser have been studied in a retrospective study. Clinical results are presented. For each technique, blanching and hypertrophic scarring were examined. The results are classified into two groups: satisfactory and unsatisfactory. The clinical results show that the ST with the Hexascan is superior to the conventional PT. Scarring is drastically reduced because overdosage and overheating are avoided. Because of precisely controlled spot patterns, quality and homogeneity of blanching is improved. Treatment time can be reduced to 20% of that of the PT. PMID- 2761336 TI - Time constants in thermal laser medicine. AB - Temperature rise of laser-irradiated tissue due to direct absorption of laser light is related to laser parameters (power, spot size, irradiation time, and repetition rate) and tissue parameters (absorption and scattering coefficients, density, heat capacity, and thermal conductivity). Solutions to the bio-heat equation are approximated by introducing axial (z) and radial (r) time constants for heat conduction that represent two parallel channels for heat conduction. These axial (tau z) and radial (tau r) time constants are found proportional to squared distances (z02, r02) that represent the extent of axial and radial temperatures respectively. For convenience, z0 and r0 are approximated to the axial and radial extent of laser light in the tissue. The resulting solution of the bio-heat equation, expressed as temperature rise as function of time and position, is obviously exact for irradiation times short compared to ta z, tau r (adiabatic heating), but is also a quite reasonable approximation up to irradiation times three times the overall time constant. Comparison with (exact) numerical computations show that this holds for all ratios of (light) penetration depth to laser-beam radius; for strongly scattering materials, smaller laser beams give better predictions than do larger laser beams. Several examples of clinical relevance are discussed, such as multiple-laser-pulse irradiation of high- and low-absorbing tissues and laser treatment of port-wine stains, with some unexpected results that also show potential clinical relevance. PMID- 2761337 TI - Regulation of GH and TSH release from hyperplastic and ectopic pituitaries: effects of dopamine in vitro. AB - This study was undertaken to examine the consequences of prolonged removal of the pituitary from hypothalamic control and of estrogen-induced pituitary tumors on the susceptibility of GH and TSH release to regulatory influences of dopamine (DA). Adult male Fischer 344 rats were treated with transplants of female anterior pituitaries under the renal capsule or with Silastic capsules containing diethylstilbestrol (DES). Capsules with DES remained in place until the animals were killed (DES-IN) or were removed 7 weeks prior to sacrificing the rats (DES OUT). Both pituitary grafts and DES caused the expected elevation in plasma prolactin and suppression of plasma GH and TSH levels. Basal GH release in vitro was not affected by exposure to DES in vivo but was reduced by transplantation of the pituitary to an ectopic site. Treatment with DA in vitro suppressed GH release from the in situ pituitaries of control, DES treated and grafted rats but increased GH release from the ectopic pituitaries. Basal release of TSH in vitro was reduced in the pituitaries of DES-IN and DES-OUT animals but was not affected by the presence of pituitary transplants. No detectable TSH was released from the ectopic pituitaries in the absence of DA. DA decreased TSH release from the pituitaries of control, DES-OUT and DES-IN rats but not from the in situ pituitaries of grafted rats. In contrast, DA produced an increase in TSH release from ectopic pituitaries. These results demonstrate that somatotrophs and thyrotrophs removed from the hypothalamic influences on subjected to direct and indirect effects of DES exhibit abnormal responses to DA. We suspect that prolonged absence of normal pituitary control leads to the development of regulatory mechanism of pituitary hormone release which are different from those operating under physiological conditions. PMID- 2761338 TI - The restraint stress-induced decrease of the nocturnal prolactin surge and the physiology of pseudopregnancy and pregnancy in the rat. AB - Experiments were performed to determine whether the restraint stress-induced decrease of the nocturnal prolactin (PRL) surge affected the length of pseudopregnancy (PSP) and/or the outcome of pregnancy in rats. Vaginal cycles were monitored daily and animals were electro-mechanically cervically stimulated on the morning of metestrus to induce PSP. Animals were restraint stressed by tying the hind legs together with plastic coated bell wire beginning on day 1 of PSP from 0100-0700h with reapplication of stress at 0400h for 6-9 days and then blood sampled for PRL and progesterone plasma levels. Restraint stress significantly decreased plasma PRL (P less than 0.001) and progesterone (P less than 0.05) levels. The length of PSP was significantly decreased (P less than 0.01) for restraint animals and for control animals that were blood sampled compared to control animals that were not sampled. In the pregnancy experiment, animals were mated upon arrival into the laboratory and assigned to one of four groups. For the restraint group, stress was initiated on day 1 of pregnancy as indicated by the presence of sperm in the vaginal lavage. Animals were stressed for 6-9 days for 6 hours during the nocturnal PRL surge as described above. One control group had no treatment; a second control group was sampled only, and a third control group was injected daily with pimozide, a dopamine antagonist, and stressed for 6-9 days. The group which received no treatment had significantly greater (P less than 0.05) incidence of successful pregnancy compared to the other 3 groups; there were no differences (P greater than 0.05) between the sampled, restraint and restraint + pimozide groups in the incidence of successful pregnancy. We conclude that restraint stress during the nocturnal PRL surge minimally affects the length of PSP and that the effect of stress on the outcome of pregnancy is not due to the decrease in nocturnal PRL surge. PMID- 2761339 TI - Assessment of membrane protection by 31P-NMR effects of lidocaine on calcium paradox in myocardium. AB - In studying calcium paradox, perfused rat hearts were used to investigate the myocardial protective effects of lidocaine. Intracellular contents of phosphates were measured using the 31P-NMR method. In hearts reexposed to calcium, following 3 minute calcium-free perfusion, a rapid contracture occurred, followed by rapid and complete disappearance of intracellular phosphates with no resumption of cardiac function. In hearts where lidocaine was administered from the onset of the calcium-free perfusion until 2 minutes following the onset of reexposure to calcium, both intracellular phosphates and cardiac contractility were maintained. Therefore, it can be said that cell membranes were protected by lidocaine. PMID- 2761340 TI - Differential sensitivity to cocaine in spontaneously hypertensive and Wistar Kyoto rats. AB - Physiological, pharmacological and toxicological responses to two regimens of cocaine administration were compared between spontaneously hypertensive (SHR) and Wistar-Kyoto (WKY) rats. An initial experiment examined renal excretory and hemodynamic function in response to an acute volume load in anesthetized SHR and WKY following subacute cocaine treatment (20 mg/kg, s.c., twice a day for 9 days). Anticipated renal responses to volume loading were obtained but the responses of cocaine-treated SHR and WKY did not differ from vehicle-treated rats. A second group of experiments compared responses to continuous i.v. infusions of cocaine (1.25 mg/kg.min). In freely moving animals, no differences were noted between SHR and WKY in the increases in mean blood pressure (MBP) and heart rate (HR) produced during cocaine infusion. The elapsed time-to-onset of convulsions (Tc) elicited by cocaine was similar in both strains. However, when rats were subjected to restraint during the infusion period, pressor and tachycardic responses were observed to be significantly less in WKY than in SHR or in freely moving rats of either strain. Restraint also differentially affected rectal temperature (RT) responses to cocaine. Hypothermic responses to cocaine were observed in all WKY. Both hypothermic and hyperthermic responses were observed in SHR. A significant correlation was demonstrated between the Tc and the maximal change in RT produced during cocaine infusion. Division of SHR into two arbitrary groups was made, based on the direction of cocaine-induced change in RT. A significant (p less than 0.01) shortening of the Tc was obvious in SHR (8 of 15) in whom cocaine produced a hyperthermia. These animals were designated SHRH. The mean value for Tc in those SHR which demonstrated a lowering in RT (SHRL; 7 of 15) in response to cocaine was similar to that for WKY. Moreover, the SHRH evidenced significantly greater increases in HR, but not MBP, to cocaine infusion than did SHRL. The results indicate that restraint stress causes expression of a significant heterogeneity in the RT response of SHR to cocaine. The magnitude and direction of the RT responses are negatively correlated with sensitivity to the convulsive effects of cocaine in SHR. Stress may modify toxic responses to cocaine by interactions with body temperature homeostasis. PMID- 2761341 TI - Lack of teratogenicity of aluminum hydroxide in mice. AB - The embryotoxic and teratogenic potential of aluminum hydroxide, a therapeutic drug used as an antacid and phosphate binder, was investigated in Swiss mice. Mated female mice were given by gavage daily doses of 0, 66.5, 133 or 266 mg/kg of A1 (OH)3 on gestation days 6 through 15 and killed on gestation day 18. Females were evaluated for body weight gain, food consumption, appearance and behavior, survival rates, and reproduction data. No significant effects attributable to A1(OH)3 were noted in comparison of maternal body weight and food consumption values, appearance and behavior. No treatment-related changes were recorded in the number of total implants, resorptions, the number of live and dead fetuses, fetal size parameters or fetal sex distribution data. Gross external, soft tissue and skeletal examination of the A1-treated fetuses did not reveal differences at any dose in comparison with the controls. Thus, no evidence of maternal toxicity, embryo/fetal toxicity or teratogenicity was observed with A1(OH)3 in mice. PMID- 2761342 TI - Bone resorption in osteosclerotic mice is reduced in vitro. AB - Osteopetrosis in mammals results from a congenital reduction in bone resorption. Calvarial organ cultures were used to measure bone resorption in osteosclerotic (oc/oc) mice and their normal littermates. Measurements of cell-mediated resorption indicate that baseline isotope release by mutant calvariae was only 57% of that observed in normal littermates and isotope release by mutant bone in the presence of parathyroid hormone (PTH) was only 60% of that in normal controls. However, the response of oc calvariae to PTH was not different from normal bone when considered with respect to baseline resorption. These data indicate that bone resorption in oc mice is reduced in both its basal level and in response to PTH and suggest that oc mice are unable to establish normal baseline resorption which may in turn compromise their responsiveness to PTH. PMID- 2761343 TI - Anti-HIV drugs: comparative toxicities in murine fetal liver and bone marrow erythroid progenitor cells. AB - The toxicity of anti-HIV drugs, 3'-azido-3'-deoxythymidine (zidovudine, AZT), 2',3'-dideoxycytidine (DDC), 2',3'-dideoxy-2',3'-didehydrothymidine (d4T) and ribavirin was studied in vitro in murine fetal liver cells (FLC) and in bone marrow cells. These studies indicate that d4T is the least toxic drug and ribavirin is the most toxic agent in both models. However, the murine FLC system was found to be a more sensitive model for the assessment of toxicity of anti-HIV agents towards erythroid progenitor cells as indicated by the IC50 values. PMID- 2761344 TI - Patterns of extracellular norepinephrine in the paraventricular hypothalamus: relationship to circadian rhythm and deprivation-induced eating behavior. AB - In order to clarify the physiological role of norepinephrine (NE) in the hypothalamic paraventricular nucleus (PVN), changes in extracellular levels of endogenous NE were measured in 11 freely-moving rats using microdialysis and high pressure liquid chromatography with electrochemical detection. To determine whether there was a circadian pattern of extracellular NE in freely-eating subjects, samples of dialysate from the vicinity of the PVN were collected and assayed for NE every 2 hrs for 48 hrs. The pattern of NE averaged across subjects was similar during both 24-hr periods, with a reliable peak at the beginning of the dark cycle and relatively stable levels at all other times. When these animals were subsequently deprived of food for 24 hrs, a gradual rise in extracellular NE was observed, ultimately increasing to 215% of the predeprivation level. When the animals were refed and NE measurements were continued at more frequent intervals, extracellular levels were found to decline during the first 20 min of eating, as well as over the next 3 hrs as food intake diminished. These patterns of extracellular NE, together with previous evidence, suggest that endogenous NE in the PVN plays a role in the initiation and/or maintenance of normal eating behavior at the beginning of the nocturnal feeding period, as well as after food deprivation. PMID- 2761345 TI - Verification of NB2 lymphoma cell bioassay for the measurement of plasma and pituitary prolactin in the Mongolian gerbil (Meriones unguiculatus). AB - Serum and pituitary glands were taken from male Mongolian gerbils which had received bromocriptine implants, ether stress or no treatment (controls). Pituitary prolactin (Prl) and growth hormone (GH) mRNA were analyzed by Northern hybridization using rat cDNA probes. Pituitary and plasma Prl content were analyzed with the Nb2 lymphoma cell growth bioassay. These assays were sensitive to the decreases in Prl caused by bromocriptine and the elevation of Prl caused by ether stress. The inhibition of pituitary and plasma Prl levels by bromocriptine correlated with a marked inhibition of pituitary Prl mRNA content. In contrast, levels of GH mRNA did not change with treatment, indicating that gerbil GH does not contribute to the lactogenic activity measured in the Nb2 lymphoma cell bioassay. The results indicate that this bioassay is suitable for the measurement of gerbil pituitary and plasma Prl. PMID- 2761346 TI - Quantal melatonin suppression by exposure to low intensity light in man. AB - Plasma melatonin concentrations were examined following three relatively low intensities of artificial light. Six normal, healthy control subjects were all exposed to (a) 200 lux, (b) 400 lux and (c) 600 lux for a three hour duration from midnight to 0300 h. Blood was also collected on a control night where light intensity was less than 10 lux throughout. Significant suppression of melatonin was observed following light of 400 lux and 600 lux intensity when compared to the control night (p less than 0.05; Mann-Whitney U-test). 200 lux light did not produce a statistically significant melatonin suppression when compared with control samples. Each light intensity produced its own individual maximal melatonin suppression by one hour of exposure. Increased duration of exposure to the light had no further influence on melatonin plasma concentrations. These data confirm a dose response relationship between light and melatonin suppression, and indicate that there is no reciprocal relationship between the effects of light intensity and the duration of exposure on maximal melatonin suppression in man. PMID- 2761347 TI - Staurosporine potentiates platelet activating factor stimulated phospholipase C activity in rabbit platelets but does not block desensitization by platelet activating factor. AB - The possible involvement of protein kinase C activation in regulating PAF stimulated PLC activity was studied in rabbit platelets. PAF (100 nM for 5 seconds) stimulated incorporation of 32P into proteins and caused [3H]InsP3 levels to increase about 260% of control. These responses were compared after platelets were pretreated with either PAF, phorbol 12-myristate 13-acetate (PMA) or staurosporine and also after pretreatments with staurosporine followed by PAF or PMA. Pretreating platelets with staurosporine potentiated PAF-stimulated [3H]InsP3 levels by 54% and blocked protein phosphorylation. Pretreatments with PAF and PMA caused PAF-stimulated [3H]InsP3 levels to decrease to 115 and 136%, respectively. Staurosporine pretreatment blocked the decrease caused by the PMA pretreatment but not that by PAF. This study demonstrates that PAF-stimulated PLC activity is negatively affected by protein kinase C (PKC) activation and that inhibition of PKC activity did not prevent desensitization of PLC by PAF. PMID- 2761348 TI - Norepinephrine turnover in iron deficiency: effect of two semi-purified diets. AB - The effects of two dietary treatments on norepinephrine turnover in iron deficiency were examined. These studies were designed to bridge the gap between previous studies of poor thermoregulation in iron deficiency which used a diet (HMW, Hubbel-Mendel-Wakeman formulation) relatively high in fat (46% of calories) and moderate in carbohydrate (46% of calories) and the more recent studies of thermogenesis in iron deficiency which use the AIN-76 recommended diet which is relatively low in fat (11% of calories) and high in carbohydrate (67% of calories). Iron deficient rats grew less well and had depressed thyroid hormone concentrations regardless of dietary treatment group. The HMW diet significantly increased norepinephrine turnover in heart in iron deficient animals relative to AIN diet but had no effect in controls. Brown adipose tissue norepinephrine turnover was threefold higher in HMW rats fed a low iron diet, and only 67 percent higher in control rats. This study demonstrates that certain modest macronutrient manipulations affect norepinephrine content and turnover more in iron deficient than controls. However, abnormalities in thyroid hormone concentrations persist in iron deficient animals regardless of these dietary treatments. PMID- 2761349 TI - Effects of dietary casein and soy protein on metabolism of radiolabelled low density apolipoprotein B in rabbits. AB - Rabbits fed semipurified diets containing casein have elevated plasma cholesterol levels compared to those fed soy protein. As part of continuing studies on the mechanism of casein-induced hypercholesterolemia, two groups of six rabbits were fed these diets for 14 to 16 weeks. Animals fed the casein diet were found to have significantly higher plasma concentrations of protein, cholesterol, triacylglycerol, phospholipid and apolipoprotein B (apo B) associated with low density lipoprotein (LDL) than those fed the soy protein diet. Kinetic studies showed that the fractional catabolic rate of LDL-apo B was significantly lower in animals fed casein than in those fed soy protein regardless of whether the tracer LDL was obtained from donors fed casein or soy protein. The production rate of LDL-apo B was higher in casein-fed animals but this was not statistically significant. These results show that the efficiency of removal of LDL is significantly reduced in animals fed casein compared to those fed soy protein, and that the source of LDL did not affect the efficiency of its subsequent removal. The accumulation of LDL in casein-fed animals is consistent with down regulation of the LDL receptor. PMID- 2761350 TI - Effects of fish oil, corn oil and lard diets on lipid peroxidation status and glutathione peroxidase activities in rat heart. AB - In this study, we investigated the effect of various types of fats on heart lipid peroxidation status and on blood lipid parameters. Rats were fed either a low-fat diet (2.2% lard plus 2.2% corn oil), a corn oil diet (17%), a salmon oil diet (12.5%) supplemented with 4.5% corn oil, or a lard diet (15%) supplemented with 2% corn oil. All diets were supplemented with 1% cholesterol. Rats were fed for eight weeks. When compared with the low-fat diet, the salmon oil-diet intake resulted in a lower blood cholesterol, triglyceride and phospholipid concentrations (-50, -56 and -30%, respectively). Corn oil only tended to lower blood lipids; this decrease was significant for triglycerides only (-40%). The hypocholesterolemic effect of salmon oil diet is even more pronounced, if blood cholesterol values are compared with those of rats fed the lard diet. Heart lipid composition was not affected by dietary manipulations. Fatty acid composition of cardiac phosphatidylcholines and phosphatidylethanolamines, however, were altered by high-fat diets. In phosphatidylcholine, salmon oil induced a twelvefold decrease in the n-6/n-3 ratio and a 26% increase in the unsaturation index. For phosphatidylethanolamine, the n-6/n-3 ratio decreased 7.7-fold and the unsaturation index increased by 13%. A 50% decrease of the n-6/n-3 ratio was observed in animals fed the lard diet. Ultramicroscopic examination of ventricles revealed that those of the salmon oil group significantly accumulated lipofuscin like or ceroid material, whereas this accumulation was barely detectable in hearts of the other groups.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2761352 TI - Reaction products of alpha-tocopherol with a free radical initiator, 2,2' Azobis(2,4-dimethylvaleronitrile). AB - alpha-Tocopherol was reacted with an alkylperoxyl radical at 37 degrees C in ethanol. 2,2'-Azobis(2,4-dimethylvaleronitrile) was used to generate the alkylperoxyl radicals. The reaction products of alpha-tocopherol were isolated by reverse-phase and normal-phase high performance liquid chromatography, and their structures were characterized by infrared, ultraviolet, 1H and 13C nuclear magnetic resonances and mass spectrometry. They were 8aS-hydroperoxy-alpha tocopherone, 8aR-hydroperoxy-alpha-tocopherone, a mixture of 7,8-epoxy-8aS-ethoxy alpha-tocopherone and 7,8-epoxy-8aR-ethoxy-alpha-tocopherone, 8aS-(1R-cyano-1,3 dimethyl)butylperoxy-alpha-tocopherone+ ++, 8aS-(1S-cyano-1,3 dimethyl)butylperoxy-alpha-tocopherone+ ++, a mixture of 8aR-(1R-cyano-1,3 dimethyl)butylperoxy-alpha-tocopherone+ ++ and 8aR-(1S-cyano-1,3-dimethyl)butyl peroxy-alpha-tocopherone, 4aS,5R-epoxy-8aR-ethoxy-alpha-tocopherone, 4aR,5S-epoxy 8aS-ethoxy-alpha-tocopherone, 4aS,5R-epoxy-8aS-ethoxy-alpha-tocopherone and 4aR,5S-epoxy-8aR-ethoxy-alpha-tocopherone. PMID- 2761351 TI - In vivo incorporation of lauric acid into rat adipose tissue triacylglycerols. AB - An in vivo approach was taken to examine fatty acid esterification in adipose tissue using a coconut oil-enriched diet. Rats were fed a diet containing coconut oil (50% lauric acid) for six weeks. Triacylglycerols from perirenal adipose tissue were fractionated by silver nitrate-thin layer chromatography and, then, preparative gas chromatography. The distribution of 169 triacylglycerol types accounting for 97% of total triacylglycerols was determined. There was evidence for a very high content of mixed triacylglycerols composed of intermediate (12:0 and 14:0) and long acyl moieties. No significant differences were observed between the experimental distribution of triacylglycerol types and the random distribution, calculated from the total fatty acid composition. This indicated that most long chain triacylglycerols stored before coconut oil feeding would have been rearranged after the six weeks of coconut oil feeding. The experimental proportion of trilauroylglycerol reached 2%, as expected from its random proportion, and the proportions of dilauroylacylglycerols were slightly higher than the random values. Present results were compared with those previously obtained from triacylglycerols of adipose tissue of rats fed a low-fat standard diet. From our results and those of other authors, it is suggested that lauric acid is a good substrate for sn-glycero-3-phosphate acyltransferase and diacylglycerol acyltransferase in rat adipose tissue. PMID- 2761353 TI - The distribution of lipids and sterols in cell types from the marine sponge Pseudaxinyssa sp. AB - The sponge Pseudaxinyssa sp., unique in sterol and fatty acid composition, was cellularly dissected into fractions enriched in each of the major cell types present in the sponge: microbial symbionts (cyanobacteria), small sponge cells (pinacocytes and choanocytes), and large sponge cells (archeocytes and cyanophytes). Three phototrophic microbial symbionts were also isolated from the cell fractions and grown in culture. An unsymmetrical distribution of fatty acids and sterols was observed for the sponge cells: small cells contained larger quantities of long chain fatty acids (greater than C24) and smaller quantities of sterols than were present in the larger sponge cells. Moreover, the rare sterols 24-isopropylcholesterol predominated in the smaller sponge cells, whereas its 22 dehydro analog predominated in the larger sponge cells. Long chain fatty acids and sterols were not detected in the cultured microbial symbionts. This constitutes the first report of lipid variability according to cell type for this most primitive group of Metazoa. PMID- 2761354 TI - Effects of cholesterol oxidation derivatives on cholesterol esterifying and cholesteryl ester hydrolytic enzyme activity of cultured rabbit aortic smooth muscle cells. AB - The effects of 5 micrograms/ml of 25-hydroxycholesterol; cholestane-3 beta,5 alpha,6 beta-triol; and cholesterol on acyl CoA cholesterol acyltransferase, acid cholesteryl ester hydrolase and neutral cholesteryl ester hydrolase was studied in cultured rabbit aortic smooth muscle cells. After 1 hour incubation, 25 hydroxycholesterol resulted in a fourfold stimulation of acyl CoA cholesterol acyltransferase activity. No stimulation by 25-hydroxycholesterol was noted before 15 minutes or after 5 hours of incubation. Neither cholestane-3 beta,5 alpha,6 beta-triol nor cholesterol influenced acyl CoA cholesterol acyltransferase activity at any time interval. No significant effects of any of the sterols were noted on acid cholesteryl ester hydrolase or neutral cholesteryl ester hydrolase activity. The imbalance between acyl CoA cholesterol acyl transferase and hydrolase activities induced by 25-hydroxycholesterol could result in cholesteryl ester accumulation by arterial smooth muscle cells, which may be associated with atherosclerosis. PMID- 2761355 TI - An improved procedure for bile acid extraction and purification and tissue distribution in the rat. AB - Two bile acid extraction procedures were compared using endogenously radiolabeled tissues and feces. The method of Setchell et al. (J. Lipid Res. 24, 1085-1100, 1983) resulted in essential complete extraction, whereas that of Manes and Schneider (J. Lipid Res. 6, 376-377, 1971) gave recoveries between 56-82%. The time requirement for the method of Setchell et al. could be drastically reduced with no loss in extraction efficiency. Using extracts from endogenously labeled material, a purification procedure using C18 solid-phase extraction cartridges was developed that recovers greater than 90% of bile acids. The distribution of bile acids within the intestinal tract and liver of the rat was determined. PMID- 2761356 TI - Comparative study of methods for measuring cholesterol in biological fluids. AB - A method combining enzymatic and electrochemical detection of cholesterol in biological fluids was compared with conventional detection methods: two chromatographic methods--gas chromatography or high performance liquid chromatography--and two enzymatic methods with colorimetric detection either by kinetic measurement or at the end of the reaction. For serum, enzymatic determination is accurate with both colorimetric detection methods; but for bile, colorimetric detection is difficult to perform due to interference from bile pigments. Enzymatic cholesterol determination, combined with electrochemical detection, is simpler and gives results in good agreement with those of chromatographic methods. PMID- 2761357 TI - 2-Hydroxy fatty acids from marine sponges. 2. The phospholipid fatty acids of the Caribbean sponges Verongula gigantea and Aplysina archeri. AB - The alpha-hydroxy fatty acids 2-hydroxy-eicosanoic (1) acid, 2 hydroxyheneicosanoic (2) acid, 2-hydroxydocosanoic (3) acid, 2 hydroxytetracosanoic (4) acid, 2-hydroxy-23-methyl-tetracosanoic acid and 2 hydroxypentacosanoic (5) acid were isolated from the Caribbean sponges Verongula gigantea and Aplysina archeri. The very long chain fatty acids 5,9 nonacosadienoic acid (29:2) and 5,9,23-tricontatrienoic acid (30:3) were also identified together with the iso-prenoid fatty acid 3,7,11,15 tetramethylhexadecanoic (phytanic) acid that seems to be common in the Aplysinidae. A. archeri contained an extremely long chain fatty acid tentatively characterized as dotricontaenoic (32:1) acid. These acids were found to occur in phosphatidylserine, phosphatidylinositol, phosphatidylethanolamine, phosphatidylcholine and traces of phosphatidylglycerol. PMID- 2761358 TI - Effect of dietary fat on individual long-chain fatty acyl-CoA esters in rat liver and skeletal muscle. AB - The effect of dietary fat on the long-chain acyl-CoA ester profile of liver and skeletal muscle was investigated by feeding weanling rats 12%-fat diets composed of high-linoleic safflower oil (73% 18:2n-6), high-oleic safflower oil (70% 18:1n 9) or olive oil (70% 18:1n-9) for six and ten weeks. Approximately 50% of both hepatic and skeletal muscle acyl-CoA esters comprised linoleoyl-CoA or oleoyl-CoA with high-linoleic or oleic feeding, respectively. Total hepatic acyl-CoA ester concentration was 40% higher (p less than 0.05) in rats fed 12% fat compared with controls fed a 4%-fat diet. These data demonstrate that the long-chain acyl-CoA ester profile of liver and skeletal muscle reflects the dietary fatty acid profile. PMID- 2761359 TI - Vitamin E. deficiency increases the synthesis of platelet-activating factor (PAF) in rat polymorphonuclear leucocytes. AB - Vitamin E deficiency was found to stimulate FMLP (N-formyl-L-methionyl-L-leucyl-L phenylalanine)-induced biosynthesis of PAF (1-O-alkyl-2-acetyl-sn-glycero-3 phosphocholine) in polymorphonuclear leucocytes (PMN) from rat peritoneum. In three separate experiments each, the amounts of PAF synthesized during 6 min and 12 min incubation of PMN cells from control, vitamin E-supplemented, and vitamin E-deficient rats were 129-240, 131-227 and 248-354 pmol/10(6) cells, respectively. The activity of the acetyl-transferase, which transfers the acetyl moiety of [3H]acetyl-CoA to 2-lysoPAF (1-O-alkyl-sn-glycero-3-phosphocholine) to form [3H]PAF, was higher in PMN homogenates from vitamin E-deficient rats (2.28 +/- 0.07 nmol/min/mg protein) than in those from E-supplemented rats (1.06 +/- 0.10 nmol/min/mg protein). However, there was no difference between the two groups in the activity of acetylhydrolase (4.26 +/- 0.71 and 4.26 +/- 0.06 nmol/min/mg protein, respectively), measured as degradation of [3H]PAF to [3H]lysoPAF. In vitro addition of alpha-tocopherol did not inhibit the increased activity of acetyl-transferase in vitamin E-deficient rats, indicating that the enzyme in vitamin E-supplemented rats was not directly inhibited by alpha tocopherol. The acetyl-transferases of the two groups showed similar Km values for acetyl-CoA, but different Vmax values (225 microM and 6.4 nmol/min/mg protein in vitamin E-deficient rats, and 216 microM and 3.6 nmol/min/mg protein in vitamin E-supplemented rats), suggesting that the enzyme was not activated but increased in amount in vitamin E deficiency. PMID- 2761360 TI - Improved sensitivity of MRI in multiple sclerosis by use of extensive standardized procedures. AB - The relative value of two different MRI procedures for the assessment of infratentorial extension in multiple sclerosis (MS) was studied. Multislice spin echo techniques were used overall. Procedure A consisted of parasagittal T1 weighted images (500/30) and axial T2-weighted images (2500/30, 2500/120). Procedure B consisted of parasagittal T2-weighted images (1600/35, 1600/90). In the parasagittal T2-weighted images clear visualization of MS lesions is achieved because signal intensities of CSF and normal nervous tissue are nearly identical. All images were performed with a 0.5 Tesla MR system. Data were obtained in 98 patients with definite (N = 30) or probable MS (N = 68). Areas with abnormal signal intensity in the infratentorial regions (brainstem, cerebellum, and/or cervical spinal cord) were identified in 44% of the patients with procedure A and in 64% with procedure B. The standard application of the combination of both procedures improves the sensitivity of the MR examination for the diagnosis of MS, the delineation of infratentorial lesions and the correlation between clinical and MR data without excessively increasing imaging time. PMID- 2761361 TI - Analysis of imaging axes significance in motion artifact suppression technique (MAST): MRI of turbulent flow and motion. AB - Recently, a new technique has been demonstrated which effectively refocusses the dephasing effects of spins moving during application of MR imaging gradients. This paper presents an analysis of imaging axes significance in spin dephasing for motion occurring along the slice select, read and phase-encoding directions. A flow phantom under constant flow conditions in all experiments was used to provide complete spin dephasing when "traditional" imaging gradients were used. The MAST technique was used to refocus along various combinations of imaging axes, and variable number of terms from the Taylor expansion of motion along them. Results indicate that motion along any imaging axis can be refocussed effectively when MAST gradients are used along only the slice select and read axis. PMID- 2761362 TI - Iophendylate or spillage from epidermoid--a diagnostic dilemma on cranial MR imaging. AB - MR characteristics of iophendylate in spinal subarachnoid space are well known. Still, it is difficult to differentiate it from spilled contents of epidermoid on cranial MR imaging. PMID- 2761363 TI - Abdominal applications of fast MR imaging: a comparison of fast field echo (FFE) and spin echo (SE) pulse sequences. AB - Fast gradient echo (GE) MR imaging during breathhold was performed in 73 abdominal MR examinations in order to determine the value of GE technique in the reduction of movement artefacts and improvement of image quality. The results were compared with conventional spin-echo (SE) technique. T1-weighted SE images consistently demonstrated normal anatomy and pathology. T2*-weighted and intermediate GE technique proved to be superior to T2-weighted SE technique in a considerable number of cases providing not only better delineation of normal structures but also better lesion detection. At this stage GE technique should be considered as an adjunct to T1-weighted SE technique. If the artefacts presently inherent to GE imaging could be reduced or compensated for, this technique of rapid MR imaging during suspended respiration could become an important tool being one of the fastest techniques for abdominal MR imaging. PMID- 2761364 TI - Simple formulae for the calculation of RHO, T1 and T2 from a properly designed diagnostic NMR experiment. AB - The calculation of rho, T1 and T2 images from a minimal set of source images is considerably simplified if proper values for the sequence parameters are chosen. For the spin-echo technique a setup is suggested - a ratio of three between the effective repetition time of the T2- and the T1-weighted acquisitions - which not only produces the desired simplifications but which also is entirely compatible with normal diagnostic practice and close to optimum for two-point measurements. PMID- 2761365 TI - Paranasal sinus mucocele: unusual MR manifestations at 1.5 T. AB - The classic MR appearance of paranasal sinus mucoceles is due to its cystic composition. We present two cases of paranasal sinus mucocele that exhibit atypical signal characteristics. The morphology of this lesion, rather than its signal intensity, is paramount in establishing this diagnosis. PMID- 2761366 TI - Warfarin for dilated cardiomyopathy: a bloody tough pill to swallow? AB - Although current recommendations for the treatment of dilated cardiomyopathy include long-term anticoagulation to diminish the likelihood of systemic embolization, there have been no clinical trials examining the effectiveness of anticoagulation in preventing systemic embolization in these patients. Furthermore, those recommendations do not address the issue of the quality of life associated with long-term warfarin therapy. Using decision analysis, the authors examined the benefits and risks of long-term anticoagulation for patients 35 to 75 years of age who have dilated cardiomyopathy. The results show that anticoagulant therapy increases quality-adjusted life expectancy by 76 to 128 days, depending on the patient's age. Sensitivity analysis, however, demonstrates that the outcome is dependent on the disutility associated with long-term warfarin therapy. Interestingly, anticoagulation exerts most of its benefit by preventing pulmonary embolization, not systemic embolization. The authors conclude that the current recommendation to anticoagulate these patients, although probably correct for many patients, should take into consideration the change in lifestyle imposed by long-term anticoagulant therapy. For some patients, the benefit may not outweigh the sacrifice. PMID- 2761367 TI - Medical students' and residents' estimates of cardiac risk. AB - Resident physicians' and medical students' perceptions of atherosclerotic heart disease (ASHD) risks and their understanding of risk appraisal concepts were studied. Subjects estimated the average risks of death from ASHD, from motor vehicle accidents, and from all causes for men in three age groups. Given a patient with severe hypertension, they then estimated relative risk and used their estimates to calculate individual patient risks. Risk estimates varied widely. Only 36% of the subjects were consistently accurate estimators of ASHD and all-causes risks. Subjects who had family histories of heart disease performed significantly better than others. Only about half the subjects were able to compute the hypertensive patient's risk correctly. Thus, residents and students were not adept at estimating the average risks of death from various causes or using the estimates to assess a patient's risk. Better physician understanding of these concepts might lead to improved patient counseling in risk factor reduction. PMID- 2761368 TI - [The development of an all-Union registry of persons exposed to radiation resulting from the accident at the Chernobyl atomic power station]. PMID- 2761369 TI - [Magnetic resonance tomography in kidney tumors concomitant with symptomatic hypertension]. AB - The potentialities of NMR-tomography in renal cancer patients with symptomatic hypertension were assessed. Altogether 15 patients (9 men and 6 women) aged 24 to 74 were investigated; previously examined 25 persons were entered into the control group. A NMR-tomograph with the magnitude of the magnetic field of 0.235 T using the "spin-echo" method. The results of the investigation were compared with those of the control group and with the results of x-ray computerized tomography, abdominal aortography, dynamic scintigraphy of the kidneys, and ultrasound investigation. NMR-tomography was shown to possess high resolution permitting visualization of a kidney tumor irrespective of its site and its size exceeding 2-3 cm. It also permits obtaining additional data on the state of the kidney parenchyma, cortical and medullary substance, determining the level of ureteral obstruction, and detecting the presence of vertebral metastases. PMID- 2761370 TI - [The prognostic significance of the rate of growth in the radiation treatment of esophageal cancer]. AB - Biological growth parameters (tumor volume, doubling time with regard to a tumor site, a macroscopic type of tumor growth and semiregression time in radiotherapy or in its combination with radiomodifying agents) were analyzed in 180 esophageal cancer patients. Immediate and short-term results of therapy were shown to be in direct relation to the above factors. The most favorable prognosis is to be expected in the group of patients with fast growing tumors (doubling time less than or equal to 64 days) Unless a tumor of the esophagus has become large (a tumor volume not more than 68.6 cm3), it means exophytic or mixed growth, and radiotherapy is recommended in combination with radiomodifying agents, first of all with local hyperthermia. PMID- 2761371 TI - [The prognostic significance of cytological data in the radiation therapy of cervix cancer]. AB - Cytological investigation sometimes makes it possible to establish tumor progression or recurrence even before the appearance of the first clinical symptoms. An increase in the expression of radiation changes with further absence of tumor elements during a follow-up should be regarded as a prognostically favorable factor of the effectiveness of radiation therapy. PMID- 2761372 TI - [Local irradiation planning in prostatic cancer with the use of optimized dosage field variants]. AB - A method of dosimetric planning of multifield local irradiation of prostatic cancer using a file of optimized dose fields was proposed (the fields were computed for concrete patients). Basic charts were used to choose a necessary dose field, then the time of irradiation is computed in present directions for each concrete patient. The method was tested during the treatment of 19 patients who were given a course of radiotherapy in an outpatient setting. A continuous course of radiotherapy at a dose of 70-74 Gy was delivered. Radiation reactions of the rectum were insignificant, and they were eliminated without discontinuation of a course of irradiation. PMID- 2761373 TI - [External respiratory function during the combined treatment of breast cancer with the 254Cf irradiation of the parasternal lymph nodes]. AB - External respiratory function was investigated in 92 breast cancer patients before and after combined therapy. Changes in external respiratory function of the obstructive and restrictive type were observed only in the patients who had been subjected to preoperative gamma teletherapy, radical mastectomy and subsequent contact irradiation of the parasternal lymph nodes by administering 252Cf into the thoracic artery (vein). These changes were determined by gamma teletherapy. The absence of disturbed indicators of gaseous exchange and acid alkali balance of the capillary blood suggested a compensatory type of changes in external respiratory function. PMID- 2761374 TI - [A vacuum-capture manipulator of radiation sources]. PMID- 2761375 TI - [Efficient parameters of grid diaphragms for the radiation therapy of malignant tumors]. AB - In larger size malignant tumors it is necessary to raise a dose of irradiation and to increase field sizes whereas tolerant doses for normal tissues and stroma are reduced with an increase in the volume of irradiation. The adjustment of these two alternative requirements can be achieved with the help of grid diaphragms creating more sparing conditions of the irradiation of normal organs and tissues as a result of inhomogeneous dose distribution. The authors consider some mathematical models for assessment of the quality of an inhomogeneous dose field formed by using grid diaphragms. In this case the sparing of normal organs and tissues results only from a decrease in the volumes of irradiated normal tissues. The proposed mathematical models can be used for a choice of optimum parameters of grid diaphragms. PMID- 2761376 TI - [Effect of the radiation energy on patient radiation load and on the imaging width in lung study]. PMID- 2761377 TI - [Metrological and operating characteristics of thermoluminescent and photographic film dosimeters for the centralized individual dosimetric monitoring of medical personnel]. AB - Characteristics of a TLD thermoluminescent kit with LiF detectors of TLD and DTG 4 types (diameters 3.5 and 5 mm) and TLD-400 were compared with those of a kit of IFKU-1 individual photographic film badges. Individual thermoluminescent dosimeters record a total dose of occupational and background irradiation, and film badges--a dose of occupational irradiation only. It should be taken into account in radiation-hygienic interpretation of individual dosimetric control readings. PMID- 2761378 TI - A model of acute regional myocardial ischemia and reperfusion in the rat. AB - Studies were conducted in 76 rats to describe and validate a new closed-chest in vivo model for acute ischemia and reperfusion of the left coronary artery. Radiolabeled microsphere distribution in six rat hearts confirmed a significant reduction in arteriolar flow at the center of the ischemic zone (93% reduction of total myocardial counts compared to nonischemic region, P less than 0.01) after 7 min of occlusion. Arteriolar flow returned to control values upon reperfusion. While hemodynamic parameters in 10 rats during 7 min of occlusion and 7 min of reperfusion were monitored, end diastolic pressures increased significantly (P less than 0.01) during occlusion. Finally, the utility of this rat model was demonstrated in a study of contrast enhanced magnetic resonance imaging (N = 4). Normal myocardium could not be differentiated from acutely ischemic myocardium on noncontrast-enhanced MR images. After 5 min of myocardial ischemia and following contrast administration (albumin-Gd-DTPA), the ischemic zone appeared less enhanced than normal myocardium. Upon release of the occluder the left ventricular free wall once again yielded a homogeneous signal similar to that of the normal myocardium. PMID- 2761379 TI - Missing pulse steady-state free precession. AB - A fast imaging technique, missing pulse steady-state free precession (MP-SSFP), is described. MP-SSFP is one of a class of steady-state free precession techniques in which every nth RF pulse is missing. MP-SSFP has been implemented for the case where every third RF pulse is omitted: [-theta 1-r-theta 2-r-echo-r ]. A RF-refocused echo forms at the time of the missing pulse. This echo is less sensitive to field inhomogeneities than the gradient-recalled echoes used in most fast imaging methods. An analytical expression is obtained for the signal strength as a function of the flip angles theta 1 and theta 2, the interpulse interval tau, and the amount of interpulse dephase. The expression shows that theta 1 and theta 2 provide two degrees of freedom to optimize the signal-to noise ratio and improve tissue contrast. Two different cases, theta 1 = theta 2 and theta 1 = -theta 2, are described to demonstrate the difference in contrast. The first case gives a strong signal from spins with short T1 and short T2 while the second case has contrast very similar to a conventional SSFP technique. The theoretical expression predicts that the signal consists of multiple components which may be observed experimentally by adjusting the gradient pulses. PMID- 2761380 TI - Quantitative and qualitative fat analysis in human leg muscle of neuromuscular diseases by 1H MR spectroscopy in vivo. AB - 1H MR spectra were recorded from human gastrocnemius muscle at 63.86 MHz using the body coil of the Signa scanner as transmitter and a 3-in. surface coil as receiver. The fat content of the muscle was quantified relative to that of water in a selected volume or slice. The fat/water ratio was 0.05-0.07 for normal muscle but increased to 0.5-6.0 in primary and secondary muscular disorders such as Duchenne and myotonic dystrophy, Charcot-Marie-Tooth and polio muscular atrophy, cerebral palsy, and spina bifida. In Werdnig-Hoffmann spinal atrophy the ratio was above 10. Water-suppressed and slice-selective 1H spectroscopy was used for qualitative analysis of fat. The 1H profile of gastrocnemius muscles between healthy individuals and patients with neuromuscular diseases showed two major differences. In the normal muscle spectra, the resonance from the -(CH2)n- protons at 1.6 ppm was the most pronounced, whereas in the diseased muscle spectra resonances also appeared between 1.1 and 1.4 ppm. Some diseased muscle spectra showed multiple resonances from -CH = CH- in polyunsaturated fatty acids between 5.5 and 7.0 ppm. The corresponding resonances from = CH-CH2-, 1.9-2.0 ppm, and = CH-CH2-CH =, 2.7-2.9 ppm, were also seen. These peaks are usually not detected in normal muscle. PMID- 2761381 TI - Snapshot imaging at 0.5 T using echo-planar techniques. AB - Echo-planar imaging using a magnetic field strength of 0.5 T has resulted in an improvement in image quality compared with recent images published at 0.1 T. The sensitivity of the technique to main magnetic field inhomogeneity and transient eddy currents has necessitated innovations in gradient and radiofrequency coil design. These improvements are described, and new variations in the echo-planar pulse sequence which provide better contrast and allow separate imaging of water and fat distributions are presented. PMID- 2761382 TI - Magnetic field modulation of receptor binding. AB - Although it is widely held that the magnetic fields encountered during magnetic resonance imaging (MRI) and other procedures have no discernible effect on biological systems, we find that at early times of incubation, the amount of binding of the neurotoxin, alpha-bungarotoxin, to nicotinic acetylcholine receptor is significantly reduced in a constant 2.0-T magnetic field. This finding suggests that steady magnetic fields can directly affect the functional activity of biologically important macromolecules, in this particular case a neurotransmitter receptor. PMID- 2761383 TI - MRI detection of myocardial perfusion changes by gadolinium-DTPA infusion during dipyridamole hyperemia. AB - To detect abnormal regional myocardial coronary flow reserve, serial spin-echo MR tomograms of four control dogs and six with a partial balloon occlusion of the left anterior descending (LAD) coronary artery were acquired before and after dipyridamole infusion and during the paramagnetic effect of a bolus plus infusion of gadolinium-DTPA. Microsphere myocardial blood flow was measured for correlation with serial regional changes in MR signal intensity. Significant difference in gadolinium-enhanced MR signal intensity existed between the hypoperfused LAD and the hyperemic left circumflex perfusion beds (46 +/- 22% vs 78 +/- 29% above baseline, respectively; P less than 0.05). The percentage changes in gadolinium-enhanced MR signal and microsphere myocardial blood flow were significantly correlated (r2 = 0.93). PMID- 2761384 TI - In vivo localized ESR spectroscopy reflecting metabolism. AB - Localized electron spin resonance spectroscopy in live mice was performed using a surface coil operating at 1.1 GHz with sufficient sensitivity and stability to measure quantitatively the time course of the distribution, uptake, and reduction of nitroxides in selected organs/regions (liver, bladder, head) of mice. The ability to measure regional concentrations of nitroxides in vivo could be used for pharmacokinetic analysis of drugs labeled with nitroxides and for measurement of oxygen concentrations and redox metabolism. PMID- 2761385 TI - Self-refocusing 270 degrees Gaussian pulses for slice selection without gradient reversal in magnetic resonance imaging. AB - It is demonstrated, on the grounds of simulations, how 270 degrees Gaussian pulses can be used for slice selection in nuclear magnetic resonance imaging experiments. It is shown that the usual gradient reversal procedure can be omitted if the selective 90 degrees pulse normally used is replaced by a self refocusing 270 degrees pulse with a Gaussian time-domain amplitude profile, and some of the properties which are specific to this type of pulse are explored. PMID- 2761386 TI - PEEP--a rapid chemical-shift imaging method. AB - The phase-encoded echo-planar (PEEP) technique, a variant of echo-planar imaging, is used to achieve simultaneous high-speed spatial and chemical-shift data acquisition. This technique is the 2DFT equivalent of the projection reconstruction echo-planar method for chemical-shift imaging. Examples of images and spectra obtained using the PEEP method are presented. PMID- 2761387 TI - Sequence analysis of the wall-associated protein precursor of Streptococcus mutans antigen A. AB - The nucleotide sequence has been determined for the Streptococcus mutans wall associated protein A (wapA) gene from serotype c strains Ingbritt and GS5. The nucleotide sequence for each wapA gene was virtually identical, although the gene from strain GS5 contained a 24 base pair deletion. A 29 amino acid signal peptide was specified by each wapA gene with a mature protein of 424 amino acids (Mr, 45,276) for strain Ingbritt and 416 amino acids (Mr, 44,846) for strain GS5. In the C-terminal region of the wall-associated protein A, considerable sequence similarity was found with the membrane anchor region of proteins from other Gram positive organisms such as the group A streptococcal M protein and the group G streptococcal IgG binding protein. Adjacent to the proposed membrane anchor is a highly hydrophilic region which may span the cell wall; both sequence data and experimental evidence indicate the existence of a region immediately outside the wall at which proteolytic cleavage occurs to release antigen A of Mr 29,000 into the culture supernatant. Thus, the wall-associated protein A is a precursor of the 29,000 Mr antigen A. PMID- 2761388 TI - Molecular analysis of linear plasmid-encoded major surface proteins, OspA and OspB, of the Lyme disease spirochaete Borrelia burgdorferi. AB - The ospA and ospB genes encode the major outer membrane proteins of the Lyme disease spirochaete Borrelia burgdorferi. The deduced translation products from the ospA and ospB genes were: (OspA) 273 amino acids long with a molecular weight of 29,334, and (OspB) 296 amino acids long with a molecular weight of 31,739. The two Osp proteins showed a great degree of sequence similarity indicating a recent evolutionary event. Molecular analysis and sequence comparison of OspA and OspB with other proteins revealed a sequence similarity to the signal peptides of prokaryotic lipoproteins. These are the first sequences from Borrelia and provide interesting data on the evolutionary relationship between spirochaetes and other species as well as providing potential for spirochaete diagnostics and vaccines. PMID- 2761389 TI - Analysis of the yopA gene encoding the Yop1 virulence determinants of Yersinia spp. AB - The Yop proteins of Yersinia are important virulence determinants. The Yop1 protein sequences of Yersinia pestis, Yersinia pseudotuberculosis, and two Yersinia enterocolitica serotypes, 0:3 and 0:8, deduced from the nucleotide sequences of the corresponding yopA genes, were compared. Most differences were found in the hydrophilic domains of the proteins, whereas the hydrophobic domains were conserved. The amino acid sequences revealed a signal sequence 25 amino acids long. No cysteine residues were present, even though Yop1 forms a polymeric structure. The transcription startpoint of yopA was determined by primer extension. The coding region and transcription startpoint were separated by a leader sequence 270 nucleotides long. The yopA promoter sequence of Y.pestis is identical to the corresponding sequence of Y. pseudotuberculosis and transcription studies revealed that this promoter is active in Y.pestis. Thus, the inability of Y.pestis to express the Yop1 protein is due to a single base pair deletion in the coding region of the yopA gene of Y.pestis. PMID- 2761390 TI - Molecular characterization of a surface protein antigen gene from serotype c Streptococcus mutans, implicated in dental caries. AB - The complete nucleotide sequence of the gene for a cell-surface protein antigen (PAc) of Streptococcus mutans MT8148 (serotype c) was determined. The pac gene consisted of 4695 bp and coded for a 170773D protein. The pac gene product contained a putative 38 amino acid signal peptide, resulting in a 166817D mature protein. A potential promoter sequence and a putative Shine-Dalgarno sequence preceded the open reading frame. Two internal repeating amino acid sequences were present in the PAc. One repeating region located in the N-terminal region was rich in alanine, and the other located in the central region was rich in proline. Southern blot analysis under the less stringent condition (allowing up to 35% base mismatch) revealed that the probe covering the proline-rich region hybridized to DNA preparations from strains of Streptococcus cricetus, Streptococcus sobrinus and Streptococcus downei as well as Streptococcus mutans. PMID- 2761391 TI - Sales tax and the dental office. PMID- 2761392 TI - Getting the most out of insurance claims forms. PMID- 2761393 TI - Training in a multi-disciplinary approach to dental health in the aging. PMID- 2761394 TI - Missouri Dental Board conducts Dental Hygiene Manpower Survey. PMID- 2761395 TI - State program directors discuss manpower issue. PMID- 2761396 TI - Teamwork needed to alleviate dental assisting shortage. PMID- 2761397 TI - Take a look around. PMID- 2761398 TI - Modality effects in the coding and reproduction of rhythms. AB - The temporal coding assumption is that time of presentation is coded more accurately for auditory events than for visual events. This assumption has been used to explain the modality effect, in which recall of recent auditory events is superior to recall of recent visual events. We tested the temporal coding assumption by examining the coding and reproduction of quintessentially temporal stimuli-rhythms. The rhythms were produced by sequences of short and long auditory stimuli or short and long visual stimuli; in either case, the task was to reproduce the temporal sequence. The results from four experiments demonstrated reproduction of auditory rhythms superior to that of visual rhythms. We conclude that speech-based explanations of modality effects cannot accommodate these findings, whereas the findings are consistent with explanations based on the temporal coding assumption. PMID- 2761399 TI - Accuracy of temporal coding: auditory-visual comparisons. AB - Three experiments were designed to decide whether temporal information is coded more accurately for intervals defined by auditory events or for those defined by visual events. In the first experiment, the irregular-list technique was used, in which a short list of items was presented, the items all separated by different interstimulus intervals. Following presentation, the subject was given three items from the list, in their correct serial order, and was asked to judge the relative interstimulus intervals. Performance was indistinguishable whether the items were presented auditorily or visually. In the second experiment, two unfilled intervals were defined by three nonverbal signals in either the auditory or the visual modality. After delays of 0, 9, or 18 sec (the latter two filled with distractor activity), the subjects were directed to make a verbal estimate of the length of one of the two intervals, which ranged from 1 to 4 sec and from 10 to 13 sec. Again, performance was not dependent on the modality of the time markers. The results of Experiment 3, which was procedurally similar to Experiment 2 but with filled rather than empty intervals, showed significant modality differences in one measure only. Within the range of intervals employed in the present study, our results provide, at best, only modest support for theories that predict more accurate temporal coding in memory for auditory, rather than visual, stimulus presentation. PMID- 2761400 TI - Altering memory through recall: the effects of cue-guided retrieval processing. AB - Three experiments were designed to investigate the influence of initial recall on memory by assessing delayed recall after different immediate cued-recall tests. In all experiments, subjects performed semantic and phonemic encoding tasks on a word list. The subjects then received a cued-recall test that cued the target using the same word as the context word in the encoding task, a test that cued the target with a word from the same level at which the target was encoded, a test that cued the target with a cue from a different level at which the target was encoded, or no immediate-recall test. One day later, the subjects performed a final cued-recall test in which the type of cue (semantic or phonemic) was varied. Consistently, delayed recall was facilitated primarily when the cue on the immediate test was from the same level as the cue on the delayed test. This pattern of facilitation suggests that immediate cued-recall produces an elaboration of an existing memory representation that is closely tied to the type of cue used on the immediate test. PMID- 2761401 TI - Flashbulb memories: special, but not so special. AB - This study deals with flashbulb memories associated with the assassination of the Swedish prime minister Olof Palme. A major goal of this research was to explore the consistency of such memories through comparison of the subjects' recollections on two different occasions, one year apart. The results obtained indicated that flashbulb events are accurately recalled in terms of a narrative conception of the concomitant circumstances of the event, but that the event descriptions are not consistent with respect to the specific details of these circumstances. It was concluded that the loss of information during one year contradicts the notion that flashbulb memories persist in absolute accuracy over time, as has been claimed in previous studies. Rather, these memories appear to be reconstructions based on residuals of the circumstances concomitant with the specific event (i.e., that of first hearing of the shocking news), and these memories follow the same pattern of recollection as does recollection of other autobiographical and laboratory-induced emotional events. PMID- 2761403 TI - Semantic facilitation and translation priming effects in Chinese-English bilinguals. AB - In two experiments, semantic facilitation and translation priming effects in Chinese-English bilingual speakers were demonstrated with a lexical decision task. A 300-msec stimulus-onset asynchrony (SOA) was used between display of the prime and the target item. Experiment 1 showed that subjects' lexical decision responses were facilitated to a greater extent when primed by a translation equivalent than a semantically related between-language word. In Experiment 2, we found that pictorial, between-language, and within-language primes produced comparable effects of semantic facilitation. These results are in line with the hypothesis that lexical items in different languages and pictures are processed by means of an amodal conceptual system. PMID- 2761402 TI - Constraints on priming in spatial memory: naturally learned versus experimentally learned environments. AB - In four experiments, we explored constraints on priming in spatial memory. In Experiments 1 and 2, subjects who were familiar with the locations of buildings on the Vanderbilt campus participated in a recognition test. The subjects' task was to decide whether or not named buildings were on the campus. Foils in this recognition test were realistic but fictional names of buildings. In principle, the subjects could have performed this task without using spatial knowledge; in fact, they must not have used spatial knowledge, because there was no evidence of priming in recognition as a function of the spatial relations between buildings on the campus. This result differs from those obtained in earlier experiments that have examined memory of spatial layouts learned in laboratory settings. In Experiment 3, the fictional foils were replaced by names of buildings in an area of the campus separated geographically from the main campus. Evidently, this change induced subjects to retrieve spatial knowledge, because the spatial priming effect materialized. A fourth experiment replicated the above findings in a single experiment and demonstrated that spatial priming could be obtained when the configuration of buildings was learned experimentally. These results are explained by appealing to the "decontextualization" that takes place in memory over time. PMID- 2761404 TI - A semantic memory sentence verification model based on relative judgment theory. AB - A subjective referent model of sentence verification in semantic memory tasks based on the relative judgment theory of Link and Heath (1975), together with the derivation of a discriminability index, are presented in this paper. An attractive feature of the model is its consideration of both error rates and response times (RTs) in the calculation of the discriminability index. The model is also able to account for the frequent finding in semantic memory tasks that error RTs are longer than correct RTs. A partial replication of Experiment 2 of McCloskey and Glucksberg's (1979) sentence verification context effect studies, in which we employed 44 subjects and 28 categories, and controlled for item familiarity, revealed that error RTs were consistently longer than correct RTs--a finding inconsistent with the McCloskey and Glucksberg property comparison model, but in accord with the subjective referent model. An important fortuitous result was the detection of a context effect by the discriminability measure, an effect not detected by the RT data alone. The discriminability measures yielded a near perfect correlation with estimates of the mean step size of the random walk obtained by application of the parameter estimation program FITTRW (Heath, 1983). PMID- 2761405 TI - On the role of word frequency in the detection of component letters. AB - The experiments reported in this study were conducted to explore the issue of race models versus holistic models of word processing. In both types of model, it is assumed that an available word-level encoding for a display will conceal letter information, and thereby inhibit component-letter detection. However, whereas in holistic models it is assumed that encoding always should occur at the word or pattern level first, in the race models it is assumed that encoding occurs at all levels (e.g., feature, letter, and word) simultaneously, with the final level of encoding being at whatever level has been completed first. If the rate of word-level encoding is facilitated by increasing word frequency, the holistic models predict a generally declining latency for letter detection, because the initial step in letter detection (i.e., word-level encoding) will be occurring more rapidly. The race models, on the other hand, predict that with increasing word frequency there will be an increasing chance that the word-level encoding will win the encoding race, resulting in an increase in the latency for letter detection (i.e., the word code will conceal the letter codes). Two experiments are reported, and the obtained pattern of latency data appears to be most consistent with the race models. PMID- 2761406 TI - Familiarity effects and word unitization in visual comparison tasks. AB - The decision that two words are identical is made more quickly than the decision that two non-words are identical. This familiarity effect was shown to be larger in a simultaneous matching task than in a sequential matching task. In the simultaneous task, two words were not matched as quickly as a single letter and a letter in a predesignated location within a word. The latter finding rules out a perceptual unitization account of the familiarity effect (Silverman, 1985). The familiarity effect was interpreted to be due to the facilitated encoding of a comparison item when a holistic cognitive unit representing the target is activated in memory. PMID- 2761407 TI - Evidence for the abstractive encoding of superficial position information in visual patterns. AB - When presented a series of patterns inside a frame, subjects unintentionally retained information concerning the frame-relative location of the elements composing the patterns; they could use this superficial information to estimate the frequency with which the elements occurred at various locations within the frame. There were two aspects of the results that supported the hypothesis that this superficial element-location information was abstractively encoded and, therefore, retrievable independent of the patterns comprising the elements: (1) Correlations between actual and estimated frequency remained significant after the effects of pattern recall were partialled out, and (2) correlations were enhanced by assuming that the frequency estimate for each location was affected by the imprecise coding of position for elements falling in surrounding locations. Additional experiments indicated that an orienting task emphasizing pattern recall resulted in very inaccurate estimation of element-location frequency, and intentional instructions improved the precision of position coding for individual elements. PMID- 2761408 TI - The effect of prediction accuracy on choice reaction time. AB - In this study, we examined the effect of prediction accuracy on reaction time (RT). Subjects performed on three blocks of choice RT trials, all of which involved the mapping of four stimuli (red, green, 1, or 0) onto two response keys. The subjects were told that the four stimuli were equally probable and that their task was to respond to each stimulus onset by pressing the correct key. In one block (stimulus-prediction), the subjects predicted, prior to each trial, the precise stimulus that would appear. In a second block (category-prediction), the subjects predicted the category of the stimulus (i.e., color or digit) that would appear. In a third block (no-prediction), the subjects simply responded to each stimulus without making a prior prediction. In the stimulus-prediction block, RT was faster for correct predictions than for incorrect predictions. In addition, RT was faster on trials in which an incorrect prediction involved the correct category than on trials in which it involved the incorrect category: that is, a "half-wrong" prediction was better than an "all-wrong" prediction. In the category-prediction block, RT was faster when the stimulus category was predicted correctly than when it was not. There was little evidence of a response facilitation contribution to the correct-prediction effect. These results permit inferences concerning the encoding and organization of information in memory. PMID- 2761409 TI - Calcitonin, zinc, and testicular function. AB - Recent studies demonstrating decreases in transport kinetics of zinc (Zn) in testis in response to calcitonin (CT) and the presence of CT receptors on Leydig cells has suggested a physiological interrelationship between CT and cellular Zn metabolism in the testis. The present studies were undertaken to evaluate the acute effects of human synthetic calcitonin (hCT) on testosterone (T) synthesis and on transmembrane Zn transport as measured in a closed two-compartment model system in Leydig cells isolated from intact and thyroparathyroldectomized (TPTX) rats. Leydig cells acutely exposed to 1 ng/mL equine luteinizing hormone (LH) in vitro had a fivefold increase in medium T concentration. Calcitonin at 42 micrograms/mL had no effect on the basal T synthesis and did not affect the increase seen after LH administration. Lower doses of LH demonstrated a dose response for T production, but no alteration in the pattern of response. In TPTX rats pretreated with 167 micrograms/d (25 MRC U/d) hCT subcutaneously (sc) for three days before they were killed, a reduction to 73% of the control value was observed in the in vitro Leydig cell fractional influx coefficient for Zn transport (P less than .02). No difference was observed in the fractional efflux coefficient. Fractional flux coefficients from intact rats demonstrated qualitatively similar, but more variable, changes. These data demonstrate that there is no acute effect of CT on T synthesis in the isolated Leydig cell. There does appear, nevertheless, to be a role for CT in the modulation of transmembrane Zn transport. Clinically important Zn-dependent alterations of T synthesis may require long-term changes in Zn metabolism before they become manifest.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2761410 TI - Free and protein-bound homocysteine and cysteine in cystathionine beta-synthase deficiency: interrelations during short- and long-term changes in plasma concentrations. AB - Homocysteine interacts in a complex way in the plasma with cysteine and plasma proteins. To explore the interrelations between free and protein-bound homocysteine and cysteine during short- and long-term changes in plasma levels, free and bound homocysteine and cysteine were measured in 13 patients with homocystinuria due to cystathionine beta-synthase deficiency. Levels were measured during oral methionine loads (4 g/m2 body surface area) and after oral betaine (3 g twice daily). In six pyridoxine-responsive patients, free and bound levels of homocysteine and cysteine, measured 4 to 24 hours after oral methionine, changed in a parallel manner. Similar close tracking occurred in fasting plasma samples collected from two pyridoxine-nonresponsive patients before and during betaine therapy. Oral betaine given to seven pyridoxine nonresponsive patients decreased free and bound homocysteine and increased free and bound cysteine toward normal levels during monitoring periods of up to 300 days. In these studies as the level of homocysteine decreased, the proportion of protein-bound homocysteine and cysteine increased. The present study establishes that changes in bound and free levels of either homocysteine or cysteine track closely in the short-term (four hours or less) and generally also in the long term (up to 300 days). PMID- 2761411 TI - Serum lipids and apolipoproteins in the rat refed after starving: influence of the molecular form of nitrogen (protein, peptides, or free amino acids). AB - Efficient treatment of deep denutrition should promote the restoration of normal intestinal villous structure and the return to a positive nitrogen balance. To determine whether the plasma measurement of lipoproteins could serve as sensitive indexes of villous architecture and/or nitrogen balance, these parameters were compared in rats starved for three days and refed three types of diets containing either whey proteins (WP), whey protein hydrolysate (WPH), or amino acids, known to differ in their capacity to promote restoration of normal villous architecture. Starvation lowered the concentration of triglycerides and phospholipids but not cholesterol. Apolipoprotein AI and AIV concentrations were also significantly lowered (30% and 40%, respectively), but ApoE was significantly increased by 40%. Upon refeeding with all three diets, plasma lipids progressively returned to control values except for triglycerides, which were significantly elevated by the protein and peptide diets. Apoprotein AI continued to decrease for 24 hours on the peptide and amino acid diets. Control levels were restored in all groups after 48 hours. ApoAIV increased progressively in parallel with the restoration of the intestinal mucosa; after 48 hours of refeeding, plasma concentrations of apo AIV were significantly correlated with jejunal villous height and protein content (P less than .01). ApoE was depressed below control levels in the WP and WPH groups at 24 and 48 hours and restored only after 96 hours. Because ApoE was affected, both in the fed state and during refeeding by the form of dietary nitrogen, it may prove to reflect nitrogen balance and/or insulin: glucagon balance.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2761412 TI - Nutrition and somatomedin: nutritionally regulated release of somatomedins and somatomedin inhibitors from perfused livers in rats. AB - Circulating somatomedin activity reflects the presence of both somatomedins and somatomedin inhibitors, factors which antagonize the growth-promoting actions of somatomedins. Although both are regulated by nutrition, somatomedin inhibitors respond more rapidly than somatomedins to refeeding in fasted animals. To explore the role of the liver in such responses, release of somatomedin activity and somatomedin inhibitor activity was assessed during perfusion of livers from normal, fasted, and fasted-refed rats. Size-exclusion high-performance liquid chromatography (HPLC) revealed that liver perfusates contain both somatomedin and somatomedin inhibitor activity of apparent molecular weight (mol wt) comparable to that found in the circulation (approximately 7,000 and approximately 30,000, respectively), as well as activity of apparently higher wt. In subsequent studies, responses to nutrition were evaluated as fluctuations in bioactivity only of mol wt comparable to that found in the circulation. Release of both somatomedin and somatomedin inhibitor activity was progressive over at least two hours of recirculating perfusion. Perfusates of livers from normal fed rats had somatomedin activity (stimulation of cartilage SO4 uptake) 94 +/- 19% above buffer (P less than .01), which fell to undetectable levels after three days of fasting. With refeeding, perfusate somatomedin activity rose within three hours to approximately 25% of levels in fed rats, but did not become significant until after 12 hours (29 +/- 7%, P less than .02). Perfusates of livers of fed rats also contained somatomedin inhibitor activity (42 +/- 10% inhibition of cartilage stimulation by normal serum), which rose after three days of fasting to 114 +/- 22% (P less than .02).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2761413 TI - Computation of the effective body mass for metabolic studies of lean and obese rats. AB - The whole-animal metabolic rates of lean and obese rats cannot be directly compared because obese rats have much greater body mass than lean rats. Expressing the results as metabolic rate per unit of body mass is also not satisfactory because lean and obese rats of the same size have different body compositions. To make possible comparisons between the two types of rats, metabolic rate must be expressed per unit of effective body mass. Effective body mass for lean and obese Zucker rats can be calculated as 1.00 M0.75 and 0.82 M0.75, respectively, where M is the mass of the animal. PMID- 2761414 TI - Changes in whole body lipid composition in a murine model of insulin-dependent diabetes mellitus. AB - To assess the effect of experimentally induced insulin-dependent diabetes mellitus (IDDM) on total body lipid composition, homogenates of neonatal (0-day) and 6-day Sprague-Dawley rat pups treated on day 0 with 65 mg/kg body weight of streptozotocin (STZ) or citrate buffer alone were compared using thin-layer and gas-liquid chromatographic techniques. STZ-treated littermates in a parallel study were markedly hyperglycemic, hypoinsulinemic and attained only 50% of the gain in weight of citrate-treated controls. Although both groups were similar in protein to body weight ratios, STZ-treated pups exhibited 60% of the total lipid content of citrate-treated littermates when compared by weight. The decrease in total lipid content in the STZ-treated group resulted specifically from decreased neutral and not phospholipid content, although a small increase in phosphatidic acid and sphigomyelin was observed in this group. The changes in relative whole body lipids with short-term, high-dose STZ parallel those reported in human IDDM. PMID- 2761415 TI - Abnormalities in the metabolism of postprandial and fasting triglyceride-rich lipoprotein subfractions in normal and insulin-dependent diabetic subjects: effects of sex. AB - To investigate the effect of sex and diabetes on postprandial lipoprotein metabolism, 15 normal and 12 normolipidemic subjects with insulin-dependent diabetes mellitus (IDDM) were studied. Plasma triglyceride (TG) levels were measured and three TG-rich lipoprotein subfractions (Sf greater than 400, 100 to 400, and 20 to 100) were isolated and their composition analyzed before and every 1.5 hours for a total of 7.5 hours following ingestion of corn oil. Normal women compared with men had lower postprandial plasma TG levels (P less than .05) mostly due to lower TG in Sf 100 to 400. The composition of Sf 100 to 400 and Sf 20 to 100 lipoproteins differed in the two sexes (P less than .01), with normal women having particles poorer in TG in both the fasting and postprandial states. Diabetic men compared with normal men had smaller Sf greater than 400 particles following fat ingestion, as shown by a lower TG protein (PR) ratio (7.6 v 12.8, respectively, P less than .05). The composition of Sf 100 to 400 and 20 to 100 lipoproteins was abnormal in IDDM men due to enrichment in total cholesterol (TC) as shown by higher TC/TG, TC/PR, and TG/phospholipid (PL) ratios in both the fasting (P less than .03 to P less than .003) and the postprandial state (P less than .03 to P less than .0001). A lower PL and TG content was also consistently present. A similar enrichment in TC was observed in diabetic v normal women following fat ingestion in Sf greater than 400 only (P less than .003).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2761416 TI - Dietary fat and hormonal effects on erythrocyte membrane fluidity and lipid composition in adult women. AB - Erythrocyte ghost membrane fluidity and phospholipid linoleate were significantly increased when higher levels of polyunsaturated fats were fed to healthy, free living, premenopausal women. Fluidity was assessed by diphenylhexatriene (DPH) fluorescence polarization measurements with hypotonically lysed red blood cells from 31 female subjects fed one of two sets of diets, which were formulated from typical US foods to contain polyunsaturate to saturate ratios (P/S) of 1.0 or 0.3. Both groups of women were fed diets with 40% of energy as fat for four menstrual cycles followed by low-fat diets having 20% of energy as fat for the next four menstrual cycles. Blood was sampled during the fourth cycle of each dietary period at times estimated to correspond to maximum secretions of estrogen and progesterone to assess interactive hormonal and dietary effects on membrane composition and fluidity. Red blood cell membranes were most fluid following higher levels of linoleate intake, either by higher (40%) total fat or higher P/S levels. Membrane fluidity was directly related to the phospholipid oleate and linoleate contents and inversely related to the molar cholesterol/phospholipid ratio. Hormonal status effects on the membranes were not extensive. Membrane fluidity in cells from women fed P/S = 0.3 diets was higher at 40% than at 20% fat during the luteal phase of the fourth cycle. In contrast, women fed the P/S = 1.0 diets had more fluid red cells at 40% fat during the follicular phase of the cycle. Regression analysis showed a direct linear correlation between membrane fluidity and red cell membrane insulin binding demonstrating a relation between receptor binding and cell membrane fluidity in the human female. PMID- 2761417 TI - Effect of hypomagnesemia and exercise on slowly exchanging pools of magnesium. AB - The effects of hypomagnesemia and exercise on the slowly exchanging pools of magnesium, skeletal muscle, bone, erythrocytes, and plasma, were examined in four groups of male Sprague-Dawley rats: sedentary-normal diet (SN), exercise-normal diet (EN), sedentary-hypomagnesemic diet (SH), and exercise-hypomagnesemic diet (EH). The exercise groups swam 5 d/wk-1 for 6 weeks. The hypomagnesemic diet contained 80 ppm and the normal diet about 640 ppm of magnesium. Compared with normal-diet rats (SN and EN), dietary-deficient rats (SH and EH) gained less weight and had lower concentrations of magnesium in all tissue samples and plasma (P less than .01). Exercise groups (EN and EH) demonstrated significantly higher magnesium levels in skeletal muscle (P less than .01) and a tendency for lower levels of magnesium in plasma, erythrocytes, and bone compared with sedentary groups (SN & SH). EH rats normalized skeletal muscle magnesium, mEq.kg-1 wet tissue, (19.9 +/- 5.1) compared with the SN group (20.6 +/- 2.1). Assuming that magnesium stores that are rapidly exchanged are maintained at the expense of those that are slowly exchanged, magnesium stores in skeletal muscle appear to be most protected, with the effect accentuated by exercise. PMID- 2761418 TI - Hypogonadism does not mediate urinary calcium loss in pituitary-grafted rats. AB - Rats rendered chronically hyperprolactinemic by implantation of extra anterior pituitary glands (AP) under the kidney capsule have excess urinary calcium excretion. Although serum testosterone levels are normal in male AP-grafted rats, more subtle androgen deficiency might contribute to the increased calcium loss. Female AP-grafted rats lose the normal estrous cycle, which might also alter calcium homeostasis. The urinary calcium and calcium/sodium excretion ratio in gonadectomized AP-grafted rats of both sexes were compared with that of otherwise intact AP-grafted rats and muscle-grafted control rats. AP-grafted rats had increased urinary calcium excretion and calcium/sodium excretion ratio, regardless of gonadal status. Treatment of castrated male AP-grafted animals with testosterone or dihydrotestosterone did not have a significant effect on urinary calcium loss, nor did estrogen replacement of ovariectomized female AP-grafted rats. These studies indicate that the hypercalciuria of the AP-grafted rat is not mediated via an anti-gonadal effect of the prolactin-secreting pituitary graft. PMID- 2761419 TI - Availability of glutamine from peptides and acetylglutamine for human tumor-cell cultures. AB - In a recent study we showed that the growth behavior of a hematopoietic cell line (K 562) in culture was the same when using glutamine-containing dipeptides or glutamine as substrate. In this article we study the growth behavior of different tumor cells, originating from the hematopoietic system (K 562), stomach (Kato III), pancreas (Panc 1), and breast (T 47 D), to test the biological activity as preclinical in vitro screening system. We compared L-glutamine (GLN), N-acetyl-L glutamine (ACE-GLN), L-alanyl-L-glutamine (ALA-GLN), and glycyl-L-glutamine (GLY GLN). Cell proliferation was measured with the incorporation of [3H] thymidine or the MTT assay (cleavage of 3-(4,5-dimethyldiazol-2-yl)-2-5-diphenyl tetrazolium bromide by mitochondria). In all investigated cell types cell growth was stimulated when using glutamine-containing dipeptides or ACE-GLN instead of a glutamine-free media (not significant for T 47 D). However, GLN or ALA-GLN was advantageous to GLY-GLN or ACE-GLN when measuring cell proliferation with the MTT assay up to 72 hours. However, alanylglutamine does not enhance proliferation, compared with free glutamine. PMID- 2761420 TI - Effects of hyperthermia on the peripheral metabolism of ammonia and glutamine. AB - Although there are a number of physiological states associated with an increase in body temperature, eg, nonseptic and septic fever or exercise, the effects of hyperthermia on intermediary metabolism in vivo have received little attention. The current study was undertaken to examine the peripheral metabolism of ammonia and ammonia-related amino acids using a model of exogenously induced mild hyperthermia in nonfebrile subjects. Arteriovenous levels of metabolites were measured in subjects with known cerebrovascular insufficiency. Peripheral exchange of these metabolites was monitored before, during, and after hyperthermia to an average temperature of 38.5 degrees C. All subjects showed an increase in plasma ammonia and glutamate. There was also an associated peripheral production of ammonia and an uptake of glutamine and alanine by the skeletal muscle tissues. The exchange of glutamate was not affected. These findings indicate that hyperthermia is associated with a nitrogen-sparing effect, the mechanism of which is yet unknown. PMID- 2761421 TI - Regulation of leucine transport and oxidation in peripheral human lymphocytes by glutamine. AB - In this study we investigated the influence of physiological levels of glutamine, isoleucine, and valine on leucine oxidation and transport by peripheral lymphocytes in an in vitro system. The presence of glutamine in the incubation mixture inhibited leucine oxidation by 61%. This effect was not significantly augmented by addition of isoleucine and valine. Leucine transport revealed a Km of 124 mumol/L and a Vmax of 24 pmol/10(6) cells/30 sec. Glutamine inhibited leucine transport by 63%. The capacity of lymphocytes for leucine transport exceeded the capacity for leucine oxidation by a factor of 7.8 (13.6 +/- 0.6 v 1.74 +/- 0.1 pmol/10(6) cells/30 sec). It is concluded that glutamine is a regulator of leucine transport and oxidation in human peripheral lymphocytes, and the inhibition of leucine oxidation by glutamine is not due to an alteration of leucine transport but reflects an intracellular event. PMID- 2761422 TI - Influence of molecular structure and plasma hydrolysis on the metabolism of glutamine-containing dipeptides in humans. AB - Glutamine-containing dipeptides may serve as a source of glutamine in parenteral nutrition solutions. To study the metabolism of glycyl-L-glutamine (gly-gln) and L-alanyl-L-glutamine (ala-gln) bolus injections of both dipeptides (0.1 mmol/kg within 40 seconds) were performed in five healthy male volunteers. Furthermore, plasma hydrolase activity against both peptides was tested by in vitro incubation. Both peptides were rapidly cleared from plasma after injection; however clearance was significantly greater for ala-gln than for gly-gln (1,595 +/- 124 v 507 +/- 14 mL/min). Arterial concentrations of constituent amino acids rose after peptide injection, indicating hydrolysis of the peptides. Glutamine concentration, for example, rose from 573 +/- 29 to a maximum of 718 +/- 34 mumol/L after gly-gln and from 570 +/- 15 to 900 +/- 53 mumol/L after ala-gln injection. Both peptides were hydrolyzed by plasma hydrolases during in vitro incubation. Hydrolysis was greater for ala-gln than for gly-gln. Half-lives of ala-gln and gly-gln were 46 +/- 3 and 553 +/- 160 minutes, respectively. For both peptides, plasma hydrolysis was too low to contribute significantly to in vivo clearance. Our results indicate that gly-gln and ala-gln are suitable sources for glutamine in parenteral nutrition solutions. Furthermore, plasma hydrolases do not play a significant role in peptide metabolism. Both peptides therefore appear to be primarily metabolized via extracellular hydrolysis, presumably by hydrolases on the cell membranes and consecutive uptake of the liberated amino acid residues. PMID- 2761423 TI - Influence of alanylglutamine infusion on gastrointestinal glutamine and alanine metabolism in anesthetized dogs. AB - In this study we administered an infusion of alanylglutamine (10 mumol/kg.min) for 60 minutes to postoperative anaesthetized dogs with catheters placed in the portal and hepatic veins. Arterial plasma levels of alanylglutamine were 83 +/- 27 mumol/L 20 minutes after the onset of the infusion and remained constant throughout the infusion period. Plasma levels of glutamine and alanine approximately doubled compared with preinfusion levels, indicating a release of these amino acids from the dipeptide. The halflife of alanylglutamine, calculated after bolus injection of 2 g, was 1.7 +/- 0.5 minutes. Alanylglutamine was extracted from the liver and the gut (0.9 +/- 0.3 and 0.5 +/- 0.1 mumol/kg.min, respectively). In the basal period (without infusion of alanylglutamine), a glutamine uptake by the liver and the intestine was found. Alanine was taken up by the liver and released from the gut. The infusion of alanylglutamine significantly increased the hepatic uptake of glutamine and alanine (from 0.8 +/- 0.2 to 3.8 +/- 0.6 and from 3.0 +/- 0.4 to 7.5 +/- 0.7 mumol/kg.min respectively; P less than .01) and did not significantly change the intestinal uptake of glutamine and the release of alanine. We conclude that the infusion of alanylglutamine markedly influences the hepatic metabolism of glutamine and alanine, probably via the increased arterial and portal levels of glutamine and alanine. PMID- 2761424 TI - A woman's lot. PMID- 2761425 TI - Work, environment and the fetus. AB - The opportunities for women to work in traditionally male oriented industries will increase substantially within the next 10 years exposing them to substances and processes which might adversely affect their reproductive health. The effects which known and putative reproductive toxins may have on pregnancy outcome are reviewed against the knowledge of normal development. Any epidemiological study which looks for an association between exposure and outcome must take into account confounding factors and sources of bias which may influence the result and lead to unsound conclusions. Some of these sources of error are discussed in relation to adverse reproductive outcomes. Where there is positive evidence of an adverse effect on reproduction policies must be formulated to provide equal protection for male and female reproductive health whilst, at the same time, allowing for the unique role of women in providing a safe internal environment for the developing fetus. PMID- 2761426 TI - An evaluation of community antenatal care. AB - A study to ascertain how the community based antenatal services in the East End of Glasgow related to the guidelines set by a Working Party on Ante-Natal and Intrapartum Care (Royal College of Obstetricians and Gynaecologists, 1982) is reported. All community based clinics were visited and described. The socio economic status of the sample population was defined and users' views and preferences sought. The women sampled were often socially and economically disadvantaged. Unemployment was high. They received their community antenatal care from midwives, general practitioners and consultants in both health centres and general practitioner surgeries. Women were generally satisfied with the care they received. Answers to more specific questions indicated, however, that more information and individualised care would be appreciated. PMID- 2761427 TI - Breast feeding policies in practice--'no wonder they get confused'. AB - This paper presents the findings on breast feeding from the Policy and Practice of Midwifery Study which is a study of midwifery care in English Health Districts. Policies and practice that concern breast feeding were studied in both a national survey of maternity units and in local in-depth studies. The paper demonstrates the variations between and anomalies within maternity hospital policies and practice on breast feeding. Findings indicate that many current practices are not consistent with the available research evidence and may actively hinder the establishment of successful breast feeding. PMID- 2761428 TI - AIDS--a global concern. AB - HIV and AIDS are diseases which have rocked the health care agencies throughout the world in the 1980's. The editor of Midwifery has tried to secure a paper on the impact of AIDS on midwifery in some parts of the world. As much research has still to be done this paper is not available at the moment. The following paper was offered for publication and although written for nurses (it was presented at the 3rd International Intensive Care conference, Montreal Canada in August 1988) its message is for all health care workers. PMID- 2761429 TI - Decreased poststenotic flow disturbance during drag reduction by polyacrylamide infusion without increased aortic blood flow. AB - The infusion of polyacrylamide in open chest rats has been reported to increase aortic blood flow and the effect has been ascribed to the "drag reduction" properties of these compounds. In six anesthetized dogs the infusion of polyacrylamide to a total dose of 2 mg/kg caused a reduction in midline and separation zone Doppler spectral broadening in the common carotid artery poststenotic velocity field. This apparent reduction in poststenotic turbulence was interpreted as indicating the presence of a drag reducing effect. Despite this demonstration that polyacrylamide was present in the blood in drag reducing concentrations no increase in aortic blood flow was produced. PMID- 2761430 TI - In vivo and in vitro measurements of red cell velocity under epifluorescence microscopy. AB - Studies of blood flow in mesentery, cremaster muscle, and small bore glass tubes were performed to obtain a relationship between mean velocity (Vmean) and red cell velocity using the two-slit method under epifluorescence (Vepi) and transillumination (Vtrans) microscopy. The velocities Vepi and Vtrans obtained in vivo for 47 measurements in arterioles and venules (12- to 51-micron internal diameter) were linearly related by Vepi = 0.83 Vtrans + 0.074, and the ratio Vepi/Vtrans decreased gradually with increasing vessel diameter (P less than or equal to 0.05). In vitro studies in tapered glass tubes (diameter 30-70 micron) were conducted for feed hematocrits (HF) from 10 to 40%. Under transillumination, Vtrans/Vmean was nearly constant with an average of 1.56 +/- 0.16 (SD) for all hematocrits and diameters. The velocity ratio, Vepi/Vmean, however, decreased with HF from 1.8 to 0.8 as HF was increased from 10 to 40%. Theoretical considerations suggest that the variations of Vepi/Vmean with tube hematocrit and diameter might result from attenuation of the excitation light by absorption and scattering by red cells, and also due to a finite depth of field of the microscopic objective. PMID- 2761431 TI - The rat urinary bladder: vasoactivity and macromolecular leakage in a new model. AB - An in vivo model of the rat urinary bladder microcirculation has been developed and microcirculatory responses to agents which produce vasoconstriction, vasodilation, and macromolecular leakage have been characterized. The urinary bladder of anesthetized female Sprague-Dawley rats is exteriorized and positioned in a tissue bath with a single stay suture which does not penetrate the lumen of the bladder. All blood vessels and nerves from the animal remain intact. The tissue bath is filled with Krebs solution which is monitored and maintained at a temperature of 36 +/- 0.5 degrees and a pH of 7.4 +/- 0.5. In vivo television microscopy is used to monitor vascular diameter and flow changes and isothiocyanate-tagged bovine serum albumin fluorescence is used as an index of macromolecular leakage. Norepinephrine (10(-6) M) caused a statistically significant decrease in vascular diameters of both arterioles and venules while sodium nitroprusside (10(-7) M) significantly increased arteriolar and venular diameters, histamine (10(-4) M) caused no change in venular diameters but did induce a significant macromolecular leak from those vessels. Compound 48/80 (1 and 10 micrograms/ml) induced a significant dose-dependent macromolecular leakage from venules. However, only with the 10 micrograms/ml dose was there visually detectable mast cell degranulation. It is concluded that this rat urinary bladder model provides a stable, reproducible model of a smooth muscle microcirculatory bed in a controlled environment, which responds similarly to other microcirculations. PMID- 2761432 TI - Glomerular basement membrane as a compressible ultrafilter. AB - The ultrafiltration properties of isolated glomerular basement membrane were studied in vitro by forming membrane fragments into thin films for use as ultrafiltration membranes. The filtration properties of the films were examined using cytochrome c, myoglobin, lysozyme, ovalbumin, lactoglobulin, and serum albumin. The films behaved as compressible filters showing size-dependent rejection of the proteins. The behavior of the films was modelled using the fiber matrix hypothesis which gave good prediction of film behavior. The membrane behaved as a random fiber matrix composed of fibers of 0.8-1.0 nm in radius. PMID- 2761434 TI - Red cell distribution at microvascular bifurcations. AB - The distribution of red cell and blood volume flow was studied at 65 arteriolar bifurcations in the rat mesentery. Hematocrit and flow velocity were measured simultaneously in all three vessel segments constituting a bifurcation. Blood flow distribution was manipulated by irreversibly occluding downstream side branches of one of the daughter vessels. The dependence of fractional red cell volume flow on fractional blood flow was described using a three-parameter (X0, B, A) logit function. The critical volume flow fraction below which only plasma enters a downstream branch (X0), the nonlinearity of the relation between red cell and blood volume flow (B), and the asymmetry of that relation which is described by the parameter A decrease with increasing diameter of the vessel feeding the bifurcation. At diameters above 30 microns, phase separation is very limited. In addition, the nonlinearity parameter B decreases with decreasing hematocrit in the feeding vessel. The asymmetry parameter A strongly depends on the diameter ratio between the two daughter branches: For a given fractional blood flow, the smaller branch receives more red cells than the larger branch. Using a model for plasma skimming based on the assumption of a planar separating surface, the shape of the radial hematocrit profile in the feeding vessel has been calculated. The model predicts a decrease in local hematocrit from the vessel axis toward the wall with a distinct marginal zone free from cell centers. With increasing vessel diameter the hematocrit profile becomes more blunted while the width of the marginal zone increases. PMID- 2761435 TI - Smoking--getting the message across. PMID- 2761433 TI - The endothelial cell cytoskeleton modulates extravascular polymorphonuclear leukocyte accumulations in vivo. AB - Actin microfilaments, key elements in the endothelial cell (EC) cytoskeleton, have been noted in in vitro studies to play a modulating role in the diapedesis of polymorphonuclear leukocytes (PMN). The role of the cytoskeleton in PMN diapedesis in vivo was the subject of this study. Small skin abrasions were produced in rabbits. Cytoskeletal manipulation was accomplished by local application of phalloidin which promotes microfilament assembly or cytochalasin B which causes their disassembly, prior to addition of a chemotaxin. When the initial treatment to the abrasion site was saline, the secondary addition of more saline resulted in PMN accumulations, expressed as PMN/mm3 of 36 +/- 19, while 10(-4) M cytochalasin B led to 91 +/- 32 (P less than 0.05). Secondary addition of chemotaxins or histamine also led to significant PMN accumulations of 169 +/- 54 with 10(-8) M leukotriene (LT) B4, 318 +/- 85 with zymosan-activated plasma (ZAP), and 158 +/- 48 with 10(-4) M histamine. When the initial treatment was 10( 8) M phalloidin, PMN accumulations were reduced to 31 +/- 22 with cytochalasin B (P less than 0.05 relative to saline as initial treatment); 63 +/- 43 with LTB4 (P less than 0.05); 137 +/- 48 with ZAP (P less than 0.05); and 51 +/- 35 with histamine (P less than 0.05). In contrast, initial blister treatment with cytochalasin B rather than saline increased PMN accumulations in response to LTB4, 291 +/- 71 (P less than 0.05), and histamine, 270 +/- 56 (P less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2761436 TI - "Does your baby smoke?". PMID- 2761437 TI - Autotransfusion in a ruptured ectopic pregnancy. PMID- 2761439 TI - An American birthing. PMID- 2761438 TI - The midwife in private practice in Indonesia. AB - Indonesia is an archipelago, the largest in the world, stretching 3,200 miles from east to west. It straddles the equator between the Asian and Australian continents. The climate is tropical and has two seasons, the dry season from June to October; and the wet season from November to March. The total population is currently estimated as only 165 million and Indonesian is the national language. PMID- 2761440 TI - William Power Memorial lecture. Who cares for women? Science versus love in midwifery today. PMID- 2761441 TI - RCM maternity Watch Campaign--the results. PMID- 2761442 TI - Clinical grading--a press officer's tale. PMID- 2761443 TI - An aqua birth concept--midwives' and parent's perspectives. PMID- 2761444 TI - Water birth. PMID- 2761445 TI - Aqua-natal is magic! PMID- 2761446 TI - Midwives in Mothercare. PMID- 2761447 TI - [Predicting the effectiveness of antibiotic therapy in the treatment of gonorrhea]. AB - A complex method is suggested to prognosticate the efficiency of treating gonorrheal urethritis in men with allowance for a preliminary determination of the cell respiration activity in agents. In the case of low indices of these processes, it is possible to stimulate aerobic processes in gonococci if applying for 4 days before the specific treatment daily subcutaneous injections of plasmol (a biostimulator) by the ascending scheme and local irrigation of the urethra by oxygen cocktails through irrigators of special design. The developed method has the author certificate (A. c. 1107867 USSR). Application of the method shortens significantly the terms of treatment, the number of the infection recurrences being considerably decreased. To accelerate the determination of the sensitivity to antibiotics the procedure of genococcus microcultivation in special chambers is applied which permits observing the growth and reproduction of microorganisms in the phase-contrast microscope. PMID- 2761448 TI - [Immunologic and structural studies of lipopolysaccharides from Pseudomonas cepacia]. AB - O-serotyping of 30 Pseudomonas cepacia strains isolated from the soil and rhizosphere of different plant species in the territory of the USSR has been performed using 15 O-typing antisera according to the Heidt and Nakamura schemes. It is suggested to introduce two new O-serogroups (serogroups K and L) into the available P. cepacia classification scheme. They are most often met among the P. cepacia strains in different geographical areas of the USSR simultaneously with serogroups 2 (G) and 1 (D). To elucidate the molecular principles of serological inhomogeneity of the species the immunochemical studies of lipopolysaccharides of a number of P. cepacia strains have been conducted and the structure has been determined for repeating links of O-specific polysaccharides of P. cepacia strains attributed to 4 Nakamura serogroups, 3 Heidt serogroups, to serogroups K and L, as well as for certain strains from the collection of the Institute of Microbiology and Virology of the Ukr. SSR Academy of Sciences. PMID- 2761449 TI - [Choice of the optimal method of numerical analysis in taxonometric study of mollicutes based on electrophoresis of their proteins]. AB - Different procedures of numerical analysis are evaluated to select the most convenient of them for processing the results of mycoplasm protein electrophoresis in polyacrylamide gel (EPAAG) when solving problems of their taxonomy and systematics. This aim is satisfied most of all by the method of Sokal which permits revealing relations at the rank of species, genus and higher taxons. This method as well as the approaches developed by the authors for transforming results of EPAAG of proteins into the numerical form are recommended to improve the systematics of mollicutes with application of computers. PMID- 2761450 TI - [Biosynthesis of 14C-macrocyclic trichothecenes]. AB - Possibility of producing (14C)-macrocyclic trichothecenes (MCTC) with high specific activity was studied. (1-14C)-glucose, (2-14C)-acetate and (2-14C) mevalonate were used as precursors. The best results were obtained when labeled acetate was introduced into the medium at the end of the logarithmic growth stage of Dendrodochium toxicum 5800, a fungus-producer. Individual (14C)-MCTC with high specific activity are obtained: verrucarine A-158.1 microC/mM, rhoridine A-167.4 microC/mM; rhoridine H-161.9 microC/mM. PMID- 2761451 TI - [The effect of salvin on the growth and ultrastructure of Staphylococcus aureus 209P]. AB - Antibiotic salvin obtained from Salvia officinalis has been studied for its effect on the growth and ultrastructure of Staphylococcus aureus 209P. The antibiotic in the sub-bacteriostatic concentration considerably elongates the lag phase (up to 11-12 h) exerting no significant effect on the growth rate of the staphylococcus population as well as it prolongs duration of the exponential phase. The analysis of electronograms of staphylococcus cells subjected to the action of salvin in the concentrations similar to the minimal inhibitory concentration (MIC), has revealed the cell thinning, inhibition and destruction of the division. The introduction of 5MIC antibiotic into the exponentially grown culture made a cell wall considerably thinner, destructing its external layer; the number of lyzed cells sharply increased. The appearance of bodies not described previously with a membrane envelope and ribosomes as well as of mesosomal structures was observed. PMID- 2761452 TI - [Lactic bacteria in the digestive tract of poultry]. AB - Lactic bacteria predominate in the microflora of the digestive tract of chicken and turkey. They are represented mainly by Lactobacillus acidophilus, L. salivarius, L. fermentum and L. buchneri. Streptococcus faecium is always isolated. L. ruminis, L. vitulinus, L. delbrueckii, L. coryniformis and L. viridescens were found in this ecological niche for the first time. S. faecium and S. faecalis prevail in the digestive tract of geese and ducks, while lactobacilli are detected in a lesser amount and are represented mainly by L. plantarum. L. salivarius cells isolated from the digestive tract of poultry are highly polymorphous. Most of the lactic acid bacteria found in the digestive tract of poultry can grow at 45-50 degrees C whatever is the species they belong to. PMID- 2761453 TI - [The esterase activity of a pigmented bacterial group belonging to the Pseudomonas genus]. AB - Bacteria belonging to the Pseudomonas genus and isolated from zonal soils in different geographical zones of the USSR as well as from the rhizosphere of cultivated and wild plants were tested for their esterase activity. The studied collection of cultures included 205 strains of different pigmented Pseudomonas species which, according to the conventional taxonomy, were assigned to the so called "Pseudomonas fluorescens complex". As was shown in this study, many Pseudomonas species are potential producers of nonspecific esterases. P. maltophilia and P. geniculata synthesizing pyomelanin have the highest activity of esterase. The activity of esterase correlates with the formation of a melanin like pigment in Pseudomonas cultures. It also correlates with the species to which a culture belongs, which makes it possible to use this property as an additional criterion for the identification of Pseudomonas species. PMID- 2761454 TI - [Heterogeneity of a Pseudomonas bacteriophage population]. AB - Twenty-five isolates of virulent bacteriophages for Pseudomonas belonging to the morphological group C (Bradley, 1967) were obtained from different natural habitats. The phages of each isolate were found to differ from one another in at least one of the following characteristics: the sensitivity to an osmotic shock, to heating at 60 degrees C and to UV; the ability to cause lysis of 86 Pseudomonas strains; the reaction of neutralisation with antisera. At the same time, the phages were related by the existence of common antigens. These properties are responsible for the genetic stability of the bacteriophages in their complicated relationship with their host, Pseudomonas bacteria. PMID- 2761455 TI - [Analysis of genomic similarity in Streptomycetes belonging to the fluorescent subgroup as a confirmation of their taxonomic revision using a population method]. AB - Genomic similarity was analysed in streptomycetes belonging to the fluorescent subgroup: Streptomyces chrysomallus, S. fluorescens, S. galbofluorescens and S. citreofluorescens. The degree of reference S. chrysomalius DNA hybridization with S. fluorescens and S. galbofluorescens DNAs was 75 and 82%, respectively, thus being within the limits of the intraspecial hybridization level. S. citreofluorescens DNA showed a 55% homology with reference S. chrysomallus DNA, which corresponded to the range of interspecies hybridization. These conclusions were confirmed by the results obtained in analysing the thermostability of hybrid duplexes. Therefore, these findings are consistent with the data of revising the species taxonomy of this streptomycetes subgroup which was done using the method of comparative population analysis. The population model proposed by one of the authors can be used to assess the intraspecies level of DNA-DNA hybridization. PMID- 2761456 TI - Aboriginal deaths in custody. PMID- 2761457 TI - Trachoma "down the track". PMID- 2761458 TI - Do caring wives protect against cardiac disease? PMID- 2761459 TI - Suicides by prisoners. AB - In a consecutive series of 44 deaths of male prisoners in Brisbane Prison, a maximum-security prison, in the 15-year period 1973-1987, 20 deaths were a result of suicide. More than half the suicides occurred within the first two months in custody. Prisoners on remand were more prone to commit suicide than were sentenced prisoners. A history of psychiatric disorder was frequent, and more than one-third of the prisoners previously had received psychiatric inpatient treatment. In 40% of cases suicide had been attempted previously. Hanging was the usual method of suicide. The application of preventive measures in the presence of risk factors for suicide at the present level of knowledge are discussed. PMID- 2761460 TI - Trachoma in the Northern Territory of Australia, 1940-1986. AB - All known surveys of the prevalence of trachoma in the Northern Territory from 1940 to the present were reviewed. The crude (overall) prevalence rates for trachoma were calculated from the results of those surveys which involved whole Aboriginal communities. When three-or-more surveys had been conducted in a community over a period of 10 years or more, the results were plotted against the year of the survey. In most communities in the north of the Northern Territory (the "Top End"), the prevalence of trachoma appeared to have increased dramatically between 1950 and 1955 and then to have declined substantially at a rate of 2% per annum. This fall occurred before the mass-treatment programmes of the late 1970s and its most likely explanation is the improvement in living conditions. In five- to 10-years' time, trachoma may have disappeared completely from these communities. In most Central Australian communities, the prevalence of trachoma appears to have been constant or even to have increased. If social conditions were to begin to improve in Central Australian communities this year, and if those communities were to show the same response rates as in the Top End communities, then it could be well into the next century before the prevalence of trachoma there falls to the low rates of the Top End. This should be an impetus for social change in Central Australia; however, there might be a case for medically based control programmes in Central Australia, at least in the short term. PMID- 2761461 TI - Patients' socioeconomic background: influence on selection of inpatient or domiciliary hospice terminal-care programmes. AB - Data on 243 patients who were admitted to the Melbourne City mission inpatient and home-care programmes were collected prospectively over a 12-month period from September 1, 1985 and were analysed. The variables that were assessed included age, sex, marital status, country of birth, occupation, address, pension status, diagnosis, previous treatment and subsequent survival. It was found that the patients who were selected into the two programmes differed significantly. Hospice inpatients tended to be single (53% of subjects), older (50% of subjects were more than 70 years of age), uninsured (82% of subjects) pensioners who were very close to death (median survival, 2.6 weeks). By contrast, the patients in the home-care group were comparatively younger (21% of subjects were more than 70 years of age) and were more likely to have partners (37% of subjects were single), not to be pensioners and to have private insurance (48% of subjects); also, their median survival was significantly longer (six weeks). These findings should prove of considerable importance for the planning of terminal-care programmes. In particular, they suggest that the critical issue is not the efficacy of either inpatient or home care but rather the modification of each programme type so that it will serve better the needs of its particular constituency. PMID- 2761462 TI - Patient desire for information before a total hip-replacement operation. AB - Patients who had been admitted to hospital in the Adelaide area for a total hip replacement operation were questioned about the information that they wanted before their operation. The results showed that the majority of patients wanted to know about almost all aspects of their operation, including postoperative care. The major sources of information were the hospital doctors (surgeons, interns, and so on) who attended the patients. Doctors who regularly attended patients who were undergoing total hip-replacement operations also were surveyed in order to determine their perception of patients' desire for information; they underestimated significantly patients' wishes as indicated by the first survey. The implications of these findings for improvements in patient care are discussed. PMID- 2761463 TI - Unsuspected damage to lumbar zygapophyseal (facet) joints after motor-vehicle accidents. AB - Three zygapophyseal joints from each of 31 lumbar spines of subjects who died of injuries (mostly as a result of motor-vehicle accidents) were sectioned for low power histological study. Bony injuries, in the form of fractures of the superior articular process or infractions of the subchondral bone plate, were found in 11 of the 31 subjects and soft-tissue injuries to the capsule or articular cartilage were found in one-or-more joints in 24 of the 31 subjects, with capsular and articular-cartilage damage in 77% of cases. Healed injuries of a similar type, which were unrelated to the cause of death, were found in other lumbar spines. None of these lesions was diagnosed by standard radiological examination of the spine post mortem. It is suggested that, in survivors, bony and soft-tissue injuries to zygapophyseal joints may result in considerable pain and dysfunction and may predispose to early arthritis. PMID- 2761464 TI - Commissions and omissions: the wider context of aboriginal suicides in custody. PMID- 2761465 TI - Prospective audit of aminoglycoside usage in a general hospital with assessments of clinical processes and adverse clinical outcomes. AB - A comprehensive, multiphasic review of gentamicin and tobramycin utilization was undertaken with audits of the microbiological sensitivity of Gram-negative pathogens; indications for the prescription of aminoglycoside agents; the utilization of assay services; the adequacy of clinical drug delivery by measures of serum antibiotic levels; and the assessment of adverse outcomes by markers of nephrotoxicity. The great majority of clinical isolates of target organisms (n = 4208) was more sensitive to gentamicin (96%) and to tobramycin (99%) than to all alternative agents, including first- and third-generation cephalosporin agents. A review of the indications for the prescription of aminoglycoside agents by clinical criteria showed that in 85.6% of 278 documented cases, the choice of agent was appropriate by clinical and microbiological criteria. In a substantial (77.6%) proportion of the 511 patients who were receiving therapeutic courses of an aminoglycoside agent, serum drug assays had been performed. Assay data could not be interpreted adequately in 52.6% of 3079 assayed cases as a result of inadequate data on administration regimens (39.7%) or sampling regimens (12.9%). Where sampling was documented adequately, there was extreme variation (zero to five hours) in post-dose sampling. In only 33.2% of cases could it be concluded unambiguously that the patients were receiving safer, adequate therapy for clinically significant infections, 5.6% of patients were receiving potentially toxic doses, and 8.6% of patients showed suboptimal concentration profiles. The majority of potentially toxic levels were associated with adverse effects.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2761466 TI - Emergency medicine--a house that Jack is building? PMID- 2761467 TI - Problems with weight control during pregnancy. PMID- 2761468 TI - Should endoscopy rather than radiology be the primary investigation for dysphagia? PMID- 2761469 TI - Streptococcus suis type 2--an underdiagnosed zoonotic agent? PMID- 2761470 TI - Normal serum albumin--reduction of protein concentration. PMID- 2761471 TI - Campylobacter peritonitis. PMID- 2761472 TI - [Stereologic analysis of the density of the vascular network of the heart in hypoxia in laboratory rats]. AB - The density of the myocardiac vascular network in 3-month-old female Wistar rats exposed to intermittent hypoxia was studied. The experimental rats were sacrificed immediately (1st experimental subgroup) or 4 days (2nd experimental subgroup) after the last exposition. The volume density was statistically highly significant in the animals of the 1st subgroup and significant in the rats of the 2nd subgroup. The highly significant rise in the volume density of the myocardiac vascular network could be explained by an acute stress effect, whereas the only significant increase in the second case indicates adaptability to stress. PMID- 2761473 TI - [Incidence of sincipital hair whorls in schoolchildren]. AB - The frequency of hair whorl in the parietal area was examined in the sample of 865 schoolchildren. The simple hair whorl was more frequent in boys (62.13%) than in girls (21.41%). The double hair whorl was found only in 0.69% of the cases. The parietal hair whorl was not noticed in 58.49% of the examined children. The percentage was considerably higher in girls than in boys accounting for 77.92% and 37.13%, respectively. PMID- 2761474 TI - [Clinical and immunologic aspects of chlamydial infections in infertile women]. AB - Chlamydia Trachomatis (CT) infection of the genital tract ranges from clinically severe to the silent subclinical forms of pelvic inflammatory diseases which can result in fallopian tubes obstruction and subsequent infertility. Our investigations: The serum antichlamydial antibodies of 30 infertile patients and the cultures of Chlamydia Trachomatis from specimens of endometrial biopsies were determined as well as HSG and laparoscopic examinations. METHODOLOGY: The evaluation of serum antichlamydial antibodies were measured by ELISA test. The endometrial specimens for culture of Chlamydia Trachomatis were collected transcervically from the uterine cavity. The statistical analyses were calculated on the basis of Student t test. RESULTS: Immunological determinations showed the presence of antichlamydial antibodies in 43.6%. The endometrial cultures yielded growth of CT (36.6%) and histological signs of chlamydial endometritis were also discovered. This study pointed to the positive correlation between the results of endometrial biopsies (cultures), immunological (serological) investigations and clinical examinations showing that the chlamydial infection reached the Fallopian tubes from the endometrium which could result in infertility. PMID- 2761475 TI - [Morphometric characteristics of the glomerular zone--reparative processes after the administration of detergent]. AB - Results of the effect of detergent on the excretory mechanism were presented in this paper. Thereby, the authors investigated the glomerular zone of the adrenal gland in white laboratory rats living 30 days in the conditions of the detergent factory. The changes were registered in the augmented nuclei of the glomerular zone with presented incisuras. Reactive changes as well as the changes due to hyperactivity of the adrenal gland observed also after one month were in question. PMID- 2761476 TI - [Case reports of patients with hepatolenticular degeneration-Wilson's disease with emphasis on work capacity]. AB - We presented four patients with hepatolenticular degeneration--Wilson or hepatocerebral dystrophy-Wilson-Konovalov by soviet authors. Our cases were nervous variable of this disease or pseudosclerose (Westphal-Strumphell). The first three patients showed rigid--trembling and one trembling form of disease. All, patients were male. We think that it is very important early identification of this disease, to reduce time from acute manifestation to make a diagnosis and to apply appropriate therapy. This time period in our cases lasted from 0 to 4 years. Except use d- penicillamine (to 900 mg/daily) we think that is also very important use the acidum ascorbicum (to 4.5 gr/daily). This acidum shows less consumption of d- penicillamine and has low complication. Recurrent working ability begins with disappearance of neurological phenomenology and with rehabilitation of psychic status. All our patients we examined by ergometric and psychological tests and we obtained in results working ability population. In our experience and from therapeutic results to make this diagnosis does not mean a priori definite working ability. PMID- 2761477 TI - [Radiodiagnostic features of the pulmonary form of Q fever]. AB - Patients with the pulmonary form of Q fever and the more rarely described pleural reaction were presented. The purpose of this work was as follows: to pay attention to all characteristics of the radiological picture of the pulmonary form of Q fever, to emphasize the importance of the radiological finding for the establishment of diagnosis, to point to the present possibilities of radiology and to put forward diagnostic procedures. Namely, when managing the patients in clinical practice, radiological examination is performed almost in the first place, the referring diagnosis is most frequently optional, while clinical and laboratory findings are still incomplete and not always useful. Thus, the diagnostic procedure of radiologists is made much more difficult, particularly of those who have not had the chance of encountering these diseases in their everyday radiologic diagnostic. However, recent knowledge of some authors who have investigated these diseases in the territory of SAP of Vojvodina points to the fact that percentually Q fever most frequently appears just in this territory when compared with other parts of SFR of Yugoslavia. Anyhow, according to the results obtained, the incidence of diseases is greater than the majority of radiologists could conclude in their everyday clinical practice. This necessitates the refreshment of knowledge in this field which would lead toward further improvement of diagnostic. PMID- 2761478 TI - [Chronic infection of cultured cells by rabies viruses]. AB - The culture of the continuous cellular line BHK 21 C13 was infected in the routine way by rabies virus, a kind of fixed CVS virus. Through 100 passages, the virus was (parallely) isolated and titrated in white mice and in the cellular culture by the technique of fluorescent TFA-a antibodies. In respect to mice, infectiveness of cells was less marked, while through further passages infectiveness of cells increased, while the titre in mice decreased. In the course of 100 passages, a repeat infection of cellular culture was not performed at all, but the virus multiplied together with the chronically infected cells. PMID- 2761479 TI - [Alzheimer's disease from the aspect of hormonal and metabolic disorders]. AB - Some facts of metabolical disturbances and functional changes of brain tissue hormones in Alzheimer's disease are reviewed. Characteristics of aetiopathogenesis, clinical picture and diagnostics are referred with observations on sociomedical importance of the disease. From the known data it can not yet be concluded if these changes are a cause or outcome of the illness. PMID- 2761480 TI - [Vascular changes in the ocular fundus in patients with coronary artery disease]. AB - Confrontation of coronary arteriography, i.e. the exact invasive diagnostic method and the direct method of gaining an insight into the blood vessels of the fundus of the eye by the "in vivo" method was aimed at elucidating the fact to which extent the atherosclerotic changes in these two vessel systems were confronted. Changes in the blood vessels of the fundus, ECG changes and some of the risk factors were investigated in 52 patients who had undergone coronary arteriography. Changes in the sense of stenosing atherosclerosis of changed arteries were found in 38 patients and in 26 (68.4%) of them atherosclerotic changes in the fundus of the eye were also observed, while in 31 (81.5%) cases ECG changes were registered pointing to compromised coronary circulation. In 14 cases coronary arteriography showed the absence of atherosclerotic changes, while the positive finding obtained by ophthalmoscopy was confirmed only in one of them (7.1%). According to the results obtained, it was pointed out that the study of the fundus of the eye in addition to electrocardiogram and the existence of risk factors may serve as a reliable method in practice for the verification of atherosclerotic degree in general and ischaemic heart disease in particular in the framework of the atherosclerotic process. PMID- 2761481 TI - [Inhalation scintigraphy of the lungs and its clinical aspects]. AB - The aim of the work was to examine the new Taplin's system for the production and inhalation of radioactive aerosol in routine diagnostic application. For that purpose a new commercially produced system of the firm CADEMA was used with a small modification which made possible its repeated application. The advantage of this system is a high level of aerosol particles of optimal size from 0.7-0.8 micron and inhalation is carried out only on the basis of air circulation caused by natural breathing. Total of 125 inhalation scintigrams was made. The results show that one can get aerosol of a high quality the distribution of which does not depend significantly on the sort of material marked with 99mTc. The distribution itself is even and scintigrams of high quality can be obtained. Inhalation scintigram of high quality combined with a perfusion scintigram enables reliable estimation of regional relationship between ventilation and perfusion of the lungs which is of special interest in the diagnostic of lung thromboembolism. PMID- 2761482 TI - [Young people and smoking]. AB - Within the fight against smoking a questionnaire was made among schoolchildren of the Secondary Medical School in Zrenjanin in the period from March 1-8, 1988. The anonymous questionnaire dealt both with the schoolchildren's attitude toward smoking and the distribution of this habit among them. It comprised a total of 207 schoolchildren from the I and IV grade. The questions were aimed at the basic facts about smoking: whether they smoke, how many cigarettes they smoke daily and from when, how much pocket-money they get, their opinion about smoking as the social phenomenon and how much they know about harmful effects of smoking. Out of 119 schoolchildren from the I grade 8 were smokers (7 girls and 1 boy) which made 6.7% while out of 88 schoolchildren from the IV grade (83 girls and 5 boys) 46 (52%) were smokers. Which factors contributed to the increase in the number of smokers from I to IV grade, especially when we know that girls accounted for 94%? These facts were discussed in this paper in detail. PMID- 2761483 TI - [Results of systematic screening of women in the village of Stepanovicevo]. AB - In the framework of the "Integrated program for the prevention and control of uncommunicable diseases (CINDI) which has been launched in the collaboration with the World Health Organization at the Health Centre "Novi Sad", a total of 400 women aged 16-60 have been comprised by the mass screening in the village of Stepanovicevo with 2083 inhabitants who are mainly agricultural workers out of whom women account for 48.41%. This paper is aimed at gaining an insight into the kind and frequency of individual gynecologic diseases and circumstances which influence the psychophysical state of the woman, her working and reproductive capability in the rural environment, the parity, number of abortions, the use of contraceptive devices and the differences in morbidity between the village of Stepanovicevo and the city of Novi Sad. According to the results obtained it is pointed out that the percent of women affected by the following diseases has been considerably increased: pathologic changes on the cervix uteri, inflammatory diseases on adnexes, myoma uteri and benign changes in the breast. This high percent could be explained by the absence of the gynecologic service in the village of Stepanovicevo and women's ignorance of health culture for temporary check-ups. PMID- 2761484 TI - [Potential risk of pharmacologically induced hypochlorhydria in the treatment of peptic ulcer disease]. AB - The introduction of the very potent anti-secretory ulcer-healing drugs that effectively inhibit gastric acid secretion actualized the problem of pharmacologically induced hypochlorhydria. Potential dangers of hypochlorhydria relate mainly to the observation that various microorganisms normally destroyed by gastric acid survive and proliferate in the stomach and small intestine and thus increase the risk of the serious gastrointestinal infections. It has been also suggested that the proliferation of the intragastric bacteria may convert dietary nitrate into nitrite that may be nitrosated to carcinogenic N-nitroso compounds. Increased risks of nosocomial pneumonia or acute stress bleeding in ventilated intensive care unit patients become additional hazards during the treatment with antisecretory agents. Moreover, there is now evidence that after a course of treatment with antisecretory agents peptic ulcer recur more rapidly. Obviously, enthusiasm resulting of the great efficacy of antisecretory drugs in promoting ulcer healing must be hampered by previous considerations. PMID- 2761485 TI - [Menarche in schoolgirls in Novi Sad]. AB - Out of 947 examined schoolgirls aged 8.5-15 from the two schools in Novi Sad, 327 of them had menarche. Arithmetic mean value of the appearance of menarche was 12.25 years, the standard deviation being 0.91 years. Median was 12.59 years. The normal appearance of menarche (X +/- 2 SD) ranged from 10.4-14.1 years in our environment. According to X2 (Chi-square) test and asymmetry coefficient (beta 1) it was pointed out that the distribution of menarche in examined schoolgirls was normal and symmetric. PMID- 2761486 TI - [Determination of 17-alpha-hydroxyprogesterone in the diagnosis of congenital adrenal hyperplasia]. AB - On the basis of data from literature and by the use of commercial accessories radioimmunologic method of the determination od 17-alpha-hydroxiprogesteron (17 OHPG) serum level was determined in two variants: a) addition to the previous extraction, b) without extraction. It was initiated in the clinical work for diagnostic of congenital adrenal hyperplasia (CAH) induced by the enzymatic block of C21-hydroxilasis. 17-OHPG level was determined in a group of 15 children aged 2-12 of both sexes not suffering from endocrinous diseases. Mean values od X = 3.2 +/- 2.7 nmol/L and X = 4.3 +/- 3.3 nmol/L were obtained under a) and b), respectively. Also, 17-OHPG concentration was determined in 15 women without any endocrinous diseases by the method under b) and mean value of X = 2.5 +/- 1.7 nmol/L was obtained. 17-OHPG level was determined in a group of 7 children in whom CAH had been verified 3 days after the interruption of the substitutional therapy. According to the results of the investigation it was pointed out that there was a marked increase in 17-OHPG serum level (particularly by the use of b) method) which was far outside the range of reference values. In cases both with 17-OHPG determination and the daily pregnantriol excretion it was noticed that the increase in 17-OHPG was almost always accompanied by the increase in pregnantriol as well. Cortisolemia ranged from normal up to very lowered values.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2761487 TI - Spurious hyperphosphatemia in patients with dysglobulinemia. AB - Following the introduction of the ASTRA automated chemical analyzer to the Brooklyn VA Hospital, we identified 14 patients with normal renal function and marked hyperphosphatemia (9.1 +/- 3.1 mg/dl). Reanalysis of these samples by standard SMA-II autoanalyzer demonstrated normal phosphate concentration (3.5 +/- 0.7 mg/dl). All patients had a dysglobulinemic syndrome and further examination indicated that ASTRA reagents produced significant optical turbidity in these sera. We conclude that chemical analysis of inorganic phosphorus by methods which do not deproteinate sera prior to colorimetric analysis are subject to nephelometry in the presence of dysglobulinemic samples and may result in spurious hyperphosphatemia. PMID- 2761488 TI - Effect of L-arginine on renal tubular bicarbonate reabsorption by the rat kidney. AB - This study was designed to characterize the effect of L-arginine, a dibasic amino acid, on bicarbonate reabsorption (RHCO3) by the superficial proximal convoluted tubule using the technique of microperfusion in situ and on overall kidney RHCO3 using clearance techniques. Luminal perfusion of proximal tubules with L-arginine (5, 10, and 20 mM) resulted in a concentration-dependent inhibition of RHCO3. Capillary perfusion with L-arginine (10 mM) had no significant effect indicating that this amino acid must gain access into the cell from the luminal side to inhibit RHCO3. The inhibitory effect of L-arginine on RHCO3 was stereospecific since luminal perfusion with D-arginine (10 mM) had no significant effect on RHCO3. The lowest concentration of luminal L-arginine (5 mM) which produced a significant inhibitory effect on RHCO3 (about 13% inhibition) was comparable to that measured in the blood of rats infused with this amino acid (6.4 +/- 0.7 mM). Systemic infusion of L-arginine resulted in metabolic acidosis and only a slight increase in HCO3 excretion. To investigate whether the lack of overt bicarbonaturia was due to the reduced filtered load of HCO3 or to a stimulatory effect of acidemia on distal HCO3 reabsorption, blood bicarbonate was elevated by the infusion of NaHCO3. Under those conditions overall kidney absolute RHCO3, examined as a function of filtered load, was maximal in rats infused with L arginine, thereby suggesting that when proximal HCO3 transport is inhibited, RHCO3 beyond the end of the proximal convoluted tubule increases in a load dependent manner.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2761489 TI - Rapid separation and quantitation of major phospholipids in biological samples by combined high-performance liquid chromatography and automated phosphorus analyzer. AB - Phospholipids extracted from tissue samples were separated by an isocratic high performance-liquid-chromatographic (HPLC) method and simultaneously quantitated by an automated phosphorus analyzer. Results from various tissues were compared with previously published data obtained by thin-layer chromatography (TLC). Liver, heart, skeletal muscle, kidney and brain cortex synaptosomes from rats were examined. Optimal separation of major phospholipids of these tissues was achieved in a single HPLC run using a mobile phase of acetonitrile, methanol and sulfuric acid 100:2.1:0.05 (v:v:v). Recoveries of pure phospholipids injected onto the column averaged 75-80%. Similar recoveries were obtained with heart and skeletal muscle phospholipids, whereas liver, kidney and synaptosomes yielded lower recoveries (50-66%), suggesting the presence of other phospholipids in these tissues which did not elute from the column. The composition of total and individual phospholipids varied among the tissues and was generally similar to previously reported findings with TLC. The intraassay coefficients of variation ranged from 5 to 11%. We conclude that this technique is a reliable, rapid, and reproducible method for separation and quantitation of the major phospholipid species of tissues and subcellular fractions. PMID- 2761491 TI - Chemical medullectomy does not prevent sodium retention in nephrotic rats. AB - Experiments were performed to study the effect of chemical medullectomy on the renal retention of sodium in rats with an experimental nephrotic syndrome. Nephrosis was induced in rats by a single injection of puromycin aminonucleoside (PAN) and the renal excretion of water and electrolytes was monitored for 11 days. Sodium output in nephrotic rats fell to approximately 10% of control levels and exchangeable body sodium increased to 54.6 +/- 2.7 mM/kg compared with 41.5 +/- 0.8 mM/kg in controls. The animals had edema and ascites and there was a 35% increase in plasma volume and a corresponding fall in hematocrit. Severe structural and functional damage to the inner renal medulla induced by the injection of bromoethylamine hydrobromide (BEA) resulted in little change in the pattern of sodium and water retention caused by PAN alone. Exchangeable body sodium in rats treated with PAN and BEA was 51.5 +/- 3.8 mM/kg. It is concluded that an intact inner renal medulla is not necessary for sodium retention to occur in PAN nephrosis in rats. PMID- 2761490 TI - Experimental aluminum intoxication and parathormone: effects on the mineralization process. AB - In order to study the effect of aluminum intoxication on bone and bone cells in normal animals and its relationship with hyperparathyroidism, and so to obtain further data on a pathogenetic role of this condition in inducing osteomalacia in uremic patients, 31 rats divided in four groups were injected intraperitoneally for 11 weeks with: Al (75.6 mg); Al-PTH (Al = 75.6 mg + PTH = 200 USP during the last week); C (saline solution), and C-PTH (saline solution + PTH = 200 USP during the last week). Al injection induced a consistent increase in the element in serum and tibia. PTH administration further enhanced Al content in tibia. The trabecular bone surfaces of Al-administered rats were stained by aluminon; the endosteal borders of their compact bone were always negative. Rib histomorphometry showed absence of osteomalacia in Al group and increase in osteoid in Al-PTH group, with development of mild osteomalacia. In these groups osteoclasts were less numerous than in controls. Dynamic bone parameters showed no separation of double tetracycline labels in trabecular bone of both Al administered groups. Cortical bone was only slightly affected by treatment. All these data indicate that Al alone, in the quantity administered, does not induce osteomalacia in normal rats and that PTH, although given for a few days, enhances Al content in bone and induces osteoid increment. The reduction of tetracycline labels in all Al-treated animals is due to reduction of calcification and formation rate, which might be an index of osteoblast inhibition. The decrease in the number of osteoclasts suggests that Al might inhibit their formation. PMID- 2761493 TI - Abstracts of the 10th national congress of the Italian Society of Mineral Metabolism. Fiuggi Terme, October 14-15, 1988. PMID- 2761492 TI - Pathogenetic aspects of uremic cardiomyopathy. AB - We have considered just some of the many factors which may affect myocardial function, assessed by means of echocardiography, in uremic patients. Our findings support the view of a multifactorial genesis of the cardiac involvement in uremic patients. PMID- 2761494 TI - Effectiveness of short term canrenone treatment in idiopathic hirsutism. AB - In order to verify the anti-androgenic effects of canrenone, the major metabolite of spironolactone, 9 normally cycling women with post-puberal hirsutism, were orally administered the drug (200 mg per day for three months). In all patients, the clinical score, according to the method of Ferriman and Gallwey (F.G.I.: Ferriman-Gallwey Index), as well as endocrine function tests, including total and free testosterone, sex hormone binding globulin, dehydroepiandrosterone sulphate, 17-OH-progesterone, basal and ACTH stimulated cortisol, were evaluated prior to and after canrenone treatment. A significant reduction in hair growth (F.G.I. = 18 +/- 2 vs 23 +/- 3, p less than 0.001), and also a significant decrease, with regard to endocrine parameters, of total testosterone (0.5 +/- 0.1 vs 0.9 +/- 0.3 p less than 0.01), free testosterone (2.7 +/- 0.7 vs 4.7 +/- 1.7, p less than 0.005), dehydroepiandrosterone sulphate (228 +/- 38 vs 314 +/- 81, p less than 0.02), and sex hormone binding globulin (62.5% of basal values, p less than 0.001), were observed. Serum levels of 17-OH-progesterone, and basal and ACTH stimulated cortisol were not significantly different from pretreatment values. It is concluded that the biochemical and clinical parameter improvement, along with a well-preserved cortisol secretion (unchanged levels of 17-OH-progesterone), suggest that canrenone may represent an effective therapy for idiopathic post puberal hirsutism. PMID- 2761495 TI - [Determination of prolactin secretion in idiopathic galactorrhea]. AB - We have studied 15 women with idiopathic galactorrhoea and normal serum PRL basal values, regularly menstruating, with normal x-ray of the sella turcica and mammography. The patients were not suffering from other endocrine diseases nor taking medications known to cause galactorrhoea. These subjects and 5 normal women were submitted to an evaluation of the serum PRL circadian rhythm, to TRH test for PRL and TSH, metoclopramide test for PRL, and basal determination of TT3 and TT4. The results did not show any significant difference between the two groups and did not reveal any abnormality of PRL secretion in the patients. These data, resulting from a homogeneous series of patients, support the hypothesis of an increased sensitivity of breast receptors to PRL, or of the secretion of heterogeneous forms of PRL, biologically active on mammary tissue, but not detected by current RIA methods for PRL. PMID- 2761496 TI - [Coexistence of hyperthyroidism and thyroid carcinoma. Description of a clinical case]. AB - The association of hyperthyroidism and thyroid carcinoma, especially multicentric forms, is an unusual event. We present the case of a 49-year-old woman with clinical and radiological findings of hyperfunctioning thyroid nodule that showed, after a subtotal thyroidectomy, histologic evidence of multicentric carcinoma in one lobe and adenoma in the other lobe. The interest of this clinical case is in the coexistence of an independent adenoma with a multicentric carcinoma, revealed by radical surgery that was necessary for the occurrence of a multinodular goiter. The incidence of this situation could be underestimated in consequence of the current surgical approach to the single "hot" nodule and suggests we pay attention to these patients for the possible presence of malignancy in functionally-inhibited thyroid tissue. PMID- 2761498 TI - [In vitro analysis of diffusion through radicular tissue of paraformaldehyde contained in a paste commonly used in endodontics]. AB - The aim of the study was to show how paraformaldehyde contained in a preparation normally used in endodontic therapy spreads through the root tissues. The results reveal that paraformaldehyde has the same particular tendency as formaldehyde to spread in the periapex, maximum levels are reached after 48 hours and tend to decrease after 72 and 96 hours. PMID- 2761497 TI - [Audiological and neuropsychological development study in a sample of school children from a low-iodine area of the Central Apennines that is endemic for cretinism]. AB - We have evaluated neuropsychic development in 70 normal schoolchildren in an area of severe endemic goitre and cretinism in the Central Apennines (Montefeltro). In each subject we have studied auxological, psychometric and audiometric parameters, together with tympanograms and stapedial reflexograms. Auxological data were in the normal range, as were the stapedial reflexograms and tympanograms. On the contrary, 54.8% of the sample performed below the 25th percentile in psychometric tests (Raven test PM-47), being also 22.8% below the 5th percentile. Audiometric data showed a neurological hearing impairment in 3.1% of the children tested, as compared with 0.28% in the area of Pisa. These data point out that an impairment of central nervous system function still persists in this area of severe endemic goitre. PMID- 2761499 TI - [Evaluation of blood methyl-mercury using HPLC in dentists and their assistants]. AB - HPLC was used to measure blood levels of methyl mercury in dentists and their assistants. PMID- 2761500 TI - [Adhesion of glass ionomer to composite resins. Several practical data]. AB - The traction resistance of the bond between vitreous ionomer and composite after acid treatment of the former is analysed using various types of composite. PMID- 2761501 TI - [Ultrastructural aspects of the submandibular gland]. AB - The structure of normal human submandibular glands has been studied with the electron microscope. Secretory cells are arranged around a central lumen, and are surrounded by numerous myoepithelial cells, showing tapering process. Intercalated and striated ducts follow secretory units. Striated ducts' cells are characterized by extensive infoldings of the basal plasma membrane, among which numerous mitochondria are aligned. Furthermore, the Authors examine the submandibular gland's innervation. PMID- 2761503 TI - Infection control is vital. PMID- 2761502 TI - Guided tissue regeneration: a new adjunct to periodontal regeneration. PMID- 2761504 TI - A protocol for neonatal use of pulse oximetry. PMID- 2761505 TI - Vancomycin. PMID- 2761506 TI - Neonatal nursing--"down under". PMID- 2761507 TI - Ethics in theory and practice. Nature's way. PMID- 2761508 TI - A.S.A.P. PMID- 2761509 TI - Making medical reading count. PMID- 2761510 TI - Tobacco or health? PMID- 2761511 TI - Carcinoma of the pancreas. Is treatment worthwhile? AB - A study of 60 patients with adenocarcinoma of the pancreas demonstrates the poor prognosis associated with this disease. Unless patients had localized, resectable tumors, survival was virtually unchanged by any treatment prescribed. PMID- 2761512 TI - Erythrocyte pyruvate kinase deficiency. A case of severe congenital hemolytic anemia. AB - Although it occurs rarely, erythrocyte pyruvate kinase deficiency is a cause of neonatal jaundice and anemia across many ethnic and geographic groups. In this report of a Missouri case, an infant with this condition was also found to have Pelger-Huet leukocyte anomaly. PMID- 2761513 TI - Survey of cancer control attitudes among Missouri state legislators. AB - A number of cancer control efforts, while proven to be effective, require significant support from state and local lawmakers in order to be successful. This survey of state legislators' attitudes toward health risks and risk reduction measures that could be undertaken shows a favorable outlook for cancer control programs in Missouri. PMID- 2761515 TI - Fitness of the future. PMID- 2761514 TI - A phone call. PMID- 2761516 TI - Bronchopulmonary sequestration. AB - Bronchopulmonary sequestration is an area of lung parenchyma that is devoid of normal connection to the trachebronchial tree. Arterial supply is from an aberrant systemic artery, usually a branch of the aorta. There are two broad types of bronchopulmonary sequestration: intralobar and extralobar. The former shares a common pleura with the lung while the latter is separated by its own pleura. Definitive therapy requires pulmonary resection. PMID- 2761517 TI - Large cell lymphoma presenting as a coronal penile lesion. AB - Although the majority of penile malignancies are primary epithelial carcinomas, consideration of secondary involvement, especially from lymphoma, is important, since there are alternatives to the standard therapeutic approach of penile amputation. PMID- 2761518 TI - [Invasive candidiasis: its predisposing factors, usefulness and limitation of cultural study in its diagnosis, and consideration on the appropriate amphotericin B therapy]. AB - We have reviewed 38 patients with invasive candidiasis and examined its predisposing factors, usefulness and limitation of cultural study in its diagnosis, and effective usage of amphotericin B in its treatment. Invasive candidiasis was diagnosed in 2.4% of the patients admitted during the past 5 years. One of the most important predisposing factors for development of invasive candidiasis was extensive use of antibiotics. Destruction of the mechanical barrier against bacteria and fungi caused by endotracheal intubations and various catheterization was another important factor. Mucosal lesion of the gastrointestinal tract, including stress ulcer, non-specific inflammatory bowel disease and esophageal ulcer, was seen in 30% of the patients. These lesions were thought to be the portal of entry for candida to systemic dissemination. AMPH is the most effective antifungal agent. Total dose of 300 to 1000 mg was effective in the patients. Dosage over 1000 mg was associated with progressive decrease in creatinine clearance. This decrease was irreversible even after discontinuation of AMPH. Candidal overgrowth within the G1 tract was considered to precede invasive candidiasis. Oral AMPH administration was effective in such conditions. PMID- 2761519 TI - [Canine intestinal myoelectric activity after total gastrectomy with jejunal interposition]. AB - Changes of intestinal myoelectric activities after total gastrectomy with jejunal interposition were studied in three conscious dogs. Under general anesthesia a total gastrectomy was performed and intestinal continuity was reestablished by a 15 cm jejunal segment interposed between the esophagus and the duodenum. Two electrodes were sown each to the serosal surface of the interposed segment of the jejunum, duodenum, and distal potion of the jejunum, respectively. After recovery from the surgery, the myoelectric activities were recorded for 8 to 12 hours during fasting and after feeding a 200 ml liquid meal. In each segment, total gastrectomy did not alter the initiation of the migrating myoelectric complex (MMC) during fasting. Total gastrectomy also changed neither the postprandial inhibition of the enteric MMC nor the induction of the fed myoelectric pattern after feeding. The way of MMC propagation along the small intestine, however, showed various patterns. Each of three segments generated its own MMCs. Some complexes migrated to the next segment or had an effect on initiating new MMCs of the next segment. Although MMCs occurring in the segment of the interposed jejunum hardly migrated to the adjacent duodenum, some jumped to the distal jejunum. These results suggest that there are no coordinated activities between the interposed jejunum and the duodenum after total gastrectomy with jejunal interposition. PMID- 2761520 TI - [Relative non curative resection of gastric cancer]. AB - Relative non curative resection of gastric cancer was studied according to The General Rules of Japanese Research Society for gastric cancer. The five year survival rate was 31.2%, while 39.6% for relative curative resection and 4.9% for absolute non curative resection. The cases whose relative non curative factor was due to lymph nodes (n greater than R) resulted in a fair prognosis, but the prognosis of those concerned with peritoneal dissemination (P1) or liver metastasis (H1) was very poor. Surgical achievement to improve postoperative results may be obtained when a systemic (13), (14v) (16) lymph node dissection is performed whenever only one of them was involved in metastasis. PMID- 2761521 TI - [Experiences of postoperative staphylococcal enteritis caused by methicillin cephem resistant Staphylococcus aureus (MRSA) and the state of the isolation of MRSA]. AB - During the last 12 months, three cases of postoperative staphylococcal enteritis were experienced in our surgical ward. Kanamycin, Clindamycin and Latamoxef were given prophylactically in all cases. They developed dehydration with severe diarrhea and paralytic ileus in three to ten days after abdominal surgery. MRSA was cultured from the intestinal fluid or feces and Minocycline, sensitive anti microbial agent to the organism, was administered intravenously and their conditions improved dramatically. Since the nosocomial infections of MRSA are believed to be the cause of these cases, following items were investigated; 1) the frequency of MRSA among Staphylococcus aureus clinically isolated from patients in surgical ward, 2) the state of nasal carriage of MRSA in medical staffs and inpatients without infections in surgical ward, 3) drug sensitivity of MRSA to ten kinds of antibiotics. The results were as follows; 1) the frequency of MRSA was 83% of all the strains of Staphylococcus aureus, 2) the nasal carrier status was 2 in 46 medical staffs and 4 in 17 inpatients, 3) 124 strains of MRSA, 114 isolated from patients and 10 from nasal carriers, showed the identical drug sensitivity, that is, MRSA is sensitive to Minocycline and resistant to every other antibiotics. It is believed that these three cases were due to nosocomial infections of MRSA, and early diagnosis of MRSA enteritis should lead to early antibiotic therapy and to a cure of this serious postoperative complication. PMID- 2761522 TI - [Pathological features and treatment of ulcerative lesions of the duodenum associated with Crohn's disease]. AB - Among a total of 22 patients with Crohn's disease, eight patients with duodenal ulcerative lesions were investigated for pathological features and treatment. All duodenal ulcerative lesions of the eight patients were difficult to be distinguished morphologically from peptic duodenal ulcers at the beginning. But during the course of observation six of eight lesions revealed different pathological features from peptic duodenal ulcers: One showed highly edematous mucosa. Four granular mucosa, and another one longitudinal ulcers and cobblestone appearance. Gastric analysis of these patients showed 6.6 +/- 4.0 mEq/L of BAO and 21.3 +/- 3.4 mEq/L of MAO which was comparable to high acidity of peptic duodenal ulcers. Effectiveness of administration of anti-peptic ulcer drugs only and both anti-peptic ulcer drugs plus drugs against Crohn's disease were 40.0% and 57.1%, respectively. Two patients underwent distal partial gastrectomy. Recurrence was not observed. In conclusion, high acidity would be a cause of duodenal ulcerative lesions associated with Crohn's disease, and the pathological features of them would be affected by Crohn's disease itself. Anti-peptic ulcer drugs should to be administered as well as drugs against Crohn's disease. The method which has hypoacidity effect should be selected in operative therapy to such patients as to have stenosis of the duodenum. PMID- 2761523 TI - [Reappraisal of hepatectomy in traumatic rupture of the liver]. AB - From our experiences, the causes of high mortality rate in hepatectomy for hepatic rupture may be attributed to improper application of this procedure to trauma victims under suboptimal conditions, as most of the deaths were related to coagulopathy and uncontrollable bleeding. Accordingly, a protocol of indication for emergent hepatectomy was established in March, 1985, which included the following criteria: PH greater than 7.2, body temperature greater than 32.0 degrees C, systolic blood pressure greater than 60mmHg and no presence of coagulopathy. Of 14 cases which underwent hepatectomy before March, 1985, 9 cases died of exsanguination, coagulopathy and multiple organ failure with the mortality rate of 63.7% whereas only two of 10 cases which underwent hepatectomy after March, 1985, died, the mortality rate being markedly decreased to 20%. Considering the fact that there were no differences between these two groups of the patients regarding severity of liver trauma and clinical back ground, it indicates that the appropriate selection of the patients for hepatectomy based on the criteria has definitely decreased the mortality rate of hepatic rupture victims. PMID- 2761524 TI - [Hybrid bioartificial liver using canine hepatocytes in primary culture]. AB - Viable Hepatocytes were isolated from adult canine liver by in situ collagenase perfusion, and cultured on collagen coated borosilicate glass plates (100 X 200mm) at confluent cell density. The medium of hepatocytes in the primary culture was L-15 supplemented with aprotinin 5000U/L, proline 30mg/L, insulin 10( 8)M, dexamethasone 10(-8)M, glucagon 10(-8)M, and h-EGF 10ng/ml. Long-stroke type bioartificial liver module consisted of 200 glass plates with hepatocytes. It contained 6 billion primary cultured cells in total, that is almost equivalent to 30% of the normal canine liver. All hepatocytes in the module were quite viable during 2 weeks in the perfusion culture, and maintained various liver functions at a high level. Gluconeogenesis was 368.0 +/- 15.4mg/module/hr, albumin synthesis was 19.1 +/- 2.5mg/module/day, ureogenesis was 3.7 +/- 0.1mg/module/hr, and ammonia metabolism was 8.4mg/module/hr. Moreover, those functions were maintained at least 2 weeks in the canine plasma as well as in the culture medium with hormones. This hybrid bioartificial liver may exert various liver functions like a liver in situ. PMID- 2761525 TI - [Liver failure after hepatic resection]. AB - Pathophysiology of hepatic resection in 89 cases was investigated from the point of endotoxemia and phagocytic function in order to clarify the mechanism of postoperative liver failure. In the control group (n = 44) and the bile stasis group (n = 9) plasma endotoxin increased to 22 to 160pg/ml early after operation and decreased thereafter: but in the liver failure group (n = 10) it increased higher corresponding to high risk operation and the massive bleeding or anastomosis leakage. In control and bile stasis groups phagocytic K value, serum CH50, plasma fibronectin decreased to half of the preoperative level on the first postoperative day, and later improved. In liver failure group these levels decreased but never improved. Liver failure group was characterized by an irreversible platelets count decrease corresponding to the increase of serum bilirubin level. It was concluded that endotoxemia in the presence of a self defence system dysfunction is thought to be a trigger for organ failure. PMID- 2761526 TI - [Surgical treatment and indication for metastatic lung tumor]. AB - Prognostic factors of patients with metastatic lung tumors were evaluated on 72 patients who were treated with pulmonary resection (49 via lateral thoracotomy and 23 via median sternotomy). The 5-year survival rate of these patients was 41.3%. Two factors, i.e., tumor free interval (TFI) and tumor size, significantly affected the survival after surgery. Patients with a longer TFI and smaller tumor(s) were associated with a favorable prognosis. The prognosis, however, was neither affected by the number of metastatic lung tumors nor whether they were unilateral or bilateral. The prognosis of lung metastases from colorectal cancer was the most favorable (61.4% at 5-year). On the other hand, patients with lung metastases from renal cell carcinoma and breast carcinoma showed poor prognosis respectively. As for testicular tumors and bone or soft tissue sarcomas, chemo sensitivity is the most important prognostic factor. Good responders to prior chemotherapy showed a better prognosis than poor responders. These results urge the reappraisal of the role of surgery in the treatment of metastatic lung tumors and demonstrate that aggressive surgery can be indicated even for multiple or bilateral lung metastases. Nature of metastatic tumors, i.e., their origin and chemo-sensitivity, must be taken into consideration when the indication for surgery is decided. PMID- 2761527 TI - [Local changes in prostanoids in arteriosclerosis obliterans]. AB - In order to identify local changes in prostanoids in arteriosclerosis obliterans (ASO), plasma levels of thromboxane B2 (TXB2) and 6-keto-prostaglandin F1 alpha(6 Keto-PGF1 alpha) in cubital venous blood (CV blood), in femoral arterial blood (FA blood) and in femoral venous blood (FV blood) of 27 patients with ASO of lower limbs and of 10 healthy controls were measured by RIA technique. The following results were obtained. 1) In the ASO patients, levels of TXB2 and the ratio between TXB2 and 6-Keto-PGF1 alpha (TXB2/6-Keto-PGF1 alpha) in FV blood of ischemic legs were elevated in comparison to those in CV blood or FA blood of the same group or those in FV blood of the controls. 2) This change was more clearly observed in the femoro-popliteal group, but in the aorto-iliac+ combined group, they were elevated not only in FV blood but also in FA blood. 3) No significant difference was observed between the Fontaine I + II group and the Fontaine III + IV group in these local changes in prostanoids. 4) The severer the angiographic manifestation between the abdominal aorta and the common femoral artery, the higher the plasma TXB2 levels in FA blood. Also, the poorer the peripheral run off, the higher the plasma TXB2 production in the legs. These results suggest that the imbalance between TXA2 and PGI2 is obvious in ischemic legs of ASO patients, TXA2 is elevated downstream from damaged vessels, and the local plasma TXB2 levels reflect the severity of the vascular damage in ASO patients. PMID- 2761528 TI - [The prognosis of intermittent claudication]. AB - The purpose of this study is to obtain the informations about the fate of the limbs and lives of claudicants due to arteriosclerosis obliterans. Two hundred and seven lower limbs of 165 patients suffering from intermittent claudication were observed for an average period of about six years. Eighty-seven limbs of 69 patients were managed nonsurgically (Group A). Ninety-eight percent of limbs in Group A remained unchanged or improved, and no limb was amputated. One hundred and twenty limbs of 96 patients had arterial reconstructions (Group B). Although 75 percent of limbs in Group B had benefits by successful operations, 26 percent of them experienced graft failures, and 2.7 percent of them were amputated. Five year graft patency rates in the limbs with supra- and infra-inguinal reconstructions were 82.1 percent and 65.7 percent, respectively. Operative mortality rate was 2.1 percent, and mortality rate due to late complications was 3.3 percent. The prognosis of intermittent claudication with regular follow-up was relatively good, therefore, it is important to recognize that arterial reconstruction is not the only way to treat limbs with mild intermittent claudication. About 30 percent of claudicants died within 5 years, and 60 percent of them died from cardiac or cerebrovascular disease. The results suggested that much attention should be paid to the lives as well as the limbs of claudicants. PMID- 2761529 TI - [An aged case of peripheral arterial obstructive disease with progressive limb necrosis]. AB - An aged case of peripheral arterial obstructive disease with progressive limb necrosis is reported. A 70-year old man was admitted to our hospital with the complaint of numbness and rest pain on left lower limb. Thereafter, necrosis of the digital region of the upper limbs and the toe region of the lower limbs became progressively worse 3 weeks after onset. Bilateral lower limb amputations after lumbar sympathectomy and digital amputation of upper limbs after thoracic sympathectomy were performed. The histological findings of artery and vein in amputated limbs showed thromboangiitis obliterans. We conclude that Buerger's disease in the aged is rare, but does really exist. PMID- 2761530 TI - [Postoperative endotoxemia in patients with esophageal carcinoma: preliminary report]. PMID- 2761531 TI - [Assessment of the viability of the ischemic liver by chemiluminescenc in rats: preliminary report]. PMID- 2761532 TI - [Expression of c-myc product in gastric cancer: preliminary report]. PMID- 2761533 TI - [In vitro BrdU labeling for clinical use--flow cytometric analysis of proliferative activity in gastric cancers: preliminary report]. PMID- 2761534 TI - [Experimental assessment of lung injury with cardiopulmonary bypass using a unilateral pulmonary artery occlusion model: preliminary report]. PMID- 2761535 TI - Chromatin loop structure of the human X chromosome: relevance to X inactivation and CpG clusters. AB - Part of the higher-order structure of chromatin is achieved by constraining DNA in loops ranging in size from 30 to 100 kilobase pairs; these loops have been implicated in defining functional domains and replicons and possibly in facilitating transcription. Because the human active and inactive X chromosomes differ in transcriptional activity and replication, we looked for differences in their chromatin loop structures. Since the islands of CpG-rich DNA at the 5' ends of X-linked housekeeping genes are the regions where functional differences in DNA methylation and nuclease sensitivity are found, we looked for scaffold association of these sequences after extraction of histones with lithium diiodosalicylate. Specifically, we examined the 5' CpG islands within the hypoxanthine phosphoribosyltransferase, glucose 6-phosphate dehydrogenase, P3, GdX, phosphoglycerate kinase type 1, and alpha-galactosidase loci in human lymphoblasts obtained from individuals with 1 to 4 X chromosomes. Although we detected no scaffold-associated regions near these genes, we found several such regions at the ornithine transcarbamylase and blood clotting factor IX loci. Our results suggest that the CpG islands are excluded from the nuclear scaffold and that even though transcriptionally active, housekeeping genes are less likely than X-linked tissue-specific genes to be scaffold associated. In all cases, the pattern of scaffold association was the same for loci on active and inactive X chromosomes. PMID- 2761536 TI - The upstream muscle-specific enhancer of the rat muscle creatine kinase gene is composed of multiple elements. AB - A series of constructs that links the rat muscle creatine kinase promoter to the bacterial chloramphenicol acetyltransferase gene was generated. These constructs were introduced into differentiating mouse C2C12 myogenic cells to localize sequences that are important for up-regulation of the creatine kinase gene during myogenic differentiation. A muscle-specific enhancer element responsible for induction of chloramphenicol acetyltransferase expression during myogenesis was localized to a 159-base-pair region from 1,031 to 1,190 base pairs upstream of the transcription start site. Analysis of transient expression experiments using promoters mutated by deletion indicated the presence of multiple functional domains within this muscle-specific regulatory element. A DNA fragment spanning this region was used in DNase I protection experiments. Nuclear extracts derived from C2 myotubes protected three regions (designated E1, E2, and E3) on this fragment from digestion, which indicated there may be three or more trans-acting factors that interact with the creatine kinase muscle enhancer. Gel retardation assays revealed that factors able to bind specifically to E1, E2, and E3 are present in a wide variety of tissues and cell types. Transient expression assays demonstrated that elements in regions E1 and E3, but not necessarily E2, are required for full enhancer activity. PMID- 2761537 TI - Analysis of pre-rRNAs in heat-shocked HeLa cells allows identification of the upstream termination site of human polymerase I transcription. AB - Human rRNA precursor from normal or stressed HeLa cells were studied by S1 nuclease mapping of unlabeled RNA and by antisense RNase mapping of RNA from cells that had been labeled in vivo with [32P]PO4. Heating cells to 43 degrees C decreased the amount of newly synthesized rRNA to less than 5% of the control level and led to greater than 95% inhibition of transcription termination at a region 355 to 362 nucleotides downstream of the 3' end of 28S rRNA, with readthrough continuing into the next transcription unit. Heating of cells to 42 degrees C led to 60% inhibition of termination at this site; 50% of transcripts that extended into the nontranscribed spacer ended in a region 200 to 210 nucleotides upstream of the polymerase I (Pol I) initiation site. This is presumed to be the human upstream transcription termination site because of the absence of RNAs with a 5' end corresponding to this region, the location relative to the Pol I initiation site (which is similar to the location of upstream terminators in other species), and the fact that it is 15 to 25 nucleotides upstream of the sequence GGGTTGACC, which has an 8-of-9 base identity with the sequence 3' of the downstream termination site. Surprisingly, treatment of cells with sodium arsenite, which also leads to the induction of a stress response, did not inhibit termination. Pol I initiation was decreased to the same extent as termination, which lends support to the hypothesis that termination and initiation are coupled. Although termination was almost completely inhibited at 43 degrees C, the majority of the recently synthesized rRNAs were processed to have the correct 3' end of 28S. This finding suggests that 3'-end formation can involve an endonucleolytic cut and is not solely dependent on exonucleolytic trimming of correctly terminated rRNAs. PMID- 2761538 TI - Promoter upstream elements of the chicken cardiac myosin light-chain 2-A gene interact with trans-acting regulatory factors for muscle-specific transcription. AB - A segment of the 5'-flanking region of the chicken cardiac myosin light-chain gene extending from nucleotide -64 to the RNA start site is sufficient to allow muscle-specific transcription. In this paper, we characterize, by mutational analysis, sequence elements which are essential for the promoter activity. Furthermore, we present evidence for a negative-acting element which is possibly involved in conferring the muscle specificity. Nuclear proteins specifically bind to the DNA elements, as demonstrated by gel mobility shift assays and DNase I protection footprinting. The significance of the DNA-protein interactions for the function of the promoter in vivo is demonstrated by competition experiments in which protein-binding oligonucleotides were microinjected into nuclei of myotubes, where they successfully competed for the protein factors which are required to trans activate the MLC2-A promoter. The ability to bind nuclear proteins involves two closely spaced AT-rich sequence elements, one of which constitutes the TATA box. The binding properties correlate well with the capacity to activate transcription in vivo, since mutations in this region of the promoter concomitantly lead to loss of binding and transcriptional activity. PMID- 2761539 TI - A growth factor-responsive gene of murine BALB/c 3T3 cells encodes a protein homologous to human tissue factor. AB - Polypeptide growth factors rapidly induce the transcription of a set of genes that appear to mediate cell growth. We report that one of the genes induced in BALB/c mouse 3T3 cells encodes a transmembrane protein (mTF) homologous to human tissue factor, which is involved in the proteolytic activation of blood clotting. mTF mRNA is present in many murine tissues and cell lines. Our results raise the possibility that mTF may also play a role in cell growth. PMID- 2761540 TI - The first intron of the 4F2 heavy-chain gene contains a transcriptional enhancer element that binds multiple nuclear proteins. AB - We utilized the human 4F2 heavy-chain (4F2HC) gene as a model system to study the regulation of inducible gene expression during normal human T-cell activation. Previous studies have demonstrated that 4F2HC gene expression is induced during normal T-cell activation and that the activity of the gene is regulated, at least in part, by the interaction of a constitutively active 5'-flanking housekeeping promoter and a phorbol ester-responsive transcriptional attenuator element located in the exon 1-intron 1 region of the gene. We now report that 4F2HC intron 1 contains a transcriptional enhancer element which is active on a number of heterologous promoters in a variety of murine and human cells. This enhancer element has been mapped to a 187-base-pair RsaI-AluI fragment from 4F2HC intron 1. DNase I footprinting and gel mobility shift analyses demonstrated that this fragment contains two nuclear protein-binding sites (NF-4FA and NF-4FB) which flank a consensus binding site for the inducible AP-1 transcription factor. Deletion analysis showed that the NF-4FA, NF-4FB, and AP-1 sequences are each necessary for full enhancer activity. Murine 4F2HC intron 1 displayed enhancer activity similar to that of its human counterpart. Comparison of the sequences of human and murine 4F2HC intron 1s demonstrated that the NF-4FA, NF-4FB, and AP-1 sequence motifs have been highly conserved during mammalian evolution. PMID- 2761541 TI - Purification and characterization of an erythroid cell-specific factor that binds the murine alpha- and beta-globin genes. AB - An erythroid cell-specific nuclear factor that binds tightly to a sequence motif (5'-GATAAGGA-3') shared by many erythroid cell-specific promoters was purified to homogeneity by DNA sequence affinity chromatography. Visualization of the purified factor, which we term EF-1, showed a simple pattern comprising a polypeptide doublet with Mrs of 18,000 and 19,000. We confirmed that these species account for EF-1-binding activity by eluting the polypeptides from sodium dodecyl sulfate-polyacrylamide gels and renaturing the appropriate binding activity. Using the purified polypeptides, we mapped seven factor-binding sites that are dispersed across the murine alpha- and beta-globin genes. The murine alpha-globin gene is flanked by at least two EF-1-binding sites. One site is centered at nucleotide (nt) -180 (with respect to the alpha-globin cap site). A fivefold-weaker site is located downstream of the alpha-globin poly(A) addition site, at nt +1049. We mapped five EF-1-binding sites near the murine beta-globin gene. The strongest site was centered at nt -210. Four additional sites were centered at nt -266 (adjacent to the binding site of a factor present in both murine erythroleukemia and Raji cells), -75 (overlapping the beta-globin CCAAT box), +543 (within the second intervening sequence), and -111. PMID- 2761543 TI - Molecular cloning and sequences of lignin peroxidase genes of Phanerochaete chrysosporium. AB - The genomic clones encoding lignin peroxidase isozyme H8 and two closely related genes were isolated from Phanerochaete chrysosporium BKM-1767, and their nucleotide sequences were determined. The positions and approximate lengths of introns were found to be highly conserved in all three clones. Analysis of homokaryotic derivatives indicated that the three clones are not alleles of the same gene(s). PMID- 2761542 TI - Identification of a myocyte nuclear factor that binds to the muscle-specific enhancer of the mouse muscle creatine kinase gene. AB - The muscle creatine kinase (MCK) gene is transcriptionally induced when skeletal muscle myoblasts differentiate into myocytes. The gene contains two muscle specific enhancer elements, one located 1,100 nucleotides (nt)5' of the transcriptional start site and one located in the first intron. We have used gel mobility shift assays to characterize the trans-acting factors that interact with a region of the MCK gene containing the 5' enhancer. MM14 and C2C12 myocyte nuclear extracts contain a sequence-specific DNA-binding factor which recognizes a site within a 110-nt fragment of the MCK enhancer region shown to be sufficient for enhancer function. Preparative mobility shift gels were combined with DNase I footprinting to determine the site of binding within the 110-nt fragment. Site directed mutagenesis within the footprinted region produced a 110-nt fragment which did not bind the myocyte factor in vitro. The mutant fragment had about 25 fold-less activity as a transcriptional enhancer in myocytes than did the wild type fragment. Complementary oligomers containing 21 base pairs spanning the region protected from DNase degradation were also specifically bound by MM14 and C2C12 myocyte nuclear factors. The oligomer-binding activity was not found in nuclear extracts from the corresponding myoblasts, in nuclear extracts from a variety of nonmuscle cell types (including differentiation-defective MM14-DD1 cells and 10T1/2 mesodermal stem cells), or in cytoplasmic extracts. Both the 5' and intron 1 enhancer-containing fragments competed for factors that bind the oligomer probe, while total mouse genomic DNA and several DNA fragments containing viral and cellular enhancers did not. Interestingly, a 5' MCK proximal promoter fragment that also contains muscle-specific positive regulatory elements did not compete for factor binding to the oligomer. We have designated the factor which interacts with the two MCK enhancers myocyte-specific enhancer-binding nuclear factor 1 (MEF 1). A consensus for binding sites in muscle-specific regulatory regions is proposed. PMID- 2761544 TI - Expression of the poly(A)-binding protein during development of Xenopus laevis. AB - We have isolated and sequenced cDNA clones encoding the poly(A)-binding protein of Xenopus laevis oocytes. Polyclonal antiserum was raised against a fusion protein encoding 185 amino acids of the Xenopus poly(A)-binding protein. This antiserum localizes the poly(A)-binding protein to subcellular sites associated with protein synthesis; in the retina, immunoreactive protein is detected in the synthetically active inner segment of the photoreceptor but not in the transductive outer segment. Transcripts encoding the poly(A)-binding protein are present in oocytes, although no protein is detected on protein blots. In contrast, the levels of both transcripts and protein increase in development, which correlates with the observed increase in total poly(A) during Xenopus embryogenesis (N. Sagata, K. Shiokawa, and K. Yamana, Dev. Biol. 77:431-448, 1980). PMID- 2761545 TI - [Cor pulmonale as a sequela of tonsillar hypertrophy]. AB - Cor pulmonale secondary to adenotonsillar hypertrophy is reported in two children. Repeated attacks of upper respiratory tract infection, snoring during sleep and finally signs of right heart insufficiency and mild cyanosis at exertion led to the diagnosis. Pulmonary hypertension was proved by electrocardiography, echocardiography and cardiac catheterization. Tonsillectomy and/or adenoectomy released the cardiac symptoms. PMID- 2761546 TI - [Clinical assessment of a new glucose reflectance meter (Glucoscot II) for the detection of neonatal hypoglycemias]. AB - Glucoscot II, a new glucose reflectance meter and the corresponding test strip "Glucopat" were evaluated for their accuracy in the detection of neonatal hypoglycemia. In 100 neonatal blood samples of 44 neonates glucose was estimated with the reflectance meter and the results were compared with those from a reference method (Beckman-Glucose-Analyser). Hypoglycemia was defined as blood glucose of less than 2.2 mmol/l (40 mg/dl). The correlation between the values obtained by the test strip and the reference values was high (= 0.95). Test sensitivity was 100%, specificity 99% and the predictive value for hypoglycemia was 94%. The incidence of a blood sugar less than 2.2 mmol/l in our study population was 15%. Thirteen percent of glucose values determined with the reflectance meter deviated from the reference value by more then 20%. If our data can be confirmed by others we conclude that the Glucoscot II/Glucopat-system can be recommended as screening-test for hypoglycemia in neonates. PMID- 2761547 TI - [Sonographic diagnosis of alobar holoprosencephaly]. AB - The alobar form of holoprosencephaly is characterised by a huge spherical ventricle localized in the midline. The monoventricle communicates with a large occipital cyst, the "dorsal sac". Both thalami and plexus chorioidei are fused in the midline. The interhemisperic fissure and the falx cerebri are absent as well as the corpus callosum and the septum pellucidum. PMID- 2761549 TI - [11th annual meeting of the Society for Pediatric Pneumology. 13-15 April 1989, Graz. The child with bronchial asthma. Abstracts]. PMID- 2761548 TI - [Adrenalectomy as therapy in refractory adrenogenital syndrome]. AB - A ten year old girl with congenital adrenal hyperplasia was bilaterally adrenalectomized because even high doses of glucocorticosteroids and mineralocorticosteroids did not sufficiently suppress androgen hypersecretion. Thus, her bone age had advanced over chronological age by three years. The difficulties and started after the institution of phenytoin and clonazepam therapy for epilepsy at the age of three years. The surgical removal of the adrenal glands in such patients appears to be a logical therapeutical approach in such situations, since the organs principally are useless in patients with congenital adrenal hyperplasia, lacking the ability to react with adequate cortisol secretion. PMID- 2761551 TI - Fundamental and molecular mechanisms of mutagenesis. PMID- 2761550 TI - Natural cytotoxic activity in a cloned natural killer cell line is mediated by tumor necrosis factor. AB - The interleukin-2-dependent mouse natural killer (NK) cell line NKB61A2 concomitantly exhibits NK and natural cytotoxic (NC) activities. This was determined by the cells' ability to lyse both the NK-sensitive YAC-1 lymphoma and the NC-sensitive WEHI-164 fibrosarcoma cell lines in a 4- and 18-hour 51Cr release assay, respectively. Cell-free supernatant from NKB61A2 cells grown in culture for 48 h had substantial lytic activity against WEHI-164. The mouse mast cell line PT18-A17 and the rat basophilic leukemia cell line RBL-2H3, which both express NC activity, also produced a soluble factor during culture which lysed WEHI-164 cells. This activity was increased in the basophilic/mast cells by crossbridging the surface IgE receptors. Similar results were obtained by triggering the basophilic NC cells with the calcium ionophore ionomycin and the tumor promoter phorbol-12-myristate-13-acetate (PMA). Such triggering of NKB61A2 cells, however, did not significantly increase their NC activity. Interestingly, both ionomycin and PMA had an inhibitory effect on the NK activity of NKB61A2. Recently it has been found that tumor necrosis factor (TNF) is a major mediator of NC activity. To determine if the soluble factor responsible for the NC activity of the NK clone was related to TNF, a rabbit polyclonal antiserum to mouse TNF was tested against the cell-free culture medium of NKB61A2, PT18-A17, RBL-2H3 and murine recombinant TNF (Mu-rTNF). The lytic activity of the culture medium from all these cells and the Mu-rTNF control was abrogated by this antibody. These data suggest that the murine cell line NKB61A2 has both NK and NC activities and that the NC activity is due to a factor immunologically similar to TNF. In addition, the enhancement of NC activity in the NK cell line is apparently under control by a separate pathway, different from that in the basophilic cells. PMID- 2761552 TI - Mutagenesis of phi X174 am3 cs70 incorporated into the genome of mouse L-cells. AB - The objective of our work with phi X174 has been to develop a shuttle vector that can be used comparatively in bacterial cells, different types of mammalian cells, and possibly in the various tissues of transgenic mice, with a constant mechanism for detection and analysis of mutations independent of any host-cell type. Toward that end, we have efficiently rescued phi X174 am3 cs70 that is host-silent and stably integrated into the genome of mouse L-cells. The particular mouse L-cell line contains tandem arrays, single copies, and fragments of phi X that, upon restriction enzyme excision, can result in 5 potentially active copies per diploid genome. The excised phi X DNA is recovered by column chromatography, ligated, and transfected into highly competent spheroplasts. The Rescue Efficiency, defined as the number of viable phages produced out of the total number of potentially recoverable copies, is approx. 10(-3). The Recovery Ratio, defined as the Rescue Efficiency for chromosomally-integrated phage DNA divided by the Rescue Efficiency for phi X am3 cs70, is close to one. Mouse L-cells containing the integrated phi X174 am3 cs70 were treated with 20 mM ethyl methanesulfonate. The reversion frequency of am3 among progeny phages rescued from treated cells was 1.4 X 10(-5) (193 revertants in 1.4 X 10(7) phages). This is significantly higher than the 5.8 X 10(-7) reversion frequency of am3 (7 revertants in 1.2 X 10(7) phages) among progeny phages rescued from untreated cells. PMID- 2761553 TI - Changes in the size of pulse-labelled DNA fragments induced in human cells by inhibitors of uracil-DNA glycosylase and DNA methylation. AB - An inhibitor of uracil-DNA glycosylase, uracil, induces an increase in the size of pulse-labelled DNA fragments in human cells in vivo suggesting that dUMP incorporation into DNA and uracil-DNA glycosylase contribute to the small size of pulse-labelled DNA. It is also shown that inhibition of DNA methylation in vivo by ethionine and 5-azacytidine induces a decrease in the size of pulse-labelled DNA, and the effect is partially suppressed by uracil. In vitro experiments with purified uracil-DNA glycosylase from human placenta show that DNA hypermethylation inhibits the enzyme. The data make it possible to explain the antimutagenic effect of ethionine in mammalian cells [1] by stimulation of the repair of DNA containing incorporated uracil on the basis of the hypothesis that DNA-uracil repair stimulates mismatch correction leading to preferential excision of misincorporated nucleotides from daughter DNA strands. PMID- 2761554 TI - The effects of 1,6-dinitropyrene on spindle morphology in transformed human cells. AB - The effects of 1,6-dinitropyrene (1,6-DNP) on the fidelity of cell division were studied in the transformed human fibroblast cell line MRC5VA. Over a dose range of 0.1-10 micrograms/ml of 1.6-DNP, we observed significant increases in the levels of abnormal division stages, associated with damage to the spindle apparatus of the cell. Qualitative changes in spindle morphology and a quantitative decrease in pole-to-pole spindle length were also observed with increasing doses of 1.6-DNP. Such changes in the size and morphology of the spindle corresponded with an accumulation of cells blocked at metaphase. The presence of catalase did not modify the response, suggesting that the effects on the spindle apparatus and cell division were not caused by the generation of radicals but by the direct action of 1.6-DNP. PMID- 2761555 TI - Differential metabolism of sodium azide in maize callus and germinating embryos. AB - Sodium azide is a potent mutagen of maize (Zea mays L.) kernels that may have potential as a point mutagen for inducing biochemical mutations in maize tissue cultures. Azide mutagenicity was evaluated in friable, embryogenic maize callus and a nonregenerable maize suspension culture by determining the number of resistant variant cell lines able to grow on media containing inhibitory concentrations of lysine plus threonine (LT). The number of LT-resistant variants selected from either culture type did not increase in response to azide treatment. In addition, there was no increase in somatic mutations in more than 100 plants regenerated from azide treated LT-resistant lines. The levels of mutagenic metabolite of azide (presumably azidoalanine), were determined by bioassay in the two azide-treated maize callus types and compared to levels of mutagenic metabolite in embryos isolated from azide-treated kernels. The two types of maize tissue cultures and isolated embryos contained similar levels of mutagenic metabolite 4 h after azide treatment indicating similar uptake and conversion of azide to mutagenic metabolite in the three tissues. Mutagenic metabolite in azide-treated embryos did not significantly decrease after 40 h. However, mutagenic metabolite levels in both azide-treated tissue cultures decreased to near background levels within 20 h providing evidence for rapid metabolism of the azide mutagenic metabolite. The lack of evidence for azide mutagenicity in maize callus and its known potent mutagenicity in kernels appears to be associated with specific differences in azide metabolism between callus tissues and kernel embryos. PMID- 2761556 TI - Production of DNA single-strand breaks in unstimulated splenocytes by dimethylnitrosamine. AB - In an attempt to elucidate the mechanism whereby primary hepatocytes, but not liver S9 homogenates, generate immunosupprssive metabolites of dimethylnitrosamine (DMN), the production of DNA single-strand breaks (SSB) in unstimulated splenocytes was investigated with alkaline-elution analysis. Both hepatocytes and S9 homogenates induced SSB in cultured splenocytes by DMN - minimum detectable doses with the two metabolic activation systems (MAS) were 1 microM and 5 mM, respectively. DNA elution profiles were linear in splenocytes co cultured with DMN and hepatocytes and convex in splenocytes incubated with DMN and S9 homogenates. Aminoacetonitrile (AAN; 10 mM), a DMN demethylase inhibitor, reversed SSB in splenocytes when incubated with either MAS. Addition of exogenous calf-thymus DNA to the hepatocyte co-culture medium did not affect the production of SSB. Rocking the hepatocyte-splenocyte cultures changed the elution profile from linear to convex. All of these treatments have been previously shown to block the immunosuppression by DMN in the hepatocyte co-culture system. These results indicate that the immunosuppression by DMN is not related to DNA damage, as measured by the production of SSB, and suggest that the metabolism of DMN to intermediates capable of producing genotoxicity and immunotoxicity may be qualitatively and/or quantitatively different. PMID- 2761557 TI - Alkaline elution of DNA from stomach pyloric mucosa of rats treated with glyoxal. AB - DNA damage in the pyloric mucosa of the stomach of male F344 rats was determined by the alkaline elution method after administration of glyoxal, a direct-acting mutagen present in various heated foods, by gastric intubation. Glyoxal at doses of 50-550 mg/kg body weight induced DNA damage in the pyloric mucosa of rat stomach, detected by a 5- to 12-fold increase in the elution rate constant 2 h after its administration. N-Methyl-N'-nitro-N-nitrosoguanidine, a glandular stomach carcinogen, used as a positive control at doses of 1-100 mg/kg body weight induced a 11- to 24-fold increase in the elution rate constant, while 2 acetylaminofluorene, which is not a gastric carcinogen, given as a negative control at doses of 200-400 mg/kg body weight did not increase the elution rate constant. Thus glyoxal, which was previously suggested to induce unscheduled DNA synthesis in the pyloric mucosa of rat stomach, was confirmed to be genotoxic in this region. PMID- 2761558 TI - Effects of iron chelators and glutathione depletion on the induction and repair of chromosomal aberrations by tert-butyl hydroperoxide in cultured Chinese hamster cells. AB - The effects of iron chelators and glutathione (GSH) depletion on the induction of chromosomal aberrations by tert-butyl hydroperoxide (t-BuOOH) were investigated in cultured Chinese hamster V79 cells. t-BuOOH in a concentration range of 0.1 1.0 mM induced chromosomal structural aberrations, consisting mainly of chromatid gaps and breaks, in a dose-dependent fashion. The divalent iron chelator o phenanthroline almost completely suppressed the formation of chromosomal aberrations while the trivalent chelator desferrioxamine was less effective. GSH depletion did not affect the formation of chromosomal aberrations and DNA single strand breaks (ssb) by t-BuOOH. DNA ssb by 0.5 mM t-BuOOH were repaired within 60 min of treatment in both GSH-depleted (GSH-) and non-depleted (GSH+) cells. In contrast, chromosomal aberrations increased a little during the 60 min after treatment in both GSH- and GSH+ cells. The aberrations were then repaired in GSH+ cells but those in GSH- cells were maintained to a great extent during 20 h of post-treatment incubation. These results indicate that divalent iron mediates the induction of chromosomal aberrations by t-BuOOH. That t-BuOOH-induced chromosomal aberrations remain even after DNA ssb were repaired suggests involvement of other lesions than DNA ssb in the formation of chromosomal aberrations by the hydroperoxide. PMID- 2761559 TI - Cytogenetical characterization of Chinese hamster ovary X-ray-sensitive mutant cells xrs 5 and xrs 6. VII. Complementation analysis of X-irradiated wild-type CHO-K1 and xrs mutant cells using the premature chromosome condensation technique. AB - The complementation effect of wild-type CHO-K1 and xrs mutants after fusion, as judged by the frequencies of X-ray-induced G1 and G2 premature chromosome condensation (PCC), was studied. For induction of PCC, X-irradiated interphase cells (G1 and G2) were fused immediately with untreated mitotic cells of the same cell line or with mitotic cells of another line. The frequencies of breaks in G1 PCC, or breaks and chromatid exchanges in G2-PCC were determined and the latter parameter was compared with the frequency of chromosomal aberrations in mitotic cells following G2 irradiation. CHO-K1 cells were capable of complementing the X ray sensitivity of both xrs 5 and xrs 6 cells. However, full restoration of the repair defect in xrs cells could never be accomplished. The mutants failed to complement each other. In CHO-K1 cells, the incidence of chromosomal aberrations was significantly higher in G2-PCC (2.5-fold) than that observed in mitotic cells at 2.5 h after irradiation. The ratio of the induced frequency of aberrations in G2-PCC to that in mitotic cells was correlated with the degree of repair of DNA double-strand breaks (dsb) and reached almost 1 in xrs 5 cells indicating no repair. In addition the data indicated that, during the period of recovery of CHO K1 cells, X-ray-induced breaks decreased but exchanges remained at the same level. In contrast, due to a deficiency in rejoining of dsb in xrs mutants, breaks remained open for a long period of time, allowing the formation of additional chromatid exchanges during recovery time. PMID- 2761560 TI - Effect of nicotinic acid supplementation in vivo on oxygen radical-induced genetic damage in human lymphocytes. AB - The ability of nicotinic acid to protect human lymphocytes in vivo against oxygen radical-induced DNA strand breakage was tested. NAD+ concentrations rose progressively in lymphocytes to nearly 5 times baseline levels in human volunteers ingesting nicotinic acid (100 mg/day) for 8 weeks. Strand breaks decreased proportionately to NAD+ concentrations over this time period in lymphocytes exposed to oxygen radicals. After 8 weeks of supplementation with nicotinic acid, radical-treated lymphocytes incubated for 24 h evidenced significantly less DNA damage compared to controls. PMID- 2761561 TI - Acrylamide binding to the DNA and protamine of spermiogenic stages in the mouse and its relationship to genetic damage. AB - Mice received an intraperitoneal injection of 14C-labeled acrylamide (AA) at an exposure of 125 mg/kg to equal that used in genetic studies carried out by Shelby et al. (1986). Subsequently, spermatozoa were recovered from the reproductive tracts of the animals over a 3-week period and assayed for the amount of bound AA. A strong increase in the level of binding occurred in late-spermatid to early spermatozoa stages; these same stages are also genetically most sensitive to the action of AA. At all time points, alkylation of DNA within the sperm accounted for a very small fraction (generally less than 0.5%) of the total sperm-head alkylation. However, alkylation of protamine, a protein unique to sperm cells, was found to be correlated with total sperm-head alkylation and accounted for essentially all of the AA binding. Two radioactive adducts were found in hydrolysed protamine samples, one of which co-eluted with a standard of S carboxyethylcysteine. Protamine alkylation appears to be a significant cause of acrylamide-induced genetic damage in spermiogenic cells of the mouse. PMID- 2761562 TI - Carcinogenic tryptophan pyrolysis products in airborne particles and rain water. AB - This is the first report that carcinogenic tryptophan pyrolysis products are present in airborne particles and rain water. The airborne particles were collected from August 1988 through October 1988 at 4 locations in Japan. The amounts of 3-amino-1,4-dimethyl-5H-pyrido[4,3-b]indole (Trp-P-1) and 3-amino-1 methyl-5H-pyrido[4,3-b]indole (Trp-P-2) in the air were 0.23 +/- 0.17 pg/m3 air (mean +/- SD, n = 18) and 0.16 +/- 0.15 pg/m3 air (n = 18), respectively. Moreover, these carcinogens were detected in rain water. These results indicate that Trp-P-1 and Trp-P-2 are ubiquitous environmental components. PMID- 2761563 TI - Cytogenetic response of normal human and ataxia telangiectasia G2 cells exposed to X-rays and ara C. AB - The kinetics of rejoining of chromatid deletions and the formation of exchanges has been studied in X-irradiated normal and ataxia telangiectasia (AT) fibroblasts treated in the presence or absence of the nucleoside analogue 1-beta D-arabinofuranosylcytosine (ara C). Ara C is a powerful inhibitor of DNA synthesis as well as an inhibitor of DNA double-strand break repair. Treatment with ara C was found to increase the frequency of X-ray-induced chromatid deletions in both lines with increasing incubation time while deletions were found to rejoin with first-order kinetics and a t1/2 of 2.4-3.1 h in both cell lines. The increase in deletions in the presence of ara C is thought to be due to an interaction of ara C-induced lesions (as yet unidentified) with lesions induced by X-rays, leading to additional chromatid breaks. These results are in contrast to those previously obtained with the same lines treated with X-rays and 9-beta-D-arabinofuranosyladenine (ara A). In this case the frequency of deletions in X-irradiated cells remained constant in both lines in the presence of ara A. We therefore propose that there is a major difference in the mode of action of ara C and ara A on X-ray-induced DNA damage in G2 cells. Exchanges were formed in X-irradiated cells in the presence and absence of ara C in both lines and the frequency increased with post-irradiation incubation time. A higher frequency was formed in ara C-treated cells than in cells given X-rays alone, but the enhancement by ara C was less than that previously found in cells treated with ara A. PMID- 2761564 TI - Testing of genotoxic effects of 2,4-dichlorophenoxyacetic acid (2,4-D) using multiple genetic assay systems of plants. AB - The mutagenic activity of 2,4-D was assessed utilising cytogenetic, chlorophyll mutation, specific-locus and pollen viability endpoints in Allium cepa and Oryza sativa. In the Allium root-tip assay onion bulbs with roots were treated with 25, 50, 75 or 100 ppm 2,4-D for 4 h and the frequency of aberrations was estimated. With an increase in concentration there was rise in frequency of aberrant cells. In the case of mutation assays, presoaked rice seeds were treated with 100, 200 or 300 ppm 2,4-D for 4 h and sown in the field. Mutation frequency was estimated on M1 plant, spike and M2 seedling basis. With increasing concentration, there was a concomitant increase in mutation frequency. Highly significant chlorophyll deficient and waxy mutants besides sterile pollen were observed as compared to both positive (EMS) and negative controls (H2O). The study demonstrates that 2,4 D has genotoxic potential. PMID- 2761565 TI - The Chinese hamster aprt gene as a mutational target. Its sequence and an analysis of direct and inverted repeats. PMID- 2761566 TI - Preliminary molecular analysis of the TK locus in L5178Y large- and small-colony mouse lymphoma cell mutants. AB - Mouse lymphoma cells of the L5178Y TK+/- -3.7.2C line were exposed to sidestream and mainstream cigarette smoke condensates (CSC). Cells which survived the trifluorothymidine (TFT) challenge fell in 2 classes: large- and small-colony formers. Southern blot analysis of NcoI-digested DNA from mutant colonies yielded 2 distinct restriction fragment banding patterns when probed with the thymidine kinase (TK) cDNA clone pMtk4. One such pattern was composed of 4 bands at 6.4, 5.5, 4.7 and 2.9 kilobase pairs (kb) and was identical to that of TK+/- controls. A second pattern differed from the first only in the absence of the 6.4-kb band. The majority (83/95) of both large and small colonies derived from cells exposed to CSC exhibited restriction fragment banding patterns lacking the 6.4-kb band. The data from the present study suggest that there is no association between mutant colony size and the presence of the 6.4-kb NcoI restriction fragment at the TK locus in the mouse lymphoma mutants analyzed. PMID- 2761568 TI - Mycotic keratitis caused by Phaeotrichoconis crotalariae. New report. AB - A case of mycotic keratitis caused by Phaeotrichoconis crotalariae (IMI 275955) is described for the first time. Experimental corneal lesions in albino rabbits and the histopathology are also presented. PMID- 2761567 TI - Interference of Bis-Tris buffer with the diaminobenzoic acid fluorescence assay used to quantify DNA. PMID- 2761569 TI - [The significance of central venous catheters in the genesis of Candida endomycoses]. AB - A high concentration of yeasts in feces creates the possibility of active penetration of yeast cells into the surrounding tissue and thereby into blood vessels. Fungaemia is probably caused by this process more often than generally suspected. It is our opinion that venous catheters are contaminated very rarely by yeasts residing on the skin and it is more likely that fungaemia is the causative mechanisms. Adhesion of Candida albicans cells to the catheter wall could not be demonstrated in these investigations. The catheter material examined had no fungistatic properties. To prevent catheters becoming a secondary source of infection it would be advisable for manufacturers to add fungistatic substances to the plastic material of venous catheters. PMID- 2761570 TI - The influence of temperature and serum deprivation on the synthesis of heat-shock proteins and alpha and beta tubulin in promastigotes of Leishmania major. AB - We have examined changes in the relative synthesis of individual proteins in promastigotes of Leishmania major subjected to decreasing serum levels in vitro. We observed increases in the relative synthesis of the putative heat-shock proteins of 82 and 70 kDa and of proteins of 79 and 41 kDa but decreases in the synthesis of proteins of 38 and 28 kDa. The relative synthesis of alpha-tubulin increased, whereas that of beta-tubulin decreased, in promastigotes subjected to decreased serum concentrations. This uncoordinated regulation of the synthesis of the tubulin proteins was not reflected as an alteration in the relative levels of the messenger RNA of the respective proteins. We have also studied changes in the synthesis of proteins in L. major promastigotes subjected to a temperature change from 26 degrees C to 34 degrees C. The results indicate that the synthesis of putative heat-shock proteins of 82, 70, 65, 41, 23 and 22 kDa increased when the parasites were incubated at the higher temperature, although these proteins were synthesised in detectable amounts at 26 degrees C. We could not detect differences between infective and non-infective promastigotes, separated by binding to peanut agglutinin, in the synthesis of individual proteins in response to increased temperature. These results were confirmed by densitometer analysis of autoradiographs of labelled promastigote proteins, and the relative changes in the synthesis of the two major heat-shock proteins, as well as alpha- and beta tubulin, were estimated. PMID- 2761571 TI - A novel telomeric gene conversion in Trypanosoma brucei. AB - Gene conversion is one mechanism of antigenic variation in Trypanosoma brucei. Variant surface glycoprotein (VSG) genes are duplicated by this process to telomeric locations from which they may be expressed. We examined four independent antigenic switches in which the IsTaR 1.1 minichromosomal VSG gene is duplicated to a large chromosome where it is expressed. An unusual feature of three of these telomeric gene conversions is that the distance between the VSG gene and the end of the chromosome is identical for both the basic and duplicated copies following the antigenic switch. This suggests that the gene conversion is initiated 5' to the VSG gene and extends to the end of the telomere. The data also suggest that events other than simple nucleotide addition account for telomeric growth. PMID- 2761572 TI - Binding of chloroquine to DNA. AB - Three diverse mechanisms have been proposed to explain the antimalarial activity of chloroquine: binding to DNA, binding to hemin, or alkalinizing parasite lysosomes. In order to assess the importance of DNA binding, we have measured the affinity of DNA for chloroquine by equilibrium dialysis using tritiated chloroquine. The dissociation constant of the DNA-chloroquine complex varied from 27 microM to 2.6 mM, depending on the ionic strength of the buffer. Our results suggest that chloroquine binding to DNA is highly dependent on salt concentration. Nevertheless, because of the large number of sites present, binding to parasite DNA may still account for the antimalarial activity of chloroquine. PMID- 2761573 TI - Effects of thiastearic acids on growth and on dihydrosterculic acid and other phospholipid fatty acyl groups of Leishmania promastigotes. AB - Thiastearic acid positional isomers (8, 9, 10, 11) were examined for their ability to inhibit population growth and the biosynthesis of a phosphatidylethanolamine cyclopropane fatty acyl group, cis-9,10 methyleneoctadecanoic acid (dihydrosterculic acid), by promastigotes of Leishmania species. Thiastearic acids are candidate chemotherapeutic agents, since cyclopropane fatty acids are not formed by vertebrate cells. 8- and 10 thiastearic acids strongly inhibited the growth of strains containing the most dihydrosterculic acid (Leishmania tropica and Leishmania donovani; 25-35% phosphatidylethanolamine fatty acyl groups) and less strongly inhibited strains containing no dihydrosterculic acid (Leishmania major). The 11-thiastearic acid was less effective and 9-thiastearic acid ineffective. Strains containing 1-15% dihydrosterculic acid (L. donovani, Leishmania braziliensis, Leishmania aethiopica and Leishmania mexicana mexicana) were with few exceptions not inhibited by any of the isomers. All the thiastearic acid isomers caused a dose dependent loss of dihydrosterculic acid. This was accompanied by a loss of phosphatidylethanolamine in the case of dihydrosterculic acid-rich leishmanial strains exposed to the 8- and 10-isomers. The 8- and 10-thiastearic acids also caused a loss of C18 unsaturated fatty acyl groups and increases in palmitic and stearic acids in the phosphatidylethanolamine and phosphatidylcholine of the dihydrosterculic acid-rich and dihydrosterculic acid-free leishmanial strains. 11 Thiastearic acid was much less effective and 9-thiastearic acid ineffective. These changes were not evident in those strins which contained 1-15% dihydrosterculic acid and whose growth was not inhibited by the thiastearic acid isomers. It is concluded that thiastearic acid isomers may inhibit both dihydrosterculic acid biosynthesis and fatty acid desaturation, with the 9-isomer having the highest specificity for dihydrosterculic acid biosynthesis. Population growth of promastigotes of Leishmania species in culture is not dependent upon dihydrosterculic acid biosynthesis but is dependent upon fatty acid desaturation. PMID- 2761574 TI - Characterization of the ribosomal DNA from Trichinella spiralis. AB - Ribosomal DNA (rDNA) from three isolates of Trichinella was cloned into phage and sublcloned into the plasmid pBR322. The basic repeat unit of rDNA was variable in size, with the mapped clones ranging from 10-12 kb. There were differences in restriction sites within the genic region among the three isolates which were due to variations in the internal transcribed region (ITS) and the intergenic spacer (IGS). Three RsaI sites were mapped to the IGS repeat unit of the isolate AF1, and one RsaI site was mapped to the IGS repeat unit of Trichinella spiralis pseudospiralis (isolate Tp). The number of repetitive units in the IGS region varied markedly within and between the isolates. It was estimated that the basic repeat unit for the rDNA of isolate P1 was 10.6-28 kb, for AF1 10.7-37 kb, and for Tp it was 11-14.9 kb. There appeared to be a greater frequency of some sizes of the basic repeat unit in each of the populations, based on the relative intensity with which certain bands hybridize to the probe. PMID- 2761575 TI - Isolation and characterization of a cysteine proteinase from Fasciola hepatica adult worms. AB - Adult Fasciola hepatica worms contain multiple proteinases capable of degrading hemoglobin, immunoglobulins and collagen. Here we report the isolation and biochemical characterization of a cysteine proteinase from acidic extracts of these worms. The enzyme was purified to homogeneity by cation exchange and molecular sieve high-performance liquid chromatography. It eluted at a native molecular weight of approximately 14,500 and migrated as a single band at approximately 14,500 Da upon sodium dodecyl sulfate-polyacrylamide gel electrophoresis. Activity was assessed by employing synthetic peptide substrates, such as carbobenzoxy-phenylalanyl-arginyl-7-amino-4-trifluoro-methylcoumarin, commonly used to assay other cysteine proteinases. The proteinase was maximally active at pH 6.0, with 50% or more of the activity detected between pH 4.5 and 7.5. Inhibition of activity at pH 5.5 was seen only with compounds known to inhibit cysteine proteinases. No effect was seen with inhibitors of aspartic, serine, or metalloproteinases. The purified enzyme was stable at acidic pH at 4 degrees C, 25 degrees C, -20 degrees C, and in 1 M urea. PMID- 2761576 TI - Maternal alcohol use during breast-feeding and infant mental and motor development at one year. AB - The detrimental effects of maternal drinking during pregnancy on fetal health have been documented. The consequences for infants of maternal drinking during breast-feeding are unknown, but research in animals suggests that the infant could be affected by exposure to alcohol through the mother's milk. In a study of 400 infants born to members of a health maintenance organization, we investigated the relation of the mother's use of alcohol during breast-feeding to the infant's development at one year of age. Mental development, as measured by the Bayley Mental Development Index (MDI), was unrelated to maternal drinking during breast feeding. However, motor development, as measured by the Psychomotor Development Index (PDI), was significantly lower in infants exposed regularly to alcohol in breast milk (after alcohol exposure during gestation was controlled for), with a dose-response relation (P for linear trend, 0.006). The infants of breast-feeding mothers who had at least one drink daily had a mean PDI score of 98, whereas the infants exposed to less alcohol in breast milk had a mean PDI score of 103 (95 percent confidence interval for the difference of the two means, 1.2 to 9.8). The effect was more pronounced when mothers who supplemented breast-feeding with formula were excluded from the analysis. The association persisted even after we controlled for more than 100 potentially confounding variables, including smoking and other drug use during pregnancy and in the postpartum period. We conclude that ethanol ingested through breast milk has a slight but significant detrimental effect on motor development, but not mental development, in breast fed infants. PMID- 2761577 TI - The absence of a relation between the periconceptional use of vitamins and neural tube defects. National Institute of Child Health and Human Development Neural Tube Defects Study Group. AB - Whether taking multivitamins or folate around the time of conception can reduce a woman's risk of having a child with a neural-tube defect is controversial. To investigate this question, we examined the periconceptional use of vitamin supplements by women who had a conceptus with a neural-tube defect (n = 571), women who had had a stillbirth or a conceptus with another malformation (n = 546), and women who had had a normal conceptus (n = 573). Women with conceptuses with neural-tube defects were identified either prenatally or postnatally and were matched to control mothers for gestational age. To minimize recall bias, we interviewed nearly all the women within five months of the diagnosis of a birth defect or the birth of the infant (mean, 84 days); information on vitamin use was obtained by an interviewer who was unaware of the outcome of pregnancy. The rate of periconceptional multivitamin use among the mothers of infants with neural tube defects (15.8 percent) was not significantly different from the rate among mothers in either the abnormal or the normal control group (14.1 percent and 15.9 percent, respectively). After adjustment for potential confounding factors, the odds ratio for having an infant with a neural-tube defect among women classified as having had full supplementation with multivitamins was 0.95 as compared with the mothers of the abnormal infants (95 percent confidence interval, 0.78 to 1.14) and 1.00 as compared with the mothers of normal infants (95 percent confidence interval, 0.83 to 1.20). There were no differences among the groups in the use of folate supplements. The adjusted odds ratio for having an infant with a neural-tube defect among those receiving the recommended daily allowance of folate was 0.97 as compared with the mothers of abnormal infants (95 percent confidence interval, 0.79 to 1.18) and 0.98 as compared with the mothers of normal infants (95 percent confidence interval, 0.80 to 1.20). We conclude that the periconceptional use of multivitamins or folate-containing supplements by American women does not decrease the risk of having an infant with a neural-tube defect. PMID- 2761578 TI - Effect of a diet enriched with monounsaturated or polyunsaturated fatty acids on levels of low-density and high-density lipoprotein cholesterol in healthy women and men. AB - Polyunsaturated fatty acids are thought to lower the serum cholesterol level more effectively than monounsaturated fatty acids. It is unclear whether the difference--if any--is due to a lowering of the level of high-density lipoprotein (HDL) or low-density lipoprotein (LDL) cholesterol. We therefore placed 31 women and 27 men on a mixed natural diet rich in saturated fat (19.3 percent of their daily energy intake from saturated fat, 11.5 percent from monounsaturated fat, and 4.6 percent from polyunsaturated fat) for 17 days. For the next 36 days, they received a mixed diet with the same total fat content, but enriched with olive oil and sunflower oil ("monounsaturated-fat diet": 12.9 percent saturated fat, 15.1 percent monounsaturated fat, and 7.9 percent polyunsaturated fat) or with sunflower oil alone ("polyunsaturated-fat diet": 12.6 percent saturated fat, 10.8 percent monounsaturated fat, and 12.7 percent polyunsaturated fat). The serum LDL cholesterol level decreased by 17.9 percent in those on the monounsaturated-fat diet and by 12.9 percent in those on the polyunsaturated-fat diet (95 percent confidence interval for the difference between the effects of the two unsaturated fat diets, -9.9 percent to 0.0 percent). In men, the HDL cholesterol level fell slightly but not significantly with both diets. In women, the HDL cholesterol level did not change with either. We conclude that a mixed diet rich in monounsaturated fat was as effective as a diet rich in (n-6)polyunsaturated fat in lowering LDL cholesterol. Both diets lowered the level of HDL cholesterol slightly in men but not in women. PMID- 2761579 TI - Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 33-1989. A 26-year-old woman with fever, diarrhea, leukopenia, thrombocytopenia, and hypoxemia. PMID- 2761580 TI - Negative studies. PMID- 2761581 TI - Adjuvant therapy for node-negative breast cancer. PMID- 2761583 TI - Digoxin in chronic heart failure. PMID- 2761582 TI - Treatment of painful diabetic neuropathy with topical capsaicin. PMID- 2761584 TI - More on ingestion of a toothpick. PMID- 2761585 TI - A study of medical injury and medical malpractice. PMID- 2761586 TI - A double-blind comparison of clomipramine and desipramine in the treatment of trichotillomania (hair pulling) AB - Trichotillomania, an irresistible impulse to pull out one's own hair, is a chronic psychiatric illness that causes severe discomfort, interferes with daily activities, and leads to social isolation. Treatment is usually unsatisfactory. Thirteen women with severe trichotillomania completed a 10-week double-blind, crossover trial of clomipramine, a new tricyclic antidepressant agent with selective antiobsessional effects, and desipramine, a standard tricyclic antidepressant. Treatment with clomipramine resulted in significantly greater improvement in symptoms than desipramine, as indicated by physicians' ratings of the women's clinical progress on a scale in which lower scores indicate improvement (mean [+/- SD] scores: at base line, 10.0; after desipramine treatment, 8.7 +/- 2.4; after clomipramine treatment, 4.7 +/- 3.1; P = 0.006) and by scores on a trichotillomania-impairment scale, in which higher scores indicate greater impairment (at base line, 6.8 +/- 1.7; after desipramine treatment, 6.2 +/- 1.7; after clomipramine treatment, 4.2 +/- 2.7; P = 0.03). The severity of symptoms (mean base-line score, 15.9 +/- 3.8) was reduced more by clomipramine (10.6 +/- 6.4) than by desipramine (14.4 +/- 3.9). The patients reported that the compulsion decreased in intensity and that they were more able to resist the urge to pull out their hair during treatment with clomipramine. We conclude that clomipramine appears to be effective in the short-term treatment of trichotillomania. PMID- 2761587 TI - A randomized trial comparing ticlopidine hydrochloride with aspirin for the prevention of stroke in high-risk patients. Ticlopidine Aspirin Stroke Study Group. AB - We report the results of the Ticlopidine Aspirin Stroke Study, a blinded trial at 56 North American centers that compared the effects of ticlopidine hydrochloride (500 mg daily) with those of aspirin (1300 mg daily) on the risk of stroke or death. The medications were randomly assigned to 3069 patients with recent transient or mild persistent focal cerebral or retinal ischemia. Follow-up lasted for two to six years. The three-year event rate for nonfatal stroke or death from any cause was 17 percent for ticlopidine and 19 percent for aspirin--a 12 percent risk reduction (95 percent confidence interval, -2 to 26 percent) with ticlopidine (P = 0.048 for cumulative Kaplan-Meier estimates). The rates of fatal and nonfatal stroke at three years were 10 percent for ticlopidine and 13 percent for aspirin--a 21 percent risk reduction (95 percent confidence interval, 4 to 38 percent) with ticlopidine (P = 0.024 for cumulative Kaplan-Meier estimates). Ticlopidine was more effective than aspirin in both sexes. The adverse effects of aspirin included diarrhea (10 percent), rash (5.5 percent), peptic ulceration (3 percent), gastritis (2 percent), and gastrointestinal bleeding (1 percent). With ticlopidine, diarrhea (20 percent), skin rash (14 percent), and severe but reversible neutropenia (less than 1 percent) were noted. The mean increase in total cholesterol level was 9 percent with ticlopidine and 2 percent with aspirin (P less than 0.01). The ratios of high-density lipoprotein and low-density lipoprotein to total cholesterol were similar in both treatment groups. We conclude that ticlopidine was somewhat more effective than aspirin in preventing strokes in this population, although the risks of side effects were greater. PMID- 2761588 TI - Adverse outcomes and lack of health insurance among newborns in an eight-county area of California, 1982 to 1986. AB - In this study of hospital discharge data on births to residents of an eight county region of California, we found an increasing lack of health insurance that was associated with an elevated and increasing risk of adverse outcomes in newborns. Between 1982 and 1986, the percentage of newborns without health insurance increased overall by 45 percent (from 5.5 to 8.0 percent; P less than 0.001); the increases were larger among Asians (by 54 percent [from 7.8 to 12.0 percent]; P less than 0.001) and Latinos (by 140 percent [from 8.2 to 19.7 percent]; P less than 0.001). By 1986, the odds ratio for an adverse hospital outcome (defined as a prolonged hospital stay, transfer of the newborn to another institution, or death) was 1.31 (95 percent confidence interval, 1.17 to 1.46) in uninsured as compared with privately insured newborns, with control for race or ethnic group. There was a significant increase in risk over time (P less than 0.03); the comparable odds ratios in 1982 and 1984 were 1.11 (95 percent confidence interval, 0.93 to 1.33) and 1.19 (1.05 to 1.35), respectively. In 1986 the risks were especially elevated for uninsured as compared with privately insured blacks and Latinos (odds ratios, 2.24 [95 percent confidence interval, 1.60 to 3.13] and 1.56 [1.26 to 1.94], respectively); the increases in risk over time were the most marked in these groups. We believe that the elevated and increasing risks for uninsured newborns are explained at least in part by inadequate and diminishing access to care and that this burden is borne disproportionately by blacks and Latinos. PMID- 2761589 TI - Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 34-1989. A 74-year-old woman with vertigo and an adnexal mass. PMID- 2761590 TI - Syndrome of inappropriate antidiuresis. PMID- 2761591 TI - Obsessive-compulsive and related disorders: a hidden epidemic. PMID- 2761592 TI - Who pays? PMID- 2761593 TI - HIV infection and tuberculosis in Central Africa. PMID- 2761594 TI - Bladder cancer after chemotherapy for non-Hodgkin's lymphoma. PMID- 2761595 TI - Guillain-Barre syndrome presenting as high-altitude cerebral edema. PMID- 2761597 TI - Chorionic villus sampling. PMID- 2761596 TI - Treatment of twisted ischemic adnexa by simple detorsion. PMID- 2761598 TI - Unmasking the lone ranger. PMID- 2761599 TI - Incidence, neutrophil kinetics, and natural history of neonatal neutropenia associated with maternal hypertension. AB - Neutropenia occurs often among the newborns of women with hypertension, but its cause, mechanism, and clinical consequences have not been adequately studied. Of 72 infants whose mothers had hypertension during pregnancy, 35 (49 percent) had neutropenia, which persisted from 1 hour to 30 days. The disorder was more prevalent among newborns whose growth had been retarded in utero (P less than 0.01), those who had been delivered prematurely (P less than 0.001), and those whose mothers had had severe hypertension (P less than 0.002) or hypertension and the HELLP syndrome (hemolysis, elevated liver enzymes, and low platelets) (P less than 0.01). Kinetic investigations of circulating, marginated, storage, and proliferative neutrophils and their progenitors suggested that the neutropenia was the result of diminished neutrophil production. Noscomial infections occurred during the first 2 1/2 weeks of life in eight (23 percent) of the newborns with neutropenia, but in only one (3 percent) of those without this disorder (P less than 0.01). We conclude that the neonatal neutropenia associated with maternal hypertension is due to transiently reduced neutrophil production and is associated with an increased risk of noscomial infection. Its basic cause remains unknown. PMID- 2761600 TI - Weight, diet, and the risk of symptomatic gallstones in middle-aged women. AB - To assess the risk factors for symptomatic gallstones, 88,837 women in the Nurses' Health Study cohort (age range, 34 to 59 years) were followed for four years after completing a detailed questionnaire about food and alcohol intake in 1980. A total of 433 cholecystectomies and 179 cases of newly symptomatic, unremoved gallstones, diagnosed by ultrasonographic examination or x-ray films, were reported during the four-year follow-up. The age-adjusted relative risk for very obese women, who had a Quetelet index of relative weight (weight in kilograms divided by the square of the height in meters) of more than 32 kg per square meter, was 6.0 (95 percent confidence interval, 4.0 to 9.0), as compared with women whose relative weight was less than 20 kg per square meter. For slightly overweight women (relative weight, 24 to 24.9 kg per square meter), the relative risk was 1.7 (95 percent confidence interval, 1.1 to 2.7). Overall, we observed a roughly linear relation between relative weight and the risk of gallstones. Among the 59,306 women whose relative weight was less than 25 kg per square meter, a high energy intake (greater than 8200 J per day), as compared with a low energy intake (less than 4730 J per day), was associated with an increased incidence of symptomatic gallstones (relative risk, 2.1; 95 percent confidence interval, 1.4 to 3.3), and an alcohol intake of at least 5 g per day was associated with a decreased incidence as compared with abstention (relative risk, 0.6; 95 percent confidence interval, 0.4 to 0.8). Parity did not appear to be an important risk factor after an adjustment was made for relative weight. These data support a strong association between obesity and symptomatic gallstones and suggest that even moderate overweight may increase the risk. PMID- 2761601 TI - Acute eosinophilic pneumonia as a reversible cause of noninfectious respiratory failure. AB - Although chronic eosinophilic pneumonia is a well-known disorder, acute eosinophilic pneumonia has not been as well characterized. We describe the clinical features, results of bronchoalveolar lavage, and follow-up studies of four patients with acute eosinophilic pneumonia. The patients presented with an acute febrile illness, severe hypoxemia (partial pressure of arterial oxygen less than 60 mm Hg), diffuse pulmonary infiltrates, an increased number of eosinophils (mean +/- SEM, 42 +/- 4.8 percent) in bronchoalveolar-lavage fluid, and an absence of infection and previous atopic illness. The illness resolved rapidly after treatment with erythromycin and corticosteroids. The patients received doses of oral prednisone that were tapered over 10 days to 12 weeks, and none have relapsed since the steroids were discontinued. After a minimum follow-up period of five months, clinical evaluation, chest radiography, and pulmonary function tests have shown no residual abnormalities attributable to the acute eosinophilic pneumonia. Follow-up bronchoalveolar lavage has demonstrated less than or equal to 1 percent eosinophils in all patients. We believe that we are describing an acute form of eosinophilic lung disease distinct from previously described syndromes. It can be diagnosed by bronchoalveolar lavage and seems to respond to treatment with corticosteroids. PMID- 2761602 TI - A preliminary trial of the programmable implantable medication system for insulin delivery. AB - We undertook a trial to determine whether an implanted insulin-delivery system, the programmable implantable medication system (PIMS), could be used to treat patients with insulin-dependent diabetes. PIMS is a pulsatile, programmable pump with a battery life expectancy of five years. The reservoir is refilled transcutaneously every two months with a surfactant-stabilized human insulin preparation containing 400 U of insulin per milliliter. Eighteen patients received PIMS-delivered insulin for 4 to 25 months (mean, 18). The total PIMS implantation experience comprised 28 patient-years. Good glycemic control was established and sustained during treatment (mean plasma glucose level, 7.3 mmol per liter; mean glycohemoglobin level, 8 percent [upper limit of normal, 7.5 percent]), with significantly reduced glycemic fluctuations. The total mean daily insulin dose did not change. Insulin solutions withdrawn from the pump reservoirs contained 92 percent native insulin and preserved biologic activity. There were no surgical or skin complications, severe hypoglycemic episodes, or instances of diabetic ketoacidosis. One pump was replaced because of a manufacturing defect, and four patients had catheter blockages due to omental-tissue encapsulation; two withdrew from the study and two had devices that were repaired successfully. The actuarial rate of survival of catheter function was 78 percent at 1.5 years. We conclude from this pilot study that insulin treatment with an implanted, variable rate, programmable pump is feasible for periods up to two years. PMID- 2761603 TI - Prevention of preeclampsia--a reality? PMID- 2761604 TI - More on zidovudine and HIV-related thrombocytopenia. PMID- 2761605 TI - Declining prevalence of HIV-seropositive blood donors. PMID- 2761606 TI - A proposal to increase donations of cadaveric organs. PMID- 2761607 TI - Production of patulin by Micromycetes. AB - In the context of the screening for antifungal and antibacterial molecules among the Micromycetes, we investigated the ability of 850 strains grown in liquid medium to produce patulin. The compound was produced by 58 fungi, most of which had not been mentioned in the literature, especially Mucorales and Fungi Imperfecti. Biological tests showed that dermatophytes are the most sensitive to this molecule. It also appears that the origin of the producing strains influences their toxin producing activity. PMID- 2761608 TI - Effects of cyclopiazonic acid and aflatoxin singly and in combination on selected clinical, pathological and immunological responses of guinea pigs. AB - Cyclopiazonic acid (CPA) and aflatoxin are known sometimes to coexist in nature but little is known of possible biological interaction in mammals that consume mixtures of these two mycotoxins. Guinea pigs were dosed orally with CPA (2.2 mg/kg) or aflatoxin (0.045 mg B1/kg) singly or in combination. Effects of toxin consumption were determined on clinical health, body weight gain, pathological change, and several immunologically related parameters including delayed cutaneous hypersensitivity, antibody response, complement hemolytic titer, intracutaneous mitogen (PHA) and in vitro lymphocyte blastogenesis. In contrast to an earlier study by others, significant synergy between these two toxins was demonstrated in reduced rate of body weight gain, lethality and histologic changes (vacuolization) in hepatocytes. Reductions in complement titer, intradermal PHA, delayed cutaneous hypersensitivity response and in vitro lymphocyte blastogenesis were related to aflatin activity. No effects on antibody formation to Brucella abortus were observed with either toxin or the combination of toxins. Cyclopiazonic acid appeared to restore the suppressive effects of aflatoxin in delayed cutaneous hypersensitivity response and in vitro lymphocyte blastogenesis. PMID- 2761609 TI - Cladosporiosis (cerebral phaeohyphomycosis) of brain--a case report. AB - A case of cerebral cladosporiosis caused by Cladosporium trichoides (bantianum) now known as Xylohypha bantiana is described and illustrated. Predisposing debilitating diseases were not detectable. The Cladosporiosis diagnosis was based on visualisation of hyphal element in direct Gram's stain, direct KOH preparate of pus from brain abscess and on repeated successful cultivation of Cladosporium trichoides from specimen and by histopathology. Following surgery and anti-fungal chemotherapy the patient was cured. PMID- 2761610 TI - Phoma sorghina infection in human being. AB - Phoma sorghina is reported for the first time as an opportunistic fungal pathogen. It was repeatedly isolated from patient as well as experimental animal. The identity and taxonomy of the fungus has been discussed. PMID- 2761611 TI - Invasion of a soft contact lens by Exophiala jeanselmei. AB - The invasion of a soft contact lens by Exophiala jeanselmei is documented. All species in this genus are pathogenic. In humans E. jeanselmei is a recognized cause of mycetoma, phaeohyphomycosis and keratomycosis. This fungus has not been previously listed among lens invaders. PMID- 2761612 TI - Pityriasis versicolor in the aged: a clinical investigation and epidemiological survey in 190 elderly hospitalized patients. AB - 190 subjects over 60 yrs of age, hospitalized for long stays were checked for scaling and hyperpigmented patches of P. versicolor. 20 patients (10.5%) showed no clinical lesions; 170 patients (89.5%) showed scaling and/or hyperpigmented patches of which 13 patients (6.8%) on direct microscopic exam showed hyphae and yeasts of M. furfur, 64 (33.6%) only globular forms of P. orbiculare and 113 cases (59.4%) showed no fungal elements. Wood's light examination showed that 38 subjects (20%) were 6 positive for M. furfur and 23 for P. orbiculare while in the other 9 no fungal elements were observed on microscopic exam. Whereas 48/132 patients negative to Wood's light were positive for yeasts on microscopic exam (false negative). This study indicates that P. versicolor is not rare in the elderly and that Wood's light examination is not diagnostic. There was no relationship between P. versicolor and underlying illness. PMID- 2761613 TI - [Development of self-awareness of active and experienced nurses--overcoming dilemmas in establishing professional confidence]. PMID- 2761615 TI - [Encouraging the professional development of active and experienced nurses--more opportunities and challenges]. PMID- 2761614 TI - [Nursing as a self-chosen lifework--a letter to a nurse becoming 30]. PMID- 2761616 TI - [New awareness among nurses in their 30's--nursing actions by small group activities]. PMID- 2761617 TI - [Reflection on my 30's: continuous efforts for improvement]. PMID- 2761619 TI - [A nurse in her 30's: when the self image and an image of a nurse become one]. PMID- 2761618 TI - [Reflection on my 30's: to be out of self-negating confusion]. PMID- 2761620 TI - [A nurse in her 30's: a time for a change in the attitude to life]. PMID- 2761621 TI - [A nurse in her 30's: getting away from conventions without inconveniencing others]. PMID- 2761622 TI - [A nurse in her 30's: the basis of nursing learned through my own experiences]. PMID- 2761623 TI - [Educational needs of nurses in their 30's: results of surveys]. PMID- 2761625 TI - [A report from Tsurui Yojomura, a farm community for psychiatric rehabilitation]. PMID- 2761624 TI - [Three steps forward and two and a half steps backward--an experience of activities of a study group at a ward for mentally retarded in the past 7 years]. PMID- 2761627 TI - [Modern women in their 30's]. PMID- 2761626 TI - [An experience of a nurse who suffered serious injuries in a traffic accident during her study in the United States]. PMID- 2761628 TI - [More light in the toilet facilities: improvement needed in the public toilet facilities]. PMID- 2761629 TI - Role of strategic management in the design of a hospital information systems. PMID- 2761630 TI - Gastro-enteritis in the neonatal intensive care unit. PMID- 2761631 TI - Confusion in the elderly. PMID- 2761632 TI - The many manifestations and implications of HSV I and HSV II infections. 2. Herpes labialis. PMID- 2761633 TI - Managing hypertensives. AB - Managing the ambulatory client with hypertension is not easy. Legislation impacting on the individual nurse's practice, and the legal implications of the nursing management of the hypertensive client, translate into dependent functions which affect the day to day care given by the nurse. PMID- 2761634 TI - Computed tomography of an Australopithecus skull (Mrs Ples): a new technique. PMID- 2761636 TI - Extending our view of the nurse extender. PMID- 2761635 TI - Fibroblast function in paracrine interactions between breast cancer tissue and its stromal elements. PMID- 2761637 TI - Values and ethics in the care of patients with cancer--Part I. PMID- 2761638 TI - Role issues, job satisfaction and unit of assignment. AB - A prospective, descriptive study of role conflict and role ambiguity and its relationship to job satisfaction among a stratified, random sample of 100 registered nurses in an acute care setting is reported. Job satisfaction was measured using the Job-in-General scale developed by Smith and Ironson. Role conflict and role ambiguity were measured using the Nursing Index of Role Conflict and Role Ambiguity developed for use in this study. Both role conflict and role ambiguity were inversely related to job satisfaction, providing Pearson Project Moment correlations of -.48 (P less than .001) and -.38 (P less than .001), respectively. Additionally, perceptions of role conflict and role ambiguity were found to be greater among intensive care unit nurses. Management implications of these findings are discussed. PMID- 2761639 TI - Nursing and the 100th Congress--finishing up and looking ahead. PMID- 2761640 TI - Collaboration by consortium. AB - Recognizing that collaboration is essential for the continuing development of the nursing profession, nursing leaders in the St. Louis area organized the Nursing Consortium for Research in Practice, uniting four university schools of nursing and four large hospitals. The aim of consortium is to assist nursing faculty and nursing service personnel in the conduct of collaborative clinical research. The consortium also seeks to educate nurses about research as a component of professional nursing practice and to assist them in implementing research findings in clinical practice. The efforts of the consortium during its first four years are discussed. PMID- 2761641 TI - AACN: the critical care nurses. PMID- 2761642 TI - Winning funds for nursing research. AB - Although nurses are expected to conduct research that frequently requires substantial financial support, there is little assistance available to help them succeed in the activity. This article describes some approaches that should facilitate the process of securing funds for nursing research. PMID- 2761643 TI - Facilitating research utilization: a model for nurse managers. AB - Nursing research utilization has been studied and models have been developed by many nursing groups. However, the important role of the nurse administrator or manager in promoting utilization of research has been neglected. This pilot study used a nursing diagnosis--alterations in comfort (pain)--to identify common and expected variables in selected studies. Findings from this research together with the literature on research utilization models provided the foundation for the development of a preliminary model for nurse managers. The authors discuss this process and make recommendations for implementation. PMID- 2761644 TI - Self-care in COPD: an assessment project by practice and education. AB - This was a collaborative project between education and service that focused on teaching patients with COPD and resulted in the development and testing of an evaluation and teaching tool. The process is described and analyzed using an adaptation of Lancaster's framework for successful collaboration. PMID- 2761645 TI - HIV and AIDS: nursing concerns. PMID- 2761646 TI - An interview with Dennis O'Leary: responding to harsh criticism of the JCAHO. Interview by Helen Ripple. PMID- 2761647 TI - Innovations in management. The Tampa General Hospital: a case study in O.R. automation. PMID- 2761648 TI - RCTs: not the answer to the nursing shortage. AB - An economic analysis was made of the proposal to create registered care technologists (RCTs) as an alternative to nurse market disequilibrium. RCTs may be a short-term solution to some, but more effective options may make use of existing resources. PMID- 2761649 TI - Validation of a taxonomy of ambulatory nursing practice. AB - Ambulatory care is a complex and challenging nursing specialty. This survey of 33 ambulatory nursing administrators addressed the roles and responsibilities of nurses in ambulatory care settings. PMID- 2761650 TI - The final frontier: nursing in the emerging health-care environment. AB - The final frontier heralds a new era in which nursing finally assumes its rightful place as the leader in the health-care delivery industry through a systematized body of knowledge, new nursing technologies, and the final assumption of power through modern management techniques. Nursing is the agent of change for moving health care from a cottage industry to a full-fledged business enterprise--a business with compassion, empathy, and quality. PMID- 2761651 TI - The physician as customer: a challenge for the nurse manager. PMID- 2761652 TI - Copper and common urinary tract organisms. PMID- 2761653 TI - Lyofoam in the treatment of open wounds. PMID- 2761654 TI - Certificate of Need and aviation. PMID- 2761655 TI - Tribute to the doctor's wife and the doctor. It takes a lot of prayers. PMID- 2761656 TI - Actinic keratoses. PMID- 2761657 TI - Survey of preclinical medical students: declining interest in becoming a physician. PMID- 2761658 TI - Generic substitution. PMID- 2761659 TI - The deviated trachea. PMID- 2761660 TI - [Clinical and therapeutic aspects of essential blepharospasm]. AB - The rare disease of blepharospasm which is nowadays believed to be an extrapyramidal dystonic movement disorder is discussed in clinical, differential diagnostic and therapeutic viewpoints. The abundant number of treatment methods proposed in the literature are critically reviewed. 13 cases are described, which were treated by our own surgical procedure - a modified neurotomy of branches of the parotid plexus. The importance of botulinum-toxin treatment in mild and moderate cases of blepharospasm, as well as the success and low rate of complications in neurotomy-treated patients with severe eyelid spasms, is stressed. PMID- 2761661 TI - [Diagnosis of acoustic neuroma]. AB - Modern diagnostic procedures have enabled very early diagnosis of acoustic neuromas, making previously unattainable operative successes feasible. This change, which has taken place over the past decade, is demonstrated using data on 64 patients collected from 1970 to 1987. Over this period the case history shortened to a third, tumour size shrank to less than half and symptoms became more circumscribed and less severe. Operative results are impressive with regard to improvement or preservation of hearing and survival of the facial nerve. Technical diagnostic procedures can be reduced to a minimum of non-invasive methods. As very small intracanalicular neuromas can now be detected, there arises the question of the management strategy of choice, which would in selected cases include a period of watchful waiting. PMID- 2761662 TI - [Multiple sclerosis: atrophy of the corpus callosum and psychosyndrome]. AB - Examination with magnetic resonance imaging of 176 patients with multiple sclerosis showed that corpus callosum (CC) atrophy is common. The thinning of the CC depends on the extension of the coalescent periventricular white matter changes. A highly significant association was found between CC-atrophy and, the severity of organic mental disorder. PMID- 2761663 TI - [Polymorphonuclear leukocyte elastase in the cerebrospinal fluid in the diagnosis of acute inflammatory central nervous system diseases]. PMID- 2761664 TI - [Trans-sphenoid meningoencephalocele as a cause of anterior hypophyseal lobe insufficiency]. PMID- 2761665 TI - [Cerebrotendinous xanthomatosis: description of 2 cases and differential diagnosis in relation to encephalomyelitis disseminata]. PMID- 2761666 TI - The effect of caffeine on some mouse brain free amino acid levels. AB - Changes in free amino acids were examined in the central nervous system of mice treated with caffeine for three weeks. Caffeine was administered in the drinking water, and at the end of three weeks the level of caffeine in the cerebral cortex was 113 +/- 19 micrograms/g. When amino acid levels in cerebral hemispheres, midbrain, pons and medulla, and cerebellum were measured a significant increase in glutamine levels was found in all four regions. Glycine, alanine, serine, threonine, and GABA were significantly reduced in some regions. Caffeine appears to alter some of the metabolic or transport processes regulating amino acid pools in the brain. The decrease of GABA found in pons and medulla may contribute to the observed increase in reflex excitability after caffeine. PMID- 2761667 TI - Baclofen-induced, calcium-dependent stimulation of in vivo release of D [3H]aspartate from rat hippocampus monitored by intracerebral microdialysis. AB - The release of D-[3H]aspartate (used as a tracer for endogenous glutamate and aspartate) was studied at high K+ (100 mM) and under ischemia in rats implanted with 0.3 mm diameter dialysis tubing through the hippocampus. The effect on the D [3H]aspartate release of the two gamma-aminobutyric acid (GABA) agonists 4,5,6,7 tetrahydroisoxazolo[5,4-c]-pyridin-3-ol (THIP) and (+/-)-beta-(p chlorophenyl)GABA (baclofen), which specifically activate GABAA and GABAB receptors, respectively, was studied. Initial experiments employing HPLC analysis showed a coincident increase in the amounts of glutamate, aspartate and the amount of radioactivity following introduction of K+ (100 mM) or a period of ischemia suggesting that the D-[3H]aspartate labels the transmitter pools of the two amino acids under the present experimental conditions. The presence of 10 mM baclofen or 10 mM THIP in the perfusion medium did not inhibit ischemia induced D [3H]aspartate release. On the contrary, 10 mM baclofen alone (but not 0.1 or 1 mM) in the perfusion medium induced release of D-[3H]aspartate in a calcium dependent manner, whereas 10 mM THIP had no significant releasing effect. PMID- 2761668 TI - Functional intracellular glutaminase activity in intact astrocytes. AB - Numerous cellular metabolites such as glutamine, glutamate, phosphate, calcium, ammonia and acetyl derivatives are known to affect the phosphate-activated glutaminase activity in whole cell homogenates or extracts. Since measurements in extracts under non-physiological conditions may obscure the actual intracellular metabolic flux, the "functional" intracellular phosphate-activated glutaminase activity was measured by the formation of 3H2O from L-[2-3H]glutamine (Anal. Biochem. 127:134-142, 1982) in cultures of intact astrocytes, untreated and treated with dibutyryl c-AMP (DiBcAMP), in the presence of several potential effectors. These values were compared with enzyme levels determined in extracts from identical cells. The rate of 14CO2 release from L-[1-14C]glutamine was also measured in both untreated and DiBcAMP treated astrocytes. The intracellular activity of glutaminase for untreated cells assayed in MEM medium with 1 mM radioactive glutamine was 88 nmol/mg protein/h and in DiBcAMP treated cells the rate was 153 nmol/mg protein/h. However, the enzymatic activity measured under optimal conditions in extracts from both untreated and treated cells was much higher, but essentially the same, about 1,750 nmol/mg protein/h. The rate of 14CO2 release from L-[1-14C]glutamine was 74 and 133 nmol/mg protein/h in untreated and DiBcAMP treated cells, respectively. This represents approximately 85% of the intracellular glutaminase activity. Furthermore, increasing the concentration of glutamine in the medium from 1 to 6.4 mM increased glutaminase intracellular activity about 3 fold in both untreated and treated cells. Addition of 250 microM glutamate to the medium inhibited intracellular glutaminase activity by 70% under both treatment conditions. Deletion of glucose stimulated glutaminase activity. In contrast the removal of fetal bovine serum decreased activity by 35%.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2761669 TI - Loss of glutaminase-positive cortical neurons in Alzheimer's disease. AB - Phosphate activated glutaminase (PAG) was evaluated in the neocortex of Alzheimer and control cases. Consistent with previously reported results in rat cerebral cortex, pyramidal cells were stained immunohistochemically by a PAG specific polyclonal rabbit antibody, especially in layers II, III and V. An Alzheimer's case showed drastic depletion of PAG-positive pyramidal neurons, especially in layers II and III. Cortical PAG levels by biochemical assay were reduced to 18% of control in a small series of Alzheimer's cases (n = 3), while choline acetyltransferase (ChAT) was reduced to 28% of control in the same tissue samples. PAG staining was also observed in large neurons of the rat neostriatum. Double immunostaining for PAG and ChAT established that these large neurons also contained both enzymes. PMID- 2761671 TI - Brain taurine content as a function of cerebral metabolic rate: osmotic regulation of glucose derived water production. PMID- 2761670 TI - Effects of palmitate on astrocyte amino acid contents. AB - The effects of palmitate on intracellular and extracellular amino acid concentrations of cultured astrocytes was studied. Exposure of astrocytes to either 0.72 mM or 0.36 mM palmitate was associated with a significant reduction in the intracellular pool of glutamine and taurine. In contrast, the intracellular concentration of histidine, glycine, citrulline, isoleucine and leucine were increased in the presence of 0.72 mM palmitate. Comparable changes in the extracellular amino acid pool were not observed. The data suggest that palmitic acid, which accumulates in the brain during periods of anoxia, alters the metabolism of several amino acids in cultured astrocytes. These changes may be of significance in terms of the pathophysiology of a stress such as anoxia. PMID- 2761672 TI - Purification and characterization of chicken brain cytosolic aspartate aminotransferase. AB - Aspartate aminotransferase from the cytosolic fraction of chicken brain was isolated with acceptable yield and high degree of purity. The enzyme appeared in multiple molecular forms: alpha, beta, gamma, and delta (alpha predominates), as detected by polyacrylamide gel electrophoresis with specific staining. These different forms of the enzyme were separated by DEAE-Sephacel chromatography, and showed different isoelectric points and maximal velocities values, whereas their molecular weight, optimum pH and Michaelis constants were very similar. Generation process studies suggest that minors subforms of the enzyme could be raised from alpha form by a mechanism in which the oxidation of particular amino acid groups are involved. PMID- 2761673 TI - Prevention of muscarinic acetylcholine receptor down-regulation by chloroquine: antilysosomal or antimuscarinic mechanisms. AB - The effect of the antimalarial drug chloroquine on the carbachol-induced down regulation of muscarinic acetylcholine receptors (mAChRs) was studied in the neuroblastoma-glioma hybrid NG108-15 cells. Chloroquine, which is proposed to have both antilysosomal and antimuscarinic effects (4,11), blocked the loss of both cell surface and total mAChRs as monitored by [3H]N-methyl-scopolamine (NMS) and [3H] quinuclidinyl benzilate (QNB) bindings respectively. To the contrary, NH4Cl, only an antilysosomal agent, had no effect on the loss of surface receptors, but blocked degradation of internalized receptors following the effect of carbachol. These findings demonstrate that chloroquine prevents the agonist induced mAChR down-regulation in NG108-15 cells by both its antilysosomal and antimuscarinic effects. PMID- 2761674 TI - Changes with aging in the levels of amino acids in rat CNS structural elements. I. Glutamate and related amino acids. AB - Glutamate and related amino acids were determined in 53 discrete brain areas of 3 and 29-month-old male Fischer 344 rats microdissected with the punch technique. The levels of amino acids showed high regional variation - the ratio of the highest to lowest level was 9 for aspartate, 5 for glutamate, 6 for glutamine, and 21 for GABA. Several areas were found to have all four amino acids at very high or at very low level, but also some areas had some amino acids at high, others at low level. With age, in more than half of the areas, significant changes could be observed; decrease occurred 5 times more frequently than increase. Changes occurred more often in levels of aspartate and GABA than in those of glutamate or glutamine. The regional levels of glutamate and its related amino acids show severalfold variations, with the levels tending to decrease in the aged brain. PMID- 2761675 TI - Changes with aging in the levels of amino acids in rat CNS structural elements. II. Taurine and small neutral amino acids. AB - Taurine (Tau) and the small neutral amino acids glycine (Gly), serine (Ser), threonine (Thr), and alanine (Ala) were measured in 53 brain areas of 3- and 29 month-old male Fisher 344 rats. The ratio of highest to lowest level was 34 for Tau, 9.1 for Thr, 7.6 for Gly and Ser, and 6.5 for Ala. The heterogeneity was found in numerous areas; for example, Tau levels were more than 90 nmol/mg protein in 6 areas, and less than 20 nmol/mg protein in 10 areas. Similar heterogeneity was found with the other amino acids. The relative distribution of the small neutral amino acids showed several similarities; Tau distribution was different. With age, four amino acids decreased in 10-18 areas, and increased in only 1-3, while Thr increased in more areas than it decreased. The five amino acids of this paper, and the four of the previous paper, are among the amino acids at highest level in the brain; the sequence in their levels shows considerable regional heterogeneity. PMID- 2761676 TI - Effect of vitamin B-6 nutrition on the levels of dopamine, dopamine metabolites, dopa decarboxylase activity, tyrosine, and GABA in the developing rat corpus striatum. AB - Evidence presented in this manuscript indicates that prenatal and postnatal vitamin B-6 undernutrition produces the loss of dopamine (DA) in the corpus striatum of the developing rat brain. The concentration of striatal DA in rats fed vitamin B-6 inadequate diets was significantly lower than rats fed optimal diets at 28 and 56 days of age. The differences in striatal DA concentrations among vitamin B-6 dietary groups was more evident with age. Measurements of the major metabolites of DA, homovanillic acid (HVA), and 3,4-dihydroxyphenylacetic acid (DOPAC) in rat corpus striatum showed a significant decrease in HVA level in B-6 restricted rats compared to B-6 sufficient groups. Striatal DOPAC levels were not significantly different among any of the groups at any age. The activity of dopa decarboxylase holoenzyme was found to be significantly lower in the corpus striatum of rats fed suboptimal B-6 diets. Whether this finding has a significant effect on DA levels has yet to be determined since dopa decarboxylase is not the rate-limiting enzyme in the synthesis of DA. In an effort to determine the underlying mechanism for the loss of striatal DA, the concentration of its precursor tyrosine (TYR) was measured. Vitamin B-6 undernutrition had no significant effect on the levels of TYR in rat corpus striatum. The concentration of the inhibitory neurotransmitter GABA was also measured. The results indicate that as expected the levels of striatal GABA were significantly lower than controls at 14 and 28 days of age. On the other hand, striatal GABA levels in B-6 restricted rats did not differ from controls at 56 days of age.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2761677 TI - Choline plasmalogen synthesis by the methylation pathway in chick neurons in culture. AB - Choline plasmalogens represent a minor component of lipid membranes in most tissues. In spite of this, their rapid turnover indicates a possible functional role in the cell. The present study demonstrates that these compounds can be synthesized in neuronal cell cultures from chick embryo hemispheres by methylation of ethanolamine plasmalogens since choline plasmalogens were labeled after incubation of cells with tritiated ethanolamine or methionine. This finding could be of a particular interest since it has been suggested that choline plasmalogens, synthesized by methylation, might be involved in receptor activation. PMID- 2761678 TI - Kelatorphan, a potent enkephalinases inhibitor, and opioid receptor agonists DAGO and DTLET, differentially modulate self-stimulation behaviour depending on the site of administration. AB - Endogenous enkephalins have been found in the perikaryon of the mesolimbic dopaminergic ventral tegmental area and in axonal terminals in the nucleus accumbens. To examine whether endogenous opioid peptides may modulate this mesolimbic system, injections of dopamine receptor agonists and antagonist, the mu-opioid receptor agonists DAGO and morphine, the delta-opioid receptor agonist DTLET and kelatorphan, a new potent inhibitor of multiple enkephalin-degrading enzymes, were performed into the lateral ventricle and into the nucleus accumbens. Intracranial self-stimulation behaviour, obtained through electrodes chronically implanted into the medial forebrain bundle in the posterolateral hypothalamus of the rat, was used as behavioural paradigm. Injections of kelatorphan and DTLET into the lateral ventricle both induced an ICI 174,864 reversible increased self-stimulation behaviour, a similar increase was observed after injection of d-amphetamine, while morphine and DAGO reduced the rate of self-stimulation. In contrast, the administration of kelatorphan or dopamine receptor agonists into the nucleus accumbens reduced the rate of intracranial self-stimulation, while DTLET was without effect, when injected into the same structure. Finally, intra-accumbens injections of DAGO produced a similar behavioural profile to that produced by intraventricular injections of the drugs. Opioids may thus differentially affect intracranial self-stimulation behaviour, as a function of the neuroanatomical locus of administration. Furthermore, these results suggest that kelatorphan may increase self-stimulation behaviour through an action at delta-opioid receptor, while DAGO and morphine may reduce self stimulation behaviour through an action at mu-opioid receptors. PMID- 2761679 TI - Effects of depressant amino acids and antagonists on an in vitro spinal cord preparation from the adult rat. AB - A mature sacrococcygeal in vitro spinal preparation from the rat has been used to demonstrate effects of neutral amino acids and their antagonists. gamma Aminobutanoate (GABA), glycine and taurine (0.5-5 mM) produced dose-dependent depression of spontaneous paroxysmal activity generated in Mg2+ -free medium. The depressant effect of GABA was antagonised selectively by picrotoxin (25-50 microM) and the depressant effects of glycine and taurine were antagonised selectively by strychnine (0.2 microM). Glycine (0.5-5 mM) had a dose-dependent depolarizing action which was present at the central ends of isolated ventral roots. gamma-Aminobutanoate and taurine, had only weak depolarizing actions on ventral root fibres. Depolarizing responses to glycine showed a marked fading. Reduction in the fading appeared to be responsible for a paradoxical potentiation of glycine-induced depolarizations, which occurred in the presence of strychnine (0.2-2 microM). Strychnine (2-10 microM), picrotoxin (10-50 microM) or bicuculline (10 microM) had little or no effect on the amplitude, duration or latency of the monosynaptic component of ventral root reflexes evoked by supramaximal stimulation of dorsal roots (DR-VRP). However all three antagonists introduced slow, NMDA receptor mediated, components to these ventral root potentials. Picrotoxin and bicuculline, but not strychnine, reversibly depressed the dorsal root potential evoked from an adjacent dorsal root (DR-DRP). The depressant actions of 2-amino-5-phosphonopentanoate (AP5), kynurenate and 3-((+/ )-2-carboxypiperazin-4-yl)propyl-1-phosphonic acid (CPP) revealed both NMDA and non-NMDA receptor mediated components in the dorsal root potential. PMID- 2761680 TI - Proconvulsant and anticonvulsant effects in mice of acute and chronic treatment with cocaine. AB - The proconvulsant and anticonvulsant effects of acute and chronic exposure to cocaine were investigated in adult, male, CF-1 mice. The proconvulsant effects of cocaine in mice only manifested themselves after daily exposure to motor stimulant doses. Although daily treatment decreased electroshock convulsion threshold, no motor convulsions were observed. Animals in the proconvulsant state, however, kindled to electrically-induced convulsions more rapidly than did controls. Furthermore, daily treatment with cocaine and electroshock also enhanced the development of electrical kindling. These results illustrate that the excitatory properties of cocaine in the CNS can enhance phenomena which cause a persistent increase in excitability of the CNS. In contrast to the proconvulsant activity after chronic exposure, cocaine, administered acutely, in motor-stimulant doses, was anticonvulsant in a variety of tests using electroshock and chemically-induced convulsions. The drug elevated electroshock thresholds for both minimal and maximal convulsions and these responses were not blocked by haloperidol. In tests for minimal chemically-induced convulsions, cocaine elevated the threshold to N-methyl-DL-aspartate, but not to bicuculline; against maximal convulsions, the drug was anticonvulsant against both N-methyl-DL aspartate and bicuculline. Cocaine did not affect convulsion thresholds for strychnine, arecoline or aminophylline; these data suggest that the anticonvulsant action of cocaine is relatively selective for the gamma aminobutyric acid (GABA) and glutamate systems. PMID- 2761681 TI - Muscarinic receptor plasticity in rats lesioned in the nucleus basalis of Meynert. AB - The present study investigated the effects of chronic treatment with scopolamine (10 mg/kg i.p. for 21 days) on the muscarinic acetylcholine receptors in the frontoparietal cortex of rats, lesioned at the level of the nucleus basalis of Meynert. Ibotenic acid (25 nmol in 0.5 microliters) was injected bilaterally or unilaterally into the area of this nucleus and produced a major impairment of the cortical cholinergic system. These lesions depleted specifically frontoparietal cortical choline acetyltransferase activity. Sham-operated rats were similarly operated but no neurotoxin was injected. The chronic treatment with scopolamine caused a significant increase in the binding of [3H](-)quinuclidinylbenzilate to muscarinic receptors in the frontoparietal cortex of control and sham-operated rats but not in lesioned animals. This increase was due to an up-regulation in the number of muscarinic acetylcholine receptors, without significant change in their affinity. These results suggest that a functional presynaptic cholinergic terminal is necessary for the plasticity of muscarinic receptors in the central nervous system. PMID- 2761682 TI - Acute amitriptyline effects on parasympathetic-evoked rat saliva. AB - The present study was undertaken to investigate the acute effects of amitriptyline on salivary secretion evoked by electrical stimulation of the parasympathetic innervations of rat salivary glands. Single intravenous injections of amitriptyline (0.1-1 mg/kg) caused a dose-related decrease in flow and Na concentration of saliva from both parotid and submandibular glands. However, the only effect on K concentration was a slight increase when the salivary flow was almost completely inhibited. Amitriptyline increased the Ca concentration of nerve-evoked submandibular saliva, but had no effect on the Ca concentration of similarly evoked parotid saliva. However, amitriptyline (0.5 and 1 mg/kg) increased the protein concentration of both kinds of saliva. Amylase activity of parotid saliva was also moderately increased by amitriptyline. These effects were similar to those observed with atropine, a known cholinergic receptor antagonist. These results suggest that amitriptyline, like atropine, reduces parasympathetic-evoked salivary secretion by blocking cholinergic receptors. PMID- 2761683 TI - Comparative pharmacokinetic study of conventional and sustained-release viloxazine in normal volunteers. AB - Animal and human studies have indicated that viloxazine hydrochloride, an antidepressant drug with a half-life of 3-4 h in most subjects at low dosage, is rapidly and almost completely absorbed after oral administration. A sustained release form might be useful to decrease the frequency of administration. In our study, the pharmacokinetics of sustained-release form containing 300 mg viloxazine were compared with 300 mg conventional viloxazine in 11 normal volunteers (6 women, 5 men). Wide interindividual variations were observed with respect to plasma levels, but there was no significant statistical correlation between weight and blood concentration (conventional form: Cmax = 3,599 +/- 579 ng/ml, tmax = 86 +/- 26 min; sustained-release form: Cmax = 1,917 +/- 922 ng/ml, tmax = 215 +/- 77 min). Twelve hours after administration, plasma levels ranged between 540 and 1,600 ng/ml for the conventional form and between 660 and 2,120 ng/ml for the sustained-release form. Despite the great interindividual variation this new viloxazine form appears to be of interest for one daily administration. PMID- 2761684 TI - Diurnal variations of mood in psychiatric patients of different nosological groups. AB - In order to investigate whether diurnal variations of mood (DV) are pathognomonic for the diagnosis of endogenous depression, 130 patients and 21 healthy control subjects were examined. The patients differed in the type of primary disease (neurotic, endogenous depression, depression in schizophrenia). All subjects recorded their subjective mood on the Visual Analogue Scale every morning and evening over a period of 3 weeks. In addition, they were classified by expert rating according to clinical criteria as belonging to one of the three different groups of rhythmic type: morning type, evening type, indifference type. The results reveal that DV occur frequently but that they are nonspecific. No correlation between nosological diagnosis and rhythmic type was found. It follows that DV, therefore, cannot improve sample homogeneity in studies on psychoactive drugs. PMID- 2761685 TI - Influences of cortisol on auditory evoked potentials (AEPs) and mood in humans. AB - The present study was designed to investigate effects of cortisol on evoked potential indicators of sensory processing and on mood in 45 healthy human subjects. In order to determine the glucocorticoid effect to be primary excitatory or inhibitory, the vertex potential components. (P1, N1, P2) of the auditory evoked potential (AEP) were assessed, which also indicate a stimulus induced cortical arousal response mediated by the nonspecific sensory system of the reticular formation. The AEPs were recorded while the subject performed a vigilance task containing 8 blocks of monotonous series of tone pips presented at different interstimulus intervals. Mood was assessed by an extensive adjective checklist. Experiments were held double-blind and designed as between-group comparison. Subjects received either 40 or 20 mg hydrocortisone (constantly infused between 35 min prior to testing till the end of the experiment), or placebo. Enhanced plasma cortisol levels were related to increased amplitudes of the AEP vertex response. Furthermore, cortisol augmented self-reported concentration and reduced tiredness during task performance. The glucocorticoid effects on both AEPs and self-report measures suggest an excitatory influence of cortisol on brainstem and thalamic mechanisms mediating the stimulus-induced cortical arousal. PMID- 2761686 TI - Differential distribution of acetylcholinesterase activity among vasopressin- and oxytocin-containing supraoptic magnocellular neurons. AB - Acetylcholinesterase activity was demonstrated histochemically at light- and electron-microscopic levels, in Vibratome sections of the supraoptic nucleus of fixed hypothalami derived from osmotically stimulated and unstimulated Long Evans rats, from homozygous Brattleboro rats with hypothalamic diabetes insipidus, from lactating rats, from normal adult male house mice (Mus musculus) and from mice with hereditary nephrogenic diabetes insipidus (di/di). Reaction product was located in supraoptic magnocellular neurons; in dorsal and rostral aspects of the supraoptic nuclei lightly stained cells predominate, whereas in ventral and caudal regions densely staining perikarya predominate. Pre- and post-embedding immunocytochemical detection of oxytocin-neurophysin or vasopressin-neurophysin, combined with acetylcholinesterase histochemistry, showed that the lightly staining cells are oxytocinergic, and the densely staining cells vasopressinergic. Osmotic stimulation of the animals, either by substitution of drinking water for 3 days with 2.5% saline or reason of genetic defects which result in diabetes insipidus, enhanced the acetylcholinesterase activity of the vasopressin neurons but had little effect on the weekly acetylcholinesterase reactive oxytocin cells. Acetylcholinesterase activity was particularly marked in the hypertrophied abnormal magnocellular neurons of homozygous Brattleboro rats which do not release significant amounts of vasopressin. The increased acetylcholinesterase activity in osmotically stimulated animals cannot, therefore, be a function of vasopressin. Acetylcholinesterase activity was also detected in large multipolar neurons lying dorsolateral to the supraoptic nucleus, and in their fine axonal processes which project towards the supraoptic nucleus. A very few synaptic boutons surrounded by acetylcholinesterase reaction product were found in contact with magnocellular neuron basal dendrites. However, much of the punctate acetylcholinesterase reactivity observed at the light microscopic level and previously interpreted as representing the loci of cholinergic synaptic boutons was shown to be intracellular, and probably caused by acetylcholinesterase activity in some large, secondary lysosomes. PMID- 2761687 TI - Distinct morphologic classes of serotonergic axons in primates exhibit differential vulnerability to the psychotropic drug 3,4 methylenedioxymethamphetamine. AB - Immunohistochemical methods were used to analyse the distribution and morphology of serotonergic axons in normal macaque monkeys and in monkeys given (+/-)3,4 methylenedioxymethamphetamine. In untreated monkeys, we observed two morphologic classes of serotonergic axon terminals, which differ in regional and laminar distribution. These two axon types, fine and beaded, correspond to the serotonergic axon types which have been described in the rat. In 3,4 methylenedioxymethamphetamine-treated monkeys, there is a profound loss of serotonergic axon terminals, yet some are consistently spared. The surviving axon terminals are nearly all of the beaded type; in contrast, fine serotonergic axons are markedly reduced in density. There are regional differences in the magnitude of denervation, which reflect differences in the distribution of these two types of serotonergic axons in controls. The present study demonstrates that 3,4 methylenedioxymethamphetamine has differential neurotoxic effects on fine and beaded serotonergic axons. These results indicate that in the primate there are two distinct classes of serotonergic axon terminals, which differ in morphology, distribution, and vulnerability to psychotropic drugs. We hypothesize that in the primate, as demonstrated in the rat, these two classes of serotonergic axon terminals may arise from different raphe nuclei. In both rodent and primate, the dorsal and median raphe nuclei give rise to parallel ascending serotonergic projections, which are likely to have different pharmacologic properties and functions. PMID- 2761688 TI - Immunocytochemical localization of serotonergic fibers innervating the ocular circadian system of Aplysia. AB - The isolated eye of the mollusc, Aplysia californica, contains a circadian pacemaker whose phase can be regulated by serotonin. The results of previous biochemical and physiological studies indicate that serotonin is used as a transmitter of circadian information in the eye. Although the effects of serotonin on various physiological processes in the Aplysia eye have been studied, very little is known about the anatomy of the serotonergic innervation. We have examined the innervation of the eye using immunocytochemical methods. Serotonin-immunoreactive processes were observed in the optic nerve, in the accessory optic nerves, in the connective tissue capsule surrounding the eye, and within the eye itself. There appeared to be two sources of serotonergic input to the eye of Aplysia. One set of immunoreactive fibers was contained in the optic nerve and entered the eye in the neuropil region before radiating outward towards the peripheral retina in the layer below the photoreceptor cell bodies. A second serotonin-immunoreactive input to the eye entered from the accessory optic nerves and these fibers formed a dense plexus of fibers in the connective tissue capsule surrounding the eye. Serotonin-immunoreactive fibers from the plexus penetrated the eye and appeared to terminate in the peripheral portion of the retina. No serotonin-immunoreactive cell bodies were observed in the eye, nerves, or connective tissue capsule. These results support the hypothesis that serotonergic fibers innervate the retina of Aplysia and that these fibers travel through two distinct anatomical pathways: the optic nerve and the accessory optic nerves. PMID- 2761689 TI - The mesencephalic centre controlling locomotion in the rat. AB - A mesencephalic locomotor region has been located in the rat brain. Electrical stimulation of the mid-brain in decerebrate animals was used to elicit locomotion on a freely mobile treadwheel. The lowest threshold stimulation sites were reconstructed from histology and accumulated from different experiments. An averaging procedure, taking into account the threshold stimulus current used in each experiment, was used to identify the brain region in which neurons would have been activated in most experiments. The mesencephalic locomotor region so defined corresponds closely to nucleus cuneiformis and the immediately surrounding pedunculopontine region. PMID- 2761690 TI - Progressive pathology of the caudate nucleus, the substantia nigra pars reticulata and the deeper layers of the colliculus superior: acute behavioural and metabolic effects of intrastriatal kainic acid. AB - The acute behavioural and metabolic consequences of functional changes following unilateral intracaudate kainic acid at the level of the feline caudate nucleus, the substantia nigra pars reticulata and the deeper layers of the colliculus superior were investigated. The present study became possible since it was previously found that unilateral changes in neurotransmission processes in these structures all result in behavioural alterations that can be distinguished from each other. During the first 17 min after kainic acid, all animals displayed contralateral forced staccato head turning; these movements are characteristic for an activation of dopamine receptors and/or inhibition of GABA receptors in the rostromedial caudate nucleus. Between 15 and 50 min, all animals displayed fast, uninterrupted contralateral forced head, torso or body turning; these movements are characteristic for an activation of nigral GABA receptors. From about 48 min, all animals displayed sequences of short contralateral forced ear, head, torso and body turnings; these movements are characteristic for an inhibition of collicular GABA receptors. Furthermore, most cats displayed ipsilateral orofacial dyskinetic movements during the whole 180 min observation period. Metabolism was analysed in three cats that received [14C]2-D-deoxyglucose immediately before, 5 min after, or 70 min after kainic acid. Metabolism was increased in the ipsilateral caudate nucleus; this effect was most pronounced in the cat that received deoxyglucose immediately before kainic acid. Metabolic activity was increased in the ipsilateral substantia nigra pars reticulata; this effect was most pronounced in the cat treated with deoxyglucose 5 min after kainic acid. Metabolism was increased in the ipsilateral deeper layers of the colliculus superior in the cat that received deoxyglucose 70 min after kainic acid. The present behavioural and metabolic data suggest that kainic acid produces an increasing pathology resulting successively in functional changes in the caudate nucleus, its output-station the substantia nigra pars reticulata and the nigral output-station the deeper layers of the colliculus superior. It is suggested that the successive appearance of the latter effects is inherent in the hierarchical order of the brain structures under study. The occurrence of orofacial dyskinetic movements during the whole observation period suggests that the former movements were not mediated via the striato-nigro-collicular pathway. Finally, apomorphine injected in the ipsilateral caudate nucleus 1 week after kainic acid was significantly less effective compared to apomorphine injected 1 week before kainic acid. The c PMID- 2761691 TI - Generation of retinal cells in the wallaby, Setonix brachyurus (quokka). AB - We have examined the generation of retinal cells in the wallaby, Setonix brachyurus (quokka). Animals received a single injection of tritiated thymidine between postnatal days 1-85 and retinae were examined at postnatal day 100. Retinae were sectioned, processed for autoradiography and stained with Cresyl Violet. Ganglion cells were labelled by injection of horseradish peroxidase into the optic tracts and primary visual centres. Other cells were classified according to their morphology and location. Retinal cell generation takes place in two phases. During the first phase, which concludes by postnatal day 30, cells destined to lie in all three cellular layers of the retina are produced. In the second phase, which starts by postnatal day 50, cell generation is almost entirely restricted to the inner and outer nuclear layers. Cells produced in the first phase are orthotopic and displaced ganglion cells, displaced and orthotopic amacrine cells, horizontal cells and cones. Glia in the ganglion cell layer, orthotopic amacrine cells, bipolar and horizontal cells. Muller glia, and rods are generated in the second phase. Cells became heavily labelled with tritiated thymidine in the central retina before postnatal day 7, over the entire retina (panretinal) by postnatal day 7 and from postnatal day 18, only in the periphery. The second phase of cell generation is initiated at P50, in a region extending from the optic nerve head to mid-temporal retina. Subsequently, cells are generated in annuli, centred on mid-temporal retina, which are seen at progressively more peripheral locations. Therefore, cell addition to the inner and outer nuclear layers continues for longer in peripheral than in mid-temporal retina. We suggest that such later differential cell addition to the inner and outer nuclear layers contributes to an asymmetric increase in retinal area. This non-uniform growth presumably results in more expansion of the ganglion cell layer peripherally than in mid-temporal retina and may play a role in establishing density gradients of ganglion cells. PMID- 2761692 TI - Traumatic brain injury in the rat: characterization of a lateral fluid-percussion model. AB - Experimental fluid-percussion models produce brain injury by rapidly injecting saline into the closed cranium. In the present study we characterize the physiological, histopathological and neurological responses to mechanical brain injury in the rat produced by lateral fluid-percussion injury of graded severity. Physiological experiments (n = 105) demonstrated that all levels of injury produced an acute and transient systemic hypertension and bradycardia. Acute hypertension followed by significant hypotension occurred at higher magnitudes of injury. Post-injury suppression of electroencephalographic amplitude was related to the severity of injury. An increase in slow wave (delta/theta) electroencephalographic activity with a concomitant decrease in alpha/beta electroencephalographic activity were observed only at moderate and high magnitude of injury and were correlated with a worsened neurological outcome (r = 0.84; P less than 0.05) and increased mortality (r = 0.66; P less than 0.05). Alterations in brainstem auditory-evoked potentials were also observed only at the higher levels of injury. Histopathological analysis revealed that the extent of post-injury hemorrhage, cavitation and vascular disruption (as measured by extravasation of Evans Blue dye) was greater at the higher magnitudes of injury. Neurological scoring performed over a 4-week post-injury period demonstrated that lateral fluid-percussion brain injury produces a chronic neurological deficit that is directly related to the severity of injury. Survival was also significantly reduced at the higher magnitudes of injury. These data demonstrate that the lateral model of fluid-percussion injury in the rat reproduces many of the features of head injury observed in other models and species and may therefore be a useful experimental model for the study of the pathophysiology of traumatic brain injury. PMID- 2761693 TI - An immunological study of the secretory activity of neurons producing melanin concentrating hormone in a teleost. AB - The melanin-concentrating hormone is a general vertebrate neurosecretory peptide which, in bony fish, serves as a neurohypophysial hormone influencing pigmentary changes in response to background colour. Young carp were reared for six months in white- or black-coloured tanks to determine how this would influence the development of the neurons producing the peptide. Cytological criteria and radioimmunoassay of tissue extracts showed that the background markedly influenced the synthetic activity of these neurons. In carp reared in black tanks, the perikarya were small and poorly granulated, with small nuclei and often undetectable nucleoli. Transfer of such fish to a white tank for six days caused no significant change in hormone content but cytological criteria suggested an increased activity of some of the neurons. In fish reared on a white background, over 50% of these neurons showed a greatly enhanced synthetic activity, while radioimmunoassays showed significantly higher concentrations of immunoreactive peptide in their hypothalami but not in their pituitary glands. After such fish were moved to black tanks for six days, the neuropeptide content of the hypothalamus and pituitary gland was significantly increased. Histologically, this was reflected in the amount of immunostainable granulation in both sites but cell nuclear size was not decreased. These changes are interpreted in terms of changes of hormone synthesis and release. The observations provide evidence that the activity of many but not necessarily all of the neurons producing melanin-concentrating hormone in the carp hypothalamus is controlled by background colour. PMID- 2761694 TI - Inducing effect of skeletal muscle extracts on the appearance of calbindin immunoreactive dorsal root ganglion cells in culture. AB - Calbindin D-28k is a calcium-binding protein which is not expressed by dorsal root ganglion cells cultured from 6-day-old (E6) chick embryos. When soluble muscle extracts from embryos at E11, E18 or chickens 2 weeks after hatching were added immediately after seeding, dorsal root ganglia cells grown at E6 displayed neuronal subpopulations expressing calbindin immunoreactivity with time; the effect of muscle extract on the percentage of calbindin-immunoreactive dorsal root ganglia cells followed a dose-response curve. When muscle extract was added to cultures after a 3 day delay, the percentage of calbindin-expressing neurons was unchanged. The effect produced by muscle extract and, to a lesser degree, skin extract on the appearance of calbindin-positive neurons was not reproduced by brain or liver extracts while all four exerted a trophic action on cultured neurons. Hence it is assumed that muscle extract contains a factor which produces an inductive effect on the initiation of calbindin-expression by uncommitted subpopulations of sensory neurons rather than a trophic influence on the selective survival of covertly committed neuronal subpopulations. The fact that muscle extract promoted calbindin expression by dorsal root ganglia cells in neuron-enriched as well as in mixed dorsal root ganglion cell cultures indicates that the factor would act directly on sensory neurons rather than indirectly through mediation of non-neuronal cells. Since the active muscular factor was non dialysable, heat-inactivated, trypsin-sensitive and retained by molecular filters with a cut-off of 30 K, this factor is probably a protein. PMID- 2761695 TI - Monoclonal antibody G10 against microtubule-associated protein 1x distinguishes between growing and regenerating axons. AB - Monoclonal antibody G10 binds to an epitope on a microtubule-associated protein and specifically labels elongating axons in the developing rat central nervous system. In this paper the expression of this microtubule-associated protein epitope has been studied in developing and regenerating rat peripheral neurons and sprouting and transplanted neurons in the central nervous system. During development bright immunofluorescent fibres were seen from embryonic day 12 (the earliest age studied) to birth, but immunoreactivity declined postnatally and was only barely detectable in adult sciatic nerves. In contrast to the situation in developing axons, immunostaining could not be demonstrated in axons regenerating after crushing of the sciatic nerve nor in axons growing from grafts of septal tissue into the adult hippocampus, despite good evidence for extensive reinnervation in both cases. Immunostaining was only seen at early stages within the septal grafts, and not as axons grew out to reinnervate the host. No staining was seen in areas of deafferented hippocampus where collateral sprouting takes place. These results suggest a molecular difference between the cytoskeletons of developing and regenerating or sprouting nerves. PMID- 2761696 TI - Level off. PMID- 2761697 TI - Clinical spectrum of Niemann-Pick disease type C. AB - Analysis of the neurologic symptomatology in 22 patients with Niemann-Pick disease type C revealed 3 phenotypes: (1) an early-onset, rapidly progressive form associated with severe hepatic dysfunction and psychomotor delay during infancy and later with supranuclear vertical gaze paresis, ataxia, marked spasticity, and dementia; (2) a delayed-onset, slowly progressive form heralded by the appearance, usually in early childhood, of mild intellectual impairment, supranuclear vertical gaze paresis, and ataxia, and later associated with dementia and, variably, seizures and extrapyramidal deficits; (3) a late-onset slowly progressive form distinguished from the 2nd pattern by later age of onset (adolescence or adulthood) and a much slower rate of progression. The existence of the 1st and 2nd phenotypes within the same sibship suggests that they are variant expressions of the same clinicopathologic disorder. Niemann-Pick disease type C should be considered not only in infants and children who present with organomegaly and a progressive neurodegenerative course, but also in adolescents and adults who have insidiously progressive neurologic dysfunction and only slight organomegaly. Associated with the disease is a marked deficiency in the ability of cultured fibroblasts to esterify exogenously supplied cholesterol. Assay of this deficiency is particularly useful for confirming the diagnosis in patients with atypical presentation. PMID- 2761698 TI - Embolic stroke from a carotid arterial source in the rat: pathology and clinical implications. AB - We developed a new animal model of stroke which resembles human stroke more closely than existing models. We described the pathology produced in the brain following platelet embolism, previously described only in the retina. The common carotid artery of the rat was irradiated for 6.5 minutes with an argon laser at 514.5 nm after intravenous injection of a photosensitizing agent, rose bengal. A retinal embolus was seen in 1 rat 5 minutes after irradiation. A nonocclusive platelet thrombus was present in the carotid artery 50 minutes after irradiation, with almost all the platelet thrombus being cleared 24 hours later. Acute (1 to 10 days) changes in the brain included 44 small infarcts in 12/13 rats, cortical arterioles occluded with platelets and thickening of small vessels in normotensive rats. Chronic (4 to 12 weeks) changes included lacunes in the brains of normotensive rats and intimal proliferation of smooth muscle in the carotid artery. This is the 1st animal model of (1) stroke with emboli produced in vivo rather than injected into the carotid, (2) intimal proliferation of smooth muscle without invasion of the vessel, and (3) lacunes. This model provides results important to the laboratory study of stroke. PMID- 2761700 TI - Blink reflex excitability cycle in hemifacial spasm. AB - We studied electrically elicited blink reflex responses in patients with hemifacial spasm (HFS) by applying single isolated, as well as paired (conditioning and test), stimuli at both sides of the face. Responses after single stimuli were of larger size on the side of the spasm compared with the uninvolved side and controls. With paired stimuli, the inhibitory effect of the conditioning stimuli upon the test stimuli late response (R2), which was always observed in normals, was significantly less pronounced at short interstimuli intervals. This resulted in an enhanced recovery curve of R2, which was observed on the side of the spasm and the contralateral, clinically normal side. Patients with longer disease duration showed more striking abnormalities of the recovery curve. We suggest that there is enhanced excitability of facial motoneurons and of those brainstem interneurons that mediate the blink reflex pathway in patients with HFS. PMID- 2761699 TI - Anti-acetylcholine receptor antibodies block bungarotoxin binding to native human acetylcholine receptor on the surface of TE671 cells. AB - We assayed sera from 20 myasthenics of various clinical stages and anti acetylcholine receptor (AChR) antibody levels for their ability to affect bungarotoxin (BGT) binding to native human AChR on the surface of TE671 cells. Thirty-five percent of sera blocked BGT binding to the AChR, some at a dilution of up to 1:1000. The 7 patients whose sera blocked toxin binding were all generalized myasthenics with particularly severe disease, 6 of whom had had myasthenic crisis at some point in their course. No ocular myasthenics had blocking antibody. Blockade of toxin binding by myasthenic antibody to TE671 cells resembled blockade produced by unlabeled toxin in being irreversible with washing. There was little correlation between ability to block toxin binding and amplitude of the AChR binding antibody. These data are consistent with the hypothesis that patients with more aggressive generalized myasthenia preferentially have anti-AChR antibody that blocks toxin binding. PMID- 2761701 TI - Autologous adrenal medullary transplant in progressive supranuclear palsy. AB - We transplanted autologous adrenal medullary cells to the caudate nucleus in 3 patients with progressive supranuclear palsy, using the method Madrazo has employed for neural transplantation in Parkinson's disease. Major and minor complications occurred post-operatively from which the patients recovered. One patient had a marked improvement in his postural stability and a decreased incidence of falling. This change was evident at 1 month after surgery and has remained for the 6 months of follow-up. Postural reflexes were not altered in the other 2 patients. There was no change in extraocular movements, speech, or the rigid-bradykinetic features of parkinsonism in any patient. Adrenal medullary transplantation has only limited efficacy in progressive supranuclear palsy. PMID- 2761702 TI - Dose-dependent expression of neuronopathy after experimental pyridoxine intoxication. AB - We examined the sequence of nervous system abnormalities that resulted when rats were given excess amounts of vitamin B6 (pyridoxine). High doses of pyridoxine (1,200 or 600 mg/kg/d) for 6 to 10 days caused a neuronopathy with necrosis of dorsal root ganglion (DRG) sensory neurons, accompanied by centrifugal axonal atrophy and breakdown of peripheral and central sensory axons. Large diameter neurons with long processes and large cytoplasmic volumes were especially affected. Smaller doses (300 to 150 mg/kg/d) for up to 12 weeks had minor effects on DRG neurons, but produced a neuropathy with axonal atrophy and degeneration. Guinea pigs given 1,800 mg/kg/d developed sensory neuronopathy, whereas mice given similar or higher doses did not have neuropathologic abnormalities. Multiple factors including rate of administration, differential neuronal vulnerability, and species susceptibility have bearing on the final expression of pyridoxine neurotoxicity. PMID- 2761703 TI - Seizures after primary intracerebral hemorrhage. AB - We followed 123 patients with primary intracerebral hemorrhage (ICH), defined as bleeding without known precipitating cause except hypertension, for an average of 4.6 years or until death in order to determine the incidence, prevalence, and type of epileptic seizures. Twenty-five percent had seizures. In one-half of these, the seizures began within 24 hours of the hemorrhage. Survival table analysis predicted a potential cumulative seizure incidence of 50%, had all patients survived 5 years. Seizure incidence was high with bleeding into lobar cortical structures (54%), low with basal ganglionic hemorrhages (19%), and zero with thalamic hemorrhages. Within the basal ganglia, caudate involvement predicted seizures; within the cortex, temporal or parietal involvement predicted seizures. Although seizure incidence was high, prevalence of chronic epilepsy was much lower: 13% in 30-day to 2-year survivors and 6.5% in 2- to 5-year survivors. Seizure incidence is higher than previously reported after ICH because small lobar hemorrhages are the most epileptogenic and are now easily recognized with computed tomography. PMID- 2761704 TI - Psychogenic tremors. AB - We diagnosed 24 patients, 9 men and 15 women ranging in age from 15 to 78 years, with clinically established or documented psychogenic tremors. Clinical presentations were unique, with complex tremors (often resting, postural, and kinetic), unusual temporal profiles (abrupt onset with a variable course), absence of other neurologic signs, inconsistent and incongruous symptomatology, selective disability with ability to perform some functions despite severe tremors, distractibility that lessens or abolishes tremor, atypical tremorgraphic recordings with changing amplitude and frequency, unusual handwriting and drawing specimens, presence of multiple undiagnosed somatizations, unresponsiveness to all treatments, absence of documented disease by laboratory or radiographic tests, presence of psychiatric disease, spontaneous remissions, or recovery with psychotherapy. We present criteria for the diagnosis of psychogenic tremor. PMID- 2761705 TI - Assessment: EEG brain mapping. Report of the American Academy of Neurology, Therapeutics and Technology Assessment Subcommittee. PMID- 2761706 TI - Assessment: intensive EEG/video monitoring for epilepsy. Report of the American Academy of Neurology, Therapeutics and Technology Assessment Subcommittee. PMID- 2761707 TI - Autonomic nervous system involvement in patients with human immunodeficiency virus infection. AB - We used an autonomic nervous system (ANS) testing battery to determine whether ANS dysfunction occurred in HIV infection. Five of 10 seropositive (HIV+) patients had ANS involvement affecting both the parasympathetic and sympathetic divisions. All 5 involved patients were in Group IV of the CDC classification. PMID- 2761708 TI - Agonist substitution in advanced Parkinson's disease. AB - We studied whether Parkinson's disease patients who had lost efficacy from pergolide (PERG) could benefit if transferred to bromocriptine (BCT) therapy. Using paired t-tests, we compared motor scores at baseline (when patients were still on PERG) and after 6 months of BCT therapy in 11 patients. No significant improvement occurred in any measure on BCT therapy (mean dose 33.6 mg/day), although patients remained stable. In 6 patients on whom "on/off" data were obtained, decreased "off" time and increased "on" time without chorea occurred, but these changes were not statistically significant. The side effect profile was similar with the 2 drugs. PMID- 2761709 TI - Dural scrofula. AB - A middle-aged woman presenting with multiple cranial neuropathies, hemiparesis, and CSF pleocytosis had tuberculous infection of the cranial dura mater at autopsy. This is the first description of dural scrofula in modern medical literature. PMID- 2761710 TI - Hemispatial visual inattention masquerading as hemianopia. AB - The defect occurring when a patient fails to report a visual stimulus presented in a visual half-field may be attributed to hemianopia (deafferentation) caused by a geniculocalcarine lesion. However, failure to report a stimulus presented in a visual field may also be caused by hemispatial visual inattention. We report a patient with right thalamic and temporo-occipital lesions who had a left visual field defect when her eyes were directed either straight ahead (midsagittal plane) or toward left hemispace. However, this visual field defect abated when her eyes were directed to right hemispace, suggesting that the patient had hemispatial visual inattention rather than hemianopia. PMID- 2761711 TI - HTLV-I-associated myelopathy with adult T-cell leukemia. AB - We report a 42-year-old Japanese woman with HTLV-I-associated myelopathy (HAM) combined with adult T-cell leukemia (ATL). Combination of the 2 diseases has been extremely rare. The infrequency is explained by HLA types unique to each disease. Our patient suggests that the HAM-associated HLA haplotype does not prevent the development of ATL. PMID- 2761712 TI - Dimple sign in mail carrier's ulnar neuropathy. PMID- 2761713 TI - Topical lidocaine for relief of superficial pain in postherpetic neuralgia. PMID- 2761714 TI - Neurogenic claudication with positionally dependent weakness from a thoracic disk herniation. PMID- 2761715 TI - Electrodiagnostics in cervical disk disease. PMID- 2761716 TI - Sneddon's syndrome. PMID- 2761717 TI - Progression of Parkinson's disease. PMID- 2761718 TI - [Treatment of infections of the deep soft tissues in reconstructive vascular surgery]. AB - After 685 reconstructive vascular operations (1982-1984) on account of arterial occlusive disease in the supra-aortic arteries as well as in the aorto-iliac and femoro-popliteal segments there occurred 9 deep infections (1.31%); most infected by-passes were extra-anatomical type. In 2 cases an aseptic by-pass was performed; in 4 cases an open local treatment was performed (early broad splitting of the soft tissues and laying open the entire infected graft, surgical wound debridement and local application of antiseptic solution); in 3 cases there was no other possibility than to remove the implant and amputate the leg. Each of the 2 methods described has its specific indications: the aseptic by-pass has to be performed in retroperitoneal and inguinal infections; the open local treatment has to be performed in cases of extra-anatomical by-passes and operations in the femoro-popliteal-cruralis or supra-aortic region. The correct use of these 2 treatment modalities, with their specific indications, allows a conservative management of deep tissue infections. PMID- 2761719 TI - [Methods for preparing patients to vascular surgery. Our experience]. AB - A personal series covering two years of vascular surgery involving 58 cases without problems of sepsis has been examined. The modalities employed for preventing wound infections and prosthesis suppuration when it occurred and consisting of showers, antibiotic prophylaxis and shaving are reported. In conclusion it is maintained that a specific, disciplined protocol must be followed in all candidates for prosthesis. PMID- 2761720 TI - [Traumatic lesions of the popliteal artery]. AB - Even today, traumatic lesions of the popliteal artery mean in a large percentage of cases (from 25% to 45% according to recent reports) loss of the extremity, notwithstanding the considerable advances made by reconstructive vascular surgery. The most important series are reported in relation to events of war in the past (Korea, Vietnam) and more recently. As for lesions in everyday life, the highest percentage is the result of road and particularly motorbike accidents. A review of the most recent literature shows that the prognosis for lesions of the proximal and middle segment of the popliteal artery is greatly improved while in lesions of the distal portion and particularly the trifurcation, the percentage of failure with consequent amputation is still very high (from 30% to 40% of cases). Here personal experience of 6 cases of lesions of the popliteal artery due to osteovascular trauma observed in the past two years is reported, the diagnostic procedures and therapeutic treatment adopted being discussed. PMID- 2761721 TI - [Loco-regional complications in the surgery of the subclavian artery]. AB - Surgical treatment of subclavian artery atherosclerotic lesions has prophylactic significance in the evolution of cerebrovascular insufficiency. Local complications during interventions on subclavian artery are incidentally more significant than cerebral ischemic complications. Among local complications we reported 2 cases of phrenic nerve involvement and 1 case of thoracic duct lesion in a series of 86 operated patients. We never found cerebral ischemic complications in the surgery of subclavian artery atherosclerotic lesions. PMID- 2761723 TI - [Diagnostic and therapeutic considerations in early gastric cancer]. AB - A ten-year series of early gastric cancer is reported, stress being laid on the diagnostic and therapeutic problems associated with the condition. The importance of intensified mass screening programmes, particularly in populations at risk, is underlined to enable these potentially dangerous conditions to be treated in time. PMID- 2761722 TI - [Primary malignant non-Hodgkin's lymphoma of the stomach. Case series contribution]. AB - Fourteen cases of primary gastric non-Hodgkin malignant lymphoma have been classified according to the "Working Formulation for Clinical Usage" and according to the Kiel classification. They have been staged according to the Ann Arbor staging system modified by Musshoff and according to the Manchester staging system modified by Rao. They have been also arranged in the Friedman's macroscopic types. Clinical features, radiologic and endoscopic findings, performed surgical operations, histologic reports and prognostic factors are reported and discussed. The patients, after surgery, have been treated with radiotherapy and/or polychemotherapy, according to the suggested therapeutic pattern. The follow-up has evidenced a better prognosis than gastric carcinoma. The importance of the preoperative diagnosis is emphasized. This is often difficult to obtain, but it permits a better surgical treatment and especially the right intraoperative staging. PMID- 2761724 TI - [Carcinoma of the gallbladder. Our experience]. AB - A series of 14 patients (6 males and 8 females) suffering from gallbladder cancer has been examined. Postoperative mortality, mean survival, quality of life understood as time free from symptomatology, and the incidence of early postoperative complications in relation to the various types of radical and palliative intervention performed were evaluated. PMID- 2761725 TI - [Surgical treatment of acute suppurative cholangitis. Our experience]. AB - The results obtained in 13 cases of acute suppurative cholangitis are reported, stress being laid on the seriousness of the pathology and the need for emergency surgical treatment. PMID- 2761726 TI - [Thoracic, abdominal and thoraco-abdominal traumas. A statistical-epidemiological study of 1009 cases and diagnostic-therapeutic considerations]. AB - A study of 1009 cases of thoracic, abdominal and thoraco-abdominal traumas is presented. Relative complications are examined and some diagnostic and therapeutic considerations are put forward in relation to reported data. PMID- 2761727 TI - [Endodermal and coelomic mediastinal cysts]. AB - Eight cases of mediastinal cysts of endodermic and celomatic origin were operated on at Istituto di Chirurgia Generale e Cardiovascolare, University of Milano: two were bronchogenic cysts, two enteric and four pericardial. Embryology, morphologic presentation, clinical feature and diagnostic aspects are discussed for each group of cysts. The most modern techniques, radiological or not, available for the preoperative diagnosis are illustrated and the indication to surgical treatment of these benign mediastinal lesions is discussed. PMID- 2761728 TI - [Reconstruction of the thoracic wall in neoplasms of the manubrium of sternum]. AB - The case of a voluminous neoplasia originating at the manubrium sterni is described. Given the rapid growth of the mass and its dimensions, the mass was removed surgically together with the manubrium sterni and the sternal extremity of the clavicle and of the first two ribs. The defect in the anterior wall of the thorax was filled by a net of prolene partially covered with the mobilised pectoral muscles. Functional and aesthetic results were very good. Assisted respiration was not necessary in the immediate postoperative period and the net remained stable and firmly in place during respiration. One month after the operation, respiratory function tests were on a par with those done prior to the operation. The positioning of prolene nets for the reconstruction of the thoracic wall is an extremely effective technique which makes it possible to preserve satisfactory respiratory mechanics even after the removal of extensive portions of the thoracic wall. PMID- 2761729 TI - [Tubercular enteral fistulas]. AB - Personal experience in the treatment of two cases of postoperative tubercular enterocutaneous fistula is reported. This complication of abdominal tuberculosis is rather rare and may be a consequence of tubercular enteritis or of an extraintestinal localisation. PMID- 2761730 TI - [Gastric leiomyoblastoma. Description of a case with the cytological findings and review of the literature]. AB - A case of gastric leiomyoblastoma observed in a 76 year old woman, with details of its cytological and histological diagnosis, is reported. Cytologically, the tumour showed spindle-shaped cells, either single or arranged in clusters and bundles and constituted of epithelial-like cells with moderately irregular and hyperchromatic nuclei. The macroscopic specimen showed an ulcerated mass measuring 3.5 x 2 x 2 cm. Histologically the neoplasm showed interlacing fascicles of spindle-shaped, pleomorphic and epithelioid cells, infiltrating the gastric smooth muscle tissue, but not extending beyond it. The main cyto histological diagnosis and parameters predictive of benign and malignant behaviour in leiomyoblastoma are discussed. PMID- 2761731 TI - [Role of anterior scalene muscle hypertrophy in thoracic outlet syndrome]. AB - A case of hypertrophic anterior scalene muscle surgically treated is reported. The patient suffered from upper limb intermittent claudication at any sustained upper extremity activity such as lifting a weight or opening and closing the hand with the arm abducted. Doppler and angiographic study showed significant compression of subclavian artery with hyperabduction and Adson manoeuver. Simple anterior scalenotomy was followed by prompt recovery of symptoms. The results of scalenotomy and other surgical approaches to thoracic outlet syndrome are reviewed in the literature. The most common anomalies of anterior scalene muscle in the TOS are also described. Doppler and arteriographic study in different functional positions are necessary in the evaluation of subclavian artery compression by osseous or muscular structures. In the reported case scalenotomy was at least as effective as 1st rib resection. PMID- 2761732 TI - [Peritoneal splenosis. Report of a case and pathogenetic considerations]. AB - A clinical case of splenosis recently observed in a young man subjected at the age of 8 to splenectomy for rupture of the spleen and operated at 19 for intestinal occlusion is reported. The pathogenetic aspects of the condition, characterised by the presence of nodules of splenic tissue in the abdominal cavity, are examined through a review of the literature. PMID- 2761733 TI - [Cystic adventitial disease of the popliteal artery. Report of 2 cases and review of the literature]. AB - Two cases of cystic adventitial degeneration of the popliteal artery are reported and aetiopathogenetic theories, diagnosis and treatment discussed. One of the cases presented is of special interest because, at surgery, it was possible to observe the relationships of the artery with the articular capsule of the knee through a genicular vessel which, when sectioned, showed an exit of mucinous material the equivalent of that contained in the vasal cyst. This observation gives even more credence to the so-called "articular" aetiopathogenetic theory. The two cases were treated surgically with resection of that segment of the artery and contralateral saphenous vein graft giving an excellent short-term and long-term result and protecting from recurrences. PMID- 2761734 TI - [Peptic ulcer in the elderly]. AB - The Authors, after having reviewed all the literature on this topic, have studied all patients over 60 which were admitted with a diagnosis of peptic ulcer disease at the Institute of Surgical Pathology of the University of Pavia from January 1, 1974 until December 31, 1985. They noted, from their results, that this disease shows a predilection for adults, but is also frequently found in the elderly. In fact, in the latter, during this period of life, the complications which are most frequently observed (especially gastric) are hemorrhage and perforation; according to the Authors the former is due to arteriosclerosis which hinders vascular contraction, while the latter to a reduction of blood flow due to endarteritis, which causes necrosis of the ulcer's base, creating therefore a "locus minoris resistentiae". The Authors conclude that in the elderly, when drug therapy is inefficient, a surgical approach is necessary. In fact, with a well followed pre-operative care program the outcome of surgery is usually satisfactory and complications (mentioned above), which would render surgery and the post-operative period difficult, are prevented. PMID- 2761735 TI - [Diagnostic considerations in 104 cases of aneurysm of the subrenal abdominal aorta surgically treated in 1987]. AB - A series of 104 patients observed and surgically treated for abdominal aortic aneurysms, in the General and Cardiovascular Surgery Department of Milan University during 1987 in analysed. Particular attention is paid to the diagnostic procedures especially in those cases when the condition was found by chance during clinical examinations requested for different pathologies. PMID- 2761736 TI - [Role of intraoperative phlebography in the therapeutic approach of varicocele]. AB - Personal experience of intraoperative anterograde phlebography of the internal spermatic vein is reported. The use of this technique is suggested for controlling the result of internal spermatic vein ligature in cases of type I varicocele according to Coolsaet, diagnosed by preoperative retrograde phlebography. Early data make it possible to conclude that intraoperative anterograde phlebography is a valuable aid in reducing the frequency of recurrences. PMID- 2761737 TI - [Proximal anastomosis in aorto-bifemoral bypass. Technical considerations]. AB - Aorto-bifemoral bypass is the commonest way to correct stenotico-obstructive lesions of the aorto-iliac district. The problem of proximal anastomosis is examined by considering the advantages and disadvantages of the two types of anastomosis: end-to-end and end-to-side. On the basis of reported results and personal experience based on the use of end-to-side anastomosis, it is concluded that this is to be preferred over end-to-end, especially in view of the possibility offered by this procedure of maintaining the collateral circulations. PMID- 2761738 TI - [Our experience in the surgical treatment of cysts and fistulas of the thyroglossal duct]. AB - A clinical series of cysts and fistulas of the thyroglossal tract has been examined. Clinical aspects of this pathology and the results obtained with surgical treatment are compared with reported data. PMID- 2761739 TI - [Extracorporeal shockwave lithotripsy: treatment of choice in ureteral calculi]. AB - Extracorporeal shock wave lithotripsy represents the therapy of choice for reno ureteral stone disease being resolutive in more than 85% of cases. This procedure can be successfully applied to ureteral stones providing appropriate preoperative cystoscopic manipulations and a correct positioning of the patient on the stretcher of the lithotripter. We hereby report our experience in 119 patients with ureteral lithiasis submitted to extracorporeal shock wave lithotripsy with a 98% success rate. PMID- 2761740 TI - [Use of defibrotide in the treatment of acute superficial thrombophlebitis of the legs]. AB - The efficacy of defibrotide in the treatment of acute thrombophlebitis of the legs has been investigated in 140 patients, randomized into two groups. All patients received defibrotide either alone or as an addition to conventional therapies. Two different schemes of administration were selected and carried out in each group, according to the time of onset of thrombophlebitis. Defibrotide demonstrated a good clinical efficacy in both groups, with a highly significant reduction in those patients receiving defibrotide and conventional therapies. The clinical result were outstanding in two subgroups: extensive thrombophlebitis and brachioaxillary phlebitis. PMID- 2761741 TI - [Neoplasms of the duodenum. A description of 2 clinical cases]. AB - Duodenal tumours are a rare pathology, hard to diagnose early because of the unsubstantial symptomatology even though, in recent years, with the advent of improved techniques, a larger number have found their way into the literature. Two cases of duodenal cancer, one an adenocarcinoma localised in the first portion of the duodenum and one a subpapillary leiomyosarcoma are reported. 2 and 5 years respectively after the operation, both patients are in good health and do not present signs of disease. PMID- 2761742 TI - [Food ileus caused by a phytobezoar of the small intestine]. AB - One case of small bowel obstruction due to phytobezoar is reported. The various aetiological factors are discussed. The clinical features are not typical and small bowel obstruction can be initially recurrent until a complete intestinal occlusion. The diagnosis is not easy, and is nearly always made during urgent laparotomy. Surgical treatment consists of phytobezoar removal by enterotomy. The recognition of high-risk patients and their education to prevent phytobezoar are emphasized. PMID- 2761744 TI - [Intestinal invagination caused by multiple lipomas of the small intestine]. AB - A case of invagination caused by lipomatosis on a median loop of the small intestine is presented. Certain unusual features of the case--the rarity of the lesion and its location, the absence of symptoms before the occlusion occurred- are highlighted. PMID- 2761743 TI - [Intestinal occlusion caused by ileo-colic invagination in a patient with intestinal metastasis of melanoma]. AB - An unusual case of intestinal obstruction due to ileal metastatic melanoma is reported. An ileocolic intussusception led to intestinal obstruction. The patient underwent palliative surgery to re-establish intestinal continuity. PMID- 2761745 TI - [Spontaneous rupture of an aneurysm of the abdominal aorta in a jejunal loop]. AB - A case of spontaneous aorto-jejunal fistula treated successfully by surgical management is reported. Diagnostic and therapeutic features as well as the rarity of this uncommon complication of abdominal aortic aneurysms are underlined. PMID- 2761746 TI - [Type III entrapment syndrome of the popliteal artery. Presentation of a clinical case with diagnostic and therapeutic discussion]. AB - Following a short review of the various types of possible abnormalities in the popliteal artery entrapment syndrome, a case is presented which was misdiagnosed for more than 2 years. Problems concerning the differential diagnosis are discussed together with details of the surgical approach performed using the medial incision and the PTFE prosthesis. PMID- 2761747 TI - [Manometric evaluation of esophageal motor activity during diabetes mellitus]. AB - Intraluminal manometry was used to assess the motor activity of the oesophagus and upper (UES) and low (LES) oesophageal sphincter in 10 patients, 5 female and 5 male, average age 35.9 range 17-50, suffering from insulin-dependent diabetes mellitus. Non-invasive cardiovascular tests were also performed to evaluate autonomous neuropathy together with control tests of glyco-metabolic compensation (fructosamine and HbA1c). An increase in the basic tone of the UES was observed in 8 patients while in 3 this was associated with its incomplete release. Five patients evidenced aspecific motor disturbance such as spontaneous motor activity characterised by repetitive segmentary waves at times with biphasic appearance. IOS activity was within normal limits. It is considered that these disturbances may be attributable to the autonomous neuropathy that often complicates diabetes mellitus and that oesophageal motor disturbance, albeit aspecific, should be considered an early sign of autonomous neuropathy. It is therefore though that manometric oesophageal study may be considered a useful investigative tool for early evidencing of disturbances linked to autonomous neuropathy. PMID- 2761748 TI - [Gastric transit of a radiolabelled liquid meal in a group of patients with insulin-dependent diabetes mellitus]. AB - The functional alterations in the digestive tract observable during diabetes mellitus are frequent albeit often asymptomatic. They affect several different districts and are still not clearly defined aetiopathogenetically. It was therefore decided to evaluate the gastric transit times of a balanced liquid meal labelled with 99-Tc-colloidal sulphide in a group of patients suffering from insulin-dependent diabetes and in a group of 10 controls. The anatomical integrity of the oesophago-gastro-duodenal tract has been evaluated by endoscopy and histology. Transit times (T/2) proved significantly increased in diabetics (92.38 +/- 33.397 minutes) compared to the controls (48.63 +/- 16.423 minutes), p 0.001. No correlation was observed between gastric transit times, duration of the diabetic disease, degree of glyco-metabolic compensation and presence of autonomous neuropathy. PMID- 2761749 TI - [Connectivitis and diseases of the digestive system]. AB - Gastroenteric changes in patients suffering from connectivitis observed consecutively between 1977 and 1986 have been examined: of the 24 patients (20 f, 4 m) aged between 13 and 76 yrs observed, 12 suffered from rheumatoid arthritis, 8 systemic lupus erythematosus, 2 sclerodermia, 2 mixed connectivitis. 14 reported gastroenteric disturbances, particularly dyspepsia, rarely dysphagia, diarrhoea, melena. Gastroenteric lesions, gastroesophageal reflux, erosive oesophagitis, oesophageal diverticulum, congestive gastritis, duodenitis, duodenal ulcer, diverticular colonopathy were observed, confirming the frequency of gastroenteric changes in connectivitis. PMID- 2761750 TI - [Endoscopic gastric polypectomy. Evaluation of 5,492 endoscopies of the upper digestive tract]. AB - After a short introductory note on the incidence, classification and malignant potentiality of gastric polyps, according to the literature, the paper presents data on a six-year experience in gastric polypectomy involving 5942 endoscopies. The incidence of gastric polyps was 2.1%. Gastric polypectomy was performed on 84 patients with extirpation of 113 polyps. Assessments and comments are presented on the site, size, morphology, histological type, degree of dysplasia and degenerative potentiality of several types of gastric polyps. Gastric endoscopic polypectomy is a safe, economical, well-tolerated and valid methodology with considerable therapeutic possibilities and potential prophylactic actions against cancer. PMID- 2761751 TI - [Mid-term natural course in Naples of chronic HBeAg positive infection caused by the HB-virus. Prospective study, preliminary to antiviral treatment]. AB - 41 consecutively observed patients with chronic HB virus infection in replication phase (HBeAG positive) were followed up for an average period of 60 months with a view to evaluating the frequency of spontaneous HBeAg/anti-HBe seroconversion and the influence of the event on the clinical course of the liver disease. The 41 patients, of mean age 22 years, suffered from: 26 ECP, 7 ECA, 8 CIRR. 18 patients (41%) presented HBeAg/anti-HBe seroconversion with an annual percentage of 12%, all with stable normalisation of hepatic cytolysis tests. Factors related to HBeAg/anti-HBe seroconversion were: female sex, higher mean starting values of transaminase, positive history for EVA, absence of Virus Delta superinfection. The effectiveness of antiviral treatments will only be demonstrated when seroconversion (inhibition of viral replication) is produced much more frequently than that which occurs spontaneously. Candidates for current antiviral treatment are indicated. PMID- 2761752 TI - [Primary lymphoma of the stomach. Endoscopic study]. AB - Gastric lymphomas have been easier to diagnose since the introduction of digestive endoscopy combined with multiple target biopsy and possibly macrobiopsy. Personal experience of three primary non-Hodgkin lymphomas of the stomach is reported. Analysis of this endoscopic series reveals the multiplicity and polymorphism of the lesions that are never, in any cases, pathognomic of this pathology. PMID- 2761753 TI - [Menetrier disease. Clinico-pathologic study of a case]. AB - A classic case of Menetrier's disease in an adult male, diagnosed by histological examination of operative biopsy is reported. Stress is laid on the clinical aspects of the disease and on the histological aspects of that particular type of hyperplastic gastropathy that underlies it. Brief mention is also made of the states of pseudohyperplastic gastropathy that may represent a source of diagnostic confusion, particularly from the radiological viewpoint. PMID- 2761754 TI - [Gastroduodenal kinetic activity. Possible role of the duodenal bulb in controlling gastric emptying]. AB - The aim of the present study was to evaluate the gastro-duodenal motility coordination, both during the interdigestive phase and after antroduodenal volumetric stimulus. It has been proved that it is possible to evoke the peristaltic gastric activity by stretching the gastric walls. Thus, the Authors simulated the mechanical conditions of the meal by inflating air into the antrum. They studied 5 healthy volunteers, whose age averaged 43 +/- 22.85 years. A 120 cm probe provided with two balloons at 7 and 21 cm from the distal end, and with 7 open-tips for manometric recording, was positioned by endoscopic way. The Authors were able to evaluate the Motor Antral Threshold (i.e. minimum air volume able to evoke an antral motor reflex), obtained by means of the antral inflatable balloon. The average values of this threshold showed to be 35 +/- 5 ml of air. While keeping the duodenal balloon inflated, the repetition of volumetric antral stimulus did not show any Motor Antral Threshold. This threshold showed up again with similar volumes in every patient after deflating the duodenal balloon. The results obtained suggest the existence of a negative duodenal-antral feed-back control on gastric emptying. PMID- 2761755 TI - Meningococcal disease in Norway 1981-1982, with focus on severe septicemia and death. Epidemiological trends and relation of cases to some health service factors. PMID- 2761756 TI - Immunocytochemical indications for neuronal co-localization of GABA and aspartate in cultured neocortex explants. AB - The application of postembedding immunocytochemistry on serial semithin plastic sections, revealed the presence of gamma-aminobutyric acid (GABA)-positive and aspartate-positive neurons in cultured neocortex explants. GABA-positive neurons were found in all layers of the cultured cortex, whereas aspartate-positive neurons were mainly restricted to layer 6. Although exact quantification was not carried out because of the variability in aspartate immunoreactivity, colocalization of GABA and aspartate immunoreactivity could unambiguously be observed in a few neurons. PMID- 2761758 TI - Functional activity patterns in the forebrain of swimming rats: a 5 min 2 deoxyglucose study. AB - Effects of 5 min of swimming on functional activity patterns in the rat forebrain were examined by high resolution autoradiographic assessment of [14C]2 deoxyglucose ([14C]2-DG) uptake. In autoradiograms made from swimming rats, the isocortex displayed a columnar pattern in which columns of high optical density, oriented perpendicularly to the cortical surface, were separated by columns of low optical density of similar orientation. Increased [14C]2-DG uptake in swimming rats compared to resting rats was also apparent in the lateral septal nucleus, globus pallidus, and endopiriform nucleus. The results demonstrate that 2-DG can be used in short survival uptake experiments to gain insight into neuroanatomical patterns of functional activity. PMID- 2761757 TI - Autoradiographic localization of binding sites for vasotocin in the brain and pituitary of the sea bass (Dicentrarchus labrax). AB - Specific binding sites for vasotocin (VT) were detected in brain and pituitary of a teleost fish, the sea bass, after in vitro incubation of tissue sections with [3H]arginine-vasopressin (AVP) and light microscopic autoradiography. Conditions for the binding assay were optimized and as a result the binding was saturable and specific. In the brain [3H]AVP binding was found to occur in the pars lateralis and the pars ventralis of the ventral telencephalon, in the pars centralis of the dorsal telencephalon, in the hypothalamic region (especially in the nucleus preopticus, in the tuberal hypothalamus and around the posterior recess), in the tectum opticum and in the noncellular layer of the corpus cerebelli. In the pituitary a high density of [3H]AVP binding was observed in the areas of the pars distalis (PD) occupied by ACTH-, TSH- and GH-cells and also in the pars intermedia (PI). The present study presents the first anatomical evidence for the presence of VT specific binding sites in teleost brain and pituitary. PMID- 2761759 TI - Cold exposure or norepinephrine injections altered melatonin levels in the quail retina. AB - The possible involvement of ambient temperature and norepinephrine on daytime levels of retinal melatonin were investigated in quails. For a minimum of 1 week, experimental animals were housed under constant room temperature of 23 +/- 2 degrees C and a daily 12:12 h light-dark cycle with light on at 06.00-18.00 h. The quails were then transferred to a cold room of 4 degrees C and cold-exposed for 0, 30, 60, 90 and 120 min. Retina samples were subsequently collected at mid light for melatonin radioimmunoassay. An initial decline of melatonin was detected in the cold treated birds after 30 min of exposure. Thereafter prolongation of cold stimulation produced significant increases in the levels of retinal melatonin. In the second experiment, intra-peritoneal norepinephrine injections (0, 1, 10 and 100 micrograms/bird) at mid-light were found to increase the levels of retinal melatonin in quails. We postulate the cold-induced increase of retinal melatonin may be attributed to an augmented level of catecholamines released as a general neuroendocrine response to temperature decrements. PMID- 2761760 TI - Lithium discriminates between muscarinic receptor subtypes on guinea pig hippocampal neurons in vitro. AB - In CA3 pyramidal neurons of guinea pig hippocampal slices an outward current activated by the GABAB agonist, baclofen (0.3 microM, Ibac) was reduced by low concentrations of carbachol (Cch, 0.1-0.3 microM). The effect of Cch desensitized suggesting that the receptor subtype involved in this muscarinic effect of Cch was of the M1 subtype. The receptor subtype was also characterized by its equilibrium dissociation constant for pirenzepine (10 nM) as an M1 receptor. Li+ applied extracellularly (1 mM) or intracellularly blocked the suppression of Ibac by Cch without affecting the Cch blockade of a current termed IAHP, which is mediated by M2 receptors. While the effect of intracellular Li+ application was immediate, it developed very slowly with extracellular application. Since Li+ salts are used effectively in the treatment of mania and depression, the selective effect of Li+ on M1-mediated muscarinic neurotransmission might be important for the cholinergic hypothesis of affective disorders. PMID- 2761761 TI - Differential effects of phospholipase inhibitors in long-term potentiation in the rat hippocampal mossy fiber synapses and Schaffer/commissural synapses. AB - Bath application of the inhibitors of phospholipases, nordihydroguaiaretic acid (NDGA) and p-bromo-phenacyl bromide (BPB), to the rat hippocampal slices suppressed long-term potentiation (LTP) in Schaffer/commissural-CA1 pyramidal synapses. On the other hand, neither of the two inhibitors suppressed LTP in mossy fiber-CA3 pyramidal cell synapses. BPB did not suppress phosphatidylinositol-specific phospholipase C (PI-PLC) activity of the slices. These results suggested that the mechanisms of LTP were quite different in the CA1 and CA3 subfields of rat hippocampus: in CA1, the involvement of an arachidonate metabolism was strongly suggested, whereas in CA3, an arachidonic acid cascade may not be necessary for LTP. PMID- 2761762 TI - Electrophysiological evidence for terminal sprouting of locus coeruleus neurons following repeated mild stress. AB - To see if repeated mild stress causes plastic changes in central noradrenergic terminal axons, the density of terminal axons arising in locus coeruleus (LC) neurons of rats was quantified by antidromic stimulation technique. After the termination of stress treatments (immersion in warm water for 10 min daily) for 1 or 2 weeks, electrophysiological experiments were performed under urethane anesthesia. The frequency of LC neurons activated antidromically from the cerebral cortex increased in rats stressed for 2 weeks but not for 1 week. Since the increased frequency of antidromic responses was not due to a change in terminal excitability, the change observed here is considered to be morphological (terminal sprouting) rather than a physiological consequence. The results suggest that LC neurons dynamically alter their terminal morphology in response to environmental stimuli. PMID- 2761763 TI - Tooth pulp stimulation advances both medullary off-cell pause and tail flick. AB - It has been postulated that the so-called off-cells of nucleus raphe magnus and adjacent structures in the rat are the output elements of a system which inhibits nociceptive transmission at the spinal cord. Off-cells stop firing about 0.4 s before the tail flick reflex (TF) elicited by the application of noxious heat to the tail. When continuous off-cell activity is induced by either morphine injection or periaqueductal gray stimulation, the TF is delayed. The present results show that electrical stimulation of the tooth pulp (TP) causes the off cells to stop firing. Furthermore, when TP is stimulated during tail heating and before the expected time for TF, off-cells stop firing earlier and the TF occurs also earlier. This supports the notion that off-cells inhibit nociceptive transmission. PMID- 2761764 TI - Modulation of an inhibitory reflex in single motor units in human masseter at different joint angles. AB - The inhibitory reflex evoked in single units in human masseter by lip stimulation was recorded at several joint angles. The pre-stimulus firing frequency of the unit was kept constant. Some modulation of the inhibitory response at different vertical jaw positions (i.e. temporomandibular joint angle) was observed in most masseter units, with the majority of the modulated units being inhibited less when the teeth were closer together. PMID- 2761765 TI - Lesions of the inferior olive do not affect long- or short-term habituation of the acoustic startle response in rats. AB - Short- and long-term habituation of the acoustic startle response were assessed in a group of inferior olive-lesioned rats. Neither short- and long-term habituation, nor the performance of the reflex, were affected by the lesion. Since the cerebellar vermis is essential for long-term habituation of this reflex, we suggest that climbing fibres are not involved in this form of learning, which would therefore be mediated by the other cerebellar input, presumably the mossy fibres. PMID- 2761766 TI - Transplantation of immature murine brain tissue into the anterior eye-chamber of adult rats. AB - Embryonic mouse hippocampi (E17) were placed in the anterior eye chamber of young adult rats. The transplants were photographed twice a week. Initially the transplants increased in size, thereafter focal bleeding occurred and later regression of the transplants was seen. Regression continued until the transplants were no longer macroscopically visible. At this time the eyes were prepared for histological examination. Comparison of these transplants with immature rat hippocampi transplanted to the anterior eye chamber of rats, and with mouse-rat in vitro co-cultures suggests that the regression is a result of an immunological response. PMID- 2761767 TI - Hyperbaric pressure depresses potentiation of polysynaptic medullospinal reflexes in newborn rats. AB - Hyperbaric pressure induces hyperexcitability and convulsions in intact animals by mechanisms that are not understood. In the present experiments we examined the effects of pressure on medullospinal reflexes and synaptic interactions in the vitro brainstem-spinal cord of newborn rats. Reflex activity was recorded extracellularly from the cut ventral root of the 1st cervical nerve; the Vth and Xth cranial nerves were stimulated. Exposure to pressure of 10.1 MPa increased the amplitude and duration of individual reflex responses. Hyperbaric pressure inhibited post-tetanic potentiation, reduced recovery time and decreased the marked heterosynaptic potentiation caused by Vth nerve stimulation on the Xth nerve reflex. Xth nerve stimulation caused weak heterosynaptic potentiation of the Vth nerve reflex and was not affected by pressure. In contrast to crustacean neuromuscular junction, hyperbaric pressure in the mammalian central nervous system enhanced single polysynaptic responses but depressed frequency-dependent potentiation of medullospinal reflexes. PMID- 2761768 TI - The effect of chronic ethanol consumption on [14C]deoxyglucose uptake in rat brain in vivo. AB - The uptake of [14C]deoxyglucose by brains of rats that were given alcohol in drinking water for 7 months was investigated. There was a general, approximately 50%, increase in deoxyglucose uptake in brains of ethanol-treated rats with areas of the limbic system being particularly affected. PMID- 2761769 TI - Visual responses of sheep temporal cortex cells to moving and stationary human images. AB - Single-cell extracellular recordings were made from temporal cortical neurones in the conscious sheep. The visual responses of these cells to stationary or moving images of humans were investigated. Results from 6 animals showed that a small population of cells responded preferentially to the sight of humans as opposed to other objects or food. These cells did not respond to visual images of the human face, or to individual body parts (legs or arms) or to the smell of a human. The majority of cells showed direction selectivity, with the most effective stimulus being a human moving towards the animal. Cells did not respond differentially to the front and back view of a human although the side view was less effective. The posture adopted by the human was important, since responses were diminished or absent if the human adopted a quadrupedal as opposed to the normal bipedal posture. These results provide evidence for integrated neural processing of both visual recognition, movement and posture in the sheep temporal cortex. PMID- 2761770 TI - Well-maintained responses of acetylcholine release and blood flow in the cerebral cortex to focal electrical stimulation of the nucleus basalis of Meynert in aged rats. AB - Responses of extracellular acetylcholine (ACh) release and blood flow in the cerebral cortex in the parietal lobe following focal electrical stimulation of the nucleus basalis of Meynert (NBM) ipsilateral to the parietal cortex were compared in healthy adult (6-8 months) and aged (27-28 months) Fischer-344 rats anesthetized with halothane. The focal electrical stimulation of the NBM produced an increase in the ACh release and blood flow in the parietal cortex in both the adult and aged rats. The increased responses of ACh and blood flow observed in the healthy, adult rats were well maintained in the aged rats. PMID- 2761772 TI - Tacrine slows the rate of ageing of sarin-inhibited acetylcholinesterase. AB - Bovine erythrocyte acetylcholinesterase was inhibited by the organophosphate sarin, and the rate of ageing (the time-dependent decrease in the ability of an oxime to reactivate the enzyme) was studied. At pH 7.0 and 37 degrees C, 10(-5) M or 10(-6) M tacrine (tetrahydroaminoacridine) decreased the rate of ageing in low ionic strength buffer. Tacrine at 10(-5) M also significantly decreased the rate of ageing in 150 mM NaCl. The results indirectly demonstrated that the inhibition of substrate hydrolysis by tacrine is reversible, and that tacrine does not prevent reactivation of sarin-inhibited acetylcholinesterase. Both these observations, which were also made for rat brain acetylcholinesterase, are in contrast with reports in the literature. PMID- 2761771 TI - Somatodendritic release of endogenous dopamine: in vivo dialysis in the A10 dopamine region. AB - Using in vivo dialysis in the A10 region of the anesthetized rat, somatodendritic release of endogenous dopamine was demonstrated. Although endogenous dopamine release from the A10 region was enhanced by amphetamine pretreatment in a dose related manner, the amount of dopamine released was markedly less than the axonal release of dopamine measured simultaneously in the nucleus accumbens. PMID- 2761773 TI - In vivo release of cholecystokinin-like immunoreactivity in rat frontal cortex under freely moving conditions. AB - Release of cholecystokinin-like immunoreactivity (CCK-LI) was measured in rat medial prefrontal cortex in vivo by brain dialysis and enzyme immunoassay under freely moving condition. Perfusion of 50 mM K+ resulted in the increase of CCK-LI in the dialysate. The data on high-performance liquid chromatography (HPLC) of the dialysate showed that the increase of the CCK-LI was mainly due to the increase of CCK octapeptide sulfate itself. In the preliminary experiments, we applied this brain dialysis method for determination of CCK-LI release with drug treatment. After treatment with sulpiride (i.p.), a D2 dopamine receptor antagonist, a significant increase of CCK-LI was observed, indicating that this brain dialysis technique is applicable to detect change in the level of CCK-LI release after a certain drug treatment. PMID- 2761774 TI - Methoctramine and hexahydrodifenidol antagonise two muscarinic responses on the rat superior cervical ganglion with opposite selectivity. AB - Two novel muscarinic antagonists, methoctramine and hexahydrodifenidol, have been assessed for their action against two muscarinic agonist-induced responses on the rat superior cervical ganglion in vitro. DC recordings were made between the desheathed ganglion and its internal carotid nerve using the grease-gap technique. Hexahydrodifenidol and methoctramine antagonised the muscarine-induced M1-mediated depolarisation of this preparation with estimated pA2 values of 7.5 and 6.5, respectively. In 0.3 microM pirenzepine and 0.1 mM CaCl2, 1 microM muscarine evoked a hyperpolarisation mediated by cardiac-like M2 receptors. Hexahydrodifenidol and methoctramine antagonised this response with pIC50 values (-log10IC50) of 5.7 and 7.4, respectively. The selectivity of methoctramine for cardiac-like M2 receptors over M1 receptors is therefore confirmed and extended to these two neuronal responses. The selectivity of hexahydrodifenidol was opposite to, and greater than, that seen with methoctramine. PMID- 2761775 TI - Induction of stress protein HSP70 in nerve cells after status epilepticus in the rat. AB - The accumulation of the stress protein HSP70 was found to be an excellent marker for prolonged seizure related metabolic activity of neurons. After kainic acid (KA) induced status epilepticus we observed HSP70 immunoreactivity in the hippocampal CA4 and CA1 sectors, the subiculum, the basolateral and the lateral nuclei of the amygdala, the mediodorsal nucleus of the thalamus, the caudal part of the striatum, the claustrum and in neurons of certain neocortical areas. HSP70 positive nerve cells appeared normal in conventional histological stains. Conversely, degenerating neurons (e.g. in the hippocampal CA3 sector) remained unlabeled. PMID- 2761776 TI - Behavioral and neurochemical modifications induced by apomorphine treatment. AB - By means of quantitative receptor autoradiography, the modifications of dopamine (DA) receptors in selected target regions of A9 and A10 DA neurons were studied after chronic apomorphine treatment, at a dosage able to induce behavioral changes that are claimed to be due to the activation of the target areas of A9 neurons. An increase in [3H]spiperone binding sites (cold (+)-butaclamol) was observed in the dorsal and ventrolateral striatum, receiving fibers from A9 neurons, while there were no changes in the ventromedial and ventrocentral striatum, in the nucleus accumbens and in the cerebral cortex receiving fibers from A10 neurons. Our results suggest that the anatomical division of the DA target regions corresponds with a functional one. PMID- 2761777 TI - Sucrose octaacetate-taster mice have more vallate taste buds than non-tasters. AB - Taste buds were counted in two strains of mice which have been characterized in terms of their taste avoidance of the bitter-tasting substance, sucrose octaacetate (SOA). One strain (SWR/J) avoids SOA and is referred to as "taster' while the other strain (C57BL/6J) does not avoid SOA at the same concentration and is termed "non-taster'. The taster-strain contains a significantly greater number of taste buds in its vallate papillae than the non-tasters do. The relative number of taste buds which individual mice and humans possess probably contributes to the relative differences in their sensitivity and preference behaviors. PMID- 2761778 TI - Striatal neurons with aromatic L-amino acid decarboxylase-like immunoreactivity in the rat. AB - We found in the adult rat that a small number of striatal neurons showed aromatic L-amino acid-like immunoreactivity. These neurons had a cell body with 10-20 microns diameter and several spiny dendrites, and were distributed throughout the striatum (the caudate nucleus and putamen) without any particular topography. The number of these neurons was increased on the side ipsilateral to an electrothermic or 6-hydroxydopamine-induced lesion which had been placed in the midbrain regions around the substantia nigra pars compacta. PMID- 2761779 TI - Baclofen antagonism by 4-amino-3-(5-methoxybenzo[b]furan-2-yl) butanoic acid in the cat spinal cord. AB - When administered microelectrophoretically, 4-amino-3-(5-methoxybenzo[b]furan-2 yl)butanoic acid (MBFG) reversibly reduced the presynaptic depression by (-) baclofen of the monosynaptic excitation of spinal interneurones by impulses in muscle low-threshold afferent fibres of the cat as well as the postsynaptic depression by (-)-baclofen of the firing of these neurones. MBFG, as an antagonist of (-)-baclofen, may be useful in investigating the structure-activity relationships of central and peripheral baclofen receptors. PMID- 2761780 TI - Comparison through immunoblotting of glutamic acid decarboxylase (GAD) from newborn and adult rat brain. AB - Immunochemical characterization of glutamic acid decarboxylase (GAD) from brain extracts of newborn and adult rats was investigated using a GAD antiserum that was previously raised against brain GAD from adult rats. According to the immunoprecipitation and saturation curves, no significant differences could be found as to the recognition of newborn and adult GAD by the antiserum. On immunoblots, both extracts revealed the same two immunolabelled bands (mol.wt. 59,000 and 62,000 +/- 2000 Da). In both cases, the lightest band showed the strongest staining. Quantitative analysis of the immunolabelling indicated that each immunolabelled band was enriched about 10-fold in the adult brain extract. These data did not reveal any difference between newborn and adult GAD that was reminiscent of the difference found in an earlier study between GAD from lower and higher vertebrates. Whatever the regulatory mechanism responsible for the presence of two forms of GAD in the adult brain, it is already fully operative in newborn animals. PMID- 2761781 TI - Kainic acid inhibits cholecystokinin release from rat hippocampal slices. AB - Antagonistic interactions between cholecystokinin (CCK) and nanomolar concentrations of kainic acid (KA) have been reported in area CA3 of the rat hippocampal slice. This study tested the possibility that kainic acid inhibits the release of CCK. Elevated K+ was found to release CCK from hippocampal slices in a Ca2+-dependent manner. KA, at concentrations as low as 100 nM, inhibited this release by about one-third. Because CCK appears to exert a net inhibitory effect on the firing of CA3 pyramidal cells, the epileptogenic action of KA may be explained, in part, by the depression of CCK release. PMID- 2761782 TI - Aging does not alter cytosolic calcium levels of cortical synaptosomes in Fischer 344 rats. AB - Several lines of experimental evidence support an association between altered Ca2+ regulation and aging. It has been supposed that free cytosolic Ca2+ concentrations ([Ca2+]i) may decrease or increase in aged animals. In this study, both resting and KCl-stimulated [Ca2+]i were measured in purified cortical synaptosomes from young (3 mo.), middle-aged (12 mo.), and old (24 mo.) Fischer 344 rats. Two additional groups of rats were included, one middle-aged and one old which were trained on a treadmill for 6 months prior to experimentation. The [Ca2+]i was determined using the fluorescent Ca2+ chelator fura-2. Net KCl dependent changes (delta K) in [Ca2+]i were determined by the difference between stimulatory (100 microM Ca2+/60 mM KCl) and resting (100 microM Ca2+/5 mM KCl buffer) conditions among the 3 age groups. Significant increases in [Ca2+]i were observed in each age group upon depolarization with 60 mM KCl. However, there were no significant age-dependent differences in either resting [Ca2+]i or KCl stimulated [Ca2+]i. PMID- 2761784 TI - Significance of shape and size of the stimulating coil in magnetic stimulation of the human motor cortex. AB - Three different stimulating coil designs were evaluated for magnetic motor cortex stimulation by comparing threshold stimulus intensities at different sites over the scalp for exciting upper and lower limb muscles. Little difference was found between stimulation characteristics of two circular coils of different size, the smaller coil delivering slightly more focal stimuli. A twin coil composed of two single circular coils in series arranged side-by-side, produced significantly more powerful and more focal stimuli. It proved to be superior for exciting the leg muscles, in that less output energy was needed. For all coils, the orientation of the inducing current over the presumed motor area was the most critical stimulation parameter, and a sagittal current in anterior direction or coronal towards the stimulated hemisphere was optimal for the upper limb or lower limb muscles, respectively. PMID- 2761783 TI - Class II antigen expression on human cultured Schwann cells from patients with Charcot-Marie-Tooth disease. AB - T lymphocytes control the extent of the immune reaction by recognizing the antigen in connection with class II histocompatibility surface molecules, coded by genes located on the HLA-D locus. The expression of HLA-DR antigens is confined to a few antigen presenting cells, like lymphocytes and macrophages, which can therefore induce the initial phase of the immune reaction. We report that also Schwann cells (SC) from patients with Charcot-Marie-Tooth disease (CMT), an hereditary disorder of the peripheral nervous system, are able to express HLA-DR antigens. Human SC cultures were carried out from sural nerve biopsies of CMT and normal control cases. Cultures were tested on day 7, 14, 21 and 28, with double immunofluorescence technique using rabbit antiserum anti-S 100 and mouse anti-HLA-DR monoclonal antibody. SC from CMT were HLA-DR positive since the first few days, continuing to express class II antigens for all the duration of the culture. The presence of class II antigens on cultured SC from CMT disease suggests that immune-mediated mechanisms may be relevant in the pathogenesis of this degenerative disorder of the peripheral nervous system. PMID- 2761785 TI - Neocortical transplants grafted into the newborn rat brain demonstrate a blood brain barrier to macromolecules. AB - Vascular permeability was examined in fetal neocortical transplants grafted into the cerebral cortex of newborn rats. Methods based on the histochemical labeling of intravenously administered horseradish peroxidase or on the immunocytochemical demonstration of endogenous immunoglobulin showed the presence of a blood barrier within the transplants. PMID- 2761786 TI - Extracellular space in the developing retina assessed by electron microscopy: laminar and topographic distribution. AB - The extent of extracellular space (ECS) in the developing retina of the cat has been measured by electron microscopy in material fixed using techniques developed by others to preserve ECS. ECS is generally greater in foetal than in adult material. It is particularly marked in the plexiform layers of retina at the time of synaptogenesis and in the axon layer at the time of axon growth. The changes in ECS occur first in the central retina, and spread to the periphery. These observations suggest that the high volumes of ECS found in the foetus are not artefactual, but accompany and may play a role in developmental processes. PMID- 2761787 TI - Low uptake of [3H]2-deoxy-D-glucose by cultured rat Schwann cells. AB - [3H]2-Deoxy-D-glucose (2-DG) was used to investigate the glucose uptake in cultured rat Schwann cells from postnatal Sprague-Dawley rat sciatic nerves. The glucose uptake of Schwann cells slightly increased in a time- and dose-dependent manner. However, the maximal uptake level was much lower than that of ethylnitrosourea (ENU)-induced transformed rat schwannoma-like cells and fibroblasts. By autoradiography of the cultured system, we were able to visualize the accumulation of [3H]2-DG grains in the schwannoma-like cells and fibroblasts, but not in Schwann cells. PMID- 2761788 TI - Adrenergic neurons in the nucleus tractus solitarius receive GABAergic synapses. Demonstration by dual immunocytochemistry in the rat. AB - By means of a dual immunocytochemical labeling for phenylethanolamine-N methyltransferase and glutamate decarboxylase, synaptic associations between adrenaline-synthesizing neurons and GABAergic terminals are demonstrated in the medial nucleus tractus solitarius of the rat. These relationships could constitute an anatomical substrate for the presumed role of GABA in modulation of baroreceptor reflexes at this level. PMID- 2761789 TI - Immunocytochemical localization of cell adhesion molecule L1 in developing rat pyramidal tract. AB - L1 is a representative of a family of carbohydrate neural cell adhesion molecules. The expression of L1 was studied during postnatal development of the rat pyramidal tract by immunohistology using polyclonal antibodies to L1 in spinal cord cervical intumescences. On postnatal day 1 (P1), L1 immunoreactivity was present in the entire dorsal funiculus, consisting of the ascending fasciculus gracilis and fasciculus cuneatus and the descending pyramidal tract. At that time the cervical pyramidal tract contains the first outgrowing corticospinal axons. At P4 both the fasciculus gracilis and the pyramidal tract are immunoreactive whereas the fasciculus cuneatus is negative. At P10 the pyramidal tract is intensely labelled whereas both ascending bundles are negatively stained. In the period between P4 and P10 the pyramidal tract is characterized by a massive outgrowth of corticospinal axons. During pyramidal tract myelination, between P10 and the end of the third postnatal week (P21), L1 immunoreactivity is progressively reduced. These observations suggest that L1 may play a prominent role in outgrowth, fasciculation and the onset of myelination of rat pyramidal tract axons. The differential L1 immunoreactivity of the pyramidal tract and the earlier developing ascending systems in rat dorsal funiculus indicate that this polyclonal antiserum is a useful differentiating marker for outgrowing fibre tracts. PMID- 2761790 TI - Ultrastructural correlates of functional relationships between nigral dopaminergic or cortical afferent fibers and neuropeptide Y-containing neurons in the rat striatum. AB - This study examines the ultrastructural relationships established by the nigrostriatal dopaminergic and the corticostriatal afferent fibers with neuropeptide Y (NPY)-containing neurons in the rat striatum. By means of dual immunolabeling procedures using peroxidase conjugated F(ab) fragments and 125I labeled protein A, direct appositions and morphologically defined synaptic contacts of the symmetrical type were visualized between tyrosine hydroxylase labeled nerve terminals and NPY-labeled neurons. After deafferentation of the striatum from its cortical input direct appositions and asymmetrical synaptic contacts were evidenced between characteristic degenerative boutons and NPY positive neurons in the striatum. These results suggest that striatal NPY interneurons undergo direct influence from both nigrostriatal dopaminergic and corticostriatal neuronal systems. PMID- 2761791 TI - Nursing documentation: a new prospective. PMID- 2761792 TI - The write content: a guide for revising and grading texts and manuscripts. AB - Your writing should reflect the way you think and work and should, therefore, be in accordance with the requirements of the scientific method. The WRITE CONTENT lists nine desirable features of scientific writing along with descriptions of how they are facilitated in the writing process. Assembled in checklist form, these features become the criteria that can guide composition and evaluation. PMID- 2761793 TI - Academic credit for experiential learning. AB - If the formal education process is to be relevant to adult nursing students, their life experience should be acknowledged. Of particular significance is determining how prior life experiences have produced outcomes in the adult nursing student equivalent to what is expected in the nursing education program. The author discusses how to assess experiential learning for academic credit. PMID- 2761794 TI - Enhancing the educational benefits of collaborative research. AB - Careful planning for student involvement in collaborative research will greatly enhance the potential for teaching and learning. Active participation by students as contributing members of the research team results in an increased understanding of the research process and of content related to the research question. Students also profit from the teamwork involved. The authors offer practical suggestions for maximizing student involvement at each stage of the research project. PMID- 2761795 TI - A mini publication workshop for students. AB - A mini workshop on publishing is one teaching strategy that has been successfully used to teach a research class how to disseminate research findings. By taking students step by step through the publication process, using specific examples from faculty members' publishing experiences, some of the mystery behind publishing is lifted. Also, nursing students become more confident in their own ability to publish manuscripts. PMID- 2761796 TI - Reducing the barriers to RN educational mobility. AB - How can the needs of RN students be met without compromising the quality of the educational experience? The model of flexible clinical scheduling described here has built-in safeguards to preserve quality and promote flexibility. The author discusses the benefits for both students and faculty. PMID- 2761797 TI - The nursing shortage--what is the nurse educator's role? PMID- 2761798 TI - Enhancing the image of nursing through the care plan. AB - As nurses, we know that the liberal arts are integrated into our professional studies. But how can this be conveyed to our academic peers as well as the public? The author discusses a novel use of the nursing care plan to show nonnurses the breadth and scope of professional nursing. The setting was a national conference of professional and liberal arts educators, and the nursing care plan was presented as a teaching tool. The results were exhilarating. PMID- 2761799 TI - AIDS education and training centers. PMID- 2761800 TI - Customer relations training: long term impact on staff's behaviors. PMID- 2761801 TI - A feminist perspective on nursing education. AB - Models of nursing education that mirror the human, caring side of nursing that we expect students to put into practice in the clinical arena are needed in the classroom. In that interest, the authors explore the relationship between feminism and nursing education and outline the characteristics of a nursing education process based on feminist principles and values. PMID- 2761802 TI - Neurological investigations. PMID- 2761803 TI - Surgery for epilepsy. PMID- 2761804 TI - Cerebrovascular accidents. PMID- 2761805 TI - Community care of a patient with multiple sclerosis. PMID- 2761806 TI - Catching the boomerang. PMID- 2761807 TI - Education in neurological nursing. PMID- 2761808 TI - Continuing education. PMID- 2761809 TI - Preparing children for admission to hospital. PMID- 2761810 TI - Assessing patients with leg ulcers in the community. PMID- 2761811 TI - The nursing care of children undergoing craniotomy. PMID- 2761812 TI - Motor neurone disease. PMID- 2761813 TI - ENT nursing. The removal of foreign bodies. PMID- 2761814 TI - Opportunities in ENT nursing. PMID- 2761817 TI - Community patients' toilet needs. PMID- 2761816 TI - Congenital oesophageal abnormalities. PMID- 2761815 TI - The patient with hearing impairment. PMID- 2761818 TI - Feminine hygiene. PMID- 2761819 TI - Documentation in operating theatres. PMID- 2761820 TI - Sleep deprivation in critically ill patients. PMID- 2761821 TI - Management of drug abuse. PMID- 2761822 TI - Care after laryngectomy. PMID- 2761823 TI - Cardiac nursing: children undergoing cardiac surgery. PMID- 2761824 TI - Cardiac nursing: signs of neonatal heart disease. PMID- 2761825 TI - Cardiac nursing. PMID- 2761826 TI - Cardiac nursing: cardiac catheterisation. PMID- 2761827 TI - Cardiac nursing: nursing assessment following cardiac resuscitation. PMID- 2761828 TI - The nurse's role in ethical decisions. PMID- 2761829 TI - Sensory deprivation in the ICU. PMID- 2761831 TI - Elderly people. PMID- 2761830 TI - Cardiac nursing: diet and heart disease. PMID- 2761832 TI - Elderly people: accidental hypothermia. PMID- 2761833 TI - Elderly people: nutrition and the elderly. PMID- 2761834 TI - Elderly people: metabolic bone disease. PMID- 2761835 TI - Elderly people: incontinence. PMID- 2761836 TI - Elderly people: the older stoma patient. PMID- 2761837 TI - Elderly people: the older patient in ICU. PMID- 2761838 TI - Total abdominal hysterectomy. PMID- 2761839 TI - Elderly people: normal ageing. PMID- 2761840 TI - Elderly people: depressive illness in the older person. PMID- 2761841 TI - Respiratory and thoracic nursing. PMID- 2761842 TI - Respiration: politics in the air? PMID- 2761843 TI - Respiration. Asthma: the Orem self-care nursing model approach. PMID- 2761845 TI - Removal of the spleen. PMID- 2761846 TI - Respiration: respiratory investigations. PMID- 2761844 TI - Family participation in the care of central venous lines. PMID- 2761847 TI - Respiration: pulmonary tuberculosis. PMID- 2761848 TI - The newborn. Early days. PMID- 2761849 TI - The newborn. Normal abnormalities. PMID- 2761851 TI - Management of cavity wounds. PMID- 2761850 TI - Infant feeding. PMID- 2761852 TI - The causes of neonatal jaundice. PMID- 2761853 TI - Treatment of alcohol problems. PMID- 2761854 TI - Care of the nappy area. PMID- 2761855 TI - Neonatal nursing. PMID- 2761858 TI - Blood investigations. PMID- 2761856 TI - Management of anaemia. PMID- 2761857 TI - Haematology opportunities. PMID- 2761859 TI - Initial treatment of burns. PMID- 2761860 TI - Defend the caring aspects of nursing. PMID- 2761861 TI - Nursing a patient with rabies. PMID- 2761862 TI - Multiple myeloma. PMID- 2761863 TI - Blood transfusions. PMID- 2761864 TI - Strategies for preventing thromboembolism in patients with acute myocardial infarction. PMID- 2761865 TI - Cocaine. PMID- 2761866 TI - Full dose subcutaneous heparin therapy. AB - Anticoagulation is used extensively for the treatment and prevention of thromboembolic disease. Full dose anticoagulation with heparin is usually administered intravenously via continuous 24-hour infusion to avoid complications with intermittent intravenous administration. Continuous intravenous therapy is costly and cumbersome for nurses and patients. Subcutaneous administration of heparin in full dosage offers an attractive therapeutic alternative. This study examines the safety, efficacy, and cost considerations of this form of therapy. Fifteen patients admitted to the hospital for myocardial infarction were evaluated. After the patients were transferred from the cardiac intensive care unit, intravenous heparin was discontinued, while therapeutic anticoagulation was maintained via the subcutaneous route. Complications were limited to local hematoma formation. A cost comparison revealed substantial savings with subcutaneous administration. PMID- 2761867 TI - A proposal concerning products liability. PMID- 2761868 TI - The prima facie tort rule: a possible medical-legal answer to the medical malpractice crisis. PMID- 2761869 TI - Nonfatal pulmonary edema following cocaine smoking. PMID- 2761870 TI - Chest wall deformity following expansion of irradiated soft tissue for breast reconstruction. PMID- 2761871 TI - Psoas abscess in the neonate. PMID- 2761872 TI - Pulmonic valve replacement for pulmonic insufficiency one year after mitral valve replacement. PMID- 2761873 TI - New York State's do-not-resuscitate law. PMID- 2761874 TI - The do-not-resuscitate law. PMID- 2761875 TI - The response to treatment with pituitary growth hormone: the New Zealand experience. AB - Ninety-four growth hormone deficient New Zealand children were treated with thrice weekly intramuscular injections of human pituitary growth hormone (GH) from 1979 to 1985 and the results from 43 children were analysed in detail. Their height velocity was mean (SD) 4.0 (1.9) cm/yr immediately prior to treatment and 8.5 (3.1) cm/yr in the first year of treatment. In each of the first three years of treatment the height velocity was significantly increased (p less than 0.001), but there was a significant decline in height velocity between the first and second, and second and third years. Nevertheless each year of treatment gave a highly significant gain in relative height. Bone age did not advance more rapidly than chronological age during the first two years of treatment, but did so subsequently. The response to GH, as assessed by the increase in relative height, was negatively correlated with the relative height at the start of treatment and with the maximum pretreatment plasma GH response to insulin hypoglycaemia. There was no correlation with pretreatment relative height velocity or aetiology of GH deficiency. Height velocity improved in five of 14 children treated with thyroxine after starting GH. Discontinuation of GH for one year in 34 children resulted in a highly significant reduction in growth rate from 7.5 (2.4) cm/yr to 2.5 (2.0) cm/yr, however four prepubertal children continued to grow at a rate exceeding 4 cm/yr. PMID- 2761877 TI - Tobacco advertising--why the fuss? PMID- 2761876 TI - Vitamin B12 concentrations in the elderly: a regional study. AB - A prospective study of 100 subjects over 70 years of age residing in rest homes or geriatric wards within the Auckland region showed that 23% of the population sampled had a serum vitamin B12 concentration below the reference range. Less than half (48%) of the group with a reduced serum vitamin B12 concentration had other haematological findings on initial screening suggestive of megaloblastosis. Comparative data from hospital and community based laboratories demonstrated that 20% and 29% respectively of samples from individuals aged greater than 70 years referred for serum vitamin B12 analysis had a B12 concentration below the reference range. Reduced serum vitamin B12 abnormalities in elderly individuals should not be ignored and some guidelines for investigations with which to establish a diagnosis are presented. PMID- 2761878 TI - Resuscitation skills of first year postgraduate doctors. AB - The resuscitation skills of twenty seven doctors in their preregistration year were examined using a series of mock clinical scenarios and theoretical testing. All failed to reach basic life support standards of the American Heart Association and major deficiencies were revealed in the provision of ventilatory support, pharmacological therapy and the use of resuscitation equipment. Specific educational deficiencies that were apparent included: (1) early initial training without subsequent revision or testing; (2) the inadequate gaining of practical skills and equipment familiarity during the trainee intern and first year house officer years; and (3) an ill defined curriculum of emergency care that was fragmented between specialties and between lay and medical teachers. PMID- 2761879 TI - Antibiotic therapy costs. AB - The total cost of antibiotics, rather than acquisition costs alone was estimated. Preparation and administration costs, laboratory and monitoring costs, and labour costs are considered separately for the major antibiotics used within Christchurch Hospital. The oral route of antibiotic administration is by far the cheapest. The cost of infusion therapy compared with an IV push is considerable. This added about +15-+30 in equipment costs and another +20-+30 in labour costs and often constituted over 50% of the total cost of therapy. The cost of adverse reactions and differences in efficacy should ultimately be included but it was impossible to quantitate these factors in terms of absolute costs. Acquisition costs alone are a poor guide to the true costs of therapy. The cost of administering the drug should be considered in the contexts of efficacy, toxicity and impact on the environment. We contend that these considerations should be implied to the overall impact on the hospital budget, rather than the pharmacy costs alone. PMID- 2761880 TI - Hypertension registers in general practice: levels of control and nondrug management. AB - Sixty-five general practitioners throughout Northland agreed to establish and maintain hypertension registers for a three year trial period beginning in 1982. Opportunistic blood pressure screening was undertaken of all patients aged 20-69 attending practices for whatever reason. Patients with an average of six readings on at least three separate occasions which exceeded WHO criteria for hypertension (diastolic blood pressure greater than 95 mmHg and/or systolic blood pressure greater than 160 mmHg) were entered onto the registers as were patients already receiving antihypertensive drugs. In all 3703 patients were registered. The percentage exceeding WHO criteria fell from 49.4% to 38.8% for those followed up for twelve months and from 48.6% to 34.5% for those followed up for twenty-four months. The percentage with diastolic blood pressure less than 90 mmHg increased significantly for each follow up group and with length of follow up. Overall 8.2% at entry were managed without drugs, for those followed up for thirty months this fell to 6.2% with individual practice percentage varying from nil to over twenty. There appears scope to manage between 10-20% of hypertensives without drugs. PMID- 2761881 TI - Prepaid health care in general practice: acceptability and effect on utilisation. AB - A prepaid child health scheme was offered to the patients of a rural practice in January 1988. The acceptability of the scheme was monitored in terms of entry and exit rates. The effectiveness of the scheme was measured in terms of its effect on the rates of consultation for acute illness and prevention, and the cost of the scheme to the practice and to patients was assessed. The scheme reduced the annual cost of general practice services for those children enrolled in the scheme by $73.68. There was no evidence that the scheme improved access for the low users of child health care. The scheme was a financial loss for the practice. PMID- 2761882 TI - Alternative medicine a cruel hoax--your money and your life? PMID- 2761883 TI - Physiotherapists--a professional body. PMID- 2761884 TI - Rehabilitation information after total hip replacement. PMID- 2761885 TI - Deaths to the elderly in residential institutions due to major fires. PMID- 2761886 TI - Fulminant delta hepatitis in a young Samoan. PMID- 2761887 TI - General practitioners fees for children. PMID- 2761888 TI - Variability in antihypertensive drug costs. PMID- 2761889 TI - Cervical cancer in Pacific Island Polynesians. PMID- 2761890 TI - Temporary artery biopsy in suspected temporal arteritis: a five year survey. AB - A retrospective five year review of 75 patients hospitalised in Middlemore Hospital, Auckland, who underwent temporal artery biopsy shows that the procedure was performed without complications and that the result could significantly alter patient management. Patients biopsied were all 50 years or older, predominantly female (77%) and caucasian (90%). Biopsies were positive in 14 patients (18.7%). Polymyalgia was present in 64% in both biopsy positive and negative groups. Visual disturbance was more frequent in the biopsy positive group (43% versus 21%) but not statistically significant. Jaw claudication and abnormalities of the temporal artery on examination were significantly more frequent in the biopsy positive group. Final diagnoses included 16 with temporal inflammatory polyarthritis, and 4 with malignant disease. As a result of a negative biopsy corticosteroids were stopped in 13 patients, reduced in dose in 5 patients, and begun in low dose in 7 patients. PMID- 2761891 TI - Does autonomic neuropathy in diabetes cause hearing deficits? AB - This study examined the effect of autonomic neuropathy on hearing in diabetes mellitus. Twelve diabetics with autonomic neuropathy and eleven healthy controls were examined for hearing loss using standard audiological tests. Several subjects in both groups had some abnormal hearing tests, but the incidence was no greater in the diabetic group. No group trends were apparent. Diabetic autonomic neuropathy is unlikely to be associated with hearing deficits. PMID- 2761892 TI - User pays in the mental health service--256 discharges from Ashburn Hall. AB - A retrospective descriptive analysis was undertaken on all patients discharged from Ashburn Hall over a 14 month period. The sample of 256 patients was found to have a female to male ratio of 6:4 and contained 4.3% of individuals without school certificate (cf 48.3% national statistics) and 23% with a university degree or diploma (cf 13.2% in the general population). Seventy-four point six percent of the sample had some significant previous psychiatric history although for 68% of the sample this was their first admission to Ashburn Hall. A quarter of the sample came from the surrounding geographic area and patients were more likely to be referred by specialists rather than general practitioners as geographic distance increased from the hospital. Comparisons with the public system showed a predominance of patients with major affective disorder and less patients with a diagnosis of substance abuse and mental retardation. PMID- 2761893 TI - Myofascial pain in children. AB - Five children with acute and chronic regional myofascial pain syndromes, involving the sternomastoid, the external oblique, the rectus abdominis and the biceps femoris, are described. The trigger points were treated initially by vapocoolant therapy followed by muscle stretching, and subsequently by moist heat applications and continuing muscle stretching. The pain resolved in all cases. Such syndromes received little attention in the medical literature, and consequently, affected patients have been given alternative diagnoses. The article seeks better recognition of such syndromes in order to provide adequate and appropriate management. PMID- 2761894 TI - AIDS and general practice. AB - Using a postal questionnaire, a random sample of 1000 general practitioners throughout New Zealand were surveyed about their contacts with patients concerning AIDS or HIV infection and about their needs for information on AIDS related matters. A response rate of 86% was achieved. Almost all doctors (95%) had had some contact with patients concerning AIDS during the previous 12 months and 86% had had at least one request for the HIV antibody test. Taking blood samples for HIV testing was quite commonly performed by the doctor in the surgery, rather than referring the patient elsewhere. Referral to a specialist AIDS or STD clinic was rare. Continuing education was requested by most doctors. Specific information topics of interest included personal safety, patient care and ethical issues. PMID- 2761895 TI - Deaths from lung cancer and ischaemic heart disease due to passive smoking in New Zealand. PMID- 2761896 TI - Failed vasectomy. PMID- 2761897 TI - Homicide and psychiatry. PMID- 2761898 TI - Myalgic encephalomyelitis. PMID- 2761899 TI - Variability in antihypertensive drug costs. PMID- 2761900 TI - ACC specialists. PMID- 2761901 TI - Meningeal leukaemia as the first manifestation of CGL blast crisis. PMID- 2761902 TI - Routine antepartum human immunodeficiency virus infection screening in an inner city population. AB - Human immunodeficiency virus (HIV) infection occurs disproportionately among inner-city minority women of reproductive age. Once pregnant, these women have a high risk of delivering infants with perinatally acquired infection. Identification and counseling of HIV-infected parturients may be an effective means of preventing perinatal HIV infection. Few data are available on the seroprevalence of HIV infection in the inner-city population or on the clinical and demographic determinants of risk. To better characterize HIV infection in inner-city parturients in Atlanta, we conducted routine antepartum screening for HIV antibody in 3472 women. Ten (2.8 per 1000) were seropositive on enzyme-linked immunosorbent assay (ELISA) and Western blot testing. Four women were seropositive on repeat ELISA but negative on Western blot. Four infected women had had heterosexual contact with a person at risk for HIV, three were intravenous drug users, one had possibly become infected via blood transfusion, and two had no apparent risk factors. Seven of the seropositive women had no self identified risk factors and would not have been identified if screening had been performed using current Centers for Disease Control criteria. Ten percent of the women screened had self-identified risk factors for HIV infection and were seronegative. Ninety-six percent of women consented to HIV testing. These data suggest that inner-city parturients in Atlanta are at risk for HIV infection and that routine antepartum HIV screening can be performed provided the appropriate multidisciplinary team is in place for counseling and follow-up. PMID- 2761903 TI - Previous intra-amniotic infection as a risk factor for subsequent peripartal uterine infections. AB - The risk of recurrent intra-amniotic infection was assessed in 76 women with a previous pregnancy complicated by intra-amniotic infection. Recurrent intra amniotic infection occurred in five (6.6%), not significantly different from the incidence of 4.4% in a comparison population. When controlled by logistic regression for the increased cesarean section rate in the group with previous intra-amniotic infection, the incidence of endometritis was not significantly different between the groups. After eliminating nulliparas and patients who did not undergo labor, the incidence of intra-amniotic infection in patients with previous infections was not significantly increased over the comparison group. Those patients who did develop recurrent intra-amniotic infection had significantly longer labors (P less than .001), duration of ruptured membranes (P = .002), and duration of internal monitoring (P less than .001), and an increased number of vaginal examinations (P less than .001). PMID- 2761904 TI - Smoking in pregnancy: relation of birth weight to maternal plasma carotene and cholesterol levels. AB - Not all mothers who smoke during pregnancy deliver small infants. Nutritional supplementation during pregnancy apparently protects the fetuses of some mothers. Our previous studies showed that plasma levels of carotene and cholesterol were correlated with birth weight. The present study examined the association between mid-pregnancy plasma levels of carotene and cholesterol and subsequent birth weight. In a prospective study of 388 women (47.8% smokers), levels of plasma nutrients and demographic and anthropometric measurements were obtained at 19 and 36 weeks' gestation and related to indices of infant size at birth. In non smokers, the level of plasma cholesterol at mid-pregnancy correlated positively with birth weight. In contrast, in mothers who smoked more than ten cigarettes daily, the relationship of cholesterol to birth weight was dependent on the simultaneously observed level of plasma carotene. When plasma cholesterol and carotene concentrations were both low at mid-pregnancy, birth weight was low. On the other hand, when the carotene level was high and the cholesterol level low, birth weight was at least equivalent to that of non-smokers. The interactive effect of smoking, cholesterol, and carotene on birth weight was significant (P = .017) after adjusting for gestational age, sex, prenatal care, race, previous low birth weight infants, parity, weight at mid-pregnancy, and total weight gain during pregnancy. Among smokers, the smallest infants were born to mothers having the greatest decrease in plasma carotene between 19-36 weeks' gestation. Smokers whose plasma carotene remained constant or increased had larger infants; a similar association was not observed for cholesterol.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2761905 TI - Nutrition intervention program in a prenatal clinic. AB - Pregnant women who are underweight for height and gestational age are at risk of delivering infants weighing less than infants born to women of standard weight. This study demonstrated that a nutrition intervention program geared toward these high-risk women improved infant outcome. A group of 57 underweight and failure-to gain pregnant women (treated) who received extensive nutrition counseling and follow-up from a nutritionist throughout their pregnancy was compared with a similar group of 52 underweight pregnant women (control) who received no counseling. Women in the treated group gained significantly more weight during their pregnancy than did controls. The treated women also delivered infants who averaged 300 g heavier than those born to the control group, a statistically significant difference. Other factors reported to compromise infant outcome such as ethnic background, income status, age, and smoking did not significantly affect infant birth weight. PMID- 2761906 TI - Twin gestations: I. Antenatal care and complications. AB - In order to determine the occurrence of antenatal complications in twin pregnancies, we examined the medical records of 939 consecutive twin gestations delivered at Women's Hospital, Los Angeles County/University of Southern California Medical Center between 1980-1985. The rates of occurrence of the eight most common antenatal complications were determined and compared with their incidence in singleton gestations. In addition, complication rates were related to zygosity, levels of antenatal care, and time of antenatal diagnosis. Twin gestations had an 83% incidence of antenatal complications, in contrast to a 32% incidence in singleton gestations. The increased complication rate was due to the disproportionate increase in three complications: preterm labor, pregnancy induced hypertension, and fetal death. Other complications did not occur more frequently in twin gestations than in singleton gestations. Monozygotic gestations were more frequently complicated by fetal death, and dizygotic gestations by pregnancy-induced hypertension. PMID- 2761907 TI - Multiple pregnancy with late death of one fetus. AB - Twenty cases of fetal death complicating a multiple pregnancy after 20 weeks' gestation are reviewed. We evaluated gestational age at diagnosis and delivery (29.3 +/- 0.7 and 31.8 +/- 0.9 weeks, respectively), interval from diagnosis to delivery (2.6 +/- 0.6 weeks), and cause of fetal death as a group and by type of placentation (76.5% monochorionic). Eighty-five percent of the surviving fetuses were delivered preterm, and the four neonatal deaths were all due to extreme prematurity, with a mean (+/- SEM) birth weight of 794 +/- 237 g. Perinatal mortality was 585 per 1000, 450 for twin A and 750 for twin B. The causes of fetal death varied. Maternal disseminated intravascular coagulation was not diagnosed in any pregnancy in the present series. The high risk of complications related to preterm birth, compared with the low risk of problems related to continuation of a multiple pregnancy after diagnosis of a fetal death, argues in favor of conservative management in this setting. PMID- 2761908 TI - Arrest disorders and infant brain damage. AB - In the past, difficult labors have been associated with maternal and infant damage. Today, changing patient management is associated with less trauma and more frequent use of cesarean births to avoid potential fetal neurologic damage. In this report, arrests of dilatation and descent and prolongation of the decelerative phase of labor were reviewed with respect to the later appearance of brain damage in infants after 2 years of age, in association with obstetric interventions including cesarean birth, forceps, and oxytocin. Charts of 413 infants born after abnormal labors were studied. Log-linear analysis was performed to determine the contribution of method of delivery and oxytocin use to the presence of neurologic abnormalities. Statistical testing ruled out the presence in the model of a three-way interaction, and excluded the two-way interactions of neurologic abnormalities-oxytocin use and neurologic abnormalities-method of delivery. Chi-square tests of partial association and marginal association for the delivery-oxytocin interaction yielded values of 33.54 (P less than .0001) and 33.78 (P less than .00001). This model asserted that method of delivery and use of oxytocin were unrelated to the presence of neurologic abnormalities, but were related to each other. PMID- 2761909 TI - A population study of the relationship between fetal death and altered fetal growth. AB - In order to describe the relationship between fetal death rate and impaired fetal growth, we examined over 850,000 births in Illinois between 1980-1984 (using the state computer data file) and assessed the mean/modal birth weights at each gestational age and the relationship between birth weight and fetal death rate at each gestational age. We were interested in the following questions: 1) Is the relationship between impaired fetal growth and fetal death rate the same at each gestational age? and 2) What birth weight would result in a quadrupling of the fetal death rate at each gestational age? Using exponential regression analysis, we determined for each gestational age the fetal death rate at the modal birth weight and similarly, the birth weight expected to result in a quadrupling of the fetal death rate. As gestational age advanced, the birth weight percentile resulting in the constant outcome also increased (second percentile at 25 weeks; 17th percentile at 42 weeks). We also compared these data with similar data from Denver. The findings indicate the following: 1) Fetal death rate increases exponentially as birth weight decreases at each gestational age; 2) the birth weight percentile that results in a constant outcome is not consistent at each gestational age; and 3) if assessment of risk is to be inferred based on the relationship between birth weight and gestational age, the tenth percentile (whether Denver, Illinois, or elsewhere) does not predict stillbirth accurately. The implications point to the use of outcome-oriented risk assessments to predict fetal death when examining the relationship between birth weight and gestational age. PMID- 2761910 TI - Factors predisposing to and outcome of gestational diabetes. AB - Two hundred thirteen women with abnormal glucose tolerance tests (GTTs) were diagnosed over 9 years by a screening program involving the total antenatal population. Each subject was matched for age, parity, and ethnic group with a control. The gestational diabetics were subdivided into classes A1 or A2 based on the fasting plasma glucose value of their GTT: A1 when below 6.0 mmol/L (108 mg/dL) and A2 when 6.0 mmol/L (108 mg/dL) or higher. All received treatment with dietary advice and some with insulin. Birth weight was not related to maternal age or severity of diabetes, but was related to maternal obesity. However, neonatal morbidity indices such as admission to the special care baby unit for longer than 48 hours and polycythemia (hematocrit above 65%) were related significantly to the severity of the diabetes and not to maternal age or obesity. PMID- 2761911 TI - Antenatal and intrapartum factors associated with the occurrence of seizures in term infant. AB - To identify antenatal and intrapartum risk factors associated with seizures in term newborns, 40 infants who had seizures within 72 hours of birth were compared with 400 controls using logistic regression analysis. The risk of seizure in the term newborn was approximately one per 1000 in the population studied. The logistic regression model identified a group of infants in whom the risk of seizure was approximately one per 100. The risk factors included in the model were antepartum anemia, antepartum bleeding, asthma, meconium-stained amniotic fluid, presentation other than occiput anterior, fetal distress, and shoulder dystocia. Consistent with other studies, our analysis confirmed a strong association between seizures and factors that increase the risk of fetal asphyxia. PMID- 2761912 TI - Low somatomedin C and high growth hormone levels in newborns damaged by maternal alcohol abuse. AB - To study the mechanism of alcohol-induced fetal damage, we determined the somatomedin C and growth hormone (GH) concentrations of umbilical cord blood samples in 56 infants of alcohol-abusing women and in 20 infants of alcohol abstinent women. In addition, maternal serum somatomedin C concentrations were determined 1-7 days before delivery. Twenty-five infants born to alcohol-abusing mothers were growth-retarded and also had other signs of fetal alcohol effects, but the remaining 31 infants born to the drinkers and all infants of abstinent mothers were healthy. The somatomedin C levels of infants with fetal alcohol effects (mean +/- SD 4.6 +/- 1.5 nmol/L) were lower (P less than .005) than the levels of healthy infants of drinking (6.8 +/- 4.0 nmol/L) or abstinent (7.1 +/- 3.3 nmol/L) mothers, but the levels did not correlate with infant birth weight, placental weight, or fetal GH or maternal somatomedin C levels. Alcohol drinking was not associated with any changes in maternal somatomedin C levels. The GH levels of infants with fetal alcohol effects (25.4 +/- 22.6 ng/mL) were elevated (P less than .01) when compared with those of infants of abstinent mothers (13.1 +/- 5.3 ng/mL), but did not differ from those of healthy infants of drinking mothers (19.9 +/- 15.1 ng/mL). Low somatomedin C levels and high GH levels in infants born to the drinkers suggest a disharmony in the regulation of the synthesis and/or release of these growth factors, which may be of importance in alcohol-induced fetal damage. PMID- 2761914 TI - The second-look operation and surgical reexploration in ovarian tumor of low malignant potential. AB - Patients at the University of Michigan Medical Center who were reoperated on for either operative staging, suspected disease, or a second-look procedure with the diagnosis of ovarian tumor of low malignant potential are reported. At the time of initial surgery, 29 patients were thought to have benign disease based on visual inspection of the ovarian mass, and seven patients had a frozen-section report of benign disease. Fifteen patients underwent restaging operation, and disease was found in seven patients. One patient remained as stage Ia, one patient was upstaged to stage Ib, and five patients were upstaged to either stages II or III. Thirteen patients underwent 22 operations for suspected disease. Malignancy was encountered in 19 of these 22 operations. A second-look operation was performed on 20 patients, and 17 of these were negative. All patient with original stages I or II disease had negative second-look operations, whereas three of the eight patients with stage III disease had positive second look operations. Reexploration for staging in the ovarian tumor of low malignant potential will yield a reasonable number of positive results, whereas the second look operation in early-stage disease has a very low yield. PMID- 2761913 TI - Neonatal anuria with maternal angiotensin-converting enzyme inhibition. AB - The use of angiotensin-converting enzyme inhibitors as antihypertensives has increased rapidly since the introduction of captopril in 1981. Seven cases of neonatal renal failure have been reported in patients with exposure to angiotensin-converting enzyme inhibitors that continued to the time of delivery. Two cases resulted in death of the newborn; the other five patients recovered after peritoneal dialysis. Because the relative frequency of normal outcomes is unknown, these data are insufficient for incidence-rate estimates or risk/benefit analyses. However, given the potential neonatal morbidity and mortality associated with late-pregnancy exposure to angiotensin-converting enzyme inhibitors, alternative therapies in the third trimester should be given consideration. If these drugs must be used in this context, the clinician should be prepared to deal with renal failure and hypotension in the newborn. The Food and Drug Administration invites reports of adverse pregnancy outcomes associated with such exposure. PMID- 2761915 TI - Plasma lipid-associated sialic acid and serum CA 125 as indicators of disease status with advanced ovarian cancer. AB - Levels of plasma lipid-associated sialic acid and serum cancer antigen 125 (CA 125) were measured in 49 consecutive patients with advanced ovarian cancer (International Federation of Gynecology and Obstetrics stages III or IV) and in 43 women with benign gynecologic diseases who served as controls. Levels were evaluated in 22 previously untreated patients before initial debulking surgery, in 11 with negative second-look operation, and in 16 with persistent or progressive disease confirmed by second-look operation or reexploration. Plasma lipid-associated sialic acid values had a sensitivity of 100% in previously untreated patients, a specificity of 73% in those with negative second-look, and a sensitivity of 87% in those with positive second-look, or persistent disease. CA 125 values were 77, 100, and 75%, respectively. By combining both markers, there were no false-negative results in previously untreated patients or false positive results in those who were disease-free. Only one of 16 patients with persistent disease had false-negative results for both markers and progressive disease on reexploration. The predictive values of a positive assay with plasma lipid-associated sialic acid, CA 125, and both markers combined were 92.3, 100, and 100%, respectively. The predictive values of a negative assay were 80, 55, and 88.9%, respectively. The combined use of plasma lipid-associated sialic acid and CA 125 enhanced the individual reliabilities of these tests in patients with advanced ovarian carcinoma. PMID- 2761916 TI - CA 125, NB/70K, and lipid-associated sialic acid in monitoring uterine papillary serous carcinoma. AB - Ninety-four plasma samples from 18 women with uterine papillary serous carcinoma were analyzed for three circulating tumor markers: CA 125, NB/70K, and lipid associated sialic acid. Tumor marker values were correlated with the patients' clinical status. Preoperatively, CA 125, NB/70K, and lipid-associated sialic acid were elevated in 62, 64, and 67%, respectively. The distribution of clinical stages was I -- 56%, II -- 28%, III -- 6%, and IV -- 11%. The distribution of surgical stages was I -- 28%, II -- 17%, III -- 0%, and IV -- 56%. Nine of ten patients with an elevated tumor marker had extrauterine disease confirmed surgically. Eight of nine patients with elevated levels of two markers had extrauterine disease. Four of four patients with three elevated markers had extrauterine disease. There were two false-positive elevations, both in patients who had occult surgical stage II disease. Rising and falling tumor marker levels correlated with progression and regression of disease, respectively. A doubling of CA 125 predicted clinical recurrence in four of six women an average of 17 weeks before clinical confirmation. Lipid-associated sialic acid levels that increased by 25% or by five units predicted recurrence or rapid progression in three of six patients in an average of 5 weeks, and a 50% elevation in NB/70K predicted recurrence in two of three patients by 5 and 3 weeks before clinical confirmation. Although the number of patients in this series is small, preoperative elevated tumor markers in patients known to have uterine papillary serous carcinoma correlate closely with the presence of extrauterine disease. This information should influence surgical management and may be useful in postsurgical treatment assessment. PMID- 2761917 TI - Randomized clinical trial comparing systemic interferon with diathermocoagulation in primary multiple and widespread anogenital condyloma. AB - Two hundred three patients (median age 26 years; range 18-45) with untreated multiple and widespread anogenital condyloma were randomly assigned to one of four study arms in order to compare the efficacy, toxicity, and tolerability of recombinant interferon alpha-2b with those of diathermocoagulation. Of 200 evaluable patients, 51 were treated intramuscularly (IM) with 3 x 10(6) U (3 MU)/m2 daily for 3 weeks (total dose 63 MU/m2), 50 received subcutaneous thrice weekly injections of 3 MU/m2 for 4 weeks (total dose 36 MU/m2), 51 underwent diathermocoagulation, and 48 were not treated and were used as a control group. Six months after the end of treatment, the overall response rate (complete and partial responses) was 70%: 57 and 82% for patients receiving interferon alpha-2b (IM and subcutaneously) and diathermocoagulation, respectively, and 8% for the control group. After 6 months from therapy, no significant differences in complete response were found among the different types of treatment: 20, 20, and 35% for the two interferon groups and the diathermocoagulation group, respectively. Fifteen and two complete responders in the cauterization and interferon groups, respectively, experienced disease recurrence (P less than .01). All patients given interferon therapy complained of flu-like symptoms, which declined progressively after the first week of treatment. Fatigue, lasting as long as patients received interferon, was the most prevalent chronic side effect. We conclude that systemic recombinant interferon alpha-2b is active in treating patients with primary condyloma lesions and does so as well as cauterization.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2761918 TI - Prenatal screening for human immunodeficiency virus infection: purpose, priorities, protocol, and pitfalls. PMID- 2761919 TI - In-office infertility support group. AB - The office health care team is often concerned about the emotional aspects of infertility patient management. Is it adequately addressed? Patients often lack the proper means of ventilating their feelings and providing physicians with feedback regarding their frustrations in infertility treatment. A method of addressing the emotional aspects of infertility patient management using office personnel is described. Specifically, our office nurse conducts evening sessions allowing conversation, questions, voicing of complaints, and a vehicle for feedback from physicians to patients. A feeling of trust in the program and improved relationships with office personnel have resulted, as well as better patient-physician communication. This program can be incorporated easily into an infertility practice. PMID- 2761920 TI - A new technique for reduction of prolapsed fetal membranes for emergency cervical cerclage. AB - A new method to replace fetal membranes that have prolapsed through an incompetent cervix, which includes overfilling of the urinary bladder, was successful in four consecutive patients who presented with this clinical entity. PMID- 2761921 TI - Electrocoagulation of the endometrium with the ball-end resectoscope. AB - Thermal destruction of the endometrium for treatment of dysfunctional uterine bleeding was accomplished with a urologic resectoscope with ball-end electrode in 15 patients. After at least 6 months of follow-up, ten experienced amenorrhea and four hypomenorrhea. One failure occurred; the patient underwent vaginal hysterectomy 4 months after the procedure and was found to have adenomyosis. PMID- 2761922 TI - Puerperal uterine inversion. PMID- 2761923 TI - The prevention of meconium aspiration in labor using amnioinfusion. PMID- 2761924 TI - CA 125 in peritoneal washings and fluid: correlation with plasma CA 125 and peritoneal cytology. PMID- 2761925 TI - Maternal brain death and prolonged fetal survival. AB - A 30-year-old woman suffered massive brain injuries after a motor vehicle accident at 15 weeks' gestation. The patient was diagnosed as brain-dead on her tenth hospital day. She was supported with intensive care for 107 days after this diagnosis, and a normal 1555-g male infant was delivered at approximately 32 weeks' gestation by repeat cesarean section. The child is developing normally at 11 months of age. This represents the longest reported case of prolongation of pregnancy after brain death. PMID- 2761926 TI - Bacterial meningitis following epidural anesthesia for vaginal delivery: a case report. AB - Acute bacterial meningitis following epidural anesthesia is a rare event. We describe a case in which a young woman received epidural anesthesia for vaginal delivery. The initial attempt at placement of the epidural resulted in entry into the subarachnoid space. The patient's postpartum course was complicated by persistent headache. She received epidural blood patch on two occasions, but her headache continued and she developed persistent fever. The diagnosis of acute bacterial meningitis was made on postpartum day 3. Contamination of the subarachnoid space may have occurred at the time of the inadvertent spinal tap or via the epidural blood patch. Alternatively, this contamination may have occurred during a spontaneous bacteremic episode, as Streptococcus sanguis is a mouth organism commonly involved in dental caries. PMID- 2761927 TI - Hemodynamic observations during paroxysmal hypertension in a pregnancy with pheochromocytoma. AB - A patient with pheochromocytoma diagnosed at 17 weeks' gestation was studied at rest, during an episode of paroxysmal hypertension, and during phenoxybenzamine treatment. Cardiac output was estimated noninvasively by Doppler technique. During paroxysmal hypertension, the mean blood pressure was 102 mmHg, cardiac output fell by 40%, and systemic vascular resistance rose by 250%. Phenoxybenzamine treatment did not change the resting cardiac output or systemic vascular resistance. These observations suggest that serious fetal compromise might occur even with mild episodes of hypertension associated with pheochromocytoma. PMID- 2761928 TI - Successful pregnancy in a patient with congenital partial cervical atresia. AB - Successful pregnancy in a patient with isolated congenital partial cervical atresia is reported for the second time. She presented with primary amenorrhea, abdominopelvic pain, and endometriosis. After a late diagnosis, successful repair of the cervix, and multiple treatments for endometriosis, she eventually conceived. The pregnancy was complicated by repeated antepartum hemorrhage and complete placenta previa. A normal male infant was delivered by elective cesarean section. PMID- 2761929 TI - Cardiac output measurements during and after triplet gestation. AB - In a gravida with a triplet gestation complicated by fainting attacks and transient episodes of apparently positional hypotension, cardiac output was measured noninvasively to determine the optimal posture during cesarean section. Before delivery, cardiac output and mean arterial pressure were highest in the left semilateral position and lowest in the right semilateral posture. Shortly after delivery of the infants, cardiac output was still highest in the left semilateral position but lowest in the supine posture. Twenty-four and 48 hours later, the values were almost identical in all three positions. Noninvasive cardiac output monitoring provided a simple method of detecting the occurrence and severity of caval compression and of determining the optimal position of the gravida during cesarean section. PMID- 2761930 TI - Severe fetal brain injury without evident intrapartum asphyxia or trauma. AB - Two appropriate-for-dates term infants were born after uncomplicated labors and atraumatic deliveries. They were depressed at birth, developed seizures on the first day of life, and followed clinical courses compatible with hypoxic-ischemic encephalopathy. However, the umbilical cord vessel pH and blood gases were normal. The children are now severely retarded and have cerebral palsy. These cases prove that the events of labor and delivery may not be responsible for all cases of brain damage in surviving children. PMID- 2761931 TI - Fetal death as a complication of intrauterine intravascular transfusion. AB - This report describes and illustrates a case of a fetal death 2 hours after an ultrasonically guided intravascular intrauterine transfusion. The apparent cause of fetal death was a cord hematoma at the site of puncture, with umbilical vein thrombosis. The hematoma appears to have been related to injection of pancuronium before confirmation of needle placement, resulting in creation of a dead space in the cord adjacent to the puncture site. A total of 68 such procedures performed on 23 fetuses with three fetal deaths (4%) have been reported. This case is the first documented procedure-related death in a consecutive experience of 35 transfusions in 15 fetuses at this institution. PMID- 2761932 TI - Fetal death from sepsis following a reassuring intrapartum fetal acoustic stimulation test. AB - An intrapartum fetal death within 20 minutes of a reassuring acoustically stimulated fetal heart rate acceleration is reported. The cause of death in this instance was congenital pneumonia, gram-negative sepsis, and meconium aspiration. Umbilical cord pH values obtained at delivery did not demonstrate asphyxia (ie, low pO2, high pCO2, and low pH), but suggested a metabolic acidosis typical of sepsis. PMID- 2761933 TI - Fetal survival following coagulopathy at 17 weeks' gestation. AB - Placental separation in the third trimester of pregnancy may be associated with coagulopathy, fetal distress, or intrauterine death. We report a case of vaginal bleeding due to placental separation at 17 weeks' gestation associated with disseminated intravascular coagulation. After treatment with blood, fresh frozen plasma, and fibrinogen, the pregnancy progressed uneventfully for another 12 weeks, when delivery by emergency cesarean section was performed. PMID- 2761934 TI - Vaginally administered cocaine overdose in a pregnant woman. AB - The deleterious effects of cocaine have been described in the adult population and in the neonate. Documentation of adverse effects in pregnant patients has been limited. We report the first known fatal vaginal administration of cocaine. PMID- 2761935 TI - Cocaine use and acute rupture of ectopic pregnancies. AB - The hemodynamic changes associated with ingestion of cocaine may precipitate rupture of ectopic pregnancy. Two cases are presented in which this association was suspected. We believe this to be the first report of this clinical entity, representing a risk factor that should be identified in patients with suspected ectopic pregnancy. PMID- 2761937 TI - Pelvic inflammatory disease complicated by massive helminthic hyperinfection. AB - Strongyloidiasis is a potentially life-threatening condition which, when appropriately diagnosed early in its course, is easily eradicated. When severe, it may mimic other disease processes including appendicitis or severe pelvic inflammatory disease. The diagnosis of parasitic infestation should be considered in any individual who has lived in an endemic area and presents with diarrhea regardless of attendant conditions and superimposed disease processes. A minimum workup consisting of stool examination for ova and parasites should be performed on all such individuals. Thiabendazol is the treatment of choice in nonpregnant patients; however, piperazine tartrate has established safety and efficacy in pregnancy and is therefore preferable in the pregnant patient. PMID- 2761936 TI - Necrotizing fasciitis of the vulva during chemotherapy. AB - A case of necrotizing fasciitis of the vulva arising in a leukemic patient during a chemotherapy nadir is presented. The nature of the process was not recognized initially, and the patient was treated with intravenous antibiotics. After clinically evident necrosis developed, prompt surgical debridement was carried out. Clinical improvement followed and the wound healed well. This case suggests that chemotherapy with its attendant immunosuppression is a predisposing factor in the development of necrotizing fasciitis and warrants a high index of suspicion. PMID- 2761938 TI - Relapsing Clostridium difficile toxin-associated colitis in ovarian cancer patients treated with chemotherapy. AB - Symptomatic relapse of Clostridium difficile toxin-associated colitis occurred in three patients with ovarian cancer. In two patients, C difficile toxin-positive diarrhea initially appeared in association with antibiotic therapy. The third patient developed diarrhea after chemotherapy, without recent antecedent antibiotic administration. Patients were initially treated with oral metronidazole and became asymptomatic and toxin-negative. A symptomatic toxin positive recurrence then developed after the subsequent course of systemic chemotherapy. Recurrent C difficile toxin-associated colitis or pseudomembranous colitis after chemotherapy has not been reported previously in the gynecologic oncology literature. Clostridium difficile-induced diarrhea must be considered in chemotherapy patients with diarrhea because management concepts vary from those for noninfectious diarrhea. PMID- 2761939 TI - A uterine tumor that resembled ovarian sex-cord tumors: a low-grade sarcoma. AB - A case is presented of a recurrent uterine tumor best classified as a variant of an endometrial stromal tumor of low-grade malignancy with predominant ovarian sex cord-like differentiation. This patient is the youngest to be reported with such a lesion fulfilling the group II criteria of Clement and Scully, and the first to develop recurrence. PMID- 2761940 TI - Cystic ovarian enlargement resulting from autoimmune oophoritis. AB - Autoimmune oophoritis is a rare cause of premature ovarian failure. Previous studies of autoimmune oophoritis have detailed the clinical, immunologic, and histologic findings. The gross pathologic features of the involved ovaries have detailed the clinical, immunologic, and histologic findings. The gross pathologic features of the involved ovaries have not been emphasized. Herein, we describe a 35-year-old woman with autoimmune oophoritis who presented with symptoms referable to a right cystic adnexal mass. She underwent a diagnostic laparotomy and right salpingo-oophorectomy for removal of an 8.0-cm-diameter, twisted multicystic ovary. Microscopically, mononuclear inflammatory cells infiltrated multiple follicular and luteal cysts. We have seen two additional patients with histologically verified autoimmune oophoritis who underwent diagnostic laparotomy and oophorectomy because of cystic enlargement of the ovaries. Stimulation of ovarian follicles by elevated levels of pituitary gonadotropins probably causes the cystic changes. Recognition of this aspect of autoimmune oophoritis may help to prevent oophorectomy in patients whose functioning ovarian tissue is already compromised by autoimmune destruction. PMID- 2761941 TI - Fatal recurrent reexpansion pulmonary edema. AB - A case is reported of fatal recurrent unilateral reexpansion pulmonary edema following thoracentesis in a woman with stage IV ovarian adenocarcinoma. Reexpansion pulmonary edema is a rare complication resulting from reexpansion of a collapsed lung after treatment of pleural effusion, pneumothorax, or atelectasis. The etiology is unknown, and there are no guaranteed measures of prevention. The clinical presentation varies from asymptomatic to rapidly progressive fatal pulmonary edema. The diagnosis is established by chest x-ray. Depending on the severity of the clinical symptoms, treatment varies from monitoring with serial chest x-rays to mechanical ventilation. Reexpansion pulmonary edema is fatal in 20% of cases. Gynecologists should be aware of this rare entity because it may require immediate diagnosis and aggressive treatment. PMID- 2761942 TI - Confidentiality and OH--barrister faces barrage of questions. PMID- 2761943 TI - Mining & tunnelling. Nursing the chunnel. PMID- 2761944 TI - Shift work--a growing occupational hazard. PMID- 2761945 TI - Mining & tunnelling. Skin disorders in the coal-mining industry. PMID- 2761946 TI - Mining & tunnelling. Working in hot conditions. PMID- 2761947 TI - Occupational Health & Safety 1989/90 purchasing sourcebook. PMID- 2761948 TI - [Biological and biochemical characteristics of the oral spirochetes isolated from the focus of marginal periodontitis]. AB - Since they are found to be increased in lesions of acute necrotic ulcerative gingivitis or marginal periodontitis, agents for these diseases. In the present study, 38 pure cultured strains were obtained as a result of isolation and culture of samples collected from lesions of marginal periodontitis (periodontal pokets), and the biological and biochemical characteristics of these strains were investigated. 1) Light microscopy (including dark-field microscopy) and transmission electron microscopy (negative staining) were used for observation of the morphology and cellular structure of the strains. The cells had a spiral shape, and showed active movement. Based on the above findings the cultured strains were all confirmed to be spirochetes of small to medium size, being 0.08 0.24 micron in width. 2) Growth and motility of the strains were investigated on various types of culture medium. Intense growth and movement were noted in strains cultured in bovine liver exudate medium containing horse serum (pH 7.2) at 37 degrees C under anaerobic conditions produced by the evacuation-replacement method (95% N2, 5% CO2) for 3-7 days after inoculation. 3) Thirty-five strains were positive for indole production and decomposition of urea, mucin, hippuric acid and esculin. Production of hydrogen sulfied was observed in 31 strains. In decomposition tests for 17 carbohydrates, 17 strains were positive for galactose and 14 strains were positive for glucose, while 11 strains were positive for dextrin and 10 strains for fructose upon decomposition of soluble starch. Other carbohydrates were also decomposed by a few strains. 4) In an investigation of the production of alcohol and lower fatty acids, among the metabolic products detected by gas chromatography, a large amount of acetic acid and small amounts of ethanol, lactic acid, propionic acid, pyruvic acid were observed. 5) The results of enzyme activity tests using an API ZYM system indicated relatively high activities of esterase, esterase-lipase, alpha-glucosidase, alkaline phosphatase, trypsin and acid phosphatase. PMID- 2761949 TI - Effects of prostaglandins and several vasoactive substances on blood pressure, respiration and blood flow by intra-ventricular, intra-arterial and intravenous routes. AB - Differences by routes of administration of the effects of prostaglandins and vasoactive substances on blood pressure, peripheral blood flow and respiration were investigated. Intravenous prostaglandins evoked respiratory excitation in rabbits, and lowered blood pressure more prominently and longer after intracarotid injection than after the intrajugular administration. The effects of prostaglandins were apparently more conspicuous after vertebral artery than via carotid artery. In rats, 1 microgram/kg i.v. of PGE1 and PGE2 caused a fall of blood pressure but 1 microgram/kg i.v. of PGF2 alpha caused a rise. PGF2 alpha produce a decrease of blood pressure when injected 10 micrograms/kg i.v.. A remarkable elevation of blood pressure occurred in rats following injection into the lateral cerebral ventricle of 0.1 microgram/kg of PGE1 or PGF2 alpha or of the same dose of 5-hydroxytryptamine (5-HT). Intra-arterial injection of PGE1 gave rise to an increase in blood flow of rabbit dorsal skeletal muscle whereas that of PGF2 alpha resulted in blood flows. The above results indicate that the effects of prostaglandins on these parameters essentially vary to slight extents with the species of animals and differ in intensity with routes of administration. PMID- 2761950 TI - [The impedance diagram of the nitella]. AB - From olden time the resistance and capacitance of the living body were measured by alternating current bridge and the impedance diagram was made by rend 1/omega c using orthogoual axises, and it showes an arch. But by this research the impedance diagram of the Nitella was a line those are measured by finite alternating current. Formerly the frequencies were from 0.2Kc to 20Kc, but by this research the capacitance are nothing at over 4Kc. PMID- 2761952 TI - [Future and current status of dentistry from the view of restorative materials]. PMID- 2761951 TI - [Effects of salivary ultrafiltrates on the production of phenol from tyrosine by oral microorganisms]. AB - The metabolism of oral microorganisms is known to correlate with oral diseases. Protein degradation by oral microorganisms is usually followed by the production of phenol from tyrosine. The purpose of this study is to clarify the effect of salivary ultrafiltrates [MW: less than 10,000, 1,000-10,000 (intermediate fraction), less than 1,000, less than 500] on the production or the decomposition of phenol by oral microorganisms. Salivary sediment and salivary ultrafiltrate, the molecular weight of which is less than 10,000 unless otherwise stated, were incubated at 37 degrees C for 24 hours with tyrosine or phenol at a final concentration of 2.5 mg/100 ml. After incubation, the phenol produced (or remained) was extracted with ether and determined spectrophotometrically. Phenol production by oral microorganisms was not seen in the non-dialyzable fraction of saliva even when tyrosine was added. It was confirmed that the presence of the salivary ultrafiltrates was essential for the production of phenol by oral microorganisms. Phenol production in the salivary ultrafiltrate was further increased with the addition of tyrosine or non-dialyzable fraction of saliva. Phenol disappeared within 48 or 72 hours after the salivary sediment was incubated with phenol. The decomposition of phenol was inhibited with the salivary ultrafiltrate. Phenol production was enhanced with the addition of Good's buffer. Optimum pH of phenol production by oral microorganisms in the ultrafiltrate of saliva was within the range from 6.5 to 7.0 in the presence of Good's buffer (MOPS). Phenol production decreased with the reduction of the molecular weight of the salivary ultrafiltrates. The phenol production was increased when the intermediate fraction was added to the ultrafiltrate (MW: less than 1,000). The increase of the phenol production was considered to be due to the peptides in the intermediate fraction. PMID- 2761953 TI - [Present status and future prospects of morphological studies of salivary glands]. PMID- 2761954 TI - [Progress in dental caries research. Etiology and prevention]. PMID- 2761956 TI - [Gene therapy against bone resorption]. PMID- 2761955 TI - [Application of fluoride mouthrinse to dental public health]. PMID- 2761957 TI - [Cytotoxicity of benzethonium chloride on cultured mammalian cells]. AB - Cytotoxicity of benzethonium chloride on cultured mammalian cells was studied. Growth of V79 cells, derived from Chinese hamster lung was inhibited by treatment with benzethonium chloride at above 30 micrograms/ml for 24 to 48 hr. Inhibitory effect on survival of V79 cells was not observed in cultures treated with benzethonium chloride at 3 micrograms/ml for 2 to 24 hr. Meanwhile, treatment with benzethonium chloride at 10 micrograms/ml for 2 to 24 hr elicited 11.4% to 75.0% inhibition of cell survival. Exposure of cells to benzethonium chloride at 3 to 30 micrograms/ml for 2 hr resulted in inhibition of DNA-, RNA-, and protein syntheses of the cells, in a dose-dependent manner. PMID- 2761958 TI - [On the peculiar dentin existing in the gutter-shaped root]. AB - The purpose of this study is to investigate the histological structure of the gutter-shaped root. Materials investigated in this study deal with 15 japanese lower molars of adults having gutter-shaped roots and 2 of them of children. Buccolingual, mesiodistal, and horizontal ground sections of them were prepared and observed with binocular microscopy, polarizing microscopy, phase microscopy, fluorescent microscopy, microradiograph, and scanning electron microscopy. It is thought that the lingual dentin of the gutter-shaped root is transparent and roentgenopaque because it has primarily slender and sparse dentinal tubules. It is considered that the lingual dentin differs from the transparent dentin of which dentinal tubules were secondarily filled with calcified substance. It is considered that the lingual dentin of the gutter-shaped root is thinner than the buccal dentin because the forming time of the lingual dentin isn't brief but the forming speed of it is late. It is thought that the peculiar dentin is formed at the lingual part because one odontoblast shares more broad forming space of the dentin there than the other part. PMID- 2761959 TI - [Cytotoxicity of chloramphenicol on cultured mammalian cells]. AB - Cytotoxicity of chloramphenicol on cultured mammalian cells was studied. Growth of V79 cells, derived from Chinese hamster lung was inhibited by treatment with chloramphenicol at above 300 micrograms/ml for 24 to 48 hr. Inhibitory effect on survival of V79 cells was not observed in cultures treated with chloramphenicol at 300 to 1,000 micrograms/ml for 2 to 12 hr. Meanwhile, treatment with chloramphenicol at 3,000 micrograms/ml for 2 to 24 hr elicited a dose-related reduction of cell survival. Inhibition of cell survival was also observed in cultures treated with 300 to 3,000 micrograms/ml for 24 hr in a treatment time dependent manner. Exposure of cells to chloramphenicol at 300 to 3,000 micrograms/ml for 2 hr resulted in an inhibition of DNA-, RNA-, and protein syntheses of the cells, in a dose-related fashion. PMID- 2761960 TI - [Clinico-statistical study of inpatients and autopsied cases in our clinic]. AB - The statistics of clinical observation at Department of Internal Medicine, Nippon Dental University at Niigata from July 1981 to December 1987 (duration 6.5 years) were as follows: Total number of inpatients: 1,238, Total number of death cases: 106. Findings include: 1) Ratio of male patients to female patients 1.34:1.00. Male deceased patients to female deceased patients 1.52:1.00. 2) Average patients number hospitalized per year was 200. The high percentaged of certain advanced aged groups was reflected by the recent demographic changes in the society in general.; in their 60's 46.0%, in their 70's 24.3%, in their 80's 6.7%. In these age groups, female number is tendency to increase the number of male. 3) The diseases of inpatients were mostly due to the digestive tract, which accounted for 60.4% of the total. Of this percentage, 65% was due to hepato-biliary diseases. 4) The death statistics of malignant tumor was 68.9%; Benign diseases being 31.1%. Male patients died from hepatocellar carcinoma, lung cancer, colon cancer and stomach cancer, in descending order. Females died from cancer of the biliary tract, stomach cancer and hepatocellular carcinoma, again, in descending order. 5) 71.7% of all deaths were caused by the digestive tract, in particular, hepatocellular carcinoma, cancer of the biliary tract, liver cirrhosis and primary biliary cirrhosis, all belonging primarily to the hepato-biliary disease group. 6) As a result of 58 autopsies performed for 106 death cases, 32 cases had complete autopsies and 26 cases had partial organ punctures. PMID- 2761961 TI - [Resistance and capacitance of the human skin at the transient and constant condition applied by the finite alternating potential]. AB - For the measurement of resistance and capacitance of the living body, there is a method that a finite alternating current is applied to the living body and the values of resistance and capacitance are obtained from the changes of the amplitude and the phase angle of the passing potential. In this method resistance and capacitance can be measured for both transient and constant states at each frequency applied to the living body. In the transient state the potential follows a transcendental function which includes exponential terms, and these terms just become zero in the constant state. Therefore the computer program developed for the transient state can be utilized for any state. The author applied the finite alternating current of three cycles to the human skin, and measured the resistances and capacitances for each frequency. PMID- 2761962 TI - [Development of mandibular movements associated with growth and development of stomatognathic system]. AB - In order to clarify the development of mandibular movements associated with growth and development of the stomatognathic system, we compared the mandibular movements of children with normal occlusion at different Hellman's dental age between IIA and IIIB, during tooth tapping movements using the following 7 different kinds of frequency; ad lib.; 1 time/sec, 2 times/sec and 3 times/sec movements with reguration; 1 time/sec, 2 times/sec and 3 times/sec movements without reguration. Then, we determined the correlation between the results and the subjects' chronological age and obtained the following findings. 1) During 5 strokes between the 3rd and 7th strokes after the start of the tooth tapping movements, mandibular movements were not very diversified among 30 tooth tapping movements using the 7 different kinds of frequency, and the mean values were almost consistent. 2) In the 5 strokes between the 3rd and 7th strokes at all dental age, each determined item showed minimal dispersion during the 3 times/sec unregurated movements. 3) In the following items, changes related to age were noted during the 3 times/sec unregurated movements. (1) Cycle time decreased and became closer to the calculated value (333.33 msec), and maximum velocity in closing increased as age advanced. (2) Although there was no significant correlation with the subjects' chronological age, degree of mandibular opening, duration of opening phase, duration of closing phase, duration of occluding phase and velocity peak time in opening decreased, and maximum velocity in opening increased as age advanced. (3) Velocity peak time in closing was only slightly influenced by age. 4) These results indicate that mandibular movements develop in the course of growth and development of the stomatognathic system. PMID- 2761963 TI - [The effect of mouthwash on oral malodour production]. AB - Volatile sulphur compounds (VSC), hydrogen sulphide, methyl mercaptan and dimethyl sulphide are by-products derived in oral cavity through putrefactive activity of microorganisms. VSC are the principal cause of physiological oral malodour. There are indications that these compounds are cytotoxic to oral tissues. Hence, it has been considered that the prevention of oral malodour has an important role in preventive dentistry. The objective of this study is to ascertain the effect of two mouthwashes, sodium azulenesulphonic acid and povidone-iodine, which are frequently used in dental clinics, on concentration of VSC in mouth air. The VSC were analyzed using VSC analysis system. VSC were determined at immediately after rince and at one, two and three hours after rince. The results indicated that neither mouthwash was very effective in controlling VSC production. No reduction in VSC was observed at one and two hour post-rinsing with sodium azulenesulphonic acid mouthwash, and only 39% reduction of total sulphur of VSC was observed at one hour following the use of the povidone-iodine containing products. However, this effect was lost within two hours post-rinsing. PMID- 2761964 TI - [The deformed partially edentulous ridge in the area of the anterior teeth and that reconstruction. Part I. Analysis of types of defects by the study casts]. AB - The purpose of the study was investigated the incidence and type of anterior ridge deformities in partially edentulous patients. Furthermore that deformed partially edentulous ridge were investigated which esthetic problem were existence or not, and what type of edentulous ridge have to do the ridge augmentation. A random sample of 94 casts 118 regions was evaluated. The results obtained were as follow: 1. These partially edentulous ridge were measured distance by the divided into Apicocoronal loss D1 and Buccolingal loss W, and relationship between D1 and W was significant. But the relationships of D1 and W weren't found between 1 to 2 missing tooth, and on the presence of the root exposure. 2. The resorption form at the palatal regions of upper differed from lower, remained to alveolar crest on palatal regions. But the resorption form at the Buccal region were similar to upper and lower. 3. Using Seibert's classification, we found that the Class III was the most prevalent deformity (55.1%). The other prevalent defect was discerned the Class 0 (17.8%) greater than Class I (16.1%) greater than Class II (11.0%). 4. An unesthetic pontic-to ridge relationship observed in an Apicocornal loss or a Buccolingal loss. 5. The surgical procedures for reconstruction to partially edentulous ridges should be carried out the either D1: greater than 3 mm or W: greater than 3 mm. The edentulous ridges which lacked in the either D1: greater than 2 mm or W: greater than 2 mm were considered preparatory application. PMID- 2761965 TI - [Study on the formation of experimental infected rabbit]. AB - The purpose of the present study is to produce a model of infections of oral cavity by inducing abscess in the mandibla of New Zealand White rabbits as close to the oral cavity infection site as possible in order to determine whether the administered antimicrobial agents will transfer to the localized inflammatory foci. The pus to be collected should be 0.5 to 1.0g or more to permit bioassay and it should be collectable under nearly uniform conditions at all times. New Zealand White rabbit was the experimental animal used, in which anesthesia was induced intraperitoneally to expose the mandibula. A hole was made in the mandibula, into which a small cotton pellet inoculated with Streptococcus milleri and Bacteroides fragilis, whose cell concentrations had been adjusted to 10(8)CFU/ml, was implanted and the opening was carefully closed with sutures tightly. These two species of bacteria had been selected because mixtures of gram positive cocci and anaerobic bacteria have been isolated in most cases from the occluded abscess of oral cavity infections. As a result of the above procedure, it was found that one week after production of the infected model animal, the abscess contained adequate volume of, pus for collection and demonstrated viability of the two transplanted species of bacteria. This animal model was considered an ideal model for use in the studies on treatment of infections in the oral cavity by administering antimicrobial agents to determine the extent of drug transfer into the pus and bones where purulent foci are present. PMID- 2761966 TI - [Bone and suppurative lesion distribution of antimicrobial agents (ampicillin and ofloxacin) in experimental infected rabbits]. AB - Using Streptococcus milleri and Bacteroides fragilis in the mandibula of the domestic rabbit, a jaw-bone infected model was prepared; ampicillin (ABPC) a penicillin derivative and ofloxacin (OFLX) a pyridonecarboxylic acid derivative, were administered orally, injected intramuscularly, or infused intravenously; their concentration in the pus, mandibula, supramaxilla, humerus, femur, sternum, ilium and serum were measured. Pharmacokinetic studies compared the penetration. (1) By oral administration, the maximum ABPC concentration in the pus and bone tissues was 5.9 to 34.3% of the serum, by intramuscular injection 10.4 to 27.5% and by i.v. infusion 12.1 to 42.4%. (2) The maximum concentration of orally administered OFLX in the pus and bone tissues was 52.5 to 111.7% of the serum, by intramuscular injection 56.4 to 100.3% and by i.v. infusion 61.2 to 121.8%. (3) When administered orally, injected intramuscularly, or infused intravenously ABPC showed good penetration into the pus, mandibula and ilium, and OFLX into the pus, sternum and ilium. When infused intravenously, OFLX in the pus and bone tissues was higher than the MIC of both strains. (4) When ABPC was administered as under 3 routes, T1/2 was longer in the pus and most bone tissues than in the serum. T1/2 of OFLX was shorter in most bone tissues by all administration routes than in serum, T1/2 was longer for OFLX than for ABPC, except when orally administered. (5) AUC of ABPC was in the order of intravenous infusion, intramuscular injection and oral administration. About the same AUC of OFLX was shown after i.v. infusion and i.m. injection, both values being about double after oral administration. In all administration routes, AUC of pus surpassed AUC of serum and AUC of OFLX greatly surpassed that of ABPC. PMID- 2761967 TI - [Long-term observation of patients with trauma of the lower anterior primary teeth]. AB - Three patients who had had trauma of the lower primary central incisors at the age of 1.5 years or less were observed with regard to the IIIB and/or IVA after eruption of the permanent dentition, and the findings were discussed from the viewpoint of space control. Patient 1 suffered shedding and loss of A perpendicular A following a fall downstairs at the age of 1.5 years. Measurement of the distance between B perpendicular B teeth revealed a tendency toward space closure and decrease until the age of 4 years and 6 months. At the age of 5 years and 11 months, the space was greater than that at the age of 4.5 years. The patient was also found to have brownish, partially parenchymatous defects of the permanent dentition, which were considered to be a sequela. Patient 2 suffered dislocation of A perpendicular A and root exposure at the age of 1 year and 1 month, and received treatment involving restoration and fixation for a 10-day period using a resin splint. Because of a fistula at the apical region of A and a discolored brown with internal resorption revealed by roentgenography, which were observed at the age of 4 years and 10 months, tooth extraction was performed and the course was observed with local space maintenance. When the patient was 6 years and 4 months old, eruption of 1 perpendicular 1 and hypoplasia of the labial surface were recognized. Since it proved possible to preserve A perpendicular A until the patient was 4 years old, the course was observed without any decrease in space until permanent dentition was accomplished. Patient 3 suffered shedding and loss of A perpendicular A at the age of 8 months. When the patient was 1 year and 3 months old, eruption of B perpendicular B occurred with mesial inclination. At the ages of 2 years and 7 months and 6 years and 4 months the patient underwent treatment with a space retainer and eruption of 1 perpendicular 1, respectively, without association of abnormal findings on the labial surface, probably because crown formation of 1 perpendicular 1 had not yet occurred due to the trauma suffered by the patient.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2761968 TI - Some thoughts on floating. PMID- 2761969 TI - The ONA-PAC: making nursing's voice heard. PMID- 2761971 TI - The uninsured: a lack of realpolitik. PMID- 2761970 TI - Learning from medical students, Part II. PMID- 2761972 TI - The Ohio State Medical Board: is it doing its job? PMID- 2761973 TI - Socialized medicine--the patient-victim. PMID- 2761974 TI - The Canadian health-care paradigm. PMID- 2761975 TI - The Canadian health-care system: is it losing its appeal? PMID- 2761976 TI - Third-party payor calls--nuisance or necessity? PMID- 2761977 TI - Medicine's brave new world: a public alert. PMID- 2761978 TI - AIDS: not the only infectious killer. PMID- 2761979 TI - Current management of chronic congestive heart failure. PMID- 2761980 TI - Office staff can help in risk reduction. PMID- 2761981 TI - Total joint replacement: both a miracle and a disappointment. AB - Total joint arthroplasty has become a successful therapy for patients with debilitating arthritis of the major weight-bearing joints. However, by current standards, the life of a total joint implant is approximately 10 to 15 years. Older, more sedentary patients enjoy greater and longer-term success than younger, active patients. Eventually, most implants fail because of component loosening. Currently, efforts to obtain longer-term implant stability are focused on achieving bone growth into the implanted components. A new process of plasma spraying hydroxyapatite--an entirely biocompatible, bioceramic material--onto porous, titanium alloy components promotes bone ingrowth into the components resulting in implant fixation, which is superior to current methods of cemented or cementless fixation. Early results suggest that hydroxyapatite-bioingrowth fixation may be the start of a new era in joint implant surgery. PMID- 2761982 TI - Tools for the job. PMID- 2761983 TI - Quality control of dental X-ray machines. PMID- 2761984 TI - Use of a database in clinical dentistry. PMID- 2761985 TI - Hypotensive effect of carteolol on intraocular pressure elevation and secondary glaucoma associated with endogenous uveitis. AB - The therapeutic effects of carteolol hydrochloride were evaluated in the treatment of 44 uveitis patients (51 eyes) with intraocular pressure elevation or secondary glaucoma. Carteolol ophthalmic solutions, either 1% or 2%, were given twice day for more than 4 weeks in glaucomatocyclitic crisis and for more than 8 weeks in other forms of uveitis. Intraocular pressure significantly decreased from week 1 of treatment and persisted within normal limits until week 8 in glaucomatocyclitic crisis. Similarly, intraocular pressure decreased significantly from week 2 in other forms of uveitis. Intraocular pressure was well controlled in patients with open-angle glaucoma, but the control was insufficient in patients with angle-closure glaucoma. No adverse reactions such as systemic hemodynamic effects or exacerbations of intraocular inflammation were observed during this study. Carteolol therefore seems to be effective for the treatment of intraocular pressure elevation and secondary glaucoma associated with endogenous uveitis. PMID- 2761986 TI - A new approach allowing an early prognosis in breast cancer: the ratio of estrogen receptor (ER) ligand binding activity to the ER-specific mRNA level. AB - We have performed a quantitative analysis of steady-state levels of ER-mRNA for 88 untreated, primary breast carcinomas. We compared the amount of specific mRNA with the amount of ER receptor measured, through ligand binding activity, by calculating the ratio R = [ER-protein/ER-mRNA]. This analysis showed that the relative level of ER-mRNA displayed a large range of values partly related to the concentration of ER-protein. We found a greater percentage of tumors with a high R ratio value in the tumor population containing elevated levels of ER-protein. A statistical analysis performed on a homogeneous population of 63 patients shows no correlation between the R ratio, lymph-node involvement and histological grade. However, R appears to be significantly related to the risk of relapse within a relatively short period of time following the first observation. An R value higher than 1.5 appears to constitute a significant and early prognostic factor of recurrence (P = 0.003). PMID- 2761987 TI - Disturbances in growth control and gene expression in a C3H/10T1/2 cell line that stably overproduces protein kinase C. AB - We have utilized a retroviral expression vector to construct a series of C3H/10T1/2 murine fibroblast cell lines that stably overexpress a full length cDNA encoding rat protein kinase C beta 1 (PKC). These cell lines contain 3-11 fold greater PKC enzyme activity than parental cells or control cells that carry an integrated vector lacking the cDNA insert. 10T1/2-PKC-4, a line with an 11 fold increase in PKC activity, is morphologically altered, grows to 4-fold higher saturation density, and has decreased adhesiveness when compared to control cells. These cells also show constitutive and inducible alterations in the levels of two PKC-regulated genes, phorbin and TPA-R1. However, 10T1/2-PKC-4 cells do not have a transformed morphology, are incapable of growth in soft agar, and are non-tumorigenic in nude mice. When 10T1/2-PKC-4 cells are cultured in 2.5% calf serum and 100 ng ml-1 TPA, numerous large, dense foci appear 2-3 weeks after the cells reach confluence. TPA is required for focus formation, and control cells do not form foci under the same conditions. However, when such foci are isolated and grown in the absence of TPA, the cells closely resemble later passage 10T1/2-PKC 4 cells. Therefore, the events leading to focus formation appear to be reversible. The 10T1/2-PKC-4 cell line should be valuable for more precisely defining molecular events relevant to tumor promotion and multistage carcinogenesis. PMID- 2761988 TI - A time for collective action. PMID- 2761989 TI - Empowerment: change = change: empowerment. PMID- 2761990 TI - [Risk of sudden infant death: recommendation for an early detection and prevention program]. AB - The cause of sudden infant death syndrome is still unknown. Therefore, screening systems for its early diagnosis must refer to factors likely involved the multifactorial origin of this syndrome. In this paper a SIDS prevention program is presented. Children with a history of high risk for SIDS were polysomnographically examined. Particularly the respiration pattern was investigated. If there was a demonstrable disturbance of respiration control the children were prophylactically treated with aminophylline. PMID- 2761991 TI - [Treatment of post-hemorrhagic hydrocephalus in premature infants]. AB - Our experiences in the course of illness of very low birth weight infants suffered from posthemorrhagic hydrocephalus are described. Clinical proceedings for performing of the hydrocephalus are explained, advantages and disadvantages of treatment by serial lumbal punctures, influences of drugs on the dilatation of the ventricles and the insertion of ventriculo-peritoneal shunts are discussed. The outcome was unfavourable in hydrocephalus following Grad III ore IV hemorrhage. Therefore the prevention of severe hydrocephalus must be the common sense of obstetricians and neonatologists. PMID- 2761992 TI - [Intermittent catheterization in children with neurogenic bladder]. AB - Urinary tract infection and incontinence can be treated with intermittent Catheterization, routine bladder studies should be began. The infection of the upper urine tract is going down, the social continence is going on. PMID- 2761993 TI - [Follow-up study of auditory evoked brain stem potentials--a contribution to the differential diagnosis of facial paralysis]. AB - The case report of a 5-year-old girl suffering from an acute peripheral facial paralysis is used to discuss the clinical picture of Bell's paralysis. In the present case the sign was due to a brain-stem encephalitis, the diagnosis being based on brain-stem acoustically evoked potentials. Although not significantly influencing further practical procedure the authors consider it worth mentioning that apparently banal "peripheral" facial paralyses can actually be part of complex CNS lesions. PMID- 2761994 TI - Uric acid serum concentrations in CF-children after pancreatic enzyme supplementation. AB - In 16 CF-patients (age: 7-23 years; 7 females, 9 males) we analysed the serum concentration of uric acid after a standard meal and pancreatic enzyme supplementation by PANKREON FORTE or PANGROL 400 "neu" (both 2800-3000 U lipase/kg body mass/meal). Simultaneously we measured the uric acid excretion into the urine. We found an effective digestion and subsequent resorption of triglycerides and glucose but no significant changes of the uric acid serum levels during the 8-hours-test period. The uric acid excretion was lower than in the nocturnal period before the test. We conclude that a dangerous hyperuricemia and/or hyperuricosuria do not usually occur in pancreatic enzyme supplementation. PMID- 2761995 TI - [Differential diagnostic considerations in tumors in childhood in the ear-nose throat specialty]. AB - 198 children with tumours in the head-neck region were treated in the Clinic of ENT of Karl Marx University of Leipzig in the period from 1953 to 1985. 166 benign and 32 malignant tumours were verified histologically. All of the tumours were analyzed in relation to histological classification and distribution of age and sex. Problems of differential diagnosis, early recognition, therapy, and prognosis were demonstrated with examples. An optimal interdisciplinary cooperation between pediatrician, oncologist, cyto-histologist, and otorhinolaryngologist is necessary. PMID- 2761996 TI - [Colonoscopic diagnosis and treatment of intestinal invagination in children]. AB - 1. The possibilities of diagnostics and treatment of an intestinal invagination in children by the help of a colonileoscopy are discussed. 2. Clinico endoscopical comparisons of ileocaecal invaginations in children and their connections with the sphincteric function of the Bauhin's ileocaecal valve are made. PMID- 2761997 TI - [Malignant bone marrow infiltration in nuclear magnetic resonance tomography]. AB - Magnetic resonance imaging (MRI) is currently the only non-invasive method detecting changes of bone marrow. While yellow bone marrow produces a high signal intensity, which is similar to subcutaneous fat, any other cellular infiltration of the bone marrow causes a decrease of signal intensity because of replacement of marrow fat cells. In this report we describe two patients, who underwent MRI because of clinical symptoms of coxitis, in order to exclude Perthes disease. Both cases showed decreased signal intensity of the bone marrow particularly of the proximal femura, highly indicative of cellular bone marrow infiltration. Bone marrow aspiration in these patients showed acute lymphocytic leukemia in one case and marrow infiltration by neuroblastoma cells respectively in the other case. Because of its high sensitivity, MRI is also suitable in detecting focal bone marrow disease. For these cases a biopsy of these focal bone marrow lesions can be performed in order to stage the disease properly as in the presence of neuroblastoma or malignant lymphoma presenting with localized disease, however, with focal bone marrow metastases on MRI. In addition MRI can also be used to follow up the disease as well as therapy by showing the regression of these bone marrow lesions. PMID- 2761998 TI - [Glaucoma in childhood]. AB - An overview about the classification, diagnostic and therapy of the congenital glaucomas is given. The morphological findings play an important role in the classification as well as in the diagnostic procedure. Tonometry, Sonioscopy, corneal diameter measurements, oculometry and the evaluation of the optic disc are the main diagnostic criterias. The specific normal values for newborn babies and small children are demonstrated. Up to now no satisfactory medical treatment is available for the congenital glaucomas. Goniotomy is the operation of choice. The technique of goniotomy and their modifications leeding to the cyclodialysis ab interno are described. Own longtime results of goniotomy are finally demonstrated. PMID- 2761999 TI - [Indications for magnetic resonance tomography in diseases of the central nervous system in children]. AB - Answering the above mentioned questions we conclude: 1. MRT is the method of choice to get a precise, clear and reproducible imaging of malformations and space occupying lesions of the CNS. 2. MRT is able to detect inflammatory processes of the CNS earlier than CT. Extension and localization of which are illustrated more precisely. Because there is no ionizing radiation MRT is of importance for follow-up studies. Concerning diffuse inflammatory diseases or early diagnosis of Herpes simplex Encephalitis MRT yields more precise and earlier results. 3. In cases of cerebral seizures with or without lesions in EEG MRT should be used instead of CT. MRT offers multiplanar imaging; there are no bony artefacts. 4. CT is superior to MRT, if calcifications or acute bleedings are expected. MRT provides better differentiation of subacute and chronic hemorrhages. 5. To find out cerebral AV-Malformations MRT is better than angiography. Angiography, however, is important for preoperative questions, and for smaller AV-Malformations especially in the spinal canal. 6. Metabolic and degenerative lesions as well as disturbances of white matter myelination are better seen in MRT due to high soft tissue contrast. 7. In newborns and infants sonography is the best imaging modality and might be completed by MRT and/or CT. PMID- 2762000 TI - [You make the diagnosis. Neurocutaneous dysplasia: Sjogren-Larsson syndrome]. PMID- 2762001 TI - [Indomethacin or ligation in the treatment of persistent ductus arteriosus: a report of clinical experiences]. AB - A haemodynamically significant, patent ductus arteriosus in mechanically ventilated preterm infants can be closed by two means today, either medical or surgical. The aim of our project was to compare the efficiency of these two kinds of therapy over a period of two years in condition that the indication for closing was given in all cases according to the same principles. The PDA was closed by ligation in 16 cases, by medical means (Indomethacin) in 15 cases. The outcome was significant different. 93% of the preterm infants treated with Indomethacin survived, but only 56% of the ligation-group, the main cause of death was the broncho-pulmonary dysplasia. The reason was the posterior day of life at the time of ligation compared with the Indomethacin-group. The broncho pulmonary dysplasia is the result of pulmonary overcirculation because of prolonged patiency of the PDA. Only preparatory reasons were responsible for the delay of the day of ligation (organisation of the paediatric surgical crew including anesthesia), whereas the beginning of the medical therapy could be decided autonomously and therefore the period of pulmonary overcirculation could be shortened. PMID- 2762002 TI - [Spoiling the child and neglect]. PMID- 2762003 TI - The disease pattern and causes of death of spinal cord injured patients in Japan. AB - In recent years, the lifespan of patients with spinal cord injury (SCI) in Japan has been markedly prolonged, resulting in changes in the pattern of diseases developing after SCI and causes of death. We carried out a questionnaire survey on these problems and obtained the following results: 1. Disease pattern in SCI patients. The morbidity during 3 days in October 1987 and the past history after SCI were investigated in 426 SCI patients, and the results were compared with those in the national health survey carried out by the Japanese government in 1984. The incidence of urological complications and pressure ulcer was high, as was to be expected. In addition, the incidence of diabetes, hypertension, skin diseases, peptic ulcer, and hepatic disease were also significantly higher in the SCI patients. 2. Causes of death in SCI patients. Causes of death were analysed in 522 SCI patients who died, and the results were compared with those of the survey undertaken in 1967. The major causes of death were urinary tract infections and respiratory dysfunction in the early stage of cervical cord injury. Comparison with the results of the survey in 1967 showed a significant decrease in deaths from urinary tract infection; and a significant increase in those from CVA. PMID- 2762004 TI - Pathological studies and pathological principles on the management of extension injuries of the cervical spine. AB - Extension injury to the arthritic spine of elderly individuals involves rupture of the anterior longitudinal ligaments and disks at several levels, but no bony injury can be observed on X-ray. There are many small focal haemorrhages in the central portion of the spinal cord and the injury is often accompanied by incomplete paresis. As the injury is a stable injury with the posterior ligament complex being intact, it is only necessary to immobilise the cervical spine conservatively. Laminectomy is not indicated. In hyperextension injury of the rigid cervical spine and in momentary posterior dislocation observed in middle aged individuals, rupture of the anterior longitudinal ligament and disk is observed at a single site, but being spontaneously reduced, traumatic findings cannot be observed on X-ray. The spinal cord is crushed at the site of injury to bring about severe neural damage. When this type of injury is diagnosed or suspected, further damage may be inflicted on the spinal cord if skull traction is made with calipers in the extended position and the condition at the time of injury is reproduced. Therefore, the patient should be nursed in a shell or between sandbags in a neutral position or even in a position of slight flexion. In extension fracture dislocation with compression which resembles on X-ray a flexion injury, all of the three columns of the spine are destroyed to bring about an extremely unstable condition. As the spinal cord is extensively injured to involve several segments, decompression surgery for relief of neuroparalysis should not be performed when complete paralysis develops simultaneously with fracture dislocation. Therefore, it should be first treated conservatively with skull traction, and in cases where stability cannot be restored, surgical fixation of the spine should be performed. PMID- 2762005 TI - Microangiographic study of spinal cord injury and myelopathy. AB - Post-mortem microangiography has been performed in 12 patients with traumatic cervical cord injury, 2 patients with myelopathy, and one patient with post traumatic syringomyelia. Microangiography defined 4 zones in the injured spinal cord. In traumatic injury, the size and extent of the non-filling area (Zone 1) was directly related to the injury force. Subsequently these areas became cavitated. Surrounding the non-filling area, widely extending areas demonstrated filling of capillaries but showed damaged neurons and axons (Zone 2). In the chronic stage, Zone 2 replaced by gliomesenchymal tissue. The capillaries in the gliomesenchymal scars revealed a distorted abnormal arrangement (Zone 3). In a case with myelopathy, the hypervascular areas (Zone 4) were observed just around the chronically compressed area. The vascular increases were considered to be a reaction against chronic compression. In a patient with post-traumatic syringomyelia, the vascular network of the posterior grey matter disappeared and the central arteries were distorted by the distending forces of the syrinx. The microangiographs suggested that vascular factors might play a significant role in original cavity formation; but in cavity extension, these factors were not primary. PMID- 2762006 TI - Significance of spinal cord swelling in the prognosis of acute cervical spinal cord injury. AB - Seven cases of acute cervical cord injury examined by CT-myelography are reported. Cord swelling was observed in 2 patients who developed complete lesions. Another 5 cases had an incomplete lesions. Spinal cord swelling indicated severe cord damage. External decompression seemed to have little effect on cord swelling. When cord swelling is absent, neurological improvement was expected though the initial neurological state showed severe deficits. A further 4 patients who had an acute cervical cord injury who were treated by myelotomy at the injury site are also reported. Two patients obtained significant improvement in upper limb function. The presence or absence of cord swelling as shown by CT myelography is important for diagnosing the severity of cord damage. Myelotomy in the immediate post-accident period may relieve the effects of cord swelling. PMID- 2762007 TI - Experimental study of reflectance spectrophotometric analysis of the dog's dural sac--in the open decompressed state and after the application of external dural pressure. AB - Haemoperfusion and oxygen saturation were studied by tissue reflection spectra on the dural sac of dogs, Experimentally, decompression laminectomy and external pressure on the dural sac were carried out. Haemoperfusion and oxygen saturation were investigated in the open state, and after an external pressure was applied. After the application of external pressure, paraplegia occurred. The tissue Spectrum Analyser 'TS-200' (Sumitomo Electric Industries Co. Ltd, Japan) was used for the measurement of haemoperfusion and oxygen saturation. With this apparatus, an optical fibre probe is applied to irradiate tissue with white light, and the absorption spectrum of the reflected light from tissue is analysed. It has been confirmed that oxygen saturation was not changed in either state, however, haemoperfusion was decreased when external pressure was applied. PMID- 2762008 TI - Disturbances of micturition in patients with a spinal arteriovenous malformation. AB - Neuro-urological studies were performed on 9 patients with a spinal arteriovenous malformation (S-AVM). The micturitional history revealed that all 9 patients had voiding symptoms, obstructive in 9 and irritative in 3 patients. All patients still had obstructive symptoms after treatment of S-AVM. Six of the 9 patients had a large volume of residual urine before treatment; 5 showed urinary retention. Four of the 5 patients (80%) for whom urodynamic studies were performed before treatment had micturitional dysfunction; 2 patients had detrusor hyperreflexia, 1 with detrusor external urethral sphincter dyssynergia (DSD) and 1 with a normal sphincter, 1 patient had an autonomous bladder with DSD and 1 patient had an atonic bladder with DSD. Only 1 patient had a normal bladder and sphincter. Findings of the urodynamic studies after treatment in 9 patients showed detrusor hyperreflexia in 3 patients (2 with DSD and 1 with normal sphincter), autonomous bladder in 1 patient with DSD, atonic bladder in 4 patients (2 with DSD, 1 with incompetent sphincter and 1 with normal sphincter) and normal bladder with normal sphincter in 1 patient. Lower urinary function after treatment of S-AVM was improved in 2 patients, unchanged in 4 patients and worsened in 3 patients. The above results showed 80% of S-AVM had a severe neuropathic bladder manifested mainly by disturbance of micturition. Treatment of S-AVM does not necessarily improve the lower urinary tract function. PMID- 2762009 TI - Voiding dysfunction in patients with human T-lymphotropic virus type-1-associated myelopathy (HAM). AB - Voiding dysfunction was evaluated in 16 of 17 patients with human T-lymphotropic virus type-1 associated myelopathy (HAM). Among 16 patients 11 had both frequency and difficulty in voiding and 12 had urge incontinence of urine. Sensation of vesical filling and voiding remained either intact or only slightly suppressed in all patients. Residual urine ranging from 50 to 320 ml was observed in 14 patients. Urodynamic studies showed in every patient an overactive bladder with involuntary detrusor contraction. Only 2 patients had detrusor sphincter synergia, 6 patients had complete detrusor sphincter dyssynergia and 8 patients had incomplete detrusor sphincter dyssynergia. An overactive bladder associated with detrusor sphincter dyssynergia and less affected vesical sensation seems to be a characteristic urodynamic finding in HAM. These results combined with other neurological findings suggest that in patients with HAM lateral columns of the spinal cord between sacral and ponsmesencephalic micturition centre are mainly affected and that the posterior columns of the spinal cord are relatively less affected. PMID- 2762010 TI - The clinical features of spasms in patients with a cervical cord injury. AB - A study concerning subjective symptoms of spasms which occur during 24 hours was carried out in 13 quadriplegic patients. All had spasms. Tonic and clonic spasms occurred involving their limbs and trunk. Extensor spasms occurred more often in the lower limbs than in the upper limbs. The duration of spasms was 8 seconds on average and the frequency was 15 times on average per day. The spasms which were severe tended to last longer in duration and were more frequent in occurrence. No spasms occurred without a trigger. The activities in daily living were interfered with by spasms in most patients. Most of these activities also triggered spasms. PMID- 2762011 TI - Periodical, neurological-functional assessment for cervical cord injury. AB - The residual, reversible potentials of neurological-functional recovery in patients paralysed due to a cervical cord injury were periodically checked according to the various assessment methods from the initial period of 72 hours after injury to the final follow-up of 7 years. In our series, the data on the neurological changes were a little different from those reported in the literature. In the complete paralysis group, only 2 of the 30 patients showed slight functional recovery of less than 1 grade in the Frankel classification with descent of the cord lesion level. Twenty three patients showed descent of a half to one segment from the initial cord lesion level. The remaining 5 patients deteriorated because of ascent of a half to two segments from the initial cord lesion level. All patients with complete paralysis remained essentially unchanged. In the incomplete group, 58 of the 70 patients had significant recovery of more than 1 grade in the Frankel classification. The grade of neurological recovery was different in each patient. Patients with a central cord lesion showed remarkably better recovery of the cord function than those with other types of cord lesions. Nineteen of the 49 patients with a central cord lesion regained independent walking ability with or without aid. Neurological recovery in the incomplete paralysis group might be expected until approximately 6 months after injury. The early appearance of signs of recovery was an indication of better results. There was no difference in the neurological recovery between patients who had been realigned surgically and those who have been realigned non-surgically. Our neurological-functional assessment method reflecting the sectional and logitudinal cord level function and expressing more detailed information was demonstrated. Magnetic resonance imaging (MRI) was used to assess residual cord function. The area of abnormal signal intensity almost corresponded to the cord level diagnosed neurologically. PMID- 2762012 TI - Transition of physical fitness in wheelchair marathon competitors over several years. AB - Twenty eight stress tests for 14 wheelchair marathon competitors were performed to determine their physical fitness just before the Oita International wheelchair marathon since 1984. All the subjects were wheelchair-bound Japanese males and workers at Sun Industry. Oxygen consumption at the maximal workload was significantly larger than that of non-athletic paraplegics and the mean values were 35.0 +/- 4.8 ml/kg in competitors and 22.6 +/- 5.0 ml/min/kg in non-athletic paraplegics. Eight competitors had more than 2 stress tests and 6 of them had 3 tests from 1984 to 1987. The oxygen consumption at the maximal workload of their third test was very high (46.5 +/- 6.8 ml/min/kg) equal to highly trained paraplegics, and was larger than the result of the first test significantly. Their physical fitness was reduced significantly during the off season, however their physical fitness was maintained at a satisfactory higher level than that of non-athletes. This study demonstrated that individual training for wheelchair marathoners had improved the competitors' physical fitness over several years. PMID- 2762013 TI - Interaction between surface protein antigens of Streptococcus mutans and human salivary components. AB - The potential involvement of surface antigens (Ags) I/II and III of Streptococcus mutans in its adherence to salivary pellicle-coated tooth surfaces was investigated. The binding of radiolabelled Ag I/II to hydroxyapatite was increased by pretreating the mineral with human parotid saliva, and binding was maintained in the continuous presence of saliva. Binding of Ag III to hydroxyapatite was inhibited by pretreatment with, or in the presence of, saliva. Various aminohexoses, and also tris, inhibited the binding of Ag I/II. When Ags I/II and III were tested for their ability to bind to salivary components separated by SDS gel electrophoresis, several proteins capable of binding Ag I/II were identified, notably 2 proteins of apparent relative molecular mass 28,000 and 38,000. Analysis of these proteins, isolated by micro-preparative electrophoresis, indicated high proportions of proline, glycine, and glutamic acid, and overall compositions similar to basic proline-rich salivary proteins. PMID- 2762014 TI - A common antigen of Treponema denticola and other Treponema species detected by monoclonal antibody. AB - Murine monoclonal antibodies against Treponema denticola were produced. One monoclonal antibody (MSA257) reacted with 34,000 dalton antigens of all T. denticola strains, including ATCC strains and our isolates. This monoclonal antibody also reacted with antigens of other treponema strains tested. PMID- 2762015 TI - Activity of amine-stannous fluoride combination and chlorhexidine against some aerobic and anaerobic oral bacteria. AB - The in vitro susceptibility of 128 bacterial strains was tested to amine fluoride stannous fluoride (AmF + SnF) and chlorhexidine (CHX) solutions. Actinobacillus actinomycetemcomitans, Streptococcus mutans, and Bacteroides intermedius were among the species investigated. The 50% and 90% minimal inhibitory concentrations (MICs) were assessed by an agar dilution method. The MIC ranges for A. actinomycetemcomitans were 2-32 micrograms/ml for CHX and 0.25-64 micrograms/ml for AmF + SnF. The respective values for S. mutans were 0.5-8 micrograms/ml (CHX) and 2-8 micrograms/ml (AmF + SnF); and 4-8 micrograms/ml (CHX) and 2-4 micrograms/ml (AmF + SnF) for B. intermedius. Streptococcus faecalis and Staphylococcus aureus were most resistant of the control strains (MIC 64 micrograms/ml to CHX and 32 micrograms/ml to AmF + SnF, respectively). Thus, both solutions tested exerted a definite inhibitory action on the dental plaque pathogens studied. PMID- 2762016 TI - Effect of a bacteriocin-producing strain of Streptococcus sobrinus on infection and establishment of Streptococcus mutans on tooth surfaces in rats. AB - The effect of bacteriocin produced by Streptococcus sobrinus MT6223 on infection and establishment of Streptococcus mutans MT6222 was studied in specific pathogen free rats. These strains were isolated from a carious lesion of a single subject. S. mutans MT6222 was found to be susceptible to the growth inhibitory action of S. sobrinus MT6223. When simultaneously inoculated into the oral cavity of rats, even a small inoculum (10(5) CFU) of S. sobrinus MT6223 completely inhibited colonization of S. mutans MT6222 on the tooth surface. Also, S. sobrinus MT6223 eliminated S. mutans MT6222 when MT6223 (10(8) CFU) was inoculated 2 days after the inoculation of 10(8) CFU cells of MT6222. Similar results were obtained in dental plaque samples from the tooth surface and the fissures of the upper molars at the end of the experiment. However, when S. sobrinus MT6223 (10(8) CFU) was inoculated 2 weeks after the inoculation of S. mutans MT6222 (10(8) CFU), MT6223 coexisted with MT6222. However, the plaque samples showed that MT6223 inhibited the establishment of MT6222 on smooth surfaces, but not in fissures. In addition, MT6223 protected against subsequent infection with MT6222. However, a nonbacteriocinogenic mutant of S. sobrinus MT6223 did not inhibit the infection and establishment of S. mutans MT6222. PMID- 2762017 TI - Relationship between mutans streptococci in saliva and their colonization of the tooth surfaces. AB - The relationship between the salivary concentration of mutans streptococci and their prevalence on different tooth surfaces was studied in 114 subjects. Plaque samples were obtained from all tooth surfaces in the dentition and the infection magnitude of mutans streptococci was determined. The salivary concentrations of mutans streptococci correlated significantly with the number of colonized tooth surfaces and with the infection level of mutans streptococci for individual teeth or groups of tooth surfaces. The highest correlation values were found for buccal and approximal surfaces and for molars followed by premolars and anterior teeth. The 10 tooth surfaces best reflecting the salivary levels of mutans streptococci were 5 buccal and 5 approximal sites, 6 of them localized on maxillary posterior teeth. A significant positive relationship was noted between the prevalence of mutans streptococci in saliva and on the dorsum of the tongue. PMID- 2762018 TI - Possible effect of medically administered antibiotics on the mutans streptococci: implications for reduction in decay. AB - The decline in dental caries in children in North America, Scandinavia, Britain, Ireland and many Commonwealth nations is well documented. The multiple uses of fluoride can account for most, but not all, of this reduction. In this investigation, data are provided which suggest a relationship between antibiotic usage for medical purposes and a decline in both mutans streptococci (MS) and caries. Children attending Grades 1 and 2 in the Coldwater, Michigan school system and who reportedly never received antibiotics had significantly higher proportions of MS in the fissure plaques of first molars than subjects who received antibiotics. The level of decay in the primary dentition was inversely related to the reported usage of antibiotics. The frequent usage of antibiotics could reduce the incidence of dental caries by delaying the colonization of the teeth by the MS. This was evaluated by a prospective study in infants to determine what effect reported antibiotic usage would have on the colonization of newly erupting primary teeth. Only 2 of 10 infants cultured at 2 to 3 week intervals for periods up to 1 year after tooth eruption became colonized by the MS. One had never received antibiotics and the second had been on antibiotics for a single 5-day period. Seven of the 8 non-colonized infants had received antibiotic therapy for periods ranging from 10 to 181 days. Both the Coldwater study and the prospective study of infants suggested a relation between frequency of antibiotic usage for medical purposes and the MS levels on the teeth. PMID- 2762019 TI - The effect of subminimal inhibitory concentrations of antimicrobial agents on three bacterial mixtures. AB - A test tube technique was developed to screen bacterial mixtures to detect interbacterial interactions that play a role in determining sensitivity to antimicrobial agents. We found 3 mixtures where these bacterial interactions change the sensitivity to antimicrobials or change the proportions of each bacterial species in the mixture. The mixtures were: Fusobacterium nucleatum 102.3 and Bacteroides endodontalis ATCC 35406; F. nucleatum 102.3 and B. endodontalis BN11 a-f; and Capnocytophaga ochracea 1956c and Eubacterium saburreum 162.4. The antimicrobials used were metronidazole for the first 2 mixtures and tetracycline for the last. F. nucleatum seems to protect B. endodontalis from the action of metronidazole. Conversely, the growth inhibition of C. ochracea by E. saburreum was lifted when tetracycline was present. We also found that the growth of C. ochracea can then permit the subsequent growth of E. saburreum. The test tube method permits the evaluation both of interbacterial interactions and the detection of any protective mechanism against antimicrobial agents in a bacterial mixture. We found that F. nucleatum 102.3 can decrease the metronidazole level in the culture medium, and by the use of 14C-metronidazole we demonstrated that acetamide is produced from metronidazole. PMID- 2762020 TI - Growth and metabolic properties of Bacteroides intermedius in anaerobic continuous culture. AB - Two strains of Bacteroides intermedius BH20/30 and BH18/23, have been grown in anaerobic continuous culture under various conditions for periods up to 54 days. Strain BH20/30 grew over a relatively wide pH range from 5-8 with a maximum at pH 7.0 at a dilution rate (D) of 0.1 h-1 with a glucose limitation, while strain BH18/23 had an optimum between 5.8 and 7.3 and would not grow above and below this range. The maximum growth rate (mu max) for the latter strain was shown to be 0.23 h-1, or a doubling time of 3.0 at the upper limit of pH 7.3. The yield values (Y glucose) for strain BH18/23 reached 187-177 g cells (dry weight) per mole of glucose in the optimum pH range (6.0-7.0) and amino acid analysis of the spent medium indicated that these high values were the results of the combined use of glucose and amino acids; the cultures also exhibited proteolytic activity. The major acid end-products in the same pH range were formate and succinate with lesser concentrations of acetate, isovalerate and fumarate; small amounts of lactate appeared as the cells were stressed at pH values above 7.5 when the culture was 'washing out' of the chemostat. Glucose metabolism appeared to function through the glycolytic pathway in B. intermedius BH18/23 since the glycolytic inhibitors, sodium fluoride and sodium iodoacetate, completely inhibited glucose utilization as did the proton ionophore, gramicidin, and the ATPase inhibitor, N,N1-dicyclohexylcarbodiimide (DCCD). Inhibition by these latter compounds indicated that the saccharolytic Bacteroides utilize proton gradients generated by proton-extruding ATPase (H+/ATPase) to conserve energy.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2762021 TI - Opsonic IgG antibody against Actinobacillus actinomycetemcomitans in localized juvenile periodontitis. AB - Actinobacillus actinomycetemcomitans is a gram-negative bacterium frequently recovered from periodontal lesions of patients with localized juvenile periodontitis (LJP). Elevated levels of serum IgG and IgM antibodies to A. actinomycetemcomitans antigens are frequently observed in LJP patients, although the functional properties of such antibodies have not been characterized systematically. In this study, we analyzed serum from LJP subjects infected with A. actinomycetemcomitans with respect to the presence of IgG antibodies expressing opsonic, bactericidal and/or leukotoxin-neutralizing activity against this organism. The IgG fractions obtained from serum of 3 LJP patients with elevated antibody titers to A. actinomycetemcomitans contained opsonic activity against a non-leukotoxic Y4 strain, as well as for a highly leukotoxic JP2 strain. Opsonic activity required the presence of complement. The IgG fractions of pooled normal serum and serum from a fourth LJP subject with minimal ELISA reactive IgG antibody against this organism lacked detectable opsonic activity. Leukotoxin-neutralizing IgG antibodies, although variably present, did not influence neutrophil killing of the leukotoxic JP2 strain. None of the sera tested contained bactericidal IgG antibodies capable of promoting direct complement-mediated killing of A. actinomycetemcomitans. These results indicate that LJP subjects infected with A. actinomycetemcomitans are capable of producing opsonic IgG antibodies which may facilitate neutrophil-mediated host defense against this periodontopathic organism. PMID- 2762022 TI - Closed wound drainage system. PMID- 2762023 TI - An interview at St. Peter's Hospital: development of a program for monetary compensation for certified nurses. Interview by Ann Maher. PMID- 2762024 TI - Measurement issues. PMID- 2762026 TI - Reducing the threat of hip fracture. PMID- 2762025 TI - Radiograph assessment of the basal thumb joint. AB - Evaluation and treatment of basal thumb joint problems require a careful history, physical examination, and radiographs. The "true" AP and stress views provide useful information which supplements the standard plain radiographs. Additional maneuvers such as local injection and other imaging modalities are also sometimes employed, but their discussion is beyond the scope of this brief review. PMID- 2762027 TI - Multifaceted pediatric congenital hand reconstruction. AB - The management of a variety of complex congenital hand deformities is presented. The importance of early parental education by the surgeon and the rehabilitation team is stressed so that staged reconstruction can be planned and executed. New surgical techniques are demonstrated that provide the patient with the ability to perform normal bimanual activities at an early age. PMID- 2762028 TI - Treating the victims of the Armenian earthquake. A conversation with Neil Kahanovitz, MD. Interview by Jackie Syrop. PMID- 2762029 TI - Clinical applications of volumetric three-dimensional imaging. A report of three cases. AB - Three-dimensional imaging has evolved rapidly. We believe that volumetric image processing (VIP) represents a major advance within this modality. VIP preserves the fidelity of the original computed tomography (CT) data and allows the viewer to interact with the images in real time. This complements and integrates the information acquired on two-dimensional CT studies, as illustrated in three representative cases. PMID- 2762030 TI - Flexor digitorum profundus avulsion. A unique presentation. AB - Simultaneous avulsion of the insertion of the flexor digitorum profundus tendon and a displaced intra-articular fracture of the distal phalanx occurred in a 45 year-old man. Review of the literature reveals that this is a rare injury. A case report is presented, along with a review of the literature. PMID- 2762031 TI - Treatment of phalangeal fractures of the hand with intraosseous wire fixation. AB - Most phalangeal fractures of the hand can usually be treated by closed methods; however, those fractures that require open reduction may be effectively treated by the intraosseous wire-fixation technique. Twenty-five unreducible or unstable phalangeal fractures were treated with open reduction and intraosseous wire fixation. Functional results are reported in terms of total active motion and flexion to distal palmar crease of the involved fingers. Acceptable union was achieved in all cases, whereas functional assessment revealed 11 excellent and 14 fair results. Our operative technique and postoperative regimen are reported. A closely supervised postoperative therapy program appears to be critical in achieving a satisfactory end result. PMID- 2762032 TI - Physeal growth arrest of the distal radius treated by the Ilizarov technique. Report of a case. AB - Growth arrest of the distal radius may follow a severe injury to the growth plate. When the growth of the distal radius ceases in the child, continuing ulnar growth results in radial deviation of the hand and dislocation of the distal radioulnar joint. Treatment options in such a limb-length discrepancy are resection of the physeal bony bridge, lengthening of the shaft of the radius with bone graft using the principle of the Wagner technique, resection or epiphysiodesis of the distal ulna, and lengthening through a metaphyseal corticotomy without the use of bone graft. We report a case of metaphyseal lengthening of the radius employing the Ilizarov external fixator for controlled distraction osteogenesis. PMID- 2762033 TI - Tips of the Trade #14. A guide for the proper placement of a above a cannulated Asnis screw above a sliding DHS hip screw. AB - Low fractures of the femoral neck are often treated by reduction and internal fixation with a sliding screw and plate. In base of the neck fractures, a supplemental cannulated screw should be used to prevent rotation of the femoral head and neck during sliding screw insertion. It is critical that the large sliding screw and the smaller supplemental screw are inserted in parallel alignment, without impinging upon each other. This article describes an easily manufactured guide that facilitates parallel placement of the screws and assures adequate clearance between the two screws. PMID- 2762034 TI - Pediatric update #8. Acute hematogenous osteomyelitis in children. Long-term results of surgical treatment. AB - A retrospective review (1970-1982) of the clinical experience of 68 children with acute hematogenous osteomyelitis (AHO) is presented. Analysis of the epidemiologic, clinical, laboratory, radiologic and bacteriologic findings is made. Our series was treated mainly by an aggressive primary surgical protocol which is described in detail. Seventeen percent developed chronic osteomyelitis. The role of surgery in the treatment of AHO is discussed. It is our belief that surgical treatment has definite advantages over the conservative regime and it remains our treatment of choice. PMID- 2762035 TI - The prevalence and pathology of Schistosoma nasale Rao, 1933 in cattle in Sri Lanka. AB - During 1987 a total of 1393 cattle was examined for Schistosoma nasale infection at the Kandy slaughterhouse, Sri Lanka. The overall prevalence was 12.6% (monthly range 3-17%). Based on the appearance of macroscopic lesions, 6 types (0-5) were recognized; type 5 being the most severe, with cauliflower-like growths obstructing the nasal cavity. Older bovines with 8 permanent incisors were more heavily infected (29.1%) than younger ones with no permanent incisors (6.0%). The severity of the lesions increased also with the age of the animals. Observations on the localization of the lesions showed that the first sessile nodular areas appear on the medial septum, on the dorsal edge of the ventral nasal concha and on the lateral wall of the middle meatus of the nasal cavity. Later, they gradually spread over the whole mucosal surface of the anterior part of the cavity but were rarely found further than 10 cm posterior to the nasal opening. The histopathology showed that granuloma formation due to the presence of eggs was the most common feature of the respiratory mucosa. PMID- 2762036 TI - Gastrointestinal hormones: environmental cues for Fasciola hepatica? AB - The effects of pharmacological concentrations of several gastrointestinal hormones on the rate of sucker activity and the frequency and the amplitude of spontaneous longitudinal muscle contractions have been examined in adult Fasciola hepatica. Caerulein and serum decrease the rate of oral sucker activity; motilin decreases and CCK-PZ increases ventral sucker activity when compared to controls. Caerulein, serum and motilin significantly inhibit the frequency of contractions while bile, caerulein and motilin decrease the amplitude of contractions. These results suggest that F. hepatica can recognize and respond to certain gastrointestinal hormones and there may be adaptive value in these behavioural responses. PMID- 2762037 TI - The diet and gastrodermal ultrastructure of polystomatid monogeneans infecting chelonians. AB - All polyopisthocotylean monogeneans previously studied, including representatives of the Polystomatidae infecting anuran amphibians, feed on host blood. However, the present analysis of species of Polystomoides, Polystomoidella and Neopolystoma, polystomatids which infect chelonian reptiles, has shown that this group has diverged nutritionally from related parasites. Histochemical tests failed to demonstrate haemoglobin in the gut caeca, and X-ray microanalysis confirmed the absence of haematin (or high concentrations of bound iron) in the gastrodermis. The chelonian polystomatids (and also the single monogenean which infects a mammal, Oculotrema hippopotami) feed on epithelial cells and mucus, the diet typical of monopisthocotyleans. Transmission electron microscopy revealed the same gastrodermal architecture in representatives of Polystomoides from Africa, N. America and S.E. Asia. The organization of the caecal epithelium conforms with that of blood-feeding polyopisthocotyleans, with two components: lamellated cells responsible for intracellular digestion interspersed with elements of a non-lamellated connecting syncytium. In other polyopisthocotyleans, the syncytium probably has a skeletal, supportive role, related to the problems of intracellular accumulation of haematin, but in polystomatids infecting chelonians the syncytium is extremely reduced and its presence probably reflects an ancestry amongst blood-feeding relatives. The utilization of the presumably more primitive monogenean diet of epithelial cells and mucus by chelonian polystomatids may be related to the scarcity of superficial blood vessels in their oral and urinary bladder habitats. PMID- 2762038 TI - Host predisposition to trichuriasis: the mouse--T. muris model. AB - Predisposition to trichuriasis in mice is reflected in the inability of certain strains, or certain individuals within strains, to express protective immunity. Poor responders fail to expel worms and harbour chronic patent infections. The mechanisms underlying this phenomenon were studied in poor responder mice challenged after abbreviated or prolonged primary infections. Mice exposed to a complete primary infection were fully susceptible when challenged after the removal of the primary infection by anthelmintic. Failure to expel either infection suggests (a) that non-responsiveness to a primary infection does not reflect an inability to expel worms of a certain size, i.e. is not a consequence of the speed of the immune response in relation to parasite growth and (b) that non-responsiveness is long-lasting. Challenge after abbreviation of primary infections at different stages of worm development showed that persistence of larvae beyond day 21 was critical in determining poor response to reinfection. By inference the same conclusion can be drawn about the inability of such mice to expel primary infections. Serological analysis suggested a relationship between low antibody titres, restricted antigen recognition profiles and resistance to infection. It is suggested that the later stages of parasite development are immunosuppressive; the implications for human trichuriasis are discussed. PMID- 2762039 TI - Ancylostoma ceylanicum in the hamster: observations on the host-parasite relationship during primary infection. AB - The course of primary infection with a hamster-adapted strain of Ancylostoma ceylanicum was studied in inbred DSN and randomly bred WO/GD and WO/CR hamsters. Infective larvae were administered orally and began to develop in the small intestine without embarking on a tissue migration. Only the occasional larva was detected in other organ sites. It was concluded that the developing larvae moulted on days 3-4 and again to the pre-adult stage about 9-11 days post infection. Worm burdens in infected hamsters were stable for at least 11 weeks after infection. There was no sudden expulsive phase and some adult worms survived for over 200 days. Overall the sex ratio of worms in groups of hamsters killed concurrently was about 50% although occasionally the ratio was biased in favour of one sex in individual animals. The blood packed cell volume (PCV) was significantly depressed 2 weeks following infection and continued to decline until a point of stability was achieved 4-5 weeks post-infection. The PCV subsequently remained depressed throughout the period of observation. Infected hamsters lost weight if kept in groups, but not when housed in separate cages. Groups of animals which lost weight did not recover to normal values within 11 weeks of infection. It is suggested that this model of hookworm infection has scope for exploring aspects of the host-parasite relationship which the canine models cannot fulfill adequately. PMID- 2762040 TI - Action of cyclosporin A on the tapeworms Hymenolepis microstoma, H. diminuta and Mesocestoides corti in vivo. AB - The in vivo activity of two cyclosporins, cyclosporin A (CsA) and a non immunosuppressive derivative of dihydrocylosporin A (DHCsA-d) against three tapeworms, Hymenolepis microstoma, H. diminuta and Mesocestoides corti, has been assessed. CsA reversibly reduced the dry weight of H. microstoma in the mouse, briefly delayed oviposition and had a statistically significant effect on worm numbers recovered. Oral and subcutaneous treatments of both CsA and DHCsA-d were effective in reducing worm weight; juvenile worms were most susceptible but worms of all ages responded to drug by a dramatic reduction in weight from which they recovered. Multiple courses of CsA were no more active than single courses of treatment but dose response suggested that a threshold level of drug was necessary to evoke activity. By contrast, H. diminuta in the rat was completely unaffected by CsA but no explanation for the differences in drug response by these two closely related helminths is forthcoming. Mesocestoides corti responded reversibly to CsA in the mouse by a reduction in asexual proliferation of both liver and peritoneal cavity tetrathyridia. The data presented argue in favour of a range of anti-parasitic activities by cyclosporins but the details of the various putative modes of action remain to be defined. PMID- 2762041 TI - Fluctuations in rat liver alanine-amino-transferase activity during experimental nippostrongylosis. AB - The activity of the gluconeogenic enzyme, alanine-amino-transferase (ALT), in a preparation from the liver of rats was studied by means of an in vitro assay throughout the course of a primary infection of Nippostrongylus brasiliensis, established by a subcutaneous injection of approximately 4000 3rd-stage larvae. The activity was measured on days 1-14 p.i. in both uninfected and infected rats and a marked pattern in the enzyme's activity was observed. In infected rats, the activity increased from 1.46 +/- 0.19 U/g liver on day 1 p.i. to a peak on day 4 p.i. of 10.75 +/- 1.62 U/g liver, then decreased to a trough of 0.44 +/- 0.18 U/g liver on day 10 p.i. before returning to original levels by day 14 p.i., by which time the infection had been largely eliminated. In uninfected rats the activity of the liver enzyme remained constant throughout this period with a value of 2.54 +/- 0.12 U/g liver. The activity of the enzyme in vitro was found to be related to the size of the inoculum on days 4 and 10 p.i. It was proposed that these observations could be due to either (1) a direct effect of the parasite, or (2) a consequence of the host immune response to the infection. In order to investigate the second proposition more fully, liver ALT activity was investigated by in vitro assay on selected days p.i. in rats experiencing a secondary N. brasiliensis infection.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2762042 TI - A study of coagulase-negative staphylococci isolated from clinically significant infections at an Australian teaching hospital. AB - Some 151 isolates of coagulase-negative staphylococci isolated from patients at an Australian teaching hospital were characterized by biochemical analysis, antibiotic sensitivity patterns and slime production. S. epidermidis was the predominant species (64%) isolated from clinically significant infections, and all S. epidermidis isolates from true bacteremias produced slime. Forty-nine per cent were resistant to methicillin and 61% to gentamicin. S. haemolyticus isolates from clinically significant infections also showed antibiotic resistance and 80% were resistant to more than five antibiotics. The importance of coagulase negative staphylococci as pathogens in this large teaching hospital was confirmed. PMID- 2762043 TI - A molecular marker associated with mild hemoglobin H disease. AB - The clinical spectrum of HbH disease varies from a benign disorder to a severe anemia which is blood-transfusion dependent. Heterogeneity at the clinical level is now being understood in terms of the underlying molecular defects. In this study a mild phenotype found in a group of patients with HbH disease is associated with two types of alpha-thalassemia. These are: alpha+-thalassemia ( alpha 3.7/) and alpha 0-thalassemia (--SEA/). In contrast, a second group with more severe HbH disease has a non-deletional alpha-thalassemia defect instead of alpha+-thalassemia (genotype alpha alpha T/--SEA). In the majority of cases, the basis for non-deletional alpha-thalassemia is Hb Constant Spring. PMID- 2762044 TI - Detection and typing of paraproteins: comparison of different methods in a routine diagnostic laboratory. AB - In this paper we review four methods: Protein electrophoresis (PE), immunoelectrophoresis (IEP), immunofixation electrophoresis (IFE) and a nephelometric kappa:lambda ratio method for the ability, first, to detect, and second, to isotype paraproteins in urine and serum. IFE was the most sensitive assay both in the detection of paraproteins and the most accurate in their typing. The nephelometric kappa:lambda ratio was associated with false-positive and false-negative results and cannot be considered suitable for routine diagnostic use. Although IFE was the most sensitive assay it was not without problems. Dilution of the serum to produce a concentration suitable for IFE is critical, and the assay is demanding in operator skill and time. The extra paraproteins identified by IFE are generally of low concentration and with the exception of certain well-defined clinical situations are probably not of great importance in patient management. In the case of diseases where the demonstration of a small amount of paraprotein is important, such as amyloidosis, then IFE should be performed in case other techniques fail to demonstrate a paraprotein. Otherwise, IFE is best reserved for paraproteins detected by PE which cannot be typed by IEP. A schema for the management of paraprotein identification for use in a routine diagnostic laboratory is presented. PMID- 2762045 TI - Differences between heart valve allografts and xenografts in the incidence and initiation of dystrophic calcification. AB - Following surgical removal because of primary tissue failure, 30 antibiotic sterilized human aortic valve allografts and 27 glutaraldehyde-treated porcine aortic valve xenografts were examined for macroscopic and microscopic evidence of dystrophic calcification. These grafts had been mounted on stents and used for from 34 to 166 months to replace diseased mitral valves. After explantation the grafts were carefully examined then prepared for light microscopy, for transmission electron microscopy and for energy dispersive X-ray microanalysis. Gross calcification occurred significantly (p = 0.002) more frequently in xenografts (89%), and was more extensive than in allografts (53%). Calcification usually appeared as nodular excrescences on the cusps, although occasionally it formed plates within them. This reduced tissue pliability and was usually associated with either valvular stenosis or regurgitation. The calcified deposits contained calcium and phosphate in ratios approaching those of hydroxyapatite. In xenograft valves the smallest discrete deposits of calcification were spherical and usually associated with membranous debris of porcine donor fibroblasts, but allografts did not contain donor cell remnants and early calcification was linearly arranged along collagen fibres. PMID- 2762046 TI - Validity of bronchoalveolar lavage in acute lung injury: recovered cells accurately reflect changes in the lung parenchyma. AB - Bronchoalveolar lavage (BAL) has come into widespread use as a tool to diagnose and manage various lung diseases. However, the usefulness of BAL is based on the assumption that the cells recovered in BAL fluid accurately reflect cellular populations in the lung parenchyma. To test this hypothesis, random source (n = 16) dogs were given intravenous phorbol myristate acetate (PMA) to produce acute, diffuse lung inflammation. Dogs were divided into three groups. Group I animals (n = 2) underwent BAL and open lung biopsy at time zero. Group II (n = 7) animals underwent hourly BAL after PMA with open lung biopsy at 3 h. Group III (n = 7) animals underwent hourly BAL after PMA with open lung biopsy at 6 h. When BAL cell populations were compared with the corresponding biopsies, there was a direct correlation (r = 0.67) between BAL neutrophil percentages and neutrophils present in histologic sections. These findings suggest BAL accurately reflects changes in the lung parenchyma in acute lung disease. PMID- 2762047 TI - Capillary prothrombin time test for oral anticoagulant control. PMID- 2762048 TI - [Heredity and comparative effectiveness of several methods of specific hyposensitization in children with pollinosis]. PMID- 2762049 TI - [Etiology of toxic erythema in newborn infants and its effects on the health status of young children]. AB - A total of 68 neonates with toxic erythema (TE) were examined for risk factors of its origin depending on the intensity of the clinical manifestations of erythema. It has been established that sensitizing factors (aggravated allergological anamnesis, food, allergens, late toxicosis of pregnancy) and high content of estrogen hormones in the newborn are implicated in the genesis of the generalized TE pattern. The study of the catamnesis of 84 children of the first three years of life with a history of TE of the newborn revealed that the children appeared highly susceptible to respiratory diseases and showed early formation of the allergic manifestations. It is recommended that neonates with marked TE should be attributed to the second health group and be administered the treatment and prophylactic measures beginning from the stay at the maternity home. PMID- 2762050 TI - [Disorders of protein metabolism in neonatal hyperbilirubinemia and their correction by extracorporeal detoxification]. AB - A close relationship was established between the gravity of bilirubin intoxication, dysproteinemia and hyperpeptidemia in neonates. It is shown that accumulation of peptides belonging to the medium molecule group and associated pathophysiological manifestations may account for a graver course and less favourable prognosis of hemolytic disease of the newborn as compared to conjugation hyperbilirubinemia. It is suggested that the measures aimed at bilirubin removal by the control of the medium molecule effects should be supplemented. The results of hemosorption (51 sessions in 42 children) and substitution transfusion (27 operations in 24 children) were subjected to clinical and laboratory comparisons. In addition to bilirubin removal from the body, hemoperfusion permits the correction of protein metabolism abnormalities occurring in hemolytic disease. PMID- 2762051 TI - [Creatine kinase BB and lactate in the cerebrospinal fluid of neonates and infants with perinatal injuries of the CNS]. AB - A study was made of the content of creatine kinase-BB (CK-BB) and lactate in cerebrospinal fluid (CSF) of 202 neonates and infants with perinatal CNS injuries. The relationship was found between the rise of the CK-BB content and the gravity of perinatal CNS injuries. The highest content of CK-BB in CSF was marked in neonates with cerebral disorders complicated by infectious and inflammatory diseases (pneumonia, sepsis). Within the first 5 days of life, the children of this group demonstrated the relationship between the content of CK-BB and lactate of CSF. The measurement of the content of CK-BB in CSF should be used for early diagnosis, assessment of the gravity and course of perinatal CNS injuries in neonates and in infants. PMID- 2762052 TI - [Dynamics of inherent interactions between the classical and alternative pathways of complement activation in premature infants with suppurative-inflammatory diseases]. AB - Altogether 57 premature infants were examined. Of these, 15 presented with neonatal sepsis, 36 with local purulent infection (LPI) of different etiology, and 6 children were conventionally normal serving as control. Early activation of the alternative pathway of the complement system was shown by the patients as compared with control. The development of neonatal sepsis was attended by the increased role played by the classical pathway of complement activation. At the same time the course of LPI was characterized by differences in the degree of participation of the classical and alternative pathways in the antiinfectious defence of the neonates. It has been established that high activation of the alternative pathway seen in the premature children may be considered as a prognostic sign enabling one to classify them with the risk group in terms of the possibility of the development in them of an infectious process. PMID- 2762053 TI - [Disseminated intravascular coagulation in newborn infants with infection]. AB - The treatment of disseminated intravascular coagulation (DIC) in infants with sepsis should be instituted after multimodality therapy of pyo-inflammatory diseases taking into account the degree of hemostatic disorders. In stage I DIC (hypercoagulation one), it is necessary to reach an adequate level of the inhibitors of the thrombin and plasmin systems. In this case it is quite sufficient to use donor's cryoplasma without heparin administration. In stage II DIC (transitory one) and stage III (hypocoagulation one), it is required that the drugs possessing antithrombin and antiplasmin activity, substitution therapy with blood preparations and components as well as measures to control hemorrhagic diathesis may be used. PMID- 2762054 TI - [Maternal health--a determining factor of the infant's health]. PMID- 2762055 TI - [A method for the assessment of adaptation possibilities of a child's body]. AB - The authors suggest a new method for the assessment of the adaptation potentialities of the child's body according to the conjugated shift in the systolic arterial pressure and heart rate (in percent from normal) within the system of coordinates. The method provides an objective evaluation of the individual responses of the child to different actions, supplements an overall estimation of the health status, and makes it possible to identify the risk group children. PMID- 2762057 TI - [Clinical manifestations of the initial period of systemic lupus erythematosus in children]. PMID- 2762056 TI - [A rapid test of urine microflora sensitivity to antibacterial drugs in the treatment of children with nonspecific inflammatory diseases of the kidney and urinary tract]. AB - The authors describe their own method for rapid determination of urine microflora sensitivity to antibacterial drugs. The method is based on the capacity of the microorganisms (as a totality of particles with the refractive index different from that of the medium) of increasing the optical density of the medium under the conditions of unlimited resources of the nutrition and space at the expense of reproduction in a liquid culture medium. The lack of the optical density increase in the urine sample after addition to it of a certain amount of antibacterial substances evidences the death of the population of the microorganisms and of its sensitivity to the antibacterial drug under study. The method proposed by the authors was compared to those widely used in clinical practice. With special reference to a concrete patient, the results obtained with the authors' method turned out to correlate with those derived with the use of the conventional methods for urine microflora sensitivity to antibacterial drugs (the disc method and the triphenyltetrazolium chloride test). That the final result of the investigation can be obtained after 2--6 hours and low labour intensivity of the method permit the institution of adequate antibiotic therapy within the first day since the patient's admission to the hospital. PMID- 2762058 TI - [Marfan's syndrome in the pediatric practice]. PMID- 2762059 TI - [Possibilities of immunization against measles of children with injuries of the CNS]. PMID- 2762060 TI - [Significance of the patent-information warranty of scientific research in pediatrics]. PMID- 2762061 TI - [Characteristics of the development during the 1st year of life of children born to mothers with threatened premature labor of the endocrine etiology]. AB - As many as 50 children with the antenatal period complicated by prematurity risk were subjected to clinical and hormonal studies during the first year of life. To estimate adrenal function, excretion of 17-ketosteroids, corticoids and their fractions with urine was investigated. The children born in a satisfactory state with a physiological body weight and length demonstrated the lag in the establishment of motor and static functions as well as mental retardation. It has been discovered that the clinical course of the early neonatal and subsequent periods of the child's development is dependent on adrenal function. PMID- 2762062 TI - [Experience in the organization of a district neonatal center]. PMID- 2762063 TI - [Experience in the joint work of health services of the Moscow Railway and the Chair of the Developmental Physiology and Child Rearing of the CIAMT in prophylactic child services]. PMID- 2762064 TI - [Classification of malabsorption syndrome]. PMID- 2762065 TI - [Rhabdomyoma of the heart in a newborn infant]. PMID- 2762066 TI - [Use of quantum hemotherapy in young children with severe variants of pneumonia]. PMID- 2762067 TI - [Experience in the use of ultraviolet irradiation of autologous blood in the treatment of intestinal infections in young children]. PMID- 2762068 TI - SDT analysis of experimental thermal pain, with "signal" and "no-signal" being determined psychophysically. AB - In a signal-detection experiment, the effects of repeated pain stimulation and the induction of fear on pain thresholds and SDT parameters were studied. "Signal" and "no-signal" were not defined physically, but by means of an independent criterion as the primary sensations "pain" and "no-pain." First, the relationship between sensation levels for "phasic" (short stimulus, used in the SDT procedure) and "tonic" (longer stimulus, used in the criterion measurement) heat stimuli was determined in 14 subjects. It was quadratic (polynomial regression) and sufficient to define the distinction between "signal/pain" and "no-signal/no-pain." In the signal-detection experiment, a significant upward trend (adaptation) in threshold parameters, but no systematic change in the SDT parameters (discrimination ability and response bias) was found. Manipulation of anxiety by instructions caused unsystematic changes in discrimination ability. The procedure employed determines both the absolute strength of pain sensation and the ability to discriminate pain from no pain. These variables proved to be independent. PMID- 2762069 TI - Influence of cognitive style and interstimulus interval on the hemispheric processing of tactile stimuli. AB - 16 adult subjects performed a tactile recognition task. According to our 1984 study, half of the subjects were classified as having a left hemispheric preference for the processing of visual stimuli, while the other half were classified as having a right hemispheric preference for the processing of visual stimuli. The present task was conducted according to the S1-S2 matching paradigm. The standard stimulus was a readily recognizable object and was presented tactually to either the left or right hand of each subject. The comparison stimulus was an object-picture and was presented visually by slide in a tachistoscope. The interstimulus interval was .05 sec. or 2.5 sec. Analysis indicated that the left-preference group showed right-hand superiority, and the right-preference group showed left-hand superiority. The notion of individual hemisphericity was supported in tactile processing. PMID- 2762070 TI - Left-handedness and life expectancy. AB - Halpern and Coren recently described an association between left-handedness and a lower life expectancy. This finding is not unexpected because left-handedness has been linked to three leading causes of death in our society--alcoholism, smoking, and breast cancer--as well as to several neurological and immune disorders. PMID- 2762071 TI - Language and motor findings in benign megalencephaly. AB - 9 children between the ages of 5 and 12 yr. whose head circumferences were greater than the 98th percentile and showed negative CT scans and histories for disease associated with increased brain size were studied. A battery of language, articulation, intelligence, and motor tests were administered to subjects and in each case to a sibling whose head circumference was normal. Analysis showed few differences in intelligence and language comprehension between the megalencephalic children and their siblings. Significant differences were observed in motor proficiency, with over 50% of the megalencephalic children scoring below the 10th percentile for their age group. Three megalencephalic children displayed articulation errors. All subjects had at least one parent whose head circumference exceeded the 98th percentile. These results suggest a relationship between benign megalencephaly and developmental motor difficulties. PMID- 2762072 TI - Auditory illusion analogous to Baldwin illusion redux. AB - Two tones, differing only in duration, were used to define an interval. The perceived midpoint of the interval was displaced towards the tone of longer duration. PMID- 2762073 TI - Wavelength effects on critical flicker frequency in human infants. AB - We examined 3-mo.-old human infants' ability to detect flicker in 454-nm blue and 627-nm red lights at 1.5 log cd/m2. Infants showed the same critical flicker frequency (CFF) to both wavelengths, suggesting that retinal cones mediate the detection of flicker at this luminance level. Infants' CFFs for chromatic stimuli were much lower than those reported for achromatic stimuli and also much lower than adults' CFFs tested under the same conditions. PMID- 2762074 TI - Gender effects in pain perception. AB - Studies have shown that women report more pain than men when pain is induced in the laboratory. As sex differences in perceived pain have not been established with clinical or endogenous pain, research was undertaken to compare reported pain of males and females arising from one of three sources. Two groups of adults and one group of children were studied. Analysis indicated no sex differences in reported clinical or endogenous pain for children or adults. PMID- 2762075 TI - Comparison of two tests of visual-motor development used to assess children with learning disabilities. AB - To examine the validity and sensitivity of the Test of Visual-motor Skills and the Developmental Test of Visual-motor Integration, 38 students with learning disabilities were administered each test twice over a 6-mo. period. Correlations between age-equivalents, percentile ranks, and zeta-scores ranged from .58 to .71, supporting the construct validity of the Test of Visual-motor Skills. However, mean scores on the Developmental Test of Visual-motor Integration were significantly higher with all three methods of reporting test results and do not support concurrent validity. Subjects made a significantly greater mean change in age-equivalent score on the Test of Visual-motor Skills, suggesting that this score is preferable for measuring change in children receiving remedial programs for visual-motor dysfunction. PMID- 2762076 TI - Early studies of mental health delivery systems. AB - Newly discovered sociological studies of mental health clinics' delivery systems are corroborated in retrospect by the author's current research. New data detail further the empirical, statistical, and systemic features of the delivery system's operations. PMID- 2762077 TI - Relationships between the Goodenough-Harris Draw-a-Person Test and a body-image test in Costa Rican children. AB - Although researchers have used drawings of the human figure to evaluate body image in adults and children, test measures of the concepts involved have not been precisely constructed, so the purpose of this study was to estimate the body image concept relations measured on the Goodenough-Harris Draw-a-Person Test and on the Prueba para Diagnostico de Imagen Corporal--Universidad Nacional for 90 kindergarten, first and second graders. Factor analyses (sex by grade, 2 x 3; and sex by age, 2 x 7) showed that sex was not a significant factor on either measure, but grade and age were. A Pearson correlation for the total scores on both tests was a moderate, significant value of .45. Correlations of the total with subtest scores varied from .30 to .50. Values were strongest for first grade children from 6 to 6 1/2 yr. of age (.59 to .78), at the beginning of the developmental period in which children gradually gain an awareness of the parts of the body, their functions and left-right concepts. PMID- 2762078 TI - Coincidence-anticipation performance of adolescent baseball players and nonplayers. AB - 10 adolescent baseball players and 10 nonplayers made estimates of baseballs' arrival at the front edge of a home plate. Balls were projected 45 ft. by a pitching machine at speeds of 35, 40, 45, and 50 mph. Subjects made estimates with the dominant and nondominant eye closest to the oncoming ball. Analysis indicated that players were no more accurate than nonplayers but did respond significantly earlier and with consistency. Eye dominance had no effect on performance. PMID- 2762079 TI - Effect of test expectancy on preferred study strategy use and test performance. AB - Among undergraduates in a carefully controlled design, 9 students who took notes studied longer than groups of 30 and 17 who did not. No differences were observed on test scores, retention interval, comprehension scores, or reading rate. Whether students expected multiple-choice or free-recall testing, strategies were similar, suggesting study oriented to rote learning. PMID- 2762080 TI - How accurately can elbow flexion force be estimated? PMID- 2762081 TI - Elementary counting of cardinal and ordinal numbers by persons with mental retardation. AB - Cardinal and ordinal counting skills were assessed in 37 mentally retarded adult workers and 42 school children with mental retardation. The major results were the very poor performance of the younger children (essentially at chance beyond the numbers 1 and 2) and the overall marked inferiority in ordinal compared with cardinal counting. PMID- 2762082 TI - Visual superiority effect in televised prevention of victimization programs for preschool children. AB - Preschool children have been reported to remember more visual than auditory content from television programs. 80 preschool children were randomly assigned to conditions where visual or auditory components of a televised program on personal safety were manipulated. Visually modeled actions were slightly more salient for preschool-age children than actions represented auditorily. The combination of visual and auditory input provided the superior educational method. PMID- 2762083 TI - Apparel shopping behavior of elderly men and women. AB - 70 interested elderly (65 yr. and over) men and women participated in an investigation of older consumers' apparel-shopping behavior and satisfactions and dissatisfactions with available clothing and facilities. Analysis showed that the participants considered shopping ease, wide variety, and label/brand as some of the important factors while shopping for clothes. The respondents were satisfied with good selection, closeness of the mall, and reasonable sales. However, their dissatisfactions ranged from service to fit and size, youthful styles, and abundance of imported clothing. In-store displays, mail order catalogs, and window shopping were the most commonly used sources of apparel information. Several implications of the findings were discussed and suggestions for further research were made. PMID- 2762084 TI - Relations of moderate physical exercise to scores on hostility, aggression, and aggression, and trait-anxiety. AB - 100 male subjects were selected from a midwestern university and categorized into 5 jogging groups, advanced, intermediate, beginning, drop-out joggers and nonexercisers, who were administered the Commitment to Running Scale, the Buss Durkee inventory measuring hostility and aggression, and the State-Trait Anxiety Inventory. Analysis of covariance with age as a covariate was performed using a 5 x 2 design with the 5 levels of jogging and status of the jogger (student/nonstudent) as independent variables. Fisher's LSD was used for multiple comparisons. Joggers scored higher than drop-outs or nonexercisers on the Commitment to Running Scale. Nonexercisers had higher mean scores on trait anxiety than advanced, intermediate, and drop-out joggers; advanced joggers had a lower mean trait-anxiety score than any other group. Nonexercisers had higher mean aggression and hostility scores than drop-out or advanced joggers; drop-out and advanced joggers did not differ significantly but their scores were significantly lower than those of other groups of joggers. These findings confirm that jogging affects trait anxiety, hostility, and aggression positively, which supports use of exercise preventively. PMID- 2762085 TI - Body-image distortion in normal-weight college women. PMID- 2762086 TI - Analysis of errors on the Trail Making Test. AB - This study was designed to determine whether the number and/or types of errors on the Trail Making Test differentiated head-injured and normal control subjects. Errors on Part B were categorized into two types of shifting errors (from number to letter and from letter to number) and two types of sequencing errors (number and letter). Subjects consisted of 133 head-injured patients and 145 normal controls. Analysis showed that the frequency of errors on Parts A and B did not differ significantly between the groups nor did the percentage of subjects making errors. Total shifting and sequencing errors also did not differentiate between the two groups. Although head-injured subjects were more likely than controls to err in shifting from letters to numbers, this finding was of no apparent clinical usefulness. The discriminative value of time scores was confirmed. PMID- 2762087 TI - Psychological differentiation and schizotypal traits: negative results with the Group Embedded Figures Test. PMID- 2762088 TI - Geophysical variables and behavior: LVIII. Autonomic activity, hemolysis, and biological psychokinesis: possible relationships with geomagnetic field activity. PMID- 2762089 TI - Developmental study of the effect of dimensionality and presentation mode on original thinking of children. AB - A sample of 188 children in three age groups, preschool, first and third grades, were administered the Patterns Task of Multidimensional Stimulus Fluency Measure in four test conditions. The conditions systematically varied dimension (three or two) and presentation mode (handling or nonhandling). The fluency measure assessed ideational fluency, popular and original responses, as a measure of creative potential in young children. Analysis showed that dimensionality does not play a major role in the generation of original responses for any grade. However, handling 3-dimensional or 2-dimensional stimuli did appear to facilitate original thinking in preschool children. The use of 2-dimensional photographs which depict dimensionality appeared to compensate for the need to have 3 dimensional stimuli. PMID- 2762090 TI - Dichotic listening in children with serious language problems. AB - 20 children with serious language problems (mainly expressive) were tested with the Dichotic Listening (DL) test for language laterality. 16 were right-handed and 4 left-handed. The dichotic test consisted of series of pairwise presentations of CVC-syllables with "target-syllables" that should be detected interspersed among "distractors." The child pointed to a sheet of paper on which a picture representing the targets (and distractors) was printed. In addition, the children were tested on several expressive and impressive language tests and on finger-tapping. Analysis showed an increased frequency of subjects with a left ear advantage (LEA) and a reduced amplitude of the right-ear advantage (REA) for those subjects showing a right-ear advantage. Correlations with the language variables and with finger-tapping are presented and discussed. PMID- 2762091 TI - Smoking and performance on simulated firefighting tasks. PMID- 2762092 TI - Referred children's cognitive patterns on the WISC-R. AB - A variety of theoretically and clinically derived WISC-R subtest regroupings have been proposed to provide clinicians with alternative methods by which to interpret children's individual cognitive profiles. The present study was conducted to examine selected subtest groupings for a sample of 105 children referred for psychological evaluation because classroom learning problems were suspected. The statistical analyses used were repeated-measures analysis of variance for comparison across a set of four subtest regroupings proposed by Bannatyne in 1974 and dependent t tests for comparisons of several dichotomous sets of subtest regroupings proposed by Kaufman in 1979. A number of significant cognitive pattern differences with these referred children showed marked similarity to learning disabled and conduct-problem children. Implications and suggestions for research are provided. PMID- 2762093 TI - Left-arm dominance in active positioning. AB - The relative accuracy of the left and the right arms in active positioning was studied in a group of 24 male right-handed undergraduates. The task required active positioning of the left and right arms at each of the four angular positions (30 degrees, 45 degrees, 60 degrees, and 75 degrees). The left arm was more accurate in active positioning than the right arm. There was a progressive increase in error for both arms as the arms flexed more in reducing the angle at the joint. Results are discussed in light of suggestions concerning the superiority of the right hemisphere in the processing of kinesthetic and proprioceptive information. PMID- 2762094 TI - Attitude toward physical education and self-concepts of asthmatic and nonasthmatic children taught by physical education specialists. AB - 50 asthmatic and 741 nonasthmatic children in Grades 4 to 6 were compared on attitudes toward physical education and self-concept. Data were collected using the Children's Attitude Inventory Toward Physical Education, a paired-comparison inventory for indicating preferences among 10 school subjects, and the Children's Self-concept Scale. Analysis of variance and X2 indicated no significant differences between asthmatic and nonasthmatic children on the three measures. PMID- 2762095 TI - Attention and the Muller-Lyer illusion: simulation of an experiment by Larsen and Garn. PMID- 2762096 TI - Motor slowing in asymptomatic HIV infection. AB - To examine neuropsychological deficits associated with the human immunodeficiency virus (HIV), 25 asymptomatic homosexual men and sexual partners of intravenous drug users and 25 seronegative homosexual men and nonhigh-risk heterosexuals were assessed on measures of fine motor control, visual scanning, attention, depression, and global psychological functioning. Analysis suggested that HIV infection is associated with reduced fine motor control. Seropositivity is associated with elevated depression and global psychological maladjustment. When depression and global adjustment were analyzed as covariates, motor slowing was evident in the seropositive group. These findings suggest an association between motor slowing and HIV infection in asymptomatic subjects and point to the necessity of measuring affect at least as a control variable. Further study is needed to determine whether the fine motor deficit evident in this sample is limited to distinct subgrouping of the over-all sample. PMID- 2762097 TI - Color aftereffect contingent on text. AB - During adaptation, two different letter strings (each five or six letters) were presented to subjects alternately, one in green and the other in magenta. The extent to which these letter strings subsequently elicited a color aftereffect was assessed. In different experiments, the chromatic letter strings consisted of words and nonwords. The results indicated that letter strings that form English words can contingently elicit a color aftereffect. This was the case even when the words were anagrams. There was no evidence that nonword letter strings could contingently elicit such an aftereffect, even when the nonwords conformed to English orthography. The results are relevant to understanding other contingent color aftereffects (McCollough effects), illusory color noted by computer operators who work at monochrome (green or amber) displays, and the processing of text. PMID- 2762098 TI - Perceived self-motion elicited by postrotary head tilts in a varying gravitoinertial force background. AB - We measured the effects of postrotary head tilts on the perceived duration and the apparent axis of illusory self-rotation experienced following counterclockwise body rotation in high (1.8 G), normal (1 G), and low (0 G) gravitoinertial force environments. In the absence of head movements, the duration of illusory afterrotation was shorter in 0 G and 1.8 G than in 1 G, and it was further shortened by 40 degrees pitch-back head movements in 1 G and 1.8 G. Clockwise illusory afterrotation about the torso's vertical z-axis was always experienced in trials without postrotary head tilts. In trials with head movements, half the subjects experienced no change in this pattern; however, half experienced transient rightward roll of the torso's z-axis, which remained the rotation axis. The duration and extent of apparent roll were greater in 0 G and smaller in 1.8 G than in 1 G. We provide a functional explanation for the tendency for perceived self-rotation to be determined relative to the torso and to the gravitoinertial vertical rather than solely in relation to head position and head-fixed angular velocity sensors. PMID- 2762099 TI - Analysis of simple reaction time to a sinusoidal grating by means of a linear filter model of the detection process. AB - Simple reaction time (RT) to a sinusoidal grating was analyzed in terms of a linear filter model of the detection process. First, RT contrast functions were determined over a wide range of spatial frequencies and retinal illuminances. Second, calculating the time course of the linear filter's response, theoretical visual latency contrast functions were derived for the same conditions of spatial frequency and retinal illuminance as those in the RT measurements. Comparison of the two functions showed that the contrast dependence of the RT functions was much larger than that of the visual latency functions. The discrepancy between the two functions was satisfactorily described as a power function of the slope of the filter's response at threshold level. On the basis of these results, we propose a model of the RT process. According to the model, the RT process is mediated by a cascade that consists of a level detector, which includes a linear filter followed by a threshold device, and a differentiator of the filter's response. PMID- 2762100 TI - Figure-ground organization in real and subjective contours: a new ambiguous figure, some novel measures of ambiguity, and apparent distance across regions of figure and ground. AB - This study was designed to assess the effects of organization, luminance contrast, sector angle, and orientation on a new, highly ambiguous Cs-keyhole figure. Organization and contrast were the most important factors, and sector angle also influenced figure-ground relationships. There was no significant effect of orientation, nor was there any significant interaction between any of the factors. Several new measures of figure-ground organization were developed, such as ambiguity ratios based on reaction times and on ratings of the strength of perceived organizations, providing new quantitative measures of figure-ground relationships. Distances measured across figural regions appeared smaller than equal distances across the ground in the new reversible figure, and also in Rubin's classic vase-face figure presented in real and subjective contours. Inducing a perceptual set to see a particular organization in a reversible figure influenced the apparent distance across that organization. Several possible explanations of the observed effects are considered: (1) an instance of Emmert's law, based on the difference in apparent depth of figure and ground; (2) an aspect of the Muller-Lyer illusion; (3) a feature-detector model of contour attraction; (4) a natural set or predisposition to see a figure as smaller; and (5) framing effects. The first two explanations appear the most promising. PMID- 2762101 TI - Effect of click rate and delay on breakdown of the precedence effect. AB - The precedence effect was tested as a function of echo-click delay and click rate after an abrupt switch in location between leading and lagging clicks. Click trains at three rates, 1/sec, 2/sec, and 4/sec, with delays ranging between 2 and 20 msec, were presented to subjects in an anechoic chamber. Duration of the click train after the switch in location was 12 sec, and echo click perceptibility was assessed throughout this period. The number of echo clicks heard was an increasing monotonic function of delay. The subjects reported a "fade-out" of echo clicks after a set number of clicks at each delay, regardless of rate. This result was interpreted as a buildup in inhibition of echoes produced by the ongoing click train. Suppression of echoes was stronger when the leading click originated from the right side than from the left side. PMID- 2762102 TI - Movement versus focusing of visual attention. AB - In two experiments, we investigated the idea that attention moves through visual space in an analog fashion. The spatial distribution of attention was determined by presenting a spatially informative cue and comparing reaction times to targets at cued and uncued locations as a function of the interval from cue onset to target onset (SOA). Facilitation and inhibition were measured by reference to a neutral condition in which the cue provided no spatial information. In the first experiment, we used a central cue (an arrow), and in the second experiment, we used a peripheral cue (a 50-msec flash). With central cue, the facilitatory effects of the cuing were initially equal for all locations on the indicated side of the display, and then decreased for all locations except the one that had been specifically cued. These results are interpreted as being more consistent with "focusing" of an initially broad "beam" of attention than with "movement" of a narrow beam from fixation to the cued location. With peripheral cues, strong facilitation specific to the cued location was manifest as early as 50 msec after cue onset, but this effect decreased with increasing SOA. Inhibition for uncued locations increased with increasing SOA at a rate that generally reflected their distance from the cued location. Taken together, these results reveal important differences between peripheral and central cues in the generation of attentional selectivity, not just in the time-course of events, but also in the nature of the processes involved. PMID- 2762103 TI - Binaural and temporal integration of the loudness of tones and noises. AB - Subjects judged the loudness of tones (Experiment 1) and of bursts of noise (Experiment 2) that varied in intensity and duration as well as in mode of presentation (monaural vs. binaural). Both monaural and binaural loudness, for both types of signals, obeyed the bilinear-interaction prediction of the classic temporal integration model. The loudness of short tones grows as a power function of both intensity and duration with different exponents for the two factors (.2 and .3, respectively). The loudness of wide-band noises grows as a power function of duration (with an exponent of approximately .6) but not of sound pressure. For tones, binaural summation was constant but fell short of full additivity. For noises, summation changed across level and duration. Temporal summation followed the same course for monaural and binaural tonal stimuli but not for noise stimuli. Notwithstanding these differences between tone and noise, we concluded that binaural and temporal summation are independently operating integrative networks within the auditory system. The usefulness of establishing the underlying metric structure for temporal summation is emphasized. PMID- 2762104 TI - A limited-capacity response process in absolute identification. AB - In two absolute identification experiments, the dependency of the current response, Rn, on the immediately preceding stimulus, Sn-1, and response, Rn-1, was measured by means of multivariate information transmission (see McGill, 1954). In these experiments, the amount of stimulus information available to subjects, measured as the amount of information transmission from a current stimulus, Sn, to Rn, was manipulated. The magnitude of the dependency of Rn on Sn 1 and Rn-1 was inversely proportional to that of information transmission from Sn to Rn, supporting the argument of Ward and Lockhead (1971) that the less stimulus information the subjects get, the more their responses will be likely to depend on previous stimuli and responses. Interestingly, the sum of information transmission from Sn, Sn-1, and Rn-1 to Rn was always about 2.5 bits, without respect to the variance of each term. This result could have arisen from the operation of a limited-capacity response process. PMID- 2762105 TI - Higher formant normalization results from auditory integration of F2 and F3. AB - Two experiments were conducted to test the hypothesis that higher formant normalization results from the auditory integration of F2 and F3 when they are within 3 Bark of each other. In the first experiment, Formants 3-5 were manipulated in both a "hid"-"head" continuum (in which F2 and F3 are within 3 Bark of each other) and a "hood"-"HUD" continuum (in which F2 and F3 are not within 3 Bark of each other). It was found that there was a shift in identification consistent with the higher formant normalization effect only in the "hid"-"head" continuum. In the second experiment, F3 alone was manipulated in a "hood"-"HUD" continuum. The amplitude of F3 in this continuum was increased (as compared with the F3 in the "hood"-"HUD" continuum used in Experiment 1) and a pretest indicated that the shift in F3 could be detected. As in the first experiment, there was no shift in identification associated with shifting F3 frequency in a back-vowel continuum. The results of these experiments are not consistent with an explanation of higher formant normalization in which hearers adjust an internal vowel space in response to higher formant information; rather, the present findings indicate that higher formant normalization results from auditory integration of F2 and F3. PMID- 2762106 TI - Age differences in discrimination of simulated single-formant frequency transitions. AB - We studied auditory discrimination of simulated single-formant frequency transitions that resembled portions of certain speech consonants. Significant age differences in transition discrimination occurred; both children and older adults required larger acoustic differences between transitions for discrimination than did teenagers/young adults. Longer transitions were more easily discriminated than shorter transitions by all listeners, and there were no differences between discriminations of rising and falling transitions. Teens/young adults and older adults, but not children, required larger frequency differences to discriminate frequency transitions followed by a steady-state sound than for transitions alone. There were also age differences in discrimination of steady-state sounds. These developmental-perceptual differences may help explain why children and older adults who have good pure-tone sensitivity may experience difficulty in understanding speech. PMID- 2762107 TI - Consonant and vowel perception and production: early English-French bilinguals and English monolinguals. AB - This study is a comparative analysis of the English phonetic systems of 10 fluent adult English-French bilinguals who acquired their two languages prior to age 8 and who were English-dominant, and of 10 adult English monolinguals. The objective of the study was to determine whether or not early English-dominant bilinguals perceive and produce speech as English monolinguals do. Discrimination and identification tests of synthetic (d-t) and (i-I) continua and speech production tests revealed that the bilinguals' discrimination and production of (d) and (t) and their production of (I) did not differ significantly from the monolinguals'. However, the bilinguals' identification of (d-t) and (i-I) and one aspect of their production of (i) did differ significantly from that of the monolinguals. The present results indicate that early bilingualism can yield monolingual-like performance in at least one of the bilinguals' languages, but only with respect to certain aspects of the phonetic system. These findings are viewed in light of sound-class distinctions, the perception-production dichotomy, and bilingual phonetic transfer and restructuring. PMID- 2762108 TI - Apparent motion: evidence of the influence of shape, slant, and size on the correspondence process. AB - Four stimulus elements configured as a notional diamond were flashed in pairs to elicit apparent motion. When the elements were identical (4 Zs), the direction of apparent motion was ambiguous. When the elements were pairs of different letters (Cs and Os, Es and Zs), letters of different sizes (Zs and zs), or oppositely oblique lines, the direction of apparent motion tended to be between identical elements. This was true, however, only for an initial, brief observation period. Subsequently, the direction of apparent motion tended to be determined by the direction of motion perceived at first, regardless of the character of the elements. This quickly established directional set (within 10 sec) largely swamped any tendency to resolve correspondence in terms of a feature of the stimulus. It appears to be based on spatial rather than retinal or egocentric coordinates. PMID- 2762109 TI - Profiles of the newly licensed nurse. PMID- 2762110 TI - Criteria for placement and replacement of dental restorations. PMID- 2762111 TI - The University of Minnesota School of Dentistry Xerostomia Clinic. PMID- 2762112 TI - Etiology and clinical manifestations of xerostomia. PMID- 2762113 TI - Usual, reasonable, and customary dental fees today. PMID- 2762114 TI - Sequences flanking the repeat arrays of human minisatellites: association with tandem and dispersed repeat elements. AB - We present DNA sequences flanking cloned hypervariable human minisatellites. In addition to providing confirmatory evidence that minisatellites cluster with other tandem repeats, these flanking sequences contain a high frequency of interspersed repetitive elements. These elements include a retroviral LTR-like sequence, from which one of the minisatellites appears to have expanded, and a recently described short interspersed repeat. We present our own findings concerning this element, in particular that those examples studied do not show significant evolutionary conservation, despite suggestions that the element may have a cis-acting function. PMID- 2762115 TI - Synthesis and properties of oligonucleotides containing 4-thiothymidine, 5-methyl 2-pyrimidinone-1-beta-D(2'-deoxyriboside) and 2-thiothymidine. AB - Methods are given for the synthesis of derivatives of 4-thiothymidine (4ST), 5 methyl-2-pyrimidinone-1-beta-D(2'-deoxyriboside) (4HT) and 2-thiothymidine (2ST) suitable for incorporation into oligodeoxynucleotides by the cyanoethyl phosphoramidite method. 4HT and 2ST are incorporated with no base protection but the sulphur atom in 4ST is protected with an S-sulphenylmethyl (-SCH3) function. This can be removed with dithiothreitol after synthesis. These T analogues have been incorporated into GACGATATCGTC, a self-complementary dodecamer containing the Eco RV recognition site (underlined), in place of the two T residues within this site. Although pure dodecamers are obtained in each case the syntheses are not as efficient as those seen when normal unmodified bases are used mainly due to the chemical reactivity of 4ST, 4HT and 2ST. Some of the chemical properties of oligonucleotides containing these bases (reactivity towards NH3) as well as their physical properties (melting temperatures, U.V., fluorescence and circular dichroism spectra) have been determined and are discussed. PMID- 2762116 TI - Cooperative interaction of chicken lysozyme enhancer sub-domains partially overlapping with a steroid receptor binding site. AB - Expression of the lysozyme gene is a marker for the differentiation of macrophages, lysozyme transcription being gradually increased during maturation. We have analyzed the fine structure and function of two macrophage-specific enhancer elements of the chicken lysozyme gene (E-2.7 kb and E-0.2 kb). Both increase their activities upon LPS induction, both contain multiple binding sites for similar or identical nuclear factors and both can be divided into two functional modules. For the E-0.2 kb enhancer we found a synergistic activity of the modules to be dependent on their distance. Binding sites for nuclear proteins within enhancer E-0.2 kb overlap substantially with the previously identified progesterone/glucocorticoid receptor binding site, which is required for steroid induction of lysozyme transcription in the oviduct. PMID- 2762118 TI - Codon usage and gene expression level in Dictyostelium discoideum: highly expressed genes do 'prefer' optimal codons. AB - Codon usage patterns in the slime mould Dictyostelium discoideum have been re examined (a total of 58 genes have been analysed). Considering the extreme A + T richness of this genome (G + C = 22%), there is a surprising degree of codon usage variation among genes. For example, G + C content at silent sites varies from less than 10% to greater than 30%. It was previously suggested [Warrick, H.M. and Spudich, J.A. (1988) Nucleic Acids Res. 16: 6617-6635] that highly expressed genes contain fewer 'optimal' codons than genes expressed at lower levels. However, it appears that the optimal codons were misidentified. Multivariate statistical analysis shows that the greatest variation among genes is in relative usage of a particular subset of codons (about one per amino acid), many of which are C-ending. We have identified these as optimal codons, since (i) their frequency is positively correlated with gene expression level, and (ii) there is a strong mutation bias in this genome towards A and T nucleotides. Thus, codon usage in D. discoideum can be explained by a balance between the forces of mutational bias and translational selection. PMID- 2762117 TI - Purification of human transcription factor IIIC and its binding to the gene for ribosomal 5S RNA. AB - Transcription factor hTFIIIC was purified from cytoplasmic extracts of HeLa cells using four different chromatographic steps. This procedure yields a protein fraction which actively supports transcription in reconstitution assays and contains five major polypeptide chains with a molecular mass ranging from 25 to 250 kDa as estimated by SDS-PAGE and silver staining. In this fraction a polypeptide with a molecular mass of approximately 110 kDa could be identified as a specific DNA-binding component of hTFIIIC. By electrophoretic mobility shift and footprinting analyses it could be demonstrated that purified hTFIIIC binds specifically to the 5S gene. The protected region encompasses the A-Box promoter element and flanking sequences extending toward the 5'-proximal end of the gene. By addition of hTFIIIC to preformed TFIIIA/5S DNA complexes, we observe an additive effect of both factors on the footprint boundaries. PMID- 2762119 TI - An oocyte-expressed alpha-tubulin gene in Xenopus laevis; sequences required for the initiation of transcription. AB - We have studied the expression of X alpha T14, a member of the alpha-tubulin multigene family in Xenopus laevis. Small amounts of X alpha T14 RNA are detectable in a range of cell types, but much higher levels are present in ovary and tissue culture cells. In oocytes X alpha T14 transcripts accumulate during early vitellogenesis but their level declines in more advanced stages. Faithful and efficient initiation of transcription occurred on cloned X alpha T14 injected into oocytes even at low template levels. We have examined the amount of transcript produced by various deletion mutants relative to a co-injected control gene. The presence of 200bp of DNA 5' and 53bp of DNA 3' to the initiation site sufficed for high levels of promoter activity, although maximum activity required 560 bp of 5' flanking DNA. The DNA between -200 and -60 was necessary for transcription in oocytes and contains several sequence motifs implicated in transcriptional regulation including three CCAAT boxes and a sequence resembling a heat shock element. An 8 bp deletion that removed the latter element from 5kb of 5'-flanking DNA reduced promoter activity by 60%. PMID- 2762120 TI - Nucleotide sequence, genomic organization and evolution of a major repetitive DNA family in tilapia (Oreochromis mossambicus/hornorum). AB - A highly repetitive DNA sequence from tilapia (Oreochromis mossambicus/hornorum) has been cloned and sequenced. It is a tandemly arrayed sequence of 237 bp and constitutes 7% of the fish genome. The copy number of the repeat is approximately 3 x 10(5) per haploid genome. DNA sequence analysis of 7 cloned repeats revealed a high degree of conservation of the monomeric unit. Within the monomeric unit, a 9 bp AT rich motif is regularly spaced approximately 30 bp apart and may represent the progenitor of the amplified sequence. One cloned repeat, Ti-14, contained a 30 bp deletion at a position flanked by a 7 bp direct repeat. The Ti 14 sequence appears to have been amplified independently of the major 237 bp tandem array. A higher-order repeat unit, defined by longer-range periodicities revealed by restriction endonuclease digestion, is further imposed on the tandem array. PMID- 2762121 TI - A family of heat shock protein 70-related genes are expressed in the promastigotes of Leishmania major. AB - We describe the isolation and characterisation of two novel genes of the parasitic protozoan Leishmania major that are related by nucleotide sequence homology to eukaryotic genes encoding 70 Kd. heat shock proteins. The transcription of neither gene is heat-inducible but both are constituitively expressed throughout the promastigote stage of the parasite life cycle. A third gene shows differential expression between non-infective and infective promastigote stages in the absence of any temperature change. These genes are related by sequence homology to the tandemly-repeated hsp70 genes of trypanosomatids, but are located on different, dispersed chromosomes within the genome of L. major. The open reading frame for translation derived from one of these sequences contains a putative mitochondrial signal peptide at its amino terminus. PMID- 2762122 TI - Chemiluminescent detection of DNA: application for DNA sequencing and hybridization. AB - A non-radioactive DNA detection chemistry is described and its application is shown for DNA hybridization and standard dideoxy DNA sequencing. The method employes a biotin-streptavidin system which binds an enzyme specifically to a target DNA and upon exposure to substrate, the enzyme catalyzes a chemiluminescent reaction. The image is captured within seconds by a Polaroid or X-ray film. The method is capable of detecting DNA in the hundred attomol range. PMID- 2762123 TI - Highly efficient synthesis of oligodeoxyribonucleotides using alpha-phenyl cinnamoyl group for selective amino protection. AB - alpha-phenyl cinnamoyl (alpha-PhCm) group has been found to be highly selective for exocylic amino function of all the three deoxynucleosides viz, 2' deoxyadenosine, 2'-deoxyguanosine and 2'-deoxycytidine. The stereospecific nature of the group confers stability to the N-protected derivatives of 2' deoxyadenosine and 2'-deoxyguanosine towards acids thereby minimising depurination. The easy preparation and introduction of the group, stability of the protected monomers, milder conditions for deprotection resulting in negligible side products during synthesis and above all hydrophobicity of the group are the additional advantages. PMID- 2762124 TI - Construction of a 42 base pair double stranded DNA microcircle. AB - A procedure for the construction of double stranded DNA microcircles is described that overcomes the natural limits of established circularization procedures. Starting with two synthetic oligonucleotides which are able to form dumbbell shaped structures, two subsequent ligation reactions yield a microcircle of double stranded DNA of 42 base pairs. This is by far the smallest circle of double stranded DNA yet described. These microcircles can be constructed in quantities required for high resolution structural analyses such as X-ray crystallography and NMR spectroscopy. PMID- 2762126 TI - The isochore organization and the compositional distribution of homologous coding sequences in the nuclear genome of plants. AB - The isochore structure of the nuclear genome of angiosperms described by Salinas et al. (1) was confirmed by using a different experimental approach, namely by showing that the levels of coding sequences from both dicots and Gramineae are linearly correlated with GC levels of the corresponding flanking sequences. The compositional distribution of homologous coding sequences from several orders of dicots and from Gramineae were also studied and shown to mimick the compositional distributions previously seen (1) for coding sequences in general, most coding sequences from Gramineae being much higher than those of the dicots explored. These differences were even stronger for third codon positions and led to striking codon usages for many coding sequences especially in the case of Gramineae. PMID- 2762125 TI - Isolation and functional analysis of chicken 90-kDa heat shock protein gene promoter. AB - We report the nucleotide sequence of a 2652 bp derived from a chicken 90-kDa heat shock protein (hsp 90) genomic clone. This fragment contains 890 bp of the 5' flanking region and 1762 bp of structural gene sequence encoding the first 85 amino acids of the protein. The start site of transcription was determined by primer extension and RNase mapping. Two introns have been identified. The first intron presents two features in common with the unique intron of the hsp 83 of drosophila: its location just before the ATG initiation codon and its length of approximately 1.3 Kb. The 5' flanking region contains a TATAA element, a CCAAT box and several putative cis-regulatory elements that might account for the basal level of expression and developmental regulation of the gene. Functional analyses show that hsp 90 gene expression is constitutive and heat inducible and that a full heat shock response requires the cooperativity of two distinct blocks of overlapping heat shock response elements. PMID- 2762127 TI - Pre-activation strategy for oligodeoxyribonucleotide synthesis using triaryloxydichlorophosphoranes in the phosphotriester method. AB - Triaryloxydichlorophosphoranes were tested as condensing agents for oligodeoxyribonucleotide synthesis in the phosphotriester method. Tris(2,4,6 tribromophenoxy)dichlorophosphorane (BDCP) was found to be a relatively stable crystalline material which could be used as a chemical reagent. A notable feature of the BDCP-promoted condensation reaction was studied by 31P-NMR. A small amount of BDCP compared to the conventional condensing agent was effective for the generation of active nucleotide intermediates and BDCP itself was quantitatively converted into an inert material, tris(2,4,6-tribromophenyl)phosphate (2). Thus, BDCP enabled us to separate the activation step from the condensation process in the phosphotriester method. This preactivation method was applied to the solid phase synthesis. PMID- 2762128 TI - A characterization of the elements comprising the promoter of the mouse ribosomal protein gene RPS16. AB - The elements comprising the mouse rpS16 promoter were characterized by transfection experiments with mutant genes in which various portions of the 5' flanking region and exon I were removed or substituted with extraneous DNA sequence. These experiments were carried out with otherwise intact rpS16 genes transfected into monkey kidney (COS) cells and also with chimeric rpS16-CAT gene constructs transfected into mouse plasmacytoma cells and COS cells. The locations of the functionally important elements were generally correlated with the locations of binding sites for specific nuclear factors, which were identified by gel-mobility shift analyses and methylation interference footprints. The most upstream element, which is located approximately 165 bp from the cap site, binds the Sp1 transcription factor and augments the promoter activity by 2 to 2.5-fold. In addition, there is a complex bipartite element in the -83 to -59 region, an element in the -37 to -12 region and an element in the +9 to +29 region of exon I, all of which are essential for rpS16 expression. The rpS16 promoter has a general architecture that resembles other mouse rp promoters; however, it also possesses some distinctive characteristics. PMID- 2762129 TI - Nucleotide sequence of wild-type and mutant nifR4 (ntrA) genes of Rhodobacter capsulatus: identification of an essential glycine residue. PMID- 2762130 TI - Nucleotide sequence of 5S ribosomal RNA of Rhodococcus fascians. PMID- 2762131 TI - cDNA sequence of a heat-inducible protein of Chenopodium sharing little homology with other heat-shock proteins. PMID- 2762132 TI - Nucleotide sequence of the NS gene of influenza virus A/Chile/1/83 (H1N1). PMID- 2762133 TI - Nucleotide sequence of cDNA encoding P400 protein in the mouse cerebellum. PMID- 2762134 TI - Nucleotide sequence of an ovine insulin-like growth factor-II cDNA. PMID- 2762135 TI - A Dictyostelium discoideum cDNA coding for a protein with homology to the rat ribosomal protein L7. PMID- 2762136 TI - Nucleotide sequence of human enteric adenovirus type 41 hexon-associated protein VIII precursor (pVIII) including the early region E3 promoter. PMID- 2762137 TI - Chick alpha tropomyosin gene contains three sets of mutually exclusive alternatively spliced exons. PMID- 2762138 TI - Increased recombinational efficiency in insect cells irradiated with short wavelength ultra-violet light. PMID- 2762139 TI - An improved method for the purification of high molecular weight bacterial chromosomal DNA. PMID- 2762140 TI - Biphasic amplification of very dilute DNA samples via 'booster' PCR. PMID- 2762141 TI - Two hour DNA hybridizations using a new transfer membrane. PMID- 2762142 TI - Plasmid multimers as high resolution molecular weight standards for pulsed field gel electrophoresis. PMID- 2762143 TI - Detection of translocation breakpoints by pulsed field gel analysis: practical considerations. PMID- 2762144 TI - Kinetoplastid mitochondria contain functional tRNAs which are encoded in nuclear DNA and also contain small minicircle and maxicircle transcripts of unknown function. AB - The mitochondrion of Leishmania tarentolae contains approximately 35-40 tRNAs many of which comigrate with cytoplasmic tRNAs. Both mitochondrial (KtRNA) and cytoplasmic (CtRNA) tRNAs are functional, as they could be acylated either by mitochondrial or cytoplasmic synthetase extracts. There are two methionyl tRNA species in the cytoplasmic and mitochondrial fractions, one of which is unique to each fraction, indicating that the KtRNA fraction is free of CtRNA contamination. Leucyl and glycyl tRNAs were identified by hybridization with a genomic clone from Trypanosoma brucei. KtRNA hybridizes with nuclear chromosomes, but not with minicircle or maxicircle DNA. KtRNA isolated by DEAE chromatography or agarose gel electrophoresis contains additional small RNAs which hybridize with both minicircle and maxicircle DNA. These transcripts do not migrate like tRNAs in acrylamide gels and their functions is unknown. We suggest that most if not all mitochondrial tRNAs in L. tarentolae are nuclear-encoded and imported into the mitochondrion. PMID- 2762145 TI - Chloroplast-like transfer RNA genes expressed in wheat mitochondria. AB - In the course of a systematic survey of wheat mitochondrial tRNA genes, we have sequenced chloroplast-like serine (trnS-GGA), phenylalanine (trnF-GAA) and cysteine (trnC-GCA) tRNA genes and their flanking regions. These genes are remnants of 'promiscuous' chloroplast DNA that has been incorporated into wheat mtDNA in the course of its evolution. Each gene differs by one or a few nucleotides from the authentic chloroplast homolog previously characterized in wheat or other plants, and each could potentially encode a functional tRNA whose secondary structure shows no deviations from the generalized model. To determine whether these chloroplast-like tRNA genes are actually expressed, wheat mitochondrial tRNAs were resolved by a series of polyacrylamide gel electrophoreses, after being specifically end-labeled in vitro by 3'-CCA addition mediated by wheat tRNA nucleotidyltransferase. Subsequent direct RNA sequence analysis identified prominent tRNA species corresponding to the mitochondrial and not the chloroplast trnS, trnF and trnC genes. This analysis also revealed chloroplast-like elongator methionine, asparagine and tryptophan tRNAs. Our results suggest that at least some chloroplast-like tRNA genes in wheat mtDNA are transcribed, with transcripts undergoing processing, post-transcriptional modification and 3'-CCA addition, to produce mature tRNAs that may participate in mitochondrial protein synthesis. PMID- 2762146 TI - Identification of two transactivation domains in the mouse oestrogen receptor. AB - We have identified two discrete transactivation domains within the mouse oestrogen receptor whose relative activities vary according to the target promoter. One domain lies within the N-terminal region and is active in the absence of oestradiol. The second domain is contained within the C-terminal portion of the protein and depends upon oestrogen binding for its activity. The location and oestrogen dependence of this domain has been confirmed using chimaeric receptors containing the Lex A DNA binding domain. Although transactivation by the C-terminal domain is dependent upon ligand binding the analysis of receptor deletion mutants has demonstrated that these two functions are not entirely coincident. PMID- 2762148 TI - Distribution and sequence homogeneity of an abundant satellite DNA in the beetle, Tenebrio molitor. AB - The mealworm beetle, Tenebrio molitor, contains an unusually abundant and homogeneous satellite DNA which constitutes up to 60% of its genome. The satellite DNA is shown to be present in all of the chromosomes by in situ hybridization. 18 dimers of the repeat unit were cloned and sequenced. The consensus sequence is 142 nt long and lacks any internal repeat structure. Monomers of the sequence are very similar, showing on average a 2% divergence from the calculated consensus. Variant nucleotides are scattered randomly throughout the sequence although some variants are more common than others. Neighboring repeat units are no more alike than randomly chosen ones. The results suggest that some mechanism, perhaps gene conversion, is acting to maintain the homogeneity of the satellite DNA despite its abundance and distribution on all of the chromosomes. PMID- 2762147 TI - Isolation of human cDNA clones of ski and the ski-related gene, sno. AB - cDNA clones of ski and the ski-related gene, sno, were obtained by screening human cDNA libraries. The predicted open reading frame of h-ski could encode a protein of 728 amino acid residues. The h-ski protein is highly homologous with the v-ski protein. The overall homology between h-ski and v-ski is 91% at the amino acid level. DNA sequencing analysis revealed two types of cDNA clones from the sno (ski-related novel gene) gene, possibly due to alternative splicing. The first type, named snoN (non Alu-containing), encoded a protein of 684 amino acid residues. The second type, named snoA (Alu-containing), encoded a protein of 415 amino acid residues. The first 366 amino acid residues of snoN and snoA are the same, but subsequent amino acids show divergence. Several transcripts of h-ski (6.0, 4.7, 3.8, 3.0, 2.1 and 1.8 kb) were detected. The mRNAs of h-sno were 6.2, 4.4 and 3.2kb. PMID- 2762149 TI - Highly sensitive detection of DNA using enzyme-linked DNA-probe. 1. Colorimetric and fluorometric detection. AB - In order to develop non-radioactive oligonucleotide derivatives and to examine their utility as a diagnostic tool, namely as DNA-probe, an enzyme-linked oligonucleotide was synthesized. Oligonucleotide complementary to M13mp8 phage DNA was linked to alkaline phosphatase via a crosslinker and a spacer. M13mp8 phage DNA (single strand) immobilized on the nitrocellulose membrane was hybridized with the enzyme-linked oligonucleotide. The hybrid was detected with three detection methods; (1)colorimetric detection in solution, (2)colorimetric one on membranes, and (3)fluorometric one in solution. Methods(2) and (3) gave high sensitivities to detect as low as several to several tens attomoles of DNA and it was found that those methods with enzyme-linked oligonucleotides are potent for DNA-probe methodology from the viewpoint of automation. PMID- 2762150 TI - Presence of multiple species of polypeptides immunologically related to transcription factor TFIIIA in adult Xenopus tissues. AB - Transcription of 5S RNA gene in Xenopus oocytes requires a 38 kDa transcription factor TFIIIA, which interacts with the 50 bp internal control region of the gene. We looked for TFIIIA-like polypeptides in the extracts of adult Xenopus tissues on the basis of their antigenic cross-reactivity to anti-TFIIIA antibody. Several species of polypeptides ranging from 30 to 50 kDa were found in kidney, stomach, liver and testis. Although these polypeptides reacted specifically to anti-TFIIIA antibody, proteolytic peptide mapping of three representative ones did not reveal any mutual similarities. They also seemed to be distinct from TFIIIA. Possible functions of these proteins are discussed. PMID- 2762152 TI - Mutagenesis analysis of a self-cleaving RNA. AB - The hammerhead structural model proposed for sequences that mediate self-cleavage of certain RNAs contains base-paired three stems and 13 conserved bases. Insertion, deletion and base substitution mutations were carried out on a 58 base RNA containing the sequence of the single-hammerhead structure of the plus RNA of the virusoid of lucerne transient streak virus, and the effects on self-cleavage assessed. Results showed that there is flexibility in the sequence requirements for self-cleavage in vitro, but alterations of the conserved sequence or predicted secondary structure generally reduced the efficiency of self-cleavage. PMID- 2762153 TI - Differential replication of circular DNA molecules co-injected into early Xenopus laevis embryos. AB - Replication of co-injected supercoiled DNA molecules in fertilized Xenopus eggs was monitored through the blastula stage of development. The extent of replication, as measured by 32P-dTMP incorporation into form I DNA, was directly proportional to the number of molecules, rather than the size, of the plasmid injected. Although only a small fraction of molecules of either template was replicated, incorporation was predominantly into full length daughter molecules. Over at least a 20-fold concentration range of microinjected DNA, injection of equal masses of DNA resulted in greater incorporation into the smaller form I DNA present in molar excess. The extent of incorporation into supercoiled DNA for a particular plasmid was apparently independent of the concentration of a second, co-injected plasmid. The relative extents of replication of co-injected supercoiled templates could be altered simply by changing the molar ratios of the templates. PMID- 2762151 TI - Branch point selection in alternative splicing of tropomyosin pre-mRNAs. AB - The rat tropomyosin 1 gene gives rise to two mRNAs encoding rat fibroblast TM-1 and skeletal muscle beta-tropomyosin via an alternative splicing mechanism. The gene is comprised of 11 exons. Exons 1 through 5 and exons 8 and 9 are common to all mRNAs expressed from this gene. Exons 6 and 11 are used in fibroblasts as well as smooth muscle whereas exons 7 and 10 are used exclusively in skeletal muscle. In the present studies we have focused on the mutually exclusive internal alternative splice choice involving exon 6 (fibroblast-type splice) and exon 7 (skeletal muscle-type splice). To study the mechanism and regulation of alternative splice site selection we have characterized the branch points used in processing of the tropomyosin pre-mRNAs in vitro using nuclear extracts obtained from HeLa cells. Splicing of exon 5 to exon 6 (fibroblast-type splice) involves the use of three branch points located 25, 29, and 36 nucleotides upstream of the 3' splice site of exon 6. Splicing of exon 6 (fibroblast-type splice) or exon 7 (skeletal muscle type-splice) to exon 8 involves the use of the same branch point located 24 nucleotides upstream of this shared 3' splice site. In contrast, the splicing of exon 5 to exon 7 (skeletal muscle-type splice) involves the use of three branch sites located 144, 147 and 153 nucleotides, upstream of the 3' splice site of exon 7. In addition, the pyrimidine content of the region between these unusual branch points and the 3' splice site of exon 7 was found to be greater than 80%. These studies raise the possibility that the use of branch points located a long distance from a 3' splice site may be an essential feature of some alternatively spliced exons. The possible significance of these unusual branch points as well as a role for the polypyrimidine stretch in intron 6 in splice site selection are discussed. PMID- 2762154 TI - Dependence of the linking deficiency of supercoiled minichromosomes upon nucleosome distortion. AB - The contribution from each nucleosome to the linking number of minichrosome DNA depends on two factors. These are the wrapping number, omega, which is the number of times the DNA wraps about the axis of the nucleosome; and the winding number, phi, which is the number of base pairs on the nucleosome divided by the helical repeat of the DNA. If the nucleosome is distorted with DNA surface contacts being preserved, phi remains unchanged. The wrapping number may still change, however, depending on the extent of the distortion. For example, if the usual cylindrical shape of the nucleosome is deformed into an ellipsoid while preserving the equatorial radius, then the wrapping number will increase. We apply these concepts to minichromosomes torsionally stressed by supercoiling with, for example, DNA gyrase. We analyze the experimental result that the maximum amount of supercoiling obtained by gyrase treatment of minichromosomes is the same as that of naked DNA. In particular, we show that this phenomenon can be explained by a relatively slight distortion of the nucleosome core while maintaining the surface contacts of the DNA on the core. PMID- 2762155 TI - Nucleotide sequence of a maize mitochondrial tRNAGlu (UUC) gene. PMID- 2762157 TI - Cloning and sequencing of the haemagglutinin-neuraminidase gene of mumps virus (Miyahara strain). PMID- 2762156 TI - Cloning and sequencing of the fusion protein gene of mumps virus (Miyahara strain). PMID- 2762158 TI - Nucleotide sequence of a hop stunt viroid (HSVd) isolate from the German grapevine rootstock 5BB as determined by PCR-mediated sequence analysis. PMID- 2762159 TI - Nucleotide sequence of tryptophan tRNA gene in Acholeplasma laidlawii. PMID- 2762160 TI - The sequence of cDNA of bovine coronavirus 32K nonstructural gene. PMID- 2762161 TI - A tandemly repeated DNA sequence from Brassica juncea. PMID- 2762162 TI - The beta-actin gene of carp (Ctenopharyngodon idella). PMID- 2762164 TI - Nucleotide sequence of the cDNA for murine intercellular adhesion molecule-1 (ICAM-1). PMID- 2762163 TI - Nucleotide sequence of a full length cDNA clone encoding for beta-tubulin of the sea urchin Paracentrotus lividus. PMID- 2762165 TI - Sequence analysis of a genomic clone encoding an endochitinase from Solanum tuberosum. PMID- 2762166 TI - Sequence of the right hand terminal palindrome of the human B19 parvovirus genome has the potential to form a 'stem plus arms' structure. PMID- 2762167 TI - Nucleotide sequence of an element detecting highly polymorphic regions in insect genomes. PMID- 2762168 TI - Direct sequencing from low-melt agarose with Sequenase. PMID- 2762169 TI - Improved genetic fingerprinting using RNA probes. PMID- 2762170 TI - A Dutch pedigree with mild hemophilia B with a missense mutation in the first EGF domain (factor IXOud en Nieuw Gastel). PMID- 2762171 TI - Drug and alcohol abuse. PMID- 2762172 TI - Managing immunization. PMID- 2762173 TI - School health worker and supplementary nutrition in Indian schools. PMID- 2762174 TI - Guidelines for nursing management of people infected with human immunodeficiency virus (HIV). 4. Basic principles of nursing management. AB - Presented below is the third installment of the series of guidelines developed jointly by the World Health Organization and the International Council of Nurses. They contain basic information on the nursing management of people with HIV infection, including guidance on the prevention of transmission, and the routine care and counselling of infected persons. PMID- 2762175 TI - Occupational health nursing: a modern concept. PMID- 2762177 TI - Relationship between the work values and job satisfaction in nursing profession. PMID- 2762176 TI - Child nutrition: a primary health care approach towards health for all by 2000 AD. PMID- 2762178 TI - Guidelines for nursing management of people infected with human immunodeficiency virus HIV. 4. Basic principles of nursing management (contd.). PMID- 2762179 TI - Autonomic dysreflexia: a life threatening emergency. PMID- 2762180 TI - Time course of the discomfort in young patients undergoing orthodontic treatment. AB - Discomfort may accompany orthodontic movement of teeth. The purpose of this study was to determine the time envelope of discomfort induced in young patients (10-16 years) following placement of orthodontic separators and arch wires. Secondly, psychosocial factors concerning feelings of "self" were investigated. Forty-five experimental and 14 control patients seeking orthodontic treatment were included. A data sheet consisting of several visual analogue scales measuring patient perceptions of dental discomfort and psychosocial factors was used. The results indicated that the experimental group experienced significant discomfort with both separators and arch wires at 4 and 24 hr compared to controls; however, the discomfort dissipated by 7 days. The appearance of the teeth and face were significant factors predicting the patient's perspective of "self." The results have significant clinical implications and these are discussed. PMID- 2762181 TI - Lack of stability in enamel defects in primary teeth of children with cerebral palsy or mental retardation. AB - The Developmental Defects of Enamel (DDE) index was used to study the reliability across time of assessment of enamel defects in primary teeth in neurologically handicapped children. Fourteen of the 48 children originally examined were available for re-examination 6 months later. The original findings were confirmed in only 6 of these children (5 with no enamel defects and 1 with an enamel defect). Discrepancies noticed between the 2 examinations in the other 8 children could be explained on the basis of biological processes that occurred during the 6-month interim, namely, attrition, abrasion, crown fracture, caries, and possibly remineralization of a hypomineralized defect. These findings suggest that the optimum time for studying such defects is as soon as possible after the teeth erupt. PMID- 2762182 TI - Fluoride retention following topical application of a new APF foam. AB - The oral retention of fluoride (F) following the topical application of a newly developed APF foam was compared with a conventional APF gel. Twenty adults aged 16-26 years participated in the study. Ten of the subjects received the F foam and gel treatments, on separate occasions, with a saliva ejector while another 10 subjects received the same treatment without saliva ejector. Approximately 4 g of the gel, and 0.9 g foam, were dispensed for each treatment. The amounts of fluoride applied, recovered from the mouths, and retained in the mouth were calculated for each treatment. PMID- 2762183 TI - The prevalence of fluorosis-like lesions associated with topical and systemic fluoride usage in an area of optimal water fluoridation. AB - The frequency of using self-applied (over-the-counter) fluoride products and prescribed supplemental fluorides, and the prevalence of fluorosis-like enamel lesions in the permanent dentitions of children living in an optimally fluoridated urban community were investigated. Subjects were selected randomly, and consent forms and questionnaires concerning fluoride usage and residency status were provided to guardians prior to examination. After a supervised tooth brushing event, 300 consenting subjects were examined by the principal investigator using Dean's index to assess levels of fluorosis-like lesions. The principal investigator was standardized with another investigator prior to the examinations to obtain an interexaminer agreement level of 97%, and an intraexaminer agreement level of 96%. Portable dental equipment was used during all examinations. Chi-square analysis indicated no statistically significant difference between the frequency of tooth brushing with a fluoridated dentifrice at an early age and the prevalence of fluorosis-like enamel lesions. However, there was a significant difference (P less than 0.05) between the prevalence of fluorosis-like lesions, and the frequency of using prescribed fluoride supplements and gels, and over-the-counter rinses. PMID- 2762184 TI - Screening preschool children for dental caries using a microbial test. AB - The present report describes the usefulness of a microbial caries screening test in a population of children younger than 6 years. Two hundred children presenting to a private pediatric dental office were screened for Streptococcus mutans using a test adapted for the dental office. The numbers of S. mutans colonies were recorded semiquantitatively and carious lesions were assessed clinically and radiographically. Ninety-three per cent of children with caries were positive on the test (sensitivity), while 57% of the infected children had caries (specificity). Uninfected children were almost always caries free (predictive value negative 95%). The results also showed an increasing percentage of children with caries in groups of children with increasing infection level. These findings are consistent with both the central role of S. mutans in caries initiation and the multifactorial nature of caries development. The dramatically better results in the present report may reflect a closer correlation between caries activity and S. mutans infection in younger than in older children. Microbial screening may be useful for identification of young children infected with cariogenic microorganisms so that preventive and therapeutic treatments can be tailored to the needs of individual patients. PMID- 2762185 TI - Management of an early ankylosed mandibular second primary molar: case report. AB - An unerupted mandibular second primary molar first was observed in a healthy male 3 years, 4 months of age. The report presents the rationale to allow the first permanent molar to erupt fully. The treatment objectives are presented with the description of the fixed appliances used to accomplish the objectives. PMID- 2762186 TI - Rubinstein-Taybi syndrome: case report. AB - A patient with Rubinstein-Taybi syndrome is presented with the characteristic clinical features including small and short stature, severe mental retardation, and small maxilla with a dental malocclusion. Treatment for this patient was accomplished utilizing a general anesthetic. These special patients who lack the ability to accept dental treatment in the normal situation require extensive and comprehensive dental treatment compared with nonhandicapped patients. PMID- 2762187 TI - Guidelines to the prevention of problems in record keeping. Part I. PMID- 2762188 TI - [Bladder exstrophy: a neonatal emergency. I: Functional reconstruction]. AB - The goal of the treatment involving the children with exstrophy of the bladder must include urinary continence, protection of renal function, good reconstruction of the penis and a good quality of life. The staged approach (Jeff's protocol) includes bladder closure with penile lengthening, when necessary, in the first week of age, epispadias repair and finally bladder neck reconstruction with bilateral ureteral reimplantation. The authors present their experience on staged functional reconstruction of classical bladder exstrophy (40 patients). They had no dehiscences of the abdominal wall and bladder at the primary bladder closure, at any age, with or without bilateral iliac osteotomy. The final successful rate in the staged functional bladder reconstruction was about 70% and it is continuously improving. In the authors' opinion the successful initial bladder closure is perhaps the most important factor for obtaining a larger bladder more quickly and for achieving a high urinary continence; it must be performed in tre first days of life. PMID- 2762189 TI - [Bladder exstrophy: a neonatal emergency. II: Urinary diversion]. AB - The goal of the therapy involving the children with exstrophy of bladder must include urinary continence, protection of renal function and a good quality of life. Primary closure of the bladder would seem to be the ideal solution, but when it is impossible or fails, ureterosigmoidostomy can provide satisfactory solution. We have treated 15 selected exstrophied patients with ureterosigmoidostomy. The average length of follow up was 8 years and 9 months (range is from 19 years to 18 months). All patients have normal renal function; in 13 patients upper urinary tract is normal and two have a moderate ureteral dilatation. In 13 patients the fecal and urinary continence is complete, in two it's acceptable. We report radiological and manometric studies of the rectum and sigma after ureterosigmoidostomy. The long term results are excellent; it is mandatory to have correct indications, meticulous care in the operative technique producing a long submucosal tunnel with direct anastomosis of the ureter to the bowel, post operative management and follow up care. PMID- 2762190 TI - [Hydronephrosis in childhood. Long and mid-term morphologic and functional results]. AB - Hydronephrosis in infancy and childhood is a frequent urinary malformation and is almost always congenital. In over 80% of the cases it is due to ureteropelvic junction obstruction; in about 17%, anomalous renal vessels at the ureteropelvic junction are present. The authors analyze their experience in the surgical treatment of hydronephrosis. 360 hydronephrosis out of 335 patients were operated on from November 1971 to November 1988. 108 patients were less than 1 year old (32.2%). Primary nephrectomy was carried out only in 11 of the 360 hydronephrosis operated on (about 3%). An anterior approach and a simple dismembering pyeloplasty were performed in the majority of the cases. From the radiological point of view there was an impressive amelioration or normalization in about 92% of the cases operated on. From the functional point of view the radionuclide scan showed a normal or slightly reduced renal function in almost 90% of the cases operated on. The preoperative and postoperative radionuclide study showed a moderate increase of the renal function in the majority of the cases controlled. The authors stress the importance of prenatal ultrasound diagnosis to improve long term results of an early surgical treatment. PMID- 2762191 TI - [Ectopic ureter]. AB - Ectopic ureter is quite a rare malformation, and it can be more or less serious depending on its anatomy (monolateral or bilateral ectopy, duplicated ureter, single ureter) and the associated malformations. It's more common in female patients. Ectopic ureteral orifice can be either intravesical (bladder neck) or, more often, extravesical. Ectopia in women is more frequently found in the urethra and the vaginal vestibule; much less frequently in vagina and in uterus. In men it is mostly found in the posterior urethra; in the male genital tract is very rare. In most cases ectopic ureter is associated with pyelo-ureteral complete duplication: the upper kidney usually works badly or doesn't work at all, due to renal dysplasia or pyelonephritis. More rarely ureteral ectopia affects a single urinary system and can be monolateral or, in the most serious forms, bilateral. The main clinical signs are urinary incontinence accompanied by regular micturition (more exactly pseudoincontinence) in the female patients, and urinary infection. In the male there is no urinary incontinence. Authors report their experience about 54 ectopic ureters in 51 children. Treatment is always by surgery: the choice has to be made between conservative or radical attitude. 38 total exeresis of the ectopic excretory pathway (upper heminephroureterectomy or nephroureterectomy), 9 ureteral reimplantations, 1 uretero-pyeloanastomosis have been done. Outcome is always satisfactory in monolateral forms, more uncertain in bilateral forms with single ectopic ureter, due to incontinence and reduced bladder capacity problems and the possible associated renal failure. PMID- 2762192 TI - [Transureteroureteroanastomosis in children. Indications and results]. AB - Transureteroureterostomy is a method of internal urinary diversion available to maintain the integrity of the urinary system, when the lower ureter is compromised. The usual requirements are a donor kidney with a minimal renal function on one side and a normal contralateral recipient kidney and ureter. From January 1972 to October 1988 in our Division transureteroureterostomy has been done in 52 children. In some cases the procedure was used simultaneously with reimplantation or cutaneous ureterostomy. The majority of patients had been referred with previous failed ureteral reimplantation or with unilateral reflux or ureteral obstruction in neurogenic bladder with small capacity and compliance. Results (14 years to 6 months follow-up) are very good with excellent results for both kidneys in 98% of the cases. Our experience and that of other authors confirm that transureteroureterostomy is a technique simple with low morbidity and excellent results. PMID- 2762193 TI - [Treatment of urethral stenoses in children using a balloon catheter]. AB - The management of the urethral strictures in children has involved dilatation, internal urethrotomy and urethroplasty. Each method of management has varying degrees of success and is associated with special problems. The authors describe their experience in the management of urethral strictures in 32 children by inflatable balloon catheter. The procedure involves atraumatic catheterization by an urethral catheter under radioscopic vision, followed by introduction of a balloon catheter on a flexible guide which is then filled by contrast medium. The stenosis is visible on the balloon and the rapidity with which it "yields" can readily be appreciated. Control of dilatation is effected by voiding urethrography. This method entails much less discomfort and more advantages than conventional urethral dilatation. No complication was observed. All patients underwent a second balloon dilatation, without radioscopy and 25 also a third prior to obtain a good and permanent result. PMID- 2762194 TI - [Nutrition errors in children]. AB - Errors in the childhood feeding administration are commonly met, particularly during the first and second year of life, according to the poor or vague knowledge among paediatricians. A first proof of this assumption is given when, as a consequence of digestive disturbance, caused by a wrong nourishment, the paediatrician suggests remedies that, substantially, make the same primitive mistakes. A second proof is given when a particular diet, due to the presence of intestinal disturbance and already seen to be inefficacious, is reproposed, even more than once, with industrial aliments which differ from the ones used in the name and the brand but not in the composition. Finally, another proof is given when in the exclusion therapy due to an intolerance towards gluten, towards cow's milk, towards disaccharides, the paediatrician inserts, in the diet, products containing, respectively, the above mentioned components. These and other mistakes are reported in the present casuistry (121 cases), the majority of which (75 cases) is accompanied by specific examples. Between the cases that mostly stand out we find the so called "precocious weaning" as cause of digestive disturbance and, frequently, as initial moment of a chain of errors responsible, in their turn for the protraction and the chronicization of the aforementioned intestinal pathology. PMID- 2762195 TI - [Small skin surgery in children: skin analgesia with a cream made of lidocaine and prilocaine]. AB - The problems arising daily in the management of many skin diseases as the removal of warts, molluscum contagiosum, etc. are often complicated simply by the fear of the pain of some treatment modalities (i.e., cryosurgery, curettage, etc.). A choice between no analgesia and analgesia by the classic percutaneous infiltration with local anaesthetics is sometimes difficult. A new lidocaine/prilocaine cream provides us an effective local anaesthesia for such treatments. PMID- 2762196 TI - [Height and weight increase in Sassarian children in the last 20 years]. AB - Height and weight were obtained for 4349 children (2330 males and 2019 females), aged 3-11 years and attending the primary school in Sassari, Sardinian, in 1986. Findings were compared to those reported by De Toni and Aicardi for the same population in 1966 in order to find out possible changes occurred in this lapse of time. The results of our study show that in the last 20 years children have become taller and heavier, but at the same time they seem to be rather "fatter" than in the past. PMID- 2762197 TI - [Evaluation of the possible effects of phototherapy on the nonnutritive sucking patterns in newborn infants]. AB - The eventual incidence of the phototherapy on the patterns of the nonnutritive sucking in the neonate at term has been evaluated. The comparison between the two groups of newborns (those in phototherapy treatment and the control group), allowed us to make a conclusion that the phototherapy does not affect in a significant way the patterns of the nonnutritive sucking in the newborns at term, as it is shown from the evaluation of the t-student test p less than 0.01. PMID- 2762198 TI - [Reye's syndrome: reports of 7 cases in the period 1982-1987]. AB - Reye's syndrome is an acute non-inflammatory encephalopathy with fatty degeneration of inner organs. The disease seems to be the metabolic response to a generalized mitochondrial insult. From 1982 to 1987, we studied 7 patients, age range being 2 months to 12 years, affected by R.S. None of them had taken salicylic acid before; three of them had been treated with acetaminophen. Two out of the seven patients examined had serious neurologic problems; other two recovered completely both under clinical and histological aspects, as it is shown by the hepatic biopsy done before and after the disease, and the remaining three died. We have tried to demonstrate the importance of hepatic biopsy in the diagnosis of R.S. and in the verification of the reversibility of the histological phenomenon. Hepatic biopsy demonstrated that the disease stopped at the initial stage, limited itself and evolved towards a complete recovery. PMID- 2762199 TI - [Kawasaki disease in a subject with G6PD deficiency]. AB - A case of Kawasaki disease in an 8 year old boy affected by G6PD deficiency is described. The patient couldn't be treated with aminosalicylic acid but he received 400 mg/Kg/die of gammaglobulin from 13th to 18th day. No coronary complications occurred, even if coagulopathy was documented, and platelets activation was back to normal three months after the beginning of the disease. PMID- 2762200 TI - [Description of a case of tuberous sclerosis in a 2-month-old girl]. AB - Tuberous sclerosis was suspected in a 2 months old infant with hemilateral convulsions and typical skin lesions. C.A.T. and fundus exams confirmed the diagnosis. The case is interesting because of the very young age at which diagnosis was possible. PMID- 2762201 TI - Ultraviolet radiation at high latitudes and the risk of skin cancer. AB - Solar irradiance in the spectral region 280 to 800 nm was measured with a double monochromator at 2 locations in Norway, Tromso (69.7 degrees N) and Longyearbyen (78.2 degrees N). During the observational (midnight sun) period in Longyearbyen, the maximum UVB irradiance recorded was less than 0.3 W/m2, and no radiation was detected for wavelengths below 300 nm. Such low levels are believed to be a consequence of the low solar elevation angle and the high ozone content of the Arctic ozone layer, which absorbs the incident UV light. With levels between 280 and 350 DU over the period of study, Tromso and Longyearbyen recorded only one ninth of the calculated UVB radiation at the equator. There is therefore a considerably higher risk of radiation damage to the skin in equatorial regions (controlling for skin type), a finding that agrees with the statistical evidence for a 7-8 times higher rate of skin cancer in the white population of equatorial countries. PMID- 2762202 TI - Reaction to UV-induced erythema in young patients with basal cell carcinoma. AB - The effects of an irradiation 6 times the minimal erythemal dose of UVB were studied using a visual scale from 1 to 4+ in 12 patients aged under 45 years with a past medical history of basal cell carcinoma, and in 12 sex-, age- and skin type-matched controls. Erythema was significantly more intense at days 15 (p less than 0.01) and 22 (p less than 0.001) in patients than in controls. Pigmentation was significantly weaker at day 22 than in controls (p less than 0.005). PMID- 2762203 TI - Different sensitivities to ultraviolet light-induced cytotoxicity and sister chromatid exchanges in xeroderma pigmentosum and Bloom's syndrome fibroblasts. AB - The relationship between ultraviolet (UV) light-induced sister chromatid exchanges (SCE) and UV cytotoxicity was compared among fibroblast strains from 18 patients with xeroderma pigmentosum (XP) (6 group A, 1 group C, 3 group D, 5 group E, 3 variant), 2 patients with Bloom's syndrome (BS) and 3 normal subjects. Spontaneous SCE frequencies in all of the XP strains were indistinguishable from those in normal cells, while BS cells exhibited about 10 times more spontaneous SCE than did normal cells. SCE were induced dose-dependently by UV at doses of 0 4.0 J/m2 in all the strains. The mean frequencies of UV-induced SCE were much higher in XP-A and -C cells than in normal cells. XP-D and -E cells were slightly more sensitive to UV-induced SCE formation than normal cells. XP-variant cells were almost as sensitive as normal cells. The induced SCE frequencies plotted as a function of surviving fraction were relatively lower in XP-A and -D cells than those in normal cells, though in XP-C, -E, and -variant cells they were almost the same as those in normal cells, suggesting that, in XP-A and -D groups, UV damage is more lethal than producing SCE in surviving cells. By contrast, 2 BS strains exhibited significantly higher frequencies of UV-induced SCE than the other strains as a function of not only UV dose but also surviving fraction. These results reflect the essential differences between XP and BS cells in UV induction of SCE. PMID- 2762204 TI - Sunscreen testing using the mouse ear model. AB - During the developmental stages of sunscreen formulation it is desirable to have a simple, accurate and inexpensive biological model to test product effectiveness. Another desirable attribute is a quantitative, unbiased response endpoint for evaluation. We have developed such a test system based upon the ear swelling response of hairless albino mice. With this system, irradiation times are greatly reduced; furthermore, the response parameter is metric and can be determined noninvasively with an inexpensive micrometer. Protection factors determined with the mouse ear model show high correlation with the sun protection factors as determined on human subjects (r = 0.92) and were linearly related over a wide range of values. This new method affords a simple, accurate and inexpensive system for evaluation of efficacy and safety of new products. PMID- 2762205 TI - Connubial photosensitivity to musk ambrette. PMID- 2762206 TI - Dacarbazine-induced photosensitivity. PMID- 2762207 TI - Quantification of urocanic acid isomers in human stratum corneum. PMID- 2762208 TI - Reciprocity of ultraviolet erythema in human skin. PMID- 2762209 TI - Drug fever caused by 8-methoxypsoralen. PMID- 2762210 TI - Pediatrician's perspective. Observations of a junior pediatrician. PMID- 2762211 TI - Transdermal drug transport and metabolism. II. The role of competing kinetic events. AB - The steady-state flux and skin tissue distribution of a topically applied diester of salicylic acid was measured in vitro in the presence and absence of an esterase inhibitor. When compared with data obtained previously under in vivo conditions, the results presented here provide insight into the role of competing diffusional and hydrolytic events in the delivery and distribution of topically applied drugs. Furthermore, these results, when combined with a theoretical analysis of topical drug delivery and metabolism, suggest that the differences in delivery and drug distribution seen under in vitro conditions are related to both altered drug removal and altered hydrolysis rates. PMID- 2762212 TI - Procedures to characterize in vivo and in vitro enantioselective glucuronidation properly: studies with benoxaprofen glucuronides. AB - The diastereoisomeric glucuronic acid conjugates of R/S-benoxaprofen are the major benoxaprofen metabolites and are found in urine at high concentrations. The conjugates of R- and S-benoxaprofen can be separated directly on a C18 reversed phase column using a mixture of acetonitrile and tetrabutylammonium hydroxide buffer, pH 2.5 (28:72, v/v), as the mobile phase. The k' values of S- and R benoxaprofen glucuronides are 57.5 and 63.0, respectively. Diluted urine or deproteinized plasma samples were injected without further treatment. With fluorescence detection at 313/365 nm, quantifiable limits of 50 ng equiv./ml were found for the conjugates. The intra- and interday variability was below 12%. Utilizing this analytical procedure it is possible to characterize enantioselective glucuronidation both in vivo and in vitro. For in vitro procedures, apparent rates of formation and the R/S ratio may be substrate (benoxaprofen) and cosubstrate (UDPGA) dependent. Moreover, enantioselective cleavage of the formed benoxaprofen glucuronides by alkaline hydrolysis, hydrolytic enzymes, and acyl migration must be controlled for both in vitro and in vivo studies since R-benoxaprofen glucuronide is degraded faster than the S diastereomer under certain conditions. PMID- 2762213 TI - The area function method for assessing the drug absorption rate in linear systems with zero-order input. AB - A noncompartmental approach for determination of the apparent zero-order absorption rate constant (k0) has been developed. The procedure evolves from the convolution integral and requires individual oral-dose plasma concentrations values and calculation of area intervals under the plasma concentration-time curves after intravenous administration. The proposed method was evaluated and compared with the Wagner-Nelson, Loo-Riegelman, deconvolution, nonlinear regression, and moment methods using errorless and errant simulation data from one- or two-compartment models. The area function method is generally equal to the best of these techniques (nonlinear regression) and superior to the weaker methods (moment, deconvolution, Loo-Riegelman), especially for errant two compartment data. Coupled with a companion procedure for constructing fraction absorbed versus time plots and assessing first-order absorption rate constants, the area function methods offer direct and accurate means of discerning drug absorption kinetics without the need for assignment of a disposition model for drugs with linear elimination kinetics. PMID- 2762214 TI - Statistical moment analysis of hepatobiliary transport of phenol red in the perfused rat liver. AB - A new experimental system was applied to study hepatobiliary transport of drugs. Rat livers were perfused using a single-pass technique, and phenol red was momentarily introduced to this system from the portal side. Outflow dilution patterns of phenol red were analyzed using statistical moment theory, and kinetic parameters of hepatic distribution and elimination of phenol red were calculated from moments, namely, the hepatic extraction ratio (Ei) and elimination rate constant (kel,i). A larger distribution volume (Vi) was obtained for phenol red than for 131I-human serum albumin (HSA) and 51Cr-red blood cells (RBC), indicating its extravascular diffusivity. The biliary excretion of conjugated phenol red was delayed relative to that of the free agent. The larger biliary mean transit time (tbile,conj.) represents the processes of biliary transport and intrahepatic metabolism. Further, the effects of dose and perfusion temperature on the hepatobiliary transport of phenol red were determined. With high doses or low perfusion temperatures (20 and 27 degrees C), Ei, kel,i, and intrinsic clearance (CLint,i) of phenol red and biliary recovery of free and conjugated phenol red (Fbile,free, Fbile,conj) significantly decreased. The temperature dependent and saturable processes in hepatic uptake, metabolism, and biliary excretion of phenol red were assessable to moment analysis. PMID- 2762216 TI - An in vitro model to evaluate muscle damage following intramuscular injections. AB - An isolated rat muscle preparation was developed to screen for muscle damage (myotoxic potential) following intramuscular injections. Myotoxicity is evaluated by the total cumulative efflux of the enzyme creatine kinase from the extensor digitorum longus muscle into the incubation medium over a 2-hr period or by the slope of the cumulative creatine kinase efflux curve. The system allows for rapid screening of compounds and/or formulations regarding their myotoxic potential and is not sensitive to fluctuations of in vivo creatine kinase levels caused by animal handling or patient conditions. A good rank-order correlation was obtained between this in vitro technique and the in vivo myotoxicity of a number of pharmaceutical formulations, as indicated by circulating creatine kinase levels and histological observations. PMID- 2762215 TI - Drug binding to alpha 1-acid glycoprotein studied by circular dichroism. AB - The interactions of acidic and basic drugs with alpha 1-acid glycoprotein (alpha 1-AGP) were investigated using circular dichroism (CD) measurements. Extrinsic Cotton effects were generated by the binding of drugs to alpha 1-AGP. The CD data suggested the presence of a single binding site on the alpha 1-AGP molecule. The induced ellipticities of the acidic drug-alpha 1-AGP system decreased with increasing pH, while the ellipticities for the basic drugs increased with pH. The ellipticities for all drugs were reduced by the addition of fatty acids. Furthermore, the induced ellipticities decreased in the presence of cesium chloride for basic drugs bound to alpha 1-AGP. The extrinsic Cotton effects therefore appear to result from hydrophobic interaction with alpha 1-AGP for the acidic drugs and from hydrophobic and electrostatic interactions for the basic drugs. PMID- 2762217 TI - The determination of microscopic ionization constants of a substituted piperazine using estimates from model compounds. AB - The microscopic ionization constants of 1-[3-(4-chlorophenyl) propyl] piperazine (I) were determined using piperazine (P) and 1,4-bis[3-(4-chlorophenyl)propyl] piperazine (II) as models for one of the ionizations. The macroscopic ionization constants for all three compounds were measured potentiometrically, and the micro constants of P and II, which are symmetrical molecules, were calculated from their macro constants. Only one micro constant of either P or II was suitable as a model for elucidating the micro constants of I. PMID- 2762219 TI - Facilitated transport of basic and acidic drugs in solutions through snakeskin by a new enhancer--dodecyl N,N-dimethylamino acetate. AB - The permeation characteristics of two model drugs, clonidine (basic) and indomethacin (acidic), were studied by determining their penetration fluxes through hydrated shed snakeskins (Elaphe obsoleta) at 32 degrees C. The drugs were formulated in buffers of different pH's, ranging from 3 to 7. The total penetration fluxes at pH 7.0 for both compounds using skins pretreated with dodecyl N,N-dimethylamino acetate were at least 11 times higher than those of the control runs without enhancer treatment. Equations were derived to calculate the permeability coefficients (Ki) and fluxes (Ji) for the ionized and the nonionized species to allow for comparison of their penetration ability through the model membrane. The permeability coefficient of clonidine is 2.50 x 10(-3) cm/hr for the nonionized form and 2.41 x 10(-4) cm/hr for the protonated form. This result indicates that the nonionized form penetrates the skins better than the ionized form. Both permeability coefficient values are 11 times larger than the corresponding values obtained from the control skins. The total flux of clonidine is dependent on its initial concentration in the donor cell but is independent of the ionic strength of the solution formulations. The penetration characteristics of indomethacin are similar to those of clonidine, with a higher permeability coefficient of the nonionized form (3.90 x 10(-3) cm/hr) than of the ionized form (7.97 x 10(-4) cm/hr) using pretreated skins. While the enhancer shows 24 times penetration enhancement of the ionized form of indomethacin, it does not enhance the penetration of the nonionized species. PMID- 2762218 TI - Racial differences in drug response: isoproterenol effects on heart rate in healthy males. AB - It was the purpose of this study to investigate racial alterations in beta adrenoceptor response. Two groups of healthy, male volunteers gave their consent. There were eight black Americans (mean age, 26.1 +/- 2.5 years) and eight white/Caucasian Americans (mean age 24.4 +/- 1.8 years). Each subject underwent an isoproterenol sensitivity test. There was a significant (P less than 0.05) decrease in the ratio of Emax to ED50 in the white group (25.3 +/- 6.4) compared with the black group (37.1 +/- 12.4). Over the dose range of 0.1 to 1.0 micrograms there was a significant increase in response at both the 0.25- and the 0.5-microgram dose (P less than 0.05), with the black American group appearing to respond with a greater rate of rise in heart rate following the initial doses. PMID- 2762220 TI - The role of calcium ions and bile salts on the pancreatic lipase-catalyzed hydrolysis of triglyceride emulsions stabilized with lecithin. AB - Lecithin-stabilized triglyceride emulsions are subject to hydrolysis by pancreatic lipase. The time profiles of these reactions are characterized by a lag-phase and a zero-order phase. Lag phases are more pronounced with long-chain triglycerides. Ca2+ is effective in reducing the lag-phase and activating lipase. Kinetic analysis of the reactions suggests that, like previous findings by others, taurodeoxycholate (TDC) micellar solutions combine with the lipase colipase complex to form another catalytically active enzyme form. This enzyme form exhibits reduced activity in the absence of Ca2+. In the presence of Ca2+ the mixed micelle-lipase complex becomes more active and opens a new pathway for lipolysis. It is suggested that this enzyme form can bind more easily to interfaces with different physicochemical properties. Under these conditions, Ca2+ activates the lipolysis of short-, medium-, and long-chain triglycerides by a similar mechanism. Maximum activities were measured in the presence of approximately 6 mM TDC and 30 mM Ca2+. The experimental conditions approximate the physiological conditions in the gastrointestinal tract since all of the factors studied here have been reported to be necessary for in vivo lipolysis and/or absorption of triglycerides. A mechanistic model for lipolysis in the presence of Ca2+ and the bile salt TDC is proposed which accounts for most of the experimental observations in a quantitative manner. PMID- 2762221 TI - Stability of phenobarbital N-glucosides: identification of hydrolysis products and kinetics of decomposition. AB - The two diastereomers of 1-(1-beta-D-glucopyranosyl)phenobarbital, (1A) and (1B), decompose to 1-(1-beta-D-glucopyranosyl)-3-(2-ethyl-2-phenylmalonyl)urea (2A or 2B) followed by decarboxylation to 1-(1-beta-D-glucopyranosyl)-3-(2 phenylbutyryl)urea (3A and 3B) under physiological conditions of temperature and pH. The sigmoidal pH-rate profile and the Arrhenius parameters indicate that degradation takes place by hydroxide ion attack on the undissociated and monoanion forms of 1A and 1B. The rates of hydrolysis of the nonionized species of 1A and 1B are more than two orders of magnitude faster than those of common 5,5-disubstituted or 1,5,5-trisubstituted barbiturates. Molecular modeling studies suggest that rate enhancement is due to intramolecular hydrogen bonding in the transition state of the C2' hydroxyl with the tetrahedral hydrated C6 carbonyl as well as hindered rotation around the N1-C1' of phenobarbital and glucose. Based on these studies it is recommended that any data related to the quantitation of 1A and 1B be reevaluated depending on how the samples were collected, stored, and analyzed. PMID- 2762222 TI - Permeability and mechanism of albumin, cationized albumin, and glycosylated albumin transcellular transport across monolayers of cultured bovine brain capillary endothelial cells. AB - We have measured the permeability and binding characteristics of bovine serum albumin (BSA), cationized BSA (cBSA), and glycosylated BSA (gBSA) to primary cultures of bovine brain capillary endothelial cells (BBCEC). These endothelial cells serve as an in vitro model to study the binding, uptake, and transcellular transport of small and large molecule flux across the blood-brain barrier. The rate of [3H]BSA flux across the cultured BBCEC monolayers grown onto polycarbonate membranes (5-microns pore size) was linear with increasing BSA concentration and the flux could be inhibited by temperature reduction to 0-4 degrees C. The maximal binding of [3H]BSA was 0.04 fmol/mg total cell protein and could not be inhibited by nonradiolabeled BSA. The binding of cBSA and gBSA was rapid and could be inhibited by nonradiolabeled cBSA or gBSA, respectively. The maximal amount bound was 1.8 fmol/mg total cell protein for cBSA and 17.4 fmol/mg total cell protein for gBSA. The dissociation constants (Kd's) were 27 +/- 13 and 3.7 +/- 1.1 nM for cBSA and gBSA, respectively. The flux rates of cBSA and gBSA across the endothelial cell monolayers were linear with respect to concentration and they were approximately seven times greater than those observed for BSA. Each of the proteins appeared on the antiluminal side of the endothelial cell monolayers primarily (90%) as intact protein as determined by trichloroacetic acid (TCA) precipitations and sodium dodecyl sulfate (SDS)-polyacrylamide gel electrophoresis (PAGE). The results for BSA are similar to those observed for lucifer yellow, a fluid-phase endocytic marker.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2762223 TI - Pharmacokinetics and oral bioavailability of scopolamine in normal subjects. AB - The pharmacokinetics and bioavailability of scopolamine were evaluated in six healthy male subjects receiving 0.4 mg of the drug by either oral or intravenous administration. Plasma and urine samples were analyzed using a radioreceptor binding assay. After iv administration, scopolamine concentrations in the plasma declined in a biexponential fashion, with a rapid distribution phase and a comparatively slow elimination phase. Mean and SE values for volume of distribution, systemic clearance, and renal clearance were 1.4 +/- 0.3 liters/kg, 65.3 +/- 5.2 liters/hr, and 4.2 +/- 1.4 liters/hr, respectively. Mean peak plasma concentrations were 2909.8 +/- 240.9 pg/ml following iv administration and 528.6 +/- 109.4 pg/ml following oral administration. Elimination half-life of the drug was 4.5 +/- 1.7 hr. Bioavailability of the oral dose was variable among subjects, ranging between 10.7 and 48.2%. The variability in absorption and poor bioavailability of oral scopolamine indicate that this route of administration may not be reliable and effective. PMID- 2762224 TI - Prediction of the distribution volumes of cefazolin and tobramycin in obese children based on physiological pharmacokinetic concepts. AB - So as to estimate the appropriate dose of antibacterial drugs in obese children, prediction of the volume of distribution in these children was attempted based on physiological pharmacokinetic concepts which had been constructed from results in normal-weight children. Serum concentration-time data after intravenous drip infusions of tobramycin and cefazolin were analyzed using noncompartmental analysis of obese children in whom the degree of obesity ranged from 30 to 80%. Volume of distribution at steady state (Vss) per total body weight of tobramycin was significantly less than that for normal-weight children (P less than 0.05), whereas the value of cefazolin was almost equal to that for normal-weight children. The equation to express the difference of Vss between cefazolin and tobramycin obtained in normal-weight children failed in obese children, suggesting that there is a large decrease in the extracellular space in obese children exceeding the interindividual variations in normal-weight children. The Vss value (liter) for tobramycin was predicted by using the equation 0.261 . (ideal body weight (kg) + 0.4 . [total body weight (kg) - ideal body weight (kg)]). The Vss value of cefazolin was predicted to be 0.3 . (predicted Vss of tobramycin) + 0.052 . total body weight (kg). A good correlation between the predicted and the observed Vss values was obtained. PMID- 2762225 TI - Differential molecular connectivity in data-base fragment searching. AB - A general scheme is described in which molecular fragments are coded from molecular connectivity values. Specifically a fragment is described by the difference between a simple connectivity index of a certain order and the valence connectivity index of the same order. This numerical value is then used to search for that particular fragment among stored fragment values associated with a molecular connectivity calculation. Examples illustrate the method. PMID- 2762226 TI - Short-chain alkyl esters of L-dopa as prodrugs for rectal absorption. AB - The bioavailability of L-dopa following rectal administration of a series of short-chain alkyl esters of L-dopa was determined in rats and dogs. The esters were stable (greater than 360 min) to hydrolysis in physiological buffer. In vitro enzymatic hydrolysis of the esters in plasma was species dependent, with the hydrolytic rate being faster in rat plasma (t 1/2 less than 5 min) than dog plasma (t 1/2 = 68-181 min) or human plasma (t 1/2 = 96-238 min). In vivo hydrolysis in dogs, as indicated by the L-dopa plasma profile following intravenous administration of the esters, was very rapid (high extravascular esterase activity). Significant L-dopa bioavailability was observed in rats following rectal administration of the methyl (46%), ethyl (14%), isopropyl (48%), butyl (100%), and 4-hydroxybutyl (13%) esters of L-dopa (rectal L-dopa absorption, less than 5%). In dogs, significant L-dopa bioavailability was also observed for the methyl (28%), isopropyl (30%), butyl (32%), and 4-hydroxybutyl (34%) esters of L-dopa in the presence of carbidopa. The data indicate that these highly water-soluble (greater than 600 mg/ml) esters of L-dopa are potential candidates for controlled-release rectal delivery systems designed to provide more constant plasma L-dopa levels. PMID- 2762227 TI - Controlled gastric emptying. II. In vitro erosion and gastric residence times of an erodible device in beagle dogs. AB - An erodible gastric retention device fabricated from various polymeric blends was examined in vitro for its dissolution properties and in vivo in fasting dogs for assessment of its gastric retention potential. Dissolution studies were conducted with extruded rods of polymer blends to assess their potential as candidates for the erodible component of a gastrically retained device. Based on results from dissolution studies, rods of poly(ortho ester)/polyethylene blends (POE/PE) (45% erosion at pH 1.5 and 24 hr) were used to fabricate arms for tetrahedron-shaped devices. Corners for the tetrahedral device were fabricated from Silastic 382 loaded with 15% barium sulfate for X-ray visualization. Beagle dogs were dosed with tetrahedron-shaped test devices administered in gelatin capsules and gastric retention monitored by X ray over a 24-hr period. A comparison of in vitro erosion rates and in vivo performance of various polymer blends indicated a definite trend for increased gastric retention of devices made from the more slowly eroding blends. The results indicate that the blending of erodible and nonerodible polymers is a valid approach for obtaining materials that will provide the necessary structural properties to achieve gastric retention yet lose integrity within a desired time. PMID- 2762228 TI - Side-effect evaluation of a new diazepam formulation: venous sequela reduction following intravenous (i.v.) injection of a diazepam emulsion in rabbits. AB - Diazepam has been incorporated into a stable, submicronized injectable emulsion. Venous sequela induction in rabbits following iv administration of diazepam in a marketed hydroalcoholic solution and in the emulsion were determined and compared over a 5-day period. There was a marked difference in the local reactions induced by the iv administration of the marketed diazepam hydroalcoholic solution and the diazepam emulsion, even on the first postinjection day. This difference was confirmed by pathological analysis. The highest mean venous sequela score was reached by the rabbit group injected with the marketed diazepam solution. It should be noted that no statistical difference was observed between the saline and the diazepam emulsion rabbit groups during the 5 days of the observation period. The moderate increase in the venous sequela score values compared to that for the saline solution should be attributed to the intrinsic effect produced by diazepam itself, and not to the emulsion vehicle, which was shown not to induce any vascular reaction in the present study. PMID- 2762229 TI - Modification of gelatin beadlets for zero-order sustained release. AB - A three-phase suspension process was used for the preparation of gelatin beadlets containing succinylsulfathiazole. When the beadlets were hardened with 10% formalin at 5 degrees C for varying periods of time up to 24 hr, the 6-hr hardening time gave the slowest release rate. Drug release rate from gelatin beadlets was slower in simulated gastric fluid (SGF) than in simulated intestinal fluid (SIF) but the sustained effect was too limited to be useful for most applications. When the hardened gelatin beadlets were coated with cellulose acetate butyrate (CAB) by an emulsion-solvent evaporation method, a more pronounced sustained effect and a nearly zero-order release were found in SIF. The effects of the amount of gelatin used, the amount of CAB employed, and the length of hardening time on drug release were investigated. The treatment of gelatin beadlets with formalin reduced the swelling action of gelatin in aqueous medium. A nonzero-order drug release rate was observed when the gelatin swelled sufficiently to rupture the CAB coating. The drug release rate can be adjusted by using different ratios of hardened gelatin beadlets and CAB coating in which the gelatin enhances the release rate and the CAB serves as a barrier. PMID- 2762230 TI - Determination of reserpine by circular dichroism. PMID- 2762231 TI - Human chorionic gonadotropin levels in pregnancies with aneuploid fetuses. AB - Maternal serum human chorionic gonadotropin (hCG) and the free alpha-hCG subunit were evaluated in 249 women from 9 to 11 weeks gestation who subsequently underwent chorionic villus sampling for determination of fetal karyotype and in 20 women of 18 or more weeks gestation who were ascertained to have an aneuploid fetus by genetic amniocentesis. Seven of the first-trimester pregnancies were determined to be aneuploid and six had hCG levels in the normal range (one triploid pregnancy had elevated hCG levels) whereas 12 of the 20 second-trimester cases had abnormal hCG levels and an additional three had elevated levels of alpha-hCG. This study confirms the previous report of abnormal maternal serum hCG levels in women with an aneuploid fetus at greater than or equal to 18 weeks gestation and demonstrates that hCG evaluation is not useful at 9-11 weeks gestation for selecting pregnancies at risk for fetal aneuploidy. PMID- 2762232 TI - Direct preparations from chorionic villi--relationship between villous morphology and mitotic index. AB - It has been postulated that chorionic villi with abundant sprouts have a higher mitotic index and are therefore preferable for obtaining direct chromosome preparations from chorionic villus samples. This theory was tested by correlating villous morphology with mitotic index. Surprisingly, no statistically significant relationship was found. Choice of culture medium, however, was found to be important, with serum-free RPMI yielding a higher mitotic index than 40 per cent FCS in MEM. We conclude that villous morphology, as assessed in this study, is not a major factor in determining the success of direct chromosome preparations. PMID- 2762233 TI - Triploidy: pregnancy complications and clinical findings in seven cases. AB - Seven cases of triploidy were encountered by the Prenatal Diagnosis Program at Dartmouth-Hitchcock Medical Center over an 8-year period through associated pregnancy complications. We describe the characteristic findings that facilitate prenatal diagnosis and management. Our experience includes fetuses with major central nervous system abnormalities (spina bifida aperta, holoprosencephaly) and anterior abdominal wall defects, which are detectable with routine prenatal diagnostic screening examinations (ultrasound and AFP). In addition, we stress the importance of recognizing obstetric complications and associated cystic placental changes, which are quite common among triploid conceptuses. Molar changes associated with triploidy have a more benign prognosis than that associated with diploid moles. Such molar changes may relate to the presence of a diploid paternal chromosome complement. The usefulness of cytofluorometric DNA determinations in helping to confirm a clinical suspicion of triploidy is emphasized. These cases are presented in an effort to facilitate prenatal recognition and management of this common cytogenetic condition and prevent unnecessary Caesarean section deliveries. PMID- 2762234 TI - Trisomy 16 detected at chorion villus sampling. AB - Trisomy 16 detected at chorion villus sampling (CVS) may reflect the placental but not the fetal karyotype. We describe a case in which the pregnancy continued until intrauterine death at 37 weeks. Cytogenetic study of two placental samples showed 47, + 16 and 46,XX; the fetus was morphologically grossly normal, but fetal tissue culture was unsuccessful. Conservative management may be appropriate when trisomy 16 is detected at CVS and the pregnancy is normal ultrasonographically. PMID- 2762235 TI - Trisomy 12 mosaicism in amniocytes and dysmorphic child despite normal chromosomes in fetal blood sample. AB - Trisomy 12 mosaicism (44 per cent) was detected prenatally in cultured amniocytes. A cordocentesis was performed to confirm the result. Only normal cells were found in the fetal blood sample. The fetus was estimated to be at a low risk of having a chromosomal abnormality and the pregnancy continued. Eight days after birth, a congenital heart defect was detected in the child. Several dysmorphic features were also evident. Further karyotyping of different tissues revealed normal blood and urinary cells but trisomic cells in the placenta (100 per cent) and in skin fibroblasts (25 per cent). The child died at 5 weeks of age. In this case, the fetal blood sample failed to reveal the real chromosome constitution of the fetus. PMID- 2762236 TI - Prenatal diagnosis of 45,X/46,XX mosaicism in the fetus. Should the pregnancy be terminated? AB - 45,X/46,XX True mosaicism was found in the amniotic fluid cell culture study in our patient and was confirmed by rapid fetal blood karyotyping. Elective termination of the pregnancy revealed a morphologically normal female fetus with true mosaicism but no features of Turner's syndrome. PMID- 2762237 TI - A rare case of de novo structural rearrangement of X chromosome diagnosed by amniocentesis. AB - A dicentric X chromosome was found in a female fetus during cytogenetic studies performed on amniotic cells. Blood samples from the parents showed normal karyotypes and the pregnancy was terminated. The mechanism for the formation of this 'de novo' rearrangement is discussed. PMID- 2762238 TI - Prenatal sampling and bicornuate uterus. PMID- 2762239 TI - Prenatal diagnosis of propionic acidemia: amniocentesis at the 11th week of pregnancy. PMID- 2762240 TI - Fetal anemia. PMID- 2762241 TI - Failure to diagnose Lesch-Nyhan syndrome by first trimester chorionic villus sampling. PMID- 2762242 TI - Comparison of procedures to determine protein content of developing bean seeds (Phaseolus vulgaris). AB - Micro-Kjeldahl, Lowry and Bradford procedures were compared for determining the protein content of Phaseolus vulgaris seeds during their development. Micro Kjeldahl and biuret techniques were also compared with mature seeds of a normal and a genetically-improved bean cultivar. The protein contents of casein and soy protein isolate were as well estimated by these four methods. For many samples of both bean and food protein products large disagreements were found between micro Kjeldahl and the other three procedures. PMID- 2762243 TI - Protein digestibility (in vitro) of chickpea and blackgram seeds as affected by domestic processing and cooking. AB - Protein digestibility (in vitro) of grains of chickpea (Cicer arietinum) and blackgram (Vigna mungo) cultivars varied from 48 to 53% and 52 to 58%, respectively. Soaking, cooking (both of unsoaked and soaked seeds), autoclaving and sprouting improved significantly the protein digestibility of all the cultivars of chickpea and blackgram. Autoclaving was found to be most effective followed by cooking and sprouting; cooking of sprouts had only marginal effect. Protein digestibility was higher when soaked instead of unsoaked grains were cooked. PMID- 2762244 TI - Oil content and fatty acid composition of promising Indian Brassica campestris L. (Toria) genotypes. AB - Seeds of sixty four genotypes of Brassica campestris L. (Toria) were analyzed for oil content and fatty acid composition. Oil content varied from 38.9% to 44.6%. Major fatty acids viz. oleic, linoleic, linolenic, eicosenoic and erucic acids exhibited ranges from 10.1% to 17.3%, 5.9% to 14.5%, 5.2% to 15.0%, 7.7% to 13.7% and 39.6% to 59.9%, respectively. Compared to the standard cultivar ITSA, four genotypes contained 5 to 8% lower content of erucic acid; and six genotypes contained significantly higher content of linoleic acid. Oil was positively correlated with erucic acid. The observed inverse relationship between linoleic and erucic acid contents might be utilized in breeding nutritionally better Toria cultivars with both high linoleic and low erucic acid contents. PMID- 2762245 TI - Effect of fermentation on protein, fat, minerals and thiamine content of pearl millet. AB - Natural as well as single, mixed and sequential pure culture (S. diastaticus, S. cerevisiae, L. brevis and L. fermentum) fermentations of pearl millet flour for 72 h lowered pH and raised titratable acidity. The fermentation either decreased or did not change the protein content of pearl millet flour. Natural fermentation increased whereas pure culture fermentation decreased the fat content. Ash content did not change. Natural fermentation at 20 degrees C and 25 degrees C increased whereas at 30 degrees C it decreased the thiamine content of the pearl millet flour. Yeast fermentation raised the level of thiamine two- to three-fold, while lactobacilli fermentation lowered it significantly. PMID- 2762246 TI - Mineral utilization of malted sorghum and corn with added crayfish in rats. AB - Forty adult rats were used to study the mineral balances of malted and unmalted wet- or dry-milled sorghum and corn combined with crayfish and fed rats for 12 days. Five out of the twelve days were for adjustment and the rest for balance period. These mixtures each was calculated to provide 1.6 g N daily for the entire study period. Malting and wet milling produced increases in crude protein content of the cereal grains. However, the increases were much more evident in sorghum. Wet milling caused increases in calcium retention in corn groups. It produced the same effect on phosphorus balance only in sorghum groups. On the other hand, it produced positive iron balances only in unmalted corn and malted sorghum groups. The results suggest improved mineral nutriture due to malting except for the Fe retention of the MDC:CR group. PMID- 2762247 TI - Amino acid composition protein quality and water-soluble vitamin content of germinated cowpeas (Vigna unguiculata). AB - Amino acid composition, protein digestibility, calculated protein efficiency ratio (C-PER and DC-PER), chemical scores and water-soluble vitamin content of cowpea seeds germinated at 25 degrees C or 30 degrees C for 24 h were determined. Also, the effect of processing steps (heated-air drying, decortication and cooking) on these parameters were examined. Germination had little effect on amino acid profile of cowpeas. In vitro protein digestibility was not improved significantly by germination nor by decortication but was improved by cooking. C PER and DC-PER ranged from 1.95 to 2.21 and from 1.63 to 1.82, respectively. DC PER compared well with reported rat PER of cowpea products and seemed more sensitive than C-PER. Based on whole egg values, chemical scores ranged from 37.7 to 45.8% (mean +/- SD; 42.2 +/- 2.4%). Germination increased the contents of niacin, thiamin and riboflavin significantly. Decortication resulted in up to 30% loss in niacin while thiamin content was reduced 41% by cooking. PMID- 2762248 TI - Heart attacks, vitamin E and calculus--the links explored. PMID- 2762249 TI - The medics are not blameless. PMID- 2762250 TI - Looking after the teeth of children in China. PMID- 2762251 TI - All present and collect. PMID- 2762252 TI - Fluoride: more data needed. PMID- 2762254 TI - Labs weigh price of success ... and cost of failure. PMID- 2762253 TI - Could vaccines prevent cavities? PMID- 2762255 TI - The fluoride era. PMID- 2762256 TI - Look into a Dental World. Interview by Jeremy Cowan. PMID- 2762257 TI - Dentistry 1990--What your surgery should contain. PMID- 2762258 TI - [Immunochemical study of surface glycoconjugates of yeast-like fungus of the Candida genus]. AB - Two complex preparations (extract I and extract II) of surface antigens were obtained from the yeast-like fungus Candida maltosa by treatment of intact cells with beta-mercaptoethylamine and pronase. Immune diffusion in agar gel revealed antigenic heterogeneity of the preparations. Both of the extracts were found to have at least 3 antigenic components. The extracts induce hypersensitivity of intact guinea pigs and candida sensitization on the 12th day after the injection of Candida maltose intact cells into the animals. The common antigen components of extracts I and II were found by means of immunochemical and chromatographic assays. The extracts preserved the antigenic activity after enzyme hydrolysis with pronase. PMID- 2762259 TI - [The use of a direct linear method for analyzing glucocorticoid-hormone-receptor interaction in peripheral blood leukocytes]. PMID- 2762260 TI - [Comparative evaluation of the effectiveness of vitamin D3 preparations (1-alpha hydroxy- and 1-alpha,25-dihydroxycholecalciferol in various forms of osteoporosis and osteomalacia]. AB - Clinical investigations have shown that 1 alpha-hydroxycholecalciferol (oxydevit, alphacalcidiol) and 1 alpha, 25-dihydroxycholecalciferol (rocaltrol) are act vitamin D3 agents producing a positive clinical effect in different types of osteoporosis and osteomalacia. Clinical improvement of the patients' status (alleviation of the pain syndrome, an increase in motor activity) was noted in 1 2 mos., an x-ray picture of regeneration of the bone structure of both axial and peripheral skeleton--in 6-12 mos. after the initiation of therapy. Therapy was attended by an increase in the serum content of total and ionized calcium, the return of alkaline phosphatase activity to normal, and a decrease in the level of parathormone. During prolonged therapy these agents administered at daily doses of 0.25-2 micrograms caused no pathological side-effects and hypercalcemia. In osteoporotic conditions all these drugs were equal in their clinical effectiveness. Rocaltrol has some advantages in the presence of associated liver pathology. PMID- 2762261 TI - [Various immunologic indices in primary chronic adrenal insufficiency]. AB - Patients with primary chronic adrenal insufficiency (PCAI) in decompensation demonstrated a decrease in the total level of blood immunoglobulins, in particular IgG, with the normal level of B-lymphocytes. A decrease in IgG and an increase in IgA content was noted in the eucorticoid state; relative and absolute lymphocytosis determined by an increase in T- and B-lymphocytes was also noted. In overdosage of cortisone acetate the total number of immunoglobulins was normal, but IgA was raised and IgG lowered. The number of B-lymphocytes was significantly elevated. The number of T-lymphocytes was within normal but an increase in the level of T-suppressors was noted. PMID- 2762262 TI - [Blood hyperviscosity syndrome in type I diabetes mellitus]. AB - Blood rheological properties and oxygen metabolism were investigated in 50 patients with type I insulin dependent diabetes mellitus. Metabolic and morphological phases of the blood hyperviscosity syndrome were defined in relation to the nature of hemorheological disturbances. Oxygen metabolic disturbances were of unidirectional type manifesting themselves in a decrease in tissue oxygenation and the development of tissue hypoxia. Such disturbances of rheological properties and oxygen metabolism caused the development and progression of diabetic microangiopathies. Therefore pharmacological correction of hemorheological disturbances is a reserve method of therapy of patients with diabetes mellitus. PMID- 2762264 TI - [Remission in diabetes insipidus]. PMID- 2762263 TI - [The fibronectin level in children with diabetes mellitus]. AB - A study was made of the level of fibronectin in 42 pediatric patients with insulin dependent diabetes mellitus. Blood plasma fibronectin was determined by an immunoturbidometric method. A raised concentration of fibronectin was established in patients with a period of disease over 5 yrs., in decompensation of 3rd degree, and the presence of microangiopathies. PMID- 2762265 TI - [Present-day trends in the organization of follow-up observations of patients with diabetes mellitus (lecture)]. PMID- 2762266 TI - [Insulin resistance in experimental hypo- and hyperthyroidism]. AB - The effect of thyroid hormones on the realization of body insulin function was investigated on the models of hypo- and hyperthyroidism. Hyperthyroidism resulting from thyroidectomy, caused the development of insulin resistance, expressed in a lowered body reaction to i. v. insulin infusion, a decrease in tissue sensitivity and reactivity to insulin. Insulin resistance in hypothyroidism was accountable for by a decrease in the serum total activity of insulin-like growth factors. Insulin resistance in hyperthyroidism was less notable and observed only in 10-day administration of thyroiodine; more prolonged administration of the drug (up to 30 days) restored insulin sensitivity. This effect can be accounted for by enhanced insulin independent glucose consumption caused by thyroid hormones. PMID- 2762267 TI - [Functional and morphologic investigations of the human adrenal cortex in various diseases]. AB - The paper is devoted to investigations of the human adrenal cortex on autopsy material obtained 1 h after death. The purpose was to study the features of 3 cortical zones in some diseases with relation to sex and age. Quantitative histoenzymological analysis was used, metabolic indices of corticocytes and the cortical microvascular wall in 3 functionally differentiated zones (glomerular, fascicular and reticular) were estimated. Histoenzymological reactions were subjected to cytospectrophotometric analysis with subsequent statistical processing of data array. Age-related features of the adrenal cortex differed considerably among men and women, and were associated with corticocytes as well as with the cortical microvascular wall. There was no age-related decrease in enzymatic activity in all the adrenocortical structures but there was change in the interrelationship among the 3 differentiated zones. In some diseases change of enzymatic activity proper was noted in all the zones however a histotopogram of the cortex typical of a given age, was preserved. Functional and morphological investigations permitted assessment of the rearrangement of intraadrenal homeostasis, reflecting, probably, shifts in the synthesis of the main 3 classes of corticosteroid hormones. PMID- 2762268 TI - [Antistressor effect of ethanolamine in acute alcoholic intoxication]. AB - Experiments on albino female rats have shown that ethanol, administered intragastrically at a single dose of 2 g/kg, demonstrates steroidogenic properties. Ethanolamine (a natural metabolic product), administered at a dose of 100 mg/kg, increases the basal level of corticosterone in the rat plasma suppressing the steroidogenic activity of ethyl alcohol. PMID- 2762269 TI - [Mechanism of phasic fluctuations of glycemia after administration of diabetogenic substances]. AB - Dithizone induces similar glycemic changes in rabbits, golden hamsters and mice (triphasic fluctuations resulting in diabetes). In rabbits who received 8-(p toluenesulfonylamino)-quinoline, 8-(benzenesulfonylamino)-quinoline or alloxan, the glycemic reaction is similar to that observed after a dithizone injection. A degree of glycemic reaction to chromophiric chelants injected to animals, depends on their accumulation in the lysosome-segregation apparatus, of insulin producing cells (acidotropic action). PMID- 2762270 TI - Effectiveness of discriminant analysis of serum CA 19-9 and elastase 1 in diagnosis of pancreatic carcinoma. AB - The accuracies of assays of serum CA 19-9 and elastase 1 in the diagnosis of pancreatic carcinoma were investigated by the cutoff method and discriminant analysis of data on 98 patients with pancreatitis, 65 patients with pancreatic carcinoma, 107 patients with benign diseases of other organs, and 108 patients with cancer of other organs. Comparison of the diagnostic accuracies of the cutoff method and multivariate analysis of CA 19-9 and elastase 1 showed that the latter was better for diagnosis in terms of its specificity. The performance of multivariate analysis was validated on independent data consisting of 52 patients with pancreatitis, 27 patients with pancreatic carcinoma, 79 patients with benign diseases of other organs, and 29 patients with cancer of other organs. Multivariate analysis of CA 19-9 and elastase 1 was very useful for differentiation of patients with and without pancreatic carcinoma: 24 (88.9%) of 27 patients with pancreatic carcinoma were correctly classified. Moreover, by this method, all patients with pancreatic carcinoma of less than 2 cm in longest diameter and 81.3% of those without jaundice were correctly classified. PMID- 2762271 TI - Type of dietary lipids exerts a major influence on the secretory activity of the exocrine pancreas: medium-term studies. AB - A possible influence of the type of dietary lipids on the pancreas exocrine function was tested on rats. For this purpose, four groups of rats were fed on different diets comprising 5% of different types of lipids: fish oil, evening primose oil, hydrogenated beef tallow, and a mixture of fish oil and evening primose oil. After a 6 week feeding period, the secretory activity of the pancreas was measured. Under resting conditions, rats fed hydrogenated beef tallow release different proportions of amylase, lipase, and serine proteases as compared to rats fed unsaturated lipids. In stimulated conditions, there was no significant difference in the relative proportions of enzymes secreted by the pancreas among the different groups of rats but the secretory response to cerulein stimulation from rats fed saturated lipids was increased by more than 40%. These results demonstrate that the type of dietary lipids exerts a major influence on the secretory activity of the pancreas. PMID- 2762272 TI - Intracellular distribution of pancreatic tumor antigen purified from BHP-induced adenocarcinomas in Syrian hamsters. AB - Pancreatic tumor antigen (PTA) was purified to apparent homogeneity from hamster pancreatic adenocarcinomas by a rapid and simple procedure using column chromatography on Mono P and Superose 6. Amino acid analysis indicated essential similarities between hamster PTA and human pancreatic cancer-associated antigen (PCAA, PCAAc), although differences in the contents of several amino acid residues between the two proteins did suggest species variation. Investigation of the binding pattern of antibody raised against PTA by peroxidase-labeled antibody immunocytochemistry revealed that, whereas PTA is absent or only faintly expressed in normal epithelium, it is very strongly positive in transplantable hamster pancreatic adenocarcinomas induced by nitrosamines. PTA was found to be distributed over the entire surface of neoplastic cells and it was concluded that the presence of PTA on the basolateral surface of malignant pancreatic epithelial cells, where it might have access to the blood circulation, could be one explanation for the observed elevated concentrations of PTA in the serum. PTA is thus a potential marker for hamster neoplastic pancreatobiliary duct-type cells. PMID- 2762273 TI - Xanthine oxidase inhibitor in acute experimental pancreatitis in rats and mice. AB - It has been suggested that oxygen-derived free radicals play a decisive role in the pathogenesis of acute experimental pancreatitis in a model of edematous pancreatitis. Accordingly, allopurinol, a xanthine oxidase inhibitor, was shown to mitigate the development of nonfatal acute pancreatitis in ex vivo perfusion models using dogs. For further evaluation of allopurinol, its effect was studied in two forms of fatal necrotizing acute experimental pancreatitis: sodium taurocholate-induced pancreatitis in rats and choline-deficient ethionine supplemented diet-induced pancreatitis in mice. Allopurinol did not affect the mortality rate, pancreatic enzyme elevation in serum and ascites, the enzyme content of the pancreas, or any parameter indicating histopathological damage in the pancreas. Although these experiments did not determine the role oxygen derived free radicals play in the development of pancreatitis, they show, none the less, the absence of any beneficial therapeutic effect of a xanthine oxidase like allopurinol on the development of the disease once it has begun. PMID- 2762274 TI - Effect of fatty acid on secretin release and cholinergic dependence of pancreatic secretion in rats. AB - We investigated the effects of oleic acid in the duodenum on pancreatic exocrine secretion and plasma secretin, and determined the role of cholinergic dependence on pancreatic secretion and secretin release in response to oleic acid in anesthetized rats. Oleic acid emulsion (pH 6.5) in three different doses of 0.06, 0.25, and 1 mmol/h was infused intraduodenally for 1 h with or without intravenous administration of atropine in a dose of 100 micrograms/kg/h. Intraduodenal administration of oleic acid resulted in significant increases in pancreatic juice volume and bicarbonate output, in a dose-related manner (p less than 0.001). Plasma secretin concentration caused dose-dependent elevation (p less than 0.001) by oleic acid, which correlated very well with bicarbonate output in response to oleic acid (p less than 0.001). Atropine inhibited pancreatic secretion including juice volume and bicarbonate output stimulated by oleic acid in each dose, statistically significantly (p less than 0.05-0.01), but did not affect plasma secretin concentration. Thus, we conclude that oleic acid in the duodenum stimulates pancreatic secretion and endogenous secretin release in rats, and that secretin release is not influenced by the cholinergic tone, although pancreatic secretory response is inhibited significantly. PMID- 2762275 TI - The pancreatic ductal system of the rat: cell diversity, ultrastructure, and innervation. AB - The morphological features and innervation of the pancreatic ductal epithelium of the rat was investigated. For the purposes of this study, pancreatic ducts were classified as either intercalated, intralobular, interlobular, or main. Epithelial cells of these different classes were classified as either principal or specialized. Principal cells make up the majority of epithelial cells in all classes of ducts. Ultrastructural analysis indicated that cytoplasmic vesicles, some containing amorphous material, were often seen in the apical portion of principal cells. Similarly, a common feature of these cells was the appearance of apical membrane projections containing various cytoplasmic organelles. These vesicles and apical membrane projections became larger as one progressed through the ductal system to the main duct. Junctional complexes contained well-developed tight junctions that, when analyzed by freeze-fracture analysis, were found to consist of three to five sealing strands in a parallel arrangement. Specialized cells could be morphologically divided into five categories: light cells, basal cells, goblet cells, endocrine cells, and brush cells. Light cells, which only differed from principal cells by their clear, lightly staining cytoplasm, were found in all classes of ducts. Basal cells, which were attached to the basement membrane of the ductal epithelium but did not extend to the lumen, were found in all classes of ducts except the intercalated ducts. Goblet cells and endocrine cells were observed in the main and interlobular ducts, while cells very similar in morphologic appearance to the brush cells of the lung were found restricted to the interlobular ducts. Localization of biogenic amines by histofluorescence indicated that adrenergic nerve fibers were associated with the main ducts and interlobular ducts. Histochemical localization of acetylcholinesterase activity indicated that cholinergic fibers were also associated with the main and interlobular ducts. These results indicate that in the rat, the pancreatic ductal system is composed of a number of cell types that are differentially distributed in the various classes of ducts, and pancreatic ducts are associated with adrenergic and cholinergic nerves. PMID- 2762276 TI - Effect of alcohol and alcoholic beverages on nonstimulated pancreatic secretion in humans. AB - The effects of alcoholic beverages on pancreatic secretion, blood trypsin levels, the release of gastrin and cholecystokinin were studied and compared with those of an alcohol and a glucose solution. Studies were done on six healthy male volunteers. The trypsin level was measured in the duodenal aspirate, while blood trypsin and gastrin levels were measured by radioimmunoassay and the cholecystokinin level was measured by bioassay. Studies were done on 5 different days, and on each day, the effects of either a glucose solution; an alcohol solution; or wine, beer, and gin solutions infused into the stomach were compared. The glucose solution stimulated trypsin secretion (a threefold increase above the basal measure) and the release of cholecystokinin without changes in the blood trypsin level. Blood alcohol levels, after the alcohol solution and all alcoholic beverages, were similar, and subjects showed mild symptoms of intoxication. Pancreatic enzyme secretion and trypsin blood levels were not significantly affected by either alcohol or the alcoholic beverages. Wine and beer caused significant release of gastrin and cholecystokinin. Under the conditions of this study, which reproduce those of excessive alcohol drinking, alcohol and alcoholic beverages did not stimulate pancreatic enzyme secretion, although wine and beer increased the release of gastrin and cholecystokinin. We conclude that alcohol and alcoholic beverages do not affect nonstimulated pancreatic enzyme secretion. PMID- 2762277 TI - Demonstration of human immunodeficiency virus by colorimetric in situ hybridization: a rapid technique for formalin-fixed paraffin-embedded material. AB - A colorimetric method of in situ hybridization has been developed for the rapid detection of human immunodeficiency virus (HIV) in formalin-fixed paraffin embedded material. Following optimization of digestion conditions, biotin-labeled DNA probes are detected with an alkaline phosphatase conjugate. The method is verified using fixed paraffin-embedded cell blocks of HIV-infected and uninfected lymphocyte cell cultures. Hybridization specifically detects both viral RNA and proviral DNA. Formalin fixation for intervals up to 21 d did not significantly hamper the signal under the appropriate digestion conditions; however, Trump's fixation for even 12 h greatly reduced the intensity of the hybridization. This technique for in situ hybridization is amenable to automation, provides results within 6 h, and results in good morphologic preservation. A key feature of the technique is the use of human placental DNA as an endogenous positive control to optimize the empirically determined conditions for protein digestion. PMID- 2762278 TI - Grading of soft tissue sarcomas: necrosis as a determinant of survival. AB - All cases of sarcomas of soft tissue occurring in males age 20-79 in Western Washington from 1981 to 1984 were studied with respect to the influence of multiple clinical, gross, and histologic parameters in predicting survival. Among histologic parameters studied, a strong and statistically significant association of necrosis of more than 15% of the tumor with death was observed. This effect was seen even when controlling for the influence of histology, site, stage of disease, and other factors. It is concluded that necrosis can serve as a prognostically relevant criterion for separating aggressive (nongrade 1) soft tissue sarcomas into intermediate grade (grade 2) and high grade (grade 3) tumors. PMID- 2762279 TI - The spectrum of histopathology of the testis in acquired immunodeficiency syndrome. AB - This study underscores an unexpectedly high incidence of histologic abnormalities in 33 testes from 31 patients who died of acquired immunodeficiency syndrome. Histologic changes of seminiferous tubules were classified into five categories: "Sertoli cell only" (14 testes, 42%), hypospermatogenesis (9, 27%), peritubular fibrosis and tubular hyalinization (5, 15%), maturation arrest (4, 12%), and normal (1, 3%). Significant interstitial fibrosis was found in 18 testes and mild lymphocytic infiltration in 5. Leydig cells were increased in 4 and decreased in 12. Opportunistic infections or Kaposi's sarcoma were not found in any of these testes. Possible explanations for the high incidence of the testicular abnormalities include direct viral cytopathic effect, antisperm antibody produced by homosexual activities, and thermal damage to the germ cells due to prolonged febrile state. PMID- 2762280 TI - Mycobacteria can be seen as "negative images" in cytology smears from patients with acquired immunodeficiency syndrome. AB - The cytologic diagnosis of mycobacterial infections has historically depended on the recognition of the characteristic granulomatous or purulent host response and the identification of acid-fast bacilli with special stains. However, immunocompromised patients with infections may not mount the expected response and the pathologist must have a high index of suspicion for the presence of organisms. We report the cytology findings from three patients with acquired immunodeficiency syndrome in which mycobacteria were seen on the routine modified Wright-stained (Diff-Quik) slides without special stains in the absence of granulomatous inflammation. The organisms appeared as negative images--unstained, rodshaped structures against the deep blue background of the stain. The findings were confirmed with Ziehl-Neelsen stain and culture. Implications for patient management are discussed. PMID- 2762281 TI - Proceedings of the 1988 Subspecialty Conference on Gastrointestinal Pathology at the USCAP. United States and Canadian Academy of Pathology. Diagnostic nonproblems in gastrointestinal biopsy pathology. PMID- 2762282 TI - AIDS pathology update: report of the conference, AIDS pathology update, San Francisco, California, October 7-8, 1988. PMID- 2762283 TI - Acute surgical abdomen and myelofibrosis. AB - Extramedullary hematopoiesis associated with fibrosis is found frequently in the liver and spleen, but seldom in other organs. Acute abdomen due to extramedullary hematopoiesis has been reported in two patients with intestinal obstruction because of heavy infiltration of the terminal ileum. This report describes the case of a 71-year-old woman with myeloid metaplasia involving the gallbladder mimicking acute cholecystitis. As far as we know, involvement of the gallbladder by extramedullary hematopoiesis has never been reported before. PMID- 2762284 TI - The unitary nature of mammalian pathology. PMID- 2762285 TI - Is atherosclerosis increasing in Mexico City? AB - This report compares quantitative measures of atherosclerosis in aortas and coronaries from autopsies of deceased men from Mexico City collected during 1960 to 1964 and 1986 to 1987. The comparison of lesions in two different time periods provides an opportunity for determining whether the extent of atherosclerosis has changed over time in Mexico City. Three pathologists independently evaluated the extent of fatty streaks (FS), fibrous plaques (FP), calcified plaques (CA), and complicated lesions (CO) in 165 aortas and 120 sets of coronary arteries collected during 1986 to 1987 for comparison with similar gradings of 128 aortas and coronary arteries from the International Atherosclerosis Project in 1960 to 1964. Neither FS nor more advanced lesions differed significantly in either the descending thoracic or abdominal aorta between the two collection periods. In contrast, there were more extensive FP and raised atherosclerotic lesions (RL = FP + CA + CO) in the coronary artery segments evaluated in the younger age groups in 1986 to 1987 versus 1960 to 1964. Additional analyses, based on 75 pairs of aortas and 32 pairs of coronary arteries from age-matched cases, all regraded by the team of pathologists after blind coding, showed more FS in both aortic segments and more extensive involvement with RL in the three main branches of the coronary arteries in the more recent study. An overview of our findings suggests that atherosclerosis, particularly in the coronary arteries, is increasing in Mexico City. This hypothesis merits careful testing in parallel with consideration of possible changes in the risk factors that could be responsible for changes in extent of lesions. PMID- 2762286 TI - Granulocytic fragments in sepsis. AB - We report here three patients with sepsis and one with acute pancreatitis and possible sepsis who developed granulocytic fragments on blood smears obtained prior to death. In case 1, these fragments were identified cytochemically. In case 3, granulocytic cytoplasmic projections and fragments were identified by electron microscopy of the buffy coat. All patients had leukerythroblastosis. The average corrected white blood count (WBC) was 46 X 10(9)/liter with 34 nucleated red blood cells (nRBC)/100 WBC. Patient 1 had thrombocytosis whereas patients 2, 3, and 4 were thrombocytopenic. Terminal complement levels were decreased in patients 3 and 4 as previously noted in sepsis (Sprung CL, Shultz DR, Marcial E, et al.: Complement activation in septic shock patients. Crit Care Med 14:525, 1986). A general correlation between nRBC and granulocytic fragments/100 hpf (high power field) was observed in patients 3 and 4. Granulocytic fragments were not identified on the blood smears of several patients with leukemoid reactions without erythroblastosis. Although the precise etiology of these fragments is unclear, we believe their recognition is important because all patients died within 32 hours after granulocytic fragments were identified. Furthermore, these fragments can falsely elevate the platelet count. Although myeloid fragments have previously been noted in leukemia and lymphoma, this is the first report of their association with conditions unrelated to hematologic neoplasms. These fragments can easily be recognized by careful examination of the blood smear and represent a newly recognized aspect of the septic shock syndrome. PMID- 2762287 TI - Dysplastic melanocytic nevi: a reproducible histologic definition emphasizing cellular morphology. AB - Histologic criteria commonly used to diagnose dysplastic melanocytic nevi (DMN) have not been correlated adequately with biology nor subjected to rigorous reproducibility studies. To address these failings, we developed histologic definitions emphasizing cellular morphology based on the appearance of typical melanocytes in sun-protected buttock skin, fully-evolved atypia in the vertical component of metastasizing primary cutaneous melanomas, and slight and moderate degrees of atypia defined within these limits in selected varieties of DMN. Reproducibility of our histologic definitions were tested by using two pathologists working independently to assess single routine tissue sections of 19 melanocytic lesions on two occasions at least 6 mo apart. Lesions included five previously diagnosed primary invasive cutaneous melanomas, seven lesions selected for gross morphologic features characteristic of DMN, and four solar lentigines and three common acquired nevomelanocytic nevi preselected for typical appearance and stable growth history. For the primary pathologist using the grading scheme, agreement rates between first and second readings were 84% for final diagnosis and 79% for the highest degree of cellular atypia; for the secondary pathologist, agreement rates for first and second readings for both parameters were 84%. Agreement rates comparing second readings of final diagnosis and highest degree of cellular atypia by the two pathologists were 89% and 79%, respectively. Most of the architectural and host response features commonly associated with DMN were less reproducible. In conclusion, we demonstrated very good reproducibility of histologic definitions used to differentiate the intraepidermal component of DMN from that of melanoma and benign melanocytic and nevomelanocytic hyperplasias, based on a biologic correlation emphasizing cellular morphology. Reproducible histologic definitions are a requisite first step in defining a clinical pathologic correlation for DMN. PMID- 2762288 TI - A morphologic study of Vietnam veterans. AB - The possibility that service in Vietnam has had an adverse effect on Vietnam veterans and is the cause of some of their current illnesses has been a controversial issue in the post-Vietnam period. Addressing this problem, a pathology study has been carried out at the Armed Forces Institute of Pathology (AFIP). Pathologic diagnoses found in Vietnam veterans have been compared with a control group of contemporary veterans without Vietnam service. This has revealed no statistically significant or unexplained differences in their demographic, anatomic, or morphologic findings. The essential similarity of their disease profiles to date fails to suggest the presence of any unique environmental factor that might have acted on the Vietnam group. PMID- 2762289 TI - Sternomastoid tumor of infancy (fibromatosis colli): diagnosis by aspiration cytology. AB - Sternomastoid tumor (SMT), as part of the spectrum of muscular torticollis, presents in infants as a discrete mass lesion in the neck, typically unassociated with neck torsion. We describe two patients who underwent fine needle aspiration (FNA) of their neck mass. The cytopathology of these aspirates was composed solely of a mixture of benign-appearing spindle cells and degenerating myofibers. Both infants showed a gradual disappearance of the mass without surgical intervention. We believe that FNA cytology is a diagnostic tool applicable to neonates. Additionally, in the proper clinical setting, aspiration cytology can be diagnostic of the clinicopathologic entity of SMT. PMID- 2762290 TI - Pattern of double glomerulopathies: a clinicopathologic study of superimposed glomerulonephritis on diabetic glomerulosclerosis. AB - Among 1715 renal biopsies investigated by means of light microscopy, immunofluorescence, and/or electron microscopy, 20 cases of various glomerulopathies (GP) were found to be superimposed on diabetic glomerulosclerosis (DGS). The most frequently superimposed GPs were acute GN (nine cases) and cryoglobulinemic GN (six cases). Although the former association is known to occur, the latter has not so far been reported. In the other patients DGS was associated with crescentic GN (two cases), membranoproliferative GN, membranous GN, and IgA nephropathy (one case each). Morphologic clues allowing the identification of the superimposed GP and the diagnostic relevance of the available morphologic methods were stressed. In particular, light microscopy was sufficient to identify the superimposed crescentic GN, whereas immunofluorescence and/or electron microscopy were needed in the other cases in order to show the composition and the seat of the deposits, respectively. In addition, electron microscopy was useful in identifying some peculiar features such as humps, mesangial cell interposition, and organized deposits in cryoglobulinemic GN. The actual frequency of superimposed GPs is difficult to assess: either under or overestimation is possible. Pathologists must be aware that this miscalculation is not an episodic event and that the estimation must be carefully sought whenever clinical data are equivocal and not fully fitting with DGS alone. The duration of the diabetes seems to favor the superimposition of GN on DGS. In these patients the prognosis is poor, not only when it could be expected to be, as in the cases with superimposition of crescentic or membranoproliferative GN, but also when DGS is associated with acute GN, whose prognosis is generally favorable. PMID- 2762291 TI - Identification of the operator of the lux regulon from the Vibrio fischeri strain ATCC7744. AB - Escherichia coli that carry a recombinant plasmid bearing the Vibrio fischeri lux regulon express luminescence that mimics the luminescence of V. fischeri. The lux regulon consists of two divergently transcribed operons, the rightward operon (luxICDABE genes) and the leftward operon (luxR gene). The luxR and luxI genes and the control region separating the two operons supply the primary regulatory control over the lux regulon; the regulatory mechanisms result in a dramatic increase in the rate of luciferase synthesis after induction, apparently due to a unique autoregulatory positive feedback mechanism, and in an enormous difference (greater than 10(4] in levels of luminescence in cells before and after induction. The generally accepted model of primary regulation of bioluminescence in V. fischeri involves the interaction of the product of the luxR gene and N-(3 oxohexanoyl)homoserine lactone, the autoinducer produced by the enzyme encoded by luxI, the first gene of the rightward operon, with an operator sequence within the control region to stimulate transcription of the rightward operon in a positive feedback loop. We have used deletion mapping of a transcription reporter vector to determine the approximate location of the operator. By site-directed mutagenesis of the presumed operator, we have demonstrated that the 20-base-pair inverted repeat ACCTGTAGGA/TCGTA CAGGT (where the vertical line is the center of symmetry), which bears striking similarity to the recognition sequence for the pleiotropic repressor protein LexA, is the operator of the lux regulon. We also found that deletion of sequences upstream of the palindrome leads to increased transcription from the rightward promoter (PR), indicative of a cis-acting element that represses transcription in the absence of the LuxR-autoinducer complex. Modifications of the palindrome that eliminate stimulation by LuxR autoinducer of transcription from PR have no effect on repression by the cis acting mechanism(s), suggesting that the palindrome is not necessary for repression of the rightward operon. Thus, it appears that the large increase in transcription upon induction of the lux regulon is the result of at least two independent mechanisms, one positive and the other negative. PMID- 2762292 TI - Structural characterization of a 2:1 distamycin A.d(CGCAAATTGGC) complex by two dimensional NMR. AB - Two-dimensional NMR has been used to study the 2:1 distamycin A.d(CGCAAATTGGC).d(GCCAATTTGCG) complex. The nuclear Overhauser effect spectroscopy (NOESY) experiment was used to assign the aromatic and C1'H DNA protons and to identify drug-DNA contacts. These data indicate that two drug molecules bind simultaneously in the minor groove of the central 5'-AAATT-3' segment and are in close contact with both the DNA and one another. One drug binds with the formyl end close to the second adenine base of the A-rich strand, while the other drug binds with the formyl end close to the second adenine of the complementary strand. With this binding orientation, the positively charged propylamidinium groups are directed toward opposite ends of the helix. Molecular modeling shows that the minor groove must expand relative to the 1:1 complex to accommodate both drugs. Energy calculations suggest that electrostatic interactions, hydrogen bonds, and van der Waals forces contribute to the stability of the complex. PMID- 2762293 TI - Nucleotide sequence and genomic organization of feline immunodeficiency virus. AB - An infectious molecular clone of the Petaluma strain of feline immunodeficiency virus (FIV) was isolated from a recombinant bacteriophage library containing genomic DNA prepared from FIV-infected Crandall feline kidney (CRFK) cells. The integrated provirus has a total length of 9472 base pairs. Three long open reading frames corresponding to GAG, POL, and ENV gene coding frames are evident. In addition, an open reading frame overlaps the 3' end of POL, in the region that encodes viral infectivity factor in the primate viruses. Several short open reading frames are present in the intergenic region between POL and ENV and within ENV, which may serve as exons for production of TAT and REV equivalents in FIV. Alignment of the predicted amino acid sequences of the FIV proteins with those of other lentiviruses indicates that FIV did not arise recently from any other characterized lentivirus. PMID- 2762294 TI - Autoregulatory control of beta-tubulin mRNA stability is linked to translation elongation. AB - Tubulin synthesis in animal cells is controlled in part by an autoregulatory mechanism that modulates the stability of ribosome-bound tubulin mRNAs. For beta tubulin, the initial recognition event for this selective RNA instability has previously been shown to be a cotranslational binding (presumably by tubulin itself) to the nascent amino-terminal beta-tubulin tetrapeptide just after it emerges from the ribosome. Although this "autoregulation" of tubulin expression is thus obligatorily linked to the translation process, the mechanism of how a cotranslational protein-protein binding event ultimately triggers RNA degradation is unknown. Using protein synthesis inhibitors to slow and ultimately to block translation elongation, we now show that the mRNA destabilization pathway requires ongoing ribosome translocation. PMID- 2762295 TI - Predicting the orientation of eukaryotic membrane-spanning proteins. AB - We have developed a rule to predict the orientation of the first internal signal anchor sequence in eukaryotic transmembrane proteins synthesized on the rough endoplasmic reticulum. The difference in the charges of the 15 residues flanking the first internal signal-anchor determines its orientation, with the more positive portion facing the cytosol. In proteins that span the membrane more than once, the orientation of all subsequent transmembrane segments would be determined by that of the most N-terminal one. PMID- 2762296 TI - Isolation and characterization of cDNA encoding the alpha subunit of Cap Z(36/32), an actin-capping protein from the Z line of skeletal muscle. AB - cDNA encoding the alpha chain of Cap Z has been isolated by screening a lambda gt11 library with affinity-purified antibodies. A single cDNA insert (designated CE2) of 2153 base pairs (bp) contains an open reading frame of 836 bp, which is incomplete at its 5' end. The technique of "rapid amplification of cDNA ends" has been used to extend the 5' end of this open reading frame to a potential transcription initiation site that is preceded by 320 bp of an apparently untranslated region. The protein predicted by the resulting nucleotide sequence has a Mr of 32,960 and contains four regions that show close homology with four alpha-chymotryptic digestion fragments of the alpha chain. The amino acid composition of the alpha chain of Cap Z and the predicted protein are also similar. Northern blot analysis of whole chicken embryos shows two mRNA species of 1.9 and 2.4 kilobases, respectively, that hybridize with CE2. Three potential polyadenylylation signals in two regions of CE2 460 bp apart are identified, suggesting that the two messages may result from the use of alternative polyadenylylation sites. Comparison of the sequence data with that of other known actin-capping and severing proteins shows no significant homologies, suggesting that Cap Z may be a member of a unique group of capping, nonsevering proteins. PMID- 2762297 TI - Low density lipoprotein receptor-related protein mediates uptake of cholesteryl esters derived from apoprotein E-enriched lipoproteins. AB - Low density lipoprotein receptor-related protein (LRP) is a recently described cell-surface protein of 4544 amino acids that contains reiterated sequences found in the 839-amino acid receptor for low density lipoprotein (LDL). In the current studies, we purified LRP from rat liver, prepared polyclonal antibodies that recognize the extracellular domain, and demonstrated an immunoreactive protein of approximately 600 kDa in human fibroblasts. The function of this LRP was studied in mutant human fibroblasts that do not produce LDL receptors. The mutant cells were incubated with beta-migrating very low density lipoprotein (beta-VLDL) that was isolated from cholesterol-fed rabbits and artificially enriched with apoprotein (apo) E by incubation in vitro with human apo E produced in a bacterial expression system. The apo E-enriched beta-VLDL, but not unincubated beta-VLDL, stimulated incorporation of [14C]-oleate into cholesteryl [14C]oleate 20- to 40-fold in the mutant cells. This stimulation was blocked by chloroquine, suggesting that such stimulation resulted from receptor-mediated uptake and lysosomal hydrolysis of the cholesteryl esters in apo E-enriched beta-VLDL. Stimulation of cholesterol esterification was blocked by the antibody against LRP, but not by an antibody against the LDL receptor. Unlike the LDL receptor, the amount of LRP was not reduced when cells were incubated with oxygenated sterols. We conclude that LRP can mediate the cellular uptake and lysosomal hydrolysis of cholesteryl esters contained in lipoproteins that are enriched in apo E. PMID- 2762298 TI - Tryptophan fluorescence quenching as a monitor for the protein conformation changes occurring during the photocycle of bacteriorhodopsin under different perturbations. AB - The rates of the quenching and recovery of tryptophan fluorescence are determined in the microsecond-millisecond time scale during the photocycle of bacteriorhodopsin under different perturbations. The kinetics suggest the presence of two quenching processes, a rapid one (on the time scale of photocycle intermediate L550 formation or faster) and a slow one (slightly slower than the slow component of intermediate M412 formation). The slow quenching process is found to respond to different perturbations in the same manner as the slow component of M412 formation. It has the same activation energy, it is inhibited if metal cations are removed, it is negligible at pH values greater than the pKa of tyrosine, and its rate is slowed down when 75% of the lipids are removed. These results, together with the observed value of the quenching activation energy, suggest that the rates of the tryptophan fluorescence quenching, like those of tyrosinate and M412 formations during the cycle, are all determined by the rates of the protein conformation changes. The pH studies of the slow quenching process show that the maximum quenching probability occurs at neutral pH. A rapid decrease in quenching occurs at lower pH (approximately 3 and approximately 5.5) and higher pH (approximately 9). Two quenching mechanisms involving energy transfer to either retinal or to tyrosinate are considered. Protein conformation changes resulting from a change in the ionization state of amino acids of different pKa values could change the tryptophan-retinal (or tryptophan-tyrosinate) coupling and thus the quenching efficiency. PMID- 2762299 TI - Enzymes work by solvation substitution rather than by desolvation. AB - Considerable attention has recently been drawn to the hypothesis that enzymes catalyze their reactions by displacing solvent and creating an environment similar to the gas phase for the reacting substrates. This "desolvation hypothesis" is reexamined in this paper by defining a common reference energy for reactions in various environments. It is argued that consistent attempts to describe the actual energetics of enzymatic reactions, taking either gas phase or solution as a reference, would contradict the above hypothesis. That is, the enzyme does remove water molecules from its substrate, but substitutes these molecules for another polar environment (namely, its active site). By taking amide hydrolysis as an example, we use experimentally estimated solvation energies and analyze the reaction profile in the gas phase, in solution, and in enzyme active sites. We show that the gas-phase reaction is characterized by an enormous activation barrier (associated with forming the charged nucleophile from neutral fragments), although the nucleophilic attack is essentially barrierless. On the other hand, the enzyme and solution reactions are found to have similar reaction profiles, with a lower activation barrier for the enzymatic reaction. Presumably, the fact that previous analyses of this problem did not involve the construction of the relevant thermodynamic cycles (and quantitative estimates of the corresponding solvation energies) led to the desolvation hypothesis. Our conclusion is that enzyme active sites provide specific polar environments that do not resemble the gas phase but that are designed for electrostatic stabilization of ionic transition states and that "solvate" these states more than water does. PMID- 2762300 TI - Effects of lipid packing on polymorphic phase behavior and membrane properties. AB - The self assembly of phospholipid molecules in the bilayer form was considered in terms of equivalent molecular shapes representing intermolecular forces. The equivalent size of each phospholipid headgroup was approximated by the net atomic volume plus the volume of the associated water molecules, which was derived from water/hydrocarbon partitioning experiments. The equivalent lengths of unsaturated acyl chains were derived from the retention time data from chromatographic measurements. The spontaneous curvature of various phospholipid monolayers was calculated from their equivalent molecular shapes, and the energy required to flatten them to the bilayer plane was calculated, using the known bending modulus. With increasing bending energy, the mixtures showed increasing susceptibility to phospholipase A2, facilitated lipid transfer rate by phospholipid exchange proteins, permeability to carboxyfluorescein, incorporation of human erythrocyte proteins, and calcium transport by Ca-ATPase from sarcoplasmic reticulum in reconstituted vesicles. When the calculation was applied to known lipid compositions of nine cellular membranes, the protein/lipid ratio and phospholipid/cholesterol ratio were found to have a positive and a negative correlation, respectively, with the latent bending energy of the phospholipids. The energy expense in conforming to a bilayer phase may be an important physical parameter regarding the activity and the biogenesis of membranes. PMID- 2762301 TI - Tumor-elicited polymorphonuclear cells, in contrast to "normal" circulating polymorphonuclear cells, stimulate invasive and metastatic potentials of rat mammary adenocarcinoma cells. AB - Circulating polymorphonuclear cell (PMN) levels rise in proportion to the metastatic potential of the tumor in 13762NF mammary adenocarcinoma tumor-bearing rats. These tumor-elicited PMNs (tcPMNs) secrete high levels of the basement membrane-degrading enzymes, type IV collagenase and heparanase, suggesting that metastatic tumor cells stimulate neutrophilia so that the tcPMNs might assist tumor cell extravasation during metastasis. To test this hypothesis, purified proteose peptone-elicited PMNs from peritoneal exudate, circulating normal PMNs, and tcPMNs were evaluated for their effects on in vitro invasive and in vivo metastatic potentials of syngeneic 13762NF mammary adenocarcinoma tumor cells. tcPMNs caused a dose-dependent increase in invasion through a reconstituted basement membrane barrier in an in vitro invasion assay. At PMN:tumor cell ratios of 30:1, invasion potential significantly (P less than 0.05) rose to 26-fold, 40 fold, and 37-fold for poorly metastatic MTLn2 cells, highly metastatic MTLn3 cells, and moderately metastatic MTF7 cells, respectively. In contrast, purified proteose peptone-elicited PMNs and circulating normal PMNs did not significantly alter invasive potential. Intravenous coinjections of purified proteose peptone elicited PMNs did not change the number of experimental lung metastases, but tcPMNs at ratios to 50:1 significantly raised the mean number of metastases 23 fold for MTLn2, 3- to 4-fold for MTLn3, and 1.6- to 1.8-fold for MTF7. These results demonstrate that tcPMNs contribute to the metastatic propensity of mammary adenocarcinoma clones by increasing efficiency of invasion through basement membrane. PMID- 2762302 TI - Tetrahydrobiopterin, the cofactor for aromatic amino acid hydroxylases, is synthesized by and regulates proliferation of erythroid cells. AB - The only known role for 6(R)-5,6,7,8-tetrahydrobiopterin (BH4) is as the cofactor for the aromatic amino acid hydroxylases. However, BH4 has been shown to be synthesized by cells that do not contain any hydroxylase activity, suggesting that it may have still undiscovered functions. Our finding of much higher levels of BH4 and GTP cyclohydrolase, the first enzyme of de novo BH4 biosynthesis, in rat reticulocytes compared to mature erythrocytes raised the possibility that BH4 might play a role in erythrocyte maturation. We have now demonstrated, by using murine erythroleukemia (MEL) cells as a model for erythrogenesis, that BH4 synthesis is required for proliferation of these cells. Inhibition of BH4 biosynthesis in rapidly dividing MEL cells with N-acetylserotonin, a potent inhibitor of sepiapterin reductase, the terminal enzyme in the BH4 biosynthetic pathway, results in inhibition of DNA synthesis and mitogenesis without induction of hemoglobin synthesis. The inhibition of DNA synthesis is reversed by repletion of cellular BH4 levels with sepiapterin, a pterin that is readily taken up by the cells and converted to BH4 by the sequential reductions of sepiapterin reductase and dihydrofolate reductase. Treatment of MEL cells with hexamethylene bisacetamide, an inducer of differentiation, results in a decrease in BH4 synthesis accompanied by a cessation of growth and concomitant hemoglobin synthesis. The inhibition of proliferation induced by hexamethylene bisacetamide can be reversed by maintaining high intracellular levels of BH4, which also decreases the amount of hemoglobin. The mechanism of the BH4 effect has not yet been elucidated, but it appears as though BH4 synthesis is more intimately linked with cell proliferation than with the differentiation process. PMID- 2762303 TI - Mutator phenotype of Werner syndrome is characterized by extensive deletions. AB - Werner syndrome (WS) is a rare autosomal-recessive disorder characterized by the premature appearance of features of normal aging in young adults. The extensive phenotypic overlap between WS and normal aging suggests they may also share pathogenetic mechanisms. We reported previously that somatic cells from WS patients demonstrate a propensity to develop chromosomal aberrations, including translocations, inversions, and deletions, and that WS cell lines demonstrate a high spontaneous mutation rate to 6-thioguanine resistance. We report here the biochemical and molecular characterization of spontaneous mutations at the X chromosome-linked hypoxanthine phosphoribosyltransferase (HPRT) locus in 6 thioguanine-resistant WS and control cells. Blot hybridization analysis of 89 independent spontaneous HPRT mutations in WS and control mutants lacking HPRT activity revealed an unusually high proportion of HPRT deletions in WS as compared with control cells (76% vs. 39%). Approximately half (58%) of the deletions in WS cells consisted of the loss of greater than 20 kilobases of DNA from the HPRT gene. These results suggest that an elevated somatic mutation rate, and particularly deletions, may play pathogenetically important roles in WS and in several associated age-dependent human disease processes. PMID- 2762304 TI - Decrease by chronic energy intake restriction of cellular proliferation in the intestinal epithelium and lymphoid organs in autoimmunity-prone mice. AB - In previous studies we demonstrated that chronic energy intake restriction (CEIR) by a diet relatively low in fat, relatively high in carbohydrate, and reduced 40% in total calories extends life span and delays development of autoimmune disease in autoimmunity-prone mice. To investigate a possible cellular basis for this dramatic action of CEIR, we analyzed the rate of incorporation of [3H]thymidine by cells of the intestinal epithelium, thymus, spleen, and mesenteric lymph nodes in ad libitum-fed mice vs. CEIR mice of three autoimmunity-prone strains. In New Zealand Black (NZB), MRL/MP-lpr/lpr (MRL/lpr), and BXSB mice, CEIR slowed the rate of uptake of [3H]thymidine and, by inference, the rate of cellular proliferation among epithelial cells along the entire length of the gastrointestinal tract. Furthermore, CEIR decreased the apparent proliferative rate of lymphoid cells of the thymus, spleen, and mesenteric lymph nodes. This action by CEIR on the proliferative rate of cells of these rapidly replicating cell populations may point to an important mechanism by which calorie restriction inhibits the development of autoimmune disease and extends longevity in autoimmunity-prone mice. PMID- 2762305 TI - Structure of an antibody-antigen complex: crystal structure of the HyHEL-10 Fab lysozyme complex. AB - The crystal structure of the complex of the anti-lysozyme HyHEL-10 Fab and hen egg white lysozyme has been determined to a nominal resolution of 3.0 A. The antigenic determinant (epitope) on the lysozyme is discontinuous, consisting of residues from four different regions of the linear sequence. It consists of the exposed residues of an alpha-helix together with surrounding amino acids. The epitope crosses the active-site cleft and includes a tryptophan located within this cleft. The combining site of the antibody is mostly flat with a protuberance made up of two tyrosines that penetrate the cleft. All six complementarity determining regions of the Fab contribute at least one residue to the binding; one residue from the framework is also in contact with the lysozyme. The contacting residues on the antibody contain a disproportionate number of aromatic side chains. The antibody-antigen contact mainly involves hydrogen bonds and van der Waals interactions; there is one ion-pair interaction but it is weak. PMID- 2762306 TI - Megabase-sized linear DNA in the bacterium Borrelia burgdorferi, the Lyme disease agent. AB - Using pulsed-field gel electrophoresis we examined the genome of Borrelia burgdorferi, a eubacterium of the spirochete phylum and the agent of Lyme disease. A population of this species' cells was lysed in situ in agarose blocks. An abundant DNA form that behaved as a linear duplex molecule under different electrophoretic conditions was found. The estimated size of the molecule was 950 kilobases. DNA from two other genera of spirochetes did not enter the gel under these conditions. These studies indicate that Borrelia spirochetes, perhaps uniquely among prokaryotic organisms, have linear chromosomes. PMID- 2762307 TI - Tumor necrosis factor alpha activates human immunodeficiency virus type 1 through induction of nuclear factor binding to the NF-kappa B sites in the long terminal repeat. AB - Expression of human immunodeficiency virus type 1 (HIV-1) can be activated in a chronically infected T-cell line (ACH2 cells) by a cytokine, human tumor necrosis factor alpha (TNF-alpha). TNF-alpha treatment of ACH2 cells resulted in an increase in steady-state levels of HIV RNA and HIV transcription. Gel mobility shift assays demonstrated that the transcriptional activation of the HIV long terminal repeat (LTR) by TNF-alpha was associated with the induction of a nuclear factor(s) binding to the NF-kappa B sites in the LTR. Deletion of the NF-kappa B sites from the LTR eliminated activation by TNF-alpha in T cells transfected with plasmids in which the HIV LTR directed the expression of the bacterial chloramphenicol acetyltransferase gene. Thus, TNF-alpha appears to activate HIV RNA and virus production by ACH2 cells through the induction of transcription activating factors that bind to the NF-kappa B sequences in the HIV LTR. PMID- 2762308 TI - Characterization of a RNA virus from the parasite Leishmania. AB - We were interested in screening a series of isolates of the protozoan Leishmania for the presence of viruses. The experimental procedure we used was based on an enzymatic assay originally developed for viral RNA-dependent RNA polymerases. Simultaneously, total promastigote nucleic acid preparations were analyzed for the presence of viral genome and/or transcripts. Two isolates, both classified as L. braziliensis guyanensis, were found to be positive for RNA polymerase activity and to carry a large (6 kilobases) RNA species. The polymerase reaction products hybridized to the 6-kilobase RNA, believed to be the viral genome. In conjunction with electron microscopical observations these results indicate the presence of an RNA virus in these Leishmania isolates. PMID- 2762309 TI - Primary structure of four allatostatins: neuropeptide inhibitors of juvenile hormone synthesis. AB - Four neuropeptides that inhibit juvenile hormone synthesis by the corpora allata have been isolated from brains of the virgin female cockroach Diploptera punctata. These allatostatins are 8-13 amino acids long, are amidated, and show sequence similarity, including a 3-amino acid sequence at the C-terminal end that is common to all four peptides. The peptide sequences are as follows: allatostatin 1, Ala-Pro-Ser-Gly-Ala-Gln-Arg-Leu-Tyr-Gly-Phe-Gly-Leu-NH2; allatostatin 2, Gly-Asp-Gly-Arg-Leu-Tyr-Ala-Phe-Gly-Leu-NH2; allatostatin 3, Gly Gly-Ser-Leu-Tyr-Ser-Phe-Gly-Leu-NH2; and allatostatin 4, Asp-Arg-Leu-Tyr-Ser-Phe Gly-Leu-NH2. An in vitro bioassay of the synthesized allatostatins showed greater than 40% inhibition of juvenile hormone synthesis by corpora allata of virgin females with 10(-9) M allatostatin 1, 10(-8) M allatostatins 2 and 4, and 7 X 10( 7) M allatostatin 3. Inhibition by allatostatins 1-4 was reversible. In addition, allatostatin 1 inhibited juvenile hormone synthesis by corpora allata from mated females and last-instar larvae of D. punctata and corpora allata of adult female Periplaneta americana. PMID- 2762310 TI - Osmoregulatory changes in myo-inositol transport by renal cells. AB - Renal medullary cells contain high concentrations of myo-inositol, sorbitol, betaine, and glycerophosphocholine, whose levels vary with urinary osmolality. Accumulation of these "compatible" organic osmolytes is believed to help the cells osmoregulate in response to the high extracellular osmolality that occurs as part of the urinary concentrating mechanism. MDCK cells (a line from dog kidney) were previously shown to accumulate myo-inositol in response to increased medium osmolality. We demonstrate here that this accumulation requires the presence of myo-inositol in the medium, implying that the myo-inositol is not synthesized by the cells but rather is transported into them from the extracellular solution. The MDCK cells contain sodium-dependent myo-inositol transporters. Relative to isotonic controls, sodium-dependent myo-inositol uptake is higher in cells exposed to increased osmolality either acutely (1-7 days) or chronically (greater than 1 year). Transport is further enhanced when the cells are cultured in myo-inositol-free medium. The transport has both high- and low affinity components. The observed changes in transport involve changes in maximal velocity of the high-affinity component but not in its Km. We conclude that renal cells can osmoregulate by changing the number (or, less likely, the transport turnover rate) of functioning sodium-dependent myo-inositol transporters. PMID- 2762311 TI - Mass spectrometric charting of bovine posterior/intermediate pituitary peptides. AB - The feasibility for charting neuropeptides in neuroendocrine tissues on the basis of the universal property and inherent specificity of their molecular weights was explored. As a model, a comprehensive MS analysis of extractable peptides from bovine posterior/intermediate pituitary was performed. Two suitable MS techniques -namely, plasma-desorption time-of-flight and fast atom bombardment MS--were evaluated, and each method could identify more than 20 peptides, including N terminally acetylated and C-terminally amidated species. In toto these peptides account for almost the entire lengths of propressophysin, prooxyphysin, and proopiomelanocortin. Some of the experimentally determined molecular weights did not match any known peptides. Three of these species were identified as acidic joining peptide (4-24) [proopiomelanocortin(83-103)], C-terminal glycopeptide(22 39) [propressophysin(130-147)], and glycosylated C-terminal glycopeptide(1-19) [propressophysin(109-127)] by conventional sequence analysis. PMID- 2762312 TI - Coupling of nonpolymerizable monomeric actin to the F-actin binding region of the myosin head. AB - Polymerizations of skeletal G-actin induced by salt and myosin subfragment 1 (S 1) were suppressed by reaction of G-actin with m-maleimidobenzoyl-N hydroxysuccinimide ester. The G-actin derivative, containing few intramolecular crosslinks and a free maleimide group, was covalently coupled in solution to the S-1 heavy chain. The resulting complex could no longer bind to F-actin. The SH-1 and SH-2 thiols of S-1 were not involved in the complexation and the covalent link was shown to be exclusively on the 50-kDa segment of the S-1 heavy chain. The specific conjugation of the two proteins followed formation of a reversibly associated pyrophosphate-sensitive binary complex which was characterized by different approaches. Potentially, these complexes may be useful in developing the crystallography of actin-bound S-1. PMID- 2762313 TI - Cis-acting elements of the sea urchin histone H2A modulator bind transcriptional factors. AB - Functional tests, performed by microinjection into Xenopus laevis oocytes, show that a DNA fragment containing the modulator of the early histone H2A gene of Paracentrotus lividus enhances transcription of a reporter gene when located, in the physiological orientation, upstream of the tk basal promoter. Gel retardation and DNase I footprinting assays further reveal that the H2A modulator contains at least two binding sites [upstream sequence elements 1 and 2 (USE 1 and USE 2)] for nuclear factors extracted from sea urchin embryos, which actively transcribe the early histone gene set. Interestingly, USE 1 is highly homologous to a cis acting element previously identified in the H2A modulator of Psammechinus miliaris [Grosschedl, R., Machler, M., Rohrer, U. & Birnstiel, M. L. (1983) Nucleic Acids Res. 11, 8123-8136]. Finally, a cloned oligonucleotide containing the USE 1 sequence competes efficiently in Xenopus oocytes with the H2A modulator to prevent enhancement of transcription of the reporter gene. From these results, we conclude that USE 1 and perhaps USE 2 in the H2A modulator are upstream transcriptional elements that are recognized by trans-acting factors common to Xenopus and sea urchin. PMID- 2762315 TI - Cationic liposome-mediated RNA transfection. AB - We have developed an efficient and reproducible method for RNA transfection, using a synthetic cationic lipid, N-[1-(2,3-dioleyloxy)propyl]-N,N,N trimethylammonium chloride (DOTMA), incorporated into a liposome (lipofectin). Transfection of 10 ng to 5 micrograms of Photinus pyralis luciferase mRNA synthesized in vitro into NIH 3T3 mouse cells yields a linear response of luciferase activity. The procedure can be used to efficiently transfect RNA into human, rat, mouse, Xenopus, and Drosophila cells. Using the RNA/lipofectin transfection procedure, we have analyzed the role of capping and beta-globin 5' and 3' untranslated sequences on the translation efficiency of luciferase RNA synthesized in vitro. Following transfection of NIH 3T3 cells, capped mRNAs with beta-globin untranslated sequences produced at least 1000-fold more luciferase protein than mRNAs lacking these elements. PMID- 2762314 TI - Molecular cloning and expression of cDNA encoding a lumenal calcium binding glycoprotein from sarcoplasmic reticulum. AB - Antibody screening was used to isolate a cDNA encoding the 160-kDa glycoprotein of rabbit skeletal muscle sarcoplasmic reticulum. The cDNA is identical to that encoding the 53-kDa glycoprotein except that it contains an in-frame insertion of 1308 nucleotides near its 5' end, apparently resulting from alternative splicing. The protein encoded by the cDNA would contain a 19-residue NH2-terminal signal sequence and a 453-residue COOH-terminal sequence identical to the 53-kDa glycoprotein. It would also contain a 436-amino acid insert between these sequences. This insert would be highly acidic, suggesting that it might bind Ca2+. The purified 160-kDa glycoprotein and the glycoprotein expressed in COS-1 cells transfected with cDNA encoding the 160-kDa glycoprotein were shown to bind 45Ca2+ in a gel overlay assay. The protein was shown to be located in the lumen of the sarcoplasmic reticulum and to be associated through Ca2+ with the membrane. We propose that this lumenal Ca2+ binding glycoprotein of the sarcoplasmic reticulum be designated "sarcalumenin." PMID- 2762316 TI - Point substitutions in Japanese alloalbumins. AB - We have completed the structural study of five rare types of inherited albumin variants (alloalbumins) discovered in the Biochemical Genetics Study of 15,581 unrelated children in Hiroshima and Nagasaki. We have also identified the structural change in five other alloalbumin specimens detected during clinical electrophoresis of sera from Japanese living near Tokyo. Each of the five albumin variants from Nagasaki and Hiroshima has a single amino acid substitution. All of these substitutions differ, and none has been reported in non-Japanese populations. No instances of proalbumin variants or of albumin B (the most frequent alloalbumins in Caucasians) were detected in the children in Hiroshima and Nagasaki. However, one instance of a variant proalbumin and two examples of albumin B occurred in Japanese from the vicinity of Tokyo. In addition a previously unreported point substitution was found in albumin Tochigi, which is present in two unrelated persons from Tochigi prefecture. Four of the point mutations in the Japanese alloalbumins are in close proximity in a short segment of the polypeptide chain (residues 354-382) in which three additional point substitutions have been reported in diverse populations. These results, combined with earlier data, suggest that point substitutions are grouped in certain segments of the albumin molecule. PMID- 2762317 TI - Resolution and partial characterization of factors required for in vitro transcription by mammalian RNA polymerase II. AB - Multiple protein factors from HeLa cells are necessary for the accurate initiation of transcription on minimal promoters in vitro. We have partially purified these factors by chromatographic methods. In addition to RNA polymerase II, six factors A-F (FA, FB, FC, FD, FE, and FF) necessary for initiation at the beta-globin promoter start site in vitro have been identified. Certain of these (FA, FC, and FE) have been purified to near homogeneity. The present purification scheme yields sufficient amounts of purified material for the more detailed characterization and cloning of the genes for these activities. Among these factors, FD and FF were required with template DNA at an early step of formation of the initiation complex, whereas FB, FA together with FC, and FE were effective when added at successively later stages in the process of complex formation. PMID- 2762318 TI - Mechanism by which cellulose triggers cellobiohydrolase I gene expression in Trichoderma reesei. AB - The expression of cellobiohydrolase I mRNA from Trichoderma reesei, measured by Northern blot hybridization, is controlled by the nature of carbon sources used in the culture medium. Cellulose and the soluble disaccharide sophorose, but not glycerol or glucose, act as inducers. Cellobiohydrolase I mRNA was undetectable when antibodies to the major members of the cellulolytic system were present in the culture medium prior to the addition of cellulose. These antibodies had no repressive effect if sophorose was used as an inducer. The results strongly suggest that a low constitutive cellulolytic system catalyzes the formation of a soluble inducer from cellulose and that this inducer triggers the expression of the cellobiohydrolase I gene transcript, most probably at the transcription level. PMID- 2762320 TI - Dictyostelium discoideum contains a gene encoding a myosin I heavy chain. AB - We have cloned and completely sequenced a gene encoding the heavy chain of Dictyostelium myosin I. Like the myosin I molecules from Acanthamoeba, the Dictyostelium myosin I heavy chain is composed of a globular head domain fused to a 45-kDa glycine-, proline-, and alanine-rich carboxyl-terminal domain, rather than the coiled-coil rod domain of conventional myosins. Comparisons of the Dictyostelium myosin I heavy-chain amino acid sequence with those of the Acanthamoeba myosins I reveal that they are highly similar throughout, including the unconventional carboxyl-terminal domains. The Dictyostelium myosin I gene is expressed in growing cells as a 3600-nucleotide mRNA. Measurements of the steady state level of this mRNA at different times during starvation-induced aggregation and development are consistent with a role for myosin I in chemotaxis and aggregation. Generation of Dictyostelium cells lacking myosin I by gene disruption and/or antisense RNA production should provide a way to test directly the role of this nonfilamentous myosin in cell motility. These experiments will be simplified by the fact that Southern blot analyses of Dictyostelium genomic DNA are consistent with there being a single myosin I heavy-chain gene. PMID- 2762319 TI - Actin filaments mediate Dictyostelium myosin assembly in vitro. AB - Because myosin thick filaments form in the actin-rich cortex of nonmuscle cells, we have examined the role of Dictyostelium actin filaments in the assembly of Dictyostelium myosin (type II). Fluorescence energy transfer and light-scattering assembly assays indicate that self-association of Dictyostelium myosin into bipolar thick filaments is kinetically regulated by actin filament networks. Regulation is nucleotide dependent but does not require ATP hydrolysis. Myosin assembly is accelerated approximately 5-fold by actin filaments when either 1 mM ATP or 1 mM adenosine 5'-[beta,gamma-imido]triphosphate (AMP-P[NH]P) is present. However, actin filaments together with 1 mM ADP abolish myosin assembly. Accelerated assembly appears to require transient binding of myosin molecules to actin filaments before incorporation into thick filaments. Fluorescence energy transfer assays demonstrate that myosin associates with actin filaments at a rate that is equivalent to the accelerated myosin assembly rate, evidence that myosin to actin binding is a rate-limiting step in accelerated thick filament formation. Actin filament networks are also implicated in regulation of thick filament formation, since fragmentation of F-actin networks by severin causes immediate cessation of accelerated myosin assembly. Electron microscopic studies support a model of actin filament-mediated myosin assembly. In ADP, myosin monomers rapidly decorate F-actin, preventing extensive formation of thick filaments. In AMP P[NH]P, myosin assembles along actin filaments, forming structures that resemble primitive stress fibers. Taken together, these data suggest a model in which site directed assembly of thick filaments in Dictyostelium is mediated by the interaction of myosin monomers with cortical actin filament networks. PMID- 2762321 TI - Protein evolution on rugged landscapes. AB - We analyze a mathematical model of protein evolution in which the evolutionary process is viewed as hill-climbing on a random fitness landscape. In studying the structure of such landscapes, we note that a large number of local optima exist, and we calculate the time and number of mutational changes until a protein gets trapped at a local optimum. Such a hill-climbing process may underlie the evolution of antibody molecules by somatic hypermutation. PMID- 2762322 TI - Dynamics of mitochondrial DNA evolution in animals: amplification and sequencing with conserved primers. AB - With a standard set of primers directed toward conserved regions, we have used the polymerase chain reaction to amplify homologous segments of mtDNA from more than 100 animal species, including mammals, birds, amphibians, fishes, and some invertebrates. Amplification and direct sequencing were possible using unpurified mtDNA from nanogram samples of fresh specimens and microgram amounts of tissues preserved for months in alcohol or decades in the dry state. The bird and fish sequences evolve with the same strong bias toward transitions that holds for mammals. However, because the light strand of birds is deficient in thymine, thymine to cytosine transitions are less common than in other taxa. Amino acid replacement in a segment of the cytochrome b gene is faster in mammals and birds than in fishes and the pattern of replacements fits the structural hypothesis for cytochrome b. The unexpectedly wide taxonomic utility of these primers offers opportunities for phylogenetic and population research. PMID- 2762323 TI - Date of the monocot-dicot divergence estimated from chloroplast DNA sequence data. AB - The divergence between monocots and dicots represents a major event in higher plant evolution, yet the date of its occurrence remains unknown because of the scarcity of relevant fossils. We have estimated this date by reconstructing phylogenetic trees from chloroplast DNA sequences, using two independent approaches: the rate of synonymous nucleotide substitution was calibrated from the divergence of maize, wheat, and rice, whereas the rate of nonsynonymous substitution was calibrated from the divergence of angiosperms and bryophytes. Both methods lead to an estimate of the monocot-dicot divergence at 200 million years (Myr) ago (with an uncertainty of about 40 Myr). This estimate is also supported by analyses of the nuclear genes encoding large and small subunit ribosomal RNAs. These results imply that the angiosperm lineage emerged in Jurassic-Triassic time, which considerably predates its appearance in the fossil record (approximately 120 Myr ago). We estimate the divergence between cycads and angiosperms to be approximately 340 Myr, which can be taken as an upper bound for the age of angiosperms. PMID- 2762324 TI - Chromosome mapping of the human gene encoding the 68-kDa nuclear antigen (p68) by using the polymerase chain reaction. AB - Chromosome mapping by Southern analysis of DNA from somatic cell hybrids is often unsuccessful when only cDNA probes are available. p68 is a putative RNA helicase that is antigenically related to the simian virus 40 large tumor antigen. By using the polymerase chain reaction and oligode-oxynucleotide primers based on the cDNA sequence, we have identified introns in the p68 gene. Comparison of human and mouse DNA fragments amplified with these primers revealed length differences that allowed us to identify the human gene. Application of this technique to DNA from human-mouse somatic cell hybrids and cell lines derived from them by chromosome-mediated gene transfer allowed us to map p68 to the distal part of the long arm of chromosome 17. PMID- 2762325 TI - Genetic analysis of amplified DNA with immobilized sequence-specific oligonucleotide probes. AB - The analysis of DNA for the presence of particular mutations or polymorphisms can be readily accomplished by differential hybridization with sequence-specific oligonucleotide probes. The in vitro DNA amplification technique, the polymerase chain reaction (PCR), has facilitated the use of these probes by greatly increasing the number of copies of target DNA in the sample prior to hybridization. In a conventional assay with immobilized PCR product and labeled oligonucleotide probes, each probe requires a separate hybridization. Here we describe a method by which one can simultaneously screen a sample for all known allelic variants at an amplified locus. In this format, the oligonucleotides are given homopolymer tails with terminal deoxyribonucleotidyltransferase, spotted onto a nylon membrane, and covalently bound by UV irradiation. Due to their long length, the tails are preferentially bound to the nylon, leaving the oligonucleotide probe free to hybridize. The target segment of the DNA sample to be tested is PCR-amplified with biotinylated primers and then hybridized to the membrane containing the immobilized oligonucleotides under stringent conditions. Hybridization is detected nonradioactively by binding of streptavidin-horseradish peroxidase to the biotinylated DNA, followed by a simple colorimetric reaction. This technique has been applied to HLA-DQA genotyping (six types) and to the detection of Mediterranean beta-thalassemia mutations (nine alleles). PMID- 2762326 TI - Human beta satellite DNA: genomic organization and sequence definition of a class of highly repetitive tandem DNA. AB - We describe a class of human repetitive DNA, called beta satellite, that, at a most fundamental level, exists as tandem arrays of diverged approximately equal to 68-base-pair monomer repeat units. The monomer units are organized as distinct subsets, each characterized by a multimeric higher-order repeat unit that is tandemly reiterated and represents a recent unit of amplification. We have cloned, characterized, and determined the sequence of two beta satellite higher order repeat units: one located on chromosome 9, the other on the acrocentric chromosomes (13, 14, 15, 21, and 22) and perhaps other sites in the genome. Analysis by pulsed-field gel electrophoresis reveals that these tandem arrays are localized in large domains (50-300 kilobase pairs) that are marked by restriction fragment length polymorphisms. In total, beta satellite sequences comprise several million base pairs of DNA in the human genome. Analysis of this DNA family should permit insights into the nature of chromosome-specific and nonspecific modes of satellite DNA evolution and provide useful tools for probing the molecular organization and concerted evolution of the acrocentric chromosomes. PMID- 2762327 TI - Cis-acting elements determine the locus-specific shutoff of class I major histocompatibility genes in murine S49 lymphoma sublines. AB - Several tumors have been reported to down-regulate expression of their class I major histocompatibility molecules, potentially altering their immune recognition. To investigate this phenomenon, we are using various sublines isolated from the S49 lymphoma of the BALB/c mouse strain. These S49 tumor sublines were previously found to have shut off expression of their Kd, Dd, and/or Ld class I molecules in a locus-specific manner. Extensive Southern blot analyses indicated that there were no major chromosome aberrancies in these S49 sublines, and analyses of steady-state class I mRNA suggested that a form of transcriptional regulation was responsible for their variant class I expression. In this report, we characterize the nature of this locus-specific regulation of class I in S49 cells by producing somatic cell hybrids. Three phenotypically distinct S49 sublines were each fused to tumor cells with normal class I expression, and several of the resulting hybrids were analyzed. In every case, the class I molecules expressed by the hybrids were an exact composite of the two fusion partners. Thus, these fusions failed to rescue expression of the Kd, Dd, and/or Ld molecules shut off within each of the S49 tumor sublines. These findings indicate that this locus-specific shutoff of class I expression results from a cis-acting defect and not trans-acting factors. Because the analysis of each of three phenotypically different S49 cells implicated a form of cis dominant regulation, we hypothesize that a common mechanism generating homologous mutations in class I genes is operative in S49 tumor cells. PMID- 2762328 TI - In vitro propagation of human hepatitis B virus in a rat hepatoma cell line. AB - A rat hepatoma cell line (Q7) of Morris hepatoma origin was transfected with a construct containing the tandem dimer genome of human hepatitis B virus (HBV) and the neomycin-resistant selection marker. The culture medium of several neomycin resistant single-cell clones was found to accumulate high levels of secreted HBV surface antigen and core-related e antigen. HBV-specific replication intermediates, including relaxed circular and single-stranded DNA with a minus strand polarity, could be found in both the intracellular fraction and the extracellular culture medium by the Southern blot procedure. One of these clones, designated Q7 HBV-21, was characterized in further detail. DNA polymerase activity was present in the virus particles produced by Q7 HBV-21 cells. Characteristic transcripts of HBV, including the 3.5-, 2.5-, and 2.1-kilobase mRNA as well as a core-gene-related transcript of 2.2 kilobases could be detected. Electron microscopic examination of the conditioned medium from Q7 HBV 21 cells identified 42-nm Dane-like particles as well as 22-nm subviral particles with a spherical or filamentous shape. This Q7 HBV-21 cell line has been maintained in the absence of neomycin for 1 year without losing the properties of HBV DNA replication and Dane-like particle production. Our results strongly suggest that the species barrier of HBV infection is at an early step of viral absorption onto or penetration into the target hepatocytes. This nonhuman system for HBV production in culture could be used to complement the human HepG2 system. PMID- 2762329 TI - Polar/apolar chemical inducers of differentiation of transformed cells: strategies to improve therapeutic potential. AB - N,N'-Hexamethylenebisacetamide (HMBA) induces transformed cells to differentiate, accompanied by suppression of oncogenicity. Clinical trials have shown that HMBA can cause positive therapeutic responses in some cancer patients, but clinical efficacy may be limited, in part, by dose-related toxicity. Potential improvements in efficacy may be accomplished by changes in the chemical structure of inducing agents and by increasing the sensitivity of tumor cells to inducers of differentiation. We have previously described an approach to improving tumor cell responsiveness to inducing agents. Transformed cell lines that have acquired low levels of resistance to vincristine display a markedly increased sensitivity to HMBA. We now report on a series of hybrid polar/apolar compounds--some of which are as active as HMBA and several of which are significantly more active than HMBA in vitro--whose chemical structures make it likely that they have different pharmacokinetics. Vincristine-resistant murine erythroleukemia cells also are shown to have marked increased sensitivity to these hybrid polar/apolar compounds. Thus these findings suggest potentially useful strategies for the application of polar/apolar inducers of differentiation to the treatment of cancers. These studies also provide approaches to further understanding of the biological process of terminal differentiation. PMID- 2762330 TI - Ascorbate is an outstanding antioxidant in human blood plasma. AB - We have shown recently that the temporal order of antioxidant consumption in human blood plasma exposed to a constant flux of aqueous peroxyl radicals is ascorbate = protein thiols greater than bilirubin greater than urate greater than alpha-tocopherol and that detectable lipid peroxidation starts only after ascorbate has been consumed completely. In this paper, we show that it is indeed ascorbate that completely protects plasma lipids against detectable peroxidative damage induced by aqueous peroxyl radicals and that ascorbate is the only plasma antioxidant that can do so. Plasma devoid of ascorbate, but no other endogenous antioxidant, is extremely vulnerable to oxidant stress and susceptible to peroxidative damage to lipids. The plasma proteins' thiols, although they become oxidized immediately upon exposure to aqueous peroxyl radicals, are inefficient radical scavengers and appear to be consumed mainly by autoxidation. Our data demonstrate that ascorbate is the most effective aqueous-phase antioxidant in human blood plasma and suggest that in humans ascorbate is a physiological antioxidant of major importance for protection against diseases and degenerative processes caused by oxidant stress. PMID- 2762331 TI - Central vasopressin infusion prevents hibernation in the European hamster (Cricetus cricetus). AB - The amount of immunocytochemically detectable vasopressin in the brain of the European hamster (Cricetus cricetus) shows a seasonal variation; i.e., dense vasopressin immunoreactivity is present in the lateral septum during summer but is absent in autumn and winter [Buijs, R. M., Pevet, P., Masson-Pevet, M., Pool, C. W., De Vries, G. J., Canguilhem, B. & Vivien-Roels, B. (1986) Brain Res. 371, 193-196]. In the winter period the European hamster hibernates. Since vasopressin in the lateral septum is known to be involved in the control of body temperature, we investigated whether infusion of vasopressin in the lateral septum during autumn-winter could influence hypothermic patterns normally seen in hibernating animals. Hamsters whose lateral septum was infused with vasopressin showed almost no periods of hypothermia, whereas hamsters treated with control infusions displayed a normal hibernation pattern. The results indicate that persistence of vasopressin release in the lateral septum of the European hamster during winter can prevent hibernation. PMID- 2762332 TI - Age-related development of a heterozygous phenotype in solitary neurons of the homozygous Brattleboro rat. AB - A single-base deletion in the single-copy vasopressin gene is the cause of diabetes insipidus in the homozygous Brattleboro rat (di/di). It results in the synthesis of an altered vasopressin precursor of which the axonal transport is blocked. Paradoxically, a small number of solitary hypothalamic neurons displays all the immunoreactivities of the wild-type vasopressin precursor (i.e., vasopressin, neurophysin, and a glycopeptide). In the present paper we provide evidence that these neurons have undergone a switch to a genuine heterozygous (di/+) phenotype; i.e., they contain the immunoreactivities of both the wild-type and the mutated vasopressin precursors. In the neural lobe, glycopeptide fibers are also present, showing that axonal transport of the wild-type precursor is restored. Moreover, the number of neurons displaying this di/+ phenotype increases markedly and in a linear way (from 0.1% up to 3% of the vasopressin cells) with age. These findings indicate that after mitotic division has ceased, genomic alterations occur in somatic neurons in vivo. The molecular event generating the di/+ phenotype in the di/di animal could involve a somatic intrachromosomal gene conversion between the homologous exons of the vasopressin and the related oxytocin genes. PMID- 2762334 TI - Should alternative medicine come into the fold? PMID- 2762335 TI - Incontinence sheaths: when are they necessary? PMID- 2762333 TI - Comparative 13C and 31P NMR assessment of altered metabolism during graded reductions in coronary flow in intact rat hearts. AB - 13C NMR spectroscopy may offer a unique ability to characterize the metabolic response to graded reduction in coronary flow since it allows repeated, nondestructive identification of products of intermediary metabolism in the same heart. The sensitivity of 13C parameters of glucose metabolism was compared with changes in levels of phosphocreatine, ATP, and pH as determined by 31P NMR in the intact, beating rat heart model during graded reductions in coronary flow. Experiments were performed during 60 min of perfusion with [1-13C]glucose (5 mM) at normal flow (15 ml/min) and at the reduced flow rates of 5 and 2 ml/min. During flow at 5 ml/min, isovolumic developed pressure fell to 51 +/- 4% of control. Although phosphocreatine, ATP, and pH were not changed, [3-13C]lactate was increased (1.46 +/- 0.12 mumol/g of wet weight vs. 0.63 +/- 0.08 during normal flow). In addition, the time to 50% maximum enrichment of [2-13C]glutamate was prolonged (17 +/- 1 min vs. 9 +/- 1 min during normal flow), indicating that glucose-supported flux through the tricarboxylic acid (TCA) cycle was decreased. The relative anaplerotic contribution to citrate synthase-supported TCA flux was increased from 6% to 35%. These 13C metabolic changes could not be reproduced by reduced [1-13C]glucose delivery in the absence of ischemia, although similar reduced TCA flux indices were reproduced in additional hearts when workload was reduced by low calcium (0.7 mM) perfusion. Therefore, the information provided by 13C NMR spectroscopy can be a more sensitive indicator of flow-induced alterations in cardiac metabolism than that provided by the much more commonly used 31P NMR technique. PMID- 2762336 TI - Managing an implantable drug delivery system. PMID- 2762337 TI - Wound care protocols are not recipes for success. PMID- 2762338 TI - Ensuring job satisfaction need not be costly. PMID- 2762339 TI - Who should manage pain--patient or nurse? PMID- 2762340 TI - Preparing children for hospital: a school-based intervention. PMID- 2762342 TI - The north west looks forward to regeneration. PMID- 2762341 TI - Managing an operating department. PMID- 2762343 TI - A role in the community promoting good health. PMID- 2762344 TI - What can you do after registration? PMID- 2762345 TI - Prevalence, phenotypic heterogeneity and familial aspects of bilateral renal agenesis/dysgenesis. PMID- 2762346 TI - Genetics of kidney disorders. Proceedings of the Fifth International Clinical Genetics Seminar. Rethymno, Crete, October 25-30, 1988. PMID- 2762347 TI - Familial idiopathic hypercalciuria. PMID- 2762348 TI - Nephropathy in hereditary osteo-onycho dysplasia (HOOD): variable expression or genetic heterogeneity? PMID- 2762349 TI - Familial membranoproliferative glomerulonephritis type 2 (MPGN-2). PMID- 2762350 TI - Senior-Loken syndrome: ultrastructural features of heterozygous state associated with IgM nephropathy. PMID- 2762351 TI - Familial hematuria: a clinical, ultrastructural and morphometric study. PMID- 2762352 TI - Congenital/infantile nephrotic syndrome with diffuse mesangial sclerosis: relationship with Drash syndrome. PMID- 2762353 TI - Prenatal diagnosis of congenital nephrotic syndrome of non Finnish type. PMID- 2762354 TI - Congenital nephrotic syndrome and tracheoesophageal fistula with esophageal atresia (type IIIB). PMID- 2762355 TI - Posterior urethral valves with polydactyly: case report of a six year old boy. PMID- 2762356 TI - Polycystic kidney disease in children: differential diagnosis between the dominantly and recessively inherited forms. PMID- 2762357 TI - Cystic kidneys in children. Cooperative study of the German "Arbeitsgemeinschaft fur Padiatrische Nephrologie". PMID- 2762358 TI - Non-allelic genetic heterogeneity of autosomal dominant polycystic kidney disease? PMID- 2762359 TI - A high incidence of PKD in a large geographic area of south-western Hungary: a medical genetic study. PMID- 2762360 TI - Study in the chemical constituents of plantago cynops L. and antibacterial evaluation of verbascoside. AB - Oleanolic acid, verbascoside, plantarenaloside and four sterolic derivatives were isolated from the aerial parts of Plantago cynops L. These constituents in this species were determined and described for the first time. An antibacterial evaluation was carried out for verbascoside. PMID- 2762361 TI - [Hemoglobin niosomes. I. Preparation, functional and physico-chemical properties, and stability]. AB - Hemoglobin niosomes. I, Preparation, functional and physical properties and stability. Hemoglobin niosomes (non ionic liposomes) obtained from L'Oreal synthetic lipids by solvents vaporization appear as unilamellar spherical red vesicles, isolated from each other and with heterogeneous size (0.5 to 4 microns). Their suspensions show a visible spectra superimposable to that of free hemoglobin which is incorporated at a rate of 0.3 to 0.5 g per lipid gram. Vesicles are permeable to oxygen and the hemoglobin dissociation curve can be modified similarly to non-encapsulated hemoglobin. Niosomes appear physically stable while hemoglobin undergoes a progressive oxidation to methemoglobin reaching 30% after 5 months at 4 degrees C. Even in the absence of dicetylphosphate (DCP), niosomes possess a negative charge confering to them an electrophoretic mobility. 5% DCP allows to obtain a zeta potential near to that of erythrocytes. The niosomes suspensions are more viscous than red blood cells but their rheological behavior is similar and the vesicles may have some deformability. PMID- 2762362 TI - Effects of zinc acexamate on blood flow and prostanoid levels in the gastric mucosa of the rat. AB - The effects of the new antiulcer compound zinc acexamate on blood flow and prostanoid levels in the gastric mucosa have been studied. Zinc acexamate (30 and 300 mg/kg) dose-dependently prevents the reduction induced by the perfusion of noradrenaline (3.5 micrograms/kg.min, 30 min) in gastric mucosal blood flow, as measured by 3H-aniline clearance. Zinc acexamate pretreatment also increases the levels of prostaglandin E2 in the gastric mucosa of the rat, both under control conditions and after infusion with noradrenaline. The levels of thromboxane A2 and prostacyclin were not modified by zinc acexamate. These results confirm the importance of microcirculation in pathogenesis and the idea that the antiulcer activity of zinc acexamate is due in part to its action in increasing the mechanism which defend the gastric mucosa against aggression. PMID- 2762363 TI - Lumbar CSF eicosanoids in neonates. AB - Lumbar CSF eicosanoids were measured in 11 neonates with perinatal asphyxia and 12 neonates with suspected sepsis. In the asphyxia group low levels of thromboxane B2 and prostaglandin F2a were detected in five neonates, all of which had had a lumbar puncture prior to 4 hours of age. In the group with suspected sepsis two infants had positive blood cultures and one had strep meningitis. CSF eicosanoids were nondetectable in all patients in this second group with the exception of the infant with meningitis. With meningitis CSF eicosanoids were markedly elevated. These findings suggest that lumbar CSF eicosanoids do not appear to be a clinically useful tool. The data further suggest that eicosanoids are involved in the inflammatory response to meningitis. PMID- 2762364 TI - Metabolism of leukotriene C4 in the anesthetized guinea pig. AB - The distribution and metabolism of [3H] leukotriene (LT)C4 has been studied in the anesthetized guinea pig. The intravenous administration of [3H] LTC4 (1 muCi/kg) to seven guinea pigs showed a rapid vascular clearance of radioactivity with significant metabolism evident at the 15 sec and 1 min time points with material chromatographing like LTC4 (45.6 +/- 7.5%, 35.0 +/- 4.4%). LTD4 (18.4 +/ 5.1%, 33.2 +/- 4.4%) as well as polar material (25.5 +/- 6.0%, 29.7 +/- 4.7%) respectively. The biliary recovery of radioactivity was found to be 74.5 +/- 5.5% n = 4, over 120 min in the guinea pig with less than 1% of radioactivity present in the urine. Examination of the metabolic profile of the biliary radioactivity showed total conversion of LTC4 to LTD4 which was the major metabolite at early time points, and LTD4 as well as LTE4 at later time points. Significant radioactivity which increased with time was also present at the solvent front of the chromatogram indicating the presence of polar biliary metabolites. These results show that the major route of elimination of peptide leukotrienes is through the bile duct in the anesthetized guinea pig and that LTD4 is the major eliminated metabolite in this model. PMID- 2762365 TI - Influence of rat prenatal and postnatal exposure to a non-steroidal anti inflammatory agent (flunoxaprofen) on cardiovascular function in the progeny. AB - The present experiments evaluated in rats the effects of prenatal and postnatal exposure to a non-steroidal antiinflammatory agent, flunoxaprofen (5-10 and 20 mg/kg/day by the oral route), on cardiovascular function in the pups. In both conscious and anaesthetized rats pre- and postnatal flunoxaprofen exposure at the 30th and 60th day of age, significantly (P less than .05) induced a decrease of pressor response to carotid-sinus baroreceptor stimulation and to L-noradrenaline (0.1-1 and 5 micrograms/kg iv), and an increase of the hypotensive responses to L isoprenaline (0.01-0.1 and 1 microgram/kg iv) and acetylcholine (0.01-0.1 and 1 microgram/kg iv). These effects were not observed in rats on the 90th day of age. Moreover, pre- and postnatal flunoxaprofen exposure did not modify systolic arterial blood pressure of plasma levels of catecholamines and acetylcholinesterases. Our results also show that in normotensive rats flunoxaprofen exposure during pregnancy did not affect the body weight, systolic or diastolic blood pressure or heart rate of pregnant rats. It did not affect the length of gestation, number of pups per litter or pup body weight. No macroscopic teratogenic effects were observed. PMID- 2762366 TI - Studies of the cation binding properties of an oligomeric derivative of prostaglandin B1. AB - The ionophoretic activity of PGBx, an oligomeric mixture synthesized from 15 dehydro PGB1, with different cations was measured using arsenazo III-entrapped liposomes. The order of ionophoretic activity was Zn2+ greater than Co2+ greater than Mn2+ greater than Cu2+ greater than Ca2+ greater than Ba2+ greater than Sr2+ greater than Mg2+. The intrinsic fluorescence of PGBx was quenched by the binding of divalent cations as well as by La3+ and H+. Quenching by K+ and Na+ was minimal. The order of quenching strength of divalent cations was Zn2+ greater than Co2+ greater than Cu2+ = Mn2+ greater than Ca2+ greater than Ba2+ greater than Sr2+ greater than Mg2+. Binding affinities of these cations determined by a murexide indicator method were in good agreement with that determined by the fluorescence quenching reaction. The cation binding affinity of PGBx in aqueous solutions correlates with the ionophoretic activity in liposomes. The binding affinity for K+ was estimated from the inhibition by K+ of Ca2+ binding by PGBx. Although PGBx has a lower selectivity for divalent cation binding than the ionophore A23187, the characteristics of the binding affinity of these two compounds for various ions were similar. The pK of PGBx as determined by fluorescence quenching was 6.7. The molecular weight of the divalent cation binding unit was estimated to be about 680, with each PGBx molecule having three such binding sites. The binding of Ca2+ to such a site is one-to-one. PMID- 2762367 TI - Elevation of thromboxane in pressure wounds. AB - Arachidonic acid metabolites have been implicated as mediators of progressive dermal ischemia. Decubitus ulcer formation results from chronic mechanical pressure on the skin which results in a diminished blood supply to the skin and underlying tissues. To evaluate the role of thromboxanes in pressure wounds, we measured TxB2, a stable metabolite of TxA2, in spontaneously occurring pressure wounds on Greyhound dogs. In pressure wounds in which the skin was showing early signs of pressure necrosis but was still intact, elevated TxB2 concentrations were found in healthy appearing tissues immediately adjacent to the pressure wounds, in the inner edge of the wounds, and in the center of the wounds. Significantly greater TxB2 concentrations (P less than 0.05) were found in the center of the intact wounds versus the TxB2 concentrations in the inner edge of the wounds or in healthy appearing tissues adjacent to the wounds. In pressure wounds in which the center of the wound had ulcerated or had an eschar, elevated TxB2 concentrations were found in tissues in the inner edge of the wounds and in healthy appearing tissues immediately adjacent to the pressure wounds. These results demonstrate the occurrence of elevated thromboxane concentrations in and around spontaneously occurring pressure wounds. PMID- 2762368 TI - Lipoxygenase metabolites of arachidonic acid do not induce mucus secretion from rabbit intestinal goblet cells in vitro. AB - Lipoxygenase metabolites of arachidonic acid are effective mucus secretagogues in the respiratory tract but their efficacy in the intestinal tract was unknown. Mucosal explants and sheets of epithelial cells isolated from rabbit small and large intestine were exposed to leukotrienes B4, C4, and D4 and monohydroxyeicosatetraenoic acids 5-HETE, 12-HETE, and 15-HETE. Light and electron microscopic inspection of goblet cells in treated tissues failed to detect evidence of recent compound exocytosis of mucin granules or other morphological evidence of secretory activity. These results indicate that lipoxygenase metabolites are not directly responsible for the increased mucus secretion observed in ulcerative colitis. PMID- 2762369 TI - Postprandial hyperlipemia inhibits platelet aggregation without affecting prostanoid metabolism. AB - The objective of this work was to characterize changes in platelet aggregability during postprandial hypertriglyceridemia with special emphasis on arachidonic acid metabolism. Ten healthy young men consumed 100 g fat after a fasting period of 12 hr. In-vitro platelet aggregation induced by ADP and collagen was measured at 0, 3, 5, and 9 hours after the fat intake. The major arachidonic acid metabolites, 12-hydroxyeicosatetraenoic acid (12-HETE), thromboxane A2 (TXA2), prostaglandin F2 alpha (PGF2a), and prostaglandin E2 (PGE2) produced during collagen-induced platelet activation were quantified by gas chromatography/mass spectrometry. A significant decrease in platelet aggregability induced by both ADP and collagen was detected during the postprandial hyperlipemia. No significant changes could be found in the prostanoid pattern of collagen activated platelets. There was no correlation between the degree of the inhibition of platelet aggregation and the relative or absolute increase of triglyceride-levels in the plasma during the postprandial hyperlipemia. PMID- 2762370 TI - Comment by P. V. Peplow on; Production Rates of Prostaglandin F, 6-Keto PGF1 alpha and Thromboxane B2 by Perifused Human Endometrium. PMID- 2762371 TI - Endothelium-dependent and -independent mechanisms of action of acetylcholine in monkey and dog isolated arteries. AB - In helical strips of monkey coronary and mesenteric arteries and dog mesenteric arteries partially contracted with prostaglandin (PG)F2 alpha, the mechanism of action of acetylcholine (ACh) has been analyzed by the use of pharmacological antagonists and by the endothelium-derived relaxing factor (EDRF) bioassay and the 6-keto PGF1 alpha radioimmunoassay. In conclusion, ACh releases vasodilator substance(s) from endothelium (EDRF) and also PGs from subendothelial tissues. Vasoconstrictor PGs appear to counteract the dilator action of EDRF in monkey coronary arteries, whereas vasodilator PG, possibly PGI2, appears to facilitate the relaxation caused by EDRF in monkey and dog mesenteric arteries. PMID- 2762372 TI - Different sensitivities for four calcium entry blockers of serotonin-, but not K+ induced contractions of isolated jugular vein and aorta of the rat. AB - We investigated the inhibitory effect of the calcium entry blockers (CEBs) nifedipine, diltiazem, flunarizine and gallopamil on K+-and serotonin (5-HT) induced contractions of the rat jugular vein and aorta in vitro. In both tissues all four CEBs inhibited K+-induced contractions concentration-dependently in a similar manner in the same concentration range. Only a smaller contraction due to hyperosmolarity of the medium as the result of addition of 100 mmol/l KCl persisted. 5-HT-induced contractions were antagonized more strongly by nifedipine than by diltiazem and flunarizine, suggesting different sites of action. Moreover, the arterial preparation proved to be more sensitive to CEB pretreatment than the jugular vein preparation. Gallopamil influenced 5-HT induced contractions also by an antiserotonergic effect. PMID- 2762373 TI - Effects of sennosides A + B and bisacodyl on rat large intestine. AB - Oral and intracecal administration of bisacodyl or sennosides A + B (10-100 mg/kg each) to rats induced a similar quantity of soft feces within 24 h and a similar acceleration of large intestinal transit time, but in each case bisacodyl had a prolonged action. Net fluid absorption in the perfused rat colon was reduced to a comparable extent by local bisacodyl in 1/10 of the molar concentration of rhein, an active metabolite of sennosides; recovery was delayed after bisacodyl. These results show that the time course of the laxative action of both drugs is different, probably attributable to their different pharmacokinetics. Both drugs influence colon motility as well as colonic secretion, but fluid secretion may contribute more to the laxative effect of bisacodyl than to that of sennosides. PMID- 2762374 TI - Role of carboxylesterase in protection against soman toxicity. AB - Rats were injected intraperitoneally with phenobarbital (PB) and 3 methylcholanthrene (MC) which are microsomal enzyme inducers, and methyl iodide (MeI), cobalt chloride (CoCl2) and tri-o-cresyl phosphate (TOCP) which are inhibitors of the enzymes glutathione transferase, cytochrome (cyt) P-450 and carboxylesterase, respectively, and then challenged with soman (i.p.) to know its LD50. Pretreatment with PB and MC increased and TOCP decreased, whereas MeI as well as CoCl2 did not alter the LD50 value of soman in rats. The 1/2 LD50 dose of soman did not affect the liver microsomal cyt P-450 level, but significantly lowered carboxylesterase (CaE) and cholinesterase (ChE) activities in liver microsomes and in blood plasma. Induction of plasma CaE was more important than microsomal CaE in PB-mediated protection against soman toxicity. Gel filtration of plasma into four protein fractions for their relative soman binding capacity showed that a high-molecular-weight protein fraction (180,000 daltons on SDS PAGE) which had no CaE activity could bind soman 6 times more than the low molecular-weight CaE-containing protein fraction (60,000 daltons on SDS-PAGE). PMID- 2762376 TI - Behavioural manifestations elicited by apomorphine, influence of the route of administration. AB - In order to investigate the influence of the route of administration on behavioural effects induced by apomorphine (APO), 6 increasing doses were administered by intraperitoneal and by subcutaneous route to male Wistar rats. Dose-response curves for stereotypy, rearing, sedation, grooming, yawning and penile erection were calculated. The occurrence of stereotypy precluded other behavioural manifestations. APO was more potent when administered subcutaneously, with potency ratios between the routes of 10.4 for stereotypy, 4.6 for sedation, 6.8 for grooming, 11.8 for yawning and 7.5 for penile erection. PMID- 2762375 TI - Age and gender effects on chlordiazepoxide kinetics: relation to antipyrine disposition. AB - Twelve normal subjects aged 24-41 years, and 12 subjects aged 62-79 years, received single 50-mg doses of chlordiazepoxide hydrochloride by mouth and by intravenous injection on two occasions. Chlordiazepoxide volume of distribution was significantly correlated with body weight (r = 0.63, p less than 0.001), but was not related to age or sex. Among male subjects, elimination half-life was prolonged (20 vs. 8 h, p less than 0.025) and clearance reduced (20 vs. 43 ml/min, p less than 0.05) in elderly as opposed to young volunteers. Among women, there was no significant difference between elderly and young subjects in elimination half-life (12 vs. 13 h) or clearance (29 vs. 22 ml/min). Absolute bioavailability of oral chlordiazepoxide was not less than 100%, and was unrelated to age or sex. Among 20 subjects who received a single 1.0- to 1.2-gram intravenous dose of antipyrine on another occasion, clearance of chlordiazepoxide and of antipyrine were significantly correlated (r = 0.62, p less than 0.01). Like many other low-clearance oxidatively metabolized compounds, chlordiazepoxide clearance is reduced and half-life prolonged in elderly men, but not elderly women. Individual variations in chlordiazepoxide clearance are significantly correlated with those of antipyrine, a drug commonly used as an index of hepatic oxidizing capacity. PMID- 2762377 TI - Noradrenergic output and clinical response in depressed women during amitriptyline therapy. AB - The measurement of the urinary excretion of 3-methoxy-4-hydroxyphenylglycol (MHPG) in 59 unipolar depressed women before and during administration of 100 mg amitriptyline (AMT) i.m. daily for four weeks showed that the patients could be divided into high or low MHPG excretors. An analysis of the excretion course of MHPG and 3-methoxy-4-hydroxy mandelic acid during therapy showed, in most patients, a lower urinary excretion of both these noradrenaline (NA) metabolites in comparison with basal values. Therapy also decreased plasma noradrenaline concentrations and blood pressure values both at rest and on orthostatic challenge. Available evidence seems to suggest that AMT administration caused a lower overall noradrenergic output that might be partially responsible for a diminished sympathetic nervous activity. The authors were unable to confirm that the baseline MHPG level can predict the clinical response to antidepressant treatment and they found no significant correlations between changes in bio chemical or physiological variables and drug plasma concentrations or clinical response. The possibility that depressed patients might be grouped according to their different NA metabolism needs to be validated in a larger patient sample. PMID- 2762378 TI - Desipramine dose prediction based on 24-hour single-dose levels: feasibility and validity. AB - The authors present a prospective study of a rapid desipramine dose adjustment on the basis of a 24-hour plasma concentration after a single 150 mg dose. For this, they use a prediction table constructed from data in the literature showing strong correlation between steady-state plasma levels and 24-hour single-dose levels. Despite the fact that desipramine action is not always linear, the method appears to be feasible and valid. In an attempt to reach a 150 ng/ml level, the authors obtained steady-state levels ranging from 85 to 317 ng/ml, with 14 of the 19 patients in the range between 125 and 250 ng/ml. Moreover, 11 of the 19 patients received a daily dose of 250 mg or more desipramine from the third day of treatment onward; in ten of these cases, this dose had been adapted. PMID- 2762379 TI - Ultraviolet radiation--induced malignant melanoma in Monodelphis domestica. AB - Several lines of evidence support the hypothesis that ultraviolet radiation (UVR) is involved in the etiology of cutaneous melanoma in humans. However, progress in understanding the mechanisms involved in induction of melanotic tumors by UVR has been hindered by lack of a suitable animal model. During the course of multiple exposures (3 times/wk for 70 wk) of the South American opossum, Monodelphis domestica, to UVR, we first observed the appearance of areas of dermal melanocytic hyperplasia (MH) on the exposed skin. Post-UVR exposure to photoreactivating light (320-500 nm) suppressed the occurrence of MH. We also observed at 100 weeks from first exposure that 10 of 46 surviving animals had developed melanotic tumors which arose, presumably, from areas of MH. Tumors on three of the 10 animals have been classified as malignant melanomas based on metastasis to lymph nodes. We conclude from these results that UVR can act as a complete carcinogen for melanoma induction and, based on the photoreactivation of MH induction, that DNA damage is involved in melanoma formation. PMID- 2762380 TI - Formation of aggregates of tryptic fragments derived from the carboxyl-terminal half of pea phytochrome and localization of the site of contact between the fragments by amino-terminal amino acid sequence analysis. AB - Limited trypsinization of large pea (Pisum sativum cv. Alaska) phytochrome and subsequent size-exclusion chromatography (SEC) in 0.1 M Na phosphate, pH 7.8, yielded a high-molecular-mass aggregate of tryptic fragments of phytochrome. Further SEC in 0.1 M Tris-HCl, pH 7.5, plus various concentrations of NaSCN, indicated that the tryptic-fragment complex contained an aggregate of 7 fragments of molecular mass from 38 to 55 kDa. The amino-terminal sequence of each fragment was determined from the samples electroblotted from sodium dodecylsulfate polyacrylamide gels onto polyvinylidene difluoride membranes, in order to localize the various fragments on the phytochrome polypeptide chain. All of the 7 fragments in the aggregate were found to be derived from the carboxyl-terminal half of phytochrome. A portion of the polypeptide chain (from Ala-752 to Arg 1000) common to all the tryptic fragments has been assigned as the site(s) of contact of the fragments. The tryptic-fragment complex, as well as large phytochrome itself, has been shown by SEC to dissociate to monomers in 2 M NaSCN. The result indicates that the main force involved in maintaining the complex and in contacts between monomers of phytochrome is non-ionic in nature. Relationship between the contact site(s) of the tryptic-fragment complex and large phytochrome monomer is discussed. PMID- 2762381 TI - Photosensitized oxidation of biomaterials and related model compounds. AB - Aluminium trisulfonatophthalocyanine (A1PCS), a dye being widely advocated for use in photodynamic therapy, produces singlet oxygen with a quantum yield of 0.34 in oxygenated water at pH 7. Triplet A1PCS abstracts an electron from a variety of amines and phenols, the rate of electron transfer depending upon the thermodynamic driving force, forming the A1PCS radical anion. This latter species reduces molecular oxygen to superoxide ions with high efficiency. The triplet state also abstracts an electron from biological components, including NADH, vitamin C, cysteine, methionine, tyrosine, tryptophan, uracil, and guanine, but not from DNA. These results suggest that photoinduced electron abstraction from appropriate biomaterials could compete with singlet oxygen production under in vivo conditions. PMID- 2762382 TI - Geometry of intercalation of psoralens in DNA approached by molecular mechanics. AB - The results of molecular mechanical calculations on intercalation complexes of 3 carbethoxypsoralen, 5-methoxypsoralen, 8-methoxypsoralen, 7-methylpyrido[3,4 c]psoralen (MepyPs) and 7-methylpyrido[4,3-c]psoralen (2N-MePyPs) with the double stranded duodecanucleotide d(CGCGATATCGCG)2 are presented. In the energy minimized structures, the psoralens are intercalated with their plane orthogonal to the helix axis. Stacking interactions between the furan ring of the psoralen and the adjacent bases are maximized in most derivatives studied, whereas the effect of the various substituents of the psoralen ring is to specifically push part of the molecule towards either the minor or the major groove, preventing a symmetrical intercalation (with respect to the two strands of the DNA). The relative position of the psoralen ring and of the adjacent thymine foreshadows the formation of furan-side monoadducts in 3-CPs, MePyPs and 2N-MePyPs, whereas the formation of a pyrone-side monoadduct appears as geometrically more favourable in 5-MOP and both furan- and pyrone-side monoadducts can be geometrically envisaged in 8-MOP. A good correlation therefore exists between the more or less favourable equilibrium geometries and the experimentally observed photoreactions. The present study is the first attempt to characterize the geometrical parameters as part of a complex set of geometrical, dynamical and excited state parameters governing the overall DNA-psoralen photoreaction. PMID- 2762383 TI - Monofunctional angular furocoumarins: sequence specificity in DNA photobinding of 6,4,4'-trimethylangelicin and other angelicins. AB - The sequence specificity in the photoreaction (365 nm) of 6,4,4' trimethylangelicin (TMA) with DNA fragments of the lac I gene of Escherichia coli was studied by using DNA sequencing methodology. In order to map the sites of TMA photoaddition, we took advantage of the (3'-5') exonuclease activity associated with T4 DNA polymerase, which is blocked by bulky adducts, such as furocoumarin photoadducts. A quantitative analysis of the sites of photoaddition is reported. TMA was demonstrated to photoreact with thymine and, to a lower extent, to cytosine. AT-rich sequences and TTT sites in a GC context are the most reactive sites towards TMA whereas TA, AT, CA, AC sites are weaker sites with similar reactivity. Cytosines in alternated CG sequences are also targets of TMA photobinding. We observed a less pronounced sequence specificity of TMA than that of other psoralen derivatives already studied (Sage and Moustacchi, 1987; Boyer et al., 1988). A comparison with other furocoumarins 4,4'-dimethylangelicin (4,4' DMA), 4'-methylangelicin (4'-MA), angelicin, 4,5',8-trimethylpsoralen (TMP) and 8 methoxypsoralen (8-MOP) is also reported. The role of flanking sequence and consequently of the local conformation at the various sites of photoaddition is discussed. A preferential orientation of the TMA molecule during the intercalation in the dark is suggested. Hot alkali treatment of TMA-modified DNA did not reveal any DNA strand breakage due to photooxidized bases. PMID- 2762384 TI - Resistance of human and mouse myeloid leukemia cells to UV radiation. AB - Sensitivity of mouse bone marrow and myeloid leukemia cells as well as the sensitivity of human myeloid leukemia cells to UV light was tested. Criteria were the in vivo colony-forming ability of UV exposed cells and the inhibition of DNA synthesis during post-irradiation incubation for 24 h in vitro. Mouse bone marrow cells irradiated with a small dose of UV light (5 J/m2) and injected into x irradiated animals did not form hemopoietic colonies on the recipients' spleens, and the recipients died. However, mouse leukemia cells, after irradiation with higher doses of UV light, retained the ability to form colonies on the spleens, and all recipient mice died with typical symptoms of leukemia. In vitro, mouse bone marrow cells exhibited high sensitivity to UV light as compared to mouse myeloid leukemia cells. Human leukemia cells were also resistant to UV light, but more sensitive than mouse leukemia cells. These results indicate that myeloid leukemia cells are resistant to UV light as compared with normal bone marrow cells. PMID- 2762385 TI - The effects of near-UV radiation on human lens beta-crystallins: protein structural changes and the production of O2- and H2O2. AB - beta-Crystallins (beta 1-, beta 2- and beta 3-crystallin) comprise nearly half the protein of the human lens. The effect of near-UV radiation, which is one of the possible risk factors in cataract formation, on the beta-crystallins is investigated in this study. Protein intersubunit crosslinking, change in charge of the protein subunits to more acidic species and changes in protein tertiary structure (conformation) by 300 nm irradiation are reported. The fluorescence yield of protein tryptophan residues decreases by 300 nm irradiation. There is an increase in nontryptophan fluorescence (lambda cx 340 nm, lambda cm 400-600 nm), and in protein absorption at 340 nm, due to the formation of tryptophan photooxidation products. Both tryptophan and its oxidation products can be photoexcited by 300 nm irradiation and the latter are known to be good photosensitizers. The results provide evidence for the generation of H2O2 in the irradiated human beta-crystallin solutions by the Type I photosensitizing action of the chromophores absorbing at 300 nm. The H2O2 is generated via the intermediate production of O2 anion; the latter spontaneously dismutates to H2O2, presumably via O2- protein interactions. The amount of H2O2 generated per absorbed photon is compared for various solutions of beta 1-, beta 2- and beta 3 crystallins from human lenses of different age. PMID- 2762386 TI - [Let us modernize the nurse education system]. PMID- 2762387 TI - [The perception of time, freedom and pleasure in disease]. PMID- 2762389 TI - [You only have one heart...]. PMID- 2762388 TI - [Methods of conservative treatment in orthopedics]. PMID- 2762390 TI - [Fatigue and rest]. PMID- 2762391 TI - [Scientific research in nursing]. PMID- 2762392 TI - [The influence of international nursing organizations on nursing in Poland]. PMID- 2762393 TI - [The main killers]. PMID- 2762394 TI - [Patients in the cardiac surgery department]. PMID- 2762395 TI - [Pharaoh ants in hospitals and health centers]. PMID- 2762396 TI - [The place of humanistic sciences in nursing]. PMID- 2762397 TI - Orofacial and mandibular reconstruction with the iliac crest free flap: a review of 60 cases and a new method of classification. AB - Sixty vascularized iliac crest free-tissue transfers were used for oromandibular reconstruction, 46 as osteocutaneous and 14 as osseous flaps. Forty-one patients had preoperative radiotherapy, and 8 had failed previous attempts at reconstruction. Forty-nine of the 60 reconstructions were carried out primarily, most commonly following ablative surgery for radiorecurrent squamous carcinoma. Ages ranged from 19 to 85 years, and follow-up ranged from 2 months to 5 years. Flap survival was 95 percent. Eight-six percent of patients returned to their previous activities. There were 2 perioperative deaths, and 31 patients were alive at follow-up. Horizontal defects from 5 to 16 cm were reconstructed, and in 22 patients, both oral lining and skin coverage were replaced. Radiographic evidence of bone union was noted in 96 percent of synostoses, and clinical union was seen in all but one patient. One patient required bilateral hemimandibular reconstructions for sequential primaries at different operative sittings. Functional and cosmetic results were generally satisfactory and were excellent in bone-only reconstructions. Several surgical principles evolved to minimize bulk and eliminate the need for intermaxillary fixation or external fixation postoperatively. To improve results in large or more lateral through-and-through defects, an accessory pectoralis musculocutaneous flap proved advantageous. Cosmetic and functional results depend largely on three factors: the extent of the surgery, the leanness of the patient, and his or her position on the surgical learning curve. PMID- 2762398 TI - Cleft lip with and without cleft palate in blacks: an analysis of 81 patients. AB - The clinical records of 81 black patients with cleft lip with or without cleft palate were reviewed. Four had midline clefts. Of the remaining 77, 45 were unilateral (left 28, right 17), with 11 of these involving only the primary palate. Bilateral clefts were seen in 32, with only 2 involving just the primary palate. Males and females were approximately equal in number. Two were associated with EEC syndrome. Other congenital anomalies were seen in 9 patients. The family history was positive for clefts in 5 of 65 patients (7.7 percent). A review of 255 white patients with cleft lip with or without cleft palate revealed a positive family history in 94 (37 percent). The difference was statistically significant. PMID- 2762399 TI - A comparative study of the skin envelope of the unilateral cleft lip nose subsequent to rotation-advancement and triangular flap lip repairs. AB - The secondary nasal skin envelope asymmetries were studied after unilateral cleft lip repair using the original (obsolete) rotation-advancement (Millard I) and the triangular flap techniques (Bardach's modification). Secondary correction of the nasal deformity was not performed in either group. Our findings indicated that in both groups, vertical asymmetries of the nasal skin envelope were similar. The alar dome on the cleft side was depressed, the columella was shorter on the cleft side, and there was hooding at the nostril apex. The principal difference between the two lip repairs was observed in the horizontal dimension of the nasal skin envelope. The position of the alar base was more normal following the Millard I repair, while the triangular flap repair left the alar base laterally displaced. When considered together with flattening of the cleft alar dome, a horizontal skin-envelope deficiency from middome to lateral alar crease was produced in the Millard I group. More lateral positioning of the alar base after the triangular flap technique minimized this horizontal skin deficiency. The triangular flap technique produced a secondary nasal deformity that looked worse but was easier to correct. The clinical implications of these findings are discussed. PMID- 2762400 TI - Congenital double lip: a review of seven cases. AB - Congenital double-lip deformity is an infrequent developmental abnormality affecting the lips, more commonly the upper lip. We report seven cases of double lip, all in males, of which six were in the upper lip and one in the lower lip. It was quite interesting to observe that in the upper lip, the buccal portion of the double lip appeared on either side with a midline constriction; in the lower lip, it was prominent in the midline without any central constriction. Surgical excision under regional nerve block anesthesia gives good results. The embryology, clinical appearances, and histopathology are discussed with a review of the literature. PMID- 2762401 TI - Transplantation and transposition of skeletal muscles into the faces of monkeys. AB - Restoration of normal facial movement after long-term facial paralysis with muscle atrophy has not yet been achieved reliably by either free grafts, in which fibers degenerate and regenerate, or by grafts made with microneurovascular repair, in which most fibers survive. Our purpose was to compare the structural and functional properties of free muscle grafts and continuously perfused muscle flaps transplanted into the faces of monkeys. In adult monkeys, the facial muscles were replaced by either a free graft of a donor muscle from the lower limb or a denervated flap of ipsilateral temporalis muscle. Each graft or flap was reinnervated with the preserved buccal branch of the facial nerve. The control muscles, grafts, and flaps were examined 90 days later for gross appearance, contractile properties, and fiber areas. Compared with muscle flaps, free grafts showed greater adaptability to the new location and innervation and a closer approximation to the structural and functional properties of the original facial musculature. PMID- 2762402 TI - Primary treatment of the infected sternotomy wound with muscle flaps: a review of 211 consecutive cases. AB - Between 1978 and 1987, 15,595 median sternotomies were performed at Emory University Hospitals. Sternal wound infections developed in 246 patients (1.6 percent). Mediastinitis was present in 211 patients, while superficial infections were detected in the remaining 35 patients. Debridement and muscle or omental flap closure were performed in all instances of mediastinitis, with an overall mortality rate of 5.3 percent. The results of this treatment are reviewed, and the evolution of current therapeutic guidelines is described. When compared with closed-catheter irrigation and open granulation techniques, flap closure is shown to result in a fourfold decrease in mortality, an increased success of primary therapy, and a diminished length of hospitalization following treatment. This evidence supports the conclusion that debridement and flap closure should be considered the primary therapy for patients with poststernotomy mediastinitis. PMID- 2762403 TI - Smooth vs. rough: an 8-year survey of mammary prostheses. AB - One-hundred and seventy patients (124 augmentations and 46 reconstructions) were followed for 8 post-operative years. Ninety patients received the "standard" smooth silicone mammary prosthesis, and 80 patients received a polyurethane covered prosthesis. The longest follow-up was 4 years and the shortest was 1 year, with the average just over 2 years. Six types of complications were registered, with three attributed to implant design (wrinkles, draping, capsules) and three to the operator or surgery (infection, hematoma, extrusion). Firm capsule formation was considered a complication only if another intervention (reoperation, closed capsulotomy, etc.) was recommended by the surgeon or requested by the patient. Ninety-six percent of the patients with polyurethane prostheses had a satisfactory (grade II) or better than satisfactory (grade IA or IB) result, whereas 72 percent of the patients with a standard silicone-gel prosthesis achieved a satisfactory (grade II) or better than satisfactory (grade IA or IB) result. Technical details for use of polyurethane prostheses are given, as well as complications inherent to the polyurethane-covered implant. PMID- 2762404 TI - The nutrient flap: a new concept of the role of the flap and application to the salvage of arteriosclerotic lower limbs. AB - The nutrient flap is a new concept of the role of the flap. It has three functions: (1) it provides supplementary blood flow to ischemic zones, (2) it assists venous drainage in regions of venous insufficiency, and (3) it induces the formation of a capillary network. Its skin covering role is only accessory. We have applied this principle to osteitis, pseudoarthrosis, and arteriosclerosis. The nutrient flap constitutes a new type of treatment for stage IV arteriosclerosis of the lower limbs when classical revascularization techniques cannot be performed and when high amputation is indicated. Four clinical cases and the surgical techniques used are described. The flap, usually raised from the latissimus dorsi, is anastomosed to the popliteal artery by means of an inverted saphenous vein graft. It is applied to the distal extremity of the limb after excision of the necrotic tissues. The nutrient flap preserves weight bearing by maintaining the heel. PMID- 2762405 TI - Fluorometric analysis of an attempt to reclaim ischemic flaps in rats with Fluosol. AB - An experiment was designed to answer two questions as they apply to random skin flap survival: Is there a therapy that can improve random skin-flap survival when given postoperatively? And if so, when does one start such a therapy? Fluosol-DA 20% (Fluosol) has increased random skin-flap survival when given preoperatively in our laboratory. An experiment was devised to see if it could rescue failing flaps. One-hundred Sprague-Dawley rats were divided into a control (N = 25) and five experimental groups (N = 15). All had 10 X 13 cm reverse McFarlane random flaps raised and reinset. The experimental groups underwent hemodilution with either Ringer's lactate or Fluosol at 4, 8, and 12 hours after flap elevation. All were kept in 50% oxygen for 72 hours postoperatively. The flaps and their corresponding necrotic areas were measured on day 7. As to when to institute a therapy, we simultaneously evaluated the use of a microfluorometer as a monitor of flap survival. Analysis of flap survival showed little difference between control and experimental Ringer's lactate or Fluosol groups. Analysis of the microfluorometric data led to the following points. First, as a monitor of flap viability, it is limited by a lack of specificity and sensitivity. Second, comparison of the data from portions of the flap destined to live with those destined to die suggests that it may not be failure of circulatory inflow that leads to flap death. PMID- 2762407 TI - Health care for all but not for nothing. PMID- 2762406 TI - Elbow joint salvage with the transverse rectus island flap: a new application. AB - The transverse rectus island flap has gained wide acceptance in breast reconstruction. We introduce its use in reconstruction of extensive wounds of the elbow region. Three cases are presented. Its principal advantages over other methods are size, pedicle length, reliability, acceptable donor defect, and potential prevention of elbow and shoulder stiffness. Its disadvantages are bulk, weight, and required staged procedures. PMID- 2762408 TI - Free-fat injections for the correction of hemifacial atrophy. AB - Three adult patients with long-standing hemifacial atrophy were treated with repeated free-fat injections at 4- to 8-week intervals. The longest follow-up study to date is 18 months, and following the expected postoperative resorption, no further loss of bulk of injected fat has been observed. On palpation, the feel of the fat is normal, and facial expression is also good. The relative ease of this procedure, which does not entail any scarring, appears to justify more widespread use of free-fat injections to restore facial soft-tissue depressions. PMID- 2762409 TI - Aneurysm of the median artery causing recurrent carpal tunnel syndrome and anatomic review. AB - A patient is presented who had recurrent carpal tunnel syndrome symptoms in his left hand 1 year after having undergone release of the transverse carpal ligament. On exploration, this was found to be due to an aneurysm of a median artery and possibly scarring due to this compression around the branches of the bifurcated median nerve. This represents the first case in the literature to comment on (1) the absence of bilaterality of the anatomic finding and (2) carpal tunnel syndrome relative to median artery aneurysm. With this in mind, a plea is made for careful exploration of the carpal tunnel, maintaining an incision as far to the ulnar side of the median nerve as technically possible with thorough visualization of the contents of the tunnel and any anatomic variance involved. The incidence of the combination of aberrant median artery with high bifurcation of the median nerve is unknown, as is the incidence of aneurysm of the median artery. PMID- 2762410 TI - Guarded burr for deepening of nasofrontal junction. AB - Appropriate deepening of the nasofrontal junction remains one of the most difficult parts of rhinoplasty. A guarded burr is introduced that provides a safe and effective means of deepening or creating a shallow nasofrontal groove. The burr has a special guard that prevents the cutting of soft tissue. The guarded burr is introduced in position through the routine elevation of the bridge soft tissue subperiosteally. The safety latch is used for orientation. With gentle movement along the line connecting the canthi, the desired amount of bone can be removed from the nasofrontal junction with little time consumed. It is important to avoid continuous friction, since this might result in significant heat production and thereby thermal injury to the soft tissue and fluid collection. PMID- 2762411 TI - The short-lip deformity after triangular flap repair: a lengthening technique. AB - A method for lengthening of the short lip after triangular-flap repair of the unilateral cleft lip is documented. This technique offers a minimal additional scar line and a maximum effect. PMID- 2762412 TI - Nipple reconstruction with the double-opposing-tab flap. AB - The double-opposing-tab flap, a new method of nipple reconstruction used in 50 patients to date, is described. This technique uses two dermal-fat flaps, each similar to those described by Hartrampf, but with tab extensions inspired by the skate flap of Little. The donor sites of the two flaps are closed like Burrough's triangles, bringing the flaps into opposition so that they support each other's projection. The tabs cover all the exposed fat on the nipple so that no skin graft is required on the nipple proper. The result is a nicely shaped nipple that can be designed directly over a scar, maintains a projection averaging 3.8 mm at 10 months, and is technically easy to construct. PMID- 2762413 TI - A surgical approach to the motor branch of the ulnar nerve. AB - Isolated injury to the motor branch of the ulnar nerve is a relatively rare injury, often initially misdiagnosed. If repair is attempted through the original laceration without complete motor branch exposure, results can be less than satisfactory. A recent case illustrates this injury and provides us with an opportunity to review the surgical anatomy of the motor branch of the ulnar nerve. The surgical approach to the motor branch has been detailed and specifically emphasizes complete motor branch exposure from the main ulnar nerve trunk to the most distal motor branch entry into the adductor pollicis muscle. This approach permits definition of the exact level of the nerve injury, preservation of any intact proximal fine motor branches, and facilitates the mechanics of nerve repair. PMID- 2762414 TI - Determining undergraduate curriculum content in plastic surgery. AB - The purpose of this study was to determine the cognitive knowledge and clinical skills related to plastic surgery that are essential for inclusion in an undergraduate curriculum. A questionnaire was distributed to surgical clerkship directors, plastic surgeons, and 1980 graduates of four medical schools. Respondents were asked to rate (0-3) the importance of 74 knowledge items and 28 clinical skills in relation to the knowledge/proficiency necessary for students to achieve prior to graduating from medical school (0 = unnecessary, 3 = indepth knowledge/proficiency important). Results of the questionnaire enabled the determination of mean response scores and the hierarchical ranking of questionnaire items. There was a high degree of correlation between the rankings of the three groups of respondents indicating agreement on knowledge and clinical skills in plastic surgery that are essential, as well as those nonessential, for the competent practice of medicine. PMID- 2762416 TI - Spreader-graft fixation. PMID- 2762415 TI - Soft-tissue undermining with lip repair: influence on facial growth. PMID- 2762417 TI - Polyurethane implants: reduction in capsular contracture or in capsule formation? PMID- 2762418 TI - The intraligamental dental syringe facilitates steroid injection into hypertrophic scars and keloids. PMID- 2762419 TI - Marcaine spray. PMID- 2762420 TI - Painless injections: "the magic dot". PMID- 2762421 TI - A simple method for nasotracheal intubation in patients with pharyngeal flaps. PMID- 2762422 TI - Submucous cleft palate. PMID- 2762423 TI - Fat embolism after dermolipectomy and liposuction. PMID- 2762425 TI - [Abnormal psychosocial development and legal responsibility--results of psychopathometric studies]. AB - The introduction (1968) of the legal concept of Grave Abnormal Development of the Personality Amounting to a Disorder into the penal code, made possible criminal deculpation on the basis of psychosocial maldevelopment. On the basis of an intelligence- and personality-diagnostic test-battery (Psychopathometry), the findings obtained in the examination of a sample of culprits on probation under this legal provision, has been compared with a control group homogeneous in respect of the significant parameters. Psychopathometric methods can and should reasonably supplement expertises of this culprits with defective psychosocial development. PMID- 2762424 TI - [Changes in the manifestation of guilt perception in endogenous depression in advanced age]. AB - The manifestation of endogenous depressions has clearly changed in the last decades. Ideas of guilt and sin have decreased or changed their contents, whereas feelings of insufficiency, physical complaints and hypochondriac ideas have clearly increased. The importance of the experience of guilt in the case of endogenous depressions and transcultural aspects of the guilt phenomenon are pointed out. By means of 301 case-histories of depressive patients at the involutional period the change in the manifestation of the depression within four periods of time is pointed out and its possible causal relationships are discussed. PMID- 2762426 TI - ['Commitment-adequate' personality diagnosis using the Seitz (revised) Personality Questionnaire for Prisoners within the scope of forensic-psychologic psychiatric expert assessment]. AB - In this contribution, the necessity and expediency, but also the limits of the application of psychodiagnostic methods within the scope of forensic psychological-psychiatric expertises are discussed. A survey is given on results of statistical analysis, revision and validation gained with a personality questionnaire relevant to prison situation (PFI acc. Seitz, 1983). PMID- 2762427 TI - [Legal aspects of traumatic cerebrovascular lesions]. AB - The paper opens with an account of what may be entailed in traumatic damage to cerebral vessels and cervical vessels, and its pathomechanism. There follows an account of two cases involving traumatic cerebral infarction and the resulting problems for the expert witness. Ascertainment of the relationship between external trauma and cerebral infarction depends on the nature and degree of the traumatic violence (precise trauma anamnesis), the reaction of the organism thereto, and the seriousness of previous complaints (arteriosclerosis, causes of cerebral embolism). PMID- 2762428 TI - [Causes and incidence of self-mutilation in severely mentally handicapped patients]. AB - Without regard to early childhood self-injurious behaviour is as a rule therapeutic difficulty to influence. Therefore analysis of the joint of causes is relevant for prevention. Among 87 hospitalized oligophrenic patients there were 10 with self injury, their sensibility for pain was considerably diminished at least. Early hospitalization resp. missing or very early deficit of maternal affection and of familiar contacts on the whole are considered to be a risk for later severe self injury. PMID- 2762429 TI - [Primary melanoblastoma as a cause of occlusive hydrocephalus]. AB - Primary melanoblastomas of the Central Nervous System are comparatively rare tumors. Lumpy or diffuse forms may occur either alone or in combination. On the basis of actual case histories, diffuse cerebral and medullary melanoblastoma is presented as a rare cause of occlusive hydrocephalus. PMID- 2762430 TI - [Behavior of heart rate following active change in posture with pharmacologic block of the autonomic nervous system]. PMID- 2762431 TI - Gender and schizophrenia: implications for understanding the heterogeneity of the illness. AB - This study begins to test the hypothesis that schizophrenic men and women may be at risk for experiencing different subtypes of the illness. Given past research, hypotheses predict that schizophrenic men will have an earlier age of onset, poorer premorbid history, lower family morbid risk, and poorer course. Data consist of 332 schizophrenic patients diagnosed according to DSM-III and 713 of their first-degree relatives from the double-blind Iowa 500 and non-500 family studies. Survival analysis was used to estimate age of onset, and Stromgren's abridged method for age correction was used to estimate family morbidity risks. Findings support our hypotheses and suggest that men may be at risk for experiencing a more severe form of schizophrenia. PMID- 2762432 TI - Circadian rhythms in depression and recovery: evidence for blunted amplitude as the main chronobiological abnormality. AB - Circadian rhythms of body temperature, plasma cortisol, norepinephrine (NE), thyroid stimulating hormone (TSH), and melatonin were compared in 16 endogenously depressed, 15 recovered (after 3 weeks of anti-depressant treatment), and 16 normal subjects. The depressed patients showed clear circadian rhythm abnormalities, consisting mainly in amplitude reduction. This amplitude reduction was significantly correlated with the patients' Hamilton depression scores. Normal circadian profiles were restored after recovery when amplitude, in particular, was increased. Features of the circadian rhythms observed in remission may be associated with antidepressant drug effects, whereas those observed in depression resemble the circadian rhythms observed in normal subjects living under conditions of temporal isolation and those of blind subjects. Our findings suggest that depression may be related both to a weakening of the coupling processes between internal pacemakers and to an abnormal sensitivity to environmental information. PMID- 2762433 TI - Thermoregulatory response to thermal challenge in seasonal affective disorder: a preliminary report. AB - It has recently been proposed that alterations in central dopamine (DA) functional activity may, in part, account for certain behavioral changes observed in seasonal affective disorder (SAD) during the winter. To explore this possibility, a preliminary study of thermoregulatory heat loss to an endogenous heat challenge--a strongly DA-dependent process--was undertaken in groups of four SAD woman and four nonpsychiatric control women across three conditions (winter, after successful phototherapy, and summer). Homeostatic heat loss during recovery from heat challenge in SAD, but not in control, subjects was found to be a significant function of light condition and of clinical state. Thermoregulatory heat loss in SAD subjects was significantly blunted in winter during depression, was similar in efficiency to control subjects after a successful antidepressant response to phototherapy, and tended to be more efficient than controls in summer during a euthymic state. Results raise the possibility that a common effect of phototherapy and summer light conditions is a facilitation of central DA activity in SAD. PMID- 2762434 TI - Diagnosing major depression in cocaine abusers: the use of depression rating scales. AB - This study compared the sensitivity and specificity of three rating scales in detecting major depression in 149 hospitalized cocaine abusers. Patients were administered the Beck Depression Inventory (BDI), the Hamilton Rating Scale for Depression, and the Symptom Checklist-90 at admission and at 2 weeks and 4 weeks of hospitalization. The admission BDI score offered the best combination of sensitivity and specificity. However, the low specificity of all the scales and the low prevalence rate of major depression in this population made the positive predictive power of the instruments weak. The results support some limited use of the BDI as an initial screening instrument in cocaine abusers. PMID- 2762435 TI - Endocrine response to syncope in panic disorder. PMID- 2762436 TI - Caution in locating the gene(s) for affective disorder. PMID- 2762437 TI - Biological psychiatry: is there any other kind? PMID- 2762438 TI - Quantitative computed tomographic study in schizophrenia: cerebral density and ventricle measures. AB - Twenty-seven chronic schizophrenics and nineteen controls, all male, were evaluated by computed tomography (CT) scans. Lateral, third and fourth ventricles and cerebral density numbers were measured. In the schizophrenic patients there was a significant increase in third ventricle width, Ventricular Brain Ratio (VBR) and there were significantly higher densities of white matter in the right frontal and parietal region. PMID- 2762439 TI - The relationship between smooth pursuit eye movement impairment and psychological measures of psychopathology. AB - Two hundred and eighty-four male college volunteers were screened for smooth pursuit eyetracking deficiencies, a commonly reported concomitant of schizophrenia. A sample of 36 subjects, weighted with poor eyetrackers, was brought into the National Institute of Mental Health laboratory and retested on electro-oculogram and infrared tracking procedures. They were also administered psychological tests which assessed nine dimensions relevant to schizophrenic, neuropsychological, and affective disorders. In the area of schizophrenia-like symptoms, measures of attention deficits, stimulation avoidance, and identity problems predicted poor eyetracking for the whole sample. Using the poor eyetracking subjects alone (N = 24), interpersonal withdrawal was also significantly related to poor performance but not stimulation avoidance. In the neuropsychological area, measures of attention control and perceptual-motor dysfunction for the total sample, and perceptual problems and general intellectual decrements for the poor eyetrackers were significantly related to poor performance. There was no relationship between measures of affective dysfunction and poor eyetracking. PMID- 2762440 TI - Experiences of alien control in schizophrenia reflect a disorder in the central monitoring of action. AB - Twenty-three acute psychotic patients who were drug free at the time of testing performed a motor task designed to elicit many errors. Normal subjects and many of the psychotic patients were able to correct these errors in the absence of visual feedback. The ability to make such corrections depends on the subject knowing what response he has just made. Patients with experiences of alien control of their thoughts and actions who formed a subgroup of those classified as schizophrenic, were significantly less likely to make error corrections in the absence of visual feedback. This result is consistent with our previous suggestion (Frith, 1987) that these symptoms are a consequence of problems with the central monitoring of responses. PMID- 2762441 TI - Gender differences in schizophrenia: rehospitalization and community survival. AB - This study tested the hypothesis that schizophrenic men experience a poorer course than schizophrenic women. A representative sample from Hannover, FRG, including 278 first admission DSM-III schizophrenics, were followed for three years. Findings demonstrated that schizophrenic women experience fewer rehospitalizations, shorter lengths of stay, and survive longer in the community than schizophrenic men. Implications of the role of gender for schizophrenia are discussed. PMID- 2762442 TI - Is sex necessarily a risk factor to depression? AB - To isolate and quantify possible determinants of any increased prevalence of depressive disorders in women we studied a select group of men and women, initially similar in terms of a number of putative social determinants of depression, and reviewed the sample five years later when social role diversity was anticipated. We used the Diagnostic Interview Schedule (DIS) to generate DSM III and RDC diagnoses to estimate lifetime depressive disorders, and established (via corroborative reports) the likely accuracy of those data. Despite lifetime depression being a relatively common experience, no significant sex differences in depressive episodes were demonstrated, suggesting the possible irrelevance of biological factors in determining any sex difference. As there was not major social role divergence over the five year study, we interpret the lack of a sex difference as a consequence, and suggest that findings support the view that social factors are of key relevance in determining any female preponderance in depression described in general population studies. PMID- 2762443 TI - Incidence and perception of psychosocial stress: the relationship with breast cancer. AB - This study explored the incidence and perception of psychosocial stress among 1596 patients attending breast screening clinics and 567 controls attending a well women clinic. It was found that some major life events (e.g. death of husband, death of close friend) were significantly related to breast disease and severity. The implications of the results are discussed. PMID- 2762444 TI - Priming and cued recall in elderly, alcohol intoxicated and sleep deprived subjects: a case of functionally similar memory deficits. AB - Young, old, alcohol intoxicated, and sleep deprived subjects studied weakly and strongly related word pairs, and were tested in lexical decision priming and cued recall. Results showed memory deficits for old, alcohol intoxicated, and sleep deprived subjects in cued recall of weakly related pairs. In contrast, there were no differences between these three groups and a control group of young subjects in cued recall of strongly related pairs, and there were no differences between groups in priming. This pattern of results is interpreted to support (a) a hypothesis of functional similarities between the memory deficits associated with adult ageing, alcohol intoxication, and sleep deprivation; (b) the notion that memory deficits in these subjects are more likely to occur in tasks which require effortful rather than automatic processes; and (c) the view that the memory deficits observed are due to inefficiencies at both encoding and retrieval. PMID- 2762445 TI - Factorial validity of the EE scales. AB - High 'expressed emotion' (EE) has been held to be predictive of a poor course in patients with schizophrenia, a finding that has emphasized the predictive validity of the EE measure. We review appropriate research examining properties of the EE measure to suggest that, in particular, little is known about the construct validity of the EE measure. We report a longitudinal study examining three measures of parental style (EE; Parental Bonding Instrument or PBI; and interviewer ratings). By comparing EE scale scores with ratings derived by an interviewer we find support for the accuracy of the process generating EE scale scores, and by factor analytic techniques we examine the factorial (construct) validity of the EE scales. A principal components analysis suggested two other dimensions of relevance in parents involved with a schizophrenic member (vigilance, and acceptance of illness in their child) which may be of value in predictive studies. We examined the capacity of interviewer-generated scores (as a simple clinical rating) and factor scores (as central constructs) to predict the course, and were unable to discriminate 'relapsers' and 'non-relapsers' with either predictor. PMID- 2762446 TI - Intelligence and musical improvisation. AB - We investigated whether somebody with a severe mental impairment could not only remember and reproduce music, but was also able to generate it. Musical improvisation requires the ability to recognize constraints and also demands inventiveness. Musical improvisations on a traditional, tonal and also on a whole tone scale composition were produced by a mentally handicapped and by a normal control musician. It was found that not only the control but also the handicapped subject could improvise appropriately within structural constraints, although with the tonal music the idiot-savant showed some stylistic latitude. It is concluded that cognitive processes such as musical input analysis, decision making, and output monitoring are independent of general intellectual status. PMID- 2762447 TI - A comparison of practices, attitudes and interactions in two established units for people with a psychiatric disability. AB - This study evaluates and compares aspects of residential care in a community hostel setting and a hospital setting for people with a psychiatric disability. The clients were assessed to establish their level of general functioning, the comparison indicating there was no significant difference between the two groups on the measure used. A previously published protocol was used as a method of comparing the units. The findings indicated that the hospital unit was more individually orientated both in practices and staff attitudes, and had staff who were more optimistic about clients' potential accomplishments. No differences were found between perceived involvement of staff in decision making, or staff resident interactions. These findings have implications for the 'Care in the Community' movement, as they indicate that the nature of a service is as important as its location. They suggest that the relocation of services to the community in itself will not automatically overcome some of the difficulties associated with institutional care. PMID- 2762448 TI - The General Health Questionnaire: a psychometric analysis using latent trait theory. AB - This study examines the Likert-style successive integer scoring of Goldberg's (1972, 1978) General Health Questionnaire (GHQ) with a psychometric model in which the thresholds between successive categories within each item can be estimated. The model is particularly appropriate because the scoring of the successive categories, which are not named in the same way across items, by successive integers has received substantial discussion in the literature. Results from 1967 teachers in Western Australia who completed the 30-item form of the GHQ show that the items conform reasonably well to the model at a general or macro-level of analysis. In particular, the original ordering of categories is supported. However, as expected, there are systematic differences between distances among threshold within items and systematic differences among thresholds between items. The differences between positively and negatively orientated items confirm a suggestion in the literature that these two classes of items form sufficiently different scales so that they could be treated as separate, though reasonably correlated, scales. PMID- 2762449 TI - Validity of the Japanese version of the GHQ among antenatal clinic attendants. AB - The validity of the Japanese version of the 30-item General Health Questionnaire (GHQ) was examined against the semi-structured interview-based Research Diagnostic Criteria (RDC) as external criteria. The GHQ total score discriminated 'cases' and 'non-cases' satisfactorily but its recommended cut-off point was higher (7/8) than that of the original English version (4/5). Discriminant function analysis revealed that only 13 items contributed to the discriminatory power and that their discriminant function score was better than a simple summation of the 30 GHQ item scores in terms of validity. PMID- 2762450 TI - Development of a new self-report questionnaire to measure self esteem. AB - In constructing a new self-report questionnaire for measuring self esteem, the aim has been to satisfy psychometric requirements without sacrificing the intuitive meaning of the concept. Self esteem is seen as a composite, and examination of its components may have more analytic or predictive value than 'global' scores. Preliminary reliability and validity data are encouraging. PMID- 2762451 TI - Agitation and touch in the nursing home. AB - The relationship between manifestations of agitated behaviors and interpersonal distance was examined in 24 nursing home residents with high agitation and severe cognitive impairment. Analysis indicated that agitated residents displayed divergent responses to touch: touch was related to an increase in aggressive behaviors and to a decrease in physically nonaggressive behaviors (e.g., strange movements). The positive relationship between aggressiveness and touching suggests that residents may interpret touching as a violation of their personal space. The finding that residents exhibited fewer strange movements when touched suggests that touching can act as a quieting and comforting form of communication. The implications of these findings for caregivers are discussed. PMID- 2762452 TI - Age and living conditions as related to perceptions of ambiguous figures. AB - For ambiguous figures, reversing and embedded/hidden subfigures, data were obtained from four groups of 20 subjects each varying in age (young or elderly) and living environments (in college, in the community, and in nursing homes or confined to an institution). 10 men and 10 women were tested in each of the four groups. Dependent measures were the number of reversals passively reported for the Necker cube, the Mach book, the Schroeder staircase within 90 sec. on each task, and the number of embedded/hidden figures located. Younger subjects generally saw more reversals and found more embedded figures than elderly ones. The subjects' living situation, education, and verbal ability also were correlated with perceptual performance. These results suggest generalization of age associations with scores in 90 sec. must be tempered by consideration of other factors which affect intactness, basic competence, and how competence is measured. PMID- 2762453 TI - An integrative model of supervisory training for medical center personnel. AB - The development of a comprehensive supervisory training program for V.A. Medical Center personnel is described. The program draws upon the literature of both organizational psychology and cognitive-behavior therapy and has four basic components: (a) needs assessment and evaluation, (b) awareness-building and cognitive restructuring, (c) skill training, and (d) application on the job. The training program consists of 16 modules developed on the basis of a preliminary needs assessment and literature review. An initial investigation of the model's efficacy indicated significant improvements in the supervisors' knowledge of sound supervisory practices as well as high levels of satisfaction and self reported productivity in a sample of supervisors who underwent training. Plans for outcome research and the continuing need for an integration of subdisciplines are discussed. PMID- 2762454 TI - Maslach Burnout Inventory: factor structures and norms for USA pharmacists. AB - This study was conducted to establish normative data as well as evaluate the construct validity and reliability of the three subscales of the Maslach Burnout Inventory when given to a national sample of USA licensed practicing pharmacists. Data were subjected to principal factors analysis with iteration and a varimax rotation to obtain a three-factor solution. Visual analysis and statistical comparison provided empirical support for the presence of the hypothesized (a priori) constructs of Emotional Exhaustion, Depersonalization, and Lack of Personal Accomplishment. Internal consistency of the derived subscales, as measured by Cronbach's alpha coefficient, were comparable with previous data. Pharmacists' subscale scores were significantly lower than those obtained in studies of the helping professions. PMID- 2762455 TI - Norms for free associations and five types of constrained associations. AB - Normative data on verbal free associations and constrained associations of five types (opposites, superordinates, examples of categories, coordinates, and properties) were collected from 72 men and 72 women (mean age, 19.2 yr.). A list of the different responses given by subjects for each of 360 stimuli and the frequency of each response is available. PMID- 2762456 TI - The Geriatric Depression Scale: discriminant validity and elderly day-treatment clients. PMID- 2762457 TI - Personality priorities of adolescents: some Caribbean findings. AB - The Personality Priorities Inventory for Adolescents was administered to a sample of 194 Caribbean adolescent students (80 boys and 114 girls) to measure their personality priorities. The subjects had a mean age of 15.6 yr. and were randomly selected from the Grade 10 population of high schools in Barbados. The rank order which emerged from the analysis indicated preference for Pleasing behaviors followed in order by Significance, Avoiding, and Detaching. Comparison between the sexes showed girls as being more inclined toward Pleasing, Significance, and Avoiding than boys. PMID- 2762458 TI - Relations of spanking and other parenting characteristics to self-esteem and perceived fairness of parental discipline. AB - Punishment has long been a controversial topic in psychology, perhaps partly because its effects are different under different circumstances. This study used retrospective reports from college students to examine the effects of spanking, a common aversive punishment, on self-esteem and perceived fairness of parental discipline, while taking the effects of other parental characteristics into account. No parental characteristic interacted with the slightly negative effect of spanking on self-esteem and fairness. However, controlling for positive communication or for a parent-oriented motivation for spanking eliminated the negative effects of spanking, suggesting that the negative effects reflected use of spanking as a replacement for positive communication with the child. PMID- 2762459 TI - MMPI correlates of college women who reported experiencing child/adult sexual contact with father, stepfather, or with other persons. AB - MMPI responses were obtained from three groups of college women (n = 171): those reporting child/adult sexual contact with father/stepfather, with other persons, and a control group reporting no such experience. A comparison of group mean MMPI validity and clinical scales showed the father/stepfather group to have several subscales elevated to clinically significant levels. None of the subscales for the other two groups were so elevated. PMID- 2762460 TI - Eating motivations and bulimic behavior among college women. AB - Given observed correlations between certain types of motivations for alcohol use and problem-drinking outcomes, it was hypothesized that a similar pattern of eating motivations might predict bulimic eating behavior. For a sample of 161 college women, eating motivations which imply stress reduction or mood alteration correlated positively with bulimia as measured by the Bulimia Test. PMID- 2762461 TI - Effect of homosexuality upon public health and social order. AB - Are homosexuals "not dangers to society" and is homosexuality "compatible with full health"? To answer these questions 4,340 adult respondents drawn via area probability sampling from 5 metropolitan areas of the USA self-administered an extensive sexuality/public order questionnaire of over 500 items. Bisexuals and homosexuals (about 4% of the sample) as compared to heterosexuals: (1) more frequently exposed themselves to biological hazards (e.g., sadomasochism, fisting, bestiality, ingestion of feces); (2) exposed themselves sexually to more different bodies (e.g., more frequently admitted to participating in orgies, reported considerably larger numbers of sexual partners); (3) more frequently reported participating in socially disruptive sex (e.g., deliberate infection of others, cheating in marriage, making obscene phone calls); and (4) more frequently reported engaging in socially disruptive activities (e.g., criminality, shoplifting, tax cheating). From the standpoints of individual health, public health and social order, participating in homosexual activity could be viewed as dangerous to society and incompatible with full health. PMID- 2762463 TI - Effects of race on interrater reliability of peer ratings. AB - The effect of race on interrater reliability of peer ratings was investigated using data collected on 1,219 U.S. Army ROTC cadets at summer camp. White raters rating white ratees had a higher interrater reliability than black raters rating black ratees. Implications of this study are discussed. PMID- 2762462 TI - Birth seasonality in developmentally disabled children. AB - 26 children with diagnoses of autism and 22 children with diagnoses of childhood schizophrenia or a variant thereof were compared on the variable of winter birth. Analyses showed that autistic children had a higher proportion of winter births than schizophrenic children. These findings are related to other research linking winter birth to negative-syndrome adult schizophrenia. PMID- 2762464 TI - Some determinants of fear about AIDS among Australian college students. AB - An 18-item questionnaire assessing attitudes toward AIDS and homosexuality was administered to 420 Australian tertiary students. The predictive power of attitudes toward homosexuality, empathy toward AIDS sufferers, knowledge about AIDS, church attendance, age, and sex was tested using independent and stepwise multiple-regression analyses. In the stepwise analysis attitudes toward homosexuality and empathy toward AIDS sufferers were the major contributors to fear about AIDS. Church attendance and age improved the over-all prediction significantly, but only slightly. In the independent analysis all variables, except church attendance, were significant predictors. Educational programmes on AIDS should address the relationship between homosexuality and fear of AIDS. PMID- 2762465 TI - Smoking and narcotics use among chronic pain patients. AB - Among 137 noncancer patients having pain for more than 6 mo. and being within 30 to 69 yr. of age, narcotics users were evenly distributed but tobacco smokers were significantly more likely than nonsmokers to use narcotics. PMID- 2762466 TI - Risk-taking, responsibility for health, and attitude toward avoiding AIDS. AB - A telephone survey was completed with 400 adults to explore a possible relation between health risk-taking and perceived personal responsibility for health. The attitude that AIDS could be avoided by being careful was weakly associated with responses to questions about wearing seat belts and smoking. The pattern held only among those who thought their health was good for people their age. After reviewing related literature, it appears that poor health status and dogmatism may contribute to denial of risk and to risky sexual behavior. Themes for public health educational campaigns are suggested. PMID- 2762467 TI - Discrimination against AIDS victims. AB - Samples were taken from "Middletown" in 1985, 1986, and 1987 to assess tendencies to discriminate against AIDS victims and what factors were related to this tendency. A tendency to discriminate against AIDS victims has decreased significantly from 1985 to 1987, and those who are most likely to discriminate were members of the Christian Right and who have more of an individual than a community orientation. PMID- 2762468 TI - Attention checklist: a rating scale for mildly mentally handicapped adolescents. AB - A check list for attentional deficits without reference to hyperactive behavior observed in the classroom was constructed, and teachers' ratings were factor analyzed. The check-list rating was compared to a widely used rating scale for attention deficit-hyperactive disorder (AD-HD), the Abbreviated Conners Rating Scale. Both scales were given to 15 teachers to rate 100 mildly mentally handicapped adolescent students. Analysis showed that 33% of the mentally handicapped students were rated above 1.5 on the Conners Scale, which is the cut off for hyperactivity. This is much higher than the prevalence of hyperactivity in regular classrooms. The two sets of ratings correlated strongly (.84). Check list items were grouped under one factor explaining 70.7% of variance and so are recommended for use in discriminating attentional deficit in mentally handicapped as well as in regular class students. The high correlation with ratings on the Conners Scale suggests that AD-HD is a unitary syndrome with attention being most problematic for children labeled hyperactive. PMID- 2762469 TI - Psychology of computer use: X. Effect of learning Logo on children's problem solving skills. AB - A natural experiment was used to determine whether learning the computer language Logo improves children's problem-solving strategies outside of the Logo context. 8-yr.-olds who learned Logo in school were found to use both debugging techniques and procedurality in their computer programming. They and a group of control children of the same age were pre- and posttested on a game requiring debugging skills (Mastermind) and another game requiring procedural skills (Tower of Hanoi). Boys, but not girls, trained in Logo showed an improvement in debugging skills relative to the control children. Improvement in procedural skills was not related to training in Logo. The results were discussed in terms of distance of transfer, degree of expertise, and the basis of sex differences in computer programming. PMID- 2762470 TI - Effects of AIDS on homosexual attitudes and behavior. PMID- 2762471 TI - Psychological coping and the management of pain with cognitive restructuring and biofeedback: a case study and variation of cognitive experiential therapy. AB - Pain is generally recognized as being influenced by multiple psychological factors. Cognitive experiential therapy may use cognitive restructuring with imagery and hypnosis. The restructuring of negative cognitive, affective, behavioral, and physiological states occurs through six stages. This case study illustrates the use of cognitive restructuring and biofeedback with a woman hospitalized for depression and a chronic pain syndrome consisting of tension headache pain. Measures of headache pain (frequency, intensity), skin temperature, and assessment with the Millon Behavioral Health Inventory consisting of broad categories and scales were taken at pretest, posttest and follow-up. The biofeedback treatment alone showed some physiological improvement. Cognitive restructuring and biofeedback resulted in improvements on the Millon, and reduction of headache symptoms at the posttest. Gains on the Millon broad categories of personality coping styles and psychosomatic correlates were maintained at follow-up and chronic headache pain was not reported. Self-report headache frequency and intensity decreased over time with the cognitive restructuring and biofeedback approach. PMID- 2762472 TI - Religious compulsions and the spectrum concept of psychopathology. AB - The authors present a clinical description of obsessive-compulsive disorder (OCD) among a unique population of patients with religious compulsions. Analysis of 2 cases demonstrates that OCD represents a psychopathological spectrum, varying along a continuum of insight and resistance. Associated clinical features together with diagnostic and treatment implications are considered. PMID- 2762473 TI - Nosology and etiology of a spirit disorder (vimbuza) in Malawi. AB - In this study the traditional and transitional nosology and etiology of the spirit disorder vimbuza was investigated by interviewing patients (n = 116) who were suffering from that condition. The illness concept was compared with western psychiatric classifications. As a result, 23 symptom descriptions were identified, 13 can be referred to as conversion or dissociation disorder and 7 to depressive neurosis. The remaining 3 symptom descriptions refer to an acute delusional or confusional state. Comparing the traditional and transitional symptom descriptions on the head and heart, a shift from the heart to the head becomes evident in the transitional or urban Malawian. The transitional etiology is the same as the traditional etiology, only that the transitional person more often refers to 'Too much thinking' and 'natural' than to 'bad ancestral spirits' and 'witchcraft'. PMID- 2762474 TI - Quality of affective symptomatology and its importance for the definition of schizoaffective disorders. AB - 169 patients with schizophrenic symptomatology at least once and a mean follow-up period of 20 years were divided in three groups regarding the presence and type of accompanying affective symptomatology. The groups were compared regarding sociodemographic and other premorbid features and long-term outcome. The results show that not every depressive or euphoric symptom but only melancholic or manic symptomatology qualifies the schizophrenic syndrome as schizoaffective. PMID- 2762475 TI - Availability of treatment and diagnostic labelling. AB - A sample of pre-1967 case records with a hospital diagnosis of schizoaffective disorder were presented for rediagnosis to members of the present staff of the Institute of Psychiatry/Maudsley Hospital. The raters were asked to make a diagnostic choice of either schizophrenia or schizoaffective disorder or affective disorder and indicate how useful they would consider certain treatments for the present episode and for the long term. There was a significant trend in diagnosis to affective disorder but this trend was not correlated with the usefulness of certain treatments, e.g. lithium, a drug which had not been in use before 1967. PMID- 2762476 TI - The Brief Psychiatric Rating Scale. Dimension of schizophrenia--reliability and construct validity. AB - This study has focussed on a 10-item Brief Psychiatric Rating Scale (BPRS) subscale for the quantification of schizophrenic states. Seven psychiatrists interviewed jointly patients who all fulfilled the DSM-III criteria of schizophrenia, and in a subsequent pencil-and-paper procedure a judgment analysis was performed. The reliability analysis showed that less experienced BPRS raters made less consistent judgments implying the cautionary statement that the proper use of a scale for schizophrenia requires specialized training with the scale. The validity analysis showed that the BPRS items had an additive relationship implying that the sum of these items is a sufficient statistic for the measurement of severity of schizophrenic states. Finally, the results seem to indicate, that the underlying dimension defined by the 10-items BPRS subscale includes hierarchically the negative and positive symptoms of schizophrenia. PMID- 2762477 TI - [Causal attributions and coping with illness in patients with breast cancer]. AB - The aim of the present study was to investigate whether breast cancer patients who attribute their disease to different causes differ in their ability to cope with the disease. A semistructured interview technique was used to question a total of 107 patients, six months after the operation, about the psychological stress involved in their disease and how they coped with it. In addition, two further questionnaires were used: the Freiburg questionnaire concerning adjustment to the disease (FKV) and another questionnaire to register the causes to which the patients attributed their disease (PUK). The results revealed that environmental pollution was the most frequent and important cause of disease mentioned by the patients. This mainly correlated with depressive adjustment to the disease. The same type of adjustment was also frequently seen in patients who attributed their disease to individual psychic problems. Daily stress mentioned as the cause of disease was additionally closely connected with the desire for social support. In accordance with the poor adjustment in connection with internal causes reported in the literature, it was further shown that attribution to psychic causes made psychic adjustment to the disease more difficult, at least within the first six months after the operation. PMID- 2762479 TI - [Satisfaction with inpatient management. Development of a questionnaire and initial validity studies]. AB - In Germany methodologically reliable procedures to assess patients satisfaction with inpatient health care are almost totally missing. With reference to the well known American CSQ-Questionnaire (Attkisson et al.) a 17-items questionnaire (to assess satisfaction) was developed and presented to a sample of 300 patients undergoing inpatient treatment within a psychosomatic clinic (the rate of responding was about 80%). With a concise form of the questionnaire (Zuf-8, 8 items) an economical and reliable test-instrument is presented in this paper to measure general satisfaction, which also was investigated in regard to item- and factor analysis. This method seems suitable for measuring patient satisfaction with inpatient psychosomatic treatment. The investigated scales of satisfaction show a statistically significant correlation with additionally obtained patient characteristics. This inquiry also suggests that it might be rewarding to pursue the often neglected phenomenon of questionnaires filled out incomplete as an indicator of latent dissatisfaction. PMID- 2762478 TI - [Coping with disease from the psychosomatic-psychotherapeutic viewpoint exemplified by pancreatectomized patients]. AB - In the past few years psychosomatic medicine, apart from investigating the psychosocial sources of bodily disorders, has begun to focus also on the opposite side of the problem, the question of how people experience illness and cope with it. This "somatopsychic" view can be regarded as a supplement to the so far prevailing psychosomatic perspective and its approach. The present study describes and analyzes various strategies of coping with illness as observed in a group of pancreatectomized patients, a group of patients which has not been investigated before in this field of research. Based upon the experience of long term psychotherapeutic care, the study differentiates between the more problematic and the more beneficial forms of coping, and empirically verifies their prevalence and adaptivity in a sample of pancreatectomized patients, not selected with regard to the extent of care needed. The findings are discussed from the methodological and the psychosomatic-psychotherapeutic point of view. PMID- 2762480 TI - [Experimental study of forehead temperature in autogenic training]. AB - Thermometry of the forehead and cheeks was done in 35 longtime trainees of Autogenic Training (AT). Results revealed a significant increase in forehead skin temperature rather than the hypothesized decrease. Cheek temperature rose significantly more than forehead temperature. This difference between cheek and forehead temperatures could explain the subjective impression of coolness of the forehead during the sixth standard exercise of Autogenic Training. PMID- 2762481 TI - [A systems theory approach to the solution of the Bieri trilemma]. AB - Psychosomatic theories reach at the question about the mind-body problem some difficulties, which are resumed in the trilemma of Bieri. We propose a solution of the implicated contradictions with a systemic approach. PMID- 2762482 TI - DSM-IV issues for consultation psychiatry. PMID- 2762483 TI - Screening for Axis II personality disorders in women with bulimic eating disorders. AB - The Personality Diagnostic Questionnaire (PDQ) was completed by 628 eating disordered women: 300 with normal-weight bulimia, 15 with anorexia nervosa with bulimic features, and 313 with subdiagnostic eating disorders. Three-quarters (75%) of subjects with normal-weight bulimia had personality disorder diagnoses, compared with 50% of those with subdiagnostic eating disorders. The average number of separate PDQ diagnoses was 2.7 for the normal-weight bulimia group, 2.5 for the group with anorexia nervosa with bulimic traits, and 1.5 for the subdiagnostic group. The most common PDQ diagnoses were schizotypal, histrionic, and borderline disorders, but avoidant and dependent personality features also occurred. Personality disturbances may be common in patients with eating disorders. PMID- 2762484 TI - Psychological correlates of two measures of coronary-prone hostility. AB - The psychological correlates of the Cook and Medley Hostility (Ho) Scale and independent behavioral ratings of hostility were compared in a sample of adult, middle-aged male participants from the National Heart, Lung and Blood Institute Twin Study. Although the Ho Scale and behavioral ratings of hostility purport to measure the same construct, the underlying correlational pattern for each was quite different. Scores on the Ho Scale were associated positively with anxiety, neuroticism, and the tendency to "fake good"; behavioral hostility was related to measures of dominance, vigor, and self-confidence. Some correlates, such as the hard-driving and speed and impatience subscales from the Jenkins Activity Survey, represent a core set of correlates common to both. The meaning of hostility must be clarified before this construct's link to coronary heart disease can be defined. PMID- 2762485 TI - Microstress, mood, and natural killer-cell activity. AB - The interactions between transient minor negative and positive life events ("microstressors"), concurrent mood states, and immunological functioning were assessed by measuring levels of natural killer-cell activity (NKA), stress, and mood weekly for four weeks. No association was found between the frequency of either positive or negative microstressors and NKA, nor between concurrent mood ratings and NKA. Some individuals showed a marked and unexplained variability in NKA on a week-to-week basis. These results do not support the hypothesis that the minor stresses of everyday living affect immune function. The study does suggest that single cross-sectional determinations of NKA may not be suitable for studies of psychosocial factors and NKA. PMID- 2762486 TI - Depression in hemodialysis patients. AB - Psychiatric evaluation of depression in medically ill patients using DSM-III-R or Research Diagnostic Criteria (RDC) is difficult because these diagnostic systems have not been validated for this population. Diagnosis of depression has been especially problematic in patients with end-stage renal disease (ESRD). This study found a 17.7% prevalence of RDC-defined minor depression and a 6.5% prevalence of major depression in 124 ESRD patients treated with hemodialysis. Vegetative symptoms of depression were less useful for discriminating between those with and without depression than were the psychological symptoms of suicidal ideation, depressed mood, and discouragement. PMID- 2762487 TI - Validity of the 28-item General Health Questionnaire in hospitalized gastroenterology patients. AB - The usefulness of the 28-item General Health Questionnaire (GHQ) in detecting psychiatric comorbidity in a sample of hospitalized gastroenterology patients was tested. Validity coefficients were determined by comparing the results of the GHQ with findings from a psychiatric interview. At the best discriminating score (8/9), the GHQ yielded a sensitivity of 77%, a specificity of 75%, a positive predictive value of 67%, and a misclassification rate of 24%. The GHQ did not accurately identify alcohol dependence and abuse and did not discriminate between patients with anxiety disorders and those with depressive disorders. Despite its limitations, the GHQ, if supplemented with specific questions about alcohol abuse, can effectively screen medical inpatients for psychiatric disorders. PMID- 2762488 TI - Characteristics of patients referred to psychiatrists for competency evaluations. AB - Requests for inpatient psychiatric consultations at a general hospital over a three-year period were reviewed. Of 2,423 referrals, 79 (3.3%) were specifically for evaluation of competency, and 78.5% of those cases resulted in a diagnosis of an organic mental disorder. The proportion of referrals with organic mental disorder was significantly greater than it was in a control population of patients referred for consultation for any reason. Patients with organic mental disorder who were referred for competency evaluation had greater cognitive impairment than did control subjects. PMID- 2762489 TI - Hidden grief reactions on a psychiatric consultation service. AB - Assessment of the family and social relationships of 123 medical and surgical patients consecutively referred to the psychiatric consultation-liaison service revealed that acute or unresolved grief was present in 15% of patients. Patients with unresolved grief often presented with depression and/or conflict with the medical or nursing staff. The referring physician in most cases recognized the presence of acute grief; however, all cases of unresolved grief presented as "hidden" grief reactions. Patients with acute grief rarely had associated psychiatric illness, whereas all patients with unresolved grief had concurrent psychiatric disorders. The management of acute and unresolved grief in hospitalized medical or surgical patients is discussed, and illustrative cases are presented. PMID- 2762491 TI - Treatment in combined medical psychiatry units: an integrative model. AB - Approximately 14 medical psychiatry units have opened over the last 15 years due to the recognition of the frequent concurrence of medical and psychiatric illnesses. This article discusses the clinical problems encountered when medical care and psychiatric care are integrated and their impact on medical and nursing staff. Group therapy programs on medical psychiatry units may enhance psychiatric treatment and help maintain a psychiatric focus by both patients and staff, despite the patients' significant medical problems. Medical psychiatric units must adopt an integrative model of care that includes all disciplines involved on the units if they are to meet their goal of providing effective medical and psychiatric care. PMID- 2762490 TI - Typical patterns in atypical anorexia nervosa. AB - Only a few published accounts describe atypical anorexia nervosa. To provide more information about this eating-disorder subtype, 15 patients (12 females, 3 males) with atypical anorexia nervosa were studied. In general, the 12 female patients were characterized by 1) older age at onset and presentation, 2) recurring bouts of depression, 3) numerous somatic complaints, 4) unmet dependency needs, and 5) little evidence of distortion in body image. The three male patients were characterized by a younger age at onset compared to the females, and in many ways they resembled young female anorexics or bulimic anorexics. PMID- 2762492 TI - Thoughts on patient care and the Emperor's New Clothes. PMID- 2762493 TI - Factitious AIDS. PMID- 2762495 TI - A new anchor system for the fixation of partial or complete dentures. PMID- 2762494 TI - Registered nurse staffing in nursing homes? PMID- 2762496 TI - A new inclusion denture marking system. PMID- 2762497 TI - Histologic investigation of tissue reactions in anterior and lateral alveolar ridges of the mandible induced by complete dentures. PMID- 2762498 TI - Predictability of cavitation based upon radiographic appearance: comparison of two film types. PMID- 2762499 TI - The importance of phase I therapy in the treatment of periodontal disease: a case report. PMID- 2762500 TI - Prevalence of interproximal bone loss in a dental school population in Saudi children and young adults. PMID- 2762501 TI - The effect of three filling techniques on marginal leakage around Class II composite resin restorations in vitro. PMID- 2762502 TI - Curing acrylic resin in a domestic pressure cooker: a study of residual monomer content. PMID- 2762503 TI - Correlation between film position, bite-wing shadows, clinical pitfalls, and the histologic size of approximal lesions. PMID- 2762504 TI - A clinical observation on extensive periapical lesions of posterior teeth and their treatment with resinifying therapy. PMID- 2762505 TI - Paresthesia of the inferior alveolar nerve caused by periapical pathology: a case report. PMID- 2762507 TI - Nightguard vital bleaching. PMID- 2762506 TI - Dentistry in the 21st century. PMID- 2762508 TI - The role of enamel pearls in localized severe periodontitis. PMID- 2762509 TI - Surface roughness evaluation of composite resin polishing techniques. PMID- 2762510 TI - Analysis of stresses and breaking loads for Class I cavity preparations in mandibular first molars. PMID- 2762512 TI - Interproximal tooth morphology and its effect on plaque removal. PMID- 2762511 TI - The effect of an air-polishing device on tensile bond strength of a dental sealant. PMID- 2762513 TI - Time as a factor in the heat curing of composite resins. PMID- 2762514 TI - Changes in dentists' attitudes and behavior concerning infection control practices. PMID- 2762515 TI - Pulp curettage--surgical technique. PMID- 2762516 TI - A multidisciplinary approach for optimal total patient care: a case report. PMID- 2762517 TI - Notation of numerical abnormalities by an addition to the FDI system. PMID- 2762518 TI - [A systems model of the reproductive death of mammalian cells. A comparison with experimental data and the biological meaning of the parameters of the model]. PMID- 2762519 TI - [Differential radiation susceptibility of endogenous precursor cells forming "early" and "late" hematopoietic foci in the spleen of mice]. AB - No colonies were found in the spleen at "early" times (7-8 days) after irradiation of mice with doses of 8-9 Gy, while at "later" times (after 15 days) a confluent growth of the colonies was observed. The endogenous splenic foci of haemopoiesis of the "late" type were characterized by the preferable growth of granulocytic colonies. PMID- 2762520 TI - [Radiation stimulation of the production of thymocyte growth factor and its possible role in thymus recovery]. AB - Cells of two lines originating from intrathymic precursors of mouse T-lymphocytes produce an autocrine growth factor. The factor production during a certain period of the development of lines is drastically increased by radiation. The stimulatory effect of radiation cannot be explained by the release of the factor due to cell death. The administration of cultural supernatants, containing thymocyte growth factor, to the exposed mice favours the recovery of the thymus at early times following irradiation and influences the thymocyte response to the effect of growth factors. PMID- 2762521 TI - [Effect of myelopeptides on the postradiation recovery of the thymus]. AB - The influence of myelopeptides on the postirradiation recovery of thymus was studied by estimating the thymus cellularity, proliferation of thymocytes in vivo, and composition of thymocyte subpopulations characterized by the expression of Thy-1,2 and Sc-1 antigens and receptors for peanut agglutinin. A single intraperitoneal administration of myelopeptide (the optimal dose of 10(-5) mg/mouse) 24 h following 6.5 Gy irradiation gives rise to proliferative and differentiation processes favoring the recovery of thymus. PMID- 2762522 TI - [Patterns in the combined action of irradiation and glucose loading on tumor cells]. AB - It was shown that incubation of Ehrlich ascites tumor cells with glucose or in buffer solutions of low pH decreases their viability. The cell survival rate depends on pH values irrespective of the protoxidation method and oxygenation conditions used. At the same time, radiosensitivity of Ehrlich ascites tumor cells is practically invariable with pH being decreased from 7.0 to 5.0. The effects of glucose and radiation are additive in conditions simulating the effect of hyperglycaemia in vivo. PMID- 2762523 TI - [Effect of polyamines on the cellular radiation reaction]. AB - The influence of polyamines (e.g. putrescine, spermine and spermidine) on the survival rate of HeLa cells and the mitotic index of A. cepa meristem cells, as well as a change in a radiation response of cells under the effect of polyamines have been investigated. Putrescine was shown to produce the lowest cytotoxic effect on mammalian cells, whereas the cytotoxic effect on plant cells was either insignificant or absent at all. One-hour incubation of HeLa cells with putrescine of 5 x 10(-4)-5 x 10(-5) M prior to or after irradiation with a dose of 6 Gy increased the survived cell fraction. Spermine of 10(-3) M increased considerably the mitotic index of the exposed meristem as compared to irradiated meristem untreated with spermine. The role of polyamines in the formation of radiation damage to a cell is discussed. PMID- 2762524 TI - [Characteristics of the metabolism and gonadal action in mice of tritium-labelled deoxycytidine]. AB - The levels of 3H-deoxycytidine binding in mice and rats were shown to depend on the amount of the carrier and the routes of administration, and the dynamics of its retention, on the dose and schedule of its administration. As estimated by the criterion of the testis mass decrease the 3H-deoxycytidine dose of 37 kBq/g is equivalent to gamma-radiation dose of 0.06 Gy. The coefficient of 3H deoxycytidine absorption from the digestive tract of mice and rats is 2-10 times as high as that of 3H-thymidine, while both compounds administered to rats transcutaneously have the same absorption coefficients amounting to 0.02. PMID- 2762525 TI - [Ornithine decarboxylase activity in rat tissues in the late periods after irradiation]. AB - Ornithine decarboxylase activity in some rat tissues was shown to grow at remote times after gamma irradiation (60Co) with nonlethal doses. The authors suggest that ornithine decarboxylase activity should be used as a biochemical marker of remote effects of ionizing radiation. PMID- 2762526 TI - [Antiradiation effectiveness of amino acid mixtures of various compositions]. AB - Radioprotective efficacy of differently composed amino acid mixtures (e. g. swine brain hydrolyzate, mixtures of several crystalline amino acids, etc.) was estimated. The survival rate and average life of exposed animals increased after the administration of amino acid preparations. The most pronounced effect was produced by the mixtures composed of several crystalline amino acids. PMID- 2762527 TI - [The antiradiation effect of the cytostatic ribamidil and the possible mechanisms of its action]. AB - Ribamidil has a cytostatic effect on bone marrow cells and a radioprotective therapeutic action. Ribamidil favors CFUs proliferation and does not interfere with the process of CFUs migration. PMID- 2762529 TI - [The dosage thresholds for disordered physical work capacity in mice and rats following irradiation]. AB - Physical efficiency of mice and rats at early times following irradiation with doses of 35 to 200 Gy was estimated by the muscle endurance and motor coordination indices. A threshold nature of the effects was exhibited at high doses. For instance, as large as 40 Gy was the dose threshold at which stability in the accomplishment of the known operations was impaired; at 70-100 Gy, the accomplishment decreased down to 50% of the initial level, by the 2nd hour after irradiation, with the subsequent partial restoration; 200 Gy was the threshold dose at which the disturbances were irreversible. These values were also similar to those of the threshold doses at which clinical picture of the affection was changed. PMID- 2762528 TI - [A multifactorial study on the relative postradiation changes in various categories of behavioral reactions in rats]. AB - The use of the methods of multifactor, orthogonal and composition planning in studying the behavioural disturbances in rats after gamma irradiation with doses of 0.258 to 1.29 C/kg and the application of the proposed method of discrimination of effects by empirical models permitted to establish the informative and adequate dependences of the probability of these disturbances on dose of nonuniform irradiation and the degree of strengthening of the conditioned reflex. It was shown that the effect of radiation decreased, in a discrete manner, the probability of making the first decision by rats in a behavioural task (here we deal with the "dose-response" function). The average time of making the first decision after irradiation was invariable within the dose range under study. Within the range of the studied factors both the value of the dose of whole-body irradiation and the degree of strengthening of the conditioned reflex significantly affected the probability of fulfilling the task by the animals the significance of the radiation dose being several times higher. The effects of the interaction of the two factors, that is, irradiation and the degree of the radiation affection, were insignificant in changing the behavioural reactions under study. PMID- 2762530 TI - [The rate of repair of a radiation lesion of the central nervous system during protracted and fractionated irradiation]. AB - In experiments with fractionated and prolonged irradiation of guinea pigs and dogs it was shown that the recovery of CNS from acute radiation affection may be approximated, for different animal species, by an exponential function at a rate of 0.02 h-1 and a half-life period of approximately 30 h. PMID- 2762531 TI - [The phasic structure of early disorders of functional capacity following irradiation in rats]. AB - In experiments with rats it was shown that an early decrease in physical efficiency after irradiation involves some partially mutually superimposed phases. Phases of excitation, hypokinesia and neurological disorders are identified in early transient inefficiency followed by phases of an early transient diminution of efficiency and a reversible disturbance of the accomplishment of the known operations. Simultaneously, there is a phase of an irreversible decrease of the informational capacity of CNS as well as the tolerance to early transient in efficiency upon repeated exposure. PMID- 2762532 TI - [Distribution of the relative biological effectiveness of fast neutrons according to the depth of the irradiated tissue]. AB - A study was made of the dependence of relative biological effectiveness (RBE) and isoeffective dose of fast neutrons (produced by U-120 cyclotron) upon the depth of the exposed tissue. It was shown that the isoeffective dose and RBE vary significantly with the depth of the tissue-equivalent medium. The investigations were carried out with the purpose of improving the radiobiological and dosimetric techniques for the treatment of malignant tumors using a neutron beam from U-120 cyclotron. PMID- 2762533 TI - [Stimulation of the postradiation recovery of hematopoiesis in irradiated animals using a calf splenic extract]. AB - The injection of a purified cytoplasmic supernatant from calf splenocytes to lethally irradiated mice and hamsters favors the recovery of haemopoiesis and increases the survival rate. Proteins of 50--75 kDa molecular mass, having no specific features but being highly labile, are responsible for the radiobiological effect. The enzymic characteristics of the purified extract permit to suggest that the inhibitors of DNAase I and Ca2+, Mg2+-endonucleases are involved in the postirradiation transformations in the exposed animals. PMID- 2762534 TI - [Dose-effect correlations in a stochastic function of cell reactivity]. AB - A random reactivity function involving a correlation between "refusal" probabilities in cells irradiated with various doses was estimated. The dose effect curves were obtained for this reactivity function and their behaviour in the simplest correlation functions was analyzed. PMID- 2762535 TI - [The effect of a low dose of ionizing radiation and of gangliosides on the adenylate cyclase activity of the chicken thymus and thyroid in ontogeny]. AB - Adenylate cyclase (AC) activity was studied in thymus and thyroid gland of intact chick embryos and those irradiated with a dose of 0.029 Gy prior to incubation, and newly hatched chicks in the presence of total ganglioside fractions extracted from the same organs. Gangliosides were shown to increase the enzyme activity of thymocytes and thyrocytes during the postnatal development. It is suggested that small radiation doses potentiate the stimulatory effect of ganglioside fractions on AC. PMID- 2762536 TI - [Morphologic study of tissue basophils of the skin in rats after acute local irradiation]. AB - A comparative morphological study was made of tissue basophils (TB) of rat skin at remote times (40, 70, 140, and 360 days) following single local exposure to soft and hard X-radiation with the doses at the skin surface of 15, 20, and 30 Gy. The TB response was maximum in the subepidermal and supramuscular layers of friable connective tissue. Changes in a median TB diameter were of a phase nature and a function of radiation dose absorbed in the skin layers under study. PMID- 2762537 TI - [The early and late effects of a radiation lesion by 14C(14C-stearic acid)]. AB - In experiments with mice a study was made of the biological effect of radiocarbon (14C-stearic acid) injected intraperitoneally in doses of 2.2, 1.2 and 0.5 MBq/g. The doses absorbed within the body made up an average of 13.4 and 1.7 Gy respectively. The animals of the 1st group exhibited a severe degree of radiation affection and those of the 2nd and 3d groups median and mild degrees. Metabolism peculiarities and formation of absorbed 14C doses, as well as early and remote effects of radiation were investigated. PMID- 2762538 TI - Integrating values education into an allied health curriculum. Part I. AB - Values education involves the explicit attempt to teach individuals about values and the process of valuing. An overview of popular approaches to values education includes inculcation, value clarification, moral development, and value analysis. Each approach will be presented by detailing the purpose, teaching methods, and an instructional model. Methods of incorporating these approaches into an allied health curriculum are offered along with sample student learning activities. PMID- 2762539 TI - Practical CT dosimetry. AB - The dose from computed tomography (CT) examinations is not negligible from a radiation safety standpoint. Occasionally, one encounters a case in which an unsuspected pregnant woman undergoes a CT pelvic scan, and the radiologist is required to estimate the dose to the fetus. This article addresses practical methods of CT dosimetry with a specific discussion on fetal dose estimate. Three methods are described: (1) the use of a dose chart, (2) the pencil ionization chamber method, and (3) the thermoluminescence dosimetry (TLD) method. PMID- 2762540 TI - Stripes in the abdomen. PMID- 2762541 TI - Radiologic exchange. Patient dose can be reduced by using 105 mm photofluoro spot films instead of the screen-film cassette spot radiographs. PMID- 2762542 TI - The radiographer's role as clinical teacher. PMID- 2762543 TI - Radiation therapy technology ... a career choice that dares to touch your heart. PMID- 2762544 TI - Instructional objectives within the cognitive domain. PMID- 2762545 TI - Radiographic equipment and the Pepsi syndrome. PMID- 2762547 TI - An investment goal. PMID- 2762546 TI - A manager's investment. PMID- 2762549 TI - Education requirements. PMID- 2762548 TI - Innovation and improvements the answer to technology recruitment. PMID- 2762550 TI - Death and dying. Part II--The hospice project. PMID- 2762551 TI - Nurse refuses to follow resident's orders. Case in point: Ress v. Abbott Northwestern Hosp. (438 N.W. 2d 727--MN (1989)). PMID- 2762552 TI - Legal case briefs for nurses. N.Y.: failure to raise bedrails; MO.: resignation bonus incentive. PMID- 2762553 TI - Nurse midwife charges anti-trust violations. Case in point: Sweeney v. Athens Reg. Medical Center (709 F. Supp. 1563--GA (1989)). PMID- 2762554 TI - Effects of indomethacin, prostaglandin E2 and prostaglandin F2 alpha on mouse blastocyst attachment and trophoblastic outgrowth in vitro. AB - A study was performed in order to investigate the participation of prostaglandins (PGs) during implantation. The effects of indomethacin on mouse blastocyst attachment and trophoblastic outgrowth were examined in vitro. Studies were also carried out on cultures supplemented with PGE2 and/or PGF2 alpha along with indomethacin. (1) Blastocyst attachment and trophoblastic outgrowth were inhibited by indomethacin dose-dependency. (2) In the cultures supplemented with indomethacin and PGE2 or PGF2 alpha, respectively, the inhibitory effects of indomethacin were reduced. (3) In the cultures supplemented with all three substances with treatment (1) and (2), inhibition of indomethacin was partially reversed, but still lower than control group without indomethacin. The above results indicate that both PGE2 and PGF2 alpha have a promoting effect on implantation, and PGF2 alpha was more effective than PGE2. PMID- 2762555 TI - 16,16 Dimethyl prostaglandin E2 decreases the formation of collagen in fibrotic rat liver slices. AB - The effect of 16,16 dimethyl prostaglandin E2 (DMPG) on fibrogenesis was studied in slices from normal and fibrotic rat liver. Rats received a cirrhogenic diet for seven months; supplemented controls received a diet with the deficient nutrients restored. Slices from fibrotic livers incorporated more 14C-proline and produced more 14C-hydroxyproline in TCA precipitable proteins than slices from control livers. DMPG (10(-10) M) decreased the incorporation of labeled proline and the synthesis of labeled hydroxyproline in slices from fibrotic livers to the same extent, suggesting that DMPG did not affect the hydroxylation of proline per se. The magnitude of the DMPG induced decrease in labeled proline incorporation correlated with the hydroxyproline content in the liver (i.e. with increasing fibrosis there was a greater effect of DMPG: while in control rat liver slices, DMPG had no effect). DMPG did not change the size of the proline pool, its specific activity, or the activity of proline oxidase. We conclude that under these conditions of enhanced fibrogenesis, DMPG decreases the formation of collagen in vitro, possibly by lowering the incorporation of proline into collagen precursors. This may explain, at least in part, the inhibition of fibrogenesis by DMPG in vivo. PMID- 2762556 TI - Human isolated bronchial muscle preparations from asthmatic patients: effects of indomethacin and contractile agonists. AB - Airway reactivity to histamine was determined in a group of non-asthmatic and asthmatic patients prior to thoracotomy. The latter group was more reactive to histamine provocation than the former (PC40: 28.40 +/- 6.27 mg/ml and 1.15 +/- 0.19 mg/ml, respectively). Subsequent to the surgical intervention, isolated human bronchial muscle preparations were obtained from both groups (15 non asthmatic and 5 asthmatic subjects). Histamine concentration-effect curves were generated both in the absence and in the presence of indomethacin (1.7 microM; 30 min). Neither the basal tone nor the histamine response and sensitivity of the preparations were altered by the antiinflammatory drug. In bronchial preparations from one asthmatic subject, indomethacin significantly reduced the prostaglandin production during histamine contraction. Prostaglandin E2 and F2 alpha contracted isolated human bronchial muscle preparations from these asthmatic individuals. These data suggest that endogenous prostaglandins may not regulate the contractile response to histamine in vitro. PMID- 2762557 TI - Levuglandin E2 crosslinks proteins. AB - Levuglandin E2 (LGE2), a gamma-ketoaldehyde produced by rearrangement of the prostaglandin endoperoxide PGH2 under the aqueous conditions of its biosynthesis, causes extensive intermolecular crosslinking of ovalbumin at pH 6 or pH 7 and 37 degrees C. The time dependence of protein oligomerization is monitored by SDS PAGE. Effects of pH and concentration on the extent of LGE2-induced crosslinking are examined. The efficacy of LGE2 for inducing crosslinking is compared with other oxidative metabolites of arachidonic acid (AA), including the prostaglandins PGE2, PGD2, PGA2, PGB2, and PGF2 alpha, as well as malondialdehyde and E-4-hydroxy-non-2-enal. LGE2 is orders of magnitude more effective in crosslinking protein than any other cyclooxygenase or lipoxygenase metabolite of AA tested. PMID- 2762558 TI - Role of eicosanoids in relative oxygen tolerance of newborn rabbits. AB - Prolonged exposure to hyperoxia can result in significant lung injury, although newborn animals are more oxygen-tolerant than adults. Mechanisms affording tolerance to the newborn are incompletely understood. This study examined the hypothesis that eicosanoids play a significant role in newborn oxygen tolerance. One litter of term newborn albino rabbits and 15 adult rabbits were exposed to 65 hours of greater than 95% O2. An additional litter of newborns served as a normoxic control. Normoxic newborn rabbits had very high quantities of 6-keto PGF1a and low TXB2 in bronchoalveolar lavage (BAL) fluid. Sixty-five hours of oxygen exposure in newborn rabbits produced no evidence of lung injury on light microscopy, 97% of BAL white cells were alveolar macrophages and BAL protein was low. An equal period of oxygen exposure produced significant lung injury in adult rabbits. BAL fluid from oxygen-injured adults contained a 17-fold greater percentage of PMN and 16-fold higher protein than oxygen-exposed newborns. Hyperoxic adults had significantly lower 6-keto-PGF1a, and significantly higher LTB4 and LTC4 in BAL compared to hyperoxic newborns. This study confirms the hypothesis of relative oxygen tolerance in newborn rabbits compared to adults, and suggests that this tolerance may have been afforded by higher pulmonary levels of the protective prostacyclin metabolite. PMID- 2762559 TI - Prostaglandins in cerebrospinal fluid of healthy human volunteers, abstinent alcoholics and rhesus monkeys. AB - A sensitive and selective assay for measuring prostaglandins in cerebrospinal fluid has been developed, based on the selected-ion-monitoring, electron-capture negative ionization GC/MS detection for the MO-PFB-TMS derivatives of prostaglandins E2, E1, F2 alpha, F1 alpha, and 6-keto-F1 alpha. Improvements over previously published assay procedures have been made, and the new assay has been applied to measurement of prostaglandin concentrations in lumbar CSF of healthy human volunteers, abstinent alcoholic patients, in cisternal CSF of Rhesus monkeys, and continuously sampled lumbar CSF of awake Rhesus monkeys. Results indicated that the concentrations of PGE2, PGE1, PGF1 alpha, and 6-keto-PGF1 alpha were below 15 pg/mL CSF in lumbar CSF of healthy humans and abstinent alcoholics, and in cisternal CSF of Rhesus monkeys. In contrast, continuously sampled lumbar CSF of awake Rhesus monkeys contained more than 200 pg/mL of PGE2, PGF2 alpha, and 6-keto-PGF1 alpha, probably present as a result of local production. PMID- 2762560 TI - [Epidemiological chronicle]. PMID- 2762561 TI - [Infectious diseases in Poland 1987]. PMID- 2762562 TI - [Measles--1987]. PMID- 2762563 TI - [Brucellosis--1987]. PMID- 2762564 TI - [Trichinosis--1987]. PMID- 2762565 TI - [Parasitic intestinal diseases--1987]. PMID- 2762566 TI - [Incidence of HIV infection 1987--the situation in Poland in comparison with the world situation]. PMID- 2762567 TI - [Whooping cough--1987]. PMID- 2762568 TI - [Scarlet fever--1987]. PMID- 2762569 TI - [Epidemic parotitis--1987]. PMID- 2762570 TI - [Influenza--1987]. PMID- 2762571 TI - [Rubella--1987]. PMID- 2762572 TI - [Cerebrospinal meningitis and encephalitis--1987. 1. Incidence and mortality]. PMID- 2762573 TI - [Bacterial food poisoning and/or infections--1987]. PMID- 2762574 TI - [Botulism--1987]. PMID- 2762575 TI - [Viral hepatitis--1987. Total incidence]. PMID- 2762576 TI - [Tetanus--1987]. PMID- 2762577 TI - [Diarrhea in infants up to 2 years of age--1987]. PMID- 2762578 TI - [Infectious mononucleosis--1987]. PMID- 2762579 TI - [Scabies--1987]. PMID- 2762580 TI - [Rabies--1987. 1. A method of epidemiologic analysis]. PMID- 2762581 TI - [Projective identification and the psychoanalytic dialogue]. AB - A survey of several psychoanalytic conceptions of projective identification is followed by a discussion, with case illustrations, of its communicative and defensive function. In this context, special attention is paid to the use of language as an instrument for the destruction of the object--in this case, the analyst--who is simultaneously yearned for and experienced as a threat. PMID- 2762582 TI - Spectroscopic imaging by dephasing amplitude changing (SIDAC). AB - A technique for spectroscopic imaging based on a new concept of dual encoding (i.e., both phase and frequency encoding) of position along the direction of the read-out gradient is proposed. The phase encoding is produced by changing the amplitude of the dephasing gradient as in conventional phase encoding. High resolution spectroscopic images of a normal human thigh obtained by a 2.0 Tesla whole body MR imaging system are presented. PMID- 2762584 TI - Caroli's disease associated with polycystic kidney: its noninvasive diagnosis. AB - We present a case of Caroli's disease, a relatively uncommon congenital abnormality, together with CT, US, and scintigraphic findings. The patient had chronic renal failure, complicated by polycystic kidney. No hepatic fibrosis was observed. Intrahepatic biliary lithiasis and gallstones were detected, but the patient was asymptomatic. Because surgery on an abnormal biliary tract may increase the risk of cholangitis, and intravenous administration of contrast media could be invasive in patients with polycystic kidney, CT, US, and scintigraphy are considered to play an important role in diagnosis. Noninvasive diagnostic procedures in Caroli's disease are described in this report. PMID- 2762583 TI - Right aortic arch with atresia of aberrant left subclavian artery: case report. AB - We report a case of right aortic arch with atresia of the proximal portion of the aberrant left subclavian artery, a rare congenital vascular anomaly. Differential diagnosis from other conditions including right aortic arch with isolation of the left subclavian artery is discussed. PMID- 2762585 TI - Comparison between air CT and MRI in the detection of small acoustic neurinomas. AB - Air CT proved useful in yielding images of acoustic tumors as an air filling defect in 11 (24%) of 46 patients. Six of the 11 tumors were small ones of less than 1 cm in diameter. Air CT was also able to exclude an intracanalicular tumor in 29 patients (63%). MRI was performed for comparison in eight patients (nine tumors) already diagnosed by air CT as having an acoustic tumor. MRI detected eight (89%) of nine tumors. A false negative result on MRI was obtained only in one intracanalicular tumor (4.3 mm in size). This was considered to be attributable to limitations of spatial resolution including the wide slice thickness. A protocol for radiological investigation and management of patients whose clinical symptoms and/or audiovestibular examination are highly indicative of acoustic tumor is proposed and discussed. PMID- 2762586 TI - Comparison of survival of black and white patients in each stage of Hodgkin's disease during 1970-1980. AB - A survival and mortality study of all the patients referred to the radiotherapy department between 1970 and 1980 with a diagnosis of Hodgkin's disease was performed. Generally, black patients with cancer have a poorer survival rate compared with that of white patients with cancer, as reported by the U.S. Department of Health and Human Services. In this series, no difference in survival and mortality was found between patients of the two races when they were compared in each stage of Hodgkin's disease. PMID- 2762587 TI - Thoracic vertebral photopenia may predict fatty changes of the corresponding bone marrow following irradiation. AB - We present a patient with unresectable bronchogenic carcinoma who underwent irradiation, then had four consecutive bone imaging studies in a 26-month period. Apparent photopenia of the upper thoracic vertebrae developed within six months after irradiation and became more apparent in the images thereafter. At autopsy a section of the corresponding bone marrow showed extensive fatty changes with very few residual blood vessels. Radiation damage of the vascular networks may significantly reduce the blood supply, when integrity of the blood supply is essential for delivery of a normal bone image by the bone-imaging agent. Interruption of blood supply may cause photopenia, and this interruption plus irradiation to marrow elements may also affect the hematopoietic activity of the corresponding bone marrow. The occurrence of radiation-induced photopenia on a bone-imaging study may indicate fatty changes of the corresponding marrow. PMID- 2762588 TI - Afterloading intracavitary irradiation and expanding stent for malignant biliary obstruction. AB - A double lumen catheter was developed as an applicator for the remote afterloading (RALS) of 60Co source for the intracavitary irradiation of an obstructed common bile duct caused by carcinoma of the gallbladder. This was followed by the placement of nylon-covered expandable metallic stents to maintain patency. This combination effectively provided palliation. PMID- 2762589 TI - Betamethasone-dixyrazine combination versus high-dose metoclopramide as antiemetic treatment in doxorubicin and cisplatin chemotherapy. AB - In a prospective randomized and double-blind cross-over study, a new antiemetic regimen consisting of betamethasone (1 x 8 mg) and dixyrazine (a phenothiazine derivative) (4 x 10 mg) was compared with a standard high-dose metoclopramide (4 x 1 mg/kg) schedule for antiemetic treatment in doxorubicin and cisplatin chemotherapy. 100 consecutive patients (62 without prior experience of chemotherapy and 38 with prior experience) entered the study and were followed during 1-4 courses of chemotherapy. Effect and side effect parameters were recorded on questionnaires for patients and nurses using the visual analog scale for quantification. The correlation between the two ways of recording (self scoring versus recording by nursing staff) was very high, both for effect variables (nausea and vomiting) and the adverse reactions (sedation and extrapyramidal reactions). The median number of courses per patient was 3.0 (range 1-4) and altogether 299 courses were studied. Full emetic protection was achieved in 58% with betamethasone-dixyrazine and in 34% with high-dose metoclopramide regardless of prior patient experience or the cytostatic agents administered. With doxorubicin regimens, betamethasone-dixyrazine gave full protection in 80% compared to 40% for metoclopramide. Cisplatin regimens were a greater challenge and protection against nausea and vomiting was achieved only in 27% with betamethasone-dixyrazine and in 18% with metoclopramide. Adverse reactions were a significant problem with metoclopramide: restlessness 33%, akathisia 19%, parkinsonism 16%, and acute dystonia 3%. Sedation was the same with the two regimens (80%). PMID- 2762591 TI - A comparison of dose calculations at points around an intracavitary cervix applicator. AB - An intercomparison was made between dose-rate calculations performed in 10 institute in The Netherlands for intracavitary applications with the Selectron LDR remote afterloading machine. The results of 11 computer planning systems of five different manufacturers were compared with reference dose-rate calculations. The difference in clinically relevant dose-points like rectum and bladder, were less than 2% if the values of the coordinates of source and dose-points were given, except for one type of planning system, that showed differences up to 10%. The errors observed for the latter system were probably due to a coarse calculation grid, which becomes important in regions with a high dose gradient. If the reconstruction process of source and dose-point positions from radiographs was included as it usually is in practice, then the accuracy became worse and the planning system that showed large errors before, gave unacceptable errors of 30% to 40% in the rectal area. This is due to additional errors introduced in the reconstruction. The intercomparison showed that it is very important that computer treatment planning systems for brachytherapy calculations are tested before clinical use. The reconstruction technique for source and dose-point positions should be part of this test. Radiographs should be made of a phantom that simulates the cervix application, and the radiography technique should be similar to the one that is clinically employed. PMID- 2762590 TI - Repair capacity and kinetics of human skin during fractionated radiotherapy: erythema, desquamation, and telangiectasia after 3 and 5 year's follow-up. AB - Prospective clinical fractionation studies on acute and late reactions in skin have been going on since 1972 at the Radiotherapy Department in Gothenburg. The clinical assay consisted of breast cancer patients irradiated postoperatively to the internal mammary nodes from unilateral or bilateral fields exposed to various dose schedules. 750 fields in 450 patients have been analysed. Schedules with 1, 2 or 5 fractions per week and 2 or 3 fractions per day were evaluated with erythema, desquamation and telangiectasia as endpoints. For some schedules a dose response relationship was established in a limited dose range, but often there was only one dose group per schedule. These data are suited to analysis by the method of direct analysis of quantal response. This was used in the present analysis, along with the linear quadratic (LQ) model and its generalization, the incomplete repair (IR) model. The repair capacity was similar for erythema and desquamation, with alpha/beta ratios between 7.5 and 11.2 Gy. Unexpectedly, there was more significant time factor during radiotherapy courses up to 6 weeks for erythema and desquamation, but the repair capacity was changed after 4 weeks for both endpoints, and alpha/beta increased to between 18.3 and 34.5 Gy. The repair capacity for late telangiectasia differed significantly from that for erythema and desquamation, with alpha/beta values between 2.8 and 4.3 Gy. There was a significant time factor for telangiectasia with characteristic doubling time of about 16 days, when an exponential function for time was used. Concerning the repair kinetics in skin, there were insufficient data to obtain precise estimates, but there was a suggestion of two components of repair. This was inferred from higher-than-predicted recovery with 15-min intervals, when the data were fitted with the monoexponential model. The monoexponential fit gave t1/2 between 1.1 and 1.3 h for acute effects and 3.5 h for late effects. Recovery after 15-min fractionation intervals, if it resulted from a fast repair component, would be consistent with a half-time of 0.3-0.4 h. The time factor and the relative long half-time for repair for late effects have important implications for multiple-fraction-per-day treatment, and imply that interfraction intervals of 4 h or less, as commonly used, will be insufficient. Instead, intervals of 6 h or longer are recommended. Using accelerated fractionation with a significant reduction in overall treatment time a dose reduction is still necessary to take into account the time factor for late effects.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2762592 TI - [Thymoma of fusiform cells. Report of a case]. AB - A 63 yo female was hospitalized with a 2 week history of vomiting, epigastric pain, anorexia and weight loss. She had an incidental finding of left anterior upper mediastinal mass on Chest Xray and TSP of 2.2 gm% and globulins of 1.2 gm% along with endobronchial larvae of Ascaris lumbricoides and malignant cells and Strongyloides stercoralis in the gastric mucosa. She died after a progressively deteriorating course and at autopsy a thymoma predominantly composed of spindle shaped cells was found. This rare variant of thymoma has been associated with red cell agenesis and with immunodeficiency (Good's syndrome). PMID- 2762593 TI - [Asymptomatic rectosigmoid perforation and peranal extrusion of a catheter of ventriculoperitoneal derivation]. AB - A case of asymptomatic rectosigmoid perforation and peranal extrusion of the distal portion of the ventricle-peritoneal shunt catheter in an infant with congenital hydrocephalus is reported. It is studied the mechanism of the spontaneous reduction of the missing tube and the form to approach this rare complication. PMID- 2762594 TI - [Infection caused by Paracoccidioides brasiliensis in people living in Cocle and Veraguas, Republic of Panama]. AB - Intradermal application of yeast phase paracoccidioidin antigen obtained by sonication and lysis from the fungus to 111 residents of Veraguas province (68 men and 43 women) and 130 Cocle province residents (57 men and 73 women) elicited a positive reaction in 9.01% (1/111) and 26.15% (34/30) of the Veraguas and Cocle residents respectively. Positive reactions ranged between papules of 5 and 27 mm in diameter, the majority being between 11 and 20 mm. Infection was more frequent in men (1:1.47 for Veraguas and 1:1.28 for Cocle) and in those involved in farming. A prevalence of 21.95% P. brasiliensis infection is demonstrated for the Republic of Panama. PMID- 2762595 TI - [Choanal atresia]. AB - A report of eight patients with choanal atresia, three male and five female is presented. The atresia was bilateral in five cases and unilateral in three, bony in seven and membranous in one. Three attempts at surgical repair in neonates and early aged infants via the transnasal approach were unsuccessful resulting in choanal stenosis which necessitated surgical reintervention via the transpalatal route. The transpalatal approach, when the children were between three and sixteen years of age, was successful in the other five patients and in the three cases of stenosis. The importance of the knowledge and awareness of the disease is stressed. Only this will permit the early diagnosis necessary in order to save most affected infants. The high incidence of congenital anomalies makes imperative the careful evaluation of these patients in order to detect the presence of other pathological processes. The information that can be obtained from computerized tomography makes its use highly recommendable in all cases of choanal atresia. Surgical treatment via the transpalatal approach seem to give the best results with the least surgical complications. PMID- 2762596 TI - [Current situation of the Aedes aegypti mosquito in the metropolitan area of Panama city]. AB - Ae. aegypti was reintroduced into Panama in 1985; control was unsuccessful and by 1988 Ae. aegypti larvae were detected in every borough of Panama Metropolitan Area. Only 3% of the Panama City population has dengue antibody (against DEN 2) and virtually no one is immune to other serotypes. The relative risk of the introduction of Dengue virus into Panama is discussed. PMID- 2762597 TI - Oogenesis and ovulation in normal conditions or induced by homologous hypophysis in Hoplias m. malabaricus (Pisces, Erythrynidae). AB - The macroscopical, histological and histochemical study of the ovary of Hoplias m. malabaricus during its annual cycle makes it possible to classify oocytes in nine stages, which characteristics, inherent to each stage, have given evidence of certain aspects still unknown for this species. The hormonal induction by homologous hypophysis makes it possible to obtain the final oocyte maturation and the ovulation. PMID- 2762598 TI - Final maturation and ovulation provoked by supply of homologous hypophysis in Hoplias m. malabaricus (Pisces, Erythrinidae). AB - The final maturation and the ovulation were induced in recently collected specimenes of Hoplias m. malabaricus that show oocytes with complete vitellogenesis, by using homologous hypophysis. The hormonal supply was a gradual and positive results were obtained with 9 to 10 hypophysis/kg injected according to 3 different methods. The time of oocytes' maturation from the first dose ranges between 32 and 60 hours a 18 degrees C. The stages of maturation of the oocyte were controlled by intraovaric cannulations using a numerical index to determine the position of the germinal vesicle. PMID- 2762599 TI - [Total proteins levels and embryonic development of eggs of sea urchins (Lytechinus variegatus) treated with YbCl3]. AB - Total proteins levels and the embryonic development of sea urchin (Lytechinus variegatus) eggs treated with 25 micrograms/ml of YbCl3 in sea water for one hour were studied. After the treatment, eggs were let to develop for 24 hours when the total proteins levels were determined and morphological changes as well as the synchronism of the embryonic development have been checked. PMID- 2762600 TI - [Ultrastructural aspects of the skeletal striated muscle, macrophages and fibroblasts during the regression of tadpole tails]. AB - Striated muscle fibres and fibroblasts observed at electron microscope were entirely developed when the tail of tadpoles reached its maximum size. However, during resorption of the tail, striated muscle fibres showed signs of degeneration: rupture and disorganization of myofibrils, altered mitochondria and lipid droplets in the cytoplasm. A great amount of macrophages phagocyting myofibrils and fibroblasts containing collagen fibrils in several breakdown stages were also observed among degenerated muscle fibres. PMID- 2762601 TI - [Cytochemical and ultrastructural characteristics of the lining epithelium of the distal part of the epididymis in hamsters (Mesocricetus auratus)]. AB - In the terminal segment of the hamster epididymidis there was some evidence of micro-merocrine protein secretion a the level of the principal cells and clear evidence of granular secretion in the light cells, presumable of glycoproteins. The PAS and protein cytochemistry reactivities observed in both these cells, of the ductus epithelial lining, but especially in the light cells, are suggestive of mucopolysaccharides and protein complexes synthesis and secretion. This secretion is carried out to the epididymal epithelium from the lumen and luminal content. A complex of small vacuoles and vesicles appeared to form from the Golgi complex is showed in the principal cells. It was suggested that this complex may represented merocrine secretory vacuoles and vesicles in these cells. Dense granules, at the TEM level, are observed in all the cytoplasm of the light cells, with correspondence to similar PAS-positive granules observed in these cells, at the light microscope level. These granules, at the TEM level, are actually secreted to the epididymal duct lumen, by the apical cytoplasms of the light cells. Signs of absorption were suggested to the principal and light columnar cells through the ultrastructural observations of micropinocytosis, apical multivesicular bodies or great membrane-bounded vacuoles in the adluminal cytoplasms. PMID- 2762602 TI - Lead in the environment: coming to grips with multisource risks and multifactorial endpoints. PMID- 2762603 TI - On the relationship between carcinogenicity and acute toxicity. AB - Parodi et al. and Zeise et al. found a surprising statistical correlation (or association) between acute toxicity and carcinogenic potency. In order to shed light on the questions of whether or not it is a causal correlation, and whether or not it is a statistical or tautological artifact, we have compared the correlations for the NCI/NTP data set with those for chemicals not in this set. Carcinogenic potencies were taken from the Gold et al. database. We find a weak correlation with an average value of TD50/LD50 = 0.04 for the non-NCI data set, compared with TD50/LD50 = 0.15 for the NCI data set. We conclude that it is not easy to distinguish types of carcinogens on the basis of whether or not they are acutely toxic. PMID- 2762605 TI - Estimating the risks of smoking, air pollution, and passive smoke on acute respiratory conditions. AB - Five years of the annual Health Interview Survey, conducted by the National Center for Health Statistics, are used to estimate the effects of air pollution, smoking, and environmental tobacco smoke on respiratory restrictions in activity for adults, and bed disability for children. After adjusting for several socioeconomic factors, the multiple regression estimates indicate that an independent and statistically significant association exists between these three forms of air pollution and respiratory morbidity. The comparative risks of these exposures are computed and the plausibility of the relative risks is examined by comparing the equivalent doses with actual measurements of exposure taken in the homes of smokers. The results indicate that: (1) smokers will have a 55-75% excess in days with respiratory conditions severe enough to cause reductions in normal activity; (2) a 1 microgram increase in fine particulate matter air pollution is associated with a 3% excess in acute respiratory disease; and (3) a pack-a-day smoker will increase respiratory restricted days for a nonsmoking spouse by 20% and increase the number of bed disability days for young children living in the household by 20%. The results also indicate that the estimates of the effects of secondhand smoking on children are improved when the mother's work status is known and incorporated into the exposure estimate. PMID- 2762604 TI - A stochastic two-stage model for cancer risk assessment. II. The number and size of premalignant clones. AB - Mathematical expressions are derived, under different dosing patterns, for the number and size of premalignant clones within the framework of a two-mutation model for carcinogenesis, which has previously been shown to be consistent with a large body of epidemiologic and experimental data. PMID- 2762606 TI - A risk assessment for selected lead-induced health effects: an example of a general methodology. AB - The research described here is part of a larger risk assessment project to aid the U.S. Environmental Protection Agency (EPA) in its review of the primary National Ambient Air Quality Standard for lead. The methodology can be applied to many situations in which a policy decision about a toxic substance is required in the face of incomplete data. Numerical results are presented for three potentially adverse lead-induced effects of interest to EPA: elevated erythrocyte protoporphyrin (EP), hemoglobin (Hb) decrement, and intelligence quotient (IQ) decrement. PMID- 2762607 TI - [Effect of several inhalation anesthetics on ectopic cardiac automaticity. Intervention of the calcium ion]. AB - The effect of halothane, enflurane and isoflurane (at concentrations ranging from 0.1 v/v% to 5 v/v%) on ventricular automaticity induced by a local injury, has been studied in the isolated right ventricle of the rat. Both, halothane and isoflurane, effectively reduces ventricular frequency at all concentrations tested. On the contrary, enflurane (0.3, 0.5 and 1 v/v%) increases ventricular automaticity. The effect of enflurane was either potentiated or reduced respectively in the presence of lower or higher calcium concentrations. PMID- 2762608 TI - [A controversial entity: myocardial contusion in 51 patients with thoracic trauma]. AB - We studied the incidence of myocardial contusion following thoracic trauma in a group of 51 patients. The goal of this review is an assessment of the repercussion of this lesion in mortality and treatment. Also we considered the diagnostic options. Our finding show that this lesion is relatively frequent, 8 patients were considered with myocardial contusion (15.7%), but generally is not worth of extraordinary treatment. We considered the ECG a valuable diagnostic procedure and the CPK-MB a specific test, but brief and often with troubled interpretation due to the great rhabdomyolysis and the huge liberation of total CPK. In 4 patients there was obvious elevation of CPK-MB levels. All but one were in the ECG group. Other diagnostic procedures in those patients were not available. PMID- 2762609 TI - [Hypokalemic effect of salbutamol administered intravenously in the preoperative period]. AB - In 8 healthy patients (ASA I-II) there was analyzed the effect of salbutamol over serum levels of potassium, glucose, insulin, AMPc and GMPc. Also were determined the arterial blood pressure and heart rate. The drug was administered intravenously, as bronchodilator, during the preoperative period. There was a significant decrease in kaliemia (p less than 0.001 immediately after receiving the salbutamol infusion and p less than 0.05 at 60 min). Their plasma potassium levels dropped from 4.03 +/- 25 to 3.45 +/- 0.16 mEq.l-1. The plasma levels of glucose and insulin increased with a significance of p less than 0.001 post salbutamol perfusion. There were no changes in the plasmatic AMPc and GMPc. Heart rate increased from 67 +/- 10.8 to 80.5 +/- 13.7 (p less than 0.01) post perfusion, returning afterwards to their basal values. Arterial blood pressure was unmodified. PMID- 2762610 TI - [Microsurgical catheterization of the intrathecal space in the rat for chronic infusion of drugs]. AB - An original technique for placement of intrathecal catheters suitable for drug administration is described. For implantation a microsurgical laminectomy is carried out, opening the dura mater and placing the catheter under surgical microscope control. Only a few instrumentation is mandatory. The mean time for this surgery was between 15 and 20 minutes. A 10% of the animals operated on developed neurological deficits and must be dropped. The mortality rate was a 5%. No catheter malfunctions were found. PMID- 2762611 TI - [The current situation of anesthesiology and recovery in Spain. A national survey (IV): Extrasurgical activity]. AB - It is showed the results of an inquest carried out at 170 departments of anesthesia about their extrasurgery activities. Training programs, systematic and available preoperative assessment, controls at the delivery, pediatric anesthesia, neonatal resuscitation, pain treatment units, recovery units and hospitalization wards, emergency service, transportation of critical patients and available human resources are analysed. PMID- 2762612 TI - [Use of axillary perivascular blockage of the brachial plexus with a catheter as treatment in accidental intra-arterial injection of drugs]. AB - We report the intraarterial injection of a flunitrazepam tablet dissolved in water in a patient with intravenous drugs addiction. Several ecchymotic lesions were present at different sites of the arm. In order to achieve analgesia and the sympathetic blockade of the arm, we performed an axillary perivascular block of the brachial plexus by means of the intermittent injection through a catheter of 0.25% bupivacaine with a 1:200,000 epinephrine solution. In addition, an anticoagulant treatment with heparin was started as prophylaxis of the thrombosis of the vessel. There was a satisfactory clinical course even though a distal phalange had to be amputated on the 18th day. We propose the continuous perivascular block as the method of choice of this type of medical problem. PMID- 2762613 TI - [Determination of subanesthetic concentrations of halothane in the environment of operating and recovery rooms]. AB - Concentrations of halothane in parts per million (ppm) in the air were determined during 4 days in the operating rooms and the recovery room of pediatric surgery during the course of surgical anesthesia by inhalation. The operating rooms did not have an anesthetic gas scavenging system. Eighteen samples of air were taken by passive diffusion in sampling tubes of activated charcoal (mode Drager Orsa 5). The samples were analysed by gas chromatography). We found concentrations between 4.7 ppm and 34.2 ppm that exceed those considered as admissible that range from 2 to 5 ppm. Our present recommendations to reduce the atmospheric contaminating anesthetic gases are the use of scavenging equipment, air conditioned rooms and routine inspection and leak detection of apparatus and anesthetic circuits. PMID- 2762614 TI - [Prader-Willi syndrome and anesthesia]. PMID- 2762615 TI - [Intradural anesthesia in a patient with normotensive hydrocephalus]. PMID- 2762616 TI - [Prolonged apnea during electroconvulsive therapy]. PMID- 2762617 TI - [A knot in a central venous catheter inside the basilic vein]. PMID- 2762618 TI - [Retrograde orotracheal intubation]. PMID- 2762619 TI - [Ultrastructural study of the liver from rats treated with ethanol and/or carbon tetrachloride]. AB - The cellular ultrastructure of isolated hepatocytes and hepatic tissue in ethanol and/or carbon tetrachloride treated rats at different times. The ultrastructural modifications induced by ethanol and carbon tetrachloride, isolated administrations, are similar: Many lipidic vacuoles, several graded-injury mitochondria and R. E. R. degeneration. These effects are also induced by ethanol and carbon tetrachloride association and furthermore nuclei indentations. Some mitochondrial autophagocytosis affecting to the less electrodense hepatocytes are noted. PMID- 2762620 TI - [Anatomopathologic repercussions of segmental liver resection]. AB - We present an experimental study of the anatomopathologic repercussions of segmental liver resection. Sixty rats were used, distributed into 3 groups of 18 animals each one with 6, group I, as follows: 1) anesthesia and laparotomy; 2) 30% liver resection; 3) 50% liver resection, and 4) 80% liver resection. The three resection groups were distributed into three subgroups according to parameters studied at 24 hours, 72 hours and 10 days, respectively. The data studied were: 1. Inflammation: activation of Kupffer cells, state of the lobule and portal spaces. 2. Degeneration: steatosis, necrotic foci, infarction and eosinophilic degeneration. 3. Regeneration: hepatocytic hypertrophy, mitosis, binucleation and trabeculation. The results confirm that the resected liver undergoes regenerative processes that condition the adaptation of the animal after hepatic exeresis. PMID- 2762622 TI - [Surgical treatment of cancer of the colon: a review of 175 cases]. AB - We present a review of 175 cases of carcinoma of the colon out of 270 cases of colorectal cancer operated in our service during the period 1980-1986. It is noteworthy that 46.8% of the patients underwent emergency surgery for occlusion and/or diastasic tumoral perforation, and that they presented an advanced average age (48.5% were over 70 years). In emergency surgery there was a predominance of bypass operations (73%) versus tumoral resection (27%). In programmed surgery the index of resectability was 83%. The global operative mortality was 12.5%, but separately it was greater for emergency surgery (18%) than for elective surgery (7.5%). Wound infection occurred in 35% of emergency operations and in 11.8% of programmed operations. An anastomotic fistula appeared in 6.9% of cases, with a similar incidence for mechanical and manual anastomoses. It is concluded that early detection of the disease is necessary to reduce the percentage of urgent operations, and consequently the rates of operative morbi-mortality, and improve long-term survival. PMID- 2762621 TI - [Immediate prognosis factors in total gastrectomy in cancer]. AB - We present a series of 76 patients operated over a period of nine years, diagnosed as gastric cancer (CG), in whom radical oncologic total gastrectomy (GT) with esophago-jejunal anastomosis (EY) on a Roux-en-Y loop (Y-R) was performed. The tumor was located in the cardias in 27 patients, body in 37, fornix in 3, gastric stump in 7 and over plastic linitis in 2. We performed total gastrectomy enlarged to the spleen in 63 patients, to the pancreas in 28, to the colon in 5 and to the liver in 4. We describe the most salient technical details of the surgical intervention. Twenty-six percent of the patients presented postoperative complications, which we divided into two groups: anastomosis failures, among which are emphasized 4 severe esophagojejunal fistulas, a fistula of the duodenal stump (MD) and respiratory complications. The mortality was 7.8%, corresponding to 4 esophago-jejunal fistulas, 1 fistula of the duodenal stump and 1 bilateral bronchopneumonia. We analyzed various parameters that we consider important prognostic indicators of postoperative morbi-mortality. Applying the Fischer test, we attempted to assign statistical significance to these parameters. Age over 60 years increased postoperative mortality. Super-radical surgery did not increase mortality. On the other hand, patients in stages IIIb and IV have a worse prognosis, with a mortality in the first 30 days of 28.5%. Esophago-jejunal anastomosis on a Roux-en-Y loop is the procedure of choice used by our center after total gastrectomy for gastric cancer, yielding the most acceptable morbi-mortality figures. PMID- 2762623 TI - [Usefulness of microscopic study of the duodenal bile in the diagnosis of pancreatitis of unknown cause]. AB - In spite of the numerous causes of acute pancreatitis reported, among which the most frequent are biliary lithiasis and alcoholism, the etiology remains obscure in many patients, being termed idiopathic in these cases. The presence of microcalculi in the bile juice has been described as a cause of some pancreatitis initially labeled as of unknown cause. We studied the duodenal bile juice of 22 patients who were admitted on various occasions for acute pancreatitis, in whom the etiology could not be clarified in spite of the anamnesis and explorations. Microscopic study of the bile juice showed the presence of microlithiasis in 36.3% of cases. We conclude that microscopic study of the bile juice is a risk free technique that should be included systematically in the investigation of the etiology of idiopathic pancreatitis. PMID- 2762624 TI - [Acute postoperative pancreatitis]. PMID- 2762625 TI - [Segmental portal hypertension caused by aneurysm of the distal splenic artery]. AB - A case is reported of segmental portal hypertension secondary to compression of the splenic vein by an aneurysm of the distal splenic artery. Splenectomy was used to treat the aneurysm and segmental portal hypertension, as well as the hypersplenism existent. Collateral circulation through the short gastric veins originated grade V gastroesophageal varices, which makes this mechanism of production equivalent to that described in cases of thrombosis of the splenic vein. PMID- 2762626 TI - [Antral varices in a patient in sclerosing treatment of esophageal varices]. AB - Descriptions of antral varices are very rare in the literature and there are no previous descriptions of this entity occurring after endoscopic sclerosis of esophageal varices. We present a 48-year-old patient with portal hypertension due to alcoholic liver cirrhosis in whom antral varices were demonstrated in the course of the fourth sclerotherapy session for his esophageal varices, when these had decreased dramatically in size. We review the radiological and endoscopic aspects. PMID- 2762627 TI - [Duodenal duplication in adults]. AB - A case is presented of intestinal duplication in the duodenum of a 17-year-old patient initially diagnosed as anorexia nervosa due to her extreme thinness and scant accompanying symptomatology. The etiopathogenesis, anatomic, clinical and diagnostic features, and different treatments of duodenal duplication are briefly reviewed. PMID- 2762628 TI - [Chronic intestinal ischemia. Apropos of a case successfully treated with surgery]. AB - A case is presented of chronic intestinal ischemia due to arteriosclerotic obstruction of the celiac trunk and superior mesenteric artery. The diagnosis was reached by right transfemoral aortography. Surgical treatment was direct reimplantation of the superior mesenteric artery on the anterior aspect of the healthy aorta and installation of a retrograde Dacron graft between the aorta and common hepatic artery. The patient's postoperative course was satisfactory, with total remission of the symptomatology; revascularization was confirmed by a new aortography at six months. The diagnostic and therapeutic problems posed by this pathology are commented. PMID- 2762629 TI - [Deep cystic colitis located in a previous surgical anastomosis]. AB - Deep cystic colitis is a rare disease of which about one hundred cases have been reported in the medical literature. Two forms are known, segmental and localized, the latter being the most frequent. We offer a case of a patient who developed a picture of deep localized cystic colitis on a previous surgical anastomosis, a very infrequent association. The value of intraoperative biopsy in these cases is discussed. It is necessary to be aware of this entity and its clinicopathologic correlations to differentiate it, especially from the therapeutic and prognostic points of view, from well differentiated colorectal carcinoma and colloid (mucoid extracellular) carcinoma. PMID- 2762630 TI - [Acute pancreatitis: an infrequent complication of cystic fibrosis (mucoviscidosis)]. AB - We comment the case of a 25-year-old woman, diagnosed since the age of 7 as cystic fibrosis, who presented acute pancreatitis, an exceptional complication of the underlying disease. In the ultrasonographic exploration and endoscopic retrograde cholangiopancreatography was appreciated dilation of the pancreatic ducts, with mobile echoes and filling defects, respectively, compatible with mucus plugs. The etiopathogenesis of this type of acute pancreatitis and the procedure for reaching an etiological diagnosis are discussed. Although the patient presented moderate grade pancreatic failure, there is presently no agreement as to whether pancreatitis secondary to cystic fibrosis can be considered as chronic pancreatitis. PMID- 2762631 TI - [A peculiar case of anorectal melanoma]. PMID- 2762632 TI - [Lead poisoning: any changes in its epidemiology?]. PMID- 2762633 TI - [Viral replication, histologic damage and enzymatic activity in chronic hepatopathies caused by B virus. Analysis of 21 patients]. AB - In 21 patients from the out-patient clinic of the Internal Medicine Department of our hospital with chronic hepatitis (HC) due to B virus (HBV) and anti-HBC (IgG) serology but not HBsAg, a study was made of the possible correlation between viral replication levels (RV) --as expressed by DNA polymerase values (DNAp)-- and, respectively, histologic changes and serum enzyme movements (GPT, GOT). Our study parted from the diverse criteria cited in the literature concerning the role assigned to viral replication per se and/or immune response per se in the genesis of histologic damage (DH). All patients exhibited signs of moderate clinical and enzymatic activity. The levels of viral replication in the group studies were significant (compared to a control group), which supports the thesis that a certain degree of viral replication, although very attenuated, persists in these patients and is the basis of the continued histological damage that eventually leads to liver cirrhosis (CH) and its derivatives, often with little clinical translation. As regards histologic damage, the correlation with DNAp is reciprocal and of moderate significance, supporting the criterion that the multiform expression of histologic damage in liver cirrhosis due to HBV (HCB) (cellular necrosis, intracellular degenerative phenomena, inflammatory cellular infiltrate, fibrosis) is, at the very least, unproportional to the degree of viral replication and can even be reciprocal. Only the severity of the overall hepatic process remains a function of immune response.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2762634 TI - [Non-excisional treatment of spontaneous rupture of the esophagus]. AB - We present 7 personal cases of Boerhaave syndrome, 6 treated surgically and one managed with conservative measures. Boerhaave's syndrome is one of the most serious gastro-intestinal perforation pictures. Although its frequency is scant, because of its seriousness it is important to be aware of it for early diagnosis. While a prompt diagnosis is important in any pathology, it is even more so in this syndrome since there is a clear relationship between the time lapse from perforation to the onset of treatment and the rate of survival. Although we present one case cured medically, this is exceptional and treatment is eminently surgical and should be as early as possible. The technique that provides the best results and an excellent morbimortality rate in relation to efficacy is primary suture followed by a fundal patch. In delayed cases with patients in deteriorated condition, other techniques can be considered. Due to its initial severity and a tendency to postoperative complications, the patient should be closely controlled, and correct antibiotic therapy and complete parenteral support nutrition are very important in treatment. PMID- 2762635 TI - [Does the ingestion of caustics produce irreversible motor changes in the esophagus? Manometric study of 17 cases]. AB - During the acute period of caustic esophagitis, important alterations in esophageal motor function appear. However, it is not known if these alterations persist later. To determine whether motor disorders persist (after the aggression) in the esophagus that has suffered caustic aggression, a manometric study was made in two groups of patients classified as mild (9 cases) or severe esophagitis (8 cases), and results were compared with those of a control group. Patients who had developed stenosis or suffered the caustic aggression less than a year earlier were excluded. The probable existence of motor anomalies could determine the appearance of dysphagia or reduce the effectiveness of motor clearance of the esophageal body, thus conditioning a situation of esophageal defenselessness against physiological or eventual abnormal episodes of gastroesophageal reflux (RGE). Our results indicate that in a variable percentage of cases some peristaltic dysfunctions can persist in the esophageal body in relation to the severity of the initial lesion. PMID- 2762636 TI - [Complete section of the choledochus caused by non-penetrating trauma of the abdomen. Use of minimal catheter jejunostomy]. AB - A case is presented of complete section of the choledochus as the sole lesion in closed abdominal trauma. A study is made of the difficulties of an early diagnosis of this pathology, as well as techniques for intraoperative localization and repair. Emphasis is placed on the use of peritoneal lavage as a preoperative diagnostic method and Tc99m HIDA scintigraphy of the biliary tract. The surgical technique is reviewed, assuming that the most physiological and anatomic procedure is end-to-end choledochoduodenostomy using reabsorbable sutures. We recommend the use of minimal transcatheter jejunostomy (YMC) as a method for immediate replacement of bile juice and inhibition of secretion, as well as the possibility of postoperative physiological nutrition using this approach. PMID- 2762637 TI - [Correlation of the risk of gastric cancer in the province of Soria and the nitrate content of drinking water]. AB - Diverse previous epidemiological studies have associated the risk of gastric cancer (CG) with the nitrate content of drinking water in certain high risk areas in Columbia and Denmark, but in other countries no relation has been found and the topic is still controversial. In the present study and analysis is made of the differential risk of gastric cancer in the province of Soria (Spain) in terms of mortality and incidence in each of the natural regions of this province, investigating an eventual correlation with the nitrate content of the drinking water. Although the maximum nitrate content found barely exceeded the maximum limits suggested by the WHO, these values have a statistically significant positive linear correlation with the adjusted mortality (p less than 0.01) and incidence rates of gastric cancer in men (p less than 0.05). The authors discuss the need for further investigation of the topic in Spain since the nitrate values encountered might not reflect the true magnitude of environmental nitrate exposure, or there could be other factors related to agricultural work in the grain-producing regions where the maximum rates of gastric cancer in men are recorded. PMID- 2762638 TI - [Prevalence of peptic ulcer in smokers and non-smokers in Aragon]. AB - The present study has attempted to determine the prevalence of peptic ulcer (UP) in smokers and nonsmokers in the geographic region of Aragon (Spain) using a sample of 10,000 subjects, 1,897 with ulcer, 1,708 of them diagnosed by endoscopy. The prevalence of smokers is 42.4% (63% of males and 14% of females). The prevalence of peptic ulcer in smokers (26.87%) is double that of nonsmokers (13.38%) (p less than 0.05). In males, all of the locations (duodenal, duodenal + gastric and gastric) are more common among smokers than among nonsmokers. These differences do not exist in women, gastric ulcer being more common among nonsmokers. Complications were more frequent among smokers with ulcer (60%) than among nonsmokers with ulcer (40%). PMID- 2762639 TI - [Course of cellular immunity in patients with chronic inflammatory intestinal disease]. AB - In a preliminary study of the immunological aspects of intestinal inflammatory disease we found an immunological deficit of T helper lymphocytes, decreased monocytes and chemotaxis and poor response to nonspecific mitogen stimulus. Based on these findings, the study was repeated in the same patients three years later to confirm the evolution of this deficit. Recuperation was observed in the cases in which the disease evolved favorably, suggesting that certain aspects of the immune disorder might be secondary. PMID- 2762640 TI - [Atypical locations of tuberculosis of the colon]. AB - We present four cases of tuberculosis of the colon in the form of multiple segmental lesions located in the ascendant, transverse and descendant colon. We comment on the rarity of these locations and how they are easily confused with other diseases, like adenocarcinoma or Crohn's disease. For a correct diagnosis, affectation of the cecum and terminal ileum is useful. In cases in which these zones are not involved, differentiation is very difficult and can only achieved by bacteriological and histological studies after colonoscopy and biopsy. PMID- 2762641 TI - [Internal lateral sphincterectomy. Results]. AB - In January 1986 we initiated a prospective study in our center to evaluate the results of surgery in patients with anal fissure. Three groups were considered according to type of surgery: internal lateral sphincterotomy (ELI), lateral sphincterotomy and resection of cutaneous fibroma (ELI + FC), and sphincterotomy with hemorrhoidectomy (E + H). The basic objective was to evaluate postoperative pain, days of hospitalization and out-patient follow-up, complications and number of recurrences. Postoperative pain occurred in 12% of internal lateral sphincterotomies, in 42% of lateral sphincterotomies with resection of cutaneous fibroma in 50% of sphincterotomies with hemorrhoidectomy, as measured by the number of patients who requested analgesics. The hospital stay was similar in the first two groups (96 and 90% less than 24 hours) and longer in the third (50% greater than 24 hours). Out-patient follow-up was limited to one visit in 90% of internal lateral sphincterotomies, while 85% of internal lateral sphincterotomies + fibroma resection required more than two visits and 100% of sphincterotomies with hemorrhoidectomy needed three or more. Nine percent of those operated had mild complications like low fever, ecchymoses, fistula or wound infection. No patient presented incontinence or recurrence of the fissure. We conclude that internal lateral sphincterotomy is an ideal procedure for the treatment of anal fissure and, if possible, additional surgery should be avoided, however insignificant it may appear. PMID- 2762642 TI - [Cystadenoma of the pancreas: presentation of 3 new cases]. AB - The authors contribute three new cases of pancreatic cystadenoma, two of the mucinous variety and one microcystic-serous, to the series of cases that have appeared in the recent literature. Emphasis is placed on the importance of a correct surgical strategy in the approach to the problem of cystic pancreatic tumors. The importance of microscopic study of the varieties of cystadenoma and their possible prognostic implications are considered. PMID- 2762643 TI - [Double esophageal membrane in a patient with Plummer-Vinson syndrome]. AB - A case is presented of a 27-year-old patient with Plummer-Vinson syndrome. Radiological and endoscopic study detected a double membrane in the cervical esophagus. After esophageal dilation, dysphagia remitted and the patient remains asymptomatic. PMID- 2762644 TI - [Esophageal pseudomotor]. AB - A patient was referred by Zone Cardiology due to the absence of heart disease in spite of a history suggestive of coronary ischemia and occasional dysphagia. We performed EDA and encountered a submucous mass that was depressible by the endoscope and pulsatile. Biopsy was not performed, but PA-lateral X-ray disclosed a large aortic aneurysm that was later confirmed by CAT. PMID- 2762645 TI - [Cancer of the colon with a duodenal fistula. Its surgical treatment]. AB - The authors present an infrequent case: fistulization of a colonic cancer to duodenum. A side from its rarity, the case is interesting from the surgical point of view. Not many years ago, the fact that carcinoma of the hepatic angle had infiltrated the duodenum was interpreted as a sign of nonresectability. Now prognosis is not considered to depend on this complication, but instead, on tumoral stage, as in any other colonic tumor. The ideal technique is block resection, which requires enlarged right hemicolectomy and partial excision of the duodenum, if possible, or cephalic duodenopancreatectomy in selected cases. Although appreciable survival rates have been reported in this situation, the most important benefit may be an improved quality of life for the patient if resection is not curative. PMID- 2762646 TI - [Intestinal cystic pneumatosis producing an acute pseudoappendicular picture]. AB - The authors present a new case of intestinal cystic pneumatosis that presented with a picture similar to acute appendicitis. The literature was reviewed without finding any case of this form of presentation and the characteristics of the disease are summarized. The advantages of separately classifying cases of necrosing acute enteritis are indicated. PMID- 2762647 TI - [Suprarenal myelolipoma: an infrequent cause of acute abdomen]. AB - Adrenal myelolipoma is a benign tumor associated with chronic disease and a long survival after surgical exeresis. It is scarcely symptomatic and only exceptionally has an acute onset, wherein lies the interest of this report. PMID- 2762648 TI - [Gastric volvulus and diaphragm relaxation]. PMID- 2762649 TI - [Tuberculosis of the cecum. Presentation of a new case]. PMID- 2762651 TI - [Lack of clarity in medical articles. Apropos of 1 case]. PMID- 2762650 TI - [Pneumoperitoneum caused by acute appendicitis]. PMID- 2762652 TI - [Basal lipid energy utilization in obese women and men]. AB - In 16 abdominal type obese males, in 16 gluteal-femoral type obese females and in 10 nonobese males and 9 nonobese females, as controls, the influence of body fat distribution on basal lipid oxidation was evaluated by indirect calorimetry. Basal lipid oxidation was significantly higher in the obese males (1.21 +/- 0.12 g/kg-FFM.die) than in the nonobese males (0.47 +/- 0.13 g/kg-FFM.die; p less than 0.001), but not significantly different between obese and nonobese females (0.98 +/- 0.16 and 0.89 +/- 0.13 g/kg-FFM.die; p ns). A significant correlation between basal lipid oxidation and percentage of body fat was found only in the male subjects (r = 0.51; p less than 0.01). These results suggest that basal lipid oxidation differs in the two sexes according to adipose tissue anatomic location. PMID- 2762653 TI - [Hospital pseudo-infections caused by Mycobacterium gordonae]. AB - Sputum specimens from 15 patients with respiratory disease were reported to have positive cultures for Mycobacterium gordonae, an organism generally considered to be non-pathogenic for man. None showed typical radiological changes for mycobacteriosis. Mycobacterium gordonae was also isolated from some components of the aerosol therapy instrument. Because aerosol therapy was used for 4 patients only, we were not able to establish whether the Mycobacterium gordonae was only a colonizer. We suggest that its isolation in culture must be evaluated in an adequate clinical context before concluding that it is pathogenic. PMID- 2762654 TI - [Echocardiographic changes in primary autoimmune hypothyroidism]. AB - Echocardiographic features in patients with autoimmune hypothyroidism have been described. Plasma levels of T3, T4 and TSH have been compared with the severity of the echocardiographic alterations. Echocardiography demonstrated abnormalities more frequently in patients with severe hypothyroidism. No pericardial effusion has been detected. We discuss the possible etiopathogenic mechanisms. PMID- 2762655 TI - [Peritoneovenous shunt complicating a glomerulonephritis associated with bacteremia. Description of a clinical case]. AB - We report the case of a patient who exhibited a complication following implantation of the LeVeen valve. This is the first example of a delayed complication in our experience, occurring approximately 3 years after the implantation. Biochemical and clinical data showed bacteremia due to meningococci resulting from the valve (and this was subsequently confirmed by microbiological data). PMID- 2762656 TI - [Fibrodysplasia ossificans progressiva or Munchmeyer's disease. Personal observation]. AB - We report here a case of fibrodysplasia ossificans progressiva in a 14-year-old boy, affected from birth by microdactyly of the big toes. This skeletal abnormality also existed in his paternal great-grandfather. When he was 7, some ectopic ossifications occurred and inexorably progressed despite all therapies. Fibrodysplasia ossificans progressiva is a serious and rare disease with a terrible development, leading to a sort of petrifaction of the patient. The lack of knowledge on this ectopic ossification process explains the want of suitable treatments to stop the course of this disease. PMID- 2762657 TI - [Severe hypopotassemia and rhabdomyolysis in a normotensive subject after use of a nasal spray containing 9-alpha-fluoroprednisolone]. AB - We report the case of a 16-year-old boy who was admitted to our hospital for acute urinary retention, flaccid paralysis of the legs and arms and rhabdomyolysis due to a nasal spray containing 9-alpha-fluoroprednisolone. In our normotensive subject, rhabdomyolysis occurred after vigorous physical activity performed before the administration. The case emphasizes the need to avoid the use of 9-alpha-fluoroprednisolone considering its intense mineralocorticoid activity. PMID- 2762658 TI - [Platelet aggregation inhibitory therapy in chronic arterial occlusive disease of the lower limbs: results of short-term clinico-instrumental study with indobufen]. AB - Aim of our study was to evaluate the effectiveness of indobufen in the treatment of II degree stage lower limb occlusive arterial disease. Forty patients were randomly assigned to the iIndobufen (400 mg/die) treatment group or the no treatment control group (20 patients each). Doppler pressure measurement (Winsor index) and subjective symptomatology were evaluated at the time of enrollment and after one month. A significant improvement (p less than 0.01) was noted only in the treated group. We conclude that indobufen may be of therapeutic value in the treatment of peripheral occlusive arterial disease. PMID- 2762659 TI - [Autonomic neuropathy in type I diabetes in children]. AB - We tested some cardiovascular reflexes (Valsalva ratio, deep-breathing, postural hypotension) in 53 subjects suffering from diabetes type I in childhood with an average disease length of 13 +/- 6 years, in order to estimate possible damage to the autonomic nervous system without clinical symptomatology. A rather high percentage of signs of neurovegetative involvement combined with the progressive increase of further complications during the course of the disease, suggests early neurologic damage. We confirm the sensitivity of adopted tests and deep breathing in particular. PMID- 2762660 TI - [Study of variations in hematologic parameters in rugby players undergoing physical training at a high altitude]. AB - Thirty-three well-trained rugby players, ranging in age from 18 to 30 years, were studied during basal training for one year. Peripheral blood parameters and iron metabolism indices were investigated before, during and at the end of the season. The hematologic status showed no substantial changes with respect to physical activity even if considered by age and team-role. However, a significant reduction (P less than 0.001) in RBC count, hemoglobin, hematocrit, serum iron, plasma transferrin and ferritin, was observed when compared with those obtained from a group of healthy untrained controls. Since the decrease in serum iron and ferritin concentrations was significant so as to justify a similar reduction in Hb and Ht values, two pathogenic mechanisms must be considered: e.g., a moderate hemodilution secondary to plasma expansion combined with a decrease in iron stores caused by chronic iron loss through feces, profound sweat and urine. The present study demonstrates that mild anemia (sports anemia) may develop in well trained rugby players with heavy physical work load, due to increased plasma volume with a relative thinning of RBCs. This pseudo-anemic condition is associated with a reduction in iron stores which can lead to a true iron deficiency anemia. A yearly blood test and, if necessary, iron supplementation could prevent this condition. PMID- 2762661 TI - Functional gut disorders and health care seeking behavior in an Italian non patient population. AB - We conducted a survey on functional gut disorders and health care seeking behavior in a large non-patient population of an Italian region (Umbria). 533 subjects were interviewed by means of a specific questionnaire. 44 (8.5%) reported symptoms compatible with the irritable bowel syndrome, 30 (5.8%) had non colonic pain, 48 (9.2%) chronic constipation, and 20 (3.8%) dyspepsia. It is concluded that in our region there is a relatively high percentage of subjects that do not commonly seek health care, although affected by functional gut disorders. PMID- 2762662 TI - [Evaluation of the antigliadin antibody titer in adult celiac disease]. AB - Serum gliadin antibodies of the IgA and IgG isotypes were assessed with an enzyme linked immunosorbent assay technique in adults during different phases of coeliac disease (30 on a gluten-containing diet and 24 on a gluten-free diet), in patients with other gastrointestinal disorders (Crohn's disease, ulcerative colitis) and in healthy controls. Significantly higher antibody values were found in 70% of coeliacs on a gluten-containing diet, compared with the findings in the healthy controls and with those in the same subjects after one year on a gluten free diet. Serum antibodies of the IgA class were associated with severe small intestine villous atrophy and were found exclusively in coeliac disease. Gliadin antibodies of IgG class were less disease-specific and were occasionally detected in sera from patients with gastrointestinal diseases and in 6% of healthy controls. PMID- 2762663 TI - Intrarticular methotrexate in the therapy of rheumatoid arthritis. AB - Five patients with oligoarticular rheumatoid arthritis were treated with intra articular injections of methotrexate and orgotein in the knee joints. The employed dose of the antimetabolite was very low and orgotein was simultaneously administered to prevent local tissues from cytolysis-related damage. Clinical results were fairly good and support the hypothesis that methotrexate may be used intra-articularly as an immunosuppressor rather than at the heavily toxic doses required for a cytostatic effect. PMID- 2762664 TI - [Clinical study of picotamide in patients with vascular diseases]. AB - The authors report on a group of 44 patients operated on for vascular disease, treated with antiplatelet therapy (picotamide). These patients were followed up for a period of 12 months with clinical and instrumental controls (Doppler ultrasound) in order to evaluate the evolution of atherosclerotic disease. PMID- 2762665 TI - Treatment of tumor-induced osteolysis by APD. AB - Bisphosphonates, associated with rehydration, became the treatment of choice of malignant hypercalcemia when it became apparent that these compounds normalized plasma calcium in most cases within a few days and with almost no side effects, and that their effect was prolonged. Dichloromethylene bisphosphonate and aminobisphosphonate, especially APD, were shown to inhibit bone resorption with no noticeable inhibition of bone formation, and were highly effective in the long term treatment of Paget's disease. APD was used in almost 300 patients with malignant hypercalcemia published in the literature and has been used in the medical clinic at Lausanne for several years. When given to 14 patients with malignant hypercalcemia at the dose of 25 mg/day until plasma calcium became normal for two consecutive days, APD had to be given for 4-11 days, severe hypercalcemia needing longer treatment than mild hypercalcemia (Adami et al. 1982). When given for a fixed period of 6 days, again plasma calcium normalized in all patients, whether APD was given i.v. (30 mg/day, ten patients) or orally (1200 mg/day, ten patients) (Adami et al. 1985). Further shortening of the treatment to one single infusion given over 24 h did not decrease the efficacy, as long as high enough doses were given (Blomqvist 1986). For severe hypercalcemia of above 3.5 mmol/liter 60-90 mg had to be given, while 30-45 mg was sufficient in milder cases (Body 1984). Otherwise, mild, transient, and asymptomatic hypocalcemia could occur. Normalization of plasma calcium went along with clinical improvement, sometimes even with correction of coma. Renal function was improved, even when the initial plasma creatinine levels were up to twice normal. Hypercalcemia could reoccur, but the duration of the effect of APD (1 week to several months) depended among other things on the dose administered. The decrease in plasma calcium was accompanied by a decrease in urinary calcium and hydroxyproline, both showing inhibition of bone resorption. In the case of recurrency, the treatment could be repeated with almost unaltered efficacy, except in end-stage cancer disease. When given to 13 normocalcemic patients with bone metastases from breast cancer, hydroxyproline and urinary calcium again decreased. Bone pains and radiologic signs of metastatic bone resorption also showed significant improvement, although these latter effects could also be explained by the antitumoral treatment, in this uncontrolled open trial.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2762666 TI - Effects of impermeant medium ions on the composition of rabbit renal cortical slices. AB - When incubated in isosmotic oxygenated medium in which chloride was completely replaced by gluconate, rabbit renal cortical slices lost chloride with sodium, potassium and water before reaching a new steady-state composition after 15-30 min. When corrected for extracellular space, there was an electroneutral loss of alkali metal cations (Na + K) with chloride, accompanied by isosmotic loss of water from the cells. The losses of chloride and water were independent of medium pH over the range of 6.4-8.2, and were the same with potassium rather than sodium as the dominant medium cation. Incubation in isosmotic sodium chloride medium restored tissue composition of slices transferred from gluconate medium. This recovery was not dependent specifically upon medium chloride, for slice water content also recovered when nitrate rather than chloride was substituted for medium gluconate. With sodium completely replaced by n-methyl d-glucamine (nmdG+), cells in slices lost far more sodium and potassium than chloride before reaching a new steady-state composition after some 30 min. However, the loss of water was as predicted from the total losses of measured inorganic ions. With sodium and chloride completely replaced by nmdG+ and gluconate, there was a greater loss of water than found with unilateral substitutions. Again, the combined loss of diffusible inorganic cations exceeded the loss of chloride but the water loss was that expected for isosmotic loss accompanying the measured losses of ions. These results reveal that both gluconate and nmdG+ behave as impermeant ions in this tissue preparation. It is suggested that, in the absence of medium sodium, sodium-hydrogen exchange is inhibited. Retained hydrogen ions are buffered on charged cellular non-diffusible solutes and the associated hydroxyl (or bicarbonate) ions are lost from the cells accompanied by the inorganic univalent cations lost in excess of chloride in nmdG+ medium. PMID- 2762668 TI - Breast pathology. PMID- 2762667 TI - Action of aldosterone on citrate synthase in cultured renal collecting duct cells. AB - Cultured renal collecting duct cells from neonatal rabbit kidney were used to examine the influence of aldosterone on enzymatic activity of citrate synthase during increase in Na+ transport. Control epithelia showed citrate synthase activity of 71 +/- 3 mU/mg protein (n = 28), while after aldosterone treatment citrate synthase activity was significantly increased to 79 +/- 6 mU/mg at 1 h (n = 5), to 88 +/- 6 mU/mg at 2 h (n = 6) and to 93 +/- 8 mU/mg protein at 3 h (n = 5). Citrate synthase activity subsequently decreased to basal values. Spironolactone fully blocked the aldosterone-induced increase in citrate synthase activity. The time course of enzyme stimulation after aldosterone administration indicates that the hormone activates citrate synthase during the physiological early response phase. PMID- 2762669 TI - Atypia in fine-needle aspiration cytology of the breast: a histologic follow-up study of 301 cases. AB - A gray area of uncertainty exists in fine-needle aspiration (FNA) cytology of the breast in which common criteria to distinguish benign from malignant lesions overlap. Aims of this study were to define this area and to evaluate statistically cytomorphologic criteria in a semiquantitative analysis. In a test set of specimens from well-differentiated carcinomas and benign proliferative lesions, signs of malignancy were cell dissociation, arrangement in small clusters, nuclei greater than 16 microns, anisonucleosis, irregular nuclear borders, nucleoli, and necrosis. Features in favor of benignancy were large monolayers, nuclei less than 16 microns without variation in size, smooth nuclear borders, and bipolar nuclei in the monolayers. Originally the term "atypia" had been applied to 956 (12%) of all FNAs of the breast performed at our institute from 1974 to 1985. Using these criteria in a review of all 301 cases in which histologic follow-up and cellular smears were available, much better results were obtained than originally; specificity increased from 80% to 95%, and sensitivity increased from 60% to 90%. The number of overdiagnoses decreased from 24 to seven, and underdiagnoses decreased from 57 to nine. In this selected series, the area of uncertainty was restricted to 16% of the cases; the number of these cases that proved to be malignant and benign was equal. In such cases of indistinct cytomorphologic criteria, a surgical biopsy is indicated for histologic studies. PMID- 2762670 TI - Carcinoma in situ in sclerosing adenosis of the breast: an immunocytochemical study. AB - In this report, seven cases of sclerosing adenosis of the breast are reported in which a lobular (5) or ductal (2) in situ carcinoma was also present. In two cases, mastectomy was performed because invasive carcinoma was diagnosed on frozen section. In the other cases, the referring pathologists initially considered the diagnosis of invasive carcinoma. A well-defined PAS-positive basal lamina (BL) was always present around the proliferating glandular structures. In addition, residual myoepithelial cells lying on the BL were immunologically demonstrated, a feature usually seen in in situ carcinomas. Therefore, it appears that the study of BL and myoepithelial cells should be added to pattern recognition in the diagnosis of these lesions. PMID- 2762671 TI - Head and neck cancer. PMID- 2762672 TI - Recombinant human erythropoietin therapy. Part II: Patient management. PMID- 2762673 TI - [Malignant hyperthermia during alcohol withdrawal]. AB - Heat shock is the consequence of malignant hyperthermia triggered by general anaesthesia, the use of neuroleptic drugs, or strenuous muscular exercise. Chronic alcoholism could be a contributing factor by facilitating the triggering of malignant hyperthermia. We describe two cases of malignant hyperthermia which occurred during the summer in undernourished chronic alcoholics showing withdrawal syndrome during their stay in hospital. General anaesthesia and neuroleptics were excluded as the origin of their malignant hyperthermia, and we looked for new mechanisms to explain the heat shock, other than shivering associated with the withdrawal syndrome or the high temperature of the season. These two patients were considered deficient in thiamine on admission, their plasma pyruvic acid level being sharply increased (185 mumol/l and 304 mumol/l respectively; normal range: 45.6-91.2 mumol/l). This deficiency can lead to disregulation of thermal centres. Other metabolic disorders, frequently observed in alcoholics, could facilitate heat release during withdrawal syndrome shivering. The risk of heat shock during abrupt alcohol withdrawal should not be underestimated. PMID- 2762674 TI - [Severity of desmoid tumors with retroperitoneal development in Gardner's syndrome. Apropos of 2 cases]. AB - We report two cases of retroperitoneal desmoid tumours in patients with Gardner's syndrome. These tumours are rare and of poor prognosis. In our two cases, the predominant clinical manifestations were caused by compression of the ureters, bladder and nerve roots. In the first patient, the tumours developed after colectomy, while in the second patient the discovery of the desmoid tumour preceded that of a cancer of the colon. Finally, in the first patient, an attempted treatment with a non-steroidal anti-inflammatory agent (sulindac) had to be discontinued after 4 months on account of side-effects. PMID- 2762675 TI - [Hypereosinophilic syndrome in a HIV I+ patient]. PMID- 2762676 TI - [Clinical and pharmacokinetic study of amikacin during repeated intramuscular administration in elderly patients]. AB - Pharmacokinetics of amikacin in elderly patients during repeated intramuscular administration. The aim of the study was to evaluate a standard dosage of Amikacin, 7.5 mg/kg every 12 hours, in elderly subjects whose renal function was reduced by half, in view of the narrow therapeutic interval of the aminoglycosides. Twelve subjects, aged from 72 to 96 years (mean age: 82 years; mean weight: 58.7 kg) and suffering from severe infections, were therefore treated with intramuscular Amikacin as monotherapy at the dosage of 7.5 mg/kg repeated every 12 hours for 5 days. Clinical, biological (creatinine clearance estimated by the method of Cockroft) and bacteriological data were recorded on D0 and D5. The pharmacokinetic study included plasma Amikacin assays at the following times: D0 (control), D1 (1h, 3h, 6h, 12h), D2 (24h, 25h, 27h, 36h), D3 (48h, 49h), D5 (96h, 97h, 99h, 102h, 105h, 108h), D6 (120h, 132h). Clinical success was observed in 9 out of the 12 cases, with no undesirable side effects. At this age and at this dosage, peak concentrations (Cmax) remain close to the required "therapeutic" levels, 25 to 30 mcg/ml; the residual concentrations (Cmin), highly-correlated with creatinine clearance values, are also close to the desired levels (4-10 mcg/ml). The absence of side effects, and in particular the lack of renal side effects, during this treatment trial suggest that the usual dosage of Amikacin IM, 7.5 mg/kg/12 h, need not be reduced in elderly subjects if creatinine clearance remains above 30 ml/mn and if the treatment is of short duration. PMID- 2762677 TI - [A new case of hypoglycemic hemiplegia]. PMID- 2762678 TI - [Hypoglycemic hemiplegia]. PMID- 2762679 TI - [A forgotten cause of pyopneumothorax: tuberculosis]. PMID- 2762680 TI - [Typhoid fevers complicated by acute renal failure, by rhabdomyolysis and by acute pancreatitis]. PMID- 2762681 TI - [Pseudoleukemic hypereosinophilia accompanying metastatic malignant hemangioendothelioma of the heart]. PMID- 2762682 TI - Surface electromyography of pelvic floor muscles in healthy children. Methodological study. AB - Pelvic floor muscle activity was recorded in ten healthy children, aged six to ten years, by using surface electromyography and a polygraph writer. The electromyograms were recorded simultaneously from four electrode pairs on the perineum and three electrode pairs on adjacent muscle groups, i.e. hip and abdominis muscles. The children performed ten different manoeuvres. Necessary prerequisites for this investigatory method include good electrode application, adequate instruction of the child and the child's adjustment to the method. Using the described procedure, it was possible to record pelvic floor muscle activity without any appreciably detectable electrical influence from adjacent muscles. The method sometimes allows selective recording of electromyographic activity between the ventral urogenital and the dorsal anal regions. Therefore both anal and urethral electrode pairs should be used to achieve functional information about the pelvic floor muscles. The envisaged method should be useful as a tool for assessment of pelvic floor muscle exercises in children with voiding disorders. PMID- 2762683 TI - The quality of outpatient psychiatric care. A survey of patient satisfaction in a sectorised care organisation. AB - Patient satisfaction with outpatient psychiatric care in a sectorised care organisation was studied by means of a mailed questionnaire to a one-year population of patients. Response rate was 40.7%. The results showed a high general satisfaction with treatment. Satisfaction was highest in areas of treatment planning/treatment design, treatment accomplishment and relationship to staff. A somewhat lower level of satisfaction was noted concerning information and coinfluence of the patient. Level of satisfaction was not related to social and psychiatric background characteristics. Patients with longer time in therapy showed a higher level of satisfaction. Patients' ratings of the quality of information and coinfluence were related to both satisfaction with treatment and treatment outcome, pointing to the importance of these factors for course of treatment and treatment success. A comparison with patient satisfaction with in hospital care revealed significant differences in favour of the outpatient group. It is concluded that surveys of patient satisfaction with care may be a important and useful tool in the evaluation of changes in care organisations and in the monitoring of quality assurance standards. PMID- 2762684 TI - Variations between midwives regarding administration of obstetrical analgesia. AB - Variations among 32 midwives involved in a total of 1578 deliveries were studied regarding attitudes to and use of obstetrical analgesia. Relevant data were obtained from the register of the maternity department of a Swedish regional hospital. This was complemented with information about the midwives' attitudes to pharmacological pain relief in labour and delivery, collected by means of a mailed questionnaire. Variations between midwives (range), expressed as percentages of each midwife's total number of deliveries, were considerable: epidural block (EDA), 9-48%; Pethidine, 0-41%; Entonox (N2O/O2), 8-62%; pudendal block (PDB), 11-71%. Midwives working on night-shift used less EDA, but more pethidine, than their day-shift colleagues. 59% of all the midwives were critical of current levels of obstetrical use of analgesics in Sweden, while 41% felt the level to be about right. Night-shift midwives were rather more critical than day shift midwives. Midwives critical of current levels of obstetric medication used EDA and PDB less often than their more enthusiastic colleagues, but the difference was not statistically significant. On the other hand, critical midwives used more Pethidine (p less than 0.05) and also more Entonox than their less critical colleagues, though again the difference was statistically non significant. PMID- 2762685 TI - Sleep and wakefulness in normal preadolescent children. AB - Eighteen healthy children, 9 boys and 9 girls, between 8 and 12 years of age were examined with polygraphic sleep records, multiple sleep latency tests (MSLTs), and measurements of reaction times. Sleep was recorded at home on Oxford Medilog 9 channel cassette tape recorders (Oxford Medical Systems, Abingdon, U.K.) and sleep staging was performed from the screen of the display unit. Two consecutive nights were recorded. MSLT was done in the laboratory. The subjects were given 30 min to fall asleep on four occasions during the day after the last recorded night of sleep. Reaction times were measured repeatedly between each MSLT trial. More slow wave sleep was found in this study compared to others. Also, the first night effect was slight. It is proposed that this is due to the fact that the recordings were performed at home. The initial sleep cycle was incomplete in almost all subjects. A sleep stage with traits of both rapid eye movement (REM) and non-REM could be seen in this cycle, probably representing an abortive REM period. MSLT confirmed the low daytime sleepiness in healthy preadolescent children. A sleep latency of 10 min or less on two or more sleep trials, or a daily mean sleep latency of less than 20 min, is rarely seen in this age group. The reaction times were within normal limits for the age of the subjects. Nighttime sleep values, daytime sleep latencies, and reaction times were not correlated in these normal-sleeping children. PMID- 2762686 TI - Sleep and nighttime pruritus in children with atopic dermatitis. AB - The number of scratching episodes and average frequency with which they started during each sleep stage as well as the effects of nighttime pruritus on objective sleep parameters in nine children with atopic dermatitis were assessed in the sleep laboratory. Scratching episodes occurred during rapid eye movement (REM) sleep and non-REM (NREM) sleep. The largest average frequency corresponded to stage 1, followed by stage 2, REM sleep, stage 4, and stage 3. Sleep maintenance was markedly altered. Total sleep time decrease was related mainly to smaller amounts of stage 4 NREM sleep. REM sleep percentage of total sleep time was increased as compared with normal children of the same age. Furthermore, in six of nine patients REM sleep latency was found to be decreased. PMID- 2762687 TI - Polysomnographic assessment of DIMS: empirical evaluation of its diagnostic value. AB - This investigation examined the diagnostic value of polysomnography (PSG) for evaluating disorders of initiating and maintaining sleep (DIMS). The sample consisted of 100 outpatients who presented to the Duke Sleep Disorders Center with a complaint of chronic insomnia. All patients were given comprehensive medical, psychiatric, behavioral, and ambulatory PSG evaluations. Sleep disorder diagnoses were assigned using the criteria of the Association of Sleep Disorders Centers. Overall, PSG yielded important diagnostic information in 65% of the sample: 34% were given a primary sleep disorder diagnosis that was heavily dependent on PSG data [periodic movements of sleep (PMS) = 25%, apnea = 3%, and subjective insomnia = 6%]; 15% were given a secondary diagnosis of one of these three disorders; and PSG ruled out suspected PMS in 9% and sleep apnea in 7% of the sample. Patients greater than 40 years of age had a significantly higher rate of positive PSG findings than younger patients. Using only the clinical exam, two experienced sleep clinicians were able to predict only 14 of 25 PMS cases and one of three cases of sleep apnea. Based on these data, we suggest using PSG routinely with older insomniacs and with younger patients who fail initial treatment. PMID- 2762688 TI - Sleepiness and nap sleep following a morning dose of clonidine. AB - The effects of a single oral dose of clonidine on morning nap sleep and daytime sleepiness were evaluated in 18 normal young adult male volunteers aged 18-21 years. Polysomnography and subjective sleepiness (Stanford Sleepiness Scale and linear analog sleepiness rating scale) measures were obtained on 2 mornings. Half the subjects received placebo and half clonidine (0.25-0.3 mg) on both occasions. Subjects were instructed to stay awake on the first morning (wake) and to sleep on the second (sleep). Efforts were made to help subjects maintain arousal on the wake day. Results from the wake morning showed that clonidine subjects were significantly sleepier than placebo subjects as measured by introspection. In addition, clonidine subjects tended to have more polysomnographic signs of sleepiness (microsleeps) when not actively aroused. On the sleep morning, clonidine and placebo subjects slept for approximately 90% of the 3-h nap. Stage 1 and rapid-eye-movement (REM) sleep were significantly reduced and stage 2 sleep significantly increased in the clonidine group. In conclusion, a morning dose of clonidine produced profound sedation in waking subjects and marked REM suppression in sleeping subjects. PMID- 2762689 TI - Comparison between the results of an automatic and a visual scoring of sleep EEG recordings. AB - In this paper, results from the visual scoring of nocturnal polygraphic recordings, carried out by nine different groups of readers from different Italian sleep laboratories, are analyzed; inter-and intragroup variability is shown and statistically discussed. Data are then compared with the results of an automatic scoring of the same recordings, carried out by the Medilog Sleep Stager. The validity of this automatic method of scoring is discussed. Finally, an epoch by epoch analysis is described, with the aim of achieving a more detailed evaluation of the intergroup variability. PMID- 2762690 TI - A method for checking interobserver reliability in observational sleep studies. AB - Disturbances of the sleep/wake cycle occur frequently in nursing home residents. Because of the many technical difficulties in studying sleep and rhythms in such patients, systematic behavioral observations offer an alternative approach. In this study we describe a method for determining interrater reliability of such observations. Two individuals observed 39 nursing home residents four times per hour during daytime and nighttime hours. Results indicated high interrater reliability for both sleep/wake and the presence of apnea during sleep. Both day and night observations were made reliably. We found only 101 discrepancies of 1.160 tandem observations. These results suggests that behavioral observations are a viable approach in the study of the sleep/wake cycle in nursing home settings. PMID- 2762691 TI - Nocturnal penile tumescence in healthy 20- to 59-year-olds: a revisit. AB - This report presents data on normative nocturnal penile tumescence (NPT), based on a study of 48 healthy men aged 20-59 years, without complaints of erectile dysfunction. In general, the current measures show good concordance with those reported by Karacan and colleagues in 1976. The effect of "pathology-free" aging (from age 20 to 59) on electrographic measures of NPT is relatively modest, accounting for 8.4-14.4% of the variance. Furthermore, no age effect on visual estimates of erectile fullness or on buckling force estimates of penile rigidity were present. Maximum buckling force and maximum erectile fullness showed stability across the four decades of the Pittsburgh sample. PMID- 2762692 TI - H-reflex suppression and autonomic activation during lucid REM sleep: a case study. AB - A single subject, a proficient lucid dreamer experienced with signaling the onset of lucidity (reflective consciousness of dreaming) by means of voluntary eye movements, spent 4 nonconsecutive nights in the sleep laboratory. The subject reported becoming lucid and signaling in 8 of the 18 rapid-eye movement (REM) periods recorded. Ten lucid dream reports were verified by polygraphic examination of signals, providing a total of 12.5 min of signal-verified lucid REM. H-Reflex amplitude was recorded every 5 s, along with continuous recording of electroencephalogram, electrooculogram, electromyogram, electrocardiogram, finger pulse, and respiration. Significant findings included greater mean H reflex suppression during lucid REM sleep than during nonlucid REM and correlations of H-reflex suppression with increased eye movement density, heart rate, and respiration rate. These results support previous studies reporting that lucid REM is not, as might be supposed, a state closer to awakening than ordinary, or nonlucid, REM; rather, lucid dreaming occurs during unequivocal REM sleep and is characteristically associated with phasic REM activation. PMID- 2762693 TI - International Symposium on Vaccine Development and Utilization. Washington, D.C., 9-10 June 1986. Proceedings. PMID- 2762694 TI - Implementation of vaccine programs in Ecuador. AB - The experience in Ecuador with various immunization strategies between 1971 and 1984 and their impact on immunization coverage and morbidity due to vaccine preventable diseases are described. A national campaign of social mobilization was undertaken in 1986, raising coverage levels substantially. PMID- 2762695 TI - Expanded Programme on Immunization in Nigeria. AB - A brief description is given of the Expanded Programme on Immunization in Nigeria, which emphasizes the use of fixed facilities with outreach extension. PMID- 2762696 TI - Mobilization for an Expanded Programme on Immunization in Somalia. AB - Political commitment, adequate planning, careful logistics and media preparation, and adequate supervision, coupled with house-to-house registration of vaccines, including follow-up of nonattendees, were important ingredients in accelerating and improving immunization coverage in Somalia. Satellite immunization sites with outreach teams, along with utilization of traditional birth attendants to channel mothers, are planned to ensure sustainability of achievements. PMID- 2762697 TI - Expanded Programme on Immunization in Thailand. AB - In 1976, despite a 20-year immunization program, vaccine-preventable diseases (other than smallpox) remained important causes of morbidity and mortality in Thailand. Three major problems were identified: a lack of proper target age groups, inadequate vaccination coverage, and a defective cold chain. The National Expanded Programme on Immunization (EPI), focusing on diphtheria, pertussis, tetanus, poliomyelitis, measles, and tuberculosis, was initiated on a nationwide basis in 1977. Data indicate that the program has reduced morbidity and mortality from most vaccine-preventable diseases in Thailand. The goal of the EPI is to have every eligible child fully immunized with efficacious vaccines by 1990. Strategies have been developed and are being used by the "accelerated EPI" to achieve this goal. PMID- 2762698 TI - Vaccine delivery management. AB - During the typical 12- to 18-month voyage of a vaccine from manufacturer to immunization site, many situations arise in which the cold chain may be interrupted. Extensive efforts have been made in the 1980s to ensure an uninterrupted cold chain through the use of improved equipment and better training of personnel. One important advance is the vaccine cold-chain monitor, which identifies weak spots in the cold chain and prevents the use of heat damaged vaccine. Further improvements will require efforts by the recipient countries (e.g., better use of the private sector for transport and equipment management), by donor agencies (e.g., greater consideration of the operational and maintenance costs of the equipment selected and resolution of fuel shortages), and by industry (e.g., more appropriate packaging and pricing of vaccine, extension of the expiration period, and increased heat stability. PMID- 2762699 TI - Vaccine distribution: an operations research study. AB - The implementation of an immunization program in rural areas is affected by lacunae in the vaccine distribution system. A study conducted in India identified the extent to which irregular supply of vaccines has affected the immunization program. This study also identified other problem areas, such as a faulty cold chain and the need for an improved monitoring and control system and for better supervision. A model was designed to represent the immunization program and was used to assess the performance of the system under different supply conditions and operational policies. The study identified a number of improvements that could be made in the vaccine distribution system. PMID- 2762700 TI - Immunization opportunities taken and missed. AB - A significant proportion of nonvaccination is the result of the failure of the health system to make use of every opportunity for immunization. Answers to the four questions: Who is not vaccinated? Where could vaccinations have been given? When could vaccinations have been given? and Why were vaccinations not given? are important to understanding the epidemiology of nonvaccination. PMID- 2762701 TI - Field evaluation of a simplified unit-dose syringe for administration of measles vaccine. AB - Ezeject is a plungerless syringe prefilled with lyophilized measles vaccine. Ezeject syringes were compared with standard 3-cc syringes and 10-dose measles vaccine vials in the vaccination of 884 Guatemalan infants 8-23 months of age. Vaccination was performed by experienced vaccinators and by individuals without prior vaccination experience who received 2.5-3 hours of training. The overall seroconversion rate following administration was 96%, regardless of the type of syringe used or of the experience of the vaccinator. No significant adverse events were observed in children vaccinated with the new syringes. Although incomplete emptying was noted in 87% of the Ezeject syringes used, this had no effect on the serologic response to measles vaccine. Aspiration for detection of blood before injection of the vaccine was performed significantly (P less than .001) less frequently with Ezeject than with 3-cc syringes by both experienced and inexperienced personnel. Inexperienced vaccinators administered measles vaccine significantly faster (P less than .001) with Ezeject than with 3-cc syringes, but the times were similar for experienced vaccinators. Ezeject is an acceptable alternative to standard syringes for the administration of measles vaccine. Several design modifications that would improve the handling of the device and eliminate the possibility of its reuse have been suggested. PMID- 2762702 TI - Immunization programs and human immunodeficiency virus. AB - The emergence of human immunodeficiency virus (HIV) in epidemic form has implications for immunization programs. Infection with HIV, which is capable of infecting cells of the immune system and which can remain latent for many years, results in profound and progressive immunosuppression. As a consequence, vaccines may not elicit a protective response from HIV-infected individuals. Stimulation of the immune system may also be a cofactor for the progression of infection to AIDS, since stimulated lymphocytes are needed for the replication of HIV. HIV positive individuals may also react differently to vaccines than do uninfected persons. The standard vaccines in use today are extremely safe. The possibility that the excellent safety profile of vaccines may be altered in HIV-positive patients must be considered. Since this virus can be transmitted through exposure to blood and blood products, mass immunization programs must take steps to minimize the possibility of accidental transmission of infection during a mass vaccination program. Finally, the problems and prospect for the testing and use of vaccines to prevent HIV are discussed. PMID- 2762703 TI - Increasing vaccine coverage through new delivery systems: a Sudan approach. AB - Public education, community mobilization, and health education raise the awareness of mothers and families and provide them with the network to see that their children are immunized. In Sudan a birth registration and follow-up system was developed to ensure the full immunization of all newborn children. Three different systems are under investigation in health centers in the Khartoum region to increase the number of children one year of age who are fully immunized. A simple continuous system for health education and the availability of health facilities appear to be important elements in increasing vaccination coverage. PMID- 2762704 TI - Role of nongovernmental agencies in vaccine delivery. AB - Zaire, a large central African country with a population of more than 30 million, has had much experience with nongovernmental agencies in its health sector. Of special importance have been missionary groups that established health facilities and conduct "mobile" health activities in rural areas. They established efficient communications and supply networks, and because they could refrigerate vaccines, they were among the first groups to deliver vaccines in rural areas. Expansion of Expanded Programme on Immunization services to rural areas was only made possible through the efforts of nongovernmental agencies. PMID- 2762705 TI - Global control of vaccine-preventable diseases: how progress can be evaluated. AB - In the developing world, excluding China, less than 40% of infants receive a third dose of diphtheria-tetanus-pertussis or poliovirus vaccines. More than 3 million children still die annually from measles, neonatal tetanus, and pertussis, while more than a quarter of a million children are crippled by poliomyelitis. Acceleration of existing efforts, with the use of approaches that must differ according to the requirements of individual countries, constitutes the overriding priority for the Expanded Programme on Immunization (EPI). In evaluating immunization programs, priority should be placed on monitoring immunization coverage and disease incidence. Routine reports are essential for this purpose, although they may usefully be supplemented by surveys. The problems revealed by an evaluation of immunization programs can be taken as being generic to the health services as a whole, until proven otherwise. Therefore, in remedying these problems, approaches that improve the health services as a whole should be sought. PMID- 2762706 TI - Political, economic, and administrative resources available for the control of vaccine-preventable diseases. AB - The harnessing of broad social mobilization with immunization appears to be the only feasible way of controlling the vaccine-preventable diseases and of achieving universal immunization by 1990. Burkina Faso, Colombia, Nigeria, Syria, and Turkey have marshalled national forces to assist the health sector, with the result that sizeable gains in immunization have been made in the past three years. In these countries effective use has been made of the personal involvement of top political leaders, beginning with presidents and prime ministers. The media has been used to deliver a single message: get your child vaccinated. This message has been reinforced through coalitions involving religious leaders, primary teachers, village heads, policemen, soldiers, and truck drivers. Support has been gathered from nongovernmental organizations and individuals, ranging from Rotary International to actors, comedians, and sports figures. These political, economic, and administrative resources constitute a low-cost, elastic, permanently renewable resource base that can aid health ministers not only in beginning immunization coverage but also in maintaining it. PMID- 2762707 TI - Prospects for universal immunization: strategies for achievement. AB - The technology, experience, management abilities, and international organization now exist for universal immunization coverage in most areas of the world. Unprecedented improvements in immunization coverage have been achieved in recent years because of the collaborative efforts of the international agencies and individual countries. The major barriers still existing can potentially be solved by providing for long-term external support for some countries, by improving the training available to health workers, by enlisting the involvement of political leaders, and by mobilizing all segments of society to improve the health of their children so that immunization does not become the responsibility of the health departments alone. PMID- 2762708 TI - [Urinary incontinence]. PMID- 2762710 TI - [A psychoanalyst with the caregivers]. PMID- 2762709 TI - [At the risk of certain suffering]. PMID- 2762711 TI - [Guiding the family]. PMID- 2762712 TI - [How to help the caregivers in guidance?]. PMID- 2762713 TI - [Bases for nutrition (1). Foods]. PMID- 2762714 TI - [Focus on waiting rooms]. PMID- 2762715 TI - [Nurses in the report]. PMID- 2762716 TI - [Allergies, allergens, and co...]. PMID- 2762717 TI - [Drugs in general anesthesia]. PMID- 2762718 TI - [Helloh ... with the Red Cross--the other side of the coin]. PMID- 2762719 TI - [Splenectomy: technic, postoperative care]. PMID- 2762720 TI - [There always remain forts to be conquered]. PMID- 2762722 TI - [The nursing profession in France]. PMID- 2762721 TI - [Good day, nurses!]. PMID- 2762723 TI - [A model of private-public partnership: continuous chemotherapy at home]. PMID- 2762724 TI - Current concepts in implant dentistry. PMID- 2762725 TI - The shrinking sensory world of the elderly. PMID- 2762726 TI - Relationships between sensory decline among the elderly and the physical environment: implications for health care. Maximizing the wellbeing of the elderly through environmental change is of great importance. AB - There is an unprecedented increase in elderly people who are 85 years of age and older. At this point in life multiple sensory deficits become significant thereby limiting their means for gathering information and social interaction. Without sensory function the world becomes inaccessible. Therefore, it is extremely important to maximize the quality of life among the elderly through environmental means. This will offset the perception that most elderly are cognitively impaired when in fact attention to their sensory loss through adaptive environmental design can maximize well-being. Total wellness is dependent upon it. PMID- 2762727 TI - Ectopic bone in multinodular goiter. PMID- 2762728 TI - Delayed spontaneous splenic rupture in sarcoidosis. PMID- 2762729 TI - Health care needs of homeless and runaway youths. Ama report of the Council on Scientific Affairs. PMID- 2762730 TI - Increased production of IgE protein and IgE antibodies specific for fungal antigens in patients with the acquired immunodeficiency syndrome. AB - Levels of IgE protein and IgE antibodies specific for 8 different allergenic extracts were measured in the serum of a large series of patients infected by the human immunodeficiency virus (HIV) and in HIV-seronegative subjects belonging to the same risk groups (intravenous drug-users, homosexual men and hemophiliacs). The proportion of subjects showing elevated IgE levels was higher among HIV infected patients with group IV disease than among HIV-infected patients with group II-III diseases or seronegative individuals. In addition, many HIV-infected patients with elevated IgE levels showed the presence in their serum of IgE antibodies specific for fungal antigens. PMID- 2762731 TI - HBeAg/anti-HBe circulating immune complexes in patients chronically infected with hepatitis B virus. AB - An enzyme-linked immunosorbent assay based on the ability of polyethylene-glycol (PEG) fixed on a solid support to adsorb circulating macromolecules (PEG-solid phase test) was developed in order to provide evidence for the existence of immune complexes of HBeAg/anti-HBe (HBeAg/anti-HBe complex) in sera of HBsAg chronic carriers. The method can detect HBeAg in immune complexes whether antigen or antibody is in excess. In the chronic phase of HBV infection, HBeAg/anti-HBe complexes are formed transiently in the course of the disease, unrelated to the phases of virus replication or peaks of hepatocytolysis, or to the histologic picture of liver disease. Our study indicates that this method offers a new approach to the understanding of biological and clinical problems of the HBeAg/anti-HBe antigenic system in chronic HBV infection. PMID- 2762732 TI - [Risk factors and short-term prognosis in ischemic and hemorrhagic attacks: review of 503 patients admitted to the Neurologic Clinic of Modena]. AB - Cerebrovascular risk factors, characteristics of the lesion (ischaemia or haemorrhage in the carotid or vertebro-basilar area) and mortality in the acute phase were studied in 503 patients admitted for first stroke. Seventy-five per cent of the patients had an ischaemic lesion and 25% a hemorrhagic one. Most of the ischaemic lesions occurred in patients aged 71-80 years, while haemorrhagic strokes hit subjects aged 61-70 years. Hypertension favors haemorrhage and heart disease and the older age favors ischaemia. Coma at onset negatively influences prognosis; mortality is more frequent among older patients, subjects in coma or with haemorrhagic lesions. Twelve per cent of the patients died in the first three weeks post-onset. PMID- 2762733 TI - [Deep cerebral lesions: neuro-rehabilitative aspects]. AB - All 21 patients under rehabilitative care, who were followed by the authors, suffered from language and motor deficits, the latter being part of a deficient hemi-syndrome caused by deep vascular cerebral lesions, in both thalamic (8 patients) and basal ganglia (13 patients) sites. All subjects, on entry and 3 months after treatment, underwent a language test, routine tests, De Renzi Vignolo's Token test and neuromotor evaluation, to study muscle tone, the presence of pathological synergies, sensitivity, active motility and functionality. On entry, patients with thalamic lesions had fewer problems than those with lesions of the basal ganglia at both symbolic and neuromotor levels. A better recovery of the functional capacities in the treatment period was thus achieved. PMID- 2762734 TI - [Preparation, properties and therapeutic potential of cytidine diphosphocholine incorporated into liposomes]. AB - Cytidine diphosphocholine (CDC) was incorporated into unilamellar egg lecithin liposomes with a yield of 23% and subsequently administered to rats by intracardiac injection. Unlike free CDC, 0.2% of which was absorbed by the brain, 21% of the CDC-liposomes was absorbed by the brain, while their relative distribution among brain phospholipids was similar. The changes in blood concentration and brain content of CDC, with and without liposomes, were measured at different times after administration. The CDC-liposome association significantly increased, unlike CDC alone, the levels of dopamine catabolites in the striatum of rats treated with haloperidol (0.15 mg/Kg/die) after 5 days of intravenous administration (20 mg/Kg/die). PMID- 2762735 TI - Comparison of the growth and metastasis of four human intestinal tumor cell line xenografts. AB - The growth and metastasis of four human intestinal tumor cell lines: one duodenal adenocarcinoma (HTB-40) and three adenocarcinomas of the colon (CCL-218, CCL-222 and HT-29) have been compared in vitro and in vivo in nude mice. HTB-40 was the fastest growing cell line in vitro with a doubling time (DT) of 14.8 h. CCL-218 and CCL-222 grew more slowly in vitro with doubling times of 21.6 and 22.8 hours, respectively. All three of these tumors grew more slowly in vivo with doubling times ranging from 39.1 h (CCL-218 in male nude mice) to 65.3 h (CCL-222). The growth of CCL-218 cells was significantly slower in female nude mice DT 51.0 h). HT-29 was the slowest growing in vitro (DT 23.8 h) and in vivo (DT about 100 h). HT-29 also showed the greatest discrepancy between its DT measured in vivo as compared to in vitro, suggesting a greater clonogenic cell loss from HT-29 tumors in vivo. Histologic evaluation of these tumors grown subcutaneously in nude mice showed all to be anaplastic and to produce liver micrometastases. However, more extensive abdominal and liver metastases were observed in the nude mice injected with HT-29 cells, and some of these metastases had morphologic features of moderately well-differentiated epithelium. These results indicate the usefulness of the HT-29 tumor cell line as an experimental model of metastasis from a human colonic adenocarcinoma. PMID- 2762736 TI - Expression of placental alkaline phosphatase in epithelial ovarian tumours. AB - The expression of placental alkaline phosphatase in 116 ovarian epithelial tumours was examined in formalin-fixed tissues used for routine histopathologic examination. In the total material, 51% of the tumours displayed positive immunoreactivity, as described by the monoclonal anti-placental alkaline phosphatase antibody C2, with similar incidence (46-67%) in the four major groups of the adenocarcinomas, i.e., serous, mucinous, endometrioid and mesonephric tumours. By use of a histochemical staining index the mucinous and mesonephric tumours demonstrated a more intense staining (2.1 and 2.6) compared to the serous and endometrioid tumours (0.9 and 1.5). The relevance of the findings is discussed in relation to the use of monoclonal antibody technologies for radioimmunolocalization and radioimmunotherapy. PMID- 2762737 TI - Reactivity of visceral yolk sac endoderm with lectins: changes related to age and species. AB - The expression of receptors for lectins reacting with extraembryonal endoderm was compared between mouse and rat at different stages of gestation. Fluorescein conjugated Helix pomatia agglutinin (HPA), Dolichos biflorus agglutinin (DBA), Sophora japonica agglutinin (SJA), peanut agglutinin (PNA), Bandeiraea simplicifolia agglutinin 1 (BSA-1) and gold-conjugated DBA and PNA were used. It was shown that the rat visceral endoderm does not express the receptors for HPA, while the mouse tissue does. Other lectins react with the visceral endoderm of both species but the reactivity disappears at different days of gestation. The control of expression of receptors for the lectins suggests that they may be involved in the recognition system important during differentiation. PMID- 2762738 TI - Albumin and the unique pattern of inhibitors of cortisol catabolism by lymphocytes in serum of cancer patients. AB - We have shown previously that sera of cancer patients (CPS) possess ethanol extractable substances which can inhibit the catabolism of cortisol by lymphocytes (CCL). In the present study an attempt was made to purify the inhibitory material by gel filtration. Chromatography of normal serum and CPS on a Sephadex G-10 column showed one peak of CCL inhibition with control serum and two peaks with CPS. The one peak which was common to both sera appeared with the void volume and was identified as albumin. The second peak which was present with CPS only, appeared at a molecular weight range of 300-350 daltons. We postulate that CPS may contain a relatively high concentrations of small molecules which are not bound to proteins and which might modulate the normal function of the immune system. PMID- 2762739 TI - Immunophenotypic analysis of colorectal carcinomas with monoclonal antibodies 47D10 and anti-carcinoembryonic antigen. AB - A series of 80 colorectal adenocarcinomas were analyzed immunohistochemically for the antigen recognized by a new monoclonal antibody (MCA) 47D10. These antigens are part of a complex family of substances similar to, yet distinct from carcinoembryonic antigen (CEA), and are termed nonspecific cross-reacting antigens (NCA). Formalin-fixed paraffin-embedded sections of colorectal adenocarcinomas were evaluated for the expression of these antigens and compared to the expression of CEA. Our study shows that 83.8% of the cases were positively stained for NCA while 91.3% were positive for CEA. Both antigens were coexpressed in 80% of the cases. No correlation was found between MCA 47D10 immunoreactivity and tumor grade, stage, size or location within the colon. In 25 cases, the benign colonic mucosa adjacent to the carcinoma stained positively with MCA 47D10. Normal colon does not express NCA as recognized by MCA 47D10, except in rare cells. Forty-eight of these cases had serum available for study. Both NCA and CEA were determined in these serum samples. Forty-two of these sera demonstrated elevated CEA levels, whereas only 8 showed increased levels of the 47D10 antigen(s). These findings suggest that the gene product(s) recognized by MCA 47D10 can be independently expressed or, more commonly, coexpressed with CEA in these tissues. PMID- 2762740 TI - Enolase isoenzymes in human cerebral metastasis. AB - gamma-Enolase [one of the three possible subunits of the dimeric enzyme enolase (EC 4.2.1.11)] has been reported as a marker for human neurons, neuroendocrine cells and tumors derived from these cells. In recent years, however, its presence has been reported in nonneuronal tumors. For employment in the histopathologic diagnosis of tumors of the nervous system, exact knowledge of the enolase isoenzyme patterns occurring in these tumors is a prerequisite. In human gliomas, the presence of varying quantities of gamma-enolase has been demonstrated. The present study examines the enolase isoenzyme pattern in human cerebral metastases of various primary progeny, using electrophoresis of tumor tissue extracts as well as immunohistochemistry. Additionally, a number of primary tumors of nonneuroepithelial tissue was examined by immunohistochemistry. The presence of gamma-enolase was demonstrated in a significant number of brain metastases. A relation between enolase isoenzyme pattern and survival after operation for brain metastasis could not be found. For histopathologic diagnosis of tumors of the adult human central nervous system, analysis of the enolase isoenzyme pattern is not reliable. PMID- 2762741 TI - [The scanner and the temporomandibular joint; anatomic-radiologic comparisons. Apropos of 26 cases of masticatory apparatus pain-dysfunction syndrome]. AB - Among 500 CT scan of temporomandibular joint (TMJ), examined since 1982 by bilateral direct sagittal method (Department of Radiology, Pr. A. Treheux, C.H.U. 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, C.H.U. Nancy). These cases were chosen among a hundred of 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, arthrotic 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- 2762742 TI - [Fracture injuries of the mandibular arch. A repair technic]. AB - The authors describe a technique for reduction of external lateral displacement of the posterior portions of the mandibular arch following unifocal or multifocal fractures. To achieve reduction they use a basilar wire transfixing the floor of the mouth and stretched between two horizontal branches, most often combined with a symphyseal osteosynthesis. This study of ten cases demonstrates the good functional and cosmetic results obtained with this method. PMID- 2762743 TI - [Amelogenesis imperfecta and hypothalamo-hypophyseal insufficiency]. AB - Eleven patients with hypopituitarism, medio-facial hypoplasia and amelogenesis imperfecta were examined. The hypothalamo-pituitary dysfunction affected somatotrophic, gonadotrophic, corticotrophic and thyrotrophic function. The facial anomalies included medio-facial hypoplasia with hypertelorism and amelogenesis imperfecta. The latter--hypoplastic in nature--was noted in all anterior teeth and affected both dentitions. The enamel defect was confirmed on microscopic examination of an impacted tooth. The spectrum of malformation may also present as amelogenesis imperfecta in association with somatotropin deficiency. A genetic mechanism may possibly account for the clinical elements. PMID- 2762744 TI - [Osteogenesis imperfecta and dentinogenesis imperfecta. Apropos of 4 cases]. AB - Based on four personal cases of osteogenesis imperfecta and dentinogenesis imperfecta, the authors review the semiological elements constituting the syndrome, and assign each case to the Sillence (1979) classification. The author established his classification on clinical criteria and the genetic nature of the various forms of osteogenesis imperfecta, however, the most recent discoveries concerning collagen biochemistry confirm that the condition is without doubt more heterogenous than suggested clinically, thereby better explaining the wide range of mutations encountered. PMID- 2762745 TI - [Diffuse gangrenous cervicofacial cellulitis of stomatologic origin in 7 patients with HIV-1 infection]. AB - A new clinical aspect of AIDS in Africa is represented by acute gangrenous cervico-facial cellulitis. In most of cases, the infection was due to infected tooth. Seven patients presenting with such clinical findings were HIV-1 infected (Western Blot). Bacteriological investigations failed to show bacteria responsible of these syndromes except for 4 cases. All patients healed after surgical treatment done in emergency and antibiotherapy. No mediastinal localisation was noticed. Prevention by removing all infected teeth must be emphasized in HIV infected patient. PMID- 2762746 TI - [Mucocele of the maxillary sinus. Apropos of 60 cases from the stomatology department of the Cardiology Hospital in Lyon]. AB - 60 cases of maxillary sinus mucosal cyst diagnosed in patients with cardio vascular pathology, are reported. Symptoms, histology and treatment are recalled. Surgical excision (or sinusoscopy) seems to be necessary in "high risk" patients (8.4% of asymptomatic infection). PMID- 2762747 TI - [Cystic hamartoma of the mandibular angle. Apropos of a case]. AB - A large cyst of mandibular angle was surgically removed in a 20 years-old woman. This cyst was discovered during childhood and was associated with a branchial para-mandibular cyst. It was histologically lined either with a malpighian epithelium with sebaceous islands or with a ciliated cylindrical epithelium. Because of its topography, its association with a branchial cyst and its histological feature quite similar to that of a cyst of thyroglossal duct, this cyst was thought to represent a simplified salivary ectopy composed only of a cystic secretory duct without any salivary parenchyma. PMID- 2762748 TI - [Undifferentiated epithelioma of the parotid and cystadenolymphoma. Apropos of a case]. AB - A case of undifferentiated epithelioma of the left parotid gland occurred 2 years after the removal of a cystadenolymphoma in the right parotid gland. The relationship of these two tumours was supported by several statements: the immunohistochemical study demonstrated in the epithelial cells of the 2 neoplasms the existence of ACE, usually thought as characteristic of cystadenolymphoma. Besides, it showed a high number of plasma cells secreting IgA in the stroma of the 2 tumours, the ultrastructural study performed on the epithelioma also demonstrated some similarities between epitheliomatous cells and epithelial cells of cystadenolymphomas (outlined epidermoid or glandular differentiation, numerous mitochondria). A peculiar, perhaps immunological mechanism could induce the cancerization, according to the theories used to explain the histogenesis of cystadenolymphoma. PMID- 2762749 TI - [Parotid tuberculosis. Apropos of 2 cases]. AB - The authors report 2 cases of parotid gland tuberculosis treated in the O.R.L. Service of C.H.U. H. Thameur, Tunisia. It's very rare infection even in the countries where the tuberculosis is common (Kuruvilla) (1981) (3). The preoperative diagnosis is difficult with a pleomorphic adenoma, a sarcoma or every parotid tumor. A skin's fistula will help the diagnosis which is confirmed by pathology and bacteriology. The treatment consist in a operative management with specific antibiotics. The prognosis is commonly well. PMID- 2762751 TI - Erosive prepyloric changes--a manifestation of stress? AB - To study the relationship between stress and the endoscopic diagnosis of erosive prepyloric changes (EPC), upper gastrointestinal endoscopy was performed twice in 19 cadets from the Military Academy, once in a 'non-stressed' situation and once after exposure to a standardized stress model. Five biopsy specimens per examination were obtained from the prepyloric mucosa, and the features of acute and chronic inflammation, erosion, and campylobacter-like structures (CLS) were evaluated. The endoscopy showed a significant (p less than 0.001) aggravation of EPC after stress. The histologic examination showed an increase of acute inflammation (p less than 0.05) and a higher density of CLS (p less than 0.01) after stress, as compared with the findings under non-stressed conditions. No association was observed between CLS and EPC. The study sheds new light on the pathogenesis of EPC, as it shows that EPC is aggravated during stress. PMID- 2762750 TI - Protection of gastric epithelial cell monolayers from a human cell line by omeprazole in vitro. AB - Omeprazole has an anti-ulcerogenic effect and protects rat gastric mucosa against drug-induced damage in vivo. We have evaluated omeprazole protection against damage induced by sodium taurocholate to gastric epithelial cell monolayers, an experimental model that completely excludes the influence of systemic factors. Furthermore, since our model consists of mucus-producing cells, the acid inhibitory effect of the drug in any protection is negligible. The role of prostaglandin and sulfhydryls in any such protection has also been evaluated. Monolayers of gastric cells from a well-differentiated human cell line were studied. A chromium-51 release assay was used to assess cell damage. Sodium taurocholate damaged cells dose-dependently (r = 0.97, p less than 0.01). Pretreatment with omeprazole significantly reduced the amount of cell damage brought about by sodium taurocholate (p less than 0.001). Indomethacin did not prevent the protection afforded by omeprazole, nor did incubation with omeprazole increase the amount of prostaglandin E2 produced by cultured cells. Omeprazole did not increase the amount of sulfhydryl compounds in cultured cells. These results indicate that omeprazole protects gastric cells independently of systemic factors and of inhibition of gastric acid secretion. This protection is not related to stimulation of prostaglandin synthesis nor is it associated with an increase of endogenous sulfhydryl compounds. PMID- 2762752 TI - Clinical significance of serum type-III procollagen aminopropeptide in hepatitis B virus-related liver diseases. AB - Serum type-III procollagen aminopropeptide (PIIIP) has been considered a marker of hepatic fibrogenesis. In an attempt to evaluate the clinical significance of serum PIIIP in patients with hepatitis B virus (HBV)-related liver diseases, the levels of the peptide were measured in 66 healthy adults and 200 patients with HBV-related liver diseases. As compared with the healthy adults (12.3 +/- 3.1 ng/ml), the serum PIIIP levels were significantly elevated in patients with acute hepatitis (17.4 +/- 6.6 ng/ml), chronic persistent hepatitis (18.3 +/- 4.9 ng/ml), and inactive liver cirrhosis (22.1 +/- 7.1 ng/ml). The PIIIP levels in patients with chronic active hepatitis (CAH) (33.9 +/- 23.1 ng/ml) were the highest among HBV-related liver diseases and had a tendency to increase with the severity of CAH. Of the liver-diseased patients with serum PIIIP levels greater than 30 ng/ml, 91% had a recent episode of severe hepatocellular damage, whereas 56% of patients with greatly elevated serum liver aminotransferase levels had no associated high increase in serum PIIIP levels. Thus, we suggest that fibrogenesis in HBV-related liver diseases is initiated by severe hepatocellular damage, but liver damage can also take place without prominent hepatic fibrogenesis. Serum PIIIP may be a serum marker to predict the active fibrogenesis of HBV-related liver diseases. PMID- 2762753 TI - Evaluation of anamnestic data in patients referred for oral cholecystography. AB - The knowledge about how patients are selected for elective gallbladder investigations is limited. In this study the anamnestic data of 817 patients referred for an elective cholecystography have been compared with those of 789 matched controls. Other diseases in the medical history were commonly seen, and different gastrointestinal symptoms occurred frequently in the patients. Only 207 (23%) patients presented with a gallstone disease, and no symptom was commoner in these patients than in the patients with normal cholecystograms. The low positive yield could be due to liberal and unclear indications for oral cholecystography. Many gallstones detected this way may in fact be asymptomatic, which should be borne in mind when a cholecystectomy is considered. PMID- 2762754 TI - Bacterial overgrowth after high-dose corticosteroid treatment. AB - A 63-year-old man with systemic lupus erythematosus and selective IgA deficiency developed intractable diarrhoea the day after treatment with prednisone, 50 mg daily, was started. The diarrhoea was considered to be caused by bacterial overgrowth and was later successfully treated with doxycycline. Although IgA deficiency is a risk factor for bacterial overgrowth, a further predisposing condition is necessary for development of this disorder but was not present in this case. We therefore suppose that high-dose treatment with corticosteroids might be a hitherto undescribed risk factor for bacterial overgrowth in vulnerable patients. PMID- 2762755 TI - Time-specific development of pancreatic hypersecretory capacity during chronic caerulein treatment in rats. AB - It is well established that repeated injections of the cholecystokinin (CCK) analogue caerulein induce pancreatic hypersecretion and growth, but so far the time-specific development of hypersecretory capacity has not been studied. Rats were given intraperitoneal injections of caerulein (1 microgram/kg) three times daily for 0-7 days. On the day after the last injection a secretory test was performed with the rats under urethane anaesthesia. Subsequently, pancreatic tissue composition was analysed. Basal and caerulein-stimulated secretion rates of fluid and trypsin were elevated after as little as 1 day of caerulein treatment. These values remained significantly greater than those of the controls after 2-7 days' administration of the peptide. Pancreatic tissue hypertrophy (increases in absolute pancreatic weight, protein and trypsin contents, and also in these values normalized to DNA) appeared after 2 days' pretreatment. Tissue growth turned to hyperplasia (increase in tissue DNA content) after 5 days' caerulein administration. We conclude that chronic administration of the CCK analogue caerulein induces adaptation of the pancreas in a sequential order. First, the hypersecretory state appears, followed by hypertrophy, and, finally, pancreatic growth turns into hyperplasia. PMID- 2762756 TI - Abnormal intestinal permeability pattern in colonic Crohn's disease. Absorption of low molecular weight polyethylene glycols after oral or colonic load. AB - Intestinal permeability to different-sized polyethylene glycols in Crohn's disease of the colon was compared with that in ileal Crohn's disease and in controls without inflammatory bowel affection. The permeability was assessed both after ingestion of the marker (oral load) and after deposition in the colon during colonoscopy (colonic load). After oral load the absorption was least in the patients with colonic Crohn's disease, intermediate in ileal disease, and greatest in the controls. After colonic load, however, the values were highest in colonic Crohn's disease. The study indicated that in Crohn's disease of the colon there is abnormal permeability in apparently uninvolved proximal small intestine as well as in the colon. Since oral load tests preferentially reflect the absorptive properties of the proximal small bowel, regional tests of absorption are important when the aim is to assess the permeability of the distal small intestine or the colon. PMID- 2762757 TI - Bioactivity studies on new gastrin analogues. AB - Gastrin antagonists may be useful in the treatment of peptic ulcer disease and gastrointestinal malignancies. The aim of the present study was to synthesize gastrin analogues and test them for their ability to inhibit gastrin-stimulated acid secretion. Five peptides were synthesized: peptide [2], in which methionine was replaced by leucine, and the COOH-terminal amide was replaced by the thiomethylamide; peptide [3], in which the COOH-terminal phenylalanine was removed, and the aspartic acid thioamidated; peptide [5], in which methionine was replaced by leucine, and the peptide bond between leucine and aspartic acid was replaced by a thioamide; peptide [7], in which the bond between leucine and aspartic acid was replaced by a ketomethylene amino bond; and, finally, peptide [8], in which a beta-bend was induced in the COOH-terminal region by the introduction of a D-phenylalanine in place of glycine. The biologic effect of the peptides was tested in the totally isolated, vascularly perfused rat stomach. The peptides were tested in concentrations of 10(-9), 10(-7), and 10(-5) M for agonist activity and together with gastrin 1-17, 5.2 X 10(-10) M, at a concentration of 10(-5) M for antagonist activity. Peptide [2] had full biologic activity but greatly reduced potency, and peptide [7] had a faint biologic activity. None of the peptides showed any antagonist activity. PMID- 2762758 TI - Chronic antral gastritis, Lewis(a+) phenotype, and male sex as factors in predicting coexisting duodenal ulcer. AB - Chronic antral gastritis, Lewis(a+) phenotype (Le(a+)), and male sex are common in patients with peptic ulcer. To approximate the relative risks (RR) and possible interactions of these factors in predicting coexisting active duodenal (DU) or gastric ulcer (GU), a consecutive endoscopic series of 140 ulcer patients and 215 non-ulcer controls was examined. The Lea phenotype (Le(a+) versus Le(a-)) was determined immunohistochemically as binding of Le(a)+-specific monoclonal antibody to surface epithelial secretory mucosubstances in gastric biopsy specimens. The presence versus absence of the gastritis was determined histologically from antral specimens. The RRs of the factors in the prediction of ulcer were approximated as age-adjusted RRs when the risk of ulcer in the absence of the factors--that is, in the absence of gastritis, in female sex and in Le(a-) phenotype--was applied as a base line (RR = 1). A case-control design, logistic linear modelling, and the maximal likelihood method were used in estimation of the risks. The RR of coexisting distal ulcer (DU or pyloric or prepyloric GU) was increased in the presence of gastritis (RR = 10.2), in male sex (RR = 3.0), and in Le(a+) phenotype (RR = 1.8). The RR of proximal ulcer (angular or corpus GU) was increased in the presence of gastritis (RR = 35) but decreased in the presence of male sex (RR = 0.5) and Le(a+) phenotype (RR = 0.7). As predictors of both distal and proximal ulcer, gastritis, sex, and Le(a) phenotype were independent of each other; that is, their joint value in prediction of ulcer is a multiplicand of the marginal risks. Thus, a 50-fold difference in the joint RR could be approximated between the extreme risk groups for distal ulcer--that is, between Le(a+) males with gastritis and Le(-a) females with normal antrum. In a consecutive series of outpatient endoscopies, 45% of females and 8% of males could be categorized to these extreme 'low'- and 'high'-risk groups, respectively. We conclude that sex, Le(a) phenotype, and gastritis are factors that, at least in ordinary outpatient endoscopy material, divide subjects to subgroups with very different risks and probabilities for having coexisting peptic ulcer. PMID- 2762759 TI - Gastric and oesophageal emptying in obesity. AB - Gastric and oesophageal emptying were evaluated in 31 obese patients and 31 control subjects. A double-isotope technique was used to measure gastric emptying of a mixed solid/liquid meal, and oesophageal emptying was measured as the time taken for a bolus of the solid meal to enter the stomach. Gastric emptying of the solid (p less than 0.001) and the liquid (p less than 0.02) meal and oesophageal emptying (p less than 0.001) were delayed in the obese patients compared with the control subjects. There were no significant relationships among gastric emptying, oesophageal emptying, and upper gastrointestinal symptoms in the obese patients alone, but in the total group of 62 subjects there were significant correlations between body mass index and both gastric (r = 0.44, p less than 0.01) and oesophageal (r = 0.45, p less than 0.001) emptying. These results indicate that delayed gastric and oesophageal emptying occurs frequently in obesity and that these abnormalities relate to body weight. PMID- 2762760 TI - Repeated screening for colorectal cancer with fecal occult blood test. A prospective randomized study at Funen, Denmark. AB - Two screenings with Hemoccult-II were performed in a randomized study, allocating 30,970 persons to screening and 30,968 as controls in a population of 140,000 between 45 and 74 years old on the island of Funen, Denmark. The test was completed in 20,672 initially and in 18,779 of these during rescreening 2 years later. Positive H-II tests were found in 215 and 159 persons during the two screenings, respectively. A total colonoscopy was performed in 187 and 144, and cancer was detected in 37 and 13 and adenomata in 86 and 76, respectively. Interval cancers had developed in 40 persons at the end of the second screening, and 39 non-responders had developed cancer. Cancer was diagnosed in 115 controls and an adenoma in 100 during the same period. Interval cancers presented as rectal cancers more frequently than those detected by screening. Early cancers were more frequent in the screening group, and, accordingly, more patients had curative and also less extensive surgery, with a low postoperative mortality. The total number of deaths from colorectal cancer was 37 in the screening group, including interval cancers and cancers in non-responders and persons who developed cancer before they could be invited, which suggests a reduction in mortality of 27% (51 deaths among controls, compared with 37). The reduction is as yet not statistically significant, and final evaluation must await at least one more screening, ending in 1990, and a follow-up of some years. Removal of more large adenomas during screening makes it possible that the incidence of cancer will decrease. PMID- 2762761 TI - Increased tissue concentration of neuropeptide Y in the duodenal mucosa in coeliac disease. AB - Neuropeptide Y (NPY) is localized to intestinal nerve fibres, of which there are few in normal duodenal mucosa. In the duodenal mucosa of 10 patients with coeliac disease and in a control group of 21 patients with other gastrointestinal symptoms but with normal function of the small intestine we studied the frequency of such fibres by immunohistochemistry and the tissue concentration of NPY by radioimmunoassay. Patients with coeliac disease had an increased number of NPY nerve fibres and significantly elevated tissue concentrations compared with the control group. The eluted fractions obtained by high-pressure liquid chromatography of duodenal extracts showed the same immunoreactive components in the two groups. This study therefore suggested proliferation of the peptide containing nerve system in coeliac disease. The increased NPY levels in the duodenal mucosa may be of functional significance for the disease symptoms. PMID- 2762762 TI - Endoscopic sclerotherapy of oesophageal varices in rabbits. The long-term effect on oesophageal collagen content and mechanical strength. AB - Sixteen rabbits with oesophageal varices were randomized to no treatment (n = 8) or endoscopic paravenous sclerotherapy of the varices (n = 8). Eight other rabbits served as sham-operated controls. Four months after sclerotherapy the animals were killed, and the mechanical strength and collagen content of the oesophagus were determined at proximal, middle, and distal levels. In animals treated by sclerotherapy there was a 15% increase in collagen content at the distal level when compared with controls and non-treated animals (2p less than 0.05). This was not accompanied by changes in the mechanical strength. At middle and proximal levels there were no differences between the groups. It is concluded that the late effect of one single session of paravenous sclerotherapy of oesophageal varices is a slight fibrosis in the distal oesophagus, with no changes in the mechanical properties of the oesophageal wall. PMID- 2762763 TI - Clinical experience with isolated hyperbilirubinemia. AB - Experience from 73 consecutive patients with non-hemolytic, isolated hyperbilirubinemia indicates that such patients almost without exception have increased serum levels of unconjugated bilirubin (greater than 17 mumol/l) and a conjugated bilirubin of less than 30% of total. Normal total bilirubin values were observed in 15% of 500 determinations, although some subjects never had normal values. The reduced caloric intake test had a low 'sensitivity' as a test for diagnosing Gilbert's syndrome, particularly in females. Long-term (9-29 years) follow-up study demonstrated that hyperbilirubinemia is lifelong and not associated with increased morbidity or deficiency of coagulation factors II, VII, and X. The data suggest that no further medical study is necessary in subjects with moderate isolated hyperbilirubinemia and normal blood reticulocyte count. PMID- 2762764 TI - Failed ileoanal anastomosis: correlations between clinical function and anal canal neurophysiologic and histologic examinations. AB - Ten patients with an ileoanal anastomosis had conversion to permanent ileostomy 13 (range, 6-29) months after the primary procedure. Causes for reoperation were incontinence in seven patients, unacceptable stool frequency without incontinence in two patients, and atypia in the mucosal remnant with perfect continence in one patient. Stool frequency, continence function, anal canal resting pressure, external anal sphincter (EAS) EMG/pressure relationship (in terms of slope, m), EAS fiber density (FD), and pressure in the distal ileum were registered, and the mucosa and the anal sphincter muscles were examined histologically. There were significant correlations between continence function and EAS changes in terms of both neurophysiologic tests (m and FD) and the histologic picture. The abnormalities in six incontinent patients were consistent with denervation of the EAS. The main reason for fecal leakage in one patient was the high amplitude of pressure waves in the distal ileum. Preservation of mucosal epithelium proximal to the dentate line per se did not seem essential to maintain continence. PMID- 2762765 TI - Compared effect of n-3 and n-6 dietary fatty acids on rat intestinal acyl CoA:cholesterol acyltransferase activity. AB - Polyunsaturated fatty acids are known to lower plasma cholesterol concentrations. We studied their effect on intestinal acyl-CoA:cholesterol acyltransferase (ACAT) activity in rats fed either salmon oil or corn oil (17% fat) with or without 1% cholesterol. After an 8-week feeding period we confirmed the hypolipidemic effect of salmon oil and we established its ability to stimulate ACAT activity in rats fed low-cholesterol diets. The most striking effect of 1% dietary cholesterol on ACAT activity was obtained in the control group (34% enhancement), whereas cholesterol supplementation had no effect on ACAT activity in the salmon oil group. The results enable us to suggest that n-3 fatty acids have an effect per se on ACAT activity; the regulation of enzyme activity by dietary cholesterol probably involves independent processes. PMID- 2762766 TI - Induction of non-specific immunosuppression in mice by mycobacterial infections and its relationship to macrophage activation. AB - The development of non-specific immunosuppression during the infection of different strains of mice with three mycobacterial species was evaluated by studying the immune response to a heterologous antigen (sheep red blood cells) and comparing it with the induction of non-specific resistance to a Listeria monocytogenes challenge. It was shown that early (at 15 days) immunosuppression developed in Mycobacterium avium-susceptible mouse strains infected with a high inoculum dose [2.5 x 10(8) colony forming units (CFU)] of virulent M. avium but not in resistant mice infected with a similar inoculum nor in susceptible mice infected by a smaller inoculum dose (2.5 x 10(6) CFU). In the latter case it developed only during the second month of infection and was of smaller magnitude. An inoculum of M. avium of attenuated virulence did not induce immunosuppression. M. lepraemurium induced a late immunosuppression, which occurred when extensive bacterial proliferation had already taken place. The non-pathogenic M. bovis BCG induced immunosuppression in C57BL/6 mice. The results do not establish a correlation between the development of generalized immunosuppression and susceptibility to infection. It could be seen that the early immunosuppression was observed in those situations where there was extensive macrophage activation as shown by the development of non-specific resistance to a listeria challenge. The late immunosuppression was observed when bacterial proliferation was extensive. PMID- 2762767 TI - Complement-fixing properties of human IgA antibodies. Alternative pathway complement activation by plastic-bound, but not specific antigen-bound, IgA. AB - The complement-fixing properties of human IgA antibodies bound to specific antigen, or coated directly on plastic surfaces, were examined in comparison with those of IgG antibodies. Use was made of antigen-binding (anti-staphylococcal alpha-toxin) IgA and IgG monoclonal antibodies and normal polyclonal IgA and IgG, purified greater than 99.9% by avoidance of denaturing processes. Complement fixation ELISA was used, with a high density of biotin-conjugated staphylococcal alpha-toxin bound to avidin-coated plates for the efficient capture of antibodies, and conditions were adjusted for the assessment of classical and alternative pathways of complement activation. Although IgA coated directly on plastic surfaces activated the alternative complement pathway in a dose-dependent manner, IgA antibodies bound to antigen failed to fix complement by either classical or alternative pathways. In contrast, IgG antibodies, either bound to antigen or coated directly on plastic, activated complement mainly by the classical pathway. It was concluded that the complexation of IgA antibodies with antigen is insufficient to elicit complement activation: rather a degree of denaturation seems to play a part in the expression of alternative complement pathway-activating properties by IgA. PMID- 2762768 TI - A rapid separation procedure to analyse phosphorylation of two putative protein kinase C substrates in intact lymphocytes. AB - Activation of protein kinase C (PKC) has been implicated in the regulation of many biological processes including the regulation of T and B lymphocyte responses. A direct means of studying activation of this kinase is to analyse specific phosphorylation events of cellular substrates. In the present report we describe a fractionation method that allows quantitative analysis of phosphorylation of two distinct PKC substrates using normal human T cells and T cell tumour lines. This method, which selectively visualizes PKC-dependent phosphorylation of both an 80- and a 19-kDa substrate, involves three simple fractionation steps and allows a large number of samples to be analysed simultaneously. Since specific antibodies to these cellular substrates are not commonly available, the present method provides an alternative approach which makes it feasible to use phosphorylation of the 19- and 80-kDa proteins as a sensitive marker for PKC activation. Finally, in a cellular system where PKC mediated phosphorylation of these substrates can be studied without prior purification, the present method results in greatly improved resolution of these phosphorylation events. PMID- 2762769 TI - Urinary diversion via the continent ileal reservoir. Functional characteristics and long-term outcome. AB - The aim of the present investigation was to study the functional characteristics and the long-term outcome after urinary diversion via a continent ileal reservoir. The villus height and absorptive capacity of ileal mucosa were studied in cats after exposure of the ileal mucosa to urine. In 16 patients at various intervals after their reservoir construction, the absorptive rate of L phenylalanine was estimated after instillation of a test solution into the reservoir. The influence of the reservoir pressure was studied in 13 patients with empty and full reservoirs. The reservoir pressure was registered during renography and the volume recovered from the reservoir was measured. Twenty-one patients registered their emptying patterns and their emptying volumes during seven 24-hour periods. Urine samples were taken for determination of electrolytes (Na+, K+, Cl-), osmolality, pH and possible bacteriuria. Mucus in the urine was measured at various postoperative time intervals. Seventeen patients were followed postoperatively with a yearly determination of renal function and urography in special reference to the upper urinary tract. Routine blood tests, vitamin B12 in serum and base excess were also determined. In six patients, the excretion of titratable acid was determined after peroral loading with ammonium chloride. After exposing ileal mucosa to urine in cats, a significant decrease was found in the villus height and the absorption of water and electrolytes. This was true for the isotonic test solution but not for the hypertonic solution. The rate of active absorption of L-phenylalanine from the patient reservoirs decreased with the postoperative interval. With ordinary filling volumes, the pressure in the reservoir did not interfere with upper urinary tract drainage. The patients emptied their reservoir with a frequency similar to that of the voiding frequency of normal individuals. The 24 h volume was somewhat increased but the excretion of electrolytes and osmoles was normal. Bacteriuria was often present but, as long as reflux was prevented, it seemed to be of no harm. Mucus production did not diminish with time. Long-term follow-up (5-11 years) of renal function and upper urinary tract configuration disclosed that deterioration is infrequent and occurs only as a consequence of reflux or obstruction to flow. No metabolic disturbances have occurred. PMID- 2762770 TI - Extracorporeal shock wave lithotripsy--medical, technical, economic and policy implications. Proceedings from an international meeting. Linkoping, Sweden, 1989. PMID- 2762771 TI - Extracorporeal shock wave lithotripsy. The need for comprehensive assessments. PMID- 2762772 TI - The use of mobile lithotripters in Georgia, USA. PMID- 2762773 TI - Experience with a mobile extracorporeal shock wave lithotripter in The Netherlands. PMID- 2762774 TI - ESWL monotherapy of renal calculi substratified by site, size and multiplicity. PMID- 2762775 TI - The introduction of ESWL in Europe--what is the issue? PMID- 2762776 TI - Monitoring the diffusion of ESWL in Sweden. PMID- 2762777 TI - "Lithostar" lithotripsy--Manchester experience. PMID- 2762778 TI - Treatment of large staghorn stones and ureteral stones without anesthesia. PMID- 2762779 TI - What do our patients have to endure in order to get their stones removed? PMID- 2762780 TI - Extracorporeal shock wave lithotripsy--what will the issue be? PMID- 2762781 TI - Evaluation of biliary extracorporeal shock wave lithotripsy in the United Kingdom -problems with clinical trials. PMID- 2762782 TI - Gallstone lithotripsy--the Sheffield experience. PMID- 2762783 TI - Extracorporeal shock wave therapy of gallbladder stones--preliminary results. PMID- 2762784 TI - An overview of different ESWL-systems. PMID- 2762785 TI - A universal lithotripter for interdisciplinary use: the Siemens "Lithostar Plus". PMID- 2762786 TI - Early patterns of diffusion, organization and use of ESWL. PMID- 2762787 TI - [The physician as consumer. An appeal for consumer protection]. PMID- 2762789 TI - [Amborum Special F and ASFO--2 glucocorticoid-containing herbal remedies]. AB - Amborum Special F and ASFO are two names of a herbal remedy which is adulterated with the glucocorticoid betamethasone. Patients with asthma, rheumatic and chronic diseases import the drug direct from Burbank, California, USA. Its impressive antiasthmatic effect is reported in two patients. While under therapy the first patient developed Cushing's syndrome and the second showed suppression of adrenal cortisol production. The manufacturer, who claims that the drug contains no "western medicine" and in particular no cortisone, is unscrupulous enough to recommend it for children under two years of age. We have observed that a marked glucocorticoid effect and marked glucocorticoid side effects are achieved with small doses of betamethasone. A review of the literature and the two cases reported here suggest that the equivalence doses given in textbooks and tables of glucocorticoid equipotency are incorrect for betamethasone. Betamethasone is a more potent glucocorticoid than hitherto reported. PMID- 2762788 TI - [Iron and iron-binding proteins in the differential diagnosis of pleural effusion]. AB - Iron, iron-binding capacity, lactoferrin and total protein were determined in the plasma and pleural fluid of 30 patients with cardiac failure (n = 10), infectious/inflammatory disease (n = 9) and metastatic carcinoma (n = 11). In 16 patients pleural transferrin and ferritin was also measured. Plasma iron and total iron-binding capacity were reduced in inflammatory and neoplastic disease, whereas hyposideremia with normal iron-binding capacity was seen in patients with heart failure. Plasma lactoferrin was reduced in metastatic carcinoma. Exudates (protein greater than or equal to 30 g/l; infectious/inflammatory: 9/9, carcinomatous: 10/11) had significantly higher iron, lactoferrin, transferrin and ferritin concentrations than transudates (protein less than 30 g/l; heart failure: 10/10, carcinomatous: 1/11). Statistically, infectious/inflammatory exudates could be distinguished from neoplastic exudates by a higher median iron concentration (non-parametric Wilcoxon-Mann-Whitney test). Overlap of the respective ranges, however, did not allow a clear-cut differential diagnosis in individual cases. Pleural lactoferrin concentrations, on the other hand, correlated with the pleural granulocyte count and nonspecifically reflect the degree of granulocytic inflammation. Positive pleural/plasma correlations of protein and of iron concentrations were found in exudates only. Within exudates and transudates, on the other hand, total protein correlated with transferrin but not with iron concentrations. Therefore, and because of the substantially higher pleural/plasma ratio for iron than for transferrin concentrations, a quantitatively important, non-transferrin bound iron pool in pleural fluids, most probably ferritin, must be assumed.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2762790 TI - [Aortic valvular dysplasia in a dog]. AB - A case of aortic valve dysplasia in a 6 year old male cocker spaniel is described. The dog was presented to the veterinarian because of strong dyspnea and frequent coughing. Clinical examination, EKG, radiographs and angiocardiography all pointed towards a tentative diagnosis of aortic insufficiency. Four months after the first appointment the dog was presented again with congestive heart failure, neural symptoms and strong abdominal pain. Electrocardiography and concentrations of LDH and CK were typical of myocardial infarction. Autopsy revealed a narrowing of the aortic valves in combination with a subaortic stenosis and several infarctions localized in the left ventricle as well as a recent infarction in the left kidney. PMID- 2762791 TI - [The frequency and geographic distribution of Giardia infections in ruminants in Switzerland]. AB - In various districts (Cantons) of Switzerland 815 calves (a few days up to 6 months old), 382 lambs and 20 young goats (both groups 1-6 months old) were selected randomly for a single coprological examination (flotation method) for Giardia infection. In average 26.6% of the calves, 29.8% of the lambs and 4 of 20 young goats excreted Giardia cysts. In 9 Cantons the percentages of cyst excretors among the calves varied between 15 and 32, but these differences were not significant. Further there were no significant differences in the frequency of cyst excretion between calves of 3 different breeds and 2 age groups (up to 3 months old and 3 to 6 months). The intensity of cyst excretion was high and varied in random samples between 4.1 x 10(3) and 3.0 x 10(5) cysts per g of faeces in calves and between 2.2 x 10(3) and 1.6 x 10(5) in lambs. In 5 of 7 farms where calves and lambs were maintained simultaneously both animal species were Giardia infected. As expected, trophozoites of Giardia isolates from calves and lambs belonged to the Giardia duodenalis type and could not be differentiated on a morphological basis. Giardia cysts from calves (average measurements: 13.7 x 9.1 microns) and lambs (13.8 x 9.2 microns) were indistinguishable both morphologically and morphometrically. The results indicate that Giardia infections are frequent and geographically widely distributed in calves and lambs in Switzerland. PMID- 2762793 TI - [Animal rights]. PMID- 2762792 TI - [Urinary incontinence in spayed female dogs: frequency and breed disposition]. AB - A follow up study was performed in 412 spayed bitches in order to determine the incidence of urinary incontinence. The period between the operation being performed and the survey being made varied between 3 and 10 years. 83 animals (20.1%) were incontinent independent of the surgical procedure (ovariectomy versus ovariohysterectomy). The onset of incontinence varied between immediately to 12 years with an average period of 2.9 years after surgery. 57 of these incontinent bitches were treated with ephedrine or estrogen. In 73.7% a good response was achieved with ephedrine and a further 23.7% showed some improvement. Generally ephedrine was more successful than estrogen in the treatment of incontinence. There appears to be a strong connection between body weight and the incidence of incontinence. Of bitches with a body weight of less than 20 kg only 9.3% were incontinent. Whereas in bitches with a body weight of more than 20 kg the incidence was 30.9%. Of the breeds Boxers showed a high incidence of incontinence (65%) while breeds such as German Shepherds (10.6%) or Dachshunds (11.1%) showed a low incidence in relation to the average incidence rate (20.1%). PMID- 2762794 TI - [Chronic periorchitis and periepididymitis of cattle]. AB - The Authors describe chronic vaginitis of bovines in intensive breeding. All of the 78 subjects examined presented vaginitis, accompanied by fibrinous hydrocele. On the spermatic cord and the tail of epididymis, initial lesions consisted of granulomas and fibrinous bridges between vaginalis propria of testicle and of epididymis. Subsequently appeared adherence and synechiae, which join the deferens and epididymis body to didymis, and thickening of albuginea. Synechiae can develop between peritesticular vaginalis propria and communis. Histopathological findings: peritoneal-like papillary structures with metaplastic mesothelial cells; diffuse lympho-plasmacellular infiltration with eosinophils and mast cells; intense capillary angiogenesis. The epididymal lesions are: diffuse mononuclear infiltration; periarteritis nodosa; papillary proliferations of endothelium; endothelial degeneration; tubular ectasia and stenosis; intraepithelial cyst. Noticeable within testis: periarteritis nodosa; fibrosis of albuginea; spermatocytes vacuolisation; multinucleate spermatids; epithelial shedding. The Authors pointed out: the serological and bacteriological testings furnished inconclusive results; only pathological finding always present is a large infestation of cremasteric muscle with Sarcocystis, to which is attributed the etiopathogenesis of flogosis, that is chronic from the beginning. The Authors propose the terminology of "Chronic peritesticular and periepididymal vaginitis" or "Chronic Periorchitis and periepididymitis". PMID- 2762795 TI - Vacuum tumescence: an option for spinal cord injured males with erectile dysfunction. AB - Vacuum tumescence with constriction/retention bands is an option for management of male erectile dysfunction. The appropriateness of this system for individuals with spinal cord injury was evaluated at the Palo Alto, California, Veterans Administration Medical Center, Spinal Cord Injury Center. Following a structured educational program and use of the system for at least 2 months, 13 male subjects and 9 female partners responded to a questionnaire evaluating their satisfaction and the safety of the device. Findings indicate an increase in frequency of intercourse and increased sexual satisfaction with use of the device without occurrence of significant physical problems for the subjects or their partners. PMID- 2762796 TI - Spinal cord injuries and a mandatory seat belt law. PMID- 2762797 TI - Effect of applications of sewage sludge on N, P, K, Ca, Mg and trace element contents of plant tissues. AB - A four-month study was conducted in a greenhouse with Larix laricina grown on sand and nursery soil. This culture was fertilized with anaerobically digested sludge at various rates and doses. No direct relationship could be established between the growth of seedlings and the quantities of sludge applied. Relationships were, however, established between the quantities of sludge applied and the elemental composition of the tissues. There was a significant, positive correlation between the growth of seedlings and the phosphorus and nitrogen content of their tissues. These elements originated from the wastewater sludge. Tissues had potassium deficiencies and an excess of calcium, magnesium and trace elements. PMID- 2762798 TI - Composition of chlorinated dibenzodioxins and dibenzofurans in various samples. AB - The composition of chlorinated dibenzodioxins (CDD) and dibenzofurans (CDF) in terms of the degree of chlorination (tetra- to octachloro-) is displayed by principal components projection. Chlorinated dibenzodioxins and dibenzofurans with 4-6 chlorines are the main classes in samples of crabs and lobsters, CCD with 7 and 8 chlorines prevail in human samples. Chlorinated dibenzodioxins and dibenzofurans from incinerator ash are similar to those from human tissues. Those from gaseous incinerator emissions are enriched in less chlorinated classes and resemble residues isolated from conifer needles. Compositions of CDD and CDF in ambient air vary depending on both local and remote sources. PMID- 2762799 TI - Urinary nitrite in Japanese patients with urinary tract infections. AB - Urinary nitrite, a precursor of carcinogenic nitrosamines, and nitrate were measured in 73 Japanese patients with urinary tract infections (UTI) and in two control groups. Nitrite was detected in 12% of patients with uncomplicated UTI (226 +/- 161 mumol/l) and in 42% of those with complicated UTI (375 +/- 297 mumol/l). None of the subjects in the control groups excreted detectable amounts of nitrite. The excretion of nitrite in four out of five nitrite excretors continued for at least 14-55 days. The concentrations of urinary nitrite were significantly correlated with those of nitrate- plus nitrite-nitrogen, which reflect dietary nitrate ingestion. The results suggest the importance of close monitoring of nitrite excretor group in UTI patients, to clarify the mechanism of the association between UTI and bladder cancer. PMID- 2762800 TI - Trace element analysis in environmental and occupational health: box plot representation of elemental composition results. AB - Box plots are used in the visual representation of large data sets and in exploratory data analysis. They display batches of data with five values being used to describe the data set. These are the median, the upper and lower extremes of the range of values and the 75 and 25 percentiles. A notch about the median, e.g. at the 95 percent level of significance, can be incorporated in the display allowing the difference between the medians of different sets to be established. The method, although not recently established, has so far found little application in the analytical field. Hence, in an effort to strengthen its applicability, the features and capabilities of box plots, in terms of data reporting and insight into the data set, are here described through elemental composition studies in relation to environmental and occupational health. PMID- 2762801 TI - Cadmium and lead contents in rice available in various areas of Asia. AB - Rice samples, 207 in total, were collected from 15 (Australia has been included in Asia) areas of Asia (192 samples) and in four areas in other parts of the world (15 samples). The samples were wet-ashed and analysed for cadmium (Cd-R) and lead (Pb-R) by flameless atomic absorption spectrophotometry. Both Cd-R and Pb-R in the 207 samples distributed log-normally, with a geometric mean (GM) [geometric standard deviation (GSD)] of 20.0 ng g-1 (3.176) and 15.7 ng g-1 (3.498), respectively. No significant difference was observed in Cd-R and Pb-R between common rice (188 samples) and glutinous rice (19 samples), whereas effects of polishing were absent on Cd-R and inconclusive on Pb-R. Among the 11 areas in which more than 10 samples were collected, the GM of Cd-R varied by less than 10 ng g-1 (i.e., Australia and India) to greater than 50 ng g-1 (Japan and Taiwan), and the GSD was also as large as three in many areas. A similar analysis for Pb-R showed an even wider variation in GM from the lowest of 5 ng g-1 (Japan) to the highest of 90 ng g-1 (India). Geometric standard deviations were also two or greater in most areas. Among the three areas (China, Korea and Japan) where Cd R, cadmium in blood (Cd-B), Pb-R and lead in blood (Pb-B) values were all available, both Cd-R and Cd-B were high in Japan, medium in Korea and low in China, whereas Pb-R and Pb-B were low in Japan, and high in China and Korea. Possible causes of variation in Cd-R and Pb-R are discussed. PMID- 2762802 TI - The radioactivity of coloured rain in Thessaloniki, Greece. AB - The radioactivity of coloured rain precipitated over Thessaloniki, Greece, on 4-5 April 1988 was determined. The long-lived fission product radionuclides such as 137Cs, 134Cs, 144Ce, 106Ru and 125Sb were identified in dust originating from the Sahara desert which was precipitated with the rain to produce coloured rain. Caesium-137 concentrations reached 1000 Bq kg-1, resulting in a deposition of 3.03 Bq m-2, which is four orders of magnitude lower than measured on 5-6 May 1986 after the Chernobyl reactor accident. PMID- 2762803 TI - A longitudinal study of dentine lead levels and intelligence, school performance and behaviour: the measurement of dentine lead. AB - Shed deciduous teeth were obtained from a sample of 996 New Zealand children who were participants in a longitudinal study. For each child, estimates of dentine lead were obtained from two samples of dentine. The information was used to estimate the magnitude of random errors of measurement in dentine lead values and it was estimated that between 15 and 20% of the variance in dentine lead values was attributable to random errors of measurement. In addition, dentine lead levels were influenced by small systematic errors of measurement arising from the age at which the tooth was collected and the type of tooth analysed. These sampling factors, however, accounted for less that 3% of the variance in dentine lead values. The implications of these findings for the interpretation of correlations between dentine lead levels and other variables are discussed. PMID- 2762804 TI - Assimilation of thorium isotopes into terrestrial vegetation. AB - Vegetation and root zone soil from 17 locations within and near the boundaries of a former thorium processing plant were collected and analyzed for 232Th, 228Th and 230Th in order to evaluate the degree of movement of these radionuclides from soil to root tissue, as well as the extent of their translocation into above ground plant compartments. Concentration ratio (CR) values ranged as follows: 232Th: 0.0003-0.3218 (shoots), 0.0065-0.9057 (roots); 228Th: 0.0038-0.3300 (shoots), 0.0183-0.7335 (roots); 230Th: 0.0007-0.4560 (shoots), 0.0076-1.252 (roots). Root/shoot ratios were 1.03-85.6 (232Th), 1.54-45.8 (228Th) and 1.36 54.5 (230Th). In nearly all instances, the CR values for 228Th exceeded those for 232Th, with the average 228Th/232Th CR ratios being 3.36 and 1.68 for shoots and roots, respectively. No discernable difference was observed between 230Th and 232Th concentration patterns. The increased 228Th/232Th CR ratio observed is presumably due to the intake of 228Ra into the plant structure, leading to subsequent production of 228Th, through decay, within the plant. It is estimated that approximately 80% of the resident 228Th in above-ground vegetation originates through this mechanism. PMID- 2762805 TI - Sources and storm loading variations of metal species in a gullypot catchment. AB - The temporal variations of metal species in the outflow from a single gullypot catchment are discussed for two storms with differing hydrological characteristics, and the major contributing sources within the system are identified from an analysis of six discrete storm events. Under low flow conditions the dissolved metals are complexed by organics present in the gullypot liquor and interstitial sediment waters, and the strongly bound fraction predominates in the gullypot outflow. As the flow increases the Chelex removable fraction becomes important due to acid washing initially of road-surface sediments and subsequently of the mobilized gullypot sediments. The particulate associated metals exhibit distinct temporal similarities to the storm hydrograph and chemograph for suspended solids with the exchangeable fraction being dominant. Hydrodynamic sorting mechanisms on the road surface produce the earlier contributions for this fraction, with later inputs, particularly for Cd and Pb, from chemical exchange processes within overturned gullypot sediment. This basal sediment also provides important inputs of the carbonate and hydrous oxide fraction for Cu and Zn as the gullypot contents become oxygenated later in the storm. The consequences of these findings are discussed in terms of gullypot maintenance and the water quality of stormwater outfalls. PMID- 2762806 TI - Assessment of air pollution sources in an industrial atmosphere using principal component and multilinear regression analysis. AB - Aerosol samples collected in the industrial area of Estarreja, Portugal, were used to assess the source classes responsible for the particulate levels observed in the local atmosphere. Principal Component Analysis was applied separately to the concentrations of aerosol constituents and meteorological variables to obtain the number of Principal Components and to verify the influence of weather conditions on ambient air quality. The technique led to the conclusion that soil and transport emissions represent important aerosol sources even in this industrial environment. The quantitative contribution of each source class was calculated using Multilinear Regression Analysis; 37% of the aerosol mass had a soil origin, 8% was from sea spray, 18% resulted from transport emissions and 24% contained ammonium salts. Twelve percent of total suspended particle (TSP) mass could not be explained by any of the six Principal Components retained. Ammonium salts and two other minor Principal Components seem to result mainly from industrial emissions. More specific information about the contribution of each particular source was not possible with this technique. PMID- 2762807 TI - Nickel-induced histopathological alterations in the gill architecture of a tropical freshwater perch, Colisa fasciatus (Bloch & Schn.). AB - The effect of a sub-lethal concentration of 64 ppm (2.279 x 10(-4) mol l-1) of nickel sulphate (NiSO4.7H2O) on the gill of a freshwater tropical perch, Colisa fasciatus, was investigated after 96 h exposure. Prominent changes noticed were: hypertrophy of respiratory and mucous cells; separation of the epithelial layer from the pillar cell system; cauterization and sloughing; extensive necrosis of the epithelium; and hyperplasia leading to clubbing at the tip of the lamellae. PMID- 2762808 TI - Are radiation-induced effects hormetic? PMID- 2762809 TI - AIDS and i.v. drug use. PMID- 2762810 TI - Animal experimentation. PMID- 2762811 TI - Estrogen use linked to breast cancer. PMID- 2762812 TI - New rules on misconduct. PMID- 2762813 TI - Ocular dominance column development: analysis and simulation. AB - The visual cortex of many adult mammals has patches of cells that receive inputs driven by the right eye alternating with patches that receive inputs driven by the left eye. These ocular dominance patches (or "columns") form during early life as a consequence of competition between the activity patterns of the two eyes. A mathematical model of several biological mechanisms that can account for this development is presented. Analysis of this model reveals the conditions under which ocular dominance segregation will occur and determines the resulting patch width. Simulations of the model also exhibit other phenomena associated with early visual development, such as topographic refinement of cortical receptive fields, the confinement of input cell connections to patches, monocular deprivation plasticity including a critical period, and the effect of artificially induced strabismus. The model can be used to predict the results of proposed experiments and to discriminate among various mechanisms of plasticity. PMID- 2762814 TI - Neural cadherin: role in selective cell-cell adhesion. AB - Cadherins are a family of Ca2+-dependent intercellular adhesion molecules. Complementary DNAs encoding mouse neural cadherin (N-cadherin) were cloned, and the cell binding specificity of this molecule was examined. Mouse N-cadherin shows 92 percent similarity in amino acid sequence to the chicken homolog, while it shows 49 percent and 43 percent similarity to epithelial cadherin and to placental cadherin of the same species, respectively. In cell binding assays, mouse N-cadherin did not cross-react with other mouse cadherins, but it did cross react with chicken N-cadherin. The results indicate that each cadherin type confers distinct adhesive specificities on different cells, and also that the specificity of N-cadherin is conserved between mammalian and avian cells. PMID- 2762815 TI - [Intraluminal balloon occlusion of the aorta in traumatic massive hemorrhage]. AB - Management of massive abdominal hemorrhage is a major challenge in trauma care. In this clinical setting high aortic blockade is known to be effective, as it stops arterial bleeding and restores the vital central circulation. Balloon occlusion of the descending aorta provides an alternative to thoracotomy with aortic cross-clamping, thereby avoiding this major surgical procedure. For introduction of the balloon the recommended technique is cut-down and insertion of the balloon to the femoral artery. More research and clinical experience are needed to define useful indications and to explore the long-term consequences of aortic balloon occlusion. PMID- 2762816 TI - [Humoral and cellular changes of non-specific immune response following severe trauma]. AB - The influence of trauma and hemorrhagic shock on the non-specific immune system has been pointed out in various experimental studies. Other investigations have also been able to find a relationship between these changes and a higher incidence of post-traumatic complications in the form of organ failure. Our aim was to demonstrate the potential changes in the cellular defense system in a clinical study on multiple trauma patients. The polymorphonuclear leukocytes (PMNL) are the main representative of the mobile, non-specific immune system. Our study revealed a significant deterioration of PMNL function after trauma. The metabolic activity and phagocytic function were mainly affected by a decrease in the concentration of so-called "opsonins." The opsonins are important for the identification and engulfment of debris (necrosis, fat emboli and thrombi) and bacterial substances (endotoxin). Next to the opsonin level, a change in the receptor configuration is important for phagocytosis. However, we could not find any substantial evidence of surface receptor alteration. The reticuloendothelial cells (RES), a stationary phagocytic system, also showed a significant reduction in clearance function in these polytraumatized patients. Similar to PMNL, these disturbances were based on the reduction of the opsonine concentration. We were able to demonstrate a significant disturbance in immune function in multiple trauma patients with post-traumatic complications compared to patients with a normal clinical course after injury. Disturbances in the PMNL function (seen after 4 days) were found to appear after the RES disturbances. Systemic interaction between these two phagocytic systems cannot be excluded and further investigation is therefore required. PMID- 2762817 TI - [Traumatic cerebral infarct in multistage dissection of the extracranial internal carotid artery]. AB - A 26-year-old motorcyclist bounced against the side of a turning car with about the speed of 70 km/h. On admission to the clinic, he was awake with stable circulation. The main injuries were contusion of the chest with pneumothorax on the right side, blunt trauma of the abdomen without hematoperitoneum, and a fracture of the right femur. There was no visible trauma of the head, but only circumscribed cutaneous bleeding on the right side of the neck. About 16 h later, he showed an alteration in his level of consciousness and gradually "malignant" cerebral infarction of the left hemisphere with increasing intracranial pressure developed. Brain function began to cease and death occurred on the 4th day. The autopsy revealed neither traumatic damage to the skull, brain or cervical spine, nor were there pathological findings in the cerebral vessels. The main damage consisted of multiple dissections of the inner wall of the left internal carotid artery and the left medial cerebral artery. Proceeding from a temporarily sealed tear of the extracranial vessel, a large intramural hemorrhage had occurred between the media and adventitia and had compressed the lumen completely. The intracranial portion was closed by expanding thrombosis. These lesions are of indirect origin and are the result of vast overstretching of the arteries by the head turning over the edge of the top of the car. The victim was found at once after the crash with his body hanging the deeply dented side of the car and the head (with the helmet on) on the roof. PMID- 2762818 TI - [The "chapeau-claque" mechanism. Biomechanical aspects of roentgen diagnosis of vertebral fractures]. AB - During follow-up examinations of patients with fractures of the spine at the Inner City Surgical Clinic in Munich, particular attention was paid to the problem of the diagnosis of fractures of the dorsal edges of vertebral bodies. Repeatedly we found a kind of a deformation resembling collapse or folding up of a "chapeau claque" top hat. PMID- 2762819 TI - [Insertion of distal screws in interlocking nailing using a new free-hand control device]. AB - While it is technically easy to introduce the proximal screw in interlocking nailing, the torsion of the nail being driven into the medullary canal can make distal locking more difficult. There are two approaches to the insertion of the distal screws: the c-arm-mounted device and the free-hand technique. The Grosse Kempf c-arm device was introduced in 1978, but it requires modification of the fluoroscopy unit and is time consuming. The free-hand technique has certain disadvantages because of involuntary movement during the change from aiming to drilling. Furthermore, the bulky power drill makes monitoring of the path of the drill bit impossible, and the radiation time can be considerable. A new free-hand distal aiming device for the interlocking nail was therefore designed in our department. The main objectives were to provide a simple, yet precise instrument with few parts that would allow monitoring of the direction during process of penetrating the nail hole. The device consists of two metal rings on both ends of an X-ray translucent cylinder with a central 4-mm hole in it. A pin with a sharp tip (diameter 4 mm, length 160 mm) is inserted through the hole. Using the image intensifier, the device is then placed so that the sharp tip of the pin points to the bone. The device is moved until the two metal rings are superimposed on each other and give the impression of one ring with the nail hole in the middle. On the screen the pin then appears as a dot inside the nail hole.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2762820 TI - [Dislocations of the talus joints]. AB - With the exception of fracture dislocations following fractures of the ankle joint and talus, dislocations in the talus are very infrequent injuries. They pose a lot of management problems: soft-tissue damage in open and closed dislocations, imperfect reduction caused by osteochondral fragments, recurrent instability, and aseptic necrosis of the talus, which is greatly feared. Anatomical and prognostic criteria are included in a classification of mono-, bi- and triarticular dislocations of the talus. Based on six of our own cases treated in the last 12 months, we report the mechanisms of injury, management, and early results. In accordance with the results in the literature in the last few years, reconstruction of ligament damage and joint debridement were carried out in four cases and the results described. One case of open total dislocation of the talus is presented, which was complicated by a fracture of the calcaneus without traumatic avascular necrosis. PMID- 2762821 TI - [Injuries caused by parasailing]. AB - The new sport of parasailing seems to be set to go through the same stages of enthusiasm, disillusionment and consolidation as hang gliding did some years ago. The high number of injuries we see in our clinic, which is in one of the areas of Germany where parasailing is most popular, shows that the phase of enthusiasm is still in full swing. A total of 48 injuries sustained during parasailing and treated in our clinic within 6 months were analyzed with reference to causes, patterns, and frequencies. Most of the injuries occurred with unfavorable wind and weather conditions; 58% of them occurred in the start phase as the result of falls on uneven ground, on rocks, or trees; 10% during the flight phase as a result of turbulence or collisions with obstacles; and 32% during the landing phase, mainly by falling on the back from some height while landing too slowly, or by falling forward while landing too fast with back wind. As to the sites of the injuries, 60% were to the lower extremity, 26% to the upper extremity, and 14% to the body. The most serious injuries were fractures (42%), contusions (26%), ligamentous lesions (19%), luxations (6%), and deep wounds (6%). The most frequent injuries were ligamentous lesions and fractures of the upper ankle (14), spine contusions (5), radial fractures (4), knee contusions (4), hand fractures (3), calcaneus fractures (2) and shoulder luxations (2). We classed 56% of the injuries as mild, 42% as moderate, requiring subsequent operation or hospital treatment, and 1 as severe, with 2 months' hospital inpatient treatment.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2762822 TI - [Treatment of infected total hip endoprostheses]. AB - In total hip arthroplasty the most serious complication besides aseptic loosening is infection. The results observed in 42 cases of infected hip arthroplasties are presented. In contrast to early superficial infection, deep infection following total hip replacement is difficult to treat. Depending on the general condition of the patient, a well-defined, adequate treatment is required. In patients at vital risk the provocation of a permanent fistula can be recommended as an alternative method in preference to revision arthroplasty. PMID- 2762824 TI - Monoclonal antibodies I. PMID- 2762823 TI - [Treatment of chronic decubitus ulcers by fascio-cutaneous and cutaneous flaps in paraplegic patients]. AB - Together with musculocutaneous flaps, cutaneous and fascio-cutaneous flaps have proved to be the most successful for the closure of decubital ulcers in paraplegic patients. These complicated and infected skin/soft tissue defects must not be closed until the ulcers have been cleaned locally as far as possible of necrotic and suppurating secretions and coverings and a specific antibiotic treatment administered. From October 1986 to May 1988, a total of 67 decubital ulcers in 53 patients were covered with fascio-cutaneous or cutaneous flaps after a preparatory local treatment. Except in 6 patients who had preoperative sepsis with temperatures ranging from 38 degrees C to 39 degrees C (infection of the urinary tract) no antibiotic treatment was used perioperatively. As a result, we observed a reduced rate of local complications (11%) and a shorter duration of treatment and hospitalization (about 6 weeks less) even though these patients were at risk of complications in view of the average ulcer size, frequency of bone involvement and the frequent presence of multiple ulcers. PMID- 2762826 TI - Cisplatin: contemporary treatment approaches. PMID- 2762825 TI - Uptake of gallium in the mediastinum. PMID- 2762827 TI - [Hemodynamic effects of the Bezold-Jarisch reflex in rabbit]. AB - The Bezold-Jarisch reflex induced by intracoronary injection of nicotine (ICIN) of 5 micrograms/kg was studied in 40 anesthetized rabbits. Heart rate (HR), arterial blood pressure (ABP), left ventricular pressure (IVP), left ventricular dp/dt (LV dp/dt) and cardiac output (CO) were monitored and total peripheral resistance (TPR) was calculated. HR, ABP, LVP and LV dp/dt were decreased following ICIN. These inhibitory responses induced by ICIN were enhanced by sino aortic denervation but abolished by bilateral vagotomy. Decreases in CO and TPR were also observed in response to ICIN. With the heart paced artificially to prevent bradycardia, the decreases in CO, TPR and ABP were still significant. Bilateral stellate ganglion section plus atropinization which abolished the decreases in HR and CO, did not significantly change the hypotensive response to ICIN. These data suggest that the hypotension evoked by Bezold-Jarisch reflex in rabbit is largely due to the decreases in TPR and partially caused by the decrease in CO. PMID- 2762828 TI - [Measurement for instantaneous acceleration of ventricular pressure and its significant]. AB - The indices of the first and second derivatives of the left ventricular pressure were compared in terms of their inotropic sensitivity and preload, afterload and heart rate dependence in 14 rabbits. In comparison with (dp/dt)max, (d2p/dt2)max is more sensitive to inotropic stimulation. Both indices are increased with increasing preload, afterload and heart rate (HR), but the difference in their dependences on load and HR is not statistically significant. The results suggest that (d2p/dt2)max is a better index of ventricular performance than (dp/dt)max. PMID- 2762829 TI - [Role of rostral ventrolateral medulla in the pressor response to intracerebroventricular injection of neostigmine]. AB - Experiments were carried out on 47 urethane-chloralose anesthetized and flaxedil immobilized rabbits under artificial respiration. Intracerebroventricular injection (ICV) of neostigmine (100 micrograms/200 microliters) caused a marked increase in blood pressure (BP), left ventricular pressure (LVP) and renal sympathetic nerve discharge (RND), while femoral blood flow (FBF) and conductance (COND), were decreased and the heart rate (HR) was initially reduced and then slightly increased. Microinjection of atropine (0.25 micrograms/site) into the rostral ventrolateral medulla (rVLM) caused a decrease in BP, HR, RND and LVP and a increase in FBF and COND. Pretreatment of atropine injection into rVLM before ICV of neostigmine blocked the pressor response of neostigmine. These results indicate that rVLM is important for the pressor response to ICV neostigmine, which may be mediated via cholinergic muscarinic receptors in rVLM. PMID- 2762830 TI - [Effect of cardiac sympathetic nerves on changes of TXB2 and 6-keto-PGF1 alpha in venous blood of ischemic myocardium]. AB - Experiments were performed on 54 anesthetized, open-chest dogs to observe the effect of cardiac sympathetic nerves and alpha- and beta-adrenoceptor blockades on changes of platelet function during the early phase of myocardial ischemia. It was shown that contents of TXB2 and 6-keto-PGF1 alpha after coronary occlusion were markedly increased, and the platelet count was reduced in the coronary venous blood of ischemic myocardium. It was found that the changes in parameters of platelet function after coronary occlusion were significantly relieved by topical application of lignocaine-soaked gauze pads to the ischemic area of the heart or by bilateral stellectomy for blocking impulse of afferent and efferent of cardiac sympathetic nerves, compared with changes in parameters of control group, P less than 0.01. On the other hand, changes in parameters of the control group could be restored by intravenous infusion of noradrenaline to dogs which bilateral stellectomy was performed on, but not by infusion of normal saline. Different effects of alpha- and beta-adrenoceptor blockades on the changes in aforementioned parameters were found. The changing degrees in elevation of TXB2 and 6-keto-PGF1 alpha and in decrease of platelet count were significantly relieved by intravenous infusion of yohimbine (an alpha 2-blocker), phentolamine (a nonselective alpha-blocker), and propranolol (a beta-blocker), but not by infusion of prazosin (an alpha 1-blocker). Results were compared with the control group, P less than 0.01. These results suggest that cardiac sympathetic nerves play an important role for the changes of platelet function during the early phase of myocardial ischemia and that, yohimbine and phentolamine may exert an improving effect by blocking alpha 2-receptors on the platelet membrane, and propranolol may directly contribute to stabilization of the platelet membrane. PMID- 2762831 TI - [Effects of microiontophoretically applied flurazepam on the respiratory units in the region of the nucleus parabrachialis of the rabbit]. AB - Experiments were carried out on 36 urethane-chloralose aneasthesized, paralyzed, vagotomized and artificially ventilated rabbits. Five-barrel glass micropipettes were used to record unit discharges and to apply flurazepam iontophoretically in the region of the nucleus parabrachialis. Inspiratory units (IUs), expiratory units (EUs), phase-spanning units (I-EUs and E-IUs) and non-respiratory units (NRUs) were observed. 26 (55.3%) out of 47 IUs, 17 (94.4%) out of 18 EUs, 11 (91.7%) out of 12 I-EUs, 2 (18.1%) out of 11 E-IUs and 43 (60.6%) out of 71 NRUs were depressed by flurazepam. The depressant ratio of EUs and I-EUs was statistically different from that of IUs and E-IUs respectively. In flurazepam sensitive 5 IUs and 2 EUs, the depressant effect could not be antagonized by GABA A receptor antagonist bicuculline. In 10 flurazepam sensitive NRUs, there were 6 (60%) units whose depressant effect of flurazepam could be antagonized by bicuculline. In addition, the effects of acetylcholine (ACh) on the respiratory units and NRUs were examined, 15 (75%) out of 20 IUs were excited and the remaining units were not influenced. The effects of ACh on the EUs, I-EUs and E IUs were variable, but the effects of ACh on the NRUs were mainly excitatory. In 5 IUs and 1 phase-spanning respiratory units, the depressant effect of flurazepam could not be antagonized by ACh. The results showed that flurazepam mainly depressed the EUs and I-EUs in the region of nucleus parabrachialis, thus interfering with the normal phase transition between the inspiratory and expiratory phase and reducing the respiratory rate.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2762832 TI - [Electrophysiological properties of the cells in intermediolateral nucleus of neonatal rat spinal cord slices in vitro]. AB - Intracellular recordings were made from the cells in the interm ediolateral nucleus (IML) of neonatal rat spinal cord slices in vitro. Both resting and active electrophysiological properties of the cellular membrane were investigated. Resting membrane potential ranged from -46 to -70 mV. The means of input resistance, time constant and membrane capacitance were 108.3 +/- 67.9 M omega (mean +/- SD), 9.9 +/- 5.6 ms and 138.6 +/- 124.2 pF, respectively. Repetitive firing at high frequency (up to 150 Hz) could be produced in thirty five cells (85.4%) in response to intracellular injection of depolarizing current, while single spike firing produced in the remaining cells (15.6%). The amplitude and duration of action potentials evoked by intracellular stimulation were 63.4 +/- 9.0 mV and 2.4 +/- 0.6 ms, respectively. The threshold at the level of 18.7 +/- 6.2 mV was more depolarized than the resting potential. In most of cells, spikes induced by intracellular stimulation were followed by afterhyperpolarization, whose peak amplitude and duration were 5.1 +/- 2.7 mV and 90 +/- 31.8 ms, respectively. EPSP, orthodromic action potentials and, rarely, IPSP could be evoked by dorsal root stimulation, and antidromic action potentials were obtained by ventral root stimulation. Identification of sympathetic preganglionic neuron and functional significance of electrophysiological properties were discussed. PMID- 2762833 TI - [Comparison of the development between the satellite cells of ALD and PLD muscles of adult chicken in vitro]. AB - Satellite cells isolated from the anterior (slow) and posterior (fast) latissimus dorsi of adult chick were cultured separately in the absence of neural factors. The cells were observed under an inverted phase contrast microscope every day. The morphological changes of satellite cells, described by other workers, were seen in these cultures. Furthermore, the difference in the time course of development of the satellite cells from different muscles was found. That is, the transformation of the satellite cells of PLD into the myoblasts and the fusion of the latter delayed about 24 h as compared with ALD. The results support the idea that there may be an intrinsic developmental tendency in the myogenic cells of bird, since it proved possible to see the difference of the myogenic cells even in mononuclear phase. PMID- 2762834 TI - [Effects of splenectomy on changes in hemorrheologic parameters following coronary occlusion in dogs]. AB - Effects of splenectomy on changes of hemorrheologic parameters in the early stage of myocardial ischemia were observed in dogs. The results showed that splenectomy alleviated the increase in hematocrit and high shear viscosity of whole blood (r = 230 s-1) during 120 min of myocardial ischemia induced by coronary occlusion. Splenectomy reduced the increase in low shear viscosity of whole blood (r = 5.75 s-1) at 40 min and 80 min post-occlusion, but did not affect it at 120 min post occlusion. Splenectomy had no effect on changes in blood viscosity fibrinogen concentration and plasma viscosity following coronary occlusion. PMID- 2762835 TI - [Change of sympathetic efferent discharges in different regions during the Bezold Jarisch reflex in rabbit]. AB - In 46 anesthetized rabbits, the sympathetic efferent discharges in different vascular regions were recorded during the Bezold-Jarisch reflex induced by intracoronary injection of nicotine. The discharges of renal nerve, cardiac nerve, splenic nerve, ramus of stellate ganglion to cervical plexus and ramus of superior cervical ganglion to external carotid artery decreased significantly following injection of nicotine. The decrease in efferent discharge is more prominent in renal, cardiac and splenic nerves than in the other two nerves. These results demonstrated that the reduction in discharge of sympathetic efferent fibers of different regions and hence decrease in total peripheral resistance might play a significant role in initiating hypotension during the Bezold-Jarisch reflex. PMID- 2762836 TI - [Effects of stenosis on blood flow in the coronary artery of dogs]. AB - The effects of stenosis on coronary blood flow (CBF) were studied in 22 open chest mongrel dogs. A progressive stenosis was produced by a micrometer constrictor on the left circumflex coronary artery. Mean aortic pressure (Pa), distal coronary pressure (Pc) and stenotic segment pressure drop (delta P) were measured. Curve of CBF versus % stenosis showed that CBF was relatively constant with stenosis less than 85%, CBF rapidly decreased with stenosis of 85-95%, and then slowly reduced as stenosis was further increased. The change in CBF versus % stenosis was expressed as follows: CBF = 1.48 X 10(10) theta -27.6 A (where A = % stenosis in lumen area). With progressive coronary artery stenosis (greater than 75%), the change in percent stenosis and Pc showed a negative correlation: Pc = 159.1-1.36A (r = -0.73, P less than 0.01); the change in Pc and CBF showed a positive correlation: Pc = 16.9 + 1.3 CBF (r = 0.74, P less than 0.01). PMID- 2762837 TI - [Inhibition of renal sympathetic efferent activities induced by stimulation of the paraventricular nucleus of the hypothalamus(PVH) in rabbits]. AB - Experiments were performed on rabbits anesthetized with chloralose-urethane mixture, paralyzed with gallamine triethiodide, and ventilated artificially. Bilateral vagi, aortic and carotid sinus nerves were severed. Renal sympathetic efferent discharge (RSED) and its histogram were recorded, while the blood pressure (BP) of the femoral artery was monitored. When PVH was strongly stimulated, a transient increase of RSED was observed, which was followed by an inhibition of RSED. The inhibition of RSED was divided into two phases: the initial inhibitory phase without change in BP and the late inhibitory phase with an increase of BP. It was found that both the duration of total inhibition and the late, but not initial, inhibitory phase were positively correlated with the alterations of BP. When PVH was weakly stimulated, no change in BP was observed, but the inhibition of RSED still appeared. The inhibition duration was shortened remarkably following cutting of baroreceptor nerves. In some experiments, the RSED inhibition was not accompanied by a definite excitatory response. The present results indicate that 1) an inhibitory mechanism of PVH-renal sympathetic efferent system is present in the central nervous system; 2) the initial inhibitory phase of RSED originates from central mechanisms, while the late inhibitory phase is associated with the baroreceptor reflex and a direct action of the central nervous system; 3) the inhibition of RSED seems not to be a post excitation depression, but an active inhibition exerted by the PVH on the spinal sympathetic preganglionic neurons. PMID- 2762838 TI - [Projection of afferent impulses from the brachial plexus and sciatic nerve to the corpus striatum in pigeons]. AB - The corpus striatum were systematically explored by recording averaged potentials elicited by stimulation of the brachial plexus and sciatic nerve in 53 pigeons. It was found that the projection areas of brachial afferents were located within the neostriatum, the hyperstriatum and the ectostriatum. The sciatic projection areas overlap with the brachial projection areas in the neostriatum and a part of the hyperstriatum. Moreover, the brachial and sciatic projection are as in the striatum receive the inputs from both sides of the body. We suggest that the somatic projection areas of fore- and hindlimb are distributed diffusely in the striatum of the pigeon. That the projection area of forelimb is relatively larger is probably related with functional differentiation of the forelimb. Furthermore, the convergence of afferent impulses originating in the different regions of the body within the same brain area may be important for the integration of limb activities in pigeon. PMID- 2762839 TI - [Effect of intraseptal noradrenaline on somatic and visceral pain threshold of rabbits]. AB - With electric stimulation of the splanchnic nerve or the skin of the tip of rabbit's ear to measure visceral or somatic pain threshold, we studied the effects of noradrenaline microinjection into the septal nucleus on visceral pain and somatic pain and the relationship between the intraseptal noradrenaline and the intra-PAG opiate peptidergic system. There was no effect on visceral pain threshold after injections of alpha-agonist clonidine (10 micrograms/2 microliters) or alpha-antagonist phentolamine (10 micrograms/2 microliters). In a group injected with beta-agonist isoprenaline (1 micrograms/2 microliters), visceral pain threshold was raised remarkably, while beta-antagonist propranolol (10 micrograms/2 microliters) injected into bilateral septal nuclei decreased visceral pain threshold. Phentolamine (10 micrograms/2 microliters) or propranolol (10 micrograms/2 microliters) injected into septal nucleus induced an elevation of somatic pain threshold. The results indicate that the beta-receptor in spetal nucleus plays an important role in the modulation of visceral pain. Both alpha-and beta- adrenergic receptors have effects on the modulation of somatic pain. Intra-PAG microinjection of naloxone (1 micrograms/1 microliters) attenuated visceral analgesia produced by injection of isoprenaline (1 micrograms/2 microliters) into septal nucleus. Microinjection of anti-leu enkephalin antiserum (1:20,000) into PAG also attenuated the analgesia. When microinjection of isoprenaline into septal nucleus produced analgesia, the release of leu-enkephalin immunoreactive-like-substance in PAG was significantly increased. The results suggest that the analgesic effect of intra-septal noradrenaline on visceral pain is somehow related with the endogenous opiate peptidergic system in PAG, and the leu-enkephalin in PAG plays an important role in this process. PMID- 2762840 TI - [Electrophysiological study of the corticonuclear projection in the lobule VII of cat cerebellum]. AB - Antidromic field potentials and antidromic unit responses of Purkinje cells (PCs) to the stimulation of fastigial nucleus (FN), interposed nucleus (IN) and dentate nucleus (DN) were respectively recorded from the lobule VII of posterior cortex of decerebrated cats, to identify the corticonuclear projection in the lobule VII. After antidromically identified, simple and complex spike responses of PCs to natural peripheral forepaw extension-flexion stimuli were observed. All data were analysed by a computer, and average field potentials and poststimulus time histograms (PSTHs) were constructed. The results show that the corticonuclear zones are sharply demarcated on the lobule VII of posterior cortex. The boundary between the fastigial zone (FZ) and the interposed zone (IZ) on the lobule VII is not straight, but bends. Among sublobule VII Aa-VII Ad the FZ-IZ boundary bends from 2.8 mm to 1.5 mm laterally to the midline. The boundary between IZ and dentata zone (DZ) was about 5.0 mm away from the midline. The PSTHs of the simple and complex spike activities showed that part of PCs in all three different corticonuclear zones responded to the forepaw flexion-extension stimulation, but proportion of the cells affected was quite different among the three zones. In the IZ 84% PCs were modulated by the forepaw stimulation, while in the FZ and DZ it was 59% and 20% respectively. These results support previous finding that information processing involved in the modulation of Purkinje cell activity in response to the forepaw stimulation occurs in all 3 zones examined. PMID- 2762841 TI - [Left ventricular end-systolic pressure-dimension relation and its sensitility to the positive inotropic factor in the anesthetized open-chest dogs]. AB - Left ventricular end-systolic pressure-dimension relation (ESPDR) was generated by the transient occlusion of the inferior vena cava (IVC) or thoracic aorta (AO) in 13 anesthetized open-chest dogs, while the left ventricular pressure was measured by a TP-200T pressure transducer and the anterior-posterior dimension was measured by a pair of ultrasonic crystal implanted in the endocardium and recorded by a Sonomicrometer. The results showed that: (1) the ESPDR was shown to be linear, unaltered by preload or afterload changes; (2) dobutamine produced a significant increase in the slope (Emax) of the ESPDR-IVC and ESPDR-AO relations, without remarkable effect on the dimension-axis intercept (Do). However, the change in Emax was more significant for ESPDR-IVC (174.43 +/- 23.48%, n = 18), as compared with that for the ESPDR-AO (71.02 +/- 12.46%, n = 12); (3) Do of the ESPDR-AO relation was smaller than that of the ESPDR-IVC both under control and during dobulamine infusion. We conclude that the linear ESPDR can be derived in the anesthetized open-chest dogs either by caval occlusion or by aortic occlusion, and the slope appears to reflect left ventricular contractility. However, techniques used to generate the ESPDR may influence results, including the Do and the sensitivity of Emax to the inotropic state. PMID- 2762842 TI - [Studies on the origin of different discharge pattern of the two types of phrenic motoneurones by cross-correlation analysis]. AB - Experiments were performed on twenty five anesthetized, paralyzed, vagotomized and artificially ventilated rabbits. Discharges of single phrenic nerve fibers were recorded. According to their discharge patterns, phrenic motoneurones were divided into two types: tonic units (TU) and phasic units (PU). A cross correlation analysis was done between TU and TU, PU and PU, or TU and PU. In 21/36 pairs of phrenic motoneurones, the cross-correlation histogram showed a significant central peak, which represented synchronization of the pair of units resulting from a common input. There were three types of synchronization: short term, broad peak and high frequency-oscillatory synchronization. The difference in synchronization number between heterogeneous pairs (1 TU and 1PU, 2/10 showing synchronization) and homogeneous pairs (2 TU or 2 PU, 19/26 showing synchronization) was statistically significant (x2-test, P less than 0.05). These results suggest that TU and PU have different central inputs, which result in their different discharge patterns between the TU and PU. PMID- 2762843 TI - [Role of prostaglandin E in modulation of granulopoiesis by marrow stroma]. AB - The stroma layer (SL) cultured from mouse bone marrow cells for one week, had an inhibitory effect on the granulocyte-macrophage progenitor cells (CFU-GM). The inhibitory effect decreased in the 2nd week SL, while the 3rd week SL promoted CFU-GM growth greatly. When indomethacin (1 x 10(-7) mol/L) was added into the CFU-GM culture system, the score of CFU-GM on the 1st week SL was raised, and on the 2nd week SL was further increased significantly, but it leveled off on the 3rd week SL. The addition of exogenous 10(-8) mol/L PGF1 suppressed the CFU-GM growth on all the 1st to 3rd week SLs. When 1 x 10(-8) mol/L PGE1 was added with 2 x 10(-7) mol/L indomethacin, 1st week SL-CFU-GM increased to 42.61%, 2nd week SL-CFU-GM nearly to 100% of the control. For the 3rd week SL-CFG-GM, 1 x 10(-7) mol/L indomethacin was enough to reverse the inhibition induced by exogenous 1 x 10(-8) mol/L PGE1. It is suggested that definite amount of PGE was produced from cells in the 1st week SL. The secretion of PGE from SL was reduced during 2nd week, and almost stopped in the 3rd week SL. The results indicate that the modulation of granulopoiesis by marrow stroma is, at least partly, mediated by PGE. PMID- 2762844 TI - [Antagonistic effects of angiotensin II and morphine on synaptosomal calcium uptake]. AB - Behavioral observations have repeatedly shown that the analgesic effect of morphine can be antagonized by intracerebroventricular injection of angiotensin I (A I), although mechanisms underlying the action were obscure. Since a prevention of Ca2+ uptake into the nerve terminals was considered as one of the mechanisms for morphine analgesia, we examined the effect of A I and morphine on the 45Ca uptake by rat brain synaptosomal preparations. Morphine of 10(-8)-10(-6) mol/L produced a dose-related suppression on synaptosomal 45Ca uptake, which was completely reversed by the opioid antagonist naloxone of 10(-6) mol/L. A I of 10( 8)-10(-6) mol/L, on the contrary, enhanced 45Ca uptake. This effect was totally abolished by saralasin, a A I antagonist, at 10(-6) mol/L. When synaptosomal preparations were incubated in a mixture of morphine (10(-6) mol/L) and A I (10( 8)-10(-6) mol/L), the effect of morphine was almost completely reversed. The results suggest that the distinct effect of A I may account for, at least in part, the antagonistic effect of A I on morphine analgesia. PMID- 2762845 TI - [Comparison of promoting the proliferation and fusion of myoblast between conditioned media from fibroblasts of chick embryo and fetal mouse]. AB - Conditioned media were prepared by using the collected media which had cultured fibroblasts from muscle tissue of fetal mouse (ICR) or chick embryo (Leghorn chicken). The effects of these media on the proliferation and fusion in mouse or chick myoblast were studied quantitatively. The results were as follows: (1) the conditioned medium from fibroblasts of fetal mouse promoted the proliferation of mouse or chick embryonic myoblasts by 2.65 times (P less than 0.001) or 2.35 times (P less than 0.01) as compared with control groups respectively. (2) The conditioned medium from fibroblasts of embryonic chicken promoted the proliferation of chick or mouse embryonic myoblasts by 2.66 times (P less than 0.01) or 2.17 times (P less than 0.01) respectively. (3) The conditioned medium from fibroblasts of fetal mouse enhanced the fused rate of mouse or chick myoblasts by 1.9 or 2.6 times respectively. The conditioned medium from fibroblasts of embryonic chick enhanced the rate of chick myoblast fusion by 2.1 times, but the effect on the mouse myoblast fusion was not remarkable. The results suggest that the effect of fibroblast conditioned media on myoblast proliferation is similar in the two species, but the effect on the fusion of myoblasts is somewhat species-specific. PMID- 2762846 TI - [Cross correlation function of BAEP for objective assessment of hearing threshold]. AB - Brainstem auditory evoked potentials (BAEP) recorded were equally divided into two subensembles and a cross correlation function R (lambda) was calculated for them. The average amplitude of R (lambda) around lambda = 0 was chosen as the criterion for hearing threshold measurement. A linear regression equation which represented the relationship between the criterion and stimulus intensity above threshold was obtained on 21 normal and abnormal ears and thus a equation for assessment of hearing threshold was derived. When the equation was applied to ears to be evaluated, the criteria obtained at three different stimulus intensities above threshold were put into the equation and the mean value was calculated for assessment of hearing threshold. The results from 8 ears with different degrees of hearing loss demonstrated that the differences between estimated thresholds and corresponding subjective thresholds are 4.6 dB on the average. PMID- 2762847 TI - [Effects of human chorionic gonadotrophin and progesterone on small intestinal migrating myoelectric complex in rats]. AB - The effects of human chorionic gonadotrophin (HCG) and progesterone (P) on migrating myoelectric complex (MMC) of the small intestine in ovariectomized rats were investigated by implanted monopolar-electrode in the intestinal wall of the duodenum, jejunum and ileum. The results showed (1) after i.v. administration of HCG the periodicity of the duodenal and upper jejunal MMC was interrupted by irregularly prolonged phases II occurring intermittently; (2) after i.m. administration of P the duration of phases I and II of the duodenal MMC was significantly prolonged, but the periodicity was not affected; (3) the effect of P plus HCG on MMC was similar to that of HCG alone, but the combined effect was spread over the whole small intestine. These results suggest that HCG can induce remarkable changes of the small intestinal MMC, which are similar to those observed in pregnant rats. In the presence of P, the effect of HCG is enhanced markedly. PMID- 2762848 TI - [Effect of tyrosine on progesterone and hCG production by human trophoblast cells in vitro]. AB - The purpose of the present study was to investigate the effect of tyrosine on progesterone and hCG production by human placental cells in vitro. The results showed that the three concentrations (0.02 mmol/L, 0.2 mmol/L and 2mmol/L) of tyrosine inhibited progesterone secretion by trophoblast cells in vitro. While progesterone secretion was suppressed by tyrosine, hCG secretion was unchanged. Thus, it seems unlikely that the suppression of progesterone production by tyrosine was due to a decrease in hCG production. It was further demonstrated that tyrosine inhibited 3 beta-HSD activity of trophoblast cells, indicating that the progesterone production inhibition by them might be due to the decreased 3 beta-HSD activity of trophoblast cells. PMID- 2762849 TI - [Ultrastructural changes in rat-incisor dentinogenic cells after administration of 5-fluorouracil]. AB - Single intraperitoneal injections (180 mg/kg) of 5-fluorouracil (5-FU) were administered to male Wistar rats weighing 100 g each. After 1, 2, 3, 4, 5, 7, 10 and 21 days, the animals were fixed by perfusion with a mixture of 2.5% glutaraldehyde and 2.0% paraformaldehyde. The maxillary incisors were dissected out; and optical-microscopy, microradiography, and transmission electron microscopy were made of changes occurring in the dental-papilla cells, odontoblasts, and dentin matrix. 1. One day after the 5-FU injection, considerable amount of damage had occurred in the basal portion of the incisor forming a large void in the dental-papilla (cell-free region) immediately below the inner enamel epithelium. But, 4 days after the injection, the cell-free region was filled again with numerous newly regenerated dental-papilla cells (reparative region). Thereafter these cells differentiated as regular odontoblasts. 2. In 1 day after the injection, dental-papilla cells that had begun differentiating into odontoblasts degenerated and atrophied (degeneration region). Round cells appeared on the pulp sides of degenerated and atrophied odontoblasts 3 days after the injection. These cells increased in both size and number and formed a hard tissue in which the degenerated odontoblasts had embedded. The matrix of the newly forming hard tissue was composed of closely arranged collagen fibrils. Matrix vesicles were observed in the initial stage of its mineralization. Dentin had deposited on the pulp side of this hard tissue 21 days after the injection. 3. Dentin formation in the reparative region began 7 days after the injection; and, by the twenty-first day, ordinary dentin thickness had been attained. In the degeneration region, however, a little dentin was formed. In contrast, on both sides of the degeneration region, dentin formed in a virtually normal fashion and grew thicker with the passing of time, creating a deep, bowl-shaped concavity in the degeneration region. PMID- 2762850 TI - [Pharmacokinetic significance of measurement of salivary penetration of protein unbound pyridonecarboxylic acid antimicrobial agents]. AB - The author attempted to determine the feasibility of monitoring blood concentration of antimicrobial agents by estimating blood levels of the agents on the basis of their content in saliva. Since it is difficult to determine drug tissue-penetration degree in humans, at present, tissue concentrations must be estimated from corresponding blood concentration. In the case of orally administered drugs exhibiting great individual differences in absorption by the gastrointestinal tract, frequent blood collection is required for blood concentration monitoring. Noninvasive and very simple saliva collection, on the other hand, has already been used for monitoring concentrations of such drugs as carbamazepine and antiepileptics. PPA, ENX, NFLX, and OFLX are pyridonecarboxylic acid antimicrobial agents of great usefulness because of their expanded antimicrobial spectrum and their effectiveness even against gram-negative bacteria that exhibit no adequate response to other oral antimicrobial agents. After PPA, ENX, NFLX, and OFLX were administered orally to healthy volunteers, serum and saliva samples were collected. The samples were then centrifuged, deproteinized, and freeze-dried. 1. After the freeze-dried samples were dissolved to give tenfold to twentyfold concentrated solutions, levels of agents were bioassayed by means of the thin-layer-disc method. On the basis of the data obtained in this way, pharmacokinetic analyses were performed according to the one compartment model of Imoto and Yamaoka. A personal computer (NEC-8801, 9801) was used in drawing simulated curves. 2. Percentages of salivary as compared to serum concentrations were as follows: PPA (500 mg)-70, ENX (300 mg)-75, ENX (200 mg)-78, NFLX (200 mg)-35, and OFLX (200 mg)-105. Corresponding values for pharmacokinetic data were as follows: PPA (500 mg)-77.2, ENX (300 mg)-74.2, ENX (200 mg)-85.0, NFLX (200 mg)-30.0, and OFLX (200 mg)-91.6. Coefficients of correlation (r =) between salivary and serum concentrations in measured data were as follows: PPA (500 mg)-0.915, ENX (300 mg)-0.989, ENX (200 mg)-0.953, NFLX (200 mg)-0.887, and OFLX (200 mg)-0.886.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2762851 TI - [Ultrastructural changes in rat-incisor odontoblasts and dentin caused by administration of sodium fluoride]. AB - Subcutaneous injections of 8.4 mg of sodium fluoride were administered to young male Wistar rats weighing 100 g each. After 1, 3, 6, 12, and 24 hours and then after 2 and 4 days, the rats were fixed by perfusion; and their upper incisors were subjected to optical microscopy, microradiography, and electron microscopy. In some instances, 0.1% ruthenium red (RR) was added to the fixing or demineralizing solution for the sake of observing acid-mucopolysaccharide distribution. 1. The following changes were observed in odontoblasts: swelling of the rough endoplasmic reticulum, vacuole formation, increased numbers of autophagic vacuoles and Golgi vacuoles, and abnormal accumulation of cytosome-4. All of these changes tended to have recovered by 24 hours after administration. 2. In the predentin, abnormal increases in amounts of amorphous substance occurred 1 hour after and continued until 12 hours after administration. Thereafter, increases gradually retarded; and the level observed in controls was restored by the fourth day after administration. RR staining showed this amorphous substance to contain large amounts of acid mucopolysaccharides. 3. Two types of abnormal collagen--segmental collagen aggregate (SCA) and fibrous long spacing collagen (FLS)--were observed in the amorphous substance mentioned in the preceding paragraphy. In longitudinal sections, SCAs were 320 nm long and 200 nm wide; symmetrically arranged striations were visible within them. FLSs were observed as long, thick fibrils with periodic striations of about 160 nm. With the passing of time, these abnormal collagen aggregates and fibrils shifted from the distal end of the odontoblast toward the dentin, in which they became embedded. 4. Mineralization in the abnormal collagen commenced with deposition of needle-shaped or thin platelike crystals. As time passed, the collagen came to be completely covered with the crystals. Loosening of collagen molecular binding seems to occur following advances in mineralization and crystal growth. 5. Abnormality in dentin mineralization resulted in the formation of a hypermineralized layer and a hypomineralized layer beneath the hypermineralized layer. The hypermineralized layer contained densely distributed crystals. Its boundary with the hypomineralized was clearly observable. The boundary with teh regular dentin, however, was shifting and indistinct. PMID- 2762852 TI - [Experimental studies on augmentation of the mandibular region with proplast and lyophilized homogenous cartilage]. AB - Proplast I, Proplast II and freeze-dried homogenous cartilage (1 x 2 x 5 mm) were implanted under and over the rabbit mandibular periosteum. Histological observations and contact microradiography (CMR) were performed to investigate the healing process in the surgical sites from 1 to 24 weeks after the operation. In addition, microangiography (MA) was carried out to investigate changes of vascularization in the groups in which Proplast implants were made. Results 1. Proplast implantation group 1) In the supraperiosteal placement group, CMR revealed no new bone formation around or inside the Proplast and no morphological changes of the host bone in contact with the Proplast. In the subperiosteal placement group, from the early postoperative stage, new bone formation occurred from the host bone beside the Proplast. New bone penetrated the Proplast from the new bone region and from the host bone in contact with the Proplast. In 6 months after the operation, Almost all Proplast pores were filled with new bone. From a comparatively early postoperative stage, resorption fossae appeared in the host bone surface. In addition, Haversian canals inside the host bone enlarged and the host bone cortex gradually grew thinner. No differences in new bone volume or host bone changes were noticed between the Proplast I and Proplast II groups. 2) In the supraperiosteal placement group, granulation tissue proliferation with slight round cell infiltration was observed around and inside the Proplast at an early stage. In 2 weeks after the operation, blood clots disappeared from the Proplast, in the center of which granulation tissue proliferated. Thereafter, granulation tissue was gradually transformed into fibrous tissue, although no new bone was observed in any region. Change almost never occurred in the host bone cortex, but slight swelling occurred in the periosteum in contact with the Proplast after 1 week. 3) In the subperiosteal placement group, swelling and slight round cell infiltration were observed in the periosteum covering the Proplast at an early postoperative stage. But, after 4 months, the periosteum had returned to normal condition. Beside and inside the Proplast, rapid granulation tissue proliferation and new bone formation were observed. New bone formation was observed beside the host bone, but not beside the periosteum. For a comparatively long time, resorbed fossae in the host bone surface and enlarged Haversian canals persisted. Host bone width gradually decreased.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2762853 TI - [Growth and development of the dental arch and alveolar ridge in the incisal segment from the late period of mixed dentition to the early period of permanent dentition]. AB - The purpose of this study is to provide information on normal growth and development of the dental arch and alveolar ridge. Materials were longitudinal casts obtained from 38 children (male: 19, female: 19) with normal dentition. The casts were taken at 2-month intervals for the purpose of providing information on tooth emergence. Measurements for chronological age were taken from 11 years and 6 months to 13 years and 6 months. Measurements for dental age were taken during a period of 1 year before and 1 year after emergence of the permanent second molar. In addition to these dental age measurements, other measurements for dental age were made at each evaluation of dental arch length and basal dental arch length for a period of 1 year before and 1 year after emergence of the permanent second premolar. After a reference plane had been established and each cast had been standardized, a formcorder was used to trace 5 sagittal sections at the midline and at the region of the right and left central and lateral incisors. Growth and development of dental arch length, basal arch length, and alveolar width in both the maxilla and the mandible were measured on these 5 sagittal sections. Total dental arch length was taken to be the distance between the mesial surfaces of the permanent first molars and the labial surface of each incisor. Total basal arch length was taken to be the distance between the ridge of the posterior region of the basal arch and the most concave point of the labial basal arch. In addition to casts, lateral cephalometric films were used to measure, at ages 12, 13 and 14, changes in the vertical and horizontal dimensions of both the central incisors and the jaws and the long axes of the permanent central incisors. Results and conclusions 1. Mean growth in dental arch length 1) In the maxilla When growth was evaluated by chronological age, in 2 years, the total dental arch length decreased 1.0-1.2 mm in the region of the central incisors and 0.8-0.9 mm in the region of the lateral incisors. Evaluated by dental age based on the emergence of the permanent maxillary second premolar, up to 2 months before the emergence of that tooth, no notable changes occurred in the total dental arch length in the regions of both the central and lateral incisors. But a remarkable decrease of 0.9-1.1 mm took place thereafter.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2762855 TI - [The significance of information system of the presso-reception and reception of mandibular position based on the investigation of hardness discrimination ability of foods]. PMID- 2762854 TI - [Longitudinal changes in amounts of maxillary growth]. AB - The purpose of this study is to investigate postnatal developmental changes in the shape of the maxilla. Normal maxillary form at each development stage and amounts of growth were analyzed by longitudinally measuring 136 Indian skulls. Maxillary growth changes were assumed on the basis of mean values and growth rates of each region measured. Results 1) Vertical growth Vertical growth of the maxilla (N-Pr) at the fifth (permanent-dentition) stage approximately doubled growth in the first (pre-eruption) stage. The corpus of the maxilla and its alveolar process lay beneath the foramen infraorbit. Vertical growth in this region (m-Pr) increases rapidly during the period of eruption of deciduous and permanent teeth. In permanent dentition, the vertical dimensions of the upper (N m) and lower (m-Pr) parts of the foramen infraorbit were almost the same. 2) Growth in width As the eyes grow, the upper face widens. Resulting development in the tensed zygomatic-maxillary suture at the inferior margin of the orbit expands the upper surface of maxilla. Maxillary width increased by approximately 1.8 times between the first and fifth stages. PMID- 2762856 TI - XIth International Conference on the Social Sciences and Medicine. Leeuwenhorst, The Netherlands, 24-28 July 1989. PMID- 2762857 TI - AIDS: methodological problems in studying its prevention and spread. AB - This paper outlines some problems in conducting AIDS research in developing countries, discusses the impact of the socio-cultural setting on study efforts, and emphasizes the need for adopting methodological approaches that are highly sensitive to the environment. The importance of seeing AIDS as a disease that affects humans not merely biologically, but also socially--in terms of their conceptions of sexual behavior and their belief systems of disease, illness and sickness--is considered. The potential of scientists to disregard this facet in the study of AIDS is stressed. The imperatives for interdisciplinary collaboration between the medical and social scientists are examined to argue that without combining research agendas, significant variables will be ignored in the search for ways to control AIDS. Special attention is given to the limitations of several methods that are employed by medical and social science researchers, including research designs, sampling, data collection and analysis, to suggest that with AIDS research these may be difficult to operationalize. The ethical implications of some of these are weighed. The interaction of economic and political conditions of the context with research activity is explored. Suggestions are given which take cognizance of the fact that it is human beings and Third World conditions, as well as the complexities of HIV and AIDS, that make AIDS research so problematic. PMID- 2762858 TI - Assumptions governing approaches to diagnosis and treatment. AB - The article analyses two representative medical textbooks, one about regular or 'orthodox' medicine and the other about alternative or complementary medicine. The following dimensions of the disease-concept are discussed: definition, epidemiology, causation, natural history, pathology, clinical features, diagnostic procedures, treatment, effects, complications, rehabilitation, prognosis, prevention, doctor-patient relations, position of the patient, costs and burdens. Although the analysis is not yet complete, some general inferences may be drawn, i.e. the leading model of thinking in regular medicine may be termed 'classical' as opposed to that of complementary medicine, being more 'perspectivistic' in nature. Definitions of disease, as well as diagnostic procedures and therapeutic interventions are organ-specific in regular medicine, and whole-person oriented in complementary medicine. Complementary medicine pays more attention to developmental aspects in disease, the partnership of the patient, the long-term restoration of health, the avoidance of harmful side effects. Also, organisation of the care system is quite different for these types of medicine: being hospital-directed and highly differentiated in regular medicine, while the organisational model of complementary medicine is essentially of a home-centred, integrated type. PMID- 2762859 TI - The health of adolescents: beliefs and behaviour. AB - Adolescence is a period of transition from childhood to adulthood in which interlocking changes in the body, mind and social relationship take place. Healthy development depends on both a propitious environment and the action of adolescents themselves. A stable family, peace, material conditions for physical health, and educational, social and vocational opportunities with a chance to make use of them before marriage, are necessary environment conditions. However, within this context the adolescent must experiment with new behaviours and relationships inevitably courting some risks. Adolescent health is especially linked to behaviour. If the environment is inadequate or dangerous and the adolescent lacks self-esteem, behaviours dangerous to health are more likely to occur. These include: precocious and unprotected sexual behaviour sometimes resulting in too early or unwanted pregnancy and sexually transmitted diseases; the use of tobacco, alcohol and other drugs; injuries arising accidentally from risk taking behaviours especially when combined with alcohol or drugs; intentional injury whether self-inflicted or inflicted by others; and poor eating and habits of hygiene leading to obesity, or emaciation, acne and poor teeth and gums. Adolescent behaviour is often governed by their beliefs about what others think. Two way communication in a trusting atmosphere will reduce myths and misinformation and encourage healthy behaviour. The promotion of health, the prevention of problems, and their treatment and rehabilitation when they arise can best be accomplished with the active co-operation of young people. PMID- 2762860 TI - Understanding childrens' health behaviour: the implications for health promotion for young people. AB - Understanding the causes and determinants of young people's health behaviour is central to the development of relevant and effective health promotion programmes. This paper traces the development of health education programmes in the past two decades, identifying the influence of a range of concepts and theories which emerged during that period. Drawing on results from a WHO Cross-National Study of children's health behaviour, the relationships between individual behaviours and a range of social and environmental influences are illustrated, together with the inter-relationship between individual behaviours as 'lifestyles'. The implications for health education programmes from the results are identified and special emphasis is given to the need to communicate effectively with young people through a range of networks and through the media, as well as through traditional school health education. The need to continue research into 'lifestyles' is also stressed. PMID- 2762861 TI - Technological disaster--survival and bereavement. AB - Differences between natural and man-made disaster are described, deleterious psychological effects of technological components catastrophe appearing to be longer lasting. The psychological components of the experience of survival are outlined, and the concept of post-traumatic stress disorder located within this. Bereavement reactions, complicated by enhancement of the factors accompanying sudden, violent death, are also described, and risk factors noted. Finally, the development of community-based preventative mental health programmes which are acceptable to victims are detailed, emphasising restoration of the victims' sense of control over their own lives and the value of self-help. The role of counselling and specialist treatment is placed in this context. PMID- 2762862 TI - Ecological upheavals with special reference to desertification and predicting health impact. AB - This paper begins with an introduction that touches on the ecological upheavals of earthquakes, floods, as well as other upheavals that result from sudden huge crowding of people in one place such as in refugee situations and situations of a famine disaster. The point is made that for sudden emergencies the health impact will very much depend on the nature of traumatic physical damage on the people's bodies and property as well as the capacity with which response is organised for assessment of damage and medical management. A number of texts are mentioned with respect to management in emergencies, including health, feeding and water and the point made that familiarity with these texts provides a starting point in responding to emergencies. These have put together information on how one goes about organising the response to save lives. Also mentioned are the consequences of the approach taken to providing food in these situations; whether it is through distribution of dry ration to be taken home, or whether one is dealing with shelter situations. In this introduction, land degradation/desertification is mentioned as being the largest and possibly the most devastating ecological upheaval. The rest of the paper goes on to address this ecological upheaval of land degradation/desertification. The magnitude of this upheaval is presented. The contribution of overcultivation, overgrazing, deforestation and irrigation to desertification are discussed. The health consequence of this process is then presented and finally, there is a discussion on the challenges that social scientists and health professionals could help to address in order to bring about some appropriate interventions that would contribute to arresting and possibly reversing the desertification process. PMID- 2762863 TI - The contribution of medical care to inequalities in health: differences between socio-economic groups in decline of mortality from conditions amenable to medical intervention. AB - In order to investigate the contribution of medical care to the widening of mortality differences between socio-economic groups, we studied differences in the decline of mortality from conditions which have become amenable to medical intervention. For England and Wales, data on occupational mortality from the Decennial Supplements of the years around 1931, 1961 and 1981 were used. For the Netherlands, a more indirect approach had to be followed, using data on geographical variation in mortality for the years around 1952, 1962, 1972 and 1982. In England and Wales during the period 1931-1961 mortality from conditions which became amenable to medical intervention generally declined more in relative terms among the higher occupational classes, both for men and for married women. During the period 1961-1981 the picture was less consistent, although for about half of the conditions mortality declines were again larger in the higher occupational classes. The findings for the Netherlands suggest a similar pattern of differential mortality decline for a small number of conditions only. Possible explanations for these findings are discussed. We conclude that: the widening of the mortality differences between socio-economic groups in England and Wales was partly due to differences in decline of mortality from conditions amenable to medical intervention; the same may be true to some extent for the Netherlands, but the evidence is not striking; differences in decline of mortality from 'amenable' conditions were probably due, at least in part and at least up to 1960, to differences between socio-economic groups in accessibility, utilization or quality of medical care.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2762864 TI - Justice across the generations. AB - The title, 'justice across the generations', is reminiscent of expressions such as 'hands across the seas'. The latter is, of course, impossible in reality, but it symbolizes friendship between persons in far-flung lands. Is 'justice across the generations', likewise, no more than a hopeful metaphor, or is there, or at least should there be, some concrete reality to it? If so, what is, or should be, the substance of that reality? This text consists of some free association reflections, principally in the context of health care and mainly in the form of questions, on the concepts proclaimed in the title, namely, justice, across and generations, and what relevance these might have for our present and future societies. PMID- 2762865 TI - Non-governmental organizations in the health field: collaboration, integration and contrasting aims. AB - Non-governmental organizations, from being voluntary agencies often with relief or religious mission orientations, have become very important players in the field of social development. In this paper something is given of their evolution, diversity, aims and activities; and of the important role they now play in many instances, as well as some of the obstacles to collaboration, co-ordination and integration at different levels of operation--internationally, nationally and locally. PMID- 2762866 TI - Man and his parasites: integration of biomedical and social approaches to transmission and control. AB - The significance of sociocultural and behavioural factors in the transmission and control of parasitic infections has been underestimated. Explanations for this neglect include the failure of communication between biomedics and social scientists and reliance on control measures such as mass chemotherapeutic and anti-vector programmes which do not involve the participation of the community at risk. The need for an integrated approach to both the impact of parasitic infections and their control is now being recognised. Given their very high prevalence and the background socio-economic and other factors which exacerbate the problem, parasites of the subtropical and tropical countries will be the main emphasis of this discussion. The paper will illustrate a number of methodologies employed to look at the relationship between sociocultural and parasitic infections rather than provide a catalogue of interesting and yet isolated examples of human risk behaviours. These methodologies will include assessments of both individual risk factors and a broader framework to include larger social groupings including 'outsiders' involved in control programmes. Finally, the importance of this type of emphasis within control strategies will be discussed and a concluding section on research priorities and recommendations will be presented. PMID- 2762867 TI - Pain: its experience and treatments. AB - Recent sociological research about pain, in particular chronic pain, is part of a broader current of sociological inquiry into the problems raised by chronic illnesses. This inquiry is organized around two major axes: the relationship between chronic illnesses and medical work and the patient's experience of chronic illness. The first two parts of this article examine the place of research on pain in, and its contribution to, the sociological literature. The third part, based on personal field work, indicates how reflection on chronic pain and its medical treatments helps an understanding of the relationship between medical work and subject experience; and paths of possible research are pointed out. PMID- 2762868 TI - Schools of thought on pain. AB - Through an analysis of the way pain specialists speak about pain and deal with pain patients, the prevailing approaches to pain in eight academic pain centers in the Netherlands have been traced and studied. Major categories for distinguishing between the diverse approaches to pain are: theoretical statements about pain, definitions of pain patients, statements about therapy, and about recovery. On the basis of these categories, five ideal typical schools or approaches have been deduced. After a brief description of these schools, according to the above categories, and from the point of view of an ideal typical adherent (actor) of each school, I proceed to an in-depth inquiry into the major basic assumptions of these approaches with respect to their portrayal of man and the role of medicine. Finally, envisaging the phenomenon of pain within the context of everyday life, a new model is proposed for understanding the experience of pain; this also sheds light on the medical problem of patients with 'intractable' pain. PMID- 2762869 TI - A new age for older people? Policy shifts in health and social care. AB - This paper considers health and social policies for older persons from a cross national perspective and attempts to uncover some of the factors influencing policy formulation and implementation. The focus is on community care, its meanings and practical implementation. Examples are drawn from Western Europe and the U.S.A. to illustrate and explain differences and similarities. Two sets of explanatory factors are considered crucial. First, the structure of health and social care systems create incentives for clients, care providers and planners in certain directions. The degree of organisational fragmentation and of public control are seen to be the most important structural factors. Second, it is argued that the political and ideological context within which health and social systems operate must be understood if one is to assess the likely directions of future policies. PMID- 2762870 TI - Professional reimbursement and professional behavior: emerging issues and research challenges. AB - The decisions and actions of health care professionals have a major impact on such health care outcomes as cost, quality and equity. It is widely believed that professional behavior is determined, in part by how and how much they are paid. Professionals can respond to reimbursement incentives at both the individual level (treatment decisions, referral patterns, specialty choice, etc.) and at the level of the professional association. Health care analysts usually identify and discuss three principal reimbursement modes: salary, capitation, and fee-for service. Mixed systems are proliferating and need to be evaluated. Payment levels are determined by a mix of equity, market, and political considerations. They are believed by many to influence the behavior of providers, who are thought to act so as to preserve target incomes. The target income hypothesis has been tested for the case of physicians operating in a fee-for-service environment. The impact of changes in reimbursement levels on the behavior of other groups of professionals and on the behavior of professionals working in other reimbursement modes remains unclear. Both policy-makers and researchers need to broaden the way in which they think about professional reimbursement. To date, the field has been dominated by economists, inquiry has focused heavily on physicians, and empirical work has emphasized those dimensions of outcome which are most easily measured. Changes in the organization of health services and in society-at-large intensify the need for a broader view. PMID- 2762871 TI - Conceptual and methodological problems in research on the quality of life in clinical medicine. AB - This introductory paper discusses three issues: theory, validity of measurement and benefits of assessment. It is argued that the conceptual entity 'quality of life' remains ill-defined, although researchers commonly agree on its multi dimensional nature. The selectivity of dimensions under study is illustrated by referring to recent work on the quality of life in cancer and in cardiovascular disease. Despite conceptual weaknesses, promising developments are apparent in research methodology. The issue is discussed with special reference to the convergent and discriminant validity of some widely used research methods. Improvements in therapy and patient-physician relationships are considered among the major benefits of assessing the quality of life in clinical practice. In conclusion, this field of research, if based on appropriate theory, opens important opportunities for cross-fertilization between advanced medicine and the social sciences. PMID- 2762872 TI - Assumptions of the QALY procedure. AB - The Quality Adjusted Life Year (QALY) has been proposed as a useful index for those managing the provision of health care because it enables the decision-maker to compare the 'value' of different health care programmes and in a way which, potentially at least, reflects social preferences about the appropriate pattern of provision. The index depends on a combination of a measure of morbidity and the risk of mortality. Methodological debate has tended to concentrate on the technicalities of producing a scale of health; and philosophical argument has concentrated on the ethics of interpersonal comparison. There is little recognition of the fragility of the theoretical assumptions underpinning the proposed combination of morbidity and risk of mortality. The context in which the proposed indices are being developed is examined in Section 2. Whilst most working in the field of health measurement eschew over-simplification, it is clear that the application of micro-economics to management is greatly facilitated if a single index can be agreed. The various approaches to combining morbidity and mortality are described in Section 3. The crucial assumptions concern the measurement and valuation of morbidity; the procedures used for scaling morbidity with mortality; and the role of risk. The nature of the valuations involved are examined in Section 4. It seems unlikely that they could ever be widely acceptable; the combination with death and perfect health poses particular problems; and aggregation across individuals compounds the problem. There are also several technical difficulties of scaling and of allowing for risk which have been discussed elsewhere and so are only considered briefly in Section 5 of this paper.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2762873 TI - [An alarming respiratory disorder]. PMID- 2762874 TI - [The psychotic patient and the hospital facing the necessary treatment]. PMID- 2762875 TI - [Jeannot and Jeannette. History of a process between a couple]. PMID- 2762876 TI - [The game of the alcoholic according to and following Bateson]. PMID- 2762877 TI - [The suicidal patient in the hospital]. PMID- 2762878 TI - [Presentation: apropos of the interrelationships between institutionalized psychotic patients, their families and their caregivers]. PMID- 2762879 TI - [Somatization and hypochondria]. PMID- 2762880 TI - [The intramural day hospital--an element in the therapeutic choices in the trial of breaking the chronicity cycle]. PMID- 2762882 TI - [Family therapy and infant-child psychiatry]. PMID- 2762881 TI - [Forced relationships]. PMID- 2762883 TI - [A systematic approach within the institution]. PMID- 2762884 TI - Hydrocarbon ingestion: an unusual cause of multiple pulmonary pseudotumors. AB - I have reported a case of multiple pseudotumors seen on chest x-ray film after ingestion of roach killer in a suicide attempt. Hydrocarbon ingestion should be added to the list of causes of multiple pulmonary mass lesions. PMID- 2762885 TI - Delayed hemolytic transfusion reactions in sickle cell anemia. AB - Delayed hemolytic transfusion reaction (DHTR) developed in three patients with sickle cell anemia seen over an 18-month period at Cook Country Hospital. The DHTR was associated with severe pain crisis, with spherocytic hemolytic anemia, a positive direct antiglobulin test result, previously undetected erythrocyte alloantibodies, and disappearance of Hb A on cellulose acetate electrophoresis. Delayed hemolytic transfusion reactions may be more common than is generally recognized and should be considered when a patient has a sickle cell pain crisis shortly after receiving a transfusion. PMID- 2762886 TI - Fusobacterium necrophorum sepsis with cerebral infarction. AB - We have described the case of a 23-month-old female child in whom Fusobacterium sepsis progressed to cerebral infarction despite therapy with intravenous chloramphenicol and ampicillin. Some clinical improvement was noted upon addition of metronidazole to the treatment regimen. The child survived, but has severe neurologic sequelae. Physicians should suspect anaerobic infection in children who have signs of severe neurologic infection and in whom cultures are negative for aerobes. In selected cases, early treatment with metronidazole may be helpful. PMID- 2762887 TI - Listeriosis as an obstetric complication in an immunocompromised patient. AB - We have reported a case of maternal death associated with Listeria monocytogenes septicemia in a woman who was being treated with immunosuppressive drugs for lupus nephritis. This report, coupled with a previous case of L monocytogenes sepsis in a pregnant patient with AIDS, emphasizes that L monocytogenes infection may be an important, unrecognized pathogen in pregnant women with impaired immunity. PMID- 2762888 TI - Corynebacterium equi peritonitis in a patient receiving peritoneal dialysis. AB - Our patient represents the first reported case of peritonitis due to C equi. He had no known exposure to farm or domestic animals, and no evidence of underlying systemic immunodeficiency. After relapse, the patient was successfully treated with vancomycin, and catheter removal was not necessary. We suggest that C equi be added to the growing list of organisms not typically thought to be human pathogens that can cause peritonitis in patients receiving CAPD and recommend intraperitoneal vancomycin as primary therapy. Catheter removal may be necessary to clear the infection. Identification of the organism is important, as it may not respond to treatment with antibiotics such as cephalosporins or penicillins, which are commonly used to treat peritonitis. PMID- 2762889 TI - Metastatic laryngeal carcinoma as a cause of progressive ophthalmoplegia. AB - We have described a patient with primary laryngeal carcinoma who had bilateral progressive ophthalmoplegia. Repeated studies of cerebrospinal fluid and initial radiologic examinations failed to provide a diagnosis. Sphenoidal sinusotomy and biopsy were necessary to confirm the diagnosis of metastatic laryngeal carcinoma- a previously unreported phenomenon. PMID- 2762890 TI - Attempted self-administration of electroconvulsive therapy. AB - Rarely, a misguided or delusional patient will attempt to self-administer a relatively more invasive form of medical or surgical treatment. I believe this report to be the first described case of an attempt to self-administer ECT. A patient with schizoaffective disorder reported benefits from regularly applied electric shocks modeled on previously administered ECT and delivered by a modified electric livestock fence. Such a practice exposes the patient to the risk of a variety of injuries. PMID- 2762891 TI - Trichosporon beigelii peritonitis. AB - A patient receiving continuous ambulatory peritoneal dialysis, and who was known to be seropositive for human immunodeficiency virus but without AIDS or ARC, had peritonitis secondary to Trichosporon beigelii. The patient had been receiving oral antibiotics and had had recurrent bouts of bacterial peritonitis. Infection was cured with removal of the peritoneal catheter and intraperitoneal and intravenous amphotericin B. The course of this episode of Trichosporon beigelii peritonitis was similar to that of peritonitis caused by other yeasts. PMID- 2762893 TI - Prothrombin activity. PMID- 2762892 TI - Acalculous gallbladder disease. PMID- 2762894 TI - Pockets of subcutaneous cocaine: legal and clinical implications in a cocaine induced death. PMID- 2762895 TI - Internal medicine as a specialty. PMID- 2762896 TI - Emergency cardiac maneuvers. PMID- 2762897 TI - Have you laid yourself liable? PMID- 2762898 TI - Intimations of mortality. PMID- 2762899 TI - Stopping. PMID- 2762900 TI - AIDS in Hispanics. PMID- 2762901 TI - Behavioral prescription writing in smoking cessation counseling: a new use for a familiar tool. AB - Tobacco use, a self-inflicted epidemic, causes more than 390,000 deaths in the United States each year. Smoking is a habit perpetuated by both physiologic and psychosocial mechanisms. Physician use of behavioral prescriptions is a practical, familiar, and efficient method for achieving smoking cessation. Physicians should ask patients if they want to quit smoking, take a smoking history, motivate patients to quit by personalizing risks, set a quit date, and then follow the behavioral prescription. Behavioral prescription involves writing prescriptions based on a plan that leads the patient through five successive weeks of behavioral modification, culminating in complete cessation of cigarette use. Physician time involved is minimal, since the approach requires only two meetings in person--one at an initial patient visit, and a second at a follow-up appointment. PMID- 2762902 TI - Late stage Lyme borreliosis in children. AB - These cases illustrate that late stage Lyme borreliosis can occur in children without a history of tick bite or ECM; this disorder can manifest itself initially as a seventh cranial nerve palsy, heart block, or arthritis, and the arthritis syndrome can mimic oligoarticular juvenile rheumatoid arthritis. The diagnosis of Lyme borreliosis depends upon clinical recognition. In the absence of ECM, tests for antibodies to Borrelia burgdorferi can provide an invaluable tool in assisting in the diagnosis. Children who live in or visit areas endemic for Lyme borreliosis and who have arthritis, heart block, or neurologic disorders such as facial palsy should be tested for antibodies to Borrelia burgdorferi if no other cause for the disease syndrome is identified clinically. PMID- 2762903 TI - Neurologically asymptomatic patients with a single cerebral lacuna. AB - Sixteen patients with CT evidence of a single cerebral lacuna had no clinical findings to indicate stroke syndromes. All patients had systemic arterial hypertension; 12 (75%) had cardiographic evidence of left ventricular hypertrophy, ten (63%) had radiologic evidence of cardiomegaly, and ten (63%) had clinical signs of hypertensive retinopathy. All lacunas were located in the supratentorial region (seven in the anterior capsular limb, three in the caudate, two in the external capsule, two in the putamen, one in the corona radiata, and one in the thalamus). During the three-year follow-up period, seven had clinical lacunar stroke syndrome, three had cortical stroke, two had myocardial infarction, and one died suddenly of unknown cause. PMID- 2762904 TI - Isolated limb perfusion for stage I melanoma of the extremity: a comparison of melphalan and dacarbazine (DTIC). AB - Isolated limb perfusion (ILP) for melanoma of the extremity was first used clinically more than 30 years ago. Although ILP with chemotherapeutic agents has become routine practice in many oncologic centers, few studies have evaluated the therapeutic efficacy of particular agents. Two consecutive groups of 100 patients with stage I extremity melanoma of 1.5 mm thickness or greater were treated by ILP with either melphalan (L-PAM) or dacarbazine (DTIC). Demographics, clinical and pathologic stage, disease site, and complications were similar in both groups. No significant difference in the overall incidence of recurrent disease at two years was found between patients treated with either DTIC or L-PAM (22% vs 16%, respectively; P = .28). Patients who had perfusion with L-PAM, however, had a lower incidence of in-transit metastasis and recurrence at the scar than those having DTIC therapy (4% vs 12%, P = .06) at two years of follow-up. This preliminary report suggests that L-PAM may be more effective than DTIC in controlling scar recurrences and in-transit metastasis. Continued follow-up of this series of patients, with further analysis of patterns of recurrence and disease-free and overall survival at five years, will be necessary to better define the relative efficacy of L-PAM and DTIC in isolated limb perfusion. PMID- 2762905 TI - The elderly victim of rape. AB - A common misconception about sexual assault is that the rapist is motivated by a sexual desire stimulated by a victim seductive in her behavior or dress. A retrospective analysis of 740 reported sexual assaults revealed 21 cases involving a victim between the ages of 60 and 90 years of age. The elderly victim was more often white and the assailant more often black than when younger victims are involved. Also, the data suggest that the rape of elderly women may involve a relatively few rapists, and that their assaults are of a serial nature. This study concludes that these rapists are motivated by anger, possibly racially related, and a need to express power, rather than by sexual desire. PMID- 2762906 TI - Assessment of nutritional status in noninstitutionalized elderly. AB - Aging may modify both the availability of and needs for certain nutrients. Our study was done to assess the contribution of age alone to micronutrient levels in older volunteers (aged 60 or more). One hundred two healthy elderly white subjects, 63 women and 39 men, carefully screened by history or chart review, were studied in the fasting state. All were noninstitutionalized without serious chronic or acute illness; their diets were nutritionally adequate, containing more than two thirds of the recommended dietary allowance (RDA) for all nutrients, and no subject was taking more than twice the RDA of fat-soluble vitamins. These subjects had higher levels of plasma and red blood cell carnitine, and vitamins A, E, and C. They had lower levels of albumin, transferrin, and zinc than younger laboratory reference subjects. Retinol-binding protein, serum and red blood cell folate, and copper levels were not different. With increasing age, levels of transferrin and vitamins C and E fell; all other measured micronutrient levels were similar. Albumin, vitamin C, and copper values were higher among elderly women, and plasma and red blood cell carnitine values and zinc levels were higher in elderly men. There was great variability in the micronutrient levels despite similar nutrient intakes. PMID- 2762907 TI - New drug approvals in 1988. PMID- 2762908 TI - [Rehabilitation in severe cranio-cerebral trauma and closed diaphyseal fractures of the femur]. PMID- 2762909 TI - [Benign intracranial hypertension]. PMID- 2762910 TI - [Prognosis of the development of ischemic stroke]. PMID- 2762911 TI - [Barbiturate dependence]. PMID- 2762912 TI - [Fluorescent endoscopy in the diagnosis of cancer of the stomach]. PMID- 2762913 TI - [Microcirculatory disorders of the arm in post-mastectomy edema]. AB - Microcirculation disorders have been examined in 125 patients with postmastectomy edemas of the arms by the following methods: indirect radionuclide lymphography, phlebography, capillaroscopy, radionuclide examination of the microcirculation, measurement of the tissue pressure, morphologic examination of the skin and subcutaneous fat. The studies have made it possible to single out four principal stages of the microcirculatory disorders: functional, reversible, progressing, and decompensation. A correlation between the edema severity and the stage of the disorders has been revealed. Microcirculation changes have been related to the development of hypoxia, dystrophic changes aggravating the process. Administration of antioxidants and antihypoxants (prodectin, trental, vitamin E) for the correction of microcirculatory disorders has improved the immediate results of therapy. PMID- 2762914 TI - [Drainage of the uterine cavity in postpartum endometritis]. AB - Analyzes the results of management of protracted torpid postpartum endometritis (10 cases) and severe septic endometritis following a cesarean section (9 cases), multiple-modality treatment of these patients including prolonged influent aspiration drainage of the uterine cavity. Describes the drainage system, its fixation, and operation. Discusses a differentiated approach to infusion of the drugs directly into the uterine cavity in cases with the uterine inflammations. Demonstrates the advantages of multiple-modality treatment including the above method for some forms of postpartum endometritis. PMID- 2762915 TI - [Rheography of the pancreas]. AB - Basing on the anatomotopographic relationship between the head of the pancreas and the duodenum, and on their common blood supply, the authors have developed an original technique for recording the rheogram of the pancreas. Using a tube with two electrodes, introduced similarly as for routine duodenal exploration, rheograms of 31 normal subjects have been recorded. Computer processing of these rheograms has made it possible to derive a polynomial including 9 signs, describing the pancreatic circulation. The method is simple, informative, available for any clinic, brings highly significant results. PMID- 2762916 TI - [Diagnosis of cholestasis in acute hepatitis A and B using a mathematical method]. PMID- 2762918 TI - [External instrumental fixation of the spine in the treatment of spinal diseases and injuries]. AB - The authors analyze the results of treatment of 358 patients with specific and nonspecific spondylitis and with aftereffects of unstable fractures of the vertebrae proper, who have been operated on the spine destruction or instability area with the extrafocal fixation of the operated on segments by means of the Byzov apparatus. This method has yielded good clinical and functional results, effected the stability of the anterior and posterior portions of the operated on sites; it permits early (starting from the 5th-10th day postoperation) exercise of the patients, helps normal functioning of the body organs and systems, and activates the repair processes in the operated on sites. The incidence rate of the postoperative complications drops drastically, the patients rapidly recover their working abilities, and the invalidism is more rare. PMID- 2762917 TI - [Lymphovenous anastomoses in the prevention of post-mastectomy edema of the arm]. AB - Analysis of the clinical and experimental data has prompted the authors to try surgical correction of an impaired lymph drainage in the arm after radical mastectomy by effecting lymphovenous anastomoses. These anastomoses are intended to eliminate lymphostasis, the principal reason of a postmastectomy edema, by draining the lymph, outflowing from the arm, to the vein. The optimal sites for the formation of a lymphovenous anastomosis have been found the cubital fossa and the anterointernal surface of the lower third of the shoulder. The formation of such an anastomosis simultaneously with radical mastectomy eliminates operation lymphorrhea of the wound already by days 4-5 postoperation, this facilitating the wound healing. Such an approach to radical mastectomy technique may completely prevent the development and progress of a postmastectomy edema of the arm. PMID- 2762919 TI - [Acute bronchitis]. PMID- 2762920 TI - [Disorders of fatty acid composition and the processes of lipid peroxidation in chronic ischemic heart disease]. AB - The levels of lipid fractions, free and bound fatty acids, initial and end lipid peroxidation products in the blood plasma, red cell membrane resistance to hemolysis, and myocardial contractility before, during, and after therapy with lipostabil forte (0.6-1.8 g daily or 10 ml (0.5 g) i.v.) and bezafibrate (0.2 g 3 times daily) along with nitrates (10 to 30 tablets) have been examined by the routine methods in 159 patients with stable angina pectoris and postinfarction cardiosclerosis. A negative effect of high doses of nitrates on myocardial hemodynamics and fatty acid composition has been revealed, resulting in accumulation of bound fatty acids. Lipostabil has improved the patients' status, myocardial function, and lipid composition, reduced the levels of atherogenic lipids and lipid peroxidation products, as well as the concentration of fatty acids with an uneven number of C atoms, increased the fatty acid nonsaturation index and the level of medium-strand fatty acids. Improvement of the patient's condition in bezafibrate therapy has been less evident; the concentration of atherogenic lipids has been reduced, but the levels of bound fatty acids and of lipid peroxidation products has increased. Bezafibrate is recommended to be administered together with antioxidants. PMID- 2762921 TI - [Adaptation disorders and rehabilitation of drillers working on the shift expedition schedule in Western Siberia]. PMID- 2762922 TI - [Subpleural nerve block in stenocardia and myocardial infarction]. PMID- 2762923 TI - [Survival of patients with a history of myocardial infarction (data of a 10-year follow-up)]. PMID- 2762924 TI - [Diphtheritic myocarditis in adults]. PMID- 2762925 TI - [Effect of nasal provocation tests on bronchial patency in allergic rhinitis and asthma]. PMID- 2762926 TI - [Gastrointestinal biorhythms in chronic intestinal diseases]. AB - Gastric and intestinal bio-electrical activity (BEA) was assessed from body surface by means of a modified electrogastrograph, EGS-4M, in 387 patients with various intestinal conditions and 39 normal subjects. The method is simple, atraumatic and rather inexpensive. It revealed qualitative and quantitative BEA changes (uncoordination in half the cases, and increased amplitudes of waveforms I, IV and V) in patients with mild disorders, which were chiefly functional and involved no organic gastro-intestinal lesions (i.e., signs of gastric or colonic irritation). In cases of chronic small-intestinal conditions, involving impaired absorption syndrome, reduced waveform II and III amplitudes showed correlation to the severity of the latter. BEA normalization in the course of treatment provides an objective indicator of the degree of patient rehabilitation and the efficiency of treatment at large. BEA parameters cannot be used for nosologic or differential diagnosis. BEA measurements, combined with other techniques, can be useful for the assessment of motor/evacuatory activity of the digestive system. PMID- 2762927 TI - [Cancer of the short esophagus]. PMID- 2762928 TI - [Changes in the rheologic properties of the blood in peptic ulcer]. PMID- 2762929 TI - [Effect of hyperbaric oxygenation on lipid peroxidation and the antioxidant system of the blood in hepatitis B]. PMID- 2762930 TI - [Detection of Yersinia antigens in biological substrates from adult patients with Yersinia infection]. PMID- 2762931 TI - Preferential loss or inactivation of chromosome Z4 APRT allele in CHO cells. AB - In CHO cells, heterozygotes for the adenine phosphoribosyltransferase (APRT) locus arise spontaneously at high frequencies. However, such heterozygotes always yield APRT- mutants at low spontaneous rates. In an attempt to determine whether differences in the genomic environments of the two CHO APRT alleles might render one gene more susceptible to high-frequency spontaneous inactivation or deletion, we have mapped the functional APRT allele in four different spontaneous APRT heterozygotes. In each case, the functional APRT gene was found to reside on the Z7 chromosome; it was always the Z4 APRT allele that had been lost or inactivated. Two of these heterozygotes were shown to be physically hemizygous while the other two retained two copies of the APRT gene, indicating that the high-frequency event can involve either spontaneous deletion or inactivation. PMID- 2762932 TI - Intrapericardial diaphragmatic hernia. A case report. AB - A case of intrapericardial diaphragmatic hernia caused by blunt trauma is reported. The patient presented with gastric outlet obstruction symptoms. The diagnosis was made pre-operatively by means of plain chest radiography and barium swallow examination. Laparotomy was the surgical approach used. The diaphragmatic defect was too large to close primarily and a Marlex mesh-graft was used. Hydropneumopericardium, pericarditis and cardiac arrhythmias occurred postoperatively and the patient died despite efforts to treat these complications. Because of the rarity of this condition and possible fatal consequences, the important aspects of intrapericardial diaphragmatic hernia are reviewed. PMID- 2762933 TI - Pre-operative prophylactic transvenous cardiac pacing for bifascicular heart block. AB - Some authorities consider that the combination of right bundle-branch block with left axis deviation (bifascicular block) is not an indication for prophylactic insertion of a pacing generator in patients undergoing non-cardiac surgery. Five patients who developed peri-operative progression of bifascicular block to complete heart block are described. Bifascicular block, together with any other cardiovascular condition, advanced age or surgery in regions that promote vagal stimulation, merit consideration for prophylactic pacing. A cardiological opinion is an essential aspect of the pre-operative preparation of patients with this abnormality. PMID- 2762934 TI - Mesosigmoidoplasty in the treatment of sigmoid volvulus in children. AB - Sigmoid volvulus is a rare disease of childhood, which requires surgery. The case of a 12-year-old boy is reported. The main aetiopathogenetic causes and the proper surgical approach are also described with particular reference to the so called mesosigmoidoplasty, which consists of shortening the mesosigmoid by incision along its axis and transverse suture. PMID- 2762935 TI - Radiological signs of loosening of the femoral stem in cementless total hip arthroplasty. AB - The radiological evaluation of cementless stem hip arthroplasty has received scant attention in medical publications. A retrospective analysis of 34 patients who underwent RM iso-elastic hip arthroplasty indicated the existence of a reproducible series of radiological features visible on plain radiography, which correlated both with clinical failure and with arthrographic evidence of loosening in 10 cases. In addition, there was correlation with scintinographic results and findings at revision surgery. The radiological signs were as follows: radio-opaque lines within radiolucent zones, the 'pedestal' sign, stem shift, localised cortical hypertrophy, and proximal bony overgrowth. PMID- 2762936 TI - Surgical audit--workload, utilisation of manpower and beds, pattern of admission and operations in a community teaching hospital. AB - The first surgical audit from a South African teaching hospital is presented. During a 1-year period (1987) 1,725 patients were treated in a 60-bed unit (29 patients/bed/yr). Eighty per cent of admissions were emergencies; 1036 operative procedures were performed (45% emergency operations). Aspects of workload, utilisation of beds, pattern of admission and operations are discussed. The audit indicated that a surgical unit in an urban teaching hospital for white patients serves mainly as an acute surgical facility. PMID- 2762937 TI - Percutaneous drainage of immature pancreatic pseudocyst. A preliminary study of 4 cases. AB - The management of immature pancreatic pseudocysts is controversial because surgical external drainage is associated with a high morbidity and mortality rate. A study was conducted during which immature pseudocysts that were enlarging, causing pain or giving respiratory distress were selected for percutaneous drainage and placement of a pigtail drainage catheter under ultrasonographic guidance. This preliminary study of 4 cases demonstrated that this procedure is safe and does not cause morbidity or mortality. It is suggested that there will be no recurrence provided the catheter is well secured and that no communication between the cyst and the pancreatic duct can be seen on sinography and endoscopic retrograde cholangiopancreatography. PMID- 2762938 TI - Recombinant alpha-interferon as salvage therapy in multiple myeloma. A pilot study. AB - Ten patients with end-stage multiple myeloma refractory to conventional chemotherapy and hemibody irradiation received recombinant alpha-interferon as salvage therapy. The median duration of treatment was 8 weeks. One patient had an objective response and survived 8 months, whereas in the remaining 9 patients the disease progressed and median survival was 11.5 weeks. Side-effects were substantial and included confusion with extreme weakness, resulting in 5 patients refusing further therapy. The low response rate and the morbidity in this pilot study resulted in its discontinuation and the conclusion that recombinant alpha interferon as single-agent therapy used for salvage in patients with refractory myeloma is of no value. PMID- 2762939 TI - Validity of the register of medical practitioners for manpower planning. Results and recommendations from a postal sample survey. AB - A postal survey was conducted to assess the validity of the register of medical practitioners held by the South African Medical and Dental Council. This register has been used by researchers as a data source for assessing the distribution of medical practitioners. The register is not adequate for this function unless adjusted by sample survey results. Crucially, it overestimates rural and homeland doctor resources. The survey also revealed under-representation of women as doctors (17% of all doctors are women) and as specialists (6% of all specialists are women) and unavailability due to retirement of registered doctors as service providers (6% of all registered doctors are retired), particularly in community health (24%). Collection of this information at annual registration is recommended, along with the establishment of an 'overseas' section of the South African register. Failure to implement these recommendations will seriously impede health services research. PMID- 2762940 TI - Scintigraphy in skeletal trauma. AB - Five case reports demonstrate the value of bone scintigraphy in trauma. The bone scans clearly demonstrated fractures of the hip and pelvis that were not radiologically evident or the presence of which was doubtful, and also identified a number of unsuspected fractures in a patient with multiple injuries. PMID- 2762941 TI - Mercury poisoning. A case report and comment on 6 other cases. AB - The diagnosis of mercury poisoning requires a high index of suspicion. Mercury poisoning in a patient involved in illicit gold extraction is reported and 6 other cases considered. Some of the clinical features and treatment of this condition are discussed. PMID- 2762942 TI - Metachronous sarcomas in a patient with bilateral retinoblastomas. A case report. AB - This is the first reported case of two metachronous sarcomas developing in a patient after treatment of bilateral retinoblastomas. The histogenesis of the tumours is not clear. PMID- 2762943 TI - Identification of gene mutations allows for the molecular diagnosis of familial hypercholesterolemia. PMID- 2762944 TI - Quality of condoms. PMID- 2762945 TI - An outbreak of haemorrhagic conjunctivitis at a mine hospital. PMID- 2762946 TI - Hypothyroidism and hyperparathyroidism associated with lithium toxicity. PMID- 2762947 TI - General anesthesia in sickle cell disease. PMID- 2762948 TI - Nutritional aspects of hypertension. PMID- 2762949 TI - The total costs and demands of treatment of hypertension in South Africa. Contributions of drug costs, hidden costs and mass strategies. PMID- 2762950 TI - Effects of calcium antagonists on hypertension and diastolic function. AB - Calcium antagonists are known to decrease blood pressure acutely and chronically in hypertensive patients with hypertensive heart disease, and also to improve their systolic function. However, disorders of diastolic function may occur early in hypertensive heart disease. The improvement of diastolic function by nifedipine and diltiazem is described, although it was difficult to exclude systolic unloading as a cause of the improvement. It is emphasised that diastolic dysfunction can exist in hypertensive heart disease, and that the calcium antagonists nifedipine and diltiazem can improve diastolic dysfunction. PMID- 2762952 TI - Cancer balance sheet--bad news and good news. PMID- 2762951 TI - Treatment of femoral shaft fractures in children by early spica casting. AB - Eighty-five children with femoral shaft fractures were studied prospectively to determine the benefits of early application of a single-hip spica cast. They were compared with 85 children with similar fractures treated by skin traction for 4 weeks followed by a spica cast for 2 weeks. The study revealed that femoral shaft fractures in children can be treated in a single-hip spica cast with results comparable to those achieved by traction. The additional advantages were substantial savings in cost, early reunion of child with parents and increased availability of beds. PMID- 2762953 TI - You are only as old as you feel. PMID- 2762954 TI - An electronic apparatus for early detection of changes in red cell content of blood during anaesthesia. A preliminary report. AB - An electronic apparatus was developed for anaesthetists to use to detect changes in red cell concentration during surgery. The mechanism is based on the relationship between the red cell content and the electrical conductivity of blood. In a pilot study of 170 blood samples, a correlation coefficient of 0.9806 was obtained between haematocrit and the instrument readings. To evaluate the instrument's performance in practice, and factors that might influence its readings, a series of 10 cases of aortic surgery were investigated. It is concluded that, although changes in electrolyte concentration, pH and temperature do affect the instrument's readings, these are insignificant compared with those of red cell content, and that the device can be used to indicate a drop in red cell concentration. PMID- 2762955 TI - Oxygen saturation after bronchography under general anaesthesia. AB - Thirty-six patients undergoing bronchography or bronchoscopy under general anaesthesia were continuously monitored by pulse oximetry for 5 hours after these procedures. Significant falls in oxygen saturation were observed in the first hour and were of most clinical relevance in patients with preexisting pulmonary dysfunction who underwent bronchography. These results support the recommendation that supplementary oxygen should be provided for all patients undergoing this investigation. PMID- 2762956 TI - A 75 g glucose load for diabetic screening in pregnancy--an evaluation. AB - Screening for impairment of glucose tolerance in pregnancy is mandatory if a satisfactory standard of antenatal care is to be achieved. This is especially so in a population in which the prevalence of diabetes is unusually high such as in South African Indians. A number of screening systems have been devised utilising different glucose loads for glucose tolerance tests. Using the 75 g load recommended by the World Health Organisation our mean glucose value was 8.4 mmol/l. The sensitivity of this test was 83% with a specificity of 90.7%. A protocol of screening at an antenatal clinic is presented. PMID- 2762957 TI - Motor neuron disease in blacks. Epidemiological observations in Natal. AB - A series of 86 black, Indian and white patients with motor neuron disease were analysed retrospectively. Although the material does not allow statistically valid conclusions, there are sufficient cases among blacks to allow two prima facie observations in this population group: (i) motor neuron disease has an earlier age of onset than in whites and Indians; and (ii) more patients come from peripheral and rural areas than would be expected in prevailing circumstances. PMID- 2762959 TI - Visualisation of the C7-T1 level in the suspected injury to the cervical spine. PMID- 2762958 TI - The geriatric imperative. A major challenge to health professionals. PMID- 2762960 TI - On the need to maintain intravenous sedation without loss of the patient's consciousness. PMID- 2762961 TI - A contentious case. PMID- 2762962 TI - [Intraoperative anterograde spermatic phlebography: its usefulness in the treatment of varicocele]. AB - The value of intraoperative anterograde spermatic phlebography in the treatment of varicocele is maintained. The knowledge of the vascular anatomy making it possible to adapt surgical tactics to the needs of the particular patient. Use of this technique significantly reduced the risk of postoperative recurrences. PMID- 2762963 TI - [Ectopic ureter. Description of a clinical case with appearance of stress urinary incontinence]. AB - A case of ectopic ureter in a 45 year old woman arising after the onset of stress incontinence is reported. The patient presented complete pyeloureteral duplication with an ectopic ureter whose orifice drained into the proximal urethra. The embryology, diagnostic and therapeutic problems of the case are discussed with emphasis on the tardive appearance of the symptoms. PMID- 2762964 TI - [Specular crossed renal ectopia and balanic hypospadias in monozygotic twins]. AB - The observation of a balanic hypospadia with chordee associated with a renal malformation in both of identical twins is reported. Monozygosity of twins was demonstrated with the study of ABO, MNS, HLA and RH factor systems. Urography, performed in both twins, showed a specular crossed renal ectopia with fusion. Abdominal ultrasounds, Chest-X-ray and barium meal showed no other abnormalities. After an analysis of the embryogenetic mechanisms of twinning, the Authors elaborate a hypothesis to explain the development of this specular renal malformation, never reported up to date in identical twins. PMID- 2762965 TI - [Papillary cystadenoma of the epididymis. Apropos of a rare case in a patient with grade III varicocele]. AB - Primary tumours of the epididymis are rare and one of the rarest is papillary cysto-adenomas. For this reason, a case arising in a patient with Grade III varicocele seemed worth reporting. The report discusses the clinical case and describes the histological characteristics of the tumour. PMID- 2762967 TI - [International Conference on Informatics in Nephrology. Turin, 3 June 1987. I. Proceedings]. PMID- 2762966 TI - [Epidermoid cysts of the testis]. AB - Two cases of epidermoid cysts are described. Benign tumours of the testis are rare pathology entities accounting for less than 1-3% of all testicular tumours. Epidermoid cysts of the testis are included in this group of tumours and this pathology is most common in young adults. 85% of these cases, reported in the literature, are treated with an orchiectomy. The Authors describe an orchiectomy in an adult and a simple enucleation of the cyst in a young man; in the end the Authors draw their conclusion. PMID- 2762968 TI - [Lombardy regional registry for the replacement treatment in chronic renal insufficiency. Problems and prospects]. PMID- 2762969 TI - Computerized patient management in a nephrology department. AB - An integrated approach is described for the computerized management of a nephrology department. On a medical point of view, the system comprises a minimum medical record for every patient, different specialized records and knowledge bases presently covering hypertension, diabetes and chronic renal failure. From a technical point of view, the methodology used integrates data and knowledge management techniques. Various individual reports facilitate patient management. For hypertensive patients, an expert system is combined with the record system. The results of a preliminary evaluation are reported and future developments considered. PMID- 2762970 TI - [Tele-monitoring of dialysis. General and clinical aspects]. PMID- 2762971 TI - [Project of a teledialysis system. Technical aspects]. PMID- 2762972 TI - [A new dialysis folder: 1987]. PMID- 2762973 TI - [A simplified computerized file for patients on dialysis]. PMID- 2762974 TI - [Management processing of hemodialytic data. A 6-year experience]. PMID- 2762975 TI - [Automatic management of laboratory analyses]. PMID- 2762976 TI - [A predictive model of vascular instability in dialysis]. PMID- 2762977 TI - [Optimization of dialysis time using a personal computer]. PMID- 2762978 TI - [Computerization of "dialytic efficiency"]. PMID- 2762979 TI - [Analytic calculation of total urea mass in a single-pass dialysate during hemodialysis]. PMID- 2762980 TI - [Retinoic acid effect on the differentiation of blast cells in suspension]. AB - Cells from three patients showed maturation after incubation with retinoic acid (2 had M-3 AML and 1 had CML-B). Three additional patients showed spontaneous maturation (1 with M-2 and 2 with M-4 AML), and in them cell maturation was also achieved after incubation with retinoic acid and cytosine arabinoside (10 nM). These results confirm different maturation capability of leukaemic cells, as well as the possibility to induce cellular maturation with retinoic acid, especially in patients with acute promyelocytic leukaemia (M-3). PMID- 2762981 TI - [Comparative epidemiologic study of mortality caused by leukemia in Spain and the U.S.A. (1951-1983)]. AB - A study of the mortality due to leukaemias in Spain between 1951 and 1983 was performed. A clearly increasing trend was appreciated, with progressive higher affectation of males in the last four years, the mortality rates being constantly higher for this sex. When cytological types of the leukaemias, sex, and the different age groups were taken into account, and after comparing these findings with data reported from the United States of America, it was found that our mortality rates are in general much lower than those of the USA. Although the clinical course of the disease is similar for both countries as regards the four major groups of leukaemias, a striking increase of mortality in childhood (5-9 years) was found here in acute lymphoblastic leukaemia, which suggests, in accordance with our previous reports, high affectation of children in Spain. It seems advisable to improve the techniques and means of treating and preventing complications, especially infectious ones, in childhood. PMID- 2762982 TI - [Blood transfusion and survival of patients with neoplasms of the colon and rectum]. AB - The fate of 248 patients diagnosed of colorectal malignancies between 1973 and 1982 and subjected to radical surgery with curative purposes was analysed. The effect of peroperative whole blood and packed red cells transfusions, along with other co-variants, on the survival of the patients was studied. It was found, by means of the Cox analysis, that whole blood and the Duke's staging system had the most important correlation (p = 0.003 and p = 0.02, respectively) on the patients' prognosis and survival, no such relationship being found with packed red cells transfusion (p = 0.25). Dose-related association between the relapse index and the number of whole blood units transfused was shown by the Mantel's global trend test (p = 0.015). The different effect of the transfusion products would confirm the hypothesis that the relationship between transfusion and poorer prognosis, thought to be due to patient's immunosuppression and hence higher relapse index, could be determined by any ill-defined plasmatic factor. PMID- 2762983 TI - [Chronic myelomonocytic leukemia and solid neoplasms: is it a causal or a fortuitous association?]. AB - Out of a series of 36 patients with chronic myelomonocytic leukaemia (CMML), five cases are reported with the association of this hemopathy to solid neoplasms. In two patients this last was a cutaneous tumour, while the remainders had, respectively, papilloma of the bladder, carcinoma of the sigma, and cutaneous T cell lymphoma. These neoplasms were diagnosed in all cases prior to the discovery of CMML. When applying the "patient/year" method, significantly higher frequency of solid tumours was found for CMML patients, which would support the hypothesis that this myelodysplasia could be regarded as a paraneoplastic condition. PMID- 2762984 TI - [Reference intervals of hematologic parameters in the elderly]. AB - Red blood cell counts, haemoglobin, haematocrit, MCV, MCH, MCHC, RDW, platelet count, plateletcrit, platelet distribution width, white blood cell count, white cell differential count (absolute and per cent) and serum iron were studied in 167 people (96 women and 71 men) aged between 60 and 89 years. Significant differences between both sexes were found for all values except RDW, platelet count and percent differential count of white cells. The intervals comprising the central 95% of each values were calculated. In the time of the analysis, only haemoglobin concentration in men showed significant decrease with ageing, although inverse correlation with age was observed for haemoglobin, red cell count and haematocrit in men, and for platelet count in women. PMID- 2762985 TI - [Sudan black B-positive acute lymphoblastic leukemia]. AB - Inasmuch as Sudan black B stain is highly specific for myeloid cells and since over 3% positive blast cells meet the needs of diagnosis for myeloblastic leukaemias, we had the opportunity to study a 27 year-old male with acute leukaemia whose morphological, cytochemical, immunocytochemical (HLA-DR, CD-10, CD-19, CD-20, CD-21 all positive) and ultrastructural features were clearly in accordance with acute lymphoblastic leukaemia, except for 42% Sudan black B positivity of the bone marrow blast cells. The practical interest of this case comes from the necessity to take this rare ALL case into account. PMID- 2762986 TI - [Complete double remission and prolonged survival of a patient diagnosed with plasma cell leukemia]. PMID- 2762988 TI - [Study of the leukocyte anomaly of Pelger-Huet with the new Technicon H-1 system]. PMID- 2762987 TI - [Plasma cell leukemia]. PMID- 2762989 TI - [Free erythrocytic protoporphyrin and thalassemic trait]. PMID- 2762991 TI - [Topical contraception--spermicidal agents]. PMID- 2762990 TI - [Free erythrocytic protoporphyrin and thalassemia minor]. PMID- 2762992 TI - [Symptomatology of the menopause. The climacteric]. PMID- 2762993 TI - [Prescription of compensatory estrogens-progestagens in the menopause]. PMID- 2762995 TI - [Women, their menopause and their sexuality]. PMID- 2762994 TI - [Menopause. Which estrogens and which progestagens?]. PMID- 2762996 TI - [Women, their menopause and their body weight]. PMID- 2762997 TI - [Osteoporosis and its diagnosis]. PMID- 2762998 TI - [How to teach mothers who want to avoid routines. Indulging motherhood]. PMID- 2762999 TI - [The menopause]. PMID- 2763000 TI - [Motherhood without risk. A new hope for Africa]. PMID- 2763001 TI - [Vaccination of all the children in the world--the goal is in sight]. PMID- 2763002 TI - Dorsal vascular network of the first web space. Anatomical bases of the kite flap. AB - Thirty dissections were performed on adult non embalmed cadavers, after vascular injection with MICROFIL or Methylene blue. In contrast to the classical descriptions of a single dorsal metacarpal artery, this study shows the existence of a vascular network with 1 or 2 vessels running over or under the deep aponeurosis. Direct cutaneous arteries provide blood supply to the kite flap when the only dorsal metacarpal vessel of the first web space is in a deep situation. The main source of blood supply to the kite flap is described in each anatomical variation of the dorsal network. PMID- 2763003 TI - Anatomical intra-laryngeal anterior branch study of the recurrent (inferior) laryngeal nerve. AB - The studies are based upon 60 dissections of the recurrent laryngeal n. (inferior laryngeal n.). The authors describe in detail the branches destined for the intrinsic musculature of the larynx. This study is a working approach for interventions of selective laryngeal reinnervation in man. The conclusion is that, it is necessary to resect the inferior cornu of the thyroid cartilage, to reach the abductor and adductor branches of the vocal cord. PMID- 2763004 TI - Morphological and functional changes of the lumbar spinous processes in the elderly. AB - Starting from about the 40th year of life the lumbar spinous processes of man undergo morphological changes, which mainly affect their posterior edges. These changes consist of asymptomatic osseous appositions or spurs radiologically visible in the lateral view, with a major incidence in the elderly. Spondyloarthritis is a constant accompanying finding. Histologically the condition corresponds' to a process of substitution by Haversian bone of a layer of calcified fibrocartilage, which constantly occupies the ligamentous and tendinous attachments for a variable distance. While in the young adult fibrocartilaginous metaplasia is limited to the bony attachments of the spinous ligaments, in the elderly it spreads to the greater part or to all of their thickness. The author believes that such a phenomenon is due to a reduced flexibility of the vertebral column as a whole and to exaggerated lumbar lordosis with ageing. The elongation of the lumbar spinous processes secondary to osseous appositions increases the posterior arm of the lever and favours the "extensores spinae" m. PMID- 2763005 TI - Reflections on the mechanical structure of the base of the skull and of the face. Part 2: Discussion, current concepts and theories. PMID- 2763006 TI - MRI anatomy of the nerves of the upper limb. AB - In view of the good anatomic definition of the images obtained by magnetic resonance imaging (MRI), we have defined MRI sections allowing study of the nerves of the upper limb. PMID- 2763007 TI - Biometry of infrarenal inferior vena cava measured by cavography. Clinical applications. AB - Placement of a transvenous vena cava filter has became a common way to control recurrent pulmonary embolism. However few studies have been reported on the diameter of the infrarenal inferior vena cava (IIVC) where the device is usually placed. This study based upon 100 cavographies has showed the calculated average diameter of IIVC was 20.9 mm (range 12-27 mm) in its middle part and 21.3 mm (range 10-31 mm) in its terminal end. The calculated average IIVC length was 96 mm (range 80.3-142 mm). There was no statistical correlation between caval size and age, sex, height, weight and corporeal area. There was a statistical difference of left renal vein location between patients presenting with lumbar arthrosis and those without. We discuss different methods to measure IIVC in particular tomodensitometry. CT scans reviewed in our department show that the largest diameter of IIVC is not in a frontal plane and that the width seen on cavography is the projection of the largest diameter on the film. Therefore, the range of the real caval diameters is greater than indicated above. PMID- 2763008 TI - Magnetic resonance imaging of the brain stem. Anatomico-radiological correlations. AB - Magnetic resonance imaging of 30 normal volonteers' posterior fossae was performed on a CGR Magniscan machine with a magnetic field strength of 0.5 Tesla. We chose the inversion recovery signal with a Tr of 2,000 ms, a TE of 21 ms and an inverse time of 500 ms. This sequence gives a better definition of the grey matter, the white matter and the CSF. To study the brain stem we suggest 8 horizontal and 3 sagittal sections. PMID- 2763009 TI - MRI of the mandible. AB - Eighteen patients with abnormalities of the mandible and two normal volunteers were studied with MRI. Correlation was made with MR, CT, plain X-rays, clinical examination, and surgical findings when possible. In primary tumors of the mandible, MR was able to differentiate between solid and cystic lesions. In the cases of secondary invasion of the mandible by malignant tumors, MR was able to demonstrate replacement of the normal high signal bone marrow by low signal tumor. In some cases, the extent of marrow involvement shown on MR and confirmed at surgery was significantly underestimated by clinical examination, plain films, and CT. From this limited experience, it appears that MR may play an important role in imaging pathology of the mandible. PMID- 2763010 TI - Congenital absence of the pericardium and its relationship to the ligamentum arteriosum. AB - An anatomic and embryologic study of congenital absence of the pericardium and the relationship of the ligamentum arteriosum to this defect was carried out by the authors. A case report is presented to clinically correlate the anatomic and radiologic findings in this anomaly. The authors propose that visualization of the ligamentum arteriosum by computed tomography is a characteristic sign for congenital absence of the left pericardium. PMID- 2763011 TI - Vascularization of the inner border of the foot: surgical applications (24.06.88). PMID- 2763012 TI - The XIII Federal International Congress of Anatomy 1989. PMID- 2763013 TI - Anatomical basis of pelvic growth in bladder exstrophy. AB - Pelvic growth in bladder exstrophy was studied in 10 patients. Growth of their pelves in length as well as in width was similar to that found by Tanner. Meanwhile, the speed at which the diastasis of the pubic symphysis increases is variable. Before 5 years of age and during the end of growth it is fast, whereas it is slow between 5 and 10 years of age. There are no radiological abnormalities of hip joint orientation, and the acetabular angles are normal. PMID- 2763014 TI - Anatomical bases for a safe method of subclavian venipuncture. Clinical experience in 350 cases. AB - Based on fundamental anatomical considerations which are explained in detail we developed a safe technique for the catheterization of the subclavian v.: the point of puncture, which is situated about 25 mm below the junction between the medial and the middle thirds of the clavicle, is accurately determined with the help of a pattern described in the paper. The needle is directed towards the palpable dimple between the spinous processes of the 6th and the 7th cervical vertebrae. The only structure the cannula can reach is the medial portion of the subclavian v. into which the catheter is inserted. Therefore pneumothorax, haemothorax or other incidents do not occur. The method was tested in 350 cases and proved to be absolutely free of complications. PMID- 2763015 TI - A morphometric study of the lumbar foramen. Influence of flexion-extension movements and of isolated disc collapse. AB - The authors undertook a morphometric study of the intervertebral foramina in anatomic specimens of spines unaffected by degenerative lesions. They studied the variations in shape and size of 38 intervertebral foramina during flexion extension movements and following an isolated disc collapse. The cast technique takes into account the bony prominences, the bulge of the disc anteriorly and of the capsulo-ligamentous structures posteriorly. In flexion, all the diameters of the foramina are maximal. In full extension all the diameters decrease significantly: the pedicles come closer together, the disc bulges posteriorly and the ligamentum flavum is pushed forward by the superior articular process of the underlying vertebra. A disc collapse of 4 mm decreases all the diameters, and in this case lumbar extension results in a sufficient decrease of foraminal diameter to threaten the nerve root. PMID- 2763016 TI - Investment for an aging population. PMID- 2763017 TI - Costs of three common surgical procedures: 1987 update. PMID- 2763018 TI - Life expectancy remains at record level. PMID- 2763019 TI - Projections of the population of states by age. PMID- 2763020 TI - On innovative analyses of health care data. PMID- 2763021 TI - Papers presented at the fiftieth annual meeting of the Society of University Surgeons. Baltimore, Md., Feb. 9-11, 1989. PMID- 2763022 TI - The content of tumor DNA as an indicator of prognosis in patients with T1N0M0 and T2N0M0 carcinoma of the breast. AB - To determine if the flow cytometric measurement of the content of the tumor DNA could provide prognostic information in T1N0M0 and T2N0M0 carcinoma of the breast, we isolated nuclei from paraffin-embedded tumor specimens from 128 consecutive patients who underwent modified radical mastectomy and were found to have a T1 or T2N0M0 carcinoma of the breast. The content of DNA of the nuclei was determined by flow cytometry. Although the average tumor size was not significantly different, 17 of 56 patients with aneuploid tumors died of cancer compared with 2 of 72 with euploid tumors. The 10-year overall actuarial survival rate of the euploid and aneuploid groups was 72% and 67%, respectively (p less than 0.02). A hazards model of the data shows that the DNA content of the tumor is the most significant indicator of prognosis, with a 2.25-fold increased risk of death for patients with aneuploid tumors. These data show that the tumor DNA content can be used to identify a group of patients with T1 or T2N0M0 carcinoma of the breast with the same prognosis as a group of patients without carcinoma of the breast that would be unlikely to benefit from adjuvant therapy. PMID- 2763023 TI - Treatment of experimental gram-negative bacterial sepsis with murine monoclonal antibodies directed against lipopolysaccharide. AB - Monoclonal antibodies (MAbs) directed against gram-negative bacterial lipopolysaccharide (endotoxin, LPS) are currently being evaluated as an adjunctive form of therapy for lethal gram-negative bacterial sepsis and shock. The exact binding site within the LPS molecule against which antibody should be directed in order to maximize both cross-reactivity among bacterial strains and protective capacity has not been established. By developing a panel of MAbs that bound to various regions of the LPS molecule (O saccharide; outer, intermediate, and inner core; lipid A), we were able to determine that some epitopes in the inner core/lipid A region of LPS were broadly shared among different genera of gram-negative microorganisms, on the basis of immunoblot analysis of MAb binding to LPS. Pretreatment with lower doses of O saccharide-specific MAbs (2 micrograms per animal) provided protection against a lethal intraperitoneal challenge of viable Salmonella minnesota bacteria, compared with core LPS-specific MAbs, which required at least 1.0 mg of MAb per mouse to provide a similar degree of immunoprotection. Although inner core LPS-specific MAbs are less protective than O saccharide-specific MAbs, these MAbs will probably be more useful in the treatment of gram-negative sepsis because of their ability to bind to many types of LPS and enhance survival during infection, which is caused by a wide variety of gram-negative bacteria. PMID- 2763024 TI - Selective effects of tumor necrosis factor-alpha on wound healing in rats. AB - Many growth factors are believed to act simultaneously in wounds. Tumor necrosis factor-alpha (TNF-alpha) is a cytokine released by activated macrophages. In various concentrations it has inflammatory, cytolytic, mitogenic, antitumor, and possibly angiogenic or antiangiogenic effects; therefore it is likely to affect wound healing. With stainless steel wire mesh wound cylinders implanted in rats, we tested topical TNF-alpha in wounds, alone and in combination with platelet derived growth factor (PDGF) and transforming growth factor-beta (TGF-beta). The cylinders were injected daily for a total of 12 days, after which we measured the accumulation of protein, DNA, and hydroxyproline in each cylinder. TNF-alpha had little effect by itself; it inhibited the growth-promoting effects of TGF-beta, but it did not influence the effects of PDGF. These results agree with the in vitro studies showing synergism of TNF-alpha and PDGF and antagonism between TGF beta and TNF-alpha. They also suggest that TGF-beta may have a negligible role in normal healing and emphasize that interaction of growth factors must be understood before appropriate clinical use can be planned. PMID- 2763025 TI - Dietary marine oil supplements fail to affect cholesterol metabolism or inhibit atherosclerosis in rabbits with diet-induced hypercholesterolemia. AB - Dietary marine oil supplements may protect against atherosclerosis, although their influence on plasma lipids, in vivo cholesterol metabolism, and aortic cholesterol accumulation remains uncertain. The effects of daily administration of marine oil--delivering 100 mg of eicosapentaenoic acid, 59 mg of docosahexaenoic acid, and 221 mg of omega-3 fatty acids per kilogram--were assessed in 33 New Zealand white rabbits. Six animals (group I) were immediately killed. In the remaining animals stable hypercholesterolemia was induced with a 0.25% cholesterol-enriched diet. After 7 weeks on this diet, six animals were killed (group II). Total plasma cholesterol had increased significantly (982 +/- 119 mg/dl vs. 55.6 +/- 7.1 mg/dl, mean +/- SEM, p less than 0.001). The remaining animals randomly received a tap-water placebo (group III, n = 12) or marine oil (group IV, n = 9) daily. After 3 months, total plasma cholesterol was similar (p = NS) among group II (982 +/- 119 mg/dl), group III (965 +/- 54 mg/dl), and group IV (913 +/- 46 mg/dl). No significant differences in HDL cholesterol, LDL cholesterol, VLDL cholesterol, or triglyceride levels developed between the placebo and marine oil groups. Two-hour, hepatic total lipid, neutral steroid, fatty acid, bile acid, and cholesterol synthesis rates were not significantly affected by marine oil treatment. Thoracic aortic cholesterol content increased during cholesterol feeding (5.7 +/- 0.9 mg/gm vs. 1.1 +/- 0.05 mg/gm, group II vs. group I, p less than 0.05). Marine oil supplementation had no effect on the progressive accumulation of cholesterol in the thoracic aorta (28.8 +/- 2.5 mg/gm vs. 29.4 +/- 1.8 mg/gm, group IV vs. group III, p = 0.84). The abdominal aortic cholesterol contents were also similar. These results do not support the use of dietary marine oil supplements for the amelioration of lipid metabolism or the prevention of atherosclerosis. PMID- 2763026 TI - Interdigestive gastric motility patterns: the role of vagal and nonvagal extrinsic innervation. AB - Our study was designed to determine separately the roles of vagal and nonvagal extrinsic innervation in the initiation and coordination of patterns of gastric contractile activity and in the organization of the gastric slow wave. Four dogs first underwent transection of all extrinsic and intrinsic neural continuity to the stomach, except for careful preservation of vagal innervation to the stomach (stage 1). Manometry catheters and serosal electrodes were placed in the antrum, and electrodes were fixed to the small intestine. After recovery, motility was recorded during fasting and after feeding. A cyclic motor pattern occurred in the stomach with a period that was not different from that of the migrating motor complex in the small intestine (113 +/- 11 minutes vs 112 +/- 11 minutes; p greater than 0.05). Gastric and intestinal motility remained coordinated in time. Feeding inhibited this cyclic motor pattern in stomach and intestine. Antral tachygastria (slow wave frequency greater than 8 cycles/min) was infrequent (less than 1% of time). Each animal was restudied after completing extrinsic gastric denervation by a transthoracic vagotomy (stage 2). Vagotomy did not alter the presence, appearance, or period of cyclic gastric activity, nor did it disrupt temporal coordination with the duodenal migrating motor complex or increase the prevalence of tachygastria. In conclusion, neither vagal nor nonvagal extrinsic innervation to the stomach was required for initiation or coordination of the characteristic cyclic gastric motility pattern during fasting; although vagal innervation may modulate gastric myoelectric activity, its precise role is not evident in this study. PMID- 2763027 TI - Evidence for neutrophil-related acute lung injury after intestinal ischemia reperfusion. AB - Intestinal ischemia-reperfusion injury is a common and important clinical event associated with the activation of an endogenous inflammatory response. Some of the mediators of this response may be involved in the pathogenesis of multiple organ system failure. The purpose of this study was to determine whether remote organ dysfunction--specifically, acute lung injury--occurs after intestinal ischemia-reperfusion injury. After an ischemia-reperfusion event in rat intestine, whole lungs were obtained for measurement of tissue adenosine triphosphate (ATP) and myeloperoxidase values, and evaluation of histologic condition. In addition, lung microvascular permeability was assessed by determination of the rate at which iodine 125-labeled bovine serum albumin sequestration in the extravascular compartment occurred. Lung tissue ATP levels were no different in sham-operated animals than in those that had undergone 120 minutes of intestinal ischemia. Within 15 minutes of gut reperfusion, however, lung ATP decreased from 3.82 +/- 0.27 to 1.53 +/- 0.90 x 10(-7) moles/50 mg tissue, p less than 0.05. Neutrophil accumulation in the lungs, estimated by tissue myeloperoxidase determination, increased sevenfold (0.13 +/- 0.02 to 0.97 +/- 0.25 units/gm, p less than 0.05) after 120 minutes of ischemia and 15 minutes of reperfusion. Lung microvascular permeability increased threefold after 120 minutes of intestinal ischemia and 120 minutes of reperfusion (0.10 +/- 0.01 vs. 0.35 +/- 0.05 [lung/blood counts per minute], p less than 0.05). Intestinal ischemia followed by reperfusion is associated with acute lung injury characterized by increased microvascular permeability, histologic evidence of alveolar capillary endothelial cell injury, reduced lung tissue ATP levels, and the pulmonary sequestration of neutrophils. These data confirm an acute lung injury associated with intestinal ischemia-reperfusion and suggest a possible pathogenic role for the neutrophil. PMID- 2763028 TI - Compartmentalizing chemomechanical transduction in the ejecting heart. AB - The efficiency of transferring the total energy generated by ventricular contraction (pressure-volume area, PVA) to external work (EW) and internal work (IW) and the myocardial oxygen consumption (MVO2) at zero PVA were determined during volume loading on right heart bypass before and after a 50% augmentation (CaCl2, 0.03 mEq/kg/min, n = 7) or depression (20 minutes of 37 degrees C ischemia with 30 minutes of reperfusion, n = 7) of the contractile state. An increased EW efficiency (64% +/- 7% vs. 81% +/- 6%, p less than 0.01) with reciprocally decreased IW efficiency (36% +/- 7% vs. 19% +/- 6%, p less than 0.01) occurs with calcium chloride-augmented contractility. A reversible ischemia and reperfusion insult has the converse effect on these relative efficiencies (EW, 73% +/- 4% vs. 49% +/- 4%; IW, 27% +/- 4% vs. 51% +/- 4%; each p less than 0.01). Calcium chloride increases the oxygen requirements of both basal metabolism (28 +/- 2 vs. 67 +/- 9 ml O2/beat/100 gm LV, p less than 0.01) and fiber shortening (11 +/- 5 vs. 62 +/- 11 ml O2/beat/100 gm LV, p less than 0.01). The postischemic heart has a decreased oxygen need for shortening (20 +/- 2 vs. 3 +/- 4 ml O2/beat/100 gm LV, p less than 0.01), paralleling the depressed inotropic state. This new model of compartmentalized chemomechanical transduction may allow specific modulation of the energetic derangements attendant to the surgically treated heart. PMID- 2763029 TI - Myocardial contusion in the stable patient: what level of care is appropriate? AB - To evaluate the significance of myocardial contusion, we evaluated 243 stable patients hospitalized for blunt chest trauma between 1982 and 1986. The groups were identified according to results of radionuclide angiography, mean injury severity score (ISS), and outcome. Group I (n = 71; mean ISS = 12.7) patients were those without myocardial contusion by radionuclide angiography. Two patients with cardiac complications were in this group. The patients with myocardial contusion were divided into two groups. Group II (n = 69; ISS = 19.5) patients had myocardial contusion as an isolated injury, and group III (n = 103; ISS = 30.9) patients had myocardial contusion and injury to at least one other organ system. Three patients from group II had cardiac complications. Eleven patients from group III had cardiac complications. There were no significant differences between the cardiac complication rate in the three groups, and each complication was present when the patient arrived in the emergency department. The predicted mortality rate based on ISS was 10% to 20% for patients with myocardial contusion, whereas the observed mortality rate for the groups (II and III) overall was 0.58%. We conclude that in the stable trauma patient myocardial contusion (1) does not by itself increase the risk of complication, (2) does not necessitate intensive care unit monitoring, (3) should be devalued when computing ISS scores, (4) may account for lengthy and often unnecessary hospitalization, and (5) in patients at risk for complications may be identified by ECG abnormalities on arrival to the emergency department. PMID- 2763030 TI - Endotoxin-induced bacterial translocation: a study of mechanisms. AB - Previously, we documented that nonlethal doses of endotoxin cause the translocation (escape) of bacteria from the gut to systemic organs. The purpose of this study was to determine which portion(s) of the endotoxin molecule induces bacterial translocation and to examine the role of xanthine oxidase activity in the pathogenesis of endotoxin-induced bacterial translocation. Nonlethal doses of Salmonella endotoxin preparations (wild type, Ra, or Rb), containing the terminal portion of the core polysaccharide, induced bacterial translocation, whereas those preparations lacking the terminal-3 sugars (Rc, Rd, Re, or lipid A) did not induce bacterial translocation. Additionally, only those endotoxin preparations that induced bacterial translocation injured the gut mucosa, increased ileal xanthine dehydrogenase and oxidase activity, and disrupted the normal ecology of the gut flora, resulting in overgrowth with enteric bacilli. Inhibition of xanthine oxidase activity by allopurinol prevented endotoxin (Ra)-induced mucosal injury and reduced the incidence of bacterial translocation from 83% to 30% (p less than 0.01). These results suggest that endotoxin-induced bacterial translocation requires the presence of the terminal core lipopolysaccharide moiety and that xanthine oxidase-generated oxidants are important in the pathogenesis of endotoxin-induced mucosal injury and bacterial translocation. PMID- 2763031 TI - Operative venodilation: a previously unsuspected factor in the cause of postoperative deep vein thrombosis. AB - Intraoperative venodilation in veins distant from the site of operation has been shown to occur in animals and has been directly correlated with focal venous endothelial damage. This exposure of subendothelial collagen could serve as initiation sites for thrombus formation. This study tests the hypothesis that human beings (1) significant operative venodilation occurs and that it correlates with postoperative deep venous thrombosis (DVT); (2) operative venodilation can be pharmacologically controlled; and (3) this control reduces the incidence of postoperative DVT. Twenty-one patients undergoing total hip replacement had their contralateral cephalic vein continuously monitored with modified ultrasonographic instrumentation, with a continuous on-line recorder graphing venous diameter. Patients were randomly assigned to receive 0.5 mg of dihydroergotamine and 5000 U of heparin (DHE/Hep) for prophylaxis or placebo, with investigators "blinded" Postoperatively, all patients underwent ascending phlebography. Patients in whom postoperative DVT developed (11) had a mean operative venodilation of 28.9% +/- 3.93%, and those in whom DVT did not develop (10) had a mean venodilation of 11.6% +/- 1.55% (p = 0.001). Only 17% (2/12) dilating less than 20% baseline diameter had DVT compared with 100% (9/9) dilating greater than 20% of baseline diameter (p = 0.002). Patients receiving venotonic agent DHE had significantly less venodilation and DVT (p less than 0.001) compared with patients receiving the placebo. Patients who had DVT and whose veins dilated greater than 20% were older than patients who did not have DVT and whose veins minimally dilated: p = 0.04 and p = 0.07, respectively. Although there was a trend toward increased venoconstriction in patients receiving DHE/Hep (p = 0.09), there was no correlation of venoconstriction with ultimate thrombotic outcome. Maximal venodilation occurs during handling of soft tissue (muscle), and this occurs significantly sooner than maximal venoconstriction, which occurs during bone manipulation. We conclude that excessive operative venodilation is a new and important etiologic factor that leads to postoperative DVT. Operative venodilation can be pharmacologically controlled with the venotonic agent DHE. The combination DHE/Hep reduces postoperative DVT by the reduction of operative venodilation in the presence of low doses of an anticoagulant. These findings offer a new approach for predicting postoperative DVT and an object rationale for developing effective prophylaxis. PMID- 2763032 TI - Direct cytotoxic effect of oxygen radicals on the gastric mucosa. AB - Oxygen radical release has been proposed as a pathogenetic factor in the formation of acute gastric mucosal injury. We assessed the ability of the naturally occurring oxygen radical generating system hypoxanthine/xanthine oxidase (HX/XO) to cause gross gastric mucosal injury and measured the effect on regional mucosal blood flow. Local intra-arterial infusion of HX/XO into the vascular network of the stomach caused marked gross mucosal injury in the antrum and corpus. This injury occurred even in the absence of exogenous luminal acid and was aggravated by luminal acidification with 1 ml of 0.1N HCl. The selective oxygen radical scavenger superoxide dismutase (SOD) prevented mucosal injury caused by HX/XO. The effects of HX/XO and SOD were not mediated by alterations in regional gastric mucosal blood flow, as measured by the radiolabeled microspheres and reference sample method. These findings suggest that oxygen radicals are capable of causing substantial gastric mucosal injury by a direct cytotoxic effect independent of luminal acid or mucosal blood supply and give support to the concept that oxygen radical release may be a major primary pathogenetic factor in the development of acute gastric mucosal injury. PMID- 2763033 TI - The development and evaluation of a clinical test of surgical resident proficiency. AB - The two purposes of this study were to develop a clinical test of surgical resident proficiency and to compare this clinical test with currently applied methods of resident evaluation. Appendicitis is a common surgical disease, and its accurate diagnosis depends largely on clinical acumen. Ten third-year surgical residents prospectively evaluated 107 patients admitted because of suspected appendicitis. After taking a history, performing a physical examination, and reviewing laboratory data, these residents were asked to state, as a percentage, the likelihood that each patient had appendicitis. Sixty-three patients had appendicitis documented by pathologic inspection after appendectomy. Forty-four patients did not have appendicitis, as was determined by operation (17) or by in-house observation and resolution of abdominal pain (27). These outcomes were used to calculate a diagnostic ability score (DAS) for each resident. Residents were evaluated by standard methods including in-service examinations and monthly evaluations by the attending staff. Residents were also evaluated by nonstandard, but potentially useful, neuropsychologic and psychologic tests, including the trail making test, the Ravens progressive matrices test, the paced auditory serial addition test (PASAT), the grooved pegboard test of manual dexterity, and the profile of mood states (POMS) psychologic questionnaire. Cumulative scores were calculated and compared by multiple regression with coefficient variance analysis. The correlation (R2) of DAS with standard evaluation techniques was as follows: In-service (0.055), faculty (0.508), trails (-0.293), Ravens (0.028), PASAT (0.251), dexterity (0.432), POMS (0.381). We found that (1) the DAS is a discriminating clinical test; (2) the DAS correlates with subjective faculty evaluation; and (3) the DAS does not correlate with in-service examination scores. We conclude that faculty evaluation remains the best currently applied test of surgical resident clinical proficiency as measured by the DAS. PMID- 2763034 TI - Evidence that activation of Kupffer cells results in production of L-arginine metabolites that release cell-associated iron and inhibit hepatocyte protein synthesis. AB - Activated macrophages are known to metabolize L-arginine to unstable intermediates that induce cytotoxic activity through the release of mitochondrial iron in target cells. We have recently shown that rat Kupffer cells (KC) use L arginine to inhibit cocultured hepatocyte (HC) protein synthesis. Based on these two facts, a hypothesis is proposed that endotoxin-triggered KC release intermediates of L-arginine metabolism that inhibit HC protein synthesis by oxidizing iron at critical mitochondrial enzymes, thus interfering with mitochondrial respiration and energy production. Results of experiments testing this hypothesis showed that the metabolism of L-arginine was required for inhibition of protein synthesis and iron release and that the end products of L arginine metabolism did not possess cytostatic or cytotoxic activity toward HC. The possibility that this cell culture phenomenon might provide insights into the mechanism of hepatic insufficiency in sepsis is raised. PMID- 2763035 TI - Inhibition of wound repair by thymic hormones. AB - To further define the role of the thymus in wound healing, we studied the effects of two thymic hormones on fibroplasia in normal euthymic and in nude athymic mice. Groups of 10 mice underwent a 2.5 cm dorsal skin incision with subcutaneous placement of polyvinyl alcohol sponges. Starting on the day of wounding, the following daily injections were given: (1) thymopentin (TP5), an active synthetic pentapeptide of thymopoietin, a naturally occurring thymic hormone (1 microgram/day/IM); (2) thymulin or facteur thymique serique (FTS), a naturally occurring circulating thymic hormone (0.2 microgram/day/IM); (3) control saline solution (0.1 ml/day/IM). All mice were killed 4 weeks after wounding, and wound breaking strength and hydroxyproline content of the sponge granulomas were measured. The results show that both thymic hormones impaired wound breaking strength and reparative collagen synthesis in normal and athymic mice. The magnitude of the wound healing impairment induced by the two hormones was equal in the thymus-bearing and in the nude mice. The data support previous findings, which suggested that the thymus has an inhibitory effect on wound healing. PMID- 2763037 TI - Critical care education in general surgery residencies. AB - Surgical critical care (SCC) was recently identified as an essential component of general surgery by the American Board of Surgery (ABS). Previous studies have found limited attention to critical care education in general surgery programs. This survey was developed to determine the changes in critical care education, following the emphasis by the ABS. The survey determined the format for SCC education, the time and resources committed, and the views of the program directors toward SCC. Program directors of all 296 approved general surgery residencies were surveyed, with a 79% response. Most program directors (91%) agree that SCC is an essential component of general surgery, and 72% believe a separate intensive care unit (ICU) rotation should be used in SCC education. Education in SCC was provided by a separate ICU service in 110 (47%) of the programs. The remaining 53% used care of patients in the ICU during traditional services as their educational experience. The average ICU rotation for surgery residents was 9 weeks and usually occurred in the second year of training. In 97% of the 110 programs with an ICU service, lectures and conferences were conducted regularly. Seventeen programs sponsored critical care fellowships, and 25 additional programs were considering them. Ninety percent of surgical ICU services had faculty that consisted exclusively of surgeons or surgeons and other specialists. Only 53% of surgeons attending on an ICU service had a reduction in their other responsibilities. Despite overwhelming agreement that critical care is an essential component of general surgery, less than half of the training programs have an ICU service to coordinate resident education in SCC. If surgeons are to continue to provide total care to their patients, there needs to be increased commitment to SCC education. PMID- 2763036 TI - Protamine-induced reductions of endothelial cell ATP. AB - Protamine, a polycationic protein used to reverse heparin anticoagulation, is frequently associated with decreased oxygen consumption, systemic hypotension, pulmonary artery hypertension, and bradycardia. This investigation examines the hypothesis that these events reflect toxic effects of protamine on endothelial cells. Cultured bovine pulmonary artery endothelium was exposed to protamine (12.5 to 500 micrograms/ml, corresponding to clinical doses 0.75 to 30 mg/kg), either alone (n = 6) or 3 minutes after exposure to heparin, 0.1 IU/microgram protamine (n = 6). ATP was measured 1 to 180 minutes after protamine by a luciferase-luciferin assay and cell viability determined by trypan blue exclusion. Ultrastructure was assessed by transmission electron microscopy. Polylysine, 25 micrograms/ml, a cytotoxic polycationic agent, was also studied. Dose-dependent reductions in ATP (range, -11% to -51%) and ATP per viable cell (up to -41%) occurred. Decreases in ATP did not occur until after 30 minutes with protamine alone, compared with differences as early as 1 minute after protamine with prior heparin. Progressive mitochondrial injury was noted evident by swollen cristae, vacuolization, and eventual disruption. Polylysine caused similar changes. Protamine decreases endothelial cell ATP and prior heparin exposure accelerates this effect. The toxicity may reside in the positive charges on these molecules and mitochondrial damage may account for reductions in cellular ATP and systemic oxygen consumption. PMID- 2763038 TI - Caffeine prevents cholesterol gallstone formation. AB - Methylxanthines are known to inhibit in vitro gallbladder absorption. Increased gallbladder absorption has been observed during formation of cholesterol gallstones. Therefore we tested the hypothesis that caffeine would inhibit in vivo gallbladder absorption and thus prevent formation of cholesterol gallstones. Sixteen adult male prairie dogs received a control nonlithogenic diet, and 16 were fed a diet containing 1.2% cholesterol. Half of the animals in each group received caffeine in their drinking water. Gallbladder and hepatic bile were examined microscopically and analyzed for biliary lipids and electrolytes. The gallbladder/hepatic bile ratios of bile acids and sodium were calculated as indices of gallbladder absorption. All eight animals receiving the 1.2% cholesterol diet formed cholesterol gallstones, whereas none of the eight animals fed the cholesterol diet plus caffeine formed gallstones. The cholesterol saturation index was similar, however, in both groups. In animals fed a control diet, the administration of caffeine significantly increased hepatic bile flow and decreased the gallbladder/hepatic bile ratio for both bile acids (5.4 +/- 0.9 vs 3.6 +/- 0.3; p less than 0.05) and sodium (1.26 +/- 0.03 vs 1.12 +/- 0.03; p less than 0.01). In animals fed the high-cholesterol diet, caffeine significantly decreased the ratios for both bile acids (9.0 +/- 1.6 vs 5.3 +/- 0.6; p less than 0.05) and sodium (1.37 +/- 0.06 vs 1.21 +/- 0.01; p less than 0.05), lowered gallbladder bile protein levels, normalized gallbladder stasis, and lowered serum cholesterol levels. In summary, caffeine prevented formation of cholesterol gallstones in this experimental model. The effect of caffeine may be the result of alterations in multiple biliary parameters including the inhibition of gallbladder absorption. PMID- 2763039 TI - The reversal of increased gluconeogenesis in the tumor-bearing rat by tumor removal and food intake. AB - The accelerated mobilization of peripheral protein and subsequent increased gluconeogenesis are regarded as mechanisms of cancer cachexia. To determine the relation of gluconeogenesis to different degrees of tumor burden and subsequent tumor removal in the fed and fasted states, we examined the activity and mRNA levels of the key regulatory enzyme for gluconeogenesis: phosphoenolpyruvate carboxykinase (PEPck) in the liver of Fischer rats with a transplanted methylcholanthrene-induced sarcoma. PEPck activity in liver cytosol, after a 24 hour fast, was significantly higher in the tumor-bearing rats than in their pair fed controls. The increase in enzyme activity was clearly evident at 8% tumor burden and correlated positively with the degree of tumor burden (r = 0.85, p less than 0.01). Removal of the tumor produced a complete reversal of PEPck activity 10 days after excision. Regular feeding also abolished this increased enzyme activity. A similar trend was seen in the mitochondria. PEPck mRNA levels of rats with greater than 11% tumor burden in the fed state were decreased more than those of controls. PEPck mRNA levels were equally elevated in tumor bearers and controls in the 24-hour-fasted state. These results suggest that tumor bearing simulates the fasted state associated with hypoglycemia, which in turn triggers induction of the gluconeogenic enzyme, PEPck. PMID- 2763040 TI - Perioperative recombinant human erythropoietin. AB - The risks of transfusion-associated infectious disease have made increased efforts to avoid homologous transfusion imperative. Little attention has been focused on efforts to accelerate erythropoiesis as a method of reducing homologous blood use. Recombinant human erythropoietin (rHuEPO) has been shown to enhance erythropoiesis. The purpose of this study was to evaluate the effects of perioperative rHuEPO administration on postoperative erythropoiesis. Fifteen baboons were divided into three groups of five each. Group I received no rHuEPO. Group II received five daily preoperative doses of rHuEPO (1000 U/kg). Group III received five daily preoperative doses and 14 daily postoperative doses of rHuEPO (1000 U/kg). All animals underwent a laparotomy followed by an exchange transfusion to a final hematocrit of 15%. The time in days required to recover to hematocrits of 20% was significantly shorter in both groups that received preoperative doses of rHuEPO when compared with that of controls (3.3 vs 5.7 days, p less than 0.01). The recovery times to hematocrits of 25%, 30%, and baseline levels were all significantly shorter in the group that received both preoperative and postoperative doses of rHuEPO. The data show that perioperative dosage of rHuEPO significantly accelerates postoperative erythropoiesis. Perioperative administration of rHuEPO may reduce the requirements for homologous transfusion. PMID- 2763041 TI - [Nursing values. Does a common nursing philosophy provide better overall care?]. PMID- 2763042 TI - [Relatives in the hospital. Nurses should take parents seriously!]. PMID- 2763043 TI - [Nursing theory. Kari Martinsen's and Joyce Travelbee's nursing theories--a comparison and an evaluation]. PMID- 2763044 TI - [Administration. Finally quiet in the hospital departments?]. PMID- 2763045 TI - [Taking management very seriously]. PMID- 2763046 TI - [Geriatric institutions--we must put words to our visions!]. PMID- 2763047 TI - [Nursing and philosophy]. PMID- 2763048 TI - [Health service in the forest]. PMID- 2763049 TI - [Practical guidance in group method]. PMID- 2763050 TI - [Cross-professional AIDS project. Program for HIV-positive subjects: time, trust and safety]. PMID- 2763051 TI - [An about-face in the Norwegian Nurses' Association?]. PMID- 2763052 TI - [Taking geriatric care seriously]. PMID- 2763053 TI - [Professional nursing development. Takeoff in development--that's worthwhile!]. PMID- 2763054 TI - [Santiago in Chile today]. PMID- 2763056 TI - [What is meant with two-part management?]. PMID- 2763055 TI - [Drugs and the aged. Is a pill then not harmful?. Interview by Bjorn Arild Ostby]. PMID- 2763057 TI - [Nationwide Organization of Norwegian Nursing Students gives priority to education]. PMID- 2763058 TI - [Practice studies in nursing education]. PMID- 2763059 TI - [Complaints following episiotomy and tears]. PMID- 2763060 TI - [Experiences from the USA. AIDS in an acute psychiatric department]. PMID- 2763061 TI - [Health services in development!]. PMID- 2763062 TI - [Miriam Bergholz action]. PMID- 2763063 TI - [Drug trial]. PMID- 2763064 TI - [When the wisw write for the wisw. Interview by Ina Kjogx Pedersen]. PMID- 2763065 TI - [AIDS. Project nurse: new niche in the profession. Interview by Grethe Kjaergaard]. PMID- 2763066 TI - [AIDS. What are we to do with our AIDS patient, ask nurses]. PMID- 2763067 TI - [Lack of knowledge about brain death among nurses]. PMID- 2763069 TI - [Executive Board recommends proposal for new structure]. PMID- 2763068 TI - [We need more information about brain death]. PMID- 2763070 TI - [Drug information. Sorbact--a bacteria-adsorbing compounds]. PMID- 2763072 TI - [Manuscript guidelines]. PMID- 2763071 TI - [From manuscript to finished article]. PMID- 2763073 TI - [Government's prevention program--and Danish Nursing Council's remarks]. PMID- 2763075 TI - [Structure. Proposal on new legislation and regulations]. PMID- 2763074 TI - [Structure. Voluntary to be in the Unemployment Insurance Fund and in the local club]. PMID- 2763076 TI - [Health policy. Minister's shift signifies a shift in course. Government's prevention program]. PMID- 2763077 TI - [Health policy. 12 ministeries for prevention plan]. PMID- 2763078 TI - [32 school directors give their opinion on the new basic education]. PMID- 2763079 TI - [Health care. Groups for Arabic-speaking mothers very successful]. PMID- 2763080 TI - [Back in line]. PMID- 2763081 TI - [Education. Classroom teaching system creates a better climate in nursing schools]. PMID- 2763082 TI - [Education. A study in the 8th semester]. PMID- 2763083 TI - [Education. PR course against failing recruitment]. PMID- 2763084 TI - [Identity crisis. Nurses--angel and witch]. PMID- 2763085 TI - [Nurses' role in a multi-professional pain clinic]. PMID- 2763086 TI - [Working environment. Prestige project causes environmental problems. Interview by Jette Kingod]. PMID- 2763087 TI - [Working environment. Nursing managers often find themselves in a vulnerable position]. PMID- 2763088 TI - [Working environment. Give psychological first aid]. PMID- 2763089 TI - [Working environment. Violent episodes are a common problem]. PMID- 2763090 TI - [Working environment. Help for self-help from the Labor Inspection]. PMID- 2763091 TI - [Working environment. Branch Safety Council has an amplified role]. PMID- 2763092 TI - [Working environment. Hazardous tar fumes sucked away]. PMID- 2763093 TI - [Working environment. Battle about the environment]. PMID- 2763094 TI - [Working environment. Injuries reveal a poor environment. Interview by Soren Palsbo]. PMID- 2763095 TI - [Working environment. Standards on the assembly belt. Interview by Soren Palsbo]. PMID- 2763096 TI - [Working environment. Pregnant nurses--an exposed group]. PMID- 2763097 TI - [Working environment. Feelings of total loneliness and emptiness]. PMID- 2763099 TI - [Working environment. Safety manager: we know that as well. Interview by Grethe Kjaergaard]. PMID- 2763098 TI - [Working environment. I did not listen to my own body]. PMID- 2763100 TI - [Respect for the brain-dead fellow human being]. PMID- 2763101 TI - [Break with a good examination tradition]. PMID- 2763103 TI - [A new tax system: choice between plague and cholera?]. PMID- 2763102 TI - [Lopsided pool moneys]. PMID- 2763104 TI - [Professionalism and fun at Denmark's first nursing festival]. PMID- 2763105 TI - [Working environment. The roentgen department has evil in its environment]. PMID- 2763106 TI - [When patients delay us]. PMID- 2763107 TI - [Open letter. Salary which matches the tasks]. PMID- 2763108 TI - [Multi-professionalism will reinforce cooperation]. PMID- 2763110 TI - [Education. The multi-professional should not replace the professionally specific]. PMID- 2763109 TI - [Education. Minister's proposal creates uncertainty at a critical time]. PMID- 2763111 TI - [Education. Massive protest against minister's proposal on user charges]. PMID- 2763112 TI - [Education. Minister of Health threatens health care and nursing]. PMID- 2763113 TI - [Retrovir]. PMID- 2763114 TI - [The new structure in the house]. PMID- 2763115 TI - [Economic policy. Less in available income with plan of social democrats]. PMID- 2763116 TI - [Education. Rather an entirely new education system than a new round of saving]. PMID- 2763117 TI - [Psychiatry. Octopus must disappear from hospitals. Interview by Mette-Marie Davidsen and Mette Ellegaard]. PMID- 2763118 TI - [Psychiatry. Nurses carry the psychiatric system. Interview by Mette-Marie Davidsen and Mette Ellegaard]. PMID- 2763119 TI - [Psychiatry. How is it with continuing education?]. PMID- 2763121 TI - [Changing functions for psychiatric nursing?]. PMID- 2763122 TI - [Psychiatry. Nurses' advantage is also their disadvantage. Interview by Mette Ellegaard and Mette-Marie Davidsen]. PMID- 2763120 TI - [Psychiatry. The bitter end]. PMID- 2763123 TI - [Psychiatry. Where they still are weak and poor]. PMID- 2763124 TI - [Psychiatry. Far to neighbors--short to help]. PMID- 2763125 TI - [Psychiatry. Health system's fires in the course of 10 years. Interview by Mette Marie Davidsen and Mette Ellegaard]. PMID- 2763126 TI - [Executive Board. Danish Nurses' Council should continue to characterize continuing education]. PMID- 2763127 TI - [Psychiatry. Battle about the mentally ill]. PMID- 2763128 TI - [Psychiatry today: 7 down]. PMID- 2763129 TI - [Danish nurses' Unemployment Fund]. PMID- 2763130 TI - [What do regulations and agreements say about vacation conditions?]. PMID- 2763132 TI - ["One listens to you--stop AIDS"]. PMID- 2763131 TI - [Scandinavia's first university course on urinary tract therapy]. PMID- 2763133 TI - [Self-chosen abortion following fetus' sex determination]. PMID- 2763135 TI - [Health visitor can build a bridge between home and hospital. Interview by Grethe Kjaergaard]. PMID- 2763134 TI - [Prevention. We end up by failing the largest at-risk group in AIDS. Interview by Niels Ekstarnd]. PMID- 2763136 TI - [Day periods can be good for both the patient and the nurse]. PMID- 2763137 TI - [District psychiatry. Male nurses facing future psychiatry]. PMID- 2763138 TI - [Education. Play and cases in teaching]. PMID- 2763139 TI - [Health visitors as key persons in Danish nutritional guidelines. Interview by Mette-Marie Davidsen]. PMID- 2763140 TI - [Research. Health visitors' connection to the hospital]. PMID- 2763141 TI - [Routine procedure or bubbles]. PMID- 2763142 TI - [Where have nurses been in women's research?]. PMID- 2763143 TI - [Education. Inservice education with a built-in future]. PMID- 2763144 TI - [Nursing care. We can learn from Seattle in spite of Minnesota's dominance]. PMID- 2763146 TI - [Movie premiere. Discussion film about hospitals]. PMID- 2763145 TI - [Nursing care. Open care plans--why and how!]. PMID- 2763147 TI - [It hurts me that I didn't stay in the room during his last hours]. PMID- 2763148 TI - [Nursing care. When open nursing kardex is a 'sleeping pillow'. Interview by Mette-Marie Davidsen]. PMID- 2763149 TI - [Organization. The same framework for all professional associations]. PMID- 2763150 TI - [Lokken is self-housekeeping]. PMID- 2763151 TI - [Computerized nursing care]. PMID- 2763152 TI - [Health care as basis for nursing care]. PMID- 2763153 TI - [Something happens to you when you sing says night nurse. Interview by Lars Peter Bergqvist]. PMID- 2763154 TI - [Executive Board. Catalog of legislation with proposal which is ground for worry]. PMID- 2763155 TI - [Who declares war against an old enemy of health]. PMID- 2763156 TI - [Report from France. Stiff competition among health visitors in private practice]. PMID- 2763157 TI - [Invitation to laxatives]. PMID- 2763158 TI - [Patients' Complaints Tribunal. Poor communication cause of many complaints. Interview by Jette Kingod]. PMID- 2763159 TI - [PKA (Pension Fund Administrative Office). Good interest on pensions]. PMID- 2763160 TI - [Nursing care. Open nursing care plans are a way not a goal]. PMID- 2763161 TI - [Drug information. Pharmacist gives advice]. PMID- 2763163 TI - [Continuing education inspires home nurses]. PMID- 2763162 TI - [Parish assistants--an overlooked source for aid]. PMID- 2763164 TI - [Diabetic diet. Misleading cookbook for diabetics]. PMID- 2763165 TI - [Nurses' pension secures new vacation center]. PMID- 2763166 TI - [Education. Students want nurse instructors]. PMID- 2763167 TI - [Education. Medical practice--a part of the new basic education?]. PMID- 2763168 TI - [Danish Nursing Council's declaration and collegial regulations as agreed upon on 5-19-1989]. PMID- 2763169 TI - [Nurses ignore opportunity to join]. PMID- 2763170 TI - [God's standard in nursing]. PMID- 2763171 TI - [Executive Board. It colors autumn with difficult subjects]. PMID- 2763172 TI - [Open letter. Aarhus University worried about plans by Health Ministry]. PMID- 2763173 TI - [Denmark's College of Nursing. Nurses should not be too clever]. PMID- 2763174 TI - [Significance of van Merten's index in the diagnosis of ventilation-perfusion disorders and causes of respiratory insufficiency]. AB - The ventilation-perfusion correlations were studied in 30 normal persons and in 60 patients with chronic heart and pulmonary diseases with the aid of van Marten's index (RCO2). It is shown that capnographic determination of the index is of paramount importance in the diagnosis of ventilation-perfusion disorders and of the causes of respiratory failure since the index rises only in patients with the clinical signs of obstructive ventilatory insufficiency. PMID- 2763175 TI - [Thermographic diagnosis of acute and chronic non-specific pulmonary diseases]. AB - Based on an analysis of the results of the use of mesomorphic thermography, the authors have worked out thermographic criteria for differential diagnosis of pulmonary diseases. Altogether 100 patients with acute pneumonia, 17 with exacerbation of chronic pneumonia, 47 with acute bronchitis and 63 with exacerbation of chronic bronchitis were examined. In acute pneumonia and chronic pneumonia exacerbation, foci of hyperthermia appeared in the projection of a focus of infiltration. The intensity of the foci of hyperthermia was found to depend on the inflammatory process spreading. In acute bronchitis and chronic bronchitis exacerbation, the zones of hyperthermia were localized in the projection of the lung root to the posterior surface of the chest or along the spine with a potential enlargement upwards. Thermosymmetry with a temperature gradient not exceeding 0.6 degrees C may be regarded as thermographic criterion for the patients' recovery. PMID- 2763176 TI - [Differential diagnosis of primary vascular pulmonary hypertension]. AB - The paper is concerned with 18 patients suffering from primary vascular pulmonary hypertension. Of these, 7 patients had the thromboembolic pattern of primary vascular pulmonary hypertension and 11 primary pulmonary hypertension. All the patients underwent comprehensive examinations including routine clinical examinations, x-raying of the chest organs, ECG, ultrasound cardiography, measurement of the pressure in the pulmonary artery by invasive and non-invasive methods. The patients were also subjected to radionuclide studies using radionuclide scintigraphy of the lungs by means of 99mTc microspheres and radionuclide phlebography. Analysis of the clinical picture and of the findings obtained with the majority of instrumental methods including radionuclide scintigraphy did not reveal any appreciable differences between the patients with the thromboembolic pattern of primary vascular pulmonary hypertension and those suffering from primary pulmonary hypertension. Radionuclide phlebography has demonstrated that the patients with the thromboembolic pattern showed the changes in the phlebogram significantly more often than those with primary pulmonary hypertension. It is advisable that radionuclide phlebography should be included into the schedule for examining patients with primary vascular pulmonary hypertension. PMID- 2763177 TI - [Present-day problems of lung auscultation]. PMID- 2763178 TI - [Excretion of individual proteins in the urine as compared to the morphologic findings of renal biopsy specimens in patients with arterial hypertension]. PMID- 2763179 TI - [Possibilities of the immunodiagnosis of erythroleukemia]. AB - The authors describe 6 cases of acute leukemia in which erythroid antigens identified by monoclonal antibodies HAE-3 and HAE-9 (against glycophorin A and antigen of nuclear erythroid cells) were expressed on blasts. The morphocytochemical methods were employed to establish different varieties of leukemia according to the FAB-classification: 2-L1, 2-L2, 1-M2, and 1-M. In 4 cases, the existence of the markers of the early stages of differentiation was shown immunologically. Two patients demonstrated the mixed, variant of leukemia (erythroid-T-cellular and erythroid-myeloid). In 5 out of the 6 cases, the patients turned out refractory to chemotherapy. The lethal outcomes were recorded in the first acute period or in the stage of a relapse (one patient) after a very short 2-month remission. PMID- 2763180 TI - [Systemic polychondritis (Meyenburg-Altherr-Uehlinger syndrome]. PMID- 2763181 TI - [Clinico-functional characteristics of minimally pronounced aortal insufficiency]. AB - Fifty-five patients with "pure" aortal failure (AF) aged 16 to 48 years were examined. There were 39 men and 16 women. Of these, 22 patients presented with minimal, 20 with moderate, and 13 with pronounced AF. The protodiastolic murmur regarded as the most significant clinical sign could be heard in 19 out of the 22 patients with minimal AF, which appears to be determined by high frequency oscillations connected with the protodiastolic murmur. During phonocardiographic studies, that murmur was recorded only in 8 patients (36.6 percent) with minimal AF. Analysis of the ECG readings identified the signs of insignificant hypertrophy of the left ventricle (LV) only in 5 out of the 22 patients. The employment of Doppler's ultrasound cardiography made it possible to record the reverse blood flow in the left ventricle cavity in all the cases. In patients with minimal AF, the ultrasound cardiography did not discover any enlargement of the size, thickness of the walls or mass of the LV myocardium. Myocardial contractility, the stroke and cardiac indices remained within normal. However, there was a decrease in the effective ejection fraction of the LV. The typical "vibration" of the anterior cusp of the mitral valve was demonstrable in all AF patients. Thus the clinical and instrumental examination of patients with minimal AF permitted revealing the definite diagnostic characteristics which should be taken into consideration to recognize the heart disease under discussion. PMID- 2763182 TI - [Sudden death in mitral valve prolapse]. AB - The authors describe a case of sudden death (SD) of a patient with unaltered coronary arteries, myxomatous degeneration and mitral valve prolapse (MVP). The case was marked by an isolated prolapse of the anterior cusp of the mitral valve because of its congenital structural abnormalities, which was not encountered previously in MVP patients who died suddenly. Microscopic examination showed large-focal cardiosclerosis at the basis of the papillary muscles determined by dysfunction of the mitral apparatus which might be related to the pathogenesis of lethal arrhythmia. It is believed that MVP patients should constitute a separate group with high risk of SD. PMID- 2763183 TI - [Diagnosis of variants of Wegener's granulomatosis]. PMID- 2763184 TI - [Analysis of errors in the diagnosis of B12-deficient (pernicious) anemia]. PMID- 2763185 TI - [Chronic enteritis]. PMID- 2763186 TI - [The main requirements for and principles of the design of the automated support system ensuring the functioning of the medical diagnostic centers]. PMID- 2763187 TI - [Problems and prospects for outpatient diagnosis as exemplified by the activity of the scientific-consultative department of the All-Union Cardiology Research Center of the Academy of Medical Sciences of the USSR]. PMID- 2763188 TI - [Diagnostic centers in the Soviet public health system]. PMID- 2763189 TI - [Clinico-angiographic correlations in intramural myocardial infarction]. AB - The results of examination of 74 patients aged 33 to 65 years with intramural myocardial infarction (MI) are analyzed. It is established that as compared to patients with transmural MI, this group of patients showed recurrent attacks of angina pectoris and MI more frequently (during treatment at hospital). In addition, the exercise test in such patients was positive more often either (the data are statistically significant). The symptomatology of intramural MI is determined by the fact that the area of blood supply to tht subtotally stenosed infarction-dependent vessel is considerably larger as compared to the area of injury as a result of which the preserved myocardium experiences severe hypoxia. It is advised that in complicated intramural MI, angiography of the venous arteries may be carried out. Moreover, provided there are indications, endovascular or surgical revascularization of the myocardium may be considered. PMID- 2763190 TI - [Clinical significance of reciprocal changes in the ECG in acute myocardial infarction]. AB - A total of 206 patients with acute myocardial infarction marked by infarction localization in the anterior and inferior walls were examined. It is revealed that reciprocal changes, namely the depression of the ST segment are of prognostic significance in the assessment of the clinical course of the disease, with the ST depression being recorded for over one day. The patients demonstrated a reduction in left ventricle (LV) function, namely a decrease in the ejection fraction of the LV. Moreover, in this group of patients, a greater number of cases with multiple lesions of the coronary vessels were recorded. The reciprocal changes correlated well with the size of myocardial injury. PMID- 2763191 TI - [Clinical regularities of myocardial infarction repair]. AB - A total of 136 patients with trans- and 200 with non-transmural myocardial infarction (MI) were examined over time for chlorine-soluble mucoprotein (MP), serum hexoses (SH), their fraction-hexoses of glycosaminoglycans (H-GAG), and hexoses of glycoproteins (H-GP), serum, plasma and urine hydroxyproline (SHP, PHP, UHP). The computation of regressions made it possible to prove multidirectional changes in chlorine-soluble MP, SH, H-GAG, SHP, PHP, and in UHP. Approximation of the curves enabled MI patients to be distributed into subgroups marked by rapid and moderate repair tempo. The factors that prolong MI repair according to the X-square test are as follows: age over 60 years, heart aneurysms, recurrent MI, chronic grade 2A heart failure, diabetes mellitus, chronic bronchitis combined with lung emphysema and stage 2 respiratory failure. That whether MI is transmural or non-transmural is not per se the sole factor determining MI repair. PMID- 2763192 TI - [The relation of electric myocardial instability to the intensity of coronary disease--correlation of the data of programmed electrostimulation of the ventricles, selective coronarography and contrast ventriculography]. AB - Altogether 104 persons with coronary disease were examined in order to determine the correlation between the presence of electric myocardial instability (EMI) identified with the aid of programmed electrostimulation of the ventricles (PESV) and the gravity of injuries to the coronary vessels and to the contractile myocardium of the left ventricle (LV). In accordance with the number of the stimulation-induced recurrent contractions (RC), the patients were distributed into 4 groups. The patients of the second group (4 to 9 RC), of the third group (with unstable tachycardia) and of the fourth group (with stable tachycardia) were considered as having EMI. A marked relationship was discovered between EMI identified with the aid of stimulation and the condition of the contractile myocardium of the LV according to the ventriculography readings (the frequency of recording akinetic and dyskinetic myocardial segments, the magnitude of the end diastolic pressure). Coronary circulation failure (the degree of stenotic injury to the coronary arteries, the number of impaired vessels) did not determine EMI according to the PESV data. PMID- 2763193 TI - [Hypertrophic cardiomyopathy: clinical picture and diagnosis in myocardial hypertrophy of various localizations]. AB - Sixty-nine patients with hypertrophic cardiomyopathy (HCMP) were subjected to clinical, electrocardiographic and ultrasound cardiographic examinations. Two dimensional ultrasound cardiography revealed 4 types of most frequently occurring localizations of myocardial hypertrophy. The relationship was found between obstruction of the outlet tract of the left ventricle and localization and thickness of myocardial hypertrophy. The clinical and electrocardiographic signs of the disease were established in patients with HCMP in different localizations of myocardial hypertrophy. Subject to examination were also 15 relatives of the 5 patients. In 7 of them, HCMP was diagnosed for the first time. PMID- 2763194 TI - [Magnetic resonance tomography of the heart in hypertrophic cardiomyopathy]. AB - The authors provide the results of the use of magnetic resonance tomography (MRT) in examining 20 patients suffering from hypertrophic cardiomyopathy (HCMP). MRT was made using an apparatus with a field force of 0.23 synchronized with the ECG. The MR-sections were performed both in transverse and inclined planes oriented along the long axis of the left ventricle. MRT made it possible to identify and to assess with a high accuracy asymmetric hypertrophy of the left ventricle myocardium including the cases with apical localization of hypertrophy. Analysis of the data showed a certain decrease of the left ventricle cavity in the systole, dilatation of the left atrium and pronounced hypertrophy of the myocardium (mainly of the interventricular septum). The asymmetry coefficient amounted to 2.1. Correlation of the MRT data and two-dimensional ultrasound cardiography readings demonstrated good comparability of the results obtained with the use of both methods. MRT can be applied in the diagnosis of HCMP in cases where it is difficult to carry out ultrasound cardiography as well as for diagnosis verification provided the results derived with the use of other research methods are inconclusive. PMID- 2763195 TI - [Electrocardiogram changes in hypertrophic cardiomyopathy]. AB - Eight versions of ECG alterations were identified in 84 patients with hypertrophic cardiomyopathy (HCMP). As for the most prevalent version (60.7 percent of the cases), the pathological Q waves or QS were recorded in the presence of the voltage signs of ventricular hypertrophy or without such signs. The use of ultrasound cardiography and roentgenocardiography made it possible to distinguish 3 groups of patients with different myocardial hypertrophy. The first group included 20 patients with isolated hypertrophy of the interventricular septum (IVS), the second group 40 patients with IVS and left ventricle hypertrophy, and the third group included 24 cases of IVS hypertrophy and combined hypertrophy of the ventricles. The main features of ECG alterations were determined in accordance with the types of hypertrophy under consideration. In the first group, Q waves were mainly recorded (in 71.4 percent of the cases). In the second group, the signs of left ventricle hypertrophy were recorded in 50 percent of the cases while Q/QS in 62.5 percent of the cases. In the third group, the voltage signs of ventricular hypertrophy were observed in 62.5 percent of the cases, whereas the Q and QS were recordable less commonly (in 41.7 percent of the cases). PMID- 2763196 TI - [Activation of the complement system in dilated cardiomyopathy]. AB - The levels of anaphylatoxins (C3a, C5a) in blood, components of complements C3 and C4, antibodies to cardiolipin, IgG, IgA, IgM, IgE and circulating immune complexes were measured in 21 patients with dilated and hypertrophic cardiomyopathy (DCMP and HCMP) and in 11 donors. The mean level of C3a in DCMP patients (572 +/- 55 ng/ml) was significantly higher than in HCMP patients (344 +/- 30 ng/ml) and in donors (294 +/- 43 ng/ml) (p less than 0.001). On comparison of C5a concentrations in DCMP patients (2.2 +/- 0.52 ng/ml), HCMP patients (3.3 +/- 1.2 ng/ml) and in donors (1.6 +/- 0.82 ng/ml) no significant differences were found (p greater than 0.05). It has been established that in the group of DCMP patients with thromboembolic complications, the concentrations of C3a (736 +/- 95 ng/ml) were significantly higher than in those without such complications (334 +/ 14 ng/ml) (p less than 0.001). The data obtained permit discussing the role of anaphylatoxins in the development of thromboembolic complications in DCMP patients. PMID- 2763197 TI - [Status of the peripheral circulation in patients with ischemic heart disease with the tachysystolic form of atrial fibrillation according to data of bipolar rheovasography]. AB - In order to analyze peripheral circulation in coronary disease (CD) patients with tachysystolic atrial fibrillation (TAF), as many as 108 patients were examined. Based on the magnitudes of the cardiac index and the pressure of left ventricle filling the patients were distributed into 5 groups depending on the variant (hypovolemic, hypokinetic, hypervolemic, normokinetic, and hyperkinetic) of the TAF dynamics. Twenty-two CD patients with sinus tachycardia and 28 persons without any cardiovascular pathology were also examined. All the examinees were exposed to longitudinal bipolar rheovasography (RVG) of the legs. The most pronounced changes in the blood flow in the lower limbs manifested by the lowest magnitudes of the pulse blood content, circulation intensity, velocity of the systolic inflow, and the highest tone of the peripheral arteries were recorded in patients with the hypovolemic and hypokinetic patterns of the TAF hemodynamics. The peripheral circulatory disorders correlated well with the degree of circulatory failure and with the incidence of the clinical manifestations of microcirculatory abnormalities. At the same time the RVG readings in patients with the hyperkinetic, normokinetic, and hypervolemic variants of the hemodynamics and in those with sinus tachycardia appeared to be similar. The relationship was also established between the time of pulse wave spreading and the degree of circulatory failure, atherosclerosis of the peripheral arteries and the degree of the reduction in stroke volumes because of variations in the duration of cardiac cycles. Antiarrhythmic treatment favoured the improvement of the RVG readings both in cases where the rhythm became rarer and where the sinus rhythm got recovered.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2763198 TI - [Potential of the method of transesophageal stimulation of the left atrium]. AB - The authors provide the results of examining the conduction system of the heart in 623 patients with different disorders of heart conduction and rhythm by means of transesophageal pacing (TEP). The non-invasive electrophysiological examination of patients with sick sinus syndrome with latent disorders of atrioventricular (AV) conduction, and with supraventricular tachyarrhythmias turned out to be of high diagnostic value, inducing no complications. Application of programmed TEP (scanning extrastimulus on basis pacemaking) employed by the authors for the first time during TEP considerably widens the diagnostic possibilities of the technique permitting the measurement of the refractory periods of the conduction system (the refractory periods of the sinus node, atria, and AV-conduction system along normal and additional pathways), the performance of the trigger and removal of supraventricular arrhythmias with diagnostic and treatment purposes in view. The use of TEP for the treatment of patients with the syndrome of the prolonged QT interval and ventricular premature heart beat accelerates the choice of adequate antiarrhythmic therapy and raises its efficacy. PMID- 2763199 TI - [The clinical importance of atrial fibrillation-flutter induced by electric transesophageal stimulation of the heart]. AB - A study was made of the clinical importance of atrial fibrillation-flutter (AFF) induced by using different modes of left atrium stimulation via the esophagus. Ninety-eight patients were entered into the study including 40 patients with a history of AFF paroxysms, 24 with risk factors of AFF development, and 27 practically normal persons. The stimulation modes applied permitted reproducing stable paroxysms of AFF in 85 percent of the patients with a history of arrhythmias and in none of the normal persons. As for the patients with risk factors, stable paroxysms of AFF could be induced in 33 percent of the cases. The specificity and sensitivity of transesophageal electrophysiologic stimulation (TEES) with the modes applied were 100 and 82 percent, respectively. The investigations have demonstrated that TEES appeared most effective when applied in the mode of an even increase of the frequency of the set pace up to 300 imp/min. PMID- 2763200 TI - [Echocardiographic diagnosis of Valsalva's sinus aneurysm]. AB - Valsalva's sinus aneurysm is a congenital heart disease that may occur both as isolated abnormality or combined with other ailments. The present paper summarizes the results of the use in 20 patients of non-invasive research methods, namely ultrasound cardiography and Doppler's cardiography, in the diagnosis of Valsalva's sinus aneurysms and concomitant heart diseases. Analysis of the findings has shown that the use of ultrasound cardiography in conjunction with pulse Doppler's cardiography permits demonstration with a high accuracy of the direct signs of Valsalva's sinus aneurysm without use of invasive methods, identification of the rupture of its wall and the pathological diastolic blood flow to the cavity corresponding to the rupture. In addition, the application of the above techniques makes it possible to diagnose with a high degree of significance the concomitant abnormalities such as the defects of the interventricular and interatrial septa, aortal valve failure and, in some cases, the signs of concomitant bacterial endocarditis. PMID- 2763201 TI - [The efficacy of isolated ultrafiltration of the blood in patients with refractory heart failure]. AB - Application of isolated ultrafiltration (IUF) of blood in 70 out of 100 patients with refractory heart failure (HF) made it possible, acting on some mechanisms of water excretion disorders, to attain the compensation for the HF signs. At the same time the correction of the manifestations of secondary hyperaldosteronism, hypoproteinemia, hyperbilirubinemia, and azotemia was attained only thanks to the presence of the functional reserves of the liver and kidneys. In 35 patients with cachectic HF, IUF failure was determined by marked cardial liver cirrhosis together with depletion of the functional reserves of the cardiovascular system. The lack of sufficient diuresis, hyponatremia, hypoproteinemia, and hyperbilirubinemia may be unfavourable prognostic signs despite the reduction of HF intensity consequent on IUF. PMID- 2763202 TI - [Potential of noninvasive determination of the left atrioventricular aperture in mitral stenosis (according to data of ultrasound studies)]. AB - The results of the measurement of the mitral opening in mitral stenosis patients by planimetry and by the computation method via the half-cycle of the atrioventricular pressure were found to be in satisfactory agreement except those in a group of patients with concomitant failure of the semilunar aortic valve. Moderate or appreciable mitral regurgitation and stenosis of the aortic ostium associated with mitral stenosis exerted no substantial effect on the accuracy of the design parameter of the mitral opening. PMID- 2763203 TI - [Instantaneous velocity parameters of expiration in patients with congenital heart disease]. AB - Nineteen patients suffering from congenital heart diseases were examined by means of the apparatus Pneumoscreen manufactured by Eger Company (FRG) and the mechanocardiograph H-106 designed by N. I. Savitsky, which synchronously recorded the curves of the volumetric speed of the flow and intrathoracic pressure. Analysis was made of the relationship of the magnitude of the instant maximal velocity characteristics of forced expiration in all lung capacities and their time-course of changes to the total pulmonary resistance. It is revealed that the decrease of the maximal velocity characteristics of forced expiration in large pulmonary capacities was directly proportional to the degree of pulmonary tissue rigidity in patients with congenital heart diseases and corresponded to the degree of hemodynamic disorders in pulmonary circulation. The fall of the instant velocity of forced expiration in small lung capacities in patients with congenital heart diseases evidences not only the presence of bronchial obstruction but also high total pulmonary resistance. PMID- 2763204 TI - [Experience in using minipress in essential hypertension]. AB - Investigation of the hypotensive action of minipress, a drug belonging to the group of selective blockers of alpha 1-adrenoreceptors, shows its efficacy in 56.3 percent of patients with stage II essential hypertension. The side-effects were recorded in 16.6 percent of the patients. It is noted that application of minipress at a mean daily dose of 3.4 ml for a long time reduces the total peripheral vascular resistance without inducing any substantial changes in the stroke volume of the heart or in the pulse rate. At the same time minipress produces a beneficial effect on the microcirculatory blood flow. PMID- 2763205 TI - [Qualitative analysis of flow-volume curves of spirographic studies]. PMID- 2763206 TI - Effects of phosphoramide mustard and acrolein, cytotoxic metabolites of cyclophosphamide, on mouse limb development in vitro. AB - Phosphoramide mustard and acrolein are toxic and reactive metabolites of the widely used anticancer drug and known teratogen cyclophosphamide. To study the mechanism(s) involved and to determine which of the active metabolites of cyclophosphamide is responsible for the production of limb malformations, the effects of exposure of cultured limb buds to phosphoramide mustard and acrolein were investigated. Fore- and hindlimbs were excised from ICR mice on day 12 of gestation and cultured in roller bottles for 6 days. Limbs were exposed to either phosphoramide mustard or acrolein (10 or 50 micrograms/ml) for the first 20 hours of the culture period. Exposure to phosphoramide mustard produced limb reduction malformations in both the fore- and hindlimbs; total limb bone area was greatly reduced, while the relative contribution of the paw to this area in forelimbs was increased. There was a fourfold reduction in both DNA and RNA; protein content was reduced only by one-half. Alkaline phosphatase activity was significantly decreased in fore- and hindlimbs exposed to phosphoramide mustard, whereas creatine phosphokinase activity was only reduced in hindlimbs in the limbs exposed to the higher concentration of phosphoramide mustard. Exposure to acrolein also produced malformed limbs with a mangled appearance; however, total limb bone area and the relative contribution of the long bones versus paw structures were not altered. Acrolein exposure had little effect on growth parameters such as DNA (decreased only in hindlimbs exposed to 50 micrograms/ml), RNA (increased in hindlimbs exposed to 50 micrograms/ml), or protein content. Alkaline phosphatase and creatine phosphokinase activities were not altered in acrolein-exposed fore- or hindlimbs. Thus, phosphoramide mustard and acrolein have dramatically different effects on developing limbs in vitro; this observation may indicate that they have different targets and/or mechanisms of action as teratogens in the limb. The effects of phosphoramide mustard are very similar to those of "activated" cyclophosphamide (4-hydroperoxycyclophosphamide). PMID- 2763207 TI - Developmental alternations in offspring of female rats orally intoxicated by aluminum chloride or lactate during gestation. AB - The oral treatment of pregnant rats by aluminum chloride or lactate at various doses was applied from day 1 to day 21 of gestation to determine its influence on mortality, weight evolution, and neuromotor maturation of their pups. No effect of treatment on litter size was detected, but an increased mortality appeared during the first week: treatment by aluminum lactate was less active than was an equivalent treatment by aluminum chloride. Weight was transitorily delayed, but the reversal of this effect could be attributed to the decrease of litter size. The neuromotor maturation of surviving pups treated with the two aluminum salts showed an important impairment during the first 2 weeks of postnatal life. PMID- 2763208 TI - Biomechanical basis of diazepam-induced neural tube defects in early chick embryos: a morphometric study. AB - The biomechanical basis of diazepam (Valium/Roche)-induced neural tube defects in the chick was investigated using a combination of electron microscopy and morphometry. Embryos at stage 8 (four-somite stage) of development were explanted and grown for 6 hr in nutrient medium containing 400 micrograms/ml diazepam. Nearly 80% of these embryos exhibited neural tube defects that were most pronounced in the forming midbrain region and typified by a "relaxation" or "collapse" of neural folds. The hindbrain and spinal cord regions were less affected. Electron microscopy revealed that neuroepithelial cells in diazepam treated embryos had smoother apical surfaces and broader apical widths than did controls. Morphometric measurements supported this observation and further showed that these effects were focused at sites within the wall of the forming neural tube that typically exhibit the greatest degree of bending and apical constriction (i.e., the floor and midlateral walls). Overall results indicate that neural tube defects associated with exposure to diazepam are due largely to a general inhibition of the contractile activity of apical microfilament bundles in neuroepithelial cells. These findings 1) emphasize the important contribution of microfilament-mediated apical constriction of neuroepithelial cells in providing the driving forces for bending of the neuroepithelium during neural tube formation and 2) suggest that agents or conditions that impair their contractile activity could play a role in the pathogenesis of certain types of neural tube defects. PMID- 2763209 TI - Determinants of recall and recall bias in studying drug and chemical exposure in pregnancy. AB - Case-control studies on effects of drugs in pregnancy rely heavily on maternal recall. At the Motherisk Program in Toronto we counsel women during early pregnancy on the risk of drug and chemical exposure; subsequently, we follow up the outcome of pregnancy after birth. This cohort has given us an opportunity to assess the magnitude of recall of early pregnancy exposure and determinants likely to affect it in 145 consecutive cases. The mean recall of exposure identity was 62%, while accurate recall of timing of exposure was 37% and of dosage 24%. Exposures that prompted the clinic visit, chronic therapeutic exposures, environmental agents, and known teratogens were recalled significantly better than were other exposures. Accurate report of smoking was significantly higher than of alcohol use (79.4% vs. 59%, respectively, P = .0002). The number of agents consumed by the pregnant woman negatively correlated with her recall; mean recall of 1 agent was 85% vs. only 40% recall of 4 agents. Women greater than or equal to 30 years of age recalled significantly worse (mean +/- SEM, 52 +/- 4%) than women younger than 30 (70 +/- 4%), P = .002) despite a similar mean number of exposures. No difference in mean recall was found between women having normal (n = 112) or adverse pregnancy outcome (n = 33). There was a recall bias in reporting alcohol consumption; postnatally, women with adverse outcome tended to report significantly less than the amount initially reported by them. PMID- 2763210 TI - A scanning electron microscope study of fetal eyelid closure accelerated by cortisone in SWV/Bc mice. AB - Eyelid closure occurs earlier in SWV/Bc and CBA/J mouse fetuses whose mothers were treated with cortisone on day 14 of gestation than it does in fetuses from untreated mothers. Similar treatment prevents the open-eyes defect of lidgap Miller mutant mice, but examination by scanning electron microscope (SEM) has shown differences in the periderm of the closing eyelids of the cortisone-treated mutant compared with those of untreated genetically normal fetuses. (Untreated mutant eyelids remain wide open and very abnormal). The present study has examined at the SEM level the accelerated eyelid closure of cortisone-treated normal strain, SWV/Bc, fetuses to investigate whether the differences from normal in the eyelids of treated lidgap-Miller fetuses are part of the mechanism of the cortisone "cure." At the SEM level, cortisone-accelerated eyelid closure of SWV/Bc fetuses is indistinguishable from that in untreated fetuses. This suggests that the early eyelid closure induced by cortisone in normal strain fetuses represents acceleration of the normal coordinated sequence of events that leads to closure, rather than an abnormality that fortuitously leads to closure. The data also indicate that the cellular abnormalities seen previously in treated lidgap-Miller mutant fetuses are a combination of 1) abnormalities due to the mutation that are not completely reversed by cortisone and 2) normal developmental stages that have become concurrent with the cortisone-induced late closure in lidgap-Miller mutant fetuses. PMID- 2763211 TI - Spinal ganglia reduction in the splotch-delayed mouse neural tube defect mutant. AB - Splotch and splotch-delayed mutants have anomalies in certain neural crest cell derivatives as well as neural tube defects. A genetic marker was used to identify mutant, heterozygote, and wild-type embryos within a litter, which enabled us to make intergenotypic comparisons. Histological studies of the lumbosacral region of day 15 and day 16 embryos indicated that the splotch-delayed mutant had similar but less severe defects in spinal ganglion development than those reported for splotch (Auerbach: Journal of Experimental Zoology 127:305-329, 1954). The ganglia were extensively reduced in size, residual, or missing in the splotch-delayed mutant, whereas in the splotch mutant, they were virtually nonexistent. Paired comparison analyses showed that all mutant embryos had a significant reduction in their volume of lumbosacral spinal ganglia when compared to their heterozygous and/or wild-type littermates. Also, some heterozygotes were found to have spinal ganglia volumes that were significantly reduced when compared to wild-type embryos. The volume of spinal ganglia was not related to the severity of the neural tube defect. In fact, three mutant embryos, which did not exhibit a neural tube defect, had spinal ganglia volumes comparable to or less than those mutants with open neural tube lesions or curly tails. This shows that the formation of abnormal neural crest cell derivatives is not a result of the neural tube closure defect. We hypothesize that the two anomalies observed in these mutants have a common etiological basis. PMID- 2763212 TI - Anatomical features associated with preaxial duplication (pd): a recessive mutation in the rat. AB - Preaxial polydactyly of the fore- and hindlimbs was found in Wistar-derived rats in 1978. Genetic analysis indicated that the polydactyly was due to the effects of an autosomal recessive gene (gene symbol; pd). Polydactylous homozygous rats had two or three pollices (six or seven digits) in the forelimbs and one to three preaxial extra digits (six to eight digits) in the hindlimbs. Skeletal examination revealed the presence of the extra carpal, metacarpal, and phalangeal bones that seemed to be complete or incomplete duplication of the navicular, greater multangular, first metacarpal, and phalanges of digit I in the forelimbs. In the hindlimbs, extra tarsal, metatarsal, and phalangeal bones were also observed preaxially. These extra elements seemed to be mirror-image duplications of the talus, navicular, second cuneiform, third cuneiform, cuboid, and metatarsals and phalanges of digits II-V with the absence of the first cuneiform, tibiale, first metatarsal, and phalanges of digit I. In addition, morphological changes were observed in the humerus, radius, and ulna in the forelimbs and femur, tibia, and fibula in the hindlimbs. Especially in the radius and tibia, thickening and bifurcation were found, indicating incomplete duplication of these bones. Based on these findings, the limb anomaly was classified as preaxial carpometacarpal/tarsometatarsal-type polydactyly with incomplete duplication of the radius and tibia. The mutant rats had other associated anomalies such as accessory spleens and cryptorchism. The males are sterile, whereas the females breed normally. PMID- 2763213 TI - Rural health, AIDS laws take effect Sept 1. PMID- 2763214 TI - Trouble on the border: international health problems merge at the Rio Grande. AB - "Mosquitoes don't have green cards", Laurance N. Nickey, MD, says. That is Dr Nickey's way of saying that disease and environmental pollutants do not recognize the political boundary that separates Texas from Mexico. Dr Nickey, director of the El Paso City-County Health District and chairman of Texas Medical Association's Council on Public Health, is a native and lifelong resident of the city. He is an expert on the public health problems that plague El Paso and the other cities along the international border, all of which are exacerbated by abject poverty and a burgeoning population. Dr Nickey works tirelessly to bring these problems to the attention of Texas physicians, legislators, and other opinion leaders because, as he says, "Out here, we feel like we're the forgotten Texans." PMID- 2763215 TI - Echinococcal disease of the extrahepatic biliary tract. AB - Cystic hydatid disease of the liver is uncommon in the United States. It is caused by the larval cestode Echinococcus granulosus. One complication of this disorder is rupture of the hepatic hydatid cyst into the biliary ducts. There have been few reported cases of this complication of hydatid disease in the US literature. We describe a case of this disorder and briefly review the literature. PMID- 2763216 TI - Suicide of AIDS patients in Texas: a preliminary report. AB - The incidence of suicide in patients with the diagnosis of acquired immunodeficiency syndrome (AIDS) in the state of Texas during the period between January 1986 and August 1987 was determined. AIDS patients were found to have a rate of suicide higher than expected when compared to the general population. The results of this study document this trend which has important implications in the care of the growing number of patients with AIDS. PMID- 2763217 TI - Panic disorder: diagnosis and treatment. AB - Panic disorder is an important entity for primary care physicians to be aware of, as patients with panic disorder often present with physical complaints and may be misdiagnosed as having a somatization disorder or hypochondriasis. While the latter disorders are difficult to treat, panic disorder is well suited to treatment using the traditional medical model. This article describes suggested evaluation of suspected panic disorder and outlines treatment strategies. While tricyclic antidepressants, monoamine oxidase inhibitors, and alprazolam are all effective antipanic agents, tricyclic antidepressants are suggested as the medication of first choice. Treatment failures most often result from an inadequate medication trial (ie, trial too brief or dosage inadequate); with adequate treatment most patients with panic disorder can be helped. PMID- 2763218 TI - Chest wall hamartoma of infancy. AB - Chest wall hamartoma is a rare intrathoracic mesenchymal tumor occurring in infants and usually present from birth. The tumor arises from the ribs and is a histologically benign focal overgrowth of normal skeletal elements. Infants often present with respiratory problems. We report a case of a 5-month-old infant with a chest wall hamartoma who presented with a fever of unknown origin. PMID- 2763219 TI - Consent requirements for treatment of minors. AB - The American Academy of Family Physicians, the American Academy of Pediatrics, the American College of Obstetricians and Gynecologists, the Nurses Association of the American College of Obstetricians and Gynecologists, and the National Medical Association recently released guidelines aimed at protecting the privacy of adolescent patients. The organizations stated that, in many cases, young people will not confide in health professionals if the young people feel that these discussions will be reported to their parents. Ultimately, the organizations said, health risks to adolescents are so impelling that legal barriers and deference to parental involvement should not stand in the way of needed health care. In Texas there is a statute regarding consent for medical treatment of minors, which responds to the above organizations' concerns about confidentially treating children for substance abuse, sexually transmitted diseases, and suicide prevention. However, the statute is silent in regard to medical treatment involving prescription contraceptives. By negative inference, the statute would preclude a minor on her own from making a decision about abortion. This article examines Texas statutes dealing with consent for medical treatment for minors and discusses US Supreme Court decisions on a minor's rights to abortions and contraceptives. PMID- 2763220 TI - Delegates approve protocol for third-party telephone review. AB - The Texas Medical Association Physician-Patient Advocacy Committee has conducted an extensive study of the telephone utilization review activities of private third-party payers and self-insured arrangements. Many of these organizations contract with private firms to conduct pre-certification and concurrent review of hospital admissions. These reviews often are accomplished by telephoning the attending physician's office. The procedures and criteria used by these firms and the qualifications of their review staff vary greatly. Physicians and their office staff are spending an increasing amount of time dealing with telephone utilization review. These review firms are not regulated or controlled by any agency. In response to the concerns expressed by physicians in dealing with telephone utilization review, Texas Medical Association's House of Delegates has approved the "Texas Medical Association Recommended Protocol for Physicians Responding to Private Third Party Telephone Review." The guidelines address concerns about confidentiality, physician documentation, patient advocacy, appeals, and cost and billing. PMID- 2763221 TI - Economics, disease burden US-Mexico border. PMID- 2763223 TI - The restructuring of ANA: negotiating 'win'. PMID- 2763222 TI - Medical federation's help is key to improving health care system. PMID- 2763224 TI - 'Seize the day'. PMID- 2763225 TI - Pet-facilitated therapy: what do RNs think? PMID- 2763226 TI - Ventilatory and heart rate responses to hypoxia and hypercapnia in patients with diabetes mellitus. AB - The ventilatory response to isocapnic progressive hypoxia and hyperoxic progressive hypercapnia in 24 diabetic patients were compared with those of sex and age matched normal control subjects. The heart rate response to hypoxia was also measured in both groups. In diabetic patients the ventilatory and heart rate responses to hypoxia were significantly lower than those in the control group (0.10 v 0.24 l/min/% fall/m2 and 0.5 l v 1.27 beats/min/% fall respectively). The ventilatory response to hypercapnia was significantly higher (1.09 v 0.76 l/min/mm Hg/m2) in the diabetic patients. There was a significant correlation between the hypoxic ventilatory response and the heart rate response in diabetic patients (r = 0.56), but not in the control group (r = 0.28). In addition, both the ventilatory and the heart rate responses to hypoxia in diabetic patients had weak but significant correlations with the heart rate variation during deep breathing. It is concluded that the ventilatory and heart rate responses to hypoxia in diabetic patients are impaired, whereas the ventilatory response to hypercapnia is well preserved. PMID- 2763227 TI - Ventilation-perfusion mismatching in acute severe asthma: effects of salbutamol and 100% oxygen. AB - Ventilation-perfusion (VA/Q) relationships and gas exchange were studied by the multiple inert gas technique in 19 patients admitted to hospital with acute severe asthma (FEV1 41% predicted) before and during the administration of intravenous salbutamol, inhaled salbutamol, or 100% oxygen. Eight patients received a continuous intravenous infusion of salbutamol (4 micrograms/min, total dose 360 micrograms) and were studied before treatment, after 60 and 90 minutes of treatment, and one hour after treatment had been discontinued. Six patients had measurements before and 15 minutes after inhaling 300 micrograms salbutamol from a metered dose inhaler on two occasions (total dose 600 micrograms) and one hour after the last dose. Measurements were also made in five patients before and while they breathed 100% oxygen for 20 minutes. At baseline (fractional inspired oxygen (FiO2) 21%) all patients showed a broad unimodal (n = 10) or bimodal (n = 9) distribution of blood flow with respect to VA/Q. A mean of 10.5% of the blood flow was associated with low VA/Q units without any appreciable shunt. One of the best descriptors of VA/Q inequality, the second moment of the perfusion distribution on a log scale (log SD Q), was moderately high with a mean of 1.18 (SEM 0.08) (normal less than 0.6). Measures of VA/Q inequality correlated poorly with spirometric findings. After salbutamol the increase in airflow rates was similar regardless of the route of administration. Intravenous salbutamol, however, caused a significant increase in heart rate, cardiac output, and oxygen consumption (VO2); in addition, both perfusion to low VA/Q areas and log SD Q increased significantly. Inhaled salbutamol caused only minor changes in heart rate, cardiac output, VO2, and VA/Q inequality. Arterial oxygen tension (PaO2) remained unchanged during salbutamol administration, irrespective of the route of administration. During 100% oxygen breathing there was a significant increase in log SD Q (from 1.11 to 1.44). It is concluded that patients with acute severe asthma show considerable VA/Q inequality with a high level of pulmonary vascular reactivity. Despite similar bronchodilator effects from inhaled and intravenous salbutamol, VA/Q relationships worsened only during intravenous infusion. PaO2 remained unchanged, however, because the change in VA/Q relationships was associated with an increase in metabolic rate and cardiac output. PMID- 2763228 TI - Exercise responses in patients treated for pulmonary tuberculosis by thoracoplasty. AB - Twenty eight subjects (mean age 64 years) who had been treated for tuberculosis by thoracoplasty in the past performed an increasing work rate exercise test, from which maximum oxygen consumption (VO2max), ventilation and heart rate were measured. VO2max was significantly lower than predicted, being 0.75 l/min in 17 subjects, 1.0 l/min in 10, and 1.5 l/min in one. Only one subject achieved a heart rate of 85% of the predicted maximum. The ratio of heart rate to oxygen consumption (HR/VO2) and heart rate at standard interpolated submaximal levels of oxygen uptake at 0.75 l/min (heart rate 0.75) and 1.0 l/min (heart rate 1.0) were normal. VO2max correlated with ventilation at maximal exercise (VE max) (r = 0.87) and FEV1 (r = 0.47). It did not correlate with resting arterial oxygen or carbon dioxide tensions, FEV1, maximum inspiratory pressure, angle of scoliosis, or number of ribs resected. The relation between ventilation and oxygen consumption (VE/VO2) and VE at the submaximal levels of oxygen consumption of 0.75 l/min (VE 0.75) and 1.0 l/min (VE 1.0) were normal. In 10 subjects a plateau of breathing frequency (fmax) was reached, after which the increase in ventilation was achieved by a further increase in tidal volume (VT). These subjects showed significantly lower values for the forced expiratory ratio, VO2max, and VEmax than those with a normal relation between tidal volume and breathing frequency. VEmax was correlated with FEV1 (r = 0.61), FVC (r = 0.46), maximum VT (r = 0.55), change in VT (r = 0.52), fmax (r = 0.56), and change in breathing frequency (r = 0.72). These results indicate that exercise in patients treated for tuberculosis by thoracoplasty is limited by ventilatory capacity and that this is due to a reduction in both dynamic lung volumes and respiratory frequency. PMID- 2763229 TI - Changes in day and night time oxygenation with protriptyline in patients with chronic obstructive lung disease. AB - The effect of protriptyline, a tricyclic antidepressant, on sleep architecture, nocturnal arterial oxygen desaturation, pulmonary function, and diurnal arterial blood gases was investigated in an open study of 14 patients with stable chronic obstructive lung disease. Daytime and overnight measurements were made before and 2 and 10 weeks after they started protriptyline (20 mg daily at bedtime). Two patients had to be excluded before the second visit and one before the third visit because of changes in treatment for their chest disease. Protriptyline caused mouth dryness in all patients and dysuria in six men. With protriptyline there were no significant changes in total sleep time, sleep period time, or the percentages of total sleep time occupied by stage I-II and stage III-IV sleep. The mean (SEM) percentage of total sleep time spent in rapid eye movement (REM) sleep decreased from 11.1 (1.7) to 4.6 (0.7) at two weeks and to 4.2 (1.0) at 10 weeks. After protriptyline the time spent during sleep with an arterial oxygen saturation (SaO2) below each 5% increment above 65% was less than the baseline time; the lowest SaO2 (%) reached during sleep increased from 64.5 (1.7) to 72.7 (2.1) at 2 weeks and to 77.4 (2.1) at 10 weeks. Lung volumes and expiratory flows were unchanged during the study. Daytime arterial oxygen tension (PaO2) increased from 57 (1.4) mm Hg before treatment to 62 (1.9) mm Hg at 2 weeks and to 66 (1.9) mm Hg at 10 weeks (7.6 (0.2), 8.3 (0.3), 8.8 (0.3) kPa). Carbon dioxide tension fell from 52 (2.3) mm Hg to 49 (1.4) mm Hg at 2 weeks and to 48 (2.0) mm Hg at 10 weeks (6.9 (0.3), 6.5 (0.2), 6.4 (0.3) kPa), but these changes were not significant. These results suggest that protriptyline may benefit patients with chronic obstructive lung disease by reducing the sleep induced falls in SaO2 and improving diurnal PaO2; a controlled trial is now required. PMID- 2763230 TI - Differential lung function in an infant with the Swyer-James syndrome. AB - A previously healthy two year old boy had an adenoviral infection at the age of 13 months and developed hyperlucency of the left lung, chronic respiratory distress, and failure to thrive. Bronchodilators and steroid treatment had no effect. Radionuclide lung scans using an intravenous bolus of xenon-133 both before and after treatment showed substantially reduced function on the hyperlucent side and modestly reduced function on the other side. Fibreoptic bronchoscopy showed no structural abnormalities. Partial forced expiratory flow volume (PEFV) curves, generated from end inspiration by rapid compression of the chest wall with an inflatable jacket, were obtained from the total respiratory system and from each lung separately by inflating a Fogarty catheter in the contralateral mainstem bronchus. Expiratory flow rates and volumes during both tidal breathing and PEFV manoeuvres were considerably decreased in the hyperlucent lung. PEFV curves from the "healthy" right lung and from the total respiratory system were similar in shape and showed a moderately obstructive pattern. The right lung ventilated about four times as much as the left when measured by bronchospirometry and about three times as much when measured by the radionuclide technique. The lung scans appeared to reflect adequately the functional abnormality in this infant with the Swyer-James syndrome. PMID- 2763231 TI - Clinical and radiographic study of activated carbon workers. AB - Activated carbon is made in Sri Lanka by passing steam through charcoal made from coconut shells. The carbon does not contain free silica. Sixty six men who had worked in a factory making activated carbon for an average of 7.2 years had no more respiratory symptoms than a control group, and none showed radiological evidence of pneumoconiosis. There was no evidence that people exposed to charcoal and pure carbon for up to 11 years are at risk of developing pneumoconiosis. PMID- 2763232 TI - Horner's syndrome caused by an intercostal chest drain. AB - Horner's syndrome occurred in a young woman as a complication of the treatment of a traumatic pneumothorax with an intercostal drain. The nerve damage probably occurred when the lung had fully re-expanded, pressing the tip of the intercostal drain, lying at the apex of the pleural cavity, on to the sympathetic chain. PMID- 2763233 TI - Sulfadoxine specific lymphocyte transformation in a patient with eosinophilic pneumonia induced by sulfadoxine-pyrimethamine (Fansidar). AB - A patient developed eosinophilic peripheral pulmonary infiltrates while receiving malaria prophylaxis with sulfadoxine-pyrimethamine (Fansidar). Withdrawal of Fansidar and treatment with corticosteroids led to rapid recovery. No exacerbation occurred after cessation of corticosteroids. Lymphocyte transformation testing gave a positive result in the presence of sulfadoxine but not pyrimethamine. It is concluded that drug hypersensitivity to sulfadoxine was the cause of the eosinophilic pneumonia in this patient. PMID- 2763234 TI - Alveolitis associated with sulphamethoxypyridazine. AB - A woman developed alveolitis which appeared to be caused by sulphamethoxypyridazine and which resolved after withdrawal of the drug and six months' treatment with prednisolone. PMID- 2763235 TI - Proceedings of the British Thoracic Society, 1988 winter meeting. 8 and 9 December, London. PMID- 2763236 TI - Attitudes to smoking and smoking habit among the staff of a hospital. AB - A survey of the smoking habits and attitudes towards smoking of all staff working in a teaching hospital with a specialist thoracic department has been carried out. Six hundred and sixty three (70%) of the 949 members of staff returned a voluntary self completed questionnaire. Completion rates were highest among medical, administrative, and clerical staff, and lowest among domestic and catering staff. Of the 663 responders, 136 (23%) admitted to being current smokers and 135 (19%) to being ex-smokers. The great majority of responders (81 94%, depending on area of work) believed that more areas of the hospital should be entirely smoking free. Most responders, however, believed that some accommodation should be made available to staff (70%), patients (52%), or visitors (59%) who wished to smoke. About a quarter of smokers expressed interest in joining a group to help them give up smoking. PMID- 2763237 TI - Anginal chest pain in sarcoidosis. AB - Of 43 consecutive black patients (42 male) with sarcoidosis, 12 (28%) complained of chest pain that met the clinical criteria for typical (four patients) or atypical (eight patients) angina pectoris. These patients underwent cardiopulmonary assessment, which included exercise and redistribution thallium 201 scans and, if indicated, coronary angiography. Nine control patients with sarcoidosis matched for age and duration of disease, but without chest pain, were also studied by thallium-201 scintigraphy. Six of the 12 patients with chest pain had thallium scans indicative of myocardial ischaemia, but all had normal coronary angiograms; no patient from the control group had evidence of ischaemia on the thallium scan. Four additional patients with chest pain and one from the control group had other (non-specific) abnormalities on the thallium scan, so that scans were abnormal in 10 of the 12 patients with sarcoidosis who had chest pain. Most patients with anginal chest pain reported partial or complete relief of symptoms with nitrates. Anginal chest pain appears to be common in black male patients with sarcoidosis, is associated with abnormal myocardial perfusion scans, and may result from myocardial sarcoidosis. PMID- 2763238 TI - Detection of pulmonary hypertension by Doppler echocardiography of the inferior vena cava in chronic airflow obstruction. AB - Pulsed Doppler echocardiography of the inferior vena cava is an accurate method for the diagnosis of tricuspid regurgitation and impaired right ventricular compliance, two features of pulmonary hypertension. The purpose of this study was to assess the value of Doppler echocardiography of the inferior vena cava for the detection of pulmonary arterial hypertension in patients with chronic obstructive lung disease. Pulse Doppler echocardiography of the inferior vena cava and right heart catheterisation were performed in 29 patients with severe chronic obstructive lung disease. The mean pulmonary arterial pressure was 27 (10) mm Hg for the entire group; 62% of patients (18/29) had pulmonary arterial hypertension (mean pulmonary arterial pressure greater than 20 mm Hg). An adequate Doppler signal could be obtained in 25 of the 29 patients (86%). Pulsed Doppler echocardiography of the inferior vena cava gave normal results in 10 patients and disclosed tricuspid regurgitation in seven patients, impaired right ventricular compliance in seven patients, and both of these abnormalities in one patient. An abnormal Doppler echocardiogram of the inferior vena cava (tricuspid regurgitation or impaired right ventricular compliance, or both) predicted the presence of pulmonary arterial hypertension with a sensitivity of 87% and a specificity of 80%. These results suggest that pulsed Doppler echocardiography of the inferior vena cava may be a useful though imperfect method of detecting pulmonary arterial hypertension in patients with chronic obstructive lung disease. PMID- 2763240 TI - Circadian rhythm of peak expiratory flow in asthmatic and normal children. AB - A study was undertaken to examine the circadian rhythm of peak flow rate in asthmatic and normal children in the community by means of cosinor analysis. An initial study of 12 matched pairs of asthmatic and normal children was used to determine the mean amplitude of peak expiratory flow (PEF) variability in the two groups (7.8% and 4.4%) and the number of subjects required to show a significant difference. On the basis of this study 37 community based children with asthma diagnosed by questionnaire and 40 control subjects measured PEF four times daily for 14 days. Cosinor analysis of the data produced a significant fit in 20 asthmatic and 18 control children. A small but significant difference in amplitude was observed between the asthmatic (6.2%) and the control (4.2%) children. There was no significant phase difference between the rhythms in the two groups. Cosinor analysis explained 14% of PEF variance. It did not provide a reproducible estimate of phase between week 1 and week 2; the acrophase changed by more than one hour in 26 of 37 asthmatic children. The cosinor model may be inappropriate for the investigation of low amplitude circadian rhythms, especially when measurements are made infrequently. PMID- 2763239 TI - Relation of lung function and exercise capacity to mood and attitudes to health. AB - Results of psychometric tests were obtained on 161 male welders and other tradesmen in heavy industry who had recently been made redundant. Anxiety and depression were scored on the Hospital Anxiety and Depression Scale, and negative attitudes and beliefs regarding breathlessness and related aspects of respiratory health on a semantic differential scale. Scores for attitudes and beliefs about health and personal disability were pooled to give a general attitude score. Personality was rated on a standard scale. Subjects completed a questionnaire on respiratory symptoms and underwent routine spirometry, measurement of carbon monoxide transfer factor for the lung, and a progressive exercise test on a cycle ergometer. Scores for anxiety, depression, and negative mental attitudes were significantly intercorrelated; subjects with disordered personality profiles had above average scores for anxiety and depression. The psychometric scores were associated with clinical grade of breathlessness, lung function, and the physiological response to exercise. The general attitude score could be predicted from the anxiety and depression scores and from lung function expressed relative to age and stature, the combination of mood score and FEV1 explaining 38% of the variance in general attitude score. The general attitude score accounted for more than half the explained variance in the clinical grade of breathlessness and contributed more to the variance in maximal oxygen uptake (R2 = 0.11) than FEV1. It was associated with the level of habitual activity but not with smoking category, wheeze, chronic cough or phlegm. Thus attitude to disability reflected the subject's assessment of his exercise capacity and was closely related to the clinical grade of breathlessness. PMID- 2763241 TI - Longitudinal course of extrinsic allergic alveolitis in pigeon breeders. AB - The purpose of this study was to assess the longitudinal course of pigeon breeders' disease by evaluating 24 patients with the acute form of the disease 10 years after their original diagnosis. Twenty one patients attended for clinical assessment, pulmonary function studies, chest radiography, and antibody measurement. Eighteen had continued to keep pigeons, emphasising their commitment to the hobby. Despite continued antigen exposure pigeon related symptoms had improved in most patients and only five still had troublesome symptoms. Four patients had residual abnormalities of pulmonary function or chest radiographs and three had chronic bronchitis. Fanciers had attempted to regulate their exposure to the birds by use of masks and by spending less time in their lofts but this is an unlikely explanation for the benign course of their disease, as levels of antibody to pigeon gammaglobulin remained high, suggesting that appreciable antigen exposure was still occurring. In most cases a state of equilibrium between host and antigen appeared to have developed. This observation has implications for the clinical management and understanding of the nature of the disease. PMID- 2763242 TI - How many manoeuvres should be done to measure maximal inspiratory mouth pressure in patients with chronic airflow obstruction? AB - To determine the number of maximal mouth pressure manoeuvres needed to obtain a reproducible value of maximal inspiratory mouth pressure (MIP), we studied 44 patients with chronic airflow obstruction, with a mean (SD) % predicted FEV1 value of 53.9 (25), who were clinically stable. Maximal inspiratory mouth pressure was determined with an anaeroid manometer during maximal inspiratory efforts in a quasi static condition at residual volume. All patients performed 20 consecutive maximal inspiratory mouth manoeuvres, each one separated by 30-40 seconds. The mean (SD) values of MIP varied from 71.5 (25.5) cm H2O at the first measurement to 80.1 (27) cm H2O at the last measurement. Maximal values of MIP were usually achieved after nine determinations. It is concluded that to obtain a reproducible MIP value in patients with chronic airflow obstruction who are untrained and unexperienced in such manoeuvres a minimum of nine technically acceptable maximal mouth pressure manoeuvres should be performed. PMID- 2763243 TI - Adrenal function in patients with active tuberculosis. AB - Although tuberculosis is a recognised cause of adrenal insufficiency, little is known about adrenal function in patients with active tuberculosis. Ninety Melanesian adults with active tuberculosis (30 pulmonary, 30 miliary, 30 extrapulmonary) had adrenal function assessed prospectively before and three to four weeks after starting antituberculous chemotherapy. Basal serum cortisol concentrations were normal in 55 (61%) and raised in 35 (39%) of the subjects. No patient had a low basal cortisol concentration. After Synacthen stimulation, cortisol responses were normal in 81 (92%) of the patients and subnormal in seven (8%). After antituberculous chemotherapy the response to Synacthen stimulation was normal in all but one patient. It is concluded that adrenal dysfunction is an uncommon problem in patients with active tuberculosis, and that, contrary to recent reports, antituberculous chemotherapy regimens that include rifampicin do not have an adverse effect on adrenal function. PMID- 2763244 TI - Distribution of allergy in a population sample residing in Tucson, Arizona. PMID- 2763245 TI - Abnormal lung lymphatics and respiratory failure. AB - A 65 year old man presented with respiratory failure, pleural effusions, fine reticulonodular shadowing on a chest radiograph, and severe impairment of carbon monoxide diffusing capacity (transfer factor). Open lung biopsy showed only dilated pleural and subpleural lymphatic channels. Hypoplastic deep pulmonary lymphatics may have led to respiratory failure. PMID- 2763246 TI - Opportunist pulmonary infection with Legionella bozemanii. AB - Three cases of pulmonary Legionella bozemanii infection in immunocompromised patients are described. The diagnosis was made by culture in each case and would not otherwise have been made, and it is recommended that a culture specific for Legionella species should be included in the investigation of patients with suspected opportunist pulmonary infections. PMID- 2763247 TI - Discrete pleural masses without effusion in a young man: an unusual presentation of tuberculosis. AB - Extensive tuberculous infection of the pleura presented radiographically as multiple discrete nodules, without associated effusion or lesions of lung parenchyma. PMID- 2763248 TI - Primary pulmonary lymphoma in a patient with the acquired immune deficiency syndrome. AB - A case of primary pulmonary lymphoma presenting as a nodular lesion on the chest radiograph in a patient with the acquired immune deficiency syndrome is described. PMID- 2763249 TI - Chronic necrotising pneumonia caused by Aspergillus niger. AB - A woman with asthma developed chronic necrotising semi-invasive pneumonia due to mixed Aspergillus niger and Candida albicans infection; though not severely immunosuppressed, she may have been predisposed by long term oral corticosteroid and recurrent oral antibiotic treatment. The diagnosis should be considered in patients with chronic airflow limitation who develop cavitating pneumonia. PMID- 2763250 TI - Pericardial actinomycosis with cardiac tamponade from a contiguous thoracic lesion. AB - A case of acute pericardial tamponade due to actinomycotic infection is reported, in which computed tomography showed a mass adjacent to the heart and a pericardial effusion. The patient had aggressive medical treatment with penicillin and survived. PMID- 2763251 TI - Haemoptysis as the sole presenting symptom of dissection of the aorta. AB - A 75 year old man who had had haemoptysis for 24 hours was found to have his left lower lobe compressed by a dissection of the aorta, which was otherwise symptomless. PMID- 2763252 TI - Transfer factor for carbon monoxide in patients with diabetes with and without microangiopathy. PMID- 2763253 TI - Prospective study of asthma in relation to smoking habits. PMID- 2763254 TI - Correlations between histological type, clinical behaviour, and prognosis in thymoma. AB - Seventy four cases of thymoma were reclassified into three histological categories--cortical (30), medullary (9), and mixed (34) (the remaining patient had an intrathymic thymoma)--for an investigation of the relation between histological type, clinical behaviour, and long term prognosis. There were significant differences between the histological types in the frequency of myasthenia gravis and of the different tumour stages, the mean age of the patients, and prognosis. Myasthenia gravis occurred more commonly in patients with cortical (33%) and mixed thymoma (35%) than in patients with medullary thymoma (11%). Five, 10, 15, and 20 year actuarial survival was 100% for medullary thymoma; 85%, 76%, 65% and 65% respectively for mixed thymoma; and 52%, 45%, 45%, and 45% for cortical thymoma. Medullary thymoma is a benign tumour arising late in life and there was no mortality in this series after surgery alone. Cortical thymoma usually presented in middle age and must be regarded as malignant; mortality was 50% at five years despite a multidisciplinary approach, with surgery and postoperative radiotherapy in all patients and chemotherapy in selected cases. Mixed thymoma had a better prognosis than cortical thymoma, but must be regarded as potentially malignant. One third of the total patients had died by 10 years despite radical tumour resection. PMID- 2763255 TI - Effects of an external resistance on maximum flow in chronic obstructive lung disease: implications for recognition of coincident upper airway obstruction. AB - To determine how the presence of generalised airflow limitation due to chronic obstructive lung disease affects the recognition of simulated upper airway obstruction, a study was carried out in 12 patients (mean (SD) age 57 (7) years) with chronic obstructive lung disease (FEV1% predicted 53 (22), range 21-70) and 12 matched control subjects. Patients and control subjects performed maximal inspiratory and expiratory flow-volume curves in a variable volume plethysmograph with and without upper airway obstruction simulated at the mouth with a series of polythene washers of internal diameter 4, 6, 8, 10, and 12 mm. In patients, as in normal subjects, peak expiratory flow (PEF) and maximum inspiratory flow at 50% of vital capacity (Vmax50) were more sensitive to upper airway obstruction than were FEV1 or maximum expiratory flow at 50% VC (VEmax50); but the reductions in all indices caused by simulated upper airway obstruction were smaller in the patients than in the controls. The fall in PEF (whether expressed in absolute units or as a percentages) consequent on severe (4 mm) upper airway obstruction became smaller with increasing severity of chronic obstructive lung disease. The subjects also produced flow-volume curves with and without 6 mm upper airway obstruction while breathing helium and oxygen (heliox). In both groups the effects of heliox on PEF and Vmax50 were increased when upper airway obstruction was simulated. It was confirmed that the functional recognition of upper airway obstruction is more difficult in patients with chronic obstructive lung disease than in normal subjects and this difficulty increases with severity of disease; an unusually large increase in PEF or Vmax50 while the patient is breathing heliox should raise the suspicion of coexisting upper airway obstruction, but such a pattern is not specific. PMID- 2763257 TI - Repeatability of ventilatory function measurements in a population survey of 7 year old children. AB - The within subject variability of forced vital capacity (FVC), forced expiratory volumes in one second (FEV1) and half a second (FEV0.5), peak expiratory flow (PEF), and flow rates at 25-75%, 75-85%, 25%, 50%, and 75% of expired FVC were assessed among 7 year old children from the general population. Within occasion variability in 232 children was lowest for FVC (coefficient of variation (CV) 5%) and FEV1 (CV 4%), and greatest for end expiratory flow rates. The precision of measurement for FEV1 supports its use for bronchial provocation tests, particularly those using a graded challenge. In this context the value of PEF (CV 7%) and mid expiratory flow rates (CV 11%) is limited by their poorer repeatability. Between occasion variability was assessed in 171 children tested at an interval of one to four weeks. The difference between the variances between occasions and within occasions was attributed to biological variation; this accounted for a substantial component of the between occasion variance in all indices, particularly FEV1 (73%) and PEF (66%). Together, within subject variability, sex, and height accounted for about half of the measured variance between subjects for all indices except FVC (68%). These results have implications for epidemiological studies. PMID- 2763256 TI - The fluctuant nature of precipitating antibodies in dairy farmers. AB - Four hundred and forty five of 888 dairy farmers studied in an epidemiological survey four years previously were restudied to determine change in precipitins and in clinical features. Subjects answered the same questionnaire, which was filled in by the same nurse in the same winter months, and had blood withdrawn for precipitin analysis (double diffusion technique). Of the 445 subjects retested, 48 (10.8%) had been precipitin positive at the first study; of these, 34 remained positive four years later and 14 had reverted to negative. Twenty eight subjects previously negative for precipitins had become positive, so that 62 subjects in all were precipitin positive when restudied (13.9%). Of the 445 farmers, 369 were precipitin negative at both studies. The prevalence of symptoms, including cough, sputum production, wheezing, dyspnoea, and fever and chills, was similar for subjects who were consistently negative for precipitins and consistently positive and for those who changed from one to the other. Only one subject developed farmer's lung; he had precipitins in both studies. This study shows a fluctuation in the precipitin state of dairy farmers, suggesting that more farmers have precipitins at least once in their lifetime than are identified by screening at a single point in time. Relatively few develop farmer's lung or other respiratory symptoms. The presence of precipitins in a symptomless farmer appears to have no clinical importance. PMID- 2763258 TI - Effects of posture on the distribution of pulmonary ventilation and perfusion in children and adults. AB - In the adult the distributions of ventilation and of perfusion show the same directional dependence on gravity. In children, however, the distribution of ventilation in response to gravity is the reverse of that seen in adults. The aim of the current study was to determine whether perfusion showed the same reversal in children or followed the adult pattern. Distribution of perfusion was measured with intravenous technetium-99m macroaggregated albumin and distribution of ventilation with inhaled krypton-81m. Eighteen children and seven adults were studied; they had been referred for lung scanning for various respiratory problems. The effect of gravity was examined by giving aliquots of macroaggregated albumin and 81mKr by inhalation to the subject in the supine and the lateral decubitus position. Counts in the dependent lung were compared with those in the upper lung. The dependent lung in the lateral decubitus position received more of the total perfusion than it did in the supine position in seven children with a normal chest radiograph (mean 7.0%, range 4.8-10.9% more) and in 11 children with an abnormal radiograph (mean 3.4%(0.1-10.0%)). Ventilation, however, changed in the opposite direction, falling by 7.1% (-3.2% to -12.8%) in five children with a normal chest radiograph and 11.2% (-2.8% to -19.3%) in eight children with an abnormal radiograph. Fractional V/fractional Q (an index of the ventilation:perfusion ratio) decreased in the dependent lung in the children when they moved from the supine to the decubitus position. The same directional change was recorded in adults, but it was significantly less than in the children, irrespective of whether the chest radiograph was abnormal. In children and adults with various respiratory problems the effect of posture on the distribution of perfusion is similar. PMID- 2763259 TI - Vertical gradients of lung density in healthy supine men. AB - Computed tomography was used to determine the vertical gradient of physical density in peripheral lung tissue of 12 healthy supine subjects, at total lung capacity and residual volume. At total lung capacity the mean (SD) density of peripheral lung tissue at the level of the mid right atrium was 0.0715 (0.017) g/cm3 and the vertical gradient of density was slight. At residual volume the density of peripheral tissue at the same level was 0.272 (0.067) g/cm3 and the vertical density gradient was curvilinear and more pronounced. Predictions of the gradient at residual volume were made on the basis of the known compliance of the lung and measured effects were attributed to the action of gravity on blood vessel distensibility at total lung capacity. These predictions agreed closely with the actual density gradient measured at residual volume and provide a basis for forecasting the vertical density gradient that would exist in healthy lungs at any degree of inflation. Departure from these gradients would imply local abnormalities of lung compliance, distribution of mechanical stress, or distensibility of vessels. PMID- 2763260 TI - Malignant pleural mesothelioma in western Glasgow 1980-6. AB - This study reviews all histologically proved cases of malignant pleural mesothelioma seen in the western district of Glasgow during 1980-6. Sixty eight cases were identified (three female) with an age range at presentation of 48-85 (mean 68.9) years. Asbestos exposure was identified in 54 (80%) of the patients, most of whom had been shipyard workers. Pain and dyspnoea were the most common presenting symptoms. Pleural effusion was found in 57 (84%) of the patients, in a ratio of 2.6 right:left. The median survival was only 30 weeks from the time of presentation. Prognosis was significantly better for those presenting with dyspnoea than for those with pain (median survival 44 v 22 weeks). Postmortem examination was performed in 40 cases and metastatic disease found in more than three quarters. There was no significant difference between the incidence of the various tumour cell types or any relation between cell type and survival or the incidence of metastatic disease. A substantial increase in cases of malignant pleural mesothelioma has been found in an area of already high incidence. The use of rigorous histological criteria to determine histological cell type has shown that this previously valued variable is of no discriminatory value with regard to disease activity or survival. PMID- 2763261 TI - Radiographic measurement of total lung capacity in acute asthma. AB - The thoracic cage appears to be large during attacks of asthma. Lung volume measurements by body plethysmography and helium dilution have suggested that total lung capacity may be increased during an acute attack of asthma, but doubt has been cast on the accuracy of these measurements in the presence of airflow obstruction. The change in total lung capacity has therefore been investigated during and after an acute attack of severe asthma in 32 patients by a radiographic technique. There was a small decrease (0.29 l) in mean total lung capacity between admission and follow up, though a quarter of the subjects showed a slight increase. There was no correlation between change in total lung capacity and change in expiratory flow rates, arterial carbon dioxide tension on admission, body mass index, and length of stay in hospital. Our findings agree with previous reports of a decrease in total lung capacity with improving airway obstruction, but the changes were small and inconsistent. PMID- 2763262 TI - Synchronous pulmonary carcinoid tumour and non-Hodgkin's lymphoma: report of two cases. AB - Two cases of synchronous pulmonary carcinoid tumour and non-Hodgkin's lymphoma are described. PMID- 2763263 TI - Management of severe haemoptysis by bronchial artery embolisation in a patient with cystic fibrosis. AB - Severe haemoptysis in a patient with cystic fibrosis was successfully treated on two occasions by bronchial artery embolisation. PMID- 2763264 TI - Predicted values: how should we use them? PMID- 2763265 TI - Breathing patterns during sleep in patients with nocturnal asthma. PMID- 2763266 TI - The interactions of factors X and IX with phospholipid. AB - The interactions of human factors X and IX with phospholipid were studied with an ELISA system. In the presence of calcium ions, factor X bound to phosphatidylserine with an affinity of 1.56 x 10(10) M-1 and to phosphatidylcholine with an affinity of 5.6 x 10(9) M-1. In the presence of calcium ions, factor IX bound to phosphatidylserine with an affinity of 8.4 x 10(8) M-1 and no binding to phosphatidylcholine was observed. No competition of factors X and IX for phosphatidylserine binding sites was observed. PMID- 2763267 TI - Australian snake venoms and their in vitro effect on human platelets. AB - Thrombocytopenia is generally not associated with cases of envenomation by Australian snakes, however the clinical evidence is conflicting. The in vitro effect of these venoms upon platelets had hitherto not been studied. This study systematically examines the effect on human fresh and fixed platelets of twenty Australian snake venoms, nineteen elapid and an hydrophiid; for comparision four crotalid venoms from the Americas and S.E. Asia were also included. Electron micrographs were taken of platelets after exposure to some of the venoms. Results demonstrated that all venoms except the hydrophiid venom caused fresh platelets to irreversibly aggregate directly, and this was associated with degranulation as evidenced by electron microscopy (EM). Response to all venoms by fixed platelets was less marked and also suggests, that metabolically, active platelets are necessary for the venoms to exert their maximal effect. The hydrophiid venom's action on fresh platelets was unique, as a plasma co-factor was required before aggregation could be induced. Crotalid and hydrophiid venoms were more active against platelets than the elapid venoms. Nevertheless, platelet aggregation and degranulation in the presence of elapid venoms suggests that a platelet response in vitro may be a significant factor in the "defibrination syndrome" induced in humans by Australian snakes. PMID- 2763268 TI - Improved method for purification of human platelet factor 4 by affinity and ion exchange chromatography. AB - A simple method for the reproducible purification of human platelet factor 4 (PF4) is described. PF4 is obtained in a highly purified form from platelet concentrate by utilizing a combination of affinity and FPLC ion-exchange chromatography. In every instance, after elution from heparin affinity and cation exchange chromatography, SDS gel electrophoresis reveals a single band attributable to PF4. Moreover, the amino acid composition of PF4 isolated by this method is compatible with that described for a PF4 cDNA clone and with other reported PF4 analysis. The purified protein is used to study in vitro the affinity of PF4 for several glycosaminoglycans (GAGs), by measuring the fluorescence of each PF4-GAG complex bound to fluorescamine. PF4 affinity for GAGs is as follows: heparin greater than heparan sulphate much greater than dermatan sulphate. PMID- 2763269 TI - Protein C assays in uremia. AB - Protein C was determined in 42 patients with terminal uremia and 20 healthy controls in three different ways 1) anticoagulant activity 2) amidolytic activity 3) antigen level. Protein C anticoagulant activity was markedly decreased in uremia, but was partly normalized during hemodialysis treatment, whereas the amidolytic activity and antigen level of protein C were normal and without changes during dialysis. The activities and antigen levels of factor II and X were normal before and after hemodialysis. In anticoagulated patients we found a good correlation between prothrombin levels and protein C levels determined with three different assays. We did not find any evidence for a defect carboxylation of protein C as the cause for the defective protein C in uremia. The BaCl2 precipitation in the Protein C anticoagulant assay was incomplete both in uremia and in controls but without differences between the two groups. In vitro addition of urea and creatinine did not decrease protein C activity. The cause of the defective protein C in uremia is still not known but it might contribute to thromboembolic complications. PMID- 2763270 TI - C-terminal peptide alcohol, acid and amide analogs of desulfato hirudin54-65 as antithrombin agents. AB - Analogs of the antithrombin peptide hirudin54-65 with C-terminal modifications have been synthesized in order to examine the requirements for alpha-thrombin inhibition. The C-terminal residue, Gln65, could be replaced with L-amino acids or amino alcohols with neutral or charged hydrophilic side chains without greatly affecting the peptide's antithrombin potency as determined by inhibition of thrombin-induced clot formation in human plasma in vitro. Derivatives with D- or L-amino carboxamides at position 65 had significantly reduced potency, but still retained activity. Deletion of residue 65 with conversion of residue 64 to the amide or alcohol derivative resulted in a three-fold loss of potency. In addition to these results the solid-phase synthesis of peptide alcohols via direct displacement of p-nitrobenzhydrylideneisonitroso resin attached peptides with the desired C-terminal amino alcohol is reported. PMID- 2763271 TI - Molecular aspects of cloricromene (AD6) distribution in human platelets and its pharmacological effects. AB - Cloricromene (AD6) is an investigational drug which inhibits platelet aggregation and release reaction. We studied the relationship between its action and its distribution and metabolism in platelets. Incubation of anticoagulated whole blood or platelet-rich plasma (PRP) without exogenous aggregating agents resulted in a progressive decrease of platelet count with a concomitant increase of beta thromboglobulin (BTG) release. AD6 (20-50 mumols/l), but not acetylsalicylic acid (ASA), incubated with whole blood or PRP, prevented the fall in platelet count and the release of BTG for at least 150 min. Moreover, incubation of PRP with AD6 (50 mumols/l) and subsequent stimulation by ADP at threshold concentrations resulted in a significant reduction (about 30%) in aggregation for at least 90 min. AD6 (20 mumols/l) added to PRP was rapidly metabolized by hydrolysis of an ester bond to AD6 acid, a stable catabolite pharmacologically inactive in platelets. Significant amounts of AD6 acid (up to 13.26 +/- 2.80 pmol/10(6) platelets) were associated with the platelets after incubation either at 37 degrees C or 4 degrees C. The amount of AD6 acid in the platelet pellet was proportional to AD6 concentration (2 to 100 mumols/l). PRP incubation with AD6 acid (20 mumols/l) resulted in very low levels (less than 1 pmol/10(6) platelets) of the same compound in the platelet pellet after 1, 5 or 30 min. These data suggest that AD6 is taken up as an ester and converted to its acid catabolite with a consequent long-lasting inhibition of platelet function. PMID- 2763272 TI - Heart valve replacement with the Bjork-Shiley monostrut valve in patients over 60 years of age. AB - Over a period of five years (1983-88) 210 Bjork-Shiley monostrut mechanical tilting disc prostheses were implanted in 176 patients over the age of 60. There were 61 aortic valve replacements, 86 mitral valve replacements and 29 multiple replacements. Patients were aged between 61 and 78 years (mean 65.5 years), 89% were in NYHA grades III and IV preoperatively and 34.6% had had previous cardiac surgery. Concomitant coronary surgery was performed in 15.9%. Early mortality was 9.1%. Follow-up is 100% complete. There were eight late deaths (3.1 per 100 patient years) of which three were valve-related (prosthetic endocarditis 2, periprosthetic leak 1). Actuarial survival at five years is 98% for aortic valve replacement and 93% for mitral valve replacement. There were no major embolic events and four possible minor embolic events. Overall freedom from anticoagulant complications was 88.9% at five years. No deaths occurred because of anticoagulant-related haemorrhage. There were no episodes of valve failure (thrombotic obstruction or mechanical disruption). Six patients were reoperated for complications: two for periprosthetic leak and three for prosthetic endocarditis. These results compare favourably with those of other valve substitutes and justify the continuing use of the Bjork-Shiley monostrut tilting disc prosthesis in the elderly. PMID- 2763273 TI - Isolated mitral valve replacement. With Carpentier-Edwards bioprosthesis :independent risk factors for long-term survival and prosthesis failure. AB - From 1976 through 1986, 188 patients (female/male ratio: 2/1, age 20-77 years, mean 58 years) with isolated mitral valve disease underwent valve replacement using the Carpentier-Edwards porcine bioprothesis (CEPB). Nine hospital deaths (4.8%) were excluded from further analysis. Follow-up was 0.2-11.3 years (mean 5.2 years); preoperatively, 74% had atrial flutter/fibrillation, and 75% were in NYHA-classes III-IV. All patients were put on life-long coumadin treatment. Preoperative predictability of long-term survival and prosthesis-related complications was examined using Cox regression analysis. Five preoperative variables were found to have independent predictive value as regards long-term survival: myxomatous degeneration of the valve (p = 0.002), chronic regurgitation (p = 0.003), age (p = 0.004), NYHA-class III-IV (p = 0.05), and atrial flutter/fibrillation (p = 0.05). A prognostic index calculated form the final Cox model identified six risk groups (I-VI) having cumulative 10-year survivals +/- SE of: I (n = 9) 100%, II (n = 10) 90 +/- 9%, III (n = 30) 73 +/- 10%, IV (n = 70) 51 +/- 9%, V (n = 43) 17 +/- 10%, and VI (n = 17, 7-year survival) 16 +/- 13% (p less than 0.0001). The incidence of late valve-related complications (%/patient-years) were: hemorrhage, 1.2; thromboembolism, 0.5; Endocarditis, 1.0; paravalvular leak, 0.2; and primary tissue failure, 1.5. Previous closed comissurotomy adversely influenced the occurrence of hemorrhage, while calcified mitral annulus were predictive of endocarditis. Younger age (less than or equal to 45 years) had a strong predictive influence of primary tissue failure.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2763274 TI - Retrograde internal mammary to coronary artery anastomoses. AB - In an effort to expand the utilization of the internal mammary artery (IMA) for revascularization of the distal coronary artery branches, distally pedicled retrograde internal mammary arteries (retro-IMA) were evaluated in 10 mongrel dogs with a mean weight of 38 +/- 13 kg. One IMA was transected at it's origin (retro-IMA) and compared to the contralateral IMA which was transected at the level of the 5th intercostal space. At a mean systemic pressure of 68 +/- 15 mmHg the mean pressure measured at the tip of the IMAs with antegrade flow was 63 +/- 14 mmHg in the retro-IMAs with retrograde flow (p less than 0.05; pressure ratio 0.8). With the same mean systemic pressure, mean antegrade free flow of the IMAs was assessed 97 +/- 43 ml/min versus 48 +/- 13 ml/min in the retro-IMAs with retrograde flow (p less than 0.005; flow ratio 0.5). Left retro-IMA to coronary artery anastomosis was performed in 6 animals to the distal left anterior descending (LAD) coronary artery and in 2 animals to the distal left obtuse marginal branch. Right retro-IMA to coronary artery anastomosis to the right posterior descending coronary artery was performed in 2 animals. The LAD coronary artery was ligated proximally to the retro-IMA to coronary artery anastomosis while the retro-IMA remained crossclamped. After documentation of significant ischemia (EKG, left atrial pressure), the crossclamp of the retro-IMA graft was removed. Subsequent normalisation of EKG and left atrial pressure occurred in all animals. We conclude that the canine retro-IMA delivers significant retrograde flow and discuss a possible use in humans. PMID- 2763275 TI - Anatomically corrected malposition of the great arteries, inflow ventricular septal defect, and subaortic stenosis: diagnostic and operative implications. AB - Intracardiac correction of the combination of rare congenital heart lesion of anatomically corrected malposition of the great arteries, severe muscular as well as fibrous subaortic stenosis, and ventricular septal defects in the inflow and the trabecular septum in a 2 1/2 years old boy is reported. There was an additional large secundum atrial septal defect. The operation consisted of resection of the subaortic stenosis by a combined transatrial and transaortic approach, thereby regaining a wide outflow tract of the systemic ventricle. Both the ventricular and atrial septal defects were closed with Dacron patches. Reinvestigation 10 days after the operation revealed a residual pressure gradient across the outflow of the systemic ventricle of less than 10 mmHg. A secondary ventricular septal defect was detected in the anterior muscular septum at the same time and closed with a patch in a reintervention. At discharge from the hospital two weeks later the child was in excellent condition and had a stable sinus rhythm. The preoperative differential diagnosis of a double outlet right ventricle with L-malposition of the aorta as well as possible surgical approaches are discussed. PMID- 2763276 TI - Ultrastructural changes of coronary artery endothelium induced by cardioplegic solutions. AB - Coronary artery endothelial and myocardial ultrastructure was studied in guinea pig heart-lung preparations (HLP) subjected to ischemic cardiac arrest induced by three hypothermic solutions. Two of the solutions used had high potassium chloride concentration ("Alabama" and "St. Thomas") while the third, instead, was a bicarbonate buffer (Kreb's solution). Five experimental groups were studied. In group 1 (control) the HLP were not subjected to cardiac arrest. Groups 2, 3, and 4 were subjected to a period of cardiac arrest of 30, 60, and 120 minutes respectively. In group 5, HLP were reperfused with blood for 30 minutes after 60 minutes of cardiac arrest. A thin ring of the left anterior descending coronary artery and myocardial fragments were obtained at the end of each experiment and were analyzed by means of transmission electron microscopy (TEM). Functional parameters were recorded in group 5. HLP perfused with Alabama solution showed a well-preserved endothelium and myocardium. HLP perfused with Krebs solution showed slight changes of the endothelial glycocalix only in group 4. Further, HLP perfused with Krebs solution showed extensive myocardial lesions (groups 3 and 4). These ischemic changes were not completely reversed after reperfusion (group 5). HLP perfused with St. Thomas solution showed only endothelial changes. These lesions were mainly characterized by: disappearance of the glycocalix and pynocytotic vesicles, endothelial cell bulging (group 2), and loss of the endothelial continuity (groups 3, 4, and 5). Hemodynamic parameters were significantly changed only in the Krebs-perfused HLP which showed a deterioration of the cardiac function related to the ischemic damage.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2763277 TI - Reliability of different temporary myocardial pacing leads. AB - Temporary myocardial pacing leads are routinely used for diagnosis and treatment of postoperative arrhythmias following open-heart surgery. The intention of this study is to compare five different electrodes for reliability during the postoperative period. A standardised technique of implantation was used to place 147 ventricular and 81 atrial wire electrodes in 149 patients. During operation and then daily over the next ten days, the stimulation threshold, P- and R-wave sensing, and impedance were measured with a pacing system analyser to evaluate the reliability of the pacing and sensing function. Five measurements were taken at each time; the mean values were statistically analysed. The number of failures in pacing and sensing and the course of the tested parameters during the postoperative period were compared. As a result, bipolar pacing leads (Osypka TME 64a/66a) proved to be more reliable than unipolar wires (Ethicon HD 12S, Osypka TME 60/60a), particularly in atrial sensing. Also the Medtronic 6400/6500 showed good reliability for the ventricle, so that they can be recommended for VVI-mode pacing. In conclusion, for reliable function during the postoperative course up to 10 days a specially developed bipolar temporary pacemaker electrode can be recommended for both atrial and ventricular or sequential pacing. PMID- 2763278 TI - Chemical pleurodesis in primary spontaneous pneumothorax. AB - Spontaneous pneumothorax presents a high recurrence rate after conventional pleural drainage procedures. Different pleural scarifying agents are used in an attempt to prevent early and late recurrence. To investigate the effect of tetracycline and 30%-glucose, we conducted a randomized study on 20 patients with primary spontaneous pneumothorax: 10 patients were treated by pleural drainage combined with chemical pleurodesis; 10 patients were treated by pleural drainage alone. Chemical pleurodesis resulted in a statistically significant reduction (p less than 0.05) in early recurrence. The rate and magnitude of late recurrences however was unaffected by the pleurodesis treatment, although recurrence in the chemically treated group was later than in the conventional drainage group. PMID- 2763279 TI - Bilobectomy in a 90-year-old patient. AB - A 90-year-old patient was admitted to our clinic after two weeks of dangerously increasing hemoptysis. Bronchoscopy showed the segment bronchi of the right lower lobe to be subtotally occluded by a tumour. A biopsy was not taken because of simultaneous bleeding. After weighing the risks, surgery was decided on despite the advanced age of the patient. The centralized position of the tumour necessitated a bilobectomy. Histology showed a small-cell bronchial carcinoma T2N1M0. After initial secretion retention and mild transitional syndrome, the postoperative course was uncomplicated. Four weeks after surgery, the patient could be transferred to his local hospital where he was discharged home after a further two months. There was no reappearance of hemoptysis. At the last check up, one year postoperatively, there was no tumour recurrence. The patient lives alone in his flat as prior to surgery. This case shows that, in individual patients, larger pulmonary resections are also possible and justified in the tenth decade of life. PMID- 2763280 TI - Cardiac surgery in the Federal Republic of Germany during 1988. A report by the German Society for Thoracic and Cardiovascular Surgery. PMID- 2763281 TI - [Clinical case. Colonic obstipation before the pelvic flexure]. PMID- 2763282 TI - [Legal foundation and practical execution of slaughtering and meat examination of game animals]. AB - Meat regulations also involve game inspection. On the one hand the previous publications dealt with the regulations and their practice concerning game intended for slaughter, especially the control of fences and the gaining of meat. On the other hand regulations concerning game hunted for food (deer: red deer, sika deer, fallow deer, roe deer; horned ungulates: European mufflon, chamois; wild boar; European hare; European rabbit; game such as badger and raccoon) and regulations to be observed by hunters, mainly for the gaining of meat were discussed. At the beginning the following publication completes the previous ones concerning game hunted for food and later deals with the meat inspection of slaughtered game. PMID- 2763283 TI - [Disseminated intravascular coagulation in a cow of the breed "Deutsche Rotbunte" with fungal mastitis and abomasal displacement]. AB - This report describes a 7-year-old cow of the breed "Deutsche Rotbunte" which was brought into the clinic because of intense fungal mastitis and left displacement of the abomasum. A disseminated intravascular coagulopathy (DIC) was determined by coagulation assays and verified by necropsy and histopathological examination. PMID- 2763284 TI - [The use of fenbendazole for controlling helminths in small zoo ruminants]. AB - By means of coproscopical examination the anthelmintic efficacy of 5.0 mg fenbendazole/kg body weight and 0.714 mg/kg body weight, administered for seven consecutive days, was determined in three series of trials on small ruminants in the zoological gardens of Munich. Both doses proved to be highly effective against trichostrongylids; the egg output was reduced to an average of 100% and 80-100%, respectively. Despite of a partly lower efficiency after the multiple administration of a low level doses (7 x 0.714 mg fenbendazole/kg body weight) this is a sufficient and economical treatment for the control of the infestation with endoparasites in the - in this respect - difficult housing systems of zoological gardens. PMID- 2763285 TI - [Liver cirrhosis in young calves]. AB - Among the cattle admitted to the II. Medizinische Tierklinik of the University of Munich during the years 1982-86, 38 calves of up to 6 weeks of age had a dystrophy (n=5), pre-cirrhosis (n=21) or cirrhosis (n=12) of the liver. Similar hepatic lesions were found in three 1- to 7-day-old calves and in 1 foetus aborted in the 7th month of gestation which were submitted for necropsy. Of the 38 patients (74% male, 87% German Fleckvieh) 25 had been ill since the first seven days of life (mean age on admittance: x=14 days). These hepatopathies showed no significant preponderance in regard to breed, sex or season. The general condition of the calves was moderately to severely disturbed. Catarrhal enteritis resistant to treatment was the main clinical finding in 32 of the 38 patients. Nine calves developed central nervous symptoms (delayed reflexes, impaired coordination, convulsions, opisthotonus). Neurohistological examination of one of these calves revealed massive astrocytic oedema, shrinkage of individual nerve cells and formation of the so-called hepatic glia (hepatoencephalopathy). Even in the last days before death icterus of the sclera was noted in only 11 of the 38 patients; of these, nine also displayed icterus of the mucous membranes. The calves died between the third day to seventh week of life; mean age at death 18 days. Haematological examination: in 12 cases mild to marked anaemia (but without signs of haemolysis), marked granulocytosis with a shift to the left in 20 cases, sometimes additionally neutrocytes with nuclei resembling Pelger's nuclear anomaly (pseudo-Pelger), granulocytes with basophilic stippling as well as lymphoidocytes. The blood glucose levels were usually markedly reduced. 15 calves had a pronounced refractory hypoglycaemia with blood glucose levels under 1,66 mmol/l. Neither albumin concentration nor the specific serum globulin fractions showed significant differences when compared to an age matched control group.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2763286 TI - [Diaphragmatic eventration in a breeding sow]. AB - A sow of 190 kg weight suddenly died, one day before due to delivery, though seeming to be quite healthy a few hours previously. Pathomorphological investigation revealed a 11 cm wide gap in the diaphragma in the area of the hiatus oesophageus with an eventratio diaphragmatica simplex incarcerata. The pathogenesis is suggested to be a widening of an inborn small gap in the diaphragma through the increase of intraabdominal pressure due to pregnancy and beginning labour. PMID- 2763287 TI - [The use of collagen fasciae and fibrin adhesive for supporting wound healing in skin defects with large surfaces]. AB - In 50 domestic pigeons, two circular pieces were removed from the skin to the right and left of the crista sterni, and the wounds were treated in different ways: A. with a collagen membrane dampened with a sodium chloride solution, B. with a fibrin glue, C. with a combination of A) and B). The wounds of group D were left untreated. Scab formation could be seen in all cases, also under the transparent membrane. The collagen membrane had no protective function in the experiment, however, it contributed to the acceleration of re-epithelialisation and the reduction of the wound diameter. The additional application of fibrin glue improved wound healing even further. PMID- 2763288 TI - [Dexamethasone and prednisolone use in pigeons]. AB - The concentrations of dexamethasone and prednisolone in the plasma of pigeons are measured by radioimmunoassay. The plasma curves show a more rapid ascent and steeper descent after dexamethasone injection (1 mg, 2 mg, 4 mg and 10 mg/kg of body weight IM) than after prednisolone injection (3 mg, 5 mg, 10 mg and 50 mg/kg of body weight IM). The longer-lasting effect after prednisolone injection could likewise be seen in the white blood count. The immunosuppressive effect of glucocorticoid preparations especially should be considered when applying antibiotics. PMID- 2763289 TI - [A sex chromosome mosaic in male pseudohermaphroditism in a horse]. AB - In a 7 months old foal with a male pseudohermaphroditism the cytogenetic investigation revealed a XO/XYY-mosaic with a centric fusion of the Y chromosomes. PMID- 2763291 TI - [Observations of the sand flea (Tunga penetrans) in humans and dogs in French Guiana]. AB - The occurrence of sand fleas (Tunga penetrans) in a reservation in the north of French Guyana is described. The parasite is found on dogs, Europeans and children of the local Indian tribes. Infections in man are supported by a big population of stray dogs as well as by the local cottage construction. Due to the simultaneous efficiency against the larvae of Dermatobia hominis lvermectin is only of limited suitability for the treatment of tungiasis in dogs. In man single parasites can be removed with a splinter forceps. In dogs footbathing with 0.2% Neguvon has shown to be effective. On long term a reduction of the stray dog population is recommended. PMID- 2763290 TI - [Diabetic neuropathy in dogs and cats--a bioptic electron microscopic study]. AB - Electron microscopic examination of peripheral nerves within dermal corium based upon skin biopsies (punch diameter = 6 mm) of chronic diabetic dogs and cats in comparison with normal controls revealed that more than 90% of the diabetic animals (31/34 dogs, 9/10 cats) had developed characteristic neuropathies. The main features were of axonal atrophy of myelinated and unmyelinated fibers, demyelination and - to a lesser degree - intraaxonal accumulation of glycogen (about 25%). In contrast with human diabetic polyneuropathy vascular basement membranes were throughout of normal appearance. Thickening of the perineural basement membranes were observed in a few canine cases only. Diagnostic procedures as well as questions on pathogenesis are discussed in detail. PMID- 2763292 TI - [Chronic inflammatory bowel diseases in cats]. AB - The aetiology of chronic idiopathic intestinal inflammation is unknown. It is characterized by a diffuse infiltration with inflammatory cells into the intestinal mucosa and sometimes submucosa. Cats with chronic intermittent vomiting and diarrhoea, later on accompanied by anorexia and weight loss, are presented. Definitive diagnosis can be obtained by intestinal biopsy only. An immune pathogenesis is suspected, which is supported by the fact, that chronic inflammatory bowel disease responds to steroid therapy. PMID- 2763293 TI - [Percutaneous partial diskectomy in the dog--an alternative to surgical disk fenestration]. AB - A new, technically simple operation method for the fenestration of disks is described which was performed successfully on six experimental dogs on the thoracolumbar disks and did not stress them very much. A percutaneous partial diskectomy (PPD) of the anulus fibrosus and the nucleus pulposus with a bone drill (diameter 5 mm) is performed. The extracted cylinder bone allows a histological judgement of the disci intervertebrales. This method was applied to 10 animal patients with discopathia, and it showed that evidently PPD is a good alternative to the conventional thoracolumbar disk surgery (dorsolateral fenestration). Besides the technical simplicity of this method its advantage is a quicker practicability and less operative stress of the patient. PMID- 2763294 TI - [The test of a centrifugal hematology system for use in clinical practice]. AB - The QBC is a centrifugal haematology system. Modified haematocrit capillaries are measured optically. The parameters haematocrit, total leukocyte count, relative and absolute values of granulocyte and lympho-/monocyte fractions, and total thrombocyte count are stated. The microhaematocrit method, the counting chamber, and the differential blood count are reference methods. Blood samples of the dog, cat and horse were used for the study. As a screening method the QBC analysis meets all requirements for the veterinary practice. PMID- 2763295 TI - 2,3,7,8-Tetrachlorodibenzo-p-dioxin alters embryonic palatal medial epithelial cell differentiation in vitro. AB - 2,3,7,8-Tetrachlorodibenzo-p-dioxin (TCDD) is teratogenic in mice, inducing cleft palate and hydronephrosis. After exposure in vivo, TCDD specifically alters differentiation of embryonic palatal medial epithelial cells. In this study, the palatal epithelial cell response to TCDD is determined in vitro. C57BL/6N palatal shelves were placed in organ culture on gestation day (GD) 12 in Richter's improved modified Eagle's medium:Ham's F12 medium (1:1) with 1% fetal bovine serum for 3 or 4 days. Medium contained 0.1% dimethylsulfoxide and TCDD at 0, 10( 13), 10(-12), 10(-11), 10(-10), and 10(-9) M, with some doses at 5 x 10(-11), 7.5 x 10(-11), and 5 x 10(-12) M. Epithelial cell responses to TCDD occurred over a narrow range of concentrations, with maximal response at 5 x 10(-11) M. Cytotoxicity was detected at 1 x 10(-10) M. At a stage when control medial cells ceased proliferation and EGF receptors were not detected immunohistochemically. TCDD-exposed medial cells incorporated [3H]thymidine and high levels of epidermal growth factor receptors were detected. TCDD prevented programmed cell death of medial peridermal cells, and induced a shift in the differentiation of medial cells toward an oral-like phenotype. The responses to TCDD observed after exposure in vitro were indistinguishable from previously reported effects observed after exposure in vivo. In the present study, the distribution of TCDD in the fetus after exposure in vivo was examined. The levels of exposure to TCDD are similar for in vitro and in vivo exposure routes. The levels of TCDD in 1 x 10(-11) to 1 x 10(-10) M solutions (3 to 32 pg/ml) were comparable to levels observed in fetal tissues after in vivo exposure on GD 11 to 30 microns/kg [3H]TCDD, where the palatal shelf contained 1.4 to 3.5. pg TCDD, representing 0.0003% of the total dose. In vivo, TCDD was detected in the GD 11 embryo 3 hr postexposure and the TCDD was equally distributed between the embryonic head and body. At 72 hr postexposure, 0.035% of the total dose was in fetal tissues, and 1% of the TCDD in the fetus was found in the palatal shelf. The present study shows that the palatal epithelium responds to TCDD in vitro in a manner comparable to that observed after in vivo exposure, and that the response occurs at a concentration comparable to in vivo levels in the fetus. The availability of an in vitro system will facilitate studies of TCDD toxicity that are difficult or impossible to perform in vivo, such as comparisons of TCDD effects between species, including human tissues. PMID- 2763296 TI - Reproductive toxicity of 2-methoxyethanol applied dermally to occluded and nonoccluded sites in male rats. AB - 12-Methoxyethanol (2-ME), also known as Methyl Cellosolve, was applied on the backs of Sprague-Dawley male rats at dose levels of 0, 625, 1250, or 2500 mg/kg/day on occluded (covered) sites, and 0, 1250, 2500, or 5000 mg/kg/day on nonoccluded (uncovered) sites for 7 consecutive days. Because deaths occurred at a dose level of 2500 mg/kg/day among rats with occluded test sites, dosing of this group was discontinued after 5 days. The number and morphology of caudal epididymal sperm, number of testicular spermatids, and weights of reproductive organs were determined on Weeks 4, 7, 10, and 15; fertility was assessed on Weeks -1, 4, 7, 10, and 14. The effects of treatment were dose-related and included a decline in epididymal sperm count and testicular spermatid count, a reduction in weights of testes and epididymides, an increase in the number of sperm with abnormal morphology, and a reduction in fertility in rats exposed to 2-ME. The above effects were seen with or without occlusion, but they were more severe and recovery proceeded at a slower rate when the skin sites were covered. PMID- 2763297 TI - Teratogenicity and placental transfer of all-trans-, 13-cis-, 4-oxo-all-trans-, and 4-oxo-13-cis-retinoic acid after administration of a low oral dose during organogenesis in mice. AB - 13-cis-Retinoic acid (isotretinoin) is teratogenic in humans at therapeutic doses (0.5-1.5 mg/kg) but only marginally teratogenic in the mouse at a high dose of 100 mg/kg. Previous results explained why the cis isomer of retinoic acid was much less teratogenic than the trans isomer in mice. It was found that the placental transfer of all-trans retinoic acid to the mouse embryo was far greater than that of the 13-cis isomer. Since our previous study had been performed with exceedingly high doses (100 mg/kg) of 13-cis-retinoic acid and all-trans-retinoic acid, we have now performed additional experiments with 10-fold lower doses. Studies were also done with the main metabolites of the two retinoids (the 4-oxo derivatives) to elucidate the metabolism, pharmacokinetics, and teratogenicity of each single compound. It was shown that all-trans-retinoic acid and 4-oxo-all trans-retinoic acid were extremely teratogenic, whereas their corresponding cis isomers caused only 2% cleft palate. Embryonic exposure to the trans isomers was likewise higher than that to the cis isomers, as shown by the far higher embryonic peak concentrations and by the 30-fold higher areas under the concentration-time curve values reached for the trans isomers compared with the cis isomers. At 8 hr, embryo/maternal plasma ratios were higher than 1 after administration of the all-trans compounds. Concentrations found in the placenta and yolk sac were higher for the trans forms than for the cis forms. We propose a model for a facilitated transport of the all-trans forms to the developing embryo and suggest that the conversion to the trans isomer and trans metabolite could play a major role in the teratogenicity of 13-cis-retinoic acid in humans. PMID- 2763298 TI - Induction of peroxisomal beta-oxidation in the rat liver in vivo and in vitro by tetrazole-substituted acetophenones: structure-activity relationships. AB - LY171883, a leukotriene D4 antagonist in the tetrazole-substituted acetophenone structural class, previously was demonstrated to cause peroxisome proliferation in rodents. In the present studies, several analogs were tested to determine if there are structural requirements for the induction of peroxisomal beta-oxidation in the rat liver in vivo and in cultured rat hepatocytes. Liver weight and serum triglycerides also were measured in vivo. The increases in peroxisomal beta oxidation caused by the tetrazole-substituted acetophenones in vivo ranged from negligible to greater than 17-fold and there was good agreement with the structure-activity relationships found in cultured hepatocytes. N-methylation of the acidic nitrogen of the tetrazole blocked the peroxisomal effects, indicating that the free acid was required for activity. The length of the alkyl chain linked to the tetrazole also influenced the activity of the compounds. However, the more important determinant of peroxisomal activity may be the spatial orientation of the acidic tetrazole with respect to the planar backbone of the molecule. The data indicate there is a target site for peroxisome proliferation in the liver that is able to distinguish between structurally similar analogs. This site appears to be distinct from the leukotriene receptor since both inducers and noninducers of peroxisomal beta-oxidation were shown previously to be potent leukotriene antagonists. PMID- 2763299 TI - Metabolism and disposition of ethylene carbonate in male Fischer 344 rats. AB - Ethylene carbonate (EC) has a toxicity profile which resembles that of ethylene glycol (EG). To determine whether the toxicity of EC could be explained on the basis of its metabolism to EG, male Fischer 344 rats were given 200 mg/kg of uniformly labeled [14C]EC in water by gavage and the disposition of the radiolabel was then followed for 72 hr. EC was rapidly metabolized, with approximately 57 and 27% of the administered dose eliminated in the expired air as 14CO2 and in the urine, respectively; the remainder was found in the carcass. Separation of the urinary metabolites using liquid chromatography revealed a single radioactive peak. This metabolite was unequivocally identified as ethylene glycol via gas chromatography-mass spectrometry with the aid of 13C enrichment of the EC dose. Measurement of whole blood levels of EC and EG in rats given 200 mg/kg of EC by gavage revealed blood levels of EG approximately 100-fold higher than the levels of EC in these same animals, with a half-life of EG in blood of 2 hr, indicating rapid conversion of EC to EG. In a separate group of animals administered an equimolar dose of [14C]EG (141 mg/kg), approximately 37% of the dose was expired as 14CO2 and 42% was excreted in the urine as parent compound. When expressed on the basis of the ethanediol moiety, the disposition of EC was identical to that of EG. In view of the rapid and extensive biotransformation of EC to EG and the similarity of the existing (though limited) toxicity data base of EC compared to EG, utilization of the extensive EG systemic toxicity data base for assessing the safety of EC appears justified. PMID- 2763300 TI - Pretreatment with EDU decreases rat lung cellular responses to ozone. AB - The phenylurea compound EDU (N-[2-(2-oxo-1-imidazolindinyl)ethyl]-N'-phenylurea) has been shown to protect plants from the damaging effects of ozone exposure. Models of rat lung injury, based on acute exposure to 2 ppm ozone for 3 hr and on exposure to 0.85 ppm ozone for 2 days, were used to determine whether EDU pretreatment of rats protected lungs from oxidant injury. Rats were pretreated with 100 mg/kg body wt EDU by ip administration for 2 days prior to and on the days of ozone exposure. No adverse toxicological effects of EDU pretreatment were observed. Lung superoxide dismutase (SOD) and catalase (CAT) activities were significantly enhanced from 636 to 882 U/lung and from 599 to 856 U/lung, respectively. One day following acute exposure (2 ppm for 3 hr), an ozone-induced increase of polymorphonuclear leukocytes (PMNs) from 0.01 to 1.18 million cells/lung was decreased to 0.68 million by EDU pretreatment. No alteration occurred in the degree of lung permeability indicated by increased lavage fluid albumin. EDU pretreatment also significantly decreased ozone-induced increases in PMN recovery after 2 days exposure to 0.85 ppm ozone from 5.54 to 2.12 million cells/lung. However, in this second case, EDU pretreatment reduced the observed ozone damage, indicated by a decrease in lavage fluid albumin and by a decrease in the macrophage and lymphocyte infiltration associated with this length of ozone exposure. The observation that EDU-treated cultured pulmonary arterial endothelial cells increased SOD and CAT activities identified a potential lung site of EDU interaction. These data demonstrated that although EDU pretreatment appears not to prevent initial ozone damage, it does reduce the infiltration of PMNs and might therefore prevent amplification of the injury associated with this cell type. PMID- 2763301 TI - Dosage-dependent absorption of cadmium in the rat intestine measured in situ. AB - Previous studies have shown that the disposition of cadmium (Cd) following oral administration is dosage dependent and may possibly be due to dosage-dependent intestinal absorption of Cd. Though extensively studied, the precise nature of Cd absorption by the intestine remains unclear. Similarly, the role of metallothionein (MT) in the intestinal absorption of Cd remains equivocal. The present study was designed (1) to characterize the intestinal absorption of Cd in the rat, and (2) to determine the role of MT in intestinal Cd absorption. The study has been conducted with an isolated intestinal loop preparation in situ, which allows direct measurement of intestinal absorption under nearly physiological conditions. Under urethane-induced anesthesia. Cd (0.1, 10, 100, 1000, or 10,000 micrograms/kg) was injected intraluminally into the isolated intestinal loop in situ and all mesenteric venous (portal) blood exiting from the loop was collected for 90 min. Absorption of Cd into the portal circulation was low at all dosages studied. The percentage of the dosage absorbed ranged from 0.09% at the 0.1 microgram/kg dosage to 3.4% at the 10,000 micrograms/kg dosage. At low dosages (0.1 and 10 micrograms/kg), little difference was noted in the fractional absorption of Cd (0.09 and 0.14% of the dosage, respectively). However, the fractional absorption of Cd was 10-fold greater in rats administered 100 micrograms Cd/kg (1.1% of the dosage). Administration of higher dosages of Cd (1000 and 10,000 micrograms/kg) further increased the percentage of the dosage absorbed (1.8 and 3.4%, respectively). To evaluate the role of MT in the intestinal absorption of Cd. rats were subcutaneously injected with zinc (Zn) for 4 days (30 mg/kg/day) and the absorption of an intermediate dosage of Cd (100 micrograms/kg) was subsequently assessed in situ. Zn pretreatment increased the endogenous concentration of MT in the intestine 25-fold. Following intraluminal administration. 93% of Cd in intestinal cytosol of Zn-treated rats was bound to MT whereas 40% of the cytosolic Cd was bound to MT in saline-treated (control) rats. Moreover, the amount of Cd in intestinal cytosol was 2-fold greater in Zn treated rats than in control rats. However, the intestinal absorption of Cd in rats pretreated with Zn demonstrated no difference from that in saline-treated rats. These results indicate that the intestinal absorption of Cd is dosage independent at low dosages of Cd (less than 10 micrograms/kg) and dosage dependent at high dosages (greater than 10 micrograms/kg). Furthermore, saturation of intestinal MT is not a major determinant of the observed dosage dependent absorption of Cd. PMID- 2763302 TI - Transport and activation of S-(1,2-dichlorovinyl)-L-cysteine and N-acetyl-S-(1,2 dichlorovinyl)-L-cysteine in rat kidney proximal tubules. AB - An important step in understanding the mechanism underlying the tubular specificity of the nephrotoxicity of toxic cysteine conjugates is to identify the rate-limiting steps in their activation. The rate-limiting steps in the activation of toxic cysteine conjugates were characterized using isolated proximal tubules from the rat and 35S-labeled S-(1,2-dichlorovinyl)-L-cysteine (DCVC) and N-acetyl-S-(1,2-dichlorovinyl)-L-cysteine (NAC-DCVC) as model compounds. The accumulation by tubules of 35S radiolabel from both DCVC and NAC DCVC was time and temperature dependent and was mediated by both Na+-dependent and independent processes. Kinetic studies with DCVC in the presence of sodium revealed the presence of two components with apparent Km and Vmax values of (1) 46 microM and 0.21 nmol/mg min and (2) 2080 microM and 7.3 nmol/mg.min. NAC-DVVC uptake was via a single system with apparent Km and Vmax values of 157 microM and 0.65 nmol/mg.min, respectively. Probenecid, an inhibitor of the renal organic anion transport system, inhibited accumulation of radiolabel from NAC-DCVC, but not from DCVC. The covalent binding of 35S label to cellular macromolecules was much greater from [35S]DCVC than from NAC-[35S]DCVC. Analysis of metabolites showed that a substantial amount of the cellular NAC-[35S]DCVC was unmetabolized while [35S]DCVC was rapidly metabolized to bound 35S-labeled material and unidentified products. The data suggest that DCVC is rapidly metabolized following transport, but that activation of NAC-DCVC depends on a slower rate of deacetylation. The results are discussed with regard to the segment specificity of cysteine conjugate toxicity and the role of disposition in vivo in the nephrotoxicity of glutathione conjugates. PMID- 2763303 TI - Biochemical and structural evidence for ethanol-induced impairment of testicular development: apparent lack of Leydig cell involvement. AB - The present study was conducted to provide biochemical and morphological evidence for ethanol-induced impairment of testicular development. The specific activities of testicular postmeiotic enzyme markers--sorbitol dehydrogenase (SDH), lactate dehydrogenase (LDH), and alpha-glycerophosphate dehydrogenase (GDH)--increased with age in CFW mice from ages 23 to 60 days, providing a biochemical measure of testicular development during puberty. Chronic ethanol treatment via liquid diets from ages 20 to 55 days resulted in decreased activities of SDH and LDH at ages 40 and 44 days, and of GDH at ages 34, 40, and 44 days. These decreases were consistent with an arrest in the developmental increase in SDH, LDH, and GDH at ages 31 +/- 0.6, 31 +/- 2.6, and 24 +/- 0.5 days, respectively. After 29 days of ethanol treatment (age 50 days), testicular weights, epididymal sperm content, and sperm motility were reduced, relative to controls, by 37, 83, and 60%, respectively (p less than 0.05). Epididymal weights were unaffected. Light microscopic evaluation of testes revealed disorganization of spermatogenesis, germ cell degeneration, decreased tubular luminal diameter, and vacuolation of Sertoli cells in ethanol-treated mice at age 50 days. Electron microscopic analysis showed that germ cell degeneration was not restricted to a specific cell type. Stage IX-XI tubules were observed in which spermatids had been retained and underwent phagocytosis within the Sertoli cell. Sertoli cells showed evidence of atypical nuclear invaginations. Sertoli cells underwent degenerative changes and were sloughed into the rete testis. However, relative Leydig cell size, as well as fractional volume occupied by the nucleus, mitochondria, and endoplasmic reticulum were unaffected by ethanol. The data (1) confirm previous findings suggesting ethanol-induced delayed testicular development; (2) suggest that certain aspects of testicular development are arrested relatively early in ethanol treatment (4-11 days); and (3) indicate that the Sertoli cell, rather than the Leydig cell, is the primary target with regard to the deleterious effect of chronic ethanol treatment on testicular maturation. PMID- 2763304 TI - Characterization of hemoglobin adduct formation in mice and rats after administration of [14C]butadiene or [14C]isoprene. AB - Occupational exposures to 1,3-butadiene or isoprene occur through their use in the manufacture of rubber and other related polymer products. The purpose of this study was to determine if butadiene or isoprene administration would result in the formation of adducts with blood hemoglobin (Hb), and if such adducts can be used as a measure of previous exposure(s). Male B6C3F1 mice and male Sprague Dawley rats were injected intraperitoneally with 1, 10, 100, or 1000 mumol [14C]butadiene or 0.3, 3.0, 300, 1000, or 3000 mumol [14C]isoprene per kilogram body weight. Animals were killed 24 hr later. Globin was isolated from blood samples and was analyzed for 14C by liquid scintillation spectroscopy. Hb adduct formation was linearly related to administered doses up to 100 mumol [14C]butadiene or 500 mumol [14C]isoprene per kilogram body weight for mice and rats, respectively. For [14C]butadiene, the efficiency of Hb adduct formation in mice and rats within the linear response range was 0.177 +/- 0.003 and 0.407 +/- 0.019 (pmol of 14C-adducts/mg globin)/(mumol of retained [14C]butadiene/kg body wt), respectively (mean +/- SE; n = 18). For [14C]isoprene, these values for mice and rats were 0.158 +/- 0.035 and 0.079 +/- 0.016 (pmol of 14C-adducts/mg globin)/(mumol of retained [14C]isoprene/kg body wt), respectively (mean +/- SE; n = 12). Hb adducts also accumulated linearly after repeated daily administration of 100 mumol [14C]butadiene or 500 mumol [14C]isoprene per kilogram body wt to mice and rats, respectively, for 3 days. [14C]Butadiene-derived Hb adducts in blood showed lifetimes of approximately 24 and approximately 65 days for mice and rats, respectively, which correlate with the reported lifetimes for red blood cells in these rodent species. Thus, levels of butadiene- or isoprene-derived adducts on Hb in circulating blood may be a useful measure of prior repeated exposures to these compounds. PMID- 2763305 TI - Structural requirements for anthracycline-induced cardiotoxicity and antitumor effects. AB - By employing rat cardiac myocytes in culture and mouse L-1210 leukemia cells, we have compared different anthracycline analogs with respect to their ability to kill cardiac myocytes and tumor cells. Anthracyclines induced a decrease in cellular ATP and glutathione from both cardiac myocytes and L-1210 cells in a time- and concentration-dependent fashion. Moreover, the decrease in ATP in cardiac myocytes was followed by release of the cytoplasmic enzyme lactic acid dehydrogenase and of adenine nucleotides after anthracycline treatment. At very low concentrations of anthracyclines, at which ATP and glutathione were not affected, the drugs induced complete cessation of the growth of L-1210 cells. Some structural alterations in the anthracycline molecule resulted in parallel changes in antitumor activity and in cardiotoxicity. But other structural alterations resulted in dissimilar changes in antitumor activity and cardiotoxicity. Although the results indicate that the structural requirements for inducing cardiotoxicity and antitumor activity may be different, they also indicate that the mechanisms by which anthracycline causes cell death in tumor cells and cardiac myocytes may be the same. PMID- 2763306 TI - Effect of lead on the stromal cells of bone marrow in rats in vitro. AB - The effect of lead on the stromal cells of bone marrow in rats was studied in cultures in vitro. Toxic effects of lead were manifested by a decrease in erythrocyte count and hemoglobin level in peripheral blood. Lead stimulated an increase in the number of fibroblasts, while the macrophage count dropped. The number of adipocytes remained unaffected. PMID- 2763307 TI - Inhalation toxicity of high flash aromatic naphtha. AB - A petroleum distillate--a high aromatic naphtha--consisting of a 50/50 blended mixture of equivalent products. SHELLSOL A* and SOLVESSO 100**, containing C9 isomers (75 percent) particularly trimethyl benzenes, was examined for systemic toxicity in rats by inhalation exposure. A preliminary 13-week inhalation study with SHELLSOL A had resulted in liver and kidney weight increases in female rats at the high (7400 mg/m3) and medium (3700 mg/m3) exposure levels, and a low grade anaemia in females at all exposure levels (7400, 3700 and 1800 mg/m3). The follow up 12-month inhalation study in rats described here used atmosphere generated from the SHELLSOL A/SOLVESSO 100 blend of 1800, 900 and 450 mg/m3. Initial reduction in body weight gain occurred in both male and female rats at the higher exposures. Various statistically significant haematological changes were transiently seen in males up to six months, but were not considered biologically significant. High exposure male liver and kidney weights were increased at 6 and 12 months but, in the absence of histopathological changes, were considered to be physiological adaptive responses. No treatment-related histopathological abnormalities were found. It is concluded that chronic exposure to this high aromatic naphtha is without systemic toxicity in rats under the conditions of these studies. PMID- 2763308 TI - Toxicity of mixtures of trichloroethylene, tetrachloroethylene and 1,1,1 trichloroethane: similarity of in vitro to in vivo responses. AB - The toxicities of various combinations of trichloroethylene (TRI), tetrachloroethylene (TET) and 1,1,1-trichloroethane (TCE) were examined in suspensions of rat hepatocytes and in vivo. For each pair and for the three solvents together, an interactive toxicity was demonstrated in vitro, as determined by release of potassium ion and cytoplasmic enzymes. A similar pattern of response was found after administration to the intact rat for increases in plasma alanine aminotransferase and sorbitol dehydrogenase, both indices of hepatotoxicity. Plasma urea levels were significantly elevated on exposure to the three chemicals together. Thus a remarkably similar pattern of toxicity was found in vitro and in vivo, which supports the possible use of hepatocyte suspensions as a screening procedure for toxicity of mixtures. PMID- 2763309 TI - Dominant lethal assay of 2,4-pentanedione vapor in Fischer 344 rats. AB - 2,4-Pentanedione (2,4-PD: CAS No. 123-54-6) is a volatile industrial chemical of moderate acute toxicity, centrally neurotoxic by repeated exposure to high vapor concentrations, fetotoxic, and clastogenic. Its wide use and known toxicology indicated the conduct of a dominant lethal assay. Male Fischer 344 rats, 20 per group, were exposed to 2,4-PD vapor concentrations (mean +/- SD) of 0, 99.1 +/- 2.2, 412 +/- 12.6 and 694 +/- 9.1 ppm, for 6 hr/day for 5 consecutive days. The day following the final exposure they were bred to unexposed female Fischer 344 rats, 2 per week for 8 consecutive weeks. Weight loss occurred with males during 2,4-PD exposure for the 412 and 694 ppm groups, with compensatory increased weight at 694 ppm, for the first two weeks postexposure. No histopathological change was seen in brain, testes or thymus from high concentration males sacrificed after eight weeks of mating. Minor transient reproductive and gestational effects were present at 412 and 694 ppm. At week 2 there was a reduction, not statistically significant, in the number of corpora lutea and total and viable implants per dam at 694 ppm, and a slight increase in preimplantation loss. At week 3 the number of pregnant females was slightly reduced at 412 and 694 ppm, causing a lowered female fertility index. At week 4 there was a slight reduction in the number of total and viable implants per litter and a significant preimplantation loss at 694 ppm. The dominant lethal factor (FL%) was increased slightly at 694 ppm for weeks 2 and 4. Thus, the "no observable effect" level for dominant lethal effects was 99 ppm. The results, although not statistically significant, are dose-related and compatible with a transient slight dominant lethal effect at the spermatid stage of spermatogenesis. PMID- 2763310 TI - Some scientific judgments in the assessment of the risk of environmental contaminants. AB - The assessment of risk due to environmental contaminants depends, in part, on scientific data. When such data are incomplete, as is usually the case, assumptions based on scientific judgments are made to analyze the consequences. Specifically, when health related data needed to assess the risk posed by environmental contaminants are missing or incomplete, it becomes necessary to make assumptions using scientific judgment to estimate the risk. Different scientists can and do make different assumptions, and the resulting differences in opinion can result in controversy. The present discussion presents a few of the consensus judgments of the Science Advisory Board (SAB) of the U.S. Environmental Protection Agency concerning the health effects and risk for such environmental contaminants as 1,2-dichloroethylene, dichloromethane, para dichlorobenzene, polychlorinated biphenyls, perchloroethylene, and xylene, as well as the implications of the more likely cancer mechanisms, the exposure routes, and pharmacokinetics to the risk assessment process. In some of these examples, the scientific data have been developed to the extent that specific judgments by groups such as the SAB can result in greater confidence that one is correct in the assessment of risk. Because of the uncertainties in current scientific knowledge for many environmental contaminants, judgments differ and there is no right or wrong opinion. PMID- 2763311 TI - Tropospheric ozone: the dynamics of human exposure. AB - The conditions in the ambient atmosphere conducive to ozone exposure are examined, and placed into a context of the time and locations where individuals would be expected to be affected by high ozone. This is done for both 1 h and 8 h averaging times. Concentrations of ozone in the ambient atmosphere can violate the National Ambient Air Quality Standard (NAAQS) and also the Time Weighted Average-Threshold Limit Value (TWA-TLV) for workers. Exposures that occurred in a 1982 episode associated with a health effects study are described in detail. The effective dose received by a camper at a children's summer camp appeared to be similar to that delivered to volunteers during a controlled human exposure study in which effects on pulmonary function were observed. PMID- 2763313 TI - Developmental toxicity of Clarified Slurry Oil applied dermally to rats. AB - Clarified Slurry Oil (CSO), the heavy residual fraction from the fluidized catalytic cracker, was applied to the shaven backs of groups of 10 pregnant rats at doses of 0, 4, 8, 30, 125, and 250 mg/kg/day. All groups received the test material on gestation days 0-19. CSO was applied undiluted and left uncovered on the skin; collars were placed on the rats to minimize ingestion of the test material. Signs of maternal toxicity, some of which were seen at dose levels as low as 8 mg/kg/day, included vaginal bleeding, decreased body weight gain, reduced food consumption, death, increased relative liver weights, atrophy of the thymus, and aberrant serum chemistry. The number of fetal resorptions/deaths was markedly increased and the number of viable offspring decreased by CSO at dosages of 30 mg/kg/day and above. The group receiving 250 mg/kg/day carried no viable offspring. Fetuses from pregnant females exposed to CSO at dose levels in excess of 8 mg/kg/day were smaller than those from control and 4 mg/kg/day groups, and their skeletons showed decreased ossification. Abnormal external development and visceral development were observed in living and dead fetuses exposed in utero to CSO at dose levels as low as 8 mg/kg/day. Based on these data, 4 mg/kg/day represents the No-Observed-Adverse-Effect-Level for both maternal and developmental toxicity. PMID- 2763312 TI - Pulmonary function responses of young and older adults to mixtures of O3, NO2 and PAN. AB - The pulmonary function of 32 nonsmokers (eight men and eight women, 18-26 years of age; eight men and eight women, 51-76 years of age) was measured before and after two-hour exposures to (1) filtered air (FA), (2) 0.45 ppm ozone (O3), (3) 0.13 ppm peroxyacetyl nitrate + 0.45 ppm O3 (PAN/O3), (4) 0.60 ppm nitrogen dioxide + 0.45 ppm O3 (NO2/O3), and (5) 0.13 ppm PAN + 0.60 ppm NO2 + 0.45 ppm O3 (PAN/NO2/O3). Subjects alternated 20-minute periods of rest and exercise (ventilation = 25 L/min). Forced vital capacity (FVC) was measured pre-exposure and five-minutes after each exercise period. Forced expiratory volume in one sec (FEV1.0) and forced expiratory flow between 25 and 75 percent of FVC (FEF25-75%) were calculated from the FVC tests. Data were analyzed by 4-factor analysis of variance (sex, age, time period, exposure). The responses of men and women were similar. FA exposure induced no effects. The young subjects' decrements in FVC, FEV1.0 and FEF25-75% became significant (P less than 0.01) after the second exercise period of the O3, NO2/O3 and PAN/NO2/O3 exposures, while the PAN/O3 decrements were significant (P less than 0.01) after the first exercise period. Although PAN/O3 induced significant decrements earlier than the other conditions including O3, the mean pre- to post-exposure decrements for the four conditions including O3 were similar. In contrast, the older subjects had smaller and fewer significant decrements in pulmonary functions. They had significant mean decrements in FVC following the third exercise period of the NO2/O3 and PAN/NO2/O3 exposures, in FEV1.0 after the third exercise period of the PAN/O3 and NO2/O3 exposures, and in FEF 25-75% beginning after the second exercise period of the NO2/O3 exposure. The results suggest that older men and women are less responsive to O3 and mixtures of O3, NO2 and PAN than young men and women, and that O3 is responsible for the decrements observed in pulmonary function. PMID- 2763315 TI - A conference on environmental/occupational health training. Cincinnati, Ohio, April 28-29, 1987. Proceedings. PMID- 2763314 TI - The role of enzyme induction on metabolite formation of bis(2-methoxyethyl) ether in the rat. AB - The effect of enzyme induction on the metabolism of the reproductive toxicant bis (2-methoxyethyl) ether (diglyme) was studied in male Sprague-Dawley rats. Rats were given either daily doses of diglyme at 5.1 mmol/kg body wt. by gavage or 0.1% (w/v) phenobarbital (PB) in the drinking water for 22 consecutive days. In one study, a significant reduction in the hexobarbital sleeping time was determined for rats pretreated with diglyme or PB in comparison with that determined for naive rats. In a second study, naive and pretreated rats given single oral doses of 14C-diglyme at 5.1 mmol/kg body wt. showed similar urinary 14C excretion patterns. Urinary metabolites were separated and quantified by hplc to evaluate the influence of pretreatment with either diglyme or PB on the 14C diglyme urinary metabolite profile. The amount of (2-methoxyethoxy) acetic acid, the principal metabolite, was similar for rats given no pretreatment and for rats pretreated with either diglyme or PB. However, both pretreatments resulted in significant increases in the formation of methoxyacetic acid, a recognized reproductive toxicant. PMID- 2763316 TI - Training under Superfund. PMID- 2763317 TI - The role of the private sector in innovative approaches to research and training. PMID- 2763318 TI - Public responsibilities and opportunities in educating professionals and workers. PMID- 2763319 TI - Public health needs for properly trained and sensitized professionals. PMID- 2763320 TI - NIEHS training in environmental toxicology. PMID- 2763321 TI - Public health--theory and practice in occupational medicine programs. PMID- 2763322 TI - Experience from the Occupational Health Clinic at San Francisco. PMID- 2763323 TI - A Kellogg-supported program at the University of Iowa. PMID- 2763324 TI - Early worker and employer training initiatives at OSHA. PMID- 2763325 TI - Experience of the National Cancer Institute. PMID- 2763326 TI - Preoperative teaching: easing the patient's anxiety. AB - 1. Individual instruction is the preferred method for teaching patients; however, because of staffing limitations, nurses have less quality time to provide teaching solely by this method. 2. A booklet describing basic information about surgery and an accompanying videotape allow patients to review the material at their own pace and ask questions when they are ready. 3. The booklet and videotape allow the nursing staff to reinforce the material without neglecting other patients and provide flexibility of teaching methods to accommodate the various learning needs of different patients. PMID- 2763328 TI - Living with thoracic outlet syndrome. PMID- 2763327 TI - When work isn't fun: how to endure the unenjoyable. AB - 1. Learning to expect and adapt to unpleasant tasks and to cope with difficult days is important for satisfactory adjustment in nursing. 2. Feelings of unhappiness with work may be related to either internal or external events, such as low self-esteem or a verbal attack by a colleague. 3. An attitude of enjoyment enhances not only personal feelings of well-being but also promotes physical health both in the nurse and her patients. 4. The use of humor, focusing on the positive, talking about unenjoyable tasks, and concentrating on bringing happiness to others all help to promote a feeling of enjoyment in the workplace. PMID- 2763329 TI - When an employee is exposed to HIV: preventing future accidents. PMID- 2763330 TI - Ethics in the age of technology. PMID- 2763331 TI - Thoracic outlet syndrome: resectioning the first rib as a last resort. AB - 1. Thoracic outlet syndrome is a general term referring to compression neuropathies of the brachial plexus and subclavian vessels. 2. The symptoms result from compression of the brachial plexus or the subclavian vessels; the most common are pain and paresthesia but these may be accompanied by complaints of muscle weakness and easy fatigability of the extremity. 3. First rib resection has been proven valuable; however, because of the possibility of severe and irreversible complications, surgery should be used as a last resort. PMID- 2763332 TI - Biochemistry in Italy. PMID- 2763333 TI - Low-frequency resonance and cooperativity of hemoglobin. PMID- 2763334 TI - Fifth International Workshop on Aspiration Cytology and Other Noninvasive Methods of Diagnosis of Rejection in Transplantation. March 27-29, 1989, Washington, DC. Proceedings. PMID- 2763335 TI - Third International Alexis Carrel Conference: Accelerated atherosclerosis. March 30-31, 1989, Washington, D.C. Proceedings. PMID- 2763336 TI - Evidence for the acceleration of atherogenesis by circulating norepinephrine. PMID- 2763337 TI - Experimental evidence in monkeys for beneficial effects of estrogen on coronary artery atherosclerosis. PMID- 2763338 TI - Inhibition of smooth muscle cell proliferation by heparin molecules. PMID- 2763339 TI - The effects of circulating immune complexes on atherosclerotic lesions in experimental animals and in younger and older humans. PMID- 2763340 TI - Present experience of Sandimmun in pregnancy. PMID- 2763342 TI - Riboflavin status in Saudi Arabia--a comparative study in different regions. AB - Riboflavin (vitamin B2) status was investigated in male and female Saudis of different age groups in different regions of Saudi Arabia using the assay of glutathione reductase (GR) in presence and absence of flavin adenine dinucleotide (FAD) and determination of the activity coefficient (AC) for GR. The overall prevalence of riboflavin deficiency as determined by an AC value of 1.3 or above, in the male population of Al-Hafouf, Jaizan and Riyadh was found to be 32.6%, 17.8% and 17.1%, respectively, while in the female population the prevalence was 41.5%, 22.3% and 37.9%, respectively. Within each region a marked variation was found in the different age groups. In this paper the riboflavin status and the prevalence of riboflavin deficiency in three regions of Saudi Arabia is presented and the possible causes for a high prevalence of riboflavin deficiency in the Saudi population are discussed. PMID- 2763341 TI - Food consumption of children with and without xerophthalmia in rural Tanzania. AB - Food intake of 26 children (4-9 years old) of whom nine had xerophthalmic eye lesions (Bitot's spots), was recorded over a period of four days. The principal staple foods were maize and sweet potatoes, while sorghum and cassava were also used as staple foods. The intake of energy was rather low partly due to the bulkiness of the diet. Protein intake was above the recommended intake but mainly derived from vegetable sources. The intake of retinol, beta-carotene, folic acid and iron was low in all children especially those with xerophthalmia. Dried green leafy vegetables contributed about 20% of the total beta-carotene intake during the period that the survey was carried out. PMID- 2763343 TI - A community survey of haematological values in rural Nigeria. AB - Most studies on haematological values in Nigeria have been in hospital patients. The present study provides information on haematological values of red blood cell counts, haematocrit, haemoglobin, mean corpuscular haemoglobin concentration, blood groups and genotypes. The study shows that there is agreement in some respects between the values obtained and those available in standard text books. It also shows that the values are influenced by sex and dietary in-take. Differences in ethnic composition of different populations studied previously was concluded from the differences in the blood genetics of the study population and of those previously reported elsewhere in Nigeria. Iron deficiency anaemia was established using haematological values. PMID- 2763344 TI - Prevalence of neurological disorders in Udo, a rural community in southern Nigeria. AB - The residents of Udo, a rural community of Edo-speaking people (population 2,925) in Bendel State, Nigeria were screened in a door-to-door survey for neurological disorders by specially instructed primary health care workers (PHW). A standard protocol was followed by PHW in collecting census data, administering a screening questionnaire, and performing a simple neurological examination. A neurologist confirmed the presence of neurological disorders in 235 (47%) of 504 screen positive subjects after further clinical evaluation. The point prevalence ratios, per 1,000 population, for the most common neurological disorders identified in Udo were: migraine 63.2, febrile convulsions in children under 7 years of age 10.7, epilepsy 6.2, peripheral neuropathy 2.1 and myelopathy 1.7. PMID- 2763345 TI - Trachoma in Kaduna, northern Nigeria. Recent observations on pattern of clinical presentation. AB - At the Guinness eye hospital, Kaduna, Northern Nigeria, where 40-60,000 new cases are yearly seen, trachoma is now responsible for less than 0.5% of blindness and less than 0.5% ocular morbidity. This contrasts with the situation about 30 years ago when it was a major problem. Most of our trachoma patients now have trivial intensity of disease and cicatrising/healed lesions. This rate and pattern of presentation suggests a decline in the importance of trachoma, although confirmation depends on actual community assessment. PMID- 2763346 TI - The prevalence of human immunodeficiency virus among pregnant women attending a hospital in the Moungo district, Cameroon. AB - A seroepidemiological survey conducted from January to May 1986 among 650 pregnant women from mixed rural/urban origin in the Moungo district, Cameroon, revealed a very low prevalence of antibodies to human immunodeficiency viruses (HIV). One subject appeared to be infected with HIV 2. This is remarkable since HIV 2 has been isolated predominantly from West-African subjects. Further epidemiological and antropological studies are required to explain the distribution of HIV 1 and HIV 2 throughout the African continent. PMID- 2763347 TI - The effects of glucose-6-phosphate dehydrogenase deficiency on the haematological parameters and clinical manifestations in patients with sickle cell anaemia. AB - This study was conducted on 81 children with sickle cell anaemia (SCA) from the south-western province of Saudi Arabia. Ten of these children had associated glucose-6-phosphate dehydrogenase (G-6-PD) deficiency due to the presence of the phenotype 'G-6-PD Mediterranean'. Slightly lower, statistically non significant, values of red blood cell count, total haemoglobin, packed cell volume and red cell indices were found in SCA patients with G-6-PD deficiency. However, certain clinical features were improved in these patients. Comparison was also made with results published from the eastern province of the country, where SCA is reported to be mild. It is suggested that G-6-PD deficiency due to G-6-PD 'Mediterranean' worsens certain manifestations and improves others in SCA patients with a severe form of SCA, while improvement in haematological parameters is observed in SCA patients with mild SCA. PMID- 2763348 TI - Haemoparasites of blood donors in Calabar. AB - The study of haemoparasites in our blood donors revealed the following parasite prevalences: microfilaria (mf) of Loa loa (1.3%); Dipetalonema perstans (15.6%); Loa loa and D. perstans (0.2%), Plasmodium falciparum (3.3%), Plasmodium malariae (1.0%) and a mixture of P. falciparum and P. malariae (0.2%). No trypanosomes were observed in the 480 blood samples screened. There were more cases of D. perstans infection in the 24-30 year age group, indicating their increased exposure frequencies. Matching of ABO blood group and mf infection rates shows that the O blood group has a higher prevalence rate with regard to D. perstans than Loa loa. The B blood group, however, had the highest cumulative % of mf infection (23.4%), but these values are consistent with the preponderance of the various blood groups in the study population. Commercial donors, most of whom come from the less affluent social classes, had higher prevalence rates of mf. It is recommended that blood be properly screened for mf before donation for transfusion. Recipients of infected blood should be followed up so that any consequent infection would be treated immediately. PMID- 2763349 TI - Outbreak of cutaneous larva migrans in a family household. AB - An outbreak of cutaneous larva migrans in a household is described. The attention of practising physicians, health authorities and the populace is directed at the increasing prevalence of this otherwise rare disease, as well as the need for a comprehensive programme to rid the community of unwanted domesticated animals. PMID- 2763350 TI - Cardiovascular and pulmonary complications of epidemic typhus. AB - A case of typhus fever associated with cardiac and pulmonary complications is reported. The patient was a 24-year-old Egyptian female with characteristic clinical presentation of rickettsial infection, though no rash was present throughout the course of the disease. We could not find a report of such complications in the English medical literature. PMID- 2763351 TI - Hansen's disease: a cause of lymphadenopathy in endemic areas. AB - In this paper we report two unusual cases of leprosy, both presenting with lymphadenopathy as the initial manifestation of the disease. Lymphadenopathy was the dominant presenting complaint of the first patient in whom skin lesions were absent. A diagnosis of lepromatous leprosy was made only after a lymph node biopsy. Following this diagnosis neural involvement was evident. In the second patient the lymphadenopathy was associated with polyarthritis leading to a false clinical diagnosis of Still's disease. This unusual presentation in both cases led to a delay in the final diagnosis which was based on histopathological examination of lymph nodes. The clinical and histopathological features of both patients are discussed. Superficial nerves should be palpated in all patients presenting with lymphadenopathy in endemic areas. PMID- 2763352 TI - Attitudes of Nigerians towards blood donation and blood transfusion. AB - In an attempt to improve voluntary blood donation at the University of Calabar Teaching Hospital (U.C.T.H.) a questionnaire was designed to determine the attitudes of the people towards blood transfusion and blood donation. Of the 246 that responded to the questionnaire 196 (79.7%) would be willing to donate blood freely while 50 (20.3%) would not donate their blood. The most common reason for non-donation and non-acceptance of blood transfusion was religious belief. The results suggest that although most Nigerians are willing to donate blood freely, more positive steps should be taken to educate the population about blood donation and transfusion. PMID- 2763353 TI - Chronic diarrhoea: a methodologic basis for its apparent heterogeneity. AB - The etiologic and epidemiologic patterns of chronic diarrhoea vary extensively between studies. While undoubtedly some of this heterogeneity reflects the complexity of the disease entity, inconsistencies in methodology between studies may result in some of the variation. To illustrate this problem we examined 44 papers on chronic diarrhoea for comparability of the age range of subjects under study and for the use of standardized definitions of 'chronic' and 'diarrhoea'. There was wide variation in the age ranges examined, extending from two weeks to 91 years. No definition or description of 'diarrhoea' was provided in 13 (30%) studies while 'chronic' remained undefined or undescribed in 11 (25%) papers. Among the 14 (32%) studies providing a definition of 'diarrhoea', four different sets of criteria were used and among the 22 (50%) papers defining 'chronic', eight different definitions were employed. PMID- 2763354 TI - Anthrax in Ethiopia. AB - Twenty-seven patients with cutaneous anthrax were identified over a three-year period at Gondar College of Medical Sciences in North Central Ethiopia. Nine patients who delayed seeking medical care presented with severe symptoms and three patients died. Eighteen patients were clustered within four families in which an attack rate of 32% occurred. Ninety-three percent of patients could trace their disease to exposure to the products of a specific diseased animal. Characteristics of anthrax in Ethiopia include a known exposure to diseased animals, occurrence within families, frequent treatment by local healers, and high morbidity and mortality. PMID- 2763355 TI - Trypanosomiasis in a rural hospital in Tanzania. A retrospective study of its management and the results of treatment. AB - A retrospective analysis was done of the management and the results of treatment in 158 trypanosomiasis patients seen in a rural hospital in Tanzania during 1985. The distribution of cases in the population and during the year reflected an endemic situation. 109 patients (68.9%) were in the meningoencephalitic (ME) stage and 49 (31.1%) in the hematolymphatic (HL) stage of the disease. In total 19 patients (12.0%) died, 17 with ME and 2 with HL trypanosomiasis. Encephalopathy was seen in 19 (17.9%) of 106 patients treated with melarsoprol, and 10 of them died. In 15 (24.4%) of 64 patients who were discharged as HL trypanosomiasis evidence of CNS-involvement was found during follow-up after 3 and/or 9 months. PMID- 2763356 TI - Tropical surgical abdominal emergencies: acute appendicitis. AB - In a prospective 5-year investigation of acute appendicitis 603 consecutive patients with the disorder were studied in detail. Of this number 388 (64.3%) were female and 215 (35.7%) male giving a female: male ratio of 1.8:1. The patients were aged 4-65 years with a median age of 23.1 years; females with a median age of 22.1 years were younger than males with a median age of 25.4 years. Patients presented to hospital late: 3-7 days (median 5 days) from the onset of symptoms; the strikingly most common of these was abdominal pain seen in all the patients, and tenderness, local or with rebound was uniformly elicited. Supportive laboratory and radiological services were not regularly available; however, when white cell count was obtainable leucocytosis with a left shift was a useful finding. At operation 422 (70%) patients had an acutely inflamed appendix, 121 (20%) gangrenous or perforated appendicitis and 18 (3%) an appendix abscess; an appendix mass was palpable in 42 (7%) patients and these were treated conservatively. Wound infection complicated surgery in 18 (3%) patients; there were no operative deaths. Acute appendicitis was the second commonest surgical abdominal emergency during the period under study, and the results of treatment compare favourably with series from the developed countries of the West. PMID- 2763357 TI - Splenectomy in Nigerian children with sickle cell anaemia. AB - A total of 4359 children with sickle cell anaemia were treated at the University of Nigeria Teaching Hospital, Enugu, Nigeria in an eight year period 1979-1986. Of this number 4 children with hypersplenism associated with intractable complaints were offered splenectomy as the treatment of choice. Following splenectomy they had improved haematological indices and general wellbeing, but splenectomy did not abolish abdominal or bone pain crises. This study emphasizes that though splenectomy could be of beneficial effect on carefully chosen cases of hypersplenism, it has not become a major form of therapy for the majority of children with sickle cell anaemia in Nigeria. PMID- 2763358 TI - Renal and electrolyte profile in steady state sickle cell disease: observations in patients with sickle cell disease in The Netherlands. AB - During a study of clinical and laboratory features in 83 patients with sickle cell disease in the Netherlands, serum creatinine, sodium, potassium, uric acid and osmolality were determined and reported for 65: 39 with homozygous sickle cell (SS) disease, 5 with beta degrees thalassaemia (S beta degrees thal), with sickle cell beta + thalassaemia (S beta degrees + thal) and 17 with sickle cell haemoglobin C (SC) disease. Data on history of hyposthenuria was unreliable. Haematuria was reported in 6 (7%) of the 83 patients. Four of the six patients with a history of haematuria, two of whom had elevated creatinine levels, had SS disease. Lower mean levels of serum sodium and higher levels of serum potassium were observed in SS's than in the other genotypes (p less than 0.001). Hyperkalaemia of greater than 5 mmol/l was seen in 50% of SS disease cases and in 33% of paediatric SC disease cases. Some high potassium levels must be ascribed to in vitro haemolysis. The rate of hyperuricaemia ranged from 24% to 40% among the various genotypes. Clinical gout was not observed. PMID- 2763359 TI - Use of a portable glucose meter in a Nigerian diabetic clinic. AB - We assessed the performance of a portable glucose meter in a tropical environment. This was undertaken in an effort to reduce the costs of regular blood glucose measurements for our diabetic patients, many of whom were finding regular laboratory tests financially burdensome. The glucose meter was as accurate as the laboratory up to glucose concentrations of 250 mg/dl (14 mmol/l) but slightly overestimated results above that level. Nevertheless, it gave results comparable to those obtained with similar instruments in temperate countries, with a correlation coefficient of 0.91. Its cheapness, alternative power source from dry battery, use of finger prick capillary rather than venous blood, ease of operation, and quick production of results make it almost ideal for use in developing countries. PMID- 2763360 TI - Birthweight distribution in a healthy urban population in Surabaya-Indonesia. AB - The birthweight distribution was assessed in an apparently healthy urban population in Surabaya, Indonesia. A total of 924 pregnant women of a middle income group were enrolled at 20-24 weeks of gestation of which 543 women delivered in the university hospital. In the latter group mean birthweight of liveborn singletons was 3047 g for males and 2900 g for females. The percentages of low birthweight by sex were 7.9% and 13.8% respectively. These values were lower than those reported for more affluent women in Indonesia and comparable with those of rural Madurese women studied in the same time period. PMID- 2763361 TI - The role of macrophages in experimental Campylobacter-infections of mice in Lagos, Nigeria. AB - The role of macrophages in experimental campylobacteriosis was studied in mice whose macrophages had been blocked using colloidal carbon particles as the blockading agent. Two sets of mice received 0.4 ml intraperitoneally and 0.4 ml intravenously of colloidal carbon, respectively, and each set was then inoculated with a clinical isolate of Campylobacter jejuni intraperitoneally. The treatment resulted in a lethality of 66.6% in mice given colloidal carbon intraperitoneally and 58.0% in mice given colloidal carbon intravenously within the first three days post infection. The control groups (mice injected only with C. jejuni) had a lethality of 16.6% (p less than 0.05). Mice receiving only colloidal carbon showed no lethality. These results suggest that the activities of macrophages as scavenger cells are important factors in the defence mechanism of mice against experimental campylobacteriosis. PMID- 2763362 TI - Brucellosis: atypical presentation with peritonitis and meningitis. AB - A case of brucellosis associated with peritonitis, intestinal obstruction, granulomatous hepatitis, inappropriate antidiuretic hormone (ADH) secretion and meningitis is reported. Initially, the patient was diagnosed as a case of disseminated tuberculosis and treated accordingly. However, the serologic tests for brucellosis were strongly positive and the patient was subsequently treated as a case of brucellosis and recovered fully. The gastrointestinal manifestations of brucellosis are reviewed. PMID- 2763363 TI - Giant vesico-prostatic and prostatic calculi. AB - Prostatic calculi formation after prostatectomy is an unusual and late complication. We report three such cases of giant size calculi following transvesical prostatectomy. Various aetiological factors and their prevention are discussed. PMID- 2763364 TI - Combined intrauterine and extrauterine pregnancy in a consistent twin producer. AB - A case is presented of a simultaneous intra- and extra-uterine pregnancy in a gravida five. The history of persistent twin deliveries assisted in establishing the correct diagnosis when the patient presented with signs of a septic incomplete abortion. PMID- 2763365 TI - The value of electrocautery to the inferior turbinates in the treatment of chronic rhinitis. AB - A study involving 69 patients with chronic nonspecific rhinitis who did not benefit from medical treatment and were subjected to cautery to the inferior turbinate. Fifty-one (73.9%) benefited from the procedure with little or no complications. This procedure which is cheap and yet effective is advocated for developing countries where cost of equipment, technical difficulties and complications will influence the choice of surgical treatment by the practitioner. PMID- 2763366 TI - Multiple pregnancy as a risk factor in rural Tanzania. PMID- 2763367 TI - [Uhl's disease. Apropos of 3 cases observed in children]. PMID- 2763368 TI - [Thyroid microcarcinoma. Apropos of 3 cases]. PMID- 2763369 TI - [Primary tumors of Meckel's diverticulum. Apropos of 2 cases]. PMID- 2763371 TI - [How to complete a difficult gastrectomy for duodenal ulcer]. PMID- 2763370 TI - [Severe meningitis in an intensive care unit]. PMID- 2763372 TI - [Omphalocele: diagnostic and therapeutic aspects. Apropos of 150 cases]. PMID- 2763373 TI - [The conservative treatment of the spleen (apropos of 18 cases]]. PMID- 2763374 TI - [Arthroscopy of the knee: diagnostic significance. Apropos of 300 cases]. PMID- 2763375 TI - Lung macrophages. PMID- 2763376 TI - Ultrastructural morphometric study of follicular center lymphocytes: I. Nuclear characteristics and the Lukes-Collins' concept. AB - A combined ultrastructural and morphometric image analysis study was carried out on the nuclear profiles of follicular center and mantle zone lymphocytes of six cases of reactive hyperplasia in human lymph node biopsies. For accuracy of morphological observations and sampling at low magnifications, sections were mounted on formvar-covered slot grids. Measurements of nuclear profile features of small (untransformed) lymphocytes in mantle zones served as the standard for a supposed unimodal population in each case. Analysis of nuclear profile area values indicated that during lymphocyte transformation in follicular centers nuclei had a gradual and progressive increase in size and that the sampled nuclear profiles in both the mantle zone and follicular center were unimodal. Lymphocyte nuclear shape (contour index) was a more complex, and likely biologically independent, feature than nuclear area in both the mantle zone and follicular center. Nuclear profile contour indexes of mantle zone lymphocytes were more irregular than suspected and in some cases had mean values greater than those of follicular center lymphocytes. Furthermore, the frequency distribution of nuclear contour index was not normally distributed in either the follicular center or mantle zone due to the presence of a small proportion of highly irregularly shaped nuclear profiles in both sites. The results indicated that some premises of existing concepts of follicular center cells and the process of lymphocyte transformation in follicular centers were incorrect and should not be directly extrapolated to the nuclear profile characteristics in non-Hodgkin's lymphoma. PMID- 2763377 TI - Ultrastructural morphometric study of follicular center lymphocytes: II. Analyses of cleaved-cell populations do not support the Lukes-Collins' concept. AB - Ultrastructural morphometric analysis was carried out on six cases of lymph node biopsies with reactive hyperplasia to establish the frequency and depth of invaginations in nuclear profiles situated in the mantle zones and follicular centers. The frequency distribution of the depth of invaginations was similar in nuclear profiles whether in the small lymphocytes of mantle zones or the small, partially transformed (centrocytes) and fully transformed (centroblasts) lymphocytes of follicular centers. Invaginated and cleaved lymphocytes were not confined to the partially transformed (centrocytic) lymphocytes of follicular centers, and nuclear profiles with invaginations bore no resemblance to those depicted in the Lukes-Collins model. A considerable proportion of mantle zone lymphocyte nuclear profiles had invaginations (ranging from 7.5% to 53.6%) and there was no difference between the frequency of deep indentations or clefts in mantle zone lymphocytes (8.1 +/- 5.4%) and the small unstimulated (9.3 +/- 5.3%) and partially transformed (8.4 +/- 1.4%) lymphocytes in follicular centers. Computer modeling of stylized nuclei with conical indentations indicated that all lymphocytic nuclei likely have multiple invaginations or groove-like creases. PMID- 2763378 TI - Fine structure of A: autonomic nerve fibers and terminals in human myocardium; and B: myocardial changes in congenital heart disease. AB - In a histological and fine structural study of right atrial biopsy specimens from 31 patients with rheumatic heart disease (RHD), aged 7 to 46 years, and 11 patients with congenital heart disease (CHD), aged 3 to 36 years, nerve fibers or endings were seen by electron microscopy in 11 specimens. There was concurrence of ordinary axons along with terminals bearing pale cholinergic or dark adrenergic synaptic vesicles. Smaller and denser cholinergic vesicles suggested proliferation followed by exhaustion of such nerve endings. The closest proximity of nerve terminal to muscle fiber was about 100 nm. In one RHD specimen a "specific terminal cell" was present between a nerve ending and muscle fiber; in another a possible neuromuscular contact was developing at the surface of a regenerating small muscle fiber with a few myofilaments. Unmyelinated axons amidst increased subendocardial and subepicardial collagen, with prominent fibroblasts and depleted muscle fibers, were seen more frequently in specimens of CHD. Loss of myofibrils and accumulation of mitochondria, with infrequent formation of lipofuscin bodies, characterized degenerating muscle fibers in CHD also, although to a lesser degree than in RHD (reported earlier, 1985). The myocardial blood vessels in CHD tended to have pale swollen endothelial cells and narrowed lumen. The most severely affected cases of CHD were those with (1) a very wide atrial septal defect (ASD), (2) ventricular septal defect (VSD) with vegetations near the defect, (3) infundibular pulmonary stenosis, and (4) Fallot's tetralogy. PMID- 2763379 TI - Ultrastructural behavior of human immunodeficiency virus (HIV) in multinucleated giant cells in the brain of a Japanese hemophiliac presenting AIDS encephalopathy. AB - Human immunodeficiency virus (HIV) was detected ultrastructurally and immunohistochemically in the brain of a Japanese hemophiliac presenting AIDS encephalopathy. The encephalopathy was characterized by the multifocal occurrence of multinucleated giant cells mainly in the subcortical areas. The giant cells were identified immunohistochemically to be macrophages. HIV particles were observed in and out of the giant cells, and most of the particles ingested in the cells were membrane-bound. Some virus particles were found in pinocytic vesicles or phagocytic vacuoles, whereas the others were degradated in the lysosomes of the cells. Budding of HIV particles from the cell surface was also observed, indicating replication of the virus in vivo. These findings suggest ingestion, digestion, and replication of HIV by brain macrophages in AIDS. PMID- 2763380 TI - Intracisternal paracrystalline serpigenous inclusions: a marker of disordered fibroblastic proliferation. AB - Three young children with characteristic fibroblastic tumors are presented. These comprised one case each of congenital fibrosarcoma, dermatofibrosarcoma protuberans, and fibrous hamartoma of infancy. Ultrastructural examination in each tumor revealed the presence of a peculiar intracisternal paracrystalline material that exhibited transverse periodicity between 18 and 22 nm. Elongated profiles lying within rough endoplasmic reticulum had a serpigenous outline. It is thought that this material is related to procollagen or its precursors and its presence may signify disorders of fibroblastic proliferation that may occur in fibrous tumors. PMID- 2763381 TI - Gray platelet syndrome. PMID- 2763382 TI - Imaging of metal-coated biological samples by scanning tunneling microscopy. AB - A method for imaging biological samples by scanning tunneling microscopy (STM) is presented. There are two main difficulties in imaging biological samples by STM: (1) the low conductivity of biological material and (2) finding a method of reliably depositing the sample on a flat conducting surface. The first of these difficulties was solved by coating the samples with a thin film of platinum carbon. The deposition problem was solved by a method similar to a procedure used to deposit biological molecules onto field ion microscope (FIM) tips. STM images of bacteriophage T7 and filamentous phage fd are shown. The substrate on which the samples were absorbed was atomically flat gold. The images do not show molecular detail due to the metal coating, but the gross dimensions and morphology are correct for each type of virus. Also, the surface density of virus particles increases and decreases in the way expected when the conditions of deposition are changed. These methods allow reliable and reproducible STM imaging of biological samples. PMID- 2763383 TI - Cardiac cycle-dependent variation of integrated backscatter is not distorted by abnormal myocardial wall motion in human subjects with paradoxical septal motion. AB - To define the dependence of cardiac cycle-dependent variation of integrated backscatter on regional myocardial wall motion, 8 children mean age 10.6 +/- 1.3 y with congenital cardiac lesions associated with paradoxical septal motion were studied (study group). Six healthy children mean age 9.0 +/- 0.3 y with no history of cardiac disease served as controls (control group). Subjects in the study group had paradoxical septal motion but normal septal wall thickening detected by conventional two-dimensional and M-mode echocardiography. The control group had normal septal motion evident by conventional echocardiographic criteria. The percentage of systolic septal thickening was 46 +/- 4.5% and 42 +/- 5.9% in the study and control groups (p = NS). Cyclic variation was measured in parasternal long-axis views from several septal sites in each subject. Mean values of the magnitude of cyclic variation from independent septal sites were averaged to yield a regional average value for each subject. The average regional magnitude of cyclic variation was 8.3 +/- 1.0 dB and 5.7 +/- 0.4 dB in the study and control groups (p = NS). The results indicate that the measurement of cyclic variation of integrated backscatter is not distorted by altered regional wall motion, and that it reflects intrinsic contractile function. PMID- 2763384 TI - Continuous-wave ultrasound and neoplastic transformation in vitro. AB - C3H/10T1/2 cells in suspension were assayed using an initiation-promotion protocol for neoplastic transformation induced by continuous-wave ultrasound. Cells were insonated at 1.765 MHz for 40 min. Two ultrasonic intensities were used: 1.3 and 2.6 W/cm2 spatial average. The first intensity was found to be noncytotoxic; the second resulted in immediate lysis of 20% of the cells, followed by the clonogenic survival of 64% of the remaining cells. Ultrasound was delivered alone or in combination with X-rays (2 Gy, 240 kVp given before ultrasound), and/or 12-O-tetradecanoyl-phorbol-13-acetate (TPA, 0.1 microgram/ml post-irradiation). Under all treatment conditions, there was no effect of ultrasound on transformation at the 95% confidence level. PMID- 2763385 TI - Correlation artifacts in speed of sound estimation in scattering media. AB - A recently described method for speed of sound estimation in tissues in pulse echo mode involves reception of echoes generated by an ultrasonic pulse by means of a linearly tracking transducer. When the peaks of echo amplitudes are used as markers of arrival time, stairstep-like artifacts appear in the echo arrival time vs. transducer position plots. We postulate that these artifacts are a consequence of the speckle phenomenon commonly encountered in ultrasonic imaging. To test this hypothesis, we report computer simulations and water tank experiments which demonstrate similarities between the behavior of the stairsteps and the properties of ultrasonic speckle. Additionally, equations describing the precision of the speed of sound estimation in terms of the second order statistical properties of the stairstep artifact are derived. PMID- 2763386 TI - Prediction of in situ exposure to ultrasound: an improved method. AB - The acoustic output of medical ultrasonic equipment is usually measured in water but to determine the safety (or performance) of a machine it is necessary to know the in situ acoustic pressure levels inside a patient. At present, when estimates of these levels are made, a linear propagation model is used although in practice the propagation is nonlinear. This paper shows that such a model can lead to large errors (80% or more in pressure) and in particular that in situ predictions of the peak-negative acoustic pressure are too low. To describe the field in water and in tissue it is necessary to take account of diffraction, attenuation, and dispersion as well as nonlinear propagation. It is difficult to use acoustic output levels in water to predict in situ values because the amplitude in water approaches a limit, an effect known as saturation. Nevertheless, a method of making such predictions is presented in this paper and is validated by comparison with experiment. The method is relatively time-consuming to implement and has not yet been applied to pulsed fields, so there is a need for more complete and simpler methods. PMID- 2763387 TI - Differing effects of ultrasound-irradiation on suspension and monolayer cultured HeLa cells, investigated by scanning electron microscopy. PMID- 2763388 TI - Cholecystokinin and gastrin inhibit histamine stimulated aminopyrine uptake in isolated rabbit gastric glands. AB - In the present study we have analyzed if cholecystokinin (CCK) or gastrin (G) can inhibit acid production in isolated rabbit gastric glands as revealed by the aminopyrine technique. The results show that G 17 I, CCK 8 NS, CCK 8 S, ceruletide and CCK 39 significantly inhibit histamine induced aminopyrine accumulation. No significant inhibition was noted for G 4, G 34 and NT G 1-13. As a group the CCK peptides were more effective than the gastrin peptides in inhibiting the aminopyrine uptake. CCK 8 S and ceruletide, the most potent inhibitors, reduced histamine induced aminopyrine accumulation with an ED50 of 10(-9) and 10(-10) M respectively. These potencies are similar to those by which CCK peptides stimulate isolated pancreatic acini to secrete amylase. Inhibition evoked by CCK 8 S was most effective following 20-40 min of incubation time, possibly indicating that the effect is mediated by the release of an intermediate substance. The results may therefore indicate a role for cholecystokinin as a physiological inhibitor of acid secretion in the rabbit. The results may also contribute to explain why the potent gastric secretagogue gastrin per se fails to stimulate acid formation in gastric glands isolated from the rabbit. PMID- 2763389 TI - Parietal cell vagotomy and truncal vagotomy in elective duodenal ulcer surgery- results after six to twelve years. AB - In a randomized trial between 1974 and 1980, parietal cell vagotomy (PCV) was compared with truncal vagotomy (TV) in the treatment of duodenal ulcer in 106 patients. After a mean period of 3.9 years no significant differences were found between PCV and TV patients with respect to Visick grading and recurrence rates. Nor did the preoperative location of the ulcer-prepyloric or duodenal significantly influence the recurrences. The latter follow-up reported in 1981, showed that PCV was not superior to TV. The present paper describes a re-analysis of the same material in 1985. After a mean observation time of 8.7 years no significant differences in the ulcer recurrence rate were found between PCV and TV. Equal patient satisfaction with the two procedures was found. In patients with prepyloric ulcers, preoperatively, there was a higher recurrence rate among those who had undergone PCV than TV. PMID- 2763390 TI - Implantable drug delivery systems in computed tomography and magnetic resonance imaging--a comparison between titanium and stainless steel. AB - The effect of implantable drug delivery systems on computed tomography (CT) and magnetic resonance imaging (MRI) was investigated in a phantom and in two patients. The implantable systems of identical construction consisted either of medical grade titanium alloy or stainless steel. Images of a phantom showed artefacts of the stainless steel port in both CT and MRI. These artefacts were substantially reduced in images of the titanium port. Similar results were found in situ in two patients. PMID- 2763391 TI - Radiotherapy in benign uterine bleeding disorders. The Radiumhemmet metropathia cohort 1912-1977. Short and long term results. AB - Radiotherapy was earlier a method of choice for treatment of benign bleeding disorders (metropathia), especially in women of high surgical risk. During the period 1912 to 1977 933 women with benign bleeding disorders were treated at Radiumhemmet with intracavitary brachytherapy or external irradiation or a combination of both. The result with regard to cure of the uterine bleedings was good (48%). Hormonal withdrawal symptoms after treatment were noted in 45% of the patients. In the long term follow up an increased risk of cardiovascular death was found in women treated before menopause. Malignant tumours occurred in 107 cases versus 90.2 expected (RR 1.19). The estimated ovarian dose of ionizing radiation varied from 3.5 Gy to 6.0 Gy for the three standard techniques. Two women gave birth to a healthy child 4 and 5 years after intracavitary radium treatment. The estimated absorbed dose to the ovaries in these two women were 1 Gy and 4 Gy, respectively. PMID- 2763392 TI - Hip fractures--treatment and early complications. AB - A prospective follow-up study was performed on 282 patients with hip fractures with respect to early complications and their possible relation to patient or treatment variables. A hip fracture patient needed at least 1-2 hours in the operating theatre (length of anaesthesia), while the operating time was half or less. The operative trauma, measured in operating time and blood loss, was greater in patients with trochanteric fractures than in those with fractures of the femoral neck. Reduction was difficult and only half the internal fixations were satisfactory, as judged from X-rays at the end of the operation. The immediate results of the operations were satisfactory in the trochanteric group, but some problems were encountered in the group with fractures of the femoral neck. Complications were frequent and interrelated. At multiple discriminant analysis higher age, delay of operation, trochanteric fracture and long operating time were often found to be negative factors. Bladder catheterization increased the risk of urinary tract infection to some degree. PMID- 2763393 TI - Influence of treatment factors on the outcome after hip fractures. AB - To investigate the influence of different treatment factors in the outcome and rehabilitation after hip fractures, a series of 282 consecutive patients with femoral neck or trochanteric fractures were followed up prospectively for two years postoperatively. The long-term results were analysed by a review of the patients' records after 10 years. The hospital stay and aftercare in the total material were shorter when the operation was not delayed. In patients from their own homes, the hospital stay was influenced by the day of operation in relation to admission, the duration of operation and the operative result (the possibility of achieving stable internal fixation). Social rehabilitation was affected by day of operation, duration of operation and postoperative complications in the femoral neck group and by postoperative complications in the trochanteric group. The walking capacity was reduced after the fracture in most patients and only about one-half of the patients became independent walkers. Reoperations led to a greatly increased length of hospital stay in patients with trochanteric fractures and to a moderate increase in those with cervical fractures. Fracture healing was influenced by treatment factors both in the femoral neck group (poor reduction and postoperative infection) and in the trochanteric group (postoperative infection and unstable internal fixation). Mortality was related to preoperative factors and was not influenced by the treatment. The frequency of the occurrence of another hip fracture up to 10 years postoperatively was 17.4%, with an equal distribution of fracture types. PMID- 2763394 TI - [Ileocystoplasty and enteropathies]. AB - The formation of a neobladder by the transformation of sections of the terminal ileum has become an important alternative to supravesical urinary diversion. The discussion about the optimal urosurgical technique however has, so far ignored the problems of consecutive enteric defunctionalization and deficiency symptoms resulting from the anatomical shortening of the ileum. The analysis of experimental investigations and functionally comparable syndromes, such as Crohn's disease, permits an insight into the pathophysiological consequences. These relate to disorders in the bile acid and vitamin B12 metabolism and to the potential induction of a secondary hyperoxaluria, with a subsequent oxalate calculus diathesis. Further more, the reduction of the absorption area in the ileum can lead to calcium and vitamin D malabsorption with the development of intestinal osteopathy. These pathophysiological relationships must be taken into account in the long-term medical care of patients with ileal neobladder. The preventive and therapeutic measures are described. PMID- 2763395 TI - [Urethral tumor recurrence following radical cystoprostatectomy--an indication for primary cystoprostato-urethrectomy?]. AB - A total of 273 male patients underwent radical cystoprostatectomy between 1967 and 1987, 22 of them being regarded as at risk for urethral tumor recurrence. In these 22 primary simultaneous urethrectomy was performed or urethrectomy followed shortly after cystectomy because of the histology of the cystectomy specimen. Of the remaining 251 patients, a urethral tumor recurrence was observed in 23 (9.2%). Another patient with a urethral recurrence had originally been operated on in another hospital. The first urethral tumor recurrence was observed in 1977, but between October 1987 and May 1988, 7 patients were treated for urethral recurrence or rerecurrence, suggesting that this problem will be recorded increasingly often with improved survival rates from the original bladder tumor and longer follow-up of these patients. In 21 of the 24 patients with recurrence, multifocal tumor growth (multiple primary tumors, multifocal carcinoma in situ, unifocal primary tumor with concomitant carcinoma in situ or severe dysplasia) was found in their primary cystectomy specimen. Two had unifocal tumors. The original histology of the patient operated on elsewhere is not known. The data suggest that primary simultaneous urethrectomy should be performed in all patients undergoing cystoprostatectomy for multifocal bladder tumors. All patients in whom the urethra is left in place need regular washout cytologies of the urethra for the rest of their lives to ensure early diagnosis of any urethral tumor recurrences. PMID- 2763396 TI - [3 years' experience with the ileum neobladder--the first 108 patients]. AB - Between April 1986 and April 1989, each of 108 patients received an ileum neobladder, 94 patients for total bladder substitution after radical cysto prostatectomy and 14 for augmentation of a fibrotic and contracted bladder following tuberculosis, interstitial cystitis or radiotherapy of the pelvis. The operative technique is standardized, relatively simple and safe, and it prevents upper urinary tract deterioration and reflux. Continence is preserved in more than 80% of all patients by the function of the external urethral sphincter and by the high capacity and the low internal pressure of the intestinal reservoir. Follow-up of more than 3 months postoperatively was possible in 96 patients, the evaluation including micturition behavior at home and a urodynamic investigation. Stress incontinence requiring correction by an artificial sphincter was found in 3 and nocturnal incontinence necessitating some external device in 6 patients. There was no perioperative mortality. Local tumor recurrence and/or metastases occurred in 14 patients; 7 patients died postoperatively, 5 owing to tumor progression, 1 of pneumonia and serve metabolic acidosis, and 1 owing to septicemia of unknown cause. Re-operation was necessary in 13 patients, in 6 because of mechanical ileus or intra-abdominal abscess, in 3 because of stenosis of the uretero-ileal anastomosis, in 1 because of tumor progression, in 1 because of vesico-vaginal fistula, in 1 patient because of incisional hernia, and in 1 because of wound dehiscence. Urethrotomy or dilatation of urethral strictures was necessary in 8 patients. All other early and late complications were rare and could be managed by conservative means.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2763397 TI - [Life after urostomy. A retrospective study]. AB - The study reported, which was based on a questionnaire and psychological tests, examined cystostomy patients with respect to the work-up and acceptance of their altered body. It was noted that 30% of the patients judged their situation as good, and 25% could accept the cystostomy, but a great many has to live with sexual disturbances, reduced social mobility, increased dependence, and psychic consequences; some had to give up their jobs. Sex, earlier psychosomatic diseases, developmental disorders in early childhood, which influence the personality, significantly affect the acceptance of the stoma. The problems are discussed. Suggestions are made, which include a plan for a holistic therapy. PMID- 2763398 TI - [Late metastasis of an extragonadal Leydig cell tumor]. AB - The case of a 36-year-old patient who underwent extirpation of a Leydig cell tumor of the epididymis is presented. Five years later a retroperitoneal mass was removed, which was found to be a metastatic Leydig cell carcinoma. The literature conrains reports of only 32 cases of metastatic Leydig cell tumors, all of which had originated in the testis and not extragonadally. The symptoms, treatment and prognosis are discussed with reference to the literature. PMID- 2763399 TI - Primary amyloidosis of urethra. AB - Primary localized amyloidosis of the urethra is rare; only 17 cases reported to date. Its clinical importance is significant, however, in that its presentation mimics carcinoma and treatment should be conservative. We describe an additional case and briefly review the literature. PMID- 2763400 TI - Penile ecthyma gangrenosum. Complication of drug addiction. AB - We present a case of ecthyma gangrenosum involving the penis in an IV drug abuser probably resulting from direct arterial septic embolization from a femoral injection site. An increased awareness of this condition is essential because misdiagnosis has been reported in up to 100 percent of cases. Prompt diagnosis is essential to begin appropriate therapy. PMID- 2763401 TI - Intravesical BCG and second primary malignancies. PMID- 2763402 TI - Determination of false negative rate in fine-needle aspiration of prostate. Study of sequential aspirations in 30 untreated carcinoma patients. AB - Despite several studies comparing the diagnostic accuracy of core needle biopsy and fine-needle aspiration (FNA) in the diagnosis of prostatic adenocarcinoma, no clear picture of the false negative rate for FNA is available. We studied 101 follow-up FNA evaluations in 30 patients with untreated well-differentiated carcinoma. The patients were followed for a median of two years and seven months and had from two to seven FNA follow-up evaluations (median = 2.5 evaluations per patient). If three inadequate evaluations are omitted, the combined rate of positive plus suspicious FNA biopsies was 92.9 percent (88.8% plus 4.1%, respectively). The residual false negative rate was 7.1 percent. The clinical features and follow-up data are described. A semiquantitative definition of "suspicious for malignancy" is suggested. We conclude that in experienced hands. FNA is a highly efficacious method for the diagnosis of prostatic adenocarcinoma. PMID- 2763404 TI - Squamous cell carcinoma of bladder after successful intravesical therapy with Bacillus Calmette-Guerin. AB - A case of invasive squamous cell carcinoma of the bladder following intravesical immunotherapy with Bacillus Calmette-Guerin in a patient with pre-existing squamous dysplasia of the bladder is presented. PMID- 2763403 TI - Conservative management of renal carbuncles in children. AB - Renal carbuncles have traditionally been treated with surgical drainage and appropriate antibiotic therapy. Recently, 2 pediatric patients with well documented renal carbuncles were treated with antibiotic therapy alone. Close follow-up documented complete resolution in both cases. Late studies showed no evidence of renal scarring or functional compromise. PMID- 2763405 TI - [Is eating estrogen-treated calf's meat dangerous?]. PMID- 2763406 TI - [The responsibility for confidentiality--private insurance medicine information- data protection]. AB - 1. Professional discretion/insurance discretion and data privacy protection are dependent, they overlap and supplement. The insurance discretion has contractual foundations, which originate in the personal insurance's unique confidential relationship. Data privacy protection is conceptually based on the Federal Data Protection Law, signed on Jan. 27, 1977. Insurance discretion and data privacy protection are of the upmost universal personal rights protected under the constitution. 2. Violation of either the "doctor's duty of discretion" or the "personal insurance's duty of discretion" is punishable by law. 3. The regulations regarding the policy holder's violation of his duty to disclose substantial risks and their verification are supplemented by contractual stipulations calling for a release from the duty of professional discretion. 4. The data privacy protection clause, also a contractual stipulation, takes into account the "relativity of the personal domain" in view of the insurance companies' mass business and the particulars of the "community of risks". 5. Professional discretion/insurance discretion and data privacy protection have experienced a legally ensured and practical interpretation. However this does not exonerate the insurance medical doctors, especially in borderline cases, from reflecting with great care and according to standard legal principle on the observance of professional discretion. PMID- 2763407 TI - [Clinical and morphologic aspects of benign bone tumors and tumorous bone lesions. Follow-up, therapy and prognosis]. AB - In this study, a total of 1434 benign bone tumors and 384 tumor-like bone lesions that have been diagnosed from 1945 until 1974 in the Institute of Pathology of the University of Freiburg was reviewed and statistically analysed. The most frequent tumors include 720 osteochondromas, 345 enchondromas and 93 osteomas (80.8%). The remainder of 276 cases included several tumorous bone lesions with an individual share of below 5%. Our 64 osteoclastomas (4.5%) are in reality tumors of low grade of malignancy. There was an equal distribution among both sexes (737 male, 695 female). Predominate location were the bones of extremities and the skull. Most often, we have found these tumors in the lower legs, and one third was localized in hands and feet. 60% of the benign bone tumors of the hands have been enchondromas. Osteomas and hemangiomas have been localized most often in the skull, and ossifying and non-ossifying fibromas in the jaws. Main localization of osteoclastomas was the knee. Roentgenograms have always been put into consideration for diagnoses and have, together with the histological findings, facilitate an exact classification. Clinical findings have only exceptionally shown indicative symptoms (e. g. night pain in cases of osteoid osteomas); otherwise there were vague swelling, pain or disfunction. Benign bone tumors are poor of symptoms. Concerning therapy, most bone tumors have been cured by operation (curettage, excision). In some tumors (especially in chondromyxoidfibromas) recurrences have occurred. No investigated bone tumor has shown a malignant transformation. PMID- 2763408 TI - [Expert assessment of psychosomatic disorders in rheumatology]. AB - There are often big problems regarding expert evidences of psychosomatic clinical pictures, because, contrary to the complaints expressed and perceived by the patient, somatic findings are not evident to justify a permanent disablement. Nearly without exception it is a question of chronified cases of psychosomatic complaints up to real psychoneuroses. The diagnosis and delimination from a simulation is difficult and is frequently failed. Without doubt there are cases, in which only the psychic component determines the vocational disablement. PMID- 2763409 TI - A necrotizing meningoencephalitis of pug dogs. AB - Clinical and pathologic features of a sporadic, necrotizing meningoencephalitis affecting adolescent and mature pug dogs are described. Many of the affected animals were closely related. Acute and chronic forms occur, with clinical signs reflecting the pathologic affinity of the disease for the cerebral hemispheres. No etiologic agent has been identified. The extensive necrosis and affinity for the cerebral hemispheres are similar to alphatype herpesvirus encephalitides of other species. PMID- 2763410 TI - Hereditary polycystic kidney disease associated with osteorenal syndrome in rats. AB - Hereditary polycystic kidney disease (PKD) was seen in Han:SPRD rats and identified as an autosomal, incomplete dominant trait. Homozygous animals died at 3 to 4 weeks of age, while heterozygous males were severely ill or moribund within about 6 months. Heterozygous females developed PKD to a lesser extent than males and survived longer. Renal secondary hyperparathyroidism and osteodystrophia fibrosa were seen in most males but were absent in females. In male rats metastatic calcification was found in kidneys, lungs, glandular and forestomach, blood vessels, and heart. In a few uremic males ulcerative enteritis occurred in cecum and colon. Blood urea nitrogen values were significantly increased in both sexes. PMID- 2763411 TI - A scanning electron microscopic study on surface lesions in fluorosed enamel of roe deer (Capreolus capreolus L.). AB - Scanning electron microscopy of surface enamel lesions in fluorosed permanent premolars and molars of free-ranging Roe deer revealed two types of pits. Post eruptive lesions that resulted from mechanical stress on hypomineralized enamel during mastication were characterized by steep walls and a typical honeycomb structure on their bottom, a result of fracture of enamel rods; holes left by fractured rods were surrounded by interrod enamel. Pits of developmental origin (hypoplasias), either as shallow depressions of enamel surfaces or narrow holes running deep into the enamel, were characterized by convex, rounded walls covered by numerous Tomes' process pits. Pits of hypoplastic and post-eruptive origin were often found in the same tooth. Intact enamel surfaces of fluorosed teeth resembled that of controls. PMID- 2763412 TI - Conjunctiva-associated lymphoid tissue (CALT) in normal and Bordetella avium infected turkeys. AB - Conjunctiva-associated lymphoid tissue (CALT) was characterized in normal and Bordetella avium-infected turkey poults during the first 5 weeks of life. At 1, 5, 12, 19, 25, and 33 days post-hatching (DPH), upper and lower eyelids were examined by gross, histologic, and electron microscopic techniques. CALT was confined to the proximal part of the lower eyelid near the conjunctival fornix; it appeared by 5 DPH as individual lymphoid nodules and as dense masses by 19 DPH. In the upper eyelid, CALT was present only as isolated nodules. Histologically, CALT was composed of dense lymphocyte infiltrates within subepithelial connective tissue, intraepithelial lymphocytes, and flattened lymphoid-associated epithelium that lacked goblet cells. Germinal centers were in CALT by 19 DPH. By scanning electron microscopy, epithelial cells over lymphoid areas were flat and had short, irregular microvilli; non-lymphoid areas were covered by cells with tall, regular microvilli. Transmission electron microscopy revealed that with increasing age of birds, the epithelium over conjunctival lymphoid infiltrates became progressively flattened and infiltrated by lymphocytes. Some blood vessels in CALT had high endothelial cells; lymphocytes were in the lumen and between or beneath endothelial cells. In B. avium-infected poults, CALT was increased, developed earlier, and contained more germinal centers than in normal poults. We conclude that CALT of turkeys closely resembles other mucosal lymphoid tissues and may serve as a site for local antigen uptake.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2763413 TI - Acute airsacculitis in turkeys inoculated with Pasteurella multocida. AB - Thirty female turkeys, inoculated into the caudal thoracic air sacs with Pasteurella multocida were examined from 0 to 6 hours post-inoculation (PI). The air sac reacted rapidly and intensely with exudation of heterophils. Circulating leukocyte and thrombocyte numbers remained normal except for an absolute lymphopenia by 6 hours PI. P. multocida was initially isolated from blood at 3 hours PI. Total cell counts increased markedly in air sac lavage fluids by 1.5 hours PI and continued to increase until 6 hours PI. Heterophils predominated in lavage fluids (greater than 94%), with macrophages comprising the remaining cells. Microscopically occasional heterophils were present within air sac blood vessels and perivascularly by 0.5 hour PI. They became more numerous by 1.5 and 3 hours PI when transepithelial migration into the air sac lumen was seen. By 6 hours PI, there was diffuse, severe swelling of air sac epithelium and mesothelium, and bacteria were located in air sac interstitium. Ultrastructurally, endothelial and air sac epithelial cells were swollen and vacuolated Interdigitating processes of air sac epithelial cells were separated. These results indicate that air sacs can be the portal of entry for P. multocida into the systemic circulation, probably via damaged air sac epithelium. PMID- 2763414 TI - Evidence that blood-borne infection is involved in the pathogenesis of bovine pneumonic pasteurellosis. AB - Five calves were inoculated intravenously with 10(8) colony forming units (cfu) of Pasteurella haemolytica A1; the mean score for pneumonic consolidation 3 days post-inoculation was 28%, and the mean clinical score was 7.8. Five calves inoculated intratracheally with 10(9) cfu of the same strain of P. haemolytica had comparable scores (34% and 8.8). Histological lesions of fibrinous pneumonia were similar in all calves. P. haemolytica was recovered from all but one of the affected lungs. From one calf killed in extremis 3 hours after intravenous inoculation, numbers of bacteria recovered from lung were 1,000-fold greater than from liver and spleen. A similar difference in bacterial numbers was also obtained from a gnotobiotic calf killed in extremis, 12 hours after intravenous inoculation of 10(8) cfu P. haemolytica. Evidence from these experiments supports the hypothesis that the blood-borne route is important in the pathogenesis of bovine pneumonic pasteurellosis. PMID- 2763416 TI - Abortion in two foals associated with Nocardia infection. PMID- 2763415 TI - Bronchoalveolar lavage cytology in cynomolgus monkeys and identification of cytologic alterations following sequential saline lavage. AB - Total and differential cell counts were determined on cytolytic specimens obtained by fiberoptic bronchoscopy and bronchoalveolar lavage (BAL) of five normal cynomolgus monkeys. Total nucleated cell counts ranged from 100 to 430 cells/microliters. Macrophages were approximately 91% of total nucleated cells, while lymphocytes were 3%, neutrophils 4%, and eosinophils 2% of the initial BAL from each monkey. Less than 1% of the cells were mast cells and ciliated or nonciliated epithelial cells. The effects of repeated saline BAL on pulmonary cell populations were evaluated. Saline lavage of individual lung lobes resulted in a marked rise in circulating blood neutrophils at 4 hr after BAL; there was a similar rise in neutrophils in lavage fluids 24 hr after the initial lavage. Differential and total cell counts of both blood and lavage fluid returned to normal if subsequent lavages were spaced at 48-hr intervals. Lymphocytes were not present in saline-lavaged lung lobes, and protein levels of lavage fluids did not rise significantly. BAL produced a transient, reversible, intra-alveolar influx of neutrophils which was preceded by mobilization of bone marrow-stored neutrophils. Neutrophilia in the lavage fluid and blood was not detectable if lavage and blood sampling procedures were done at 48-hr intervals (which did not alter Ia antigen expression among BAL cells). These observations indicate that BAL is a valid method for sampling and assessing pulmonary cellular and fluid constituents if the procedures are done at intervals of at least 48 hr. PMID- 2763417 TI - Emperipolesis of lymphoid neoplastic cells in feline hepatocytes. PMID- 2763418 TI - Ultrastructural analysis of platelets and megakaryocytes from a dog with probable essential thrombocythemia. AB - Blood platelets and bone marrow megakaryocytes from a dog with essential thrombocythemia were analyzed by transmission electron microscopy and compared with those of control dogs. Platelets varied in size and shape and contained enlarged and dilated open canalicular systems. Megakaryocytes were dysmorphic and had evidence of abnormal maturation, with large numbers of megakaryoblasts containing alpha granules and poorly organized and reduplicated demarcation membranes. The fewer, more mature megakaryocytes lacked normal cytoplasmic organization. Most notable was the absence of well-demarcated "platelet fields," due to the excessive and disorderly array of demarcation membranes. PMID- 2763419 TI - Magnetic resonance imaging of hepatic neoplasms in the rat. AB - Magnetic resonance imaging (MRI) at microscopic resolution was done on a live rat that had chemically induced hepatic neoplasms. Beginning at the anterior aspect of the liver, 16 contiguous transaxial slices (each 1.25 mm thick) were produced using three-dimensional Fourier transform sequences. The rat had been treated with diethylnitrosamine (200 mg/kg) at 70 days of age, and, subsequently, received periodic implants of 17a-ethynylestradiol for 60 weeks. Carr-Purcell Meiboom-Gill (CPMG) sequences (repetition time = 2,000 and echo time = 20, 40, 60, 80 ms) were done to give quantitative measures of spin-spin relaxation times (T2). Pixel-by-pixel curve fitting from these multiple images yielded calculated T2 images. Histologic evaluation of three abnormal areas in the liver revealed solid and cystic hepatocellular adenomas. Although lesions were evident in early echo images of the CPMG sequence, they were more apparent in the late-echo images. This was consistent with longer T2 relaxation times for the lesions. The voxels of dimensions (230 x 230 x 1,250 microns) permitted resolution of volume elements less than 0.07 mm3. This in turn permitted clear delineation of focal lesions less than 3 mm in diameter. The potential for MRI at microscopic resolution in toxicologic research is clearly demonstrated. PMID- 2763420 TI - Morphometric evaluation of rhesus articular cartilage: correlation of hexosamine and 35SO4 = incorporation. AB - Morphometric evaluation of 20 rhesus articular cartilage samples were correlated with hexosamine and an 18-hour incorporation of 35SO4- as a measure of proteoglycan production on samples from the same joint. Reduced chondrocyte cellularity was the basis of the reduced maintenance of the matrix by the chondrocyte. In the more cellular cartilage, the matrix/lacunae area ratio was less than 25, and the less cellular group had a ratio of greater than 40. An inverse correlation existed between morphometric cartilage matrix/lacunar area ratio and hexosamine content. A significant difference of 35SO4 incorporation was not seen between the three morphometric grades. Morphometric assessment reduces the subjectivity of articular cartilage evaluation. PMID- 2763421 TI - Experimental visceral leishmaniasis in the opossum. AB - Adult wild-trapped opossums were infected with Leishmania donovani (Khartoum strain, WR 378) and evaluated as an animal model of visceral leishmaniasis. All infected opossums died within 32 days. Loss of body fat, hepatomegaly, and petechiae of skin and abdominal musculature were seen at necropsy. Microscopically, numerous amastigote-laden macrophages were seen in histologic sections of liver, spleen, and lymph nodes; fewer parasite-laden macrophages were in the bronchial-associated lymphoid tissues and renal glomeruli. Hematological findings included thrombocytopenia (terminal), neutropenia, and lymphopenia. Blood lymphocyte blastogenesis in response to concanavalin A and phytohemagglutinin was decreased markedly at day 24 post-infection (PI). Serum antibodies (1:40 dilution) to promastigotes of L. donovani were detected in five of eight infected opossums tested on days 10 and 24 PI. Total bilirubin concentrations and alanine aminotransferase and aspartate aminotransferase activities were increased after day 25 PI. Activated partial thromboplastin times and one-stage prothrombin times were prolonged before death. Concurrently, factors V, VIII, and XII activities were decreased. PMID- 2763422 TI - Pulmonary alveolar microlithiasis in Afghan pika (Ochotona rufescens rufescens). AB - Lung lesions of 60 Afghan pikas (Ochotona rufescens rufescens) were examined histologically; 38 cases of pulmonary alveolar microlithiasis were found. Neither sex was predominantly affected, and there was no predilection for age. PMID- 2763423 TI - Olfactory neuroblastomas in two cats. PMID- 2763424 TI - Intrahepatic biliary coccidiosis in a dog. PMID- 2763425 TI - Decreased serum iron and zinc concentrations in cattle receiving intravenous dexamethasone. PMID- 2763426 TI - Extensive intestinal atresia and forestomach distention in a full term fetal calf. PMID- 2763427 TI - Diverticulosis and colonic leiomyosarcoma in an aged rhesus macaque. PMID- 2763428 TI - Future directions in veterinary pathology. PMID- 2763429 TI - Flunixin pharmacokinetics and serum thromboxane inhibition in the dog. AB - Flunixin meglumine administered orally to beagle dogs at doses of 0.55, 1.10 or 1.65 mg/kg bodyweight was rapidly absorbed to produce maximum mean plasma concentrations of 2.40 +/- 0.70, 4.57 +/- 1.12 and 7.42 +/- 2.07 micrograms/ml, respectively. Thereafter, the plasma concentrations of flunixin fell rapidly to values less than 0.10 micrograms/ml from 24 hours after drug administration at all dosage levels. The maximum mean inhibition of serum thromboxane B2 was 91.5 per cent after the lowest dose of flunixin and 98.8 per cent for both the intermediate and high dose rates. At plasma concentrations of flunixin above 2 micrograms/ml there was more than 90 per cent inhibition of thromboxane. PMID- 2763430 TI - Immune response and protection of cattle and pigs generated by a vaccinia virus recombinant expressing the F protein of rinderpest virus. AB - The immune response of cattle and pigs to a vaccinia recombinant virus containing the fusion (F) protein gene of rinderpest virus was examined. Half the cattle and all the pigs gave humoral response to primary vaccination and all the cattle gave an anamnestic response to a second vaccination 28 days after the primary vaccination. All the cattle after a single or secondary vaccination were completely protected clinically after exposure to a lethal dose of the Saudi 1/81 strain of virus. Prior vaccination with another TK- vaccinia recombinant (VVCAT) suppressed, but did not abrogate, the immune response to the rinderpest F recombinant. The pigs gave a humoral immune response in the absence of any local reaction at the site of vaccination. PMID- 2763431 TI - Some radiographic and clinical aspects of ununited anconeal process. PMID- 2763432 TI - Efficacy of nitroxynil against a benzimidazole-resistant strain of Haemonchus contortus in sheep. PMID- 2763433 TI - Detection of five genetically variable serum proteins from horse urine. PMID- 2763434 TI - Ectopic pregnancy in a cat. PMID- 2763435 TI - Tetanus in a dog. PMID- 2763436 TI - Immaculate conception? PMID- 2763437 TI - Nomenclature of chromosomes. PMID- 2763438 TI - Prostaglandins and clostridial vaccination. PMID- 2763439 TI - Antibiotic residues and clinical records. PMID- 2763440 TI - Anthrax vaccination. PMID- 2763441 TI - Dogs at nurseries. PMID- 2763442 TI - Haemorrhagic lesions resulting from Trypanosoma vivax infection in Ayrshire cattle. AB - Infection of Ayrshire cattle with a stock of Trypanosoma vivax from the Galana Ranch, Kenya, resulted in an acute disease characterised by profound anaemia and haemorrhage, which reached maximum severity between 3 and 5 weeks after infection. Bleeding from the ears, nose and rectum occurred. At necropsy, petechial and ecchymotic haemorrhages were widespread, but were particularly severe in the gastrointestinal tract. In confirmation of the gross findings, congestion, haemorrhage and degenerative changes in most tissues and organs were found histologically. Thrombi were seen in the lymphatic vessels and clots of fibrin were present in the ventricles of the brain. The anaemia was a consequence of frank blood loss through haemorrhaging, exacerbated by erythrophagocytosis of deformed red blood cells, whose occurrence was indicative of microangiopathic changes. Animals were euthanised between 23 and 36 days after infection when they became recumbent with PCV values as low as 9%. There is no doubt that animals affected by this syndrome in the field would die within a few weeks of infection, if left untreated. PMID- 2763443 TI - Detection of Babesia bigemina in cattle by a radioimmunoassay incorporating specifically depleted antigen. AB - It was observed that mild acidification (pH less than 4.0) together with solvent extraction of the soluble sonicate of a crude preparation of Babesia bigemina infected cattle erythrocytes caused a quantitative loss of B. bigemina-specific antigen. Cross-reacting antigen activities with Babesia bovis remained intact. These properties were utilized in an assay system wherein antibody response to the specifically depleted antigen preparation was subtracted from the response to the initial crude preparation leaving the net B. bigemina response. The radioimmunoassay based on this antigen system was verified using sera from known negative cattle and from cattle previously infected with B. bigemina, B. bovis or Anaplasma marginale. The following discrimination values were obtained: B. bigemina-positive sera less than 2% false negatives; negative sera, 2% false positives; B. bovis-positive sera, 4% false positives; A. marginale-positive sera, 0% false positives. Levels of cross-reactivity in the false positive results were in the "suspect" rather than positive class and in the case of B. bovis-positive sera, may have been due to non-specific antibodies induced by blood inoculation. In animals naturally infected with B. bovis only, there were no false positive reactions. B. bigemina antibodies were readily detectable in field sera for at least 10 months post-infection following infection by the cattle tick Boophilus microplus. This assay overcomes the problems of currently used tests for B. bigemina infection as it is both sensitive and specific and is able to discriminate between both field and laboratory infections of B. bigemina and B. bovis. PMID- 2763444 TI - Infectivity of cryopreserved Babesia bovis, Babesia bigemina and Anaplasma centrale for cattle after thawing, dilution and incubation at 30 degrees C. AB - Blood containing either Babesia bovis, Babesia bigemina or Anaplasma centrale was mixed with an equal volume of 3 M glycerol in phosphate-buffered saline with or without glucose and then stored in liquid nitrogen for 2-30 days. After being thawed, the parasitized blood was subjected to various procedures, including dilution up to 1000-fold followed by incubation at 30 or 4 degrees C for 8 h, before infectivity of the parasites was tested in a total of 70 cattle. The results showed that the blood cryopreserved with glycerol remained highly infective after thawing, despite dilution and incubation for 8 h at 30 degrees C. The results have practical application in the use of frozen, live vaccines against bovine babesiosis and anaplasmosis. PMID- 2763445 TI - Motility response of levamisole/benzimidazole-resistant Haemonchus contortus larvae. AB - Electronic measurements of the motility of third stage larvae of a susceptible and a levamisole/benzimidazole-resistant strain of Haemonchus contortus were made after incubation in solutions of anthelmintics for 24 h. Results confirmed the resistance to benzimidazoles, but failed to show differences in response to levamisole. Visual observations of paralysis of first and third stage larvae in solutions of levamisole also failed to show significant differences between the two strains. The tests as conducted failed to demonstrate levamisole resistance, suggesting that nematode strains may vary in their mechanisms of resistance to levamisole. PMID- 2763446 TI - A comparison of two methods and two additives for faecal cultivation of bovine trichostrongyle larvae. AB - The larval recovery rates of Ostertagia ostertagi and Cooperia oncophora from monospecific copro-cultures were determined by the methods of Corticelli and Lai, and Henriksen and Korsholm using vermiculite or polystyrene pellets as inert additives. The addition of either vermiculite or polystyrene pellets in the two culture methods significantly (P less than 0.05) improved larval recoveries of both parasite species. Recovery rates with the Henriksen and Korsholm method were higher (P less than 0.05) for both species than with the Corticelli and Lai method. Advantages and disadvantages inherent in the use of the two culture methods with and without additives are discussed. PMID- 2763447 TI - Epidemiology of Oestrus ovis infection of sheep in the highveld of Zimbabwe. AB - During a period of 13 months, 507 heads of sheep, obtained from an abattoir near Harare, were examined for infection with Oestrus ovis larvae. The prevalence of infection varied from 6 to 52%, the highest being in November and the lowest in April. The mean annual larval burden was 1.12. The maximum number of larvae recovered from a single head was 57 in the month of November. Two larval peaks were observed, the first and highest in November and the second in August/September. Some flies are present throughout the year, except in May. There are at least 3 generations of flies per year. The wet summer period from January to May seems to be unfavourable, as very few flies are present. There is no overwintering of first instar larvae in the heads of sheep. PMID- 2763448 TI - Relationship between the resistance of crossbred cattle to ticks, Boophilus microplus (Canestrini, 1887) and Hyalomma anatolicum anatolicum (Koch, 1844). AB - Studies were undertaken to determine the effect of repeated pure infestations with Boophilus microplus on susceptibility to subsequent pure infestations with Hyalomma anatolicum anatolicum, and the effects of pure infestations with both species of tick on susceptibility to a series of mixed infestations. Crossbred (Bos indicus X Bos taurus) calves were infested with Boophilus microplus (17 times), H. a. anatolicum (four times), followed by five mixed infestations of B. microplus and H. a. anatolicum. The decline in B. microplus engorgement from a mean yield of 274.4 +/- 60.3 ticks per host after the first exposure, to a mean yield of 9 +/- 4.6 per animal after the seventeenth exposure, was observed in animals exposed to only B. microplus. This might be due to acquired resistance. However, these animals were found to be as susceptible to H. a. anatolicum as animals which had never been exposed to ticks of either species. A decline in the yield of H. a. anatolicum from a mean yield of 92.1 +/- 10.7 after the first exposure to 54.7 +/- 11.3 after the fourth exposure, indicated that the cattle could also acquire resistance to repeated pure infestations with this species. After repeated pure infestations with both tick species, cattle reacted to five mixed infestations showing a high degree of resistance to B. microplus and low resistance to H. a. anatolicum (mean yield for B. microplus was only 10 +/- 8.1 ticks per host after the first mixed exposure and declined to 1.3 +/- 1.7 after the fifth, whereas the mean yield for H. a. anatolicum was 71.4 +/- 11.3 ticks per host following the first exposure and declined to 37.3 +/- 7.8 after the fifth). Host responses elicited to one species do not provide cross-resistance to the second species used in this study. PMID- 2763449 TI - Class I antigens of the bovine major histocompatibility system and resistance to the cattle tick (Boophilus microplus) assessed in three different seasons. AB - Two consecutive calf crops consisting of 141 three-quarters Brahman/one-quarter Shorthorn cattle were assessed for resistance to the Australian cattle tick Boophilus microplus in May, July and October 1983. Although the level of expressed resistance to artificial infestation varied considerably between seasons, the animals maintained very similar rankings for resistance in all three seasons, and the repeatability of tick resistance ranged from 0.59 to 0.82. The cattle were typed for 30 bovine class I lymphocyte antigens. Antigens W6 and CA31 were associated with susceptibility to artificial tick infestation but none of the other lymphocyte antigens showed strong associations with resistance or susceptibility. PMID- 2763450 TI - Effects of migrating Gasterophilus intestinalis larvae (Diptera: Gasterophilidae) on the mouth of the horse. AB - Lesions were formed in the mouth of the horse by first- and second-stage Gasterophilus intestinalis larvae. The lesions resulted as larvae burrowed through the top millimeter of the tongue and then became embedded in the interdental gingiva. Appearance of the lesion was dependent on the degree of larval burrowing activity and healing that had taken place. Active tunneling production occurred at the posterior end of the lesion. Extensive change in configuration and color was apparent along the longer lesions with active larvae. Virtually all tissue in the path of the larvae was removed while forming a tunnel. Tissue destroyed included tops of the lamina propria mucosae evaginations and the deeper portions of the lamina epithelialis mucosae. Histopathologic findings showed that the tissue removed included the nerve and blood supply of the proprial evaginations. Hemorrhage and exocytosis into the tunnels included erythrocytes mixed with some macrophages, lymphocytes and scant numbers of eosinophils. Air shafts excavated in the tongue by larvae enabled bacteria to enter into the tunnels. Bacteria became adhered to larvae and initiated microabscesses. Microabscesses were composed of clotted erythrocytes, bacteria, disintegrating epithelial cells, and large numbers of neutrophils. Cells surrounding the tunnel exhibited pyknosis, epithelial hydropic degeneration and became separated from each other. Healing of tongue lesions occurred as epithelial cell growth below raised the tunnel upward and affected tissue desquamated. Interdental gingiva invaded by larvae were hyperemic and denuded of epithelia. Recession and ulceration of the gingiva produced periodontal pockets. Extensive invasion by larvae led to compound periodontal pockets. Larval mouth hooks were embedded in the submucosa of the pockets and tore at engorged capillaries. The cephalic portion of embedded larvae became surrounded by a cellular exudate containing erythrocytes and mononuclear cells. Attachment of second-stage larvae at the root of the tongue did not produce observable damage. PMID- 2763452 TI - Use of DMSO for the cryopreservation of Tritrichomonas foetus in liquid nitrogen. AB - Four Tritrichomonas foetus strains were successfully preserved in liquid nitrogen at -196 degrees C in the presence of 10% dimethylsulfoxide (DMSO) for 7 months (Strain 1) and 6 months (Strain 2, 3 and 4). The percentage of viable organisms after thawing ranged between 65 and 85%, depending upon the strain. The method used is described in detail. PMID- 2763451 TI - Enzymes of oxidant defence system of leucocytes and erythrocytes in bovine anaplasmosis. AB - The glutathione oxidant defence system in leucocytes and erythrocytes of six Anaplasma marginale-infected calves was examined by assaying glutathione peroxidase (GSH-px), glutathione reductase (GSSG-R), reduced glutathione (GSH) and superoxide dismutase (SOD). In addition, GSH-S-transferase and arginase levels were measured in leucocytes. There was a significant decline in the activities of leucocyte GSH-px, GSSG-R and SOD in the post-patent period; whereas arginase activity rose significantly following the patent period of anaplasmosis. The activity of erythrocyte SOD declined in the post-patent stage. The infection also caused a decline in red cell GSH (P less than 0.05). The results suggest that the glutathione oxidant defence system of peripheral blood cells is significantly influenced by the Anaplasma infection. PMID- 2763454 TI - Plenary lectures of the 13th Conference of the World Association for the Advancement of Veterinary Parasitology. Berlin, German Democratic Republic, 7-11 August 1989. PMID- 2763453 TI - Distribution of Onchocerca spp. microfilariae in the dermis of cattle. AB - A grid was drawn on a lateral half of 10 hides, from cattle infected with both Onchocerca gutturosa and Onchocerca lienalis, which were obtained from an abattoir in central Florida. Paired 7-mm diameter skin cores were taken from 24 grid sites on each hide and microfilariae (mff) extracted to determine their distribution. The only consistent pattern distribution was that mff were recovered from all 10 hides at four sample sites along the ventral midline near the umbilicus. Microfilariae were also frequently found in large numbers along the dorsal cervical midline and in the region of the tarsal and carpal-metacarpal joints. PMID- 2763455 TI - Resistance of some capsular serotype D strains of Pasteurella multocida to rabbit polymorphonuclear neutrophil phagocytosis. AB - The mechanism of resistance of Capsular Type D strains of Pasteurella multocida to killing by rabbit polymorphonuclear neutrophils (PMN) was studied using an in vitro assay that differentiates intra- from extracellular bacteria. Two Capsular Type D strains (3761 and 3766), resistant to killing by rabbit PMN, and one Type A strain (R1), susceptible to PMN destruction, were compared. After combining opsonized bacteria and PMN, the Capsular Type D Strains 3761 and 3766 remained extracellular while the Capsular Type A Strain R1 was internalized by PMN. Thus, both Type D strains were resistant to phagocytosis by rabbit PMN. PMID- 2763456 TI - Infectious barley stripe mosaic virus RNA transcribed in vitro from full-length genomic cDNA clones. AB - Full-length genomic cDNA clones of the Type and ND18 strains of barley stripe mosaic virus (BSMV) were transcribed in vitro using T7 RNA polymerase. The combination of RNAs alpha, beta, and gamma synthesized in the presence of 5' cap analogs was infectious after inoculation onto barley plants, conclusively demonstrating the tripartite nature of the BSMV genome. Transcripts synthesized in the absence of cap analogs were not infectious. A gamma-specific subgenomic RNA which is normally present in BSMV virions was not required to establish a systemic infection. In vitro transcripts of variant cDNA clones which were isolated from the ND18 strain, containing either a simple nucleotide substitution or a 372-nucleotide duplication similar to one found in the genome of the Type strain, were also found to be biologically active. Two dicotyledonous hosts which have a differential response to infection with the Type and ND18 strains of BSMV were identified and these phenotypes were shown to be faithfully reproduced by inoculation with in vitro transcripts derived from the appropriate full-length cDNA clones. PMID- 2763457 TI - The superimmunity gene sim of bacteriophage P1 causes superinfection exclusion. AB - Previous work has shown that the sim gene of bacteriophage P1, if cloned into a multicopy vector, confers immunity against P1 infection to cells. We show that a 1.85-kb DNA fragment from the sim region of P1 (in the multicopy plasmid pMK4) expresses immunity and encodes three proteins with molecular weights of about 25, 24, and 15 kDa. Deletion of 650 bp from the sim region abolished synthesis of all three proteins and of the sim phenotype. Expression of sim did not prevent adsorption of P1 to cells. Successful transfection with linear P1 DNA suggests that the recombinational circularization of P1 DNA is not inhibited in the presence of sim. Plasmid pMK4 and a P1 prophage can be stably maintained in the cell indicating that replication of the prophage is not disturbed by sim. The prophage can be induced in the presence of sim. This shows that the sim phenotype is not caused by preventing lytic replication or phage maturation. In cells with pMK4 there is no expression of genes from infecting phages and transduction frequency is drastically reduced. We suggest that sim functions as a superinfection exclusion system by preventing transfer of DNA from the adsorbed phages into the cytoplasm. PMID- 2763458 TI - Mechanism of synthesis of turnip yellow mosaic virus coat protein subgenomic RNA in vivo. AB - Turnip yellow mosaic virus (TYMV) possesses a monopartite single-stranded (+) sense RNA genome in which the coat protein (cp) gene is 3' proximal and is expressed in vivo via a subgenomic RNA. Evidence is presented here that this subgenomic RNA is synthesized in vivo by internal initiation of replication on ( ) RNA strands of genomic length. The double-stranded RNAs (dsRNAs) from TYMV infected plants have been isolated, purified, and characterized. Under native conditions, no dsRNAs (replicative intermediates and/or replicative forms) of subgenomic length corresponding to subgenomic cp RNA can be detected by ethidium bromide staining of RNA-sizing gels or by Northern blot hybridization using RNA probes. The presence of nascent subgenomic cp (+) RNA strands on the dsRNA of genomic length has been demonstrated using two different approaches: (1) Northern blot hybridization using (-) RNA probes under denaturing conditions and (2) characterization of the 5' ends of nascent (+) RNA strands upon labeling by vaccinia virus nucleoside-2'-methyltransferase. PMID- 2763459 TI - Some characteristics of a retrovirus isolated from transformed bovine cells. AB - A novel retrovirus has been isolated from bovine cells transformed after cocultivation with leukocytes from an animal suffering from sheep-associated bovine malignant catarrhal fever. Morphologically and in its morphogenesis the virus resembles the type D Mason-Pfizer monkey virus (MPMV) as well as the ovine jaagsiekte retrovirus (JSRV). It is also serologically related to these two viruses, whereas a relationship to other known bovine retroviruses was not detected. However, its density of 1.16 g/ml in sucrose and the preference of its reverse transcriptase for manganese ions are closer to the characteristics of type C retroviruses. Unsuccessful attempts at transmission suggest that the virus may be defective in some function affecting its infectivity. PMID- 2763460 TI - Alfalfa mosaic virus temperature-sensitive mutants. V. The nucleotide sequence of TBTS 7 RNA 3 shows limited nucleotide changes and evidence for heterologous recombination. AB - Nucleotide sequence determination of the coat protein cistron of the alfalfa mosaic virus (AIMV) temperature-sensitive mutant, Tbts 7 (uv) revealed a small number of point mutations of which only one results in the replacement of an amino acid: the asparagine residue at position 126 is replaced by an aspartate residue. RNA transcribed in vitro from a Tbts 7 cDNA 4 clone directed the production in vitro of a polypeptide which shows the same altered electrophoretic mobility in SDS-polyacrylamide gels as the Tbts 7 coat protein. Nucleotide sequence analysis of the 32-kDa open reading frame revealed some base changes, but none of these lead to changes in the primary structure of the protein. The 5' terminal sequence of Tbts 7 RNA 3 was analyzed by cDNA cloning. At least three different types of nontranslated leader sequences were found, indicating considerable heterogeneity at the 5' end of the mutant RNA 3. The results indicated that the low abundance of RNA 3-containing particles in Tbts 7 virus preparations might be due to malfunctioning of the 5' terminus of Tbts 7 RNA 3 during replication. PMID- 2763461 TI - A measles virus subgenomic RNA: structure and generation mechanism. AB - A plaque-derived line of measles virus induced the synthesis of 21S subgenomic RNA in addition to 50S genomic RNA. The nucleotide sequence of the former RNA was determined in comparison with that of the latter. The 21S subgenomic RNA was 2646 nucleotides long and had a copyback structure containing a 50S genomic 5'-end. At the site where copying turns back, there was a 15-nucleotide-long sequence resembling the "measles virus consensus sequence" which is present at the beginning of each gene on the measles virus genome and is presumed to serve as a signal for the initiation of transcription. Recognition of the specific sequence may have been involved in the aberrant replication and may represent an additional and novel copy choice mechanism leading to the generation of subgenomic RNAs. PMID- 2763463 TI - Bacteriophage T4 late gene expression: overlapping promoters direct divergent transcription of the base plate gene cluster. AB - Eight 5' ends of RNA molecules which encompass the bacteriophage T4 base plate late genes 51 to 26 region have been mapped by S1 nuclease protection and reverse transcription within a 246-bp DNA segment. Two of eight 5' ends are initiated at two absolutely conserved late promoter sites, P51 and P26a, that direct RNA synthesis on opposite strands. These two promoters share four of eight promoter sequence base pairs. A third 5' end arises from another promoter, P26b, which shows one base pair mismatch with respect to the absolutely conserved -10 sequence. All the other 5' ends arise from RNA processing and/or degradation. Since no other late transcription promoter sites were found within the base plate cluster sequence, we propose that the two overlapping late promoters, P51 and P26a, direct the expression of the T4 base plate gene cluster, included between map coordinates 114,000 and 121,038: P51 directs the transcription of genes 51, 27, 28, 29, 48, and 54 on the rDNA strand and P26a the transcription of genes 26 and 25 on the /DNA strand. This peculiar promoter configuration might account for the low level of transcription of these late genes. PMID- 2763462 TI - Comparison of the three large polymerase proteins of influenza A, B, and C viruses. AB - The three large RNA segments of influenza C virus C/JJ/50 were cloned and sequenced, and the deduced amino acid sequences were compared with those of the polymerase (P) proteins of influenza A and B viruses. The coding strategy of the C virus RNA segments is the same as that for the large A and B virus segments as one long open reading frame is present in each segment. RNA segment 1 of influenza C virus encodes the equivalent of the PB2 protein; it has an approximate 25% sequence identity with the corresponding (cap binding) influenza A and B virus PB2 proteins. The PB1 protein of influenza C virus, coded for by segment 2, has an approximate 40% sequence identity with the corresponding proteins of influenza A and B viruses including the Asp-Asp sequence motif found in many RNA polymerase molecules. The PB1 polymerase is thus the most highly conserved protein among the influenza A, B, and C viruses. Although the protein coded for by RNA 3 of influenza C virus shows an approximate 25% sequence identity with the acid polymerase (PA) proteins of the A and B viruses, its sequence does not display any acid charge features at neutral pH. This protein is thus referred to as the P3 (rather than the PA) protein of influenza C virus. PMID- 2763464 TI - What is the potential of avirulent influenza viruses to complement a cleavable hemagglutinin and generate virulent strains? AB - A large pool of avirulent influenza viruses are maintained in the wild ducks and shorebirds of the world, but we know little about their potential to become virulent. It is well established that the hemagglutinin (HA) is pivitol in determining virulence and that a constellation of other genes is also necessary (R. Rott, M. Orlich, and C. Scholtissek, 1976, J. Virol. 19, 54-60). The question we are asking here is the ability of avirulent influenza viruses to provide the gene constellation that will complement the HA from a highly virulent virus and for the reassortant to be virulent. Reassortant influenza viruses were prepared between ultraviolet treated A/Chicken/Pennsylvania/1370/83 (H5N2) [Ck/Penn] and influenza viruses from natural reservoirs. These viruses included examples of the predominant subtypes in wild ducks, shorebirds, and domestic poultry. Attention was given to the influenza viruses from live poultry markets, for it is possible that these establishments may be important in mixing of influenza genes from different species and the possible transmission to domestic and mammalian species. The reassortants were genotyped by partial sequencing of each gene and were tested for virulence in chickens. Each of the reassortants contained the hemagglutinin and matrix (M) genes from Ck/Penn and a majority of genes from the viruses from natural reservoirs indicating a preferential association between the HA and M genes. The reassortants containing multiple genes from wild ducks and a cleavable HA were avirulent indicating that the gene pool in ducks may not have a high potential to provide genes that are potentially virulent. In contrast, a disproportionate number of viruses from shorebirds and all avirulent H5N2 influenza viruses from city markets provided a gene constellation that in association with cleavable H5 HA were highly virulent in chickens. An evolutionary tree based on oligonucleotide mapping established that the H5N2 influenza viruses from birds in city markets are closely related. PMID- 2763465 TI - The complete nucleotide sequence and genome organization of red clover necrotic mosaic virus RNA-1. AB - The complete nucleotide sequence of red clover necrotic mosaic virus (RCNMV) RNA 1 has been determined. RNA-1 is 3889 nucleotides in length with a 5' terminal m7GpppA cap. The RNA contains three large open reading frames (ORFs): the 5' proximal ORF, encoding a 27-kDa polypeptide; the internal ORF, coding for a 57 kDa polypeptide; and the 3' terminal ORF, encoding the 37-kDa capsid protein. The sequence results confirm in vitro translation of 27-, 50-, and 37-kDa products but do not account for the observed 90-kDa product. A translational frameshift event from the 27- to the 57-kDa ORFs is proposed to explain the synthesis of the observed 90-kDa in vitro product. The putative translational frameshift region is structurally similar to several retrovirus frameshift regions and the putative barley yellow dwarf virus (BYDV) frameshift regions. Extensive amino acid homology was observed in the 57-kDa downstream ORF with the downstream domains of the carnation mottle virus (CarMV), turnip crinkle virus (TCV), maize chlorotic mottle virus (MCMV) readthrough, and BYDV fusion proteins. The 57-kDa ORF contained the conserved "GDD" motif. A significant alignment between the capsid proteins of RCNMV, CarMV, and TCV was also observed. Given the extensive amino acid sequence similarity of RCNMV, CarMV, and TCV polymerase and capsid proteins, we speculate that they are closely related, evolutionarily. PMID- 2763466 TI - Molecular cloning and nucleotide sequence of the genome of hog cholera virus. AB - A cDNA clone derived from genomic RNA of hog cholera virus (HCV) was identified using an oligonucleotide complementary to the RNA encoding a hexapeptide from the putative RNA-dependent RNA polymerase of the closely related bovine viral diarrhea virus (BVDV). This clone served as a probe for screening different size selected cDNA libraries. After molecular cloning and nucleotide sequencing the HCV genome was shown to consist of 12,284 nucleotides containing one long open reading frame. Sequence comparison revealed a high degree of homology between HCV and BVDV genomic RNAs. With respect to HCV the genome of BVDV contains an insertion coding for 90 amino acids. PMID- 2763467 TI - Mapping and insertional mutagenesis of a vaccinia virus gene encoding a 13,800-Da secreted protein. AB - The objective of this study was to identify and characterize the gene encoding a protein of approximately 12 kDa that is secreted from cells infected with the vaccinia virus. The absence of this protein from the medium of cells infected with a spontaneous deletion mutant (6/2) suggested that the open reading frame (ORF) was located within a 12,800-base pair segment near the left end of the genome (G. Kotwal and B. Moss, Nature (London) 335, 176-178, 1988). Antibody to the 12-kDa protein immunoprecipitated an appropriate size in vitro translation product of mRNA that hybridized to a DNA segment containing an ORF (N1L) that could encode a 13.8-kDa polypeptide. The similarity in the sizes of the in vitro translation product and the secreted protein was consistent with the absence of processing. Transcriptional analysis revealed major and minor early RNA start sites preceding the N1L ORF as well as a late RNA start site with an atypical TAAAAT sequence. The N1L gene was interrupted by replacing a segment of the ORF with the Escherichia coli beta-galactosidase gene. When two-dimensional polyacrylamide gel electrophoretic patterns of [35S]methionine-labeled proteins secreted from cells infected with parental and recombinant viruses were compared, a spot missing from the latter corresponded in molecular weigh and isoelectric point with that predicted from the N1L ORF. The latter analysis revealed the presence of other secreted proteins of similar molecular weight but different isoelectric points that also appear to map within the left end of the vaccinia genome. The recombinant virus was attenuated as judged by the increased intracranial LD50 for mice but nevertheless induced antibody and cytotoxic responses after intradermal and intraperitoneal injections. Relative to the parental virus, the recombinant was also more attenuated for immunodeficient nude mice, based on their survival time after infection. PMID- 2763468 TI - Nucleotide sequence of the bacteriophage P22 gene 19 to 3 region: identification of a new gene required for lysis. AB - The nucleotide sequence of a 2558-bp region of bacteriophage P22 at the right end of the genetic map between genes 19 and 3 was determined. A new gene that is partially required for lytic growth, named gene 15, was noted. P22 mutants were constructed which lack gene 15 function, and the gene 15 product was found to be required for lysis in the presence of some divalent cations. It has extensive amino acid sequence similarity with the phage lambda Rz gene, which has a similar function, and weak similarity to the phage T7 18.5 gene which previously had no known function. A hybrid P22 phage, in which the T7 18.5 gene replaces the P22 gene 15, exhibits the plating properties of wild-type P22, strongly suggesting that the two genes have similar functions. In addition, deletions were constructed which show that phage P22 has no additional genes required for lytic growth of lysogeny between genes 19 and 3. PMID- 2763469 TI - Southern bean mosaic virus RNA remains associated with swollen virions during translation in wheat germ cell-free extracts. AB - L-[35S]Methionine-labeled translation complexes were prepared by incubating either swollen intact southern bean mosaic virus (SBMV) particles or unencapsidated SBMV RNA in a wheat germ extract. The complexes were analysed by sucrose gradient centrifugation and by electron microscopy and dot blot hybridization of fractions from these gradients. In these complexes, 80 S ribosomes appeared to be associated with intact or near intact particles, suggesting that SBMV particles disassemble only after their RNA has initiated translation. This is in contrast to some other isometric viruses, such as turnip yellow mosaic virus, which appear to release their RNA rapidly prior to translation. PMID- 2763470 TI - Bean mild mosaic virus: genome and its translation products. AB - Viral RNA from purified preparations of bean mild mosaic virus (BMMV) was resolved into two RNAs of mol. wt 1.5 X 10(6) daltons (R1) and 0.76 X 10(6) daltons (R2). Complementary DNA hybridizations, infectivity tests, and in-vitro translation studies established that R2 is a subgenomic RNA derived from R1. In vitro translation studies showed that the genomic RNA (R1) coded for two major proteins of mol. wt. 40.5 kD and 25.7 kD. Of these, the 40.5 kD protein was shown to be the capsid protein that is translated in vitro from both the R1 and R2 RNAs. Time-course studies on the appearance of in-vitro translation products showed that the 25.7 kD product is the earliest product made when the genomic R1 RNA is translated. This is not one of the products of R2 RNA. Several of the characteristics of BMMV described in this paper show similarities with turnip crinkle virus (TCV) and carnation mottle virus (CarMV). PMID- 2763471 TI - Health characteristics by occupation and industry of longest employment. AB - Includes estimates on length of longest job held, limitation of activity, disability days, incidence of acute conditions, persons injured, hospitalizations, and utilization of medical and dental services of persons aged 17 years and over in the civilian noninstitutionalized population. These estimates are presented by occupation and industry of longest employment for those who had ever worked. Estimates are based on data collected in the National Health Interview Survey of 1980. PMID- 2763472 TI - Trends and variations in first births to older women, United States, 1970-86. AB - Trends and variations in first-time childbearing women in their thirties and older are presented for the years 1970-86. The report focuses on the decline in childbearing by women in their twenties, particularly well-educated women, and the extent to which these women have delayed motherhood. Maternal and infant health characteristics are also discussed. The information presented is drawn from the live birth certificates of all states and the District of Columbia. PMID- 2763473 TI - [Comparison of the QRS score and the left ventricular ejection fraction in patients after acute myocardial infarct]. AB - In 90 subjects, mean age 52 +/- 9 years with a first acute myocardial infarction (AIM) the authors evaluated the QRS score by Wagner's method. The assembled values were compared by linear regression with values of the ejection fraction (EF) of the left ventricle (LV), calculated according to Dodge's method from left sided ventriculography made during the same period (on average 45 +/- 9 days after the development of AIM). For the entire group a correlation r = -0.43 (p less than 0.001) was obtained, for the sub-group of patients with AIM of the anterior wall (n = 44), r = -0.57 (p less than 0.001), correlation was found in patients with AIM of the lower wall (n = 27), r = -0.11 (p greater than 0.1). For the sub-group of patients of the whole group under the age of 60 years incl. (n = 60) the correlation was r = -0.52 (p less than 0.001), in patients above 60 years (n = 22) no correlation was found (r = -0.21, p greater than 0.1) between the QRS score and the EF of the LV. Calculation of the QRS score is a conventient auxiliary method for assessment of the affection in AIM of the anterior wall and in patients under 60 years of age. PMID- 2763474 TI - [Comparison of changes in the mobility of the left ventricular wall with coronarographic findings in patients after myocardial infarct]. AB - The authors examined by echocardiography at rest and after exertion a group of 55 patients after a clinically confirmed first transmural infarction. They compared the echocardiographic findings with coronarographic ones. The finding at rest, as regards impaired mobility of the left ventricular wall, corresponded to the clinical finding and the coronarographic finding. By diagnosis of the extended asynergy of contraction during an isometric load it was not possible to differentiate the functional and organic cause of impaired mobility and thus to assess the extent of the coronary affection. The impaired mobility of the left ventricular wall is associated above all with the state of the blood supply rather than with the finding on the coronary artery. PMID- 2763476 TI - [Diltiazem VUFB (Diacordin Spofa) in the treatment of arterial hypertension]. AB - In an eight-week open clinical investigation controlled by placebo in 21 hypertonic patients the author tested the calcium ion antagonist produced in Czechoslovakia, Diltiazem, VUFB. Its very favourable antihypertensive action was proved in patients with arterial hypertension stage I and II (according to WHO), using a maximal daily dose of 180 mg without the need of combination with other antihypertensive drugs, incl. diuretics. The undesirable effects were mostly weak and developed during the first 12 days of administration of the drug. Then they disappeared. Only two patients discontinued treatment on account of severe subjective complaints. In the latter patients, however, lack of confidence into the new drug played a major role. PMID- 2763475 TI - [Diagnosis of myocardial ischemia using functional ST mapping and 201Tl stress scintigraphy]. AB - The authors compared the value of two non-invasive methods in the diagnosis of myocardial ischaemia, i.e. precordial working maps of the ST segment and working scintigraphy of the myocardium with 201T1 after a load. On comparison with the finding on the coronary arteries, the authors found a high sensitivity of mapping, 89.3%, and of 201T1 scan, 92.9%, while the specificity of both methods was lower, 57.1%. Both methods are equally valuable for diagnosis of myocardial ischaemia; for assessment of the site of affection thallium scintigraphy of the myocardium is preferable. PMID- 2763477 TI - [Electrophysiologic properties of diltiazem VUFB tablets: effect on atrioventricular conduction]. AB - The authors investigated the action of a single oral dose of the recently developed preparation Diltiazem VUFB tabl. on electrophysiological parameters of atrioventricular conduction - the AH, HV interval, Wenkebach's point and the relative, functional and effective refractory period of the atrioventricular node. The preparation affects significantly parameters of the level of the node and its effect is comparable with data on the action of diltiazem produced abroad. PMID- 2763478 TI - [Antihypertensive therapy using metipamide VUFB]. AB - In a group of 17 patients with mild hypertension the antihypertensive effect of Metipamide VUFB was investigated. In the course of fourteen weeks' treatment the mean blood pressure declined from 20.5/13.3 kPa to 17.3/11.2 kPa and at the end of the investigation the diastolic blood pressure readings were normal in all patients. Echocardiography revealed a slight decline of the total peripheral resistance. The natriuretic effect was confirmed which is in the foreground of the antihypertensive action of metipamide. Investigation of side-effects of treatment revealed in 12 patients hypokaliaemia calling for substitution treatment, or when used clinically, a combination with a potassium sparing diuretic. There was a rise of the AST and ALT activity. The renal function did not change. The clinically significant drop of serum uric acid was striking. Glucose tolerance and serum lipids were not affected. PMID- 2763479 TI - [Angioimmunoblastic lymphadenopathy--present problems]. AB - Angioimmunoblastic lymphadenopathy is usually characterized as a lymphoproliferative disease caused by an abnormal reaction to various chemical and biological antigens and the possible development into malignant lymphomas of different types. The authors evaluate clinical and laboratory findings in a group of their patients suffering from the above disease. They emphasize the variable symptomatology, the frequently atypical course and the ensuing diagnostic difficulties. PMID- 2763480 TI - [Natural HLA-A, B and DR antibodies in the serum of non-immunized men]. AB - From 643 sera of healthy women and men in 67 a positive reaction with B lymphocytes and/or monocytes of healthy subjects was found. Forty-seven sera gave only occasional weak reaction. Twenty sera were from 18 subjects (13 men without a transfusion in the case-history 5 women with pregnancy in the case-history). In nine sera of men (= 1.40%) HLA-A, B cytotoxins, usually bi-or multispecific, were detected, in four sera of men (= 0.62%) HLA-DR antibodies were present in two instances their specificity was assessed: anti-HLA-DR7, anti-HLA-DRI + weak DR4. All these antibodies can be considered natural. In three women HLA-A, B cytotoxins were detected, in two monocytic antibodies. From the results ensues that it is useful to test women donors with a case-history of pregnancy for the presence of HLA-antibodies. The author discusses whether antibodies revealed in sera of 13 men are really natural or whether they developed for other reasons. PMID- 2763481 TI - [The incidence of occupational diseases in the health services within the catchment area of the Clinic for Occupational Diseases of the School of Medicine in Prague]. AB - The authors analyzed notified occupational diseases at the department of occupational diseases during the 10 past years, focusing attention on workers in the health workers' union. The highest ratio is that of viral hepatitis (64.8%) and skin diseases (14.7%). These are followed by other infectious diseases, tuberculosis, asthma bronchiale, etc. The largest number of occupational diseases was reported in female health workers (74.7%) which is consistent with nationwide data on occupational diseases. The high ratio of women is not surprising with regard to the marked feminization of this occupation. The highest ratio of occupational diseases was reported in women aged 21-30 years, whereby viral hepatitis accounted for 32.6%. Occupational diseases are important not only from the medical but also from the economic aspect. Therefore even a minor reduction of occupational diseases has marked economic consequences. From the investigation ensues that at present it is important to concentrate above all on two groups of occupational diseases, i.e. occupational infectious contagious diseases and occupational skin diseases. A prerequisite for reduction of type B viral hepatitis is immunization of health workers at risk departments against hepatitis B, which is being implemented at present. PMID- 2763482 TI - [Elevated indicators of liver metabolism in patients with giardiasis]. AB - The authors present an account on 60 patients where, based on the clinical picture, parasitological examination and laboratory parameters, the diagnosis of giardiasis was established. Among these patients a rise of one or several indicators of liver metabolism was found in 31%. The authors discuss whether the above conditions can be considered hepatitis within the framework of the basic parasitic disease. They eliminated non-parasitic causes (obstruction, HBsAg positive hepatitis, drug hepatitis, toxic hepatopathies) of elevated transaminase and bilirubin levels. For collection of duodenal juice or faeces for parasitological examination they used a gastrofibroscope or rectoscope. After treatment normalization of transaminase and bilirubin serum levels was recorded as well as regression of clinical symptoms and of eosinophilia. PMID- 2763483 TI - [Loffler's endocarditis]. AB - The authors describe Loeffler's endocarditis and the treatment of this clinical entity. Among diagnostic methods which drew attention to a cardiac affection associated with eosinophilia, non-invasive examination methods were of decisive importance. They comprised conventional electrocardiographic examination, X-ray of the chest and two-dimensional echocardiography. PMID- 2763484 TI - [An unusual chronic myeloproliferation]. AB - The authors draw attention to possible difficulties associated with the accurate diagnosis of myeloproliferative conditions. On the example of two patients they demonstrate the abnormal course of the disease reminding in one case of chronic myeloid leukaemia and in the second case of the myelofibrotic syndrome. Even detailed and repeated laboratory examinations incl. cytochemistry, cytogenetics, trepanobiopsy and cultivation of haemopoietic stem cells did not contribute to accurate assessment of the diagnosis. The picture of inexplicable myeloproliferation associated with a favourable clinical condition persists for 26 years in one patient and 12 years in the other. PMID- 2763485 TI - [The organization of the delivery of medical care to the wounded and ill during their evacuation]. PMID- 2763486 TI - [Constant attention and concern for the health of the soldiers of the Antiaircraft Defense Forces]. PMID- 2763487 TI - [The organization of the collection of venous blood for biochemical and general clinical studies in a polyclinic]. PMID- 2763488 TI - [Experience in teaching military naval therapy]. PMID- 2763489 TI - [The organizational aspects of rendering medical care to wounded patients with explosive mine trauma]. PMID- 2763490 TI - [Changes in the iris in the phytotherapy of digestive organ diseases]. PMID- 2763491 TI - [A method for the prevention of the formation of salivary fistulae in gunshot wounds of the parotid gland]. PMID- 2763492 TI - [The biological effects in external exposure to low doses of ionizing radiation]. PMID- 2763493 TI - [Evaluation of the efficacy of measures for the early active detection of patients with respiratory organ tuberculosis]. PMID- 2763494 TI - [A nomogram for assessing the maximum intensity of electromagnetic radiation in a short-range antenna field]. PMID- 2763495 TI - [Health inspection problems at the current stage]. PMID- 2763496 TI - [Characteristics of psychoprophylactic and mental hygiene work in the navy]. PMID- 2763497 TI - [Human ecology and health]. PMID- 2763498 TI - [Inventors and innovators in medicine (2)]. PMID- 2763499 TI - [The official visit of military physicians of the USA to the Soviet Union]. PMID- 2763500 TI - Effect of gamma irradiation on the human immunodeficiency virus and human coagulation proteins. AB - The effect of gamma irradiation on HIV and plasma coagulation factors F VIII:C, F VIII:vWF and FIX was studied. Donor plasma was harvested from single donations, frozen and irradiated in the frozen state at target doses from 0 to 40 kGy (0-4 mRad). HIV was inoculated into human plasma and irradiated in a similar manner. A range of other viruses, not suspended in plasma, were also irradiated to establish viral inactivation. An inactivation rate of 0.164 TCID50 dose/ml/kGy was demonstrated for HIV compared to rates of 0.00173, 0.00526 and 0.00286 log10 units/ml/kGy for F VIII:C,F VIII:vWF and FIX respectively. The use of gamma irradiation to inactivate infectious agents present in human plasma may eliminate the need for any post-production viral inactivation methods and provide a means of assuring the safety of as yet untreated products such as cryoprecipitate and fresh frozen plasma. PMID- 2763501 TI - A novel method for removal of human immunodeficiency virus: filtration with porous polymeric membranes. AB - We propose a new method to rid solutions of a virus by using a novel regenerated multilayered structured cellulose membrane (BMM). When the filtrate of human immunodeficiency virus (HIV) preparation was obtained through BMM it showed no infectivity. Electron microscopic observation revealed that HIV was completely caught by the multilayers of the BMM. Conveniently, BMM was seldomly found to adsorb protein molecules and also to have a high filtration rate. These characteristics may have a use in the removal of other variously sized pathogenic agents from plasma. PMID- 2763502 TI - False negative results in a competitive immunoassay for anti-HIV-antibodies due to the presence of rheumatoid factors. AB - One serum from a blood donor, which had both HIV-antibodies and rheumatoid factor, gave positive results with EIA anti-HIV screening tests and Western blot, but negative results with the Abbott's ENVACOR assay. Moreover, this serum and 5 out of 6 sera containing only rheumatoid factors were able to interfere with ENV and CORE reactions. Rheumatoid factors bind to the beads used in ENVACOR test and are also able to react with the conjugate. Most of the rheumatoid factors bind to the ENV conjugate, though with a wide range of activity. Obvious binding of rheumatoid factors to the CORE conjugate could not be demonstrated. Binding of rheumatoid factors both to the bead and to the conjugate leads to high optical density values and therefore results in the negative range according to the normal interpretation of the ENVACOR competition procedure. PMID- 2763503 TI - Influence of blood storage time and plasma histamine levels on the pattern of transfusion reactions. AB - The data from 359 transfusion reactions reported over a 3-year period have been compared with those obtained from 359 matched units given at the same time as the former but not implicated in a reaction. It was found that patients who developed reactions which were not accompanied by a change in body temperature received units with a longer storage time than patients experiencing febrile reactions. In addition it was noted that reactions which included a skin rash also tended to be associated with units stored for longer. In a further prospective assessment plasma histamine levels were measured in a group of 71 patients experiencing 'anaphylactoid', febrile and mixed transfusion reactions as well as in individuals in whom blood transfusions did not cause a reaction. The 'anaphylactoid' reaction group demonstrated a mean plasma histamine level in excess of 1 ng/ml, whereas mean concentrations below 0.50 ng/ml were recorded in the other 3 groups. Our data also suggested that in general, more and 'older' blood was given to the 'anaphylactoid' reactors. The high plasma histamine concentrations could readily contribute to the rash, wheeze and flushing recorded in these individuals. Thus, if a long shelf-life for stored blood is required, strategies which remove histamine from the unit may be worth considering. PMID- 2763504 TI - HLA class I (Bg) antigens on red cells of SLE patients: a serological study with polyclonal and monoclonal antibodies. AB - The enhanced HLA class I (Bg) on red blood cells (RBC) of many patients with systemic lupus erythematosus has allowed a significant correlation to be made between their HLA-B types and haemagglutination reactivity with lymphocytotoxic anti-HLA-B sera stimulated by pregnancy alone. Therefore the class I expression on these RBC relates to classical, rather than non-classical, class I gene products. Studies of class I expression on RBC by means of monoclonal antibodies (MAb) to epitopes on the heavy polypeptide chain and beta 2-microglobulin (beta 2m) have suggested that the complete extracellular structure is present. The specific effect of chloroquine in 'stripping HLA' from RBC had been assumed to support the concept that HLA class I was adsorbed from plasma. However, from our data, we conclude that HLA class I is an intrinsic membrane component. We suggest that the action of chloroquine is to remove beta 2m alone, which prevents normal class I expression and also results in conformational changes to the class I heavy chain, but that it is not capable of removing the membrane-bound heavy chain. PMID- 2763505 TI - Analysis of natural killer cells in patients with idiopathic autoimmune hemolytic anemia. AB - A functional and phenotypic analysis of the circulating natural killer (NK) cell population was carried out in 9 patients with idiopathic autoimmune hemolytic anemia (IAHA). The NK-cell activity, assessed by a sensitive method based on the inhibition of target clone growth in plasma semisolid medium, was markedly decreased in all patients as compared with normal controls and was not restored by stimulation of the cells with recombinant alpha interferon (alpha-IFN). Analysis of peripheral blood phenotypic markers showed that cells bearing Leu7 and CD16 antigens numbered in the normal range. These findings suggest that IAHA patients exhibit a functional impairment of the NK compartment. PMID- 2763506 TI - A new HLA-B antigen, BHT: definition by serological and biochemical means. AB - In 3 unrelated individuals, a new, so far unknown HLA-B-locus antigen was found. This HLA-B antigen, provisionally termed 'BHT', is recognized by extra reactions with alloantisera against the B5 cross-reactive group. BHT can be clearly discerned from all cross-reactive antigens by one-dimensional isoelectro focusing (1D IEF), as it reveals, on IEF gels, a characteristic, rather neutral double banding pattern different from all known HLA class I bands. The BHT banding pattern, which is identical in all 3 BHT-positive individuals, segregates with the haplotype A28, BHT, Cw7, DRw6. PMID- 2763507 TI - New platelet antigen, Siba, involved in platelet transfusion refractoriness in a Japanese man. AB - Siba, a new platelet-specific alloantigen involved in a case of platelet transfusion refractoriness is reported. The IgG platelet alloantibody was detected in a multiply transfused patient of Japanese extraction (Sib), by the presence of HLA antibodies. After transfusion of HLA-compatible platelets, the patient suffered from refractoriness. Adsorption studies with pooled lymphocytes showed that the serum contained anti-platelet activity. Family studies indicate that Siba is inherited as an autosomal codominant trait and separate from HLA and Baka. As of this report, segregation from Zw(PlA) and Yuk (Pen) antigen systems have not yet been determined. The gene frequency of Siba in the Japanese population is estimated to be 0.136. PMID- 2763508 TI - The Dolichos biflorus and peanut lectins. PMID- 2763509 TI - Delayed haemolytic transfusion reaction caused by anti-LebH antibody. PMID- 2763510 TI - Acute renal failure following transfusion of accidentally frozen autologous red blood cells. PMID- 2763511 TI - [The primary structure of the hemagglutinin of influenza A (H3N2) viruses isolated in the USSR in 1985]. AB - The primary structure of hemagglutinin of the members of three main antigenic groups of current influenza A (H3N2) viruses was determined. A phenomenon of "antigenic mimicry" was found to be due to the accumulation of reversions in hemagglutinin structure at late stages of antigenic drift. PMID- 2763512 TI - [The pharmacokinetics of recombinant alpha 2-interferon (reaferon)]. AB - The use of electrochemical iodination under potentiostatic conditions resulted in generating 131I-labeled alpha 2-interferon (IF) the antiviral activity of which differed statistically insignificantly from that of the intact preparation. The resulting radioactive analogue of alpha 2-IF was successfully used for the study of pharmacokinetics of reaferon (RFN) in experimental animals which determined the parameters of the processes of its elimination from the blood stream, accumulation and release from the liver, the organ in which the highest accumulation of alpha 2-IF is observed. It is concluded from the foregoing that it would be expedient to use RFN for treatment of viral disease of the liver and the lungs. PMID- 2763514 TI - [Abortive and recurrent rabies in dogs intracerebrally infected with the rabies street virus]. AB - In the experiments on dogs inoculated intracerebrally with the "paralytic rabies" variant of the "Yak" strain of street rabies virus we observed spontaneous recovery of 1 out of 5 sick animals. Rabies in this dog was verified by three isolations of the virus from the saliva during the disease and by an increase of antibody titres in the time course of to 6776. In another experiment, among 7 dogs developing rabies after intracerebral inoculation with the "convulsive rabies" variant of the virus one animal showed recurrent form of rabies. The diagnosis of rabies was confirmed by isolation of the virus from the saliva in primary disease as well as by virus isolation from the salivary glands and the brain of the dog dying with recurrent rabies. PMID- 2763513 TI - [Effect of immunosuppression on the development and outcome of an acute infection in mice caused by administration of the Lassa virus]. AB - In experimental infection of mice with Lassa virus, the infectious virus could be detected in all the organs and brain tissues tested. Histopathological lesions were demonstrated in cerebral and spinal cord tissues only. Roentgen irradiation in a dose of 500 R and cyclophosphamide protected mice against a lethal Lassa virus dose. Cyclosporin A in various doses exerted no effect on the outcome of the acute infection. The adoptive transfer of splenocytes from mouse donors inoculated intraperitoneally prevented the development of lethal disease symptoms and death of mice-recipients. It is suggested that immunocompetent cells are involved in the development and outcome of experimental infection of mice with Lassa virus. PMID- 2763515 TI - [Virological and serological characteristics of outbreaks and sporadic cases of acute gastroenteritis]. AB - Specimens from patients with gastroenteritis (GE) collected during outbreaks and from sporadic cases reported in the USSR in 1979-1984 were examined by electron microscopy (EM), enzyme immunoassay, rotavirus neutralization test in cell culture. All the winter-spring outbreaks and a considerable number (34.9%) of sporadic GE cases were caused by rotaviruses. The summer-autumn outbreaks were of non-rotavirus nature. In water-borne winter-spring outbreaks in adults, severe forms of GE with signs of dehydration were observed. Among infants, cases of virus-carrier state were detected. The rate of rotavirus detection by EM in winter-spring outbreaks depended on the time of specimen collection and decreased after 4 days from the onset of the disease. Apart from rotaviruses, adeno-, astro , calici-, coronaviruses, and picornavirus-like particles were detected by EM in feces from GE patients. PMID- 2763516 TI - [The use of colloidal gold-labelled antibodies for demonstrating viral antigens]. AB - The principal possibility of using antibodies conjugated with colloid gold for better visualization of viruses, viral antigens, and their immune complexes in electron microscope was studied on the experimental model of HBs-antigen and Venezuelan equine encephalomyelitis virus. The same method was used for the study of the thin structure of influenza A (H1N1) virus hemagglutinins using monoreceptor antisera. PMID- 2763517 TI - [Enhanced immunogenicity of influenza virus hemagglutinin when incorporated into liposomes]. PMID- 2763518 TI - [Purification of infectious influenza virus by microfiltration]. PMID- 2763519 TI - [Cell engineering in virology]. PMID- 2763520 TI - [The tasks of the public health network in controlling diabetes mellitus in Bulgaria]. PMID- 2763521 TI - [The secretory type of persons who have survived a myocardial infarct]. AB - 250 persons (117 men and 73 women) with past myocardial infarction, between 19 and 65 years of age, were examined for the secreting quality (or nonsecreting) of ABO(H) antigens in the saliva. The secreting persons were additionally examined for the antigens titer. 38.40% of the persons examined were found to be nonsecreting which is twice as many than are normally found among the Bulgarian population (18.69%). In the group of patients with past myocardial infarction the weak secreting persons were significantly more numerous while the moderate and strong secreting persons were significantly less. The data of the study allow the conclusion that the nonsecreting and the hyposecreting types are a risk factor for myocardial infarction. PMID- 2763522 TI - [Determination of the transaortic valve gradient in aortic stenosis by continuous Doppler echocardiography]. AB - A correlative study was carried out between the transvalvular aortic gradient determined by continuous wave Doppler echocardiography and by cardiac catheterization (retrograde or transseptal) in 41 patients with proved by invasive methods aortic valvular stenosis of different degree with or without accompanying aortic incompetence (light, moderate or severe). A considerable correlation was found between the transvalvular aortic gradient determined by the two methods (r = 0.75). In spite of that in considerable number of cases there is overestimation or underestimation of the transvalvular aortic gradient determined by Doppler echocardiography compared with the one determined by cardiac catheterization. The overestimation of the transvalvular aortic gradient determined by Doppler echocardiography is due to the accompanying aortic incompetence of greater degree and to the condition that the gradient determined by Doppler echocardiography is maximum instantaneous while the one determined by cardiac catheterization is peak to peak and is principally of lower values. The underestimation of the transvalvular aortic gradient is due to the presence of considerable left ventricular dysfunction and technical faults in the Doppler echocardiographic examination. PMID- 2763523 TI - [The prognostic value of an early bicycle ergometry test and the management of patients with uncomplicated acute myocardial infarct]. AB - In 75 men with uncomplicated acute myocardial infarction early symptom-limited submaximum bicycle ergometric test was performed 24-48 hours before discharge from hospital. 32 patients (42.7%) showed a positive test (ST-depression greater than 0.1 mV with duration of greater than or equal to 0.08 s and/or angina pectoris). The prognosis assessed by the number of cases with unstable angina pectoris, recurrent myocardial infarction or sudden death in the patients with positive test is significantly worse (p less than 0.0001). The patients with positive early bicycle ergometric test are indicated for direct examination and are potential candidates for aortocoronary bypass or percutaneous transluminal coronary angioplasty. An algorithm for attitude toward patients with uncomplicated acute myocardial infarction is presented. PMID- 2763524 TI - [Complex assessment of the electrophysiological changes in patients with right ventricular cardiac loading]. AB - In 216 patients with right ventricular cardiac overload the changes of 76 electrophysiological indices were studied--indices of the corrected orthogonal electrocardiogram after Frank, corrected orthogonal vectorcardiogram, spatial electrocardiogram and high-speed spatial electrocardiogram. The patients with right ventricular cardiac overload are divided into two basic groups--patients with systolic and patients with diastolic overload. The indices are assessed on the basic criteria of sensitivity, specificity and realization. Variation analysis as well as statistical comparison with 119 healthy persons are performed. On the basis of the results of the study "sets" of 4 indices each with 97-98% sensitivity are determined, indices from all methods used are included in the "sets". The conclusion is reached of the good possibilities of the electrophysiological methods when a combination of indices with the help of a computer is made. PMID- 2763525 TI - [Campylobacter pylori in patients with chronic gastritis and gastric and duodenal peptic ulcer]. AB - The presence of Campylobacter pylori was studied in biopsy material from gastric mucosa taken by guided biopsy during fiber gastroduodenoscopy from 101 patients with chronic gastritis (n = 50), peptic gastric ulcer (n = 28), peptic duodenal ulcer (n = 7), gastric cancer (n = 10) and gastric polyposis (n = 6). Campylobacter pylori was found in various quantity--moderate (++) and considerable ( )--in 64% of the patients with chronic gastritis, in 85.7% of the patients with peptic gastric ulcer and in 100% of the patients with peptic duodenal ulcer as well as in half of the patients with gastric cancer and polyposis. The quantity of Campylobacter pylori correlated with the severity of the inflammatory process and the degree of atrophy of the gastric antral mucosa. A tendency toward seasonal incidence of Campylobacter pylori infection of gastric mucosa was established: 78.69% of the patients examined during spring time (April May) and 60.0% of the patients examined during winter time (January-February) had Campylobacter pylori infection. This explains to a certain extent the seasonal exacerbations of the pathological process in chronic gastritis and peptic ulcer. The development of a well expressed chronic atrophic gastritis is in direct relation with the greater quantity of Campylobacter pylori in the gastric mucosa. The study reveals the pathogenetic relations between the presence and quantity of Campylobacter pylori and the development and evolution of chronic gastritis and peptic gastric and duodenal ulcer. PMID- 2763526 TI - [Changes in the biochemical indices in iron-deficiency erythropoiesis]. AB - In 608 patients with iron-deficiency anemia the following indices were examined: serum iron, total iron-binding capacity, serum ferritin, hemoglobin, free protoporphyrin, reduced glutathione as well as the activity of porphobilinogen synthetase in the erythrocytes. Increased of free protoporphyrin and of reduces glutathione as well as increased activity of porphobilinogen synthetase were found which the authors accept as an expression of iron-deficiency erythropoiesis. Serum ferritin was lowered but in many patients its level did not indicate totally exhausted iron reserves despite the well expressed anemia accompanied by a low serum iron level and transferrin saturation. In these patients an additional pathogenetic mechanism is supposed leading to retaining of some quantity of iron in the cells of the monocytic-macrophagal system. PMID- 2763527 TI - [Thrombocyte aggregation and the secretion reaction in hemophilia patients]. AB - The action of platelet aggregation and release reaction on the tendency toward bleeding in patients with hemophilia was studied. Were examined 43 patients with hemophilia A, 14 of them with hemorrhages, 5 patients with hemophilia B, 5 patients with hemophilia A and factor VIII inhibitor and 2 patients with congenital factor VII deficit. Disturbed aggregation with ADP was found in 2 patients and with adrenalin also in 2 patients with hemophilia A without hemorrhages, in 1 patient with hemophilia A with hemorrhages and in 1 patient with hemophilia B. In the remaining patients the examined indices were normal. No data for spontaneous aggregation were found. The results of the study indicate that no connection was established between the tendency toward bleeding in the hemophiliac patients and the platelet aggregation and release reaction. No data for platelet hyperactivation by the hemorrhages were found. PMID- 2763528 TI - [Cardiac tamponade from right ventricular rupture in severe lipomatosis]. AB - A case of an 80 years old woman with II-degree obesity is presented. The patient showed no hemodynamic disturbances prior to her death despite bilateral cardiac overload causes by chronic pulmonary inflammatory processes and arterial hypertension. The rupture of the right ventricular cardiac wall with cardiac tamponade was due to the massive fatty infiltration of the cardiac wall and to the sharp increase of the hydrostatic pressure in the right ventricle in the course of pulmonary embolism. PMID- 2763529 TI - [A case of Pendred's syndrome]. AB - A very rate case of a combination of congenital deaf-mutism and sporadic goiter due to peroxidase insufficiency is presented. This condition is known as Pendred's syndrome. The special features of the case requiring surgical treatment in contrast to the generally accepted conservative attitude are pointed out. PMID- 2763530 TI - Drug availability in Jamaica. AB - The availability of drugs and the supply system in Jamaica were examined. The Jamaica Commodity Trading Company imports all drugs through an international tendering system for the public health sector, and vital drugs for private distributors. For the 18-month period from January 1988, 652 awards were made, consisting of 426 (65%) brand and 226 (35%) generic drugs. There were several strengths and formulations for many drugs, including 19 preparations of 2 antibiotics. The University Hospital of the West Indies (UHWI) has been experiencing recurrent delays in the supply of several important drugs. In contrast, the private hospitals and pharmacies surveyed were adequately supplied. Many brands of several classes of drugs were available, including 51 antibiotics and 18 different anti-inflammatory analgesic and anti-hypertensive agents. However, several drugs used in special situations were only available at the UHWI. There is a need for the supply of drugs to be a priority in the public health sector and for the use of several drugs to be rationalized. PMID- 2763531 TI - Visceral complications of electrical burn injury. A report of two cases and review of the literature. AB - Two patients with high voltage electrical injury involving the trunk are presented. Both injuries were complicated by visceral damage; and one patient died from sepsis secondary to bowel perforation. The rarity of this complication is examined in light of the pathophysiology of electrical injury; and its management is discussed with reference to previously published reports on this condition. PMID- 2763532 TI - Spontaneous rupture of the spleen in pregnancy with splenic conservation. AB - Spontaneous rupture of the spleen in pregnancy is rare. It presents with severe internal haemorrhage with a high perinatal and maternal mortality. Splenic preservation is now a well-known option in dealing with splenic damage, and is recommended where possible to avoid diminished immunological competence. This is the first reported case of splenic preservation following splenic damage in pregnancy. PMID- 2763533 TI - Hoarseness following brachial plexus block. AB - A case is described in which the patient developed hoarseness following a left brachial plexus block, using the supraclavicular approach. Possible paralysis of the left recurrent laryngeal nerve is discussed. PMID- 2763534 TI - Fanconi's aplastic anaemia in two sisters in Trinidad and Tobago. AB - This report describes two cases of Fanconi's anaemia in Trinidadian sisters of East Indian origin. The cases have been confirmed by chromosomal analysis which showed increased breaks and ring forms. Anorexia was a persistent finding in both cases. One of the sisters also had a poor growth hormone response. PMID- 2763535 TI - Success of didactic gastroenterology teaching for postgraduate medical residents. AB - Although the Doctor of Medicine programme in Internal Medicine at the U.W.I. is a structured course with several teaching formats, the optimally effective form of teaching remains unknown. An experimental didactic teaching course in Gastroenterology was preceded and followed by an examination. This was conducted to determine the effectiveness of this form of teaching. The majority of residents ranked the course favourably. The mean examination score increased by 6.4%, from 25.4% before the course to 31.8% at the end. Although the more senior residents scored higher than their juniors in the pre-test, this difference disappeared in the post-test. Structured didactic teaching requires close supervision, active participation by trainee and reinforcement for the full benefit to be attained. PMID- 2763536 TI - Thyroid-gonad relationship in chronic schizophrenia. AB - The effects of the severity of psychiatric illnesses on thyroid function and their relationship to serum testosterone levels were studied in 38 men of African origin, suffering from chronic schizophrenia. Significantly lower levels of serum T4, T3, FT4I and testosterone in acutely psychotic patients indicated decreased thyroid-gonadal activity. Higher serum T4 and FT4I and lower serum TSH, testosterone and cortisol levels were observed in patients whose illnesses were in remission. Levels of both FT4I and testosterone in clinically stable patients, however, were not significantly different in comparison to controls, suggesting recovery from the illness. No significant differences either in thyroid or gonadal hormones were observed between patients exhibiting depression or elated affects; among disorganized, catatonic, paranoid and undifferentiated types; and among patients treated with different psychotropic drugs. The possible mechanisms involved in such thyroid-gonad relationship are discussed. PMID- 2763537 TI - The effect of blood sugar, therapy and blood pressure on lipoprotein profiles of diabetics in Trinidad & Tobago. Possible association with ischaemic heart disease. AB - The aim of this investigation was to examine the effects of fasting blood sugar, the type of therapy and blood pressure levels on lipoprotein profiles of diabetics in Trinidad and Tobago, and to determine how these biochemical and physiological risk factors may influence the development of ischaemic heart disease. Seven hundred (700) diabetic patients attending outpatient clinics at Sangre Grande and Port-of-Spain General Hospitals were surveyed. The data obtained in this study on the relationship of serum lipids to diabetic control support the hypothesis that poor control of blood sugar is conducive to accelerated atherosclerosis. Hypertensive patients and those maintained on insulin showed a greater predisposition to ischaemic heart disease (IHD) than did non-hypertensives and patients maintained on oral hypoglycaemic agents, respectively. PMID- 2763538 TI - The effect of demographic factors on serum lipids in diabetics of Trinidad and Tobago. Possible association with ischaemic heart disease. AB - This study was undertaken in order to investigate the effect of race, sex, weight, activity level and residential area on serum lipoprotein patterns, and to determine how this could possibly relate to the incidence of ischaemic heart disease (IHD). Seven hundred (700) diabetics attending outpatient clinics at Sangre-Grande and Port-of-Spain hospitals were screened. There were 132 males and 249 females of African descent; 99 males and 163 females of East Indian extract, and 19 males and 38 females of other ethnic origins. The average age of the population studied was 50 years (+/- 15). The results obtained from this study indicate that diabetes mellitus is apparently more common in women that in men, particularly in those women who have borne children, and the incidence rises markedly after menopause. East Indians have higher triglyceride (TG), very low density lipoprotein cholesterol (VLDL-C) and low density lipoprotein cholesterol (LDL-C), but lower high density lipoprotein cholesterol (HDL-C) concentrations than their counterparts of African origin. TG, LDL-C and total serum cholesterol (TC) concentrations are highest in overweight-obese patients while HDL-C concentrations are highest in the lower weight division. The domestic working class, as well as those who were in retirement, have higher TG, LDL-C and TC than members of other occupational status. The fractions mainly affected by a residential area are TG, HDL-C and LDL-C. Moreover, diabetes mellitus and its consequent impact on lipoprotein homeostasis imposes a greater predilection to IHD, especially among members of the East Indian community. PMID- 2763539 TI - Diagnosing dislocation of the hip in infancy. AB - In evaluating the diagnosis of dislocation of the hip in childhood by orthopedists in Oregon in 1985, we identified 36 dislocations in 32 patients, an incidence of 0.9 per 1,000 live births. In 12 patients, 12 dislocations (33%) were diagnosed after the neonatal period, 5 of which were diagnosed at walking age. Of the 12 children with a late diagnosis, 10 had normal hips when examined in the neonatal period. Neonatal screening will not detect all cases of congenitally dislocated hip. If dislocation of the hip in childhood is to be diagnosed in a timely manner, it is essential that children's hips be examined at the time of routine well-baby evaluations until a normal gait has been established. PMID- 2763540 TI - Dialysis disequilibrium syndrome. PMID- 2763542 TI - Pancreatic injury--a taxing problem. PMID- 2763541 TI - Therapeutic options in the management of life-threatening arrhythmias. 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, and John G. Fitz, MD, Assistant 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- 2763543 TI - More on the dialysis disequilibrium syndrome. PMID- 2763544 TI - Lip-reading the bedside care shortage. PMID- 2763545 TI - Additional thoughts on the hospital nursing shortage. PMID- 2763546 TI - Transdermal clonidine therapy and nicotine withdrawal. PMID- 2763547 TI - Prolactinoma in a middle-aged man with an osteoporotic fracture. PMID- 2763548 TI - Recognizing and treating alcoholism. PMID- 2763549 TI - Unpredictable adverse reactions. PMID- 2763550 TI - A new role for American medicine? PMID- 2763551 TI - Rational rationing. PMID- 2763552 TI - Radiologic case. Fibroadenoma of the breast. PMID- 2763553 TI - The professional satisfaction of New Mexico physicians. PMID- 2763554 TI - [Embolic complications in atrial fibrillation]. PMID- 2763555 TI - [Late results of the surgical treatment of stomach ulcer using the Maki method]. PMID- 2763556 TI - [Effect of a low-calorie diet on serum lipid levels and metabolic function of the liver in obese women during the climacteric period]. PMID- 2763557 TI - [Evaluation of the hematocrit value in the capillary and venous blood of newborn infants]. PMID- 2763558 TI - [Hyperthyroidism masked by circulatory failure and attacks of unstable atrial fibrillation]. PMID- 2763559 TI - [Cryotherapy in rheumatology]. PMID- 2763560 TI - [Hemolytic anemia and myocarditis caused by Mycoplasma pneumoniae infection]. PMID- 2763561 TI - [Giant cell arteritis]. PMID- 2763562 TI - [Staphylococcal septicemia]. PMID- 2763563 TI - [Sarcoidosis of the larynx]. PMID- 2763564 TI - [Analysis of the pathogenesis of various post-traumatic strokes]. PMID- 2763565 TI - ["Induced detoxification treatment" of opiate dependent patients--a new therapy concept]. AB - Induced detoxification treatment of opiate addicts by means of naloxone was developed at the intensive care unit of the Department of Psychiatry at the University of Vienna. Two methods were tested 1. Rapid opiate withdrawal by means of a staggered naloxone regimen. 2. Ultrashort opiate detoxification during general anaesthesia using high doses of naloxone. In an open trial 15 patients were treated with staggered doses of naloxone while under tiapride. The various discomforts were satisfactorily reduced, and the detoxification syndrome was limited to 50 hours. In a second open trial 6 patients were administered 10 mg naloxone under general anaesthesia. All naloxone induced withdrawal syndromes can be suppressed by barbiturate anaesthesia. They do not appear even after the effect of the anaesthesia wears off if the patient is kept on a naloxone regimen as long as opiates remain present in the circulatory system. Both methods shorten detoxification treatment and provide smooth transition to a naltrexone maintenance programme. PMID- 2763566 TI - [Therapy of metastatic carcinoid with the somatostatin analog octreotide and with recombinant interferon alfa 2b]. AB - A 69 year-old male with carcinoid syndrome and undetectable primary tumour, but disseminated liver metastases, was treated with somatostatin analogue octreotide (Sandostatin) and later additionally with recombinant interferon alpha 2 b (r IFN alpha 2 b, Intron A). The carcinoid symptoms (flushing, diarrhoea) were stopped within hours by octreotide. Simultaneously, the urinary 5-hydroxyindolacetic acid (5-HIAA) excretion and serum serotonin levels decreased by more than 50%. In spite of continued treatment with r IFN alpha 2 b a reduction in dosage of octreotide resulted in a rapid recurrence of carcinoid symptoms, suggesting that IFN alpha 2 b had no effect on the carcinoid symptoms in this patient. Since, furthermore, no regression of the tumour mass was observed, treatment with IFN was stopped after 8 months. During 15 months of treatment to date the patient has been kept free of symptoms by octreotide. PMID- 2763567 TI - [The importance of sleep for life and health]. PMID- 2763568 TI - [Street noise and sleep: whole night somnopolygraphic, psychometric and psychophysiologic studies in comparison with normal data]. AB - In 3 sleep-laboratory studies the effects of nocturnal traffic noise on the sleep of young (1st study: mean age 25 years, n = 10) and elderly (2nd study: mean age 62 years, n = 10) healthy subjects as well as adaptation phenomena (3rd study: one week in young volunteers, n = 10) were investigated. Objective sleep quality was evaluated for baseline- and traffic noise-conditions by means of somnopolygraphic all-night recordings between 22:30 ("lights out") and 6:00 ("buzzer") in the sleep-laboratory. In the morning sleep- and awakening quality were measured by a self-rating scale and psychometric and psychophysiological tests. Traffic noise, presented by a loudspeaker throughout the night with an intensity of 68 to 83 dB (A) (L eq = 75.6 dB [A]), caused a lengthening of sleep latency and intermittent wakefulness as well as a reduction of total sleep time and sleep efficiency as compared to baseline. Concerning sleep architecture, traffic noise led to an increase of light sleep, while deep sleep and, more pronounced, REM sleep were shortened. Although we found these changes in both generations, they reached the level of significance in young subjects only. The objective results were reflected in a significant deterioration of subjective sleep- and awakening quality after traffic noise. Objective awakening quality was unaffected . In the course of a one-week nocturnal traffic noise, we observed an increase of S 4 and a decrease of S 3. The last 3 nights revealed a significant improvement in subjective sleep quality, suggesting adaptive phenomena.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2763570 TI - Post basic education in the Southern Health Board area. PMID- 2763569 TI - The quality of nursing care is dependent on the communication skills of the nurse. PMID- 2763571 TI - Nursing function and computer support. PMID- 2763572 TI - Hydrogen peroxide-dependent liver microsomal N-demethylation and N-oxygenation of stobadine, a gamma-carboline antiarrhythmic and cardioprotective agent. AB - 1. Hydrogen peroxide was capable of supporting the N-methylation and N oxygenation of stobadine in rat liver microsomes. NADPH and O2 were not required. 2. The metabolic conversions promoted by H2O2 were completely abolished by preheating the microsomes for 5 min at 90 degrees C prior to assay, indicating the enzymic nature of the reaction. 3. The response to phenobarbital pretreatment and to inhibitors such as SKF 525-A, metyrapone and CO indicated participation of cytochrome P-450 in its oxidized form. 4. Microsomal cytochrome P-450 could not be replaced by haemoglobin, catalase, horseradish peroxidase or by its conversion to cytochrome P-420. 5. Comparative experiments on rabbits, guinea pigs and rats showed species differences in the extent of the peroxidatic metabolism of stobadine, the order of activity not being the same for C- and N-oxidation. PMID- 2763573 TI - Biotransformation of diethenylbenzenes. I. Identification of the main urinary metabolites of 1,4-diethenylbenzene in the rat. AB - 1. Biotransformation of 1,4-diethenylbenzene (1) in rat was studied. Six urinary metabolites, namely, N-acetyl-S-[2-(4-ethenylphenyl)-2-hydroxyethyl]-L-cysteine (3), N-acetyl-S-[1-(4-ethenylphenyl)-2-hydroxyethyl]-L-cysteine (4), N-acetyl-S [1-(4-formylphenyl)-2-hydroxyethyl]-L-cysteine (5), 1-(4-ethenylphenyl)ethane-1,2 diol (6), 4-ethenylbenzoic acid (9) and 4-ethenylbenzoyl-glycine (12) were isolated and identified by n.m.r. and mass spectrometry. 2. G.l.c.-mass spectral analysis of the methylated urine extract allowed the identification of four other metabolites, as 4-ethenylphenylacetic acid (11), 4-ethenylphenylacetylglycine (13), 4-ethenylmandelic acid (7), and 4-ethenylphenylglyoxylic acid (8). 3. The structures of the identified metabolites indicate that the main reactive intermediate in the metabolism of 1 is 4-ethenylphenyloxirane (2). The first step in the biotransformation of 1, formation of an oxirane, is very similar to the metabolic activation of styrene. However, subsequent steps lead not only to analogues of styrene metabolites but also to oxidation of the second ethenyl group leading to compound(s) which may contribute to the toxicity of 1, e.g. to the aldehyde 5. 4. Rats dosed with a single i.p. dose of 1 excreted nearly 5.6% of the dose as the glycine conjugate 12, irrespective of the dose. 5. In contrast, the total thioether fraction decreased significantly with increasing dose, being 23 +/- 3, 17 +/- 5 and 12 +/- 1% of dose at 100, 200 and 300 mg/kg, respectively (mean +/- SD). PMID- 2763574 TI - Deconjugation of p-hydroxytriamterene sulphate in the rat. AB - 1. The extent of deconjugation of p-hydroxytriamterene sulphate was studied in rats, by h.p.l.c., after i.v., i.p., and oral administration. 2. After i.v. administration, deconjugation accounted for 29-54% of the recovered dose as free p-hydroxytriamterene in urine and faeces. Following i.p. administration, 70-88% was deconjugated and 72-96% was deconjugated after oral administration. Most of the p-hydroxytriamterene was recovered in faeces. PMID- 2763575 TI - Arterial-venous concentration gradient as a potential source of error in pharmacokinetic studies. Plasma concentration differences of 6-chloro-2 pyridylmethyl nitrate on constant infusion to rats. AB - 1. Plasma concentrations of 6-chloro-2-pyridylmethyl nitrate (CPMN) at different sampling sites in the circulation were determined during and after constant infusion in the rat. 2. An arterial-venous CPMN concentration gradient was found and characterized by the following trends. During CPMN infusion into the right atrium, plasma concentrations were higher in arterial (aortic arch) than venous (inferior vena cava) plasma. After cessation of infusion the venous plasma concentrations were significantly higher (P less than 0.05) than those in arterial samples. There was a low concentration gradient between the right atrium and the peripheral artery, but substantial difference between the peripheral artery and the vein. There was a 1.8-2.4 extraction ratio of CPMN across the arterial-venous bed. PMID- 2763576 TI - The pharmacokinetics of the enantiomers of mexiletine in humans. AB - 1. This study examined the pharmacokinetics of the enantiomers of mexiletine in five healthy subjects who were each given a single, 300 mg, oral dose of racemic mexiletine hydrochloride. 2. The time course of the concentration ratio between the R(-) and the S(+) enantiomers (R/S) in plasma showed a progressive decrease, with a mean +/- S.D. ratio of 1.37 +/- 0.11 at 1 h and 0.64 +/- 0.11 at 48 h. Similarly, the R/S ratios in urine were 1.38 +/- 0.42 and 0.55 +/- 0.12 at 1 h and 72 h, respectively. 3. The terminal elimination half-life of S(+)mexiletine was 11.0 +/- 3.80 h, which was significantly greater (P less than 0.05) than that of the R(-) enantiomer, 9.10 +/- 2.90 h. S(+)Mexiletine also showed a significantly greater apparent volume of distribution (P less than 0.01) and renal clearance (P less than 0.05) than R(-)mexiletine. There was no significant difference in the apparent oral total drug clearance of the enantiomers. 4. The disposition of mexiletine enantiomers in man was stereoselective, and the differences observed between the enantiomers may be due largely to differences in their serum protein binding. PMID- 2763577 TI - [The aged in France]. PMID- 2763578 TI - Relative bioavailability of rectally administered phenobarbital sodium parenteral solution. AB - Rectal administration of antiepileptic drugs may be a useful alternative route when oral administration is not possible due to illness, surgery, or status epilepticus. Although parenteral administration often replaces oral administration in these circumstances, there is not always a desirable intravenous line available or repeated intramuscular injections may not be practical. The purpose of this study was to determine the relative bioavailability and time course of absorption of the commercially available parenteral phenobarbital sodium solution administered rectally in comparison with the same preparation given intramuscularly. Seven healthy adult volunteers were given phenobarbital 5 mg/kg intramuscularly and rectally five weeks apart. Eighteen blood samples were drawn over 288 hours. Pharmacokinetic parameters following intramuscular versus rectal administration were the following: area under the curve 5916 vs. 5253 mumol.h/L; half-life 112 vs. 113 h; time to maximum concentration 2.1 vs. 4.4 h; and maximum serum concentration 36.2 vs. 31.4 mumol/L. Mean relative bioavailability for rectal phenobarbital was 90 percent. Therefore, the parenteral phenobarbital sodium solution given rectally is well absorbed and provides a useful alternative route of administration. PMID- 2763579 TI - Meperidine binding to isolated alpha 1-acid glycoprotein and albumin. AB - Interpatient variability in response to a given dose of meperidine, a synthetic opiate analgesic, may be partially explained by variability in plasma protein binding. Alpha 1-acid glycoprotein (AAG), a plasma protein that primarily binds basic drugs, has been shown to increase in patients during stress such as trauma or surgery. The objective of this study was to determine the extent of meperidine binding to AAG and albumin as a function of both protein and meperidine concentrations. We performed a simple extraction procedure and a highly sensitive gas chromatograph analytical procedure. The results indicated that meperidine binding did not vary significantly with meperidine concentration at a given AAG concentration. However, meperidine binding increased significantly (p less than 0.01) as AAG concentration increased. Conversely, meperidine binding to albumin appeared to be independent of concentration of either meperidine or albumin. In conclusion, alpha 1-acid glycoprotein is a major plasma protein which binds meperidine in patients during stress. Further studies are suggested to elucidate the role of AAG on the pharmacologic effects of meperidine. PMID- 2763580 TI - Isoflurane for the management of status epilepticus. AB - When conventional therapy fails in status epilepticus, general anesthesia is recommended. We present our experience with isoflurane, an inhalational anesthetic, in the management of a patient with refractory status epilepticus. The seizures were controlled with relatively small concentrations of isoflurane. Hypotension, the only adverse effect of isoflurane, was managed with fluid and dopamine infusions. PMID- 2763581 TI - Stability of intravenous famotidine stored in polyvinyl chloride syringes. AB - The stability of intravenous famotidine in dextrose 5% injection (D5W), NaCl 0.9% injection (NS), and sterile water for injection stored in polyvinyl chloride (PVC) syringes at 4 degrees C for 14 days was studied. The concentration of famotidine samples was determined at time 0, 7 days, and 14 days by reverse-phase high-performance liquid chromatography. Samples were inspected for visual changes and tested for changes in pH. Results of the HPLC analysis indicated that the famotidine samples remained within 94-100 percent and 99-103 percent of the time 0 concentrations at 7 and 14 days, respectively. Repeated measures analysis of variance demonstrated a significant time effect on famotidine concentration as concentrations changed over time (p less than 0.01). This change was small in magnitude, however, and concentrations decreased at 7 days and increased at 14 days. Famotidine is stable at a concentration of 2 mg/mL in D5W, NS, and sterile water for injection stored in PVC syringes at 4 degrees C for 14 days. PMID- 2763582 TI - Quotation accuracy in review articles. AB - The purpose of this study was to determine the accuracy of referenced statements in review articles focused on drug therapy. Review articles published between January and December 1987 in Clinical Pharmacy, DICP, Drugs, and Pharmacotherapy were used. Ninety-nine references from these articles were randomly selected and pulled to determine if the published study results were in agreement with the review article statement. These references accounted for 165 statements. Thirty nine of 165 statements in the review articles (24 percent) were found to be inappropriate when compared with the original references. These inappropriate quotations were classified as either wrong, misleading, or deriving from only the discussion section of the original article. There is a need for increased awareness by authors to differentiate between reported results, article hypothesis, and their own interpretations, as well as for accuracy in quotation. PMID- 2763583 TI - Treatment of psychosis in pregnancy. PMID- 2763584 TI - Bromocriptine in treatment of depression. PMID- 2763585 TI - Biotechnology: product development and evolving patent law. PMID- 2763586 TI - Nonprescription drug approval: therapeutic strategy or marketing decision? PMID- 2763587 TI - Neonatal alprazolam withdrawal--possible effects of breast feeding. PMID- 2763588 TI - pH-buffered 2-chloroprocaine for intravenous regional anesthesia. PMID- 2763589 TI - Ceftizoxime stability in i.v. solutions. PMID- 2763590 TI - Comment: vancomycin dosing methods. PMID- 2763591 TI - Comment: phenytoin equation accuracy. PMID- 2763592 TI - Comment: impact of a kinetic service on aminoglycoside patients. PMID- 2763593 TI - Hospital pharmacy issues on antibiotics. Proceedings of a symposium. August 4, 1988, Williamsburg, Virginia. PMID- 2763594 TI - Alterations in vitamin A metabolism by polyhalogenated aromatic hydrocarbons. AB - Adequate stores and adequate tissue levels of vitamin A are maintained by a balance of tissue demands and dietary intake of the vitamin and are modified by many factors, including xenobiotics. It is well established that exposure to polyhalogenated aromatic hydrocarbons (PHAH) decreases hepatic content of vitamin A. Recent findings indicate that hepatic depletion of vitamin A is accompanied by an increase in serum and renal vitamin A content and enhanced excretion of vitamin A metabolites in urine and feces. Examination of tissue retinoid profiles reveals that PHAH exposure causes the generation of increased amounts of polar retinoids. It is very likely that PHAH affect enzymes crucial for regulation of vitamin A storage as well as enhance activities of specific enzymes in vitamin A metabolic pathway. PMID- 2763595 TI - [Clinical symptoms and duration of anamnesis in patients with hypophyseal tumors]. AB - In 88 patients with operated pituitary tumours a retrospective statement of the duration of the disease up to the beginning of the therapy was carried out. In the case of the prolactin secreting tumours the times of anamnesis are approximately only half as long as in the comparable data of literature. The cause of this may by the large proportion of macroprolactinomas among our patients. In acromegaly the duration of the disease is from 3/4 to 25 years. By their insiduous clinical progression hormone-inactive tumours render an exact dating of the beginning of the disease impossible. Issuing from the still too long times of anamnesis the clinical symptoms of the endocrine-active and endocrine-inactive pituitary tumours relevant to practice are demonstrated. Including these symptoms into differential-diagnostic consideration an early diagnosing should be possible at least in endocrine-active tumours. PMID- 2763596 TI - [Drug compliance behavior of hypertensive patients in 3-shift work with a prescription for 3 or more single doses daily]. AB - 82 hypertensive patients with a prescription of medicaments of three and more individual doses a day who worked in the three-shift system were anonymously asked about their behaviour concerning the intake of tablets. 78% said not to have obtained any recommendations for the intake of tablets during the nightwork. 20.7% of them took antihypertensive drugs at night during the shift. 51.3% in the day-time and 28.0% did not take any tablets during the night-work. The compliance was approximately 60%, similarly as in hypertensive patients working in the one shift system. With 3.7% the non-compliance was lowest during the night-shift. It was 22.0% during the early shift and 12.1% during the late shift. Side-effects and disturbances of the good health, respectively, during the antihypertensive treatment were stated with 14.0% and with 7.3% they appeared most frequently during the night-work. There was a statistically ascertained connection between the intake of tablets at night during work and the side-effects. They altogether appeared more infrequently, when a concrete advice was given by the physician. From this is concluded that on principle in shift-workers a treatment of the hypertension is to be aspired to with one or two individual doses a day, otherwise in a prescription of three individual doses the tablets should not be taken at night during work, but in the day-time. The temporary intake of tablets during shift-work as well as possible side-effects and corresponding behaviour patterns when disturbances of good health are appearing are to be discussed in detail particularly with the three-shift workers.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2763598 TI - [The Saxon test for objective assessment of xerostomia. A contribution to the diagnosis of Sjogren's syndrome]. AB - In 100 patients with rheumatoid arthritis and in a control group of 100 test persons with healthy joints who were exactly equal concerning age and sex with the help of a simple method (back-weighing of a sponge after defined retention time in the oral cavity) the secretion of the saliva was measured. According to the test variant in 9-10 patients and 0-1 controls, respectively, pathologic values were found. In comparison to other symptoms which are characteristic for the presence of a Sjogren syndrome, an average sensitivity and high specifity could be ascribed to the test for the evidence of a functional disturbance of the salivary glands. PMID- 2763597 TI - [Verapamil in primary hyperparathyroidism]. AB - In a female patient with primary hyperparathyroidism and disturbances of cardiovascular function clinical, biochemical and electrocardiographic as well as bone scintigraphic parameters were analyzed before and during therapy with verapamil (Falicard) for 7 month. Verapamil therapy resulted in decrease of the frequency of the supraventricular tachycardia, and, in higher doses (4 X 120 mg), also reduction of blood pressure, however, with dose limiting bradycardia and prolongation of PQ-time. Both the normalization of serum phosphate level, diminution of hypercalcemia of the ionized calcium and the decrease of hypercalciuria and increase of scintigraphic index as an expression of the decrease of high activity of bone metabolism suggest alterations of the calcium homeostasis. Under oral calcium load the constantly increased PTH values markedly could be suppressed indicating an alteration of intracellular parathyroid calcium set point. Discussion is performed with respect to possible protective metabolic and cardiovascular effects of calcium antagonists in this endocrine functional disorder. PMID- 2763599 TI - [Possibilities for the success of radon treatment of patients with progressive scleroderma]. AB - Physiotherapy and spa-therapy occupy a high value in the treatment of the progressive sclerodermia. On the basis of 59 radon cures at Bad Brambach in patients with this disease is shown that a success of the cure lasting for a long time is to be expected particularly in patients with a relatively bad initial situation. Above all an amelioration of the subjective condition as well as the movability of the joints is achieved. The necessity of repeated cures at an interval of 1 to 2 years is discussed in selected patients. No evidence can be rendered concerning a possibly specific radon effect. PMID- 2763600 TI - [HLA-A, B-antigens and hypertrophic cardiomyopathy]. AB - 21 HLA-A, B-antigens were typed in 82 patients with hypertrophic cardiomyopathy and their 17 diseased relatives in 15 families, and their frequency was statistically compared with 300 healthy persons. A statistically significant lower frequency of the HLA-antigen B35 could bei stated (3.66% in contrast to 19.33%). An insignificant occurrence of HLA-B40 and a more frequent occurrence of HLA-Bw22 were statistically significant only before the p-correction. A statistic evaluation was done also in the groups of patients who were subdivided according to the age, the breadth of the ventricular septum and the presence of the obstruction. The importance of the results for the pathogenesis and prognosis of the disease was discussed. PMID- 2763601 TI - [Cough during the middle of the night--an early symptom of bronchial asthma?]. AB - With regard to a differentiated therapy it is necessary to demarcate the clinical picture of the bronchial asthma early from the other chronic (obstructive) pulmonary diseases. Despite subtle anamnestic statement, careful clinical examination and simple functional tests of the lung in individual cases a clear diagnostic coordination and differential-diagnostic demarcation, respectively, cannot be performed. Before the use of further proceeding bronchologic and allergologic investigation techniques the questioning after nocturnal attacks of hacking cough is recommended which in our own clinical material could be proved in the phase of manifestation in 139 of 162 patients with bronchial asthma. PMID- 2763603 TI - [Peritonitis, septic shock and endotoxin--an animal experiment study]. AB - Fecal peritonitis was produced by a sphincter-system leading to intestinal perforation. In 10 beagle dogs endotoxin was measured with the Limulus test. There was a correlation between endotoxin appearance and microbiological findings in the peritoneal cavity and in the blood. Endotoxinaemia correlated with the clinical severity of peritonitis. PMID- 2763604 TI - [Videodensitometry analysis of stomach wall motility--presentation of a new method]. AB - The videodensitometry is a suitable method for recording the gastric wall motility. It provides biosignals amenable by computer. There are no special demands to any organic form or kind of contraction. The asymmetry of the stomach makes no difference, therefore. The hitherto usual manometry will not be superseded. Both methods complete themselves in an ingenious manner. The radiation exposure by videodensitometry can be diminished by modifying the system for image causation. PMID- 2763605 TI - [Chemoprevention of secondary abdominal echinococcosis--experimental study and clinical observation]. AB - An experiment was carried out in white mice by intra-abdominal injection of protoscolices. A chemoprophylaxis of the secondary abdominal echinococcosis was practised by means of Mebendazole (Vermox) in a dosage of 50 mg/kg body weight daily for 90 days. The chemoprophylaxis started on the twentieth day after the infection. Three animal groups were divided: group 1--peroral application of the drug, group 2--injection of the drug, group 3--control group. The autopsy of the mice were carried out one month after the end of the chemoprophylaxis. An echinococcosis was diagnosable only in the control group. The application in one patient showed the same good result. PMID- 2763607 TI - [Special obstetric problems in managing labor following cesarean section]. AB - The prevalence of primary repeat cesareans in the 37th and 38th weeks of gestation and the highest rate of premature births explain the shorter duration of pregnancy associated with this mode of delivery. In cases where ecbolics were administered labour was prolonged and the rate of secondary repeat cesareans was higher. Late rupture of the amniotic sac seems to increase the chances of successful vaginal delivery. Biparietal cranial diameter had no influence on the mode of delivery; significantly higher values were found only in cases of cranial pelvic incongruity. The frequency of primary repeat cesareans increased in proportion to the age of the mother. The time interval since the previous cesarean delivery is of no importance. Birth weights were lower in the group of elective repeat cesareans owing to lower gestational age. It does not always appear justified to rule out a vaginal birth in cases of twins. Regional anesthesia is not a contraindication. PMID- 2763602 TI - [Differential diagnosis of so-called premature performance failure or premature aging]. AB - In a district of about 70,000 inhabitants (two thirds urban, one third rural population) from 1978 to 1987 32 women at the age between 50 and 60 years and 63 men at the age between 50 and 65 years with premature decrease in vitality on cerebrovascular basis were observed and treated. The cases were differential diagnostically subdivided. 32 patients belonged to the group of more distinct chronic cerebro-organic psychosyndromes, additionally also involution psychoses; the number of the untimely retirement from the working process was 100%. In 24 patients there were pseudoneurasthenic syndromes of the cerebral arteriosclerosis; 75% early retired from the working process. In 39 patients the cases in question were the proper premature decrease in vitality or a so-called premature ageing on biophysical basis; 41% early retired. A premature ageing may exist also without any so-called organ-valued findings, the symptoms are credibly described. Conflicts with the environment and psychic false reaction may be the result. Optimum therapeutic and rehabilitative troubles may bring successes which are not to be underestimated in the cases without distinct organic processes. The question of invalidization is thoroughly to be examined individually. PMID- 2763606 TI - [Morphology of the placenta in relation to glycemia status in pregnancy in diabetes mellitus]. AB - Morphological investigations in 569 placentas of diabetic women have been performed. The histological results of 300 placentas from diabetic women delivered between 1969 and 1973 were compared to 269 placentas of diabetic women from the time period 1979 to 1983. The latest time period was characterised by normoglycemic metabolic control throughout pregnancy. Besides the morphological findings clinical results especially the perinatal mortality and morbidity during the two time periods are discussed. Morphological changes in the placenta of diabetic women are depending one the quality of metabolic control during pregnancy, independing on the White classes. Normoglycemia reduces placental maturation disorders, perinatal mortality and morbidity. PMID- 2763608 TI - [Long-chain non-esterified fatty acids in pregnancy, labor and post partum]. AB - Serum concentrations of non-esterified fatty acids (NEFA) remain unchanged up to the 21th week of gestation in comparison to non-pregnant women; also after the 37th gestational week only slightly increased concentrations are observed in women without labour. Under delivery, however, NEFA in maternal serum are approximately three times higher than those of non-pregnant women. This increase occurs only in NEFA with a chain-length of C12 to C18. Post partum values reach those of non-pregnant women within a few days. The concentrations of NEFA with a chain-length of C12 to C18 in umbilical artery and vein are significantly lower than in maternal serum. PMID- 2763609 TI - [New aspects of radiologic pelvimetry. Digital image intensification radiography: preliminary results of validation possibilities and results in various types of pelvic disproportion]. AB - Within 1 year with 1325 births 54 cases necessitated operative obstetric intervention due to a disproportion between fetal head and maternal pelvis. In 40 cases radiologic pelvimetry was performed, using the conventional technique. 75% of cases turned out to be due to a midplane or outlet contraction. As, on the one hand, this type of pelvic disproportion seems to be of increasing importance, on the other hand generously adoperated radiologic diagnosis is not well accepted by the patients due to X-ray burden, Digital Image Intensifier Radiography (DIR) has been introduced for pelvimetry. X-ray burden amounts to only 5% of that of the conventional technique. Enhanced postprocessing and interactive measurement possibilities are further advantages of DIR. Using the appropriate softwear, interactive measurement results are characterized by the lack of mistakes due to X-ray divergence, if only the distance between measurement level and desk surface is known. By analyzing 30 computer tomograms measurement levels of the most important pelvic distances could be calculated in relation to the position of the anterior iliac spine. These relations show a very low interindividual variation. Thus, possible errors in measurement amount to a maximum of only 3.5%. The evaluation of our cases reveals the necessity to reassess the normal ranges for pelvic parameters, for the use of those deriving from conventional pelvimetry failed to describe correctly the anatomy of birth channel. For this sake, additional measurements, esp. of sacral and pelvic outlet anatomy have to be performed. Based upon these measurements, a computer aided modelling of the birth channel and a simulation of the birth could be achieved.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2763610 TI - [Rubella infection in pregnancy in naturally acquired immunity]. AB - This case-report concerns the problem of rubella-reinfection in pregnancy (17th week of gestation). Inspite of documented maternal immunity infection was followed by transmission of virus to the fetus. Nowadays in most countries antenatal maternal screening for rubella seems to be sufficient. The observation of cutaneous exanthema, however, demands further investigation, even if maternal immunity was documented. PMID- 2763612 TI - [Endogenous eczema--atopic dermatitis. Neurodermitis constitutionalis atopica]. PMID- 2763611 TI - [Pregnancy and labor in chronic anterior horn lesion]. AB - This is the case of a 35-year old woman who suffers from a chronic form of spinal muscular atrophy and who has successfully completed four pregnancies between 1982 and 1987. After a short discussion of etiology, pathology, heredity and the differential diagnosis we describe the obstetric problems of our patient. The pregnancies were mainly aggravated by recurrent cystitis. In all the four deliveries the patient had to undergo cesarean section followed by severe lung problems. After the third pregnancy the patient had a nephrectomy cause of a pyonephrosis. We could not see an aggravation of the disease at it is described in some cases of Charcot-Marie-Tooth disease or polyneuritis. Three of the four children showed a striking muscular hypotonia post partum that disappeared soon after the neonatal period. PMID- 2763613 TI - [Inhalation mite provocation in atopic patients in relation to high altitude conditions]. AB - The clinical diagnosis of allergy of the respiratory system caused by flour or dust mites--i.e. perennial bronchial asthma and/or allergic rhinitis--hat to be proved by the case history, prick test, RAST, as well as provocative inhalation, before any hyposensitization measures are taken. The mountain climate (above 1500 m) is especially appropriated for these procedures since mites cannot live here. With regard to the pulmonary function and the correlation to RAST, we evaluated 83 specific bronchial and nasal provocative inhalation tests with dust or flour mites performed on patients suffering from atopic dermatitis and allergies of the respiratory system. PMID- 2763614 TI - [Quantitative assessment of heliotherapy in psoriasis vulgaris in high altitude climate]. AB - At the Davos Clinic for Dermatology and Allergy (Alexanderhausklinik), patients suffering from psoriasis were treated with natural UV irradiation over 6 weeks in 1987: the average doses applied amounted to 1.042 J/cm2 UVB (= 41.7 sunburn units (SU] and 41.511 J/cm2 UVA. These doses were far below those of artificial UV sources usually required in the treatment of psoriasis. The doses were also far below those which statistically increase the incidence of non-melanotic skin cancer. PMID- 2763615 TI - [Methods of alternative medicine treatment assessed by patients with allergies and patients with chronic skin diseases]. AB - 71 patients suffering from allergies and chronic skin diseases were questioned as to the so-called "alternative-medical" methods of treatment they had undergone. Two thirds of the patients judged the treatment as favorable or excellent, although the typical symptoms of only half of them, at the most, were actually improved. Part of the patients were able to reduce or do without their former medication. The vast majority of those patients who had already experienced a climatic therapy judged the success of such a treatment as good or excellent, when it was compared to a traditional or "alternative-medical" therapy alone. We discuss our results. PMID- 2763616 TI - [The age limit]. PMID- 2763617 TI - [Professional freedom and personal protection of elderly employees]. AB - A whole range of collective bargaining covenants, staff agreements, and employment contracts stipulate age limits which lead to a termination of employment when the employee reaches a certain age (e.g., 55, 60, or 65). In the Federal Republic of Germany, as opposed to the United States, it tends to be overlooked that this in many cases constitutes a form of "age discrimination", thereby hindering the personal development of the employees affected. The author argues that legal age limits should be evaluated in the light of constitutional standards. He arrives at the conclusion that such age limits frequently do not conform with the guarantees provided by Art. 12 of the Grundgesetz ("Basic Law") of the Federal Republic of Germany. This is particularly true when age limits are implemented as a tool of employment policy. One can but hope that the current line of reasoning of the Bundesarbeitsgericht (Federal Labor Court), which allows a broad application of age limits, will receive an impetus in a new direction. This could come about by a decision of the Full Court of the Bundesarbeitsgericht or by legislative action. PMID- 2763618 TI - [Gliding retirement, part-time work for the aged and partial pension problems and chances for an alternative form of terminating professional life]. AB - The article deals with chances and risks of the concept "gliding retirement". Special notice is taken of partial-pension schemes. Possible consequences for employees with respect to their financial situation and to their working conditions are discussed. PMID- 2763619 TI - [Adjustment to early retirement in males]. AB - The article deals with pre-retirement as a critical life-event in the livespan of men. The empirical study shows modes of experiencing and adapting to pre retirement. The predictors of adjustment to and satisfaction with retirement, as well as consequences of retirement in social participation are discussed. PMID- 2763620 TI - [Preparing for retirement. Aspects of didactic adult education]. AB - The beginning of the post-professional lifetime is one of the most significant transition points in human biography. Adult education is a central institution which prepares people for important changes of their living conditions after retirement. This article gives a description of motivations for an institutional preparation for retirement and shows its possible limitations. It introduces the elementary didactic categories of a differential pedagogical concept as participant-orientation and experience-orientation and shows their effects on planning, arrangement, and practice of special educational offers. PMID- 2763621 TI - Social class and social mobility--effects on survival. A study of an entire birth cohort during an 80-year life span. AB - The survival of all individuals living within a limited area (N = 489), born in 1902 and 1903, were studied from birth until 80 years of age according to parents' social class, own social class, and occupational mobility. There were no statistical significant differences in survival according to parents' social class. Bivariate survival analysis between 20-80 years of age, based on own social class, shown no significant differences. Concerning social mobility, when males and females were analyzed separately, those men with no mobility had a significantly lower survival rate than those with downward or upward mobility. For women there was no such difference in survival. In a multivariate survival analysis among eight social factors, sex and marital status had the greatest effect on survival between 20-80 years of age. Widows and widowers had, unexpectedly, a higher survival compared to married and never married persons. PMID- 2763622 TI - [Grief and depression in the aged]. AB - Bereavement after recent or earlier losses of loved ones is analyzed in 155 patients older than 60 years. Patients were treated by psychiatrists for endogenous, neurotic, or reactive depression. Bereavement was characterized by depressive syndromes, depressive and anxiety developments, chronification of somatic complaints, induction of endogenous depression, lack of grief or late onset of grief reaction, substance abuse and suicide. Women are more prone to bereavement. Special stressors and characteristic features of bereavement in old age are discussed. The pivotal meaning of interpersonal dependence on lost ones is discussed. Difficulties in the management of bereavement in old people are mentioned. PMID- 2763623 TI - Changes of organ indices of CBA/Ca inbred mice as function of age. AB - Weight changes of seven organs: brain, heart, lungs, liver, spleen, small intestine, and kidneys, were analyzed during aging of male CBA/Ca inbred mice. Data were collected as absolute organ weights, organ weights related to body, as well as brain weights. It was established that most organs increase their weight up to nearly two years of age, after which there is a dramatic decline. Body weight shows a distinct plateau or constancy along the lifespan of the animals; consequently, body weight seems to be generally the most favorable reference point to express some of the physiological changes and parameters of the aging organism. Variation coefficients of the organ weights generally become higher with age. PMID- 2763624 TI - [Preparation and experimental studies with an allogenic tissue adhesive during the addition of a dipeptide which promotes wound healing]. AB - The indication for application of tissue sealants in operative medicine was extended in the last years. With an allogenic fibrin adhesive system produced from coagulation plasma-fractions COHN I and cryoprecipitate an effective tissue glue system is introduced which is comparable to international known preparations. By addition of a wound healing compound to this tissue glue the revascularisation and connective tissue organisation of the wound area can be accelerated. Experimental data with this combined sealant prove the excellent sealing of the wound surfaces and an increased tension strength of the sealed wound. PMID- 2763625 TI - [A method for the preparation of demineralized bone matrix]. AB - A procedure for preparation of a demineralized bone matrix (DBM) implant is demonstrated. The main steps of this method are refrigeration, milling/sieving, defatting, demineralization, freeze-drying and sterilization. These steps are standardized but also viable. Therefore this method is on the one hand international comparable on the other hand it creates the possibility for further investigations to improve the osteoinductive capacity of DBM. PMID- 2763626 TI - [Relevant laboratory diagnostic methods for the evaluation of the osteoinductivity of bone matrix implants]. AB - For the valuation of the osteoinductive efficacy of different bone grafts bears upon increasing the determination of the alkaline phosphatase, the content of calcium, hydroxyproline and protein. We could prove the quantitative differentiation of different prepared bone matrix implants being possible, nevertheless the histological examination is an unavoidable, full of good sense completion. PMID- 2763627 TI - [Measuring chemiluminescence during blood preservation. 1. Spontaneous chemiluminescence]. AB - A device for the measurement of spontaneous chemiluminescence (SCL) of biological fluids and cell suspensions according to Vladimirov (1966) description with using of contemporary equipment was constructed. Its dark impulse rate at room temperature of the photomultiplier was 1.5 s-1. The volume of measuring cell was 2 ml. An application of the device to investigate the blood during its conservation (21 days at 4 degrees C) showed an absence of the SCL of whole blood. The mean values of plasma SCL were in agreement with literature data. There were no regular changes of plasma SCL during the storage of blood indicating unsuitability of SCL for the detection of blood injury during its conservation. PMID- 2763628 TI - [15N] ammonium test for liver function diagnosis. AB - The functional state of the liver can be assessed by oral administration of 15N labelled ammonium chloride (tracer) and subsequent isotope analysis of [15N]urea and [15N]ammonia in urine. Clinical tests based on the ratio of the excess abundances of [15N]ammonia to [15N]urea excreted in urine 3 hours after oral administration of the tracer gave values for patients with liver diseases which differed significantly from these of healthy subjects. PMID- 2763629 TI - [Indirect spectrophotometric microdetermination of sulfated glycosaminoglycans with dimethylmethylene blue]. AB - A microanalysis technique has been developed for the quantitative estimation of proteoglycans in cartilage extracts measuring the spectrophotometric decrease of absorbance of the dye dimethylmethylene blue after complexing with sulfated glycosaminoglycans at 590 nm. The reproducibility of the method is shown investigating the influence of different substances. PMID- 2763630 TI - [A complex program for microcomputer-supported immunoassay analysis]. AB - The increasing availability of analytical methods based on saturation analysis call for efficient assay calculation. A comprehensive computer program was developed, allowing the calculation of different kinds of assays. Due to the user friendly structure it can be used also by inexperienced laboratory staff without difficulties. Its large adaptability can be a usefull support to optimize various kinds of assays. PMID- 2763631 TI - [Modified cuvettes for the FK fluorescence measuring attachment to SPEKOL appliances manufactured by VEB Carl Zeiss JENA]. PMID- 2763632 TI - Letter on complication secondary to ACE inhibitors prompts a query. PMID- 2763633 TI - Questions views expressed in article on health insurance. PMID- 2763634 TI - Portrait of an impaired physician. AB - Since its inception five years ago, The Medical Society of Virginia's Impaired Physician Program has evaluated 140 physicians. Of these, 60 have completed treatment and aftercare monitoring, and 80 are being followed. Who are these physicians? the Editors asked Dr. David G. Fluharty, Jr., the program's medical director. What are they like? How about some case reports? The program's confidentiality prevented him from divulging any identifying information, Dr. Fluharty replied. He could say, however, that within the Virginia program's experience, impaired physicians fall into two distinct age groups. About a quarter of them are 28 years old +/- a few years; these younger doctors usually are dysfunctional due to "hard" drugs. The remaining three-quarters are 42 years old +/- a few years; in this group impairment is due most often to alcoholism. As for case reports, Dr. Fluharty continued, the program's compelling experience is that one case is pretty much like another, so similar are the historical patterns of birth, background, and behavior. To illustrate, he drew the following composite picture of an impaired physician in the larger, older, alcoholic group. PMID- 2763635 TI - Beer potomania syndrome in an alcoholic. AB - To summarize, patients with the "beer potomania" syndrome are characterized by 1) a history of chronic alcohol ingestion (in a hypotonic form); 2) protein malnutrition; 3) signs, symptoms and laboratory values consistent with water intoxication, including hyponatraemia, hypochloraemia and, usually, hypokalaemia; 4) no evidence of another cause of hyponatraemia such as steroid use, diuretic use, hyperlipidaemia, etc. The pathophysiology involves the inability to excrete sufficient free water, based on a loss of normal renal urea gradients. Patients may actually be total-body sodium depleted, yet have elevated urinary sodium and fractional sodium excretion due to this disorder of water metabolism. Attention to proper nutrition during the acute illness may obviate the need for potentially hazardous administration of hypertonic saline. PMID- 2763636 TI - More on smoking bans. PMID- 2763637 TI - Drug war. PMID- 2763638 TI - Fifty years of change. PMID- 2763639 TI - [Vardfacket's reference group: divided opinion about agreements]. PMID- 2763640 TI - [Leadership most popular seminar subjects]. PMID- 2763641 TI - [Call upon Ruth as witness--it can be the first step toward a smoke-free life. Interview by Britta Nilsson]. PMID- 2763642 TI - [Women's environment can be compact when men are my deliverance!. Interview by Madeleine Salomon]. PMID- 2763643 TI - [Safety caught in the middle when investigators examine themselves]. PMID- 2763645 TI - [Knowledge on HIV has not increased]. PMID- 2763644 TI - [National Social Welfare Board states: Sweden is a small country with few experts. Interview by Jan Thomasson]. PMID- 2763647 TI - [Inger Ohlsson examines the environment: we don't forget psychological harm. Interview by Jan Thomasson]. PMID- 2763646 TI - [Breakdown in cooperation between community and county. Home for drug addicts closed]. PMID- 2763648 TI - [Koena, nurse in South Africa: "profession divided in fight against apartheid"]. PMID- 2763649 TI - [Nurses ask for new trial in dialysis lawsuit]. PMID- 2763650 TI - [In the village pharmacy pills can be found--on the field grow nature's medicine]. PMID- 2763651 TI - ["Cancer patients are no victims to their illness". Interview by Monica Trozell]. PMID- 2763652 TI - [Health care--an endless adventure]. PMID- 2763653 TI - [KTK Congress: rising prices should give higher wages already this year. Interview by Jan Thomasson]. PMID- 2763654 TI - [Women's attitudes scare men away from nursing]. PMID- 2763656 TI - [We in the laboratories will show what we can do]. PMID- 2763655 TI - [Venture in managers' education]. PMID- 2763657 TI - [A stressed nurse lives dangerously!]. PMID- 2763658 TI - [We look forward to community geriatric care]. PMID- 2763659 TI - [The future is near. When we all become more, become older, and become more expensive to take care of--do nurses know the way to health?]. PMID- 2763660 TI - [The future is near. Agneta in a health knot. A novel about tomorrow]. PMID- 2763661 TI - [The future is near. Nurses must market their message]. PMID- 2763662 TI - [Vardfacket in Zimbabwe. Grits 3 times, though awful, for Mozambiques refugee children]. PMID- 2763663 TI - [Waiting for geriatric health care]. PMID- 2763665 TI - [Help patients to dare state their needs]. PMID- 2763664 TI - [Break with tradition of obedience]. PMID- 2763666 TI - [Of course, one can measure quality of care!]. PMID- 2763667 TI - [Stroke: nursing care--refreshing our knowledge]. PMID- 2763668 TI - [Dementia--future's greatest challenge]. PMID- 2763669 TI - [Cataract--new technic gives everybody better vision again]. PMID- 2763670 TI - [Handling of drugs--inadequate supervision leads to dosage errors]. PMID- 2763671 TI - [Port-A-Cath--a small box to improve the care of children]. PMID- 2763672 TI - [Welcome]. PMID- 2763673 TI - [Many can stay at home through a venture in home care]. PMID- 2763674 TI - [Maj wrote about her mother's dementia--now other relatives flock to her lectures]. PMID- 2763675 TI - [They come from Turkey to Sweden. Hamza, 22, follows tradition and helps his parents]. PMID- 2763676 TI - [Stop talking--do something!]. PMID- 2763677 TI - [My children do not have to take care of me!]. PMID- 2763678 TI - [Future health care for the aged a test of strength for society]. PMID- 2763679 TI - [Group living: a dignified way to care for the elderly and personnel]. PMID- 2763680 TI - [Illnesses gave Estrid other ideas--nurse becomes homeopath. Interview by Eva Dahlgren]. PMID- 2763681 TI - [Hospice in New York. In the home one takes care of both body and soul]. PMID- 2763682 TI - [Hospice in New York. Suddenly Mr. Reed wanted to talk with me about dying]. PMID- 2763683 TI - [Midwives in Uppsala give notice: "we are irreplaceable--that's why we get paid better!"]. PMID- 2763684 TI - [Useless in life and death]. PMID- 2763685 TI - [From Uruguay to Sweden with the aid of colleagues in the laboratory]. PMID- 2763686 TI - [SHSTF's demand of the TCO congress: reevaluation of women's work!]. PMID- 2763688 TI - [Soon tourists will flock to Gotland--at that time refugees must be off]. PMID- 2763687 TI - [Team work between pharmacy and ward makes nurses' job safer]. PMID- 2763689 TI - [3 nurses manage health care in Sandviken]. PMID- 2763690 TI - [Effective supervision with decentralization]. PMID- 2763691 TI - [International nurses' days. This year it is the school nurses' turn to be noticed]. PMID- 2763692 TI - [Data entry in health care provides safer record handling]. PMID- 2763693 TI - [The alarm is received by Anders--it could be a heart infarct]. PMID- 2763694 TI - [Nurses in ambulance save lives]. PMID- 2763695 TI - [Notice to quit as a weapon. Fight means more than a few 100-krona notes. Interview by Britta Nilsson]. PMID- 2763696 TI - [Notice to quit as a weapon. Employers have ignored dissatisfaction. Interview by Jan Thomasson]. PMID- 2763698 TI - [Notice to quit as a weapon. We must anchor lone policies better. Interview by Kaj Nyman]. PMID- 2763697 TI - [Notice to quit as a weapon. New wage policies provides equitable wages in health care. Interview by Kaj Nyman]. PMID- 2763699 TI - [Winners or losers?]. PMID- 2763700 TI - [Motto in a Catholic hospital: serve, pray and work!]. PMID- 2763701 TI - [Nurse and work inspector--Lena knows the environment she has to inspect. Interview by Kaj Nyman]. PMID- 2763702 TI - [Bengt Lindqvist with the County Council Organization: county councils doing a good job]. PMID- 2763704 TI - [Terminology, clinical picture and treatment of atopic dermatitis and neurodermatitis]. AB - Analysis of 66 cases with neurodermatitis has made it possible to distinguish five conditions: atopic dermatitis, diffuse, disseminated, or local neurodermatitis, prurigo. Each of these nosologic entities in characterized by a specific course. The authors consider that the term 'atopic dermatitis' is inadequate and should be changed. PMID- 2763703 TI - [Electron microscopic study of the interaction of human neutrophils and mononuclear cells with Trichophyton rubrum]. AB - Effector action of the neutrophils and mononuclear cells on Tr. rubrum has been revealed by electron microscopy. Destruction of Tr. rubrum by effector cells may be both extracellular--via the formation of a cooperative phagosome and solid contacts (mostly in interactions of effector cells with hyphae) and intracellular (phagocytosis of the spores). Platelets have been found to contribute to effector cell cooperation in interaction with Tr. rubrum. PMID- 2763705 TI - [Atopic dermatitis]. PMID- 2763706 TI - [Problems of dermatology and venereology in conducting universal dispensary care of the population]. AB - The author emphasizes the necessity of screening for sexually transmitted diseases within the frames of annual prophylactic check-ups of the population and describes methods for such screening. PMID- 2763707 TI - [Validation and experience in the use of local oxygen therapy in the system of the combined treatment of psoriasis patients]. AB - Comprehensive examinations of dermal morphology and function, carried out in 50 patients suffering from psoriasis, have revealed manifest hypoxia, depression of the intramitochondrial energy production, reduction of the cellular synthetic potency, increased protein catabolism, impaired transcapillary transport and vascular and tissue permeability, immediate and delayed type hypersensitivity local immune reactions. Basing on these findings, the authors have developed a new effective method for multiple modality treatment of psoriasis patients. The new scheme includes, besides the routine modalities (sedative and lipotropic drug, vitamins, UV irradiation, diets, ointments), subcutaneous injections of oxygen into the large foci (200 ml daily, 12-18 injections per course, alternating the injection sites) and oral intake of copper sulfate and reduced iron (3 times daily after meals for 20-30 days). The study has involved 112 patients with psoriasis (61 patients in the test group and 51 in the reference one). Clinical and morphologic examinations have demonstrated the advantages of the new method: clinical remission has occurred 1.8 times more often, the length of treatment has been cut by 7 days, an earlier and more complete recovery of the morphofunctional characteristics of the dermis has been achieved. PMID- 2763708 TI - [Morbidity from allergic dermatoses and pruritus in Blagoveshchensk]. AB - The intensive morbidity index in respect of allergic dermatoses has made up 12.07 in 1986, allergic dermatitis being the most prevalent (72%). The morbidity has been the highest among subjects aged 21 to 40. Seasonal changes in the allergic dermatoses incidence rates have been determined: skin itching, urticaria, and neurodermatitis have been the most prevalent in October, whereas eczema occurred mostly in May. PMID- 2763709 TI - [Detoxifying function of the liver in patients with rubromycosis during treatment with antimycotics]. AB - Oral therapy with nizoral and griseofulvin influences the system of cytochrome P = 450-dependent monoxygenases of the liver, this resulting in the depression of antipyrine microsomal oxidation. Recommendations are given on how to regard the data of antipyrine test over the course of therapy with oral antimycotic drugs. PMID- 2763710 TI - [Use of mefenamic acid as a connective tissue stabilizer in treating arthropathic psoriasis]. AB - The findings of biochemical studies, carried out in 30 patients suffering from psoriatic arthropathy, are analyzed. The parameters examined are: the blood and urine glycosaminoglycans, urine hydroxyproline levels, and blood hyaluronate glycan hydrolase and N-acetyl-B-D-glucosaminidase activities, i. e. the matrix and collagen metabolites as the indicators of the connective tissue destruction and lysosomal enzymes activation responsible, among other factors, for this destruction. The studies have revealed a correlation between the enzymic activity augmentation and the levels of the connective tissue degradation products and the dissemination and severity of the skin and articular processes. The patients have been treated with mefenamic acid, an enzymic activity inhibitor. The therapy has been effective in 76% of patients; 13% of these have developed a remission shortly after therapy (in 46.7 days on an average). The therapy has alleviated both skin and articular symptoms; a tendency to normalization of the biochemical characteristics has been observed. A continuous course of therapy has not been associated with side effects. The author recommends this pathogenetically based and confirmed by laboratory investigations method to be included into a complex of therapeutic measures for patients with psoriatic arthropathy. PMID- 2763711 TI - [Urticarial vasculitis]. AB - A female patient aged 39 with urticarial vasculitis is described. She has developed stubborn not itching blisters on the skin, suffered from periodic fevers, arthralgias; laboratory analyses have shown leukopenia, hypocomplementemia, immune complexes circulating in the blood and fixed in the skin vessel walls. Histologic examination has revealed leukocytoclastic vasculitis. The differential diagnosis between this condition, chronic urticaria, and lupus erythematosus is discussed. PMID- 2763712 TI - [Latent porphyria cutanea tarda]. AB - A total of 142 subjects have been examined; of these 49 healthy relatives of patients with manifest porphyria cutanea tarda (PCT) (group 1), 48 subjects with melanodermal skin changes characteristic of PCT abd with anamnesis aggravated for alcoholism (group 2), and 45 patients with chronic liver diseases (group 3). None of the examinees has developed photosensitization symptoms. The findings have been compared to the results of examinations of 24 normal subjects and of 145 patients with manifest PCT. Minimal abnormalities of porphyrin metabolism have been detected in 43 subjects (30.2%). In group 1 subjects these abnormalities presented as increased levels of uroporphyrin and fecal coproporphyrin, in Groups 2 and 3 as secondary coproporphyrinuria and a symptomatic rise of fecal protoporphyrin level. Latent PCT has been diagnosed in 18 patients (12.7%). In latent PCT the total porphyrin excretion with the urine has been 10-fold lower than in manifest PCT, not exceeding 1000 nmol/day; in has been associated with a relative elevation of uroporphyrin level (up to 42-65% of the total porphyrin content). Increased coproporphyrin concentrations have been recorded, with coproporphyrin share making up over 60% of the total amount. It is possible that the minimal shifts of porphyrin metabolism anticipate the development of the biochemical syndrome of latent PCT. The author suggests criteria for the early diagnosis of the latent forms of the disease. He considers that the examinees should be referred to a group at risk of developing manifest PCT. PMID- 2763713 TI - [Pringle's adenoma of the sebaceous glands combined with vitiligo and logoneurosis]. AB - This combination has been effectively treated with oral undevit, vitamin B15, Quater's mixture, elenium, and external 2% alcohol solution of salicylic acid, fukorcin, 10% streptocide liniment, lorinden C, ftorocort, cryotherapy with liquid nitrogen, electrocoagulation. PMID- 2763714 TI - [Experience in using laser photophoresis in dermatological practice]. AB - A rationale is given for the use of a new physiotherapeutic method for the treatment of dermatologic patients: laser photophoresis. Experiments have demonstrated a better diffusion of the drug during photophoresis than through semipermeable membranes. The method has been employed in therapy of 27 patients with chronic eczemas with ortafen, a new Soviet anti-inflammatory nonsteroid drug. PMID- 2763715 TI - [Significance of toxic metabolites of the fungus Trichothecium roseum Link ex Fr. for viticulture]. AB - The plant-pathogen fungus Trichothecium roseum produces in vitro as well as in vivo the toxic metabolites trichothecin, trichothecolone and rosenonolactone. Trichothecin is cytotoxic and inhibits the alcoholic fermentation. It is not metabolized by yeast during the alcoholic fermentation. All toxins showed a minor biological activity against microorganisms other than yeast. Trichothecin caused a bitter taste in wine at higher toxin concentrations (greater than 5 mg/l). Trichothecin was detected in a few samples of wine of higher quality. PMID- 2763716 TI - [Determination of the endotoxin content of egg products using a miniaturized chromogenic Limulus test]. AB - A chromogenic Limulus amoebocyte lysate assay was applied to monitor endotoxin concentration in egg products. Analysis of differently contaminated whole egg probes revealed a strong correlation of endotoxin concentration to total bacterial count 6 x 10(4) cfu x ng-1, where cfu = colony-forming unit) as well as to number of Enterobacteriaceae (1 ng/7 x 10(2) cfu). Similar relations were also found for egg white and egg yolk probes. A significant influence of heat pretreatment of egg probes (65 degrees C, 60 min) on endotoxin detection could be excluded. Up to a concentration of 10 mg x ml-1 endotoxin-free whole egg material did not interfere with the test system. A miniaturized version of the chromogenic Limulus test, which can be carried out in microtiter plates, is described. PMID- 2763717 TI - Immunocrossreactivity of antisera against grain prolamines of wheat, rye, barley and oats. AB - Prolamines extracted from wheat (gliadin), rye (secalin), barley (hordein) and oats (avenin) were used to raise antibodies in rabbits. The four prolamines were separated by SDS-PAGE and blotted onto nitrocellulose. The immunocrossreactivity of the separated prolamines with the four antisera was studied. The close botanical relationship between wheat and rye, and to a lesser extent barley, is clearly established. The crossreactivity of gliadin, secalin and hordein with anti-avenin serum was found to be weak. In contrast, avenin shows a strong crossreactivity with anti-gliadin serum. PMID- 2763718 TI - Identification of semen in stain by determination of the specific activity of L tartrate-inhibitable acid phosphatase. AB - For identification of semen in stain the specific activity of L-tartrate inhibitable acid phosphatase (ACP) was determined. With each stain extract, both enzyme activity and protein concentration were determined, and the specific activity (enzyme activity/protein concentration) was calculated. Seminal stains showed a value of 23.8 +/- 15.2 (mean +/- SD) IU/mg protein, while vaginal fluid stains showed a value of 0.088 +/- 0.049 IU/mg protein. Stains of other body fluids did not show any L-tartrate-inhibitable ACP activity. Furthermore, only eight of 30 plant juice stains showed any levels of L-tartrate-inhibitable ACP, although all plants tested showed ACP activity. As the present method enables us to analyze forensic samples quantitatively, it seems to be useful for forensic practice. PMID- 2763719 TI - [Comparative measurement of cocaine and its metabolites in blood, cerebrospinal fluid and the brain]. AB - This study investigated the transfer of cocaine and its metabolites from plasma into the cerebrospinal fluid. The concentration of cocaine and its metabolites in plasma and cerebrospinal fluid was determined by radioimmunoassay because this method only, the sum of the drug and metabolites restored. In sheeps a sublethal cocaine hydrochloride dose (2,4 mg/kg b. wt.) was administered intraarterial daily for up to 8 days. In the first hours after administration the concentration of cocaine in cerebrospinal fluid was low. It is supposed that a barrier against the transport of cocaine from blood into cerebrospinal fluid exists. After intrathecal administration a delay of transport could from CSF to blood not be seen. PMID- 2763720 TI - [Value of skull identification as evidence using a superimposed video image technic with reference to individual craniometric differences in the human skull]. AB - The possibility of using the video superimposition technique for the identification of a skull by comparing it with photographs of missing persons is based on the fact that the human skull, unlike any other part of the human skeleton, shows unmistakable individual characteristics. In order to obtain a quantification, the individuality of human skulls is defined in terms of craniometric data and their probability distribution. First calculations based on the coordinates of some important encephalometric points of 52 European skulls suggest that there are individual aspects comparable to those of fingerprints. Under certain conditions, the video superimposition technique can establish very strong evidence for the identity of an unknown skull, provided that it is applied correctly and carefully. PMID- 2763721 TI - [A transition zone phenomenon of the skin in cadavers lying in bath water]. AB - In three cases a phenomenon is reported, seen on the skin of bodies found dead after a longer time of lying in bathtubs filled with water. The sign was parallel to the surface of the water and showed a breadth up to about 1 cm. Contrary to the surrounding skin, the mark was characterized by paleness and clearly les distinct formation of postmortem alterations as put-refaction. Searching for an explanation, temperature measurements were performed in model. The results showed the marginal paleness of the skin to be a thermal phase transition phenomenon. This mark has a forensic message too: it demonstrates a longer remaining of the corpse in the corresponding position, is a statement concerning the high of the water level, and allows a reconstruction of the original situation after manipulation, but is no sign of vital reaction. PMID- 2763722 TI - [The detection of HIV antibodies in blood stains]. AB - Blood samples were collected on cotton wool and stored at +20 degrees C. These samples were tested in an enzyme linked immunosorbent assay and the immunoblotting test. HIV-antibodies could be detected in samples stored up to four month. PMID- 2763723 TI - [Psychogenic disorders in males and females]. AB - The influence of sex difference on symptoms, behavior during illness, the interactional dynamics of conflict, and external society reality is studied here in two random samples of 615 and 739 patients who sought psychotherapeutic treatment. The comparison shows that greater importance is attached to interpersonal relations and social reality (early marriage with child, separation, divorce) as well as to coming to terms with these things emotionally among women, who were in the majority in all clinical studies. Women often fall ill because of difficult relationships from which they cannot free themselves inwardly and toward which the remain oriented with disappointment and complaints, even after actual separation. A stronger need for close personal relationships leads them (often against the background of a conflict-ridden parental family) to an early partnership that is often cemented by pregnancy, only to be dissolved later by divorce. The counter-image of such relational problems is more often found among male patients, who show difficulties in limiting their own autonomy and in establishing dependable emotional ties and social relations. The relationships between the different realities of the two sexes, the structure of their needs and the resulting predilection to illness are examined in detail. PMID- 2763724 TI - [A new concept of psychosomatic research exemplified by premature labor]. AB - One of the most serious problems of psychosomatic research is the adequate choice of the method applied to clinical questions. In the past empirical investigations have been based upon univariate and moreover linear correlations. In this study a multivariate nonlinear concept was developed which was generated in a first trial proven and confirmed prospectively in a second one using two sorts of mathematical analyses. The first included 35 patients with premature labour and 25 healthy pregnant women as controls. The latter was conducted with 238 patients being recruited in the first trimester of pregnancy, 30 of whom developed premature labour in the course of the study. Using a questionnaire consisting of the main aetiological variables identified in the basic investigation and using the statistical procedures mentioned above the occurrence of premature labour was predicted in more than 90%. Only one patient who was not suspected to develop premature uterine activity was not classified correctly. Besides clinical usefulness the model of research presented provides evidence for the most important aetiologic conditions of the disease as far as psychosocial factors are concerned and offers a new approach to quantifying research including somatic and non-somatic variables. PMID- 2763725 TI - [Widowhood and grief reaction in Brazil. A pilot study]. AB - Following a short introduction to transcultural research on widow(er)hood and mourning, the author reports on a Brazilian pilot study in which the reactions to mourning, social relationships, psychosomatic complaints, the tendency toward depression and suicide, etc., are studied in 26 Brazilians who have lost their partners. The results here, as in earlier studies by the same author, show that this group is distinctly "at risk". Finally, an "impact system of widow(er)hood" is developed that establishes the relationship between economic, sociocultural, psychological and somatic factors and the decisive experience of the death of a partner. PMID- 2763726 TI - [Aspects of roentgen ray burden in endourologic surgery]. AB - In 1987 a total of 322 endourological procedures with punctual use of x-rays were performed at our ultrasonographic-radiological working table. The personal dosimetric supervision of 4 surgeons who performed the interventions was analyzed in dependence of our local dosimetric realities. The radiation exposure of the surgeon and the possibilities of supervision and reduction of the exposition are presented. PMID- 2763727 TI - [Non-medicamentous prevention of calcium oxalate urinary calculi]. AB - In a prospective study the efficacy and actual outcome of non-medicamentous preventive measures with metabolically unremarkable calcium-oxalate urolithiasis were investigated in 49 idiopathic calcium-oxalate stone formers. Overnight urine excretion was not increased. The mean concentration and excretion of essential parameters in terms of lithogenesis were hardly influenced. The obvious reduction of the pelvi-calyceal area in both lithogenous and non-lithogenous kidneys after one year of calculus prophylaxis was striking. By means of a discriminant function including morphological parameters and high-molecular urine components some developments may be verified in the discriminant space suggesting a good prophylactic result in many patients. PMID- 2763728 TI - [Priapism as a complication following diagnostic papaverine test]. AB - In 5 out of 84 patients suffering from impotence a prolonged erection was observed after intracavernous papaverine injection. Treatment consisted of puncture of the cavernous body, blood evacuation and intracavernous adrenaline injection. In 4 patients erectile function could be preserved and in the fifth patient a penile prosthesis has been implanted. PMID- 2763729 TI - [Resection of the deep dorsal penile vein in the treatment of vascular-induced impotence]. AB - In 10 patients aged from 26 to 58 years suffering from impotence caused by abnormal venous outflow a resection of the deep dorsal vein of the penis was performed. In all patients an improvement of the sexual function was observed. PMID- 2763730 TI - [Effect of allotransplantation of the testis on several metabolism parameters in primary hypogonadism]. AB - The allotransplantation of a testis with immunological control and immunosuppressive treatment may ensure a quite satisfactory hormone compensation and acceptable sexual rehabilitation of patients suffering from primary hypogonadism. These patients show characteristic biochemical changes: reduction of testosterone, iron and calcium blood concentration and carbonic anhydrase activity, but increase of FSH, LH and oxyproline concentration, whereas content of copper and zinc and activity of transferrine and ceruloplasmin are normal. In cases of successful testicular allotransplantation normalization of the above mentioned biochemical parameters occur together with an improvement of blood hormone balance (increased level of testosterone and decreased FSH and LH levels). PMID- 2763732 TI - [20% of Latex gloves were defective after use]. PMID- 2763731 TI - [Contact allergy from materials in operating and experimental gloves]. PMID- 2763733 TI - [Emergency case series. 1. Pathophysiology: development mechanisms vital in threatening cases]. PMID- 2763734 TI - [Emergency case series. 2. Symptoms and diagnosis]. PMID- 2763735 TI - [Nursing bottle syndrome in small children]. PMID- 2763736 TI - [Emergency case series. 3. Rescue and care]. PMID- 2763737 TI - [Emergency case series. 4. Reestablishment of breathing]. PMID- 2763738 TI - [Results of surgery of the hemorrhaging stomach and duodenal ulcer--a 10-year retrospective study]. AB - Operations were performed on 131 patients for haemorrhagic peptic ulcer at Wenckebach Hospital, between 1977 and 1986. Roughly two thirds of all patients had never had ulcer before. Persistent haemorrhage was recorded from about 20 per cent of these cases by emergency gastroscopy. Immediate surgical action had to be taken on 23.7 per cent. Interval interventions were possible for 28.2 per cent, while almost 50 per cent had to be laparotomised for early recurrent bleeding. Mortality in the wake of immediate emergency operations and surgery for recurrent bleeding was nearly twice as high as that in the context of interval interventions. Resection was performed on 70 per cent, haemostasis only on 26 per cent, and additional vagotomy on 14 per cent. Overall mortality amounted to 27.5 per cent including 36.6 per cent for women and 22.8 per cent for men. Ulcer localisation had no impact on mortality. The highest mortality rate, 38.2 per cent, was recorded from patients on whom only haemostasis had been performed, while 16.7 per cent were recorded from those to whom additional vagotomy had been applied. Lethality in the context of resection amounted to 25.6 per cent. Twenty three patients had to be relaparotomised (17.6 per cent), which pushed up the mortality rate to 43.5 per cent. PMID- 2763740 TI - [A simple point score for definition of the risk of postoperative complications]. AB - During a 5-year-period we recorded prospectively 5,823 patients who had undergone general surgery and documented the postoperative complications as wound infection, pneumonia, reoperations and death. A score including all these complications was developed to evaluate the risk of an operation more exactly than using the wound infection rate alone. This method seems to provide a continuous monitoring and the comparison of the complication risks of certain operations within a quality assurance program. For gastric and colon surgery we found a correlation between postoperative antibiotic use and score, but not between score and postoperative hospitalization time. PMID- 2763739 TI - [Perforation of gastroduodenal ulcer. Risk factors and choice of procedure]. AB - The well known surgical risk factors, such as age, time of perforation as well as size and localisation of necrosis, were confirmed in retrospective and prospective analyses of perforation of gastroduodenal ulcers (n = 504). Incidence was unchanged in the two different time-related groups, with 3.2 or 3.7 cases in one month. There was a clear-cut need for excision of the ulcer or necrotic margin. Perforation was attributable to malignant tumours in 2.1 per cent of the cases. The authors have definitely adopted the concept of earlier primary surgery (23 per cent of all cases, as compared to 10.4 per cent before). The risk associated to it was found to be lower than linked to palliative operations. The lethality rate was as low as 7.6 per cent, once due consideration was given to the above risk factors for adequate choice of surgical methods. Particular attention was given to ulcer localisation and clinical course. Hence, lethality has clearly dropped below earlier data. PMID- 2763741 TI - [Idiopathic retroperitoneal fibrosis. Differential diagnosis of abdominal colic]. PMID- 2763742 TI - [Duodeno-cephalopancreatectomy with preservation of the pylorus]. PMID- 2763743 TI - [Conservative management versus osteosynthesis in the treatment of tibial shaft fractures]. AB - Treatment was rendered to 1,693 patients with 1,728 tibial shaft fractures at the University Hospital of Granada, Spain, between 1971 and 1987. After 139 patients had died, 1,554 patients with 1,571 tibial fractures were actually left for treatment. Forms of fractures were subdivided according to Johner and Wruhs. Conservative treatment, according to Bohler-Sarmiento, was applied to 589 cases, while surgery was performed on 982. Different ways of osteosynthesis were used, including tibial plates (n = 284), intramedullary nailing according to Kuntscher (n = 308), and lock nailing according to Klemm (n = 336). Other methods of osteosynthesis, such as elastic nailing according to Ender (n = 36) and external fixation (n = 18) were rarely used and, therefore, were not statistically evaluated. --The author's result have provided evidence to the effect that conservative treatment according to Bohler (and modified by Sarmiento) worked well, with only 11.4 per cent complications in cases of closed and open fractures. However, only moderate results were obtained from follow-up checks, since compensation was usually not possible for the majority of primary lateral fragment displacements, so that for consolidation limbs had to be kept immobilised for much longer periods of time, and this entailed poor functional results. --Very poor results were obtained from plate osteosynthesis, in the context of surgical treatment, with the rate of complications being as high as 34.9 per cent. Better results were achieved by intramedullary nailing, with complications in 14.9 per cent of all cases. Yet, it is the author's view that lock nailing has become the established optional method. PMID- 2763745 TI - [Valgus osteotomies preceding total endoprosthesis]. AB - A progress report is presented in this paper on 172 follow-up checks of cases with valgus osteotomy of the hip. Patients aged between 25 and 45 years with advanced coxarthrosis and severe deformations of the hip joint were predominant on the list. Valgus osteotomy, using surgical techniques according to Pauwels and Bombelli, proved successful under these conditions in 85 per cent of all cases. Those good results were reflected in lasting reduction of pain and maintenance of adequate articular functionality. Bridging of the time gap up to endoprosthetic replacement at age levels of 50 or 60 years has been considered another benefit of the method. There were no severe complications. The failure rate was clearly increased among patients with overweight. PMID- 2763744 TI - [Treatment of the patient with multiple trauma and prognostic assessment of the follow-up course]. AB - After a short view of literature demands of treatment of multiple seriously injured patients, some ideas to optimize their attending are discussed. A practicable method of prognostication for critical injured patients is presented in 40 cases. It could be reached a real rating, nobody who survived was classified in the group with unfavourable prognosis. Existing problems of gradation are explained. PMID- 2763746 TI - [Concept of functional therapy exemplified by fresh closed humeral fracture]. AB - The method of functional treatment of closed humerus fractures has gained an established position of success. A good outcome has proved to depend not only on correct indication, but it also depends decisively on physiotherapeutic exercises. The challenge to the physiotherapist has grown, and a standardised concept is now required. The authors' own approach is described in some detail. Excellent success was obtained from 80 in 82 cases, with average periods of treatment being shortened by something between two and four weeks. PMID- 2763747 TI - [Healing without complications of a traumatic hip dislocation with epiphyseolysis]. PMID- 2763748 TI - [Myogenic contracture of the knee joint]. PMID- 2763749 TI - [The behavior of cytoplasmic progesterone receptors in the cycling endometrium and the effect of hormonal contraceptives]. AB - Concentration of cytosolic progesterone receptor (PR) was measured by means of an exchange procedure in the endometria of 80 women. Investigations carried out in 35 normal menstruating females showed a gradual increase of PR during the preovulatory and immediate postovulatory phases, decreasing to the lowest level at the end of the cycle. Measurements in endometrial samples obtained from women on combined hormonal contraceptives demonstrated a significant decline of PR concentration in the periovulatory phase resulting in a flattening of the sinusoid PR concentration curve. The stronger down regulation effect of the preparation containing 1.5 mg of dienogest is due to the higher progestogenic efficacy of dienogest in the respective dosage. We consider the down regulation phenomenon a useful means among others to characterize the progestogenic potency of a steroid. PMID- 2763750 TI - [Behavior of parameters of liver metabolism in intermediate-term use of the gestagen dienogest in the treatment of endometriosis]. AB - The effects of the progestational compound dienogest (17 alpha-cyanomethyl-17 beta-hydroxy-estra-4,9-dien-3-one) on liver metabolism have been studied in 101 otherwise healthy women with endoscopically proven endometriosis. The women aged 17 to 45 years were treated with 2 mg dienogest in tablet form daily for 24 weeks. Aspartate amino transferase (ASAT), alanine amino transferase (ALAT), gamma glutamate transferase (GGT), alkaline phosphatase (AP), lactate dehydrogenase (LDH), and total bilirubin (BILI) were determined in serum before and after 1, 3 and 6 months use of the progestin. During the therapy period no deviations from the normal ranges were found. There was a slight significant decrease of ASAT and ALAT and a slight significant increase of LDH and BILI (p less than 0.05) remaining within the normal laboratory values. Since no undesirable metabolic side-effects have so far been observed with dienogest, it may be considered an effective new alternative treatment for endometriosis. PMID- 2763752 TI - [Urinary incontinence in the female over 60 years of age--urodynamic findings]. AB - A group of 20 urinary continent postmenopausal women and two stress incontinent groups in the age of 60-69 and 70-79 years have been examined concerning standardized conditions without and with stress. The measurements using the pneumatic-hydraulic pump perfusion were recorded under standardized conditions. The whole pressure profile without stress decreased with increasing age and with stress incontinence. The maximum urethra closure pressure has been displaced in the distal part of the urethra. The stress profile demonstrated a shortening of the continence zone, a clear decrease of the urethra closure pressure and a bad pressure transmission in the whole urethra, especially in its distal part. These fluctuations make us expect, that there are only a few promising possibilities of conservative treatment in stress incontinent postmenopausal women over 70 years. PMID- 2763751 TI - [Incidence and significance of humoral antibodies in females with recurrent spontaneous abortions]. AB - Serum samples from 70 patients with two or more early spontaneous abortions and, for comparison, sera from 20 healthy and fertile women were assayed by indirect immunofluorescence for the presence of antibodies to sperms and genital organ antigens and for non-organ specific and organ specific antibodies. All sera were tested for thyreoglobulin antibodies by hemagglutination. The frequency of sperm antibodies and autoantibodies was significantly higher in patients with recurrent abortions than in the control group. There was no relation between the type or titer of antibodies and the clinical data of the patients. PMID- 2763753 TI - Serum levels of some fat metabolism parameters in women with uterine leiomyoma. AB - Serum levels of total cholesterol (TC), HDL-cholesterol (HDL-C), triglycerides (TG) and, 17 beta-estradiol (E2), as well as the values of LDL1-cholesterol (LDL1 C), HDL-C/TC, and HDL-C/LDL1-C were determined in 72 patients with uterine leiomyoma and 45 healthy women aged 34-54. The subjects were divided into three groups according to age and menstrual status (B1I-III). The patients were further subdivided into groups N and P, depending on the leiomyoma size, in order to assess the intensity of the pathogenic process. The values of cholesterol parameters (CT, HDL-C) showed a statistically significant increase in the youngest patients. The study also confirmed the opinion that hyperestrogenism could play a role in the etiopathogenesis of uterine leiomyoma. PMID- 2763754 TI - Evaluation of the Staph-Zym-system for identification of Staphylococcus hyicus and Staphylococcus intermedius. AB - The Staph-Zym system was evaluated as a means for identifying cultures of Staphylococcus hyicus isolated from pigs and bovines and cultures of Staphylococcus intermedius isolated from canines. The selected cultures had been identified by conventional methods. The Staph-Zym system correctly identified all 52 S. hyicus and all 33 S. intermedius. It is concluded that the Staph-Zym system is a practical and reliable test for identifying mostly animal pathogenic S. hyicus and S. intermedius, and might possibly be useful for veterinary microbiologists. PMID- 2763755 TI - Granulocyte isolation from whole blood of goat, sheep, cattle, horse, dog, pig, and man. AB - A simple two step procedure for the isolation of caprine, ovine, bovine, equine, canine, porcine and human peripheral blood granulocytes is described. After enrichment of granulocytes by centrifugation, contaminating erythrocytes are lysed hypotonically. Recovery, purity, and viability of the granulocyte suspensions are determined. FACScan analysis of the cell suspensions measuring cellular size by forward and sideward light scatter is compared with the corresponding analysis of whole blood leukocytes. Constituencies of the isolated cell suspensions and loss of granulocyte subpopulations through isolation procedure is discussed with regard to granulocyte function assays. PMID- 2763756 TI - Antigenic relationship between the dermonecrotic toxins produced by Pasteurella multocida type D and type A. AB - Crude dermonecrotic toxins (DNT) were prepared from Pasteurella multocida (P.m.) type D and type A strains isolated from pigs with atrophic rhinitis. Rabbits were immunized with the DNT of P.m. type D. This serum neutralized the DNT of P.m. type A to the same degree as the homologous one both in vitro (cytopathogenicity for tissue culture cells) and in vivo (mouse lethality and dermonecrotic activity in guinea pig). PMID- 2763757 TI - Amblyomma variegatum ticks and the occurrence of bovine streptothricosis in Antigua. AB - The association between the occurrence of Amblyomma variegatum ticks and streptothricosis was studied on the Caribbean island of Antigua. The prevalence of streptothricosis was higher on animals having A. variegatum ticks compared to that of animals not infested with A. variegatum ticks. There was a steady increase in the prevalence of severe lesions as the level of infestation with adult A. variegatum ticks increased. However the distribution of skin lesions could not be related to the predilection feeding sites of adult A. variegatum ticks. PMID- 2763758 TI - Detection of a baculovirus in the tiger prawn Penaeus monodon. AB - In postlarval Penaeus monodon from a hatchery in Asia a baculovirus was detected in the epithelial cells of the hepatopancreas by electron microscopy. The baculovirus was identified as the Monodon baculovirus (MBV). PMID- 2763759 TI - [The effect of ivermectin on reactivated somatic larva of Ancylostoma caninum Ercolani 1859 (Ancylostomidae) in the pregnant dog]. AB - It was evaluated by means of a controlled test to what extent reactivated larvae of Ancylostoma caninum were influenced by single or double treatment with ivermectin. The investigations were done with a total of ten experimentally infected bitches. The single treatment of dams two to ten days ante partum with 0.5 mg or 1 mg ivermectin per kg bodyweight reduced the wormburden of their puppies on an average by 96.6% and 98.5%, respectively. The double treatment with 0.5 mg/kg bodyweight ante and post partum each with an interval of ten days completely prevented lactogenic infections with Ancylostoma caninum. Following a single application of 0.5 mg ivermectin per kg bodyweight the excretion of larvae was markedly delayed and remained on a low level. In addition the infections of the puppies of single treated dams became patent on an average 9.5 and 14.5 days later than the controls. In the bitches no side-effects, neither local nor general, were seen after the treatment with ivermectin. All forty puppies of the treated bitches were born without visible damages. PMID- 2763760 TI - [Comparative studies of paramyxovirus isolates from wild birds]. AB - As a result of a surveillance programme in North-Germany, paramyxovirus-isolates of serogroup 1 with different pathogenicity were isolated from different species of feral birds (Black-headed gull, mallard, tawny owl, tree sparrow, mute swan). In chick embryo fibroblast monolayers these isolates produced plaques exhibiting different plaque morphology. After cloning the isolates, further physicochemical, serological and pathogenicity testings were performed. On the basis of mean death time and intracerebral pathogenicity index, two of the isolates were found to be avirulent (lentogenic), whereas the others proved to be virulent (velogenic). SDS Polyacrylamide-gel-electrophoresis showed polypeptide patterns similar to that of the PMV-1 reference strains. Summarizing all relevant findings of these investigations under consideration of the suggestions for the virological description of avian PMV (Alexander, 1987; Alexander et al., 1987; Who-Expert Committee, 1980), including the recently established serotyping by means of monoclonal antibodies, the following designations of the PMV isolates tested herein are proposed: 1. PMV-1/black-headed gull/Germany/SSP-233/83, lentogenic NDV, monoclonal antibody group G 2. PMV-1/mallard/Germany/SSP-284/83, lentogenic NDV, monoclonal antibody group H 3. PMV-1/tawny owl/Germany/SSP-262/84, velogenic NDV, monoclonal antibody group B 4. PMV-1/tree sparrow nestling/Germany/SSP 352/84, velogenic NDV, monoclonal antibody group B 5. PMV-1/mute swan/Germany/SSP 204/85, velogenic NDV, monoclonal antibody group B. PMID- 2763761 TI - [Sensitivity of Argas (Persicargas) walkerae to optic irradiation and localization and organization of light perceiving or permeability areas of the integument]. AB - Considering a negative phototaxis as a stimulus reaction to narrow - or wideband monochromatic radiance of varying ranges of wavelengths and different irradiance it was established that both unfed and engorged I. and II. nymphs, as well as male and female adult ticks of Argas (Persicargas) walkerae, responded almost to the whole spectrum of the investigated wavelengths from 246-809nm, however, depending on the irradiance. Peaks of sensitivity with 50-100% of phototactically negative reacting ticks, however, were only registered in the range of 415 nm to 604 nm at moderate and high irradiance. Interstadially unfed and fed ticks showed no or only slight differences of reaction. Engorged ticks responded analogously to the unfed ticks but usually with smaller percentages. The lower readiness of reaction of the engorged stages was also established by the comparison of the temporal threshold values, which were ca. 1 min shorter for unfed ticks. Ablation tests for localizing light perception in or through the integument by means of covering the integumental areas in various combinations and simultaneously confronting them with the highly sensitive range of wavelengths from 446-568 nm revealed that unfed female adults probably perceived the light stimuli primarily through the dorsum. Covering the entire dorsum with white or black paint caused a phototactically negative response in 10-30% of the ticks. Untreated control ticks reacted to the light stimuli with a proportion of 50-75%. Scanning electron microscopical examinations of the dorsum, ventral surface and supracoxal folds of unfed female ticks gave no evidence of morphologically recognizable, superficially organized or integument-integrated photoreceptor areas or optical organs similar to lenses. PMID- 2763762 TI - Necrotizing pneumonia in cats associated with infection by EF-4a bacteria. AB - Two cases of severe necrotizing pneumonia in cats caused by Gram-negative bacteria called "Eugonic Fermenter 4a" (EF-4a) are described. The gross lesions resembled to those commonly seen with lung tuberculosis in other animal species. PMID- 2763763 TI - Seroepidemiological survey on Rift Valley fever in Zambia. AB - This study was carried out to define the role of cattle as an amplifier of Rift Valley fever. Three areas of different density of cattle population were surveyed. Cattle do not seem to play a significant role as an amplifier of the virus in human beings. PMID- 2763764 TI - [Experiments on the excitability of the cultured embryonic epidermis cells of Cynops orientalis]. AB - It has been reported that in Cynops orientalis the cells in the atypical epidermis resulted from isolation of the ectoderm from the early gastrula and cultured in vitro possesses very low excitability. The great majority of the explants didn't display action potential (AP) with electric stimulus up to 6 V duration 1 ms). If, however, the epidermis was taken from the flank region of a neurula with the underlying mesoderm, in such explant the epidermis cells became excitable at a lower threshold of stimulus. The mesoderm seemed to exert some influence upon the epidermis. In order to study whether tissues other than mesoderm possess similar effect on the excitability of epidermis cells, different combinations of explants were made with the experimental embryological technique and their excitability was examined electrophysiologically. In all experiments the explants were stimulated extracellularly and the action potential was recorded intracellularly. The specimens were stimulated with electric stimulus at 6 V at first, and, if they displayed AP the strength was lowered to determine the threshold of stimulus to evoke AP. The duration of stimulus was fixed at 1 ms. For the control of all series, the ectoderm or epidermis was isolated at the same stage and cultured for the same length of period as the experimental explants but without any treatment. 1). The effect of calf serum. In this group the effect of calf serum was examined and following series were carried out: a) Gastrula ectoderm cultured in Holtfreter solution containing 10% calf serum; b) calf serum + agar as implant: calf serum was mixed with agar (1:1) and cut into small pieces when cooled, and the serum + agar pieces were wrapped with ectoderm; c) heated serum + agar, heated serum was mixed 1:1 with agar and the small pieces were wrapped with ectoderm. In all the experiments the excitability of the epidermis cells was raised more or less but the agar pieces containing fresh serum seemed to be more effective, perhaps due to the higher concentration of the serum and the intimate contact with the epidermis cells (Tab. 1) In the series with serum + agar as implant and in the series with heated serum + agar as implant, it occurred frequently that during cultivation the implants will be extruded and after the extrusion of the implant the remaining epidermis became less sensitive to stimulation.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2763765 TI - An extensive increase of junctional communication capacity in endoderm development of the Xenopus embryo. AB - The present result shows that in blastula and gastrula stages although endoderm cells of the Xenopus embryo may be electrically coupled with each other, most of them can not detectably transfer the 376 dalton molecular weight tracer, the carboxyfluorescein, to their contiguous neighbor cells. They become capable of such junctional dye transfer at the end of gastrulation. This transition reflects temporally well ordered development of junctional communication capacity from low to high level, which may be related to the developmental program of endodermal cellular differentiation. The time course of this transition provides a measure for study of the effects of various factors on the development of junctional communication capacity in this embryo. PMID- 2763767 TI - [A study of lymphocyte subsets in human normal tonsil and lymph node]. AB - A series of T and B lymphocyte specific monoclonal antibodies was used to determine the localization of lymphocyte subpopulation in frozen and paraffin tissue sections of human normal tonsil and lymph node by means of immunocytochemical technique. In the paracortical and interfollicular area of tonsil and lymph node, most lymphocytes reacted with Leu 1, Leu 3 a, Leu 4 and OKT4. The numbers of Leu 2 a and OKT8 positive cells were rare in tissue. These cells were not only limited in paracortical area, they also appeared in considerable numbers in medullary cords of lymph nodes. Leu 2 a and OKT 8 positive cells decreased with prominent follicular hyperplasia of tonsils. In addition, substantial leu 3 a and Leu 4 cells were found in the germinal centers. This finding supports the importance of these lymphocyte subsets in regulation of human immune response. In the mantle zone of secondary follicles, the majority of lymphocytes were positive for OKB 2 and BA 1, whereas, the IgM positive cells were predominately observed in the cytoplasma and extracellular substance of B lymphocytes in the germinal centers, but the lymphocytes bearing sIgM were rarely observed. In the mantle zone, the IgM were frequently found on the surface of membrane of small lymphocytes, however, the staining intensity was much than that in the germinal centers. PMID- 2763766 TI - [Studies on cell surface fibronectin of transformed Syrian hamster lung cells induced by butyric acid]. AB - In this paper, Fn was analysed qualitatively and quantitatively in three Syrian hamster cell lines, ie, nontransformed baby hamster lung fibroblasts cell line (BHL), a transformed cell line (BHLB4) and a butyric acid-induced phenotypically reversed cell line (ButB4) respectively. Fn was visualized on cell surface by means of indirect immunofluorescence technique. Immunofluorescence of Fn on the surface of BHL was bright with a stripe-like distribution, while that on the surface of BHLB4 was very dim or dispersed. On ButB4 cell surface, the intensity and distribution of immunofluorescence was similar to that on BHLB4 cells. Fn was isolated by affinity chromatography from the cell surface of the three cell lines. Its molecular weight was 250 kDa on SDS-polyacrylamide electrophoresis. The quantity of Fn isolated from surface of ButB4 was a bit lower than that from BHL, but was much higher than that from BHLB4. The result offers us a useful criterion for transformation and reverse transformation. PMID- 2763768 TI - Resection arthroplasty of the rheumatoid forefoot. AB - After discussing the term of resection arthroplasty of the rheumatoid forefoot, the problem of indications and contraindications for surgery is dealt with. Experience obtained by operations is presented together with the recommended operative technique. PMID- 2763769 TI - Do steroid hormones influence the concentration of PGF2 alpha receptors of the uterine muscles? AB - Uterine contractions are largely regulated by steroid hormones. The receptors which are important from the point of view of uterine contractions (such as oxytocin, alpha- and beta-adrenergics) are also influenced by steroid hormones. In this paper the regulation by steroids of PG2 alpha receptors was studied in vivo. Due to ovariectomy, the concentration of PG2 alpha decreased significantly in rats without a change in affinity. As a result of in vivo progesterone treatment, the PG2 alpha receptor concentration decreased to its third as compared to that of the ovariectomized control also without a change in affinity. PG2 alpha receptor concentration was not changed by in vivo estrogen treatment in comparison to that of the ovariectomized control but a high-affinity, low capacity binding-site appeared. Our experiments revealed the in vivo regulation by steroid hormones of the PGW2 alpha receptors of the rat myometrium. PMID- 2763770 TI - Management and care of the precanceroses of the stomach in the 11-year material of our clinic. AB - The present paper surveys over the past 11 years the cases of the endoscopic laboratory of our clinic which, according to criteria accepted all over the world, were considered as precancerous states of the stomach. According to the authors' experience, an advance in the management of malignant diseases can only be expected by referring to operation the cases in their early stage, if the examination and regular control of the patients are carried out with the predisposing factors being considered by a team involving the surgeon, endoscopist and pathologist. PMID- 2763771 TI - Clinicopathological problems of the local tissue effect of copper-containing IUDs. II. Electron-microscopic study of the endometrial scraping. AB - For assessment of the tissue effect of copper-containing IUDs routine electron microscopic study was made of the endometrial scrapings. It was established that there was evidence of severe, degenerative changes not only on the IUD but also in the endometrial cells and, occasionally, also in the muscle layer of the uterus. These were characterized by pyknosis of the endometrial cells and alterations of the intracellular components. In this material of the study of 22 endometrial specimens obtained from beside IUDs, relatively few microtubuli were found in the endometrial cells. The changes seemed to be too severe to be ascribed to a sterile inflammation. The sporadic changes in the endothelial cells were found to be non-specific. PMID- 2763772 TI - Clinicopathological problems of the local tissue effect of IUDs containing copper. III. Cytochemical study of the endometrial scrapings. AB - The clinicopathological problems of the tissue effect of copper-containing IUDs are discussed. In the third part of their series, authors present the cytochemical analysis of the endometrial scrapings. For the investigations, dithizone, salicylaldoxime, rubeanic acid as well as dimethylglyoxime were used. The reaction precipitate, the copper dithizone complex, could be visualized partly intracellularly and intramitochondrially and partly interstitially. The technical problems of copper demonstration are also dealt with. PMID- 2763773 TI - Longitudinal and vertical ultrastructural lesion of crural muscle in post thrombotic syndrome. AB - The vertical and longitudinal ultrastructural changes of the crural muscle (triceps surae) were studied in a selected patient material of 18 patients suffering from post-thrombotic syndrome. The transmission and scanning electron microscopic method helped in revealing that the damage had affected the contractile system, the mitochondria and the endoplasmic reticulum and in addition marked degenerative phenomena occurred. It was shown that vertically the impairments of the fine structure were localized in foci and involved the muscle layers to the same extent. Longitudinally--distally--the muscle changes displayed an increasingly aggravating diffuse appearance. Of the several factors responsible for the development of the pathological ultrastructural picture, tissue hypoxia and metabolic disorder, as well as a decreased microcirculation (hypoperfusion) and chronic inactivity are to be emphasized. PMID- 2763774 TI - Aimed application of antibiotics in treating hand infections. AB - Surgical exploration is of prime importance in treating hand infections. In addition, it is essential to apply up-to-date and adequate antibiotic treatment. Authors employed antibiotics during the treatment of hand infections of 65 various aetiologies and types by considering the antibiotic sensitivity spectrum of the most frequent pathogens as also the effective concentration of the antibiotic acting in the inflammatory focus. For assessing effective antibiotic concentrations, samples were collected during exploration from the inflammatory tissues, and based on their assessments, it was pointed out that an adequate inhibitory antibiotic concentration cannot be reached by each antibiotic by applying it in the usual dose and way. The use of certain antibiotics is recommended in view of the most frequent pathogens of hand infections, of the spectrum of the antibiotic selected by the authors as well as in that of the measured tissue antibiotic concentrations in the dosage used by them. The effective application as well as dosage are also published. Regarding that, in practice, antibiotic treatment should be started according to the nature of the disease without knowing the spectrum of resistance and the pathogen, it is considered important for them to select initially, beside the surgical treatment, an antibiotic which is probably effective and is capable of entering in a sufficient amount the focus of inflammation. PMID- 2763775 TI - Multiple primary malignant tumours of patients treated for colorectal carcinoma (clinical analysis of 61 cases). AB - Multiple primary malignant tumours were found by the authors in a population of 543 patients treated during 10 years for colorectal cancer at an incidence rate of 11.2%. Thirty-nine of 69 patients had tumours of metachronous and 22 of synchronous appearance. Of patients treated for multiple tumours, the ratio of women (p less than 0.1) was much higher, the average age was much (2 years) higher and occurrence of malignant disease in the family was more frequent than in those with a solitary tumour. Based on the high incidence reported on in the literature and in their own material, they draw attention to the practical, clinical aspects of the problem. The difficulties in diagnosing multiple colonic tumours are described in detail, pointing out the importance and possibility of pre- and intra-operative examinations aiming at completeness. Based on survival data, it is stated that multiple malignancies do not by all means imply incurability. An improvement of therapeutic results is expected, beside the improvement of surgical results, of the introduction of up-to-date examination methods, of the care and continuous follow-up of the patients at risk. PMID- 2763776 TI - A simple method for intraoperative autotransfusion in cardiac surgery. AB - Authors present a simple, safe and inexpensive method of intraoperative autotransfusion (ATF) for open-heart surgery. A brief comparison is given with other techniques already in use. PMID- 2763777 TI - The endoscopic treatment of choledocholithiasis. PMID- 2763778 TI - [Epidemiological aspects of Campylobacter infections in Belgium]. AB - In the context of a surveillance programme for infectious diseases in Belgium, a network of microbiological laboratories, since February 1983, weekly registers the isolation of a number of pathogenic agents, among which Campylobacter. Some epidemiological characteristics of Campylobacter in Belgium are discussed. Between 54 and 58% of the isolations are reported from males. About 50% of the cases are observed in children under 5 years of age. The mean weekly number of isolations per laboratory is rising in May and remains high until October November. PMID- 2763779 TI - Blood viscosity parameters in coronary heart disease: effect of fish oil supplementation. AB - We have evaluated blood viscosity parameters in 20 men suffering from coronary heart disease (CHD) and in 15 control subjects. Whole blood viscosity at a standardized haematocrit of 45% was significantly increased in the CHD-patients, both at low (p less than 0.001) and high (p less than 0.05) shear rate. The increased whole blood viscosity in these patients was explained by an increased plasma viscosity (p less than 0.01), while the erythrocyte suspension viscosity values at a standardized haematocrit of 70%, reflecting erythrocyte deformability, were within the normal range. We have studied the effects of a daily supplementation of 1.5 g omega-3 polyunsaturated fatty acids on blood viscosity in the CHD patients. After 6 weeks of treatment whole blood viscosity, at low and high shear rate, and plasma viscosity were significantly improved (all p less than 0.05), although not normalized. There was no effect of the fish oil on erythrocyte deformability. PMID- 2763780 TI - Primary sclerosing cholangitis and idiopathic pulmonary fibrosis: a case report. AB - Primary sclerosing cholangitis (PSC) and idiopathic pulmonary fibrosis (IPF) were each separately described in association with a variety of chronic idiopathic inflammatory diseases such as retroperitoneal fibrosis, Sicca complex or Riedel's thyroiditis. We report a case which may be the first description of the association between PSC and IPF. The physiopathogenic implications of such an association are discussed. PMID- 2763781 TI - [Endoscopic sphincterotomy]. AB - The last 105 endoscopic sphincterotomies performed between 1983 and 1987 are evaluated and compared with the recent data of the literature. The sphincterotomy has been successful in 98 cases (93%). The indications were: 95 cases of common bile duct stones and 10 inflammatory stenoses of the duodenal papilla. The stones have been removed in all cases of sphincterotomy for choledocholithiasis (100% of the successful sphincterotomies, 93% of all attempts). The morbidity rate was 5%. There has been no need for emergency intervention. Mortality was zero. In order to obtain high success rates with endoscopic sphincterotomies and removal of stones with minimal morbidity and mortality, the procedure should be performed by an experienced operator who avoids precutting in case of difficult insertion and who makes calibrated incisions related to the volume of the stones (not larger than 2 cm). Endoscopic sphincterotomy is a safe method of treatment for choledocholithiasis and papillary stenosis. It carries a lower morbidity and mortality than surgery. PMID- 2763782 TI - [Essential thrombocytosis]. AB - Essential thrombocythemia (ET) belongs to the group of clonal myeloproliferative disorders such as polycythemia vera (PV), chronic myelogenous leukemia (CML), and idiopathic myelofibrosis (MF). This rare disorder, characterized by an important thrombocytosis, includes a mucocutaneous hemorrhagic diathesis and thromboembolic events. Neurologic manifestations are frequent in ET and are due to obstruction of the cerebral microvasculature. Both thrombocytosis and platelet dysfunction can be responsible for the thrombo-hemorrhagic phenomena in ET. First symptoms of ET in our patient was thrombosis of the vertebral artery with a secondary embolic event in the thalamus region although the platelet count was below 600.10(9)/l, the classic diagnostic limit for ET. These data strongly suggest that qualitative platelet abnormalities rather than thrombocytosis are the main cause for thrombo embolic events in ET. PMID- 2763783 TI - Inherited factor XIII deficiency. AB - A new observation of inherited factor XIII deficiency is described. The patient had presented in the past with an umbilical haemorrhage, a cerebral haemorrhage, multiple haematomas with delayed onset after minimal trauma, and episodes of spontaneous haemarthrosis. The biological diagnosis was made at the age of 7 years. The child had undetectable transamidating activity and factor XIII a chains, while the level of b chains was reduced. The values observed in the parents were intermediate between those of the patient and those of normal plasma. Heated factor VIII concentrates were found to contain only low amounts of factor XIII, and were thus unsuitable for the prophylactic therapy of this rare disease. The patient was successfully treated with monthly injections of a factor XIII concentrate. PMID- 2763784 TI - Thionamides and iodide in iodine-induced thyrotoxicosis. PMID- 2763785 TI - Low-dose cytosine arabinoside in myelodysplastic syndromes. PMID- 2763786 TI - Effects of neurotropin in patients with hereditary spino-cerebellar degeneration. PMID- 2763787 TI - Prevalence of psoriasis in Norway. AB - Information on prevalence of psoriasis was obtained from a health interview survey conducted by Central Bureau of Statistics of Norway in 1985 of a representative sample of the Norwegian population. Altogether 149 cases of psoriasis were registered in the study population of 10,576 persons, giving an overall prevalence of 1.4%, with no difference between males and females. A peak prevalence was observed in the age group 30-49 years, and a significantly lower prevalence of 0.5% was found in Hedmark and Oppland counties, as compared with the country as a whole. A higher prevalence of psoriasis among females was found in urban vis-a-vis rural areas, and in urban areas, the prevalence was higher for females than for males. No difference in prevalence was found between various socio-economic groups. PMID- 2763788 TI - Psoriatics in Norway. A questionnaire study on health status, contact with paramedical professions, and alcohol and tobacco consumption. AB - Information on health status, use of prescription-drugs, contact with paramedical professionals and alcohol and tobacco consumption was obtained from a health interview survey, conducted by the Central Bureau of Statistics of Norway in 1985, of a representative sample of the Norwegian population. A total of 149 cases of psoriasis were registered in the study population of 10,576 persons, giving an overall prevalence of 1.4%. Among psoriatics, 75% felt that they suffered from chronic disease, while 66% suffered from one or more diseases in addition, indicating an increased susceptibility to diseases other than psoriasis, in psoriatics. 46% of the psoriatics used prescription-drugs, indicating that in many cases both the psoriasis as well as the other disease(s) were mild or moderate, not requiring therapy. Psoriatics had few contacts with rep-resentatives of the paramedical professions. Rather, there was a tendency to turn to alcoholic drinks and in larger amounts, among psoriatics. Fewer were total abstainers, and males with psoriasis drank more frequently. Among psoriatics, daily cigarette smoking was more frequent (48%) than among non psoriatics (36%), the difference being greatest among females. PMID- 2763789 TI - Health promotion among health professionals. PMID- 2763790 TI - It's your day to enjoy! PMID- 2763791 TI - The mature learner and distance education. PMID- 2763793 TI - Nursing research--alive and well in Alberta. PMID- 2763792 TI - What nurses are saying about nursing. Part four. PMID- 2763794 TI - Position paper on graduate education in nursing. PMID- 2763795 TI - A team approach to assessment and care planning in home care. PMID- 2763796 TI - New perspectives on the functional anatomical organization of the basolateral amygdala. AB - We have examined the functional anatomical organization of the basolateral amygdaloid nucleus (BL) in the rat and guinea pig using combined light and electron microscopic methods. Afferent and efferent connections as well as the internal organization of the BL have been studied with combined tracing, immunohistochemical, and Golgi techniques. We have found that the BL receives an intense cholinergic innervation from the ventral forebrain cholinergic system and, for the first time, described a group of intrinsic cholinergic neurons in the BL. The innervation from the primary olfactory cortex and the thalamus, as well as the GABAergic innervation of the amygdalostriatal projection neurons, is also described. Electron microscopic analyses have shown that the cholinergic system as well as the thalamic afferents primarily innervate the distal dendritic arbor of the projection neurons in the BL, whereas the GABAergic fibers are directed primarily towards their soma and proximal dendrites. Correlated light and electron microscopic studies have revealed that the projection neurons in the BL share many features with pyramidal and spiny stellate cells in the cerebral cortex. The ultrastructural characteristics of the afferent fiber systems and of the non-projection neurons in the BL are also reminiscent of the situation in the cerebral cortex. The observations reported in this study lend further support to the concept of a cortical-like organization of the BL. The anatomical observations of the BL are discussed particularly in relation to three major forebrain systems: 1. the ventral striatopallidal system, 2. the continuum formed by the centromedial amygdala, the substantia innominata and the bed nucleus of the stria terminalis, and 3. the cholinergic ventral forebrain system. The clinical implications of the results obtained in this series of experimental studies are discussed in relation to Alzheimer's disease and complex partial seizures. The cholinergic system, in particular, has attracted much interest in relation to senile dementia of Alzheimer's type (SDAT), which often seems to be characterized by disruption of the ventral forebrain cholinergic projection system. We have found that the cholinergic innervation of the BL is often significantly reduced in SDAT, but interestingly enough, the areas of the basolateral amygdala with the highest content of cholinergic markers contain the smallest numbers of senile plaques. PMID- 2763797 TI - Two cases of necrotizing myelopathy associated with malignancy caused by herpes simplex virus type 2. AB - Two cases of necrotizing myelopathy were autopsied; one was complicated with lung carcinoma and the other with chronic type adult T cell leukemia (ATL leukemia). To our knowledge, they were the first cases of their type in Japan. In both cases, necrosis of the spinal cord was observed in the gray and white matter along most of its extent. Marked changes were found in the lumbar segment. The patients were not treated with intravenous cancer chemotherapy or irradiation. Immunohistochemical and electron microscopic examination revealed an extremely strong infection of herpes simplex virus (HSV) type 2. However, HSV type 1 and cytomegalovirus antigens were not detected. PMID- 2763798 TI - Microglial and neural differentiation in human teratomas. AB - Ten human teratomas arising outside the central nervous system (CNS) were studied using a panel of immunohistochemical, and lectin histochemical stains to determine the relationship of the presence of microglia to markers of neural maturity or differentiation. Microglia, identified by silver carbonate, Ricinus communis agglutinin-1 (RCA-1), or both were found in eight out of ten cases. They were common in mature areas which also had S-100, glial fibrillary acidic protein, vimentin, neurofilament, and synaptophysin immunostaining. Microglia were distinguished from macrophages in necrotic foci. Cells which were RCA-1 positive and silver carbonate positive were found in immature neural tissues but these lacked all typical features of microglia. These observations indicate that true microglia are frequent in nonCNS teratomas and that they are found in association with other indicators of neural maturation. The presence of possible precursors in immature areas suggests that microglia undergo maturation concurrent with neural differentiation in these tumors. PMID- 2763799 TI - Muscle regeneration. The effect of hypophysectomy on cell proliferation and expression of insulin-like growth factor-I. AB - Against the background of the importance of growth hormone (GH) for normal muscle growth, a study was performed to investigate whether lack of GH after hypophysectomy affects the cell proliferation and the local production of insulin like growth factor-I (IGF-I) in the early stages of muscle regeneration in adult rats. The level of IGF-I in the serum of hypophysectomised rats was reduced to about 30% of that of controls. The incorporation of [methyl-3H]thymidine into the regenerating muscle showed a peak 6 days after the operation and then gradually declined to the end of the period of study 30 days after initiation of regeneration by ischemic necrosis. The DNA content rose to a maximum level after 6-8 days, and remained high after 30 days. There was no major difference in the incorporation of [3H]thymidine in regenerating muscle of hypophysectomised and control rats, but the DNA concentration in the regenerating muscles of hypophysectomised rats was significantly reduced after 30 days. There was a corresponding reduction in the number of nuclei per muscle fibre, indicating that hypophysectomy has a small effect on the cell proliferation during the early stages of muscle regeneration. Immunohistochemical demonstration of IGF-I in the regenerating muscle revealed the transient presence of immunoreactive material in satellite cells and myotubes after 6 to 8 days of regeneration but no immunoreactivity after 30 days. No obvious difference was observed between hypophysectomised and control rats, indicating that the endogenous production of IGF-I in regenerating skeletal muscle can occur independently of GH. PMID- 2763800 TI - Lesions of excitatory pathways reduce hippocampal cell death after transient forebrain ischemia in the gerbil. AB - Transient forebrain ischemia produces a spatially and temporally selective pattern of neuronal degeneration in the hippocampal formation of the Mongolian gerbil. Ischemic neuronal death has been suggested to depend on the activation of excitatory hippocampal pathways that project to the vulnerable neurons. This idea was tested by examining the effect of a unilateral entorhinal cortical lesion or a unilateral knife cut lesion of intrahippocampal pathways on the neuropathology produced by 5 min of complete forebrain ischemia. A prior lesion of either the ipsilateral entorhinal cortex or the mossy fiber and Schaffer collateral commissural pathways partially prevented the destruction of CA1b pyramidal cells in most animals. It did not, however, reduce the extent of ischemic neuronal death in any other hippocampal subfield. Within area CA1b, an entorhinal lesion protected an average of 23% of the pyramidal cells and a transection of both mossy and Schaffer collateral-commissural fibers protected an average of 36.5%. CA1b pyramidal cells saved from ischemia-induced degeneration appeared clearly abnormal when stained with cresyl violet or by silver impregnation. It is suggested that lesions of excitatory pathways attenuate ischemic damage to area CA1b by directly or indirectly reducing the level of synaptic excitation onto the vulnerable neurons. However, only a relatively small percentage of hippocampal neurons can be protected by these lesions in the gerbil ischemia model and there is reason to believe that the neurons protected in this manner may not be electrophysiologically competent. Synaptic excitation therefore appears to play an important, but not an essential, role in this model of ischemic brain damage. PMID- 2763801 TI - Experimental study on subacute neurotoxicity of methotrexate in cats. AB - An experimental study on the pathogenesis of methotrexate (MTX)-related neurotoxicity including disseminated necrotizing leukoencephalopathy (DNL) was conducted in cats. MTX was administered to the cerebrospinal fluid (CSF) of adult cats using either an intracisternal intermittent instillation (ICI) model or an intraventricular continuous instillation (IVC) model. Furthermore, the synergistic effects of CSF-flow disturbance with kaolin-induced hydrocephalus, and 60Co irradiation were morphologically examined in these models. None of the animals from either the ICI and IVC groups showed DNL, but all animals showed segmental axonal degeneration, suggesting that MTX had a direct toxic effect on the axon. In the ICI groups, no apparent synergistic effect of CSF-flow disturbance and radiation was noted on this axonal change. In the IVC groups, CSF flow disturbance augmented the degree of the axonal injury. Axonal degeneration and fibrin exudation in the walls of small blood vessels occurred in one animal of the IVC groups with CSF-flow disturbance, suggesting that a toxic effect of MTX on blood vessels is another mechanism of MTX-induced neurotoxicity. PMID- 2763802 TI - Hypomyelination in the neonatal rat central and peripheral nervous systems following tellurium intoxication. AB - Neonatal rats were exposed to Tellurium (Te), via the mother's milk, from the day of birth until sacrifice at 7, 14, 21, and 28 days of age. Light and electron microscopy revealed Schwann cell and myelin degeneration in the sciatic nerves at each age studied. These changes were similar to those described in weanling rats as a result of Te intoxication. In the CNS, hypomyelination of the optic nerves was convincingly demonstrated at 14, 21, and 28 days of age, accompanied by some evidence of myelin degeneration. These changes were also seen in the ventral columns of the cervical spinal cords, although less markedly, and were confirmed by quantitative methods. There was little evidence of oligodendrocyte pathology in the CNS, and it appears that degeneration of these cells is not the primary cause of the CNS hypomyelination, in contrast to the PNS where Schwann cell degeneration has been shown to precede the myelin pathology. PMID- 2763803 TI - Effect of arachidonic acid on cultured cerebromicrovascular endothelium: permeability, lipid peroxidation and membrane "fluidity". AB - The relationship of free arachidonic acid (AA) to cellular permeability, lipid peroxidation and physical state "fluidity" of the membrane was investigated in cultured endothelial cells (EC) dissociated from cerebral microvessels of rats. The results demonstrate that AA can induce a reversible alteration of endothelial permeability to trypan blue albumin (TBA). Exposure of EC to AA increases membrane "fluidity" as measured by fluorescence anisotropy using 1,6-diphenyl 1,3,5 hexatriene as a fluorescent probe. The AA modification of EC membrane "fluidity" is not associated with changes in EC permeability. Addition of AA and H2O2 to the incubation medium of EC leads to persistant alteration of EC permeability which can be prevented by catalase treatment. Both AA and H2O2 induce a greater formation of malondialdehyde, the product of lipid peroxidation, than AA alone. These findings strongly suggest that a release of AA either from the capillary or cellular membrane of the brain under a pathological condition may alone or through a peroxidative process alter the function of blood-brain barrier. PMID- 2763804 TI - Human oligodendrocytes in dissociated cell culture. AB - Human oligodendrocytes have been successfully maintained in cell cultures for 14 weeks using a modification of a method used previously for animal brain cell cultures. Dissociated cell cultures from spinal cords of human foetuses of 10 to 20 weeks gestional age were investigated for up to 98 days. Oligodendrocytes were identified by monoclonal human antiserum specific for myelin-associated glycoprotein, by polyclonal rabbit antiserum against myelin basic protein, and by the mouse monoclonal antibody I6G1. Astrocytes were identified by polyclonal antibodies against glial fibrillary acidic protein. Immunocytochemical cell identification was corroborated by electron microscopy, by which glial cells were investigated both in situ and in culture. Immunocytochemical staining of myelin associated glycoprotein showed specifically labelled oligodendrocytes on electron microscopy. The present study indicates that human oligodendrocytes, a putative target in demyelinating disease, can be studied in dissociated cell culture of human foetal spinal cord for several weeks in vitro under stable conditions. PMID- 2763805 TI - Distribution of epithelial membrane antigen in normal and neoplastic human ependyma. AB - The ependyma and choroid plexus of 23 normal brains and 20 ependymal tumors were examined immunohistochemically for expression of epithelial membrane antigen (EMA) using a specific monoclonal antibody. The ependyma of normal brains showed three patterns of immunoreactivity: membrane immunoreactivity confined to the luminal surface; irregular punctate intracytoplasmic immunoreactivity in the subependymal layer; and spherical and ring-like intracytoplasmic immunoreactivity in the subependymal layer. Of 13 differentiated ependymomas 11 reflected the immunoreactive patterns of normal ependyma. The anaplastic ependymomas and ependymoblastomas had no immunoreactivity. Our results indicate that EMA has a highly selective distribution in the ependyma, and is a marker for differentiated ependymoma. PMID- 2763806 TI - Cerebral amyloid angiopathy and astrocytic gliosis in Alzheimer's disease. AB - Astrocytic reaction at amyloid infiltrated cortical vessels was studied using glial fibrillary acidic protein (GFAP) stain in two cases of Alzheimer's disease (AD). Sections from the visual and prefrontal cortex were stained with H&E, Bodian, Congo red, and thioflavin S in addition to GFAP. Senile plaques and neurofibrillary tangles were present in both cases. The density of astrocytes surrounding vessels infiltrated with amyloid was variable. In the same area, there were vessels with minimal perivascular astrocytic reaction as well as vessels displaying more pronounced perivascular gliosis; there was no constant excessive gliosis around vessels with severe amyloid deposits. However, if amyloid infiltrating the vessel wall protruded into the perivascular neuropil of the cortex, then prolific reaction of astroglia, similar to that seen at interstitial senile plaques was apparent, and a neuritic component was distinct. It appears that once amyloid of AD type is deposited in the neuropil, whether in form of interstitial plaque or perivascular plaque, it causes a similar astroglial and neuritic reaction. PMID- 2763807 TI - Sarcomatous proliferation of the vasculature in a subependymoma. AB - A case of a recurrent posterior fossa subependymoma in a 60-year-old man is reported. In the recurrent tumor, the vasculature had undergone apparent sarcomatous proliferation of the endothelial cells. The bizarre cells expanded and replaced the vessel walls, and stained for Factor VIII-related antigen. The literature on gliosarcomas arising in brain tumors other than high-grade gliomas is reviewed. PMID- 2763808 TI - Contrast sensitivity in macular degeneration and the relation to subjective visual impairment. AB - Contrast sensitivity was determined with electronic and computer equipment (Cadwell CTS 5000) and with optotype test charts (LH low contrast test) in 31 patients, aged 47-89, with macular degeneration, mostly of the age-related type. Values of maximal sensitivity and mean sensitivity in different spatial frequency bands were estimated. Visual acuity at distance and the magnification factor needed for reading were also determined. Each of these measures were correlated with a score obtained in a subjective evaluation of difficulties with visual discrimination and orientation. It was found that poor visual discrimination and orientation was better correlated with low contrast sensitivity than with low visual acuity. The outcome of the LH-test was a better predictor of orientation problems than the electronic test. PMID- 2763809 TI - Progressive cone-rod dystrophy and high myopia in a Finnish family. AB - Progressive cone-rod dystrophy was diagnosed in a 35-year-old man (the proband). In the family study, 29 of the relatives were examined. The brother of the proband was also found to have cone-rod dystrophy. In the family of the mother of the proband, there were four men who had high myopia possibly connected with cone rod dystrophy. The other relatives had no signs of cone-rod dystrophy or high myopia. The relatives not examined were reported healthy with no eye trouble. The disorder could be autosomal recessive hereditary if only the confirmed cone-rod dystrophy of the proband and his brother is taken in consideration. However, no relationships between the families of the mother and father of the proband could be found going back to the year 1830. Therefore, the autosomal recessive inheritance was not established. The most probable mode of inheritance would be X chromosomal recessive if high myopia and cone-rod dystrophy are thought to be parts of the same syndrome. PMID- 2763810 TI - Recording pattern reversal visual evoked response with the scanning laser ophthalmoscope. AB - We recorded visual evoked responses (VERs) to alternating, checkerboard pattern stimuli using the scanning laser ophthalmoscope (SLO). Retinal position and focus of checkerboard stimuli were monitored on the SLO video monitor throughout testing. Checkerboard size, check size, and retinal positions were varied. Consistent with other, well-established pattern reversal techniques, the SLO method produced: 1) reliable VERs with amplitudes of 2 to 10 microvolts, 2) maximum amplitudes at an intermediate check size for a fixed overall pattern size, and 3) variations in VER amplitude depending on stimulus retinal position relative to the fovea. Hence, the SLO-VER technique would be useful for clinical VER measurements when precise retinal stimulus position and focus are desired. PMID- 2763812 TI - Low-pressure glaucoma and the concept of the IOP tolerance distribution curve. AB - Although glaucoma is considered to be caused by an elevated IOP, many eyes with an IOP within the normal range develop manifest glaucoma. The concept of an IOP tolerance distribution may clarify this paradox. The frequency of low-pressure glaucoma is a result of the constellation of the IOP distribution and the distribution of the IOP tolerance limit in the population. The low risk of glaucoma in the high normal IOP range is counteracted by the large number of eyes in this IOP range. It is possible to calculate the prevalence of glaucoma and the distribution of IOP in the untreated glaucoma population, resulting from different alternative distributions of IOP tolerance limit. Credible results were obtained by assuming a normal distribution of the IOP tolerance limit with an average = 26 mmHg and a standard deviation = 2.5 mmHg. In the development of glaucoma, the importance of the IOP relative to other factors, increases continually from low importance at low IOP to high importance at high IOP. PMID- 2763811 TI - The effect of hypoxia on the central light reflex of retinal arteries and veins. AB - Computerized scanning microdensitometry was used on fundus photographs of 40 men (aged 18-23 years) and effects of hypoxia on intensity profiles of the 'light reflex' in 140 arteries and 138 veins were analysed. Changes from sea level to four levels of acute hypoxia of simulated altitude were studied: 8000 feet (ft) (2438 meters) (m), 10,000 ft (3048 m), 12,500 ft (3810 m), and 15,000 ft (4572 m) using a low-pressure chamber. The intensity of the reflex increased at 12,500 ft and 15,000 ft by 24% (P less than 0.05) and 39% (P less than 0.01) in arteries and 50% and 33% in veins (P less than 0.05), respectively. As an overall response from sea level to all four altitudes, the width of the reflex was reduced. The reduction in width was negatively correlated to the diameter of the arteries (P less than 0.0001) and veins (P less than 0.001) at sea level, and the variability of changes was larger in veins (P less than 0.01). Funduscopic light reflected from intravascular blood columns of retinal vessels is thus influenced by hypoxic stress, and 12,500 ft of simulated altitude represents a threshold value of circulatory interest. PMID- 2763813 TI - Observations concerning the course of glaucoma. AB - Four cases with glaucomatous damage to the optic nerve head preceding a rise in intraocular pressure from normal or borderline to high values, are reported. The question of whether such cases are exceptional or typical and, therefore, best explained by a coincidence of diseases or by one disease going through successive stages is discussed on the basis of 10 further cases from a population study. Many clinicians claim that there are two groups of patients: a large one with 'ordinary' glaucomas supposedly caused by high intraocular pressures and a small one with low tension glaucomas presumed to have low perfusion pressures for other reasons. This classification circumvents the discussion on etiology and gives theoretical support to conventional treatment. Accumulated clinical observations indicate, however, that it should not be accepted without discussion. We describe here a few selected cases with glaucomatous damage to the optic nerve head preceding a rise in the intraocular pressure from normal or borderline to high values. PMID- 2763814 TI - Argon laser trabeculoplasty for chronic angle-closure glaucoma uncontrolled by iridotomy. AB - Nineteen eyes of 19 Japanese patients with medically uncontrollable chronic angle closure glaucoma following laser iridotomy or surgical iridectomy underwent argon laser trabeculoplasty (ALT), applying low-power and a small number of laser burns over a small extent of the trabecular meshwork. All the eyes had glaucomatous optic disc damage, visual field loss, and intraocular pressure elevation before ALT. In each case, the extent of peripheral anterior synechiae was equal or less than 50% of the angle. The mean follow-up was 35 months. Life-table analysis (Kaplan-Meier method) showed that the probability of success was 66% at the end of three years after ALT. It is concluded that in the cases of uncontrollable chronic angle-closure glaucoma following laser iridotomy or surgical iridectomy, ALT should be tried before filtration surgery. PMID- 2763815 TI - The effects of different energy levels in argon laser trabeculoplasty. AB - In a retrospective survey of 143 eyes of 143 patients with chronic open-angle glaucoma, 0.2 second argon laser trabeculoplasty was found to produce a greater decrease in intra-ocular pressure, especially at higher initial values, and was associated with a reduction in the medications used. In addition, fewer patients required further intervention (repeat trabeculoplasty or drainage surgery) compared with those undergoing 0.1 second trabeculoplasty. This effect may have occurred because of the difference in the mean energy delivered between the two groups, which arose chiefly as a result of the duration employed. PMID- 2763816 TI - Accumulation of lipid peroxidation products in human cataracts. AB - The role of free-radical-induced lipid peroxidation (LPO) in the development of human lens opacity was investigated. 130 human crystalline lenses impaired with cataract of various etiology (senile, traumatic, complicated cataracts) at different stages of cataract development as well as 18 transparent human lenses were studied. Primary products of LPO (diene conjugates), secondary products (ketodienes) and the end products (Schiff bases) were distinctly accumulated in cataractous lenses. Initial stages of cataract were characterized by the accumulation of primary LPO products, while in the latest stages there was a prevalence of fluorescent end products of LPO. It was concluded that the accumulation of polar hydroxy groups in the lipid bilayer of plasma membranes of lenticular fibers is one of the possible causes of their injury in cataracts. PMID- 2763817 TI - Glycoconjugates in exfoliation syndrome. A lectin histochemical study of the ciliary body and lens. AB - The binding of ten biotin-coupled lectins with different carbohydrate specificities to exfoliative material and neighbouring tissues was studied in 16 formalin-fixed and paraffin-embedded human eyes. Eight of the eyes were exfoliation positive while the rest were exfoliation negative. Exfoliative material reacted intensely with Lens culinaris (LCA), Canavalia ensiformis (ConA) and Ricinus communis (RCA-I) agglutinins. Positive reaction was also seen with wheat germ (WGA), peanut (PNA) and soybean (SBA) agglutinins. The superficial zonular lamella, zonular fibers and the non-pigmented epithelium of the ciliary body had a rather similar lectin-binding profile to exfoliative material. The lens capsule was essentially unreactive with all the lectins used. The lens epithelium reacted faintly with ConA, LCA, WGA and RCA-I. Pre-treatment with neuraminidase to remove sialic acid resulted in increased binding of PNA and SBA to exfoliative material, zonular fibers and the zonular lamella, and in decreased binding of WGA to the non-pigmented epithelium of the ciliary body, zonular fibers and the zonular lamella. The results indicate that alpha-mannosyl, beta galactosyl, N-acetyl-D-glucosaminyl and N-acetylneuraminic acid residues are present in glycoconjugates of exfoliative material and neighbouring tissues. PMID- 2763818 TI - Some metabolic changes during human corneal organ culture. AB - In order to evaluate the changes in medium composition during closed system corneal organ culture at 30 degrees C, pH, pO2, glucose and lactate was measured 1 to 7, 14 and 28 days after incubation of a total of 49 human corneas. During organ culture pO2 decreased from 17.3 kPa to 8.8 kPa at day 28. The average oxygen consumption was initially 0.16 mumole/h/cm2, but decreased rapidly to an average of 0.04 mumole/h/cm2 during the first weeks of incubation. The glucose concentration fell from 5.1 mM to 0.25 mM after 28 days, and the lactate concentration rose from 2.5 mM to 11 mM. The concentration changes were for both substances highest during the first 14 days of organ culture. The pH fell from 7.36 to 6.64 after 28 days. These findings indicate that the cultured human cornea predominantly metabolizes glucose anaerobically, and that the metabolic activity decreases during incubation. The limiting metabolic factors for prolonging the culture period seem to be development of severe acidosis and glucose depletion in the medium. PMID- 2763819 TI - The measurement of IgE in tear fluid: a comparison of collection by sponge or capillary. AB - We have used commercially available reference concentrations of immunoglobulin E (IgE) and tear samples from atopic patients to compare the recovery of IgE from fluid collected in cellulose sponges or glass capillary tubes. There was no statistically significant difference in the values for IgE in the reference samples recovered from capillaries or sponges (P = 0.16), but at some concentrations both methods produced a higher reading than the control samples (P less than 0.001). There was no significant difference when the values for IgE in the first or second of paired tear samples were compared using either sponges or capillaries for collection, but the mean value of samples collected by capillary tubes was lower (P = 0.02). The collection of tears in sponges for IgE estimation is less time consuming than capillary collection and for clinical practice it is as sensitive as collection in capillaries. PMID- 2763820 TI - Uncomplicated retrobulbar neuritis and the development of multiple sclerosis. AB - A retrospective study of 30 patients hospitalized with a diagnosis of uncomplicated retrobulbar neuritis was carried out. The follow-up period was 2-11 years; 57% developed multiple sclerosis. When the initial examination revealed oligoclonal bands in the cerebrospinal fluid, the risk of developing multiple sclerosis increased to 79%. With normal cerebrospinal fluid the risk decreased to only 10%. In the majority of cases, the diagnosis of MS was made during the first 3 years after retrobulbar neuritis. PMID- 2763821 TI - Acute bilateral corneal hydrops caused by high temperature and high moisture in the Finnish sauna. A clinical and histological case report of a patient with keratoconus. AB - A 44-year-old healthy male with bilateral keratoconus developed acute hydrops of both his corneas with an interval of 3 years. On both occasions he had bathed in a hot, humid Finnish sauna the preceding evening. Penetrating keratoplasty had to be performed in the acute stage in both instances, as medical therapy brought no improvement. The contributory role of hot, moist air to the development of acute hydrops is discussed. Histopathological examination of the corneal buttons revealed clear-cut breaks in Descemet's membrane with marked posterior stromal oedema. PMID- 2763822 TI - Ocular Munchhausen syndrome induced by incest. AB - This report describes a young female patient whose long-lasting ocular problems were ultimately found to be due to self-induced damage of the corneas with chemicals, and later, self-inflicted perforation of the eye with a safety pin. More than one year after these ocular symptoms were presented, it was discovered that the eye diseases were in fact attempts by the patient to escape from the psychic anxieties which were the result of an incestuous relationship between the patient and her father. PMID- 2763823 TI - Bilateral serous retinal detachments in the H.E.L.L.P. syndrome. AB - The first case of the H.E.L.L.P. syndrome with ophthalmic signs is described. This syndrome of pregnancy is characterized by Haemolysis, Elevated Liver enzymes and Low Platelets in association with upper abdominal pain. Diagnosis and treatment is often delayed, while a non-obstetric cause for these findings is sought. The present report adds serous retinal detachments in association with sub-retinal opacities to the signs which should raise suspicion of this syndrome. PMID- 2763824 TI - Orbital metastasis from cutaneous malignant melanoma. AB - Orbital metastasis is a rare presenting sign of a cutaneous malignant melanoma. Fewer than 30 cases of orbital metastases have been published so far. A 69-year old man was remitted to our clinic for removal of an orbital tumour verified with CT. Fine-needle aspiration biopsy revealed the tumour to be a metastasis from a cutaneous malignant melanoma diagnosed 4 years earlier. The patient died 3 months after detection of the orbital metastatic tumour. This case illustrates the value of simple fine-needle aspiration biopsy in the diagnosis of orbital tumours. PMID- 2763825 TI - Plasmacytoma of the uvea in a case of multiple myeloma. AB - A case of plasmacytoma in the uvea, both clinically and grossly anatomically mimicking a malignant melanoma, is described in a 63-year-old man who died from multiple myeloma. This is an extremely rare condition in the eye. Only one report of a similar tumour has been found in the literature. PMID- 2763826 TI - Cytologic and biochemical examination of the subretinal fluid in diagnosis of Coats' disease. AB - Two babies presenting with unilateral leukocoria were found to have total retinal detachment in one eye, associated with subretinal yellowish-white deposits. As no calcification was found and subretinal fluid aspiration yielded many fat-laden macrophages without any evidence of retinoblastoma cells in addition to a high level of cholesterol, the difinitive diagnosis of Coats' disease was made. Subsequently, retinal detachment surgery and cryotherapy were performed, in an attempt to preserve the affected eye. PMID- 2763827 TI - Two flash photorefractometry in screening of amblyogenic refractive errors. PMID- 2763828 TI - Monitoring middle ear pressure by tympanometry. A study of middle ear pressure variation through seven hours. AB - The aim of this investigation was to monitor fluctuations in middle ear pressure, to study tympanometric signs of Eustachian tube functioning and to assess the validity of the tympanometric readings. In 20 patients with a low initial middle ear pressure (-150 daPa or lower) and 5 normals, impedance tympanometry was performed every 3 min through 7 h. Median pressure for the patients was -150 daPa (range 100 to -400 daPa) and for the normals 0 daPa (range 50 to -50 daPa). A remarkable pressure increase was seen after changing the body position to the supine. The patients were arranged into three groups according to the lowest middle ear pressure registered. Median pressures for the groups were running at a rather constant level. However, the individual pressure fluctuations in many patients were so great that a single tympanometric reading has to be considered unreliable when selecting patients for insertion of ventilation tubes. Thirteen patients never equalized their negative middle ear pressure, indicating that their Eustachian tube did not open during the test period. In spite of this the pressure did not decrease to lower values, indicating that maintaining a relative constant middle ear pressure is independent of opening of the Eustachian tube. PMID- 2763829 TI - Sensorineural hearing loss and acute otitis media in children. AB - Sensorineural hearing of 359 otoscopically and tympanometrically normal 5-year old children with known otitis-history was studied under ideal conditions. In the subgroups of children with a different number (0, 1-2, 3-7, greater than or equal to 8) of attacks of acute otitis media (AOM) in their history, the mean bone conduction thresholds unregularly varied from 0.1 dB to 7.4 dB, depending on the frequency and the subgroup studied. The proportion of the ears with a bone conduction threshold greater than 10 dB at 0.5, 1, 2 or kHz ranged, also unregularly, from 10.8% to 0.5%, the greatest percentages being found at 0.5 and 1 kHz in the children without a history of AOM. Thus, neither AOM nor its treatment, even if frequently occurring, seem to cause permanent sensorineural hearing loss in children. PMID- 2763830 TI - Experimental cholesteatoma. Epidermal ingrowth through tympanic membrane following middle ear application of propylene glycol. AB - This study was designed to investigate morphological changes in the tympanic membrane (TM) associated with cholesteatoma formation in experimental animals following application of propylene glycol to the middle ear. A 50% solution of propylene glycol was applied bilaterally to the middle ear cavities of 30 young adult chinchillas. The animals were sacrificed for light and electron microscopic study at intervals of 2 days to 6 weeks after a single application of 0.2 ml of the propylene glycol solution. At 2 days there was complete destruction of the epidermal and mucosal layers of the TM. The denuded lateral surface rapidly became re-epithelialized by hyperplastic epidermal cells and by 2-3 weeks, keratinizing epidermis penetrated damaged areas of the fibrous layer of the lamina propria to reach the medial surface of the TM. These epidermal cells proliferated in the middle ear cavity, forming cholesteatomas. Our observations indicate that invasion of the intact, but structurally altered, tympanic membrane by hyperplastic epidermis is a primary mechanism of cholesteatoma formation in the animal model. PMID- 2763831 TI - Reflex activation in allergen-induced nasal mucosal vascular reactions. AB - Subjects with allergic rhinitis were challenged unilaterally with diluent and increasing doses of allergen. Challenge with the highest dose of allergen was also carried out after topical anesthesia of the nasal cavity using lidocaine. In the contralateral, unprovoked nasal cavity the mucosal blood flow was determined using the 133Xenon wash-out technique and the nasal airway resistance was determined by rhinomanometry before and after challenge. Nasal symptom scores were estimated 15 min after each challenge. Blood flow in the nasal mucosa in the unprovoked right nasal cavity decreased in a dose-dependent manner for th two highest doses of allergen where a reduction of 21% (p less than 0.05) and 26% (p less than 0.01) was obtained. Nasal airway resistance increased somewhat after the highest dose (p greater than 0.05). Topical anesthesia in the provoked nasal cavity inhibited the decrease in blood flow in the unchallenged nasal cavity. These findings suggest that the changes in the tone of the resistance vessels, but not the capacitance vessels, which are induced by allergen, are largely reflex-mediated. PMID- 2763832 TI - Cultivation of ethmoidal sinus ciliated epithelia. AB - Proceeding from the cultivation of human epidermal cells we succeeded in cultivating mucosal cells from ethmoidal sinuses and in characterizing them by scanning electron microscopy. In particular, the reaction of ciliated cells and goblet cells in vitro and their ability to reproduce were compared with the reaction of keratinocytes. Ethmoidal sinus cells show adhesion and spreading rates similar to those of skin cells; they proliferate faster (3 days up to monolayer) and differentiate in vitro to ciliated epithelia. It would seem possible to use them for lining of plastic prostheses for the respiratory tract. PMID- 2763833 TI - Vertical hyoid bone displacement and fundamental frequency of phonation. AB - Vertical displacement of the hyoid bone as well as its effects on F0 were studied using five excised human larynges. Cranial force introduced to the hyoid bone caused a widening of the vestibule of the larynx, enlargement of the laryngeal ventricles, abduction of the ventricular folds, heightening of the epiglottis and slight abduction of the vocal folds. The displacement (X +/- SD) of the anterior part (corpus) of the bone was 8.0 +/- 5.2 mm and of the posterior part, 22.2 +/- 6.1 mm with a 10 N force. The difference was statistically significant and was found to depend mainly on the tight middle hyothyroid ligament. The cranial force displacing the hyoid bone invariably showed a positive relationship with F0. The F0 changes were statistically significant but relatively small (X +/- SD): 8 +/- 8.4 Hz (about 10%) with an intact hyothyroid ligament. When the subglottal pressure was low, a change in the vibratory pattern of the vocal folds was found in several specimens. The F0 changes found in the present study are too small to explain alone the differences in the so-called intrinsic F0 of vowels. However, they are believed to contribute to this phenomenon. PMID- 2763834 TI - The rabbit VX2 tumour as a model for carcinomas of the tongue and larynx. AB - Animal models of carcinomas can provide useful information for the evaluation of new treatments. In the rabbit, the VX2 tumour is a fast growing, transplantable squamous cell carcinoma. By implanting a cell suspension of the tumour into the tongue and/or the larynx, a useful new model for studying or treating tumours in this region has been developed. The tumours were evaluated histologically and showed features consistent with human carcinomas, including surface ulceration, lymphatic spread and encroachment of the airway. The VX2 tumours in these sites have features which offer advantages over existing models. These include the ability to study several sites of tumour growth in the same animal, to follow rapidly growing tumours, storage of the tumour in liquid nitrogen allowing experiments to be started when convenient, and the large size of the rabbit larynx which permits considerable tumour growth before airway embarrassment. PMID- 2763835 TI - Experimental study of nystagmus induced by injecting various solutions into the middle ear cavity. AB - Injecting of various solutions into the middle ear cavity of cats and rabbits provoked certain characteristic types of nystagmus which resembled caloric nystagmus or clinical cases of peripheral vestibular disorders. Solutions with different degrees of specific gravity, osmotic effect and ion composition were used in this study. Direction-changing positional nystagmus, irritative nystagmus, and paralytic nystagmus were elicited according to the physical or chemical properties of each solution. Histological findings showed mild changes in the perilymphatic space and/or in the endolymphatic space in the period with some characteristic types of nystagmus. Infiltration of the substances into the inner ear fluids from the middle ear cavity via a round window membrane were probably responsible for these types of nystagmus. PMID- 2763836 TI - Hensen's cell cyst of the organ of Corti. AB - The temporal bone collection at the Massachusetts Eye and Ear Infirmary contains the bones of two subjects with bilaterally symmetrical cyst formations in the Hensen's cell areas of the organs of Corti. In both subjects the cysts are located in the 8-14-mm regions of the cochlear ducts. Both cochleas of one subject show pressure atrophy of the outer hair cells, demonstrating that the cysts may have the potential for producing high-tone hearing loss. While the genesis and contents of the cysts are unknown, it is postulated that they may represent the coalescence of lipid droplets extruded from Hensen's cells. PMID- 2763838 TI - Auditory investigations in hypothyroidism. AB - Twenty patients with thyroprivic hypothyroidism with a mean age of 34.8 years (range: 15-50 years) were investigated. Peripheral/central functions of the auditory system were assessed in the hypothyroid state and they were re-evaluated in the euthyroid state after treatment with levothyroxine. The mean observation period for re-evaluation was 3.7 months (range 3-7 months). Sixteen patients with hypothyroidism (80%) demonstrated hearing loss when compared with randomly selected age- and sex-matched normal subjects. Twelve of the hypothyroid patients had sensorineural hearing loss and 4 had mixed loss. Special hearing tests revealed a cochlear type of hearing loss. The tympanogram curve was of Type B in one ear of each of the 4 patients. Brainstem electric response audiometry showed prolonged, absolute latency of wave V and interpeak latencies I-III and I-V. The amplitudes of waves I, II and V were reduced. Following treatment with levothyroxine a statistically significant improvement in hearing thresholds was observed by pure-tone audiometry. Tympanogram curves returned to normal in 3 out of 4 patients. Brainstem electric response parameters did not show significant reversibility to normalcy following treatment. The results of auditory investigations suggest a causal relationship between hypothyroidism and hearing loss. The site of lesion in the auditory system is probably at several levels, viz. in the middle ear, and at cochlear and retrocochlear sites. PMID- 2763837 TI - Hyaluronan content in human inner ear fluids. AB - Histochemical analyses of the luminal contents of the endolymphatic sac in numerous mammalian species have indicated a presence of acid mucopolysaccharides or proteoglycans. In the present study, one of these substances, hyaluronan (hyaluronic acid; HA), in endolymphatic sac endolymph and vestibular perilymph in humans, was biochemically determined with a highly specific radioassay. A considerable variation in HA concentration was noted between the individual ES endolymph samples, with a mean value of 2.50 micrograms/g (range 0.00-10.86). In perilymph the HA concentrations were less variable and the mean concentration was 0.91 micrograms/g (range 0.56-1.51). The difference between endolymph and perilymph HA concentration was not statistically significant (p greater than 0.05). The ability of HA to interact with proteoglycans, thereby forming giant hydrophilic molecules, could be important for ES function. These molecules may create a swelling pressure which is resistant to compressive forces that under conditions of increased intracranial hydrostatic pressure otherwise could cause ES collapse and impaired function. PMID- 2763839 TI - [Carbachol nasal provocation test in vasomotor and polyposis rhinopathy]. AB - A group of 117 subjects suffering from vasomotor rhinopathy (33 with nasal polyposis) were studied with the nasal provocation test with carbacholine in order to evaluate aspecific nasal reactivity. The results obtained by quantifying the variations in nasal secretions and rhinomanometric resistance after application of the test substance indicate the following: a marked hypersecretory response and obstruction in 80% of the vasomotor rhinitis cases; a more marked aspecific reactivity in perennial allergic rhinitis sufferers than in those with seasonal atopic rhinopathy; a lack of statistical significance between the group of those with atopic polyposis and those with a negative skin test. The authors conclude by confirming the usefulness of the test for aspecific reactivity in the diagnosis of vasomotor rhinopathy and propose its use for better screening those patients to undergo specific hyposensitivity therapy. PMID- 2763840 TI - [Transtracheal oxygen therapy with oxycath: introduction technic, complications, results in 12 treated patients]. AB - Continuous oxygen therapy is essential in the treatment of advanced chronic obstructive pulmonary disease (COPD). A transtracheal oxygen administration system is more effective in the rehabilitation of these patients than are traditional systems, nasal canula or Venturi mask devices. In the present work the authors describe a simple technique for introducing the transtracheal catheter. The procedure is performed under local anesthesia and a Teflon catheter is inserted between the second and third tracheal rings. In a case study of 12 patients the complications encountered included purulent drainage of the skin tract and accidental displacement of the transtracheal catheter. No procedure related deaths were incurred. Subjectively, the patients experience a sensation of being able to breathe more easily, thus resulting in increased outdoor activity. PMID- 2763841 TI - [Salvage surgery after unsuccessful radiotherapy of cancer of the larynx]. AB - The problem of the surgical management of irradiation failures in laryngeal carcinoma is taken into consideration. A series of 60 consecutive laryngectomies performed at the E.N.T. Department of the Regional Hospital of Varese from 1982 1987 is presented. All patients had previously undergone curative radiotherapy for squamous cell carcinoma of the larynx with subsequent local recurrence. The postoperative course is examined in relation to the observed 11 cases of complications (18.3%) taking them into consideration individually. A statistical analysis is also presented for the incidence of complications in relation to the most significant parameters. No significant difference was found in regard to timer elapsed since termination of radiotherapy (more or less than 6 months), irradiation field extension (limited to the larynx or extended to the neck nodes), type of surgical salvage (including neck dissection or not) and pre operative hemoglobin and blood proteins values. In those patients who had previously undergone irradiation, total laryngectomy is quite a safe procedure in terms of potential local-regional complications. The choice of primary radiotherapy should not be influenced by the fear of such complications arising if salvage surgery is required after local recurrence. PMID- 2763842 TI - [Ultrastructural aspects of cholesteatoma of the middle ear]. AB - Middle ear cholesteatomas were intraoperatively obtained from 6 male patients and studied under light (L.M.), transmission (T.E.M.) and scanning (S.E.M.) electron microscopy. Cholesteatoma proved to be formed by keratinizing squamous epithelium, or matrix, and by connective tissue, chorion or perimatrix. With regard to the matrix, a progressive differentiation of cells belonging to the stratum germinativum could be observed towards spinosum, granulosum and corneum cells with formation of keratinized lamellae. Moreover, keratinocytes and Langerhans cells were found in the stratum spinosum. The perimatrix consisted of granulation tissue, or inflamed subepithelial connective tissue displaying inflammatory cells. Furthermore, the advancing front of cholesteatoma proved to be formed by lymphocytes and plasma cells, partially covered by respiratory type epithelium. PMID- 2763843 TI - [A case of brown tumor of the vomer]. AB - A case of brown-tumor of the vomer in a 21-year-old woman is described. The term giant cell lesions encompasses a variety of conditions. Three distinct entities are found in the facial area i.e. giant cell reparative granuloma, true giant cell tumor and brown-tumor. After having described the clinical, radiological and histopathological characteristics of the lesion, emphasis is placed on the importance of clinical, anamnestic, laboratory, radiological and histological findings in accurately differentiating the various types of giant cell lesions of the facial skeleton. PMID- 2763844 TI - [Precancerous oral lesions. Diagnostic and therapeutic protocol]. AB - The NRC (National Research Council) task force on head and neck cancer issued this document to help clinicians involved in diagnosing and treating precancerous oral diseases. Chapter 1 includes definition, epidemiology, risk factors (alcohol, smoking, poor oral hygiene), WHO classification, clinical picture of leukoplakias, erythroplasia, lichen planus, as well as their natural history. Chapter 2 points out the clinical signs to be looked for in order to make a proper diagnosis and discusses biopsy techniques. Chapter 3 deals with therapeutic procedures (surgical technique and medical treatment), while Chapter 4 concerns follow-up according to the clinical and histological diagnosis. Finally, some statistical forms are enclosed: Form 1 consists of information regarding educational qualifications, occupation, alcohol consumption, smoking and dietary habits; Form 2 consists of information about previous diseases and the history of the present disease; Form 3 records the signs and symptoms observed for the precancerous lesion; Form 4 records treatment modalities; Form 5 records patient follow-up. PMID- 2763845 TI - [Rheologic investigation of electrode gels]. AB - Nine electrode gels have been investigated 6 of them are used in hospital pharmacies of this country. The results were compared to properties of two gels from abroad, the recommended electrode gel has been developed on this basis. Character of formed gel structure has been studied by flow curves and structural forces have been numerically characterized by determining the parameters of the function made linear. By determination of electric conductivity the proposed Carbopol gel has been found suitable not only to supersonic tests but also to ECG and may be to EEG. PMID- 2763846 TI - [Edge surface characteristics of emulsifiers. III. Research on Tween 61]. AB - Edge surface tension of paraffin/water systems has been studied in the presence of Tween 61, Span- and Tegin-series, respectively. It has been established that edge surface tension decreases more steeply and in a higher degree when Tween 61 had been dissolved in the lipophylic phase. Edge surface tension of liquid paraffin solutions of lipophylic emulsifiers measured against aqueous solutions of Tween 61 changed as power function with the concentration. The same relationship has been found between adhesive work and concentration of tensids. PMID- 2763847 TI - [Effect of gelatin solution on parameters of tablets containing well-compressible active principles]. AB - Theobromine tablets have been prepared by wet granulation using gelatin solutions of various concentrations. It has been established that film formed from 2 per cent gelatin solution does not assure sufficient binding force. Lamella forming tendency could be observed on tablets. Furthermore, it has been ascertained that tablets proper in respects of both physical parameters and active principle release can be prepared with 5 per cent gelatin solution. It seems to be unnecessary to use 10 per cent gelatin solution. Behaviour of gelatin solutions at compression of starch and their role in active principle release have been discussed. Attention has been drawn to loss of biological value because of the "aging" of the gelatin film. PMID- 2763848 TI - Formulation of polyethylene glycol ointment bases suitable for tropical and subtropical climates. I. AB - The present study dealt with the investigation of the physical characteristics of 18 polyethylene glycol ointment bases with the aim of finding out their suitability for use in tropical and subtropical climates. Different ratios of low and high molecular weight polyethylene glycols were helpful for preparation of these ointment bases. The investigated physical characteristics included the drop point, the congealing range and the spreadability properties of bases. The drop point was determined by the Ubbelohde apparatus, the congealing range by the double-walled Zhuckov flask, penetrability by penetrometer, and spreadability by the parallel plate extensometer. The results of these physical parameters indicated that PEG 400:PEG 4000 blend gave very good bases for use in tropical and subtropical areas. Furthermore, it was observed that, the type and the amount of PEG used would affect greatly the drop point, congealing range and consistency of the prepared bases. Results obtained with PEG 2000 and PEG 6000 bases showed less variability with respect to molecular weight and solid content. PMID- 2763849 TI - [Application of beta-cyclodextrin during direct pressing of tablets]. AB - In case of tablets prepared by direct procedure the compressibility of beta cyclodextrin has been studied. It has been established that beta-cyclodextrin- because of its very good flowing behaviour--can successfully be applied as ingredient in direct pressing. When hardness of tablets has to be increased 20% Avicel pH 101 (VN) has been recommended. By comparative test of 1:1 mol physical mixture of chloramphenicol-beta-cyclodextrin and the granulated product it has been ascertained that method of preparation of products, behaviour of applied solid binding materials and degree of applied pressing force decisively influence the compressibility of products. Furthermore, it has been found that application of beta-cyclodextrin influences advantageously the dissolution rate of active principle from tablets. PMID- 2763850 TI - A longitudinal study of mental health problems in a suburban population in Sudan. AB - A psychiatric study of 197 children living in villages outside Khartoum was made in 1964-1965. In 1983, 104 randomly chosen subjects were investigated again. All were interviewed by a psychiatrist and somatically examined. The overall psychiatric impairment was 14% (males, 18%; females, 8%) according to the psychiatric interview; the Self-rating Questionnaire gave a higher figure (28%). The rate of somatic illness was similar: 14% according to the medical doctor, 22% according to the self-rating of the subjects. Childhood data predicted 17% of the variance in adult mental health. Somatic state of health in childhood and traditional type of work by the father were the most important variables. Data from the life situation of the individual explained 67% of the variance in adult mental health. PMID- 2763851 TI - History of separation anxiety in patients with panic disorder and depression and normal controls. AB - The frequency and severity of separation anxiety for subjects with panic disorder and major depression was compared with that for normal controls. The subjects were diagnosed according to DSM-III criteria. Each subject completed a questionnaire consisting of 9 items derived from DSM-III criteria for separation anxiety disorder. The incidence of separation anxiety and its severity were significantly higher for the panic disorder subjects than for normal controls but there was no significant difference between depressed and panic disorder subjects. Panic disorder subjects with a history of separation anxiety disorder had a significantly earlier onset of panic attacks. PMID- 2763852 TI - Utilization of psychiatric inpatient care. A study of changes related to the introduction of a sectorized care organization. AB - Utilization of inpatient care in a catchment area was studied by means of a 4 year comparison before and after a sectorization of the care organization. There was almost no reduction in the number of patients hospitalized, but the number of admissions was reduced by 20% and the total number of days in hospital by 40%. An initial rise in the hospitalization of nonpsychotic patients was found in the new organization, probably because of the increased accessibility and availability of psychiatric care in the catchment area. The rate of hospitalization decreased for schizophrenic patients and remained unchanged for other psychotic patients. There was a significant reduction in rates of readmission, and mean length of stay in hospital was reduced for all groups of patients except patients with a diagnosis of neurosis or personality disorder. A reduction in rates of compulsory care, primarily for patients with alcohol diagnosis, was found. The sectorized care organization has fulfilled the objective of reducing inpatient care. However, great attention must be paid to evaluating new patient categories reached by the development of outpatient facilities, especially in areas where accessibility to and availability of the care organization were formerly low. PMID- 2763853 TI - Delirium among elderly persons admitted to a psychiatric hospital: clinical course during the acute stage and one-year follow-up. AB - Seventy elderly patients meeting the DSM-III criteria for delirium were examined during the acute stage and followed up to one year. The mean age of the patients was 75 years (range 60-88), their delirium lasted on average 20 days (range 3-81) and the psychiatric hospitalization on average 30 days (range 8-365). The most common etiologies for delirium were stroke, infections and metabolic disorders. For 57 cases (81%) a predisposing structural brain disease was found. During the index admission, the cognitive dysfunction associated with delirium ameliorated significantly (the mean +/- SD Mini-Mental State Examination score 9.7 +/- 6.6 at admission and 13.9 +/- 7.2 at discharge; P less than 0.001), but during the one year follow-up progression of the basic central nervous system disease was seen together with declining cognition and deterioration of functions of daily living. PMID- 2763854 TI - The incidence of negative symptoms in early schizophrenia, mania and other psychoses. AB - Despite increasing interest in negative symptoms in schizophrenia there has been little work on their incidence in early schizophrenia or in other psychoses. This study examined 79 nondepressive psychotics within 2 years of onset of illness, diagnosed by Research Diagnostic Criteria and assessed for negative symptoms using the Scale for the Assessment of Negative Symptoms. Marked negative symptoms were observed in nearly half of patients diagnosed as suffering definite schizophrenia and were rarely found in other psychoses. Negative symptoms were not significantly correlated with positive symptoms, depression or exposure to neuroleptics, but were correlated with developing extrapyramidal side effects. PMID- 2763855 TI - Obsessive-compulsive disorder in people that abuse codeine. AB - The author describes patients with severe obsessive-compulsive disorder observed only when they abused codeine. PMID- 2763856 TI - Dexamethasone suppression test nonsuppression and tardive dyskinesia. PMID- 2763857 TI - Cortisol secretion in adolescents with major depressive disorder. AB - Plasma cortisol concentrations were determined every 20 min for 24 h, in a nonstressful environment, among 48 rigorously assessed, mostly outpatient, drug free adolescent subjects during an episode of major depression (MDD) and among 40 normal adolescent subjects. There were no significant differences in the 24-h mean, peak, or nadir, or the time of the nocturnal rise, in plasma cortisol in the 2 groups. Analyses of different subgroups of MDD adolescents according to suicidality, severity of depression, separation anxiety, psychotic subtype, endogenicity, duration of episode, and sex also revealed no significant group differences. Only one adolescent (with MDD) was identified clearly as a hypersecretor of cortisol. These results indicate that abnormalities of spontaneous cortisol secretion are an unusual finding among adolescents with major depression when studied in a nonstressful environment. PMID- 2763858 TI - Personality factors and pathological gambling. AB - Pathological gambling is a disorder in which personality factors are thought to be important. Therefore, we compared 19 male pathological gamblers with 18 male normal controls for their scores on 3 personality questionnaires. Pathological gamblers were found to have significantly higher psychoticism and neuroticism scores on the Eysenck Personality Questionnaire than controls. Gamblers also had significantly higher total hostility scores on the Hostility and Direction of Hostility Questionnaire. The possible implications of these findings are discussed. PMID- 2763859 TI - Paranoid symptoms and disorders among 100 Hmong refugees: a longitudinal study. AB - Paranoid disorder has been recognized as a special problem among migrants in general, and refugees in particular. Controversy exists about whether vulnerability to paranoia is a pre-emigration or postmigration phenomenon, and whether paranoia is caused by genetic or organic factors, victimization, or the stress of acculturation. Information is limited on the distribution of paranoid symptoms among refugees. The course of paranoid symptoms in refugees is unknown. Findings reveal that: most refugees have no or mild paranoid symptoms (suspiciousness or mistrust); a small number have severe symptoms (ideas of reference, paranoid delusions or paranoid hallucinations); paranoid symptoms (unlike depressive symptoms) tend to remain at about the same level over several years; and the prevalence and incidence of paranoid disorders among refugees are high compared with other groups. PMID- 2763860 TI - Rapid cycling depression in adolescence. A case treated with family therapy and carbamazepine. AB - This report aims at alerting the clinician to the existence of rapid cycling depression in adolescence. The importance of integrating psychodynamic, social and pharmacological modalities in evaluation and treatment is emphasized. PMID- 2763861 TI - Functional impairment in tardive dyskinesia: medical and psychosocial dimensions. AB - The author presents 22 patients with tardive dyskinesia who were referred to him through consultation. Several patients had functional impairment caused by their movement disorder. Impaired gait was noted in 6 patients, speech impediment in 3 and thoughts of suicide in 1. Psychosocial difficulties were reported in 12 patients. The author concludes that tardive dyskinesia can lead to difficulties in patients who are suffering from the severe form. PMID- 2763862 TI - Serum and red blood cell folate in depression. AB - Serum folate concentrations were estimated in patients with major depressive disorders, lithium-treated patients, detoxified alcoholic patients and normal controls. Red blood cell (RBC) folate concentrations were also estimated in subgroups of patients with major depressive disorder and normal controls. Results showed significantly lower serum and RBC folate concentrations in patients with major depressive disorder than in normal controls. Lower serum folate concentrations were associated with greater severity of depression. There was no association between serum and RBC folate concentrations and endogenicity of depression or the presence of weight loss. PMID- 2763864 TI - Measurement of subjective variables: the Discan method. PMID- 2763863 TI - Obsessive-compulsive symptoms in childhood and adolescence. AB - We investigated 61 patients (38 boys and 23 girls) under 18 years of age with obsessive-compulsive symptoms seen in the Department of Psychiatry, Nagoya University Hospital, from 1982 until 1986. In this period, a total of 1293 patients under 18 years of age visited the clinic. The percentage of patients with obsessive-compulsive symptoms was 5%. The earliest onset of symptoms was at age 3 years, and the average age of onset was 11.6 years. We found no particular tendency in terms of the number of siblings and the birth order of the patients. Obsessive traits were the fundamental personality traits of patients. Moreover, according to the other characteristics of personality, the patients were subdivided into schizothymic, viscous temperament, and cyclothymic. Parents of the patients were more apt than usual to have obsessive-compulsive personalities. Psychiatric disturbances and occupations were also investigated. Incidents related to school situations commonly triggered obsessive-compulsive symptoms. The most frequently noted obsessive thought was dirt phobia, and the most common compulsive behavior was washing. School refusal and violence at home were especially common as associated symptoms of obsessive-compulsive symptoms. We also describe the treatment regimen and the outcomes of the patients. PMID- 2763865 TI - Action of peripherally administered cholecystokinin on monoaminergic and GABAergic neurons in the rat brain. AB - In an acute study, cholecystokinin octapeptide sulfate (CCK) in doses of 1, 10 or 100 micrograms/kg body weight was injected intraperitoneally into rats just prior to the dark cycle. Rats were sacrificed two hours following the CCK injection. Norepinephrine levels were elevated in the dorsal amygdala of rats injected with 10 micrograms of CCK as well as in the septum of rats injected with 1 and 10 micrograms of CCK. The dopamine level in the septum of rats injected with 1 microgram of CCK as well as the gamma-aminobutyric acid (GABA) level in the lateral hypothalamus of rats injected with 10 micrograms of CCK were also elevated. In a chronic study, CCK (1 microgram/kg body weight/h) was subcutaneously infused into rats with Alzet osmotic minipump for seven consecutive days. The daily food consumption did not change during the 7 days of CCK infusion. The dopamine turnover in the striatum accelerated and the GABA level increased. On the contrary, dopamine metabolism in the substantia nigra and locus coeruleus decreased. Furthermore, the serotonin level in the substantia nigra decreased. Norepinephrine levels decreased in the nucleus paraventricularis, the locus coeruleus and the substantia nigra. The results suggest that peripherally administered CCK may act on the monoaminergic neurons and GABAergic neurons in the brain. PMID- 2763866 TI - Inhibitory effect of calcitonin on pure human pancreatic secretion. AB - The inhibitory effect of calcitonin on human pancreatic secretion was evaluated to examine whether the different results reported earlier between humans, cats and dogs can be ascribed to the different sensitivity of these species to calcitonin, as suggested by some investigators. Pancreatic juice was obtained by endoscopic cannulation of the pancreatic duct from 11 patients with relapsing pancreatitis during intravenous infusion of secretin (1 U/kg/h) plus caerulein (0.04 microgram/kg/h). After steady secretion was attained 20 min after the beginning of collection, five 2-min fractions were obtained before, and ten 2-min fractions were obtained after intravenous infusion of calcitonin (1 IU/kg/h). The pre- and post-calcitonin fractions from each patient were compared by Student's t test. Calcitonin inhibited the secretory volume (26.8 to 65.6%) and bicarbonate secretion (21.4 to 62.0%) in 8 patients, and amylase (48.4 to 89.5%) and lipase secretion (47.4 to 90.5%) in all patients. The present studies reconfirmed that prominent inhibition of enzyme secretion occurs in humans. A new finding was that significant inhibition of the secretory volume and bicarbonate secretion occurs in humans. The inhibitory effects of calcitonin in humans did not appear to differ from those in cats and dogs, when evaluated similarly with the use of pure pancreatic juice. PMID- 2763867 TI - Long-term follow-up of patients with extracardiac valved conduits. AB - Seventeen patients having extracardiac valved conduits placed between the right ventricle and pulmonary artery were followed for 7 to 87 months postoperatively (mean, 42 months), at the Heart Institute, Kenritsu Amagasaki Hospital, Japan. There were no late deaths in the study group. Three conduits have been replaced, all because of conduit stenosis. In two-dimensional echocardiographic examinations, commissural fusion and calcification of the valve were noted in 6 out of 16 xenograft valved conduits. Mechanical valve immobility was found in one patient. Neointimal peel of the dacron graft was noted in 6 out of 17 cases, and marked left ventricular deformity in the short axis view was found in 6. Late cardiac catheterization was done in 6 patients who were suspected of having valve failure and right ventricular hypertension by two-dimensional echocardiography. All 6 of these patients showed a high pressure gradient between the pulmonary artery and right ventricle and also had elevated right ventricular pressure. In conclusion, two-dimensional echocardiography is a simple, non-invasive and very accurate method for detecting conduit stenosis and valve failure. An echocardiographic series should be performed for a long-time postoperatively because obstructions of valved conduits may be progressive, and an operation may be advisable in order to prevent the development of advanced right ventricular hypertrophy and deterioration. PMID- 2763868 TI - Return to work after heart valve replacement. AB - One hundred patients who underwent heart valve replacement during the years 1977 to 1985 were reviewed an average of 57 months after surgery. The overall rate of reemployment after the operation was 78%. The most important factors influencing the return to work were the employment status before surgery, age at the time of surgery, the number and site of the diseased valve, the preoperative New York Heart Association (NYHA) functional class and the number of times cardiac surgery was performed. These factors were closely related to the optimal timing of heart valve replacement. It was suggested that the rate of return to work and the quality of life would be improved if the heart valve replacement had been performed at an earlier stage of the disease. PMID- 2763869 TI - Skeletal disease in primary hyperparathyroidism. AB - Most patients with primary hyperparathyroidism in the 1980s do not have evidence of bone disease when they are evaluated by conventional radiography. We sought to determine whether skeletal involvement can be appreciated when more sensitive techniques, such as bone densitometry and bone biopsy, are utilized. We investigated 52 patients with primary hyperparathyroidism. They had mild hypercalcemia, 2.8 +/- 0.03 mmol/liter (11.1 +/- 0.1 mg/dl), low normal phosphorus, 0.9 +/- 0.03 mmol/liter (2.8 +/- 0.1 mg/dl), and no symptoms or specific radiological signs of skeletal involvement. The greatest reduction in bone mineral density was found at the site of predominantly cortical bone, the radius (0.54 +/- 0.1 g/cm; 79 +/- 2% of expected), whereas the site of predominantly cancellous bone, the lumbar spine (1.07 +/- 0.03 g/cm2), was normal (95 +/- 3% of expected). The site of mixed composition, the femoral neck (0.78 +/ 0.14 g/cm2), gave an intermediate value (89 +/- 2% of expected). Preferential involvement of cortical bone with apparent preservation of cancellous bone in primary hyperparathyroidism was confirmed by percutaneous bone biopsy. Over 80% of patients had a mean cortical width below the expected mean, whereas cancellous bone volume in over 80% of patients was above the expected mean. The results indicate that the majority of patients with asymptomatic primary hyperparathyroidism have evidence by bone densitometry and bone biopsy for cortical bone disease. The results also indicate that the mild hyperparathyroid state may be protective of cancellous bone. The therapeutic implications of these observations await further longitudinal experience with this study population. PMID- 2763870 TI - In vitro mineralization of fetal rat parietal bones in defined serum-free medium: effect of beta-glycerol phosphate. AB - We have developed a bone organ culture system that mineralizes in vitro. Fetal rat parietal bones (20 days old) were cultured in a chemically defined serum-free medium containing physiological 3 mM phosphate. During 5 days in culture, calcium content increased from 26 to 55 micrograms and dry weight increased from 137 to 194 micrograms. After 2 days in vivo, the calcium content of the parietal bone showed a comparable increase to 49 micrograms and dry weight increased to 183 micrograms. During culture, the mineralized bone area in thick sections increased from 11 to 23%, which paralleled the doubling in calcium content. Fluorescent calcein labeling during the 5 day culture period demonstrated that calcification occurs in an ordered pattern. Protein synthesis was assessed by measuring incorporation of [3H]proline into collagenase-digestible protein (CDP) and noncollagen protein (NCP). The percentage collagen synthesis decreased from 17.5% at 0 time to 5.0% at 2 days and then increased to 9.4% at 5 days of culture. Varying the inorganic phosphate concentration in the medium or adding beta glycerol phosphate was found to affect mineralization. After 5 days in culture, bones treated with 1 mM phosphate exhibited a large region of unmineralized osteoid with only a 23% increase in calcium content compared with 112% in control (3 mM phosphate) bones and a 28% increase in dry weight compared with a 40% increase in control. Treatment for 5 days with 6 mM phosphate or 1, 3, or 10 mM beta-glycerol phosphate had no significant effect on dry weight compared to control bones. However, bone calcium content increased significantly from 55 +/- 5 micrograms in control cultures to 105 +/- 7 with 6 mM phosphate, 74 +/- 6 with 3 mM beta-glycerol phosphate, and 75 +/- 5 micrograms with 10 mM beta-glycerol phosphate. Calcified area measured by histomorphometry was also significantly greater than in control bones, but this was mainly due to ectopic calcification in the periosteum, representing from 23 to 74% of the total increase in calcified matrix in bones cultured with 6 mM phosphate or 1-10 mM beta-glycerol phosphate. Ultrastructural analysis demonstrated that ectopic calcification was associated with cell death and debris. Therefore, calcification with beta-glycerol phosphate and high concentrations of inorganic phosphate differed from mineralization in vivo or in bones cultured with a physiologically concentration of phosphate. PMID- 2763871 TI - Osteoclast formation in vitro from progenitor cells present in the adult mouse circulation. AB - The development of multinucleated cells with tartrate-resistant acid phosphatase (TRAP) activity was studied in coverslip cultures of murine blood leukocytes and in cocultures of blood leukocytes with murine fetal bone rudiments. Cells with TRAP activity were not present among the leukocytes before culture and were absent in the bone rudiments at the time of explanation. After 14 days, macrophages with only tartrate-sensitive acid phosphatase activity developed in cultures of leukocytes without long bones. Multinucleated cells were not seen. In cocultures of leukocytes with bone rudiments, however, multinucleated cells with a strong TRAP activity had formed after 10-14 days of coculture. These TRAP positive cells had invaded the bones and resorbed part of the calcified matrix. Electron microscopy revealed ruffled borders on the resorbing cells. In cocultures, TRAP-positive cells also formed from leukocyte fractions depleted of strongly adherent cells. Also on the cellophane supports of the cocultures, mononuclear cells with a stellate appearance and a strong TRAP activity were seen. We suggest that, in the cocultures, osteoclasts developed from a TRAP negative, circulating progenitor cell. The presence of osteoclast progenitor cells in the circulation is discussed in light of the descent of osteoclasts from hematopoietic stem cells. That appearance of TRAP activity was always seen in resorbing cells and was not acquired in monocytes present in the leukocyte fraction by mere culture means that in the mouse TRAP is a useful marker for osteoclasts. PMID- 2763872 TI - Normal vertebral dimensions and normal variation in serial measurements of vertebrae. AB - A total of 568 lateral spine radiographs of 191 generally healthy white perimenopausal women were used to determine the limits of normal for shape and dimensions of the vertebral bodies most often involved in osteoporotic fracture. Anterior and posterior vertebral heights for T7-L4 were used to compute wedge shape, relative posterior height, and relative serial change. Wedge shape was defined as anterior height minus posterior height divided by posterior height. Relative posterior height was defined as the posterior height of a vertebra minus the posterior height of the vertebra superior divided by the posterior height of the vertebra superior. The degree of normal wedging depended on position: wedge values progressed down the spine, from a mean of -0.106 at T7 to 0.048 at L4. The minimum normal wedge value ranged from -0.209 at T7 to -0.083 at L4. Radiographs on a cohort of 28 osteoporotic women were evaluated both by ordinary clinical reading of the radiographs and by using the standards developed from the normal subjects. Initial agreement between the two modes of assessment was 85.4%, and in resolving the remaining disagreements the clinician agreed that he had initially misread the films in all but 3.2%. On the basis of this limited experience, we conclude that the use of such objective standards, in a computer-operated algorithm, is more accurate than routine radiographic assessment. Serial x-rays spanning a 15-20 year period in these women permitted determination of both reproducibility and longitudinal change in vertebral dimensions in the perimenopause. The mean relative serial change was not significantly different from zero for all vertebrae.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2763873 TI - Acetate inhibition of chick bone cell proliferation and bone growth in vitro. AB - A hypothesis has been advanced that parenteral solutions as commonly formulated for use in clinical practice have a toxic effect on cell metabolism. A specific component of these solutions, sodium acetate, has been suggested to disrupt normal bone turnover and therefore to contribute to the osteopenia observed in patients receiving hemodialysis and parenteral nutrition (PN). We developed an in vitro model to test the hypothesis that sodium acetate at concentrations that are infused in PN solutions has a deleterious effect on bone metabolism. Osteoblasts and preosteoblasts from 16- to 17-day-old embryonic chick calvaria, and tibiae and femora from 10-day-old embryonic chicks were grown in BGJb medium (control) or in BGJb medium plus sodium acetate (5, 10, or 20 mM). Calvarial cell proliferation was quantified by direct cell counts as well as by incorporation of [3H]TdR into DNA as an index of cell proliferation. Calvarial cell alkaline phosphatase activity was quantified by the ability of extracts of the cultured cells to hydrolyze p-nitrophenyl phosphate to p-nitrophenol, and bone growth was determined by measuring final dry weight. Calvarial cell counts as well as DNA synthesis showed a dose-dependent decrease in the presence of sodium acetate (5 20 mM) compared with controls. [3H]TdR incorporation was decreased a mean 19% with 5 mM, 38% with 10 mM, and 63% with 20 mM acetate. Alkaline phosphatase activity per cell increased 48% with 5 mM, 140% with 10 mM, and 355% with 20 mM acetate. Cell viability as assessed by trypan blue exclusion was identical for test and control media (greater than 95%).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2763874 TI - Cyclosporin A induces in vivo inhibition of resorption and stimulation of formation in rat bone. AB - We investigated a possible "in vivo" effect of cyclosporin A, an immunosuppressive agent, on normal rat bone remodeling. At an oral daily dose of 7 mg/kg for 14 days, the blood level of cyclosporin A was in the usual effective range and no change in renal function or magnesium metabolism was observed. Treated rats had decreased bone resorption: urinary hydroxyproline, plasma acid phosphatase, and the number of osteoclasts in caudal vertebrae were significantly reduced. By contrast, bone formation assessed by dynamic histomorphometry after double tetracycline labeling was increased. No modification of calciotropic hormones (vitamin D metabolites and parathyroid hormone as assessed by urinary cyclic AMP) was observed at the end of the treatment. These results suggest that in vivo cyclosporin A treatment induces bone remodeling modifications related to either a direct or a lymphokine-mediated effect on bone cells. PMID- 2763876 TI - Effects of altered calcium intake on diurnal and calcium-stimulated plasma calcitonin in normal women. AB - We sought to determine if any protective effect of dietary calcium (Ca) or Ca supplements on bone could be at least partially mediated by increased calcitonin (CT) secretion. First we studied 10 healthy premenopausal women (median age, 35.5 years) who were randomized to high or low dietary Ca intake (1752 versus 391 mg elemental Ca per day) for 2 weeks and then crossed over. At the end of each dietary period, blood was drawn on 1 day at 0800, 1200, 1700, and 2000 h to assess diurnal variation of plasma CT levels. CT secretory reserve was assessed on the next day by Ca infusion (2 mg Ca per kg body weight over 5 minutes). Next, we studied 10 healthy premenopausal women who took a low-Ca diet (approximately 400 mg Ca per day) for a 2 week control period. The women were then randomized to high- or low-Ca intake [400 mg dietary Ca +/- 1500 mg Ca per day (as supplemental CaCO3)] and then crossed over. At the end of each study period, the diurnal variation in CT was tested on day 1; the CT secretory reserve was assessed on day 3 by an oral Ca load (500 mg as CaCO3)] and on day 5 by Ca infusion. Plasma immunoreactive CT was measured in whole plasma (iCT) and after silica extraction (exCT), predominantly monomeric CT. Neither increased dietary Ca nor Ca supplements affected the diurnal levels of iCT or exCT or augmented plasma CT responses to an oral Ca load.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2763875 TI - Ultrastructural localization of tartrate-resistant, purple acid phosphatase in rat osteoclasts by histochemistry and immunocytochemistry. AB - The intracellular localization of the tartrate-resistant purple acid phosphatase in osteoclasts of developing rat bone has been determined immunocytochemically using an antiserum to the purified bone-derived purple acid phosphatase. The localization of the immunoreactivity was compared with the results of enzyme histochemistry using p-nitrophenylphosphate as substrate and 10 mM tartrate. Both methods revealed the presence of the enzyme in numerous vesicles of various sizes up to 2-3 microns in diameter and in granules. There was no immunoreactivity in the Golgi apparatus, and tartrate completely inhibited the histochemical activity of this organelle. No consistent extracellular activity could be detected, nor was any reaction product observed at the ruffled border. The localization of the tartrate-resistant purple acid phosphatase in osteoclasts is consistent with an intracellular function for this enzyme. PMID- 2763877 TI - Stimulation of inositol phosphate formation in ROS 17/2.8 cell membranes by guanine nucleotide, calcium, and parathyroid hormone. AB - In addition to stimulation of cyclic AMP, parathyroid hormone (PTH) may influence cellular events by utilizing other pathways of hormone action, such as the generation of inositol phosphates (IPs). We sought to examine this potential action of PTH by assessing the formation of inositol phosphates in PTH-sensitive ROS 17/2.8 cells. The polyphosphoinositides were labeled by growing the cells with [3H]inositol following which cell homogenates were prepared. The nonhydrolyzable guanine nucleotide, GTP gamma S, and calcium ion, alone and together, stimulated all three IPs, IP1, IP2, and IP3. IP1 formation was linear over 30 minutes but IP2 and IP3 accumulated more rapidly peaking by 5 minutes for all agonist conditions. The proportion of total P as IP3 was enhanced when the cells were grown with retinoic acid (1 microM) or when the assay was conducted at pH 4.5. In addition, the lower pH was associated with much more enzyme activity. PTH agonists, bPTH-(1-84) and bPTH-(1-34), both caused a small but significant stimulation of IP3 formation. When bPTH-(1-84), and the analog bPTH-(3-34)amide, that inhibits PTH-mediated adenylate cyclase activity were present together, there was additive stimulation of IP3 formation compared with that with either agent alone. The results demonstrate that inositol phosphate formation can be stimulated directly in a membrane preparation of ROS cells by GTP gamma S, calcium ion, and PTH and that the enzyme mediating this activity, phospholipase C, is regulated by a guanine nucleotide binding protein. PMID- 2763878 TI - Relationship of body composition, muscle strength, and aerobic capacity to bone mineral density in older men and women. AB - We evaluated the relationship of body composition, maximal aerobic capacity (VO2max), and muscle strength to bone mineral density in 91 healthy men and women, age 61-84 years. Lean body mass was estimated from two independent measures of fat mass, bioelectrical impedance and skinfold thickness. VO2max was determined by treadmill ergometry with direct measurement of oxygen consumption. Grip and back strength were measured by isometric dynamometry. Mineral density of lumbar spine and midradius were measured by dual- and single-photon absorptiometry. Men had significantly greater lean mass, muscle strength, aerobic capacity, and bone density than women. In women, grip strength correlated with forearm and spine density (r = 0.37, r = 0.28, p less than 0.05). In men, grip strength correlated with forearm density (r = 0.47, p less than 0.05), and back strength was significantly correlated with both spine (r = 0.46, p less than 0.01) and forearm density (r = 0.46, p less than 0.01). In women, neither forearm nor spine density correlated significantly with aerobic capacity. In men, midradius density did not correlate significantly with oxygen consumption, but the simple correlation between spine density and VO2max was significant (r = 0.41, p less than 0.05). Back strength and VO2max were significantly related in men (r = 0.47, p less than 0.01). By stepwise multiple regression, back strength emerged as the most robust predictor of spine mineral, accounting for 19% of the variation in bone density. Addition of VO2max to the regression did not add significant predictive value. However, when VO2max was expressed per kilogram lean body mass, both back strength and VO2max contributed significantly to the prediction of spine density in men, and the coefficient of determination R2 increased to 0.30. We conclude that body mass and grip strength, but not aerobic capacity, significantly predict bone density in elderly women. In elderly men, back strength is a more robust predictor of axial bone density than traditional expressions of aerobic capacity, but VO2max per kilogram lean mass and back strength both make significant contributions to the prediction of spine mineral density. The applicability of these results to younger men and women is uncertain. PMID- 2763879 TI - Parathyroid hormone-related protein relaxes rat gastric smooth muscle and shows cross-desensitization with parathyroid hormone. AB - Previously, we reported that parathyroid hormone (PTH) is a potent and effective relaxant of rat gastrointestinal smooth muscle. Since the recently discovered PTH related protein (PTHrP) has amino-terminal homology with PTH and acts like PTH on bone and kidney, we decided to study the effects of synthetic PTHrP analogs on the isometric tension of rat fundic strips. Rat (r) PTH-(1-34), human (h) PTHrP (1-34), and [Tyr0]hPTHrP-(1-34) relaxed acetylcholine-stimulated fundic strips in a dose-dependent manner, with an IC50 of 6, 10, and 31 nM, respectively. However, maximal doses of [Tyr0]hPTHrP-(1-34) were considerably less effective than the other two peptides. Addition of rPTH-(1-34) or hPTHrP-(1-34) to a maximally effective dose of [Tyr0]hPTHrP-(1-34) produced no further relaxation, indicating that [Tyr0]hPTHrP-(1-34) also has antagonistic properties. Bovine PTH-(3-34) an established in vitro antagonist of PTH, partially inhibited the relaxant effect of PTHrP. Fundic strips that had been desensitized by preincubation for 30-45 minutes with either rPTH-(1-34) or hPTHrP-(1-34) (330-500 nM) were also insensitive to the relaxant action of either peptide, but in the same preparations, the relaxation produced by vasoactive intestinal peptide was unaffected. These studies indicate that PTHrP and PTH can interact with the same receptor. Whether PTHrP influences gastrointestinal motility in normal or tumor bearing persons remains to be investigated. PMID- 2763880 TI - Muscle strength, physical fitness, and weight but not age predict femoral neck bone mass. AB - Hip fractures are the most serious complication of osteoporosis. Although low proximal femoral bone mineral density (BMD) does not cause hip fractures directly, it is clearly a prerequisite for the increased risk associated with aging. To investigate the mechanism of the age-related decline in proximal femoral bone mineral density, we have examined the relative importance of muscle strength, physical fitness, and body mass index (BMI) in addition to age in the determination of proximal femoral BMD in 73 healthy female volunteers age 20-75 years. Muscle strength was an independent predictor of BMD at all three sites in the proximal femur as well as in the lumbar spine and forearm; proximal femur BMD was also predicted by physical fitness. BMI was a positive predictor of bone mass at all sites. In the proximal femur, age was not an independent predictor of BMD at any site. In postmenopausal women muscle strength was a significant predictor of bone mass in the femur and forearm, but not in the spine. However, BMI remained predictive of bone mineral at all sites. Muscle strength, physical fitness, and weight appear to exert independent effects upon bone mass. Age effects may be mediated indirectly through associated changes in these factors. The integrated physical load on the skeleton may be a final common pathway. PMID- 2763881 TI - [Xanthogranulomatous pyelonephritis. Our experience in the last 10 years]. AB - A retrospective study of 34 xanthogranulomatous pyelonephritis (XGP) cases operated on in our Service was performed. An analysis is made of the clinical signs, laboratory data, imaging diagnostic techniques and the value of cytology in the assessment of this entity. A very characteristic clinical and biological picture, although somewhat nonspecific of XGP, was encountered. The high sensitivity of simple abdominal X-ray films and I.V.U., as well as the high specificity of cytologic studies in the diagnosis of the disease, was shown. PMID- 2763882 TI - [Prognostic factors in superficial bladder carcinoma. Analysis of 250 cases]. AB - Surface vesical tumors constitute 80% of transitional cell tumors. They are neoplasms of slow evolution, but characterized by their tendency to recur and progress in time. The prognostic factors, as regards recurrence and progression, are going to depend on a series of macroscopic or microscopic anatomic characteristics. We present our observations on some prognostic aspects in surface vesical carcinoma obtained from a study of 250 patients. By way of conclusion, from our observations we may infer that neither age, nor sex nor location, save in the case of patients under the age of 40, have prognostic value in the evolution of the primary tumor, which will be noticeably better (lower percentage of relapses and longer illness-free period) in patients with a single tumor of low grade and state, and in general in patients receiving intravesical prophylactic chemotherapy treatment, and no difference is found between thio-tepa and adriamycin. PMID- 2763883 TI - [Evaluation of seminal carnitine as a marker of epididymal function]. AB - Carnitine is present in seminal fluid either as a free compound or in acetylated form, and as can be inferred from the latest studies, it is of epididymal origin. In the present study, a comparative analysis has been made between carnitine levels in a group of subjects made up of fertile males and another group composed of patients with varying degrees of oligo-asthenospermia. The levels of free carnitine were measured through the enzyme-colorimetry method of Marquis and Fritz. It was found that carnitine levels were significantly lower in the oligo asthenospermic group, and that such levels decreased progressively as the degree of oligo-asthenospermia increased. On the other hand, a regression analysis showed an increase in carnitine values as seminogram parameters measuring sperm motility and maturation (vitality, active motility, hypo-osmotic test, sperm count per ml and total sperm count of ejaculate) increased. Such differences lead us to think that carnitine plays an important role in the maturation process and in development of sperm motility. PMID- 2763884 TI - [Value of postoperative cytology for the early diagnosis of incomplete resection of bladder tumors]. AB - The possibility that after T.U.R. of superficial bladder tumors, some fragments remain unresected, or that local metastases may have gone unnoticed during surgery which may later be interpreted as early relapses of the original tumor, has led us to assess urine cytology taken through early bladder lavage after T.U.R. as a means to control complete removal of tumors during endoscopic surgery. After comparing cytologic results with cystoscopic and biopsy findings, it was found that the sensitivity of the method increased progressively with the degree and staging of the original lesion, with "in situ" carcinomas presenting the highest percentages relating to low grade cytology due to the great similarity these cells have with those of urothelial repair. The best time to obtain samples for cytologic study is at the withdrawal of the catheter, coinciding with cessation of hematuria. PMID- 2763885 TI - [Our experience in the endoscopic treatment of ureteral lithiasis. 120 cases of transurethral ureterorenoscopy]. AB - We present our experience over 3 years in the treatment of ureteral lithiasis by means of transurethral ureteroscopy. We analyze the results of our first 120 cases. The percentage of overall successes is 74%, which varies significantly according to whether the calculus is located in the upper or lower third of the ureter and according to the curve of apprenticeship. Iatrogenic problems drop considerably after 50 cases. Rigid transurethral ureteroscopy has become our preferential therapeutic procedure in practically every type of ureteral lithiasis and we have discarded flexible transurethral ureteroscopy for its useless results. PMID- 2763886 TI - [Torsion of the hydatid of Morgagni]. AB - We present 22 cases of torsion of the hydatid of Morgagni, attended in our hospital in the space of seven years (1981-1988), which were subjected to emergency operation. The ages ranged from 6 months to 16 years, with an average age of 9 years. The typical symptomatology was the sudden appearance of acute pain, located most frequently in the left side, accompanied by vegetative symptoms, without the existence of fever and micturition syndrome. The most significant exploratory diagnostic element in torsion of the hydatid of Morgagni prior to surgery is the palpation of a painful nodule on the upper pole of the testicle and which corresponds to the twisted hydatid. We outline the guidelines for diagnosis and treatment used, emphasising the importance of early surgery as the means of suppressing the symptomatology and forestalling complications, besides confirming the diagnosis. PMID- 2763887 TI - [Prospective study for the evaluation and prophylaxis of urinary tract infections, secondary to the intravesicular instillation of cytostatics]. AB - The aim of this study is to ascertain the number of urinary infections that occur after every catheterization for the instillation of an endovesical cytostatic and to attempt to reduce the percentage of infections by means of specific plans and methods. The study was carried out during the months of April, May, June, July, September, October and November 1988 and the collection of urine for culture was laid down as standard practice in all patients before instillation. In the same way, a urine sample was studied if the patient displayed symptomatology after instillation. 474 instillations were carried out on 77 patients during the above mentioned period of time. The number of urine samples collected with significant bacteriuria was 18, which represents 3.8% (reliability margin 2.2%-6%, p less than 0.05). PMID- 2763888 TI - [Vesical malacoplakia]. AB - We present a new case of vesical malacoplakia in a 55-year-old male with acute clinical cystitis accompanied by hematuria. We underline the favorable response to treatment with cholinergics and sulfonamides. We comment on the different etiopathogenic and endoscopic points of view. We review the different therapeutic concepts of this singular affection. PMID- 2763889 TI - [Cyst of the prostatic utricle or remnant of the Mullerian duct?]. AB - The presence of a deep pelvic cyst posed the problem of diagnosing cysts originating from a prostatic utricle and those from mullerian vestiges. A case is presented of a male who came for consultation complaining of infertility. After complementary tests, the diagnosis of deep pelvic cyst was arrived at. It was considered that the cyst originated from vestiges of the mullerian duct based on the following clinical and pathological findings: - Appearance in the third decade of life. - No association with external genital anomalies. - Difficulty of surgical removal due to adherence to the prostate gland, seminal vesicles and posterior vesical wall. PMID- 2763890 TI - [Value of LDH in the diagnosis of pseudocystic renal cancer]. AB - An asymptomatic case of cystic renal carcinoma is presented. The only diagnosis of certainty was given by a marked increase in L.D.H. levels in the fluid of the tumor after puncture. The pros and cons of imaging studies, and the relative lack of value of aspiration cytology when negative results are encountered are discussed. The pathological anatomical findings of the nephrectomy sample certified the diagnosis, showing the presence of a pseudocystic adenocarcinoma due to intratumor necrosis. PMID- 2763891 TI - [Benign unilateral hematuria causing anemia by mesangial deposit of IgM]. AB - We present a case of benign unilateral persistent hematuria, due to nephrectomy due to important anemia and requiring several blood transfusions. The only pathological finding obtained during the study of the kidney was the presence of mesangial deposits of IgM. This process is very rare due to its unilateral feature, relevance of the hematuria and from the paradoxical finding that a percutaneous biopsy revealed a normal kidney during a study prior to nephrectomy. PMID- 2763892 TI - [Angiosarcoma of the kidney]. AB - A case of renal angiosarcoma is presented. The extremely unusual frequency of this entity, its clinical and pathological features, and mode of presentation accompanied by intense intratumor hemorrhage, a unique finding compared to other cases of renal angiosarcoma thus far reported, have been highlighted. PMID- 2763893 TI - [Experimental renal insufficiency in rabbits produced by the intrarenal injection of cyanoacrylic ester]. AB - Through a percutaneous intrarenal injection of 2 ml cyanoacrylic ester to each kidney, acute renal failure was induced in 10 experimental rabbits. Seven of the animals died as a consequence of uremia before a period of 64 hours. The other three remained alive for 96 hours although suffering from stable renal failure. Cyanoacrylic ester solidifies immediately after injection, leading to a hardened body which fills the renal pelvis, ureters and also the renal vessels. Each injection induces hydronephrosis and necrotic-hemorrhagic lesions, and infarcts in the case of vascular injection. With this simple technique immediate acute renal failure can be obtained experimentally without causing trauma or involving extrarenal structures. PMID- 2763894 TI - Adolescent patterns of communication about sexually related topics. AB - For this investigation, a sample survey of 179 black females, representing 53 family units, provided data for examining familial patterns in the amounts of information received about the menstrual cycle, sex, and contraception among adolescent daughters, mothers, and grandmothers, and the major source of information about these three topic areas. Significant relationships were found within the triads in the amount of information received about the three topic areas, suggesting familial patterns in the amount of information transmitted intergenerationally. This sample was more likely to report mothers as the source of information, suggesting their importance as formal agents of sexual socialization. Although this sample received large amounts of information about the menstrual cycle, sex, and contraception from their mothers, much information that is necessary for sexual health and informed decision making was neglected. The very young mean age (12.3 years) at first intercourse and the low proportion (24.2%) of teenagers using a method of birth control at first intercourse suggested that intergenerational communication about sex and contraception may not be meeting adolescents' needs. Consequently, attention should be focused not only on mothers as agents of sexual socialization of teenagers, but also the quality and impact of that information on the sexual health of teenagers. PMID- 2763895 TI - Psychological correlates of sexual abuse in adolescent girls in chemical dependency treatment. AB - A study involving 597 adolescent girls in treatment for substance abuse between 1984 and 1986 at nine inpatient facilities in five states reveals a strikingly high prevalence of sexual abuse victimization. Over one-third (35.2%) of the girls acknowledged such a history. In an additional 9.7% of the cases, the primary counselor reported such a history for the patient, although she had denied it, at least at intake. Within this multiproblem, highly stressed population, the sexual abuse victim appears to show slightly different and often more serious psychopathology: a greater incidence of suicidal ideation and attempts, symptoms of agitation, and a sense of shame. PMID- 2763896 TI - Future time perspective: adolescents' predictions of their interpersonal lives in the future. AB - This study investigated adolescent future time perspective. The interpersonal subscale of the Future Likelihood Inventory was administered to a sample of adolescents aged 15 to 20 years. Based on the results of this study of interpersonal life projections, it appears that adolescents do not perceive divorce in their future. However, periods of singlehood, widowhood, and nuclear family life are perceived as extremely likely, particularly among female adolescents. Differences in future time perspective were revealed for gender but not age. PMID- 2763897 TI - The effects of family structure on institutionalized children's self-concepts. AB - This study examined the effects of family structure (intact, stepparent, and single parent) on children's self-concepts, using Parish and Taylor's Personal Attribute Inventory for Children. One hundred sixty-six institutionalized children in Grades 5 through 12 participated in the study. Although a trend was noted for students from single-parent families to check fewer positive adjectives, they did not differ significantly (.05 level) from children from intact families or stepfamilies. PMID- 2763898 TI - Adolescent language as affectively coded behavior: findings of an observational research project. AB - This study aims to formulate a minimal typology of the speech-programming categories of adolescent language. In all, thirty-six adolescents (ages 13 to 18) living in the city of Toronto were recorded both in spontaneous conversational settings and in formal interview sessions. The ensuing analysis of these recordings led to the postulation of three basic categories: emotive, connotative, and socially coded language programming. These categories can be seen to provide a framework within which to conduct more specific kinds of research on adolescent language. PMID- 2763899 TI - Identity and death anxiety. AB - Sixty-three male Caucasian undergraduates were involved in a study examining possible relationships between death anxiety and Erikson's concept of ego identity. Participants were administered Marcia's Ego Identity Status Interview and Templar's Death Anxiety Scale (DAS) in counterbalanced order. A one-way analysis of variance revealed a significant main effect of ego identity status on DAS scores. One identity status, moratorium, was associated with significantly higher DAS scores than the other three statuses. Diffusion, foreclosure, and achievement statuses did not significantly differ on DAS scores. PMID- 2763900 TI - Theoretical and methodological considerations of self-concept measurement. AB - Partially replicating a study by Savin-Williams and Jaquish (1981), assessment of self-concept was explored by investigating the relationships of "presented" and "experienced" selves among seven adolescent girls participating in a team sport at a high school in Southern California. Behavior observations and self- and peer ratings were used to assess three dimensions of self (self-confidence, popularity, and athletic skill) and examine relationships between these multimethods of self-concept measurement. In general, significant correlations between behavior observations and peer ratings were found, but not between behavior observations and self-ratings, or peer and self-ratings. A behavioral approach to measuring self-concept across situations appeared to be more indicative of the multidimensionality of the self than sole reliance on self report. The authors concluded that self-concept measurement requires increased sensitivity to definition of, saliency of, and vacillation within a domain, the reference group used for social comparison, and the impact of previous experience on current views of self. PMID- 2763901 TI - Food behavior of college students. AB - Two hundred twelve undergraduate college students were surveyed near the completion of an introductory nutrition course to identify their patterns of food usage, changes in food habits, and previous nutrition background. Fifty percent increased their use of milk and milk products and 40% their use of vegetables; 50% decreased fat and sugar and one-third decreased salt and calories. About half the class used nutrient supplements before the course started as well as at the time of the survey. Although about half of the students had received some preocollege nutrition information, this factor had no relationship to eating habits. Cluster analysis indicated that students cannot be stereotyped extensively on the basis of dietary behaviors. PMID- 2763902 TI - Adolescent girls in distress: a high-risk intersection. AB - Adolescent girls in distress are at high risk due to their location at the intersection of three populations at risk: adolescents, females, and those in social distress. The first part of this article specifies the parameters of the population in terms of behavioral and personality features, based on empirical research in Israel as well as the United States. The second part discusses the main characteristics of each of the three populations, with special emphasis on the components of transition in each. The third part develops an integrative theoretical model that illustrates the uniqueness of this group and its problems, and that may serve as a basis for the development of diagnostic and treatment tools for helping these girls. In this model, the profiles of adolescents in general, adolescent boys, adolescent girls, and adolescent girls in distress are compared. The comparison is made in terms of physical, cognitive, social, and emotional development, interpersonal relationships, and status in the family. Comparison of the profiles reveals that adolescent girls in distress are located at the extreme end of the spectrum of the six developmental areas. Implications of the findings are discussed in terms of the inconsistency between messages on various levels: explicit versus implicit; intrafamilial versus social; and expectation versus opportunity. It is concluded that the specific needs of this group require the establishment of an appropriate policy as well as a variety of strategies, including nonconventional techniques, for creating a multidimensional intervention program. PMID- 2763903 TI - Adolescent psychic entropy: a response to unacknowledged fears. AB - The purpose of this study was to explore the feasibility of measuring psychic entropy in adolescents and to note the predictability of two variables--gender and grade. The subjects were 22 male and female junior and senior high school Caucasians in a central Kentucky church youth choir. They were given the 20-item Psychic Entropy Measure for Adolescents, which is a list of 20 negatively presented statements rated on a five-point scale. The five highest scoring items specifically reflect the phenomenon of psychic entropy. The findings suggest that unacknowledged adolescent fears may be developmental. The limited sample demonstrated that a revised instrument of the Psychic Entropy Measure for Adolescents could be an effective instrument in therapy. PMID- 2763904 TI - Female identity development and self-reflection in late adolescence. AB - The primary aim of this study was to assess whether the capacity for self reflection in late adolescent females is related to their level of identity development. It was hypothesized that females characterized by advanced identity status (either identity achievement or moratorium) would exhibit a greater capacity for self-reflection than those characterized by less advanced identity status (foreclosure or diffusion). Of 85 subjects who met the criteria for this study (female college students in the New York City area), 32 fit purely into one of four identity statuses; among this latter group, a t test revealed a significantly higher degree of self-reflection for the advanced identity status subjects. Implications for the psychology of identity are discussed. PMID- 2763905 TI - The sense-making approach for audience assessment of adolescents. AB - The purpose of the research was to test the methodology used to identify how adolescents approach their nutrition concerns and questions. The methodology was based on Dervin's sense-making theory. Using a time-line interview technique, 305 adolescents 14 to 16 years of age detailed a situation involving their most important nutrition concerns. Other pertinent information was obtained. Cluster analysis was chosen as the appropriate analysis to identify groups of adolescents who responded similarly to the technique. Discriminant analysis was then used to determine which variables maximally separated the groups. Four groups were identified, two of which described action-oriented approaches to dealing with nutrition situations and differed in terms of how much outside help they wanted. The remaining two groups perceived barriers to dealing with situations and also differed in how much help they wanted. A fifth group indicated no nutrition concerns or questions. The results will be used to develop and test the effectiveness of nutrition education when it is focused on the different approaches. PMID- 2763906 TI - Anxiety in adolescence and its significance for psychoanalysis. AB - The theme of this paper is the well-known resistance of adolescents to participate in analytic treatment and analysts' reservations about treating adolescents, which is perhaps less well known. Several reasons are discussed: For adolescents, the revival of separational and fusional anxieties during the process of individuation as well as resistance to the analytic setting are held responsible; analysts may lack sufficient awareness of their own adolescence and its resulting anxieties to be able to confront this developmental period. In addition, there are countertransference anxieties that are triggered and kept alive by the behavior of the juvenile patient. The different types of analyst anxieties as well as those of the adolescent under analysis are explained and their significance in the process of individuation and the course of therapy is noted. PMID- 2763907 TI - The "second skin": perceptions of disturbed and nondisturbed early adolescents on clothing, self-concept, and body image. AB - The purpose of this investigation was to determine if there were differences between regular education and emotionally disturbed early adolescents with respect to self-concept, body image, and selected uses of clothing. A questionnaire was administered to 74 regular education students from three middle schools. An additional 27 students labeled emotionally disturbed were surveyed from one of the schools. The questionnaire contained existing measures of self concept and body cathexis and a revised clothing scale developed by the authors. Analysis of the data using t tests revealed significant differences between the groups with regard to self-concept and body image. In both cases, regular education students perceived themselves more positively than did those labeled emotionally disturbed. Factor analysis of the clothing-use measure gave rise to five distinct factors, one of which revealed a significant difference between the groups when analyzed by t tests. This factor, "dependence," examined the emotional effects of the use of clothing on individuals, such as the ability to influence mood. The emotionally disturbed students were less likely to use clothing to influence mood than were the regular education students. The results of this investigation lend further credence to the importance of self-concept in the education curriculum, and imply that the usual aspects of the curriculum that deal with self-concept may be served better by helping the individual become more realistic and self-accepting. The use of clothing as a tool to enhance self concept merits further investigation. PMID- 2763908 TI - Gender differences in patterns of spatial ability, environmental cognition, and math and English achievement in late adolescence. AB - Relationships were explored among three measures of spatial ability--the Embedded Figures Test (EFT), the Mental Rotations Test (MRT), and the Differential Aptitude Spatial Relations subtest (DAT)--an environmental cognition task (MAP), American College Testing (ACT) math and English achievement, and gender in a sample of 282 undergraduates. Variance attributable to gender among the spatial tasks ranged from 0.5% in the EFT to 12% in the MRT. Gender accounted for only 1% of the variance in the MAP task. Gender differences were noted in regression analyses; women's math and English achievement scores were both predictive of spatial ability, while for men, only math achievement was predictive of spatial ability. The results were interpreted as substantiating sex role socialization theory of cognitive abilities. PMID- 2763909 TI - Students' preferences for male or female counselors for social and educational problems. AB - Fifty-eight male and 66 female junior high school students were examined to determine their preferences for sex of counselor under personal/social and educational hypothetical counseling situations. Girls demonstrated a definite same-sex preference for both counseling situations, while boys preferred male counselors for personal/social counseling and had opposite-sex preferences for educational counseling. Implications of the findings are discussed in light of earlier contradictory results from research on college students. PMID- 2763910 TI - Delinquents and drug use: a model program for community reintegration. AB - Evidence indicates that serious and persistent delinquency and the frequent use of illicit drugs emerge from common etiological roots. This suggests that treatment efforts which target risk factors of adolescent drug use and crime may be effective in preventing subsequent antisocial behavior. This paper describes Project ADAPT, a treatment program for juvenile delinquents based on the Social Development Model, which integrates this knowledge of risk factors. Project ADAPT is a 3 1/2-year demonstration project which combines behavioral skill training, supportive network development, and involvement in prosocial activities to facilitate the community reentry of youths following placement in a Washington state correctional facility. PMID- 2763911 TI - Affective quality of family relations and adolescent identity exploration. AB - The purpose of this study was to examine the relationship between adolescent pubertal status, the affective quality of family relations, and the early adolescent's exploration of a sense of ego identity. Fifty-one intact families with adolescents in the seventh grade agreed to participate. Each family member completed a battery of questionnaires designed to assess familial adaptation to pubertal growth and identity exploration. The results reveal that the affective quality of parent-adolescent relationships and the pubertal status of the adolescent appear to influence the adolescent's exploration of ego identity. The need to establish the functional significance of familial adaptation to adolescent pubertal growth for identity development is discussed. PMID- 2763912 TI - Adolescent suicide attempters presenting to a pediatric facility. AB - This study profiles the characteristics of adolescent suicide attempters and the treatment they received in a pediatric emergency room (ER). A retrospective chart review of 4,072 adolescents seen in the ER at a children's hospital (CH) from July 1984 to June 1985 was undertaken. Twenty-seven adolescents who had deliberately injured themselves were identified. The average age was 14 years 7 months (range 11-19 years). Fifty-two percent of the patients were white and 78% were female. Ingestion was the most common method (78%), followed by attempted hanging (11%), and wrist laceration (7%). After evaluation by a pediatrician in the ER, 30% of the patients were treated and released, 11% were transferred directly to a psychiatric hospital, and 59% were admitted to the CH, with an average hospital stay of 1.88 days. Once hospitalized, consultations from psychiatry (81%), social service (50%), psychology (19%), and neurology (6%) were obtained. At the time of discharge from either the ER or CH, the patients had a variety of plans for ongoing care, with 52% being referred to outpatient counseling, 37% being transferred to a psychiatric hospital, and 11% having no documented plan for ongoing care. These results demonstrate that the evaluation of suicidal adolescents cared for in a pediatric facility may be episodic and suggest the need for a comprehensive program to approach the problem. PMID- 2763913 TI - Adolescent girls' representations of their genital inner space. AB - Psychoanalytical theory and research based on Freud's observations have viewed female sexual development mainly in terms of the fantasies and sensations aroused by the external genitals of the child. Other authors refer to the significance of females' inner sexual organs that define the cavity surrounded by body mass, included in the body image. The purpose of this study was to examine the relationship between girls' representative modalities of their genital inner space and their identity formation. Randomly selected adolescent girls (n = 275) aged 11 to 18 years were asked to make a drawing (1) of the inside of their body and (2) of their sexual organs. Analysis of the main qualitative features of the drawings indicates that structuration and integration of genital inner space in the body image is a slow developmental process. PMID- 2763914 TI - Communication skills and self-esteem in prevention of destructive behaviors. AB - This study demonstrates the long-range effectiveness of SAY IT STRAIGHT training as a school-based program for the prevention of destructive behaviors by comparing juvenile police offenders among trained and untrained 9th-12th graders for 1 1/2 years following training. In the 1984-85 school year, 357 of the 740 9th-12th graders in a southwestern town completed SAY IT STRAIGHT training. Participation was voluntary and required parental permission. During a five-month pretraining period which began with the first day of school, the number of juvenile police offenders was not significantly different among students who would eventually be trained or not be trained. During the following 7 months including summer vacation, there were significantly fewer offenders among the trained students. The following school year and summer vacation there were again significantly fewer offenders among the trained students. During the whole 1 1/2 year study, the untrained students had about 4.5 times as many criminal offenses as the trained students and their offenses were more severe. Finally, 9th, 10th, and 12th graders as well as 11th-grade females who had been trained showed a significant shift toward behavioral intentions reflecting a greater willingness to implement their constructive decisions and feel comfortable doing so. This study extends the applicability of SAY IT STRAIGHT training which previously has been reported to significantly reduce alcohol/drug-related school suspensions among 6th-8th graders. PMID- 2763916 TI - [Actual food intake of small children at a child day care center]. AB - Investigations on the real food intake of children in day-care centres in the G.D.R. have not yet been carried out. Former studies compared the food intake with the recommendations for the daily intake of energy and nutrients. We have studied the daily food intake of 80 children in a day-care centre over a period of three weeks using the "simplified weighing method". The food intake at home was studied additionally by using a protocol method. The intake of energy during the stay in the day-care centre (three meals) amounted to 90 percent of the recommended quantity. The proportion of carbohydrates was lower and that of fat higher than the recommendations. The intake of iron and vitamin C was below the recommended doses. The total caloric intake and intake of fat per day were above the recommended values. Improvement of the composition of meals will help to overcome the disproportions observed. PMID- 2763915 TI - [Efficacy of child and adolescent health protection in a district--approaches for studying the effectiveness]. AB - The evaluation of the effectiveness of medical in particular preventive measures is an essential prerequisite for the determination of the priorities in the further improvement of medical care conceptions taking into account practical demands. Endeavours to define the terms of quality and effectiveness prove the difficulty of the problem. The description of approaches allows to deduce investigation approaches to judgements on the individual and collective state of health, and to coordinative and cooperative correlations in the medical care for children and adolescents for the purpose of optimizing a health care model on district level. PMID- 2763917 TI - Childhood and youth in a population of the Shendi area (Sudan). AB - This report provides actual information on birth, infancy childhood, and puberty, as well as the development until the marriageable age with respect to customs, ethnic, religious, and social factors of a population in the Shendi area (Sudan) sampled in the village of Umm'Ali: Informations of this nature might be important in view of planning, performance, and efficiency of medical and other measures of health policy directed on special populations. PMID- 2763918 TI - [The physical development of infants and young children. 4. Body mass--a longitudinal study]. AB - As a result of a longitudinal study (performed 1979-1982) on the somatic development of 84 male and 91 female children from birth up to the third year of life, values of body mass expressed as distance values, increments, and growth velocity are presented. As compared to earlier investigations made in the G. D. R. and to studies from other countries differences of the dynamics of body mass development have been found: with the exception of the birth weight the body mass tends to be higher during the first six month of life in contrast to previous studies, whereas between the 9th to the 18th month of life lower values of body mass have been measured. Additional differences in the dynamics of body mass development between boys and girls are presented. PMID- 2763919 TI - [The physical development of infants and young children. 5. Body height--a longitudinal study]. AB - As a result of a longitudinal study (1979-1982) distance values increments and growth velocity of the body length of 84 male and 91 female children are presented for the first three years of life. As compared to earlier longitudinal for the first three years of life. As compared to earlier longitudinal studies performed by other authors and to the G.D.R.-study of 1970/71, the investigated children are taller, in spite of a smaller body length at birth. PMID- 2763920 TI - [Pathology of the lower urogenital tract in children. Papers presented at the 54th congress of the Belgian Society of Urology. Brussels, 27-2 May 1989]. PMID- 2763921 TI - Antenatally diagnosed obstructive uropathy--kidney imaging vs kidney function. PMID- 2763922 TI - [Results of early surgery of obstructive uropathies diagnosed prenatally: apropos of 56 cases]. PMID- 2763923 TI - [Radiologic demonstration of the valves of the posterior urethra]. PMID- 2763924 TI - [Treatment of urethral valves]. PMID- 2763925 TI - Age related flow rate nomograms in a normal pediatric population. AB - Uroflow studies in a normal pediatric population were analysed statistically. Single studies for 511 subjects (272 boys and 239 girls) were reviewed. Nomograms relating peak flow to volume voided and age were established. An acceptable lower limit for peak flow was obtained from the data and a volume voided range was calculated so that both criteria could be used with 90% probability to define the normal voiding situation. The mean values of peak flow rate increased with volume voided in both sexes and also with age in the male population. Different sets of nomograms, which are necessary for daily clinical evaluation, are given. They define the normal values in the normal population. PMID- 2763927 TI - Neurogenic bladder. A clinical approach based on fundamental biohydraulics. PMID- 2763926 TI - Body surface related flow rate nomograms in a normal pediatric population. AB - Uroflow studies for 511 normal pediatric subjects (272 boys, 239 girls) were analyzed statistically. Nomograms relating peak flow to volume voided and body surface were established. An acceptable lower limit for peak flow was obtained from the data and a volume voided range was calculated so that both criteria could be used with 90% probability to define the normal voiding situation. Body surface area was found to be a more reliable index than age in the establishment of nomograms. In the male population the 90% probability applied to a significantly greater volume voided reliability. In the female population mean peak flow rate rose with increased body surface. Finally, in both sexes the 10% lower limit was closer to the regression mean, allowing a tighter distribution around this value. PMID- 2763928 TI - Urodynamics in children with myelomeningocele: early assessment of obstruction and incontinence. PMID- 2763929 TI - [Study of the sensory innervation of the lower limbs and the perineum using evoked somatosensory potentials]. PMID- 2763930 TI - Clean intermittent catheterization in congenital neurogenic bladder. AB - The aim of our study was to evaluate clean intermittent catheterization in children and young adults with congenital neurogenic bladder dysfunction. Thirty four patients with a follow-up of more than 3 months were included in the study. Eighty-six % of patients observed a reduction of the urinary infection rate. Urinary continence improved in 91% (however among these patients 82% also took either anticholinergic or alpha-stimulating drugs). In 46% of the subjects an improvement of the upper tracts was observed. No major complication was observed. PMID- 2763931 TI - The artificial sphincter in the treatment of congenital incontinence. AB - From 1974 to 1988 the available AMS artificial sphincter models (AS 721, AS 761, AS 742, AS 791, AS 792 and AS 800) were implanted in 40 patients with congenital incontinence using a total of 75 prostheses. Despite mechanical problems with the earliest models 82.5% of all patients obtained a good result. The definitive failure rate due to urethral erosion was 2.5% and due to infection of the prosthesis 7.5%. The remaining failures were due to upper urinary tract deterioration in four patients. PMID- 2763932 TI - [The surgical treatment of incontinence in neurogenic bladder in children]. PMID- 2763933 TI - The urge syndrome in children. PMID- 2763934 TI - [Functional urinary pathology and anorectal disorders]. PMID- 2763935 TI - Functional vesico-urethral pathology and the influence on the urinary tract in children. PMID- 2763936 TI - Locoregional anesthesia in pediatric urogenital surgery. PMID- 2763937 TI - [Hypospadias: surgical aspects and personal experience]. AB - In the last eight year period, a series of 102 hypospadias reconstruction performed in our institution were reviewed. 50% presented with marked degree of chordee. Four types of repair where used: MAGPI (n degree 18), Mathieu (n degree 41), Duckett (n degree 28), two stage repair (Duplay) (n degree 12), other procedures (n degree 3). Overall complication rate was 18% and was related to major procedure and difficult technical situations. It never compromised the final outcome of the procedure. The relatively high complication rate mentioned in the literature and in our series emphasizes that hypospadias surgery has to be done by well trained surgeons in this field. PMID- 2763938 TI - [Endocrine aspects of sexual ambiguities]. PMID- 2763939 TI - [Sexual ambiguity: urologic aspects]. AB - Ambiguous genitalia require prompt decision in the neonatal period to give the child the best opportunity to avoid later major problems of sexual identification. A team approach including the neonatologist, the pediatric endocrinologist, the geneticist and the pediatric urologist seems to be the best way to make the right decision. This paper is a review of 48 cases of ambiguous genitalia referred to our center for management. The diagnosis of female pseudohermaphroditism was established in 30 cases with 21 presented with adrenogenital syndrome. Ten patients were considered as having a diagnosis of male pseudohermaphroditism, six presented with gonadal dysgenesis and two were true hermaphrodites. Principles of surgical management for each category of patients is exposed, discussed and will be the way to treat subsequent cases. PMID- 2763940 TI - [The treatment of genital lesions in case of exstrophy and epispadias]. PMID- 2763941 TI - [Anomalies of the urogenital system associated with anorectal malformations. Apropos of 99 cases]. PMID- 2763942 TI - A time to focus on patients, not profit. PMID- 2763943 TI - Bronchial impaction in lobar collapse: CT demonstration and pathologic correlation. AB - Bronchial (or mucoid) impaction refers to the accumulation of inspissated secretions (mucus and/or inflammatory products) within a bronchus, usually accompanied by bronchial dilatation. This process may be caused by abnormal mucociliary transport and excessive production of mucus. In other cases, a discrete lesion may be present that obstructs the bronchus with inspissated secretions accumulating distal to the obstructing lesion. Lobar collapse may result in either case if a lobar bronchus is occluded by the excessive mucus or a discrete obstructing lesion. The CT manifestations of bronchial impaction in four patients with lobar collapse are described. In two patients, the lobar collapse and distal bronchial impaction were produced by a central obstructing bronchogenic carcinoma, whereas the other two patients had an abnormal mucus accumulation without a discrete bronchial obstruction. On CT, the impacted bronchi, best seen on postcontrast images, appeared as relatively low-attenuation branching structures extending from the hilum peripherally into the more opaque enhancing atelectatic lung. In the three patients who had surgical resection of the involved lobe, pathologic examination confirmed the dilated bronchi, filled with mucus (one patient), fibrinopurulent exudate (one), or mucous plugs with Aspergillus hyphae (one). This unique pattern of impaction within a collapsed lobe should be recognized on CT and prompt a search for a possible central obstructing lesion. PMID- 2763944 TI - Fibrosing mediastinitis in the posterior thorax. PMID- 2763945 TI - MR imaging of congenitally corrected transposition of the great vessels in adults. PMID- 2763946 TI - MR diagnosis of lipomatous infiltration of the interatrial septum. PMID- 2763947 TI - MR appearance of gallstones in vitro at 1.5 T: correlation with chemical composition. AB - Gallstones from 63 patients were evaluated by in vitro 1.5-T MR imaging, with T1- and T2-weighted images, and in 14 cases, a fat-suppression sequence (short-T1 inversion recovery imaging). Subsequent chemical analysis was performed on 43 gallstones. In vitro proton MR spectroscopy was performed on 14 stones. On T1 weighted MR images, foci of increased signal were seen in 46 of 63 stones (faint in 17, moderate in nine, and bright in 20). T2-weighted images showed areas of increased signal in 18 of 63 stones (faint in 15, moderate in three). T1-weighted MR imaging patterns were homogeneously dark (17), homogeneously bright (two), homogeneously faint (three), rimmed (dark rim and bright center, 32), and laminated (nine). Short-T1 inversion recovery imaging suppressed the foci of increased signal in 13 of 14 cases. Despite imaging characteristics suggestive of high lipid content, spectroscopy revealed only a single peak corresponding to a large water-proton signal. The T1 relaxation times of the water were shortened, ranging from 0.006 to 0.92 sec, explaining the increased signal seen on MR images of the gallstones. MR imaging characteristics (signal intensity, relative signal area, or imaging patterns) did not correlate with chemical composition. We hypothesize that different structural relationships must exist within gallstones of similar chemical content that alter the water bonding and hence the MR imaging characteristics. PMID- 2763948 TI - Cross-sectional imaging of abdominal wall hernias. PMID- 2763949 TI - Papillary cystadenoma of the broad ligament in a patient with von Hippel-Lindau disease. PMID- 2763950 TI - Occult fractures of the carpals and metacarpals: demonstration by CT. AB - Occult fractures of the carpals and metacarpals occur frequently and are associated with major disability. The cross-sectional display and superior resolution of CT are well suited to the demonstration of these fractures. Sixteen patients with pain and negative conventional radiographs were chosen for further evaluation by CT. Imaging was performed in two planes and showed 21 fractures. The transaxial plane was the most revealing imaging plane. Coronal imaging was equal or superior to the transaxial plane in most fractures of the scaphoid, lunate, capitate, and pisiform bones and of the bases of the metacarpal bones. The direct sagittal plane was the best imaging plane in one patient with fractures of the scaphoid and lunate bones. After discovery of the fracture on CT, surgical removal of the avulsed fracture fragment was recommended in seven patients and fusion was recommended in three. Eight patients had a marked decrease in pain after the surgical procedure. The accuracy of CT for the demonstration of occult fractures may result in earlier recognition of these fractures and a reduction in the associated disability. PMID- 2763951 TI - Anatomic relations between the median nerve and flexor tendons in the carpal tunnel: MR evaluation in normal volunteers. AB - To ascertain the dynamic changes between the median nerve and flexor tendons in the carpal tunnel, MR images of 16 wrists in eight volunteers were studied in flexion, extension, and neutral positions. T1-weighted axial images, 600/20 (TR/TE) were obtained with the wrists straight, extended at 45 degree, and flexed at 45 degree. Each scan was evaluated with regard to positional changes of the median nerve and flexor tendons in the carpal tunnel as well as alterations in nerve shape. In the neutral position, the median nerve was found in one of two standard positions: either anterior to the superficial flexor tendon of the index finger or interposed more posterolaterally between this tendon and the flexor pollicis longus. During extension, the nerve always maintained or assumed an anterior position between the superficial index finger flexor and the flexor retinaculum, while the flexor tendons moved posteriorly. With flexion, the tendons shifted anteriorly toward the retinaculum, and the median nerve was found in one of three positions. It either remained in its anterior position between the superficial index finger flexor and retinaculum or became interposed between the superficial flexor tendons of the index finger and thumb or middle finger and ring finger. Nerve shape varied with its position. Anteriorly positioned nerves were flattened in the anteroposterior plane between the tendon and flexor retinaculum; this was greatest with flexion and least with extension. Interposed nerves were flattened in the mediolateral plane or rounded in configuration. In conclusion, the alignment of the median nerve in the carpal tunnel, its shape, and its relationship to the flexor tendons were variable and dependent on wrist positioning. These findings may explain why certain wrist motions, flexion in particular, predispose a person to carpal tunnel syndrome. PMID- 2763952 TI - MR imaging of the knee in the sagittal projection: comparison of three dimensional gradient-echo and spin-echo sequences. AB - Fifty patients with suspected internal derangement of the knee had arthroscopic examinations after MR imaging with both a standard T1-weighted spin-echo (SE) sequence and a three-dimensional (3-D) gradient-echo sequence. This series permitted correlative evaluation of 100 menisci and 50 anterior cruciate ligaments. Meniscal tears were diagnosed when intrameniscal signal communicated with the meniscal surface. Criteria for diagnosing anterior cruciate ligament disruption included absence or discontinuity of the ligament, ligamentous laxity, and hyperflexion of the posterior cruciate ligament. Arthroscopic surgery confirmed the presence of 39 meniscal tears and 11 anterior cruciate ligament tears in this population. The sensitivity and specificity of the SE sequence for the diagnosis of meniscal tears were 77% and 98%, respectively. The 3-D gradient echo sequence had a sensitivity of 87% and a specificity of 88%. For disruption of the ligament, the SE technique had a sensitivity of 82% and a specificity of 95% and the 3-D technique had a sensitivity of 64% and a specificity of 100%. Although these differences in sensitivity and specificity are not statistically significant at the p less than .05 level, probably because of the small sample size, the results show the relative strengths and weaknesses of the two imaging sequences. These data suggest that because of the complementary results of the two MR techniques, both the SE and the 3-D gradient-echo sequences have a role in the diagnosis of knee injuries. PMID- 2763953 TI - Soft-tissue masses: diagnosis using MR imaging. AB - The MR images of 112 soft-tissue masses of various causes were retrospectively reviewed. Pathologic diagnosis by biopsy was available in 96 cases. Diagnosis in the remaining 16 cases was established by characteristic radiographs, CT scans, and/or arteriograms, in conjunction with appropriate history and clinical follow up. All masses were evaluated with both T1-weighted, 300-600/20-30 (TR/TE), and T2-weighted, 2000/80-100, images. They were reviewed to determine (1) if these images were sufficiently unique to allow a preoperative diagnosis based exclusively on the MR appearance and (2) if benignity vs malignancy could be predicted on the basis of the analysis of the MR image characteristics of the lesion. Concerning the latter, attention was directed to the margins of the lesions, to the impact of the lesion on the surrounding tissues (edema, infiltration, etc.), and to the intensity and homogeneity of the MR signal of the lesion. MR images were sufficiently characteristic to allow a specific diagnosis in 27 (24%) of the 112 cases (10 lipomas, eight hemangiomas, six pigmented villonodular synovitis, two hematomas, and one arteriovenous malformation). MR was incapable of reliably distinguishing between benign and malignant soft-tissue tumors. PMID- 2763954 TI - Technical aspects of abdominal CT in infants and children. PMID- 2763955 TI - CT of blunt abdominal trauma in children. PMID- 2763956 TI - The value of CT in detecting bowel perforation in children after blunt abdominal trauma. AB - In this era of conservative management for most infants and children with blunt abdominal trauma, there is a concern that the diagnosis of bowel perforation may be missed or delayed. To determine the sensitivity of CT in the detection of perforated viscus in this population, we reviewed the CT examinations of 547 consecutive children who had had blunt abdominal trauma. Of six patients (1%) with documented bowel perforation, four (67%) had free intraperitoneal air detected preoperatively by CT. The remaining two cases had secondary signs of bowel thickening and unexplained peritoneal fluid. Free intraperitoneal air was not a specific indicator for bowel perforation. Of nine patients in whom CT studies showed pneumoperitoneum, only four (44%) had a ruptured bowel. The remaining five patients had pneumoperitoneum from sources other than bowel perforation including pneumomediastinum, bladder perforation, and previous peritoneal lavage. This experience shows that the CT finding of pneumoperitoneum is useful, although not specific for the detection of bowel perforation in children with blunt abdominal trauma. When free air is not present, secondary signs of bowel wall thickening and unexplained peritoneal fluid suggest a bowel perforation. PMID- 2763957 TI - MR imaging of the craniovertebral junction, cranium, and brain in children with achondroplasia. AB - MR imaging of the craniovertebral junction, cranium, and brain was performed in 10 patients (aged 3 months to 16 years) with achondroplasia. All patients had narrowing of the subarachnoid space at the level of the foramen magnum and five had compressive deformities of the cervicomedullary junction. Apparent upward displacement of the brainstem and a relatively vertical course of the optic nerve were seen in all patients. Dilated lateral and third ventricles were seen in five patients and bifrontal widening of the subarachnoid space was evident in four. Skull asymmetry was seen in two patients and an empty sella (confirmed by metrizamide cisternography) was present in one individual. In one patient, foci of abnormal signal intensity were seen in the cervicomedullary region. Our experience indicates that MR imaging is useful in delineating the many abnormalities of the cranial, cerebral, and cervicomedullary junction present in children with achondroplasia. PMID- 2763958 TI - Interventional neurovascular treatment of traumatic carotid and vertebral artery lesions: results in 234 cases. AB - Traumatic injuries to the head and neck that result in arteriovenous fistulae are often difficult to treat by direct surgical access. This is because of anatomic location, instability of the acutely injured patient, and difficulty in localizing the exact site of injury. Between 1974 and 1988, 234 consecutive cases of traumatic injuries to the carotid or vertebral artery were evaluated by our group for intravascular embolization therapy. This included 206 cases of direct and seven cases of indirect carotid-cavernous sinus fistulae and 21 cases of traumatic vertebral fistulae. A variety of devices including detachable balloons, liquid tissue adhesives, microcoils, and silk suture were used with the goal of fistula occlusion and preservation of the parent vessel. This was achieved in 193 cases (82%). In the remaining 41 cases (18%), the carotid or vertebral artery had to be occluded by endovascular occlusion techniques because of extensive vascular injury in 28 cases and subtotal occlusion of the fistula in 13 cases. Complications included transient cerebral ischemia in six cases, pseudoaneurysm formation in five cases, stroke in five cases, and peripheral nerve injury in one case. The development of interventional neurovascular techniques has altered the management of these acutely injured patients. The preferred method for treatment has shifted from direct surgical access under general anesthesia to endovascular therapy under local anesthesia. PMID- 2763959 TI - MR characteristics of subdural hematomas and hygromas at 1.5 T. AB - MR images of 24 patients with 33 subdural collections were retrospectively reviewed to determine the spectrum of MR findings associated with such lesions. The lesions were dated by history, when available. Hematomas were grouped as follows: acute, four; early subacute, four; late subacute, four; chronic, 13. Six collections were classified as rehemorrhage; and two patients had CSF hygromas. Subdural hematomas evolved in a pattern similar to intracerebral hemorrhage with the exception of chronic subdural hematomas, in which isointensity of hypointensity relative to gray matter was observed on short TR/TE images compared with the persistent very high signal intensity noted in chronic parenchymal hematomas. Hemosiderin was rarely seen in chronic hematomas. These findings are most likely the result of the absence of a blood-brain barrier, which allowed clearance and dilution of blood products. Subdural hematomas with repeat hemorrhage demonstrated multiple phases of bleeding with layering phenomenon and more frequent hemosiderin deposition. It is possible that the clearance of blood products, as observed in chronic subdural hematomas, is impaired or poorly functional when rehemorrhage occurs. The persistence of high signal from methemoglobin in a hematoma that is expected to be in the chronic phase also suggests repeated hemorrhage. Acute CSF subdural hygromas had signal intensities identical to CSF without MR evidence of blood products. At surgery, clear fluid under pressure was found. MR imaging, with its unique ability to delineate the various phases of hemorrhage, is well suited to the evaluation of subdural hemorrhage. PMID- 2763960 TI - MR imaging of intracranial fluid levels. AB - Six patients with seven intracranial fluid levels were evaluated with both CT and MR at 1.5 T. A surgical diagnosis was obtained in six of the seven instances. MR was found to be superior to CT in detecting intracranial fluid levels, and the MR signal characteristics were helpful in identifying their contents. These cases demonstrate the necessity for a slightly different approach to lesions with fluid levels. In one patient, imaging in the prone position allowed detection of a solid component; in several others, detection of the fluid level was dependent on the selection of nonroutine windows and levels. Fluid levels are classified with respect to their components and MR features. MR is superior to CT in imaging fluid levels. The appearance of fluid levels on MR varies with their composition, the ratio of the components, the sequence parameters, and the position of the patient. PMID- 2763961 TI - The acetazolamide challenge: imaging techniques designed to evaluate cerebral blood flow reserve. AB - Cerebral blood flow was analyzed by the stable xenon (Xe)/CT scanning technique in 29 patients with significant vascular lesions before and after administration of an acetazolamide (Diamox) vasodilatory challenge. Three response types were identified: I, normal flow before Diamox with flow augmentation after Diamox; II, low flow before Diamox with flow augmentation after Diamox; and III, low or normal flow before Diamox with no augmentation or decreased flow after Diamox. Twenty-four percent of the patients studied qualified for category III. We believe that patients in this category represent a group of individuals without blood flow reserve whose clinical management should include careful consideration of their hemodynamic status. The Xe/CT scanning technique with the addition of Diamox flow challenge is a clinically accessible and effective method for assessing cerebral blood flow and blood flow reserve. PMID- 2763963 TI - Balloon occlusion of a pseudoaneurysm in a below-the-knee amputation stump. PMID- 2763962 TI - Dissecting renal artery aneurysm: treatment with an endovascular stent. PMID- 2763964 TI - Diagnostic significance of interslice gap and imaging volume in body MR imaging. AB - Thin interslice gaps and large imaging volumes are detrimental to MR signal and contrast, especially when the body coil is used. To show the influence of these two factors on fat and water signal and contrast, we performed a series of in vitro experiments. A cylinder filled with water and another filled with oil were imaged transaxially (TR = 2000 msec; TE = 20 and 70 msec) with different interslice gaps (0-150% slice thickness). A series of images was obtained to cover a 40-cm imaging volume. Increasing interslice gap thickness increased water signal without affecting fat signal, resulting in a decrease in fat/water contrast on TE = 20 msec (less T1-weighting) and increasing contrast on TE = 70 msec (more T2-weighting). Contrast nearly doubled when the interslice gap was increased from 10% to 75%. As slices moved away from the central slice, fat and water signals decreased slowly to 12.5 cm off center. Signal loss was significant with offsets greater than 12.5 cm. These results emphasize that to obtain proper contrast on T2-weighted images, the optimal interslice gap should be used and the region of interest should be near the central slice. Otherwise, images should be interpreted with caution. PMID- 2763965 TI - Contrast agents and the ozone layer. PMID- 2763966 TI - Clinical significance of traumatic pneumorrhachis. PMID- 2763967 TI - MR detection of probable hematopoietic hyperplasia involving the knees, proximal femurs, and pelvis. PMID- 2763968 TI - Semiautomated slide identification by using a personal computer and printer. PMID- 2763969 TI - Subhepatic abscess caused by appendicitis. PMID- 2763970 TI - Obstructive jaundice in polycystic disease of the liver. PMID- 2763972 TI - The nursing crisis in Alabama, a "supplier" state. PMID- 2763971 TI - Viridans streptococcal endocarditis. AB - Although responsible for a declining proportion of cases of infective endocarditis, viridans streptococci remain the commonest cause and accounted for 30% of our cases seen in Huntsville, Alabama. Usually viridans streptococcal endocarditis is associated with dental manipulation or infection and underlying heart disease but both conditions were not common in our series. Similar to the experience of other investigators, our patients exhibited a subacute course with fever, dyspnea, weight loss and heart murmur. Echocardiography, reported useful in detecting vegetations in one series, was not a sensitive diagnostic tool in our patients. We confirmed the low relapse rate and mortality rate associated with earlier reports of viridans streptococcal endocarditis but observed a high rate of complications, as noted in a recent series. PMID- 2763973 TI - FDA reconsiders ban on home kits for HIV antibody testing. PMID- 2763974 TI - Inspector General's report on physician dispensing. As the practice continues to grow, states seek more regulations. PMID- 2763975 TI - Condom counseling. PMID- 2763976 TI - Electrolyte-replacement solution alternatives. PMID- 2763977 TI - Mandate safety caps on all drug samples. PMID- 2763978 TI - Lawrence C. Weaver, PhD. Thoughts of the 1989 Remington medalist. PMID- 2763979 TI - Cancer detection and the community pharmacist. AB - A questionnaire was prepared to asses community pharmacists' perceptions of their abilities to recognize the common signs and symptoms of cancer and their preferred methods for obtaining further education. Of 5,539 questionnaires mailed, 1,187 were returned and analyzed. Seventy percent of the pharmacists reported that at least one patient per month sought advice about possible cancer signs and symptoms. Almost half estimated that between 1% and 25% of the patients who had sought advice for these cancer signs and symptoms had attempted to purchase a medication to treat these symptoms. The vast majority of the pharmacists perceived that they could recognize common signs and symptoms of skin, breast, and colorectal cancers. However, the majority felt they could not identify the symptomatology for six other common cancers. Essentially all pharmacists rated education in cancer symptomatology to be important. There was no consensus as to the type of provider, format, or times for this continuing education. These data suggest that pharmacists can play an important role in the early detection and prevention of cancer. The rate of interaction by pharmacists in this study translates to more than 60,000 patients counseled about cancer symptoms per 1,000 pharmacists per year. Further education of the pharmacist in cancer detection is warranted, and appraisal of the outcome of such educational interventions on patient-referral patterns and cancer-related diagnoses is imperative. PMID- 2763980 TI - Ciprofloxacin: a fluoroquinolone antimicrobial. Part 2. PMID- 2763981 TI - Severity of precipitated opiate withdrawal predicts drug dependence by DSM-III-R criteria. AB - Drug diagnoses in DSM-III-R are based on the dependence syndrome concept which hypothesizes that dependence on drugs is defined by behavioral and physiological changes but is separate from the social problems related to drug use. Previous studies provide support for the dependence syndrome in drug use; however, no study has examined whether biological indications of addiction are related to the dependence syndrome. The present study tests this relationship in 52 opiate addicts who were administered the Naloxone Challenge Test. The severity of withdrawal was correlated positively with the opiate dependence score, derived from the number of DSM-III-R criteria met. We also found that opiate withdrawal was inversely related to cocaine dependence and unrelated to any other drug use. Opiate withdrawal was not correlated with a global measure of social problems or to frequency or length of drug use. Our results support the validity of the dependence syndrome in opiate addiction because dependence is correlated with severity of withdrawal, is fairly specific to the drug, and is not related to social problems. PMID- 2763982 TI - Comparison of the characteristics and functioning of cocaine treatment and cocaine research subjects. AB - Comparisons were made of the functioning and characteristics of cocaine-abusing volunteers to a research ward (N = 25) and to an outpatient treatment program (N = 33) at the same research facility. It was hypothesized that individuals volunteering for clinical studies and for treatment-related studies would represent different segments of the cocaine-abusing population, and that those differences could be significant to an understanding of study findings. Demographic/background variables were assessed through use of the Addiction Severity Index, risk-taking behaviors relative to HIV infection and AIDS through use of a structured interview schedule, intellectual functioning through use of the Shipley Institute for Living Scale, and psychiatric symptoms through use of the Hopkins Symptom Check List (SCL-90R). Significant differences were obtained for criminal activity, needle sharing, and selected psychiatric symptoms. Marital status was particularly important to an understanding of differences between research and treatment groups in that unmarried treatment subjects showed significantly greater psychopathology than research subjects on 3 of 11 symptom scores. Unmarried treatment subjects showed significantly greater deviance than married treatment subjects on 7 of 11 symptom scores. The findings suggest a relationship between marital status and the psychological functioning of treatment clients and indicates that different segments of the cocaine-abusing population volunteer for different types of research. PMID- 2763983 TI - The functioning of individuals on a drug abuse treatment waiting list. AB - Using structured interviews and the SCL-90R, study was made of the behaviors of 29 applicants to a residential treatment program for cocaine abuse who had been placed on the program's waiting list for periods ranging from 1 to 6 months. It was hypothesized that applicants waiting treatment for 3 months or less (N = 16) would be more likely to view themselves as treatment candidates and would show behaviors different from those waiting 4-6 months (N = 13). Being on the waiting list a longer period was associated with greater evidence of criminal justice involvement, but with few other differences. Nearly half the total sample (48.3%) reported having significantly reduced drug use in association with their applying for treatment, but most applicants (58.6%) were pessimistic about their long-term capacity to remain free of drug-related difficulty. The pattern of SCL-90R scores for all subjects suggested significant psychiatric symptoms, including depression. Nonetheless, a majority of all applicants (51.7%) reported themselves as having become less interested in entering treatment. Nearly all applicants reported high levels of encouragement for their decision to enter treatment from persons with whom they were living and about half reported encouragement from friends. Of the 23 applicants who were IV drug users, 10 (41.7%) reported knowing someone who had contracted AIDS, 87.0% reported having changed behaviors--chiefly needle sharing--to reduce the risk of infection, and 69.6% reported having obtained HIV testing. The difficulty encountered in locating a random sample of applicants suggests the problem of maintaining a useful waiting list for treatment.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2763984 TI - Drug abuse in schizophrenia and bipolar disorder. AB - The incidence and type of drug abuse for 50 male schizophrenic patients and 60 male and female bipolar, manic patients were determined. Fifty percent of schizophrenic patients and 25% of bipolar patients abused one or more drugs. Alcohol, cannabis, and cocaine accounted for 82% of the drug abuse. PMID- 2763985 TI - Substance abuse/mental illness: diagnostic issues. AB - "Dual diagnoses" of substance abuse and mental illness disorders are common both in psychiatric and substance abuse treatment settings. Recent studies have demonstrated that specific diagnostic categories of mental illness have implications for treatment outcomes of dually disordered patients, but a diagnostic standard has not emerged. The present study compared lay-administered DIS diagnoses with clinical diagnoses of patients in a state hospital treatment program for "dual diagnoses" patients. Categories of DIS diagnoses showed weak association with categories of clinical diagnoses. Several frequent DIS diagnoses were not made clinically and vice versa. Implications for choice of diagnostic instruments to use with this patient population are discussed, as is the potential value of structured assessments in supplementing clinical data. PMID- 2763986 TI - Informed consent, deception, and the use of disguised alcohol questionnaires. AB - In preparation for a physician intervention trial to determine the effectiveness of treatment of alcoholism in a primary care setting, a study was conducted to determine patient reaction to a masked alcohol screening questionnaire. The disguised questionnaire was developed to improve the accuracy of self-reported drinking behavior and facilitate blinded randomization to an intervention and control group. Patient reaction was determined by a face-to-face structured interview. The interview was structured to elicit responses before and after the patient was informed of the true nature of the questionnaire. The sample consisted of 21 alcoholic and 33 nonalcoholic patients in a primary care clinic. Seventy-five percent of the respondents were comfortable not being fully informed when research procedures involve the use of disguised alcohol questionnaires. There was some discomfort over the deceptive nature of the questionnaire, but 83% of the subjects believed the deception was justified and necessary. Males and alcoholics in the sample were more comfortable not being fully informed about research procedures suggesting greater trust in the medical profession. Females, on the other hand, were more concerned than males about how a family member would react to the disclosure of family health information. Alcoholics and persons with only a high school education felt the use of disguised questionnaires improved their accuracy significantly more often than nonalcoholics or individuals in the sample who attended graduate school. PMID- 2763987 TI - Attitudes of mental health professionals toward alcoholism recognition and treatment. AB - The attitudes of 100 urban mental health professionals toward alcoholism diagnosis and treatment were assessed using a 23-item questionnaire. A significant number of those sampled, physicians more than other professional groups, looked upon alcoholism as a disease in its own right. Physicians, attendings more than residents, subscribed to a more medical history-taking model. While the majority of those surveyed would advise complete sobriety, a large number would not. Likewise, despite a large percentage of our sample who indicated familiarity with alcohol-related concepts, a significant number did not. Referral to Alcoholics Anonymous was highly endorsed by those advocating sobriety. The meaning of these findings is discussed in relation to the marked improvement noted in professionals' attitudes toward alcoholic patients. Based on these findings, methods of further improving the clinician's awareness of alcoholism are considered. PMID- 2763988 TI - Addiction to tranylcypromine (Parnate): a case report. AB - The monoamine oxidase inhibitors are increasingly prescribed for several disorders today, after a hiatus of nonuse lasting a decade. One case of excessive MAOI use and two cases of MAOI withdrawal are reported in the literature. This case report adds a fourth instance and suggests patient characteristics which should alert the clinician to the risk of MAOI abuse or addiction. PMID- 2763989 TI - Poland and US collaborative study on cardiovascular epidemiology. I. Introduction and baseline findings. AB - The Poland-US Agreement for Health Cooperation has as its goal the sharing of scientific information in cardiovascular disease epidemiology between the two countries. Patterns of cardiovascular disease and identification of risk factors were investigated through two large epidemiologic studies, the Pol-Monica Study in Poland and the US Lipid Research Clinics Program Prevalence Study in the United States. These two studies are described with regard to methodological issues, comparability of data collection procedures, and demographic and behavioral characteristics of the two populations involved. Mean blood pressure, lipids, and body mass indices of participants in these studies are also compared. PMID- 2763990 TI - Poland and US collaborative study on cardiovascular epidemiology. II. Correlates of lipids and lipoproteins in men and women aged 35-64 years from selected Polish rural, Polish urban, and US samples. AB - Three diverse samples of men and women aged 35-64 years living in urban Poland, rural Poland, and the United States, are described and subsequently analyzed by multiple regression methods. Total cholesterol, low density lipoprotein (LDL) cholesterol, high density lipoprotein (HDL) cholesterol, and the natural logarithm (ln) of triglycerides are treated separately as dependent variables, with several demographic, behavioral, and biologic factors as independent variables. In the analyses of total cholesterol, systolic blood pressure was statistically significant in men and women in all three samples, while Quetelet index, cigarette smoking, age, ethanol consumption, and education were significant in at least one of the samples. In the LDL cholesterol analyses, Quetelet index and cigarette smoking were the predominant variables; in the HDL cholesterol analyses, Quetelet index, cigarette smoking, ethanol consumption, and age were key variables; and in the ln triglycerides analyses, Quetelet index, cigarette smoking, education, and systolic blood pressure were significant. PMID- 2763991 TI - Poland and US collaborative study on cardiovascular epidemiology. III. Correlates of systolic and diastolic blood pressure in men and women aged 35-64 years from selected Polish rural, Polish urban, and US samples. AB - Three diverse samples of men and women aged 35-64 years living in urban Poland, rural Poland, and the United States are described and subsequently analyzed using systolic blood pressure and diastolic blood pressure separately as dependent variables in multiple regression. Several demographic, behavioral, and biologic factors are included in the models as independent variables. Heart rate, Quetelet index, high density lipoprotein cholesterol, and the natural logarithm of triglycerides were statistically significant in accounting for variation in systolic pressure in men in all three samples, whereas only heart rate and Quetelet index were significant in women in all samples. In the analysis of diastolic pressure, Quetelet index, heart rate, and ethanol consumption were statistically significant in men in all three samples, while only Quetelet index and heart rate were significant in women in all samples. PMID- 2763992 TI - Risk factors for long-term coronary prognosis after initial myocardial infarction: the Framingham Study. AB - The role of standard coronary heart disease risk factors in predicting the long term risk of recurrent coronary events in survivors of myocardial infarction is examined. Of 697 subjects (464 males and 233 females) who experienced an initial myocardial infarction during 30 years of follow-up in the Framingham Study, 459 returned for a baseline examination and were followed for up to 32 years (mean = 9.7 years) for incident reinfarction or coronary death. The Cox proportional hazards model was used to evaluate the relation of postinfarction risk factors with reinfarction and coronary death. Age-adjusted analyses showed the risk of reinfarction to be positively associated with blood pressure and serum cholesterol. Risk of coronary death was strongly associated with blood sugar level, systolic blood pressure, serum cholesterol, heart rate, diabetes, and interim reinfarction. In multivariable analyses, systolic pressure, serum cholesterol, and diabetes were predictive of reinfarction; relative weight was inversely associated with reinfarction. Systolic pressure, serum cholesterol, and the prevalence of diabetes persisted as independent predictors of coronary death. When adjustments were made for the effects of these variables, women were at only half the risk of coronary death compared with men. Higher baseline risk factors in women compared with men may obscure an important survival advantage in women. In persons recovered from an initial myocardial infarction, standard risk factors, particularly systolic pressure, serum cholesterol, and diabetes, remain important determinants of coronary prognosis over many years and warrant attention in preventing subsequent events. PMID- 2763993 TI - Coffee consumption and myocardial infarction in women. AB - The relation between coffee consumption and the risk of acute myocardial infarction was evaluated in a hospital-based case-control study conducted in northern Italy between 1983 and 1987. The study consisted of 262 women with acute myocardial infarction and 519 controls admitted to the hospital for acute, nondigestive tract disorders. Information was obtained on the average number of cups of coffee or decaffeinated coffee consumed per day before the onset of the disease which led to hospital admission and on the total duration in years of the habit. There was a positive association between heavy coffee drinking and risk of myocardial infarction (relative risk (RR) = 2.7 for consumption of four cups or more per day). After allowance for smoking and other relevant covariates, the relative risk was not elevated for consumption of up to three cups per day, but still above unity for consumption of four or more cups per day (RR = 1.7), and the multivariate trend in risk was still significant (X1(2) = 5.14, p = 0.02). The risk estimates were grossly elevated among hyperlipidemic women (multivariate RR = 7.6 for moderate and 17.9 for heavy coffee drinkers). As a result of small absolute numbers, these estimates were largely unstable and the interaction between coffee and hyperlipidemia was not statistically significant. Such estimates, nonetheless, are of potential interest in terms of etiologic correlates and implications for prevention. PMID- 2763995 TI - Nutrient intake and ovarian cancer. AB - A case-control study was conducted in Utah between 1984 and 1987 to evaluate the effects of nutrient intake on risk of developing ovarian cancer. Detailed dietary intake information was available from 85 first primary ovarian cancer cases and 492 population-based controls. Calories, fat, protein, fiber, and vitamins A and C did not appreciably alter the risk of developing ovarian cancer. However, high intake of beta-carotene appears to confer protection against ovarian cancer (odds ratio = 0.5, 95% confidence interval 0.3-1.0) after adjusting for age, number of pregnancies, and the body mass index of weight/height. PMID- 2763994 TI - Parity as a risk factor for cervical cancer. AB - In a case-control study of 759 invasive cervical cancer patients and 1,430 controls in Colombia, Costa Rica, Mexico, and Panama conducted during 1986-1987, an association with number of pregnancies persisted after adjustment for sexual and socioeconomic variables. Risks rose steadily to 5.1 (95% confidence interval 2.7-9.7) for those with 14 or more pregnancies and a relation of risk to multiparity was observed in all four study countries. Pregnancy associations appeared to relate to the number of live births rather than to miscarriages or abortions, with multiparity relations most pronounced among premenopausal women and oral contraceptive users. Human papillomaviruses types 16 and 18, as measured by filter in situ hybridization, were not significantly associated with number of births and did not explain the strong relation of parity to risk. Our results indicate the need for further consideration of reproductive factors on cervical cancer risk, with attention given to possible mechanisms of action, including hormonal factors and cervical trauma. PMID- 2763996 TI - Mammographic parenchymal patterns in women receiving noncontraceptive estrogen treatment. AB - Two population-based registers, one of women with at least one estrogen prescription, and the other of women who had undergone mammographic screening, were linked by means of the national registration number, revealing 3,436 estrogen-treated women who had attended the mammography screening program. Their mammographic parenchymal pattern was classified according to the criteria of Wolfe into two groups, one with a low risk and the other with a high risk of development of breast cancer. Estrogen replacement therapy was more common in women with a high risk than in those with a low risk mammographic parenchymal pattern (standardized morbidity ratio = 1.3). The increased probability of receiving noncontraceptive estrogen treatment in women with a high risk mammographic parenchymal pattern remained when the impact of several possible confounding factors had been taken into account in a logistic regression analysis (odds ratio = 1.36, 95% confidence interval 1.24-1.49). No evidence was found of a shift toward the unfavorable mammographic parenchymal pattern during treatment, which suggests that the treatment itself was not responsible for the high proportion of P2 and DY patterns. The mammographic parenchymal pattern must therefore be looked upon as a confounder in the context of studying breast cancer risk after estrogen treatment. PMID- 2763997 TI - A prospective analysis of physical activity and cancer. AB - Previous studies have suggested that increased physical activity may be protective against colon cancer. Most of these studies measured activity indirectly. The present study evaluated several direct measurements of physical activity and also resting heart rate as determined from an electrocardiogram. Increased activity was consistently associated with a decreased relative risk of colon cancer for each measure of activity. The colon cancer relative risk estimates for the middle and upper tertiles of a physical activity index (compared with the lower tertile) were 0.56 (95% confidence interval (CI) 0.39 0.80) and 0.71 (95% CI 0.51-0.99), respectively. Relative risk of colon cancer associated with moderate or heavy activity at home/recreation (compared with mostly sitting) was 0.66 (95% CI 0.49-0.88). A similar comparison of activity at work resulted in a relative risk estimate of 0.72 (95% CI 0.52-1.00). Relative risk of colon cancer increased significantly (p = 0.027) with increasing resting heart rate. Relative risks associated with physical activity were also evaluated for cancers of the stomach, rectum, lung, prostate, and urinary bladder. An increased relative risk of stomach cancer was associated with several measures of increased activity, but these results are preliminary and additional research is necessary to further evaluate this finding. PMID- 2763998 TI - Recurrent epidemic hepatitis A associated with consumption of raw shellfish, probably controlled through public health measures. AB - Between April 1984 and January 1985, in the Italian seaport of Livorno, the annual incidence of serologically confirmed acute hepatitis A doubled to 46 per 100,000 population. The exposure histories of each of 75 jaundiced subjects with serologically confirmed hepatitis A were compared with up to four, randomly chosen-, age-, sex-, and neighborhood-matched controls. Illness was strongly associated with consumption of raw mussels and clams within six weeks of onset of illness. When the two thirds of the subjects who had been exposed were classified according to the frequency with which they had recently consumed any type of raw shellfish, there was a clear dose-response relation. In February 1985, comprehensive control measures were introduced and the annual incidence of hepatitis A fell to 2.3 per 100,000 population, a 10-fold decrease from the preepidemic period. PMID- 2763999 TI - Incidence of four sexually transmitted diseases in a rural community: a prospective study. AB - Despite the fact that incidence studies of sexually transmitted diseases have rarely been performed in rural areas, it is generally assumed that the frequency of such diseases in rural areas is lower than in cities. We studied the incidence of four sexually transmitted diseases in a rural community (population 150,000) located in southern Quebec. Between March and September 1986, a random sample of 41 of 123 general practitioners reported all cases of syphilis, gonorrhea, chlamydial genital infection, and genital herpes at the time of diagnosis. In addition, all the specialists of the area who regularly diagnose sexually transmitted diseases reported their cases. For each case contact tracing was attempted. The estimated incidence rate was 584 per 100,000 person-years for at least one of the studied diseases. For chlamydia, gonorrhea, and herpes, the rates per 100,000 person-years were 470, 149, and 36, respectively. Over 11% of the cases had more than one of these diseases. Of the 114 index cases diagnosed by physicians, 102 were symptomatic, whereas of the 62 contact cases, only 25 were symptomatic (p less than 0.001). In addition, for genital chlamydial infection 84% of female cases were primarily diagnosed by physicians, whereas 64% of male cases were found by contact tracing (p less than 0.001). This study shows that sexually transmitted diseases are a major public health problem in rural communities. PMID- 2764000 TI - Community-acquired Legionnaires' disease associated with a cooling tower: evidence for longer-distance transport of Legionella pneumophila. AB - In the period August 10-29, 1986, 29 confirmed cases of Legionnaires' disease occurred in Sheboygan, Wisconsin; two cases were fatal. No common source of indoor exposure was identified. Water specimens were obtained from all known cooling tower units in Sheboygan; Legionella pneumophila serogroup 1 was isolated at 1 x 10(6) colony-forming units per liter from a specimen obtained August 27 at plant A. This isolate was identical to the only clinical isolate by monoclonal antibody and isoenzyme subgrouping. Of 29 persons with Legionnaires' disease, 21 lived or worked within one mile (1.6 km) of plant A; seven of the remaining eight visited within one to two miles (1.6 to 3.2 km) of plant A from three to seven days before onset of illness. Attack rates were highest for persons living within 0.5 mile (0.8 km) of plant A. These findings associate a cooling tower with community-acquired Legionnaires' disease and suggest that dissemination of Legionella may occur over longer than previously recognized distances. PMID- 2764001 TI - An outbreak of psittacosis in Minnesota turkey industry workers: implications for modes of transmission and control. AB - From June through November 1986, an outbreak of psittacosis occurred in turkey industry workers in central Minnesota. A total of 186 suspect cases were identified, and 122 cases (66%) were serologically confirmed. Cases occurred in three turkey processing plants, two rendering plants, one farm, and one "further processing" plant (where meat is removed from previously eviscerated carcasses and consumer products, such as roasts, are made). As in previous outbreaks, workers exposed to the viscera of infected birds were at greatest risk of becoming infected. However, our data showed that 31 (25%) of the confirmed cases occurred in workers at the further processing plant who had contact only with previously eviscerated carcasses. Although the specific source of infection and the mode of transmission in these workers are unclear, the use of gloves and masks by all processing workers during an outbreak might help to limit exposure. Control measures, which focused on identifying and treating ill turkey flocks, were initiated in early September; however, cases continued to occur in turkey industry workers through November. One of the flocks suspected of causing illness appeared healthy and, therefore, was not treated. Chlamydia psittaci infection in this flock was confirmed by culture after the flock had been processed. A rapid test for diagnosing C. psittaci infection in turkey flocks at the time of processing might be useful in preventing exposure of large numbers of workers. PMID- 2764002 TI - Reliability, dependability, and precision of anthropometric measurements. The Second National Health and Nutrition Examination Survey 1976-1980. AB - The components of reliability for eight anthropometric measures were studied in 95 male and 134 female subjects from the Second National Health and Nutrition Examination Survey (NHANES II). The contributions to unreliability variance (Sr2) that occur as a result of measuring errors (Sp2, imprecision variance) and of intrasubject fluctuations in a measurement due to physiologic factors (Sd2, undependability) were estimated (Sr2 = Sp2 + Sd2). Unreliability was then related to the between-subject variance (S2) to estimate the reliability (R = 1 - (Sr2/S2)) of the measurement. Four of the anthropometric measurements (weight, height, sitting height, and arm circumference) had reliabilities in excess of R = 0.97. In the first three of these, measurement imprecision made up two thirds or less of unreliability, and undependability (Sd2) was stable by two weeks. Lesser but still acceptable reliabilities were obtained for triceps and subscapular skinfolds, bitrochanteric breadth, and elbow breadth (R = 0.81-0.95). For these variables imprecision (Sp2) was the major source of error. Furthermore, the unreliability (Sr2) between observers was twice as high or more than the unreliability within observers for these variables, evidence that imprecision (Sp2) is the single most important source of unreliability in these anthropometric measurements. Unreliability standard deviations of skinfolds increased in a linear manner with skinfold thickness corresponding to an unreliability coefficient of variation of 13-19 per cent. None of the other measurements showed such scale effects. Analyses of the kind suggested will help epidemiologists decide whether reliability can be increased by improving precision, and whether there is a need to improve reliability in the first place. Reliability appears to be adequate for all anthropometry in the NHANES II. PMID- 2764003 TI - Retrospective estimation of diabetes incidence from information in a prevalent population and historical mortality. AB - If the distribution of onset age of disease in a well-defined prevalent (cross sectional) population of patients is known, disease incidence rates specific for age and calendar time period may be estimated, assuming known mortality rates and a closed population. This paper develops a method of estimation, illustrates this method on Danish diabetes data, and discusses its general applicability. The prevalent population of diabetic subjects in Fyn County on July 1, 1973 was ascertained from prescriptions, and information on disease onset was obtained from the patients' medical records. In this study only patients with onset of disease before or at age 30 years were studied. The mortality of diabetic subjects in Denmark was estimated from retrospective hospital data covering the period since 1933, and historical age-specific population sizes of Fyn County were obtained from census data. The incidence of diabetes increases with calendar time and with age for most cohorts. The variation with age for a fixed calendar year is more complicated, however, usually displaying a local maximum at about the age of puberty and a higher incidence at the upper end of the studied age range. PMID- 2764004 TI - Sex differentials in morbidity and mortality risks examined by age and cause in the same cohort. AB - Many studies indicate that women live longer than men but report more physical illness. This report is the first prospective study of sex ratios for morbidity and mortality due to a variety of causes in a single cohort: a random sample of 5,239 adults, aged 30 years or older in 1965, who have been followed through 1983 (19 years) by cause and age. For both cancer incidence and mortality there was a female excess before age 50 years, followed by a male excess peaking between ages 60 and 69 years. Sex ratios for ischemic heart disease mortality, on the other hand, indicated a male excess at virtually all ages, and that these sex ratios declined with age. However, three measures of heart disease morbidity (self reported chest pain, heart trouble, and high blood pressure) demonstrated a female excess that did not vary by age. All four measures of functional disability (impaired self-care, impaired mobility, cessation of work, and reduction of work) demonstrated a female excess that did not vary by age (with the exception of a male excess in impaired self-care in adults aged 30 to 39 years). Further analyses of sex differences in health need to acknowledge the heterogeneity of the relation of sex to disease, and the complex age-sex interaction that varies remarkably with both cause and manifestation of outcome (morbidity vs. mortality). PMID- 2764005 TI - Probability of introducing diseases because of false negative test results. AB - The use of diagnostic tests for the selection of healthy individual persons or animals for inclusion in certain groups carries with it an inherent risk of including those with infections because they falsely reacted negatively. The factors of sensitivity of the test, prevalence of the disease, and the size of the group all influence the degree of such risk. The probability of including an infected individual person or animal can be calculated combining conditional probability and the binomial distribution. PMID- 2764006 TI - Re: "Dietary Epidemiology of Cancer of the Colon in Western New York" and "Dietary Calcium Intake as a Mitigating Factor in Colon Cancer". PMID- 2764007 TI - Re: "Smoking, Nonsteroidal Anti-Inflammatory Drugs, and Acetaminophen in Gastric Ulcer. PMID- 2764009 TI - Re: "Use of Modeling in Infectious Disease Epidemiology". PMID- 2764008 TI - Re: "Risk Factors for HIV Infection in Male Sexual Contacts of Men with AIDS or an AIDS-Related Condition. PMID- 2764010 TI - Baby Doe, Congress and the states: challenging the federal treatment standard for impaired infants. AB - In its amendments to the Child Abuse Prevention and Treatment Act, Congress set forth a strict standard for treatment of impaired infants. The statute, shaped by right-to-life groups and certain medical organizations, calls for aggressive treatment in virtually all cases, regardless of the degree of suffering imposed and the burdens and risks involved. The federal rule evidences deep distrust of parental decisionmaking, relegating most parents to a nonparticipatory bystander role. Congress did not make its rule binding on the states. Rather, it conditioned the receipt of federal funds upon incorporation of the rule into each state's law. Most states have accepted the condition, largely through rulemaking by state child abuse agencies. This article challenges the authority of state administrators to promulgate these rules, and argues that state constitutions, little mentioned in the Baby Doe debate thus far, may prohibit many states from adopting the federal standard. Ordering medical interventions that perpetuate extreme conditions of physical and mental devastation, subjecting infants to grave suffering for uncertain benefits, and depriving parents of virtually all decisionmaking power violates the norm of governments constitutionally committed to individual liberty, human dignity and family autonomy. A constitutionally sound approach to this issue would permit careful, ethical deliberation, attention to the individual circumstances of each infant Doe and a reasonable degree of parental control. PMID- 2764011 TI - Most-favored-nation clauses and monopsonistic power: an unhealthy mix? AB - Most-favored-nations clauses appear in health insurance contracts allegedly to prevent price discrimination by health care providers among competing insurers. In fact, use of these provisions often works to exclude competitors from the health insurance market. This Note examines the antitrust implications of most favored-nations clauses as used in the health insurance industry. PMID- 2764012 TI - AIDS--discovery--Belle Bonfils Memorial Blood Center v. Denver Dist. Court. PMID- 2764013 TI - AIDS--products liability--Jones v. Miles Laboratories, Inc. PMID- 2764014 TI - Insurance--AIDS--Life Ins. Ass'n of Mass. v. Commissioner of Ins. PMID- 2764015 TI - Physician self referral arrangements: legitimate business or unethical "entrepreneurialism". AB - An emerging legal and ethical controversy in the health care industry centers on physician investment in health care facilities to which they make patient referrals. This Article analyzes the policy debate surrounding these physician self referral arrangements as well as the various responses to such arrangements. The Article asserts that an effective legal or ethical response to self referral arrangements must acknowledge and balance both the possible pro-competitive effects of such arrangements and the inherent potential for abuses in this type of business practice. From this perspective, the most effective form of regulation consists of extensive structural guidelines which focus on the physician's referral behavior and limit restrictions on investment procedures. Such an approach would minimize referral abuses and conflict of interest concerns but promote business and competitive freedom. PMID- 2764016 TI - Controlling drug effects through improved oral formulations. The pharmacokinetics of the prazosin gastrointestinal therapeutic system. AB - Influences that determine a drug's effects include pharmacokinetic factors (the serum concentrations of drug as determined by the drug dose, absorption, distribution, and excretion) and pharmacodynamic factors (the intensity of drug effect). Most assessments of drug effect focus on the therapeutic range, i.e., the serum concentrations below which therapeutic effects are unlikely and above which toxic effects may be seen. A goal for many treatment regimens is to maintain serum drug concentrations within the therapeutic range. Maintenance of drug concentrations within the therapeutic range can be difficult with many traditional oral dosage formulations. Soon after administration of standard tablets, capsules, or liquids, a pronounced peak level is observed in serum. At the end of a dosage interval, serum concentrations are frequently below those needed to exert therapeutic effect. One reason for the wide range in serum concentrations with standard oral formulations is that these products usually exhibit first-order drug absorption, in which the rate of absorption from the gastrointestinal tract continually varies following a dose (from high to low) and is directly determined by the amount of drug remaining in the gastrointestinal tract. First-order absorption, therefore, results in changing absorption rates, wide swings in serum drug concentrations, a relatively short duration of action, and often, inconsistent drug effects over a dosage interval. One way to address the problems with standard oral products that have first-order absorption is to produce products that control drug release and absorption. A large number of controlled-release oral products are now on the market and use a variety of technologies. The ideal controlled-release formulation would result in zero-order drug absorption, in which the rate of drug absorption from the gastrointestinal tract would be constant and not determined by the amount of drug in the gastrointestinal tract. Zero-order absorption, therefore, results in an unchanging absorption rate, consistent serum levels, a longer duration of action, and more steady drug effect. Zero-order absorption is particularly preferable in situations that require a consistent, long-term therapeutic effect, e.g., in patients with hypertension, asthma, or arrhythmias. Of all the controlled-release preparations on the market, however, very few exhibit zero-order absorption; most can be categorized somewhere between first- and zero-order kinetics. An advanced technology tablet has been invented to produce zero-order drug absorption for prazosin and nifedipine.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2764017 TI - Lack of cross-reactivity between IgE to salmon and protamine sulfate. AB - Immediate type-generalized reactions to protamine sulfate are uncommon but may be fatal. The mechanisms of severe or fatal reactions are unknown in most cases. One theory is that contaminating fish (salmon) proteins present in protamine solutions induce anaphylaxis in salmon-sensitive subjects. A second hypothesis is that protamine interacts with anti-salmon IgE to cause anaphylaxis. We assessed these hypotheses by establishing an indirect amplified enzyme-linked immunosorbent assay (ELISA) for IgE to salmon. Sera obtained from two subjects anaphylactically sensitive to salmon demonstrated high binding to salmon that was not inhibited by preincubation of sera with 500 or 1000 micrograms of protamine or Aspergillus fumigatus. Serum from a patient who experienced anaphylactic shock from protamine was indistinguishable from control sera in the ELISA for IgE to salmon. Anti-protamine IgE could not be demonstrated in separate experiments. The assays prove that 1) serum IgE to salmon is not inhibited by protamine and 2) serum from a patient experiencing a severe reaction to protamine did not contain IgE to salmon or protamine. The experiments do not support the notion that there is cross-reactivity between IgE to salmon and protamine sulfate in the cases evaluated. PMID- 2764018 TI - Sleep apnea, sleep disorders, and hypothyroidism. AB - The symptoms of hypothyroidism are protean and include apathy, somnolence, lethargy, personality change, and intellectual deterioration. Many of these symptoms may be related to hypothyroid-induced sleep disorders. Hypothyroidism is associated with abnormal ventilatory drive, abnormal sleep architecture, and sleep apnea. Central, obstructive, and mixed patterns of sleep apnea are commonly observed in hypothyroidism. A case of severe sleep apnea in a grossly myxedematous patient who improved dramatically following thyroid replacement alone is presented. Myxedema is a reversible cause of sleep apnea, and thyroid function testing should be considered in its diagnostic work-up. PMID- 2764019 TI - Thromboembolization complicating left ventricular pseudoaneurysm: serial two dimensional and color-flow Doppler echocardiographic observations. AB - A left ventricular pseudoaneurysm was diagnosed by two-dimensional echocardiography and color-flow Doppler imaging, and confirmed by computerized tomography and angiocardiography, in a man with known coronary disease who had had recent recurrent systemic emboli. A thrombus within the pseudoaneurysm was visualized, and its disappearance on serial echocardiograms coincided with the occurrence of embolization to the aortic bifurcation. PMID- 2764020 TI - Stress fibers in endothelial cells overlying atherosclerotic lesions in rabbit aorta. AB - Endothelial injury or dysfunction has long been postulated to promote atherogenesis, but structural alterations of endothelium in atherosclerosis have remained obscure. We report the common occurrence of actin-containing stress fibers, stainable by rhodamine-phalloidin, in endothelium overlying atherosclerotic lesions in cholesterol-fed rabbits. Nonlesioned areas in the same aortas showed normal endothelium with minimal development of stress fibers, which was no different from the appearance of endothelium in chow-fed rabbits. Microtubule organization revealed by immunofluorescence appeared normal in all areas. The development of stress fibers may be related to an altered substratum for endothelial attachment. This study provided no evidence to relate stress fiber formation with lesion initiation, but an association with well-developed foam cell lesions was evident. PMID- 2764021 TI - Biologic contrasts between medullipin I and vasoactive glyceryl compounds. AB - Medullipin I causes a delayed onset depressor response when injected intravenously into rats. The glyceryl compounds selachyl alcohol (SA) and monoolein (MO) cause similar vasodepression. The neutral lipid 1-O-hexadecyl-2 acetyl-sn-glycerol (HAG) was suggested by Blank et al to be medullipin I (Med I, formerly ANRL). Biologic comparisons were made between Med I and various glyceryl compounds, including SA, MO, HAG, alkyl glyceryl ethers of phosphatidyl choline (termed APRL by us), diacylated SA, and the n-butyl boronic acid derivative of SA and MO. The n-butyl boronic acid derivative of Med I also was evaluated. The delay in onset of the depressor response to Med I was reduced by the injection of Med I into the portal vein; that of SA and MO was not. Med I, SA, and MO were activated by the liver, while APRL and HAG were not. Tween 20 inhibited Med I, SA, and MO, but not APRL and HAG. Proadifen (SKF 525A) inhibited Med I, but not SA and MO. The n-butyl boronic acid derivatives of SA, MO, and Med I were inactive. Med I, like SA and MO, appeared to have two hydroxyl groups in close proximity. It was concluded that Med I is neither HAG, APRL, SA, nor MO. PMID- 2764022 TI - Dominant inheritance of Wiedemann-Beckwith syndrome: further evidence for transmission of "unstable premutation" through carrier women. AB - We report on a 4-generation family in which the Wiedemann Beckwith syndrome (WBS) was transmitted as an autosomal dominant trait. The condition occurred in sibs born to carrier women and in children born to affected mothers. Presumptive carrier women were examined for microsigns of WBS in an attempt to determine whether extreme variability of the disorder, rather than an unaffected carrier state, was present. No minor stigmata of the WBS could be found in the presumptive carriers. Our study supports a previous hypothesis that in some families the WBS can be transmitted in a 2-step process involving first an unstable premutation and then a "telomutation." Because only females appear to be transmitters of the telomutation, an ovum-mediated sex-associated factor may be involved in the process of telomutation. PMID- 2764023 TI - Two rare developmental defects of the lower limbs with confirmation of the Lewin and Opitz hypothesis on the fibular and tibial developmental fields. AB - We report on two unrelated patients with malformations of the lower limbs. One had a unilateral apparent doubling of the volume of the femur with distal bifurcation, shortness of the tibiae, absence of fibulae, and lateral ray deficiencies of both feet. The other had a partial duplication of the distal left femur, hypoplasia and proximal dislocation of the ipsilateral tibia, syndactyly of the right 1st and 2nd toes, and preaxial polydactyly of the left foot. This report supports the hypothesis of Lewin and Opitz on the presence of two distinct fields of development: the fibular and the tibial. PMID- 2764024 TI - Femoral duplication: a case report. AB - Femoral duplication is a rare anomaly that has been described as an isolated entity and in association with other congenital defects. Since the description by Erlich in 1885, 24 additional cases have been reported. The present report concerns a 34-week black female infant with apparent bilateral femoral duplication associated with a meningocele and abdominal, genitourinary, vertebral, and lower-limb anomalies. The cause is unknown. Femoral duplication is a developmental field defect, hence causally heterogeneous. PMID- 2764025 TI - Humero-radio-ulnar synostosis: a new case and review. AB - We report on a patient with humero-radio-ulnar synostosis and upper limb oligoectrosyndactyly. All cases have been sporadic including discordance in monozygotic twins, and similar findings have occurred in thalidomide embryopathy. Further observations of similarly affected patients are needed to elucidate the nature of this upper limb defect and its cause. PMID- 2764026 TI - Aplasia of the tibia with bifurcation of the femur and ectrodactyly: evidence for an autosomal recessive type. AB - Two unrelated families are presented, each with 2 affected offspring with bifid femur, absent tibia, and ectrodactyly. The healthy parents are consanguineous. It is postulated that this combination of malformations is causally heterogenous with both autosomal dominant and autosomal recessive modes of inheritance; hence, it is established as a developmental field defect. PMID- 2764027 TI - Familial uterine hernia syndrome: report of an Arab family with four affected males. AB - We report an Arab Bedouin family including four males with uterine hernia syndrome. All had a male chromosome constitution and phenotype, inguinal herniae, cryptochidism, and persistence of Mullerian derivatives. Histopathological studies confirmed the presence of both testicular tissue and Mullerian derivatives. The presence of two affected brothers and two affected maternal uncles suggests X-linked inheritance. Autosomal recessive determination with male sex limitation is also a possibility based on parental consanguinity in one sibship. PMID- 2764028 TI - Slowly progressive macrocephaly with hamartomas: a new syndrome? AB - We report on an 8 1/2-year-old boy with slowly progressive macrocephaly, psychomotor retardation, multiple subcutaneous angiolipomas, hypertelorism, exotropia, prolonged drooling, cutis marmorata, telangiectasia, congenital heart defect, broad thumbs and great toes, and muscle wasting. The syndrome is similar to the Bannayan-Zonana syndrome and seems to be inherited as an autosomal dominant trait. The father has partial manifestations of the syndrome. PMID- 2764029 TI - A case of the Freire-Maia Odontotrichomelic syndrome: nosology with EEC syndrome. AB - We report on a patient, born to consanguineous parents, who had a complex malformation syndrome of severe upper limbs anomalies, peculiar face, structural ear anomalies, nasolacrimal duct obstruction, and abnormal hair and nails. We think that the clinical manifestations of the patient are similar to those described by Freire-Maia as the odontotrichomelic syndrome; the differential diagnosis between this syndrome and ectrodactyly, ectodermal dysplasia, and cleft/lip palate (EEC) syndrome is discussed. PMID- 2764030 TI - Multivariate analysis of body shape in fragile X (Martin-Bell) syndrome. AB - Human body shape measures can be more informative in studies of developmental abnormalities than distances between body landmarks. Such measures were obtained by an appropriate transformation of 34 distances between trunk/limbs and head/face landmarks in 43 men and 72 women with the Martin-Bell Syndrome (MBS), and in 99 and 103 normal men and women, respectively. The transformation of the original distances was performed by adjusting individual measures for an overall size measure using regression analysis. Thus obtained body shape variables were used in discriminant analysis in order to obtain unbiased classification probabilities of individuals having the MBS or being normal. The average percent correctly classified male and female individuals was high (93 and 87, respectively). Moreover, the body shape variables were used to obtain shape dimensions by means of principal component analysis. There was no difference between the MBS and normal individuals in the first (most important) principal component (shape dimension). This component represents the relative proportions between trunk and limb lengths and widths, or between midfacial lengths and widths. However, there were appreciable differences in some succeeding components. The problem of interpretation of shape dimensions as derived from principal component analysis and of their relevance to abnormal development in the MBS individuals is discussed. PMID- 2764031 TI - Duplication of 5q11.2----q13.1 from a familial (5;20) balanced insertion. AB - A 2-year-old boy with gross motor delay and few minor anomalies has a pure duplication of a small segment of chromosome 5q11.2----q13.1. A balanced insertion of this 5q segment into chromosome 20q proximal to the centromere has been found in his father, uncle, and paternal grandmother. PMID- 2764032 TI - Osteodysplastic primordial dwarfism: report of a further case with manifestations similar to those of types I and III. AB - We describe a male infant with microcephalic osteodysplastic primordial dwarfism. The clinical and radiological manifestations most closely resemble those of the patient described by Winter et al. to have manifestations overlapping with both osteodysplastic primordial dwarfism types I and III. The classification of the patient within the spectrum of osteodysplastic primordial dwarfism is discussed and the distinctive neuropathology documented. PMID- 2764033 TI - Terminal deletion 4q in a severely retarded boy. AB - We report a boy with a de novo terminal deletion of chromosome 4q, (q31----qter) and compare him to 17 previously reported cases with the same anomaly. This case contributes further to the delineation of the del(4)(q31) phenotype, which seems to be clinically recognizable. PMID- 2764034 TI - Familial distal arthrogryposis with craniofacial abnormalities: a new subtype of type II? AB - We report on 5 relatives in 3 generations with an apparent new type of distal arthrogryposis. These individuals have manifestations of type I distal arthrogryposis, but in addition, have craniofacial anomalies that include facial asymmetry, hypertelorism, downslanting palpebral fissures, high nasal bridge, malar hypoplasia, micrognathia, highly arched palate, notched chin, and posteriorly angulated ears. Their intelligence is normal. Although these manifestations preclude us from placing this family in the type I (isolated) distal arthrogryposis category, we also are unable to place them in any of the recognized subtypes of type II distal arthrogryposis. Thus, we think this family may have a previously undescribed form of autosomal dominant type II distal arthrogryposis. PMID- 2764035 TI - Clinical, pathological, and biochemical studies on an infantile case of sulfatide/GM1 activator protein deficiency. AB - A 28-month-old black male died with severe complications of mental and motor deterioration, seizures, and aspiration. Autopsy demonstrated moderate liver enlargement, normal spleen and kidneys, small testes, and a grossly normal brain. Further examination showed irregular macrogyrae with evidence of a storage or sclerotic process. Thin layer chromatography of the lipids in formalin-fixed tissue demonstrated elevated levels of ceramide trihexoside and possibly sulfatides in liver and a decrease in the ratio of galactosylceramide to sulfatide in brain. Examination of the gangliosides in formalin-fixed brain indicated a slight increase in the percentage of GM1 ganglioside and a clear elevation in GM2 and GM3 gangliosides. Cultured skin fibroblasts had a normal activity for a large number of lysosomal enzymes including arylsulfatase A and galactocerebrosidase. When the cells were loaded with [14C]sulfatide only about 12% of the sulfatide was metabolized after 3 days. Extracts of the cells were subjected to SDS-PAGE and immunoblotting with antisphingolipid activator protein 1 (SAP-1) rabbit antiserum, and no cross-reacting material was detected confirming the diagnosis of metachromatic leukodystrophy caused by SAP-1 deficiency. This patient was clinically more severe than the other patients described previously with this deficiency. Further studies are underway to define the nature of the mutation in this patient. PMID- 2764036 TI - "Acadian" and "classical" forms of Friedreich ataxia are most probably caused by mutations at the same locus. AB - "Acadian ataxia" is a form of Friedreich ataxia found in individuals of Acadian ancestry. It was described by Barbeau (in Sobue I (ed): Spinocerebellar Degeneration; Tokyo: Univ. Tokyo Press, pp 121-142, 1980) as having a slower course of degeneration and less severe secondary symptoms than "classical" Friedreich ataxia. He suggested that these 2 forms of the disease may be distinct. The mutation causing "classical" Friedreich ataxia has recently been mapped to chromosome 9 through genetic linkage studies, and here we show that the locus causing Friedreich ataxia in Acadian families from southwestern Louisiana is tightly linked to the same DNA marker, D9S15. Thus, these 2 disorders, which may be differentiated clinically, are most probably due to mutation(s) at the same locus on chromosome 9. PMID- 2764037 TI - Genetic aspects of artificial insemination with donor semen: the French CECOS Federation guidelines. AB - The genetic problems raised by assisted reproduction using donor gametes (AID) are numerous and often complex. They concern the legitimacy and the appropriate forms of genetic screening for both gamete donors and recipients; the identification of genetic indications justifying the use of this method of reproduction; and ascertainment of the state of health of the conceptus at birth. The experience and guidelines of the French CECOS Federation, which comprises 20 AID treatment centers, are described. The discussion emphasizes the need for an international exchange of view on this subject. PMID- 2764038 TI - Fetal growth retardation, hydrocephalus, hypoplastic multilobed lungs, and other anomalies in 4 sibs. PMID- 2764039 TI - IVIC syndrome: report of a third family. PMID- 2764040 TI - IVIC syndrome report by Czeizel et al. PMID- 2764041 TI - Spontaneous loss of fetuses with chromosomally unbalanced D/21--or reciprocal translocations in late pregnancy. PMID- 2764042 TI - Duplicate report crossing over in Norrie disease family. PMID- 2764043 TI - Missed abortion: still appropriate terminology? AB - The term missed abortion has been in the obstetric literature more than 100 years. With ultrasonographic evaluation of early pregnancy, its textbook definition (death of a fetus without its expulsion for greater than or equal to 8 weeks) is rarely fulfilled. Yet the term missed abortion is still extensively used today with regard to early pregnancy losses. We recommend its abandonment and in its place the use of the following terms: first trimester intrauterine fetal death, second trimester intrauterine fetal death, and anembryonic gestation. PMID- 2764044 TI - Multidisciplinary team counseling for fetal anomalies. AB - Prenatal management of fetal anomalies requires a cooperative effort of the family, obstetrician, ultrasonographer, neonatologist, pediatric subspecialists, nursing staff, geneticists, and social workers. Our approach to these patients is to convene all team members and the family shortly after an anomaly is identified to review the diagnosis, prognosis, plans, and alternatives. Team counseling offers a clear definition of the problem, avoids unnecessary confusion and anxiety for the family, and provides a supportive environment during this family crisis. Our experience with 28 families has been favorable and is described herein. PMID- 2764045 TI - Anal and perianal abnormalities in prepubertal victims of sexual abuse. AB - We describe anal and perianal findings in 310 prepubertal children who were determined to be victims of sexual abuse; 206 (66%) had perinea that appeared normal. Abnormal findings were present in 104 children (34%): anal gapping in 61 children; skin tags in 44; rectal tears in 33; sphincter tears in 15; human papillomavirus lesions in 4; perineal scarring in 2; and bite marks in 1. Normal appearing perianal and anal regions were noted in 150 of 175 children (85%) who denied anal assault, and in 11 of 70 (16%) who described such assault. In comparison, anal and perianal abnormalities were observed in 59 of the 70 children (84%) who gave a clear history of anal assault, but in only 25 of 175 (15%) who denied such abuse. Failure to document perianal abnormalities in almost two thirds of the patients demonstrates the limitations of the medical evaluation in validating allegations of sexual abuse. PMID- 2764046 TI - Phosphorus 31 nuclear magnetic resonance examination of female reproductive tissues. AB - Nuclear magnetic resonance spectroscopy is a powerful method of investigating the relationship between metabolism and function in living tissues. We present evidence that the phosphorus 31 spectra of myometrium and placenta are functions of physiologic state and gestational age. Specific spectroscopic abnormalities are observed in association with disorders of pregnancy and gynecologic diseases. Our results suggest that noninvasive nuclear magnetic resonance spectroscopy examinations may sometimes be a useful addition to magnetic resonance imaging examinations, and that nuclear magnetic resonance spectroscopy of biopsy specimens could become a cost-effective method of evaluating certain biochemical abnormalities. PMID- 2764047 TI - A new surgical technique to treat refractory labial fusion in the elderly. AB - An elderly woman with refractory labial fusion was treated by labial separation. The subsequent raw area was covered by a rotational skin flap from the thigh. The flap was deroofed of epithelium proximally and tunnelled subcutaneously. The distal portion emerged to cover the raw clitoral area and this successfully prevented contraction and scarring. PMID- 2764048 TI - Pregnancy loss in a small chorionic villus sampling series. AB - Two previous reports have suggested that the pregnancy loss rate with chorionic villus biopsy is high in the initial 100 to 300 cases. In the initial 211 cases of this study, the total pregnancy loss rate (7.1%) and losses not attributed to induced abortion or cytogenetic abnormality (2.8%) do not support this contention. PMID- 2764049 TI - Maternity shelter care for adolescents: its effect on incidence of low birth weight. AB - A group of 112 pregnant adolescents residing in a maternity shelter was compared with a group of 113 pregnant adolescents residing in their own homes but receiving identical medical care. The sheltered group was made up of a particularly high-risk group: they were more likely to be black, unmarried, receiving public assistance, and registered later for prenatal care than the group living at home. Despite these differences, the sheltered group delivered significantly fewer infants of low birth weight and preterm gestation than the control group. Variables assessed in this study fail to explain this difference. It is concluded that the services offered in a maternity shelter can have a positive impact on the reduction of low birth weight deliveries in a group of high-risk patients. These results indicate that the social and behavioral correlates of low birth weight remain to be fully defined and understood. PMID- 2764050 TI - Ceramide lactoside in amniotic fluid: high concentration in chorioamnionitis and in preterm labor. AB - The mechanisms responsible for the onset and progression of preterm labor are poorly understood. In the present study a total of 115 amniotic fluid specimens were analyzed for a lipid that has not previously been detected in amniotic fluid. This glycolipid was identified as ceramide lactoside. It was found in two dimensional thin-layer chromatograms for evaluation of lung maturity and quantified by gas chromatography. Ceramide lactoside concentrations in amniotic fluid were low in spontaneous labor at term (1.7 +/- 0.7 nmol/ml) and in pregnancies that were not associated with spontaneous preterm labor (1.4 +/- 0.6 nmol/ml). The concentrations were high in chorioamnionitis with signs of infection (11.8 +/- 5.8 nmol/ml) and in preterm labor without clinical signs of chorioamnionitis (5.4 +/- 4.0 nmol/ml). A high ceramide lactoside (greater than or equal to 5 nmol/ml) predicted chorioamnionitis with signs of infection at a sensitivity and a specificity of 94% and 95%, respectively. A moderately high ceramide lactoside concentration (greater than or equal to 2.5 nmol/ml) predicted spontaneous preterm labor: sensitivity, 82%; specificity, 95%. Little, if any, ceramide lactoside was present in urine, vernix, normal fetal membranes, or lung effluent, whereas this glycolipid was present in large amounts in granulocytes and in inflamed fetal membranes. We propose that phagocytosing granulocytes release ceramide lactoside into amniotic fluid. PMID- 2764051 TI - Cardiac isoenzymes and electrocardiographic changes during ritodrine tocolysis. AB - To investigate the potential myocardial ischemic effects of ritodrine, we studied 36 singleton and four twin preterm pregnancies during ritodrine therapy. We serially determined serum creatinine phosphokinase (CPK-MB fraction) and lactic dehydrogenase isoenzymes and performed electrocardiography before and during ritodrine infusion and again within the first 24 hours of oral drug therapy. We observed that serum CPK-MB and lactic dehydrogenase isoenzymes remained within the normal range during therapy periods. The incidence of sinus tachycardia and non-specific T wave changes were 100% and 25%, respectively. In three of four twin pregnancies, ST-T segment depression in leads I, V4, V5, and V6 of the electrocardiogram was noted. Our study suggests that (1) the recommended ritodrine regimen does not produce direct myocardial damage, and (2) ritodrine may cause cardiac ischemia as determined by electrocardiography, which theoretically would progress to myocardial damage if not treated properly. PMID- 2764052 TI - Continuous tissue pH monitoring in the term fetus. AB - Since Saling's work in 1961, many investigators have attempted to perfect methods to detect fetal acidosis during labor. A system for continuous tissue pH monitoring of the fetus is evaluated in this study of 59 patients. There was poor correlation of tissue pH values and capillary scalp pH values in 19 cases (r = 0.487), and no significant correlation of tissue pH values to the outcome measurements of Apgar scores and cord gas levels. The benefits realized were those of monitoring the trend of tissue pH over time. We believe that a continuous pH monitoring system offers several advantages over intermittent fetal scalp sampling. Further refinement of the technology employed may offer such a system in the future. PMID- 2764053 TI - Abscess of allantoic duct remnant. AB - A recently submitted placenta was found to be histopathologically unique. Funicitis was present at the early gestational age of 22 1/7 weeks, and an abscessed allantoic duct remnant was present. The latter finding had not previously been seen at this pathology department, nor could reference to it be found in the literature. PMID- 2764054 TI - Infection and labor. IV. Cachectin-tumor necrosis factor in the amniotic fluid of women with intraamniotic infection and preterm labor. AB - A growing body of evidence supports a causal link between subclinical intrauterine infection and preterm labor. The mechanisms responsible for the onset of parturition in this setting have not been elucidated. The conventional view has been that bacterial products increase prostaglandin biosynthesis by intrauterine tissues and this, in turn, leads to the onset of labor. An alternative or complementary mechanism is that microbial products activate the host monocyte-macrophage system and that cytokines released during this process signal the initiation of parturition by stimulating prostaglandin biosynthesis by intrauterine tissues. This study was conducted to determine if cachectin-tumor necrosis factor is present in the amniotic fluid of women with intraamniotic infection and whether this cytokine can alter the rate of prostaglandin biosynthesis by intrauterine tissues. Amniotic fluid from 54 women was assayed for tumor necrosis factor. Tumor necrosis factor was not detectable in the amniotic fluid of women without intraamniotic infection regardless of the presence or absence of term or preterm labor. On the other hand, the amniotic fluid of 11 of 15 women with preterm labor and intraamniotic infection had measurable tumor necrosis factor. This cytokine stimulated prostaglandin E2 biosynthesis by amnion cells in monolayer culture in a dose-dependent fashion. These data support the concept that macrophage activation is involved in the onset of human parturition in the setting of infection. We propose that the host (fetus and/or mother) signals the onset of parturition through the secretion of inflammatory cytokines released in response to bacterial invasion. PMID- 2764055 TI - Twin-to-twin transfusion syndrome: what are appropriate diagnostic criteria? AB - One hundred seventy-eight consecutive twin pregnancies were studied to reevaluate the standard diagnostic criteria for chronic twin-to-twin transfusion syndrome of an intertwin hemoglobin difference greater than 5 gm/dl and a birth weight difference greater than 20%. Hemoglobin differences greater than 5 gm/dl were found in six pregnancies with monochorionic placentas but also in seven with dichorionic placentas. Birth weight differences greater than 20% occurred no more commonly in monochorionic than in dichorionic pregnancies. Of the four pregnancies with a coexisting hemoglobin difference greater than 5 gm/dl and birth weight difference greater than 20%, only one had a monochorionic placenta and therefore likelihood of vascular anastomoses. Diagnosis of twin-to-twin transfusion syndrome cannot be definitively established by current standard diagnostic criteria. PMID- 2764056 TI - Successful twin pregnancy after embryo donation to a patient with XY gonadal dysgenesis. AB - A twin pregnancy was established in a patient with XY gonadal dysgenesis. The pregnancy was supported with exogenously administered hormones for the initial 100 days. The infants were delivered by emergency cesarean section at 35 weeks' gestation when severe preeclampsia developed in the mother. PMID- 2764057 TI - Ovarian hyperstimulation presenting as acute hydrothorax after in vitro fertilization. AB - Ovarian hyperstimulation that occurs with an isolated hydrothorax as the only symptom has previously been reported. We describe the second such case, the first to occur after in vitro fertilization and embryo transfer. PMID- 2764058 TI - Normal amniotic fluid volume changes throughout pregnancy. AB - The purpose of this study was to provide a quantitative characterization of the changes in amniotic fluid volume that occur throughout gestation. From 705 published amniotic volumes for normal pregnancies, we found that after log transformation, amniotic fluid volume had a uniform variability over 8 to 43 weeks' gestation. Thus the 95% confidence interval covered the range of 1/2.57 to 2.57 times the mean volume at any given gestational age. Contrary to expected trends, mean amniotic fluid volume did not change significantly between 22 and 39 weeks and averaged 777 ml, with the 95% confidence interval ranging from 302 to 1997 ml. The data are summarized in nomograms covering 8 to 43 weeks' gestation. PMID- 2764059 TI - Randomized trial of diet versus diet plus cardiovascular conditioning on glucose levels in gestational diabetes. AB - We studied the impact of a training program on glucose tolerance in gestational diabetes mellitus. Women with gestational diabetes mellitus (N = 19) were randomized into either group I, a 6-week diet alone group (24 to 30 kcal/kg/24 hours; 20% protein, 40% carbohydrate, 40% fat), or group II, which followed the same diet plus exercise (20 minutes three times a week for 6 weeks). An arm ergometer was used to maintain heart rate in the training range. Glycemic response was monitored by glycosylated hemoglobin, a 50 gm oral glucose challenge with a fasting and 1-hour plasma glucose, and blood glucose self-monitoring, fasting and 1 hour after meals. Week 1 glycemic parameters were the same for both groups. Week 6 data (mean +/- SD) were as follows: group I glycosylated hemoglobin, 4.7% + 0.2% versus group II, 4.2% +/- 0.2%; p less than 0.001. The group I glucose challenge fasting value was 87.6 +/- 6.2 versus 70.1 +/- 6.6 mg/dl, p less than 0.001 for group II. The group I 1-hour plasma glucose challenge result was 187.5 +/- 12.9 mg/dl versus 105.9 +/- 18.9 mg/dl for group II, p less than 0.001. The glycemic levels diverged between the groups at week 4. We conclude that arm ergometer training is feasible in women with gestational diabetes mellitus and results in lower glycosylated hemoglobin, fasting, and 1 hour plasma glucose concentrations than diet alone. Arm ergometer training may provide a useful treatment option for women with gestational diabetes mellitus and may obviate insulin treatment. PMID- 2764060 TI - Thrombosis prophylaxis in pregnancy with use of subcutaneous heparin adjusted by monitoring heparin concentration in plasma. AB - Twenty-six pregnant women were given prophylactic heparin treatment because of previous thromboembolic complications. The mean duration of treatment was 25 weeks (range, 6 to 32 weeks). The amount of heparin was adjusted to a plasma concentration of 0.08 to 0.15 IU/ml, measured as anti-factor Xa activity. This effect was compared with that on activated partial thromboplastin time. The average dose was 16,400 IU/24 hours or 225 IU/kg of body weight per 24 hours. When the plasma concentration was within the stipulated range, the dose was 234 IU/kg of body weight/24 hours. No significant prolongation of activated partial thromboplastin time was found in two thirds of the samples. Blood coagulation was either not activated or only slightly activated, as verified by a low level of fibrinopeptide A. Platelet counts and antithrombin III levels were generally not depressed. No thromboembolic complications occurred during the pregnancies or puerperium. Bleeding during delivery was not increased. No fractures of the spine caused by osteoporosis were found on radiologic examination post partum. PMID- 2764062 TI - Increased myometrial responsiveness to oxytocin during term and preterm labor. AB - The contractile effects of oxytocin on the longitudinal and circular muscle of rat uteri from animals undergoing term and preterm labor were studied in vitro to define the action of the hormone. The maximal tension and slopes of oxytocin dose contractile-response curves, but not the pD2 values (-log ED50), were higher in both muscle layers at term delivery and also during preterm delivery induced with antiprogesterones compared with responses from tissues of nondelivering animals. These data indicate that the myometrium is hyperresponsive and hyperreactive to oxytocin during term and preterm birth but not hypersensitive. The increase in oxytocin responsiveness of the myometrium may be fundamental to the initiation of labor and regulated by the increases in oxytocin receptors and postreceptor events, including gap junctions. PMID- 2764061 TI - Zinc, cadmium, and hypertension in parturient women. AB - Zinc deficiency and cadmium toxicity have both been implicated in hypertension during pregnancy. The goals of this study were twofold: first, to assess the different zinc indices (plasma, red blood cell zinc, heat-labile alkaline phosphatase, and placental zinc) in normotensive and hypertensive parturients to determine whether they are altered in the different types of hypertension that occur during pregnancy; second, to assess whole-blood cadmium and placental cadmium with regard to hypertension and zinc status. Patients were diagnosed as having chronic hypertension or preeclamptic toxemia and were then further divided into groups on the basis of smoking status. Each patient was matched with a normal control subject based on age, parity, and smoking status. Forty-three hypertensive patients and their matched control subjects were studied. No differences were found in the various zinc indices between chronic hypertensive parturients and normal control subjects. However, in parturients with preeclamptic toxemia, the plasma zinc level was 19% lower than in control subjects (p less than 0.02); these patients had the lowest plasma zinc level of the three groups. Placental zinc was also 12% lower in patients with preeclamptic toxemia than in control subjects (p less than 0.04). Whole-blood cadmium and placental cadmium levels did not differ between control subjects or hypertensive patients. However, a significant positive correlation was found between whole blood cadmium and plasma zinc levels in preeclamptic toxemia (r = 0.53; p less than 0.05). The results support a marginal zinc deficiency in parturients with preeclamptic toxemia but not in those with chronic hypertension. The role of cadmium in the cause of preeclamptic toxemia remains unclear. PMID- 2764063 TI - Power spectrum analysis of myometrial electromyogram and intrauterine pressure changes in the pregnant rhesus monkey in late gestation. AB - Various methods have been used to quantify myometrial activity in the pregnant rhesus monkey during the last third of gestation. A precise definition of activity must retain the characteristics of epoch duration, amplitude, and the repetitive frequencies of active epochs. We used Fast Fourier Transform and power spectrum analysis to determine whether the patterns of myometrial contractility consist predominantly of contractions or contractures. This analysis allows quantification of activity represented by each of these patterns of activity. We applied these methods to myometrial electromyogram and intrauterine pressure recordings in pregnant rhesus monkeys to characterize the changes in myometrial activity that occur after surgery, after intravenous indomethacin administration, and when food is withdrawn for 48 hours. We conclude that changes in the frequency pattern of myometrial activity provide important information in relation to labor and delivery contractions. PMID- 2764064 TI - Pattern of human chorionic gonadotropin binding in the polycystic ovary. AB - The histologic evolution of polycystic ovaries in the estradiol valerate-treated rat coincides with the development of a unique plasma pattern of luteinizing hormone. To assess the role of luteinizing hormone in polycystic ovaries, it is necessary to evaluate the luteinizing hormone sensitivity of the specific tissues in the polycystic ovary. Therefore, we examined the pattern of luteinizing hormone binding sites in polycystic ovaries. Rats at 4 or 8 weeks after estradiol valerate treatment each received an intrajugular injection of iodine 125-labeled human chorionic gonadotropin. Some rats also received a 1000-fold excess of unlabeled human chorionic gonadotropin in the same injection. Ovaries were prepared for autoradiography. Dense accumulations of grains occurred over the theca of normal and atretic secondary follicles in all ovaries and over clusters of secondary interstitial cells. The iodine label was variable over the typically hypertrophied theca of precystic follicles. The theca of definitive cysts showed little or no label. These results indicate that cyst formation coincides with the loss of luteinizing hormone/human chorionic gonadotropin binding to the affected follicles. PMID- 2764065 TI - Effect of a 48-hour intravenous delta 4-androstenedione infusion on the pregnant rhesus monkey in the last third of gestation: changes in maternal plasma estradiol concentrations and myometrial contractility. AB - Increased myometrial activity in the pregnant rhesus monkey occurs in situations in which plasma estrogen concentrations are elevated. Examples of such situations are after laparotomy, with or without hysterotomy, and before delivery. The increased activity occurs primarily in the hours of darkness. To investigate the possibility of a causal relationship between the rise in estrogens and myometrial activity, we infused androstenedione intravenously for 48 hours to the rhesus monkey in the last third of gestation. Myometrial activity was quantified either as an increase in the number of individual contraction events or as a change in the power spectrum at high frequencies characteristic of contractions. Androstenedione infusion was followed by increased myometrial activity. Maternal plasma 17 beta-estradiol concentration was significantly elevated at 10 AM on the second day of androstenedione infusion. We conclude that, in the rhesus monkey late in gestation, estradiol may play a role in the regulation of the contraction activity observed during the hours of darkness in several different situations. PMID- 2764066 TI - Attempted suicide and pregnancy. PMID- 2764067 TI - Sperm antibodies and infertility. PMID- 2764068 TI - Isolation of human immunodeficiency virus from the placenta or from maternal blood contaminating the placenta? PMID- 2764069 TI - Candida warrants concern. PMID- 2764070 TI - Child abuse, neglect, and adult behavior: research design and findings on criminality, violence, and child abuse. AB - Using a prospective cohorts design, a large sample of physical and sexual abuse cases was compared to a matched control group. Overall, abused and neglected subjects had higher rates than did controls for adult criminality and arrests for violent offenses, but not for adult arrests for child abuse or neglect. Findings are discussed in the context of intergenerational transmission of violence, and directions for future research are suggested. PMID- 2764071 TI - Maternal affect and toddlers' social-emotional competence. AB - Mothers' and toddlers' discrete emotions, as well as their more general psycho social functioning, were coded. Indices of maternal emotion and psychosocial functioning showed patterns of correlations with child indices and with each other. Two possible explanations of these patterns, child temperament and socialization of emotion, are discussed. PMID- 2764072 TI - Severity of maternal depression and three types of mother-to-child aggression. AB - This study of low-income, single mothers suggests that severity of depression conditions the relationship between depression and three types of mother-to-child aggression. Compared to nondepressed mothers, moderately but not severely depressed women are more likely to be physically violent, and both moderately and severely depressed women are at increased risk for high frequencies of verbal/symbolic aggression. PMID- 2764073 TI - Temperament and individuality: a study of Malay children. AB - Malay parents of 40 infants and preschool children were interviewed using translations of temperament questionnaires by Thomas and Chess, and by Carey. Similarities and differences between Malay children and previously studied American children are discussed, and relationships suggested among temperament ratings and Malay child-rearing practices and values. PMID- 2764074 TI - Acceptance of the mental illness label by psychotic patients: effects on functioning. AB - Labeling theory predicts that psychotic patients who accept the label of mental illness will function less well than those who reject their diagnosis. Accepted psychotherapeutic theory suggests the reverse. Two predictive models were tested. Results supported the central hypothesis of the psychotherapeutic model but not that of the labeling model, although some elements of the latter model were affirmed. Besides acceptance of diagnosis, an internal locus of control appears important for good outcome in psychosis. PMID- 2764075 TI - Impact of a family support program on mothers' social support and parenting stress. AB - The study examined two components of a family support program, a mothers' self help discussion group and a parent education group, to determine their effects on social support and parenting stress. Findings suggest that, after three months of program participation, mothers in both groups felt less social isolation and parenting stress than did mothers in the control group. PMID- 2764076 TI - The Foster Care Research Project: clinical impressions. AB - A two-year prospective study compared individual and group models of support for foster parents. Results showed greater foster parent satisfaction with the group model. An independent critique identified methodological flaws that would preclude further differentiation of the models and suggested that clinical impressions and trends in favor of the group model be given credibility. Operation of the group model is described, and reasons for the differences between clinical and experimental findings are discussed. PMID- 2764077 TI - The developmental-clinical rationale for the use of seclusion in the psychiatric treatment of children. AB - The use of seclusion as an element in a therapeutic management model for ego deficient children is presented, based on what is known about the normal socialization process and the ego deficits of some psychiatrically hospitalized children. A distinction is made between retaliatory punishment and supportive control techniques. Specific recommendations for the implementation of seclusion in a nurturing environment are made. PMID- 2764078 TI - The relationship between borderline personality disorder and anxiety disorders. AB - Eleven "pure" borderlines, ten borderlines with depression, 16 "pure" depressives, and 31 normal subjects were compared on a number of standardized inventories of anxiety. While patient groups experienced more anxiety of all types than did normals, borderlines did not emerge as more anxious than other patient groups. Qualitative differences in the anxiety experienced by borderlines and nonborderlines are discussed. PMID- 2764079 TI - Group work with men who experienced incest in childhood. AB - Behavioral, cognitive, and emotional issues presented by adult males who had been victims of incest in childhood are examined. Work with an ongoing therapy group is described, and long-term treatment is proposed as a means of providing support and clarifying distorted belief systems that cause many incest victims to behave dysfunctionally. PMID- 2764080 TI - Consultation to a clinic following suicide. AB - A case study arising from consultation to a health care clinic experiencing difficulties following the suicide of one of two key staff members is presented. The impact of the event on surviving staff members and on the functioning of the organization is described. The role of the consultants in delineating leadership tasks to facilitate mourning and thus allow a return to normal work operations is noted. PMID- 2764081 TI - Determination of adult stature from metatarsal length. AB - The results of a study to determine the value of foot bones in reconstructing stature are presented. The data consist of length measurements taken on all ten metatarsals as well as on cadaver length from a sample of 130 adults of documented race, sex, stature, and, in most cases, age. Significant correlation coefficients (.58-.89) are shown between known stature and foot bone lengths. Simple and multiple regression equations computed from the length of each of these bones result in standard errors of estimated stature ranging from 40-76 mm. These errors are larger than those for stature calculated from complete long bones, but are approximately the same magnitude for stature calculated from metacarpals and fragmentary long bones. Given that metatarsals are more likely to be preserved unbroken than are long bones and given the ease with which they are accurately measured, the formulae presented here should prove useful in the study of historic and even prehistoric populations. PMID- 2764082 TI - Developmental changes in the facial soft tissues. AB - Short-base stereophotogrammetry was used to study differential growth and development of the soft tissues of the face. Thirteen facial parameters were measured at ages 9, 11, 13, 15, and 16 years on 170 facial contour maps selected from a mixed longitudinal study of 26 boys and 26 girls. Each parameter was measured three-dimensionally, and its developmental progress at the earlier stages was expressed as a percentage of its value at 16 years of age. Standing height development was assessed in the same way. Three parameters that measured soft tissues surrounding the eyes grew little but were very advanced in their development, following a "neural" pattern. The remaining facial parameters grew more but were less advanced, and standing height was least advanced. There appeared to be three separate patterns of development, "neural," "facial," and "skeletal." Girls were, in general, smaller than boys, but their development was more advanced when measured as a percentage of size at 16 years compared with boys. PMID- 2764083 TI - Familial aggregation of blood pressure and anthropometric variables in patrilocal households. AB - Fifty-three households in a small Indian fishing community were surveyed for blood pressure, pulse rate, and anthropometric measurements (height, weight, and three skinfolds). In addition to nuclear family relationships, correlations for extended family members and in-laws living within a common household were estimated by maximum likelihood. Based on likelihood ratio tests, the hypothesis that correlations among genetically unrelated pairs from the same household are zero is rejected for systolic blood pressure. Among genetically related individuals, the degree of relationship does not affect the magnitude of the blood pressure correlations. For the anthropometric measurements, family resemblance is significant only for first-degree relatives, except that the correlation for uncle-child pairs is significant for subscapular skinfold, and brother-in-law-sister-in-law pairs resemble each other for height and weight. The results suggest that common household environment is a significant determinant of blood pressure but not fatness in this population. PMID- 2764084 TI - Genetic variation within two linguistic Amerindian groups: relationship to geography and population size. AB - Nine Carib and eight Tupi groups were studied for a minimum of eight common polymorphic systems and compared in terms of genetic distances using the methods of Nei and Edwards. Two levels of genetic information were distinguished, one with a maximum of 20 loci and another with a maximum of 12 loci considered. The dendrograms produced consistent, reproducible results, independent of the method used, when a minimum of ten polymorphic systems were included in the analysis. Irrespective of the number of systems or the method used, the Tupi showed two to three times higher average interpopulation genetic distances than the Carib groups, which may be due to their lower average population sizes, allowing for the action of genetic drift and/or founder effects, as these two sets of populations do not differ significantly in geographic range, years of contact with non-Indians, or degree of acculturation. PMID- 2764085 TI - Allocation and discrimination based on human odontometric data. AB - This study contrasts the confidence with which individuals may be grouped and then re-allocated on the basis of odontometric data. These data are derived from the mesiodistal and buccolingual diameters of 202 Lengua Indians of Paraguay (100 males, 102 females), 125 Caucasoid schoolchildren (59 male, 66 female), and 206 Negroes (106 male, 100 female). Multivariate intergroup discrimination is effected by means of canonical and stepwise discriminant analysis, whilst allocation is evaluated by means of posterior and typicality probabilities. Bias is reduced by means of a jackknifing procedure. High levels of discriminatory confidence (each Wilk's Lambda, P less than 0.01) are matched by high percentage correct classification (Caucasoid, 67.4-75.0%; Negro, 71.0-77.3%; Amerindian, 65.2-78.1%). However, these results are not matched by allocatory procedures: only 21.7% of caucasoids, 21.4% of Negroes, and 28.8% of Amerindians could be re allocated with probabilities in excess of 80%. It is concluded that while multivariate discriminant techniques may be usefully employed in the separation of different populations, individuals may not be assigned with the same degree of confidence, even with an a priori knowledge of their group membership. PMID- 2764086 TI - Early-life background and the development of non-insulin-dependent diabetes mellitus. AB - The relationship of early-life background factors to type 2, or non-insulin dependent, diabetes mellitus (NIDDM) was examined with reference to family history of diabetes in two groups of Nisei (U.S. born/raised Japanese American) men from King County, Washington with identical mean (+/- S.E.M.) ages: 78 with NIDDM, 61.6 (+/- 0.7) years of age; and 79 with normal glucose tolerance (NGT), 61.6 (+/- 0.6) years of age. The early-life variables were birthplace, parents' education, father's occupation and mother's employment status during subject's childhood, sibship size, son birth order, physical activity and weight assessed for ages 15-20 years, and educational achievement. Multivariate logistic regression models were used to test for the effect of each variable on the risk for diabetes in the presence of other variables. Results are presented as odds ratios (OR) with 95% confidence intervals (CI). Significantly higher risk for NIDDM was found with urban birthplace (vs. rural, OR = 2.09, 95% CI = 1.37-3.19), parents' education above primary level (vs. primary level or less, OR = 1.64, 95% CI = 1.08-2.50), mother being employed (vs. housewife, OR = 2.17, 95% CI = 1.43 3.45), subject being less active-lean as a youth (vs. more active-lean, OR = 1.69, 95% CI = 1.11-2.63), and subject's not attaining a college degree (vs. college degree, OR = 2.17, 95% CI = 1.41-3.33). In separate analyses of the early life variables by family history of diabetes, the interplay of environmental influences with familial predisposition to NIDDM is evident. The developmental background of NIDDM is discussed with reference to the concept of phenotype amplification within the context of the effects of westernization. PMID- 2764087 TI - Structural adaptations of the femur and humerus to arboreal and terrestrial environments in three species of macaque. AB - One reason to measure cross-sectional structural properties of primate long bones is to define mechanically relevant complexes of traits that describe the adaptation of bone to different biomechanical environments. This can be effectively accomplished when congeneric species having different postural and locomotor behaviors are compared. This paper compares the cross-sectional geometry of the femur and humerus in three behaviorally different macaque species as a basis for defining such patterns. Cross-sectional moments of inertia in the standard anatomical planes were calculated at five locations along the diaphyses of the femur and humerus in Macaca fascicularis, M. nemestrina, and M. mulatta. The data suggest that the "barrel-shaped" femur is associated with behaviors for which long limbs and small body size are an asset. This may be associated with, but is not restricted to, leaping behaviors. The data also suggest that structural rigidity of the femur and humerus is greater per unit body weight in primates that spend significant amounts of time in terrestrial environments than in those that are more restricted to climbing in arboreal environments. PMID- 2764088 TI - Role of supraspinatus in the quadrupedal locomotion of vervets (Cercopithecus aethiops): implications for interpretation of humeral morphology. AB - Various researchers have noted that terrestrial and arboreal monkeys often differ in the degree to which the greater tubercle of the humerus projects proximally beyond the profile of the humeral head. These differences have been associated with differing leverage requirements for supraspinatus during quadrupedal locomotion. Although Jolly (The Baboon in Medical Research, Vol. II., pp. 23-50, 1967) suggested that a projecting tubercle can be related to the ability of supraspinatus to control more exactly the passive humeral retraction that occurs during support phase of quadrupedalism, most workers emphasize a link between this bony trait and the need for powerful or rapid protraction of the forelimb during swing phase of terrestrial quadrupedalism. We report on an EMG analysis of supraspinatus function showing that the muscle does not act as a brachial protractor during quadrupedalism, even in the relatively cursorial vervet monkey. We suggest that differences in greater tubercle projection can be related to the degree of mobility of the shoulder, and that supraspinatus size is determined by the interaction of greater tubercle height, adaptive importance of brachial elevation, and body size. PMID- 2764089 TI - Mechanism of hypoxic injury to pulmonary artery endothelial cell plasma membranes. AB - We exposed monolayer cultures of pulmonary artery endothelial cells or plasma membranes derived from these cells to hypoxic (0 and 5% O2) and normoxic (20% O2; control) conditions and measured cellular contents of malondialdehyde and conjugated dienes, plasma membrane fluidity and lipid composition, and plasma membrane-dependent transport of 5-hydroxytryptamine (5-HT). Hypoxia caused significant increases in malondialdehyde and conjugated dienes, in fluidity, and in 5-HT transport. Hypoxia also caused a significant decrease in plasma membrane total phospholipids and a marked increase in plasma membrane free fatty acids that appeared to be due to release of fatty acids from the plasma membrane phospholipids. The increases in fluidity and 5-HT transport and the alterations in fatty acids were reversible after return to control conditions. These results indicate that hypoxia alters the physical state, lipid composition, and function of endothelial cell plasma membranes by a combination of stimulation of membrane lipid peroxidation and accelerated degradation of membrane phospholipids, the latter probably secondary to activation of membrane phospholipases. PMID- 2764090 TI - Effects of systemic inhibition of prostaglandin production on protein metabolism in tumor-bearing rats. AB - Two rat tumors, Morris hepatoma 7777 (MH) and Yoshida ascites hepatoma AH130 (YAH) were compared, and the influence of systemic inhibition of prostaglandin (PG) synthesis on muscle protein metabolism was evaluated. Tumor-bearing rats were compared with ad libitum- and pair-fed controls. Rats were also treated with naproxen, an inhibitor of PG synthesis. Tumors caused progressive anorexia and weight loss and resulted in decreased weight and/or protein content of the soleus, extensor digitorum longus, and epitrochlearis muscles. The extent of this wasting varied with muscle and tumor type. Muscle wasting induced by the tumors appeared to result from increased protein degradation and/or decreased protein synthesis, as determined in isolated epitrochlearis muscle. In YAH, reduced feed intake did not appear to be responsible for muscle wasting; however, in MH, it accounted for a significant proportion of the muscle loss. YAH produced large amounts of PGE2. Treatment of rats with naproxen inhibited tumor PGE2 production and muscle protein loss in rats bearing YAH. Naproxen had no effect on muscle weight or protein degradation in rats bearing MH. These results would appear to implicate PGE2 in the development of cachexia in the laboratory rat. PMID- 2764091 TI - Flufenamic acid senses conformation and asymmetry of human erythrocyte band 3 anion transport protein. AB - With Cl as substrate, the human red blood cell anion transport (band 3) protein can exist in four conformations: Ei, with the transport site facing the cytoplasm; Eo, with the transport site facing the external medium; and ECli and EClo, the corresponding forms loaded with Cl. Flufenamic acid (FA), an inhibitor that binds to an external site different from the transport site, binds to Eo with a dissociation constant of 0.0826 +/- 0.0049 (SE) microM. Binding of iodide or sulfate to the external-facing transport site reduces the affinity by 1.66 or 14.3-fold, respectively. Changing from Eo to Ei lowers the affinity by 3.7-fold, and binding of cytoplasmic iodide to Ei further decreases the affinity by 5.5 fold. Thus changes in orientation of the transport site and substrate binding, even at the opposite side of the membrane, cause sufficient conformational changes in band 3 to affect FA binding substantially. If the possible effects of Cl binding to the transport site on FA affinity are estimated from the iodide data, the dependence of FA inhibitory potency on Cl concentrations inside and outside the cell suggests that there are at least 6.5 times as many inward-facing as outward-facing Cl-loaded transport sites. This information can be used to calculate the distribution of capnophorin among the various conformations under different circumstances and to devise conditions for recruiting the transport molecules toward a particular conformation. PMID- 2764092 TI - Mechanism of chloride uptake in rabbit corneal epithelium. AB - The mechanism of chloride uptake at the basal membrane (stromal side) of rabbit corneal epithelium was examined by observing the effects of ion transport inhibitors and ion concentrations on the stimulated epithelial short-circuit current (Isc). Loop diuretics inhibited the theophylline-stimulated peak and sustained Isc. Treatment with 4,4'-diisothiocyanostilbene-2,2'-disulfonic acid (DIDS, 0.2 mM) and/or 5-(N,N-dimethyl)amiloride (0.1 mM) as well as the potent anion exchange inhibitor, 5c(+)[(2,3,9,9a-tetrahydro-1H-fluoren-7-yl)oxy]acetic acid (0.01 mM), had no significant effect on Isc. These results are consistent with Cl- uptake by a Na+-Cl- or Na+-K+-2Cl- cotransport mechanism rather than Cl( )-HCO3(-)-OH- exchange coupled to Na+-H+ exchange. Incubation in low [Na+] or [Cl ] before stimulation with forskolin (0.1 mM) reduced both peak and sustained Isc, and saturation kinetics were exhibited. Hill coefficients for [Na+] and [Cl-] were 0.99 and 1.04, respectively, for peak Isc and 0.66 and 1.18, respectively, for sustained Isc. Apparent ion affinities for Na+ and Cl- were 13.5 and 18 mM, respectively, for peak Isc and 15 and 22 mM, respectively, for sustained Isc. These results favor Cl- uptake by a 1 Na+:1 Cl- cotransport mechanism for the rabbit corneal epithelium, but involvement of K+ in this process has not been eliminated. PMID- 2764093 TI - An ATP-sensitive conductance in cultured smooth muscle cells from pregnant rat myometrium. AB - The whole cell voltage-clamp technique was used to study the effects of extracellular ATP in cultured smooth muscle cells isolated from pregnant rat myometrium. An inward current was elicited by ATP (IATP) in cells held at -70 mV under voltage clamp. The amplitude of IATP was reduced by estrogen pretreatment and by the end of pregnancy. IATP not only did not undergo any desensitization but showed facilitation. The current-voltage relationship of IATP was linear and reversed close to 0 mV. Changing the sodium electrochemical gradient by decreasing extracellular or intracellular sodium resulted in a linear relationship between the reversal potential of IATP and Na equilibrium potential that, however, differed from the predicted curve for a purely sodium conductance. The conductance activated by ATP was monovalent cation selective with little discrimination between potassium, cesium, and sodium ions. IATP was depressed by divalent cations, and the rank order of potency was Co greater than Mg greater than Ca greater than Ba, suggesting that the free-acid form of ATP was the effective ligand. Adenosine, AMP, and ADP were ineffective in eliciting IATP, whereas ATP gamma S and alpha,beta-methylene ATP were capable of mimicking the effects of ATP, although they were less potent. These results are consistent with the free-acid form of ATP activating a monovalent cation-selective and estrogen sensitive conductance in myometrium. PMID- 2764094 TI - Glycolytic and oxidative metabolism in primary renal proximal tubule cultures. AB - Cultured cells often exhibit alterations in energy metabolism (increased glycolytic activity and decreased oxidative metabolism) during adaptation to the culture environment. The role of hypoxia as a mediator of these effects was examined by comparison of metabolism in primary rabbit renal proximal tubule (RPT) cultures maintained in stationary culture dishes (DISH), shaking Erlenmeyer flasks (SHAKE), and DISH cultures transferred back to SHAKE conditions (RESHAKE). Both oxidative metabolism and transport capacity were fully preserved in SHAKE cultures over a 24-h period. In contrast, within 6 h, DISH cultures exhibited a continuous decline in transport-dependent and -independent oxygen consumption, respiratory capacity, and ATP and K+ contents. The loss of oxidative metabolism in DISH cultures was accompanied by stimulation of lactate production, detectable within 1 h after plating. Comparison of metabolic properties of DISH cultures to those of RPT exposed to graded levels of hypoxia suggested that medium oxygen tensions may be as low as 1-3% in DISH cultures. RESHAKE cultures exhibited metabolic properties comparable to those of SHAKE cultures, indicating reversibility of DISH culture metabolism on reoxygenation. We concluded that DISH cultures rapidly become hypoxic as a consequence of static culture conditions. Shaking suspension cultures may provide a more metabolically appropriate model for long-term in vitro studies. PMID- 2764095 TI - Swelling, reductive stress, and cell death during chemical hypoxia in hepatocytes. AB - In rat hepatocytes, we examined the relationship between cell volume, bleb formation, and loss of cell viability during chemical hypoxia with KCN plus iodoacetic acid. In hypotonic media (150-200 mosmol/kgH2O), cells swelled to a greater extent during chemical hypoxia than in isotonic media, but rates of cell killing were identical. Sucrose (300 mM) added to isotonic media prevented early cell swelling but actually accelerated cell killing. In contrast, mannitol (300 mM) improved cell survival but did not prevent cell swelling. Bleb formation occurred regardless of buffer tonicity. The antioxidants desferrioxamine and cyanidanol but not superoxide dismutase +/- catalase delayed lethal cell injury. Cell killing was greater during aerobic compared with anaerobic chemical hypoxia. Hydroperoxide formation was measured using a dichlorofluorescin assay and was accelerated during aerobic but not anaerobic chemical hypoxia. The results indicate that cell swelling is not the driving force for bleb formation or lethal cell injury. We conclude that "reductive stress" caused by respiratory inhibition favors formation of toxic oxygen species and may contribute to lethal cell injury during intermittent or incomplete oxygen deprivation. PMID- 2764096 TI - Simulated ischemia and intracellular pH in isolated ventricular muscle. AB - Isolated guinea pig papillary muscles were subjected to an in vitro model of ischemia, consisting of superfusion arrest and immersion in paraffin oil, which results in restriction of substrate supply and metabolite washout. Intracellular pH (pHi) and surface pH (pHs) were measured with glass microelectrodes. Contractile force declined to 82% of the pre-"ischemic" value after 2 min and to 37% of the control value after 10 min. In addition, a shortening of the time to peak and duration of contraction was noted. The rate of force development decreased later than the rate of relaxation. After 10 min, pHi was acidified on average 0.08 pH unit, which is about one-third of the measured pHs change. Tripling the ischemic pHi change by reduction of the intracellular buffering power only slightly increased the rate of tension decline. Experimental pHi changes of similar magnitude, induced during normal superfusion, had a smaller effect on contractile force and failed to reproduce the characteristic changes in time course of the contraction. It is concluded that, in our condition of simulated ischemia, the intracellular acidification cannot account fully for the rapid decline in contractility. PMID- 2764097 TI - Computer analysis reveals changes in renal Na+-glucose cotransporter in diabetic rats. AB - A novel, computer-assisted program was developed to analyze the time course of Na+-glucose cotransport by rat renal cortical brush-border membrane vesicles (BBMV). Transporter characteristics can be measured, which routine kinetic analyses fail to distinguish: cotransporter membrane density is derived from the picomoles of D-glucose bound per milligram of protein. Binding is stereospecific, blocked by phlorizin, and supported equally well by Na+ or K+ (but not Cs+). Quasi-first-order influx and efflux rate constants for the composite Na+-driven influx and the (presumed) Na+-independent efflux processes were highly dependent on glucose concentration. Either two Na+-glucose transporters exist in proximal tubules or a single mechanism abruptly changes rate when glucose falls to low levels. The major operation mode is slow, has a high capacity but low affinity, and may have a 2 Na+:2 glucose stoichiometry (Hill coefficient is unity). The minor system is a fast, smaller-capacity, higher-affinity operation with a 2 Na+:1 glucose stoichiometry that was not distinguishable when the same data were analyzed in conventional kinetic plots. Results with streptozocin-induced diabetic rats illustrate the method's utility. Low-glucose-affinity cotransporters were upregulated in hyperglycemic, but not in cachectic, ketoacidotic animals. Rate constants, especially for efflux, were decreased in diabetes. PMID- 2764098 TI - Adrenalectomy prevents obesity in glutamate-treated mice. AB - Mice treated with monosodium glutamate (MSG) in the neonatal period grow into obese, stunted adults without overeating. We have previously demonstrated normal control of brown adipose tissue (BAT) thermogenic function in the MSG-treated mouse and have concluded that thermoregulation at a lower than normal body temperature for most of the time is a major cause of its obesity. The objective of the present experiments was to find out whether adrenalectomy would prevent obesity in the MSG-treated mouse, as it does in hyperphagic obese rodents, and whether the thermoregulatory anomaly would be prevented by this procedure. MSG treated mice that were adrenalectomized at 5 wk of age and studied at 10 wk of age did not become obese. Adrenalectomy increased body temperature of MSG-treated mice to normal (male mice) or almost normal (female mice). Adrenalectomy increased BAT mitochondrial guanosine 5'-diphosphate binding in MSG-treated mice, indicative of an increased thermogenic state, but had the same effect in control mice. We conclude that obesity in the MSG-treated mouse is secondary to the high level of corticosterone in its blood, which raises its metabolic efficiency, an effect of corticosterone also seen in normal lean mice, and causes it to thermoregulate at a low energy-conserving level. This latter effect is peculiar to the MSG-treated mouse and is not seen in corticosterone-treated normal mice. PMID- 2764099 TI - Volume regulation of human lymphocytes by aldosterone in isotonic media. AB - In vitro binding of aldosterone to mineralocorticoid receptors on human mononuclear leukocytes (HML) and its effects on the intracellular sodium and potassium concentrations of HML have already been described. In the present paper this easily accessible human cell model was investigated with regard to the regulation of the cell volume by aldosterone, since the concordant changes of sodium and potassium were expected to be accompanied by water and volume shifts. As determined by the measurement of cell diameter and the planimetric estimation of cell area in photographs, cell volume decreased by approximately 16% when cells were incubated in RPMI-1640 medium without aldosterone added for 1 h at 37 degrees C, a decrease not seen when 1.4 nM aldosterone was added to the incubation medium; the effect was half maximal at a concentration between 0.07 and 0.14 nM. One hundred forty nanomoles canrenone antagonized the action of aldosterone, but cortisol was ineffective. The results indicate concordant changes of intracellular sodium and potassium and cell volume, if studied under the same conditions. These data are the first to demonstrate that aldosterone is a major physiological determinant of lymphocyte volume in isotonic media. PMID- 2764100 TI - Transient reduction of metabolic rate by food restriction. AB - It is widely held that restriction of food intake leads to a decrease in metabolic rate, and this effect has been implicated as the mechanism by which food restriction retards aging in laboratory rodents. Data on which this belief is based were obtained mostly from studies of basal metabolic rate after acute rather than chronic food restriction. In contrast we previously reported no effect of chronic food restriction on metabolic rate measured under usual living conditions. The present study examines changes in metabolic rate immediately after restriction of food so as to include the initial response to decreased intake of food. Two groups of specific pathogen-free Fischer 344 rats were housed under barrier conditions from 6 to 24 wk of age. Restricted rats were fed 60% of food consumed by rats eating ad libitum. Metabolic rate was measured indirectly by gas analysis with rats under normal daily living conditions (24MR) and basal metabolic rate (BMR) was also measured. Both 24MR and BMR decreased after food restriction, but this decrease was transient, so that within a few weeks metabolic rate of restricted rats was the same as that of rats fed ad libitum. PMID- 2764101 TI - Neuropeptide Y in the human female genital tract: localization and biological action. AB - The distribution, localization, and smooth muscle effects of neuropeptide Y (NPY) were studied in the human female genital tract. High concentrations of NPY immunoreactivity were demonstrated in the uterine artery, the ovary, the fallopian tube, cervix, and the vagina. The NPY immunoreactivity was confined to nerve fibers. The highest density of nerve fibers was observed in relation to blood vessels, although some NPY-immunoreactive nerves were also seen close to nonvascular smooth muscle. The NPY-immunoreactive material throughout the genital tract was identical to synthetic amidated human NPY with regard to size, hydrophobicity, and charge as evaluated by gel filtration, high-performance liquid chromatography, and isoelectric focusing. NPY (10(-10) to 10(-6) M) exerted a direct vasoconstrictory effect on small arteries dissected from the cervix and an additive effect of NPY and norepinephrine responses was observed. Exogenous NPY did not have a direct effect on nonvascular smooth muscle specimens from the fallopian tube or the myometrium. The close relation between NPY immunoreactive nerves and blood vessels, the presence of NPY-immunoreactive material identical to amidated synthetic human NPY, and the vasoconstrictory effects of NPY indicate that NPY is involved in the regulation of the blood flow in the human female genital tract. PMID- 2764102 TI - Interaction of calcium with porcine adrenal chromogranin A (secretory protein-I) and chromogranin B (secretogranin I). AB - Secretory granules of endocrine cells contain one or more of the acidic secretory proteins chromogranin A (secretory protein-I), chromogranin B (secretogranin I), and secretogranin II (chromogranin C). It has been proposed that these proteins play a role in the packaging of secretory products. In the present study, lysates of purified porcine adrenal chromaffin granules containing chromogranins A and B and a putative chromogranin B fragment bound calcium and formed aggregates in the presence of 10-20 mM calcium at pH 5-6 and at 100 mM or less KCl, NaCl, or norepinephrine. The precipitates contained virtually all of the chromogranin B and the chromogranin B fragment and about one-third of the chromogranin A. The aggregates did not form or were dissociated at the pH and salt concentration of the extracellular fluid. Calcium precipitated purified chromogranin A and chromogranin B from pure solution to the same extent as from the granule lysates. Parathormone, added to the lysates, was incorporated in the precipitates, whereas the acidic secretory protein ovalbumin and norepinephrine were not. These findings suggest that secretory protein-I and secretogranin can exist in situ as aggregates that may include selected secretory products. PMID- 2764103 TI - Fuel-mediated teratogenesis: biochemical effects of hypoglycemia during neurulation in mouse embryos in vitro. AB - Hypoglycemia has been reported to induce congenital malformations and growth retardation in rodent embryos during the period of neural tube closure in vitro. However, the biochemical alterations responsible for the production of the dysmorphogenic effects have not been evaluated. Therefore, the rates of glucose metabolism by glycolysis, citric acid cycle, oxidative pentose phosphate pathway (PPP), and anabolic utilization were evaluated in mouse embryos and extraembryonic membranes using the whole embryo culture technique. Altered glucose metabolism by glycolysis and oxidative PPP, as well as altered anabolic synthesis, were produced by exposure to hypoglycemia. In embryos exposed to mild hypoglycemia (80 mg/dl) altered metabolism by the PPP and an associated effect on nucleic acid synthesis were in part responsible for the dysmorphogenic effects of this treatment. In contrast, severe hypoglycemia (40 mg/dl) appeared to have an immediate effect on glycolytic metabolism in addition to effects on the PPP and nucleic acid synthesis. Therefore, a multifactorial biochemical mechanism contributes to the induction of malformations by severe hypoglycemia in mouse embryos in vitro. Furthermore, the differential effects of moderate vs. severe hypoglycemia on glycolytic metabolism, and possibly energy production, may account for the differences in the severity of these treatments on embryonic growth and the incidence of malformations. PMID- 2764104 TI - 1,25-Dihydroxyvitamin D3-induced alterations of lipid metabolism in human monocyte-macrophages. AB - An in vivo atherogenic role of dietary vitamin D has been postulated. To address this hypothesis we sought to determine the in vitro effects of its active circulating metabolite, 1,25-dihydroxyvitamin D3 [1,25(OH)2D3] on lipid metabolism in human monocyte-derived macrophages. When cultured 6 days in the presence of 10(-8) M 1,25(OH)2D3 monocyte-macrophages accumulated significantly more triglycerides than control cells: 987.6 +/- 26.8 vs. 779.3 +/- 24.1 micrograms/mg protein (P less than 0.001). Triglyceride accumulation was associated with a hormone-induced stimulation of triglyceride synthesis as determined by [3H]oleate incorporation into cellular triglycerides. The effect of the hormone was significant after 24 h and dose dependent [10(-11) to 10(-8) M 1,25(OH)2D3]. It was specific since 10(-7) M 25-hydroxyvitamin D3 and 24,25 dihydroxyvitamin D3 did not stimulate triglyceride synthesis, and its magnitude decreased from 1 to 9 days of culture. 1,25(OH)2D3 (10(-8) M) modified the cholesteryl ester metabolism of monocyte-macrophages only in the presence of acetylated low-density lipoproteins (50 micrograms/ml); it induced a significant increase of cellular cholesteryl ester content (21.9 +/- 1.1 vs. 11.7 +/- 1.7 micrograms/mg protein; P less than 0.001) and of esterification rate of cholesterol measured by [3H]oleate incorporation into cellular cholesteryl esters (17.2 +/- 0.9 vs. 6.5 +/- 0.3 nmol.mg protein-1.24 h-1; P less than 0.001) by comparison with control cells. These results show that 1,25(OH)2D3 alters in vitro lipid metabolism in the human monocyte-macrophage and suggest a new in vivo role for the hormone. PMID- 2764105 TI - Mean plasma hormone concentration is controlled in a linear manner by secretory impulse frequency. PMID- 2764106 TI - Feedback regulation by trypsin: evidence for intraluminal CCK-releasing peptide. AB - The mechanism by which intraluminal proteases inhibit pancreatic secretion and CCK release was investigated in conscious rats. We hypothesized that the stimulation of pancreatic secretion and CCK release that occurs in the absence of luminal trypsin is caused by a trypsin-sensitive, cholecystokinin (CCK)-releasing peptide that is tonically secreted intraluminally by the small intestine. We tested whether rapid saline perfusion of the lumen of the proximal intestine in rats with jejunostomies would wash out the putative peptide, thereby inhibiting the spontaneous pancreatic secretion caused by diverting bile and pancreatic juice from the intestine. Rats were prepared with cannulas draining bile and pancreatic juice, a duodenal cannula and a jejunostomy 10-12 cm from the ligament of Treitz. During diversion of bile and pancreatic juice to the exterior, the proximal intestine was perfused with phosphate-buffered saline at 3 ml/min via the duodenal cannula and the intestinal washes collected from the jejunostomy outlet. Rapid intestinal perfusion significantly inhibited pancreatic protein and fluid secretion stimulated by diversion of bile and pancreatic juice to the exterior. Reinfusion of the concentrated intestinal washes prevented the "washout" inhibition. The active factor in the intestinal washes was heat stable and trypsin sensitive. Rapid washout perfusion of isolated jejunal loops in Thiry Vella fistula rats reduced plasma CCK from 20.4 +/- 3.6 to 10.4 +/- 1.8 pM, and reinfusion of the washes into the loop returned plasma CCK to 17.1 +/- 3.8 pM. The results support the hypothesis that a trypsin-sensitive, CCK-releasing peptide in intestinal secretions mediates feedback regulation of pancreatic secretion in rats. PMID- 2764107 TI - Relation between fasting antroduodenal motility and transpyloric fluid movements. AB - The effect of fasting antroduodenal motility on duodenogastric fluid movements was studied in 12 healthy volunteers. Antroduodenal motility was recorded using a multilumen manometry tube. Gastric emptying and secretion and the duodenogastric reflux of bile acids and marker were measured simultaneously by means of a marker dilution technique. Gastric emptying and acid secretion were higher in phase II than in phase I of the fasting motor activity cycle [median (range) 1.74 (1.2 4.2) ml/min vs. 0.90 (0.0-2.4) ml/min and 63.5 (6.4-115.0) vs. 37.9 (5.8-86.4) mumol/min, P less than 0.01]. The duodenogastric reflux rates of bile acids and marker were similar in all phases and showed large intra- and interindividual variations. There was no correlation between antroduodenal coordination during phase II motility and gastric emptying and duodenogastric reflux. It is concluded that the interdigestive motility pattern has moderate effects on fasting emptying of liquid gastric contents and on gastric secretion but no effects on duodenogastric reflux. PMID- 2764108 TI - Compartmental modeling of the hepatic transport of taurocholate in the rat in vivo. AB - Compartmental analysis was used to study the hepatobiliary transport of taurocholate (TC) in the rat in vivo. The available data are the following: [14C]TC kinetics in blood and bile, weighting factors associated with these data and computed from a theoretical variability model, and TC excretion rate in bile. The lumped model that best fits the data contains five compartments: three compartments for TC distribution in blood and two compartments for the liver. It includes a compartmental representation of the laminar flow of bile in the collecting catheter. This model overestimates TC concentration in blood. A perfusion model that includes a compartment representing explicitly the sinusoidal TC concentration gradient was developed. TC concentration in blood estimated by this model is in good agreement with direct measurements, showing that the perfused model has a better descriptive capacity than the lumped model. The amounts of TC estimated in the two hepatic compartments are similar to values previously published. PMID- 2764109 TI - Processing of cholecystokinin by isolated liver cells. AB - Although hepatic uptake of cholecystokinin (CCK) has been demonstrated, the liver cell involved and the mechanism of uptake remain unclear. We have used dispersed rat hepatocytes, Kupffer cells, and hepatic endothelial cells to characterize uptake and metabolism of radiolabeled CCK peptides. Only rat hepatocytes showed significant uptake of 125I-labeled cholecystokinin octapeptide (125I-CCK-8). Peptide specificity of uptake by hepatocytes was similar to that seen in the isolated perfused rat liver, with extraction of 125I-CCK-8 being sevenfold greater than that of 125I-CCK-33. Uptake was saturable, as 10(-4) M CCK-4 inhibited uptake of 125I-CCK-8 by 85%. Uptake was rapid, temperature dependent, and extensive and was decreased by metabolic inhibition, a proteolytic enzyme (trypsin), organic anions (sulfobromophthalein and taurocholic acid), and an inhibitor of anion transport 4,4'-diisothiocyanostilbene-2,2'-disulfonic acid. In addition, uptake was dependent on extracellular anions but not on extracellular sodium, calcium, or magnesium. After uptake, hepatocytes released radiolabel in a time- and temperature-dependent manner, predominantly in metabolized forms. Thus the hepatocyte is the liver cell that extracts CCK by an active, anion-dependent process. The characteristics of the uptake process resemble those described for organic anions and small, cyclic peptides and suggest that small, linear peptides may undergo hepatocyte extraction by a similar mechanism. PMID- 2764110 TI - Viability of the vascularly perfused, recirculating rat intestine and intestine liver preparations. AB - Function and stability of vascularly perfused, recirculating in situ rat intestine (I) and intestine-liver (IL) preparations were evaluated in fasted and nonfasted rats because these techniques may be readily applied in drug metabolism studies. The rat intestine was perfused with blood medium (7.5 ml/min) via the superior mesenteric artery, with the venous outflow draining into the portal vein, which, together with hepatic arterial flow (2.5 ml/min), constituted the total blood flow (10 ml/min) to the liver. Maintenance of intestinal membrane integrity was observed. Rapid [14C]glucose absorption against a concentration gradient and a lack of [3H]-polyethylene glycol 4000 (PEG 4000, less than 4%) and Evans blue absorption by the recirculating I and IL preparations resulted after bolus injections of these markers into the pyloric end of the duodenum. Other indexes that revealed stable intestinal and liver functions were the following: preservation of reservoir perfusate volume, constancy in perfusion pressure, bile flow, and hemoglobin concentrations, evidence of intestinal glucose utilization and liver glucose production, and a lack of significant leakage of serum glutamic oxalic transaminase. The intestine and liver consumed oxygen at relatively constant rates, but the consumption rates for the fasted tissues (I or L) were significantly higher than those for nonfasted tissues. These results indicate that the vascularly perfused I and IL preparations were maintained in a viable and stable state for a 2-h perfusion period. PMID- 2764111 TI - Villus contraction aids repair of intestinal epithelium after injury. AB - A highly reproducible in vitro model of intestinal epithelial injury in guinea pig ileum was used to study the structural and functional events that accompany rapid epithelial repair. This model is characterized by denudation of the villus tip followed by rapid restitution of the epithelial barrier. Using standard electrophysiological and quantitative morphometric techniques, we found that immediately after injury the number of cells lost exceeded the number of empty cell positions on the denuded basement membrane by 100%. Concurrently, cytoplasmic processes of subepithelial myofibroblasts contained condensations of microfilaments that were not apparent in controls. Additionally, villus height was diminished immediately after injury, and progressively decreased during the restitution period. In tissues that were depleted of ATP using the uncoupler dinitrophenol and in tissues functionally denervated by tetrodotoxin, villus shortening after injury was significantly reduced. Denervation also retarded functionally and structurally defined reestablishment of epithelial barrier function. These data suggest that intestinal epithelial repair is aided by energy dependent, neurally mediated villus contraction. We speculate that the subepithelial network of myofibroblasts is responsible for this process, which effectively minimizes the denuded surface area to be reepithelialized. PMID- 2764112 TI - Human gastric emptying and colonic filling of solids characterized by a new method. AB - Our first aim was to compare 111In-labeled Amberlite IR-12OP resin pellets and 131I-labeled fiber in the assessment of gastric and small bowel transit and colonic filling in healthy humans. Both radiolabels were highly stable for 3 h in an in vitro stomach model and remained predominantly bound to solid phase of stools collected over 5 days [90.5 +/- 2.1 (SE)% for 131I and 87.4 +/- 1.4% for 111In). The lag phase of gastric emptying was shorter for 111In-pellets (30 +/- 11 min compared with 58 +/- 12 min for 131I-fiber, P less than 0.05). However, the slope of the postlag phase of gastric emptying and the half time of small bowel transit were not significantly different for 111In-pellets and 131I-fiber. Filling of the colon was characterized by bolus movements of the radiolabel (10 80% range, 26% mean) followed by plateaus (periods of no movement of isotope into colon lasting 15-120 min, range; 51 min, mean). Half of the bolus movements occurred within 1 h of the intake of a second meal. Thus 111In-labeled Amberlite pellets provide an excellent marker for the study of gastric and small bowel transit and colonic filling in humans. The ileum acts as a reservoir and transfers boluses of variable sizes into the colon, often soon after the intake of a subsequent meal. PMID- 2764113 TI - Relationships between gastric emptying of solid and caloric liquid meals and alcohol absorption. AB - The effects of three variations in meal composition (a solid and a liquid meal consumed together, a liquid meal consumed alone, and a liquid meal consumed 90 min after a solid meal) on the rates and patterns of solid and liquid gastric emptying were examined in 13 volunteers. By including alcohol (0.5 g/kg body wt) in the liquid meal, the relationship between alcohol absorption and gastric emptying was also assessed. The lag phase and the initial emptying phase of the solid meal were prolonged (P less than 0.001) when the liquid meal was consumed with the solid meal, compared with when the liquid meal was consumed 90 min after the solid meal. In this latter situation, consumption of the liquid meal caused the cessation of emptying of solid food, and this second lag phase was followed by a slower (P less than 0.001) than initial emptying phase. Gastric emptying of the liquid meal was slower (P less than 0.005) when solid food was present and was slowest (P less than 0.05) when liquid was consumed 90 min after the solid meal. Alcohol absorption was fastest (P less than 0.05) when the liquid meal was consumed alone and slower (P less than 0.01) when alcohol was consumed with or after the solid meal. For all three meals there was a close correlation (r greater than or equal to 0.91; P less than 0.001) between alcohol absorption and liquid emptying. We conclude that gastric emptying of liquid may be influenced by solid food and that the rate and pattern of solid emptying may be modified by the presence of liquid.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2764114 TI - Carbachol inhibits stimulant-induced increases in fundic D-cell cytosolic Ca2+ concentration. AB - We undertook these studies to examine the mechanisms by which carbachol inhibits somatostatin release. For these studies, we utilized cultured D-cells isolated from the canine gastric fundus. Carbachol inhibited somatostatin release induced by both pentagastrin and 12-O-tetradecanoyl-phorbol-13-acetate but did not alter the redistribution of protein kinase C induced by these agents. In contrast, carbachol diminished the increase in D-cell cytosolic free calcium levels ([Ca2+]i) induced by pentagastrin, and this effect was no longer evident after pretreatment of D-cells with pertussis toxin. Although carbachol by itself had no effect on [Ca2+]i, after pretreatment of D-cells with pertussis toxin, carbachol both enhanced [Ca2+]i and stimulated somatostatin release. These data indicate that carbachol activates signals in D-cells that result in both increase and decrease in [Ca2+]i. The latter effect, which appears to be mediated via a pertussis toxin-sensitive guanine nucleotide binding protein, may be one mechanism responsible for cholinergic inhibition of somatostatin release. PMID- 2764115 TI - Bronchial epithelial cells release chemoattractant activity for monocytes. AB - Lung macrophages are monocyte-derived cells that play a central and essential part in local immunity. Because the bronchial epithelial cells that line the airway can modulate their local cellular environment by releasing chemotactic factors for neutrophils, lymphocytes, and fibroblasts, we postulated that the bronchial epithelial cells might release chemotactic activity for monocytes. To test this hypothesis, bovine bronchial epithelial cells were isolated and cultured. The supernatant fluids were collected at 12, 24, 36, 48, 72, 96, and 120 h and evaluated for monocyte chemotactic activity, using a blind-well chamber technique. The supernatant fluids possessed significantly greater chemotactic activity than medium alone, with optimal migration contained in supernatant fluids harvested at 72 h (5.8 +/- 2.3 vs. 39.8 +/- 2.8 cells/high-power field, P less than 0.001). Partial characterization of the released monocyte chemotactic activity revealed that the cells released a low-molecular-weight lipid-soluble chemotactic factor after 24 h in culture, but in contrast, a high-molecular weight protein chemokinetic factor was released after 72 h in culture. These findings suggest that bronchial epithelial cells may release chemotactic activity for, and thus may modulate the recruitment of, monocytes into bronchial passages. PMID- 2764116 TI - Airway diseases: role of epithelium and inflammatory peptides. PMID- 2764117 TI - Endotoxin stimulates platelet-derived growth factor production from cultured human pulmonary endothelial cells. AB - The interaction of Gram-negative bacterial cell wall products (endotoxins) with endothelial cells is thought to be responsible for many of the damaging manifestations of Gram-negative sepsis. Because cultured human endothelial cells are relatively resistant to the direct cytotoxic actions of endotoxin, it is possible that many of the systemic effects of endotoxin may be caused by stimulation of endothelial cells to produce biologically active mediators which could then act on targets such as smooth muscle cells, fibroblasts, and leukocytes. We hypothesized that one such endothelial cell-derived mediator could be platelet-derived growth factor (PDGF), a protein that causes proliferation of mesenchymal cells, chemotaxis of leukocytes, fibroblasts and smooth muscle cells, and vasoconstriction. We therefore examined the effect of endotoxin on PDGF-like protein production by cultured adult human pulmonary artery endothelial cells. Twenty-four hours of endotoxin exposure resulted in a threefold increase in the steady-state levels of mRNA coding for PDGF B-chain (c-sis) and a two- to threefold increase in the amount of newly synthesized PDGF released into the media, as measured by immunoprecipitation of [35S]methionine-labeled protein with anti-PDGF antiserum. We conclude that human pulmonary artery endothelial cells in culture are stimulated both to produce increased amounts of PDGF mRNA and to release PDGF-like protein after exposure to endotoxin. This increased release of PDGF-like protein by human endothelial cells may play a role in the inflammatory infiltrate, vasospasm, and fibroblast proliferation that characterize the host response to endotoxin. PMID- 2764118 TI - Lung fibroblasts produce chemotactic factors for bronchial epithelial cells. AB - The interaction between the epithelial cells and the subjacent mesenchymal cells in the airway is thought to play a major role during tissue repair and morphogenesis. To evaluate this interaction, we cultured human lung fibroblasts and bovine bronchial epithelial cells and determined that fibroblast-conditioned medium has chemotactic activity for bronchial epithelial cells. This activity was nondialyzable, heat labile, pepsin labile, acid stable, lipid inextractable, and eluted from Sephadex G-150 column chromatography in the high-molecular-weight range. DEAE-Sephacyl ion exchange and gelatin-Sepharose affinity chromatography revealed two peaks containing chemotactic activity, one of which may be fibronectin, since it binds to gelatin, reacts in a specific immunoassay, and is inhibited of chemotactic activity by anti-fibronectin antiserum, and another of which does not appear to be fibronectin, since it does not bind to gelatin nor react in the immunoassay. Thus lung fibroblasts can produce at least two chemotactic factors for bronchial epithelial cells that may play a role during lung tissue repair and morphogenesis by modulating bronchial epithelial cell migration. PMID- 2764119 TI - Brief perinatal hypoxia impairs postnatal development of the bronchiolar epithelium. AB - We placed pregnant rats in 10% O2 on the last day of gestation for less than or equal to 9 h plus 1-2 h (with their pups) after the onset of delivery. In the pups this brief perinatal hypoxia led to an altered cellular composition of the bronchiolar epithelium that persisted at least to age 30 days; it was characterized by a higher nuclear numerical density (Nvn) of Clara cells, a lower Nvn of ciliated cells, and a lower percentage and Nvn of Clara cells in mitoses compared with control rats. The perinatal hypoxia also led to a significantly lower volume and volume density of the secretory apparatus (rough endoplasmic reticulum and secretory granules) on day 7 in 10% O2-born rats. The data on the Nvn of Clara and ciliated cells and on Clara cell mitoses are consistent with the notion that exposure to 10% O2 impaired the differentiation of Clara cells into ciliated cells and this impairment persisted well beyond the period of exposure. PMID- 2764120 TI - Thyroid inhibition and developmental increases in fetal rat lung antioxidant enzymes. AB - After demonstrating that prenatal exogenous thyroid hormone administration to pregnant rats produces decreases in fetal lung antioxidant enzyme (AOE) development despite increases in surfactant development, we examined the role of endogenous thyroid hormones on the development of these two lung systems. We administered the antithyroid drug methimazole (or diluent) to pregnant rats for the final 3 days before premature or term delivery; in a second series of experiments, propylthiouracil was administered for the 10 days before delivery. Both antithyroid drugs, known to cross the placenta, produced significantly decreased thyroid hormone levels in the pregnant dams. Fetal offspring from methimazole-, and propylthiouracil-treated dams demonstrated significant increases in pulmonary superoxide dismutase activity at 20 and 21 days of gestation and in catalase and glutathione peroxidase activities at 21 days compared with control offspring. Surfactant, measured as lung tissue disaturated phosphatidylcholine, was not different between either experimental group and controls. These results suggest that thyroid blockade increases AOE because the influence of thyroid hormone on AOE development may be one of depression. The findings confirm that certain hormonal regulators may influence different developing fetal lung systems in different ways. PMID- 2764121 TI - Effect of increases in cytosolic Ca2+ on inner medullary collecting duct cell pH. AB - Changes in cytosolic calcium concentration (Cai2+) have been implicated in the regulation of intracellular pH (pHi) in several cell types. In the present study we investigated the mechanism by which an increase in Cai2+ stimulates H+ secretion and a rise in pHi in cultured rat inner medullary collecting duct (IMCD) cells. Confluent monolayers were made quiescent by incubation for 24 h in 0.1% serum before study. Changes in pHi and Cai2+ were measured with the fluorescent probes, 2,7-biscarboxyethyl-5(6)-carboxyfluorescein (BCECF) and fura 2. In nominally bicarbonate-free media containing 110 mM Na+ and 1 mM Ca2+, addition of the Ca2+ inophore, ionomycin (10 microM), produced a biphasic response in pHi, a transient acidification from 7.29 +/- 0.07 to 7.12 +/- 0.05 at 2 min followed by a sustained alkalinization to a steady-state value of 7.51 +/- 0.10 at 10 min. The rate of alkalinization was dose dependent. The alkalinization was not affected by 1 mM amiloride, removal of extracellular Na+, or by the proton pump inhibitor, N-ethyl maleimide (NEM). Metabolic energy was not required, but removal of extracellular Ca2+ prevented the alkalinization. By use of the fluorescent probe bisoxonol to assess membrane potential, ionomycin was shown to cause depolarization under the same experimental conditions as those for alkalinization. The Ca2+-induced alkalinization was mimicked by cell depolarization (induced by raising extracellular K+ in the presence of valinomycin 1 microM). We conclude that changes in Cai2+ are important in the regulation of pHi in the IMCD. Ca2+-induced cell alkalinization may be mediated by changes in membrane ionic conductance. PMID- 2764122 TI - Effect of adenosine A1 analogue on tubuloglomerular feedback mechanism. AB - To evaluate further the role of adenosine in the transmission of tubuloglomerular feedback signals, we studied the effects of an adenosine receptor antagonist and an adenosine A1-receptor agonist on feedback-mediated changes in stop-flow pressure (SFP). In orthograde perfusion experiments conducted in anesthetized rats, systemic administration of the adenosine receptor blocker 1,3-dipropyl-8 sulfophenylxanthine (PSPX) did not inhibit feedback responses. Control SFP feedback responses averaged 9.7 +/- 0.65 before and 8.6 +/- 0.55 mmHg during systemic infusion of the receptor blocker. In retrograde perfusion experiments, intratubular administration of the A1 agonist (360 nM) N6-cyclopentyladenosine (CPA), added to a hypotonic solution, markedly enhanced feedback responses. This effect was completely prevented by coinfusion of PSPX. Addition of 10 mM of the antagonist to the CPA-containing solution attenuated SFP feedback responses to less than 1 mmHg (delta = 0.44 +/- 0.50). Furthermore, PSPX also inhibited feedback responses obtained with an isotonic solution alone. Furosemide, which has been shown to block normal SFP responses obtained with isotonic solutions, failed to block CPA-induced decreases in SFP. These data demonstrate that intraluminal administration of an adenosine A1 analogue causes feedback-mediated decreases in SFP and therefore support a role for adenosine receptors in the signal transmission pathway. PMID- 2764123 TI - Ca2+ absorption in the pars recta of cortical S2 rabbit proximal tubules: role of diffusion. AB - Individual partes rectae of cortical S2 proximal tubules were dissected from rabbit kidneys and perfused in vitro. The bath was a protein-free, plasmalike solution, whereas the perfusate simulated "late" proximal tubular fluid (high [Cl ], low [HCO3-], absence of Na+-cotransported solutes). Transepithelial voltages at the perfusion and collection ends were measured simultaneously in doubly cannulated tubules. Ionized calcium concentrations in perfusates, collectates, and the bath were calculated from measurements of calcium ion activities made in situ with Ca2+-selective microelectrodes. Epithelial calcium permeability was estimated from the bath-to-lumen movement of 45Ca. Total calcium concentrations of perfused and collected fluids were measured by continuous-flow microcolorimetry. Under these conditions there was a lumen-positive transepithelial voltage that was equal at both ends of the tubules. Luminal [Ca2+] [corrected], which decreased along the length of the tubule, was greater than that of the bath. Using the measured calcium permeability, we calculated the diffusional component of the net calcium absorptive flux from the mean transepithelial delta [Ca2+] and the measured transepithelial voltage. We found that ionic diffusion accounted for the net flux, suggesting that diffusion is the primary mechanism of calcium absorption in this segment of the rabbit nephron. PMID- 2764124 TI - Intramyocardial pressure: interaction of myocardial fluid pressure and fiber stress. AB - Previous measurements of intramyocardial pressure (IMP) have yielded systolic pressures that range from values lower than to far exceeding systolic left ventricular pressure (LVP). This study identifies a possible mechanism underlying these divergent observations by building on established morphology of the ventricular wall. It is hypothesized here that the generation of fiber stress as a manifestation of myocardial contraction increases fluid pressure in the myocytes and the interstitial spaces. This increase in fluid pressure in turn generates the pressure in the ventricular cavity. Thus there are two quantities of interest: intramyocardial fluid pressure (IFP) and intramyocardial fiber stress (IFS). To test the hypothesis, we conducted experiments on conditioned dogs, utilizing a side-mounted catheter-tip strain gauge transducer to sense IMP as the sum of IFP and some component of IFS. In addition, a recessed end-tip fiber-optic transducer with its sensing element shielded from local myocardial fibers was employed to sense IFP. Both IFP and IMP were measured at various depths in the left ventricular free wall. The effects of inotropic interventions by administration of epinephrine and propranolol, mechanical interventions via clamping of the aorta and ligation of the left anterior descending coronary artery, and neural interventions by stimulation of the ansa subclavian of the stellate ganglion and right vagus were recorded. A transmural gradient in the wall for both IMP and IFP was observed. Systolic values of IFP recorded in the endocardium match those of LVP, with peak IMP exceeding both. The results support the hypothesis and offer an interpretation of the long-standing controversy regarding the magnitude of IMP with respect to LVP. PMID- 2764125 TI - Effect of coronary occlusion and reperfusion on myocardial blood flow during infarct healing. AB - Coronary occlusion (CO) of 1 h or longer causes transmural myocardial infarction (MI) in the rabbit. We studied how reperfusion of an infarct affected myocardial blood flow (MBF) acutely and after 3 wk of healing. CO was performed in rabbits for 60 or 180 min (n = 22) followed by reperfusion, and MBF to normal and infarcted zones was determined by radioactive microspheres. In a separate series (n = 23), MBF was measured at 21-25 days post-CO in three groups that had either permanent CO or reperfusion after 60 or 180 min of CO. MBF to the infarct was approximately 8 +/- 3% (+/-SE) of normal MBF (3.8 +/- 0.5 ml.min-1.g-1) during 60 180 min of CO but 3 wk later had increased to 33 +/- 6% of normal MBF (P less than 0.005). Reperfusion after 60 or 180 min of CO resulted in 74 +/- 6% and 41 +/- 5% return of normal MBF, respectively, but 3 wk later, MBF had decreased to 25 +/- 5% (P less than 0.001) and 24 +/- 4% (P less than 0.025) of normal MBF, respectively. Thus after 3 wk of postinfarction healing, MBF to the permanently occluded infarcts increased fourfold, whereas MBF decreased by 50% in the reperfused infarcts so that MBF to the scar tissue was comparable among the three groups and was not influenced by acute post-MI reperfusion. PMID- 2764126 TI - Nonuniform transmural recovery of contractile function in stunned myocardium. AB - With the use of an epicardial Doppler probe, systolic wall thickening was selectively measured in the inner, mid, and outer layers of the left ventricular (LV) wall in 16 conscious dogs undergoing a 15-min left anterior descending artery (LAD) occlusion followed by 7 days of reperfusion (REP). Under control conditions, percent thickening fraction (ThF) was significantly greater (P less than 0.01) in the inner layer [36.0 +/- 2.3% (mean +/- SE)] than in the mid (28.6 +/- 2.1%) or outer (21.3 +/- 2.2%) layers. During LAD occlusion, 11 dogs exhibited transmural dyskinesis (group 1), whereas 5 had transmural hypokinesis (group 2). In group 1, all layers exhibited comparable degrees of paradoxical systolic thinning during LAD occlusion. After REP, however, recovery was delayed in the inner compared with the mid and outer layers. At 2 h, ThF averaged 34.2 +/ 11.9% of base line in the endocardium vs. 61.7 +/- 16.2% in the midmyocardium and 51.0 +/- 12.3% in the epicardium (F = 4.29, P less than 0.002); similar differences were noted at 3 and 4 h. In the mid and outer layers, ThF returned to base-line values by 24 h, whereas in the inner layer it was still significantly depressed (P less than 0.05) at 24 h (77.3 +/- 5.1% of base line) and recovered by 48 h. The inner-to-outer ThF ratio was decreased (P less than 0.01) for 24 h after REP, indicating maldistribution of thickening in the "stunned" myocardium. In group 2, all layers exhibited hypokinesis during LAD occlusion. Again, recovery of function after REP was delayed in the endocardium compared with the other layers. This study demonstrates that after both severe ischemia resulting in dyskinesis and mild ischemia resulting in hypokinesis, REP is associated with slower recovery of function in the inner than in the outer layers. Thus myocardial "stunning" is a nonuniform phenomenon with maximal severity in the subendocardium. PMID- 2764127 TI - Calf sweat lactate in peripheral arterial occlusive disease. AB - The energy metabolism of sweat glands was studied to evaluate the reduction in oxygen delivery in the tissue of patients with peripheral arterial occlusive disease. We compared lactate concentration in pilocarpine-iontophoresis sweat collected from the middle calf area ([ L]sw) of 10 healthy subjects (group 1) and 84 patients suffering from intermittent claudications (group 2, n = 49), from rest pain (group 3, n = 21), and from severe ischemic skin changes (group 4, n = 14). In addition, the effect of a vasoactive drug (naftidrofuryl, 600 mg) or placebo infusion on [L]sw was investigated (n = 30). Results (means +/- SE) showed that 1) [L]sw (mmol/l) increased significantly with the severity of the symptoms: group 1 = 16.5 +/- 0.4, group 2 = 18.7 +/- 0.4, group 3 = 22.8 +/- 0.9, and group 4 = 27.5 +/- 2.0; and 2) [L]sw was reduced by 10% (P less than 0.01) after naftidrofuryl infusion, whereas there was no change after placebo infusion. We suggest that lactate in calf sweat is a good indicator in the evaluation of the severity of peripheral occlusive arterial disease and in assessing the efficiency of vasoactive drug treatment. PMID- 2764128 TI - Vasopressin-induced pulmonary vasodilation in rats. AB - Experiments were performed to determine the pulmonary vascular responses to exogenous or endogenous arginine vasopressin (AVP) in rats. Both in vitro and in vivo approaches were used to examine the direct pulmonary vasoactive properties of AVP and how those properties affect pulmonary hemodynamics in the intact animal. In conscious, unrestrained rats, constant infusion of AVP (4.0 mU.kg 1.min-1 iv) resulted in a fall in mean pulmonary artery pressure (PAP), although systemic pressure was increased. Coincident with the fall in PAP were similar reductions in cardiac output and heart rate. Similarly, bolus administration of AVP reduced PAP, and this effect was augmented during hypoxia. Another series of experiments examined the effect of endogenous AVP released by arterial hypoxemia on pulmonary hemodynamics in conscious rats. Administration of a specific V1 vasopressinergic antagonist had no effect on the PAP response to hypoxia; however, systemic resistance tended to fall following V1-antagonism. To determine the vasoactive properties of AVP independent of these changes in blood flow, a series of experiments were performed on isolated, perfused rat lungs. Injection of 25, 200, or 2,000 mU of AVP into the circulation of the isolated lung was without effect under normoxic conditions. In contrast, 25 mU AVP elicited reproducible pulmonary vasodilation when injected during ongoing hypoxic pulmonary vasoconstriction. This vasodilatory response was unaffected by meclofenamate or by the platelet-activating factor receptor antagonist SRI 63 441, but was blocked by a specific V1-vasopressinergic antagonist. We conclude that although AVP exerts profound systemic vasoconstriction, the pulmonary circulation appears relatively unaffected by exogenous or endogenous AVP in vivo.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2764129 TI - Platelets adhere to thrombin-treated endothelial cells in vitro. AB - Interaction of thrombin with vascular endothelial cells was investigated as a mechanism promoting platelet activation and adherence to endothelial monolayers. We found that pretreatment of endothelium with alpha-thrombin in the absence of platelets results in the attachment of platelets to endothelial cells after the removal of fluid-phase alpha-thrombin. This activity was eliminated by exposure of alpha-thrombin-pretreated endothelial cells to active site inhibitors of alpha thrombin or by adding alpha-thrombin in the presence of excess diisopropyl fluorophosphate-inhibited thrombin, suggesting retention of active alpha-thrombin by a receptor-mediated mechanism. Morphological data and the results of [14C]serotonin release studies indicate that platelets are activated by alpha thrombin-pretreated endothelium and that adherence represents aggregates of activated platelets as well as individual platelets. Adherence on alpha-thrombin pretreated endothelium is dependent on divalent cations. Platelets also adhered to aortic segments pretreated with thrombin. The data of the current studies support the contention that alpha-thrombin can promote adherence of activated platelets to endothelial cells because of the binding and retention of alpha thrombin to endothelial cells in a manner in which it remains active and available for platelet activation. PMID- 2764130 TI - Low-density lipoprotein transport in blood vessel walls of squirrel monkeys. AB - Transmural accumulations of low-density lipoprotein (LDL) were examined in the blood vessel walls of four squirrel monkeys. Vascular wall concentrations of LDL were measured using quantitative autoradiography after 125I-labeled LDL circulation for 30 min. Profiles of relative tissue concentration from different sections in the same region were similar to each other, and there was little animal-to-animal variation. Concentrations were highest near the luminal endothelium, lower near the medial-adventitial border, and lowest within the media. Profiles from different regions fell into three groups: 1) aortic samples had steep intimal concentration gradients and near-zero media concentrations; 2) the iliac, femoral, popliteal, and common carotid arteries had higher intimal concentrations than group 1 but had similar concentrations deep within the media; and 3) the cerebral and coronary arteries, inferior vena cava, and pulmonary artery had intimal concentrations that were similar to group 2, but the concentrations deep within the media were greater than either groups 1 or 2. Arterial bifurcation profiles from the inner wall and the outer walls were similar to each other and to profiles from the upstream and downstream areas. Out of 280 total sites examined, 15 examples of profiles with substantially increased concentrations near the luminal endothelium were found scattered throughout the cardiovascular system, demonstrating that there are focal regions throughout the cardiovascular system which have greatly increased 125I-LDL transendothelial permeability. PMID- 2764131 TI - Summation of sinoaortic baroreflexes depends on size of input signals. AB - We studied sinoaortic baroreflex summation in seven anesthetized rabbits by paying special attention to the sigmoidal nature of the open-loop characteristic curve of the two reflexes. Carotid sinuses were isolated to control carotid sinus pressure (CSP). Aortic nerves were cut, and the left aortic nerve was electrically stimulated. Initially, CSP was set between 75 and 95 mmHg, and the parameters for aortic nerve stimulation (ANS) were chosen so that mean arterial pressure (MAP) was between 80 and 100 mmHg. We then increased CSP and ANS mildly so that MAP would fall by 10-20 mmHg in each case. Comparison of the sum of these decreases with the decrease caused by simultaneous increases in CSP and ANS showed no statistical difference, indicating a simply additive summation. With mild decreases in CSP and ANS, a similar additive summation was observed in the reflex increases in MAP. When we input slightly larger changes in CSP and ANS so that MAP fell by 20-30 mmHg for each stimulus, comparison of the sum of the separate effects with the combined effect on MAP indicated a mildly inhibitory summation. By analyzing the total peripheral resistance calculated from aortic flow data, we found this inhibitory summation occurred in the reflex controls of the total peripheral resistance. We conclude that the summation of the sinoaortic reflex controls of arterial pressure can be regarded as simply additive when small input signals are given in the physiological range of both reflexes, but the summation is mildly to moderately inhibitory when moderately larger input signals are given. PMID- 2764132 TI - Effects of aging on agonist-activated 86Rb efflux in arteries of Fischer 344 rats. AB - Segments of thoracic aorta (DTA), tail artery (TA), and mesenteric artery branches (MAB) were obtained from male Fischer 344 rats at ages of 1, 2, 6, 12, 24, and 30 mo and were used to determine the effects of aging on agonist activated 86Rb (and 42K) efflux. At all three arterial sites, basal efflux decreased during development (1-6 mo), but no further changes were observed with aging (6-30 mo). The initial efflux response to 10 microM norepinephrine (NE) in the presence of 1 microM propranolol exhibited either no change (DTA) or an increase (TA and MAB) during development (1-6 mo), but all three sites showed a large decrease during aging (6-30 mo). Changes in the steady-state response to NE paralleled changes in the basal efflux at all ages and arterial sites. The initial efflux response to 75 mM K+-physiological salt solution (PSS) for the DTA in the presence of 1 microM phentolamine and 1 microM propranolol decreased during development followed by an increase during aging, whereas for the TA and MAB, there were no significant changes with age. The steady-state efflux response to K+ decreased during development at all three sites but was increased only for the DTA during aging. The steady-state efflux response to K+ was not altered for the TA and MAB during aging. Efflux responses using 42K were qualitatively similar, but rate constants were quantitatively larger than those with 86Rb at all three arterial sites and at all ages.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2764133 TI - Steroids during development of genetic hypertension in rats of Lyon strain. AB - The urinary excretion and the plasma concentration of deoxycorticosterone (DOC), corticosterone, 18-hydroxy-DOC (18-OH-DOC), aldosterone, and 19-nor-DOC were measured by specific radioimmunoassays in genetically hypertensive (LH), normotensive (LN), and low blood pressure (LL) male rats of the Lyon strains at two ages that characterize the development of their systolic blood pressure (SBP). When compared with both LN and LL controls, 5-wk-old LH rats exhibited an increased urinary DOC and decreased urinary corticosterone excretions, which were significantly related to the SBP level (r' = 0.618 and -0.520; n = 23; P less than 0.01 for DOC and corticosterone, respectively). In addition, the adrenal synthesis of LH rats was found to rely on an increased 18-hydroxylase activity as indicated by elevated urinary 18-OH-DOC/corticosterone and aldosterone/corticosterone associated with a lower 11-beta-hydroxylase activity shown by the decreased urinary corticosterone/DOC. Twenty-wk-old LH rats with fully developed hypertension exhibited normal urinary excretion of steroids and a decrease in plasma DOC concentration, which negatively correlated with the SBP level (r' = -0.574; n = 25; P less than 0.01). In conclusion, the present study demonstrates that in the Lyon model of genetically hypertensive rats, compared with two genetically different control strains and maintained under physiological unstressed conditions, the development of hypertension is associated with an increased urinary excretion of DOC. After the full development of their hypertension, the mineralocorticoid synthesis in LH rats returns to normal or low levels which could, however, remain inappropriately high for their sodium body content. PMID- 2764134 TI - A dynamic analysis of cardiovascular regulation using sinusoidal acceleration in dogs. AB - Control of cardiovascular function during time-dependent pooling of blood in the upper and lower body was studied in intact dogs (n = 5) and in dogs in which hearts had been surgically denervated (n = 5). The animal was positioned horizontally on a platform mounted on the arm of a centrifuge; rotation of the platform at one of nine rates with a period ranging from 3.3 min to 4 s exposed the subject to a sinusoidally varying force (+/- 2 g) that periodically translocated blood from the chest to the lower quarters and back again. The resulting oscillatory changes in arterial blood pressure (BP), cardiac output, stroke volume, heart rate (HR), and peripheral resistance (PR) were analyzed using a fast Fourier transform. Normal dogs were superior to cardiac-denervated dogs in minimizing arterial BP fluctuations, especially in the midfrequency range (i.e., approximately 0.032 Hz); after pharmacological alpha-, beta-, and muscarinic-receptor blockade, the BP oscillations were similar in the two groups. The unblocked denervated dogs regulated BP poorly primarily because of their inability to 1) make appropriately timed changes in HR and 2) minimize inappropriate oscillations in SV. Both groups of dogs in the unblocked state showed large appropriately timed PR fluctuations at the lower frequencies, which minimized BP oscillations; these became less optimally timed as acceleration frequency increased, thereby potentiating the natural disposition for BP to oscillate at the acceleration frequency. Afferent information from cardiac receptors did not appear to be essential for controlling this aspect of vascular function. PMID- 2764136 TI - Aortic impedance and compliance in hypertensive rats. AB - We compared aortic impedance and compliance in normotensive control and hypertensive Wistar rats. Hypertension was induced by unilateral nephrectomy plus steroid and salt water administration. After at least 8 wk of sustained hypertension (tail-cuff systolic pressures greater than 172 mmHg), open-chest ascending aortic micromanometric pressures and electromagnetic flows were measured. We used a frequency-modulated pacing method to enhance the energy content of the pressure and flow signals at specific low frequencies and their multiples. Impedance spectra were calculated using both Fourier series and spectral analysis methods. Compliance was calculated from the low-frequency impedance moduli, assuming a windkessel model for the arterial system. During pentobarbital sodium anesthesia under baseline conditions, the hypertensive rats had higher total resistance (219,000 vs. 126,000 dyn.s.cm-5), higher characteristic impedance (7,334 vs. 5,377 dyn.s.cm-5), larger first zero crossing of impedance phase angle (13.9 vs. 10 Hz), larger ratio of backward to forward pressure waves (0.67 vs. 0.48), and lower compliance (0.00498 vs. 0.00720 ml/mmHg) than controls. The differences between the groups were eliminated when the blood pressures of the hypertensive rats were normalized by vasodilation with nitroprusside or when the control rats were made hypertensive by vasoconstriction with phenylephrine. Thus the hemodynamic alterations appear to be secondary to the increased blood pressure. These base-line differences and the responses to vasoactive drugs are similar to findings in humans, suggesting that this rat model is a good hemodynamic model of human hypertension. PMID- 2764135 TI - Influence of saline infusion on blood-tissue albumin transport. AB - Anesthetized rats were infused with lactated Ringer solution (LR) at constant rate for 30 or 60 min; delivered volume loads ranged from 0.03 to 0.08 ml/g body wt. Controls were given only a sustaining infusion of saline at 0.002 ml.g-1.h-1. Only 7-14% of the LR remained in the plasma at the end of the infusion; 76-88% entered the interstitial compartment, and 7-17% was excreted. The amount of plasma protein lost from the circulation with the extravasated fluid was studied simultaneously by two methods: 1) material balance in the whole animal and 2) changes in 131I-labeled albumin uptake (VA) and water content (VW) in individual tissues. The extravasation of 0.03-0.06 ml fluid/g body wt (75-160% initial plasma volume) did not significantly increase plasma protein extravasation in the whole rat. Nearly all of the sampled tissues of LR-infused rats had higher VW than controls. Tissue VA tended to increase with VW, but the regression slopes (delta VA/delta VW), a measure of the tracer albumin concentration of capillary filtrate relative to plasma, were low; skin, 0.006; paw, 0.018; skeletal muscles, 0.007; heart, 0.057; jejunum, 0.095; ileum, 0.045; cecum, 0.026; and colon, 0.027. These ratios are consistent with the very small loss of total plasma protein observed and attest to high solvent-drag reflection coefficients (sigma approximately equal to 1 - delta VA/delta VW): greater than 0.98 in capillaries of skeletal muscles, skin, and paw and 0.91-0.97 in heart and intestine. PMID- 2764137 TI - Histamine-induced calcium transients in vascular smooth muscle cells: effects of verapamil and diltiazem. AB - We investigated the effects of verapamil and diltiazem on histamine-induced Ca2+ transients in vascular smooth muscle. 1) With the use of quin2 microfluorometry, cytosolic Ca2+ concentrations were directly measured in cultured vascular smooth muscle cells of the rat aorta. In the presence of extracellular Ca2+, histamine induced an elevation of cytosolic Ca2+ concentrations of a peak and plateau type. The peak component is due to a release of Ca2+ from cellular store sites, and the plateau component depends on extracellular Ca2+. Verapamil and diltiazem inhibited the plateau component, and the 50% inhibitive concentration (IC50) of verapamil and diltiazem for 10 microM histamine was 0.09 and 0.18 microM, respectively. Only at high concentrations did verapamil (IC50 = 8.7 microM) and diltiazem (IC50 = 95.7 microM) inhibit the Ca2+ release from the cellular store sites, as induced by 10 microM histamine. 2) Histamine, verapamil, and diltiazem competed with [3H]mepyramine for binding to the porcine aortic membranes, the order of potency being verapamil (Ki = 7.1 microM) greater than histamine (Ki = 18 microM) greater than diltiazem (Ki = 114 microM). From these results, we conclude that verapamil and diltiazem strongly inhibit the histamine-mediated, extracellular Ca2+-dependent intracellular [Ca2+] increase. In addition, verapamil and diltiazem seem to inhibit the release of Ca2+ from intracellular store sites, only at high concentrations, and probably by competing with histamine for binding to the H1-receptor. The inhibitory effects of Ca2+ antagonists on the histamine-induced contraction or spasm of vascular smooth muscle may well relate to these mechanisms. PMID- 2764138 TI - Cardiac function during long-term hypoxemia in fetal sheep. AB - To examine right ventricular function during long-term hypoxemia, we instrumented 12 fetal sheep with intravascular catheters and an electromagnetic flow probe on the pulmonary artery. In six cases, hypoxemia was induced by infusing N2 gas into the maternal trachea for 2 wk. Maternal arterial PO2 was less than 60 Torr, and fetal arterial PO2 was reduced from approximately 26 to approximately 19 Torr. Six cases served as nonhypoxic controls. We studied fetal cardiac function by increasing either preload with a volume infusion of 5% (wt/vol) dextrose or afterload by administering methoxamine (alpha-adrenergic agonist). In hypoxic animals, right ventricular output (QRV) and stroke volume (SV) were not affected on the first 2 days but fell 30% on day 3. Fetal arterial pressure (Pfa) increased 20%, hemoglobin concentration increased approximately 30%, and fetal heart rate (FHR) showed minimal changes. Within 2 wk, QRV recovered to normal values, whereas ventricular sensitivity to arterial pressure was reduced. We observed no change in plasma concentration of "cardiac enzymes" or differences in fetal growth between groups. In conclusion, during prolonged hypoxemia, right ventricular function showed a triphasic response (primary maintenance, secondary depression, and subsequent recovery), achieving a new steady state 2 wk after the start of hypoxia, characterized by decreased sensitivity to afterload, associated with polycythemia and hypertension. PMID- 2764139 TI - Effects of reflex stimuli on blood flow to the adrenal medulla. AB - The goal of this study was to examine changes in blood flow to the adrenal medulla during reflex stimuli that release catecholamines. Adrenal blood flow was measured with microspheres during exercise in conscious dogs and during bicuculline-induced seizures in anesthetized dogs. In awake dogs, blood flow to the adrenal cortex and adrenal medulla was 310 +/- 48 and 1,613 +/- 258 (SE) ml.min-1.100 g-1, respectively. Blood flow to the cortex and medulla was not affected by moderate exercise. Anesthesia (pentobarbital sodium) reduced blood flow to the adrenal cortex and medulla to 158 +/- 12 and 243 +/- 24 ml.min-1.100 g-1, respectively. In anesthetized dogs, seizures markedly increased blood flow to the adrenal medulla (282 +/- 68 to 1,257 +/- 128 ml.min-1.100 g-1), and this response was blocked by sectioning the greater splanchnic nerve. Vasodilator responses of the adrenal medulla to adenosine were not impaired by adrenal denervation. Blood flow to the adrenal cortex was not affected by seizures but increased in response to intravenous adenosine. These findings suggest that 1) anesthesia decreases adrenal blood flow, particularly to the adrenal medulla, and 2) reflex stimuli that release catecholamines can produce selective increases in blood flow to the adrenal medulla. PMID- 2764140 TI - Phosphocreatine and oxidative metabolism-contraction coupling in rabbit aorta. AB - Oxidative metabolism-contraction coupling was studied in single rabbit aortic rings by measuring changes in phosphocreatine (PCr) and ATP content, the ratio of PCr to free creatine (Cr), and changes in muscle force under conditions in which cellular energy production was inhibited. We compared rings with markedly different total PCr content by using rings loaded with creatine, control (unloaded) rings, and rings exposed for 30 min to zero-glucose solution. Creatine loading resulted in increases in PCr content to 300% of control. Maintained muscle force generated by 30 microM norepinephrine was decreased by hypoxia, 0.05 and 0.1 mM cyanide, removal of glucose from the bathing media, or glucose removal plus hypoxia. There was no difference between creatine-loaded and unloaded rings in the mechanical effects of these perturbations. Changes in muscle force induced by inhibition of energy production using the various perturbations correlated with changes in PCr/Cr. Data are consistent with oxidative metabolism-contraction coupling being regulated by energy delivery to a reaction or reactions controlling muscle force. Metabolism-contraction coupling is not controlled by total energy stores or by PCr or Cr concentration. PMID- 2764141 TI - Effect of linoleic acid infusion on blood pressure in normotensive and hypertensive rats. AB - High dietary intake of linoleic acid lowers arterial pressure, and, in vitro, linoleic acid inhibits the enzymatic activity of renin. The purpose of the present study was 1) to evaluate the effect of intravenous infusion of linoleic acid on blood pressure in normotensive and hypertensive Sprague-Dawley rats and 2) to determine whether the hypotensive response to linoleic acid infusion is caused by inhibition of circulating renin. Blood pressure was decreased (P less than 0.01) by linoleic acid infusion in normotensive sodium chloride-deprived animals and in animals with two-kidney, one-clip hypertension. In contrast, linoleic acid infusion did not affect blood pressure in normotensive rats on a "normal" or high sodium chloride intake, in rats with deoxycorticosterone acetate (DOCA)-salt hypertension, and in anephric rats. In sodium chloride-deprived rats, the reduction of blood pressure by linoleic acid infusion was associated with increased plasma renin activity (P less than 0.05); serum angiotensin-converting enzyme activity was unchanged. The in vitro enzymatic activity of exogenous renin in plasma of anephric rats was not affected by linoleic acid infusion. In two kidney, one-clip hypertensive animals, pretreatment with indomethacin did not alter the hypotensive response to linoleic acid. Thus, although linoleic acid infusion lowered blood pressure in high renin but not in low renin states, the reduction of blood pressure was not related to inhibition of circulating renin or to alterations of endogenous prostaglandin biosynthesis. PMID- 2764142 TI - Histamine's effect on pulmonary vascular resistance and compliance at elevated tone. AB - Histamine's effect on the longitudinal resistance and compliance distribution in the canine pulmonary circulation was determined under control and elevated vascular tone using the thromboxane analogue U46619. The arterial-, venous-, and double-occlusion techniques were used in isolated blood-perfused dog lungs at both constant flow and constant pressure. Large and small blood vessel resistances and compliances were studied in lungs given the following treatments: 1) histamine; 2) histamine in lungs pretreated with the H1-receptor antagonist diphenhydramine, and 3) histamine in lungs pretreated with the H2-receptor antagonist cimetidine. The results of this study indicate that histamine constricts small and large veins through H1-receptor mediation at both normal and elevated vascular tone. When vascular tone was elevated, H2-receptor vasodilatation was also apparent in all blood vessel segments. Histamine decreased total, middle compartment, and large vessel vascular compliances by an H1-receptor effect. When vascular tone was elevated, histamine's H1-receptor mediated vasoconstrictor effect on compliance vessels was less due to the presence of an H2-receptor-mediated vasodilatory system. PMID- 2764143 TI - Acute effects of partial compression of ductus arteriosus on fetal pulmonary circulation. AB - To determine the acute effects of increased pulmonary artery pressure and flow on the fetal pulmonary circulation, we studied the response of pulmonary blood flow and vascular reactivity to partial compression of the ductus arteriosus in 22 chronically prepared late-gestation fetal lambs. An inflatable occluder was placed loosely around the ductus arteriosus for compression. Partial compression of the ductus rapidly increased mean pulmonary artery pressure from 45 +/- 1 to 60 +/- 1 mmHg (mean +/- SE) and left pulmonary artery blood flow from 65 +/- 6 to 151 +/- 11 ml/min at 30 min (P less than 0.001; 12 animals). Despite keeping pulmonary artery pressure constant, pulmonary blood flow steadily declined and by 2 h was not different from base-line values. Pulmonary vascular resistance initially fell during the first 30 min of partial compression but then steadily increased and remained elevated above base-line values for at least 30 min after the release of the occluder (P less than 0.001). The decline of pulmonary vascular resistance during the first 30 min of compression was blunted after treatment with the cyclooxygenase inhibitor, meclofenamate (P less than 0.001; 6 animals). Rapid incremental ductus compressions demonstrated a decrease in the slope of the pressure-flow relationship from 3.30 +/- 0.27 (control) to 1.59 +/- 0.21 ml.min-1.mmHg-1 during the postcompression period (P less than 0.001; 12 animals). The vasodilation response to small increases of fetal PO2 was markedly blunted during the postcompression period (P less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2764144 TI - Sequential topographical portrayal of myocardial blood flow. AB - Methods to portray myocardial blood flow in a two-dimensional continuum are advantageous in that they allow blood flow history to be overlaid on histological or histochemical descriptions of the consequences of ischemia. We describe here autoradiographic methods that allow such portrayals at three separate times during the evolution of ischemic injury. A computer-based image-analysis system was used to derive such flow maps by taking advantage of the physical characteristics of radioactive isotopes. PMID- 2764145 TI - Cardiac adaptations to aortic constriction in adult and aged rats. AB - Myocardial function in vitro and myosin heavy chains (MHCs) were studied in control and hypertrophied hearts of adult (9-10 mo) and aged (25-28 mo) female Fischer 344 rats 7 days after aortic constriction. Aortic constriction increased left ventricular mass to 110 and 112% of the control values of 484 +/- 12 and 617 +/- 18 (SE) mg in adult and aged rats, respectively. After aortic constriction, there was a significant age-related difference in the adaptation of peak pressure development in vitro, as peak left ventricular systolic pressure increased and decreased in hearts of adult and aged rats. The maximum rate of pressure development in control hearts of aged rats was 79% of the adult value of 11,264 +/- 1,527 mmHg/s; hypertrophy did not alter values of either age group. alpha-MHC accounted for 82 +/- 1 and 48 +/- 3% of the total left ventricular MHC for the adult and aged control groups, respectively, and values were not altered by aortic constriction. With hypertrophy 7 days after aortic constriction, there is an impairment in the adaptation of left ventricular function in hearts of aged compared with adult rats. This impairment is not explained by alterations in MHC isoform. PMID- 2764146 TI - Effects of intravenous AVP on cardiac output, mesenteric hemodynamics, and splanchnic nerve activity. AB - To elucidate the effects of intravenous arginine vasopressin (AVP) on the neural control of the circulation, we investigated the action of AVP on neural circulatory control with respect to its influence on cardiac output (CO), mesenteric blood flow (MBF), and splanchnic nerve activity (SpNA) in conscious rats. We implanted Doppler flow probes and bipolar electrodes into seven Wistar rats for continuous monitoring of CO, MBF, and SpNa. After the infusion of four different equipressor doses of AVP and methoxamine, the decreases in heart rate (HR) and CO were significantly greater with AVP than with methoxamine. Pretreatment with atenolol and methscopolamine bromide abolished the decreases in HR after both AVP and methoxamine injections but attenuated the AVP-induced decreases in CO less than the methoxamine-induced CO decreases. In untreated rats and in rats receiving cardiac autonomic blockade, the reduction in MBF and the increases in mesenteric resistance were greater after AVP than after methoxamine. Furthermore, SpNA decreased to a greater extent with all doses of AVP than with methoxamine. We conclude that in the rat the exaggerated reduction in CO induced by circulating AVP is not because of a sensitization of neural mechanisms but rather to caridac actions of the peptide. In contrast, AVP sensitizes the sympathetic control of the mesenteric vascular bed to counterbalance its potent local vasoconstrictor effects. PMID- 2764147 TI - Validation of laser-Doppler flowmetry in measurement of spinal cord blood flow. AB - Laser-Doppler flowmetry (LDF) is a non-invasive method for continuous on-line monitoring of microvascular blood flow. LDF has previously been validated with established methods in various tissues, yet its validity and resolution in the central nervous system (CNS) remain unclear. We compared LDF with the microsphere method (MS) using two independent laser probes placed on the dorsal lumbar spinal cord (L5 laminectomy) of anesthetized rabbits (n = 9). After base-line flow measurements, spinal cord blood flow (SCBF) was increased (up to 50%) with phenylephrine (10-80 micrograms.kg-1.min-1 iv) and decreased (up to 50%) with chlorisondamine (10 mg/kg iv) or other stimuli. The percentage changes of lumbar SCBF and vascular resistance (VR) from the base line obtained by LDF and MS excellently agreed (rBF = 0.86, rVR = 0.94, P less than 0.0001). LDF estimated also the absolute SCBF values parallel to MS (r = 0.77, P less than 0.001). In conclusion, the validity of LDF in estimating the SCBF and dynamic changes of BF and VR is confirmed. Therefore, LDF may prove useful for monitoring CNS microcirculation in normal or pathophysiological states. PMID- 2764148 TI - A high density in vitro extracellular electrode array: description and implementation. AB - The detailed activation sequence in myocardium provides information critical to the understanding of the mechanisms of cardiac arrhythmias and the influence of interventions. Despite the pivotal role of activation mapping, the interpretation of isochronic maps and the correlation to detailed tissue morphology may be limited when the interelectrode distances are large with respect to cell dimensions. Additionally, dynamic beat-to-beat variations in the activation pattern or the effect of interventions such as single extra stimuli cannot be assessed adequately without recording from all sites simultaneously. To surmount these limitations, we have fabricated and tested an extracellular recording array consisting of 224 bipolar tungsten wire electrodes with a 350-microns interelectrode distance (140 microns edge-to-edge distance), and used signal processing equipment to record from all electrodes simultaneously at a 2-kHz sample rate. Stimulation can be performed sequentially from 12 different sites at 30 degree angles around the periphery of the recording array. Transarray bipoles can be recorded from any combination of eight radially oriented sites. Activation maps recorded in normal tissue after programmed stimulation and activation maps from an area of fixed anatomic block in the epicardial border zone of infarcted tissue are presented. The results demonstrate a lack of influence of the recording array on the electrophysiological properties of the tissue as verified with transmembrane action potential recordings and sequential extracellular maps. This electrode permits precise assessment of transient details of the activation sequence with unparalleled anatomic resolution. PMID- 2764149 TI - Left atrial hypertension causes pleural effusion formation in unanesthetized sheep. AB - We studied the effect of left atrial pressure (LAP) elevation on the formation of pleural effusion in unanesthetized sheep. We prepared the animals by placing catheters in the left atrium, pulmonary artery, femoral artery, and vein. We also placed a balloon catheter in the left atrium. After a recovery period of at least 1 wk, we measured LAP, pulmonary artery pressure (PAP), systemic arterial pressure, systemic venous pressure, cardiac output, plasma protein concentration, and plasma colloid osmotic pressure (pi c). We calculated capillary pressure (Pc) as 0.5(PAP - LAP). We then elevated LAP such that Pc-pi c was between -10 and 19.5 mmHg for 6-24 h. At the end of the experiment, we killed the sheep and measured the volume and protein concentration of the right pleural effusion. We also determined the extravascular fluid to blood free dry weight of the right lung. We found that pleural effusions and pulmonary edema formed when Pc-pi c greater than 5 mmHg. We also found that the pleural effusion volume correlated with the amount of pulmonary edema. Our data show that elevated LAP may cause pleural effusions, but only after pulmonary edema has developed. PMID- 2764150 TI - Beyond pure parasystole: promises and problems in modeling complex arrhythmias. AB - The dynamics of pure parasystole, a cardiac arrhythmia in which two competing pacemakers fire independently, have recently been fully characterized. This model is now extended in an attempt to account for the more complex dynamics occurring with modulated parasystole, in which there exists nonlinear interaction between the sinus node and the ectopic ventricular focus. Theoretical analysis of modulated parasystole reveals three types of dynamics: entrainment, quasiperiodicity, and chaos. Rhythms associated with quasiperiodicity obey a set of rules derived from pure parasystole. This model is applied to the interpretation of continuous electrocardiographic data sets from three patients with complicated patterns of ventricular ectopic activity. We describe several new statistical properties of these records, related to the number of intervening sinus beats between ectopic events, that are essential in characterizing the dynamics and testing mathematical models. Detailed comparison between data and theory in these cases show substantial areas of agreement as well as potentially important discrepancies. These findings have implications for understanding the dynamics of the heartbeat in normal and pathological conditions. PMID- 2764151 TI - Neurons in rostral VLM are inhibited by chemical stimulation of caudal VLM in rats. AB - Recent evidence suggests that neurons in the caudal ventrolateral medulla (CVLM) exert a tonic inhibition on the neurons in the rostral ventrolateral medulla (RVLM) that are essential for the maintenance of arterial pressure (AP). To test the hypothesis that selective activation of cell bodies in the CVLM can inhibit the discharge of neurons in the RVLM, activity from 88 neurons in the RVLM was recorded extracellularly while 2-30 nl sodium glutamate (Glu; 0.15 M) were microinjected into depressor sites of the CVLM of urethan-anesthetized male Wistar rats. Results obtained from spontaneously breathing and artificially ventilated rats were essentially similar and are presented together. Twenty-five neurons were characterized as cardiovascular because they were inhibited by baroreceptor activation and showed rhythmicity of their spontaneous activity in synchrony with the cardiac cycle. Activation of cell bodies in the CVLM inhibited the firing rate of 23 of these cardiovascular neurons and excited 2. The remaining 63 neurons could not be considered cardiovascular because they either were not barosensitive or lacked cardiac cycle-related rhythmicity. Injection of Glu into the CVLM inhibited 26 of these neurons, excited 22, and had no effect on 15. These results provide direct evidence for the existence of an inhibitory pathway from neurons located in the CVLM to cardiovascular neurons in the RVLM. PMID- 2764152 TI - Urethral responses to sacral stimulation in chronic spinal dog. AB - Urethral activity was investigated in the awake chronic spinal-injured canine using urodynamic recordings, video cystofluoroscopy, and urethral pressure recordings without anesthesia. Bladder contractions and voiding were induced by electrical stimulation with epidural electrodes inserted into the sacral canal. Urethral pressure remained elevated during stimulation and for 1-3 s afterward. Poststimulation voiding occurred with three different patterns: 1) pulsatile voiding in which squirting of urine was associated with contractions in the membranous urethra; 2) "on and off" voiding in which pulsatile flow was interrupted for brief periods of time; and 3) steady-stream voiding in which nonpulsatile flow was followed by pulsatile flow. Viewing these voiding patterns with fluoroscopy indicated that the proximal membranous urethra was important in all of the patterns. We conclude that in the chronic spinal-injured canine the skeletal muscle within the membranous urethra (rhabdosphincter) is involved in responses to sacral stimulation and various voiding patterns. PMID- 2764153 TI - Protein metabolism and beta-myosin heavy-chain mRNA in unweighted soleus muscle. AB - To investigate the relative influence of protein synthetic and degradative control mechanisms in vivo during skeletal muscle atrophy, we measured myofibril and total mixed protein synthesis rates in muscles of rats prevented from hindlimb weight-bearing for 5 h and 7 days. Protein synthesis rates were determined by infusing the animals with [3H]Leu for 5 h and measuring the specific activity of [3H]Leu in the aminoacyl-tRNA precursor and protein product fractions of the muscles. In the soleus muscle, myofibril protein synthesis rates decreased from a control value of 5.9 to 4.6%/day during 5 h of hindlimb unweighting and to 2.4%/day after 7 days of hindlimb unweighting. The relatively more phasic muscles (plantaris, medial gastrocnemius, quadriceps) showed a tendency for increased myofibril protein synthesis rates (117-127% of control) during the first 5 h followed by a decrease (46-62% of control) at 7 days of hindlimb unweighting. A predicted time course of soleus muscle myofibril protein degradation rate was obtained from a numerical model of the decrease in soleus myofibril protein synthesis rate as a first-order process [half-time (t1/2) = 0.3 day by least-squares fit] and the time course of soleus muscle myofibril protein previously observed with hindlimb unweighting (Thomason et al., J. Appl. Physiol. 63: 130-137, 1987). The degradation rate model makes specific, testable predictions for the mechanism of myofibril protein degradation during soleus muscle atrophy: 1) the first-order degradation rate constant does not obtain a fixed value over a 24-day period but is continuously changing throughout atrophy, and 2) the first-order degradation rate constant changes on a time scale slower than protein synthesis rate.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2764154 TI - Thermoregulatory control of expired air temperature in diving harp seals. AB - Expired air temperature (Tex), metabolic rate (MR), and skin (Ts) and body (Tb; rectal) temperatures were recorded in four or five young (1-2 yr) harp seals (Phoca groenlandica) in air [mean air temperature (Ta) = -30, -10, or 10 degrees C] and in water [mean water temperature (Tw) = 2.3 or 24.8 degrees C, with Ta = 30, -10, 0, or 10 degrees C]. Apparent lower critical temperature was below -10 degrees C in air. Above this Ta, mean MR was 5.85 W.kg-0.75 (2.23 W.kg-1), while mean MR was 12.56 W.kg-0.75 (4.69 W.kg-1) at Ta -30 degrees C. When seals were immersed in water of 2.3 degrees C, mean MR was 6.13 W.kg-0.75 (2.31 W.kg-1), regardless of Ta. At Ta -30, -10, and 10 degrees C, mean Tex in air were 9.5, 13.0, and 25.0 degrees C, respectively. The corresponding values for seals in water (Tw = 2.3 degrees C) were 8.0, 9.5, and 15.5 degrees C, respectively. The low Tex recorded at Ta -30 and -10 degrees C in air and at all Ta in water (Tw = 2.3 degrees C) suggests that heat was conserved by nasal heat exchange. At Ta 10 degrees C, mean Tex of seals in air was approximately 10 degrees C higher than mean Tex of seals in water (Tw = 2.3 degrees C). Furthermore, seals subjected to a Tw of 24.8 degrees C at Ta 0 degrees C had a mean Tex 10 degrees C higher than when subjected to Tw 2.3 degrees C at the same Ta. These observations suggest that Tex in seals is under thermoregulatory control. In a series of forced dives of up to 5-min duration Tex was found to be the same before and after the dive regardless of dive duration and Ta. PMID- 2764155 TI - Control of thermoregulatory sweating during exercise in the heat. AB - The purposes of this study were the following: 1) to determine whether erythrocyte infusion alters the control of thermoregulatory sweating and 2) to demonstrate how increases and decreases of both plasma tonicity and blood volume influence the thermoregulatory control parameters of threshold temperature and sweating sensitivity. Six non-heat-acclimated and five heat-acclimated males attempted heat stress tests (HSTs) both before and shortly after (48-96 h) autologous erythrocyte infusion. The non-heat-acclimated subjects were euhydrated for both HSTs, whereas the heat-acclimated subjects were studied in a euhydrated and a hypohydrated (-5% body wt) condition both pre- and postinfusion (500 ml of solution containing approximately 60% hematocrit of autologous erythrocytes). The HSTs consisted of treadmill exercise (335 W.m-2) in a hot (35 degrees C, 45% relative humidity) environment, and esophageal temperature and local sweating rate were continuously measured during 25 min of exercise. These experiments resulted in a matrix of conditions where both plasma tonicity and blood volume were increased or decreased relative to control conditions (euhydration, preinfusion). The findings concerning thermoregulatory sweating during exercise in the heat were summarized as follows: 1) acute polycythemia decreases the threshold temperature and increases the sweating sensitivity, 2) both threshold temperature and sweating sensitivity are increased or decreased from control levels dependent on the combined influence of plasma tonicity and blood volume, and 3) equations are presented that describe how plasma tonicity and blood volume alter threshold temperature and sweating sensitivity values. PMID- 2764156 TI - Plasma catecholamine and glucose concentrations during hemorrhagic hypotension in anesthetized dogs. AB - Hemorrhage-induced hepatic glycogenolytic responses were compared in pentobarbital-anesthetized dogs with a temporary functional adrenalectomy (ADRX) and in dogs with an acute hepatic denervation (HNX). Plasma concentrations of catecholamines [CAs; epinephrine (E), norepinephrine (NE), and dopamine (DA)] were determined in aortic (AO), hepatic venous (HV), portal venous (PV), and adrenal venous (ADV) blood collected simultaneously before, during, and after hemorrhage (H). Plasma glucose (GL) concentrations were measured in AO and HV blood. AO blood was bled (5.3 +/- 0.5 ml.kg-1.min-1, n = 42) until AO systolic pressure dropped to half (72.9 +/- 4.7 mmHg) of its control value (148.0 +/- 4.4 mmHg), and the hypotension was maintained for 5 min. In control dogs (CTL; n = 12), H markedly increased ADV CAs with a predominant increase in E over NE and DA. AO CAs increased similarly. By contrast, however, changes in HV CAs were characterized by a significant increase in NE that was more pronounced than the increases in E and DA. The increases in NE were associated with significant increases in both HV GL and AO GL. In dogs with ADRX (n = 10), AO CAs remained unchanged during H, but both HV NE and HV GL rose concomitantly to an extent similar to that observed in CTL dogs. In dogs with HNX (n = 10), HV NE remained unchanged during H, but HV GL increased to an extent similar to that observed in dogs with ADRX, along with significant increases in AO CAs. In dogs with HNX combined with ADRX (n = 10), HV NE and AO CAs did not change at all during H, resulting in a marked attenuation (50%, P less than 0.05) of the increasing response of HV GL.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2764157 TI - In vitro evidence for an inhibitor of lipogenesis in serum from overfed obese rats. AB - Involvement of a humoral agent in regulation of energy balance has been demonstrated by parabiosis experiments. Overfed obese rats produce a blood-borne factor that inhibits adipose fatty acid synthesis in their partners, resulting in loss of body fat without significant inhibition of food intake. An in vitro bioassay was developed to test small serum samples for antilipogenic activity. Epididymal adipocytes from ad libitum-fed rats were preincubated for 12 h with 2% serum. Basal adipocyte fatty acid synthesis, measured in a subsequent serum-free incubation, was inhibited by obese serum. Insulin response was not changed. Characterization studies indicated that the factor was probably a protein, larger than 30 kDa, but not a protease or a low-density lipoprotein and was not associated with serum albumin. Physiological experiments demonstrated that the agent was produced when body weight was raised substantially above "set-point." Inhibitory activity was neither species specific nor pituitary dependent. Structure, origin, and physiological significance of the factor are unknown, but it may be involved in the control of body fat content. PMID- 2764158 TI - Renal sympathetic nerve activity and renal responses during head-up tilt in conscious dogs. AB - Renal sympathetic nerve activity (RSNA) was measured in conjunction with functional responses of the kidney during head-up tilt in eight conscious female dogs. A 40 degree head-up tilt resulted in a sustained increase in RSNA by 53 +/- 10% (P less than 0.05) relative to control level. Urine flow and osmolal and sodium excretions decreased significantly to a nadir of -55 +/- 4, -42 +/- 7, and -59 +/- 10%, respectively, whereas free water clearance and creatinine clearance did not change significantly during head-up tilt. The systemic arterial pressure (at kidney level) increased significantly from 110 +/- 4 to 129 +/- 6 mmHg, and central venous pressure decreased significantly from -0.7 +/- 0.5 to -7.6 +/- 0.6 mmHg. The chronic bilateral renal denervation, which was performed 2-4 wk before the experiment, abolished both the antidiuretic and antinatriuretic responses to heald-up tilt. These results indicate that an increase in RSNA plays a significant role in the decrease in urine flow and sodium excretion induced by 40 degree head-up tilt in conscious dogs. PMID- 2764159 TI - Interstitial and intravascular pressures in conscious dogs during head-out water immersion. AB - Water immersion (WI) causes an increase in plasma volume in humans and dogs. To determine the mechanism for this fluid movement, the transmission of external water hydrostatic pressure to the interstitial and vascular compartments was studied in six conscious dogs. Systemic arterial, central venous, peripheral arterial (ulnar artery) and venous (cephalic vein), pleural, intra-abdominal, and interstitial fluid hydrostatic (by Guyton's capsule and wick catheter method) pressures and external reference water pressure were measured at three different levels of WI: 1) extremities only, 2) midchest, and 3) midcervical levels at 37 degrees C. There was a significant linear relationship between interstitial fluid hydrostatic pressure (X) and external water pressure (Y): (Y = 0.86X + 1.4, r = 0.93 by Guyton's capsule; Y = 0.85X + 2.4, r = 0.93 by wick catheter. However, vascular pressures did not change when dogs were immersed at the level of the extremities. These pressures increased only during WI at the midchest and midcervical levels. Therefore the pressure gradient that develops between the interstitial and intravascular compartments is probably the major reason for the transcapillary fluid shift during WI. PMID- 2764160 TI - Osmoregulation and body fluid compartmentalization in dehydrated heat-exposed pigeons. AB - Osmoregulatory and volume-regulatory responses of heat-acclimated pigeons (Columba livia) were studied during normal hydration and dehydration combined with heat exposure. Dehydrated heat-exposed pigeons (exposure to 50 degrees C following 48 h of water deprivation; 16-18% mass loss) could recover 97% of their initial body mass within 30 min of free drinking at the end of heat exposure. At the end of heat exposure, body temperature increased by 3 degrees C and hematocrit increased by 12.5%. Serum electrolyte and protein concentrations increased by 33-53% (P less than 0.001). Serum osmolality reached an outstanding mean value of 436.7 +/- 28.5 mosmol/kg (n = 11), 30.5% higher than the normal mean value. Serum glutamic-pyruvic transaminase and glutamic-oxaloacetic transaminase concentrations did not change during dehydration, suggesting no impairment in circulatory function. Blood urea nitrogen increased sixfold, indicating a total shutdown of the kidney. Relative plasma volume was maintained during dehydration at the expense of extravascular spaces and with a decreased vascular permeability as indicated by the increase in Evans blue-labeled albumin half-life (control, 104 +/- 53 min; dehydration, approaching infinity). Altogether, extracellular fluid volume and intracellular fluid volume contributed 53 and 47% of the evaporative water loss, respectively. It is concluded that plasma volume regulation may play an important role in the effective thermoregulatory responses of heat-exposed dehydrated pigeons. This regulation is achieved by preferential shifts of body water reserves among the various body water compartments coinciding with a remarkable tolerance to high osmotic pressures. PMID- 2764161 TI - Lateral cerebroventricular injection of neuropeptide Y stimulates feeding in sheep. AB - We compared the effects of neuropeptide Y (NPY) injected into the lateral ventricle (LV) and periphery (ip in rats; iv in sheep) on feed and water intake. In sated rats, a bolus injection of 1.18 or 2.35 nmol of NPY administered LV, but not ip, increased (P less than 0.05) feed intake on average of 809% within 30 min of injection. In sated sheep, an LV bolus injection of 2.35 nmol of NPY increased feed intake by 154% within 30 min. Similar doses of human pancreatic polypeptide and peptide YY were less orexigenic than NPY in sheep. After 24 h, cumulative feed intakes were similar among control and peptide treatments. Intravenous injection of 2.35 nmol NPY did not increase feed intake in sheep. Water intake was stimulated (P less than 0.05) by NPY (LV injection) in both the presence and absence of feed. We propose that NPY is involved in the central regulation of consummatory behavior in sheep. PMID- 2764162 TI - Electrophysiological study of micturition reflexes in rats. AB - Electrophysiological techniques were used to examine the asynchronous and evoked activity on postganglionic nerves to the urinary bladder in the urethananesthetized rat. Distension of the bladder (0.4-0.6 ml) evoked reflex contractions of the bladder (mean intravesical pressure 28 cmH2O) and efferent firing on postganglionic nerves. Electrical stimulation of afferent and efferent axons in the pelvic nerve elicited short-latency (0.3-11 ms) responses and long latency (45-170 ms) reflexes on the nerves. The short-latency responses consisted of nonsynaptic axonal volleys with conduction velocities ranging from 0.5 to 11 m/s and synaptic responses with latencies of 6-11 ms. Stimulation of the pelvic nerve elicited late supraspinal reflexes (mean latency 122 +/- 28 ms) in 60% of normal rats and an early reflex (mean latency 56 +/- 5 ms) in 25% of those animals in which a late reflex was also identified. Early reflexes (mean latency 50 +/- 9 ms) were elicited in 100% of chronic spinal animals. The conduction time for the afferent and efferent limbs of the reflexes was calculated to be 7 and 58 ms, respectively, with a central delay of 57 ms for the late and less than 5 ms for the early reflex. It is concluded that sacral parasympathetic input to the urinary bladder of the rat is mediated by supraspinal and spinal reflex pathways. It is likely that in normal animals the late-occurring supraspinal reflex mediates micturition. The significance of the spinal reflex in the normal animals is uncertain; however, this reflex is essential for the generation of automatic micturition in chronic spinal preparations. PMID- 2764163 TI - Alternative mechanism for attenuated pressor responses in AV3V-lesioned dogs. AB - We lesioned the periventricular tissue of the anteroventral portion of the third cerebral ventricle (AV3V) of dogs to evaluate the mechanism that accounts for blunting of the pressor activity of angiotensin II (ANG II). AV3V lesions were done with a microknife using a transbuccal approach; the procedure denervated the organum vasculosum of the laminae terminalis, the nucleus medianus, and the medial preoptic nucleus. Two to four days after surgery, the conscious AV3V lesioned dogs showed adipsia and their blood contained increased quantities of Na+ (175 +/- 2 meq/l) and an elevated osmolality (352 +/- 5 mosmol/kg). Cardiac rate was faster (131 +/- 8 beats/min) in AV3V-lesioned dogs, but their mean arterial pressure (MAP) was within normal values (99 +/- 4 mmHg). These changes were accompanied by an almost 18-fold increase in the plasma levels of immunoreactive ANG II (irANG II). In contrast, plasma vasopressin (AVP) levels fell to nondetectable values. Pressor responses produced by intravenous infusions of ANG II or injections of norepinephrine (NE) were significantly blunted 3 days after AV3V ablation. Short-term treatment of eight AV3V-lesioned dogs with the synthetic AVP analogue, 1-desamino-8-D-arginine vasopressin, reduced plasma Na+ and irANG II levels. The pressor activity of peripheral infusions of ANG II was restored to prelesion values, whereas pressor responsiveness to NE remained depressed. These data suggest that the blunting of the pressor action of ANG II in AV3V-lesioned dogs is an expression of a disorder in the regulation of renal and behavioral mechanisms maintaining fluid balance and AVP secretion.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2764164 TI - Measurement of hepatocellular function, cardiac output, effective blood volume, and oxygen saturation in rats. AB - The available techniques do not permit the measurement of hepatocellular function, cardiac output, effective blood volume, and oxygen saturation in small animals without the need of blood or tissue sampling. We present methodology that permits us to measure the above variables in the rat. Multiple doses of indocyanine green (ICG; 0.16-2.6 mg/kg) were given to pentobarbital-anesthetized rats, and [ICG] was continuously measured by an in vivo hemoreflectometer. Initial velocity of clearance (Vo) was determined from the [ICG] vs. time plot for each dose by nonlinear regression. The maximal velocity of clearance (Vmax; indicating hepatocellular function) was calculated. Vmax was 1) accurately determined using two, three, or four doses of ICG; 2) it was 1.09 +/- 0.16 mg.kg 1.min-1, not different from the Vo of the near-saturating dose of 25 mg/kg; and 3) it decreased after partial hepatectomy. Cardiac output was 41.89 +/- 1.46 ml.100 g-1.min-1, effective blood volume was 6.12 +/- 0.34 ml/100 g, and oxygen saturation was 92 +/- 2%. These methodologies may prove useful in the evaluation of hepatocellular dysfunction and hemodynamic parameters in the rat during and after various diseased states. PMID- 2764165 TI - A renaissance of sulfobromophthalein infusion method for animal studies of hepatobiliary function? PMID- 2764166 TI - Psychiatric services in jails and prisons: who cares? PMID- 2764167 TI - On being ethical in an unethical world. PMID- 2764168 TI - Response to the presidential address: the research alliance: road to clinical excellence. PMID- 2764169 TI - Oscillations of attachment in borderline personality disorder. AB - The authors propose that oscillations of attachment in borderline personality disorder stem from a central problem with regulation of interpersonal distance. This problem derives from borderline patients' conflicts between fears of abandonment and domination. When they move closer to others, they fear that they will be dominated; when they move away, they fear that they will be abandoned. Whichever direction they move, they experience negative feedback. This gives rise to recurrent oscillations between attachment to and detachment from others. Because the oscillations are reinforced by the ambivalent reactions of significant others and the involvement of third parties, family therapy is often indicated. PMID- 2764170 TI - Managed health care and the Massachusetts experience. AB - Managed health care, through prepaid health delivery systems and utilization review organizations, is perhaps the greatest trend in modern health care. The authors examine the remarkable growth of managed care and outline its clinical, economic, ethical, and practical implications. They then review examples of how organized psychiatry has been involved in managed care and describe the efforts to date of the Massachusetts Psychiatric Society in this area. Managed care is here to stay. The future climate of psychiatric practice and the care available to psychiatric patients are dependent on informed and organized activities by psychiatrists and their local and national representatives. PMID- 2764172 TI - Spectral analysis of cyclic symptoms in late luteal phase dysphoric disorder. AB - Fifty-eight subjects self-referred for premenstrual difficulty were evaluated for late luteal phase dysphoric disorder through a spectral analysis technique applied to prospective symptom ratings. Data from the Schedule for Affective Disorders and Schizophrenia--Life-time Version were used to group the subjects according to the absence or presence of past or present psychiatric disorders. The two psychiatric groups were compared with regard to both patterns of significant symptom change and premenstrual symptom severity. Differences between the groups are used to discuss issues regarding the reliable identification of late luteal phase dysphoric disorder and the impact of other psychiatric disorders on this syndrome. PMID- 2764171 TI - Cyclothymic mood swings in the course of affective disorders and schizophrenia. AB - The authors assessed cyclothymic mood swings and psychosocial adjustment in 38 unipolar depressed, 27 bipolar, 35 schizophrenic, and 27 other psychiatric patients 4 years after hospital discharge and in 153 normal control subjects. The patients were significantly more cyclothymic at follow-up than the control subjects, but there were no differences in cyclothymia between the diagnostic groups. Cyclothymic patients showed significantly poorer posthospital functioning than noncyclothymic patients. These findings raise questions concerning the scope of the hypothesized cyclothymic-bipolar spectrum. Minor mood swings in a variety of patients with poor posthospital adjustment may reflect persistent vulnerability to psychopathology. PMID- 2764173 TI - Panic response to lactate administration in alcoholic and nonalcoholic patients with panic disorder. AB - The authors administered lactate to 12 abstinent alcoholics with panic disorder, 10 nonalcoholic patients with panic disorder, and eight control subjects. They found that the alcoholic patients had fewer panic attacks in response to lactate infusion than the nonalcoholic patients. This finding was not attributable to differences in baseline anxiety or the change in plasma chemical values brought about by sodium lactate administration. The authors suggest that there may be subgroups of patients with panic disorder who need further characterization to meaningfully elucidate the pathophysiology of the disorder. PMID- 2764174 TI - A polysomnographic and clinical report on sleep-related injury in 100 adult patients. AB - In 100 consecutive adults who came to a sleep disorders center complaining of repeated nocturnal injury, polysomnographic study identified five disorders: night terrors/sleepwalking (N = 54), REM sleep behavior disorder (N = 36), dissociative disorders (N = 7), nocturnal seizures (N = 2), and sleep apnea (N = 1). Ninety-five patients sustained ecchymoses, 30 had lacerations, and nine had fractures. DSM-III axis I disorders (past or current) were found in 48.1% of the group with night terrors/sleepwalking and in 30.6% of the group with REM sleep behavior disorder; these were mainly affective disorders. In these two groups, clonazepam controlled the symptoms of 51 of the 61 patients to whom it was given. PMID- 2764175 TI - Differences between patient and family assessments of depression in Alzheimer's disease. AB - A structured interview covering the DSM-III criteria for major depression was adapted for separate use with Alzheimer's disease patients and with their families. Data from 36 patients yielded a depression rate of 13.9%, whereas information from their families indicated that the rate was 50.0%. This disagreement reflected greater family endorsement of patients' loss of interest or pleasure, irritability, fatigue, and feelings of worthlessness. Use of DSM-III R criteria narrowed but did not eliminate the discrepancy between patients' and families' assessments of the patients' depression. Uniform procedures for gathering and integrating data from the family that are relevant to diagnosis in this group are indicated. PMID- 2764176 TI - Prevalence of severe mental disorders in disaffiliated and homeless people in inner Melbourne. AB - The authors determined the prevalence of mental illness in 382 people representative of the occupants of shelters for the homeless and cheap single room accommodations in inner-city areas of Melbourne. Clinicians were trained to use a standardized diagnostic instrument, the Structured Clinical Interview for DSM-III-R, to diagnose a range of severe mental disorders, including psychotic, affective, and substance-related disorders. Almost half the people interviewed received diagnoses of current disorders, and over 70% received lifetime diagnoses. There was considerable comorbidity. Many factors are likely to contribute to the concentration of people with mental disorders in such homeless and disaffiliated groups. PMID- 2764177 TI - Media power and public mental health policy. AB - The author describes the functions of the news media and their influence on public mental health policy making. News media functions are divided into the categories of selecting the news, reporting information, serving as a channel of communication, presenting views and opinions, and legitimizing the issues. These functions are illustrated by focusing on a highly publicized New York City policy to involuntarily hospitalize mentally ill homeless people living in the streets. Strategies are suggested to mental health professionals on how to effectively interact with the news media. PMID- 2764178 TI - Birth order of patients with DSM-III-R somatization disorder. AB - A sample of 143 patients, 76 meeting strict DSM-III-R criteria for somatization disorder and 67 somatizers, was studied using Slater's index to measure birth order position. The results showed that birth order position was not associated with the diagnosis of somatization disorder and that sibship position in both groups occurred by chance. Thus, although environmental factors may influence the development of somatization disorder, the expression of environmental influence through birth order is unlikely. PMID- 2764179 TI - Sleep panic attacks: new clinical findings and theoretical implications. AB - Forty-five panic disorder patients and 26 normal control subjects were surveyed regarding their histories of sleep panic attacks, insomnia, and vulnerability to exogenous panic stimuli. Sixty-nine percent (N = 31) of the patients reported having experienced sleep panic at some time in their lives, and 33% (N = 15) of the patients experienced recurrent sleep panic. The implications of these findings for the management of panic disorder are discussed. PMID- 2764180 TI - Comparison of adolescent- and adult-onset unipolar depression. AB - The author compared the longitudinal clinical profiles of patients with adolescent-onset (N = 20) and adult-onset (N = 38) unipolar depression. The findings support the validity of subtyping depression by age at onset and comorbid substance abuse. PMID- 2764181 TI - Morning versus evening bright light treatment of late luteal phase dysphoric disorder. AB - Six women with late luteal phase dysphoric disorder had a significant reduction in depression ratings after treatment with evening, but not morning, bright light. Bright light may offer an alternative to the pharmacologic treatment of premenstrual mood disorders. PMID- 2764182 TI - Calcium channel blockers for tardive dyskinesia in geriatric psychiatric patients. AB - Nifedipine treatment resulted in variable improvement in tardive dyskinesia in eight geriatric psychiatric patients. Patients with affective disorders and hypertension demonstrated improvement in other areas as well. PMID- 2764183 TI - Clonazepam for the treatment of stupor in catatonic schizophrenia. PMID- 2764184 TI - Depression in patients receiving lorazepam for panic. PMID- 2764185 TI - Bulimia that predates restricting anorexia nervosa. PMID- 2764186 TI - Overuse of the term "acting out". PMID- 2764187 TI - Treatment of the severely mentally ill poor. PMID- 2764188 TI - Dosage of oral and depot fluphenazine. PMID- 2764189 TI - Integrating the psychotherapies. PMID- 2764190 TI - Medical students' attitudes toward cocaine use. PMID- 2764191 TI - Compulsive water drinking and water intoxication. PMID- 2764192 TI - Do not go gently into that good night: more about the junior faculty academic dilemma. PMID- 2764193 TI - Legal concept of torts and emotional distress. PMID- 2764194 TI - Antidepressants and cessation of smoking. PMID- 2764195 TI - Distinction between Alzheimer's disease and primary degenerative dementia of the Alzheimer type. PMID- 2764196 TI - Biochemical basis for schizophrenia. PMID- 2764197 TI - Doctor strikes and other signs of discontent. PMID- 2764198 TI - Risk factors associated with participation in the Ontario, Canada doctors' strike. AB - To identify factors associated with participation in the 1986 Ontario, Canada doctors' strike, we surveyed 1,028 physicians; 69 percent responded, of whom 42 percent participated in the strike. Risk factors for participation included income greater than $135,000, being a surgeon or gynecologist, having previously "opted out" of the Ontario Health Insurance Plan, being professionally dissatisfied, being politically conservative, favoring political activism by physicians, holding a positive view of the social consequences of extrabilling, and perceiving family, associates, patients and the public to favor the strike. Eighty percent of strikers, but 32 percent of non-strikers, met criteria we established for four strike-prone groups: the "economically rational," the "ideologically committed," the "professionally disaffected," and the "socially malleable." Respondents belonging to one or more of these groups were much more likely to have participated in the strike (64 percent vs 17 percent). Strategies to deal with physician militancy should address the multiplicity of motives that appeared to have influenced doctors in Ontario. PMID- 2764199 TI - Induced abortion and the risk of subsequent ectopic pregnancy. AB - This study assessed the effect of legal induced abortion on ectopic pregnancy risk by using a comparison group of reproductive-age women who were at risk of becoming pregnant during the same time period the women with ectopic pregnancy conceived. Cases were members of Group Health Cooperative of Puget Sound who were hospitalized for ectopic pregnancy from October 1981 through September 1986 (N = 211). Controls were randomly selected members matched to cases on age and county of residence (N = 457). All subjects in this analysis had had one or more prior pregnancies. Eighty-eight cases (41.7 per cent) and 177 controls (38.7 per cent) had a history of one or more induced abortions. The relative risk of ectopic pregnancy associated with one abortion was 0.9 (95 per cent confidence interval 0.6, 1.3), adjusted for age, county, reference date, religion, gravidity, age at first pregnancy, lifetime number of sexual partners, and miscarriage history. Among women with two or more prior pregnancies, the risk associated with two or more abortions was 1.2 (0.6, 2.4). Controlling for pelvic inflammatory disease and use of intrauterine devices did not alter these risks. We conclude that legal abortion as performed in the US since 1970 has little or no influence on a woman's risk of ectopic pregnancy in subsequent pregnancies. PMID- 2764200 TI - The relationship of smoking and ectopic pregnancy. AB - A case-control study, using data abstracted between 1983 and 1987 from a large perinatal registry, was conducted to explore the relationship between smoking and ectopic pregnancy. Women with ectopic pregnancy (n = 634) seen at University of Illinois Perinatal Network Hospitals were compared to women who were delivered of a single live-born infant (n = 4287). Adjusted for age and race, women who reported smoking during pregnancy had a greater than twofold risk of ectopic pregnancy (Odds Ratio = 2.5, 95% confidence interval = 1.9, 3.2) compared to women who never smoked. The estimated relative risk rose from 1.4 (95% CI = 0.8, 2.5) for a woman smoking fewer than 10 cigarettes a day to 5.0 (95% CI = 2.9, 8.7) at one and a half or more packs of cigarettes per day (p-value for trend less than 0.001). Although further basic and epidemiologic research is necessary, the observed dose-response relation strengthens the argument that smoking may be a causal factor in the development of ectopic pregnancy. PMID- 2764201 TI - Maternal smoking during pregnancy: no association with congenital malformations in Missouri 1980-83. AB - Using a multisource birth defects registry developed by the Missouri Center for Health Statistics for the years 1980-83, we examined the relation between maternal smoking during pregnancy and the occurrence of congenital malformations. There were 288,067 live singleton births in this data set of which 10,223 had one or more congenital malformations. When adjusted for potential confounders the odds ratio for congenital malformations in the infants of women who smoked during pregnancy was not increased (odds ratio = 0.98, 95% confidence interval = 0.94 - 1.03). We examined the relation between smoking and groups of malformations using the International Classification of Diseases, 9th Revision, as well as analyzing for certain specific malformations within each group and found no increased risk for infants of smokers. PMID- 2764202 TI - Does maternal employment affect breast-feeding? AB - A prospective survey of maternal employment and breast-feeding initiation and duration was conducted among 668 Black and 511 White women who delivered their first child in Washington, DC. Ninety-one percent of White women (n = 511) and 80 percent of Black women (n = 668) reported working during pregnancy. Black women who planned to return to work part time vs full time were more likely to breast feed rather than formula-feed (adjusted odds ratio, 2.3; 95% confidence intervals (CI) = 1.4, 3.7). Using Cox regression, Black women who returned to work had a shorter duration of breast-feeding than those not returning to work (hazard ratio = 0.5 (CI = 0.3, 0.9]. Black and White women returning to professional occupations had a longer duration of breast-feeding compared to women returning to sales or technical positions (hazard ratio for Black women = 2.4 (CI = 1.4, 44); hazard ratio for White women = 1.6 (CI = 1.0, 2.5]. In addition, White women in professional occupations had a longer duration of breast-feeding than women in clerical positions (hazard ratio = 1.7 (CI = 1.1, 2.6]. Until employers in the United States develop a maternity policy which does not discourage breast feeding, the recommended six months of breast-feeding will be difficult to achieve for most employed women. PMID- 2764203 TI - Pregnancy characteristics and outcomes of Cambodian refugees. AB - This study describes the perinatal characteristics of Cambodian refugees in Massachusetts. Data were abstracted from the records of 452 consecutive pregnancies among Cambodian women and 110 low-income Whites receiving obstetrical services at the same clinic and hospital in Lowell, Massachusetts. Pregnancies of Cambodian women were marked by a higher proportion of older mothers, grand multiparas, previous adverse birth outcomes, and short interpregnancy intervals. We identified maternal anemia (29.9 percent with hemoglobin less than 110 g/L) and inadequate utilization of prenatal care (32.3 percent with first visit in the 3rd trimester) as possible risk factors for the Cambodians. The prevalence of primary cesarean birth was only 6.3 percent in the Cambodians, compared to 15.6 percent in the comparison group, largely due to the infrequent occurrence of prolonged labor among multiparas. Despite the prominence of several risk factors for adverse birth outcomes in this population, major pregnancy complications were less common and the prevalence of low birthweight (6.4 percent) was close to the state average. Logistic regression analysis of risk factors for low birthweight identified young maternal age and short stature as the strongest factors operative in this community. Many of our findings are consistent with a strong cultural emphasis on managing the size of the baby to avoid a difficult labor and delivery. PMID- 2764204 TI - Catholicism and fertility in Puerto Rico. AB - This paper examines the association between fertility and religious affiliation among Puerto Ricans. Bongaarts' proximate determinants framework is used to compare religious categories on behaviors that directly affect fertility. We found no difference in recent fertility between Catholics and non-Catholics in Puerto Rico (total fertility rate = 2.5). We also found Catholics and non Catholics to be similar on age at first marriage (23.3 and 23.4 years, respectively), contraceptive use (71 percent and 69 percent of married women currently contracepting), and breast-feeding practices (mean duration of breast feeding of 4.4 and 4.3 months). Differences were observed between less committed and more committed Catholics in total fertility rate, age at first marriage, and contraceptive use, but these differences were not large and were in the opposite direction from the expected. Our findings support the theory of convergence of Catholic and non-Catholic fertility for the US. Our discrepancy with findings from the National Survey of Family Growth is evidence of the cultural diversity in the US Hispanic population and indicates the importance of disaggregating by ethnicity or national origin when studying this population. PMID- 2764205 TI - Acculturation and low birthweight among Latinos in the Hispanic HANES. AB - Self reports from 1,645 Latino mothers of Mexican descent who participated in the Hispanic Health and Nutrition Examination Survey (HHANES) were used to relate the birthweight of their infants to the HHANES acculturation index. After controlling for parity, a one point increase on the acculturation scale was found to be associated with a 1.19 (95% CI = 1.05, 1.34) increase in risk of maternal low birthweight (LBW) (1.98 risk increase for four points). The estimated relative risk increased to 1.34 (1.12, 1.60) with controls for age at interview, wealth, city size, and years of education; controlling for current smoking status reduced the relative risk to 1.31. US-born respondents were also at increased risk relative to Mexican-born, but this relation was explained by acculturation. The effect of education was found to depend on level of acculturation. Years of education was unrelated to risk among the Mexican-oriented, while increased education was associated with reduced risk in the US-oriented. These results suggest that factors associated with a Mexican cultural orientation may be protective against the risk of LBW. PMID- 2764206 TI - Fetal death ratios in a prospective study compared to state fetal death certificate reporting. AB - A cohort of 6,254 pregnancies surviving at least 20 weeks of gestation was identified through pregnancy testing and follow-up at three Kaiser Permanente medical offices in northern California in 1981-82. Fetal death ratios per 1,000 live births were 12.1 for all fetal deaths versus 5.0 for the subset of fetal deaths reported to the California state registrar. Only fetal deaths resulting in overnight hospitalization of the mother were reported. Seventy-nine percent of fetal deaths over 28 completed weeks since the last menstrual period (LMP) were reported versus only 10 percent between 20 and 28 completed weeks since the LMP. Ninety-three percent of fetuses over 400 grams were reported. The unreported fetal deaths were mainly those perceived by attending physicians as spontaneous abortion, especially missed or incomplete spontaneous abortion. Physicians apparently preferred the label of spontaneous abortion over stillbirth or fetal death whenever fetal maturity could not be substantiated, regardless of prior estimates of the date of the LMP. Fetuses as large and developed as potentially viable infants were the most likely to be reported. PMID- 2764207 TI - Major trauma in geriatric patients. AB - Contemporary trauma to the elderly, its severity and associated mortality and morbidity in 111 United States and Canadian trauma centers are described. Three thousand eight-hundred thirty-three (3,833) trauma patients age 65 years or older are compared to 42,944 injured patients under age 65. Although both groups had equivalent measures of injury severity, the older group had higher case fatality and complication rates and longer hospital stays. The results raise important questions regarding the triage, acute care, accurate prediction of outcome, and hospital reimbursement for the elderly injured patient, with implications for care evaluation, quality assurance, and the long-term viability of trauma centers and systems of care. PMID- 2764208 TI - Relation between vegetarian/nonvegetarian diets and blood pressure in black and white adults. AB - We examined the possible interaction of race and diet on blood pressure (BP) in volunteer Black Seventh Day Adventists compared to volunteer White church members. Height, weight, waist and hip circumference, and resting seated BP were recorded in Black vegetarians (n = 55; age: 54.7 +/- 16.9 yrs), Black nonvegetarians (n = 59; 56.1 +/- 14.1 yrs), White vegetarians (n = 164; 52.2 +/- 16.7 yrs), and White nonvegetarians (n = 100; 52.6 +/- 15.6 yrs) attending a regional conference. Forty-four percent of the Black nonvegetarians were medicated hypertensives, compared to only 18 percent of the Black vegetarians, 7 percent of the White vegetarians, and 22 percent of the White nonvegetarians. Black vegetarians exhibited lower age and sex-adjusted systolic BP (means = 122.9/74.4 mm Hg) than Black nonvegetarians (means = 132.2/75.9 mm Hg). After further adjusting BP for body mass index and waist/hip ratio, the systolic BP among Black vegetarians remained lower (122.8) than Black nonvegetarians (129.7) but higher than that of the Whites who showed no diet-related BP differences. PMID- 2764209 TI - Sample size and power based on the population attributable fraction. AB - Most methods for calculating sample size use the relative risk (RR) to indicate the strength of the association between exposure and disease. For measuring the public health importance of a possible association, the population attributable fraction (PAF)--the proportion of disease incidence in a population that is attributable to an exposure--is more appropriate. We determined sample size and power for detecting a specified PAF in both cohort and case-control studies and compared the results with those obtained using conventional estimates based on the relative risk. When an exposure is rare, a study that has little power to detect a small RR often has adequate power to detect a small PAF. On the other hand, for common exposures, even a relatively large study may have inadequate power to detect a small PAF. These comparisons emphasize the importance of selecting the most pertinent measure of association, either relative risk or population attributable fraction, when calculating power and sample size. PMID- 2764210 TI - Chronic stressors and maternal depression: implications for prevention. AB - We report on the use of an instrument to measure exposure to stressors among 149 women presenting with their children for pediatric care at an urban primary care center. Overall, 38.3 percent of the women had significant levels of depressive symptoms; 71.4 percent of those in the "high stress" group had an adjusted prevalence odds ratio of 5.00 [95% CI = 2.12, 11.82]. We conclude that screening in the pediatric office is feasible for identifying women at high risk of becoming depressed. PMID- 2764211 TI - Immunity to diphtheria and tetanus in inner-city women of childbearing age. AB - This study was conducted to determine immunity to diphtheria and tetanus in 232 inner-city women experiencing a recent birth. Forty-three (18.5 percent) of the women had levels of diphtheria antitoxin below the protective level (less than 0.01 unit/ml), whereas only 10 (4.3 percent) had insufficient levels of tetanus antitoxin. The percent of women susceptible increased with age, with 33 percent and 25 percent of women over the age of 30 years susceptible to diphtheria and tetanus, respectively. PMID- 2764212 TI - Caffeinated beverages and low birthweight: a case-control study. AB - A case-control study, examining the effect of first trimester maternal caffeine consumption on low birthweight, was performed in the Kaiser Permanent Medical Care Program. Heavy consumption (greater than 3 servings/day) of coffee, cola and greater than 300 mg/day of caffeine from all sources (coffee, tea and cola) was associated with a marginally increased risk of low birthweight. Our data support previous findings of a modest effect of caffeine consumption on fetal growth. PMID- 2764213 TI - Mathematical models and scientific reality in occurrence rates for disease. PMID- 2764214 TI - The AIDS Action Committee SafetyNet program: small group parties for safer sex education. PMID- 2764215 TI - A note from the tobacco industry. PMID- 2764216 TI - Determinants of stopping smoking: Italian National Health Survey. PMID- 2764217 TI - A contrasting view on rheumatoid arthritis. PMID- 2764218 TI - Laws regulating tattooing. PMID- 2764219 TI - Comment on changes in alcohol-related inpatient care. PMID- 2764220 TI - Behavior of clients of prostitutes. PMID- 2764221 TI - Adenoma malignum (minimal deviation adenocarcinoma) of the uterine cervix. A clinicopathological and immunohistochemical analysis of 26 cases. AB - We reviewed 26 examples of the rare variant of cervical adenocarcinoma that has been designated "adenoma malignum." The patients, three of whom had Peutz-Jeghers syndrome, ranged in age from 25 to 72 years (average, 42 years). The most common presenting symptom was menometrorrhagia, followed by vaginal discharge, postmenopausal bleeding, and abdominal swelling in decreasing order of frequency. In 12 of the patients, the diagnosis was established on the basis of the examination of a cervical biopsy specimen, endocervical curettage specimen, or both. In three of these cases, however, up to four biopsies were performed before the diagnosis was established. In the remaining 14 patients, the diagnosis was not made until the time of operation or pathologic examination of a hysterectomy specimen. On gross examination, the cervix usually appeared abnormal, but occasional specimens were considered unremarkable. The cervix was typically described as firm or indurated. Microscopic examination showed glands that were irregular in size and shape and lined predominantly by mucin-containing columnar epithelial cells with basal nuclei. The tumors typically exhibited deep invasion of the cervical wall, and a portion of the infiltrating tumor was associated with a stromal response in most cases. Minor foci of tumor with a less well differentiated appearance were present in 15 of the 26 tumors. Argyrophil cells were present in six of 15 tumors. Five of the six tumors containing argyrophil cells stained immunohistochemically for serotonin and peptide hormones. Positive staining for serotonin was seen in four tumors; one of these also contained a few cells positive for neurotensin. Cytoplasmic staining of the tumor cells for carcinoembryonic antigen (CEA) was seen in five of six cases. CEA reactivity was very focal in two of the positive tumors. Microscopic features that were most helpful in distinguishing adenoma malignum from normal endocervix or benign endocervical glandular proliferations were the presence of markedly irregular, abnormally shaped glands; invasion of the cervical wall; a loose edematous or desmoplastic stromal response; foci of less well-differentiated tumor; vascular invasion; perineural invasion; and positive staining for CEA. Despite radical therapy in most of the cases, the prognosis was poor. Follow-up data were available for 22 patients. Thirteen of them died of recurrent tumor, four were alive with recurrent tumor at the time of last follow-up examination, and only three patients were disease free for 2 years or more.4+ tumor of the PMID- 2764222 TI - Metastases from carcinomas of the pancreas simulating primary mucinous tumors of the ovary. A report of seven cases. AB - We report seven patients with mucinous tumors of the ovary that we interpreted as metastases from adenocarcinomas of the exocrine pancreas. The ovarian metastases closely resembled primary mucinous tumors of the ovary. The patients' ages ranged from 29 to 87 years (average, 63 years). The ovarian and pancreatic tumors were discovered synchronously in five patients. In two patients, the pancreatic tumor preceded the ovarian tumor by 9 months and 8.5 years, respectively. In four patients, the clinical presentation simulated primary ovarian cancer. The ovarian tumors were typically large, multiloculated cystic neoplasms. Six of them were bilateral; the status of the opposite ovary is not known in one case. Microscopically, they manifested varying degrees of differentiation, usually containing foci resembling mucinous cystadenoma, mucinous tumor of borderline malignancy, and well-differentiated mucinous cystadenocarcinoma. The primary pancreatic tumors were typical ductal adenocarcinomas in six patients and mucinous cystadenocarcinoma in the seventh. Features pointing toward the metastatic nature of the ovarian tumors included bilaterality, surface desmoplastic implants, and extraovarian spread. The possibility of metastases should be strongly considered whenever evaluating mucinous ovarian tumors, especially those that are bilateral or have other unusual features. The pancreas is an important source of metastatic tumors that simulate primary ovarian mucinous cystadenocarcinomas and borderline tumors. PMID- 2764223 TI - Morphologic and functional changes in the remnant liver following resection for cirrhosis or chronic hepatitis. AB - We studied the late effects of hepatic resection on the remnant liver in patients with cirrhosis or chronic hepatitis. Data were obtained from 15 patients who underwent primary resection for hepatocellular carcinoma, followed by a second operation for recurrence. The mean interval between primary and second operations was 21.5 months (range, 7-39 months). When we compared the histologic features of the resected specimens obtained at the two operations, no apparent changes were noted in 14 of the 15 patients who had had an uneventful perioperative course. However, in the remaining patient, who had experienced postoperative intraperitoneal bleeding, the histologic diagnosis was changed from chronic inactive hepatitis to cirrhosis 7 months later. With regard to serum chemistry, there was no statistically significant difference in values between the two operations. We conclude that hepatic resection does not derange morphologic and functional status of the remnant liver and that advancement of chronic liver disease may occur in case of perioperative complications leading to liver cell damage. PMID- 2764224 TI - Pseudosarcomatous stromal reaction in primary and metastatic urothelial carcinoma. A source of diagnostic difficulty. AB - We report five urothelial carcinomas (one primary and four metastatic) with pseudosarcomatous stromal reaction. The exuberant stromal reaction led to a histologic misdiagnosis in three of the original small biopsy specimens. The differential diagnoses of primary spindle cell lesions of urinary tract include spindle cell carcinoma, carcinosarcoma, sarcoma, and benign pseudosarcomatous lesions. The distinction between those conditions and urothelial carcinomas with pseudosarcomatous stromal reaction is obviously of great clinical significance. In an initial small biopsy specimen, it may be difficult to make such a distinction. Immunostaining for cytokeratin and examination of more material should be performed. In our study of metastatic urothelial carcinomas with pseudosarcomatous stromal reaction, clinicopathologic correlations along with immunostaining for keratin proved to be useful. The stromal inductive capability of transplanted urothelium, which has been established in animal experiments, has occasionally also been reported in humans. The malignant urothelium in humans similarly appears to be capable of inducing stromal reaction. PMID- 2764226 TI - Dioctophyme larva in the subcutaneous tissues of a woman in Ohio. AB - A nematode larva undistinguishable from Dioctophyme renale was found in the subcutaneous tissues of the abdomen of a 23-year-old woman from Ohio. This is the third case of Dioctophyme larva reported in humans. Although it is not known how the infection was acquired, we suggest that ingestion of raw fish was the probable source. We further hypothesize that such a larva could eventually migrate to the kidney and grow to the adult state. PMID- 2764225 TI - Multifocal rhabdomyoma of the neck. Report of a case studied by fine-needle aspiration, light and electron microscopy, histochemistry, and immunohistochemistry. AB - A 32-year-old Caucasian man presented with a tumor in the right side of the neck. Preoperative fine-needle aspiration showed large multinucleated cells with abundant granular cytoplasm that were consonant with the features of a granular cell tumor. At surgery, two separate tumors were found. Histologically, the tumor proved to be an adult rhabdomyoma, the 11th such multifocal case reported. The striated muscle origin of this benign tumor was confirmed by immunohistochemical and ultrastructural studies. The tumor cells were desmin-, myoglobin-, and actin positive. They showed variable numbers of thick and thin filaments, as well as hypertrophic Z-band material. Histochemical studies showed the presence of basophilic muscle cells, vesicular nuclei, ragged red fibers, and diffuse acid phosphatase positivity. These features, together with the absence of actual muscle cell proliferation and the assumption that the mass of the tumor could be explained by the enormous swelling of the muscle cells, lead us to conclude that an adult rhabodomyoma is merely the result of a process of disorderly degeneration and regeneration rather than a real neoplasm or a hamartomatous lesion. PMID- 2764227 TI - Immunohistochemical detection of steroid receptors in a case of pulmonary lymphangioleiomyomatosis. AB - Abnormal proliferation of smooth muscle cells in pulmonary lymphangioleiomyomatosis (LAM) is thought to be influenced by estrogen and progesterone. However, the results of previous studies using cytosolic methods to measure estrogen and progesterone receptor content in lung tissue from these patients have been inconsistent. We used immunohistochemical methods to study the tissue distribution of estrogen and progesterone receptors in LAM as well as in smooth muscle of several other organs, including histologically normal lung, colon, bladder, prostate, uterus, and uterine leiomyomas. Progesterone receptor was expressed strongly and estrogen receptor more weakly by the abnormal myoid cells of LAM. Hormone receptors were absent from all other constituents of lung tissue in our patient. These findings were similar to those in histologically normal myometrium and uterine leiomyomas. Although we found focal labeling of prostatic stromal cells with anti-progesterone receptor, no other smooth muscle tissue expressed either estrogen or progesterone receptor. We conclude that LAM is an abnormal proliferation of smooth muscle cells that express both estrogen and progesterone receptors. PMID- 2764228 TI - Identification of Taenia solium antigens in cerebrospinal fluid and larval antigens from patients with neurocysticercosis. AB - Two antigens (190 and 230 kDa) of the larvae of Taenia solium were detected in the cerebrospinal fluid (CSF) of 14 of 18 patients in which neurocysticercosis was suspected. Nine of these were confirmed by histopathology. Seven antigens were detected in cyst fluid of T. solium larvae removed from the brains of 6 infected patients. Two of these antigens had the same Mr as the T. solium antigens detected in the CSF. Polyacrylamide gel electrophoresis and electro immunoblotting analyses were used for the identification and characterization. Antibodies in rabbit anti-larval antiserum and antibodies in sera of infected individuals recognized the same larval antigens in the larval cyst fluids and in the CSF of infected patients. PMID- 2764229 TI - Determinants of surface membrane maturation during the cercarial-schistosomula transformation of Schistosoma mansoni. AB - The transformation of free-living cercariae to parasitic schistosomula of Schistosoma mansoni is accompanied by the formation of a multilaminate surface membrane which binds concanavalin A (Con A). This transition normally occurs with penetration of intact skin of the mammalian host, but can be accomplished by vortexing and incubating organisms at 37 degrees C in complex tissue culture medium (e.g., Earle's lactalbumin). We determined the minimal conditions that initiate surface maturation by monitoring surface changes by transmission electron microscopy and surface fluorescein-conjugated Con A labeling. Cercariae incubated in water for 2 hr at 37 degrees C retained their trilaminate surface and were non-fluorescent. After incubation in 116 mM NaCl for 3 hr at 23 degrees C, no organisms were covered by intense surface fluorescence; increasing the temperature to 37 degrees C resulted in 50% of the parasites becoming fluorescent. The addition of 26 mM NaHCO3 (pH 7.4) to parasites incubated in NaCl at 37 degrees C resulted in 98% of the organisms binding Con A. No significant difference in surface Con A binding was found between organisms incubated with the chelators EGTA or EDTA and controls. Mechanical stimulus by itself was not effective in stimulating surface maturation. The conditions that initiated surface maturation were elevation of temperature to 37 degrees C and NaHCO3 containing medium. PMID- 2764230 TI - Treatment with a single dose of albendazole improves growth of Kenyan schoolchildren with hookworm, Trichuris trichiura, and Ascaris lumbricoides infections. AB - We studied the growth of primary schoolchildren with hookworm (87%), T. trichiura (97%), and A. lumbricoides (49%) who received a single 400 mg dose of albendazole or an identical placebo. Children were allocated at random to placebo (PL, n = 72) or albendazole (A, n = 78) groups, treated, and re-examined 6 months later. The A group gained significantly more than the PL group in weight (1.3 kg), percent weight for age (4.5% age points), percent height for age (0.5% age points), percent weight for height (4.3% age points), percent arm circumference (2.9% age points), and in triceps and subscapular skinfold thicknesses (1.2 mm). The PL group showed significant decreases between exams in percent weight for age, percent height for age, percent weight for height, percent arm circumference for age, and skinfold thicknesses for age. The A group had highly significant increases (P less than 0.0002) in all of these parameters except height for age. From Exam 1 to 2, the A group exhibited decreases (P less than 0.0002) in geometric means eggs per gram of feces (epg): for hookworm, means = 1,183 epg at Exam 1 vs. 136 epg at Exam 2 (67% egg reduction); for T. trichiura, means = 2,857 epg at Exam 1 vs. 1,061 epg at Exam 2 (28% egg reduction); and for A. lumbricoides, means = 86 epg at Exam 1 vs. 2 epg at Exam 2 (91% egg reduction). The PL group had a borderline increase in geometric means hookworm egg count, no significant change in T. trichiura egg count, and a small but significant decrease in A. lumbricoides egg count. Decreases in intensities of all infections were significant predictors of growth improvement. Hookworm egg count entered the equations for all 6 measurements, and A. lumbricoides and T. trichiura entered 4/6 equations. Single dose treatment with albendazole, despite continual exposure to infection, can permit improved growth rates in areas where intestinal helminths and protein-energy malnutrition are highly prevalent. PMID- 2764231 TI - Moniliformis moniliformis from a child in Florida. AB - An acanthocephalan infection in a 15-month-old male in Pensacola, FL was successfully treated with pyrantel pamoate. He was not overtly ill. PMID- 2764232 TI - Human gnathostomiasis: infection with an immature male Gnathostoma spinigerum. AB - Gnathostomiasis, usually caused by larvae of Gnathostoma spinigerum, is a significant cause of morbidity in the Far East. We report a case of gnathostomiasis involving a male Thai residing in Kuwait who presented with acute pain in the right iliac fossa. A resection of the terminal ileum and cecum was performed. Microscopic examination showed a parasite in an eosinophilic abscess. The nematode was identified as an immature male G. spinigerum based on size, morphology, and distribution of cuticular spines. PMID- 2764233 TI - Epidemiology and control of dengue virus infections in Thai villages in 1987. AB - A severe epidemic of dengue hemorrhagic fever (DHF) in Nakhon Ratchasima, Thailand in August of 1987 prompted a field investigation. DHF rates of 0.4-6.5 cases per 1,000 residents in subdistricts and 2-15 cases per 1,000 residents in 10 villages investigated were reported. Epidemics peaked in neighboring villages at different times; in June and July, and in August before the rainy season began late in the month. In 4 primary schools representing 6 villages, sera from groups of randomly selected children were tested for dengue IgM with the antibody capture ELISA test. Rates of recent dengue infection were 10-65% in the schools and correlated closely with reported rates of DHF. In an effort to control vectors, malathion fog and temephos (1% abate sand granules) were applied. Villagers were educated in prevention and were urged to cover water receptacles. The percentage of houses with larvae dropped from 67 to 20, the percentage of containers with larvae decreased from 30 to 5, and the number of containers with larvae per 100 households decreased from 221 to 33. This was a serious epidemic in which conventional control measures were only moderately effective. PMID- 2764234 TI - Medical treatment of non-streptococcal recurrent tonsillitis. AB - Forty patients with a history of recurrent non-beta-hemolytic streptococcal tonsillitis (RNST) participated in a prospective randomized study comparing penicillin and clindamycin in the treatment of acute non-group A streptococcal infection. The efficiency of each antibiotic was evaluated according to its ability to alleviate acute infection and prevent recurrence. Surface tonsillar cultures were obtained both before and ten days after the termination of therapy, and specimens were processed for aerobic and anaerobic bacteria. Beta-lactamase producing bacteria (BLPB) were present in 36 (90%) tonsillar cultures. Thirty-one BLPB were isolated in 17 patients before penicillin therapy and 42 BLPB were recovered from 19 after such treatment. Thirty-three BLPB were recovered in 19 patients before clindamycin therapy, after which four BLPB were isolated in three patients (P less than .05). From the second day posttherapy onward, significantly fewer patients who received clindamycin had fever, pharyngeal injection, and sore throat. In a 1-year follow-up period, recurrent tonsillitis was noted in 13 of the patients who received penicillin and in two treated with clindamycin (P less than .001). The data clearly demonstrate the superiority of clindamycin therapy over penicillin in patients with RNST. PMID- 2764235 TI - Incidence of amikacin ototoxicity: a sigmoid function of total drug exposure independent of plasma levels. AB - A sigmoid curve was found to closely describe the relationship between the incidence of amikacin ototoxicity (greater than or equal to 15 dB hearing loss at a given frequency) and either (1) total dose, or (2) the area under the curve (AUC) describing plasma drug concentration v time over the total period of amikacin administration (total AUC) in continuously infused guinea pigs. Total dose or total AUC estimates of the drug exposure required to produce ototoxicity in 50% of the animals (ED50s) were not significantly different over an eight-fold range of dosing rates or plasma concentrations. A theoretical explanation for this result is that ototoxicity occurs only when a critical amount of drug is accumulated at the ototoxic site by an essentially unidirectional process with a rate that is slow and linearly related to the extracellular drug concentration. The sigmoid relationships for pooled data were parallel in slope for all hearing frequencies from 2 to 32 kHz, and the ED50s showed a strong negative linear relationship to the log of the hearing frequency over this range. The magnitude of ototoxicity expressed as the number of octaves (frequency ratios of 2) for which hearing loss damage was continuous from 32 kHz downward, was correlated to both total dose (r = .605) and total AUC (r = 0.703). No relationship between ototoxicity and plasma level or dosing rate was found. The extreme steepness of the dose-effect curve for the incidence of ototoxicity greatly amplified the variability between individuals and offers an explanation for the unpredictability of aminoglycoside ototoxicity in human patients. The results indicate that either total dose or total AUC (in cases of highly unpredictable blood levels), and not peak or trough serum levels, should be used as an index of ototoxic risk and that the safety limits of drug exposure should be set conservatively. PMID- 2764236 TI - Nuclear magnetic resonance spectroscopy of plasma for the detection of head and neck cancer. AB - The plasma of 15 normal volunteers, four patients with benign head and neck disease, and 12 patients with biopsy proven head and neck malignancies were evaluated using water-suppressed nuclear magnetic resonance (NMR) spectroscopy. While the mean full width at half height (HHLW) of the NMR spectra showed a significant difference between groups (P less than .05), the predictive value of a positive test was only 57% the sensitivity was only 33%, and individual values in all groups demonstrated considerable overlap. The mean HHLW of the control group was 38.5 Hz +/- 3.5 compared with 35.2 Hz +/- 4.7 for the cancer group and 35.0 Hz +/- 10 for the benign disease group. This method was not able to distinguish patients with malignancy from those with benign disease or controls. Its use as a specific screening method for head and neck malignancy cannot be recommended. PMID- 2764237 TI - Minor salivary gland tumors: the role of radiotherapy. AB - Previous analyses of minor salivary gland tumors (MSGTs) have not clearly established the role of radiotherapy in their treatment. The following is a retrospective review of 44 patients treated from 1956 to 1984 with MSGT of the maxillary sinus (15 of 44), nasal cavity/ethmoid complex (six of 44), or hard palate (23 of 44). Histological findings included adenocarcinoma (18), adenoid cystic (17), high-grade mucoepidermoid (six), and mixed malignant (three). Treatment was by surgery (18 of 44), radiotherapy (eight of 44), or a combination of both (18 of 44). Patients treated with radiotherapy, either alone or combined with surgery, had disease that was inoperable, marginally resectable, or residual after surgery. Despite this handicap, 3-year local control rates for all treatment modalities were similar (surgery, 78%; radiotherapy, 63%; and combined treatment, 83%). Absolute 3-year survival rates were 94% for surgery, 63% for radiotherapy, and 78% for combined therapy, with death attributable to distant metastases a significant factor in the advanced cases treated with radiotherapy. A dose response relationship was apparent in those patients whose treatment involved radiotherapy. Clearly, MSGTs are radioresponsive lesions and radiotherapy can play an important role in their management. PMID- 2764238 TI - Interstitial thermoradiotherapy for recurrent head and neck cancer. AB - From 1985 to 1987, 22 head and neck sites in 20 patients with recurrent tumors were treated with interstitial thermoradiotherapy (ITRT). The sites treated were 15 neck (68%), four tongue (18%), two parotid (9%), and one buccal mucosa (4%). Squamous cell carcinoma was diagnosed in 21 sites and adenocarcinoma in the other. All patients had prior radiotherapy (RT), including 15 who underwent a combination of RT and surgery. Interstitial RT with iridium 192 (mean dose, 40 Gy) was combined with interstitial microwave hyperthermia (mean thermal dose, 90 units). Complete response (CR) was obtained in 15 (68%) sites and partial response (PR) in seven (32%) sites. There were no local recurrences in the 15 CR patients during a period of observation of up to 30 months. Of the seven PR patients, one had radical neck dissection and is free of tumor after 28 months. Tumor volume was an important factor influencing CR (P less than .001), whereas RT and thermal dose were not (P = .3). Of the 20 patients treated, 19 experienced major subjective benefit. Serious complications occurred in two patients: one had localized soft tissue necrosis, the other had aspiration pneumonia. ITRT was well tolerated by patients despite prior aggressive therapy. High objective response rate and low toxicity demonstrate the value of this treatment combination in the management of patients with postradiation recurrence of head and neck tumors. PMID- 2764239 TI - Voice evaluation of myomucosal shunt after total laryngectomy: comparison with esophageal speech. AB - The vocal quality attained with a tracheoesophageal myomucosal shunt (MMS) as described by Strome was evaluated in four patients and compared with three esophageal speakers and two normal subjects. The patients with MMSs acquired speech sooner. Fundamental frequency, pitch, timbre, and melody were analyzed with computerized electroglottography and sonography. Intelligibility was deemed better after the MMS primarily because phonation time approximated that of normal speech, and this study suggests that, following total laryngectomy, the vocal quality achieved using the MMS is preferrable to that of esophageal speech. PMID- 2764240 TI - Inverted papilloma: a follow-up study including primarily unacknowledged cases. AB - Inverted papillomas (IPs) in the nose or the paranasal sinuses exhibit a tendency for rapid growth with bone destruction, a high recurrence rate, and an association with malignancy, requiring early diagnosis and aggressive surgical therapy. A number of operative approaches have been reported in the literature, with greatly varying results. Furthermore, the incidence of IP and the association with carcinoma are not well-established. In this study, we present a series of 42 patients with IP. Drawing from the resources of two institutes of pathology, we reviewed all specimens of nasal cavity or paranasal sinus tissue taken between the years 1975 and 1986, and performed a thorough follow-up of all IP patients. The incidence was found to be 0.6 cases per 100,000 inhabitants per year in a well-defined representative geographic region. Two patients had concomitant carcinoma. When the initial surgical approach was lateral rhinotomy, the recurrence rate was 50%. This was not significantly different from that noted following excision through a sinusectomy (62%) or simple endonasal excision (43%). However, initial procedures were selected individually, mainly on the basis of tumor size and location. Accordingly, a limited procedure is considered justified even in cases with lateral lesions, if the tumor is sufficiently visible and confined. In other cases, lateral rhinotomy is required. Septal IPs are often detected at an early stage and are therefore often amenable to local excision. PMID- 2764241 TI - Aspiration in patients with head and neck cancer and tracheostomy. AB - Tracheopulmonary aspiration is a common occurrence in patients with dysphagia associated with head and neck cancer. We performed quantitative scintigraphic analysis of tracheopulmonary aspiration in 125 patients with head and neck cancer; 58 of these patients had a tracheostomy. Tracheopulmonary aspiration occurred in 58% of patients with a tracheostomy and in 23% of patients without a tracheostomy. In six of seven patients with a tracheostomy, tracheopulmonary aspiration significantly increased when the obturator was removed and, in these patients, occlusion of the tracheostomy tube during feedings eliminated or reduced the complication. Our studies suggest that aspiration can be monitored accurately and conveniently by scintigraphy, and that this technique is useful in the evaluation and management of dysphagia in debilitated patients. PMID- 2764242 TI - Extramedullary hematopoiesis of the middle ear. AB - A 22-year-old man with sickle cell disease developed a conductive hearing loss as a result of extramedullary hematopoiesis in the right middle ear. This is the first reported case of conductive hearing loss from extramedullary hematopoiesis and only the second report of extramedullary hematopoiesis in the middle ear. PMID- 2764243 TI - Clinical radiology quiz. Warthin's tumors. PMID- 2764244 TI - [Alkaline phosphatase isoenzyme activity in the serum of women during the second half of pregnancy]. AB - The authors determined total alkaline phosphatase activity as well as the activity of placental, bone marrow and liver isoenzymes in sera of 185 pregnant women with normal pregnancy, divided, into 6 groups according to their gestational age (from 20 to 40 weeks' gestation). It was established an increase of bone marrow and placental isoenzymes of alkaline phosphatase parallel to an increase of gestational age, while the values of liver isoenzyme were comparatively constant, with the exception at 34-36 weeks' gestation when was elevated. Inferences are made for the origin of hyperphosphatemia during pregnancy. PMID- 2764245 TI - [Changes in the progesterone serum concentration of sexually immature rat pups treated with estradiol and reserpine]. AB - The authors carried out studies on sexually immature rats of Wistar strain. After exact determination of the day of delivery rats were divided into 4 groups: I- injected with 0.9% of sodium chloride on 35th, 36th and 37th day; II--injected with the reserpine only on the same days; III--injected with estradiol on the same days; IV--injected with estradiol on the same days. The animals were killed on the 38th day after delivery. The obtained results revealed that progesterone concentration in sera of sexually immature rats was not increased after treatment with estradiol. This showed that similar effect, established in sexually mature rats, was observed in sexually immature rats as well. Serum progesterone concentration of sexually immature rats was elevated after treatment with estradiol and reserpine. This is a new original fact for participation of adrenergic system in formation of steroid sexual hormone--progesterone in the ovary. PMID- 2764246 TI - [Our experience in treating peritonitis following cesarean section]. AB - Fourteen parturients were admitted and treated in the ward of emergency operative gynecology of the "N. I. Pirogov" RNPISMP for the period of 1980-1986 in connection with peritonitis after caesarean section. Four out of 14 parturients died. The clinical course of peritonitis after caesarean section is changed considerably under present conditions. Nontypical symptoms of its course create considerable difficulties in diagnosis and lead to late therapeutic measures, which worsen the outcome of treatment considerably. Some peculiarities in the clinical course of peritonitis are described in this paper. A method for surgical treatment and measures for the postoperative period are proposed. PMID- 2764247 TI - [Comparative evaluation of the black foam film method for determining lung surfactant maturity in the newborn infant]. AB - The present study evaluates a recently introduced method of black foam film (BFF) for determination of lung maturity, adapted for examination of nasopharyngeal aspirate (NFA) in the newborn and as well as to discover its diagnostic value by clinical verification and comparison with the method of total phospholipids (TPL) and with the ratio of lecithin/sphingomyelin (L/S). Comparing the results, obtained by the various methods, it was found that the capability of NFA of the newborn children to form BFF reflected the content of TPL and the ratio of L/S. The good correlation with the clinical state respectively with respiratory function of the examined children indicates the possibility that the method of BFF could be used for postnatal evaluation of lung maturity. PMID- 2764248 TI - [Dynamic changes during the follow-up in the blood pressure of premature infants after the use of intensive therapy]. AB - In the present study the authors analyzed the results from measurement of blood pressure in 400 healthy preterm infants respective also small for the gestational age infants as well as dynamic changes, which they observed after usage of biological products, administered by venous infusions. The results showed that blood pressure in preterm infants was a variable constant, which was influenced definitely by body weight, morphological maturity and general state of children during the examination. The obtained results have value of a model, which illustrates for the first time in our country the changes in blood pressure during the first eleven weeks of their life in a comparatively large contingent of risk preterm infants. PMID- 2764249 TI - [Gynecological morbidity in teachers]. AB - On the basis of the study Plovdiv-85 the level of gynecological morbidity was discovered during the performed complex prophylactic examinations of teachers. This morbidity occupied eight place in the frequency of pathological impairment of teachers. It was established a manifested dependence between age, length of service and the level of morbidity. On the basis of the obtained information the needs of gynecological patients were established for dispensary system observation and performance of optimal medical and social therapy as well as the usage of sanatorium-health resort basis for complete rehabilitation. The size of the presented extract allows to assume that the obtained results of gynecological morbidity among teachers is statistically significant and representative for their social group in the country. PMID- 2764250 TI - [Chronic stress and the degree of anxiety in girls with menstrual cycle disorders]. AB - The present study was made with the aim to clarify the role of personality attitude as well as of stress actions found in three elements of the environment family, school and social encirclement in wider aspect in the occurrence of menstrual disturbances. Anxiety as a personality characteristic was examined by a clinical inquiry as well as by the test for anxiety of Taylor and acute and chronic stress actions were search for. 228 girls at the age of 15 and 18 years were investigated. Diagnosis "psychogenic amenorrhea" was established in 34 out of 228 girls. In regard to physical and sexual development there was not significant difference with the girls of the control group. There was direct connection between stress event and the disturbance in the menstrual cycle in 41.2% of the examined girls. The fourth (elevated anxiety) and fifth degree (highly elevated anxiety) according to Taylor was established altogether in 70% of the cases. Polymorphous anxiety was found in structural respect. Third degree according to Taylor-mean manifested anxiety was established in 26% of the girls of the control group. Inferences are made in connection with the therapy. PMID- 2764251 TI - [Progesterone secretion in healthy women and in women with uterine myoma]. AB - The author studied the concentration of steroid sexual hormones by radiologic methods in blood sera of 38 women with uterine myoma and with various variants of the menstrual cycle. It was established that progesterone secretion was monotonous during the first phase and did not differ from that of healthy women. Progesterone secretion was considerably lowered during the third phase-luteal. In this way the author confirms that in women with uterine myoma the disturbances in hormonal correlations and more exactly the deficit of progesterone plays certain role in the pathogenesis of some parameters of development of myoma. PMID- 2764252 TI - [Functional research on carbohydrate metabolism in women with climacteric metropathy]. AB - The study was carried out on 61 women with climacteric metropathy at mean age of 48,33 years. Histopathologic endometrial finding of the performed curettage showed predominating anovulatory or organic character of the bleeding. The mean values of oral glucose tolerance test in women of the whole group did not exceed the established reference values. However there was a reduced glucose tolerance as the values of the test were within range zone. This is an important fact in determining a model for hormonal prophylaxis and treatment. PMID- 2764253 TI - [The x-ray characteristics of the changes in the fallopian tubes of women with primary sterility who have had an appendectomy]. AB - Using hysterosalpingography an attempt was made to classify the changes occurring in the uterine tubes of 114 women with primary sterility, undergone appendectomy in the past. It was established that changes in the tubes presented various character and included 2/5 of the material. There was direct dependence between appendectomy with complications and the gravity of the tubal factor. PMID- 2764254 TI - [A case report of primary carcinoma of the fallopian tube]. PMID- 2764255 TI - [A foreign body in the bladder of a child]. PMID- 2764256 TI - [Single-hormone prophylaxis of uterine hemorrhages in the premenopause]. AB - Single-hormone prophylaxis with gestagen (Primolut nor) was carried out on 62 women with uterine bleedings during the premenopause of climacteric at mean age of 46.8 years. A ten-day scheme with application of 5 mg of gestagen daily from 16 to 25 day of the cycle for a period of 6 months was used. The treatment provided stable clinical characteristic of the successive pseudomenstrual cycles could continue for a considerable time practically till disappearance of pseudo menstruation and transition of the woman in postmenopause. Primolut nor was a convenient drug also in women under continuous anticoagulant treatment. However it was effective and could not be used for treatment of accompanied climacteric symptoms. PMID- 2764257 TI - A survey of indoor air quality in twenty-nine anchorage residences. AB - During the winter of 1987-88, 29 Anchorage residents who contacted various agencies with indoor air pollution inquiries had their homes inspected and monitored for several indoor air pollutants. A survey form was completed during an interview with occupants of each residence visited. Data were collected on house characteristics and behavior of occupants. The mean nitrogen dioxide (NO2) concentration for residences with measurable amounts of this gas was .024 ppm, while the mean formaldehyde (HCHO) concentration with measurable levels was .037 ppm. Residences with gas cooking ranges had mean NO2 concentrations twice as high as those with electric ranges. Several residences had NO2 concentrations exceeding recommended standards. PMID- 2764258 TI - Hypersensitivity to larvae of chironomids (non-biting midges). Cross sensitization with crustaceans. AB - In 2,368 consecutive adult patients with asthma and/or rhinitis the incidence of positive skin prick test (SPT) with a chironomid extract (CHIR) (produced from "red feather mosquito larvae" used as fish food) was 14% (26% in atopics and 4% in non-atopics). RAST with chironomid was positive in 4% of 110 consecutive sera (8% in atopic sera). Significant correlations were found between RAST and SPT results with chironomid and between SPT results with CHIR and with various crustaceans. Correlations were also found reciprocally among SPT results with different crustaceans and between some crustaceans and moluscs (clam and oyster) as well as among RAST results with chironomid, shrimp and crab. Inhibition experiments showed that chironomid extracts inhibited RAST with shrimp, and vice versa. It is concluded that Chironomidae might be allergens of clinical importance in asthma and rhinitis in Sweden, that cross-allergy exists between chironomids and shrimp and that cross-allergy also might occur among chironomids, crustaceans and molluscs. PMID- 2764259 TI - Characterization of Micropolyspora faeni antigens by human antibodies and immunoblot analysis. AB - IgG, IgM and IgA antibody responses against Micropolyspora faeni (Mf) antigens were studied by means of immunoblotting experiments using 70 sera derived from three groups of farmers, namely patients with extrinsic allergic alveolitis (EAA) due to thermophilic actinomycetes (n = 25), patients without EAA but with hay exposure (n = 14), and patients suspected to have EAA (n = 31), and 27 sera from two groups of control persons (healthy laboratory workers, n = 13; healthy farmers, n = 14). Patients with EAA showed IgG, IgM and IgA antibody responses mainly against the antigens with molecular weights (MW) of 11, 12, 25, 35 and 60 kD ("major antigens"), and in addition, but less often, against six antigens with MW in the range of 15 to 62.5 kD ("minor antigens"). The other two groups of patients and also the exposed control persons showed very similar results; however, the antibody response in healthy farmers was substantially weaker in comparison to the three groups of patients and was almost limited to the major antigens with MW 11, 25 and 60 kD. Although patients with proven EAA had higher amounts of antibodies, there was no correlation between this antibody response and the onset of disease. The results indicate the necessity of including at least the major antigens with MW of 11, 25 and 60 kD in all extracts used for in vitro diagnosis of Mf-induced EAA. PMID- 2764260 TI - Occupationally related respiratory symptoms in trout-processing workers. AB - All eight production workers from a small trout-processing factory were studied because of respiratory or rhinitis symptoms when working next to the automatic gutting machine. Seven of the eight had positive histamine provocation tests. Four patients had elevated total IgE levels while one had a slightly elevated eosinophil count. All workers had either weakly or moderately positive RAST against contaminated water from the outlet drain of the gutting machine. This water contained 1 microgram endotoxin/ml. We concluded that five of the workers had probably developed occupationally related asthma from inhalation of contaminated aerosol from the gutting machine. Inhalation of endotoxin from gram negative bacteria may be the cause of this disorder. An alternative explanation is a Type I allergy caused by fish or bacterial protein with or without a simultaneous effect of endotoxin. PMID- 2764261 TI - Allergen-coated lancets (Phazet) for skin prick testing in children. AB - With a new allergen-coated lancet (Phazet), skin prick tests can be made directly on the skin without separate use of liquid extract (the Phazet dry method), and reactions are recorded as for the ordinary method with liquid allergen extract (Pharmalgen) (the Pharmalgen wet method). 100 children were tested in parallel with the two methods. As a double control each Phazet was used twice (Phazet 1 and 2) in each child, who was tested with nine standard allergens. Good agreement was found between the results obtained with the two methods and also between Phazet 1 and Phazet 2. No general reactions were shown in relation to the numerous skin prick tests with allergen extract of a strength up to 100,000 BU/ml. 66% of the children preferred the Phazet while 22% had no preference. PMID- 2764262 TI - PEP-spacer: an adaptation for administration of MDI to infants. PMID- 2764263 TI - [Monitoring infection at the intensive care unit--a multicenter pilot study]. AB - During a period of 3 months an infection survey was carried out in 4 intensive care units (ICUs), 2 in Vienna, Austria, and one each in Ulm and Munster, Federal Republic of Germany, using a common protocol. A total of 329 patients was monitored prospectively. This pilot study was performed to evaluate the usefulness of parameters included in the monitoring form. It was attempted to characterize the patient populations of the four units. Mean duration of stay (1 12 days), mortality (8-26%), leading diagnosis upon admission, intubation rate (41-91%) and use of pulmonary artery catheter (12-35%) were distinctly different. The rate of patients admitted already with an infection was 9-43%, septicemia was diagnosed in up to 27% of the diseased. The rate of infection acquired in the unit was between 12 and 37%, the most frequent types were bronchopneumonia, septicemia and urinary tract infection. When septicemia patients were compared to non-septicemia patients who had been admitted for more than 3 days, it appeared that the latter stayed significantly shorter at the ICU and showed less frequently bronchopneumonia or urinary tract infection at the time of admission. Septicemia patients acquired more frequently additional infections like broncho pneumonia or urinary tract infection while staying at the ICU. The median day of onset of septicemia was the fifth day and only in a quarter of cases diagnosis could be supported by a positive blood culture. The use of antibiotics in the 4 ICUs is compared and shows marked differences. Based upon experience with this type of infection survey a new modified protocol is introduced, which displays the time course of documented events. PMID- 2764264 TI - [The effectiveness of intratracheal antibiotic administration. Clinical, microbiologic and pharmacologic results]. AB - In 199 artificially ventilated patients of an internal intensive care unit clinical, bacteriological and pharmacological effects of endotracheally administered gentamicin were investigated. The dose schedule was 2-4 x 40 mg gentamicin/day. The incidence of secondary achieved pneumonia was reduced from 70% to 18%. The endotracheal colonization of pathogenic microorganisms reached 29.6% concerning bacterial microorganisms and 61% concerning fungi, 51.8% of all specimen were sterile. During 4 years of investigation there were found 19 secondary resistances of different bacteria, 12 persisted. Serum concentrations of gentamicin under endotracheal administration of 40 mg in 6-h-intervals didn't reach therapeutic values. In case of renal disorder the dose interval should be prolonged to twelve hours. PMID- 2764265 TI - [Preventive use of Pentaglobin in intensive care treatment of trauma patients]. AB - Basing on 50 posttraumatic intensive-care patients with medium grade lesions (ISS criteria), the prophylactic effect of an intravenously applicable IgM preparation (Pentaglobin) against nosocomial infections was investigated. The prophylaxis group received on the 3rd, 4th and 5th day a daily dose of 10 g each. At the same times the controls were given 12.5 g human albumin each. Whereas no difference was seen between both groups regarding the definitive outcome of the treatment, the prophylaxis group clearly showed fewer infection pointers during the clinical course. In particular, the incidence and magnitude of febrile temperatures were significantly lower between the 4th and 8th days of treatment. Our results indicate, however, that the prophylactic use those patients who are at particularly high infection exposure risk, e.g. through reintervention surgery, haemorrhage complications or extensive diagnostic interventions. PMID- 2764267 TI - [Remote artificial respiration and anesthesia in nuclear magnetic resonance imaging]. AB - Ferromagnetic equipment and equipment driven by alternate current cannot be used close to patients undergoing magnetic resonance imaging. Therefore, we tested a ventilator (Siemens Servo 900-D) that was placed more than 7 m away from the patient (outside the magnetic influence of 1.5 teslas) using tubing measuring 9 m in length. Tubing for children above the age of 8 and adults had a width of 22 mm; for neonates and children up to the age of 8 the width was 10 mm. Since the compressed air in such long tubes must be taken into consideration, we plotted nomograms for children and adults that helped to estimate respiratory minute volume including the compressed volume and a table to read the volume of compressed air that has to be added to respiratory volumes already established for ventilated patients from the ICU. In eight patients aged 7 weeks to 56 years (4 to 75 kg body wt.), capnography and blood gases showed that the nomograms were sufficiently accurate to allow safe ventilation. To improve safety, remote monitoring is recommended using long tubing or lines for oscillometric blood pressure measurement, capnography, and pulse oximetry as well as telemetric ECG. PMID- 2764266 TI - [Laboratory diagnostic possibilities in fungus infections in intensive care patients]. AB - Severe yeast infections of intensive care patients are promoted by numerous predisposing factors among which antibacterial broad spectrum therapy plays an important role. Since typical clinical pictures are lacking, basic procedures of mycological diagnostics are culture and differentiation of yeast strains and detection of immunological reactions against yeast antigens as well. Among 200 intensive-care patients with suspected systemic mycosis, Candida albicans was the prevailing yeast, followed by Torulopsis glabrata and Candida krusei. In the immunocompetent patient, serological procedures discriminating between antibodies of the IgG and IgM class may be suitable for the surveillance of the course of the disease. - In early stages of endomycotic infections and in the immunocompromised host as well, detection of candida antigens by means of specific latex tests and the detection of yeast-specific metabolites (e.g. arabinitol) by gas chromatographic methods provide helpful tools in the diagnosis of severe opportunistic fungal infections. PMID- 2764268 TI - [The pharmacokinetics of midazolam following intramuscular administration]. AB - There have been conflicting reports on the pharmacokinetics of midazolam, administered i.m. The aims of this study were to determine the pharmacokinetic data of midazolam following different doses and to test whether a correlation exists between its plasma level and sedative effect. METHODS. Fifteen patients between the ages of 18 and 50 were divided into three groups for i.m. administration of midazolam 0.05 mg/kg (group 1), 0.1 mg/kg (group 2), or 0.15 mg/kg (group 3) i.m. Venous blood was drawn 6, 12, 18, 24, 30, 36, 42, 48, 54, 60 min, and 2, 3, 4, 6, 8 h after the injection. After the same times the sedative effect was estimated by the anesthetist (awake, sleeping but easy to wake, sleeping and difficult to wake, unconscious). The plasma midazolam levels were determined by gas chromatography. The following pharmacokinetic parameters were ascertained: Cmax (peak concentration), tmax (time to attain peak concentration), clearance, elimination half-life. RESULTS. The peak concentration is directly proportional to the dosage of midazolam and the relation between the two is linear. The median Cmax values were 35.3 ng/ml (group 1), 103 ng/ml (group 2) and 123.5 ng/ml (group 3). The duration of tmax was between 12 and 36 min (means = 27 min). There was no significant difference between the groups in clearance, tmax, or elimination half-life. A significant correlation was found between the plasma midazolam levels and the degree of sedation. However, we observed a considerable variability in the effect. CONCLUSION. A 95% confidence interval for the prediction of the peak concentration of midazolam after i.m. injection is stated. Midazolam should be administered at a dose of 0.05 mg/kg at the most, if unconsciousness after premedication is to be avoided. PMID- 2764269 TI - [Preoperative normvolemic hemodilution in heart surgery. Pulmonary changes with the use of new technics]. AB - Interest in preoperative hemodilution (HD) has intensified perceptibly again, because of the increasing risk of adverse reactions to donor blood. However, in coronary surgery patients the use of HD is still the subject of controversy, as it may possibly influence organ function and especially lung water content. New techniques, including membrane oxygenation, extracorporeal circulation (ECC) with only "partial" bypass due to 2-stage cannulation, and hemoconcentration with cell separators, have significantly modified patient management in the field of cardiac surgery. Therefore, the influence of moderate hemodilution (12 ml/kg) on extravascular lung water (EVLW) was investigated under these conditions in 45 patients with coronary artery disease. Volume replacement was performed either with hydroxyethyl starch solution (HD-HES group, n = 15, ratio of replacement 1:1) or with Ringer's lactate (HD-RL-group, n = 15, ratio 2.5:1); 15 patients not subjected to HD served as controls. ECC was carried out with membrane oxygenators only in partial bypass. Both during and after ECC, blood was concentrated by means of a cell-saving system allowing separation and reinfusion of the red cells while the plasma is discarded. EVLW was measured using a double-indicator dilution technique with indocyanine green. Starting from comparable baseline values, EVLW was not significantly changed by hemodilution. After ECC, however, the HD-RL group showed a significant increase in lung water content (means: +2.49 ml/kg equal 42.6%), whereas this was not significantly changed in the other groups. By 5 h after ECC, the lung water content had returned to baseline values and no more differences could be observed between the groups.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2764270 TI - [Reliability and limitations of pulse oximetry in corrective cyanotic heart surgery]. AB - The aim of this study was to evaluate the agreement between arterial and pulse oximeter saturation values, especially under hypoxemic conditions, and to test the applicability of the method under routine anesthesia conditions. We studied 13 patients (12 children, 1 adult) with congenital cyanotic heart defects; 12 had a surgical correction during nonpulsatile cardiopulmonary bypass and 1 had a palliative operation. Arterial and pulse oximeter measurements were simultaneously taken and compared during induction of anesthesia, surgery, and in some cases during the postoperative period. Pulse oximeter saturation values were recorded by an Ohmeda Biox 3700 pulse oximeter, and the corresponding arterial saturations determined with a CO Oximeter (OSM2 Hemoximeter, Radiometer). The values lay in the range of 43%-100% arterial oxygen saturation. The results were evaluated while taking into account the steady state and non-steady state situations (i.e., when there were rapidly changing pulse oximetric saturation readings and difficulties in coordinating the comparative arterial measurements time-wise), as well as the equipment's internal characterization of the signal quality (High Quality Signal (HQS)/Low Quality Signal (LQS]. The correlation analysis for all comparative measurements, under both steady state and non-steady state conditions, gave a result of r = 0.927. When the comparison was restricted to the measurements in the steady state conditions, r = 0.935 resulted. The pulse oximetry saturation values had a tendency to lie below the corresponding arterial values. The fact that the pulse oximetry values were designated with HQS or LQS was no indication of a better or worse correlation with the arterial value.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2764271 TI - [Sympatho-adrenergic reactions following theophylline administration with the use of various anesthesia technics]. AB - The mechanism of action of theophylline is still the subject of controversy. Possible mechanisms that have been suggested are inhibition of phosphodiesterase, release of catecholamines, effects on intracellular calcium, and adenosine antagonism. With regard to these aspects, it was the aim of this study to compare sympatho-adrenal responses after theophylline application during different anesthetic techniques. A total of 60 patients scheduled for orthopedic surgery were investigated: they were divided into three groups of 20 patients who received either halothane anesthesia with thiopentone induction, modified neurolept anesthesia with fentanyl and midazolam, or spinal anesthesia with bupivacaine and mepivacaine. Within these three groups, the patients were randomly allocated to a theophylline collective receiving an injection of theophylline, 4 mg/kg body weight and to the control group. Plasma levels of epinephrine and norepinephrine (by HPLC/ECD), glucose, lactate and free glycerol and MAP and HR were determined over a period of 120 min. In all groups, epinephrine levels increased immediately after injection of theophylline; group levels of epinephrine were higher in the theophylline-groups than in controls (P less than 0.0001). A remarkable increase was observed within 60 min. Peak epinephrine concentrations were comparable after single injections of 100 micrograms or infusions of 5 micrograms/min. The norepinephrine increase after theophylline injection was brief and less pronounced. MAP, HR, glucose, lactate and free glycerol were not influenced by theophylline. A comparison of the theophylline patients showed no statistical differences attributable to the different anesthetic techniques.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2764272 TI - [The Oxytron: a new device for administering oxygen in the spontaneously breathing patient]. AB - The Oxytron (Weinmann, Hamburg, FRG) electronic oxygen conserver (patent pending) is a new device designed to deliver precise amounts of oxygen at the optimum point in the breathing cycle via a nasal cannula. In 200 Oxytron the delivered volume of oxygen was 35 +/- 5 ml within 150-200 ms at the beginning of the inspiratory phase of the respiratory cycle. Four different settings are possible: setting 1 provides one insufflation every 4th breath; setting 2 provides one insufflation every 2nd breath; setting 3 provides three insufflations every 4 breaths; and setting 4 provides an insufflation with every breath. These settings provide approx. The equivalent of 1-4 l oxygen per minute on a continuous flow basis. Both clinical experience and literature reports show variations in savings, with an average ratio of approx. 6:1 to 7:1. In the clinical evaluation, the following advantages were found: easy handling, exact oxygen delivery, increased oxygen saving and increased oxygen delivery with increasing respiratory rate. Due to the lack of any alarm system monitoring disconnection or failure of oxygen supply must be considered a disadvantage. PMID- 2764273 TI - [Magnetic resonance tomography: a patient-connected system for artificial respiration and monitoring]. AB - Physical phenomena that occur during magnetic resonance imaging (MRI) and the position of the patient inside the scanning tube necessitate adaptations of anesthetic techniques and devices. An anesthesia unit is presented that operates in close proximity to the patient without interfering with the imaging process. This unit enables the anesthesiologist to be close to the patient and his equipment, and minimizes the length of necessary tubing between patient and anesthesia apparatus. The unit consists of commonly used, commercially available devices with only minor modifications. PMID- 2764274 TI - [Central venous catheterization with an incorporated J-wire and contamination protective sleeves for rapid venous catheterization of the external jugular vein]. AB - The external jugular vein can easily be identified in most patients and provides an alternative access to the superior vena cava. Unfortunately, advancement of the catheter may be hampered for anatomical reasons, e.g. the presence of valves. Use of a flexible guide-wire with curved tip (J-wire), as first proposed by Blitt et al., results in a significant increase in the rate of successful cannulations. This method necessitates tedious surgical draping, however, that may not always be practicable. Therefore, a catheter was developed that is wrapped in a protective sleeve and contains a J-wire instead of the common plastic mandrin, thus making contamination during insertion impossible. PMID- 2764275 TI - 1989-1990 Lab Guide. PMID- 2764276 TI - Craniometrical estimation of the native Japanese Mishima cattle, using multivariate analysis. AB - The present study on measurement of the skull of Mishima cattle, which has been postulated as the only pure representative breed of native Japanese cattle, was performed using craniometrical multivariate analysis. The data of the skull of Mishima cattle was compared with 17 breeds of cattle, i.e. Korean cattle (Hamhung, Pyongyang, Chinju Suwon, and Kwangju), Mongolian cattle, Hainan Tao cattle, northeastern Chinese cattle (Shuangliao, Shenyang, Tongliao, Luta, and Chilin), Astatic Water Buffalo, Yak, Bos Banteng, American Bison, and Holstein Friesian. The Mishima cattle was included in the group of Korean breeds, especially it was closed on the group of Pyongyang and Chinju breeds. The distance on the craniometrical multivariate analyzing co-ordinate between Mishima cattle and Hainan Tao breed of Zebu cattle was larger than the distance between Mishima cattle and Korean breeds. While result, as a above the present study was very important for the origin of "Wagyu" (native Japanese cattle). Since the northern route theory of the origin of Mishima cattle has been reported on the type of serum enzymes and hemotypes. It was suggested that the craniometrical multivariate analysis supported to the northern route theory of the origin of Mishima cattle. PMID- 2764277 TI - [Moss fiber distribution in the hippocampus of chimeric mice]. AB - Large differences in hippocampal lamination have been found between several inbred strains of mice. These variations are thought to be caused by differences in developmental processes. We produced aggregation chimaeras between the inbred strains BALB/c and C57BL/6 and studied the lamination patterns in these animals. Next to some intermediate patterns, several patterns not occurring in the donor strains were obtained. These patterns differed also from those found in F1 hybrids. Thus, although the genetic information from both parental strains is present in both F1 and chimaeric mice, different processes occur during development. PMID- 2764278 TI - [The effect of a modified blood supply on the craniofacial growth of rabbits. 1. Vascular casts]. AB - This series describes changes in the arteries of the head and neck and the growth of the muscles of mastication, the skull and lower jaw after unilateral ligation of the common carotid artery. 1st REPORT: Kallocryl casts of the arterial system of the head and neck in rabbits aged about 8 months were made. The casts from ligated animals were compared with those from control animals. The description deals with the arrangement and number of anastomoses. PMID- 2764279 TI - [The attachment and function of the infrahyoid muscles]. AB - The insertion of the infrahyoid muscles to the hyoid bone with special remark to the topographical relations to each other was studied in 102 specimen. Many variations were found in the omohyoid muscle. 6 healthy test persons came in for electromyographical investigations. The involvement of these muscles in head movements could be recorded and studied. PMID- 2764280 TI - Three dimensional study of the rat urinary bladder in states of contraction and distension. AB - A qualitative and quantitative study of the apical surface of the superficial cells of the rat urinary bladder was made when the bladder was in states of contraction and distension. The study was performed with the scanning electron microscope. Qualitatively, no significant changes were observed with respect to the regional cell topography analyzed (fundus, body and neck of bladder) and only a progressive disappearance of folds and grooves with a more pronounced flattening of the poligonal luminal cell surface was apparent as distension increased. The quantitative data found point to significant differences between the cell populations analyzed, in particular the hexagonal cells, both at regional level and with respect to the state of contraction-distension of the urinary bladder. Isolated immature cells can be seen occupying the area left by desquamated cells that have different shapes, sizes and morphological characteristics to the mature cells. PMID- 2764281 TI - An allometric study of the development of the cloacal bursa in the domestic fowl. AB - The allometric relation between the increment of the body weight and the relative growth of the cloacal bursa shows that the bursal growth is greater than the body growth, during the period analysed (from the 16th d of embryonic development through the 28th post-hatched day). No statistical difference in the mean relative bursal weight between male and female birds was achieved in the above mentioned period analysed. The advantages of using an allometric study for the evaluation of an organ's growth during development are discussed. PMID- 2764282 TI - Descriptive and functional morphology of the locomotory apparatus of the spotted hyaena (Crocuta crocuta, Erxleben, 1777). AB - The musculature of the limbs, neck and back of Crocuta crocuta is described and some functional aspects are discussed. The myology of C. crocuta generally corresponds with that of H. hyaena. Both species show adaptations to lifting and carrying heavy loads, but the larger size and more robust morphology of C. crocuta enables it to master larger prey than H. hyaena. A remarkable over extension of the tarsus in C. crocuta is described which was observed both in the cadaver and in vivo, during the gallop. PMID- 2764283 TI - [Biometry of the tibia]. AB - This study investigates the relations between 67 tibia parameters. For this investigation, 30 human tibia of unknown sex and age were examined from the bone collection of the Department of Anatomy of the University of Alcala de Henares (Madrid). Many tibia parameter relationship were established, which were correlated through statistical analysis. 3 groups of parameters correlations were established: antero-posterior diameters of the diaphysis; perimeters of the diaphysis and width of the proximal extremity of the bone. The authors present the statistical values of all the measurements, which are of great anthropological interest. PMID- 2764284 TI - [The vomeronasal organ (VNO) of newborn guinea pigs is functionally sound]. AB - The present investigation demonstrates that the vascularization of the vomeronasal organ in the newborn guinea pig is capable of generating a pumping mechanism for suction of stimuli from the nasal cavity into the lumen of the organ. PMID- 2764285 TI - Effects of succinylcholine at the masseter and adductor pollicis muscles in adults. AB - The effect of succinylcholine on baseline tension and evoked twitch height was measured at the masseter and the adductor pollicis muscles in ten adults undergoing elective surgery. During thiopental-nitrous oxide-enflurane (end-tidal concentration less than 0.25%) anesthesia, supramaximal stimulation was applied to both the ulnar nerve and the nerve to the masseter. Baseline tension and the isometric force of contraction were measured at the jaw and the thumb. Cumulative dose-response relationships were obtained by giving succinylcholine in incremental doses (initial dose, 0.10 mg/kg, followed by 0.05- or 0.1-mg/kg increments, depending on response). An infusion was started after the maximum effect of the first dose, at a rate adjusted to compensate for the rapid metabolism of the drug. There was no difference between the sensitivity of the masseter and the adductor pollicis. The ED50 values were (mean +/- SEM) 0.11 +/- 0.01 mg/kg at both muscles. The ED90 values were 0.17 +/- 0.02 mg/kg at the masseter and 0.16 +/- 0.01 mg/kg at the adductor pollicis. Onset of action was more rapid at the masseter. In six of the ten patients, baseline tension at the jaw was found to increase by a mean of 80 +/- 24 g (range 25-188 g). It is concluded that in adults, masseter neuromuscular blockade can be achieved with succinylcholine doses approximately equal to those required to block the adductor pollicis. In addition, the drug may cause increased tension in the muscles of the jaw. PMID- 2764286 TI - A comparison of EEG determinants of near-awakening from isoflurane and fentanyl anesthesia. Spectral edge, median power frequency, and delta ratio. AB - To evaluate the efficacy of the computer-processed electro-encephalogram (EEG) for determining near-awakening from anesthesia, 14 patients were monitored during emergence from either isoflurane or fentanyl anesthesia at the termination of major surgical procedures. The raw EEG was obtained using bilateral frontomastoid electrodes. The compressed spectral array was digitized and recorded on disk in 4 s epochs using a Tractor Northern "Nomad" processor. The EEG information was displayed in four formats: 1) the frequency-power spectrum from 1-20 Hz, 2) the 95% power frequency, 3) the 50% power frequency, and 4) the ratio of power in the 8-20 Hz frequency range to the power in the 1-4 Hz frequency range (delta ratio). During emergence from isoflurane, there were obvious changes in the EEG frequency power spectrum that occurred several minutes before patients opened their eyes in response to verbal stimuli. Although no one descriptor of EEG activity could be shown to be superior in anticipating when patients would respond by opening their eyes, awakening was always presaged by an abrupt decrease in power in the 1-4 Hz frequency range; this resulted in a marked increase in the delta ratio value. During emergence from fentanyl anesthesia, however, there was no obvious change in the overall EEG frequency-power spectrum. However, the same numeric EEG descriptors that were predictive of awakening from isoflurane also occurred during emergence from fentanyl, even though they usually occurred within 1 min of awakening. It is concluded that EEG criteria for identifying when patients will awaken from anesthesia are more reliable with isoflurane than with fentanyl. PMID- 2764287 TI - Normovolemic hemodilution and lumbar epidural anesthesia. AB - This randomized study was designed to determine the cardiovascular effects of normovolemic hemodilution and lumbar epidural anesthesia in patients scheduled for vascular surgery. The patients were randomly assigned to three different groups: group 1 (N = 10) included patients undergoing lumbar epidural anesthesia without hemodilution; group 2 (N = 10) consisted of patients with normovolemic hemodilution without epidural anesthesia; and in group 3 (N = 10) normovolemic hemodilution was produced during lumbar epidural anesthesia. The three groups included several patients with a history of either myocardial infarction or stable mild angina or treated and controlled hypertension. In group 1, the level of epidural anesthesia reached T-9 +/- 1. After lumbar epidural anesthesia and 7 mL/kg colloid infusion, pulmonary capillary wedge pressure increased slightly but significantly above baseline, without significant changes either in mean arterial pressure or in cardiac index. In group 2, the same colloid infusion as in group 1 when infused before normovolemic hemodilution increased pulmonary capillary wedge pressure and cardiac index without significant effects on arterial blood pressure. Normovolemic hemodilution using a colloid solution decreased hemoglobin concentration (18%) and increased cardiac index significantly (9%). No significant change in systemic oxygen transport or in total body oxygen consumption was observed. In group 3, with anesthesia to T-9 +/- 1, hemodynamic changes were as observed in group 1. After normovolemic hemodilution, hemoglobin concentration decreased significantly (15%), whereas cardiac index increased significantly (15%) without significant changes either in mean arterial pressure or in heart rate. Systemic oxygen transport and total body oxygen consumption did not change significantly. No patient experienced chest pain or electrocardiographic evidence of myocardial ischemia.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2764288 TI - Intraoperative temperature monitoring sites in infants and children and the effect of inspired gas warming on esophageal temperature. AB - This study tested the hypotheses that 1) temperatures of "central" sites are similar in infants and children undergoing noncardiac surgery and 2) airway heating and humidification increases distal esophageal temperature. Twenty children were randomly assigned to receive 1) active airway humidification using an airway heater and humidifier set at 37 degrees C (N = 8), 2) passive airway humidification using a heat and moisture exchanger (N = 6), or 3) no airway humidification and/or heating (control, N = 6). There were no statistically significant differences between tympanic membrane, esophageal, rectal, and axillary temperatures. The temperatures of the peripheral skin surface (forearm and fingertip) were significantly lower than tympanic membrane temperature and significantly different from each other. Although esophageal and tympanic membrane temperatures in the entire group were similar, esophageal temperatures in patients receiving active and passive airway humidification were about 0.35 degrees C above tympanic temperatures after induction of anesthesia. In contrast, esophageal temperatures in patients without airway humidification were 0.25 degrees C below tympanic temperatures after induction of anesthesia. Esophageal tympanic membrane temperature differences in the patients given active and passive humidification differed significantly from the corresponding sum in the control group at all times, but not from each other. PMID- 2764289 TI - Early postoperative arterial oxygen desaturation. Determining factors and response to oxygen therapy. AB - Oxygen arterial saturation (SaO2) was measured with a pulse oximeter in 209 patients after elective surgery. Measurements were made upon arrival in the recovery room (RR) and 1 hr later. On each occasion, the patients randomly and alternately breathed--for 10 min at a time--room air or 35% O2. Factors that might influence the incidence of postoperative hypoxemia were analyzed. After breathing room air for 10 min after arrival in the RR, the mean SaO2 was 90.7 +/- 3.9% (+/- SD). Twenty min after and 1 hr after arrival in the RR, mean SaO2 increased significantly to 92.4 +/- 3.5% (P less than 0.001) and 93.2 +/- 3.0% (P less than 0.001), respectively. Postoperative hypoxemia (SaO2 less than or equal to 90%) after breathing room air for 10 min at 10 min, 20 min, and 1 hr after arrival in the RR occurred in 43.8%, 26.9%, and 16.9% of the patients, respectively. Breathing 35% O2 for 10 min 10 min after arrival in the RR, as well as 20 min and 1 hr after arrival, significantly increased SaO2 above the SaO2 level after breathing room air by 5.7% (P less than 0.001), 4.3% (P less than 0.001), and 4.0% (P less than 0.001), respectively. A significant multiple correlation was found between low SaO2 levels while breathing room air on arrival in the RR and fentanyl dose, age, and concentration of halothane used intraoperatively (R = 0.46; P less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2764290 TI - Solubility of I-653, sevoflurane, isoflurane, and halothane in plastics and rubber composing a conventional anesthetic circuit. AB - This study defines some characteristics of a standard anesthetic circuit that may impede anesthetic induction and recovery with I-653, sevoflurane, isoflurane, and halothane. Partition coefficients for anesthetic circuit components (masks, bellows, bags, airways, and circuit tubes) consistently ranked halothane greater than isoflurane greater than sevoflurane greater than I-653, suggesting a reverse order of washin and washout rates for an anesthetic circuit constructed from similar components. Consistent with this prediction, the concentrations of I-653 increased and decreased more rapidly than those of the other agents at any flow rate during washin (0.5, 1, or 2 L/min gas inflow rates) or washout (1, 3, or 5 L/min) in a conventional anesthetic circuit. The rates of change in I-653 concentration closely approximated the maximal possible theoretical rates. Our results suggest that absorption of I-653 by circuit components or soda lime should not hinder induction of or recovery from anesthesia. PMID- 2764291 TI - Ether does not antagonize bronchoconstriction caused by acetylcholine, histamine, or phenylephrine. AB - The effect of ether as a possible antagonist of mediator-effected bronchoconstriction was tested in eight anesthetized, paralyzed, and mechanically ventilated baboons. Ether administered intravenously had no effect on bronchoconstriction caused by acetylcholine, histamine, or phenylephrine administered by the same route, either alone or in combination with propranolol. PMID- 2764292 TI - Autotransfusor removal of fentanyl from blood. PMID- 2764293 TI - Ulnar train-of-four stimulation in predicting face movement during intracranial facial nerve stimulation. PMID- 2764294 TI - Metabolism of isoflurane in patients receiving isoniazid. PMID- 2764295 TI - Intravenous injection of liquid halothane. PMID- 2764296 TI - Etomidate myoclonus and the open globe. PMID- 2764297 TI - "Sciatic radicular pain" or piriformis muscle syndrome? PMID- 2764298 TI - "Statistical power" and interpretation of small studies: does atracurium pretreatment reduce the incidence of succinylcholine fasciculations? PMID- 2764299 TI - Venous air embolism during hip arthrography. PMID- 2764301 TI - Pulse oximetry probe disconnection. PMID- 2764300 TI - The effect of fingerprinting ink on pulse oximetry. PMID- 2764302 TI - An anesthetic adapter for all metered dose inhalers that is readily available to all. PMID- 2764304 TI - Aminophylline reversal of midazolam sedation. PMID- 2764303 TI - Inability to thread epidural catheter through epidural needle. PMID- 2764305 TI - Severe lightning pain after spinal anesthesia in a patient with tabes dorsalis. PMID- 2764306 TI - Segmental early relaxation of the left ventricle. AB - The clinical, electrocardiographic, and angiographic findings of 90 patients, whose RAO 30 degrees left ventriculograms showed segmental early relaxation (SER), were compared with those of 100 patients without SER. There were no significant differences in age and sex distribution or in clinical and coronary angiographic findings between the two groups. There was, however, a significantly lower prevalence of pathologic Q or QS patterns in the anterior leads of the ECG in the group with SER. SER occurred more frequently in segments with well preserved systolic contraction and was confined to the anterolateral segments in the great majority of the patients (80%). An inverse correlation was found between SER and geographically related critical coronary artery stenosis. PMID- 2764307 TI - Diagnosis of arteriosclerosis obliterans by impedance technique with special reference to relative blood flow of the lower extremity. AB - Simultaneous recordings of impedance cardiography of the chest and impedance plethysmography of the lower extremity were performed on 105 limbs with or without arteriosclerosis obliterans (ASO) documented by angiography. The ratios of blood flow to the lower extremity--leg stroke volume/cardiac stroke volume- (LSV/CSV) were 11.2 +/- 3.3% in normal male subjects, 11.1 +/- 5.5% in normal female subjects, and 3.1 +/- 1.2% in lower extremities with ASO, respectively. The normal value (range) for LSV/CSV calculated from the normal groups by the percentile method was between 4.9% and 17.8%, and the diagnostic accuracy of this value was 100% for sensitivity and 97.5% for specificity. LSV/CSV is a good index for the diagnosis of ASO and makes it possible to minimize error when expressed as an absolute value. PMID- 2764308 TI - Urinary excretion of connective tissue protein markers in arterial disease. AB - In diseases of major arteries there is an increased turnover of connective tissue components. This implies a greater excretion of fragments of collagen and elastin. The changes for each of these may be useful in further delineating the nature of the disease. In a preliminary study, the urine of 10 Marfan's syndrome patients was analyzed. The hydroxyproline (collagen) concentration was up to eight times higher than that of control subjects. The desmosine (elastin) crosslink concentration was either normal or slightly reduced in these patients. The mean of the ratio of hydroxyproline to desmosine was nearly seven times higher in the patients. PMID- 2764309 TI - Usefulness of angiography in studying carcinoma of the bladder. AB - Angiography of the pelvic vasculature can be quite helpful in assessing bladder tumors, for it provides useful results both when used alone and when used in combination with other methods. It is especially useful when there is doubt about the results of simpler methods, particularly in younger patients. PMID- 2764310 TI - Catheter atherectomy: functional results in peripheral arterial disease. AB - In 10 patients with peripheral arterial disease (PAD) atherectomy was performed with the Simpson atherectomy catheter. PAD was diagnosed by clinical evaluation, oxzillography, Doppler ultrasound examination, treadmill walking, and angiography. Eight patients belonged to stage II and 2 to stage IV. Two stenoses were located in the iliac artery, and the others in the superficial femoral artery or popliteal artery or both. The treadmill walking distance before the intervention ranged from 24 to 67 m before and 105 to 115 m after the procedure (speed 2 mph; gradient 12.5%). After atherectomy, the walking distance improved by 35% to 126%. No patient in stage II perceived pain. In these patients treadmill exercise was terminated because of dyspnea. The ankle/arm ratio (Doppler ultrasound) ranged from 0.4 to 1.0 before atherectomy with a mean improvement of 0.15 afterward (stages II and IV). Control angiography within three to six months in 4 patients did not reveal any significant change at the site of the original stenosis. PMID- 2764311 TI - Experimental atherosclerosis and oxygen free radicals. AB - Oxygen free radicals are known to produce cellular injury by peroxidation of phospholipids in the cell membrane. These free radicals might damage the endothelial cell and thus set the stage for atherosclerosis. The authors studied the effect of high-cholesterol diets on the genesis of atherosclerosis and lipid peroxidation products, malondialdehyde (MDA) in rabbits. The animals were divided into four groups each comprising 5 rabbits, on the basis of their diets. Group I, control diet; group II, cholesterol; group III, coconut oil; group IV, a mixture of cholesterol, coconut oil, and cholic acid. Rabbits were sacrificed five months after being on the respective diets. Blood samples were obtained for the measurements of total cholesterol, high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), very low density lipoprotein cholesterol (VLDL-C), triglycerides, and MDA at the end of the protocol. The aortas were removed from different animals for the identification of atherosclerotic plaques. Plaques were detected in all the animals in group II and group IV. The serum total cholesterol, LDL-C, and VLDL-C were significantly higher in animals of group II and IV than in those of group I. The values for serum total cholesterol, HDL-C, LDL-C, and VLDL-C in group III were not significantly different from those in group I. The blood MDA and serum triglycerides were also higher in animals of group II and IV than in those of group I. There were, however, no significant differences in these parameters in group III as compared with those in group I.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2764312 TI - Rate-dependent ST segment depression--a case report. AB - A patient with resting heart rate over 100 beats per minute (bpm) displayed 1.5-2 mm ST segment depression in her ECG during daily activities. She had unprovoked further increase in her heart rate up to 145 bpm, and during these episodes, her ECG displayed further ST segment depression up to 3 mm and of 0.12 second duration. An organic cause could not be found to explain her sinus tachycardia. Results of all laboratory investigations, including coronary angiography, were normal. It was observed that during an episode of reflex vagotonia, when her heart rate was below 95 bpm, her previously depressed ST segments became isoelectric. With the thought that this patient's ST segment depression was rate dependent, carotid sinus massage was performed, and when the heart rate slowed to 95 bpm her depressed ST segments became isoelectric. The same response was accomplished with beta blockers. Sympathetic hyperactivity was thought to be the most likely mechanism of ST segment depression in this patient. A critical increase in heart rate caused these ECG abnormalities. PMID- 2764313 TI - Occult pulmonary artery associated with failure to thrive and recurrent pneumonia -a case report. AB - Occult pulmonary artery is an uncommon cardiovascular defect. Associated symptoms include recurrent pulmonary infections and congestive heart failure. The authors describe a one-year-old boy initially diagnosed as having broncho-pulmonary dysplasia who developed severe failure to thrive, recurrent pneumonias, and pulmonary hypertension. The presence of an occult right pulmonary artery was suspected by lung perfusion scan and diagnosed by cardiac catheterization and angiography. After surgical repair, his clinical course improved and his growth and development were normal. This case demonstrates the importance of including occult pulmonary artery in the differential diagnosis of infants with failure to thrive associated with recurrent pulmonary infection. PMID- 2764314 TI - Hypersensitivity angiitis associated with naproxen. AB - A 52-year-old male developed cutaneous necrotizing vasculitis, renal failure, massive proteinuria, and elevated serum IgE levels following oral naproxen therapy. Renal biopsy specimen revealed cellular crescents in more than 40% of the glomeruli and a rare arteriole displayed thickening and eosinophilia of intima. Electron microscopic examination showed fusion of epithelial foot processes. Discontinuation of naproxen therapy was associated with disappearance of cutaneous lesions and improvement of renal function. PMID- 2764315 TI - The effect of bacterial infection in the worsening of atopic dermatitis: correlations with humoral immunologic patterns. AB - The contribution of secondary infection to severity and tendency to relapse in atopic dermatitis during childhood has been assessed. A total of 57 children aged between 4 months and 14 years were followed for an average of 4.73 months. A secondary infection was diagnosed in 22 (31.4%) of 70 relapses, since the lesions only subsided with antibiotics active on the bacteria isolated from the skin, usually a coagulase-positive Staphylococcus aureus. The eczema was more severe at presentation and hypogammaglobulinemia G more often found in those children who were more susceptible to secondary infections. The hypogammaglobulinemia G was present in 13 out of the 57 patients, but it normalized with age and was not correlated with IgE levels. In the children in whom the relapse or the worsening of the eczema could be attributed to secondary infection because of the positive response to the antibiotic treatment, the lesions had the appearance of pustules or showed more exudation, although in some cases only the worsening of the erythema and itching was observed. A secondary bacterial infection should be considered a likely cause of relapse or worsening of atopic dermatitis. Furthermore it may be that, at least in first year of life, hypogammaglobulinemia G is part of an immunologic impairment of atopic dermatitis which favors the susceptibility to secondary infections. PMID- 2764316 TI - (Radio) rocket immunoelectrophoresis a useful screening method for house dust extracts. AB - House dust (HD) extracts prepared from HD collected in households from West Germany, USA, and Spain were investigated by (radio) rocket immunoelectrophoresis. By pouring agarose gels containing different antisera side by side in strips onto a glass plate, the antigen/allergen components of HD extracts could be detected simultaneously in one electrophoretic separation. In addition to mite and animal dander, antigens/allergens of pollens, mold and food (ovalbumin and cow serum) could be detected in most of the extracts. PMID- 2764317 TI - Glucocorticosteroids attenuate aspirin-precipitated adverse reactions in aspirin intolerant patients with asthma. AB - We evaluated the effects of corticosteroid pretreatment on the intensity of adverse reactions to aspirin during carefully controlled aspirin challenges in 13 aspirin-sensitive asthmatics. Two studies were performed. First, using a double blind crossover design, we administered to five patients 75 mg prednisone daily or placebo for two days preceding the challenge. No consistent protection against adverse reactions was achieved. In the second study, a 10-day pretreatment with 15 mg oral prednisolone and topical intrabronchial and intranasal beclomethasone offered total clinical protection against bronchospasm produced by threshold doses of aspirin in five of eight patients. In two others, the bronchospasm provoked was less severe, and only in one patient did its intensity remained unchanged. There was a significant reduction in fall of mean pulmonary function tests following the second aspirin challenge, which was performed after ten days of steroid treatment. Steroids given for ten days also prevented significantly nasal discharge and nasal blockade. When diagnostic challenge tests with aspirin are carried out in asthmatic patients on long-term corticosteroid therapy, there is an increased possibility of false negative results. PMID- 2764318 TI - Contribution of peer review to scientific progress. PMID- 2764320 TI - Epinephrine doses in cardiac arrest: is it time to outgrow the orthodoxy of ACLS? PMID- 2764319 TI - Evaluation of colorimetric dipstick test to detect alcohol in saliva: a pilot study. AB - The Alco Screen Saliva Dipstick is an inexpensive, easy-to-use, colorimetric test that gives a semiquantitative estimation of the blood alcohol value by measuring the relative concentration of salivary alcohol. To evaluate its accuracy, we compared the results from tests with the Alco dipstick with values from simultaneously measured blood alcohol tests in 53 patients who were suspected of having ingested alcohol. The correlation between Alco dipstick results and blood alcohol values was strong (r [Spearman's rho], + .91). When the blood alcohol concentration was 0.1 g/dL or more, the Alco dipstick test was 90.9% sensitive, 71.4% specific, and 92% efficient. At Alco dipstick values of 0.02 and 0.05 g/dL, however, semiquantitative concordance was unsatisfactory. Nevertheless, even at the 0.05-g/dL value of salivary alcohol, the test was still valuable as a screen of de facto alcohol ingestion. Definitive diagnosis of relative alcohol intoxication requires confirmatory breath or blood alcohol concentrations by standard methodologies. PMID- 2764321 TI - Injury prevention and the call of the wild. PMID- 2764322 TI - 'Things are seldom what they seem...'. PMID- 2764324 TI - Progress in blood warming. PMID- 2764323 TI - Questions on cardiac pacing. PMID- 2764325 TI - Bedside cerebrospinal fluid glucose analysis. AB - We studied the reliability and accuracy of a two-minute reagent strip (Chemstrip bG) and hand-held autoanalyzer (Accu-Chek IIR) for determining cerebrospinal fluid glucose. We found that both bedside methods were highly reliable (r = 0.93, Chemstrip bG: r = 0.95, Accu-Chek II) and were very accurate (89.7% and 96.6% accurate at +/- 15 and 20 mg/dL, respectively, for the Chemstrip bG: 91.7% and 95.8% accurate at +/- 15 and 20 mg/dL, respectively, for the Accu-Chek II) over a wide range of glucose values in 237 determinations. There was no significant difference between the two bedside methods. We conclude that these two methods of bedside glucose estimation are both highly reliable and accurate and could be used to quickly determine patients' cerebrospinal fluid glucose values. PMID- 2764326 TI - Trauma score versus revised trauma score in TRISS to predict outcome in children with blunt trauma. AB - We analyzed the accuracy of TRISS and a revised TRISS to predict survival outcome in a group of 1,562 consecutive children less than 15 years old admitted with blunt trauma to a pediatric trauma center. TRISS is an index that computes a probability of survival for each patient based on Trauma Score, Injury Severity Score, and age. R-TRISS uses the Revised Trauma Score instead of the Trauma Score. We used a statistical method based on TRISS and R-TRISS to compare patient outcomes from the pediatric study group with those of an adult baseline control group from the Major Trauma Outcome Study. Both TRISS and R-TRISS have the capability to accurately quantify survival outcome for children with blunt trauma; there was no statistical difference between the two methods to do so. PMID- 2764327 TI - A practical radiographic comparison of short board technique and Kendrick Extrication Device. AB - Cervical spine immobilization is necessary during the prehospital care of most trauma patients. Earlier studies performed in controlled, indoor settings suggested short board technique (SBT) was the standard against which other methods of cervical stabilization should be measured. Our study approximated the prehospital setting by comparing the use of tape, SBT, and Philadelphia collar (PC) with tape, the Kendrick Extrication Device (KED), and PC after immobilization in and extrication from a compact car. Seven men were immobilized with KED and SBT in addition to PCs and tape. These subjects were extricated and then taken by ambulance stretcher across a 50-yd length of concrete to the radiology suite. Flexion, extension, lateral bending, and rotation were measured. KED-PC (16 degrees +/- 8 degrees) was statistically superior to SBT-PC (41 degrees +/- 5 degrees) in limiting rotation (P less than .001). KED-PC and SBT-PC were similar in their abilities to limit extension (8 degrees +/- 4 degrees vs 6 degrees +/- 5 degrees), flexion (4 degrees +/- 2 degrees vs 4 degrees +/- 4 degrees), and lateral bending (13 degrees +/- 5 degrees vs 17 degrees +/- 6 degrees). In an approximation of the prehospital setting, tape, a PC, and either KED or SBT substantially limit extension, flexion, and lateral bending of the normal cervical spine. KED-PC is more beneficial in rotation. PMID- 2764328 TI - Pharyngeal tracheal lumen airway training: failure to discriminate between esophageal and endotracheal modes and failure to confirm ventilation. AB - The pharyngeal tracheal lumen (PTL) airway is a new airway control device for emergency medical technicians (EMTs) and paramedics and functions as either an esophageal obturator or an endotracheal tube. We developed a ten-step PTL airway training protocol that included proper airway insertion, patient ventilation, and confirmation of tube placement by auscultation. We then prospectively evaluated the effectiveness of training by testing the ability of 32 EMTs and paramedics to discriminate between esophageal and endotracheal mode placement. Training consisted of a group demonstration followed by supervised individual practice on a Laerdal Adult Intubation Model. All 70 insertion attempts resulted in esophageal obturator mode placement. As a result, trainees did not have an opportunity to practice discrimination between esophageal and endotracheal placement. Six weeks after initial training, 19 of the entry group were randomly and blindly assigned to ventilate each of two Laerdal models that had been previously intubated with the PTL, one in esophageal mode and the other in endotracheal mode. In the esophageal mode, 15 of 19 trainees (79%) correctly selected the esophageal port to ventilate, but four (21%) could not decide and abandoned the airway. In the tracheal mode, 16 of 19 trainees (84%) correctly selected the tracheal port to ventilate, one (5%) was unable to decide, and two (10.5%) selected the wrong tube and attempted ventilation with the esophageal port even though the tracheal balloon was completely occluding the airway. Ventilation was confirmed with auscultation in only 50% of the attempts (19 of 38). Our study indicates that the training protocol was inadequate to teach critical decision-making in the use of the PTL airway.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2764329 TI - Emergency department revisits. AB - We reviewed the charts of patients returning within 72 hours to our emergency department to determine whether monitoring revisits is a useful quality assurance indicator. Patient visits for June and December 1987 were selected to eliminate a potential seasonal difference. Of the 13,261 visits during these two months, 455 (3.4%) were revisits within 72 hours. Charts were available on 444 patients, of whom 407 (91.7%) represented cases in which the return and the initial visits were clearly related. Charts were reviewed for deficiencies in medical management, appropriate prescribed follow-up, patient education, and patient compliance. Suspected medical management problems were discussed by the three senior authors, and a consensus decision was made. Return visits were considered avoidable if a deficiency was noted in at least one of the areas listed above. There were 297 unscheduled related return visits, 96 (32.3%) of which were avoidable. Of these avoidable visits, 38 (39.6%) had medical management deficiencies, 14 (14.6%) had inappropriate prescribed follow-up, 20 (20.8%) had not been given proper education, and 35 (36.5%) were due to patient noncompliance. Of the 110 scheduled return visits, there was one (0.9%) deficiency in medical management and none in the other categories. Of the unscheduled return visits, 146 (49.2%) returned within 24 hours; 89 (30.0%) between 24 and 48 hours; and 62 (20.8%) between 48 and 72 hours. Of the avoidable visits, 85% returned within 48 hours, as did 92% of those with medical management deficiencies.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2764330 TI - Experience with a mobile coronary care unit in Brisbane. AB - We examined the performance of a hospital-based mobile coronary care unit staffed by emergency physicians, coronary care nurses, and ambulance personnel in a metropolitan setting (Brisbane, Australia). Our unit attended 2,260 calls during 18 months of operation. Standard dispatched ambulances arrived first to 78% of the 2,260 calls. Ten percent of these calls were to patients who had died or had arrested; 45% of these patients were found in ventricular fibrillation and 10% were discharged alive from the hospital. Survival was related to the performance of CPR before the arrival of the unit and to the finding of ventricular fibrillation. As the success of our unit was clearly inferior to that reported from centers where the first-responders are licensed to defibrillate, its operations have ceased and regular ambulance crews are being taught to recognize and treat patients with ventricular fibrillation. PMID- 2764331 TI - Mountaineering and rock-climbing injuries in US national parks. AB - Mountaineering and rock climbing have become increasingly popular in recent years and involve an estimated 100,000 participants; accordingly, the number of climbing-related injuries has also increased. We analyzed 127 climbing-related injuries reported to the US National Park Service in 1981 and 1982, 36 (28%) of which were fatal. Falls accounted for 75% of all climbing-related injuries; median length of fall was 91 m for fatal injuries and 9 m for nonfatal injuries. The majority of injuries (69%) occurred while ascending. Falls on snow or ice were longer than falls on rock, and injuries on snow or ice were more likely to be fatal. We discuss considerations and strategies for the prevention of climbing related injuries. A new conceptual model suggests that the methods of traditional mountaineering safety programs may be of limited efficacy in further reducing the number of climbing-related injuries. PMID- 2764332 TI - Unsuspected foreign body in the frontal sinus and anterior cranial fossa. AB - We present the case of a 46-year-old man who was involved in a motor vehicle accident in which his forehead struck the dashboard of his semi-tractor trailer. A toggle switch penetrated the anterior and posterior tables of his frontal sinus and lodged in the frontal lobe. The foreign body was not found on physical examination at an emergency care facility. The wound was closed, and the patient was sent home. Severe headaches prompted his return the next day. Skull roentgenograms showed the toggle switch, and the patient was referred to our institution for definitive care. This unusual case serves to emphasize the potential for a foreign body to penetrate the frontal sinus with few physical findings. PMID- 2764333 TI - Hysterical stridor: a benign cause of upper airway obstruction. AB - We present the cases of three patients with stridor that resolved spontaneously. Paradoxical vocal cord motion was documented in one patient. Normal vocal cord motion was present in the other two patients, but stridor had resolved in both cases. Many different terms have been used to describe this entity in the literature. Emergency physicians must recognize the subtle signs of hysterical stridor. Once more serious etiologies are ruled out, sedation and reassurance instead of aggressive airway intervention are required for this benign condition. PMID- 2764334 TI - Management of hemorrhage from severe scalp lacerations with Raney clips. AB - A 23-year-old man was assaulted about the head and face with a wrench, sustaining multiple severe scalp lacerations. Massive bleeding from the lacerations ensued, resulting in refractory hypovolemic shock. Emergency department control of this hemorrhage was accomplished by the application of Raney clips to the edges of the scalp lacerations. Following stabilization and radiologic studies, the patient was admitted to the ICU, where his scalp wounds were managed definitively. The remainder of his hospital course was unremarkable, and he was discharged on the third hospital day to be followed in the surgical clinic as an outpatient. PMID- 2764335 TI - Problem-based ACLS instruction: a model approach for undergraduate emergency medical education. AB - The optimal format for teaching advanced cardiac life support (ACLS) to medical students and other groups with little emergency medicine experience has not been studied extensively. We report an ACLS provider course that was taught to sophomore medical students using a self-directed, problem-based learning model. The traditional two-day provider course format was replaced by a series of clinical problems that emphasized various aspects of the ACLS curriculum. Students then met weekly with an ACLS instructor who served as a tutor to discuss the problem. A specific set of learning objectives for the entire ACLS curriculum was developed into a study unit index and given to students at the beginning of the course. Enhanced practice time was offered to students in the form of traditional teaching stations and skills laboratories. Students were tested using standard ACLS criteria. The students in the problem-based course achieved a higher pass rate on the written test and skills stations than senior medical students did in a standard two-day course during the same time period. The problem-based format with enhanced practice time would appear to be an effective alternative for groups that need to acquire the basic skills needed in a resuscitation attempt but have little previous experience in this area. PMID- 2764336 TI - Oral vaccination of dogs fed canine adenovirus in baits. AB - Six groups of 5 dogs each were fed dilutions of canine adenovirus-2, either as raw liquid or after insertion into cornmeal baits. By the fourth week after vaccination, 29 of the 30 dogs developed high titers of serum-neutralizing antibodies to the virus. PMID- 2764337 TI - Survival analysis for evaluation of corneal ulcer healing times in calves with naturally acquired infectious bovine keratoconjunctivitis. AB - A clinical trial examining the efficacy of 2 drugs for treatment of a natural epizootic of infectious bovine keratoconjunctivitis was performed. The study was conducted in 103 grazing Hereford calves during the summer of 1985. The calves were prospectively and randomly assigned to 1 of 3 groups at the beginning of the study on June 17, and were examined 3 times weekly thereafter until the final observation on August 6. Calves in group 1 (n = 34) were not treated and were used as controls. Calves of group 2 (n = 34) with corneal ulcers were treated with a long-acting oxytetracycline formulation (OTC group). The parenteral treatment was repeated in 72 hours. Affected calves of group 3 (n = 35) were treated topically with furazolidone spray when they developed new corneal ulcers, or when existing lesions worsened during subsequent examination periods (NFZ group). Healing times of the corneal ulcers were reported in 3 ways: the combined times for ulcers present in both eyes of a calf simultaneously (method A), independent times of each ulcer on a calf (method B), and time of the first ulcer for each calf (method C). Censored healing times were examined as left censored (ulcer present at the beginning of the study), right censored (ulcer not healed at the end of the study), or uncensored (true) healing times. The effect that the treatments had on healing times were investigated by use of notched box and whisker plots, life tables, and Cox regression models. The analysis indicated that treatment of calves with either antimicrobial reduced the healing time of corneal ulcers, compared with untreated controls.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2764339 TI - Collection of bronchoalveolar lavage fluid in cats, using an endotracheal tube. AB - Bronchoalveolar lavage fluid was collected from 12 anesthetized cats by use of an endotracheal tube and syringe adapter. The safety of the technique was evaluated by monitoring mucous membrane color, capillary refill time, pulse rate, respiratory rate, ECG, and arterial blood gas tensions and by necropsy findings. Group A consisted of 3 cats that were administered (by lavage) 4 aliquots of 20 ml of saline solution during anesthesia for placement of femoral artery catheters. Group B consisted of 4 cats that were administered a smaller total volume of saline solution (3 aliquots of 5 ml/kg of body weight) during a separate anesthetic period, other than the one for placement of catheters. Group C consisted of 5 cats administered 3 aliquots (5 ml/kg) of saline solution during a separate anesthetic period and administered supplemental oxygen for 5 to 10 minutes before and for 20 minutes after the lavage procedure. Group-A cats had a prolonged recovery period that was attributed to the lengthy anesthetic period required for placement of femoral catheters. The effect was eliminated in the cats of the other groups in which the lavage procedure itself accounted for only 5 to 10 minutes of anesthetic time. Evaluation of mucous membrane color, capillary refill time, ECG, pulse, and respiratory rate revealed no persistent abnormalities. Transient increase in pulse and respiratory rate was seen in some cats. Blood gas analysis revealed noticeable decrease in arterial oxygen pressures (Pao2) after the lavage procedure. In group-C cats, oxygen supplementation allowed the maintenance of normal or above normal Pao2.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2764338 TI - Xeroradiographic evaluation of the equine larynx. AB - The normal radiographic anatomy of the equine larynx was determine by use of xeroradiography and dissection. The body and laminae of the thyroid cartilage, the muscular process of the arytenoid cartilages, and the dorsal lamina and arch of the cricoid cartilage had radiographic evidence of mineralization (calcification) and/or ossification in clinically normal horses. There was a significant (P less than 0.01) increase in the degree of mineralization of the thyroid and arytenoid cartilages with advancing age. Horses with diagnosis of arytenoid chondrosis (arytenoid chondral dysplasia, arytenoid chondropathy) by use of endoscopy had radiographic changes that included: enlargement with increased density of the arytenoid cartilage region, abnormal patterns of mineralization (dystrophic mineralization or osseous metaplasia), abnormal contour of the corniculate process(es) and laryngeal masses, sometimes obliterating part or all of the lateral laryngeal ventricles. PMID- 2764340 TI - Vascular anatomy of the equine small colon. AB - The vasculature of 22 small colons from dead adult ponies was perfused with latex or barium sulphate solution. The vascular anatomy was studied by use of dissection and alkali digestion of the latex specimens and microangiography of the barium sulphate-perfused specimens. The small colon is supplied by the caudal mesenteric artery. The left colic artery arises from the caudal mesenteric artery, which then becomes the cranial rectal artery. Branches from the left colic and cranial rectal arteries form anastomosing arcades that become narrower distally along the length of the small colon. From these arcades arise terminal arteries, which enter the small colon wall and give rise to a subserosal, an intermuscular, and a large submucosal plexus, with frequent anastomoses between them. The venous drainage closely parallels the arterial supply, except near to its origin from the portal vein, when the left colic vein and caudal mesenteric vein are separate from the corresponding arteries. PMID- 2764341 TI - Normal blood supply to the canine mandible and mandibular teeth. AB - The normal blood supply to the canine mandible and mandibular teeth was determined by microangiography and correlated histology. Branches of the inferior alveolar artery supplied the cortical bone of the mandibular body. Vessels from the periosteal and endosteal surfaces supplied symphyseal cortical bone. Direct vascular anastomoses were not found to cross the fibrous mandibular symphysis. Blood supply to the mandibular teeth was via dental arteries derived from the inferior alveolar artery, with interdental and interradicular arteries supplying the alveolar bone and periodontal ligament. PMID- 2764342 TI - Scanning electron microscopy of corrosion casts of the optic nerve microcirculation in dogs. AB - Scanning electron microscopy of vascular corrosion casts of the optic nerve region in normal and glaucomatous Beagles demonstrated that the blood supply to the laminar optic nerve is derived from short posterior ciliary arteries, cilioretinal arteries, and longitudinal pial vessels. The short posterior ciliary arteries formed a ring of striated pillars around the scleral canal. The central retinal artery was not present in the dog. Differences between the casts in normal and glaucomatous dogs were not detected. PMID- 2764343 TI - Failure of aspirin to impair bovine platelet function. AB - The effect of aspirin on bovine platelet function and thromboxane A2 (TXA2) production in stimulated platelets was evaluated. A single dose of aspirin (100 mg/kg of body weight) was administered orally to Holstein cows, and blood samples were obtained before and at regular intervals for 7 days after treatment. The production of TXA2 was assessed by measuring the stable metabolite thromboxane B2, using a specific radioimmunoassay. Within 4 hours of aspirin administration, the production of TXA2 was significantly (P less than 0.05) decreased, irrespective of whether collagen, adenosine diphosphate, or platelet activating factor was used to initiate platelet aggregation. Despite the inhibition of TXA2 release from the stimulated platelets, platelet function, assessed by initial rate of aggregate formation and extent of aggregation, was unaffected by aspirin administration. The extent of aggregate formation in response to collagen, adenosine diphosphate, or platelet activating factor was independent of the amount of TXA2 released from platelets before and after aspirin treatment. The results suggested that TXA2 formation is not the primary biochemical pathway involved in the aggregation of stimulated bovine platelets. PMID- 2764344 TI - Tissue sulfonamide concentration and correlation in turkeys. AB - Nineteen hen turkeys (10 to 12 kg each) were used in a feeding study to determine sulfadimethoxine and sulfaquinoxaline concentrations in blood serum, liver, and skeletal muscle, as well as the respective ratios at selected withdrawal intervals. Two feeds were prepared by use of premixes to achieve 60 mg of sulfadimethoxine/kg and 100 mg of sulfaquinoxaline/kg, respectively. Each of the medicated feeds was given to 9 turkeys for 7 days. The turkeys were then fed nonmedicated feed at intervals from 24 to 56 hours and were slaughtered. One turkey was used as control. The serum/liver and serum/muscle ratios for sulfaquinoxaline were 60 to 70% higher than for sulfadimethoxine. However, the liver/muscle ratio for both sulfonamides was equivalent, approximately 3. Disposition of both sulfonamides approximated first-order pharmacokinetics. The calculated half-life of sulfadimethoxine was half that of sulfaquinoxaline, approximately 16 vs 30 hours. The coefficients of variation in the serum/tissue ratios for both sulfonamides were between 13% and 25% for serum/liver and less than 15% for serum/muscle, indicating excellent potential for using serum as a predictor of actionable concentrations of sulfonamide residues. PMID- 2764345 TI - Ultrastructural changes in laminar optic nerve capillaries of beagles with primary open-angle glaucoma. AB - Ultrastructural examination of optic nerve capillaries in the canine lamina cribrosa revealed many spherical, membrane-bound, electron-dense inclusions that closely resembled Weibel-Palade bodies, in pericytes and endothelial cells of preglaucomatous, early, moderately, and advanced affected Beagles with hereditary primary open-angle glaucoma. This ultrastructural difference between the laminar capillary endothelial cells of normal and glaucomatous Beagles could represent a functional vascular disorder, because Weibel-Palade bodies are associated with microcirculatory abnormalities. PMID- 2764346 TI - Morphologic changes in the lamina cribrosa of beagles with primary open-angle glaucoma. AB - Optic nerve axoplasmic flow is known to be impaired at the scleral lamina cribrosa in Beagles with hereditary primary open-angle glaucoma and is similar to the condition in human beings. Trypsin and detergent digestion to remove all neural, vascular, and glial cellular tissue revealed a well-developed scleral lamina cribrosa in the normal dog in this study. Beagles with primary open-angle glaucoma had signs of mechanical distortion of the anterior lamina cribrosa prior to the detection of ophthalmoscopic changes in the optic nerve head. This change in the supporting architecture of the optic nerve began early and increased in severity as the disease process progressed. PMID- 2764347 TI - Effects of testosterone on the prevention of T-2 toxin-induced adrenocortical necrosis in mice. AB - To evaluate the effect of exogenous testosterone on the development of T-2 toxin induced necrosis of adrenal glands, mice were allotted to 3 treatment groups. Each treatment group contained castrated male, and castrated and sexually intact female mice. Each mouse in group 1 was given 0.16 mg testosterone propionate at 48-hour intervals for a total of 12 injections, group-2 mice were given similar injections of only the vehicle, and group-3 mice were given no treatment. Twenty four hours after the last injection, the mice in all 3 groups were exposed for 10 minutes to an aerosol of T-2 toxin. All mice alive at 24 hours after exposure were euthanatized and the adrenal glands and thymuses were examined histologically. Necrosis of the adrenal cortex was not found in any of the mice given preexposure treatment with exogenous testosterone, whereas all mice given vehicle only or no treatment had T-2 toxin-induced necrosis of the inner portion of the adrenal cortex. Lymphocytolysis in the cortex of the thymus confirmed that each mouse of all 3 treatment groups had experienced systemic mycotoxicosis. The uniform severity of the lesion in all mice suggests that the thymus was not protected by exogenous testosterone administration or by the castration status of the mice. We propose that T-2 toxin-induced adrenal necrosis in mice is prevented by the presence of testosterone. PMID- 2764348 TI - Effect of xylazine treatment on equine proximal gastrointestinal tract myoelectrical activity. AB - Five 5 to 6 month old horses were surgically prepared with silver electrodes sutured to the serosa of gastric antrum, duodenum and proximal portions of the jejunum. Normal migrating motility complex (MMC) periodicity was determined during daytime hours in horses that were fed and horses from which food was withheld for 24 hours. Periodicity was defined as time span from the end of one period of regular spike activity (RSA) to the end of the next RSA in the MMC. The periodicity was 120.5 +/- 9.5 (SEM) minutes in horses from which food was withheld, and was 125.7 +/- 20.3 minutes in horses fed hay free choice. Coincident with each duodenal RSA, antral spike activity ceased. Xylazine (0.25 and 0.5 mg/kg), given IV during the period of intermittent spike activity of the MMC to either fed or unfed horses induced, within 2 minutes, a RSA complex in the duodenum that migrated to the proximal portion of the jejunum. This was followed by a period of no spike activity of normal duration, which proceeded on to a period of intermittent spike activity of varying duration to complete the MMC cycle. Pretreatment IV administration of an alpha 2-adrenergic antagonist, tolazoline (1 mg/kg) also provoked a RSA complex, but blocked the xylazine effect. The results indicated that xylazine resets the duodenal MMC in the horse, but does not seriously disrupt proximal gastrointestinal tract motility, and that control of MMC periodicity in this region probably involves more than alpha 2 adrenergic receptors. PMID- 2764349 TI - Electromyographic activity of cubital joint muscles in horses during locomotion. AB - Electromyographic (EMG) activity of 4 muscles of the cubital joint and the strain of forelimb hooves were recorded telemetrically in 4 Thoroughbreds (with and without a rider) standing, walking, trotting, and cantering. Bipolar fine wire electrodes were inserted into the muscles, and strain gauges were attached to the hoof wall. Motion pictures (16 mm), synchronized with EMG tracings, were taken to obtain kinematic data. When horses were standing, the biceps brachii had tonic activity, but the brachialis and the caput longum and the caput laterale of the triceps brachii had no EMG activity. The biceps brachii had EMG activity during the stance phase. The brachialis had EMG activity from the end of the stance phase to the middle of the swing phase. Unlike the biceps brachii, the brachialis acted as a flexor muscle of the cubital joint during locomotion. The EMG activity of the caput longum of the triceps brachii was detected from midswing phase to early stance phase. The EMG activity of the caput laterale of the triceps brachii began in midswing or late-swing phase and ceased in early stance or midstance phase. During locomotion, caput longum EMG activity always preceded caput laterale activity. When horses were cantering, the brachialis and the caput longum (acting mainly in the swing phase) had an EMG activity phase different from those in leading and trailing forelimbs. These 4 muscles had similar EMG activity patterns during locomotion in horses with and without a rider. PMID- 2764350 TI - Erythrocyte distribution in ducks. AB - A study on erythrocyte distribution was performed on 10 healthy, nonstressed adult white Pekin ducks. Results indicated 2 populations of erythrocytes, with average mean corpuscular volumes of 128.37 fl/cell and 308.50 fl/cell. Variations in erythrogram patterns were evident over time, when comparing specimens from different ducks or the same duck. There were 5 patterns of cell number/volume distribution observed between the 2 cell populations when all ducks were studied. Females had a greater change than did males when population density and volume percentage comparisons were made on erythrocyte compartments. PMID- 2764351 TI - Effects of intermittent and continuous administration of decoquinate on bovine coccidiosis in male calves. AB - Male Holstein calves were each inoculated with 350,000 sporulated oocysts of Eimeria bovis. Two calves were given decoquinate (0.5 mg/kg of body weight) continuously in dry feed for 29 days, and 2 calves each were given 0.5, 1, or 1.5 mg of decoquinate/kg on an every 2nd-or 3rd-day schedule for 29 days. Calves given decoquinate continuously did not discharge oocysts but had slightly loose feces. In general, the number of oocysts discharged increased and fecal consistency decreased as the time between feeding of medicated feed increased. Calves given 0.5 or 1.5 mg of decoquinate/kg every 3rd day discharged more oocysts and had more diarrhea than did calves given 1 mg of decoquinate/kg every 3rd day. At postinoculation day 29, calves were euthanatized. At necropsy, intestinal tissues of calves given decoquinate were mostly normal. Apparently, reduced infections along with the elapsed time were sufficient to resolve most intestinal lesions caused by the coccidia. Decoquinate was most effective when fed continuously at 0.5 mg/kg. However, when fed at 1 or 1.5 mg of decoquinate/kg every 2nd day or 1.5 mg of decoquinate/kg every 3rd day, oocyst production was reduced and clinical coccidiosis was prevented. PMID- 2764353 TI - Comments on pine needle-induced changes in cows having premature births. PMID- 2764352 TI - Controlled test of anthelmintic activity of a macrocyclic lactone (compound F28249-alpha) in lambs. AB - A controlled blind test was performed in 1984 to evaluate the anthelmintic activity of experimental formulations of compound F28249-alpha against gastrointestinal parasites in lambs in Kentucky. Twenty-five lambs were allotted to 5 groups of 5 lambs/group. The drug was administered SC to 2 groups (A, 0.2 mg/kg of body weight; B, 0.3 mg/kg) and orally to 2 groups (C, 0.2 mg/kg; D, 0.3 mg/kg). Group E received a placebo subcutaneously. Lambs were euthanatized 7 days after treatment for necropsy and identification and enumeration of worm parasites in the gastrointestinal tract. Group-E lambs harbored 7 genera (including 10 species) of nematodes and 1 genus of tapeworms. Worm collection data for group-A lambs indicated 97% to 100% of the mature Haemonchus, Ostertagia, Trichostrongylus, and Trichuris, and immature Haemonchus were removed; and 23% to 73% of the mature Cooperia, Nematodirus, and Strongyloides, and immature Nematodirus were removed. In group-B lambs, 94% to 100% of the mature Haemonchus, Nematodirus, Ostertagia, Trichostrongylus, and Trichuris, and immature Haemonchus were removed as were 70% to 84% of mature Strongyloides and immature Nematodirus, respectively, and 0% for mature Cooperia. The percentage of all nematodes removed in group C and D was 100%, except for Cooperia (95%) in group C and immature Nematodirus (93% and 95%), respectively. Toxicosis was not apparent. Small fibrotic or blood streaked lesions were observed at necropsy in muscle at the injection site of 2 lambs in group B and 1 lamb in group E. PMID- 2764354 TI - Congress modifies nursing's amendments. PMID- 2764355 TI - House adopts new structure for ANA. PMID- 2764356 TI - Representing RNs is major focus. PMID- 2764357 TI - RNs provide human touch in high-tech world. PMID- 2764358 TI - Nurses agree that technology enhances care. PMID- 2764359 TI - Computerized systems advance nursing care. PMID- 2764360 TI - AMA reports to House on RCT status. PMID- 2764361 TI - Seoul hosts world nursing community. PMID- 2764362 TI - Council acts on shortage of nurses. PMID- 2764363 TI - Joel recounts Beijing experience. PMID- 2764364 TI - The association of circulating endotoxin with the development of the adult respiratory distress syndrome. AB - Despite extensive investigation, the pathogenesis of the adult respiratory distress syndrome (ARDS) remains uncertain. As yet, there is no clear explanation of why some patients at risk for ARDS develop the syndrome, whereas others do not. Neutrophils and complement fragments have been implicated in the acute lung injury, but it is clear from published data that evidence of complement activation alone predicts neither the development nor the severity of ARDS. We investigated whether the combination of endotoxin, a leukocyte-priming agent, and complement fragments, leukocyte-stimulating agents, was associated with the development of ARDS. Ninety-eight patients were identified as being either at risk for the development of ARDS or having ARDS, and serial blood samples were obtained. There was no correlation between C5 fragments and the development of ARDS. C3 fragment levels were increased in 89% of the patients with ARDS, but they were also increased in 62% of patients at risk. Endotoxin was detected in 74% of the plasma samples obtained from patients at risk who subsequent developed ARDS and in 64% of the plasma samples obtained from the patients with ARDS. In contrast, only 22% of the plasma samples obtained from the patients at risk who did not develop ARDS had measurable endotoxin. We suggest that the combination of endotoxin and complement fragments may be one mechanism involved in the development of ARDS. PMID- 2764365 TI - Long-term respiratory support and risk of pneumonia in critically ill patients. Intensive Care Unit Group of Infection Control. AB - In 724 critically ill patients who had received prolonged (greater than 24 h) ventilatory assistance since admission to the ward, we analyzed the relationship between artificial ventilatory support and pulmonary infection. Two different approaches were used. The first, plotting the incidence of pneumonia versus the duration of ventilatory support, confirms previous data: the incidence rises from 5% in patients receiving one day of respiratory assistance to 68.8% in patients receiving more than 30 days. In the second approach, the same data were computed as an actuarial life table with the day of pneumonia onset as terminal event. This different approach, focusing on the onset of infection rather than on incidence, allows a new insight into the problem of nosocomial infection: pneumonia in patients with respiratory support is an early occurrence with a high and constant rate of acquisition and, therefore, a high risk of infection in the first eight to ten days. Later pneumonia acquisitions were rare, and the risk after ten days of ventilatory support is low. PMID- 2764366 TI - Diagnostic value of quantitative cultures of bronchoalveolar lavage and telescoping plugged catheters in mechanically ventilated patients with bacterial pneumonia. AB - We compared the diagnostic value of quantitative cultures of bronchoalveolar lavage (BAL) and telescoping plugged catheter (TPC) samples in 34 nonimmunocompromised, mechanically ventilated (MV) patients with suspected bacterial pneumonia. A control group of seven "noninfected" MV patients was also studied. In 92% of patients with bacterial pneumonia (32 of 34), simple endotracheal aspiration samples recovered one or more microorganisms. Both BAL and TPC samples cultured colony-forming units (cfu) greater than or equal to 10(3)/ml of one or more microorganisms in 56% (19 of 34) of patients. TPC and BAL culture results agreed on 88.5% (54 of 61) of the recovered microorganisms. Sterile TPC and BAL cultures agreed on 80% (4 of 5) of the cases. Microorganisms cultured from blood samples were also cultured from BAL and TPC specimens. Culture results from the two techniques completely disagreed in only one case (3%). In the control group, one TPC and two BAL cultures yielded microorganisms in cfu greater than or equal to 10(3)/ml. Specificities of BAL and TPC were 71 and 86%, respectively, whereas specificity of endotracheal aspiration was only 14%. Both the bacterial index obtained by TPC and BAL, as well as the quantitative cultures, correlated moderately well (r = 0.78 and 0.72, respectively, p less than 0.001 for both correlations). BAL and TPC results caused changes of antibiotic treatment in 11 of 23 survivors. Neither BAL nor TPC caused complications. Our results demonstrate that BAL and TPC diagnose bacterial pneumonia in MV patients with similar accuracy. Culture results from both techniques showed excellent qualitative and reasonable quantitative agreement. PMID- 2764367 TI - Aeroallergens in dairy barns near Cooperstown, New York and Rochester, Minnesota. AB - We sampled atmospheric barn air using a volumetric air sampler in ten barns near Cooperstown, NY and six barns near Rochester, MN, and, with radioimmunoassays, measured allergens of Aspergillus fumigatus, Thermoactinomyces vulgaris, Micropolyspori faeni, short ragweed, rye grass group I pollen, Alternaria (Alt 1), Dermatophagoides sp. Lepidoglyphus destructor, common insect allergen, mouse urine, rat urine, and cattle epithelium. The most abundant allergen present was A. fumigatus followed by L. destructor. This study provides initial data on barn aerobiology and demonstrates for the first time the abundance of L. destructor allergens in North American dairy barns. More comprehensive study of barns, poultry houses, confinement houses for swine, and other agricultural environments from various geographic locations is needed to define the allergen levels to which millions of farm workers are exposed each day. While most of the allergens were expected, the presence of airborne allergens reactive with antisera to Dermatophagoides suggests indirectly that substantial amounts of pyroglyphid mites are present in some barns. PMID- 2764368 TI - The influence of refractoriness to adenosine 5'-monophosphate on allergen provoked bronchoconstriction in asthma. AB - Repeated bronchoprovocation with adenosine 5'-monophosphate (AMP) in atopic, nonasthmatic subjects produces a state of refractoriness to the nucleotide that may be due either to depletion of preformed mediators from airway mast cells or down-regulation of purinoceptors on the surface of these cells. To investigate this further, we compared the effect on immediate allergen-provoked bronchoconstriction of preceding repeated challenges with histamine and AMP in eight atopic, mildly asthmatic subjects. In three successive AMP concentration response studies, the geometric mean PC20 AMP increased from 275.3 to 1154.3 (p less than 0.01) and 1976.7 (p less than 0.01) mg/ml, respectively, whereas no significant similar increase in PC20 occurred with repeated histamine challenges. Refractoriness to AMP was not associated with any significant decrease in airways responsiveness to histamine. When compared with the response after repeated provocation with inhaled histamine, repeated exposure of the airways to AMP potentiated, rather than inhibited, immediate allergen-induced bronchoconstriction by a mean 57 +/- 22.6% (p less than 0.05) when the data were expressed as the area under the FEV1-time response curve. The ability of airways that have been rendered less responsive to inhaled AMP to exhibit an increased response to allergen suggests that tachyphylaxis to AMP is unlikely to be caused by depletion of preformed mast cell-derived mediators such as histamine. PMID- 2764369 TI - Localization of the site of the bronchoconstrictor effects of leukotriene C4 compared with that of histamine in asthmatic subjects. AB - Although the sulfidopeptide leukotrienes are known to be potent bronchoconstrictors, the relative aerodynamic site of response to these compounds is controversial. We determined the decrease in maximal expiratory flow rates (Vmax) from partial and maximal flow-volume curves in seven asthmatic subjects after inhalation of aerosols of histamine or leukotriene C4 (LTC4) while breathing air or a mixture of 80% helium and 20% oxygen (He/O2). Density dependence (DD) of maximal expiratory flow was determined from partial expiratory flow volume curves by an isovolumic comparison of maximal expiratory flows with subjects breathing He/O2 with those obtained while breathing air. Measurements were made before and after inhalation of aerosols generated from graded concentrations of each constrictor agent. An aerodynamic site of response to LTC4 more central than for histamine was indicated by a significant (p less than 0.02) increase in DD with the former but not with the latter agonist. The ratio of Vmax at 30% vital capacity determined from maximal and partial maneuvers (M/P) was routinely higher at baseline while breathing He/O2 compared to the corresponding values with air, suggesting a degree of peripheral obstruction that was reversed by a deep inhalation. Obstruction induced by LTC4 inhalation resulted in a greater increase in M/P compared with baseline when air was the test gas (p less than 0.02). This was not observed when He/O2 was the test gas. Similar effects on M/P were not induced by histamine aerosol inhalation, consistent with a central airway response to LTC4 that was not affected by volume history.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2764370 TI - The effects of deep inhalation on maximal expiratory flow during intensive treatment of spontaneous asthmatic episodes. AB - Asthmatic patients who came to hospital for treatment of severe attacks were assessed for level of obstruction and the effects of a deep inhalation (DI) on degree of obstruction at various stages of their treatment and after recovery over several days. The more severe the obstruction, the greater was the constrictor effect of a DI; as lung function improved with intensive treatment, including corticosteroids, the constrictor effect diminished. Thus, we believe the constrictor effects of a DI relate to the degree of inflammation in the obstructive process. These longitudinal data relating severity to the effects of a DI were nearly identical to previously published cross-sectional data in a group of patients with spontaneous asthma with widely different levels of lung function. It is possible that the response to a DI in a given asthmatic subject serves as a functional marker for the predominant mechanism for obstruction. PMID- 2764371 TI - Influence of the menstrual cycle on airway function in asthmatic and normal subjects. AB - Investigations of premenstrual asthma (PMA) have been based on studies of asthmatics already aware of a deterioration of asthma premenstrually. Little is known, therefore, about relationships between the menstrual cycle and airway function in asthmatics who do not complain of PMA or in normal subjects. We investigated airway function in both of these groups for three or four consecutive menstrual cycles. Daily records of asthma symptoms and peak expiratory flow rates were maintained by 11 asthmatics and 29 normal control subjects. Standard spirometry and serum estradiol and progesterone levels were measured during the follicular, midluteal, and late luteal phases of the menstrual cycle. Airway reactivity to methacholine was tested during the follicular and luteal phases. The normal group showed no significant changes in symptoms, peak flow rates, spirometric parameters, or airway reactivity. Although the asthmatic group also demonstrated no significant changes in spirometry and airway reactivity, asthma symptoms (shortness-of-breath, cough, wheeze, and chest tightness) deteriorated significantly (p less than 0.001) from the follicular to the luteal phase, as did the morning peak flows of the asthmatics (p = 0.045). Airway function and reactivity were not related to hormone levels in either group. This study indicates that asthmatics not previously aware of PMA will record a premenstrual worsening of asthma symptoms and peak expiratory flow rates. These changes are not related to a deterioration in spirometry and airway reactivity or to the absolute levels of circulating progesterone and estradiol. PMID- 2764372 TI - Relationship of nocturnal bronchoconstriction to sleep stages. AB - The possible role of sleep stages in the pathogenesis of nocturnal asthmatic attacks is still under debate because previous studies suffered methodologic limitations that prevented the possibility of providing a clear-cut answer to the question. To evaluate the relationship of nocturnal asthma to sleep, eight asthmatics with unstable asthma (seven with history of nocturnal wheeze) and four reference subjects were submitted to all-night polysomnography, including the continuous evaluation of esophageal and supraglottic pressure (with two catheters) as well as of airflow (with a face mask), so as to derive total lung resistance, supraglottic resistance, and, by subtraction lower respiratory resistance (Rlr). Stage 3-4 was characterized by the highest peaks in Rlr and by longer episodes of bronchoconstriction; conversely, neither the onset nor the remission of the latter were specifically related to any sleep stage. Considering episodes remitted with an awakening. Stage 3-4 was marked by higher Rlr peaks than during REM sleep. We conclude that sleep plays a contributory role in the multifactorial pathogenesis of nocturnal asthma, with a higher susceptibility during slow-wave sleep, probably related to a decreased responsivity to resistive loads. PMID- 2764373 TI - Hypoxic and hypercapnic ventilatory responses in awake children with congenital central hypoventilation syndrome. AB - Congenital central hypoventilation syndrome (CCHS) has been thought to be a disorder of central chemoreceptor responsiveness. Previous studies in CCHS have shown decreased or absent ventilatory responsiveness to both hypercarbia and hypoxia. However, hypoxic responsiveness during wakefulness has not been systematically studied. We studied hypoxic and hypercapnic ventilatory responses during wakefulness in five children with CCHS (6 to 11 yr of age). To measure the hypercapnic response, the children rebreathed a hyperoxic hypercapnic mixture until PaCO2 reached 56 to 69 mm Hg. For the hypoxic response, the children rebreathed a hypoxic gas mixture, at mixed venous PCO2, until SaO2 had fallen to less than 78%. We found that the ventilatory responses to hypercapnia and hypoxia were very variable (linear correlation coefficients ranging from -0.44 to +0.63 for hypercapnic responses and from -0.15 to +0.77 for hypoxic responses), with no significant change from baseline in response to either stimulus. There was no evidence of progressive ventilatory stimulation despite increasing stimulus. Additionally, these children had no subjective sensation of dyspnea or discomfort. This establishes that hypoxic and hypercapnic ventilatory control is absent during wakefulness. Chemoreceptor control (peripheral and central) is, therefore, defective in all states in children with CCHS. We speculate that the defect in CCHS lies in central integration of the central and peripheral chemoreceptor signals. PMID- 2764374 TI - Alcohol consumption and chronic obstructive pulmonary disease. AB - This study examined the relationship between lifetime alcohol consumption and respiratory symptoms in 195 subjects (including 111 alcoholics) and FEV1 level in 165 subjects (including 91 alcoholics). After adjustment for age and cigarette smoking status, using multiple logistic regression, lifetime alcohol consumption was a significant predictor of chronic cough and chronic phlegm, but not of any wheeze or persistent wheeze. Multiple linear regression analysis indicated that lifetime alcohol consumption was also a predictor of lower levels of FEV1 in a model that included age, pack-years of cigarette smoking, and an interaction between alcohol consumption and pack-years. The interaction between smoking and alcohol consumption was in a direction opposite to the independent effects of alcohol and smoking, suggesting a protective effect of alcohol with heavier amounts of smoking. Additional study is needed to further assess the relationship between respiratory symptoms and alcohol consumption, and between pulmonary function and alcohol consumption. PMID- 2764375 TI - Mortality associated with respiratory function and symptoms in advanced age. The Framingham Study. AB - Pulmonary function, cigarette smoking, and respiratory symptoms were determined in 3,133 men and women at the 13th examination of the Framingham Study (1972 to 1976). Deaths in the subsequent 10-yr period were identified. Forced expiratory volume in one second and forced vital capacity were standardized for body size by dividing by the square of the height (FEV1/ht2, FVC/ht2). As expected, mean values of these pulmonary function measures were lower in women compared to those in men, older participants compared to younger, smokers compared to nonsmokers, and those with respiratory symptoms compared to those without. In men and women under 70 yr of age and women over 70 yr of age, FEV1/ht2 was inversely related to mortality after adjustment for age, smoking, and respiratory symptoms. In older men, FEV1/ht2 was not related to mortality, but symptoms of dyspnea were associated with increased risk of death. PMID- 2764376 TI - Oxygen consumption of the respiratory muscles in normal and in malnourished patients with chronic obstructive pulmonary disease. AB - Patients with severe chronic obstructive pulmonary disease (COPD) commonly experience weight loss. An increased energy expenditure for respiration might explain the increased caloric requirements and weight loss seen in this patient population. We measured the oxygen cost of augmenting ventilation (O2 cost) using an open circuit technique with dead-space stimulation of ventilation in nine normally nourished (greater than 90% ideal body weight) and in 10 malnourished (less than 90% ideal body weight) patients with COPD as well as in seven normal control subjects. O2 cost was significantly elevated in the malnourished patients with COPD (4.28 +/- 0.98 ml O2/L ventilation) relative to the normally nourished group (2.61 +/- 1.07) and the normal control subjects (1.23 +/- 0.51) (p less than 0.001). The measured resting energy expenditure (REEmeas) was also increased compared with predicted values (REEpred) in the malnourished population (REEmeas/REEpred = 94.57 +/- 6.21% for control subjects, 105.5 +/- 19.66% for normally nourished patients with COPD, and 119.4 +/- 11.69% for malnourished patients with COPD) (p less than 0.005). The malnourished population was characterized by a greater degree of hyperinflation (RV/TLC = 0.55 +/- 0.09 for normally nourished versus 0.69 +/- 0.06 for malnourished patients) and inspiratory muscle weakness (PImax = 51 +/- 16.5 for the normally nourished and 34 +/- 12.2 for the malnourished population). We conclude that malnourished patients with COPD are characterized by a relative increase in resting energy requirements and, specifically, increased energy requirements for augmenting ventilation. This increase in energy requirements may result from the increased mechanical work load associated with severe COPD and/or a reduced ventilatory muscle efficiency. PMID- 2764377 TI - Efficiency of the respiratory muscles in healthy individuals. AB - We evaluated respiratory muscle performance by determining the energy cost of breathing against incremental threshold loads and calculating the efficiency of the respiratory apparatus for handling the added work. In five subjects, the energy cost of breathing against the loads, and thus the calculated efficiency of the respiratory muscles, was reproducible on repeated measurements. In all subjects, the calculated efficiency varied while breathing with low loads but was relatively constant at loads that resulted in a mouth pressure of 20 to 60% of the subjects' maximal static inspiratory pressure (PImax). The mean efficiency calculated between 20 to 60% of PImax in 30 normal subjects (15 males and 15 females) ranged between 1.54 and 7.98%. It was significantly greater in males (5.41 +/- 0.43%) (mean +/- SEM) than in females (2.41 +/- 0.17%). There was no relationship between efficiency and body size, but the efficiency correlated with inspiratory muscle strength (PImax). We suggest that measurement of the efficiency of the respiratory muscles over a spectrum of incremental threshold loads is a simple, noninvasive, and reproducible method of assessing respiratory muscle performance and may have clinical application. PMID- 2764378 TI - Effects of hyperoxia and vitamin E on the fatty acid composition of rat lung microsomes and mitochondria. AB - Peroxidation of lung membrane lipids in vitro produces very specific changes in lung membrane fatty acid content with some fatty acids being affected more than others. We performed a series of experiments to determine the changes occurring in fatty acid composition in lung microsomes and mitochondria during an in vivo hyperoxic exposure. Hyperoxia did produce specific changes in the relative content of fatty acids present in lung microsomes and mitochondria of both vitamin E-supplemented and vitamin E-deficient rats. Changes were noted to occur in saturated and polyunsaturated fatty acids. The total amount of lung lipids extractable in the microsomal fractions decreased after hyperoxia in both the vitamin E-supplemented and the vitamin E-deficient animals with no changes occurring in extraction of lung mitochondrial total lipids. Decreases in lung mitochondrial fatty acids caused by hyperoxia occurred in the same fatty acids in both the vitamin E-supplemented and the vitamin E-deficient animals with few polyunsaturated fatty acids (PUFA) being affected. Decreases in lung microsomal fatty acids occurring during hyperoxia were different in the vitamin E supplemented animals from those in the vitamin E-deficient animals with many more PUFA decreasing in the vitamin E-deficient group. The greatest number of PUFA found to decrease after hyperoxia when comparing all the different groups occurred in the microsomal fraction of the vitamin E-deficient rats. These data suggest that vitamin E-deficient animals have increased peroxidation of lung microsomal PUFA or a decrease in production of lung microsomal PUFA in vivo during a hyperoxic exposure. PMID- 2764379 TI - Effect of bradykinin on airway ciliary motility and its modulation by neutral endopeptidase. AB - We studied the effect of bradykinin on ciliary activity and its modulation by peptidases in cultured rabbit tracheal epithelium in vitro. Bradykinin (10(-7) M) elicited a rapid, transient increase in ciliary beat frequency (CBF) from the baseline values of 1,031 +/- 25 to 1,388 +/- 38 beats/min (mean +/- SE, p less than 0.001), followed by a decline to a steady-state value of 1,180 +/- 30 beats/min, which was still greater than the baseline CBF. This ciliostimulation was dose-dependently inhibited by the B2-receptor antagonist (D-Arg,Hyp3,Thi5.8,D Phe7)-bradykinin but not by the B1-receptor antagonist (Des-Arg9,Leu8) bradykinin. Nifedipine, Ca2+-free medium, indomethacin, the phospholipase A2 inhibitor mepacrine, and the methyltransferase inhibitor 3-deazaadenosine reduced the change in CBF. Involvement of tachykinins, leukotrienes, prostaglandin D2, or thromboxane A2 was ruled out because bradykinin's action was not affected by (D Pro2,D-Trp7.9)-substance P, nordihydroguaiaretic acid, or SQ29548, an antagonist for prostaglandin D2 and thromboxane A2. Bradykinin also increased prostaglandin E2 release (p less than 0.01), an effect that was abolished by indomethacin and Ca2+ deficiency. The CBF dose-response curve for bradykinin was shifted to lower concentrations by 1 log U by the neutral endopeptidase inhibitor phosphoramidon (p less than 0.01), whereas the angiotensin-converting enzyme inhibitor captopril was without effect. These results suggest that bradykinin interacts with B2-type receptors and stimulates ciliary activity through Ca2+-dependent prostaglandin E2 release, and that neutral endopeptidase may play a role in modulating the effect of bradykinin on airway mucociliary transport. PMID- 2764380 TI - Stimulation of hamster pulmonary neuroendocrine cells and associated peptides by repeated exposure to cigarette smoke. AB - Although the normal function of pulmonary neuroendocrine (PNE) cells containing bioactive peptides is poorly understood, various pulmonary diseases are associated with hyperplasia of these cells, and they also may be progenitors for small cell lung cancer in humans. In this study we have investigated the effects of subchronic cigarette smoke exposure in the hamster on the PNE cells and their peptide content. Daily exposure to standard research cigarette smoke for as long as 90 days led to progressively higher levels of serum calcitonin (iCT) as well as higher lung tissue iCT and the gastrin releasing-like peptides or mammalian bombesin (MB). Subsequent to a 30-day period during which there was no further exposure to smoke, serum levels returned to control levels, but the lung levels of both iCT and MB remained higher than control levels. Also, after the 90 days of exposure, immunocytochemistry revealed an increase in the number of iCT containing PNE cells. This increase in the number of PNE cells correlated well with the increased iCT content of the lung tissue. We conclude that subchronic cigarette smoke exposure causes an increase in pulmonary levels of iCT and MB, which may be linked to the observed proliferative response of the PNE cells. PMID- 2764381 TI - Immunohistochemical demonstration of enkephalin-containing nerve fibers in guinea pig and rat lungs. AB - Met-enkephalin (Met-Enk) and Leu-enkephalin (Leu-Enk), the opioid peptides originally isolated from the brain, are believed to act as inhibitory neuromodulators at various synaptic sites. In this immunohistochemical study, we have investigated the localization and distribution of Met- and Leu-Enk immunoreactivities in airways and pulmonary vessels of guinea pigs and rats. Immunoreactivities to both peptides were found in nerve fibers and nerve terminals distributed mainly to the trachea and major bronchi, and were especially prevalent in the smooth muscle layer, in the lamina propria, and around tracheal and bronchial glands, but not in the epithelium. Few immunoreactive nerve fibers were detected in smaller bronchi, bronchioles, and alveoli. Enkephalin-immunoreactive nerve fibers were also localized in the walls of pulmonary and bronchial vessels. Within airway microganglia, immunoreactivity was observed in a few nerve terminals, but not in ganglion cell bodies. Met- and Leu-Enk immunoreactive nerve fibers showed similar distribution patterns, though minor differences were noted between the two species: Enk-immunoreactive nerve fibers in the smooth muscle layer were more abundant in guinea pigs than in rats, whereas those in mucous glands were richer in rats than in guinea pigs. These results document the presence of Met- and Leu-Enk immunoreactivity in nerve fibers supplying guinea pig and rat airways and pulmonary vessels, and provide a morphologic basis for the view that enkephalins are likely neurotransmitters or neuromodulators in the lung. PMID- 2764382 TI - Alveolar type II cells, surfactant protein A (SP-A), and the phospholipid components of surfactant in acute silicosis in the rat. AB - Silica instillation causes a massive accumulation of surfactant phospholipids and the appearance of hypertrophic type II cells in the rat. We have examined the metabolic consequences of silica instillation with a special emphasis on surfactant protein A (SP-A), the major glycoprotein of surfactant. Fourteen days after instillation of 10 mg of silica, the amount of phospholipids in lavage increased 14-fold and the amount of SP-A increased 10-fold. The phospholipid composition of lavage material from silica-treated animals was altered by a reduction in the percentage of phosphatidylglycerol and an increase in phosphatidylinositol. The percentage of saturated phosphatidylcholine did not change. Type II cells isolated from rats treated with silica could be separated into cells of normal size and of increased size by centrifugal elutriation. There was an increase in phospholipid and SP-A content in the larger type II cells isolated from silica-treated rats relative to type II cells from control rats (by 45% and 70%, respectively, when expressed per micrograms protein; p less than 0.01). Activities of the phospholipid biosynthetic enzymes cholinephosphate cytidyltransferase, lysophosphatidylcholine acyltransferase, and phosphatidylglycerol phosphate synthetase increased (nmol/min/mg cell protein) in the hypertrophic type II cells relative to type II cells from control rats (by 40%, 112%, and 95%, respectively, p less than 0.05). Incorporation of (1-14C) acetate was also increased in hypertrophic type II cells relative to type II cells from control rats (by 43%, p less than 0.05). The only difference in the distribution of acetate incorporated into individual lipids was a slight increase in the percentage incorporated into phosphatidylinositol. Although the increase in phosphatidylcholine found in the lavage could be due to increased synthesis as reflected by the changes in enzymatic activity and rate of acetate incorporation, the reduction in phosphatidylglycerol in lavage and in type II cells could not be explained simply by a reduction in synthesis on the basis of available data. There was a marked increase in SP-A content in lavage and in type II cells isolated from silica-treated rats without a significant change in the relative abundance of SP-A mRNA. This dissociation of SP-A mRNA abundance and apoprotein content suggests that factors other than transcription may be important for the observed accumulation of SP-A in silica-treated rats. We conclude that the phospholipidosis and proteinosis that occur subsequent to silica instillation in the rat lung are not solely attributable to increase in the rates of synthesis of these components. PMID- 2764383 TI - Antileukoprotease is associated with elastin fibers in the extracellular matrix of the human lung. An immunoelectron microscopic study. AB - Human lung antileukoprotease (ALP) is a potent inhibitor of neutrophil elastase that is locally produced by submucosal bronchial glands and by secretory cells in the bronchiolar epithelium. In a recent light microscopic investigation, ALP was detected in the connective tissue matrix of the lung. The present immunoelectron microscopic study was performed in order to extend our knowledge about the exact localization of ALP in the extracellular matrix of the lung. Both elastin and ALP were detected in central and peripheral human lung specimens using specific antibodies in a two-step, gold-labeling procedure. ALP could be demonstrated in the parenchymal matrix of the alveolar walls exclusively in association with the amorphous elastin fibers. In addition, the subepithelial connective tissue of the bronchial wall also showed a clear labeling for ALP, which was present exclusively over the elastin fibers. The results of this study strongly suggest that ALP play a modulating role in destructive pulmonary diseases such as emphysema in which degradation of elastin fibers by elastase is thought to occur. PMID- 2764384 TI - Morphometric analysis of intraluminal mucus in airways in chronic obstructive pulmonary disease. AB - Mucus volume in both central and peripheral airways was assessed in 13 patients, six with chronic bronchitis (CB) and seven with chronic pulmonary emphysema (CPE), by morphologic quantitative measurement in autopsied lungs, and the results were compared with those from four control lungs (NL). The patients with CB and CPE had severe obstructive impairment that did not differ significantly between the two groups (FEV1%, mean 45% in CB and mean 49% in CPE). Mucous hypersecretion during clinical remission differed significantly between the CB and CPE groups (mean 80 ml/day in CB and mean 8 ml/day in CPE). The length of the airway basement membrane and the area of mucus were measured with a digitizing computer. The volume ratio of mucus to airway lumen, which was defined as the volume ratio of mucus to airway lumen calculated as a cylinder by the length of basement membrane, was regarded as the mucus occupying ratio (MOR). MOR was significantly higher in CB lungs (4.1 +/- 1.0% in central airways and 19.6 +/- 3.8% in peripheral airways, mean +/- SE) than in NL (0.3 +/- 0.1% in central airways and 0.6 +/- 0.3% in peripheral airways, respectively) in both central and peripheral airways (p less than 0.05 and p less than 0.01, respectively), whereas no significant increase in MOR was found in CPE lungs, compared with NL. Furthermore, peripheral airway MOR was significantly higher than that of central airways in CB lungs (p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2764385 TI - Effects of instillation of fly ash in the lung: physiochemical properties and immune responses. AB - In this study, we examined physiochemical properties of fly ash and aluminum silicate and investigated the effects of these compounds on IgE antibody production and macrophage response in the lung. Fly ash was round in shape, and aluminum silicate was indefinite in shape with respirable size. Both compounds consisted of alumina and silica as the main elements with respirable size. Enhanced IgE and IgG antiovalbumin (OA) antibody production was observed in mice first instilled intratracheally with the aluminum compounds and then given OA aerosol exposure. Histopathologic observations after instillation of fly ash and aluminum silicate showed that a large number of macrophages had ingested the compounds. However, the amount of free compound and the distribution of macrophages were different in mice given fly ash from those given aluminum silicate. These data indicate that particles of fly ash and aluminum silicate instilled into lung act as adjuvant for the production of IgE and IgG antibodies. PMID- 2764386 TI - Driving simulator performance in patients with sleep apnea. AB - Although previous studies have shown that patients with obstructive sleep apnea have a higher automobile crash rate than normal subjects, objective measurements of driving performance in patients with sleep apnea have not been reported. Therefore, we compared the driving performance of subjects with untreated, severe sleep apnea to that of control subjects on two driving simulators. Using a simulator with road films, six subjects with untreated, severe apnea performed worse than did a control group of seven normal subjects on both highway and city/rural driving (p less than 0.05). Using a personal computer program simulating a monotonous highway drive, 12 subjects with untreated sleep apnea performed worse than 12 control subjects. The patients with apnea hit a greater number of road obstacles during their 30-minute simulated drive than did the control subjects (44 +/- 52 in patients with apnea versus 9 +/- 7 in control subjects, p less than 0.05). Six patients with apnea hit fewer road obstacles after treatment with nasal continuous positive airway pressure (CPAP) than before treatment (29 +/- 19 before CPAP versus 13 +/- 8 after CPAP, p less than 0.05). We conclude that: (1) driving simulator performance of untreated subjects with severe obstructive sleep apnea is worse than that of control subjects; (2) driving simulator performance of subjects treated with nasal CPAP improves. PMID- 2764387 TI - Nomenclature of mycobacterial disease. PMID- 2764388 TI - Transtracheal oxygen decreases inspired minute ventilation. PMID- 2764389 TI - NIH Workshop on Withholding and Withdrawing Mechanical Ventilation. PMID- 2764390 TI - Nursing considerations related to withdrawal of mechanical ventilatory support. PMID- 2764391 TI - Digital manipulation of the thrombosed arterio-venous conduit. AB - The utility of a bedside technique for digital manipulation of the thrombosed arterio-venous conduit was retrospectively reviewed. During an 18 month period the records of all patients at this institution who were undergoing chronic hemodialysis, via a forearm modified arterial bovine heterograft, and who were successfully treated by digital manipulation for graft thrombosis were examined. Thirteen patients who underwent 30 successful graft manipulations constituted the study group. Bedside manipulation attempts were performed from one to 72 hours from the period of last known function. Complete response to the technique was indicated by the appearance of a pulse and panrhythmic bruit and thrill throughout the conduit. The average duration of restored flow was 58.6 days (range one to 430 days). No serious or life threatening complications (e.g. problems related to pulmonary thromboembolism) were observed. Conduit thrombosis secondary to faculty cannulation, prior hypotension, or extrinsic compression was amenable to the technique; however, when occlusion was secondary to an intrinsic problem in the graft (stenosis of the venous or arterial anastomosis), operative revision was required. If successful, the technique allows for immediate dialysis access without the need for additional measures. The procedure has negligible morbidity and can spare the patient considerable time and expense. PMID- 2764392 TI - Chronic rupture of abdominal aortic aneurysms. AB - Chronic rupture of the aorta is a rare condition. In this report, the presentation, diagnosis, and management of two patients with this complication is described. Chronic rupture may occur without hypotension and may mimic several other conditions. CT scans are superior to ultrasound in diagnosis and evaluation. Emergency repair is not necessary in clinically stable patients and careful preoperative planning may diminish morbidity and mortality. PMID- 2764393 TI - Delayed hemorrhage from an anomalous carotid artery following tracheostomy. AB - A report is presented in which a patient's unusual aortic arch anomaly ruptured following tracheostomy. Appreciation of the high incidence of such anomalies may prepare the physician to avoid injury during tracheostomy or successfully manage late hemorrhage when it occurs. PMID- 2764394 TI - The duodenum. Part 4: Surgery. AB - This is the last part of our efforts to present, if possible, the duodenum in toto as an anatomical and surgical entity. For all practical purposes, Part 4 is a short presentation of the anatomy involved in mobilization and exposure of the duodenum from a surgical standpoint with specific applications. A table with most of the anatomical complications of duodenal surgery is also included. PMID- 2764395 TI - Gastric schwannoma after Nissen fundoplication. A rare complication? AB - Surgical repair of an hiatal hernia results in changes in the local anatomy of the cardia and fundus that may be difficult to interpret by radiological examination. Endoscopy can clarify the radiological changes resulting from surgery, such as pseudodiverticula and pseudotumors, and, when conducted as part of the routine follow-up program, may reveal uncommon complications. PMID- 2764396 TI - The continent gastrostomy. AB - In an attempt to facilitate long-term care and patient acceptance of gastrostomy feeding, the technique of permanent Janeway gastrostomy was modified. Using an auto-stapling device, a full-thickness gastric tube (6 cm long and 1.5 cm in diameter at its base) is created from the anterior wall of the stomach, based on the greater curve, with special attention to its vasculature. The base is invaginated into the stomach wall to create a tight valve. After skin closure, the terminal 1 cm is excised and the mucosa is sutured flush with the skin. A #10 French tube is inserted and positioned perpendicularly. A gastrostomy thus created will allow intermittent cannulation without leakage of gastric contents. Results of this procedure in 26 patients show a postoperative wound infection incidence of 3.8 per cent. With a mean follow up of 257 days, the gastrostomy was continent in 87 per cent of patients. PMID- 2764397 TI - Leiomyoma of the male nipple. A case report and literature review. AB - A case of leiomyoma arising in the nipple of a 55-year-old male is presented. The patient had undergone two minor surgical procedures on the nipple and areola in prior years. It is not known whether biopsies were taken during these procedures. PMID- 2764398 TI - Small-bowel obstruction caused by heterotopic pancreas in an adult. AB - Aberrant pancreatic tissue has been found in several abdominal and intrathoracic locations, most frequently in the stomach or duodenum. Heterotopic pancreas in the jejunum or ileum is a rare, usually asymptomatic, incidental finding. A review of the English language literature since 1950 shows only one pediatric and one adult case of heterotopic pancreas causing small bowel intussusception. The authors report a case of ileo-ileal intussusception caused by a submucosal mass of aberrant pancreatic tissue that remained undetected during several diagnostic tests and two laparotomies. PMID- 2764399 TI - Fibrinogen degradation products in fresh frozen plasma. Possible contribution to immunosuppression. AB - Recent investigations implicate a variety of specific serum factors as immunosuppressive agents, among them variably sized fragments produced by the degradation of fibrin/fibrinogen. Random samples of fresh frozen plasma were tested for fibrinogen degradation products by a latex agglutination method. Thirty-one per cent of the units tested contained greater than 40 micrograms/ml fibrinogen degradation products, and a total of 86 per cent contained greater than 10 micrograms/ml fibrinogen degradation products. Fresh frozen plasma is often used in the treatment of critically ill trauma and surgery patients, and especially in severely burned patients, who are immunosuppressed by the nature of their injury. Since fibrinogen degradation products have been shown to have both in vitro and in vivo immunosuppressive effects, administration of fresh frozen plasma to these patients should be carefully evaluated in light of its potential ability to worsen their already compromised immune status. PMID- 2764400 TI - An improved technique for partial splenectomy. AB - Partial splenectomy should be a part of the armamentarium of every surgeon managing traumatized patients. Patients with hematologic disorders may also be candidates for partial splenic resection. An improved technique for partial splenic resection is presented. PMID- 2764401 TI - Nonfunctioning adrenal tumors. Dilemmas in management. AB - A retrospective study conducted from 1975-1987 at Vanderbilt University Medical Center and affiliated hospitals identified 28 patients, ranging in age from 22 to 74 years, who were noted to have "nonfunctioning" adrenocortical tumors. Eighteen (64%) were men, and ten (36%) were women. A left adrenal mass was present in 16 (57%) patients, a right in 11 (39%) patients, and one (4%) patient had bilateral adrenal enlargements. Nineteen patients underwent an adrenalectomy. Ten were found to have adrenocortical adenomas, ranging is size from 2.5-4.0 cm in greatest diameter. Three were adrenocortical carcinomas (3.0, 5.5, and 8.0 cm). A necrotic mass (14.0 cm) was found in one patient. Two patients had myelolipoma, one had ganglioneuroma, and one had a suspected primary melanoma. Five patients were not operated upon and were followed by serial computed tomographic scans for variable periods; two died of unrelated cardiac problems, and one was lost to follow-up. Three patients underwent biopsy with benign pathology. The data indicate a high incidence of adenoma and carcinoma in patients with nonfunctioning adrenal tumors that measure more than 3.0 cm in diameter. These tumors have the potential to progress to malignant degeneration without any recognizable clinical or endocrine abnormalities. The authors thus conclude that all patients with "nonfunctioning" adrenal tumors that are larger than 3.0 cm in diameter should undergo surgical exploration and excision. PMID- 2764402 TI - Optimization and decision-making in radiological protection. A report of a Task Group of Committee 4 of the International Commission on Radiological Protection. PMID- 2764403 TI - Baseline measurement of bone mass predicts fracture in white women. AB - STUDY OBJECTIVE: To determine if a single bone mass measurement of the radius is predictive of future fractures at any site. DESIGN: Observational study of a cohort of free-living subjects and a cohort of retirement-home residents with an average follow-up of 6.7 years and 5.5 years, respectively (range, 1 to 15 years for both cohorts). SETTING: General community and a retirement home. SUBJECTS: Volunteer sample of white women (386 free-living and 135 living in a retirement home) who were free of disease and were not receiving medication known to affect bone metabolism. In terms of physical condition subjects ranged from the totally independent to the wheelchair-bound. MEASUREMENTS AND MAIN RESULTS: A radial bone mass measurement was done at the initial visit. Subsequent non-spine fractures were reported by the subjects at follow-up visits, which were less than a year apart in most cases, and verified with medical records. Cox regression was used to model time to first fracture as a function of age and bone mass. These analyses showed that for every 0.1 g/cm decrement in bone mass, the relative risk of fracture was 2.2 (CI, 1.7 to 2.8) for the free-living and 1.5 (CI, 1.2 to 1.9) for the retirement-home residents. Baseline age did not predict the risk of fracture in either cohort, and controlling for baseline age did not reduce the relative-risk estimates of bone mass. Similar analyses also showed that bone mass was a statistically significant predictor for first hip fractures (n = 30) among the nursing-home residents (relative risk, 1.9; CI, 1.4 to 2.7) and first forearm fractures (n = 10) among the free living (relative risk, 3.6; CI, 1.9 to 6.8). For both cohorts, the 8-year probability of any nonspine fracture was about 80% for subjects with initial bone mass less than 0.6 g/cm and was less than 10% for subjects with initial bone mass greater than 0.8 g/cm. Similarly, those in the retirement home with bone mass below 0.6 g/cm had a 6-year probability of hip fracture of 43%, compared with a 17% risk for those with greater bone mass. CONCLUSION: A single bone mass measurement of the radius is predictive of future nonspine fractures at all sites, and at both the forearm and the hip. Baseline age was not a significant predictor of fracture within either cohort. Relative risk estimates were not dissimilar across fracture sites. PMID- 2764404 TI - Hypoxemia during air travel in patients with chronic obstructive pulmonary disease. AB - STUDY OBJECTIVE: To quantitate and identify determinants of the severity of hypoxemia during air travel in patients with chronic obstructive pulmonary disease. DESIGN: Prospective study of physiologic variables before and during intervention. SETTING: Referral-based pulmonary disease clinic at a U.S. Army medical center. PATIENTS: Eighteen ambulatory retired servicemen (age 68 +/- 6 [SD] years) with severe chronic obstructive pulmonary disease (forced expiratory volume in the first second [FEV1] 31% +/- 10% of predicted). INTERVENTION: Altitude simulation equivalent to 2438 meters (8000 feet) above sea level in a hypobaric chamber. MEASUREMENTS AND MAIN RESULTS: Radial artery catheter blood oxygen tension in the patients declined from a ground value (PaO2G) at sea level of 72.4 +/- 9 mm Hg to an altitude value (PaO2Alt) of 47.4 +/- 6 mm Hg after 45 minutes of steady state hypobaric exposure. The PaO2G correlated with PaO2Alt (r = 0.587; P less than 0.01). Multiple regression analysis revealed that the preflight FEV1 reduced the variability in PaO2Alt not explained by PaO2G in the equation: PaO2Alt = 0.453 [PaO2G] + 0.386 [FEV1% predicted] + 2.440 (r = 0.847; P less than 0.001). Residuals from two previously published formulas using PaO2G also correlated with FEV1 (r greater than or equal to 0.765; P less than 0.001). CONCLUSIONS: Arterial blood oxygen tension declined to clinically significant levels in most patients during hypobaric exposure. When combined with the preflight arterial PO2 at ground level (PaO2G), the measurement of the preflight FEV1 improved prediction of PaO2 at altitude (PaO2Alt) in patients with severe chronic obstructive pulmonary disease. PMID- 2764405 TI - Multicentric reticulohistiocytosis: response to alkylating agents in six patients. AB - STUDY OBJECTIVE: To determine the efficacy of alkylating agents in multicentric reticulohistiocytosis. DESIGN: Open consecutive case series. SETTING: Tertiary care referral clinic. PATIENTS: Six patients with skin-biopsy-proven multicentric reticulohistiocytosis. All had skin nodules and polyarthritis. INTERVENTION: Five patients received cyclophosphamide (dose range, 1.25 to 2.2 mg/kg body weight) and one patient received chlorambucil (0.1 mg/kg). Therapy was administered from 6 to 24 months. MEASUREMENTS AND MAIN RESULTS: In five patients treated with cyclophosphamide a response was seen within 4 months. Four patients eventually had a complete remission and one had almost a complete remission. The four patients in complete remission had cyclophosphamide therapy discontinued after 6, 12, 16, and 18 months. Three of the four patients remained in complete remission off therapy at 6, 6, and 22 months, whereas one had a recurrence after 6 months. The one patient given chlorambucil went into a complete remission and stopped treatment after 12 months. He remained in complete remission 32 months after stopping medication. CONCLUSION: Our experience with patients with aggressive multicentric reticulohistiocytosis shows that alkylation therapy is warranted. We conclude that a response to an alkylating agent may be expected. Whether after treatment for 6 to 18 months most patients may be able to discontinue the drug and remain in remission has yet to be shown. The rarity of multicentric reticulohistiocytosis precludes the possibility of a double-blind study. PMID- 2764406 TI - Recruiting students for medicine. AB - The applicant-to-acceptance ratio in the nation's 127 medical schools has slowly but steadily declined during the last decade to 1.7:1 (60.5% acceptance rate) for the 1987-1988 academic year. The 28,123 applicants in this academic year represent a decrease of 3200 applicants from the previous year. The decline in the number of applicants is even more striking because it occurred despite the welcome increase of female applicants between 1965 to 1988 (36% of the entering class in the 1987-1988 academic year). The laudable changes in the Medical College Admission Test (MCAT) examination, which take effect in 1991, will not solve this problem. We believe that the causes of the flight away from medicine as a career are several and represent the combined effect of changes in the practice of medicine itself and their negative impact on the profession, as well as deeply-seated shifts in values, attitudes, and aspirations among the young people in our society. We discuss several factors concerning the phenomenon in question and offer some suggestions concerning solutions for this important problem. Our goal in this brief essay is to stimulate discussion and awareness among physicians concerning medical school admissions and to galvanize into action the medical profession and other key persons who are keenly interested in high-quality health care for our people. PMID- 2764407 TI - Effective reduction in the serum 1,25-dihydroxyvitamin D and calcium concentration in sarcoidosis-associated hypercalcemia with short-course chloroquine therapy. PMID- 2764408 TI - Profound sympathoinhibition complicating hypovolemia in humans. PMID- 2764409 TI - Carotid endarterectomy. PMID- 2764410 TI - Odds ratio and relative risk. PMID- 2764411 TI - Environmental or genetic effects in inflammatory bowel disease. PMID- 2764412 TI - [Pure chronic thrombocytopenia caused by a defect of production: genetic anomalies and acquired diseases]. PMID- 2764413 TI - [Treatment of reflex algoneurodystrophies by sympathetic blockade with guanethidine]. AB - Reflex sympathetic dystrophy (RSD) can be treated by regional sympathetic blockade with guanethidine. This method was used systematically in 25 patients with post-traumatic RSD of the upper (n = 8) or lower limb (n = 17). Sixty three blocks were performed, each patient receiving 1 to 4 blocks. The results were appreciated by the effects after one month on pain, mobility and trophic changes. They were excellent in 7 cases, good in 4 cases and poor in 7 cases. The results were better in moderate RSD without psychiatric overlay. Thirteen patients were cured after 3 months. Pain decreased significantly 2 days after injection in 28 of the 63 blocks. The effects on mobility and trophic changes always occurred after the analgesic effect. No side effects were observed with the exception of one patient who had a convulsion 2 hours after the injection. These results show that regional sympathetic blockage with guanethidine is useful for the treatment of RSD, especially in its moderate stages. In view of the negligible risks and its efficacy, the authors consider it to be the first line treatment of moderate RSD. PMID- 2764414 TI - [Anatomo-clinical conference. Pitie-Salpetriere Hospital. Case No. 2-1987. Fever and regressive sciatica in a Corsican woman]. PMID- 2764415 TI - [Non-tuberculous mycobacterium infections. Present status and therapeutic uncertainties]. PMID- 2764417 TI - [Increase of the sedimentation rate and unexplained weight loss in the elderly: an unrecognized diagnosis, human immunodeficiency virus infection]. PMID- 2764416 TI - [The epidemiology of AIDS in Africa]. PMID- 2764418 TI - [Psoriasis and HIV infection. 10 cases]. PMID- 2764419 TI - [Acquired ichthyosis: a new cutaneous sign of collagen diseases]. PMID- 2764421 TI - [Tropical calcifying pancreatitis: a new cause of pancreatitis and diabetes in Parisian hospitals]. PMID- 2764420 TI - [Major hypersplenism with chronic agranulocytosis in regenerative nodular hyperplasia of the liver. Correction by splenectomy]. PMID- 2764422 TI - [Lyme borreliosis: a clinical diagnosis (2 cases)]. PMID- 2764423 TI - [Meningoencephalitis in infectious mononucleosis. Apropos of 2 cases]. PMID- 2764424 TI - [Cerebral thrombophlebitis disclosing functional protein C deficiency]. PMID- 2764425 TI - [Acute pseudovascular multiple sclerosis: an uncommon neurologic emergency]. PMID- 2764426 TI - [Rhizomelic pseudopolyarthritis: a disease or syndrome?]. PMID- 2764427 TI - [Algodystrophy mimicking acute ischemia. 3 new cases]. PMID- 2764428 TI - [Apparently isolated macrodactyly of the toe with localized angiodysplasia. 2 cases]. PMID- 2764429 TI - [Rheumatoid polyarthritis and autoimmune deafness. Apropos of a case]. PMID- 2764430 TI - The effect of transcleral cryopexy on the vitreous gel. PMID- 2764431 TI - The elastic modulus of central and perilimbal bovine cornea. AB - Data on the elastic properties of corneal tissue are needed to define the parameters involved in a model for radial keratotomy. Using bovine corneal tissue, we measured stress-strain relationships of tissue at different locations in the cornea. From this data we calculated Young's modulus of elasticity of five specimens at peripheral and central corneal locations. Increasing levels of stress produced increased resistance to stretch, a property typical of soft biologic materials such as cornea. Linear regression analysis of the data showed that the elastic modulus of the peripheral tissue was greater than that of central tissue at all values of applied stress. These linear relationships were statistically different, using an analysis of covariance, indicating that peripheral corneal tissue is stiffer than central corneal tissue. This information supports the suggestion that a peripheral circular ligament of corneal tissue exists and helps to maintain the curvature of the cornea. It is the disruption of this ligament that is believed to cause some of the change in corneal curvature when radial keratotomy is done. PMID- 2764432 TI - Vitamin A in Stevens-Johnson Syndrome. AB - A 9-year-old boy was admitted to the Pediatric Department with high fever, severe photophobia, and a rash on his face, eyelids, and neck. Two days before admission he received injections of penicillin. During the night his general condition worsened, and his fever rose to 40 degrees C. He began to hallucinate, and clear fluid-filled blisters appeared on his skin and mouth. Severe photophobic epiphora, conjunctival injection, and punctate keratitis were also observed. Several hours after local administration of corticosteroids and antibiotic eye drops, his eyelids swelled severely, the corneas became covered by pseudomembranes, and later, in attempting to open the eyelids, the skin peeled off and the eye lashes fell out. Treatment consisted of artificial tear eye drops, and intravenous antibiotics and steroids. His condition improved gradually, visual acuity became 6/15 in both eyes, and a superficial punctate staining of the cornea was observed. The Schirimer test showed lacrimal hyposecretion. A tarsal conjunctival biopsy showed a complete absence of goblet cells. Vitamin A was administered topically and systemically. After three months of treatment with Vitamin A, tear secretion was almost normal, and conjunctival biopsy indicated a regeneration of goblet cells. PMID- 2764433 TI - Unilateral proliferative sickle retinopathy: a model for photocoagulation in the proliferative retinopathies. AB - We present a case report of a patient with unilateral proliferative sickle retinopathy who progressed to intractable vitreous hemorrhage, traction retinal detachment, and severe loss of vision after unsuccessful vitrectomy surgery. The patient's other eye had chronic uveitis resulting in widespread destruction of the retinal tissue, and subsequently the eye did not have any evidence of neovascularization. This observation is consistent with those seen in proliferative diabetic retinopathy where retinal damage from high myopia, trauma, or other cause typically protects that eye from the advanced stages of diabetic retinopathy. As in this case, the eye with long-standing uveitis did not have proliferative sickle retinopathy. PMID- 2764434 TI - Does conjunctival resection in ptosis surgery lead to dry-eye syndrome? AB - On collating the results of four ophthalmic surgeons after conjunctivolevator resection in ptosis surgery we found no instance of dry-eye syndrome. Our conclusions were based on clinical findings and Schirmer testing after many hundreds of such operations. This study was undertaken because some ophthalmic surgeons had speculated that removal of conjunctiva in this type of surgery would lead to keratoconjunctivitis sicca. Despite prolonged follow-up (as much as 30 years), this has not occurred. All contributing surgeons expressed satisfaction with conjunctivolevator resection in ptosis surgery on selected cases. PMID- 2764435 TI - Borderline spindle cell nevus of the ciliary body as a second primary melanoma--a clinicopathologic case. AB - We present the case of a 22-year-old woman who underwent surgical excision of a malignant melanoma of the skin three years previously and whom we saw for a pigmented tumor of the iridocorneal angle of her right eye associated with end stage secondary glaucoma. After the clinical diagnosis of ring melanoma, she underwent enucleation of the eye. The pathologic examination showed a lesion predominantly appearing as a nevus with areas of borderline melanoma formation. The main features of this case were the young age of the patient, the predominant nevoid appearance of this diffuse ciliary body tumor with ring configuration, and the fact that it is a second primary melanoma in such a young patient. PMID- 2764436 TI - Advanced versus immature cataracts--a preliminary report. AB - We did a prospective clinical study to determine whether removing cataracts which had reached an "advanced" stage were: (1) more difficult to remove, or (2) resulted in decreased postoperative visual acuity compared with immature cataracts. Our data showed that 48.5% of the advanced cases were more difficult to remove than immature cataract cases (17%). The presence of "peripheral lacy cortex" occurred 37 times more frequently in the advanced group than in the immature group. These two parameters might explain the difference in postoperative visual acuity where only 79% of the advanced and 92% of the immature cataracts had 20/40 visual acuity or better (P less than 0.01). Our results suggest that patients should be informed of the increased risks in waiting to have surgery done. PMID- 2764437 TI - Primidone/phenobarbital-induced periodic alternating nystagmus. AB - A 37-year-old man with a history of seizures developed periodic alternating nystagmus (PAN) along with other signs of primidone/phenobarbital toxicity. The PAN gradually diminished in cycle length and intensity, finally resolving with gradual discontinuation of the drugs. PMID- 2764438 TI - Phonosurgery: indications and pitfalls. AB - Twenty-five patients underwent type 1 thyroplasty (external medialization of abducted true vocal cord) during a 2-year period 1986 to 1988) at the University of Iowa. The most common indication for thyroplasty was post-thyroidectomy vocal cord paralysis. Eighteen patients (72%) had either a good or an excellent initial result. Five patients were revised. Postrevision, 21 patients (84%) had achieved either a good or an excellent result. Complications were limited to one case of significant vocal cord edema and another instance of vocal cord hemorrhage. No patient required a tracheotomy. No prosthesis extruded. We feel that phonosurgery has the advantages over traditional Teflon injection of allowing the patient's head to be in a neutral position during the operation; of allowing local anesthesia; of permitting a predictable, graduated end point of the procedure; and of being infinitely adjustable, with preservation of the vocal cord mucosal wave. PMID- 2764439 TI - Laryngotracheal reconstruction with composite nasal septal cartilage grafts. AB - The composite nasal septal graft has been used successfully by us to reconstruct patients with high tracheal and laryngotracheal stenosis. We have treated ten patients and have been able to decannulate seven of these patients. When these ten cases are added to the six original cases presented in an earlier report (1981), certain conclusions can be drawn. The success or failure of these procedures, which is judged by the ability to decannulate the patient, appears to be related to the extent of the initial injury. We discuss the indications for the composite nasal septal graft and the use of additional treatment, including stents, steroid injections, dilatations, and flaps. In conclusion, the addition of these ten cases to the original six cases of composite nasal septal grafts now provides the opportunity to review indications and contraindications for the use of this graft in the management of advanced laryngotracheal stenosis. PMID- 2764440 TI - Bedside videolaryngoscopic assessment of intubation trauma. AB - Telescopic laryngoscopic examination was performed at the bedside after extubation in 29 consecutive surgical intensive care unit patients who required endotracheal intubation for more than 16 hours. The examinations were documented with a portable video recording system. The majority of patients exhibited evidence of acute endolaryngeal trauma. Vocal fold ulceration and vocal fold motion abnormalities were the most common lesions. Patients with abnormal larynges were followed up after discharge from the intensive care unit. Most of the identified injuries resolved without intervention. However, silent aspiration was identified frequently in patients with vocal fold paresis and was thought to be a significant factor in postoperative pulmonary complications. Early identification of significant laryngeal trauma and/or vocal fold paresis in critically ill patients is important for both postoperative pulmonary care and voice rehabilitation. This pilot study demonstrated that documentation of the laryngeal examination is feasible in critically ill patients in an intensive care unit setting. PMID- 2764441 TI - Implantation of the Melbourne/Cochlear multiple-electrode extracochlear prosthesis. AB - The Melbourne/Cochlear multiple-electrode extracochlear implant is designed for deaf patients who are unsuited to multiple-electrode intracochlear implantation. The implant consists of a receiver-stimulator package connected via a lead wire assembly to six individual stimulating electrodes. There is a choice of two alternative surgical procedures, both of which are via a combined middle ear approach using anterior and posterior tympanotomies. Four active electrodes shaped into compressible platinum-iridium soft-balls are fed through the mastoid cavity and across the facial recess, and placed into cavities that are made over the cochlear turns that project to the medial wall of the middle ear. One hard ball active electrode is placed into the round window niche. One hard-ball reference electrode is placed into the hypotympanum. An additional electrode wrapped around the lead wire assembly can be used as an alternative reference electrode. A specially designed insertion needle facilitates the placement and the fixation of the soft-ball electrodes. PMID- 2764442 TI - Auditory brain stem response monitoring during middle ear surgery. AB - Conductive hearing loss can be determined in the course of middle ear surgery by sound probe stimulation and simultaneous recording of auditory brain stem responses. Mechanical properties of the ossicular chain, usually judged subjectively by the surgeon's visual and tactile senses, can be quantified objectively. Thus, disarticulation of ossicles can be localized precisely, and fixation of the head of the malleus can be differentiated from stapes fixation. Moreover, the function of the reconstructed ossicular chain or prosthesis may be ascertained. PMID- 2764443 TI - Salivary gland carcinosarcoma: true malignant mixed tumor. AB - True malignant mixed tumor, or carcinosarcoma, of salivary gland origin is rare. Only 19 cases have been reported in the literature and a review of cases seen at the University of Iowa over the last 60 years yielded only two. In one case the mesenchymal component of the tumor contained both osteosarcoma and chondrosarcoma. In the second case, the history and the histology suggest a progression from carcinoma ex pleomorphic adenoma to a carcinosarcoma. These features are documented in this report and literature review. PMID- 2764444 TI - Fetor from ulcerated head and neck tumors: causation and therapy. AB - Almost all extensive tumors of the head or neck generate a fetor very unpleasant for the patient, his family, and the nursing staff. Thirty-one patients suspected of having a microbial superinfection of the tumor masses caused by anaerobes or an aerobe-anaerobe mixed infection were examined, and tumor samples from the oral cavity, throat, and larynx were obtained. Anaerobes could be demonstrated in every case, especially Bacteroides melaninogenicus. In the antibiotic treatment, clindamycin (Cleocin) proved to be superior to metronidazole (Clont). Within 12 to 24 hours after initiation of treatment, at the most 36 hours, the fetor almost always disappeared. The odor was stopped as long as antibiotic therapy continued. PMID- 2764445 TI - Large pituitary adenomas with extension into the nasopharynx. Report of three cases with a review of the literature. AB - Three cases of pituitary adenoma with extension into the nasopharynx and nasal cavity are reported. The occurrence of this rare tumor underscores the need to consider a pituitary tumor whenever a patient presents with rhinologic complaints and destruction of the sellar floor. Epistaxis, although exceptional, may be the first manifestation of a pituitary tumor. Immunohistochemical analysis combined with staining for the pituitary hormones proved to be essential for reaching a definite diagnosis. Magnetic resonance imaging seems to be the modality of choice for differentiation between tumorous and nontumorous sinus obstruction. PMID- 2764446 TI - Eyes open versus eyes closed: effect on human rotational responses. AB - The effect of eyelid closure on the response to rotational vestibular stimulation was assessed by evaluating 16 normal human subjects with both earth vertical axis (EVA) and earth horizontal axis (EHA) yaw rotations with either eyes closed (EC) or eyes open in the dark (EOD). Results indicated that for EVA rotation, the subjects' responses were of larger magnitude and less variable with EOD than with EC. However, for EHA rotation, responses were of larger magnitude and equally variable with EC as compared to EOD. Our data also indicated that the quality of the EHA response with EC was altered because eyelid closure influenced the amount of periodic gaze. We conclude that eyelid closure has an effect upon both canalocular and otolithocular reflexes and suggest that both EVA and EHA rotational testing be performed with EOD rather than with EC. PMID- 2764447 TI - Eustachian tube lumen: comparison between normal and inflamed specimens. AB - This study presents measurements of the cross-sectional luminal area of the eustachian tube. Comparisons are made between the lumens of eustachian tubes obtained from temporal bones presenting acute or secretory otitis media and those from noninflamed temporal bones. The material consisted of 71 temporal bones obtained postmortem from individuals up to 2 years of age. Forty-six of these showed no middle ear inflammation, while 25 presented either acute or secretory otitis media. In both groups the lumens of all the eustachian tubes were patent, presenting no obstruction. The mean cross-sectional area of the lumens of inflamed temporal bones was smaller than that of the noninflamed ones. This difference was not found to be statistically significant in the cartilaginous regions and was found to be statistically significant or borderline significant in the bony parts of the eustachian tube. PMID- 2764448 TI - Acute airway obstruction and achalasia of the esophagus. AB - Patients with achalasia tolerate considerable distension of the esophagus. Respiratory symptoms usually are due to regurgitation and pulmonary aspiration of retained food rather than to a space-occupying mechanism. We describe a case of previously undiagnosed achalasia presenting in an elderly woman with symptoms consistent with tracheal obstruction of acute onset. PMID- 2764449 TI - Facial nerve paralysis with benign parotid masses. AB - Facial paralysis in the presence of a parotid mass has been associated classically with a presumed diagnosis of malignancy. However, isolated case reports have documented the occurrence of paresis or paralysis secondary to pathologically benign, nonneurogenic parotid lesions. These previous cases have been reviewed and three additional cases are described. Comparisons are made on age, sex, symptoms, physical findings, pathologic findings, and prognosis. Involvement of the seventh nerve may be explained on the basis of compression, especially in association with local inflammation. Although facial paralysis still should be considered indicative of a malignancy, it also may be caused by benign masses, particularly those associated with rapid enlargement and/or infection. PMID- 2764450 TI - Epithelioid sarcoma. AB - Epithelioid sarcomas are histogenetically and often biologically peculiar soft tissue malignancies that may be either primary or metastatic in the head and neck. The sarcomas have high recurrence and metastatic rates and a sometimes torpid course but nonetheless poor survival. PMID- 2764451 TI - [A new Plasmodium species from a lemur: Plasmodium coulangesi n. sp]. AB - The splenectomy of a female Lemur macaco macaco, showing a scanty blood infection by Haemosporidians and a Trypanosome was followed by a dramatic increase of the rate of intra-erythrocytic parasitaemia. Three species of Plasmodium where then identified. The first species was unknown; it is described in this paper and named Plasmodium coulangesi n. sp. It is characterised by--the low (6). constant number of merozoites in mature schizonts,--the disposition of the pigment, well apart from the parasitic mass to which it is linked by a tiny wisp of cytoplasm,- the normal host erythrocyte, the shape, size and colour of which are unaltered. The second species was provisionaly designated as Plasmodium sp.; it was previously seen in the same host by Garnham and Uilenberg in 1975 and designated by these authors as Plasmodium girardi Buck, Coudurier et Quesnel, 1952. Only gametocytes of the last species were found; they are similar to those of Plasmodium lemuris Huff and Hoogstraal, 1963. PMID- 2764452 TI - [Plasmodia of lemurs in Madagascar]. AB - Lemur macaco macaco from Ambanja region was found polyparasitized by four different species of Plasmodium: --Plasmodium coulangesi recently described by lepers et al. (1989). --P. bucki n. sp.: its main differential characterisitics are the large numvber (32) of merozoites produced in mature schizonts and the stippling, resembling Maurer's dots, in an hypertrophied pinkish erythrocyte. - P. percygarnhami n. sp. (= P. girardi sensu Uilenberg, 1970 pro parte and sensu Garnham et Uilenberg, 1975 pro parte) producing 20 merozoites in mature schizonts and developing inside a deformed corpuscle (holly leaf-shaped or sometimes sea urchin-shaped) which may also become decolourized when parasitized by older stages. --(?) Plasmodium lemuris: gametocytes are very large (11 microns x 7 micron); the parasitized erythrocyte is much hypertrophied (+/- 10 microns), distored and of a pinkish colour; one schizont only, possibly exo-erythrocytic, was found. The authors hypothesized this parasite to be a Haemoproteid. The analysis of published data led the authors to make the following modifications to the nomenclature previously established: --Plasmodium girardi Buck et al., 1952, sensu Garnham, 1966, sensu Uilenberg, 1970 parte and sensu Garnham and Uilenberg, 1975 pro parte, is refered to as Plasmodium sp., for stages developing in the blood of Lemur fulvus fulvus. The taxon P. percygarnhami is to be employed for stages developing in L. m. macaco and P. girardi Buck et al., 1952 for those developing in Lemur fulvus rufus. --Plasmodium foleyi Buck et al., 1952, sensu Garnham and Uilenberg, 1975 in L. f. fulvus is named Plasmodium uilenbergi n. sp., P. folleyi being a parasite of L.f. rufus. Excluding P. lemuris which probably does not belong to the genus Plasmodium, the morphological analysis led to individualize 7 species, in the three species of Lemurs studied. A phenomenon of "vicariance" thus appears, similar to what is known for the african Rodent Plasmodia, but with a more pronounced speciation. The vicariant species form a pair constituted of: --on the one hand a small species developing in a red blood cell of normal size, P. girardi in L.f. rufus, P. sp. in L.f. fulvus, P. percygarnhami, with also, P. coulangesi, in L. m. macaco; --on the other hand a large species determining an hypertrophy of the erythrocyte, P. foleyi in L.f. rufus, P. uilenbergi in L.f. fulvus and P. bucki in L.m. macaco. PMID- 2764453 TI - [Schistosoma intercalatum: morphologic and biometrical changes of the eggs in relation to the localization in the definitive host and with the geographical origin of the parasite (Cameroon and Zaire)]. AB - A study of the egg morphology and biometry of Schistosoma intercalatum is carried out. A comparative study shows that the egg size varies according to the localization: the smallest are in utero, the largest in the liver, those from the faeces being intermediate. The increase in size could depend on the miracidial development. Some morphological features vary in relation with size especially the width. Regarding the geographical origin, two morphological differences are reported: the first is the presence of a "shoulder" at the spined end of the egg of the Cameroon strain and its absence in the Zaire strain; the second is the dissymmetry of the eggs from Zaire and the relative symmetry of the eggs from the Cameroons. The eggs from the Cameroons which tend to be larger but narrower than those from Zaire, are significantly different. PMID- 2764454 TI - [Large-scale production of amastigotes by a human monoblastoid cell line]. AB - In this study, a human monoblastoid cell line (TPH-1) was tested in vitro for the production of Leishmania amastigotes. The number of TPH1 cells increased with time and 6 days after promastigote infection the percentage of infected cells was around 45%. Pre-treatment of TPH1 cells with retinoic acid induced the cells to differentiate into unreplicating macrophage-like cells. Ninety per cent was parasitized 6 days after promastigote infection; the number of amastigotes quintuplied during this period of time; this result was irrespective of the Leishmania species used for experiments. Viable and infective parasites were obtained from treated and nontreated cells. TPH1 cells merit further consideration for research concerning new molecules active against Leishmania. PMID- 2764455 TI - Chondritis of the burned ear: a preventable complication if ... PMID- 2764456 TI - Hydrostatic distention and pharmacological treatment of epinephrine-induced microarterial spasm. AB - The efficacy of using hydrodistention and vasodilatory drugs to relieve spasm in arteries was investigated. The femoral arteries of 64 rabbits (divided into five groups) were placed in spasm by the topical application of epinephrine (1 mg/ml). In group A (controls) vasospasm was induced without further treatment. In group B vasospasm was induced, and the arteries were hydrodistended with normal saline. In three additional groups vasospasm was induced and either 10% lidocaine hydrochloride (group C), verapamil hydrochloride (group D), or chlorpromazine hydrochloride (group E) was applied. Thirty minutes later the vessels were hydrodistended. All vessels were measured at set intervals, and some specimens were retained for light and electron microscopy. All methods of spasm relief were successful, although to varying degrees. Hydrodistention alone produced the widest dilation for the longest time. Lidocaine was the most successful drug treatment alone. Verapamil followed by hydrodistention was the most successful combination regimen, but did not produce better results than hydrodistention alone. Hydrodistention alone produced significant arterial wall damage, resulting in permanent structural modifications. Prior vasodilatory drug treatment reduced but did not eliminate hydrodistention damage. Although hydrodistention dilates for longer periods than vasodilatory drugs, the arterial wall damage associated with hydrodistention indicates that it should be used only when all other methods of vasodilation have failed. PMID- 2764457 TI - Treatment of peripheral ischemia secondary to lidocaine containing epinephrine. AB - Accidental injection of local anesthetics containing epinephrine into a digit can cause distal tissue necrosis. Norepinephrine infiltration in subcutaneous tissue also causes tissue necrosis. Phentolamine has been used to prevent necrosis from norepinephrine. Because both epinephrine and norepinephrine are alpha- and beta adrenergic stimulators, the rat foot model was developed to study the possible use of phentolamine or labetalol in protection against tissue necrosis after injection of epinephrine in the extremity. Phentolamine was found to be useful in preventing tissue necrosis after the injection of local anesthetic containing epinephrine in the skin of the rat foot. Labetalol was found to be less effective in preventing tissue necrosis. Phentolamine may be useful in preventing tissue necrosis after the inadvertent injection of epinephrine containing local anesthetics in the digit. PMID- 2764458 TI - Complications of reduction mammaplasty: comparison of nipple-areolar graft and pedicle. AB - A retrospective study of breast reductions in 268 patients by two plastic surgeons was performed. Particular attention was paid to those patients treated by inferior pedicle techniques; these patients were compared with those treated by free nipple grafts. According to our findings, patients with skin loss were heavier and had longer suprasternal notch-to-nipple distances. Patients who had free nipple grafts were older and heavier and had larger specimen weights and longer suprasternal notch-to-nipple distances. Fifty-four of the original 268 patients were included in a substudy of larger breasts, defined as those with a specimen weight of over 700 g. Nineteen patients underwent free nipple grafts, and 35 underwent inferior pedicle techniques. None of the 19 patients having free nipple grafts developed complications, whereas 6 of the 35 undergoing inferior pedicle techniques sustained significant complications. We conclude that free nipple grafts should be considered over inferior pedicles in heavier patients with breast ptosis. PMID- 2764459 TI - Failure of pentoxifylline to enhance skin flap survival in the rat. AB - The effect of pentoxifylline, a hemorheological agent that increases erythrocyte flexibility and augments capillary blood flow, on the survival of the dorsal skin flap of the rat was studied. An experimental group received intraperitoneal injections of pentoxifylline twice daily, 50 mg/kg/day, and a control group was given identical volumes of saline. Standard McFarlane flaps sized 4 x 9 cm (n = 22) and narrower 2 x 6-cm flaps (n = 18) were constructed 14 days later. After a postoperative observation period of 7 days, no significant difference in tissue survival between the pentoxifylline-treated animals and the controls was found in either flap model. Fourteen days preoperative treatment with pentoxifylline appeared to have no effect on flap survival. PMID- 2764460 TI - The effect of endogenous skin bacteria on burn wound infection. AB - Burn wound sepsis can be due to exogenous or endogenous bacteria. When rare organisms cause infection, exogenous sources are implicated. This sets into motion hospital infection control team searches, which are both exhausting and harassing to patients and staff. This study examines the skin bacteria present at admission and the frequency of endogenous infection in burn patients. Sixty-two patients with burns up to 92% of the total body surface area underwent unburned skin bacterial surveillance on admission and at weekly intervals using RODAC contact plates. Burn wounds were biopsied for quantitative and qualitative analyses. Morphologically dissimilar colonies were isolated and identified using standard gram-positive and gram-negative identification strips (Analytab Products, Inc. [API]). On admission, the patients harbored Staphylococcus species, many of which were burn wound sepsis were infected with the same organisms cultured from their unburned skin on admission. A subset of patients (14) grew methicillin-resistant Staphylococcus aureus from their wounds or other sites. A comparison with admission isolates showed identical susceptibilities. These data suggest skin is an endogenous source of infection in the burned patient. PMID- 2764461 TI - "Smile" reconstruction in facial paralysis. AB - Reanimation of the face following facial nerve paralysis, especially the socially important smile, presents a complex surgical challenge requiring an individualized approach. Both neural and non-neural operative procedures have been used in an attempt to achieve the goal of a symmetrical synchronous smiling expression. A retrospective review of the results of both neural and nonneural methods was made to determine the relative efficacy of various methods. Of the neural techniques, early direct nerve repair primarily consistently achieved the best functional recovery. Double nerve grafts were found to be superior to a single nerve graft in nerve severance with a nerve gap at the facial nerve trunk bifurcation in delayed cases. In long-standing cases, ipsilateral or cross-face nerve grafting followed by functioning muscle transfer gives the most acceptable synchronous smile. Although cross-face nerve graft only, hypoglossal facial transfer, or non-neural techniques such as temporal muscle transfer achieved restoration of the smile, their inconsistent results and asynchronous action still limited the patient's confidence in social interactions. PMID- 2764462 TI - An alternative technique for correction of cryptotia. AB - Cryptotia is rare in the western world, and consequently any one surgeon's experience with its correction is limited. A procedure for the correction of cryptotia is described, which takes into account the details of the deformity. It adds skin flap from the preauricular tissue to cover the reconstructed cartilage of the anterior and superior helix. Two patients with cryptotia were treated with this technique, and good postoperative results were achieved. PMID- 2764463 TI - Intractable retroauricular abscess associated with microtia and aural atresia- some views in relation to the congenital cholesteatoma and microtia. AB - Five microtic and aural atretic ears associated with intractable retroauricular abscess unresponsive to conservative treatment are reported. The pathogenesis of this abscess is primary cholesteatoma called "cholesteatoma auris congenita of atretic ear," and these lesions can be clearly explained by the embryological development of the external auditory meatus. Microtic ears with such lesions invariably have part of the cartilaginous canal patent but have an atrophic bony canal. Therefore, grade 3 microtia has never been affected theoretically. We also discuss the relationship between the retroauricular abscess and the development of the tympanic bone. The evaluation of this lesion with computed tomography is mandatory for the detection of an occult congenital cholesteatoma behind the atretic canal, and regular follow-up of the patients with microtia and aural atresia is necessary for plastic surgeons. PMID- 2764465 TI - Re: Anous and Hallock: immediate reconstruction of the auricle using the amputated cartilage and the temporoparietal fascia. PMID- 2764464 TI - Tattooing for the management of white patches. AB - Although biologically more or less inert, a white patch is a social taboo in India. When a white patch is localized and remains static in spite of conservative treatment, it can be dealt with by tattooing as a camouflage procedure. Inert pigments of skin color match are impregnated into the intradermal plane. The procedure is simpler than melanocyte transfer and serves the purpose of hiding a white patch. In the present study, histology of the tattooed skin was studied to confirm the retention of the pigments into the intradermal plane. The patient remains pain-free in the postoperative period. The procedure does not keep the patient away from work, nor does it require hospitalization or general anaesthesia. It can be dealt with as an office procedure, making it relatively inexpensive. PMID- 2764466 TI - Serum albumin and the specificity of free tri-iodothyronine as a test for hypothyroidism. AB - Serum free tri-iodothyronine (FT3), using two different radioimmunoassays, and serum albumin, using bromocresol green dye-binding method, were measured prospectively in 1374 adults investigated for thyroid disease. The results of similar pairs of measurements in 6608 serum specimens obtained from adults, but using one of the radioimmunoassays for FT3, were examined retrospectively. A close correlation was observed between the FT3 values and serum albumin concentration. Normalisation of the FT3 level using a standard albumin value of 43 g/L in the absence of chemical evidence of hypothyroidism (serum thyrotrophin less than 6.5 mIU/L) gave a distribution of FT3 values which closely resembled that from a normal population. The effects of acute illness and old age, which may lower the FT3 value, can be corrected by this transformation. PMID- 2764467 TI - A simple time-resolved fluoroimmunoassay of total thyroxine in serum. AB - We describe a non-isotopic heterogeneous competitive immunoassay of total thyroxine in serum. Thyroxine, released from its binding proteins by merthiolate (thimerosal), competes with immobilised thyroxine (thyroxine-bovine globulin conjugate) for binding to a monoclonal biotinylated antibody. The amount of biotinylated antibody bound, which is inversely related to the amount of thyroxine in the sample, is then quantified by adding streptavidin labelled with the europium chelator 4,7-bis(chlorosulphophenyl)-1,10-phenanthroline-2,9 dicarboxylic acid (BCPDA) in the presence of excess Eu3+. The complex formed (bovine globulin-thyroxine-antibody-biotin-streptavidin-BCPDA-Eu3+) is measured on the solid-phase by time-resolved fluorescence. The assay is simple to perform and its characteristics are similar to those of other currently used immunoassay techniques. PMID- 2764468 TI - Radioiodination for therapy. AB - A method for the radioiodination of antibodies for therapy is described. The method resulted in a high efficiency of labelling (88-94%) with negligible damage to the antibody. Good localisation of labelled antibody was demonstrated. Doses of radiation to operators were very low. PMID- 2764469 TI - The value of C-reactive protein in the diagnosis of intestinal perforation in typhoid fever. AB - Serum C-reactive protein concentrations were measured in 28 Nigerian patients with typhoid fever on presentation at hospital and at intervals thereafter. Five of the 28 (18%) were subsequently diagnosed as suffering from ileal perforation. These patients had concentrations of C-reactive protein during the first 24 h of admission which were significantly higher (mean = 229 mg/L) than those without perforation (mean = 91 mg/L). C-reactive protein may have a role in the prediction of early diagnosis of perforation in patients with typhoid fever. PMID- 2764470 TI - Comparison of two latex agglutination test kits for serum myoglobin in the exclusion of acute myocardial infarction. AB - The Myolex (Orion) and the RapiTex (Behringwerke) latex agglutination tests for the rapid detection of elevated levels of serum myoglobin were studied prospectively in patients suspected of acute myocardial infarction, who were admitted to hospital within 8 h of pain onset. Using admission blood samples drawn 3.4 +/- 2.0 h (mean +/- SD) after onset of symptoms, the negative predictive values of both tests were too low to use these assays in the early exclusion of myocardial infarction in the emergency department. However, the negative predictive values obtained with the second blood samples, drawn 4 h later, indicated that the myoglobin agglutination test could be of value in the exclusion of myocardial infarction. PMID- 2764471 TI - Diagnostic value of serum testosterone measurement in infancy: two case reports. AB - The diagnostic value of serum testosterone measurement and hCG stimulation during early infancy is highlighted by describing two unrelated cases in whom such investigations aided diagnosis and management. When performed on infants between 2 and 9 weeks of age, these measurements can provide valuable information on the integrity of the hypothalamic-pituitary axis in male infants and can identify the presence of testicular tissues in babies with abnormal or ambiguous genitalia. PMID- 2764472 TI - Theophylline assay on Kodak Ektachem DTSC--performance and interference by structurally-related compounds and salicylate. AB - Theophylline was measured with a Kodak Ektachem DTSC using its property of uncompetitive inhibition of alkaline phosphatase. Within- and between-batch reproducibility was satisfactory. Agreement with consensus mean values on quality assessment samples was good as was agreement on patients' samples with a high performance liquid chromatography reference method and an automated fluorescence polarisation immunoassay. At therapeutic theophylline concentrations, no interference was seen with caffeine, theobromine, 1,7-dimethylxanthine, 1,3 dimethyluric acid or 3-propylxanthine. 3-methylxanthine (a theophylline metabolite) gave a positive bias but the concentrations of this metabolite found in serum are such that the clinical significance of this finding is questionable. Salicylate at concentrations which might be found during therapy for paediatric rheumatoid arthritis also gave a positive bias. PMID- 2764473 TI - Comparison of potassium ISFETs with the Radiometer KNA1 and the Corning 902 ion selective electrode analysers for whole blood potassium ion estimation. AB - Evaluation of the performance of potassium ion sensitive field effect transistors (K+ ISFETs), developed by Thorn EMI in a form suitable for mass production and for incorporation in 'near the patient' analysers, showed only very small constant and proportional biases against the Radiometer KNA1 and the Corning 902 for whole blood potassium ion estimation. Between batch imprecision tests with whole blood showed the K+ ISFET was comparable in performance to the Corning 902 but inferior to the Radiometer KNA1. The evaluation demonstrated that ISFET manufacturing technology has now reached a stage of development at which ISFETs should be considered seriously for use in clinical chemical analysers. PMID- 2764474 TI - A fast automated method for measuring serum and urine citrate. PMID- 2764475 TI - Manganese-heparin precipitation of very low-density lipoprotein: screening for type III hyperlipoproteinaemia. PMID- 2764476 TI - An evaluation of the Abbott TDx serum cortisol assay. PMID- 2764477 TI - Observer variance in the reporting of faecal occult blood results using the Okokit II method. PMID- 2764478 TI - Lack of effect of overnight storage of heparinised blood at 4 degrees C on plasma phosphate concentration. PMID- 2764479 TI - Biological variation of serum and urine creatinine and creatinine clearance. PMID- 2764480 TI - Is freeze-dried serum suitable for inter-laboratory standardisation of fructose assays. PMID- 2764481 TI - Why the assay of serum cystine by protein precipitation and chromatography should be abandoned. PMID- 2764482 TI - Oligoclonal bands and the IgG index in multiple sclerosis: uses and limitations. AB - The relationship between two tests commonly used in the investigation of multiple sclerosis (MS), the IgG index and oligoclonal bands, has been assessed. Using an immunoblotting technique specific for IgG, analysis of cerebrospinal fluid for oligoclonal bands was found to provide greater diagnostic sensitivity than the IgG index without any loss of specificity. In patients without oligoclonal bands the IgG index had no diagnostic value for MS and in the presence of bands the magnitude of the index was unrelated to the clinical certainty of the diagnosis. High values of the IgG index were invariably associated with the presence of oligoclonal bands and the IgG index appeared to have no clinical significance independent of this relationship. Even as a screening test the IgG index has serious limitations. PMID- 2764483 TI - Budget management of National Health Service pathology laboratories. PMID- 2764484 TI - Relative diagnostic value of serum non-SHBG-bound testosterone, free androgen index and free testosterone in the assessment of mild to moderate hirsutism. AB - Recent evidence suggests that steroid hormone loosely bound to albumin is available for target-cell entry. Preliminary studies have suggested that a measure of this fraction, non-sex-hormone-binding globulin-bound testosterone (NSB-T), provides the best in vitro diagnostic test for idiopathic hirsutism. We compared the diagnostic value of NSB-T, total testosterone (T), free testosterone (fT), and the free androgen index (FAI) in supporting the clinical diagnosis in 22 pre-menopausal women with hirsutism. NSB-T supported the diagnosis in 50% of cases, compared with 23% for T, 55% for fT by analogue RIA, and 68% for FAI. We conclude that in mild to moderate hirsutism the measurement of NSB-T does not yield diagnostic information addition to that provided by the FAI. PMID- 2764485 TI - Alterations in fructosamine and glycated albumin levels during childhood. AB - Age-related changes in the blood concentrations of glycated proteins during childhood and adolescence were examined by measuring the blood fructosamine (FA), glycated albumin (GA), glucose levels and total serum protein levels in 611 healthy children (325 boys and 286 girls) aged 0-18 years old. These levels were compared with those of 130 healthy adults. GA was measured by a newly developed, highly precise method of high-performance liquid chromatography (inter-assay coefficient of variation, 4.9%). The FA values of all groups of up to 15 years old (grouped in two year age brackets) were significantly lower than those of adults. The mean serum concentrations of GA in infants up to four years old were also significantly lower than in adults. A slight but statistically significant positive correlation was found between age and values of FA (r = 0.36, P less than 0.001), but not of GA (r = 0.04). Levels of total serum proteins showed a positive correlation with those of FA (r = 0.47, P less than 0.001) but a weak correlation with those of GA (r = 0.29). These results suggest that age should be taken into account when the FA levels of children and the GA values of infants are evaluated. PMID- 2764486 TI - Glycated haemoglobin and other biochemical parameters in Sudanese diabetics. AB - Fasting levels of glycated haemoglobin, cholesterol and triglycerides were studied in 44 patients with non-insulin-dependent diabetes mellitus (NIDDM), 31 patients with insulin-dependent diabetes mellitus (IDDM) and 28 healthy Sudanese individuals. Results confirmed previous observations showing correlation of glycated haemoglobin with fasting blood glucose in NIDDM (r = 0.634; P less than 0.001), and with cholesterol in IDDM (r = 0.355; P less than 0.05). No correlation of glycated haemoglobin with triglycerides was observed in either group of diabetics. A negative correlation was demonstrated between glycated haemoglobin and the duration of diabetes (r = -0.552; P less than 0.01) in IDDM. It seemed that control improved in these patients as their diabetes progressed, probably through self-education. PMID- 2764487 TI - Assessment of the bioactivity of human and bovine thyrotrophin preparations using a porcine thyroid cell bioassay. AB - The biopotency of six preparations of thyrotrophin (TSH) has been compared in a highly sensitive in vitro porcine thyroid cell bioassay using iodide uptake as an endpoint. Three of these preparations were of human origin and three derived from bovine pituitary tissue. One human TSH preparation, the 2nd International Reference Preparation, 80/558, was used to calibrate the other five. The log dose log response curves for all preparations were sigmoidal in shape. For the purpose of evaluation the central linear portions of the curves were compared. With all preparations the slopes in this region were very similar. The relative biopotencies of the bovine preparations (unit:unit) were at least five times those of the human standards when measured using the porcine thyroid cell bioassay. These findings emphasise the need to control the TSH standards employed in a variety of bioassays, particularly those used for between-laboratory comparison. PMID- 2764488 TI - Development of an assay for human growth hormone in urine using commercially available reagents. AB - An assay for the measurement of human growth hormone in urine (u-HGH) has been developed using commercially available reagents and its analytical variables have been investigated. The procedure is sensitive to 0.50 muU/L urine, has an interassay precision of 6.2-7.5 (CV%) over the standard curve, and shows good parallelism and recovery. Urine samples for the assay can be collected in plain plastic bottles, stored at room temperature for up to 24 h and, after adding preservative, at -20 C before assay for three months. There was a good correlation between the responses of HGH in serum and in urine during clonidine and insulin stimulation tests. PMID- 2764489 TI - Feasibility of a short term severely restricted sodium diet with counselling support. AB - For the purpose of short term clinical trials previous studies have made use of metabolic kitchens to provide severely restricted sodium diets. We evaluated the feasibility of administering a 5-day severely restricted (22 mmol) sodium diet on an outpatient basis with counselling support, outside a metabolic unit. In 13 highly-motivated volunteers, 24-h urinary sodium excretion fell from 128.5 +/- 11.9 on a normal diet to 19.2 +/- 2.88 mmol per day and plasma sodium dropped from normal diet to 19.2 +/- 2.88 mmol per day and plasma sodium dropped from 140 +/- 0.41 to 137 +/- 0.78 mmol/L, showing that such an approach is effective. PMID- 2764490 TI - An automated method for the analysis of urinary free catecholamines using ASTED and high-pressure liquid chromatography. AB - A high-pressure liquid chromatography procedure for the measurement of free catecholamines in urine is described. 'On-line' sample preparation using a cartesian robot combined with the ASTED process ensures minimal operator intervention and reduced costs. PMID- 2764491 TI - Interference of plasma fluorophores on the red blood cell zinc protoporphyrin: haemoglobin ratio as determined on a haematofluorimeter. AB - Direct measurement of the zinc protoporphyrin:haemoglobin ratio (ZPP:Hb ratio) in blood samples is performed by using a haematofluorimeter. Interference by non specific fluorophores can be eliminated by removing the plasma and making the measurement on washed red blood cells (RBCs). After re-suspending RBCs in isotonic saline, haematofluorimeter readings for the ZPP:Hb ratios revealed higher stability in the course of time whereas a good relationship was found with results obtained by application of an extraction method. Separate reference ranges were established for adult male and female subjects. After washing, the mean values calculated for ZPP:Hb ratios of subjects belonging to the reference groups demonstrated a reduction of 0.04 mumol ZPP mol Hb, corresponding with approximately 30%. In the patients' group, application of washing resulted in a variable decrease of ZPP:Hb ratios. PMID- 2764492 TI - A comparison of two intact-molecule parathyroid hormone assays. PMID- 2764493 TI - 18th annual meeting of the European Thyroid Association. Abstracts. Copenhagen, Denmark, June 26-30, 1989. PMID- 2764494 TI - [Chronic hepatitis caused by hepatitis B virus. Comparative study of the histologic lesions and of viral replication]. AB - The incidence of two markers of viral replication (viral DNA in sera and HBc Ag on liver) was studied in 22 patients and compared to the histological features of needle biopsy of the liver. We obtained a 100% qualitative correlation between both methods. The presence of these two markers of replication is independent of the histological feature of the hepatic lesions we studied. Using our knowledge of the recent discoveries about chronic HBV infection, we proved that a close examination of both results modifies the predictive value of each one. The pejorative characteristic of the CAH is particularly doubtful in some cases. PMID- 2764495 TI - [Severe forms of hemorrhagic rectocolitis. Predisposing role of the amebic graft?]. AB - Severe forms of ulcerative colitis are somewhat rare but have a severe prognosis. Apart from the usual predisposing factors, the amebic graft must be especially emphasized, at least in those countries where the parasite is endemic. Entamoeba histolytica was consistently identified in 19 cases of the severe form that we found out of a total of 126 cases of ulcerative colitis. Usually the parasite was found in the shape of massive infestation and in most cases it proved to be resistant to the amebicides currently available. The clinical picture shown by the 19 patients was identical to that given in the literature for severe forms of ulcerative colitis. Therapeutically, it was essential to combine one (or, if necessary, several) course(s) of treatment with amebicides with the usual therapeutic measures until the parasite was destroyed in the intestine. This work suggests that any attack on ulcerative colitis must automatically include an anti amebic course of treatment, and this should strictly precede any corticosteroid therapy, even administered as enemas. PMID- 2764496 TI - [A new case of appendicular villous tumor]. PMID- 2764497 TI - [Prevention and treatment of gastroduodenal lesions caused by NSAID]. PMID- 2764498 TI - [Results of a follow-up of 200 patients with gastric cancer treated surgically]. PMID- 2764499 TI - [Surgical treatment of recurrences of colorectal cancers (amputations excluded)]. PMID- 2764500 TI - Image cytometry DNA analysis of invasive squamous cell carcinoma of the esophagus. AB - The Feulgen-DNA content of squamous carcinoma cell nuclei from the human esophagus was assessed in punch biopsies from 47 untreated patients. Forty-four of the 47 biopsies (93.6%) demonstrated aneuploid cell populations, and the remaining 3 (6.4%) were non-diploid. Previous studies have demonstrated that in esophageal dysplasias adjacent to invasive squamous cell carcinoma, DNA in single cells is substantially altered. Thus the process of esophageal carcinogenesis can be monitored not only by histological changes, but also by DNA aberrations in single cells. Quantitative DNA measurement appears, therefore, to be a complement to the histological evaluation of esophageal lesions with suspected, but not unequivocal, evidence of neoplastic growth. PMID- 2764501 TI - Monoclonal antibodies against ovarian carcinoma-associated antigens, raised by immunization with cyst fluids. AB - Intrasplenic immunization with ovarian tumour derived cyst fluids was used to generate monoclonal antibodies (Mabs) against human ovarian carcinomas. Seven Mabs were characterized immunocytochemically using indirect immunofluorescence assays (IFA) on frozen sections of gynaecologic tumours (n = 85), non gynaecologic tumours (n = 50), normal human tissues (n = 66), and on 8 ovarian carcinoma cell lines. The Mabs reacted with 67-96% of 49 ovarian carcinoma tissues tested. Although 6 out of 7 Mabs showed slight cross reactivity with some endometrial, cervical, and oviductal carcinomas, little reactivity with non gynaecologic tumours or normal tissues was found. Based on immunoelectronmicroscopy, all the antigenic determinants defined by the Mabs appeared to be associated with the tumour cell membrane. Among the seven Mabs, OV TL 16 (IgG1 subclass) and OV-TL 23 (IgM class) reacted positively with 96% and 82% of the ovarian carcinomas respectively. Staining of 100% of the ovarian carcinomas examined (n = 49) could be achieved by combining OV-TL 16 with 23, as also by other combinations of the Mabs. It is concluded that a panel of these newly developed Mabs may be suitable for diagnostic purposes in histopathology. PMID- 2764502 TI - Increased activity of a basic LDH 5-related isoenzyme in cells derived from chronic myeloid leukemia. AB - The LDH isoenzyme pattern in cells derived from patients (n = 24) with chronic myeloid leukemia (CML) was studied using a high resolution isoelectric focusing (IEF) technique. In K562 cells a highly basic (band B, IEP greater than 10.5) LDH isoenzyme was detected. Using a 2-dimensional technique combining electrophoresis and IEF, its relation to the LDH 5 isoenzyme was demonstrated. From its heat stability it is concluded that band B is composed of 4 M subunits. The activity of the basic band correlated with the number of CML blast cells and was absent in juvenile, band and segmented neutrophils. Our observations are compatible with a gradual loss of activity during myeloid differentiation. The nature of band B remains unclear, but artefacts due to ligand (lactate, pyruvate, NAD+) binding were ruled out. PMID- 2764503 TI - Enhancement of adriamycin-induced cytotoxicity by increasing retention and inhibition of DNA repair in DOX-resistant P388 cell lines with new calcium channel blocker, DMDP. AB - The effect of DMDP, N-(3,4-dimethoxyphenethyl)-N-methyl-2-(2-naphthyl)-m-dithiane 2-propylam ine hydrochloride, on DOX-induced cytotoxicity, drug uptake, DNA damage and repair was investigated in adriamycin sensitive and resistant P388 cell lines. In vitro, the DOX-resistant P388 cells used are about 300-fold more resistant than the sensitive cells. Resistant cells were characterized by lower DOX accumulation, rapid drug efflux, significant decrease of DNA single and double strand breaks and rapid repair of the induced single strand breaks. DMDP, a calcium channel blocker, is an effective modulator of DOX resistance in P388 cells. This modulation was found to be highly dependent of the concentration of the modulators, optimal at the maximally moncytotoxic concentrations of 1-4 microM, and the duration of exposure to the modulator, optimal under conditions of continuous exposure to the modulator. Under the optimal conditions in the presence of the modulator, DMDP, both intracellular concentration and retention of DOX were restored in the resistant P388 cells to the value comparable to those found in DOX sensitive P388 cells. Even though DOX accumulation and retention were at a comparable level in both the sensitive and resistant cells in the presence of DMDP, the amount of DNA single strand breaks achieved in the resistant cells was only about 30% of the amount of damage observed in the sensitive cells. The data indicate that if P388/R cells were only exposed to DOX for about 2 h, the induced DNA single strand breaks were repaired rapidly within 8 h thereafter, while no significant repair was seen in the resistant cells exposed to DOX in combination with DMDP. In contrast, the repair of the extensive DNA single strand breaks induced by DOX in P388/S cells was not effected by DMDP. These data clearly demonstrated that resistance to DOX in P388 cells are multifactorial. Restoration of intracellular accumulation and retention of DOX by DMDP in the resistant cells are although necessary but not sufficient for complete restoration of the sensitivity of the highly resistant cells. PMID- 2764504 TI - Raman spectra of methyl substituted benz[c]acridines and their complex with DNA. AB - Raman spectra of methyl substituted benz[c]acridines (BAc) in the solid state were recorded. Their assignments were proposed for the frequencies of Raman spectra observed. The purpose of this work was to elucidate the mechanisms of interaction between BAc and DNA in vitro. For the DNA-BAc complex, the data show that BAc interact not only with the bases pair, but also with the sugar-phosphate site of DNA within the interbinding process. PMID- 2764505 TI - Analysis of CA-125 levels in the sera of patients with non-ovarian carcinomas and non-malignant diseases. AB - CA-125 is known as a marker of ovarian carcinoma; it is useful in monitoring response to treatment and it is even said to be a means of detecting ovarian carcinomas. We have studied the serum levels of CA-125 in 260 patients with advanced carcinomas (excluding ovarian cancer) and in 120 patients with non malignant diseases (excluding gynaecological diseases). Our cut-off value was 20 IU/ml. Sensitivity was 0.53 and Specificity only 0.38; sensitivity was high in lung cancer (0.56), in breast cancer (0.46) and in cancer of the stomach (0.91). Five percent of the cancer patients had values higher than 233.5 IU/ml. Sensitivity was correlated with the presence of a metastatic disease (p less than 0.001). A second assay was obtained in 163 cases; a concordance between the variation of the serum level and the clinical evolution was found in 65% cases. A high rate of false positive values was found in cases of acute pneumonia (0.74) and of gastro-intestinal diseases (0.41). In view of these results, the optimal threshold value was set at 65 IU/ml. CA-125 appears to be a useful marker in the monitoring of advanced non-ovarian carcinomas. PMID- 2764506 TI - Reduction of 4-epiadriamycin cardiotoxicity by milrinone, a new cardiotonic agent. AB - Recently, several non-catecholamine, non-glycoside cardiotonic drugs have been described. New compounds include amrinone, sulmazole and milrinone. Milrinone, a close analogue of amrinone, is about 30 times more potent than amrinone. In attempts to alleviate anthracyclines toxicity, we have previously reported that amrinone and sulmazole reduced the negative inotropic effect of adriamycin and 4 epiadriamycin in isolated guinea pig atria. The present study reports the effects of 4-epiadriamycin on electrically driven isolated guinea pig left atrium, in normodynamic or hypodynamic conditions. Exposure for 60' to 4-epiadriamycin (100 micrograms/ml) caused a depression of contractile force and of maximal rate of contractile force (df/dt). The negative effects of 4-epiadriamycin are antagonized by milrinone at 20 micrograms/ml. PMID- 2764507 TI - Cytotoxic activity of a series of heteroaryl-ONN-azoxy-sulphones and aryl sulphonylhydrazones. AB - Synthesis of heteroaryl-ONN-azoxysulphones and pyrazolyl-ONN-azoxycyanides was carried out by the action of the appropriate reagents on the corresponding nitroso derivatives. Pyrazolyl-ONN-azoxyamides were obtained by hydrolysis of the corresponding cyanides. Synthesis of the arylsulphonylhydrazones was carried out by reacting R-substituted phenyl-sulphonylhydrazines on the isomers of methylfuroxancarbaldehyde. Cytotoxic activity was assessed on HeLa cells. Some of the compounds tested inhibit the colony-forming ability of the tumor cells at low concentrations. PMID- 2764508 TI - Vinblastine-C4 alkyl maleoyl and amino acid maleoyl derivatives: I. Chemistry and physicochemical data. AB - Vinblastine-C4 acyl derivatives were synthesized by linking alkyl maleoyl or amino acid maleoyl compounds through an ester linkage at the C4 position of the vindoline moiety of vinblastine. The condensation of the above mentioned compounds was performed by the mixed anhydride method. Their synthesis, yields and physiochemical data are reported. PMID- 2764509 TI - Vinblastine-C4 alkyl maleoyl and amino acid maleoyl derivatives. II. Experimental antitumor activity against leukemias and human tumor xenografts. AB - The experimental antitumor activity of new vinca analogues was evaluated in mice. Among the derivatives tested, compounds n.8 and 14 demonstrated good activity against the P388 leukemia. These analogues were further investigated in 3 human carcinomas xenografted in nude mice. Compound n.8 compared favourably with vinblastine in the MX1 xenograft. Derivative n.14 showed activity against HepG2 and MX1 xenografts. As expected, derivative n.14 showed no activity against the CX1 tumor. Because of their significant antitumor activity in different models, further development of these compounds in being considered. PMID- 2764510 TI - Modulation of prolactin receptors (PRL-R) by lactogenic and steroid hormones in human breast cancer cells in long-term tissue culture (T-47D). AB - In order to improve the knowledge of prolactin receptors (PRL-R) in human breast tumors, we studied PRL-R modulation by lactogenic and steroid hormones in the PRL R rich human breast cancer cell-line, T-47 D. The PRL-R were assayed on a preparation of cell total membranes. We demonstrated an abnormal homologous in vitro regulation of PRL-R. Concentrations of human growth hormone (hGH) greater than 500 ng/ml were required to cause a decrease in PRL-R, with a maximal down regulation at 2000 ng/ml and for 48 hours. Human placental lactogen (hPL) induced a decrease in PRL-R at concentrations greater than 500 ng/ml but later than hGH; ovine prolactin (oPRL) had no effect on PRL-R. Moreover, we also demonstrated that progestins specifically modulated the expression of PRL-R in T-47D cells: Org 2058, a synthetic progestin induced a statistically significant increase in PRL-R after a twenty-four hour incubation period: this effect was already observed at 10(-9) M and was maximal for 10(-6) and 10(-5) M (186% +/- 3.5% (+/- SEM) for total PRL-R). At 10(-6) M, the stimulation occurred early at three hours and was maximal at twenty-four hours. Conversely estradiol (10(-9) to 10(-6) M), cortisol (10(-9) to 10(-6) M), dexamethasone (10(-9) to 10(-5) M) and RU 486 (10( 9) to 10(-5) M), a progestin and glucocorticoid antagonist, had no effect on PRL R levels. The Org 2058 PRL-R stimulation was abolished in the presence of RU 486. The abnormal PRL-R down-regulation in the human breast cancer cell-line, T-47D, may contribute a growth advantage to these malignant cells over normal tissues. The progestin PRL-R dependence suggests that high levels of PRL-R may reflect a functional progesterone receptor (Pg-R) and a highly hormone-dependent-phenotype of the tumor. These results support a potential role of PRL in the etiology of breast tumors and may have important implications in the management of human breast cancer. PMID- 2764512 TI - Differential activity of two oncogenes from chromosome #7 in human glioblastoma cell lines. AB - Human glioblastoma cell lines are known to develop polysomy of cytogenetically intact chromosomes #7 and overexpression of the erbB oncogene (7p12-p14) at a level even higher than is to be expected from the number of #7 chromosomes. The met oncogene, however, which is also located on chromosome #7 (7q31-q32), was shown not to be overexpressed in a panel of 7-polysomic glioblastoma cell lines overexpressing erbB. Molecular analysis of the cell line HeRo gave proof that there is no detectable amplification or rearrangement of the erbB gene which could be responsible for its overexpression. These findings favor the assumption of differential regulation of the met and erbB oncogenes, e.g. by means of insufficient activity of a trans-acting erbB suppressor gene possibly located on a chromosome with a low copy number. PMID- 2764511 TI - Triple combination of retinoic acid+aclacinomycin A+ dimethylformamide induces differentiation of human acute myeloid leukaemic blasts in primary culture. AB - Differentiation induction therapy provides unalternative for treatment of acute myeloid leukaemia (AML) patients who are either unsuitable for or unresponsive to conventional cytotoxic chemotherapy. The effect of a triple combination of retinoic acid(RA)+aclacinomycin A (ACM)+dimethylformamide (DMF) on differentiation of blasts from 24 AML patients was studied. Non-adherent mononuclear cells were seeded at a concentration of 5 x 10(5) cells/ml in 24-well tissue culture plates containing RPM11640 culture medium with 20% fetal calf serum and 10% 5637-conditioned medium and incubated with 10(-6) M retinoic acid, 80nM aclacinomycin A and/or 100mM dimethylformamide alone and in combinations with each other for six days at 37 degrees C in a humidified incubator under 5% CO2. Morphological, cytochemical and functional differentiation into mature cells were induced in blasts from 22 out of the 24 AML patients after exposure to the triple combination of 10(-6)M RA+80nM ACM+100mM DMF for 6 days in primary culture. These highly effective results justify a clinical trial of this triple combination for AML patients who are either unsuitable for or unresponsive to conventional cytotoxic chemotherapy. PMID- 2764513 TI - Malignancies in the families of patients with gastric polyps. AB - The present series consists of 155 patients with gastric polyps who attended the Central University Hospital of Tampere/between 1972 and 1983/but who did not develop gastric malignancies during the follow-up. 93 patients with non-ulcer dyspepsia served as controls. Both the experimental and control patients were interviewed with the help of a schedule as to the occurrence of malignancies among their family. The family was defined as parents, grand parents, brothers, sisters and children. There was a total of 961 members in the families of the study patients and 755 in the families of controls. In the families of the men with gastric polyps, the frequency of intestinal malignancies as a percentage of all malignancies was higher than in the controls, 10.3 and 2.9 percent, respectively (p less than 0.01). The frequency of gastric malignancies in the families of the women with gastric polyps was higher than in the controls and in men, 6.2, 3.1 and 2.4 percent, respectively (p less than 0.05, and p less than 0.025). The frequencies of all malignancies were similar in the study and control families. Thus there seems to be some family -related accumulation of intestinal malignancies in men and of gastric malignancies in women with gastric polyps. PMID- 2764514 TI - Lectin binding sites in normal rat ovary and ENU-induced Sertoli cell tumors of the ovaries. AB - A panel of seven fluorescein isothiocyanate (FITC) labeled lectins were used to study the distribution of specific binding sites in histologic sections of rat ovaries and ENU-induced Sertoli cell tumors (SCT) of the ovaries. Ten SCT and 5 normal ovaries derived from Berlin Druckey IV (BD-IV) rats were examined by FITC lectins. The tissues examined were fixed in 10% buffered formalin and embedded in paraffin blocks. In normal ovaries, lectin binding sites were more uniform, ordered and consistent than in ovarian SCT where some lectin staining appeared disorderly inconsistent and varied with the degree of tumor differentiation. Two lectins, (from Triticum vulgaris [WGA] and Arachis hypogaea [PNA], uniformly stained the apices of the ovarian surface epithelium and subadjacent tunica vaginalis. The ovarian stroma, oocyte nucleus, follicular and granulosa-theca cells, stained uniformly strong with succinated Con A (from Con-canavalia ensiformis). Three lectins (from Triticum vulgaris, Ulex europeaus [UEA-1] and Arachis hypogeae) accentuated the basal lamina in the SCT and normal ovarian follicles. The zona pellucida was strongly labeled with lectin derived from Triticum vulgaris, Ricinus communis (RCA) and moderately with lectin derived from Arachis hypogeae. The oviduct ampulla exhibited an intracytoplasmic strong vesicular labeling with lectins derived from Triticum vulgare, Dolichos biflorus (DBA), Glycin max (Soybean-SBA) and Arachis hypogeae. The SCT cells showed an inconsistent, irregular labeling pattern with lectins derived from Ulex europaeus, Dolichos biflorus and Soybean mostly as a coarse granular cytoplasmic labeling. Neuraminidase digestion enhanced lectin staining with PNA in normal ovary and in SCT. This data provided at list of lectin markers for distinct components of the BD-IV rat ovary and ovarian SCT. PMID- 2764515 TI - Lectin binding sites of cultured ovarian Sertoli cell tumors and follicular granulosa cells. AB - A panel of seven alkaline phosphatase labeled lectins was used to probe nitrocellulose electroblots of SDS-PAGE separated proteins from a primary culture of normal ovarian granulosa cells and an ENU-induced Sertoli cell tumor cell line (SCTL-I). Several additional lectin binding proteins were observed in silver stained SDS-PAGE gels as well as with lectins in SCTL-I. Succinated concanavalin A (Suc. Con A), Ricin communis agglutinin (RCA-I), Ulex europaeus agglutinin (UEA 1), Soybean agglutinin (SBA), Dolichos biflorus agglutinin (DBA) and Peanut agglutinin (PNA) stained more intensely in SCTL-I than normal granulosa cells. The same lectins as above, labeled with fluorescein isothiocyanate (FITC), were used to study the distribution of specific binding sites of tissue cultured cells grown in chamber/slides. Both normal ovarian granulosa cells and SCT cells exhibited strong peninuclear cytoplasmic labeling with Con A UEA-1 and WGA exhibited predominantly a nuclear and granular cytoplasmic staining pattern. SBA and DBA exhibited a strong coarse granular cytoplasmic labeling in granulosa cells and moderate granular cytoplasmic in SCT cells. In granulosa cells, Golgi regions stained strongly with PNA but weakly in SCT cells. RCA-I staining was negative in both cultures. Labeling of tissue cultured cells with lectins provides more details than histological sections of lectins binding sites at cellular structural levels. PMID- 2764516 TI - Morphological transformation and chemotactic migration of fibroblasts by TGF-beta related 25Kd polypeptide. AB - 25Kd is a polypeptide molecule that shows many characteristics of the transforming factor type beta. We have studied the ability of 25Kd to induce morphological changes and also chemotactic migration of normal and transformed fibroblasts. It was found that normal cells exposed to 25Kd show an aberrant morphology while transformed cells are no longer randomly distributed over the culture dish but instead organize into clusters. In vitro, 25Kd is a potent chemoattractant for fibroblasts at doses ranging from 0.1-5ng/ml. Complete inhibition of chemotaxis was achieved in the presence of anti-25Kd antibodies. PMID- 2764517 TI - Endogenous sugar receptor (lectin) profiles of human retinoblastoma and retinoblast cell lines analyzed by cytological markers, affinity chromatography and neoglycoprotein-targeted photolysis. AB - Plant lectins have previously been employed to map the composition of cellular glycoconjugates on retinoblastoma and other tumor cells. To characterize the cellular receptors in protein-carbohydrate interactions, we have applied cytological markers (fluorescent neoglycoproteins) containing common carbohydrate building-blocks to investigate the presence of endogenous carbohydrate-binding proteins in six human retinoblastoma cell lines and one established human retinoblast cell line. The staining patterns showed similar expression of endogenous sugar receptors in all cell lines, with few qualitative differences. However, application of affinity chromatography using resins with immobilized carbohydrates as affinity ligands to isolate sugar receptors (lectins) with binding specificities for beta-D-galactosides, alpha-D-mannosides, alpha-L fucosides alpha-D-glucosides and to N-acetyl-D-glucosamine and N-acetyl-D galactosamine, respectively, revealed significant differences between the cell lines, emphasizing the value of complementary biochemical analysis. To demonstrate the practical use of this type of glycobiochemical profiling, selective photodestruction of retinoblastoma cells in vitro was accomplished following incubation with synthetic neoglycoprotein-hematoporphyrin conjugates and subsequent exposure to light. This phototherapeutical approach thus combined the inherent specificity of a neoglycoprotein for a particular cellular phenotype with targeted drug activation. PMID- 2764518 TI - Characterization of androgen receptor by high performance liquid chromatography and sucrose density gradient ultracentrifugation in normal and malignant human prostatic tissues. AB - In the present study we have characterized androgen-receptor complexes of normal and malignant human prostate cytosols using sucrose density gradient centrifugation, gel permeation and anion exchange high performance liquid chromatography (HPLC). Our results indicated that: 1) malignant tissue cytosols differed from normal by the presence of a 4-5S androgen receptor form which accounted for 30% of total specific-binding of malignant tissue cytosols, 2) 8-9S androgen-receptor complexes in normal and malignant prostate cytosols were estimated as 270kDa by gel permeation HPLC, 3) 8-9S complexes were retained and could be eluted by 0.22M KCl on a linear gradient anion exchange HPLC, 4) 4-5S androgen-receptor complexes were estimated as 90kDa by gel permeation HPLC and were not retained on anion exchange HPLC in our experimental conditions, and 5) either 10X dilution of the 4-5S complexes and subsequent anion exchange HPLC, or anion exchange chromatography of 8-9S complexes at 22 degrees C were causing fragmentation of the androgen receptor molecule from normal and malignant tissues. These fragments had enhanced affinity for anion exchange columns. These results are discussed in relation to the composition of the nontransformed androgen receptor macromolecule. PMID- 2764519 TI - Hepatitis B virus markers in Chinese twins. AB - Chinese same-sex twins were recruited in order to study the distribution of different markers of hepatitis B virus (HBV) infection, including HBV surface antigen (HBsAg), antibody to HBV core antigen (anti-HBc), antibody to HBsAg (anti HBs), HBV e antigen (HBeAg) and antibody to HBeAg (Anti-HBe), as well as to compare the concordance of these markers in pair-wise fashion among monozygotic (MZ) and dizygotic (DZ) twins and singleton controls. A total of 289 pairs of MZ twins, 102 pairs of DZ twins and 375 pairs of age-sex-matched singleton controls were studied. More than 50 percent of the members of each group (64.71% of MZ twins, 51.96% of DZ twins and 62.13% of controls) were found to be infected with HBV. In general, the patterns of the response to HBV infection in the 3 groups were similarly distributed. 20.17% of the members of the 3 groups (21.45% of MZ twins, 14.22% of DZ twins, and 20.80% of controls) were HBsAg carriers. Among the HBsAg carriers, 49.19% (44.35% of MZ twins, 34.48% of DZ twins and 55.77% of controls) were HBeAg carriers. No significant difference in the concordance of HBV infection was observed in the MZ and DZ twins. However, highly significant differences were noted between MZ twins and controls, and between DZ twins and controls. Highly significant differences were also observed in the concordance of carrier status between MZ and DZ twins and between MZ twins and controls, but not between DZ and controls. As for the other HBV markers, no significant differences were observed. It is concluded that the genetic influence in response to HBV infection markers is not well-characterized and requires further study. PMID- 2764520 TI - The DNA content in rectal adenomas. AB - Flow cytometric DNA analysis was performed in 67 tubular, tubulovilous and villous rectal adenomas with different degree of dysplasia. One of the adenomas contained a focus of early invasive carcinoma. All but one of the 67 adenomas had near diploid DNA histograms; the exception was a tubular adenoma with severe dysplasia but without signs of early invasion. Flow cytometric DNA analyses of adenomas may in some cases provide valuable information. The low frequency of aneuploidy indicates, however, that routine DNA measurements are questionable. Rather, the analysis should be restricted to certain cases like those with high malignant potential, cases with suspected early invasive carcinoma, and adenomas not radically removed. PMID- 2764521 TI - Efficacy of new ruthenium complexes against chemically induced autochthonous colorectal carcinoma in rats. AB - SD rats bearing acetoxymethylmethylnitrosamine-induced colorectal carcinomas were treated by i.v. administration of trans-imidazolium bisimidazoletetrachlororuthenate (III) ImH(RuIm2Cl4), bisbenzimidazolium benzimidazolepentachlororuthenate (III) (BzImH)2(RuBzImCl5) and trans-indazolium bisindazoletetrachlororuthenate (III) In-dH(ruInd2Cl4). The dose levels used were 0.022 mmol/kg body weight administered twice weekly over ten weeks for all compounds and, additionally, 0.015 mmol/kg for ImH(RuIm2Cl4). All compounds caused a tumor growth inhibition exceeding 90%; differences were found with regard to toxicity: ImH(RuIm2Cl4 and (BzImH)2(RuBzImCl5) caused dose-related decreases in body weight and increases in mortality as shown by 21% and 29% body weight loss compared to controls as well as 10% and 45% mortality for the two dosages of the first compound, and 9% body weight loss compared to controls as well as 7% mortality for the latter compound. In contrast, equimolar administration of IndH(RuInd2Cl4) was not related to any symptoms of toxicity as evidenced by 2% body weight gain compared to controls as well as 0% mortality. Since this latter drug obviously showed remarkable activity in a highly resistant type of tumor at negligible toxicity, it certainly deserves special attention. PMID- 2764522 TI - Inhibition of carrageenin paw edema by pyridinalalkylimine rhodium(I) complexes. AB - The effects of a series of pyridinalalkyl-1,5-cyclooctadiene Rhodium(I) complexes were studied on the carrageenin paw edema model, using Sprague-Dawley rats. The series of compounds used were administered at 35, 70 and 140 mumol/kg i.p. 1hr before carrageenin application, and the effect was measured 4hr after carrageenin. The 1,5-cyclooctadienepyridinalaldoxime Rhodium(I) complex proved to be the most active compound, effective also when administered 1hr after carrageenin induction of paw swelling. However, the effects of this complex are not superior to those reported for the methyl derivative, and the overall antiinflammatory activity is inferior to that of this latter compound, particularly when the number of dosages causing at least 80% inhibition are compared. These data are consistent with those obtained in a previous investigation indicating that Rhodium(I) complexes have potential antiinflammatory properties, susceptible of further investigations extended also to other models of inflammatory disease. PMID- 2764523 TI - Synthesis and biological evaluation of new Rh (I) complexes with sulfonamide derivatives. AB - New rhodium(I) complexes, belonging to the general structure [Rh(CO)2(L)], where L were sulfonamide derivatives, were synthesized and characterized by chemical analysis and IR determinations. These complexes were assayed as cytostatic and antitumour agents in vitro against KB cells and in vivo against P388, Ehrich ascites and advanced B16 melanoma. Assays against three Trypanosoma strains were also performed. Among the new compounds, the [Rh(CO)2-(sulfamethoxydiazine)] appeared to be active in all biological systems without showing evident nephrotoxicity. Relationships between biological activity and pi electronic charge localization on N atom of the ligand amidic group were also discussed. PMID- 2764524 TI - Antitumor effect of some rhodium(I) derivatives on MCa mammary carcinoma. AB - The antitumor action of two square planar Rhodium complexes was tested on MCa mammary carcinoma and was seen to depend upon the compound used. The complex cyclooctadiene(2-pyridinalmethylimine)-Rh(I)chloride [Rh(COD)PMI]+ Cl- confirmed the antineoplastic action already shown in the Lewis lung carcinoma model. The examination of the activity of [Rh(COD)PMI]+ Cl- on the lung metastatic tumor indicates that its antineoplastic properties do not seem simply related to a cytotoxic action. It appears more likely that modifications occurring at the primary tumor level, probably different from lethal effects directed to tumor cells, are responsible for the reduction of spontaneous lung metastasis formation observed in the treated animals. The trophic effects observed on the spleen of the treated animals seem to suggest that these compounds are endowed with properties typical of biological response modifiers. PMID- 2764525 TI - The antitumor activity of some palladium(II) complexes with chelating ligands. AB - A range of palladium(II) complexes with chelating ligands were assayed for their antitumor activity against the tumors P388 and S180 in female mice. The complexes tested were [Pd(L)(ONO2)2] (L = 2,2'-bipyridyl,2-(aminoethyl)pyridine (aep), 2 (aminomethyl)pyridine (amp], [Pd(eth)Cl2] (eth = ethionine) and [Pd(dach)(Meorot)] (dach = trans-1,2-diaminocyclohexane, Meorot = dianion of 3 methylorotic acid). The complexes were administered in water except [Pd(dach)(Meorot)] which was a suspension in klucel. The LD0 values were greater than or equal to 100 mg/kg. None of the complexes were active against the P388 tumor. [Pd(L)ONO2)2] (L = aep, amp) showed marginal activity against S180, while [Pd(dach-)(Meorot)] had an optimal T/C of 267% at dose of 150 mg/kg with 2/10 survivors on day 60. PMID- 2764527 TI - Pharmacokinetics of subcutaneous azidothymidine in rhesus monkeys. AB - The pharmacokinetics of subcutaneous bolus and continuous infusion azidothymidine (AZT) was studied in rhesus monkeys. Three animals received 100 mg/m2 as a bolus injection both intravenously and subcutaneously, with the order of administration randomly determined. Two animals received a continuous subcutaneous infusion of 25 mg/m2 per h for 12 or 24 h. AZT was measured in plasma by a reverse-phase high pressure liquid chromatographic assay. Following intravenous bolus administration, AZT elimination was rapid, with a mean half-life of 1.2 h and a mean clearance of 318 ml/min per m2 (range, 200 to 441 ml/min per m2). The bolus subcutaneous dose was rapidly (time to peak concentration, 15 to 30 min) and nearly completely (fraction absorbed, 92%) absorbed without evidence of local tissue toxicity. With continuous subcutaneous infusion of AZT, the steady state was attained within 4 h and steady-state concentrations in plasma in the two animals exceeded 3.0 mumol/liter. No local tissue toxicity was observed at the infusion site. The subcutaneous route may be a practical alternative to intravenous administration of AZT and deserves further clinical study. PMID- 2764526 TI - Clinical comparison of single-oral-dose cefuroxime axetil and amoxicillin with probenecid for uncomplicated gonococcal infections in women. AB - Four hundred sixty-six female patients were enrolled in a randomized study that compared the clinical efficacies of single oral doses of cefuroxime axetil and amoxicillin with probenecid in the treatment of uncomplicated gonorrhea. Two hundred ninety-five patients had culture-positive gonococcal infections and completed the investigation. Cure rates for the patients treated with cefuroxime axetil and those treated with amoxicillin with probenecid were high (greater than 95%) for genitorectal infections. Pharyngeal infections, however, were not uniformly eradicated by either cefuroxime axetil (60%) or amoxicillin with probenecid (64%). Approximately 13% of each patient group suffered adverse events, which were gastrointestinal in the majority and were transient. Compared with amoxicillin plus probenecid, cefuroxime axetil in a single oral dose was an equally safe and effective drug for the treatment of uncomplicated gonorrhea in women caused by penicillin-susceptible strains. PMID- 2764529 TI - Pharmacokinetics of gentamicin in neonates on extracorporeal membrane oxygenation. AB - Extracorporeal membrane oxygenation (ECMO) has been used in more than 1,000 infants in 50 centers in the United States. The extracorporeal circuit contains approximately 400 ml of blood, an amount exceeding the blood volume of most full term neonates. The effect of this additional blood volume on drug disposition is unknown. In this study, we determined the pharmacokinetic parameters of gentamicin in 10 infants on ECMO. Gentamicin concentrations were determined by a fluorescence polarization immunoassay. Pharmacokinetic parameters were determined from these concentrations by using a two-compartment model. Our study demonstrated a mean steady-state volume of distribution of 0.51 +/- 0.11 liters/kg, a figure similar to that in previous studies of full-term infants. The elimination half-life was found to be prolonged (mean, 573 +/- 263 min). The creatinine level in the plasma of the infants was found to be a statistically significant predictor of elimination half-life. Recommendations regarding initial dosing levels of gentamicin in infants on ECMO are made. PMID- 2764528 TI - Comparative in vitro antibiotic resistance of surface-colonizing coagulase negative staphylococci. AB - The MBCs of nafcillin, vancomycin, gentamicin and daptomycin (LY146032) were determined for three clinical isolates of coagulase-negative staphylococci grown in suspension and adherent to biomaterials. Strains studied were the slime producing strain Staphylococcus epidermidis RP-12 (ATCC 35983), S. hyicus SE-360, and the non-slime-producing strain S. hominis SP-2 (ATCC 35982). All three strains were allowed to colonize surgical-grade disks of stainless steel, polymethylmethacrylate, and ultrahigh-molecular-weight polyethylene for 24 h, and the disks were then exposed to various concentrations of antibiotics for 24 h. Surviving adherent bacteria were mechanically dislodged from the disks and quantitated by standard broth dilution plating techniques. Biomaterial-adherent RP-12 and SE-360 yielded approximately 10 times more CFU per disk than non-slime producing SP-2 did. For all organisms, 10 times more bacteria bound to polymethylmethacrylate disks than to the other biomaterials. In general, bacteria adherent to biomaterials exhibited greater resistance to antibiotics than the same strains in suspension did. Resistance was independent of bacterial slime producing characteristics and was related to the biomaterial colonized. PMID- 2764530 TI - Effect of cimetidine on the disposition of rimantadine in healthy subjects. AB - Twenty-three healthy male and female subjects received single 100-mg oral doses of rimantadine hydrochloride on two occasions in an open-label, sequential design with a 6-day washout between doses. The first dose of rimantadine was administered alone, and the second dose was administered concomitantly with cimetidine (300 mg four times a day for 6 days). Blood and urine samples were collected, and rimantadine concentrations were determined by a gas chromatographic--mass-spectrometric method. There were no changes in the rate of absorption and the renal clearance of rimantadine when it was administered with cimetidine. Both parametric and nonparametric tests showed significant differences in the area under the concentration-time curve, apparent total clearance, and elimination rate constant between the treatments (P less than 0.01). The apparent total clearance was reduced by 18%, resulting in higher values for the area under the concentration-time curve in the presence of cimetidine. However, the wide therapeutic index of rimantadine renders these changes of little, if any, clinical consequence. PMID- 2764531 TI - Prevention of tubercidin host toxicity by nitrobenzylthioinosine 5'-monophosphate for the treatment of schistosomiasis. AB - Host toxicity of the dose regimen of tubercidin (7-deazaadenosine) plus nitrobenzylthioinosine 5'-monophosphate (NBMPR-P) used in combination therapy of schistosomiasis (M. H. el Kouni, D. Diop, and S. Cha, Proc. Natl. Acad. Sci. USA 80:6667-6670, 1983; M. H. el Kouni, N. J. Messier, and S. Cha, Biochem. Pharmacol. 36:3815-3821, 1987) was examined in vivo in mice and in vitro with human bone marrow progenitor cells. Four successive daily intraperitoneal injections of tubercidin at 5 mg/kg per day produced 100% mortality in mice within 3 to 5 days following the first injection, with massive peritonitis and intestinal obstruction secondary to abdominal adhesions. Coadministration of NBMPR-P (25 mg/kg per day) protected the mice from the lethality of tubercidin and allowed the repetition of the regimen for a second time with 100% survival until the mice were sacrificed 22 days following the first injection. Blood chemistry, hematological studies, and histological examinations showed no evidence for injury to the liver, kidney, spleen, pancreas, mesentery, or peritoneal mesothelium. In vitro, tubercidin alone had a direct dose-dependent inhibitory effect on myeloid and erythroid human bone marrow progenitor cells, and consistent inhibition (50%) of granulocyte-macrophage CFU (CFU-GM) and erythroid burst-forming units (BFU-E) occurred at 2 to 3 nM tubercidin. At higher doses, BFU-E were more sensitive to tubercidin toxicity than CFU-GM. Complete inhibition (99%) of BFU-E colonies occurred at 10 nM tubercidin, while complete inhibition of CFU-GM occurred at 100 nM. NBMPR-P at 10 to 100 nM protected CFU-GM and BFU-E from tubercidin toxicity in a dose-dependent matter. PMID- 2764532 TI - Relationship between intracellular concentration of S-adenosylhomocysteine and inhibition of vaccinia virus replication and inhibition of murine L-929 cell growth. AB - 9-(trans-2',trans-3'-Dihydroxycyclopent-4'-enyl)-adenine (compound 1) and -3 deazaadenine (compound 2), which are specific inhibitors of S adenosylhomocysteine (AdoHcy) hydrolase, were reported earlier by our laboratory (M. Hasobe, J. G. McKee, D. R. Borcherding, and R. T. Borchardt, Antimicrob. Agents Chemother. 31:1849-1851, 1987) to have anti-vaccinia virus activity with reduced murine L-929 cell toxicity compared with the prototype compound neplanocin A. In this study, we showed that the antiviral and cytotoxic effects of compounds 1 and 2 can be related to intracellular concentrations of AdoHey, which are elevated in cells treated with these inhibitors of AdoHcy hydrolase. For example, concentrations of analogs 1 and 2 that produce 50% inhibition of vaccinia virus replication caused only slight elevations in intracellular levels of AdoHcy (from 50 [controls] to 100 to 125 [drug-treated cells] pmol/mg of protein) and elevations in the ratios of AdoHcy/S-adenosylmethionine (from 0.05 to 0.1 [controls] to 0.15 to 0.19 [drug-treated cells]). In contrast to the extreme susceptibility of virus replication to slight elevations in intracellular AdoHcy, cell viability was quite tolerant to higher levels of this metabolite. For example, concentrations of analogs 1 and 2 that produced 50% inhibition of L 929 cell replication caused significant increases in intracellular levels of AdoHcy (to 825 to 950 pmol/mg of protein) and elevations in AdoHcy/S adenosylmethionine ratios (approximately 1.3). These data make it possible to assign a therapeutic index of 7 to 8 to these compounds on the basis of the comparison of intracellular levels of AdoHcy that caused 50% inhibition of vaccinia virus replication with those that caused 50% inhibition of L-929 cell replication. PMID- 2764533 TI - Suppression of colonic microflora by cefoperazone and evaluation of the drug as potential prophylaxis in bowel surgery. AB - We evaluated the activity of cefoperazone (CPZ) on the intestinal flora in terms of its use as a single prophylactic drug in colon surgery. Twenty-four healthy male volunteers between the ages of 20 and 40 were assigned to receive either CPZ, oral neomycin-erythromycin, or no antibiotics. A mechanical bowel preparation, Golytely, was also given to each of the subjects. With intravenous CPZ, antibiotic levels in the stool ranged from less than 2 to 649 micrograms/ml and the total fecal bacterial counts dropped 3 to 4 log10 CFU/g. Higher levels of CPZ were detected in the stools when an oral dose was added, 1,446 to 5,445 micrograms/ml, and the bacterial counts were reduced maximally 4 to 6 log10 CFU/g. The combination of the oral and intravenous doses produced suppression of the microflora and high levels in blood, all with a single antibiotic. PMID- 2764534 TI - Dose-dependent pharmacokinetics of mezlocillin in rats. AB - The pharmacokinetics of mezlocillin were examined in rats following bolus intravenous doses of 20 or 200 mg/kg. Mezlocillin exhibited bi- or triexponential disposition profiles, and the area under the concentration-time curve increased nonproportionally with dose similar to reported findings in humans. Apparent total, renal, and nonrenal clearances and the volume of distribution at steady state all decreased by 45 to 50% with the higher dose, and the elimination half life was longer (8 +/- 2 versus 15 +/- 3 min). Mezlocillin exhibits low saturable binding in rat serum, ranging from 20 to 40% bound. Pharmacokinetic parameters based on free drug demonstrated dose-dependent characteristics similar to those with total drug. Use of the volume of distribution from the low dose allowed calculation of the true mean residence time. The linear relationship between dose and mean residence time from free concentrations yielded pooled Michaelis-Menten parameters. These were used as initial estimates in the simultaneous nonlinear fitting of the low- and high-dose mean free concentrations to a three-compartment model with sequential distribution and Michaelis-Menten elimination to describe the nonlinearity of mezlocillin disposition further. PMID- 2764535 TI - Cellular pharmacology of 2',3'-dideoxy-2',3'-didehydrothymidine, a nucleoside analog active against human immunodeficiency virus. AB - 2',3'-Dideoxy-2',3'-didehydrothymidine (D4T) is a thymidine nucleoside analog which has potent anti-human immunodeficiency virus activity in vitro. We have studied its metabolism in cells to assist in determining its mechanism of action. D4T is metabolized in cells to the mono-, di-, and triphosphate nucleotides. Our data suggest that the initial conversion to the monophosphate is catalyzed by thymidine kinase. This enzyme has an affinity for D4T 600-fold lower than for thymidine and catalyzes the rate-limiting step in production of the triphosphate. Nevertheless, intracellular concentrations of the triphosphate approximately equal to the reported Ki for human immunodeficiency virus reverse transcriptase are attained with extracellular concentrations of free drug as low as 0.05 microM. The pattern of phosphorylation is different from that of 3'-azido-3' deoxythymidine (AZT), which has an affinity for thymidine kinase equivalent to that of thymidine and is easily phosphorylated. The rate-limiting step in formation of AZT triphosphate is conversion of mono- to diphosphate, and thus the monophosphate accumulates. On removal of D4T or AZT from the media, both triphosphates have an intracellular half-life of about 200 min, and this rate ultimately controls the rate of elimination of the drugs from cells. The differences in metabolism of D4T and AZT observed in vitro may be responsible for the differences in toxicity seen in vitro and in vivo and support the exploration of the clinical utility of D4T as an anti-human immunodeficiency virus agent. PMID- 2764536 TI - Ceftriaxone disposition in open-heart surgery patients. AB - The effects of cardiopulmonary bypass (CPB) with hypothermia and systemic heparinization on ceftriaxone disposition were evaluated in seven male patients. A bolus dose of drug (14 mg/kg of body weight) was given, and blood and urine specimens were collected before, during, and after CPB for 96 h. Creatinine, albumin, and total and free ceftriaxone concentrations in plasma were measured. The ceftriaxone free fraction (ff) in vitro was estimated by equilibrium dialysis, and the in vivo ff was obtained by the ratio of renal clearance due to filtration to creatinine clearance. Pharmacokinetic parameters were based on concentrations of total drug and free drug. Albumin decreased from 3.10 +/- 0.29 g/dl presurgery to 1.42 +/- 0.17 g/dl and recovered to 2.46 +/- 0.26 g/dl on postoperative day 4. CPB markedly increased the in vitro ff, which was reversed by protamine post-CPB (ff pre-CPB, 0.15 +/- 0.01; during CPB, 0.53 +/- 0.20; post CPB, 0.16 +/- 0.02). The in vitro ff exceeded the in vivo ff (0.53 +/- 0.20 versus 0.24 +/- 0.07), probably due to continued free fatty acid release caused by heparin during dialysis. Clearances based on free drug decreased, and the renal clearance due to filtration increased (7.6 +/- 2.8 versus 15.0 +/- 4.5 ml/min) while the creatinine clearance decreased (114 +/- 29 versus 72 +/- 28 ml/min) during CPB. Diminished binding owing to low albumin and free fatty acids explain this behavior. Lower binding also increased the volume of distribution (154 +/- 41 ml/kg) and extended the half-life (15 +/- 6 h). In summary, ceftriaxone disposition was significantly altered by CPB, resulting in marked increases in free drug concentrations, half-life, and volume of distribution and in decreased intrinsic clearance. PMID- 2764537 TI - Comparison of N-methylthiotetrazole dispositions in healthy volunteers following single intravenous doses of moxalactam, cefoperazone, and cefotetan. AB - The N-methylthiotetrazole side chain (NMTT) that is present on several cephalosporins has been implicated in the development of antibiotic-associated hypoprothrombinemia. A randomized three-way crossover trial was conducted to compare the release of the NMTT side chain from three NMTT-containing antibiotics. Single 2-g doses of moxalactam, cefoperazone, and cefotetan were given, followed by serial blood and urine sampling. The concentrations of the parent compound and the NMTT side chain in plasma, urine, and the reconstituted antibiotic solution were determined by high-pressure liquid chromatography. Peak NMTT concentrations ranged from 0.42 to 16.50 micrograms/ml and were significantly higher after moxalactam administration than after cefoperazone or cefotetan administration (P less than 0.01). The NMTT trough concentrations (12.5 h) ranged from nondetectable to 2.47 micrograms/ml and tended to be greater following cefoperazone administration. The amounts of NMTT administered (e.g., the amount in the reconstituted antibiotic solution) were 25.8 +/- 1.4, 15.2 +/- 0.9, and 22.1 +/- 3.0 mg following moxalactam, cefoperazone, and cefotetan administration, respectively (P less than 0.01). In contrast, urinary recoveries of NMTT were 57.4 +/- 26.2, 73.6 +/- 44.3, and 29.7 +/- 22.9 mg following moxalactam, cefoperazone, and cefotetan, respectively. The amount of NMTT formed in vivo and excreted unchanged, as assessed by subtracting in vitro NMTT formation from NMTT urinary recovery, was significantly higher after cefoperazone than after moxalactam or cefotetan administration (P less than 0.05). The discrepancy between in vitro NMTT production (moxalactam > cefotetan > cefoperazone) and the amount of NMTT formed in vivo and excreted unchanged (cefoperazone > moxalactam > cefotetan) demonstrated that the in vivo production of NMTT is dependent on the disposition of the parent cephalosporin. PMID- 2764538 TI - Single-dose enoxacin compared with 3-day treatment for urinary tract infection. AB - Oral treatment of simple urinary tract infections generally involves 5 to 7 days of antibiotic therapy. This study with enoxacin, a new antibacterial agent of the quinolone-azaquinolone class, investigated the efficacy of a single dose compared with 3 days of treatment. A total of 154 outpatients with symptoms of simple cystitis were treated in an open randomized study with enoxacin, either one 600 mg dose or 200 mg twice a day for 3 days. A urine sample was collected for culture before treatment, 7 to 10 days after treatment, and 4 to 6 weeks after treatment. Seventy-three patients had positive bacterial cultures from the pretreatment urine sample; the predominant pathogen was Escherichia coli, along with a number of other gram-negative organisms and Staphylococcus spp. Of these patients, 33 received a single dose of enoxacin and 40 were treated for 3 days. Follow-up examination at 7 to 10 days showed negative urine cultures in 76% of patients from the single-dose group and 89% from the multiple-dose group, a difference that was not statistically significant (P = 0.665, Fisher's exact test). A number of patients were lost to follow-up at 4 to 6 weeks. However, of those who did attend, only three patients were shown to have relapsed or become reinfected (two in the multiple-dose group and one in the single-dose group). Enoxacin was well tolerated in both groups of patients; the few adverse events were mostly mild. PMID- 2764539 TI - Feeder layer-free in vitro assay for screening antitrypanosomal compounds against Trypanosoma brucei brucei and T. b. evansi. AB - A drug-susceptible Trypanosoma brucei brucei stock, a multidrug-resistant T. b. brucei stock, and a T. b. evansi stock resistant to two commercial trypanocides were adapted to a feeder layer-free culture system. Bloodstream forms were grown continuously in a liquid medium at 37 degrees C in 4% CO2 in air. Samples of trypanosome populations in the logarithmic growth phase were incubated with various concentrations of commercial and experimental compounds. Growth inhibition was monitored after a 24-h incubation and quantified by comparing the number of generations between control and drug-treated cultures. Some of the experimental compounds [taxol, formicin B, thioridazine, Ro 15-0216, and DL-alpha (difluoromethyl)ornithine hydrochloride monohydrate] showed activity against both drug-susceptible and drug-resistant trypanosomes. Other compounds [sinefungin, 1,3,5-triacetylbenzene tris(guanylhydrazone)trimethanesulfonate hydrate, and 9 deazainosine] which inhibited the growth of drug-susceptible trypanosomes showed little or no effect upon drug-resistant parasites. Gossypol, however, had no antitrypanosomal effect on either trypanosome stock. The results obtained in this study correlate with observations obtained from drug screening in mice. The main advantages of the described in vitro screening assay are as follows: (i) lower amounts of drugs are required, (ii) results are obtained more rapidly, (iii) animals are not necessary, and (iv) the method is less labor intensive. These advantages result in an economical and rapid assay for primary drug screening. PMID- 2764541 TI - In vitro and in vivo antibacterial activities of BMY 40062, a new fluoronaphthyridone. AB - The in vitro and in vivo activities of a new naphthyridone, BMY 40062, were compared with those of ciprofloxacin and ofloxacin. BMY 40062 showed about threefold more activity than ciprofloxacin showed and four- to eightfold more activity than ofloxacin showed against staphylococci, streptococci, and enterococci. BMY 40062 showed generally twofold less activity than ciprofloxacin showed against most species of the family Enterobacteriaceae, Pseudomonas aeruginosa, and Acinetobacter spp. but twofold more activity than ofloxacin showed against these organisms. BMY 40062 and ofloxacin were more active than ciprofloxacin against Bacteroides fragilis and Clostridium difficile. The antiureaplasmal and antichlamydial activities of BMY 40062 were similar to those of the tetracyclines and were 4- and 16-fold, respectively, higher than those of ciprofloxacin. The in vitro activities of BMY 40062 were influenced by pH and magnesium, although these factors appeared to affect the activity of BMY 40062 against P. aeruginosa to a lesser extent than those of ciprofloxacin and ofloxacin. BMY 40062 was found to be bactericidal, and cross-resistance with other fluoroquinolones was observed. In mouse protection tests, the efficacy of BMY 40062 reflected its in vitro potency. BMY 40062 exhibited longer half-life, higher maximum concentration in serum, greater area under the curve, and better bioavailability in mice after oral dosing than ciprofloxacin. Compared with ofloxacin, BMY 40062 had a lower maximum concentration in serum but a much longer half-life in mice. BMY 40062 was more effective than ciprofloxacin and ofloxacin in penetrating mouse macrophages and killing macrophage-associated Staphylococcus aureus. PMID- 2764540 TI - Selection of orally active antifungal agents from 3,5-substituted isoxazolidine derivatives based on acute efficacy-safety profiles. AB - Routine in vitro screening of a new synthetic series of 3,5-substituted 2 methylisoxazolidines revealed that three imidazole analogs (PR 967-248, PR 967 234, and PR 969-566) and, to a lesser extent, a triazole analog (PR 988-399) exerted rather potent antifungal activity against three systemic and four dermatophytic classes of fungi. When tested in vivo for ability to eradicate Candida vaginitis in the rat, the triazole derivative, PR 988-399, was effective after oral administration. In this in vivo test for efficacy, PR 967-234 and PR 969-566 reduced but did not eradicate the infection, while PR 967-248 was inactive. PR 988-399 was, moreover, 4- to 13-fold less potent than the three imidazoles in inhibiting testosterone synthesis in isolated rat Leydig cells. After oral or intravenous administration, PR 988-399 and PR 969-566 elicited the fewest cardiovascular and behavioural side effects in conscious dogs. The rat safety study consisted of oral dosing followed by evaluation of the exploratory motor activity of the naive animals in a novel environment. Motor activity was suppressed least by PR 988-399 and most by PR 969-566. In a battery of mouse behavioural-neuromuscular-drug interaction tests, PR 988-399 and PR 969-566 produced the fewest central-behavioural-neuromuscular signs. These efficacy safety evaluations were performed with ketoconazole as a positive reference standard. The sequence of drug testing with respect to efficacy-safety considerations appears to be a suitable approach for early detection of orally active antifungal agents such as PR 988-399 for more advanced development. PMID- 2764542 TI - Pharmacokinetics of intravenous cefmetazole with emphasis on comparison between predicted theoretical levels in tissue and actual skin window fluid levels. AB - Cefmetazole is a cephamycin antibiotic which is resistant to hydrolysis by various beta-lactamases. This study evaluated the pharmacokinetics of cefmetazole, including its intravascular and interstitial fluid distribution, by using the skin window (SW) technique. A 2-g dose of cefmetazole was given intravenously over 30 min to each of 12 healthy adult male volunteers every 6 h for nine doses. Plasma levels were assayed at predetermined intervals after doses 1, 5, and 9. Interstitial fluid levels were determined by the SW technique. Antibiotic levels were assayed by the agar well bioassay technique. A concentration-versus-time plot indicates that cefmetazole is rapidly distributed, with mean peak levels in plasma equal to 126 micrograms/ml at the end of the half hour infusion. The mean plasma half-life was 1.1 h. Plasma and tissue distribution constants permitted calculation of theoretical levels in tissue. Parallel elimination slopes for SW and theoretical tissue level showed that the SW model distribution kinetics are closely related. The area under the curve for the SW was 73.9 mg.h/liter. This was comparable to the theoretical level in tissue, which was 96 mg.h/liter. Furthermore, the area under the curve of theoretical tissue level/plasma was 0.6 and that of SW/plasma was 0.47. These results demonstrate that the SW technique yielded a result quite close to the theoretical tissue level. Ultrafiltration analysis indicated that as cefmetazole levels in plasma increased from 10 to 250 micrograms/ml, plasma protein binding of the antibiotic dropped from 85 to 65%. Finally, 60 to 70% of the drug was recovered from the urine as biologically active drug over 6 h postinfusion. PMID- 2764543 TI - Role of sodium in the protective effect of ticarcillin on gentamicin nephrotoxicity in rats. AB - Coadministration of sodium ticarcillin with an aminoglycoside is known to reduce the nephrotoxicity of the aminoglycoside. However, it is not known whether the penicillin or the obligatory sodium load confers protection. To investigate this, gentamicin has been administered intraperitoneally in doses of 50, 60, or 80 mg/kg per day for 12 days in groups of rats receiving either a normal or a low sodium intake. Alterations in creatinine clearance have been measured. Salt depletion resulted in an enhanced nephrotoxic response with a shift in the dose response curve to the left. Administration of sodium ticarcillin to rats with a salt-depleted intake at a dose sufficient to replace sodium intake conferred an equal degree of protection to rats with a normal salt intake. We report that the obligatory salt supplement with ticarcillin is sufficient to account for the renal sparing effect of the combination treatment without having to infer a direct chemical interaction of penicillin with the aminoglycoside. PMID- 2764544 TI - Diffusion of ofloxacin into cerebrospinal fluid of patients with purulent meningitis or ventriculitis. AB - The penetration of ofloxacin was studied in 22 patients with purulent meningitis or ventriculitis treated with conventional antibiotics. Three successive doses of 200 mg were infused at 12-h intervals during the acute stage of the disease. Ten patients received three additional doses when the meninges were considered to be healed. Cerebrospinal fluid (CSF) was drawn 0.5, 3, 6, or 12 h after the last infusion. Serial plasma and CSF samples were also obtained from patients with ventricular drainage. Concentrations in CSF ranged from 0.96 +/- 0.15 to 1.80 +/- 0.29 microgram/ml, depending on sampling time. The percentage of penetration in ventricular fluid, expressed as the ratio of the CSF area under the curve from 0 to 12 h to the plasma area under the curve from 0 to 12 h, was 73 +/- 6. Ofloxacin readily diffuses into CSF of patients with meningitis or ventriculitis and may be useful for treatment of CSF infections caused by susceptible pathogens. PMID- 2764545 TI - Pharmacokinetics of cefetamet pivoxil (Ro 15-8075) with ascending oral doses in normal healthy volunteers. AB - The pharmacokinetics of cefetamet pivoxil during administration of ascending oral doses were studied in 16 male normal healthy volunteers (age, 24.5 +/- 2.1 years; weight, 73.5 +/- 8.5 kg). The subjects were randomly assigned to four oral treatments of 500, 1,000, 1,500, and 2,000 mg of cefetamet pivoxil according to a four-by-four Latin square design. After an overnight fast, the drug was administered 10 min after a standard breakfast. It was found that both the rate and extent of prodrug absorption, measured as cefetamet adsorption, were reduced with increasing doses. The time to maximum concentration of cefetamet in serum was delayed from 4.00 +/- 0.81 to 4.88 +/- 0.96 h (P less than 0.05) when the dose of cefetamet pivoxil was increased from 500 to 2,000 mg. The dose-normalized values of area under the curve from 0 h to infinity for cefetamet and fraction of dose excreted as cefetamet were reduced by averages of 10.3 and 12.5%, respectively, over the dose range studied (P less than 0.05). The changes in rate and extent of prodrug absorption are thought to be the main factors contributing to the nonlinear relationship between maximum concentration in serum and dose. The change in absorption characteristics of cefetamet pivoxil with dose is, however, expected to have few clinical consequences because the magnitudes of these changes are comparable with their respective intragroup variations. PMID- 2764546 TI - In vitro susceptibility of Bordetella parapertussis to various antimicrobial agents. AB - The in vitro activity of 18 antimicrobial agents against 32 strains of Bordetella parapertussis isolated from whooping cough patients was studied. The most active antimicrobial agents were piperacillin and minocycline, followed (in descending order of activity) by moxalactam, erythromycin, cefoperazone, tetracycline, ampicillin, cefotaxime, chloramphenicol, josamycin, sulfamethoxazole, and nalidixic acid. Isolates were resistant to benzylpenicillin, cephalothin, cefatrizine, cefaclor, streptomycin, and cephalexin. PMID- 2764547 TI - Comparison of the in vitro activities of fenticonazole, other imidazoles, metronidazole, and tetracycline against organisms associated with bacterial vaginosis and skin infections. AB - The in vitro antibacterial activity of the antifungal compound fenticonazole was compared with those of clotrimazole, miconazole, tetracycline, and metronidazole against 177 strains of bacterial species associated with either bacterial vaginosis (BV) or skin infections by agar dilution MIC determinations. BV associated Bacteroides isolates of the Bacteroides melaninogenicus-B. oralis group, Gardnerella vaginalis, Mobiluncus spp., and anaerobic, gram-positive cocci were highly susceptible to fenticonazole, clotrimazole, and miconazole; but Bacteroides spp. not associated with BV, Bacteroides ureolyticus and the Bacteroides fragilis group, were resistant. All Bacteroides strains were susceptible to metronidazole, but the susceptibility of G. vaginalis and Mobiluncus spp. varied. Among the skin bacteria, Staphylococcus aureus, coryneforms, and streptococci were highly susceptible to the imidazoles; but Staphylococcus epidermidis strains were generally resistant. This antibacterial activity may give fenticonazole a useful role in the topical treatment of vaginal discharge and in mycotic skin infections that are superinfected with bacteria. PMID- 2764548 TI - Serial trough and peak amikacin levels in plasma as predictors of nephrotoxicity. AB - We studied 113 patients treated with intravenous amikacin to determine the value of determining serial trough and peak amikacin levels in plasma for predicting nephrotoxicity. Thirteen patients (11.5%) developed renal toxicity, with significant increases from 48 to 96 h in both peak and trough amikacin levels (6.7 +/- 4.7 [standard deviation] days before the serum creatinine rose). The nontoxicity group had no change or even showed decrements in amikacin levels in plasma. A higher nephrotoxicity risk was seen in patients with increments greater than 1 microgram/ml between 48 and 96 h, with odds ratios of 16.4 for trough, 8 for peak, and 7.2 for both levels. We suggest that an increment of at least 1 microgram/ml in amikacin levels in plasma from 48 to 96 h may predict the appearance of renal toxicity. PMID- 2764549 TI - Biliary and pancreatic excretion of cefamandole. AB - After intravenous infusion of secretin and cholecystokinin in six dogs, cefamandole (50 mg/kg of body weight) was given intravenously for 10 min. Samples of serum, bile, pancreatic juice, liver, pancreas, fat, and muscle were collected over a 2-h period. Cefamandole levels were measured by a microbiological assay. The highest levels were as follows: serum, 160 micrograms/ml; bile, 3,071 micrograms/ml; pancreatic juice, 7 micrograms/ml; liver, 101 micrograms/g; pancreas, 44 micrograms/g; muscle, 20 micrograms/g; and fat, 14 micrograms/g. Levels in pancreatic juice were extremely low compared with levels in pancreatic tissue, suggesting the existence of a barrier to excretion at the ductal membrane. PMID- 2764550 TI - Influence of etoposide and cyclophosphamide on the efficacy of cloxacillin and erythromycin in an experimental staphylococcal infection. AB - The effect of monocytopenia and granulocytopenia on the outgrowth of Staphylococcus aureus as well as on antibiotic efficacy was studied in an experimental thigh infection in mice. Pretreatment with etoposide reduced monocyte numbers in blood to 14% and those of granulocytes to 54% at the time of infection. Monocytopenia did not affect the proliferation of bacteria in the infected thigh or the reduction of bacterial numbers after treatment with cloxacillin or erythromycin. Pretreatment with cyclophosphamide reduced monocyte numbers to 15% and granulocyte numbers to 3%. This resulted in a marked increase in the number of bacteria at the site of infection and a decrease in the efficacy of antibiotic treatment. PMID- 2764551 TI - Antibiotic treatment of enterococcal infection. PMID- 2764552 TI - Perception of eating and exercise in children as a function of child and parent weight status. AB - The present study assessed the effects of child body weight (obese/lean) and familial loading for obesity (two obese parents/two lean parents) on the psychophysics of sweetness, fatness and exercise workloads, as well as subjective ratings of foods varying in sugar and fat and activities varying in energy expenditure. Children were measured in a baseline state and at 6 months after the obese children had participated in a family-based behavioral weight control program. No differences between obese and lean children in perceptual ratings were observed. However, offspring of obese or lean parents differed on intensity rating, food palatability and activity enjoyment ratings. Intensity ratings for sweetness in offspring of obese parents was increased, with a similar trend for intensity ratings for fatness. Offspring of obese parents rated all foods and activities with lower palatability and enjoyment ratings than offspring of lean parents. After a 6 month family-based behavioral weight loss treatment, obese children had significant decreases in percent overweight while lean children remained stable. Changes in the pattern of food ratings were observed for the obese children, with a reduction in liking for foods high in fat and/or sugar, and an increase in ratings for food slower in fat and sugar. The effects of parental obesity on food and exercise intensity ratings and hedonic ratings were maintained. Overall, these results suggest parental weight influences behavioral factors related to obesity in children. PMID- 2764553 TI - Self-selection of protein during pregnancy and lactation in rats. AB - Protein self-selection was investigated in female rats throughout pregnancy and lactation. In the first experiment, impregnated rats were presented with either a choice between low and high protein (casein) diets, or standard lab chow and their protein intake was compared to that of non-impregnated controls. Impregnated females showed an increase in both absolute and relative protein intake at the end of pregnancy and during the second week of lactation when compared to both their own baseline intake and that of non-impregnated rats. In the second experiment, lactating rats and non-lactating controls were presented with a choice between low and high protein (casein) diets, a high protein (soybean meal) and a high carbohydrate diet, or lab chow. Lactating rats consumed more protein than non-lactating rats regardless of diet condition, but percentage protein intake was found to differ across diet choice conditions. Differences in diet fraction choice are discussed in terms of protein: carbohydrate ratios, and how different sources of protein might be utilized differently within the body. PMID- 2764554 TI - Low affinity hypothalamic [3H]mazindol binding: a probe for hypothalamic body weight regulation? AB - It has been previously suggested that low affinity [3H]mazindol binding in the hypothalamus correlates with body weight and obesity. Low affinity [3H]mazindol binding in hypothalamic crude synaptosome preparations was carried out in normoglycemic obese mice (C57 B1/6J ob/ob) as well as in their lean littermates (C57 B1/6J +/?). NIH Swiss mice were used as additional controls. Furthermore the effect on this binding site of repeated electroconvulsive shock (ECS), a treatment known to change body weight gain, was studied in rats. Neither Bmax nor Kd were altered in obese mice compared with their lean littermates or NIH Swiss mice. The obese mice had a significantly greater body weight and weight gain than either control group. Once-daily ECS over 10 days (which significantly reduced weight gain in rats) did not change binding parameters for [3H]mazindol in hypothalami. The present data do not appear to support the hypothesis that this low affinity binding site has a physiological function in the control of body weight and obesity, at least in the examined paradigm. PMID- 2764555 TI - Food intake in baboons: effects of a long-acting cholecystokinin analog. AB - Food intake of four adult male baboons (Papio c. anubis) was monitored during daily experimental sessions lasting 22h. Food was available under a two-component operant schedule. Following 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 a 10-min interval in which no response occurred, the consumption component was terminated. A long-acting cholecystokinin (CCK) analog U-67827E (U 67: 0.80-3.2 micrograms/kg) was administered, in the thigh muscle, at 1100 hrs immediately prior to the start of the daily session on Tuesdays and Fridays. U-67 significantly reduced intake during the first 8-h of the session, and intake during the entire 22-h session. The decreased intake was due to a significant decrease in the size of the first meal of the session as a consequence of decreased duration of feeding without a change in response rate. U-67 also produced dose-dependent increases in latency to the first meal of up to 2.5 h. These results demonstrate that a long-acting CCK analog decreases food intake over a prolonged period of time in a naturalistic feeding situation. In addition, the effects of U-67 were limited to the consumption component, suggesting that this CCK analog affected food intake by interacting with physiological mechanisms specifically associated with feeding. PMID- 2764556 TI - Effects of weight restriction and palatability on the apparent pharmacological regulation of alcohol consumption by rats in a limited access paradigm. AB - A number of different studies have suggested that the amount of alcohol consumed in a single bout by free-feeding rats is regulated by its pharmacological consequences. The present experiments were designed to test the limits of this apparent pharmacological regulation by examining the effect of weight restriction and enhanced palatability, two variables that have been shown to increase alcohol consumption when the alcohol is continuously available, on amount of alcohol consumed in a single bout. Increasing the palatability of the alcohol solution by the addition of saccharin enhanced consumption substantially such that the blood alcohol levels (BALS) achieved were more than twice those of animals which had drunk unadulterated alcohol. Weight restriction to 80% of free-feeding weight (FFW), however, did not increase alcohol consumption under these conditions. The similarity between these results and those obtained in studies of the regulation of feeding are discussed. PMID- 2764557 TI - Behavioral and biological correlates of dietary restraint in normal life. AB - Based on laboratory results, restrained eating has been linked to the development of binge eating and eating disorder syndromes such as bulimia nervosa. This study was designed to extend the scope of investigation of the concept of restrained eating beyond the laboratory. Eating behavior and biochemical indices of nutritional state were investigated in 60 young women, who were divided in restrained and unrestrained eaters by questionnaire. Seven-day records of food intake showed that the high-restraint group ate around 400 kcal a day fewer than the low-restraint group. Group differences in actual macronutrient intake and long-term food preferences pointed to a qualitatively altered eating pattern in restrained eaters. Actual protein portion was higher in restrained eaters. They tried to avoid calorie dense food items of high carbohydrate and fat content. Instead, they preferred food regarded as low-caloric and healthy. Plasma levels of triiodothyronine and glucose, which could be taken as indices of long-term adaptation to starvation, were not decreased in the high-restraint group. However, significantly higher levels of triglycerides in restrained eaters may reflect a biological state due to short-term starvation. The results indicate that the concept of dietary restraint predicts eating behavior not only under experimental conditions, but also in normal life. As a consequence of altered eating patterns, psychological and physiological deprivation can be hypothesized in restrained eaters, making them prone to the occurrence of overeating. PMID- 2764558 TI - Learned caloric adjustment of human intake. AB - The time course of caloric compensation of food intake was studied in human subjects presented with a new calorically dilute snack food under naturalistic conditions. In a preliminary test, two versions of the snack food, normal in calories (NC) or low in calories (LC), were found equally palatable by the subjects (15 to 17-year-old boys). In the first part of the experiment two groups were presented with a 125g serving of either NC or LC version as an afternoon snack. Intakes during the subsequent dinner (1 h later) were measured. In the second part of the experiment, the same subjects were allowed to habituate to NC or LC, i.e. on five consecutive days, subjects were served NC or LC food ad libitum at afternoon snack-time; servings and left-overs were weighed. On the sixth day, the snack was a 125 g serving of the habitual food and dinner intakes were measured. It was shown that in these adolescent males a 200 kcal difference in the afternoon snack was not immediately compensated for by dinner intake. However, precise caloric adjustment occurred after habituation. This casts in question the value for weight control of such a use of food products having lower caloric content than conventional products. PMID- 2764559 TI - Effects of nisin on growth of bacteria attached to meat. AB - Nisin had an inhibitory effect on gram-positive bacteria (Listeria monocytogenes, Staphylococcus aureus, and Streptococcus lactis) but did not have an inhibitory effect on gram-negative bacteria (Serratia marcescens, Salmonella typhimurium, and Pseudomonas aeruginosa) attached to meat. Nisin delayed bacterial growth on meats which were artificially inoculated with L. monocytogenes or Staphylococcus aureus for at least 1 day at room temperature. If the incubation temperature was 5 degrees C, growth of L. monocytogenes was delayed for more than 2 weeks, and growth of Staphylococcus aureus did not occur. We also found that the extractable activity of nisin decreased rapidly when the meats were incubated at ambient temperatures and that this decrease was inversely related to the observed inhibitory effect. These findings disclosed that nisin delays the growth of some gram-positive bacteria attached to meat. However, nisin alone may not be sufficient to prevent meat spoilage because of the presence of gram-negative and other nisin-resistant gram-positive bacteria. PMID- 2764560 TI - Effects of cadmium, copper, magnesium, and zinc on the decomposition of citrate by a Klebsiella sp. AB - The effects of Cd2+, Cu2+, Mg2+, and Zn2+ on the decomposition of citric acid by a Klebsiella sp. were studied by monitoring the degradation of [14C]citrate. The carbon concentration used was 10 micrograms of C liter-1, and the media were designed to provide at least 95% of the citrate complexed to the metal studied. After 72 h of incubation, 80% of the uncomplexed citric acid and 76% of the magnesium citrate had been decomposed. A marked inhibition was observed when Cd2+, Cu2+, or Zn2+ was bound to the organic anion; only 23% of the cadmium citrate, 14% of the zinc citrate, and 5% of the cuprous citrate had been decomposed. The effects were not the result of toxicity, since experiments run with [14C]glucose (nonchelating compound) instead of citrate resulted in similar decomposition rates regardless of the presence of the metal. To examine whether the binding of a metal to citrate enhanced its uptake by the Klebsiella sp., we studied the relative uptake of 65Zn in citrate- and in glucose-containing media. No such effect could be observed, with the uptake of Zn2+ being higher in the glucose-containing media. The study shows that metals may render low-molecular weight organic acids, such as citric acid, resistant to bacterial degradation. This stresses the importance of metals in influencing microbial decomposition of organic compounds, not only as a result of toxicity. PMID- 2764561 TI - Production of enterotoxin A by supposedly nonenterotoxigenic Staphylococcus aureus strains. AB - The production of staphylococcal enterotoxins A (SEA) and B (SEB) was studied by inoculating six well-defined staphylococcal collection strains into cow's, goat's, or sheep's milk (individually or as a 50% mixture of cow's + goat's or cow's + sheep's), into brain heart infusion, and into a medium generally used to enhance the synthesis of enterotoxins (3+3 medium). Four of the strains used are considered to be SEB producers, another is considered an SEA producer, and the remaining strain is nonenterotoxigenic but produces large quantities of staphylococcal protein A. Staphylococcal protein A masked the results in most cases. Only one strain secreted exclusively SEB, while the other three SEB producers synthesized SEA in different amounts. We conclude that enterotoxin production depends on the natural substrate and may differ from the results obtained when the strain is grown on cellophane over agar to determine its toxigenicity. PMID- 2764562 TI - Evaluation of the 7-h membrane filter test for quantitation of fecal coliforms in water. AB - The 7-h fecal coliform (FC) test for detection of FC organisms in water was evaluated to establish its validity and usefulness for emergency and disaster situations. The waters tested consisted of routine samples collected for public health surveillance and enforcement purposes. A total of 984 water samples from throughout California were assayed. These included samples from coastal salt waters, rivers, canals, and reservoirs, in addition to potable and miscellaneous freshwater sources. A portion of each sample was tested concurrently by both the 7-h FC test and the most-probable-number FC five-tube test. The 7-h FC test samples were incubated for 7 to 7.25 h at 41.5 degrees C. Overall, greater than 90% agreement was obtained between the methods in determining whether the water quality was acceptable or unacceptable. Statistical analysis of the 984 samples confirmed that the 7-h FC method was a suitable alternative to the most-probable number FC method for evaluation of freshwater samples. During emergencies or disasters, the 7-h FC test could provide a means for detection of fecal contamination of water with results available in less than 1 day. PMID- 2764563 TI - Enzyme immunoassay for macrolide antibiotics: characterization of an antibody to 23-amino-O-mycaminosyltylonolide. AB - An enzyme-linked immunosorbent assay was developed for the detection of macrolide antibiotics by using a polyclonal antibody generated in rabbits immunized with 23 amino-O-mycaminosyltylonolide (23-amino-OMT) covalently linked to keyhole limpet hemocyanin. The specificity and sensitivity of this antibody were characterized by using 23-amino-OMT coupled to alkaline phosphatase as an enzyme-linked label in a direct competitive enzyme-linked immunosorbent assay. The assay sensitivity was as low as 0.3 ng/ml for 23-amino-OMT, with a 50% inhibitory concentration of 8 ng/ml. This antibody exhibited good reactivity with 12-, 14- or 16-membered macrolides possessing amino-substituted sugar moieties, regardless of the presence of neutral sugar residues. Little or no cross-reactivity was observed with the macrocyclic lactone ring structure (tylactone) or macrolides containing only neutral sugars. No cross-reaction was observed with polyenes or nonmacrolide antibiotics. Known macrolide-producing cultures grown in fermentation broth also showed good reactivity, indicating that this assay is useful in detecting this class of metabolites in fermentation. PMID- 2764564 TI - Effect of disinfection of drinking water with ozone or chlorine dioxide on survival of Cryptosporidium parvum oocysts. AB - Demineralized water was seeded with controlled numbers of oocysts of Cryptosporidium parvum purified from fresh calf feces and subjected to different treatments with ozone or chlorine dioxide. The disinfectants were neutralized by sodium thiosulfate, and neonatal mice were inoculated intragastrically and sacrificed 7 days later for enumeration of oocyst production. Preliminary trials indicated that a minimum infection level of 1,000 oocysts (0.1-ml inoculum) per mouse was necessary to induce 100% infection. Treatment of water containing 10(4) oocysts per ml with 1.11 mg of ozone per liter (concentration at time zero [C0]) for 6 min totally eliminated the infectivity of the oocysts for neonatal mice. A level of 2.27 mg of ozone per liter (C0) was necessary to inactivate water containing 5 x 10(5) oocysts per ml within 8 min. Also, 0.4 mg of chlorine dioxide per liter (C0) significantly reduced infectivity within 15 min of contact, although some oocysts remained viable. PMID- 2764565 TI - New method to study bacterial adhesion to meat. AB - A new method was developed for the study of bacterial adhesion to meat surfaces. Thin slices of meat (40 microns thick) were inserted into a specially designed observation chamber. The meat slices were then exposed to a bacterial suspension (ca. 10(6) CFU.ml-1) to initiate adhesion (20 min of contact time) and subsequently rinsed to eliminate nonadherent bacteria. Because of the special chamber design, the disruptive force exerted on the bacteria during rinsing (shear stress) was uniform over the whole surface of the meat slices, was constant, and could be varied from 0 to 0.08 N.m-2. After being rinsed, the meat slices were stained with basic fuschin and observed under light microscopy to determine the number and distribution of adherent bacteria. This new method was used to study the adhesion of Acinetobacter strain LD2, a Lactobacillus sp., and Pseudomonas fluorescens to slices of beef fat and tendon. At 25 degrees C, most (greater than or equal to 99.9%) of the cells of the Lactobacillus sp. deposited on the meat were washed off the surface during rinsing (0.05 N.m-2), whereas a large number (ca. 10(5) CFU.cm-2) of Acinetobacter strain LD2 and P. fluorescens cells remained adherent. The extent of adhesion was similar on fat and tendon, and adherent bacteria were distributed evenly over the whole surface of the slices. This preliminary study indicates that the combined use of thin slices of meat and of the observation chamber provides us with the means to more accurately study bacterial adhesion to meat surfaces. PMID- 2764566 TI - Metabolism and some characteristics of ruminal strains of Megasphaera elsdenii. AB - Megasphaera elsdenii belongs to the group comprising the ruminal and intestinal lactate- and sugar-fermenting species. In the present study the fermentation characteristics, metabolism of glucose and lactate, and susceptibility to antimicrobial agents of four ruminal strains were investigated. Particular attention was given to the mixed-substrate fermentation pattern and resultant fermentation acid profile. Lactate was utilized more rapidly than glucose in media with both carbon sources. Interaction of the two substrates changed the composition of fermentation end products toward more valerate and less propionate in cultures with glucose and lactate. Contrary to the indications in Bergey's Manual of Systematic Bacteriology, butyrate, not caproate, was the main end product of glucose metabolism. The strains examined were rather insensitive to many antimicrobial compounds, especially to ionophores and other antimicrobial feed additives. PMID- 2764567 TI - Hybridization of DNA probes with whole-community genome for detection of genes that encode microbial responses to pollutants: mer genes and Hg2+ resistance. AB - Nucleic acids extracted from microbial biomass without prior culturing were hybridized with probes representing four mer operons to detect genes encoding adaptation to Hg2+ in whole-community genomes. A 29-fold enrichment in sequences similar to the mer genes of transposon Tn501 occurred during adaptation in a freshwater community. In an estuarine community, all four mer genes were only slightly enriched (by three- to fivefold), suggesting that additional, yet uncharacterized, mer genes encoded adaptation to Hg2+. PMID- 2764568 TI - Evaluation of different approaches for identification of xenobiotic- degrading pseudomonads. AB - Different approaches were evaluated to identify aerobic, gram-negative, biodegradative isolates assumed to be pseudomonads. Quinone and polyamine analysis allowed rapid identification to the genus level, i.e., allocation of those isolates belonging to the Pseudomonas fluorescens complex which represents the phylogenetically defined core of the heterogeneous genus Pseudomonas. Subsequent studies concentrated only on these true pseudomonads. The multiple test system API 20NE, determination of the moles percent G+C content, and polyacrylamide gel electrophoresis of soluble proteins aided in identification on the species level. Polyacrylamide gel electrophoresis of both soluble proteins and whole-cell lipopolysaccharides allowed recognition of identical strains and double isolates, which were confirmed by DNA-DNA hybridization. PMID- 2764569 TI - Ecology of Vibrio cholerae non-O1 and Salmonella spp. and role of zooplankton in their seasonal distribution in Fukuyama coastal waters, Japan. AB - Seasonal variation of human pathogens such as Vibrio Cholerae non-01 and Salmonella spp. in Fukuyama coastal waters and the role of zooplankton in their distribution were studies for a period of 1 year. Comparison of two established methods, viz., the elevated temperature method and the two-step enrichment method of enumerating V. cholerae, showed that the former is superior in the recoveries of V. cholerae non-01. Isolation of this pathogen on a wider range of salinities (0.4 to 32.5%) revealed that these organisms are apparently an autochthonous component of the aquatic environment. Temperature appears to be the most crucial element in governing the distribution of V. cholerae non-01. Among the 69 isolates serotyped, 22 different serovars were identified, while one isolate failed to react with any of the known Louisiana State University antisera tested. Zooplankton samples did not harbor more V. Cholerae non-01 than the water column did. Better isolation of an allochthonous pathogen, viz., Salmonella spp., was noticed from the water samples when swabs were employed. Of the 251 isolates serotyped, 18 serotypes with three variants of Salmonella spp. were identified. A high amount of nutrients in the water column increased the survival rate of these pathogens in saline waters as evidenced by a higher incidence of various serotypes in polluted Fukuyama port than in clean marine waters. Salmonella spp. association between V. cholerae non-01 of Salmonella spp. with zooplankton could be noticed as influencing their seasonal distribution. PMID- 2764570 TI - Rapid detection and identification of Legionella pneumophila by a membrane immunoassay. AB - Legionella pneumophila was detected and identified by an immunoblot assay using a monoclonal antibody specific to serogroups 1 to 8. Samples containing L. pneumophila were plated on buffered charcoal yeast extract agar supplemented with glycine, vancomycin, and polymyxin B. After incubation at 35 degrees C for 3 days, colonies were transferred to nitrocellulose membranes by blotting. Simultaneous detection and identification of L. pneumophila were done by treating the membrane with the monoclonal antibody and a peroxidase conjugate to mouse immunoglobulins. A diffuse cross-reaction was observed with Pseudomonas fluorescens colonies, but this was a low-level reaction that could easily be differentiated from the strong specific reactions to L. pneumophila. PMID- 2764571 TI - Complete nucleotide sequence and characterization of a cryptic plasmid from Lactobacillus helveticus subsp. jugurti. AB - A small cryptic plasmid, pLJ1, was isolated from Lactobacillus helveticus subsp. jugurti and was cloned into Escherichia coli HB101 by using pBR329 as a vector. Plasmid pLJ1 was 3,292 base pairs long and had single restriction endonuclease sites for PvuII, KpnI, AvaII, Acci, HindIII, and EcoRI. In a maxicell system, pLJ1 produced a protein of about 41 kilodaltons. PMID- 2764572 TI - Partial purification and characterization of an NAD-dependent 3 beta hydroxysteroid dehydrogenase from Clostridium innocuum. AB - In nine strains of Clostridium innocuum, 3 beta-hydroxysteroid-dehydrogenating activities were detected. 3 beta, 7 alpha, 12 alpha-Trihydroxy- and 3 beta hydroxy-12-keto-5 beta-cholanoic acids were identified as reduction products of the respective 3-keto bile acids by gas-liquid chromatography and gas-liquid chromatography-mass spectrometry. One strain was shown to contain a NAD-dependent 3 beta-hydroxysteroid dehydrogenase. Enzyme production was constitutive in the absence of added bile acids. The specific enzyme activity was significantly reduced by growth medium supplementation with 3-keto bile acids, with trisubstituted acids being more effective than disubstituted ones. A pH optimum of 10.0 to 10.2 was found after partial purification by DEAE-cellulose chromatography. A molecular weight of about 56,000 was established. 3 beta hydroxysteroid dehydrogenase activity was also found in the membrane fraction after solubilization with Triton X-100, suggesting that the enzyme was originally membrane bound. The enzyme reduced a 3-keto group in unconjugated and conjugated bile acids, lower Km values being demonstrated with disubstituted than with trisubstituted bile acids. Keto functions at C-7 and C-12 further reduced the Km value. The enzyme was found to be partially heat labile (86% inactivation at 50 degrees C for 10 min). PMID- 2764574 TI - Analysis of pectate lyases produced by soft rot bacteria associated with spoilage of vegetables. AB - Isoelectric focusing (IEF) profiles of pectate lyases (PLs) produced by five different groups of soft rot bacteria were analyzed by using the combined techniques of thin-layer polyacrylamide gel IEF and agarose-pectate overlay activity staining. Four strains of soft rot Erwinia spp. produced three or more PL isozymes. All of eight Pseudomonas viridiflava strains examined produced one single PL with a pI of 9.7. All 10 of Pseudomonas fluorescens strains produced two PLs; the major one had a pI of 10.0 and the minor one had a pI of 6.7. A single PL with a pI of greater than or equal to 10.0 was detected in one strain each of Xanthomonas campestris and Cytophaga johnsonae. PLs of six representative strains were purified from culture supernatants by ammonium sulfate precipitation and anion-exchange chromatography. All purified PL samples macerated potato slices, but to different degrees. The Mrs of alkaline PLs produced by P. viridiflava, P. fluorescens, X. campestris, and C. johnsonae were estimated by sodium dodecyl sulfate-polyacrylamide gel electrophoresis to be 42,000, 41,000, 41,500, and 35,000, respectively. IEF profiles of PLs were distinct among the bacterial species. Profiles of non-Erwinia spoilage bacteria were considerably simpler than those of Erwinia spp. The PL with an alkaline pI appeared to be the principal or the sole enzymatic factor involved in tissue maceration caused by most strains of soft rot bacteria. PMID- 2764573 TI - Expression of denitrification enzymes in response to the dissolved oxygen level and respiratory substrate in continuous culture of Pseudomonas stutzeri. AB - The onset and cessation of the synthesis of denitrification enzymes of Pseudomonas stutzeri were investigated by using continuous culture and defined dissolved oxygen levels covering the full range of transition from air saturation to complete anaerobiosis. Expression of nitrate reductase, nitrite reductase (cytochrome cd1), and N2O reductase was controlled by discrete oxygen levels and by the nature of the nitrogenous oxide available for respiration. N2O reductase was synthesized constitutively at a low level; for enhanced expression, oxygen concentrations were required to decrease below 5 mg of O2 per liter. The threshold values for synthesis of nitrate reductase and cytochrome cd1 in the presence of nitrate were ca. 5 and ca. 2.5 mg of O2 per liter, respectively. With nitrous oxide as the respiratory substrate, nitrite reductase was again the most sensitive to oxygen concentration; however, thresholds for all denitrification enzymes shifted to lower oxygen levels. Whereas the presence of nitrate resulted in maximum expression and nearly uniform induction of all reductases, nitrite and nitrous oxide stimulated preferably the respective enzyme catalyzing reduction. In the absence of a nitrogenous oxide, anaerobiosis did not induce enzyme synthesis to any significant degree. The accumulation of nitrite seen during both the aerobic-anaerobic and anaerobic-aerobic transition phases was caused by the differences in onset or cessation of synthesis of nitrate and nitrite reductases and an inhibitory effect of nitrate on nitrite reduction. PMID- 2764575 TI - Degradation and utilization of cellulose and straw by three different anaerobic fungi from the ovine rumen. AB - Three different ruminal fungi, a Neocallimastix sp. (strain LM-1), a Piromonas sp. (strain SM-1), and a Sphaeromonas sp. (strain NM-1), were grown anaerobically in liquid media which contained a suspension of either 1% (wt/vol) purified cellulose or finely milled wheat straw as the source of fermentable carbon. Fungal biomass was estimated by using cell wall chitin or cellular protein in cellulose cultures and chitin in straw cultures. Both strains LM-1 and SM-1 degraded cellulose with a concomitant increase in fungal biomass. Maximum growth of both fungi occurred after incubation for 4 days, and the final yield of protein was the same for both fungi. Cellulose degradation continued after growth ceased. Strain NM-1 failed to grow in the cellulose medium. All three anaerobic fungi grew in the straw-containing medium, and loss of dry weight from the cultures indicated degradation of straw to various degrees (LM-1 greater than SM 1 greater than NM-1). The total fiber component and the cellulose component of the straw were degraded in similar proportions, but the lignin component remained undegraded by any of the fungi. Maximum growth yield on straw occurred after 4 days for strain LM-1 and after 5 days for strains SM-1 and NM-1. The calculated yield of cellular protein for strain LM-1 was twice that of both strains SM-1 and NM-1. The cellular protein yield of strain SM-1 was the same in both cellulose and straw cultures. In contrast to cellulose, straw degradation ceased after the end of the growth phase.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2764576 TI - Influence of Pseudomonas syringae culture conditions on initiation of the hypersensitive response of culture tobacco cells. AB - The inhibitor sensitivity and timing of the ionic response of suspension-cultured tobacco cells were used as a bioassay for the Pseudomonas syringae signal that elicits the hypersensitive response in resistant plants. The ionic response of tobacco cell suspensions inoculated with P. syringae pv. syringae 61 and P. syringae pv. pisi grown in rich media was inhibited by rifampin, tetracycline, and streptomycin during a 2- to 2.5-h induction stage. Coculturing the bacteria with tobacco cells for 3 h or more before inoculating fresh tobacco cells specifically abolished the sensitivity of the ionic response to these inhibitors and reduced the response time of the tobacco cells from 3 to 1 h. The apparent activation of the bacteria during coculture was not dependent on the plant cells and could be achieved by incubating the bacteria in a nitrogen-deficient medium containing a metabolizable carbon source. Addition of proteose peptone and Casamino Acids to this medium suppressed activation of the bacteria. The results suggest that the hypersensitive response-eliciting signal forms late in the induction stage, perhaps as a result of the derepression of some of the P. syringae genes functional in elicitation of the hypersensitive response. The nature of the activated state remains elusive but is consistent with the accumulation of protein(s) whose activity indirectly elicits the ionic response. PMID- 2764577 TI - Phenotypic and genomic studies of "Cytophaga psychrophila" isolated from diseased rainbow trout (Oncorhynchus mykiss) in France. AB - Five strains of gliding bacteria were isolated in France from farmed diseased rainbow trouts reared at low water temperature. The resemblance of these bacteria to the known fish pathogen "Cytophaga psychrophila" led to their comparative study with reference strain NCMB 1947 and with an American isolate. Morphological, physiological, and biochemical characteristics of the seven strains proved to be similar. Comparison of their DNA by the S1 nuclease DNA-DNA hybridization method showed that the seven strains formed a tight genomic species with DNA relatedness above 90%. This is the first identification of this fish pathogen in a European country. The main phenotypic characteristics differentiating this bacterium from other nonpathogenic gliding bacteria of fish origin include a poor gliding movement, yellow compact or weakly rhizoid colonies on solid media, and the presence of flexirubin-type pigments. The inability to metabolize any carbohydrates, the strong proteolytic activity, the absence of growth in more than 0.5% NaCl, and the tolerance to a maximum temperature of 25 degrees C are also useful characteristics of this group of bacteria. PMID- 2764578 TI - Imagery instruction and the control of postsurgical pain. AB - This study examined the effectiveness of an innovative method of pain control, pleasant imagery, for the management of acute postsurgical pain in 32 individuals having elective surgery. In the experimental group, 16 preoperative subjects received procedural information and instruction regarding the use of pleasant imagery to control pain. In the control group, 16 subjects received procedural information only. Scores on a visual analogue scale and recorded doses of analgesics administered postoperatively provided measures of perceived pain and analgesic consumption, respectively. The t test for independent means showed that patients who used pleasant imagery perceived significantly less postsurgical pain and consumed significantly less pain medication than did the control group (p less than .05). These findings suggest that nurses can enhance the management of postoperative pain by teaching patients to use pleasant imagery. PMID- 2764579 TI - Expanded nursing care for contraceptive use. AB - Nursing actions to promote contraceptive self-care are described. Orem's self care theory was used to develop assessment tools and to plan nursing actions. PMID- 2764580 TI - Tardive dyskinetic movements over time. AB - Tardive dyskinetic (TD) movements have been noted to fluctuate in intensity throughout the hours of the day. There have been very few descriptive studies of this fluctuation; the resulting lack of knowledge has made treatment and monitoring procedures for TD problematic. This study sought to describe TD symptom variations across the hours of the day and between days and to relate these variations to control factors. This small study (eight subjects) identified several potentially important variations which need to be further examined in larger studies. PMID- 2764581 TI - Body temperature and heart rate rhythms in acutely head-injured patients. AB - This descriptive pilot study investigated the circadian (24-hour) rhythms of heart rate and temperature in acutely head-injured patients and the relationships between these variables. The convenience sample consisted of 10 patients who were admitted to the hospital with the diagnosis of acute head injury. Patel's Method of Partition was used to estimate rhythmicity. Only one patient demonstrated circadian rhythms for body temperature and heart rate with the peaks occurring at appropriate times. While three other patients had significant rhythms for these variables, the rhythms had cycles of less than 24 hours and peaks occurring at inappropriate times. Although significant correlations were found between body temperature and heart rate rhythms, they were low. PMID- 2764582 TI - Perceived perinatal complications and childbirth satisfaction. PMID- 2764583 TI - Gender differences in walking distances of people with lung disease. PMID- 2764584 TI - Ask an expert. How does one select a measurement instrument to study a clinical nursing problem? PMID- 2764585 TI - Fact and fiction about management of aortic transection. PMID- 2764586 TI - Transposition of the great arteries: a comparison of results of the mustard procedure versus the arterial switch. AB - Sixty infants with transposition of the great arteries and intact ventricular septum underwent primary surgical correction in the first 3 months of life. Twenty-three patients had a Mustard procedure (group 1) and 37 patients, an arterial switch operation (group 2). The mean age at the time of repair was 42 +/ 31 days for group 1 and 8 +/- 6 days for group 2 (p less than 0.001). The mean weight at the time of repair was 3.6 +/- 0.7 kg for group 1 and 3.4 +/- 0.5 kg for group 2 (p = not significant). Operative mortality was 8.7% (2/23) in group 1 and 8.1% (3/37) in group 2 (p = not significant). The incidence of arrhythmias in the early postoperative period was 39% (9/23) in group 1 and 11% (4/37) in group 2 (p less than 0.01). All patients were followed a mean of 4.8 +/- 2.4 years in group 1 and 2.6 +/- 1.4 years in group 2 (p less than 0.001). Postoperative catheterization has been performed in 86% (18/21) of group 1 operative survivors and 50% (17/34) of group 2 operative survivors. Ejection fraction of the systemic ventricle was 79% +/- 15% of predicted normal in group 1 and 98% +/- 6% in group 2 (p less than 0.005). The incidence of late arrhythmias was 57% (12/21) in group 1 and 3% (1/34) in group 2 (p less than 0.001). There have been 2 late deaths in group 1 and 1 late death in group 2 (p = not significant).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2764587 TI - Valve replacement in the octogenarian. AB - Twenty-five patients (11 men and 14 women) aged 80 to 88 years (mean age, 82 years) underwent valve replacement at St. Louis University from August 1980 to June 1988. Isolated valve replacement was performed in 11 patients. Combined procedures included valve replacement with myocardial revascularization (7 patients), multiple valve procedures (5 patients), and ascending aortic plication (2 patients). Fifteen patients (60%) were in New York Heart Association functional class III and 10 (40%) were in class IV preoperatively. The operative mortality was 20% and late mortality was 20% (mean follow-up, 36 months). Isolated valve replacement carried a 9% early and 0% late mortality, whereas combined procedures of any type had a 16% early and 20% late mortality. Only 7 patients (28%) had a completely uncomplicated postoperative hospitalization. Twenty patients were discharged after a mean hospital stay of 18 +/- 16 days. Their mean New York Heart Association functional class was 1.6 +/- 0.66. The 1 year and 2-year actuarial survival rate is 79% and 69%, respectively. A significant increase in operative mortality is seen when valve replacement is combined with myocardial revascularization or an additional valve procedure. Late clinical improvement, as judged by return to an independent life-style, justifies this approach for select patients. PMID- 2764588 TI - Embryonic versus adult myocardium: adenine nucleotide degradation during ischemia. AB - Neonatal myocardium demonstrates better recovery from ischemia than does adult tissue. We tested the hypothesis that developmental differences in adenine nucleotide degradation might facilitate recovery by quantitating depletion of high-energy phosphates in nine-day-old embryonic (n = 9) and 15-month-old adult (n = 14) chicken hearts at 15-, 30-, 45-, and 60-minute intervals of normothermic ischemia in vitro. Nucleotides adenosine triphosphate, adenosine diphosphate, and adenosine monophosphate and nucleosides adenosine, inosine, hypoxanthine, and xanthine were determined by high-performance liquid chromatography. Several observations in metabolite degradative response to ischemia were noted. The embryonic myocardium maintained higher adenosine triphosphate and adenosine monophosphate levels over the course of the investigation than did mature myocardium. Moreover, the adult group showed an increase in diffusible nucleoside pool metabolites. Relative immaturity of enzymes responsible for nucleotide degradation may facilitate postischemic recovery by preserving nondiffusible high energy phosphate precursors to participate in salvage resynthesis of adenosine triphosphate. PMID- 2764589 TI - Detection of multiple cardiac papillary fibroelastomas using transesophageal echocardiography. AB - Papillary fibroelastomas are rare, benign cardiac tumors that may be associated with embolization, angina, and sudden death. We report a case of multiple papillary fibroelastomas diagnosed during life by transesophageal echocardiography. Surgical resection during mitral valve replacement for rheumatic mitral stenosis prevented the development of any of the life threatening complications sometimes associated with this tumor. PMID- 2764590 TI - Treatment of median sternotomy wound infection and sternal necrosis in an infant. AB - A case of an infant with median sternotomy wound infection and sternal necrosis treated by debridement and muscle flap transposition is reported. As in adults, the procedure can be done safely and successfully. Rapid healing and chest wall stability were obtained. A later cardiac procedure was performed without technical difficulties and without untoward effects on chest wall stability. PMID- 2764591 TI - Autopsy findings 14 years after septation for single ventricle. AB - The autopsy findings of a patient who survived 14 years after ventricular septation for single ventricle are reported. Although the patient had been well for years, she suddenly died at 22 years of age. Her ventricular free walls had grown normally, but the ventricular septum did not. A crevice was found in the apex, and the ventricular septum consisted of only the Teflon patch. Microscopically, fibrosis was found only in the right atrium. PMID- 2764592 TI - Myocardial preservation: the role of magnesium. PMID- 2764593 TI - Right heart endocarditis and endocardial pacemakers. PMID- 2764594 TI - Buckling in bioprosthetic valves. PMID- 2764596 TI - The arterial switch procedure for the neonate: coming of age. PMID- 2764595 TI - Intraoperative cryoanalgesia for postthoracotomy pain relief. AB - In a randomized study, 63 patients were investigated for the benefits of cryoanalgesia after thoracotomy. Analgesia and its dependent effects such as enhancement of mobility, respiratory function, and reduced need of narcotics were evaluated. No significant differences in these variables were observed between the cryoanalgesia group and the control group. However, moderate to severe neuralgia was found in a number of patients in the cryoanalgesia group in the late postoperative period. Cryoanalgesia for pain relief after thoracotomy is not recommended. PMID- 2764597 TI - Determinants of perioperative morbidity and mortality after pneumonectomy. AB - A total of 197 consecutive patients undergoing pneumonectomy at the M.D. Anderson Cancer Center from 1982 to 1987 were reviewed. Sixty-five variables were analyzed for the predictive value for perioperative risk. The operative mortality rate was 7% (14/197). Patients having a right pneumonectomy (n = 95) had a higher operative mortality rate (12%) than patients having a left pneumonectomy (1%, p less than 0.05). The extent of resection correlated with the operative mortality rate (chest wall resection or extrapleural pneumonectomy, n = 39, 15%; versus simple or intrapericardial pneumonectomy, n = 158, 5%; p less than 0.05). Patients whose predicted postoperative pulmonary function, by spirometry and xenon 133 regional pulmonary function studies, was a forced expiratory volume in 1 second greater than 1.65 L, forced expiratory volume in 1 second greater than 58% of the preoperative value, forced vital capacity greater than 2.5 L, or forced vital capacity greater than 60% of the preoperative value had a lower operative mortality rate (p less than 0.05). Atrial arrhythmia was the most common postoperative complication (23%). Xenon 133 regional pulmonary function studies are useful in predicting the risks of pneumonectomy. PMID- 2764598 TI - Does hypothermic fibrillatory arrest improve myocardial protection during emergency revascularization? AB - Hypothermic fibrillatory arrest (HFA) was compared with conventional hypothermic cardioplegic arrest (HCA) in a model of acute regional ischemia. In 20 pigs, the left anterior descending coronary artery was occluded for 30 minutes before cardiopulmonary bypass. In the HCA group (n = 10), the heart was arrested with a hyperkalemic cold crystalloid solution, whereas in HFA animals (n = 10), the heart was vented and allowed to fibrillate spontaneously without cross-clamping. Miniature pH probes monitored intramyocardial pH during 45 minutes of arrest (HCA or HFA, both with systemic and topical myocardial cooling) and during two hours of coronary reperfusion. Hypothermic fibrillatory arrest did not ameliorate the acidosis in the ischemic (left anterior descending) region; indeed, after two hours of coronary reperfusion, there was a trend toward more acidosis in the postischemic left anterior descending territory in the HFA group. However, HFA did prevent acidosis in the nonischemic (left circumflex) territory. Infarct size expressed as percent of region at risk was 18.1% +/- 3.2% (mean +/- standard error of the mean) in the HCA animals and 18.8% +/- 4.4% in the HFA animals. These results demonstrate that HFA offers no advantage over HCA in protection of regionally ischemic myocardium in a model with minimal collateral circulation. PMID- 2764599 TI - Cryoanalgesia for postthoracotomy pain. PMID- 2764600 TI - Incidence of Cell-Saver contamination during cardiopulmonary bypass. AB - During regular bacteriological surveillance of cardiac surgical equipment and patients, the Cell Saver apparatus (CSA) was prospectively evaluated to determine if it represented an additional risk for infection. Nineteen patients were studied. After each operation, the effluent from the CSA was sterilely sealed for subsequent culture. A total of 42 aerobic and 42 anaerobic cultures were made. Postoperatively all patients were evaluated daily for four days and before discharge for clinical evidence of infection. Four patients had positive CSA cultures without evidence of postoperative clinical infection. Five patients in whom postoperative infectious complications developed had negative CSA cultures. Ten patients had negative CSA cultures and no evidence of postoperative infection. We conclude that the CSA does not appear to contribute to the risk of infection in cardiac surgical patients and that it is a safe adjunct to cardiac surgery. PMID- 2764601 TI - A 10-year comparison of mitral valve replacement with Carpentier-Edwards and Hancock porcine bioprostheses. AB - Two hundred fifty-three patients who underwent isolated mitral valve replacement with a porcine bioprosthesis had long-term evaluation. One hundred forty-seven patients received a Carpentier-Edwards porcine bioprosthesis and 106, a Hancock valve. There were no significant differences in preoperative clinical characteristics between the two groups. Cumulative follow-up was 1,375 patient years. At 10 years, 93% +/- 2.5% of the patients in the Carpentier-Edwards group and 85% +/- 7.8% of those in the Hancock group were free from valve-related death (not significant), and 95% +/- 2% and 91% +/- 3.8%, respectively, were free from thromboembolism (not significant). At 10 years, 65% +/- 7.2% of the patients in the Carpentier-Edwards group and 66% +/- 7.2% of those in the Hancock group were free from structural valve deterioration (not significant), and 64% +/- 6% and 59% +/- 7.3%, respectively, were free from reoperation (not significant). We conclude that the first generation of Carpentier-Edwards and Hancock prostheses produce comparable long-term results in the mitral position. PMID- 2764602 TI - Thrombotic obstruction of disc valves: clinical recognition and surgical management. AB - Twenty-seven patients underwent reoperation because of thrombotic obstruction of a disc-type cardiac valve prosthesis. Preoperative clinical features included effort dyspnea in 81%, new-onset angina in 44%, a new murmur in 89%, and an abnormal opening or closing sound associated with the prosthetic valve in 56%. Symptoms were present for 1 week or more before reoperation in 86%, although many patients were referred only after acute exacerbation of heart failure and development of pulmonary edema. Noninvasive studies confirmed prosthetic valve malfunction in only 33%, but cardiac catheterization documented thrombotic obstruction in all 15 patients in whom it was performed. In 14 of the 27 patients, prothrombin time was in the therapeutic range at the time of admission. Prompt reoperation for valve replacement or thrombectomy was performed with an operative mortality of 11%, and long-term outcome was satisfactory in all but 1 hospital survivor. These findings emphasize the importance of considering the diagnosis of thrombosed heart valves in patients with mechanical heart valves who are seen with nonspecific symptoms. PMID- 2764603 TI - Thoracoscopy: a review of 121 consecutive surgical procedures. AB - The records of 121 patients who underwent surgical thoracoscopy between 1976 and 1987 were reviewed. The indications for thoracoscopy were pleural effusion (88%), pleural thickening (7.4%), and a mass on the chest roentgenogram (15%). All procedures were performed under general anesthesia with a rigid thoracoscope and 91 patients (75%) were diagnosed as having a malignant process. Although thoracotomy was undertaken in 20 patients (16.5%), no patient with benign disease underwent diagnostic thoracotomy. Thoracoscopy had a 98.9% sensitivity and a 93.3% specificity in this series. One patient died of a myocardial infarction after the procedure, and 11 patients (9.1%) had other, predominantly respiratory, complications. We confirm that surgical thoracoscopy is a useful procedure in the diagnosis of pleural processes. PMID- 2764604 TI - Right thoracotomy, femorofemoral bypass, and deep hypothermia for re-replacement of the mitral valve. AB - Ten patients underwent mitral valve re-replacement for the third to sixth time through a right thoracotomy using one-lung anesthesia, femorofemoral bypass, profound systemic hypothermia, and low-flow perfusion without aortic cross clamping or cardioplegia. The indications for this approach were previous mediastinitis, severe right ventricular hypertension with multiple previous sternotomies, intact coronary artery bypass graft, or previous aortic valve replacement. There was 1 operative death, which was due to end-stage pulmonary hypertension and intractable right heart failure. Blood loss was minimal, and there was no major postoperative morbidity in the 9 surviving patients except for supraventricular arrhythmias. PMID- 2764605 TI - Inflammatory pseudotumor of the lung in adults: radiographic and clinicopathological analysis. AB - Inflammatory pseudotumors of the lung are rare in adults. We treated 7 patients with such tumors and describe the histological evidence, radiographic findings, and surgical treatment. In 5 patients, lung cancer was suspected preoperatively on the basis of the radiographic findings. Intraoperatively, the gross appearance of the pleura resembled lung cancer in 6 patients; the parietal pleura was involved in 3, and pleural indentation was present in the other 3. Two patients underwent partial resection, as the frozen section revealed a benign tumor, and 5 patients underwent lobectomy for what appeared to be lung cancer or a large mass. All of the patients are doing well without other therapy. We believe the lesion should be differentiated from lung cancer at operation by frozen sections, even though this proved pertinent in only 2 of the 7 patients. Limited resection is recommended if the lesion is an inflammatory pseudotumor. PMID- 2764606 TI - The effect of fluorocarbon emulsion on 24-hour canine heart preservation by coronary perfusion. AB - This study was designed to evaluate the effects of fluorocarbon emulsion as an oxygen carrier in myocardial preservation. The hearts were preserved for 24 hours by coronary perfusion with either oxygenated crystalloid cardioplegic solution (group C) or crystalloid cardioplegic solution with fluorocarbon added (group FC). The perfusion pressure was kept at 20 mm Hg, and myocardial temperature was maintained at 4 degrees C. Group FC demonstrated better recovery in developed pressure and maximum rate of rise of left ventricular pressure compared with group C. The postpreservation end-diastolic pressure in group C increased significantly compared with the baseline value (value obtained before preservation). On the other hand, group FC showed no significant increase of end diastolic pressure after preservation. Group FC released a significantly lower level of creatine kinase into its perfusate than did group C. Ultrastructural changes after preservation in group C showed severe ischemic injury, but there was no evidence of ischemic injury in group FC. The use of fluorocarbon emulsion proved beneficial to myocardial protection in long-term preservation of canine hearts. PMID- 2764607 TI - Hazards of transthoracic needle biopsy of the lung. PMID- 2764608 TI - Surgical resection for complications of pulmonary tuberculosis. AB - From 1975 through 1984, 24 patients at the Medical University of South Carolina underwent surgical resection for complications of pulmonary tuberculosis. The complications fell into three major categories: persistent or drug-resistant disease, bronchiectasis, and hemoptysis. The major indications for surgical intervention included hemoptysis (14 patients), drug resistance (5), possible neoplasm (3), and bronchiectasis (2). Impaired pulmonary function was common. Surgical therapy generally necessitated lobectomy, sometimes resulted in substantial blood loss, and had a total major and minor complication rate of 46%. Despite these problems, the long-term prognosis after successful resection is good. PMID- 2764610 TI - Missiles in the heart. AB - The records of 24 patients who had a missile retained in the heart and who were treated at Grady Memorial Hospital from 1968 to 1987 were reviewed. In 22, the missile lodged in the heart after its direct injury and in the remaining 2, after the bullet injured a systemic vein. Immediately after the cardiac injury, 7 of the 22 patients were seen with cardiac tamponade (3 also had hemothorax), 11 were seen with hemothorax, 5 were asymptomatic, and 1 was in shock. Seven patients underwent emergency thoracotomy; the bullet was removed in 3, but in the remaining 4 patients, it was not located. In the other 17 patients and in the 4 in whom the bullet could not be found during emergency thoracotomy, the diagnosis was suspected from the chest roentgenograms and confirmed by cardiac fluoroscopy or angiocardiography. Eight patients with retained bullets underwent elective operation; the bullet was removed from 7 and in 1 it was left embedded in the right ventricular septum. All 10 patients who underwent excision of the missile recovered without complication except 1 in whom pericarditis developed, and all were followed for up to 17 years. All 14 patients with a retained missile in the heart had no cardiac symptoms referable to the bullet and were followed for up to 15 years. This experience suggests that the management of patients with a bullet of .38 caliber or smaller that is retained in the heart should be individualized according to the patient's clinical course and the site of the bullet and that in select patients, bullets left in the heart are tolerated well. PMID- 2764609 TI - Cardiac valve replacement in the elderly: clinical performance of biological prostheses. AB - From 1975 to 1987, 1,127 elderly patients underwent 1,223 valve replacements with the Carpentier-Edwards standard or supraannular porcine bioprostheses in 1,147 operations. Of the total patient population seen during these years, 33.5% receiving a standard porcine bioprosthesis and 48.6% receiving a supraannular bioprosthesis were 65 years of age or older. Of this elderly patient population, 465 patients were between 65 and 69 years old; 618 patients, 70 and 79 years old; and 52 patients, 80 years old and older. Aortic valve replacement was performed in 635 patients, mitral valve replacement in 417 patients, tricuspid valve replacement in 2 patients, and multiple-valve replacement in 80 patients. The cumulative follow-up was 3,957 patient-years. Early mortality was 9.5%: 7.3% for the 65- to 69-year-old group, 10.7% for the 70- to 79-year-old group, and 15.4% for the group 80 years old and older. Late mortality was 5.5% per patient-year: 4.2% per patient-year for the 65- to 69-year-old group, 6.3% per patient-year for the 70- to 79-year-old group, and 14.1% per patient-year for the group 80 years old and older. Valve-related causes contributed to 7 early deaths and 33 late deaths. The overall patient survival, including operative deaths, was 70.7% +/- 1.6% at 5 years and 47.8% +/- 3.7% at 10 and 12 years. The freedom from all valve related complications was 52.1% +/- 6.1% at 10 and 12 years. The overall rate of valve-related complications was 5.0% per patient-year (fatal complications, 1.13% per patient-year). The overall rate of thromboembolism was 2.3% per patient-year and the freedom from thromboembolism, 69.6% +/- 5.2% at 10 and 12 years. The freedom from structural valve deterioration was 80.8% +/- 8.1% at 10 and 12 years: 71.7% +/- 11.0% at 10 and 12 years for the 65- to 69-year-old group, 97.9% +/- 1.2% at 10 years for the 70- to 79-year-old group, and 100% at 12 years for the group 80 years old and older. At 10 and 12 years, the freedom from valve related death was 83.7% +/- 4.3% and the freedom from reoperation, 73.3% +/- 8.6%. The freedom from valve-related death, residual morbidity from thromboembolism and anticoagulant-related hemorrhage, and reoperation was 61.7% +/- 7.0% at 10 and 12 years. The clinical performance of porcine bioprostheses in the elderly patient population has been excellent. The early mortality increases in patients 70 years old or older.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2764611 TI - Pleuroperitoneal shunts in the management of persistent chylothorax. AB - Between June 1981 and June 1988, we placed pleuroperitoneal shunts in 16 patients for the management of refractory chylothorax on the Pediatric Surgical Service, University of Virginia. The cause of the chylothorax was caval thrombosis from central venous catheters in 5 patients, idiopathic in 3, and mediastinal lymphangioma in 2, and in 6, it developed after a cardiac procedure. Chylothorax in each patient was unresponsive to thoracentesis, tube thoracostomy, and dietary manipulations. A Denver double-valved shunt system is currently employed and is implanted using general anesthesia. Manual pumping is required postoperatively for several months. Twelve (75%) of the 16 patients had excellent results with complete elimination of the chylothorax and resolution of symptoms. In 10 of these 12, the shunt has been removed. Four had an unsatisfactory result: 3 had inferior vena cava hypertension, and 3 were low-birth-weight premature infants. Four patients seen early in this series required revision of the position of the pleural catheter, with successful drainage in each instance. Pleuroperitoneal shunting is a safe, simple, and effective treatment of chylothorax in infants and children. In view of our success in treating chylothorax with these shunts, we recommend early shunting before the development of nutritional or immunological depletion. PMID- 2764612 TI - Esophageal carcinoma: surgery without preoperative adjuvant chemotherapy. AB - Our experience with 100 consecutive patients with esophageal carcinoma treated with surgical intervention as the primary method of therapy between 1967 and 1987 was reviewed. Preoperative chemotherapy was not administered by us. Follow-up was complete for all 100 patients. Twelve percent of tumors were in the proximal third of the esophagus, 21% were in the middle third, and 67% were in the distal third. Adenocarcinoma accounted for 44% of all tumors, squamous cell for 55%, and adenosquamous for 1%. Six patients were in stage I, 14 were in stage II, and 80 were in stage III; no patient was in stage IV. Surgical procedures included 85 esophagogastrectomies with primary anastomoses, 11 with colon interposition, and 4 with Roux-en-Y small-bowel interposition. Six patients had radical laryngopharyngo-esophagectomy with gastric or colopharyngeal anastomosis. Operative mortality was 3%. The mean survival of stage I patients was 182 months; stage II patients, 25 months; and stage III patients, 18 months. Our data show that surgical resection without preoperative adjuvant chemotherapy remains the cornerstone of therapy for patients with carcinoma of the esophagus. PMID- 2764613 TI - Mitral valve reconstruction in the elderly population. AB - The technique, efficacy, and long-term results of mitral valve reconstruction have been well demonstrated and reported by Carpentier and other investigators. However, most of the results reported have been in patients aged less than 65 years. Between April 1985 and September 1988, we performed mitral valve reconstruction in 176 patients using Carpentier's classification and technique for repair. Ages ranged from 15 to 86 years (mean age, 63 years). Of the repairs, 96/176 (55%) had concomitant cardiac procedures. Patients aged 65 years or more accounted for 52% (92/176) of the population and 35% (65/176) were more than 70 years old. Hospital mortality (30 day) was 4% (4/84) in the group aged less than 65 years. Hospital mortality for the group aged more than 65 years was 12% (11/92), compared with an overall 8.5% mortality. These results suggest an increased morbidity with mitral valve repair in the patients aged more than 65 years, but this group represents an even higher risk group with mitral valve replacement. PMID- 2764614 TI - Neoadjuvant therapy of squamous cell carcinoma of the esophagus: role of resection and benefit in partial responders. AB - Twenty-eight patients were treated between 1981 and 1987 with a combination of radiation therapy and two courses of 5-fluorouracil and cisplatin followed by esophageal resection. Sixteen patients (57%) underwent resection. Operative mortality was 6% (1 of 16), and the 15 operative survivors have been followed for more than 23 months. Complete pathological response was achieved in 8 of the 15 patients, and 10 patients (66%) are alive with no evidence of disease; 4 patients (27%) have survived with no evidence of disease for more than 5 years. Four partial responders are alive, and 3 are alive with no evidence of disease for more than 5 years. An aggressive approach with a low mortality has demonstrated survival benefit to complete responders and, contrary to findings of previous reports, has established a role for surgical resection and survival benefit in patients with partial response, with 3 of 7 (47%) patients surviving more than 5 years. PMID- 2764615 TI - Gentamicin solution for mediastinal irrigation: systemic absorption, bactericidal activity, and toxicity. AB - Local irrigation with gentamicin sulfate represents a possible substitute for neomycin sulfate, used for many years but now no longer available for use as an irrigation fluid. In this investigation, mediastinal irrigation with gentamicin was used in 12 patients who had experienced problems after a heart operation. The regimen employed for mediastinal irrigation with gentamicin was equipotent with that using neomycin. We sought to determine the degree of absorption and risk of either inadequate or toxic blood levels that might follow gentamicin absorption. Irrigation periods were short, ranging from one to four days and determined by measurements of plasma gentamicin concentration using radioimmunoassay evaluation. Systemic gentamicin absorption occurred in all patients. Toxic levels of higher than 8.0 micrograms/mL occurred and were size related, ie, correlated with smaller body weight and surface area, and sex related, ie, female sex. Larger-sized patients often had inadequate levels. Despite the potential risk from toxic blood levels, major increases in serum creatinine levels were not seen. These findings suggest that monitoring of plasma gentamicin levels during mediastinal irrigation with gentamicin is mandatory to avoid both inadequate treatment and toxicity. PMID- 2764616 TI - Mediastinal lymph node necrosis: a newly recognized complication of mediastinoscopy. AB - Eight cases of partial mediastinal lymph node necrosis identified at thoracotomy two to 17 days after cervical mediastinoscopy are described. In 6 cases, the involved nodes were grossly abnormal at operation, requiring frozen section interpretation. In the first 2 patients, the areas of nodal infarction were misinterpreted as necrotic tumor. Permanent sections from all 8 patients showed no evidence of tumor in the infarcted nodes. Factors predisposing to nodal infarction included right-sided tumor, central tumor, and large mediastinoscopic biopsy specimens. In all instances, the infarcted nodes were subcarinal and/or main bronchial. In 2 patients, left recurrent laryngeal nerve palsy occurred after mediastinoscopy. Necrosis in distal nodal areas should be recognized as a complication of thorough mediastinoscopic sampling, presumably due to interruption of arteries supplying these nodes. Awareness of this phenomenon by surgeons and pathologists may avert falsely positive gross or microscopic diagnoses of metastatic malignancy at thoracotomy. PMID- 2764617 TI - Complications after esophagogastrectomy using stapling instruments. AB - We studied 195 patients undergoing esophageal resection using stapling instruments during a period of over 8.5 years. Of these, 178 (91.2%) underwent operation for malignant disease. Operative death occurred in 19 patients (9.7%). Nine (4.6%) postoperative complications, excluding stricture formation, were related to the use of stapling instruments, including two operative deaths (1.0%). Anastomotic leaks and gastrotomy staple line leaks were the most common complications (four each). In 7 patients (3.6%) the circular stapler tore the esophagus; anastomotic leaks subsequently developed in 43% of these patients. After we began oversewing gastrotomy staple lines in 1984, we experienced only one gastrotomy leak due to a technical error. Postoperative stricture formation occurred soon after resection and responded well to one or two dilations. It is better to err on the side of choosing too small a stapling head when performing an esophageal anastomosis because this may reduce the incidence of leaks, and further strictures are easily dealt with. PMID- 2764618 TI - Value of fiberoptic bronchoscopy and angiography for diagnosis of the bleeding site in hemoptysis. AB - We evaluated 36 patients during active hemoptysis and compared the diagnostic yield of different procedures. Twenty-seven patients (75%) had one or more previous episodes of hemoptysis, most of which were not massive. Fiberoptic bronchoscopy was performed in 25 patients, and the bleeding site was identified in 17 (68%). The likelihood of localizing the bleeding site was significantly higher with early versus delayed fiberoptic bronchoscopy (91% versus 50%). Bronchial arteriography was performed in all 36 patients; positive arteriographies were observed in 20 cases (55.5%). Arteriography was positive in only 2 of the 8 cases in which fiberoptic bronchoscopy did not localize the site of bleeding. Bronchial artery embolization was successfully performed in 10 patients. However, the bleeding recurred within the first week after embolization in 2 patients, and 1 of them died. PMID- 2764619 TI - Hematological complications with the St. Jude valve and reduced-dose Coumadin. AB - We examined hematological complications in 415 patients having valve replacement with the St. Jude mechanical prosthesis (212, aortic valve replacement [AVR]; 159, mitral valve replacement [MVR]; and 44, AVR + MVR). There were 164 men and 251 women with a mean age of 59 years (range, 20 to 88 years). Preoperatively 386 patients were in New York Heart Association functional classes III and IV. There were 154 associated procedures (37%), the most common being myocardial revascularization. Overall hospital mortality was 7.5% (31/415), 7% after AVR, 8% after MVR, and 7% after AVR + MVR. All operative survivors were anticoagulated with Coumadin (crystalline warfarin sodium) to maintain the prothrombin time at 1.5 times control. During a mean follow-up of 21 months (range, 6 to 60 months), there were 29 late deaths (7.6%) and 5 patients (1.3%) lost to follow-up. No patient experienced structural valve degeneration. At 48 months, actuarial freedom from thromboembolism was 87% +/- 3% after AVR and 91% +/- 9% after MVR; from anticoagulation-related hemorrhage, 97% +/- 3% after AVR and 91% +/- 3% after MVR; and from hemolysis, 100% after AVR and 98% +/- 2% after MVR. Freedom from all valve-related morbidity at 4 years was 82% +/- 5% after AVR and 75% +/- 10% after MVR. Actuarial survival at 48 months was 80% +/- 4% after AVR and 65% +/- 7% after MVR. PMID- 2764620 TI - Chest wall implantation of lung cancer after thin-needle aspiration biopsy. AB - Percutaneous aspirational biopsy of intrathoracic lesions has become a popular technique. One of the rarest complications is that of implantation of malignant cells within the needle tract and subsequent development of a chest wall mass. A case of chest wall implantation of adenocarcinoma of the lung after thin-needle biopsy is reported. The lesion was successfully treated with radical full thickness excision of the chest wall and immediate reconstruction with a large rectus abdominis musculocutaneous flap. PMID- 2764621 TI - Long-term survival after triple-valve replacement. AB - A 29-year-old man with rheumatic stenosis and insufficiency of the aortic, mitral, and tricuspid valves underwent urgent triple-valve replacement on January 12, 1966, because of uncontrollable congestive heart failure. Twenty-two years and 8 months later (September 13, 1988) reoperation was necessary to replace the Kay-Shiley tricuspid prosthesis because of progressive stenosis of the valve due to pannus formation. The aortic and mitral prostheses continue to function normally. The patient has again returned to full activity. PMID- 2764622 TI - Laryngotracheoesophageal cleft: endoscopic diagnosis and surgical repair. AB - The laryngotracheoesophageal cleft results from congenital nonfusion of the upper tracheoesophageal septum and cricoid primordium. The diagnosis remains an endoscopic one and often is difficult to make in the neonate. This article describes a method for determining the diagnosis, as well as details of a successful surgical repair. PMID- 2764623 TI - Surgical implications of atrial septal defect complicating aortic balloon valvuloplasty. AB - An 80-year-old man underwent percutaneous transluminal balloon valvuloplasty for critical aortic stenosis. The procedure was performed by the antegrade atrial transseptal approach and was complicated by a persistent atrial septal defect. Symptoms recurred 6 months later, restenosis of the aortic valve was confirmed, and the atrial septal defect yielded a substantially greater left-to-right shunt. This complication of percutaneous transluminal balloon valvuloplasty poses important problems in hemodynamic assessment and operative management of patients who undergo subsequent aortic valve replacement. PMID- 2764624 TI - Successful diagnosis and surgical treatment of single ventricle, truncus arteriosus. AB - The association of single ventricle and truncus arteriosus is rare. We present the successful surgical palliation of a patient who echocardiographically and angiographically has a truncus arteriosus type I and single left ventricle. At operation, the main pulmonary artery was dissected off the truncus arteriosus, and a 4-mm polytetrafluoroethylene graft was placed from the ascending aorta to the left pulmonary artery. The patient is currently 13 months old and growing well. PMID- 2764625 TI - A technique of airway management in children with obstructed airway due to tumor. AB - Airway management of patients with tracheobronchial compression due to mediastinal masses poses a difficult problem. A new technique of direct vision endotracheal intubation is described, and other adjunctive measures are reviewed. PMID- 2764626 TI - An anterior longitudinal aortotomy with a distal aortic transection for the arterial switch operation. AB - An additional longitudinal aortotomy on the anterior aspect of the old ascending aorta after distal aortic transection is very effective for removal of the coronary buttons, prevention of deformation of the neopulmonary arterial ring, and reconstruction of the neopulmonary arterial trunk after the Lecompte maneuver, especially for the neonatal arterial switch operation. PMID- 2764627 TI - Reoperative median sternotomy. AB - Sternal reentry for reoperative cardiac procedures poses a substantial risk of technical problems. A simple technique for sternal reentry is described that is both expeditious and safe. PMID- 2764629 TI - [Problems and solutions created by a crisis]. PMID- 2764628 TI - Management of difficult sternal closure after sternal infection. PMID- 2764630 TI - [Repeated failure of the suture line of an aortic valve prosthesis. Treatment by implantation of a valvular tube in the supra-coronary position]. AB - We present our 7 years' experience in the treatment of repeated stitch failure of the suture line on aortic valve replacements. We used a valved tube placed in the supra-coronary position. This technique prevented further stitch failure and also prevented postop infections. Of eight patients operated on, five had survived. PMID- 2764631 TI - [Usefulness of 2-dimensional echocardiography in detecting intraventricular thrombi in patients with acute myocardial infarction]. AB - The purpose of this study is to determine the importance of two-dimensional echocardiography performed soon after admission to the coronary care unit to provide useful information concerning wall-motion abnormalities, and to detect and characterize left ventricular thrombi. A major goal is to identify a subgroup of patients with acute myocardial infarction who are at risk for systemic embolization; in this subgroup the benefits of anticoagulation treatment would theoretically outweigh the associated risks. We studied 7 consecutive male patients, age range from 32 to 60 years, with acute myocardial infarction. Five patients had antero-septal infarction, 1 anterolateral and another had anterior wall infarction. We performed two-dimensional echocardiography within the first week after admission. All patients had severe apical-wall-motion abnormalities (akinesis or dyskinesis) and left ventricular thrombi. All patients received anticoagulation therapy. Two-dimensional echocardiography, performed one month after the first study, showed that the thrombi had decreased in size in 6 patients and could not be visualized in 1 patient. The noninvasive nature of echocardiography allows serial evaluations of patients with known left ventricular thrombi and permits assessment of the effect of therapy. PMID- 2764632 TI - [Left aortic arch without a circumflex segment and a right descending aorta: a hypothetical case and a real example]. AB - We studied a case of a patent left ductus arteriosus, with a left aortic arch connected to a right descending aorta without an aortic circumflex (retroesophageal) segment. We believe this is the first world-published example of this--so far--hypothetical anomaly, included in Kirkling and Edwards classification of vascular rings. The case was a 27-year-old deaf-mute female patient with a patent left ductus arteriosus, with important left to right shunt and moderate pulmonary arterial hypertension who underwent a successful closing surgical procedure. In the aortographic study a left (normal) aortic arch was seen, which after giving off a large left ductus arteriosus, crossed to the right and connected to a right descending aorta. In the upper part of the thorax the esophagus and trachea were displaced to the right by the left aortic arch. The esophagus in the middle and the upper inferior parts of the thorax was also displaced to the right by the descending right aortic segment. Complete vascular ring was not evident. The case--although without clinical importance--reinforces the pathogenic concept of the Rathke diagram of a complete double aortic primitive arch originating the pulmonary and supraaortic vascular structures which are formed by the obliteration or disappearance of particular segments of the structure. This knowledge explains the embryogenesis of these complex anomalies. Our case is believed to be formed by the very early disappearance of a frontal portion of the primitive left dorsal aorta. PMID- 2764633 TI - [Pulmonary atresia with an intact interventricular septum and Ebstein's anomaly of the tricuspid valve]. AB - Patients with pulmonary atresia and intact ventricular septum have a poor prognosis with or without conventional surgical treatment. The best results of surgical treatment are obtained in those cases with a mild underdeveloped right ventricle and minor sinusoidal communication in the absence of important dysfunction of the tricuspid valve. We present five cases of pulmonary atresia with intact ventricular septum associated with dysfunction of the tricuspid valve. On the basis of radiographic, electrocardiographic and hemodynamic findings, this group of patients could not be distinguished from others without dysplasia of the tricuspid valve. Echocardiographic and angiocardiographic studies are mandatory in the differential diagnosis. A combination of systemic pulmonary artery anastomosis associated with pulmonary valvotomy, when possible, and reconstruction of the right ventricular outflow tract are indicated for surgical solution of these malformations. However, tricuspid valve replacement is indicated in some cases. PMID- 2764634 TI - [Tricuspid atresia with pulmonary atresia]. AB - The clinical presentation and long-term follow-up of 14 cases of tricuspid atresia associated with pulmonary atresia were reviewed. The electrocardiograms, hemodynamic findings and a definition of anatomic types were outlined in order to facilitate therapeutic decisions. In these types of tricuspid atresia the clinical presentation depends on the patent ductus. Despite the caliber of the ductus arteriosus, the poor tolerance to the malformation is frequent and the clinical presentation is similar to those malformations with decreased pulmonary blood flow (cyanosis since birth and hypoxic spells). In considering the age of these patients, the modified Blalock-Taussig anastomosis is the initial procedure. The Fontan procedure should be considered carefully as an alternative in older children. PMID- 2764635 TI - [Study of renal function by creatinine clearance]. AB - This paper was designed to investigate the correlation between the renal clearance and the plasma concentration of creatinine. Of the curve obtained, three segments were studied: 1 - When the glomerular filtration rate (GFR) was greater than 60 ml per min. the plasma concentration fluctuated between 0.44 and 1.59 mg/dl. 2 - When GFR was between 30 and 60 ml per min. the plasma concentration reached 2.4 mg/dl, and 3 - When GFR was less than 30 ml per min. the plasma level increased to values as high as 28 ml/min. The urinary concentration of creatinine can be divided into two broad groups depending on the GFR. The boundary of this division is around 60 ml per min. This suggests that when GFR is depressed there would exist a limitation of the tubular secretion of creatinine or urinary dilution problems. It is demonstrated that there is a poor correlation between creatinine clearance and its plasma concentration, and hence the repeated measurement of creatinine clearance becomes imperative in the follow up of patients. PMID- 2764636 TI - [Interobserver and intraobserver variation: a problem of validity in epidemiologic studies of arterial pressure]. AB - In carrying out blood pressure epidemiologic studies there may be different factors that can affect internal and external validity and thus eliminate the inferential process. As part of the Hypertension and Risk Factors Associated Study conducted in March 1987 in Cuajimalpa de Morelos, Mexico City, 23 nursing students were standardized on the blood pressure auscultatory method using a sound picture and measuring intraobserver and interobserver agreement through intraclass correlation coefficient. Even though initial standardization sessions showed difficulties in the use of instruments and in the reading of blood pressure levels, final K (kappa) values measuring interobserver agreement increased from 0.25 to 0.86. Omega values measuring intraobserver agreement fluctuated between 0.86 and 0.98. This epidemiologic technique is proposed in order to improve internal and external validity of blood pressure studies. PMID- 2764637 TI - Effects of idebenone on neurological deficits, local cerebral blood flow, and energy metabolism in rats with experimental cerebral ischemia. AB - Improvement of energy metabolism in ischemic cerebral tissue benefits the therapy of occlusive cerebrovascular disorders. In the present study, the effects of 6 (10-hydroxydecyl)-2,3-dimethoxy-5-methyl-1,4-benzoquinone (idebenone) on neurological signs, such as ischemic seizures, lactate and ATP contents of the cerebral cortex, and local cerebral blood flow, were assessed in stroke-prone spontaneously hypertensive rats (SHRSP) with experimentally induced cerebral ischemia. Experimental cerebral ischemia was caused by bilateral carotid artery occlusion (BCAO) in male SHRSP (8-10 weeks old). Pretreatment with idebenone (10 100 mg/kg, p.o.) for 3 or 10 days delayed the onset of ischemic seizure (acute stroke) and prolonged survival time in SHRSP roughly in a dose-dependent manner. When the compound (100 mg/kg, i.p.) was given once 30 min after BCAO, it exerted similar ameliorating effects on the neurological deficits. When idebenone (100 mg/kg for 3 days) was given orally, it did not significantly inhibit the decrease in regional cerebral blood flow induced by BCAO. However, the same treatment markedly inhibited increases in the lactate content and lactate/pyruvate ratio and the decrease in ATP content of the cerebral cortex. The compound did not affect cerebral blood flow in normal rats. These results suggest that idebenone ameliorates the neurological deficits related to cerebral ischemia, and that this effect is mediated by improving cerebral energy metabolism. PMID- 2764638 TI - Effects of idebenone on neurological deficits following cerebrovascular lesions in stroke-prone spontaneously hypertensive rats. AB - The effects of 6-(10-hydroxydecyl)-2,3-dimethoxy-5-methyl-1,4-benzoquinone (idebenone) on neurological deficits following cerebrovascular lesions were examined in stroke-prone spontaneously hypertensive rats (SHRSP). The SHRSP were maintained on a 1% NaCl solution as drinking water to shorten the onset time of cerebrovascular lesions (stroke). After the onset of stroke, the salt solution was exchanged for tap water, and idebenone (30 and 100 mg/kg) was administered orally once daily for 3 weeks. The neurological deficits were evaluated by a specially designed scoring system or by an open-field test. Idebenone decreased the severity of the neurological deficits in a dose-dependent manner and this was statistically significant in the high-dose group. The severity of neurological changes was inversely related to the motor activity in the open-field test performed when the experiment was terminated, indicating the appropriateness of the scoring system. Moreover, the compound (100 mg/kg) significantly ameliorated a decrease in food intake (anorexia) that followed the onset of stroke. These results suggest that idebenone may be useful to treat patients with cerebrovascular lesions. PMID- 2764639 TI - Effects of idebenone on memory impairment induced in ischemic and embolization models of cerebrovascular disturbance in rats. AB - Two rat models of memory impairment in passive avoidance learning induced by cerebrovascular disturbance, were established to estimate the effects of a cerebral metabolic enhancer, idebenone. Transient and global cerebral ischemia in rats, produced by 4-vessel occlusion for 200 s immediately after the acquisition trial of passive avoidance learning, shortened the latencies in the retention test trial performed 24 h later. This retrograde amnesia was reversed significantly by idebenone administered orally or intraperitoneally at the doses of 10 and 30 mg/kg before the retention test trial. Idebenone at a dose of 10 mg/kg, given intraperitoneally before or immediately after the ischemia, also markedly inhibited the appearance of amnesia. In the second model, permanent and cerebral hemisphere embolization produced by injecting 2,000 microspheres into the internal carotid artery, significantly impaired passive avoidance learning performed 7 days later. The repeated administration of idebenone (30 mg/kg, i.p.). once a day after the embolization, significantly improved the impairment of passive avoidance learning in the embolized rats. Furthermore, physostigmine and arginine-vasopressin as reference compounds improved the impairment of passive avoidance learning in these models. These findings suggest that idebenone ameliorates memory impairment induced by cerebral vascular disturbance in rats. PMID- 2764640 TI - Idebenone improves learning and memory impairment induced by cholinergic or serotonergic dysfunction in rats. AB - The effects of idebenone, a cerebral metabolic enhancer, on learning and memory impairment in two rat models with central cholinergic or serotonergic dysfunction were investigated using positively reinforced learning tasks. A delayed alternation task using a T maze was employed to test the effect of idebenone on short-term memory impairment induced by a cholinergic antagonist, scopolamine. A correct response, defined as a turn toward the arm opposite to that in the forced run, was rewarded with food pellets. Scopolamine (0.2 and 0.5 mg/kg, i.p.) significantly decreased the correct responses to the chance level in the 60-s delayed alternation task. The scopolamine (0.2 mg/kg, i.p.)-induced impairment of short-term memory was improved by idebenone (3-30 mg/kg, i.p.) or an acetylcholinesterase inhibitor, physostigmine (0.1 and 0.2 mg/kg, i.p.), administered simultaneously. The central serotonergic dysfunction model was produced by giving rats a diet deficient in tryptophan, a precursor of serotonin. The rats fed on a tryptophan-deficient diet (TDD) showed a slower learning process in the operant brightness discrimination task (mult V115 EXT) than did rats fed on a normal diet. Idebenone (60 mg/kg/day) admixed with the TDD decreased the number of lever-pressing responses emitted during the extinction periods. The percentage of correct responses was significantly higher in the idebenone-treated group than in the control TDD group. These results suggest that idebenone may improve both the impairment of short-term memory induced by a decreased cholinergic activity and the retardation of discrimination learning induced by central serotonergic dysfunction. PMID- 2764641 TI - Protective effect of idebenone against hypoxia in mice. AB - The effects of idebenone on survival time of mice subjected to hypoxia induced by N2 and CO2 inhalation and KCN injection were studied. Idebenone (10, 20, 50 and 100 mg/kg, i.p.) prolonged the survival time of mice exposed to a hypoxic condition (98% N2, 2% O2) in a dose-dependent manner: significant prolongations were observed at doses higher than 20 mg/kg. The drug also exerted a similar elongation effect at the same doses under conditions of 100% CO2 gas inhalation and KCN injection (3 mg/kg, i.v.). The results suggest that idebenone protects against hypoxia by improving cerebral energy metabolism. PMID- 2764642 TI - Effects of idebenone on the levels of acetylcholine, choline, free fatty acids, and energy metabolites in the brains of rats with cerebral ischemia. AB - Cerebral ischemia was induced by a 200-s occlusion of both common carotid arteries in rats in which both vertebral arteries had been permanently cauterized. In the ischemic rats, a significant decrease in acetylcholine (ACh) and a marked increase in choline were observed in the cerebral cortex, hippocampus, striatum, and diencephalon. A slight increase in choline was also observed in the cerebellum and brain stem. Pretreatment with idebenone (10 mg/kg, i.p.) inhibited the decrease in ACh and the increase in choline in the forebrain regions. In addition, the same dose of idebenone inhibited the increments of lactate and free fatty acid contents and tended to inhibit the decrement of the ATP content in the cerebral cortex of the cerebral ischemic rats. These results indicate that idebenone inhibits the alteration of the ACh level and the disruption of membrane phospholipids in the brain of ischemic rats; these effects may be mediated by improved cerebral energy metabolism. PMID- 2764643 TI - Brain distribution of idebenone and its effect on local cerebral glucose utilization in rats. AB - To investigate the possible action sites of a cerebral metabolism activator, idebenone, (6-(10-hydroxydecyl)-2,3-dimethoxy-5-methyl-1,4-benzoquinone), its distribution in the brain and effect on local cerebral glucose utilization (LCGU) were studied in normal (WKY) and stroke-prone spontaneously hypertensive rats (SHRSP) with cerebrovascular lesions. 14C-Idebenone distributed rapidly into the brain after intravenous administration (10 mg/kg), and the total 14C contents in the brain at peak time corresponded to 0.45-0.56% of the dosages. An autoradiographic study showed that the 14C levels were higher in the white than in the gray matter. When 14C-idebenone was administered orally (100 mg/kg) and intraperitoneally (30 mg/kg), the total 14C levels were not markedly different among the brain regions of the rats. The concentration of unchanged idebenone was higher in the cerebral cortex, thalamus, and cerebellum than that in the other brain regions. Studies on LCGU demonstrated that idebenone (30 mg/kg/day, i.p., for 3 days) improved the reduction of LCGU in SHRSP with stroke, especially in the temporal cortex, thalamus dorsomedial nucleus, subthalamic nucleus, mamillary body, hippocampus dentate gyrus, caudate-putamen, inferior colliculus, and cerebellar nucleus. Based on these results, possible action sites of idebenone for its main pharmacologic effects are discussed. PMID- 2764644 TI - Inhibition of lipid peroxidation by idebenone in brain mitochondria in the presence of succinate. AB - Lipid peroxidation in brain mitochondria was induced by NADH in the presence of ADP and FeCl3. A novel quinone compound, idebenone, inhibited this peroxidation and the inhibition was markedly enhanced by succinate, a substrate of mitochondrial respiration. The concentration of succinate required to exert the maximal effect was 1.5 mM. The concentration of idebenone giving 50% inhibition (IC50) was 0.5 and 84 microM in the presence and absence of succinate, respectively, indicating that succinate enhances the inhibition by 170-fold. Moreover, the inhibitory effect of idebenone in the presence of succinate was abolished by adding thenoyltrifluoroacetate (TTFA), an inhibitor of complex II in the mitochondrial respiratory chain. These results indicate that idebenone is changed through complex II to its reduced form, which protects mitochondria against lipid peroxidation. PMID- 2764645 TI - Effects of idebenone on lipid peroxidation and hemolysis in erythrocytes of stroke-prone spontaneously hypertensive rats. AB - Stroke-prone spontaneously hypertensive rats (SHRSP) were kept on a 1% NaCl solution as drinking water to shorten the onset-time of a stroke. The level of lipoperoxide (LPO) in the erythrocytes of SHRSP loaded with salt for 22 days was significantly higher than that of the controls. Idebenone treatment (30 mg/kg per day, p.o.) markedly decreased the LPO to the level of the controls. Hemolysis in SHRSP was accelerated by the salt-loading. Idebenone significantly inhibited the hemolysis in a dose-dependent manner. These results suggest that idebenone inhibits lipid peroxidation in erythrocytes and stabilizes the erythrocyte membrane. PMID- 2764646 TI - Effects of idebenone and related compounds on respiratory activities of brain mitochondria, and on lipid peroxidation of their membranes. AB - The oxidation of succinate and NADH in a ubiquinone-depleted canine brain mitochondrial preparation was restored by a low molecular weight benzoquinone, idebenone. Idebenone inhibited NADH(NADPH)/ADP-Fe3+-dependent lipid peroxidation in canine brain mitochondria and protected against the resulting inactivation of NADH-cytochrome c reductase activity. Idebenone did not affect the activities of succinate oxidase in canine and rat brain mitochondria but suppressed the oxygen consumption in NADH oxidation. This suppression might be related to the inhibition of lipid peroxidation. These results suggest that idebenone functions as an electron carrier in the respiratory chains of brain mitochondria and as an antioxidant against membrane damage caused by lipid peroxidation in brain mitochondria. PMID- 2764648 TI - What do internists think? PMID- 2764647 TI - Effects of idebenone on electroencephalograms of patients with cerebrovascular disorders. AB - A daily dose of 90 mg of idebenone was given to nine patients with cerebrovascular disorders to investigate its effects on clinical symptoms and electroencephalograms (EEG). Changes in EEG before and after the administration were compared quantitatively by computer analysis using the wave-form recognition method. Significant increase in frequency in the alpha band (O1) and trends of increased appearance of beta waves, decreased appearance of alpha 1 bands, and lowered amplitude in the alpha 1 and alpha 2 bands were observed after administration of idebenone. The theta waves of 30 microV and over had a significantly diminished maximum amplitude (C3) and a tendency to appear less often. Mean frequency of the EEG and appearance of fast waves apparently increased in the patients showing improvement of the clinical symptoms as compared with those not showing improvement. The results suggested that idebenone improved the EEG in the patients with cerebrovascular disorders, causing changes in EEG similar to those observed with psychostimulants. PMID- 2764649 TI - Neoplastic fever. A proposal for diagnosis. PMID- 2764650 TI - Improvement in family physician recognition and treatment of hypercholesterolemia. AB - Physician management of hypercholesterolemia has been poor in the past. This study investigates the effect of education and laboratory report changes on cholesterol management. Three chart audits were performed on 146 patients with cholesterol levels above 6.21 mmol/L. The first audit occurred before and the second audit shortly after the National Cholesterol Education Program (NCEP) issued their new recommendations. The recognition rate of hypercholesterolemia improved significantly after the NCEP guidelines were released. A similar significant improvement was noted in the number of patients asked to have a repeated cholesterol determination, and the number treated with diet. The third audit, after the laboratory changed its normal cholesterol range, showed a smaller improvement that was statistically insignificant. These results suggest that the NCEP guidelines are affecting physician practice. PMID- 2764651 TI - Mild nephrotoxicity associated with vancomycin use. AB - Nephrotoxicity related to vancomycin hydrochloride therapy has been reported at overall rates of 7% to 16% and as high as 35% when combined with an aminoglycoside antibiotic. We conducted a prospective study in older men. A group that received vancomycin was compared with a control group to determine the incidence of nephrotoxicity secondary to vancomycin therapy alone and in combination with aminoglycosides, to identify possible risk factors associated with nephrotoxicity, and to determine the incidence of other adverse effects associated with vancomycin use. Nephrotoxicity occurred in 11 (17%) of 66 patients receiving vancomycin and in 3 (5%) of 57 controls overall. Stepwise logistic-regression analysis failed to identify underlying illnesses or concurrent risks that may have contributed to the development of nephrotoxicity associated with vancomycin. Adverse effects, including phlebitis (14%), neutropenia (1%), rash (0%), and red neck syndrome (0%), occurred at rates similar to previous reports. PMID- 2764652 TI - Focal segmental glomerulosclerosis. A common entity in nephrotic black adults. AB - We studied 100 renal biopsy specimens from adults with the primary nephrotic syndrome in an inner city hospital serving mostly black patients and found that 47 had focal segmental glomerulosclerosis. Most of the men presented in the third decade of life, a peak distribution not seen in women. Half of the patients were hypertensive at presentation. Two thirds of the patients had not used intravenous drugs. The addicts were younger than nonaddicts (mean +/- SD age, 27 +/- 4 years vs 35 +/- 13 years), had greater proteinuria (10 +/- 5 g/d vs 6.3 +/- 5 g/d), and exhibited more glomerulosclerosis and tubulointerstitial fibrosis on biopsy. Of the 18 patients (8 addicts) remaining under our care, 4 addicts and 4 nonaddicts became uremic within 3 years. We conclude that even in the absence of drug addiction, focal segmental glomerulosclerosis is a common cause of primary glomerular disease in black adults, in whom it may represent a nonspecific glomerular reaction to injury. The prognosis in the nonaddict may not be different from that in the addict, but more patients need to be studied. PMID- 2764653 TI - An autopsy-based study of diagnostic errors in geriatric and nongeriatric adult patients. AB - One hundred sixty-two consecutive adult autopsies (87 of subjects over age 65 years and 75 of subjects aged 23 to 64 years) performed at a university hospital were studied retrospectively by six internists to determine (1) if diagnostic errors were quantitatively or qualitatively different between the two age groups; (2) if the underlying causes of error (divided into nine categories) were different or age related in any way between the two groups; and (3) any aspects of care that related age to clinical outcome. We found the frequency of major clinical/autopsy discrepancies to be similar to those in previous studies (35%), but in only 7% of cases were these likely to have affected therapy/outcome. Ther was no difference in the frequency of major discrepancies between age groups. There were significantly more "unexpected" minor discrepancies in the older patients, probably related to the multiplicity and complexity of their problems, but these would have affected therapy/outcome in only 1 (3%) of 37 cases. The most common causes of 136 clinical "errors" in 151 autopsies were, in order of frequency: a diagnostic "blind spot," a conscious decision not to pursue a clinical finding (not a real "error"), failure to account for a symptom or sign, atypical presentations, and inadequate follow-up of abnormal laboratory findings. There were no differences between the geriatric and adult groups in terms of frequency or cause of the errors. We conclude that (1) there is no difference in the diagnostic accuracy regarding cause of death between geriatric and nongeriatric patients in the acute hospital environment, and (2) closer attention to basic knowledge and clinical skills and a special focus on judgment and reasoning skills, utilizing autopsy findings among other things, will lead to even further improvement in clinical care at all ages. PMID- 2764654 TI - Effect of patient gender on evaluation of intern performance. AB - To explore the effect of patient gender on the perceptions of intern performance, 366 patients were interviewed during hospitalization in acute medical services. Women reported being more satisfied with the care they received than did men. In particular, women were more satisfied than men with their intern's demonstration of personal concern. The women placed more importance on personal manner and concern, and their greater satisfaction with these behaviors may have contributed to higher ratings of overall satisfaction. In contrast, the men seemed less satisfied with their intern's personal concern; they also tended to weigh such concern less in determining overall satisfaction. Men considered the presentation of information by the physician and the establishment of dialogue with the physician as more important. The amount of such dialogue may have been inadequate to generate higher levels of overall satisfaction for the men patients. PMID- 2764655 TI - Evaluation of an intervention aimed at reducing inappropriate use of preoperative blood coagulation tests. AB - A multiphase intervention trial based on education, implementation of criteria, and restriction, aimed at modifying the established clinical policy of mandatory preoperative screening for coagulation abnormalities, was carried out on five surgical wards of a general hospital. The education period did not influence the ordering of partial thromboplastin time tests, despite a significant posteducational change in surgeons' attitudes. In contrast, administrative restriction of coagulation test orders led to a 50% decline on four of the five study wards. We conclude that an educational intervention followed by administrative restriction may be considered an acceptable means of overcoming clinician reluctance to change well-established but redundant clinical policy. PMID- 2764656 TI - Evaluation of the do not resuscitate orders at a community hospital. AB - Demographic, medical, and outcome characteristics for 821 do not resuscitate (DNR) patients were compared with 300 age- and sex-matched control patients, and with 230 patients for whom cardiopulmonary resuscitation had been performed. Do not resuscitate patients were more likely to be female and older than cardiopulmonary resuscitation patients and to have a child as next of kin. Although DNR patients in intensive care units had comparable illness levels before and at the time of the order, treatment levels were reduced when the order was written. In general, DNR patients received more nursing care than other patients. Hospital mortality was 59.8% for DNR, 83.9% for CPR, and 1.7% for control patients. We identified diagnosis, prior activity, hospital unit, and employment status as predictors of DNR. According to documentation, 20% of patients participated in the DNR decision. Introduction of a DNR progress note form significantly improved documentation of the DNR process, but further efforts to improve DNR practice and patient participation are recommended. PMID- 2764658 TI - HIV-2-associated AIDS in the United States. The first case. AB - A 41-year-old woman from the Cape Verde Islands, Africa, who had been residing in the United States for 11 months was found to have human immunodeficiency virus type 2 (HIV-2)-associated acquired immunodeficiency syndrome (AIDS). Antibody to HIV-2 was found by enzyme immunoassay and was verified by radioimmunoprecipitation. The patient was being treated for pulmonary tuberculosis at the time of her admission to our institution. Further laboratory and clinical evaluation at our facility revealed depressed CD4 lymphocytes, oral candidiasis, and cryptococcal meningitis with indeterminate results on serologic testing for HIV type 1 (HIV-1). The biopsy specimen of a lesion in the right occipital lobe of the brain documented Toxoplasma gondii, indicating a clinical diagnosis of AIDS. To our knowledge, our study presents the first known patient with HIV-2-associated AIDS in the United States. Our patient provides further evidence that HIV-2 causes severe immunodeficiency and opportunistic infection. The condition should be suspected in the face of normal or repeatedly equivocal HIV-1 antibody test results in the presence of clinically documented AIDS. PMID- 2764659 TI - Leptospirosis. Epidemiological features of a sporadic case. AB - Leptospirosis occurred in a 45-year-old man with presumed infection from an exposure to contaminated water at his source of employment. An intensive epidemiological investigation, including serological examination of all family members and pets and cultures on the patient and his family pets (cats and dogs), proved that the leptospiral organism was acquired by the patient's exposure to his dogs. The risk of acquiring infection from dogs that are asymptomatic and vaccinated is emphasized by this report. PMID- 2764657 TI - Promoting cancer screening. A randomized, controlled trial of three interventions. AB - To determine effective methods of promoting routine cancer screening, we randomly assigned 62 internal medicine residents to receive cancer screening reminders (computer-generated lists of overdue tests at patients' visits), audit with feedback (monthly seminars about screening, with feedback about their performance rates), or no intervention (controls). Half of the residents in each group also were randomized to receive patient education (patients received literature and notices of overdue tests). We reviewed a sample of each physician's medical records to assess performance of seven tests during 9-month periods before and after initiating the interventions. Cancer screening reminders increased performance of six of seven tests; audit with feedback, four of seven tests; and patient education, one of two targeted breast cancer screening tests. The results indicate that the cancer screening reminders strategy was the most effective in promoting the performance of routine cancer screening tests. PMID- 2764660 TI - Therapeutic radiation and hyperparathyroidism. A case-control study in Rochester, Minn. AB - A case-control study was conducted among residents of Rochester, Minn, to assess the influence of prior therapeutic radiation on the risk of primary hyperparathyroidism. Fifty-one cases of surgically proven primary hyperparathyroidism diagnosed from 1975 through 1983 were each matched by age and gender to two control subjects, with radiation exposure documented through preexisting medical records. The overall odds ratio for any prior therapeutic radiation therapy was 1.9 (95% confidence interval, 0.9 to 4.4) and it was 2.3 (95% confidence interval, 0.9 to 5.7) when limited to those with prior head and neck radiation. Among women, the figures were 2.9 (95% confidence interval, 1.1 to 7.5) for any prior therapeutic radiation and 3.4 (95% confidence interval, 1.2 to 10.2) for head and neck exposure. This study confirms the association between primary hyperparathyroidism and prior therapeutic radiation exposure, at least for women in this population. PMID- 2764661 TI - Complete heart block as the sole presentation of Lyme disease. AB - We report a case of Lyme myocarditis presenting solely as complete heart block in a previously healthy 32-year-old white man. Indium cardiac antimyosin scan showed diffuse uptake (2+, on a scale of 0 to 4+) during the acute phase of the illness. The electrocardiogram and the indium cardiac antimyosin scan were normal 6 weeks after completion of tetracycline and prednisone treatment. Lyme carditis should be considered in the differential diagnosis of complete heart block of unclear origins, even in patients presenting without other signs or symptoms suggestive of Lyme disease. PMID- 2764662 TI - Thiazide therapy is not a cause of arrhythmia. PMID- 2764663 TI - Gastritis and Campylobacter pylori. PMID- 2764664 TI - Hyperglycemia as a cause of chorea. PMID- 2764665 TI - Severe soft-tissue injury following intravenous infusion of phenytoin. PMID- 2764666 TI - [Changes in the intellectual function in workers exposed to mixtures of organic solvents]. AB - A study was made assessing the intellectual functioning of a group of workers exposed to various solvents (N = 51) in comparison to a non exposed group (N = 49). It was administered the complete WAIS test. The overall intellectual functioning in the exposed group was below that in the non exposed group, as observed in the I.Q. The intellectual Deterioration Index was above the normal limit in the exposed group but not so in the control group. The Intellectual functioning was diminished regarding the previous level in the exposed group and the parameters with more differences between the two groups were: attention, immediate memory, visuomotor coordination and visual constructive ability, with inferior performance in the exposed group. The WAIS test showed to be a useful method for the detection of intellectual disturbances in subjects exposed to solvents at work. PMID- 2764667 TI - [Ultrastructure of human endometrium in vitro in various phases of the menstrual cycle]. AB - Samples of normal human endometrial tissue from eight young women were initiated in tissue culture. Four biopsies were obtained during the first phase of the cycle and four during the secretory phase. The aim of the work was to characterize ultrastructurally the possible changes of the glandular tissue without being dissociated from the stromal component. At eight hours of incubation there was preservation of all cellular components in the tissue from the first phase of the cycle whereas there were minor degenerative changes in the endometrium from the secretory phase but with outstanding preservation of intranuclear canaliculi typical of this phase. After 16 hours minimal changes were seen in proliferative endometrium while severe changes were present in secretory endometrium. The study suggests that whole endometrium in culture can be used to characterize the short time effect of drugs and substances administered during the first phase of the menstrual cycle. PMID- 2764668 TI - Prognostic factors in myelodysplasic syndromes: a multivariante analysis in 138 patients. AB - A multivariate analysis of clinical, biochemical and hematologic data was performed in 138 patients with myelodysplastic syndromes (MDS) in order to evaluate their prognostic significance. The most important individual variables, isolated in a previous univariate analysis, were placed in a multiple regression modeling procedure to identify major prognostic factors. Multivariate analysis tends to identify prognostic variables containing significant predictive information. Characteristics were examined on both continuous and binary bases. The FAB classification was the first parameter entered in regression equations of both models, followed by platelet count, systemic symptoms, bone marrow blast and infection. Our analysis confirms FAB classification as the best prognostic factor in MDS. It supports the previously predictive value of platelet count, hemoglobin level and bone marrow blast and recognizes the importance of systemic symptoms and infection as prognostic characteristics in MDS. PMID- 2764669 TI - [Inflammatory reaction in neurocysticercosis in experimental studies in rabbits]. AB - In order to know if dexamethasone is a satisfactory protector to the inflammatory effect of cysticercosis in the central nervous system and if the rabbit is an useful animal for this experimentation twenty five rabbits were infected in the cisterna magna some with an emulsions of scolex and others with the fluid of the vesicle. The animals were sacrificed after two weeks and the brains were studied by the pathologist. The results indicate that dexamethasone is useful as a protector of the rabbit brain in cases of cysticercosis and that this animal is an adequate tool for this sort of experimental work. PMID- 2764670 TI - Epidemiology of acute diarrhoea in a rural medical care system in Mexico (IMSS COPLAMAR). AB - This paper shows the results of a study of acute diarrhoea (AD) in 137 rural communities in Mexico. We studied 51 communities with 1000 inhabitants or less, 45 communities with 1001 to 5000 inhabitants and, 41 with 5001 to 15000 inhabitants. All in all we observed 4,796.9 persons year during a period comprised from March 1982 to February 1983. In communities with more than 5000 inhabitants there occurred 0.85 episodes of AD per person-year, whereas in the smaller ones the incidence was only 0.58 episodes per person-year p less than 0.01). In small communities the frequency was higher in families with poor water supply and inadequate excreta disposal, whereas in large communities the frequency was not affected by such services. In 95.6 percent of the cases the episodes were self-limited within the first 14 days. There were seven deaths, five occurring in children under one year of age, six in children living in small communities and, five associated with dehydration. These results suggest that the size of the community constitutes a risk factor for AD in rural areas, which deserves to be explored in further studies. The lethality observed in small communities stresses the need of programs for better treatment of this frequent disease. PMID- 2764671 TI - [Functional abnormalities of complement in familial and sporadic ankylosing spondylitis]. AB - Levels of complement fractions of 12 patients with sporadic ankylosing Spondylitis and 6 patients with familial Ankylosing Spondylitis (N. Y. Criteria) were studied by an hemolytic and functional method (microhemolysis in plate. Cordis Lab. Miami, Fla. USA). Abnormal levels were found in 94% of them high levels of C1 and C2 (p 0.002), and C3 (p 0.05) C8 and C9 (p 0.001) deficiencies, mixed or isolated, correlated with the severity of the diseases. C9 deficiency belongs to familial Ankylosing Spondylitis. These functional deficiencies of serum complement can favor the colonization and persistence of germs, which could mediate in the genesis of Ankylosing Spondylitis. PMID- 2764672 TI - Experimental evaluation of mimosa tenuiflora (willd.) poir. (Tepescohuite) I. Screening of the antimicrobial properties of bark extracts. AB - Mimosa tenuiflora (Willd.) Poir, is a tree from the south areas of Mexico. This bark is popularly used as remedy to treat different skin lesions. The present study demonstrates the in vitro antimicrobial properties of the water and ethanolic extracts prepared with the dried and powdered bark of this plant. A clear inhibition growth effect was observed in all the gram positive and gram negative organisms, yeasts and dermatophytes used. PMID- 2764673 TI - [Zoo accidents. On the nature of such accidents and possible responsibility of the victim and others and recommendations for preventing such incidents]. PMID- 2764674 TI - [Unusual suicide caused by a stab wound in the neck]. AB - A case is reported of a man with a deep nape stabwound completely severing the medulla of the spine. A strangely formed bottle neck fragment is the assumed weapon. Further investigations allow a scene reconstruktion, police inquiries throw light on a previous acute psychotic disorder of the suicide. PMID- 2764675 TI - [An unusual death in water]. AB - A case of combined suicide involving the explosion of a handgranate in water demonstrates the possible misinterpretation of external injuries. PMID- 2764676 TI - [An unusual grazing gunshot]. AB - Report on a grazing shot with multiples wounds on both hands by a single bullet. PMID- 2764677 TI - [Gm/Km determination in sperm traces]. AB - In the forensic laboratories of the Federal Republic of Germany and West-Berlin 23 different semen stains and in our own laboratory 20 semen stains were typed in the gm/km-system doing 125 and 61 (own) test respectively. Examination was carried out by means of the haemagglutination method, which has been used successfully in typing bloodstains. Our critical assessment based on earlier experiences with semen stains was now confirmed and statistically evaluated: typing was successful in about 35-50% of the tests, but besides false-negative results, there was also a considerable percentage (4-10%) of false-positive ones. Therefore for the present it seems best to exclude the gm/km-typing of secretion stains from forensic investigations in order to avoid false incriminations or exonerations of suspects. PMID- 2764678 TI - Pep5, a new lantibiotic: structural gene isolation and prepeptide sequence. AB - A wobbled 14-mer oligonucleotide was derived from the amino acid sequence of the 34-residue propeptide of the lantibiotic Pep5 (Kellner et al. 1989). Using this hybridization probe, the structural gene of Pep5, pepA, was located on the 18.6 kbp plasmid pED503. The nucleotide sequence of pepA codes for a prepeptide with 60 residues and proves that Pep5 is ribosomally synthesized. The N-terminus of the prepeptide has a high alpha-helix probability and a characteristic proteolytic cleavage site precedes the C-terminal 34-residue propeptide. Our present theory is that maturation of Pep5 involves (a) enzymic conversion of Thr, Ser and Cys into dehydrated amino acids and sulfide bridges, (b) membrane translocation and cleavage of the modified prepeptide. PMID- 2764679 TI - [Autopsy in neonatal death]. AB - Among 125 neonatal deaths which occurred between 1985 and 1987 in a neonatal intensive care unit, 90 autopsies (72%) were performed. Autopsies in 58 cases (64%) confirmed antemortem conclusions. In 26 cases (28%) post-mortem examination rectified antemortem findings whereas in 6 cases (6.6%) it did not contribute to a better understanding of the cause of death. When there was a risk of an heritable disease and genetic counselling was necessary (31 cases), the autopsy permitted to provide the diagnosis in 4 cases and to reassure the family in 17. In 23 cases the post-mortem examination had to be completed by perimortem studies to be contributive. As no antemortem data allowed to predict the value of the autopsy, a postmortem study should by systematically requested in cases of death during the neonatal period. PMID- 2764680 TI - [Urinary calculi in children. Etiologic survey]. AB - Thirty-three children with urinary calculi were studied. In 12, a metabolic cause of calculi was identified (4 hyperoxaluria, 6 hypercalciuria, 2 cystinuria). In 14 children, lithiasis was associated with a urinary tract infection. No identifiable cause could be found in 7 children. A protocol for metabolic evaluation is proposed. PMID- 2764681 TI - [Multicystic renal dysplasia. Spontaneous remission of a hypertrophic form]. AB - A case of spontaneous regression of the tumor type of multicystic dysplastic kidney (MDK) is reported. This case is consistent with recent data on the natural history of MDK. The classical therapeutic approach which involves surgery is discussed in the context of this case and of others with a similar course. PMID- 2764682 TI - [Nephritis caused by ventriculo-atrial shunt: possible cure without reoperation of the valve?]. AB - A case of ventriculo-atrial shunt nephritis in a 3 year-old child is reported. It was induced by an infection with Staphylococcus Albus. Complete cure of kidney disease was obtained with antibiotics (Oxacilline and Rifampicine) alone without resorting to surgical removal of the valve. Attention is drawn to the fact that a long-term clinical and biological follow-up is necessary to make sure that this conservative attitude does not compromises renal function. PMID- 2764683 TI - [Tinea capitis presenting as staphylococcal pyodermatitis of the scalp]. AB - Two severe cases of pyoderma (staphylococcus aureus) of the scalp, resistant to appropriate antibiotic treatment, proved to be due to exotic dermatophytes (Trichophyton soudanense and Trichophyton violaceum) in two North African children living in France. Both cases exemplify the growing number of Tinea capitis due to anthropophilic species imported from Africa by immigrated populations, their sometimes atypical clinical presentation and their familial epidemiology. Fungal cultures and identification procedures are essential for the diagnosis and epidemiological investigation of such cases. PMID- 2764684 TI - [Diagnosis of spinal cord tumor in pediatric orthopedics]. AB - The clinical findings leading to the diagnosis of a spinal cord tumor in pediatric orthopedics are reported with a discussion of the neuro-urological aspects. PMID- 2764685 TI - [Radiologic case of the month. Tumor calcinosis]. PMID- 2764686 TI - [Posology of amikacin in newborn infants, adapted to the postconceptional age]. AB - Two consecutive studies of amikacin plasma levels were performed in 63 and 64 neonates whose postconceptional age (PCA) ranged from 26 to 45 weeks. The first study, using a dose of 7.5 mg/kg every 12 hours, permitted to establish a dosage related to PCA. Half-life elimination of amikacin was strongly correlated with PCA (r = -0.42, p = 0.0009). The apparent volume of distribution was correlated with none of the variables studied. The mean volume of distribution was 640 +/- 190 ml/kg. From these data, the inferred dosage was 10 mg/kg, given at intervals of time predetermined as a function of PCA. A second prospective study proved the value of this PCA adapted dosage. The maximal concentrations obtained were higher (21.6 +/- 5.9 vs 18.5 +/- 4.6 micrograms/ml, p less than 0.001), the nadir concentrations were not significantly increased (5.7 +/- 3.1 vs 5.2 +/- 3.7 micrograms/ml, NS) and the number of nadir concentrations outside the desired interval of 2-8 micrograms/ml was smaller (p less than 0.01). PMID- 2764687 TI - [Prevention in pediatrics in the Nord-Cotentin. Prospective study of 255 cases]. AB - Over a 4 month period, the medical records of 255 children with an age range of 6 months to 3 years and who had been admitted to the Cherbourg Hospital Department of Pediatrics were prospectively studied. Ninety-nine % had received BCG vaccination but only 71% had a positive skin test. Ninety-two % were vaccinated against diphtheria, tetanus, whooping cough and poliomyelitis and 61% against measles. Seventy-eight % of parents said that they had correctly administered vitamin D, at least up to 18 months of age. Seventy % of children were fed cow's milk during the second half of the first year and at least 35% had at least one hematological sign of iron deficiency. The promotion of routine immunizations as well as vaccination against rubella-mumps-measles seems to be desirable goals. There is a need for the widespread use of adapted milk formulas up to 1 year of age and for systematic iron supplementation of pregnant women and of infants presenting with evidence of iron deficiency or on cow's milk. PMID- 2764688 TI - [Failure of intravenous immunoglobulins in treating allo-immune neonatal thrombopenia]. PMID- 2764689 TI - Improving the validity of clinical exercise testing: the relationship between practice and performance. AB - Many studies involving exercise testing fail to address the issue of practice. Those that do vary considerably with respect to the parameters of practice used. We evaluated the effect of two standardized practices on a horizontal submaximal exercise test performed on a treadmill. Healthy men (n = 20) with no previous treadmill exposure were alternately assigned to the experimental (practice) or control (no practice) group. Heart rate (HR), systolic blood pressure (SBP), rate pressure product (RPP), step cadence (CAD) and perceived exertion (PE) were recorded at the end of each work load of the practices and/or tests. We observed no significant differences in these variables over the common work loads for the first practice session in the experimental group and the exercise test in the control group (p greater than 0.05). The two groups were homogeneous with respect to fitness and magnitude of arousal on initial exposure to the treadmill. During the submaximal test, HR, SBP, RPP, CAD, and PE were systematically lower for the experimental group than for the control group. The SBP and RPP were significantly lower in the experimental group (p less than 0.01). The CAD tended toward statistical significance (p less than 0.07), whereas HR and PE were not significantly different for the two groups (p greater than 0.05). When the four common work loads were compared over the two practices and the exercise test for the experimental group, SBP and CAD were significantly higher for practice 1 than for practice 2 and the test (p less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2764690 TI - Exercise training in individuals with diabetic retinopathy and blindness. AB - Limited guidelines exist for rehabilitation programs for individuals with diabetes mellitus, blindness, and associated autonomic neuropathy. Abnormalities in autonomic function have been postulated to interfere with exercise conditioning and may predispose individuals to exercise-induced hypoglycemia. Twenty-nine individuals with diabetes mellitus underwent standardized noninvasive testing for the evaluation of cardiovascular autonomic function and graded exercise before entering a rehabilitation program. Inadequate responses of heart rate to respiratory variation were observed in 28 patients, abnormal heart rate responses to postural maneuvers were seen in 23, and postural hypotension was noted in nine. Individuals with symptomatic postural hypotension were able to exercise using a stationary bicycle, but developed hypotensive episodes on walking or prolonged standing. Blood glucose consistently decreased by a mean of 76 (+/- 9) mg/dl after each exercise session, even though low levels of exercise were performed (2.9 +/- 0.2 metabolic equivalents, for 28 +/- 1 min). There was no relationship between the degree of autonomic neuropathy and the level of blood glucose fall. There was, however, a significant correlation (r = -0.59, p = 0.001) between the decrease in blood glucose level and the amount of regular insulin used in the routine morning dose. Precautions were taken to avoid hypoglycemia, and insulin and diet were adjusted accordingly to prevent severe hypoglycemic reactions. PMID- 2764691 TI - Treating chronic hemiparesis with modified biofeedback. AB - Eleven patients with chronic spastic hemiparesis were treated with biosignal processing (BSP), a modified biofeedback method in which the patient practices useful tasks, not isolated individual movements. A surface EMG measures sequential movements, and an acoustic signal monitors muscle exertion. The patient first learns how the signal develops by using the unaffected limb. Then the patient tries to reproduce the course of the signal in the paretic limb. Patients received 12 to 30 treatments for upper and/or lower extremities. We measured maximum strength as expressed through the EMG signal; ability to perform the trained action as measured by specific grading systems; and general increase in movement competence during a Bobath movement test. Ten patients showed improved strength; four made marked progress in the performance of specific tasks with the upper extremity, as did four with the lower extremity. Four patients in each group improved in general movement. We recommend the integration of useful tasks into movement exercises in EMG biofeedback therapy. PMID- 2764692 TI - Using phonation time to estimate vital capacity in amyotrophic lateral sclerosis. AB - Amyotrophic lateral sclerosis (ALS) is a neuromuscular disease in which progressive respiratory weakness is usually the proximate cause of death. Since continued assessment of respiratory function is important in predicting progression, phonation time was measured in a group of 41 ALS patients and correlated with measured vital capacity. The findings show that the variance in phonation time accounts for nearly 50% of the variability of vital capacity, and therefore, successive measurements of phonation time are a useful means of estimating the loss of vital capacity. PMID- 2764693 TI - Environmental control unit utilization by high-level spinal cord injured patients. AB - The study was designed to evaluate the use of an environmental control unit (ECU) by high-level spinal cord injured patients. The technology is relatively new, and to the best of the authors' knowledge, no comprehensive study has been made of the utility of the ECU. Data were obtained from 29 high-level spinal cord injured persons who had been using ECUs for at least one year. The subjects had a mean age of 24.2 years; 89.7% were men; and 51.7% of the injuries resulted from vehicular accidents. Most (93%) of the subjects perceived the ECU as increasing their independence. Operation of the telephone was indicated as the most important function (61%); control of television sets were second (21%) in rank. Of the subjects who worked or went to school, only two used their ECUs for those purposes. Subjects felt comfortable for longer periods without attendant care when the ECU was available. Some of the subjects felt that they had received inadequate training (30%) and that their attendants lacked understanding of the ECU (36%). Steps should be taken to increase the employment potential of ECU users by providing units with additional features and by increasing the training of both users and their attendants. Design of units that are more "user friendly" is also needed. PMID- 2764694 TI - Efficacy and generalization of treatment for aphasic naming errors. AB - Two severely aphasic patients who made frequent semantic errors in verbal picture naming, as well as frequent errors in written naming, were studied. Contrasting patterns of errors across various language tasks provide evidence that the two patients' naming errors arose from different underlying deficits. The effectiveness of cueing hierarchies on improving each patient's written naming was demonstrated in single-subject experiments using a multiple baseline design. Although both patients exhibited acquisition and maintenance of written naming, only one showed generalization to verbal naming and to untrained stimuli. Different results are interpreted as a reflection of separate sources of the subjects' naming errors. It is concluded that determining the cognitive basis of an individual's naming difficulty may permit predictions concerning language behaviors that are likely to improve concurrently as a function of treatment. Also, reporting specific deficits of patients should allow other clinicians to select appropriate candidates for therapy procedures found to be effective in within-subject treatment experiments. PMID- 2764695 TI - Quadriplegia from spinal cord injury in muscular dystrophy. AB - Recommendations for exercise programs in patients with muscular dystrophy are controversial. These programs are designed to keep a patient ambulatory or functional for as long as possible. There have been no reports of a patient with muscular dystrophy who incurred a spinal cord injury. This report details the course of recovery and rehabilitation of a man with facioscapulohumeral muscular dystrophy with quadriplegia from a traumatic spinal cord injury. The patient was admitted to a spinal cord injury unit. After prolonged bedrest, he participated in physical and occupational therapy that was designed to exercise him just short of fatigue. Except for one incident, when the patient reinjured his spinal cord, he did not lose function that he had already attained. The rehabilitation of this patient demonstrates that it is possible for a patient with facioscapulohumeral muscular dystrophy who sustains a traumatic quadriplegia to enter a rehabilitation program with expectations for a good outcome despite a double disability. PMID- 2764696 TI - Biofeedback device for patients on axillary crutches. AB - The axillary crutch is commonly prescribed as an ambulatory aid to patients with temporal or permanent disability in the lower extremity. When fitting the axillary crutch, it is important that the user be instructed not to bear excessive weight on the axillary bar. Excessive weight bearing on the axillary bar can result in a sevenfold increase in the reaction force under the armpit. This force may be a contributory factor to crutch paralysis or thrombosis of the axillobrachial artery. In order to prevent this occurrence an electronic biofeedback device was designed and developed for use in the training of 3-point swing-through axillary crutch ambulation. It detects excessive weight bearing on the axillary bar during crutch ambulation and produces an audible signal which prompts the patient to make necessary adjustment to relieve load bearing on the axillary bar. The design and development of the biofeedback device is discussed in this paper. PMID- 2764697 TI - Rehabilitation "treatment" (versus training) for "recovery". PMID- 2764698 TI - The convergence projection theory. PMID- 2764699 TI - [Influence of reduced water supply on the digestibility of nutrients and on some metabolic parameters in sheep]. AB - A digestibility experiment was carried out under conditions of reduced water supply (1/3 in comparison to the control group) and feed supply ad libitum or on maintenance level with 5 wethers of an average body weight of 43.2 kg. They were fed with alfalfa pellets with a Na supplement in the form of NaH2PO4. The water restriction increases the apparent digestibility of the nutrients (except crude fat), significantly so, however, only in the group fed ad libitum as a result of the lower digestibility in ad libitum feed intake. In the group with water restriction the absolute amount of digested nutrients is diminished, however, and in group Ib (feed supply on maintenance level) falls clearly below maintenance requirements. In a comparison of the values of apparent digestibility of the nutrients acquired by various methods (traditional method and indicator method - HCl insoluble remaining ash) the latter method is more susceptible to error. This method is, however, considerably easier in its execution. In comparison to ad libitum water supply the mean retention time of the feed increases due to restricted water supply. The decreased feed intake seems to have a bigger influence on the mean retention time of the marker than water restriction. PMID- 2764700 TI - [Urea utilization in growing lambs. 7. NPN- and pure protein-N-utilization at various ages]. AB - The utilization quota of NPN and pure feed protein for body protein synthesis was calculated on the basis of N balance experiments with 15N labelled urea with the help of model concepts of a 3-pool model and its mathematical usage. In lambs weighing 13 kg, the efficiency of amino acid and nucleic acid synthesis in the non-amino acid N pool was 64%. This results in a total utilization quota for NPN and pure protein in the ration of 40% and 60%, resp. Lambs weighing 27 kg showed an efficiency in amino acid and nucleic acid synthesis in the non-AA N pool of 77% and in the AA N pool of 60%. The total utilization quota of NPN was 47% and that of pure protein 56%. The pure protein in the ration was thus about twice as well utilized for total protein synthesis and for protein synthesis for crude protein retention as the NPN compounds in the ration. PMID- 2764701 TI - [Influence of energy concentration and source on the utilization of feed protein and NPN in lambs. 2. 15N balance and utilization of pure protein and NPN]. AB - In an experiment 12 lambs of the merino species were divided into 4 groups. The variants HE received 740 or 718 EFU cattle/kg DM and the variants NE 689 or 671 EFU cattle/kg DM. The different energy concentrations resulted from differentiated quotas of dried sugar beet chips and wheat starch supplements. Within the variants, sub-variants with (HESZ, NESZ) or without (HES, NES) sugar supplements were formed. Due to varied DM intake, the average energy intake in all groups was 42 EFU cattle/kg LW0.75. N balance experiments using 15N-labelled urea were carried out, and 15N accumulation of N excretion was projected to a steady state. The partial utilization of pure protein and NPN in the ration was ascertained with the help of a 3-pool compartment model of N utilization in ruminants. In the non-amino acid N pool HE utilized 84% of NPN and NE 77% for the synthesis of amino and nucleic acids. The efficiency of protein synthesis in the amino acid N-pool were in HESZ 64%, HES 70%, NESZ 70% and NES 73%, resp. The total utilization of NPN is the sum of the partial utilization in the two pools, whereas the total utilization of pure protein is calculated from the true digestibility and the efficiency of the utilization in the AA-N pool. The total utilization of NPN for the synthesis of protein for the protein pool amounted to 40/35/41/33% and that of pure protein to 54/51/49/50%. Energy intake being identical, energy concentration did not have an influence on the utilization of pure protein and NPN, whereas NPN utilization was better in rations containing sugar. The pure protein in the ration was by 19 ... 52% better utilized than NPN. PMID- 2764702 TI - The effect of selenium deficiency on the feed consumption and growth of goats. AB - The feed consumption of goats was only reduced after considerable Se depletion. The conversion of Se-depleted animals to an Se-rich ration increased feed consumption within one day. An intrauterine Se deficiency (less than 38 micrograms Se/kg DM of the ration) did not induce intrauterine growth depression in kids. Se depletion led to a highly significant postnatal growth depression which increased with advancing Se depletion both during the lactation period and after weaning. PMID- 2764703 TI - The effect of selenium deficiency on reproduction and milk performance of goats. AB - Even with a high vitamin E offer, Se deficiency (less than 38 micrograms/kg DM of the ration) led to a 33% lower conception rate (P less than 0.05) in goats and to a greater than 50% lower number of kids on the 91st day of life. The Se deficiency reduced the milk production significantly by 23% during the first 56 days of lactation, the milk fat production by 11% and the milk protein production by 12%. PMID- 2764704 TI - Influence of 13-cis and all-trans retinoic acid on rat embryonic development in vitro: correlation with isomerisation and drug transfer to the embryo. AB - In vitro experiments using whole rat embryo cultures show that all-trans retinoic acid (all-trans RA) administered at low concentrations (30 ng/ml culture medium) is 10 times more active than 13-cis retinoic acid (13-cis RA) and 3 times more active when administered at high concentrations (1000 ng/ml culture medium). Morphological investigation of the embryos shows that both substances directly influence embryonic development in an identical manner. Isomerisation products of the administered compounds (all-trans RA from 13-cis RA and vice versa) were detected by HPLC both in the culture medium and the embryo. Correlation of embryonic retinoid concentration with the observed effects led us to suggest that the isomerisation to all-trans RA is crucial in regard to 13-cis RA-induced abnormal embryonic development. A 100% effect can be induced in vitro with very low amounts of all-trans RA (7.2 ng/g) in the embryo. PMID- 2764705 TI - Absorption and tissue distribution of various polychlorinated dibenzo-p-dioxins and dibenzofurans (PCDDs and PCDFs) in the rat. AB - A defined mixture of polychlorinated dibenzo-p-dioxins and dibenzofurans (PCDDs and PCDFs) was parenterally administered to rats and absorption and tissue distribution were measured: 1) Toluene/DMSO (1 + 2; v/v) proved to be a convenient vehicle for the subcutaneous administration of the various PCDDs and PCDFs. Seven days after application the rate of absorption was 90% of the administered dose or even higher for almost all of the PCDDs/PCDFs in the mixture. In a few cases only (e.g. OCDD) the rate was found to be 84-89%; 2) Seven days after subcutaneous administration all 2378-substituted congeners were found in the liver, whereas only a few non-2378-substituted congeners could be measured in minor quantities. The 2378-substituted congeners also predominated in adipose tissue; however, most of the non-2378-substituted congeners were also detected; 3) The amount deposited within the liver as percentage of the administered dose differed for the various 2378-substituted PCDDs and PCDFs, ranging from less than 10% for OCDD or 2378-T4CDF, and between 60 and close to 100% for 12378-P5CDD or the H6CDDs. Therefore, the concentration ratio (liver/adipose tissue) was also found to be very different, ranging from less than 3 in the case of 2378-T4CDD or 2378-T4CDF to greater than 40 in the case of 1234678-H7CDD, 23478-P5CDF, 123678-H6CDF, or 1234678-H7CDF; 4) Studies performed at the time period of ongoing absorption (13-14 h after injection) provided the first evidence that some of the non-2378-substituted congeners do reach substantial concentrations in hepatic tissue shortly after administration; 5) Subsequent to intraperitoneal injection of the same PCDD/PCDF mixture the concentrations within the liver were found to be almost identical with that found after subcutaneous injection. In contrast, much higher concentrations of the congeners were found in (abdominal) adipose tissue; 6) In the liver of untreated rats of the same strain no T4CDDs/T4CDFs or P5CDDs/P5CDFs were detectable under our experimental conditions. PMID- 2764706 TI - Effects of commercial chlorophenolate, 2,3,7,8-TCDD, and pure phenoxyacetic acids on hepatic peroxisome proliferation, xenobiotic metabolism and sister chromatid exchange in the rat. AB - The induction of hepatic peroxisome proliferation and drug metabolizing enzymes and of sister chromatid exchange (SCE) in lymphocytes was studied in male Han/Wistar rats after exposing them for 2 weeks to a commercial chlorophenolate formulation (Ky-5) (100 mg/kg/day), to 2,3,7,8-tetrachlorodibenzo-p-dioxin (2,3,7,8-TCDD; 0.05-5 micrograms/kg/wk) and to the pure phenoxyacetic acids, 2,4 dichlorophenoxyacetic acid (2,4-D; 100 mg/kg/day) and 2-chloro-4 methylphenoxyacetic acid (MCPA; 100 mg/kg/day). The chlorophenolate formulation and pure 2,4-D and MCPA caused significant increases in the number of peroxisomes in liver cells, although the average size of peroxisomes was not affected, whereas the effect of even the highest dose of 2,3,7,8-TCDD remained small. This finding indicates that dioxin impurities do not account for the peroxisome proliferation induced by chlorophenolate. The relative weight of the liver increased significantly in rats treated with the chlorophenolate formulation and with 2,3,7,8-TCDD (5.0 and 0.5 micrograms/kg). The pattern of induction of xenobiotic metabolizing enzymes showed some differences between chlorophenolate treatment and 2,3,7,8-TCDD treatment. Furthermore, the effects of pure phenoxyacetic acids were different from that seen with chlorophenolate and 2,3,7,8-TCDD. The highest dose of 2,3,7,8-TCDD increased the frequency of SCE in circulating lymphocytes slightly, but significantly. PMID- 2764707 TI - An in vivo study of benzene metabolite DNA adduct formation in liver of male New Zealand rabbits. AB - Rabbits were treated with benzene (586 mg/kg/b.i.d./4 days) after which DNA was isolated from liver and analyzed for adduct formation using the [32P] post labeling method of Randerath and coworkers (Randerath et al. 1981; Reddy et al. 1984, 1986, 1987). Liver 500 g and 9000 g fractions were analyzed for adducts. There appeared to be several adducts in both the 500 g and 9000 g fractions observed on radioautographs of cellulose-TLC plates. Several adducts were also observed when the 9000 g fraction was studied using HPLC. PMID- 2764708 TI - In vitro covalent binding of the pyrethroids cismethrin, cypermethrin and deltamethrin to rat liver homogenate and microsomes. AB - Phenobarbital-induced rat liver homogenate and microsomes were used to study covalent binding of 14C-labelled (at the alcohol moiety) cismethrin, 14C-labelled (at the alcohol and acid moieties) cypermethrin, and 14C-labelled (at the alcohol and acid moieties) deltamethrin. Covalent binding was dependent on pyrethroid concentration. With liver homogenate, inhibition of esterases by tetraethylpyrophosphate and of mitochondrial respiration by rotenone or potassium cyanide only slightly altered the covalent binding level. With microsomes, inhibition of cytochrome P-450 and mixed function oxidases by carbon monoxide and piperonyl butoxide reduced the covalent binding so far as to be nearly absent. Eighty percent inhibition of epoxide hydrolase decreased the covalent binding by 50%. The comparison of data between alcohol and acid labelling of the same pyrethroid suggested that, in vitro, the whole molecule is bound to proteins and that hydrolysis can occur afterwards. The experiments stress the role of cytochrome P-450-dependent monoxygenases in the covalent binding process. PMID- 2764709 TI - Changes in the inducibility of a hepatic aldehyde dehydrogenase by various effectors. AB - A hepatic soluble aldehyde dehydrogenase (ALDH), inducible by polycyclic aromatic hydrocarbons, was studied in Wistar rats in connection with substances known to affect drug metabolism or aldehyde dehydrogenase activity, such as phenobarbital (PB), disulfiram (DS), beta-diethylaminoethyl diphenylpropylacetate (SKF 525A) and calcium cyanamide (CC). 3-Methylcholanthrene (MC) was given as a model inducer of ALDH (100 mg/kg, i.p., as a single dose) and the animals were killed after 3 days. Pretreatment with PB (1 g/l drinking water, for 2 weeks) enhanced the inducing effect of MC. On the contrary, pretreatment with DS (100 mg/kg, i.p., daily x 4) reduced by 70% the expected increase in ALDH activity. Neither SKF 525A (25 mg/kg, i.p., daily x 4), nor CC (5 mg/kg, i.p., daily x 4) could affect the action of the inducer. At the above doses, basal ALDH activity was inhibited by DS (30%) and CC (70%), but was not affected at all by PB or SKF 525A. The results were somewhat different when the various effectors tested were administered to animals already treated with MC (20 mg/kg, i.p., daily x 6). In this case, DS did not affect the already induced ALDH activity. On the contrary, CC was still an effective inhibitor. Unexpectedly, post-treatment with SKF 525A further enhanced the initial induction brought about by MC. Our findings show that substances affecting microsomal drug metabolism can interfere with the process of ALDH induction by MC. The additive result of PB pretreatment is probably due to the enhanced accumulation of an active metabolite of MC.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2764710 TI - Differential effects of methylmercury on the synthesis of protein species in dorsal root ganglia of the rat. AB - Dorsal root ganglia from control and methylmercury (MeHg)-treated rats were incubated in vitro with 35S-methionine ant the proteins synthesized were analyzed by two-dimensional electrophoresis. The double labelling method, in which proteins of control dorsal root ganglia labelled in vitro with 3H-leucine were added to each of the two samples as an internal standard, was used to minimize unavoidable errors arising from the resolving procedure itself. The results obtained showed that the effect of MeHg on the synthesis of proteins in dorsal root ganglia was not uniform for individual protein species in the latent period of MeHg intoxication. Among 200 protein species investigated, 157 showed inhibition of synthesis close to that of the total proteins in the tissue (68% of the control). Among the remaining protein species, 20 showed real stimulation of synthesis, whereas 7 were moderately inhibited and 16 were inhibited more strongly than the total proteins in the tissue. These results suggest that the effect of MeHg on the synthetic rates for protein species in dorsal root ganglia differs with the species, and that unusual elevation or reduction of the synthesis of some protein species caused by MeHg may lead to impairment of normal nerve functions. PMID- 2764711 TI - Differentiated neuroblastoma cells are more susceptible to aluminium toxicity than developing cells. AB - The influence of aluminium (20-50 micrograms/ml) on neuronal function was examined using electrophysiological techniques and neuroblastoma clone cells which offer a convenient model of differentiating and fully active neurons. Two specific questions were addressed: 1) Can differentiated cells maintain their normal excitable function when exposed to aluminium? 2) Can proper development of electrophysiological properties be achieved in its presence? We report that aluminium caused premature onset of deterioration in fully differentiated cells. Within 4-6 days they depolarized from -29.3 +/- 0.9 mV to levels lower than -15 mV; compound polyphasic action potentials were gradually replaced by slow monophasic spikes before the final loss of excitable properties and structural deformations was noticed. Developing cells followed the normal pattern of differentiation in the presence of aluminium: within 7 days they extended neurites, hyperpolarized and exhibited polyphasic spikes. These results show that neuroblastoma cells are apparently less susceptible to aluminium's toxicity during the process of development than after differentiation. Possible mechanisms by which aluminium may exert its effects are discussed in view of these observations. PMID- 2764712 TI - Pharmacokinetics of the soman simulant 1,2,2-trimethylpropyl dimethylphosphinate (PDP) in rats. AB - The soman simulant 1,2,2-trimethylpropyl dimethylphosphinate (PDP) antagonizes the therapeutic complications due to persistence of the nerve agent 1,2,2 trimethylpropyl methylphosphonofluoridate (soman) in rats. Using [13D]PDP or 1,2 dimethylpropyl dimethylphosphinate as an internal standard, we developed a gas chromatographic procedure for the analysis of PDP in aqueous solution and in blood samples. This procedure was used to investigate the pharmacokinetics of PDP in anaesthetized rats at intravenous doses of 2.0 and 0.6 mg/kg. The blood concentrations measured over a 420-min period can be described by a two compartment open model with a rapid distribution phase (t 1/2 = 4.3 min) and a rather slow elimination phase (t 1/2 ss = 2-3 h). The kinetics are approximately linear with dose. Under "steady state conditions", PDP distributes evenly over the central and peripheral compartment (Vdss = 1.1-1.5 1.kg-1). At most 0.7% of intact PDP is renally excreted, which indicates that it is extensively metabolized. Since the partition coefficients (20 degrees C) over n-octanol and water of PDP and soman are in the same range, i.e., 12 and 60, respectively, the much more rapid decrease in blood levels of C(+/-)P(-)-soman compared to PDP must be due to metabolic pathways of soman which are not available for PDP. At comparable doses, the blood level of PDP is initially 1 order of magnitude higher than that of C(+/-)P(-)-soman. This ratio increases in the course of 420 min to 4 orders of magnitude.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2764714 TI - Acrylamide and thiamine. AB - Acrylamide administration to rats caused clear alteration of blood thiamine content, which appeared to reflect suppressed intake and/or utilization of the vitamin in the body. Decreased utilization of thiamine does not seem to be induced by decreased binding of thiamine pyrophosphate (TPP) and apotransketolase, because acrylamide did not affect the Km of TPP for transketolase activity. PMID- 2764713 TI - Effect of soman intoxication on the organization of rat brain ribosomes and the translational activity of mRNA in a cell-free system. AB - The effect of soman on rat brain ribosomes organization and translational activity of mRNA in cell-free system was studied in rats exposed to 1.3 LD50 soman (120 micrograms/kg body weight) and in rats repeatedly injected with 0.4 LD50 soman (35 micrograms/kg). Fifteen minutes after the injection of 1.3 LD50 soman the heavy polyribosomal fraction from rat brain was found to be enriched and translational activity of mRNA was enhanced. In rats administered five injections of 0.4 LD50 soman at 24-h intervals, the low density ribosomes appeared as the predominant fraction whereas the activity of mRNA in all cell free system was significantly impaired. It is concluded that soman intoxication expresses a stimulatory or inhibitory effect on the processes of protein synthesis in the rat brain, depending on the dose schedule of soman administration. PMID- 2764715 TI - Non-genotoxicity of acrylic acid and n-butyl acrylate in a mammalian cell system (SHE cells). AB - Acrylic acid (AA), ethyl acrylate (EA) and n-butyl acrylate (BA) are widely used in the production of plastics, coatings and acrylic fibres. Occupational exposure occurs primarily via inhalation and/or skin contact. In chronic inhalation experiments EA and BA did not induce neoplastic changes in rats and mice (Klimisch and Reininghaus 1984; Miller et al. 1985). Additional investigations showed that AA and BA were not carcinogenic in mice after chronic dermal application (De Pass et al. 1984). However, recently other authors reported a weak carcinogenic potential of AA and BA after chronic dermal administration to mice (Cote et al. 1986). The conditions of the latter study lead to the suggestion that the observed tumours had developed secondarily due to the local irritating and corrosive properties of AA and BA. This view is supported by the negative results of AA, EA and BA in the conventional Ames test (Waegemaekers and Bensink 1984). Mutagenicity data in mammalian cell systems of EA were equivocal (Henschler 1986) and were lacking for AA and BA. For this reason the mutagenic potential of AA and BA was investigated in Syrian hamster embryo fibroblasts (SHE cells). DNA repair (UDS assay), chromosomal changes (micronucleus assay) and morphological transformation were chosen as biological end-points. PMID- 2764716 TI - Guinea pig maximization test for skin sensitisation: the use of fewer test animals. AB - Current European Community (Annex V) guidelines recommend the use of 20 test animals in the guinea pig maximisation test for skin sensitization. The suitability, for classification and labelling purposes, of reducing the number of test animals has been examined by analysing the results of 40 studies submitted to the Health and Safety Executive, and by the use of a mathematical model. Our results suggest that in most cases an experiment with ten test animals can be used to determine satisfactorily whether a substance should be labelled with the risk phrase "may cause sensitisation by skin contact". However, serious consideration should be given to the need for additional investigation if two or three of the ten test animals show a sensitisation response. The highest non irritant concentration of a substance should be used at challenge. Clearer guidance in Annex V on evaluating challenge responses would be beneficial. PMID- 2764717 TI - Effects of co-administration of di(2-ethylhexyl)phthalate and testosterone on several parameters in the testis and pharmacokinetics of its mono-de-esterified metabolite. AB - The administration of 1 g/kg di(2-ethylhexyl)phthalate (DEHP) or 5 mg/kg testosterone for 1 week did not affect the testicular and prostatic gland weights in rats. However, co-administration of DEHP and testosterone induced severe testicular atrophy accompanied by a decrease of zinc concentration in the testis and reduction of the activity of testicular specific lactate dehydrogenase isozyme. These changes were similar to the results of high dose administration of DEHP alone. Values of biological half-life and area under the concentration-time curve (AUC) of mono(2-ethylhexyl)phthalate, the main metabolite of DEHP, in testes after a single co-administration of DEHP (p.o.) and testosterone (i.p.) were higher than those after DEHP administration alone. Results suggest that the co-administration of DEHP and testosterone enhanced the adverse effects of DEHP on testes as the result of changes in pharmacokinetic values of MEHP. PMID- 2764718 TI - Testicular atrophy and loss of nerve growth factor-immunoreactive germ cell line in rats exposed to n-hexane and a protective effect of simultaneous exposure to toluene or xylene. AB - Testicular and germ cell line morphology in rats were studied 2 weeks, 10 months and 14 months after cessation of a 61-day inhalation exposure to 1000 ppm n hexane. Androgen biosynthetic capacity of testis, testosterone blood concentration, vas deferens morphology and noradrenaline (NA) concentration, epididymal sperm morphology, and fertility were also studied. Severe testicular atrophy involving the seminiferous tubules with loss of the nerve growth factor (NGF) immunoreactive germ cell line was found. Total loss of the germ cell line was found in a fraction of animals up to 14 months post-exposure, indicating permanent testicular damage. No impairment of androgen synthesis or androgen dependent accessory organs was observed. Simultaneous administration of 1000 ppm n-hexane and 1000 ppm toluene, or 1000 ppm n-hexane and 1000 ppm xylene, did not cause germ cell line alterations or testicular atrophy. Toluene and xylene were thus found to protect from n-hexane induced testicular atrophy. PMID- 2764719 TI - Cytotoxic effects of acrylamide and its related compounds assessed by protein content, LDH activity and cumulative glucose consumption of neuron-rich cultures in a chemically defined medium. AB - Cytotoxicity of acrylamide on neuronal cells cultured in a chemically defined medium was studied with morphological alteration, protein content, LDH activity and cumulative glucose consumption as toxicity indicators. The cumulative glucose consumption was significantly reduced by exposure to acrylamide before the other indicators were affected, suggesting that it would be the most sensitive indicator in the present study and that inhibition of glucose utilization might be one of the mechanisms of acrylamide neurotoxicity. The cumulative glucose consumption was applied for assessing cytotoxicity of acrylamide and its related compounds in neuronal cultures. The ED50 values were 0.8, 5.8, 15.0 mM for acrylamide, N-isopropylacrylamide, and methacrylamide, respectively, which are neurotoxic in in vivo studies. N,N'-methylene-bis-acrylamide, which is not reported to be neurotoxic, however, showed the lowest ED50 value, 0.2 mM, indicating that it was most potently toxic to neuronal cells. The results suggest the necessity of a cautious approach to neurotoxicity assessment from culture studies. PMID- 2764720 TI - Decrease in the mechanical strength of bones of rats administered cadmium. AB - The mechanical properties of the bones of young, adult and old rats administered various concentrations of cadmium were measured to prove the direct effect of cadmium on the bones of young rats. The young rats were divided into three subgroups, which were administered 0 (control), 5 and 10 ppm cadmium, respectively. The adult rats were subdivided into six groups, administered 0, 10, 20, 40, 80 and 160 ppm cadmium, respectively. The old rats were divided into three subgroups, which were administered 0, 80, and 160 ppm cadmium, respectively. The length of the administration was 4 weeks in every group. The decrease in the mechanical strengths of bones of young rats administered with cadmium was observed. On the other hand, no change in mechanical strength of bones was observed in the case of adult and old rats, administered up to 160 ppm cadmium. The correlation between the cadmium in bones and the decrease in the strength of the bone shows that cadmium directly affects the mechanical properties of bones of young rats. PMID- 2764722 TI - Immature alveolar/blood barrier and low disaturated phosphatidylcholine in fetal lung after intrauterine exposure to O,O,S-trimethylphosphorothioate. AB - Intrauterine exposure to the potent lung toxicant OOS-TMP was found to result in neonatal lethality attributed to immature lungs (Koizumi et al. 1988). The present study was initiated to investigate biological/pathological profiles of such pulmonary immaturity. OOS-TMP was given p.o. to five pregnant female Sprague Dawley rats on gestation day (G) 19 at 2.5, 7 or 20 mg/kg. Control (N = 6) or pair-fed dams (N = 5: pair-fed to 20 mg/kg dams) received 2 ml/kg corn oil. On G 22, fetuses were delivered by Cesarean section. The biochemical maturity of lungs was assessed by glycogen content and production of disaturated phosphatidylcholine (DSPC), a major component of pulmonary surfactant. Mean DSPC content was significantly lower in fetuses from dams dosed at 7 or 20 mg/kg while mean glycogen concentration, in contrast, was 3- to 6-fold higher in those fetuses than fetuses from control or pair-fed dams. Pathological examination revealed that in fetuses delivered from dams dosed at 7 mg/kg or 20 mg/kg, glycogen-rich cuboidal epithelial cells completely covered the terminal air space and alveolar/blood barriers stayed at the poorly developed stage. The stage of the pulmonary development in those fetuses was similar to those in fetuses on G19. Therefore it was concluded that intrauterine exposure to OOS-TMP delayed pulmonary development, thereby causing respiratory failure after birth. PMID- 2764721 TI - A pneumotoxin, O,O,S-trimethyl phosphorothioate, induces hemorheological alteration in rats. AB - O,O,S-trimethyl phosphorothioate (OOS-TMP), an impurity present in widely used organophosphorus insecticides, has been shown to induce lung injury after oral administration. To date, very little is known about the hemorheological changes which may occur during the inflammation of lung caused by OOS-TMP. The present study has demonstrated that oral administration of OOS-TMP (10 mg/kg, 20 mg/kg) to rats produced an increase in whole blood apparent viscosity at 24, 48 and 72 h following the treatment in rats. Concomitantly, the plasma fibrinogen level and red blood cell (RBC) aggregation were increased at 24 and 48 h. There was no change in RBC filterability. Thus, OOS-TMP, a pneumotoxin, was capable of causing a systemic hemorheological alteration, probably via increase in fibrinogen content, an acute-phase protein, in rats. PMID- 2764723 TI - Pulmonary clearance and toxicity of zinc oxide instilled into the rat lung. AB - Pulmonary toxicity of zinc oxide (ZnO) was evaluated by investigating the metabolic fate and inflammatory potency of ZnO instilled into the rat lung. Groups of three rats received single intratracheal instillations of ZnO suspension at a dose of 100 micrograms Zn/rat in the time-course experiment or received 20, 50, 100, 200, 500 and 1000 micrograms Zn/rat and were killed 2 days after treatment in the dose-response experiment. It was suggested that ZnO particles were solubilized in the bronchoalveolar milieu and cleared from the lung with a half-life of 14 h. Metallothionein (MT) was induced with a peak at 2 days. The content of MT was proportional to the dose of ZnO, but contributed little for the accumulation of Zn in the lung. A dose of 20 micrograms Zn/rat was sufficient to develop maximum responses for beta-glucuronidase activity and surfactant content in the bronchoalveolar lavage fluid. Moreover, the activity of lactate dehydrogenase and protein content in the lavage fluid increased significantly at 20 micrograms Zn/rat. These results suggest that the recommended ZnO concentration in the work-place atmosphere of 5 mg/m3 might not be adequate. PMID- 2764724 TI - Approximate lethal dose versus median lethal dose in acute toxicity testing of pharmaceuticals. A retrospective study. AB - The relation between approximate lethal doses (ALD, i.e. the lowest dose at which mortality occurs) and the corresponding median lethal doses (LD50) was investigated in 231 acute toxicity studies in mice and rats. The ALD values were divided into four classes (less than 5 mg/kg, 5-50 mg/kg, 50-500 mg/kg, 500-2000 mg/kg) and the LD50/ALD factors were calculated. In intravenous studies the LD50 values were higher than the ALD values by mean factors of 1.27-1.61 in mice and 1.25-2.84 in rats. In oral studies the LD50 values were higher by mean factors of 1.46-2.5 in mice and 1.59-2.1 in rats. Only in 20 cases (8.7%) did the LD50 values differ by factors higher than 2. PMID- 2764725 TI - The influence of a non-ionic surfactant on rectal absorption of virus particles. AB - A bacterial virus, suspended in three different vehicles, was introduced into the rectum of rabbits. The virus was detected in the circulating blood as early as 10 min after the administration. The quantity of virus found in blood and the duration of its presence, were enhanced when a non-ionic surfactant was used as vehicle of the virus. PMID- 2764726 TI - Spurious cross-reactions between plant viruses and monoclonal antibodies can be overcome by saturating ELISA plates with milk proteins. AB - It has been claimed recently [Dietzgen (1986) Arch Virol 91: 163-173] that a series of monoclonal antibodies (Mabs) produced against the nepovirus, arabis mosaic virus (ArMV) cross-reacted with the tobamovirus, tobacco mosaic virus (TMV). In the present report, this alleged cross-reactivity was re-examined by two ELISA procedures using Mabs produced against each of the two viruses. It was found that when highly concentrated preparations of Mabs were used, all antibodies reacted in a nonspecific manner with several plant viruses. However, when defatted milk instead of bovine serum albumin was used both as blocking agent and as diluent for the Mabs, the spurious cross-reactions between unrelated viruses were abolished. The use of milk as blocking agent did not prevent the detection of genuine cross-reactions between related nepoviruses. PMID- 2764727 TI - Production of hepatitis B virus surface antigen containing pre-S1 and pre-S2 domains by Chinese hamster ovary cells. AB - We have established transformed Chinese hamster ovary cells, which secrete hepatitis B virus surface antigen containing both pre-S1 and pre-S2 domains into culture medium, by using the autologous S gene promoter. PMID- 2764729 TI - Comparison in inhibitory effects of lipolysis products on cholesterol esterification. AB - The effects of lipolysis products (glycerol, free fatty acids and lysolecithin) on cholesterol esterification in LDL and HDL3 were studied. The effects of oleic acid, linoleic acid and EPA on cholesterol esterification in LDL and HDL3 were also compared. 14C-FC labeled lipoprotein, LCAT source (lipoprotein deficient plasma) and test substance were incubated at 37 degrees C, and cholesterol esterification rates were estimated. In LDL, glycerol and palmitic acid did not inhibit cholesterol esterification. The inhibition rates of cholesterol esterification by lysolecithin were same as those by linoleic acid in LDL and increased to 100% at 2.5 mM depending on the concentrations. The effects of oleic acid, linoleic acid, and EPA were compared. The inhibition rates of cholesterol esterification in LDL were highest by EPA, next by linoleic acid and lowest by oleic acid. In HDL3, glycerol did not inhibit cholesterol esterification. Palmitic acid inhibited cholesterol esterification in HDL3. The inhibition rates of cholesterol esterification by lysolecithin in HDL3 were always lower than those by linoleic acid. The inhibition rates by palmitic acid were almost same as those by lysolecithin in HDL3. The inhibition rates of cholesterol esterification by EPA were higher than those by linoleic acid in HDL3. The inhibition rates of cholesterol esterification by oleic acid were close to those by linoleic acid in HDL3. Polyunsaturated FA suppressed LCAT activities much stronger than saturated FA at physiological concentrations. PMID- 2764728 TI - Immune responses to wild and vaccine rubella viruses after rubella vaccination. AB - Antibody responses to individual structural proteins (E1, E2, and C) of the M33 wild rubella virus and the RA 27/3 live attenuated rubella strain were assayed by immunoblotting in 11 girls, following immunization with RA 27/3 rubella vaccine. Serum samples were drawn before immunization and at 10 days, 1 month, 1 year, 2 years, and 3 years afterwards. All the subjects showed antibodies to E1 glycoprotein of both the virus strains up to three years after immunization, indicating the importance of E1 in immunity. Antibodies to E1 were always present when with neutralizing activity was observed. Antibodies to E2 protein of both the viruses and to the C protein of the M33 virus gradually disappeared with time in some samples, while antibodies to C protein of the RA 27/3 virus strain were found persistently in all the sera. PMID- 2764730 TI - Role of platelet secretory products in modified lipoprotein metabolism in macrophages. AB - Macrophage-derived foam cells and platelets are found in many lesions of atherosclerosis. Macrophages possess scavenger receptors that take up modified low density lipoproteins (LDL) like acetylated or acetoacetylated LDL (aLDL, aaLDL) resulting in accumulation of esterified cholesterol (EC) and acquisition of the characteristics of foam cells. We obtained a certain platelet secretory product from washed platelet-rich plasma which had been frozen and thawed three times (PSP alpha). We studied the effect of PSP alpha in modified lipoprotein metabolism in macrophages. When mouse or human macrophages were incubated with aaLDL and PSP alpha, much more EC was accumulated than with aaLDL only. Though the increase in EC of macrophages was dependent on the concentration of PSP alpha, it declined in high concentrations of PSP alpha. PSP alpha moderately increased 125I-aaLDL binding and cellular metabolism. PSP alpha also affected 125I-oxidized LDL binding and cellular metabolism, but it did not affect the metabolism of 125I beta-migrating very low density lipoprotein (beta VLDL). These results suggest that substances shed by activated platelets play a role in atherosclerosis as potent mediators of EC accumulation in macrophages and by affecting the receptor-mediated endocytosis of modified lipoproteins. PMID- 2764731 TI - Diabetes enhances vasoreactivity to calcium entry blockers. AB - Equipotent concentrations of diltiazem and verapamil relaxed coronary resistance vessels in isovolumically-perfused rat hearts. In diabetic hearts, the vasodilator response to diltiazem, and to a lesser extent verapamil, was significantly augmented. The addition of both calcium entry blockers also produced greater relaxation in precontracted isolated thoracic aorta of diabetic animals suggesting that diabetes increases the sensitivity of calcium entry blockers in two separate vessel types. PMID- 2764732 TI - Lipid and carbohydrate metabolism in cholestyramine-fed rats. AB - In rats fed semipurified diets, increasing amounts of dietary cholestyramine counteracted the effects of dietary cholesterol on plasma and liver cholesterol concentrations. These effects were associated with increasing rates of fecal bile acid excretion. Cholestyramine caused an increase in plasma triglyceride concentrations, and increased the ratio of triglycerides to cholesterol in plasma. The anion resin did not influence plasma glucose concentrations and blood concentration of acetoacetate, beta-hydroxybutyrate and lactate. Thus cholestyramine specifically affects cholesterol metabolism and plasma triglyceride concentrations without influencing other metabolites of fatty acid and carbohydrate metabolism. PMID- 2764733 TI - [Effect of social isolation on the ultrastructure of the dog brain]. AB - Ultrastructural changes in the central nucleus of the amygdalar body, field CA I of the hippocampus, piriform cortex, field 17 and field 7 have been studied in dogs, bred under conditions of social isolation. The changes are more numerous in emotiogenic structures. Similar ultrastructural rearrangements are revealed in the amygdalar body, hippocampus and in both fields of the neocortex. They are: neurons with different degree of chromatolysis, reactive changes in some organelles, terminals with agglutinated vesicles, or with their reduced number, increasing amount of synapses with a short active zone. At the same time, in the piriform gyrus vacuoles, membrane-like and osmiophilic inclusions, terminals with granular vesicles of various size are found more often. PMID- 2764734 TI - [Ultrastructural organization of the septum pellucidum in dogs subjected to long term partial intraspecific isolation]. AB - The dogs have been kept under conditions of a partial intraspecific isolation for a long time, beginning from early stages of the postnatal ontogenesis. The reactive changes in neurons, interneuronal contacts are shown to produce proliferation of neuroglial cells and a number of their ultrastructural reorganizations. Phagocytic cells--astrocytes and microgliocytes--activate. However, enhancement of trophic processes is noted, manifesting itself as hyperplasia of lamellar processes of astrocytes in the neuropil, as an increased number of neurons with subsurface cisterns, in their area an astrocyte process is constantly revealed. PMID- 2764735 TI - [Ventrolateral nucleus of the cat thalamus and its connection with field 4 of the cerebral cortex]. AB - By means of silver nitrate impregnation after Fink-Heimer and Golgi-Kopsch structural peculiarities have been revealed in the neurons of the ventral lateral nucleus (VL) of the cat thalamus and its connections with the motor cortex. The results of the observations demonstrate a complex morphological organization of the VL. It makes reciprocal connections with the field 4 of the motor cortex. Terminal fibers from the VL end in the layers I, III, V and VI of the field 4 gamma and in the whole thickness of the fundal field anatomically having no layers. No degenerating fibers are found after destruction in the fields 4 delta and 4 sfu. Basing on measurements of neuronal nuclei in the VL two cell populations are revealed, that demonstrates presence of two types of the neurons in the VL--large relay and small short axonal, each of them having several varieties. Complex synaptic contacts in the VL in the form of serial synapses and triads are also demonstrated. PMID- 2764736 TI - [Comparative study of the cholinergic and adrenergic innervation of the cerebral vessels in humans and various laboratory animals]. AB - Choline- and adrenergic innervation of intracerebral branches of the middle and posterior cerebral arteries has been investigated histochemically and electron microscopically in slices, or after their preparation after W. Penfield. The vessels have been studied in the area of the fields 41, 17 of the cerebrum, trunk and spinal cord of the human being, cat and dog. When studying innervation of the intracerebral arteries (ICA), the preparation method has some advantages in comparison with investigation of these vessels in slices of the brain. Around most of the ICA from 200 up to 30 mcm in the diameter choline- and adrenergic nervous conductors are revealed. Using the method for calculating varicosities in nervous plexuses, it is demonstrated that degree of the ICA innervation is two times less than that in the arteries of similar caliber in the cerebral pia mater. PMID- 2764737 TI - [Adrenergic innervation of lymph nodes and the thoracic duct]. AB - By means of incubation of slices in 2% solution of glyoxylic acid distribution of adrenergic fibers in the rabbit lymph nodes and in the thoracic lymphatic duct has been studied. Adrenergic fibers get into parenchyma of the lymph nodes via two ways. The first--the perivascular, when the nervous fibers make a plexus and get into the node along the blood vessels, the second--diffuse nervous fibers get together with trabecules in between the lymphoid nodules. The distribution density of the adrenergic fibers is not the same in different groups of the lymph nodes. In the lumbar nodes it is the highest. In the lymph nodes of the cervical part the density of the sympathetic fibers is, as a rule, lower than in the lumbar, but higher than in the axillary nodes. The lowest density of th adrenergic fibers is in the mesenteric, superficial inguinal lymph nodes and in the lymph nodes, situating near the thoracic part of the aorta. In the lymphatic duct wall small amount of adrenergic fibers are revealed, they form a plexus, predominantly in the cranial part. PMID- 2764738 TI - [Distribution of acetylcholinesterase-positive nerve fibers in the wall of the great saphenous vein in women]. AB - A relative density of acetylcholine esterase-reactive fibers in adventitium of the large subcutaneous vein changes in the postnatal ontogenesis in women: it is the lowest in newborns, the greatest in mature women, in old women it grows small. In newborns these fibers are situated in the compact layer of the adventitium, in mature and old women they are revealed in interlayers of the connective tissue that separate fasciculi of muscle fibers of the external longitudinal and internal circulatory layers of the middle sheath. PMID- 2764739 TI - [Various characteristics of the structure of the cardiac lymphatic bed and the morphofunctional basis of its insufficiency]. AB - Structural peculiarities of the cardiac lymphatic bed have been studied, as well as its adaptive and pathological changes under physical load, acute and recurrent coronary insufficiency under conditions of mechanical blockade of the lymph outflow from the organ, which have been modelled in dogs and rabbits. The cardiac lymphatic bed is injected with various staining masses and investigated stereoangioscopically in translucent preparations, in semithin slices and electron microscopically. The rearrangement of lymphatic capillaries and vessels revealed is of stereotypical character. The degree of manifestation and correlation of morphofunctional reactions, characterizing development of insufficiency of the cardiac lymphatic vessels is mainly determined by intensity and exposition of pathological effects, exercised on it, while etiologic factors are of less importance. PMID- 2764740 TI - [Intraorganic blood vessels of the intestinal graft after its ortho- and heterotopic transplantation]. AB - In experiments, performed on 85 dogs of both sex ortho- and heterotopic total autotransplantation of the small intestine and extracorporal connection of the allogenic segments of the small intestine have been carried out. Certain dependency of morphological changes of the intraorganic blood bed on the operation model has been stated. Essential changes in the blood bed at the heterotopic autotransplantation depend on inadequate regional hemodynamics in the graft. Therefore, the heterotopic model should be considered less preferable than the orthotopic one. One of the peculiarities in reconstruction of the intraorganic vascular bed after ortho- and heterotropic transplantation of the small intestine is, evidently, opening of lympho-venular anastomoses. PMID- 2764741 TI - [Status of the capillary endothelium of the lung in normovolemic perfusion of the organ through the system of the pulmonary artery]. AB - Pulmonary perfusion for 30 min to the dog under conditions of normovolemia is not accompanied with any essential changes in parameters of alveolar capillaries endothelium. Just the opposite, transformation of endothelial lining of the peribronchial capillaries demonstrates possible disturbances of the liquor transport across the walls of these vessels. The volumetric part of the interstitial space near these capillaries increases, while in the alveolar septa it does not change. In lymph formation, flowing out of the lung, together with bronchial capillaries, blood capillaries of the alveoli must take part. PMID- 2764742 TI - [Ultrastructure of human adrenal glands at various periods of prenatal morphogenesis]. AB - As demonstrates the electron microscopical investigation of the adrenals in human embryos and fetuses 6--32-week-old, at the age of 10--12 weeks glomerular and fasciculo-reticular zones are already differentiating. Subsequently, during following stages of the prenatal morphogenesis, when ultramicroscopical signs of the zonal belonging of cells and specific activity of steroid-synthesizing organells, the cortical reaction to the birth stress is manifested. Installation of the cells of the medullary substance takes place along nervous fibers, via paravasal and intravascular ways. Formation of the medullary substance by the time of birth is evidently not completed. Some critical estimations on the well known concept of the fetal cortex are presented. As the authors think, it needs to be recomprehended. PMID- 2764743 TI - [A method of low-temperature strengthening of microtome knives and medical cutting instruments]. PMID- 2764744 TI - [A method of fixation of the membranous labyrinth for microscopic studies]. PMID- 2764745 TI - An evoked potential mapping of transcallosal projections in the cat. AB - In ten adult cats anesthetized with ketamine hydrochloride the neocortex was exposed and rectangular pulses (1 msec, 0.5 Hz and variable intensity) were applied to discrete points of one side and transcallosal evoked potentials were recorded from the other. The stimulation and recording positions were determined on a cartesian map of most of the exposable neocortical areas and the potentials were analysed as to their components, voltage and latency. Passive spread and electrotonic potentials and the effects of increasing frequency were also analysed. The results showed large transcallosal potentials in some areas and an increase of potentials in the caudorostral direction, attaining the highest values in anteromedial areas of the suprasylvian gyrus. Confirming anatomical studies, a few silent spots were found in the motor and somesthetic cortex and in restricted posterior regions of the visual cortex, where small or zero voltages occurred. While causing weak contralateral potentials, stimulation of some posterior sites provoked high voltage potentials in anterior regions of the side being stimulated and in the corresponding area of the opposite site. These posterior sites are poorly interconnected by the corpus callosum. The L-shaped indirect connection described in this work may be involved in some types of epilepsy and may explain the effectiveness of partial callosotomy in their treatment. PMID- 2764746 TI - [Brief comments on the pathogenesis of spinal cysticercosis]. AB - The spinal forms of neurocysticercosis are rather rare. The more common presentation is the leptomeningeal form. We have reported two patients with an exclusively spinal involvement verified through surgery. The current theory of downward migration of the parasites from the cerebral to the spinal subarachnoid space cannot explain primary spinal forms, and it is suggested that retrograde flow through the epidural vertebral veins provides an alternative route. PMID- 2764747 TI - [Apnea crisis with perinatal onset in infants]. AB - A case of neonatal apnea is reported. Clinical, laboratory, radiological and pathological findings are discussed. The failure of response to therapeutic procedures is suggestive of different cause than anoxia. PMID- 2764748 TI - [Acute polyradiculoneuritis and acquired immunodeficiency virus]. AB - A 50-year-old man with positive test for human immunodeficiency virus (HIV) by enzyme-linked-immunoassy and Western-blot, without clinical manifestations of acquired immunodeficiency syndrome (AIDS), developed acute polyradiculoneuritis and was treated by plasmapheresis with improvement. We believe that chemical homologies of antigenic determinants between HIV and P2 protein of peripheral nervous system and myelin basic protein may induce crossed-reaction, thus developing acute polyradiculoneuritis and central nervous system involvement, respectively. The nervous system involvement hy HIV also occur in the HI-viremy, seric conversion alone, and AIDS with or without oportunistic infections. PMID- 2764749 TI - [Nifedipine as a coadjuvant drug in the treatment of uncontrolled epilepsy: a preliminary report]. AB - The authors report the use of nifedipine as a coadjuvant drug in the treatment of three patients with uncontrolled epilepsy. PMID- 2764750 TI - [L-dopa, biperiden and sebum excretion in Parkinson disease]. AB - Sebum secretion was measured on the forehead of 47 patients with Parkinson's disease before and after treatment with anticholinergic (biperiden), levodopa + AAID and bromocriptine, by the osmic acid technique. Another 100 patients under biperiden, levodopa + AAID or association of both, for at least one year, were also evaluated. The male parkinsonian "de novo" patients have shown greater sebum secretion than female patients. It was also concluded that biperiden failed to reduce sebum secretion rate. On the other hand, it was found that L-dopa + AAID reduces the sebum secretion (CL = casual level and SER = sebum excretion rate) on both male and female patients. Bromocriptine (10mg/day) was the second dopaminergic therapy employed in the present work. Similarly to L-dopa, this dopaminergic agonist was able to significantly reduce sebum secretion (both CL and SER) of male patients. There was a positive and significant correlation for the 50-59 years old male patients "de novo" between CL and tremor, hypokinesia, gait and posture or functional incapacity, before treatment. After a period of treatment correlation was no more found. In relation to parkinsonians under chronic treatment was found a positive and significant correlation between sebum secretion and hypokinesia. The level of sebum secretion on parkinsonian "de novo" patients before treatment was equal to parkinsonian patients under chronic treatment regardless the treatment, except for greater than or equal to 60 years old parkinsonians who have shown CL and SER higher than "de novo" parkinsonian patients with the same age but without treatment. The treatment with L-dopa + AAID significantly decreased both CL and SER of "de novo" parkinsonian patients.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2764751 TI - [Myasthenia gravis: treatment with thymectomy, corticoids and plasmapheresis]. AB - This paper reviews a 12 year experience with myasthenia gravis management (surgical and drug therapy). A total of 27 patients were submitted to thymectomy, and 12 out of 13 showed fairly good results with this only form of therapy (15.3% with complete remission, 46.15% with marked improvement and 30.7% with moderate improvement). The other 14 need either a combination of surgery and plasmapheresis or corticosteroids with the cummulative results of: 14.8% of remission (4 out of 27), 74% of improvement (20 out of 27), 7.4% of worsening (2 out of 27) and 3.7% without change (1 out of 27). Two other patients not submitted to surgery showed either a stable state of their symptoms or a mildly worsening. Another eight patients not submitted to surgery could not be bollowed up. The authors also conclude by the validity of the use of plasmapheresis in myasthenic crises leading to a transient relief of the symptoms and suggest the use of corticosteroids as a second choice, due to their undesirable side effects and difficulty in their reduction and elimination without worsening the symptoms. Other immunosuppressive drugs could be used in cases in which those above cited therapies showed unsuitable results. PMID- 2764752 TI - Malignization of an arachnoid cyst. AB - A case of evolvement of fibrosarcoma from a supratentorial arachnoid cyst (verified in surgery five years before) is presented, with brief comments on the embryonic origin of the tissues involved. PMID- 2764753 TI - Chronic recurrent Guillain-Barre syndrome: report of 3 cases. AB - The classical Guillain-Barre syndrome is an acute or subacute polyradiculo neuropathy whose main clinical features are progressive weakness of the limbs, decrease or absence of tendon reflexes, and sensory changes. Although in most of the cases there is complete recovery in weeks or months, some patients have a slow and progressive relapsing course and present thickening of the peripheral nerves. In this paper we describe three cases of the chronic and relapsing variety of Guillain-Barre syndrome, two of which had prominent hypertrophic changes in the peripheral nerves with onion bulb formations. The clinical and pathological features of this disease are reviewed. The three patients improved with the use of steroids. PMID- 2764754 TI - Failure of treatment of myasthenia gravis by cyclosporin-A: A case report. AB - Recently, cyclosporin-A (Cy-A) has been used in the treatment of myasthenia gravis (MG). This drug could be employed in some patients refractory to classic treatments or that develop undesirable side effects. It is reported the case of a 22 year-old woman with generalized and severe MG, and diabetes mellitus. She had been submitted to thymectomy and reoperated, to the classic ethiopathogenic methods of therapy, and to total body irradiation. No therapeutical results were observed. Also, she developed transient and slow bone marrow depression, and liver dysfunction. Owing to these limitations and to the absence of response to treatments mentioned. Cy-A use was attempted in this case. Unfortunately, Cy-A did not influence the myasthenic symptomatology. Cy-A also failed in suppressing anti-AChR production, which increased during Cy-A therapy. Results observed in this case are in disagreement with literature data on the subject. PMID- 2764755 TI - [Periodic lateralized epileptiform discharges in neurocysticercosis]. AB - A case of a girl (10 years old) with a psycho-organic syndrome plus headache without signs of clear intracranial hypertension is related. The diagnosis of neurocysticercosis was made by CSF abnormalities. PLEDs over the left cerebral hemisphere were recorded at the first day after treatment with praziquantel (50mg/kg/day during 21 days). The first CT scan was normal and just after the treatment showed a prominent left cerebral hemisphere involvement, despite parenchymatous dissemination of cysticerci was bilateral. The treatment was successful and the patient became asymptomatic in the two years follow-up. The neurophysiologic aspects of this EEG abnormality is also discussed. PMID- 2764756 TI - Neuroprostheses, lessons to be learned. PMID- 2764757 TI - The artificial heart, the inevitable development: will it be the U.S. or abroad? PMID- 2764758 TI - Selective removal of triglyceride-rich lipoproteins by plasmapheresis in diabetic patients with severe hypertriglyceridemia. AB - Two diabetic patients with marked intractable hypertriglyceridemia under treatment with hemodialysis for chronic renal failure were treated by either an apolipoprotein B-dependent removal of lipoproteins using dextran sulfate cellulose column plasmapheresis or a size-dependent removal of lipoproteins using hollow-fiber filtration plasmapheresis. In one patient, a column packed with hollow fibers was used as a plasma separator and a dextran sulfate cellulose column as an adsorbent. In another patient, because the hollow-fiber column did not separate plasma from whole blood, a centrifuge-type blood cell separator was used for the plasma separation. The amounts of plasma cholesterol, triglycerides, and phospholipids removed by plasmapheresis were 30%, 33%, and 30%, respectively, when the combination of a hollow-fiber column and a dextran sulfate cellulose column was used. Corresponding values were 31%, 29%, and 27%, respectively, when the combination of the centrifuge-type blood cell separator and the hollow-fiber column was used. The efficiency of lipid removal was almost the same with both techniques. As for plasma separation, the centrifuge-type blood cell separator was more efficient than the hollow-fiber column. Some losses of albumin and platelets were observed when combination plasmapheresis using the centrifuge-type blood cell separator and the hollow-fiber column was performed. In conclusion, we prefer the centrifuge-type blood cell separator to the hollow-fiber column for plasma separation of marked hypertriglyceridemia. The second filter must be chosen for each patient according to the size of the lipoproteins. PMID- 2764759 TI - Study of the excretion mechanism of a perfluorochemical emulsion. AB - The excretion mechanism of perfluorochemicals (PFC) via the lung has been studied by physicochemical and histochemical methods. Monocytes that had phagocytized PFC particles were found in the lung capillaries, and alveolar macrophages that had phagocytized PFC particles were found in the alveoli. Vacuolated macrophages were observed microscopically in the alveolar space of rats injected with PFC emulsions. The PFC content in alveolar macrophages reached a maximum level of 1.44 mg/l x 10(8) cells 72 h after injection. It was confirmed by means of a wavelength dispersive x-ray analyzer that fluorine atoms were present in the vacuolated alveolar macrophages. The peroxidase activity of the PFC-phagocytizing macrophages suggest that monocytes phagocytize PFC particles in the circulation and migrate to the alveolar space. This study shows that the monocyte/macrophage system is related to one mechanism for excretion of PFC after intravenous injection of PFC emulsions. PMID- 2764760 TI - Isoelastic polyurethane prosthesis for segmental trachea replacement in beagle dogs. AB - Porous polyurethane (nonwoven) was used for the development of tracheal prosthesis, which--in a special testing design--was adapted to shape and biomechanic properties of the natural organ. This prosthesis was implanted into 19 beagle dogs using inverted, everted, and end-to-end anastomosis. Insufficiency of the anastomosis or infection was observed in the everted and end-to-end anastomosis, whereas the inverted anastomosis showed complete incorporation into surrounding tissue of the porous prosthesis but was complicated by airway obstruction due to anastomosis granuloma. PMID- 2764761 TI - The effect of antihypertensive drugs on protein adsorption, platelet adhesion, and blood coagulation toward an artificial surface. AB - Protein adsorption and platelet adhesion are two important biological processes arising at the blood-prosthetic interface. The ability of certain antihypertensive and anticholesterol drugs, namely, clonidine, hydralazine, sembrina, frusemide, clofibrate, sorbitrate, thyroxine, etc., to modulate the surface-induced platelet adhesion to polycarbonate substrate was investigated using washed calf platelets in the presence and absence of fibrinogen. This study also demonstrated the changes in protein-surface binding with these drugs using electrophoretic techniques. It seems that the addition of these drugs to the polymer-protein system increased the level of surface-bound albumin variably. These drugs also reduced the fibrinogen surface concentration and inhibited the surface-induced platelet adhesion to variable degrees. Therefore, it may be possible that the enhanced albumin-surface concentration, or reduced fibrinogen surface binding, in the presence of these drugs may be one of the parameters for a reduced platelet-surface attachment, which may also improve the blood compatibility of the substrate. A better understanding of the mechanism of these drugs under in vivo conditions is needed to correlate these findings. PMID- 2764762 TI - The preparation of a urokinase-AT-III-PGE1-methyldopa complex, and its effects on platelet adhesion, coagulation times, protein adsorption, and fibrinolysis. AB - Modifications of urokinase by substances possessing useful therapeutic activity permit combined action preparations to be obtained. Here an attempt was made to develop a complex having combined action for therapeutic activity. The possibility of repeatedly modified urokinase with antithrombin-III-methyldopa prostaglandin E1 had been experimentally demonstrated. The complex was immobilized on albuminated substrate, which showed fibrinolytic, anticoagulant, and antiplatelet effects simultaneously, in addition to the normal antihypertensive action of methyldopa. The complex immobilized substrate also demonstrated an increase in albumin-surface attachment and a reduction in fibrinogen binding. This may be one of the parameters for a reduced platelet surface attachment, which may also improve the blood compatibility of the substrate. The approaches suggested indicate the possible new ways of creating nonthrombogenic surfaces with wider applications. A better understanding of the mechanism of these complexes are needed in in vivo conditions to correlate these findings. PMID- 2764763 TI - Changes of the serum amikacin (AMK) level in patients with serious acute renal failure treated by continuous arteriovenous hemofiltration (CAVH). AB - This study clarified changes in the serum amikacin (AMK) levels in the blood of 5 patients (4 men and 1 woman; average age 59.2 +/- 5.9 years) with serious acute renal failure treated by continuous arteriovenous hemofiltration (CAVH). The following principal results were obtained. (A) The average remaining rate of AMK in the blood after 6 h was 60.8 +/- 5.3% and 50.4 +/- 5.3% after 12 h. The average half-life period (t1/2 beta) of AMK in the blood during CAVH was 18.3 +/- 3.4 h. (B) The remaining rate of AMK in the blood after 12 h correlated significantly with the blood urea nitrogen (BUN) level (r = 0.71, p less than 0.05) and with the volume of urine excreted per day (r = -0.71, p less than 0.05). (C) The average lowest AMK concentration after 24 h for a continuous 17 day period was 3.3 micrograms/ml. These results suggest that the administration of 100 mg of AMK once a day is useful and safe for patients with serious acute renal failure treated by CAVH and that it will not accumulate in the body. PMID- 2764764 TI - Optimization of hemofilters for the development of implantable artificial kidneys. AB - The concept of developing an implantable artificial kidney demands, in addition to the regeneration of endogenous filtrate, a small hemofilter with a high filtration rate. Conventional capillary filters are limited in their capacity to yield adequate filtrate, even if the number of capillaries is increased. To improve filter design so as to modify flow conditions for filtration rate augmentation, it is necessary to consider such factors as blood flow through a single capillary, wall shear rate, and transmembrane pressure (ptm) in in vivo applications, where such biological considerations as blood pressure, blood flow, and flow characteristics of blood are important. These requirements lead to a completely new filter type, the "curl filter," characterized by a large effective filtration surface in a relatively small number of hollow fibers in which optimal flow conditions prevail. PMID- 2764765 TI - Perfusion of uremic blood ultrafiltrate on uncoated charcoal. AB - A granular uncoated charcoal removes from uremic blood ultrafiltrates many chemical species that are not removed by dialysis. Charcoal treatment dramatically improves the general condition of the patients and normalizes their blood pressure. To obtain a rapid depuration, the initial treatment should be intensive (at least 16 daily treatments) and the effects prolonged over time by once-a-week charcoal treatment between two standard hemodialyses. Biogel P2 chromatography documents well all the events of a depurative treatment that cannot be monitored by hematochemical analyses. PMID- 2764766 TI - The Second International Symposium of Red Cell Substitutes. October 3, 1989, Sapporo. Abstracts. PMID- 2764767 TI - Root resorption caused by impacted permanent teeth. Case report. AB - A case of severe external root resorption in several teeth caused by unerupted permanent teeth is presented along with the initial surgical treatment. PMID- 2764769 TI - The porcelain-faced pinlay--a simple solution to the worn dentition. Clinical hints and case reports. PMID- 2764768 TI - Fusion of maxillary third and supernumerary fourth molars. Case report. AB - Fusion of teeth is most commonly reported in the deciduous dentition, particularly in the anterior teeth. Recently, additional cases of fusion have also been reported in the mandibular molars of the permanent dentition, and are not considered uncommon. However, reports of the involvement of maxillary molars appear to be particularly rare in the literature. This case is another example of the quite rare phenomenon of fusion of maxillary third and supernumerary fourth molars. PMID- 2764770 TI - A migratory abscess pointing intraorally and extraorally. Case report. AB - A case of migratory abscess pointing both intraorally and extraorally at a considerable distance from the causative site is reported. The anatomy of the area leading to the formation of such an abscess is described. PMID- 2764771 TI - A comparison of the cariogenicity of two infant snack foods. AB - Two snack foods marketed specifically for infants were compared in caries prediction tests. A milk powder-supplemented fruit and cereal snack bar produced more titratable acid but did not reach as low a terminal pH as a sweet biscuit on in vitro fermentation by salivary organisms. In an intra-oral caries test the fruit/cereal bar caused significantly less enamel softening than the biscuit. While this latter test does not assess food retention in the mouth and other factors important in caries, the results suggest that, under similar usage by children, the fruit bar will be less cariogenic. Because it was not absolutely safe with respect to caries, frequency of eating cannot be disregarded. Availability of the fruit snack bar is an important development, allowing an additional choice for parents who wish to select low-cariogenicity foods for their children. PMID- 2764772 TI - Shelf-life of tooth-coloured restorative materials in Papua New Guinea. AB - A survey of Dental Officers and Dental Therapists in Government Health and Defence Force Clinics throughout Papua New Guinea indicated that the problem of slow setting and even failure to set is a frequent occurrence with composite resin materials. This is because these materials tend to deteriorate at high temperatures to which they may be subjected during transport, initial storage and clinical storage awaiting use. Eight brands of composite resin, including paste paste, powder-liquid and light-activated systems, as well as three glass ionomer cements were evaluated over a period of twelve months with respect to shelf-life and suitability for use in a tropical environment. Preliminary results indicated that, although a light-activated composite resin appeared to be the material of choice, it may not be suitable because it is relatively expensive and requires a curing light which is electrically operated. A powder-liquid composite resin was, therefore, the recommended product. On the other hand, it was also suggested that a powder-water glass ionomer cement, Chemfil II, might be a suitable alternative for a developing, tropical country such as Papua New Guinea. PMID- 2764773 TI - Clinical Note no. 8. Adhesive tabs for bitewing radiography. PMID- 2764774 TI - Asthma in the Australian community. PMID- 2764775 TI - Testing children for pulmonary function. AB - Tests of pulmonary function provide evidence of the nature and severity of lung disease; they occasionally aid a specific diagnosis and they are an excellent guide to the patient's progress. They assist the physician to establish the severity of the disease. PMID- 2764776 TI - Concepts, questions and goals in general practice. Are you asking the right questions? AB - The author has developed a set of questions that can be used as a guide to planning a thoughtful consultation: one that will lead to improved diagnostic and management decisions. PMID- 2764777 TI - Common puerperal complications. AB - The final article in a three-part series (the first two appeared in AFP May) deals with practical problems of the puerperium in a sensitive way. The author emphasises that a doctor should be aware of the possible problems and should be readily available to the postnatal patient. PMID- 2764778 TI - Complications of chronic glue ears. AB - Glue ears if left untreated progress to many of the major middle ear disorders. The process of destruction of the drum, ossicles and mucosa may halt spontaneously leaving varying stages of damage, or proceed to the sometimes life threatening complications of some of the conditions described. PMID- 2764779 TI - An analysis of diagnostic content in a postgraduate teaching programme. AB - In this study the diagnoses of consultations collected on videotape for teaching purposes are analysed. The consultations involved genuine patients and Family Medicine Programme trainees during a general practice term. Diagnostic content is demonstrated to reflect the normal work experience of trainee general practitioners. PMID- 2764780 TI - Schober's test (modified). PMID- 2764781 TI - Patient education. Bereavement. PMID- 2764782 TI - Caring for people at home. Aids to walking. PMID- 2764783 TI - Is hour hobby really necessary? PMID- 2764784 TI - Essential adrenaline. PMID- 2764785 TI - Migrants and health. PMID- 2764786 TI - A friendly encounter. PMID- 2764787 TI - General practice training. PMID- 2764788 TI - Pictorial essay. Common oral lesions. PMID- 2764789 TI - Epithelial cell surface morphology in the endolymphatic sac: a scanning electron microscopic study in the mouse. AB - The apical, lateral and basal surface structures of the epithelial cells in the murine endolymphatic sac were studied using the freeze-cracking technique and scanning electron microscopy. In this way, it was possible to visualize the luminal surface and the interior of the cell simultaneously. The light epithelial cells, with their smooth rounded nuclei and many mitochondria, had numerous microvilli on their apical cell surface, whereas the dark epithelial cells, with indented nuclei, had only a few such microvilli. The lateral surfaces of these cells were flat, with few projections facing a dilated lateral intercellular space. PMID- 2764790 TI - Electro-olfactogram (EOG) in olfactometry. AB - The electro-olfactogram (EOG) is a potential originated in olfactory epithelium evoked by odorous stimulation, which has been demonstrated and termed by Ottoson (1959). In order to ascertain the clinical application of EOG, we attempted to record similar potentials in human subjects. In some preliminary experiments using rabbits, it was quite easy to produce Ottoson's findings. In human subjects, however, there were sometimes great technical difficulties owing to the hidden anatomical position of the olfactory epithelium. Then we utilized Olympus selfoscope endoscopy for placing and retaining the electrode to the olfactory portion precisely and safely, with a tube for sending airborne odor. As results, we succeeded in recording negative spike discharge similar to Ottoson's findings. We examined a total of 27 nasal cavities in 22 patients with peripheral olfactory disorders and 11 nasal cavities in 12 patients with central olfactory disorders. The positive EOG rate in patients with peripheral or central olfactory disorders was 28 and 69%, respectively. Moreover, the positive rate was decreased in proportion to the degree of olfactory disorders in chronic rhinosinusitis. No positive EOG was observed in anosmic nasal cavities, while it was 68% in normal persons and resulted in an equal value to anosmia group caused by the damage of central olfactory pathway. From these results, it is considered that the positive EOG study is the only method which provides objective finding for the differential diagnosis of anosmia caused by disorders of olfactory epithelium or disorders of central olfactory tract. PMID- 2764791 TI - Ranula and sarcoid granuloma of a sublingual gland. AB - A case is reported in which the treatment of the ranula consisted of dissection of the cystic wall along with excision of the sublingual gland of origin. The histological picture of the gland was consistent with sarcoidosis. Thereafter, all other examinations were negative for sarcoidosis. However, there remains the possibility that the lesion may be the precursor of widespread sarcoidosis which might occur in the future. PMID- 2764792 TI - Primary squamous cell carcinoma of the parotid gland: a case report with electron microscopic findings. AB - Primary squamous cell carcinoma of the parotid gland is a rare tumor. Histological and ultrastructural features of a primary squamous cell carcinoma arising in the right parotid gland is presented. Light microscopically the tumor consisted of poorly differentiated squamous cell nests. PAS reaction was negative. Ultrastructurally the tumor cells were oval or spindle shaped and the cytoplasmic processes were frequently found. The majority of the tumor cells contained numerous intermediate filaments in their cytoplasm. No secretory granule was found. The desmosomes were well developed. It is known that mucoepidermoid carcinoma may be often misdiagnosed as squamous cell carcinoma. These findings can enable us to distinguish primary squamous cell carcinoma from mucoepidermoid carcinoma of the parotid gland. PMID- 2764793 TI - Fibrosarcoma of the neck in an adult female. AB - This paper is a case report of a 53-year-old housewife with fibrosarcoma of the neck. On 27 August 1986, she was admitted to our hospital with discomfort on the right side of her throat and difficulty in swallowing. She had no history of radiation therapy to the neck. The tumor was below the right submandibular gland and was movable. No enlarged lymph nodes were palpated in the neck. The mean CT number of the tumor was 59.5 H.U. The tumor was almost circular and its surface was smooth. Upon operating, the tumor was observed to be connected to the greater cornu of the hyoid bone and the superior cornu of the thyroid cartilage. The tumor measured 50 x 42 x 35 mm and was well circumscribed but not encapsulated. The cut surfaces were generally fleshy, glistening and grayish-white. The tumor was composed of small amounts of collagen and reticulin, producing fairly uniform spindle cells arranged in interlacing bundles, forming a herring bone pattern. The tumor cell showed rather little atypism, but did show obvious mitotic activity. Thus, the tumor was diagnosed as well-differentiated fibrosarcoma. When the patient was last seen, in April 1989, there was no evidence of recurrence. PMID- 2764794 TI - Neural networks--an artificial intelligence approach to the analysis of clinical data. AB - This paper describes an approach to the pattern recognition problem of categorizing evoked response waveforms, using that branch of artificial intelligence known as neural networking. A total of 19 subjects (38 eyes) were exposed to a reversing chequerboard pattern, and the resulting Pattern electroretinogram (PERG) recorded. This was repeated for each of the subjects at contrast levels of 75%,50% and 25%, with the resulting response becoming less pronounced as the contrast level was decreased. The subjects were also given an Arden contrast sensitivity test, and the resulting scores recorded for each eye. The averaged responses from each of the 3 contrast levels for each of the 38 eyes tested were used as the input to a computer simulated 3-input per neuron cascaded neural network. The output and weighting parameters for the individual neurons were then varied until the network was able to optimally classify the PERG results on the basis of the Arden contrast sensitivity scores. The neural network was thus taught to recognize patterns in the PERG responses in much the same way that an experienced clinician might. A second neural network was similarly taught to classify the PERG responses on the basis of a clinician's subjective rating of each of the responses. PMID- 2764795 TI - Commercialising biomedical technology. AB - Engineers and scientists working with biomedical technology are a highly inventive lot. However, it is disappointing to see how few of the products of that inventiveness ever see the light of day outside the hospitals or institutions in which they are developed. This is usually because the developers do not know how to go about commercialising their products. The two basic options in commercialising a new product are to license the product to an existing company, or to establish a new company to manufacture and market it. Whichever approach is taken, a "Business Plan" is an essential requirement. This is a selling document which is needed either to convince an existing company that it would be profitable for it to license the product, or to convince an investor/financier to fund the establishment of a new company to commercialise it. PMID- 2764796 TI - Scientific and technical staffing of radiation oncology departments. Australasian College of Physical Scientists and Engineers in Medicine Topic Group on Radiotherapy Staffing. PMID- 2764797 TI - Pulse, a PC-based graphics pulse sequence editor for NMR and MRI. AB - A flexible, personal computer (PC) based, screen-graphics oriented pulse sequence editor called PULSE has been developed for nuclear magnetic resonance (NMR) spectroscopy and magnetic resonance imaging (MRI). PULSE is used to set such NMR spectroscopic parameters as the delay and duration of rf transmit and receive gates, rf phase, sampling times, and such imaging parameters as rf pulse shape and gradient waveforms. The output of PULSE is a set of programs that can be loaded into a hardware pulse programmer. With PULSE, any desired NMR or MRI pulse sequence can be programmed quickly and easily. PMID- 2764798 TI - Three-dimensional radiation treatment planning. AB - A major aim of radiation therapy is to deliver sufficient dose to the tumour volume to kill the cancer cells while sparing the nearby healthy organs to prevent complications. With the introduction of devices such as CT and MR scanners, radiation therapy treatment planners have access to full three dimensional anatomical information to define, simulate, and evaluate treatments. There are a limited number of prototype software systems that allow 3D treatment planning currently in use. In addition, there are more advanced tools under development or still in the planning stages. They require sophisticated graphics and computation equipment, complex physical and mathematical algorithms, and new radiation treatment machines that deliver dose very precisely under computer control. Components of these systems include programs for the identification and delineation of the anatomy and tumour, the definition of radiation beams, the calculation of dose distribution patterns, the display of dose on 2D images and as three dimensional surfaces, and the generation of computer images to verify proper patient positioning in treatment. Some of these functions can be performed more quickly and accurately if artificial intelligence or expert systems techniques are employed. PMID- 2764799 TI - Standards and calibration facilities of the Australian Radiation Laboratory for ionizing radiation beams. AB - The Australian Radiation Laboratory (ARL) maintains national standards of exposure and working standards of absorbed dose. Some of the exposure standards maintained by ARL have been compared recently with those of the Bureau International des Poids et Mesures (BIPM) for 100 to 250 kV x-rays and 60Co gamma rays. The absorbed dose standard for 60Co gamma rays is compared regularly with other standards through the International Atomic Energy Agency (IAEA) and World Health Organization (WHO). All results show good agreement. A range of calibration qualities is offered at ARL, extending from 10 kV x-rays to 60Co gamma rays. A system of regional facilities has been developed for radiation protection calibrations; each facility is supplied with a set of 137Cs sources and an ionization chamber and electrometer for use with x-rays. The system is now almost complete throughout Australia. PMID- 2764800 TI - The influence of age and dietary fat in an animal model of sudden cardiac death. AB - The influence of dietary fat on myocardial vulnerability to arrhythmia was examined using coronary artery occlusion and reperfusion in the anesthetised rat as a whole animal model of ventricular fibrillation and sudden cardiac death. Animals were fed a reference (REF) diet alone or supplemented 12% by weight with tuna fish oil (TFO) (rich in n-3 fatty acids), sunflower seed oil (SSO) (rich in n-6 fatty acids) or sheep perirenal fat (SF) (rich in saturated fatty acids). Feeding periods of 6, 12, and 18 months and a total of 108 rats were used. The incidence of ventricular fibrillation in occlusion was reduced from 46% of REF animals to 6% and 21% in TFO and SSO groups respectively and increased to 68% in the SF-fed rats. The incidence of ventricular tachycardia was also reduced by TFO and SSO. The duration of arrhythmic episodes was increased by SF and reduced by TFO and SSO. The incidence of fibrillation on reperfusion of acutely ischemic myocardium (15 minutes occlusion) was significantly reduced by TFO only (12%, REF = 50%, SSO = 30%, SF = 70%). Severity of arrhythmias increased with age as did the extent of dietary influence. Mortality from fibrillation which only occurred in rats aged 12 months or older (REF = 13%) was increased by SF (43%) mainly in reperfusion (38%) but did not occur in TFO or SSO. These results indicate the potential benefit of dietary modification to include a higher proportion of polyunsaturated fat especially fish oil in reducing risk of sudden cardiac death.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2764801 TI - Transesophageal electrocardiography and atrial pacing in acute cardiac care: diagnostic and therapeutic value. AB - The utility of transesophageal electrocardiography using a bipolar 'pill electrode' was assessed in 17 consecutive patients with tachycardia presenting to our casualty department. Standard 12-lead electrocardiography showed regular narrow QRS tachycardia in 12 patients, and five patients had wide QRS tachycardia. Esophageal atrial electrogram recordings were obtained in 14 patients (82%), and these were helpful in determining the mechanism of tachycardia in 11 patients (78%). Of these 11, seven patients fulfilled criteria for atrioventricular junctional (AVJ) tachycardia based on measurement of the minimum interval between the onset of ventricular depolarisation and earliest atrial (esophageal) activity. One of these patients had presented with a wide QRS tachycardia. The other four patients were diagnosed as having ventricular tachycardia (VT) following diagnosis of AV dissociation. Atrial overdrive pacing, via the pill electrode, successfully reverted four of the nine patients (44%) with narrow QRS tachycardia but no patient with VT. Esophageal recording during tachycardia is a simple, relatively non-invasive technique which is helpful in suggesting the mechanism of tachycardia both in patients with narrow and wide QRS tachycardia, and may have a therapeutic role in patients with AVJ tachycardia. PMID- 2764802 TI - Chloroquine abuse and heart block in Africans. AB - Twelve of 30 Africans with heart block gave a history of chronic chloroquine abuse. Eleven of these had evidence of chloroquine retinopathy whereas four of the 18 nonabusers had abnormal ophthalmologic findings, thought to be senile changes. The chronic chloroquine abusers were all male and were younger (mean age 51.6 years) than the non-abusers (mean age 61.2), nine of whom were female. Serum chloroquine levels were not helpful diagnostically. In the absence of other etiological factors, chronic chloroquine toxicity is important in the causation of heart block in Africans. PMID- 2764803 TI - Familial hypoparathyroidism due to an abnormal parathyroid hormone molecule. AB - The case of a 53-year-old man with familial hypoparathyroidism in the presence of circulating immunoreactive PTH is discussed. The patient responded to exogenous PTH by an increase in urinary cAMP excretion and by several post cyclase parameters including an increase in serum calcium and 1,25-dihydroxyvitamin D, an increase in urinary phosphate excretion and a decrease in urinary calcium. Immunoreactive PTH was detected in this patient's serum by three separate anti PTH antisera. This immunoreactive PTH behaved aberrantly with these antisera. Nonparallelism to the standard curve was seen in two radioimmunoassays and the material was detected by an antiserum which preferentially binds bovine PTH. No circulating PTH binding activity was detectable. Family studies confirmed the genetic nature of the abnormality. HPLC studies revealed the presence of an abnormally hydrophobic fraction containing immunoreactive PTH. We believe these findings constitute strong evidence for the presence of an abnormal PTH molecule with reduced biological activity resulting in hypoparathyroidism. PMID- 2764804 TI - Acute lymphoblastic leukemia in Chinese adults in Hong Kong. AB - Forty-four previously untreated Chinese adult patients with acute lymphoblastic leukemia (ALL) were treated with vincristine, adriamycin and prednisone with or without L-asparaginase. The clinical features and prognostic factors were similar to those reported in Caucasian series. Overall complete remission (CR) rate was 52%. Duration of first remission and overall median survival were nine and 12 months respectively. The addition of L-asparaginase did not improve CR rate or duration of remission and was associated with clotting dysfunction and other adverse reactions. Factors associated with a higher CR rate include age less than 40 years, blast count less than 10 x 10(9)/l and CALLA + phenotype at presentation. Sex, platelet count and FAB morphology did not affect CR rate. Bone marrow relapse occurred in 11 patients and was associated with short survival after relapse (median two months; mean two months; range 0.5-7 months). Central nervous system relapse occurred in four patients and was compatible with relatively long survival after relapse (median 13 months; mean 12 months; range 6 12 + months). The poor CR rate and short median survival in this study could not be adequately explained by an increase in risk factors and is likely to be due to what is currently regarded as suboptimal chemotherapy. PMID- 2764806 TI - Cutaneous vasculitis due to cyclophosphamide therapy for chronic lymphocytic leukemia. AB - A 55-year-old male with chronic lymphocytic leukemia developed a skin eruption after receiving oral cyclophosphamide. Subsequent rechallenge with parenteral cyclophosphamide led to recurrence of the skin lesions, which on biopsy were shown to be vasculitic in nature. PMID- 2764805 TI - Treatment of malignancy-associated hypercalcemia with norethisterone: a case report. AB - Hypercalcemia is a common cause of morbidity in cancer patients. The mechanism of malignancy-associated hypercalcemia includes increased bone resorption and decreased renal calcium clearance which also occur in primary hyperparathyroidism. Norethisterone can inhibit bone resorption and has recently been shown to be effective treatment for mild hyperparathyroidism in post menopausal women. We report the successful use for the first time of norethisterone (5 mg daily) in a case of malignancy-associated hypercalcemia after other standard agents failed. PMID- 2764807 TI - Hypokalemia with nephrocalcinosis: a variant of Bartter's syndrome. AB - A 28-year-old male presented with profound hypokalemia and was found to have a variant of Bartter's syndrome with nephrocalcinosis, hypercalciuria, normal distal fractional reabsorption of chloride and normal sodium delivery to the distal tubule. PMID- 2764808 TI - Malignant paraganglioma causing bilateral pleural effusions. AB - A male patient presented with dyspnea due to a large left pleural effusion, and pleural biopsy revealed a malignant paraganglioma. Raised urinary catecholamine levels confirmed a functioning tumour. Aggressive local spread occurred which did not respond to cytotoxic chemotherapy. The primary site of the tumour was most likely the aorticosympathetic chain. PMID- 2764809 TI - Sample size for clinical and biological research. PMID- 2764810 TI - Treatment of advanced squamous cell carcinoma of head and neck with cisplatin and continuous 96 hour infusion of 5-fluorouracil. PMID- 2764811 TI - Rhodococcus equi: an emerging opportunistic pathogen? AB - Human infection with Rhodococcus equi is apparently rare with most published reports describing the development of lung abscesses in immunocompromised hosts. Of only 18 cases of infection previously recorded, four have recently occurred in patients with the acquired immune deficiency syndrome (AIDS). In Australasia, R. equi has frequently been isolated from soil and infected farm animals yet no human infections have been reported thus far. Three cases of R. equi infection have occurred in New Zealand and, collectively, they cover a wider spectrum of disease than that previously recognised. The natural history of R. equi infections, their clinical features and treatment are described in the light of our recent experience. PMID- 2764812 TI - Paroxysmal cerebellar ataxia. AB - This report describes the clinical features of 13 cases of periodic, paroxysmal cerebellar ataxia. A family history suggestive of an autosomal dominant disorder was present in 10 cases, the first two reported Australian families involved with this disorder. Variation in the age of onset, frequency of attacks and the presence of distinct symptom complexes within one kindred confirm the heterogeneous nature of this disorder. CT head scans were performed on nine cases and were normal in eight. EEG findings were abnormal in six of nine performed. Treatment with acetazolamide resulted in abolition of paroxysms in nine of the 10 treated cases. In addition, two children had dramatic improvement in previously impaired gross and fine motor skills. PMID- 2764813 TI - The metabolism of C3 and C4 in patients with immune complexes and normal complement levels. AB - The metabolism of the complement proteins, C3 and C4 was examined in two groups of patients with a high incidence of detectable immune complexes but normal levels of complement components. The specific aim was to ascertain whether significant ongoing complement activation occurred in these patients. Eleven patients with rheumatoid arthritis (RA), 11 with infection and 11 control subjects were studied. Each received approximately 10 microCi 125l.C4 and 2.5 microCi 131l.C3 by intravenous injection. Analysis of turnover data showed that there was significant hypercatabolism of both C3 and C4 in the two study groups compared to controls. Plasma production of C4 was normal for both groups (despite the presence of C4 null alleles in six out of 11 of the RA group), while C3 production was significantly elevated in both RA and infection (p less than 0.01 and p less than 0.001 respectively). Patients with infection showed a significant increase in extravascular/intravascular distribution of both proteins. The data show that immune complex formation is associated with accelerated turnover of complement proteins, irrespective of co-existing tissue damage or changes in the serum concentration of complement components. The findings suggest that both activation of complement and maintenance or enhancement of protein synthesis are important for the efficient processing of immune complexes in vivo. PMID- 2764814 TI - Hemorrhagic myocardial infarction complicated by free wall-rupture: a case associated with unusual clinical features following intravenous thrombolytic therapy. AB - A patient is described who developed a systolic murmur soon after she was administered intravenous thrombolytic therapy for acute myocardial infarction. She died and autopsy revealed extensive hemorrhagic myocardial infarction and a free-wall rupture. A review of the literature suggests that this may be an unusual complication of thrombolytic therapy. PMID- 2764815 TI - An intracranial arteriovenous malformation and palatal myoclonus related to pseudoxanthoma elasticum. AB - Pseudoxanthoma elasticum is a rare hereditary disorder of elastic tissue with central nervous system manifestations due to occlusive vascular disease and aneurysm formation. Here we report the first recorded case of an intracranial arteriovenous malformation (AVM) in a patient with pseudoxanthoma elasticum. The AVM, which was located in the pons, also had an unusual manifestation, namely palatal myoclonus. PMID- 2764816 TI - Lymphomatoid granulomatosis presenting as a progressive cervical cord lesion. AB - A 50-year-old male presented with symptoms of a progressive spinal cord lesion over two and a half months investigations, including myelography, CT scan and magnetic resonance imaging (MRI), did not show cord compression although the MRI scan demonstrated thickening of the posterior cervical meninges. CSF examination revealed pleocytosis, increased total protein and cells suggestive of a lymphoproliferative disorder. Open lung biopsy of an asymptomatic left midzone mass was diagnostic of lymphomatoid granulomatosis. We believe this to be a case of lymphomatoid granulomatosis presenting as a progressive cervical myelopathy. PMID- 2764818 TI - Very high dose intravenous gammaglobulin in thrombocytopenia of pregnancy. AB - A 22-year-old woman with severe idiopathic thrombocytopenic purpura, complicating pregnancy, was unresponsive to high-dose corticosteroids and three separate infusions of high-dose intravenous immunoglobulin using the conventional schedule of 400 mg/kg/d for five days. A dramatic albeit transient, elevation of her platelet count followed a six day course of very high dose immunoglobulin (1000 mg/kg/d) thus allowing elective lower segment cesarean section to be performed without complications and with the delivery of a live, female infant. Two months later a further course of very high dose gammaglobulin was again effective in raising the patient's platelet count prior to elective splenectomy. No adverse reactions were seen to either infusion. PMID- 2764817 TI - Late-onset post-hemiplegic hemidystonia: CT and angiographic findings. AB - A 27-year-old woman is described who suffered an acute left hemiplegia at the age of three years and 20 years later she noted the onset of unilateral left limb dystonic movements. Her cranial CT scan showed an area of low density, consistent with longstanding infarction, in the right lentiform nucleus. Cerebral angiography demonstrated aneurysmal dilatation of the terminal portion of the right internal carotid artery, minor irregularity of the lenticulostriate branches of the right middle cerebral artery (suggestive of Moya Moya disease) and occlusion of the right anterior cerebral artery. The dystonic movements improved with levodopa therapy. Clinico-radiological correlation in this case supports recent evidence for a disruption of pathways between the caudate nucleus, lentiform nucleus and thalamus in the pathophysiology of hemidystonia. PMID- 2764819 TI - Non Campylobacter pylori spiral organisms in the gastric antrum. AB - Colonisation of the human gastric antrum with non Campylobacter pylori spiral organisms is described. A moderately severe histological gastritis was present despite the fact that these organisms, in contrast to C. pylori, were not closely associated with the epithelial cell surface. Although in vitro culture of the organisms was unsuccessful, in vivo culture was achieved in the mouse stomach. Further study of these spiral organisms should provide important clues to the role of bacteria in upper gastrointestinal disease. PMID- 2764820 TI - Australian immunology: another perspective. PMID- 2764821 TI - Giant cell arteritis and amyloidosis. PMID- 2764822 TI - Endocrine dysfunction in lymphomatoid granulomatosis. AB - Endocrine abnormalities in lymphomatoid granulomatosis are rare and have never been a major determinant of the clinical course. We describe three patients who illustrate that a wide range of endocrine dysfunction (hypoadrenalism, hypercalcemia, hypothyroidism, diabetes insipidus and hypogonadism) may be encountered in this disorder. Moreover, such endocrine manifestations may be the major feature at presentation, the treatment of which may significantly influence the subsequent clinical outcome. PMID- 2764823 TI - Suction lipectomy. PMID- 2764824 TI - What are the roles of a surgical mentor? PMID- 2764825 TI - Ascending aortic aneurysms associated with aortic valve regurgitation: St Vincent's Hospital's experience. AB - This report represents a retrospective analysis of the St Vincent's Hospital experience with combined replacement of the aortic valve and ascending aorta using a composite conduit and coronary artery reimplantation, in 44 patients, from 1 January 1981 to 30 June 1988. The mean age at operation was 48 years. Annuloaortic ectasia was the most common indication for operation in 24 patients (54%). There were three hospital deaths (7%). Forty-one patients were discharged from hospital and were followed up for a total of 1,106 patient months (mean = 26.5 months). There were three late deaths (7%). One death was due to a new dissection, one to a cerebrovascular accident and one to a drug overdose. So far, no patients have required reoperation. Of the 36 surviving patients available for follow-up, 28 are in New York Heart Association class I, seven patients are in class II and one in class III. Composite graft replacement reduces the risk of recurrent dissection and aneurysm formation and of periprosthetic leak. In the present experience, it is the method of choice in patients with degenerative lesions in the ascending aorta and aortic valve and particularly for annuloaortic ectasia. The exact surgical technique currently used has been the result of an evolution of different techniques. PMID- 2764826 TI - Acute dissection of the aorta: which test? AB - With the recent advent of computerized tomography (CT) and magnetic resonance imaging, the clinician is now faced with a variety of tests for the investigation of suspected acute aortic dissection. Forty-two patients were referred to the Department of Radiology over a 4.5-year period for the investigation of suspected dissection; 20 were diagnosed as having the condition. From the results of the evolving experience, it is believed that all patients suspected of having this disease should be studied with a three level dynamic CT in the first instance because the presence or absence of dissection and the type of dissection (type A or type B) can be determined with confidence. PMID- 2764827 TI - Suction lipectomy: review of 888 areas in 300 patients. PMID- 2764828 TI - Intrathoracic stapled anastomosis after oesophagectomy for cancer. AB - Fifty consecutive oesophagectomies for cancer are reported which were performed using a two-stage technique with an intrathoracic stapled anastomosis. The oesophagus was resected through a right thoracotomy. Continuity was restored using orthotopic stomach, mobilized through an abdominal incision and anastomosed to the oesophagus at the apex of the thorax. No deaths occurred within 30 days, but two patients died without leaving hospital. Routine contrast study revealed no anastomotic leaks. Major complications were: chylothorax (one), transient bilateral recurrent laryngeal nerve palsy (one), anastomotic bleed (one), respiratory failure (one) and brain abscess (one). Four upper resection margins contained tumour (all in middle third tumours). With this technique, a reliable anastomosis can be made high in the chest. The amount of oesophagus removed is comparable with that obtained with the 'three-stage' or transhiatal procedures. The problem of occult submucosal spread in oesophageal tumours remains. PMID- 2764829 TI - Regeneration and phagocytic function of devascularized spleens. AB - The phagocytic function of normal splenic tissue and of regenerated tissue following splenic artery ligation was investigated in rats using radiolabelled stannous fluoride colloid. Colloidal carbon was used to determine the histological location of phagocytosis within the spleen. Six months after ligation, the median weight of the devascularized spleens was 25% of that of spleens in control rats. Technetium stannous colloid clearance by devascularized spleens was reduced to 10% of normal and 25% when corrected for spleen weight. The colloidal carbon injected intravenously was observed primarily in the marginal zone in both normal and devascularized spleens. Histologically, devascularized spleens contained significantly less white pulp and marginal zone. The splenic tissue which regenerates following ligation does not have the phagocytic ability of normal splenic tissue. This may be due to the decreased regrowth of the lymphoid compartments of the spleen. PMID- 2764830 TI - Pre-operative albendazole therapy for recurrent hydatid disease. AB - Two patients with recurrent hydatid disease had a 1-month course of albendazole before surgery. In one case with a thick-walled host capsule, the scolicidal effect was incomplete, but, in the second case, in which thin-walled cysts were present, albendazole entered the cyst and was completely effective as a scolicidal agent. For thick-walled cysts, it may be necessary to use albendazole for more than 1 month pre-operatively in order to achieve a scolicidal effect. PMID- 2764831 TI - Primary choledochal echinococcosis. AB - Hydatid cysts involving organs other than liver and lungs are rather uncommon. A case of primary hydatid cyst of the common bile duct producing obstructive jaundice due to extrinsic compression of the bile duct is reported. PMID- 2764832 TI - Dirofilariasis in Australia: unusual cause of a breast lump. AB - A breast lump due to infestation with Dirofilaria repens is reported in a Sri Lankan student residing in Brisbane. Although human infestation with this parasite is not uncommon in certain Asian countries, this is the first report of such a lesion occurring in Australia. PMID- 2764833 TI - Correction of developmental and intelligence test scores for premature birth. AB - When using tests of infant development and intelligence in children born prematurely, the subject's age is commonly corrected for the degree of prematurity. However, there is disagreement: first, on whether this correction should ever be applied, and second, at what age to discontinue the adjustment. In a theoretical model, the difference between corrected and uncorrected scores in early infancy was massive and the difference remained clinically important until the age of 8.5 years in children who were born extremely prematurely. The clinical implications of using corrected or uncorrected scores were then evaluated in 174 very low birthweight children without severe sensorineural disabilities and with paired Bayley Mental Development Index (MDI) and Wechsler Preschool and Primary Scales of Intelligence (WPPSI) full scale scores. Failure to correct for prematurity reduced the mean MDI by 12.1 points but reduced the mean WPPSI by only 4.1 points. The disparity between individual MDI and WPPSI scores increased significantly with decreasing gestational age if uncorrected scores were used (P = 0.015) but not if scores were corrected. Using corrected scores, the MDI correctly predicted the WPPSI category in 86.1% of children (P less than 0.001) but in only 54.6% using uncorrected scores (the difference was not significant). It is suggested that a practical solution to the dilemma is to correct test scores for prematurity in the age range 2-8.5 years recognizing that only in extremely immature infants will uncorrected scores be substantially lower than corrected ones at a later age. PMID- 2764834 TI - A longitudinal study of the interactive effects of perinatal complications and early family adversity on cognitive ability. AB - The effects of high, medium and low levels of perinatal complications and family adversity on intelligence quotient (IQ) scores were examined in a large sample of Dunedin children tested every second year in the age group 3-13 years. The aim was to test the hypothesis that favourable environmental circumstances attenuate the effects of perinatal complications on later cognitive ability. The results did not support this hypothesis but rather suggested that perinatal complications and family adversity have independent adverse effects on the development of children's cognitive ability. PMID- 2764836 TI - Thirty-six consecutive under 5 year old domestic swimming pool drownings. AB - Data were collected by the local nurse on each of the 36 drownings in domestic swimming pools of under 5 year olds that occurred between 1 September 1982 and 31 December 1986. The likely effect of New Zealand's 1987, Fencing of Swimming Pools Act in preventing these drowings, had it been in effect, is considered. It is concluded that at least 29 (80%) of the 36 drownings would have been prevented. Examination of the circumstances of the drownings leads to the conclusion that certain alternatives to the fencing law that have been proposed, such as teaching water skills to infants, fencing property boundaries, and use of pool covers, are unlikely to have been as effective. PMID- 2764835 TI - Growth and catch-up growth of Australian infants of low birthweight. AB - The growth of 90 infants of low birthweight (1500-2499 g) has been studied longitudinally from birth to 2 years of age. Seventy-five per cent of those infants were of birthweight that was appropriate-for-gestational age (AGA) and of mean gestational age 33.6 weeks (boys) and 34.5 weeks (girls). Twenty-four per cent were small-for-gestational age (SGA) and of mean gestational age 39.4 weeks (boys) and 38.5 weeks (girls). The data showed that, when gestational age was considered, the growth of AGA infants was similar to that of full-term infants of normal birthweight; SGA infants displayed accelerated growth ('catch-up'), particularly in the first months of life with upward percentile crossing from below the 5th toward the 50th. These results provide further evidence of the need to consider gestational age and whether AGA or SGA when assessing the growth of low birthweight infants. PMID- 2764837 TI - Experience with neonatal screening for cystic fibrosis in New Zealand using measurement of immunoreactive trypsinogen. AB - Neonatal cystic fibrosis (CF) screening has been performed in New Zealand for a total of 7 years. This study reports the experience with this procedure in New Zealand over a 4 year period and compares it with 2 years when diagnoses of CF were suggested by clinical features only. A total of 72 infants were confirmed as having CF during 4 years of screening. Twenty-eight infants were found to have CF during 2 years in which screening was not performed. There were 29 false positive diagnoses during the screening years and six false negative diagnoses. Three of the false negative diagnoses occurred because of laboratory error, but three occurred because either the first or second measurement of immunoreactive trypsinogen (IRT) was normal. Faecal chymotrypsin was measured in samples from 434 infants at the time of the second IRT and assisted with the diagnosis for one infant which might otherwise have been missed. Only 42.5% of infants were asymptomatic at the time of the confirmatory sweat test. Significant morbidity and mortality was associated with meconium ileus which occurred in 24% of infants with CF. Improved ascertainment of cases of CF has occurred since screening began. Further follow-up is required to determine other benefits of newborn screening. PMID- 2764838 TI - Prospective study of nosocomial rotavirus infection in a paediatric hospital. AB - Hospital-acquired enteric infections, particularly those due to rotavirus, were investigated by studying 220 patients under 3 years of age who were admitted without gastroenteritis to two paediatric general medical wards during a 10 month period. Faecal specimens were collected within 48 h of admission and then daily until the patients were discharged. Samples were also collected after discharge if patients developed enteric symptoms within 2 days of discharge. Fourteen per cent (31 of 220) of patients acquired rotavirus infections while in hospital, 23% (seven of 30) excreted rotavirus only after discharge; 29% of patients infected with rotavirus were asymptomatic (nine of 31). Acquisition of rotavirus infection was most prevalent during the months May-August, with a prevalence of 34% (12 of 35) in May. Hospitalization was prolonged in those patients who acquired rotavirus (11.1 days compared with 8.0 days, P less than 0.05). This study highlights the importance of rotavirus as a cause of hospital cross-infection, particularly in the very young patient, and emphasizes the need for further assessment of factors involved in its acquisition. In order to determine correctly the incidence of hospital-acquired illness, it is essential to follow patients after discharge from hospital. This study reinforces the importance of developing preventive measures in order to reduce the frequency of this illness. PMID- 2764839 TI - Prenatal diagnosis of homozygous alpha 0-thalassaemia by direct DNA analysis of chorionic villi in Singapore. AB - First-trimester prenatal diagnosis by DNA analysis was carried out for seven pregnancies at risk for homozygous alpha 0-thalassaemia. Transabdominal placental biopsy was carried out at 10-12 weeks' gestation. The presence of alpha-globin genes in the fetal DNA was determined by restriction endonuclease mapping and hybridization with cloned alpha-globin probe. Homozygous alpha 0-thalassaemia was detected in two fetuses and the pregnancies were interrupted. Alpha 0 thalassaemia in both cases was confirmed by electrophoresis of the umbilical cord blood where only haemoglobin Bart's was detected. The remaining five fetuses were diagnosed as normal or as possessing alpha-thalassaemia-1 trait and the pregnancies are being carried to term. The use of DNA analysis in prenatal diagnosis of fetuses at risk for homozygous alpha 0-thalassaemia enables detection of the haemoglobinopathy at 10 weeks' gestation. PMID- 2764840 TI - Distribution of plasma vitamin E levels in supplemented very low birthweight infants. AB - The distribution of plasma Vitamin E (VE) was determined in 25 very low birthweight (VLBW) infants who were supplemented with 100 mg/kg per day of alpha tocopherol acetate, given intragastrically. Their mean birthweight was 917 g and mean gestational age was 28 weeks. Mean plasma VE levels after 1 and 6 weeks' supplementation were 2.7 mg/dL (s.e.m. = 1.0) and 6.4 mg/dL (s.e.m. = 1.4), respectively (the difference was not significant). There was wide variability in plasma VE levels in these infants despite being on an identical dose of tocopherol. Plasma VE was less than 0.5 mg/dL in 12% of samples, 0.5-3.0 mg/dL in 32%, 3.1-5.0 mg/dL in 18%, and 5.1-20 mg/dL in 38%. Fifteen of the 25 infants had at least one level in the range which has been associated with an increased incidence of septicaemia and necrotizing enterocolitis (greater than 5.0 mg/dL). These data suggest that if a policy of VE supplementation for VLBW infants is chosen, monitoring of plasma VE levels appears necessary so that the dosage can be adjusted in order to maintain plasma VE within the optimal range. This study's dosage regimen of supplementing infants with 100 mg/kg per day of VE was associated with a high incidence of elevated plasma VE levels and it is concluded that it is not advisable to use such large doses of VE in the premature newborn. PMID- 2764841 TI - Hyperinsulinism in infancy. AB - Five infants with persistent hypoglycaemia due to hyperinsulinism were reported. Provocative tests for insulin release were unhelpful. Diazoxide was useful in the treatment of three patients but many side-effects were observed. These included petechial rash, hypertrichosis, acute renal failure, fluid retention and cardiac failure. Two patients underwent spontaneous remission. Three patients had nesidioblastosis, two of whom were subjected to 95% pancreatectomy. Postoperatively, recurrence of hypoglycaemia was due to hyperinsulinism in one patient and to presumed glucagon deficiency in the other. Phenytoin effectively corrected the hypoglycaemia in the patient who had postoperative hyperinsulinism. It is recommended that medical therapy with diazoxide (10-15 mg/kg per day) together with a diuretic be commenced once hyperinsulinism is diagnosed. Subtotal pancreatectomy should be performed early in these patients if hypoglycaemia cannot be controlled with medical therapy or if side-effects of treatment are documented. PMID- 2764842 TI - Traumatic rupture of the posterior urethra. PMID- 2764843 TI - Visual display lowers detection threshold of angular, but not linear, whole-body motion stimuli. AB - The influence of a visual display, fixed relative to the subject, on thresholds for detection (at 75% correct) of discrete Y-axis linear movements and of discrete Z-axis angular movements, was determined in a group of 12 subjects. Both the linear and the angular, whole-body, motion stimuli had a cosine bell velocity trajectory with a duration of 2.6 s. Thresholds for the detection of the linear motion stimuli in darkness were not significantly different from those obtained when either a simple LED display or an instrument dial were illuminated; the mean threshold was 0.039 m.s-2. None of the subjects reported apparent movement of the visual display. In contrast, the presence of either visual display lowered angular motion thresholds on average by a factor of 2.7 from that obtained in darkness (1.61 degrees.s-1). All subjects reported apparent movement of the visual display, an oculogyral illusion, at stimulus intensities close to the dark threshold. These findings imply that otolithic afferents, unlike those from the semicircular canals, do not interact with neural centres mediating visual localization. PMID- 2764844 TI - Human intravascular immunoglobulin responses to exercise-heat and hypohydration. AB - Several investigators have suggested that prolonged exercise and hypohydration alter the intravascular mass of immunoglobulins. Those studies, however, have methodological concerns which make generalizations from their data very tenuous. This study examined the effects of prolonged moderate intensity exercise in the heat and hypohydration on changes in the intravascular mass of immunoglobulins. Five heat-acclimated males attempted two Heat Stress Tests (HSTs). One HST was completed when subjects were euhydrated and the other HST when subjects were hypohydrated (-5% from base line body weight). The HSTs consisted of 30 min of rest in a 20 degrees C antechamber, followed by a 120-min exposure (2 repeats of 15 min rest and 45 min walking) in a hot (35 degrees C, 45% rh) environment. The following observations were made concerning immunoglobulin responses to hypohydration and exercise-heat stress: a) the changes in concentrations (mg.dl 1) of the measured immunoglobulins were often a reflection of changes in the plasma volume; b) hypohydration increased the intravascular mass (g) of the complement enzyme C3 during resting conditions, but did not alter the intravascular mass of IgG, IgA, and IgM, and c) prolonged treadmill exercise in the heat, when either euhydrated or hypohydrated, did not alter the intravascular mass of IgG, IgA, IgM, and C3. These data indicate that the intravascular mass of immunoglobulins does not change during prolonged moderate intensity exercise in the heat, and that hypohydration results in a translocation of C3 to the intravascular space. In addition, these data indicate that immunoglobulins do not provide a stress index for hypohydration. PMID- 2764845 TI - Low temperature worsens mammalian oxygen toxicity. AB - Oxygen toxicity was assessed in mice exposed to 5 ATA of oxygen. Central nervous system toxicity was measured as the latent period before convulsions, and lung damage estimated by wet and dry weight measurements. Our results confirmed previous findings that hyperbaric oxygen induces hypothermia in animals, and this effect is profound in mice exposed to 5 ATA of oxygen at ambient temperatures of 15 degrees C and 5 degrees C. However, even marked hypothermia had very little effect on the latent times to convulsions in mice. Unexpectedly, the combination of hypothermia and hyperbaric oxygen produced much more severe lung damage than either treatment alone, with a 2.7-fold increase in weight in the 5 degrees C group (average rectal temperature of 16.1 degrees C). These results indicate that hyperoxic-induced hypothermia cannot be considered a protective mechanism against oxygen toxicity and indeed hypothermia can markedly potentiate hyperbaric oxygen toxicity. PMID- 2764846 TI - Human mononuclear cell function after 4 degrees C storage during 1-G and microgravity conditions of spaceflight. AB - Future space missions of long duration may require that autologous leukocytes be stored in flight for infusion to restore normal immune competence in crewmembers. Peripheral blood mononuclear cells (PBMNCs), as leukocyte concentrates in autologous plasma and 2% dextrose, were stored in the microgravity conditions provided by the U.S. Space Shuttle Columbia (Mission 61-C). Activity of PBMNC after space flight was compared with that from a series of preflight ground control experiments, which demonstrated in culture a progressive daily loss in mitogen-stimulated protein synthesis at 24 h and thymidine uptake at 72 h after storage for 7 d at 4 degrees C. Post-storage viabilities were at least 90% as determined by trypan dye exclusion. A progressive reduction in the percentage of PBMNC expressing cell-surface phenotype markers, which was similar for monocytes, B cells, and T-cell subsets, also occurred after storage. The ability of PBMNC, stored for 8 d in Columbia's middeck, to become activated and proliferate in vitro was similar to that of cells that remained in identical flight lockers on the ground as 1-G controls, thus indicating that PBMNCs were not adversely affected by storage under microgravity conditions. PMID- 2764847 TI - A study of the effects of prolonged simulated microgravity on the musculature of the lower extremities in man: an introduction. AB - The reduction of muscle strength and size of the lower extremities has been observed following spaceflight. However, there are virtually no data from direct measurements of muscle tissue which provide a means of understanding the physiological alterations associated with the impaired function. We therefore conducted a study in which eight healthy men underwent 30 days of continuous exposure to 6 degrees headdown tilt as an analogue for space microgravity. We used percutaneous muscle biopsy, computed tomography, anthropometry, and in vivo muscle strength measures under controlled experimental conditions to provide new data about mechanical, structural, and metabolic characteristics of skeletal muscle in man following exposure to microgravity. PMID- 2764849 TI - Alterations of the in vivo torque-velocity relationship of human skeletal muscle following 30 days exposure to simulated microgravity. AB - The purpose of this study was to examine the effect of 30 d of 6 degrees headdown bedrest (BR) on the in vivo strength of skeletal muscle. Peak angle specific (0.78 rad below horizontal) torque of the knee extensor (KE) and flexor (KF) muscle groups of both limbs was assessed during unilateral efforts at four speeds (0.52, 1.74, 2.97 and 4.19 rad.s-1) during concentric and at three speeds (0.52, 1.74 and 2.97 rad.s-1) during eccentric actions. The average decrease (p less than 0.05) of peak angle specific torque directly post-BR for the KE across speeds of concentric and eccentric actions was about 19% (n = 7). Recovery for 30 d following BR markedly improved strength to about 92% (p greater than 0.05) of "normal." Strength of the KF was not altered (p greater than 0.05) by BR (about a 6% decrease independent of speed and type of muscle action). Changes of strength were not affected by the type or speed of muscle action. The results indicate that strength of extensor more than of flexor muscle groups of the lower limb is decreased by 30 d of bedrest and that this response does not alter the nature of the in vivo torque-velocity relation. PMID- 2764848 TI - Changes in volume, muscle compartment, and compliance of the lower extremities in man following 30 days of exposure to simulated microgravity. AB - The purpose of these experiments was to test the hypothesis that reduced size of the leg muscle compartment following exposure to long-duration microgravity would be associated with increased leg compliance. Eight men, 31-45 years of age, were measured for vascular compliance of the calf and serial circumferences of the thigh and calf before, during and after 30 d of continuous 6 degrees head-down bedrest. Cross-sectional areas (CSA) of muscle, fat, and bone compartments in the thigh and calf were determined pre- and post-bedrest by computed tomography. Calculated leg volumes decreased (p less than 0.05) in the calf by 9.9% and in the thigh by 4.5% from pre- to post-bedrest. Muscle compartment CSA also decreased (p less than 0.05) in both calf (-4.8%) and thigh (-8.1%); leg compliance (vol%/mm Hg x 100) increased (p less than 0.05) from 3.9 +/- 0.7 to 4.9 +/- 0.5. Calf compliance measured before and after bedrest was inversely related to calf muscle compartment CSA (r = -0.61, p less than 0.05) and the percent decrease in calf muscle compartment CSA from pre- to post-bedrest was inversely correlated with an increase in calf compliance (r = -0.72, p less than 0.05). Increased leg compliance following long-duration spaceflight is associated with reduced size of the leg muscle compartment. PMID- 2764850 TI - Structural and metabolic characteristics of human skeletal muscle following 30 days of simulated microgravity. AB - Percutaneous needle biopsy samples were obtained from the vastus lateralis and soleus muscles before and after 30 d of 6 degree head-down bedrest to determine the influence of this model of simulated microgravity on human skeletal muscle. Fiber atrophy was evident in both muscles with both fast-twitch and slow-twitch fiber cross-sectional areas decreasing. Predominant atrophy of slow-twitch fibers was not evident. The soleus had a greater proportion of slow-twitch fibers than the vastus lateralis before bedrest. Neither muscle showed a change in fiber type percentage with bedrest. Phosphofructokinase and lactate dehydrogenase activities in the soleus and vastus lateralis muscles were similar before and after bedrest. The activities of beta-hydroxyacyl-CoA dehydrogenase and citrate synthase, however, were reduced during bedrest with these responses being somewhat greater in the soleus. While the ultrastructure of most of the fibers of the soleus and vastus lateralis appeared normal after bedrest, evidence of remodeling was present in both muscles. The proliferation of core/targetoid lesions, honeycomb networks, regenerating satellite cells, necrotic foci and myofibrillar disorganization after bedrest indicates that force development is an important factor in determining the organization of the fine structure of muscle. The results indicate that short-duration exposure to simulated microgravity decreases fiber size and the capacity for aerobic energy supply of human skeletal muscle. Moreover, disorganization of the contractile machinery occurs. Thus, it appears that bedrest alters the "normal" load-time constraints imposed on skeletal muscle sufficiently to change its inherent structural and metabolic characteristics. PMID- 2764851 TI - Characteristics and preliminary observations of the influence of electromyostimulation on the size and function of human skeletal muscle during 30 days of simulated microgravity. AB - During 30 days (d) of bedrest, the practicality of using electromyostimulation (EMS) as a deterrent to atrophy and strength loss of lower limb musculature was examined. An EMS system was developed that provided variable but quantifiable levels of EMS, and measured torque. The dominant leg of three male subjects was stimulated twice daily in a 3-d on/1-d off cycle during bedrest. The non-dominant leg of each subject acted as a control. A stimulator, using a 0.3 ms monophasic 60 Hz pulse waveform, activated muscle tissue for 4 s. The output waveform from the stimulator was sequenced to the knee extensors (KE), knee flexors (KF), ankle extensors (AE), and ankle flexors (AF), and caused three isometric contractions of each muscle group per minute. Subject tolerance determined EMS intensity. Each muscle group received four 5-min bouts of EMS each session with a 10-min rest between bouts. EMS and torque levels for each muscle action were recorded directly on a computer. Overall average EMS intensity was 197, 197, 195, and 188 mA for the KE, KF, AF, and AE, respectively. Overall average torque development for these muscle groups was 70, 16, 12, and 27 Nm, respectively. EMS intensity doubled during the study, and average torque increased 2.5 times. Average maximum torque throughout a session reached 54% of maximal voluntary for the KE and 29% for the KF. Reductions in leg volume, muscle compartment size, cross-sectional area of slow and fast-twitch fibers, strength, and aerobic enzyme activities, and increased leg compliance were attenuated in the legs which received EMS during bedrest.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2764853 TI - Soviet space flight: the human element. AB - Building on past experience and knowledge, the Soviet manned space flight effort has become broad, comprehensive, and forward-looking. Their long-running space station program has provided the capabilities to investigate long-term effects of microgravity on human physiology and behavior, and test various countermeasures against microgravity-induced physiological deconditioning. Since the beginning of Soviet manned space flight, the biomedical training and preparation of cosmonauts has evolved from a process that increased human tolerance to space flight factors, to a system of interrelated measures to prepare cosmonauts physically and psychologically to live and work in space. Currently, the Soviet Union is constructing a multimodular space station, the Mir. With the emergence of dedicated laboratory modules, the Soviets have begun the transition from small scale experimental research to large-scale production activities and specialized scientific work in space. In the future, additional laboratory modules will be added, including one dedicated to biomedical research, called the "Medilab." The longest manned space flight to date (326 d) has been completed by the Soviets. The biomedical effects of previous long-duration flights, and perhaps those of still greater length, may contribute important insight into the possibility of extended missions beyond Earth, such as a voyage to Mars. PMID- 2764852 TI - Effects of propranolol on acute mountain sickness (AMS) and well-being at 4,300 meters of altitude. AB - A number of physiological responses and adjustments occur at high altitude to compensate for hypoxia. We hypothesized that interference with one component of the normal compensatory process, the sympathetic nervous system, would hinder altitude acclimatization and thereby exacerbate acute mountain sickness (AMS) and compromise well-being. Twelve young males (21.2 +/- 0.4 years) received either 80 mg propranolol (PRO; n = 6) or placebo (PLA; n = 6), t.i.d. at sea level (SL) and during the first 15 d of a 19-d residence at 4,300 m (HA). Individuals were randomly assigned to each group. The Environmental Symptoms Questionnaire (ESQ) was administered at SL and twice daily (AM and PM) during the entire altitude exposure in order to assess AMS symptoms and subjective feelings of well-being. Supine heart rate (HR) was determined at rest twice at SL and four times at HA. HR in the PLA group increased 40% over SL values (57 +/- 3 to 80 +/- 4 beats/min) by day 7 at HA (p less than 0.01). HR in the PRO group did not increase above SL values during medication at HA. By 4 d after the medication administration was terminated, HR in the PRO group had increased and did not differ from the PLA group. Throughout the entire altitude exposure, ESQ scores for the PRO group were lower than or similar to the PLA group. Furthermore, cessation of PRO treatment did not result in a change in well-being. These findings suggested that interference with the normal acclimatization process by beta-adrenergic blockade did not exacerbate AMS or reduce feelings of well-being. PMID- 2764855 TI - Deploying and testing an expandable surgical chamber in microgravity. PMID- 2764854 TI - Cold weather or cold immersion induced reduction of circulation within the distal extremities. PMID- 2764856 TI - High altitude can accurately be simulated by using altered oxygen concentrations. PMID- 2764857 TI - Change in cardiac myocyte size distribution in aortic-constricted neonatal rats. AB - Regional changes in cardiac myocyte size and population distribution were examined in Sprague Dawley rats receiving an abdominal aortic constriction at five days of age. At specific time intervals post-constriction, hearts were recovered from constricted animals and weight-matched controls and isolated myocytes were obtained from right and left ventricles using retrograde coronary perfusion with collagenase. Cell volume and cardiac myocyte population distribution curves were determined using a Coulter Channelyzer system. Cell length was measured directly using a Bioquant Image Analysis system. Myocyte cross-sectional area was calculated from cell volume/length. By three months of age, heart weight and heart weight-body weight ratio in constricted animals had increased by approximately 115% (p less than 0.001) in females and 85% (p less than 0.001) in males compared to controls. Between 15 and 90 days of age, the growth response, as indicated by increased cell volume, was approximately 4x greater in constricted females and 2.5x greater in constricted males compared to corresponding controls. This increase was manifested by a shift in the mean size of the myocyte population to the right and a substantial widening of the distribution. Most of the enlargement was due to increased cross-sectional area, with only a moderate contribution from increased cell length. Significant increases in size were seen in both left and right ventricles. By three months of age, a significant interaction was apparent between aortic constriction and sex. The capacity for hypertrophy was greater in the smaller myocytes in female rats of similar age compared to males. The final degree of hypertrophy was similar for male and female rats, possibly indicating a critical upper limit in cell size for cardiac myocytes. PMID- 2764858 TI - Morphological and smooth muscle cell phenotypic changes in fetal rabbit aorta during early development. AB - Previous studies from our laboratory noted a) high aortic cholesterol esterification activity in the fetal rabbit, and b) increased susceptibility of fetal aortic explants to smooth muscle cell proliferation in culture, two features commonly associated with atherogenesis. This prompted us to examine in detail morphological development of fetal aorta and its relationship to fetal plasma cholesterol levels. Our studies made three important observations: 1) plasma cholesterol levels were high in early fetus which decreased at term; 2) in early fetus aortic endothelial cells appear to protrude into the lumen, whereas at birth the cells become flat, forming a continuous endothelium sheet; 3) in early fetus, smooth muscle cells exist predominantly in synthetic phenotype, while at birth the cells appear contractile. Despite the presence of synthetic smooth muscle cells and hypercholesterolemia in early fetal life, no accumulation of lipids was evident under transmission electron microscopy. PMID- 2764859 TI - Response of cultured endothelial cells to mechanical stimulation. AB - Endothelial cells covering the luminal surface of vessels are exposed to at least two different mechanical forces: 1) fluid shear stress produced by the circulation of blood, and 2) periodic stretching and relaxing as a result of the diameter oscillations caused by blood pulsation. In this study we present an apparatus which was constructed to imitate the volume pulse with its typical incisura of the abdominal aorta. Using this apparatus, we exposed cultured endothelial cells to continuously produced cyclic and directional stretching and relaxation for three days. In all experiments cells remained attached and viable when subjected to mechanical stimulation. The vast majority of endothelial cells which underwent mechanical stimulation became elongated and oriented with their longer axis perpendicular to the direction of stretching (angle of cell orientation: alpha = 88.7 degrees +/- 12 degrees; means +/- SD), whereas cells on unstretched membranes had a cobblestone-like appearance and remained in random orientation. In the stretched cells, the factor of elongation was f = 6.8 +/- 1.3; means +/- SD; unstretched cells which exhibited a polygonal shape had a factor of elongation of f = 1.8 +/- 0.8; means +/- SD. In addition, the behavior of cytoskeletal components such as microfilaments and microtubules was examined in the process of cell orientation as both are actively involved in alterations of cell shape and cell migration. Actin filaments were oriented as both are actively involved in alterations of cell shape and cell migration. Actin filaments were oriented in parallel alignment perpendicular to the stretch direction (angle of actin filament orientation: beta = 90.4 degrees +/- 9 degrees; means +/- SD). A distinct orientation of microtubules was not observed, although a noticeable number of microtubules was observed to be in parallel alignment. Furthermore, microtubules of cells which underwent mechanical stimulation exhibited a pronounced asymmetric intracellular distribution with strongly fluorescent cytoplasmic areas in which microtubules seemed to be accumulated. The results indicate that endothelial cell elongation and orientation in vitro can be induced by periodic stretching and relaxation comparable to the periodic oscillations of the vessel wall due to blood pulsation in vivo. PMID- 2764860 TI - Differential effect of nicotinic acid derivatives on smooth muscle and endothelial cell proliferation. AB - The pathogenesis of atherosclerosis is a multifactorial process. A possible anti atherosclerotic drug should therefore interfere with different targets that are important during the development of an atherosclerotic lesion. Two of the early events are the activated migration and proliferation of arterial smooth muscle cells. Here we investigated in several in vivo and in vitro experiments the effect of two nicotinic acid derivatives L44 and L44-0, on smooth muscle cell migration and proliferation. Balloon catheter de-endothelialization was used as an animal model for intimal lesion formation. Migration was subsequently quantified in vitro using the explant outgrowth technique. Subcultured smooth muscle and endothelial cells were used to test the effect of the drugs on proliferation. Time-lapse video microscopy was applied to differentiate between smooth muscle cell migration and proliferation on the level of individual cells. We showed that L44 and L44-0 are very effective in decreasing smooth muscle cell proliferation and migration. Endothelial cell proliferation, important to re establish endothelial integrity was, however, not affected. PMID- 2764862 TI - Programming for generalization to high and low risk parenting situations in families with oppositional developmentally disabled preschoolers. AB - This study examined the generalization effects of a training program for parents of oppositional, mildly developmentally disabled preschool children. Specifically, the study sought to determine the possible differential generalization effects of treatment to high and low risk parenting settings. Treatment comprised child management and planned activities training procedures specifically designed to enhance generalization effects. A multiple baseline design across subjects that incorporated a non-treatment control subject was employed. Dependent measures included deviant child behavior, accuracy of parent implementation of treatment procedures, and specific measures of aversive and non aversive parent behaviors. Three of the treated families showed marked reductions in levels of deviant behavior, as well as increases in parental implementation of treatment procedures in both the training setting and the low risk generalization setting. Two of these three families showed comparable improvements in the high risk setting. The control subject showed little improvement in either generalization setting. It was concluded that the treatment program was effective in producing generalization effects in parent training. PMID- 2764861 TI - Myosin P-light chain isoenzymes in the human heart: evidence for diphosphorylation of the atrial P-LC form. AB - We studied myosin light chains (LC) of human atrium and ventricle of normal and diseased individuals by a high-resolution 2-dimensional polyacrylamide gel electrophoresis (2D-PAGE) technique. Atrial LCs (ALC-1, ALC-2 (= P-LC)) revealed both higher molecular weights and lower isoelectric points (IEP) than their ventricular counterparts (VLC-1, VLC-2 (= P-LC)). Different P-LC forms with their distinct myosin isoenzymes have been designated as P-LC-polymorphism and myosin P LC isoenzymes, respectively. In the dephosphorylated state two VLC-2 forms (VLC-2 and VLC-2*) with the same MW and different IEP, but only one ALC-2 form, were found. In the partially phosphorylated state ALC-2 appeared to be single- and double-phosphorylated (three spots in the 2D-PAGE), whereas the two VLC-2 forms appeared to be single-phosphorylated each (four spots in the 2D-PAGE). Phosphoryl transfer from ATP to the P-LC forms was studied using skinned fibers incubated with MLCK (myosin light chain kinase) and (gamma-32P)ATP. Ventricular myosin P-LC isoenzyme pattern was usually the same in normal and diseased patients: the VLC-2 to VLC-2* ratio was approx. 70/30, but in one patient with valvular heart disease (VHD) the relation was 55/45 (shift to the VLC-2* form). In hypertrophied atria of VHD patients a shift of the myosin P-LC isoenzyme pattern to the VLC-2* form occurred, too. PMID- 2764863 TI - Beginnings of reading. The effects of the preschool reading center. AB - This study examined the effects of the daily Reading Center in a preschool classroom on 16 children over a school year. Objective variables, related to the Center and derived from the interface between the concepts of developmentally appropriate practice and emergent literacy, were measured. The Center was found to be developmentally appropriate since it was child-centered in terms of the interaction with children, adults and materials, voluntary participation, child selected words and individualized instruction based on a pretest for 20 beginning reading skills (i.e., emergent literacy). Concurrently, the Center had features of a teacher-centered activity with the implementation of a rather specific instructional procedure. The experimental children showed marked gains in their acquisition of the 20 beginning reading skills while their matched controls, in other classrooms, who did not have the Reading Center experience, showed a slight increase. The advantages are discussed of a detailed behavior analysis on related independent, dependent, and accompanying measures for a thorough understanding of the results. PMID- 2764864 TI - An uncontrolled evaluation of inpatient and outpatient cognitive-behavior therapy for bulimia nervosa. AB - Inpatient (n = 27) and outpatient (n = 22) cognitive-behavior therapy programs for bulimia nervosa were evaluated in an uncontrolled experiment. Both treatment conditions included exposure with response prevention and cognitive restructuring. Inpatient treatment had a mean length of stay of 5 weeks. Outpatient treatment lasted 15 weeks. Both groups were followed after the end of treatment. The results showed that both programs were effective in reducing problems associated with bulimia nervosa. The inpatient program led to very rapid progress, whereas the outpatient program led to more gradual improvement. There was, however, a trend toward relapse for inpatients. Other psychological disturbances, (e.g., depression) were improved after inpatient, but not outpatient, treatment. These data were discussed in terms of their implications for treatment planning for cases of bulimia nervosa. PMID- 2764865 TI - Relative efficacy of intensive and spaced behavioral treatment of stuttering. AB - Twenty adult and adolescent stutterers were randomly assigned to two treatment formats consisting of either 16 two-hour sessions of fluency training administered within a concentrated period of four consecutive days (intensive treatment), or two two-hour sessions per week for eight weeks (spaced treatment). Frequency of stuttering and rate of speaking were repeatedly assessed from speech samples obtained in six different clinic and extra-clinic speech settings. The efficiency of treatment, subject compliance, and communication "attitudes" were also measured. Fluency training produced significant reductions in stuttering frequency, and significant improvements in speaking rate and communication attitudes for both treatment formats. Both formats were found equivalent on all measures. In addition, generalization of treatment effects was observed in all settings. However, maintenance of generalization effects was uneven across settings, suggesting the possible need for differential levels of training for different speaking situations. PMID- 2764866 TI - [Intra-articular pressure in the large joints--a biomechanical variable pressure pump system]. AB - Because of the anatomy and biomechanics intraarticular pressure modifications are caused by loading and movement of a joint. These continuous pressure alterations are examined in the hip joint of cadavers and in the shoulder-joint of cadavers and volunteers. The clinical importance is shown. The hereto hardly know changes of intraaticular pressure cause a strong synoviamovement and serve the provisioning of the joint-cartilage with the help of the changing, pressure pump system. PMID- 2764867 TI - [Behavior of human rib and patella cartilage]. AB - Report is based on compression- and relaxation experiments with 90 rib- and 30 patella cartilage samples of different aged human bodies to evaluate the elastic and viscoelastic response. The results indicate biomechanical similarities and differences between patella-and rib cartilage as well as in the several age groups. In all age group we could obtain that rib cartilage is "stiffer" than patella cartilage and a loosening in capacity of tensional reduction with increasing age. PMID- 2764868 TI - [Radiologic dislocation value of the dysplastic hip joint in the child]. AB - The discussed index is determined by the comparison of the proportion of localisation of the proximal and of the femur and transverse dimension of the pelvis by x-ray examination. It has been found by radiological measurements of 400 hip joints children in the age of 3-24 months, in whom dysplasia of the hip joint with dislocation was diagnosed. The displacements were divided into 5 grades on the basis of extent of lateral and superior dislocation. The index makes displacement objective, replacing the visual assessment; it allows to compare the displacements on x-ray pictures performed at different ages and in different conditions of x-ray exposition. It has proved to be very useful in diagnosis and analysis of treatment result of large material of congenital dysplasia of the hip with dislocation. PMID- 2764869 TI - [Ergotherapy in finger and middle hand fractures]. AB - The value of ergotherapy (ET) was examined again. Two groups of patients were compared. 223 patients-treated with and 344 patients-attended without ET. It could be shown, that ET reduce the disablement in cases of fractures of metacarpalia and phalanges 1. In all cases with ET is the function of the injured hand something better and the rehabilitation more extensive. This could be underlined to, by measurement of ADUK. PMID- 2764870 TI - [Indications for endoprosthetic management of pertrochanteric fractures]. AB - In case of pertrochanteric fracture in osteoarthrotic hip, the endoprothesis is indicated. The authors expand the indication for endoprothesis in pertrochanteric fractures on very old patients with the possibility of mobilization immediately after operation. The results confirm the procedure. Condition for success is a differentiate application from the technique of operation. PMID- 2764871 TI - [Dysplasia epiphysealis hemimelica--a case report]. AB - One case of dysplasia epiphysealis hemimelica is described. It is an uncommon disorder belonging to the group of osteochondromatoses. The disease occurs on young children and is localized mainly in the ankle and knee joints. The time in which the patient came to our hospital was to late to make a causal operation. It is the reason to describe this case of dysplasia epiphysealis hemimelica. PMID- 2764873 TI - [The systematization of the enzyme-linked immunosorbent assay (=ELISA)]. AB - Using the example of the detectability of immunological methods the study shows the considerable influence exerted by this detectability on the quantitative and qualitative parameters and the necessity of a systematization of the methods. This systematization already starts with the product labeling: A sufficient description of antibodies has to contain five qualities. The profitability of the experimental research is improved by optimized product and method systematization. ELISA is presented in a systematized form as a modular system optimizing the comparability of these methods. In order to detect the gain of information transparency obtained by systematization, an ELISA, described in the literature, is presented in the original and in the systematized form. PMID- 2764872 TI - [The evaluation of hormone and metabolite profiles after the infusion of glucose, propionate and butyrate in cattle]. AB - Lactational performance in high-yielding dairy cows has its limits in metabolic processes. Energy metabolism is maintained by mobilization of body reserves via hormonal regulation, resulting in lipolysis and sometimes ketoacidosis. For characterization of such conditions the intraruminal and intravascular application of glucose and volatile fatty acids was used in ruminant physiology. On the other hand the results of such experiments were correlated to actual and potential milk yield. For this investigation pairs of monozygous Holstein Friesian twins were tested as heifers and as cows by intravenous infusion of glucose, propionate and butyrate after 18 hours of feed withdrawal. Insulin, growth hormone, glucose, free fatty acids and beta-hydroxybutyrate were measured before, during and up to 4 hours after infusion of substrates. Each substrate caused a transient change in plasma concentrations of metabolites and hormones. Differences between heifers and cows are discussed with the time series of the mean concentrations. The reaction profile of each animal was characterized by different parameters. Analysis of these parameters revealed a close relation between hormones and metabolites even under the conditions of the load-test. PMID- 2764874 TI - [Salmonella gallinarum field isolates of the biovars pullorum and gallinarum]. AB - In 40 cases salmonellae of the serovar Salmonella (S.) gallinarum were culturally isolated from domesticated gallinaceous birds submitted for diagnostic purposes in the period of 1979-1989. On the basis of the cultural and biochemical features found 35 of them could be assigned to the biovar Pullorum and 5 to the biovar Gallinarum. Of 35 isolates of the biovar Pullorum, 29 were isolated from pure bred chickens of small fancy-exhibition type flocks, 4 from floor-housed adult brown hybrid laying hens and one each from broiler chicks and pheasant chicks (Phasianus colchicus). Acute to subacute courses of the pullorum disease were observed in the 4 flocks of brown hybrid hens. Of 5 isolates of the biovar Gallinarum, 4 were isolated from adult brown hybrid laying hens kept in battery cages and one from floor-housed brown hybrid pullets of the laying type. First cases of fowl typhoid occurred early in the summer of 1988. The disease was characterized by a peracute course in the 4 flocks of brown laying hens and by a more acute course in the pullet flock. The primary source of the fowl typhoid producing organisms was not elucidated. PMID- 2764875 TI - Regulation of mevalonate 5-pyrophosphate decarboxylase in isolated cells from chick intestinal epithelium. AB - The present studies were undertaken to determine whether mevalonate 5 pyrophosphate decarboxylase (EC 4.1.1.33) is subject to physiological regulation in the intestinal mucosa. Activity was determined in epithelial cells isolated in a villus-to-crypt gradient from chicks fed on different diets in order to vary the sterol flux across the intestinal epithelium. When animals were fed on cholesterol, decarboxylase activity was decreased in all the cell fractions studied, although percentages of inhibition were maximum in crypts of jejunum and ileum. In contrast, decreased sterol flux as a consequence of cholestyramine feeding stimulated decarboxylase activity, especially in villi of the duodenum, where values increased 3-fold with respect to controls. On the other hand, the total cellular sterol content was significantly increased by the cholesterol diet. In duodenum and jejunum, 20-30% of the total cholesterol was in the esterified form under these conditions. However, dietary cholestyramine did not significantly affect amounts of total cellular cholesterol in any of the cell fractions. These results demonstrate that mevalonate 5-pyrophosphate decarboxylase activity changes considerably under different dietary situations and that the existence of secondary sites in the physiological regulation of sterol synthesis in the intestinal mucosa should be considered. PMID- 2764876 TI - Oxidation state of tissue thiol groups and content of protein carbonyl groups in chickens with inherited muscular dystrophy. AB - Indirect evidence suggests that oxidative stress may play a role in the pathogenesis of inherited muscular dystrophy, but the significance and precise extent of this contribution is poorly understood. Compared with normal muscle, significantly higher contents of glutathione, glutathione disulphide, protein glutathione mixed disulphides and protein carbonyl groups, and significantly lower contents of free protein thiol groups, were found in pectoralis major muscle of genetically dystrophic chickens (the muscle affected by this disease) at 4 weeks of age. Other tissues did not show such marked disease-related differences. Interestingly, the protein pool in normal, but not dystrophic, pectoralis major muscle was relatively less oxidized in relation to the glutathione pool as compared with other tissues studied. The mechanisms by which this unique relationship between the thiol pools is maintained remain unknown. Although the physiological consequences of the increased content of protein carbonyl groups and the altered thiol pools in dystrophic muscle are not clear, the changes evident at such a young age are consistent with the occurrence of oxidative stress and may reflect significant damage to cellular proteins in this disease. PMID- 2764877 TI - Plasma from uninephrectomized rats stimulates phospholipid methylation and arachidonic acid release in renal-cortical slices. AB - Phospholipid methylation and arachidonic acid release in renal-cortical slices was investigated in vitro after addition of plasma from uninephrectomized or sham operated rats. Plasma from uninephrectomized rats ('uni-plasma') stimulated phospholipid methylation when obtained within the first 3 h after uninephrectomy. With different amounts of added plasma a graded response in phospholipid methylation was obtained. Addition of 50 nM-12-O-tetradecanoylphorbol 13-acetate for 10 min to intact slices also stimulated phospholipid methylation, whereas incubation of slices before addition of 'uni-plasma' with 100 microM-1-(5 isoquinolinylsulphonyl)-2-methylpiperazine prevented it, suggesting that protein kinase C stimulates phospholipid methylation in renal-cortical slices. Plasma from uninephrectomized rats also stimulates [3H]arachidonic acid release from phosphatidylcholine (PtdCho) and phosphatidylethanolamine (PtdEtn) via activation of phospholipase A2. Two mechanisms of phospholipase A2 activation are proposed: first, in which it is activated by protein kinase C and releases 3H radioactivity from PtdCho, and second, in which phospholipase A2 is stimulated by Ca2+ ions and releases 3H radioactivity from PtdEtn. PMID- 2764878 TI - Determination of the structure of a novel acidic oligosaccharide with blood-group activity isolated from bovine submaxillary-gland mucin. AB - In this study we investigated the structure of an acidic fucose-containing pentasaccharide released from bovine submaxillary-gland mucin by alkaline borohydride treatment. The structure, determined by a combination of one dimensional and two-dimensional 1H-n.m.r. spectroscopy at 270 MHz and methylation analysis involving g.l.c.-m.s., was as follows: Fuc alpha(1----2)Gal beta(1--- 4)GlcNAc beta(1----3)[NeuAc alpha(2----6)]GalNAcol This pentasaccharide is a novel structure and is the first report of a blood-group-H type 2 determinant on a submaxillary-gland mucin. PMID- 2764879 TI - Purification and characterization of a small dermatan sulphate proteoglycan implicated in the dilatation of the rat uterine cervix. AB - A small dermatan sulphate proteoglycan (DSPG) was extracted from rat cervices and was purified by using DEAE-Sephacel ion-exchange chromatography, gel filtration on Sepharose CL-2B and CsCl-density-gradient centrifugation. Sedimentation equilibrium centrifugation gave a weight-average Mr of 95,000. Amino acid analysis showed a high content of aspartic acid, glutamic acid, glycine and leucine. The glycosaminoglycan chains had Mr 50,000 as determined by gel filtration. Chondroitin AC lyase and chondroitin ABC lyase digestions of these chains showed that they were composed of 75% dermatan sulphate and 25% chondroitin sulphate. Chondroitin ABC lyase digestion produced a core protein of Mr 45,000. The core protein, after treatment with HF, had Mr 37,000. Amino acid sequences of the N-terminus and a CNBr-cleavage peptide showed similarity to the sequences of core proteins of small proteoglycans of bovine and human origin, but the N-terminal glycosaminoglycan-attachment site (Ser-Gly-Ile-Ile) differed from the consensus sequence (Ser-Gly-Xaa-Gly) [Bourdon, Krusius, Campbell, Schwartz & Ruoslahti (1987) Proc. Natl. Acad. Sci. U.S.A. 84, 3194-3198]. A polyclonal antibody against the rat cervical DSPG reacted with small proteoglycans from cervices of human, mouse, dog, cow and sheep. DSPG is the major proteoglycan species present in the cervix. The amount of DSPG per cervix increases 4-fold during pregnancy, then falls precipitously within 1 day post partum. A role in cervical dilatation is postulated for this proteoglycan. PMID- 2764880 TI - The distribution of heavy-chain isoforms of myosin in airways smooth muscle from adult and neonate humans. AB - Changes in the expression of heavy chains of myosin during development determine the functional characteristics of striated muscles. The distribution of heavy chain isoforms of smooth-muscle myosin was determined in the airways of adult and infant humans to see whether it might underlie the hyperreactivity of human airways. The protein bands corresponding to myosin were separated using SDS/polyacrylamide-gel electrophoresis (4% gels) and identified by immunoblotting using both monoclonal and polyclonal antibodies against smooth-muscle myosin and non-muscle myosin. The relative proportion of each heavy chain stained by Coomassie Blue was measured by densitometric scanning. Three major bands corresponding to myosin heavy-chain isoforms were found; the two slower migrating bands (MHC1 and MHC2) were smooth-muscle myosin, and the third band was non muscle myosin. The MHC1/MHC2 ratio was 0.69:1 in adult bronchus, and in infant bronchus and trachea. This contrasted with the airway smooth muscle in pigs, which was run concurrently, where the smooth-muscle heavy-chain ratio changed with development [Mohammad & Sparrow (1988) FEBS Lett. 228, 109-112]. The non muscle myosin heavy chain comprised 63% of the smooth-muscle myosin. In both adult and infant lungs an additional putative myosin heavy chain which migrated slightly more rapidly than non-muscle myosin heavy chain was identified using the monoclonal smooth-muscle myosin antibody BF 48. This was unique to the human species. PMID- 2764881 TI - Identification of dexamethasone-binding sites on male-rat liver plasma membranes by affinity labelling. AB - Binding studies with [3H]dexamethasone identified two binding sites on plasma membranes prepared from the male rat liver, a low-capacity site with a KD of 7.0 nM and a higher-capacity site with a KD of 90.1 nM. Both sites exhibited glucocorticoid responsiveness and specificity for glucocorticoids and progestins. Triamcinolone acetonide, which competes well for the binding of dexamethasone to the cytosolic glucocorticoid receptor, did not compete well for the binding of [3H]dexamethasone to the plasma-membrane binding sites. The binding sites were sensitive to protease and neuraminidase treatment, and resistant to extraction with NaCl, but were extracted with the detergent Triton X-100. As these experiments indicated the presence of plasma-membrane protein components which bind glucocorticoids at physiological concentrations, affinity-labelling experiments with dexamethasone mesylate were conducted. Two peptides were specifically labelled, one at approx. Mr 66,000 and one at Mr 45,000. The Mr 66,000 peptide was not sensitive to glucocorticoids, and was extracted by NaCl, and so did not correspond to either of the sites identified in the dexamethasone binding studies. The Mr-45,000 entity, on the other hand, resembled the dexamethasone-binding sites in its response to glucocorticoid manipulation of the animal and in its resistance to salt extraction. This peptide was not present in rat serum. Thus we have identified a plasma-membrane peptide which binds dexamethasone. Whether this peptide is involved in transport of the glucocorticoid across the plasma membrane remains to be determined. PMID- 2764882 TI - Regulation of expression of avian slow myosin heavy-chain isoforms. AB - The slow tonic anterior latissimus dorsi (ALD) muscle of the chicken contains two isomyosins, namely SM-1 and SM-2. The proportions of the two isoforms change with age, SM-2 expression increasing at the expense of SM-1. Applying a load on the wing increases the rate and extent of SM-1 replacement. Here we have demonstrated that decreasing the load by removal of the distal portion of the wing in 1-week old chickens had an effect opposite to that of overloading in that it slowed muscle growth and the rate of SM-1 elimination. Experimental unloading of muscles previously weighted for 1 or 3 weeks slowed the growth rate of muscles, with consequent regression of relative hypertrophy; however, it did not lead to the reexpression of SM-1 myosin. This indicates that the overload-induced changes in myosin expression are not readily reversible. Nerve section produced unexpected results, in that it advanced the normal developmental shift in myosin expression toward predominance of the SM-2 isoform, similar to the effect of muscle overload. PMID- 2764883 TI - Mimicked translocation of glucose and glucose 6-phosphate with artificial enzyme membranes. AB - An approach to the mechanism which may govern the behaviour of biological compartmentalized systems is presented. Artificial enzyme membranes with immobilized glucose oxidase, invertase or hexokinase were used to separate two compartments of a specially designed diffusion cell. Asymmetry in volume, hydrodynamic conditions and enzyme location was purposely chosen in order to create situations which could not be obtained with an enzyme free in solution, and was then used to tentatively mimic situations existing in vivo. Experiments were conducted and a translocation effect of H2O2, glucose and glucose 6 phosphate was obtained. A theoretical analysis taking into account the different identified parameters of the system was elaborated. PMID- 2764884 TI - Regulation of prostaglandin synthesis by protein kinase C in mouse peritoneal macrophages. AB - Resident mouse peritoneal macrophages synthesized and released prostaglandins (PGs) when challenged with 12-O-tetradecanoylphorbol 13-acetate (TPA) or 1,2 dioctanoyl-sn-glycerol (DiC8). Both stimuli were found to activate Ca2+/phospholipid-dependent protein kinase C (PKC). 1-(5-Isoquinolinesulphonyl)-2 methylpiperazine ('H-7') and D-sphingosine, known to inhibit PKC by different mechanisms, were able to decrease the PKC activity of macrophages in a dose dependent manner. Addition of either PKC inhibitor decreased PG synthesis and also the release of arachidonic acid (AA) from phospholipids induced by TPA or DiC8. Simultaneously TPA or DiC8 also decreased incorporation of free AA into membrane phospholipids of macrophages. AA incorporation could be restored, however, by pretreatment with the PKC inhibitors. Our results demonstrate an involvement of PKC in the regulation of PG synthesis in mouse peritoneal macrophages and provide further evidence that reacylation of released fatty acids may be an important regulatory step. PMID- 2764886 TI - Structure of cDNA clones coding for the entire prepro alpha 1 (III) chain of human type III procollagen. Differences in protein structure from type I procollagen and conservation of codon preferences. AB - Two overlapping cDNA clones that cover the complete length of the mRNA for human type III procollagen were characterized. The data provided about 2500 base pairs of sequence not previously defined for human type III procollagen. Two tripeptide sequences of -Gly-Xaa-Yaa- were identified that were not detected previously by amino acid sequencing of human type III collagen. The two additional tripeptide units, together with three previously detected, establish that the alpha 1 (III) chain is 15 amino acids longer than either the alpha 1 (I) or alpha 2 (I) chains of type I collagen. The additional tripeptide units made hydropathy plots of the N-terminal and C-terminal regions of type III collagen distinctly different from those of type I collagen. The data also demonstrated that human type III procollagen has the same third base preference in codons for glycine, proline and alanine that was previously found with human and chick type I procollagen. In addition, comparison of two cDNA clones from the same individual revealed a variation in structure in that the codon for amino acid 880 of the alpha 1 (III) chain was -CTT- for leucine in one clone and -TTT- for phenylalanine in the other. PMID- 2764885 TI - Activation of hepatocyte protein kinase C by redox-cycling quinones. AB - The effects of quinone-generated active oxygen species on rat hepatocyte protein kinase C were investigated. The specific activity of cytosolic protein kinase C was increased 2-3-fold in hepatocytes incubated with the redox-cycling quinones, menadione, duroquinone or 2,3-dimethoxy-1,4-naphthoquinone, without alterations in particulate protein kinase C specific activity or Ca2+- and lipid-independent kinase activities. Redox-cycling quinones did not stimulate translocation of protein kinase C; however, activated protein kinase C was redistributed from cytosol to the particulate fraction when quinone-treated hepatocytes were exposed to 12-O-tetradecanoylphorbol 13-acetate (TPA). Quinone treatment did not alter cytosolic phorbol 12,13-dibutyrate (PDBu) binding capacity, and the cytosol of both control and quinone-treated hepatocytes exhibited a Kd for PDBu binding of 2 nM. Quinone-mediated activation of cytosolic protein kinase C was reversed by incubation with 10 mM-beta-mercaptoethanol, dithiothreitol or GSH, at 4 degrees C for 24 h. Furthermore, protein kinase C specific activity in control cytosol incubated in air increased by over 100% within 3 h; this increase was reversed by thiol-reducing agents. Similarly, incubation of partially-purified rat brain protein kinase C in air, or with low concentrations of GSSG in the presence of GSH, resulted in a 2-2.5-fold increase in Ca2+- and lipid-dependent kinase activity. In contrast with the effects of the redox-cycling quinones, when hepatocytes were treated with the thiol agents N-ethylmaleimide (NEM), p benzoquinone (pBQ) or p-chloromercuribenzoic acid (pCMB), the cytosolic Ca2+- and lipid-dependent kinase activity was significantly inhibited, but the particulate associated protein kinase C activity was unaffected. The Ca2+- and lipid independent kinase activity of both the cytosolic and particulate fractions was significantly stimulated by NEM, but was unaffected by pBQ and pCMB. These results show that hepatocyte cytosolic protein kinase C is activated to a high Vmax form by quinone-generated active oxygen species, and this effect is due to a reduction-sensitive modification of the thiol/disulphide status of protein kinase C. PMID- 2764887 TI - Characterization of isoelectric subspecies of asialo-beta 2-glycoprotein I. AB - Isoelectric focusing of purified beta 2-glycoprotein I (beta 2-G-I) revealed five major bands with isoelectric points (pI) between 5.1 and 6.1. Neuraminidase treatment decreased the number of bands to two (pI 8.0 and 8.2). The two asialo subfractions of beta 2-G-I were purified by cation-exchange column chromatography. The more basic isoform II was found to have a higher content of lysine. Western-blot analysis of different plasma samples confirmed the heterogeneity of beta 2-G-I in plasma. Plasma treated with neuraminidase showed two bands irrespective of the number of isoforms as well as of the concentration in native plasma. This led us to the conclusion that human plasma beta 2-G-I consists of two isoproteins that are sialylated to different extents. PMID- 2764888 TI - A phospholipid-stimulated protein kinase from Dictyostelium discoideum. AB - A protein kinase with unusual characteristics has been found in Dictyostelium discoideum. This kinase can use histone H1 as exogenous substrate, and the activity is stimulated by phospholipids, but not by Ca2+. This enzyme has been partially purified by using chromatography on DEAE-cellulose DE-52, spermine agarose and phosphatidylserine-polyacrylamide. The protein kinase activity is very labile, even in the presence of protease inhibitors, making further purification difficult. In the activity-containing fractions, an endogenous protein of 140 kDa is labelled in vitro with [gamma-32P]ATP under conditions in which intramolecular rather than intermolecular reactions are favoured. This protein is labelled only in the presence of phospholipids, but not of Ca2+. We propose that the 140 kDa phosphoprotein might be the autophosphorylated enzyme. PMID- 2764890 TI - Activation of rat liver microsomal glutathione transferase by limited proteolysis. AB - The activity of rat liver microsomal glutathione transferase is increased by limited tryptic proteolysis; the membrane-bound and purified forms of the enzyme are activated about 5- and 10-fold respectively. The cleavage sites that correlate with this activation were determined by amino acid sequence analysis to be located after Lys-4 and Lys-41. Differences in the relative extent of cleavage at these two sites did not consistently affect the degree of activation. Thus the data support the conclusion that cleavage at either site results in activation. The trypsin-activated enzyme was compared with the form activated with N ethylmaleimide, which modifies Cys-49. These two differently activated forms were found to have similar kinetic parameters, which differ from those of the unactivated enzyme. The relatedness of the two types of activation is also demonstrated by the observation that microsomal glutathione transferase fully activated by N-ethylmaleimide is virtually resistant to further activation by trypsin. This is the case despite the fact that the N-ethylmaleimide-activated enzyme is much more susceptible to trypsin cleavage at Lys-41 than is the untreated enzyme. The latter observation indicates that activation with N ethylmaleimide is accompanied by a conformational change involving Lys-41. PMID- 2764889 TI - Information from e.x.a.f.s. spectroscopy on the structures of different forms of molybdenum in xanthine oxidase and the catalytic mechanism of the enzyme. AB - X-ray spectroscopy was used to provide further information on the structure of the molybdenum centre of xanthine oxidase. Earlier work was confirmed and two states of the enzyme, not reported on by previous workers, were studied. One of these was the complex of the enzyme with pyridine-3-carboxaldehyde, in which most of the metal is in the Mo(V) state, giving the e.p.r. signal known as Inhibited. The other was the complex with the inhibitor alloxanthine, with the metal as Mo(IV). For both complexes clear evidence was obtained that an oxo ligand of molybdenum was present, but not a sulphido ligand. This information complements structural information on these complexes already available from e.p.r. spectroscopy, and has permitted us to revise and refine the structures previously proposed. The mechanism of action of the enzyme is discussed in the light of the present findings on the persistence of the oxo group in the reduced enzyme complexes, as well as of related evidence [George & Bray (1988) Biochemistry 27, 3603-3609] for an oxo group in the catalytic intermediate that gives the Mo(V) e.p.r. signal known as Very Rapid. PMID- 2764891 TI - A carboxypeptidase Y pulse method to study the accessibility of the C-terminal end during the refolding of ribonuclease A. AB - Carboxypeptidase Y pulses, applied after various times of refolding, were employed to probe the accessibility of the C-terminus of RNAase A during the refolding process. The increase in resistance against proteolytic cleavage was measured by determination of the amount of liberated C-terminal amino acids and by activity assays. The results indicate that the C-terminus of RNAase becomes inaccessible early in the course of refolding, if folding is carried out at low temperatures under conditions that effectively stabilize the native state. At higher temperatures (25 degrees C) or under conditions of marginal stability, intermediates are not populated and protection against proteolytic cleavage is not detectable before the formation of the native state. The method described may be used to monitor the accessibility of the C-terminus of various proteins during refolding. However, intermediates on the folding pathway can only be observed if the native state is stable against carboxypeptidase attack. PMID- 2764892 TI - The Streptomyces K15 DD-peptidase/penicillin-binding protein. Active site and sequence of the N-terminal region. AB - The N-terminal region of the Streptomyces K15 DD-peptidase/penicillin-binding protein shows high homology with that of other penicillin-interactive proteins or domains. The active-site serine residue of the conserved tetrad Ser-Xaa-Xaa-Lys occurs at position 35. There is no indication for the presence of a signal peptide or an N-terminal hydrophobic sequence, suggesting that the Streptomyces K15 enzyme is probably anchored to the membrane by a C-terminal peptide segment. PMID- 2764893 TI - Fluorimetric coupled enzyme assay for lysoplasmalogenase activity in liver. AB - We developed a continuous spectrofluorimetric assay of lysoplasmalogenase activity with the use of horse liver alcohol dehydrogenase as a coupling enzyme. In this method the disappearance of NADH is measured spectrofluorimetrically. The excitation and emission monochromators were set at 340 and 460 nm respectively. The assay is 10 times as sensitive as the previous u.v. spectrophotometric method. We could detect approx. 0.02 nmol of aldehyde produced/min per ml. PMID- 2764895 TI - Normal plasma vitamin E concentration. PMID- 2764894 TI - The human reg gene encodes pancreatic stone protein. PMID- 2764897 TI - Purification and characterization of human liver dehydroepiandrosterone sulphotransferase. AB - A form of sulphotransferase capable of sulphating dehydroepiandrosterone and other steroids was purified from cytosol prepared from human liver. Dehydroepiandrosterone sulphotransferase was purified 621-fold when compared with the activity in cytosol using DEAE-Sepharose CL-6B and adenosine 3',5' bisphosphate-agarose affinity chromatography. During affinity chromatography, dehydroepiandrosterone sulphation activity could be resolved from p-nitrophenol sulphation activity catalysed by phenol sulphotransferase by using a gradient of adenosine 3'-phosphate 5'-phosphosulphate. The purified enzyme was most active towards dehydroepiandrosterone but was capable of conjugating a number of other steroids, including pregnenolone, androsterone and beta-oestradiol. No activity towards p-nitrophenol or dopamine, substrates for the phenol sulphotransferase, was observed with the pure enzyme. A single band with a subunit molecular mass of 35 kDa was observed by Coomassie Blue staining following SDS/polyacrylamide-gel electrophoresis of the purified enzyme. A molecular mass of 68-70 kDa was calculated for the active form of the enzyme by chromatography on Sephacryl S 200, suggesting that the active form of the enzyme is a dimer. PMID- 2764896 TI - Differences in adult and foetal human cytochrome P-450 forms recognized by monoclonal antibodies with specificity for the P450III family. AB - Six murine monoclonal antibodies raised against a major human adult liver cytochrome P-450 (P-450) of the PCN family (P450III) detected a protein in human foetal liver microsomes (microsomal fractions) which had an approx. 1 kDa higher molecular mass on SDS/polyacrylamide-gel electrophoresis than the protein recognized in human adult liver microsomes. Although each of the antibodies recognized both the adult and the foetal forms, antibody HL4 showed higher affinity for the foetal form. Recognition by the monoclonal antibodies of peptides generated by proteolytic cleavage of microsomal proteins showed different patterns for the adult and foetal forms. It is concluded that the foetal P-450 form recognized by antibodies to the major human adult liver form P450hA7, although structurally similar, is either a distinct P-450 isoenzyme or that the adult and foetal proteins have different covalent modification. Immunoquantification experiments showed comparable levels of the P-450 forms in adult and foetal liver, although there appeared to be less inter-individual variation in foetal livers. PMID- 2764898 TI - Characterization of a cytoskeletal matrix associated with myelin from rat brain. AB - Extraction of rat brain myelin in a buffer containing Triton X-100 yielded a soluble fraction and an insoluble residue that was enriched in cytoskeletal elements. Immunoblot analysis of the detergent-soluble fraction and the insoluble cytoskeletal residue showed that all of the tubulin and more than half of the actin were found within the cytoskeletal fraction. The distribution of myelin specific proteins was also examined, and revealed that 2',3'-cyclic nucleotide 3' phosphohydrolase (CNPase) I and most of the myelin basic proteins (MBPs) were equally distributed between both fractions. By contrast, the large MBP (21.5 kDa) and CNPase II (50 kDa) were observed to partition almost entirely with the cytoskeletal fraction. Proteolipid protein was found predominantly in the detergent-soluble fraction, as was DM-20 protein. Analysis of the cytoskeletal fraction by sucrose-density-gradient centrifugation demonstrated that a distinct subset of lipids was tightly bound to the cytoskeletal protein residue. The cytoskeleton-associated lipid was considerably enriched in cerebroside and sphingomyelin by comparison with total myelin lipids. These results indicate that a cytoskeletal matrix is associated with multilamellar myelin, and suggest that this structure may play a fundamental role in myelinogenesis. PMID- 2764899 TI - The synthesis and purification of 2'-carboxy-D-arabinitol 1-phosphate, a natural inhibitor of ribulose 1,5-bisphosphate carboxylase, investigated by 31P n.m.r. AB - 2'-Carboxy-D-arabinitol 1-phosphate (2CA1P), a natural inhibitor of ribulose 1,5 bisphosphate carboxylase was synthesized from 2'-carboxy-D-arabinitol 1,5 bisphosphate (2CABP). The selective dephosphorylation of 2CABP with either acid phosphatase or alkaline phosphatase was investigated by using 31P n.m.r. The n.m.r. spectra of the progress of the reactions indicated that both phosphatases preferentially removed the 5-phosphate from the bisphosphate. After the consumption of all of the bisphosphate, alkaline phosphatase generated a mixture of 2'-carboxy-D-arabinitol 1- and 5-monophosphates in the ratio of about 4:1, along with Pi. The enzyme also hydrolysed the monophosphates to 2' carboxyarabinitol, thus decreasing the yield of 2CA1P further. In contrast, acid phosphatase catalysed almost quantitative conversion of 2CABP into 2CA1P, preferring to hydrolyse only the 5-phosphate. In either case, separation of the 2CA1P from Pi or other products of enzymic hydrolysis was readily accomplished by conventional ion-exchange chromatography or h.p.l.c. PMID- 2764900 TI - Isolation and structural analysis of rat gastric mucus glycoprotein suggests a homogeneous protein backbone. AB - We isolated monomeric gastric mucus glycoprotein from the rat stomach by applying three successive CsCl-density-gradient steps in the continuous presence of guanidinium chloride. The rat gastric mucin was pure as compared with mucin isolated without the chaotropic reagent. In addition, the presence of guanidinium chloride resulted in a better preservation of the protein moiety. The purified mucin was fractionated according to buoyant density and chemically radiolabelled on tyrosine or cysteine residues and digested with specific proteinases. Analysis of mucin fractions of various densities gave identical peptide patterns, suggesting that the fractions contain a common protein backbone. Electron microscopic images of the individual mucin molecules were recorded using rotary shadowing. They showed large filamentous molecules with a mean length of 208 nm that, after proteolytic digestion, yielded glycopeptides with a mean length of 149 nm. Heterogeneity in buoyant density and electrophoretic mobility is located in this large glycopeptide which remains after proteolytic digestion. Metabolic labelling of the mucin with [35 S]sulphate and [3H]galactose, followed by purification and proteolytic digestion, revealed that this glycopeptide accounts for most of the mass and contains relatively little protein, but probably all the oligosaccharides and sulphate. As this protein part is masked by the oligosaccharides, detailed study by the methods described was not possible. The results indicate that rat gastric mucin is homogeneous in a major part of the protein backbone and that the heterogeneity of the molecule originates most likely from differences in sulphate and/or sugar composition. PMID- 2764901 TI - Monoamine oxidase A from human placenta and monoamine oxidase B from bovine liver both have one FAD per subunit. AB - I present the first clear evidence that the protein: FAD ratio in human monoamine oxidase A and bovine monoamine oxidase B has an upper limit of 65 kDa and 57 kDa per FAD, respectively. To now it had been assumed that the protein: FAD ratio was 100-120 kDa to 1 FAD and that there was one FAD per two subunits which were assumed to be of the same size. For the present work the purity of monoamine oxidase A and monoamine oxidase B was improved over that previously achieved. Protein was determined by quantitative amino acid analysis and FAD content was measured by spectrophotometric titration of SDS-denatured enzyme with NaS2O4 standardized against riboflavin. The cause of the previous misassignment of the protein: FAD ratio was judged as having been due to the use of impure enzyme preparations. Knowledge of the correct protein: FAD ratio is important in devising cloning strategies for this enzyme, in understanding its structure, function, mechanism, and in the studies of its biosynthesis. PMID- 2764902 TI - Antibodies to insulin receptor tyrosine kinase stimulate its activity towards exogenous substrates without inducing receptor autophosphorylation. AB - Anti-peptide antibodies directed against a highly-conserved sequence of the insulin receptor tyrosine kinase domain have been used to study the relationship between this specific region and kinase activation. Antibodies have been prepared by the injection into a rabbit of a synthetic peptide (P2) corresponding to residues 1110-1125 of the proreceptor. The peptide exhibits 88-95% sequence similarity with the corresponding sequence in the v-ros protein and in receptors for epidermal growth factor and for insulin-like growth factor 1. Two antibodies with different specificities could be separated from total antiserum obtained after immunization with P2. One antibody [anti-(P-Tyr)] cross-reacted with phosphotyrosine and immunoprecipitated solely autophosphorylated receptors. This antibody was shown to increase or decrease the receptor tyrosine kinase activity depending on its concentration. In all circumstances receptor autophosphorylation and substrate phosphorylation were modulated in a parallel fashion. The second antibody (anti-P2) failed to immunoprecipitate the insulin receptor, but was found to interact with both the peptide and the receptor by e.l.i.s.a. assay. Using a tyrosine co-polymer we found that anti-P2 activated the insulin receptor kinase leading to substrate phosphorylation at a level similar to that observed with insulin. This effect was additive to the hormonal effect. In contrast, receptor autophosphorylation was not modified by the anti-peptide. The differential effect of this anti-peptide further supports the idea that receptor autophosphorylation and kinase activity towards exogenous substrates might be independently regulated. Finally, our data suggest that conformational changes in the receptor tyrosine kinase domain may be sufficient for activation of its enzymic activity. PMID- 2764903 TI - Study of the flux and transition time control coefficient profiles in a metabolic system in vitro and the effect of an external stimulator. AB - Control of flux and transition time was investigated with a reconstructed rabbit muscle glycolytic system in vitro as an experimental model. The results show agreement with the summation property for the Flux Control Coefficients [Kacser & Burns (1973) Symp. Soc. Exp. Biol. 27, 65-104; Heinrich & Rapoport (1974) Eur. J. Biochem. 42, 89-95]. Control of flux is almost exclusively located at the hexokinase- and phosphofructokinase-catalysed steps, whereas control of transition time is distributed more evenly between the enzymes of the system. The summation value of the Transition Time Control Coefficients is near to -1, suggesting the existence of another Summation Theorem besides that already stated for Flux Control Coefficients. Finally, we study the effect of an external stimulator of the system (fructose 2,6-bisphosphate) on the Control Coefficient profiles. The effect appears to be greater on the Transition Time Control Coefficient distribution than on the Flux Control Coefficients. PMID- 2764904 TI - Single-step purification and h.p.l.c. analysis of glutathione transferase 8-8 in rat tissues. AB - GSSG selectively elutes two GSH transferases from a mixture of rat GSH transferases bound to a GSH-agarose affinity matrix. One is a form of GSH transferase 1-1 and the other is shown to be GSH transferase 8-8. By using tissues that lack this form of GSH transferase 1-1 (e.g. lung), GSH transferase 8 8 may thus be purified from cytosol in a single step. Quantitative analysis of the tissue distribution of GSH transferase 8-8 was obtained by h.p.l.c. PMID- 2764905 TI - Purification and characterization of a labile rat glutathione transferase of the Mu class. AB - A labile GSH transferase homodimer termed 11-11 was purified from rat testis by GSH-agarose affinity chromatography followed by anion-exchange f.p.l.c. The enzyme is unstable in the absence of thiol(s) and has relatively low affinity for both 1-chloro-2,4-dinitrobenzene (Km 4.4 mM) and GSH (Km(app.) 4.4mM). Its mobility on SDS/polyacrylamide-gel electrophoresis is slightly less than that of subunits 3 and 4 and its pI is 5.2. Subunit 11 has a blocked N-terminal amino acid residue, but after CNBr cleavage fragments accounting for 113 amino acid residues were sequenced and showed 65% homology with corresponding sequences in subunit 4, indicating that it is a member of the Mu family. GSH transferase 11 is a major isoenzyme in testis, epididymis, prostate and brain and present at lower concentrations in other tissues. PMID- 2764906 TI - Phospholamban is a good substrate for cyclic GMP-dependent protein kinase in vitro, but not in intact cardiac or smooth muscle. AB - 1. Cyclic GMP-dependent protein kinase phosphorylates purified phospholamban. It also phosphorylates phospholamban present in vesicles of cardiac sarcoplasmic reticulum and smooth muscle microsomal fractions, and in transformants of Escherichia coli which contain a plasmid into which a gene encoding phospholamban has been inserted. 2. In vitro the phospholamban present in cardiac sarcoplasmic reticulum membranes is a better substrate for cyclic GMP-dependent protein kinase than for cyclic AMP-dependent protein kinase. 3. Studies using [32P]Pi to label the cellular ATP in intact cardiac or smooth muscle failed to demonstrate that phosphorylation of phospholamban occurs in response to stimuli which increase intracellular cyclic GMP. Possible reasons for this functional separation between increased cyclic GMP and phosphorylation of phospholamban are discussed. PMID- 2764907 TI - Haem-binding-site heterogeneity and haem Cotton effects of Glycera dibranchiata monomeric haemoglobins. AB - The five major components of the monomeric haemoglobin from Glycera dibranchiata were separated and characterized by absorption spectroscopy, isoelectric focusing, azide-binding affinities and nitrosyl autoreduction kinetics. The differences found among the components are discussed in terms of haem-pocket variations. In addition, the Fourier-transform i.r. spectra of pooled monomeric haemoglobin carbonyl (HbmCO) and the major component carbonyl are reported. The c.d. spectra of the carbonyl and azide derivatives of the five components are compared and found to be similar. The c.d. spectra of myoglobin(II) carbonyl [Mb(II)CO] and of apomyoglobin (apoMb) reconstituted with a symmetric synthetic iron porphyrin carbonyl, meso-tetra-(p-carboxyphenyl)porphinatoiron(II) carbonyl [TCPPFe(II)CO], are compared with the c.d. spectra of pooled HbmCO and its TCPPFe(II)CO analogue. HbmTCPPFe(II)CO shows a negative Soret c.d. band whereas MbTCPPFe(II)CO produces both a negative and a positive Soret c.d. band. Displacement of the symmetric porphyrin by 8-anilinonaphthalene-1-sulphonate and the resulting fluorescence emission are reported. PMID- 2764908 TI - Mass spectrometric detection of cross-linked fatty acids formed during radical induced lesion of lipid membranes. AB - A mass spectrometric method is described for the quantitative determination of dimers of polyunsaturated fatty acids (PUFA) formed in the hepatic endoplasmic reticulum of rats upon inhalation of tetrachloromethane. The results show that dimers account for a considerable fraction of microsomal PUFA which disappear during CCl4 metabolism. Cross-linking of the membrane lipids of the endoplasmic reticulum seems to be a significant process with respect to cell toxicity. PMID- 2764909 TI - Vitamin K1 reduction in human liver. Location of the coumarin-drug-insensitive enzyme. AB - The antidotal effect of vitamin K in overcoming poisoning by coumarin anticoagulant drugs is mediated by a vitamin K-reducing enzyme of the endoplasmic reticulum [Wallin & Martin (1987) Biochem. J. 241, 389-396]. With microsomes obtained from human liver biopsies, we have investigated the localization and the transverse orientation of this enzyme in the endoplasmic reticulum and compared its orientation to that of the other enzymes of the vitamin K-dependent carboxylation system. All enzymes were protected by the microsomal membrane and thus appear to have a luminal orientation in the endoplasmic reticulum, consistent with their role in the vitamin K-dependent modification of secretory glycoproteins. Separation of rough and smooth microsomes showed that vitamin K dependent carboxylase activity was 6-fold higher in rough than in smooth microsomes. Vitamin K1 reduction by the coumarin-drug-sensitive (pathway I) and insensitive (pathway II) enzymes of the vitamin K-dependent carboxylation system was the same in rough and smooth microsomes. The data suggest a close association between the pathway I and II enzymes in the endoplasmic reticulum. These pathways may be partial reactions of multienzyme complex which carries out the various activities associated with the vitamin K-dependent carboxylation system. PMID- 2764910 TI - Testing transport models and transport data by means of kinetic rejection criteria. AB - In the case of a transport system obeying Michaelis-Menten kinetics, completely general relationships are shown to exist between the final ratio of internal and external substrate concentrations, alpha, and the V/Km ratios found in zero-trans entry, zero-trans-exit and equilibrium-exchange experiments (where V is a maximum substrate flux and Km a substrate half-saturation constant). The proof depends on a new method of derivation proceeding from the form of the experimental data rather than, as has been the practice in kinetic analysis, from a hypothetical reaction scheme. These general relationships, which will be true of all mechanisms giving rise to a particular type of behaviour (here Michaelis-Menten kinetics), provide a test for internal consistency in a set of experimental data. Other relationships, which are specific, can be derived from individual reaction schemes, with the use of traditional procedures in kinetic analysis. The specific relationships include constants for infinite trans entry and exit in addition to constants involved in the general relationships. In conjunction, the general and specific relationships provide a stringent test of mechanism. A set of results that fails to satisfy the general relationships must be rejected; here systematic error or unexpected changes in the transport system in different experiments may have distorted the calculated constants, or the system may not actually obey Michaelis-Menten kinetics. Results in accord with the general relationships, on the other hand, can be applied in specific tests of mechanism. The usefulness of the theorem is illustrated in the cases of the glucose-transport and choline transport systems of erythrocytes. Experimental results taken from several studies in the literature, which were in accord with hyperbolic substrate kinetics, had previously been shown to disagree with relationships derived for the carrier model, and the model was rejected. The new analysis shows that the data violated the general relationships and therefore cannot decide the issue. More recent results on the glucose-transport system satisfy the general relations and agree with the carrier model. PMID- 2764911 TI - Iron release from haemosiderin and ferritin by therapeutic and physiological chelators. AB - Iron release from both human and horse spleen haemosiderin to desferrioxamine was substantially less than that released from ferritin samples. This finding contradicts a previous report [Kontoghiorges, Chambers & Hoffbrand (1987) Biochem. J. 241, 87-92]. Differences in phosphate content of cores and in core size between haemosiderin and ferritin did not account for the different iron release rates. Iron released to acetate was found to stimulate lipid peroxidation in liposomes, whereas that released to stronger chelators such as citrate and desferal did not. Absorption spectra and gel-filtration studies suggest that the acetate-solubilized iron was in the form of low-molecular-mass (less than 5 kDa) ferrihydrite fragments. PMID- 2764912 TI - Stimulation of phosphorylcholine turnover and diacylglycerol production in human polymorphonuclear leukocytes. Novel assay for phosphorylcholine. AB - Receptor-bypassing stimulants of human polymorphonuclear leukocytes (PMNLs), such as ionomycin or phorbol 12-myristate 13-acetate (PMA), generate an increase in diacylglycerol (DAG) which is independent of a phospholipase C specific for phosphatidylinositol 4,5,-bisphosphate (PIP2). Activation of a phospholipase C specific for phosphatidylcholine (PC) has been implicated as a source of DAG in other cells by measuring the release of radiolabelled phosphorylcholine. However, since PMNLs could not be labelled sufficiently with [3H]choline, we developed an h.p.l.c. assay to quantify mass levels of phosphorylcholine after enzymic conversion to [32P]CDP-choline with CTP-phosphorylcholine (choline phosphate) cytidylyltransferase (EC 2.7.7.15). This assay was linear to at least 20 nmol, and was sensitive to 10 pmol of phosphorylcholine. Baseline phosphorylcholine levels in unstimulated PMNLs were 2300 +/- 510 pmol/10(7) cells and were decreased by pretreatment with PMA (166 nM) or ionomycin (1 microM) for 10 min by 360 +/- 130 and 600 +/- 290 pmol/10(7) cells respectively (P less than 0.05). In contrast, baseline DAG levels were 147.6 +/- 11.7 pmol/10(7) cells in unstimulated PMNLs, and were increased by PMA or ionomycin by 1320 +/- 222 and 1891 +/- 264 pmol/10(7) cells respectively (P less than 0.05). Similarly, the chemoattractant fMet-Leu-Phe raised DAG levels by 731 +/- 111 pmol/10(7) cells and decreased phosphorylcholine levels by 180 +/- 60 pmol/10(7) cells. Activation of PMNLs by PMA, ionophore or fMet-Leu-Phe thus leads to the sustained production of DAG accompanied by the disappearance of phosphorylcholine. This suggests that these stimulants enhance PC turnover via a hydrolytic mechanism which is independent of phospholipase C, with activation of a PC-specific phospholipase D being a plausible mechanism. PMID- 2764914 TI - Temperature dependence of plasma membrane physical state in living Madin-Darby canine kidney cells. AB - Using 1-[4-(trimethylamino)phenyl]-6-phenylhexa-1,3,5-triene (TMA-DPH) as a probe, we have done fluorescence anisotropy experiments to estimate, in situ, the temperature dependence of the lipid order of the plasma membrane of MDCK cells. In intact monolayers, anisotropy vs temperature biphasic curves were obtained, indicative of discontinuous change in lipid physical state starting around 27 degrees C, in the apical domain of the plasma membrane. The very high anisotropy values (r greater than 0.33) determined below this temperature strongly suggested it corresponded to a phase separation phenomenon. Biphasic curves with similar critical temperatures zone were also obtained when measuring anisotropy or fluorescence lifetime of suspensions of MDCK cells. This suggests that changes in lipid physical state might be involved in the marked dependence on temperature of tight junction formation and of electrical conductance in MDCK monolayers. PMID- 2764913 TI - Effect of secretagogues on chromogranin A synthesis in bovine cultured chromaffin cells. Possible regulation by protein kinase C. AB - Chromogranin A is a major component of storage granules in many different secretory cell types. After [35S]methionine labelling of proteins from cultured bovine chromaffin cells, chromogranin A was immunoprecipitated with specific antibodies, and the radioactivity incorporated into chromogranin A was determined and used as an index of its synthesis rate. Depolarization of cells with nicotine or high K+ evoked a Ca2+-dependent increase in chromogranin A synthesis, whereas muscarine, which does not evoke significant Ca2+ influx from bovine chromaffin cells, had no effect on chromogranin A synthesis. Forskolin, an activator of adenylate cyclase, affected neither the basal nor the nicotine-stimulated rate of chromogranin A synthesis. In contrast, 12-O-tetradecanoylphorbol 13-acetate (TPA), an activator of protein kinase C, significantly enhanced the incorporation of radioactivity into chromogranin A. Sphingosine, an inhibitor of protein kinase C, abolished both nicotine-stimulated and TPA-induced chromogranin A synthesis. In addition, long-term treatment of chromaffin cells with TPA decreased protein kinase C activity and inhibited the nicotine-stimulated chromogranin A synthesis. These results suggest that protein kinase C may play an important role in the control of chromogranin A synthesis. PMID- 2764915 TI - cDNA cloning and sequence determination of rat membrane-associated phospholipase A2. AB - Based on the partial amino acid sequences of membrane-associated phospholipase A2 (PLA2M), belonging to group II, purified from rat spleen, the cDNA encoding PLA2M was cloned by a new cloning strategy utilizing enzymatic cDNA amplification. At the N-terminus of the coded 146 residues, which were deduced from the cDNA sequence, the putative signal peptide was found despite the tight adherence of this enzyme to the membrane. The sequence of rat PLA2M exhibits 75% homology with that of human group II PLA2 in the protein-coding region. The result of RNA blot analysis showed that rat ileal mucosa contains the largest amount of the PLA2 transcript among the tissues examined. PMID- 2764916 TI - Isolation and sequencing of a cDNA clone encoding acid phosphatase in rat liver lysosomes. AB - A full length cDNA for acid phosphatase in rat liver lysosomes was isolated and sequenced. The predicted amino acid sequence comprises 423 residues (48,332 Da). A putative signal peptide of 30 residues is followed by the NH2-terminal sequence of lysosomal acid phosphatase (45,096 Da). The deduced NH2-terminal 18-residue sequence is identical with that determined directly for acid phosphatases purified from the rat liver lysosomal membranes. The primary structure deduced for acid phosphatase contains 9 potential N-glycosylation sites and a hydrophobic region which could function as a transmembrane domain. It exhibits 89% and 67% sequence similarities in amino acids and nucleic acids, respectively, to human lysosomal acid phosphatase. The amino acid sequence of the putative transmembrane segment shows a complete similarity to that of the human enzyme. Northern blot hybridization analysis identified a single species of acid phosphatase mRNA (2.2 kbp in length) in rat liver. PMID- 2764917 TI - Identification of a retina-specific MEKA protein as a 33 K protein. AB - A photoreceptor-specific MEKA protein was purified from bovine retinal soluble fraction. The purified sample was eluted as a single peak of 74 kDa protein from a Superose column, which was dissolved into three components, MEKA protein (32 kDa), beta-(36 kDa) and gamma-(10 kDa) subunits of transducin on a SDS-PAGE. From several lines of evidence, we concluded that MEKA protein is identical with a 33k phosphoprotein reported by Lee et al (1). PMID- 2764918 TI - Free radical-mediated degradation of proteins: the protective and deleterious effects of membranes. AB - Lipid membranes have been shown to scavenge free radicals generated by various means. However, under oxidative conditions, unsaturated lipids within membranes can produce damaging free radicals. We have determined the relative importance of these two conflicting properties of lipid membranes with the use of liposomal membrane studies. (1) Liposome membranes can protect extra-liposomal albumin from free radicals derived from sources other than peroxidizing lipid. When albumin or copper (an essential component of the free radical generating systems used) were encapsulated, protein damage was further reduced. (2) Using sodium dodecyl sulphate (SDS) polyacrylamide gel electrophoresis (PAGE) we demonstrate that the exposure of albumin to peroxidizing liposome membranes results in both cross linking and degradation. Our results indicate that protein damage is substantially less than in the case of other biologically relevant free radical generating systems. We discuss our findings with respect to membrane function and the in vivo exposure of cells to free radicals. PMID- 2764919 TI - Liberation of oligosaccharides from glycosphingolipids on PC12 cell surface with endoglycoceramidase. AB - Endoglycoceramidase (EGCase) cleaves the linkage between the oligosaccharide and ceramide of glycosphingolipids (Ito, M., and Yamagata, T., J. Biol. Chem. 261, 14278-14282, ibid, 264, in press). Intact cells of rat pheochromocytoma line PC12 were treated with the highly purified EGCase I and the oligosaccharides released were analyzed by HPLC. Cleavage of the oligosaccharides with the enzyme reached a plateau as the amount of the enzyme was increased. At maximum, 42% of the oligosaccharides from globoside, 40% from GalGb3Cer, and 60% from Gb3Cer were liberated during 1h of incubation without impairing the viability of cells. The only partial liberation indicates that not all oligosaccharides of cell surface glycosphingolipids are accessible to the enzyme. The use of EGCase offers an important new method to access the functions of glycosphingolipids on cell surface in situ. PMID- 2764920 TI - Heparin increases mRNA levels of thrombospondin but not fibronectin in human vascular smooth muscle cells. AB - The effects of heparin (180 micrograms/ml) on steady state mRNA levels for fibronectin, thrombospondin, actin and collagen types I and III were investigated in human umbilical artery smooth muscle cells. Heparin caused a 120% increase in thrombospondin mRNA levels and a 60% and 180% increase in the mRNA levels of procollagen chains alpha 2(I) and alpha 1(III), respectively. No change in fibronectin or actin mRNA levels resulted from heparin treatment. We reported earlier (Biochem. Biophys. Res. Comm. 148:1264, 1987) that heparin increases smooth muscle cell synthesis of both fibronectin and thrombospondin. These data show that heparin coordinately regulates thrombospondin mRNA and protein levels. The heparin induced increase in fibronectin biosynthesis apparently reflects control at the translational or post-translational level. PMID- 2764921 TI - Biological activities of cyclic enkephalin pseudopeptides containing thioamides as amide bond replacements. AB - Analogs of H-Tyr-cyclo(N epsilon-D-Lys-Gly-Phe-Leu) have been prepared which contain thioamides at the 3-4 position (monothio), 3-4 and 5-2 positions (dithio), and 2-3, 3-4, and 5-2 positions (trithio). These compounds have been tested for opioid activity in mu- and delta-receptor selective bio- and binding assays. As the number of sulfurs increased, the biological activities dropped on the guinea pig ileum and fluctuated modestly on the mouse vas deferens assay. Surprisingly, the compounds displayed increasing delta selectivity as the number of sulfurs increased. In the binding assay, the thioamide analogs tended to retain affinity toward the mu receptor. The mono- and dithio-analogs were more mu selective than the parent, while the trithio-analog was more delta selective. These results suggest that the subtle exchange of sulfur for oxygen can have a significant impact on receptor selectivity and affinity, and probably reflect the different conformation/structural requirements for binding vs. the biological transduction event. PMID- 2764922 TI - RNA polymerase II transcription complexes are destabilized by ATP or GTP. AB - In vitro transcription by RNA polymerase II requires hydrolysis of the beta-gamma bond of ATP after the transcription complex forms, prior to RNA synthesis. It was observed that the presence of ATP during transcription complex formation inhibits subsequent transcription when the remaining 3 rNTPs are added. We now report that ATP or GTP inhibits transcription if either is present during transcription complex formation to added to preformed complexes. This inhibition is not due to purine rNTP degradation and occurs if as little as 2 mM ATP or 50 mM GTP is added to forming or preformed complexes. Deoxy derivatives of ATP inhibit similarly. AMP-PNP, a beta-gamma imido derivative, neither satisfies the energy requirement nor inhibits transcription if added to incubations of forming or of preformed transcription complexes. PMID- 2764923 TI - Formation of directly mutagenic alpha-hydroxy-N-nitrosopiperidine phosphate ester by near-ultraviolet irradiation of N-nitrosopiperidine in phosphate buffer. AB - Previously we found that direct-acting mutagens can be formed from N nitrosodialkylamines on exposure to near-ultraviolet light in the presence of phosphates. We have now isolated the mutagenic photoproduct formed from N nitrosopiperidine and inorganic phosphate and identified its structure as the phosphate ester of alpha-hydroxy-N-nitrosopiperidine. This reaction represents a new, non-enzymatic activation of promutagenic N-nitrosodialkylamines. PMID- 2764924 TI - Rapid oxidative-elimination of the terminal base from model deoxynucleotide esters. AB - The 5'-isopropyl esters of 2'-deoxycytidylate, 2'-deoxyadenylate, 2' deoxyguanylate and 2'-deoxythymidylate were synthesized and used as model substrates to demonstrate that the 3'-terminal deoxynucleoside can be rapidly removed by combined 3'-hydroxyl oxidation and beta-elimination. Trifluoroacetyloxy-dimethylsulfonium ion oxidation of the free 3'-hydroxyl group gave almost 80% yields of the free purine and pyrimidine bases in less than 5 minutes reaction at -80 degrees C. PMID- 2764925 TI - The secondary structure of human amyloid deposits as determined by circular dichroism spectroscopy. AB - The deposition of amyloid fibrils has been associated with a diversity of pathologies including plasma cell dyscrasias, chronic inflammatory diseases, and several types of neurological diseases including Alzheimer's disease. Using circular dichroism spectroscopy, the secondary structure of a human amyloid protein deposit from a patient with plasma cell (light chain)-associated amyloidosis (amyloidosis AL) has been determined. The protein contains 52% beta structure, which is consistent with these depositions arising from the aberrant catabolism of immunoglobulin light chains, which are rich in beta sheets. The protein was also found to contain 20% alpha-helix, suggesting that partial refolding may occur during amyloidogenesis. PMID- 2764926 TI - Insulin-like growth factor I activity is stored in the yolk of the avian egg. AB - Growth factors of maternal origin may be incorporated into the vertebrate egg and play a role in early phases of embryo growth and differentiation. An avian insulin-like growth factor I (IGF-I) activity from unfertilized chicken egg-yolk has been partially purified by HPLC. The material is slightly more hydrophobic than recombinant human IGF-I. It reacts in a human IGF-I radioimmunoassay and is specifically depleted by anti-human IGF-I antibodies. Like authentic IGF-I, the extracts enriched in IGF-I activity stimulated the accumulation of delta crystallin mRNA in epithelial cells from chick embryo lens with a potency approximately equivalent to its IGF-I immunoactivity. PMID- 2764927 TI - Expression and stability of insulin-like growth factor-I (IGF-I) mRNA splicing variants in the GH3 rat pituitary cell line. AB - We have employed Northern blot analyses and solution hybridization/RNase protection assays to evaluate the presence and stability of IGF-I mRNA splicing variants in the GH3 rat pituitary cell line. All of the IGF-I mRNA size classes and IGF-I mRNAs with alternately-spliced 5'-untranslated regions and E-peptide coding regions seen in adult rat liver also were present in GH3 cells, although the proportions of the 5' splicing variants were significantly altered. In actinomycin D-treated cells, all IGF-I mRNA splicing variants were equally stable; thus, changes in the levels of some splicing variants were not due to differential mRNA stability. Additionally, all IGF-I mRNA size classes seen on Northern blots were equally stable; this data suggests that the large IGF-I mRNA species is not a precursor of the smaller species. PMID- 2764928 TI - On the metabolism of GM3 ganglioside in cultured human foreskin fibroblasts. AB - The metabolism of GM3 ganglioside in cultured human foreskin fibroblasts was investigated by labeling cultured cells with [1-3H]-galactose for 48 hours, followed by a 48 hour chase. More than 80% of the radioactivity associated with GM3 was found in the hexose portion of the carbohydrate chain, whereas approximately 12% of the radioactivity was observed in the sialic acid moiety. The hexose and sialic acid residues lost 42% and 53% of their initial radioactivity, respectively, during the chase period, indicating an active metabolism of these sugar residues of GM3 in growing cultures. PMID- 2764929 TI - Isolation of 11 beta-hydroxylated androgens from testicular vein blood of the mature boar. AB - The isolation of 11 beta-hydroxyandrostenedione and 11 beta-hydroxytestosterone from testicular vein blood of the mature male domestic pig is described. Blood was collected from veins and arteries on the surface of the testes of mature boars. Steroids were extracted from plasma with SEP-PAK C18 cartridges and recovered with acetonitrile. A separation of steroids was made by high performance liquid chromatography (HPLC) using acetonitrile/water (37/63; v/v), and fractions were collected manually with detection at 254 nm. Preliminary identification was based on comparison with the HPLC retention time of an authentic steroid standard. Final characterization was achieved by means of capillary gas chromatography-mass spectrometry (GC-MS). The findings record the first evidence for the secretion of C19-11-hydroxylated steroids by normal testes in a mammalian species. PMID- 2764930 TI - (-)-Indolactam V activates protein kinase C and induces changes in muscarinic receptor functions in SH-SY5Y human neuroblastoma cells. AB - The effects of a synthetic protein kinase C (PKC) activator, (-)-indolactam V (ILV), were studied in SH-SY5Y human neuroblastoma cells. (-)-ILV induced a translocation of PKC from cytosol to plasma membrane and displaced 3H-phorbol dibutyrate binding in the micromolar range. In addition, (-)-ILV caused a decreased sensitivity of cells to muscarinic agonist-induced Ca2+ mobilization measured with quin-2 and induced a down-regulation of cell surface muscarinic receptors. All the changes induced by (-)-ILV were similar in magnitude to those seen with the phorbol ester tetradecanoyl phorbol acetate (TPA). The results suggest that (-)-ILV is a full activator of PKC and a promising alternative to phorbol esters in studies on mechanism of actions of PKC. PMID- 2764931 TI - Antipeptide antibodies toward the extracellular domain of insulin receptor beta subunit. AB - In order to investigate structure and function of beta-subunit extracellular portion, four polyclonal antibodies (AP1, AP2, AP3 and AP4) toward peptides comprised in this region were generated. None of them recognizes native human and rat insulin receptor both in vitro and in whole cells. Two antibodies, AP1 and AP2, immunoprecipitate isolated (DTT-reduced) human beta-subunits and bind to human IM-9 cell after alpha-subunit tryptic cleavage. Only AP1 recognizes rat beta-subunit both in vitro and in trypsin treated rat FAD cells. These findings suggest that: (i) the extracellular portion of the insulin receptor beta-subunit is partially covered by the alpha-subunit in human and rat native insulin receptors; (ii) human and rat beta-subunit extracellular domains are different, at least in the amino acid sequence corresponding to residues 785-796 of the human insulin receptor. PMID- 2764932 TI - Ubiquitous formation of catalase compound II in hemoglobin-free perfused rat liver and detection of novel spectral species. AB - Spectral examinations of hemoglobin-free perfused rat livers with a high sensitivity reflectance spectrophotometer have revealed an accumulation of catalase Compound II to an amount comparable to that of Compound I under the aerobic steady state. This finding is in contrast to a recent proposal that NADPH associated with catalase both prevents and reverses the accumulation of Compound II (Kirkman, H. N., Galiano, S., and Gaetani, G.F. (1987) J. Biol. Chem. 262, 660 666). Furthermore, spectral species with a broad peak extending from 550 to 600 nm were observed in a time range between the methanol-induced decays of Compound I and Compound II. When rats were treated with 3-amino-1,2,4-triazole, catalase Compound I was not detected but spectral species with peaks at 570, 556 and 530 nm were observed. These novel spectral profiles suggest contributions from "peroxy" and "ferryl" forms of cytochrome oxidase. PMID- 2764933 TI - Bradykinin-induced translocation of protein kinases C in neuroblastoma NCB-20 cell: dependence on 1,2-diacylglycerol content and free calcium. AB - Bradykinin (BK)-induced production of 1,2-diacylglycerol (1,2-DG) and translocation of protein kinases C (PKCs) were examined in neuroblastoma-derived hybrid NCB-20 cells. Mass analysis of 1,2-DG exhibited a biphasic increase by 1 microM BK stimulation: the first transient phase and the second broad sustained phase. Among three subspecies of PKC expressed in these cells, types II and III were observed to translocate from cytosol to membrane in response to BK as well as PBt2 by Western blotting analysis. Type II translocated more rapidly and distinctly than type III. However, after treatment with quin 2/AM, the second phase of 1,2-DG formation completely disappeared and PKCs translocation by BK or PBt2 was completely abolished. BK-induced IP3 (1,4,5) formation was temporally consistent with the first transient phase of 1,2-DG formation. These findings suggest that PKCs translocation by BK stimulation is caused by 1,2-DG produced not only via phosphoinositide metabolism, but via other phospholipid breakdown which is Ca2+-dependent. PMID- 2764934 TI - Heat shock induction of HSP 89 is regulated in cellular aging. AB - Induction of heat shock proteins (HSPs) was evaluated as a function of age of the IMR-90 human diploid fibroblasts. Heat shock (42 degrees C) markedly increased the synthesis of proteins with apparent molecular weights of 98, 89, 72, 50, 42 and 25 KDa, with HSP 89 and 72 being most prominent. This heat shock induction of HSPs was inversely correlated to the population doubling level (PDL) of the cell cultures used. For example, the synthesis rate of HSP 89 increased from a basal heat shock of young cells (PDL 18); in the old cells (PDL 51), the increase was from 1% to a maximum of 4% at 10-12 hrs after initiation of the heat shock. Western blot analysis showed that HSP 89 constituted approximately 2 and 10% of total cellular proteins in control and heat shocked (42 degrees C, 12-24 hrs) young cells; corresponding values for the old cells were 2 and 4.5%, respectively. Northern blot quantitation of the amount of mRNA hybridizable to cDNA probes of HSP 89 provided evidence that this age-dependent decrease in induction of HSP 89 in IMR-90 cells was attributable to a transcriptional/pre translational mechanism. PMID- 2764935 TI - The human cystatin C gene (CST3) is a member of the cystatin gene family which is localized on chromosome 20. AB - The fourth gene from the human cystatin gene family of salivary-type cysteine proteinase inhibitors has been isolated and partially characterized by DNA analysis. The gene, which we name CST3, codes for human cystatin C, and has the same organization as the CST1 gene for cystatin SN and the CST2 gene for cystatin SA. Southern analysis of EcoR I digested DNAs from 32 independent somatic cell hybrid clones hybridized to a probe from CST1 demonstrated that all members of the cystatin gene family segregate with human chromosome 20. These results indicate that the genes for salivary-type cystatins and cystatin C are members of a multigene family--the cystatin gene family. PMID- 2764936 TI - Ultraviolet light-resistant primary transfectants of xeroderma pigmentosum cells are also DNA repair-proficient. AB - In a previous work, an immortal xeroderma pigmentosum cell line belonging to complementation group C was complemented to a UV-resistant phenotype by transfection with a human cDNA clone library. We now report that the primary transformants selected for UV-resistance also acquired normal levels of DNA repair. This was assessed both by measurement of UV-induced [3H]thymidine incorporation and by equilibrium sedimentation analysis of repair-DNA synthesis. Therefore, the transduced DNA element which confers normal UV-resistance also corrects the excision repair defect of the xeroderma pigmentosum group C cell line. PMID- 2764937 TI - Attenuation of low dose phenobarbital induction of hepatic microsomal aminopyrine N-demethylase activity in rats by cimetidine. AB - Cimetidine, a substituted imidazole, is an inhibitor of hepatic cytochrome P-450 mediated drug metabolism in rats and humans. We investigated the effect of cimetidine on phenobarbital induction of hepatic microsomal aminopyrine N demethylase activity in the rat. Phenobarbital induction of aminopyrine N demethylase was log-linear in the range of 1-6 mg/kg/day and the ED50 was approximately 3 mg/kg/day. Cimetidine 75 mg/kg (four times a day) attenuated the induction of aminopyrine N-demethylase activity by 58% in low dose (3 mg/kg/day) but not in high dose (40 mg/kg/day) phenobarbital treated rats. This result could not be explained by residual inhibition of enzyme activity by cimetidine and suggests that cimetidine affects the induction of hepatic cytochrome P-450 by low dose phenobarbital. PMID- 2764938 TI - Coordinate induction of electrophoretic variants of juvenile hormone esterase. AB - Major and minor electrophoretic variants of juvenile hormone esterase (JHE) were found in the hemolymph of last instar larvae of Trichoplusia ni, both before and after metamorphic commitment. The average ratios of activity of the two major forms were similar during both last stadium peaks in activity. Immunological analysis showed that the hemolymph concentration of JHE during this stadium paralleled the level of enzymatic activity, and no putative higher molecular weight, inactive forms were detected. Immunological analysis provided the first evidence of relatedness of major and minor forms. After hormonal stimulation, the concentration of the two major forms increased concomitantly and by a similar proportion, suggesting that charge variation, at least for these two major forms, is not a point of hormonal or developmental regulation of JHE. PMID- 2764939 TI - Design and chemical synthesis of a 32 residues chimeric microprotein inhibiting both trypsin and carboxypeptidase A. AB - A chimeric peptide, 32 amino acids long, bearing two active sites, one inhibiting trypsin (Kd = 1.8 10(-9) M), one carboxypeptidase A (Kd = 3 10(-9) M), was designed and synthesized. It is a "squash inhibitor" (EETI II, 28 amino acids) elongated with the 4 amino acids from the C-terminus of the potato carboxypeptidase inhibitor. It has 3 disulfide bridges assembled in the particular knotted topology shared by the two inhibitors, by conotoxin omega, and possibly by E. coli enterotoxin ST1b. PMID- 2764940 TI - Loss of alpha I type I collagen gene expression in rat clonal bone cell lines is accompanied by DNA methylation. AB - Four clonal cell lines subcloned from a clonal population of fetal rat calvaria cells show a loss of type I collagen synthesis. Northern blot analysis showed that the level of alpha 1(I) collagen mRNA expression in each of the clonal populations parallels the level of collagen protein expression in each of these cell lines. The methylation pattern of the collagen gene in these clonal cell lines was determined using the restriction endonucleases MspI and HpaII. It was found that the loss in collagen type I expression correlated positively with the degree of methylation of alpha 1(I) procollagen genes, indicating that methylation of CpG may be an important mechanism of collagen gene regulation. PMID- 2764941 TI - Multiple forms of SppI (secreted phosphoprotein, osteopontin) synthesized by normal and transformed rat bone cell populations: regulation by TGF-beta. AB - Metabolic labeling has revealed that rat bone cell populations in culture synthesize several forms of the secreted phosphoprotein, SppI. Most cell populations produced two major [32PO4]-labeled forms that behaved anomolously on SDS-PAGE migrating at 60 kDa and 56 kDa on 10% gels and 55 kDa and 44 kDa on 15% gels. Minor forms of intermediate sizes were also resolved. In normal bone cells the 60 kDa form was predominant and was the only form produced by the clonal bone cell line, RCA 11, whereas the 56 kDa a form predominated in the transformed bone cell line, ROS 17/2.8. In all populations [35S]-methionine-labeling revealed SppIs at approximately 60 kDa but no 56 kDa form. Each form of SppI was specifically cleaved by thrombin which generated fragments of approximately 28 kDa. Transforming growth factor beta 1 increased SppI mRNA levels 3 to 6-fold within 24 h in the normal bone cells, but no increase occurred in the ROS 17/2.8 cells. The elevated expression of SppI was reflected in a selective increase in the synthesis of the [32PO4]-and [35S]-methionine-labeled 60 kDa SppIs. PMID- 2764942 TI - Presence of covalently attached fatty acids in rat apolipoprotein B via thiolester linkages. AB - Thiolester linked lipids in rat apolipoprotein B (ApoB) were examined by incubating reduced and carboxymethylated ApoB in 6 M urea buffer with [14C]methylamine at pH 8.5, 30 degrees C. It was observed that [14C]methylamine was covalently incorporated into ApoB, and there was a [14C]methylamine modified product which was lipid in nature. After extraction with organic solvents, the [14C]methylamine labeled product showed its Rf on TLC to be similar to that of the synthetic N-methyl fatty acyl amide. After purification on TLC and transesterification with 3 N methanolic HC1, methyl esters of C16:0, C18:0 and C18:1 fatty acids were identified by gas-liquid chromatography. These results suggest that rat ApoB, similar to human ApoB, contained covalently linked fatty acids through the high energy, labile thiolester bonds. PMID- 2764943 TI - Selective inhibition of complex I of the brain electron transport system by tetrahydroisoquinoline. AB - The effects of 1,2,3,4-tetrahydroisoquinoline on the enzyme-protein complexes in the electron transport system were studied in mitochondria isolated from mouse brains. Tetrahydroisoquinoline significantly inhibited the activity of NADH ubiquinone reductase, but had no effect on the activities of succinate-ubiquinone reductase, dihydroubiquinone-cytochrome c reductase, or ferrocytochrome c-oxygen reductase. The biochemical properties of tetrahydroisoquinoline in this study were quite similar to those of the dopaminergic neurotoxin 1-methyl-4 phenylpyridinium ion. PMID- 2764944 TI - Glutathione S-transferase is an in vitro substrate of Ca++-phospholipid-dependent protein kinase (protein kinase C). AB - Glutathione S-transferase was found to be a good substrate of Ca++-phospholipid dependent protein kinase in vitro. Of 6 isozymes of glutathione transferase purified from rat liver cytosol (1-1, 1-2, 2-2, 3-3, 3-4, 4-4), only isozymes 1 1, 1-2 and 2-2 were significantly phosphorylated by the kinase purified from rabbit brain. Phosphorylation was more pronounced in subunit 1 than in subunit 2, and the degree of the phosphorylation was similar in all three homo- and heterodimers, where 1 mol of phosphoryl group per mol subunit was transferred to the subunit 1. The phosphorylated transferase 1-1 showed decreased affinity for bilirubin, suggesting that the phosphorylation affects the function of glutathione S-transferase in an isozyme-specific manner. PMID- 2764945 TI - Nanosecond fluorometry of the single tryptophan in cytochrome P-450e (P450IIB2). AB - Properties of the single tryptophan residue in rat liver microsomal phenobarbital inducible cytochrome P-450e (P450IIB2) were studied by the nanosecond time resolved fluorometry. The tryptophan fluorescence decay time was found to be 3.6 ns and it was not affected by the addition of substrate (perhydrophenanthrene). This result strongly indicates that the tryptophan residue is not a part of the substrate-binding site. PMID- 2764946 TI - Simultaneous measurement of cytosolic free calcium concentration and cell circumference during contraction, both in a single rat cardiomuscular cell, by digital imaging microscopy with indo-1. AB - We have developed a novel system using digital imaging microscopy with indo-1 to measure the cytosolic free calcium concentration [( Ca2+]i). The method is particularly suitable for measuring the rapid change in [Ca2+]i in relation to the cell motion. With this system, we made the first successful simultaneous measurement of [Ca2+]i and cell circumference during contraction in an electrically stimulated single rat ventricular myocyte. It was found that the level of [Ca2+]i was elevated during contraction, and that the onset and peak time of the calcium transient preceded that of the decrease in circumference. PMID- 2764947 TI - Electron microscopic evidence for endocytosis of superoxide dismutase by hepatocytes using protein-gold adducts. AB - Cu, Zn superoxide dismutase, an intracellular, carbohydrate-free protein, was found to bind to hepatocytes and endothelial cells by electron microscopy of liver treated with enzyme-gold conjugates. In cultured hepatocytes, the free enzyme, but not bovine serum albumin, competed for the binding, and at 37 degrees C, the gold-protein complexes were internalized in a typical process of receptor mediated endocytosis. PMID- 2764948 TI - Anaerobic transformation of phenol to benzoate via para-carboxylation: use of fluorinated analogues to elucidate the mechanism of transformation. AB - Isomeric fluorophenols were used as phenol analogues to investigate the transformation of phenol to benzoate by an anaerobic, phenol-degrading consortium derived from freshwater sediment. Transformation of 2-fluorophenol and 3 fluorophenol led to the accumulation of fluorobenzoic acids. 2-Fluorophenol was transformed in the presence or absence of phenol, while 3-fluorophenol transformation was only observed in the presence of phenol. Identification of the resulting fluorobenzoate products as 3-fluorobenzoate and 2-fluorobenzoate isomers, respectively, together with the nontransformation of 4-fluorophenol indicated that the carboxyl group was introduced para to the phenolic hydroxyl group. PMID- 2764949 TI - Relaxing action of okadaic acid, a black sponge toxin on the arterial smooth muscle. AB - Vasodilator responses induced by okadaic acid were investigated in isolated pig coronary artery and dog basilar artery precontracted with high K. Okadaic acid showed the relaxing effect at the concentrations above 3 x 10(-7)M. The relaxation was not inhibited by the treatment with various receptor antagonists, indomethacin, ouabain and high concentration of Ca2+ (7.5mM) and by the removal of endothelium. The intracellular Ca2+ level measured with fura 2 was not changed apparently in spite of the relaxation by okadaic acid. The maximum rate of relaxation was slowed under the conditions of low temperature (30 degrees C), anoxia and by the addition of 2-deoxy-D-glucose instead of glucose. These results suggest that okadaic acid causes vasodilation probably by its intracellular effect on Ca2+ sensitivity of contractile elements, and the ATP-producing system may be involved in this relaxation. PMID- 2764950 TI - Pre-mRNA with a trimethylguanosine cap structure can be spliced efficiently in vitro. AB - A chemically synthesized 2,2,7-trimethylguanosine cap (TMG-cap) analogue was added to an in vitro pre-mRNA splicing system. A slight inhibition of the splicing was observed, but it was much less remarkable than that by a 7 methylguanosine cap analogue. This result does not favor a direct role of the TMG cap structure of small nuclear RNAs in pre-mRNA splicing, and suggests that the TMG-cap does not effectively interact with the 7-methylguanosine cap binding factors. Using the SP6 in vitro transcription system and a TMG-cap analogue, we prepared a beta-globin transcript which has a TMG-cap at the 5' end. This TMG capped transcript was spliced accurately and efficiently in vitro. PMID- 2764952 TI - Changes in circular dichroic and absorption spectra of myoglobin induced by carboxymethylation. AB - Changes in the circular dichroic and absorption spectra were studied on solutions of myoglobin whose histidine residues had been modified by carboxymethylation under denaturing conditions. Carboxymethylation resulted in a dramatic decrease in the molar extinction coefficient in the Soret region indicative of a major change in the heme environment. This was accompanied by a remarkable change in the secondary structure of the protein involving helix-to-random coil transition, indicating that extensive histidine modification prevented unfolded myoglobin from refolding to its native conformation. PMID- 2764951 TI - Auto-oxidation of Lingula unguis and Siphonosoma cumanense hemerythrins induced by some perturbants. AB - Auto-oxidation of human adult hemoglobin and Siphonosoma cumanense and Lingula unguis hemerythrins were investigated in the presence and absence of perturbants. In the presence of urea, there were no drastic increases in auto-oxidation rates for the three proteins. In contrast, thiocyanate and laurate enhanced the auto oxidation rates remarkably. In the presence of thiol reagents such as PCMB and NEM, auto-oxidation rates were enhanced with dissociation into subunit, but not enhanced so much with SH-modification only. Thus oligomerization is probably necessary to protect auto-oxidation. PMID- 2764953 TI - Modulation of chromatin structure and histone H1 content of rat intestinal epithelial cells in response to dietary methionine-cysteine restriction. AB - Rats were fed for 6 days a control diet, a diet low in methionine-cysteine or the diet low in methionine-cysteine followed by 2 days of the control diet. One group was pair-fed the control diet with the food intake of the methionine-cysteine restricted group. The mass of cells obtained from 60 cm of the jejunum decreased significantly after methionine-cysteine restriction, increased after refeeding and was higher in the pair-fed than the methionine-cysteine restricted rats. Sedimentation values showed an increase in amount of chromatin of greater than 100S in the methionine-cysteine restricted restricted as compared with the control chromatin. In the heavy chromatin regions histone H1 in percent of the total proteins was significantly higher in the methionine-cysteine restricted than the control rats, while transcription activity was significantly diminished. PMID- 2764954 TI - Isoelectric point heterogeneity of the two oligomeric forms of heart mitochondrial creatine kinase. AB - Rabbit heart mitochondrial creatine kinase has been recently shown to exist in two oligomeric forms: a dimer and an octamer, the latter being the form associated with the inner mitochondrial membrane [(1988) Biochem.Biophys. Res. Commun. 153,1310.]. We report here on the determination of the isoelectric points (pI) of the two purified forms by thin layer isoelectric focusing. The pI of the dimer is 8.2 and that of the octamer is 8.8; the former is higher by more than one pH unit than that of the cytoplasmic form MM-CK. It is proposed that the higher pI of the octamer is responsible for its binding to the inner membrane. PMID- 2764955 TI - Tissue specificity of chromatin glycoproteins recognized by concanavalin A. AB - Chromatin glycoproteins recognized by Concanavalin A have been isolated from pig liver, kidney and heart by the use of immobilized lectin. Two groups of proteins differing in affinity for DNA have been analysed. Glycoproteins are mainly present in the group of proteins which are tightly bound to DNA. Mono and bidimensional electrophoretic patterns of total tightly bound proteins reveal a similarity among the three organs examined, while the corresponding patterns of the glycoproteins are typical for each organ. The tissue specificity of chromatin glycoproteins, together with their capability to interact not only with DNA but possibly also with other nuclear components, suggest a role for these proteins in the mechanism of genome expression. PMID- 2764956 TI - Protective effect of glutathione against oxygen-induced growth inhibition of human diploid fibroblasts. AB - The reduced glutathione level in human diploid fibroblasts was increased by the addition of N-acetylcysteine or reduced glutathione ethylester into the culture medium, while it was decreased by the addition of L-buthionine-(R,S)-sulfoximine or diethyl maleate. The hyperbaric oxygen-induced reduction in colony-forming ability was prevented in the N-acetylcysteine- or reduced glutathione ethylester treated cells, and enhanced in the L-buthionine-(R,S)-sulfoximine- or diethyl maleate-treated cells. The extent of the growth inhibition is well correlated with the cellular glutathione level. It is deduced that glutathione is an important safeguard against the oxygen-induced growth inhibition of human diploid cells. PMID- 2764957 TI - Sequence specificity in spermine-induced structural changes in CG-oligomers. AB - The role of spermine in inducing A-DNA conformation in deoxyoligonucleotides has been studied using CCGG and GGCC as model sequences. It has been found that while CCGG adopts an alternating B-DNA conformation in low salt solution at low temperature, addition of spermine to this medium induces a B --greater than A transition. In contrast, the A-DNA-like structure of GGCC in low salt solution at low temperature does not change under the influence of spermine. This suggests a sequence-dependent behaviour of spermine. Further these results suggest that the A-DNA conformation observed in the crystals of d(iCCGG) and d(GGCC)2 might have been due to the presence of spermine in the crystallization cocktail. PMID- 2764958 TI - Effects of vanadyl sulphate on ornithine decarboxylase and progesterone levels in the ovary of rat. AB - The effects of vanadyl sulphate in vitro on the levels of ODC activity and progesterone synthesis in ovaries were studied. The levels of ODC in the ovaries were stimulated with high concentration of vanadyl sulphate and at low concentrations there was no change in the levels of ODC activity. On the contrary progesterone levels were stimulated with low concentrations of vanadyl sulphate and were inhibited at higher concentrations. Vanadyl sulphate showed additional stimulation of ODC activity, when it was added with hCG and caused inhibition of hCG induced progesterone biosynthesis. These results show that the effects of vanadyl sulphate on ODC and progesterone are different. PMID- 2764959 TI - Partial purification and properties of the isozymes of S-adenosylmethionine synthetase from sheep liver. AB - Three forms of AdoMet synthetase were separated from sheep liver. The apparent molecular weights of the native isozymes were 122,000, 62,400 and 70,800 for the alpha-, beta 1- and beta 2-form, respectively and beta 1 was the predominant form. The alpha-form exhibited negative cooperativity with [S] 0.5 values of 31 microM for methionine and 62 microM for ATP; while the two beta-forms exhibited positive cooperativity with [S]0.5 values for methionine of 82 microM and 70 microM and those for ATP of 572 microM and 505 microM for the beta 1- and beta 2 form, respectively. Dimethylsulfoxide markedly stimulated the activities of the two beta-forms at low methionine concentrations. However, at high methionine levels, it inhibited the activity of the beta 2-form but not that of the beta 1 form. The effect of dimethylsulfoxide on the alpha-form was not significant. AdoMet was inhibitory at high concentrations. However, it had a slight stimulatory effect on the two beta-forms at low concentrations when methionine level was also low. These results suggest that AdoMet synthetase is a regulatory enzyme and the reaction rate in vivo can be directly influenced by substrate and product concentrations. PMID- 2764960 TI - Protein-phosphate complexes as an inhibitor of iron-induced lipid peroxidation. AB - Effect of phosphate buffer (pH 6.2) alone or in the presence of bovine serum albumin and other proteins on iron (II)-induced lipid peroxidation was studied. Phosphate buffer alone and in the presence of bovine serum albumin was found to inhibit lipid peroxidation. The inhibition was higher when bovine serum albumin was also present. Other proteins also inhibited lipid peroxidation in the presence of phosphate. Inhibition by proteins in the presence of phosphate seems to be due to binding of iron with phosphate and with protein-phosphate complexes. Reversal in inhibition was observed with an increase in iron concentration in reaction mixture. Equilibrium dialysis showed more binding of iron to protein in the presence of phosphate than in the presence of chloride ions. PMID- 2764961 TI - Large-scale synthesis of the mRNA analogue C17AUGA4C17. AB - The large-scale synthesis of the mRNA analogue C17AUGA4C17 is described. This molecule is 41 bases in length and contains three unique codons in its central region. tRNA binding studies at 6 mM Mg2+ in the absence and presence of the labeled heteropolymer show the mutual stimulation of tRNA and mRNA binding and demonstrate that this mRNA provides a simple and suitable system for the analysis of the reactions of the ribosomal elongation cycle. PMID- 2764962 TI - Structural and functional peculiarities of alpha-ketoglutarate dehydrogenase with non-interacting active sites. AB - The properties of alpha-ketoglutarate dehydrogenase with non-interacting active sites were investigated. The substrate and coenzyme saturation curves are found to be hyperbolic, which is consistent with the absence of cooperativity between the active sites of the enzyme. The peculiarities of KGD of this form, determining its functional properties, were revealed. Thus, 6 cysteine residues of the enzyme possess different properties in comparison with the form of the enzyme with interacting active sites. 3 Sulfhydryl groups of the "non cooperative" enzyme form were rapidly oxidized in the process of the enzyme isolation and storage; thereafter they could not be reduced by dithiols. Three other cysteine residues are probably involved in the formation of disulfide bonds. Two of them are supposed to form intramolecular disulfide, whereas the third one is thought to be modified by some low molecular weight disulfide. The reduction of these sulfhydryl groups by dithiols is shown to be accompanied by the appearance of the kinetic cooperativity with respect to the substrate. It is suggested that the thiol/disulfide exchange in vivo can regulate a reversible conversion of the "non-cooperative" KGD form into one with interacting sites. PMID- 2764963 TI - Changes in activity and subcellular localization of alpha-like DNA polymerase during cell cycle of Physarum polycephalum. AB - Regulation of DNA replication was given attention by examining the subcellular localization of alpha-like DNA polymerase in Physarum polycephalum. The activity per plasmodium increased by 2-fold in the cytoplasm during the G2-phase, and decreased with a concomitant increase in nuclei prior to DNA replication. This would suggest that the enzyme translocates from the cytoplasm to the nucleus, co ordinately with DNA replication. In nuclei, the nuclear matrix-bound activity increased during the S-phase, but changes did not always parallel the rate of DNA replication. On the other hand, the activity measured without exogenous templates did change with the rate, although the activity was low. It is, therefore, suggested that part of the enzyme binding with the matrix participates in DNA replication. PMID- 2764964 TI - In vitro sulfation of sublingual salivary gland mucin: structures of 35S-labeled oligosaccharides. AB - The enzyme which catalyzes the transfer of sulfate ester group from 3' phosphoadenosine-5'-phosphosulfate to salivary mucus glycoprotein was located in the detergent extract of the Golgi-rich membrane fraction of rat sublingual salivary glands. Alkaline borohydride reductive cleavage of the synthesized 35S labeled glycoprotein led to the liberation of the label into the reduced acidic oligosaccharide fraction. A 90.3% of the total label was found incorporated in two oligosaccharides. These were identified in order of abundance as sulfated penta- and heptasaccharides. The pentasaccharide was characterized as SO3H,6G1cNAc beta 1,3Ga1 beta 1, 4G1cNAc beta 1,3(NeuAc alpha 2,6)Ga1NAc-01, and the heptasaccharide as SO3H,6G1cNAc beta 1,3Ga1 beta 1,4G1cNAc beta 1,3Ga1 beta 1,4 G1cNAc beta 1,3(NeuAc alpha 2,6)Ga1NAc-01. PMID- 2764965 TI - Changes in relationship between blood glucose level and plasma 1,5 anhydroglucitol level in KK mice. AB - We compared the relationship of the blood glucose level to the plasma 1,5 anhydroglucitol (1,5AG) level between KK mice with abnormal glucose metabolism and ICR mice as controls. Although the plasma 1,5AG level did not show any significant correlation with the blood glucose level in the controls, it tended to logarithmically decrease with the rise in the blood glucose level in KK mice. Thus it is possible that the plasma 1,5AG level is specifically related to the abnormal glucose metabolism in this model of diabetes mellitus and that its routine examination in diabetic patients may help delineate the metabolic derangement in the disease. PMID- 2764966 TI - Reconstitution of C27-steroid 26-hydroxylase activity from bovine brain mitochondria. AB - We have previously demonstrated the presence of cytochrome P-450 in a soluble preparation of bovine brain mitochondria (Oftebro, H., Stormer, F.C., and Pedersen, J.I. (1979) J. Biol. Chem. 254, 4331). In the present work we show that this preparation, in the presence of NADPH, adrenodoxin and adrenodoxin reductase catalyzes omega-hydroxylation of a number of C27-steroids that are intermediates in bile acid biosynthesis. The rates of hydroxylation were 1-2 order of magnitudes lower than reported for similar preparations from rat and human liver. No significant activity was detected with cholesterol as substrate. The physiological significance of brain mitochondrial cytochrome P-450 is discussed. PMID- 2764967 TI - Effect of acylated derivatives of ascorbate on ornithine decarboxylase induction in Ehrlich ascites tumor cells. AB - We studied the effects of 6-0-acylated derivatives of ascorbate on ornithine decarboxylase (ODC, E.C.4.1.1.17) activity and the ODC-mRNA level in Ehrlich ascites cells. These derivatives are known to inhibit cell growth. When cells grown to the stationary phase were diluted and stimulated with fresh medium containing 10% dialyzed fetal calf serum, the ODC activity increased rapidly and transiently with a peak at 4 hr. Ascorbate or 2,6-dipalmitoyl ascorbate had little or no effect on the induction of ODC, but 6-0-palmitoyl ascorbate (6P) suppressed the enzyme activity in a time- and dose-dependent way. 6-0-Stearoyl ascorbate had a similar effect. The amount of ODC-mRNA formed after growth stimulation was not affected by 6P. These results indicate that the treatment of Ehrlich ascites tumor cells with 6P caused dose-dependent suppression of ODC induction post-transcriptionally. PMID- 2764968 TI - Molecular cloning and sequence analysis of cDNA coding for canine gastrin. AB - We have isolated and sequenced cDNA clones encoding for preprogastrin from a canine antral cDNA library. Comparison of this sequence with those of porcine, human, and rat gastrin reveals extensive (83%) homology in the gastrin coding region as well as short regions of conserved nucleotides in the noncoding regions. The canine sequence encodes a preprogastrin of 104 amino acids which consists of a signal peptide, a 37-amino acid prosegment, and a 34-amino acid gastrin sequence, followed by a glycine (the amide donor), and flanked by pairs of arginine residues. PMID- 2764969 TI - Induction of intracellular and extracellular beta-galactosidase activity in Phycomyces blakesleeanus. AB - The inductive effect of different sugars on beta-galactosidase synthesis in Phycomyces blakesleeanus has been studied. The enzyme was inducible by galactose and fructose. When grown on these sugars the enzyme level was 10-20 times greater than when grown on glucose. We have detected both intra- and extracellular beta galactosidase activity when Phycomyces blakesleeanus was grown on galactose, but only extracellular beta-galactosidase activity when grown on fructose plus lactose. PMID- 2764970 TI - Effects of gamma-ray irradiation in utero on developing hearts of rat embryos: inhibition of accumulation of a 27-kDa protein. AB - Rat embryos were irradiated in utero with 1.5-Gy (teratogenic dose) of 60Co gamma rays on Day 9 of gestation, and the protein composition of each embryonic heart was examined by two-dimensional electrophoresis on Day 18. Almost all of about 450 protein species detected were identical to those of the non-irradiated hearts. However, a 27-kDa protein was reproducibly found in decreased amount in the irradiated samples. In the normal development of the heart, this protein accumulates rapidly either during the last several days of gestation or upon birth. Therefore, the irradiation with gamma-rays inhibited the accumulation of this protein. PMID- 2764971 TI - Inhibitory effect of tannin on poly(ADP-ribose) glycohydrolase from human placenta. AB - Tannin, a naturally occurring polyphenolic compound, was found to inhibit the activity of purified poly(ADP-ribose) glycohydrolase from human placenta. The inhibition was dose-dependent and half maximal with 2.8 micrograms/ml of tannin. The inhibitory effect of tannin was two and three orders of magnitude more than those of ADP-ribose and cAMP, respectively. Kinetic analysis revealed that the inhibition by tannin was competitive with respect to the substrate poly(ADP ribose). PMID- 2764972 TI - Tissue-specific differential modulation of arginase and ornithine aminotransferase by hydrocortisone during various developmental stages of the rat. AB - The activities and regulatory patterns of arginase and ornithine aminotransferase (OAT) of the liver (a mitotic tissue) and kidney cortex (a post-mitotic tissue) of immature, adult, and senescent male rats were studied. The activities of the liver enzymes were highest in the immature rat and decreased gradually with age. However, in the kidney cortex, the activity of arginase was highest and decreased significantly thereafter while that of OAT shows no significant change throughout the life span of the rat. Further, the activity of kidney cortex arginase was approximately 1/20th of that of the liver enzyme. Adrenalectomy and hydrocortisone treatments altered the activity of arginase in both tissues and that of OAT in the liver only. However, the kidney cortex OAT was not responsive towards these treatments. Actinomycin D inhibited the hydrocortisone-mediated induction of arginase of both the liver and kidney cortex and that of the liver OAT. PMID- 2764973 TI - Evidence for estradiol-induced differential expression of genes for brain RNA polymerase during developmental stages of the rat. AB - In order to gain insight into the steroid hormone-induced differential expression of genes for several rate-limiting enzymes of various metabolic pathways during differentiation, growth, adulthood, and senescence in rats, nuclear RNA polymerase of the cerebellum and cerebral hemispheres were studied. The level of this enzyme in both the tissues was highest in the immature rats and decreased significantly thereafter with increasing age. Ovariectomy decreased, and estradiol administration increased significantly the activity of this enzyme in both cerebellum and cerebral hemispheres of immature, young-adult, adult, and late-adult rats but not of senescent rats. However, the effects of these treatments were highest in the young-adult rats. PMID- 2764974 TI - Polyamine metabolism in chronic lymphocytic leukemia. AB - We have previously shown that polyamines have profound effects on lymphocyte proliferation and function. We now report that the proliferative response of cultured lymphocytes from patients with chronic lymphocytic leukemia is abrogated by the addition of diacetyldiaminohexane (HMBA), the 6-carbon analogue of diacetylputrescine. In addition, this study demonstrates the post-translational modification of proteins by polyamines in CLL-lymphocytes, a decrease in the uptake of exogenous spermidine by CLL-lymphocytes which have been exposed to HMBA, and the significant conversion of spermidine to N1-acetylspermidine in CLL lymphocytes. PMID- 2764975 TI - Increased catabolism of phosphatidylcholine to betaine regulates the liver phosphatidylcholine content in rats fed orotic acid. AB - Feeding a semi-synthetic diet containing 1% orotic acid to rats for one day stimulates the CDPcholine pathway of liver phosphatidylcholine synthesis 4.5-fold without significantly increasing the liver phosphatidylcholine level. The liver betaine level increases 1.6-fold. The present experiments were performed to investigate the source of the increased liver betaine. Orotic acid feeding did not alter the rate of oxidation of 1,2[14C] choline to betaine. After liver phosphatidylcholine was labelled in vivo with 2[14-C]-ethanolamine, over 90% of the choline-derived radioactivity was recovered in liver betaine and this was consistently increased in rats fed orotic acid. It is concluded that the increased synthesis of liver phosphatidylcholine caused by dietary orotic acid is accompanied by an increased rate of liver phosphatidylcholine catabolism, with betaine as the major end-product of the choline moiety. PMID- 2764976 TI - Tumor size-dependent elevations of serum gangliosides in patients with head and neck carcinomas. AB - Serum gangliosides were studied in 100 patients with benign or tumoral head and neck lesions. Whereas very few changes over the normal level were noticed in benign cases, 78% of patients with head and neck carcinomas had a significant elevation of serum gangliosides, mostly accounted for by GM3 and GD3. Such an increase was correlated with the observed tumor size, and the level of serum gangliosides returned to normal within one month after surgery. Follow-up of patients showed that further elevations of serum gangliosides were associated with relapses. PMID- 2764977 TI - Phosphatidylserine modulates calf intestine alkaline phosphatase activity towards low and high molecular weight substrate. AB - Pretreatment of calf intestine alkaline phosphatase with phosphatidylserine resulted in an inhibition of the phosphatase activity towards low - (p nitrophenylphosphate) and high (phosphohistone) molecular weight substrate. Phosphatidylcholine, irrespectively of the substrate used did not cause enzyme modulation. 12-O-tetradecanoylphorbol-13-acetate, 1,2-diolein as well certain retinoids, known to effect phosphatidylserine-sensitive enzyme systems (Castagna, M. et al. 1982, J. Biol. Chem. 257, 7847-7851; Gmeiner, B. 1986, Biochim. Biophys. Acta 856, 392-394) had no influence on the modulated phosphatase. The lipid interacting drug trifluoperazine inhibited the enzyme activity towards phosphohistone, but not towards p-nitrophenylphosphate as a substrate. The results indicate that acidic phospholipid may play a role in activity modulation of calf intestine membranous alkaline phosphatase activity. PMID- 2764978 TI - Synthesis and initial processing of gastric apomucin. AB - The initiation of the processing of apomucin was investigated using mucus glycoprotein synthesizing polysomes from rat gastric epithelial cells. The polysomes were isolated from cells labeled with [3H]palmitic acid and [14C]N acetylgalactosamine, purified on Helix pomatia-Sepharose affinity column, dissociated to release peptidyl-tRNA, and chromatographed on DEAE-HPLC column to separate peptidyl-tRNA complexes from the free and ribosomal RNA and proteins. The analysis of the HPLC purified peptidyl-tRNA revealed that complexes were labeled with [3H]palmitic acid and [14C]N-acetylgalactosamine. Digestion of the peptidyl-tRNA with RNase released 3H and 14C labeled peptides, while alkaline degradation destroyed the complex and rendered the [3H]palmitic acid extractable with hexane. The treatment of the 3H and 14C labeled peptidyl-tRNA complexes with alpha-N-acetylgalactosaminidase led to the release of radiolabeled N acetylgalactosamine, whereas alkaline borohydride reduction produced N acetylgalactosaminitol. The fatty acid residues have been detected in peptidyl tRNA containing 2,000Da peptides, whereas N-acetylgalactosamine was discernible on 5,000Da peptides. PMID- 2764979 TI - Isolation and characterization of an acidic lethal phospholipase Az from Malayan cobra (Naja naja sputatrix) venom. AB - An acidic, lethal phospholipase Az was purified to electrophoretic homogeneity from the venom of the Malayan cobra (Naja naja sputatrix). The enzyme has an isoelectric point of 5.58, a molecular weight of 12000, and a medium lethal dose (LD50) of 0.86 micrograms/g in mice by intravenous injection. The enzyme also exhibited weak anticoagulant and edema-forming activities. The amino acid composition of the enzyme is similar to those of other cobra venom phospholipases Az. PMID- 2764980 TI - Evidence of a pH-dependent conformational change at the active site of lysolecithin:lysolecithin acyltransferase from rabbit lung. AB - It has been shown that both activities, hydrolysis and transacylation, of lysolecithin:lysolecithin acyltransferase, as well as the conformation of the polypeptide are critically dependent on a pK around 5.8, but the question remains if the same residue(s) is responsible for the conformational change and the loss of activity. In this paper, ultrasonic cavitation is used to study the pH dependent inactivation. The results show that there are two first-order inactivation constants which depend on pH and that the transition between them has a pK of 5.9. As the constants of ultrasonic inactivation are very dependent on the accessibility of the residues it is concluded that the conformational change modifies the accessibility of the active site. PMID- 2764981 TI - Different binding of propranolol enantiomers to human alpha 1-acid glycoprotein. AB - The binding of propranolol enantiomers to human alpha 1-acid glycoprotein was studied using high performance liquid chromatography in order to provide insight into binding models and to describe individual binding parameters of both enantiomers. The binding of (-)-propranolol was shown to be saturable with one major binding site (n = 0.81, k = 2.73 x 10(5)/M). The saturation process achieved its upper asymptotic value at drug/protein molar ratio of approximately 1. In the case of the opposite (+)-enantiomer the binding isotherm did not show evidence of saturation even at higher drug/protein molar ratios (up to 50). The individual binding parameters for (+)-enantiomer were n = 0.38, k = 3.4 x 10(6)/M and n'k' = 1.39 x 10(4)/M for the saturable and nonsaturable binding component, respectively. At drug/protein molar ratio 2 the circular dichroism measurements confirmed the existence of different binding models for individual propranolol enantiomers. PMID- 2764982 TI - Metabolism in rat liver microsomes of the nitroxide spin probe tempol. AB - Paramagnetic nitroxide spin labels have been extensively used to probe various biophysical and biochemical properties of the cellular environment. Recently nitroxides have been proposed as contrast enhancing agents in proton magnetic resonance imaging and contrast enhancement has been demonstrated in animal studies. Nitroxides, possessing a stable unpaired electron, increases the relaxation rates of protons, providing an enhancement of contrast. Nitroxides are metabolized intracellularly principally via reversible reduction to hydroxylamines. Rates of reduction depend on the physical characteristics of the nitroxides, in general 5-membered pyrrolidine ring are reduced more slowly than those with a 6-membered piperidine ring. Oxidation back to the nitroxide is relevant for lipid soluble hydroxylamines, while is low for water soluble ones. It is known that nitroxides are metabolized by subcellular fractions (cytosol, mitochondria, microsomes), though the enzymatic and non-enzymatic systems involved are poorly characterized. In the present study, the first of the necessary steps toward a systematic study of the metabolism of nitroxides by subcellular organelles, we have chosen to study the metabolism of 4-hydroxy 2,2,6,6-tetramethylpiperidine-N-oxyl in isolated rat liver microsomes. Microsomes were able to reduce Tempol slowly without any substrate addition; when NADPH was added, the reduction rate substantially increased. In phenobarbitone induced rats the reduction rate was significantly higher than in not-induced microsomes. NADPH dependent reduction rate was inhibited by thallium chloride (an inhibitor of the flavin-centered cytochrome P-450 reductase), superoxide dismutase, and by N ethylmaleimide; menadione increased it. The Tempol reduction rate was not significantly affected by various cytochrome P-450 inhibitors with the sole exception of metyrapone. A solution containing purified cytochrome P-450 reductase and NADPH readily reduced Tempol. Microsomes fortified with NADPH were able to reduce Tempol at an appreciable rate. In order to distinguish between reduction of nitroxides to hydroxylamine or destruction of nitroxides following nitroxide reduction, microsomal suspensions were treated with a mild oxidant (ferricyanide 0.5-10 mM). The recovery varied from 40 to 60%, indicating a process of probe destruction leading to as yet unknown metabolites. The present study clearly indicates that, in this model system, cytochrome c (P-450) reductase and not cytochrome P-450 is responsible for the observed Tempol metabolism; along with hydroxylamine formation, other Tempol derived metabolites are formed during the process. PMID- 2764983 TI - Ethanol effects on active Na+ and K+ transport in cultured fetal rat hepatocytes. AB - To define further the influence of ethanol on membranes, its effects on Na+ pump function were studied in monolayer cultures of fetal rat hepatocytes. The effects of ethanol (2 and 4 mg/ml) on total K+ influx, ouabain-sensitive K+ influx, Na+ pump density (from specific [3H]ouabain binding), pump turnover rates and intracellular Na+ were measured following exposure of the cells to ethanol for 1 24 hr. In parallel studies, the effects of ethanol (2 mg/ml) on cell water content and membrane fluidity were measured. Ethanol had no immediate effect on K+ influx, but after 1 hr ethanol in concentrations of 2 and 4 mg/ml decreased the total K+ influx (mumol/10(11) cells/sec) from a control of 8.5 +/- 0.64 to 4.46 +/- 0.50 and 4.09 +/- 0.26 respectively (N = 6 for each experiment; P less than 0.001). This represented the maximum effect of ethanol since after 6 and 24 hr of ethanol treatment the K+ influx had increased towards control levels but remained significantly (P less than 0.01 for 2 mg/ml and P less than 0.001 for 4 mg/ml) below that in control cells even at 24 hr. The decrease in K+ influx reflected a decrease in mean ouabain-sensitive K+ influx from a control of 5.87 to 3.24 and 2.70 (mumol/10(11) cells/sec) after a 1-hr treatment with 2 and 4 mg ethanol/ml medium respectively. Ethanol (2 mg/ml) treatment for 1-hr decreased Na+ pump density (x 10(5) molecules ouabain per cell) from a control of 2.80 +/- 0.30 to 1.70 +/- 0.11 (P less than 0.001). At 6 and 24 hr [3H]ouabain binding showed a pattern similar to that seen with the K+ influx, tending to return to pretreatment levels. There was no change in individual pump turnover rates in the presence of ethanol. Following exposure to ethanol, cellular Na+ content steadily increased over the first 6 hr and then returned to control levels. When corrected for parallel changes in cell volume, however, intracellular Na+ concentration increased by 17% (P less than 0.01) after 1 hr and thereafter remained at this higher level throughout the 24-hr period. Measurements of membrane fluidity showed that it was increased markedly by ethanol at a concentration of 2 mg/ml and that the effect bore a close temporal relationship to the changes in active K+ influx and Na+ pump density. We conclude that ethanol has a depressant effect on hepatic Na+ pump function, resulting in an increase in intracellular Na+ and an eventual gain in cell water.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2764984 TI - Glutathione conjugation of the fluorophotometric epoxide substrate, 7 glycidoxycoumarin (GOC), by rat liver glutathione transferase isoenzymes. AB - The fluorophotometric substrate, 7-glycidoxycoumarin (GOC), was examined for the assay of epoxide-glutathione (GSH)-conjugating activities of seven major GSH transferases (GSTs) isolated from rat liver cytosols. GST 7-7 (GST-P), isolated from the liver cytosol of rats bearing hepatic hyperplastic nodules, catalysed the GSH conjugation of GOC at a higher rate than any other examined GST isolated from the normal rat liver cytosol. GSTs 3-3, 3-4 and 4-4 (group 3-4 enzymes) had specific activities towards GOC by one fifth to one third of that of GST 7-7. GSTs 1-1, 1-2 and 2-2 (group 1-2 enzymes) had very low activities towards this epoxide. A kinetic study indicated that GST 7-7 showed the largest kappa cat/Km value for the catalytic reaction of GOC-GSH conjugation among the GSTs. In spite of their much smaller kappa cat values, group 3-4 enzymes showed much larger kappa cat/Km values for GOC than the group 1-2 enzymes, because GOC had a much higher affinity for group 3-4 enzymes than for group 1-2 enzymes. A comparative study was also done with GSH conjugations of styrene 7,8-oxide (STO) and 1-chloro 2,4-dinitrobenzene by the GSTs. Unlike GOC, the conjugation of STO was mediated at rates about twice as high by group 3-4 enzymes than by GST 7-7. STO was also a very poor substrate for group 1-2 enzymes. PMID- 2764985 TI - Myosin light-chain kinase inhibitor, 1-(5-chlornaphthalene-1-sulfonyl)-1H hexahydro-1,4-diazepine (ML-9), inhibits catecholamine secretion from adrenal chromaffin cells by inhibiting Ca2+ uptake into the cells. AB - For determination of whether myosin light-chain kinase (MLCK) is involved in the secretory mechanism of adrenal chromaffin cells, the effect of a preferential inhibitor of the enzyme, 1-(5-chlornaphthalene-1-sulfonyl)-1H-hexahydro-1,4 diazepine (ML-9), on catecholamine secretion from cultured bovine adrenal chromaffin cells was studied. ML-9 did not affect basal catecholamine secretion, but inhibited catecholamine secretion stimulated by acetylcholine, high K+, veratridine or palytoxin. At similar concentrations to those inhibiting the secretion of catecholamine, ML-9 also inhibited increased [45Ca]2+ uptake by the cells induced by these stimulants. However, it did not inhibit catecholamine secretion induced by the Ca2+ ionophore A23187. Moreover, it did not affect catecholamine secretion from digitonin-permeabilized cells induced by a micromolar Ca2+ concentration in the presence of Mg ATP. These results indicate that ML-9 inhibits catecholamine secretion from adrenal chromaffin cells by inhibiting the transmembrane Ca2+ uptake mechanism, but not by inhibiting the intracellular Ca2+-dependent mechanism. The possible role of MLCK in stimulus secretion coupling in adrenal chromaffin cells is discussed. PMID- 2764986 TI - Interconversion of NAD(H) to NADP(H). A cellular response to quinone-induced oxidative stress in isolated hepatocytes. AB - Quinones may be toxic by a number of mechanisms, including oxidative stress caused by redox cycling and arylation. This study has compared the cytotoxicity of four quinones, with differing abilities to arylate cellular nucleophiles and redox cycle, in relation to their effects on cellular pyridine nucleotides and ATP levels in rat hepatocytes. Non-toxic concentrations (50 microM) of menadione (redox cycles and arylates), 2-hydroxy-1,4-naphthoquinone (neither arylates nor redox cycles via a one electron reduction) and 2,3-dimethoxy-1,4-naphthoquinone (a pure redox cycler) all caused markedly similar changes in cellular pyridine nucleotides. An initial decrease in NAD+ was accompanied by a small, transient increase in NADP+ and followed by a larger, prolonged increased in NADPH and total NADP+ + NADPH. At toxic concentrations (200 microM), the quinones caused an extensive depletion of NAD(H), an increase in levels of NADP+ and an initial rise in total NADP+ + NADPH, prior to a decrease in ATP levels and cell death. Nucleotide changes were not observed with non-toxic (20 microM) or toxic (100 microM) concentrations of p-benzoquinone (a pure arylator) and ATP loss accompanied or followed cell death. A novel mechanism for the activation of 2 hydroxy-1,4-naphthoquinone has been implicated. Our findings also suggest that a primary event in the response of the cell to redox cycling quinones is to bring about an interconversion of pyridine nucleotides, possibly mediated by an NAD+ reduction, in an attempt to combat the effects of oxidative stress. PMID- 2764987 TI - Histamine inhibition of mixed function oxidase activity in rat and human liver microsomes and in the isolated perfused rat liver. AB - The imidazole ring is a common structural feature of some xenobiotics that inhibit cytochrome P-450-catalysed reactions. Histamine is a 4-substituted imidazole and a preliminary study has shown it to be an inhibitor of rat liver microsomal drug oxidation. This work has now been extended. Histamine appears to be a competitive inhibitor of the alpha-hydroxylation (HM) (Ki = 164 microM; IC50 at 20 microM = 308 microM) and O-demethylation (ODM) (Ki = 243 microns; IC50 at 20 microM = 400 microM) of metoprolol in rat liver microsomes. Of the metabolites of histamine only N-acetylhistamine showed comparable inhibitory potency to that of the parent compound. Histamine impaired the disappearance of lignocaine when incubated with rat liver microsomes. This was accompanied by a corresponding inhibition of 3-hydroxy-lignocaine appearance. Histamine produced a type II spectral interaction with rat liver microsomes (lambda max = 432 nm, lambda min = 408 nm; Ks = 0.11 mM). When histamine was incubated alone with rat liver microsomes no loss of substrate was observed. The oxidation of metoprolol by human liver microsomes was impaired by histamine (IC50 values for ODM appearance at 25 microM: liver HL1 greater than 10, HL3 = 3.8 and HL4 = 3.7 mM). In comparison, cimetidine had an IC50 value of 1.5 mM using microsomes from liver HL3. Addition of histamine impaired the elimination of metoprolol by the isolated perfused rat liver in a dose-dependent manner (P less than 0.001, one-way analysis of variance). These data demonstrate that histamine can enter hepatocytes, interact with cytochrome P-450 and inhibit some drug oxidation reactions. The physiological relevance of inhibition of drug metabolism by histamine remains to be determined. PMID- 2764988 TI - Influence of electrophilic character and glutathione depletion on chemical dysmorphogenesis in cultured rat embryos. AB - To examine the importance of reduced intracellular glutathione (GSH) in the modulation of dysmorphogenesis and to gain insight into the electrophilic character of the embryotoxic intermediates generated in the rat embryo from N acetoxy-2-acetylaminofluorene (AAAF) and acetaminophen (APAP) in cultured embryos, the effects of GSH depletion on the embryotoxicity, dysmorphogenesis and covalent binding of these agents were examined. Both AAAF (90 microM) and APAP (500 microM) produced concentration-dependent, statistically significant (P less than or equal to 0.05) decreases in embryonic length as well as embryonic and visceral yolk sac protein content when rat embryos were exposed in vitro between days 10 and 11 of gestation. The predominant malformations observed upon exposure to AAAF and APAP were prosencephalic hypoplasia and abnormal neurulation respectively. Exposure of conceptuses to [3H]APAP followed by separation and fractionation of the cellular RNA, DNA and protein via density gradient centrifugation resulted in detectable binding in fractions that contained protein, but not DNA or RNA. This suggested that the rat conceptus is capable of bioactivating APAP to a soft electrophile that selectively arylates protein. In contrast, conceptuses exposed to [3H]AAAF exhibited detectable binding to RNA, DNA and protein, indicative of conversion to both hard and soft electrophiles. Depletion of GSH was accomplished by pretreating conceptuses with 500 microM L buthionine-S,R-sulfoximine (BSO) from the start of the culture period (day 9.5) until the morning of day 10. When conceptuses were depleted previously of GSH by BSO, exposure to APAP resulted in significant potentiation (relative to APAP alone) of the observed embryotoxicity. These conceptuses displayed further decreases in both embryonic size and protein content of the embryo and yolk sac, as well as increased incidence of abnormally open anterior neuropores and increased binding (3-fold) of [3H]APAP to protein. In contrast, pretreatment with BSO did not potentiate the AAAF-elicited decreases in embryonic size or protein content, nor the severity of prosencephalic hypoplasia, although a slight increase in binding of [3H]AAAF to DNA was observed. Taken together, these data are consistent with the concept that abnormal neurulation elicited by APAP results from the generation of one or more soft electrophilic species, whereas elicitation of prosencephalic hypoplasia by AAAF appears to be a consequence of conversion to a relatively hard electrophile(s). PMID- 2764989 TI - Depression of liver microsomal vitamin K epoxide reductase activity associated with antibiotic-induced coagulopathy. AB - Hypoprothrombinemic changes in blood coagulation parameters, such as prolongation of prothrombin time, increase in the level of plasma protein induced by vitamin K absence, and decrease in plasma prothrombin level, were detected in rats fed a vitamin K-deficient diet. These changes were enhanced by the administration of beta-lactam antibiotics containing N-methyltetrazolethiol, thiadiazolethiol or methyl-thiadiazolethiol. Microsomal vitamin K epoxide reductase activity was suppressed with the maximum effect at 1-2 days after the treatment and with recovery, thereafter, gradually to the normal level after 5-7 days. Hypoprothrombinemic alterations in blood coagulation parameters following a single administration of antibiotic to vitamin K-deficient rats were somewhat delayed compared with the change in the epoxide reductase activity, but the effects of the antibiotic on both blood coagulation parameters and the enzyme activity disappeared completely 7 days after the antibiotic treatment. Antibiotic induced depression of the epoxide reductase activity was observed even in the vitamin K sufficient rats, although the hypoprothrombinemic changes in the blood coagulation parameters did not develop. Vitamin K administration could normalize the blood coagulation parameters in the hypoprothrombinemic rats caused by treatment with the antibiotics but without recovery of the decreased epoxide reductase activity. These results suggest that some antibiotics inhibit liver microsomal vitamin K epoxide reductase, which causes hypoprothrombinemia to develop under vitamin K-deficient conditions. PMID- 2764990 TI - 2,5-Hexanedione modifies skeletal proteins of the red blood cells and increases the binding of hemoglobin to the membrane. AB - The effects of 2,5-hexanedione (2,5 HD) on skeletal proteins of red blood cells (RBCs) were investigated both in vitro (human RBCs) and in vivo in male Sprague Dawley rats which had been treated with the drug for several days. We found that 2,5 HD induced the following major changes in the electrophoretic pattern of the skeletal proteins: (i) the appearance of high-molecular weight bands, (ii) a dose dependent decrease in spectrin Bands 1 and 2, and (iii) a dose-dependent increase in the amount of hemoglobin (Hb) associated with the membrane. Membranoskeletons, prepared from resealed ghosts which had been previously treated with 2,5 HD, were able to bind an increased amount of Hb from untreated RBCs, thus suggesting a drug-induced modification of the membrane. Extraction of spectrin and actin from ghosts did not remove the membrane-bound Hb and, furthermore, Hb bound to 2,5 HD treated membranes mainly bearing Band 3 and free of peripheral proteins. These data suggested a 2,5 HD-induced modification of an intrinsic membrane protein, probably Band 3. This hypothesis was consistent with the observation that 2,5 HD also induced a modification of Band 3 aminogroups, as evidenced by a dose dependent decrease in the binding of eosin probes. Furthermore, RBCs treated in vitro with 2,5 HD bound an increased amount of autologous immunoglobulins (IgG). As reported by Kay and Low et al. the binding of autologous IgG is a phenomenon associated with the aging process of RBCs and may involve a modification of Band 3. Our data show that RBCs treated with 2,5 HD acquired various characteristics of senescent cells such as spectrin cross-linking, Hb-membrane binding and increased IgG binding, and suggest that 2,5 HD treatment might affect RBC survival. PMID- 2764991 TI - Inhibition of phosphorylation of the mitochondrial 34 kDa protein. A unique effect of vanadium ions? AB - We have shown previously that vanadate stimulates overall endogenous phosphorylation of proteins in subcellular particulate fractions. In brain mitochondria there is a single peptide band of Mr (approx.) 34 kDa, phosphorylation of which is inhibited rather than stimulated by both vanadate and vanadyl ions. Here, further characterization of this unique effect of vanadium ions is reported. Phosphorylation of the 34 kDa protein proceeds in the Triton X 100 extracts of mitochondria. The P-labeled 34 kDa band was recovered from TCA sediments of endogenously phosphorylated mitochondria. Acid lability of the phosphate linkage suggests a bond of P-N type. Phosphorylation of the 34 kDa protein is highly sensitive to Mg2+, while Mn2+ is a less potent activator. The results provide further evidence for existence of a protein occurring exclusively in mitochondria, the phosphorylation of which is selectively modified by both vanadate anion and vanadyl cation in a way differing from those hitherto described. PMID- 2764992 TI - Effects of carbon tetrachloride on calcium homeostasis. A critical reconsideration. AB - The incubation of isolated rat hepatocytes with 0.172 mM carbon tetrachloride caused a rapid decrease in the calcium content of both mitochondrial and extramitochondrial compartments. However, the release of Ca2+ from the intracellular stores was not associated with an increase in the cytosolic Ca2+ levels as measured by activation of phosphorylase alpha or by Quin-2 fluorescence. A rapid rise in hepatocyte free calcium was only observed with concentrations of CCl4 higher than 0.172 mM. The lack of activation of phosphorylase alpha was not due to the inhibition of the enzyme by CCl4, since in CCl4-treated hepatocytes the phosphorylase activity could be stimulated by glucagon, butyryl--cAMP or by the increase of cell calcium induced by the addition of A23187. Ca2+-dependent ATPase of plasma membranes was only slightly affected in the early phases of poisoning with CCl4 when both mitochondrial and extramitochondrial calcium pools were already lowered. This led to the conclusion that calcium released from intracellular organelles could be extruded from the cells in sufficient amounts to prevent the increase of the cytosolic levels. A rise in hepatocyte free calcium was observed during the second hour of incubation with CCl4, concomitantly with the appearance of both LDH leakage and plasma membrane blebbing. The addition of EGTA to the medium prevented both the increase in cytosolic Ca2+ and the blebbing suggesting that they were a consequence of an influx of calcium into the cells. However, neither EGTA nor the addition of inhibitors of calcium-dependent phospholipase A2 or non-lysosomal proteases were able to protect against cell death. These latter results suggested that the alterations of calcium distribution induced by CCl4 in isolated hepatocytes were not a primary cause of the toxic effects, although they did not exclude that a sustained rise in cytosolic Ca2+ could contribute in the progression of cell injury. PMID- 2764993 TI - Effect of caffeine on urea biosynthesis and some related processes, ketone bodies, ATP and liver amino acids. AB - An increase in urea synthesis has been found in rats administered large doses of caffeine. A parallel increase in urea biosynthesis was also found in hepatocytes isolated from caffeine-treated rats, which confirms a greater capacity for urea synthesis induced by caffeine. This increase appeared only after some days of caffeine treatment; during the first days there was no increase in serum urea levels or in in vitro studies of urea synthesis in isolated hepatocytes. However, no appreciable changes were found in either cytosolic or mitochondrial redox states, or in ATP levels in in vivo and in vitro studies. A parallelism was observed between the decreased amino acid levels in caffeine-treated rats and in isolated hepatocytes incubated with different concentrations of caffeine. Several possible mechanisms to explain these findings are considered in the discussion. PMID- 2764994 TI - Biochemical studies of six nitrogen-containing heterocycles in rat tissues. AB - Female rats were dosed orally with one-fifth the LD50 of either 1 nitrosopiperidine (a carcinogen), cyclohexylamine, piperidine, 4-carboxy-1 nitrosopiperidine, 4-cyclohexyl-1-nitrosopiperidine or 2,6-dimethyl-1 nitrosopiperidine at 21 and 4 hr before they were killed. The five noncarcinogenic compounds had no effects on any experimental variables examined [hepatic DNA damage, ornithine decarboxylase (ODC) activity, serum alanine aminotransferase (SGPT) activity, cytochrome P-450 and glutathione content]. After administration of 40 mg/kg of 1-nitrosopiperidine, marked hepatic DNA damage and a 3- to 7-fold increase in the activity of hepatic ODC were observed. 1-Nitrosopiperidine (120 mg/kg, 3/5 LD50) caused DNA damage in rat liver and esophagus but not in leukocytes. This higher dose of 1-nitrosopiperidine also increased hepatic ornithine decarboxylase activity by 9-fold. Thus, this hepatic biochemical assay system correctly identified the one carcinogen and the five noncarcinogens in this series of six nitrogen-containing heterocycles. PMID- 2764995 TI - Biliary excretion of organic anions in clotrimazole-treated rats. PMID- 2764996 TI - Effect of fenofibrate treatment on linoleic acid desaturation in liver of obese Zucker rats. PMID- 2764997 TI - Anaesthetic influences on brain haemodynamics in the rat and their significance to biochemical, neuropharmacological and drug disposition studies. PMID- 2764998 TI - DNA-methylation in HL-60 cells treated with 3-deaza-(+/-)-aristeromycin and 3 deazaadenosine. PMID- 2764999 TI - [Spectral features of amines of 2-phenylbenzazoles upon interaction with DNA]. AB - Absorption and fluorescent spectra of various synthetic aminophenyl derivatives of benzoxazole, benzothiazole and benzimidazole have been studied to estimate the efficiency of their binding with DNA. The significance of different functional groups of the fluorochromes for their interaction with DNA was determined, and main demands are formulated to the compounds to be used as potential fluorescent probes for DNA studies. PMID- 2765000 TI - [Total synthesis and properties of prostaglandins. XXIV. Synthesis of glycerides with prostaglandin acyl residues]. AB - Synthesis of a number of model triglycerides and lysoglycerides bearing the acyl moieties of 11-deoxyprostaglandin E1, and palmitic acid residues has been carried out. PMID- 2765001 TI - Psoriatic arthritis in children. AB - A proposed definition of juvenile psoriatic arthritis (JPsA) was used to identify definite or probable JPsA in 35 children. Definite JPsA (24 patients) was defined as arthritis associated, but not necessarily coincident, with a typical psoriatic rash, or arthritis plus at least 3 of 4 minor criteria: dactylitis, nail pitting, psoriasis-like rash, or family history of psoriasis. Probable JPsA (11 patients) was defined as arthritis plus 2 of the minor criteria. In 33 of 35 patients, the onset of arthritis was pauciarticular, but the disease followed a polyarticular course in 23 of 35. Chronic anterior uveitis (6 of 35), antinuclear antibodies (22 of 35), anticollagen antibodies (10 of 35), HLA-DR4 (2 of 28), and HLA-DR8 (5 of 28) occurred with frequencies similar to those seen in patients with juvenile rheumatoid arthritis. JPsA may have more in common with juvenile rheumatoid arthritis than with the seronegative spondylarthropathies with which it is traditionally associated. PMID- 2765002 TI - Pristane-induced arthritis. The immunologic and genetic features of an experimental murine model of autoimmune disease. AB - Pristane was injected intraperitoneally into mice of several strains, inducing an inflammatory seropositive arthritis in susceptible strains. The evolving histologic features included synovial hyperplasia, periostitis, and progressive marginal erosions. Multiple serologic immune abnormalities, including rheumatoid factor and anticollagen antibodies, also developed. Genetic analysis indicated that the major histocompatibility complex (H-2), C5 hemolytic complement (Hc), Newcastle disease virus-induced interferon (IF-1), and athymic (nu/nu) loci were involved in regulating susceptibility to pristane-induce arthritis. This experimental murine disease may provide a novel model of rheumatoid arthritis. PMID- 2765003 TI - Altered metabolism of poly(ADP-ribose) in the peripheral blood lymphocytes of patients with systemic lupus erythematosus. AB - A method was developed to measure poly(ADP-ribose) metabolism in peripheral blood lymphocytes. The technique involved the isolation of lymphocytes on Ficoll gradients, followed by lysis with 5M NaCl. The synthesis and degradation of poly(ADP-ribose) in this crude lysate, measured by the incorporation of 3H labeled NAD into acid-precipitable counts, was compared in 18 patients with systemic lupus erythematosus (SLE), 10 patients with rheumatoid arthritis, and in 10 control patients without rheumatoid arthritis. Patients with SLE showed a 70% decrease in poly(ADP-ribose) synthesis (P less than 0.001); this decreased synthesis persisted even with the addition of histones or DNase. We present possible explanations of the role of poly(ADP-ribose) in SLE. PMID- 2765004 TI - More on the posterior tibial tendon in rheumatoid arthritis. PMID- 2765005 TI - Comment on the article by DeRemee. PMID- 2765006 TI - Wegener's granulomatosis and trimethoprim/sulfamethoxazole treatment. PMID- 2765007 TI - Corynebacterium kutscheri septic arthritis. PMID- 2765008 TI - Physician compensation for drug surveys. PMID- 2765009 TI - Increased expression of HLA-DQ antigens by interstitial cells and endothelium in the synovial membrane of rheumatoid arthritis patients compared with reactive arthritis patients. AB - We investigated cellular phenotypes and expression of class II major histocompatibility complex antigens on endothelium and cellular infiltrates in synovium from patients with rheumatoid arthritis (RA) or reactive arthritis, using an indirect immunoperoxidase technique. The RA specimens showed synovial lining layer hypertrophy and several focal accumulations of lymphocytes, both of which were absent in the reactive arthritis synovium. The percentage of cells expressing monocyte/macrophage markers was significantly higher in RA specimens. The percentages of cells expressing B and T cell markers were similar in both diseases. There was no significant difference in the expression of HLA-DR or DP by endothelium in the 2 diseases, but a marked increase in expression of HLA-DQ by endothelium was observed in the RA synovium versus that from patients with reactive arthritis. This overexpression of HLA-DQ was also seen in the interstitial cells of RA patients compared with reactive arthritis patients. In the reactive arthritis synovium, a significant population of cells (30%) was noted to be HLA-DR positive, and negative for macrophage and lymphocyte markers. Some of these cells had a dendritic morphology. The coexpression of HLA-DQ and HLA-DR may play an important role in antigen presentation and disease chronicity in RA. PMID- 2765010 TI - Sleep fragmentation in rheumatoid arthritis. AB - Fatigue is commonly reported by patients with rheumatoid arthritis (RA), and it is frequently used to evaluate disease activity and response to therapy. We theorized that the feeling of fatigue in patients with RA may be a manifestation of disturbance of sleep. Sixteen patients with chronic, active RA, who were selected for early onset of fatigue (less than 6 hours after morning awakening), were extensively evaluated by formal all-night polysomnographic recording and multiple sleep latency testing (MSLT). Although no sleep deprivation was found, all patients had some type of marked disturbances of sleep, including unanticipated sleep apnea (2 patients), frequent movement of extremities (all 16 patients), and frequent arousal (all 16 patients). The alpha-delta sleep pattern was present in 13 patients, and 7 were found by MSLT to be hypersomnolent. None of the patients accurately recognized the degree of their sleep disruption. Our findings from the MSLT indicate that fatigue in patients with RA may be a manifestation of sleep fragmentation, rather than a nonspecific constitutional symptom. PMID- 2765011 TI - Pain control and rational thinking. Implications for rheumatoid arthritis. AB - In this study, we examined the factor structure of the Coping Strategies Questionnaire and studied the relevance of the coping process to health status in rheumatoid arthritis patients. The 2 factors of the questionnaire that were analyzed were Coping Attempts and Pain Control and Rational Thinking. The Pain Control and Rational Thinking factor was related to pain and psychological status, even after demographic variables and disease severity were statistically controlled. In addition, increases in Pain Control and Rational Thinking scores were related to improvements in pain, psychological status, and health status. Implications for the psychological care of rheumatoid arthritis patients are discussed. PMID- 2765012 TI - Validity of the Center for Epidemiological Studies Depression Scale in arthritis populations. AB - Using data from 3 studies of patients with rheumatoid arthritis, we examined the extent to which responses to items in the Center for Epidemiological Studies Depression Scale (CES-D) are influenced by aspects of the disease process other than depression. Our findings suggested that 4 CES-D items (i.e., "I felt that everything I did was an effort," "I felt hopeful about the future," "My sleep was restless," and "I could not get going") may be influenced by aspects of the disease process and, thus, are not necessarily indicative of depression among persons with arthritis. The impact that these items have on the interpretation of CES-D scores was assessed in relation to 2 research issues: estimation of the prevalence and severity of depression in arthritis populations and identification of the determinants of depression among individuals with arthritis. Our results suggest that the original CES-D may overestimate the prevalence and severity of depression among patients with arthritis. The magnitude of this bias is modest, however. The results also suggest that in studies designed to identify the determinants of depression among individuals with arthritis, inclusion of the 4 items identified is unlikely to have any effect on study findings. PMID- 2765013 TI - Telomerase: the beginning of the ends. PMID- 2765014 TI - Representation for all? PMID- 2765015 TI - Exposure of the proximal intracranial carotid artery. PMID- 2765016 TI - The effect of heated oxygen on body temperature: a pilot study. PMID- 2765018 TI - Use of first name. PMID- 2765017 TI - Exercise training after anterior Q wave myocardial infarction: importance of regional left ventricular function and topography. PMID- 2765019 TI - Amyotrophic lateral sclerosis. PMID- 2765020 TI - Tracheostomy in obstetric practice? PMID- 2765021 TI - More on methods for CK-MB. PMID- 2765022 TI - Re: A Serious Complication of Vesical Ether Instillation: Ether Cystitis. PMID- 2765023 TI - Malignant melanoma and redheads. PMID- 2765024 TI - Statistics alone can't prove murder. PMID- 2765025 TI - Care for the child with central nervous system tumors. PMID- 2765026 TI - The isolation of HIV-positive patients. PMID- 2765027 TI - Inhibition of exocytosis by intracellularly applied antibodies against a chromaffin granule-binding protein. AB - Exocytotic secretion requires the interaction and fusion of secretory vesicles with the plasma membrane. This process could be mediated by specific recognition molecules acting as intracellular, membrane-bound receptors and ligands. One possible component of such a recognition site on the plasma membrane is a protein of relative molecular mass (Mr) 51,000 (51K) that has been isolated from bovine adrenal chromaffin cells. This protein binds strongly to chromaffin granules, the secretory vesicles of these cells. To determine the function of this membrane anchored chromaffin granule-binding protein in exocytosis, we tested the effect of intracellularly injected antibodies on secretion. Here we show, by two independent techniques in two different cell types, that antibodies against this protein inhibit exocytosis. In rat pheochromocytoma cell cultures, monospecific antibodies, applied by erythrocyte ghost fusion, impair the release of 3H noradrenaline. The same antibodies, introduced into individual chromaffin cells through a patch pipette, block exocytosis, as revealed by the measurement of membrane capacitance. These results demonstrate the functional involvement in exocytosis of a plasma membrane protein with high affinity for secretory vesicles. PMID- 2765028 TI - Ethics committees. PMID- 2765029 TI - Poststernotomy neuralgia: a new pain syndrome. AB - Fifty-four patients developed severe intercostal neuralgia a few weeks after sternotomy. Immediate relief afforded by parasternal nerve blocks confirmed that the pain derived from scar-entrapped neuromas of the anterior rami of the first 4 6 intercostal nerves in the upper (and mainly left) interchondral spaces after insertion of the sternal wires. Permanent relief (i.e., over 6 months) followed repeated bupivacaine blocks in 57.4% of the patients, phenol blocks in another 22.2%, and alcohol blocks in a remaining 9%. Treatment was successful in 87% of the patients. PMID- 2765030 TI - Antihypertensive compounds with potent protein kinases inhibitory activity. AB - A new indorocarbazole antibiotic SF2370 has been found in the culture broth of Actinomadura sp.; it has also been found to have the activities of antihypertension and diuresis. Derivatives of SF2370, NA0344, NA0345 and NA0346, when injected (0.1-1 mg/kg i.v.) significantly lowered the blood pressure of anesthetized normotensive rats and showed a long lasting antihypertensive action. In the case of p.o. administration to conscious restrained SHRs, measurement of blood pressure by the plethysmographic method indicated that 10 mg/kg of the compounds was enough to lower the blood pressure; the antihypertensive activities were found to remain more than 12 hrs after oral administration. By studying of the mode of antihypertensive action, these compounds dose dependently relaxed the isolated aortic preparation contracted by norepinephrine. In addition, it was found that protein kinase C activity of mice brain was inhibited by the compounds; the IC50 values were in the range of 0.062-0.20 microM. Moreover, a superprecipitation of actomyosin from smooth muscle of chicken gizzard was inhibited by the compounds, having an IC50 values of 0.31-0.72 microM. PMID- 2765031 TI - Preparation and calculated conformations of the 2'-, 3'-, 4'-, and 6'-deoxy, 3'-O methyl, 4'-epi, and 4'- and 6'-deoxy-fluoro derivatives of methyl 4-O-alpha-D galactopyranosyl-beta-D-galactopyranoside (methyl beta-D-galabioside). AB - The glycosyl chlorides of the 3-O-methyl (6) and 4-deoxy-4-fluoro (8) O benzylated derivatives of D-galactopyranose and 2,3,4,6-tetra-O-benzyl-D glucopyranose were condensed with methyl 2,3,6-tri-O-benzoyl-beta-D galactopyranoside to give, after deprotection, the 3'-O-methyl (23), 4'-deoxy-4' fluoro (25), and 4'-epi (27) derivatives, respectively, of methyl beta-D galabioside (1). The glycosyl fluorides of 2,3,4-tri-O-benzyl-D-fucopyranose and the 3-deoxy (12) and 4-deoxy (16) O-benzylated derivatives of D-galactopyranose were condensed with methyl 2,3,6-tri-O-benzyl-beta-D-galactopyranoside (21), to give, after deprotection, the 6'-deoxy (31), 3'-deoxy (34), and 4'-deoxy (37) derivatives of 1, respectively. The 2'-deoxy (41) derivative of 1 was prepared by N-iodosuccinimide-induced condensation of 3,4,6-tri-O-acetyl-D-galactal and 21 followed by deprotection. Treatment of methyl 2,3,6-tri-O-benzoyl-4-O-(2,3-di-O benzoyl-alpha-D-galactopyranosyl)-beta -D- galactopyranoside with Et2NSF3 (DAST), followed by deprotection, provided the 6'-deoxy-6'-fluoro (46) derivative of 1. Molecular mechanics calculations yielded conformations for 23, 25, 27, 31, 34, 37, 41, and 46 with small deviations from the calculated conformation for 1 (phi H/psi H: -40 degrees/-6 degrees). PMID- 2765032 TI - Structural gene isolation and prepeptide sequence of gallidermin, a new lanthionine containing antibiotic. AB - Peptide antibiotics containing lanthionine and 3-methyllanthionine bridges, named lantibiotics are of increasing interest. A new lantibiotic, gallidermin, has been isolated from Staphyloccus gallinarum. Here we report the isolation of its structural gene which we name gdmA. In all lantibiotics so far studied genetically, three peptides can be formally distinguished: (i) the primary translation product, which we call the prepeptide; (ii) the propeptide lacking the leader sequence and (iii) the mature lantibiotic. Unlike the plasmid-coded epidermin, gdmA is located on the chromosome. The gdmA locus codes for a 52 amino acid residue prepeptide, consisting of an alpha-helical leader sequence of hydrophilic character, which is separated from the C-terminus (propeptide) by a characteristic proteolytic processing site (Pro-2 Arg-1 Ile1). Although pro gallidermin differs from pro-epidermin (a recently isolated lantibiotic) only by a single amino acid residue exchange. Leu instead of Ile, the N-terminus of the prepeptide differs by an additional two exchanges. PMID- 2765033 TI - [Planned predonation with a view to autologous transfusion during cardiac surgery. Preliminary results in 21 patients]. PMID- 2765034 TI - [Rheologic and cytologic study of autologous blood collected with Cell Saver 4 during cesarean]. AB - Intra-operative autologous transfusion has been frequently used in vascular and traumatic surgery for about ten years. The technique would be justified in other procedures when intra-operative bleeding is significant and the quality of retrieved blood is satisfactory. We have studied the potential use of intra operative autologous transfusion during caesarean section of 15 parturients. The quality of autologous blood (at different stages of the procedure) was assessed after being recovered and washed by "Cell Saver 4" (Haemonetics). Blood quality was assessed through 1) measuring the following: erythrocyte deformability with Erythrometer and Hemorheometer; blood and plasma viscosities; ATP, 2.3 DPG and plasma hemoglobin rates; and RBC morphology through SEM; 2) bacterial detection and identification; 3) detection of foetal cells which could create immunological disturbances if reinjected into the mother. The results showed: 1) little variation in RBC deformability properties with ATP and 2.3 DPG rates which, apart from a slight decrease, remained within the normal range; 2) a 20 fold increase in plasma hemoglobin persisting, despite successive washes, in 80% of cases; 3) positive Staphylococcus epidermidis hemoculture clinically irrelevant in the reinjectable bag in 90% of cases; 4) close to 1% foetal cells in the reinjectable bag in 20% of cases; 5) 8% abnormal cells as seen on SEM (Stage I echinocytes) and a slight swelling of the RBCs, which could account for their fragility. These preliminary results show that intraoperative autologous transfusion could be used in obstetrical surgery, provided that certain precautions are taken to minimize the aforesaid drawbacks. PMID- 2765035 TI - [Information storage by the French blood banking community in 1988]. AB - This report presents the results of a survey about computerization of the French Blood Bank Community. Questionnaires issued on the behalf of the French Automation Working Party (G.A.I.T.S.) were sent, then analysed during the second term of 1988. The answers allowed us to obtain a picture of the advance of computerization in the French Blood Transfusion Services. PMID- 2765036 TI - [Preparation of maternal platelets collected by separator for use in fetal transfusion in a case of alloimmunization by anti-PLA1]. AB - In one case of fetal thrombocytopenia due to maternal immunization against PLA1 fetal platelet antigen, maternal platelets were collected by automated plasmapheresis. The platelets were collected 24 hours before fetal transfusion at 28, 29, 31 and 36 weeks of gestation. The maternal platelets were irradiated and concentrated in a small volume (7.10(10) to 1,4.10(11) plts in less than 20 ml maternal plasma) a few hours before transfusion. When prepared as described, maximal and irreversible platelet aggregation is obtained with 20 microM of ADP and the pH is over 6, 5-6 hours after concentration. The amounts of transfused platelets were determined to increase theoretically fetal platelet counts over 200,000 plts/mm3. The fetal platelet counts, determined immediately after transfusion, showed an increase of 100,000 plts/mm3. Prenatal fetal transfusion of maternal platelets is available to avoid fetal bleeding during delivery, and during the early neonatal period. PMID- 2765037 TI - [Abstention and exclusion of donors exposed to the risk of HIV infection. Report of the meeting of 9 March 1989]. PMID- 2765038 TI - Atypical mycobacterial infection. PMID- 2765039 TI - Hyperprolactinemia and its management. PMID- 2765040 TI - [Inflammatory disease of the gastrointestinal tract at the University Hospital, Medical Center, Puerto Rico. 1980-87]. AB - Although ulcerative colitis and Crohn's disease have been known for a long time, the etiology is still unknown, and at times it is difficult to distinguish one from the other. In addition, the characteristics of the disease make their epidemiologic study difficult. We have reviewed 70 cases with the diagnosis of Crohn's disease or ulcerative colitis, and compared our results with those published from other parts of the world. We found a high proportion of ulcerative colitis to Crohn's disease, 5.36:1. There was no difference in affected age groups or most frequent symptoms; but we found Crohn's disease to be more frequent in the colon. We also found a very low incidence of extraintestinal manifestations. We believe an adequate standard protocol should be followed for the evaluation of patients with inflammatory bowel disease, including complementary studies to assess disease patterns and complications. PMID- 2765041 TI - Toxoplasmosis simulating progressive multifocal leukoencephalopathy. PMID- 2765042 TI - Prostatic cancer with metastasis to the penis. PMID- 2765043 TI - [Future trends in health services in Puerto Rico]. PMID- 2765044 TI - [Extraction of senile cataract by means of suction]. PMID- 2765045 TI - Serum cholesterol levels in Puerto Rican volunteer blood donors. AB - The blood samples of four hundred and fifty eight healthy volunteer blood donors were analyzed to determine their serum lipid profile. Based on these lipoprotein analyses, it was concluded that approximately 12% of the sampled population was in a high risk group for coronary heart disease. PMID- 2765046 TI - The surgical treatment of adenocarcinoma of the duodenum distal to the ampulla of Vater. AB - The case analysis of five patients with post-ampullary adenocarcinoma of the duodenum showed this to be a tumor which favors local extension into surrounding organs, instead of lymphatic or hepatic metastasis. This justifies and aggressive resectional approach to treatment, pancreaticoduodenectomy being the basic operation to be applied. Proximity to the superior mesenteric vessels involving them in four out of five of our tumors, is the major anatomic limiting factor. Leaving vascular control for the end of the excision and perfusing them to maintain viability of the gut until a comfortable vascular anastomosis can be constructed, should solve the problem. Misdiagnosis proved to be a prominent source of error, causing delays and inappropriate therapy. The Cancer Registry of Puerto Rico has documented an incidence of carcinoma of the duodenum similar to that of the ampulla of Vater. This fact demands the same care in the conduct of diagnostic procedures of the distal duodenum as is customary in the visualization of the ampulla. PMID- 2765047 TI - Should we do CPR. PMID- 2765048 TI - Rationing medical services in Puerto Rico. PMID- 2765049 TI - [Experiences with the distorted Freiburg Speech Test--diagnosis and rehabilitation of hearing disorders]. AB - In accordance with the description of an extended technique of distorted speech at different values - 15 dB, - 10 dB, - 5 dB and 0 dB with the plotted frequency characteristic, we used the procedure with different kinds of sensorineural hearing loss. The method analyse the peripheral hearing system very simply. In cases of acoustic tumours the quotient is very large and it is better to reduce the degree of distortion (-10, -5 and 0 dB). Generally, it is possible to detect the phase of degeneration of the inner hair-cells and afferent nerve fibres in all cases of sensorineural hearing loss. The test is also of very good help in fitting hearing aids because method picks out the hard hearing persons with very disturbed discrimination of speech. PMID- 2765050 TI - [Correlation of the latency shift and brain stem potentials in basocochlear hearing loss and the time course of the click stimulus-induced evoked wave in the cochlea]. AB - Frequency-specific information on high tone loss in the inner ear can, and if so only indirectly, be obtained from changes in latency of the click-evoked brain stem potential (ABR). The relationship between latency increases of the Jewett wave-V in basocochlear hearing loss and the time course of the travelling wave on the basilar membrane will be presented. The latency increases of basocochlear hearing loss at 2 kHz, 1 kHz and 500 Hz correspond to both the computer-simulated time course of the travelling wave and to those of the derived responses. From a pathophysiological standpoint, receptor cells in basocochlear hearing loss are not functional, beginning at the oval window, so that, dependent on the degree of inactivity, a delay corresponding to that of the time course of the travelling wave passes until active hair cells are reached and action potentials released that produce, when summed up a potential of delayed latency. PMID- 2765051 TI - [Multiplanar imaging of the temporal bone. Initial results]. AB - In the head and neck area CT imaging (particularly the HR-technique) is a well established diagnostic procedure. Besides other locations it has been successfully used in the preoperative evaluation of the temporal bone. Nevertheless, the sophisticated anatomy of this special area is hard to interpret in certain cases. In the present study we report on our preliminary results in producing a multiplanar reconstruction of the area mentioned above. Temporal bones were used that had been excised during autopsy. The specimen were examined under a CT imager of the 3rd generation with a high-resolution mode. Sections of 1 mm thickness were obtained. For the evaluation a surface model was used; the segmentation was carried out mainly automatically. The surface was calculated using a triangulation algorithm. The obtained data enabled us to receive three dimensional aspects of the temporal bone; these reconstructions could be examined from any desired perspective. Our results indicate that the multiplanar reconstruction might be of great importance for the diagnostic evaluation of temporal bone diseases in the future. In the meantime several technical problems have to be solved to guarantee a sufficient quality of the reconstructed specimen. PMID- 2765053 TI - [Technical difficulties in stapectomy and stapedotomy in general and grasping and placement of the wire prosthesis in particular]. PMID- 2765052 TI - [Assessment of the effectiveness of analgesics in the pain laboratory]. AB - In 1987 the Fifth World Congress on Pain was held in Hamburg with about 2,500 participants, for the first time in Germany after the previous congresses in Florence, Montreal, Edinburgh and Seattle. --In the following lines, Professor Bromm, one of the organisers of the congress, gives a brief insight into modern methods to measure the efficacy of analgesics. PMID- 2765054 TI - Populus candicans and the Balm of Gilead. AB - Bud exudates of some poplars are compared using GC-MS. P. candicans resembles P. balsamifera. A sample of "Balm of Gilead" purchased in Oxford proved not to resemble its supposed source, P. candicans. Instead it was similar to P. nigra, from which it was presumably collected in Europe. PMID- 2765055 TI - Topography of the chloroplast cytochrome b6: orientation of the cytochrome and accessibility of the lumen-side interhelix loops. AB - The topography of chloroplast cytochromes f and b6 was probed with proteases carboxypeptidase A (CpA), trypsin, and Staph, aureus V8. The cytochrome and its proteolytic products were detected by heme stain and, in most experiments, by immunoreaction. In thylakoids, the only protease that significantly affected the intactness of cytochrome f was CpA that caused a small (delta Mr = -1-2000) decrease in the apparent molecular weight. In SDS-treated thylakoids, both trypsin and V8 degraded cytochrome f. The inferred topography of cytochrome f., with the COOH-terminus on the stromal (n) side, one membrane-spanning alpha-elix near the COOH-terminus, and most of the Cyt f mass on the lumen (p) side, is consistent with that previously inferred by others. Cytochrome b6 was not sensitive to CpA, but was more sensitive to trypsin and V8 protease than cytochrome f, cytochrome b-559, or the 17 kDa OEC extrinsic protein. Trypsin caused a small decrease in size of cytochrome b6, which was observed using whole protein antibody as a single smaller band (delta Mr approximately 2000) or two smaller discrete bands (delta Mr = -1000 and 2500, respectively) which, unlike the untreated protein, did not react with antibody generated to a peptide mimicking Asp-5-Gln-14 near the NH2-terminus. These shortened tryptic fragments were attributed to cleavage after R-10 and K-23 near the NH2-terminus, implying an orientation with the NH2-terminus on the stromal side of the membrane. The sensitivity of cytochrome b6 toward this trypsin cleavage was increased if the membranes were first incubated with CpA, showing that the NH2-terminal region of cytochrome b6 is masked by the COOH-terminal domain of one or more thylakoid proteins.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2765056 TI - Do we need more generalists? AB - The author identifies the confluent forces that have structured U.S. medicine in favor of specialism since World War II. He concludes that any effort to increase the number and proportion of generalists in medicine is problematic in the absence of antecedent and concurrent transformations in the structure and functioning of academic health centers and in the financing of medical care, and of major, long-lasting changes in the delivery of health care. Only after these larger considerations have been addressed can the benefits of a generalist oriented system be anticipated. Even then, the gains expected to accrue from a greater number of generalists might prove illusory. PMID- 2765057 TI - Maternity leave policies for residents: an overview of issues and problems. AB - This article examines evidence of the need for maternity leave policies in residency programs and reviews studies of such policies. The author concludes that communication to residents of an established maternity leave policy facilitates equitable treatment of residents and minimizes disruptions for their colleagues and patients. The development of maternity leave policies is discussed in the context of existing and proposed federal legislation and the current pressures on program director and hospital administrators to improve other aspects residency training. Strategies for building flexibility in residency programs are presented. PMID- 2765058 TI - A last call for self-regulation of biomedical research. AB - The indecisive response of the academic community to well-publicized cases of research fraud or serious misconduct has been characterized as a failure of self regulation. The Institute of Medicine (IOM) Report on the Responsible Conduct of Research suggests measures for improving the research environment, by a combination of more explicit definition of standards of acceptable research practices, appointment of individuals to promote research standards and to respond to charges or complaints, improvement of supervision of research trainee, teaching of research ethics as well as technical skills, and reduction of the pressure to publish. The National Institutes of Health was asked to ensure that research institutions take such actions by requiring assurances as a condition of research funding. This essay discusses the recommendations and implications of the IOM report. PMID- 2765059 TI - A program to teach residents humanistic skills for notifying survivors of a patient's death. PMID- 2765060 TI - Strengthening textbook proposals. PMID- 2765061 TI - Passing NBME Part I. PMID- 2765062 TI - Medication noncompliance. PMID- 2765063 TI - A combined primary care residency in internal medicine and pediatrics. AB - The authors describe the development and evaluation of a primary care residency program encompassing both internal medicine and pediatrics. The combined residency is a four-year program of alternating six-month rotations in the two disciplines. One-fourth of the program is ambulatory medicine and includes training in a clinic for children and adults. Patient demographics are maintained for each resident, and an ambulatory-medicine-focused curriculum consisting of weekly conferences and self-directed independent study is used. The program is routinely evaluated and is highly rated by patients and residents. Factors critical to its success include emphasizing goals and experiences in outpatient versus inpatient care, developing an ambulatory practice to help support resident salaries, adequately preparing residents to take the board examinations in both disciplines, and providing a comprehensive primary care curriculum. PMID- 2765064 TI - A profile of academic physicians in British Columbia. AB - To determine the extent of involvement of British Columbia's physician community in the operation of the province's only medical school, the authors sent questionnaires to all physicians who had any affiliation with the University of British Columbia (UBC). About 20 percent of the province's physicians were involved in some capacity with the UBC Faculty of Medicine, which accepts about 120 students into the first year annually. Most faculty held "clinical" appointments, meaning that they pursued largely non-academic careers. Full-time academic appointees worked more than 20 percent more hours annually than did their "clinical" counterparts, and average hours for men exceeded those for women. As many as two-thirds of the full-time faculty were also engaged in sufficient clinical practice activity to be classified as full-time practicing physicians by a definition adopted by a provincial Joint Medical Manpower Committee. PMID- 2765065 TI - Unmet needs and unused skills: physicians' reflections on their liberal arts education. AB - Physicians who graduated from 1955 to 1982 from three liberal arts colleges in southeastern Pennsylvania were asked about the ways that their undergraduate education had prepared or failed to prepare them for careers in medicine and about changes that they would, in retrospect, have made in their courses of undergraduate study. For many, college had failed to meet their perceived need, as physicians, for skill in dealing with people, but had provided skills in the form of basic science knowledge and willingness to be different that exceeded the demands of their careers. They wished that in college they had taken more courses in the humanities--especially art, history, music, and English literature--and less chemistry, mathematics, physics, and biology. Would-be physicians should be encouraged to take full advantage of the humanizing opportunities of a liberal arts education with confidence that it will contribute to their future professional and personal lives. PMID- 2765066 TI - Medical students' early expectations and later opinions of aspects of their first year. AB - A survey of medical students on their first day of medical school and again near the end of their first year measured the discrepancy between their expectations of various aspects of the first year and their retrospective opinions about these aspects. The entering students had specific, detailed expectations about numerous aspects, many of which were not confirmed by their subsequent experience. The same students were reminded, one year later, of their unfulfilled expectations about the first year and were asked to describe any effects these expectations had had on class emotional climate and morale. They recalled both serious disappointments and pleasant surprises but no general change of class morale. A serendipitous finding was the profound indifference of the second-year students to their first-year emotional responses. Our results challenge the general practice of basing curriculum renewal programs on cross-sectional student surveys with no consideration of baseline expectations, and of relying on students to initiate improvements in educational programs. PMID- 2765067 TI - Characteristics of medical schools and their affiliated institutions. AB - Survey data from a sample of 58 U.S. and six Canadian medical schools were used to describe the current network of medical schools and their affiliates. Results showed that each medical school in the study averaged over 11 affiliates. The largest percentages of affiliates reported were in the categories of "community" hospitals (that is, the nongovernmental, not-for-profit hospitals), Veterans Administration hospitals, and city hospitals. Characteristics of the medical schools, such as class size, ownership, year established, and the presence of a university hospital, were not related to either the number or the kind of affiliates. However, the sizes of the affiliated institutions were associated with the year the medical school was established, the presence of a university hospital, and the class size of the medical school. PMID- 2765068 TI - Impact of a required family medicine clerkship on medical students' attitudes about primary care. AB - A study of 314 medical students before and after a required third-year clerkship in family medicine explored relationships among exposure to the clerkship and changes in attitudes toward primary care. The survey instrument contained 29 statements distinguishing the philosophy of primary care from that of subspecialty-oriented medicine and asked students' to state their future residency plans. The responses of the primary care and subspecialty-oriented groups were the most disparate, whereas the students who were uncertain about residency plans shifted on several items from an alignment with the specialty group toward an alignment with the primary care group. This study shows that experience in a family medicine clerkship may be associated with changes in attitudes that represent development of a more informed image of primary care. PMID- 2765069 TI - AAMC data report. HIV/AIDS education in U.S. medical schools. PMID- 2765070 TI - Framework for institutional policies and procedures to deal with misconduct in research. AAMC papers. PMID- 2765071 TI - Analysis of cell cycle subpopulations from cytometric data. AB - As a result of experimental error, measurements of the DNA content of cells from proliferating populations give rise to histograms in which the G1-phase, S-phase and G2-phase distributions overlap. A new method for distinguishing these subpopulations is proposed, based on a model in which the S-phase subpopulation is made up of a number of uniformly overlapping log-normal curves, whose composite has a rectangular central part and sloping ends. The ratio between certain parameters of the slopes and the height of the rectangle is shown to be closely related to the degree of overlap of the constituents by a defined cubic polynomial. It is then possible to calculate the numbers of cells in each of the three phases of the cell cycle, even when only a few hundred cells have been measured. PMID- 2765072 TI - Cytometric and histologic predictors of prognosis in ampullary carcinoma treated with pancreatico-duodenectomy. AB - The association between several clinical, histologic and karyometric variables and the survival rates of patients with ampullary carcinoma was examined. Cases were limited to those treated exclusively by pancreaticoduodenectomy for which follow-up data was available, eliminating those cases with deaths due to other causes. The histologic type was classified as papillary, intestinal or mixed while the differentiation was recorded as well, moderate or poor. The stroma was categorized as scanty, moderate or abundant, and the tumor stage was evaluated according to Martin's classification. High-resolution morphometric and microphotometric (DNA content) evaluation of Feulgen-stained nuclei was performed using the microTICAS system. Statistical analyses were performed to examine the relationship between these variables and survival. Neither the tumor stage nor the presence of positive lymph nodes was a significant prognostic indicator, nor was the degree of differentiation or the amount of stroma. However, the survival showed a significant association with several karyometric variables and with the histologic type. Specifically, aneuploid DNA ploidy profiles, higher mean ploidy values and larger nuclei were associated with a lower survival rate. Short-term survivors (less than five years) had a mean ploidy of 2.8N, a mean 5N exceeding rate of 8.3% and a mean nuclear area of 41 sq microns, while long-term survivors (greater than or equal to five years) had corresponding means of 1.9N, 0.6% and 26 sq microns. These differences are all significant at a two-tailed significance level of less than .05 using a separate variance estimate t-test. In addition, papillary tumors showed a better prognosis than did intestinal or mixed tumors (Breslow P less than .04 and Mantel-Cox P less than .009). PMID- 2765073 TI - Dissociation of cellular protein and DNA content in mild and moderate dysplasia as a reflection of the degree of aneuploidy in cancer. AB - Tumor progression was analyzed in vivo. The bronchial epithelium in five beagle dogs was weekly treated by 20-methylcholanthrene (20-MC). Bronchial cells were harvested before each application of the drug. The cytologic criteria used in the diagnostic procedure were based on a grading developed for Papanicolaou-stained preparations of human squamous bronchial epithelium. The cells were then destained and restained by Feulgen-naphthol yellow S technique. An increased variation in the protein/DNA ratio was an early event in tumorigenesis; it occurred even before aneuploid cells appeared in mild dysplasia, as compared with the control cells. A large increase in the coefficient of variation (CV) in the protein/DNA ratio in mild dysplasia vis-a-vis the control cells was positively correlated to the degree of aneuploidy occurring later in tumorigenesis. These results were compared with the findings in breast cancer cells from patients with near-diploid, aneuploid and near-tetraploid tumors. The CV in the protein/DNA ratio was significantly higher in the aneuploid tumors, indicating an increased dissociation between cell growth and DNA synthesis. PMID- 2765074 TI - Karyometric marker features in tissue adjacent to in situ cervical carcinomas. AB - Subtle changes in nuclear chromatin structure have been documented in the histologically normal mucosa adjacent to neoplastic lesions. To evaluate the expression of such "marker features" in tissue adjacent to squamous carcinomas in situ (CIS) of the uterine cervix, normal-appearing ectocervical tissues from five cases of CIS were compared with ectocervical tissues from control patients with squamous metaplasia. Formalin-fixed, paraffin-embedded tissue sections were Feulgen stained and analyzed with the microTICAS video microphotometer. Discriminant analysis revealed seven features that helped to distinguish nuclei from ectocervical tissue adjacent to CIS from those of control tissue. These features reflected changes in nuclear shape and chromatin distribution that were not detected by routine histopathologic analysis. The findings may reflect a subtle premalignant change in the apparently normal mucosa adjacent to a cervical neoplasm; they may also reflect the influence of the neoplasm on the adjacent mucosa. PMID- 2765075 TI - Karyometric marker features in tissue adjacent to invasive cervical carcinomas. AB - A companion study showed the existence of statistically significant changes in the value of karyometric "marker features" in the nuclei of histologically normal appearing ectocervical epithelium adjacent to carcinomas in situ. In this second part of the study, the results obtained in patients with invasive cervical carcinomas were analyzed. Formalin-fixed, paraffin-embedded tissue sections were Feulgen stained and analyzed with a microTICAS video microphotometer. The results, demonstrated for the first time in histologic material, indicate that the marker features are clearly expressed in a majority of nuclei observed in the normal-appearing tissue adjacent to invasive lesions. This effect was statistically significant. The best marker features selected by the discriminant analysis were nuclear roundness, nuclear perimeter length, total optical density and a run length texture measure. These findings may reflect a subtle transformation of the apparently normal cervical epithelium adjacent to an invasive cervical carcinoma. PMID- 2765076 TI - A method to cope with the random errors of observed accident rates in regression analysis. AB - The paper is concerned with linear multiregression analysis on accident rates related to road geometric design elements. Supposing that a data set of accident records and geometric design elements of a certain stretch of a road is given, there are two steps for regression analysis: first, division of the road into a number of segments; and second, application of regression analysis to the set of segments. The main interest of the present paper is the first step. Occurrence of a traffic accident in a road segment is a stochastic event and an observed accident rate in a segment contains a certain magnitude of random error that deteriorates the explanatory power and reliability of the regression analysis. Random errors are required to be appropriately controlled for an effective regression analysis. The first part of the paper discusses how to evaluate a random error contained in an accident rate of a road segment and shows that a random error depends on the number of accidents and vehicle-kilometerage of the segment. It is then shown that random errors of the segment should be as much as possible equal to each other and small enough compared with the accident rate variance based on the discussion of how the random errors affect the efficiency of regression analysis. Several alternative criteria on the random errors for dividing a road into segments are proposed and numerical examples of Tokyo-Kobe Expressway are presented to examine the appropriateness of the alternative criteria. One of them is finally recommended as the most practically useful criterion. PMID- 2765077 TI - The optimism bias and traffic accident risk perception. AB - Research suggests that people are excessively and unrealistically optimistic when judging their driving competency and accident risk. In this study, college-age drivers compared their risk of being involved in a variety of described traffic accidents relative to their peers. They also rated each of the accidents along a number of dimensions hypothesized as being related to optimism. In addition, subjects provided global estimates of their driving safety, skill, and accident likelihood. Significant optimism was evident for both the accidents and the global ratings. Optimism increased with driving experience and marginally with age. Those with more driving experience considered human factors to be more important in accident causation; those assigning more importance to human factors also rated themselves as more skillful drivers. For the specific accidents, perceived controllability was a strong predictor of optimism. The findings for controllability are interpreted in terms of other recent data and hypothesized explanations of the optimism bias. In general, it appears that optimism arises because people persistently overestimate the degree of control that they have over events. PMID- 2765078 TI - Cross-cultural differences in driver risk-perception. AB - This study investigated differences in risk-perception among U.S., Spanish, West German, and Brazilian drivers. Subjects estimated the risk involved in slide projected traffic scenes. The scenes, photographed in the United States and Spain, were rated for the amount of risk by using a seven-point scale. The subject groups in each country included younger, middle-aged, and older nonprofessional drivers, as well as middle-aged professional (bus, taxi, or truck) drivers. In the data analyses, the independent variables were subjects' country, age, professional driving experience, and sex, and 23 dichotomously coded characteristics of the traffic scenes. The following are the main findings: (1) Spanish drivers reported the highest risk, while U.S. drivers reported the lowest risk; (2) younger drivers tended to report lower risk than middle-aged and older drivers; (3) nineteen of the 23 analysed characteristics of traffic scenes contributed significantly to risk ratings, even after simultaneously controlling for the effects of all other scene characteristics; (4) ten scene characteristics had a differential effect on the risk ratings in the four tested countries; (5) two scene characteristics had a differential effect on the risk ratings in the four tested subject groups; (6) none of the variables affected differentially the risk ratings of professional vs. nonprofessional drivers and males vs. females. These findings provide information concerning the desirable country- and age specific emphasis in driver education, driver licensing, and public information campaigns. PMID- 2765079 TI - Cross-cultural differences in driver risk-taking. AB - This study investigated differences in simulated driver risk-taking behavior among U.S., Spanish, and West German subjects. The task consisted of performing a simulated intersection crossing on a video display. Subjects were shown an intersection with moving traffic on a horizontal road, and they were asked to attempt (under time pressure) a fixed number of crossings with a car moving vertically. The subjects in all three countries included younger, middle-aged, and older persons of both sexes. The following are the main findings: (1) The performance of West German subjects tended to differ from those of U.S. and Spanish subjects. Specifically, West German subjects attempted fewer crossings, had a higher probability of success, and had greater safety margins. (2) Target risk-level of performance, measured by probability of successful crossings, was not affected by age or sex. (3) Probability of attempted crossings was greater for males and younger subjects than for females and older subjects. (4) Similarly, safety margins during attempted crossings were smaller for males and younger subjects than for females and older subjects. These results suggest that there are differences among countries in the target risk-level of performance. However, the present findings imply that within each country all subjects (regardless of age and sex) tended to have the same target risk-level. To attain this risk-level of performance, males and younger subjects (because of their presumed superior psychomotor skills and/or greater experience with video tasks) attempted to cross more gaps (and, consequently, smaller gaps), with resulting smaller safety margins. PMID- 2765080 TI - Cross-cultural differences in driver self-assessment. AB - This study investigated differences in driver self-assessment among U.S., Spanish, and West German drivers. Subjects responded to 14 questions that used five-point semantic scales dealing with driver performance and abilities. Pairs of questions, concerning the same driving-related aspects, differed by requesting a self-assessment on an absolute basis and in relation to the average driver. The subjects in all three countries included younger, middle-aged, and older drivers of both sexes. The following are the main findings: (1) a majority of drivers in each country rated themselves positively on all driving-related scales studied; (2) significant effects of country, age group, and sex of the subjects were present for several of the scales; (3) some of these effects remained significant even after controlling for the differential driving experience. For example, U.S. drivers assessed themselves as safer than did West German and Spanish subjects, younger subjects less wise than middle-aged and older subjects, and males more relaxed than females. PMID- 2765081 TI - Fatalities caused by nonvenomous animals: a ten-year summary from Sweden. AB - All 58 deaths caused by nonvenomous animals in Sweden 1975-1984 were scrutinized. In 38 cases horses were involved, in 16 cattle and in one case each a moose, a lion, a dog and a ram. In the horse-related fatalities, the most common cause of accident was that the horse bolted or reared, causing the rider to fall off the horse or the cart or sulky. Falls were thus associated with 22 horse-related deaths. In cattle-related accidents, all fatalities where the cause of accident was known occurred due to aggressive behaviour of the animal. In horse-related accidents, head injuries dominated, while in cattle-related accidents head and chest injuries were equally common. It is suggested that wearing a proper helmet is the most important safety measure in horse-related activities. In cattle related activities, the herding of untethered bulls together with cows is particularly dangerous and should be avoided. PMID- 2765082 TI - The relation between alcohol-related fatal accidents and per capita alcohol consumption in Ontario: comments on a paper by Mann and Anglin. PMID- 2765083 TI - Injury severity scoring: a comparison of early clinical versus discharge diagnosis. AB - The Abbreviated Injury Scale (AIS) and the Injury Severity Score (ISS) are objective means of assessing injury. Accepted methodology involves retrospective scoring of injury based on discharge diagnoses. Recently, early clinical scoring, supplemented by review at discharge, has been introduced. A prospective study was instituted to compare these methodologies. Four hundred sixty consecutive victims of blunt trauma were scored using both clinical and retrospective methodologies by independent, blinded observers. Of these, 333 patients had a change in ISS, 174 with a change of greater than four points. The population mean ISS remained unchanged; however, paired values were significantly different (p less than .03). We conclude that either methodology is applicable for studies of large populations of trauma victims. When accurate individual AIS or ISS scoring is required, the clinical method combined with discharge review is most appropriate. PMID- 2765084 TI - Epilepsy and driving in North Carolina: an exploratory study. AB - Epileptic drivers offer a risk to the general driving population, both because of affected brain function and because of possible effects of medication. A 1982 pilot study examined the driving records of 112 persons using North Carolina Division of Health Services clinics for the treatment of epilepsy who also held a North Carolina driver's license. Of those undergoing treatment in the clinics, 26% were known by the Division of Motor Vehicles (DMV) to be epileptics. This group had a reported crash rate 1.4 times that of the general driving population, whereas the rate for epileptics not known to the DMV was 1.1 times the general rate. Epileptics with grand mal and temporal or psychomotor seizures accounted for all recorded crashes. Implications for highway safety administrators and for future research are discussed. PMID- 2765085 TI - Agricultural pesticide accidents and prevention in Ecuador. AB - Accidents due to the misuse and abuse of agricultural pesticides is a worldwide problem. Although data gaps exist, there is an ever-growing body of information on the incidence and nature of pesticide-caused poisonings in the developing countries of the world. The information gathered in a field study in Ecuador, South America, among rural-based users of pesticides contributes to the understanding of the problem. Factors that contribute to accidental poisonings are detailed and described and are related to accident prevention efforts. PMID- 2765086 TI - Granulocyte activation by a cell surface complex of Staphylococcus saprophyticus: a receptor-mediated phenomenon. AB - High molecular weight cell surface complex (CSC) from Staphylococcus saprophyticus strain S 1 could be shown to be a potent stimulator of human polymorphonuclear leukocyte (PMN) chemiluminescence whereas human monocytes were not activated. Heating of the CSC (100 degrees C for 5 min) as well as protease treatment significantly (p less than 0.001) inhibited the PMN activating process suggesting that the protein part of the molecule mediates its biological activity. Data on the biochemical character of the CSC are given. Preincubation of PMNs with CSC inhibited another chemiluminescence response to this substance and to homologous opsonized S. saprophyticus, respectively. However, restimulation with formylmethionyl peptides (fMLP) or non-opsonized staphylococci suggested that the PMN function is a receptor-mediated phenomenon. These data were substantiated since fMLP activated PMNs could be evidently re-stimulated with CSC but not with analogue peptides. Evaluation of the bactericidal capacity of human PMNs yielded comparable results. PMID- 2765087 TI - Inhibitory effect of Toxoplasma lysate antigen on the multiplication of transplanted tumor in mice. AB - Tachyzoites of the RH strain of Toxoplasma gondii were pretreated by a process of freezing and thawing followed by ultrasonication. After ultracentrifugation at 144,000 g for 120 minutes, the resulting supernatant contained a protein (TLA 144), which consisted mainly of a component of protozoan origin with a molecular weight of 10,000-20,000, and additional sugars, peptides, and amino acids. TLA 144 was soluble in water and of very low toxicity. Mice that had been inoculated with allogeneic (S-180) and syngeneic (Meth A) transplantable tumor cells, were injected intramuscularly with 100 micrograms of TLA 144 once a week for some time beginning one week after transplantation. It was found that after TLA treatment the multiplication of tumor cells was more intensely inhibited than following administration of OK-432, one of the biological response modifiers (BRMs). PMID- 2765088 TI - Mycobacterium scrofulaceum, serovar Cole. AB - Cole strains of Mycobacterium, originally introduced as M. scrofulaceum serovar No. 44 and later rejected as belonging to M. avium were re-investigated and compared with well-documented strains of M. scrofulaceum. Our data show that the Cole serovar belongs to M. scrofulaceum and should be re-introduced as serovar No. 44 of M. scrofulaceum. PMID- 2765089 TI - Characterization of extracellular neuraminidase produced by Actinomyces pyogenes. AB - Extracellular neuraminidase from Actinomyces pyogenes could be isolated by ammonium sulfate precipitation, ion exchange chromatography with DEAE cellulose and gel filtration on Ultrogel ACA 54. The purified enzyme had a molecular weight of approximately 50,000 Dalton, a pH optimum at pH 6.0, a temperature optimum at 55 degrees C and a Km value of 1.4 X 10(-4) mol/l with N-acetyl-neuraminlactose as substrate. Preparative isoelectric focussing of the culture supernatant revealed neuraminidase activity mainly at pH 6.5. The enzyme activity was not influenced by metalions or EDTA. PMID- 2765090 TI - Type-specific antigen of Streptococcus rattus strains (KAY1 and FA1). I. Characterization. AB - A serotype-specific antigen was extracted from Streptococcus rattus KAY1 strain isolated first in Japan from human dental plaque and purified on an ion exchange column to compare it chemically and immunologically with that of FA1 strain which had been examined extensively by previous workers. Antigens of both strains reacted in a double diffusion test specifically with anti-FA1 serum which had previously been demonstrated specific for the strains in the same test, agglutination reactions and/or radioimmunoassay using whole cells. After separation on a DEAE-Sephadex A-25 ion exchange column the antigen was found to be resistant to various enzymatic treatments with pronases, lipase and nucleases and produce a single precipitin band against absorbed anti-FA1 serum in immunoelectrophoresis. Chemical analysis of this antigen revealed that it composed of carbohydrate, protein and a few percentages of glycerol and phosphorus. Hapten inhibition tests between antigen and antibody showed that galactose as well as glucose were the most potent inhibitors, suggesting their involvement in the antigenic determinant. Involvement of the sugars was also supported by gas chromatographic analysis and abolishment of reactivity with antiserum after the treatment of antigens with NaIO4. Moreover, protein does not seem to be involved since after SDS-PAGE analysis an enzyme immunoassay gave a negative reaction with immunoblotted antigens. PMID- 2765091 TI - Isolation and characterization of hyaluronidase from Streptococcus uberis. AB - All tested cultures of Streptococcus uberis produced free hyaluronidase. Hyaluronidase could be isolated by ammonium sulfate precipitation and was further purified by chromatography on DEAE-cellulose, gelfiltration on ultragel ACA44 and isoelectric focusing. The purification factor was estimated to be 1689. The purified hyaluronidase had an isoelectric point at pH 4.9 and a molecular weight of approximately 54000 D. It showed maximal enzyme activity at pH 6.0 and 45 degrees C. The Michaelis constant was estimated to be 7.0 X 10(-2) mg/ml. Hyaluronidase activity was stimulated by Ca++, Mg++, Mn++, Co++, Li+, and K+ and inhibited by Zn++ and Cd++ at final concentrations of 10 mmol/l, respectively. PMID- 2765092 TI - Streptolytic activities of a lytic enzyme from Staphylococcus hyicus. AB - The LE IIIb fraction of the bacteriolytic enzyme from Staphylococcus hyicus could be isolated by ionic exchange chromatography and subsequent gel filtration. Isoelectric focusing of the highly purified enzyme preparation revealed an isoelectric point at pH 10.3. The lytic activity of LE IIIb on streptococci of various serogroups could be effectively analyzed with the help of an aggregometer and expressed as increase of transmittance at 546 nm. The streptococci differed in their LE IIIb lysis pattern, which was more pronounced with those of serological groups C and D and Streptococcus uberis. The lytic effect of the LE IIIb fraction was optimal at low molarity (0.01 mol/l) of the lysis buffer and reduced in the presence of HgCl2 and EDTA. PMID- 2765093 TI - The gnotobiotic piglet as a model for the pathogenesis of Campylobacter jejuni infection. AB - The pathogenesis of enteric changes was studied in gnotobiotic piglets which, after hysterectomy had been infected orally with Campylobacter jejuni on the first day of their life. The involvement of the entire large intestine became clinically manifest by scouring on days post infection (DPI) 4 to DPI 5, and pathomorphologically, by simultaneous inflammation and severe edema of the intestinal wall. Histology and SEM revealed inflammatory edema with abundant neutrophils, microulcerations, focal propagation and activation of goblet cells, and a presence of mucin-positive material within the intestinal lumen. TEM examination revealed disconnected interdigitating folds and wide dilated intercellular spaces between enterocytes. The endothelial cells of small blood vessels in the lamina propria showed hypertrophy with increase in the thickness of their basal lamina. Ultrastructural lesions of the large intestinal microcirculation also support the hypothesis that disturbances in the vascular system are responsible for edema in the cecum and colon. Gnotobiotic piglets may be used as a suitable animal model to study colitis induced by C. jejuni. PMID- 2765094 TI - M-VAC or MVC for the treatment of advanced transitional cell carcinoma: metastatic, induction, and adjuvant. AB - The cisplatin-based combination chemotherapy regimens of M-VAC (methotrexate, vinblastine, doxorubicin, cisplatin) or MVC (methotrexate, vincristine, cisplatin) were given to 25 patients with metastatic urothelial carcinoma, 13 with locally advanced bladder cancer, and 10 as adjuvant therapy after radical surgery. Toxicity was significant with two deaths. Forty-eight percent of the patients with metastatic disease had a complete (20%) or partial (28%) response. Survival was only improved if a CR was achieved. Nine of 13 patients given M VAC/MVC as neoadjuvant therapy underwent cystectomy and six are free of disease (mean 31 months). Three of the four patients who did not have radical surgery are also free of disease. These regimens appear to be superior to cisplatin alone. In the overall response evaluation, however, toxicity is greater. PMID- 2765095 TI - Chronic experimental autoimmune encephalomyelitis in the guinea pig. Presence of anti-M2 antibodies in central nervous system tissue and the possible role of M2 autoantigen in the induction of the disease. AB - Experimental autoimmune encephalomyelitis (EAE) can be transferred adoptively with T cells sensitized to the basic protein of myelin (BP). However, in the guinea pig, the chronic form of EAE has not been found to be inducible with BP alone, nor has it been adoptively transferred. An antibody response to the central nervous system (CNS) myelin autoantigens was looked for in serum and target CNS tissue in S13 guinea pigs with isologous CNS tissue-induced chronic EAE. Antibody activity was estimated by an immunoenzymatic technique and by autoradiography, using immunoprecipitated and electrophoresed relevant radiolabelled antigens. In serum, IgG antibody response to BP and M2 reached its maximum level 30 to 40 d after immunization and then declined progressively until it became undetectable. On the other hand, while anti-BP antibodies were seldom detected in CNS tissue acid extract, anti-M2 IgG antibodies were always present in CNS tissue of chronic EAE animals, and the amount of these antibodies were related to the severity of symptoms and lesions. No antibody response to proteolipid or to galactocerebroside was detected in serum or CNS tissue. BP immunized controls showed no chronic EAE and no response to M2 in their serum or CNS tissue. Inasmuch as M2 has been shown to be a glycoprotein of CNS myelin, and anti-M2 antibodies to have a demyelinating property, the latter would be responsible for CNS tissue demyelination in chronic EAE. A shared role of BP and M2 in the induction of chronic EAE in the guinea pig is suggested. PMID- 2765096 TI - Elevated levels of the 90 kd heat shock protein in a proportion of SLE patients with active disease. AB - The human 90 kd heat shock protein (hsp 90) is associated with the receptor for glucocorticoid hormones and is believed to play a role in the cellular response to corticosteroids. The levels of this protein in the peripheral blood lymphocytes of patients with systemic lupus erythematosus (SLE) have been investigated and compared with those observed in normal individuals and patients with rheumatoid arthritis. Fifteen percent of SLE patients were found to exhibit hsp 90 levels well in excess of those observed in the other groups. These patients all had active disease. The significance of these findings is discussed both in terms of the disease processes occurring in these patients and the efficacy of steroid therapy. PMID- 2765097 TI - Class II MHC antigen induction on rat insulinoma (RINm5F) and colon carcinoma (TS) cells by co-culture with diabetic and normal xenogenic lymphocytes. AB - Two MHC Class II-negative rat epithelial cell lines (RINm5F beta-cells and TS colic cells) were co-cultured with xenogenic lymphocytes from Type I diabetic patients or from low-dose streptozotocin (SZ) diabetic mice. MHC Class II antigens (Ag) were easily induced on both cell lines in such co-culture conditions, representing an experimental approach to insulitis. Our data indicate that: (1) lymphocytes from diabetic patients or from SZ mice were more efficient than lymphocytes from healthy controls in inducing Class II Ag on RIN cells. Lymphocytes from patients with autoimmune thyroid diseases were also more efficient than control lymphocytes, indicating that the ability to induce Class II may be related to the activation of lymphocytes rather than being diabetes specific. (2) Rat colon carcinoma cells (TS) were also induced to express high levels of Class II Ag upon co-culture with SZ or control mouse lymphocytes. (3) Class II+ RIN cells were observed after 24 h of co-culture; their number increased after 48 and 72 h. The number of class II+ RIN increased proportionally to the number of lymphocytes in the culture. (4) Induction of Class II Ag was obtained by cell-free supernatants of mouse lymphocytes/RIN co-cultures and was inhibited by cyclosporine A, suggesting that Class II induction in this model is mediated by lymphokines. (5) Depletion experiments indicate that both monocytes and lymphocytes play a role in this Class II induction. PMID- 2765098 TI - Serum IgD levels in mice: effect of strain, age and autoimmune disease. AB - Serum IgD levels were studied in mice. Strain-related variability of serum IgD levels was noted, and advanced age was associated with markedly increased IgD levels in a large percentage of mice from all strains. Strains prone to spontaneously arising autoimmune disease had elevated IgD levels; in NZB mice this was already present very early after birth (one week), whereas in MRL mice the elevated serum IgD levels were first seen somewhat later (3 months). In contrast, mice with collagen type II (CII)-induced autoimmune arthritis had no increase in serum IgD. Injection of the immunomodulating agents LPS and complete Freund's adjuvant (CFA) did not have a significant effect on serum IgD levels, but IL-1 induced a significant decrease in IgD. PMID- 2765099 TI - Natural autoantibodies in nude and normal outbred (Swiss) and inbred (BALB/c) mice. AB - Spleen cells from adult unprimed outbred (Swiss) and inbred (BALB/c) mice, either normal (no) or athymic-nude (nu) as well as spleen cells from Swiss nude mice bearing two different human tumors (BUR and PINQ), were fused with the mouse non secreting myeloma cell line P3X63 Ag8-653. The supernatants of immunoglobulin secreting hybrids, all containing IgM, were screened for antibody activity against macromolecular antigens (autologous: actin, tubulin, myosin, dsDNA) and haptens (TNP, NP, NIP and NBrP). Furthermore, their idiotypic determinants were analyzed using a rabbit anti-idiotype which recognizes a major cross-reactive idiotype (IdD23) of BALB/c natural polyreactive autoantibodies. In all the mice studied, we identified: (1) hybrids reacting strongly with one or more haptens (10.7 to 37.8%) and (2) hybrids secreting natural monoclonal autoantibodies (NMoAb) with broad reactivities (polyreactive and/or oligoreactive) against autoantigens and/or haptens (11.4 to 26.8%). The results indicate that: (1) cells secreting natural autoantibodies with broad reactivities exist in both normal and nude mice, independently of the genetic background (inbred/outbred) of the mouse. However, in nude mice, the natural autoantibodies exhibit a more restricted pattern of reactivity (oligoreactive) compared to those of normal mice, and do not express the common idiotype IdD23 of natural polyreactive autoantibodies. (2) Tumors grafted into nude mice seem to induce the expression of polyreactive autoantibodies bearing the IdD23. PMID- 2765100 TI - Characterization of two anti-DNA antibodies bearing distinct idiotypes. Correlation with clinical manifestations. AB - Spontaneous idiotype shift of anti-DNA antibodies in systemic lupus erythematosus was shown to be associated with changes in the clinical manifestations of the disease. Characterization of two anti-DNA antibody preparations from the same lupus patient showed that lupus nephritis was associated with antibodies showing higher specific antigen-binding activity and avidity to DNA and presenting more cationic quality upon isoelectric focusing and Western blot analysis than the ones found in patients without renal involvement. Lupus cerebritis was associated with anti-DNA antibodies with different idiotypic characteristics not shared by anti-DNA antibodies present in lupus nephritis. Lupus cerebritis anti-DNA antibodies had less specific antigen-binding activity and avidity to DNA and did not show cationic quality. Idiotypic and immunochemical changes of anti-DNA antibodies in lupus may be associated with various clinical manifestations. PMID- 2765101 TI - Positive crossmatches--when is it safe to transplant? AB - There is no doubt that the interpretation of a positive lymphocytotoxic crossmatch test has changed over the past 10-15 years. It is now generally accepted that the original dogma put forward in the mid-1960s "that a renal transplant must not be performed in the presence of a positive lymphocytotoxic crossmatch" is no longer tenable, and many positive crossmatch transplants have already been successfully carried out. However, the precise conditions under which such a transplant can be performed are still not fully understood. Some factors which should be considered when deciding whether or not to transplant in the presence of a positive crossmatch are: (1) the specificity of the antibody, and this can be HLA class I, class II or non-HLA; (2) the time interval between the last positive crossmatch serum and transplantation; and (3) the immunoglobulin class of the antibody, either IgG or IgM. PMID- 2765102 TI - Effect of cyclosporin A on carbohydrate metabolism in the rat. AB - Liver and kidney carbohydrate metabolism was investigated in rats treated with daily doses of 15 mg/kg body weight cyclosporin A (CyA) for 2 and 8 weeks or of 50 mg/kg body weight CyA for 2 weeks. The higher dosage caused significantly reduced liver glycogen and liver glycogen synthetase activity (of both active I form and total enzyme activity), whereas the activity of the glycogen-degrading enzyme phosphorylase (active a-form and total activity) remained unchanged. Plasma glucose and glucagon levels, as well as blood ketone bodies of these animals, increased significantly and plasma insulin decreased. In contrast, kidney glycogen and glucose content were higher in rats treated with 50 mg CyA, probably due to enhanced ketone body utilization. Reduced liver glycogen synthetase activity was also found in rats treated with 15 mg CyA. Our data suggest that hypoinsulinemia, induced by CyA, might be a contributing factor to the hyperglycemia, which is mainly due to inhibition of liver glycogen synthesis. PMID- 2765103 TI - Plasma levels following intranasal and intravenous administration of human interferon-beta to rabbits. AB - Rabbits were given single doses (2 x 10(6) IU) of human fibroblast interferon (HuIFN-beta) by the following routes of administration: (a) intravenous injection, (b) dropwise intranasal administration of a liquid dosage form, and (c) spraywise intranasal administration of a powder dosage form. Following the intravenous injection, plasma HuIFN-beta concentrations declined rapidly in a biphasic manner in agreement with a two-compartment model, whilst concentrations following the intranasal administrations conformed to a one-compartment model. Maximum plasma levels and the areas under the plasma concentration-time curve (AUC) in response to dose were studied in the case of the spray administration, and found to be proportional to dose. The systemic bioavailability of HuIFN-beta (administered with sodium glycocholate and excipients) via the nasal routes was about 3% of that via the intravenous route. The elimination half-lives did not differ significantly between these two routes of administration. PMID- 2765104 TI - Synthesis and cytotoxic activity of pyridylthio, pyridylsulfinyl, and pyridylsulfonyl methyl acrylates. AB - Nineteen 2-pyridylthio (2), 2-pyridylsulfinyl (3) or 2-pyridylsulfonyl (4) derivatives of (Z)-methyl acrylate were synthesized in order to investigate the effect of the oxidation state of the sulfur atom, and the position and nature of pyridyl substituents on cytotoxic activity. Analogous sulfinyl and sulphonyl derivatives were equipotent, and more potent than analogous thio derivatives, in an vitro L1210 screen. In most cases, incorporation of nuclear trifluoromethyl and chloro substituents at various positions of the pyridyl ring of the sulfinyl derivatives (compounds 3b-3h) decreased activity relative to the unsubstituted sulfinyl 3a (ED50 0.43 micrograms/ml). Compounds 3b, 3d and 3i exhibited weak antineoplastic activity in an in vivo P388 screen at a dose of 5 mg/kg. PMID- 2765105 TI - Evidence that the antimalarial activity of artemisinin is not mediated via intercalation with nucleotides. AB - The interaction of artemisinin, a new sesquiterpine lactone antimalarial drug, with some target macromolecules represented by calf thymus deoxyribonucleic acid (DNA) and the dinucleotide guanylyl (3----5) cytidine (GpC) was studied by 1H NMR. There was no intercalation between artemisinin and DNA or GpC as judged by the lack in change of chemical shifts (delta delta) or coupling constants (delta J) of the C-13, C-14, and C-15 methyl groups of artemisinin. This conclusion was substantiated by studying the optical rotatory dispersion (ORD) between artemisinin and these target macromolecules. It is suggested that artemisinin exerts its antimalarial action via a mechanism different from that of the aminoquinolines antimalarial agents, possibly through the peroxygen linkage which is essential for artemisinin biological activity. PMID- 2765106 TI - Micronized emulsion for controlled release of physostigmine after oral administration. Part I. Formulation design. AB - Our aim was to incorporate physostigmine in a fine micronized emulsion delivery system which would prolong drug release following oral administration. Investigation of various types of equipment and experimental conditions led to a fine micronized emulsion of mean droplet size around 1 micron, which was stable at pH 5.5. The effect of physostigmine concentration and salt formation on the interfacial tension and zeta potential of the emulsion was studied. Physostigmine base markedly decreased the interfacial tension as compared to physostigmine hemisulfate and salicylate. Zeta potential was highest in the case of the salicylate. After storage at 4 37 degrees C for four months, the emulsion did not undergo any significant change. PMID- 2765107 TI - Micronized emulsion for controlled release of physostigmine after oral administration. Part II. Release characteristics and pharmacological evaluation. AB - In vitro release of physostigmine from an emulsion was more prolonged than from a tablet. This prolongation was attributed to the retention capacity of the dispersed oil droplets. Increase of the oily phase volume ratio from 20 to 50% did not substantially decrease the rate of release, and decrease of the mean oil droplet size did not affect the release profile, indicating that the drug was mainly localized in the external phase of the emulsion. The profiles agreed with those predicted from our earlier mathematical equation based on a three compartment model system. In rabbits there were no significant differences in the Tmax and AUC values obtained by use of a tablet and the emulsion form, but the emulsion form elicited less enzyme inhibition. T20 (the therapeutic occupancy time) was markedly extended following use of the emulsion form. PMID- 2765108 TI - Preparation and evaluation of intragastric buoyant preparations. AB - The design and preparation of two drug formulations which float in gastric juice are described. One, a buoyant tablet, consisted of powdered soybean protein, drug and sodium bicarbonate. The other, a laminated film-type preparation, consisted of a drug film, an effervescing film containing sodium bicarbonate and outer drug release regulating films. Cinnarizine, an acid-soluble drug, was chosen as model drug, and carboxyvinyl polymer, ethyl cellulose and hydroxypropyl cellulose were used in the preparation of the films. Both formulations showed favorable buoyancy in an in vitro acidic dissolution test medium and also sustained release properties. In an absorption study using beagle dogs, cinnarizine was found in the blood even 24 hr after oral administration of the buoyant tablet or film-type preparation. Similar buoyant tablets containing barium sulfate were administered orally to a healthy volunteer, and it was confirmed by roentgenography that the tablets floated for almost three hours. PMID- 2765109 TI - Concerning racemic fixed ratio mixtures. PMID- 2765110 TI - Effect of pH on the nuclear magnetic resonance relaxivity of encapsulated solid paramagnetic substances. AB - Encapsulation, by acid-stable materials, of solid paramagnetic metal complexes based on sulphonated polystyrene ion-exchange resin, prevents the significant demetallation which otherwise occurs when the complexes are subjected to an acidic environment equivalent to that of the human stomach (pH 1-2). In turn, this protects the ability of those complexes to enhance the nuclear magnetic resonance (NMR) spin-lattice relaxation rate of water. Application of the results in the development of contrast agents for MR imaging of the gastrointestinal (GI) tract, in the evaluation of coatings used in drug formulations, and in the measurement of GI transit times of drugs is suggested. PMID- 2765111 TI - QSAR study of the role of hydrophobicity in the activity of HMGR inhibitors. AB - The 3-hydroxy-3-methylglutaryl-coenzyme A reductase (HMGR) inhibitory activity of 7-(aryl/biphenyl)-6-heptenoic acids was quantitatively analysed using hydrophobicity, van der Waals volume and electronic parameters. The activity was primarily a function of hydrophobicity, and was well correlated with the hydrophobicity of ortho and meta substituents on the aryl/biphenyl moiety. The electronic properties of para substituents on the aryl/biphenyl ring influenced the inhibition. Our equations predict that substituents with positive polar and sigma and negative resonance constants might lead to better inhibition. PMID- 2765112 TI - Molecular cloning and sequence analysis of putative chicken prolactin cDNA. AB - A cDNA library was prepared from mRNA isolated from anterior pituitary glands of incubating bantam hens, in which prolactin mRNA levels were predicted to be very high. Nine clones, representing abundant mRNA species, were identified and shown to contain homologous sequences. Two clones, of 871 bp and 580 bp, were analysed by DNA sequencing. The shorter clone was found to be a truncated cDNA product but otherwise identical to the longer clone. The 871 bp cDNA, PRL101, contains an open reading frame capable of encoding a polypeptide of 229 amino acids. This putative polypeptide has a high degree of homology to mammalian prolactins (approximately 70%), strongly suggesting that PRL101 encodes chicken preprolactin. The protein was predicted to have a 30 amino acid signal sequence which would be cleaved off to give a mature protein of 199 amino acids. The peptide sequence also had a 26% homology to chicken growth hormone, which is related to prolactin. This similarity confirms the conclusion that PRL101 is a chicken prolactin cDNA clone. An abundant mRNA of approximately 880 b was detected in poly(A)+ RNA from pituitary glands probed with PRL101. Analysis of chicken genomic DNA showed that there is one copy of the prolactin gene in the genome. PRL101 hybridized strongly to genomic DNA from closely related galliforms (quail and turkey) and less strongly to DNA from more distantly related species (duck and ring dove). PMID- 2765113 TI - Pro-opiomelanocortin mRNA size heterogeneity in ACTH-dependent Cushing's syndrome. AB - As an approach to understanding the abnormalities of pro-opiomelanocortin (POMC) gene regulation in human ACTH-secreting tumours, we have analysed the POMC mRNA content of nine such tumours using the Northern blot technique. Most of the tumours and normal human pituitary contained easily detectable quantities of POMC mRNA. The length of this message in most tumours was similar to, or slightly larger than, that in the normal pituitary (1150-1200 bases). Ribonuclease H studies suggested that the origin of any size heterogeneity was a longer poly(A) tail in the tumour RNA. Some tumours, however, expressed a short POMC mRNA (800 bases) which may lack the first two exons of the POMC gene as has been described. A third POMC mRNA size variant (1500 bases) was also seen in low levels in two cases, and as the principal mRNA species in one case. Primer extension and S1 nuclease protection studies suggested that most transcripts in the tumours analysed originated from the conventional promoter, and thus the use of an alternative promoter is not an adequate explanation for the expression of this gene in ectopic ACTH-secreting tumours. PMID- 2765114 TI - Oestrogen receptor mRNA and a related RNA transcript in mouse ovaries. AB - Oestrogen receptor mRNA expression in mouse ovaries was analysed by Northern blotting of total RNA using 32P-labelled RNA probes complementary to different functional domains of the oestrogen receptor. The approximately 6.5 kb mouse oestrogen receptor mRNA transcript was present in immature and adult ovaries at extremely low abundance compared with uterus and oviduct. Using a probe complementary to the steroid-binding domain of the oestrogen receptor (probe EF), a novel RNA transcript of approximately 1.5 kb was also found in the ovaries but was absent from uterus and oviduct. The melting temperature of the hybrid produced by the approximately 1.5 kb transcript with probe EF was approximately 10 degrees C lower than that produced by authentic oestrogen receptor mRNA, which demonstrates incomplete sequence homology between the two transcripts and indicates that the approximately 1.5 kb RNA is not a truncated form of oestrogen receptor mRNA. Furthermore, the approximately 1.5 kb RNA lacks the DNA-binding domain found in the oestrogen receptor. The approximately 1.5 kb RNA, but not oestrogen receptor mRNA, was enriched in total RNA from isolated granulosa cells compared with residual ovarian tissue. The encoded product of this novel oestrogen receptor-related RNA could be a steroid-binding protein involved in oestrogen action in the ovaries. PMID- 2765115 TI - Multiple forms of 17 beta-hydroxysteroid oxidoreductase in human breast tissue. AB - 17 beta-Hydroxysteroid oxidoreductase, the enzyme that catalyses the interconversion of oestradiol and oestrone, is known to be present in human breast tissue. However, it is not known whether one or more forms of the enzyme is present. Homogenates of breast adipose tissue and breast glandular tissue were fractionated and fractions assayed in the oxidative direction with NAD+ and NADP+ as coenzymes, and in the reductive direction with NADH and NADPH as coenzymes. Ultracentrifugation of homogenates showed that there was membrane-bound activity and soluble activity. The soluble activity was due to a number of forms of the enzyme with different molecular weights, three in breast adipose tissue and two in breast glandular tissue, as shown by fractionation with (NH4)2SO4 followed by chromatography on Sephadex G-200. The forms of the enzyme isolated differed in their affinities for substrates and coenzymes and in the relative rates at which they catalysed the oxidative and reductive reactions. Preliminary experiments with breast tumours showed that they also contained membrane-bound activity and more than one soluble form of the enzyme. PMID- 2765116 TI - [Role of food allergy in atopic dermatitis]. AB - Food allergy is one of the main causes of atopic dermatitis. Its frequency was established at 41.3% in our study. Eggs, cows milk and wheat were the foods most often responsible for DA. Proof by elimination-reintroduction is the best diagnostic criterion in food allergy, leading to suppression of the food if its nutritional importance permits this. This food suppression leads to 84% clinical improvement of DA. PMID- 2765117 TI - The prevalence of allergic disorders in Saudi Arabia: preliminary analysis based on surveying 300 individuals. AB - Prospective surveying of 300 (150 males, and 150 females) randomly selected individuals was carried out to study the pattern and prevalence of allergic disorders in the community. The mean age was 32.8 and 26.8 years for males and females, respectively. A total of 28 participants (17 males, and 11 females) (9.3%) were found to have personal history of allergic disorders. No significant sex difference was noted in the distributions of those allergies, except for more male predominance for allergic rhinitis. The latter was seen in 7 males and only one female (p = 0.033). Prevalence of bronchial asthma was rather rare as it was identified in only 2 individuals (0.7%). More males (16) than females (2) admitted a positive family history of allergy (P = 0.0005). Most of the familial history of allergic disorders was due to bronchial asthma (11 relatives). We conclude that allergic disorders are common in our local community. However, for more detailed assessment, a larger sample that includes various age distributions and different socioeconomic classes should be screened. PMID- 2765118 TI - Physicochemical characterization of alpha-crystallins from bovine lenses: hydrodynamic and conformational properties. AB - A detailed investigation of hydrodynamic and conformational behavior has been made of the HM alpha-crystallin and alpha-crystallins of bovine lens. Results from this study indicated that HM alpha (high-molecular-weight alpha-crystallin) and alpha (low-molecular-weight alpha-crystallin) possess considerable size and charge heterogeneities in their native structures and subunit polypeptides, respectively. Sedimentation velocity showed a heterogeneous polydisperse system of HM alpha with an average sedimentation coefficient of about 50S and a more homogeneous system of alpha-crystallin of 20 S. Viscosity and circular dichroism studies pointed to a compact and globular shape of dominant beta-sheet conformation for alpha-crystallin, yet a highly asymmetrical and aggregated form for HM alpha. The conformational stability of alpha-crystallin was investigated in the presence of various denaturants. The evidence presented shows that hydrogen bonding is the main force in maintaining the quaternary structure of compact native alpha-crystallin. Conformational flexibility of alpha-crystallin demonstrated in the equilibrium unfolding study indicated a multistep transition that made the extraction of thermodynamic data from the heat denaturation study difficult. Temperature perturbation on alpha-crystallin suggested the possible involvement of hydrophobic interaction in the aggregation process, leading to the formation of HM alpha from alpha-crystallin. The comparison of conformational properties between HM alpha and alpha-crystallin strongly indicated that HM alpha is a denatured form of alpha-crystallin. PMID- 2765119 TI - Microsequence analysis of winged bean seed proteins electroblotted from two dimensional gel. AB - Electroblotting method employing a semidry blotting apparatus for the subsequent protein microsequence analysis (Hirano, 1987) was improved. This method is convenient and allows rapid and efficient transfer of the proteins from a polyacrylamide gel (1 mm thick) onto the Polybrene-coated glass-fiber sheet or polyvinylidene difluoride membrane filter in only 20 min. The electroblotted proteins could be sequenced directly with the gas-phase protein sequencer at a 20 pmole level. This method was applied to the sequence analysis of winged bean seed proteins. A portion of the crude extracts from only one-twentieth of a seed of the winged bean was separated by two-dimensional polyacrylamide gel electrophoresis and electroblotted, and the N-terminal amino acid sequences of the blotted proteins were analyzed. The sequences of about 60% of the blotted major proteins, including nine Kunitz trypsin inhibitor-like proteins with heterogeneity in the N-terminal sequences, a protein that has a homologous sequence to the leghaemoglobin, nitrogen-fixing root nodule-specific protein, and a soybean basic 7S globulin-like protein could be easily identified. PMID- 2765121 TI - A review of photogrammetry with applications to implant film calibration and seed matching. AB - The basic concepts of photogrammetry, the science of making geometric measurements from photographs, are reviewed with an emphasis on applications to implant dosimetry. A seed matching algorithm is developed using those concepts. PMID- 2765120 TI - Physicochemical characterization of beta-crystallins from bovine lenses: hydrodynamic and aggregation properties. AB - A detailed investigation of the hydrodynamic and aggregation behaviors has been made on the beta-crystallins of bovine lens. Results from this study indicated that beta H (high-molecular-weight beta-crystallin) and beta L (low-molecular weight beta-crystallin) exhibited considerable heterogeneity in their native structures and subunit polypeptides. Low-speed sedimentation equilibrium showed a heterogeneous paucidisperse system in each beta-crystallin fraction. Viscosity and circular dichroism studies pointed to a compact and globular shape and the presence of beta-sheet and beta-turns in these crystallins. Dissociation of beta H by urea and guanidinium HCl followed by reassociation during gel-filtration chromatography produced an elution pattern with two fractions corresponding to beta L crystallin and high-molecular-weight aggregates without the formation of native beta H. By contrast, under similar treatment, about 60% beta L reassociated into the correct native structure and the rest into high-molecular weight fractions. Amino acid analyses of beta H and beta L and their corresponding subunit polypeptides demonstrated the close similarity of these crystallins. Trace element analyses indicated that both Ca and Mg are present in beta H and beta L crystallins and may be involved in maintaining the native quarternary structures of these proteins. PMID- 2765122 TI - Effect of lung-density correction in treatment planning for tangential-fields breast irradiation: a case report. AB - We report on the effect of lung-density correction on dose distribution in a transverse slice containing the isocenter for tangential-fields breast irradiation. In this case study we analyzed the target coverage as well as hot spots for four types of treatment plans: Plan 1 assumes uniform unit density throughout, Plan 2 utilizes all the treatment parameters of Plan 1, but takes into account the lower lung density. Plan 3 is generated by optimizing the dose distribution in the presence of the lower lung density, and Plan 4 is an improvement on Plan 3 by using custom instead of standard wedges. Our analysis shows that consideration of the lower lung density is important for optimal treatment planning for the breast and that specially designed wedges can improve the dose distribution. PMID- 2765123 TI - A head swivel technique for breast tangents. AB - Two of the major problems with treating breast tangents are the difficulties in simulating the treatment and the reproducibility of the setup on a day to day basis. This paper describes a simple technique which takes advantage of the head swivel capability of certain cobalt-60 units to allow simulation and treatment of the breast and chest wall based upon a setup at the field edges which are normally not on mobile breast tissue. The technique offers some of the advantages of half block techniques but does not require the use of half blocks or bridges. PMID- 2765124 TI - The use of a spreadsheet computer program to expedite TLD reporting. AB - A method has been devised using an electronic spread sheet that will shorten the data processing time and give a printed report of the results. Lithium Fluoride chips are used in pairs so as to produce the same average response. The raw TL readings along with descriptive comments are entered into the computer. The program then computes the single chip dose, the average dose for each chip pair, applies a non-linearity correction factor and prints out a report with comments and patient data. The program offers several advantages: It is much faster than hand calculations, it provides a precise and accurate conversion of raw data to final data, and outputs an organized display of calibration factors, input data, dosimetry data, patient data and listing of involved personnel. The program is easy to use and can be run on any computer that can support a spreadsheet program. PMID- 2765125 TI - A daily radiation therapy record form. AB - This communication reviews one institution's experience in developing a reliable and accurate radiation therapy record form. The design of a daily record is highly subjective. With the subjectivity of this process in mind, the purpose of this presentation is to describe the advantages of our form and to acquaint the reader with the literature useful in preparing a therapy record that fulfills their facility's requirements. PMID- 2765126 TI - A typical patient simulation and dosimetry data sheet. AB - A typical, comprehensive "Patient Simulation & Dosimetry Data" sheet has been developed. It contains all essential patient simulation, treatment and radiation dosimetry parameters and also relevant anatomical diagrams. The form can be used for any radiation therapy modality. PMID- 2765127 TI - Alignment modification for pencil eye shields. AB - Accurate alignment of pencil beam eye shields to protect the lens of the eye may be made easier by means of a simple modification of existing apparatus. This involves drilling a small hole through the centre of the shield to isolate the rayline directed to the lens and fabricating a suitable plug for this hole. PMID- 2765128 TI - Increased expression of glycolysis-associated genes in oncogene-transformed and growth-accelerated states. AB - An accelerated rate of glucose transport and catabolism is a common characteristic of cellular transformation. We have previously found elevated expression of the glycolytic enzyme glyceraldehyde-3-phosphate dehydrogenase (GAPDH) in human pancreatic and colonic adenocarcinomas (Schek et al.: Cancer Res 48:6354-6359, 1988). To investigate further the expression of this enzyme in the process of tumorigenesis, we examined GAPDH expression in a panel of oncogene transformed fibroblasts. Significant elevations of GAPDH mRNA and glucose transporter protein mRNA levels were observed in ras- and mos-transformed NIH 3T3 cells, whereas little or no change was found in c-src-, v-src-, c-myc-, E1A-, v fos-, and PKC-gamma-transfected cells. Furthermore, the level of GAPDH mRNA correlated with the transformed state in a series of ras-transformed and revertant cell lines. Immunoblot analysis confirmed that GAPDH polypeptide was significantly elevated in the cell lines with elevated mRNA levels. Cell cycle analysis data suggested that the effect on GAPDH expression correlated with oncogene expression rather than cell growth fraction. These results suggest that altered GAPDH gene expression occurs during some growth deregulated states, and this, along with increased glucose transporter (and possibly other glycolytic enzyme) expression, is likely to contribute to the increased metabolic capacity of cells in these states. PMID- 2765129 TI - Decline in sialic acid composition of cellular membranes isolated from ovine corpora lutea during prostaglandin-induced luteolysis: apparent independence of autoimmune recognition. AB - Sialic acid was quantified in plasma membranes of corpora lutea isolated during prostaglandin (PG) F2 alpha-induced luteolysis in sheep. Concentrations of sialic acid within membranes decreased after injection of PGF2 alpha, and before signs of luteal regression (i.e., a decline in tissue concentrations of progesterone) were manifested. Removal of residues of sialic acid from luteal membranes was not associated with cellular binding of gamma globulin, as monitored by indirect immunofluorescence microscopy. We suggest that desialylation of luteal membranes could be an important aspect of the mechanism of luteolysis. Such a process does not appear to involve participation of autoantibody. PMID- 2765130 TI - Treatment of recurrent spontaneous abortion by immunization with paternal lymphocytes: correlates with outcome. AB - Previous observations have suggested that defective recognition of fetal alloantigens by the maternal immune system is associated with recurrent pregnancy failure and that this may be prevented by boosting the maternal immune system with paternal or pooled third-party leukocytes. The mechanism whereby this process achieves success is not clear, and accordingly to explore this we immunized 28 couples with recurrent fetal loss with 80 x 10(6) paternal peripheral blood mononuclear leukocytes (PBML) and followed various immunological parameters. The couples studied, in whom 55% achieved a successful pregnancy, showed no increase in sharing of human lymphocyte antigen (HLA)-A, -B, or -DR antigens and no consistent evidence of a decreased mixed leukocyte reaction (MLR) or MLR plasma-blocking factors compared with control couples. Immunization did not alter these parameters but did induce antipaternal lymphocytotoxins, although the presence of the latter did not correlate with pregnancy outcome. There was a correlation between rapid conception after immunization and a subsequent successful pregnancy. A successful pregnancy also correlated with sustained postimmunization, postconception maternal antipaternal allospecific CD-8+ suppressor T cells. Although these findings provide overall evidence that immunization produces changes in the way in which the maternal immune system interacts with the fetus, larger numbers of couples and a higher dose of paternal lymphocytes will be needed to establish clearly whether this therapy works and its mechanism of action. PMID- 2765131 TI - Relationship of antibodies to sperm head to etiology of infertility in patients undergoing in vitro fertilization/embryo transfer. AB - Antibodies to sperm head (ASA-H) are believed to impair reproduction, probably because of a reduction in fertilization of human oocytes. However, the incidence of ASA-H in couples with different etiologies of infertility undergoing in vitro fertilization/embryo transfer (IVF/ET) is unestablished. To examine this question, the semen, serum, and follicular fluid of 11 couples with unexplained infertility and 25 couples with tubal infertility undergoing IVF/ET were tested with the immunobead binding assay to identify ASA-H of IgA, IgG, and IgM isotypes. Comparing couples with unexplained vs. tubal infertility, 46% vs. 4% had ASA-H of at least one isotype in female serum (P = .006), 36% vs. 4% had ASA H in follicular fluid (P = .023), 27% vs. 0% had ASA-H in semen (P = .023), and 18% vs. 4% had ASA-H in male serum (P = .022), respectively. ASA-H were present in one or more fluids tested in 55% of patients with unexplained infertility, compared to 8% of patients with tubal infertility (P = .005). Of the six women with ASA-H in their serum, 83% (5/6) were undergoing IVF/ET for unexplained infertility compared to 17% (1/6: P = .08) undergoing IVF/ET for tubal infertility. In summary, clinically significant ASA-H are present in a substantial number of infertile women undergoing IVF/ET, particularly those whose infertility is unexplained. Based on these findings, we conclude that it is efficacious to screen all women with unexplained infertility undergoing IVF/ET for ASA-H. PMID- 2765132 TI - In vitro sensitivity of Candida (Torulopsis) glabrata to clotrimazole. AB - Vulvovaginitis caused by Candida (Torulopsis) glabrata is often refractory to intravaginal imidazole therapy. Clotrimazole achieves its fungistatic activity for Candida albicans and C. glabrata by inhibiting different steps in intermediary cell metabolism. For C. glabrata, alkylation precedes dimethylation. The possibility that this altered sequence might account for the relative therapeutic nonresponsiveness was studied by determining comparative minimal inhibitory concentrations (MICs) of clotrimazole. In vitro analyses of ten strains of C. glabrata and 30 control strains of C. albicans performed using both agar and broth dilution tests revealed that four-fold lower MICs were consistently demonstrable with C. glabrata, irrespective of inoculum size. The data suggest that clinical difficulties encountered in the therapy of torulopsis vulvovaginitis probably represent the inability of intravaginal medication to eradicate urethral/urinary bladder colonization and subsequent reinfection rather than true therapeutic failures. PMID- 2765133 TI - Effects of antibodies against chicken riboflavin carrier protein on fetal hepatic cell ultrastructure. AB - Day 12 pregnant mice administered antibodies to cRCP exhibited riboflavin deprival, which resulted in progressive alteration in the fetal hepatic cell structure, which eventually led to fetal wastage and termination of pregnancy. These changes were evident as early as 1 h following antiserum treatment. Three hours following treatment, other degenerative changes such as disorganization of glycogen particles and endoplasmic reticulum and degranulation of mitochondria were observed. Nuclear pycnosis, and increased myelin figures, accumulation of lysosomes, all indicative of autolytic changes, occurred 6 h following treatment. PMID- 2765134 TI - Is immunotherapy for habitual aborters an immunologically hazardous procedure for infants? AB - Physical development and tests of immunologic function are reported from the first year of life for 13 infants born to mothers who were habitual aborters and who had undergone subcutaneous vaccination with their husband's lymphocytes. The mean weight of the infants at birth was 2,975 +/- 540 g, including one infant who was small for dates. Physical development parameters for the first year were all within normal range. Immunologic studies were performed at ages 0, 1, 3, 6, 9, and 12 months. The studies included the following: (1) serum levels of immunoglobulins and complement components; (2) the number of peripheral blood lymphocytes (PBL) and their subpopulations; and (3) proliferative responses by PBL against unrelated lymphocytes and some mitogens (pokeweed, phytohemagglutinin, and concanavalin A). All were normal when compared with studies of infants of nonimmunized mothers. These observations suggested that subcutaneous vaccination of women with their husband's lymphocytes did not result in any adverse effects on their infants' physical or immunologic development. PMID- 2765135 TI - In vitro and in vivo embryo toxicity of antilaminin antibodies in the rat. AB - Rats mated after laminin immunization had higher frequencies of resorptions (57%) than those immunized with bovine serum albumin (20%) and had sera that were toxic to cultured rat embryos. In addition, sera from rats immunized with laminin A chains but not B chains were toxic to cultured embryos. The toxicity of sera to embryos was related to the reactivity of sera to specific laminin fragments rather than to sera IgG levels against intact laminin. In addition, resorptions in pregnant rats immunized with laminin were not related to the sera antilaminin IgG levels. However, levels of uterine antilaminin IgA, the predominant uterine isotype, increased considerably during the first 3.5 days of pregnancy, while sera antilaminin IgG remained constant. (Am J Reprod Immunol. PMID- 2765136 TI - Treatment of recurrent spontaneous abortion: immunization with seminal plasma trophoblast-lymphocyte crossreacting antigen. PMID- 2765137 TI - Ninth annual symposium of the American Society for the Immunology of Reproduction. Portland, Maine, June 14-18, 1989. Abstracts. PMID- 2765138 TI - Serological analysis of cell surface antigens in choriocarcinoma cell lines. AB - Major histocompatibility complex (MHC) antigens as well as blood group related antigens were investigated in four newly established gestational choriocarcinoma cell lines (NaUCC-1, -2, -3, and -4) using protein A and immune adherence assays. Antibodies to both monomorphic determinants of HLA class I antigens and beta 2 microglobulin reacted with all of the choriocarcinoma cell lines at levels equal to or much greater than SCH, which was teratoid choriocarcinoma cell line. Antibodies to polymorphic determinants not only of the patient's HLA type, but also of the husband's type, reacted to NaUCC-1 and -2. These results indicated that all four newly established choriocarcinoma cell lines express class I HLA antigens. However, we could not demonstrate expression of class II antigens. No expression of blood group A and B antigens could be established, and binding of antibody to Rho(D) antigens was only positive in the NaUCC-1 cell line. These results suggest that some choriocarcinoma cell lines actually express alloantigens and that choriocarcinomas have the character of transplanted tumors that have activities to induce transplantation immunity of the patients. PMID- 2765139 TI - Membrane fluidity of trophoblast cells and susceptibility to natural cytotoxicity. AB - This study examines the relationship between membrane lipid microviscosity and susceptibility of villous trophoblast to lysis by natural cytotoxic cells. Trophoblast-enriched cell suspensions prepared from term human placentae were treated with cholesteryl hemisuccinate (CHS)--a modulator of membrane lipid microviscosity. CHS-treated cells were more susceptible targets for natural lymphocyte cytotoxicity than were untreated controls. In binding experiments, increased binding of lymphocytes to CHS-treated target cells was found. Preincubation with progesterone prevented membrane rigidification by CHS. Progesterone, cortisol, and estriol restored the impaired resistance of CHS treated trophoblast cells to lysis. We determined microviscosity and progesterone concentration in villous surface membranes, prepared from placentae from idiopathic spontaneous abortions and normal first-trimester pregnancies. An inverse relationship was found between progesterone content and microviscosity of the membranes. Microviscosity of the membranes from abortion placentae was significantly higher (P less than .01) and progesterone concentration was significantly lower (P less than .001) than those in the membranes of normal first trimester placentae. PMID- 2765140 TI - Early pregnancy loss, premature and low birth weight delivery, and increased maternal lymphocyte cytotoxicity. AB - Lymphocytes of 628 pregnant women were tested for natural cytotoxic activity to human embryonic fibroblast cells. The data were analyzed with regard to previous obstetric history, symptoms occurring during the present gestation, and the outcome of pregnancy. The normal rate of cytotoxicity during pregnancy was established by determining cytotoxic activity of the lymphocytes from 56 healthy pregnant women. The values higher than the mean + 2 SD of the "normal" (greater than or equal to 40%) were considered as high. Increased cytotoxicity was associated with the occurrence of previous spontaneous and missed abortions, as well as with bleeding and uterine contractions during the present pregnancy observed at the time of the test. In 15 out of 35 cases resulting in spontaneous abortion and 15 out of the 34 pregnancies resulting in missed abortion, cytotoxic activity of the lymphocytes during pregnancy was higher than normal. Similarly, in 38 and 32.7% of the pregnancies resulting in preterm (n = 121) or low birth weight deliveries (n = 101) respectively, we found increased lymphocyte cytotoxicity, in contrast to that being found in 5.4% of uncomplicated normal pregnancies. These data suggest that at least some pregnancy failures might be immunologically mediated. PMID- 2765141 TI - Fetus as an allograft: noncytotoxic maternal antibodies to HLA-linked paternal antigens. AB - A cellular enzyme-linked immunospecific assay (CELISA) was used to monitor maternal humoral responses in human pregnancy. Non-cytotoxic IgG antibodies to paternal lymphocytes were detected in sera from 6 of 20 normal first trimester primigravidae and 6 of 13 multiparae. No antibody activity against lymphocytes from their partners was detected in sera from any of the 15 nulliparous women. The differences in antibody response between primigravidae and nulliparae (P = 0.024) and between multiparae and nulliparae (P = 0.005) were statistically significant. Lymphocytotoic antibodies to T- and B-lymphocytes were present in sera from three multiparae, but from none of the women in the other two groups. Family studies indicated that the non-cytotoxic pregnancy-associated maternal antibodies were directed to HLA-linked antigens (P less than 0.001). Evidence obtained using cell panels and platelet absorption suggested, however, that these antibodies were not directed to the currently recognized HLA specificities (HLA A, -B, -C, or -DR). PMID- 2765142 TI - Leucocyte aggregation in burned patients. AB - Leucocyte aggregation describes one type of biophysical behaviour of white cells. To test whether this parameter is changed in burned patients, 15 burn victims were investigated immediately after admission into hospital. Cell counts and aggregation were measured and related to the prognosis of the injury. Compared with normal controls, burning injury is associated with higher white cell counts and enhanced leucocyte aggregation. Fatal injuries showed a (non-significant) tendency for higher aggregation values than survivors. There are significant positive correlations between white cell counts, maximal aggregation values and the burned body surface area. The results suggest that leucocyte aggregation is pathologically enhanced in response to burns. Possibly this alteration is of prognostic importance. PMID- 2765143 TI - Burn resuscitation with a low-volume plasma regimen--analysis of mortality. AB - The results of a mortality analysis from the Burn Center in Rambam Medical Center, Haifa, Israel, over a 5-year period are presented. The management of severe burns during the 'shock' period included a low-volume resuscitation formula consisting mainly of plasma and a small volume of crystalloid solution. The efficacy of burn management was assessed by probit analysis of the mortality data. We derived the percentage of body surface area burned associated with a 50 per cent probability of death (LA50) for four different age groups. The LA50 values obtained were compared to those obtained from other series; they compared favourably, demonstrating that resuscitation with low volumes consisting mainly of colloids may reduce complications associated with fluid overloading and therefore improve the LA50. PMID- 2765144 TI - Burns in the elderly. AB - This report describes the treatment and prognosis of 37 burned patients over 70 years of age. PMID- 2765146 TI - An example of burn prevention: the 'Urim' factory fire. AB - The blanket factory building at Kibbutz Urim in Israel was completely destroyed by a devastating fire. Forty-five of the 62 workers were injured, most of them very mildly, by inhalation of smoke. No skin burns were recorded. The preplanned fire evacuation programme that was routinely rehearsed and precisely carried out during the event prevented the grave results that could have followed such a disaster. PMID- 2765145 TI - Flash burns to the face. AB - A characteristic 'crow's foot' pattern is seen around the eye in many flash burns. The protective blink reflex underlies this, and the injury is due to convected rather than radiant energy. PMID- 2765147 TI - Uses and abuses of a biosynthetic dressing for partial skin thickness burns. AB - The following report reviews 851 applications of Biobrane on partial skin thickness burn wounds awaiting epithelialization. After the patients had been evaluated and resuscitated as needed, the burn wounds were cleansed and debrided. Those evaluated as shallow were treated with Biobrane application. Joint surfaces were splinted for immobilization. The wound was inspected at 24 and 48 h and if any fluid had accumulated it was aspirated and the wound was redressed. When the Biobrane was adherent, the wound was covered with a light dressing and joint immobilization was discontinued. Treatment with Biobrane dressing provided certain advantages over other topical wound care. As the dressing changes were performed less frequently outpatient care was possible, with a resultant decrease in both the length of hospital stay and the ultimate cost of burn care. Wound desiccation is prevented and pain is decreased. Accurate diagnosis of wound depth is crucial if Biobrane is to be used. Very deep wounds will not allow Biobrane adherence, neither will it occur if the wound has a high bacterial count. If joint surfaces are not splinted, the Biobrane will shear and not adhere to the wound. Convex and concave surfaces can be treated with Biobrane, which may need to be meshed. PMID- 2765148 TI - Use of topically applied silver sulphadiazine plus cerium nitrate in major burns. AB - All patients hospitalized between May 1987 and June 1988 suffering from burns covering over 50 per cent of the body surface area were treated by topical application of a cream containing cerium nitrate (0.05 M) and silver sulphadiazine (0.03 M) (CN + SSD). Eleven patients were included in this series, with a mean age of 35 years (range 22-65), a mean total burn size of 78 per cent (range 50-96 per cent) and full skin thickness covering a mean of 48 per cent (range 10-91 per cent). Eight patients survived (73 per cent) (mean age 36 years; mean total burn surface 73 per cent; mean full skin thickness burn surface, 38 per cent). These results are far better than those obtained in our Unit where a survival rate of 34 per cent was obtained in a comparable series of patients treated before 1987. Sixty positive blood cultures were obtained, which included a large variety of organisms with a slight predominance of Staph. aureus, Candida albicans and Ps. aeruginosa. Wound cultures were positive in 72 per cent of swabs and showed a predominance of Ps. aeruginosa (59 per cent of all the strains isolated). Even if CN + SSD appears in this series not to be very efficient in preventing wound colonization and septic complications, it permitted a very high survival rate in the treated patients, taking into account the extreme severity of the injuries. This beneficial effect is probably the consequence of the protective action of the yellow-green eschar formed by CN + SSD.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2765149 TI - Survival rates of patients hospitalized in French burns units during 1985. AB - This survey analyses data from 17 French burn units with respect to age, severity of injury and survival of patients admitted to hospital during 1985. Of the 2398 patients treated, more than half were between 15 and 50 years old. About 90 per cent of the patients had burns covering less than 50 per cent of the body surface area. The overall mortality rate was 11.8 per cent. The LD50 for the 2398 patients was a burned surface area of approximately 60 per cent of the total body surface area. The LD50 for patients less than 30 years old was a burn covering just over 80 per cent of the total body surface. The survival rate as a function of the Baux index was also analysed. PMID- 2765150 TI - Car radiator burns: a report on 72 cases. AB - Seventy-two cases of car radiator burns (CRB) were treated in the Burns Unit, Hamad Medical Corporation, Doha, Qatar, over a 6-year period (1982-87). All the patients were males and most were between 20 and 40 years old. Chest wall, face and right upper limb were the commonest sites involved. Most of the patients suffered from relatively minor scalds. The scenario of the accidents as well as the topography of the burned areas were characteristic to this particular type of injury. The exceptionally high temperatures in the summer months were significantly related to the incidence of this type of burn. PMID- 2765151 TI - Ambulatory management of burns in children. AB - A randomized trial of three treatment methods for the ambulatory management of minor burns in children has shown Op-site to be superior. The dressing is cost effective and well tolerated, with the advantage that children can return to their normal activities without jeopardizing the healing process. PMID- 2765152 TI - [Intubation of the small intestine in ileus. Technic, results, complications]. AB - Operative intestinal intubation with Miller-Abbott-tube was performed on 188 patients from 1974 to 1988 in the Surgical Department of Dresden Academy of Medicine. In a retrospective analysis, the advantages and disadvantages of the method in treating the adhesion ileus are described and complications and lethality after predominantly orthograde nasal intestinal intubation are discussed. Exact indications and various operational details may help to reduce complications due to the tube-method to a minimum. The relatively high postoperative lethality (22.3%) was mainly caused by cardiopulmonary illness and peritonitis and does not result from the operative procedure. The fact that no early recurrent bowel obstruction was observed may be stated as an essential result, even though a relaparotomy due to late recurrence had to be made within 1 to 5 years after the first operation in 4% (8 patients) of 188 intestinal intubations. PMID- 2765153 TI - [The importance of liver changes in workers with chronic benzene exposure]. AB - Essential parameters of hepatic functioning in 84 labourers, whose exposition to benzene is differing in assimilation as well as length of time is discussed.--45 persons from the same county without contact to benzene or hepatotoxic agents served as control-group. Neither long-term exposure to benzene nor its size were of any influence on the hepatic data controlled.--Correlations became evident in non-occupational factors such as alcoholism and overweight.--Any damaging effect of benzene on the liver can be excluded. PMID- 2765154 TI - [Intestinal metaplasia and fungus involvement in peptic and neoplastic lesions of the mucosa of the stomach]. AB - 260 ulcers and 128 cancers were found by means of stomach biopsies. Analyzing the coincidence of ulcer resp. cancer with intestinal metaplasia or fungus contamination about double the frequency of linkage to intestinal metaplasia (26% versus 15%) and likewise to fungus contamination (13% versus 7%) could be ascertained.--The figures in the combinations of cancer resp. ulcer with fungus infection and IM (4% cancer; 2% ulcers) were strikingly low. This is to be explained by an increased immunologic defense function of the intestinalised stomach mucosa.--Following demands of practice any neoplastic process with ulcerated fungi-contaminated lesion of stomach mucosa has to be safely excluded. PMID- 2765155 TI - [The current risk of gallbladder and bile duct surgery]. AB - The lethal operative risk in gallbladder and bile duct operations decreased from 2.16% in the period 1964-1976 to 1.32% in the period 1979-1987.--Main operative risk factors are gallbladder and bile duct complications and the age beyond the 6th decade of life.--The lethality of choledocholithiasis actually amounts to the 37-fold of uncomplicated cholecystolithiasis and the lethality of all primary and secondary gallstone operations after the 6th decade of life amounts to the 38 fold in comparison with younger patients.--A further reduction of operative risk appears possible by reason: 1. Consequent early operation. 2. immediate operative or endoscopic removal of extrahepatic cholestasis, 3. complex intraoperative diagnostics of bile duct and papilla Vateri, 4. preoperative single dose AB prophylaxis or short-term therapy, 5. general low dose heparin prophylaxis, 6. primary endoscopic therapy in residual stones or irreversible stenosis of papilla Vateri and 7. interdisciplinary diagnosis and treatment of senile complications. PMID- 2765156 TI - [Biotransformation in patients following Depressan-induced hepatitis]. AB - In 17 patients who more than 1 year ago had suffered from a dihydralazine induced hepatitis the biotransformation velocity was investigated and compared with a healthy control group. 15 out of the 17 patients and 5 out of the 10 volunteers are slow acetylators. All slow acetylators eliminate sulfamethazine more slowly than rapid acetylators.--The elimination of caffeine and metamizol--test substances for oxidative biotransformation reactions--was retarded in patients after dihydralazine induced hepatitis in comparison to control persons. Slow acetylators have to be controlled carefully because of their higher risk of dihydralazine induced drug hepatitis. PMID- 2765157 TI - [Infections caused by anaerobes and antibiotic resistance]. PMID- 2765158 TI - [Clinical manifestations of infection by human immunodeficiency virus in children]. AB - HIV infection in children presents a wide spectrum of clinical manifestations, from asymptomatic to opportunistic infections, neurologic deterioration and malignancy. This retrospective study describes the characteristics of 30 HIV infected children, attended at the Hospital Infantil de Mexico. Six patients were asymptomatic and 24 symptomatic. Twenty four patients presented a secondary infection, 66% opportunistic infections, compared against the 100% who presented around 3 serious bacterial infections. The most frequent infections were: candidiosis 18 children, pneumonia 14, sepsis 8, cryptosporidiosis 5, urinary tract infection 5, and otitis 5. We were able to demonstrate P. carinii pneumonia in only one patient. These differences in the frequency of related infections may represent regional differences by country. PMID- 2765159 TI - [Concepts of pharmacy employees concerning the management of diarrhea in children]. AB - The purpose of this study was to establish the concepts of the drugstore salesforce on the management of acute diarrhea in children. The study was carried out in Guatemala by means of a direct interview of 427 employees of an equal number of drugstores, that were representative of the total drugstores in the country. The results showed that one third of the employees only have grammar education or less, that they were young adults without training in medicine or drug therapy, and that it frequent that people ask for medication for diarrhea in children. For food during diarrhea, fat, milk, meat and beans were mentioned as bad foods, and starch gruels, vegetables and soups were mentioned as good food. From the total sample 82.4% stated that antibiotics are indicated always or almost always, 69.8% prescribe antidiarrheicals as caolin/pectine alone or in combination with antibiotics or sulfonamides, and 33.0% prescribe antibiotics, being ampicillin, chloramphenicol and cotrimoxazole the more common; 73.5% prescribe oral rehydration, but only 8.7% of drugstores have oral rehydration salts recommended by WHO/UNICEF. Based on these results it is recommended to establish a longitudinal program in order to train this group of people who are in primary care, on the management of acute diarrhea in children. PMID- 2765160 TI - [Multiple organ failure syndrome: correlation of mortality and the Modified Criteria for Multiple Organ Failure]. AB - Seventy-two patients from one month to 15 years of age that according with the Modificated criterion of multiple organ failure (MCMOF) had two or more organ failures were studied. They were divided into two groups: Group I consisted of 55 patients that survived and group II of 17 patients that died. In both groups, the MCMOF was determinated upon admission and discharge, as well as the maximum obtained during the evolution. The comparison of both groups, with respect to the number of organic failures presented and the points of MCMOF showed highly significant differences with p less than 0.001, found in group I: 1.27 +/- 0.96 organ failures and a value of 4.84 +/- 2.92 of the MCMOF and in the group II: 3.84 +/- 1.59 organ failures and 25.68 +/- 7.57 points of the MCMOF respectively. The comparison between the number of organic failures at admission and discharge showed significant differences in both groups, having the tendency to decrease in group I from 1.87 +/- 1.01 to 0.56 +/- 0.60 and in the group II to increase from 3.41 +/- 1.46 to 4.35 +/- 1.45. The same phenomenon was observed for the values of the MCMOF with a qualification of 7.72 +/- 5.36 to 1.87 +/- 1.82 in a group I and from 18.94 +/- 10.31 to 33.38 +/- 8.27 in group II. Spearman correlation coeficient between the number of organic failures and values of the MCMOF showed and r = 0.99 and equivalent p less than 0.001, highly significant. PMID- 2765161 TI - [Long-term clinical course of patients with chronic autoimmune thrombocytopenic purpura]. AB - We studied 296 patients with thrombocytopenic purpura in our hospital from 1974 to 1985; 179 acute and 117 chronic forms. We identificated inherence forms (9.5%), of the last 106, 73 accepted to participate in the long time study. We found 69 patients with autoimmune chronic thrombocytopenic purpura, with the following response to the treatment with prednisone: 1. Long total remission for 8 to 100 months in 27 patients. 2. Total remission with relapse in 35 patients. 3. Partial remission in 5 patients. 4. No remission in 2 patients. We realized splenectomy in 16 patients of second group, in four of third group and one of fourth group. Everybody are in total remission althrough we had two with temporal relapse. We analyzed the factors with the excellent evolution, 5 of 69 patients with autoimmune forms (7.2%), their evolution to disseminated eritematous lupus. Nobody of the cases evolutioned to malignance. PMID- 2765162 TI - [Determination of C-reactive protein in low-risk newborn infants]. AB - We present the results of the determination of C-reactive protein (CRP) in neonates with low risk of developing infection and without obstetric trauma. In determining the values of CRP we used the technique of latex agglutination. We included 56 neonates determining the changes in the values obtained in samples of cord blood and 24 hours. At birth, in 51 cases, the CRP was negative (0.91), 4 cases were positive at a dilution 1:4 (0.07) and one case at a dilution 1:8 (0.02). At 24 hours, in 47 cases (0.84) the CRP was negative; in 6 cases (0.04), at a dilution 1:8 and one more positive result at a dilution 1:6. There was not difference in the dilutions of the CRP in relation to the moment of sampling. We suggest that the method of latex agglutination is useful in sistemating the application use of CRP in neonates. PMID- 2765163 TI - [Leigh disease. Presentation of a clinical case]. AB - Leigh's disease is also known as subacute necrotizing encephalomyelopathy. The outstanding clinical features are alterations of the state consciousness, cranial nerve manifestations and bilateral pyramidal signs. The disease is a result of unexplained biochemical disturbances in the private metabolism. In this article we present the clinical characteristics, its course and the features in the nuclear magnetic resonance in a child with Leigh's disease. PMID- 2765164 TI - Acquisition of classical conditioning without cerebellar cortex. AB - The left cerebellar cortex was surgically aspirated in rabbits who were then subsequently trained for classical conditioning of the nictitating membrane. All rabbits were trained sequentially on both eyes. Rabbits with the lesion confined to the cerebellar cortex were able to learn with the eye ipsilateral to the lesion although it took many times longer than reported for either naive rabbits or for rabbits first trained on the unlesioned, contralateral side. Rabbits with lesions that included the cerebellar cortex and the cerebellar interpositus nucleus did not learn with the eye ipsilateral to the lesion. Learning with the eye contralateral to either type of lesion was always very rapid. It is now clear on the basis of this and previous studies that cerebellar cortex, unlike the cerebellar interpositus nucleus, is not essential for acquisition or relearning/retention of classical conditioning. However, cerebellar cortex normally plays an important role since acquisition of classical eyeblink conditioning is prolonged and of poor quality in its absence. PMID- 2765165 TI - Central but not basolateral amygdala mediates memory for positive affective experiences. AB - Rats were trained in an 8-arm radial maze on a task in which memory for magnitude of reinforcement was tested. Rats received a single trial per day consisting of a study phase and a test phase. In the study phase, the animals received 1 or 7 pieces of food on different arms of the maze. After the study phase, the rats were delayed for 5 s, 5 min or 15 min. After the delay the animals were allowed to choose between the two arms presented in the study phase. The correct response, leading to an additional reinforcement, was to select the arm in which the animal had received the 7 pieces of food. After learning this task to a criterion of 80% or better performance on blocks of 10 trials for each delay, the animals received electrolytic lesions of the basolateral or central amygdala. After recovery from surgery animals were tested at each delay. The results indicate that there were no deficits at any delay with basolateral amygdala lesions. In contrast, lesions of the central amygdala produced a marked deficit at the 5- and 15-min delays, but no deficit at the 5-s delay. Based on the assumption that in this task memory for magnitude of reinforcement is a function of the formation of reinforcement-spatial location associations resulting in the activation of affective experiences, it is concluded that the central but not basolateral amygdala is involved in the coding of positive affect information. PMID- 2765166 TI - A new one-trial test for neurobiological studies of memory in rats. II: Effects of piracetam and pramiracetam. AB - The effects of the nootropic drugs Piracetam (Pir) and Pramiracetam (Pram) were evaluated on recognition-memory of rats in a new one-trial test. This test is based on spontaneous exploratory activity and does not involve rule learning or reinforcement. Recognition is measured by the time spent by rats in exploring two different objects, one familiar (the sample), the other new. When the retention interval is 1 min, normal rats spend more time exploring the new object which demonstrates that they recognize the familiar one, but they do not discriminate between the two objects after a 24-h interval. Three doses of Pram (15, 30 and 60 mg/kg) and Pir (100, 200 and 400 mg/kg) were administered i.p. 30 min before the acquisition trial. The doses of 30 mg/kg of Pram and of 400 mg/kg of Pir produced a significant improvement in retention when the intertrial interval was 24 h. This effect was not associated with a change in overall exploratory behavior. This study shows that the new object-recognition test may be a useful tool for pharmacological studies of memory in rats. PMID- 2765167 TI - The neural structures involved in cross-modal recognition and tactile discrimination performance: an investigation using 2-DG. AB - Given the failure of the ablation method to identify the neural structures/systems that are crucial for cross-modal recognition (CMR) and for tactile discrimination performance (TDP), we injected radioactive 2-deoxy [14C]glucose (2-DG) into monkeys trained to a high level of CMR or TDP. Nine monkeys were trained to recognize in one sense-modality, to a level greater than 80% correct, the objects experienced in the alternate modality on only a single prior trial. After injection, CMR was continued (Expt. 1a) exactly as before, except that all CMR problems were now in only one direction; or (Expt. 1b) the second--the CMR--trial of each problem was not realized (i.e. no objects were available in the second modality) so that the monkey merely 'expected' the cross modal trial. Nine other monkeys were trained on a graded roughness discrimination task with conventional 'titration' procedures to a stable level of performance, either (Expt. 2a) without having undergone any cortical removal, or (Expt. 2b) after unilateral removal--contralateral or ipsilateral to the preferred hand--of the posterior insula or of the second somatosensory projection cortex (SII). Exactly the same training procedures were continued in Expt. 2 after injection of 2-DG. Coronal radiographs were made at 490 microns for all 18 monkeys (and also for a 19th, which served as a control in Expt. 1b). The optical densities of the autoradiographs were measured quantitatively in respect of 50 structures or part structures (e.g. sulci, thalamic nuclei, subcortical structures); they were rated either with the aid of 'pseudo-colours' produced by the computer, or directly by judging the black/white optical densities, in respect of 29 other structures. These 79 structures were then the dependent variables in MANOVAs or ANOVAs, to determine differences between groups; or within groups with respect to the left/right and ipsilateral/contralateral hemispheres; or interaction effects. It was found that certain structures (e.g. the ventral portion of the claustrum, the insula with its extension ventrally into the fundus, nucleus Medialis dorsalis and nucleus Pulvinar oralis) repeatedly, whereas others (e.g. the amygdala) never gave rise to significant outcomes. Structures in the left cerebral hemisphere were frequently found to be more strongly labelled than those in the right hemisphere.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2765168 TI - Evidence that apomorphine and (+)-amphetamine produce different types of circling in rats. AB - Apomorphine and (+)-amphetamine are known to produce circling in naive rats. Frame by frame analysis of videotape recordings of the behaviour of Wistar rats treated with a subcutaneous injection of apomorphine (1.1 mg/kg; n = 8) or (+) amphetamine (0.5 and 1.0 mg/kg; n = 8 and n = 8) was used to study this behaviour in more detail. In line with previously reported studies, apomorphine was found to change the functioning of hindlimb stepping. In contrast, (+)-amphetamine was found to change the functioning of forelimb stepping. These data imply that apomorphine and (+)-amphetamine produce their drug-specific circling via different substrates within the brain. PMID- 2765169 TI - Blockade of the nootropic action of piracetam-like nootropics by adrenalectomy: an effect of dosage? AB - The present experiments demonstrate that the absence of any memory-improving action of nootropics in adrenalectomized animals cannot be ascribed to an effect of dosage. Doses of 1, 10, 100, 1000 and 3000 mg/kg p.o. of piracetam, oxiracetam, aniracetam or pramiracetam are ineffective in adrenalectomized mice. PMID- 2765170 TI - The timing of mentally represented actions. AB - The performance of subjects walking blindly to previously inspected visual targets (located at 5, 10 or 15 m from the subjects) was studied in 2 experiments. In Expt. 1, subjects selected as good visual imagers were instructed to build up a mental representation of the target. Then they had to either actually walk or imagine themselves walking to the target. Walking time was measured in both the actual and the mental performance. It was found that subjects took almost exactly the same time in the two conditions. Accuracy of these subjects was also measured in the actual walking task. They were found to make no direction errors and to slightly overshoot target location. Subjects from another, control, group, who received no instructions about visual imagery made much larger errors. In Expt. 2, actual and mental walking times were measured in the same subjects as in Expt. 1, while they carried a 25-kg weight on their shoulders. In this condition, actual walking time was the same as in Expt. 1, although mental walking time was found to increase systematically by about 30%. These results are discussed in terms of the neural parameters encoded in the motor program for actually executing or mentally performing an action. PMID- 2765171 TI - An experimental test of the theory that visual information is stored in the inferotemporal cortex. AB - This experiment employed reversible cold lesions to assess the possible storage functions of inferotemporal cortex (IT) for visual information. Four Macaca fascicularis were chronically implanted with 4 bilateral sets of cryodes which covered dorsal and ventral IT. Animals learned visual discrimination problems while subsections of IT were cooled. Retention was then tested with the previously warm tissue cold as well as with all of IT cold. In addition, an attempt was made to replicate previous studies showing spared retention of visual discriminations with preoperative overtraining. When animals learned a visual discrimination with partial bilateral IT cooling, retention was good when the previously warm tissue was cooled. If learning occurred with partial IT cooling confined to a single hemisphere, retention was lost when the previously warm tissue was cooled. When acquisition occurred without any cooling, retention was severely impaired when IT was cooled, even if animals received 1000 trials of overtraining. The results are attributed to distributed stimulus-analyzing properties of IT. PMID- 2765172 TI - Lesions of the anterior temporal stem and the performance of delayed match-to sample and visual discriminations in monkeys. AB - Resection of the medial temporal lobes in humans produces an anterograde amnesia in which past memories are seemingly intact, but the ability to form new memories is compromised. Efforts to reproduce these symptoms in animals have relied extensively on the delayed non-match-to-sample (DNMS) and the delayed match-to sample (DMS) tasks. DNMS deficits have been found with combined damage to the amygdala and hippocampus, but not to the adjacent white matter (the temporal stem) that connects the temporal cortex to other brain areas. DMS deficits are, however, produced by lesions to either the anteroventral temporal cortex or the orbital frontal cortex. These two areas are interconnected through the anterior temporal stem. The present study examined the hypothesis that an anterior temporal stem lesion would impair DMS in monkeys. The anterior extreme of the temporal stem was transected in 4 Macaca fascicularis and resulted in a powerful deficit on DMS at all delays. Postoperative retention of preoperatively learned visual discriminations and postoperative learning of new visual discriminations were not reliably impaired. PMID- 2765173 TI - Head and body movements evoked electrically from the caudal superior colliculus of rats: pulse frequency effects. AB - The effects of pulse frequency and current intensity on circling elicited from the caudal superior colliculus (SC) of rats were studied. The displacement of the head with respect to the body were measured for different levels of frequency (20, 29, and 50 Hz) and current (200 or 500 microA) at a pulse duration of 0.1 ms. The rate of circling increased monotonically with frequency and current. The rate at which the head was displaced laterally varied as a function of frequency. It is postulated that lateral head and body movements are affected by the firing frequency of SC output neurons. PMID- 2765175 TI - The hippocampal formation is necessary for rats to learn and remember configural discriminations. AB - A negative patterning discrimination problem was arranged by reinforcing rats for bar pressing when either a light or tone was presented (L+/T+) but not reinforcing the response when the compound stimulus, light and tone, was presented (LT-). To solve this problem, the animal must be able to construct a unique configural representation of the compound that can be distinguished from the representations of the individual elements. We have proposed that the hippocampal formation is essential for the acquisition and retention of associations involving configural representations. Thus, our theory predicts that animals with hippocampal formation damage will not learn the negative patterning problem and that animals who learned this problem before receiving hippocampal formation damage will not retain the solution. These predictions were confirmed by the results of two experiments. The animals with hippocampal formation damage were unable to solve the negative patterning problem. These animals were able to solve a simple discrimination in which responding in the presence of a light was rewarded but responding in the presence of a tone was not rewarded. These results are discussed in relation to several other theories of hippocampal formation function. PMID- 2765174 TI - Early rearing environment and dorsal hippocampal ibotenic acid lesions: long-term influences on spatial learning and alternation in the rat. AB - Behavioural responses in a set of spatial and cue tasks were assessed in adult rats that had been given ibotenic acid lesions of the dorsal hippocampus at weaning. The lesions or sham operations were immediately followed by one month of differential rearing, either in enriched, social or isolated housing environments. The differential rearing was followed by standard (social) housing conditions until behavioural testing began at 4 months of age. Compared to sham operated rats, the rats with early cytotoxic lesions showed substantial impairments on learning and efficient strategy formation in radial arm maze, retention of a spatial location, but not of a cue-marked location, in a + maze and spontaneous alternation. Differential rearing had some long-term effects depending on the task. Sham-operated rats which had been housed in isolation used a pattern of strategies in the radial arm maze that resembled the pattern used by rats with lesions. Early enrichment, on the other hand, alleviated lesion deficits only in a spontaneous alternation task in a T-maze where the variety and salience of proximal cues were maximised. Enrichment increased lesion deficits in the radial maze task, where distal cues only could guide performance. The results suggest that the hippocampus may play an important role in the use of contextual information and that behavioural recovery after early hippocampal damage--limited to situations in which featural information is highly salient--may be permanently induced by rearing in environments, as in enriched ones, where rats can attend to and manipulate environmental cues. PMID- 2765176 TI - Scopolamine disruption of septo-hippocampal activity and classical conditioning. AB - Sixteen New Zealand White rabbits were implanted with multiple-unit recording electrodes in the hippocampus and lateral septum. Animals received either scopolamine hydrobromide (HBr) or scopolamine methylbromide (MBr, 1.5 mg/kg sc) prior to nictitating membrane conditioning. Slow wave analysis indicated that HBr reduced 5- to 8-Hz and increased 9- to 12-Hz hippocampal activity and increased 1 to 4-Hz activity in both hippocampus and lateral septum. Integrated unit activity from the HBr group showed suppression of responses in septum and hippocampus during learning, whereas the MBr group developed conditioned responses in both structures. Behavioral findings indicated that HBr took longer to reach criterion (M = 329.5 +/- 45.3) than MBr (M = 120.2 +/- 16.0). This experiment showed that centrally active anticholinergic drugs alter the patterns of neuronal activity in the septo-hippocampal region that predict and accompany normal learning. Such drugs delay behavioral acquisition as well, a result suggesting a modulatory role for this brain system in the acquisition phase of classical conditioning. PMID- 2765177 TI - Spontaneous perseverative turning in rats with radiation-induced hippocampal damage. AB - This study found a new behavioral correlate of lesions specific to the dentate granule cell layer of the hippocampus: spontaneous perseverative turning. Irradiation of a portion of the neonatal rat cerebral hemispheres produced hypoplasia of the granule cell layer of the hippocampal dentate gyrus while sparing the rest of the brain. Radiation-induced damage to the hippocampal formation caused rats placed in bowls to spontaneously turn in long, slow bouts without reversals. Irradiated subjects also exhibited other behaviors characteristic of hippocampal damage (e.g., perseveration in spontaneous exploration of the arms of a T-maze, retarded acquisition of a passive avoidance task, and increased horizontal locomotion). These data extend previously reported behavioral correlates of fascia dentata lesions and suggest the usefulness of a bout analysis of spontaneous bowl turning as a measure of nondiscrete-trial spontaneous alternation and a sensitive additional indicator of radiation-induced hippocampal damage. PMID- 2765178 TI - Hippocampal lesions and associative learning in the pigeon. AB - The performance of pigeons with hippocampal lesions was compared with that of unoperated and neostriatal-lesioned control Ss in 3 experiments. In Experiment 1, hippocampal-lesioned birds were retarded in the acquisition and the maintenance levels of autoshaped responding. However, the deficit was attenuated following the addition of a response contingency to the autoshaping schedule. In Experiment 2, the hippocampal-lesioned birds showed impaired performance on a differential reinforcement of low rates of responding schedule. From the high levels of responding in Experiment 2, underresponding was observed in hippocampal-lesioned birds relative to control Ss on return to the autoshaping schedule in Experiment 3. Results are interpreted in terms of impaired classical conditioning in hippocampal-lesioned birds. PMID- 2765179 TI - Improvement of memory by a vasopressin fragment: importance of individual differences in mnemonic function. AB - Three studies examined the effect of AVP4-9 on memory in an appetitively motivated task (the radial maze) to ascertain the generality of the mnemonic effects seen with vasopressin analogues in avoidance paradigms. Both pre- and posttrial administration of this vasopressin fragment significantly alleviated the forgetting seen in the control condition. However, a significant relation was observed between the proficiency of the rats and the degree to which their performance was improved by the posttrial AVP4-9 treatment. The more proficient subjects did not benefit from this treatment despite the fact that their performance provided evidence of significant forgetting. This pattern of results suggests that physiological differences of animals varying in mnemonic ability may account for their disparate response to the peptide treatment. The present findings support vasopressin's putative mnemonic role but indicate that exogenous administration of vasopressinlike peptides may improve memory only in certain subgroups, and possibly only under particular testing conditions. PMID- 2765180 TI - Association of sleep parameters and memory in intact old rats and young rats with lesions in the nucleus basalis magnocellularis. AB - Relations between sleep and memory were examined as a function of aging in rats. Sleep (24 hr), passive avoidance retention, and choline acetyltransferase (CAT) activity were assessed in 3 age-groups (6, 15, and 24 months old). Age-related alterations were evident in sleep, memory, and cortical and striatal CAT activity. Retention deficits in old rats were significantly correlated with several measures of paradoxical sleep. Similar analyses in 6- and 15-month-old rats with ibotenic acid-induced lesions of the nucleus basalis magnocellularis (NBM) showed several alterations in sleep, memory, and cortical CAT activity comparable to those seen in the old rats. One measure of paradoxical sleep, bout duration, correlated significantly with retention scores in rats with lesions. Thus, fragmented paradoxical sleep accompanies memory impairments in old rats and in young rats with NBM lesions. PMID- 2765181 TI - Disruption of the connections between the mediodorsal and sulcal prefrontal cortices alters the associability of rewarding medial cortical stimulation to place and taste stimuli in rats. AB - This study involved 2 tests of conditioned reward with self-stimulation (SS) of the prefrontal cortex. In Experiment 1, rats were tested for a conditioned taste preference (CTP) induced by pairing a novel flavor with SS of the medial prefrontal cortex (MC). Normal rats displayed a CTP. Rats with bilateral cuts of the connections between the MC and sulcal prefrontal cortex (SC) did not show a CTP. In Experiment 2, similar cuts had no effect on the ability of SC SS to promote a CTP, showing that the cuts spare the ability to learn a CTP. In Experiment 3, rats were tested for a conditioned place preference by pairing MC SS with environmental cues. Lesioned rats, but not intact rats, had a CPP. Results suggest the presence of prepotent relations, dependent on intrinsic prefrontal connections, between the rewarding effects of prefrontal stimulation and distinct sensorimotor domains. PMID- 2765182 TI - Reversal of an aluminum-induced behavioral deficit by administration of deferoxamine. AB - Administration of aluminum sulfate in the drinking water of male Sprague-Dawley rats for 30 days resulted in a reduction in the number of days to reach extinction criterion on a passive avoidance task (38% control level). The behavioral deficit was not due to nonspecific effects caused by lower fluid consumption. Partial reversal of the deficit was produced by discontinuing aluminum treatment 2 weeks prior to testing (p less than .05). Injection of the aluminum chelator deferoxamine returned the performance of the aluminum-treated animals to control levels in a dose-dependent manner but had no effect on control animals. No differences in open-field activity were evident across groups. These results indicate that the behavioral impairment is a specific, reversible, toxic effect of the aluminum administration. PMID- 2765183 TI - Interactions between simultaneously activated behavioral systems in the rat. AB - Interactions between electrically induced attack and teeth-chattering from 1 electrode and grooming from another were examined in male albino rats. The interaction between electrically induced attack and deprivation-induced feeding, as well as the effect of food deprivation on attack, was also studied. Results indicate that attack appears to be a dominant response, for it suppressed grooming and feeding at a low level of activation. On the other hand, it was not affected by simultaneously induced grooming or feeding. However, food deprivation decreased the threshold for attack, leaving attack latency, attack form, or bite targets unaffected. Teeth-chattering, suggested to be related to attack and flight, was also a dominant response. Results suggest that interactions between behavioral systems are in favor of the systems that must act acutely on activation in order to survive. Apparently, the regulations governing these interactions are represented in the functional organization of the brain. PMID- 2765184 TI - Spatial EEG correlates of nonassociative and associative olfactory learning in rabbits. AB - Recent studies have shown that spatially distributed olfactory bulbar activity correlates with odor-specific behavioral responding (Coopersmith & Leon, 1984; Freeman & Grajski, 1987; Freeman & Schneider, 1982; Freeman & Viana di Prisco, 1986; Grajski, Breiman, Viana di Prisco, & Freeman, 1986; Gray, Freeman, & Skinner, 1986; Sullivan & Leon, 1986; Viana di Prisco & Freeman, 1985). The present studies established olfactory bulbar spatial electroencephalogram (EEG) correlates of nonassociative and associative learning in odorant stimulation in rabbits. Behavior was quantified by measuring magnitude and probability of the sniff response. It was shown that (a) olfactory bulbar spatial EEG amplitude patterns do not simply reflect odor (peripheral) stimulation, (b) repeated presentations of a nonreinforced odor initially reveal a transient EEG pattern change but the pattern change does not recur after the subject has habituated to the odor, and (c) repeated presentations of a reinforced odor (mild cutaneous shock), with a second nonreinforced odor serving as a control, reveal that coexisting, odor-specific spatial EEG amplitude patterns emerge with the acquisition of differential behavioral responding. PMID- 2765185 TI - Mesencephalic reticular formation lesions made after habituation training abolish long-term habituation of the acoustic startle response in rats. AB - Lesions to the mesencephalic reticular formation (MRF) in rats severely attenuate the acquisition of long-term habituation of the startle response when the lesions are made prior to habituation training. The present experiments extend the finding of habituation deficits to animals with MRF damage made after the animals have habituated to an auditory stimulus. Following habituation training, some animals received lesions to the MRF. The startle amplitudes of these animals immediately changed from control levels to levels indistinguishable from those of animals that never habituated across days--animals with MRF lesions made prior to habituation training. The mechanism responsible for long-term habituation appears to be a progressive increase in activity within a long-term habituation pathway extrinsic to the reflex circuit for the startle response, but the synaptic mechanisms responsible for this change are unknown. PMID- 2765186 TI - Nucleus accumbens cholecystokinin (CCK) can either attenuate or potentiate amphetamine-induced locomotor activity: evidence for rostral-caudal differences in accumbens CCK function. AB - In this study the effects of cholecystokinin (CCK) microinjections into the rostral or caudal nucleus accumbens (Acc) on locomotor activation derived from systemic amphetamine treatment were examined. It was found that CCK microinjections into the rostral Acc attenuated and CCK microinjections into the caudal Acc potentiated amphetamine-induced locomotor activity. Results indicate that rostral Acc CCK microinjections have dopamine antagonistlike effects and caudal Acc CCK microinjections have dopamine agonistlike effects on amphetamine induced locomotor activity. The relevance of the present findings to previous results regarding CCK-dopamine interactions is discussed. PMID- 2765187 TI - Amphetamine accelerates recovery of locomotor function following bilateral frontal cortex ablation in cats. AB - Prior work has demonstrated that d-amphetamine hastens recovery of beam-walking ability following unilateral sensorimotor or frontal cortex ablation (Hovda & Feeney, 1984). In this study, after bilateral frontal cortex ablation, cats given injections of d-amphetamine showed an enduring acceleration of recovery of beam walking ability relative to saline controls. In general, rates of spontaneous and drug-induced recovery in cats with bilateral lesions were similar to those previously reported for cats with unilateral ablations. These results indicate that the bilateral corticostriate and corticothalamic projections from the contralateral homotopic cortex do not mediate the beneficial effects of d amphetamine on locomotor recovery after unilateral cortical ablation. PMID- 2765188 TI - Development of shock-induced analgesia: a search for hyperalgesia. AB - With the use of parameters intended to maximize the potential to observe hyperalgesia, the possibility was examined that hyperalgesia might be the immediate response to aversive stimulation, whereas analgesia is delayed (Matzel & Miller, 1987). Consistent with the later prediction, analgesia in rats, as assessed by latency to paw lick in response to thermal stimulation, increased as a function of the delay between a tailshock (Experiment 1) or footshock (Experiment 3) and the test of pain sensitivity. However, in neither case was a hyperalgesic response observed at shock offset. In Experiment 2, the strength of the analgesic response was found to increase as a direct function of both the time since the tailshock and tailshock intensity over the limited ranges examined, but no hyperalgesia was observed immediately after either low- or high intensity shock. In Experiment 4, the opiate antagonist naloxone was found to attenuate both a weak immediate and stronger delayed analgesia, results suggesting a common underlying mechanism. This mitigates the likelihood that differential behavioral responses at short and long delays following shock were obscuring hyperalgesia at the time of shock offset or were summating with an analgesic response at the long delay to create the impression of enhanced analgesia. In total, these experiments provide evidence that opioid analgesia mediates a compensatory process that increases over time, but they provide no evidence that pain sensitivity increases above baseline levels immediately following an aversive event. These data are discussed in relation to preparatory models of endogenous analgesic functioning and the role of endogenous opioids in learning. PMID- 2765189 TI - Roles of neurotransmitter receptors in behavior: recovery of function following decreases in muscarinic receptor density induced by cholinesterase inhibition. AB - Cholinergic neurotransmitter levels were elevated in rat brain by reducing its inactivating enzyme, acetylcholinesterase (AChE), with an anti-AChE agent. Elevated levels result in decreases in cholinergic (muscarinic) receptors. Withdrawal of agent after 10 days of chronic treatment began a gradual return of neurochemical variables toward normal states, yet not fully achieving them within the following 29 days of the experiment. All behavioral and physiological variables measured showed significant effects at the start of the treatment period, developing tolerance at different rates as treatments continued. They also recovered differentially during withdrawal. Results are consistent with a theoretical model in which thresholds for normal functioning of different behavioral and physiological processes are associated with different receptor densities. PMID- 2765190 TI - Sex differences in brain and personality correlates of the ability to identify popular word associations. AB - The ability of men to identify popular word associations had earlier been shown to be affected by left-sided thalamic surgery for movement disorders; now, over a year later, the impairment has been observed with operations on both sides. In addition, upon testing at approximately the same time interval, men who had undergone temporal lobe surgery for epilepsy have also shown the impairment. In contrast, women have improved after the operations. The Word Association Test (WAT) requires a subject to identify popular word associations to 54 words. In a large group of unoperated subjects, the errors on the WAT were greater for men than for women, although the men scored higher on the Wechsler-Bellevue Intelligence Scale (WB). WAT scores were found to correlate with scores on the WB and the Minnesota Multiphasic Personality Inventory, and the WAT scores of the men tended to show a higher correlation with these measures than did those of the women. PMID- 2765191 TI - Disrupted eyelid conditioning in a patient with damage to cerebellar afferents. AB - A 54-year-old woman with damage to cerebellar circuitry resulting from a cerebrovascular accident underwent classical conditioning of the eye-blink response to a tone conditioned stimulus and an air-puff unconditioned stimulus. In contrast to 5 age-matched controls who readily acquired the conditioned response (CR), emitting a mean of 56.7 CRs over 70 trials, the patient emitted only 6 CRs in 100 trials and never emitted 2 consecutive CRs. There were no differences in spontaneous blink rate, sensitivity to the air puff, or sensitivity to the tone between the experimental subject and the control subjects. That conditioning of the eye-blink response is disrupted in a human with damage to cerebellar circuitry is consistent with an accumulating body of literature indicating that the cerebellum is the essential site of plasticity for classically conditioned somatic responses. PMID- 2765192 TI - Dopamine and preparatory behavior: III. Effects of metoclopramide and thioridazine. AB - The effects of metoclopramide and thioridazine on feeding behaviors of male hooded rats were investigated in 2 experiments. Metoclopramide (2.5-7.5 mg/kg) attenuated conditioned preparatory responses to a conditional stimulus signaling delivery of a meal. However, consummatory responses were affected only by the highest dose. Similar effects had previously been observed following administration of pimozide (Blackburn, Phillips, & Fibiger, 1987). Thioridazine (10-30 mg/kg) had no significant effect on any measure of feeding behavior. The different effects of the 2 drugs may be related to their preferential actions at dopamine terminals in anatomically distinct regions of the forebrain. PMID- 2765193 TI - Dissociation of item and order memory following parietal cortex lesions in the rat. AB - Rats with parietal cortex lesions were tested for both item and order memory for a list of spatial events in a probe recognition procedure. Rats with parietal cortex lesions were impaired for all events within the item memory task but had good memory for the early events within the order memory task. These data suggest a dissociation of function between item and order memory for parietal cortex damaged animals. In conjunction with previous findings with rats with medial prefrontal cortex lesions, these data suggest that item and order memory can be coded and represented independently. PMID- 2765194 TI - Tolerance development in UChA and UChB rats by ethanol inhalation. AB - The development of tolerance by exposure to ethanol vapor in rats of the UChA and UChB strains has been studied. The exposure to ethanol vapor (6-7 mg per liter of air) during 46 hours developed clear tolerance to ethanol narcosis time in rats of both strains and sexes, while no tolerance to latency time was developed in any of these strains. Regarding the hypothermic effect of ethanol, only male rats of the UChB strains showed a decrease of rectal temperature significantly lower (p less than 0.05) than its respective control group. Blood alcohol levels (BALs) at awakening after the injection of ethanol (60 mmole/kg IP) were also determined. The results showed only a significantly lower BAL (p less than 0.05) in the females of the UChA strain subjected to ethanol inhalation. PMID- 2765195 TI - Influence of different concentrations of ethanol on energy expenditure, substrate utilisation, and activity in the rat. AB - The acute (one hour) effects of intraperitoneal injections of four concentrations (10%, 30%, 45% and 60%) of a single dose (0.5 g/kg) of ethanol were investigated in unanesthetised rats in an open-circuit calorimeter. Ethanol increased energy expenditure, with the greatest effect being produced by the two lowest concentrations. In contrast, ethanol decreased respiratory quotient, with the greatest effect being produced by the two highest concentrations. The decreased respiratory quotients indicate that ethanol promotes an exclusive reliance on lipids as a source of energy, and further causes lipids to be catabolised for the synthesis of glucose. The peak metabolic effects were produced at a dose that did not significantly affect motor activity, which indicates that the metabolic effects are not secondary to changes in activity. These data support the view that ethanol's effects on energy expenditure and substrate utilisation are mediated by distinct mechanisms. Moreover, since the different metabolic effects were produced by the same ethanol dose, they cannot be due to ethanol's energy content. Thus, ethanol concentration is a major modulator of its effects on energy expenditure and substrate utilisation quite apart from effects due to dose, motor activity or its energy content. This suggests the need to consider the effects of ethanol concentration when analysing ethanol's other pharmacological effects. PMID- 2765196 TI - Reasons for alcohol use by female heavy, moderate, and occasional social drinkers. AB - Subjective and behavioral reasons for drinking alcohol were elicited from 26 female social drinkers for 3 points in time by means of standardized questionnaire items selected from the Alcohol Use Inventory and the Alcoholic Stages Index. The 26 women resided for 35 days on a clinical research unit and could consume alcohol on 21 days. On the first study day subjects recalled subjective and behavioral reasons for drinking for the 21 days immediately prior to admission to the study and the 21 days of greatest alcohol consumption during the previous year. On the day after the end of the alcohol acquisition phase of the study, subjects responded to questions about their reasons for alcohol consumption during 21 days on the research unit. Each subject was classified as a heavy, moderate, or occasional drinker on the basis of observed alcohol intake. The heavy, moderate, and occasional drinkers differed significantly in history of alcohol use, and differences in questionnaire response patterns were reported for all 3 time intervals. In contrast to moderate and occasional drinkers, heavy social drinkers had significantly elevated questionnaire item scores for the 21 days of heaviest alcohol consumption during the past year and for the 21 days immediately prior to the study. However, both heavy drinkers and occasional social drinkers had significantly elevated scores for the 21-day alcohol acquisition phase on the research unit. Scores for moderate social drinkers were similar for each of the 3-time intervals. PMID- 2765198 TI - Brain adenosine modulation of behavioral interactions between ethanol and carbamazepine in mice. AB - The effect of the anticonvulsive drug carbamazepine on ethanol-induced motor incoordination and loss-of-righting reflex was investigated in male CD-1 mice. The results of the investigation showed that carbamazepine significantly potentiated the motor incoordinating effect of ethanol in a dose-dependent fashion. Although carbamazepine did not alter the onset time, it significantly prolonged the duration of ethanol-induced loss-of-righting reflex. Pretreatment with theophylline significantly attenuated the carbamazepine-induced potentiation of ethanol-induced motor incoordination and loss-of-righting reflex. Results from a blood ethanol study indicated no effect of carbamazepine on the clearance of ethanol. The data suggest the involvement of nonadenosinergic mechanism in carbamazepine-ethanol behavioral interactions which is responsible for the accentuating effects of carbamazepine on ethanol-induced motor incoordination and duration of loss-of-righting reflex. PMID- 2765197 TI - Effects of nicotine and nicotine/ethanol on human placental amino acids transfer. AB - Ethanol abuse and smoking during pregnancy both result in decreased offspring weight. One explanation for this may be impaired placental nutrient transport. This study assessed this possibility utilizing the 4-hr perfused human placental system and human placental vesicles exposed to "physiological," 0.2 microM and large (about 20 microM) nicotine concentrations alone, as well as nicotine combined with ethanol, 200 or 400 mg/ml, for up to 48 hr. Two nonmetabolizable amino acids, alpha-aminoisobutyric acid (AIB) and cycloleucine (CLEU) were used as probes. Nicotine was measured by gas chromatography in the placental perfusion system and vesicles and verified as to concentration. There was no statistically significant evidence of decreased transport of these amino acids with exposure to nicotine alone or nicotine and ethanol together in either test system. Thus, brief exposure to nicotine and ethanol does not impair amino acid transport by the human placenta. PMID- 2765200 TI - Rats treated chronically with the benzodiazepine, diazepam or with ethanol exhibit reduced variability of behavior. AB - The hypothesis that chronic treatment with diazepam or with ethanol reduces behavioral variability, was tested on rats in a radial maze. Eight groups (n = 6) of male Sprague-Dawley rats were given one of eight treatments of diazepam (0.0, 1.5, 3.0 or 6.0 mg/kg, IP, -30 min) or of 10% ethanol (0.0, 1.0, 1.5, or 2.0 g/kg, IP, -15 min) for 2 sessions of baseline and 18 sessions of acquisition. Each session consisted of 3 trials of 8 rewards each. Emptied food wells were immediately rebaited so that an entry into any arm produced a reward of 2 food pellets. Both diazepam and ethanol produced a dose-dependent reduction in the variability of arm choice, reduction in the variability of angle of turn between arms, and reduction in the variability of goal-directed behavior. Correlations between these measures suggested they were not independent. The implications of these reductions in behavioral variability for other effects of anxiolytic drugs are described. PMID- 2765199 TI - Hippocampal mossy fiber-CA3 synapses after chronic alcohol consumption and withdrawal. AB - A quantitative study of the CA3 pyramidal cells and of the mossy fiber-CA3 synapses (MF-CA3) of the rat hippocampal formation was performed in rats alcohol fed for 6, 12 and 18 months and respective age-matched controls. Additional groups alcohol-fed for 6 and 12 months and withdrawn for 6 months were also studied. The numerical densities of the CA3 pyramids and of the synapses were calculated applying the disector method to adjacent sections of the CA3 pyramidal cell layer and the stratum lucidum respectively. The results showed a progressive loss of pyramidal cells in alcohol-treated and withdrawal groups and a significant decrease of MF-CA3 synapses after 18 months of alcohol feeding. Taking into account that both hippocampal granule and CA3 pyramidal cells are reduced, the maintenance of the relative number of MF-CA3 synapses in 6- and 12 month alcohol-fed rats suggests the formation of new contacts. The increased proportion of the MF plasmalemma occupied by synapses can also be interpreted as an additional compensation process. These data show that MF-CA3 synapses display plastic and degenerative changes after chronic alcohol consumption and withdrawal which presumably will lead to functional modifications of the hippocampal circuitry. PMID- 2765201 TI - A histochemical study of the distribution of aldehyde dehydrogenase activity in brain structures of rats with genetically different alcohol-related behaviour. AB - Brain samples from rats genetically selected for high or low voluntary alcohol intake (AA and ANA strains) or for differences in alcohol-induced motor incoordination (AT and ANT strains) were analyzed by histochemistry for aldehyde dehydrogenase (EC 1.2.1.3; ALDH) activity in various CNS structures. All strains exhibited the highest ALDH activities in neurons of the mesencephalic tract of trigeminal nerve nucleus and in spinal cord motoneurons, while the lowest activities were observed in the somatosensory cortex. Although the general distribution pattern of ALDH activity was similar in the genetically selected strains, some potentially important differences were observed. AA rats with high voluntary alcohol consumption had lower ALDH activity (with acetaldehyde as substrate) in the neuropil of the olfactory tubercle but higher activity (with benzaldehyde as substrate) in the spinal cord motoneurons, Purkinje cells and capillary endothelium of the cerebellum as compared to the corresponding structures from the alcohol avoiding ANA rats. Alcohol-resistant AT rats had higher ALDH activity, with benzaldehyde, in most CNS structures than did the alcohol-sensitive ANT's, significantly so in the lamina II of the somatosensory cortex and the neurons of the lateral hypothalamic area. This relationship was also found with acetaldehyde as substrate in the neurons of the hypothalamic arcuate nuclei and in cerebellar capillaries, but the ANT's had the higher activity in the neurons of the cerebral cortex V lamina. We suggest that some of the differences observed may relate to the differences between the rat strains with respect to voluntary alcohol intake and alcohol-induced motor incoordination. PMID- 2765202 TI - Embryonic ethanol exposure impairs detour learning in chicks. AB - Six groups of 30 fertile eggs each were injected with 200 microliters of either sterile water or a 37.5% (v/v) ethanol solution immediately before incubation or on days 7 or 14 of incubation. Regardless of day of injection, the ethanol groups had a lower proportion of chicks who completed pipping and hatching. Of the chicks surviving to pip and hatch, the group injected with ethanol immediately before incubation was delayed significantly in pipping compared to the other ethanol-injected groups and to the group injected with water immediately before incubation (p less than 0.05 in all cases). Also, compared to the chicks injected with water, the chicks in all ethanol groups required more trials to attain criterion on a detour learning task when tested 7-10 days after hatching (p less than 0.05). PMID- 2765203 TI - Effect of testosterone administration on rates of ethanol elimination in hypogonadal patients. AB - Rates of ethanol elimination were determined in four hypogonadal subjects at one week and again at eight weeks after the administration of one dose of 200 mg of testosterone cypionate (Depo-testosterone). Ethanol elimination was unchanged in two patients, slightly decreased in one, and markedly increased in one patient at eight weeks as compared to one week after testosterone administration. In the three patients with little or no change in ethanol elimination, initial high levels of plasma-free testosterone, ranging from 445.0 to 3.8 ng/dl did not decrease to abnormally low levels, but ranged between 1.6 and 7.7 ng/dl (normal, 1.20-2.10 ng/dl). In the fourth patient, an increase in ethanol elimination from 86.6 to 107.4 mg/kg body weight/hr was associated with a decrease in plasma-free testosterone from a high level of 4.7 to 0.8 ng/dl. These results indicate that pharmacological plasma concentration of testosterone do not affect the rate of ethanol elimination. A suppressing effect of testosterone on rate of ethanol elimination may occur at levels of plasma-free testosterone which extend from abnormally low up into the normal physiologic range. PMID- 2765204 TI - Ro15-4513 antagonizes depression of open-field horizontal activity by ethanol in rats. AB - The imidazobenzodiazepine, Ro15-4513, has been shown to antagonize some of the behavioral effects of ethanol (ETOH). In rats having relatively little experience in the open field, the actions of ETOH (0.75 g/kg IP), Ro15-4513 (1.25 mg/kg and 2.5 mg/kg, IP), and Ro15-4513 in combination with ETOH were measured on horizontal activity. Rats receiving ETOH showed a significant depression in horizontal activity. Doses of Ro15-4513 given alone produced no significant differences in activity from baseline levels. Rats pretreated with Ro15-4513 prior to receiving ETOH, however, showed a significant attenuation of the ETOH induced depression of activity. These results indicate that Ro15-4513 is effective in attenuating the depressive effects of ETOH in the open field in rats having little experience in the apparatus. PMID- 2765205 TI - Patient--or client? PMID- 2765206 TI - Active and passive mobility of lower limb joints in elderly men and women. AB - An age associated decline in joint mobility during the early and middle adult years is well documented, however, little information exists on the progress of this aspect of joint function during old age. Active and passive ranges of 10 lower limb joint motions were measured in 80 healthy, active men and women aged from 70 years, to examine the relationship between the capacity for joint movement and age, gender, and type of motion. Joint mobility declined consistently as age increased, with women generally having greater movement capability than their male peers. The predominant trend was for a more rapid reduction in mobility during the ninth decade. Passive ranges were larger than those produced actively, and the pattern of change in both measurement modes was parallel over the age range. It is hypothesized that the consistent decline in mobility indicates the importance of biological aging of articular structures as a primary cause of increasing resistance to movement, while environmental causes, such as changing activity status, are suggested by the variation in the magnitude and patterns of change over the age range. PMID- 2765207 TI - Prospective cognitive assessment of stroke patients before inpatient rehabilitation. The relationship of the Neurobehavioral Cognitive Status Examination to functional improvement. AB - Prospective studies establish cognitive status as an important determinant of post-stroke rehabilitation success. The Neurobehavioral Cognitive Status Examination (NCSE) briefly assesses cognition in the ability areas of language, constructions, memory, calculation and reasoning. The NCSE, as well as the commonly used Mini-Mental State Examination and Albert's Test, were administered to 38 stroke patients before inpatient rehabilitation to determine the extent to which they predict rehabilitation outcome. Rehabilitation outcome was measured as the difference between initial and discharge Barthel Index score. The NCSE was shown to be a more sensitive indicator of impairment than the Mini-Mental State Examination and Albert's Test, especially in subsections of orientation and memory (X2 = 8.690, df = 1, P less than 0.005; X2 = 13.348, df = 1, P less than 0.001, respectively). Stepwise multiple regression revealed that attention, calculations and judgement were in association the best predictors of improvement in the Barthel Index scores. Therefore, the NCSE provides both a rapid and sensitive measure of cognitive function and it appears to predict functional status change as a result of inpatient stroke rehabilitation. PMID- 2765208 TI - Certificates for added/special qualifications. Status report and implications for the field. PMID- 2765209 TI - Passive exercise and reinnervation of the rat denervated extensor digitorum longus muscle after nerve crush. AB - Denervated extensor digitorum longus muscles of Wistar rats were passively exercised for 4 days (2 h/day) after peroneal nerve crush 1 cm from the muscle. Isometric contractile properties and endplate ultrastructure were measured 11 days postcrush. No significant differences were observed in tension characteristics between the exercised and nonexercised muscles on day 11. However, the postsynaptic area of endplates for exercised muscles were closer in size to controls than those for the nonexercised ones. In addition, the endplates from the exercised muscles exhibited increased numbers of axonal sprouts and terminals than nonexercised muscles. These results demonstrate that denervated muscles exercised 4 days before reinnervation can preserve the structure of the endplate as well as enhance reinnervation and sprouting at these endplates after 11 days of denervation. PMID- 2765210 TI - Computer-generated headache. Brachiocephalgia at first byte. AB - Twenty-four women employed as computer operators were evaluated for complaints of occipital headaches, as well as neck and shoulder pain. Although the symptoms were highly variable with respect to duration, intensity and distribution, they were mutually consistent in that they started or intensified with the resumption of the work week. The patients varied in age from 25 to 58 with a median average of 48 years. Fifteen demonstrated radiographic evidence of cervical degenerative disc disease and in an additional four, electromyographic evidence of cervical root compromise was present. Multiple precipitating factors were identified in Monday's headache including the predisposing presence of unrecognized impairment of visual acuity in 4 and cervical radiculopathy in 16. Mechanically, prolonged postural cervical hyperextension frequently combined with repetitive head rotation appeared to trigger the discomfort complaints. Undue elevation of the CRT screen, prolonged copying of laterally displaced hard copy, the wearing of bifocals, as well as seating either excessively soft or with a tendency to pitch the operator forward were identified as additional aggravating factors. PMID- 2765211 TI - Intramuscular recording in neurodiagnostic studies. AB - Intramuscular (IM) recordings are often used in nerve conduction studies involving deep or proximal muscles and in other electrodiagnostic tests. Little is known of how various needle electrode configurations and placements influence the characteristics of the evoked responses and their clinical interpretation. The present set of investigations sought to characterize the amplitude, waveform, consistency, latency and muscle discrimination capabilities of IM recordings from a variety of muscles using monopolar, concentric and bipolar electrodes. Results indicate that 1) all forms of IM electrodes studied show marked changes in response waveform with changes in position of the electrode tip, but the monopolar electrode configuration shows the least amount of change; 2) the concentric electrode does not differentiate well between deep and superficial muscle responses; 3) the latency of the evoked response does not change with the depth of penetration within a muscle; 4) the latency of response recorded from IM electrodes may be longer, the same or shorter than that recorded from surface electrodes; and 5) monopolar electrodes should be used when onset latency or waveform is the critical parameter to be recorded from deep or atrophied muscles. PMID- 2765213 TI - Abstracts of scientific papers, Association of Academic Physiatrists. Spring meeting. March 1989--Scottsdale, Arizona. PMID- 2765212 TI - The mechanical performance of ambulation using spring-loaded axillary crutches. A preliminary report. AB - Crutches with the extension post replaced by a spring-loaded post were compared with standard axillary crutches with respect to stresses developed during the stance phase of locomotion. Seven subjects were tested using both standard and spring-loaded crutches. The crutches were fitted with strain gauges; crutch length and grip location were adjusted for each subject using accepted standards. Subjects ambulated using a three-point "swing-through" gait pattern while strain gauge data were recorded. Spring-loaded axillary crutches had 22% smaller shock waves upon initial contact and 24% smaller peak stresses (P less than 0.05). Subjects reported improved endurance and comfort with the spring-loaded crutch. Although larger trials will be necessary, these initial results show promise in reduction of impact-loading of the upper extremity of patients using axillary crutches. PMID- 2765214 TI - [King Salomon was not so "wise"]. AB - Starting from criticism of proceeding of psychological experts (see especially the article of Kurti "Blood alcohol" 1986/23, 381-393) and relevant legal valuations the so-called "wisdom" of King Salomo is subject to a satirical critical appreciation on the background of our contemporary equity. In the course of this appreciation it is shown, constructive on the arguments of Kurti, that not only the psychological and medicinal experts do not sufficiently clear up, they moreover are guided by "prejudices" which also can be found in wordings of laws and relevant enacts. Hence follows Kurti's demand to mete out appropriate importance to the arguments. PMID- 2765216 TI - [Alcohol concentration in the paranasal sinus fluid in drowning]. AB - In 20 of 31 drowned persons we found 0.3 to 3.5 ml fluid in the maxillary and sphenoid sinus. In 18 cases the fluid could be recognised roentgenologically. In 9 cases blood and fluid in the paranasal sinus were free of ethanol. In 6 of 11 cases the concentration of ethanol in blood and fluid of the paranasal sinus corresponded very well, in the other cases the variation ranged from -51.8 to 147%. Ethanol in both blood and fluid of the paranasal sinus seems to confirm the diagnosis "drowning". PMID- 2765215 TI - [Long-term safe driving practice--a bonus for alcohol perpetrators and those leaving the scene of an accident and its limitations]. AB - Authors report about considerations to leave the driving license or to shorten the waiting period to receive back license in cases of a first alcohol offence or a flight after an accident when driver had a long driving experience. In 1981 such efforts were distinctly discussed for the first time. Meanwhile they have been taken up by jurisdiction, especially by law--courts of Saarland. This is proved by series of decisions. Suppositions for non-objected driver's experience as a bonus when decided upon withdrawal of license or about duration of waiting period for giving back license are precised. Moreover, the question is discussed in which case leaving of license or shortening of waiting period even in cases of a longyear experience as driver is not justified. PMID- 2765217 TI - A reevaluation of the indications for orbital rim fixation and orbital floor exploration in zygomatic complex fractures. PMID- 2765218 TI - Temporomandibular joint arthroscopic surgery. PMID- 2765219 TI - Comparison of small fenestra stapedotomies with and without KTP 532 laser. PMID- 2765220 TI - Otitis media. Incidence, duration, and hearing status. AB - The middle ear status and hearing sensitivity in 483 normal infants have been closely monitored as part of the Dallas Cooperative Project, University of Texas at Dallas, effort to assess the effect of early otitis media with effusion on speech and language development. At least one episode of otitis media with effusion occurred in 73.5% of the children between the ages of 6 and 18 months. Almost a quarter of these were discovered at "well-baby" checkups and were appropriately classified as "silent." The hearing levels, the methods of hearing assessment, and the implications of these data are described. PMID- 2765221 TI - Evoked otoacoustic emissions and sensorineural hearing loss. AB - Following Kemp's original studies, several others have confirmed the existence of otoacoustic emissions. Their clinical relevance remains, however, to be clarified. The various published studies have concerned small series. This study sought to specify otoacoustic emission characteristics in relation to sensorineural hearing loss (148 ears of 76 subjects). The results show that the presence of otoacoustic emissions drops as a function of hearing loss and that there is a highly statistically significant correlation between otoacoustic emission threshold and hearing loss at the 1000-Hz frequency. Otoacoustic emissions are never found when hearing loss at 1000 Hz exceeds 40 dB hearing level and when the mean audiometric hearing loss (at 500, 1000, 2000, and 4000 Hz) exceeds 45 dB hearing level. The main practical conclusion is that otoacoustic emission presence indicates middle frequency functional integrity of the outer hair cells of Corti's organ. Absence of otoacoustic emissions is harder to interpret. PMID- 2765223 TI - Transplantability of human head and neck squamous cell carcinomas in athymic nude mice. AB - Tumor material from 91 patients with squamous cell carcinoma of the head and neck was transplanted subcutaneously in athymic nude mice. In the first (man to mouse) passage, the calculated mean probability of tumor take in a single mouse was 11%. The probability of growth in the first passage was significantly better for moderately and poorly differentiated tumors than for well-differentiated tumors. Also, the implantation of lymph node material resulted in a significantly better tumor take rate than material taken from a primary tumor. Transplantability was not dependent on the following characteristics: localization, T or N stage of the tumor, or the sex of the patients. Once growth was established, all variables studied had no influence on the probability of growth in the subsequent mouse passages. A relationship between tumor growth in nude mice and patient prognosis could not be found. When transplanting head and neck squamous cell carcinoma in nude mice, it has to be recognized that some tumor characteristics will influence the success of tumor growth. PMID- 2765222 TI - Combined effects of aspirin and noise in causing permanent hearing loss. AB - Several authors have investigated the interaction of noise and aspirin in hearing loss, with conflicting results. We studied the combined effects of noise and high doses of aspirin on hearing in rats. Thirty-eight Sprague-Dawley rats were divided into the following five groups: (1) controls; (2) aspirin only; (3) noise only; (4) 8-day per 200 mg of aspirin per noise; and (5) 12-day per 200 mg of aspirin per noise. Auditory brain-stem-evoked responses were measured in each animal prior to, 24 hours after, and 3 weeks after aspirin and noise exposure. The animals were killed and hair cells were counted in 200-micron segments and expressed graphically. Results showed significant differences in permanent threshold shift and hair cell loss between all noise-exposed animals and non noise-exposed animals. There was also a significantly greater amount of hair cell loss in group 5 when compared with groups 3 or 4. The 12-day per 200 mg of aspirin per noise regimen (group 5) also proved to be fatal for 6 of 15 of these animals, and caused significant weight loss in the survivors. No weight loss or deaths were noted in any other group. PMID- 2765224 TI - Circulating levels of selenium and zinc in relation to nutritional status in patients with head and neck cancer. AB - There is evidence that selenium and zinc are involved in malignant neoplasia. The exact role of these trace elements, however, is not completely understood. For this reason, we studied circulating levels of selenium and zinc in relation to food intake and nutritional status in 14 patients with head and neck cancer. Six patients without cancer served as controls. The patients with cancer were in different stages of disease. They were untreated or in an initial phase of oncologic treatment. Five of these patients were severely cachectic according to weight loss and nutritional status, which included body mass index, anthropometric values, and serum albumin level. These patients also demonstrated decreased circulating levels of selenium and zinc. Plasma glutathione peroxidase (selenium-dependent enzyme) activity, however, was not significantly different when the cachectic patients with cancer were compared with controls. We found that the plasma selenium level was positively correlated to both short-term and long-term selenium intake when all 20 patients were accounted for. However, no significant correlation could be shown between plasma selenium and serum albumin levels. Although only one patient demonstrated a plasma value below the reference value, serum zinc was positively correlated to the serum albumin level. We conclude that plasma selenium concentrations are essentially related to food intake but not necessarily to weight loss. Low circulating levels of zinc are, rather, associated with the catabolic state of the patient with cancer. PMID- 2765225 TI - Accurate radiographic evaluation of mandibular fractures. AB - Proper radiographic evaluation is essential to confirm the presence and location of a mandibular fracture. The panoramic view of the mandible is considered to be a very accurate technique and has been heavily relied on by many clinicians as the initial or sole means of diagnosing mandibular fractures. Three cases of mandibular fractures are presented in which a panoramic view failed to demonstrate fractures of the mandible that were obvious on plain film radiographs. Diagnosis and treatment planning should not be based on the information obtained from a single roentgenogram such as a panoramic view. The combination of the mandibular series with the panoramic view provides increased diagnostic information that should enable accurate diagnosis of fractures in all areas of the mandible. PMID- 2765226 TI - Pharyngoesophageal dysmotility in globus sensation. AB - Ambulatory esophageal pH monitoring, radiologic examination, endoscopy, and manometry were undertaken in 142 patients with globus. The results demonstrate that abnormal gastroesophageal reflux occurred in 23% of patients, implying that, while reflux may be responsible for globus in some patients, it is not the cause of globus sensation in the majority of individuals with this symptom. Comparing patients with globus and control subjects, there were no differences in lower esophageal sphincter pressures, esophageal body motility, or tonic upper esophageal sphincter pressures, but patients with globus exhibited higher pharyngeal and upper esophageal sphincter after-contraction pressures during deglutition. The physiological significance of this pharyngeal and upper esophageal dysmotility is not clear and it may be no more than a secondary phenomenon. Alternatively, it may contribute to the generation of globus, perhaps in combination with other physical and psychological triggers. PMID- 2765227 TI - Mucosal melanoma of the head and neck. AB - From 1972 to 1988, 15 patients presented to the Duke University Melanoma Clinic, Durham, NC, with malignant melanoma of the mucus membranes of the upper aerodigestive tract. Eleven patients had a nasopharyngeal origin of their melanoma, while 4 patients had oropharyngeal lesions. The average age of the patients was 58.4 years. Median survival for the patients was 1.8 years, with a 5 year survival of approximately 10%. Survival was found to be independent of sex, tumor site, and extent of disease at presentation. Recurrence occurred in 80% of the patients and the median time to recurrence was 10 months. The median survival following recurrence was 13 months and was independent of the site of recurrence. Mucosal melanoma of the head and neck continues to result in a poor prognosis in spite of aggressive treatment. PMID- 2765228 TI - Laryngeal paralysis as the presenting sign of aortic trauma. AB - Disruption of the thoracic aorta is usually fatal without prompt surgical attention. Left recurrent laryngeal nerve paralysis has been reported in approximately 10% of patients who survive long enough to develop a pseudoaneurysm, but the time of onset has rarely been specified. In this study, 50 cases of thoracic aortic trauma were reviewed to determine the incidence and timing of laryngeal paralysis, compared with 50 cases of atherosclerotic aneurysms matched for location. Four patients in the traumatic group were hoarse, and the onset was immediate in 3. Six in the atherosclerotic group became hoarse. Results indicate that laryngeal paralysis following severe trauma can be a very early sign of aortic injury and requires prompt and thorough investigation. PMID- 2765229 TI - Carbon dioxide laser excision of earlobe keloids. A prospective study and critical analysis of existing data. AB - When steroid injections have failed, the most common approach for the treatment of earlobe keloids is surgical excision. The carbon dioxide laser has recently been used with varying reported success in the treatment of keloids and hypertrophic scars. Proponents of this technique claim that the intrinsic properties of laser surgery, which slows fibroblast proliferation, may be responsible for delaying or preventing the recurrence of keloids. We report results on the effectiveness of carbon dioxide laser excision of earlobe keloids. Eighteen patients were followed up from 8 months to 2 years, or up to a recurrence. Four patients within this group with bilateral keloids provided a self-controlled sample. One ear was randomly chosen for laser excision and the other for scalpel excision. There were recurrences in both groups. There were also 17 recurrences in a group of 23 keloids excised by laser, 9 occurring between 6 and 12 months postoperatively. We failed to demonstrate a lower recurrence rate of earlobe keloids using the carbon dioxide laser and discuss some of the factors responsible for this outcome. PMID- 2765231 TI - The effects of radiation on tracheoesophageal puncture. A retrospective study. AB - A census survey of the records of the Department of Otolaryngology. The Ohio State University, Columbus, identified 108 patients with tracheoesophageal puncture (TEP) for voice restoration. Fifty-one patients received radiation therapy in the management of the disease, 50 did not, and seven were unavailable for follow-up. The records were reviewed and chi 2 tests applied to identify possible effects of radiation therapy on the achievement of TE speech and on TEP related complications. Results of a census indicate that, with the exception of radiotherapy, the two groups of patients were highly similar with respect to ultimate achievement of TE speech and to the frequency with which complications occurred, eg, stoma stenosis or leakage via TE fistula. These findings support the incorporation of TEP with the total laryngectomy procedure, even for patients for whom radiation therapy is indicated. PMID- 2765230 TI - Craniofacial resection of ossifying fibromas and osteomas of the sinuses. AB - Massive fibro-osseous lesions of the frontal and ethmoidal sinuses are rare. If left untreated, these lesions can produce chronic infection, orbital complications, and/or intracranial events. In the past, resection of these lesions has usually been subtotal and a risk of damage to intracranial structures existed, particularly to the dura, due to poor exposure, and a high recurrence rate was also present. We have treated eight such lesions with a combined craniofacial approach for total resection with resolution of symptoms, without recurrence, and without occurrence of cerebrospinal fluid leak, damage to the orbital contents or intracranial structures, or resultant cosmetic deformity. PMID- 2765232 TI - Microvascular free flap reconstruction for head and neck defects. AB - In a three-year period, 53 microvascular free-tissue grafts were performed on 51 patients to repair defects following major head and neck ablative surgery or trauma. The vast majority were done at the time of tumor resection. The remainder were done as secondary operations after resection or injury. The choice of free flap was dictated by the reconstructive needs of the patient and donor site availability. Fifty-two (98%) of 53 free-tissue transfers were successful with one failure resulting from venous thrombosis. Complications were noted in 16 of 53 flaps. The majority of these complications were in flaps used to replace bony defects or oropharyngeal resections. Although free flaps may appear to be more risky than traditional forms of reconstruction, they offer the surgeon a greater spectrum of reconstructive options. Limitations of the use of free flaps result only from lack of technical skills and specialized equipment. PMID- 2765233 TI - Management of petrous apex lesions. AB - Advancements in imaging pose new diagnostic and therapeutic dilemmas as smaller lesions in the relatively inaccessible regions of the petrous apex and clivus are identified. Differentiation of true pathology from artifact and anatomic variants is critical in management of these lesions. We describe our experience with five patients diagnosed with petrous apex lesions: three, cholesteatomas; one, cholesterol granuloma; and one, false-positive. Soft-tissue obliteration of the temporal bone defect with postoperative follow-up using high-resolution computed tomographic scanning and magnetic resonance imaging is proposed as an alternative to exteriorization. PMID- 2765234 TI - Modern presentations of Bezold's abscess. AB - The use of antibiotics in suppurative otitis media has greatly diminished the incidence of complications. Deep neck abscess arising from acute mastoiditis, a disease thoroughly described by Frederick Bezold early in this century, has become rare. In the last three years we have treated five cases of deep neck abscess of otogenic origin at our hospital. These cases exemplify Bezold's classic description in their site of origin in the mastoid process and route of spread in the neck. However, our contemporary examples differed in clinical setting, latency of onset, and bacterial cause. In four of the cases, delay in diagnosis occurred because of failure to recognize the disorder. Computed tomography has proved valuable in the anatomic diagnosis and surgical planning. Renewed familiarity with the clinical presentations and pathogenesis of this now uncommon condition may prevent delay in diagnosis and initiation of therapy. PMID- 2765235 TI - Traumatic retropharyngeal hematoma. AB - The development of a retropharyngeal hematoma following a whiplash injury is a rare occurrence. The potential for airway compression necessitates rapid assessment and treatment. An 80-year-old man who had been receiving long-term aspirin therapy sustained a retropharyngeal hematoma following a motor vehicle accident. Management consisted of tracheostomy, neck exploration, and evacuation and drainage of the hematoma. To the best of our knowledge, there are less than 20 citations of traumatic retropharyngeal hematoma in the English literature. Retropharyngeal hematoma has been associated with cervical extension/flexion injuries, anticoagulation therapy, great-vessel trauma, and foreign body ingestion. PMID- 2765236 TI - Voice analysis revisited. PMID- 2765237 TI - Clinical observation regarding laser surgery for early glottic cancer. PMID- 2765238 TI - Allergic rhinitis after tonsillectomy. PMID- 2765239 TI - Pathologic quiz case 2. Monostotic fibrous dysplasia of the temporal bone. PMID- 2765240 TI - Pathologic quiz case 1. Seborrheic keratosis, irritated type. PMID- 2765241 TI - [Effect of testosterone on in vitro proliferation of bone marrow granulocyte macrophage progenitor cells (CFU-GM). I. Observations in normal subjects]. AB - A hypothetical mechanism whereby testosterone propionate (Tp) seems to stimulate the granulopoiesis has been studied. We cultured in agar human bone marrow cells harvested 24 h before and after parenteral administration of 100 mg Tp to 4 volunteer subjects having no hematologic disorders. The dynamic features of the proliferating progenitor cells (growth of the CFU-GM) were studied in agar cultures according to an original method of repeated topographic scoring of dishes. In this way we obtained a classification of the newformed cellular aggregates (CA) based on their size and on their appearance time in vitro. The results were analysed according to the following dynamic classification of the CFU-GM: AC-A = CA observed on day 7 of culture and degenerate on day 12; AC-B = CA present on both days 7 and 12, distinct as B-persistent (CA persistent with the same size in the interval between 7th and 12th day of incubation) and as B progressed (CA progressed to a wider size in the same interval); AC-C = CA appeared ex novo at the 12th day of culture. After acute Tp pre-treatment we observed, in the first period of culture (observations made on day 7), a decrease of the number of the small size CA (P1 = 5-10 cells), while the number of the wide size CA (P2 = 11-30 cells; P3 = 31-50 cells; P4 = more than 50 cells per CA) was increased. The number of the AC-A was unmodified.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2765242 TI - [Effect of testosterone on the in vitro proliferation of bone marrow granulocyte macrophage cells (CFU-GM). II. Observations in hypogonadal subjects]. AB - CFU-GM cultures in agar double layers were performed from bone marrow unfractionated cells of four subjects with hypogonadism, before and 24 hours after acute administration of 100 mg of testosterone propionate (Tp). Cell aggregates (CA) of CFU-GM were classified according to their sizes (P1 = 3-10 cells; P2 = 11-30; P3 = 31-50; P4 = over 50 cells) and according to their appearance time in culture (CA-A: appearing at the 7th day; CA-C: appearing only at the 12th day). The total of proliferating progenitors (tPP) also embraces CA present, in the same microscopic field, on both scoring times (CA-B). In all hypogonadal men studied, the treatment with Tp yielded increase of tPP (on the average of 65%) and increase of the total number of cells appeared in culture (TCP, increase on the average of 82%) calculated as product [CA number] x [average size of CA]. These results are in agreement with those already observed by us in CFU-GM cultures of normal subjects. Yet it is interesting to note that, while in normal subjects the exogenous testosterone effect expresses itself with a higher increase of CFU-GM number in the second interval of culture (CA-C), in hypogonadal men the CFU-GM number increase occurs mostly in the first period of the culture (CA-A).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2765243 TI - [Effect of various environmental illumination modalities on the muricidal behavior of male Wistar rats]. AB - The aim of this research is to study the effects of different modalities of environment lighting on the appearance of the muricide behaviour in the Wistar male Rat. Indeed it is known that the exposition of Rats in environment to continuous light determine a reduction of the cerebral content of serotonin, which is known to unchain the muricide behaviour in naturally not muricide Rats. The animals are kept in different situations of environment lighting: 1) L/D = the natural light of the day alternated with the dark of the night; 2) L/L sodium = continuous light emitted by a sodium steam lamp; 3) L/L neon = continuous light issued from fluorescent neon tubes. The muricide behaviour is studied by comparison Rat-Mouse. The results obtained show that the continuous sodium steam light (L/L, sodium) remarkably increase the percentage of the animals which become muricide compared to the control animals bred in natural environment with a normal succession day-night (L/D). On the contrary the percentage is remarkably reduced compared to the control animals in Rats of the same group when these animals are exposed to continuous light issued from fluorescent neon tubes (L/L, neon). PMID- 2765244 TI - [Effect of a short-term diet based on precooked corn flour on the muricidal behavior of male SM Wistar rats]. AB - The aim of this research is to observe if the lack of cerebral serotonin, obtained by a diet almost devoid of tryptophan (precooked yellow corn meal) is able to trigger the muricide behaviour in male Rats naturally non-muricide. To determine the tryptophan content in the food used and in 4 types of selected maize flour (Zea mays: indurata, indentata, opaque/2 and synt. marano), 3 different methods have been used (ion-exchange chromatography, spectrofluorometry, spectrophotometry). The muricide behaviour, or the interspecific attack, has been tested by comparison Rat-Mouse. The results show that the feeding with a diet "short term" (4 days), composed of precooked corn meal, with a very low content of tryptophan, induces the appearance of muricide or aggressive behaviour towards the Mouse in more than half of the Wistar Rats, bred in a room constantly lighted by sodium steam light. The appearance of the above-mentioned behaviour is connected with the decrease in cerebral serotonin. PMID- 2765245 TI - [Effects of a short-term diet of precooked corn flour on the vaginal cycle, in rats placed in various conditions of environmental illumination]. AB - The aim of this research is to study the effects of a diet almost devoid of tryptophan, which is given by a feeding with precooked yellow corn meal (corn mush), on the alterations of the estrous cycle of animals in several conditions of environmental lighting. Indeed, it is known that cerebral serotonin influences the releasing of LH and consequently the ovulation. The different types of environmental lighting are: 1) Natural (alternating Day-Night = L/D). 2) Continuous dark (D/D). 3) Continuous light by sodium steams (L/L sodium). 4) Continuous light by fluorescent neon tubes (L/L neon). The muricide behaviour is studied by comparison rat-mouse. The feeding with precooked yellow corn meal (diet lacking of tryptophan) unchains in the 100% of the observations the CEA (Constant Estrous Anovulatory), and significantly shrinks the estral cycle in the female Wistar Rat in several conditions of environmental lighting. PMID- 2765246 TI - [Hypothalamic temperature and thermogenesis of brown fat during desynchronized sleep in rats]. AB - The relationship between hypothalamic temperature and deep interscapular temperature measured just below the brown fat lobes has been studied during desynchronized sleep at two ambient temperatures (24 degrees C and 4 degrees C) before and after adaptation (9 days) to cold (4 degrees C). The results show that the increase in hypothalamic temperature during this stage of sleep occurs independently of a transfer of heat from interscapular brown fat. PMID- 2765247 TI - [Peptidergic innervation of the human dental pulp: neuropeptide Y]. AB - The localization and distribution of the Neuropeptide Y (NPY) has been studied with immunofluorescent methods in the human dental pulp. Immunofluorescence for the NPY has been observed in nervous fibers running in medium and big nerves associated in vascular structures, and in single fibers scattered in the pulpar connective or organized in the subdontoblastic plexus. PMID- 2765248 TI - [Mid-term effects of 1-carnitine on the lipidogram of rabbits with surgically denervated heart]. AB - L-Carnitine induces reversibility upon the lipid-graph of a rabbit with a surgically denerved heart after 90 days since it reduces the percentage of stearic acid but also increases thoroughly linoleic acid that notoriously has a plastic and regulatory effect on the heart. PMID- 2765249 TI - [Fatty acids in the development and stabilization of the rat brain]. AB - The development of the rat's brain demonstrates the increase of the short, medium and long C-chain saturated fatty acids and of the docosahexaenoic acids and the decrease of the mono-unsaturated fatty acids, of the linoleic-arachidonic acids, of the alpha-linolenic-eicosapentaenoic acids. The stabilization of the brain in the adult rat increases all the saturated and mono-unsaturated fatty acids and triene, while it decreases all the poly-unsaturated (omega-6; omega-3) fatty acids. The CCl4 poisoning cuts down the linoleic-arachidonic acids and the alpha linolenic acid throughout the development of the rat's brain; after the growth, CCl4 increases triene, ac. eicosapentaenoic and reduces the linoleic-arachidonic and alpha-linolenic-ac. docosahexaenoic acids. PMID- 2765250 TI - [A supplement with poly-unsaturated nutrients in the development and stabilization of the rat brain]. AB - The supplementation with poly-unsaturated nutrients (linoleic and alpha-linolenic acids) induces in the rat's brain: -through the development, the reduction of both these nutrients and the increase of the arachidonic and docosahexaenoic acids; -through the stabilization of the brain, the increase of both these nutrients and of eicosapentaenoic acid; -in consequence of the CCl4 poisoning, the increase of the eicosapentaenoic acid and the decrease of the docosahexaenoic acid: perhaps, owing to membrane-lytic effect of the toxic compound. PMID- 2765251 TI - [Cytochemical study of cells of primary and disseminated ascite Yoshida tumor cells]. AB - The different distribution of cytochemically demonstrable enzymes: lactate dehydrogenase (LDH, 1.1.1.27), succinate dehydrogenase (SDH, 1.3.99.1), dihydrofolate reductase (DHFR, 1.5.1.3), acid phosphatase (AcP, 3.1.3.2) and alkaline phosphatase (ALP, 3.1.3.1), has been documented in Yoshida ascites hepatoma cells in vivo or stored at 80 degrees C. The dehydrogenase activities (LDH, SDH, DHFR) show a strong reaction in all samples. An increased level of these enzyme activities has been observed in the malignant cells spreading through the organs of tumor bearing rats. On the contrary, in the same samples, acid and alkaline phosphatase activities are very low. The strong dehydrogenase activities observed in Yoshida ascite cells stress the rapid turnover of tumor cells. Our results indicate that the histochemical method may be a useful tool to detect the scattered tumor cells. Furthermore, the cytochemical methods allow the characterization of the metabolic pathways employed by the primary and disseminated tumor cells. PMID- 2765253 TI - Pathobiology of Alzheimer's disease. Fifth Paulo Foundation International Symposium. Hanasaari, Espoo, Finland, June 17-19, 1988. Proceedings. PMID- 2765254 TI - The hard core of Alzheimer's disease. PMID- 2765252 TI - [Critical aspects in determining total radioactivity of biological samples]. AB - During measurements of radioactivity in some milk samples with liquid scintillation counter (about one year after the nuclear accident of Chernobyl) we have observed an increase of the values of scintillation fluid with the passing of time. Although this enhancement is absolutely small (about 2 c.p.m. in 500 min), it is very important for an exact measurement of samples at low counting, as those tested. Our protocol of measure provides for insertion of alternate blanks and samples in the automatic sample-holders of liquid scintillation counter. The values of measurement of samples are taken during the increase phase subtracting the value of blank interpolated on the increasing straight line from c.p.m. of sample. Finally, we report the collected values of the whole radioactivity in some milk samples: at least 5-6 nCi/L contrary to about 1 nCi/L of 137Cs reported by USL. In our opinion it is important to consider the whole radioactivity as measure of the overall biological danger of radioactive samples. In fact, this measurement takes into account also biologically very dangerous radionuclides as 3H, 14C, 90Sr. PMID- 2765255 TI - Future challenges of cardiovascular research. PMID- 2765256 TI - Longevity of man: relative weight and fatness in middle age. AB - By February, 1948, examinations in the Twin Cities Prospective Study were completed on 284 executive men, then aged 45-55 and "healthy". In 35 years 183 died, 110 were alive, one was lost. Entry body fatness, indicated by body mass index, skinfold thickness at three sites, relative girth, and body density, did not significantly discriminate the 35-year dead from survivors. Age at death was not related to any fatness measure. The multiple logistic equation in five solutions using age, blood pressure and smoking plus each fatness item separately, found no discrimination of dead from survivors by any fatness measure. In other long time prospective studies, two suggested excess mortality at far extremes of over- and under-weight, several found survivors significantly fatter than the dead, others found no relation between fatness and longevity. Framingham reported fatness a risk factor for death when allowance is made for smoking but that singular claim has been criticized. PMID- 2765257 TI - The North Karelia project: 15 years of community-based prevention of coronary heart disease. AB - The North Karelia Project - a community-wide health intervention programme - was launched in 1972 as response to the local petition to reduce the heavy toll of heart disease in North Karelia. The strategy of community-based prevention was based on the previous pioneering international work on epidemiology of cardiovascular diseases and prevention in which Finland had in many ways participated. Comprehensive scientific evaluation of the programme was carefully designed. The effects of the programme on risk factor reduction and on prevention of cardiovascular diseases are assessed by large population surveys every five years and by data on incidence of cardiovascular diseases and mortality rates. The authors present the 15 years' results and some of the most recent findings of the North Karelia Project, and discuss the overall experience and its national an international implications. PMID- 2765258 TI - Seven Countries Study. First 20-year mortality data in 12 cohorts of six countries. AB - Out of the original 16 cohorts in the Seven Countries Study on Cardiovascular Diseases, 12 population samples in six countries have reached the 20 year follow up deadline. Data on mortality became fully available for a total of 8287 men aged 40-59 at entry examination (two cohorts in Finland, one in the Netherlands, three in Italy, two in Yugoslavia, two in Greece, and two in Japan). Death rates from CHD as well as from all causes follow the traditional falling north to south trend (18 fold between the extremes for CHD; 2.7 fold for total mortality). The differences in all causes mortality are, however, largely accounted for by the variation in CHD mortality. The mean entry levels of serum cholesterol and representative levels of the consumption of saturated fats, mono-unsaturated fats, poly-unsaturated fats and carbohydrates explain a large proportion of inter cohort difference in CHD mortality (81% for saturated fats). By applying the proportional hazards model to the pools of national cohorts, with CHD deaths as end-point and five risk factors as covariates, only age and mean blood pressure are universally significant predictors of fatal events. Cholesterol, smoking habits, body mass index and physical activity play some part but not in all the pools. Age and mean blood pressure are also the only universal risk factors for all causes of death. PMID- 2765259 TI - Using serum cholesterol to identify high risk and stimulate behavior change: will it work? AB - If the measurement of serum cholesterol is to be used to identify a sub population at high risk of subsequent disease and to stimulate behavior change in this group to lower serum cholesterol, the test must be able to both discriminate and motivate the group. The ability of the test to motivate has been documented in a randomized trial. This paper therefore tests, in a cohort of United States men ages 40-59 at entry, the ability of serum cholesterol to discriminate between individuals who would and would not die from coronary heart disease. While risk of death increased with increasing serum cholesterol, the values for men who developed coronary heart disease overlapped the values of the men who did not develop the disease. Overall test accuracy declined from 92% correctly classified when 5% of the population was defined as "at high risk" to 55% when 50% of the population was defined as "at high risk". On a receiver operating curve, defining 5% of the men as "high risk" yielded a false positive rate of 5% and a true positive rate of 8%. Increasing the proportion of men defined as "at high risk" to 50% increased the true positive rate to 75% but also increased the false positive rate to over 50%. Monte Carlo simulation demonstrated that lowering mean serum cholesterol 0.78 mmol/l in the entire population would lower deaths from coronary heart disease by 28%. The same effect could be achieved by lowering the serum cholesterol of all people in the top 20% of the distribution to 4.66 mmol/l.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2765260 TI - The risk-map of Europe. WHO ERICA Research Group. AB - In Europe around 1970 there were only a few small and often poorly known epidemiological studies on risk factors and the incidence of coronary heart disease. In order to enhance the utilization of the information contained in them, the Medical Clinic in Heidelberg offered uniform data analysis to qualifying contributing centres. Thirty-five studies from 17 countries joined this WHO project covering a total sample of 151,923 men and women. The first objective was to draw up a risk distribution map of Europe that would help to understand changes in cardiovascular disease mortality. In this first report the geographical distribution of the four main risk factors--blood pressure, cholesterol, smoking, and weight--is presented together with an overall risk estimate. The well known north-west--east-south decrement in coronary heart disease mortality is clearly supported by this analysis. The second publication will deal with multivariate risk prediction calculated from European data. PMID- 2765261 TI - International differences in developing improvements in cardiovascular health. AB - The mortality rates for the years 1975-1985 for all causes, cardiovascular disease, coronary heart disease and cerebrovascular diseases obtained from the WHO Data Bank in Geneva were analysed separately for men and women in the age group 30-69 years. Data from 30 industrialised countries were available for the analysis. In most of the countries cardiovascular diseases are still responsible for nearly half the deaths in men. The highest mortality rates, except for coronary heart disease, in the age groups studied are in Eastern Europe. Most countries in this region have also registered an increase in the mortality rates during the last decade. This increase is more pronounced in men than in women. The importance of the WHO MONICA Project (Multinational Monitoring of Cardiovascular Disease and Their Determinants) for interpreting these trends is discussed. Information is provided about another WHO project "The Intensified Programme in Coronary Heart Disease Prevention" in which 27 countries are participating. The aim of this project is to facilitate the national action plans for preventing coronary heart disease and exchanging information on their implementation in different countries. PMID- 2765262 TI - Dose-response relationships in blood lipids during moderate freshwater fish diet. AB - Fish and fish oils are known to counteract coronary heart disease risk factors. We have previously showed that eating moderate amounts of freshwater fish modifies lipid and prostanoid metabolism in healthy students. In this study, the dose response relationship was clarified. One hundred male students took part and were randomly divided into control and four fish diet groups with different fish diets. Hematological, serum lipid and vitamin E and A analyses were performed. Already 1.5 fish containing meals per week increased n-3 to n-6 ratio of fatty acids in erythrocyte ghost phosphatidylethanolamine. The serum triglyceride and apolipoprotein B concentration fell significantly in the group eating 3.8 fish containing meals a week for 12 weeks. At two lower doses (1.5 and 2.3 meals/week) the tendency to lower values was already seen. No significant changes were observed in the serum cholesterol, apolipoprotein A1 and vitamin E and A concentrations. The hematological variables also remained unchanged. The results show that moderate amounts of fish as a constituent of normal diet have beneficial effects on lipid metabolism. PMID- 2765263 TI - A comprehensive community approach to adolescent drug abuse prevention: effects on cardiovascular disease risk behaviors. AB - This paper reports the effects of a multi-community drug prevention trial on the use of cigarettes, alcohol, and marijuana in early adolescents and their parents, effects on parent prevention practices, and the relationship of family health behaviors to adolescent cigarette and alcohol use. Annual self-report surveys were administered to a population-based sample of 6/7th grade students from all schools in a 15 community area (n = 5008). Students were also administered an expired air (CO) measure of cigarette smoking to increase the accuracy of self reported smoking and drug use. A sub-sample of parents were also surveyed at one year follow-up (n = 620). Logistic regression analyses of student data indicated that program groups were increasing in monthly drug use prevalence rates at an average of half the rates of control groups at one year follow-up (3.4 vs 14.5% for cigarette use, 4.2 vs 9.6% for alcohol use (greater than 1 drink), 3.5 vs 7.6% for marijuana use); effects were similar for weekly use rates, and have been maintained at two year follow-up. Analyses of parent data at one year follow-up indicated that the odds of program group parents rating drug prevention practices and personal involvement in prevention programs as extremely important, discussing prevention with their children, and exercising regularly were higher compared to control group parents; and perceived child use of cigarettes and marijuana, and self-use of alcohol in the last week was lower (odds ratios averaged across prevention ratings for each substance = 1.85, 1.72, 1.37, 1.53; for use items .34, .73, .59; P less than .10-- .002). PMID- 2765264 TI - Project SMART parent program: preliminary results of a chronic disease risk reduction trail. AB - Project SMART Parent Program is a school-based healthy lifestyle promotion program designed to reduce chronic disease risk in adults and to provide a health conscious home environment for children through the adoption of healthy lifestyle by their parents. Parents in the high involvement condition received comprehensive health status appraisals, and a program designed to reduce dietary fat intake, and increase aerobic activity levels. Parents in the low involvement condition received only the comprehensive health status appraisals. ANCOVA, using treatment condition as the independent variable and change scores as the dependent variables, were used to assess program outcomes. At the first posttest measure, the intervention group compared to the control group had a significantly greater decrease in blood cholesterol, a greater gain in aerobic fitness, a greater weight loss, and a greater decrease in body fat. At the second posttest measure, the intervention group had significantly greater gain in aerobic fitness, a greater decrease in body fat, a greater decrease in systolic blood pressure, and a marginally significant decrease in weight. Preliminary results provide strong support for the effectiveness of the Parent Program in reducing chronic disease risks. PMID- 2765265 TI - Ischaemic heart disease risk factors specific for Warsaw population. AB - This study evaluated ischaemic heart disease risk factors specific for Warsaw's population, including those with the strongest prognostic value for the incidence of myocardial infarction. Out of a population of 5874 men aged 40 - 59 years employed in seven Warsaw enterprises, 4330 men without any symptoms of ischaemic heart disease were followed up for six years. The computed multivariate logistic function finally included five risk factors, among which age, diastolic blood pressure and the number of cigarettes smoked remained statistically significant; serum cholesterol levels and body mass index had no significant influence. This function predicted correctly the myocardial infarction incidence in the general male population of Warsaw aged 35 - 64 years; the ratio of expected to observed cases was 0.93. PMID- 2765266 TI - Food consumption patterns in the Seven Countries Study. Seven Countries Study Research Group. AB - At the end of the 1950s the Seven Countries Study was designed to investigate the relation between diet and cardiovascular diseases. Sixteen cohorts were selected in: Finland, Greece, Italy, Japan, the Netherlands, the United States and Yugoslavia. During the 1960s food consumption data were collected in random samples of these cohorts using the record method, and data were coded into a standardised form. The average daily consumption per person per cohort was calculated for 16 food groups. Large differences were observed in food consumption patterns between the different cohorts. These differences have diminished during the past 25 years, but the relative position of the cohorts in the distribution of different foods has been maintained. This makes future research into the relation between diet and diseases at population level possible. PMID- 2765267 TI - Risk factors for cardiovascular disease among 55 to 74 year-old Finnish men: a 10 year follow-up. AB - The importance of serum total cholesterol, systolic blood pressure, and smoking as predictors of cardiovascular (CVD) disease were studied in 867 men aged 55 to 74 years belonging to the Finnish cohorts of the Seven Countries Study. Men had no definite history of myocardial infarction nor any signs of cerebrovascular disease at baseline in 1974. During the 10-year follow-up 248 men either died from CVD or had non-fatal CVD event, including a total of 188 fatal and nonfatal coronary heart disease (CHD) events. Age-adjusted relative risk of CVD event for men aged 55 to 64 with cholesterol over 7.4 mmol/l compared to below 6.0 mmol/l was 2.6, with systolic blood pressure over 159 mmHg vs. below 135 mmHg 1.8, and smoking over 19 cigarettes per day vs. never smoker 1.7. Corresponding relative risks for men aged 65 to 74 were 1.0, 1.4 and 1.2, respectively. The results for CHD events were closely similar. The results indicate that, in terms of relative risk, systolic blood pressure retains its importance as risk factor for CVD and CHD from late middle age to old age, whereas the importance of smoking is diminished, and serum cholesterol is of little importance in old age. PMID- 2765268 TI - Diet and physical activity of men in east and west Finland in 1969. AB - The purpose of the study was to discover the effects of physical activity on men's diets. The food consumption of 1306 men aged 50 to 69 years was studied using the dietary history method. The men were grouped in four classes according to their physical activity. With increasing activity their consumptions of cereals, potatoes, milk and milk products, fats and sugar increased. The men in East Finland used more milk, butter and fish than those in the West. The consumption of cereals, potatoes and eggs was higher in West than in East Finland. The intake of energy and energy yielding nutrients was greatly dependent on the physical activity but their contributions to the total energy intake were independent. The consumption of minerals and vitamins was adequate in all activity classes. The changes in the diet caused by physical activity seemed to be more quantitative than qualitative. PMID- 2765269 TI - Changes in alcohol consumption and mortality in aged Finnish men. AB - Drinking patterns and changes in alcohol consumption from 1974 to 1984 and associations between alcohol consumption in 1974 and ten-year mortality rates from cardiovascular, violent, cancer or all causes were studied among Finnish men born between 1900 and 1919. The overall absolute alcohol consumption was low in both 1974 and 1984. The average alcohol consumption and drinking pattern did not significantly change with increasing age, though some individual changes occured. Moderate or heavier alcohol consumption was a significant risk factor for cancer deaths among non-smoking men, but not in male smokers. Moderate or heavier alcohol consumption might also be a significant risk factor in violent death. Low, moderate or heavier alcohol consumption was not a significant risk factor for coronary deaths among the men in this rural Finnish population. PMID- 2765270 TI - How far is the Belgian population from the recommended nutritional goals and ideal serum cholesterol? Belgian Interuniversity Research on Nutrition and Health Study Group. AB - In a national Belgian nutritional study (the B.I.R.N.H. Study), the authors review how far the Belgian population is from the recommended nutritional goals and ideal serum cholesterol. They also make comparisons between genders and look at differences according to the linguistic background (French- or Dutch-speaking subjects). Only a small percentage of the Belgian population reach the nutritional goals for total fat intake in males (8.4%) and females (7%), saturated fat intake (7.0% and 6.2%, respectively), and P/S ratio (13.5% and 12.4%, respectively). The percentages reaching nutritional goals are somewhat higher for polyunsaturated fat intake (27.9% and 28.6%, respectively) and dietary cholesterol (39.4% and 54.6%, respectively). A total of 29.9% of the male population, and 32.7% of the female population are at 'high risk' of CHD according to their serum cholesterol levels. In general the results are better for the Dutch-speaking population than for their French-speaking counterparts. In conclusion, despite modifications in eating patterns and a decrease in CHD mortality in Belgium during the 1970s, a very high percentage of males and females are still far from the recommended nutritional goals and ideal serum cholesterol levels. PMID- 2765271 TI - A new fitness test for cardiovascular epidemiology and exercise promotion. AB - The present study suggests that the 2-km walking test is relatively simple to administer by trained instructors, it is as accurate in predicting VO2 max as most available indirect methods, and it is socially acceptable for a normal population. Thus, the test seems to provide a feasible alternative for the testing of cardiovascular fitness in epidemiological research and exercise promotion. PMID- 2765272 TI - Dietary polyunsaturated fat and hypertension. AB - A significant reduction in blood pressure has been observed during low-fat high poly unsaturated fattyacids/saturated fattyacid--ratio diets in a series of studies conducted in the U.S. and Finland. The results suggest the active role of linoleic acid but the effects of decreased intake of saturated fats and the concomitant changes in the intake of other dietary components cannot be ruled out. PMID- 2765273 TI - New stereological method for obtaining unbiased and efficient estimates of total nerve cell number in human brain areas. Exemplified by the mediodorsal thalamic nucleus in schizophrenics. AB - Using a new stereological technique, the total number of nerve and glia cells can be estimated in selected brain regions. The method is completely independent of precise knowledge of nerve cell size, section thickness and of dimensional changes in brain tissue induced by histological procedures. It therefore provides an unbiased estimate of total nerve cell number. As an example, the total neuron number from the mediodorsal nucleus of thalamus in brains from schizophrenic patients is compared to control cases. The total neuron number was reduced by 40% in the brains from chronic schizophrenic patients. PMID- 2765274 TI - Effects of selective oral antimicrobial prophylaxis and systemic antibiotics on the fecal flora and fecal beta-aspartylglycine concentration in patients with acute leukemia. AB - The influence of selective oral antimicrobial prophylaxis (SOAP) and systemic antibiotic treatment (SAT) on the intestinal flora of fourteen granulocytopenic patients was investigated. For SOAP, patients received Cotrimoxazole, Polymyxin and Nystatin; Gentamicin, Ticarcillin and Cefuroxime were administered for SAT. Under SOAP, a complete elimination of Enterobacteriaceae and a marked reduction of yeasts and staphylococci was found. A reduction in the number of anaerobic species was also observed; however, the concentration of anaerobic bacteria remained constant. In contrast, additional systemic antibiotic treatment caused a significant reduction of aerobic as well as anaerobic bacteria, except for microorganisms pathogenic to neutropenic patients (i.e. Staphylococcus epidermidis and Candida sp.). The fecal concentration of beta-aspartylglycine was inversely correlated with the presence of anaerobic bacteria. PMID- 2765275 TI - Granulomatous gastritis associated with Campylobacter pylori. AB - Three cases of granulomatous inflammation in gastric biopsies showing Campylobacter pylori infestation are described. This type of reaction to Campylobacter pylori has not previously been described, and occurred in 1.1% of gastric biopsies containing Campylobacter-like organisms (CLO), in this series of all gastric biopsies submitted for histological examination during one year. Two other cases each showed a mucosal granuloma: one was a patient with Crohn's disease and the other had foreign body giant cells in a biopsy of the edge of a healing gastric ulcer. Each of our three CLO-positive cases with granulomas showed scanty CLO's only. Thus, although granulomatous inflammation associated with CLO's is uncommon as a proportion of all CLO-positive gastric biopsies, these currently represent the commonest condition associated with granulomas in gastric biopsies, in our experience. PMID- 2765276 TI - Neoplasms of the central nervous system in Norway. V. Meningioma and cancer of other sites. An analysis of the occurrence of multiple primary neoplasms in meningioma patients in Norway from 1955 through 1986. AB - The association between meningioma and a primary malignant neoplasm at another site was studied. The data from the population-based Norwegian Cancer Registry were analysed according to whether the meningioma occurred before or after the malignant neoplasm. Male patients with meningioma showed a raised risk for developing a subsequent renal cancer. A significant association was found between meningioma and subsequent breast cancer in females 50-64 years old at time of meningioma diagnosis and between breast cancer and subsequent occurrence of meningioma. Breast cancer patients with symptoms of an intracranial neoplasm may therefore have a potentially curable meningioma and female meningioma patients over 50 years should be considered for breast cancer screening programmes. PMID- 2765277 TI - Leishmania interaction with human monocytes and neutrophils: modulation of the chemotactic response. AB - Infection of host cells with Leishmania, which are obligate parasites of mononuclear phagocytes, most probably involved chemotaxis of host cells towards the parasite. We have examined the chemotactic properties of a sonicate derived from L. mexicana amazonensis promastigotes for normal human peripheral blood monocytes and neutrophils. L. m. amazonensis sonicate exhibited chemotactic activity for monocytes and neutrophils. Treatment at 65 degrees C for 30 min, enhanced the activity for neutrophils but not for monocytes, while treatment at 100 degrees C for 60 min abolished the activity. Additional studies showed that the sonicate generated chemotactic activity in serum, presumably by activating the alternative complement pathway to produce C5a, for monocytes and neutrophils. Incubation of monocytes and neutrophils with the sonicate inhibited the chemotactic activity of these cells towards various chemoattractants. When the sonicate was heat-treated the inhibitory effect was lost, except when sonicate was used as a chemoattractant. These results indicate the presence of specific receptors for factor(s) from L. m. amazonensis promastigotes on human monocytes and neutrophils. PMID- 2765278 TI - Diagnostic value of monoclonal antibody B72.3 in detecting adenocarcinoma cells in serous effusions. AB - In serous effusions, the cytologic diagnosis of adenocarcinoma, and its distinction from mesothelial hyperplasia and malignant mesothelioma, is still difficult. This study compares the immunoreactivity of antibody B72.3 with that of anti-CEA, anti-LeuM1-antigen and anti-keratins in 41 serous effusions from patients with different malignant disorders. B72.3 selectively stained adenocarcinoma cells in 80% of the cases and was as good as anti-CEA and superior to anti-LeuM1-antigen and anti-keratins. It is concluded that B72.3 forms a useful supplement to conventional cytomorphology in the distinction between adenocarcinoma cells, reactive mesothelial cells and malignant mesothelial cells in serous effusions. PMID- 2765279 TI - Visual acuity assessment in children. PMID- 2765280 TI - Combined surgery for cataract and glaucoma. PMID- 2765281 TI - Visual acuity development: a study of preterm and full-term infants. AB - Visual acuity was measured in both preterm and full-term infants by means of forced-choice preferential looking. The ages of infants tested ranged from one month to 12 months. The results of both groups were considered and compared in terms of natal and conceptional age. The data suggested that preterm infants show visual responses equivalent to their full-term counterparts by nine months of age. Trends indicate that visual acuity development in healthy preterm infants appears to be accelerated when compared with full-term infants of the same post conceptional age. PMID- 2765282 TI - Surgical management of oculomotor nerve palsy with lateral rectus transplantation to the medial side of globe. AB - An operation for complete third nerve paralysis involving lateral rectus muscle transplantation to the medial side of the globe as a basic procedure is described. An inferior rectus muscle recession plus resection of an apparent completely paralysed medial rectus was subsequently performed at a second stage operation. The results appeared to be an improvement on previous surgery, particularly in terms of ocular motility, with almost full adduction of the operated eye being achieved. This adduction movement occurred as part of a normal conjugate movement of the two eyes, and the question arises as to the responsible muscles, with some evidence to suggest that relearned action of the transplanted lateral rectus muscle may be implicated. Finally, a Fasanella-Servat procedure as a third stage operation appeared to be adequate to correct the ptosis. PMID- 2765283 TI - Conal anaesthesia: a new approach to retrobulbar anaesthesia. AB - We have set out critically to assess the current percutaneous technique of retrobulbar anaesthesia. Access to the confined space within the muscle cone is limited by the globe itself and the medially directed lateral orbital wall. By approaching the retrobulbar muscle space with a curved needle through the inferior conjunctival sac these anatomical constraints are overcome. This technique is referred to as conal anaesthesia. A quantitative comparison of the two techniques demonstrates that the conal approach produces more reliable and effective muscle block with faster onset of action than conventional percutaneous anaesthesia. The conal approach is safe and offers advantages with its ease of application, excellent anaesthesia and akinesis and through its rapid and consistent results. PMID- 2765284 TI - Bilateral internuclear ophthalmoplegia--an unusual initial presenting sign of giant cell arteritis. AB - A 63-year-old man presented six days after the sudden onset of horizontal double vision. His left eye became divergent two days later. On initial examination he had bilateral internuclear ophthalmoplegia with weakness of adduction and abducting nystagmus. Convergence was weak but there were no other neuro ophthalmic signs. Constitutional signs included confusion and unsteadiness on his feet. A provisional diagnosis of arteritis was made. His ESR was 92 mm/h and a superficial temporal artery biopsy confirmed the diagnosis of giant cell arteritis. After two weeks or oral prednisolone his eye movements returned to normal. There have been no further relapses. This would appear to be a unique presentation of giant cell arteritis. The causes of internuclear ophthalmoplegia are discussed along with a review of the ocular and neuro-ophthalmic signs of giant cell arteritis. PMID- 2765285 TI - Spontaneous resolution of primary congenital glaucoma. AB - We report a further four cases of spontaneously resolved primary congenital glaucoma, including one case seen both prior and subsequent to the resolution. This condition is detected usually in eyes with megalocornea, which are later found to have breaks in Descemets membrane. Two other patients also had this diagnosis made, but later developed active glaucoma, requiring surgical treatment, indicating the need for continued observation of apparently abortive forms of congenital glaucoma. PMID- 2765286 TI - Postural drainage in the management of postoperative hyphaema. AB - We describe the technique of postural drainage of hyphaemas following trabeculectomy alone or when combined with lens extraction and intraocular lens implantation. This technique helps avoid surgical intervention and seems to have no short-term deleterious effect on bleb function. PMID- 2765287 TI - The clinical grading of lens opacities. AB - A simple system has been developed for the clinical grading of the presence and severity of lens opacities. The densities of nuclear opacities as seen on clinical slit-lamp examination are graded in comparison with a set of standard photographs. The extent of cortical opacities seen on retroillumination is estimated in terms of segments involved. The dimensions of posterior subcapsular opacities are measured using the slit beam. Inter- and intraobserver trials were conducted with three observers. Twenty subjects were selected to provide a range of lens opacities. Weighted Kappa statistics for intraobserver agreement for these three types of opacities range between 0.58 and 1.00 and for interobserver agreement between 0.41 and 0.71. This clinical grading system shows good reproducibility and compares well with the grading of lens opacities in photographs. It should prove to be of considerable use in clinical and epidemiological studies of cataract. PMID- 2765288 TI - Primary care physicians' assessment and prevention of HIV infection. AB - The degree and depth to which primary care physicians counsel patients at risk for human immunodeficiency virus (HIV) infection is a major concern. To determine which factors influence whether physicians counsel patients at risk for HIV, primary care physicians's clinical experience, knowledge, attitudes, and preventive counseling advice in hypothetical case scenarios were assessed. Ninety nine adult primary care physicians in the Washington, D.C., metropolitan area were interviewed by telephone from May through November 1987. Ninety-one physicians had tested or referred patients for HIV antibody tests. However, 58% could not name the ELISA or Western blot as the tests. The most frequent HIV prevention recommendations were using condoms (67.7%), abstaining from sexual activity (36.4%), getting tested for HIV (30.3%), and safe sex (23.2%). Naming the HIV antibody tests was the most significant predictor of preventive counseling advice; other significant predictors included physicians' personal comfort with counseling homosexual patients and various physician practice and demographic characteristics. Previous studies showed that homophobia was the main inhibitor of effective AIDS counseling. These results suggest that physicians' lack of knowledge and general discomfort in counseling patients about sexual risk factors, rather than homophobia alone, are important barriers to preventive counseling about HIV infection. PMID- 2765289 TI - Communicating AIDS information to Hispanics: the importance of language and media preference. AB - Though Hispanics are the fastest-growing minority group in the United States and have a high cumulative incidence of acquired immunodeficiency syndrome (AIDS), very little data are available concerning attitudes and beliefs concerning AIDS in this population. In January 1988, 216 Hispanics from three clinics in Oregon participated in a survey regarding AIDS information acquisition and knowledge. Overall, respondents reported receiving more information about AIDS from broadcast media such as television (42.6%) and radio (19.9%) and less from print media such as newspapers (18.5%) and pamphlets (17.6%). Respondents whose primary language was Spanish tended to have fewer information sources and relied relatively more on broadcast media than on print media. Though over 90% of the sample believed AIDS could be transmitted sexually, only 50% thought condoms could prevent transmission. Compared to primarily English speakers, respondents whose primary language was Spanish were more likely to believe that AIDS could be casually transmitted and less likely to believe that condoms could prevent transmission. This study suggests that more information delivered in an effective manner, both culturally and linguistically, is needed. PMID- 2765290 TI - Factors influencing physicians' preventive practices. AB - We used data on a stratified random sample of 809 Quebec physicians to determine the extent to which the integration of prevention into medical practice was related to physicians' sociodemographic background, area of specialization, medical practice characteristics, and professional attitudes. Among factors positively associated with physicians' preventive practices were favorable attitudes toward prevention, patient education and patient-oriented activities, being in primary care medicine or in a medical specialty such as cardiology, gastroenterology, or pneumology, practicing in a public community health center on a salary basis, working in a group practice, having an office-based practice, devoting time to research activities, being older, and being a woman. Specialization in neurology, hematology, dermatology, nephrology, obstetrics gynecology, and most notably surgery was negatively associated with preventive practices, as was working in an emergency room. Overall, the study variables explained 33% of the variance in physicians' preventive practices. The study underlines the prevailing role of attitudes in predicting physicians' preventive practices. PMID- 2765291 TI - Is breast self-examination predicted by knowledge, attitudes, beliefs, or sociodemographic characteristics? AB - The relationship of women's sociodemographic characteristics, knowledge, attitudes, and beliefs to breast self-examination (BSE) practice is not clear. We therefore studied these variables among older women at risk for developing breast cancer to determine which might be associated with the sensitivity, specificity, and frequency of BSE practice. We interviewed 300 women 40 to 68 years of age and measured BSE sensitivity and specificity using manufactured silicone breast models containing lumps. Of 54 variables and 10 scales examined univariately, six were associated with BSE sensitivity, one was negatively associated with specificity, and 10 were associated with frequency. No variable was associated with more than one component of BSE practice, and BSE frequency was not associated with BSE sensitivity or specificity. Using multivariate analysis, BSE sensitivity was best explained by type of employment, health interest, and perceived vulnerability to breast cancer, which accounted for approximately 16% of the variance. BSE frequency was best explained by intention to perform BSE, knowing how to perform BSE, using the correct method of BSE, self-confidence in the ability to perform BSE monthly, and self-confidence in the ability to find small lumps. These variables accounted for 27% of the variance. Sociodemographic characteristics, knowledge, attitudes, and beliefs poorly predicted how accurately women practiced BSE but somewhat better predicted how often women practiced BSE. PMID- 2765292 TI - Hypertension in elderly people in a preventive health program. AB - Control of hypertension is increasingly being recognized as a significant component of any preventive health care program for the elderly because of the high prevalence of hypertension in this group and its impact on health, particularly cardiovascular diseases. This study evaluates the hypertension screening component in one of the oldest and largest health promotion programs for the elderly in the United States, the Preventive Health Care for the Aging Program (PHCAP) in California. Our findings show that 26.7% of PHCAP participants had hypertensive readings on examination. Of these, 20% had mild hypertension, 5.6% moderate hypertension, and 1.1% severe hypertension. Urban participants were more likely than rural participants to have hypertension. Of those with severe hypertension, living alone was a significant factor when controlling for other variables. Overall, 40.2% of the hypertensive patients were not aware of their hypertension, and whites and Hispanics were less aware than blacks of their hypertensive status. Men were also less aware than women. These findings suggest ways to improve hypertension control programs for healthy elderly people who are self-referred to community-based preventive health care programs. PMID- 2765293 TI - Epidemiology course for medical students focuses on proposal writing. AB - Teaching epidemiology to medical students is often seen as a difficult, if not impossible, task. After experimenting with several other approaches, faculty at the West Virginia University School of Medicine have developed a course centered around the production of a research proposal using National Institutes of Health criteria and format. The course content, while comprehensive, emphasizes the clinical uses of epidemiology. Lectures are combined with self-study and individualized teaching to assist the students as they explore their chosen topic. This problem-solving approach to teaching and learning epidemiology in medical school has proved both effective and more acceptable to students, as evidenced by the quality of their research proposals, National Medical Examination Board Scores, student evaluations, and improved faculty-student interaction. PMID- 2765294 TI - Fine-needle aspiration biopsy in the preoperative diagnosis of solitary thyroid nodules. AB - Out of a total of 200 patients with solitary thyroid nodules, 41 diagnosed by fine-needle aspiration biopsy (FNAB) (group A) and 159 by clinical and/or scintiscanning data (group B), 22 were found to have malignant neoplasias, 31 adenomas, 145 simple goiters and 2 thyroiditis. The use of the FNAB technique led to a percentage increase in the operations for malignant neoplasias, while it markedly reduced the number of surgical interventions for simple goiter. Statistical calculation of the sensitivity, specificity, negative predictive value and overall diagnostic accuracy of FNAB indexes demonstrated that FNAB is a simple, reliable, useful and cost-effective procedure. PMID- 2765295 TI - Reproducibility of DNA measurements in imprints of thyroid adenoma. Variation sources. AB - DNA measurement represents a type of quantitative analysis which allows us to gain prognostic information on malignant tumors and to study the natural history of the epithelial neoplasia. However, there are sources of variation in evaluating the DNA content. These include variation due to field selection, variation between observers (interobserver variation), and variation between laboratories (interlaboratory variation). The influence of various variation sources was studied in 4 experiments. When DNA measurements were made from the same microscopic fields, the results did not differ remarkably. However, observer training proved to be important. Intra- and interobserver variation was lower among experienced morphometrists than among inexpert observers. Different laboratories and image analyzers may give different results when the same case is measured. To overcome at least part of the potential variation sources, undergraduates and postgraduates at the Departments of Pathology of Ancona and Kuopio Universities are specially trained in the use and application of morphometry. Special sampling rules should be applied and observers encouraged to follow the rules as uniformly as possible. PMID- 2765296 TI - Transmural differences in ischaemic heart disease: a quantitative histologic study. AB - To evaluate the possible transmural differences in the structure of left ventricular myocardium in patients with ischaemic heart disease, 45 human hearts were examined with morphometric methods. There were 10 control hearts, 10 hearts with coronary atherosclerosis but without myocardial infarction, 11 hearts with acute subendocardial infarction and 14 hearts with acute transmural infarction. The following histoquantitative parameters were separately estimated for both subendocardium and subepicardium in each heart: the volume fraction of diffuse connective tissue, the mean fiber diameter and the numerical density of arterioles. Diffuse myocardial fibrosis was more severe in subendocardium in all groups, the highest values were found in hearts with acute subendocardial infarction. In all groups the numerical density of arterioles was higher in subendocardium. The numerical density of arterioles was increased in respect to the controls in both subendocardium and subepicardium in hearts with coronary atherosclerosis without evidence of myocardial infarction and in hearts with acute subendocardial infarction. The possible pathophysiological implications for ischaemic heart disease are discussed on the basis of these results. The results suggest different pathophysiological mechanisms in subendocardial and transmural myocardial infarction. They also suggest that transmural differences should be considered when the findings of endomyocardial biopsies are evaluated. PMID- 2765297 TI - Biologic and molecular characterization of producer and nonproducer clones from HUT-78 cells infected with a patient HIV isolate. AB - HUT-78 cells were infected with a reverse transcriptase (RT)-positive supernatant of a culture of peripheral blood lymphocytes (PBL) from an AIDS patient and then cloned. Of these clones, two have been isolated and characterized. Clone D10 is persistently and productively infected with an HIV variant. The clone F12, in spite of the presence of an integrated full-length HIV provirus, does not release virus particles in the medium. D10 and F12 clones substantially differ in terms of protein pattern; that is, D10 is super-imposable to infected HUT-78 cells, whereas F12 exhibits a decreased uncleaved p55 gag precursor and the presence of uncleaved gp160 and of a unique p19, although they do not show qualitative or quantitative differences in viral RNA synthesis. Restriction patterns of F12 proviral DNA do not show major genomic deletions. These results indicate that F12 clone cells carry an HIV genome with minor mutations that probably affect the correct production of viral proteins at a posttranscriptional level. In addition, the F12 clone is resistant to high-multiplicity superinfection with HIV-1 or HIV 2. PMID- 2765298 TI - Identification and biologic characterization of an acutely lethal variant of simian immunodeficiency virus from sooty mangabeys (SIV/SMM). AB - A virus pool isolated from lymphoid tissue of a macaque (PBj) infected for 14 months with SIV/SMM was found to be associated with acute disease and death. Six of six pig-tailed macaques, one of three rhesus macaques, and three of four SIV/SMM-seronegative mangabeys developed acute disease within 5 days and died from 7 to 13 days postinoculation; however, neither of two SIV/SMM-infected mangabeys died or developed disease. The virus associated with acute disease and death was shown by electron microscopy to be a lentivirus and was serologically indistinguishable from SIV/SMM by immunofluorescence and radioimmunoprecipitation assays. A biologic clone generated from lymphoid tissue of an animal that died 7 days after inoculation of the lethal pool resulted in death within 8 days of three of three pig-tailed macaques. Comparison of the lethal virus, designated SIV/SMM(PBj14), with the parent virus, SIV/SMM-9 (the isolate with which macaque PBj was originally inoculated), showed that although the kinetics of replication in peripheral blood mononuclear cells (PBMC) from pig-tailed macaques and mangabey monkeys were similar, SIV/SMM(PBj14) replicated more efficiently than SIV/SMM-9 in human PBMC and also replicated in chimpanzee PBMC whereas SIV/SMM and other SIV isolates did not. In addition, the variant was shown to replicate efficiently in some established cell lines whereas replication of SIV/SMM-9 in cell lines could be demonstrated only occasionally. That parental SIV/SMM-9, but not SIV/SMM(PBj14), was neutralized by serum from macaque PBj suggests that the variant may have been generated by immune selection. Comparison of sequential virus isolates from macaque PBj for host range and the ability to be neutralized and of sequential serum samples for neutralization activity indicated that changes in biologic properties were detected in virus isolates and serum obtained at 6 months after infection and later. Normal macaque PBMC infected in vitro with SIV/SMM(PBj14), but not with SIV/SMM-9 or other virus pools from PBj, formed syncytia with Sup-T1 cells, whereas all isolates formed syncytia with MOLT-4 clone 8 cells. These data suggest that, relative to SIV/SMM-9, SIV/SMM(PBj14) acquired multiple mutations, at least one (or more) of which is in the gene coding for the envelope glycoprotein. Continued analysis of this series of SIV/SMM isolates with diverse properties may lead to the identification of specific regions of the viral genome that influence defined biologic properties. Furthermore, the availability of a strain of SIV that induces rapid onset of disease and death may facilitate screening of drugs for antiviral activity against lentiviruses. PMID- 2765299 TI - [The composition of glycosphingolipids and the effect of neuraminidase on cultured glioma cell lines]. AB - The composition of glycosphingolipid on human cultured glioma cell line U 251 and rat glioma cell line C6 was analysed by high performance thin layer chromatography. As a result, the major gangliosides were simple gangliosides such as GM3 (U 251: 7.7%, C6: 84.3%), GM2 (U 251: 32.6%) and SPG (U 251: 30.0%) on glioma cells whereas the major neutral glycosphingolipids were CDH, CTH and globoside. After treatment with neuraminidase 2.92 nmol/mg dry weight and 3.73 nmol/mg dry weight of sialic acid were freed from U 251 cells and C6 cell, but only 8.11% (U 251 cell) and 11.24% (C 6 cell) of these sialic acids originated from glycolipid, and thus the major part of sialic acid might be released from glycoprotein of the cells. The gangliosides that react to neuraminidase are SPG, GD1a and GD1b in U 251 cells and are GM1a and little GM3 in C 6 cells. The biolabelling study using N-acetyl-14C-mannosamine as a precursor of sialic acid demonstrated that the precursor was mainly incorporated into both or either of GM3 and SPG in the acidic glycolipid fraction. In addition, no significant change on proliferation and morphology of glioma cells after neuraminidase treatment was observed in this study. PMID- 2765300 TI - [Astrocytic proliferation in the brain adjacent to infarcted lesion: immunohistochemical study of astroprotein (GFAP) and bromodeoxyuridine (BrdU)]. AB - Although cerebral infarction is a destructive process of nerve cells and brain tissue, the nature is not exclusively disintegrating but also includes active cellular reaction which may modify the progression of tissue damage. Most prominent cellular reaction in the area surrounding infarction can be recognized as a trophic or proliferative change of glial cells. In the present study we produced a focal cerebral ischemia in Mongolian gerbils and investigated the dynamic change of astrocytes in the brain adjacent to thalamic infarction. Using immunohistochemical methods, astrocytes were identified with the antibody to astroprotein (GFAP) and the DNA synthesizing (S phase) cells were detected with the antibody to bromodeoxyuridine (BrdU). The posterior communicating artery of a gerbil was occluded by coagulation through the trans-tympanic bulla approach under general anesthesia with ketamine hydrochloride (80 mg/kg, i.p.). Thirty min after intravenous administration of BrdU (200 mg/kg), animals were sacrificed by transcardiac perfusion with 75% ethanol on days 1, 2, 3, 5 and 7 post-infarction. Ethanol-fixed, paraffin-embedded blocks were cut coronally into 6 microns-thick sections at the level of dorsal hippocampus. Double-labeled immunohistochemical technique (avidin biotin peroxidase-complex method) was carried out with each antibody using 3,3'-diaminobenzidine tetrahydrochloride and 4-chloro-1-naphthol as chromogens. The population of GFAP-positive cells and their S-phase fraction (the number of BrdU-positive nuclei divided by the number of GFAP-positive cells expressed in per cent, %) were examined. The data demonstrated that the regional GFAP-positive cells increased continuously between days 1 to 5 (105.9 to 528.8 cells/mm2) postinfarction (44.6 cells/mm2 in normal brain).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2765301 TI - [Cell kinetic analysis of human brain tumors by bivariate flow cytometric measurement of cellular DNA content and amount of incorporated bromodeoxyuridine]. AB - Cell kinetics of 91 human brain tumors obtained from 88 patients were analyzed with the following two methods, 1) bivariate (two-color) flow cytometric measurement of cellular DNA content and amount of bromodeoxyuridine (BrdU) incorporated into cellular DNA, in 66 specimens, 2) immunohistochemical detection of BrdU incorporated S-phase cells, in 34 specimens. Patients were given an intravenous 1 hour infusion of 200 mg/sq. m. of BrdU 1-2 hours before the surgical removal. The excised tumor specimen was divided into several portions. One was fixed with 70% ethanol and embedded in paraffin, and another was digested mechanically and/or chemically to obtain a single cell suspension, and fixed in 70% ethanol. Paraffin-embedded tissue sections were stained by the peroxidase antiperoxidase immunohistochemical method using anti-BrdU monoclonal antibody (MoAb). Single cell suspensions were reacted with fluorescein isothiocyanate (FITC) conjugated anti-BrdU MoAb, or anti-BrdU MoAb and FITC-conjugated second antibody successively by the staining with propidium iodide, for flow cytometry (FCM). Rates of S-phase fraction in single cell suspensions calculated by bivariate FCM were correlated well with labeling indexes (LI, i.e. the percentage of BrdU incorporated cells) calculated in tissue sections, but not with the result of analysis of DNA histogram by Dean's method. This discrepancy is probably due to large coefficient value in several samples. Histological malignancy of the tumors was reflected both in the proliferating index (PI, i.e. % S+G2M phase) calculated by bivariate FCM and the LI by immunohistochemical method. PI tended to be high in primitive neuroectodermal tumors and metastatic carcinomas, moderately high in gliomas, and low in benign tumor groups.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2765302 TI - [An autopsy case of thrombotic thrombocytopenic purpura--topography of the vascular lesion in the central nervous system]. AB - We reported the pathological findings of an autopsy case of thrombotic thrombocytopenic purpura, with special reference to the topography of vascular lesion in the central nervous system. Amorphous eosinophilic, PAS-positive thrombi, endothelial proliferation and aneurysmal dilatation of affected vessels were prominent features in the visceral organs such as the heart, kidneys, liver, pancreas, adrenals, thyroid and alimentary tracts. Most of these vascular lesions were restricted to the arteriolar-capillary junctions. There were no thrombi in the lungs as reported previously. In addition, the thrombi were rarely seen in so called portal vessels existed in the liver, pancreas and anterior pituitary gland. In the central nervous system, there were many vascular lesions similar to those of visceral organs in the cerebral gray matter, brain stem and cerebellar cortex. A few lesions were also seen in the white matter, subarachnoid space and choroid plexus. Many foci of chromatolytic neurons as well as a few petechial hemorrhages and minute infarcts were observed in the parenchyma. The characteristic of the vascular lesions in the cerebral and cerebellar cortex was the sites of thrombi. They were predominantly located at the bifurcation of arterioles, 20-50 microns in diameter, and were numerous in the third or fourth cortical layer of the cerebrum, and in the Purkinje cell layer of the cerebellum. Although the etiology of TTP is still unknown, the characteristic topography of vascular lesions suggests primary endothelial involvement in this disease. PMID- 2765303 TI - [A case of chronic renal hemodialysis and intracranial hypertension--a study on CSF dynamics]. AB - There are many reports on the disequilibrium syndrome due to dialysis in patients with chronic renal failure. However, they do not mention the findings of CT cisternography and MRI. We intend to investigate the mechanism of CSF dynamics in a patient with disequilibrium syndrome by means of these radiological examinations. A 31 year-old woman who had suffered from renal failure for 18 years was found to have prominent increase of serum creatinine (18.1 mg/dl) and BUN (127 mg/dl) 3 years ago. At that time, digital marking of the skull was already present by X-ray examination without other destruction in bone survey of the whole body. She was hemodialysed by the hollow fiber kidney three times weekly (dialysis time 4.5 hours, dialysate osmotic pressure 270 mOsm/kg H2O). Three months ago, she began to complain of severe headache, nausea and vomiting 2 hours after the beginning of dialysis, so that she was referred to Kosei Hospital. On admission, she showed exophthalmus, concentric narrowing of the visual field, optic atrophy and hyperreflexia in jaw and four extremities. After admission, she received hemodialysis therapy thrice weekly (dialysis time 5 hours, dialysate osmotic pressure 290 mOsm/kg H2O). At the same time, 200 ml of glycerol (contents of glycerin 10, fructose 5, NaCl 0.9%) was administered intravenously during dialysis, which ameliorated the symptoms of intracranial hypertension. Laboratory studies revealed marked decrease of serum creatinine, BUN and uric acid levels and osmotic pressure, and increase of blood pH at the time of postdialysis compared with predialysis. Manometric CSF pressure increased up to 310 mmH2O at the day without dialysis before the glycerol administration.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2765304 TI - [Chronic demyelinating polyradiculoneuropathy associated with malignant histiocytosis]. AB - A case of malignant histiocytosis (MH) presenting with peripheral nerve involvement is described. A 67-year-old man initially noted left facial weakness on July 20, 1986. The symptom was improved within a week, however, two weeks later he noticed numbness in his fingers and a burning pain in his legs, which was followed by double vision and progressive weakness in all four limbs. On examination, he was found to have total ophthalmoparesis of the right eye and a trace of the left facial palsy. There was severe weakness of the leg muscles, as well as mild weakness of the arms. This was accompanied by wasting of his limbs. All tendon reflexes were absent. Planter responses were flexor. Although cutaneous sensation was intact, vibratory sense was markedly impaired in the legs below the knees. The sphincter function was mildly disturbed. The sedimentation rate was 32 mm/hr. The hemoglobin was 11.9 g/dl and the leukocyte count was 5,700/mm3. The platelet count fell to 60,000/mm3. Results of routine biochemical and radiological studies were unremarkable. The cerebrospinal fluid protein level was 129 mg/dl with a normal cell count. Motor nerve conduction study revealed marked reduction in amplitude of the compound muscle action potential, slow motor nerve conduction velocities and multifocal conduction blocks along the nerve trunks (the left ulnar nerve in the forearm, the bilateral tibial nerve in the lower leg). F-wave was absent or elicited with prolonged latency and with increased chrono-dispersion. Sensory nerve had normal or nearly normal conduction. EMG sampling showed an impaired interference pattern during voluntary contraction and a few denervation potentials at rest.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2765305 TI - [Differential diagnosis and origin of epithelial cysts in the central nervous system--report of seven cases and review of literature]. AB - Seven cases of epithelial cysts are presented with special reference to histological findings. Differential diagnosis and origin of the cysts are also discussed. Two are autopsy cases and 5 are surgical cases. Median age of the patients is 41 years. Three cysts are in the posterior fossa, 1 in the supratentorial region, 1 in both infra- and supratentorial regions and 2 in the spinal canal. On light microscopy, the type of cell lining the cyst wall and the presence of cilia and PAS-positive cells are studied. All cyst walls were lined by a single layer of cuboidal to columnar epithelium. Cilia was seen in 1 and PAS positive cells were found in 5 out of 7 cases. On electron microscopy of the 4 cases available for study, continuous basement membrane and microvilli were observed in all cases. Coating material covering microvilli was noted in 2 cases. According to these histological findings, these cysts are classified as follows: 1 multiloculated cyst, 1 (respiratory) epithelial cyst, 3 (enterogenous) epithelial cysts, 1 ependymal lined cyst and 1 neuroectodermal cyst. Various non neoplastic cystic lesions are found in the central nervous system, such as arachnoid cyst, ependymal cyst, colloid cyst, choroid epithelial cyst, neurenteric cyst, and Rathke's cleft cyst. Although histological difference between arachnoid cyst and other epithelium-lined cysts is relatively clear, the precise discrimination between other cystic lesions is difficult and controversial. Some authors have considered these cysts as a neuroectodermal origin because of their histological similarity with choroid plexus or ependyma.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2765306 TI - [The correlation of host-immunocompetence and host-humoral states to the take incidence and proliferative activity of implantation C-6 glioma cells]. AB - Recently it has become evident that "second growth factor" of growth hormone (GH), such as somatomedins, has an effect on the proliferation and growth of tumor cells derived from nervous tissue. Effects of host-immunocompetence and the host-humoral states on the take incidence and proliferative activity of brain tumor cells were studied using two animal models: nude mouse and pituitary Snell dwarf mouse. Nude mouse is known to be immunodeficient. Pituitary Snell dwarf mouse is characterized by lack of circulating GH, TSH, prolactin, in addition to immunodeficiency. Cell line used in this experiment was C-6 cell of rat glioma cell. After intracranial implantation of C-6 glioma cells in the animals, the take incidence and growth rate of C-6 glioma cells were followed up and measured over a period of 2 months. Tissues of implants were studied immunohistochemically and biochemically. Regardless of cell line, successful take incidence in the different animal species was found to be greater in the descending order of nude mouse, dwarf mouse. This confirmed the role of immune status for the successful take of iso-, or heterologous tumor cells after implantation. We are now investigating the effect of exogenous GH on the growth rate of cells implanted in the dwarf mouse. This may clarify the effect of growth factors on proliferative activity of implanted tumor cells. PMID- 2765307 TI - Femoral bone density in young male adults with stress fractures. AB - Femoral bone mineral density (BMD) was measured by dualphoton absorptiometry in 41 young military recruits who had one or several stress fractures, during their physical training program. These fractures involved the following locations: Femur (neck: n = 10, diaphysis: n = 2), calcaneus (n = 10), tibia (n = 8), fibula (n = 3), metatarsus (n = 8). The stress fracture group generally had a lower bone density than that of a control group, consisting of 48 young military recruits matched for age, height and weight. However, the BMD was significantly lower ( 10%) in patients with femoral and calcaneal locations, but it did not differ for other locations. To determine the possible effect of this intense physical activity on bone mineral mass, bone mass was measured again in 35 subjects from the control group at the end of their training. The BMD remained stable or increased in 28 subjects, but decreased significantly (greater than 2%) in 7 subjects, demonstrating the individual variability in the adaptation of bone to this stress. Our results suggest that lowered bone mass could be a factor that encourages the development of stress fractures (femoral and calcaneal) in young subjects submitted to intense physical activity to which they are not accustomed. PMID- 2765308 TI - Effects of age and sex on bone density in the rhesus monkey. AB - Normative data for bone density of cortical and trabecular bone in the rhesus monkeys is described in the present study. Changes of bone density (g/cm2) for the humerus, the third lumbar vertebra, and the eighth caudal vertebra of the rhesus monkey show differences due to age and sex of the subjects (males n = 57; females n = 49). In general, bone density increased with age and then reached a plateau at approximately 3 to 4 years in all bones measured. In the humerus, older females (greater than 30 years) had a significantly lower bone density than females of 4 to 24 years, while bone density in older males did not decrease. In the vertebrae, some evidence of advanced age-related decreases in bone density was found in both sexes. These results indicate that the rhesus monkey shows a natural pattern of change in bone mineralization which parallels that seen in humans. The physiological similarity between the rhesus monkey and human further suggests a potential role for this species in the future investigation of osteoporosis. PMID- 2765310 TI - Time course of "escape" from calcitonin-induced inhibition of motility and resorption of disaggregated osteoclasts. AB - The reversible calcitonin (CT)-induced inhibition of osteoclastic activity has been studied to clarify the mechanisms responsible for the so-called "escape phenomenon." Osteoclasts disaggregated from neonatal rabbits were cultured on glass coverslips or thin bovine bone slices. Resorption activity was evaluated by using time-lapse recording and scanning electron microscopy. Addition of CT to the cultures caused most osteoclasts on glass surfaces to be immotile and contracted. From 1.5 h onward, in cultures with CT, osteoclasts started to escape from CT-induced quiescence independently of other cells. CT also prevented osteoclasts on bone slices from excavating bone while concomitant cell immobility occurred. Inhibited osteoclasts were able to regain apparent bone-resorbing potency only after resumption of cytoplasmic immobility. The resumption of bone resorption could begin as early as 9.7 h after CT addition. The observations indicate that CT-induced inhibition of osteoclastic bone resorption is associated with inhibition of cytoplasmic motility and that the "escape" phenomenon reflects resumption of activity of osteoclasts that were previously inhibited by CT action rather than the resportive activity of newly formed osteoclasts. PMID- 2765309 TI - The comparative effect of ovarian hormone administration on bone mineral status in oophorectomized rats. AB - The effect of oophorectomy and hormone replacement therapy on cortical and trabecular bone mass was assessed in Sprague-Dawley rats. Bone mineral density (BMD) of the femur and the lumbar spine was determined by dual photon absorptiometry 4 months after surgery. Femoral mineral content was also determined. A significant decrease in bone density and in calcium content was observed after surgical castration. Bone mineral loss was prevented by either progesterone or estrogen, while the combination of progesterone and estrogen had no effect on the bone mineral content. The present study suggests the possibility that estrogen-progestin treatment may be less effective than a therapy with estrogen alone, and that further study on the effect of progesterone alone would be worthwhile. PMID- 2765311 TI - Orientation of collagen in human tibial and fibular shaft and possible correlation with mechanical properties. AB - The pattern of collagen orientation in two human tibiae and fibulae was studied. Serial 100 microns plane parallel cross-sections at 1 cm intervals at the same level in tibia and fibula were cut using an annular blade saw. Distribution of transversely oriented collagen was mapped using circularly polarized light and an image analyzing computer. In both the tibia and fibula the pattern of collagen orientation is characteristic, which may be related to the distribution of the bending forces normally operative in these bones. PMID- 2765312 TI - Bone and Tooth Society, autumn meeting. September 23, 1988, Cardiff. Abstracts. PMID- 2765313 TI - A physiological view of in vivo calcium dynamics: the regulation of a nonlinear self-organized system. AB - Our aim is neither to re-evaluate the term homeostasis, nor to summarize the conventional concepts in the field of calcium metabolism and its regulation, nor even to comment on their advantages and their limitations (excellent recent reviews have been published). This paper is rather a position article and references to the current literature will be made only if they contribute to a better understanding of our proposals; in contrast, emphasis will be placed on a literature which has, until now, remained unfamiliar to the field of calcium metabolism. The text is organized around three related features which are largely dictated by the characteristics of our recently published compartmental self oscillatory model for rat calcium metabolism: (a) The circadian behavior associated with calcium dynamics in vivo may be viewed as a "key" temporal behavior for investigating the spatiotemporal organization of calcium metabolism in the normal rat. Within the bone, a large part of this circadian behavior should stem from the physico-chemical properties of the transformations of calcium-phosphate associations at the extracellular fluid (ECF)/mature bone interface; (b) an important part of the maintenance of a nearly constant plasma calcium concentration (homeostasis) results from interaction between nonlinear oscillators belonging to both calcium metabolism and calcium-regulating hormones. This implies that: firstly, calcium metabolism, like any biological system, is a complex dynamic system which has evolved over a long period and whose metabolic components--gut, kidney, bone--are organized as dynamic entities, adapted to periodic relationships with the external environment. The intrinsic nature of the circadian behavior of bone calcium efflux proposed here is a sufficient demonstration of this. Secondly, the existence of rhythmic variations in the main calcium regulating hormones, parathyroid hormone (PTH), calcitonin (CT) and vitamin D (VitD), are in agreement with this argument. As developed below, fascinating properties emerge from interaction between oscillators (hormones and target organs) which provide a new perspective on calcium regulation; and (c) one of the striking properties of the kind of nonlinear dynamic system required for this representation of calcium metabolism is that periodicity is only one of many temporal expressions. Thus, qualitative diversity in the temporal expression of calcium metabolism can be expected with varying experimental situations and different modes of temporal regulation of calcium metabolism might be physiologically effective, depending on the species studied.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2765314 TI - Plasma calcium control at quiescent bone surfaces: a new approach to the homeostatic function of bone lining cells. PMID- 2765315 TI - Skeletal fluorosis: histomorphometric analysis of bone changes and bone fluoride content in 29 patients. AB - Bone fluoride content (BFC) was measured and histomorphometric analysis of undecalcified sections was performed in transiliac biopsy cores from 29 patients (16 men, 13 women, aged 51 +/- 17 years) suffering from skeletal fluorosis due to chronic exposure to fluoride. The origin of the exposure, known in 20 patients, was either hydric (endemic or sporadic) or industrial, or in a few cases iatrogenic. Measured on calcined bone using a specific ion electrode, BFC was significantly high in each specimen (mean +/- SD; 0.79 +/- 0.36% on bone ash). The radiologically evident osteosclerosis observed in each patient was confirmed by a significant increase in cancellous bone volume (40.1 +/- 11.2% vs. 19.0 +/- 2.8% in controls, p less than 0.0001). There were significant increases in cortical width (1292 +/- 395 mcm vs. 934 +/- 173 mcm, p less than 0.0001) and porosity (14.4 +/- 6.4% vs. 6.5 +/- 1.7%, p less than 0.002), but without reduction of cortical bone mass. Cancellous osteoid volume and perimeter, as well as width of osteoid seams, were significantly increased in fluorotic patients. The increase in cancellous osteoid perimeter was almost three-fold greater than that noted in cancellous eroded perimeter. In 15 patients doubly labeled with tetracycline, the mineral apposition rate was significantly decreased, mineralization lag time was significantly increased. The fluorotic group had a greater number of osteoblasts than controls with a very high proportion of flat osteoblasts. The ultrastructural characteristics reflecting the activity of the bone cells were clearly visible on electron microscopy. Bone formation rate and adjusted apposition rate were significantly decreased in skeletal fluorosis. On stained sections and microradiographs, bone tissue showed typical modifications for skeletal fluorosis (linear formation defects, mottled bone). The volume of cancellous interstitial mineralization defects and the proportion of mottled periosteocytic lacunae were markedly increased in skeletal fluorosis. These two parameters were significantly correlated together but neither of these was significantly correlated with BFC. Renal function did not significantly influence the changes in BFC and histomorphometry of fluorotic patients. Skeletal fluorosis is thus characterized by an unbalanced coupling in favor of bone formation, and a great number of osteoblasts with a high proportion of flat osteoblasts.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2765316 TI - Lingual nerve damage associated with the removal of lower third molars. AB - In a study of 1117 consecutive surgical procedures by a variety of operators to remove a lower third molar, the incidence of lingual nerve damage was determined to be 11%. Slightly more than half the cases made a full recovery within 6 weeks. All who would recover fully did so within 36 weeks. Six cases (0.5%) in the series failed to make a full recovery. Most strongly implicated in the temporary dysaesthesias was the raising and retraction of the lingual mucoperiosteal flap, especially in the case of unerupted teeth, when general anaesthesia was used. A variable incidence was found between individual operators. Cases of permanent damage arose when distal bone was removed with a bur, despite the use of a lingual flap retractor. The high incidence of lingual nerve damage in this series suggests that dental surgeons should be much more alert to the danger of this complication, and also that a warning of its possible occurrence should be given as part of the process of obtaining informed consent to operation. PMID- 2765317 TI - Professional indemnity insurance: a looming crisis. AB - Dentists around the world have watched with alarm and concern the development of the problems with professional indemnity insurance in the United States. Premiums for general practitioners start at about US$ 4000, with at-risk specialists such as oral surgeons or orthodontists in California paying upwards of $ 30,000. Some Californians have signs in their waiting rooms saying 'I am not insured!' PMID- 2765318 TI - Visit to Poland. AB - In October 1988 a small group of five visited Poland, to see the medical and dental services in hospitals and clinics throughout the country. PMID- 2765319 TI - Preventive dental care for toddlers. PMID- 2765320 TI - Swiss orthodontics--a difference? PMID- 2765321 TI - Allergic reactions to cold sterilising solutions. PMID- 2765322 TI - A lay member's perspective. PMID- 2765323 TI - Current support for dental research. PMID- 2765324 TI - Identification of caries risk in schoolchildren: salivary buffering capacity and bacterial counts, sugar intake and caries experience as predictors of 2-year and 3-year caries increment. AB - Six variables which are capable of measurement at the chairside were assessed for their ability to identify children who would experience high caries increments during the subsequent 2 or 3-year period. The predictor variables measured in 84 urban schoolchildren, aged 11-12 years at baseline, were: baseline caries experience, salivary buffering power, counts of salivary Streptococcus mutans and lactobacilli, and two estimates of between-meal sugar intake. All the predictor variables showed statistically significant correlations with either 2-year or 3 year caries increment. Approximately 25% of subjects were identified as high risk individuals on the basis of a 2-year DFS increment of 5 and above, or a 3-year increment of 8 and above. None of the predictor variables achieved the target predictive value of 80%, either individually or in combination. The combination of Streptococcus mutans counts and buffering capacity measurements at baseline correctly identified low risk during the 3-year period in 78% of individuals (specificity), but only identified 12 out of 19 individuals (63%) at high risk (sensitivity), giving a predictive value of 75%. The predictive value for baseline caries experience was 66%. The results of the present study indicate that the salivary diagnostic tests have potential, but need further development before they can be used with confidence in clinical practice. PMID- 2765325 TI - Diabetes mellitus as a risk factor for acute myocardial infarction in Asians and Europeans. AB - Ischaemic heart disease is commoner among immigrants from the Indian subcontinent than among Europeans in the United Kingdom. The excess cannot be accounted for by differences in smoking, blood pressure, or lipid concentrations. There is, however, an increased prevalence of diabetes mellitus in the Asian population. Separate estimates of the relative risk of acute myocardial infarction associated with diabetes from parallel case-control studies were made to compare the importance of diabetes as a risk factor in the two ethnic groups. For Asians the relative risk was 3.3 (95% confidence interval 1.9 to 5.8) and for Europeans 1.3 (1.0 to 1.7). Calculations of population attributable risk indicated that clinical diabetes mellitus accounts for 21% of the incidence of myocardial infarction in Asians but only 3% of the incidence in Europeans. Diabetes mellitus is of sufficient quantitative importance as a risk factor to account for the whole of the observed excess of deaths from ischaemic heart disease among Asians in the United Kingdom. PMID- 2765326 TI - Responsiveness of the ductus arteriosus to prostaglandin E1 assessed by combined cross sectional and pulsed Doppler echocardiography. AB - Cross sectional echocardiography combined with Doppler echocardiography was used to record either ductal morphology or the flow profile within the ductus arteriosus before and after infusion of prostaglandin E1 in 25 newborn infants with cyanotic and acyanotic congenital heart disease with ductus dependent blood flow. The ultrasound results were compared with changes in arterial oxygen tension and the overall clinical response to prostaglandin E1 seen during the same period in 24 of the 25 patients in whom the degree of ductal narrowing could be determined with the ultrasound method. At the time of the study, the ductus was widely patent or slightly narrowed in 12 patients and was closed in two patients. These patients did not respond to prostaglandin E1. There was prominent localised narrowing of the ductus in seven patients and generalised narrowing in three. After the infusion of prostaglandin E1 there was no ductal narrowing in these patients, except for one patient who had slight residual localised narrowing. There was also a considerable change in the ductal flow profiles in each patient. In these 10 patients infusion of prostaglandin E1 resulted in an increase in arterial oxygen tension, clinical improvement, or both. The present study indicates that prostaglandin E1 is effective in patients with prominent narrowing of the ductus but is not in patients in whom the ductus is widely patent or closed. Cross sectional echocardiography combined with Doppler echocardiography was useful for predicting the responsiveness of the ductus arteriosus to the infusion. PMID- 2765327 TI - Postpartum myocardial infarction. AB - A 29 year old woman had a myocardial infarction three weeks post partum. Coronary angiography was performed six days later. No abnormalities were seen initially, but re-injection of the left coronary artery resulted in a dissection that extended through the anterior descending and circumflex branches and a reinfarction. This case suggests that myocardial infarctions occurring in patients with angiographically normal coronary arteries may be caused by dissections that heal by the time of catheterisation. PMID- 2765328 TI - Fatal intrathoracic haemorrhage after cardiopulmonary resuscitation and treatment with streptokinase and heparin. AB - A 66 year old man with acute myocardial infarction underwent cardiopulmonary resuscitation before being treated with streptokinase and heparin. Seventeen hours later he died of an intrathoracic haemorrhage caused by multiple fractures of the sternum and ribs. PMID- 2765329 TI - Malignant melanoma of the right atrium: antemortem diagnosis by transvenous biopsy. AB - About half of all patients with malignant melanoma have cardiac metastases. Histological confirmation antemortem of a secondary malignant melanoma of the heart is difficult. The diagnosis of a secondary melanoma in the right atrium was confirmed by transvenous biopsy in a 46 year old woman who had had a melanoma excised from her right leg two years before. PMID- 2765330 TI - Chemical shift magnetic resonance imaging of human atheroma. AB - Fifteen necropsy specimens of human descending aorta and from eight patients with atheromatous vascular disease were studied by magnetic resonance imaging at 0.5 T. Images were acquired in coronal and transverse planes to localised protruding lesions and then chemical shift imaging was performed by techniques described by Dixon and by Hinks. These techniques produce images in which signal strength is proportional to lipid content. The signal was expressed as a percentage of that from extravascular fat. The total lipid content and its distribution within the plaques were noted. After imaging, the postmortem specimens were examined histologically and the lipid content of the plaque was assessed on a semiquantitative scale. The distribution of lipid within the plaque and between intima and media was also noted. The findings of chemical shift imaging agreed well with histological examination both for total lipid content and for distribution within each plaque. Chemical shift imaging also provided an assessment of the lipid content of the plaques measured in living patients, but validation was more difficult. The usefulness of the technique in routine clinical practice remains to be established. PMID- 2765331 TI - Regional aortic compliance studied by magnetic resonance imaging: the effects of age, training, and coronary artery disease. AB - Arterial compliance was measured in 70 healthy volunteers, 13 athletes, and 17 patients with coronary artery disease. Magnetic resonance images were acquired at end diastole and end systole through the ascending aorta, the aortic arch, and the descending thoracic aorta. Regional compliance was derived from the change in luminal area in a slice of known thickness and from the pulse pressure. Total arterial compliance was also measured from the left ventricular stroke volume and the pulse pressure. In the volunteers, mean (SD) regional compliance (microliters/mm Hg) was greatest in the ascending aorta (37 (18], lower in the arch (31 (15], and lowest in the descending aorta (18 (8], and it decreased with age. Compliance in the athletes was significantly higher than in their age matched controls (41 (16) versus 22 (11) microliters/mm Hg). In the patients with coronary artery disease it was significantly lower (12 (4) v 18 (10] than in age matched controls. Total arterial compliance also fell with age in those with coronary artery disease although there was more variation. The results suggest a possible role for compliance in the assessment of cardiovascular fitness and the detection of coronary artery disease. PMID- 2765333 TI - Ethanol-inducible cytochrome P450 in rabbits metabolizes enflurane. AB - Following anaesthesia with enflurane, some patients receiving isoniazid have increased serum concentrations of fluoride ion, presumably because of induction of an isozyme of cytochrome P450 which is responsible for enflurane biodegradation. In rats, isoniazid and ethanol enhance metabolism of enflurane and also induce a form of cytochrome P450 which is homologous with a form of rabbit liver cytochrome P450 known as 3a. Isoniazid, ethanol and imidazole increase the concentration of cytochrome P450 3a in hepatic microsomes. We have pretreated rabbits with imidazole, the most potent of the three inducers of isozyme 3a, to determine if the hepatic microsomal metabolism of enflurane is enhanced and if purified isozyme 3a catalyses the oxidation of enflurane. Imidazole produced a 250% increase in the hepatic microsomal metabolism of enflurane, sevoflurane, methoxyflurane and the control substrate, aniline. Polyclonal antibodies to cytochrome P450 3a inhibited 90% of enflurane metabolism, but only 40% of methoxyflurane biotransformation in the microsomes from imidazole-pretreated rabbits. Thus isozyme 3a or a structurally similar cytochrome P450 seemed to catalyse almost all microsomal metabolism of enflurane. In addition, purified cytochrome P450 3a catalysed the metabolism of enflurane, sevoflurane and methoxyflurane, and the oxidation of these anaesthetics by cytochrome P450 3a was stimulated four-fold by cytochrome b5, a protein which serves as an alternate source of electrons for some cytochrome P450 reactions. PMID- 2765332 TI - Magnetic resonance imaging of coarctation of the aorta in infants: use of a high field strength. AB - Nineteen infants with suspected coarctation of the aorta were studied with electrocardiographically gated magnetic resonance imaging on a 1.5 T whole body imaging system. In all cases imaging was successful and produced diagnostic images of high resolution. Coarctation was shown in 12 cases. The position and shape of the coarctation were well displayed by the magnetic resonance images. In addition, they clearly showed the relation of the coarctation to arteries arising from the aortic arch and to the length and diameter of the aortic isthmus and the distal aortic arch. The anatomy was confirmed at operation in all 12 patients, except for two with a small ductus arteriosus (arterial duct), which was not seen in the magnetic resonance images. In the seven remaining patients, coarctation was excluded. Magnetic resonance imaging produced high quality images that showed the anatomy better than other non-invasive methods. It provided all the anatomical information required for surgical correction. PMID- 2765334 TI - Midazolam acts synergistically with methohexitone for induction of anaesthesia. AB - The induction dose-response of midazolam was compared with the dose-response of its combination with methohexitone sodium and with that of methohexitone alone. Three groups of 60 unpremedicated ASA physical state I or II women undergoing minor gynaecological interventions were studied. The end-point of induction of anaesthesia was inability to open eyes upon command. Dose-response curves were determined for each group with a probit procedure and compared with an isobolographic analysis. Midazolam was found to act in synergism with methohexitone for induction of anaesthesia. Twenty-seven percent ED50 for methohexitone was required in combination with 33% of ED50 for midazolam to achieve the ED50 of the combination. This degree of synergism is in agreement with that described in animal research. PMID- 2765335 TI - The auditory evoked response as an indicator of awareness. AB - The latency of the early cortical wave Nb of the auditory evoked response (AER) was compared with responses to Tunstall's isolated forearm test, while the concentration of nitrous oxide was progressively reduced during light anaesthesia in seven patients. A threshold Nb latency of 44.5 ms was chosen to discriminate between an early cortical AER containing three waves and that with two waves of longer latency. When Nb latency decreased below this threshold, four of the patients has positive responses, indicating awareness. The addition of a volatile anaesthetic abolished any response, and increased Nb latency to more than 44.5 ms. The three wave AER pattern, therefore, is associated with a depth of anaesthesia at which awareness occurs. PMID- 2765336 TI - Extradural analgesia in the intrapartum management of a patient with pulmonary hypertension. AB - We describe the intrapartum management of a patient with severe pulmonary hypertension using extradural analgesia with a low dose of 0.125% bupivacaine and fentanyl 20 micrograms ml-1 by continuous infusion at a rate of 2.5 ml h-1. This provided effective analgesia and haemodynamic stability. The importance of continuous direct measurement of pulmonary artery pressure is emphasized. PMID- 2765337 TI - Influence of thiopentone on upper airway muscles. AB - Surface electromyograms of tongue and neck muscles were measured in 14 patients before surgery under general anaesthesia to assess their relative importance in the maintenance of airway patency during sedation with i.v. thiopentone. During the i.v. administration of successive 50-mg doses of thiopentone, the mean activity of the genioglossus, sternothyroid and sternohyoid (strap muscles), and scalene muscles decreased. There was a wide variation in response, with frequent activation of the scalene and strap muscles after small doses of thiopentone. The activity of the strap and scalene muscles changed from a tonic pattern to activity in phase with inspiration. Airway obstruction was frequent and accompanied by significant increases in phasic muscle action which did not overcome the obstruction. The pattern of changes observed suggests that loss of tonic activity in the sternothyroid and sternohyoid muscles is associated with airway obstruction. PMID- 2765338 TI - Caesarean section at 27 weeks gestation with removal of phaeochromocytoma. AB - We describe the anaesthetic management of a 31-yr-old woman undergoing combined Caesarean section and removal of phaeochromocytoma during the 27th week of pregnancy. The technique used (general anaesthesia with extradural block) provided good operating conditions and a relatively stable haemodynamic state. PMID- 2765340 TI - Airways re-revisited. PMID- 2765339 TI - Hypotension and bradycardia following superior laryngeal nerve block. AB - Severe hypotension and bradycardia occurred in two patients after superior laryngeal nerve block for awake tracheal intubation. Both patients required treatment with anticholinergic drugs and i.v. infusions and made a good recovery. PMID- 2765341 TI - Paravertebral block for post-cholecystectomy pain relief. PMID- 2765343 TI - Computerized monitoring of depth of anaesthesia with isoflurane. AB - Changes in brain activity were studied at different depths of isoflurane anaesthesia. Ten healthy women (ASA group I) were investigated during non critical surgery. Two channels of the EEG were stored on tape simultaneously with alveolar concentration of carbon dioxide, inspired oxygen concentration, mean arterial pressure, ECG and temperature. Signal processing was made offline. Spectral information from 2-s EEG segments was extracted using autoregressive modelling. Repetitive hierarchical clustering was used to define a common learning set of basic patterns. With this learning set, the EEG was classified, and the results presented in a class probability histogram. The basic patterns were related to the clinical depth of anaesthesia in all patients and assigned specific colours. Using this colour code, the class probability histogram showed a high degree of simplicity. Decreasing or increasing the isoflurane concentration caused the same trend in the class profile in all patients. This indicates that the EEG pattern might be a sensitive tool for decision making during administration of general anaesthetics. PMID- 2765342 TI - Automatic arterial pressure regulation using isoflurane: comparison with manual control. AB - A self-tuning, closed-loop controller, based on the algorithm of Clarke and Gawthrop, was used to regulate the inspired concentration of isoflurane to reduce arterial pressure electively in 33 patients undergoing ENT surgery. The patients were allocated randomly to one of four groups and received differing doses of fentanyl and labetalol to vary the range of sensitivities to the hypotensive action of isoflurane. The performance of the controller was evaluated at two target arterial pressures (AP), by its response to simulated changes in AP and by a comparison with a further group of eight patients with manual control of AP. The controller's undershoot of AP (range 2.8 +/- 0.5-4.5 +/- 1.3 mm Hg) and % time spent within +/- 5 mm Hg of the target AP (range 83 +/- 3.4-89 +/- 2.2%) were acceptable and equalled the manual performance figures (range 3.3 +/- 0.8 mm Hg; 90 +/- 5%). The regulation of induced hypotension in all four groups was rapid, accurate, stable and reproducible. PMID- 2765344 TI - Effects of thiopentone on median nerve somatosensory evoked potentials. AB - We have studied the effects of an i.v. bolus of thiopentone 4 mg kg-1 on the median nerve somatosensory evoked potentials (SSEP) in 15 unpremedicated patients. The latency and amplitude of the SSEP response over the second cervical vertebra (SC) and sensory cortex (P15, N20, P25) were recorded before and for 12 min after injection. Data were analysed at 0, 4, 8 and 12 min for time-related alterations. Cortical amplitude was variable, with a tendency to decrease (P less than 0.03). There was a statistically significant but clinically insignificant transient increase in latency of the cortical N20 (P less than 0.008), and interwave conduction times of SC to P15 (P less than 0.007) and SC to P25 (P less than 0.039). The relation of these results to the proposed mechanism of thiopentone action at synapses is discussed. PMID- 2765345 TI - Priming with alcuronium and tubocurarine accelerates the onset of neuromuscular block. AB - The individual rate of onset of action of tubocurarine and alcuronium has been examined with and without a priming dose of the same agent or the other agent, by measurement of changes in the evoked compound electromyogram of the adductor pollicis muscle. Priming was associated with acceleration of the onset of neuromuscular block. PMID- 2765346 TI - Production of laudanosine following infusion of atracurium in man and its effects on awakening. AB - Twenty patients were given maximal doses of atracurium or vecuronium by infusion during surgery. Anaesthesia was maintained with an infusion of thiopentone, nitrous oxide and fentanyl. In patients administered atracurium, the plasma laudanosine concentration at cessation of surgery was 0.34 (SD 0.22) micrograms ml-1; there was little tendency to cumulate during operation. A 20% higher arterial concentration of thiopentone was found at awakening in patients given atracurium, suggesting CNS stimulation by laudanosine, although the effect is too modest to be of clinical significance. PMID- 2765347 TI - Comparison of i.v. sedation with midazolam and inhalation sedation with isoflurane in dental outpatients. AB - I.v. midazolam was compared with inhalation sedation using isoflurane in 80 dental outpatients. Preoperative anxiety was comparable in both groups and decreased after operation to similar values. The dental surgeon and the patients rated the techniques as equally satisfactory. Midazolam produced faster induction of sedation (P less than 0.001) and more amnesia for the injection of local analgesic (P less than 0.001), whereas isoflurane produced more euphoria (P less than 0.01) and quicker recovery (P less than 0.001). The incidence of postoperative side effects was similar in the two groups. PMID- 2765348 TI - Prevention of tourniquet pain by spinal isobaric bupivacaine with clonidine. AB - In order to assess the effect of spinal clonidine on tourniquet pain, 30 patients scheduled to undergo orthopaedic surgery under spinal anaesthesia were allocated randomly to two groups. Patients in group I (n = 15) received 0.5% isobaric bupivacaine 15 mg plus isotonic saline 1 ml. Patients in group II (n = 15) received 0.5% bupivacaine 15 mg plus clonidine 1 ml (150 micrograms). Sensory block was evaluated by pinprick and motor block with Bromage's scale. The presence of clonidine significantly prolonged the duration of sensory and motor block. Three patients in group I, but none in group II, experienced tourniquet pain. Hypotension and bradycardia were not worsened by spinal clonidine. The use of clonidine may be a useful technique to augment bupivacaine spinal block. PMID- 2765349 TI - Postoperative pain--prevention or relief? PMID- 2765350 TI - Proceedings of the Anaesthetic Research Society. Warwick, April 7-8, 1989. Abstracts. PMID- 2765351 TI - Non-fatal paradoxical air embolism. PMID- 2765352 TI - Sedation for endoscopy. PMID- 2765353 TI - Ventilation requirements during caesarean section. PMID- 2765354 TI - Acellular vascular matrix: a natural endothelial cell substrate. AB - A preliminary assessment was made of the acellular vascular matrix graft as a substrate for endothelial cell seeding, with respect to surface pretreatment (none versus fibronectin and/or serum) and presence of exogenous growth factor. Arteries were harvested from greyhounds and exposed to a sequential detergent extraction process to produce the acellular vascular matrix. Human umbilical vein endothelial cells were grown in tissue culture, harvested in first passage, then seeded at 10(5) cells/cm2 on sections of acellular vascular matrix and on gel coated polystyrene positive controls. After 18 hour incubation, endothelial cell seeded acellular matrices were fixed and processed for histologic and planimetric analysis; control wells were fixed and endothelial cells were counted by planimetry. Pretreatment of the acellular vascular matrix was found to have no effect on the percentage of endothelial cell coverage of the matrix. There was significantly better endothelial cell coverage of the acellular matrix than on matched gel-treated polystyrene control wells. Withdrawal of growth factor resulted in a significant reduction in endothelial cell coverage for all acellular vascular matrix groups. Growth factor withdrawal also significantly reduced attachment of endothelial cells on gel-treated polystyrene. Cell surface area was significantly smaller when growth factor was withdrawn from all groups except from the acellular vascular matrix without pretreatment. We conclude that: (1) the acellular vascular matrix is conductive to endothelial cell adherence and spreading even without pretreatment; and (2) sudden withdrawal of exogenous growth factor may impair early coverage of substrates by endothelial cells due to an effect on their adherence or spreading. PMID- 2765355 TI - Cell seeding for small diameter ePTFE vascular grafts: a comparison between adult human endothelial and mesothelial cells. AB - A series of experiments was performed to compare the ability of adult human endothelial and mesothelial cells to attach and spread upon ePTFE graft material. Both cell types were harvested enzymatically and grown in culture. Two types of adhesion assay were used to assess the ability of the cultured cells to attach to ePTFE either uncoated or precoated with a variety of substrate proteins. The results showed that fibronectin, laminin, type 4 collagen and preclotted blood all greatly improve the attachment rate of endothelium to ePTFE. The extracellular matrix proteins, however, give patchy cell attachment, whereas cells seeded onto preclotted ePTFE form a virtually confluent monolayer after one hour's incubation. The matrix proteins similarly improve mesothelial attachment, although in all cases attached cells remain largely rounded up, with relatively few spreading on the surface. Mesothelial attachment to preclotted ePTFE is no better than attachment to the untreated material. It would seem that a preclotted graft seeded with endothelial cells is the combination most likely to result in a confluent monolayer within one hour. PMID- 2765356 TI - Human microvessel endothelial cell isolation and vascular graft sodding in the operating room. AB - We have evaluated multiple factors inherent to an operating room-compatible endothelial cell procurement and sodding procedure. Microvessel endothelial cell isolations have been performed on fat tissue obtained from over 140 patients with a 100% success rate. Liposuction-derived fat was optimal with respect to cell yield, and isolation time. The devices and equipment used were acceptable to the operating room and the complete cell procurement procedure was successful even in the hands of personnel with minimal training. Fat digestion was achieved using crude clostridial collagenase, with an average cell yield of 1 x 10(6) microvessel endothelial cells/gm of fat. Evaluation of this procedure with canine fat using an operating room acceptable procedure resulted in a 100% procurement success rate requiring 1.5 hours (+/- .5 hrs) for completion of the fat isolation, and cell isolation procedure. Microvessel EC could subsequently be used in graft seeding or sodding techniques to establish endothelial cell monolayers on vascular grafts. Our results indicate that one person with minimal cell isolation background can reproducibly isolate large quantities of sterile autologous endothelial cells in the operating room for immediate use in endothelial cell seeding/sodding procedures. PMID- 2765357 TI - Endothelial cell interactions with native surfaces. AB - Since native vessels are presumably the ideal surface for endothelial cells, we have examined endothelial cell interactions with natural surfaces as a standard to determine the possibilities obtainable on a surface. We have examined three separate types of natural surfaces including human amnion, superficially-injured human arteries, and tanned bovine carotid arteries. When basement membrane collagen is a principal component of a surface, such as with amnion or a superficially denuded large vessel, very rapid cell attachment and spreading occurs. Intact confluent monolayers covering 100% of the amnion surface are present as early as one hour. Human arteries superficially injured to denude their endothelium also exhibit excellent affinity for EC adherence and spreading. Endothelial monolayers cover 80.8% (+/- 5.3) of this surface after one hour, with 91.4% (+/- 1.2) coverage after two hours. For tanned bovine carotid arteries, one and two hour endothelial cell incubation results in coverage of 59.2% (+/- 1.3) and 75.9% (+/- 4.1), respectively. This surface is composed of interstitial collagen of the arterial wall in medial and adventitial layers. Electron microscopy reveals excellent endothelial cell spreading with little or no exposed underlying basement membrane. This suggests that polymeric surfaces designed to mimic injured native surface could allow an endothelialized surface to develop within minutes to hours. PMID- 2765358 TI - A comparison between fibronectin and Matrigel pretreated ePTFE vascular grafts. AB - Two distinct series of experiments were performed to compare the behavior of ePTFE vascular grafts coated with basement membrane gel to that of identical grafts coated with fibronectin. Bilateral carotid interposition grafts (10 cm long) were interposed in 16 conditioned mongrel dogs. In the first series of experiments (n = 10), each graft was seeded with radiolabeled endothelial cells and initial endothelial cell adherence was determined. Following restoration of blood flow in the grafts, endothelial cell retention was measured for 24 hours. Seeding efficiency was 66.48% (+/- 13.2) for fibronectin-coated grafts and 56.58% (+/- 13.51) for gel-coated grafts. There was a slow, constant loss of activity during the first 90 minutes of imaging, and at 24 hours of observation the activity remaining on the fibronectin-coated graft was 13.2 +/- 3.98% of the initial graft activity. Although the basement membrane gel had a higher mean activity at 24 hours (18.9 +/- 7.22%), the difference was not statistically significant at any interval. In the second series of animals (n = 6), radiolabeled platelets were injected within 60 minutes following restoration of flow. Total platelet activity on the explanted grafts was 3.36 (+/- 1.35) x 10(5) counts per gram/0.2 minute for the fibronectin-coated grafts. The gel-coated grafts had 2.74 (+/- 1.33) x 10(5) counts per gram/0.2 minute, a difference that was not statistically significant. Thus, despite its theoretical appeal, basement membrane gel was no better than fibronectin in increasing endothelial cell adherence and retention, and the resulting flow surface of grafts treated with either compound appeared to attract platelets to an equal degree. PMID- 2765359 TI - Below-knee femoropopliteal bypass using externally supported polytetrafluoroethylene (PTFE) grafts. AB - Twenty-seven externally supported polytetrafluoroethylene (PTFE) grafts were implanted in the femoropopliteal position crossing the knee joint. All patients underwent surgery because of limb threatening ischemia (rest pain or gangrene). There was one early graft failure (successful thrombectomy). No patient died postoperatively. The mean follow-up period was 17.32 months (range 3-44 months). Cumulative patency rate for this follow-up period was 73%. Absence of kinking when bending the knee joint was determined by ankle Doppler pressure measurements and arteriography. If an adequate saphenous vein is not available for knee crossing femoropopliteal bypass, externally supported PTFE can be used, yielding short-term patency rates comparable to those obtained with autologous venous bypasses. PMID- 2765360 TI - The histology of seeded PTFE grafts in humans. AB - To define the histology of PTFE femoral-popliteal grafts seeded with enzymatically-derived endothelium, we examined light level and selected scanning electron micrographs of 20 graft biopsies. Thirteen grafts were chronically occluded and the midgraft samples had a thin lining of fibrin with scattered erythrocytes and leukocytes. One anastomotic sample showed a similar pattern, while three others had neointimal fibrous hyperplasia. Six of the seven remaining midgraft samples demonstrated confluent endothelial healing over parts of the flow surface. The cells were commonly distributed along one side of the graft as viewed in cross-section. Distribution patterns were not improved by changing from a single inoculum with two graft rotation-incubation periods to a sequential inoculation separated by a graft rotation. Circumferential distribution was achieved in one instance in which inoculation was characterized by a relatively high cell density. No luminal endothelium was seen when inoculation cell densities were very low. Smooth muscle cells and fibroblasts were not seen in the subendothelial "inner capsules" of the midgrafts. We conclude that endothelialization occurs in a high proportion of seeded PTFE grafts in humans, that the donor vein surface area should measure at least 5.25% of the inoculated graft surface, that further modifications in the seeding technique will be required to achieve consistent circumferential endothelial distribution, that subendothelial smooth muscle cell invasion is uncommon in the midgraft, but that anastomotic neointimal fibrous hyperplasia probably contributed to some graft failures. PMID- 2765361 TI - In vivo magnetic resonance imaging of the effects of photodynamic therapy. AB - Nuclear magnetic resonance (NMR) proton imaging and measurements of the parameters T1 and T2, have been carried out in vivo on the murine mammary tumour T50/80. Tumours had been treated 24 h previously by photodynamic therapy (PDT, using haematoporphyrin derivative and 630 nm laser light). Proton images clearly demarcated a high signal-intensity region on the side of the tumour closest to the incident light beam, while the parts of the tumour more remote from the beam resembled the images from untreated controls. Both T1 and T2 values were raised in the high-intensity region. This high-intensity region was shown to correspond to PDT-induced histological necrosis, the low-intensity region to histologically intact tumour. Linear regression analysis of the relationship of depth of necrosis measured histologically and 'depth of necrosis' measured from the NMR images, yielded a slope of 0.93 (r2 = 0.95). PMID- 2765363 TI - Intracellular localisation of a subunit of human DNA polymerase alpha affecting primase activity recognised by monoclonal antibody (HDR-854-E4) and its application to distinction between proliferative and non-proliferative lesions. AB - We have successfully established one murine hybridoma that secretes a monoclonal antibody specific for the 77,000 subunit of human DNA polymerase alpha. The results of immunochemical studies, using HDR-854-E4 monoclonal antibody (MAb) and immunoperoxidase detection methods, demonstrate intranuclear and intracytoplasmic localisation of the subunit in all the human culture cell lines tested. The immunoperoxidase reaction product exhibits a diffuse pattern of distribution within the cytoplasm and nucleoplasm, but nucleoli are clearly negative. In cultured cell lines, HeLa and KATO III, more than 95% of the cells are positive, suggesting that the subunit antigens persist throughout the mitotic cycle. No subunit antigen was recognised in resting mononuclear cells (MNC). Immuno electron microscopic examination of HeLa cells confirms and extends these observations. We have further examined the expression level of the subunit antigen in various normal and cancerous tissues. Strong reaction was observed in proliferating normal and cancer cells such as cancer cells from the gastrointestinal (GI) tract, thyroid, malignant lymphoma, breast, cells in the germinal centres of lymph nodes, epithelial cells in the GI tract and nephrogenic zones in fetal kidney. Finally, we utilised this antibody as a diagnostic tool in biopsies of the thyroid and GI tract. Thyroid cancer was stained positively with this antibody, while follicular adenoma was not. Gastric cancer was stained strongly and adenomatous polyp and hyperplastic polyp were stained moderately. This antibody is not only specific and powerful for application of a novel approach to the complex biochemical mechanisms of mammalian DNA replication, but also useful for distinction between proliferative and non-proliferative lesions. PMID- 2765362 TI - Characterisation of a messenger RNA selectively expressed in human breast cancer. AB - A complementary DNA library from MCF-7 cells was screened using 32P-cDNA derived from a breast carcinoma and from normal breast tissue. From 10(5) plaques (20% of library) we obtained a clone (Md2) which was differentially expressed in the carcinoma. The distribution of its corresponding transcript of 6-700 nucleotides was examined in normal and neoplastic cells, by filter and in situ hybridisation. We observed localisation of 35S-Md2 to the tumour cells of breast cancers with no significant reaction over stromal or vascular elements or on normal ductal epithelia. M13 sequencing showed Md2 to be 250 nucleotides in length, of which 197 were homologous to the 3'-untranslated region and a short open reading frame of the pS2 gene (Masiakowski et al., 1982). Md2 mRNA was found principally in breast carcinoma cell lines and tumours, with low levels in benign breast disease and no expression in non-breast squamous cell lines. Approximately 43% (23/54) of carcinomas contained this mRNA (varying from + to + + + + level); it was present in 20/38 (53%) of ER positive carcinomas compared to 3/16 (19%) of ER negative carcinomas. In 21 patients who had undergone primary endocrine therapy for recurrent disease expression of Md2 in the primary tumour correlated with the subsequent response to treatment (P = 0.041) and was of similar predictive value as ER status. Both tests correctly predicted outcome in about 76% of cases. PMID- 2765364 TI - Conversion of xanthine dehydrogenase to xanthine oxidase as a possible marker for hypoxia in tumours and normal tissues. AB - The enzyme activities of endogenous xanthine dehydrogenase (XDH) and xanthine oxidase (XO) have been measured in 10 different types of mouse tumour and seven normal tissues. The conversion of XDH to XO has been observed in two tumour types upon the prolonged clamping off of the blood supply to the tumours. It is proposed that a similar conversion might also occur naturally in chronically hypoxic cells and that the ratio of the XO activity to the combined XO + XDH activities (%XO activity) could well serve as a marker for tissue hypoxia. A qualitative relationship exists between the %XO activity and literature values of the hypoxic fraction for some tumours measured by radiobiological assays. The influence of tumour size (about 0.2-1.8 g) on %XO activity is presented for all 10 tumours as well as %XO activity determinations for four of the normal tissues. PMID- 2765365 TI - Induction of malignant nasal cavity tumours in Wistar rats fed Chinese salted fish. AB - Epidemiological evidence has implicated Chinese salted fish as a human nasopharyngeal carcinogen. In the present study, 221 Wistar-Kyoto rats aged 21 days were randomly assigned to one of three experimental groups. Rats in group 1 (high dose group) were fed a powder diet of one part Chinese salted fish to three parts certified rat chow during the first 18 months. Similarly, rats in group 2 (low dose group) were fed a powder diet of one part salted fish to five parts rat chow for 18 months. Rats in group 3 were given rat chow only throughout the 3 year experiment. Four malignant tumours of the nasal cavity were observed among rats fed the experimental diets (three and one respectively in the high and low dose groups). No comparable tumours were observed in controls, compatible with the historical control rate of zero. Our results, therefore, further strengthen the hypothesis that Chinese salted fish is a human nasopharyngeal carcinogen; they also establish Wistar rats as a viable animal model for carcinogenicity studies of this food in the laboratory. PMID- 2765366 TI - Structural alterations of the RB1 gene in human soft tissue tumours. AB - Sixty-nine primary soft tissue tumours were examined for alterations of the RB1 gene which has previously been implicated in the genesis of retinoblastoma. In three tumours loss of both alleles of this gene (homozygous deletion) was detected. Two of these, both leiomyosarcomas, contained a chromosomal breakpoint within the RB1 gene, while in the third tumour, a radiation induced sarcoma, complete deletion was observed. Using a probe that detects a polymorphic locus within the RB1 gene we found loss of only one allele (heterozygous deletion) in 33% of soft tissue sarcomas examined, including two leiomyosarcomas, a malignant peripheral nerve sheath tumour, a rhabdomyosarcoma and a chondrosarcoma. When taken together our results suggest that alterations of the RB1 locus may play an important part in the pathogenesis of soft tissue tumours and particularly in leiomyosarcomas which accounted for four of the eight RB1 alterations observed in this study. PMID- 2765367 TI - Appraisal of the MTT assay as a rapid test of chemosensitivity in acute myeloid leukaemia. AB - We describe the application of a simple, rapid, semi-automated assay to the sensitivity testing of cytotoxic drugs in 23 patients with acute myeloid leukaemia (AML). The survival of blast cells from the bone marrow was measured by the MTT assay after 48 h continuous exposure to drugs both singly and in combination. There was a linear relationship between the number of leukaemic cells and the optical density of the formazan produced. The assay demonstrated a variation in drug sensitivity between patients. The technique was reproducible and there was no significant difference in response between blast cells obtained from bone marrow or from peripheral blood. Preliminary results show a correlation between in vitro and in vivo data. The test can be repeated throughout the course of the disease to help identify any change in tumour sensitivity. This technique appears to give useful information to assist in the management of acute myeloid leukaemia. PMID- 2765368 TI - Colony forming ability of human breast carcinomas: lack of prognostic significance. AB - To study whether colony growth in vitro reflects the prognosis of breast cancer patients, specimens from a total number of 138 patients with primary breast carcinomas were cultivated in the Courtenay-Mills soft agar method. The plating efficiency (PE) values were related to various clinical and histopathological parameters. No significant correlation was found between colony forming ability and menopausal status, histopathology, TNM-status or steroid hormone receptor status. The crude survival of the patients was not significantly correlated to the in vitro growth of the tumours; neither was there any difference in relapse free survival between patients whose tumours failed to grow in vitro and those having growing tumours (PE greater than 0). A multivariate survival analysis of 115 patients with primary tumours without distant metastases revealed that the PE was not a significant independent prognostic indicator, as it gave no additional prognostic information above that of node and ER status. It is concluded that routine measurement of colony formation in vitro is not warranted in the management of breast cancer. PMID- 2765369 TI - Chlorpromazine reduces UV-induced squamous cell carcinogenesis in hairless mice and enhances UV-induced DNA damage in cultured cells. AB - Administration of the photoactivable compound chlorpromazine (CPZ) to SKH-1 hairless mice via their drinking water (CPZ, 0.01%) significantly reduced the rates of accumulation and yields of squamous cell carcinomas induced by long-term repeated exposures of these animals to solar UV radiation. This protective effect of CPZ was partially reversed in mice given a single injection of ethyl nitrosourea at birth. In in vitro studies, the presence of CPZ (0.2 mM) in mammalian cell cultures enhanced the yield of DNA single-strand breaks induced in the cells by exposure to monochromatic UVA radiation at 334 nm. Collectively, the results suggest that CPZ may exert antineoplastic effects against UV-induced skin tumours by the induction of DNA damage. PMID- 2765370 TI - Changing patterns of relapse in Hodgkin's disease. AB - The patterns of early and late relapses (those occurring later than 3 years after diagnosis) in 432 patients achieving complete remission after treatment for stage I and II Hodgkin's disease at the Royal Marsden Hospital between 1964 and 1983 were studied to identify factors predicting for late relapse. The incidence of early relapse has fallen progressively in recent treatment eras as staging procedures and management have improved but in contrast there has been no decrease in the risk of late relapse. The incidence of late relapse was greater in patients treated with radiotherapy rather than combined modality therapy (P less than 0.05). However, patients who were clinically staged and treated with combined modality therapy retained as high a risk of relapse between 3 and 6 years as in years 2 and 3. The risk of late relapse was also greater in patients with stage II disease and in those without B symptoms at presentation. Patients falling into the higher risk categories for late relapse require continued close follow-up beyond 3 years to monitor for possible relapse. PMID- 2765372 TI - Changes in mammographically normal contralateral breast in cases of breast carcinoma. PMID- 2765371 TI - Use of a modified N-nitrosoproline test to show intragastric nitrosation in patients at risk of gastric cancer. AB - Intragastric nitrosation has been implicated in the pathogenesis of gastric cancer and in precancerous conditions such as pernicious anaemia and the post gastrectomy state. Intragastric nitrosation was assessed in at-risk patients by N nitrosoproline (NPRO) excretion using both a conventional and a modified test. Twenty-four hour urinary excretion of NPRO was measured after oral administration of sodium nitrate (300 mg) and L-proline (500 mg) as an indirect indicator of intragastric nitrosation. In the conventional test no differences in intragastric nitrosation were found between at-risk patients and controls. In the modified test the loading dose of sodium nitrate was omitted and urinary NPRO levels were found to be significantly increased in Polya partial gastrectomy patients (P = 0.003) and post-vagotomy patients (P = 0.03) compared to controls. In pernicious anaemia patients NPRO levels were also higher than in controls but just failed to reach statistical significance. This study has confirmed that hypochlorhydria results in increased intragastric nitrosation, thus facilitating the formation of potentially carcinogenic N-nitroso compounds. PMID- 2765373 TI - Drug acetylation in breast cancer. AB - The acetylator phenotype was determined in 100 patients with breast cancer and 100 control female subjects using isoniazid. The proportion of fast acetylators in the breast cancer patients (43%) was not significantly different from the control group (43%). We conclude that acetylator phenotype is unlikely to be an important determinant of the risk of developing breast cancer. PMID- 2765374 TI - Combined surgery and chemotherapy for the treatment of primary gastrointestinal intermediate- or high-grade non-Hodgkin's lymphomas. AB - Fifty-five consecutive patients with primary gastrointestinal intermediate or high grade non-Hodgkin's lymphoma were analysed to assess the efficacy of chemotherapy following surgical tumour resection. Histological subtypes were high grade (n = 18), intermediate grade (n = 36) and unclassified (n = 1). The majority of patients had gastric presentation (71%) and localised disease (84%). Surgery consisted of radical resection in 25 patients (45%) and partial or palliative excision in the remaining cases (22 and 8 respectively). Four subjects died within 3 months of surgery, two patients refused adjuvant chemotherapy and 49 completed the postoperative chemotherapeutic programme. Chemotherapy included either Fi2/74 (adriamycin + vincristine + bleomycin + cyclophosphamide + prednisone) or Fi3/74 (adriamycin + VM26 + bleomycin + cyclophosphamide + prednisone). Excluding the group who underwent radical tumour resection, postoperative chemotherapy induced complete remission in 81% of the remaining 30 patients. The 10-year cause-specific survival for the 53 treated patients was 76% (median follow-up 58 months) with a stable curve plateau after 80 months. Proportional-hazard multivariate statistics showed that survival was influenced by type of surgical resection (P less than 0.05) and stage (P less than 0.05), whereas age, sex and histological subtype were not influential. Our data indicate that chemotherapy following surgical resection of gastrointestinal lesion induces long-term remission in primary gastrointestinal lymphomas. PMID- 2765375 TI - The role of carbohydrate antigen 19-9 as a tumour marker of oesophageal cancer. AB - Carcinoma of the oesophagus is endemic in certain well demarcated areas throughout the world, and a method of screening population groups at high risk for oesophageal cancer is urgently needed. In this study the sensitivity and specificity of the carbohydrate antigen CA19-9 as a marker of carcinoma of the oesophagus in African patients was examined. The normal range was established by assay of serum samples from healthy black blood donors, using a solid phase radioimmunoassay with mouse monoclonal antibody to CA19-9 labelled with 125I. Serum concentrations of CA19-9 were then measured in 100 African patients with oesophageal cancer and 28 patients with benign oesophageal disease. The upper limit of CA19-9 in the normal controls was 40 U ml-1. Thirty-four patients with oesophageal cancer and five with benign oesophageal disease had elevated levels. Therefore, in this series, the sensitivity of CA19-9 as a marker of oesophageal cancer was 34% and the specificity was 82%. While CA19-9 is not sufficiently sensitive to be used as a screening test of oesophageal cancer, it compares favourably with other known tumour markers of this disease, and may have a role in monitoring disease recurrence and response to treatment. PMID- 2765376 TI - Oestrogen receptor status of primary breast carcinomas and their metastases. Relation to pattern of spread and survival after recurrence. AB - Immunohistochemical antibody techniques for detection of oestrogen receptors (ER) were applied to formalin fixed, paraffin embedded sections from 62 primary breast cancers, the metastases of their original regional lymph nodes (29 cases), bone marrow carcinosis (43 cases) and liver metastases (20 cases). Forty per cent of the primary tumours and 31% of the regional lymph node metastases were ER positive; in contrast, less than 20% of liver and bone marrow metastases were ER positive. The ER status of regional lymph node metastases was concordant with that of the primary tumour in 90% of the cases. The concordance rate was 75% for liver metastases and 58% for bone metastases. Patients with ER positive primary tumours had recurrence significantly more often in bone; ER negative tumours recurred more often in the liver. The survival after recurrence (SAR) was significantly related to the ER status of the primary tumour and to that of the regional lymph node metastases. In contrast, the SAR was not associated with the ER status of bone marrow carcinosis or liver metastases. Cox analyses showed that age and ER status of the primary tumour were the most important independent prognostic factors compared to other clinical, therapeutic, pathoanatomical and biochemical features. The study supports the hypothesis that tumour cell clones with different ER content are selected and adapted to grow in various anatomical sites. Moreover, the ER status of the primary tumour seems to be more important for the prognosis than the ER status of bone and liver metastases. PMID- 2765377 TI - Bone mineral content of women receiving tamoxifen for mastalgia. AB - Dual photon absorptiometry (DPA) has been used to measure the effect of short and medium-term administration of tamoxifen on bone density in the axial skeleton of women with mastalgia. This provided a unique opportunity to monitor the effect of this 'anti-oestrogenic' agent in predominantly premenopausal women, not suffering from malignancy. In addition, plasma levels of calcium, phosphate, alkaline phosphatase and serum levels of oesteocalcin (GLA) have been assayed, both before and after 3 months of starting either tamoxifen or placebo treatment. No significant alterations in bone density were seen. Osteocalcin, alkaline phosphatase and electrolytes were unchanged and there was no dose response observed in women receiving either 10 mg or 20 mg of tamoxifen. Although possessing anti-oestrogenic properties, tamoxifen is also a partial agonist. Administration for the short periods does not measurably influence spinal or femoral bone density and thus the agent can probably be given safely for the short-term treatment of mastalgia. PMID- 2765378 TI - Operation manual for control of selection, production, preclinical toxicology and phase I trials of endocrine agents for patients with cancer. PMID- 2765379 TI - Children's learning skills: a cautionary note on ethnic differences. AB - In the summer term of their first year in junior schooling, pupils of seven schools in the West Midlands were tested for attainments in reading, spelling and number. Ninety-one children were from Asian families and 149 children were of indigenous parentage. About three years earlier all subjects had been rated on Part I of the Guide to the Child's Learning Skills, the predictive validity of which is supported by the attainment testing. The linear regression slopes of attainments on ratings do not differ significantly between the ethnic samples. PMID- 2765380 TI - Conference abstracts. Papers presented at the annual conference of the Education Section of the British Psychological Society. Harrogate, October 1988. PMID- 2765381 TI - Teacher expectations in infant school: associations with attainment and progress, curriculum coverage and classroom interaction. AB - There is still much debate, particularly in North America, about whether teachers' expectations have an effect on pupils' achievement, and through which factors expectations might be mediated. This paper reports on associations between teachers' academic expectations at the beginning, and children's attainments at the end of the school year. The study took place in infant schools in London. Associations were significant during all three years of infant school, and were not explained by children's attainments at the time of the expectation rating. Range of effects, in standard deviation units, of associations between expectations and progress over the school year ranged from 0.4 to 0.8. Two possible mediating factors between expectations and attainment were explored: differential curriculum coverage and differential classroom behaviour. It was found that children for whom teachers had higher expectations were given a wider range of activities in written language and mathematics, and this was so over and above attainments at the beginning of the school year. In contrast, there was no evidence that expectations were related to measures of classroom interaction like teacher praise and instructional contact. PMID- 2765382 TI - Teachers' and boys' and girls' perceptions of competence in the primary school: the importance of physical competence. AB - Research into the role of teachers in maintaining self-concepts which reflect gender stereotypes has been hampered by the lack of parallel multidimensional instruments. The development of the Teachers' Rating Scale of the Child's Competence (TRSCC) and the Perceived Competence Scale for Children (PCSC) (Harter, 1982) answers this problem. Thirty-six boys and 38 girls of mean ages 10 years 8 months (SD = 3.6 months) and 10 years 9 months (SD = 3.3 months) respectively completed the PCSC while their teachers (N = 12) completed the TRSCC. It was found that: (1) teachers' mean ratings of boys' competence did not significantly differ from their ratings of girls' competence; (2) teachers' ratings demonstrated significant differences between boys and girls in the pattern of interrelationships of the domains of competence; (3) teachers' perceptions and pupils' self-perceptions in the patterns of interrelationships amongst the domains of competence showed similar patterns for teachers and boys, and almost similar patterns for teachers and girls; (4) teachers were more important for girls' self-perceived competence than for boys' self-perceived competence; (5) both teachers and pupils use perceived physical competence as a construct associated with significantly differentiating between boys and girls in other domains of competence. These findings have pedagogical implications for the treatment of girls. PMID- 2765383 TI - School leavers' changing identifications with different social categories and their "internalisation" of the category "school leaver". AB - A modified Social Identity Inventory is shown to be a powerful tool for exploring the "internalisation" of social categories by school leavers. It revealed two basic forms of their representation of the category "school leaver". The first is a relatively stable representation that is negative and significantly underpinned by the attribution of bad qualities. However, this is not generally seen as relevant to self. In contrast, there is a second representation which is both relatively labile and self-relevant. It, like the first representation, includes worries about boredom and the future, but it involves the attribution of favourable qualities rather than unfavourable qualities. The reliability and sensitivity of different SII scores is also examined. PMID- 2765384 TI - Similar-sequence and similar-structure in retarded and non-retarded children's development. AB - Three questions important in relation to the developmental-difference controversy were addressed. The first, to what extent do retarded and non-retarded children show a similar sequence in their development of concepts, was answered using scalogram analyses which supported a common order of acquisition of conservation concepts when intermediate as well as conservation and non-conservation categories were used. There was a high degree of similarity in sequence within as well as between attributes. The second question, how far does the similar structure hypothesis hold, was answered in the terms set by the developmental theorists. Multiple regression analyses and comparisons of mean mental ages for each of the conservation subgroups supported the similar-structure hypothesis. Non-retarded and retarded children with no known organic condition revealed similar structures. The third question concerned findings of volume conservation in retarded children and how these might be interpreted. It is argued that recognition of conservation in displacement volume tasks need not imply a generalised stage of formal operations nor be interpreted in terms of ceiling in development. Overall the findings have implications for ordering and providing appropriate levels of experiences for retarded children without assuming fixed limits in their development. PMID- 2765385 TI - Monitoring changing attitudes towards Christianity among secondary school pupils between 1974 and 1986. AB - The Francis scale of attitude towards Christianity Form ASC4B was administered to the whole pupil population in years one through five of two co-educational comprehensive schools in 1974. The study was replicated at four-yearly intervals in 1978, 1982 and 1986. The results confirm the finding that attitudes towards Christianity decline throughout the years of compulsory secondary schooling and also establish that there has been a significant and progressive decline in attitude scores throughout this age range during the 12-year period between 1974 and 1986. PMID- 2765387 TI - Rapid development of renal lesions in diabetic DBA mice infected with the D variant of encephalomyocarditis virus (EMC-D). AB - Marked hyperglycaemia and renal lesions developed rapidly in DBA mice infected with 10 plaque-forming units of the D-variant of encephalomyocarditis virus (EMC D). Renal alterations were demonstrated in the glomeruli, tubular epithelium and small vessels 2 months after infection. Glomerular changes were characterized by mesangial thickening due to an increase of basement membrane-like material in the mesangial matrix. Nodular glomerular lesions were commonly observed 3 months after infection, whereas distinct thickening of the glomerular basement membrane was rarely seen. Besides these glomerular changes, glycogen inclusions in the distal tubular epithelium and medial degeneration in the arterioles were also noticed. The EMC-D-infected DBA mouse appears to be a useful experimental model for the study of human diabetic nephropathy. PMID- 2765386 TI - Can growth of capillaries in the heart and skeletal muscle be explained by the presence of an angiogenic factor? AB - Capillary growth was induced in rabbit hearts by long-term bradycardial pacing, and in skeletal muscles by long-term electrical stimulation. In order to find out what factors may be responsible for it, samples of all tissues were analysed for angiogenic activity (AA). To estimate the possible role of mechanical factors, blood flow was measured at rest and during maximal dilatation. Rabbit hearts were paced at half the normal frequency for 24 h/day for 1-2 months by electrodes implanted in the right atrium. Gastrocnemius-plantaris muscles were stimulated at 10 Hz via implanted electrodes, 8 h/day for 14 days. Unpaced hearts and non stimulated muscles served as controls. Capillary density (estimated in frozen cross-sections stained for alkaline phosphatase) was higher in paced than in control hearts (2235 +/- 86, s.e.m. cap/mm2, 1815 +/- 83, P less than 0.005); capillary/fibre ratio was 2.84 +/- 0.21 in stimulated and 1.243 +/- 0.06 in control gastrocnemius (P less than 0.001). The presence of AA was assayed on chicken chorioallantoic membrane (CAM). All paced and 50% of control hearts showed positive CAM results. Control gastrocnemii gave positive results in 25%, plantaris in 30%: stimulated muscles showed 30% and 37.5% positive responses. Coronary blood flow at rest was significantly lower in chronically paced than control hearts (2.172 g/ml/min, 3.025 +/- 0.187, P less than 0.05) and not significantly different during maximal dilatation (9.217 +/- 1.722 and 11.166 +/- 1.158 respectively). Blood flow per heart beat was significantly higher during acute bradycardia as well as in bradycardially paced hearts at rest. Blood flow in stimulated muscles was significantly higher than in controls both at rest (26.2 +/- 3.36 ml/100 g/min as compared to 8.5 +/- 2.15, P less than 0.001) and during muscle contractions (56.1 +/- 4.5 and 20.7 +/- 2.6). It can thus be concluded that growth of capillaries in skeletal muscles may be due to mechanical factors connected with the increased blood flow while in the heart AA may act in concert with blood flow changes. PMID- 2765388 TI - The endolymphatic perfusion of lymph nodes with toxic materials. AB - Individual lymph nodes of sheep were perfused, via a cannula in one of their afferent lymphatics, with a variety of toxic materials. This procedure was designed to ablate the parenchyma of the nodes so that the macrophage-rich afferent lymph would pass unaltered into the efferent duct, which also had been cannulated. Although many materials caused transient inflammation and/or immunoblastic responses, few caused lasting alterations in the cellular composition of the efferent lymph. Only melphalan, an alkylating agent, succeeded in damaging the internal structure of the nodes so that true afferent lymph appeared in the efferent duct and abundant dendritic macrophages could be collected. In the doses necessary to achieve this enough of the melphalan became systematized to produce a transient alopecia. PMID- 2765390 TI - Platelet accumulation and turnover on de-endothelialized aortae in rats. AB - Previous studies indicate that the subendothelium of rabbit aortae de endothelialized with a balloon catheter rapidly becomes covered with a monolayer of platelets; after 60 min few additional platelets accumulate and although most platelets are lost from the injured surface by 4 days, there is a substantial delay before re-endothelialization. We examined the dynamics of platelet accumulation on rat aortae de-endothelialized with a balloon catheter to determine if the response to this type of injury is similar to rabbit aortae. When 51Cr-platelets were injected prior to aortic de-endothelialization, 25,500 +/- 2,750 platelets/mm2 accumulated on rat subendothelium in the first 15 min. After 60 and 92 h, fewer platelets remained on the surface (13,740 +/- 2,400 and 5,020 +/- 1,330 platelets/mm2, respectively). When 51Cr-platelets were injected into rats 30 min after injury, platelet accumulation in a 30-min period was 8,610 +/- 1,230 platelets/mm2. By 4 days rat aortae did not accumulate newly injected platelets significantly in a 30-min period, but in a 24-h period 20,600 +/- 3,490 platelets/mm2 accumulated. Morphologically, the non-endothelialized areas of rat aortae were almost completely covered with platelets 4 days after injury. Fourteen days after injury, rat aortae did not accumulate newly injected platelets and, morphologically, no platelets were present on the surface which was almost re-endothelialized. Thus, in rats, as with rabbits, platelets rapidly accumulate on de-endothelialized aortae and the ability to attract newly introduced platelets is considerably reduced shortly after injury. In contrast to rabbits, however, de-endothelialized aortae in rats remain attractive to new platelets up to 4 days following injury, but less so than at the time of injury. Also, in contrast to rabbits, 14 days after injury to rat aortae the surface is almost completely re-endothelialized. Thus, there are species differences in platelet interactions with de-endothelialized vessels. PMID- 2765389 TI - Serum amyloid A gene expression and AA amyloid formation in A/J and SJL/J mice. AB - Serum amyloid A (SAA) gene expression and AA amyloid fibril formation were studied in A/J and SJL/J mice, two strains which have been reported to possess defects in AA fibril formation. Four types of inflammatory stimulation were employed: acute inflammation stimulated with lipopolysaccharide (LPS), chronic inflammation with casein in complete Freund's adjuvant, amyloidosis with injection of amyloid enhancing factor (AEF) together with casein in complete Freund's adjuvant, and non-amyloidogenic inflammation in the presence of AEF with injection of AEF together with LPS. Both A/J and SJL/J mice developed splenic amyloidosis 1 day after initiation of chronic inflammation in the presence of AEF. No amyloid deposits were detected during any of the other types of inflammation. Amyloidotic mice exhibited decreased amounts of SAA mRNA in liver and spleen concomitant with decreased amounts of SAA in serum. Alpha-I-acid glycoprotein mRNA was present in liver throughout the course of AEF accelerated amyloidosis, indicating that decreased SAA gene expression and AA fibril formation is not part of a general inhibitory effect of AEF on protein synthesis. PMID- 2765391 TI - Testicular dysfunction in experimental chronic renal insufficiency: a deficiency of nocturnal pineal N-acetyltransferase activity. AB - Biochemical correlates of neuroendocrine/gonadal function and nocturnal levels of serotonin N-acetyltransferase (NAT) activity were determined in partially nephrectomized (PNx), male, Long Evans rats following a 5-week period of chronic renal insufficiency (CRI). PNx animals demonstrated two to four-fold elevations in urea nitrogen and three to four-fold reductions (P less than 0.02) in plasma total testosterone concentrations as compared to sham-operated controls. The pituitary LH contents of PNx rats were decreased to approximately 60% of the control value (P less than 0.05). There were no differences in plasma prolactin levels between the control and PNx groups either at mid-day or in the middle of the night. Nocturnal pineal NAT activity in PNx rats was markedly reduced to approximately 20% of the control value (P less than 0.001). Similar evidence of gonadal dysfunction (reduced plasma total testosterone and testes testosterone content) and a significant decrease in night-time levels of pineal NAT activity were also observed after 13 weeks of CRI in PNx rats of the Sprague-Dawley strain that were housed under a different photoperiod. These results suggest that pineal gland dysfunction is a feature of CRI in the PNx model. Such an abnormality might contribute to the pathogenesis of gonadal dysfunction in CRI. PMID- 2765392 TI - Chlamydia trachomatis oculogenital infection in the subcutaneous autotransplant model of conjunctiva, salpinx and endometrium. AB - The subcutaneous pocket model of salpingeal, endometrial, and conjunctival autografts for studying Chlamydia trachomatis infection in monkeys is described. Portions of the salpinx that were transplanted included fimbria, ampulla, and isthmus. The model is an extension of the original model which consists of either salpingeal fimbria or conjunctive autografts. Transplantation of the ampulla portion of the Fallopian tube enabled us to increase the number of pockets or test sites. Salpingeal and conjunctival autografts could be established during a single surgery. In addition, it is possible to autotransplant endometrium and provoke endometritis. The autografts were shown to be susceptible to C. trachomatis infection. Preliminary rechallenge experiments showed infection of the subcutaneous transplants may induce immunity, indicating the model may be used for immunity and vaccine studies. Simultaneous transplantation of different parts of the oviduct, endometrium, and conjunctive should expand the usefulness of the subcutaneous model in other studies on mixed infections or immune responses to infection. PMID- 2765393 TI - Renal structure and function in streptozotocin-diabetic rats treated with cyclosporin A. AB - The effect of cyclosporin A (CsA), administered daily by gavage at 20 mg/kg body weight, on renal structure and function was investigated in normal and streptozotocin-diabetic male adult Sprague-Dawley rats over 12 weeks. In the non diabetic animals CsA caused a progressive decrease in glomerular filtration rate and increased enzymuria. In contrast, the diabetic state was associated with massive increases in both enzymuria and urine flow rates, but a trend towards increased urea and creatinine clearance rates. CsA treatment of diabetic animals did not significantly alter the above parameters, nor affect circulating glucose levels, and trough serum CsA concentrations were similar in both diabetic and non diabetic animals. The kidneys from CsA-treated non-diabetic animals showed chronic tubular damage. In the streptozotocin groups, the only morphological abnormality which could be related to diabetes was excess glycogen deposition in distal renal tubules. CsA-treatment of these groups was not associated with structural enhancement of either the drug's nephrotoxicity or the diabetes related changes. Indeed the results indicate that the diabetic state affords some protection against the functional aspects of CsA-nephrotoxicity. PMID- 2765394 TI - Simian adenovirus type 7 (SA-7) induces tumours of nerve-supporting or paraneural cell origin in newborn hamsters. AB - Simian adenovirus type 7 (SA-7) was found to induce tumours originating from nerve-supporting or paraneural cells in newborn hamsters, regardless of injection site or tissues. SA-7 induces glioblastomas characterized by definite localization (subependymal regions) and its main cell type, bipolar spongioblast like cells, in the brain of hamsters inoculated as newborns. When the eyes of newborn hamsters were directly inoculated, SA-7 failed to induce retinoblastoma (0/27), but retro or peri-bulbar SA-7 tumours frequently occurred in tissues closely related to the peripheral nerve apparatus, including the oculomotor nerve or ciliary ganglion. These tumour cells were situated like stromal cells in these nerve tissues. The histological features of the orbital tumours were similar to those of SA-7-induced subcutaneous tumours but not to brain tumours. In contrast with other hamster brain tumours induced by human adenovirus type 12 or human papova JC virus, medulloepithelioma or medulloblastoma, SA-7 induced tumours exhibit distinctive histological and localization characteristics. PMID- 2765395 TI - Studies on carrageenin air pouch inflammation in the rat. AB - Inflammation was induced in the 6-day subcutaneous air pouch of the rat by injection of carrageenin. The model was characterized in terms of exudate volume, leucocyte accumulation, granuloma, vascular permeability and protein clearance up to 7 days after injection of carrageenin. From days 2-3 rapid and reproducible changes in these responses were observed which indicated a change from polymorphonuclear (PMN) leucocyte-dominated to mononuclear (MN) leucocyte dominated inflammation. A second injection of carrageenin on day 3 gave increases in exudate formation and PMN accumulation on day 4. Administration of carrageenin mixed with 3 day inflammatory exudate gave an increased exudate volume and decreased leucocyte accumulation at 6 h. Reduction of 6-h cellular accumulation by use of a lower dose of carrageenin or a I-day air pouch gave complete inhibition of exudate formation on day 3. In contrast, inhibition of the 6-h cell response with prednisolone had no effect on the 3-day response. Daily treatment with indomethacin gave increased PMN accumulation on day 3. Similar treatment with prednisolone additionally reduced exudate volume. Treatment on day 2 with prednisolone gave similar effects whereas indomethacin, BW755C and protease inhibitors had no effect. Administration of colchicine at this time gave inhibition of exudate volume on day 3 whereas complement depletion gave increases in volume and PMNs. PMID- 2765396 TI - The production of arthritis in the guinea-pig by intra-articular reaction between lymphokines and inflammatory leucocytes. AB - A single intra-articular injection of lymphokine into the guinea-pig knee joint resulted in a sequence of changes in joint architecture whose histopathological features resembled that of an acute inflammatory reaction progressing to a chronic state. At 24 h there was a mild hyperplasia and hypertrophy of the synovium with intense polymorphonuclear leucocyte infiltration. At 72 h, the synovium was heavily infiltrated with diffuse and focal aggregations of mononuclear cells; erosion of cartilage and bone by synovial pannus was accompanied by a subsynovial fibrosis. By 1 week, leucocytic infiltration of the synovium had decreased markedly although the erosion and fibrosis persisted. However, when lymphokine was injected together with oil-elicited peritoneal exudate cells a more intense arthritis ensued: at 72 h synovial pannus was prominently eroding bone and this was accompanied by the appearance of multinucleate cells resembling osteoclasts in the zone of erosion. These features were shown to resemble closely the histopathology of experimental allergic arthritis in the guinea-pig, in contrast to the lesser severity of synovitis resulting from the adoptive cellular transfer of delayed hypersensitivity into the joint. The results indicate that lymphokines may play a role in the induction of experimental allergic arthritis by recruiting and activating cells involved in chronic inflammation. PMID- 2765397 TI - Muscle fibre necrosis induced by intramuscular injection of drugs. AB - A number of amphiphilic and lipid-soluble drugs of heterogeneous pharmacological properties, when injected into rat anterior tibial muscles, induced acute muscle fibre necrosis. The myotoxic agents were: penicillin, cloxacillin, phenobarbital, haloperidol, diazepam, hydantoin, metoclopramide, pentazocine and chlorpromazine. The regenerative process, studied using the latter three medications, showed rapid regeneration, complete within 3 weeks. Injection of the water-soluble drugs aminophylline, tranexamic acid and vitamins B6 and B12 produced no tissue damage. The pathogenesis of muscle fibre necrosis is suggested to involve direct damage to cell membranes by lipid soluble drugs. PMID- 2765398 TI - Increased chemiluminescence of polymorphonuclear leucocytes in dogs with volume overload heart failure. AB - Polymorphonuclear leucocyte (PMN) stimulation is known to generate oxygen free radicals. Exogenous oxygen free radicals, generated by xanthine and xanthine oxidase, have been implicated in the decrease of cardiac contractility. It is possible that PMN have increased capacity to release oxygen free radicals in failing heart. It was, therefore, decided to investigate PMN chemiluminescence (oxygen free radicals) from blood in dogs with heart failure due to chronic volume overload. The dogs were divided into two groups: (A) normal, six dogs; (B) dogs with mitral insufficiency (MI) of 6-9 months' duration, six dogs. Haemodynamic parameters were recorded to assess cardiac failure. Mixed venous blood was collected to measure PMN chemiluminescence. Stimulation of PMN was initiated by addition of opsonized zymosan and chemiluminescence was monitored using a luminometer. The haemodynamic parameters in dogs with MI showed that these dogs had left ventricular failure. The peak chemiluminescent activity of PMN in blood of dogs with left ventricular failure was approximately four times that in the blood from normal dogs. This increase in chemiluminescence reflects an increase in the generation of oxygen free radicals from PMN in dogs with chronic heart failure. The decrease in the myocardial contractility in cardiac failure might be due to an increase in the oxygen free radicals produced by the PMN. PMID- 2765399 TI - Association of fibrinogen with human platelets pretreated with chymotrypsin or aggregated with ADP or thrombin: an immunocytochemical study. AB - Although platelets can be induced to aggregate in the absence of external fibrinogen, the response is greatly potentiated by fibrinogen and fibrinogen becomes associated with the surface of stimulated platelets. We compared the aggregation response and association of fibrinogen with the surface of platelets aggregated by ADP or thrombin, and of chymotrypsin-treated platelets aggregated by fibrinogen. The association of fibrinogen with the surface of the platelets was visualized using an electron microscope immunocytochemical method. The aggregation response and the pattern of fibrinogen association was different with each of the three agonists studied. ADP-induced aggregation was associated with pseudopod formation and fibrinogen binding; granule contents were not released and aggregation and fibrinogen binding were reversible. Thrombin-induced aggregation was associated with extensive pseudopod formation and the release of granule contents, but platelet-to-platelet adherence did not appear to involve fibrinogen binding at sites remote from regions of granule discharge; disaggregation did not occur, and visible fibrin did not form rapidly in the absence of added fibrinogen. Fibrinogen-induced aggregation/agglutination of chymotrypsin-treated platelets was similar to ADP-induced aggregation in that fibrinogen binding was required and granule contents were not released; it differed from ADP-induced aggregation in that pseudopod formation did not occur and the aggregates were irreversible. Fibrinogen-induced aggregation of chymotrypsin-treated platelets differed from thrombin-induced aggregation of untreated platelets in every respect except irreversibility. Thus neither pseudopod formation, fibrinogen binding nor the release of granule contents is essential for platelet-to-platelet adherence, although one or other or all may occur in association with it. If platelets are not stimulated to release their granule contents, fibrinogen binding appears to be necessary for extensive platelet aggregation. PMID- 2765400 TI - Identification of a tissue kallikrein in human polymorphonuclear leucocytes. AB - We have identified a tissue kallikrein in polymorphonuclear (PMN) leucocytes of normal human blood and bone marrow by immunocytochemistry, radioimmunoassay and enzymology. Immunoreactive tissue kallikrein was visualized in the mature neutrophil leucocytes and in immature forms such as metamyelocytes and myelocytes. No tissue kallikrein was detected in eosinophil leucocytes, lymphocytes, macrophages, megakaryocytes and platelets. So far, we have failed to observe immunoreactivity to tissue kallikrein in basophils. The presence of tissue kallikrein in extracts prepared from PMN leucocytes isolated from peripheral blood was demonstrated by immunodiffusion, dot-blotting and by radioimmunoassay. The kininogenase and amidase activity of the extracts resembled that of tissue kallikrein in being resistant to soya bean trypsin inhibitor and sensitive to trasylol. The amidase activity attributable to tissue kallikrein was completely inhibited by specific antisera. PMID- 2765401 TI - Platelet-dependent induction and amplification of polymorphonuclear leucocyte lysosomal enzyme release. AB - Degranulation of human polymorphonuclear leucocytes induced by opsonized zymosan (OpZ) was studied in the presence or absence of platelets, either resting or stimulated by thrombin. Lysozyme secretion from polymorphonuclear leucocytes stimulated with OpZ increased in the presence of platelets. A further increase was observed when platelets had been stimulated with thrombin. The effect was dependent on platelet concentration (10-80 platelets/polymorphonuclear leucocytes). Resting polymorphonuclear leucocytes could be activated by platelets that had been stimulated with thrombin with an optimal effect observed at 0.1 U/ml of thrombin. Substitution of platelets with platelet-released products only resulted in significant stimulation of polymorphonuclear leucocytes at concentrations above those used in the coincubations experiments. Zymosan coated with various opsonins showed a gradient in the relative intensity of polymorphonuclear leucocytes degranulation. Platelet-dependent enhancement of polymorphonuclear leucocytes degranulation was higher with opsonins that were poorer at inducing lysosomal secretion. The role of platelets as helper cells in the activation of polymorphonuclear leucocytes appears to be dominant when polymorphonuclear leucocytes are challenged in suboptimal conditions. Positive interactions between platelets and polymorphonuclear leucocytes may be relevant in vivo at the site of inflammation where platelets could enhance effector functions of polymorphonuclear leucocytes. PMID- 2765402 TI - Chromosomes and other prognostic factors in acute lymphoblastic leukaemia: a long term follow-up. AB - Cytogenetic, clinical and laboratory features at diagnosis were examined in a group of 80 children with acute lymphoblastic leukaemia (ALL) who had been followed up for a minimum of 5 1/2 years. The 17 (21%) with high hyperdiploidy tended to have low leucocyte counts and common ALL, but their favourable outcome (75% event-free survival) was independent of these factors. No patient with hypodiploidy survives while the pseudodiploid and normal groups have an intermediate prognosis. Cytogenetic analysis showed examples of patients with the well-recognized translocations and a number with apparently unique ones. Among the latter were some long-term survivors. We conclude that cytogenetic analysis identifies a good risk group of patients who remain well on long-term follow-up, but that the presence of a translocation does not necessarily imply a poor outcome. PMID- 2765403 TI - Recombinant human interferon (IFN) alpha-2b in chronic myelogenous leukaemia: dose dependency of response and frequency of neutralizing anti-interferon antibodies. AB - Twenty-seven patients with Philadelphia chromosome positive chronic myelogenous leukaemia in the chronic phase were treated with low doses of recombinant interferon (IFN) alpha-2b. Ten patients entered a complete and six a partial haematologic remission with a median duration of 5.8 and 9.1 months respectively. Five minor cytogenetic responses were observed. These results are inferior compared to other studies with higher interferon-doses. Fever was an acute side effect after injection of IFN, limb pains and fatigue occurred protractedly. Haematologic side effects, nonspecific EEG changes, weight loss, and development of pulmonary infiltrates were observed in later periods of the treatment. Eight patients developed neutralizing anti-IFN antibodies after 4.2-20.4 months (median 12.8 months). Anti-IFN antibodies were associated with relapse or refractoriness to IFN treatment: five out of nine patients with rising WBC after initial fall had antibodies, while four did not. Two out of four patients with primary non response had IFN-antibodies. These results may indicate a serious problem in the long-term treatment of CML with recombinant interferon. PMID- 2765404 TI - Effects of verapamil on the cellular accumulation of daunorubicin in blast cells and on the chemosensitivity of leukaemic blast progenitors in acute myelogenous leukaemia. AB - Verapamil, a calcium channel blocker, was studied for its effects on the cellular daunorubicin (DNR) accumulation in blast cells and on the sensitivity of the blast progenitors to DNR in 30 acute myelogenous leukaemia (AML) patients. Using flow cytometry, verapamil was shown to increase the accumulation of DNR in blast cells. The effect was more prominent in the patients who showed poorer response to chemotherapy including DNR. The per cent increases of DNR content by verapamil were 6.4 +/- 6.3% and 19.5 +/- 23.1% in the 16 responders and the 14 nonresponders, respectively (P less than 0.05). The data suggest the presence of enhanced efflux of DNR in nonresponders. Marked variation in the effects of verapamil among nonresponders suggests the heterogeneity of the mechanisms of drug resistance involved. Verapamil also enhanced the sensitivity of blast progenitors to DNR. The degree of increase of cellular DNR accumulation by verapamil correlated with the degree of increase in chemosensitivity of blast progenitors (nonresponders, P less than 0.005; responders, P less than 0.05). We conclude that enhanced efflux of DNR in blast progenitors may be related to remission induction failure in at least some of resistant AML patients. PMID- 2765405 TI - Heterogeneous mechanisms of autocrine growth of AML blasts. AB - The ability of blast cells to grow autonomously and to produce autostimulatory growth factors has been investigated in 25 consecutive patients with AML. An autostimulatory index (ASI) was calculated (no. of colonies without CSF divided by no. of colonies with CSF) and patients classified into four groups: Group 1 (n = 3): non-growers; Group 2 (n = 4): CSF-dependent (ASI less than 0.1); Group 3 (n = 11): partially autonomous (ASI 0.1-0.8); and Group 4 (n = 7): fully autonomous/CSF-unresponsive (ASI greater than 0.8). In Group 3 patients colony formation and DNA synthesis were significantly (P less than 0.01) augmented by CSFs but at high cell concentrations became CSF-independent. Blast cell conditioned medium (BCCM) from these patients exhibited potent autostimulatory activity, increasing DNA synthesis by less than or equal to 5-fold, and also stimulated CSF-dependent homologous blasts by less than or equal to 20-fold. In 5/5 this activity was neutralized by anti-GM-CSF, which also inhibited autonomous proliferation of their blast cells. Group 4 blasts also secreted GM-CSF but their BCCM possessed no autostimulatory activity, and anti GM-CSF failed to inhibit their autonomous growth. No membrane-associated CSF activity was found, however purified cytosolic fractions stimulated proliferation of CSF-dependent homologous blasts, consistent with production and secretion of CSF which is present in active form in the cytosol but does not autostimulate via membrane receptors. These results suggest that autocrine mechanisms are important in regulating blast cell proliferation, but that the mechanisms are heterogeneous. PMID- 2765406 TI - Human immunodeficiency virus detection: correlation with clinical progression in the Edinburgh haemophiliac cohort. AB - HIV p24 antigenaemia and virus detection in cultures of peripheral blood lymphocytes were examined in 16 of 18 haemophiliacs infected with HIV by a single batch of Scottish National Blood Transfusion Service factor VIII concentrate. Six (38%) had p24 antigenaemia and 11 (69%) had positive lymphocyte cultures. All seven patients with serious HIV disease (CDC group IV) had positive lymphocyte cultures whereas four (57%) had p24 antigenaemia. Four of nine (44%) patients with asymptomatic HIV disease (CDC groups II and III) had positive cultures and two (22%) had p24 antigenaemia. Twenty-eight of 36 samples from the symptomatic group were HIV culture positive compared with nine of 30 samples from the asymptomatic group (P less than 0.001). None of 14 antibody negative haemophiliacs who also received the implicated batch of factor VIII had p24 antigenaemia or positive HIV cultures. The ability to detect HIV in cultured lymphocytes correlates with the clinical severity of HIV disease in this cohort. PMID- 2765407 TI - Heterogeneity of fibrinogen receptor expression on platelets activated in normal plasma with ADP: analysis by flow cytometry. AB - Fibrinogen receptor expression of platelets activated in normal plasma by ADP was measured by flow cytometry after labelling bound fibrinogen with fluorescein conjugated antifibrinogen antibody. The platelet response to ADP was heterogeneous both with respect to number of platelets binding fibrinogen and the amount of fibrinogen bound per platelet. The proportion of platelets showing positive antifibrinogen antibody binding increased with increasing ADP concentration; however, even at 10(-3) M ADP, usually about one-fifth of the platelets failed to demonstrate bound fibrinogen. The non-responsive platelets tended to be the smaller ones. The relative fluorescence intensity of individual platelets also increased as ADP concentration was increased, indicating that the average number of fibrinogen molecules bound was also related to agonist concentration. The amount of fibrinogen bound following platelet activation directly correlated with the quantity of surface glycoprotein IIb detected by Tab antibody and with platelet size. This study demonstrates that platelet response to ADP in native plasma is heterogeneous in both the proportion of platelets activated and in the number of available fibrinogen receptors per platelet. This heterogeneity is related to platelet size and glycoprotein IIb-IIIa content. These observations indicate that models of ligand interaction with membrane receptors on intact cells requiring an exposure step must take into account the heterogeneity of response within a cell population. In addition to providing new insights into the response of individual platelets to activation, these results suggest that study of platelet bound fibrinogen by flow cytometry may be useful for the detection of platelet activation in vivo. PMID- 2765408 TI - Immunoblot analysis of platelet glycoprotein IIb in patients with Glanzmann thrombasthenia in Israel. AB - Recent studies have indicated that severe ('type I') Glanzmann thrombasthenia is a heterogeneous hereditary disorder caused by quantitative and/or qualitative abnormalities of platelet membrane glycoproteins (GP) IIb and IIIa. Immunoblot analysis of sodium dodecyl sulphate (SDS)-solubilized platelets was carried out on controls and 18 patients (12 Iraqi-Jews, two Iranian Jews and four Arabs) employing three antibodies (one monoclonal and two polyclonal) directed at different sites on GPIIb. Nonreduced control platelet samples contained a major Mr approximately 140k immunoreactive protein that was split into an Mr approximately 120k (alpha) and an Mr approximately 25k (beta) band after reduction with mercaptoethanol. The nonreduced samples from all 18 patients tested had trace amounts of Mr approximately 140k band corresponding to normal GPIIb; the intensity of this band was estimated to be less than 1% of the normal amount. Unlike the control samples, however, this Mr approximately 140k band did not change electrophoretic mobility following reduction. Since GPIIb originates from a single chain precursor molecule of Mr approximately 140k that comprises both the alpha and beta chains, and which does not change mobility with reduction, our data suggest that the platelets of these patients contain small amounts of this precursor. PMID- 2765409 TI - Hereditary stomatocytosis: consistent association with an integral membrane protein deficiency. AB - We studied the RBC membrane proteins of four patients, including a mother and daughter, with hereditary stomatocytosis. One- and two-dimensional gel electrophoresis revealed that a 28 kDa integral protein, present in normal RBC membranes, was absent in all four patients. This abnormality, reported once previously (Lande et al, 1982), appears to be a characteristic feature of hereditary stomatocytosis, and may be related to the underlying permeability defect in this disorder. PMID- 2765410 TI - A non-human primate model for the study of oral iron chelators. AB - Recent studies have demonstrated that parenteral deferroxamine can prolong life in patients with iron overload. We have developed a non-human primate model of iron overload and have accurately determined negative iron balance in parenteral and oral studies of deferroxamine and a new chelator, desferrithiocin. Cebus monkeys were loaded with iron dextran (10 mg/kg twice weekly) until their serum contained a transferrin saturation greater than 75%, and (in two animals) liver biopsies showed iron loading. When complete iron balance studies were performed at this time, basal iron balance was -53 +/- 11 micrograms (N = 4), providing a low background for provocative studies. Iron balance was determined for intramuscular (N = 2) and oral (N = 3) deferroxamine, as well as intramuscular (N = 1) and oral (N = 4) desferrithiocin. The pattern of iron excretion after parenteral deferroxamine strongly resembled that of the iron-loaded, transfused human. Desferrithiocin was found to have significant activity as an oral chelator. This Cebus monkey model accurately determines negative iron balance and readily permits precise comparison of iron chelators given parenterally or orally. This model may offer an important step between rodent and human trials of promising new iron chelators. PMID- 2765411 TI - Treatment of chronic myelomonocytic leukemia with low dose etoposide. PMID- 2765412 TI - A novel deletion of the entire alpha-globin gene cluster in a British individual. PMID- 2765413 TI - Hyperferritinaemia as a significant indicator suggesting malignant histiocytosis. PMID- 2765414 TI - Replacement therapy for protein C deficiency using fresh frozen plasma. PMID- 2765415 TI - Undergraduate teaching of occupational health. PMID- 2765416 TI - Hydroxyl radical mediated DNA base modification by manmade mineral fibres. AB - Manmade mineral fibres (MMMFs) were examined for their ability to hydroxylate 2 deoxyguanosine (dG) to 8-hydroxydeoxyguanosine (8-OH-dG), a reaction that is mediated by hydroxyl radicals. It appeared that (1) catalase and the hydroxyl radical scavengers, dimethylsulphoxide and sodium benzoate, inhibited the hydroxylation, whereas Fe2+ and H2O2 potentiated it; (2) pretreatment of MMMFs with the iron chelator, deferoxamine, or with extensive heat (200-400 degrees C), attenuated the hydroxylation; (3) the hydroxylation obtained by various MMMFs varied considerably; (4) there was no apparent correlation between the hydroxylation and the surface area of different MMMFs, although increasing the surface area of a fibre by crushing it increased its hydroxylating capacity; and (5) there was good correlation between the hydroxylation of dG residues in DNA and the hydroxylation of pure dG in solution for the 16 different MMMFs investigated. These findings indicate that MMMFs cause a hydroxyl radical mediated DNA base modification in vitro and that there is considerable variation in the reactivity of different fibre species. The DNA modifying ability seems to depend on physical or chemical characteristics, or both, of the fibre. PMID- 2765417 TI - Risk factors in the genesis of sensorineural hearing loss in Finnish forestry workers. AB - A detailed analysis of risk factors for the development of sensorineural hearing loss (SNHL) was carried out in 199 forest workers. The hearing threshold of both ears at 4000 Hz was measured, and the effect of age, exposure to noise, blood pressure, presence of vibration induced white finger (VWF), tobacco smoking, plasma LDL-cholesterol concentration, and consumption of drugs were evaluated by multiple linear regression analysis. Aging was the major risk factor, followed by exposure to occupational noise and the presence of VWF. Plasma LDL-cholesterol concentration and the use of antihypertensive drugs also correlated significantly with SNHL. These main factors were able to explain about 28% of the SNHL variance. Additional factors in the analysis, including smoking, systolic and diastolic blood pressure, and consumption of salicylates did not significantly contribute to the genesis of SNHL. PMID- 2765418 TI - Variability in biological monitoring of solvent exposure. I. Development of a population physiological model. AB - Biological indicators of exposure to solvents are often characterised by a high variability that may be due either to fluctuations in exposure or individual differences in the workers. To describe and understand this variability better a physiological model for differing workers under variable industrial environments has been developed. Standard statistical distributions are used to simulate variability in exposure concentration, physical workload, body build, liver function, and renal clearance. For groups of workers exposed daily, the model calculates air monitoring indicators and biological monitoring results (expired air, blood, and urine). The results obtained are discussed and compared with measured data, both physiological (body build, cardiac output, alveolar ventilation) and toxicokinetic for six solvents: 1,1,1-trichloroethane, trichloroethylene, tetrachloroethylene, benzene, toluene, styrene, and their main metabolites. Possible applications of this population physiological model are presented. PMID- 2765419 TI - Pulmonary function in histology technicians compared with women from Michigan: effects of chronic low dose formaldehyde on a national sample of women. AB - Chronic workplace exposure to formaldehyde and solvents at low doses reduced pulmonary function in 280 non-smoker white women working as histology technicians. They were studied during national workshops at four United States cities for four years. Height and age adjusted comparisons of pulmonary function were made with women in a stratified random population sample of Michigan and with a selected subset of the population that was used to model predictive pulmonary equations for function. The major functional change in histology technicians was a steeper decrement in vital capacity and flows from age 20 to 60 by regression analysis than occurred in the modelled Michigan population. Furthermore non-smoking and currently smoking women studied at two sites had significantly lower flows than were found in the sample of Michigan women. There was no consistent effect of an aerosol bronchodilator on flows of women at the four sites. Diffusing capacity for carbon monoxide single breath and alveolar volume were below the comparison group of Michigan women only when tested at Washington DC. PMID- 2765420 TI - Occupational allergy in an entomological research centre. I. Clinical aspects of reactions to the sheep blowfly Lucilia cuprina. AB - Twenty eight per cent (15) of 53 workers engaged in a sheep blowfly breeding programme designed to control genetically the pest Lucilia cuprina experienced allergic manifestations resulting from contact with this insect. The most common symptoms were rhinitis, affected eyes, rashes, and lower respiratory symptoms, usually, but not always, immediate in type. A personal history of non-insect related asthma, allergic rhinitis, or eczema, or a combination of these was more common in the fly allergic group but some workers experienced allergic symptoms only when exposed to the adult sheep blowfly. Raised levels of serum IgE antibodies specific for adult and larval allergens were found in approximately 70% of symptomatic workers, whereas only 30% and 7% of two groups of asymptomatic workers were found to have these antibodies. It is concluded that the sheep blowfly is an important source of airborne allergens and can prove a considerable occupational health hazard. Measures designed to reduce worker contact with blowflies and their emanations considerably reduced the incidence of allergic symptoms in the exposed workers. PMID- 2765421 TI - Atmospheric concentrations of polycyclic aromatic hydrocarbons during chimney sweeping. AB - Air sampled from the breathing zone of chimney sweeps during "dirty work" and soot samples were analysed for polycyclic aromatic hydrocarbons (PAH). A total of 20 PAH were quantified by gas chromatography-mass spectrometry in 115 air samples and 18 soot samples. These included benzo(b)fluoranthene, benzo(a)pyrene (BaP), chrysene, dibenz(a,h)anthracene, and indeno (1,2,3-cd)pyrene, all of which are animal carcinogens. The summed atmospheric concentration of these compounds depended on the type of fuel used and averaged 2.27 micrograms/m3 for oil fuel. If a mixture of oil and solid fuel was used the concentration was 5.06 micrograms/m3; pure solid fuel heating yielded 5.08 micrograms/m3. The air concentrations of BaP were 0.36, 0.83, and 0.82 micrograms/m3 respectively. The soot samples recovered after using the three different fuel types were 10.50, 109.10, and 51.25 mg BaP/kg. The maximum total concentrations of the five carcinogenic PAH were 243.70, 691.06, and 213.94 mg/kg respectively. The time weighted, shift mean concentrations of 0.02 to 0.21 micrograms/m3 benzo(a)pyrene obtained on 11 days form the basis for the industrial medical estimation of risk. PMID- 2765422 TI - Acute neurobehavioural effects of toluene. AB - An acute inhalation chamber study of 42 college students was performed to investigate the relation between exposure to 0, 75, and 150 ppm of toluene and changes in central nervous system function and symptoms. Paid subjects were exposed for seven hours over three days. Verbal and visual short term memory (Sternberg, digit span, Benton, pattern memory); perception (pattern recognition); psychomotor skill (simple reaction time, continuous performance, digit symbol, hand-eye coordination, finger tapping, and critical tracking); manual dexterity (one hole); mood (profile of mood scales (POMS]; fatigue (fatigue checklist); and verbal ability were evaluated at 0800, 1200, and 1600 hours. Voluntary symptoms and observations of sleep were collected daily. An analysis of variance and test for trend was performed on the difference and score for each concentration reflecting an eight hour workday where each subject was their own control. A 3 x 3 Latin square study design evaluated toluene effects simultaneously, controlling for learning across the three days and the solvent order. Intersubject variation in solvent uptake was monitored in breath and urine. A 5-10% decrement in performance was considered significant if it was consistent with a linear trend at p less than 0.05. Adverse performance at 150 ppm toluene was found at 6.0% for digit span, 12.1% for pattern recognition (latency), 5.0% for pattern memory (number correct), 6.5% for one hole, and 3.0% for critical tracking. The number of headaches and eye irritation also increased in a dose response manner. The greatest effect was found for an increasing number of observations of sleep. Overall, no clear pattern of neurobehavioural effects was found consistent with the type 1 central nervous system as classified by the World Health Organisation. Subtle acute effects, however, were found just below and above the ACGIH TLV of 100 ppm toluene, supporting the position that the guideline be lowered since the biological threshold of behavioural effects may be comparable with the TLV. PMID- 2765423 TI - Occupational asthma due to tylosin tartrate. PMID- 2765424 TI - Pleural mesothelioma in a lift mechanic. PMID- 2765425 TI - Increased concentrations of haemoglobin X and Y in the erythrocytes of workers in a chemical plant in Japan. PMID- 2765426 TI - Are fixed-dose oestrogen/progestogen combinations ideal for all HRT users? AB - Although progestogens protect the endometrium against excessive oestrogen-induced stimulation, they can cause adverse symptomatic and psychological effects and may have undesirable metabolic consequences. Thus, the minimum progestogen dose which results in consistent endometrial transformation should be prescribed. To define this dose for norethisterone and dl-norgestrel, 197 endometrial samples obtained from postmenopausal women receiving conjugated equine oestrogens (0.625 mg or 1.25 mg daily) with one of six doses of norethisterone (or the acetate), or one of three doses of dl-norgestrel added for the first 12 days of each calendar month were examined with the light microscope; 109 samples were also assessed by transmission electron microscopy. There was an inverse relation between the percentage of samples showing proliferative features and the progestogen dose. However, proliferative endometrium was observed in 6% of samples with the highest dose of dl-norgestrel (500 micrograms) and in 3% of samples with 2.5 mg norethisterone. Conversely, complete secretory transformation was observed in 25% of samples with the lowest dose of norethisterone (0.1 mg) and in 40% of samples with 75 micrograms dl-norgestrel. Mild atypical hyperplasia was diagnosed in four samples. There was a wide inter-patient variation in response and none of the nine progestogen dose regimens induced secretory change in every patient. PMID- 2765427 TI - Bladder neck electrical conductivity in the treatment of detrusor instability with biofeedback. AB - A new method for controlling the symptoms and objective signs of detrusor instability was investigated in a pilot study. The method uses the activity of the bladder neck, monitored by a conductivity catheter, as a biofeedback signal. Voluntary closure of the bladder neck mechanism abolishes abnormal detrusor activity. Ten severely symptomatic women with detrusor instability were assessed clinically and urodynamically before and after a course of biofeedback. Statistically significant improvements in the symptoms of urgency and urge incontinence were found. Five of the seven women who agreed to have repeat cystometry had stable cystometrograms. There was a statistically significant fall in the mean maximum deflection at rest from 41.5 to 16.5 microA (P less than 0.05) measured during bladder neck electrical conductivity tests before and after treatment. PMID- 2765428 TI - Perinatal mortality in rural Tanzania. AB - Prolonged labour was the most frequent cause of perinatal death in a rural hospital in the south western highlands of Tanzania. After the introduction of an obstetric policy aiming to prevent prolonged labour by making use of the guidelines of the partogram, perinatal mortality was reduced from 71 to 39 per 1000 births. Baird's clinico-pathological classification is still considered a useful instrument for the discovery of avoidable factors in perinatal deaths. The concept of the partogram should be an integral part of the training of medical auxiliaries in the field of maternal and child health (MCH). PMID- 2765429 TI - Histological features of uteroplacental vessels in normal and hypertensive patients in relation to birthweight. AB - Placental bed biopsies were obtained during caesarean section from normal, pre eclamptic and hypertensive pregnancies. Of the 14 biopsies from normal pregnancies 13 showed normal vascular physiological changes in the decidua and in the myometrium. Biopsies from 24 pregnancies complicated by pre-eclampsia showed acute atherosis in 18 and physiological changes limited to the decidua in six; none had normal physiological changes. Biopsies from five hypertensive patients showed all three types of histological changes. The mean birthweight centile was lower in the group with atherosis than in the group with limited and the group with normal physiological changes. PMID- 2765430 TI - Comparison between mefenamic acid and danazol in the treatment of established menorrhagia. AB - Forty women with established menorrhagia were treated with either mefenamic acid (500 mg thrice daily for 3-5 days in two cycles) or danazol (100 mg twice daily for 60 days) in an open parallel group randomized study. Mefenamic acid reduced mean menstrual blood loss from 160 ml to 127 ml (20%, P less than 0.01). Danazol reduced mean menstrual loss from 163 ml to 65 ml (60%, P less than 0.001). The percentage reduction in menstrual blood loss was significantly greater in the danazol group than in the mefenamic acid group, but the adverse side-effects occurred significantly more often in the danazol group (75%) than in the mefenamic acid group (30%, P less than 0.005). Overall, approximately half the women in each group were prepared to continue with the treatment they received to reduce their menstrual bleeding. PMID- 2765431 TI - A protocol for the routine measurement of lactate and pyruvate in cord blood. AB - The influence of the site of sampling and the delay in sample collection on cord blood concentrations of lactate and pyruvate were investigated. A delay in sample collection of greater than 1 min after cord clamping could invalidate the results obtained. Samples from umbilical artery had higher lactate values (mean 3.13 mmol/l) than paired vein samples (mean 2.32 mmol/l) but there were no significant differences in lactate values between different sites sampled within the umbilical vein. A calculation was devised to circumvent the need to take cord blood samples immediately after delivery. PMID- 2765432 TI - Transmission of human immunodeficiency virus by heterosexual contact with reference to antenatal screening. PMID- 2765433 TI - Expression of HLA antigens in the cornea. PMID- 2765434 TI - Melanoma of the iris. PMID- 2765435 TI - A study of iris melanoma in Northern Ireland. AB - A retrospective study of all cases of iris melanoma in Northern Ireland over a 15 year period was undertaken. A total of 18 cases were identified. Of these, nine were histologically proved to be iris melanomas of various types. Within the period of follow-up two patients died from metastatic deposits. In both cases invasion of the anterior face of the ciliary body was present on histological examination. The implications for management are discussed. PMID- 2765436 TI - Anterior chamber lens implantation after vitreous loss. AB - Vitreous loss is a serious complication of cataract surgery. Following vitreous loss it is common practice to perform a primary implantation of an anterior chamber lens (AC-IOL). We retrospectively analysed 642 consecutive cases of cataract extraction performed between 1983 and 1986 with special attention to those patients in whom vitreous loss occurred and an AC-IOL was placed. There were 27 such cases, and 24 of these were available for follow-up. Eighteen (75%) had visual acuity of 20/40 or better. All six patients (25%) who had a visual acuity of less than 20/40 in the operated eye had a functional visual acuity of 20/200 or less. Complications that occurred in this group are discussed. We are concerned that the complications associated with vitreous loss and with AC-IOLs may be acting in concert to cause visually disabling results. PMID- 2765437 TI - Penetration of 2% cyclosporin eyedrops into human aqueous humour. AB - The penetration into the eye and the systemic absorption of 2% cyclosporin eye drops were determined by polarisation immunofluorescent assay of cyclosporin in the aqueous humour and plasma of 30 patients at the time of cataract surgery. The results were then compared with the corresponding results after oral administration at a dosage of 5 mg/kg/day to three further patients. The maximum intraocular concentration (24 (SD 9) mg/l) was achieved four hours after topical administration. This level was slightly less than that found in aqueous humour (28 (SD 10) mg/l) 12 hours after systemic administration of the drug at a dosage of 5 mg/kg/day. Both these levels are below the minimum therapeutic level (50-100 mg/l). Topical application of cyclosporin A did not produce detectable levels in plasma at any time. These results indicate that the efficacy of cyclosporin A in the control of intraocular inflammation is attributable to its systemic immunoregulatory effect rather than to the local ocular effect. PMID- 2765438 TI - Trabeculectomy versus trabeculotomy in congenital glaucoma. AB - Congenital glaucoma is one of the main causes of blindness in children and is more common in Saudi Arabia than in Western countries, perhaps owing to the prevalence of consanguinity with families. Trabeculotomy has given poorer in Saudi Arabia than elsewhere. This study compared the results of trabeculotomy (67% success rate) with trabeculectomy (54% success rate), and reports fewer complications following trabeculotomy. PMID- 2765439 TI - Occurrence of malignant glaucoma after laser iridotomy. AB - A case is described of malignant glaucoma with extreme shallowing of the anterior chamber (AC) and an abnormally high intraocular pressure (IOP) following laser iridotomy for acute angle closure glaucoma. The episode followed the use of strong miotic (pilocarpine hydrochloride 4%) and was reversed by mydriatics including phenylephrine hydrochloride. Serial estimation of anterior chamber depth is important in the management of angle closure glaucoma. PMID- 2765440 TI - Decreased formation of aqueous humour in insulin-dependent diabetic patients. AB - The rate of aqueous humour formation was measured by fluorophotometry in 34 insulin-dependent diabetic patients and 12 non-diabetic controls to determine whether or not aqueous flow in diabetics differed from that of normal controls, and whether or not aqueous flow among diabetics was correlated with the stage of retinopathy. Diabetic patients were divided into three groups based on the degree of retinopathy; group I without retinopathy, group II with minimal to moderate non-proliferative retinopathy, and group III with proliferative retinopathy. Aqueous flow (mean, SD) in diabetic patients was: 1.55 (0.32) microliter/min in group I, 1.51 (0.47) microliter/min in group II, and 1.26 (0.39) microliter/min in group III. No statistically significant difference was found among these three diabetic groups. Aqueous flow in the non-diabetic controls was 2.18 (0.40) microliter/min, and this was statistically significantly greater than in each of the diabetic groups. Intraocular pressure, age, duration of diabetes, haemoglobin A1C, and blood glucose levels had no significant effect on aqueous flow in diabetic patients. PMID- 2765441 TI - Tonicity of human tear fluid sampled from the cul-de-sac. AB - A 'freezing point' depression technique was used to determine the osmolality of 384 samples of tear fluid originating from the middle of the lower tear prism and the lower cul-de-sac of one eye of each of 12 young adults. Tear fluid from the cul-de-sac (mean 341.0 mosm/kg) was found overall to be significantly hypertonic (p less than 0.0001) relatively to fluid from the tear prism (mean 315.5 mosm/kg). However, the difference between the two sampling sites was highly variable between individuals, ranging from a maximum mean site difference of 64.5. mosm/kg for one of the six cul-de-sacs found to be significantly hypertonic, to a mean site difference of 25.0 mosm/kg for one of the two cul-de sacs found to be significantly hypotonic. These results suggest that a unique localised tear environment exists inside the lower cul-de-sac, which has several clinical consequences--for example, for pharmaceutical absorption, ocular microbiology, and hydrophilic contact lens performance. PMID- 2765442 TI - Passive limitation of adduction after Cuppers's 'Fadenoperation' on medial recti. AB - In 40 eyes of 20 esotropic subjects in which a 'Fadenoperation' was performed on the medial recti we measured the resistance to ocular rotation in adduction before and after the operation. The difference between the two sets of force measurements demonstrates that the Fadenoperation on medial recti produces a mechanical restriction to adduction which can explain the effect of the surgical procedure on the strabismic deviation. PMID- 2765443 TI - Acute acquired comitant esotropia. AB - Acute acquired comitant esotropia has been used to describe a dramatic onset of a relatively large angle of esotropia with diplopia and minimal refractive error. We describe six children aged 5 to 11 years who developed an acute non accommodative esotropia with diplopia. Neurological examination, including CT scan, in each of these children gave negative results. We suggest that this is an unusual presentation of esotropia of undetermined aetiology. The diagnosis, clinical characteristics, and management are discussed. PMID- 2765444 TI - Clinical criteria for the assessment of disease activity in Graves' ophthalmopathy: a novel approach. AB - Patients with serious inflammatory Graves' ophthalmopathy should be treated with anti-inflammatory drugs or radiotherapy to prevent complications like fibrosis, while those with non-inflammatory ophthalmopathy may be treated by surgery immediately. It is often difficult, however, to distinguish inflammatory from non inflammatory Graves' disease. We therefore present a simple clinical classification here to differentiate between these two conditions. This classification is based on the classical signs of inflammation--pain, redness, swelling, and impaired function. After two consecutive clinical examinations an 'activity score' can be determined, ranging from 0 to 10 points. In a retrospective study testing the efficacy of this classification we found that patients with an activity score of 3 or more at the beginning of therapy responded well to anti-inflammatory drugs, while those with a lower activity score mostly did not. Comparing the pretreatment activity score with the degree of enlargement of the extraocular muscles on the CT scan, we found a significant correlation between these two parameters: the higher the activity score, the more the enlargement of the muscles. We conclude that this classification facilitates the proper selection of patients for treatment. PMID- 2765445 TI - Use of limbal ring-rod for radiological localisation of ocular foreign body. AB - The limbal ring-rod and the proportional geometric drawing method provide a simple, inexpensive, and fairly accurate measure for the radiological localisation of ocular foreign bodies, and the results simulate those of orbital tomography. PMID- 2765446 TI - Assessment of visual function in suspected ocular malingering. AB - Three new techniques are presented for assessing visual acuity in the presence of suspected malingering. The first technique is based on the preferential looking method commonly used to test acuity in infants. The second uses polarising filters to present stimuli briefly to both eyes or to each eye alone, without the patient's being aware of which eye is tested. The third presents the stimuli on a computer monitor and separates the ray paths of the two eyes by means of special spectacles that obscure vision in one eye for fractions of a second while a stimulus is presented. PMID- 2765447 TI - Convulsion following intravenous fluorescein angiography. AB - Tonic-clonic seizures followed intravenous fluorescein injection for fundus angiography in a 47-year-old male. Despite precautions this adverse reaction recurred on re-exposure to intravenous fluorescein. PMID- 2765449 TI - Corneal amyloidosis. AB - A 54-year-old man presented with a corneal lesion which on excision biopsy was found to be composed of amyloid. This material was presumably laid down in response to chronic irritation from the scarred lid and thus represents an example of secondary localised amyloidosis. PMID- 2765448 TI - Corneal thickness in nephropathic cystinosis. AB - Cystinosis is a rare autosomal recessive metabolic disorder in which non-protein cystine accumulates within cellular lysosomes owing to a defect in lysosomal cystine transport. The pathognomonic ocular manifestation of cystinosis is the deposition of distinctive iridescent crystals in the cornea, not associated with any inflammatory response or recognised change in corneal function. We measured corneal thickness in nine patients with infantile nephropathic cystinosis. We also studied a corneal button from one of these patients who underwent corneal transplantation. All nine patients had increased corneal thickness in comparison with an age matched control population. Electron microscopy analysis of the cystinotic button revealed structural changes of both epithelium and endothelium layers. Increased corneal thickness in patients with nephropathic cystinosis may reflect subclinical corneal oedema. PMID- 2765450 TI - Purtscher's retinopathy and fat embolism. AB - A 19-year-old woman who sustained multiple trauma but no head injury developed fulminant fat embolism syndrome (FES). Her neurological deterioration was associated with cerebral oedema and the concomitant Purtscher's type retinopathy. We suggest that the pathogenesis of the retinopathy and of the cerebral oedema are the same and that Purtscher's retinopathy and retinopathy of the FES are indistinguishable. PMID- 2765451 TI - Orbital mucormycosis with retinal and ciliary artery occlusions. AB - A 61-year-old man presented with acute, painful loss of vision in the left eye due to a central retinal artery occlusion. Fluorescein angiography confirmed the central retinal artery occlusion and also identified a nasal posterior ciliary artery occlusion. CT scanning revealed a left medial orbital mass with adjacent ethmoid sinusitis. Transnasal ethmoid biopsy disclosed mucormycosis. A left external ethmoidectomy, maxillectomy, and orbital exploration were performed, after which the patient was treated with daily intravenous amphotericin B for six weeks. Coexistence of retinal and nasal posterior ciliary artery occlusion due to mucormycosis may relate to their common origin from the ophthalmic artery. Treatment without exenteration was successful. PMID- 2765452 TI - Morning glory syndrome associated with marked persistent hyperplastic primary vitreous and lens colobomas. AB - A case of morning glory syndrome with striking persistence of primary vitreous is presented. The hypothesis that the syndrome is an expression of abnormal closure of the embryonic fissure is substantiated by the coexistence of lens colobomas. Furthermore, the marked primary vitreous hyperplasia shows the way in which persistence of primary vitreous influences the clinical expression with respect to optic pit and colobomas of the optic nerve. PMID- 2765453 TI - Polaroid print film for fluorescein angiography. PMID- 2765454 TI - A retrospective study of the stability of midface osteotomies in cleft lip and palate patients. AB - Relapse following midface osteotomies in cleft lip and palate patients was investigated in a retrospective study. The amount of surgical movement and subsequent relapse was measured using a computer aided digitisation programme with reference to the cranial base. The mean maxillary surgical advance was 5.09 mm horizontally and 5.70 mm vertically. After a mean follow up period of 22 months the mean relapse of the anterior maxilla was 0.90 mm (17%) horizontally and 1.55 mm (27.2%) vertically. Preliminary indications are that direct skeletal fixation of the maxilla by bone plates results in less relapse than when cranio maxillary fixation is employed. PMID- 2765455 TI - Changes in the facial profile following correction for mandibular prognathism. AB - A retrospective study of 33 patients was undertaken to investigate the changes occurring in the facial profile following surgical correction of mandibular prognathism. The parameters measured included surface area, shift of selected points, facial outline length and directional measurement in relation to the sella-nasion plane. The calculation of linear regression equations enabled prediction of the shift of selected soft tissue points and facial outline length. It is considered, that the analysis provides an accurate picture of the behaviour of the soft tissues in response to a given amount of bony movement following correction of the deformity. PMID- 2765456 TI - A short guide to studying medicine for the dental graduate. AB - Advice is offered to dentally-qualified trainees with an interest in oral and maxillofacial surgery who may be considering applying for a place in medical school from two trainees who have recently completed their medical studies. PMID- 2765457 TI - Traumatic blindness following a malar fracture. PMID- 2765459 TI - Using stainless steel tape and artery clips to hold miniplates. AB - A technique for holding Champy miniplates is described and illustrated. PMID- 2765460 TI - A locking bar modification for splint localisation. AB - Currently used techniques for the construction of localising bars are generally regarded to constitute a disadvantage of cap splints. A simplified method of localisation is described. PMID- 2765458 TI - The fate of miniplates in facial trauma and orthognathic surgery: a retrospective study. AB - The fate of 279 Champy miniplates used routinely as permanent implants over a 5 year-period in the management of maxillofacial trauma and orthognathic surgery has been analysed retrospectively. Trauma patients (62) and orthognathic patients (47) were analysed separately; in each group those patients who had plates removed were compared to the patients with retained plates. This study indicates that the morbidity of retaining plates is within acceptable limits and that the routine removal of plates at 3 months may be unnecessary. PMID- 2765461 TI - Reduction and fixation of jaw fractures using acrylic splints. AB - This paper proposes the criteria for application of acrylic splints in the treatment of various types of maxillofacial fractures. These were based mainly on the number of remaining teeth that are important for the restoration of occlusion. The acrylic splints studied consisted of intermaxillary, lingual and labiolingual types that hold a dental arch and a cap type that covers a dental arch. It was found that the intermaxillary type was best indicated for the loss of multiple teeth, the lingual type for the predicted intraversion of bone fragments and the labiolingual as well as cap types for the deciduous or mixed dentition. Clinical application based on the above standard, which was attempted in our 60 patients, produced successful results. In addition, the usefulness of these acrylic splints as an intraoral apparatus was discussed. PMID- 2765462 TI - A tongue resection in macroglossia due to primary amyloidosis. AB - A lady of 62 years with longstanding macroglossia from primary amyloidosis had the anterior two-thirds of her tongue successfully resected. She had Factor X deficiency. The surgical, anaesthetic and haematological problems encountered are described. PMID- 2765463 TI - Oropharyngeal colonisation with fungi and gram-negative rods in patients treated with radiotherapy of the head and neck. AB - Twenty-five patients treated for malignant conditions of the head and neck were investigated for the development of oral radiation mucositis as well as oropharyngeal colonisation with fungi and Gram-negative bacilli. The colonisation rate of the patients increased from 20% to 80% during therapy. The patients were colonised mainly with fungi, but also to a lesser extent with Gram-negative bacilli. During radiotherapy free volatile fatty acids in saliva were determined by direct gas-liquid chromatography. The amounts of acetic, butyric and propionic acid decreased during radiotherapy and remained at low levels 6 months after therapy. Radiation induced mucositis was observed in 28% of the patients after 1 week of irradiation. After 3 weeks of therapy all patients showed varying grades of mucositis. In seven of the 19 survivors (36%) erythema was still present 6 months after radiotherapy. PMID- 2765464 TI - Metastatic thyroid carcinoma: an unusual presentation. AB - A case is described in which the presentation of symmetrical thyroid lesions combined with their unusual site and histological appearance served initially to mask the underlying thyroid neoplasm. PMID- 2765465 TI - Secondary chordoma of the mandible. AB - The first case of primary sacrococcygeal chordoma metastasising to the mandible and presenting with obstructed labour is described. The pathological features of this tumour, its clinical presentation and management are discussed. PMID- 2765466 TI - Training in the speciality. PMID- 2765467 TI - A cephalometric study of incisor angulations in a Nigerian population. AB - This paper has the objective of establishing a standard norm for incisor angulations in a Nigerian population. The upper incisor angle to the Frankfort plane has a biological norm of between 119 degrees and 127 degrees, while the lower incisor angle (to the mandibular plane) is between 96 degrees and 104 degrees. The value for the interincisal angle is between 108 degrees and 116 degrees. PMID- 2765468 TI - Acceptance of recommended cross-infection procedures by orthodontists in the United Kingdom. AB - The aim of this study was to try to gather orthodontists' current opinions regarding the prevention of cross-infection, to correlate this and suggest some guidelines acceptable to the profession. PMID- 2765469 TI - Class III malocclusion: a cephalometric study of Saudi Arabians. AB - The records of 500 consecutive Saudi Arabian patients referred for orthodontic treatment were examined clinically and cephalometrically for Class III malocclusion. A control group was drawn at random from the same sample. The incidence of Class III was 9.4 per cent, with mandibular prognathism being the commonest presentation of the malocclusion. The upper and lower incisors exhibited a marked degree of dentoalveolar compensation, on dental bases having mean values of SNA--78.77 degrees and SNB--81.17 degrees. The maxillary length was reduced, as were the saddle and maxillary-mandibular plane angles. The gonial angle (ArGoMe), anterior and posterior facial heights, and mandibular lengths (ArGo, ArPo) were all significantly larger than the control group. The cephalometric values of the control group showed the increased tendency to bimaxillary protrusion in the Saudi Arabian sample. PMID- 2765470 TI - The effect of bracket type and ligation method upon forces exerted by orthodontic archwires. AB - The effects of bracket type and ligation method upon the forces exerted at 1.5-mm deflection by three archwire materials were measured in a simulated clinical situation. Significant force differences were found when archwires were used in standard edgewise or straightwire brackets, respectively, and also when Alastik modules were used for ligation instead of steel ligatures. PMID- 2765471 TI - An inverted upper lateral incisor. AB - A case is presented of an inverted upper lateral incisor in an 11-year-old patient. It is believed that involvement of this tooth is previously unreported. PMID- 2765472 TI - Membership in orthodontics. PMID- 2765473 TI - Debate on sterilization. PMID- 2765474 TI - Diagnostic value of panoramic radiographs in children aged 9-10 yrs. PMID- 2765475 TI - Structure of the human lipoprotein lipase gene. AB - Human genomic clones that span the entire lipoprotein lipase (LPL) gene have been isolated and used to determine its structure. The gene is approximately 30 kilobase (kb) pairs in length in which the mRNA specifying sequence is divided into 10 exons. Exons 1-9 are of average size (105-276 bp) whereas exon 10, which specifies the entire 3' uncoding sequence, is 1948 bp in length. Exon 1 codes for the signal peptide, exon 2 includes the protein domain that was shown to bind to the lipoprotein substrate, and exons 6 and 9 code for sequences that are relatively rich in basic amino acids and therefore likely to be involved in anchoring of the enzyme to the capillary endothelium by interaction with the acidic domain of heparan sulfate. Four closely spaced mRNA 5' termini were observed, indicating multiple transcription initiation sites, one of which seems to be favored. Two potential enhancer sequence motifs in the 5' upstream region were observed. One may specify expression in response to intracellular Ca2+ mobilization, and the other may be responsible for expression in adipocytes. PMID- 2765476 TI - Competitive inhibition of phospholipase A2 in vesicles. AB - Kinetic studies with phospholipase A2 are complicated by the fact that binding of the enzyme to the interface precedes catalytic turnover. This difficulty can be overcome by monitoring interfacial catalysis in the scooting mode where the enzyme does not leave the interface. The kinetics of inhibition by transition state analogues shows that specific competitive inhibition is the result of competition between inhibitor and substrate for the binding to the active site of the enzyme in the interface. Several lipophilic compounds, including alkanols, substituted butyrophenones, aristolochic acid, and mepacrine apparently reduce the rate of lipolysis by promoting the desorption of phospholipase A2 from the interface. PMID- 2765477 TI - Regulation of oxidation-reduction potentials of anthranilate hydroxylase from Trichosporon cutaneum by substrate and effector binding. AB - The pH dependence of the redox behavior of anthranilate hydroxylase from Trichosporon cutaneum in its uncomplexed and anthranilate-complexed forms, as well as the effects on the reduction potential, at pH 7.4, of enzyme in complex with 3-methylanthranilate, salicylate, 3-acetylpyridine adenine dinucleotide phosphates, and azide plus anthranilate, is described. At pH 7.4 the midpoint potential of uncomplexed enzyme (EFlox/EFlredH-) is -0.229 V vs SHE, close to that of free flavin. The aromatic substrates and effector all shift the midpoint potential value in a positive direction by 0.068-0.100 V. This shift results in thermodynamically more favorable reduction of the substrate/effector-complexed enzyme by NADPH. Consistent with thermodynamic considerations, the aromatic substrates (or effector) are bound to the reduced enzyme 2-4 orders of magnitude more tightly than to the oxidized enzyme. The tighter binding of the substrate to the two-electron-reduced enzyme may be related to the double hydroxylation reaction performed by this enzyme, which is a more complex reaction than is carried out by typical flavoprotein hydroxylases. The acetylpyridine nucleotides appear to have no significant regulatory role. PMID- 2765478 TI - Mouse steroid 15 alpha-hydroxylase gene family: identification of type II P 450(15)alpha as coumarin 7-hydroxylase. AB - We identified type II P-450(15)alpha as mouse coumarin 7-hydroxylase (P-450coh). Unlike type I P-450(15)alpha, the other member within the mouse steroid 15 alpha hydroxylase gene family, type II catalyzed little steroid 15 alpha-hydroxylase activity, yet structurally there were only 11 substitutions between type I and type II P-450(15)alphaS within their 494 amino acid residues (Lindberg et al., 1989), and the N-terminal sequence (21 residues) of P-450coh was identical with that of both P-450(15)alphaS. Induction by pyrazole of coumarin 7-hydroxylase activity correlated well with the increase of type II P-450(15)alpha mRNA in 129/J male and female mice. Pyrazole, on the other hand, was less in males or not effective in females in inducing the 15 alpha-hydroxylase activity and type I P 450(15)alpha mRNA. Expression of type I and II in COS-1 cells revealed that the latter catalyzed coumarin 7-hydroxylase activity at 10 to approximately 14 pmol min-1 (mg of cellular protein)-1. The former, on the other hand, had a high testosterone 15 alpha-hydroxylase but little coumarin 7-hydroxylase activity. It was concluded, therefore, that type II P-450(15)alpha is the mouse coumarin 7 hydroxylase. Identification of type II as the P-450 specific to coumarin 7 hydroxylase activity and characterization of its cDNA and gene, therefore, were significant advances toward understanding the basis of genetic regulation of this activity in mice (known as Coh locus). PMID- 2765479 TI - Isotope effects on the crotonase reaction. AB - The primary, alpha-secondary, beta-secondary, and beta'-secondary deuterium and primary 18O kinetic isotope effects on V/K for the dehydration of [(3S)-3 hydroxybutyryl]pantetheine by bovine liver crotonase (enoyl-CoA hydratase, EC 4.2.1.17) have been determined by the equilibrium perturbation method. The primary deuterium and 18O kinetic isotope effects are 1.61 and 1.051, respectively. The secondary deuterium effects at C-2, C-3, and C-4 are 1.12, 1.13, and 1.00 per H, respectively. The large 18O isotope effect suggests C-O bond cleavage is largely rate determining but is consistent with either an E1cb or E2 mechanism with a large amount of carbanion character. The beta-secondary effect is a factor of 1.05 greater than the equilibrium isotope effect, indicating that this C-H bond is less stiff in the affected transition state or that its motion is coupled to the reaction coordinate motion. Analytical solutions to the differential equations describing uni-uni equilibrium perturbations are presented. PMID- 2765480 TI - Phospholipid asymmetry in large unilamellar vesicles induced by transmembrane pH gradients. AB - The influence of membrane pH gradients on the transbilayer distribution of some common phospholipids has been investigated. We demonstrate that the transbilayer equilibrium of the acidic phospholipids egg phosphatidylglycerol (EPG) and egg phosphatidic acid (EPA) can be manipulated by membrane proton gradients, whereas phosphatidylethanolamine, a zwitterionic phospholipid, remains equally distributed between the inner and outer monolayers of large unilamellar vesicles (LUVs). Asymmetry of EPG is examined in detail and demonstrated by employing three independent techniques: ion-exchange chromatography, 13C NMR, and periodic acid oxidation of the (exterior) EPG headgroup. In the absence of a transmembrane pH gradient (delta pH) EPG is equally distributed between the outer and inner monolayers of LUVs. When vesicles composed of either egg phosphatidylcholine (EPC) or DOPC together with 5 mol % EPG are prepared with a transmembrane delta pH (inside basic, outside acidic), EPG equilibrates across the bilayer until 80 90% of the EPG is located in the inner monolayer. Reversing the pH gradient (inside acidic, outside basic) results in the opposite asymmetry. The rate at which EPG equilibrates across the membrane is temperature dependent. These observations are consistent with a mechanism in which the protonated (neutral) species of EPG is able to traverse the bilayer. Under these circumstances EPG would be expected to equilibrate across the bilayer in a manner that reflects the transmembrane proton gradient. A similar mechanism has been demonstrated to apply to simple lipids that exhibit weak acid or base characteristics [Hope, M. J., & Cullis, P. R. (1987) J. Biol. Chem 262, 4360-4366] PMID- 2765481 TI - Synthesis and characterization of N-parinaroyl ganglioside GM1: effect of choleragen binding on fluorescence anisotropy in model membranes. AB - N-cis-Parinaroyl ganglioside GM1 and N-trans-parinaroyl ganglioside GM1 were synthesized and characterized by HPLC, TLC, component analysis, absorbance spectroscopy, and proton NMR spectroscopy. Steady-state fluorescence anisotropy of the purified compounds, incorporated into phosphatidylcholine liposomes, was measured in the presence and absence of choleragen (cholera toxin) and choleragenoid (cholera toxin B subunit). In gel-phase liposomes, anisotropy measurements indicated that the motion of the parinaroyl ganglioside was not affected by addition of choleragen or choleragenoid. In fluid-phase liposomes, however, addition of toxin resulted in increased anisotropy (decreased rotational motion) of the fluorescent gangliosides. This decreased motion was not observed with other parinaroyl lipid probes, such as phosphatidylcholine, glucosylceramide, or free fatty acids, indicating that the effect was due to specific ganglioside/toxin interactions. Varying the amount of ganglioside or the amount of toxin suggested that the effect of toxin on probe motion was saturable at approximately 1 choleragen (or choleragenoid) molecule/5 ganglioside molecules. These results are consistent with previous hypotheses regarding the ganglioside/choleragen interaction and indicate that parinaroyl ganglioside probes will be useful in elucidation of the molecular details of this interaction. PMID- 2765482 TI - Interaction of melittin with phosphatidylcholine membranes. Binding isotherm and lipid head-group conformation. AB - The binding of melittin to nonsonicated bilayer membranes composed of 1-palmitoyl 2-oleoyl-sn-glycero-3-phosphocholine was studied with an ultracentrifugation assay and with 2H and 31P nuclear magnetic resonance. Melittin binding could best be described by a partition equilibrium with Kp = (2.1 +/- 0.2) X 10(3) M-1, measuring the binding isotherm in the concentration range of 0-100 microM melittin and taking into account electrostatic effects by means of the Gouy Chapman theory. This partition coefficient is smaller than that deduced for small sonicated vesicles and attests to the tighter lipid packing in the nonsonicated bilayers. Deuterium magnetic resonance revealed a conformational change of the phosphocholine head group upon melittin binding. The quadrupole splittings of the alpha and beta segments of the choline head group varied linearly with the amount of bound melittin but in opposite directions; i.e., the alpha splitting decreased, and the beta splitting increased. This conformational change is not specific to melittin but is a response of the phosphocholine head group to positive membrane surface charges in general. Quantitatively, melittin is one of the most efficient head-group modulators, the efficiency per unit charge comparable to that of charged local anesthetics or hydrophobic ions. PMID- 2765483 TI - Thermodynamics of phospholipid bilayer assembly. AB - Thermodynamic properties of bilayer assembly have been obtained from measurements of the solubility of the sodium salt of dimyristoylphosphatidylglycerol (DMPG) in water. The standard free energy of bilayer assembly delta G degree a is shown to be RT 1n Xs + zF psi 0 where Xs is the mole fraction of dissolved lipid, F is the Faraday constant, z is the valence of the counterion (Na+), and psi 0 is the electrical double-layer potential of the ionized bilayer. The function d 1n Xs/dT was found to be discontinuous at 24 degrees C, the gel-liquid-crystal transition temperature (Tm) for DMPG. This function was unaffected when solubilities were measured in 0.001 M NaCl solutions; thus, psi 0 is constant in the experimental temperature interval (4-40 degrees C). Using a value of psi 0 = -180 mV [Eisenberg et al. (1979) Biochemistry 18, 5213-5223], and the temperature dependence of delta G degrees a, values for delta H degrees a and delta S degree a at 24 degrees C were calculated for the gel and liquid-crystal states of DMPG. For the gel, delta H degrees a and T delta S a are -26.2 and 12.7 kcal/mol, respectively; for the liquid-crystal, delta H degrees a and T delta S degrees a are -19.2 and -5.7 kcal/mol, respectively. The calculated value for the latent heat of the gel-liquid-crystal transition is 7 kcal/mol, in agreement with calorimetric measurements. PMID- 2765484 TI - Quantitative fluorescence measurement of chloride transport mechanisms in phospholipid vesicles. AB - A quantitative fluorescence assay has been developed to measure Cl flux across liposomal membranes for use in chloride transporter reconstitution studies. A Cl sensitive fluorophore [6-methoxy-N-(3-sulfopropyl)quinolinium; SPQ] was entrapped into phospholipid/cholesterol liposomes formed by bath sonication, high-pressure extrusion, and detergent dialysis. Liposomes containing entrapped SPQ were separated from external SPQ by passage down a Sephadex G25 column. There was less than 10% leakage of SPQ from liposomes in 8 h at 4 degrees C and in 2 h at 23 degrees C. Cl influx (JCl in millimolar per second or nanomoles per second per centimeter squared) was determined from the time course of SPQ fluorescence, measured by cuvette or stopped-flow fluorometry, in response to inward Cl gradients. In 90% phosphatidylcholine (10% cholesterol liposomes at 23 degrees C, JCl in response to a 50 mM inward Cl gradient was 0.06 +/- 0.01 mM.s-1 (SD, n = 3) in the absence and 0.27 +/- 0.02 mM.s-1 in the presence of a K/valinomycin voltage clamp (0 mV), showing that the basal Cl "leak" is conductive; JCl increased (1.7 +/- 0.1)-fold in the presence of a 60-mV inside-positive diffusion potential. Accuracy of chloride influx rates determined by the SPQ method was confirmed by measurement of 36Cl uptake. In liposomes voltage-clamped to 0 mV, JCl was linear with external [Cl] (0-100 mM), independent of pH gradients, and strongly dependent on temperature (activation energy 18 +/- 1 kcal/mol, 12-42 degrees C) as predicted for channel-independent Cl diffusion.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2765485 TI - Temperature dependence of the structural dimensions of the inverted hexagonal (HII) phase of phosphatidylethanolamine-containing membranes. AB - The characteristic temperature dependence of the lattice basis vector length d of phospholipid-water systems in the inverted hexagonal (HII) phase has been investigated with X-ray diffraction. For 1,2-dioleoyl-sn-glycero-3 phosphoethanolamine (DOPE), d falls sharply from 78.1 A at 10 degrees C to 62.5 A at 90 degrees C. When used in conjunction with the volume fractions of the constituents, d can be used to determine the dimensions within the lipid and water regions. These data showed that a reduction in the radius of the HII-phase water cylinders Rw accounted for most of the reduction in d. From geometrical relationships between the dimensions in the HII phase, it was shown that both d and Rw are sensitive functions of the thickness of the lipid monolayer dHII. The characteristic shape of d(T) could be parameterized with the small temperature dependence of dHII along with the ratio v/a, which is the ratio of the specific volume to the area per lipid molecule at the polar interface. The ratio v/a was found to be independent of temperature for the fully hydrated HII system. Additional measurements made with a mixture of DOPE and 1,2-dioleoyl-sn-glycero-3 phosphocholine (DOPC), mole ratio 5.07:1, produced a similar parameterization of d(T). The larger basis vector lengths for this mixture compared to those for DOPE can be attributed to a smaller ratio of v/a, which was also found to be temperature independent for this mixture. The smaller value of v/a is due to the larger effective headgroup area of DOPC.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2765486 TI - Bioluminescence spectral and fluorescence dynamics study of the interaction of lumazine protein with the intermediates of bacterial luciferase bioluminescence. AB - The mechanism of the shifting of the bioluminescence spectrum from the reaction of bacterial luciferase by lumazine protein is investigated by methods of fluorescence dynamics. A metastable intermediate is produced on reaction of Vibrio harveyi luciferase with FMNH2 and O2. It has an absorption maximum at 374 nm and a rotational correlation time (phi) derived from the decay of its fluorescence (maximum 500 nm) anisotropy of 90 ns (2 degrees C). Lumazine protein from Photobacterium phosphoreum has an absorption maximum at 417 nm and a fluorescence maximum at 475 nm. Lumazine protein forms a protein-protein complex with luciferase, and the complex has a phi of approximately 100 ns. A mixture of lumazine protein and the intermediate would be expected to have an average correlation time (phi av) around 100 ns, but instead, the result is anomalous. The phi av is much lower and is also wavelength dependent. For excitation at 375 nm, which is mainly absorbed in the flavin chromophore of the intermediate, phi av = 25 ns, but at 415 nm, mainly absorbed by the lumazine derivative ligand of lumazine protein, phi av approximately 50 ns. It is proposed that protein-protein complexation occurs between lumazine protein and the luciferase intermediate and that in this complex energy transfer from the flavin to the lumazine is the predominant channel of anisotropy loss. A distance of 20 A between the donor and acceptor is calculated. In the bioluminescence reaction of intermediate with tetradecanal, a fluorescent transient species is produced which is the bioluminescence emitter.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2765487 TI - Laser temperature-jump, spectroscopic, and thermodynamic study of salt effects on duplex formation by dGCATGC. AB - Salt effects on duplex formation by dGCATGC have been studied with spectroscopic, thermodynamic, and kinetic methods. Circular dichroism spectra indicate different salt conditions have little effect on the structures of the duplex and single strand. NMR chemical shifts indicate the structure of the duplex in 1 M NaCl is similar to that of the B-form determined previously in 0.5 M KCl [Nilges, M., Clore, G. M., Gronenborn, A. M., Brunger, A. T., Karplus, M., & Nilsson, L. (1987) Biochemistry 26, 3718-3733]. Optical melting experiments indicate the effect of Na+ concentration on melting temperature is similar to that expected for a polynucleotide with the same GC content. Laser temperature-jump experiments indicate the effect of Na+ concentration on the rate of duplex formation is much less than is observed for polynucleotides. The observations are consistent with expectations based on a counterion condensation model. This is surprising for a duplex with only 10 phosphates. PMID- 2765488 TI - Conformation of recombinant desulfatohirudin in aqueous solution determined by nuclear magnetic resonance. AB - The three-dimensional structure of recombinant desulfatohirudin in aqueous solution was determined by 1H nuclear magnetic resonance at 600 MHz and distance geometry calculations with the program DISMAN. The input for the structure calculations was prepared on the basis of complete sequence-specific resonance assignments at pH 4.5 and 22 degrees C and consisted of 425 distance constraints from nuclear Overhauser enhancements and 159 supplementary constraints from spin spin coupling constants and from the identification of intramolecular hydrogen bonds. Residues 3-30 and 37-48 form a molecular core with two antiparallel beta sheets and several well-defined turns. The three disulfide bonds 6-14, 16-28, and 22-39 were identified by NMR. In contrast to this well-defined molecular core, with an average root mean square distance for the polypeptide backbone of 0.8 A for a group of nine DISMAN solutions, no preferred conformation was found for the C-terminal segment 49-65, and a loop consisting of residues 31-36 is not uniquely constrained by the NMR data either. These structural properties of recombinant desulfatohirudin coincide closely with the previously described solution conformation of natural hirudin, but the presence of localized differences is indicated by chemical shift differences for residues Asp 5, Ser 9, Leu 15, Asp 53, Gly 54, and Asp 55. PMID- 2765489 TI - Folding of a peptide corresponding to the alpha-helix in bovine pancreatic trypsin inhibitor. AB - A short peptide corresponding to the alpha-helical region of BPTI shows partial folding in aqueous solution (pH 7) as judged by circular dichroism (CD). Folding is temperature and denaturant sensitive, and the peptide is monomeric. The difference CD spectrum, obtained from spectra at two temperatures, indicates that the peptide folds as an alpha-helix. Difference CD spectroscopy provides a sensitive assay for helix formation in peptides exhibiting small amounts of structure. Helix stability in this peptide shows a marked pH dependence which is consistent with stabilizing charged side-chain interactions with the helix dipole and/or salt bridge formation. PMID- 2765490 TI - Fine mapping of DNA single-stranded regions using base-specific chemical probes: study of an open complex formed between RNA polymerase and the lac UV5 promoter. AB - We have used diethyl pyrocarbonate (DEP), which carbethoxylates adenine bases, and dimethyl sulfate (DMS), which methylates guanine residues and single-stranded cytosines, to probe bases in open complexes between RNA polymerase and the lac UV5 promoter in vitro. We compared the kinetics of reactivity between bases in an open complex and those in a single-stranded 35-mer fragment corresponding to the lower template strand of lac UV5 in the region -25 to +10 relative to the transcription start site. We observed that cytosine and adenine residues in the 35-mer fragment reacted according to a second-order process with DMS and DEP, respectively, at sufficiently low concentrations of the reagents and that the degree of reactivity was base position independent. In an open complex in the absence of substrates, we observed reactivity with DEP in adenines from -12 to +4 as well as +21 on the template strand and methylation by dimethyl sulfate of cytosines -6, -4, -2, and -1. No hyperreactivity was observed on the nontemplate strand. The degree of reactivity of bases between -12 and +4 was position dependent, maximum reactivity being displayed by bases in the middle of the region. The reaction was first order within the range of reagent concentration investigated. It was confirmed that in the presence of ApA and UTP cytosine +5, as well as cytosines -6, -4, -2, and -1, in an open complex became reactive to DMS. With regard to DEP the extent of reactivity of the adenine at position +3 was increased markedly, adenine +4 was brought into the single-stranded region, and the overall reactivity of adenine -10 decreased.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2765491 TI - Ultraviolet resonance Raman spectroscopy of distamycin complexes with poly(dA) poly(dT) and poly(dA-dT): role of H-bonding. AB - Raman spectra are reported for distamycin, excited at 320 nm, in resonance with the first strong absorption band of the chromophore. Qualitative band assignments to pyrrole ring and amide modes are made on the basis of frequency shifts observed in D2O. When distamycin is dissolved in dimethyl sulfoxide or dimethylformamide, large (30 cm-1) upshifts are seen for the band assigned to amide I, while amides II and III shift down appreciably. Similar but smaller shifts are seen when distamycin is bound to poly(dA-dT) and poly(dA)-poly(dT). Examination of literature data for N-methylacetamide in various solvents shows that the amide I frequencies correlate well with solvent acceptor number but poorly with solvent donor number. This behavior implies that acceptor interactions with the C = O group are more important than donor interactions with the N-H group in polarizing the amide bond and stabilizing the zwitterionic resonance form. The resonance Raman spectra therefore imply that the distamycin C = O groups, despite being exposed to solvent, are less strongly H-bonded in the polynucleotide complexes than in aqueous distamycin, perhaps because of orienting influences of the nearby backbone phosphate groups. In this respect, the poly(dA dT) and poly(dA)-poly(dT) complexes are the same, showing the same RR frequencies. Resonance Raman spectra were also obtained at 200-nm excitation, where modes of the DNA residues are enhanced. The spectra were essentially the same with and without distamycin, except for a perceptable narrowing of the adenine modes of poly(dA-dT), suggesting a reduction in conformational flexibility of the polymer upon drug binding. PMID- 2765492 TI - Volume changes in the binding of lanthanides to peptide analogues of loop II of calmodulin. AB - The solution expansion accompanying coordination of lanthanide ions to synthetic peptide analogues of a metal-binding loop in calmodulin was determined by a density method. This study was designed to further test the hypothesis that the nonlinear expansions observed upon sequential addition of Ca2+ to intracellular calcium-binding proteins reflect principally upon the coordination event at specific binding sequences. Three peptides of 13 residues each were synthesized as analogues of binding loop II in mammalian calmodulin: Peptide I was the native analogue; peptide II contained an aspartyl in place of an asparaginyl residue at position 5 from the N-terminus; for peptide III, the aspartyl residue in position 3 of the native analogue was interchanged with the asparaginyl residue in position 5. Thus, the number of charged-oxygen donor atoms for coordination was the same in I and in III, but the latter peptide could permit two pairs of acidic groups to converge toward the metal ion as in some loops of these proteins. The observed expansions with different lanthanide ions to the same peptide varied appreciably, suggesting dissimilar structures [Gariepy et al. (1983) Biochemistry 22, 1765-1772]; coordination to the simpler tetracarboxylate sequestrants, on the other hand, generated an expansion profile approximately as expected from the properties of the lanthanide series. The largest expansions were generated with peptide II (having the additional acidic group) for all lanthanides tested.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2765493 TI - Use of site-directed mutagenesis to destabilize native apomyoglobin relative to folding intermediates. AB - Site-directed mutagenesis has been used to study the effect on the stability of human apomyoglobin (apoMb) of modifying the size, hydrophobicity, and charge of a central residue in the G.B helix-helix packing interface. Some stability measurements have also been made on the corresponding holomyoglobins (heme present). Cys-110, a central helix pairing residue in the G helix, has been changed to Ala, Ser, Asp, and Leu. Stability to low-pH-induced unfolding has been measured for both native apoMb and the compact folding intermediate discovered by Griko et al. [Griko, Y. V., Privalov, P. L., Venyaminov, S. Y., & Kutyshenko, V. P. (1988) J. Mol. Biol. 202, 127-138]. As judged by its circular dichroism spectrum, this intermediate has a substantial helix content (about 35%). Whether or not this inferred helical structure is closely related to the myoglobin structure is not yet known. The mutational evidence shows that integrity of G.B helix pairing is important for the stability of apoMb as well as of myoglobin and that this helix pairing site is very sensitive to both steric and electrostatic disruption. Our results also suggest that G.B helix pairing does not stabilize the compact intermediate; hence, disrupting this site destabilizes the native protein relative to the compact intermediate. Such selective destabilization of the native state relative to equilibrium folding intermediates is not restricted to acid denaturation: urea denaturation of the Leu mutant appears to display at least one stable intermediate, while wild-type and the remaining mutant apoMbs undergo two-state urea unfolding transitions. PMID- 2765494 TI - Flash photolysis of the serum albumin-heme-CO complex. AB - Protoheme-CO in aqueous solution does not exhibit a geminate ligand recombination reaction. Addition of a protein, either globin or serum albumin, to which heme binds strongly, leads to an observable geminate reaction in aqueous solution. The bimolecular kinetic data for the albumin-heme-CO complex show two stable components, one heme-like in rate and difference spectrum, and one hemoglobin like. The geminate reaction correlates spectrally with the hemoglobin-like component. PMID- 2765495 TI - Selection of a nucleation-promoting element following chemical modification of tubulin. AB - Following a 16-h incubation with a large excess of 2,5-hexanedione (2,5-HD) while in the assembled state, bovine brain tubulin contained a powerful nucleating component, the presence of which lowered the dissociation rate from 83 s-1 for untreated tubulin to 13 s-1 for 2,5-HD-treated tubulin. This nucleating component could be selectively concentrated by sequential stringent (conditions of low temperature and low tubulin concentration) cycles of assembly and disassembly. In 2-(N-morpholino)ethanesulfonic acid buffer without glycerol, the critical concentration of assembly of untreated tubulin (2.4 mg/mL) was 19 times higher than that of 2,5-HD-treated tubulin subjected to three sequential stringent cycles of assembly and disassembly (0.13 mg/mL). This highly nucleating 2,5-HD treated tubulin preparation could both copolymerize with untreated tubulin and seed subcritical concentration assembly of untreated tubulin. Experiments to define the assembly-altering component have identified structural alterations to the alpha-tubulin monomer. While the alpha-tubulin subunit of native untreated tubulin dimer contained no chymotryptic cleavage sites, the native 2,5-HD-treated alpha-tubulin subunit was cleaved by chymotrypsin to yield a 37-kDa C-terminal fragment. PMID- 2765496 TI - Spectral observation of an acyl-enzyme intermediate of lipoprotein lipase. AB - There have been several studies indicating that hydrolysis reactions of fatty acid esters catalyzed by lipases proceed through an acyl-enzyme intermediate typical of serine proteases. In particular, one careful kinetic study with the physiologically important enzyme lipoprotein lipase (LPL) is consistent with rate limiting deacylation of such an intermediate. To observe the spectrum of acyl enzyme and study the mechanism of LPL-catalyzed hydrolysis of substrate, we have used a variety of furylacryloyl substrates including 1,2-dipalmitoyl-3-[(beta-2 furylacryloyl)triacyl]glyceride (DPFATG) to study the intermediates formed during the hydrolysis reaction catalyzed by the enzyme. After isolation and characterization of the molecular weight of adipose LPL, we determined its extinction coefficient at 280 nm to quantitate the formation of any acyl-enzyme intermediate formed during substrate hydrolysis. We observed an intermediate at low pH during the enzyme-catalyzed hydrolysis of (furylacryloyl)imidazole. This intermediate builds early in the reaction when a substantial amount of substrate has hydrolyzed but no product, furylacrylate, has been formed. The acyl-enzyme has a lambda max = 305 nm and a molar extinction coefficient of 22,600 M-1 cm-1; these parameters are similar to those for furylacryloyl esters including the serine ester. These data provide the first spectral evidence for a serine acyl enzyme in lipase-catalyzed reactions. The LPL hydrolysis reaction is base catalyzed, exhibiting two pKa values; the more acidic of these is 6.5, consistent with base catalysis by histidine. The biphasic rates for substrate disappearance or product appearance and the absence of leaving group effect indicate that deacylation of intermediate is rate limiting. PMID- 2765497 TI - Phosphorylated sites within the functional domains of the approximately 100-kDa steroid-binding subunit of glucocorticoid receptors. AB - The steroid-binding subunit of the glucocorticoid receptor is known to be a approximately 100-kDa phosphoprotein composed of an immunogenic, DNA-binding, and steroid-binding domain. When isolated from WEHI-7 cells, this protein contains between two and three phosphoryl groups per steroid-binding site (Mendel WEHI-7 cells, this protein contains between two and three phosphoryl groups per steroid binding site (Mendel et al., 1987). To identify the domains that contain these phosphorylated sites, we have analyzed the phosphate content of selected proteolytic fragments of the approximately 100-kDa steroid-binding protein from nonactivated and activated receptors. The approximately 100-kDa steroid-binding protein from WEHI-7 cells grown in the presence of [32P]orthophosphate was covalently labeled with [3H]dexamethasone 21-mesylate, purified with the BuGR2 monoclonal antibody, digested with chymotrypsin or trypsin, and analyzed by sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE). Chymotrypsin digestion of this protein yields a approximately 45-kDa fragment containing both the steroid-binding and DNA-binding domains, which contained both 32P and 3H. Trypsin digestion of the protein yields a approximately 29-kDa fragment encompassing the steroid-binding domain but not the DNA-binding domain of the approximately 100-kDa protein, which also contained both 32P and 3H. The 32P/3H ratio of each fragment provides a measure of phosphate content per steroid binding site and indicated that each fragment has approximately 30% of the phosphate content of the intact protein. This is sufficient to account for one of the three receptor phosphoryl groups.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2765498 TI - Cytochrome P-450 and oxygen toxicity. Oxygen-dependent induction of ethanol inducible cytochrome P-450 (IIE1) in rat liver and lung. AB - The ethanol-inducible form of cytochrome P-450 (P-450IIE1) has previously been shown to exhibit an unusually high rate of oxidase activity with the subsequent formation of reactive oxygen species, e.g., hydrogen peroxide, and to be the main contributor of microsomal oxidase activity in liver microsomes from acetone treated rats [Ekstrom & Ingelman-Sundberg (1989) Biochem. Pharmacol. (in press)]. The results here presented indicate that oxygen exposure of rats causes an about 4-fold induction of P-450IIE1 in rat liver and lung microsomes. The induction in liver was not accompanied by any measurable increase in the P-450IIE1 mRNA levels, but the enhanced amount of P-450IIE1 accounted for 60% of the net 50% increase in the level of hepatic P-450 as determined spectrophotometrically. The induction of P-450IIE1 was maximal after 60 h of O2 exposure, and concomitant increases in the rates of liver microsomal CCl4-dependent lipid peroxidation, O2 consumption, NADPH oxidation, O2- formation, H2O2 production, and NADPH-dependent microsomal lipid peroxidation were seen. Liver microsomes from oxygen-treated rats had very similar properties to those of microsomes isolated from acetone treated rats with respect to the P-450IIE1 content and catalytic properties, but different from those of thyroxine-treated animals. Treatment of rats with the P 450IIE1 inducer acetone in combination with oxygen exposure caused a potentiation of the NADPH-dependent liver and lung microsomal lipid peroxidation and decreased the survival time of the rats. The results reached indicate a role for cytochrome P-450 and, in particular, for cytochrome P-450IIE1 in oxygen-mediated tissue toxicity. PMID- 2765499 TI - DNA bending by the bulge defect. AB - Comparative gel electrophoresis measurements were used to characterize DNA bending in molecules containing an extra adenosine on one strand, the so-called bulge defect. We used oligomers containing A6 tracts separated from the bulged base by varying numbers of nucleotides to determine the direction and magnitude of the bulge bend. Helix unwinding by the bulge was determined from the electrophoretic anomaly as a function of the size of the repeated monomers. We conclude that the bulge bend is 21 degrees +/- 3 degrees, primarily in the direction of tilt away from the bulged base. The total helical advance of the DNA at the bulge site is smaller than would be the case if the complementary T were present, corresponding to an unwinding by 25 degrees +/- 6 degrees. These values are in good agreement with the results of NMR and energy minimization studies of the bulged base in double-helical deoxyoligonucleotides [Woodson, S. A., & Crothers, D.M. (1988) Biochemistry 27, 3130-3141] PMID- 2765500 TI - Dual-wavelength ratiometric fluorescence measurements of membrane potential. AB - This work shows that the voltage across membranes in two very different preparations, lipid vesicles in suspension and individual HeLa cells under a microscope, is linearly related to the ratio of fluorescence excited from the two wings of the absorption spectrum of a voltage-sensitive dye. The dye di-4-ANEPPS [1-(3-sulfonatopropyl)-4-[beta-[2-(di-n-butylamino)-6-naphthyl] vin yl]pyridinium betaine] is well characterized from earlier investigations and responds via a rapid (less than millisecond) spectral shift to membrane potential changes. The resultant small change in fluorescence intensity monitored at a single wavelength is useful for measurements of temporally well-defined voltage transients such as action potentials. The dual-wavelength approach described in this work extends the usefulness of this fast potentiometric dye by filtering out complex or artifactual changes in fluorescence intensity and providing a voltage-dependent signal that is internally standardized. Thus, rapid measurements of membrane potential are made possible in nonexcitable cells. PMID- 2765501 TI - Phosphorylation of chick heart muscarinic cholinergic receptors by the beta adrenergic receptor kinase. AB - Previous studies have demonstrated that muscarinic cholinergic receptors (mAChR) become markedly phosphorylated when intact cardiac cells are stimulated with a muscarinic agonist. This process appears to be related to the process of receptor desensitization. However, the mechanism of agonist-induced phosphorylation of mAChR is not known. In situ phosphorylation studies suggested that agonist induced phosphorylation of mAChR may involve the participation of a receptor specific kinase and/or require agonist occupancy. These observations regarding phosphorylation and desensitization of mAChR are similar to observations made for beta-adrenergic receptors. Recent studies have indicated that homologous desensitization of beta-adrenergic receptors may be due to the phosphorylation of these receptors by a novel protein kinase that only recognizes the agonist occupied form of the receptors. As muscarinic receptors are structurally homologous to beta-adrenergic receptors, we have initiated studies to identify the protein kinase responsible for the phosphorylation of muscarinic receptors by determining whether the chick heart muscarinic receptor would serve as a substrate for the beta-adrenergic receptor kinase (beta-AR kinase). We report that the purified and reconstituted chick heart muscarinic receptor serves as an excellent substrate in vitro for the beta-AR kinase. Phosphorylation of mAChR receptors by the beta-AR kinase was only observed in the presence of a muscarinic receptor agonist and was prevented in the presence of antagonist. Both the extent of phosphorylation (3-4 mol of P/mol of receptor) and the phosphoamino acid composition of the mAChR after incubation in vitro with beta-AR kinase were similar to the characteristics of agonist-induced phosphorylation of mAChR in situ.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2765503 TI - The kinetic mechanism of cation-catalyzed phosphatidylglycerol transbilayer migration implies close contact between vesicles as an intermediate state. AB - We have investigated variations in the rate of Mn2+-catalyzed phosphatidylglycerol transbilayer migration [Lentz, Madden, & Alford (1982) Biochemistry 21, 6799] with changes in phospholipid and cation concentration over more than a 100-fold range of both parameters. The slope of a double logarithmic plot of the rate of transbilayer lipid migration versus lipid concentration was 1.7, suggesting that lipid redistribution was dependent on vesicle aggregation or collision. A model involving transitory dimerization of vesicles was able to account for the concentration dependence of the transbilayer redistribution rate. The observed variation in rate with the logarithm of Mn2+ concentration was complex: linear above 0.4 microM (corresponding to roughly 2.5 Mn2+ per vesicle) but involving a steeper dependence on Mn2+ below 0.04 microM (roughly four vesicles per Mn2+). The rate of transbilayer redistribution increased substantially between 37 and 56 degrees C, yielding a nonlinear Arrhenius plot. There was no evidence of either fusion or lipid exchange between vesicles at the low concentrations of Mn2+ needed for transbilayer redistribution. The data are consistent with a model suggesting transitory "micro-domains" of a dehydrated, interbilayer complex as involved in the transition state and are inconsistent with a model involving an inverted micelle-type structure for the transition state. PMID- 2765502 TI - Lipoprotein lipase gene expression in THP-1 cells. AB - Lipoprotein lipase (LPL) mRNA levels are under the control of signals that activate phospholipase C, resulting in activation of protein kinase C (PKC) and mobilization of intracellular Ca2+ in the human monocytic leukemia cell line THP 1. Induction of LPL in THP-1 cells appears to be mediated by PKC since it was affected by both phorbol 12-myristate 13-acetate (PMA) and a diacylglycerol analogue. This induction was blocked by the specific PKC inhibitor H-7. Although Ca2+ mobilization by the ionophore A23187 also induced LPL mRNA, the mechanism is most likely independent of activation of the Ca2+/calmodulin protein kinase. Depletion of cells of PKC made them refractory to induction by A23187, suggesting that Ca2+ mobilization acts by activating PKC. Addition of cycloheximide (CHX) to undifferentiated THP-1 cells resulted in a transient increase in steady-state mRNA levels (3-fold). Sustained superinduction of LPL mRNA occurred when PMA and CHX were added simultaneously. These results suggest that the level of LPL mRNA is regulated either by a labile regulatory protein, which represses transcription of the LPL gene, or by a protein affecting mRNA stability. PMID- 2765504 TI - Analysis of protein-mediated 3-O-methylglucose transport in rat erythrocytes: rejection of the alternating conformation carrier model for sugar transport. AB - 3-O-Methylglucose (3OMG) transport in rat erythrocytes (RBCs) is mediated by a low-capacity, facilitated diffusion-type process. This study examines whether the characteristics of sugar transport in rat RBCs are consistent with the predictions of two diametric, theoretical mechanisms for sugar transport. The one site carrier describes a transport mechanism in which sugar influx and efflux substrate binding sites are mutually exclusive. The two-site carrier describes a transport mechanism in which sugar influx and efflux substrate binding sites can exist simultaneously but may interact in a cooperative fashion when occupied by substrate. Michaelis and velocity parameters for saturable 3OMG transport in rat erythrocytes at 24 degrees C were obtained from initial rate measurements of 3OMG transport. The results are incompatible with the predictions of the one-site carrier but are consistent with the predictions of a symmetric two-site carrier, displaying negligible cooperativity between substrate binding sites. This allows reduction of the two-site carrier transport equations to a form containing fewer constants than the one-site carrier equations without limiting their predictive success. While the available evidence does not prove that rat erythrocyte sugar transport is mediated by a two-site mechanism, we conclude that adoption of the formally more complex one-site model for sugar transport in rat erythrocytes is unnecessary and unwarranted. Counterflow experiments have also been performed in which the time course of radiolabeled 3OMG uptake is measured in cells containing saturating levels of 3OMG. The results of these experiments are consistent with the hypothesis [Naftalin et al. (1985) Biochim. Biophys. Acta 820, 235-249] that exchange of sugar between intracellular compartments (cell water and hemoglobin) can be rate limiting for transport under certain conditions. PMID- 2765505 TI - In vitro characterization of tissue-specific nuclear proteins preferentially bound to the mouse beta-globin gene during MEL cell terminal differentiation. AB - Using DNA restriction fragments of the mouse beta-globin gene and other promoter containing DNA fragments (LTR-MMTV and pBR322) as controls, we have characterized by protein blotting, in extracts of mouse erythroleukemia (MEL) cells, specific nuclear DNA binding proteins with a preferential affinity for the beta-globin DNA. Some proteins (110 and 75 kDa) appear in differentiated MEL cells while others (100, 95, and 35 kDa) are present in immature MEL and normal erythroblast cells and bind selectively to the far-upstream region of the gene. These proteins could modulate either positively or negatively the expression of the beta-globin gene and maybe, of other genes, during the terminal differentiation of erythroid cells. PMID- 2765506 TI - Effects of conversion of phenylalanine-31 to leucine on the function of human dihydrofolate reductase. AB - Oligonucleotide-directed, site-specific mutagenesis was used to convert phenylalanine-31 of human recombinant dihydrofolate reductase (DHFR) to leucine. This substitution was of interest in view of earlier chemical modification studies (Kumar et al., 1981) and structural studies based on X-ray crystallographic data (Matthews et al., 1985a,b) which had implicated the corresponding residue in chicken liver DHFR, Tyr-31, in the binding of dihydrofolate. Furthermore, this particular substitution allowed testing of the significance of protein sequence differences between mammalian and bacterial reductases at this position with regard to the species selectivity of trimethoprim. Both wild-type (WT) and mutant (F31L) enzymes were expressed and purified by using a heterologous expression system previously described (Prendergast et al., 1988). Values of the inhibition constants (Ki values) for trimethoprim were 1.00 and 1.08 microM for WT and F31L, respectively. Thus, the presence of phenylalanine at position 31 in human dihydrofolate reductase does not contribute to the species selectivity of trimethoprim. The Km values for nicotinamide adenine dinucleotide phosphate (reduced) (NADPH) and dihydrofolate were elevated 10.8-fold and 9.4-fold, respectively, for the mutant enzyme, whereas the Vmax increased only 1.8-fold. Equilibrium dissociation constants (KD values) were obtained for the binding of NADPH and dihydrofolate in binary complexes with each enzyme. The KD for NADPH is similar in both WT and F31L, whereas the KD for dihydrofolate is 43-fold lower in F31L. Values for dihydrofolate association rate constants (kon) with enzyme and enzyme-NADPH complexes were measured by stopped-flow techniques.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2765507 TI - Calculations of free energy profiles for the staphylococcal nuclease catalyzed reaction. AB - Calculations of the free energy profile for the first two (rate-limiting) steps of the staphylococcal nuclease catalyzed reaction are reported. The calculations are based on the empirical valence bond method in combination with free energy perturbation molecular dynamics simulations. The calculated activation free energy is in good agreement with experimental kinetic data, and the catalytic effect of the enzyme is reproduced without any arbitrary adjustment of parameters. The enormous reduction of the activation barrier (relative to the reference reaction in water) appears to be largely associated with the strong electrostatic effect of the Ca2+ ion and the two arginine residues in the active site. This favorable electrostatic environment reduces the cost of the general base catalysis step by almost 15 kcal/mol (by stabilizing the OH- nucleophile) and then stabilizes the developing negative charge on the 5'-phosphate group in the second step of the reaction by about 19 kcal/mol. The basic features of the originally postulated enzyme mechanism (Cotton et al., 1979) are found to be compatible with the observed activation free energy. However, the proposed modification of the mechanism (Sepersu et al., 1987), in which Arg 87 interacts only with the pentacoordinated transition state, is supported by the simulations. Further calculations on the D21E mutant also give results in good agreement with kinetic data. PMID- 2765508 TI - Conformational change of band 3 protein induced by diethyl pyrocarbonate modification in human erythrocyte ghosts. AB - Diethyl pyrocarbonate inhibited the phosphate exchange across the human erythrocyte membrane. The exchange rate was inhibited only when the membranes were modified with the reagent from the cytosolic surface of resealed ghosts. The intracellular modification by diethyl pyrocarbonate inhibited the extracellular binding of [3H]dihydro-4,4'-diisothiocyanostilbene-2,2'-disulfonic acid to band 3 protein. Furthermore, the extracellular 4,4'-dinitrostilbene-2,2'-disulfonic acid protected the membranes from the intracellular modification by diethyl pyrocarbonate. These results suggest that the extracellular binding of 4,4' dinitrostilbene-2,2'-disulfonic acid to band 3 protein induces the conformational change of the intracellular counterpart of band 3 protein and the diethyl pyrocarbonate susceptible residue(s) is (are) hidden from the cytosolic surface of the cell membrane in connection with the conformational change. Conversely, under the conditions where the diethyl pyrocarbonate modification is confined to the intracellular side of the membrane, the extracellular binding site of [3H]dihydro-4,4'-diisothiocyanostilbene-2,2'-disulfonic acid is hidden from the cell surface. PMID- 2765509 TI - Ca2+-dependent structural changes in bovine blood coagulation factor Va and its subunits. AB - The calcium dependence of the structures of bovine blood coagulation factor Va and its subunits (Vh and Vl) has been examined spectroscopically in order to characterize the conformational changes which accompany the binding of Ca2+ to Vh and Vl to form factor Va. The far-UV CD spectra of the isolated subunits indicate that the secondary structures of both Vh and Vl are predominantly beta-sheet (greater than 45%), with little alpha-helix content (less than 15%). No change in the far-UV CD spectrum was observed when factor Va was formed by the addition of Ca2+ to an equimolar mixture of Vl and Vh. Hence, no detectable change in secondary structure occurs during the formation of factor Va. In contrast, the addition of Ca2+ to an equimolar mixture of Vh and Vl caused a small (2%) increase in the total intrinsic fluorescence intensity and a blue shift in the emission spectrum that resulted from a tertiary structural change and/or the association of nonpolar surfaces at the subunit interface. This fluorescence change correlated closely with the appearance of functional factor Va, since the rate of the spectral change was the same as the rate of recovery of cofactor activity, and since both were half-maximal near 50 microM Ca2+. This fluorescence change required both subunits, was reversed by the addition of EDTA, and was observed only with metal ions that can substitute for Ca2+ in reconstituting factor Va activity from Vh and Vl (Mn2+ and Tb3+; not Mg2+). When a sample containing ANS (8-anilino-1-naphthalenesulfonate) and an equimolar mixture of calcium-free Vh and Vl was titrated with Ca2+, the ANS emission intensity decreased by about 30%, most likely because the association of Vl and Vh caused nonpolar regions at the subunit-subunit interface to become inaccessible for ANS binding. The calcium dependence of this spectral change yielded a Kd of 51 +/- 2 microM, and the rate of the decrease in ANS fluorescence occurred at nearly the same rate as the recovery of factor Va activity. Thus, both intrinsic and extrinsic fluorescence data, as well as other data, indicate that the calcium binding site in factor Va has an apparent Kd of 50 microM under our conditions and that the calcium-mediated binding between Vl and Vh involves hydrophobic interactions between the subunits.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2765510 TI - Expression and sequence analyses of serum amyloid A in the Syrian hamster. AB - Reactive amyloidosis occurs during chronic inflammation and involves deposition of amyloid A (AA) fibrils in many organs. Amyloid A is derived by proteolysis from serum amyloid A component (SAA), a major acute-phase reactant in many species. Since spontaneous amyloidosis occurs commonly in Syrian hamsters, we have studied the structure and expression of SAA genes during inflammation in these animals. Two cDNA clones and one genomic clone were sequenced, suggesting that Syrian hamster SAA is encoded by at least two genes. Hepatic mRNA analyses showed that SAA was inducible in many hamster organs during acute inflammation. These studies also demonstrated that SAA mRNA for one isotype is maximally expressed at a site of local tissue damage. PMID- 2765511 TI - Resonance raman investigations of site-directed mutants of myoglobin: effects of distal histidine replacement. AB - The resonance Raman spectra of met-, deoxy-, and (carbonmonoxy)myoglobin (MbCO) are studied as a function of amino acid replacement at the distal histidine-E7 position. The synthetic wild type is found to be spectroscopically identical with the native material. The methionine and glycine replacements do not affect the met or deoxy spectra but do lead to distinct changes in the nu Fe-CO region of the MbCO spectrum. The native MbCO displays a pH-dependent population redistribution of the nu Fe-CO modes, while the analogous population in the mutant systems is found to be pH independent. This indicates that histidine-E7 is the titratable group in native MbCO. Moreover, the pH dependence of the population dynamics is found to be inconsistent with a simple two-state Henderson Hasselbalch analysis. Instead, we suggest a four-state model involving the coupling of histidine protonation and conformational change. Within this model, the pK of the distal histidine is found to be 6.0 in the "open" configuration and 3.8 in the "closed" conformation. This corresponds to a 3 kcal/mol destabilization of the positively charged distal histidine within the hydrophobic pocket and suggests how protonation can lead to a larger population of the "open" conformation. At pH 7, the pocket is found to be "open" approximately 3% of the time. Further work, involving both IR and Raman measurements, allows the electron nuclear coupling strengths of the various nu Fe-CO and nu C-O Raman modes to be determined. The slowly rebinding conformational state, corresponding to nu Fe-CO = 518 cm-1 (nu C-O = 1932 cm-1), displays unusually weak coupling of the Fe-CO mode to the Soret transition. Studies of the nu Fe-CO region as a function of temperature reveal that the equilibria between the conformational states are quenched in both the native and glycine mutant below the freezing point of the solvent. Unusual line narrowing of the nu Fe-CO modes at the phase transition is also observed in all samples studied. This line narrowing stands in marked contrast to the other heme Raman modes and suggests that Fe-CO librational motion and/or distal pocket vibrational (or conformational) excitations are involved in the line broadening at room temperature. PMID- 2765512 TI - Refolding of denatured ribonuclease observed by size exclusion chromatography. AB - The unfolding and refolding of pancreatic ribonuclease have been observed by absorbance, fluorescence, and size exclusion chromatographic measurements in solutions of guanidinium chloride continuously maintained at pH 6.0 and 4 degrees C. The spectral measurements were fitted with a minimal number of kinetic phases while the chromatographic measurements were simulated from an explicit mechanism. All of the measurements are consistent with a minimal mechanism involving seven components. The folded components include the native protein and two transiently stable intermediates each having the same hydrodynamic volume. The intermediate having all native peptide isomers has an unfolding midpoint in 3.8 M denaturant while the intermediate having one nonnative peptide isomer has an unfolding midpoint in 1.3 M denaturant. The unfolded protein is distributed among four components having the same hydrodynamic volume but differing peptide isomers. At equilibrium, 10% of the denatured protein has all native isomers, 60% has one nonnative isomer, 5% has a different nonnative isomer, and 25% has both nonnative isomers. In low denaturant concentrations, the dominant component with one nonnative isomer can refold to transiently populate the compact intermediate with the same nonnative isomer. PMID- 2765513 TI - Pulse radiolytic measurement of redox potentials: the tyrosine and tryptophan radicals. AB - With the technique of pulse radiolysis we have measured the redox midpoint potentials of the tryptophan side chain neutral indolyl radical (1.05 +/- 0.01 V vs NHE, pH 7.0 and 25 degrees C) and the tyrosine side chain neutral phenoxy radical (0.94 +/- 0.01 vs NHE, pH 7.0 and 25 degrees C). These potentials were obtained by using a variety of inorganic reference compounds in both kinetic and equilibrium protocols. We compare these results with others already in the literature, and we also present data useful in establishing a pulse radiolysis redox reference scale over the range 0.42-1.28 V. PMID- 2765514 TI - Solution conformation of conotoxin GI determined by 1H nuclear magnetic resonance spectroscopy and distance geometry calculations. AB - Conformational analysis of conotoxin GI, one of the neurotoxic peptides produced by a marine snail, genus Conus, was performed by a combination of nuclear magnetic resonance spectroscopy (NMR) and distance geometry calculations. The resulting conformers on minimization of the target function were classified into two groups. The difference in the structures of the conformers is mainly due to the difference in the orientation of the side chain of the tyrosyl residue. The results show that the solution structure of conotoxin GI satisfies the conformational requirements for the biological activity of an antagonist toward nicotinic cholinergic receptors elucidated in a series of studies on alkaloids. The structure is discussed on the basis of the results of comparison of the atomic arrangements of the active sites of snake venom peptides and molecular models based on the results of secondary structure prediction. PMID- 2765515 TI - Electron-nuclear double resonance spectroscopy of 15N-enriched phthalate dioxygenase from Pseudomonas cepacia proves that two histidines are coordinated to the [2Fe-2S] Rieske-type clusters. AB - We have performed ENDOR spectroscopy at microwave frequencies of 9 and 35 GHz at 2 K on the reduced Rieske-type [2Fe-2S] cluster of phthalate dioxygenase (PDO) from Pseudomonas cepacia. Four samples have been examined: (1) 14N (natural abundance); (2) uniformly 15N labeled; (3) [15N]histidine in a 14N background; (4) [14N]histidine in a 15N background. These studies establish unambiguously that two of the ligands to the Rieske [2Fe-2S] center are nitrogens from histidine residues. This contrasts with classical ferredoxin-type [2Fe-2S] centers in which all ligation is by sulfur of cysteine residues. Analysis of the polycrystalline ENDOR patterns has permitted us to determine for each nitrogen ligand the principal values of the hyperfine tensor and its orientation with respect to the g tensor, as well as the 14N quadrupole coupling tensor. The combination of these results with earlier Mossbauer and resonance Raman studies supports a model for the reduced cluster with both histidyl ligands bound to the ferrous ion of the spin-coupled [Fe2+ (S = 2), Fe3+ (S = 5/2)] pair. The analyses of 15N hyperfine and 14N quadrupole coupling tensors indicate that the geometry of ligation at Fe2+ is approximately tetrahedral, with the (Fe)2(N)2 plane corresponding to the g1-g3 plane, and that the planes of the histidyl imidazoles lie near that plane, although they could not both lie in the plane. The bonding parameters of the coordinated nitrogens are fully consistent with those of an spn hybrid on a histidyl nitrogen coordinated to Fe. Differences in 14N ENDOR line width provide evidence for different mobilities of the two imidazoles when the protein is in fluid solution. We conclude that the structure deduced here for the PDO cluster is generally applicable to the full class of Rieske-type centers. PMID- 2765516 TI - Occurrence and inducibility of cytochrome P450IIIA in maternal and fetal rats during prenatal development. AB - The purpose of this study was to quantify cytochrome P450IIIA1 in fetal and maternal livers of uninduced and pregnenolone-16 alpha-carbonitrile (PCN) induced rats during the course of prenatal development. The activities and levels of P450IIIA in hepatic microsomes from maternal rats and fetuses at 15-21 days of gestation were measured by triacetyloleandomycin (TAO) inhibited debenzylation of (benzyloxy)phenoxazone and by immunoassay with defined antiserum specific for P450IIIA. P450IIIA was not detectable (less than 10 pmol/mg for maternal microsomes and less than 2 pmol/mg for fetal microsomes) by immunoassay in uninduced maternal or fetal livers. In hepatic microsomes from PCN-induced dams, values ranged from 59.3 to 116 micrograms P450IIIA1/mg of protein during the same gestational period. Changes in debenzylase activity of 15.9-46.5 pmol of resorufin (mg of protein)-1 min-1 were consistent with these findings as were the changes in TAO-inhibitable debenzylase activity. In the transplancentally induced fetal liver, debenzylase activity increased steadily from 0.19 pmol of resorufin mg-1 min-1 at day 15 to 9.34 pmol of resorufin mg-1 min-1 at day 21 and was paralleled by the TAO-inhibitable activity that ranged from 0.09 pmol of resorufin mg-1 min-1 at day 15 to 3.33 pmol of resorufin mg-1 min-1 at day 21. The amount of immunoreactive P450IIIA1 also increased from 0.5 to 28.7 micrograms/mg of microsomal protein.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2765517 TI - 31P NMR magnetization-transfer measurements of ATP turnover during steady-state isometric muscle contraction in the rat hind limb in vivo. AB - 31P NMR magnetization-transfer measurements have been used to measure the flux between ATP and inorganic phosphate during steady-state isometric muscle contraction in the rat hind limb in vivo. Steady-state contraction was obtained by supramaximal sciatic nerve stimulation. Increasing the stimulation pulse width from 10 to 90 ms, at a pulse frequency of 1 Hz, or increasing the frequency of a 10-ms pulse from 0.5 to 2 Hz resulted in an increase in the flux which was an approximately linear function of the increase in the tension-time integral. The flux showed an approximately linear dependence on the calculated free cytosolic ADP concentration up to an ADP concentration of about 90 microM. The data are consistent with control of mitochondrial ATP synthesis by the cytosolic ADP concentration and indicate that the apparent Km of the mitochondria for ADP is at least 30 microM. PMID- 2765518 TI - Resonance energy transfer between the active sites of rabbit muscle creatine kinase: analysis by steady-state and time-resolved fluorescence. AB - Resonance energy transfer between the reactive thiols of rabbit muscle creatine kinase was evaluated. The reactive thiols are located at the active site, one occurring on each subunit of the dimeric protein that is known to be a constituent of the M-line structure of the myofibril. Transfer efficiency was evaluated from energy donor quenching of fluorescence by steady-state and phase modulation lifetime measurements and determination of sensitized emission of the acceptor. Several sulfhydryl-specific donor fluorophores were used including 5 [[[(iodoacetyl)amino]ethyl]amino]naphthalene-1-sulfonic acid, 7-(dimethylamino)-3 (4-maleimidylphenyl)-4-methylcoumarin, and 2-[4 (iodoacetamido)anilino]naphthalene-6-sulfonic acid (IAANS). Energy transfer acceptors included 5-(iodoacetamido)fluorescein and the nonfluorescent dye [4-[[4 (dimethylamino)phenyl]azo]phenyl]iodoacetamide. In order to prepare the necessary homodimer labeled with both donor and acceptor, advantage was taken of the biphasic reaction between creatine kinase and IAANS. In some instances, donor/acceptor hybrids were prepared by denaturation/renaturation procedures, and possible deviations from expected hybridization stoichiometry were considered. Disproportionation of singly labeled dimers (to unlabeled and doubly labeled dimers) was not observed when the brain isozyme of creatine kinase was used to trap dissociated dye-conjugated or unlabeled muscle-type subunits of creatine kinase. From studies of five different donor/acceptor combinations, the efficiency of energy transfer was found to occur over a range of 5-14%, indicating that the reactive thiols are well separated. Overlap integrals and quantum yields were evaluated, and estimates of the range of orientation factor were obtained to determine a range for the distance between the active sites of creatine kinase. When the ranges are overlapped, a limited distance of 48.6-60.4 A is obtained.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2765519 TI - RNA catalytic properties of the minimum (-)sTRSV sequence. AB - We have identified an RNA catalytic domain within the sequence of the 359 base long negative-strand satellite RNA of tobacco ringspot virus. The catalytic domain contains two minimal sequences of satellite RNA, a 50-base catalytic RNA sequence, and a 14-base substrate RNA sequence. The catalytic complex of catalytic RNA/substrate RNA represents a structure not previously found in any RNA catalytic reaction described to date. The reaction is truly catalytic since the catalytic RNA has multiple substrate cleavage events and is not consumed during the course of the reaction. A linear relationship is seen between reaction rate and catalytic RNA concentration. The reaction has a Km of 0.03 microM, a kcat of 2.1/min, a temperature optimum of near 37 degrees C, and an energy of activation of 19 kcal/mol. PMID- 2765520 TI - Binding energetics of phosphorus-containing inhibitors of thermolysin. AB - The importance of a specific hydrogen bond between thermolysin and a phosphonamidate inhibitor, Z-NHCH2-PO(O-)-Leu-Leu (1) [Bartlett, P. A., & Marlowe, C. K. (1987) Science (Washington D.C.) 235, 569-571], has been reevaluated. We have determined the inhibition constants (binding free energies) for thermolysin of phosphonamidate n-hexyl-P(O)(O-)-Leu-Trp-NHMe (4), phosphonate n-hexyl-P-(O)(O-)OCH(iBu)CO-Trp-NHMe (5), and phosphinates n-hexyl-P(O)(O )CH2CH(iBu)CO-Trp-NHMe (6) and Z-NHCH2PO(O-)CH2CH(iBu)CO-Leu (3). Replacement of the P-NH group by P-CH2 (1----3 and 4----6) weakens the overall binding free energy by about 1.5 kcal/mol. A negligible difference in solvation energy has been measured for these pairs, and the basicity of the P-O- ligand for zinc in each pair remains nearly unchanged as determined by pH titration of their 31P NMR resonances. Therefore, this value of 1.5 kcal/mol can be assigned to the specific hydrogen bond known to exist between the P-NH of 1 and thermolysin [Tronrud, D. E., Holden, H. M., & Matthews, B. W. (1987) Science (Washington, D.C.) 235, 871 574] and inferred to exist between 4 and the enzyme. Substitution of P-O for P-NH (1----2 [Bartlett, P. A., & Marlowe, C. K. (1987) Science (Washington, D.C.) 235, 569-571] and 4----5) weakens the overall binding free energy by 4.1 kcal/mol for each pair as the basicity of the P-O- ligand decreases by about 1.6 pH units. The measured solvation energy difference between 4 and 5 (and by inference between 1 and 2) is negligible.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2765521 TI - Characterization of the L lambda phase in trehalose-stabilized dry membranes by solid-state NMR and X-ray diffraction. AB - Solid-state nuclear magnetic resonance (NMR) spectroscopy and X-ray powder diffraction were used to investigate the mechanism of trehalose (TRE) stabilization of lipid bilayers. Calorimetric investigation of dry TRE-stabilized bilayers reveals a first-order phase transition (L kappa----L lambda) at temperatures similar to the L beta'----(P beta')----L alpha transition of hydrated lipid bilayers. X-ray diffraction studies show that dry mixtures of TRE and 1,2-dipalmitoyl-sn-phosphatidylcholine (DPPC) have a lamellar structure with excess crystalline TRE being present. The L kappa phase shows typical gel-phase X ray diffraction patterns. In contrast, the L lambda-phase diffraction patterns indicate disordered hydrocarbon chains. 2H NMR of specifically 2H chain-labeled DPPC confirmed that the acyl chains are disordered in the L lambda phase over their entire lengths. 2H spectra of the choline headgroup show hindered molecular motions as compared to dry DPPC alone, and 13C spectra of the sn-2-carbonyl show rigid lattice powder patterns indicating very little motion at the headgroup and interfacial regions. Thus, the sugar interacts extensively with the hydrophilic regions of the lipid, from the choline and the phosphate moieties in the headgroup to the glycerol and carbonyls in the interfacial region. We postulate that the sugar and the lipid form an extensive hydrogen-bonded network with the sugar acting as a spacer to expand the distance between lipids in the bilayer. The fluidity of the hydrophobic region in the L lambda phase together with the bilayer stabilization at the headgroup contributes to membrane viability in anhydrobiotic organisms. PMID- 2765522 TI - Thermodynamics of intersubunit interactions in cholera toxin upon binding to the oligosaccharide portion of its cell surface receptor, ganglioside GM1. AB - The binding and the energetics of the interaction of cholera toxin with the oligosaccharide portion of ganglioside GM1 (oligo-GM1), the toxin cell surface receptor, have been studied by high-sensitivity isothermal titration calorimetry and differential scanning calorimetry. Previously, we have shown that the association of cholera toxin to ganglioside GM1 enhances the cooperative interactions between subunits in the B-subunit pentamer [Goins, B., & Freire, E. (1988) Biochemistry 27, 2046-2052]. New experiments presented in this paper reveal that the oligosaccharide portion of the receptor is by itself able to enhance the intersubunit cooperative interactions within the B pentamer. This effect is seen in the protein unfolding transition as a shift from independent unfolding of the B promoters toward a cooperative unfolding. To identify the origin of this effect, the binding of cholera toxin to oligo-GM1 has been measured calorimetrically under isothermal conditions. The binding curve at 37 degrees C is sigmoidal, indicating cooperative binding. The binding data can be described in terms of a nearest-neighbor cooperative interaction binding model. In terms of this model, the association of a oligo-GM1 molecule to a B protomer affects the association to adjacent B promoters within the pentameric ring. The measured intrinsic binding enthalpy per protomer is -22 kcal/mol and the cooperative interaction enthalpy -11 kcal/mol. The intrinsic binding constant determined calorimetrically is 1.05 x 10(6) M-1 at 37 degrees C and the cooperative Gibbs free energy equal to -850 cal/mol.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2765523 TI - Influence of glycolipid oligosaccharide and long-chain base composition on the thermotropic properties of dipalmitoylphosphatidylcholine large unilamellar vesicles containing gangliosides. AB - The thermotropic behavior of dipalmitoylphosphatidylcholine large unilamellar vesicles containing gangliosides has been studied by high-sensitivity heating and cooling differential scanning calorimetry. These studies have been directed to identify and evaluate the influence of both the ganglioside lipidic portion and oligosaccharide moiety on the physical properties of phospholipid bilayers containing gangliosides. The influence of the ganglioside lipidic portion has been evaluated by studying the behavior of vesicles containing different GD1a molecular species carrying homogeneous lipid moieties (C20 or C18 sphingosine or sphinganine and stearic acid). The influence of the ganglioside saccharide portion was evaluated by investigating the thermotropic behavior of vesicles containing different gangliosides (GM1, Fuc-GM1, GD1a, GT1b) carrying the same homogeneous long-chain base moiety (C20 sphingosine and stearic acid). These studies, in conjunction with previous studies using homogeneous lipidic portion ganglioside GM1 and phosphatidylcholines of various chain lengths [Masserini, M., & Freire, E. (1986) Biochemistry 25, 1043-1049], indicate that, for a given oligosaccharide composition, gangliosides exhibit lateral phase separation in an extent dependent upon the length and unsaturation difference between the ganglioside long-chain base and phosphatidylcholine acyl chains. For a given ganglioside lipidic composition the extent of phase separation is dependent upon the number of sugar units present in the glycolipid. The addition of Ca2+ induces or enhances phase separation in a manner dependent on the long-chain base and oligosaccharide composition. Cooling differential scanning calorimetry experiments showed that the ganglioside property to form aggregates within the membrane is independent of the initial physical state of the bilayer.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2765524 TI - Fluorescence depolarization of cis- and trans-parinaric acids in artificial and red cell membranes resolved by a double hindered rotational model. AB - Although steady-state anisotropy measurements of phase-sensitive probes provide a qualitative description of the phase behavior of biomembranes, there is little information about the physical state of lipid domains. We have developed a ground state double hindered rotator model (DHR) for fluorescence anisotropy decay, in which probes possess separate rotational correlation times and r infinity in each phase. To validate the model, multifrequency differential phase angles (delta) and modulation amplitudes (lambda) were measured in a two-compartment cuvette with combinations of POPOP, TMA-DPH, and DPH in isotropic solvents and in DPPC liposomes. Rotational parameters obtained by fitting the DHR model were similar to those of a single hindered rotator model fitted to data obtained separately for each probe. As predicted by the model, negative delta and decreasing lambda with increasing modulation frequency were obtained when fluorophores in isotropic solvents were paired with fluorophores in DPPC liposomes. The rotational parameters of the phase-sensitive fluorophores cis-parinaric (cPnA) and trans parinaric (tPnA) acid in DPPC/DMPC (1:0, 0:1, and 1:1) liposomes were determined at 15-40 degrees C. Two lifetimes (1 and 3 ns) were obtained above the phase transition temperature (Tc); greater than 95% of the fluorescence intensity was described by two lifetimes (3-9 and 12-32 ns) below Tc. Negative delta values were obtained when solid-phase lipid was present. r infinity varied from 0.26 0.32 below to 0.11-0.14 above Tc; at intermediate T, where two phases coexists, r infinity values were approximately 0.23 and approximately 0.31. These data indicate very hindered PnA rotation in solid-phase lipid.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2765525 TI - Elucidation of intermediate (mobile) and slow (solidlike) protein motions in bovine lens homogenates by carbon-13 NMR spectroscopy. AB - The motional dynamics of lens cytoplasmic proteins present in calf lens homogenates were investigated by two 13C nuclear magnetic resonance (NMR) techniques sensitive to molecular motion to further define the organizational differences between the cortex and nucleus. For the study of intermediate (mobile) protein rotational reorientation motion time scales [rotational correlation time (tau 0) range of 1-500 ns], we employed 13C off-resonance rotating frame spin-lattice relaxation, whereas for the study of slow (solidlike) motions (tau 0 greater than or equal to 10 microseconds) we used the solid-state NMR techniques of dipolar decoupling and cross-polarization. The frequency dependence of the peptide bond carbonyl off-resonance rotating frame spectral intensity ratio of the lens proteins present in native calf nuclear homogenate (42% protein) at 35 degrees C indicates the presence of a polydisperse mobile protein fraction with a tau 0,eff (mean) value of 57 ns. This mean value is consistent with the average value calculated from the known water-soluble nuclear lens protein polydispersity assuming a cytoplasmic viscosity 3 times that of pure water. Lowering the temperature to 1 degree C, a temperature which produces the cold cataract, results in an overall decrease in tau 0,eff to 43 ns, suggesting a selective removal of beta H-, LM-, and possibly gamma s-crystallins from the mobile lens protein population. The presence of solidlike or motionally restricted protein species was established by dipolar decoupling and cross polarization. The fraction of motionally restricted protein in the nuclear region varied from 0.35 to 0.45 in the temperature range of 35-1 degree C. For native cortical homogenate (25% protein), the off-resonances rotating frame spectral intensity ratio frequency-dependent curves for the protein carbonyl resonance yielded tau 0,eff values of 34 and 80 ns at 35 and 1 degree C, respectively. Both values were reconciled with the known lens cortex soluble protein polydispersity using an assumed cytoplasmic viscosity 1.5 times that of pure water at the same temperature. Comparison of proton dipolar-decoupled and nondecoupled 13C NMR spectra of native cortical homogenate at 20 degrees C indicates the absence of significant contributions from slowly tumbling, motionally restricted species. This interpretation was confirmed by the failure to detect significant lens protein 13C-1H cross-polarization at this temperature. However, at 1 degree C, the fraction of solidlike protein was 0.15. Concentrated cortical homogenates at 20 degrees C (42% protein), by contrast, gave cross-polarization spectra with maximum absolute signal intensities 50-70% of native nuclear homogenates, but with similar magnetization parameters... PMID- 2765526 TI - Dynamics of Antarctic fish microtubules at low temperatures. AB - The tubulins of Antarctic fishes, purified from brain tissue and depleted of microtubule-associated proteins (MAPs), polymerized efficiently in vitro to yield microtubules at near-physiological and supraphysiological temperatures (5, 10, and 20 degrees C). The dynamics of the microtubules at these temperatures were examined through the use of labeled guanosine 5'-triphosphate (GTP) as a marker for the incorporation, retention, and loss of tubulin dimers. Following attainment of a steady state in microtubule mass at 20 degrees C, the rate of incorporation of [3H]GTP (i.e., tubulin dimers) during pulses of constant duration decreased asymptotically toward a constant, nonzero value as the interval prior to label addition to the microtubule solution increased. Concomitant with the decreasing rate of label incorporation, the average length of the microtubules increased, and the number concentration of microtubules decreased. Thus, redistribution of microtubule lengths (probably via dynamic instability and/or microtubule annealing) appears to be responsible for the time dependent decrease in the rate of tubulin uptake. When the microtubules had attained both a steady state in mass and a constant length distribution, linear incorporation of labeled tubulin dimers over time occurred at rates of 1.45 s-1 at 5 degrees C, 0.48 s-1 at 10 degrees C, and 0.18 s-1 at 20 degrees C. Thus, the microtubules displayed greater rates of subunit flux, or treadmilling, at lower, near-physiological temperatures. At each temperature, most of the incorporated label was retained by the microtubules during a subsequent chase with excess unlabeled GTP.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2765527 TI - Oxidative metabolism of spironolactone: evidence for the involvement of electrophilic thiosteroid species in drug-mediated destruction of rat hepatic cytochrome P450. AB - In a preliminary paper [Decker et al. (1986) Biochem. Biophys. Res. Commun. 136, 1162] we have shown that the antimineralocorticoid spironolactone (SPL) preferentially inactivates dexamethasone (DEX) inducible rat hepatic cytochrome P450p isozymes in a suicidal manner. These findings are now confirmed, and the kinetic characteristics of such a process are detailed. In an effort to elucidate the mechanism of SPL-mediated inactivation of cytochrome P450, we have examined the metabolism of SPL in vitro. Incubation of [14C]SPL and NADPH with liver microsomes prepared from DEX-pretreated rats results in the formation of several polar metabolites separable by HPLC with UV detection. This process is found to be dependent on NADPH, O2, SPL, and enzyme concentration, as well as temperature. Furthermore, metabolite formation was significantly attenuated by P450 inhibitors CO and n-octylamine. Mass spectral analysis (thermospray LC/MS, FAB/MS, and FAB/MS/MS) of the two most prominent polar metabolites indicated that these compounds had molecular weights that corresponded to the sulfinic and sulfonic acid derivatives of deacetyl-SPL (SPL-SH). These findings document the formation of previously unreported polar metabolites of SPL by rat liver microsomes enriched in cytochrome P450p and implicate a role for this isozyme in the oxidation of the thiol moiety of deacetyl-SPL. The detection of such metabolites also implicates a catalytic trajectory that includes the thiyl radical and/or sulfenic acid species as a plausible protagonist in drug-mediated inactivation of cytochrome P450p. PMID- 2765528 TI - A subfamily of bovine prolactin-related transcripts distinct from placental lactogen in the fetal placenta. AB - The placentae of many species express genes homologous to the pituitary hormones. In the bovine, two transcripts distinct from the pituitary hormones have been previously described: bovine placental lactogen (bPL) and bovine prolactin related cDNA I (bPRCI). Here we provide evidence for a subfamily of prolactin related transcripts quite different from bPL and the rodent placental homologues, which include proliferin and rat prolactin-related proteins. Bovine prolactin related cDNAs II and III (bPRCII and bPRCIII) are about 75% similar in nucleotide sequence to one another and bPRCI, but only 56% similar to bPL, and about 45% to the rodent placental transcripts. The deduced amino acid sequences follow a similar pattern: they are about 60% similar to one another, but only about 35% similar to bPL as well as the predicted rodent placental proteins. mRNA levels corresponding to bPL, bPRCI, and bPRCIII in the fetal placenta show distinct patterns. The role of these predicted hormones during pregnancy remains to be determined. PMID- 2765529 TI - Transient spectroscopy of bacterial rhodopsins with an optical multichannel analyzer. 1. Comparison of the photocycles of bacteriorhodopsin and halorhodopsin. AB - We used a gated optical multichannel analyzer to measure transient flash-induced absorption changes in bacteriorhodopsin (BR) and halorhodopsin (HR) and developed criteria for calculating the absorption spectra of the photocycle intermediates and the kinetics of their rise and decay. The results for BR agree with data reported by a large number of other authors. The results for HR in the presence of chloride are consistent with earlier data and reveal an additional intermediate, not previously seen, in the submicrosecond time scale. Although an M412-like intermediate is not in the HR photocycle, a one-by-one comparison of the rest of the intermediates observed for BR and HR indicates a striking similarity between the photocycles of the two bacterial rhodopsins. This was previously not apparent, perhaps because the experimental approaches to the spectroscopy of the two pigments were different and the data were thus more fragmented. PMID- 2765530 TI - Transient spectroscopy of bacterial rhodopsins with an optical multichannel analyzer. 2. Effects of anions on the halorhodopsin photocycle. AB - We find that the photocycle of halorhodopsin (HR) in the presence of nitrate (but not chloride) consists of two parallel series of reactions. The first is essentially the same as that which occurs in the presence of chloride: HRhv--- HRK----HRKL----HRL----HRO----HR. The second photocycle, however, which we describe as HRhv----HR'K----HRKO----HRO----HR, seems characteristic of what one would observe in the absence of chloride. Absorption spectra are calculated for all species but HRK and HR'K, which occur at shorter times (less than 60 ns) than we can resolve. At nitrate concentrations between 0.1 and 1 M, the proportion of HR which enters the first kind of photocycle increases in such a way as to suggest that nitrate can substitute for chloride, but much less effectively. At lower anion concentrations, the two photocycles are independent of one another, but at higher concentrations, they interact; i.e., the reaction HRKO----HRO--- HRL can be observed. Thus, HRO must be common to the two photocycles. Kinetic fitting of the time dependence of HRL and HRO at different chloride concentrations provides evidence for the participation of chloride in the interconversion of HRL and HRO. The results are consistent with a model in which the photoreaction is influenced by the binding of an anion (either chloride or nitrate) to site II in HR: when an anion is bound, the HRK-initiated HRL-type photocycle is observed, but when the site is not occupied, the HR'K-initiated HRO type photocycle is seen. PMID- 2765531 TI - Expression of two kallikrein gene family members in the rat prostate. AB - We have characterized two kallikrein gene family members expressed in the prostate and submaxillary glands of rats. One mRNA (S3) is identical with the previously characterized submaxillary gland S3 mRNA that encodes an enzyme closely related to tonin. The second mRNA (P1) encodes a novel kallikrein-like enzyme that retains key amino acid residues responsible for the characteristic enzymatic cleavage specificity of kallikrein. Two P1-specific oligonucleotide probes derived from the P1 mRNA sequence were used to demonstrate the presence of P1 mRNA in the prostate and submaxillary glands and its absence in eight other rat tissues known to express one or more members of the kallikrein family. The P1 coding gene (rGK-8) was identified among genomic clones containing kallikrein family members by hybridization with a P1-specific oligonucleotide probe. The identification of the P1 gene was verified by nucleotide sequencing; the exon sequences of rGK-8 match the P1 mRNA sequence. The upstream region of rGK-8, where transcriptional regulatory elements likely reside, is very similar to that of other rat kallikrein family genes which are expressed in distinct tissue specific patterns. PMID- 2765532 TI - An unusual polyanion from Physarum polycephalum that inhibits homologous DNA polymerase alpha in vitro. AB - From extracts of microplasmodia of Physarum polycephalum and their culture medium, an unusual substance was isolated which inhibited homologous DNA polymerase alpha of this slime mold but not beta-like DNA polymerase and not heterologous DNA polymerases. Analysis, especially NMR spectroscopy, revealed the major component to be an anionic polyester of L-malic acid and the inhibition to be due to poly(L-malate) in binding reversibly to DNA polymerase alpha. The mode of inhibition is competitive with substrate DNA and follows an inhibition constant Ki = 10 ng/mL. Inhibition is reversed in the presence of spermine, spermidine, poly(ethylene imine), and calf thymus histone H1. According to its ester nature, the inhibitor is slightly labile at neutral and instable at acid and alkaline conditions. Its largest size corresponds to a molecular mass of 40 50 kDa, but the bulk of the material after purification has lower molecular masses. The inhibitory activity depends on the polymer size and has a minimal size requirement. PMID- 2765533 TI - 1H NMR characterization of Chromatium gracile high-potential iron protein and its ruthenium-modified derivatives. Modulation of the reduction potentials in low- and high-potential [Fe4S4] ferredoxins. AB - The NMR spectra of the high-potential iron protein from the photosynthetic bacterium Chromatium gracile and its ruthenium-labeled (His-42 and His-20) derivatives are reported. The isotropically shifted resonances in both the oxidized and reduced forms show a complex pH dependence due to the presence of three ionizable residues (Glu-44, His-20, and His-42). Assignments have been made to specific residues and the spectral features compared to those of other bacterial HiPIP's. The decrease in the reduction potential with increasing pH for this class of proteins is attributed to stabilization of the oxidized state of the cluster by delocalization of electron density onto the neighboring Tyr-19 residue. PMID- 2765534 TI - Macro and micro rate zonal analytical centrifugation of polydisperse and slowly diffusing sedimenting systems in isovolumetric density gradients. Application to cartilage proteoglycans. AB - A method to study the polydispersity of zonally sedimenting and slowly diffusing macromolecules or particles in isokinetic or isovolumetric density gradients is presented. First, a brief theory is given for predicting the zonal profile after a "triangular" (or "inverse") zone is centrifuged. This type of zone is essential to preserve hydrodynamic stability of the very slowly diffusing polydisperse solutes. It is proven, both by semitheoretical considerations and by computer calculations, that the resulting concentration profile of macrosolute is almost identical with that obtainable with a rectangular zone coextensive with the triangular one and carrying the same total mass. Next, practical procedures are described for the convectionless layering of very small triangular zones (50 microL or less). The linearity and stability of the zones are experimentally tested and verified. Finally, the method is applied to cartilage proteoglycan preparations that included either the monomeric molecules only or both the monomeric and the aggregated ones. The zonal results are compared with those obtained by using conventional boundary sedimentation. The two sets of results are seen to coincide fairly well, thus proving that the present technique can add to preparative zonal centrifugation the analytical precision of boundary sedimentation. A multimodal polydisperse system is suggested to describe the aggregated proteoglycan macromolecules. PMID- 2765535 TI - A proton nuclear magnetic resonance investigation of the anion Bohr effect of human normal adult hemoglobin. AB - High-resolution proton nuclear magnetic resonance spectroscopy has been used to investigate the molecular mechanism of the Bohr effect of human normal adult hemoglobin in the presence of two allosteric effectors, i.e., chloride and inorganic phosphate ions. The individual hydrogen ion equilibria of 22-26 histidyl residues of hemoglobin have been measured in anion-free 0.1 M HEPES buffer and in the presence of 0.18 M chloride or 0.1 M inorganic phosphate ions in both deoxy and carbonmonoxy forms. The results indicate that the beta 2 histidyl residues are strong binding sites for chloride and inorganic phosphate ions in hemoglobin. The affinity of the beta 2-histidyl residues for these anions is larger in the deoxy than in the carbonmonoxy form. Nevertheless, the contribution of these histidyl residues to the anion Bohr effect is small due to their low pK value in deoxyhemoglobin in anion-free solvents. The interactions of chloride and inorganic phosphate ions with the hemoglobin molecule also result in lower pK values and/or changes in the shapes of the hydrogen ion binding curves for several other surface histidyl residues. These results suggest that long range electrostatic interactions between individual ionizable sites in hemoglobin could play an important role in the molecular mechanism of the anion Bohr effect. PMID- 2765536 TI - Anthracycline incorporation in human lymphocytes. Kinetics of uptake and nuclear concentration. AB - Fluorescence emission spectra from anthracycline-treated cells suspended in buffer have been studied. The kinetics of uptake and the nuclear concentration of anthracyclines in human lymphocytes have thus been determined using the fluorescence properties of these drugs. Four anthracyclines have been used: adriamycin (ADR), 4'-O-tetrahydropyranyl-adriamycin (THP-ADR), carminomycin (CAR) and aclacinomycin A (ACM). We have shown that no quenching of the drug fluorescence is obtained through interaction of the drugs with the various components of the cell except the nucleus. No quenching is observed with cells lacking nucleus such as platelets and erythrocytes. Quenching of drug fluorescence occurs when drugs intercalate between base pairs of DNA only. This allows rapid determination of the amount of drug intercalated between nuclear base pairs in the steady state. We have thus estimated that one molecule of drug can bind for every 10, 8.3, 10 and 6.7 DNA base pairs in the case of ADR, THP ADR, ACM and CAR, respectively. The kinetics of drug incorporation into the nucleus, once the cells have been solubilized with triton X-100, is very fast for the four drugs. However, the kinetics of drug uptake by the intacts cells strongly depends on the nature of the drug. When 10(9) cells/l are incubated with 1 microM drug, 50% of the final nuclear concentration is reached within 97 min, 3.2 min, 3.0 min and 1.2 min in the case of ADR, THP-ADR, CAR and ACM, respectively. The kinetics directly correlates with the polarity of the molecule. PMID- 2765537 TI - Effects of altering carbohydrate metabolism on energy status and contractile function of vascular smooth muscle. AB - Substrate-dependent changes in vascular smooth muscle energy metabolism and contractile function were investigated in isolated porcine carotid arteries. In media containing glucose glycogen catabolism accounted for all the estimated high energy phosphate turnover that occurred in conjunction with contraction induced by 80 mM KCl. However, in glucose-free media glycogen catabolism accounted for only a portion of the estimated ATP utilization in resting and contracting arteries, even though glycogen stores were not depleted. The glycogenolysis and lactate production that ordinarily accompanies contraction was completely inhibited by 5 mM 2-deoxyglucose (2-DG). However, there was no decrease in the high-energy phosphate levels when compared to control resting arteries similarly treated with 2-DG. The results suggest that an endogenous non-carbohydrate source may be an important substrate for energy metabolism. Treatment of arteries with 50 microM iodoacetate (IA) in media containing glucose resulted in a marked reduction of high energy phosphate levels and an accumulation of phosphorylated glycolytic intermediates, as demonstrated by 31P-NMR spectroscopy. In glucose free media, 50 microM IA had only a slight effect on high-energy phosphate levels, while glycogenolysis proceeded unhindered. With 1 mM IA in glucose-free media, the oxidative metabolism of glycogen was inhibited as evidenced by the depletion of high-energy phosphates and the appearance of sugar phosphates in the 31P-NMR spectra. Thus, the titration of enzyme systems with IA reveals a structural partitioning of carbohydrate metabolism, as suggested by previous studies. PMID- 2765538 TI - Alteration in protein kinase C activity and subcellular distribution in sickle erythrocytes. AB - In agreement with previous data, membrane protein phosphorylation was found to be altered in intact sickle cells (SS) relative to intact normal erythrocytes (AA). Similar changes were observed in their isolated membranes. The involvement of protein kinase C (PKC) in this process was investigated. The membrane PKC content in SS cells, measured by [3H]phorbol ester binding, was about 6-times higher than in AA cells. In addition, the activity of the enzyme, measured by histone phosphorylation was also found to be increased in SS cell membranes but decreased in their cytosol compared to the activity in AA cell membranes and cytosol. The increase in membrane PKC activity was observed mostly in the light fraction of SS cells, fractionated by density gradient, whereas the decrease in cytosolic activity was only observed in the dense fraction. PKC activity, measured in cells from the blood of reticulocyte-rich patients, exhibited an increase in both membranes and cytosol, thus explaining some of the effects observed in the SS cell light fraction, which is enriched in reticulocytes. The increase in PKC activity in the membranes of SS cells is partly explained by their young age but the loss of PKC activity in their cytosol, particularly in that of the dense fraction, seems to be specific to SS erythrocytes. The relative decrease in membrane PKC activity between the dense and the light fractions of SS cells might be related to oxidative inactivation of the enzyme. PMID- 2765539 TI - Adrenal cytochrome P-45011 beta-proteoliposomes catalyzing aldosterone synthesis: preparation and characterization. AB - Purified cytochrome P-45011 beta from bovine adrenocortical mitochondria was successfully incorporated into the liposome membranes composed of phosphatidylcholine, phosphatidylethanolamine and cardiolipin at a molar ratio of 2:2:1. The incorporation of P-45011 beta into the liposome membranes was ascertained by the Ficoll density gradient centrifugation and the protein refractoriness to trypsin digestion. The prepared proteoliposomes containing P 45011 beta and phospholipid at a molar ratio of 1:3000 were unilamellar vesicles of about 40 nm in average diameter. The P-45011 beta embedded in the liposome membranes was found to be more stable than the detergent-solubilized form. The reconstituted system containing the P-45011 beta-proteoliposomes, adrenodoxin and NADPH-adrenodoxin reductase showed catalytic activities not only for the hydroxylation of 11-deoxycorticosterone at 11 beta- and 18-positions but also for its conversion into aldosterone with a turnover number of 2.3 nmol/min per nmol of P-45011 beta. A successive reaction without the intermediates leaving from the enzyme was suggested for the P-45011 beta-mediated conversion of 11 deoxycorticosterone to aldosterone following the result that the formation of aldosterone was linear with respect to time without the lag phase; this was confirmed by the result that radioactivity in aldosterone from 3H-labeled 11 deoxycorticosterone was scarcely decreased by the addition of unlabeled intermediates to the reactions system. PMID- 2765540 TI - Role of monovalent cations in fluid secretion from the exocrine rabbit pancreas. AB - The role of Na+ in fluid secretion by the isolated rabbit pancreas was investigated. The fluid secretion rate is reduced upon replacement of Na+ in the bathing medium by Li+, K+ or choline. The inhibition depends on the nature of the substituting cation, and is largest with choline. Upon replacement, the substituent cation appears in the secreted fluid, and the Na+ concentration in the secreted fluid is decreased in a mirror-like fashion. When Na+ is replaced by Li+ or choline, the secretory Na+ concentration is decreased, although less than in the bathing medium, and the K+ concentration is increased. When Na+ is replaced by K+, the Na+ and the K+ concentration in the secreted fluid are approximately equal to their bathing medium concentrations. In the Li+ and choline medium, stimulation of the pancreas by carbachol or CCK-8 increases the fluid secretion rate. In addition, it increases the Li+ or choline concentration, and decreases the Na+ and K+ concentrations in the secreted fluid. In normal and K+ medium, stimulation causes only a slight increase in fluid secretion rate, with no change in the secretory Na+ concentration. In normal medium, stimulation leads to a decrease in the secretory K+ concentration. The effects of replacing Na+ appear to be the result of a direct inhibition of the active HCO3- transport underlying secretion, and an indirect inhibition related to the permeability of the pancreas for the various cations. The stimulants are likely to act by increasing the permeability of the tight junctions. PMID- 2765541 TI - A model for fluid secretion in the exocrine pancreas. AB - Fluid secretion by the isolated rabbit pancreas is strongly dependent on the presence of Na+ in the bathing medium. Substitution of Na+ by another cation such as Li+ or K+ causes an inhibition of fluid secretion rate and a change in the composition of the secreted fluid which is dependent on the nature of the substituent cation. Stimulation of the pancreas by CCK-8 or carbachol increases paracellular ion permeability and, in some cases, also fluid secretion rate. We present a simple, quantitative model for ion and water secretion which accounts for the effects observed upon Na+ substitution and stimulation. The main features are active, Na+-dependent transcellular HCO3- transport and passive, paracellular cation and anion permeation. The activity of the HCO3- pump is dependent on the energy status of the cell and on the Na+ concentration in the bathing medium, and is competitively inhibited by K+. The paracellular ion permeabilities can be modulated by stimulatory agonists. We examine the extent to which, according to the model, fluid secretion is controlled by the various system parameters such as ion permeabilities and ion pump activity, and by external parameters such as the ion concentrations in the bathing medium. In addition, calculation of the effects of changes in these parameters are carried out in order to gain more insight in the mechanisms of secretion. PMID- 2765542 TI - Parinaroyl and pyrenyl phospholipids as probes for the lipid surface layer of human low density lipoproteins. AB - A simple protocol employing lipid transfer proteins was developed to label human low density lipoprotein (LDL) in a controlled manner with parinaroyl and pyrenyl phosphatidylcholines. In order to study the lipid fluidity in the surface lipid layer of LDL, the temperature-dependence of both polarization (parinaroyl probes) and excimer to monomer (E/M) intensity ratio (pyrenyl probes) were analyzed. A series of pyrenyl phosphatidylcholines containing a pyrenyl fatty acid varying from 6 to 14 carbons in length at the sn-2 position were inserted into LDL to investigate the lateral distribution of different phosphatidylcholines in the lipoprotein surface at 37 degrees C. Both polarization and E/M vs. temperature plots displayed discontinuities in the region of 22-32 degrees C, which coincides with the melting of the neutral lipid core, indicating that the latter induces an ordered to more disordered phase transition in the surface lipid layer. Determination of the E/M intensity ratio as a function of pyrene lipid concentration in LDL showed a linear relationship for the pyrenyl hexanoate and octanoate species, whereas a slope discontinuity was observed for the lipids containing a longer pyrenyl chain. These data suggest that two lipid domains with distinct properties exist in the surface layer and secondly, pyrenyl lipids partition between these domains in a chainlength-dependent manner. This is consistent with measurement of the tryptophan to pyrene energy transfer efficiency vs. pyrenyl lipid concentration, which showed a biphasic relationship for the long-chain pyrenyl lipids. These measurements further indicate that two surface lipid domains correspond to the protein-lipid boundary and the bulk lipid phase, respectively. The fact that relatively small changes in chainlength have a marked influence on the partitioning of pyrenyl lipids between the boundary and the bulk phase suggests also that native phospholipid species may not be randomly distributed in the surface lipid layer of LDL. PMID- 2765543 TI - Triphasic effects of short chain n-alcohols on synaptic membrane transport of choline and of gamma-aminobutyric acid. AB - n-Alcohols, when added in increasing concentrations, had an unusual triphasic effect on the uptake of choline and of gamma-aminobutyric acid by isolated synaptosomes. There was slight inhibition of these uptakes at low n-alcohol concentrations, followed by a sharp peak of uptake enhancement, and then greater inhibition. The n-alcohol concentrations required for these effects were proportional to published n-alcohol membrane/buffer partition coefficients, with the peaks of uptake enhancement occurring at 60 mM n-propanol, 20 mM n-butanol and 7.5 mM n-pentanol. Synaptosomal membrane potential, as estimated from synaptosomal accumulation of the permeant cation [3H]tetraphenylphosphonium, was not affected by n-alcohols in the concentrations used in this study, suggesting that neither the inhibitory or enhancing effects of these n-alcohols were attributable to changes in trans-synaptosomal membrane ion gradients. The inhibiting and enhancing effects of n-alcohols could be reproduced in determinations of gamma-aminobutyric acid uptake by isolated synaptic plasma membranes, suggesting that the observed effects are due to a direct action of the n-alcohols on the synaptosomal plasma membrane. These effects may be attributable to a change in membrane binding of these alcohols from the membrane core to the membrane surface as alcohol concentration is increased. PMID- 2765544 TI - Study of the transcortin binding to human endometrium plasma membrane. AB - Transcortin complexed with progesterone was shown to bind specifically to the plasma membrane of human decidual endometrium. The binding reaction was characterized by a high affinity (an apparent Kd value was (1.0 +/- 0.2).10(-10) mol/l) and high selectivity: such human serum proteins as albumin, orosomucoid, transferrin, thyroxine-binding globulin and sex hormone-binding globulin did not compete with transcortin for the membrane binding sites. Transcortin binding to the membrane was steroid-dependent: transcortin-cortisol complex bound to the membranes substantially more weakly than transcortin-progesterone, and specific binding of transcortin devoid of steroid was not detected. Using a radioimmunoassay, we have measured the concentration of endogenous transcortin in highly purified membrane preparations solubilized with sodium cholate. It was found that an extensive washing of decidual strips with a physiological buffer prior to the membrane isolation resulted in a decrease of the endogenous transcortin level along with an increase of the specific membrane binding of exogenous 125I-labeled transcortin. Affinity chromatography on immobilized transcortin was used to isolate transcortin-binding components from 125I-labeled, cholate-solubilized plasma membrane of decidual endometrium. Along with lipid components, the structure of which was not investigated, a 125I-labeled transcortin-binding sialoglycoprotein with a minimal Mr of 20.0 +/- 1.5 kDa and a pI of approx. 3.3 was detected. In the presence of transcortin, this sialoglycoprotein could be precipitated with a monospecific antitranscortin antiserum. Using hydroxylapatite as a separating agent, the interaction of transcortin and the membrane sialoglycoprotein in model systems containing the two proteins and various steroid hormones was studied. It was found that the membrane sialoglycoprotein displayed a higher affinity for transcortin progesterone than for transcortin-cortisol (the Kd values were, respectively, 2.10(-11) and 7.10(-11) mol/l) and it did not bind transcortin complexed with testosterone. PMID- 2765545 TI - Lipid permeability of the intestinal microvillus membrane may be modulated by membrane fluidity in the rat. AB - Fatty acids and cholesterol permeate across the intestinal microvillus membrane at rates dictated by the hydrophobicity of the permeating lipid and the permeability properties of the microvillus membrane. A theory has evolved suggesting that the chemical composition and physical properties of the microvillus membrane are important in determining microvillus membrane lipid permeability in vivo. This communication reports a test of this hypothesis. To compare in vivo membrane lipid permeability within the same intestinal region, but under conditions were membrane physical properties were radically altered, rats were fed an inhibitor of cholesterol synthesis. This resulted in the replacement of 87-90% of membrane cholesterol with its' precursor, 7 dehydrocholesterol. Marked changes in membrane physical properties were observed, including a reduction in the static and dynamic component of membrane fluidity within the jejunal microvillus membrane. These changes were limited primarily to the outer regions of the bilayer. Associated with these alterations was a pronounced reduction in membrane lipid permeability. Therefore, microvillus membrane lipid permeability, in vivo, appears to be correlated with physical properties of the bilayer, especially those of the superficial regions. PMID- 2765546 TI - The spectroscopic analysis for binding of amphipathic and antimicrobial model peptides containing pyrenylalanine and tryptophan to lipid bilayer. AB - The binding of basic amphipathic fluorescent peptides to lipid bilayers was studied in relation to their antimicrobial activity. Four fluorescent peptides containing pyrenylalanine or tryptophan in an amphipathic basic peptide (4(4] consisting of four repeated units of tetrapeptide, -L-Leu-L-Ala-L-Arg-L-Leu-, were found to have antimicrobial activities against Gram-positive bacteria and to take conformations with fairly high alpha-helical content both in aqueous solutions and liposomes. The fluorescence spectroscopic data suggested that the pyrenylalanine-peptide existed as a monomer in methanol or liposomes but as an oligomer in aqueous solutions to form an excimer between pyrenylalanyl residues. Upon binding with liposomes, the fluorescence spectra of the tryptophan containing peptide shifted to a shorter wavelength, indicating the change in the state of tryptophan from hydrophilic environment to hydrophobic one. The analytical data for the quenching of tryptophan fluorescence by I- anion suggest that the tryptophan residue in the peptide is not deeply buried in the hydrophobic core of the bilayers. Based on these findings, it is suggested that the peptides may interact with liposomes in such a manner that they lie parallel to the surface of the lipid bilayers with their hydrophobic regions shallowly in the amphipathic moiety of the bilayers. PMID- 2765547 TI - Senescence-induced alteration in cell surface carbohydrates correlated using proton NMR spectroscopy and a lectin-based affinity-binding assay. AB - Changes in the cell surface oligosaccharides in human fetal lung fibroblasts (IMR 90) are studied as the cells progress to senescence using nuclear magnetic resonance spectroscopy (NMR) and a biochemical assay. A lectin-based affinity binding technique is used which measures the organization of carbohydrates on the cell surface. Proton NMR studies of the water in samples of frozen cell suspensions of young and old cells provide information on the local dynamics of the cell surface by monitoring the motion of bound water. Changes in the lectin binding density and affinity class distribution correlate with a decrease in the water proton linewidth in frozen cells. These observations reflect alterations in the conformation or structure of the cell surface oligosaccharides and local constituent water. PMID- 2765548 TI - How many Na+-dependent carriers for L-alanine and L-proline in the eel intestine? Studies with brush-border membrane vesicles. AB - Using brush-border membrane (BBM) vesicles prepared from the intestine of the European eel, the specificity of L-alanine and L-proline Na+-dependent transport was investigated by measuring the uptake of isotopically labelled substrates. In the presence of Na+ ions, cross-inhibition between alanine and proline transports was observed; in addition alpha-(methylamino)isobutyric acid (MeAIB) inhibited proline but had no effect on alanine uptake. These results can be explained by the presence, in eel intestinal BBM vesicles, of at least two distinct agencies for Na+-dependent proline and alanine translocation. The first system is specific for alanine and short-chain neutral amino acids; the second system, specific for imino acids and the N-methylated analogues, is regulated by alanine concentration. PMID- 2765549 TI - Lipid bilayer permeation by neutral aluminum citrate and by three alpha-hydroxy carboxylic acids. AB - Several groups have proposed that aluminum (Al) may permeate biological membranes as a neutral complex with citrate. We tested this hypothesis by measuring aluminum citrate flux across unilamellar phospholipid vesicles (liposomes). Results from two independent procedures show that lipid bilayer permeation by the neutral aluminum-citrate complex is slow (P approximately equal to 1 x 10(-11) cm.s-1). We then compared aluminum-citrate permeation with permeation by a series of alpha-hydroxy carboxylic acids and by trimethylcitrate. This comparison showed that the aluminum-citrate flux is limited by diffusion across the water/lipid interface. This is due to hydrogen bonding between water and the citrate carboxyl groups, and by hydration of the bound metal in the aqueous phase. By analogy with citric acid, steric hindrance of diffusion within the bilayer does not affect the permeation rate of aluminum citrate. Elevated tissue levels of Al in subjects fed a diet supplemented with citric acid and Al(OH)3 cannot be explained by lipid bilayer permeation of the neutral complex. PMID- 2765550 TI - Solubilization of DMPC and DPPC vesicles by detergents below their critical micellization concentration: high-sensitivity differential scanning calorimetry, Fourier transform infrared spectroscopy and freeze-fracture electron microscopy reveal two interaction sites of detergents in vesicles. AB - The interaction of sodium deoxycholate, sodium cholate and octyl glucoside with sonicated vesicles of L alpha-dimyristoyl-phosphatidylcholine (DMPC) and L alpha dipalmitoylphosphatidylcholine (DPPC) at concentrations below the critical micellization concentration (cmc) of the detergents was studied by high sensitivity DSC (hs-DSC), Fourier transform infrared spectroscopy (FT-IR) and freeze-fracture electron microscopy. The two phospholipids exhibited a striking different thermotropic behaviour in the presence of these detergents. For DPPC vesicles, the detergents were found to interact exclusively in the aqueous interface region of the bilayer below the membrane saturation concentration Rsat while in DMPC vesicles two coexisting interaction sites below this concentration persist. These are detergents which interact at the aqueous interface region (site 1) and in the acyl chain region (site 2) of the DMPC vesicles. The partition coefficients K of the detergents between DPPC vesicles and the water phase were calculated from the hs-DSC results at two detergent/phospholipid molar ratios Rtot less than or equal to Rsat as 0.35, 0.049 and 0.040 mol-1 for sodium deoxycholate, sodium cholate and octyl glucoside, respectively. In contrast, for DMPC the K values for Rtot less than or equal to Rsat were found to be dependent on Rtot due to the occupation of site 2 by the detergents above a certain Rtot. The model is discussed on the basis of the detergents free energies of transfer from the water phase to site 1 and site 2 of the vesicles, respectively. The solubilization behaviour of DPPC vesicles, dependent on whether the total detergent concentration is above or below the cmc at Rsat, differed significantly as revealed by hs-DSC. This suggests that in the latter case an additional hydrophobic effect could facilitate the formation of disc shaped mixed micelles. Moreover, this different behaviour was employed to measure the cmc values of the detergents studied in the presence of the vesicles by hs-DSC. PMID- 2765551 TI - Electrogenic uptake of D-imino acids by luminal membrane vesicles from rabbit kidney proximal tubule. AB - Some characteristics of electrogenic uptake of D-proline and hydroxy-D-proline by luminal membrane vesicles isolated either from pars convoluta or from pars recta of rabbit proximal tubule were indirectly studied by the spectrophotometric method. In vesicles from pars convoluta, the uptake of D-imino acids was mediated by both Na+-dependent and Na+-independent, but electrogenic processes. Indirect evidence for coupling between D-imino acids and H+ fluxes was obtained by the following observations: (1) Addition of the H+ ionophore (FCCP) to the vesicle dye (3,3'-diethyloxadicarbocyanine iodide) suspension completely abolished the Na+-independent electrogenic uptake of D-proline and hydroxy-D-proline by membrane vesicles from pars convoluta. (2) Addition of a relatively low concentration of D-proline in the incubation system decreased the H+-gradient dependent renal uptake of radioactive L-proline to approx. 60% of the control value. By contrast, the uptake of D-proline in vesicles from pars recta was strictly Na+-dependent, since no transient depolarization of membrane vesicles was ever observed in the absence of Na+. A comparison between the transport characteristics of D-imino acids and their naturally occurring L-isomers indicated that these compounds probably share common transport systems located along the proximal tubule of rabbit kidney. PMID- 2765552 TI - Changes in surface capacitance and conductance parallel to phospholipid membranes associated with phase transition: effects of halothane. AB - The effects of phase transition on the surface capacitance and conductance parallel to dipalmitoyl- (DPPC) and dimyristoyl-phosphatidylcholine (DMPC) membranes were studied by impedance dispersion. The phospholipid aggregates were embedded into pores of a polycarbonate filter and the impedance dispersions were measured at a frequency range from 30 Hz to 1.0 MHz. When the frequency was below 120 kHz, the capacitance showed a peak at the pretransition temperature and a steep rise at the main-transition temperature. In this system, the observed capacitance consists of frequency-dependent and -independent parts. The frequency dependent part is a surface phenomenon and arises from the lateral motion of counterions at the membrane/water interface. The frequency-independent part represents mainly the properties of the bulk lipid phase. Addition of halothane decreased the total capacitance of the DPPC aggregates at the low frequency range to 1/2 to 1/8 of the control depending upon the temperature. The surface component was solely responsible for this capacitance decrease, because the non surface component was slightly increased instead. The data suggest that halothane inhibited the lateral ionic flow parallel to the interface. PMID- 2765553 TI - Reactions of 1-bromo-2-[14C]pinacolone with acetylcholinesterase from Torpedo nobiliana. Effects of 5-trimethylammonio-2-pentanone and diisopropyl fluorophosphate. AB - 1-Bromo-2-[14C]pinacolone, (CH3)3C14COCH2Br [( 14C]BrPin), was prepared from [1 14C]acetyl chloride and tert-butylmagnesium chloride with cuprous chloride catalyst, followed by bromination. It was examined as an active-site directed label for acetylcholinesterase (acetylcholine acetylhydrolase, EC 3.1.1.7) (AcChE). AcChE, isolated from Torpedo nobiliana, has k(cat) = (4.00 +/- 0.04).10(3) s-1, Km = 0.055 +/- 0.008 mM in hydrolysis of acetylthiocholine, and k(cat) = (5.6 +/- 0.2).10(3) s-1, Km = 0.051 +/- 0.003 mM in hydrolysis of acetylcholine. BrPin, binding in the trimethyl cavity, acts initially as a reversible competitive inhibitor, Ki = 0.20 +/- 0.09 mM, and, with time, as an irreversible covalently bound inactivator. Introduction of 14C from [14C]BrPin into Torpedo AcChE at pH 7.0 was followed by SDS-PAGE, autoradiography and scintillation counting, in the absence and presence of 5-trimethylammonio-2 pentanone (TAP), a competitive inhibitor (Ki = 0.075 +/- 0.001 mM) isosteric with acetylcholine; 1.8-1.9 14C was incorporated per inactivated enzyme unit at 50% inactivation. TAP retarded inactivation by [14C]BrPin, and prevented introduction of 0.9-1.1 14C per unit of enzyme protected. Prior inactivation of AcChE by BrPin prevents reaction with [3H]diisopropyl fluorophosphate [( 3H]DFP). Prior inactivation by DFP or [3H]DFP does not prevent reaction with [14C]BrPin, and this subsequent reaction with BrPin does not displace the [3H] moiety. [14C]BrPin alkylates a nucleophile in the active site, and this reaction does not alkylate or utilize the serine-hydroxyl. PMID- 2765555 TI - Effects of Ca2+ and Zn2+ on trifluoperazine-S100 proteins interactions: induced circular dichroism and fluorescence spectra. AB - Interactions of trifluoperazine (TFP) with S100 proteins, EF-hand type Ca2+ binding proteins, in the presence of Ca2+ and Zn2+ were studied with induced circular dichroism (CD) and fluorescence spectra. The positive CD bands of TFP were induced at around 265 nm by adding either S100a or S100a0 protein in the presence of Ca2+. No CD band of TFP was, however, induced by adding S100b protein in the presence of Ca2+. Addition of Zn2+ to the TFP/S100 protein solutions did not induce any CD band at all. The fluorescence intensity of 2-p toluidinylnaphthalene 6-sulfonate (TNS) bound to S100a or S100a0 protein decreased by adding TFP in the presence of Ca2+, while that bound to S100b protein decreased by adding TFP in the presence of Zn2+, indicating that TFP binds to S100a protein and S100a0 protein in a Ca2+-dependent manner and to S100b protein in a Zn2+-dependent manner. From these results together with other experimental findings it was suggested that (1) TFP binds to S100a protein and S100a0 protein in the presence of Ca2+, with half-saturation points of 18 and 3 microM, respectively, (2) TFP binds to S100b protein only in the presence of Zn2+, (3) alpha-subunit of S100 protein binds to TFP specifically in a Ca2+ dependent manner and beta-subunit in a Zn2+-dependent manner. PMID- 2765554 TI - Synthesis and biological properties of 4-norleucine-neuropeptide Y; secondary structure of neuropeptide Y. AB - Neuropeptide Y (NPY) is a 36 amino acid peptide amide isolated from porcine brain. The NPY analog, 4-norleucine-NPY was synthesized by a solid-phase method and purified to homogeneity in 20% yield by reverse-phase chromatography. Investigation of the biological properties indicated that the analog is an agonist of NPY. Secondary structural analyses revealed that NPY and the analog exhibited predominantly alpha-helical and beta-sheet structures, respectively; however, experiments in trifluoroethanol indicated that the analog has the potential of assuming an alpha-helical structure. Based on circular dichroism (CD), Raman spectroscopy and Chou-Fasman analyses, a model has been proposed for the secondary structure of NPY. PMID- 2765556 TI - Characterization of rat and human steroid sulfatases. AB - Rat and human steroid sulfatases were purified from liver and placenta, respectively, by the same procedure. The rat and human enzymes were solubilized with Triton X-100, and purified by immunoaffinity chromatography with a monoclonal antibody showing high binding activities to both the enzymes. They were further purified by high-pressure anion-exchange chromatography to compare their structural and catalytic properties. Sodium dodecyl sulfate-polyacrylamide gel electrophoresis showed that both enzymes had a molecular weight of 62,000. The enzymes had similar amino acid compositions and amino-terminal amino acid sequences. Significant differences of the optimum pH, Michaelis constant and maximum velocity were observed between these enzymes. The optimum pH of each enzyme varied from 6.0 to 8.0, depending on substrates and with or without Triton X-100. In detergent-free media, steroid sulfates competitively inhibited the ability of these enzymes to hydrolyze 4-nitrophenyl sulfate. In media containing Triton X-100, on the other hand, the inhibition types of the steroid sulfates on the hydrolyzing activities of the rat and human enzymes were noncompetitive- and mixed-types, respectively. PMID- 2765557 TI - Time-resolved fluorescence studies on protoporphyrin IX-apohorseradish peroxidase. AB - The hemin moiety of horseradish peroxidase (donor:hydrogen-peroxide oxidoreductase, EC 1.11.1.7) was removed and the apoprotein reconstituted with the fluorescent protoporphyrin IX. Steady-state and time-resolved fluorescence properties of the HRP(desFe) adduct were examined; the multifrequency phase and modulation method was utilized for lifetime and dynamic polarization studies. The emission spectrum of HRP(desFe) had maxima at 633 and 696 nm. The lifetime of this emission was characterized by a single exponential decay of 16.87 ns at 22 degrees C. Debye rotational relaxation times for HRP(desFe) were determined using both static (Perrin plot) and dynamic (differential phase and modulation fluorometry) methods; these two approaches gave values of 96 and 86 ns, respectively. A spherical protein of HRP's molecular weight and partial specific volume would be expected to have a Debye rotational relaxation time, at 22 degrees C, in the range of 50 to 60 ns, depending upon the extent of hydration. Hence our results indicate that HRP(desFe) is asymmetric; the global rotational relaxation times observed are consistent with those of a prolate ellipsoid with an axial ratio of 3:1. PMID- 2765558 TI - Comparative spectroscopic studies of four crotoxin homologs and their subunits. AB - Structures of four related neurotoxins and their purified subunits from the venoms of Crotalus durissus terrificus, C. vegrandis, C. s. scutulatus and C. viridis concolor were examined by circular dichroism (CD), deconvolution Fourier transform infrared (FTIR) and fluorescence spectroscopy. CD spectra suggest that in general, the isolated subunits were decreased slightly in alpha-helix, while they were increased in beta-sheet structure, relative to intact toxins. These results were consistent with FTIR results. Fluorescence quenching (50-80%) was also observed in three of the four intact toxins as compared to spectra predicted by summation of free acidic and basic subunit spectra. It was tempting to conclude from these results that major conformational changes occur in individual subunits upon formation of the dimeric toxins. Intact crotoxin, however, when exposed to urea, yields spectra (CD, FTIR and fluorescence) that are virtually identical to control intact crotoxin. These findings suggest that the enhanced fluorescence exhibited by the isolated subunits, as well as the secondary structural changes in alpha-helix and beta-sheet, are artifacts resulting from irreversible structural changes that occur during subunit isolation by urea ion exchange chromatography. In spite of these structural changes, LD50 values of intact crotoxin reassembled from isolated subunits are unaltered from those of native crotoxin. PMID- 2765559 TI - Spectroscopic characterization of textilotoxin, a presynaptic neurotoxin from the venom of the Australian eastern brown snake (Pseudonaja t. textilis). AB - Spectroscopic behavior of textilotoxin, from the venom of Pseudonaja t. textilis, and its subunits were investigated using fluorescence, circular dichroism and Fourier transform infrared spectroscopy. Circular dichroism spectra of the B, C and D subunits indicate considerable similarity in their alpha-helix and beta sheet contents. By contrast, the A subunit displays significantly more beta-sheet and 'remainder' structure. FTIR spectra confirm conclusions drawn from CD spectra. Fluorescence spectra indicate that, in general, tryptophan residues in the A, B and D subunits are relatively exposed to the solvent. The C subunit exhibits no fluorescence, suggesting a lack of tryptophan. Comparisons of individual subunit spectra with those of the intact toxin suggest that significant changes in secondary structure may occur when the toxin dissociates. PMID- 2765560 TI - The monoclonal antibody AE-2 modulates fetal bovine serum acetylcholinesterase substrate hydrolysis. AB - The monoclonal antibody (mAb) AE-2 decreases the rate of hydrolysis of acetylthiocholine (ATC) by fetal bovine serum acetylcholinesterase (acetylcholine acetylhydrolase EC 3.1.1.7) (FBS-AChE) (Doctor, B.P. et al. (1989) Proc. 32nd Oholo Conf., Eilat, Israel, in press), but increases the rate of hydrolysis (Vmax) of the nonpolar substrate, indophenyl acetate (IPA) approx. 15-fold. The affinity (Km) of FBS-AChE for IPA changes minimally in comparison with the increase in the rate of hydrolysis. The complex is dissociated, and the modulation of substrate hydrolysis is reversed by the active-center ligand, 1 methyl-2-hydroxyiminomethylpyridinium chloride (2-PAM). PMID- 2765561 TI - Nonpolar interactions in the modification of an essential sulfhydryl of sorbitol dehydrogenase by N-alkylmaleimides. AB - A series of N-alkylmaleimides varying in chainlength from N-methyl- to N octylmaleimide inclusive was shown to effectively inactivate sheep liver sorbitol dehydrogenase at pH 7.5 and 25 degrees C. The apparent second-order rate constants for inactivation increased with increasing chainlength of the N alkylmaleimide used. Positive chainlength effects were also indicated by the Kd values for the N-ethyl and N-heptyl derivatives obtained from studies of the saturation kinetics observed for inactivation of the enzyme at high concentrations of these maleimides. The complete inactivation of sorbitol dehydrogenase was demonstrated to occur through the selective covalent modification of one cysteine residue per subunit of enzyme. The stoichiometry of enzyme inactivation was supported on the one hand by fluorescence titration with fluorescein mercuric acetate of the native and the inactivated enzyme, and, on the other hand, by the simultaneous inactivation of the enzyme with selective modification of one sulfhydryl per subunit by N-[p-(2 benzoxazolyl)phenyl]maleimide. Protection of the enzyme from N-alkylmaleimide inactivation was observed with the binding of NADH, whereas both NAD and sorbitol were ineffective as protecting ligands. Diazotized 3-aminopyridine adenine dinucleotide, in contrast to previous studies of this reagent with yeast alcohol dehydrogenase and rabbit muscle glycerophosphate dehydrogenase, did not function as a site-labeling reagent for sorbitol dehydrogenase. PMID- 2765562 TI - Calcium regulates thioredoxin reductase in human metastatic melanoma. AB - Thioredoxin reductase has been purified from human metastatic melanotic melanoma and amelanotic melanoma tissues. Enzyme from the melanotic melanoma tissue contains bound calcium showing classical sigmoidal allosteric kinetics, whereas enzyme from the amelanotic melanoma yielded normal Michaelis-Menten saturation with substrate. Calcium inhibition can be partially reversed by oxidized thioredoxin. 45Ca has been used to label the amelanotic melanoma enzyme in order to determine the number of calcium-binding sites. These isotope experiments yielded only one calcium-binding site per enzyme molecule. Enzyme labeled with 45Ca was dialyzed for 24 h without loss of radioactivity, but the addition of oxidized thioredoxin to this labeled enzyme caused 60% calcium exchange in 24 h. Comparative studies with Escherichia coli thioredoxin reductase showed similar calcium inhibition as well as partial reactivation with oxidized thioredoxin. The enzyme from E. coli previously sequenced by others, showed considerable homology with the first EF-hands calcium-binding site of calmodulin. Detailed calcium binding studies indicated that 10(-5) M of this fast exchange ion was sufficient to cause allosteric regulation in 10 min. This strong calcium-binding property could explain the allosteric nature of the thioredoxin reductase purified from human metastatic melanotic melanoma and its role in the regulation of melanin biosynthesis. PMID- 2765563 TI - Inhibition of deoxyhypusine hydroxylase by polyamines and by a deoxyhypusine peptide. AB - The inhibition of deoxyhypusine hydroxylase was studied in vitro. Of the polyamines tested, spermine and its homologue thermine exhibited the strongest inhibition against the enzyme from rat testis. Kinetic analysis revealed that the inhibition by spermine was competitive (Ki, 0.25 +/- 0.02 mM) with respect to the deoxyhypusine protein substrate. Spermidine and its homologue caldine were also inhibitors, but less potent ones than spermine. The spermidine analogues with one or both primary amino groups replaced by the cyano group did not inhibit. A number of diamines, including putrescine, were found to display little or no inhibition. The observed effects of naturally occurring polyamines on deoxyhypusine hydroxylase activity is consistent with a suggestion of regulation of this enzymic activity by cellular levels of polyamines. A synthetic peptide Lys-Thr-Gly-deoxyhypusine-His-Gly-His-Ala-Lys, the amino acid sequence of which corresponds to that surrounding hypusine in eukaryotic initiation factor 4D, was found to display competitive-type inhibition (Ki, 0.44 +/- 0.02 mM) against deoxyhypusine hydroxylase from Chinese hamster ovary cells. Free hypusine and deoxyhypusine, on the other hand, possessed no inhibitory properties. A peptide analogous to the deoxyhypusine nonapeptide with lysine in place of deoxyhypusine had little effect on enzyme activity. The preparation of a derivative of deoxyhypusine, suitably protected for use in the solid-phase synthesis of deoxyhypusine peptides, is described. PMID- 2765564 TI - Phosphorylation by cell surface protein kinase of bovine and human fibrinogen and fibrin. AB - Human and bovine fibrinogen as well as fibrin are shown to be phosphorylated by Co631 (monolayer, hamster) and RPL12 (suspension, chicken) cells by their surface protein kinase of the casein kinase II type. The phosphate label is introduced into the alpha-peptide. The kinase system phosphorylates serine residues and utilizes GTP equally well as ATP. The participation of intact cell surfaces indicates the possibility of phosphorylation of extracellular fibrinogen independently of the site of its biosynthesis. PMID- 2765565 TI - A fluorometric study of the interaction of bradykinin with lipids. AB - The interaction of bradykinin (BK) with lipids has been followed by steady-state fluorescence measurements. Addition of either cerebroside sulfate (CS) or phosphatidylinositol (PI), solubilized with the nonionic surfactant C12E8, to BK or its analogue [Gly6]-BK enhances the relative fluorescence intensity of peptide emission at 288 nm. Fluorometric titration of the peptide with lipid has been used to quantitate the interactions in terms of stoichiometry and equilibrium constant. Job's method of continuous variation for the BK-CS interaction gave a stoichiometry of 1:2 for the complex. The value of the equilibrium constant, K, for the interaction of either BK or [Gly6]-BK with CS is 1.5.10(4) M-1. The BK-PI interaction is weaker; K = 5.0.10(3) M-1. Although electrostatic forces no doubt play a major role in these interactions, measurements on the model peptide Gly Phe-Gly indicate that the phenylalanine residues of BK are disposed in the hydrophobic environment provided by the lipid-C12E8 mixed micelle. 13C-NMR measurements on [99% 13C alpha-Gly6]-BK show that there is no change in its cis/trans ratio upon interaction with CS. The increase in the relative fluorescence intensity of BK accompanying its cooperative interaction with sodium dodecyl sulfate (SDS) implicates the role of hydrophobic forces in this interaction as well. These results bear on the interpretation of the changes in circular dichroism (CD) of BK caused by SDS. PMID- 2765566 TI - Human neutrophils contain distinct cytosolic and particulate tyrosine kinase activities: possible role in neutrophil activation. AB - Tyrosine protein kinase activities were partially purified from circulating human neutrophils. Purification steps involved sequential chromatography on DEAE Sephacel, gel filtration and affinity chromatography on a column composed of a glutamine:tyrosine copolymer linked to AH-Sepharose. The results indicate that human neutrophils contain a tyrosine kinase activity in the 150,000 x g cytosolic fraction which is distinct from the activity in a detergent extractable 150,000 x g particulate fraction. These enzyme activities are dependent on the divalent cations Mn2+ and Mg2+. Kinetics for the phosphorylation of a glutamine:tyrosine copolymer substrate demonstrated an apparent Km for the cytosolic tyrosine kinase activity of 22.3 +/- 0.3 microM, and an apparent Km for the particulate extract activity of 42.7 +/- 6.0 microM. By gel filtration chromatography, the cytosolic and particulate tyrosine kinase activities have approximate molecular masses of 80-90 and 50-60 kDa, respectively. The particulate but not the cytosolic neutrophil tyrosine kinase activity was inhibited by a novel tyrosine kinase inhibitor ST638. ST638 inhibited superoxide production in intact neutrophils stimulated with the chemotactic peptide F-Met-Leu-Phe, opsonized zymosan particles, and sodium fluoride. ST638 did not, however, inhibit superoxide production in neutrophils stimulated with phorbol myristate acetate or the calcium ionophore, A23187. PMID- 2765567 TI - [Spectroscopy of intermolecular interactions of a tyrosine chromophore. III. Classification of the state of tyrosine residues in proteins based on their electron spectra]. AB - Absorption and fluorescence spectra of some tyrosine-containing proteins were analysed. Comparison of the peculiarities of fluorescence and absorption of the tyrosine chromophore in the model compounds and proteins suggested a new classification of the states of tyrosine residues in proteins: I -- tyrosyls with hydrated OH-group (lambda mf approximately equal to 304 nm); II -- tyrosyls, whose hydroxyl group forms the hydrogen bond inside the protein in a hydrophobic surrounding or in the globular fold in structured water layer (lambda mf = 306 307 nm); III -- tyrosyls whose OH-group is deprotonated in the excited state (lambda mf approximately equal to 330-350 nm). PMID- 2765568 TI - [The presence of a thermally stable domain in the spiral part of a collagen molecule]. AB - It is shown that in 0,5 M NaCl 8 M CH3COOH heat absorption and the second structure alteration in a heated solution proceed between two stages following one another, and besides, salts not only decrease the macromolecule denaturation temperature in total, but produce different destabilization effect on different regions. The presence of the thermostable domain in the macromolecule helical part permits investigation of the folding mechanism of the triple collagen helix under partial denaturation. The localization and biological role of the stable domain in the triple helix formation are suggested. PMID- 2765569 TI - [Kinetic features of aberration occurrence in thermally-induced reorganization of T4 phage]. AB - The reorganization process of bacteriophage T4B in the course of heating at various rates was studied. Reduction of the heating rate from 1 to 8.10(-4) degree per min showed that the content of normally reorganized particles was increased. PMID- 2765570 TI - [Localization of a 1-anilinonaphthalen-8-sulfonate fluorescent probe on the surface monolayer of low density lipoproteins]. AB - A decay of fluorescence probe 1-anilino-8-naphtalene sulfonate (ANS) sorbed on low density lipoproteins (LDL) surface obtained from human plasma was described. It was demonstrated that on the LDL surface the ANS probe is allocated among two pools of molecules with the time of fluorescence decay 4-7 ns and 12-16 ns. One may conclude that 75-90% of the probe is connected with lipid LDL matrix. PMID- 2765571 TI - [Homeostasis of the auto-oscillation period in a model of a cellular circadian clock]. AB - A mathematical model was numerically investigated which describes the autooscillatory temporal organization of futile cycles of the carbohydrate branch of energy metabolism. Using an optimization method we found a region in the parametric space of the model in which the circadian oscillation period was practically constant, although the major eight parameters varied in a wide range. Such homeostasis of the period is due to synergistic effects of the four feed back mechanisms regulating activities of the key enzymes. The result obtained supports the metabolic theory of the circadian cell clock. PMID- 2765572 TI - [Erythrocyte sedimentation rate in diluted suspensions and their electrophoretic mobility in a vertical electrical field]. AB - The sedimentation rates (SR) of human red blood cells (RBC) were measured in diluted suspensions using the thin plate chamber. If the suspension medium was phosphate buffer saline or 0,18 M NaCl the SR-dependence on the distance to the chambers wall corresponded to SR distribution of small particles without interaction. The more NaCl content was decreased down to 0.145 M, the more temperature-dependent variations of SR were noted, while SR distribution became distinct with the predicted one for the non-interacting particles. The use of SR distribution is discussed for testing the RBC interaction in diluted suspensions caused by sedimentation. The electrophoretic measurements carried out under vertical oriented electrical field showed the rate of RBC movement to be the linear function of the field gradient and to be not influenced under the SR modifying conditions. PMID- 2765573 TI - [Relative size of collagen body-peptides of the human cornea in the normal state and in keratoconus]. AB - Recombination-kinetic study was carried out of the ratio between collagen secondary structures in human eye cornea of different age in the norm and in keratoconus. It has been shown that in both normal and pathologically changed cornea the portion of peptide chain in telopeptides is not changed within the age interval studied. PMID- 2765574 TI - [Functional significance of a floating eye model]. AB - The role of the floating eye model in the organization of situating and producing eye micromovements was studied. There is presented a hydromechanical model of orthophoria of latent and obvious squint. It is shown that the multiformity of obvious squint depends on the variety of combinations of nonuniform forces in the right eye aparting from the left one, which is the result of nonuniform deviations of both eyes from the norm, and heterophoria is the result of combinations of uniform forces aparting and of analogous deviations of both eyes form. It is shown that the concomittant squint is caused by the existence of different polar heterophoria at both eyes, and their multiformity is the result of their various combinations. The essential necessity of the eye floating for the organization of micromovements--eye tremor and drift is established. It is shown that the eye tremor which takes place under incomplete tetanus of the musole is possible only at optimal equilibrium of the eye and absence of friction they both are at floating. The non-muscle moving character of the eye drift is revealed. It proceeds under the influence of hydromechanical forces of aparting and nonequilibrated gravity of the cornea as a result of weakening of the eye movement muscle under fixation. The cause of the optic, axis divergence (OA) with optic line (OL) and the necessity with it of postnatal development of the eye dioptrics under active influence of the motor apparatus was discovered. Physiology of the eye floating, new conclusions and a hypothesis concerning the model are discussed. PMID- 2765575 TI - [The role of tracking in the perception of objects, moving toward each other in a narrow vertical slit line]. AB - It has been shown by means of calculation and device modeling that the observed subjective pressure of two objects moving toward one another behind a narrow vertical slit corresponds to the pressure of objects retinal projections, induced in its turn by a slowed down tracing. 180e turn of one of the moving objects is also explained by tracing. PMID- 2765576 TI - [The ability of neuronal networks to generalize using an induction method]. AB - Inductive generalization means the ability of a neural network to learn a given algorithm using incomplete information about it. A consideration based on the information theory leads to a simple equation connecting characteristics of the network with those of the algorithm to be learned. The main conclusion is that the most efficient generalization is achieved on the networks with minimal complexity sufficient for realization of the algorithm under consideration. The obtained equation is compared with the results of computer simulations for a universal neural network obtained in the present paper as well as by other workers. A good agreement is observed between theoretical predictions for generalization efficacy and results of computer simulations. PMID- 2765577 TI - [Changes in the correlation of electroencephalograms connected with rhythmic movements]. AB - Estimation of the correlation (C) between EEG processes is usually based on time averaging. Event-related changes in C around the mean level can be extracted with the help of ensemble averaging (synchronous accumulation). Fast and small non stationary oscillations of C can be reliably distinguished in such a way. Curves of sign correlation averaged for 64 cycles were measured during rhythmic movements. It has been shown that the mean values of the curves coincide with the known ones. A high value of C for symmetric EEG recording and C dependence on the distance between the electrodes, etc. were found. Additional data were obtained on the relationship between changes in C and movement phases (an increase in C at the onset and the end of movement cycles multiphasic form of the C curves, etc.) and on the relation between the phases of various curves of C. PMID- 2765578 TI - [Dissipative processes in human passive skeletal muscle]. AB - The measurement of damping of low-amplitude limb oscillations permits to evaluate the energy losses in passive human skeletal muscle during small length changes. The attenuation curve for the limb oscillations is quite different from the classical attenuation curve in the presence of viscous damping. Energy losses per oscillation cycle are practically frequency independent. Thus the damping properties of passive muscles at joint angular velocities up to 100% are due mostly to the velocity-independent resistance of "dry friction" type. The value of this "friction" is about 0.07 N per sm2 of muscle cross-section. The passive muscle also has marked thixotropy, as its resistance to small amplitude low velocity stretches strongly depends on time between stretches. PMID- 2765579 TI - [Levels of free fatty acids and calcium absorption in giant squid axons at rest and upon stimulation]. AB - Nine free fatty acids (FFA) were discovered in the squid axons at rest: 12:0, 14:0, 15:0, 16:0, 16:1, 18:0, 18:1, 20:3, 20:4. The relative amount of FFA equaled 14.1 micrograms per mg of lipids. Stimulation of nervous conductors decreased the amount of acids--14:0, 15:0, 16:1, 20:3. Simultaneously a considerable increase of the content of 20:4 was observed and three new fatty acids 20:0, 20:1, 22:2 appeared. The content of FFA increased to 27.2 micrograms/mg of lipids. Calcium absorption in the squid axons was equal to 23 nmol/g, but under stimulation this parameter increased to 37 nmol/g. Exogenous fatty acids brought about also an increase of calcium absorption. The accumulation of FFA under excitation was suggested to be the result of the increase of phosphoinositides content and related to the regulation of Ca transport. PMID- 2765580 TI - [Calibration of oxygen meters and determination of the curve for hemoglobin dissociation by kinetics of oxygenation and deoxygenation of the blood]. AB - A method to determine optical oxygenometers calibration and hemoglobin--oxygen equilibrium curve for the undamaged blood is described. This method does not require the oxygen equilibrium between the blood plasma and erythrocyte cytoplasm and uses only readings of the oxygenometer calibrated. PMID- 2765581 TI - [Prospects for measuring the rheologic characteristics of human soft tissues based on the recording of their transverse rigidity]. AB - It is shown by an example of a forearm that to determine objective characteristics of rheological properties of soft human tissues by measuring their transverse stiffness (K) one should first investigate the relation between K and the diameter of the used indentor (d). The nonlinearity of the dependence K(d) for indentor diameters from 2 to 8 mm is demonstrated and it is assumed that this nonlinearity is due to heterogeneity of tissue properties in the directions normal to the axis of force action. PMID- 2765582 TI - [Denaturation of collagen in the presence and absence of nonspiral terminal segments]. AB - Difference in the mechanism of denaturation of collagen in the presence and absence of the terminal non-helical regions is shown. PMID- 2765583 TI - [Changes in heat capacity upon protein denaturation]. AB - By the use of infrared spectroscopy it has been shown that the configurational heat capacity of hydrogen bonds represents the principal contribution into the denaturational change of heat capacity of proteins. PMID- 2765584 TI - [Calorimetric study of the formation and melting of thermotropic gel in solutions of globular proteins]. AB - Scanning calorimetry has been used for studying lysozyme water solutions of different buffer molarity (mu = 0.5 divided by 1.0) and concentrations (c = 1.5 divided by 25%) at pH 2.0. It is shown that an additional high temperature maximum (HTM) can be observed on the heating curves for lysozyme solutions during irreversible denaturation. Calorimetric and rheological studies under identical heating conditions have shown that aggregation of protein during denaturation leads to the formation of the thermotropic gel. Further increase of temperature brings up the melting of this gel which results in the appearance of HTM on thermograms. Slow cooling of lysozyme gel melt leads to its reconstruction which results in the appearance of exothermic maximum on the corresponding thermograms. PMID- 2765585 TI - [Microcalorimetric study of polypeptides in the conformation of the left helix of the poly-L-proline II type]. AB - Microcalorimetry shows that polypeptide partial heat capacity changes linearly with temperature in the region of M-conformation existence and that there is a peculiarity in the transition region where this structure is exhausted, without cooperative heat absorption. PMID- 2765586 TI - Black box analysis of the skin senses as a multiple communication channel. AB - The skin senses have been investigated as a multichannel parallel information system. In psychophysical experiments using two cold two warmth and two vibration stimuli the capability of these senses have been determined for transmitting independent parallel information. A black box model is used to describe interactions within the system between pairs of signals causing two different response components in a multiple response after multimodal activation. The theory distinguishes two kinds of interaction, those between internal noise sources and between internal signal sources. It appears that the skin senses show only a very small interaction of their respective noise sources whereas their signal sources interact extensively. The repercussions for the skin as a parallel information transmitter is discussed shortly in the context of a development of an optimum "skin vision" system, which should project an environment onto the skin, employing both the sense of touch and the sense of temperature. PMID- 2765587 TI - Quadrature and the development of orientation selective cortical cells by Hebb rules. AB - We describe a new theoretical scenario for the development of orientation selective cells in a self-organizing feedforward network with modifiable synapses. A suitable choice of Hebb rule leads to a system that develops symmetric and antisymmetric response fields (quadrature pairs) at the same time as directional selectivity occurs using inhibition between neighboring cells. Quadrature phase relationships between the response properties of adjacent cortical cells is suggestive of several highly efficient information processing strategies. PMID- 2765588 TI - Covariance density estimation for autoregressive spectral modelling of point processes. AB - The use of autoregressive modelling has acquired great importance in time series analysis and in principle it may also be applicable in the spectral analysis of point processes with similar advantages over the nonparametric approach. Most of the methods used for autoregressive spectral analysis require positive semidefinite estimates for the covariance function, while current methods for the estimation of the covariance density function of a point process given a realization over the interval [0, T] do not guarantee a positive semidefinite estimate. This paper discusses methods for the estimation of the covariance density and conditional intensity function of point processes and present alternative computational efficient estimation algorithms leading always to positive semidefinite estimates, therefore adequate for autoregressive spectral analysis. Autoregressive spectral modelling of point processes from Yule-Walker type equations and Levinson recursion combined with the minimum AIC or CAT principle is illustrated with neurobiological data. PMID- 2765589 TI - Extracellular potentials of a single myelinated nerve fiber in an unbounded volume conductor. AB - The extracellular potentials of a single myelinated nerve fiber in an unbounded volume conductor were studied. The spatial distribution of the transmembrane potential was obtained by integrating the system of partial differential equations characterizing the electric processes in the active myelinated nerve fiber. The spatial distribution of the extracellular potentials at various radial distances in the volume conductor were calculated using the line source model. Up to a certain radial distance (500 microns) the discontinuity of the action potential propagation is reflected in the extracellular potentials, while further in the volume conductor the potentials are smooth. The effect of the fiber diameter and the internodal distance on the volume conductor potentials as well as the changes in the magnitude of the extracellular potential (in the time domain) between two adjacent nodes at various radial distances were studied. The radial decline of the peak-to-peak amplitude of the extracellular potential depends on the radial coordinate r of the field point and increases with the increase of r. PMID- 2765590 TI - Noise effects in an electronic model of a single neuron. AB - We consider a simple electronic circuit model of a single neuron. The neuron is assumed to be driven by an external signal comprising constant (dc) and random components. In addition, the nonlinearity parameter in the circuit is assumed to fluctuate, thereby giving rise to critical behavior including the onset of hysteresis phenomena even for system parameter values that would not otherwise support such behavior. This "noise-induced critical behavior" is analysed, in the long time limit, through a study of the probability density function describing the neural response. PMID- 2765591 TI - A fresh look at the temporal dynamics of binocular rivalry. AB - Human observers viewed dichoptic orthogonal sine-wave gratings and indicated when exclusive visibility occurred in either eye. Contrast was held constant in one eye and was increased or decreased in the other eye for a number of alternation cycles (continuous presentation) or for only the duration of a single period of exclusive visibility (synchronous presentation). The synchronous presentation condition allowed us to identify the differing effects of contrast during the suppressed and during the dominant periods. Mixed phases were recorded as distinct from suppressed and dominant phases, and new classifications of compound dominant and compound-suppressed phases are defined. The results indicate that binocular rivalry responds to stimulus contrast in two ways. 1) The duty-cycle of dominance and suppression is determined by the relative image contrast between the two eyes, with dominance of the higher contrast image being favored, and 2) the overall rate of alternation is driven by monocular image contrast during the suppressed phase (increased monocular contrast increases the alternation rate) and to a lesser extent by monocular contrast during the dominant phase (increased monocular contrast decreases the rate). A model is developed to reflect these ideas. These results support a reciprocal inhibition oscillator as the underlying mechanism of binocular rivalry. PMID- 2765592 TI - The control of oscillatory movements of the forearm. AB - The patterns of EMG activity in the biceps and triceps muscles were recorded during horizontal oscillatory movements of the forearm. Subjects showed increased frequency of oscillation as they voluntarily reduced movement amplitude. EMG burst duration was significantly correlated with wavelength of oscillation in every case. In almost half the cases burst intensity was also positively correlated with wavelength. Subjects seemed to be using one or both these methods to control amplitude. A model was developed in three stages which satisfactorily accounted for the data. PMID- 2765593 TI - [The hydration dynamics of proteins incorporated into liposomes]. AB - A mathematical model of description of protein hydratation process in liposomes is proposed. The diffusion of water molecule to protein is taken into account. The problem of description of hydratation process dynamics at instantaneous change of external conditions is solved. PMID- 2765594 TI - [Determination of liver cholesterol-7 alpha-monooxygenase activity in an in vivo experiment]. AB - The method of determination of cholesterol-7 alpha-monooxygenase activity in vivo which has a number of advantages over the existing ones is offered. [3H]cholesterin was injected into rats intravenously in the form of albumin stabilized emulsion. In 2--4 h and then every day 3H2O radioactivity of one of the cholesterin enzymatic hydroxylation products in microsomal liver apparatus was estimated in animals' urine. The dynamics of 3H2O secretion during 7 days and dependence of the urine radioactivity upon the given radionuclide dose are shown. PMID- 2765595 TI - [The action of membranotropic compounds with various structures on the parameters of the phase transition of dimyristoylphosphatidylcholine]. AB - The effect of substances of different nature on the thermodynamic characteristics of dimyristoylphosphatidylcholine (DMPC) phase transition by the differential scanning microcalorimetry has been studied. The substances disposed in hydrophobic part of membrane--alpha-tocopherol, ubiquinone Q10, ionol and vitamin K3 cause the decrease of enthalpy and cooperativity of phase transition. The substances which have the side hydrocarbon chain (tocopherol and ubiquinone Q10) compared with ones without it (ionol and vitamin K3) and reduced quinones (Q10 and vitamin K3) compared with the oxidized ones have stronger influence on the enthalpy and cooperativity of transition. The inclusion of the local anesthetic dicaine disposed mainly in the zone of polar heads of phospholipids into DMPC membranes decreases the temperature of phase transition considerably and practically does not change the cooperativity. A possibility to use the method of differential scanning microcalorimetry to estimate the localization of membrane tropic substances within lipid bilayer is under discussion. PMID- 2765596 TI - [Effect of a cyclic enkephalin analog on the protein content in the hippocampal neurons of rats during the acquisition of a 2-way avoidance conditioned reflex]. AB - The protein content has been determined by means of cytointerferometry in neurons of fields CA-1 and CA-3 of the dorsal hippocampus in rats, which were trained in a conditioned reflex of two-way avoidance (CRTA) with the action of subcutaneously injected enkephalin cyclic analogue (ECA) in a dose 10 mkg. It has been found that after ECA injection the protein content in the neuronal nuclei of the hippocampal CA-3 field reduces. The acceleration of the CRTA elaboration occurring during the action of ECA is accompanied by a drastic increase of the protein content in the neuronal nuclei of the CA-3 field. The ECA administration to the rats of the active control groups to which were presented the same number of unpaired conditioned and unconditioned stimuli as during the CRTA elaboration also enhances the protein content in the neurons of the CA-3 field. The rats of all investigated groups in the neurons of the CA-1 field display no such significant shifts. The conclusion has been drawn that ECA produces a regulating influence on protein metabolism in hippocampal neurons depending on their functional state. PMID- 2765597 TI - GHB--new hope for narcoleptics? PMID- 2765598 TI - Clinical ratings and plasma HVA during cocaine abstinence. AB - Six patients were evaluated over a 21-day period during inpatient recovery from chronic repeated cocaine use. Serial evaluations of Hamilton depression rating, cocaine craving, plasma homovanillic acid (pHVA), and plasma 3-methoxy-4 hydroxyphenylethyleneglycol (pMHPG) concentrations were determined. There was a distinct increase in cocaine craving between 1 and 2 weeks after the last cocaine use. Levels of pHVA also increased at the time of heightened craving. The data provide preliminary evidence to suggest that changes in cocaine craving during abstinence are positively correlated with changes in dopamine turnover. PMID- 2765599 TI - Chronic flupentixol treatment potentiates the reinforcing properties of systemic heroin administration. AB - The behavioral effects of systemic heroin administration were examined in rats subjected to flupentixol impregnation prior to and during behavioral testing. In the first experiment, the dose of heroin required to produce a place preference was determined in two groups of rats, one of which had received chronic flupentixol decanoate (12 mg/kg, sc, every 10 days for 6 weeks) and the other which had received the palm oil vehicle during the same time period. It was found that whereas 60 micrograms/kg of heroin was required to produce a place preference in control rats, only 7.5 micrograms/kg was sufficient to do so in chronic neuroleptic-treated rats. In a second experiment, the locomotor activating effect of heroin was evaluated in two groups of rats that had been subjected to the same chronic regimen as in Experiment 1. Locomotor activity was enhanced in both groups following 120 micrograms/kg heroin, whereas 30 micrograms/kg was ineffective in either group. Finally, it was found that neuroleptic-treated, but not control, rats rapidly learned to self-administer intravenous infusions of an unusually low dose of heroin (4 micrograms) and to discriminate these infusions from vehicle infusions. Together, these data show that chronic dopamine (DA) receptor blockade produces a marked increase in the sensitivity to the reinforcing and discriminative stimulus properties of systemic heroin administration and that this increase is not attributable to heroin induced locomotor activation. The results are discussed in terms of the role of DA systems in opiate reinforcement processes. PMID- 2765600 TI - Evoked potential variation in schizophrenic subgroups. AB - Unmedicated chronic schizophrenic inpatients and nonpsychotic controls were tested in a paradigm designed to elicit habituated event-related potentials (ERPs) to auditory stimuli. Analysis of Variance of the ERP components recorded at bilateral frontal (F1 and F2) and temporal (T3 and T4) scalp leads revealed significant decreases in N1 component amplitudes in both frontal leads in the schizophrenic subjects. P2 and N2 amplitudes also tended to be smaller at frontal leads in the schizophrenic subjects, but these differences were not found to be statistically significant overall. The schizophrenic subjects were assigned to diagnostic subgroups following administration of the Diagnostic Interview Schedule, the Maine Paranoid Scale, and the Scale for the Assessment of Negative Symptoms. Subjects meeting DSM-III criteria for paranoid schizophrenia were assigned to one subgroup (PS subgroup), and those meeting DSM-III criteria for residual or undifferentiated schizophrenia were assigned to another subgroup (RS subgroup). The Analysis of Variance of the N1 amplitude measures was repeated with subgroup diagnosis as a factor, revealing significant decreases in N1 amplitude in the PS, but not the RS, patients. Patients in the PS subgroup were found to differ significantly from those in the RS subgroup on this ERP measure, as well as from controls. These results suggest that subgroup differences exist within the schizophrenic population that are reflected in differential changes in ERP morphology. PMID- 2765601 TI - Acute and subacute effects of ECT on plasma HVA, MHPG, and prolactin. PMID- 2765602 TI - Bright light blocks amitriptyline-induced cholinoceptor supersensitivity. PMID- 2765603 TI - Animal models: promise and pitfalls. PMID- 2765604 TI - Platelet serotonin response to treatment in geriatric depression. PMID- 2765605 TI - Quantitative cytochemistry of 3 beta-hydroxysteroid dehydrogenase activity in avian granulosa cells during follicular maturation. AB - Previous studies have shown that biosynthesis of progesterone, the major steroid product of hen granulosa cells, increases during follicular maturation. However, the contribution of individual granulosa cells to the total progesterone production of each follicle is not known. The objective of the present study was to determine the presence and relative activity of 3 beta-hydroxysteroid dehydrogenase (3 beta-HSD) in individual granulosa cells isolated from each of the five largest yolk-filled preovulatory follicles of laying hens. 3 beta-HSD cytochemistry in the presence or absence of pregnenolone substrate was performed on digitonin-permeabilized granulosa cells in suspension. The stained cells were fixed in a 70% ethanol solution until 1) the percentage of cells from each follicle that stained dark blue-indicating the presence of 3 beta-HSD activity was determined by counting under light microscopy, and 2) the intensity of staining-indicating the relative amount of enzyme activity-was quantified using video image analysis. There were three findings. First, 100% of granulosa cells from each of the five largest preovulatory follicles stained positively for the presence of 3 beta-HSD activity. Second, the amount of 3 beta-HSD activity was normally distributed among granulosa cells in the population from each follicle. Third, as follicles matured from the fifth largest to the largest follicle, 3 beta-HSD activity increased steadily in individual cells, as indicated by increased staining intensities. The results indicate uniformity in the steroidogenic capacity of cells in the granulosa layer of hen preovulatory follicles.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2765606 TI - Changes in cytosolic and nuclear progesterone receptors during pregnancy in rat placenta. AB - These studies examine changes in placental growth and the abundance of progesterone receptors (Rp) in whole placentas between Days 9 and 22 of pregnancy. In addition, some placentas were dissected into decidual basalis, junctional zone, and labyrinth zone before assay of Rp. High affinity binding of 3H-progesterone to Rp was detected at all stages of pregnancy in whole placentas and in decidua basalis and the junctional zone of the placenta. Cytosolic and nuclear receptors exhibited similar affinity for progesterone in both tissues (Kd = 3.1 +/- 0.3 and 4.4 +/- 0.7 nM, respectively). Receptor binding in whole placentas increased from Day 9 to Day 12 (p less than 0.05), declined markedly at Day 16 (p less than 0.05), and returned to former levels on Days 19 and 22 (p less than 0.05). Decidua basalis contained 84% of total Rp on Day 14, which declined to 67% on Day 17 (p less than 0.05). The junctional zone contained 16% of total Rp on Day 14 and 33% on Day 17. After Day 17, junctional zone was the only source of Rp. The decline in Rp on Day 16 followed regression of decidua basalis; recovery of Rp thereafter was due to growth of the junctional zone. The labyrinth zone did not express significant amounts of Rp at any stage despite a 4 fold increase in growth in late pregnancy. Although the biologic role of the Rp in maintenance of pregnancy is poorly understood, these studies suggest that the maternal decidua basalis and fetal junctional zone are targets of progesterone action. PMID- 2765607 TI - Capacitation of bovine spermatozoa by oviduct fluid. AB - Oviduct fluid collected from chronically cannulated oviducts of heifers was evaluated for its effect on capacitation of bovine sperm in vitro. Capacitation was determined by the ability of sperm to fertilize bovine oocytes in vitro and to undergo an acrosome reaction (AR) upon exposure to lysophosphatidylcholine (LC). After incubation of sperm with 0-25% (v/v) estrual oviduct fluid (collected +/- 1 day from estrus) for 4 h, addition of LC (100 micrograms/ml) for an additional 0.25 h resulted in an increasing percentage of acrosome-reacted sperm as the concentration of oviduct fluid increased. Sperm incubated 4 h with 25% estrual oviduct fluid fertilized more oocytes than sperm incubated in medium alone (p less than 0.05) but was not different from sperm incubated with 10 micrograms/ml heparin (p greater than 0.05). Glucose inhibited the ability of LC to induce ARs in sperm incubated 4 h with heparin or estrual oviduct fluid. Incubation of sperm with 25% oviduct fluid collected at various days over the estrous cycle demonstrated that peak capacitating activity was found at estrus but was also present +/- 1 day from estrus. The active capacitating factor in oviduct fluid was found to be heat stable. In addition, when extraction procedures were applied in sequential order, oviduct fluid capacitating activity was resistant to protease digestion, precipitable by ethanol, size-excluded by Sephadex G-25, and destroyed by nitrous acid. These results suggest that a heparin-like glycosaminoglycan from the oviduct is a potential in vivo capacitating agent in the bovine. PMID- 2765608 TI - Influence of nuclear and cytoplasmic activity on the development in vivo of sheep embryos after nuclear transplantation. AB - Reconstituted sheep embryos have been produced by electrofusion-mediated nuclear transplantation in which single cells derived from embryos at the 16-cell (Day 4) and the inner cell mass (ICM) of early blastocyst stage (Day 6) were fused to unfertilized enucleated secondary oocytes. Electrofusion rates were higher with 16-cell blastomeres (82%) than with ICM cells (47%) and when an alternating current (a.c.) preceded the direct current (d.c.) fusing pulse (88% vs. 47%). The addition of cytochalasin B (7.5% micrograms/ml) to the medium for 1 h after electrofusion significantly improved the development to morula-blastocyst stage of reconstituted embryos derived from both 16-cell blastomeres (11% vs. 35%) and ICM cells (0% vs. 56%), indicating that the cytoskeletal mechanisms operating at the time of oocyte activation may affect the developmental potential of exogenous nuclei. Transplantation of 22 reconstituted morulae and blastocysts from both groups into the uteri of recipient ewes led to the development of four lambs (18%) with the phenotype of the nuclear donor breed. These findings indicate that at least some nuclei derived from transcriptionally active embryos are totipotent and able to be reprogrammed to support full-term development when fused to enucleated secondary oocytes. PMID- 2765609 TI - Dynamics of the thiol status of rat spermatozoa during maturation: analysis with the fluorescent labeling agent monobromobimane. AB - Mammalian spermatozoa undergo maturation as they pass through the epididymis. Maturation is accompanied by the oxidation of thiols to disulfides. Disulfides are probably involved in sperm chromatin condensation and tail structure stabilization. In this work, we used the fluorescent thiol-labeling agent monobromobimane to determine the changes occurring in thiols and disulfides in rat sperm heads and tails during maturation. Spermatozoa were obtained from testis, epididymis (caput, corpus, cauda, and vas deferens), and ejaculate. Intact spermatozoa were labeled with monobromobimane, with or without pretreatment with dithiothreitol. Labeling was evaluated microscopically, and quantitative analysis was carried out spectrofluorimetrically with labeled globin used as a standard. Samples were also analyzed by gel electrophoresis. The total amount of thiols and disulfides remained the same during the entire period of sperm maturation (26 +/- 0.5 nmoles thiols + disulfides/10(6) spermatozoa). However, the reactive thiols decreased markedly between the corpus and the cauda (from greater than 90% of total in testis and 75% in corpus to about 25% in cauda), with little or no further change in vas deferens and ejaculated sperm. Trypsin treatment followed by sucrose gradient was used to separate the heads from the tails. Thiols comprised 84% of the total SH + SS in the heads and 74% in the tails of caput spermatozoa, decreasing to 14% and 45%, respectively, in cauda sperm. Thus, the decrease in reactive thiols involved both heads and tails oxidation to disulfides being very marked in the head. Electrophoresis revealed that oxidation of thiols to disulfides occurred in many protein fractions during maturation in the epididymis. PMID- 2765610 TI - In vitro protein production by the human endometrium. AB - Protein secretion by the human endometrium was studied in vitro in medium after incubation of tissue minces (n = 10) or glands isolated by collagenase digestion (n = 4) from tissues obtained at the time of curettage from normal women. Samples were incubated in a serum-free medium for 24 h at 38 degrees C in the presence of radiolabeled methionine. Dialyzed medium from each sample was subjected to two dimensional gel separation, and detected by protein staining. Although 5 of the 27 proteins were considered to be present in the labeling experiments by only one of the three observers, there was agreement about the presence of the 22 others. In addition, the observers categorized the proteins into three groups for purposes of analysis: a) those associated with the follicular phase of the cycle; b) those associated with the luteal phase; and c) those not cycle-related. One protein triplet, labeled #27, showed a significant relation to the luteal phase (p less than 0.01). A complete lack of similarity between the pattern of labeled proteins obtained from the medium and labeled proteins obtained from lysates of cells incubated in the same experiments makes it unlikely that cellular lysis, as opposed to secretion, contributed to the pattern of proteins studied in these experiments. PMID- 2765611 TI - Isolation and characterization of cell subpopulations from the monkey corpus luteum of the menstrual cycle. AB - This study was designed to test the hypothesis that the corpus luteum of primate species consists of cell subpopulations that differ in physical characteristics, function, and regulation by endocrine and paracrine factors. The corpus luteum (n = 25) was removed from rhesus monkeys at the mid-luteal phase of the menstrual cycle (Days 7-8 after the surge of luteinizing hormone, LH) and enzymatically dispersed. Freshly dispersed cells were analyzed and sorted on the basis of their forward and 90 degrees light scatter (FLS and 90LS, respectively) properties using an EPICS C flow cytometer. Freshly dispersed and sorted cells were fixed, stained histochemically for the presence of 3 beta-hydroxysteroid dehydrogenase (3 beta-HSD), and measured to determine their diameters. Freshly dispersed (MIX) and sorted cells from corpora lutea during the early (Days 4-5 after the LH surge; n = 4) and mid-luteal phases of the cycle were incubated in vitro and steroid production was assessed. The size distribution of dispersed cells revealed four peaks that corresponded to small (10-15 microns in diameter) 3 beta HSD-negative, and small, medium (16-20 microns), and large (greater than 20 microns) 3 beta-HSD-positive cells. Analysis of dispersed cells for FLS and 90LS demonstrated two continua (C alpha and C beta). C alpha contained single cells and cell clusters; 99.7 +/- 0.3% (n = 3) of the cells were less than or equal to 15 microns in diameter and 96.7 +/- 0.3% were 3 beta-HSD-negative. C alpha cells produced low levels of progesterone (0.2 +/- 0.1 ng/ml per 5 x 10(4) cells; n = 3) in vitro under basal conditions. C beta consisted of single cells from 10 microns to 40 microns in diameter and contained the lipid-filled and 3 beta-HSD positive cells. Two regions (R1 and R3) of C beta were defined and their cells separated. In R1, 96 +/- 2% (n = 3) of the cells had diameters of less than or equal to 15 microns, whereas 82 +/- 4% (n = 3) of those in R3 were greater than or equal to 20 microns. Basal progesterone production by R3 cells from early luteal phase of the cycle was 12 times greater than that by R1 cells (n = 3 per group).(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2765612 TI - The development of porcine zona pellucida using monoclonal antibodies: I. Immunochemistry and light microscopy. AB - We established three monoclonal antibodies (Mabs) against the zonae pellucidae (ZP) of porcine oocytes, named STA-1, STA-2, and STA-3, and eventually we determined that they all reacted with the isolated ZP. Based on Western blotting without 2-mercaptoethanol (2-ME), STA-1 reacted with the 80,000-110,000 Mr component, STA-2 with the 42,000-63,000 Mr component, and STA-3 with the 40,000 80,000 Mr component of ZP. We immunohistochemically specified the components of porcine ZP reactive with the three Mabs during the course of follicular development. Each Mab reacted with both the ZP and the interfollicular cell space (IFCS). One ZP component, reactive with STA-2 and STA-3, was first produced in the primordial follicle and was not found at the cumulus follicle stage, which corresponds to the stage of large antral follicles more than 5 mm in diameter. Another ZP component, reactive with STA-1, was not produced until the secondary follicle stage, and was never found at the antral follicle stage. These results suggest that each ZP component is produced and secreted at a specific stage or stages of folliculogenesis. PMID- 2765613 TI - The development of porcine zona pellucida using monoclonal antibodies: II. Electron microscopy. AB - Following our previous study on the immunohistochemistry of porcine zonae pellucidae (ZP), we undertook the present study to localize the components of the ZP with immunoelectron microscopy, using three types of anti-porcine-ZP monoclonal antibodies (Mabs), named STA-1, STA-2, and STA-3. Some organelles of the oocyte were seen to react with STA-2 and STA-3 prior to ZP formation. As soon as a follicle began to mature, STA-2 and STA-3 reacted with the perinuclear space and the endoplasmic reticular membrane of the oocyte. The follicle first reacted with STA-1 at the secondary follicle stage. At this stage, the positive reaction involved the follicular cell layer as well as the oocyte and ZP. Positive reaction was scattered within and limited to the interfollicular cell space and was never found in the cytoplasm of follicular cells. At the antral follicle stage, the oocyte was surrounded by a thick, electron-dense ZP. A strong reaction was observed in the outer layer, but no significant reaction occurred in the inner layer. The convex and ragged outer margin of the ZP was characterized by the strongest reaction. PMID- 2765614 TI - Hypothalamo-pituitary portal development in the ovine fetus. AB - The ontogeny of the hypothalamo-pituitary portal system was studied in six ovine fetuses, 48-67 days of gestation (term = 147 days) after infusion of the vascular system with a silicone rubber compound. In all of these fetuses, a marked orange blush of silicone rubber could be seen, under the dissecting microscope, extending down the stalk from the hypothalamus to the pituitary. On microscopic examination, extensive and well-developed capillary connections between the median eminence, the pituitary stalk, and pituitary gland were seen in all fetuses. In an additional fetus, aged 45 days, which was not perfused with silicone rubber, portal capillary loops had penetrated the median eminence. These findings suggest that, in the ovine fetus, hypothalamic releasing factors can be transported directly via a portal vascular route to the pituitary gland as early as 45 days of gestation. PMID- 2765615 TI - Amplitude modulation of the nightly melatonin rise in the neonatal lamb and the subsequent timing of puberty. AB - Spring-born female lambs require a decrease in day length for the normal timing of puberty the following autumn. If this decrease occurs early in postnatal life (i.e. 0-10 weeks), puberty is delayed. This study tested the hypothesis that failure of the neonatal lamb to respond to the critical long-day to short-day signal is due to inadequate nocturnal melatonin secretion. The approach was to artificially increase, to adult levels, the low nighttime rises of melatonin during the early postnatal period. Eight female lambs served as controls; they were raised on short days until 17 wk of age, and then exposed to 5 wk of long days, after which they were returned to short days. This alternating sequence of photoperiods during mid-development would be expected to induce normal puberty. Sixteen experimental females were exposed to the critical block of long days much earlier; they were placed in long days between 2 and 7 wk of age and in short days thereafter. Half (n = 8) received no further treatment. The other half (n = 8) were infused nightly with melatonin during the 8-h dark phase of the 5-wk, long-day photoperiod. This increased the amplitude of the natural nighttime melatonin rises 3- to 4-fold, well into the adult range.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2765616 TI - Testosterone regulates aromatase activity in discrete brain areas of male rhesus macaques. AB - The nonhuman primate brain contains two divergent pathways for testosterone (T) metabolism. Estradiol is biosynthesized from T by aromatization through the first pathway, whereas dihydrotestosterone is produced by the action of 5 alpha reductase through the second pathway. Previously, we mapped the distribution of these enzyme activities within specific microdissected brain area and determined that aromatase activity (AA), but not 5 alpha-reductase activity (5 alpha RA), was reduced in certain brain areas after castration. In the present study, we measured AA and 5 alpha RA in thirteen brain nuclei and subregions from five castrated and five T-treated castrated male rhesus monkeys to determine whether exogenous androgen treatment could reverse the effects of castration on brain AA. We found that T, administered in a dose that maintained serum levels at 14.2 +/- 1.6 (SEM) ng/ml, suppressed circulating luteinizing hormone (Castrates = 491.9 +/ 86 ng/ml vs. T-treated castrates = 1.8 +/- 0.2 ng/ml), and stimulated AA in specific nuclei including the suprachiasmatic nucleus (n.), periventricular area, ventromedial n., and lateral hypothalamus. T treatment had no significant effect on AA in nine other nuclei or on 5 alpha RA in any brain areas that we studied. These data indicate that AA in diencephalic and limbic structures of the nonhuman primate brain is distributed heterogeneously into androgen-dependent and androgen independent regions. This distribution is similar to that found in rodents. 5 alpha RA, on the other hand, is more homogeneously distributed than AA in these same brain regions and is not controlled by androgens. PMID- 2765617 TI - A role of melatonin in the initial stage of photoperiodism in the Japanese quail. AB - To estimate whether melatonin is involved in gonadal activity in the male quail, the dynamics of plasma melatonin at an early stage of the photoperiodic response were investigated. Nocturnal levels of melatonin were manipulated by treatment with anti-melatonin (anti-M). By means of 4 additional hours of photic stimulation of the brain (provided by a red light-emitting diode inserted through the back of the head) after the environmental lights (8L:16D, lights-on, 1000 h) were turned off, the elevation of levels of melatonin after lights-off was significantly suppressed on Days 1 and 2 (p less than 0.01); after 5 days of brain-lighting, gonadal growth first became noticeable. However, 4 h of brain lighting before lights-on elicited no change in levels of melatonin or in gonadal growth. The injections of anti-M just before lights-off (at 1800 h) for the first 3 days caused significant gonadal growth (p less than 0.01), whereas injections at 2200, 0200, or 0600 h were without effect. In addition, 4 h of brain-lighting before lights-on became gonadostimulatory (p less than 0.01) when it was accompanied by the injection of anti-M at 1800 h, but remained without effect when anti-M was injected at 0600 h. These results suggest that melatonin is involved in the initial stage of photoperiodism in birds, and the timing of suppression of the elevation of melatonin levels is critical in gonadal development. PMID- 2765618 TI - Effects of external calcium, magnesium, and temperature on spontaneous contractions of pregnant human myometrium. AB - Spontaneous isometric contractions of small isolated segments from the isthmic region of pregnant human myometrium were recorded to clarify the characteristics of and influences of experimental conditions on contractions. There is a spontaneous periodicity in membrane activity of human myometrium, and contractions evoked with a sustained electric stimulus were affected by spontaneous rhythmic contractions. The frequency of contractions increased markedly, but their duration decreased when temperature of the bathing fluid was increased from 26 degrees C to 39 degrees C. Both excess (7 mM) and low (0.5 mM) calcium levels suppressed the generation of spontaneous contraction. Frequency and half-duration gradually decreased when external magnesium was increased from 0 mM to 3.6 mM. These results indicate that the pattern of contraction depends on the frequency of and intervals between each action potential, and that spontaneous contractility-particularly its frequency-is extremely sensitive to external temperature and ionic conditions. PMID- 2765619 TI - Zona drilling increases the penetrability of rat oocytes matured in vitro. AB - Immature rat follicular oocytes were cultured either with cumulus cells intact (CI) or cumulus-free (CF) in bovine serum albumin (BSA)- or serum-supplemented medium under conditions in which meiotic maturation occurs spontaneously. After 12 h of culture to permit in vitro maturation (IVM), the cumulus cells were stripped from the CI group. Control oocytes recovered 2-4 h after ovulation from oviducts of pregnant mare's serum gonadotropin (PMSG)-treated rats were similarly stripped of cumulus cells. Half the oocytes in each group had holes "drilled" in their zonae pellucidae by topical application of acid Tyrode's solution with a micropipette to enable bypass of the zona barrier to penetration. They were cultured for a further 14-16 h with epididymal sperm and then were assessed for sperm penetration and pronuclear formation. In a preliminary study using various concentration of sperm, 50,000 sperm/ml was identified as an appropriate concentration and was used in all subsequent experiments. For oocytes matured in serum-supplemented medium, penetration rates of non-drilled oocytes-expressed as a percentage of oocytes exposed to sperm for CF, CI, and ovulated oocytes were 10%, 34%, and 80%, respectively (p less than 0.01). Drilling significantly increased the penetration rates of both IVM groups (CF: 40%, CI: 77%) but not of ovulated oocytes (78%). Forty-one percent of non-drilled CF oocytes failed to form normal pronuclei after penetration. This was significantly higher than either the CI (0%) or ovulated (1%) groups (p less than 0.001). Drilling increased the incidence of failure to form normal pronuclei in penetrated oocytes of the CF group (64%) but not of the CI or ovulated groups.2z= PMID- 2765620 TI - The influence of estradiol on cholesterol processing by the corpus luteum. AB - Recent studies from our laboratory have suggested that estradiol or androgen precursor may stimulate steroidogenesis in the luteal cell by modulating intracellular cholesterol metabolism including mobilization of cholesteryl esters, stimulation of lipoprotein receptor activity and induction of 3-hydroxy-3 methylglutaryl coenzyme A reductase (HMG-CoA reductase) activity. To test the functionality of cholesteryl ester turnover per se, we measured the activities of acyl CoA:cholesterol acyltransferase (ACAT) and cholesteryl esterase, the enzymes involved in cholesteryl ester synthesis and hydrolysis, respectively; we also measured de novo synthesis of cholesterol, cholesteryl esters, and steroids. Pregnant rats, hypophysectomized and hysterectomized on Day 12, were treated for 72 h with either estradiol or testosterone, and luteal microsomal and cytosolic fractions were utilized to measure ACAT and cholesteryl esterase activity, respectively. Intact corpora luteal were employed for [14C]acetate incorporation experiments. Basal ACAT activity (expressed as pmol.min-1.CL-1 increased from a mean of 78 +/- 16 in vehicle-treated rats to 119 +/- 18 and 197 +/- 16 in the estradiol- and testosterone-treated rats, respectively. Similarly, total ACAT activity (measured in the presence of exogenous cholesterol) was also increased in estradiol- and testosterone-treated groups. On the other hand, cholesterol esterase activity (expressed either pmol.min-1.CL-1 or pmol.min-1.mg protein-1) was similar in all three groups and comparable to corpora lutea from intact pregnant rats. Hypophysectomy and hysterectomy caused a 50-60% reduction in [14C]acetate incorporation into sterols when compared with intact pregnant rat. Treatment with either estradiol or testosterone not only restored the cholesterol biosynthetic capacity but also enhanced the overall rate of [14C]acetate incorporation into steroids as compared to intact pregnant rats. The major ( 80%), newly synthesized steroid was identified as progesterone. In conclusion, the present studies suggest that the major function of luteal estradiol is to induce de novo cholesterol biosynthesis, regulate ACAT activity, and channel available free cholesterol (derived from both endogenous and exogenous sources) for steroidogenesis. PMID- 2765621 TI - Plasma prolactin levels in incubating turkey hens during pipping of the eggs and after introduction of poults into the nest. AB - Plasma levels of prolactin (Prl) associated with incubation and maternal behavior were compared in turkey hens allowed to incubate 10 fertile eggs (Group I, n = 9) or 10 infertile eggs (Group II, n = 7) in open nest boxes. At the end of the day that the first egg hatched, all unhatched eggs were removed from Group I hens and each hen was given 10 poults. At the end of the following day, infertile eggs were removed from Group II hens and each hen was given 10 poults. Although pipping of the eggs changed the incubation behavior of Group I hens, it had no effect on plasma Prl. Subsequent hatch of the eggs and/or presence of poults resulted, within 24 h, in a sharp fall in Prl levels, abandonment of the nests, and a shift to maternal behavior. Visual and auditory exposure to Group I poults had no effect on plasma Prl or incubation behavior of Group II hens incubating infertile eggs in adjacent pens. However, within 24 h after the infertile eggs were exchanged for newly hatched poults, Prl levels in Group II hens declined sharply and the hens abandoned the nests and showed maternal behavior similar to that observed in Group I hens. No significant relationships were found in either group between plasma Prl levels and quality of incubation or maternal behavior. PMID- 2765622 TI - Circadian uterine activity in the pregnant rhesus macaque: do prostaglandins play a role? AB - Eight rhesus macaques between 127 and 132 days of gestation had catheters implanted into maternal femoral vessels and the amniotic fluid cavity and were placed in a vest-and-tether system for chronic catheter maintenance. Uterine activity was continuously recorded, and paired maternal arterial blood and amniotic fluid samples were collected at 0900 h (AM) and 2100 h (PM) until delivery and analyzed for prostaglandin metabolites (PGFM and PGEM-II). A circadian pattern in uterine contractility was observed, with peak activity occurring between 1900 and 0100 h (p less than 0.001). No significant AM-PM differences were observed in maternal plasma PGFM (240 +/- 24 AM vs. 273 +/- 35 PM) or PGEM-II (537 +/- 41 AM vs. 484 +/- 34 PM) or amniotic fluid PGFM (360 +/- 72 AM vs. 287 +/- 70 PM) or PGEM-II (1626 +/- 383 AM vs. 1771 +/- 431 PM). All values represent mean +/- SEM, pg/ml. Additional samples were collected at 3-h intervals for 24 h at selected times during the study. This more intensive sampling protocol also failed to reveal any significant time trends in maternal plasma or amniotic fluid prostaglandins. Despite the lack of AM-PM differences, amniotic fluid PGFM and PGEM-II increased significantly as delivery approached (p less than 0.01). It appears that circadian uterine activity is not related to changes in maternal plasma or amniotic fluid prostaglandins. Although prostaglandins are responsible for the progression of labor, other factors may be involved in the generation of uterine activity rhythms prior to the initiation of labor. PMID- 2765623 TI - Temporal appearance of seasonal changes in numbers of Sertoli cells, Leydig cells, and germ cells in stallions. AB - The temporal appearance of seasonal changes in numbers of Leydig, Sertoli, and germ cells was evaluated to determine if seasonally increased daily spermatozoan production might be preceded by changes in numbers of either of two somatic testicular cells. A significant increase in numbers of spermatogonia and Sertoli cells preceded the significant increase in number of Leydig cells in the approaching breeding season. Seasonal changes in parenchymal weight and in numbers of Sertoli cells, Leydig cells, and germ cells were maximal in May and June. Numbers of A or B spermatogonia in June were 2.4 to 2.5 times the number present in January. During the same time period, numbers of other germ cells, as well as Leydig cells and Sertoli cells, were increased by 1.5 to 1.9 times. The magnitude of change between January and March (first time period that the change was significant) was greater for A spermatogonia (1.7-fold) than for other cell types (1.3-fold to 1.5-fold). Hence, the need to accommodate more spermatogonial progeny might cause increased testicular size and number of somatic cells, including Sertoli cells. Season did not influence the rate of degeneration between A and B spermatogonia. However, in the breeding season, the conversion of B spermatogonia to primary spermatocytes was reduced. The lack of a seasonal difference in the ratio of primary spermatocytes per Sertoli cell was consistent with a limited capacity of individual Sertoli cells to accommodate primary spermatocytes.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2765624 TI - Elimination of cellular active adhesion on microdomain-structured surface of graft-polyamine copolymers. AB - To investigate the mechanisms involved in lymphocyte adsorption on poly(2 hydroxyethyl methacrylate)-graft-polyamine copolymer, which is utilized as an adsorbent for cell separation, the role of cellular metabolism in lymphocyte adsorption on these copolymers was evaluated. We examined the effect of lowering environmental temperature and of the drug cytochalasin B that inhibits reorganization of microfilaments in cellular cytoskeletons on lymphocyte adsorption. Although the adsorption of lymphocytes on poly(2-hydroxyethyl methacrylate) was considerably reduced in the presence of cytochalasin B or by lowering temperature, no marked influence of these factors was observed for lymphocyte adsorption on poly(2-hydroxyethyl methacrylate)-graft-polyamine copolymers. These results suggest that, in contrast to common plastics surfaces including poly(2-hydroxyethyl methacrylate), the surface of poly(2-hydroxyethyl methacrylate)-graft-polyamine copolymers does not stimulate or activate adsorbed lymphocytes. PMID- 2765625 TI - Synthesis and physicochemical characterization of a new material (PUPA) based on polyurethane and poly(amido-amine) components capable of strongly adsorbing quantities of heparin. AB - The synthesis of new materials (PUPAs) based on a commercial polyurethane and a heparin-complexing polymer, poly(amido-amine), was studied. PUPAs are capable of adsorbing heparin because the basic nitrogens of poly(amido-amine), once protonated, interact with the negative charges carried by the heparin molecule. Six different samples of PUPA were synthesized having a varied ratio of the components. The quantity of basic nitrogen on the surface and the bound heparin for each sample was determined. Two different kinds of heparin are present on a PUPA surface: one is strongly bound but can be detached by 0.1 M NaOH solution, the other is physically adsorbed and is slowly released by a stream of saline solution. A relationship between the quantity of strongly bound heparin and basic nitrogen was found. SEM and FTIR-ATR analysis were performed on all the PUPA samples. The mechanical characteristics change according to chemical composition. PMID- 2765626 TI - Change in cytoplasmic free Ca2+ concentration in rabbit platelets contacting with albumin coated and uncoated polystyrene surfaces. AB - Direct measurement of cytoplasmic free Ca2+ concentration in rabbit platelets in contact with polystyrene latexes was examined by monitoring an intracellular trapped fluorescent indicator dye, Fura 2, as a quantitative evaluation of platelet activation on material surfaces. It was found that an increase in cytoplasmic free calcium levels in platelets in contacting latexes was strongly reduced by the adsorption of albumin on the latex surfaces. Further, such an elevation of cytoplasmic free calcium levels was found to require a calcium influx from an extracellular medium across the platelet-plasma membrane. PMID- 2765627 TI - Patency of heparin-PVA coated tubes at low flow rates. AB - The patency of heparin-PVA coated 1.14 mm i.d. polyethylene tubes was greater than that of control tubes without heparin in a novel test section that enabled ex vivo evaluation in dogs at low flow and shear rates (2-10 ml/min). Low shear rates were achieved by diverting a small portion of a chronic A-V shunt flow through Y-connectors into the small diameter test tubing. For shear rates in the range of 200-650 s-1 half the heparin-PVA tubes remained patent for longer than 72 min whereas half the control tubes (PVA only) only remained patent for longer than 30 min. At higher shear rates (500-1000 s-1), the 50% patency times for heparin-PVA and PVA were 225 and 123 min respectively. The increased patency at the higher shear rates was attributed more to the effect of the connector than just shear rate. The higher shear rates were achieved by changing from a Y connector in which the small diameter side-branch was cut flush to the larger diameter main line to one in which the small diameter test tubing protruded into the lumen of the main line; the latter 'protruding' connector was presumed to result in less platelet pre-activation than the other. This method has been found useful for assessing the thrombogenicity of heparinized tubes at low flow rates. PMID- 2765628 TI - Adhesion of suspension-cultured Catharanthus roseus cells to surfaces: effect of pH, ionic strength, and cation valency. AB - The correlation between the effects of pH, ionic strength and cation valency on the electrophoretic mobility and the extent of adhesion of suspension-cultured Catharanthus roseus cells to various polymer substrates is presented. The electrophoretic mobility of cells was unaltered in the pH range of 6-8, but decreased from approximately -2.2 x 10(-8) m V-1 s-1 and approached zero as the pH of the suspending liquid was decreased from 6 to 2. Similarly, the value of electrophoretic mobility decreased continuously as the ionic strength was increased from 0 to 1.0 M when cells were suspended in salt solutions of sodium chloride, calcium chloride, and aluminum chloride. However, using equimolar concentrations, the slope of the decrease in electrophoretic mobility increased following the sequence sodium chloride less than calcium chloride less than aluminium chloride. The electrophoretic mobility was near zero for suspensions containing 1.0 M calcium chloride or 0.1 M aluminium chloride. The extent of adhesion of the cells to the polymers sulphonated polystyrene less than polyethylene terephthalate less than polystyrene less than fluorinated ethylene propylene followed this sequence. These results agree with a thermodynamic model of plant cell adhesion that implicates the importance of interfacial tensions in the adhesion process. However, higher levels of adhesion were generally observed when the electrophoretic mobility for the cells in the corresponding test liquid was at a minimum absolute value. These results can be explained by considering the effects of the electrolytic properties of the suspending liquid on the electrostatic repulsive interactions between the cells and the polymer surface in terms of a double-layer phenomenon and the DLVO theory.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2765629 TI - In vitro and in vivo comparative colonization of Staphylococcus aureus and Staphylococcus epidermidis on orthopaedic implant materials. AB - Clinically, Staphylococcus aureus appears to be the dominant organism associated with infected metal implants, whereas coagulase-negative staphylococcal strains are more frequently isolated from infected polymer implants. We reproduced this trend experimentally in vitro and in vivo. Discs of a titanium alloy, poly(methyl methacrylate) and ultra-high molecular weight polyethylene were exposed to a clinical isolate of Staphylococcus aureus or either of two strains of Staphylococcus epidermidis. Within 1 h Staphylococcus aureus was always the most rapid colonizer regardless of biomaterial. However, after 8 to 24 h, Staphylococcus aureus was present in higher numbers on metal and Staphylococcus epidermidis on polymers. Moreover, the exopolysaccharide produced by Staphylococcus epidermidis appeared to offer an effective protection against host defences in vivo. PMID- 2765630 TI - Frictional response of articular cartilage containing crystals. AB - Many joint diseases are associated with the deposition of crystals in articular cartilage. Three main types are commonly found: calcium pyrophosphate, calcium hydroxyapatite and monosodium urate. The effects of these articular crystals on the frictional properties and the surface condition of the articular cartilage were studied. A total of 43 cartilage specimens cut from 19 post-mortem knee joints have been tested in purpose-designed apparatus. The results show that a high friction coefficient and a high level of crystal deposition tend to occur with a worsening of the surface quality of the articular cartilage. PMID- 2765631 TI - Biocompatibility of N-(2-hydroxypropyl) methacrylamide copolymers containing adriamycin. Immunogenicity, and effect on haematopoietic stem cells in bone marrow in vivo and mouse splenocytes and human peripheral blood lymphocytes in vitro. AB - N-(2-hydroxypropyl)methacrylamide polymeric prodrugs containing adriamycin bound to polymers via glycylphenylalanylleucylglycine side chains and, in one case, galactosamine bound via the same sequence, were tested for immunogenicity after intravenous, subcutaneous and oral application in two inbred strains of mice. The serum antibody level was determined by enzyme-linked immunoassay on the 3rd and 6th day after the last treatment. It was found that antibodies were only produced in very small amounts. In some experimental groups, the antibody titres measured following administration of copolymer conjugate were comparable with those present in non-treated controls. Attachment of adriamycin to N-(2 hydroxypropyl)methacrylamide copolymer considerably decreased its toxicity against haematopoietic precursors in bone marrow as measured by the in vivo colony-forming unit-spleen assay and its ability to inhibit [3H] thymidine incorporation by mouse splenocytes and human peripheral blood lymphocytes measured in vitro. PMID- 2765632 TI - Computerized model for accurate determination of ethylene oxide diffusion in sterilized medical supplies. AB - A computerized numerical model is described which is shown to be more generally applicable than analytical methods in the determination of ethylene oxide diffusion in polymeric material. Diffusion coefficients of ethylene oxide in poly(vinyl chloride) were determined from the rates of desorption both for conventional aeration with warm air and for microwave-assisted desorption and found to be concentration dependent. The model takes account of device geometry and concentration dependence of diffusion coefficient and its predictions are in agreement with experimental results for desorption. The model is also used to simulate the whole sterilization process with a view to a planned diminution of EO residuals after sterilization. PMID- 2765633 TI - Modified Arrhenius equation for the frequency dependence of the transition temperatures of polymers. AB - A linear relationship was established for several polymers between the pre exponential factor and the activation energy of a modified form of the standard Arrhenius equation. In addition, the energy term itself was modified such that the alpha and beta absorptions were related to the number of carbon atoms available for segmental motion. At large activation energies the modified Arrhenius relationship suggested upper limits of 495.5K and 321K for the alpha and beta transition temperatures, respectively. PMID- 2765634 TI - Weighted Kaplan-Meier statistics: a class of distance tests for censored survival data. AB - A class of statistics based on the integrated weighted difference in Kaplan-Meier estimators is introduced for the two-sample censored data problem. With positive weight functions these statistics are intuitive for and sensitive against the alternative of stochastic ordering. The standard weighted log-rank statistics are not always sensitive against this alternative, particularly if the hazard functions cross. Qualitative comparisons are made between the weighted log-rank statistics and these weighted Kaplan-Meier (WKM) statistics. A statement of null asymptotic distribution theory is given and the choice of weight function is discussed in some detail. Results from small-sample simulation studies indicate that these statistics compare favorably with the log-rank procedure even under the proportional hazards alternative, and may perform better than it under the crossing hazards alternative. PMID- 2765635 TI - Distribution-free confidence intervals for a parameter of Wilcoxon-Mann-Whitney type for ordered categories and progressive censoring. AB - Halperin, Gilbert, and Lachin (1987, Biometrics 43, 71-80) obtain confidence intervals for Pr(X less than Y) based on the two-sample Wilcoxon statistic for continuous data. Their approach is applied here to ordered categorical data and right-censored continuous data, using the generalization zeta = Pr(X less than Y) + 1/2Pr(X = Y) to account for ties. Deviations from nominal coverage probability for various sample sizes and values of zeta are obtained via simulation of either three or six ordered categories based on underlying Poisson or exponential distributions. The simulation results indicate that the proposed method performs quite well, and it is apparently superior to the approach of Hochberg (1981, Communications in Statistics--Theory and Methods A10, 1719-1732) for values of zeta far from 1/2. PMID- 2765636 TI - Simple parametric and nonparametric models for excess and relative mortality. AB - This paper studies two classes of hazard-rate-based models for the mortality in a group of individuals taking normal life expectancy into account. In a multiplicative hazard model, the estimate for the relative mortality generalises the standardised mortality ratio, and the adequacy of a model with constant relative mortality can be tested using a type of total time on test statistic. In an additive hazard model, continuous-time generalisations of a "corrected" survival curve and a "normal" survival curve are obtained, and the adequacy of a model with constant excess mortality can again be tested using a type of total time on test statistic. A model including both the multiplicative hazard model and the additive hazard model is briefly considered. The use of the models is illustrated on a set of data concerning survival after operation for malignant melanoma. PMID- 2765637 TI - A two-stage design for choosing among several experimental treatments and a control in clinical trials. AB - In clinical trials where several experimental treatments are of interest, the goal may be viewed as identification of the best of these and comparison of that treatment to a standard control therapy. However, it is undesirable to commit patients to a large-scale comparative trial of a new regimen without evidence that its therapeutic success rate is acceptably high. We propose a two-stage design in which patients are first randomized among the experimental treatments, and the single treatment having the highest observed success rate is identified. If this highest rate falls below a fixed cutoff then the trial is terminated. Otherwise, the "best" new treatment is compared to the control at a second stage. Locally optimal values of the cutoff and the stage-1 and stage-2 sample sizes are derived by minimizing expected total sample size. The design has both high power and high probability of terminating early when no experimental treatment is superior to the control. Numerical results for implementing the design are presented, and comparison to Dunnett's (1984, in Design of Experiments: Ranking and Selection, T. J. Santner and A. C. Tamhane (eds), 47-66; New York: Marcel Dekker) optimal one-stage procedure is made. PMID- 2765638 TI - Design of two-phase prevalence surveys of rare disorders. AB - Two-phase medical surveys, in which a large sample is assessed with an inexpensive screening instrument and a subsample is selected for a more thorough diagnostic evaluation, appear to have great merit in the epidemiologic study of certain rare disorders. We present the optimal design of two-phase surveys when resources are fixed and when 100% of those screened positive in the first phase must be included in the second-phase evaluation. We go on to examine the relative efficiency of this two-phase design compared to a single-phase design in which all resources are used in a survey that employs the diagnostic evaluation. Given information on the accuracy of the screen and the prevalence of the disorder, the utility of the two-phase design depends on the relative cost of the screening to the diagnostic assessments. PMID- 2765639 TI - Using latent class models to characterize and assess relative error in discrete measurements. AB - Whenever a definitive standard is not available to mark accuracy in a classification process, discrete measurement error can be discussed only in relative terms. If strong assumptions concerning the underlying discrete processes can be made, latent class models allow one to characterize patterns of agreement/disagreement among raters while simultaneously producing "consensus" estimates of prevalence. A hypothetical definitive standard serves as the latent factor. The discrete data are treated as incomplete and log-linear models can be used to parameterize latent class models and extensions of latent class models. Data from the radiographic diagnosis of dental caries by five dentists were explored to estimate prevalence, assess relative error, and examine the validity of several traditional assumptions concerning diagnostic reliability. Latent class analysis allowed a more detailed description of diagnostic error than provided by commonly used summary statistics. PMID- 2765640 TI - Statistical methods in ophthalmology: an adjusted chi-square approach. AB - Ophthalmologic studies often compare several groups of subjects for the presence or absence of some ocular finding, where each subject may contribute two eyes to the analysis, the values from the two eyes being highly correlated. Rosner (1982, Biometrics 38, 105-114) and Dallal (1988, Biometrics 44, 253-257) proposed procedures for testing whether the proportion of affected eyes is the same among the different groups, while accounting for the intrasubject correlation. In this paper we propose an alternative approach, based on a simple adjustment of the standard Pearson chi-square test for the equality of proportions. The suggested approach utilizes information on subjects who supply only one eye to the analysis, and readily generalizes to studies in which more than two units of analysis are provided by each subject. PMID- 2765641 TI - Point estimation following group sequential tests. AB - Kim and DeMets (1987, Biometrics 43, 857-864) described an exact procedure for constructing confidence intervals for a normal mean following group sequential tests when the boundaries were generated based on the notion of use functions proposed by Lan and DeMets (1983, Biometrika 70, 659-663). In this article, three point estimators for a normal mean following group sequential tests are considered, and their properties are investigated by Monte Carlo simulation. Based on the simulation results, some suggestions are made as to the choice of group sequential designs and use function. PMID- 2765642 TI - Test statistic and sample size for a two-sample McNemar test. AB - McNemar's (1947, Psychometrika 12, 153-157) test of marginal homogeneity is generalized to a two-sample situation where the hypothesis of interest is that the marginal changes in each of two independently sampled tables are equal. This situation is especially applicable to two cohorts (a control and an intervention cohort), each measured at baseline and after the intervention on a binary outcome variable. Some assumptions often realistic in this situation simplify the calculation of sample size. The calculation of sample size in a study designed to increase utilization of breast cancer screening is demonstrated. PMID- 2765643 TI - Fluorescence depolarization study of lamellar liquid crystalline to inverted cylindrical micellar phase transition of phosphatidylethanolamine. AB - The orientational order and rotational dynamics of 2-[3-(diphenyl-hexatrienyl) propanoyl]-3-palmitoyl-L-alpha- phosphatidylcholine (DPH-PC) embedded in dioleoylphosphatidyl-ethanolamine (DOPE) were studied by fluorescence depolarization technique. Upon increasing the temperature, the calculated wobbling diffusion constant D perpendicular of the fluorescent probe was found to decrease at the lamellar (L alpha) to inverted cylindrical (H II) phase transition (10 degrees C). This suggested that the increased gauche rotamers of the alkene chains in the HII phase imposes a constraint in the wobbling motion of the fluorophore. The calculated ratio of order parameter in the L alpha phase to that in the HII phase was 1.7 and different from the theoretical value of 2.0 as predicted from the change in packing symmetry. This result can be explained by a slightly higher local order parameter of the fluorophore or by the fast rotational diffusion motion of the fluorophore around the symmetry axis of the cylindrical tubes in the HII phase. PMID- 2765644 TI - Rapid mechanical and thermal changes in the garfish olfactory nerve associated with a propagated impulse. AB - Mechanical and thermal changes associated with a propagated nerve impulse were determined using the garfish olfactory nerve. Production of an action potential was found to be accompanied by swelling of the nerve fibers. The swelling starts nearly at the onset of the action potential and reaches its peak at the peak of the action potential. There is a decrease in the length of the fibers while an impulse travels along the fibers. The time-course of the initial heat was determined at room temperature using heat-sensors with a response-time of 2-3 ms. Positive heat production was found to start and reach its peak nearly simultaneously with the action potential. The rise in temperature of the nerve was shown to be 23 (+/- 4) mu degrees C. In the range between 10 degrees and 20 degrees C, the temperature coefficient of heat production is negative, primarily due to prolongation of the period of positive heat production at low temperatures. The amount of heat absorbed during the negative phase varies widely between 45 and 85% of the heat evolved during the positive phase. It is suggested that both mechanical and thermal changes in the nerve fibers are associated with the release and re-binding of Ca-ions in the nerve associated with action potential production. PMID- 2765645 TI - Mechanics and control of the cytoskeleton in Amoeba proteus. AB - Many models of the cytoskeletal motility of Amoeba proteus can be formulated in terms of the theory of reactive interpenetrating flow (Dembo and Harlow, 1986). We have devised numerical methodology for testing such models against the phenomenon of steady axisymmetric fountain flow. The simplest workable scheme revealed by such tests (the minimal model) is the main preoccupation of this study. All parameters of the minimal model are determined from available data. Using these parameters the model quantitatively accounts for the self assembly of the cytoskeleton of A. proteus: for the formation and detailed morphology of the endoplasmic channel, the ectoplasmic tube, the uropod, the plasma gel sheet, and the hyaline cap. The model accounts for the kinematics of the cytoskeleton: the detailed velocity field of the forward flow of the endoplasm, the contraction of the ectoplasmic tube, and the inversion of the flow in the fountain zone. The model also gives a satisfactory account of measurements of pressure gradients, measurements of heat dissipation, and measurements of the output of useful work by amoeba. Finally, the model suggests a very promising (but still hypothetical) continuum formulation of the free boundary problem of amoeboid motion. by balancing normal forces on the plasma membrane as closely as possible, the minimal model is able to predict the turgor pressure and surface tension of A. proteus. Several dynamical factors are crucial to the success of the minimal model and are likely to be general features of cytoskeletal mechanics and control in amoeboid cells. These are: a constitutive law for the viscosity of the contractile network that includes an automatic process of gelation as the network density gets large; a very vigorous cycle of network polymerization and depolymerization (in the case of A. proteus, the time constant for this reaction is approximately 12 s); control of network contractility by a diffusible factor (probably calcium ion); and control of the adhesive interaction between the cytoskeleton and the inner surface of the plasma membrane. PMID- 2765646 TI - Continuous fluorescence microphotolysis of anthracene-labeled phospholipids in membranes. Theoretical approach of the simultaneous determination of their photodimerization and lateral diffusion rates. AB - Anthracene is a fluorescent and photoactivatable (dimerization) group which can be used for investigating the lateral distribution and dynamics of lipids in membranes. In fluorescence recovery after photobleaching or in microphotolysis experiments, and when using this fluorophore, the bleaching (or microphotolysis) step in the illuminated part of the membrane is in fact the sum of two antagonistic processes: fluorescence decay, which is due to dimerization of anthracene residues, and fluorescence recovery, which is due to a diffusion mediated exchange of bleached and unbleached particles between the illuminated and diffusion area in the membrane. Here, we propose a new mathematical algorithm that enables such a second-order reaction-diffusion process to be analyzed. After coupling a fluorescence recovery step to a microphotolysis step, this algorithm allows us to calculate the lateral diffusion coefficient D and the photodimerization constant K of anthracene-labeled lipids in membranes, two parameters which contribute to the understanding of the fluidity of the lipid phase in membranes. This algorithm also provides us with a complete description of the anthracene-labeled molecules distribution in the illuminated and diffusion area, at any time of the experiment. The fluorescence recovery after microphotolysis procedure we propose was tested with an anthracene-labeled phosphatidylcholine inserted in egg-phosphatidylcholine multilayers, in monolayers adsorbed onto alkylated glass surfaces and in the plasma membrane of Chinese hamster ovary cells. It is shown that this procedure can also be used to evaluate the important parameters of probe mobile fraction and to determine the relative size of the illuminated and diffusion areas. This will enable membranes to be explored in terms of microdomains and/or macrodomains. PMID- 2765647 TI - Water adsorption isotherms and hydration forces for lysolipids and diacyl phospholipids. AB - The repulsive forces in a wide range of diacyl and monoacyl phospholipid systems have been obtained from the adsorption isotherms for water. From the exponential dependence of the repulsive pressure on the water content, information has been deduced regarding the hydration force. For diacyl phosphatidylcholines the strength of the hydration force and its characteristic decay length are in good agreement with values previously obtained by x-ray diffraction methods. For natural and synthetic diacyl phosphatidylcholines in the fluid lamellar phase, the hydration force extrapolated to zero layer separation (Po) is in the range 4 5.10(8) N.m-2 and the decay length is approximately 0.3 nm. The results for dimyristoyl, dipalmitoyl, and distearoyl phosphatidylcholines in the gel phase are very similar with Po approximately 2.5.10(8) N.m-2 and decay length of approximately 0.2 nm. Egg monomethyl phosphatidylethanolamine is less strongly hydrated: Po = 2.3.10(9) N.m-2, with a decay length of 0.3 nm. Egg phosphatidylethanolamine and bovine phosphatidylserine hydrate even more weakly with Po approximately 1.3.10(8) N.m-2 and decay length of approximately 0.15 nm. Mixtures with cholesterol or phosphatidylcholine increase both Po and the decay length for phosphatidylethanolamine to values closer to those for phosphatidylcholine. The repulsive forces deduced for egg lysophosphatidylcholine at 40 degrees C display a biphasic water dependence, with the low water phase being similar to lamellar egg phosphatidylcholine, and the phase at higher water content having a smaller value of Po = 2.10(8) N.m-2 but a longer decay length of approximately 0.45 nm, corresponding to a nonlamellar configuration. Bovine lysophosphatidylserine similarly yields values of PO = 1.2.108 N.m-2 and an effective decay length of 0.64 nm. The hydration behavior of the various diacyl phospholipids has been interpreted in terms of the mean-field molecular force theory of lipid hydration, and values deduced for the surface hydration potential of the various lipids. This analysis extends previous results on hydration forces, particularly to lysolipids and nonlamellar phases. PMID- 2765648 TI - delta pH-induced fluorescence quenching of 9-aminoacridine in lipid vesicles is due to excimer formation at the membrane. AB - The fluorescence of 9-aminoacridine (9-AA) is quenched in vesicular suspensions containing negatively charged lipid headgroups (e.g., phosphatidylserine) upon imposition of a transmembrane (inside acidic) pH-gradient. It is shown that this fluorescence loss is accompanied by the formation of 9-AA dimers that undergo a transition in the dimer excited state to a dimer-excimer state. This result has been obtained on the basis of the specific dimer fluorescence excitation and hypochromic absorbance spectra that are redshifted by maximally 275 cm-1 (4.4 nm) with respect to the corresponding monomer spectra, as well as by the detection of the characteristic broad excimer emission band, centered at 560 nm. The existence of the spectrally distinct dimer-excimer is further corroborated by fluorescence life-time measurements that indicate an increased lifetime of up to 24 ns for this complex as compared with the normal monomer fluorescence lifetime of 16 ns. The formation of this dimer-excimer complex from the monomers can be reversed completely and the original monomeric spectral properties restored after the abolishment of the electrochemical proton gradient. In addition to the delta pH induced dimer redshift in absorbance and fluorescence excitation, a further small redshift in monomer absorbance, fluorescence excitation, and emission spectra is observed due solely to the presence of the negatively charged phospholipid headgroups. PMID- 2765649 TI - Critical density fluctuations in lipid bilayers detected by fluorescence lifetime heterogeneity. AB - The heterogeneity of the decay of the fluorescence of transparinaric acid in single-component lipid bilayers at temperatures above their gel/liquid crystalline phase transition is shown to be due to the presence of regions of higher local density and higher acyl chain order than the predominant fluid regions. This conclusion is based on selective excitation behavior and the observation of time-resolved fluorescence anisotropies that increase at long times. The fractional amplitude of the long lifetime component of the fluorescence shows a temperature variation that conforms to conventional descriptions of critical behavior. The critical exponent extracted from this variation is 1.1, close to the value of 1.0 that describes ultrasonic data. We therefore conclude that liquid crystalline lipid bilayers exhibit critical behavior with significant density and order fluctuations. This behavior must be taken into account in the interpretation of fluorescence and other spectroscopic measurements of the properties of bilayers. PMID- 2765650 TI - Analysis of the anisotropy decay of trans-parinaric acid in lipid bilayers. AB - An analysis is presented of the complex anisotropy behavior of trans-parinaric acid in single component DEPC lipid bilayers. It is shown that a model involving two species with distinct lifetime and motional behavior is required, and is adequate, to explain the observed data. In particular, the observed increase in the anisotropy at long times demonstrates the presence of a species with a long fluorescence lifetime that has a high anisotropy. The time dependence of the anisotropy for these two environments is treated using both a purely mathematical sum of exponentials and a constrained fit based on an approximate solution of the anisotropic diffusion problem. In this latter model the anisotropy is described in terms of the second and fourth rank order parameters, (P2) and (P4), and a single dynamical parameter, D1, the perpendicular diffusion coefficient for this uniaxial probe. The parameters of both models are accurately determined from the fits to the data when two environments coexist and an association is made between lifetime components and distinct rotational sites. The values of the parameters obtained demonstrate the "solid-like" and "fluidlike" nature of these two coexisting environments. PMID- 2765652 TI - Biomagnetic functional localization of a peripheral nerve in man. AB - The first detection of the magnetic field of a stimulated peripheral nerve in man is presented. The measurement was performed noninvasively and in vivo on a healthy subject. The spatio-temporal field distribution is utilized to calculate the location of bioelectric activity on the basis of the equivalent current dipole model. The localization of the active nerve tissue is confirmed by a computer tomography image of the upper arm cross-section. Furthermore, a calculation of the total current distribution in the nerve explains the observed morphology of the signal. PMID- 2765651 TI - Resonance Raman enhancement of the Mn-N-O bending mode in nitrosyl manganese "strapped" and "open" heme complexes. AB - Resonance Raman spectra of the MnII-NO moiety in synthetic nitrosyl manganese heme complexes with and without steric hindrance are reported. The "strapped" hemes having a hydrocarbon strap (variable length) across one face of the heme hinder the perpendicular bonding of a linear ligand. These complexes were employed to investigate the effects of ligand distortion (primarily tilting) on Mn-NO stretching, Mn-N-O bending, and N-O stretching modes. It is demonstrated that ligand distortion in the MnII-NO system is a valid mechanism for causing the resonance enhancement of the Mn-N-O bending mode, similar to that observed in the FeII-CO system (Yu, N.-T., E. A. Kerr, B. Ward, and C. K. Chang. 1983. Biochemistry. 22:4534-4540). More interesting is the observation of the delta(Mn N-O) enhancement caused by the tilting of the trans Mn-N epsilon bond in the "open" heme complexes (e.g., heme-5 and proto-1X dimethylester) with 1,2 dimethylimidazole or piperidine as a base. The nu(Mn-NO) and nu(N-O) modes exhibit an increase and a decrease, respectively, as the strap length decreases (hence the steric hindrance increases). Both nu(Mn-NO) and nu(N-O) frequencies are insensitive to the strength of the trans base. The results from "strapped" and "open" model heme systems imply that the Mn-N-O geometry is essentially linear and perpendicular in the nitrosyl complexes of monomeric manganese insect hemoglobin CTT IV and sperm whale myoglobin. The unusually low nu(N-O) frequency in the manganese myoglobin complex may be caused by the distal histidine-NO interaction. The delta(Mn-N-O) enhancement in both nitrosyl manganese CTT IV and nitrosyl manganese myoglobin may be caused by a tilting of the Mn"-Nf (proximal histidine) bond. PMID- 2765653 TI - Analysis of protein-protein interaction by simulation of small-zone size exclusion chromatography. Stochastic formulation of kinetic rate contributions to observed high-performance liquid chromatography elution characteristics. AB - High-performance liquid chromatography (HPLC) procedures provide size-exclusion chromatography with sufficient speed that the elution characteristics of mixtures of interacting macromolecules are potentially determined by the kinetics of association and dissociation. However, few studies have yet addressed the consequences of interaction kinetics on HPLC analyses or evaluated the potential application of HPLC methods for the qualitative and quantitative interpretation of macromolecular interaction kinetics. An earlier simulation of small-zone chromatography of interacting molecules (Stevens, F. J. 1986. Biochemistry. 25:981-993) has been modified to incorporate the effects of association/dissociation kinetics on elution behavior. The previous assumption of instantaneous equilibration has been replaced by explicit calculation of partial relaxation of complexed and free constituent mixtures during each iteration of the simulation. In addition, a stochastically based formulation has been introduced to determine a velocity probability distribution that emulates the partial intermixing of free and complexed pools during the iteration cycle. The simulation generates bimodal elution profiles representing stable complexed and free components of mixtures for which interaction is characterized by slow kinetics relative to chromatography run times. For mixtures with rapid kinetics, a single-asymmetric peak results. When tested with a large-zone sample such that a plateau of stable concentration is generated, the simulation reproduces previous characterizations based on evaluations of solute continuity equations. Therefore, HPLC may, in many cases be an appropriate basis for techniques by which to evaluate kinetic and affinity characteristics of interacting biomolecules. PMID- 2765655 TI - Frequency tuning in the electroreceptive periphery. AB - Our studies are concerned with the frequency tuning that is provided by the electrical resonance of tuberous electroreceptors. Frequency selectivity had previously been measured in the electroreceptor's afferent fibers, and resonant conductances in the electroreceptor cell membrane had been implicated in producing the selectivity. With transdermal application of sinusoidal current, we measured the frequency dependence of the impedance of small areas of the electroreceptor/skin structure of the weakly electric fish Sternopygus and Eigenmannia, and used our data to make a quantitative linear model of the structure. The qualitative form of the model was proposed by Bennett (1). The quantitative model allows us to estimate the frequency selectivity of the voltage across the innervated membrane of the electroreceptor cells. The frequency selectivity of electroreceptor cell voltage derived from our data are as sharp as the neural selectivity at frequencies close to the most sensitive frequency. Many of our measurements supported the linear system model. However, spontaneous electroreceptor voltage oscillations were detected in some of our specimens, suggesting that the electroreceptors can operate in a regime of active nonlinearity. A simple explanation for the observed oscillations is that they arise when damping in the electroreceptor cell's resonant membrane is negative for a limited span of membrane voltage surrounding the resting voltage. The response of oscillating units to sinusoidal current was compatible with this explanation. We report experimental observations bearing on the consequences of active nonlinearity for the frequency tuning of a resonant system. PMID- 2765654 TI - A system model for investigating passive electrical properties of neurons. AB - Passive membrane properties of neurons, characterized by a linear voltage response to constant current stimulation, were investigated by busing a system model approach. This approach utilizes the derived expression for the input impedance of a network, which simulates the passive properties of neurons, to correlate measured intracellular recordings with the response of network models. In this study, the input impedances of different network configurations and of dentate granule neurons, were derived as a function of the network elements and were validated with computer simulations. The parameters of the system model, which are the values of the network elements, were estimated using an optimization strategy. The system model provides for better estimation of the network elements than the previously described signal model, due to its explicit nature. In contrast, the signal model is an implicit function of the network elements which requires intermediate steps to estimate some of the passive properties. PMID- 2765656 TI - Kinetics of voltage-induced conductance increases in the outer mitochondrial membrane. AB - The kinetics of the increase in conductance in the outer mitochondrial membrane induced by patch-clamping at various negative potentials (pipette inside negative) are reported. The changes are biphasic, a rapid increase is followed by a slowly developing larger change. The results can be predicted by a model in which an initial activation of channels is followed by their assembly into highly conducting channels. The model suggests that five to seven activated subunits form each high-conductance channel. PMID- 2765657 TI - Evaluation of the thermal coefficient of the resistance to fluorophore rotation in model membranes. AB - The thermal coefficient of the frictional resistance to fluorophore rotation (b), a parameter related to the change in the local viscosity with temperature, was determined for anthroyloxy-fatty acid probes in micelles and dimyristoyl lecithin (DMPC) and dioleoyl lecithin (DOPC) unilamellar and multilamellar vesicles. The value of b and the percent change in anisotropy with temperature (%dA/dT) remained constant with membrane depth and only depended on composition. These parameters were also the same when either in-plane, or in-plane and out-of-plane fluorophore motions were observed. This result indicates that the membranes expand isotropically. The magnitude of b was found to be primarily dependent on the packing of the hydrocarbon chains with higher b values relating to more closely-packed chains. b was responsive to the gel to liquid crystal phase transition of DMPC and the bilayer to hexagonal phase transition of egg phosphatidylethanolamine. When the enthalpy values for the fluorophore transfer from one phase to another are calculated, the values are larger than those measured by calorimetry and reflect a discrepancy between the microscopic enthalpy experienced by the fluorophore due to a change in environment versus the macroscopic enthalpy of the system as a whole. PMID- 2765658 TI - Simultaneous determination of intramolecular distance distributions and conformational dynamics by global analysis of energy transfer measurements. AB - Fluorescence energy transfer is widely used for determination of intramolecular distances in macromolecules. The time dependence of the rate of energy transfer is a function of the donor/acceptor distance distribution and fluctuations between the various conformations which may occur during the lifetime of the excited state. Previous attempts to recover both distance distributions and segmental diffusion from time-resolved experiments have been unsuccessful due to the extreme correlation between fitting parameters. A method has been developed, based on global analysis of both donor and acceptor fluorescence decay curves, which overcomes this extreme cross-correlation and allows the parameters of the equilibrium distance distributions and intramolecular diffusion constants to be recovered with high statistical significance and accuracy. Simulation studies of typical intramolecular energy transfer experiments reveal that both static and dynamic conformational distribution information can thus be obtained at a single temperature and viscosity. PMID- 2765659 TI - Low angle light scattering studies on whole, half, and quarter molecules of T2 bacteriophage DNA. AB - Static light scattering measurements have been made at angles as low as 8 degrees on whole, half, and quarter molecules of native, T2 bacteriophage DNA in 0.195 M Na+. The fragments were obtained by high-speed stirring of the native DNA, and fractionated on methylated-albumin-kieselguhr columns. Accompanying measurements of sedimentation coefficients and intrinsic viscosities were made. Because linear extrapolations of light scattering data above 8 degrees for these samples were suspect, the measurements were analyzed by fitting curves calculated from the theory of wormlike coils to experimental curves at c = 0. Results showed that the excluded volume parameter, epsilon, must be used in analyzing the scattering curves; a reasonable value of epsilon was 0.08, in agreement with that found for T7 DNA (Harpst, J. A. 1980. Biophys. Chem. 11:295-302). The persistence length of all three DNAs in this paper was 50 +/- 5 nm, showed no dependence on molecular weight, but was somewhat below that reported previously for T7 DNA (60 nm). Theoretical curves calculated with the preceding parameters had a clear upward curvature in scattering envelopes below 8 degrees for quarter and half molecules, but such curvature was minimal for whole T2 DNA, so that linear extrapolations of experimental data above 8 degrees gave a molecular weight and root-mean-square radius which were nearly the same as those from theory. The molecular weight and radius for whole T2, derived from the comparison of theory and experiment, were 115 X 10(6) and 1,224 nm, respectively. The measurements on T2 DNA were clearly at the upper limit of current techniques. PMID- 2765661 TI - A unified matrix hypothesis of DNA-directed morphogenesis, protodynamism and growth control. AB - A theoretical concept is proposed, in order to explain some enigmatic aspects of cellular and molecular biology of eukaryotic organisms. Among these are the C value paradox of DNA redundancy, the correlation of DNA content and cell size, the disruption of genes at DNA level, the "Chromosome field" data of Lima de Faria (Hereditas 93:1, 1980), the "quantal mitosis" proposition of Holtzer et al. (Curr. Top. Dev. Biol. 7:229 1972), the inheritance of morphological patterns, the relations of DNA and chromosome organisation to cellular structure and function, the molecular basis of speciation, etc. The basic proposition of the "Unified Matrix Hypothesis" is that the nuclear DNA has a direct morphogenic function, in addition to its coding function in protein synthesis. This additional genetic information is thought to be largely contained in the non protein coding transcribed DNA, and in the untranscribed part of the genome. PMID- 2765660 TI - NaCl reflection coefficients in proximal tubule apical and basolateral membrane vesicles. Measurement by induced osmosis and solvent drag. AB - Two independent methods, induced osmosis and solvent drag, were used to determine the reflection coefficients for NaCl (sigma NaCl) in brush border and basolateral membrane vesicles isolated from rabbit proximal tubule. In the induced osmosis method, vesicles loaded with sucrose were subjected to varying inward NaCl gradients in a stopped-flow apparatus. sigma NaCl was determined from the osmolality of the NaCl solution required to cause no initial osmotic water flux as measured by light scattering (null point). By this method sigma NaCl was greater than 0.92 for both apical and basolateral membranes with best estimates of 1.0. sigma NaCl was determined by the solvent drag method using the Cl sensitive fluorescent indicator, 6-methoxy-N-[3-sulfopropyl]quinolinium (SPQ), to detect the drag of Cl into vesicles by inward osmotic water movement caused by an outward osmotic gradient. sigma NaCl was determined by comparing experimental data with theoretical curves generated using the coupled flux equations of Kedem and Katchalsky. By this method we found that sigma NaCl was greater than 0.96 for apical and greater than 0.98 for basolateral membrane vesicles, with best estimates of 1.0 for both membranes. These results demonstrate that sigma NaCl for proximal tubule apical and basolateral membranes are near unity. Taken together with previous results, these data suggest that proximal tubule water channels are long narrow pores that exclude NaCl. PMID- 2765662 TI - Studies on the tryptophan residues of soybean agglutinin. Involvement in saccharide binding. AB - Modification of tryptophan side chains of soybean agglutinin (SBA) with N bromosuccinimide results in a loss of the hemagglutinating and carbohydrate binding activities of the protein. One residue/subunit is probably essential for the binding activity. Modification leads to a large decrease in the fluorescence of the protein accompanied by a blue shift. Iodide ion quenching of the protein fluorescence shows that saccharide binding results in a decreased accessibility of some of the tryptophan side chains. These results strongly point towards the involvement of tryptophan residues in the active site of SBA. PMID- 2765663 TI - Dengue virus, a flavivirus, propagates in human bone marrow progenitors and hematopoietic cell lines. AB - Dengue and other arbovirus diseases are frequently associated with bone marrow failure. We show that dengue type 4 (DEN4) propagates in colonies derived from immature human bone marrow progenitors. DEN4 was propagated in BFU-E-derived colonies and replication was dependent on erythropoietin. DEN4 was not cytotoxic. In inoculated cultures, diffuse bursts with many clusters contained large amounts of DEN4 RNA. In contrast to dengue infection of macrophages, virus propagation in semisolid culture was sustained and not enhanced by subneutralizing amounts of antibody. DEN4 also was efficiently propagated in human hematopoietic cell lines, especially those with erythroid properties. In K562 cells, DEN4 infection persisted for months; greatly slowed cell growth, again without cytotoxicity; and resulted in cytopathic changes in cell appearance. Flaviviruses can infect human hematopoietic cells and alter their proliferative capacity. PMID- 2765664 TI - Synergistic cytotoxic effect of azidothymidine and recombinant interferon alpha on normal human bone marrow progenitor cells. AB - Azidothymidine (AZT) and interferon alpha (IFN-alpha) are among the drugs showing strong in vitro activity against the human immunodeficiency virus type-1 (HIV-1). Each drug, however, has significant toxicity against normal marrow progenitor cells that frequently proves dose-limiting in patients. In this study, AZT and recombinant IFN-alpha 2a (rIFN-alpha 2a) were tested as single agents and in combination against normal myeloid (CFU-GM) and erythroid (BFU-E) colony forming cells in a standard methylcellulose culture assay. The data were analyzed using a quantitative computerized analysis based on the median-effect principle and the isobologram equation as described by Chou and Talalay (Adv Enz Regul 22:27, 1984). The ED90 for BFU-E and CFU-GM inhibition was then compared with previously measured in vivo plasma levels of each drug and the ED90 for the anti-HIV-1 effect in vitro. We demonstrate that (a) the drugs are strongly synergistic in inhibiting marrow progenitor cell growth and that this synergism occurs at drug levels that are within the range of measured plasma levels in phase I clinical trials, (b) BFU-E are more sensitive than CFU-GM to the inhibiting effects of AZT, rIFN-alpha 2a or both drugs in combination, (c) the drug concentrations in combination that synergistically inhibit bone marrow progenitors are much higher than those required to inhibit HIV-1 replication in vitro, and (d) the anti-HIV-1 effect for the combination of AZT and rIFN-alpha 2a was clearly superior to the effect of AZT or rIFN-alpha 2a alone as indicated by the combination index and the dose-reduction index. These data suggest that substantially lower doses of AZT and rIFN-alpha than those currently being tested in clinical trials might not only maintain a strong synergistic anti-HIV-1 effect but might also avoid significant hematologic toxicity. PMID- 2765665 TI - Monocyte-platelet interaction in immune and nonimmune thrombocytopenia. AB - Platelets from 24 patients with immune thrombocytopenia resistant to standard therapy (refractory ITP), 35 patients with nonimmune thrombocytopenia (non-ITP), and 32 normal donors were studied in regard to platelet surface-bound IgG (PBIgG) and the ability of these platelets to be bound by human monocytes in vitro (monocyte-platelet rosette assay). Fourteen (58%) of the platelet samples from refractory ITP patients but none (0%) from the non-ITP or control donors had PBIgG greater than 800 molecules IgG/platelet. Seventeen of 24 (71%) of the ITP patients had platelets which demonstrated increased monocyte-platelet rosette formation [rosette index (RI) greater than 2], whereas only four (11%) of the non ITP patients had such platelets. There was a direct correlation between PBIgG and rosette index for the platelets from resistant ITP patients. There was no correlation of severity of thrombocytopenia with PBIgG or rosette index. Monocyte platelet interaction in the presence of elevated PBIgG is mediated through the monocyte Fc-receptor. Platelets from five of ten refractory ITP patients with PBIgG less than 800 molecules IgG/platelet had increased rosette formation. Monocyte-platelet interaction in the absence of increased PBIgG may be due to small amounts of platelet surface IgG which are still able to mediate monocyte Fc receptor interaction or to alternate membrane receptor interaction through the monocyte C3 receptor. Our data underscore the pathophysiologic relevance of monocyte/macrophage-mediated interaction in immune platelet destruction syndromes. PMID- 2765666 TI - Covalent modification of platelet proteins by palmitate. AB - Covalent attachment of fatty acid to proteins plays an important role in association of certain proteins with hydrophobic membrane structures. In platelets, the structure of many membrane glycoproteins (GPs) has been examined in detail, but the question of fatty acid acylation of platelet proteins has not been addressed. In this study, we wished to determine (a) whether platelet proteins could be fatty acid acylated; and, if so, (b) whether these modified proteins were present in isolated platelet membranes and cytoskeletal fractions; and (c) if the pattern of fatty acid acylated proteins changed on stimulation of the platelets with the agonist thrombin. We observed that in platelets allowed to incorporate 3H-palmitate, a small percentage (1.37%) of radioactivity incorporated into the cells became covalently bound to protein. Selective cleavage of thioester, thioester plus O-ester, and amide-linked 3H-fatty acids from proteins, and their subsequent analysis by high-performance liquid chromatography (HPLC) indicated that the greatest part of 3H-fatty acid covalently bound to protein was thioester-linked 3H-palmitate. By sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) and fluorography, at least ten major radiolabeled proteins were detected. Activation of platelets by thrombin greatly increased the quantity of 3H-palmitoylated proteins associated with the cytoskeleton. Nearly all radiolabeled proteins were recovered in the membrane fraction, indicating that these proteins are either integral or peripheral membrane proteins or proteins tightly associated to membrane constituents. Components of the GPIIb-IIIa complex were not palmitoylated. Thus, platelet proteins are significantly modified posttranslationally by 3H-palmitate, and incorporation of palmitoylated proteins into the cytoskeleton is a prominent component of the platelet response to thrombin stimulation. PMID- 2765668 TI - CD antigens 1989. PMID- 2765667 TI - Expression of the mdr-1/P-170 gene in patients with acute lymphoblastic leukemia. AB - Increased expression of the multidrug resistance gene (mdr-1/P-170) and the dihydrofolate reductase (DHFR) gene have been implicated in the development of in vitro drug resistance. Overexpression, with or without gene amplification, is seen in the development of drug resistance in culture and it has been postulated that genetic modulation of mdr-1/P-170 and DHFR may also be involved in the development of clinical drug resistance. We screened lymphoblasts from 28 patients with acute lymphoblastic leukemia (ALL) for evidence of overexpression of mdr-1/P-170 using RNAse protection, RNA in situ hybridization and immunohistochemistry. Overexpression of mdr-1/P-170 without gene amplification was detected in samples from four patients (three after multiple relapses, one at presentation). Overexpression of mdr-1/P-170 was heterogeneous within the population of malignant lymphoblasts as demonstrated by RNA in situ hybridization, immunohistochemistry, and drug uptake using daunomycin autofluorescence analysis. There was no evidence of overexpression of DHFR in any of the eight patient samples tested by RNAse protection nor was there any evidence of gene amplification in 11 patient samples on Southern blot analysis. From these observations it appears that overexpression without gene amplification of mdr-1/P-170 may be one mechanism of clinical drug resistance in ALL. PMID- 2765669 TI - Locomotion of white blood cells: a biophysical analysis. AB - We determined some biophysical properties of human granulocytes, monocytes, and lymphocytes in respect to their locomotion. Granulocytes were exposed to plasma and were allowed to crawl on uncoated or glycol methacrylate coated glass plates. Monocytes did not migrate on uncoated glass, but did so on glycol methacrylated glass. Lymphocytes did not move on glass or glycol methacrylated glass, but moved on plexiglas coverslips. Granulocytes and monocytes showed a pronounced, directed movement towards a lysed erythrocyte (necrotaxis), lymphocytes showed no necrotactic response. The information collected by the granulocytes and monocytes in the necrotactic gradient was between 1 and 2 bits. This small amount of information indicated that the cellular decision in favor of a new direction of migration is based on a mechanism involving instability. We showed that the necrotactic response of granulocytes and monocytes is the product of the chemokinetic activity and the polar order parameter (= McCutcheon index) indicating that the cellular decision for a new direction of migration is independent of the speed of the cell movement. The movement of monocytes can be characterized in a similar way to that of granulocytes: the angle of deviation from a straight line path is nearly a fixed value (+/- 35 degrees). Lymphocytes stay in a restricted area after straight line movement. Particular attention was focused on cellular properties involved in locomotion. The characteristic time of the internal clock controlling the locomotion was 0.9 minutes for granulocytes and 2 minutes for monocytes. We were not able to determine the characteristic time of lymphocytes. We were able to determine the internal program responsible for the change in direction of movement. The directional memory time for granulocytes was 0.9 minutes. Monocytes had two directional memory times, short (2 minutes) and long (greater than 18 minutes). Lymphocytes had a very short directional memory time of 40 seconds. The distribution of the track velocities of migrating granulocytes and monocytes was described by bell shaped curves indicating homogeneous populations of cells. The distribution for lymphocytes had two maxima. PMID- 2765670 TI - A comparative morphometric study on the ultrastructure of adherent cells in long term bone marrow culture from normal and congenitally anemic mice. AB - The relationship between structure and function of bone marrow stromal tissue in adherent layers of long-term bone marrow cultures (LTBMCs) from normal and congenital anemic mice (C57BL, Sl/Sld, Sl+/Sl+, W/Wv, and W+/W+) was investigated. Many previously reported features were confirmed. However, in LTBMC from all strains of mice examined, isolated cilia with the axonemal structure of a 9 + O pattern with obvious dynein arms were observed in the blanket cells. The frequency of cilia was approximately 2%-5% of total number of profiles of blanket cells examined. Crystalloid inclusions (CI) were observed in cultured macrophages similar to those reported in vivo in all strains of murine LTBMC. The CI could be classified into four types according to their structure in the same way as in vivo (type A to type D), with a predominance of type A in the cultures. Viral particles were also apparent in adherent cells of all strains (except W/Wv and W+/W+), which were compatible with a type C retrovirus. Gap junctions occurred regularly between the adherent cells of LTBMC, particularly between blanket cells and preadipocytes. The most frequent appearance of gap junctions was found in Sl/Sld cultures. The phenomena of normal and abnormal hematopoiesis appear to be accurately reproduced in culture, thus retaining the same relationship between function and structure as occurs in vivo. The surface of isolated cilia of blanket cells, CI of macrophages, viral particles among adherent cells, and gap junctions between blanket cells and preadipocytes is discussed. PMID- 2765671 TI - Compartmentalization in long-term marrow culture: the role of blanket cells. PMID- 2765672 TI - Computation of the average shear-induced deformation of red blood cells as a function of osmolality. AB - A model was developed for computing the average deformation of red cells as a function of suspending medium osmolality. It assumes a population of red cells characterized by a single value for surface area and for isotonic volume, but having a Gaussian distribution in mean intracellular hemoglobin concentration (MCHC). The ability of cells of a given hemoglobin concentration to deform is assumed to be limited by either the amount of redundant surface area available or the intracellular viscosity, determined by the intracellular hemoglobin concentration. The surface area limitation is calculated by finding the dimensions of a prolate ellipsoid having the volume and surface area of the red cell. The viscosity limitation is incorporated in two ways. First, the ratio of intracellular to extracellular viscosity must lie below a certain threshold to permit deformation, and second, its magnitude determines the extent of cell elongation. This model gave a reasonable fit to experimental data for a threshold viscosity ratio close to 1. Extension to cell populations for which either mean cell hemoglobin concentration or surface area had been modified also provided a close reproduction of the experimental curves. PMID- 2765673 TI - Change of deformability and Heinz body formation in G6PD-deficient erythrocytes treated with 5-hydroxy-6-desmethylprimaquine. AB - Glucose-6-phosphate deficient human erythrocytes were incubated with low concentrations of 5-hydroxy-6-desmethylprimaquine, a metabolite of primaquine in animals, for up to 18 hours under sterile conditions. These erythrocytes became less deformable than untreated erythrocytes. This decrease in deformability was closely associated with the extent and time course of formation of Heinz bodies in the G6PD-deficient erythrocytes. These results support the hypothesis that the in vivo formation of low concentrations of 5H6DPQ by metabolism of primaquine could be the cause of Heinz body formation and the hemolytic anemia seen when primaquine is administered to G6PD-deficient individuals. PMID- 2765674 TI - Dynamics of blood coagulation factor XIII in ulcerative colitis and preliminary study of the factor XIII concentrate. AB - Blood coagulation studies were performed in twenty patients with ulcerative colitis (UC). At the active stage of UC, a marked increase in platelet count and fibrinogen concentration, and a marked decrease in Factor XIII activity level were observed. At the active stage of UC, four patients were treated with Factor XIII concentrate leading to reduction of pain, bleeding and endoscopic findings. PMID- 2765675 TI - Lineage- and differentiation-dependent alterations in the expression of receptors for glycoconjugates (lectins) in different human hematopoietic cell lines and low grade lymphomas. AB - Important biological functions and cellular recognition phenomena are supposedly governed by specific sugar-protein interactions. Human hematopoietic cell lines offer an excellent model for the study of the expression of endogenous receptors for the carbohydrate part of glycoconjugates with respect to cell lineage and modulation by differentiation. Initially, a panel of fluorescent (neo)glycoproteins was successfully employed to demonstrate cytologically the actual presence of such receptors on different cell lines: the B lymphoblast line, Daudi; the T cell lymphoblastic leukemia line, P12; the multipotent leukemic line, K562 and the promyelocytic line, HL060. Biochemical analyses were performed using affinity chromatography on supports with immobilized lactose and asialofetuin (simple or complex beta-galactosides), melibiose (alpha galactoside), fucose, N-acetyl-D-galactosamine, maltose (alpha-glucoside), the mannose-rich yeast glycoprotein, mannan, glycopeptides containing sialic acid residues and heparin. Subsequently, sodium dodecyl sulfate-polyacrylamide slab gel electrophoresis was used to detect cell lineage-dependent changes in theses parameters. Differentiation-dependent changes in the expression of receptors with specificity to galactose, N-acetylgalactosamine, maltose and heparin were similarly uncovered upon dimethyl sulfoxide-induced differentiation of HL60 cells. Differences in this type of cellular characteristic were also apparent for lymphoma cells from patients with various histological subtypes of lowgrade lymphomas. This initial description of lineage- and differentiation-dependent differences in various human hematopoietic cell lines and in cells from patients with lowgrade lymphomas suggests that advances in the knowledge of the composition of endogenous sugar receptors (lectins) may aid in understanding aspects of the biological behavior of hematopoietic cells and their related malignancies via participation of sugar-protein (lectin) interactions. PMID- 2765676 TI - Defined, serum-free culture conditions for the GM-micro-clonogenic assay using agar-capillaries. AB - Culture conditions were determined and optimised for the serum-free growth of granulocyte-macrophage (GM) colonies, derived from mouse bone marrow cells, in agar-containing glass capillaries. The standard medium is DMEM/F-12 (1:1) mixture containing per ml: 10 mg BSA, 35 micrograms transferrin, 20 micrograms soybean lipids and 5 micrograms insulin. In contrast to previous attempts by others, GM colony yield in serum-free medium was found to be equal to that in serum containing medium (around 25 colonies/capillary) and to correlate satisfactorily with the cell density at seeding.--The role of polyamine oxidases in cell proliferation experiments could be studied by this microclonogenic assay without interference from any type of serum. PMID- 2765677 TI - Clinical significance of fibrinopeptide A in acute lymphocytic and non lymphocytic leukaemia. AB - Fibrinopeptide A (FPA) was systematically investigated in 74 patients with acute leukaemia at different stages of the disease (50 with non-lymphocytic leukaemia, ANLL; 24 with lymphocytic leukaemia, ALL). At diagnosis, 75% of the cases had high FPA levels (86% in ANLL and 54% in ALL) with significantly higher levels in ANLL than in ALL (13.4 vs 4.4 ng/ml; p less than 0.001). Patients with DIC (20 cases in ANLL and 1 case in ALL) had significantly higher levels (p less than 0.001). FPA levels were neither correlated with fibrinogen or FDP levels nor with blast cell count. During chemotherapy, median FPA did not show significant changes whereas, at the end of therapy, a return toward normality was generally observed both in ALL and ANLL apart from the group of patients with acute promyelocytic leukaemia. Among the 24 patients who entered post-remission follow up (13 ANLL and 11 ALL), 10 cases out of the 11 relapsing (6/6 with ANLL and 4/5 with ALL) had increased FPA 1 to 2 months before the ascertainment of the relapse. However, 16% and 9% of the samples obtained on different occasions, respectively from ANLL and ALL cases in maintained first remission, showed FPA above the normal limit. This study demonstrates that subclinical activation of blood coagulation, as indicated by high FPA level, is common both in lymphocytic and non-lymphocytic leukemia and suggests that this phenomenon is related to disease activity. PMID- 2765678 TI - In vitro bleeding test--a sensitive method for the detection of platelet function impairment and a potential test for the control of low-dose aspirin efficacy. PMID- 2765679 TI - Annual spring meeting of the Osterreichische Gesellschaft fur Hamatologie und Onkologie. Vienna, March 17, 1989. Abstracts. PMID- 2765680 TI - [Ultrastructural study of the action of concentrated solutions of chlorhexidine digluconate on cocci in salivary flora in vitro]. AB - Chlorhexidine digluconate is a potent antibacterial compound widely used in stomatology. In this work the authors studied the ultrastructural alterations of cocci in salivary flora, treated "in vitro" with high concentrations of chlorhexidine digluconate (0.5%, 1% and 2%). The effect of chlorhexidine 0.5% on the cocci revealed rarefaction of the cytoplasm, ruptures of the cellular wall and alterations of the protoplasm in the form of "plasmoptysis" and "plasmolysis". Treatment of the cocci with higher concentrations (1% and 2%) of the drug caused a change in the appearance of the protoplasm, showing a general coagulation, damage of the cytoplasmic membrane and the cellular wall, malformation of the cell and disorganization of the nuclear chromatin. The ultrastructural alterations observed are in agreement with the results of preliminary biochemical studies. PMID- 2765681 TI - Ultrastructural diagnostic markers of the urinary bladder precancer. AB - A morphological analysis of 346 biopsy specimens from 140 patients with chronic cystitis permits one to evaluate the proliferative forms of the disease, the cases with atypical hyperplasia of the urothelium or metaplasia of the squamous cells with acanthosis and hyperkeratosis of the group at risk, belonging to bladder precancer. The early ultrastructural signs of urothelial atypia are determined, among them the thickening of the glycocalyx layer (up to 30-60 nm) irregularly covering the entire surface of atypical cells, the disappearance of vesicular apparatus and AUM, the widening of the intercellular spaces. It was found that the squamous epithelium, formed by atypical cytodifferentiation of urothelium, is inadequate for performing the barrier function inherent in normal urothelium. PMID- 2765682 TI - [Study of the action of an elastin polypeptide on dermal connective tissue]. AB - The study of the effect of an elastin polypeptide on the connective tissue of rats, in the course of skin regeneration, showed an increase in fibrogenesis and fibroblastic hyperplasia in treated animals. The difference between treated and control animals is preserved after stopping of treatment after 15 days. PMID- 2765683 TI - [The spinal periosteal layer and the fibrous sheath of the cervical spinal canal]. AB - At the cervical level, in the foramen, the rachidian nerve is surrounded by two mantles: a dural one and a fibrous one continuing the epidural periosteal sheet of which it is a thickening. We can wonder whether this fibrous sheath is at the origin of some cervical radiculalgias in which one cannot detect any radiological lesion of the skeleton or disk. PMID- 2765684 TI - [Elastometric study of the distal scaphoid ligamental complex and the scapho lunar ligament]. AB - Six wrists from fresh cadavers have formed the subject of a functional, histological and biomechanical study. This one has been realized by two methods: the one analytical, the other in the whole and in situ. The diverse experiences show up the pre-eminent role of the distal scaphoid ligamentous complex relative to the scapholunar ligament. This fact is in opposition to the generally admitted theories. It modifies the therapeutic approach to lateral carpal instabilities. PMID- 2765685 TI - Binding specificity and presynaptic action of anaphylatoxin C5a in rat brain. AB - Human anaphylatoxin C5a injected directly to the perifornical hypothalamus (PFH) of the rat elicits food intake in sated rats, an effect which mimics that of norepinephrine (NE) at the PFH. The ability of C5a to induce food intake is selectively blocked by the alpha-adrenergic antagonist phentolamine, confirming that C5a exerts its effects via an alpha-adrenergic receptor system. In this study specific C5a binding sites on rat brain slices were detected using 125I-C5a at 2.4 nM in the presence of unlabeled noncompeting C3a and competing C5a at 0.5 microM. To determine whether the in vivo activity of C5a was due to direct stimulation of an alpha-adrenergic receptor system or to indirect modulation via a specific C5a receptor, rats were pretreated at the PFH with C5ai, the "inactive" 74-desarginated derivative of C5a. C5ai blocked stimulation of feeding by C5a but had no effect on food intake elicited by NE, suggesting a presynaptic site for C5a activity. To determine whether C5a anaphylatoxin acts at presynaptic or postsynaptic sites, the ability of C5a and of NE to induce food intake in sated rats was compared before and after injection of the tyrosine hydroxylase inhibitor alpha-methyl-p-tyrosine (AMPT) to the PFH. AMPT would produce focal depletion of endogenous catecholamines by inhibition of catecholamine biosynthesis. Rats treated with AMPT failed to respond to C5a but ate excessively following NE, suggesting that C5a acts presynaptically, possibly to release NE. We propose that C5a acts at a specific C5a/C5ai receptor to modulate catecholamine activity at the brain site. PMID- 2765686 TI - Influence of early rearing on lymphocyte proliferation responses in juvenile rhesus monkeys. AB - Lymphocyte proliferation responses and natural killer cell activity were evaluated in 35 juvenile rhesus monkeys derived from five different rearing conditions. Nursery-reared monkeys had proliferation responses which were significantly higher than those of mother-reared subjects. Reexamination of the nursery-reared monkeys 1.5 years later indicated that an abnormally high response to concanavalin A was still evident at 2.5 years of age, but both PHA and PWM responses had shown an age-appropriate decrease into the normal range for this species. Proliferation responses in monkeys that had been weaned early from their mothers at 6 months of age were also higher than values for control monkeys that remained with their mothers, but below those of the nursery-reared monkeys. In contrast, monkeys that had received multiple separations from the mother between 3 and 7 months of age showed lymphocyte proliferation responses that were below normal. These results indicate that early rearing conditions can have a lasting effect on certain immune responses in the developing primate. PMID- 2765687 TI - Repeated intraperitoneal injections of saline attenuate the antibody response to a subsequent intraperitoneal injection of antigen. AB - The results of two experiments with male C3H/HeJ mice indicated that repeated intraperitoneal (ip) injections of sterile saline over a 2-week period resulted in an attenuated antibody response to the subsequent ip injection of a soluble protein antigen, keyhole limpet hemocyanin. There were no differences among experimental groups that received a different number of preimmunization injections of saline, and comparable effects were obtained simply by the daily handling of mice. Neither repeated ip injections nor handling altered preimmunization (baseline) corticosterone levels, and only previously unmanipulated mice showed an elevation in corticosterone levels 30 min after ip immunization. These latter results suggest that the depressed IgM and IgG responses were not due to the immunosuppressive effects of endogenously elevated adrenocortical steroids. PMID- 2765688 TI - [Atherosclerotic changes of the inferior dental artery correlated with those of the carotid bifurcation and the abdominal artery]. AB - 50 corpses from adults aged 20 to 75 have been used in order to study the atherosclerotic lesions occurring in typical regions (bifurcation of the common carotid artery and the abdominal aorta) and their relationship to atherosclerotic changes in the inferior alveolar artery. Histological analysis revealed that atherosclerotic alterations of the inferior alveolar artery may appear sometimes earlier than it would be expected on the ground of age. Intima cell proliferation and thickening of elastic elements in the middle layer of the arterial wall, the first signs of atherosclerosis, were found already at the beginning of the third decade of life when the signs of this process in the typical regions were not yet evident. Atherosclerosis affects essentially the functional capacity of the inferior alveolar artery. The development of atherosclerosis in the wall of this artery favours an hypovascularization of the mandible, which must be of certain importance in every operative procedure in oral surgery, especially in those inducing a severe and long traumatism in bone and soft tissues, such as dental implantations. PMID- 2765689 TI - Hydroxyapatite biomaterial implanted in human periodontal defects: an histological and ultrastructural study. AB - The purpose of the present work was to study the response of human periodontium to hydroxyapatite biomaterial particles (180-200 microns). The biomaterial was implanted in two infra-osseous periodontal defects (two patients) after clearing of the granulation tissue. At two months post-surgery, biopsies were studied using light and electron microscopy. No sign of inflammation was observed, the biomaterial aggregates were surrounded either by typical fibroblasts or larger phagocytotic cells with phagocytosis vesicles containing biomaterial crystals. These intracellular crystals were noticeably smaller than the non-phagocytized ones. Some of the phagocytized crystals showed morphological signs of intracellular dissolution. The spaces between the crystals constitutive of the aggregates were filled with organic substance containing collagen fibers. PMID- 2765690 TI - Treatment of a periodontal intrabony pocket in man by a mucoperiosteal free graft combined with a calcium phosphate implant. AB - A two-walled intrabony pocket was treated by a mucoperiosteal free graft interposed between the curetted root surface and a calcium phosphate implant. The eighteen months follow up radiography showed complete healing of the bone defect, a normal periodontal ligament space, an uninterrupted lamina dura and a well formed septum. The use of mucoperiosteal free graft may supply the wounded area with different cells such as fibroblasts, undifferentiated mesenchymal cells, periosteal cells, intercellular fibers and biochemical substances such as glucosaminoglycans, proteoglycans etc... PMID- 2765691 TI - Direct determination of unconjugated HVA in human plasma filtrates by HPLC coupled with dual-electrode coulometric electrochemical detection. AB - We report a procedure for the rapid determination of unconjugated homovanillic acid (HVA) in human plasma by cartridge filtration followed by direct injection into an isocratic HPLC system coupled with dual-electrode coulometric electrochemical detection. Sample preparation is rapid and more than 72 samples can be studied in 24 h using an automated HPLC system. The intra- and interassay precisions of the assay equal or exceed previously reported methods. While this methodology has been employed to study plasma free HVA, the concept of the technique may be applicable to other compounds, as well as different assay procedures, to greatly decrease sample preparation time. PMID- 2765692 TI - Rapid and sensitive determination of beta-phenylethylamine in animal brains by high performance liquid chromatography with fluorometric detection. AB - A reversed phase HPLC method with fluorometric detection for the analysis of beta phenylethylamine has been developed using p-methoxyphenylethylamine as an internal standard. Two columns, containing 200 microL of Dowex 50-X8 and Amberlite CG-50 respectively, were used to prepare a fraction containing beta phenylethylamine. The recoveries of beta-phenylethylamine and p methoxyphenylethylamine were 53.9 +/- 9.4% and 68.1 +/- 12.4%, respectively, and elution profile of p-methoxyphenylethylamine was sufficiently well correlated with that of beta-phenylethylamine. Regional distributions of beta phenylethylamine in rat and mouse brains were determined. The highest concentrations were found in hypothalamus and hippocampus in both animals. PMID- 2765693 TI - Lactoferrin from human breast milk and from neutrophil granulocytes. Comparative studies of isolation, quantitation, characterization and iron binding properties. AB - The isolation and properties of lactoferrin from human breast milk and from neutrophilic granulocytes were investigated. Human breast milk lactoferrin was purified by means of heparin-sepharose or Cibacron Blue affinity chromatography. Quantitative recovery using these two methods was comparable but Cibacron Blue affinity chromatography allowed for isolation of a more homogenous protein. Lactoferrin could only be isolated from human neutrophilic granulocytes by sequential use of antibody affinity followed by non-specific affinity chromatography. Both breast milk lactoferrin and granulocyte lactoferrin were separated into apo and iron-rich species by SDS polyacrylamide gel chromatography. Iron binding is accompanied by a conformational change in tertiary structure associated with more rapid electrophoretic migration. The isoelectric point of both human breast milk lactoferrin and human granulocyte lactoferrin is 5.5-6.2. Both types of lactoferrin have similar iron binding properties with release of iron from the one binding site occurring at pH 5.2-6.0 while the other binding site holds on to iron down to pH 3.6-3.2. Despite the high affinity for iron the percentage saturation of native lactoferrin is low, that for breast milk lactoferrin averaging 12-25% and that for granulocyte lactoferrin less than 10%. PMID- 2765694 TI - Evidence for the overestimation of molecular masses of proteins after chemical modification and chemical crosslinks on sodium dodecyl sulfate/polyacrylamide gel electrophoresis (SDS-PAGE). AB - Human trypsin inhibitor (home prepared), lactalbumin, trypsinogen, carbonic anhydrase, and bovine serum albumin were submitted to succinylation and their molecular masses were determined by SDS-PAGE according to the method of Weber and Osborn (1969 J. Biol. Chem. 244, 4406) before and after chemical modification. High estimates of their molecular masses were obtained. The monomer and dimer of arrowhead inhibitor proteinase-B (Chinese vegetable legume) obtained after chemical crosslink(s) were also submitted to SDS-PAGE and their apparent molecular masses were also determined and compared to the native arrowhead inhibitor proteinase-B. Abnormally high estimates of their molecular masses were obtained. Our results agree with those in the literature. PMID- 2765695 TI - Determination of halofuginone in bovine plasma by competing-ion high performance liquid chromatography after solid phase extraction. AB - A high performance liquid chromatography (HPLC) method for the determination of the anticoccidial and antitheilerial drug halofuginone in bovine plasma was developed. Samples were diluted with acetic acid (10%, v/v) and cleaned up on a Bond Elut C8 column. The analyte was eluted from the extraction column and chromatographed by reversed-phase HPLC using decylamine as a competing-ion reagent. Detection was by UV at 243 nm. Recovery from plasma was 75%, and within day and between-day coefficients of variation were 5.23 and 6.35% respectively. The specificity and sensitivity of this method (limit of detection in plasma, 1 ng/mL) were sufficiently high to enable us to characterize the time course of the drug in plasma after oral administration of therapeutic doses to cattle. PMID- 2765696 TI - Direct liquid inlet liquid chromatographic/mass spectrometric identification and high-performance liquid chromatographic analysis of a benzodiazepine glucuronide. AB - The glucuronide of N-1-hydroxy-ethyl flurazepam has been analysed by a direct liquid inlet liquid chromatographic/mass spectrometric system using MeOH/H2O (70:30 v/v) as mobile phase, at a flow rate of 0.7 ml min-1. Urine samples were purified by amberlite XAD-2 chromatography; the glucuronide was quantified by high-performance liquid chromatography using a counterion (tetrabutyl ammonium nitrate in methanol). Chromatographic results were validated by an enzymatic method: treatment of the samples with beta-glucuronidase and extraction of the parent drug with ethyl ether at pH 9. The biological application of this method was demonstrated by determination of this glucuronide in the urine of healthy human volunteers following a single intravenous administration of 50 mg of N-1 hydroxy-ethyl flurazepam. PMID- 2765697 TI - Rapid identification of calbindin-D28k cyanogen bromide peptide fragments by plasma desorption mass spectrometry. AB - Chicken intestinal calbindin-D28k is an intracellular protein which is believed to have a fundamental role in vitamin D-mediated transport of calcium. A mapping approach based on 252Cf plasma desorption mass spectrometry (PD mapping) was used to screen the DNA-deduced sequence of calbindin-D28k for sequence changes and post-translational modifications. In the PD mapping experiment, purified calbindin-D28k was cleaved with cyanogen bromide and the resulting peptides were subjected to PD mass spectrometric analysis either as a mixture or as high performance liquid chromatography isolated fractions. The DNA-derived primary structure of calbindin-D28k was confirmed by rapid PD mass spectral identification of the CNBr peptide fragments, and the nature of the N-terminal blocking group was readily determined to be an acetyl group. The relatively non destructive nature of the PD mass spectrometric analysis allowed the mapping of the N-terminal peptide through an additional in situ V8 protease enzymatic reaction. PMID- 2765698 TI - Collisional activation mass spectra of M-. ions of azo dyes containing 2 naphthol. AB - Collisionally activated decomposition mass spectra of M-. ions of azo dyes are presented. The compounds are of general structure Ar(1)--N = N--Ar(2), where Ar(1) is substituted phenyl and Ar(2) is 2-naphthol. Characteristic fragment ions observed include m/z 157, which corresponds to the 2-naphthol substituent with cleavage of the--N = N--bond represented as [Ar(2)--N]-.. Ion of general structure [Ar(1)--NH]- are also observed. Parent ion scans of m/z 157 provide a potential screening technique for 2-naphthol-containing axo dyes. Specific results are reported for the chloroform extract of FD&C Red #8, and capillary gas chromatographic introduction is compared with direct exposure probe introduction for the identification of dyes. PMID- 2765699 TI - Studies on the biotransformation of ketamine. II--Quantitative significance of the N-demethylation pathway in rats in vivo determined by a novel stable isotope technique. AB - In order to determine the fraction of an intravenous bolus dose of ketamine which is metabolized in vivo to the corresponding N-desmethyl compound, norketamine, a novel stable isotope technique was developed and applied to a study in rats. Co injection of equimolar amounts of deuterium-labeled ketamine and unlabeled norketamine to four animals, followed by gas chromatographic/mass spectrometric analysis of both the administered compounds and deuterium-labeled norketamine in plasma, yielded pharmacokinetic data from which the fraction of the parent drug subjected to N-demethylation (fm) was calculated from AUC data to be 36.8 +/- 2.4%. It is concluded that this stable isotope co-administration technique represents a powerful approach to the determination of fm, in that the pharmacokinetics of the metabolite of interest, given as the preformed compound and generated in vivo, are determined simultaneously. This experimental design thus obviates the influence of time-dependent changes in metabolite clearance which may complicate the interpretation of studies performed using the classical cross-over design. PMID- 2765700 TI - Factors affecting the fragmentation of peptides in fast atom bombardment mass spectrometry. AB - Positive ion fast atom bombardment mass spectra of a series of biologically active peptides were obtained in order to ascertain conditions that contribute to an increase in fragment ion abundance of such peptides. The effect of derivatization, hydrophobic character and the presence of acid in the matrix on fragmentation of peptides were all investigated. It is shown that a substantial increase in fragment signal ion abundance is observed when mineral acid is present in the matrix, and is in accord with the gas-phase collision model proposed by Kebarle. PMID- 2765701 TI - Profiles in altered metabolism. IV--Induction of acute dicarboxylic aciduria following 2-octynoic acid administration to the rat. AB - Rats given 2-octynoic acid by intraperitoneal injection excrete elevated amounts of medium-chain dicarboxylic acids and other acidic metabolites usually associated with human medium-chain acyl-CoA dehydrogenase deficiency. Onset of this organic acid profile is immediate and lasts for approximately 24 h. The induced acidosis in this animal model closely, acutely and transiently resembles the human disorder. The 2-octynoate load is also extensively omega- and psi oxidized, and evidence is presented for the enzymic hydration of 2-octynoate to 3 ketooctanoic acid. PMID- 2765702 TI - Rapid determination of sequence variations in actinidin isolated from Actinidia chinensis (var. Hayward) using fast atom bombardment mapping mass spectrometry and gas phase microsequencing. AB - A current limitation in the use of fast atom bombardment (FAB) mass spectrometric mapping of peptide mixtures, derived from enzymic digestion of proteins, is that most of the hydrophilic peptides are not observed. However, it has been demonstrated from previous work that esterification of the peptide mixture results in the detection of almost all peptides in FAB mass spectrometry. This strategy of FAB mapping was applied to the protein actinidin, isolated from an Italian variety of Actinidia chinensis. Two of the 12 tryptic peptides in FAB mass spectrometry did not exhibit molecular ions predicted from the known sequence of actinidin isolated from the New Zealand variety of A. chinensis. The two peptides were isolated by high-performance liquid chromatography, subjected to Staphylococcus aureus V8 protease digestion and sequenced by gas-phase microsequencing. Nine changes in amino acid composition were detected using the rapid and powerful combination of FAB mass spectrometric mapping and gas-phase microsequencing. PMID- 2765703 TI - Studies on anabolic steroids. II--Gas chromatographic/mass spectrometric characterization of oxandrolone urinary metabolites in man. AB - The metabolism of 17 alpha-methyl-17 beta-hydroxy-2-oxa-5 alpha-androstan-3-one (oxandrolone) in man has been investigated by gas chromatography/mass spectrometry. After oral administration of a 10 mg dose to man, five metabolites were detected in the free fraction of the urinary samples. Oxandrolone, the major compound excreted in urine, was detected within 72 h after administration. During this period 35.8 and 8.4% of the administered dose was excreted as unchanged oxandrolone and 17-epioxandrolone, respectively. In addition, minute amounts of 16 alpha- and 16 beta-hydroxyoxandrolone and a delta-hydroxy acid resulting from the hydrolysis of the lactone group of oxandrolone were detected in the urine samples 8-60 h after administration. Furthermore, the susceptibility of oxandrolone to hydrolysis was investigated under several pH conditions. Extraction and fractionation of steroidal metabolites was achieved by using C18 and silica Sep Pak chromatography. The mass spectra of the metabolites are presented and major fragmentation pathways discussed. PMID- 2765704 TI - The influence of early parathyroidectomy on aluminum-induced rickets in growing uremic rats. AB - Rats were subjected to a two-stage 5/6 nephrectomy and treated with aluminum for 2 and 4 weeks with a cumulative dose of 4.2 and 8.4 mg of aluminum, respectively. Other animals were parathyroidectomized and loaded with 8.4 mg of aluminum for 4 weeks. Histomorphometry and electron microscopy (tibiae), aluminum tissue (bone, kidney, liver) determination, serum (Ca, Mg, Zn, P, urea, creatinine, alkaline phosphatase, 1,25(OH)2D3, PTH) and urine (creatinine, A1) revealed that: (a) a dose of 8.4 mg aluminum was sufficient to induce rickets within 4 weeks of treatment and was associated with decreased serum calcitriol values and high aluminum accumulation within organs (electron-dense material was found in osteoblasts only); (b) previous parathyroidectomy prevented the occurrence of any aluminum-induced alteration of bone. It was associated with higher calcitriol and phosphorus values than in corresponding non-parathyroidectomized rats and significantly reduced aluminum accumulation within organs. The results was influenced neither by a drop in serum calcium values nor by different degrees of renal failure. We suggest that aluminum-induced rickets in growing uremic rats is prevented or delayed when previous parathyroidectomy has been performed. PMID- 2765705 TI - Acute plasma calcium regulation in rats: effect of vitamin D deficiency. AB - Vitamin D-replete (+D) and vitamin D-deficient (-D) rats received large doses of calcium (2-18 mg) by intraperitoneal injection and their responses to the calcium load was analysed in terms of the instantaneous and time-dependent responses of the plasma calcium concentration, [Cas]. Following an initial expansion, [Cas] returned to the preinjection value in a strictly exponential manner, with t1/2 = 22.5 +/- 2.0 (SE) min in +D and 51 +/- 5.2 min in -D animals. In both groups of animals, these rates were independent of the calcium load. Extraprolation of [Cas] to t = 0, i.e., the time just after administration of the calcium, revealed that the amount of calcium circulating at that moment was only about one-fifth of the amount that would have been found if all of the injected calcium had remained in the plasma. Calculations suggest that in all animals about four-fifths of the injected calcium load became distributed virtually instantaneously in the extracellular water. In both +D and -D groups the fraction of the injected load that left the plasma instantaneously was independent of the calcium load, of [Cas] at t = 0 or of the animals' plasma volume. The ability of rats to disperse some 80% of the load to outside the plasma would seem to constitute a major mechanism of acute plasma calcium regulation. Dilution was insufficient, however, totally to reduce [Cas] to the preinjection level. That occurred exponentially, with most of the calcium presumed to enter the skeleton. This exponential rate was markedly and significantly slower in the vitamin D-deficient animals than in their controls. PMID- 2765706 TI - The hypercalcemic Walker carcinosarcoma 256 of the rat causes an increase in serum 1,25-dihydroxyvitamin D3. AB - We have studied vitamin D metabolism in rats with the transplantable hypercalcemic Walker carcinosarcoma 256, which is a well characterized animal model for humoral hypercalcemia of malignancy. 25-Hydroxyvitamin D3 (25(OH)D3) and 1,25-dihydroxyvitamin D3 (1,25(OH)2D3) concentrations were determined in blood samples obtained from parathyroidectomized (PTX) female rats at different time intervals after intramuscular tumor cell inoculation. We observed a dramatic increase in serum 1,25(OH)2D3 (280 +/- 184 vs. 98 +/- 31 pmol/l) 6 days after tumor cell injection and 4 days after the initial rise of serum calcium, whereas 25(OH)D3 tended to decrease. In a separate control experiment we compared this to the effect of exogenous parathyroid hormone in PTX rats and found similar results. In contrast, rats exhibited no change in vitamin D metabolite blood concentration after inoculation of the normocalcemic Yoshida sarcoma, which obviously does not interfere with vitamin D metabolism. We conclude that the humoral bone-resorbing agent produced by the Walker tumor cells causes elevation of serum 1,25(OH)2D3 concentration by this fulfilling an additional criterion of PTH-like activity. PMID- 2765707 TI - A comparative electron microscopic study of apatite crystals in collagen fibrils of rat bone, dentin and calcified turkey leg tendons. AB - Crystal-collagen relationships in calcified turkey leg tendons and cortical bone and dentin of the rat were studied by bright field and selected-area dark field electron microscopy. The latter imaging technique enables the specific and direct visualization of apatite crystal sizes and their crystallographic orientations within collagen fibrils. Cortical bone possessed the longest mean c-axial length (170 +/- 50 A), then the tendon (142 +/- 43 A) and the smallest was dentin (110 +/- 30 A). Crystallographic orientations of apatite were found to alternate between a,b- and c-axial planes along the axial period of longitudinally sectioned collagen. This distribution of apatite may reflect a crystal alignment with collagen molecules as they spiral in superhelical fashion along the long axis of the collagen fibril. Apatite crystals were localized within both the gap and overlap zones of collagen fibrils even at very early stages of mineralization. The relative amounts of mineral within single collagen periods were determined as a function of electron absorbency. In the tendon at the onset of mineralization 80% of the mineral was located in the gap zone and 20% in the overlap zone; with further mineralization these relative amounts changed to 55% in the gap zone and 45% in the overlap zone. This 55/45% ratio observed in the heavily mineralized tendon was also observed in both cortical bone and dentin. The implications of these findings are discussed in view of collagen molecular ordering and the spread of apatite along collagen fibrils. PMID- 2765708 TI - Oncogenous osteomalacia: a case study. AB - A case of oncogenous osteomalacia due to a fibrosarcoma of the maxilla is reported, with a 19 year course before treatment. Metabolic studies of calcium and phosphorus were performed 3 and 19 years after the first symptomology. There was a negative balance for both phosphorus and calcium with low serum levels of 1,25-dihydroxyvitamin D which were corrected by resection of the tumor. Portions of the tumor were cultured and the supernatant did not affect phosphorus transport by a proximal tubule kidney cell line. Other portions were injected into athymic nude mice where they resulted in hypophosphatemia and phosphaturia, thus confirming the endocrine nature of the oncogenous osteomalacia factor. PMID- 2765709 TI - Comparison of bone mineral content between Japan-born and US-born Japanese subjects in Hawaii. AB - The bone mineral content (BMC) of the calcaneus, and distal and proximal radius was measured by the single photon absorptiometric technique for 2307 US-born and 172 Japan-born subjects of Japanese ancestry living in Hawaii. The bone mineral content of the US-born subjects was greater than that of their Japan-born counterparts, on the average, by 8.8% at the calcaneus, 3.5% at the distal radius and 4.5% at the proximal radius. Differences between the two groups in height, weight, thiazide use, exercise (in men), estrogen therapy (in women), and calcium and vitamin D intake accounted for much of the difference in BMC between the US born and Japan-born women, but less so for the men. Additional studies of BMC in migrant populations are needed to characterize further the environmental factors affecting bone mineral content. PMID- 2765710 TI - In vivo long-term precision of spinal bone mass measurement by dual photon absorptiometry. PMID- 2765711 TI - Decreased endosteal formation during cortical bone modelling in SAM-P/6 mice with a low peak bone mass. AB - Inter-strain differences in bone mass and density during growth were followed in three strains of mice: SAM-P/2, SAM-R/1 and SAM-P/6 (a murine model of senile osteoporosis, Matsushita et al., Am J Pathol 1986;125:276-283). Photometrically, the inter-strain disparities first appeared in mice at about age 28 days and increased until age 60 days. During this period, tetracycline labelling revealed significant strain differences regarding rate of the appositional formation at the endosteal surface but not at the periosteal surface. The order coincided with results of the photometrical assay, that is, highest in SAM-P/2, followed by SAM R/1 and SAM-P/6, respectively. Therefore, strain differences, especially the osteopenic state of SAM-P/6, occur, at least in part, by disparities in endosteal formation rates during cortical bone modelling. PMID- 2765712 TI - The parathyroid glands in the skeletal development of the ovine foetus. AB - The ionized plasma calcium concentration in foetal lambs during the last third of gestation is greater than that in the ewe. Since foetal plasma immunoreactive parathyroid hormone is less than that in the ewe the role of the foetal parathyroid glands is not clear. The effects of foetal parathyroidectomy (PTX) on the foetal:maternal gradient and on skeletal development are examined. The histomorphometry and ash content of six PTX lambs was compared with that of 11 intact animals. A reversal of the plasma ionized calcium gradient took place within 3 days without significant change in the foetal plasma inorganic phosphate or 1,25-dihydroxycholecalciferol content. Skeletal changes consistent with rickets were observed and increased in severity with the time after PTX. It is concluded that the foetal parathyroid glands play an important role in placental calcium transfer and skeletal calcification. However, the agent may be a hypercalcaemic substance other than parathyroid hormone. PMID- 2765713 TI - Expression of the chondrogenic phenotype by mineralizing cultures of embryonic chick calvarial bone cells. AB - Cells released by sequential enzymatic digestion of 18-day chick calvariae were cultured over a 4-5 week period in Alpha modified Eagles medium. In some cultures the medium was supplemented with ascorbate and/or Na-beta-glycerophosphate. Microscopic examination of these cultures showed both polygonal and spindle shaped cells. The biochemical nature of these cells was investigated by incubating the cultures with radiolabelled proline and subsequently analysing the medium and cell layer proteins by SDS/PAGE and fluorography. Osteoblast and chondrocyte-containing cultures were clearly distinguished in this way as the former cells secreted type I collagen while the latter secreted types II and X collagens as the major medium macromolecules. Type X collagen synthesis occurred after 14 days, but only in cultures supplemented with both ascorbate and Na-beta glycerophosphate, and was maintained for the duration of the culture period. Unsupplemented cultures and those containing either ascorbate alone or Na-beta glycerophosphate alone failed to synthesize type X collagen after 28 days. Isolated cells pulsed with radiolabelled proline at confluence and organ cultures of embryonic chick calvaria synthesized types I and V collagens only. These data demonstrate that the expression of phenotype by heterogeneous populations of bone cells could be modulated by a combination of culture conditions including the length of time in culture and conditions favourable for the formation of a mineralized matrix. PMID- 2765714 TI - Some effects of basic multicellular unit-based remodelling on photon absorptiometry of trabecular bone. AB - This article offers algorithms and an algebra for estimating effects of bone turnover, remodelling space, undermineralized bone and trabecular surface-to volume ratio effects on trabecular bone mass estimation by photon absorptiometry. From published histomorphometric data and other evidence the algorithms suggest the amount of mineral in a given bone sample can suggest to absorptiometry an amount of bone that differs from the truth by over 40% in the extreme, and more commonly by 5-15%. They suggest that by reducing a bone's global mineral content high bone turnover causes underestimation of true bone mass. They suggest that by letting mineral return to the remodelling space and undermineralized bone, reduced bone turnover causes apparent gains in bone mass. The commonly suggested 5-15% magnitude of such errors exceeds those assumed in the past. The algorithms suggest that after a challenge to remodelling those bone mineral changes can take from 6 months to over 3 years to reach steady states. Those features could explain why many osteoporosis treatments judged effective from initial absorptiometric evidence failed when used for long periods in patients. Finally the algorithms suggest that a real increase in ideal bone volume can even appear to absorptiometry as no gain or an initial loss, which has already happened in two human experiments. PMID- 2765716 TI - Recent trends in drug use and abuse in Nigeria. AB - This article presents an analysis of the present situation with respect to drug use and abuse in Nigeria. It is based on a review of literature on the subject, on information derived from annual Nigerian training courses on drug dependence and on reports from state directors of the Nigerian Institute on Substance Abuse (NISA). The object of the article is to highlight the need for establishing a system for monitoring the drug scene in Nigeria. PMID- 2765715 TI - Methodological issues in comparing genetic and environmental influences on bone mass. AB - Measurements of bone mineral content (BMC), bone width (BW) and BMC/BW (BMA) at the proximal radius were compared for both Japanese and Japanese-American men and women, after adjusting for measurement technique differences. Within each nationality, men had greater values than women at all ages. Japanese-Americans had substantially greater values of BMC (6-10%) and BMA (16-17%), but lower BW ( 12 to -15%), relative to Japanese. Adjustment for body size (height and weight) reduced the magnitude of these differences by approximately one-half for BMC, but had a smaller effect on BMA, and slightly increased the difference in BW. Comparison of these results to published data suggests that environmental factors may have influences on bone mass that are similar in magnitude to the effects of race. The need for additional studies to address potential methodological problems is discussed, using this and other reports as examples. PMID- 2765717 TI - Self-reported drug use among secondary school students in the Nigerian state of Ogun. AB - A survey of drug use, based on a sample of 990 students in their fourth and final year of secondary school in the Abeokuta local government area of the State of Ogun in Nigeria was conducted by means of a self-report drug-use questionnaire in September 1986. There were 534 male and 377 female respondents. Their mean age was 16.4 and the majority (89 per cent) of them were from the lower or middle socio-economic levels. The most commonly used drugs were salicylate analgesics, mild stimulants, alcohol, antibiotics and diazepam. Low use was recorded for barbiturates, cannabis, organic solvents and cocaine, and there was no reported use of narcotic analgesics or hallucinogens. Females used diazepam significantly more than males. Most users had their first contact with drugs in primary school. The author stressed the need to develop a viable drug-abuse preventive programme and a comprehensive data base in Ogun. PMID- 2765718 TI - Extent and patterns of drug use by students at a Spanish university. AB - A drug-use survey of 1,010 randomly chosen students at the University of Oviedo in Spain was carried out in 1986. The survey instrument used was a self administered questionnaire. During the 12 months before the survey, 91 per cent of the students had used alcohol, 57 per cent tobacco, 17 per cent cannabis, 9 per cent tranquillizers, 5 per cent amphetamines, 2 per cent cocaine, 2 per cent hallucinogens, 1 per cent opiates and 0.6 per cent volatile solvents. At some time in their lives, 96 per cent of the students had used alcohol, 70 per cent tobacco, 31 per cent cannabis, 19 per cent tranquillizers, 15 per cent amphetamines, 5.5 per cent hallucinogens, 5 per cent cocaine, 3 per cent opiates and 3 per cent volatile solvents. Both male and female students had begun using volatile solvents early in life. The age of first cannabis use for the majority of users was between 16 and 18. The users of other illicit drugs covered by the study had not begun using them until they were 18 or older. PMID- 2765719 TI - An evaluation of the results of a drug sample analysis. AB - An analysis of drug samples received by the National Toxicology Institute at Madrid during the period from September 1985 to May 1987 was undertaken with a view to carrying out an epidemiological assessment of drug abuse. Of 414 street drug samples, 63.5 per cent contained heroin, 12.5 per cent cocaine, 8.5 per cent amphetamine and 15.4 per cent other substances. The concentration of heroin ranged from 21 to 60 per cent in most of the samples (91.8 per cent) that contained it. Similar concentrations of cocaine were found in the samples containing that substance. Adulterants were detected in 78.8 per cent of the samples containing heroin, 59.6 per cent of the samples containing cocaine and 56 per cent of the samples containing amphetamine. The most common adulterants in the samples containing heroin were caffeine (68.4 per cent), phenobarbital (19.7 per cent), methaqualone (13.4 per cent) and procaine (13.4 per cent), while lidocaine was the most common adulterant (52 per cent) in the samples containing cocaine. PMID- 2765720 TI - Development and application of a system for monitoring drug abuse: the Malaysian experience. AB - Monitoring systems are useful epidemiological instruments for assessing the problem of drug abuse. The rapid growth of the drug dependence problem in Malaysia led to increased awareness of the need for a system for continuous monitoring of the situation. Preliminary work on the design of an appropriate monitoring system was initiated in 1976. A fully integrated national reporting system was established in 1978, linking all public services and agencies coming into contact with drug-dependent persons, including law enforcement agencies, drug abuse treatment and rehabilitation centres, and social and welfare institutions. The information system included a mechanism for systematic gathering, processing, analysing and presenting essential data on the prevention, control and management of drug abuse problems. It also included reporting on drug related events, such as hospitalizations and arrests, as well as data on known drug-dependent persons and new cases of dependence. The system has been used for routine monitoring of the extent, trends, patterns and other characteristics of drug abuse problems in Malaysia, providing basic information for policy-making and programme planning. On the basis of data generated by the system, it was estimated that the prevalence rate of drug-dependent persons per 100,000 population increased from 84.3 in 1976 to 754.6 in 1986. It was estimated that there were 119,001 drug-dependent persons in Malaysia in 1986. PMID- 2765721 TI - The effects of the liberalization of syringe sales on the behaviour of intravenous drug users in France. AB - A study to evaluate the effects of the liberalization of syringe sales in France, which was carried out in 1987 and 1988 in Paris and at Creteil, Maisons-Alfort, Metz, Bordeaux and Marseille by a research team of the Institute for Epidemiological Research on Drug Dependence (IREP) in Paris, included two samples of intravenous users of drugs, primarily heroin: a street sample of 157 persons and a sample of 123 persons undergoing treatment for drug addiction at in-patient facilities. The study, based on interviews, showed that the emergence of acquired immunodeficiency syndrome (AIDS) had brought about a radical change in the environment of intravenous drug users, of whom approximately 40 per cent were infected with the human immunodeficiency virus (HIV). Liberalized syringe sales had an obvious effect on the behaviour of intravenous drug users: approximately half of them did not share syringes and purchased them at pharmacies, while the rest continued sharing syringes in a variety of ways. The authors concluded that the decision to make syringes freely available for sale was not, by itself, sufficient to cope with the syringe-sharing problem and that, in addition, appropriate educational programmes, personalized and geared to each subject's special circumstances, needed to be provided. PMID- 2765722 TI - Japan: stimulant epidemics past and present. AB - Japan experienced a serious stimulant epidemic during the period from 1946 to 1956 and has been experiencing a second one since 1970. Over the years, a series of drug control measures have been put into effect by the Japanese Government. In 1953, the Japanese police system was reorganized, centralized and made more efficient. Law enforcement efforts were intensified, supported by the criminalization of stimulant abuse with the enactment of the Stimulant Control Law in 1951 and subsequent amendments to it that were rigorously enforced, resulting in more arrests, indictments and relatively harsh penalties for stimulant offences, as well as an increase in the number and volume of confiscations. In 1951, 26 per cent of those arrested for stimulant offences were under the age of 20. About half of those arrested were stimulant-addicted. The number of arrests increased threefold from 1951 to 1954. The amount of seized stimulants also increased considerably during that period. In 1954, there were about 550,000 chronic stimulant users and 2 million ex-users. From 1980 to 1985, the number of stimulant arrests was relatively stable, levelling off at about 20,000 annually. About half of those arrested were recidivists. In 1985, a record high of nearly 300 kg of stimulants were seized. In 1960, heavy usage of sleeping pills among young persons began in Tokyo; this was considered a foreshadowing of a period of youth drug abuse in Japan. In 1967, there was an outbreak of inhalant use among young people; since 1975, about 40,000 people have been arrested each year for inhalant-related offences. PMID- 2765723 TI - Coca-leaf production in the countries of the Andean subregion. AB - The estimated areas under coca-bush cultivation in 1988 are expected to total 44,300 hectares in Bolivia, 25,000 hectares in Colombia, 400 hectares in Ecuador and 114,400 hectares in Peru. The estimated projections for 1989 indicate that coca-leaf production may amount to 68,200 tonnes in Bolivia, 20,000 tonnes in Colombia, 300 tonnes in Ecuador and 120,100 tonnes in Peru. Of all the Andean countries, Venezuela is the only one that has no coca-leaf production problem. According to estimates for the period from 1985 to 1989, coca-leaf production will increase by 43.3 per cent in Bolivia, by 13.6 per cent in Colombia and by 26.2 per cent in Peru. Coca-leaf production in Ecuador has consistently followed a downward trend. According to estimates, since 1985 coca-leaf production in Peru has accounted for more than one half of the total amount produced in the Andean subregion, while production in Colombia, though it has increased in the same period, has accounted for a relatively small share. In 1987, estimated coca-leaf production in Bolivia amounted to 30.2 per cent of the total amount produced in the subregion. PMID- 2765724 TI - Cocaine-related problems in the city of Sao Paulo, 1982-1986. AB - From 1982 to 1986, there was an overall increase in the number and amount of illicit cocaine seized at Sao Paulo. There was a total of 1,552 seizures of illicit cocaine, which were confirmed by testing in the laboratory of the Technical Service of Forensic Toxicology, a section of the Medical-Legal Institute of Sao Paulo. The increase in cocaine seizures was accompanied by an increase in cocaine-related mortality. Although there were no cocaine-related deaths reported in the city before 1982, there was an increasing trend in the number of such deaths during the five-year period that followed. PMID- 2765725 TI - Community psychiatry: are we coping? PMID- 2765726 TI - How to insert a Minitrach. AB - Minitracheotomy is a technique of cricothyroid cannulation to allow efficient tracheobronchial toilet and the application of other techniques for respiratory support. Indications and contraindications for the procedure are reviewed. Two methods of insertion are described with their potential difficulties. Possible complications and their treatment are considered. PMID- 2765727 TI - Surgical emphysema of the neck. PMID- 2765728 TI - The research police. PMID- 2765729 TI - Are junior doctors disillusioned? PMID- 2765730 TI - Mass casualties. PMID- 2765731 TI - Combined injuries of the cranium and face. AB - The neurosurgeon and plastic surgeon are increasingly called upon to manage the care of patients with combined injuries of the cranium and face. The authors briefly review the pathogenesis and classification of craniofacial fractures and outline historical approaches to them. Current principles of management are then discussed. Experience with 167 patients is presented with emphasis on surgical technique, the sequence of repair and early primary reconstruction. The controversial issue of fontal sinus fracture repair is addressed. The authors favour preservation of the frontal sinus cavity, where possible, and do not obliterate the nasofrontal duct. With injuries to the floor of the sinus, the base of the sinus and frontonasal duct are sealed with bone graft and a vascularised soft tissue flap and the sinus is cranialised. Immediate bone grafts, using split skull or rib, are used to reconstruct areas of bony destruction or loss. Ninety-eight patients required 402 grafts. Immediate bone grafting resulted in few complications and low incidence of secondary deformities needing correction. PMID- 2765732 TI - The saphenous venous flap. AB - Eight cases, in which a new single-pedicled venous flap, based on the long saphenous vein, was used to close defects around the knee, are presented with the details of indications, size and survival. Of the eight cases, seven achieved their aim; five flaps survived completely, two had partial distal loss and one died completely. This clinical work is further confirmation that fasciocutaneous island flaps of fairly large dimensions, with a single cephalad vein, survive and can be used to cover defects in their adjacent areas. PMID- 2765733 TI - Static and dynamic computerised radioactive tracer studies, vital dye staining and theoretical mathematical calculations to ascertain the mode of survival of single cephalad channel venous island flaps. AB - Experiments were performed to ascertain the perfusion and drainage of single cephalad channel saphenous venous flaps in dogs. In the first experiment a standard saphenous flap and a single cephalad channel saphenous venous island flap were dissected on contralateral thighs of dogs. A radioactive tracer, 99mTc, was injected into a foreleg vein and its appearance in both flaps was monitored with the use of a static and dynamic scanner. After this experiment, Evans blue, a vital dye, was injected into the foreleg vein of the dog. Five minutes later both flaps were excised and the dye in the flaps was assayed quantitatively. In the third experiment radioactive tracer was injected into the single cephalad channel venous flap subcutaneously and its decay in the flap as well as its uptake in the rest of the body were measured dynamically. The experiments show that the single cephalad channel venous island flap is perfused by and drains through its single cephalad vein. A mathematical model to justify the above conclusion was worked out independently, based on standard values involved in mammalian circulatory mechanisms as in dog and man. PMID- 2765734 TI - The effect of tissue expansion on peripheral nerves. AB - The effect of tissue expansion on peripheral nerves was studied in 214 rats. Slow expansion (over 15 days) is better tolerated than rapid expansion (over 3 days). The resulting increase in length of the nerve is proportional to the degree of expansion. All the nerves which underwent expansion showed a decrease in conduction velocity and this reduction was greater for nerves which were elongated by 50% or more. PMID- 2765735 TI - The effect of deferoxamine on tolerance to secondary ischaemia caused by venous obstruction. AB - The current study investigated the efficacy of deferoxamine for treating secondary ischaemia due to venous obstruction in a rodent epigastric pedicle flap model. Rats receiving one dose of the free radical scavenger and iron chelator deferoxamine (150 mg/kg) intravenously prior to reperfusion had a mild improvement in flap survival: 46% in controls, 77% in deferoxamine-treated. This was statistically significant at p less than 0.05 (chi 2 = 5.2). This suggests that free radicals are partly involved in the mechanism of ischaemia/reperfusion injury in secondary ischaemia, as has been previously demonstrated for primary ischaemia (Angel et al., 1986b). Supporting biochemical evidence will be necessary to understand better the mechanisms involved in secondary ischaemia. PMID- 2765736 TI - Glutaraldehyde-tanned microvascular grafts. AB - In this study the efficacy of preserving microvascular heterografts with glutaraldehyde tanning was investigated. These were compared with glutaraldehyde tanned autografts. Previous studies have found that untreated autograft veins maintain a 95% patency rate, whilst untreated heterograft veins (Group 1) had a 15% patency rate at 4 weeks in this study. Autogenous glutaraldehyde-tanned rabbit carotid arterial grafts (Group 2) and glutaraldehyde-tanned human chorionic veins (Group 3) were interposed in rabbit femoral or carotid arteries. Fifty per cent and 75% patency rates were achieved respectively at 4 weeks. The low patency rate of the autogenous group suggests that the glutaraldehyde tanning technique itself is largely responsible for the low patency of glutaraldehyde tanned human chorionic veins rather than any immunological response. Therefore if human chorionic veins are to be used as a readily available preserved microvascular graft, further investigation is required to develop another technique which will reduce antigenicity without promoting thrombosis. PMID- 2765737 TI - Free flap surgery: the Welsh Regional Unit experience. AB - The evolution and uses of free tissue transfer since 1976 are documented. Two hundred free flaps have been performed with an overall success rate of 91%. The factors which may influence survival are the type of flap used, the recipient region and the timing of surgery following trauma. Twenty-five percent of cases required re-exploration postoperatively, of which 78% were successfully salvaged. Venous thrombosis was the commonest problem and appears better tolerated than arterial occlusion. Eighty-two percent of venous thromboses were salvaged compared with only 50% of arterial failures. PMID- 2765738 TI - The folded, bipaddled pectoralis major composite flap in oral cancer reconstruction. AB - We report on the pectoralis major composite (musculocutaneous or rib osteomusculocutaneous) flap used in bipaddled fashion for one-stage immediate reconstruction in 53 patients with oral cancer. Of these, 44 patients had lesions of buccal mucosa and lateral lower alveolus, and 9 patients had lesions of floor of mouth and middle third of lower alveolus. In one patient this flap was used as a free composite tissue transfer in bipaddled fashion. The flap can be used either before or after radiotherapy in oral cancer and provides both lining mucosa and skin cover. If necessary, a rib (vascularised bone graft) incorporated with this composite flap can give skeletal support for mandibular arch reconstruction. PMID- 2765739 TI - Fine needle aspiration cytology in the head and neck region. AB - Although needle aspiration diagnosis was described over 50 years ago, many patients with neck swellings are still subjected to hazardous and unnecessary open diagnostic surgical biopsy. In a six-month period, over 200 fine needle aspirates were performed on tumours from the head and neck region, 44% of which were positive for cancer. The technique of aspiration, its advantage for the patient, clinician and cytopathologist, and the results of the study will be discussed. Close cooperation between the clinician and the cytopathologist is essential. PMID- 2765740 TI - Reconstruction of a large full thickness chest wall defect by a double-folded vertical rectus abdominis musculocutaneous flap. AB - A case is reported in which a double-folded vertical rectus abdominis musculocutaneous flap was successfully transferred to cover a large full thickness chest wall defect after resection of recurrent breast cancer. A brief discussion on chest wall reconstruction is included. PMID- 2765741 TI - The long-term results of electric fire hand burns in children. AB - An 11-year retrospective series of 95 deep, electric fire hand burns in children was studied and the epidemiology, treatment and operative management analysed. From this series a group of 14 patients was recruited to assess the long-term results of this injury. At long-term follow-up (mean 14.4 years) the recorded parameters included range of movement, hand sensation, power and size. Photographs were taken and any subjective problems noted. Analysis of these data showed a marked variation in range of movement, sensation, size and appearance of the injured hands. Despite this, complaints about cosmetic results or any restriction of activities were rare. In conclusion, these injuries are particularly destructive but with appropriate surgical management, albeit protracted, and despite imperfect cosmetic results, excellent function can be obtained in the growing hand. PMID- 2765742 TI - Pharyngostome closure using the radial forearm free flap. AB - A technique is described using the radial forearm free flap for pharyngostome closure. The flap may be used in combination with local flaps for external cover only or may be raised as a double paddle for external and internal lining. PMID- 2765743 TI - Glove perforation during plastic surgery. AB - Intraoperative perforation of surgical gloves is common. Nine hundred and forty surgical gloves were tested after 100 consecutive plastic surgical operations, each involving a surgeon, a variable number of assistants and a scrub nurse. In the first 52 operations, single gloves were used and 21.5% of the staff were found to have a perforated glove. In the second 48 operations, double gloves were used by all members of the surgical team and the number with perforations (of both inner and outer gloves) was reduced to 9%. Most perforations occurred on the dorsum of the hand and fingers and on the thumb tip, especially in the non dominant hand. The risk of acquiring AIDS due to glove perforation is low but the consequences of such an event could be lethal. PMID- 2765744 TI - An unusual case of congenital chest wall deformity with polymastia and absence of part of the lung. PMID- 2765745 TI - An improvised mould for vaginoplasty. AB - The use of a simple, improvised mould for vaginoplasty is described. It is made of rubber foam rolled over a winged infusion cannula and covered over by condoms. It offers a number of advantages over conventional moulds, the main ones being its simplicity of construction and its ease of application and removal from the neo-vagina. PMID- 2765746 TI - Waiting lists. PMID- 2765747 TI - Screening for breast cancer: the UK scene. The 69th Mackenzie Davidson memorial lecture. PMID- 2765748 TI - The anatomy of the first sacral nerve root sheath shown by computed tomography. AB - Analysis of 25 patients with normal computed tomographic appearances at the lumbosacral junction revealed wide variation in the anatomical level at which the first sacral nerve root sheaths were seen emerging from the theca. In nine patients (36%), the S1 nerve root sheaths were first recognized at the level of the lumbosacral disc. In 14 patients (56%), the sheaths emerged cranial to the disc; it is possible that these patients may be more prone to neurological complications related to disc or facet joint disease, especially if the sheath is laterally sited within the lateral recess. Conversely, that minority of patients (two, 8%) in whom the root sheaths emerge caudal to the disc level may be relatively protected from neurological complications. PMID- 2765749 TI - Dysphagia after fast neutron therapy to the head and neck. AB - Nine patients presenting with dysphagia following successful treatment for head and neck cancer with neutron radiotherapy are reviewed. Combined clinical and videofluoroscopic investigation is used to analyse their deficits and provide indications for management. All patients show impairment of both the oral and pharyngeal phases of the swallow, with the exception of one subject who shows signs of focal neurological damage. It is suggested that fibrosis is the underlying cause of dysphagia in the remainder. PMID- 2765750 TI - The role of computed tomography and coronal plane tomography in radiotherapy for laryngeal cancers. AB - The results of a study undertaken prospectively in 1983 and 1984 to assess the value of computed tomography (CT) and conventional tomography in the planning of radiotherapy for laryngeal cancer are presented. Of 32 cases treated in 1983, 23 had both CT scans and coronal plane tomography prior to radiotherapy. At the end of 1983 these radiographs were reviewed and an assessment made of their value in treatment planning. As a result of this review it was decided that cancers of the larynx confined to the vocal cords should routinely have conventional coronal plane tomograms rather than CT scans. All other cases were to have CT scans and not tomograms. The results of following this policy in 1984 confirm that it is effective. There was no detriment to patients with early vocal cord cancers in performing coronal plane tomograms rather than CT scans. The survival at 24 months of both cohorts was 93%. In the more invasive cancers of the larynx, greater information about the extent of the disease was obtained using CT scans, and improved treatment plans resulted. When compared with a historical group, there appears to be an advantage for local control, 27.3% of the study group suffering local recurrence as opposed to 53.6% of the historical group. PMID- 2765751 TI - A review of occupational exposure in the North-Western Region. AB - The Ionizing Radiations Regulations 1985 require employers to monitor all classified persons and to demonstrate that all non-classified persons who work in controlled areas do not exceed three-tenths (i.e. the classification level) of any relevant annual dose limit. A review of occupational doses was undertaken to ascertain whether any person needed to be designated as a classified person and to demonstrate compliance with the Regulation regarding non-classified staff working in controlled areas. The occupational-dose data for 1986 were compared with data for 1981 to identify any areas where changes in workload, equipment or techniques had led to increases in whole-body or organ doses. The results demonstrate that the level of whole-body occupational dose received by the vast majority of NHS employees in the North-Western Regional Health Authority is, as expected, extremely low. However, two specific areas were identified where occupational doses are relatively high and need to be carefully monitored. The review has also led to a number of operational changes being implemented by the Approved Dosimetry Service. PMID- 2765752 TI - A simple technique for intraluminal irradiation in oesophageal tumours using the high-dose-rate Microselectron. PMID- 2765753 TI - Echocardiographic diagnosis of massive pulmonary embolism. PMID- 2765754 TI - Atlanto-axial rotary fixation: diagnosis by functional computed tomography. PMID- 2765755 TI - Case of the month. A rare diversion? PMID- 2765756 TI - Changes in relative biological effectiveness with depth of neutron beams. PMID- 2765757 TI - Radiology '89. Proceedings of the 47th annual Congress of the British Institute of Radiology. Eastbourne, 4-6 May, 1989. Abstracts. PMID- 2765758 TI - Vesicoureteric reflux and urinary calculi in children. AB - We present 5 patients with urinary calculi and vesicoureteric reflux (VUR). In 4 patients the VUR was probably primary and in 1 it was secondary to the calculus disease. The incidence of calculi with reflux is approximately 0.5% whereas the incidence of reflux with calculi is approximately 8%. PMID- 2765759 TI - Spontaneous perforation of the foreskin in Sweet's syndrome. PMID- 2765760 TI - Haematuria secondary to idiopathic renal vein varices. PMID- 2765761 TI - Obstruction of the vena cava secondary to an enlarged bladder. PMID- 2765762 TI - Renal carcinoma presenting as a large staghorn stone. PMID- 2765763 TI - Ureteroscopic removal of a retained "T" tube fragment. PMID- 2765764 TI - Difficulty in removing a suprapubic catheter. PMID- 2765765 TI - Urothelial tumours of the upper urinary tract. AB - We present a retrospective 10 year analysis of 76 patients with urothelial tumours of the upper urinary tract. Patients older than 65 years, and female patients, presented with more advanced stages and had a worse prognosis. The grade and stage of the tumour has the greatest impact on survival. No conclusions can be drawn on the efficacy of various types of surgery, but simple nephrectomy gave a 5-year survival of 68%, with a stump recurrence rate of 15%. We observed that patients with urothelial tumours had 4 fold increased chance of developing gastrointestinal cancer. PMID- 2765766 TI - Maximum and average urine flow rates in normal male and female populations--the Liverpool nomograms. AB - The study of voiding in men and women has been handicapped by the lack of a normal reference range covering urinary flow rates over a wide range of voided volumes. Normal volunteers (331 males and 249 females) were studied. Each voided once into a calibrated Dantec Urodyn 1000 mictiograph. On a second occasion 282 men and 46 women voided. The maximum and average urine flow rates of the first voids in both sexes were compared with the respective voided volumes. Nomogram charts, in centile form, for both the maximum and average urine flow rates were constructed using statistical transformations of the data. Males showed a significant decline in both urinary flow rates with age, although there was no statistically significant variation in either urine flow rate with respect to first versus repeated voiding. Females showed no statistically significant variation in either urine flow rate with respect to age, parity or first versus repeated voiding. The maximum and average urine flow rates in both sexes showed an equally strong relationship to voided volume. No artificial restriction of voided volume, e.g. minimum 200 ml, appeared appropriate. These nomograms offer reference ranges for both maximum and average urinary flow rates in both sexes covering a wide range of voided volumes (15-600 ml). PMID- 2765767 TI - Identification of the source of haematuria by automated measurement of red cell volume. AB - The mean corpuscular volume (MCV) of urinary erythrocytes was measured by a Coulter Counter in 42 patients with asymptomatic haematuria. All patients had the source of haematuria established by a renal biopsy, cystoscopy or radiology. The mean urine MCV was significantly less in those with glomerular disease (n = 21) than in those with non-glomerular haematuria (n = 21). In every patient with glomerulonephritis, urinary erythrocytes were smaller than those in their own venous blood. Conversely, urinary red cells larger than venous blood were confined to patients with a non-glomerular source. Coulter analysis of urine provides a simple and objective aid to the diagnosis of haematuria. PMID- 2765768 TI - Combination of blood group ABH antigen status and DNA ploidy as independent prognostic factor in transitional cell carcinoma of the urinary bladder. AB - The prognostic value of DNA ploidy and blood group (ABH) antigen reactivity was studied in a consecutive retrospective study of 230 patients with primary transitional cell carcinoma of the urinary bladder. In 195 cases the DNA ploidy and ABH reactivity could be assessed in paraffin-embedded tissue. Early progression (in the first 3 years) occurred in 2% of the patients with diploid ABH positive tumours and in 31% of those with aneuploid ABH negative tumours. The 5-year survival rates corrected for intercurrent mortality were 95 and 56% respectively. In a Cox multivariate analysis, T category, age at diagnosis and histological grade emerged as significant independent prognostic indicators of bladder cancer death, whereas ABH reactivity and DNA ploidy had no significant independent value. However, if the combination of ABH reactivity and DNA ploidy was included in the Cox model, this and T category were independent predictors. When this Cox model was applied to assess the risk of progression, the only independent prognostic factor was the combination of ABH reactivity and DNA ploidy. PMID- 2765769 TI - Long-term clinical results using the artificial urinary sphincter around bowel. AB - Four patients are presented in whom bowel was used to reconstruct a bladder. As a sphincteric mechanism was absent in all 4, the cuff from the artificial urinary sphincter was placed around the bowel to provide continence. This allowed for "normal" urination. The longest follow-up period was 11 years and the shortest 1.5 years. Both clinical and experimental data show that bowel will tolerate compression from the artificial urinary sphincter provided infection does not supervene and the pressure does not exceed 80 cm of water. PMID- 2765770 TI - Study of appropriate antibiotic therapy in transurethral prostatectomy. AB - Septicaemia is the commonest cause of morbidity and mortality following transurethral prostatectomy. Routine blind antibiotic prophylaxis is not always effective and there is a tendency to over-use potent new and expensive antimicrobials. Attempts to "sterilise" the urine preoperatively are also expensive and disruptive. However, appropriate treatment/prophylaxis can be administered economically using rapidly obtained laboratory results. We describe here a technique of routine direct antibiotic sensitivity testing (DST) of the patient's urine pre-operatively and before catheter removal. Such testing can be performed by junior medical staff in a ward side-room. An appropriate antibiotic may then be administered parenterally 1 h before surgery or catheter removal. A total of 102 consecutive patients underwent TURP and only 1 of those with infected urine became septicaemic. In this instance, an appropriate antibiotic had been incorrectly given orally before removal of the catheter. If the antibiotic sensitivities of a patient's urine are known, and an appropriate antibiotic is given parenterally 1 h pre-operatively or before catheter removal, the incidence of septicaemia following transurethral surgery may be significantly reduced. PMID- 2765771 TI - Management of localised prostatic carcinoma. AB - Localised carcinoma of the prostate may be amenable to radical curative therapy. Staging pelvic lymphadenectomy is controversial but is the only means of demonstrating lymph node spread accurately. Five patients in a group of 16 who presented apparently with localised prostatic carcinoma, and who had negative bone scan and CT scan, were shown at operation to have metastatic carcinoma involving their lymph nodes; 3 of 8 patients with high grade tumours were free of lymph node metastases. Without staging lymphadenectomy, these patients may have been inappropriately treated. PMID- 2765772 TI - Prognostic factors in the surgical treatment of azoospermia. AB - Surgery for male obstructive infertility is not always successful. A number of clinical and operative findings, not previously reported, may influence the outcome. We have studied 182 patients with azoospermia who underwent vasoepididymostomy. The pre-operative and operative findings which adversely affected the function of the anastomosis were identified. The presence of spermatozoa in the semen sample was taken to mean a successful anastomosis. Abnormal testicular histology was an adverse pre-operative finding. Adverse operative findings included non-canalisation of the epididymal tubules and hypoplasia of the epididymis; both factors were associated with a high failure rate (almost 100%). The anastomosis was a failure in 78% of the patients when no fluid was seen on sectioning the epididymis. In the absence of adverse findings the success rate of vasoepididymostomy was 59%. Pre-operative testicular biopsy, together with careful observation and recording of findings before and during surgery, are recommended to avoid needless exploration and anastomosis. PMID- 2765773 TI - Neurophysiological aspects of penile erection: the role of the sympathetic nervous system. AB - Recent studies have revealed that the initiation, maintenance and rigidity of penile erection are under parasympathetic and somatotopic control. The mechanism of penile detumescence is still under debate. Single and combined cavernous and hypogastric nerve stimulation was used to study the influence of the sympathetic nervous system on penile erection and to identify the mechanism of penile detumescence. Penile arterial flow and intracorporeal pressure recordings during various stimulation patterns indicated that erection induced by stimulation of the cavernous nerve could be blocked by excitation of the upper hypogastric nerves. Venous outflow studies demonstrated that the inhibitory effect of the sympathetic nervous system was due to active vaso- and corporeal smooth muscle constriction. It was concluded that subsidence and suppression of erection is a sympathetic function. Previous studies have shown that the neurophysiology of erection can be explained by 3 major inhibitory (sympathetic). Our findings are of clinical importance, since a better appreciation of the basic erectile mechanism is essential for successful management of erectile dysfunction. PMID- 2765774 TI - Late presentation of congenital posterior urethral valves. PMID- 2765775 TI - Renovascular hypertension associated with narrowing of the infrarenal aorta. PMID- 2765776 TI - Nephrogenic caliceal adenoma. PMID- 2765777 TI - Extracorporeal shock wave lithotripsy with the Lithostar lithotriptor. AB - Early experience of extracorporeal shock wave lithotripsy (ESWL) using the Lithostar lithotriptor is reported; 145 patients underwent 185 treatments for 189 stones. Treatments were performed with either intravenous sedation and analgesia (90%) or general anaesthesia (10%). There were 123 renal calculi, 44 ureteric calculi and 22 staghorn calculi. Stone fragmentation was achieved with 1724 +/- 1035 shocks at 19 kv. The immediate stone fragmentation rate was 90% and the 3 month clearance rate 88%. Secondary treatments were required in 19% of patients and additional procedures in 17%. A comparison between stone size and the number of shock waves required to achieve stone fragmentation revealed a linear relationship. The Lithostar is a very effective second generation lithotriptor which can be used for renal, staghorn and ureteric calculi in situ, without manipulation. PMID- 2765778 TI - Primary endoscopic surgery for ureteric stones. AB - A group of 184 consecutive patients requiring surgery for ureteric stones was studied over a 4-year period. The success rate for primary endoscopic management was 90.3%; 12 patients required ureterolithotomy for failed endoscopic manoeuvres and complications occurred in 5.5%. Optimum methods of treatment for ureteric stones according to size and location are suggested. PMID- 2765779 TI - Adenocarcinoma of the urinary bladder. AB - We report 40 patients seen over a 15-year period with a histological diagnosis of adenocarcinoma of the bladder; 18 patients had primary adenocarcinoma of the bladder, arising either from the urachus or from glandular metaplasia of the urothelium, and the other 22 had secondary lesions representing invasion from adjacent structures, notably prostate, colon and ovary. In this latter group symptoms related to the primary lesion were variable. The distinction between primary and secondary neoplasm is an important one and was rarely made on the basis of endoscopic or clinical findings alone. Urachal tumours were more common in females, whereas primary and secondary vesical adenocarcinomas were more common in males. The urachal tumours also occurred in a younger age group. Most of the adenocarcinomas, urachal or primary, were already advanced at the time of diagnosis. All tumours were palpable bimanually after resection and were at least T2 or T3. In the urachal carcinomas the results of partial cystectomy were disappointing because of the high rate of local recurrence and death from metastases. Primary non-urachal vesical adenocarcinoma carried an even poorer prognosis if non-radical surgery was carried out. The mean survival was 13 months. Radiotherapy was not effective in urachal and primary adenocarcinomas as these tumours are generally radioresistant. The treatment of secondary adenocarcinoma was governed by the primary site of the tumour. Radical surgery combined with chemotherapy and radiotherapy appeared to give the longest survival in the colonic tumours. Patients with prostatic cancer had a poorer survival rate than those with the same stage tumour but without bladder involvement, with renal failure secondary to obstructive uropathy being the commonest cause of death. PMID- 2765780 TI - Is the investigation of most stress incontinence really necessary? AB - The case histories of 494 women referred to a urodynamic clinic with the symptom of stress incontinence were studied. None had undergone previous incontinence surgery. In only 12 patients was stress incontinence the sole symptom. In the remainder, symptoms suggestive of detrusor instability were present in 417, of a voiding disorder in 261 and of an inflammatory disorder in 166. The sign of stress incontinence was present in only 168 patients and was not a reliable guide to the diagnosis of genuine stress incontinence. Urodynamic studies were necessary in 488 patients in order to obtain an accurate diagnosis. PMID- 2765781 TI - Ambulatory monitoring of bladder pressures in patients with low compliance as a result of neurogenic bladder dysfunction. AB - A group of 28 patients with neurogenic bladder dysfunction and low bladder compliance was studied using medium fill cystometry (CMG) and ambulatory monitoring (AM) during natural bladder filling. The aims of the study were to compare the 2 techniques and to determine if ambulatory monitoring might be useful in predicting upper tract dilatation. AM demonstrated significantly lower end filling pressures compared with CMG. Phasic detrusor contractions were found more commonly during AM and the frequency of phasic detrusor contractions during AM was associated significantly with poor compliance identified during CMG. Patients with upper tract dilatation had significantly greater residual urine volumes, higher pressure rises during CMG and higher frequencies of phasic detrusor contractions compared with those patients with normal upper tracts. The high pressures seen at the end of a medium fill CMG were not found during AM and therefore are unlikely to be the underlying explanation of upper tract dilatation in such patients. PMID- 2765782 TI - Evaluation of the home pad test for quantifying incontinence. AB - The home pad test to quantify urinary incontinence is described. Patients conduct the test in their homes and bring the pad, in a self-sealing plastic bag, for weighing at their next clinic visit. The validity of the procedure was assessed by measuring evaporation loss from the pads and comparing the home with the standard hospital test. Evaporation loss was shown to be acceptable if the test was carried out within 72 h of weighing. There were no significant differences between home and hospital tests and 95% of home results were within 32% below to 16% above hospital results. This was at least as consistent as the "gold standard" hospital test as 95% of the hospital results were within 28% below to 44% above repeated test results. The principal advantages in performing the pad test at home are simplicity, cost effectiveness and the relaxed environment, which reproduces more accurately the conditions leading to incontinence when compared with the relatively unfamiliar hospital setting. PMID- 2765783 TI - Urethral stricture following aortic graft surgery. AB - The incidence of urethral stricture following aortic graft surgery was investigated retrospectively in a group of 127 men. They had been catheterised prior to their operation with latex catheters. One man had been treated for a stricture 9 months after his operation. Information about post-operative urinary symptoms was obtained from a further 94 surviving patients by postal questionnaires sent at least 12 months following surgery. Eight patients underwent urological review including, where indicated, urethrography under antibiotic cover; 3 patients were identified with urethral strictures, an incidence of 3.2%. This is similar to that occurring after cardiac surgery, and urethral strictures should be considered a hazard whenever catheters are used in surgical procedures. PMID- 2765785 TI - The failed MAGPI: management and prevention. AB - Of 142 patients with hypospadias seen at this institute over the past 2 years, 8 developed meatal regression following repair of their anterior hypospadias with the meatal advancement and glanuloplasty technique (MAGPI); 5 had meatal regression which was attributed to a technical failure and 3 had severe regression of the meatus with significant subcoronal positioning, suggesting poor patient selection. None of these patients had chordee on intraoperative artificial erection. Five were treated successfully with a repeat MAGPI procedure and the remaining 3 required a Mathieu procedure. Although best indicated for mild degrees of anterior hypospadias, the success of the MAGPI procedure still requires meticulous technique and proper patient selection. PMID- 2765784 TI - Initial management of acute urethral injuries. AB - A study was made of 30 cases of acute urethral trauma treated over a 7-year period. There were 10 anterior and 20 posterior urethral injuries, the majority of these being partial ruptures. Posterior urethral injuries were caused by road traffic accidents in 75% of cases while 80% of the anterior urethral injuries were of the "straddle" type. There was only 1 case of iatrogenic injury to the anterior urethra. During follow-up, all patients required periodic dilatations for stricture except for the single case of iatrogenic injury. An average of 5 dilatations controlled all of the strictures except for 2 that required urethroplasties. PMID- 2765786 TI - The fate of testes following unilateral incarcerated inguinal hernia in adult rats. AB - The histological effects of unilateral incarcerated inguinal hernia on the ipsilateral and contralateral testes were examined in adult rats. Three groups were established. In the first group the left testis and caecum were exposed and replaced. In group 2 a left-sided incarcerated inguinal hernia was created with bilateral orchiectomy 24 h later. In group 3 a left-sided incarcerated inguinal hernia was created with reduction after 24 h. The testes of animals in groups 1 and 3 were removed after 15 days. The mean seminiferous tubular diameter (MSTD) and mean testicular biopsy score (MTBS) were determined for ipsilateral and contralateral testes in each of the 3 groups. A decreased MSTD and depressed MTBS, were pronounced in the ipsilateral testes, were found in the testes of group 3 animals. While unilateral incarcerated inguinal hernias caused more pronounced histological changes in the ipsilateral testes, they also affected the contralateral testes, but a time interval was required for the changes to become manifest. PMID- 2765787 TI - Prostaglandin 15-hydroxydehydrogenase activity in human penile corpora cavernosa and its significance in prostaglandin-mediated penile erection. AB - Prostaglandins may be involved in human penile erection and erectile failure. To evaluate the possible role of prostaglandin metabolism in the penile tissue, the activity of nicotinamide adenine dinucleotide-dependent prostaglandin 15 hydroxydehydrogenase was assayed in the corpora cavernosa of the human penis. Km values (mean +/- SD) of the enzyme for PGE1, PGE2 and PGF2 alpha were 60.1 +/- 4.2, 17.7 +/- 1.5 and 16.1 +/- 1.2 microM respectively; Vmax values (mean +/- SD) were 0.219 +/- 0.062, 0.510 +/- 0.012 and 0.424 +/- 0.007 nmol/min/mg protein respectively. The implications of these findings in the erectile process are discussed. PMID- 2765788 TI - Penile venous drainage in erectile dysfunction. Anatomical, radiological and functional considerations. AB - To elucidate further the penile venous anatomy and its role in the haemodynamics of erection, we performed pharmacological cavernometry and cavernography in 95 patients with venogenic impotence and in 12 patients with psychogenic impotence. The findings were correlated with those of dissection in 10 adult male cadavers. Cavernography confirmed that the main venous drainage of the corpora cavernosa is via the cavernous veins, with additional drainage through the crural, circumflex and deep dorsal veins and demonstrated that, in patients with venogenic impotence, the cavernous veins are the common site of leakage. Cavernometry provided valuable parameters for the quantification of the degree of venous leakage. Detailed knowledge of the penile venous system and cavernometry and cavernography are essential for the proper diagnosis and treatment of patients with venogenic impotence. PMID- 2765789 TI - Penile response to intracavernosal vasoactive intestinal polypeptide alone and in combination with other vasoactive agents. AB - Intracavernosally injected vasoactive intestinal polypeptide (VIP) (2 micrograms and 4 micrograms) resulted in penile tumescence even in men with predominantly organic impotence. Papaverine and phentolamine were successful in inducing erections in all subjects studied but the addition of VIP to this combination improved the erectile response further. A combination of papaverine and VIP produced penile rigidity similar to that with papaverine and phentolamine. While intracavernosal VIP alone produced disappointing penile responses, its combination with papaverine potentiated the response to this drug, probably by increasing venous outflow resistance. PMID- 2765790 TI - Technique for relieving vascular obstruction of the superior infundibulum (Fraley's syndrome). PMID- 2765791 TI - Stalactites and stalagmites: crystal formation on ureteric double-J stents. PMID- 2765792 TI - Pararenal pseudocyst secondary to bladder tumour. PMID- 2765793 TI - Unusual metastasis of bladder cancer. PMID- 2765794 TI - Catheters: a knotty problem! PMID- 2765795 TI - Tension pneumoperitoneum: an unusual urological cause. PMID- 2765796 TI - Squamous intra-epithelial neoplasia presenting as a urethral caruncle. PMID- 2765797 TI - Association between squamous cell carcinoma of the renal pelvis and calculi. PMID- 2765798 TI - Renal denervation with releasing renal capsule incision in the loin pain/haematuria syndrome. PMID- 2765799 TI - Minimally invasive surgery for the retrieval of complex fractured double J stents. PMID- 2765800 TI - Colon interposition in children. AB - Since 1960 we have performed 80 colonic interpositions on 79 children. We present a retrospective review of their progress. Sixty-nine interpositions were for long gap oesophageal atresia, while the remainder followed oesophagectomies, eight for strictures and two others. Overall, the transthoracic route was used in 69 per cent of cases, while 29 per cent were retrosternally placed and one was retropleural. The mean follow-up was 11.08 years. The mortality rate was 12 per cent, with one-third of deaths unrelated to the operation. Graft failure, which occurred on eight occasions (10 per cent), was due to ischaemia in four, intractable stricture in two and stomal ulceration in two. Leakage from the proximal anastomosis occurred in 31 per cent of cases and stricture formation in 27 per cent. Thirty per cent of patients complained of acid reflux, of whom one third developed stomal ulceration. We present data concerning other complications, including long-term recurrent respiratory infections, malabsorption, gastrointestinal haemorrhage, diarrhoea, intestinal obstruction and redundancy of the graft. Staging the procedure did not affect the outcome, however the higher incidence of serious complications encountered following retrosternal interposition finally led us to abandon this procedure in favour of the transthoracic route. There has been little improvement in the growth rate, but in terms of swallowing ability the outcome was satisfactory in 94 per cent of cases. PMID- 2765801 TI - Umbilical sepsis. AB - Pilonidal sinus of the umbilicus is rarely reported, and there are only 17 reported cases. On reviewing the records from Jordan University Hospital, 24 patients who were treated surgically for a discharging umbilical sinus were found. Three patients had known causes for their umbilical sepsis, namely stitch sinus, urachal remnant and an umbilical polyp. Of the remaining 21 patients, seven had clinical and pathological evidence of hair in their umbilicus. Most of our patients were young men who presented with discharge, soreness or pain, swelling, and cellulitis. Treatment by umbilical excision, leaving the skin defect to heal by secondary intention, proved satisfactory. The resultant scar resembles a normal umbilicus. PMID- 2765802 TI - Role of cholecystostomy in the management of critically ill patients suffering from acute cholecystitis. AB - Between the years 1976 and 1985, 60 patients underwent cholecystostomy for acute cholecystitis in the surgical department of the Rokach hospital in Tel Aviv. The patients' average age was 73 years; 78 per cent were 70 years or older at the time of operation. The decision to perform cholecystostomy was taken before the operation which was performed as an emergency procedure for patients considered to be at high risk for cholecystectomy. Forty-six patients (77 per cent) had severe concomitant diseases, and 42 per cent of them had two or more associated diseases simultaneously. The cardiac risk index was high in most patients (90 per cent). Fifty-two patients recovered promptly after surgery. Five patients (8 per cent) developed significant postoperative complications. Three other patients (5 per cent) died of cardiovascular complications. Forty-two patients (70 per cent) underwent an elective cholecystectomy 6-8 weeks later with no further morbidity or mortality. Eleven patients who were at high risk had no further surgery. No residual stones were found in these patients and no relapse of the disease was recorded in the long term follow-up. Four patients were lost to follow-up. We conclude that cholecystostomy may still be used as an initial life saving procedure for critically ill patients with acute cholecystitis, and serves as a definitive procedure for patients considered to be at very high operative risk and who have no residual stones. PMID- 2765803 TI - Surgical significance of the bile duct of Luschka. AB - In 20 post-mortem dissections, the subvesical bile duct of Luschka was noted in six specimens. Microscopic examination of ten other post-mortem gallbladders revealed small bile ducts on the gallbladder surface in five. Four cases of injury to the duct of Luschka during cholecystectomy are described and illustrated with cholangiographic and histological evidence. Post-cholecystectomy bile leaks from the drain tube, which closed spontaneously without sequelae, were noted in 9 per cent of 204 randomly selected cases and were regarded, at least in some, as being caused by a divided duct of Luschka. The practical significance of this duct during cholecystectomy is to keep close to the gallbladder wall during removal of the gallbladder, and to ligate a divided bile duct of Luschka if recognized at surgery. PMID- 2765805 TI - Delayed recovery of hand grip strength predicts postoperative morbidity following major vascular surgery. AB - Forearm muscle dynamometry was performed in the non-dominant arm in 61 patients undergoing major abdominal and limb vascular surgery, before operation and then 1, 3, 5, and 7 days after surgery. Six patients died in the postoperative period and seven patients developed major postoperative complications (bronchopneumonia, two; wound infection, four; myocardial infarction, one). The preoperative grip strength, measured in kilograms, of the patients who died after major vascular surgery was not significantly lower than that of patients who had an uncomplicated postoperative course. Of the 55 surviving patients, seven developed complications after surgery. These patients had significantly reduced grip strength, expressed as a percentage of the individual preoperative value (P less than 0.05), from the first to the seventh postoperative day when compared with patients without complications. The delayed recovery of grip strength preceded the clinical manifestation of complications. These data suggest that delayed recovery of voluntary muscle performance may be used to detect patients developing postoperative complications and so allow their early treatment. PMID- 2765804 TI - Changes in vascularity of liver tumours after hepatic arterial embolization with degradable starch microspheres. AB - The role of vascularity as a prognostic factor was investigated in 35 patients undergoing arterial chemotherapy for liver tumours. Compared with parenchyma, tumour vascularity was classified as hot (18 cases), cold (12 cases), and mixed (12 cases) using 99mTc-macroaggregated albumin (MAA) hepatic arterial scans. The proportion of patients showing complete and partial responses to treatment was higher in the hot group (56 per cent) than in the combined cold and mixed group (12 per cent). In 15 cases (six hot, six cold and three mixed lesions), additional MAA scans were performed immediately after arterial embolization with degradable starch microspheres (DSMs). Either complete or partial reversal of tumour vascularity was observed after DSM-embolization in five and seven cases respectively, two and two of them respectively showing native cold lesions. As tumour vascularity appears to be a prominent prognostic factor, DSM-embolization should improve the efficacy of treatment by improving liver extraction of drugs and causing flow redistribution towards hypovascular areas. PMID- 2765806 TI - Relationship between bile acid malabsorption using the 75Se homocholic acid taurine scanning method and diarrhoea following right hemicolectomy. PMID- 2765807 TI - Human fasting and postprandial sphincter of Oddi motility. AB - Sphincter of Oddi motility was evaluated in post-cholecystectomy patients with indwelling T tubes during fasting and after feeding. A triple-lumen catheter was positioned to record from the sphincter of Oddi and duodenum. The sphincter of Oddi was characterized by phasic contractions independent of duodenal contractions. During fasting duodenal wave frequency exhibited four phases, whereas only two phases could be identified from the sphincter of Oddi. A prolonged phase A in the sphincter of Oddi corresponded to duodenal phases I, II and IV. A short phase B in the sphincter of Oddi just preceded the onset of duodenal phase III and was temporally related to it. Sphincter of Oddi basal pressure increased during duodenal phases III and IV. After ingestion of food, sphincter of Oddi basal pressure, wave amplitude and duration decreased, but the frequency remained unchanged. Conversely, duodenal frequency increased but there was no change in amplitude. Thus, the human sphincter of Oddi and duodenum exhibited independent motility demonstrating distinct phases during the interdigestive period. After food, sphincter of Oddi motility altered in a manner which would facilitate the passive flow of fluid into the duodenum. PMID- 2765809 TI - Timing of strangulation in adult hernias. AB - This retrospective study aimed to determine why the incidence of strangulated hernias in adults remains high. Seventy-nine patients presented with clinical evidence of hernia strangulation which required urgent surgery during the period 1979-87. Forty-six patients (58 per cent) had noted a hernia present for at least 1 month before strangulation: 18 (23 per cent) had not reported it to their family doctor, 19 (24 per cent) were known by family practitioners or non surgical medical personnel to have a hernia but had not been referred for surgical opinion, and nine (11 per cent) had been previously assessed surgically with a view to elective repair. Of these nine, five were considered unfit, three were on waiting lists for operation and one had refused surgery. Thirty-two patients (40 per cent) presented primarily with strangulation within days of developing a hernia. The duration of hernia before strangulation in one patient was unknown. Although an unavoidable number of patients will continue to present with strangulation within days of developing a hernia, the overall incidence could be significantly reduced by greater public awareness of the risks of hernia strangulation and by a policy of immediate patient referral and prompt elective repair. PMID- 2765808 TI - Human thrombin plus 5 per cent ethanolamine oleate injected to sclerose oesophageal varices: a prospective randomized trial. AB - Fifty cirrhotic Japanese patients with oesophageal varices underwent sclerotherapy in a prospective randomized trial carried out to examine the effects of human thrombin given concomitantly with the sclerosant 5 per cent ethanolamine oleate. The two groups (25 patients each) were comparable with regard to size of the oesophageal varices, and the aetiology and severity of the liver disease. Twenty-five patients, 13 and 12 in the thrombin + and - groups, respectively, had at least one episode of variceal bleeding. The remaining 25 were given prophylactic injections. There was a significantly lower rate of occurrence of bleeding from injection sites when the injection needle was removed at the initial session of sclerotherapy in the thrombin + group, where human thrombin was injected (0.2-0.3 ml, 100-150 units per injection) just before removal of the injection needle. Endoscopy at 1 week after the initial session showed a significantly (P less than 0.05) higher rate of disappearance of red colour signs on varices in the thrombin + group (96 per cent) than in the thrombin - group (72 per cent). Fibrin degradation product E-fraction (FDP-E) values increased 1 h, 1 day and 6 days after the initial session of sclerotherapy in the two groups. The rate of increase in FDP-E values 1 h after sclerotherapy was significantly larger (P less than 0.001) in the thrombin + than in the thrombin - group. There was no clinical sign of disseminated intravascular coagulation. Administration of human thrombin plus a sclerosant seems to be useful and efficacious, especially for patients with huge oesophageal varices. PMID- 2765810 TI - Adult intussusception in Glasgow, UK. PMID- 2765811 TI - Sister Mary Joseph's nodule: a study of the incidence of biopsied umbilical secondary tumours in a defined population. PMID- 2765812 TI - Phenol treatment of pilonidal sinuses of the natal cleft. PMID- 2765813 TI - Serum phospholipase A2 activity in acute pancreatitis: an early guide to severity. AB - Daily measurements of serum phospholipase A2 activity were carried out on 73 consecutive patients admitted to hospital with acute pancreatitis. During the first 6 days there were significant differences in activity in those patients predicted as severe by multiple prognostic criteria when compared with those with mild disease. Follow-up studies at 6 weeks showed no difference between those graded as mild and those graded as severe at the time of attack. In the patients with elevated activity, nine had this at the time of admission and all were raised within 24 h. Elevated activity correlated well with the clinical outcome and showed good agreement with the multiple prognostic criteria in the prediction of severe disease. It is suggested that measurement of serum phospholipase A2 activity may provide a simple test for the early identification of most patients with severe acute pancreatitis. PMID- 2765815 TI - Sigmoid volvulus in rural Ghana. PMID- 2765814 TI - APACHE II score in massive upper gastrointestinal haemorrhage from peptic ulcer: prognostic value and potential clinical applications. AB - This study examined the prognostic value of the APACHE II scoring system in patients undergoing emergency operations for bleeding peptic ulcer. There were 96 operations for gastric ulcers and 58 for duodenal ulcers. The mean scores in survivors and in patients who died were 10.8 and 17.5 respectively. None of the 66 patients with an APACHE II score less than 11 died, while the mortality rate in those scored greater than 10 was 22 per cent. In patients scored greater than 10 non-resective procedures carried less risk of mortality than gastrectomy. The APACHE II score is useful when measuring the severity of the acute disease and predicting the outcome in these patients. If used in daily practice it may assist the surgeon in stratifying patients into a low-risk group (score less than 11) in which major operations are well tolerated and outcome is favourable and a high risk group (score greater than 10) in which the risk of mortality is high and the performance of procedures of lesser magnitude is probably more likely to improve survival. PMID- 2765816 TI - Conservative proctocolectomy: a dubious option in ulcerative colitis. AB - Conservative proctocolectomy was performed for ulcerative colitis in 19 patients, Crohn's disease in three and familial adenomatous polyposis in one. Healing was uncomplicated in only three patients (13 per cent). Eleven developed an anal discharge and nine an infected pelvic haematoma despite peranal drainage. Fourteen patients developed pelvic sepsis and, despite surgical curettage in 11, none healed. Six of these patients have had the anal sphincter divided, with healing in only one, and the anal canal has been excised in two. Eleven patients have ultimately healed at a median time of 28 months and eight have persistent sepsis after a median period of 45 months. Two patients with sepsis have had a successful ileoanal anastomosis. Conservative proctocolectomy cannot be recommended as a definitive operation for ulcerative colitis even though it may permit a subsequent restorative procedure. PMID- 2765817 TI - Multivariate analysis of factors influencing the results of restorative proctocolectomy. AB - Univariate and multivariate analyses have been used to assess the influence of 14 variables on the results of 65 consecutive ileoanal pouch procedures over 5 years. There were nine failures requiring intubation, ileostomy or pouch excision. There was a significant association between failure and pelvic sepsis (P less than 0.05, n = 8), endoanal mucosectomy (P less than 0.05, n = 7), preservation of a long rectal cuff (P less than 0.05, n = 5) and lack of experience with the operation (P less than 0.05, n = 8). Of 49 patients with preoperative evidence of ulcerative colitis, three are now known to have Crohn's disease. Functional outcome was significantly impaired in patients who developed pelvic sepsis (P less than 0.01) or a postoperative fistula (P less than 0.05), and who had an endoanal mucosectomy (P less than 0.05). Success with ileoanal pouch reconstruction increases with experience. Avoidance of sepsis is associated with a lower failure rate, improved functional results and reduced hospital stay. Preliminary colectomy is also advised to exclude Crohn's disease if the diagnosis is in question. PMID- 2765818 TI - Operative mortality following surgery for colorectal cancer. AB - From 1973 to 1986 at the Baviere Hospital, University of Liege, 476 patients underwent surgery for colorectal cancers. The overall operative mortality rate was 13.4 per cent. The following postoperative life-threatening complications occurred: myocardial infarction (14 per cent of the postoperative deaths) during the first three postoperative days; bronchopneumonia (27 per cent of the postoperative deaths) mainly during the first postoperative week; pulmonary embolism (17 per cent of the postoperative deaths) mainly during the second postoperative week; anastomotic leakage and cerebrovascular accident (14 and 8 per cent of the postoperative deaths respectively) mainly during the third and fourth postoperative weeks. Specific risk factors were chronic obstructive airways disease associated with a higher incidence of postoperative bronchopneumonia, and previous myocardial infarction associated with postoperative myocardial infarction and pulmonary embolism. General risk factors were old age and emergency procedure, both of which were associated with a higher incidence of infectious complications. The operative mortality rate fell from 20.1 per cent in the 1973-79 period to 7.8 per cent in the 1980-86 period. PMID- 2765819 TI - Idiopathic constipation associated with impaired urethrovesical and sacral reflex function. AB - Sixteen chronically constipated women (age range 20-66 years) and 29 healthy control subjects (age range 22-53 years) underwent neurophysiological assessment of the integrity of pelvic spinal reflexes. The results were compared with videourodynamic studies and multiport anorectal manometry combined with external anal sphincter electromyography. The neurophysiological assessment consisted of electrical stimulation of the dorsogenital nerve, while recording any evoked reflex activity in the external anal and urethral sphincters with concentric needle and surface electrodes. Of these constipated women, 75 per cent had absence of one or more evoked sacral reflexes (compared with 20 per cent of healthy controls, P less than 0.05). Sensory thresholds and motor unit potentials in the external anal sphincter were similar in healthy and constipated women. Nine (56 per cent) constipated women displayed urodynamic abnormalities (increased bladder capacity, acontractile bladder and genuine stress incontinence). Only 38 per cent of constipated women perceived a desire to defaecate during rectal distension with up to 100 ml, compared with 95 per cent of normal subjects (P less than 0.0005). Moreover, 73 per cent of constipated women did not relax the external anal sphincter during defaecation, compared with 12 per cent of controls (P = 0.001). Taking into account the possible significance of our data in relation to previous findings it is suggested that the integration of sensory information within the sacral cord may be impaired in chronic idiopathic constipation. PMID- 2765820 TI - Effect of mechanical bowel preparation on anastomotic integrity following low anterior resection in dogs. AB - To assess the effect of mechanical bowel preparation on anastomotic integrity after low anterior resection, 36 mongrel dogs were randomized to have low anterior resection with or without mechanical bowel preparation. All dogs received prophylactic antibiotics and anastomotic integrity was assessed on the ninth postoperative day by barium enema, inspection of anastomoses for defects after careful excision at laparotomy, and anastomotic bursting pressures. Bursting pressures were significantly higher (P less than 0.005) in the group with bowel preparation. Anastomotic defects were present in 13 per cent of animals with bowel preparation and 47 per cent without bowel preparation (P = 0.057). Pelvic abscess and death from peritonitis occurred in 6 per cent of the group with bowel preparation and 29 per cent of the unprepared group. Mechanical bowel preparation significantly enhanced anastomotic integrity and reduced complications in this model. PMID- 2765821 TI - Clinicopathologic study of early stage esophageal carcinoma. AB - As part of a consecutive series of 370 patients who underwent subtotal esophagectomy because of carcinoma of the thoracic area of the esophagus, between January 1965 and July 1988, in the Second Department of Surgery, Kyushu University Hospital, 42 patients (11.4%) with early stage esophageal carcinomas confined to the intraepithelium, mucosa, or submucosa were studied clinicopathologically. Of these 42, 26 (61.9%) had symptoms; slight dysphagia or chest discomfort was the most common symptom. The remaining 16 (38.1%) had no subjective symptoms. Endoscopic examination proved to be more useful than barium studies. Lugol-combined endoscopy was most effective in detecting the presence and spread of small malignant lesions of the esophagus. At the time of surgery, six patients with submucosal carcinoma of the esophagus had lymph node metastasis, and five died of recurrence. Described herein are the diagnostic features, clinicopathologic characteristics, and long-term results of these 42 patients with early stage, and 328 patients with advanced, carcinomas of the esophagus, detected and surgically treated in our clinics. PMID- 2765822 TI - Surgical glove perforation. PMID- 2765823 TI - Radioisotope imaging in the evaluation of vascular grafts. PMID- 2765824 TI - Recessive mutation, chromosome deletion and cancer. PMID- 2765825 TI - Inguinal hernia repair. PMID- 2765826 TI - Endoscopic balloon dilatation of colonic anastomotic strictures. AB - Nine postoperative colonic and rectal strictures were treated using dilatation balloons passed over a guide-wire introduced endoscopically. Six strictures resolved after a single dilatation. The method is simple, safe, effective and avoids further surgery. PMID- 2765827 TI - Effect of anterior resection on anal sphincter function. AB - Minor difficulties with continence may occur after low anterior resection. Intraoperative injury to the internal anal sphincter or its nerve supply may contribute to this. To study the effect of low anterior resection on the anal sphincter mechanism, anal manometry was performed on 20 patients before and 10 days after resection. Fifteen patients were studied again 6 months after operation. Resting, maximum squeeze and squeeze increment pressures were recorded. Intraoperative manometry (n = 11) and presacral nerve stimulation (n = 6) were performed to determine whether peroperative injury to the internal anal sphincter had occurred. Resting and maximum squeeze anal canal pressures were reduced by low anterior resection, and did not recover. The squeeze pressure increment did not change. Division of the inferior mesenteric artery, full mobilization of the rectum and mesorectum, and rectal transection did not affect resting anal pressure, which was reduced after EEA anastomosis (mean (s.e.m.) before, 40(5) mmHg; after, 27(4) mmHg; P less than 0.05, n = 5). Presacral nerve stimulation produced relaxation of the internal sphincter. Anal sphincter pressures are reduced after low anterior resection. The external anal sphincter and the nerve supply to the internal anal sphincter appear intact. A direct injury to the internal sphincter is postulated. PMID- 2765828 TI - Hypoplasia of defunctioned rectum. AB - The adaptive response of the large bowel to surgical defunction in man is essentially unknown, although in the rat there is progressive hypoplasia and a reduced propensity to experimental carcinogenesis. Mucosal biopsies were taken from the upper rectum completely defunctioned by a proximal stoma from 2 months to 5 years earlier in 11 patients and from 14 controls without abdominal operations or disease. Samples were established in organ culture and, after 16 h, crypt cell production rate (CCPR) was determined by a stathmokinetic technique. Crypt morphometry was also undertaken. CCPR in defunctioned large bowel was less than half that of controls: (mean (s.d.)-1.96 (0.68) versus 4.65 (0.54) cells crypt-1 h-1, P less than 0.0001). Likewise, crypt length was 24 per cent lower (0.34 (0.05) versus 0.44 (0.04) mm, P less than 0.0001) and crypt width was 38 per cent lower (0.04 (0.01) versus 0.07 (0.01) mm, P less than 0.0001). Rectal defunction causes profound and persistent hypoplasia in man. PMID- 2765829 TI - Effect of nutritional supplementation on protein synthesis in tumour and host tissues of rats with colonic cancer. AB - Rats with colonic cancer were given a palatable liquid diet which enabled them to gain weight while those fed on stock diet, either ad libitum or in restricted amounts, lost weight. Protein synthesis was measured in vivo using a flooding dose technique. Increased nutrient intake caused increases in the rate of protein synthesis in muscle, liver and non-diseased parts of the colon, but had no effect on protein synthesis in the tumours. These data suggest that enteral hyperalimentation may be safely employed in the preoperative management of patients with cancer, as it is likely to stimulate nitrogen retention in the host tissues without increasing the growth rate of the tumour. PMID- 2765830 TI - Toxic megacolon and perforation caused by Salmonella. PMID- 2765831 TI - Collagen changes around intestinal anastomoses in germ-free rats. AB - The changes in collagen, measured as hydroxyproline, concentration around both ileal and colonic anastomoses in germ-free and control rats have been investigated and compared with each other. The germ-free rats were raised, operated on and maintained under completely pyrogen-free conditions. Animals were killed 2, 3 or 7 days after operation. There was a significant reduction in the lowering of hydroxyproline concentrations around the colonic anastomosis of germ free rats compared with control rats both in the anastomosis at days 2 and 3 (P = 0.04 and P = 0.006 respectively) and in the proximal segment at day 3 (P = 0.03). In ileal anastomoses, significant differences between control and germ-free rats were only found at 7 days. Here, the increase in hydroxyproline concentration observed in control rats was significantly reduced in germ-free rats. These data are taken to support the hypothesis that bacteria affect colonic anastomotic healing by contributing to postoperative collagen degradation. PMID- 2765832 TI - Squamous cell carcinoma of the anus at one hospital from 1948 to 1984. AB - Two hundred and twenty-eight patients with anal carcinoma treated between 1948 and 1984 were reviewed. Of 145 with anal canal carcinoma, 118 were treated by total anorectal excision, nine by local excision and 13 by radiotherapy. Fifteen patients were inoperable. There were five postoperative deaths. Crude and cancer specific survival rates of 123 patients treated 5 or more years previously were 58 and 64 per cent. These rates for patients undergoing total anorectal excision were 62 and 65 per cent, and local excision 87 and 100 per cent. Eighty-three patients had carcinoma of the anal margin. Of these, 55 were treated by local excision, 18 by total anorectal excision and 20 by radiotherapy. Eight patients were inoperable. Crude and cancer-specific survival rates for 72 patients followed for 5 years were 55 and 57 per cent with respective rates of 65 and 69 per cent after local excision and 36 and 40 per cent after total anorectal excision. The 5-year survival rate of 27 patients with TNM N1 stage was 48 per cent. Histological confirmation was obtained in only nine of these patients, however, but five (55 per cent) survived 5 years after block dissection or radiotherapy. Metachronous lymphadenopathy occurred in 25 patients. The 5-year survival rate in the 23 cases that were histologically confirmed was 35 per cent after block dissection (17 cases) and radiotherapy (four cases). Using a modification of Papillon's T classification for anal canal carcinoma, stage correlated with survival after combining T1 with T2 tumours and T2 with T3 tumours. Five-year survival rates in these groups were 60 and 54 per cent respectively. The TN M-UICC classification for anal margin carcinoma correlated with survival in a similar manner. The 5-year survival rate was 65 per cent for patients with T1 and T2 tumours and 33 per cent for those with T3 and T4 tumours. PMID- 2765833 TI - Management of thyroglossal cysts in children. AB - Forty children with a suspected thyroglossal cyst were operated on by one paediatric surgeon receiving primary and secondary referrals in an 8-year period. Nine patients (22 per cent) proved to have other pathology. Multiple operations were required in eight of 17 patients (47 per cent) who had infected thyroglossal cysts but in only one of 14 (7 per cent) with uninfected cysts. In the infected group preliminary incision and drainage was necessary in five cases and cyst recurrence occurred in four (24 per cent), whereas in the uninfected group there was only one recurrence (7 per cent) in a patient with double pathology. Infection and recurrent cysts were the chief reasons for multiple operations. Recurrence was caused by inadequate performance of the correct operation (Sistrunk's) or choice of the wrong operation. Two of our own three recurrences were due to the latter, other pathology being suspected intraoperatively. Histological study of the specimens showed that thyroglossal ducts were frequently multiple and widely spaced. In children any lesion whose presentation is typical of a thyroglossal cyst should be treated with an early Sistrunk's operation. The operation in children who have other pathology has no complications and is justified. PMID- 2765834 TI - Use of an embolectomy catheter to remove a submandibular duct stone. PMID- 2765835 TI - Chronic intussusception in children. AB - Nine children presented with intussusception lasting for 14 days or more. Their mean age was 8.5 years. Diagnosis of intussusception was delayed considerably, probably due to an unusual presentation. Compared with acute intussusception, symptoms consist of infrequent attacks of abdominal pain, sporadic vomiting and no, or small, changes in defecation. Marked weight loss and an abdominal mass assume diagnostic significance, in contradiction to bloody stools. Ultrasonography can be of diagnostic value. An attempt at hydrostatic reduction is often unsuccessful. A high frequency of organic lesions precipitating intussusception warrants early surgical intervention. PMID- 2765836 TI - Surgical treatment of carcinoma involving the vagina. PMID- 2765837 TI - Pelviureteric junction obstruction and recurrent abdominal pain in childhood. AB - Three cases of recurrent abdominal pain due to pelviureteric junction obstruction in childhood are presented. Ultrasound is useful in confirming the diagnosis and pyeloplasty is recommended. PMID- 2765838 TI - Multiple primary retroperitoneal tumours: a unique case. PMID- 2765839 TI - Subclavian arteritis. PMID- 2765840 TI - Relationship between DNA ploidy and survival in patients with primary breast cancer. AB - The DNA ploidy of breast cancer tissue from paraffin blocks was measured by flow cytometry in 117 patients whose disease had been detected and treated with surgery between 1974 and 1976. Patients with aneuploid tumours had positive axillary nodes and distant metastases more often than those with diploid tumours. Aneuploid tumours were more common in postmenopausal than premenopausal women. The S-phase fraction (SPF) was significantly higher in aneuploid than in diploid tumours and positive axillary lymph nodes were found in 26 per cent of the patients who had a tumour with a SPF below the median (4.8 per cent) and in 48 per cent of those with tumours with SPF values above the median. At the primary clinical investigation 2 per cent of the patients with diploid tumours and 6 per cent of those with aneuploid tumours had distant metastases. During the follow up, the proportion of patients with distant metastases increased to 42 and 72 per cent, respectively. With a follow-up of 11.5 years, the DNA aneuploidy of the tumour showed a significant association with decreased survival. Thirty-three per cent of patients with diploid and 65 per cent of patients with aneuploid tumours had died from breast cancer during the follow-up (P less than 0.001). All patients with hypertetraploid or multiploid tumours died from breast cancer. High SPF values were associated more closely with distant metastases or death during the follow-up than low SPF values. Our results suggest that DNA ploidy measured by flow cytometry from paraffin embedded tissue blocks of human breast cancer can be used to predict the aggressiveness of the tumour and the survival of the patients. PMID- 2765841 TI - CA15-3: its relationship to clinical stage and progression to metastatic disease in breast cancer. AB - There is increasing interest in the potential role of monoclonal antibodies as tumour markers in the early detection of metastatic disease. CA15-3 is a circulating antigen which is relatively specific for breast tissue and defined by two monoclonal antibodies. It is elevated in the serum of patients with breast cancer but its relationship to clinical stage and tumour progression has not been well defined. CA15-3 levels have been measured in a consecutive series of 97 patients with breast cancer at the time of diagnosis and at 3-monthly intervals thereafter. All patients have been evaluated and followed by using routine biochemical and radiological parameters to detect occult metastatic disease. There was no difference between a control group of patients who presented with benign disease (n = 18: means(s.d.) 18.0(5.1) units/ml): and those who presented with stage I disease (n = 37: 18.4(5.3) units/ml) or stage II disease (n =21: 18.0(4.0) units/ml). Patients with stage III disease (n = 23: 32.0(10.4) units/ml) had significantly elevated levels of CA15-3 compared with those in stage I (P less than 0.001). All patients with documented metastatic disease at presentation or at follow-up had markedly elevated CA15-3 levels (n = 10: 155.8(50.2) units/ml). CA15-3 is a reliable tumour marker in patients with advanced disease. PMID- 2765842 TI - Additional value of fine-needle aspiration biopsy in a mammographic screening trial. AB - The Stockholm breast cancer screening trial used single-view mammography as the sole screening method. A majority (63 per cent) of the mammographic selected cases from the first two screening rounds had uncertain mammograms, coded as 3 on an ordinal scale from 1 to 5, where 1 and 2 are dismissed as normal mammograms and 5 stands for a typical cancer. In this group of uncertain mammograms 30 cases were malignant and 431 were non-malignant. The aim of this study was to examine whether surgical biopsy in this group could be replaced by fine-needle aspiration (FNA) biopsy, combined with the information from the mammogram and clinical examination, and whether this diagnostic strategy could select the malignant cases with a high sensitivity. FNA biopsy selected 25 of the 30 mammary carcinomas as definite malignancy or atypia, with a sensitivity of 83 per cent (95 per cent confidence interval: 69-96 per cent), and combined with the information from the mammogram and clinical examination 29 of the malignancies were selected with a sensitivity of 97 per cent (95 per cent confidence interval: 83-100 per cent). In 398 of 431 non-malignant cases the diagnosis was established with the triple diagnostic approach without needing a surgical biopsy. In a clinical follow-up study, up to 64 months after the first screening round, only one false negative case was found, included in the group of 30 malignancies described above. With this strategy the rate of negative surgical biopsies was reduced by 90 per cent in the group with uncertain mammograms and without considerably impairing the reliability of the results. PMID- 2765843 TI - Benign non-traumatic inflammatory strictures of the extrahepatic biliary system. AB - Obstructive jaundice was the presenting feature in 12 patients with benign, non traumatic strictures of the extrahepatic bile ducts. Ages at presentation ranged from 1.5 to 60 years and 11 were initially referred with diagnoses of malignant strictures. Histological examination, however, showed benign changes of chronic inflammation, with ulceration in seven, which were distinct from those of primary sclerosing cholangitis. All of the patients remain well from 3 to 14 years after surgery. The aetiology of the strictures is not known. PMID- 2765844 TI - Three-dimensional morphological study of the pancreatic microvasculature in caerulein-induced experimental pancreatitis. AB - A morphological study of the pancreatic microvasculature in experimental pancreatitis was performed in dogs, using three-dimensional scanning electron microscopy vascular casting and transmission electron microscopy. Animals with pancreatitis were characterized by a marked reduction in the number of capillaries outlined by the cast and by distortion of those that were outlined, with irregularity of the capillary lumen, abruptly terminating capillary buds and leakage of the cast material through the capillary membrane. The study provides convincing morphological evidence that one of the earliest changes in acute pancreatitis is distortion of the capillary circulation. PMID- 2765845 TI - Endoscopic sphincterotomy for bile duct stones in patients with intact gallbladders. AB - Endoscopic sphincterotomy was performed in 121 patients (age ranged 34-92 years; median 80 years) with intact gallbladders and bile duct stones. Clearance of the duct by basket or balloon extraction was attempted in 97 patients (80 per cent) and achieved in 93 of these patients (96 per cent). In 24 patients the duct was left to empty spontaneously and this occurred in 22 patients. Immediate complications due to endoscopic sphincterotomy occurred in five patients (two haemorrhage, two perforation, one haemorrhage and perforation). Of the 101 patients reviewed 12-72 months (median 24 months) after endoscopic sphincterotomy, 76 (75 per cent) have remained asymptomatic throughout the follow up period. Eighteen patients (18 per cent) required cholecystectomy for recurrent gallbladder symptoms 1-24 months after endoscopic sphincterotomy. One of the asymptomatic patients underwent cholecystectomy on the advice of his consultant. A further seven had recurrent biliary colic or cholangitis necessitating enlargement of the sphincterotomy and further stone retrieval in three of these patients. Endoscopic sphincterotomy is an effective treatment for bile duct stones in high risk patients, but subsequent cholecystectomy is required in a significant number of patients owing to continuing gallbladder symptoms. PMID- 2765846 TI - Haemorrhage in pancreatic disease. AB - Haemorrhage is a life-threatening complication in pancreatic disease. Twenty-five patients with this complication are described; 15 had major bleeding, nine had minor bleeding and one patient had a pseudoaneurysm identified at operation. Of the 15 patients with major bleeding, six presented with this complication and in nine cases it followed pancreatic resection. Of the six patients who presented with major bleeding, five underwent resection with one death while the patient managed conservatively died. The nine patients who had major bleeding after pancreatic resection were managed by ligation of the bleeding artery in six cases with one death, and one patient who rebled after ligation of the bleeding artery was successfully managed by further resection. Three patients with postresection major bleeding were managed conservatively with one death. All minor haemorrhages were managed conservatively without mortality. Deaths after major bleeding were a result of sepsis in three cases and respiratory failure in one. The severity of the underlying pancreatitis was an important factor in two patients. Pseudocysts and pancreatic fistulae were important underlying factors leading to the complication. It is recommended that patients with sepsis, a pancreatic fistula or severe underlying pancreatitis should have their haemorrhage treated by pancreatic resection, while those patients with bleeding following pancreatic resection without such complications can be managed by ligation. PMID- 2765847 TI - C-reactive protein and acute pancreatitis. PMID- 2765848 TI - Leucine kinetics in surgical patients. PMID- 2765849 TI - Operative mortality after perforated peptic ulcer. PMID- 2765850 TI - Contrast-enhanced CT scan in the early phase of acute pancreatitis. PMID- 2765851 TI - Peripheral and central auditory specialization in a gliding marsupial, the feathertail glider, Acrobates pygmaeus. AB - Two specialized features are described in the auditory system of Acrobates pygmaeus, a small gliding marsupial. Firstly, the ear canal includes a transverse disk of bone that partly occludes the canal near the eardrum. The resultant narrow-necked chamber above the eardrum appears to attenuate sound across a broad frequency range, except at 27-29 kHz at which a net gain of sound pressure occurs. Secondly, the lateral medulla is hypertrophied at the level of the cochlear nucleus, forming a massive lateral lobe comprised of multipolar cells and granule cells. This lobe has connections with the auditory nerve and the cerebellum. Speculations are advanced about the functions of these structures in gliding behaviour and predator avoidance. PMID- 2765852 TI - Topographic organization of the corticonuclear fibers from the tuber vermis and paramedian lobule in the albino rat. AB - The topographic organization of the corticonuclear fibers from the tuber vermis and paramedian lobule in the albino rat was investigated by autoradiographic anterograde tracing method. The medial portion of the tuber vermis projects to the dorsal part of the caudomedial subdivision of the medial cerebellar nucleus (MNcm), whereas the lateral portion of the tuber vermis projects to the dorsal part of the MNcm and the caudal part of the middle subdivision of the medial nucleus. The intermediate cortex of the paramedian lobule can be subdivided mediolaterally into three portions which project to the dorsolateral protuberance of the medial cerebellar nucleus, the rostrodorsal part of the posterior interpositus nucleus, and the caudodorsal part of the lateral anterior interpositus nucleus, respectively. The lateral cortex of the paramedian lobule can also be subdivided mediolaterally into two portions: the medial portion projects to the dorsolateral hump, and the lateral one to the lateral cerebellar nucleus. These results indicate that the cortical efferent fibers from the tuber vermis and paramedian lobule are clearly organized in the mediolateral direction in the albino rat. PMID- 2765853 TI - A cyto-architectonic description of the thalamus of the tammar wallaby, Macropus eugenii. AB - Very few studies are available on the cyto-architectural features of the thalamus of metatherian mammals. Most of these studies describe the thalamus of a polyprotodont metatherian, the North American opossum, Didelphis virginiana. Studies on diprotodont metatherians are fewer still. There are two descriptions of the thalamus of the Australian possum Trichosurus vulpecula. The only part of the thalamus that has been described in the wallabies is the lateral geniculate nucleus. Hence, there was a need for a description of the thalamus in a wallaby. This study describes the organisation and the cyto-architectonics of the thalamus of the tammar, Macropus eugenii. Except for the midline nuclei, the boundaries of all other nuclei are well demarcated due to their well-differentiated nuclear components. Within the lateral posterior complex, a pulvinar nucleus was identified, and the pre-tectal nuclei show extensive differentiation, as do the medial geniculate nuclei. Also, a small centre-median nucleus was identified. The anteroventral nucleus retains its dorsal position for its entire rostrocaudal extent. The nucleus of the optic tract is located in a dorsal position in the tammar, as it is in cats. The general conclusion from this study is that the nuclear organisation of the thalamus in the tammar, a metatherian mammal, is complex and comparable in most respects to that in cats, eutherian mammals. PMID- 2765854 TI - Adaptive changes of vertical vestibulo-ocular reflex induced by tenectomy of vertical recti muscles and neuronal behavior related to vertical eye movement in the region of the interstitial nucleus of Cajal in alert cats. AB - Experiments were performed in alert cats to examine adaptive changes of the vertical vestibulo-ocular reflex (VOR) induced by tenectomy of the vertical recti muscles of one eye and behavior of neurons in the region of the interstitial nucleus of Cajal (INC) during this adaptation. Continuous pitch rotations (0.11 Hz) of a constant amplitude (+/- 10 degrees) with only the operated eye uncovered produced a gradual and significant increase in VOR gain that started within 15 min, reaching a plateau within 1 h. When only the normal eye was allowed to view again, VOR gain quickly decreased to the control values within 10 min. Such reversible gain change was not observed when visual input was not allowed to the operated eye, indicating that these changes are adaptive ones to reduce visual vestibular conflict. A total of 18 neurons were recorded from the INC region during the VOR adaptation. These include 9 eye-movement-related neurons (8 vertical burst-tonic neurons and 1 vertical tonic neuron) and 9 other neurons that did not show close correlation with eye movement but were activated by pitch rotations (tentatively called pitch cells). During adaptive gain increase of the vertical VOR, all the vertical burst-tonic and tonic neurons showed a significant gain increase, whereas a significant change in response gain was observed in only 1 of the 9 pitch cells, indicating that vertical burst-tonic neurons in the INC region are involved in the adaptive gain increase in the vertical VOR.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2765855 TI - Characterizing sentence intonation in a right hemisphere-damaged population. AB - Current production studies present a mixed view of right hemisphere-damaged (RHD) patients' ability to produce normal sentence intonation. The present study characterized the sentence intonation of RHD patients, focusing on a greater number of acoustic parameters than past works, and relying on more naturally elicited speech samples through use of a story completion task. Eight RHD speakers and seven nonneurological control subjects produced declarative and imperative sentences as well as yes-no and wh-questions. Slope of F0 change, linearity of pitch contour, and variance of F0 points were calculated for each utterance as a whole, as well as for the preterminal and the terminal contour separately. RHD contours were less linear and flatter in F0 decline than normal controls for the declarative sentences. The patients' yes-no questions also differed from normal productions, displaying smaller F0 dispersion around a mean F0. Preterminal range values were more restricted for patients' utterances of yes no questions, while terminal properties between groups differed for three of the four sentence types examined. The present results suggest some disturbance in the patients' ability to manipulate fundamental frequency across sentential domains. These data are discussed in terms of current theories of a general dysprosody in RHD patients. PMID- 2765856 TI - Right hemisphere EEG sensitivity to speech. AB - Recent speech perception work with normals and aphasics suggests that the right hemisphere may be more adept than the left at making the voicing discrimination, and the reverse for place of articulation. We examined this right hemisphere voicing effect with natural speech stimuli: stop consonants in pre-, mid-, and postvocalic contexts. Using a neuroelectric event-related potential paradigm, we found numerous effects indicating bilateral components reflecting the voicing and place contrast and unique right hemisphere discrimination of both voicing and place of articulation. PMID- 2765857 TI - Dysprosody in Broca's aphasia: a case study. AB - A detailed acoustic analysis of timing, intensity, and fundamental frequency (F0) at different levels of linguistic structure was conducted on the speech output of a Broca's aphasic who was a native speaker of Thai. Timing was measured with respect to syllables, phrases, and sentences in connected speech. Intensity variation at the sentence level was measured in connected speech. F0 variation associated with the five Thai tones was measured in both isolated words and connected speech. Results indicated that timing was differentially impaired depending upon complexity of articulatory gesture and size of the linguistic structure. Timing, as well as intensity, was aberrant at the sentence level. In contrast, F0 contours of the five tones were spared at all levels of linguistic structure. Findings are interpreted to support the view that dysprosody in Broca's aphasia is more applicable to speech timing than to F0. PMID- 2765858 TI - Lateral differences in lexical access: word length vs. stimulus length. AB - A. W. Young and A. W. Ellis (1985, Brain and Language, 24, 326-358) have shown that visual length of stimuli is a major determinant of lateral differences in word processing. They suggest that the right hemisphere must first code the words in graphemic form and, therefore, is affected by the word length. They demonstrated that visual length is best defined as the number of letters. The present experiment was conducted with 36 normal subjects to test this definition of the visual length by contrasting the number of letters and the physical length in the visual field. Spaces were inserted in the short words (4-letter) so that they matched the physical length of the long words (7-letter). Our results replicated those of Young and Ellis and confirmed that visual length can be defined by the number of letters. In addition, the imagery value of the words tended to affect this Hemifield x Length effect, a result not obtained by Young and Ellis. PMID- 2765859 TI - Positional dyslexia. AB - Position-specific errors in word reading are usually associated with neglect or visual extinction on the same side as the reading problem. In this study, two patients with left-hemisphere lesions showed visual extinction on the right but reading difficulty on the left side of words and pseudowords. Further study of one patient revealed that he also had problems reading the beginning of words presented tachistoscopically or in vertical orientation. In addition, the positional difficulty was apparent when he named the letters in words. The pattern of results indicates that the positional dyslexia in these patients was not likely attributable to general deficits in visual perception or attention but may have reflected a disorder at a later stage of letter processing. PMID- 2765860 TI - On-line sensitivity to local and long-distance syntactic dependencies in Broca's aphasia. AB - Seven agrammatic Broca's aphasics and ten normal control subjects performed a word-monitoring task to determine the degree to which violations of syntax would affect word-monitoring performance. Both local and long-distance dependencies were explored, as well as the effects of additional interceding words. Results indicated that normal subjects' word-monitoring latencies were significantly slower to target words in ungrammatical contexts for both local and long-distance dependencies. Aphasic subjects showed a significant sensitivity to ungrammaticality in the local dependency condition; for the long-distance dependencies, however, no reaction time difference emerged between grammatical and ungrammatical stimuli. Results are discussed in relation to current theories of the nature of agrammatic deficits. PMID- 2765861 TI - Effects of unilateral naris closure on the olfactory epithelia of adult mice. AB - This study demonstrates, for the first time, that prolonged unilateral breathing can be harmful to the adult olfactory epithelium. Mice at least 5 months old had one naris closed by cautery and suture. These were divided into 5 groups of 10 mice which had unilateral naris closure for 1, 3, 6, 8 or 12 weeks. A control group of 10 mice was untreated. Variables that were assessed included the thicknesses and numbers of cells spanning olfactory epithelia in hematoxylin and eosin stained paraffin sections. Olfactory marker protein (OMP) immunohistochemistry was used to further visualize the differential impact of naris closure on the two sides of the nose. Unilateral naris closure for 6 weeks or longer caused dramatic losses of olfactory receptor cells in the rostral third of the open-side olfactory epithelia, but did not affect numbers of cells in caudal regions or on the closed sides. The thicknesses of the open and closed side olfactory epithelia were significantly different for only the 8-week closure group. In most mice with unilateral naris closure for longer than 6 weeks there was little or no staining of the olfactory receptor neurons or their axon bundles for OMP in the affected regions of the open side. PMID- 2765862 TI - Peripheral, but not local or intracerebroventricular, administration of benzodiazepines attenuates evoked activity of locus coeruleus neurons. AB - To determine whether benzodiazepine receptors in the locus coeruleus (LC) regulate the firing of LC neurons, the effects of systemic, intracerebroventricular, and local administration of various benzodiazepines on LC activity were compared. Systemic administration of diazepam, chlordiazepoxide, and alprazolam in anesthetized rats markedly attenuated sensory-evoked activity of LC neurons while also suppressing, but to a lesser degree, spontaneous LC firing rates. When microinfused into the LC region, diazepam, chlordiazepoxide, and alprazolam reduced spontaneous LC firing rates to the same extent observed following systemic administration; however, unlike systemic administration, infusion of benzodiazepines into the LC failed to attenuate evoked LC activity. Similarly, intracerebroventricular administration of diazepam and chlordiazepoxide suppressed spontaneous, but not evoked, LC activity. These findings indicate that benzodiazepines suppress spontaneous LC firing by stimulating benzodiazepine receptors in the LC while attenuating evoked LC activity by stimulating benzodiazepine receptors that are neither in the LC nor accessible to benzodiazepines introduced into the ventricular system. PMID- 2765863 TI - Hypothalamic sites of neuronal histamine action on food intake by rats. AB - To identify sites of histaminergic modulation of food intake, histamine H1 receptor antagonist was microinfused into the rat hypothalamus, the ventromedial hypothalamus (VMH), the lateral hypothalamus (LHA), the paraventricular nucleus (PVN), the dorsomedial hypothalamus (DMH), or the preoptic anterior hypothalamus (POAH), during the early light period. Feeding, but not drinking, was elicited in 100% of the rats (P less than 0.01) that were bilaterally microinfused with 26 nmol chlorpheniramine into the VMH. Unilateral infusion into the VMH did not affect food intake at doses of 26 or 52 nmol. Feeding was also induced by bilateral microinfusion into the PVN, but only the 52 nmol dose was effective. Bilateral infusions into the LHA, the DMH or the POAH did not affect ingestive behavior. Feeding induced by an H1-antagonist was completely abolished in all 7 rats tested when endogenous neuronal histamine was decreased by pretreatment with alpha-fluoromethylhistidine (100 mg/kg). The findings suggest that H1-receptors in the VMH and the PVN, but not in the LHA, the DMH or the POAH, may be involved in histaminergic suppression of food intake. PMID- 2765864 TI - Prolactin, vasoactive intestinal peptide, and peptide histidine methionine elicit selective increases in REM sleep in rabbits. AB - The purpose of these experiments was to determine whether (1) vasoactive intestinal peptide (VIP) produces effects on rabbit sleep similar to those reported for rats and cats; (2) peptide histidine methionine (PHM), a peptide closely related to VIP, mimics the sleep effects of VIP; and (3) pituitary prolactin (PRL), a pituitary hormone that has a sleep-related secretory pattern and for which VIP and PHM act as releasing factors, has similar effects on sleep. VIP or PHM (0.01, 0.1 and 1.0 nmol/kg) was intracerebroventricularly (i.c.v.) injected; PRL (ovine PRL, 45 and 200 IU/kg) was subcutaneously (s.c.) administered. Sleep-wake activity and brain temperature were recorded for 6 h. For controls, rabbits received artificial cerebrospinal fluid i.c.v. or PRL vehicle s.c. VIP and PHM promoted rapid eye movement sleep (REMS), although these effects were not dose-dependent. In addition, the high dose of VIP and PHM transiently increased wakefulness. Increases in REMS occurred only during hours 2 6 after i.c.v. injection of VIP and peptide histidine leucine (PHI). After s.c. injection of PRL, REMS started to increase in postinjection hour 3. The effect of the high dose was significantly more pronounced than that of the small dose. Each substance enhanced the frequency of REMS episodes, and the high dose of PRL also increased the duration of REMS bouts. These results are consistent with the hypothesis that VIP is involved in physiological regulation of REMS, and that the VIP- and PHM-induced increases in REMS may be mediated via release of PRL. PMID- 2765865 TI - Evaluation of the neurotoxic potential of N,N-dimethylamphetamine: an illicit analog of methamphetamine. AB - The purpose of this study was to evaluate the neurotoxic potential of N,N dimethylamphetamine (N,N-DMA), a controlled substance analog that has recently appeared on the illicit drug market, and compare it to that of methamphetamine, a structurally related drug with known dopaminergic and serotonergic neurotoxic activity. Like methamphetamine, N,N-DMA induced degeneration of nerve terminals in the mouse striatum, but did not produce cell loss in the pars compacta of the substantia nigra. The dopamine-depleting effects of N,N-DMA were approximately one-eighth of those of methamphetamine. Assessment of N,N-DMA's effects on serotonergic neurons showed that it did not produce a long-lasting depletion of serotonin in either the mouse or rat brain. By contrast, equivalent doses of methamphetamine depleted serotonin in the rat brain by 82%. These results indicate that N,N-DMA, the N-methylated analog of methamphetamine, is considerably less potent than its parent compound both as a dopaminergic and serotonergic neurotoxin, and raise the question of whether or not it may be possible to dissociate the neurotoxic effects of methamphetamine from its reinforcing actions by means of N-methylation. Safety of N,N-DMA in humans remains to be investigated. PMID- 2765866 TI - Effect of exogenous L-dopa on behavior in the rat: an in vivo voltammetric study. AB - L-DOPA was administered intraperitoneally (i.p.) or intraventricularly (i.v.t.) to freely moving rats to investigate the effects of exogenous L-DOPA itself on behavior. Striatal dopamine (DA) in the extracellular fluid was examined with microcomputer-controlled in vivo voltammetry, and behavioral change was observed. When L-DOPA was administered (i.p.) after pretreatment with benserazide, a peripheral DOPA decarboxylase inhibitor, behavioral change was elicited before the elevation in DA and suppressed before its reduction. After pretreatment with NSD-1015, a central DOPA decarboxylase inhibitor, behavioral change was also elicited, although DA was still not increased. When L-DOPA was injected (i.v.t.), the behavioral effect was manifested at once; DA was still unchanged at this time, but it increased after behavioral activity reached the maximum level. L DOPA was also injected (i.v.t.) into rats with striatal lesions induced by 6 hydroxydopamine (i.v.t.). Behavioral change was manifested promptly after the injection. When the dose-response curves to different dosages of L-DOPA were examined in normal rats without striatal lesions, it was found to exhibit a steeper rise than that of DA. Finally, when rats were injected (i.p. or i.v.t.) with 3-O-methyl-DOPA (3-methoxytyrosine), a major metabolite of L-DOPA, no behavioral change was elicited, and no increase in DA was recognized. These experimental results indicated that L-DOPA is related directly to the manifestation of behavioral change. PMID- 2765867 TI - Subchronic cocaine treatment enhances cocaine-induced dopamine efflux, studied by in vivo intracerebral dialysis. AB - Repeated administration of cocaine in animals results in behavioral sensitization. In order to investigate the neurochemical mechanism underlying such behavioral sensitization, we designed the following two experiments. In both experiments, rats were pretreated with cocaine (20 mg/kg i.p.) or saline, once daily for 14 consecutive days. Exp. 1: 7 days after withdrawal from the drug, the stereotyped behavioral response to a challenge of cocaine (20 mg/kg i.p.) was measured. Exp. 2: 7 days after withdrawal from the drug, we measured extracellular dopamine (DA), 3,4-dihydroxyphenylacetic acid (DOPAC) and homovanillic acid (HVA) after the challenge administration of cocaine using an in vivo intracerebral dialysis technique. The rats pretreated with cocaine (20 mg/kg i.p.) exhibited behavioral augmentation in response to a challenge of cocaine. The challenge administration of cocaine caused an increase in DA and a decrease in DOPAC. The DA level in the striatal perfusates of the cocaine-pretreated rats was significantly greater than that in the saline-pretreated rats. These results suggest that the increased extracellular DA concentration in the striatum plays an important role in the cocaine-induced behavioral sensitization. PMID- 2765868 TI - Vocalization and stapedius muscle activity evoked by local electrical stimulation of midbrain in the chicken (Gallus gallus). AB - The organization of chicken mesencephalic areas from which stapedius muscle activity and vocalization can be differently elicited was studied. Our results show the existence of an area, around the mesencephalic 'calling area', from which stapedius muscle activity can be evoked independently of vocalization. Furthermore, low threshold 'vocalization loci' stimulation evokes field potentials in the stapedius-controlling area, due to the activation of stapedius controlling neurons by vocalization neurons. PMID- 2765869 TI - Conditioning lesion effects on rat sciatic nerve regeneration are influenced by electrical stimulation delivered to denervated muscles. AB - The rate of regeneration and the initial delay of the fastest growing fibers of the rat sciatic nerve were electrophysiologically evaluated after a freeze at mid thigh. A prior section or a prior freeze at the ankle level increased the rate of regeneration and decreased the initial delay with different magnitudes. These phenomena are named 'conditioning lesion effects'. A daily electrical stimulation transcutaneously delivered to the foot sole muscles from the day following their denervation by the prior lesion did not modify the increased rate of regeneration but prevented the decrease of the initial delay whatever the type of the prior lesion. Therefore, the initiation of earlier sprouting of the parent axons seems to be specifically controlled by a signal associated with muscle denervation properties. PMID- 2765870 TI - Sustained elevation in hippocampal NGF-like biological activity following medial septal lesions in the rat. AB - Several laboratories have documented an increase in hippocampal nerve growth factor (NGF) levels, measured with biological or immunological assays, within 1-2 weeks following septal lesions or fimbria/fornix transections. In the present study we have determined the increase in NGF-like biological activity in medium conditioned by hippocampal slices at more prolonged times following medial septal lesion. In contrast to reports based on immunological assays, which demonstrate a transient increase in hippocampal NGF, elevated NGF-like biological activity was present in hippocampal slice-conditioned medium up to one year after a medial septal lesion. PMID- 2765871 TI - Adenosine antagonists delay hypoxia-induced depression of neuronal activity in hippocampal brain slice. AB - Submerged rat hippocampal slices were exposed to hypoxic medium prepared with 95% N2/5% CO2. The population spikes recorded from CA1 cell layer were completely blocked within a range of 5-10 min. The adenosine antagonist theophylline (100 microM) delayed and partially prevented the hypoxia-induced depression. Increasing concentrations of the more potent adenosine antagonist 8 phenyltheophylline (8-PT; 0.1, 1, 10 microM) resulted in progressively less hypoxia-induced depression. The antidromically elicited afterpotentials recorded in the absence of synaptic transmission in low calcium, high magnesium medium were blocked within 8 min of hypoxia. Theophylline (100 microM) and 8-PT (10 microM) delayed to a similar extent the hypoxia-induced depression of the first afterpotential but did not prevent its complete depression. PMID- 2765872 TI - Distribution of vasoactive intestinal polypeptide-like immunoreactivity in the olfactory bulb of the rainbow trout (Salmo gairdneri). AB - The distribution of vasoactive intestinal polypeptide-like structures in the olfactory bulb of the rainbow trout was studied using an indirect immunoperoxidase technique. Olfactory fibres were very strongly labelled, whereas the fibres or cell bodies in the remaining strata of the olfactory bulb showed no immunoreactivity. In addition, the olfactory nerve fibres were not immunoreactive for methionine- and leucine-enkephalins, motilin, neuropeptide Y, substance P, cholecystokinin-8 and tyrosine-hydroxylase. PMID- 2765873 TI - Footshock stress facilitates self-stimulation of the medial prefrontal cortex but not the lateral hypothalamus in the rat. AB - The effects of stress on self-stimulation were investigated by exposing rats to either controllable, uncontrollable or no footshock. Both controllable and uncontrollable footshock increased medial prefrontal cortex self-stimulation rates immediately as well as 24 h following treatment. Controllable footshock produced a greater enhancement than uncontrollable footshock. In contrast, self stimulation of the lateral hypothalamus was unaffected by either footshock treatment. These results are interpreted with reference to the neurochemical response of the mesocortical dopaminergic system to acute stress. PMID- 2765874 TI - Hippocampal mossy fiber distribution and long-term potentiation in two inbred mouse strains. AB - We studied long-term potentiation in the inbred mouse strains DBA/2 and C3H/He known to be different in both hippocampal mossy fiber distribution and several aspects of learning. Tetanic stimulation of mossy fibers resulted in a significantly stronger increase of the population spike amplitude in the CA3 pyramidal cell layer of C3H mice. This result suggests that the extent of the CA3 hippocampal mossy fiber projection correlates with synaptic efficacy in mice. PMID- 2765875 TI - Cortical blood flow increases induced by stimulation of the substantia innominata in the unanesthetized rat. AB - The possible implication of projections from the substantia innominata (SI) to the cerebral cortex in the control of local cortical blood flow (CoBF) was studied in adult Fischer rats. Local blood flow (by helium clearance) and tissue gas partial pressures (pO2, pCO2) as metabolic indices, were measured in the frontal and parietal cortices in unanesthetized animals via chronically implanted probes connected to a mass spectrometer. Stimulating electrodes, also implanted chronically, were placed in the region of the SI. Out of 37 correctly located sites, 28 gave rise to cerebrovascular responses without significant hypertension or agitation. Both frontal (+114%) and parietal CoBF (+28%) increased significantly during ipsilateral 50 microA stimulation, but did not further significantly increase at 100 microA. Contralateral stimulation induced only small, non-significant effects. SI stimulation simultaneously increased cortical pO2 and decreased cortical pCO2, significantly more so in the frontal compared to the parietal cortex, and ipsilaterally compared to contralaterally. Both the CoBF and the tissue gas changes induced by SI stimulation were strongly potentiated by infusion of 0.15 mg/kg/h of the cholinomimetic agent physostigmine. The electrocorticogram (ECoG) was not systematically activated during the SI stimulation. The evidence presented favors a role for the cholinergic projections of the SI in control of CoBF (particularly frontal cortex), especially since the flow changes observed showed no obvious dependence on changes in local pCO2 or on paCO2, and could not be attributed to hypertension or behavioral changes. PMID- 2765876 TI - Effects of castration, steroid replacement, and sexual experience on mesolimbic dopamine and sexual behaviors in the male rat. AB - The concentrations of dopamine (DA) and a DA metabolite in a terminal field of the mesolimbic DA system, the nucleus accumbens, decreased after castration, an effect that was prevented by treatment with testosterone (T) or estradiol. After castration, DA concentrations were increased in the medial preoptic area, and were unchanged in the caudate-putamen, substantia nigra, and ventral tegmental area. Changes in DA and DA metabolite concentrations in the nucleus accumbens coincided with changes in measures of sexual arousal. Sexual experience did not affect DA concentrations, but did increase DA metabolism in the nucleus accumbens, and also increased the frequency of female-directed behavior in castrated males. These results suggest that T, or its aromatized metabolite, influences the mesolimbic DA system, and that this system is involved in mediating sexual arousability. PMID- 2765877 TI - Angiotensin II inhibits the release of [3H]acetylcholine from rat entorhinal cortex in vitro. AB - The effects of angiotensin I and II on basal potassium-induced release of [3H]acetylcholine were investigated in slices of rat entorhinal cortex. Potassium (10-25 mM) produced a concentration-dependent increase in the release of [3H]acetylcholine in the presence of extracellular calcium. Angiotensin II (10( 9)-10(-5) M) (but not angiotensin I) reduced the potassium-induced release of [3H]acetylcholine in a concentration-related manner to 60% of control levels, but did not effect basal tritium release. The effect of angiotensin II was antagonised by [1-sarcosine, 8-threonine] angiotensin II, an angiotensin II receptor antagonist, but not by agents acting on alpha- and beta-adrenoceptors, muscarinic, nicotinic, histamine or 5-hydroxytryptamine receptors nor by the angiotensin converting enzyme (ACE) inhibitor SQ 29852. The results indicate that angiotensin II acting via an angiotensin II receptor can inhibit the release of [3H]acetylcholine in slices of the rat entorhinal cortex. It is hypothesised that the ability of ACE inhibitors to facilitate cognitive processes may be related to a reduced availability of angiotensin II. PMID- 2765878 TI - Characteristics of rat lateral hypothalamic neuron responses to smell and taste in emotional behavior. AB - Single unit activity in the lateral hypothalamus (LHA) of the rat was recorded while the animal learned to discriminate cue signals. Normally preferred potables (glucose, orange, or grape solution) or intracranial self-stimulation (ICSS) were used as rewards. Electric shock or tail pinch were used as aversive stimuli. The same behavior, licking, was the response required to either obtain the rewarding stimuli or avoid the aversive ones. For positive reinforcement a rat was rewarded with fluid or ICSS upon licking a spout presented in front of its mouth. In negative reinforcement experiments, an aversive stimulus, electric shock or tail pinch, was applied if the rat did not lick the spout. Solutions having smell only, taste only, or smell-plus-taste, were prepared from oranges or grape extract. Of 392 neurons analyzed, 256 responded differentially to rewarding and aversive stimuli, and 138 of these were tested with the 3 different solutions. Similar LHA neural responses occurred during actual drinking of the 3 kinds of solutions, as well as on recognition of the cue signal. Responses to smell only had shorter latency than responses to taste only. Neural activity in response to solutions that could be both smelled and tasted was the sum of activity in response to taste-only solutions plus that in response to smell-only solutions. Cue signal responses were rapidly acquired, usually within 2-5 trials, for both taste-only and smell-only solutions. The results indicate the integration of both taste and olfactory information by the same LHA neurons, and these neurons are involved in cue signal learning. Present results of LHA neuronal responses to taste and smell suggest that the intensity of gustation and olfaction may add together to enhance instinctive hedonic sensations. These neurons are involved in the formation of stimulus-reinforcement association in learning, and in elicitation of conditioned emotional responses. PMID- 2765879 TI - Vasopressin and oxytocin express excitatory effects on respiratory and respiration-related neurones in the nuclei of the tractus solitarius in the cat. AB - The effects of the iontophoretic application of vasopressin and oxytocin were examined on the activity of single neurones recorded in the region of the nuclei of the tractus solitarius (NTS) of the cat that were functionally classified as respiratory neurones or presumed reflex interneurones. The excitatory effects observed in half to two-thirds of these neurones tested (n = 37) suggest a role of these peptides in respiratory control and further support recent evidence that their involvement in autonomic control may include an action in NTS. PMID- 2765880 TI - Transmitter cosynthesis by corticopetal basal forebrain neurons. AB - The objective was to determine if corticopetal basal forebrain neurons could co synthesize different transmitters. Histochemical labeling of a molecular marker of connectivity (wheat germ agglutinin lectin-bound horseradish peroxidase [HRP]; axonal uptake and retrograde transport from neocortex) and immunohistochemical labeling of molecular markers of transmitter synthesis (glutamic acid decarboxylase [GAD]: choline acetyltransferase [ChAT]) were combined in adult cats and examined by light microscopy. Adjoining partial profiles of the same neurons in the basal forebrain co-localized GAD + HRP and ChAT + HRP in adjacent faces of serial tissue sections. GAD + ChAT were also co-localized within individual profiles of neurons in the basal forebrain from single tissue sections. The results indicate that infrequent corticopetal neurons in the basal forebrain can produce both gamma-aminobutyric acid and acetylcholine. PMID- 2765881 TI - Depression of diaphragmatic and external intercostal muscle activities elicited by stimulation of midpontine dorsal tegmentum in decerebrate cats. AB - This paper describes the inhibitory influences on external intercostal muscle activity and diaphragmatic activity, evoked by stimulation of the dorsal tegmental field (DTF) of the pons in decerebrate cats. Stimulation of the DTF along the midline decreased both the diaphragmatic and the external intercostal activities. However, the inhibitory influences on the above two kinds of respiratory muscle activities were different in nature. Diaphragmatic activity, once suppressed by stimulation, recovered in spite of the continuation of stimulation. In contrast, DTF stimulation depressed tonic discharges of external intercostal muscle, and the depressed or abolished tonic discharges did not resume even after termination of stimulation. Rhythmic external intercostal muscle activity, synchronized with diaphragmatic activity, was also suppressed by DTF stimulation and the suppressed rhythmic activity seemed difficult to recover during stimulation, compared with the recovery process of the diaphragmatic activity. PMID- 2765882 TI - Single neurones of the basal forebrain and laterodorsal tegmental nucleus project by collateral axons to the olfactory bulb and the mediodorsal nucleus in the rat. AB - The branching pattern of axons arising from cells in the basal forebrain and laterodorsal tegmental nucleus of the pontine grey, was examined using the double retrograde transport of rhodamine- and coumarin-labelled latex microspheres injected into the olfactory bulb and the mediodorsal thalamic nucleus. About 30 50% of basal forebrain neurones were double-labelled, and approximately 30-40% of laterodorsal tegmental neurones were double-labelled ipsilateral to the injections. No contralateral single or double label was observed in the basal forebrain, but approximately 30% of the contralateral laterodorsal tegmental projection was also double-labelled. PMID- 2765883 TI - Postnatal maturation of primary afferent terminations in the substantia gelatinosa of the rat spinal cord. An electron microscopic study. AB - Axodendritic dark sinuous endings occurred on the day of birth (PO) in the synaptic areas of lamina II. These terminals (TI) turned very electron dense and shrunken after capsaicin administration. From day P2, TI-terminals exhibited fluoride-resistant acid phosphatase (FRAP) reactivity. Such findings revealed their origin from primary afferent fine fibers. Dark scalloped, FRAP-reactive, central terminals of type I glomeruli (CI) were first observed on P5. During the ensuing survival times up to P20 an increasing number of CI-terminals seemed to evolve from the less mature TI-endings that gradually disappeared. A few large clear boutons, similar to the central terminals of type II glomeruli (CII) of the adult which arise from thick afferents, were also present in deep lamina II on the day of birth and became more numerous thereafter. From P5, both CI- and CII endings developed pre- and postsynaptic contacts with vesicle-containing profiles though it was sometimes difficult to distinguish the axonic (V2) from the dendritic (V1-presynaptic dendritic) profiles. CI-boutons established as many presynaptic as postsynaptic contacts with vesicle-containing profiles. In contrast, CII-terminals were mostly postsynaptic to vesicle-containing profiles. Thus, the boutons generated by thin (CI-boutons) and thick (CII-boutons) primary axons gradually develop synapses with vesicle-containing profiles probably arising from local interneurons. The resulting pre- and/or postsynaptic interactions may contribute to the physiological maturation of somatosensory integration that occurs postnatally. PMID- 2765884 TI - Neurons in the parabrachial nuclei respond to hemorrhage. AB - To examine the organization of pathways in the dorsal rostral pons that process information from cardiovascular receptors, 62 neurons in the parabrachial nuclei were tested, in rats anesthetized with urethane, for their response to hemorrhage (10 ml/kg.min) and reinfusion. Of these neurons, 21 exhibited patterns of activity in response to hemorrhage that were significantly different from those seen prior to hemorrhage. The patterns of activity appeared to depend, at least in part, on the location of the neurons within the parabrachial nuclei. The activity of 8 neurons in the external lateral and central lateral parabrachial nuclei (LT) and adjacent Kolliker-Fuse nucleus (KF) increased during hemorrhage and remained elevated during reinfusion. Multivariate regression analysis indicated that the activity of these neurons was best predicted by mean arterial pressure. In contrast, the activity of 8 neurons in the dorsal cap of the central lateral parabrachial nucleus (DR) and in the caudal medial parabrachial nucleus (MD) increased during hemorrhage and decreased during reinfusion, and appeared to be best predicted by blood volume. The activity of 5 neurons in the region between the caudal medial parabrachial nucleus and the locus coeruleus (BT) responded inversely to those in the caudal medial parabrachial nucleus, and was predicted well both by blood volume and by mean arterial pressure. Together, these data reveal a complex processing of hemodynamic signals within the parabrachial nuclei which may play a critical role in the control of neuroendocrine and sympathetic responses in relation to regulation of arterial pressure, blood volume and fluid balance. PMID- 2765885 TI - Rapid migration of grafted cortical astrocytes from suspension grafts placed in host thoracic spinal cord. AB - The cerebral cortices from 14-day gestation rat embryos were prelabeled with Phaseolus vulgaris leucoagglutin (PHAL) and homografted as a cell suspension into host thoracic spinal cord. Animals were sacrificed at 7, 14, 21 and 30 days postimplantation (DPI). Paraffin sections of cervical, thoracic and lumbar spinal cord were double-labeled for the presence of glial fibrillary acidic protein (GFAP) a specific marker for astrocytes, and PHAL, utilized as a marker for graft derived cells. PHAL-GFAP positive cells were found throughout the thoracic spinal cord at all time periods, indicating that grafted astrocytes migrated along all 3 axes of the host spinal cord (rostral-caudal, dorsal-ventral and left-right). At 30 DPI, graft-derived astrocytes were found in host cervical and lumbar spinal cord. There appeared to be a minimal delay in the onset of migration. PMID- 2765886 TI - Dorsal medullary inspiratory neurons: effects of superior laryngeal afferent stimulation. AB - In decerebrate paralyzed cats ventilated with a cycle-triggered pump, we examined the responses of inspiratory (I) neurons in the region of the ventrolateral nucleus tractus solitarius (NTS) to single electrical stimuli delivered to the ipsilateral superior laryngeal nerve (SLN). Sixty-five I neurons were classified as: I(-), I(0), I(+, early), I(+, late) or I(other) on the basis of responses to lung inflation, and as I(bulbophrenic) or I(non-bulbophrenic) on the basis of evidence of an excitatory projection to the contralateral phrenic motoneuron pool. The peristimulus histograms of contralateral phrenic activity showed an early peak of excitation with average latency of 4.9 +/- 0.1 ms (mean +/- S.E.M.), followed by depression at 7.3 +/- 0.2 ms, start of recovery from depression at 22.7 +/- 1.0 ms, and recovery to control levels at 28.4 +/- 1.1 ms. The peristimulus histograms of ipsilateral I unit activity showed an initial excitation (latency 2.9 +/- 0.3 ms), followed by spiking silence (latency 6.0 +/- 0.6 ms) and recovery to control discharge frequency at 38.8 +/- 3.6 ms. This time of inhibition was significantly longer than the time of phrenic depression, suggesting that other bulbophrenic excitatory projections are able to rapidly compensate for decreased NTS output. Subgroups of I neurons, as classified by lung inflation tests, did not differ significantly with respect to these timing variables. In contrast, latencies of excitation for I(bulbophrenic) neurons were significantly less than for I(non-bulbophrenic) neurons. PMID- 2765887 TI - Central implants of diluted estradiol: independent effects on ingestive and reproductive behaviors of ovariectomized rats. AB - The present experiment was undertaken to evaluate the hypothesis that the effects of estrogens on feeding and sexual behaviors are organized separately within the brain. Thirty-three ovariectomized rats were implanted with bilateral guide cannulae aimed at either the paraventricular nucleus (PVN), medial preoptic area (MPOA), or posterior hypothalamus (PH). Subjects that received PVN implants were stimulated with either undiluted estradiol, a 3:1, or 10:1 mixture of cholesterol and estradiol. Animals in the other groups were treated with undiluted estradiol. All females were stimulated unilaterally with cholesterol and estradiol, yielding a total of 66 stimulation sites. Histological analysis revealed that, compared to cholesterol implants, undiluted estradiol in the PVN reduced food intake and body weight. More importantly, diluted estradiol implants in the PVN significantly lowered food intake and body weight. In contrast, undiluted estradiol in the MPOA, PH, or ventromedial hypothalamus (VMH) had no significant effects on feeding or body weight. Analyses of variance revealed significant main effects of implant location on female sexual behavior. Newman-Keuls tests indicated that diluted estradiol implants in the PVN produced lordosis quotients and quality scores that were significantly lower than those obtained with VMH implants. The possibility that the behavioral changes observed were due to peripheral rather than central effects of the hormone was evaluated by comparing the results of implants that produced vaginal cell cornification to those that did not. There were no significant differences between these groups on any of the other dependent variables, indicating that peripheral estradiol sufficient to induce vaginal cell cornification was neither necessary nor sufficient to account for the behavioral changes.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2765889 TI - Behavioural tolerance to morphine analgesia is supraspinally mediated: a quantitative analysis of dose-response relationships. AB - Repeated exposure of a rat to a nociceptive testing environment ('habituation') enhances its sensitivity to noxious thermal stimuli20 and reduces the antinociceptive effect of a subsequent acute dose of morphine ('behavioural tolerance'). The present study quantitatively characterises the effects of habituation upon morphine antinociception using hot-plate (50 and 55 degrees C) and reflex withdrawal tests (dipping the tail and hindpaws into water at 49 degrees C). Dose-response relationships were modeled with the empirical function; E = Eo + (EMAX*DN)/(ED50N + DN) where E is the time-integrated response, EMAX is the response attributable to morphine, Eo is the baseline response, D is the dose and N is a steepness parameter. Habituation reduced EMAX in both hot-plate tests and also reduced Eo on the 50 degrees C hot-plate. In both reflex tests, habituation reduced Eo to that of spinal animals and EMAX to a value intermediate between that of intact and spinal animals. Neither the ED50 nor the value of N was altered by habituation. Acute spinal novice and habituated animals had similar dose-response curves and parameters. Sham spinalisation had no significant effect on any of the parameters. It is concluded that habituation to the nociceptive testing environment substantially reduces the bulbospinal contribution to morphine analgesia but has no effect upon the spinal component. PMID- 2765888 TI - 1-Methyl-4-(2'-methylphenyl)-1,2,3,6-tetrahydropyridine (2'CH3-MPTP)-induced degeneration of mesostriatal dopaminergic neurons in the mouse: biochemical and neuroanatomical studies. AB - The neurotoxic effects of 1-methyl-4-(2'-methylphenyl)-1,2,3,6-tetrahydropyridine (2'CH3-MPTP), a substituted analog of 1-methyl-4-phenyl-1,2,3,6 tetrahydropyridine, were studied in BALB/cJ mice. Moderate doses of 2'CH3-MPTP produced a greater depletion of dopamine (DA) in the striatum (45%) than in the nucleus accumbens (23%), and in these same animals, there was a 35% loss of midbrain DA neurons. The greatest loss of DA cells occurred within the substantia nigra (43%), and there was also a significant loss of cells within the ventral tegmental area (28%). Higher doses of 2'CH3-MPTP decreased levels of DA more in the axon terminal/forebrain region (72%) than in the cell body/midbrain region (25%). Similar forebrain/midbrain DA depletion ratios were also found in mice that received an electrolytic lesion of the midbrain DA neurons; there was a greater Da depletion in the forebrain (29%) than in the midbrain (8%). In both 2'CH3-MPTP and electrolytically lesioned animals there was a significant increase in DA turnover in the forebrain region, as measured by the homovanillic acid/DA ratio. These data indicate that 2'CH3-MPTP: (1) destroys DA neurons within two midbrain regions containing cells which project to the striatum (i.e. mesostriatal DA neurons), rather than just nigrostriatal DA neurons; (2) produces a greater loss of DA in the axon terminal region than in the cell body region; and (3) influences the mesostriatal DA neurons in the same way as does a lesion to the cell bodies. These data are discussed with regard to the pathophysiology of 2'CH3-MPTP. PMID- 2765890 TI - ATP-induced synaptic potentiation in hippocampal slices. AB - The purpose of this study was to investigate the influence of different adenosine triphosphate (ATP) concentrations (ranging from 400 nM to 250 microM) on hippocampal potentials recorded from pyramidal neurons. ATP applied at a concentration of 400 nM induced a 100% increase in the size of the population spike (potentiation). The potential started to increase 30-60 s after ATP application, reached a maximum after 20 min, and remained potentiated for longer than 1.5 h. Washing the slices with fresh Ringer solution did not reverse the effect. ATP applied at a concentration of 50-150 microM, temporarily depressed the potential. This depression, however, was transient, as the potential gradually recovered by itself and reached a value higher than that observed before ATP application. ATP applied at the concentration of 250 microM caused a long-lasting depression of the potential. The potential was not restored by washing the slices, but recovered after addition of 0.7 microM 3,4 diaminopyridine. These data show a concentration-dependent mode of ATP action on hippocampal neurons and suggest a role for ATP in regulating synaptic efficiency. PMID- 2765891 TI - Hexanedione effects on protein phosphorylation in rat peripheral nerve. AB - Rats were treated with either 2,5-hexanedione (2,5-HD), 1,6-hexanediol (1,6 HDIOL), or saline for 7, 15 or 24 days. Protein phosphorylation was measured in proximal and distal sciatic nerve segments following incubation with [32P]orthophosphate. In proximal segments, 2,5-HD administration caused selective time-dependent increases in isotope incorporation in a 55 kDa protein, tentatively identified as tubulin, and a 180 kDa protein. Enhanced phosphorylation was highest at 24 days when motor function was most impaired. Administration of 1,6-HDIOL produced no consistent phosphorylation changes. Animals intoxicated with 3,4-dimethyl-2,5-hexanedione for 12 days showed proximal region increases in phosphorylation of the 55 and 180 kDa proteins and the major myelin proteins, Po and Pr. PMID- 2765892 TI - Peptidylglycine alpha-amidating monooxygenase activity in spinal cord, dorsal roots, and dorsal root ganglia of Macaca fascicularis. AB - Several peptides synthesized by primary sensory neurons are alpha-amidated at the C-terminal residue, including vasoactive intestinal polypeptide, neurokinin A and substance P, which is also abundant in spinal cord. In pituitary and other tissues, the C-terminal amidation is catalyzed by peptidylglycine alpha-amidating monooxygenase (PAM). In the present study, soluble PAM activity in spinal cord and in primary sensory neurons is quantified and characterized as to cofactor and cosubstrate requirements and substrate specificity. PMID- 2765893 TI - Survival of motoneurons following axotomy is enhanced by lactation or by progesterone treatment. AB - It was shown previously that neuron loss induced by nerve transection in the hypoglossal and facial motor nuclei of female rats could be reduced by long-term testosterone treatment following axotomy. In the present study, it is reported that such neuron loss could also be attenuated by lactation-related hormones and by progesterone treatment following axotomy. PMID- 2765894 TI - Demonstration of functional acetylcholinesterase on the soma of individual neurones of Aplysia by in vivo microspectrophotometry. AB - The presence of functional acetylcholinesterase is demonstrated in vivo on somatic membranes of single ganglionic neurones of Aplysia using concurrently microspectrophotometry and electrophysiology. The similarity of the effects of an irreversible blocker of acetylcholinesterase and of phospholipase C from Bacillus cereus suggests that acetylcholinesterase is anchored in the membrane via phosphatidylinositol. PMID- 2765895 TI - Production of tumor necrosis factor-alpha by microglia and astrocytes in culture. AB - Stimulation of mouse astrocytes and microglia in enriched culture by lipopolysaccharide (LPS) results in the production of a cytotoxic factor that is functionally similar to macrophage-derived tumor necrosis factor-alpha (TNF). This cytotoxic factor kills murine L929 cells, and is neutralized by a monoclonal anti-mouse TNF. The production of this factor is inhibited by pretreatment of cells by actinomycin D. Microglia are more sensitive to LPS and produce much higher activity of cytotoxicity in lower concentration of LPS than astrocytes. These results suggest that microglia are the major producers of TNF in the brain and may play a role in certain pathological conditions in the brain. PMID- 2765896 TI - Depolarization and insulin-like growth factor-I (IGF-I) differentially regulate the mitotic cycle in cultured rat sympathetic neuroblasts. AB - Although neuroblast generation is highly reproducible temporospatially, the underlying regulation is undefined. Employing a fully defined sympathetic neuroblast culture system, we previously found that insulin growth factors regulated the mitotic cycle. We now report that depolarizing stimuli, including elevated K+ and veratridine, also increased the proportion of mitotic neuroblasts in vitro. Moreover, Na+ channel blockade prevented effects of depolarization, but not that of insulin-like growth factor I, suggesting that these influences stimulate mitosis by different membrane transduction mechanisms. PMID- 2765897 TI - Synaptic connections in the buccal ganglia of Aplysia mediated by an identified neuron containing a CCK/gastrin-like peptide co-localized with acetylcholine. AB - The identified neuron, B13, located bilaterally in the buccal ganglion of the marine mollusc Aplysia californica, contains a classical neurotransmitter (acetylcholine) and a cholecystokinin/gastrin-like (CCK/G-li) peptide. The following study demonstrates that B13 makes direct synaptic connections with several identifiable postsynaptic follower neurons. These follower neurons also receive convergent input from previously identified cholinergic neurons, B4 and B5, which do not contain a CCK/G-li peptide. The cholinergic responses mediated by B4/B5 and B13 are similar, including in at least one buccal follower, a two component inhibitory response not seen in previous studies of the buccal ganglia circuits. However, when the cholinergic responses are blocked by appropriate antagonists, a residual, slow depolarizing, chemically-mediated response is observed in two of the identifiable followers when action potentials are evoked in B13 but not when action potentials are evoked in B4 or B5. PMID- 2765898 TI - Thalamic nuclei in Alzheimer disease: evidence against the cholinergic hypothesis of plaque formation. AB - Recent studies provide evidence for a significant cholinergic projection from the nucleus basalis of Meynert (NbM) to the reticular and mediodorsal thalamic nuclei. We examined the incidence and distribution of plaques in the thalamus in order to determine whether in Alzheimer's disease degenerating cholinergic processes from the NbM induce the emergence of plaques according to the cholinergic hypothesis. The present study shows that degeneration of NbM neurons does not induce plaques in the thalamic nuclei it innervates, and that plaques appear more frequently in other thalamic nuclei that do not receive projections from the NbM. PMID- 2765899 TI - The classification of medial septum-diagonal band cells as theta-on or theta-off in relation to hippocampal EEG states. AB - The discharge patterns of cells located in the medial septum (MS)/vertical limb of the Diagonal Band of Broca (vDBB) were recorded simultaneously with hippocampal formation large amplitude irregular activity (LIA), or theta, in urethane-anesthetized rats. The main conclusion was that the majority of cells in the MS/vDBB were theta-related and could be classified according to the same scheme developed for theta-related cells in the hippocampal formation. That is, cells were classified as theta-on or theta-off, with subtypes defined as tonic or phasic, linear or non-linear. The discharge properties of hippocampal and MS/vDBB cell populations were compared. It was argued that this classification scheme encompassed all the crucial properties of theta-related cells in the hippocampal formation and the MS/vDBB. An alternative model to the septal pacemaker hypothesis, concerning the role of the medial septum in the generation of hippocampal formation theta activity, was presented and discussed. PMID- 2765900 TI - Hamster circadian rhythms are phase-shifted by electrical stimulation of the geniculo-hypothalamic tract. AB - The suprachiasmatic nuclei (SCN) contain the major pacemaker for mammalian circadian rhythms. The SCN receive photic input both directly, via the retinohypothalamic tract (RHT), and indirectly, via the geniculohypothalamic tract (GHT), which originates in cells in the intergeniculate leaflet (IGL) and anterior portions of the ventral lateral geniculate nucleus (vLGN). We tested whether electrical stimulation of the GHT would induce phase shifts in wheel running activity rhythms of Syrian hamsters housed in continuous darkness or continuous illumination. In both lighting conditions, electrical stimulation of the GHT induced mainly phase advances when given during the late subjective day and small phase delays when given during the late subjective night and early subjective day. Stimulation in the thalamus outside the GHT failed to produce similar phase shifts. Repeated daily stimulation had only a weak entraining effect on the activity rhythm. Activation of GHT neurons appears to influence the pacemaker for activity rhythms in a phase-dependent manner. PMID- 2765901 TI - Release of endogenous opioid peptides displaces [3H]diprenorphine binding in rat hippocampal slices. AB - Pharmacological depolarization by KCl or veratrine reduced [3H]diprenorphine binding to opioid receptors in the hippocampal slice in a transient, calcium dependent, and peptide-sensitive manner. These results suggest that endogenous opioid peptides were released from synaptic terminals and competitively displaced [3H]diprenorphine binding to opioid receptors. [3H]diprenorphine binding was significantly reduced by calcium-dependent depolarization throughout the hippocampus as determined by subsequent receptor autoradiography and quantitative densitometry. Displacement of binding was evident at sites in the CA1 and CA3 regions, the dentate gyrus, and the subiculum. The most dramatic reduction was evident in stratum lacunosum moleculare of CA3. Correlating the sites of maximal [3H]diprenorphine displacement with the previously described distribution of the opioid peptides suggests that the perforant path fibers release enkephalins in stratum lacunosum moleculare of CA3 and stratum moleculare of the dentate gyrus, and that mossy fibers may release both dynorphins and enkephalins near stratum pyramidale of CA3 and stratum granulosum. The lack of complete overlap between the distribution of opioid terminals and the sites of displacement indicates that these peptides may diffuse a moderate distance to their sites of action. Radioligand displacement defines the sites of endogenous opioid binding, suggests the likely sources of peptide release, and thus predicts the sites of endogenous opioid action within the hippocampus. PMID- 2765902 TI - 1-(2-Pyrimidinyl)piperazine antagonizes GABA-activated currents in cultured spinal neurones of the rat. AB - Buspirone is an anxiolytic drug with an unknown mechanism of action. We have addressed the proposal that its therapeutic effect is due to a metabolite, 1-(2 pyrimidinyl)-piperazine (1-PP), increasing the open probability of gamma aminobutyric acid (GABA)-activated channels. By making whole-cell recordings from cultured spinal neurones we demonstrated that 1-PP, in contrast to flurazepam, actually antagonizes GABA- and glycine-activated currents. These observations are inconsistent with this proposed mechanism of action for buspirone. PMID- 2765903 TI - Balint's syndrome in Alzheimer's disease: specific disruption of the occipito parietal visual pathway. AB - Previous quantitative neuropathologic analyses have shown that the association cortices of the temporal and frontal lobes are more damaged than the visual regions of the occipital lobe in Alzheimer's disease. In the present paper, we report on a subpopulation of Alzheimer's disease patients presenting a visual defect referred to as Balint's syndrome, and displaying a global caudal shift in pathology. Balint's syndrome is a defect in visuospatial skills, and the distribution of pathology suggests that the connections underlying this functional component of the visual system are devastated, whereas they are normally spared in Alzheimer's disease. These results suggest that multiple subtypes of Alzheimer's disease exist with differential distribution of pathology and corresponding neurologic symptomatology, and that neuritic plaque and neurofibrillary tangle formation involve the loss of specific corticocortical projections associated with specific functional deficits and identifiable neurologic syndromes. PMID- 2765904 TI - Delay of astrocyte reaction in the injured cerebral cortex of hypothyroid mouse. AB - Reactive change in the number of astrocytes in the stabbed cerebral cortex (layers II-VI) of the hypothyroid mouse was studied quantitatively over a 4-day period after stabbing, by immunohistochemistry for glial fibrillary acidic protein (GFAP) and S-100 protein. The reactive increase in the number of GFAP positive astrocytes was delayed in the hypothyroid mouse, compared to that in the euthyroid mouse. The number of S-100-positive astrocytes neither increased nor decreased significantly in the hypothyroid and the euthyroid mice. [3H]Thymidine autoradiography showed that the time course and intensity of the reactive proliferation of astrocytes were the same in the hypothyroid mouse as in the euthyroid mouse. These results indicate that hypothyroidism delays the reactive expression of GFAP-antigen and delays the transformation of GFAP-negative astrocytes into GFAP-positive reactive astrocytes. PMID- 2765905 TI - Increase in hypothalamic pro-opiomelanocortin gene expression in response to prolonged low level lead exposure. AB - Lead, an environmental pollutant, has been long recognized as a neurotoxic agent. Several reports have recently described behavioral disturbances caused by low level lead exposure. Lead-induced changes in neurotransmitter metabolism in the brain may help to elucidate the molecular basis for the observed behavioral alterations. In this study, the influence of low level lead exposure on the hypothalamic expression of rat opioid genes was examined. Determination of relative opioid mRNA levels revealed a dramatic increase of pro-opiomelanocortin (POMC) mRNA concentrations in response to lead. This increase was found to be specific, developmentally regulated, reversible and dependent on prolonged lead exposure. These findings may provide substantial evidence for the possible connections between early environmental inputs and the expression of neuropeptide genes in the brain. PMID- 2765906 TI - Viscerotopic control of regional vascular beds by discrete groups of neurons within the midbrain periaqueductal gray. AB - It is well established that a group of bulbospinal neurons within the rostral ventrolateral medulla plays a crucial role in the tonic and phasic control of arterial pressure. In the cat, these neurons are confined to a discrete region which has been termed the subretrofacial (SRF) nucleus. Recent evidence suggests that this nucleus is viscerotopically organized with respect to its control over different vascular beds. These observations raise the question as to whether functionally different subgroups of SRF pressor neurons receive inputs from supramedullary cell groups that also exert a specific control over particular vascular beds. To answer this question retrogradely transported tracers (i.e. rhodamine or fluorescein-labelled microspheres, wheat germ agglutinin-horseradish peroxidase) were injected into physiologically identified sites within the rostral or caudal parts of the SRF nucleus of the cat. Separate groups of neurons in the midbrain periaqueductal gray region (PAG) were found to project specifically to subgroups of cells within the rostral and caudal parts of the SRF nucleus. These findings, together with the results of recent functional studies of the PAG suggest that these distinct projections from the PAG to the SRF nucleus are involved in the expression of different patterns of emotionally coupled cardiovascular responses. PMID- 2765907 TI - Glutathione is present in high concentrations in cultured astrocytes but not in cultured neurons. AB - The levels of the antioxidants, glutathione and ascorbate were measured in primary cultures of murine astrocytes and neurons. The concentration of glutathione (reduced, GSH + oxidized, GSSG) was high in cultured, differentiated (i.e. treated with dBcAMP) and undifferentiated (i.e. untreated) astrocytes: approximately 25 (n = 2) and 16.0 +/- 5.0 (n = 7) nmol/mg protein, respectively. In contrast, glutathione levels in neurons were low: less than or equal to 1.0 (n = 7) nmol/mg protein. Ascorbate could not be detected (less than 2 nmol/mg protein) in either cell type. The apparent lack of defense mechanisms against oxidative stress may in part account for the 'fragility' of neurons in culture. The physiological implications of glutathione compartmentation in brain are discussed. PMID- 2765908 TI - Rat brain regional distribution and spinal cord neuronal pathway of FLFQPQRF-NH2, a mammalian FMRF-NH2-like peptide. AB - Phe-Leu-Phe-Gln-Pro-Gln-Arg-Phe-NH2 (F-8-NH2) is a peptide, originally detected by FMRF-NH2 antisera, and subsequently isolated from bovine brain. Using a specific radioimmunoassay for F-8-F-NH2, we have examined the regional distribution and characteristics of F-8-F-NH2 immunoreactivity (IR) in rat brain, spinal cord and pituitary gland. In CNS, F-8-F-NH2-IR is highly concentrated in the spinal cord, hypothalamus and pons-medulla (368, 202 and 136 fmol per mg protein, respectively); lowest values are in the cortex and hippocampus. A modest rostrocaudal gradient of F-8-F-NH2-IR was observed; levels in the sacral cord are 50% higher than in the cervical cord. Dorsal cord content is 8 times higher than in the ventral cord. Dorsal rhizotomy failed to change F-8-F-NH2-IR in the affected regions of the spinal cord while significantly reducing substance P levels. F-8-F-NH2-IR was significantly decreased caudal to a spinal transection, indicating the presence of a descending pathway within the spinal cord. The highest concentration of F-8-F-NH2-IR (1008 fmol per mg protein) was found in the neurointermediate lobe of the pituitary, while no F-8-F-NH2-IR could be detected in the anterior lobe. Immunohistochemically, F-8-F-NH2-IR was confined to nerve terminal-like structures in the neural lobe. The anterior and intermediate lobes were devoid of immunoreactive structures. HPLC characterization of F-8-F-NH2-IR in the dorsal spinal cord, medulla-pons and pituitary revealed one major immunoreactive peak which is more hydrophobic than bovine F-8-F-NH2. In addition to this material, the hypothalamus was found to contain another, more abundant F 8-F-NH2-immunoreactive peak. Analysis of F-8-F-NH2-IR from posterior pituitary with various antisera having differing affinities for F-8-F-NH2 and gamma 1-MSH indicates that the F-8-F-NH2-IR of rat pituitary is not due to gamma 1-MSH. The high concentration of F-8-F-NH2-like peptide in the dorsal spinal cord supports a role in mediating nociceptive transmission while the localization of F-8-F-NH2-IR in the posterior pituitary suggests an additional autonomic or endocrine function. PMID- 2765909 TI - Blood-nerve transfer of albumin and its implications for the endoneurial microenvironment. AB - Blood-nerve transfer of plasma albumin was studied by measuring the permeability coefficient-surface area (PS) product of the blood-nerve barrier (BNB) to 125I albumin in rat sciatic nerve using the i.v. bolus injection method. The calculated PS was 6.3 +/- 0.5 (S.E.M.) x 10(-7) ml.g-1.s-1. This value is smaller by more than an order of magnitude of that measured for sucrose and confirms the relative impermeance of the BNB to blood-borne solutes. From a review of the available evidence, it is concluded that normal blood-nerve exchange occurs predominantly across the endoneurial microvasculature, and the PS of the BNB reflects the permeability of capillaries to a greater extent than that of the perineurium. The only capillaries found to be less permeable than these are the cerebral capillaries. Proximo-distal differences (sciatic vs tibial) of the PS could not be detected. Blood-nerve albumin transfer was calculated at 1.2 mg.g 1.day-1, and the daily turnover of endoneurial albumin to be about 30%. It is postulated that small increases in PS of BNB to albumin lead to an elevation of endoneurial albumin concentration and, through the operation of Starling forces, subsequently produce endoneurial oedema. A major question posed by the results of this study is the identity of pathways for clearance of albumin and other macromolecules from the endoneurium. PMID- 2765910 TI - Progesterone enhances L-dopa-stimulated dopamine release from the caudate nucleus of freely behaving ovariectomized-estrogen-primed rats. AB - In the present experiment we examined the effect of progesterone upon dopamine (DA) release induced by a direct infusion of unlabeled L-dihydroxyphenylalanine (L-DOPA) into the caudate nucleus of freely behaving rats. Ovariectomized rats were implanted with a push-pull cannula directed at the caudate nucleus and subjected to perfusion under 3 different hormonal conditions: (1) following 4 days of treatment with estradiol benzoate (EB), (2) following 4 days of treatment with estradiol benzoate plus progesterone at 4-6 h prior to perfusion (EB + P-4-6 h) and (3) following 4 days of treatment with estradiol benzoate plus progesterone at 28 h prior to perfusion (EB + P-28 h). During each perfusion session and under each of the 3 hormonal treatment conditions, L-DOPA was infused through the push side of the cannula. Three increasing doses of L-DOPA (10(-6), 10(-5) and 10(-4) M) were infused with a 45-75 min interval between infusions. Regardless of hormonal treatment condition, a clear dose-response increase in DA and 3,4-dihydroxyphenylacetic acid (DOPAC), but not 5-HIAA, output was observed in response to the increasing doses of L-DOPA infusion. For each of the 3 doses of L-DOPA, maximal DA output was observed for animals tested under the EB + P-4-6 h hormonal condition, with statistically significant differences in the areas under the L-DOPA-stimulated DA response curves obtained following the 10(-6) and 10(-5) M doses of L-DOPA infusion.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2765911 TI - The effect of neuropeptide Y on drinking in mice. AB - Neuropeptide Y (NPY) when administered intracerebroventricularly is a potent stimulator of feeding and drinking in rats. In these studies we demonstrated that, in contrast, in mice NPY inhibits drinking induced by water deprivation and that associated with food intake. In addition, we found that mice failed to respond to the rat dipsogen angiotensin II. Old mice demonstrated hypodipsia compared to young mice and NPY failed to inhibit drinking in older mice. Monosodium glutamate (MSG) administered neonatally produces lesions of the arcuate nucleus, an area rich in NPY cell bodies. NPY inhibited drinking and enhanced feeding in MSG treated mice. NPY also significantly inhibited the intake of water flavored with 8% sucrose and 0.1% quinine. NPY failed to alter ingestion of 0.2% or 5% saline. These studies support the contention that marked species differences exist in the regulation of water intake between rats and mice. PMID- 2765912 TI - A persistent defect in the blood-brain barrier after ventral funiculus lesion in adult cats: implications for CNS regeneration? AB - Previous studies have shown that, in adult cats, spinal motoneurons are able to regenerate their axons after lesions in the ventral funiculus of the spinal cord. These axons regrow through a scar tissue composed of glial processes and connective tissue elements before they enter the denervated ventral root. In the present study the integrity of the blood-brain barrier (BBB) in the lesion area was assessed by i.v. injections of horseradish peroxidase (HRP), 3 weeks to 7 months postoperatively. The lesion area in the lumbosacral spinal cord was compared with the intact cervical spinal cord and the area postrema in the light and electron microscope. The results show that the BBB fails after a ventral funiculus lesion. The BBB was not restored during the examined period. The leakage of HRP appears to be the result of a transendothelial vesicular transport. In addition, it was observed that the blood vessels in the lesion area were surrounded by wide and irregular perivascular spaces with broken outer basal laminae. Other studies on traumatic defects in the BBB have indicated that the barrier is reorganized within 4 weeks after the lesion. The possibility that a prolonged defect in the BBB after a ventral spinal cord lesion might be linked with the survival of axonal sprouts is discussed. PMID- 2765913 TI - Immunocytochemical localization of GABA in neurons projecting to the ventrolateral nucleus of the solitary tract. AB - To determine the origin of gamma-aminobutyric acidergic (GABAergic) input to the ventrolateral solitary tract nucleus (vlnTS), we used a double-labeling procedure for retrogradely transported horseradish peroxidase (HRP) and the immunocytochemical localization of GABA. Following HRP injections into the vlnTS, double-labeled neurons were found within the Botzinger Complex. We conclude that these double-labeled cells are the inhibitory Botzinger neurons and that GABA is a likely transmitter in this respiratory nucleus. PMID- 2765914 TI - Entrainment of the circadian rhythm of wheel-running activity is phase shifted by ablation of the intergeniculate leaflet. AB - The phase angle of entrainment of golden hamster wheel-running activity was determined before and after bilateral destruction of the intergeniculate leaflet (IGL). Animals were maintained under continuous dim light which rhythmically varied in intensity (10-5 lux) in the form of a sine wave with a 24 h period. The phase angle of entrainment changed significantly following IGL ablation suggesting a role for the IGL in entrainment. PMID- 2765915 TI - No evidence for a circadian rhythm of protein synthesis in the rat suprachiasmatic nuclei. AB - The mammalian suprachiasmatic nuclei contain an endogenous circadian pacemaker. A quantitative autoradiographic tracer method that measures L-[1-14C]leucine incorporation into protein was used to determine whether the overall rate of protein synthesis in the nuclei varies in a circadian fashion. Unlike the robust circadian rhythms of electrical activity and energy metabolism previously recorded from the nuclei at the two time points sampled, protein synthesis remained constant. PMID- 2765916 TI - Glucocorticoids regulate the concentration of glial fibrillary acidic protein throughout the brain. AB - The role of glucocorticoids in the in vivo regulation of glial fibrillary acidic protein (GFAP) was examined. Corticosterone administration to adult rats resulted in decreased levels of GFAP throughout the brain whereas adrenalectomy caused levels of GFAP to increase. Corticosterone administration to adrenalectomized rats lowered GFAP levels to values below those of sham controls. Thus, the expression of GFAP throughout the brain appears to be physiologically regulated by adrenal glucocorticoids. PMID- 2765918 TI - Freeze fracture analysis of the axolemma of cultured dorsal root ganglion neurons in the absence of Schwann cells. AB - The distribution of intramembranous particles within the axolemma of cultured dorsal root ganglion neurons was determined by freeze-fracture microscopy. Utilizing culture conditions which eliminate Schwann cells, the particle distribution of the P-face, 735 +/- 119 microns2, and E-face, 100 +/- 39 microns2 resembled that of pre- and non-myelinated axons in vivo and no node-like E-face particle patching was seen. These results indicate that cultured neurite development is similar to that seen in vivo and that axons maintained in a glial free environment do not develop nodal, E-face membrane specializations. PMID- 2765917 TI - Effects of the imidazobenzodiazepine Ro 15-4513 on saccharin choice and acceptance, and on food intake, in the rat. AB - The general aim of the present series of experiments was to investigate the effects of the imidazobenzodiazepine, Ro 15-4513, on ingestional behavior in the rat. The more specific aims were to test its effects on preference for sweet taste, to determine if it acts as a benzodiazepine-receptor inverse agonist, and if it selectively reduces sweetness preference. The results indicated that Ro 15 4513 (1.0-10 mg/kg, i.p.) abolished the preference for a 0.05% sodium saccharin solution in a two-choice test. Water intake in the same test was unaffected. Second, at 10 mg/kg, it suppressed saccharin ingestion in an acceptance test; this effect was completely reversed by the selective benzodiazepine antagonist, Ro 15-1788 (20 mg/kg). Third, Ro 15-4513 (1.0-10 mg/kg) reduced palatable food consumption in non-deprived rats, an effect which was also antagonized by Ro 15 1788. The results are consistent the bidirectional modulation of ingestional responses to palatable taste stimuli as a consequence of drug actions at benzodiazepine receptors. Furthermore, they emphasize that any reduction in consummatory responses produced by Ro 15-4513 is likely to reflect inverse agonist characteristics, as distinct from any putative ethanol antagonist property. PMID- 2765919 TI - GABAergic neurons in the entorhinal cortex project to the hippocampus. AB - Among the entorhinal neurons that give rise to the perforant path, a small population is sparsely spinous and displays either a multipolar or a horizontal bipolar dendritic tree. By application of post-embedding immunocytochemistry to neurons of these types with previously identified projections to the hippocampus we found immunoreactivity for gamma-aminobutyric acid (GABA). Thus, it appears that the perforant path not only contains an excitatory but also a small inhibitory component. PMID- 2765920 TI - The presubicular region in Alzheimer's disease: topography of amyloid deposits and neurofibrillary changes. AB - Specific silver impregnation techniques for extracellular amyloid and intraneuronal neurofibrillary changes were used to examine the presubiculum in Alzheimer victims. Extended amyloid clouds in the absence of neurofibrillary changes were noted in the parvopyramidal layer of the presubiculum proper. The corresponding layer in the parasubiculum, in contrast, showed many neurofibrillary tangles and neuropil threads in the absence of amyloid. The transsubicular parvopyramidal layer contained both amyloid deposits and neurofibrillary changes. This severe involvement of all subdivisions of the presubicular region in Alzheimer's disease is considered to impair functions of the Papez circuit. PMID- 2765921 TI - A comparison of the effects of electrical stimulation of the amygdala and hippocampus on subpallidal output neurons to the pedunculopontine nucleus. AB - Recordings were made of the electrical activity of neurons in the subpallidal area of urethane-anesthetized rats. Output neurons from the subpallidal area to the pedunculopontine nucleus were identified by antidromic activation. The inputs to subpallidal neurons to single-pulse stimulation of the amygdala and hippocampus were investigated. More than two-thirds of the subpallidal neurons antidromically activated by pedunculopontine stimulation were inhibited by hippocampal stimulation and activated by amygdala stimulation. Subpallidal neurons not antidromically activated by pedunculopontine stimulation also responded to stimulation of the amygdala and hippocampus but no differential effects were observed. The relation of these findings to limbic influences on locomotor activity is discussed. PMID- 2765922 TI - Repeated administration of high doses of amphetamine increases release of ascorbic acid in caudate but not nucleus accumbens. AB - Linear sweep voltammetry with carbon paste electrodes was used to monitor extracellular ascorbic acid (AA) in the caudate nucleus and nucleus accumbens of behaving rats. Amphetamine (2 or 5 mg/kg) was administered 4, 6 and 8 days after surgery. In general the amphetamine-induced increase in AA was greater in the caudate than in the nucleus accumbens. Furthermore, in the nucleus accumbens the amphetamine-induced increase in AA was very similar on all test days, but in the caudate the increase in AA produced by 5 mg/kg amphetamine was progressively larger on each test day. Thus AA seems to be regulated differently in the caudate and nucleus accumbens. PMID- 2765923 TI - Survival and growth of hippocampal neurons in defined medium at low density: advantages of a sandwich culture technique or low oxygen. AB - The study of development and plasticity of hippocampal circuitry would greatly benefit from methods which allow the long-term culture of neurons at low density under precisely defined culture conditions. We report that isolated hippocampal neurons from embryonic day 18 rats can be cultured for several weeks at low densities which permits the determination of individual connections. A serum-free medium was modified from the formulation of Romijn to include the biological anti oxidants vitamin E, glutathione, pyruvate, catalase and superoxide dismutase. Neuronal survival of 80% and neuritogenesis greatly exceeded that seen in serum based cultures. It appeared that vitamins E, A and linolenic acid promoted neuritogenesis. The beneficial effects of the antioxidants suggested a toxic role of oxygen. To directly test this, cultures were incubated in reduced oxygen (9%) and compared to those in the normal 19.7% oxygen (95% air). After 3 days in culture, neurons with processes in 9% oxygen were more than double those in normal oxygen. Neuronal survival and neurite growth could be improved if the cells were grown on a substrate-coated surface covered with a coverslip. Under this condition, cells show a ring of growth between the center and the edge of the coverslip. In 9% oxygen, this ring was closer to the edge of the coverslip than in normal oxygen. The coverslip did not serve as an additional substrate for attachment since it left the neurons attached to the original substrate. However, removal of the coverslip leads to cell death within 24 h, suggesting that the cells had been exposed to a toxic factor. Variations in glial cell content (less than 10%), pH, and pCO2 were demonstrated to be unlikely explanations of the higher survival. These results suggest that growth in a diffusion-limited space, reduction of oxygen concentration to physiological levels and control of toxic oxidation with physiological antioxidants can greatly improve the survival and neuritogenesis of isolated hippocampal neurons in primary culture. PMID- 2765924 TI - Immunocytochemical analysis of [Met5]enkephalin-Arg6-Gly7-Leu8 immunoreactive structures in the rat superior cervical ganglion. AB - Indirect immunofluorescence and immunoelectron microscopy were employed to analyze the enkephalinergic systems in the rat superior cervical ganglion (SCG). These systems were identified using specific antiserum against [Met5]Enkephalin Arg6-Gly7-Leu8 (ENK-8), a peptide which is derived only from proenkephalin A. Abundant ENK-8 like immunoreactive (ENK-8-LI) neurons and fibers were observed in the SCG, but their distribution patterns were heterogenous; ENK-8-LI neurons were localized preferentially in the caudal two-thirds of the SCG, while immunoreactive fibers were found to be distributed more densely in the rostral one-third than in the remaining part of the SCG. Most of the ENK-8-LI neurons were large and had ultrastructural features resembling those of principal cells, some were identified electron microscopically as small intensely fluorescent (SIF) cells. ENK-8-LI fibers were varicose in appearance and surrounded the perikarya of neurons. Since most of these fibers were not detected after experimental decentralization of the SCG and since ENK-8-LI terminals were seen to contain small lucent vesicles, most of the former were thought to be preganglionic fibers. Immunoreactive fibers mainly formed synaptic contacts with the dendrites of non-immunoreactive principal cells, but a small proportion of ENK-8-LI principal cells also received synaptic input from them. Occasionally, immunoreactive fibers formed synapses with the processes or the soma of both ENK 8-LI and non-immunoreactive SIF cells. On the basis of these findings, we conclude that: (1) preganglionic ENK-8-LI fibers terminate mainly on the principal cells, which are devoid of ENK-8-LI structures; (2) the majority of ENK 8-LI neurons are principal cells, while the remainder are SIF cells; (3) inputs to these cells mainly involve structures lacking ENK-8 immunoreactivity; and (4) there are, however, a small number of ENK-8-LI preganglionic fibers which terminate on ENK-8-LI principal cells and SIF cells. PMID- 2765925 TI - Dose-dependent phorbol ester facilitation or blockade of hippocampal long-term potentiation: relation to membrane/cytosol distribution of protein kinase C activity. AB - We have proposed that the translocation/activation of protein kinase C (PKC) in synergism with a Ca2+-mediated event plays an essential role in hippocampal long term potentiation (LTP). In a previous study, we saw no effect of PKC-activating phorbol esters alone on baseline responses, although it has been reported by others to enhance synaptic transmission. To resolve this discrepancy, we investigated the dose-response to phorbol esters of both baseline and potentiated granule cell responses elicited with perforant path stimulation. It was confirmed that iontophoretic ejection of phorbol ester to the dentate hilus, which alone had no effect on baseline responses, prolonged the persistence of potentiation produced by 2 trains of 400 Hz stimulation. These data support the proposed synergistic model in which the effects of phorbol ester and high frequency stimulation together produce a long-lasting potentiation of synaptic activation. A similar synergism was observed with ejection of a lower dose of phorbol ester into the perforant path synaptic zone in the molecular layer. Higher doses delivered to the synaptic zone without 400 Hz stimulation were sufficient to enhance baseline synaptic responses, but these doses inhibited the initial potentiation induced with 2 trains of 400 Hz stimulation delivered immediately after ejection. There was at times a slowly developing enhancement observed after the initial blockade. Thus, induction of a persistent synaptic enhancement was observed without initial potentiation. Measurement of PKC activity in membrane and cytosol indicated that PKC activation is only associated with the persistence phase of LTP. In contrast, there was no change in PKC subcellular distribution associated with the blockade of initial potentiation by higher doses of PDBu. PMID- 2765926 TI - Single fibre motor evoked potentials to brain, spinal roots and nerve stimulation. Comparisons of the 'central' and 'peripheral' response jitter to magnetic and electric stimuli. AB - Single fibre motor evoked potentials to magnetic and electric non-invasive stimulation of brain, spinal cord and peripheral nerve were recorded in 8 healthy volunteers. The 'central motor jitter' and the 'peripheral motor jitter' were respectively calculated and a comparison between the magnetic and electric modalities was made. The highest degree of latency variability was observed for both magnetic and electric central motor jitter, whilst the peripheral motor jitter to nerve stimulation was as low as the neuromuscular one (range 16-60 microsecond). The magnetic 'central motor jitter' (range 94-1024 microsecond) was much larger than the electric one (range 55-280 microsecond), which was in the order of jitter calculated on H-reflex studies; moreover, the former was organized in a bi- or trimodal distribution. On the contrary, no significant differences were observed between the two modalities when the jitter to nerve stimulation was taken into account. Possible contributions of corticocortical circuitries containing several synaptic interruptions during magnetic as opposed to electric transcranial stimulation, is discussed. PMID- 2765927 TI - Cytotoxicity of 3-hydroxykynurenine in a neuronal hybrid cell line. AB - The toxicity of 3-hydroxykynurenine (3HK), an endogenous tryptophan metabolite which is markedly elevated in rat CNS tissue as a result of neonatal vitamin B-6 deficiency, was investigated in a neuronally derived hybrid cell line (N18-RE 105). At concentrations in excess of 100 microM, 3HK was toxic to greater than 85% of cultured cells over the course of 24 h. The time course of 3HK toxicity was studied in cultures exposed to 500 microM 3HK. Cell lysis proceeded linearly to completion in 8-12 h, but the toxic effects of exposure for 2 h were irreversible. 3HK was the most potently toxic among several related kynurenine metabolites tested. The toxic effects of 3HK exposure were markedly attenuated or abolished in the presence of either catalase or glutathione, indicating, a role of oxidative stress in 3HK toxicity. PMID- 2765928 TI - Differential effects of M1- and M2-muscarinic drugs on striatal dopamine release and metabolism in freely moving rats. AB - A dialysis loop cannula was implanted into rat striatum under anesthetized condition, and the area was perfused with Ringer's solution under freely moving condition after 3 days for surgical recovery. Dopamine (DA) and 3,4 dihydroxyphenylacetic acid recovered in the dialysate were measured by high performance liquid chromatography with electrochemical detection. The effects of M1- and M2-muscarinic receptor agents, which were perfused continuously into the striatum through the dialysis membrane, were investigated. Continuous perfusion of AF102B, an M1-selective agonist, and oxotremorine, a non-selective agonist, resulted in a dose-dependent increase in the striatal DA release. Pirenzepine (10(-5) and 10(-7) M), an M1-selective antagonist, decreased the release of DA, and the stimulatory effect of AF102B (10(-5) M) was completely inhibited by 10( 5) and 10(-7) M pirenzepine, while the stimulatory effect of oxotremorine (10(-4) M) was only partly inhibited by 10(-5) M pirenzepine. AF-DX116 (10(-5) M), an M2 selective antagonist, increased the DA release, and showed an additive effect on the DA release evoked by AF102B (10(-5) M), whereas it produced no significant effect on oxotremorine (10(-5) M)-evoked DA release. These results suggest that in vivo DA release in the rat striatum is modulated by different subtypes of muscarinic receptors; i.e., the stimulatory effect is mainly mediated by M1-sites and inhibitory effect is mainly mediated by M2-sites. The changes in the DA release induced by the various drugs were prevented by pretreatment with tetrodotoxin (TTX). Since action potential-dependent DA release (exocytosis) is blocked by the pretreatment with TTX, those drugs affect DA release by means of action potential-dependent processes. PMID- 2765929 TI - Preservation of GABAergic perikarya and boutons after transient ischemia in the gerbil hippocampal CA1 field. AB - Using an antibody directed against the gamma-aminobutyric acid (GABA) synthetizing enzyme glutamate decarboxylase (GAD) the fate of the GABAergic innervation was investigated in the hippocampal field CA1 of gerbils up to 14 days after a bilateral transient 5-min occlusion of carotid arteries. As described previously, the CA1 pyramidal cells were subject to the ischemia induced delayed neuronal death, the first signs of which were detectable after 2 days and which was fully developed after 4 days. Local GAD-immunoreactive neurons and boutons, however, exhibited no changes in their distribution and morphology over the whole 14-day period investigated, as studied both at the light and electron microscopic level. Thus, it can be assumed that the increased excitation observed during the development of delayed neuronal death, is not due to a loss of GABAergic neuronal profiles. The resistance of the GABAergic neurons to the ischemic insult is discussed in relation to the presence of Ca2+-binding proteins in this class of neurons, and the long persistence of innervation in an area nearly devoid of postsynaptic targets is considered. PMID- 2765930 TI - Kainic acid-induced seizures: potentiation by alpha-methyl-p-tyrosine. AB - We have investigated the influence of central noradrenergic and dopaminergic systems on the susceptibility of rats to seizures in the kainic acid (KA)-model of epilepsy. In the dose range of 0.75 to 10 mg/kg s.c., KA dose-dependently induced characteristic behavioural changes. Partial depletion of noradrenaline (NA) and dopamine (DA) in the brain by pretreatment with the tyrosine hydroxylase inhibitor alpha-methyl-p-tyrosine (AMPT; 250 mg/kg, i.p.) markedly potentiated KA induced epileptic symptoms. A low dose of KA (1.5 mg/kg s.c.), which was ineffective in normal rats, triggered in AMPT-pretreated rats a high incidence of wet dog shakes (WDS) and a seizure activity (seizure rating: 3.17 +/- 0.31) which was comparable in degree to that resulting from 10 mg/kg KA in rats with normal catecholamine synthesis (seizure rating: 3.33 +/- 0.28). In AMPT-pretreated rats a higher dose of KA (10 mg/kg) further enhanced seizure activity and was associated with a mortality rate of up to 80%. Within 6.5 h after AMPT pretreatment the levels of NA and DA in amygdala/pyriform cortex declined from 0.56 +/- 0.02 (control) to 0.23 +/- 0.01 ng/mg tissue and from 0.21 +/- 0.03 to 0.05 +/- 0.01 ng/mg tissue, respectively. At a dose of 1.5 mg/kg KA was ineffective on the levels of NA and DA in normal rats, but further reduced these levels in AMPT-pretreated rats to 0.08 +/- 0.02 and 0.020 +/- 0.004 ng/mg tissue, respectively. Induction of seizure activity and decline in NA and DA levels in amygdala/pyriform cortex after AMPT/KA (1.5 mg/kg) treatment was antagonized by the alpha-adrenoceptor agonist clonidine (0.1 mg/kg, i.p.).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2765931 TI - Distribution of choline acetyltransferase immunopositive structures in the rat brainstem. AB - The distribution of neurons, fibers and terminal fields in rat brainstem displaying positive immunoreactivity to a polyclonal antiserum to human placental choline acetyltransferase (ChAT) is described. The antiserum was used at the high dilution of 1:10,000 and was coupled with a sensitive detection system using the nickel ammonium sulfate intensification method. In addition to previously described ChAT immunopositive groups of large cells in the cranial motor nuclei, and the parabrachial and reticular complexes, many small or medium size, weakly immunopositive neurons were identified. Some of these appeared in structures in the region of the fourth ventricle, including the area postrema. Others were in structures associated with the superior olivary complex, including the lateral superior olive, and the medioventral, lateroventral and superior periolivary nuclei. Scattered, weakly positive cells were seen in numerous other structures, including the ventral tegmental area of Tsai, central gray, superior colliculus, spinal nucleus of nerve 5, dorsal cochlear nucleus and non-motor regions of the spinal cord. The prominent ascending fiber tract of the laterodorsal tegmental pathway was traceable from the parabrachial area to the subgeniculate region of the thalamus. Prominent terminal fields were seen in a number of brainstem structures, including the superior colliculus, pontine nuclei, anterior pretectal nucleus, interpeduncular nucleus and spinal nucleus of nerve 5. The association of small ChAT positive cells and terminal fields with many sensory structures suggests a significant cholinergic participation in the physiology of sensory function. PMID- 2765932 TI - Desensitization kinetics of a K+ acetylcholine response in Aplysia. AB - We have studied the process of acetylcholine receptor desensitization on Aplysia medial pleural neurons under voltage clamp conditions. Acetylcholine, applied by microperfusion, elicits a biphasic response on these neurons, a rapid component which reverses polarity at about -60 mV and is Cl-dependent, and a slower component which reverses at about -85 mV and is K-dependent. Both components show desensitization, and the present study focuses on the K-dependent component, which could be isolated by maintaining membrane potential at the Cl equilibrium potential or by blocking the Cl component pharmacologically. K-dependent acetylcholine responses on these neurons varied in regard to time to peak of response and rate of desensitization. While the rising phase of the response was always fitted by a single exponential process, times to peak were divided somewhat arbitrarily into three broad groups of fast (less than 3 s), medium (3-6 s) and slow (greater than 6 s). Desensitization of fast responses was best described by two exponential processes plus a constant, medium responses by a double exponential, and slow responses by single exponential plus a constant. The apparent dissociation constant of acetylcholine was 17.3 +/- 1.6 microM. The best fit of responses for a given cell remained constant over a range of acetylcholine doses, but the kinetics of both fast and slow components accelerated with dose and depolarization. The fast component of desensitization was very temperature dependent. In neurons where it was present it was abolished by cooling, while in neurons with no fast component at room temperature it would appear with warming. The time constant of the fast component varied inversely with temperature. The time constant of the slow component was maximal at 22-24 degrees C, and fell on either side of this temperature. These results suggest that receptor desensitization for acetylcholine K responses is, like Na-dependent responses, composed of two independent processes. When responses to the acetylcholine agonists, carbachol and arecoline, were compared to those of acetylcholine on fast-type neurons, the times to peak varied in the order acetylcholine less than carbachol less than arecoline. The carbachol response was best fitted by two exponential functions, while arecoline was best fitted by a single exponential plus a constant. PMID- 2765933 TI - Desensitization kinetics of a chloride acetylcholine response in Aplysia. AB - The kinetics of desensitization of acetylcholine-evoked Cl conductance increased response of Aplysia RC neurons of the abdominal ganglion were studied under voltage-clamp conditions for comparison with results of similar studies on acetylcholine Na and K responses. The response evoked by acetylcholine on RC neurons was an outward current at resting potential (about -45 mV) that reversed at about -65 mV and was blocked by D-tubocurarine and strychnine but not hexamethonium and was not activated by arecoline. From the current-voltage relation this response can be ascribed to a pure conductance increase to Cl. The apparent KD was 40.6 microM. Upon prolonged exposure to acetylcholine the response peaked within 200-400 ms, and then decayed to a plateau current in the continued presence of the agonist. The peak and plateau currents reversed at the same potential, indicating that there had not been significant redistribution of Cl. The current decay in every cell was best fit by a double exponential function plus a constant, and the average time constants were tau fast = 1.8 +/- 0.2 s and tau slow = 16.2 +/- 1.0 s. Both components were slowed by cooling. While tau fast did not change with dose, tau slow increased with dose. Both components accelerated with hyperpolarization and upon application of trifluoperazine (2 microM). These results are consistent with the interpretation that desensitization of the acetylcholine Cl response is composed of two independent processes. This conclusion is the same as that derived from studies of the acetylcholine Na and K responses, and is in general consistent with desensitization being a property of a common acetylcholine receptor, and independent of the ionic selectivity of the associated channel. There are, however, significant differences in voltage, temperature and trifluoperazine dependence of the two components of the three ionic responses which may reflect influence of the different ion channels and/or transduction mechanisms. PMID- 2765934 TI - A neurochemical study of a new mutant mouse presenting myoclonus-like involuntary movement: a possible model of spontaneous serotonergic hyperactivity. AB - The involuntary movements resembling the serotonin (5-HT) syndrome induced by 5 HT agonist, which is composed with symptoms such as head twitch, hind leg abduction and so on, are neurochemically evaluated in the new mutant mouse, Wriggle Mouse Sagami (WMS). Ritanserin (5-HT2 antagonist) and prazosin (alpha 1 adrenergic antagonist) both inhibited the symptoms, had a decrease in the number of times they fell down and prolonged the duration of sitting up, while SCH 23390 (dopamine1 antagonist) and YM-0911-2 (dopamine2 antagonist) did not affect them. Metergoline (5-HT1 and 5-HT2 antagonist) suppressed the locomotor activity, making it difficult to determine if it ameliorated the symptoms. The concentration of a metabolite of 5-HT, 5-hydroxyindoleacetic acid (5-HIAA) was higher than control values diffusely in the CNS except in the cerebral cortex. The accumulation of 5-HTP after the administration of amino acid decarboxylase inhibitor NSD 1015 was significantly enhanced in the hypothalamus, median raphe, cerebellum and pons. An increase in 5-HT and NA was also noted in the cerebellum. GABA was increased in the striatum. In the binding assay, the number of [3H]ketanserin binding sites was increased and that of [3H]prazosin binding sites was decreased in the striata. Meanwhile, no significant difference was observed either in the number of binding sites (Bmax) or the affinity (KD) in the [3H]5-HT binding study. The number of [3H]muscimol binding sites in the cerebellum was reduced with the dissociation constant (KD) unchanged. These results suggest the involvement of 'hyperserotonergic' neural systems, possibly due to the enhanced 5 HT synthesis, in the manifestation of the involuntary movements of WMS, with noradrenergic and GABAergic modification. WMS can be a useful model to study the function of the serotonergic system in the CNS. PMID- 2765935 TI - A melatonin agonist and N-acetyl-N2-formyl-5-methoxykynurenamine accelerate the reentrainment of the melatonin rhythm following a phase advance of the light-dark cycle. AB - The rate of entrainment of the urinary 6-sulphatoxymelatonin rhythm to a phase advanced photoperiod and the influence of a melatonin agonist and melatonin analogues and metabolites on the entrainment were investigated in male rats. Following an 8-h advance of a 14:10 light-dark photoperiod, the 6 sulphatoxymelatonin rhythm was disrupted completely for two days and became entrained after 5-6 days. Subcutaneous injection of the melatonin agonist, 6 chloromelatonin (0.5 mg/kg) and the brain metabolite, N-acetyl-N2-formyl-5 methoxykynurenamine (aFoMK, 10 mg/kg) two hours after dark onset on the day after the phase advance accelerated the entrainment to the new photoperiod. N-acetyl-5 methoxykynurenamine, 6-chloro-2,3-dihydromelatonin, 1,3-dihydro-5 (ethylacetamide)-7-methoxy-2H-1,4-benzodiazepin++ +-2-one and N-formylkynurenine were all without effect at a dose of 10 mg/kg. Treatment of rats with aFoMK on the day of the phase advance (day 0) together with treatment on day +1 accelerated the entrainment to the photoperiod whereas a single injection on day +2 or injections on day +1 and day +2 were without effect at a dose of 10 mg/kg. These results: (a) demonstrate the usefulness of monitoring urinary 6 sulphatoxymelatonin rhythms for pineal studies; (b) show that melatonin can indirectly influence its own secretion, presumably by interactions with the suprachiasmatic nucleus; and (c) provide further evidence for the biological activity of the brain metabolite of melatonin, N-acetyl-N2-formyl-5 methoxykynurenamine. PMID- 2765936 TI - The anxiogenic beta-carboline FG-7142 increases in vivo and in vitro tyrosine hydroxylation in the prefrontal cortex. AB - Systemic administration of the anxiogenic beta-carboline FG-7142, a benzodiazepine inverse agonist, results in a regionally selective increase in dopamine (DA) utilization in the anteromedial prefrontal cortex (PFC). We have examined both in vivo and in vitro tyrosine hydroxylation in the PFC and other mesotelencephalic DA system terminal fields in order to determine if FG-7142 effects changes in DA synthesis, and to determine if the beta-carboline biochemically activates certain DA neurons through an action occurring at the cell body level (impulse-dependent regulation) or at the terminal field level (presynaptic regulation). FG-7142 increased in vivo tyrosine hydroxylation in the PFC and in the ventral tegmental area, midbrain source of the DA innervation of the PFC; no changes were observed in mesolimbic or nigrostriatal regions. The beta-carboline also increased in vitro tyrosine hydroxylation in the PFC, but decreased tyrosine hydroxylation in striatal slices. The effects of FG-7142 were blocked by the benzodiazepine antagonist RO 15-1788. Another beta-carboline inverse agonist, methyl-beta-carboline-3-carboline-3-carboxylate, also increased in vitro tyrosine hydroxylation in the PFC. GABA exerted opposite effects to those of the beta-carbolines, decreasing in vitro tyrosine hydroxylation in the PFC and increasing DA synthesis in the CP. These data indicate that the benzodiazepine inverse agonists increase both in vivo and in vitro tyrosine hydroxylation in the PFC, and that the beta-carboline may act to increase DA synthesis at both the terminal field and the cell body level. PMID- 2765937 TI - Gap junctions between lateral spinal motoneurons in the rat. AB - Ultrastructural examination reveals gap junctional plaques between motoneurons in the dorsolateral nucleus (DLN), an androgen-sensitive motor nucleus in the lumbar spinal cord of rats. This nucleus contains motoneurons innervating the ischiocavernosus muscle and urethral sphincter. Gap junctional plaques were found along the somatic and proximal dendritic membranes of DLN motoneurons, and between membranes of bundled dendrites in the neuropil of this nucleus. Castration and androgen treatment had no significant effect on the size or frequency of gap junctions. PMID- 2765938 TI - A fluorescence histochemical method for the demonstration of central catecholamine neurons in young embryonic tissues. AB - A simple fluorescence histochemical technique is described for the production of catecholamine histofluorescence in the developing brain of rat embryos. The procedure combines the magnesium-formaldehyde-glutaraldehyde perfusion technique, with polyethylene glycol dehydration and embedding. Several examples illustrate the sensitivity of the technique and the good preservation of tissue sections. The tissue can also be stored for several weeks without an appreciable loss of fluorescence. PMID- 2765939 TI - Effects of the richness of the environment on six different cortical areas of the cat cerebral cortex. AB - The number and size of neurons and the cortical thickness were determined in areas 17, 18, 3B, 4 gamma, the posteromedial lateral suprasylvian area, and the primary auditive area of cats raised in an enriched and in an impoverished environment. A significant effect on the numerical density of neurons and on the size of the neuronal nuclei can be demonstrated in areas 17 and 18. We suggest that this preferential effect on occipital cortical regions is due to a different gradient of maturation among cortical regions. PMID- 2765940 TI - Brief ganglioside treatment produces delayed enhancement of functional recovery after medial septal lesions. AB - The effects of a 5-day ganglioside (GM1) treatment (30 mg/kg) on body weight and water intake subsequent to medial septal lesions were evaluated for 44 consecutive days. In addition, activity, rearing, and repetitive motor acts were measured on postsurgery days 5, 10, 40, and 60. The rate of increase in the body weights of rats with medial septal lesions treated with GM1 was equivalent to that of controls, while untreated rats with such lesions had reduced body weights. Rats with medial septal lesions treated with GM1 also exhibited movement times and frequency of repetitious motor acts similar to those of control rats by postsurgery day 60. No differences were found in water intake between any of the groups. Rats with medial septal lesions, whether treated with GM1 or not, had equivalent frequencies of rearings that were lower than control rats. This study emphasizes that even brief regimes of GM1 administration can exert behavioral changes in brain-damaged rats well after the treatment was administered, i.e. 40 60 days after surgery. PMID- 2765941 TI - Effects of hypothalamic lesions on temperature regulation in pigeons. AB - The effect of hypothalamic lesions on temperature regulation was studied in pigeons by recording deep and skin temperatures, shivering, panting and oxygen consumption. Thresholds of shivering and panting were assessed before and after lesions. Survival was 100% when lesions were done in awake animals in a cool environment. Lesions anterior to the anterior commissure which included the preoptic area resulted in an increased threshold of panting or a lack of panting response at body temperatures up to 44.5 degrees C. Shivering response was unchanged in these animals. Lesions posterior to the anterior commissure were followed by a lack of shivering response with no change in panting threshold. This points to a segregation of the hypothalamic structures controlling heat loss and heat gain in the pigeon. PMID- 2765942 TI - Behavioral evaluation of the stress induced by the platform method for short-term paradoxical sleep deprivation in rats. AB - To evaluate whether the results of short-term PSD (Paradoxical Sleep Deprivation) using the platform method can be influenced by stress, changes in body weight and in behavioral indices (food and water intake and ambulation and defecation in an open field) were measured in rats after each of four 5-hour sessions of confinement to small or large platforms. The animals of the two platform groups when compared to animals kept in home cages showed a similar decrease in body weight which was significant only after the first day of treatment, while no changes in the other measures were observed. It is concluded that 1) the effects of stress induced by short-term confinement to platforms do not seem to be a remarkable confounding factor in short-term PSD studies and 2) large platforms can be used both as an adequate stress control for small platforms and as a means of adapting the animals to the method. PMID- 2765943 TI - Mode of [14C] 2-deoxy-D-glucose uptake into retrosplenial cortex and other memory related structures of the monkey during a delayed response. AB - Physiological studies on the monkey retrosplenial (RS) cortex have been few, and its functional role remains to be investigated. In the present study, activity of the RS cortex was investigated using radioactive 2-DG while the monkey was performing a visual tracking task with a delay (a delayed-response task) for 45 minutes. A remarkable increase in 2-DG uptake was observed equally in the left as well as in the right RS cortex. The anterior nucleus of the thalamus also showed increased 2-DG uptake. In addition, other memory-related structures (prefrontal cortex, dorsomedial nucleus of the thalamus, amygdala and hippocampus) showed a similar increase in 2-DG uptake compared to control monkeys, though their respective absolute values were different from one another. Since the RS cortex receives afferents from the anterior nucleus of the thalamus, which is one of the main nuclei of the Papez circuit, it is assumed that the RS cortex is important in memory function. Therefore, the remarkable increase in 2-DG uptake in the present study could reflect some aspects of memory or learning processes required to perform the delayed response. PMID- 2765944 TI - Claustral influence on ipsi- and contralateral motor cortical areas, in the cat. AB - The electrophysiological relationships between the claustrum and the contralateral motor areas of the cerebral cortex were studied in anaesthetized cats. The extracellular unitary activity of 207 pyramidal tract neurons (PTNs) was recorded from area 4 (125 cells) and area 6 (82 cells). Single shock activation of the contralateral claustrum affected 26% of the total tested PTNs, causing long lasting inhibition (44 PTNs) or long lasting inhibition preceded by early excitation (10 PTNs). Forty-three neurons of the 54 were also influenced by ipsilateral claustrum stimulation. Surgical removal of motor and insular cortices ipsilateral to the stimulated claustrum did not modify claustrum inhibition on contralateral PTNs, whereas section of the corpus callosum abolished this effect, suggesting the existence of a direct claustro-contralateral motor cortex pathway passing through the corpus callosum. These results support the hypothesis that the claustrum may exert a bilateral control on motor coordination. PMID- 2765945 TI - IVT CCK-8 is more effective than IV CCK-8 at decreasing meal size in the baboon. AB - In this study, we compared the effectiveness of intravenous (IV) vs. intraventricular (IVT) cholecystokinin octapeptide (CCK-8) to decrease single meal size over a dose range of 0.1 to 4.0 micrograms/kg in a population of overnight fasted baboons. IV CCK did not decrease meal size significantly at doses of 0.5, 1, and 4 micrograms/kg (84 +/- 22%, 78 +/- 12%, and 89 +/- 33% of paired control meal sizes respectively). IVT CCK significantly decreased single meal size at all doses tested (40 +/- 18%, 26 +/- 10%, 37 +/- 15%, 26 +/- 12%, and 12 +/- 6% of paired control meal sizes at 0.1, 0.25, 0.5, 1, and 2 micrograms/kg respectively). Meal suppression with IVT CCK was significantly greater than that achieved with IV CCK at doses of 1 and 2 micrograms/kg. We conclude that in the baboon, CCK may have a direct effect at the central nervous system to suppress single meal size. PMID- 2765946 TI - Effects of soman and sarin on high affinity choline uptake by rat brain synaptosomes. AB - Synaptosomes were incubated at various time intervals following injection of 120 micrograms/kg SC of soman or sarin or with various concentrations (10(-8) to 10( 2) M) of soman or sarin in vitro. Total cholinesterase (ChE) activities in each brain region were also measured. Following soman injection, sodium-dependent, high affinity choline uptake (SDHACU) was decreased from 1 to 4 hr in the cortex and from 1 to 2 hr in the hippocampus, but increased from 2 to 24 hr in the striatum. Similarly, following sarin injection SDHACU was decreased at 0.5 hr in the cortex and from 1 to 4 hr in the hippocampus, but increased at 1 hr in the striatum. Injection of soman severely inhibited (83-99%) total ChE activity in the cortex, hippocampus and striatum from 1 to 24 hr. In contrast, sarin did not severely inhibit ChE activity in these regions and maximal inhibition (40-60%) did not occur until 24 hr after injection. With both compounds, by 168 hr ChE activity in all regions had partially recovered. Incubation of synaptosomes with soman or sarin in vitro at concentrations below 10(-4) M did not affect SDHACU in any of the brain regions. These data demonstrated that acute soman and sarin injection produced similar effects upon SDHACU in different brain regions, although the time-course of these effects was different for the two compounds. These effects were probably neither due to a direct action of these compounds on the uptake process nor dependent on ChE inhibition. PMID- 2765947 TI - Response characteristics of lamb trigeminal neurons to stimulation of the oral cavity and epiglottis with different sensory modalities. AB - A region of the trigeminal complex located at the border of the subnucleus interpolaris and subnucleus caudalis receives not only trigeminal nerve inputs from the face, tongue and palate, but also afferent terminations from other nerves which innervate the oral cavity and upper airway. To increase our understanding of the types of sensory information relayed to this region of the trigeminal nucleus, we investigated the response characteristics of single neurons to stimulation of the tongue, palate and epiglottis. Receptive field size and location of 83 trigeminal neurons were mapped, and responses to mechanical, thermal and chemical stimuli were recorded. About 90% of the neurons had one receptive field and no convergence between the oral cavity and epiglottis was observed. Furthermore, only about 15% of the trigeminal neurons responded to more than one stimulus modality. A moving mechanical stimulus elicited responses in over 90% of the cells, and 84% responded to moving and punctate mechanical stimuli. These mechanosensitive neurons generally exhibited rapidly adapting responses. Thermal and chemical stimuli were relatively ineffective. Cooling a receptor surface most often produced excitation, and warming inhibition. Responses to chemical stimuli were only observed for salts at high concentrations. These results suggest that, like oral cavity information relayed by the trigeminal nerve, afferent terminations in the trigeminal nucleus from other nerves subserving the oral cavity and upper airway function to relay mechanical sensory information.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2765948 TI - Immunohistochemical distribution of beta-protein kinase C in rat hippocampus determined with an antibody against a synthetic peptide sequence. AB - An antibody directed against a synthetic peptide sequence specific for the beta subtype of protein kinase C (PKC) was used to determine the distribution of beta PKC in rat hippocampus by immunocytochemistry. PKC was distributed primarily in the stratum oriens and radiatum of the CA1 region. Positive staining cell bodies were only observed after colchicine treatment in pyramidal cells (CA2-CA4) and granule cells of the dentate gyrus. The discrete localization of various subtypes of PKC should provide clues to their functions. PMID- 2765949 TI - A neuroanatomical substrate for alcohol drinking: identification of tetrahydropapaveroline (THP)-reactive sites in the rat brain. AB - Certain endogenously synthesized adducts, derived from a condensation reaction of a catechol- or indole-amine with a biogenic aldehyde, act in the brain to augment or suppress the drinking of ethyl alcohol. When infused directly into the cerebral ventricles, a tetrahydro-isoquinoline such as tetrahydropapaveroline (THP) can enhance markedly the consumption of alcohol even in noxious concentrations. The present study was undertaken to isolate and identify specific anatomical structures in the limbic-midbrain, limbic-forebrain which mediate the changes in the ingestion of alcohol induced by THP. In adult male Sprague-Dawley rats, a 23 ga guide tube was implanted stereotaxically either unilaterally or bilaterally in cerebral regions extending from coronal planes AP 1.0-10.0. Following recovery, each animal was tested by a standard screen for its self selection of water versus an alcohol solution offered in 10 concentrations increased on each of 10 days from 3 to 30%. THP was dissolved in an artificial CSF vehicle containing Na2S2O5 or ascorbate and then microinjected in a volume of 1.5-2.0 microliters at a depth 1.0-1.5 mm beneath the tip of the guide. After a set of 5 microinjections of THP in a dose of 25, 50 or 250 ng was given over 3 days, the same 10-day alcohol preference sequence was repeated. In nearly all rats, the microinjection series was repeated at either one or two depths 1.0-1.5 mm ventral to the first, after which the same alcohol test was repeated. The results showed that THP induces or sustains significant increases in alcohol intake when the adduct was injected at 16 sites within caudal AP planes 1.0-5.0. Structures sensitive to THP included the substantia nigra, reticular formation, medial lemniscus, zona incerta and medial forebrain bundle. When injected at 21 sites located more rostrally within AP planes 6.5-10.0, THP also evoked significant increments in alcohol intake of a similar magnitude. The reactive loci included the N. accumbens, olfactory tubercle, lateral septum, preoptic area, stria terminalis, medial forebrain bundle and rostral hippocampus. In terms of the efficacy of the dose of THP microinjected, 25, 50 and 250 ng induced alcohol self-selection in 81%, 5% and 14% of the sites, respectively. Repeated microinjections following identical procedures of two control solutions at 46 homologous sites within corresponding coronal planes from AP 1.5-10.0 produced no significant alterations in g/kg or proportional intakes of alcohol. Composite anatomical maps of the THP-reactive sites revealed their integral overlap with dopaminergic pathways which originate in the ventral tegmentum and substantia nigra and project rostrally to s PMID- 2765950 TI - A modified horizontal capillary puller for fabrication of patch-clamp pipettes. AB - A simple low-cost modification to a conventional horizontal two-stage micropipette puller is described. It allows the production of pipettes suitable for patch-clamp studies. It requires that the hard-pull stage of the fabrication process be disabled and two heating cycles, each with a different heating filament temperature, be employed. The modification is described specifically for an Industrial Science Associates, Inc. M-1 micropipette puller. However, in principle it should be applicable to any horizontal two-stage puller using a solenoid to generate the pull force. PMID- 2765951 TI - The strap-electrode: a stimulating and recording electrode for small nerves. AB - A method is described for the construction of a strap-electrode that can be used for stimulation as well as recording of small nerves. The electrode can be applied to nerves of various diameters by adjusting the strap diameter with a teflon sleeve. Shunting is minimized by using dental rubber-dam placed under the nerve and enveloping the electrode and nerve with a silicon polymer. The arrangement is very resistant against straining forces. Stable nerve recordings and stimulus thresholds were obtained for several hours. PMID- 2765953 TI - [The contribution of artificial heart research in Czechoslovakia to modern medical science]. AB - A summary of the development of total artificial heart research in Czechoslovakia is presented. The experimental setting of this research was based mainly on experiments on calves and partially on goats. The original concept of the blood pump is represented by an asymmetrical type of pump with an asymmetrical diaphragm and undulating motion of the diaphragm allowing optimal washing of the blood chamber. This is the key factor of the antithrombogenic properties of the latest version of the Brno artificial heart. For the pneumatic drive of the artificial heart control and driving units of our own construction--Chirasist-TN 3--are used. In 50 completed long-term experiments the mean survival time was 117.4 days. In the group of 23 experiments with polyurethane total artificial heart (TAH) the mean survival time was 133.9 days. The longest survival was achieved in the calf "Artur", No. 121 with 293 days of pumping which is worldwide one of the three longest survival times with TAH using the calf as an experimental animal. The experiment with an intrathoracic TAH implantation in the goat with a survival time of 184 days represents a worldwide unique success. After solving a number of technical and biological problems, we focused our attention on two crucial complications, i.e. increased central venous pressure leading to severe liver damage and diaphragm calcification. The original Brno concept concerned with the pathomechanism of central venous pressure increase made efficient pathogenetic therapy feasible and resulted in a marked protection of liver functions, so that increased venous pressure is no longer a problem in our experiments that would limit the period of survival. However diaphragm calcification has remained a serious survival limiting complication and therefore prevention of calcification is in the focus od our intensive research activities. Parallelly with these activities we have been engaged in research aimed at the clinical application of the TAN to bridge the period in severely affected patients until a suitable heart transplant is available. So far we have performed four artificial heart implantations in patients in the final stage of heart failure. We could keep these four patients on the TAH from one to ten days without the slightest failure of the system, and the blood chambers of the TAH TNS-BRNO--VII/Klin/80, removed from the patient's chest after pumping had been stopped, were completely free of thrombi.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2765952 TI - Continuous sampling of cerebrospinal fluid in the conscious rabbit. AB - A cannulation technique for continuous sampling of cerebrospinal fluid (CSF) in unanesthetized freely moving rabbits is described. A permanent stainless steel cannula constructed easily and inexpensively from commercially available material is placed into the third ventricle and fixed to the skull by anchoring screws and dental cement. This procedure allows a continuous CSF sampling with a flow rate of 11.2 +/- 4.5 microliters/min without any sign of disturbing the animal. The penetration of the third ventricle or the periodic drainage of CSF, during a one month period, does not result in a variation of CSF protein (356 +/- 20 mg/l), glucose (4.5 +/- 0.2 mmol/l) or lactate (1.80 +/- 0.05 mmol/l) concentrations. Our technique has some advantages for pharmacological or pharmacokinetic investigations. The third ventricle CSF data will complete that of cisterna magna or lateral ventricle CSF. This method allows studies in the same animal during a period of one month without any problem. Moreover, it lends itself to experiments in which physiological conditions are required. PMID- 2765954 TI - [Use of 35-lead mapping of the precordium in the evaluation of left ventricular function in patients after myocardial infarct]. AB - The aim of the investigation was to assess the ejection fraction and regional wall dyssynergy from 35-lead precordial or trunk back ECG taken from 18 consecutive patients after anterior and/or posterior myocardial infarction two months after the acute episode. The percentages of Q waves (% Q) and scores of Q and/or QS waves obtained from 35-lead ECG were compared with the ejection fraction and regional wall dyssynergy recorded by 2D echocardiography. A very good correlation (r = 0.82, SEE = 14.4, p = 0.01) was found between Q% and regional wall dyssynergy in patients with anterior myocardial infarction. There was also a good inverse correlation between ejection fraction and Q% (r = -0.71, SEE = 11.2, p = 0.05) in patients with anterior myocardial infarction. In patients with posterior myocardial infarction no significant correlation was observed by 35-precordial-lead ECG. PMID- 2765955 TI - [Comparison of the results of radioimmunologic and hemagglutination methods in the determination of antibodies against thyroglobulin and the effect of these antibodies on thyroglobulin serum levels]. AB - The following methods have been introduced at our institute: labeling of human thyroglobulin (H-Tg) with the radioiodine 125I by the lactoperoxidase method, radioimmunologic method for serum H-Tg determination by means of rabbit antiserum to H-Tg prepared at our institute, and radioimmunologic method for the determination of antibodies to thyroglobulin. Sera from 15 patients with different thyropathies were examined by the given methods. In the first part of the work the quality of 125I labeled H-Tg was studied. The maximum binding by antiserum was found to be substantially decreased as early as two weeks following labeling, The second part of the study presents our first experience with comparing our RIA method and the hemagglutination method for TgAb determination. The results yielded by the two methods did not differ significantly. The level of serum H-Tg is falsely affected by the competition of TgAb autoantibodies with the first rabbit antibody to H-Tg at recipitation by means of the second antibody. It is therefore important to establish the titer of autoantibodies before actual serum H-Tg determination. This approach is of importance e.g. in following up patients with malignant goiter. The introduced methods are a contribution to diagnosis and management of patients with thyropathies. PMID- 2765956 TI - [Sealing of ultraporous vascular prostheses with autologous fibrinogen]. AB - After their long lasting experience with commercially prepared fibrinogen for sealing off ultraporous vascular prostheses, the authors have introduced the use of freshly prepared fibrinogen from the patient's own blood. This approach provides an additional advantage by allowing to substitute the blood losses at the operation with shelfed autologous blood. The preparation of autologous fibrinogen is described and the advantages of its use are discussed. PMID- 2765957 TI - [Isolation of tick-borne encephalitis viruses from the cervical spinal cord in meningoencephalitis]. AB - In 1988 the organs of a male were examined post mortem for the presence of viruses in isolation experiments on white suckling mice. The virus isolated from the cervical spinal cord was identified as the virus of tick-borne encephalitis. Although death from tick-borne encephalitis is rather rare in Slovakia, the disease requires great attention with special focus on preventive measures. PMID- 2765958 TI - [Comparison of echocardiography, vectorcardiography, electrocardiography, coronarography and ventriculography in coronary heart disease]. AB - Fifty patients (9 women, 41 men) with angina pectoris, aged from 22 to 59 years, were examined by means of one- and two-dimensional echocardiography (ECHO), vectorcardiography (VCG) using the McFee-Parungao system of leads, standard 12 lead electrocardiography (ECG), coronarography (CAG), and ventriculography (VG). I of isolated positivity of either of these methods ans considererl as patse positivity and presence or absence of positivity in combination of at least two methods (ECG exeluted) astme positivity, or true negativity then VCG was found to have the highest sensitivity (96%), negative predictive value (80%), as well as the highest overall predictivity (83%), while ECHO had the lowest values, i.e. 55%, 36%, 64%, respectively. On the other hand, ECHO was leading in specificity and positive predictive value with 100%, whereas VCG ranked lowest with 62% and 83% respectively. The combination of ECHO and VCG versus CAG and/or VG positivity exhibited and 80% specificity, 90% sensitivity, 90% positive predictive value and 86% overall predictivity when stenosis of over 50% was considered to be criterion. If obstruction was required the figures were to 75%, 94%, 83% and 86% respectively. ECHO and VCG are complementary noninvasive methods able to predict the results of CAG and VG and have a good predictive value when lowing for mere presence of focal myocardial injury. PMID- 2765960 TI - [Cross-reactivity of HLA antigens of the donor and patient--a cause of unsuccessful thrombocyte transfusion in patients with HLA antibodies]. AB - In the microlymphocytotoxic test, specific HLA sera reacted positively with 74.74% of 99 examined samples of lymphocytes which failed to have corresponding HLA antigens yet contained HLA antigens cross-reacting with the given HLA antibody. In the serum of some patients HLA antibodies were established against HLA antigens cross-reacting with the antigens of the patient. The results show that it is not suitable to select thrombocyte and leukocyte donors on the basis of cross-reacting antigens. Therapy of patients with HLA antibodies may be clinically unsuccessful and even result in posttransfusion reaction. Patients who do not have HLA antibodies may develop them. PMID- 2765959 TI - [Clinico-immunologic examinations of foreign nationals with parasitic diseases]. AB - Clinical and laboratory parameters were studied in a randomly selected series of East Asian population. A total of 31 subjects, whose ages ranged from 18 to 20 years and who came to Czechoslovakia for a long term study of working stay, were examined. The series represented healthy population. On examination marked infestation with intestinal helminths was established. Trichuris trichiura was found in 70.9% of probands, Ascaris lumbricoides in 43.3%, while both parasites were present in 25.8%. HBsAg positivity was recorded in 38.7% of probands and as many as 75% these had markedly increased serum transaminase values. Besides mildly increased IgG levels, immunological examination yielded significantly raised IgE levels which decreased after deparasitation. Although expected, eosinophilia failed to be present. PMID- 2765962 TI - [Tumors of the heart and arterial embolisms]. AB - Tumors of the heart are a rare cause of embolism of the peripheral arterial system. A series of 26 patients operated on for heart tumor in the Institute of Cardiovascular Diseases in Bratislava over the years 1979-1988 was analyzed. Pseudomyxoma was histologically verified in 24 patients and rhabdomyoma and rhabdomyosarcoma in the other two patients. A total of 12 embolic events was recorded in 9 patients (34.6%). There were 8 instances of embolism in the central nervous system and 4 in the extremities. In all cases pseudomyxoma of the left parts of the heart was the source of embolism. In 21 cases diagnosis was established and operation indicated on the basis of ultrasonographic evidence. The authors recommend the biatrial transseptal approach. Early surgical removal of a heart tumor is the therapy of choice which prevents the development of potential complications from the heart and peripheral arteries. PMID- 2765961 TI - [The effect of metipamide on levels of sodium and potassium in erythrocytes]. AB - The effect of metipamide on the level of Na+ and K+ in erythrocytes was studied in patients with essential hypertension. The control series consisted of healthy normotonics. In normotonics Nai+ and Ki+ were not affected in vitro, whereas in hypertonics Nai+ was found to be significantly increased (p less than 0.01) and Ki+ decreased (p less than 0.025). In vivo two subgroups of hypertonics were established: a) hypertonics with normal content of Nai+ (6.9 +/- 0.3.10(-3) mol/l) and b) hypertonics with increased content of Nai+ (9.2 +/- 0.3.10(-3) mol/l compared to 7.3 +/- 0.1.10(-3) mol/l, p less than 0.005). With respect to the given heterogeneity of the series, the response to metipamide treatment failed to be uniform. A part of the patients responded to therapy by diminished Nai+, manifesting one of the potential mechanisms of the antihypertensive effect of metipamide. The significant drop of Ki+ recorded in both subgroups of patients in the course of treatment demonstrated the potassium depleting effect of the drug. PMID- 2765963 TI - [Ventricular septal defect in early childhood]. AB - In a retrospective study the results of operations for hemodynamically severe ventricular septal defect were analyzed in 18 patients with a body weight below 10 kg who had been operated on over a period of two years at the Institute of Cardiovascular Diseases in Bratislava. The first group consisted of 12 children with the mean body weight of 6650 g in whom complete correction of the ventricular septal defect was carried out by means extracorporeal circulation. Ligation of the pulmonary artery was performed in 6 infants with the mean body weight of 3420 g (second group). Patients of both groups had a serious left-to right shunt and marked pulmonary hypertension. An excellent operative result was obtained in 10 children after complete correction of the defect. Two patients of the first group and one patient of the second group died suffering from severe pulmonary hypertension. Surgical correction of the hemodynamically severe ventricular septal defect in early childhood is indicated when conservative treatment fails and should be carried out as an urgent procedure regardless the age and body weight of the patient. PMID- 2765964 TI - [Membrane-associated acetylcholinesterase in the sarcotubular system of skeletal muscles]. AB - Isolated membranes of the sarcotubular system of the skeletal muscle of the rabbit exhibit acetylcholinesterase activity. The activity of the enzyme depends on the intactness of the vesicles, it increases with time and after the action of detergents, suggesting that the enzyme may be bound to the membranes in a latent occluded form. The optimal conditions of the hydrolytic reaction were determined to be at the protein concentration of 35-40 micrograms/ml. The most suitable pH for acetylcholinesterase activity was found to be in the mildly alkaline region of pH = 8.0. The dependence of the activity of the enzyme on the concentration of the substrate displayed a hyperbolic course, the reciprocal dependence according to Lineweaver and Burk yielded the values KM = 0.69 mmol.l-1 and Vmax = 1.99 mumol/mg/h. The observed properties of acetylcholinesterase from the sarcotubular system show that the enzyme is associated with these membranes and after the action of detergents it has a well measurable activity. PMID- 2765966 TI - [Ruptured aneurysm of the abdominal aorta]. AB - Rupture of an aneurysm of the abdominal aorta is a severe abdominal emergency requiring urgent surgical intervention. The mortality rate is high since mostly elderly patients are involved with associated cardiovascular diseases and the presence of hemorrhagic shock. Prolonged hypotension may lead to renal and cardiovascular failure. The authors treated three cases of abdominal aortic aneurysm rupture under field conditions. One of the patients survived. Surgical procedure is indicated in each case of abdominal aortic rupture and the operation has to be performed early and with technical perfection. Neither advanced age nor other risk factors are contraindications to surgical intervention, since without operation the condition is inevitably fatal. PMID- 2765965 TI - [The importance of early cholecystectomy in cholelithiasis for the prevention of carcinoma of the gallbladder]. AB - The authors report on a series of 324 patients operated on for cholelithiasis. They summarize the histological findings obtained by detailed examination of the surgical specimens carried out by one pathologist. The relatively high rate (43%) of severe pathological changes in the gallbladder wall in emphasized as these may be sites of predilection for the development of carcinoma. Three cases of only histologically established carcinoma are briefly described. In two of them carcinoma developed on the basis of chronic fibroproductive cholecystitis. In the third case the gall bladder was not removed and thus histologically not examined. In the light of their findings, the authors strongly advocate early cholecystectomy, particularly in patients of advanced age groups. PMID- 2765967 TI - [Intracranial abscesses]. AB - The authors report on their experiences in treating 21 patients with intracranial abscesses admitted to the Neurosurgical Department of the Teaching Hospital in Kosice in the years 1982-1987. Suppurative inflammation of the middle ear or of the paranasal sinuses was the most frequent source of infection. Six patients died, five of them in association with the intracranial infection, one female patient died of hemorrhagic necrosis of the pancreas. Two of the survivors suffer from epilepsy, in further three motor derangement of mild or medium degree has persisted on the contralateral side. Therapeutic measures which proved effective were trepanopuncture with pus aspiration, also repeatedly performed if necessary, and administration of antibiotics according to sensitivity of the microorganisms involved. In chronic abscesses with a solid capsule and in intracranial suppuration due to foreign bodies the whole focus as well as the capsule have to be extirpated. PMID- 2765968 TI - [Extra-intracranial microanastomosis and its future]. AB - Current examination methods fail to provide exact information on potential conditions for functional rehabilitation of ischemic foci. They do not yield the necessary data which would allow to determine reliably the effect of extra intracranial microanastomosis on the clinical picture. The potentially positive effect depends on the condition of the ischemic lesion and on the pattern of the individual geometry of the cerebral vascular network. In the light of two case reports the author contests the decisive refusal of extra-intracranial microanastomosis as the therapeutic procedure in cerebral ischemia. Although the effect of microanastomosis does not warrant improvement of the clinical picture, it creates better conditions for its potential development. It is frequently impossible to decide unequivocally whether improvement was due to the operation or whether it had occurred also without it. This, however, is not a unique phenomenon in surgery. The potentiality of its positive effect, inherent to the procedure, is both its shortcoming and guarantee of its further survival. PMID- 2765969 TI - [The effect of noradrenaline, adrenaline and acetylcholine on contractility of the uterus of the guinea pig after testosterone administration]. AB - The reactivity of the isolated guinea pig uterus was studied after single (0.5 h before experiment) and repeated (7 days) in vivo testosterone administration in the dose of 10 mg.kg-1. In vitro testosterone was applied in the dose of 5.8 x 10(-5) mol. The reactivity of the isolated guinea pig uterus to norepinephrine, epinephrine, and acetylcholine was evaluated. These substances were applied cumulatively in doses of 10(-8) - 10(-4) mol.I-1. The changes of isometric contractions of the uterus were evaluated by the magnitude of the maximal response and by the pD2 value. The contractile response of the guinea pig uterus to all the mediators studied was decreased both after in vitro and in vivo administration of testosterone. The most pronounced change in the pD2 value was induced by single testosterone administration. The results suggest that, similarly as female sex hormones, testosterone may influence uterine function by its effect at receptor and nonreceptor level. PMID- 2765970 TI - [Determination of the degree of severity and prognosis in injuries]. AB - Possibilities and up-to-date approaches to establishing prognosis and the degree of severity of injuries are presented. The authors have been concerned with the problem since 1986 and report on their own experiences and observations on using the system Abbreviated Injury Scale/Injury Severity Score. They suggest certain changes which may yield an increased validity of the system. PMID- 2765971 TI - [Chromosome aberrations in children with the Williams-Beuren syndrome]. AB - Karyotypic examinations were carried out in 10 children suffering from Williams Beuren's syndrome. Chromosomal aberrations were established in two of the children. In one case the mosaic pattern of Klinefelter's syndrome was recorded, evidently presenting an instance of coincidence. In the other case deletion of the long arm of chromosome 6 (q22.2q23) was demonstrated, which according to the authors' hypothesis may represent an alternative localization of the phenotypic traits of Williams-Beuren's syndrome or of its assumed underlying defect, namely derangement of the regulation of calcium metabolism. The value of cytogenetic examination of children with Williams-Beuren's syndrome in elucidating the so far obscure pathogenesis of this disease is being emphasized. PMID- 2765972 TI - [Acute natriuretic effect of nifedipine in elderly people with essential hypertension]. AB - Following a two-week placebo period, a group of 10 elderly men (63-76 yrs) received a 20 mg nifedipine tablet each. Twelve hours later nifedipine, as compared to placebo, significantly raised diuresis, urine sodium excretion, and tubular sodium rejection, but had no affect GFR and urine potassium excretion. A significant drop in mean arterial pressure was registered six hours following nifedipine administration. After twelve hours, however, the statistical significance of the antihypertensive effect was reduced tenfold despite persisting natriuresis. In 4 elderly women (61-77 yrs), PRA level after nifedipine tended to rise, no such trend was observed for aldosterone. Although the mechanism of the natriuretic effect of Ca2+ channel blockers is not yet fully understood, it seems that the increase in Na+ excretion might be due to inhibition of Na+ reabsorption in renal tubules. It appears though as if the changes in Na+ excretion did not contribute to the acute BP decrease. PMID- 2765973 TI - [Biochemical and electrophysiological correlations of functional asymmetry of the brain]. AB - Biochemical differences in metabolic activity between the two hemispheres are manifested by a higher level of free fatty acids in the left hemisphere. Differences in the concentration of transmitters concern higher levels of norepinephrine, dopamine, choline acetyltransferase and GABA in some regions of the left hemisphere. Lesions in homologous areas of the right and left hemisphere do not have the same effect on the biochemical activity of the brain. Amobarbital and alcohol reduce the activity of the right hemisphere. The criteria used to establish electrophysiologic differences in the activity of the two hemispheres are as follows: evaluation of the value of basic activity, suppression of alpha activity, evoked potential parameters, and the degree of negativity of slow brain potentials. Signs of higher activity of the right hemisphere were recorded at visuo-spatial performances and of higher activity of the left hemisphere at verbal performance. Extracerebrally only slight electrodermal differences were observed between the right and left side of the body. PMID- 2765974 TI - [Sociobiology]. AB - Sociobiology represents a systematic study of the biological basis of social behavior. Suggesting its relations to genetics, psychiatry, the theory of games, and ethology, the author summarizes the main sociobiological postulates. The review is intended for postgraduate education. PMID- 2765975 TI - [A rare case of human autochthonous dicrocoeliasis in Czechoslovakia]. AB - The first case of not imported dicroceliasis in Czechoslovakia is reported in an eleven-year-old boy. The patient suffered from gastrointestinal complaints for about half a year. Diarrhea frequently alternated with constipation, the abdominal pain was mainly in the region of the pancreas. With the exception of eosinophilia (16%), all other laboratory findings (blood count, ELFO, urinalysis) were within normal values. Eggs of Dicrocoelium dendriticum were repeatedly found in stool specimens. The patient was successfully treated with Bithin (4,6 dichlorpentol). Examination of the other members of the family proved negative. At present the patient is without complaints, stool examinations for parasites were repeatedly negative. Contact with sheep or consumption of contaminated liver was not demonstrated. The parasitic infestation may have occurred via an intermediate host, as the patient was keen on collecting different animals, particularly snails. PMID- 2765976 TI - Characteristics of unturned eggs: critical period, retarded embryonic growth and poor albumen utilisation. AB - 1. The physiological effects of egg turning during incubation are described. 2. There was a critical period for turning, from days 3 to 7 of incubation, which affected hatchability, embryo growth and utilisation of extra-embryonic fluids. 3. Failure to turn eggs retarded formation of allantoic and amniotic fluids, restricted alumen uptake and retarded growth of the embryo, but only after day 12 of incubation. PMID- 2765977 TI - Development in culture of the chick embryo from cleavage to hatch. AB - 1. Early uterine embryos were obtained from hens by induced oviposition 7.5-8.0 h after the preceding egg was laid. They were cultured in vitro and then in recipient shells to hatch. As controls, embryos from freshly laid eggs were cultured in recipient shells to hatch. 2. For embryos cultured from uterine eggs, the hatch rate was 22.5%, and for embryos cultured from laid eggs, the hatch rate was 62.5%. 3. The weight of the chicks hatched from culture was about 60% of the weight of the preceding egg, or donor egg. Male and female chicks reached maturity and have produced viable offsprings. 4. The results show that it is possible to grow chick embryos in culture from the early cleavage stage (stage II) to hatch. They extend earlier findings on the culture of embryos from the blastoderm stage (Stage X) to hatch. The technique provides a basis for investigations on chick embryo cryopreservation. PMID- 2765978 TI - Responses in egg shell quality to sodium chloride supplementation of the diet and/or drinking water. AB - 1. Supplementing the drinking water of 50-week-old laying hens with sodium chloride (NaCl) concentrations between 0.5 and 2 g/l for 7 weeks significantly increased the incidence of egg shell defects and significantly decreased egg shell quality. Dietary NaCl concentrations between 0 and 2 g/kg had little effect on this response. 2. At similar total NaCl intakes egg shell defects were much greater when the NaCl was obtained from the drinking water rather than from the diet. 3. Hens producing eggs with defective shells as a result of receiving saline drinking water failed to recover the ability to lay eggs with good shells after 8 weeks on normal water. 4. The increased incidence of shell damage was not related to decreased food intake or increased egg weight or production. PMID- 2765979 TI - Physiological evaluation of diuresis in commercial broiler breeders. AB - A physiological investigation on an outbreak of diuresis syndrome in commercial broiler breeder hens was carried out. Daily water consumption increased 4-fold and daily manure wet weight increased two-fold in affected hens. 2. The syndrome did not have a genetic basis. It was associated with kidney dysfunction which, once acquired, was not alleviated by changing the diet, the drinking water, or the environment. Diuresis ceased when water intake was restricted and returned when water was again made freely available. 3. The syndrome was not caused by nephrogenic diabetes insipidus or diabetes mellitus. Key changes in kidney function associated with diuresis included: increased urine flow, decreased urine osmolality, reduced glomerular filtration rates, increased fraction of the glomerular filtration rate excreted as urine and decreased urinary hydrogen ion concentrations. 4. Preliminary histopathological findings and the physiological patterns of kidney dysfunction indicated that the diuresis syndrome was associated with permanent kidney damage, probably caused by the Arkansas strain of infectious bronchitis virus. PMID- 2765980 TI - Ingestive responses to mu and delta opioid receptor agonists in the domestic fowl. AB - 1. Four experiments were conducted using the highly specific mu and delta opioid receptor agonists morphiceptin (B-casomorphin 1-4, amide) or [Met5]-enkephalin, respectively, to evaluate the effect of mu and delta opioid receptor agonists on ingestive behaviour in the domestic fowl. 2. Intracerebroventricular (ICV) administration of 0.625, 1.25, 2.5 and 5.0 micrograms of morphiceptin significantly stimulated drinking, while having no effect on feeding. Intramuscular injection of 0.5, 1.5 and 3.0 mg morphiceptin/kg body weight induced a significant increase in feeding, whereas drinking was not altered. 3. ICV administration of 0.625, 1.25, 2.5 and 5.0 micrograms [Met5]-enkephalin, as well as intramuscular injection of 0.5, 1.5 and 3.0 mg [Met5]-enkephalin significantly stimulated feeding while having no effect on drinking. 4. These results suggest that, in the central nervous system, mu opioid receptor agonists stimulate drinking and delta receptor agonists stimulate feeding. At sites outside the blood-brain barrier, both mu and delta opioid receptor agonists stimulate feeding. PMID- 2765981 TI - Regulation of net intestinal calcium uptake in hens laying obligatory soft shelled eggs. AB - 1. Individually caged laying hens had a loop of thread inserted into the shell gland. This resulted in the laying of soft shelled eggs. 2. A balance study was performed for a one week period before and after the operation. After the operation birds with threads consumed less calcium than before. Their requirements for calcium for eggshells decreased, resulting in increases in both calcium excreted and calcium retained. 3. Net calcium extraction in the digestive tract was measured in groups of birds with threads and intact controls, when shelling or not, by examining ratios of Ca to TiO2 in different gut segments. Observations were made during the period following premature oviposition in birds with threads, but within the normal shelling period of control birds. The period of study was at least two weeks after the operation. 4. Birds with threads absorbed less calcium than control birds up to the upper jejunum. 5. Control birds secreted calcium between the upper jejunum and colon, but birds with threads showed little change in absorption in this part of the digestive tract. 6. The increase in calcium absorption in intact birds was a response to the stimulus of shelling an egg or replacing calcium in medullary bone during a pause day, rather than of ovulation. PMID- 2765982 TI - Changes in the concentration and composition of biliary and serum bile acids in the young domestic fowl. AB - 1. Concentrations of biliary and serum bile acids, their molecular compositions and serum cholesterol concentrations were determined in chicks at 2, 3, 4 and 6 weeks of age. 2. The concentration of biliary bile acid was maximal at 3 to 4 weeks, decreasing by 6 weeks of age. 3. The serum concentration of bile acid was maximal at three weeks of age. 4. Serum total cholesterol increased from two weeks and was maximal at 6 weeks of age. 5. Chenodeoxycholic acid was the predominant biliary unconjugated bile acid. 6. Tauro-chenodeoxycholic acid and tauro-cholic acid were the dominant molecular species of biliary and serum conjugated bile acid. PMID- 2765983 TI - Effect of corticosterone infusion on plasma corticosterone concentration, antibody production, circulating leukocytes and growth in chicken lines selected for humoral immune responsiveness. AB - The effect of corticosterone on antibody production was studied in chicken lines selected for humoral immune response. 2. Twelve cockerels (33 days old) from lines selected for high or low antibody responses after immunisation with sheep red blood cells (SRBC) were implanted with mini-infusion pumps delivering corticosterone or vehicle continuously for 14 d. 3. Three days after implantation, the chickens were immunised intramuscularly with 0.25 ml packed SRBC. Blood samples were taken before implantation, before immunisation and 3, 5, 7 and 11 d after immunization. 4. Corticosterone infusion induced higher plasma corticosterone concentrations and heterophil/lymphocyte ratios than infusion of vehicle only. Growth was considerably depressed and relative weights of the thymus, bursa of Fabricius and spleen were less in the corticosterone-infused chickens. 5. An effect of corticosterone on antibody production could not be demonstrated, and differences between selection lines were unaffected. PMID- 2765984 TI - Opioid modulation of feeding and drinking in fowls. AB - 1. D-ala2-methionine enkephalinamide (DME), the stable analogue of met-enkephalin (an opioid agonist), stimulated food intake of immature hens in the first 30 min after intracerebroventricular injection (2 and 8 micrograms/kg), but had no effect on either food or water intake when injected intravenously (15 and 60 micrograms/kg). 2. Naloxone (an opioid antagonist) had no effect on food intake after either intracerebroventricular (50 and 200 micrograms/kg) or intravenous (1 and 4 mg/kg) injection, but inhibited water intake in the second 30 min after intravenous injection. 3. Water intake was not measured after the intracerebroventricular injections of DME and naloxone. 4. Both feeding and drinking were inhibited in a dose-related way in the 7 h after intramuscular injection of nalmefene (0.2, 0.4, 0.8 and 1.6 mg/kg), a more potent and longer lasting antagonist than naloxone. 5. These data are compared with published results from similar work with birds and mammals. It is concluded that central release of endogenous opioids may reinforce both feeding and drinking in fowls, but whereas opioid blockage affects feeding more than drinking in pigeons and quail, the opposite appears to be the case in fowls. PMID- 2765985 TI - Ultrastructural alterations of the thyroid follicular cells in domestic fowls following neonatal olfactory bulbectomy. AB - 1. In order to investigate if ultrastructural alterations of thyroid follicular cells are induced by removal of the olfactory bulb at hatching, chicks were olfactory bulbectomised within 24 h after hatching and the thyroid follicular cells were examined at 5 months of age by electron microscopy. 2. Olfactory bulbectomised chickens showed a well-developed Golgi area, a highly-developed rough endoplasmic reticulum, many mitochondria and a paucity of secretory granules and lysosomes in thyroid follicular cells. 3. These hypertrophic ultrastructural changes in follicular cells of operated birds indicated that the thyroids glands were stimulated by neonatal olfactory bulbectomy. 4. This finding may suggest an establishment of the olfactory bulbothyroid glandular system during the early days of life in the chicken. PMID- 2765986 TI - Current role of semen storage and artificial insemination in the turkey industry. AB - The turkey industry is moving towards the development of stud farms, but an essential condition is the existence of efficient methods to store semen. Much research has been done recently to determine the number of viable spermatozoa in an insemination dose needed for maintaining optimum fertility. Practical methods to determine the number of intact spermatozoa in semen, both before and after storage, are under development. It is now possible to store turkey semen for 6 to 24 h without appreciable loss in fertility and hatchability. Ideal experimental conditions for 48 h storage have not yet been fully determined. Development of new storage media, allowing the insemination of very low numbers of spermatozoa, may provide interesting possibilities regarding the use of elite sires. PMID- 2765987 TI - [Epidemiology of human babesiosis in Europe. Prophylactic results]. AB - After exploring the ecology and biology of Ixodes ricinus, the vector of M. divergens, which causes human babesiosis in Europe, the author draws conclusions regarding the epidemiological features of the disease and its control. PMID- 2765988 TI - [Dog bites and infection from bacterial inoculation. Necessity for appropriate therapeutic measures]. AB - The most recent statistics in France underline a doubly increasing preoccupation: the alarming rise in the frequency of bites by dogs (watchdogs or lapdogs), and the great number of pathogenic bacteria isolated from the bite wounds. During the last three years (1985, 1986, 1987), the Bacteriological Laboratory of Nancy received 390 samples, and 56% of them contained one or more bacteria. These bacteria basically were Pasteurella (61%), but other different species were isolated and identified recently: for example, the bacterial groups EF4, M5, IIj and especially DF2. The clinical feature is usually a wound which, neglected, is suppurating. But the bacteria of the DF2 group lead to general complications, very serious: more than 50 cases of septicemia have been published. In such cases, the notion of underlying pathology is important: alcoholism, cancer, splenectomy. Therefore, this new threat calls for great vigilance: curative treatment with antibiotic therapy adjusted to the isolated and tested bacterium; but, after all bites by a dog, real prophylaxis is systematically essential, with classical actions and antibiotic therapy (betalactamine or cycline) if the organism of the patient is deficient. PMID- 2765989 TI - [Value of vasodilator treatment in beginning cardiac insufficiency]. AB - Two cooperative studies, from the Veterans Administration in 1986 and the Consensus Study in 1987 clearly assessed the beneficial prognostic effect of vasodilator therapy in congestive heart failure. Nevertheless, the results obtained are still limited, and the mortality rate remains at about 36% at 1 year under enalapril therapy. Experimental, hemodynamic and clinical data have proved the value of early vasodilator administration, especially of an angiotensin converting enzyme inhibitor in congestive heart failure of new onset or asymptomatic. Inhibition of the renin-angiotensin-aldosterone system and decrease in catecholamines improve left ventricular function and increase survival. PMID- 2765990 TI - [Report on activity in 1988 of the terminology group]. PMID- 2765991 TI - [Myelin lesions in the central nervous system caused by disturbances in plasma osmolarity: pontine and extra-pontine myelinolysis]. AB - Central pontine myelinolysis is defined by a symmetric area of myelin damage in the center of the basis pontis. In 10% of these cases, symmetric extra-pontine lesions of similar histological type are found in other parts of the brain. The MRI has provided information about the natural history of this demyelinating process. Disorders of plasma osmolarity appear to be a crucial factor in the pathogenesis of central pontine myelinolysis: rapid correction of hyponatremia or sometimes severe plasma hyperosmolarity. Alcoholic patients and, more generally, those afflicted with a serious debilitating illness are more susceptible to a hyperosmolar insult, absolute or relative. In such cases, the management of hyponatremia must be very cautious, owing to the risk of myelinolysis. PMID- 2765992 TI - [Encephalitic complications of measles in 1987]. AB - Surveillance data on subacute sclerosing panencephalitis from participating virology laboratories are reported to the French National Health Laboratory from 1980 to 1987. Among 157 individuals having S.S.P.E., at least 52 cases are related to natural measles infection which occurred since 1970, the year of measles vaccine licensure. In 1987, 39 neurological complications in the acute phase of measles were confirmed by laboratories, all of them in non-immunized persons. 34 would be preventable by vaccine according to current recommendations. Though below the current number of cases, these numbers show the importance of the failure to control measles. It is essential that a program with combined measles/mumps/rubella vaccine be rapidly initiated and completely achieved. PMID- 2765993 TI - [French medical periodicals in the international scene?]. AB - The future of internationally-oriented French-language medical journals depends on two objectives: securing the vast audience of potential English-speaking readers (ten times as great as the number of French readers) without whom there can be no international impact; and enlarging the number of French-speaking readers. The requirements of these two groups of readers are the same for selection and publication of original articles. For the convenience of English speaking readers, a special summary in English should be provided. State assistance favoring the dissemination of French articles in foreign countries would be useful and seems more likely now that a Ministry of French-Speaking Affairs has been created after summit meetings in Paris and Quebec in 1986 and 1987 to promote the use of the French language. Each year French researchers and clinicians publish more and more articles in English-language scientific and medical journals. This practice deprives our French-language journals of an increasing number of original works. If nothing is done, it will develop even more, leading to the appearance in France, as in other European countries, of journals written entirely in English. The defense of French-language medical publications is not as pointless as the director of Current Contents has suggested; however, a number of French journals need to adapt rapidly to a situation that has changed more in the past 40 years than in the two preceding centuries. PMID- 2765994 TI - [Report of the National Health Laboratory (Department of Hydrological and Thermal Studies)]. PMID- 2765995 TI - [A request for classification of the community of Blotzheim (Upper Rhine) as a health resort]. PMID- 2765996 TI - [Aspects of viral hepatitis in patients over 60 years of age]. AB - 78 acute viral hepatitis (VH) cases were seen from 1971 to 1985 in patients over 60. Virus A, B, B-Delta and non-A, non-B are, respectively, responsible for 11.5, 23.1, 5.1 and 60.3% of the cases. Severe outcome occurs in 10.3%. Early in the course of VH, the risk of progression to cirrhosis concerns 1/18 VHB, 3/4 VHD, 8/47 VH NA NB. But the long-term prognosis is not so poor as stated in previous studies. PMID- 2765997 TI - [New elements in the diagnosis and treatment of thyrotropic pituitary adenomas with hyperthyroidism]. AB - Although thyrotropin-secreting pituitary tumors are rather exceptional, the authors have studied 5 new cases from 1982 to 1988. This apparently growing pattern is due to a more accurate diagnosis because of new laboratory measurements: --Immunoradiometric assay (IRMA) of ultra-sensitive thyrotropin (TSH); --Radioimmunoassay (RIA) of free alpha subunit of TSH; --Molar ratio of free alpha subunit/TSH before and after TRH stimulation; --Morphologic assessment of pituitary adenoma by computed tomographic scanning and nuclear magnetic resonance imaging; --Characterization of thyrotropin-secreting cells by immunohistochemical technics and identification of secretion products in cultured cells. The authors illustrate these new topics with a case report harboring a partial resistance to thyroid hormones. A 6-month treatment with somatostatin analogue (SMS 201.995) is reported, before transphenoidal ablation of the adenoma. PMID- 2765998 TI - [Hemoglobinopathies and oxygen transport]. PMID- 2765999 TI - [The etiology of renal calculi]. PMID- 2766000 TI - [The effect of ethanol on the metabolism of arachidonic acid (AA) of peritoneal macrophages of mice]. PMID- 2766001 TI - [Sexual differentiation of the adipose tissue-muscle ratio. Its metabolic impact]. AB - Muscle and fat development are regulated by opposite and also cooperating factors. Adipo-muscular ratio is the result of those forces. The need of a determined fat mass and of its corollary a determined muscle mass is an important physiologic parameter. Sexual differentiation is the main factor adipo-muscular ratio. Feminine fat is twice as big as masculine fat: it predominates in the lower body, masculine fat in the upper body. Brachio-femoral adipo-muscular ratio is, among others, a good index of fat sexual differentiation. Android obesity, predominating in both sexes in the upper body, is, with genetic predispositions, the main factor of non insulin dependent diabetes carbohydrate sensitive hyperlipoproteinemia, hyperuricemia, atherosclerosis. Easy determination on fat topography before the age of 30 is, particularly in women, the best tool for an efficacious prophylaxis of obesity's metabolic complications. PMID- 2766002 TI - [The genetics of Salmonella]. PMID- 2766003 TI - [Abused children]. AB - After a description of child abuse and neglect among young children in the literature, the authors focus on the recognition of the problem by professionals. They describe the clinical symptoms which are found among battered and neglected children. When faced with this non specific and polymorphic symptomatology, they provide means to reach the diagnosis. They conclude with a brief description of the behaviour one should adopt when dealing with the children as well as with the legal protection system. PMID- 2766004 TI - [The legislation of dietetic products 25 years after the position statement of the Academy of Medicine]. AB - After years of regulatory activity organized according to the Academy's vow in 1966, the commission for foods for special dietary uses has to change the way of working. Now being more used as an authorization committee, the commission needs to be supported by a high level scientific consensus, able to be opposed to other foreign scientific opinion. The Academy of Medicine could be the place for establishing this consensus. PMID- 2766005 TI - Exploring contingency tables with correspondence analysis. AB - An algorithm for correspondence analysis is described and implemented in SAS/IML (SAS Institute, 1985a). The technique is shown, through the analysis of several biological examples, to supplement the log-linear models approach to the analysis of contingency tables, both in the model identification and model interpretation stages of analysis. A simple two-way contingency table of tumor data is analyzed using correspondence analysis. This example emphasises the relationships between the parameters of the log-linear model for the table and the graphical correspondence analysis results. The technique is also applied to a three-way table of survey data concerning ulcer patients to demonstrate applications of simple correspondence analysis to higher dimensional tables with fixed margins. Finally, the diets and foraging behaviors of birds of the Hubbard Brook Forest are each analyzed and then a simultaneous display of the two separate but related tables is constructed to highlight relationships between the tables. PMID- 2766006 TI - A FORTRAN subroutine to compute inbreeding and kinship coefficients according to the number of ancestral generations. AB - This paper presents a FORTRAN IV subroutine to calculate inbreeding and kinship coefficients from pedigree information in a diploid population without self fertilization. The user can specify the number of ancestral generations to be taken into account. It is thus possible to determine contributions of succeeding ancestral generations to the inbreeding and kinship coefficients under consideration. The subroutine is based on a recursive procedure that generates systematically all paths connecting two individuals. NP and NM, whose kinship coefficient is to be calculated (or between the father NP and the mother NM of the individual whose inbreeding coefficient is to be calculated). These paths obey the following conditions: (i) a given path does not contain the same parent offspring link more than once; (ii) the vertex of a path is an ancestor common to individuals NP and NM, with a rank lower or equal to the parameter specified in input. Constraints regarding the size of the corpus of genealogical data and the storage method are discussed, as well as the interest of this subroutine compared to the existing ones. An example of application is given. PMID- 2766007 TI - TEFOOL/2: a program for theoretical drug design on microcomputers. AB - TEFOOL/2, a program written in BASIC, is presented in this paper. The purpose of TEFOOL/2 is to provide people interested in drug design with an easy-to-handle program where some of the most important techniques in QSAR are included. The program permits the selection of the training series, performs regression calculations and searches for optimum substituents. The latter is achieved by using either a Hansch's strategy or geometrical procedures. The program is interactive and can be implemented on an IBM-PC or compatible microcomputer. Although TEFOOL/2 has been developed for its application in drug design studies, its great flexibility makes it suitable for application to any experimental design or optimization process. PMID- 2766008 TI - Software tools for motif and pattern scanning: program descriptions including a universal sequence reading algorithm. AB - Two programs, MOTIF and PATTERN, that scan sequences for matches to user-defined motifs and patterns of motifs based on identity and set membership are described. The programs use a simple and logical notation to define motifs, and may be used either interactively or by using command line parameters (suitable for batch processing). The two programs described also incorporate a simple, yet reliable, algorithm that automatically detects in which of six possible formats the sequence entry is written. PMID- 2766009 TI - Simultaneous editing of multiple nucleic acid and protein sequences with ESEE. PMID- 2766010 TI - Database for aqueous solubility of nonelectrolytes. PMID- 2766011 TI - A Macintosh program for drawing circular plasmid maps. PMID- 2766012 TI - LEHM: a convenient non-linear regression microcomputer program for fitting Michaelis-Menten and Hill models to enzyme kinetic data. PMID- 2766013 TI - POEAMS: program for outliers elimination in 'anomalous' multidimensional space. PMID- 2766014 TI - A new computer program for nematode identification. PMID- 2766015 TI - Programs for reference library managing. PMID- 2766016 TI - Contrast use: waste not--want not. AB - Efficient use of low-osmolar contrast media is essential, owing to their cost and increasing substitution for conventional agents. A study was undertaken in three radiology departments to examine use of intravascular contrast media. Over a one month period in the summer of 1987, the amount of intravascular contrast medium used and discarded was measured in one community hospital and two university affiliated hospitals in southwestern Ontario. The major part of the waste occurred in the angiography suite, while minimal wastage was recorded in computed tomography. Much less contrast was wasted in the community hospital than in the teaching hospitals. Thirteen percent of all contrast material used by the three hospitals was discarded. Some wastage appears inevitable. Multidose dispensing systems as well as variety in bottle sizes have been proposed to reduce waste. Individual departments need to be aware of the problem and analyze their own patterns of contrast use. PMID- 2766017 TI - Zero-added-dose gastrointestinal film studies. AB - A technique is described to produce diagnostic quality 70 mm x 60 mm films of upper GI fluoroscopic examinations by photography of the video-displayed image on a "slave" monitor, obtained at a dose of 0.01 milligray (1 millirad) for a 20 cm water equivalent phantom. Because the photograph is the same image already being observed, the films require no added dose over that needed for an adequate fluoroscopic examination. Diagnostic films can be made from the replay of a videocassette recorder. With exposure times of 1/30th of a second, movement blur is easily prevented. PMID- 2766018 TI - Treatment of liver tumors with yttrium-90 microspheres alone. AB - Fifteen patients with liver metastases and one patient with hepatoma were treated by infusing 15 microns diameter plastic microspheres containing yttrium-90 into the hepatic artery. Twenty additional patients were screened but were found to be unsuitable for treatment. Follow-up angiography was done in 13 of the 16 treated patients. In five patients there was a reduction in tumor volume by more than 50% and in another two patients there was a smaller reduction. In six patients gastritis or gastric ulceration occurred and in three this was demonstrated to be due to unintended infusion of microspheres into the gastric circulation. For patients treated with yttrium-90 microspheres, mean survival time after referral was 62 weeks and in the untreated group it was 30 weeks, although this difference was not significant. We conclude that yttrium-90 microspheres alone can effect reduction in the size of liver tumors in some patients in whom their use is feasible. PMID- 2766019 TI - The teaching of physics and related courses to residents in radiation oncology. AB - A survey of physics and related teaching to radiation oncology residents in 21 Canadian cancer centres was undertaken in December 1987 and January 1988. This survey illustrates a very considerable variation in the formal teaching of physics to aspiring radiation oncologists with, for example, the number of hours offered ranging from 40 to 160 in those 10 centres which have a training program. It would appear to be of benefit to radiation oncology residents, those charged with teaching them, and the radiation oncology community as a whole, to develop specific guidelines for this aspect of resident education. PMID- 2766020 TI - Diffuse thickening of the tracheal wall. PMID- 2766021 TI - Role of MRI bone marrow imaging in recurrent lymphoma. AB - Infiltration by Hodgkin disease of the bone marrow of a thoracic vertebral body in a symptomatic patient was identified by magnetic resonance imaging, but not by radiography, radionuclide bone scanning, or computed tomography. The discovery of disease at this site substantially altered subsequent therapy. PMID- 2766022 TI - Pseudoaneurysm of common iliac artery mimicking colonic metastasis on double contrast barium enema. AB - We describe a patient with a pseudoaneurysm of the right common iliac artery that on a double-contrast barium enema mimicked the appearance of metastatic tumor involving the sigmoid colon, including a mass effect and spiculated, tethered mucosal folds. In the appropriate clinical setting, computed tomography, magnetic resonance imaging, and aortography help to distinguish a pseudoaneurysm from metastatic tumor involving the bowel. PMID- 2766023 TI - Acute arsenic toxicity--an opaque poison. AB - We report a patient with fatal acute arsenic poisoning presenting as vomiting and diarrhea with the finding of intra-abdominal radiopacities on radiographs. These represent the classic features of acute arsenic toxicity and are detailed here as a reminder to others facing a similar puzzling patient with this potentially treatable poisoning. PMID- 2766024 TI - Primary squamous cell carcinoma of the breast: mammographic findings. AB - Primary squamous cell carcinoma of the breast is a rare lesion. Mammographic findings usually suggest malignancy and include an irregular, lobulated mass with poorly defined borders. Microcalcification is not a prominent finding. Tumor size is important in determining long-term outcome, and patients usually die from distant metastases. PMID- 2766025 TI - Axillary vein thrombosis in a female backpacker: Paget-Schroetter syndrome. AB - In 1875 Sir James Paget reported the first case of primary axillary vein thrombosis. Since then numerous reports of axillary vein thrombosis have appeared citing various initiating events and possible causes. We report here a patient with axillary vein thrombosis. The thrombosis appears to have been provoked by carrying a backpack. PMID- 2766026 TI - Computed tomographic evaluation of intracranial metastases from carcinoma of the prostate. AB - Intracranial metastases from carcinoma of the prostate are thought to be rare. The majority of the lesions reported have been dural in location. Subdural and intracerebral tumors are rarer. A review of previous autopsy series reveals an average frequency of 2.4%. Computed tomography offers an accurate and simple method of confirming the presence of intracranial metastases from carcinoma of the prostate. We report and discuss two patients displaying dural tumor deposits, one with possible parenchymal extension. PMID- 2766027 TI - Prevalence of genotoxic chemicals among animal and human carcinogens evaluated in the IARC Monograph Series. AB - To determine whether genotoxic and non-genotoxic carcinogens contribute similarly to the cancer burden in humans, an analysis was performed on agents that were evaluated in Supplements 6 and 7 to the IARC Monographs for their carcinogenic effects in humans and animals and for the activity in short-term genotoxicity tests. The prevalence of genotoxic carcinogens on four groups of agents, consisting of established human carcinogens (group 1, n = 30), probable human carcinogens (group 2A, n = 37), possible human carcinogens (group 2B, n = 113) and on agents with limited evidence of carcinogenicity in animals (a subset of group 3, n = 149) was determined. A high prevalence in the order of 80 to 90% of genotoxic carcinogens was found in each of the groups 1, 2A and 2B, which were also shown to be multi-species/multi-tissues carcinogens. The distribution of carcinogenic potency in rodents did not reveal any specific characteristic of the human carcinogens in group 1 that would differentiate them from agents in groups 2A, 2B and 3. The results of this analysis indicate that (a) an agent with unknown carcinogenic potential showing sufficient evidence of activity in in vitro/in vivo genotoxicity assays (involving as endpoints DNA damage and chromosomal/mutational damage) may represent a hazard to humans; and b) an agent showing lack of activity in this spectrum of genotoxicity assays should undergo evaluation for carcinogenicity by rodent bioassay, in view of the present lack of validated short-term tests for non-genotoxic carcinogens. Overall, this analysis implies that genotoxic carcinogens add more to the cancer burden in man than non genotoxic carcinogens. Thus, identification of such genotoxic carcinogens and subsequent lowering of exposure will remain the main goal for primary cancer prevention in man. PMID- 2766028 TI - Inhibition of gap-junctional intercellular communication between Chinese hamster lung fibroblasts by di(2-ethylhexyl) phthalate (DEHP) and trisodium nitrilotriacetate monohydrate (NTA). AB - Di(2-ethylhexyl)phthalate and trisodium nitrilotriacetate monohydrate, two apparently nongenotoxic carcinogens, were tested for effects on gap-junctional communication between Chinese hamster V79 lung fibroblasts. Both compounds inhibited gap-junctional communication in a concentration-dependent manner. The inhibiting effects of these chemicals on gap-junctional communication in vitro correlate with their tumor-promoting activity. Such results further support the hypothesis that inhibition of gap-junctional communication is an in vitro biomarker for some tumor-promoting chemicals. PMID- 2766029 TI - Metabolism and binding of benzo[a]pyrene in randomly-proliferating, confluent and S-phase human skin fibroblasts. AB - The metabolism of benzo[a]pyrene in randomly proliferating and confluent cultures of human skin fibroblast cells was compared with cell cultures in early S phase of the cell cycle after a G1 block. When each cell population was exposed to [G 3H]benzo[a]pyrene for 24 hours and the organic soluble metabolites in the extracellular medium and intracellular components were analyzed by HPLC, a quantitative increase in metabolism was observed in the confluent cell populations. The amount of organic soluble metabolites in the extracellular medium of the confluent dense cultures was 2.7 times the amount found in randomly proliferating cultures and 1.5 times that of the synchronized cultures. The trans 7,8- and 9,10 dihydrodiols and 3-hydroxy benzo[a]pyrene were the major metabolites formed. Small amounts of the sulphate conjugate, 9-hydroxy benzo[a]pyrene and the tetrols were also detected. Cytoplasmic as well as nuclear extracts from the confluent cell cultures also contained higher amounts of metabolites compared to those from the randomly proliferating and S-phase cells. The levels of DNA modification by metabolically activated benzo[a]pyrene did not differ among the randomly proliferating, confluent and S-phase cells. However, the S-phase cells exhibited approximately 50-fold increase in the frequency of transformation compared to the randomly proliferating cells. Confluent cells were not transformed by benzo[a]pyrene. These data suggest that factors other than random modification of DNA by the carcinogen might have a significant role in the expression of a transformed phenotype and that metabolism and transformation are not directly related. Furthermore, confluent dense cultures with a heightened capability for metabolism of benzo[a]pyrene were more active in the detoxification of benzo[a]pyrene than in the production of the metabolites associated with cellular transformation. PMID- 2766030 TI - Use of cell cultures for predicting the biological effects of mycotoxins. AB - The risk presented by mycotoxins is a toxicological problem. As the data given by physico-chemical analysis may be difficult to translate in terms of toxicity, however, especially when considering multiple contamination, we have developed a system for toxicological analysis of mycotoxins using cell cultures of different origins. The response of several cell types to a number of well defined mycotoxins was obtained in three days. This approach allowed us to: demonstrate and quantify a toxic effect, define some organ specificity related to the preferential action on a particular cell type, and detect an immunosuppressive effect. The results indicate that the system can be used for toxicological screening and that it has a predictive value for the pathological effects of tested products. PMID- 2766031 TI - Cardiac critical care. PMID- 2766032 TI - Comparison of thrombolytic agents: mechanisms of action. AB - The new generation of plasminogen activators promises certain advantages over the first-generation agents, particularly enhanced clot specificity. The tissue distribution, half-life, therapeutic profile, and optimum dosage, however, need to be evaluated for each chemically different agent. Whatever advantages these third-generation agents offer over the existing natural prototypes of the plasminogen activators will not be determined for some time. In addition, because an "agent of choice" has not been identified at this time, critical care nurses must understand the mechanisms of action of the various thrombolytic agents to ensure accurate and appropriate assessment, problem identification, and intervention in this era of reperfusion with thrombolytic therapy. PMID- 2766033 TI - Nursing of myocardial infarct patients. PMID- 2766034 TI - Role of the ventricular assist device in acute myocardial infarction. PMID- 2766035 TI - Complications associated with acute myocardial infarction. AB - AMI remains a diagnostic and therapeutic challenge for the critical care nurse. As research and technology progress, a thorough understanding of the pathophysiology of AMI is necessary to appreciate and apply advances in the treatment of this condition. Likewise, if reductions in the morbidity and mortality of AMI are to be achieved, the nurse must be aware of potential complications, especially those related to ischemia, myocardial dysfunction, and dysrhythmia. Prompt diagnosis and treatment of the complications of AMI are the best approaches for minimizing fatalities, reducing hospital stays, and providing the best prognosis for patients with AMI. PMID- 2766036 TI - Nursing care after AMI: a comprehensive review. AB - Although inadequately controlled, results of studies of cardiac rehabilitation suggest a decrease in mortality and morbidity for patients who adhere to an exercise program. These findings, however, have not been substantiated by better controlled studies. The potential benefits of cardiac rehabilitation include hemodynamic, physiologic, and symptomatic improvement. Risk factor modification, however, must also be emphasized. The hemodynamic and physiologic improvements that have been attributed to peripheral adaptations and central changes in myocardial perfusion or ventricular function have not been consistently documented. A supervised cardiac rehabilitation program, however, places the patient at no increased risk, and the qualitative improvement experienced by many patients strongly support its use. PMID- 2766037 TI - Hypercholesterolemia as a cardiovascular risk factor: nursing implications. AB - Nurses have a significant role in the primary prevention of hypercholesterolemia through public and patient education. In addition, nurses have the potential to make significant impact on reducing the cardiovascular risk associated with hypercholesterolemia through effective use of nursing interventions. Early identification of patients with hypercholesterolemia and aggressive life-style modification strategies can lead to a reduction in cholesterol levels and CHD risk. PMID- 2766038 TI - Patient selection and management in thrombolytic therapy: nursing implications. AB - Thrombolytic therapy offers the prospect of myocardial salvage and a decreased mortality rate to thousands of AMI victims. Nurses working with patients during the acute phase of their infarction have an opportunity to influence directly the patient's outcome. As professional practitioners and patient advocates, nurses have the responsibility to gain the knowledge and skill required to administer safely and effectively this lifesaving therapy. PMID- 2766039 TI - 5,5'-Dimethyloxazolidine-2,4-dione is a strong inducer of differentiation of human promyelocytic leukemia (HL-60) cells. AB - 5,5'-Dimethyloxazolidine-2,4-dione (DMO), a weak non-metabolizable acid, is commonly utilized for determining intracellular pH. In these studies, DMO was tested as an inducer of differentiation on the basis that its uptake and subsequent dissociation might transiently raise intracellular pH and activate ion fluxes critical for triggering maturation. After 5 days of exposure to 40 mM DMO, greater than 60% of HL-60 cells displayed phenotypic and functional changes characteristic of mature granulocytes. As with other inducers of HL-60 cell differentiation, commitment to differentiation required culture in the presence of DMO for more than 24 h, indicating that if transient effects on pH or ion fluxes occurred, they were not sufficient to trigger this process. DMO was either weak or inactive as an inducer of murine erythroleukemia cell (FLC) differentiation. Although other weak acids and bases triggered differentiation of both HL-60 cells and FLC, the spectrum of response differed markedly between the two lines. These results suggest that: (1) a number of common buffering agents have the potential to alter cell phenotype, and (2) their effects must be evaluated for each individual cell type. PMID- 2766040 TI - Age-dependence of the nerve fibre growth-promoting effects of hippocampus and exogenous nerve growth factor on cultured rat septum and superior cervical ganglion. AB - Explants of hippocampus from rats at various ages evoked an intense nerve fibre growth from cocultured superior cervical ganglion and septum explants taken from newborn rats. The addition of antiserum to nerve growth factor (NGF) into the culture medium inhibited the outgrowth of nerve fibres from superior cervical ganglia, while septum explants still extended nerve fibres in the same medium. Septum explants responded to added NGF, as well as to cocultured hippocampus, during the first postnatal week only, whereas ganglia extended nerve fibres in NGF-containing cultures throughout the postnatal period and even at the age of 6 months if superoptimal concentration of NGF was used. The present results suggest that hippocampus releases NGF and some other growth factor(s) in culture throughout the postnatal period from birth to adulthood. On the other hand, the capacity of septum to extend nerve fibres in response to the growth factors appears to be restricted to the first postnatal week. PMID- 2766041 TI - Activation of masked neural determinants in amphibian eggs and embryos and their release from the inducing tissue. AB - The neural-archencephalic (forehead) inducing activity of the microsomes and the high speed supernatant from Xenopus laevis ovaries and eggs was tested on gastrula ectoderm of Triturus alpestris. Both fractions have a very small inducing activity which increases considerably after autolysis or treatment with dissociating agents. A comparison with the inducing activity of the high speed supernatant from gastrulae suggests that neural inducing factors are synthesized in the ovary, stored in a masked form and activated, in part, during gastrulation. When the supernatant proteins from eggs and gastrulae were subjected to size-exclusion HPLC the neural inducing activity was eluted in different size classes, suggesting a limited proteolysis of a precursor during early embryogenesis. Further experiments have shown that treatment of the blastoporal lip from early Triturus gastrulae with actinomycin D or cycloheximide which inhibit the synthesis of RNA and protein respectively, diminishes the neural-archencephalic (forehead) inducing activity of the blastoporal lip. Treatment with actinomycin D or cycloheximide followed by ethanol, which, besides other structures, impairs the plasma membrane, does, however, not reduce the inducing activity. This may suggest that components which are needed for the transport of the neuralizing factor are diminished, when the synthesis of mRNA and protein is inhibited. Such components are probably needed for the release of the neuralizing factor from the blastoporal lip, the inducer tissue. PMID- 2766042 TI - Mouse gonadal differentiation in vitro in the presence of fetal calf serum. AB - Other workers have shown that fetal calf serum (F.C.S.) inhibits the differentiation of the rat testis, and disrupts established testicular cords, in vitro. To investigate the possibility of a serum effect in the mouse, indifferent urogenital complexes and differentiated gonads were removed from sexed fetuses and cultured for 7 days in medium with or without the addition of fetal calf serum. Cultures were assessed by light and electron microscopy. Testicular and ovarian differentiation occurred in the presence of fetal calf serum. Serum did not prevent basal lamina development in testicular cords of explants cultured to the equivalent of day-17 control testes. PMID- 2766043 TI - Ontogeny of the chick embryo spleen--a cytological study. AB - The differentiation of the chick embryo spleen was investigated from E4 till after hatching, using a number of cytological markers. The reticular fiber network, disclosed by silver staining, was a loose array of short fibers until E15. It developed into a complex pattern closely related to the specialized segments of the vascular tree between E15 and E18. While the very first cells belonging to the hemopoietic lineage could be identified as early as E4, steady state hemopoiesis set in by E10. Of the two cell lineages maturing in the organ, erythroid cells disappeared by E15, and granulocytes emigrated within 3 to 4 days around hatching. The process of lymphocyte homing, detected by specific markers, began just before hatching and was completed within the first week of life. Thus differentiation of the stromal anatomy appears as the prerequisite for the transition of embryonic (= hemopoietic) to adult (= secondary lymphoid) functions. PMID- 2766044 TI - Stage-dependent expression of the chicken delta-crystallin gene in transgenic fish embryos. AB - To study the regulation of gene expression of vertebrate crystallin genes, the chicken delta-crystallin gene was introduced into a small freshwater fish, medaka (Oryzias latipes), which lacks this gene, and its expression was examined immunohistologically at several developmental stages before hatching. The gene expression was detected in the central fiber cells of the lens at an early stage, showing a stage-dependent expression. In non-lens tissues, the expression was barely detectable before tissue differentiation. It first became substantial mainly in mesodermal tissues and then later in a greater variety of tissues, including ectodermal and endodermal ones. Thus, the non-lens expression of delta crystallin was also stage-dependent, with the stage being dependent on the tissue type. These results from lens and non-lens tissues are discussed in relation to tissue differentiation and two categories of delta-crystallin expression. PMID- 2766045 TI - Selective suppression of endogenous beta-globin gene expression by transferred beta-globin/TK chimeric gene in murine erythroleukemia cells. AB - To examine the effect of gene transfer on expression of the endogenous beta globin gene in murine erythroleukemia (MEL) cells, a beta-globin/TK chimeric gene was introduced into MEL cells. In some of the transformants, expression of the endogenous beta-globin gene was only weakly induced with the addition of DMSO, while expression of the introduced beta-globin/TK chimeric gene was well induced. Suppression of the endogenous beta-globin gene is selective for beta-globin gene, since expression of alpha-globin gene was only weakly affected in its induction in the transformants. Analysis of nine individual transformants indicated that suppression of the endogenous gene correlates more closely with the transcriptional activity than the copy number of the exogenous gene. Thus, the selective suppression can be explained by competition of positive trans-acting factor(s), present in limiting amounts, with high copy number of the exogenous gene the conformation of which is active. PMID- 2766046 TI - Replicating premeiotic germ cells of the mouse contain a novel DNA primase stimulatory factor. AB - A protein factor that stimulates DNA primase activity associated with DNA polymerase alpha has been identified in mouse germ cell populations enriched in spermatogonia and preleptotene spermatocytes. The partially purified factor enhances DNA primase activity from homologous cell types as well as DNA primase activity from Xenopus laevis oocytes in a poly dT or M 13 directed reaction. The factor does not stimulate DNA polymerase alpha activity in a gapped salmon sperm or poly dT-rA directed reaction. The DNA primase stimulating factor is identified in a male mouse germ cell population enriched in premeiotic cells; it is not detectable in middle-late pachytene spermatocytes, spermatids, Sertoli cells or fibroblasts. PMID- 2766048 TI - Development of the heartbeat during normal ontogeny and during long-term organ culture of hearts of the newt, Cynops pyrrhogaster. AB - Development of cardiac contraction was investigated in the newt, Cynops pyrrhogaster, during normal development and in hearts maintained in long-term organ culture. In the embryos the heart began beating as early as stage 33. The heart rate increased up to stage 52 and then gradually decreased to the adult rate by stage 60. The heart rate showed a logarithmic temperature dependence. In organ-cultured hearts the pattern of heart rate depended on the stage at which the heart was explanted; cultured embryonic hearts showed a pattern of increase and decline similar to that seen in vivo, and hearts explanted near metamorphosis showed only a slow decline. PMID- 2766047 TI - Lens fiber differentiation correlated with activation of two different DNAases in lens embryonic cells. AB - In order to identify the different DNAases present in the lens differentiating tissue, we have used an assay which reveals their activity directly on DNA containing gels after SDS polyacrylamide gel electrophoresis. DNAase renaturation from nuclear embryonic lens extracts does not occur after separation in 0.1% SDS polyacrylamide gel electrophoresis in contrast to that observed with purified micrococcal nuclease. When the SDS concentration in the running buffer and separating gel is decreased to 0.075%, renaturation of lens DNAase and enzyme activities are observed. Isoelectrofocusing was carried out in a polyacrylamide gel which was overlaid with an agarose gel containing DNA, permitting the visualization of the pI of DNAase activity. The presence of several DNAase isoenzymes was demonstrated in 11-day embryonic lenses. In epithelial lens nuclei, high molecular weight (MW) isoenzymes with basic pI were predominant. In post-mitotic fiber lens nuclei, two lower MW isoenzymes with acidic pI were detected as well as high MW activity with a basic pI. PMID- 2766049 TI - [Evaluation of the diagnosis of hydatidosis using immunologic technic]. PMID- 2766050 TI - [Application of electrophysiologic examination by transesophageal auricular stimulation]. PMID- 2766051 TI - [Primary studies on transesophageal atrial activation mapping]. AB - A method of transesophageal atrial activation sequence determination was created by using simultaneous recording with two unipolar esophageal leads and V1, as well as by the bipolar esophageal lead. Based on the assumption that the peak of P wave in the uni-polar esophageal lead (PE) reflects roughly the activation time of the left posterior atrium wall, and so as to the peak of P wave in V1 (PV1) for the right anterior atrium wall, four items were used as indicators of atrial activation sequence: 1. PV1-PE interval; 2. PEp-PED interval (measured from the peak of P wave in the proximal to that in the distal esophageal lead); 3. Morphology of the bipolar esophageal P wave (PEB); 4. PEp-PED-PV1 sequence; In 190 cases having undergone transesophageal atrial pacing with sinus rhythm, PV1 PE measurement was 28.0 +/- 13.9 ms and PEp-PED was 3 +/- 12 ms. During atrioventricular reciprocating tachycardia in 17 cases with type-A preexcitation and 18 cases with left-sided concealed accessory pathway, PV1-PE was -63.3 +/- 19.0 and -63.7 +/- 27.5 ms, with PEp-PED -17.1 +/- 22.0 and 16.4 +/- 16.7 ms respectively. Transesophageal atrial activation sequence determination is helpful in raising the diagnostic accuracy for arrhythmia. PMID- 2766052 TI - [Transesophageal supra-burst pacing to terminate paroxysmal supraventricular tachycardia]. AB - A new cardiac stimulation mode (transesophageal supra-burst pacing) to terminate paroxysmal supraventricular tachycardia (PSVT) in the clinical and electrophysiologic laboratory is first described for the first time in this paper. All the parameters of this method were as follows: (1) pulse duration: 10 ms; (2) pulse rate: 250-300 bpm; (3) pulse amplitude: 26-43 volts; (4) number of pulse from each supra-burst pacing: 3-5 beats. The results of terminating PSVT using this method showed that (1) among 112 patients with PSVT treated by this method, PSVT was terminated in 103 cases and failed to terminate in 9 cases; (2) during each PSVT successfully terminated by this method, once (90.4%), twice (6.6%), thrice time (3%) supra-burst pacing were respectively used. These data indicate that transesophageal supra-burst pacing is a safe, simple and useful method to terminate PSVT. PMID- 2766053 TI - [Noninvasive locational diagnosis of concealed accessory pathways in the heart]. AB - Concealed accessory pathways in the heart can be located by noninvasively mapping the left and right atrial potentials. The quantitative diagnostic criteria for locating the septal pathway are (1) the retrograde depolarization time difference between the two atria (delta A) = 0ms, (2) (delta A) less than 30 ms, (3) the change rate of delta A(delta A%) greater than 50%, (4) delta A index less than 10 and (5) the ratio of ventriculoatrial conduction time in the left to that in the right heart less than 1.2. These criteria have a diagnostic sensitivity of 100%, specificity of 87.5% and accuracy of 94.4%. PMID- 2766054 TI - [Changes in blood zinc and copper and their clinical significance in patients undergoing open-heart surgery]. AB - The levels of zinc and copper in the serum, plasma, erythrocyte and urine were determined in 17 cases undergoing open-heart surgery. Samples were taken daily before, during, and after cardiopulmonary bypass operations for 9 days. Mean plasma zinc dropped significantly 30 minutes after perfusion and reached its lowest level on the first postoperative day and remained lower than the preoperative level until the seventh postoperative day. Mean urinary zinc excretion was high on the day of operation and showed a peak value 2 hours after operation. A transient decrease of plasma copper occurred after 30 minutes of perfusion. However, it returned to the preoperative level by the first or second postoperative day followed by a persistent rise to a level significantly higher than preoperative levels from the third to the ninth day. Urinary copper excretion presented the same trend as urinary zinc excretion. The results suggest that a severe loss of zinc and copper occurs in the patients undergoing open heart surgery and a rational supply of zinc and copper is necessary. PMID- 2766055 TI - [Ultrastructural and cytochemical studies of malignant histiocytosis]. AB - The internal and surface ultrastructure and cytochemistry (MPO, AP) of the histiocytes from 16 patients were studied. The results showed that poorly differentiated histiocyte was irregular in cell contour with various projections. All had more or less neoplastic histiocytes in which numerous vacuoles and blisters along peripheral plasma membrane were seen. The neoplastic cells had numerous lysosomes, abundant short strands of rough endoplasmic reticulum, and free and poly-ribosomes in the cytoplasma. Long profiles and ring of RER as well as expansive forms were seen in 4 cases. The mitochondria were generally normal although an occasional elongated form and their cristae showed destroyed architecture in 6 cases. Occasionally, perinuclear bundles of microfilaments and prominent Golgi apparatus were seen. The nuclei of the neoplastic histiocytes were irregularly shaped and most had one or two huge nucleoli. Circular nuclear bodies were often seen. The ultrastructural cytochemistry of the neoplastic histiocytes showed: MPO was weakly positive in about 1/4 to 1/2 of the cells. AP reaction in all of the neoplastic histiocytes was always strongly positive located in the nuclear membrane. RER, lysosomes granules and Golgi apparatus. Under SEM, various surface characteristics of the neoplastic histiocytes were seen such as bleb-covered surface; bleb-ruffled surface, and ruffled surface. PMID- 2766056 TI - [Intracranial pressure monitoring in clinical practice. Report of 180 cases]. AB - 180 severe neurosurgical cases were monitored by intraventricular, epidural and subdural measurements. Intracranial infection rate was 1.1% and the intracranial hypertension rate was 83.3%. Increased intracranial pressure was most often seen in group of head injury. The outcome was poor in cases of uncontrol intracranial hypertension. It was found that intracranial pressure monitoring is useful for diagnosis, treatment and estimation of prognosis and has practical clinical value. This method and indications should be used appropriately according to the different situations. The patients with acute intracranial hypertension should be monitored intensively. PMID- 2766057 TI - [Effect of platelet-associated IgG on the morphology and ultrastructure of platelets in patients with idiopathic thrombocytopenic purpura]. PMID- 2766058 TI - Quality assurance and precision of dual photon absorptiometry in bone mineral measurement. AB - Dual photon absorptiometry (DPA) has evolved as a powerful technique in measuring bone mineral density (BMD) to assess osteoporosis and metabolic bone diseases in recent years. We introduced the first installation of DPA instrument into this country in Aug. 1987. Since the comparison among longitudinal BMD values influences the diagnosis, monitoring and medical decision-making, high precision of the system performance and strict quality assurance program are prerequisite for judgment of the difference between two successive measurements. However, the automation and black-box software design of the instrument make users gain very little knowledge how the instruments acquire the long-term system reliability. The first part of this study was designed to establish a standardized procedure to evaluate the long-term quality of the DPA instrument. Our instrument was proved to have stable sensitivity, resolution, accuracy and reproducibility in the four months of study. Three subjects with different BMD levels were scanned to evaluate the intraobserver and interobserver errors in BMD analysis expected in our laboratory (2.2 and 1.6% at 95% confidence level, respectively). The results indicated that reanalyzing the same scan by either of the two observers would produce a BMD precision error within 2.2% at a 95% confidence level. Serial scans of 7 normal volunteers within five weeks were then conducted to evaluate the overall precision of the BMD measurements. Our findings indicated that two scans would be considered as having a real BMD change if they differ by more than 3.3% at a 95% confidence level. There are at least five sets of DPA instruments that have been installed in Taiwan presently.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2766059 TI - Insulin resistance in obesity and noninsulin dependent diabetes mellitus. AB - Insulin clamp studies were carried out on 13 non-diabetics and 12 non-insulin dependent diabetics (NIDDM). Based upon the body mass index (BMI), they were further divided into obese (BMI greater than or equal to 27 kg/m2) and nonbese groups (BMI less than 27 kg/m2). All received euglycemic insulin clamp study (Humulin-S 40mU/m2/min). Thermoregulated venous samplings were done every five minutes for measurements of plasma glucose (PG) and immunoreactive insulin (IRI). Steady state plasma glucose (SSPG) was obtained 20-80 minutes and kept for 100 more minutes. The data of final 40 minutes of clamp were used for analysis. Variations in SSPG and metabolic clearance rate of glucose (MCRG) instead of glucose infusion rate (M) value were used to assess the insulin sensitivity. The results showed that insulin resistance was noted in obese non-diabetic and diabetic subjects as well as in non-obese diabetic patients, as evidenced by higher basal IRI and lower MCRG than non-obese normal controls. Correlation analysis revealed that there was no correlation between the reduction of MCRG and the BMI in either non-diabetic or diabetic patients. There was a strong negative correlation between MCRG and the ambient fasting plasma glucose in the diabetic group, whereas this correlation was not found in the non-diabetic group. In conclusion, obesity with or without diabetes did have remarkable insulin resistance. In non-diabetic obese subjects the insulin resistance did not go up as the BMI increased further. In diabetic patients, both obesity and hyperglycemia contributed significantly insulin resistance. PMID- 2766061 TI - Sustained-release theophylline-uniphyllin in nocturnal asthmatics. AB - For a period of six months, we collected 12 cases of nocturnal asthmatics (7 males, 5 females); their ages ranged from 20 to 66 (the average age is 49). We found that administration of Uniphyllin (10 mg/kg) once a day at 6 PM could maintain the blood level of theophylline within therapeutic range at least 12 to 24 hrs. The peak expiratory flow rate of the 6 cases we collected, were significantly improved. The result of pharmokinetic parameters: 1) The average of a single dose (12 cases) is AUC (ug. hr/ml) 275.1 +/- 62. k; Kel (hr-1) 0.068 +/- 0.019; Ka (hr-1) 0.33 +/- 0.07); Tmax (hr) 6.3 +/- 1.4; T 1/2 (hr) 11.2 +/- 4.4; Clearance/F (ml/kg/hr) 37.9 +/- 9.0.2). The average of steady state (12 cases) is Css (mg/L) 5. 7 +/- 2.6; Cmax-Cmin (mg/L) 10.09 +/- 1.46.3). The average of relative bioavailability (3 cases) is 82%, 83%, 102%. However, the extent of absorption data is available for only 3 subjects. There are too few subjects to draw any meaningful conclusions about this relative bioavailability. Four cases show slight symptoms, including 1 case of dizziness, 2 cases of nausea, and 1 case gaseousness. It is suggested that the drug be administered at about 6-8 PM to coincide peak levels in the early morning in nocturnal asthmatics. PMID- 2766060 TI - Primary mediastinal seminoma. AB - Primary mediastinal seminoma is a rare neoplastic disease. Only 133 cases have been reported in the literature. Five patients with primary mediastinal seminoma had been treated at VGH from 1974 to 1986. All of them received exploratory thoracotomy but only two of them were resectable. Postoperative radiation therapy was given regardless of resection. One had additional chemotherapy due to nodal involvement. All five patients showed complete resolution and were alive and free of disease for an average follow-up period of 42.6 months (range, 5-82 months). So we conclude that mediastinal seminoma is a rare neoplastic disease and can be treated primarily by surgery. Irradiation can also induce complete remission and long term survival in those with unresectable tumors. PMID- 2766062 TI - [Harlequin fetus--a case report]. AB - A one-day-old male premature baby was born to a G4P4 mother with the gestation age of 30 weeks. His birth weight was 2000 gm. He was noted to be covered with a thick, armor-like skin which is split by deep fissures and makes the feature of Ectropion and eclabium. His nose was flattened, only the nostrils were visible, and the external ears were underdeveloped. The hands and feet appeared to be swollen and crumpled. The genital organ was covered with thick fissured skin and it was impossible to distinguish sex by external appearance. Three days after delivery, the patient died of respiratory distress. He was found normal through general laboratory and chromosome study. However, dermatohistology showed hyperkeratosis, focal parakeratosis and hypogranulosis. Pathology showed PDA (patent ductus arteriosus), enlarged thymus and congestion of internal organs. Its etiology and pathogenesis somehow remain unknown. We hereby reported this harlequin fetus, the most severe type of lamellar ichthyosis, and discussed its incidence, pathogenesis, pathohistology, prognosis and the recent development in treatment. PMID- 2766063 TI - [Meconium peritonitis complicated with Enterobacter aerogenes infection--a case report]. AB - Meconium peritonitis is an aseptic peritonitis that follows a perforation of the intestines in fetal life. It is a serious complication of intestinal perforation. This article reports a female newborn who was born with gestational age of 40 weeks and birth body weight of 3400 gm. She was admitted at age of 6 days, owing to persistent vomiting, abdominal distention, tachypnea and acrocyanosis since birth. The plain abdomen showed intra-abdominal calcification and intestinal distention. Under the impression of meconium peritonitis, she was treated aggressively with exploratory laparotomy, TPN and antibiotics. During operation, dense fibrous adhesions and agglutination of the intestine were found. But no intestinal perforation was noted. Culture of ascites isolated Enterobacter aerogenes. The patient's condition was gradually recovered and she was discharged at age of 32 days. According to the previous literature, meconium peritonitis is a relative rare disease with poor prognosis. So we would like to report this case. PMID- 2766064 TI - The establishment of a radioimmunoassay of calcitonin in human serum. AB - A sensitive sequential radioimmunoassay of calcitonin (CT) is described. Synthetic human CT was used for 125I-labelling and for preparation of anti-sera. The labelled hormone was purified by QUSO and P10 column. The specific activity of the purified 125I-CT was 39.8 Ci/g. The anti-sera was produced by immunization of guinea pigs with human synthetic CT which was conjugated with carbodiimide onto BSA (bovine serum albumin). Separation of free from antibody bound 125I labelled CT was performed using DCC precipitation. Standard curves of extracted plasma, extracted plasma plus human CT were parallel to the standard curve. Recovery of 62.5 to 500 pg/ml CT were in the range of 80.72 to 113.4%. The Scatchart plot of the binding data showed a straight line with a kd of 56 pM and Bmax of 35 pM. The specificity of the antiserum was good. The lower limit of detection was 31.25 pg/ml. Our results indicate that this assay system may be useful in both clinical use and research. PMID- 2766066 TI - [Acute peritoneal dialysis in low birth weight infants]. AB - Between September 1986 and April 1988, five low birth weight infants weighing 950 gm to 2250 gm required acute peritoneal dialysis due to acute anuric renal failure. Severe hyaline membrane disease was the most common explanation for acute renal failure. All infants had severe electrolytes imbalance and fluid retention with generalized edema, which increased ventilation requirements and severely limited fluid intake. The volume of each exchange varied between 10-20 ml/kg. Four of five infants had good ultrafiltration (3.52 +/- 2.43 ml/kg/hr, mean +/- SD). Ultrafiltration was not achieved in one due to poor peripheral perfusion. Electrolytes imbalance were corrected in all patients. Although four infants died, one case given up further care after renal failure had improved, and one died of septic shock after renal function had recovered. Only one infant survived with complete recovery of renal function. We believe that early dialysis is likely to reduce both morbidity and mortality of acute renal failure in low birth weight infants. PMID- 2766065 TI - Subacute thyroiditis--61 cases review. AB - To examine the hospitalized patients with available data suggesting subacute thyroiditis, we have reviewed 80 hospital charts over the last 11 years and the data demonstrated 61 patients (48 females, 13 males, Aged 22-75 years) had evidence of subacute thyroiditis clinically or pathologically. Fifty seven of those patients had the clinical manifestation of severe tenderness over the neck, and others were painless. The thyroid function test were abnormal in 53% (30/57) of cases. All had rapid sedimentation rate (46/46). The thyroid antibodies were positive in 26% (10/39) of cases. Sixteen patients received unnecessary thyroid operation and complicated with hypothyroidism with or without hypoparathyroidism in two cases. In conclusion, all patients with painful or painless goiter should be appreciated carefully with additional study such as aspiration cytology to avoid misdiagnosis and inappropriate management. PMID- 2766067 TI - [Urinary tract infection in children: clinical analysis and investigation]. AB - The urinary tract is a common site for bacterial infection in childhood. The most important aspect of urinary tract infection in childhood is that it can lead to severe and progressive renal disease. From March 1983 to March 1987, 63 cases of suspected urinary tract infection were collected in Taichung VGH. Among them only 24 cases reached our diagnostic criteria. Eight cases were within 2 years old, which all are male. Sixteen cases were beyond 2 years old, which the ratio of male to female is 1:1. Eighteen cases presented pyuria. Ten cases had recurrent infections, among which eight cases had urinary abnormalities. The most common pathogenic organism was E. coli (44%), then Proteus (24%), Klebsiella (16%), Pseudomonas (12%). The antibiotics sensitivity test revealed 95.7% were sensitive to gentamicin and amikacin, 81% to cephalothin, 56. 5% to sulfamethoxazole trimethoprim. Imaging studies revealed nine cases (37.5%) with urinary tract abnormalities, including vesicoureteral refluxes 6 cases, right multicystic kidney with left vesicoureteral reflux 1 case, horse-shoe kidney 1 case, atonic bladder 1 case. The ratio of male to female is 2:1. All seven cases of severe vesicoureteral refluxes received surgery. One case developed post-operative ureteral stricture. One case occurred unilateral chronic renal parenchymal disease one year later. Others were free of reflux and reinfection of urinary tract. PMID- 2766068 TI - [Gemfibrozil in the treatment of hyperlipidemia]. AB - An elevated serum cholesterol level is a well known major risk factor for developing atherosclerosis in general, and for coronary heart disease in particular. There are many lipid lowering agents currently available. We used gemfibrozil in twenty hyperlipidemic cases who failed to response to diet control for three months. They were thirteen males and seven females with their ages ranging from thirty to eighty-one year-old. They included ten diabetes, one nephrotic syndrome and nine pure hyperlipidemic patients. All cases received gemfibrozil 600mg twice daily for 4-12 weeks. Gemfibrozil caused an increase in HDL cholesterol. The reductions in serum level of total cholesterol, total cholesterol/HDL cholesterol, and triglyceride were found. Only one case developed mild gastrointestinal side effect. There was no other major side effects. PMID- 2766069 TI - Aicardi syndrome--a case report. AB - The Aicardi syndrome was first described by Aicardi in in 1965, which consisted of infantile spasms, defect of the corpus callosum, a characteristic lacunar chorioretinopathy, mental subnormality, and costovertebral anomalies. All patients have been female except one male case was reported in Australia. There have been approximately over 100 cases of the Aicardi syndrome reported in the literatures since 1965. The etiology of this syndrome is unknown. The most likely cause, however, is an X-linked mutational event with lethality in hemizygous male. We report a 43-day-old female infant with classic features of Aicardi syndrome including flexion spasms, dysgenesis of corpus callosum, microphthalmia, characteristic EEG, and characteristic lacunar chorioretinopathy. PMID- 2766070 TI - [Acute pneumonitis caused by inhalation of mercury vapor--report of a case]. AB - Two characteristics, volatility and biotransformation, make mercury somewhat unique as environmental toxicant, and make mercury poisoning as one of occupational diseases in the industry. Acute mercury vapor poisoning is a rare event. It often occurs during industrial accident or ignorant experiment. We report a case, a 28-year-old male waterworks technician, who developed dyspnea, cough, chest pain, metallic taste and ache in the whole body three hours after heating approximately 30 ml of liquid mercury during an experiment. Diarrhea with tarry stool occurred the next day. Chest roentgenogram revealed diffuse pulmonary infiltrates similar to pulmonary edema in both lungs, and was complicated by pneumomediastinum and subcutaneous emphysema later. The concentration of mercury in the plasma was over the toxic level. The urinary excretion of mercury greatly exceeded normal value. During hospitalization, the patient's liver and renal function tests were both normal. He was treated with penicillamine, 300 mg every six hours orally for 10 days in addition to a support treatment and oxygen therapy. He was discharged on the 15th hospital day with partial resolution of pulmonary infiltrates and was free of symptom. PMID- 2766071 TI - Seroepidemiologic study of rubella in selected Chinese female. AB - To have a better understanding of rubella seroepidemiology among female population in Taiwan, we report a serologic survey of 4030 examinations for 2030 school girls and 2000 pregnant women, using enzyme-linked immunosorbent assay for the detection of rubella specific IgG. RA 27/3 vaccines were given to susceptible volunteer students and postpartum women for the evaluation of vaccine efficiency and its side effects. The results showed that the rubella susceptible female among 8 to 22-year-old girl students was 44.97%, which was higher than expected, as most of them experienced the outbreak of rubella in 1977. The susceptibility rate among the pregnant women was 19.35%, which was also higher than expected for an age group having been through two outbreaks in the past. All the vaccinees showed good tolerance to the vaccine and the seroconversion rate was 100%. With such high susceptibility rate among women of child bearing age and girl students, plus the endemic property of rubella infection in Taiwan, we can expect a high risk of congenital rubella syndrome. Mass vaccination against rubella should be brought into effect immediately. PMID- 2766072 TI - Staging of cervical carcinoma: accuracy of magnetic resonance imaging and computed tomography. AB - A prospective study was undertaken to assess the ability of magnetic resonance imaging (MRI) to stage cervical carcinoma. Compared to computed tomography (CT), MRI showed a high degree of accuracy in correctly demonstrating involvement of the vagina, parametria and sidewalls, bladder, and lymph nodes but tended to overestimate disease in all of the categories studied. Large-scale studies comparing the two modalities are necessary because the most accurate staging of cervical carcinoma is crucial for selecting the best treatment protocols. PMID- 2766073 TI - Omental cakes in American Burkitt lymphoma. Computed tomography demonstration. AB - Diffuse tumor infiltration of the omentum or so-called omental "cakes" is well recognized on computed tomography (CT) and is usually associated with pelvic or gastrointestinal carcinoma. However, this has not been described in American Burkitt lymphoma despite frequent intraabdominal involvement in this disease. We report two cases of American Burkitt lymphoma in which omental cakes were demonstrated by CT. PMID- 2766074 TI - Occult lung carcinoma presenting with dysphagia. The value of computed tomography. AB - Dysphagia is a relatively uncommon presenting symptom of lung carcinoma that usually occurs in association with mediastinal adenopathy. However, a bronchogenic carcinoma will occasionally involve the esophagus by direct invasion. These central lesions can be difficult to visualize on chest radiographs and may not be detected by esophagoscopy or barium swallow. In such cases, a computed tomography scan of the thorax may suggest the correct diagnosis. PMID- 2766075 TI - Aggressive infantile fibromatosis. Pulmonary metastases documented by plain film and computed tomography. AB - Aggressive infantile fibromatosis, one of the juvenile fibromatoses, is generally considered a benign lesion, but it does tend to recur locally because of its invasive nature. Distant metastases are considered rare. This case report documents pulmonary metastases arising 2 years after resection of the primary lesion from the thigh of an infant. This is the seventh reported case of distant metastasis from aggressive infantile fibromatosis. Computed tomography of the original lesion as well as the metastases are presented. PMID- 2766076 TI - Magnetic resonance imaging and computed tomography findings in a patient with lymphomatoid granulomatosis. AB - A patient with lymphomatoid granulomatosis was examined with both computed tomography (CT) and magnetic resonance imaging (MRI). The CT and MRI character of the pulmonary lesions are described as well as the patient's course and progression to lymphoma. PMID- 2766077 TI - Extraosseous Ewing's sarcoma. Computed tomography evaluation before and after chemotherapy. AB - Fourteen patients with extraosseous Ewing's sarcoma were evaluated by computed tomography (CT) and conventional radiography. The sites of involvement were in the lower extremities (six cases), the chest wall (four), pelvis (two), and the paravertebral region (two). In seven cases, the initial contrast-enhanced CT disclosed a necrotic soft tissue mass in four, two of them with peripheral enhancement. In three cases, the mass was homogeneous and did not enhance. CT enabled us to detect the size of the mass, the integrity of adjacent bone and medullary cavity, and to determine the presence or absence of metastases. CT was useful for evaluation of the patients' tumor response to treatment. In three of four patients treated with chemotherapy, CT showed evidence of a dramatic initial response. In one patient who was resistant to chemotherapy, surgical methods were required. PMID- 2766078 TI - Treated invasive cervical carcinoma. Utility of computed tomography in distinguishing between skeletal metastases and radiation necrosis. AB - The bony pelvis should be carefully evaluated on computed tomography (CT) scans of the lower abdomen and pelvis performed for staging cervical cancer or for evaluating suspected recurrence. CT provides optimal imaging of the spine and pelvis, frequently providing a clinically relevant supplement to bone scan or plain film information. In a study of eight patients with skeletal metastases from cervical carcinoma and three cases of radiation osteitis, overlap existed in their imaging characteristics. Metastases were always lytic but nearby sclerotic areas from radiation were often present. Radiation osteitis may be lytic, sclerotic, or mixed, and both may avidly accumulate bone-scanning radiotracers. The absence of a soft tissue mass, slow progression, blastic elements, and sharply defined borders on CT suggest radiation necrosis. However, in some lesions within a radiation portal, biopsy or MRI may be required for final diagnosis. PMID- 2766079 TI - Computed tomography as a diagnostic aid in diabetic and other problem feet. AB - Determining whether osteomyelitis is present in patients with foot infections represents a significant diagnostic challenge. As bone uptake with nuclide scans can be affected by soft tissue infection, we performed computed tomography (CT) on seven patients to see if marrow or bone abnormalities could be seen and used to predict the presence or absence of osteomyelitis. The CT scans correctly predicted the presence or absence of osteomyelitis in all seven patients. Four patients had osteomyelitis and three patients did not. Nuclide bone scans had one false-positive and one false-negative result. In this small series, CT proved helpful in evaluating foot problems. PMID- 2766080 TI - Computed tomography demonstration of inferior lumbar (Petit's) hernia. AB - Inferior lumbar (Petit's) hernia is an uncommon condition resulting from a defect in the posterior abdominal wall. Such hernias may be difficult to diagnose on the basis of physical signs and symptoms. A case of unsuspected inferior lumbar hernia clearly demonstrated by computed tomography (CT) is presented. Computed tomography is useful in determining the size and contents of the hernia, permitting accurate diagnosis, and planning treatment. PMID- 2766082 TI - The future of Canadian ophthalmology. PMID- 2766081 TI - Radiology pathology conference. A 67-year-old man with a 1-week history of right upper quadrant pain radiating to the back. PMID- 2766083 TI - Eye movement perimetry in glaucoma. AB - Present-day computerized perimetry is often inaccurate and unreliable owing to the need to maintain central fixation over long periods while repressing the normal response to presentation of peripheral stimuli. We tested a new method of perimetry that does not require prolonged central fixation. During this test eye movements were encouraged on presentation of a peripheral target. Twenty-three eyes were studied with an Octopus perimeter, with a technician monitoring eye movements. The sensitivity was 100% and the specificity 23%. The low specificity was due to the technician's inability to accurately monitor small eye movements in the central 6 degrees field. If small eye movements are monitored accurately with an eye tracker, eye movement perimetry could become an alternative method to standard perimetry. PMID- 2766084 TI - Duane's retraction syndrome: southwestern Ontario experience. AB - We describe the clinical ocular and medical manifestations in 71 patients with Duane's retraction syndrome. We compare our results to those of recent studies, with special focus on the prevalence of anisometropia and amblyopia, found in 14% and 17% respectively. PMID- 2766085 TI - Relative afferent pupillary defects in multiple sclerosis. AB - Relative afferent pupillary defects were found in 69 of 386 patients (18%) seen by the author at the University of British Columbia Multiple Sclerosis Clinic between Feb. 1, 1985, and Apr. 30, 1987. Pupil defects were more common in patients with clinically definite multiple sclerosis, those with recent or unilateral optic neuritis and those with unilateral or asymmetric optic atrophy. A relative afferent pupillary defect was found in 15 patients with no history of optic neuritis, 5 patients with no optic atrophy and 2 patients with normal visual evoked potentials. The frequency of relative afferent pupillary defects after optic neuritis in this group of patients was much lower than that found in a previous study of patients who presented with optic neuritis. PMID- 2766086 TI - Possibly reduced prevalence of peripapillary crescents in ocular hypertension. AB - We studied optic disc photographs from 137 healthy subjects and 195 subjects with ocular hypertension. The prevalence of peripapillary crescents was lower among hyperopes than among myopes (p less than 0.05). Moreover, the ocular hypertensive subjects had a statistically significant tendency toward a hyperopic median refraction (p less than 0.01). In keeping with this, we observed a lower prevalence rate of crescents in the ocular hypertensive group (35%) than among the healthy subjects (41%). This difference is in the expected direction and magnitude if the absence of a crescent decreases the risk of glaucomatous damage from elevated intraocular pressure, but the number of subjects was too small to obtain statistical significance; however, the evidence is suggestive. Further study, such as in a large population survey or by comparison of two groups with matched genetic heritage, is needed to substantiate the relation between the presence of a crescent and increased risk of glaucomatous damage. PMID- 2766087 TI - Public attitudes toward donation of body parts, particularly the eye. AB - A survey of 595 metropolitan Toronto residents aged 16 years or older was done during 1986-87 to assess their interest in organ and tissue donation in general and their willingness to donate eyes in particular. Subjects were selected at random from the telephone directory and were interviewed on the telephone with a prepared questionnaire. Most of the respondents were aware of the value and types of organ and tissue transplantation. Although 63% expressed a willingness to donate body parts, only 37% had signed the organ donation portion of their driver's licence or an organ donor card. The respondents who were unwilling to donate body parts expressed certain deep-rooted anxieties and fears. More public education is needed to allay the fears and misunderstandings that remain in the minds of many potential donors. PMID- 2766088 TI - Canaliculitis caused by Mycobacterium chelonae after lacrimal intubation with silicone tubes. AB - Two and a half weeks after a 62-year-old man underwent bilateral nasolacrimal intubation with silicone tubes, canaliculitis and conjunctivitis developed. Cultures yielded Mycobacterium chelonae sensitive to amikacin. Successful therapy required removal of the tubes followed by intensive intravenous and topical chemotherapy. This is, to our knowledge, the first report of mycobacterial infection as a complication of lacrimal intubation. PMID- 2766089 TI - Abstracts of the Canadian Physiological Society. 21st winter meeting. January 14 18, 1989, Whistler, B.C. PMID- 2766090 TI - Ouabain prevents loss of autoregulation in rat pial arterioles caused by reoxygenation after a brief hypoxic episode. AB - Pial arteriolar diameter changes inversely with changes in systemic arterial blood pressure. Such changes are consistent with autoregulatory functions. These responses are reduced by a brief period of hypoxia followed by reoxygenation. By using an open cranial window preparation we assessed the changes in pial arteriolar diameters during blood pressure changes in rats induced by hemorrhage and reinfusion of blood, before and after a brief period of hypoxia. The slopes of the changes in pial arteriolar diameter as a function of mean arterial blood pressure were -0.47 +/- 0.26 micron/mmHg (mean +/- SD; 1 mmHg = 133.3 Pa) before hypoxia and -0.11 +/- 0.23 micron/mmHg after hypoxia in the untreated rats. In ouabain-treated rats, corresponding slopes were -0.42 +/- 0.24 and -0.46 +/- 0.22 micron/mmHg. The observed protective effects of ouabain might be a blockade of the Na-K pump in the sarcolemma of the vascular smooth muscle. PMID- 2766091 TI - Effects of verapamil on sympathetic tone in normal and chronic sinoaortic denervated conscious dogs. AB - Previous studies have shown that calcium channel blockers from the dihydropyridine group (such as nicardipine) induce an increase in sympathetic tone from a central origin in chronic sinoaortic-denervated (SAD) dogs. In the present study, we investigated to see if verapamil possesses such properties. The effects of acute injection of verapamil (0.2 mg/kg i.v.) were compared in normal and SAD conscious dogs. Verapamil induced a decrease in blood pressure in the two groups of animals, and an increase in heart rate and plasma catecholamines (noradrenaline and adrenaline) in normal but not in SAD dogs. Contrary to the dihydropyridine studies (nicardipine), we did not find any evidence for a centrally mediated sympathoexcitatory effect of verapamil in conscious SAD dogs. PMID- 2766092 TI - Altered peripheral noradrenergic activity in intact and sinoaortic denervated Dahl rats. AB - Development of salt-induced hypertension in Dahl salt-sensitive (S) rats is dependent on sympathetic overactivity which may be partially related to arterial baroreflex dysfunction and, therefore, is regionally selective. Our first experiment was designed to determine which regions have elevated sympathetic activity in Dahl S compared with Dahl salt-resistant (R) rats. Weanling (4-week old) female Dahl R and S rats were fed low or high salt diets (0.13% and 8% NaCl) until 10 weeks of age. Norepinephrine (NE) synthesis was blocked with alpha methyl-p-tyrosine, and the fractional decline of NE concentration was measured in various tissues. Dahl S rats with increases in both arterial pressure and left ventricular weight demonstrated increased NE turnover in the sinoatrial node, the atrial appendages, the cardiac ventricles, and the renal cortex. In all of these tissues except the cardiac ventricle, increases were associated with high salt intake. Our second experiment was designed to test if arterial baroreflex dysfunction could account for regional increases in sympathetic activity. Separate groups of Dahl R and S rats fed high salt were subjected to either sham surgery or sinoaortic baroreceptor denervation 1 week prior to turnover determinations. Sinoaortic baroreceptor denervation abolished differences in NE turnover between salt-fed Dahl R and S rats in the cardiac sinoatrial node and the atrial appendages, but not in the cardiac ventricles and the renal cortex. Sinoaortic baroreceptor denervation also abolished differences between salt-fed Dahl S and R rats in the spleen but not the duodenum.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2766094 TI - Programmed electrical stimulation-induced arrhythmias in isolated hearts from adult and senescent rats. AB - In isolated hearts from normal rats, we previously demonstrated an age-related increase of spontaneous ventricular arrhythmias. The aim of the present experiments was to test the possible effect of aging on ventricular arrhythmias induced by programmed electrical stimulation. Experiments were performed in isolated cardiac preparations of 6- and 24-month-old normal Wistar rat hearts. Programmed electrical stimulation (single or double premature stimuli following a stimuli train) was tested in isolated Langendorff perfused hearts during control perfusion, after left anterior descending coronary artery ligature and during global hypoxia. No significant differences were observed between adult and senescent hearts in the incidence of programmed electrical stimulation-induced ventricular arrhythmias during these three different situations. These experiments demonstrate that the cardiac "physiological" aging process is not associated with a greater propensity to programmed electrical stimulation-induced arrhythmias. PMID- 2766093 TI - Central noradrenergic activity in intact and sinoaortic denervated Dahl rats. AB - Lesions in forebrain areas richly innervated by noradrenergic terminals and involved in cardiovascular function reduce or prevent hypertension in the Dahl salt-sensitive (S) rats fed a high (H) salt diet. This led us to examine two questions. (1) Is the noradrenergic activity altered in discrete forebrain and brainstem areas of SH rats? (2) Are these changes in noradrenergic activity eliminated by sinoaortic denervation (SAD)? Studies were done in 10-week-old female SH and Dahl salt-resistant (RH) rats. Half of the rats in each group had SAD surgery 1 week prior to study. An index of norepinephrine (NE) turnover was determined by measuring the decline in tissue NE concentration 8 h after administering alpha-methyl-p-tyrosine, a NE synthesis blocker, to animals from each of four groups: sham-RH, SAD-RH, sham-SH, and SAD-SH (n = 18-20 per group). Various discrete brain areas were obtained using the "punch technique." In SH rats the index of NE turnover was increased in the median preoptic nucleus and decreased in the paraventricular nucleus compared with RH rats regardless of SAD. In contrast, in SH rats the index of NE turnover was increased in the supraoptic nucleus and locus ceruleus compared with RH rats; however, SAD-RH had greater turnover of NE at these sites than SAD-SH. In summary, changes in noradrenergic activity in the median preoptic nucleus and the paraventricular nucleus may be related to genetic predisposition to hypertension in SH rats. In contrast, changes in the locus ceruleus and the supraoptic nucleus of SH rats may be related to impaired baroreflexes and thereby contribute to hypertension. PMID- 2766095 TI - The effects of arginine vasopressin and epinephrine on lung liquid production in fetal goats. AB - The effects of arginine vasopressin (AVP) and epinephrine on lung liquid secretion were investigated in 67 acute fetal goats (116 days of gestation to term) with intact umbilical cords after caesarean section. Secretion was measured by an impermeant tracer technique. AVP was infused intravenously (1.6-39.2 mU/(kg.min); 2 h) into 26 fetuses. All fetuses below 130 days of gestation, except one, showed no response. All above 133 days reduced secretion, or turned to reabsorption, except at the lowest infusion rate. The effect persisted, and usually increased postinfusion. Expansion of the lungs with saline did not change the response. The percentage reductions were linearly related to the logarithm of the infusion rate (threshold, 1.42 mU/(kg.min]. The absolute reductions were linearly related to fetal weight. Epinephrine was infused intravenously (0.30 6.72 micrograms/(kg.min); 1-2 h) into 12 fetuses. All fetuses (118 days to term) reduced secretion or reabsorbed by the second hour. At the highest infusion rate, reabsorption was immediate; at the lowest, secretion increased slightly, then fell significantly in the second hour. Epinephrine acted at levels considered physiological at delivery in the sheep. AVP appears to act at plasma levels found in most vaginal deliveries; it may augment epinephrine-induced reabsorption during stress, and help long-term removal of lung fluid. PMID- 2766096 TI - Effects of hypoxia or hyperoxia on the lung of the chick embryo. AB - Newborn mammals in chronic hypoxia or hyperoxia experience, respectively, an increase or decrease in lung weight:body weight ratios, possibly because of the mechanical effect on the lung accompanying the ventilatory response. Because the avian lung does not expand or contract with the breathing cycle, we asked whether or not qualitatively similar changes could be observed in the lung of chick embryos incubated in hypoxic or hyperoxic conditions. Hypoxic embryos (10% O2, days 14-18) were smaller than controls incubated in normoxia, with higher hematocrit values and larger lung weight:body weight ratios (both wet and dry). Both the total pulmonary DNA (reflecting the cellular component) and the DNA concentration were decreased in hypoxia. Hyperoxic embryos (50% O2, days 7-18 or days 14-18) had lower hematocrit values and smaller dry lung weight:body weight ratios than controls, with similar DNA concentrations. In general, the differences from controls were more apparent in those embryos hyperoxic from day 14 to 18 of incubation than from day 7 to 18. We conclude that changes in lung weights qualitatively similar to those occurring in the chronically hypoxic or hyperoxic newborn mammal can also be observed in the hypoxic or hyperoxic chick embryo, suggesting that they are not necessarily caused by changes in mechanical stretch on the lung. PMID- 2766097 TI - Chronotropic function in spontaneously diabetic BB rats. AB - In the present study, isolated atrial function in spontaneously diabetic BB Wistar rats maintained for 12 weeks on a low (BB-LI) and a high (BB-HI) dosage of insulin was examined. Basal atrial rates were unchanged in the diabetic animals, relative to nondiabetic littermates (ND-BB) or Wistar controls. The BB-HI animals were euglycemic and responded to isoproterenol in a similar manner to the ND-BB and Wistar control animals. In contrast, BB-LI animals remained hyperglycemic and exhibited lower responses to the maximum chronotropic effects of isoproterenol. Plasma thyroid hormone levels were unaltered in the BB-diabetic animals. These results therefore reveal an absence of bradycardia and hypothyroidism in spontaneously diabetic BB rats, in contrast to previous observations in streptozotocin diabetic rats. However, a decrease in chronotropic response to isoproterenol was still noted in the BB-LI animals. These findings suggest that decreased positive chronotropic effect of isoproterenol in diabetes may not be a direct consequence of altered thyroid status. PMID- 2766098 TI - Acetylcholine inhibition in rabbit sinoatrial node is prevented by pertussis toxin. AB - The effects of acetylcholine (ACh) were examined on the naturally occurring slow action potentials (APs) of the isolated, organ-cultured, spontaneously beating sinoatrial (SA) node of the rabbit, in the presence or absence of pertussis toxin. The sensitivity of the SA-node preparations to ACh was not altered after 24 h incubation in organ culture medium. Activation of the muscarinic receptor hyperpolarized the cells and reduced the frequency of spontaneous activity at low concentrations (1 X 10(-6) and 3 X 10(-6) M), and completely abolished automaticity at higher concentrations (1 X 10(-5) M). However, stimulated activity was maintained. Increased concentrations (1 X 10(-4) M) of ACh completely abolished excitability. When the SA-node preparations were cultured in the presence of 0.5 micrograms/mL pertussis toxin, concentrations of ACh as high as 1 X 10(-4) M had no effect on the AP parameters and frequency of spontaneous activity. The results indicate that inactivation of G proteins by pertussis toxin caused inhibition of the ACh effects on the automaticity of the SA node. In addition, the blocking effect of ACh to the naturally occurring slow APs was also inhibited by pertussis toxin. We conclude that in the rabbit SA node, the effects of ACh on automaticity and on the slow channels are mediated by G protein. PMID- 2766099 TI - Effects of rearing temperature and level of food intake on organ size and tissue composition in piglets. AB - Piglets are particularly susceptible to cold and nutritional stress because of their poor insulation and low body fat. The purpose of this study was to examine how ambient temperature and level of food intake affect development in piglets. Thirty-two piglets were reared individually from 14 to 56 days of age in either a cold (10 degrees C) or a warm (35 degrees C) environment. Two feeding regimens, restricted and ad libitum, were used to assess the effect of food intake on organ mass. The ad libitum fed pigs in both environments gained weight at the same rate. Paired t-tests of organ weights of ad libitum fed pigs revealed that the mass of the heart, liver, kidneys, stomach, and small intestine, and total nitrogen and the length of the small intestine were greater in cold-reared than in warm-reared littermates of the same body weight. The skin mass and total fat mass, the lengths of the body, extremities, and individual long bones, and the total surface area were greater in warm-reared than in cold-reared individuals. A regression analysis showed body weight was the most important determinant of size for all tissues measured except fat mass, which was affected slightly more by rearing temperature. Of the organs and tissue components that differed in size in warm- and cold-reared pigs, heart, kidney, stomach, skin, nitrogen, and fat mass, and small intestine length and surface area were generally affected more by rearing temperature than by level of food intake. Liver and small intestine mass and femur length were affected more by level of food intake.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2766100 TI - Fentanyl decreases catecholamine metabolism measured by in vivo voltammetry in the rat locus coeruleus. AB - The objective of this study was to investigate under controlled conditions the effects of fentanyl on the rat locus coeruleus catechol oxidation current. Using differential normal pulse voltammetry combined with electrochemically treated carbon fiber electrodes to measure the catechol oxidation current, catecholamine metabolism can be reliably monitored. Male Sprague-Dawley rats weighing 500-600 g had carbon fiber electrodes implanted into the locus coeruleus under halothane - O2 - air anesthesia with controlled ventilation and muscle relaxation. Experiments consisted of four groups of rats given the following treatments: (A) saline (n = 6); (B) fentanyl, 10 micrograms.kg-1 i.v. (n = 6); (C) naloxone, 800 micrograms.kg-1 i.v. followed 2 min later by fentanyl, 10 micrograms.kg-1 (n = 5); (D) clonidine, 200 micrograms.kg-1 i.p. (n = 6). There was no significant change in the catechol oxidation current following saline. Fentanyl produced a significant (ANOVA, p less than 0.05) decrease in the catechol oxidation current (maximum 32 min postinjection was 75.8 +/- 4.6% of baseline). This decrease was prevented by a prior injection of naloxone. Clonidine produced a significant decrease in catechol oxidation current (maximum 40 min postinjection was 54.1 +/- 7.0% of baseline). Systolic blood pressure was significantly decreased following clonidine and there were no significant changes in arterial blood gases throughout the experiments. The alpha 2-adrenergic agonist clonidine and the opioid fentanyl produced a decrease in locus coeruleus catechol oxidation current measured by in vivo voltammetry, which monitors catecholamine turnover. PMID- 2766101 TI - Opposite effects of lidocaine and diltiazem on electrophysiologic alterations in acutely ischemic porcine myocardium. AB - To investigate the actions of lidocaine and diltiazem on the ischemic alterations associated with the onset of acute ischemic arrhythmias, the left anterior descending coronary artery was occluded for 6-min periods separated by 30 min of reperfusion, under control conditions and after injection of lidocaine (2.4-3.8 micrograms/mL of plasma) or diltiazem (390-510 ng/mL) in open-chest anesthetized pigs. Sixty-one unipolar electrograms were continuously recorded in the ischemic zone. Isochronal maps and isopotential maps were determined by computer analysis. The magnitude of beat-to-beat alternation of unipolar waveforms was described by the difference between the time integrals subtended by electrograms of consecutive beats. Activation times were prolonged by ischemia and the ST segment became elevated. Delay and ST elevation developed at a faster rate in the presence of lidocaine than under control conditions, but were reduced by diltiazem. ST-T alternation was not significantly different between control and lidocaine occlusions, but the incidence of negative T waves and that of ventricular tachycardia degenerating to fibrillation were higher in lidocaine occlusions than in control occlusions. In contrast, unipolar waveform alternation and negative T waves were virtually abolished by diltiazem, even at fast pacing rates (180-210 beats/min) at which diltiazem did not reduce ST elevation. Ventricular arrhythmias also were abolished by diltiazem. Thus, lidocaine and diltiazem produce opposite effects on the ischemic alterations most closely associated with the initiating mechanism of tachycardia. This could be related to differences between these drugs with regard to their actions on transmembrane currents during repolarization. PMID- 2766102 TI - Frequency- and voltage-dependent effects of disopyramide in canine Purkinje fibers. AB - The voltage- and frequency-dependent blocking actions of disopyramide were assessed in canine Purkinje fibers within the framework of concentrations, membrane potentials, and heart rates which have relevance to the therapeutic actions of this drug. Vmax was used to assess the magnitude of sodium channel block. Disopyramide produced a concentration- and rate-dependent increase in the magnitude and kinetics of Vmax depression. Effects on activation time (used as an estimate of drug effect on conduction) were exactly analogous to effects on Vmax. A concentration-dependent increase in tonic block was also observed. Despite significant increases in tonic block at more depolarized potentials, rate dependent block increased only marginally with membrane potential over the range of potentials in which propagated action potentials occur. Increases in extracellular potassium concentration accentuated drug effect on Vmax but attenuated drug effect on action potential duration. Recovery from rate-dependent block followed two exponential processes with time constants of 689 +/- 535 ms and 15.7 +/- 2.7 s. The latter component represents dissociation of drug from its binding site and the former probably represents recovery from slow inactivation. A concentration-dependent increase in the amplitude of the first component suggested that disopyramide may promote slow inactivation. There was less than 5% recovery from block during intervals equivalent to clinical diastole. Thus, depression of beats of all degrees of prematurity was similar to that of basic drive beats. Prolongation of action potential duration by therapeutic concentrations of drug following a long quiescent interval was minimal. However, profound lengthening of action potential duration occurred following washout of drug effect at a time when Vmax depression had reverted to normal, suggesting that binding of disopyramide to potassium channels may not be readily reversed. Variable effects on action potential duration may thus be attributed to a block of the window current flowing during the action potential being partially or over balanced by block of potassium channels. Purkinje fiber refractoriness was prolonged in a frequency-dependent manner. Disopyramide did not significantly alter the effective refractory period of basic beats but did increase the effective refractory period of sequential tightly coupled extra stimuli. The results can account for the antiarrhythmic actions of disopyramide during a rapid tachycardia and prevention of its initiation by programmed electrical stimulation. PMID- 2766103 TI - Intrinsic origin of atrioventricular nodal functional properties in rabbits. AB - The goal of the present study was to document the intrinsic origin of atrioventricular nodal functional properties (recovery time, facilitation, and fatigue) in two groups of six superfused isolated rabbit heart preparations. These properties were determined from recovery curves (A2H2 versus H1A2 intervals) obtained with previously defined periodic premature stimulation sequences performed before and after autonomic blockade demonstrated effective with the injection of agonists. In group 1 preparations, the muscarinic cholinergic and beta-adrenergic receptors were blocked with atropine (1 mg/L) and propranolol (1 mg/L), respectively. The blockade reduced the facilitation and increased the fatigue by the direct membranous effect of propranolol. To avoid this effect in group 2 preparations, propranolol was replaced by sotalol (5 mg/L), which in combination with atropine altered neither the presence nor the magnitude of the functional properties. These results show that the origin of the three nodal functional properties is independent from the autonomic nervous system. PMID- 2766104 TI - Effects of hepatic blood flow on hepatic ethanol kinetics measured in cats and predicted from the parallel tube model. AB - In cats anesthetized with pentobarbital, a long-circuit technique was used to measure hepatic blood flow while portal flow was varied from 0 to 300% of normal in random steps. Arterial, portal, and hepatic venous blood samples were analyzed for ethanol concentrations during continuous infusion of ethanol (20 mumol/(min.kg body weight) into the reservoir. Measured values for logarithmic mean sinusoidal ethanol concentration, hepatic venous ethanol concentration, hepatic ethanol uptake, and ethanol extraction were compared with the values predicted by the parallel tube model for hepatic uptake of substrates using Vmax and Km determined in each cat at the start of the experiment. Measured and predicted values were very similar at all blood flows above 65% control, but statistical regression analysis indicated a small but highly significant deviation of the measured values from the predicted values. At low flows, measured values of logarithmic mean sinusoidal and hepatic venous concentrations markedly exceeded the predicted values in most cats. The results indicate that the parallel tube model, which assumes all sinusoids are identical and equally perfused, provides a useful approximation for the effects of hepatic blood flow on hepatic ethanol kinetics except at low flows. However, there appears to be a significant degree of sinusoidal heterogeneity that results in a better fit to the distributed model. Our previously reported data for hepatic galactose uptake followed a similar pattern when reanalyzed in this more rigorous way. PMID- 2766105 TI - Acetate-induced depression of electrical and contractile activity in normoxic and hypoxic guinea pig papillary muscle. AB - The action potential configuration, developed tension, and resting tension were monitored in normoxic and hypoxic guinea pig papillary muscles superfused with solutions containing no substrate, glucose, or acetate (1-10 mM). In normoxic muscle, acetate provoked a concentration-dependent transient depression of the action potential duration and force of contraction, depression was maximal after 10-30 min, and recovery was complete after 90-120 min. In hypoxic muscle, acetate accelerated functional rundown (action potential shortening, decline of developed tension, increase in resting tension). Because rundown in hypoxic muscle was sensitive to factors affecting glycolysis (moderated by external glucose; accentuated by 2-deoxyglucose), the accentuated rundown with acetate may be accounted for by a partial block of glycolysis. However, block of glycolysis cannot explain the acetate-induced transient depression in normoxic muscle, since the depression was enhanced in normoxic muscle with 2-deoxyglucose-blocked glycolysis. We suggest that the transient depression is due to a transient depression of high energy nucleotides with consequent effects on ionic currents. PMID- 2766106 TI - Electrical, contractile, and ultrastructural properties of adult rat and guinea pig ventricular myocytes in long-term primary cultures. AB - The electrical, contractile, and morphological characteristics of ventricular myocytes isolated from adult rat and guinea-pig hearts and maintained in cultures for 7-24 days are described. These cultured cells form different networks, depending on the species, when plated at certain density and maintained under specific conditions; the cells within the networks appear to be electrically coupled. Their resting and action potentials, their contractile activity (shortenings), and their pharmacological responses qualitatively resemble those of freshly isolated myocytes. Cultured cells from both species exhibit near normal ultrastructural organization of sarcomeres, myofilaments, and mitochondria, as well as formation of intercellular contacts, or gap junctions. These data indicate that cultured adult rat and guinea-pig myocardial cells that make intercellular contacts possess electrical, contractile, and ultrastructural properties and responses to pharmacological agents similar to those of the respective adult myocardial tissues and the functionally intact freshly isolated cells from which these cultures are prepared. Thus, this study indicates that long-term cultures (7-24 days) of networked cardiac myocytes could be used as a valuable experimental model in various investigations of excitation-contraction coupling in cardiac muscle. PMID- 2766107 TI - Reflected reentry, delayed conduction, and electrotonic inhibition in segmentally depressed atrial tissues. AB - Reflection is a subclass of reentrant cardiac arrhythmias in which reexcitation of the heart occurs as a result of to and fro electrotonically mediated transmission of impulses across a narrow zone of impaired conductivity. Although relatively well characterized in ventricular tissues, the reflection mechanism has not been studied in atrial tissues. In this study we examine the possibility of reflected reentry in segmentally depressed atrial tissues and evaluate conduction characteristics in these preparations. Narrow strips of atrial pectinate muscle or crista terminalis (canine and calf) were placed in a three chambered bath and the central segment was superfused with an isotonic sucrose solution or an "ischemic" Tyrode's solution. Proximal to distal conduction across the 1.0- to 1.2-mm wide ischemic gap showed step delays as long as 210 ms. Reflected reentry was readily demonstrable when prominent step delays occurred during anterograde conduction of the impulse across the gap. Progressive acceleration of the stimulation rate resulted in progressively greater impairment of anterograde conduction until complete block occurred. The incidence and patterns of reflected reentry were therefore a sensitive function of the stimulation rate. Other features exhibited by these preparations include a slow recovery of excitability following the action potential, postrepolarization refractoriness, and electrotonic inhibition and summation. Our data suggest that the characteristics of conduction and reflection in segmentally depressed atrial tissues are qualitatively similar to those in ventricular tissues. The presence of electrotonic inhibition in atrial may also help to explain the functionally inexcitable zone seen in the vortex of the leading circle model of atrial flutter. PMID- 2766108 TI - Arrhythmic effects of norepinephrine in a model of cardiac ischemia and reperfusion. AB - The aim of this study was to assess the direct effects of norepinephrine on mechanisms of arrhythmia induced by conditions of ischemia followed by reperfusion. Isolated canine Purkinje fiber-papillary muscle preparations were studied using standard microelectrode techniques. Tissues were superfused for 40 min with a solution simulating "ischemia" (i.e., hypoxic, acidotic, elevated lactate, and zero substrate) and then "reperfused" for 60 min. Ischemia produced a moderate loss of membrane potential in both tissues. Reperfusion resulted in rapid polarization of the tissues, which was accompanied by oscillatory afterpotentials and aftercontractions in 6 of 12 and 4 of 12 Purkinje fibers, respectively. This was followed by a progressive loss of membrane potential and inexcitability in Purkinje fibers. Recovery was associated with activity resembling depolarization-induced automaticity in 4 of 12 fibers. Addition of norepinephrine (0.5 microM) to the ischemic and reperfusion solutions altered primarily the reperfusion responses. Oscillatory afterpotentials and aftercontractions were larger and occurred in 8 of 8 and 6 of 8 Purkinje fibers, respectively. Norepinephrine also prevented or blunted the progressive depolarization to inexcitability in Purkinje tissues and increased automaticity occurring at low (depolarization-induced automaticity) and more polarized membrane potentials (enhanced normal pacemaker activity). This study demonstrates that norepinephrine exacerbates several potential mechanisms of arrhythmia elicited by reperfusion in canine Purkinje tissues. PMID- 2766109 TI - A direct role of endogenous prostaglandins in reperfusion-induced cardiac arrhythmias. AB - The possible role of prostaglandins (PG) in arrhythmias associated with ischemia and reperfusion was studied in isolated, superfused canine Purkinje tissues. Ischemic conditions caused partial depolarization and decrease of excitability. Neither inhibition of PG synthesis (ibuprofen, 30 micrograms/mL) nor addition of exogenous PGF2 alpha (1 ng/mL) modified responses to "ischemia." Reperfusion with normal Tyrode's solution stimulated PG production (measured as 6-keto-PGF1 alpha) and induced a series of electrophysiological events. Under control conditions, Purkinje fibres rapidly repolarized. Subsequently, these tissues began to depolarize and oscillatory afterpotentials appeared. Purkinje tissues depolarized further and became temporarily inexcitable. Return of activity was associated with depolarization-induced automaticity. Ibuprofen prevented reperfusion stimulated PG release. Ibuprofen also increased the magnitude of early repolarization and greatly attenuated subsequent depolarization. Depolarization induced automaticity was not observed under these conditions; however, oscillatory afterpotentials were not abolished by ibuprofen. Addition of PGF2 alpha to "ischemic" and reperfusion solutions in the presence of ibuprofen restored the arrhythmogenic responses. We conclude that release of endogenous prostaglandins contributes to electrophysiological changes elicited by reperfusion in canine Purkinje fibres. PMID- 2766111 TI - The protective effect of vagus nerve stimulation on catecholamine-halothane induced ventricular fibrillation in dogs. AB - Parasympathetic neural activity modulates some ventricular arrhythmias in man. Therefore, a canine model of arrhythmias produced by the interaction of halothane and catecholamines was used to study the effects of vagal stimulation on the induction of ventricular fibrillation. The dose of catecholamine required to induce ventricular fibrillation was determined during a constant heart rate. Vagal stimulation reversibly raised the norepinephrine dose that produced ventricular fibrillation from 16.4 +/- 2.4 to 30.0 +/- 3.8 micrograms (p less than 0.001, n = 10), and the epinephrine dose from 15.5 +/- 2.0 to 22.5 +/- 2.6 micrograms (p less than 0.001, n = 5). Following atropine, vagal stimulation failed to raise the threshold dose of norepinephrine (16.8 +/- 2.4 vs. 18.3 +/- 3.3 micrograms, nonsignificant, n = 6) or epinephrine (15.5 +/- 2.0 vs. 16.0 +/- 2.3 micrograms, nonsignificant, n = 5). Ligation of the cervical vagus nerves did not affect the epinephrine threshold dose (16.3 +/- 3.3 vs. 17.5 +/- 2.7 micrograms, nonsignificant, n = 5). Following elevation of basal vagal tone by morphine premedication, the norepinephrine threshold of 53.0 +/- 9.2 micrograms declined by a nonsignificant amount to 46.5 +/- 11.5 micrograms after vagotomy (nonsignificant, n = 5). Thus resting vagal tone does not prevent catecholamine halothane-induced ventricular fibrillation, whereas increasing vagal tone by electrical stimulation substantially protects against this arrhythmia. The protection is mediated through a muscarinic cholinergic receptor. PMID- 2766110 TI - Effects of K-channel blockers, calcium, and verapamil suggest different pacemaker mechanisms in cultured neonatal rat and embryonic chick ventricle cells. AB - We compared the determinants of spontaneous activity in explanted neonatal (2-day old) rat ventricle cells and in reaggregates derived from 15-day-old chick embryos. We studied the beating rate with an optical recording method and the underlying electrical activity with glass microelectrodes using the K current blockers cesium (Cs) and tetraethylammonium, varied Ca concentrations, and the Ca antagonist verapamil. In the rat (i) Cs increased the beating rate that was mediated by an increase in the slope of the diastolic potential. (ii) Ca increased the beating rate dramatically at low and medium concentrations to decrease it again at 8 mM Cao. This increase in the beating rate was mediated by an increase of the slope of the diastolic depolarization. (iii) The beating rate decreased with verapamil at concentrations between 0.5 and 2.0 microM. The effects of Cs and Ca suggest that an increase in net inward current (block of IK1) underlies the positive chronotropic effect of Cs and that the pacemaker mechanism is determined by a Ca inward current or an IT1 type current modulated by variations of Cai. In the chick reaggregates (i) Cs and tetraethylammonium decreased the beating rate that was mainly brought about by a decrease in the slope of diastolic depolarization. (ii) Ca increased the beating rate but to a lesser degree than in the rat and there was no decrease of the beating rate at higher concentrations. (iii) The increase in the beating rate was not mediated by an increase in the slope of the diastolic potential but mainly by a depolarization of the maximum diastolic potential. (iv) Verapamil inhibited electrogenesis before any change in the diastolic potential was evident. The negative chronotropic effect of Cs and tetraethylammonium is compatible with the notion that a voltage- and time-dependent K current was inhibited and that this current determines the pacemaker. Moreover, the Ca component of the pacemaker mechanism in explanted rat ventricle cells resembles either that of the sinoatrial node or represents triggered activity. PMID- 2766112 TI - Rain Man. PMID- 2766113 TI - An act of suicide: did you hear the cry? PMID- 2766114 TI - Schizophrenia and the family. PMID- 2766116 TI - Characterization of albumin-binding properties of Peptostreptococcus magnus. AB - A Peptostreptococcus magnus strain demonstrated binding activity for albumin preparations from humans, mice, and dogs, but not for rabbit or bovine albumin. The albumin binding site appeared to be heat stable and of protein nature. Treatment of P. magnus cells with trypsin under specified conditions enhanced this albumin binding. Electron micrographs and kinetic analyses revealed that this enhancement was the result of the removal of some cell wall associated proteins leading to a higher binding affinity without significant changes in binding site numbers. The albumin-binding proteins could be readily solubilized and purified by affinity chromatography. Upon gel electrophoresis the molecular mass of the albumin-binding proteins was estimated as 130 kilodaltons. PMID- 2766115 TI - Autism. PMID- 2766117 TI - Interaction between hydrogenase, nitrogenase, and respiratory activities in a Frankia isolate from Alnus rubra. AB - H2 uptake and H2-supported O2 uptake were measured in N2-fixing cultures of Frankia strain ArI3 isolated from root nodules of Alnus rubra. H2 uptake by intact cells was O2 dependent and maximum rates were observed at ambient O2 concentrations. No hydrogenase activity could be detected in NH4+-grown, undifferentiated filaments cultured aerobically indicating that uptake hydrogenase activity was associated with the vesicles, the cellular site of nitrogen fixation in Frankia. Hydrogenase activity was inhibited by acetylene but inhibition could be alleviated by pretreatment with H2. H2 stimulated acetylene reduction at supraoptimal but not suboptimal O2 concentrations. These results suggest that uptake hydrogenase activity in ArI3 may play a role in O2 protection of nitrogenase, especially under conditions of carbon limitation. PMID- 2766118 TI - Factors affecting the colonization of isolated rabbit intestinal epithelial cells by Vibrio cholerae 01 in vitro. AB - The adhesive capability of Vibrio cholerae 01 strains to isolated rabbit intestinal epithelial cells was maximally expressed when the bacteria were grown in synthetic broth and was enhanced by the presence of Ca2+ in the growth media. N-Acetyl-D-glucosamine could inhibit the adhesion of the bacteria to rabbit intestinal epithelial cells as could lipopolysaccharide O-antigen from Vibrio cholerae 01 and lectin from Triticum vulgaris. Since the lipopolysaccharide is known to contain N-acetyl-D-glucosamine and because the lectin from Triticum vulgaris shows specificity for this sugar, it is probable that N-acetyl-D glucosamine is actively involved in the adhesion of Vibrio cholerae 01 to isolated rabbit intestinal epithelial cells. PMID- 2766119 TI - Characterization of a monoclonal antibody against active pectate lyase from Erwinia carotovora. AB - A monoclonal antibody (2E2) produced against pectate lyase from Erwinia carotovora ssp. carotovora reacted with a 41- and a 44-kilodaltion protein on Western blots of concentrated Erwinia culture supernatants resolved by sodium dodecyl sulfate - polyacrylamide gel electrophoresis. It was unequivocally shown that monoclonal 2E2 reacted with an active form of pectate lyase by affinity purifying the antigen with the monoclonal. The affinity-purified antigen was enzymatically active and moved as a single protein band in a nonequilibrium isoelectric focusing gel. Monoclonal 2E2 reacted with the pectate lyases of a diverse range of E. carotovora ssp. carotovora, ssp. atroseptica, and ssp. betavasculorum strains, as well as with one of three strains of E. chrysanthemi. The electrophoretic mobility of the major protein (44 kilodaltons) that reacted with 2E2 was identical within a subspecies but differed among subspecies. PMID- 2766120 TI - Colony counts and characterization of bacteria adherent to the rumen wall and desquamated epithelial cells in conventional young lambs. AB - Characterization and enumeration of the adherent epimural community of the rumen wall of young, conventionally reared lambs were carried out from 2 to 21 days after birth. Three hundred strains were isolated by anaerobic procedures from three sites: dorsal, ventral, and caudal sacs, and from the sloughed epithelial cells. The population of epimural bacteria was very dense from the first days of the lamb's life. This population increased slightly with age. During the first week the counts were similar in the dorsal and ventral sacs, but they were 10 to 100 times lower in the caudal sac. Total counts for anaerobic bacteria were higher than the counts for aerobic bacteria. The isolated strains were distributed into 19 groups: 11 groups included aerotolerant strains, and 8 others, strictly anaerobic strains. During the first week the facultative microflora was mainly composed of Escherichia coli and Streptococci. Later, the epimural community was more complex and included Staphyloccus, Micrococcus, and Gaffkya. The strictly anaerobic microflora was mainly composed of Clostridium, Peptostreptococcus, Veillonella, Propionibacterium, and Acidaminococcus. Some of these strains appeared to be similar to those previously isolated from the rumen fluid of young lambs; however, the genera Micrococcus, Veillonella, Gaffkya, and Acidaminococcus, and E. coli seemed to be specific of the rumen wall tissues. PMID- 2766121 TI - Purification and partial characterization of a cytotonic enterotoxin produced by Aeromonas hydrophila. AB - This report describes the purification and partial characterization of a cytotonic enterotoxin produced by a human diarrheal isolate (SSU) of Aeromonas hydrophila. The extracellular enterotoxin was purified by (NH4)2SO4 precipitation, hydrophobic column chromatography, and chromatofocusing. The highly purified enterotoxin exhibited a molecular mass of 44 kDa and an isoelectric point in the range of 4.3 - 5.5 as determined by chromatofocusing. Western blot analysis using Aeromonas anti-enterotoxin revealed a single band at 44 kDa; however, cholera antitoxin failed to detect the enterotoxin antigen. This non-cholera toxin cross-reactive (non-CTC) enterotoxin was biologically active in vivo as determined by rabbit ligated ileal loop and rabbit skin vascular permeability assays. Biological activity also was in vitro by this toxin as measured by the elongation of Chinese hamster ovary (CHO) cells. The enterotoxic activity associated with this molecule was neutralized completely by homologous antibodies but not by cholera antitoxin. The purified toxin preparation was free of hemolytic and cytotoxic activities as determined by its inability to lyse rabbit red blood cells or damage CHO cells, respectively. Furthermore, this toxin induced the elevation of cAMP in CHO cells suggesting thereby that the mechanism of action of Aeromonas non-CTC enterotoxin may be similar to heat-labile enterotoxins of Escherichia coli and Vibrio cholerae. PMID- 2766122 TI - Trends in blood pressure, osmolality and electrolytes after subarachnoid hemorrhage from aneurysms. AB - Daily trends in blood pressure, osmolality and electrolytes were analyzed in a series of 173 operated aneurysm cases who had subarachnoid hemorrhage (SAH) and were admitted within 4 days of the ictus. High blood pressure was associated with a greater risk of mortality and the development of clinically significant vasospasm (VSP). High osmolality shortly after admission was related to mortality but not VSP. Changes in sodium and potassium had no obvious relationship to mortality or VSP. PMID- 2766123 TI - Regional metal concentrations in Parkinson's disease, other chronic neurological diseases, and control brains. AB - Metal deficiency or toxicity states have been recognized as a cause of several neurological disorders and are suspected in others. We analyzed four brain regions (frontal cortex, caudate nucleus, substantia nigra, and cerebellum) in 36 human brains for concentrations of 24 metals (Ag, Al, As, B, Be, Ca, Cd, Co, Cr, Cu, Fe, K, Pb, Mg, Mn, Mo, Na, Ni, P, Se, Ti, V, W, Zn). Regional metal concentrations, measured using atomic absorption and atomic emission spectroscopy, were compared between 9 Parkinson's disease (PD) brains, 15 brains from patients with other chronic neurological diseases, and 12 control brains. No significant metal concentration differences were noted between brains from PD and other chronic neurologic disease. However, parkinsonian brains (PD and parkinsonism secondary to neurofibrillary tangle disease) showed lower concentrations of magnesium in the caudate nucleus and copper in the substantia nigra than control brains. These findings may represent an etiologically important clue to parkinsonism. PMID- 2766124 TI - The effects of body weight support on the locomotor pattern of spastic paretic patients. AB - The effects of mechanically supporting a percentage of body weight on the gait pattern of spastic paretic subjects during treadmill locomotion was investigated. Electromyographic (EMG), joint angular displacement and temporal distance data were simultaneously recorded while 7 spastic paretic subjects walked at 0% and 40% body weight support (BWS) at their maximal comfortable treadmill speed. Forty percent BWS produced a general decrease in EMG mean burst amplitude for the lower limb muscles investigated with instances of more appropriate EMG timing in relation to the gait cycle. The joint angular displacement data at 40% BWS revealed straighter trunk and knee alignment during the weight bearing phase especially at initial foot-floor contact and midstance. An increase in single limb support time and a decrease in percentage total double support time were evident at 40% BWS. An increase in stride length and maximum comfortable walking speed was also seen with BWS. The use of BWS during treadmill locomotion as a therapeutic approach to retrain gait in neurologically impaired patients is discussed. PMID- 2766125 TI - Multiple electrodes for detecting spikes in partial complex seizures. AB - The contribution of various electroencephalographic electrodes in detecting spikes from patients with seizures of suspected anterior temporal origin was prospectively studied with a standard protocol. The following electrodes were studied: International Standard 10-20 positions F7-8 and A1-2, sphenoidal (SP), nasopharyngeal (NP), anterior temporal (T1-2), mandibular notch surface (MNS), and mandibular notch subdermal (MNSD). Twenty patients were recorded of whom 16 demonstrated anterior temporal spikes. There was no difference in the number of spikes detected by SP, MNS, MNSD, or T1-2 electrodes (p less than 0.05); however these electrodes detected significantly more spikes than NP, F7-8, or A1-2. The SP electrode recorded spikes of highest amplitude (p less than 0.05). We conclude that for patients suspected of having seizures of anterior temporal origin, (1) a substantial number of spikes will be missed if only the International Standard electrode system is employed; (2) in comparison to SP electrodes the non-invasive and easily applied MNS or T1-2 electrodes will detect almost all spikes and should be used in outpatient EEG recordings; (3) NP electrodes provide no information that cannot be obtained by more reliable and better tolerated electrodes. PMID- 2766126 TI - HTLV-1 associated myelopathy in Canada. AB - We report the clinical and laboratory findings of six Canadian patients with progressive myelopathy associated with HTLV-1 infection. The diagnosis was suspected on clinical grounds and supported by serological studies and positive gene amplification. Only five had emigrated from an area endemic for HTLV-1 infection. Tropical spastic paraparesis should be considered in all patients with myelopathy, even those without standard serological markers of HTLV-1 infection. The pathogenesis of this condition and the serological and molecular biological means by which this diagnosis can be made are reviewed. PMID- 2766127 TI - Pediatric head injury caused by off-road vehicle accidents. AB - Morbidity and mortality from pediatric head injuries associated with the use of off-road vehicles are increasing. We reviewed all such injuries admitted to acute care hospitals in the two largest urban centers in Manitoba between April 1979 and August 1986. Of 375 injured children, 83 suffered head injury, 70 boys and 13 girls. Ages ranged from 2 to 15 years, with a mean of 10.4 years. Head injury was defined as any injury involving face, scalp or nervous system. Dirtbikes were implicated in 34 accidents, snowmobiles in 28, 3-wheel ATV's in 19, and 4-wheel ATV's in 2. About 85% of accidents occurred in a rural setting. Loss of vehicle control was the most common cause of injury. Alcohol or drug abuse were not factors. Fifty (60.2%) patients suffered loss of consciousness, prolonged in 6 (7.2%). All head-injured children also suffered at least one associated injury, mainly involving the musculoskeletal system. Associated spinal injury occurred in 18%. The average hospital stay was 13 days. Three (3.6%) patients died as a result of head injury. PMID- 2766128 TI - Pure motor stroke due to vertebral artery dissection. AB - A 39-year-old man presented with a pure motor stroke 9 days after cervical chiropractic manipulation. Computerised tomographic scanning showed a pontine infarct. Cerebral angiography showed changes consistent with the diagnosis of bilateral vertebral artery dissection. It is postulated that the infarct resulted from artery-to-artery embolism. PMID- 2766129 TI - Distal sciatic nerve compression by a popliteal artery aneurysm. AB - A 77-year-old man developed progressive sensory and motor symptoms in the right lower leg. Examination showed neurological deficits in the distribution of the right tibial and common peroneal nerves. Swellings in both popliteal fossae were palpated. Investigation showed these to be large thrombosed aneurysms. On surgical examination on the right, the aneurysm was found to be compressing the distal sciatic nerve. PMID- 2766130 TI - Chronic aseptic meningitis in a patient with systemic lupus erythematosus. AB - Chronic aseptic meningitis is a rare manifestation of systemic lupus erythematosus. It may occur early in the course of the disease and sometimes may be the initial symptom. We report a patient with chronic aseptic meningitis associated with systemic lupus erythematosus. Magnetic resonance imaging showed several ischemic lesions and an appearance which was compatible with chronic inflammation of the ependyma of the lateral ventricles. PMID- 2766131 TI - Young age parkinsonism and common drugs. PMID- 2766132 TI - Monoclonal antibodies--gazing into the submicroscopic. PMID- 2766133 TI - Ethics of funding clinical investigation. PMID- 2766134 TI - Doctor or mister? PMID- 2766135 TI - Rupture of the diaphragm. PMID- 2766136 TI - Does the surgical trauma of "exploratory thoracotomy" affect survival of patients with bronchogenic carcinoma? AB - A retrospective review was carried out to assess the possible adverse immunosuppressive effect of exploratory thoracotomy on the survival of patients with non-small cell carcinoma of the lung with N2 nodal metastases. Between 1960 and 1982, 48 patients with non-small cell bronchogenic carcinoma underwent exploratory thoracotomy; lung resection was not done because mediastinal lymph nodes were involved. The survival of these patients was compared with that of 64 patients in whom N2 disease was established by mediastinoscopy alone and who did not undergo thoracotomy. There were no significant differences with respect to age, sex, tumour type and adjunctive radiotherapy. There were slightly more T4 tumours in the thoracotomy group (50% versus 30%). The hospital stay was longer in the thoracotomy group (2.3 +/- 1.1 versus 1.5 +/- 0.9 months [mean +/- SD]). However, follow-up studies showed that, although these patients had a more traumatic procedure, the actuarial survival curves for the two groups were virtually identical, and the 12-month survival rates were less than 20% for both groups. The median survival was 6.0 months for the thoracotomy group and 7.0 months for the mediastinoscopy group. These findings failed to demonstrate an adverse immunosuppressive effect of thoracotomy on lung cancer patients. PMID- 2766137 TI - Omental pedicle grafting in the treatment of poststernotomy mediastinitis. AB - Mediastinitis after median sternotomy may be life-threatening. It should be managed by providing adequate mediastinal drainage, removing all foreign material (including infected and dead tissues) and obliterating any dead space. Obliterating dead space may be difficult using the usual method of creating a vacuum with large-bore tubes. Alternative methods consist of muscle or omental transpositions. The authors describe the cases of two men who had mediastinitis, 1 week and 3 months respectively, after coronary artery bypass grafting. In both cases, the mediastinitis was treated successfully by omental pedicle grafting. From their experience, the authors recommend omental grafting as a method of obliterating a large mediastinal dead space when the sternal edges can be approximated but the space cannot be closed by conventional methods. PMID- 2766138 TI - Catheter drainage of the pericardium: its safety and efficacy. AB - A retrospective chart review identified 46 consecutive patients who underwent catheter drainage of the pericardium over 3 years. Cardiac tamponade was present in the majority of patients, and the underlying cause was tumour metastasis in 72%. Pericardial catheterization was accomplished by the Seldinger technique using the subxiphoid approach. Catheter insertion was successful in 42 of the 46 patients, and in only 1 was there a serious complication. The mean duration of catheter drainage was 3 days. The pericardial space was successfully drained in all but one patient, who subsequently required surgery. Intrapericardial chemotherapy was administered in 27 patients. There was no instance of catheter associated sepsis. Supraventricular arrhythmias occurred in 19% of patients, but all were managed medically. There were no late complications attributable to the period of drainage. The authors conclude that catheter drainage of the pericardium is a safe and effective means of providing definitive drainage of the pericardial space. PMID- 2766139 TI - Current operative morbidity associated with elective surgical resection for lung cancer. AB - To determine the current operative morbidity for elective surgery of lung cancer, the authors reviewed the charts of 1076 consecutive patients who underwent pulmonary resection between 1978 and 1984 at two major Canadian teaching hospitals. Of these patients, 731 (68%) had a normal course. Minor complications occurred in 206 patients (19%); the majority were supraventricular arrhythmias (100 events) and atelectasis (41 events). Nonfatal major complications occurred in 105 patients (9.8%). The overall operative death rate was 3.2%. If supraventricular arrhythmias are excluded, nearly 80% of patients had a smooth postoperative course. In order to correlate the occurrence of complications with pre- and perioperative data, several possible risk factors were analysed. For major complications and death, the age, the forced expiratory volume, weight loss, coexisting disease, stage of cancer and extent of resection were significant risk factors (p less than 0.05). The data show that elective pulmonary surgery can be done safely and complications prevented. The necessary requirements are: proper selection of patients, a well-performed operation and prompt treatment of potential problems. PMID- 2766140 TI - Destructive arthropathy of the hip following pelvic irradiation: report of four cases. AB - The replacement of orthovoltage by megavoltage radiotherapy has facilitated selective ablation of cancerous tissue, resulting in less toxicity to bone. However, damage to bone still occurs and may be more common than generally appreciated. In four women, all treated for adenocarcinoma of the reproductive tract, radiotherapy was believed to contribute to acetabular failure and secondary arthritis 2 to 31 years after treatment. In one case the condition was bilateral. Because arthritis of the hip is now common in women, there is a risk that unusual and remote factors may not be recognized or fully appreciated. In these cases prosthetic joint replacement is likely to fail. Special techniques, including bone grafting, peripheral support rings, well-fixed and optimally placed sockets and gradual rehabilitation, are mandatory. PMID- 2766141 TI - Diagnosis of acute appendicitis in pregnancy. AB - Although the clinical diagnosis of appendicitis in pregnancy seems to be complicated by the physiologic changes of pregnancy, evidence from controlled studies is lacking. The aims of this study were to determine whether there are any features of appendicitis in pregnant women that would help to establish the diagnosis and whether any difference exists between the presentation of appendicitis in pregnant and nonpregnant women. Twenty-eight pregnant women with a clinical diagnosis of appendicitis were compared with an equal number of nonpregnant patients matched for age and randomly selected from a group of patients who had appendicitis. No differences were observed in the presenting symptoms, physical signs and laboratory tests. The false-positive rates were identical. The results indicated that the diagnosis of appendicitis is no more difficult in the pregnant state than in the nonpregnant state. PMID- 2766142 TI - Neoadjuvant treatment in conservative surgery of peripheral sarcomas. AB - Twenty-five patients with soft-tissue and bony sarcomas of the head and neck and limbs were treated by local neoadjuvant therapy. It consisted of 90 mg of Adriamycin infused intra-arterially over 3 days into a vessel feeding the involved area and 30 Gy of radiotherapy given over 10 days; this was followed by a complete resection of the sarcoma 4 to 6 weeks later. All the tumors were associated with a high risk of local recurrence; eight were locally recurrent and the remainder were stage II to stage IV tumours. Serious local complications were seen in 4% of the patients. This rate compares well with other higher dose neoadjuvant regimens (35 Gy over 10 days), which are associated with a 35% local complication rate. Follow-up at a mean of 30 months demonstrated no local recurrence. All limbs were spared. Long-term morbidity was negligible. No effect on systemic control is suggested; only 63% of the patients were free of systemic disease. This report substantiates other similar experiences supporting neoadjuvant therapy followed by resection as the treatment of choice for local control of sarcomas. PMID- 2766143 TI - Medial epicondylitis caused by injury to the medial antebrachial cutaneous nerve: a case report. AB - A 35-year-old man who had chronic elbow pain due to medial epicondylitis received a steroid injection into the medial epicondyle. This was followed immediately by increased pain and symptoms of dysesthesia in the distribution of the medial antebrachial cutaneous nerve. On surgical exploration 9 months later, the nerve was found to lie directly over the medial epicondyle and appeared to have sustained an injection injury. This report draws attention to the fact that because the posterior division of the medial antebrachial cutaneous nerve may lie directly over the medial epicondyle, it may be at risk of direct injury if injections are given into the epicondyle. PMID- 2766144 TI - Femoral appendicitis: an unusual case. AB - The presentation of acute appendicitis in a strangulated femoral hernia is rare. The authors describe what they believe is the first reported case of necrotizing fasciitis as a consequence of a gangrenous appendix in this situation. An 80-year old woman presented with crepitant cellulitis of her right thigh with fever and leukocytosis, leading to a preoperative diagnosis of necrotizing fasciitis. Intraoperatively, an unsuspected gangrenous appendix was found in an incarcerated femoral hernia. A knowledge of the existence of this rare and serious condition will avoid delay in its recognition and management. PMID- 2766145 TI - Morphological studies on the venous drainage of the trachea in the neck of sheep. AB - Systemic venous drainage of the cervical portion of the trachea from the cricoid cartilage to the sternal notch was observed in 50 adult sheep. In all animals, the first five to six tracheal rings starting at the cricoid cartilage were drained by the thyroid veins (v. thyroideae) bilaterally to the external jugular veins (v. jugularis externa). A venous complex draining the remaining cervical portion of the trachea was observed only on the left side of the trachea. This complex drained to the cranial vena cava (vena cava cranialis). India ink or Evans blue dye were infused into small vessels draining this area for verification. Variations in this venous complex were classified into three types based upon length of trachea drained. Type I was found in 26%, type II found in 58%, and type III found in 16% of the sheep studied and drained 23 +/- 5%, 58 +/- 11% and 78 +/- 10% of the cervical portion of the trachea, respectively. Blood flow from this area of the trachea was 85 +/- 28 mL/min/100 g wet issue. This study identified and classified the venous drainage of the cervical portion of the trachea in sheep. PMID- 2766146 TI - Health and metabolic responses of young calves housed at -30 degrees C to -8 degrees C. AB - Newborn, male, Holstein calves, were continuously housed for three weeks in calf hutches at 17 degrees C or in a thermal environment which varied rhythmically on a daily basis either between -20 degrees C and -8 degrees C (experiment A) or between -30 degrees C and -18 degrees C (experiment B). Compared to warm-housed calves, cold-housed calves in experiment A had metabolic rates which were significantly higher (p less than 0.001) in a standing position but which were not significantly different (p less than 0.05) in a recumbent position. Recumbent and standing cold-housed calves in experiment B had an increased (p less than 0.05) metabolic rate compared to warm-housed controls. Heat loss was less (p less than 0.05) for recumbent cold-housed calves in experiment B than for standing calves in a thermoneutral environment. Localized subcutaneous hemorrhages of hindlimbs were a consistent necropsy finding among all cold-housed calves. Average daily gains of cold-housed calves were not significantly different from warm-housed controls. Clinical, physiological and pathological findings indicated that cold treatments used in the present study did not cause serious harm to calves. It was concluded that calves housed in properly managed hutches are remarkably cold tolerant. PMID- 2766147 TI - Thermal insulation of young calves exposed to cold. AB - Tissue, external and whole animal insulation values were determined for 12 newborn male Holstein calves continuously housed for two weeks in hutches within environmental chambers in which temperature was maintained at a constant 17 degrees C (three calves) or cycled on a daily basis either between -20 degrees and -8 degrees C (three calves) or between -30 degrees and -18 degrees C (six calves). Three of the six calves at the coldest temperature were outfitted with an insulated coat. The insulated coat provided calves a 52% increase in total insulation. Tissue insulation of cold-housed calves increased 37.2% over the first two weeks of life. It was concluded that the capacity for vasoconstriction improved with age. External insulation did not change significantly except during the first week in cold-housed calves without insulated coats. External insulation values were five to eight times those of tissue insulation values for all treatment groups. This indicated that insulation of structures external to the skin (hair, bedding, ground, etc.) provided most of the insulation for calves. PMID- 2766148 TI - Failure to maintain luteal function: a possible cause of early embryonic loss in a cow. AB - The effect of early pregnancy failure on the release of prostaglandin F2 alpha (PGF2 alpha) in response to oxytocin (Ot) was examined in an abnormal breeder (AB) heifer that was not able to maintain a pregnancy beyond 21 days. This animal was used in three experiments: 1) She received one intravenous injection of 100 IU Ot 17 days after the onset of oestrus (Day 0). Frequent blood samples were taken for the measurement of 15-keto-13,14-dihydro-PGF2 alpha (PGFM) by radioimmunoassay. Daily samples for progesterone (P4) determinations were taken to monitor luteal function. This was then repeated using the same animal at either day 17 or 18 or 19 (day 17-19) of pregnancy. 2) Embryos from superovulated normal breeder (NB) donors were transferred at day 7 to the AB heifer as well as to NB control animals. 3) Seven day old embryos from the superovulated AB heifer were transferred to NB recipient animals. At day 17-19 of pregnancy all the recipient heifers (experiments 2 and 3) were subjected to the same protocol as in experiment 1. The results showed that the ability of Ot to stimulate PGF2 alpha release was reduced in the NB recipients bearing viable embryos when compared to cyclic animals. However, for the AB heifer, Ot stimulated PGF2 alpha release to the same extent whether the animal was cyclic or pregnant. Furthermore, the AB animal did not have the extended luteal function associated with removal of viable embryos on day 17-19. The data suggest that the embryonic loss might have been caused by failure of the embryos to prevent the luteolytic release of PGF2 alpha. PMID- 2766149 TI - Diagnostic specificity, sensitivity and cross-reactivity of an enzyme-linked immunosorbent assay for the detection of antibody against Leptospira interrogans serovars pomona, sejroe and hardjo in cattle. AB - Outer sheath antigen was prepared from Leptospira interrogans serovars pomona, sejroe and hardjo by treating the organisms with 1.0M NaC1 followed by 0.04% sodium dodecyl sulfate (SDS). Sodium dodecyl sulfate was removed from the SDS protein complexes by the extraction of dodecyl sulfate anions as ion pairs with triethylammonium cations into an organic solvent. The outer sheath antigen was recovered from the organic solvent as a precipitate and used as the source of leptospiral enzyme-linked immunosorbent assay (ELISA) antigen. Utilizing this antigen, ELISA was adapted to detect bovine serum antibody to L. interrogans serovars pomona, sejroe and hardjo. The specificity of this assay in 344 bovine sera, which were negative in the microscopic agglutination test (MAT) for seven serovars, was 99.4%. In sera from 37 and 87 cattle which revealed MAT titers greater than or equal to 1:50 for L. interrogans serovars pomona and sejroe, the relative sensitivity of the test was 100%. The ELISA also showed a considerable degree of low level cross-reactivity with other serovars. Sixty-six (75.9%) out of 87 bovine sera which were MAT-positive (MAT titer of greater than or equal to 1:50) with serovars sejroe and hardjo only were ELISA positive with heterologous pomona antigen; 16 (43.2%) and six 16.2%) out of 37 bovine sera which were MAT positive MAT titer of greater than or equal to 1:50) with serovar pomona only were ELISA positive with heterologous sejroe and hardjo ELISA antigen respectively.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2766150 TI - The prevalence of leptospirosis and its association with multifocal interstitial nephritis in swine at slaughter. AB - An abattoir survey was undertaken to determine the prevalence of leptospirosis and its association with lesions of multifocal interstitial nephritis (so-called "white spotted kidneys") in swine at slaughter. Both cross-sectional and case control study designs were used. Of 197 kidneys from hogs randomly selected at slaughter, 11 (5.6%) had generalized grey-white foci typical of multifocal interstitial nephritis (MFIN). Antibody titers greater than or equal to 1:80 against Leptospira pomona were detected in nine (4.6%) hogs and against L. bratislava in 63 (32%) of these hogs. Leptospira pomona (kennewicki) was detected by immunofluorescence in 5/197 (2.5%) of randomly selected hogs. Leptospires identified as genotype kennewicki were isolated from six (9.8%) of 61 kidneys cultured. Leptospira bratislava was not detected by immunofluorescence or culture. There was a highly significant (p = 0.00) and strong association (odds ratio (OR) = 195) between high L. pomona titer (greater than or equal to 1:80) and the presence of leptospires in the kidneys, as detected by culture. There was also a significant (p = 0.046) and strong (OR = 8.10) association between multifocal interstitial nephritis and the presence of renal leptospires as detected by culture. The association between leptospiral titer and MFIN lesions in the prevalence survey group of animals was statistically significant (p = 0.031), but this association was not significant in the case-control study group (p = 0.071) The failure to identify L. bratislava despite serological evidence of infection suggests that some of these seropositive animals may have been transiently infected at an early age, that serological findings were falsely positive, or that immunofluorescence and isolation attempts failed to detect L. bratislava if they were indeed present in the kidneys.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2766151 TI - Pasteurella multocida and Bordetella bronchiseptica in atrophic rhinitis and pneumonia in swine. AB - A total of 163 pigs from nine farrow-to-finish herds representing various levels of atrophic rhinitis (AR) were selected for postslaughter examination of AR and pneumonia. Nasal swabs and lungs were cultured for detection of Bordetella bronchiseptica and Pasteurella multocida. Seventy-three pigs were examined at eight weeks of age and 90 contemporaries at six months of age. Mean AR scores were 1.21 and 1.11 for the eight week and six month old pigs, respectively (0 = normal, 3 = severe). In individual pigs increasing AR score was related to increasing pneumonia score in eight week old pigs but not in six month old hogs. In eight week old pigs, B. bronchiseptica and P. multocida were isolated more frequently from pigs with higher AR scores. From nasal swabs of six month old hogs, Bordetella was almost never recovered while Pasteurella was frequently isolated score. Toxigenic type DP. multocida was isolated from nasal cultures of only seven (4%) pigs and from lung cultures of only one pig. Pasteurella was never isolated from lungs of the eight week old pigs and Bordetella never from the six month old hogs. The isolation rate of P. multocida, predominantly type A, from lungs of six month old pigs increased from 11% in grossly normal lungs to 86% in lungs with severe pneumonia. Pigs from one herd free from lesions of AR and pneumonia were also examined; type AP. multocida was isolated from nasal cultures of one of six eight week old pigs. Somatic antigens of P. multocida were determined for 94 nasal and 20 lung isolates. Somatic serovar 3 was found in 93% of the nasal isolates and in all lung isolates.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2766153 TI - Immunohistochemical detection of feline calicivirus in formalin-fixed, paraffin embedded specimens. AB - An immunohistochemical technique was developed for detection of feline calicivirus (FCV) in formalin-fixed, paraffin-embedded cultured cells and tissues. Initial trials with cultured cells indicated that the indirect immunoperoxidase method using rabbit antiserum to FCV strain 255, and horseradish peroxidase-labelled antibodies to rabbit immunoglobulin G lacked sensitivity and showed excessive diffuse background staining despite trypsin digestion of sections before staining. An amplified indirect immunoperoxidase technique using commercially available biotinylated antirabbit antibodies and avidin-biotin peroxidase or streptavidin-peroxidase (SP) complexes proved highly successful. When optimal conditions, including those for trypsinization, inactivation of endogenous peroxidase and blocking were determined, the SP technique was preferred. Applied to tissue of cats in the acute phase of FCV infection, the technique provided clear identification of cells containing FCV antigens in sections in which histological detail was well preserved. PMID- 2766152 TI - The use of a microagglutination assay for the detection of antibodies to Corynebacterium pseudotuberculosis in naturally infected sheep and goat flocks. AB - Two goat flocks comprising 326 animals and four sheep flocks comprising 343 animals, all with a previously recognized problem of abscesses due to Corynebacterium pseudotuberculosis, were examined for the presence of abscesses and antibody titers to C. pseudotuberculosis as detected by direct microagglutination assay. In sheep there was a strong positive relationship between age and titer (p less than 0.0001). However, the relationship in goats between age and titer could not be determined due to a strong interaction between flock and age. When the relationship between abscesses and titer was examined, it was found that goats with abscesses had higher titers than those that did not (p less than 0.05), whereas there was no difference in titer between sheep with abscesses and those without (p = 0.5753). The sensitivity of the microagglutination test was poor to good for both species (52.3% for goats and 89.7% for sheep). The specificity of the test was fair to poor (64.9% for goats and 21.7% for sheep). Given a disease prevalence of 13.5% for goats and 8.5% for sheep the predictive value of the positive test was very poor (18.9% for goats and 9.6% for sheep) but the predictive value of the negative test was good to excellent (89.7% for goats and 95.8% for sheep). The poor specificity of the test and therefore the positive predictive value may be due in part to the criterion of classification of presence of disease, i.e. presence of an abscess at the time of sampling.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2766154 TI - Aspects of the epidemiology of nematode infections in a cow-calf herd in Ontario. AB - On May 29, 1980, 108 cows and calves were placed on a 20 hectare pasture until October 26, except that from September 18 to October 2 they were in a barn. Every two weeks during the total period, fecal samples were taken from 17 cows and 14 calves and herbage samples were collected from the pasture. Parasite fecal egg counts were estimated using the Cornell-Wisconsin centrifugation technique and herbage infective larvae by a modified Sandwich technique. Daily maximum and minimum air temperature and precipitation were recorded. The principal parasite egg found was the trichostrongyle-strongyle morulate, oval-shaped egg referred to as a gastrointestinal nematode (GIN) egg. The mean GIN egg/g of feces for cows varied from 14.2 to 23.9 and for calves it rose from 0.2 in the spring to 134.8 in the fall. Nematodirus, Trichuris, Strongyloides, Moniezia and coccidia were also found. Larvae were recovered first in July, with the greatest number, over 2000/kg of dry weight of herbage, in September and were primarily Cooperia and Ostertagia. PMID- 2766155 TI - An assessment of residual ovine nematodes on pasture under maritime conditions. AB - Residual ovine nematode pasture infections were assessed by grazing groups of ewes and their lambs on permanent sheep and cattle pastures and by the use of tracer lambs. Ostertagia spp., Cooperia oncophora, Nematodirus spp., Chabertia ovina and Trichuris spp. eggs and/or larvae survived on pastures overwinter. Second generation Ostertagia larvae were present in greatest numbers on pasture during the latter part of August and early September. The failure of a significant build-up of Cooperia oncophora was attributed to negligible worm egg output of this species in sheep. A build-up of Nematodirus spp. on pasture was not detected in this study. PMID- 2766156 TI - Diagnosis of copper deficiency and effects of supplementation in beef cows. AB - The effects of feeding supplementary dietary copper to a herd of 400 beef cows, were studied over a two year period. In the first year of the trial, the calves showed clinical signs of copper deficiency. There was improved growth following subcutaneous injection of copper ethylenediamine tetraacetate, and the treated calves had a 2.8% increase in adjusted weaning weights. In the second year of the trial pregnant cows were fed a basal ration of bromegrass silage, barley and minerals over the winter feeding period. The feed was supplemented with copper so that half received 5.5 mg/kg of copper on a dry matter basis and half 40 mg/kg. Calving occurred in the spring and half the calves were treated with injectable copper at birth and again at 12 weeks of age. There was no evidence of copper deficiency in the calves and there was no effect of high level copper supplementation on calf birth weight, or neutrophil candidacidal activity. Susceptibility to diarrhea varied in a complex fashion; morbidity was lowest in calves born to dams fed supplementary copper and highest in calves born to supplemented dams and injected with copper at birth. The cows and calves grazed the same copper deficient pasture over the summer. The average daily gain for calves born to supplemented cows was 0.999 +/- 0.010 kg/day (x +/- SEM) which was significantly greater than the 0.972 +/- 0.009 kg/day for calves from nonsupplemented dams (p = 0.044). The benefit of copper supplementation on 200 day weaning weight was estimated at 4.8 kg. Evidence of copper deficiency was seen when a herd test showed mean serum levels below 9 mumol/L and liver values below 0.09 mmol/kg wet matter. PMID- 2766157 TI - Factors associated with average daily gain, fever and lameness in beef bulls at the Saskatchewan Central Feed Test Station. AB - Data obtained from the Saskatchewan Central Feed Test Station in Saskatoon, Saskatchewan, Canada were examined for evidence of factors related to average daily gain and the diseases occurring in 326 beef bulls during the 1983-84 test. Average daily gain was found to be significantly associated with breed, pen assignment and initial test weight but was not associated with disease or age upon arrival at the test station. Lameness was associated with breed and initial weight, while fever (suspected respiratory disease) was associated with age. The predicted odds of lameness was approximately seven times greater in the animal with the heaviest as compared to the lightest initial test weight and the predicted odds of fever was approximately five times greater in the youngest as compared to the oldest animal. PMID- 2766158 TI - The frequency, distribution and effects of antibodies, to seven putative respiratory pathogens, on respiratory disease and weight gain in feedlot calves in Ontario. AB - During 1983-85, 279 calves requiring treatment for bovine respiratory disease and 290 comparison (control) animals from 15 different groups of feedlot calves were bled on arrival and again at 28 days postarrival. Their sera were then analyzed for antibodies to seven putative respiratory pathogens. On arrival, the prevalences of indirect agglutination titers to Pasteurella haemolytica, P. haemolytica cytotoxin, Mycoplasma bovis and M. dispar were greater than 50%, the prevalence of titers to bovine virus diarrhea virus (BVDV) was approximately 40%, and the prevalences of titers to infectious bovine rhinotracheitis virus (IBRV), bovine respiratory syncytial virus (RSV) and parainfluenza virus type 3 (PIV3) were all below 25%. Seroconversion during the first month after arrival occurred in more than half the calves to P. haemolytica cytotoxin, PIV3 and RSV. Seroconversion of agglutination titers to P. haemolytica, Mycoplasma and BVDV occurred in about 40% of calves, and seroconversion to IBRV was infrequent (less than 5%). Initial titers were negatively correlated to subsequent titer changes within organism. Initial titers, and titer changes between organisms were essentially independent. Light calves had an increased risk of being selected for treatment for respiratory disease. Seroconversion to P. haemolytica cytotoxin, RSV and BVDV were predictive of respiratory disease cases, explaining approximately 69% of all respiratory disease cases in the feedlots. It was not possible to accurately predict weight gain or relapse from the serological data. PMID- 2766159 TI - Adenocarcinoma of the salivary gland in a white Swiss mouse. AB - A salivary gland adenocarcinoma in a white Swiss mouse used in a titration of the scrapie agent is reported. The neoplasm originated from the serous cells of the parotid salivary gland. Retroviral particles were detected in the neoplastic salivary gland cells by electron microscopy. PMID- 2766160 TI - The detection of bovine respiratory syncytial virus in formalin fixed bovine lung with commercially available monoclonal antibodies and avidin biotin complex immunohistochemistry. AB - Eight commercially available monoclonal antibodies directed against respiratory syncytial virus antigens were tested for ability to detect bovine respiratory syncytial virus (BRSV) antigen in formalin fixed, paraffin embedded bovine lung using avidin-biotin complex immunohistochemical staining. Monoclonal antibodies from clone 18B2 purchased from Biosoft, Paris, France and those from clone 8G12 purchased from the Department of Veterinary Sciences, University of Nebraska, Lincoln, Nebraska stained BRSV antigen in infected bovine lung with acceptable background staining of uninfected tissues. This method offers advantages over other techniques for BRSV diagnosis in that fresh tissue is not required and all reagents may be purchased commercially. PMID- 2766161 TI - Studying family practice. PMID- 2766162 TI - "Teleauscultation": the next best thing to being there. PMID- 2766163 TI - Utilization management must be shared. PMID- 2766164 TI - Effect of medicolegal liability on patterns of general and family practice in Canada. AB - As part of the Federal/Provincial/Territorial Review on Liability and Compensation Issues in Health Care, in 1988 we surveyed Canadian general practitioners and family physicians to determine the effect of liability concerns on their practices in the previous 5 years. Questionnaires were sent to a random, stratified national sample of 1295 physicians, with a response rate of 64.6%. However, a high proportion of the returned questionnaires were ineligible because the physicians were not in general or family practice, were not involved in direct patient care, or had died or moved; thus, the corrected response rate was 50.8%. The newsletter of the Canadian Medical Protective Association was the source of information on liability most frequently cited (by 88.1% of the physicians) and most influential (to 62.4%). Only 15.5% of the physicians cited personal involvement with medicolegal issues as a source of information; the rate was higher for Ontario physicians and those in urban areas generally. A total of 74.6% of the respondents had altered their style of practice in the previous 5 years, and 56.3% reported changes in the scope of their practice. Concern about litigation was the most important reason for changing style of practice and reducing or eliminating administration of anesthesia, whereas lifestyle and other issues along with liability concerns most influenced decisions to reduce obstetric care and emergency department work. Our findings suggest that physicians' perceptions of liability issues have had a profound influence on primary care practice in Canada in the past several years. PMID- 2766165 TI - Exemplary family physicians and consultants: empirical definition of contemporary medical practice. AB - To identify the characteristics of exemplary family physicians and consultants, we interviewed 25 family physicians and 25 consultants (5 each in the specialties of internal medicine, obstetrics and gynecology, pediatrics, psychiatry and surgery) selected by their peers as being exemplary in their own practice setting. The results indicated that the participants had well-formulated concepts of exemplary practitioners, defining five main categories of performance: clinical competence, relationship with patients, availability, family physician consultant relationship and a fifth category that included organizational ability and personality attributes. The family physicians and the consultants placed different values on these categories and indicated that these values might change under different clinical circumstances. Their concepts appear to be compatible with, but not restricted to, a model of contemporary medical practice based on an ethic specific to medicine. PMID- 2766166 TI - Laboratory standardization of lipid measurements. PMID- 2766167 TI - The tobacco industry provides a lesson in effective lobbying. PMID- 2766168 TI - There's no light yet at end of HIV tunnel, conference told. PMID- 2766169 TI - O'Brien-Bell leaves office with his concerns about two-tier system growing. Interview by Terry Moran. PMID- 2766170 TI - The carotid endarterectomy trial: on track. PMID- 2766171 TI - Chronic fatigue syndrome. PMID- 2766172 TI - An analysis of birth weight by gestational age in Canada. PMID- 2766174 TI - The challenge for neonatology in Canada. PMID- 2766173 TI - Making the use of isotretinoin safer. PMID- 2766175 TI - Medicine in Africa. PMID- 2766176 TI - Case reports: what editors want from authors and peer reviewers. PMID- 2766177 TI - When families cannot "let go": ethical decision-making at the bedside. AB - Shared decision-making at the bedside is now a regular feature of medical practice. When disagreements arise between a patient and family members caregivers sometimes find themselves caught in a complex tangle of human relationships that strains monochrome ethical thinking. The patient's expressed wishes are often compromised for the sake of the family's needs. Conversely, a unilateral appeal for patient autonomy may prove insensitive to the hurt and the needs of the family. We describe a relatively unsuccessful attempt by a patient's caregivers to buy time to maximize the interests of the patient and her family and discuss the way in which the family dynamics militated against the rather obvious solution of promoting the patient's right to refuse treatment. The purpose of this article is not to evoke sympathy for health care professionals in dealing with such conflicts but rather to heighten awareness of the issues at stake and to stimulate thinking about ways and means to bring about a more favourable outcome than the one described here. PMID- 2766178 TI - Highlights of an international workshop on abdominal aortic aneurysms. AB - There is a growing appreciation of the magnitude of the problem of AAA in all Western countries. The large numbers of subjects needed to answer some of the questions, such as the natural history of small AAAs and risk factor analysis, requires that these studies be carried out by a multicentre group. The advantages of international collaboration, when possible, should ensure more uniform methods and definitions as well as more rapid recruitment of subjects. Granting agencies may find such an approach more attractive, and the results may be more relevant. PMID- 2766179 TI - Excipients in topical corticosteroid preparations in Canada. AB - Topical corticosteroids are widely used for the treatment of dermatoses in Canada. The effects of the various nontherapeutic components of these formulations are less well known than those of the active ingredients and may cause adverse reactions. Information on the components is fragmentary and is scattered throughout the literature. We have attempted to consolidate this information into one source. Recent provincial legislation requiring the generic substitution of interchangeable products and the nondisclosure of all ingredients in product labelling hinder the search for an excipient that has caused an adverse reaction. Practitioner participation in the Cutaneous Adverse Reaction Registry of the Canadian Dermatology Association will identify sensitizing excipients and will support efforts by the profession to obtain more effective and safer products. PMID- 2766180 TI - Should we tell them when their blood pressure is up? AB - We carried out two studies to determine the effects of feedback on subsequent blood pressure and heart rate readings in subjects without significant cardiovascular abnormalities. In both studies the subjects were randomly assigned to be told that their blood pressure was normal or was high or to receive no feedback at all; 3 minutes later another reading was taken and correct feedback provided. Study 1 was done in 114 patients who attended a family practice teaching unit for an office visit; subjects taking cardioactive medication or with chronically elevated blood pressure (diastolic pressure more than 95 mm Hg) or known low pressure (diastolic pressure less than 60 mm Hg) were excluded. Half of the subjects received feedback from a nurse and the other half from a physician. We found no effect of type of feedback or type of practitioner on subsequent readings. No adaptation of diastolic blood pressure or heart rate took place, whereas a similar rest period in the laboratory consistently triggers cardiovascular adaptation. Given the field nature of the study it was not clear whether the intervention was not powerful or whether the practitioner-patient interactions diffused the effects of an otherwise powerful intervention. Therefore, a second study with the same design was carried out in a controlled laboratory setting with 61 university students who believed they were in the adaptation phase of an experimental stress protocol. The subjects did not interact with the experimenter, who provided only the initial feedback, via intercom. The findings replicated those of study 1: type of feedback had no significant effect on subsequent blood pressure levels, and all types of feedback prevented cardiovascular adaptation. We recommend that patients be allowed to rest alone for at least 10 minutes before blood pressure is measured. Our findings suggest that practitioners need not be concerned about telling normotensive or borderline hypertensive patients that their blood pressure is elevated. PMID- 2766182 TI - Statement on influenza vaccination for the 1989-90 season. PMID- 2766181 TI - A community survey of Parkinson's disease. AB - In a rural community of 80,000 people 69 patients were identified as having a diagnosis of Parkinson's disease. After interview and examination we found that 55 met the generally accepted diagnostic criteria for Parkinson's disease, 4 had possible Parkinson's disease, 6 had essential tremor, 2 had dementia and 2 had other conditions. The patients with Parkinson's disease had clinical and epidemiologic characteristics similar to those of patients in previous, mainly hospital-based, studies. These characteristics included mean age at onset (63 years), frequency rate of dementia (20%) and presence of postural tremor (11%). The pattern of treatment varied, some patients receiving more medication than is usual for the severity of their illness, and some patients receiving less than is usual. Parkinson's disease can be difficult to diagnose and manage because of the clinical variation between patients in presentation and response to treatment. PMID- 2766183 TI - Are there too many doctors? CMA seeks "rational" approach to issue. PMID- 2766184 TI - Upsurge in malpractice claims, costs may be levelling off. PMID- 2766185 TI - Good riddance to OHIP premiums, former general manager says. PMID- 2766186 TI - Revamping of BC health legislation placed on hold. PMID- 2766187 TI - An old woman, prepared to die: what should the ER doctors do? PMID- 2766188 TI - The clinician-investigator interface in psychiatry: II--The role of the Clinical Investigation Unit. AB - The Clinical Investigation Unit has served as a natural focus for clinical research; as such it has a number of advantages and specific problems. On such units a variety of themes may occur. Some of these have the potential to interfere with the integration of clinical and research work. These include the theme that the research itself is therapy, or that research will find all the answers. Both may result in problems for the functioning of the ward. Most problematic of all is the theme that research is harmful and exploitative. Optimally, the unit develops an attitude that the research is compatible with excellent patient care. Problems of patients, staff, ethical issues, admissions policies and problems of the clinician-scientists are reviewed with recommendations on how to minimize difficulties. PMID- 2766189 TI - Attachment theory and brief psychotherapy: applying current research to clinical interventions. AB - Recent advances in attachment research provide a framework for defining the content and process of brief psychotherapy with adults. Attachment theory emphasizes a number of issues crucial to therapeutic work. Specifically, attachment relationships are enduring components of a individual's pattern of interpersonal behaviours. Functionally, attachment relationships address security needs. Insecure attachment arises from a representational model based on feared loss of the attachment figure, which predisposes the individual to have little confidence in the attachment figure's availability, responsiveness, and permanence. Behavioural responses to insecure attachment can lead to specific patterns of interpersonal relationships which, in turn, strengthen the representational model. Thus, a relatively stable, self-reinforcing system evolves and results in a consistent inability to experience security within attachment relationships. In this article, the authors describe the current framework for understanding adult attachment relationships and present clinical vignettes illustrating the saliency of attachment theory to common clinical presentations. The goal of the clinical intervention is defined as increasing the "permeability" of the individual's working model of attachment through affective and cognitive re-assessment of attachment experiences and expectations. Finally, the utility of this approach in evaluating the outcome and effectiveness of psychotherapy is highlighted. PMID- 2766190 TI - [Armed conflict and trauma: a clinical study of Latin-American refugee children]. AB - This exploratory research on psychic consequences of armed conflicts has been carried out in Montreal on 30 latin-americans, eight to 12 year-old refugees. The principal objective was to assert the importance of traumas intensity, accumulation and age of occurrence on the level and type of symptomatology (introversion-extroversion). Using two types of methodologies, clinical scales and in a more exploratory way, projective instruments to study the intra-psychic dynamic underlying the symptomatology observed. The children were classified according to trauma intensity and for this purpose, a trauma scale was defined with latin-american informants. ACHENBACH and DOMINIQUE clinical evaluation scales were applied to the measure of clinical symptomatology. These instruments were analysed as a function of the symptoms intensity and type. Among results, the accumulation and intensity of traumas were found to be in significant correlation with anxio-depressive symptoms, as reported by the children with interiorization symptoms in ACHENBACH. The predominance of interiorization is discussed. The analysis of the TAT, based on objective indicators, brought out a light frequency of violent themes in relations with the clinical symptomatology. This research indicates the relevance of projective instruments to the study of traumatic response. PMID- 2766191 TI - A prospective study of patient assaults on nursing staff in a psychogeriatric unit. AB - A 27 month prospective study concerned with aspects of patient-nurse assaults on the geriatric unit (three wards) of a Canadian provincial mental hospital was conducted. The findings were compared with those for the other words. The incidence of assaults was approximately the same in both areas (0.24-0.25 assaults/occupied bed/year respectively). In the former, the commonest diagnoses associated with assaultiveness were dementia followed by schizophrenia and in the rest of the hospital, schizophrenia. However, when base rates of assaultiveness were calculated allowing for the disproportionate number of patients with these conditions, mental retardation, and dementia were approximately twice as likely to be related to assaultiveness as schizophrenia; regardless of where the patients were located. In the geriatric unit attacks were more likely when patients were being physically guided or led and during the administration of drugs; elsewhere whilst physical restraints were being applied. In both hospital areas a comparatively small number of patients accounted for a disproportionate number of assaults and a few nurses were attacked repeatedly. The majority of episodes were trivial but in isolated cases personnel were off work for several months. The discussion focuses on the possibility of generalizing results. PMID- 2766193 TI - Multiple personality disorder: an analysis of 236 cases. AB - The authors collected a series of 236 cases of multiple personality (MPD) reported to them by 203 psychiatrists, clinical psychologists and other health care professionals. MPD patients experienced extensive sexual (79.2%) and physical (74.9%) abuse as children. They had been in the health care system for an average of 6.7 years before being diagnosed with MPD and had an average of 15.7 personalities at the time of reporting. The most common alter personalities were a child personality (86.0%), a personality of a different age (84.5%), a protector personality (84.0%), and a persecutor personality (84.0%). Patients MPD are highly suicidal with 72% attempting suicide and 2.1% being successful. The patients frequently received diagnoses for other mental disorders. The most common previous diagnoses were for affective disorders (63.7%), personality disorders (57.4%), anxiety disorders (44.3%), and schizophrenia (40.8%). PMID- 2766192 TI - [Importance of medical information for the institutionalized patient]. AB - Medical information given to patients, notably to psychiatric patients, is guided by laws. Before starting any treatment the patient's informed consent is needed. One of the criteria of validity for such a consent is adequate information of the subject. This study shows that certain factors interfere with the institutionalized patient's initial knowledge about medication, hospitalization and illness. It points out that learning is diminished by two factors: the diagnostic of schizophrenia and the length of stay in the hospital. However learning is not changed by severity of symptoms. On the other hand the initial knowledge level is diagnosis independent but altered in case of intense psychiatric symptomatology. Possible explanations of these data are discussed. In conclusion, the importance of the variable of learning capacity is shown in the practice of the informed consent for psychiatric patients. The learning capacity must be taken into account when the patient is informed. Finally, additional research on that subject is indicated particularly concerning the persons disabled by schizophrenia. PMID- 2766194 TI - Factors influencing medical students' intentions to choose psychiatry as a career. AB - Information was collected and analyzed to test a theoretical model of the interaction of previously reported correlates of intention to specialize in psychiatry. Ninety-nine first-year medical students completed a four-part questionnaire designed to demonstrate reasons for such an intention. The three main predictors of intention to specialize in this field were shown to be, in order: perception of others' views of a psychiatric career, students' attitude to psychiatry and their willingness to comply with the views of others. Although sociodemographic and personality characteristics also forecast intention to specialize in psychiatry, they did so only by operating through the three main predictors. The implications of these findings in relation to previous findings are discussed. PMID- 2766195 TI - Blindness and anorexia nervosa. AB - Two cases of anorexia nervosa in blind patients are reported. They demonstrate that blind children experience many developmental problems which are thought to be important in the etiology of anorexia nervosa. Similarly, blind children are unusually susceptible to misperceive their body size and weight. The apparent absence of a strong association between congenital blindness and anorexia nervosa challenges the presumed aetiological link between disturbed body image and identity diffusion, and anorexia nervosa. PMID- 2766196 TI - Electroretinograms (ERGs) in four autistic probands and six first-degree relatives. AB - This pilot study was designed to determine if prior reports of abnormal electroretinograms (ERGs) in autism could be confirmed and, if so, could patterns of family transmission be identified. Abnormal ERG recordings were obtained from six of the 10 subjects tested two of four autistic probands, two of four siblings, and two fathers. No family patterns emerged from our small sample, but the results point to the need to extend this interesting new area or research. PMID- 2766197 TI - The effect of anticonvulsants on the dexamethasone suppression test. AB - Rates of non-suppression on the DST were compared in 19 psychiatric inpatients and anticonvulsants and 38 psychiatric inpatients not on anticonvulsants who were matched for age, sex, and diagnosis. Patients on anticonvulsants had a significantly higher rate of nonsuppression. PMID- 2766199 TI - Treatment resistance and chronicity of depression. PMID- 2766200 TI - Mentally disordered offenders and the insanity verdict. PMID- 2766201 TI - The fourth special edition on child psychiatry. PMID- 2766198 TI - Long-term follow-up of depressive pseudodementia of the aged. AB - Forty-four elderly patients of both sexes (mean age 76.5 years) suffering from depressive pseudodementia were intensively treated for the depression. When that cleared up, cognitive function reverted to premorbid level. Patients were regularly interviewed and retested at six months intervals for four to 18 years (average 8). Some patients experienced, during the follow-up period, a recurrence of the depression for which they were again successfully treated. At the end of the observation period, 39 of the 44 patients (89%) had developed a dementia syndrome of the Alzheimer type. PMID- 2766202 TI - Adolescent personality development: three phases, three courses and varying turmoil. Findings from the Toronto Adolescent Longitudinal Study. AB - The Toronto Adolescent Longitudinal Study was launched in 1977 to examine personality development in a non-clinical sample of children from ages ten through 19 over an eight year period. Following a description of their conceptualized model of personality and of the nature of the study, the authors summarize their findings which suggest new perspectives in three areas of adolescent personality development: 1) the subphases of adolescence, 2) the routes of passage through which adolescents proceed, and 3) adolescent turmoil. PMID- 2766203 TI - Use of imagery to describe functional abdominal pain as an aid to diagnosis in a pediatric population. AB - Abdominal pain is a common presenting complaint among children and adolescents. Although psychological factors may be involved, their role is not clear and a diagnosis of functional pain is often made only after extensive investigations. Specific psychological characteristics have been associated with abdominal pain in children, but little is known about the nature of the pain itself. A retrospective study was undertaken to characterize the subjective experience and description of abdominal pain in patients hospitalized for investigation of abdominal pain. Thirty subjects with proven inflammatory bowel disease (IBD) and 32 diagnosed as having functional abdominal pain (FAP) were studied. The age, sex distribution, and duration of the pain in these groups were similar. Seven (23%) patients with IBD used imagery to describe their pain in contrast to 25 (78%) of those with FAP (P less than 0.01). Neither age nor duration of pain was associated with the use of imagery. The use of imagery was significantly associated with the diagnosis of FAP (P less than 0.01). A more detailed characterization of the way patients describe abdominal pain might assist in diagnosing its etiology. PMID- 2766204 TI - Adaption of recent Soviet Jewish immigrants and their children to Toronto. AB - This retrospective study examined the prevalence of depression and psychosomatic disorders among Soviet Jewish immigrants, and how such problems might have affected their children's adaptation. A 36-item English and Russian questionnaire was sent to 452 Soviet Jewish immigrants, requesting information on possible problems they or their children had had during the first three years after immigration. Ninety people responded, 78% of whom had children. Immigrants with depression and psychosomatic illness reported greater behaviour, academic, peer interaction, and child-parent difficulties in their children. Those who were married, were proficient in English, were professionals in the USSR and/or Canada and who had supportive friends, were more likely to adapt well. Because of the low response rate, the failure to validate the questionnaire, and the possible overrepresentation of professionals the findings are presented as preliminary pending further exploration. They are discussed for their relevance to the early identification of difficulties in immigrants and their children, and to the need for timely and informed intervention. PMID- 2766205 TI - Relationship between psychiatric illness and conduct disorder in adolescents. AB - Ninety-six psychiatrically ill adolescents admitted to an adolescent inpatient service were systematically assessed to determine the morbidity of conduct disorder (CD), with other Axis I psychiatric disorders. Twenty-six (27%) met DSM 111 criteria for CD in addition to other Axis I disorders. A CD diagnosis was significantly associated with substance abuse, and attention deficit disorder with hyperactivity. Although CD was found in 21% of depressives it was more commonly found in patients with psychotic disorders (25%) and bipolar (42%) disorders. These findings suggest that CD may be commonly found in a variety of adolescent psychiatric disorders. The implications of this finding for pharmacologic treatment of CD, the clinical assessment of the CD patient, and possible relationships between CD and adolescent psychiatric disorders are discussed. PMID- 2766206 TI - Parent satisfaction in a child psychiatric service. AB - The development and use is reported of a client satisfaction questionnaire to be answered by parents of children and adolescents referred to an outpatient psychiatric program. The structure of the questionnaire and the results from a first application are reported. It is suggested that a client satisfaction questionnaire may become an important feedback instrument useful for service planning. PMID- 2766207 TI - [The outcome of deprived infants: a retrospective study]. AB - What happens to deprived children when they grow up? The authors tried to answer this question by initially selecting 34 subjects clearly identified as suffering a deprivation syndrome in their youth. Following theoretical considerations, the authors formulated hypotheses which they attempted to verify by comparing the nine adult subjects available who had suffered deprivation during their youth with whom they were able to establish contact with nine others diagnosed as neurotic (the control group). The authors predicted that the deprived subjects would present more disability as adults than the neurotic ones. They were predicted to be more inclined towards delinquency and depression. It was hypothesized that they would not drift into psychosis, psychosomatic illness or become "young chronics". We did not expect that they would move very much on the social scale. The authors seized the opportunity to learn more about the satisfaction with the psychiatric interventions experienced during their youth. In this study, the authors used a questionnaire and four scales of the MMPI to compare the two groups. The deprived subjects demonstrated more maladaptation with a strong tendency towards delinquency and possibly depression. They were not mobile on the social scale, and did not drift into psychosomatic illnesses or become "young chronics" but some psychosis was observed among them. In the final discussion, the authors discuss the limitations of the study due to the size of the sample and problems of the methodology, along with ways that this could be strengthened in order to more successfully answer some of the questions raised. PMID- 2766208 TI - Mentally retarded adolescent sex offenders. A survey and pilot study. AB - There is not a great deal of empirical research on adolescent sex offenders and even less on mentally retarded adolescent sex offenders. This study provides some preliminary data in this area. Results of a survey of the extent and types of sexual problems evident amongst groups of mentally retarded and intellectually normal adolescents (N = 196), seen at an assessment and treatment centre in southwestern Ontario during a 14 month period is presented. In addition three groups of ten adolescents each (mentally retarded and intellectually normal sex offenders and one group of mentally retarded non-offenders with behavioural problems) were investigated to gain a more indepth perspective of characteristics of these adolescents and their backgrounds. Considering the high recidivism rate for these groups, indications for treatment are discussed with special consideration for the mentally retarded offenders. PMID- 2766209 TI - Asperger's syndrome: a review of clinical features. AB - The term Asperger's Syndrome (AS) refers to a clinical picture characterized by social isolation in combination with odd and eccentric behaviour. While the syndrome has been recognized for some time, diagnostic criteria for the disorder have not yet been established or evaluated. The objective of this paper is to describe some of the clinical features of AS. Twenty-eight children and adolescents with AS were compared to a group of psychiatric outpatients (matched on age and sex) who were also socially impaired. The AS subjects showed a range of social impairments essentially different than those seen in the control group. The sex ratio, family history, and presence of neurologic disease in some AS cases, suggest that the etiology of the disorder is similar to that in autism. The methodological limitations of the study are discussed, and a revised set of diagnostic criteria are proposed for AS. PMID- 2766210 TI - AIDS in infancy: diagnostic, therapeutic, and ethical problems. AB - Congenital AIDS is on the rise and will pose multiple problems to society and to health care workers in particular, as more infants develop the disorder. Differentiation of AIDS from infantile grief reactions is of critical importance, as infants at risk for AIDS lose their mothers who have AIDS. Team approaches are optimal and should include psychiatric perspectives. Issues of diagnosis, maladaptive psychological reactions and ethical dilemmas are discussed and illustrated in a case history. PMID- 2766211 TI - The role of child psychiatrists as consultants to day cares. AB - An increasing number of mothers of preschool children in Canada (either by choice or economic necessity) have entered the work force. It is estimated for example that 58-80% of mothers of preschool children are working. In Canada in 1986, 51.6% of women in the work force had children under the age of five (1). It is beyond the scope and intent of this paper to discuss the merits (or possible harm) of day care per se. The aim of this paper is to discuss aspects of the quality of day care, and how this might be improved by child psychiatrists being involved in day care centres and in their organization. Few would doubt that the emotional climate and the development of trusting relationships to significant others, in the first year of life, are essential determinants of the healthy personality. Hence the quality of the day care experience of small children is an essential area of study for the child psychiatrist which is as yet insufficiently recognized. This paper discusses what has been learned from the literature and from experience as a consultation-liaison child psychiatrist to a day care centre. A case example illustrates some of the important issues. PMID- 2766212 TI - Teaching child psychiatry to medical-undergraduates. AB - This article describes the findings of a survey of undergraduate curricula in the 16 Canadian medical schools in the areas of growth and development, behavioral sciences, and clinical child psychiatry. It identifies principles upon which such programs may be based and includes issues in integration of child and adult psychiatry. PMID- 2766213 TI - The "marathon assessment" in child psychiatry: a service to underserviced areas. AB - The University of British Columbia Child and Family Psychiatry Outpatient Department has, since 1974, conducted intensive child psychiatry assessments of patients referred from outlying areas. The marathon assessment, as we have called it, requires up to three days during which clinic staff conduct interviews with the referred patient and family, and perform specific investigations as necessary. By the end of the third day, the clinic team presents its findings and recommendations to the family, and by phone and letter to the referral source with arrangement for follow-up by physicians and/or mental health clinics in the patient's geographic region. The marathon evaluation has proven a worthy alternative to outreach visits by a travelling child psychiatrist and to inpatient hospital evaluations. The reasons for the advantages are enumerated. PMID- 2766214 TI - Regional Review Board: patient's right to withdraw? PMID- 2766215 TI - The survival pattern in male breast cancer. An analysis of 1429 patients from the Nordic countries. AB - A joint Nordic study was conducted to elucidate the survival pattern in male breast cancer by means of regression analysis of annual relative survival rates. A total of 1429 (98.4%) of all patients diagnosed during a 25-year to 30-year period and reported to the Nordic cancer registries were available for follow-up through 1982. The relative survival rate was lower in older patients; the relative excess risk of dying (from breast cancer) during the first 5 years of observation, calculated by multiple regression modelling, increased in a regular fashion more than three-fold from patients younger than 40 years at diagnosis to those aged 80 years or older. Significantly lower rates were found among males in Denmark and Finland, the relative excess risks of dying (compared with Sweden) being 1.39 (1.06-1.80) and 1.73 (1.22-2.45), respectively, during the first 5 years. The authors concluded first that important differences exist between male and female patients with breast cancer in the relation between survival and age at diagnosis, and secondly that a later stage at presentation or national differences in the natural history are the most likely explanations for the worse prognosis in Denmark and Finland. PMID- 2766216 TI - Cell kinetics in ovarian cancer. Relationship to clinicopathologic features, responsiveness to chemotherapy, and survival. AB - The tumor proliferative activity of 74 previously untreated epithelial ovarian carcinomas was evaluated by the thymidine labeling index (TLI) and the primer dependent alpha DNA polymerase assay (PDP-LI). The median TLI and PDP-LI were 2% (0.1 to 28.0) and 10% (3.0 to 80.0), respectively. The TLI was significantly correlated to tumor grade, International Federation of Gynecology and Obstetrics (FIGO) stage, and residual disease. However, neither the TLI nor the PDP-LI was a predictor of survival. A higher response rate was observed in the case of rapidly proliferating tumors: an objective response (OR) was observed in 38.4% of the patients with a low TLI and in 53.6% of the patients with a high TLI. The advantage of an OR in favor of the high TLI group was significant for patients treated with regimens containing doxorubicin (high TLI, 72.2% OR; low TLI, 40% OR; P = 0.03). PMID- 2766217 TI - Low-dose chemotherapy of desmoid tumors. AB - Eight patients with desmoid tumors, symptomatic, and none a candidate for conservative surgery, were treated with weekly vinblastine, maximum dose 10 mg/week, and methotrexate, maximum dose 50 mg/week. Symptomatic relief was obtained in all patients. Using Eastern Cooperative Oncology Group (ECOG) criteria, two patients had a complete remission, one of which has lasted for 30 months, four patients have had partial remissions, one patient has had a mixed response, and one patient who has been treated for only 4 weeks, a minimal response. Toxicity has been minor and transient. Chemotherapy appears to be an acceptable alternative to radical surgery in selected patients with desmoid tumors. PMID- 2766218 TI - Prognostic factors in mobile tongue and floor of mouth carcinoma. AB - This study identifies significant prognostic factors in squamous cell carcinomas of the anterior tongue and floor of mouth. It is clear that the TMN staging system does not account for other important variables that affect tumor prognosis. Tumor thickness and the presence of perineural invasion and intralymphatic tumor emboli should be examined in all resected tumors. Tumor thickness, tumor size, and perineural invasion all have an impact on survival and must be considered in treatment plans. Tumors measuring between 2 mm and 3 mm may or may not have metastases and further evaluation of this group needs to be done. Most importantly, the data in this study supports a multiinstitutional prospective evaluation of pathology specimens. Precise guidelines must be established for handling of the specimen, which must then be evaluated for the variables mentioned above. In this way, more definitive conclusions can be reached in the management of tumors of the anterior tongue and floor of mouth. PMID- 2766219 TI - Uncontrolled local recurrence after treatment of breast cancer with breast conservation. AB - Three hundred fifty-six patients with early (Stage I and II) breast cancer and 55 with advanced (Stage III and IV) breast cancer were treated between 1979 and 1985 with a consistent policy of breast conservation irrespective of tumor site, size, or histologic features. Only three patients underwent primary mastectomy (Stage III), and the remainder were treated either by wide local excision and postoperative radiotherapy (357 cases) or by needle biopsy and primary irradiation (51 cases). A total of seven of 356 (2%) Stage I and II patients have developed uncontrolled local or nodal recurrence at a median follow-up of 5 years, and nine of 55 (16%) of Stage III and IV patients. Of the 62 Stage I and II patients who have died, seven (11%) have died with uncontrolled locoregional disease. Of the 22 Stage III and IV patients who have died, eight (36%) have died with uncontrolled locoregional disease. Although the majority of local recurrences within the conserved breast could be salvaged by secondary surgery (37/38 Stage I and II patients), the development of chest wall or nodal recurrence was usually associated with the appearance of distant metastases and a poor prognosis. Data on uncontrolled local recurrence should be given in all studies of breast cancer treatment, since it represents an important end-point of therapy and a difficult clinical problem. PMID- 2766220 TI - Small bore catheter drainage and sclerotherapy for malignant pleural effusions. AB - The accumulation of large amounts of fluid in the pleural space is a common sequela of disseminated carcinomatosis. Traditional management has included therapeutic thoracentesis or the placement of a large bore chest tube for drainage with the subsequent installation of a sclerosing agent in an attempt to achieve pleural symphysis. An evaluation of all patients treated in this manner during a 4-year period was undertaken to assess the degree of success obtained with a large bore standard chest tube versus a small pigtail catheter. A study group consisting of 20 patients with a total of 24 pleural effusions was treated with drainage and sclerotherapy. In this group, eight of 13 effusions were adequately treated with pigtail catheter drainage and sclerotherapy, compared with four of 11 effusions adequately treated with standard chest tube drainage and sclerotherapy. Although the numbers are small, it appears that pigtail catheter drainage and sclerosis is at least as successful as the more traditional drainage with the standard chest tube. PMID- 2766221 TI - Osseous regeneration after therapy in patients with head and neck tumors. AB - Four patients with head and neck tumors were observed by serial computed tomography (CT) during treatment. Osseous regeneration was demonstrated at sites of initial osteolytic destruction in two patients who responded to therapy. This regeneration was observed at 4 and 7 months, respectively, after the start of therapy. No such regeneration could be seen in the other two patients who did not respond to treatment. CT may be useful not only in demonstrating initial osseous invasion, but also in monitoring treatment response. PMID- 2766222 TI - The reliability of routine pathologic diagnosis of colorectal adenocarcinoma. AB - The diagnosis of colorectal adenocarcinoma is generally considered as being reliable. However, the reproducibility of the classification of specific histologic patterns and the interrater agreement on the gradings have not been firmly established. A panel of three independent expert pathologists reviewed histologic sections from 128 patients selected among 1848 with colorectal cancer, diagnosed in 11 hospitals of the same region. The panel agreed with 92.6% of the original diagnoses of colorectal adenocarcinoma. As for agreement between panel members, the kappa value was 0.78 for the diagnosis of adenocarcinoma and 0.62 for confirmation of colorectal origin. The intraclass correlation coefficient for tumor differentiation features was 0.75. The proportion of villous and adenomatous components also generated good agreement. However, the grading of mucin secretion showed poor agreement (intraclass correlation coefficient = 0.44). Results confirm the reliability of routine pathological diagnosis and also demonstrate the reproducibility of basic diagnostic categories and pathognomonic features. Thus, to obtain reliable information from medical records for epidemiologic and clinical studies, data should be limited to well-defined diagnostic and histopathologic categories. PMID- 2766223 TI - Serum dipeptidyl peptidase activities as a possible marker of oral cancer. AB - Serum glycyl-l-prolyl 4-methyl-coumaryl-7-amide (gly-pro-MCA) hydrolase (DPP IV) and L-lysyl-L-alanyl beta-naphthylamide (lys-ala-beta NA) hydrolase (assumed to be DPP II) activities were measured in patients with oral squamous cell carcinoma and healthy subjects. The mean serum DPP IV activity of all cancer patients was significantly (P less than 0.001) decreased, compared with that of healthy subjects. Although there was no significant difference between the stages by International Union Against Cancer (UICC) classification (1978), DPP IV levels tended to change dynamically, reflecting the clinical status during therapies. The serum DPP IV activity of patients with a fair prognosis was significantly elevated toward the normal range, whereas the activity of patients with a poor prognosis was significantly decreased (P less than 0.05). In contrast, the mean serum lys-ala-beta NA hydrolytic activity of cancer patients was significantly (P less than 0.001) increased, compared with that of healthy subjects, and was changed reciprocally to DPP IV activity. The correlation of these two serum enzyme activities with tumor weights also was observed in animal models using nude mice transplanted with human KB carcinoma cells and hamsters transplanted with BHK21 cells. These results indicate that these serum enzyme levels may become an aid for the diagnosis of malignant tumors and for estimating the prognosis of the patients. PMID- 2766225 TI - Primary central nervous system lymphoma as a variant of Richter's syndrome in two patients with chronic lymphocytic leukemia. AB - Primary parenchymal central nervous system (CNS) non-Hodgkin's lymphoma subsequently developed in two patients with chronic lymphocytic leukemia (CLL). These two patients represent what we believe to be the first examples of Richter's syndrome due to primary brain lymphoma. Neither evidence for systemic lymphoma nor of progression of the leukemia was found. We believe that the description of these two cases expands the clinical spectrum in which Richter's syndrome may occur. In patients with CLL, careful attention must be given to neurologic symptoms, particularly those that develop abruptly. Primary CNS lymphoma must enter into the differential diagnosis when a cerebral mass lesion is found in such patients by the appropriate neuro-imaging. PMID- 2766224 TI - The prevalence of human T-cell leukemia virus type I infection in patients with hematologic and nonhematologic diseases in an adult T-cell leukemia-endemic area of Japan. AB - In order to clarify the prevalence of human T-cell leukemia virus type I (HTLV-I) infection in the Kagoshima district, Japan, a highly endemic area for HTLV-I, antibodies for HTLV-I (anti-HTLV-I) were examined in the sera of 6167 from healthy residents and patients with various hematologic and nonhematologic diseases. In healthy residents, including blood donors, the prevalence of anti HTLV-I was 11.9% (562/4741 persons). The prevalence increased with age, and was significantly higher in in females than in males (P less than 0.01). The prevalence of anti-HTLV-I in blood donors was 8.5%. In In hematologic diseases, the prevalence of anti-HTLV-I was 98.3% in ATL, 28.9% in lymphoproliferative disorders except ATL, and 10.6% in myeloproliferative disorders. In nonhematologic diseases, the prevalence of anti-HTLV-I was shown to be 29.5% in pulmonary tuberculosis, 25.8% in leprosy, 33.8% in chronic renal failure (CRF), 21.9% in autoimmune diseases, and 47.8% in strongyloidiasis. The various diseases except myeloproliferative disorders had significantly higher prevalence of anti HTLV-I than healthy residents (P less than 0.01 or 0.05). For autoimmune diseases, the prevalence of anti-HTLV-I in patients with blood transfusion (55.6%) was higher than in those without blood transfusion (8.7%), and healthy residents. In hemodialysis patients with CRF who had received blood transfusions the prevalence of anti-HTLV-I increased with the number of blood transfusions. Therefore, HTLV-I transmission via blood transfusion would partially explain these high prevalence of anti-HTLV-I. However, the prevalence of anti-HTLV-I in hemodialysis patients with CRF was statistically higher than that in healthy residents, regardless of blood transfusion (P less than 0.01). Furthermore, hemodialysis patients showed significantly higher prevalence of anti-HTLV-I than healthy residents, even at a younger age. Patients with pulmonary tuberculosis and leprosy showed the same results as hemodialysis patients. These results suggest that possibility that HTLV-I infection has some relation not only to ATL but also to other diseases. Therefore, it seems very important to halt the spread of HTLV-I transmission as soon as possible. PMID- 2766226 TI - Undifferentiated (embryonal) sarcoma of the liver. A clinicopathologic study of a survivor treated with combined technique therapy. AB - Undifferentiated (embryonal) sarcoma is one of the less common primary malignant tumors of the liver that typically, although not exclusively, presents in later childhood. It has come to be recognized as an aggressive neoplasm with the potential for local recurrence and distant metastasis, despite a seemingly successful total surgical resection. This report documents our experience with an 8-year-old boy who had an 80% hepatectomy for an undifferentiated (embryonal) sarcoma, followed by cisplatin (90 mg/m2), doxorubicin (20 mg/m2/d), and radiation therapy (1950 cGy) to the tumor bed. Residual microscopic tumor was very likely present in the region of the inferior vena cava, but exploratory laparotomies for the purpose of "second-look" biopsies were performed with negative results after the completion of each course of chemotherapy. The patient is off of treatment and disease-free 30 months after the diagnosis. Because the survival at this time has been so poor for this highly malignant tumor, we suggest that the combination of therapeutic techniques and second-look laparotomy(s) to identify any subclinical tumor may be a reasonable approach. Ultrastructural and immunohistochemical studies by us and other investigators indicate that the neoplastic cells are primitive mesenchymal cells by electron microscopic study and have immunoreactivity limited to vimentin, alpha-1 antitrypsin, and alpha-1-antichymotrypsin. PMID- 2766227 TI - Multilocular peritoneal inclusion cysts (so-called cystic mesotheliomas). AB - Twenty-five cases of multilocular peritoneal inclusion cysts (MPIC) were investigated. All but four cases were associated with a history of a previous abdominal or pelvic operation, or evidence of endometriosis or pelvic inflammatory disease, or combinations of these findings. All of the lesions were attached to pelvic organs, 44% also occupied the upper abdominal cavity, and 16% involved the retroperitoneum. In three cases free-floating cysts were present as well. The median diameter of the lesions was 13 cm. The cyst locules were lined by one to several layers of flat to cuboidal mesothelial cells that occasionally formed papillae, had a hobnail shape, or had undergone squamous metaplasia. The stroma was characterized by chronic inflammation and often acute inflammation. In most of the cases there was mural proliferation of the mesothelial cells, occasionally simulating a malignant mesothelioma. Twelve lesions were complicated by postoperative local recurrence; in four of these cases the recurrences were multiple; neither the size of the lesion nor the presence of mural mesothelial proliferation influenced the outcome. The clinical and pathologic data in this series suggest that the MPIC is a nonneoplastic reactive mesothelial proliferation. PMID- 2766228 TI - Single high-dose (45 mg) infusions of aminohydroxypropylidene diphosphonate for severe malignant hypercalcemia. AB - A 3-hour single intravenous infusion of aminohydroxypropylidene diphosphonate (APD) 45 mg was given to 25 patients with malignant hypercalcemia. There were seven patients with breast cancer, eight with lung cancer, and ten with a variety of other cancers. Twenty-four patients responded to a single APD 45 mg infusion, 18 of whom (75%) had falls in plasma calcium to below the upper limit of normal (less than or equal to 2.75 mmol/l). Of 15 patients who had severe hypercalcemia, i.e., plasma calcium levels greater than 3.5 mmol/l, 14 responded and 9 (60%) achieved normocalcemia. Five patients developed hypocalcemia. One patient with lung cancer developed spontaneously reversible acute dyspnea after APD which was considered to be an idiosyncratic drug reaction. Single short-duration infusions of APD 45 mg are very effective in correcting malignant hypercalcemia in the majority of patients and are particularly suitable for patients with pre-APD plasma calcium levels greater than 3.5 mmol/l, who are less likely to develop hypocalcemia. PMID- 2766229 TI - Three infants with acute megakaryoblastic leukemia simulating metastatic tumor. AB - The diagnosis of acute megakaryoblastic leukemia (AMKL) (M7, French-American British [FAB] classification) has rarely been made in children due, in part, to its pleomorphic morphology and ability to mimic other malignancies common in the pediatric age group. Three infants are described who had thrombocytopenia and the classical criteria of metastatic solid tumor in the bone marrow: patchy infiltration by cohesive clusters of cells with high nuclear cytoplasmic ratio and myelofibrosis in the bone marrow biopsy infiltrated area. This finding prompted clinical evaluation for solid tumor. The megakaryocytic lineage was ascertained by immunocytochemical studies and/or electron microscopic examinations of the bone marrow aspirates. The blasts in all three patients showed cytogenetic abnormalities that also were demonstrated by quantitative DNA analysis. None of the infants had Down's syndrome. Two of the patients are alive; one is off of therapy and the other is in remission. The third patient was transferred to another institution and lost to follow-up. Two children had wheezing that disappeared in remission. It is proposed that the clinical symptoms may be due to a substance produced, stored, or released by the leukemic cells. PMID- 2766231 TI - ICN at its best. Korea welcomes the world's nurses. PMID- 2766230 TI - Associations between smoking status and stage of colorectal cancer at diagnosis in Massachusetts between 1982 and 1987. AB - To examine the relationship between smoking and stage of colorectal cancer at diagnosis, data on 2788 current smokers and 6313 nonsmokers with known stage at diagnosis were obtained from the Massachusetts Cancer Registry. The stage at diagnosis was treated as a polytomous response variable in a logit-type, log linear (Poisson) model, with smoking status, age, sex, and race as covariates. The relative frequency of disseminated colorectal cancer was 45% greater in smokers, compared with nonsmokers (relative risk [RR] = 1.45; 95% confidence interval, 1.00 to 2.09). A substudy was conducted to determine the accuracy of the registry's smoking data; the findings suggest that the actual association may be larger than that presented above. These results confirm the presence of an association between smoking and advanced stage of colorectal cancer at diagnosis. Whether the association is due to a biologic or behavioral phenomenon cannot be determined from these data. PMID- 2766232 TI - V International Conference on AIDS. PMID- 2766233 TI - Steps to ethical reasoning. PMID- 2766234 TI - A labor of love. PMID- 2766235 TI - Nursing in Norwegian. PMID- 2766236 TI - Collaboration--at what price? PMID- 2766238 TI - [The nursing dimension in palliative care]. AB - In this 250-bed general hospital, nursing care for the dying focuses not on recovery but on self-actualization. In a broader context, patients also benefit from nursing's theory-based approach. A parallel between the evolution of the patient and the nursing process is established. PMID- 2766237 TI - [Novelty and sophistication in palliative care]. AB - The author describes a seven-bed unit set up to care for terminally-ill patients. She discusses the hopes of care team members, and the need for creativity and flexibility in their interventions. Examples of interventions are included. PMID- 2766239 TI - Sixth International Workshop on Chromosomes in Leukemia. London, England, May 11 18, 1987. Selected papers. PMID- 2766240 TI - Clinical-cytogenetic correlations in myelodysplasia (preleukemia). AB - Cytogenetic studies detected abnormalities in 107 (43%) of the 247 patients in this series. Some degree of overt clinical progression occurred in 55 patients (22%), this being 29% of those patients with cytogenetic abnormalities and 17% of those with normal chromosomes. The presence and complexity of a clonal cytogenetic abnormality correlated with shorter survival. In each clone category of a complexity classification (simple, complex, very complex), patients with some normal cells appeared to have better survival than those with none. In multiple regression analyses, the prognostic value of chromosomes was independent of (and second in importance to) the FAB type of myelodysplastic syndrome (MDS) whichever chromosome classification was used. Patients with refractory anemia (RA) had the lowest incidence of chromosome abnormalities and no cases were found to have only abnormal cells (AA). A greater proportion of patients with refractory anemia with an excess of blasts (RAEB) and RAEB in transformation (RAEB-t) had clonal abnormalities. Morphology alone is not at present able to distinguish between RA or refractory anemia with ringed sideroblasts and similar disorders that may not be MDS in the strict sense. Demonstration of a clonal cytogenetic abnormality remains a positive indication of the presence of the neoplastic nature of the disease. PMID- 2766241 TI - Cytogenetic studies of 21 patients with acute lymphoblastic leukemia in relapse. AB - Karyotypes of 21 patients, originally entered into the Third International Workshop on Chromosomes in Leukemia (3IWCL), were investigated in first, second and/or subsequent relapses. Karyotypes at diagnosis were related to the relapses in the following ways: normal to normal (N-N) (five cases); abnormal to normal (A N) (two cases); abnormal to abnormal with no change (A-A) (five cases); abnormal to abnormal with clonal evolution (A-A+) (eight cases); and normal to abnormal (N A) (one case). The A-A group comprised two each of t(4;11) and t(9;22) cases and one pseudodiploid case; included in this group were the only two patients who did not receive intensive treatment. Both A-N cases had been pseudodiploid at diagnosis. Clonal evolution A-A+ occurred in patients who had had 47-49 chromosomes or pseudodiploidy at diagnosis and was mainly due to the addition of structural change. The additional abnormalities were different in each case. The only de novo appearance of a clone (N-A) was in host cells in relapse following bone marrow transplantation. Clonal evolution occurred in patients who had been intensively treated and who relapsed late; the median time from diagnosis to relapse studied for the A-A group was 6 months and for the A-A+ group was 24 months. Survival following relapse was shorter for patients who had had a clonal abnormality at any time (median 10 months) than for those with no abnormality at diagnosis or in relapse (median 26 months). PMID- 2766242 TI - Six-year follow-up of the clinical significance of karyotype in acute lymphoblastic leukemia. AB - To evaluate the importance of pretreatment karyotype in predicting long-term outcome in acute lymphoblastic leukemia (ALL), we performed a follow-up study of the 329 patients from the Third International Workshop on Chromosomes in Leukemia. Living patients have now been followed a minimum of 6 years. Patients were divided into ten groups according to pretreatment karyotype: no abnormalities, one of the following structural abnormalities [the Philadelphia chromosome, rearrangements involving 8q24, t(4;11), 14q+, 6q-] or, in the remaining cases, modal number (less than 46, 46, 47-50, greater than 50). As previously reported for achievement and duration of complete remission, and overall survival, disease-free survival differed significantly (p less than 0.001) among chromosome groups for both adults and children. Among children, karyotype was an independent prognostic factor for predicting disease-free survival. Because of the long follow-up, we now have been able to utilize statistical models to estimate the percentage of patients cured, according to karyotype alone and combined with other risk factors. Adults with the highest likelihood of cure (21-33%) were those patients with FAB-L1, a leukocyte count of 50,000/microliters or less, and one of the following chromosome groups: greater than 50, 47-50, 6q-, or normal. In children these same characteristics were associated with the highest percentage of cure (58-71% cured). In addition, we identified several groups of children with less than 15% chance of cure who clearly need to be treated as high-risk patients at diagnosis. Future studies of patients who have received risk-adapted therapy based on these chromosome data are needed to determine if more intensive treatment will improve the outlook of patients with cytogenetically unfavorable types of ALL. PMID- 2766243 TI - Cytogenetic studies of 103 patients with acute myelogenous leukemia in relapse. AB - In order to investigate the cytogenetic patterns in relapsed acute myelogenous leukemia (AML), a clinical and cytogenetic follow-up of patients newly diagnosed for the Fourth International Workshop on Chromosomes in Leukemia (4IWCL) was evaluated at the 6IWCL. Information was received on 103 patients in relapse who were then classified into seven groups according to the diagnostic karyotype. These groups were: normal, t(8;21), t(15;17), +8, a single specific abnormality either numerical or structural other than those already listed, a single nonrandom or miscellaneous abnormality again either numerical or structural, and complex abnormalities. The patient's age, diagnostic FAB type, the number of relapses, the total survival time, and the karyotype in relapse were considered in each of these cytogenetic groups. The remission and survival rates were comparable in all groups except the +8 group, where patients relapsed earlier and had a shorter survival time. Multiple relapses occurred most frequently in the t(8;21) group, whereas none of the patients with t(15;17) relapsed more than once, although the total survival time was similar to the two groups. Thirty-nine percent of the patients relapsed with the same karyotype as at diagnosis. A more complex karyotype showing evolution was found in 53%, and 8% showed either a less complicated karyotype or appeared to have reverted to normal. Numerical abnormalities in relapse frequently involved trisomy of chromosomes 8 and/or 21. There was a nonrandom development of 9q- with relapse in patients with t(8;21). A pericentric inversion of chromosome 4, and abnormality infrequently reported at diagnosis, was found in relapse in association with t(15;17), t(8;21), and +8 karyotypes. Changes considered to be typically secondary in nature involving 5q, 7q, and 12p were seen in only seven cases. Twenty-one patients who had an apparently normal karyotype at diagnosis remained normal in relapse, indicating that absence of clonal chromosome abnormality is a real observation in AML rather than a failure of detection. PMID- 2766244 TI - The clinical significance of karyotype in acute myelogenous leukemia. AB - To evaluate further the prognostic significance of karyotype at diagnosis of acute myelogenous leukemia (AML), we have made a follow-up study of 711 patients who were diagnosed between January 1, 1980, and March 31, 1982, and who were originally reported by the Fourth International Workshop on Chromosomes in Leukemia (4IWCL). Three different chromosomal classifications were evaluated, including presence of normal and abnormal metaphases (NN-AN-AA classification), a modification of the Chicago classification, and a complexity classification. All three chromosomal classifications were shown to correlate significantly with outcome in patients with de novo AML. Furthermore, the NN-AN-AA classification and the complexity classification had independent prognostic significance when age, sex, and FAB morphology were also considered in multivariate analyses of survival. These data provide further evidence that karyotype is an important factor in predicting the outcome of patients with AML. PMID- 2766245 TI - A malignant mixed gonadal stromal tumor of the testis with heterologous components and i(12p) in one of its metastases. AB - A malignant mixed gonadal stromal tumor with mesenchymal heterologous elements of the testis is presented. This entity has been described in the ovary, but not hitherto in the testis. Karyotyping and ploidy measurement was done of the primary tumor and of an inguinal and lung metastases. The DNA ploidy and modal chromosome numbers were in agreement with each other in all samples. The most significant cytogenetic finding was the presence of the metacentric germ cell tumor marker i(12p) in an inguinal metastasis. This marker has been demonstrated in testicular and ovarian germ cell tumors and in a mixed Mullerian tumor, which raises the question of a possible relationship between the pluripotency of these tumors and the presence of i(12p). PMID- 2766246 TI - Complex cytogenetic aberrations in a well-differentiated chondrosarcoma. AB - The cytogenetic analysis of a well-differentiated (grade I) chondrosarcoma is presented. Despite a low-grade histopathology, metaphase preparations of tumor cells were characterized by numerous structural chromosome aberrations and a striking degree of genetic instability; the t(9;22)(q31;q12) that has been described recently in extraskeletal myxoid chondrosarcoma was not observed. This report suggests that chondrosarcomas may be heterogeneous cytogenetically. In chondrosarcoma, it appears that "high-grade" cytogenetic abnormalities do not necessarily engender a high-grade histology. These findings offer a possible explanation for the clinical aggressiveness of certain low-grade chondrosarcomas. PMID- 2766247 TI - Ultraviolet-induced formation of micronuclei and sister chromatid exchange in cultured fibroblasts of patients with cutaneous malignant melanoma. AB - Genetically enhanced sensitivity to ultraviolet (UV) radiation may play an important role in the development of cutaneous malignant melanoma (CMM). This was studied in cultured fibroblasts of 26 CMM patients and controls by micronucleus (MN) test and sister chromatid exchange (SCE) after UV irradiation (375 J/m2). Sister chromatid exchange and MN formation were used as parameters to detect the UV-induced genotoxic damage in the individual cell strains. We found that the UV induced level of MN was significantly increased in CMM patients (p = 0.0005), being most pronounced in the familial cases (p = 0.0001). Ultraviolet-induced SCE was also elevated in CMM patients (p = 0.001), but there was no difference between familial and nonfamilial cases. The present findings indicate that genetic predisposition contributes to the development of CMM in a subset of CMM patients and may be due to an enhanced susceptibility to UV light. PMID- 2766248 TI - A translocation (7;10)(q35;q21) in a differentiated papillary carcinoma of the thyroid. AB - A case of differentiated thyroid carcinoma is reported. Cell culture techniques and cytogenetic investigations are described. A t(7;10)(q35;q21) appears to be the sole chromosome abnormality. PMID- 2766249 TI - Cytogenetic analysis of a leiomyosarcoma cell line (SK-UT-1B). Normal diploid or with 21q deletion? PMID- 2766250 TI - Trisomy 7 in a case of transitional cell carcinoma of the kidney. PMID- 2766251 TI - Specificity of asbestos-induced chromosomal aberrations in short-term cultured human mesothelial cells. AB - Short-term cultured normal human mesothelial cells were exposed for 48 hours to three different asbestos compounds, crocidiolite, chrysotile, and amosite. In the concentration used (0.01 mg/ml) all three asbestiform minerals caused, within a few days, a significant increase of cells showing numerical and/or structural abnormalities. The abnormalities were analyzed in detail using banding techniques. The results were compared with the cytogenetic observations in 52 published cases of mesotheliomas. This comparison revealed only a few similarities as regards numerical deviations. The structural rearrangements in asbestos-exposed cultures, however, in many instances involved chromosome types and chromosome regions preferentially affected in mesotheliomas. PMID- 2766253 TI - Densitometric measurements of C bands of chromosomes 1, 9, 16, and Y in leukemic and preleukemic disorders. AB - Fifty-six patients with blood disorders (23 with chronic myeloid leukemia, 14 with acute myeloblastic leukemia, seven with acute lymphoblastic leukemia, one with chronic lymphocytic leukemia, and 11 with preleukemia states) were studied. A quantitative and objective method of C band length analysis with well-matched controls was used. The C bands of chromosome pairs 1, 9, and 16 presented a normal distribution that was similar in patients and controls, whereas the Y chromosome presented an abnormal distribution. Smaller C bands in 1qh and higher indexes of intrapair heteromorphism in pairs 1 and 9 were detected in the CML group; the group of acute leukemias (myeloblastic and lymphoblastic) presented a smaller index only in pair 1qh. No other differences in length, heteromorphism, inversion frequency, or sex were detected. PMID- 2766252 TI - Cytogenetic effects of radiotherapy. Breakpoint distribution in induced chromosome aberrations. AB - A total of 660 breakpoints were identified in the chromosome aberrations detected in lymphocytes from cancer patients after radiotherapy. The results show that chromosomes 1, 3, and 7 were significantly more affected than other chromosomes by ionizing radiation in vivo. Chromosome arms 1p, 1q, 7q, and 11p were also significantly more affected. Some bands also showed a special sensitivity to radiation, and band 1q32 was the most affected. This band is proposed as a "hot point" for the clastogenic effect of ionizing radiation. A significant clustering of breakpoints in G bands was also found, especially at the telomeres, as previously described by other authors. Clustering of breakpoints was also observed in bands where fragile sites, protooncogenes, breakpoints involved in chromosomal cancer rearrangements, and breakpoints involved in chromosomal evolution of the Hominoidea are located. PMID- 2766254 TI - Appearance of a transient inv(14)(q11q32) in a case of B cell chronic lymphocytic leukemia. AB - The inv(14)(q11q32) has been reported to be a specific chromosome aberration in T cell chronic lymphocytic leukemia (T-CLL) and different types of T-cell lymphomas. Here, the first case of B-CLL with a clonal inv(14)(q11q32) in a phytohemagglutinin-stimulated bone marrow culture is presented. In a subsequent study 9 months later, tetradecanoyl-o-phorbol-13-acetate stimulated blood and bone marrow cultures revealed a clone with a t(1;11)(p13.2;q23.1) and an aberrant chromosome 17. PMID- 2766255 TI - Multiple clonal chromosome aberrations in two thymomas. AB - Cytogenetic investigations of two thymomas of different histopathology revealed unrelated clonal karyotypic changes: 44,XY,+X,inv(2)(p25q13),del(6)(q15),-8,-16, 17 in a cortical thymoma, and 48 49,XX,+del(X)(q24),+i(5p),+?del(7)(q22),der(11)t(1;11)(q23;q25),t(11; ?)(p15;?), 18,+r in a mixed-type thymoma. These are the first thymic tumors of epithelial origin that have been investigated with banding technique. PMID- 2766256 TI - inv(12)(p11.2q13) in an endometrial polyp. AB - A benign endometrial polyp from a 50-year-old postmenopausal woman has been cytogenetically investigated. A single clonal karyotypic anomaly, inv(12)(p11.2q13), was found in about 30% of cells analyzed after short-term culture. This finding contributes further to the hypothesis that the chromosomal segment 12q13-q14, which is also involved in chromosomal rearrangements in uterine leiomyomas, pleomorphic adenomas of the salivary glands, lipomas, and myxoid liposarcomas, contains a gene or genes that are related to cellular proliferation rather than to malignant transformation. PMID- 2766257 TI - Induction of rat liver glutathione transferase subunit 7 by lead nitrate. AB - The effect of a single dose of lead nitrate (10 microM/100 g body wt), a hepatic mitogen, on rat liver glutathione transferase (GST) subunit expression was investigated. Using SDS-polyacrylamide gel electrophoresis and Western blot technique evidence for the induction of GST 7-7 is shown. This occurrence is identical to that observed in preneoplastic nodules generated in rat liver by different models of chemical carcinogenesis, suggesting that lead nitrate may be a very simple model for investigation of the mechanism of glutathione transferase 7-7 gene expression in chemical hepatocarcinogenesis. PMID- 2766258 TI - Effect of derivatives of chrysophanol, a new type of potential antitumor agents of anthraquinone family, on growth and cell cycle of L1210 leukemic cells. AB - The new C-methyl modified derivatives of the anthraquinones chrysophanol and emodin, recently synthesized by us, are potentially bifunctional agents having the ability to intercalate to nucleic acids and also having alkylating properties. Two of these compounds, namely 3-(N,N-bis(2-chloroethyl)-amino)methyl 1,8-dihydroxy-9,10-anthraquinone (Compound 31.662) and its 1,8-di-O-methylated analog (Compound 31.655) have been presently tested on murine leukemic L1210 cells in vitro with respect to their cell cycle specificity. During the initial 24 h of treatment the cytostatic effects of the drugs predominated, manifesting as suppression of cell progression through S (especially through the early portion of S phase) and G2. After 24 h, the cytotoxic effects became apparent, and there was also the appearance of cells with doubled DNA content suggestive of either endoreduplication or impairment of cytokinesis; these cells at higher ploidy level were progressing through S and G2. The observed effects were time- and dose-dependent, occurring at 0.1-0.4 micrograms/ml concentration of 31.662 and 2.0-10.0 micrograms/ml of its methylated analog, either during continuous- or after a 4-h pulse-treatment. Modulation of the cell cycle by the studied drugs is similar to that generally caused by intercalators as well as alkylating agents. However, because no positive evidence of intercalation of the studied drugs to nucleic acids was found, it is possible that alkylation of DNA or other cell constituents may be the primary lesion(s) leading to perturbation of the cell cycle. PMID- 2766259 TI - Transgenerational effect of orthoaminoasotoluol in mice. AB - Transplacental effect of orthoaminoasotoluol (OAAT) on the liver was studied in 3 generations of CBA mice. OAAT was administered to mice intragastrically at the 17, 18 and 19th day of pregnancy. A high incidence of liver tumors was observed in males (73.1% compared with 40.6% in control animals) and 34.3% in females compared to 4.6% in control animals which were the F1 descendants of treated mothers. The females of the F2 generation which were not in direct contact with OAAT developed a statistically higher, compared with the control incidence of liver tumors (24%). The liver tumor incidence in males of the F2 (20.6%) and F3 (17.8%) generations was lower than in the control group (40.5%). The liver tumor incidence in the controls was similar to that observed in F3 females (4.05%). PMID- 2766260 TI - Determination of intracellular reduced glutathione and glutathione related enzyme activities in cisplatin-sensitive and resistant experimental ovarian carcinoma cell lines. AB - The level of GSH in ovarian carcinoma cells which were sensitive and resistant to cisplatin was serially determined following tumor removal from the animals, in addition, activities of GSH-reductase and GSH-S-transferase were assessed. The GSH level in the resistant line (O-342/DDP) was almost twice as high as that in its sensitive counterpart (O-342), when determined immediately following removal of the tumor (1.55 +/- 0.47 vs. 0.81 +/- 0.32 nmol/10(6) cells). Culturing the cells resulted in a decrease of GSH levels in both cell lines during the first 4 h. Thereafter, GSH levels in both cell lines increased up to 24 h. At this time the GSH level was higher in O-342 than in O-342/DDP. GSH-reductase activity in O 342/DDP cells was significantly higher than in O-342 cells when the enzyme was determined immediately after tumor removal; at the same time there was no difference in activity of GSH-S-transferase between two cell lines. After 24 h in culture, no significant difference between O-342 and O-342/DDP cells could be observed in the activity of the two enzymes. PMID- 2766261 TI - Prognostic significance of DNA content in large bowel carcinoma: a retrospective flow cytometric study. AB - Flow cytometric (FCM) determination of DNA content was performed on surgical specimens from 44 patients with previously untreated colonic carcinoma. For each tumor, cell suspensions were prepared from 2-4 40-microns thick sections obtained from formalin-fixed and paraffin embedded tissue samples. Aneuploidy was found in 47.2% of all the tumors and the aneuploid clone had a median DNA index of 1.49 (range: 1.24-1.93). Aneuploidy was found in 26.7% of highly differentiated tumors (WHO histologic classification), in 53.8% of moderately differentiated tumors and in 100% of poorly differentiated tumors (P = 0.04). The 33.3% of stages 1 + 2 (TNM) and the 70.6% of stages 3 + 4 tumors were aneuploid (P = 0.002). Median survival from surgery was 46.4 months for all patients. It was 18.8 months for patients with aneuploid tumors and 85.7 months for those with diploid tumors (P = 0.0002). FCM determination of DNA in colon carcinomas can easily be performed on archival histological material and provides prognostic information. PMID- 2766262 TI - The occurrence of N-nitroso compounds in kiwam tobacco. AB - The concentrations of tobacco-specific nitrosamines (TSNA), volatile and non volatile N-nitroso compounds in kiwam, a fermented Indian tobacco product are presented. Total identified N-nitroso compound concentrations in kiwam ranged from 6.19 to 25.4 mg/kg fresh weight tobacco, the concentration range of TSNA was 5.43-22.2 mg/kg tobacco which accounted for 67-87% of the total identified N nitroso compound burden. The high concentrations of TSNA found in kiwam tobacco may present a considerable exposure source to carcinogenic N-nitroso compounds for people using this type of tobacco. PMID- 2766263 TI - Guidelines for use of controlled-release oral morphine in cancer pain management. Correlation with clinical experience. AB - An open study of 47 patients with cancer pain treated with repeated doses of a controlled-release oral morphine tablet was conducted to assess the acceptability of this drug and develop guidelines for its use. Each patient kept a detailed record of pain, analgesic intake, side effects, and other medications. A nurse observer/clinician followed these patients on a daily basis and kept similar records. Of 47 patients who began the study, 37 were successfully stabilized with standard morphine sulfate tablets and then switched to controlled-release morphine (CRM). Twenty-one patients who completed the study took CRM every 12 h, and 16 patients received a dose every 8 h. Doses of the CRM ranged from 30 mg every 12 h to 360 mg every 8 h. Less frequent doses and uninterrupted sleep were reported advantages. All of the patients completing the study chose to continue this method of pain management and extended care data were obtained from each patient poststudy through continued monitoring. PMID- 2766264 TI - Caregiving demands and appraisal of stress among family caregivers. AB - Ambulatory treatment for cancer has increased patients' self-care requirements and placed demands on family members to manage the illness and treatment side effects at home. This exploratory study was undertaken to assess family caregiving demands (load) and to examine caregivers' appraisals of the illness/caregiving experience. Forty-seven persons involved in the care of patients receiving radiotherapy for cancer were observed. Appraisal of stress was measured with the Appraisal of Caregiving Scale (ACS). This newly developed measure, derived from cognitive appraisal theory, is designed to assess the intensity of four possible appraisals of caregiving: harm/loss, threat, challenge, or benign. Participants also completed the Caregiver Load Scale, a measure of the time spent in caregiving activities. Satisfactory reliabilities were obtained for both measures. Family caregivers reported spending the most time in providing transportation, giving emotional support, and in extra household tasks. They received the most assistance from family and friends, and made minimal use of professional services. Caregiver load was correlated positively with the length of time on treatment and with patient dependency. Caregivers in the poorest health, those with less education, and those of lower socioeconomic status had higher scores on the ACS appraisals of harm/loss and threat. Older caregivers had significantly higher challenge and benign appraisals. There was a strong positive correlation between caregiver load and the harm/loss and threat appraisals. Findings suggest a need for frequent reassessment of demands on family caregivers throughout the course of treatment and offer direction for future research. PMID- 2766265 TI - A description of the needs of noninstitutionalized cancer patients and their primary care givers. AB - The purpose of this descriptive study was twofold: to identify the needs of the noninstitutionalized patient with cancer as defined by patients, primary care givers, and nurses, and to identify the needs of the primary care giver as defined by the same three groups of subjects. Each subject completed two forms of the Objects Content Test, an open-ended questionnaire on which subjects were asked to list the needs of patients and care givers. Content analysis was applied to the two sets of data to formulate categories of need responses; each set of data with category labels and definitions was submitted for q-sort by two successive groups of nurse experts to establish the validity of need item responses in categories. Findings revealed that patient needs were represented by six categories and caregivers' needs by seven categories. For both sets of data, the largest number of needs were in the psychological needs category. For patients, physical needs and information needs were the next largest categories; for care givers, the categories of household management needs (which encompassed patient care) and information needs were the second and third largest. Some disparity between perceived needs as generated by the three groups of subjects was noted. Further research utilizing quantitative methods is needed to determine whether suggested trends (such as nurse subjects' emphasis on informational needs for care givers and patients' infrequent listing of informational needs for themselves) have validity. PMID- 2766266 TI - Identification of problems and strengths of the hospice client by clients, caregivers, and nurses. Implications for nursing. AB - This exploratory study included instrument development as well as testing. The purpose of the study was to ascertain whether primary caregivers and hospice nurses identified the same problems and strengths of individual clients as did clients themselves. The instrument, a 27-item modified Q-sort, was based on review of literature on the concept Quality of Life. Dembo's Insider versus Outsider Perspective was the theoretical framework. Using the instrument, participants identified the problems and strengths of the client in the current time frame. Twenty consenting hospice clients, their primary caregiver, and their assigned hospice nurse were studied. No significant differences were found between clients, nurses, and caregivers when Total instrument means were compared (F = 1.38, p = 0.26). Three of the 27 items showed significant differences in the means of the three groups. Reliability coefficients showed high internal consistency on the Total instrument (0.87). Nurses and caregivers were found to identify problems and strengths of the client as perceived by the client. Findings corroborated Dembo's theory. Support of the hospice concept as the appropriate method of care for terminally ill clients was suggested. PMID- 2766267 TI - Effect of psychoeducational intervention on anxiety among Egyptian bladder cancer patients. AB - This study examined the effect of psychoeducational preparation 1-2 days prior to surgery on postoperative state anxiety among Egyptian bladder cancer patients with urinary diversion. The theoretical rationale was based upon the Betty Neuman Health-Care Systems Model. State anxiety was measured by the A-state form of the State Trait Anxiety Inventory. A total of 30 patients were assigned randomly to experimental and control groups. Fifteen patients were included in each category. Preoperatively, the total sample was interviewed about their "worries" at that time, and data from this qualitative part were categorized into three subconcepts. Results revealed that their main anxieties are related to stress associated with being cancer patients followed by stress related to the impact of surgery on their bodies and on their social and marital life. Results from the quantitative part of the study showed that psychoeducational preparation lowered significantly state anxiety on the third day postoperatively and before discharge for those patients who had the intervention. PMID- 2766268 TI - Motivational factors in breast self-examination. Implications for nurses. AB - Breast self-examination (BSE) is an important self-care activity for women to perform to maintain their life, health, and well-being. Although women are growing aware of the importance of breast self-examination, it appears that they lack sufficient motivation to perform it on a consistent basis. Nurses are ideal health professionals to motivate women to perform BSE because of their knowledge, their supportive-educative role, and their numbers located in various settings. The purpose of this article is to identify how nurses can direct their efforts in the promotion of BSE practice through the use of Orem's Self-Care Deficit Theory. This article will also explore, through the application of the PRECEDE Model, how nurses can develop effective strategies to increase the consistent practice of BSE in women. PMID- 2766269 TI - Reducing avoidable cancer mortality through prevention and early detection regimens. PMID- 2766270 TI - Inhibitory effect of antibody against basic fibroblast growth factor on androgen- or glucocorticoid-induced growth of Shionogi carcinoma 115 cells in serum-free culture. AB - Shionogi carcinoma 115 (SC115) has been accepted for 20 years as an androgen responsive mouse mammary tumor. However, we and others recently found that the growth of SC115 cells is also stimulated by high doses of glucocorticoids. We already reported the following findings. In a serum-free medium [Ham's F-12: Eagle's minimum essential medium (1:1, v/v) containing 0.1% bovine serum albumin], greater than or equal to 10(-9) M testosterone and greater than or equal to 10(-8) M dexamethasone significantly stimulated the growth of SC-3 cells (a cloned cell line from a SC115 tumor) through androgen and glucocorticoid receptors, respectively. In the present study, we have demonstrated that higher concentrations (10(-7)-10(-6) M) of weak androgens such as 4-androstene-3,17 dione or weak glucocorticoids such as corticosterone also significantly stimulate the growth of SC-3 cells and that their relative potency is found to be in parallel with their binding affinity for their receptors, respectively. Furthermore, DNA synthesis of SC-3 cells induced by 0.1 ng/ml basic fibroblast growth factor (FGF), 10(-8) M testosterone, 10(-6) M 4-androstene-3,17-dione, 10( 7) M dexamethasone, or 10(-6) M corticosterone was found to be similarly and significantly inhibited by the addition of basic FGF neutralizing antibody IgG in the present study; approximately 70% inhibition of the basic FGF, androgen, or glucocorticoid effects was attained. We already reported findings which suggest that SC-3 cells produce FGF-like peptide for their testosterone-induced growth. Therefore, the present study presents new additive information to demonstrate that the growth-stimulatory activity of various androgens or possibly glucocorticoids on SC-3 cells is mediated through a FGF-like peptide in an autocrine mechanism. PMID- 2766271 TI - Adoptive immunotherapy as an adjunctive treatment to thoracic irradiation for pulmonary tumor deposits in mice. AB - The study was performed to determine whether local thoracic irradiation (LTI) causes accumulation of adoptively transferred peritoneal exudate (PE) cells in the lung and whether such treatment improves the response of tumor deposits in the lung to LTI. Tumors in the lung were generated by sarcoma SA-NH cells injected i.v. into syngeneic (C3Hf/Kam mice. Exposure of mice to a single dose of gamma-rays ranging from 2 to 10 Gy caused a dose-dependent decrease in the number of alveolar exudate cells. Also, LTI caused a dose-dependent reduction in the number of lung tumor nodules in mice that were treated with tumor cells 4 days before irradiation. Adoptive i.v. transfer of syngeneic PE cells several hours or 2 days after LTI not only restored the radiation-depleted alveolar exudate cells to their normal levels but also led to an accumulation of transferred cells in the irradiated lung to a several-fold excess of the normal value. Maleic anhydride-divinyl ether-2-activated PE cells accumulated in the irradiated lung much more than normal PE cells and exerted antitumor activity in normal mice and in mice exposed to LTI. Their antitumor action, however, was much more pronounced in the latter, resulting in the augmentation of radioresponse of tumor nodules by a factor of 1.23. The better antitumor action of activated PE cells in mice given LTI can be ascribed to accumulation of these cells in the irradiated lung. Thus, these results show that the irradiation of the lung predisposes this tissue to accumulation of lymphoid cells, which can be beneficial in the therapy of malignant tumors by combinations of radiotherapy and adoptive immunotherapy. PMID- 2766272 TI - Metabolism and murine pharmacokinetics of the 8-(N,N-dimethylcarboxamide) analogue of the experimental antitumor drug mitozolomide (NSC353451). AB - The in vitro cytotoxicity, stability, and metabolism of the 8-(N,N dimethylcarboxamide) and 8-(N-methylcarboxamide) analogues of the experimental antitumor drug mitozolomide have been investigated in conjunction with their in vivo murine pharmacokinetics and metabolism. When tested against the TLX5 lymphoma in vitro the ID50 values for dimethylmitozolomide, methylmitozolomide, and mitozolomide were 14.6, 3.0, and 2.3 microM, respectively. The cytotoxicity of dimethylmitozolomide was dramatically increased when it was incubated with murine hepatic microsomes. There was no significant difference in the in vitro stabilities of dimethylmitozolomide and methylmitozolamide with half-lives of 43.5 and 45.8 min, respectively, in RPMI at 37 degrees C. The in vitro microsomal incubation of dimethylmitozolomide produced significant amounts of methylmitozolomide, which suggests that methylmitozolomide contributed to the cytotoxicity of dimethylmitozolomide in the presence of microsomes. The pharmacokinetics of both dimethylmitozolomide and methylmitozolomide, given i.p. at 10 mg/kg, were investigated in CBA/Ca mice bearing the s.c. solid TLX5 lymphoma. Methylmitozolomide was absorbed rapidly with maximum plasma and tumor concentrations of 10.66 mg/liter and 8.01 mg/kg, respectively, achieved 0.17 h following dosing. Dimethylmitozolomide was also rapidly absorbed with maximum plasma and tumor concentrations of 9.34 mg/liter and 5.00 mg/kg, respectively, achieved within 0.18 h of dosing. Following administration of dimethylmitozolomide, methylmitozolomide was found in both plasma and tumor tissue. The plasma and tumor area under the curves of methylmitozolomide were 87.7% and 120.8%, respectively, of those seen when mice were dosed with authentic methylmitozolomide. By comparison of the area under the curves and clearance values, it was demonstrated that 89% of the administered dimethylmitozolomide was metabolized via methylmitozolomide. PMID- 2766273 TI - Influence of cellular, microenvironmental, and growth parameters on thermotolerance kinetics in vivo in human melanoma xenografts. AB - The kinetics of thermotolerance in five human melanoma xenograft lines grown in BALB/c-nu/nu/BOM mice was studied in vivo. Local hyperthermia was given by immersing the tumor-bearing leg of the mice into a thermostatically regulated water bath. Specific growth delay was used as the end point for tumor response. Thermotolerance ratio (TTR), i.e., the ratio of the slopes of dose-response curves (specific growth delay versus heating time) for single-heated and preheated tumors, was used as a quantitative measure of thermotolerance. All melanoma lines developed thermotolerance; TTR reached a maximum (TTRmax) 16 to 24 h after the conditioning heat treatment and then decayed slowly. TTRmax and the time necessary to reach TTRmax tended to increase with increasing conditioning heat dose, whereas the half-time of thermotolerance decay did not change with the conditioning heat dose. The kinetics of thermotolerance differed considerably among the melanoma lines. After a conditioning heat treatment of 43.5 degrees C for 30 min, TTRmax ranged from 2.3 +/- 0.5 to 7.0 +/- 1.2, the half-time of thermotolerance decay from 53 +/- 13 h to 142 +/- 30 h and the time necessary to reach complete decay of the thermotolerance from 5 days to more than 14 days. TTRmax showed no correlation to heat sensitivity or any known growth and microenvironmental parameter of the melanoma lines. On the other hand, TTRmax was positively correlated to TTRmax measured in vitro when cells from the melanomas were studied in soft agar. However, TTRmax in vivo was always somewhat lower than TTRmax in vitro. Consequently, the development of thermotolerance in the melanomas in vivo was governed mainly by the intrinsic ability of the tumor cells to develop thermotolerance and was just slightly modified by the tumor microenvironment. The rate of thermotolerance decay was independent of TTRmax. The half-times of thermotolerance decay in vivo were longer than, and not correlated to, those measured in vitro. However, the decay half-time in vivo tended to increase with increasing tumor volume-doubling time, and to decrease with increasing growth fraction and vascular density. There was no relationship between decay half-time and fraction of radiobiologically hypoxic cells. Consequently, the rate of thermotolerance decay in the melanomas in vivo was governed mainly by tumor growth parameters and not by intrinsic characteristics of the tumor cells. The considerable difference in the kinetics of thermotolerance observed among the melanoma lines suggests that fractionated hyperthermia cannot be expected to give optimum clinical results until individualized treatment regimens are being used.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2766274 TI - Expression of messenger RNA species coding for a Mr 43,000 peptide associated with ferritin in human leukemia-K562 cells and its down regulation during differentiation. AB - In the current study it was found that K-562 erythroleukemia cells express the superheavy (S) mRNA and the 43 Kd S peptide which were recently discovered in activated T-lymphocytes. The S mRNA was identified by its cross-hybridization with ferritin H complementary DNA probe and the S peptide (Mr 43,000) was identified by its immunoprecipitation with CM-H-9 monoclonal antibody specific for placental isoferritin. During terminal differentiation by hemin the level of S mRNA decreased below detection, with a concomitant diminution in the biosynthesis of the S peptide. In contrast, a significant increase in the level of ferritin light (L) and heavy (H) mRNAs was observed, resulting in an increase in the rate of biosynthesis of the H and L ferritin subunits. Removal of iron by desferrioxamine reduced the biosynthesis of ferritin L and H chains without altering the level of the corresponding mRNAs. Treatment with desferrioxamine did not affect either the level of S mRNA or the biosynthesis of the S peptide. This is a demonstration of a new mRNA species which is expressed in leukemic cells and is down-regulated during cell differentiation. PMID- 2766275 TI - Genetic variation in liver tumor susceptibility, plasma testosterone levels, and androgen receptor binding in six inbred strains of mice. AB - We compared six inbred mouse strains for their relative susceptibilities to liver and lung tumor induction. Male and female mice were treated at 12 days of age with a single i.p. injection of N-ethyl-N-nitrosourea (ENU; 0.25 mumol/g), and tumor multiplicity was analyzed at 32 weeks of age (males) or 44 weeks of age (females). Male mice of the SWR/J and C57BL/6J strains were relatively resistant to hepatocarcinogenesis, averaging 0 and 0.3 tumors per animal, respectively. Male C57BR/cdJ, P/J, and SM/J mice had intermediate susceptibilities, averaging seven to 17 tumors per animal, and male CBA/J mice were the most susceptible, averaging 45 tumors per animal. Female mice were more resistant than male mice: no liver tumors were observed for SWR/J females; C57BL/6J, SM/J, P/J, and CBA/J females averaged less than one tumor per animal and C57BR/cdJ females averaged five tumors per animal. In contrast to the results for liver tumor induction, there was no difference between the sexes in lung tumor susceptibility. Male and female SWR/J mice were the most susceptible, averaging 14 lung tumors per animal; male and female CBA/J mice were moderately susceptible, averaging six tumors per animal and the C57BR/cdJ, C57BL/6J, P/J, and SM/J strains were relatively resistant, averaging less than three tumors per animal. To determine if levels of testosterone, a potent liver tumor promoter in mice, or its receptor contribute to the strain variation in liver tumor susceptibility, we measured levels of plasma testosterone as well as binding properties of the hepatic androgen receptor for the six inbred strains. Plasma testosterone in male mice ranged from 1.8 to 7.4 ng/ml and in females ranged from 0.21 to 0.42 ng/ml, which is consistent with the greater susceptibility of male mice to liver tumor development. However, variation in testosterone levels among the different strains of mice was not correlated with liver tumor susceptibility. We also demonstrated the presence of high affinity androgen receptors in mouse hepatic cytosol. The amounts of this receptor for the six strains tested ranged from 24 to 34 fmol/mg cytosolic protein. The apparent KD of the receptor for [3H]mibolerone (a synthetic androgen) differed between the strains: SWR/J, C57BL/6J, and C57BR/cdJ mice had the highest affinity (KD = 0.22 nM), P/J and CBA/J strains had an intermediate affinity (KD = 0.36 nM), and the SM/J strain had the lowest affinity receptor (KD = 0.45 nM). The strain variation in the affinity or abundance of the androgen receptor was not related to the strain variation in liver tumor induction. PMID- 2766276 TI - Mechanism of transport and intracellular binding of porfiromycin in HCT 116 human colon carcinoma cells. AB - The mechanism of uptake and efflux of porfiromycin (PFM) by HCT 116 human colon carcinoma cells or freshly obtained human RBC was investigated. The time course of uptake of radioactivity upon exposure of HCT 116 cells to [14C]PFM showed one fast and one slow phase of linear increase. The initial phase of PFM uptake was not saturable with external drug concentrations from 2 to 100 microM. PFM accumulation was temperature dependent with a temperature coefficient (Q10 24-37 degrees C) of 2.3 +/- 0.3. PFM uptake was not affected either by individual inhibitors such as 1 mM 2,4-dinitrophenol, sodium azide, iodoacetic acid, ouabain, 0.02 mM oligomycin, p-hydroxylmercuribenzoate, 0.2 mM N-ethylmaleimide, or by combinations of inhibitors. PFM uptake did not demonstrate competitive inhibition by unlabeled PFM and mitomycin C. Efflux of cellular radioactivity was not affected by the above mentioned inhibitors or by verapamil, diltiazem, or trifluoperazine. Only aliphatic alcohols accelerated the initial influx rate. The RBC, however, only exhibited the initial fast accumulation of [14C]PFM, and all the 14C accumulated by RBC was exchangeable. These data demonstrate that the uptake and the efflux of PFM in HCT 116 cells and RBC comprise a passive diffusion process. PMID- 2766277 TI - Association among DNA/chromosome break rejoining rates, chromatin structure alterations, and radiation sensitivity in human tumor cell lines. AB - The basis for radioresistance and radiosensitivity in human tumor cell lines is unknown. In a previous study, radiosensitivity in human tumor cell lines was found to be a function of the rate of DNA double-strand break rejoining. Radioresistant cell lines rejoined DNA double-strand breaks at a faster rate than more sensitive cell lines. In this study, we have expanded on that work and analyzed the rate of chromosome break rejoining, as well as the type and frequency of chromosome aberrations induced in three relatively radioresistant (D0 greater than 2.0 Gy) human squamous cell carcinoma cell lines and three relatively radiosensitive (D0 less than 1.5 Gy) squamous cell carcinoma cell lines. Radioresistant cells were found to rejoin chromosome breaks faster than more sensitive cells. The faster rate of rejoining was associated with a reduced frequency of misrepair events (chromosome exchange-type aberrations) and greater survival. There were qualitative differences between these two groups of cell lines in their ability to bind ethidium bromide as nucleoids, suggesting that the basis for altered break rejoining rates might be related to chromatin structure. PMID- 2766278 TI - Expression of a human multidrug resistance gene in ovarian carcinomas. AB - Expression of the human MDR1 gene has been shown to confer the multidrug resistance (MDR) phenotype to sensitive cells. To investigate the possible contribution of the MDR phenotype to chemoresistance in ovarian carcinoma, we have analyzed MDR1 gene expression in fresh carcinoma specimens from 50 patients. Fifteen received chemotherapy before surgery and were judged as poor responders. Thirty-five patients did not receive any drug before surgery. Control tissues were lymphocytes from 7 patients. Total RNAs were analyzed by Northern and slot blot hybridization techniques using human MDR1 complementary DNA and human gamma actin complementary DNA probes sequentially as qualitative and quantitative controls. MDR1 transcripts (4.5 kilobases) were observed in the RNA preparations obtained from 3 of 10 patients who were treated with doxorubicin or vincristine, 2 drugs known to select the MDR phenotype in vitro. In 40 other RNA preparations obtained from 35 untreated patients and 5 patients treated exclusively with cyclophosphamide and cis-platinum, no transcript could be detected. Using the exact Fisher test, the difference between the 2 groups was found to be significant (P less than 0.01). The three tumors with elevated MDR1 expression did not show MDR1 DNA amplification. Our study suggests that, in spite of the weak occurrence of the MDR process in patients with ovarian cancers, MDR1 expression can be related to previous treatment with doxorubicin or vincristine. These results favor the expression of the MDR1 gene as one of the determinants involved in the acquired chemoresistance of ovarian cancers. PMID- 2766279 TI - Regional loss of chromosome 6 in two urological malignancies. AB - Immunogenetic evidence suggests a genetic association between the major histocompatibility complex and the two genitourinary neoplasms, testicular teratocarcinoma and renal cell carcinoma. In order to develop a possible explanation for these findings, we designed a series of experiments to investigate the existence of a tumor suppressor gene in the region of HLA by looking for loss of germ line heterozygosity in these neoplasms at loci within and centromeric to HLA on chromosome 6. Restriction enzyme-digested DNA, from 15 human teratocarcinoma tumors, and corresponding normal somatic DNA, from peripheral blood mononuclear cells, were hybridized to one of three chromosome 6 probes determined to be polymorphic in this region. Probe 4c11 (6p11-cen) revealed loss of germ line DNA in three of 14 tumors. In contrast, probes pC22A (6p21.3) and p308 (6cen), which hybridize to chromosome 6p sequences, telomeric and centromeric to those sequences recognized by 4c11, did not demonstrate loss or sequence alteration in a total of 14 analyzable tumors. A total of 33 renal cell carcinoma specimens was also analyzed with the informative 4c11 probe with loss demonstrated in six of 33 tumors. In contrast, 23 different samples representing 15 other tumor types were examined with 4c11. Loss of chromosome 6p DNA was demonstrated in only two samples. These data support the hypothesis that there is nonrandom loss of DNA centromeric to HLA on chromosome 6 in both testicular teratocarcinoma and renal cell carcinoma. PMID- 2766280 TI - Therapy of central nervous system leukemia in mice by liposome-entrapped 1-beta-D arabinofuranosylcytosine. AB - Studies were undertaken to determine the therapeutic effects of liposome encapsulated 1-beta-D-arabinofuranosylcytosine (lip-ara-C) against intracranial L1210 leukemia. The effects of administration route, drug dosage, liposome type, and tumor load on therapeutic efficacy were also studied. One hundred % mice were cured after a single intracranial 40 mg/kg dose of lip-ara-C, dependent on tumor load. Intracranial lip-ara-C was more effective than i.v. lip-ara-C. A single i.v. dose of lip-ara-C was therapeutically superior to 5-day i.v. infusion of the free drug. Intracranial or i.v. lip-ara-C at therapeutic doses resulted in less systemic toxicity than i.v. infusion of free ara-C, suggesting possible use of lip-ara-C as an adjunct to treatment of central nervous system leukemia. PMID- 2766281 TI - Controlled delivery of 1,3-bis(2-chloroethyl)-1-nitrosourea from ethylene-vinyl acetate copolymer. AB - 1,3-Bis(2-chloroethyl)-1-nitrosourea (BCNU) has been found to be an effective chemotherapeutic agent against brain tumors. However, because it has a very short half-life in plasma, the exposure of neoplastic cells to BCNU is very brief. The delivery of BCNU may be enhanced by using controlled release polymers. We measured the release of BCNU from ethylene-vinyl acetate copolymer (EVAc) into blood, phosphate buffer, and brain tissue. BCNU-EVAc cylinders that weighed 60 mg were implanted in the peritoneum of rats, and BCNU was detected in blood for 6 days. Studies carried out in vitro showed that BCNU was released from EVAc at a decreasing rate for 195 h. BCNU-EVAc cylinders that weighed 15 mg were implanted either intracranially (i.c.) or i.p. in Fischer 344 rats. Controlled release of BCNU from the i.c. BCNU-EVAc implants was observed over 9 days, with peak drug levels of 49.6 micrograms/g of brain tissue in the implanted hemisphere. The BCNU levels in the contralateral hemisphere and the peripheral circulation were much lower and were detectable for only 1 day. By contrast, peak BCNU levels in the brain from the i.p. BCNU-EVAc implants were 2.7-3.0 micrograms/g for only 12 h, accompanied by peak BCNU levels in blood of 1.0 micrograms/ml tapering over 1 day. These results demonstrate the controlled release of intact BCNU from EVAc in vitro and in vivo. Furthermore, the i.c. implants resulted in localized, prolonged, high levels of the drug in the implanted hemisphere. Hence, the i.c. controlled delivery of BCNU may be more efficacious for the treatment of localized brain tumors. PMID- 2766282 TI - Comparison of the mechanism of action of busulfan with hepsulfam, a new antileukemic agent, in the L1210 cell line. AB - 1,7-Heptanediol disulfamate (hepsulfam, NSC 329680) is a new antileukemic agent with close structural similarity to busulfan. The mechanism of action of hepsulfam is not known and it has recently been entered into Phase I clinical trials by the National Cancer Institute. Waud et al. have recently shown that hepsulfam has good antitumor activity against mouse L1210 leukemia in vivo (Waud et al., Proc. Am. Assoc. Cancer Res., 29:333, 1988). In contrast, busulfan was inactive against this model tumor system. In the present study, we have compared the in vitro cytotoxicity of hepsulfam with that of busulfan and we also examined the ability of these compounds to induce DNA damage in the L1210 leukemia cell line. Our results show that L1210 leukemia cells were 7-fold more sensitive to hepsulfam than busulfan. Only hepsulfam produced an appreciable quantity of DNA interstrand cross-linking in L1210 cells, with the peak of cross-link formation being delayed 12 h following a 2-h drug treatment. In contrast, both compounds also produced DNA-protein cross-linking, again with the formation of peak levels being delayed 6-12 h after drug treatment. At equimolar concentrations, hepsulfam produced a greater quantity of DNA interstrand cross-links and DNA-protein cross links than busulfan. In contrast, busulfan produced a greater quantity of DNA protein cross-links, when compared to hepsulfam at equitoxic concentrations. PMID- 2766283 TI - Promotion by dihydroxybenzene derivatives of N-methyl-N'-nitro-N-nitrosoguanidine induced F344 rat forestomach and glandular stomach carcinogenesis. AB - Modifying effects of resorcinol, hydroquinone, p-tert-butylcatechol (PTBC), p methylcatechol (PMC), and o-methylcatechol on N-methyl-N'-nitro-N nitrosoguanidine (MNNG)-induced forestomach and glandular stomach carcinogenesis were investigated in F344 rats. Groups of 15 to 16 male 6-wk-old animals were given a single intragastric administration of 150 mg/kg of body weight of MNNG and starting 1 wk later were administered powdered diet containing 0.8% resorcinol, 0.8% hydroquinone, 1.5% PTBC, 1.5% o-methylcatechol, 1.5% PMC, or basal diet alone for 51 wk. Additional groups of 10 to 15 rats each were treated with the phenolic compounds or received basal diet without prior carcinogen exposure. Histological examination after sacrifice at Wk 52 revealed that squamous cell carcinoma development in the forestomachs of rats treated with MNNG followed by PTBC (75%, P less than 0.001) or MNNG followed by PMC (100%, P less than 0.001) was significantly greater than in animals receiving MNNG alone (20%). Treatment with PMC alone also resulted in a 40% yield of papilloma. In the glandular stomach, incidences of adenomatous hyperplasias in rats treated with MNNG followed by PTBC (31.3%, P less than 0.05) or PMC (100%, P less than 0.001) and the incidence of adenocarcinomas in rats treated with MNNG followed by PMC (100%, P less than 0.001) were significantly higher than in controls. In addition, PMC alone induced a 100% yield of adenomatous hyperplasias and 6.7% of adenocarcinomas. Thus, the results demonstrated that PTBC and PMC treatment significantly enhances forestomach and glandular stomach carcinogenesis and that PMC itself may possess weak carcinogenic potential in these organs. The ortho position appears to be important for this dihydroxybenzene activity. PMID- 2766284 TI - A human tumor lung metastasis model in athymic nude rats. AB - Experimental lung metastases regularly developed in athymic Han:rnu/rnu Rowett rats after i.v. injection of LOX human malignant melanoma cells. When 5 x 10(5) tumor cells were injected into 4-week-old rats, 89% of the animals died of lung tumors, with a mean survival time of 18 days. With 5- and 6-week-old rats, however, the fraction of animals that died decreased to 80 and 46%, with mean survival times of 35 and 38 days, respectively. The number of detectable lung colonies in each animal was about 35 in 5- and 6-week-old animals, compared to nearly 300 in 4-week-old rats. In the latter, a correlation was found between the number of tumor cells injected and the number of detectable lung colonies. The capacity of the LOX tumor to grow s.c. and to form experimental lung metastases was, by and large, similar in young nude rats and in nude mice, and no significant difference in morphology between the different tumors in the two species was seen. A high-resolution radiographic method was used to visualize lung colonies in the nude rats, and single tumors with diameters as small as 2-4 mm could be detected. By this method, for the first time, the effect of chemotherapy on a human tumor growing in a visceral organ of a rodent host could be followed by repeat X-ray examinations, mimicking a situation commonly faced in the clinic. This procedure may prove particularly useful for experimental chemotherapy studies, and may be extended to other human tumors that frequently metastasize to the lungs. Indications were obtained that some host-specific differences in tissue-preferenced growth might exist, a possibility that will be further explored. PMID- 2766285 TI - Detection of an intrinsic marker in hypoxic cells. AB - An autoradiographic method is presented for detecting, within a cell population, those cells which have been subjected to chronic hypoxia. No radioisotope is administered; rather the photographic emulsion is chemically reduced by intrinsic constituents of the cells. Hypoxic regions in the sandwich system, a multicellular in vitro tumor model, were detected in this manner. These regions were then compared with hypoxic sandwich regions as demonstrated by [3H]misonidazole labeling. Auxiliary studies, including studies on hypoxic monolayers, were consistent with the sandwich results. In all cases, the intracellular distribution of the chemographic grains was found to be cytosolic. Often the grains were clustered near the nucleus, perhaps in the region of the endoplasmic reticulum and the Golgi. We conclude that cells in a state of hypoxia and nutrient deprivation similar to that found in solid tumors retain a detectably altered biology for a significant period after reoxygenation. Therefore systematic methods of detecting previous hypoxia in histological tumor sections are feasible. PMID- 2766286 TI - Biology, cytogenetics, and sensitivity to immunological effector cells of new head and neck squamous cell carcinoma lines. AB - Twenty-one head and neck squamous cell carcinoma (HNSCC) cell lines were established from 89 fresh tumor specimens in order to study the biology of HNSCC lines, establish tumors in nude mice, and evaluate the sensitivity to immunological effector cells of these tumors in vitro and in vivo in nude mice. The lines were established from explants using differential trypsinization and culture for 2 to 20 mo. The explants were derived from 11 different sites. Three pairs of lines were derived from both the primary tumor and metastatic lymph nodes in the same patients. All cultures grew as either compact or diffuse adherent monolayers, and they had a median doubling time of 86 h (range, 33 to 531 h). DNA fingerprinting confirmed that the HNSCC lines were individual isolates. Thirteen of 14 lines tested induced tumors in athymic mice. The histology of each line growing in nude mice was similar to that of the original tumor tissue. Immunocytochemistry showed keratin production in all lines tested. Aneuploidy (36 to 87 chromosomes) was present in all 16 lines studied; the median chromosome number for lines derived from primary tumors was 70, whereas for lines originating from metastatic or recurrent tumors, it was 54. Karyotypic analysis showed deletion of the short arm of chromosome 3 (3p-) in 12 of 16 cell lines and trisomy 6 in 12 of 16 lines. In addition, translocations between chromosomes 9 and 11 or 9 and 12 were each present in five of 16 lines tested. The HNSCC lines were resistant to lysis by natural killer cells, but were efficiently lysed by lymphokine-activated killer cells in 4-h 51Cr release assays. These new lines have allowed us to establish a model of local adoptive immunotherapy of HNSCC in tumor-bearing nude mice, and they provide a resource for future studies of the biology of HNSCC. PMID- 2766288 TI - Breast cancer and alcohol consumption: a case-control study in northern Italy. AB - From 1983 to 1986, a population-based case-control study of alcohol and breast cancer (250 cases and 499 controls) was conducted in a grape-farming area of northern Italy, where wine consumption is widespread. In the study population, 30% of women were abstainers and 15% reported alcohol intakes of 30 g/day or more. After adjustment for potential confounders, no appreciable association was evident for alcohol consumptions as high as 40 g/day. Women reporting intakes of more than 40 g/day showed approximately a 2-fold increase in the risk of breast cancer (relative risk, 1.9; 95% confidence interval, 1.1-3.3). A 2-fold increase in risk was observed for consumptions of more than 40 g/day of alcohol from wine, the most common alcoholic beverage in this population. These findings suggest that an association between alcohol intake and breast cancer may exist. However, the moderate risk observed seems to be limited to the relatively small group of women consuming daily amounts of alcohol in excess of 40 g, the equivalent of about half a bottle of wine or more. PMID- 2766289 TI - Biological amplification factor for sunlight-induced nonmelanoma skin cancer at high latitudes. AB - Data for the incidence of basal cell carcinomas (BCCs) and squamous cell carcinomas (SCCs) of the skin, registered for six regions of Norway during 10 years (1976-1985), were used to evaluate the biological amplification factor Ab for induction of these cancers by sunlight. Ab is the ratio of the increment in skin cancer production to the increment in causative sunlight exposure. Two different approximations were used for the action spectrum for carcinogenesis: an erythema action spectrum; and an action spectrum for mutagenesis of cells in the basal layer of the skin. These two fundamentally different approaches yielded Ab values that were similar to within about 10%: 2.1-2.3 for BCCs; and 1.6-1.8 for SCCs. Using a radiation amplification factor for ozone depletion of 0.8-1.1, we find that the total amplification factor for BCCs is within the range 1.6-2.1 and that that for SCCs is within the range 1.3-1.7 at northern latitudes of 60-70 degrees. Thus, an ozone depletion of 1% will result in an increase in the incidence of BCCs by 1.6-2.1% and of SCCs by 1.3-1.7%. There were no significant differences between the values for men and women. Neither was there any significant difference between Ab values found for skin commonly exposed to sunlight (face) and for skin sites normally covered by clothes and therefore receiving much lower exposures, in spite of the fact that the tumor density per unit skin area was a factor of 20 or more larger at the former sites. This observation, as well as the curves relating cancer incidence with annual exposure to carcinogenic sunlight, supports a power law relationship between cancer incidence and annual sun exposure. Sunlight appears to be the main cause of BCCs and SCCs even at the high latitudes of Northern Norway. All over, BCCs were found to be about 6 times more frequent than SCCs. The ratio of the incidence of BCCs to that of SCCs seemed to be independent of the latitude. Finally, BCCs were found to be equally frequent among men and women, while SCCs were found to be about twice as frequent among men as among women. PMID- 2766287 TI - Comparison of an immunocytochemical assay for progesterone receptor with a biochemical method of measurement and immunocytochemical examination of the relationship between progesterone and estrogen receptors. AB - Using a rat monoclonal antibody raised against human progesterone receptor (PR) we have developed an immunocytochemical technique to detect PR in human normal and malignant breast tissue and have compared the distribution of this with that obtained by the conventional dextran-coated charcoal steroid-binding assay. Immunoreactive PR was detected exclusively in the nuclei of epithelial cells in 29/51 (56.9%) of breast cancers studied. There was an excellent correlation between the immunocytochemical and dextran-coated charcoal techniques, with concordance in 43/51 (84.3%) cases [regression coefficient (Spearman) = 0.78; P less than 0.001]. The relationship between PR and estrogen receptor (ER) was also examined immunocytochemically using a monoclonal antiserum to ER. Twenty-eight out of 51 (54.9%) tumors were positive for both receptors and 13/51 (25.5%) negative for both. ER-positive, PR-negative tumors were found in 9/51 (17.6%) cases whereas only one case (2%) was PR-positive, ER-negative. PMID- 2766291 TI - Elevated superoxide dismutase in Bloom's syndrome: a genetic condition of oxidative stress. AB - We have found that Bloom's syndrome (BS) cells exhibit elevated levels of superoxide dismutase activity. Since SOD activity has been shown to reflect the intracellular superoxide (O2-) content, these results indicate that BS cells exhibit oxidative stress which ultimately results in DNA damage. Elevated sister chromatid exchange, the major cytological characteristic of BS, and superoxide dismutase induction were simulated in normal lymphoblastoid cells by treatment with compounds that increase the steady-state concentration of O2(-.). The sister chromatid exchange response of a BS lymphoid cell line was modulated through the control of the endogenous O2-. content. We therefore suggest that a major biochemical defect resulting from this genetic disorder is chronic over production of the superoxide radical anion. The consequence of high O2-. levels concomitant with induced superoxide dismutase activity is the formation of enormous amounts of H2O2 which can apparently inactivate the enzymes responsible for its elimination. The inefficient removal of peroxide can result in high rates of sister chromatid exchange and chromosomal damage in BS cells and in normal cells treated with oxidation-reduction cycling compounds through the formation of highly reactive intermediary forms of active oxygen. PMID- 2766290 TI - Phase I clinical study of N-[(4-chlorophenyl)amino]carbonyl-2,3-dihydro-1H-indene 5-sulfonamide (LY186641). AB - Between February 1987 and July 1988, 45 patients with advanced refractory cancer were treated with LY186641, a diarylsulfonylurea that has shown a broad spectrum of activity in preclinical testing. Patients received a weekly p.o. dose of LY186641 for 6 consecutive weeks; responding and stable patients continued weekly therapy until progression occurred. Using a standard phase I study design, the first three patients received LY186641 at 30 mg/m2 week; the dose was escalated in subsequent patients until dose-limiting toxicity occurred. Methemoglobinemia was the major toxicity observed and was dose related. Methemoglobin levels peaked approximately 24 h after LY186641 was administered and fell to low levels after 48 h. Six patients developed fatigue, cyanosis, and dyspnea associated with serum methemoglobinemia levels of greater than 20%; four of these patients were subsequently removed from the study. Hemolytic anemia was also observed but was clinically significant in only 10 patients. Other side effects were mild and infrequent. The maximum tolerated dose of LY186641, when given at this schedule, was 2550 mg/m2/week. No objective tumor responses were observed. PMID- 2766292 TI - Heterogeneity of glutathione content in human ovarian cancer. AB - Intracellular glutathione (GSH) has been shown to be one of the major factors modulating tumor response to a variety of commonly used anti-neoplastic agents. In this study the GSH contents of human ovarian tumors from primary biopsies, nude mouse xenografts, and in vitro cell cultures were compared. Pronounced intratumor cell-to-cell heterogeneity in GSH content was observed in primary patient biopsies when assessed using flow cytometry. For example, in an ascites biopsy from a newly diagnosed patient, a 5.6-fold difference in GSH concentration existed between the cell subpopulations with the 5% highest and 5% lowest GSH contents. Similar intratumor heterogeneity in GSH content was also evident in nude mouse xenografts. In addition, for a particular tumor line, the intertumor variations of GSH content among individual whole tumors were much less than the intratumor variation among slices from an individual tumor. Nude mouse xenografts of human ovarian cancer had GSH contents that were on average only slightly lower (30%) than those found in primary biopsies. In contrast, tumor cells grown as in vitro cultures, particularly those in exponential growth phase, had GSH contents considerably greater (1.3- to 3.5-fold) than those found in situ. Plateau phase cultures, however, had lower GSH contents and were more comparable to those observed in tumors in vivo. Overall, it may be concluded that in situations where GSH plays an important part in determining tumor response to a particular treatment, nude mouse xenografts may represent the most appropriate experimental model system. PMID- 2766293 TI - Promotion by bombesin of gastric carcinogenesis induced by N-methyl-N'-nitro-N nitrosoguanidine in Wistar rats. AB - The effects of bombesin on the incidence, number, histological type, and depth of involvement of gastric cancers induced by N-methyl-N'-nitro-N-nitrosoguanidine (MNNG) were investigated in male Wistar rats. Rats received alternate-day s.c. administration of 20 or 40 micrograms/kg body weight of bombesin in depot form after p.o. treatment with the carcinogen for 25 weeks. Prolonged administration of bombesin at 40 micrograms/kg led to a significant increase in the incidence and number per rat of gastric cancers of the glandular stomach at Week 52. In rats that had received alternate-day injections of 20 micrograms/kg of bombesin, the number of gastric cancers per rat, but not the incidence of cancer, was significantly more than in untreated rats. However, bombesin at both dosages did not affect the histological appearance of the lesions or their depth of involvement. At Weeks 30 and 52, norepinephrine concentrations in the fundic and antral portion of the gastric walls and labeling indices in the antral and fundic mucosae were significantly higher in rats treated with bombesin at both dosages than in untreated rats. These findings indicate that bombesin enhances gastric carcinogenesis after administration of N-methyl-N'-nitro-N-nitrosoguanidine is stopped and that this effect may be related to its effects in increasing tissue norepinephrine concentrations in the stomach wall and increasing cell proliferation in the gastric mucosa. PMID- 2766294 TI - Quenching of DNA cross-link precursors of chloroethylnitrosoureas and attenuation of DNA interstrand cross-linking by glutathione. AB - Interstrand DNA cross-linking is essential for the antitumor activity of chloroethylnitrosoureas (CENUs). The critical cross-links have been proposed to involve a rapid O6-guanine chloroethylation on one DNA strand, followed by a rearrangement of the O6-(2-chloroethyl)guanine and slow alkylation of the second DNA strand. In view of the relative intracellular abundance of glutathione (GSH) and nucleophilicity of its thiolate ion, the ability of GSH to react with and to inactivate 2-chlorethylated DNA and the possibility that this interaction decreases net DNA cross-linking by CENUs were investigated. Chloroethylated calf thymus DNA was reacted with GSH, the DNA was precipitated and redissolved, and subsequent DNA interstrand cross-linking was determined. The DNA cross-link index was compared for both GSH-treated and 2-chloroethylated untreated DNA. Simultaneously, Col E1 plasmid DNA was chloroethylated and reacted with GSH, and the extent of DNA interstrand cross-linking was determined by agarose gel electrophoresis and compared with controls. The results show both a time- and GSH concentration-dependent quenching of chloroethylated DNA, with a corresponding decrease in the DNA cross-link index. Using [methyl-3H]GSH, it was also demonstrated that 56% of the total GSH was bound to quenched 2-chloroethylated Col E1 DNA and 25% to quenched 2-chloroethylated calf thymus DNA. GSH binding to cross-linked DNA and native DNA was insignificant. It is concluded that, in addition to direct inactivation of reactive cytotoxic CENU species, GSH may also modulate cellular response to CENUs by quenching chloroethylated DNA, thereby decreasing the formation of potentially lethal DNA cross-links. PMID- 2766295 TI - Mechanistic aspects of DNA damage by morpholinyl and cyanomorpholinyl anthracyclines. AB - Morpholino and cyanomorpholino derivatives of the anthracycline antitumor antibiotics, Adriamycin (ADM) and daunomycin (DNM), differ from their parent compounds in potency, cross-resistance and other biological properties. We therefore investigated the DNA interactions of several derivatives of ADM and DNM, including iminomorpholinoadriamycin, oxazolocyanomorpholinoadriamycin, (OCADM), and cyanomethyladriamycin (CMeADM). This work complements previous studies on morpholinodaunomycin (MoDNM), morpholinoadriamycin (MoADM), and cyanomorpholinoadriamycin (CNMoADM). As described in this work, unscheduled DNA synthesis is induced by iminomorpholinoadriamycin, 5 iminocyanomorpholinoadriamycin (ICADM), OCADM, and CMeADM but not by ADM and DNM. In addition, we observed the induction of DNA single-strand breaks by ICADM, OCADM, and CMeADM in V79 cells; previous work has shown that ADM and DNM but not MoDNM induce single-strand breaks in these cells. DNA cross-links were induced by ICADM at high concentrations (greater than 50 nM) but not by MoADM, OCADM, and CMeADM as described herein. In previous investigations, we observed that CNMoADM and cyanomorpholinodaunomycin (CNMoDNM) but not ADM, DNM, and MoDNM induce DNA cross-links. CNMoADM and CNMoDNM are the most potent cytotoxic derivatives of ADM and DNM and have their cross-linking potential in common. The fact that CNMoADM and CNMoDNM (as well as ICADM at higher concentrations) all contain an alpha cyanamide functionality and also yield cross-links suggests that this functionality is important for cross-linking. The CN moiety in [14C]N-MoADM was shown to be lost during the reaction with DNA and rat liver S9 (but not with buffer), which suggests that adduction via CN displacement is possible. On the other hand, OCADM and CMeADM both contain the alpha-cyanamine functionality but have a modified morpholino ring and do not yield cross-links. This suggests that an intact morpholino ring, which is metabolized to a reactive form, is necessary for cross-linking. A number of metabolites from MoDNM treated with rat liver S9 mix were isolated. These products, when analyzed by gas chromatography-mass spectrometry, are consistent with metabolism in the morpholino ring; however, definitive structural assignments could not yet be made. PMID- 2766296 TI - In vitro clonogenic growth and metastatic potential of human operable breast cancer. AB - In 254 patients with operable [International Union against Cancer (1972) Stages I, II, and III] breast cancer, the relations between in vitro clonogenic growth in soft agar of primary breast cancer tumors and their metastatic potential expressed by the relapse-free survivals (RFS) as well as overall survivals were studied. Sixty-four % (163 of 254) of cancers formed distinct colonies (30 or more colonies in a single dish, or 10 or more colonies in plural dishes). Other breast cancers (36%, 91 of 254) were designated to be negative for the clonogenicity. There was no correlation between the positive or negative clonogenicity and clinicopathological characteristics in breast cancer patients, including the age of patients, menopausal status, tumor size, T classification, International Union against Cancer stage, histological type (Japanese Breast Cancer Society), histologically proved axillary lymph node metastasis, and estrogen receptor (ER). At the time of median follow-up of 43 mo (range, 25 to 61 mo) after mastectomy, a recurrence of malignancy occurred in 19.0% (31 of 163) of the patients with positive clonogenic tumors, and in 8.8% (8 of 91) of those with negative clonogenic tumors (P = 0.03). There also was a significant difference (P less than 0.03 by log rank test, P less than 0.05 by generalized Wilcoxon test) in RFS curves between positive and negative clonogenicity groups. These differences in RFS were also noted in Stage II patients in favor of the negative colony formation group. In ER-negative cancer patients, the RFS of patients with positive clonogenic cancers was shown to be worse (P less than 0.03 by log rank test, P less than 0.05 by generalized Wilcoxon test) than patients with negative clonogenic cancers. There was no difference in RFS in ER-positive cancer patients. There was a trend (P = 0.09 by log rank test) of worse overall survival rate in patients with positive clonogenic growth. In a multivariate comparison using the principal component analysis composed of factors including positive node, T classification, histological type, age, ER, and colony formation, the clonogenicity showed a significant effect on the recurrence of malignancy and also on the survival of the patients after mastectomy. In conclusion, in vitro clonogenic growth of the primary tumor of breast cancer was shown to be one of the independent factors of metastatic potential in operable breast cancer patients after mastectomy. PMID- 2766297 TI - Cytotoxic and genotoxic effects of areca nut-related compounds in cultured human buccal epithelial cells. AB - Because betel quid chewing has been linked to the development of oral cancer, pathobiological effects of an aqueous areca nut extract, four areca nut alkaloids (arecoline, guvacoline, guvacine, and arecaidine), and four nitrosated derivatives [N-nitrosoguvacoline, N-nitrosoguvacine, 3-(N nitrosomethylamino)propionaldehyde and 3-(N-nitrosomethylamino)propionitrile] have been investigated using cultured human buccal epithelial cells. Areca nut extract in a dose-dependent manner decreases cell survival, vital dye accumulation, and membrane integrity, and it causes formation of both DNA single strand breaks and DNA protein cross-links. Depletion of cellular free low molecular-weight thiols also occurs, albeit at quite toxic concentrations. Comparisons of the areca nut-related N-nitroso compounds and their precursor alkaloids, at concentrations up to 5 mM, indicate that 3-(N nitrosomethylamino)propionaldehyde is the most potent on a molar basis to decrease both survival and thiol content and to cause significant formation of DNA single strand breaks. Arecoline, guvacoline, or N-nitrosoguvacoline decreases survival and cellular thiols, whereas arecaidine, guvacine, N-nitrosoguvacine, and 3-(N-nitrosomethylamino)propionitrile have only minor effects on these variables. Taken together, the present studies indicate that aqueous extract and, in particular, one N-nitroso compound related to areca nut, i.e., 3-(N nitrosomethylamino)propionaldehyde, are highly cytotoxic and genotoxic to cultured human buccal epithelial cells, of potential importance in the induction of tumors in betel quid chewers. PMID- 2766298 TI - Formation of hydroxy derivatives, aldehydes, and nitrite from N-nitrosomethyl-n amylamine by rat liver microsomes and by purified cytochrome P-450 IIB1. AB - The metabolism was examined of the esophageal carcinogen N-nitrosomethylamylamine (NMAA) by liver microsomes and slices from adult male Sprague-Dawley rats. Hydroxylation at C-2 to C-5 of the amyl group to give stable hydroxy-NMAAs was studied by gas chromatography-thermal energy analysis to determine the products. Microsomal metabolism produced mainly 4-hydroxy-NMAA, proceeded optimally in 100 mM phosphate at pH 7.4, and showed no sex differences. Induction by phenobarbital (PB) and 3-methylcholanthrene produced effects which were similar in slices and microsomes, with PB inducing hydroxylation at all positions and 3 methylcholanthrene specifically inducing 3-hydroxylation by factors of 2- and 6 fold. Clofibrate and isoniazid treatments did not affect NMAA metabolism by liver slices. Aroclor-1254 strongly induced microsomal 2- and 3-hydroxylation. For 2- to 5-hydroxylation, Km values for uninduced microsomes were, respectively, 1.6, 1.2, 0.3, and 1.1 mM, with Vmax of 0.08, 0.26, 1.06, and 0.15 nmol/min/mg protein. With PB-induced microsomes, all 4 Km values were 0.4-0.7 mM. Liver microsomal production of nitrite and aldehydes from NMAA was determined colormetrically or (for pentaldehyde) by high-pressure liquid chromatography of the 2,4-dinitrophenylhydrazone. Uninduced microsomes produced nitrite, formaldehyde and pentaldehyde from 0.6 mM NMAA at rates that were, respectively, 0.15, 0.72, and 1.15 times that for 4-hydroxylation. PB especially induced depentylation, whereas 3-methylcholanthrene induced depentylation and denitrosation, but suppressed demethylation. A reconstituted system containing cytochrome P-450 IIB1 gave metabolite ratios similar to those in PB-induced microsomes. The results account for most of the possible primary metabolites of NMAA and demonstrate the selectivity for metabolism at each position. PMID- 2766299 TI - Up-regulation of estrogen receptors by nonsteroidal antiestrogens in human breast cancer. AB - Development of resistance to hormonal therapy in breast cancer is frequently associated with a decline or loss of cellular estrogen receptors. Agents which up regulate the receptor may reduce the incidence of hormonal resistance. Antiestrogens at concentrations ranging from 0.1 to 1 microM produced a 2- to 4 fold increase of estrogen receptors in MCF-7 and T-47D breast cancer cells. This increase, which occurred as early as 3 h and was sustained throughout the 4 days of continuous exposure to tamoxifen, was primarily due to an enhancement in receptor synthesis. PMID- 2766300 TI - Differences in glycosylation state of fibronectin from two rat colon carcinoma cell lines in relation to tumoral progressiveness. AB - We have investigated the biosynthesis and carbohydrate structure of fibronectin secreted by two rat colon carcinoma cell lines. The cell line Prob yields progressive tumors after s.c. injection in syngeneic BD IX rats while tumors developed by Regb cells disappear after 20 days. No difference was observed in the fibronectin biosynthesis from both cell lines; however, the glycosylation degree was higher in Regb than in Prob cells indicating probable differences in the posttransductional process. The analysis of the glycosylation nature shows that fibronectin doesn't bear O-linked carbohydrate chains. The fibronectin of progressive Prob cells is more sialylated than that of the regressive Regb ones. In addition, the tri- and tetraantennary glycans are more important in Prob, while the fucosylated triantennary glycans are three times higher in Regb cells. These differences in the glycosylation state of the fibronectins could explain their differential susceptibility to the proteases treatment. In fact, the low glycosylated fibronectin from the progressive Prob cells was more rapidly degraded by several proteases than that of regressive Regb cells. The identification of the specific sites of proteolytic cleavage by sodium dodecyl sulfate-polyacrylamide gel electrophoresis showed that the cell attachment domain as well as the collagen binding domain of Regb cell fibronectin are particularly protected against proteolytic degradation. PMID- 2766301 TI - Development of a radioimmunoassay for the anthrapyrazole chemotherapy agent CI 937 and the pharmacokinetics of CI-937 in rats. AB - The anthracyclines daunorubicin and doxorubicin are cancer chemotherapy agents that complex DNA and are widely utilized clinically. Cumulative cardiotoxicity, however, limits their prolonged use. The novel anthrapyrazole agent, CI-937, which has shown exceptional in vivo anticancer activity and reduced cardiotoxicity in preclinical models has been developed at the Parke-Davis Pharmaceutical Research Division, Warner-Lambert Co. Due to an inability to extract CI-937 reproducibly from biological fluids, high-performance liquid chromatography is not a feasible analytical method. We developed a radioimmunoassay by conjugating CI-937 to porcine thyroglobulin to elicit rabbit antibody which was used with a radioiodinated derivative. The assay was validated for rat plasma using 50 microliters of sample with a resulting limit of quantitation of 100 pg/ml. By dilution of samples the assay can quantitate CI-937 levels up to 16 micrograms/ml. The antiserum is very specific as evidenced by cross-reactivities of less than 0.4% for structural analogues and less than 0.004% for any of the commonly used cancer chemotherapy agents. Analysis of plasma samples from rats treated with a single 5 mg/kg i.v. dose indicated that CI-937 is rapidly cleared from plasma and is extensively bound to tissues. PMID- 2766302 TI - Autocrine tumor cell growth-inhibiting activities from human malignant melanoma. AB - Autocrine-secreted tumor cell growth-inhibiting activities were isolated from supernatants of a malignant melanoma cell line, HTZ 19-dM, established from a central nervous system melanoma metastasis. HTZ 19-dM was characterized by cyto- and immunocytochemistry and karyotyping; cells were propagated in defined serum free tissue culture medium for up to 8 months. Supernatants were ultrafiltrated, dialyzed, lyophilized, and purified by Bio-Gel P-10 gel permeation chromatography, leading to three active fraction pools, MIAI [melanoma-inhibiting activity (MIA), 2 kDa), MIAII (Mr 11,500-17,000) and MIAIII (proteins at the cutoff of Bio-Gel P-10) inhibiting growth of 19-dM cells with 50% inhibitory concentrations of 0.79 microgram/ml (MIAI), 0.13 microgram/ml (MIAII), and 16.7 micrograms/ml (MIAII). MIAII could be further purified by reverse phase high pressure liquid chromatography; the main activity displayed a 50% inhibitory concentration of 0.33 microgram/ml. On sodium dodecyl sulfate-polyacrylamide gel electrophoresis one major band (molecular weight about 14,000) and two minor bands (up to Mr 17,000) were identified. Macromolecular synthesis was inhibited in 19-dM cells up to greater than 99.5%; tumor stem cell colony formation was reduced by 99.89%; the inhibitory effect of MIAII was irreversible, nonsaturable, and partially antagonized by a serum factor (depending on purification stage). MIAII was heat stable (3 min at 100 degrees C) and trypsin labile. The effect of MIAII on allogeneic neuroectodermal tumors was also investigated; proliferation of two of three malignant melanomas and two of four glioblastomas was inhibited up to 85.2%; proliferation of a neuroblastoma cell line could be inhibited to 33.8%, whereas normal fibroblasts and low grade gliomas were not influenced in their proliferation. PMID- 2766303 TI - Effects of extracellular matrix on the growth and casein gene expression of primary mouse mammary tumor cells in vitro. AB - This study describes a serum-free culture system and provides a tumor model to investigate the effects of extracellular matrices on the growth and beta-casein gene expression of mouse mammary tumor epithelial cells (MMTCs) in vitro. Primary cultures of MMTCs derived from autochthonous mammary tumors in BALB/cfC3H x DBA/8 F1 mice, FUKU cells, an established MMTC line, and COMMA-1D cells established from mouse mammary tissues were studied. A reconstituted basement membrane from the Englbreth-Holm-Swarm tumor (Matrigel) allowed a 2.7-fold increase in cell number of 5-day primary MMTC cultures in serum-free, insulin-supplemented medium. FUKU and COMMA-1D cells in serum-free medium displayed a 13.6- and 11.5-fold increase in cell number, respectively, after 5 and 6 days in culture on Matrigel. In semisolid agar cultures, Matrigel or laminin was shown to promote colony forming efficiency of FUKU cells when either of the matrices was mixed in the top agar layer. An increase of 4.4 or 2.1 times in colony-forming efficiency was detected when 20% (v/v) Matrigel or 112 micrograms/ml of laminin were mixed in the agar layer compared with FUKU cells plated in plain agar. beta-Casein mRNA was detectable by Northern blot assays in the primary mammary tumors. MMTCs in primary cultures grown on Matrigel in serum-free, insulin-supplemented medium for 4 days were inducible for beta-casein mRNA following the treatment with prolactin and hydrocortisone (FPRL) for 24 h. No beta-casein mRNA was detectable in the absence of FPRL. MMTCs in the primary cultures could also be induced for beta casein mRNA when they were cultivated on type I collagen gels for 4 days but not on laminin, type IV collagen, or plastic. However, the capacity to respond to FPRL was not lost in MMTCs cultured on laminin. When MMTCs were initially cultured on laminin for 4 days and then subcultured on Matrigel for another 4 days, they were inducible for beta-casein mRNA upon exposure to FPRL for 24 h. In contrast, no beta-casein mRNA upon exposure to FPRL for 24 h. In contrast, no beta-casein mRNA was found in MMTCs from the same tumors cultured on laminin for 8 days with the same treatment of hormones. These data demonstrate that cells from autochthonous mammary tumors, which are not dependent on estrogen for growth in vivo, are inducible in vitro for beta-casein mRNA by FPRL; and this hormonal response of MMCTs requires appropriate extracellular matrix. PMID- 2766305 TI - Amplification of the gli gene in childhood sarcomas. AB - The gli gene, originally identified by its amplified copy number in cells from a human malignant glioma, has a predicted translation product that contains five tandem DNA-binding zinc finger motifs related to those of Kruppel, a developmentally important Drosophila segmentation gene. Because of the potential importance of overproduction of this protein in neoplastic development, we examined DNAs from 29 cases of childhood sarcoma for evidence of amplification of the gli gene. In one of the 13 rhabdomyosarcomas studied, genomic DNA restriction fragments containing the gli gene were amplified approximately 30-fold, and expression of the 4.0-kilobase gli mRNA transcript was identified. The tumor with gli gene amplification lacked the usual histological features of alveolar or embryonal rhabdomyosarcoma; however, ultrastructural analysis of tumor cells established in culture revealed attenuated sarcomeres, resembling those found in primitive rhabdomyoblasts. Cytogenetic analysis of this cell line disclosed double-minute chromatin bodies, with no apparent rearrangements in the region of the gli locus on the long arm of chromosome 12, bands q13 to q14.3. A 15-fold level of gli amplification and gli mRNA transcripts were also detected in an established cell line from a patient with a rare form of osteosarcoma characterized by multipotential histological features. A similar level of gli gene amplification was observed in cryopreserved primary tumor cells from this patient, confirming that gene amplification took place during tumor development and not during in vitro cell culture. Amplified gli sequences were cytogenetically localized by in situ hybridization to a homogeneously staining region contained on a derivative chromosome 7. Of eight osteosarcomas and seven Ewing's sarcomas with typical histopathological features, none had detectable rearrangements or amplification of gli sequences. Thus, gli gene amplification in childhood sarcomas appears restricted to tumors with primitive histopathological features, perhaps reflecting overproduction of a gene product able to influence gene expression during early mesenchymal cell development. PMID- 2766304 TI - Pharmacokinetics of buthionine sulfoximine (NSC 326231) and its effect on melphalan-induced toxicity in mice. AB - Intravenous doses of buthionine sulfoximine (BSO, NSC 326231), an inhibitor of glutathione synthesis, were eliminated rapidly from mouse plasma in a biexponential manner. The initial phase of the plasma concentration versus time curve had a half-life of 4.9 min and accounted for 94% of the total area under the curve. The half-life of the terminal phase of the curve was 36.7 min and the area accounted for only 6% of the total area under the curve. Plasma clearance of BSO was 28.1 ml/min/kg and the steady state volume of distribution was 280 ml/kg. The oral bioavailability of BSO, based on plasma BSO levels, was extremely low. However, comparable glutathione depletion was apparent after i.v. and p.o. doses of BSO, suggesting a rapid tissue uptake and/or metabolism of BSO. Therefore, due to the rapid elimination of BSO from mouse plasma, plasma drug levels do not directly correlate with BSO-induced tissue glutathione depletion. Administration of multiple i.v. doses of BSO to male and female mice resulted in a marked 88% depletion of liver glutathione at doses of 400-1600 mg/kg/dose. Toxicity of i.v. administered BSO was limited to a transient depression of peripheral WBC levels in female mice given six doses of 1600 mg/kg. Multiple i.v. doses of BSO of up to 800 mg/kg/dose (every 4 h for a total of six doses) did not alter the toxicity of i.v. administered melphalan. However, multiple doses of 1600 mg/kg/dose of BSO did potentiate histopathological evidence of melphalan-induced bone marrow toxicity in 30% of the mice and, additionally, the combination of BSO and melphalan produced renal tubular necrosis in 80% of the male mice. The potentiation of melphalan induced toxicity did not appear to be related to GSH depletion, since: quantitatively similar amount of GSH depletion occurred at lower dose of BSO without any increase in melphalan toxicity. PMID- 2766306 TI - Pathophysiology of transitional tumor cell adherence to sites of urothelial injury in rats: mechanisms mediating intravesical recurrence due to implantation. AB - The mechanism by which transitional tumor cells adhere to areas of urothelial injury and the means by which heparin prevents this phenomenon were studied. Scanning electron microscopy and a radiolabeled tumor cell adherence assay were used to assess the activity of heparin and a "nonglycosaminoglycan" thrombolytic agent, recombinant tissue plasminogen activator, in preventing tumor cell adherence to areas of urothelial injury. Systemically administered heparin and intravesical therapy with recombinant tissue plasminogen activator duplicated the activity of intravesical heparin. Scanning electron microscopy showed tumor cells entrapped at the injury surface in a RBC/fibrin clot, which was prevented by intravesical heparin. These data suggest that clotting cascade activation by urothelial injury is the mechanism by which particulate adherence to the urothelium occurs. Interruption of this process by local or systemic anticoagulation with heparin or shifting of the equilibrium of clot formation/lysis toward thrombolysis with recombinant tissue plasminogen activator prevents tumor cell adherence. Intravesical thrombolytic therapy may represent a new approach to recurrence prophylaxis for superficial bladder carcinoma. PMID- 2766307 TI - Immortalization of primary baby rat kidney cells by retroviral mediated gene transfer of adenovirus E1A genes. AB - We describe a retroviral mediated gene transfer system that facilitates the transfer of heterologous genes into primary epithelial cells. Using a series of retroviral vectors containing the genes coding for the 12S and 13S mRNAs from the E1A region of adenovirus type 5 and the hygromycin resistance gene as a selectable marker, we demonstrate that, when packaged as helper virus-free amphotropic particles, these recombinant retroviruses infect murine fibroblasts and rat and human epithelial cells. Moreover, one of these constructs, containing genes for either the 12S or 13S product, is able to immortalize primary baby rat kidney epithelial cells in vitro and, thus, when used in combination with optimized culture conditions, may facilitate the establishment in culture of primary epithelial cells from a wide variety of tissues and species. PMID- 2766308 TI - A case-control study of occupational and dietary factors in colorectal cancer in young men by subsite. AB - With the hope that exposures responsible for colorectal cancer might be especially obvious among those in whom it develops early, 147 men with colorectal carcinomas first diagnosed between the ages of 25 and 44 years were compared to neighborhood controls. Physical activity on the job was protective for tumors located in the transverse and descending portions of the colon. Rectal cancer and to a lesser extent sigmoid cancers were associated with jobs in which dusts or fumes were inhaled, especially if those jobs were held for long periods in young adulthood. While risk for rectal cancer did not seem to be limited to any particular type of dust or fume, the excess risk was strongest for wood and metal dusts. Consumption of fruits and vegetables and a preference for whole grain breads were protective for colon but not rectal cancers, while consumption of deep fried foods and barbecued/smoked meats increased risk at specific subsites. Beef intake, alcohol consumption, and cigarette smoking appeared to play little or no role at any subsite. PMID- 2766310 TI - ACE-inhibition: state of the art. Symposium held during the Xth Congress of the European Society of Cardiology. Vienna, August 31, 1988. Proceedings. PMID- 2766309 TI - Positive anticalcitonin immunoscintigraphy in patients with medullary thyroid carcinoma. AB - A cocktail of three monoclonal F(ab')2 fragments against three distinct epitopes of calcitonin or PDN 21 was labelled with either 111In or 131I. These F(ab')2 fragments, a control 125I-F(ab')2 fragment and 99mTc-pertechnetate were injected into four patients suffering from medullary thyroid carcinoma. Scintigraphy data were processed by energy factor analysis for an optimal separation of images corresponding to each isotope. The best tumor detection was obtained 1-3 days after injection of the 111In-F(ab')2 cocktail which clearly labeled the thyroid tumors in the four patients (smallest tumor detected, 0.6 cm) as well as lymph node and bone metastases. In the liver, positive detection was only successful with the 131I-labeled cocktail. These results were confirmed by counting rates of resected specimens which provided average specificity indices ranging from 3.3 to 13.1. Anticalcitonin antibodies could be particularly useful for immunoscintigraphy detection of residual or recurrent medullary thyroid carcinoma in patients with elevated calcitonin serum level. PMID- 2766311 TI - Cardiac imaging: diagnosis and assessment of cardiac disorders. PMID- 2766312 TI - Structure of the so-called 'prismless' enamel in human deciduous teeth. AB - The surface enamel of human deciduous teeth showing a more negative birefringence by polarized light was investigated by differential interference contrast microscopy and by scanning electron microscopy (SEM) following EDTA etching. Though this surface enamel has been generally called the 'prismless' enamel, in this study, the so-called 'prismless' enamel was categorized into 'false', 'moderate', 'essential' and 'complex' types according to whether they took the form of distinct prisms which bended at the subsurface, indistinct circularly based prisms or not. Based on the SEM observations some types of the 'prismless' enamel showed parallel crystallites and no prism boundaries. However, if indistinct prisms showing centripetal crystallites within the circular boundaries are admitted into the prismless enamel, other types except the 'false' one will generally belong to it. PMID- 2766313 TI - Elemental surface concentration ratios and surface free energies of human enamel after application of chlorhexidine and adsorption of salivary constituents. AB - In vitro adsorption of chlorhexidine from a commercially available chlorhexidine containing (0.12%) mouthrinse (Peridex) on both ground and polished and on saliva coated enamel was studied by X-ray photoelectron spectroscopy and contact angle measurements. Furthermore, adsorption of salivary constituents was studied on chlorhexidine-treated enamel. Changes in the elemental surface composition obtained by X-ray photoelectron spectroscopy clearly demonstrated adsorption of chlorhexidine from the mouthrinse as indicated by increased N and C signals which were in all cases accompanied by a higher enamel surface free energy, estimated from the contact angle data. In addition, it was found that salivary constituents adsorb less to chlorhexidine-treated enamel than to ground and polished enamel and, moreover, that adsorbed salivary constituents were desorbed by chlorhexidine. In vivo, the effect of a 3-week use of chlorhexidine was compared with the use of a placebo and habitual oral hygiene of 10 volunteers by means of clinical contact angle measurements. Also in vivo adsorption of chlorhexidine yielded elevated surface free energies with respect to habitual oral hygiene or a placebo. Thus in vivo, the well-known favourable effects of the bactericidal properties of chlorhexidine completely overrule the unfavourable effects of high enamel surface free energies. PMID- 2766315 TI - Remineralization of bovine dentine in vitro. The influence of the F content in solution on mineral distribution. AB - In this paper remineralization of bovine dentine is reported. After demineralization of the dentine in an acidic gel system creating lesions of about 180 microns depth, the tissue was remineralized in a 1.5 mM Ca and 0.9 mM phosphate containing solution at pH 7 and 37 degrees C for 8 or 21 days. The F content in the remineralization solution was 0.02, 2, or 10 ppm as NaF. Samples were analyzed by means of microradiography and scanning electron microscopy. The results show that remineralization (without F added in solution) causes a decrease in mineral loss and in lesion depth. With 2 or 10 ppm in solution, however, a substantial mineral accumulation in the lesion, but particularly on the original dentine surface, was observed. During 3 weeks of remineralization, mineral accumulations of 67 and 70 vol% of mineral for 2 and 10 ppm F in solution, respectively, were found near the original outer surface, with the sound dentine mineral value being 48 vol%. The combined microradiography and scanning electron microscopy data show that the mineral accumulated is for a major part deposited on the dentine tissue and partly inside. The latter deposition occurred both inside the tubules as well as in the intertubular areas. Inside the tubules dense precipitates were observed. Because several differences exist between bovine and human dentine, an extrapolation to the human in vivo situation is speculative. The results indicate that the presence of fluoride in the parts per million range is important for dentine remineralization efficacy and that the outer surface area in dentine can be 'overremineralized'. PMID- 2766314 TI - Penetration of fluoride-containing self-gelling liquids into human molar occlusal fissures in vitro. AB - In this in vitro study the ability and speed of self-gelling liquid compositions to penetrate into fissures were evaluated. Two formulations containing either tetraethylsilicate, ammonium fluoride, and sodium lauryl sulfate or tetraethylsilicate, sodium fluoride, and cetylpyridinium chloride at different concentrations were used. It is shown that fissure penetration occurs when a certain minimum content of surface-active agent is present. Fissure penetration is achieved within 3-4 s, according to the fissure morphology. PMID- 2766316 TI - Studies of the dental properties of lactitol compared with five other bulk sweeteners in vitro. AB - Standardized mixed cultures of dental plaque microorganisms were incubated for 24 h in media containing six different bulk sweeteners as energy source. The attack of the acid generated on tooth mineral was measured by calcium and phosphorus analyses. Demineralization was most severe with glucose and sucrose. Less acid was generated from sorbitol and mannitol, with much reduced demineralization. Fermentation of lactitol and xylitol was only very slight, leaving the final pH high and leading to extremely low enamel demineralization figures. The amounts of polysaccharide synthesized by the microorganisms in the incubations decreased in the order: glucose greater than sucrose greater than sorbitol greater than mannitol greater than lactitol greater than xylitol. PMID- 2766317 TI - Ultrastructural changes in Streptococcus sobrinus induced by xylitol, NaF and ZnCl2. AB - The effect of xylitol, NaF, or ZnCl2 on the ultrastructure of Streptococcus sobrinus OMZ 176 was studied. The bacteria were grown statically in air for 8 h in brain-heart infusion broth supplemented with 33 mM Xylitol, 2.5 mM NaF, 0.5 mM ZnCl2, separately or in combination. The bacteria were washed briefly and prepared for scanning and transmission electron microscopy. All three agents and their combinations induced distinct ultrastructural alterations. The alterations were related to various aspects of cell morphology and varied in nature and extent among the agents. The most pronounced ultrastructural alterations were seen in bacteria grown in the presence of zinc ions. At the concentrations used, fluoride appeared to induce the least effect. PMID- 2766319 TI - In vitro study into the influence of X-ray beam angulation on the detection of artificial caries defects on bitewing radiographs. AB - Little is known about the influence of errors in angulation of the X-ray beam on the correct diagnosis of interproximal caries defects from bitewing radiographs. In this study radiographs were made of 10 artificial lesions resembling initial interproximal caries defects in mandibular teeth at different projection angles within a range of +/- 15 degrees in horizontal and in vertical direction and presented in a random order to 25 dentists. The result show that the best angle for lesion detection was site-specific with about a 7 degrees tolerance range. On the average, best detection performance was achieved with horizontal angulation perpendicular to the tooth surfaces, and vertical angulation with a positive or negative tilt of 12-15 degrees relative to the perpendicular. Deviations from the best horizontal angle resulted mainly in loss of sensitivity, while vertical misangulations caused mainly a drop of the specificity. The classification of lesions with an actual depth less than halfway into the enamel is influenced to a larger extent than that of deeper lesions. PMID- 2766318 TI - Effect of a decrease of interproximal overexposure of bitewing radiographs on the diagnosis of approximal caries. AB - In bitewing radiographs the approximal enamel is always overexposed because of the short X-ray beam path in this area. This expectedly leads to a deteriorated detectability of lesions. Abrogation of this overexposure by application of X absorbing paste in the interproximal space will presumably relieve the deterioration of lesion detection. This principle is demonstrated with aluminum cylinders in which a groove simulates a lesion. The principle is also applied to a phantom head with 0.1- to 0.7-mm lesions in the bicuspids. The resulting bitewing radiographs were scored by dentists, and a lesion detection score as used before was calculated. No score improvement resulted from the relieving of overexposure. This is ascribed to the predominant role of recognition processes in the ability to detect a lesion. PMID- 2766320 TI - Time dependency of microhardness indentations in human and bovine dentine compared with human enamel. PMID- 2766321 TI - Demineralization in acidified gelatin at different sites on the same enamel surface. PMID- 2766322 TI - In vitro induced fluoride resistance of Streptococcus mutans and dental caries in rats. AB - The aim of this investigation was to study the effect of an in vitro acquired, stable, fluoride-resistant strain of Streptococcus mutans on dental caries in rats. Three groups (P0, P5 and P10) of SPF Osborne-Mendel rats were inoculated with the fluoride-sensitive S. mutans C180-2. Three other groups (FR0, FR5 and FR10) were inoculated with cultures of the fluoride-resistant S. mutans C180-2FR. Diet SSP 20/5 and tap water (less than 0.2 ppm fluoride) were available ad libitum to all groups. The drinking water of groups P5 and FR5 was supplemented with 5 mg F-/1 and the drinking water of groups P10 and FR10 with 10 mg F-/1. At the end of the caries experiment (days 58/59) there were no significant differences in the percentages and in the numbers of S. mutans in the total maxillary plaques of groups P0 to P10 and of groups FR0 to FR10, respectively. The fluoride tolerance of S. mutans cells re-isolated from rats, inoculated with the fluoride-sensitive strain, showed an unstable decrease compared to before inoculation. S. mutans cells re-isolated from rats, inoculated with the fluoride resistant strain, showed both unstable and stable adaptation towards fluoride sensitivity. The animals superinfected with the fluoride-resistant strain developed less dentinal/fissure caries. Fluoride given in the drinking water at concentrations of 5 and 10 mg/l was effective in reducing caries irrespective of whether the animals were superinfected with the fluoride-sensitive or the fluoride-resistant strain.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2766323 TI - Prevention of rat fissure caries by sodium fluoride varnish (Duraphat) with different fluoride concentrations. AB - 125 Osborne-Mendel rats were weaned at 22-23 days, inoculated with Streptococcus sobrinus and fed a cariogenic diet for 40 days. The control group received no treatment; the study groups received applications of Duraphat containing 2.3, 1.1, or 0.6% fluoride or a placebo varnish on days 21-23. The placebo varnish had no effect on caries. Fissure caries was significantly reduced by the 2.3 and 1.1% fluoride varnishes, whereas the caries reduction found after treatment with the 0.6% fluoride varnish was not statistically significant. These results suggest that reducing the fluoride content of Duraphat by half does not significantly reduce its caries-preventive effect, but the progress of caries seems to be somewhat slower with the 2.3% fluoride varnish. PMID- 2766324 TI - Cariogenicity of a confection supplemented with sodium caseinate at a palatable level. PMID- 2766325 TI - Invasion of Streptococcus mutans and Lactobacillus salivarius in early caries lesions of gnotobiotic rats. PMID- 2766326 TI - Microflora of plaque in rats following infection with an LDH-deficient mutant of Streptococcus rattus. PMID- 2766327 TI - Effect of sorbitol, xylitol, and xylitol/sorbitol chewing gums on dental plaque. AB - The effect of sorbitol (SOR), xylitol (XYL), and the mixture XYL/SOR in chewing gums on dental plaque was studied in three groups of 7 adults (mean age 22.5 years). A fourth group of habitual users of sucrose-containing gums was used as a control. The study involved a 2-week, no-gum period followed by the use of the polyol gums for 2 weeks (10 gums/day in 5 2-gum doses). The daily consumption of XYL and SOR in the XYL and SOR groups was 10.9 g, whereas in the XYL/SOR group, 8.5 and 2.4 g of these polyols were used per day. At the end of the gum period the acidogenic response of the 48-hour plaque was tested using a 10-ml mouthrinse containing the polyols (10% w/v) present in the experimental gums, followed by a 10-ml rinse of 10% (w/v) sucrose solution. The plaque of the subjects who used XYL and XYL/SOR gums showed a significantly better ability to resist pH drops induced by the sucrose rinse than the plaque in the SOR gum group. No changes in resting pH values were observed in the XYL and XYL/SOR groups, whereas the use of SOR gum was associated with significantly lower pH values. The amount of plaque decreased in the XYL/SOR (24.3%) and the XYL (29.4%) groups, but increased in the SOR (48.3%) group, the changes in the SOR group differing significantly from those found in the other groups. The plaque and saliva levels of Streptococcus mutans generally increased in the SOR group, but decreased in groups which used XYL. PMID- 2766328 TI - Correlating Streptococcus mutans with dental caries in young children using a clinically applicable microbiological method. AB - The present study used a clinically applicable microbiological method to correlate Streptococcus mutans counts and dental caries prevalence in young children. The study population consisted of 37 subjects, between 16 and 60 months of age. Using a sterile tongue depressor, samples of unstimulated saliva were obtained from subjects and inoculated onto elevated agar plates containing a selective medium. Plates were incubated anaerobically at 37 degrees C for 48 h. chi 2 and multiple regression analyses gave highly significant relationships (p less than 0.01) between dental caries prevalence and the number of S. mutans colonies. PMID- 2766329 TI - Ultraviolet light and dental caries in children. AB - Animal experimental work has suggested that ultraviolet radiation reduces dental caries incidence. The opportunity to complete a study on children in the 1-ppm water fluoridated community of Wetaskiwin, Alberta, Canada, through an experimental school design study, became possible between 1982 and 1984 as in winter children have to travel to and from school during hours of darkness. Two classrooms at the four primary schools in the city had full spectrum lighting introduced and the 102 children entering grade 5 spent 22 months of study in the same classrooms; 83 (81%) remained in the trial. Each child had DMFT, DMFS, including degree of caries involvement, gingivitis and oral hygiene indices recorded. Results showed that children receiving the full spectrum light had very low or no increase in caries incidence over the 22-month period compared with controls. DMFS findings, excluding 'sticky fissures' over the 22-month period, increased from 2.67 to 3.23 in the group receiving full spectrum light, compared with an increase of 2.32 to 4.46 in the control group (p less than 0.001). PMID- 2766330 TI - [Use of calciotropic agents in psychiatry and neurology]. AB - Neurotransmission of impulses is a phenomenon activated by the calcium signal. Therefore changes of calcium homeostasis in the nerve cell always influence more or less this function. Changes of calcium homeostasis in the nerve cell occur under various pathological conditions, incl. hypoxia. The cytosol of the neuron is excessively saturated with calcium ions due to a shift from the extracellular space. The affected neurons release humoral factors, so-called neurotransmitters, which by receptor-controlled activation of calcium channels enhance the calcium influx from the extracellular space. After exhaustion of defense mechanisms by which the nerve cell gets rid of excessive calcium its metabolism is affected and necrosis may occur. This toxic effect of calcium can be prevented by administration of calcium antagonists represented by 1. blockers of slow calcium currents and 2. calmodulin inhibitors. The author gives an account of antipsychotic, analgetic, myorelaxing and vasodilatating effects of some calcium antagonists, and their clinical application is discussed. The author emphasizes also some possible undesirable effects of some neuroleptics mediated by the calciotropic mechanism, in particular during long-term administration. They are manifested by increased urinary calcium losses and impaired bone mineralization. Delayed regression of myorelaxation during anaesthesia is also important and must be taken into account in patients treated for prolonged periods with blockers of calcium currents. PMID- 2766331 TI - [Personal experience with surgical treatment of hyperparathyroidism in chronic kidney failure. I. Etiopathogenesis of secondary hyperparathyroidism, preoperative findings, indications for parathyroidectomy]. AB - The authors give an account of the fundamental relations of the calcium-phosphate metabolism in conjunction with the development of secondary HPT in chronic renal failure. The authors analyzed a group of 20 patients operated on account of secondary and tertiary forms of HPT as regards preoperative findings. The analysis comprised the clinical condition, biochemical, radiological and histological findings pertaining to bone, along with evidence of enlarged parathyroid glands by computed tomography and ultrasonography. The mentioned findings supplemented by some findings from the literature are the sum of indications for PTE. From the practical aspect they are indicators of the affection, of a high total ALP blood level and X-ray evidence of subperiostal absorption. PMID- 2766332 TI - [Personal experience with surgical treatment of hyperparathyroidism in chronic kidney failure. II. Surgical technic, postoperative course and the state of bone metabolism after parathyroidectomy]. AB - In 20 haemodialyzed patients operated on account of HPT, in 12 instances total PTE was performed with autotransplantation of portions of the parathyroid gland and in 8 patients so-called partial PTE was performed, leaving one parathyroid gland (in one instance two). Histomorphological examination revealed diffuse to nodular hyperplasia and twice an adenoma of the parathyroid; the mean weight of the excised tissue was 4000 mg. The follow-up period after operation varied from two months to 36 months. After total PTE the regression of HPT is more marked and more rapid. Possible relapses are more probable after partial PTE, also the possible development of hyperplasia of the implanted tissue cannot be ruled out. A new rise of C-HPT levels precedes changes of the clinical picture and a rise of indicators of bone metabolism. From linear correlations between serum levels of the ALP bone fraction, total ACP, free OH-P and values of C-PTH (p less than 0.01 0.001) conclusions can be drawn on regression or progress of the osseous finding after PTE. Data on the possible participation of aluminum osteopathy are essential, as in the florid stage it is a contraindication of PTE. The positive effect of operation recorded in 17 patients comprised not only restoration of a satisfactory mobility but also an improved mental condition. Surgical treatment of advanced forms of HPT in dialyzed patients is therefore still considered an indicated operation, provided these patients receive subsequently further aimed care. PMID- 2766333 TI - [Arrhythmia as a major manifestation of Lyme borreliosis]. AB - The submitted case-history is focused on one of the leading manifestations of cardiac affection in Lyme borreliosis. The authors recapitulate and analyze the patient's complaints, her electrocardiographic and other findings and confront them with data from the literature on this "new" nosological unit. PMID- 2766334 TI - [General problems of psychological treatment of psychosomatic disorders]. AB - The author summarizes the principles ensuing from the multifactorial theory on the pathogenesis of disease for clinical work with psychosomatic patients; he describes problems which must be resolved when attempting psychological treatment of these patients and explains general principles of therapeutic strategies in psychosomatic medicine. PMID- 2766336 TI - [Response of peripheral blood lymphocytes to antigenically nonspecific mitogens in systemic erythematosus]. AB - In 24 patients with systemic lupus erythematosus the proliferating response of lymphocytes of the peripheral blood stream to mitogens PHA, ConA and PWM was examined. The spontaneous incorporation of 3H-thymidine was increased in two patients. The mean response to PHA and PWM was reduced, while the response to ConA was within the normal range. In the active stage of the disease the lymphocyte response was in general lower in the stage of low activity. There was no correlation between the number of CD4 and CD8 lymphocytes nor the CD4/CD8 index and the lymphocyte response to mitogens. In systemic lupus erythematosus the response to PWM was lower than in rheumatoid arthritis, while in rheumatoid arthritis the response to PHA and ConA was lower than in systemic lupus erythematosus. PMID- 2766335 TI - [Structural changes in normal aging of the brain]. AB - During normal ageing of the brain its weight and volume decrease significantly and the ventricles of the brain enlarge. The number of neurons of the brain stem in some areas does not decline, in the neocortex the number of neurons declines during the period between the age of 24 and 100 years by a maximum of 10-15%. As to neurotransmitting systems, the numeric atrophy during ageing affects mainly the noradrenergic locus coeruleus and the dopaminergic substantia nigra; the cholinergic n. basalis is probably not affected. The main change which takes place in neurons during ageing is their diminution. Dendritic systems of neurons undergo during ageing regressive as well as progressive changes; in some areas progressive changes predominate, in others regressive ones, in some areas both types of changes are in equilibrium. During ageing in neurons the nucleoli diminish at a varying rate. From this it is concluded that protein synthesis is altered and there is an increase of lipofuscin; both these changes take place in different ways in different neuronal populations, similarly as the diminution of Nissl's substance. The relationship of Alzheimer's disease and ageing of the brain is obscure from the pathogenetic aspect; there exist statistically significant but only quantitative differences. No evidence was provided that ageing of the brain per se is the cause of dementia. PMID- 2766337 TI - [The effect of a low-energy protein diet in short-term ambulatory treatment of obese women]. AB - Fourteen obese women (BMI 37.2 +/- 7.3) were treated with a very low energy diet containing 1555 kJ (370 kcal) for 14 days. Weight loss occurred in all cases (4.2 10.7 kg, mean 6.46 +/- 1.68 kg), although usual weight-reducing regimens have not succeeded before. There were no complications and results of usual biochemical tests did not change. Body mass index and concentrations of serum total cholesterol decreased significantly, insulin levels fell in the first and fourth hour of a glucose tolerance test. Also serum triiodothyronine concentrations declined significantly but not below the lower limit of normal results. We concluded that short-term very low energy diet treatment enable a safe decline of excessive body mass in out-patients, including those resistant to usual reducing diets. PMID- 2766339 TI - [Reconstruction of medical education in the USSR]. AB - The submitted review is devoted to changes in undergraduate medical education in the USSR. In the first part the author discuss seven important problems faced so far by medical faculties: extensive approach to medical training, little effective organization and management of education, hitherto existing goals of undergraduate education, hitherto valid concepts of its contents, inadequate material conditions for training, declining quality of teachers and students. The mentioned problems still partly exist and make the efforts regarding reconstruction of education difficult. In the second part of the paper for each of the quoted problems changes are described which were already achieved or will be implemented in the near future. The author mentions also some controversial suggestions. Positive and negative experience with the reconstruction of the medical course are compared and weighted, incl. changes in the admission of students. PMID- 2766338 TI - [DNA analysis--a new tool for the identification of individuals]. AB - The author tested the method of DNA fingerprinting on DNA of blood donors. The results indicate that the method could be introduced in forensic practice and used as a routine procedure. PMID- 2766340 TI - Cell calcium homeostasis in non-excitable cells. PMID- 2766341 TI - Do all patients with aortic stenosis and left ventricular dysfunction benefit from aortic valve replacement? PMID- 2766342 TI - Preoperative left ventricular wall stress, ejection fraction, and aortic valve gradient as prognostic indicators in aortic valve stenosis. AB - Patients with aortic valve stenosis (AS) and left ventricular (LV) dysfunction may dramatically improve after aortic valve replacement, but operative risk is high. In an earlier study, all patients with low preoperative wall stress and low ejection fraction, or with low aortic valve gradient, died or had persistent heart failure after operation. Because wall stress is difficult to calculate, we reassessed its effect and the effect of other preoperative characteristics on outcome in 66 consecutive catheterization patients with predominant aortic stenosis referred for valve replacement. Despite ejection fraction that was inordinately low compared with afterloading wall stress in nine patients, seven patients improved with surgery. All three patients with ejection fraction less than 20% improved after surgery. Two of three patients with mean aortic valve gradients of less than 30 mm Hg improved. Mortality was 33% in patients with mean gradient less than 30 mm Hg and 19% with mean gradient less than 50 mm Hg. In the 54 patients with calculated aortic valve areas of less than or equal to 0.8 cm2, 1 (2%) had continuing heart failure, while 6 of 12 (50%, P less than .01) patients with aortic valve areas of 0.9-1.2 cm2 had continued symptoms of or died of heart failure. Patients who died or failed to improve after operation were older (71 +/- 9 years) than those who improved (65 +/- 9 years, P = .02). We conclude that wall stress calculations do not predict which patients with aortic stenosis will benefit from aortic valve replacement and that poor left ventricular function and low mean aortic valve gradient do not absolutely preclude operation. On the other hand, low gradient, non-critical valve area, and advanced age are all relative contraindications to aortic valve replacement in aortic stenosis. PMID- 2766343 TI - Analysis of aortic valve gradients by transseptal technique: implications for noninvasive evaluation. AB - The peak instantaneous aortic valve gradient derived from Doppler echocardiography is commonly used to predict the severity of aortic stenosis. Peak instantaneous gradient should not be equated with the mean gradient or "peak to peak" gradient measured at cardiac catheterization. The primary purpose of this study is to assess the relationship between the aortic valve gradients, using a two-catheter transseptal technique in 102 patients with aortic stenosis, mixed aortic stenosis and regurgitation, and following aortic valve replacement. These cases were drawn from a series of 111 consecutive transseptal procedures for patients with isolated aortic valve disease. No major complications occurred, and the most common reason for technical failure was inability to engage the atrial septum in postoperative patients. Although the peak instantaneous gradient correlates well with the mean gradient in aortic stenosis (r = .94, P less than .001), mixed stenosis and regurgitation (r = .95, P less than .001), and after aortic valve replacement (r = .86, P less than .001), it systematically overestimates both the mean gradient and the peak to peak gradient. Neither the peak instantaneous nor the mean gradient correlates highly with aortic valve area in aortic stenosis (r = -.48, P less than .01 peak; r = -.58, P less than .001 mean gradient), mixed aortic stenosis and regurgitation (r = -.39, P NS peak; r = -.42, P NS mean gradient) or following aortic valve replacement (r = -.26, P NS peak; r = -.53, P less than .01 mean gradient). Systolic time intervals also were analyzed from the simultaneous left ventricular and ascending aortic pressure tracings.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2766344 TI - Angiocardiographic evaluation of right ventricular size and morphology in tricuspid atresia. AB - The potential for right ventricular growth and physiological repair in tricuspid atresia may influence the type of Fontan procedure. To evaluate preoperative right ventricular assessment, we compared the right ventricular size and morphology determined by selective right ventricular catheterization with axial left ventricular angiography. In seven consecutive patients with tricuspid atresia and ventriculo-arterial concordance, the right ventricular volume was 12.8 +/- 9.4 cc, with a predicted normal volume (based on body surface area) of 31 +/- 16 cc, 43% (range 24-78%) of normal. Right ventricular injection outlined a right ventricular area twice that visualized from an axial left ventricular injection (33.2 vs. 16.5 cm). All patients had a well developed but small trabecular portion of the right ventricle, often unopacified with left ventricular injection. Subinfundibular narrowing adjacent to the ventricular septal defect was invariably present, creating, in effect, a two-chambered right ventricle. Selective right ventriculography demonstrates the unique morphology of the right ventricle in patients with tricuspid atresia not visualized by axial left ventriculography. PMID- 2766345 TI - Wearing of caps and masks not necessary during cardiac catheterization. AB - Although cardiac catheterization-related infections are rare, caps and masks are often worn to minimize this complication. However, documentation of the value of caps and masks for this purpose is lacking. We, therefore, prospectively evaluated the experience of 504 patients undergoing percutaneous left heart catheterization, seeking evidence of a relationship between whether caps and/or masks were worn by the operators and the incidence of infection. No infections were found in any patient, regardless of whether a cap or mask was used. Thus, we found no evidence that caps or masks need to be worn during percutaneous cardiac catheterization. PMID- 2766346 TI - Ruptured aneurysm of the sinus of Valsalva with single coronary artery. AB - This paper will report the case of a patient with an aneurysm of Valsalva's sinus accompanied by single coronary artery (the presence of only a single ostium of the coronary arteries), who survived for 14 years, under conservative treatment, after a rupture of the aneurysm. In this patient the aneurysm of Valsalva's sinus ruptured from the right coronary sinus into the right ventricular outflow tract. The single coronary artery originated from the left coronary sinus, and the right coronary artery branched from the left main trunk and ran dorsally to the aorta. No case of ruptured aneurysm of Valsalva's sinus accompanied by a single coronary artery has been reported in the literature. After 14 years of conservative treatment, the patient was surgically treated by direct suture of the ruptured aneurysm and by aortic valve replacement. The postoperative course was uneventful. PMID- 2766347 TI - Mitral balloon valvuloplasty using a retrograde transventricular approach via the brachial artery. AB - Mitral balloon valvuloplasty was performed successfully in two patients with moderately severe mitral stenosis by using a retrograde transventricular arterial approach. This technique is less costly and less time consuming as compared with the transseptal technique. It avoids the creation of an atrial septal defect, which can result in significant left to right shunt that can make interpretation of haemodynamic data difficult. The major drawback with this technique is the size of the balloon catheters in current use, which can make their introduction into the brachial artery difficult. This paper discusses technical aspects of retrograde crossing of the mitral valve. PMID- 2766348 TI - Transient acute severe aortic regurgitation complicating balloon aortic valvuloplasty. AB - Transient, acute severe aortic regurgitation documented by hemodynamic and Doppler-echocardiographic assessment was observed in an elderly woman immediately following balloon aortic valvuloplasty for critical aortic stenosis. Aortic regurgitation responded to medical therapy and resolved within 24 hr. Potential mechanisms are discussed. We suspect that an oversized balloon to aortic ring area stretched the annulus, separating the valve cusps and resulting in severe regurgitation, which rapidly normalized. PMID- 2766349 TI - Catheter selection for the stenotic aortic valve. PMID- 2766350 TI - Thromboembolic complications with nonionic contrast media. PMID- 2766351 TI - Myocardial infarction and sudden death after sport: acute coronary angiographic findings. AB - Thirteen patients, seven with acute myocardial infarction and six survivors of sudden death after sport, underwent coronary angiography within a mean of 104 min after the onset of symptoms. The admission electrocardiogram showed transmural myocardial ischemia in all patients. The ischemia-related vessel was occluded in all cases of sudden death and in three cases of acute myocardial infarction. Reperfusion was achieved in eight vessels: after intracoronary streptokinase in three, after intracoronary nitroglycerin in three, and mechanically in two. Coronary spasm was demonstrated in three vessels, and coronary thrombi, in four. The coronary lesion was described as either concentric in two or eccentric with irregular borders in eight. There was a high incidence of eccentric lesions consistent with ruptured plaques. The acute coronary angiographic findings of acute myocardial infarction and sudden death after sport are similar. Physical exercise can provoke myocardial infarction and sudden death probably by inducing plaque rupture that can evoke coronary spasm, thrombosis, or both. PMID- 2766352 TI - Transseptal left heart catheterisation in infants, children, and young adults. AB - Over a 5 yr period, from October 1983 to September 1988, transseptal left heart catheterisation, using Mullins long-sheath technique, was performed in 217 infants, children, and young adults, with various forms of congenital or acquired heart disease. The mean age was 50 +/- 45 months, (range 1 mo to 21 yr). The procedure was successful in 215 (99%) patients. Pericardial puncture occurred in three patients (1.4%), though without tamponade or sequelae. There was no mortality or morbidity. Transseptal left heart catheterisation is a safe procedure for studying the left side of the heart. In addition, and of increasing importance, it allows the performance of interventional procedures on the left side of the heart and avoids the use of retrograde catheterisation through the femoral arteries. PMID- 2766353 TI - Permanent cerebral blindness after cardiac catheterization. AB - Cerebral blindness is usually a transient event that can complicate cardiac catheterization. The neurologic deficit clears in 1-3 days. We present a patient who developed permanent cerebral blindness after undergoing transfemoral cardiac catheterization. Bilateral hemorrhagic occipitotemporal infarcts were demonstrated on magnetic resonance imaging (MRI). The patient also demonstrated denial of blindness and had transient memory disturbances due to occipitotemporal lobe infarct. The probable source of the emboli was cardiac. PMID- 2766354 TI - On "gentleness". PMID- 2766355 TI - Characterization of a natural inhibitor of the insulin receptor tyrosine kinase: cDNA cloning, purification, and anti-mitogenic activity. AB - Amino acid sequence of the precursor of the phosphorylated N-glycoprotein (pp63) secreted by rat hepatocytes was deduced from the cDNA sequence. This polypeptide (Mr = 40,586) was rich in both cysteine and proline and contained three potential N-glycosylation sites. A single pp63 mRNA species (approximately 2000 bp), found in normal hepatocytes but not in FaO hepatoma cells, appeared to result from transcription of a single gene. pp63 purified by affinity chromatography inhibited insulin receptor tyrosine kinase and receptor autophosphorylation. Only the phosphorylated form of the protein was active. In additon, pp63 antagonized the growth-promoting action of insulin in FaO cells but did not affect hormone mediated increase in amino acid transport capacity or tyrosine aminotransferase induction in these cells. PMID- 2766356 TI - Scanning and transmission electron microscopy of biodegradable microspheres (DSM) in blood vessels. AB - A type of biodegradable microsphere (DSM), approximately 45 microns in diameter, made of polymerized potato starch (Pharmacia, Sweden) was intravenously injected into rats to observe the state of DSM in small blood vessels in the kidney and liver at the electron microscopic level. Prior to their digestion with amylase, individual DSM changed their round shape to an irregularly folded one to occupy almost the whole area of the lumen. At the transmission electron microscopic level, DSM were impregnated with colloidal iron and were easily identified. Interaction of the iron labelled DSM with the surface of endothelial cells was unexpectedly loose and no adherence or fusion of this surface was observed. The starch substance was not visible in the pinocytotic vesicles of the endothelium. These findings suggest the independent profile of DSM in situ. PMID- 2766357 TI - Variation in the length of the lag phase following serum restimulation of mouse 3T3 cells. AB - We have investigated the length of the lag phase (time taken for the first cells to enter S phase) and the kinetics of entry into DNA synthesis after serum restimulation of Swiss mouse 3T3 cell cultures that were allowed to become quiescent under different conditions. Cells were allowed to reach quiescence as a confluent monolayer in medium containing 10% (v/v) calf serum. Alternatively, when serum was reduced to 1% (v/v), cultures became quiescent at about 30% confluency and there was little cell to cell contact. The results show that the lag, or prereplicative phase becomes longer as the time spent in the quiescent state increases. This is the case in both confluent and non-confluent cultures. The rate of entry of cells into the S phase, however, remains the same under all conditions. PMID- 2766358 TI - Analysis of Aprt deficient mutants of Friend erythroleukaemia cells. AB - Cytogenetic analysis of mutants of the Friend Erythroleukaemia cell line deficient in adenine phosphoribosyl transferase (Aprt) was undertaken to ascertain whether non-disjunctional events were involved in the production of this mutation. All mutant clones examined were found to carry two copies of chromosome 8, the chromosome to which Aprt maps. Since the two homologues are distinguishable by silver staining, it was also clear that no mutants contained two copies of one homologue having lost the other. Treatment of mutants with 5 azacytidine failed to reactivate the Aprt locus. PMID- 2766359 TI - Fliv-1: a surface membrane differentiation antigen of fetal rat hepatocytes. AB - A monoclonal antibody of IgG1 subclass was raised against 15 day fetal hepatocytes. The antibody appears to recognize a surface membrane-associated fetal hepatocyte antigen. Preliminary experiments suggest that the antibody recognizes a protein epitope. The tissue distribution of the antigen, designated Fliv-1, was studied by immunoperoxidase staining on whole body sections from fetal rats of different gestational ages. In 15 day fetal rats the antigen was detected on Rathke's pouch, brain infundibulum, tongue, liver, pancreatic acini, adrenal gland, vertebral myotome, and some developing muscle tissue. All normal adult tissues that were examined, two rat hepatoma cell lines, and hepatomas induced in rats by a single injection of diethylnitrosamine, were negative for the Fliv-1 antigen. On the basis of its tissue distribution, it seems unlikely that Fliv-1 is a previously described fetal hepatocyte marker. PMID- 2766360 TI - Use of electrophoretic techniques and specific antibodies to analyse tubulin isotypes in rabbit testis and spermatozoa. AB - Multiple tubulin isotypes have been described in vertebrate cells and they are known to be tissue specific (Cleveland and Sullivan, 1985; Cowan and Dudley, 1983). In this study, tubulin heterogeneity has been analysed in rabbit testis and spermatozoa by isoelectric focusing, two dimensional electrophoresis and immunoblotting performed using antibodies with different specificities. These biochemical techniques evidenced a small number of tubulin isotypes expressed by immature testis and fully maturated testis and spermatozoa of rabbit, and showed that the alpha isotypes are less acidic than the beta ones and present the post translational detyrosinated form. PMID- 2766361 TI - Implication of activation of intraperitoneal macrophages with bio-degradable microspheres. AB - To estimate the possibility that biological degradable starch microspheres (DMS) activate abdominal or intraperitoneal macrophages (IMP), two sizes of DMS (Spherex, Pharmacia, Sweden) were injected into the peritoneum of the ICR mice of 4 to 8 weeks of age. Three days after the injection, peritoneal fluid was collected and incubated for one hour at 37 degrees C under 5% CO2. The cells which adhered to the petri dish were IMP, to which DMS was added for 18 hrs. The cultured IMP were observed by scanning electron microscope (SEM) and the ratio of the active type to the total number of IMP was counted as an index of the effect of DMS to IMP. The activation effect of DMS on the incubated IMP was significant in the group which was cultured with 2 microns DMS after the 45 microns DMS injection. That indicated the possible DMS function as a potential IMP activating factor (MAF). PMID- 2766362 TI - The effect of minoxidil on endothelial cells in vitro. AB - Minoxidil - a therapeutic agent used in the control of hypertension and which has been implicated in modulation of hair follicle activity - has been shown to influence certain aspects of the physiology of cultured endothelial cells. It suspends cell proliferation in a reversible manner, appears to influence cell morphology in a dose dependent way, does not significantly alter (qualitatively) protein synthesis and does not inhibit cell migration. These results demonstrate similarities between endothelial cells and keratinocytes and dermal fibroblasts and differences between endothelial cells and dermal papilla cells, follicular root sheath fibroblasts and neutrophils in their response to this agent. PMID- 2766363 TI - Cytoskeletal organization of migrating retinal pigment epithelial cells during wound healing in organ culture. AB - Retinal pigment epithelial (RPE) cells maintained in organ culture on Bruch's membrane and the associated choroid spread and migrate into a linear wound along the exposed basal lamina. Changes in cell shape, in the organization of microfilaments, and in cell-cell and cell-substratum interactions during this time were examined by epifluorescence and transmission electron microscopy. In contrast to cuboidal stationary cells distant from the wound edge, which display well-developed apical circumferential microfilament bundles (CMBs) associated with zonulae adhaerentes junctions, the migrating RPE cells near the wound edge instead are flat, and, in addition to microfilament bundles near junctions between adjacent cells, display prominent stress fibers. Furthermore, monoclonal antibodies to vinculin labeled regions at the terminal ends of these stress fibers indicating that the RPE cells form focal contacts with the basal lamina at these sites. Electron microscopy of these regions of cell-substratum interaction confirmed the presence of microfilament bundles that terminate on the cell membrane. Folds present in the basal lamina near these sites suggest that tension is being generated by the microfilaments in the stress fibers as the migrating cells pull on the underlying basal lamina through these adhesion points. PMID- 2766365 TI - Office practice of sports medicine. PMID- 2766364 TI - Long-term observation of cultured cells by interference-reflection microscopy: near-infrared illumination and Y-contrast image processing. AB - Interference-reflection microscopy (IRM) is the only method presently available with which to visualize cell-substratum adhesions in living tissue culture cells continuously for long periods of time without the use of fluorescent markers (Curtis: J. Cell Biol. 20:199-215, 1964; Izzard and Lochner: J. Cell Sci. 21:129 159, 1976). This method utilizes approximately 1% of the incident illumination to produce the IRM image (Verschueren: J. Cell Sci. 75:279-301, 1985) and so far has required the use of high-intensity light sources in the visible spectral range (400-800 nm). Unfortunately, visible light of this intensity and spectral range induces marked changes in the behavior and morphology of motile fibroblasts, including cessation of locomotion. In contrast, the present paper reports that continuous observations of live cells in IRM for periods of up to 8 hours are possible if the illuminating light is in the red to near-infrared range (650-950 nm) and without any observable change in normal cell morphology or behavior. In addition, we describe how the technique of Y-contrast image processing can be applied to IRM images to create a three-dimensional image of the ventral cell surface topography. PMID- 2766366 TI - [Fertility and reproductive risks in older women in Czechoslovakia]. AB - From nation-wide and health statistics data on the reproduction of women above 35 years of age in the CSR were obtained for the years 1975, 1980 and 1985. The older women accounted for 3.8% of all parturient women in 1985 and their relative ratio rose in the course of ten years by 1%, but only due to the group of 35-39 years-old. The specific fertility of older women declined by 40% mainly due to induced abortions. The abortion indices in 1985 reached in the 35-39 year-old ones 2990 and in the 40-44-year-old ones 7523. The number of neonates delivered by older women did not decline so far due to the present large number of women in this age group. The authors compared the reproductive risks of older age groups with the most fertile group of 20-24 year-old ones in the period of 1984 and 1985. Pregnancy ends by spontaneous miscarriage in the group of 35-39 year-old ones 3.2X more frequently and in the group of 40-44 year old ones 6.6X more frequently. The authors assessed the specific risks of spontaneous abortion with regard to the length of pregnancy. Older women have more frequently surgical deliveries (2.4X) incl. three times more frequent Caesarean sections. Deliveries by the breech position are more frequent (1.4X) and also deliveries of low birth weight infants (1.9X). The perinatal mortality, in particular its antenatal component are 2.5X and 3.5X resp. higher. Infants of older mothers are more frequently discharged with an uncertain prognosis (1.8X) or are damaged (2X).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2766367 TI - [The effect of certain drugs on the contractility of uterine strips in vitro]. AB - The isometric method of assessment of the contractility of uterine strips in vitro makes it possible to follow up systematically the response of smooth uterine musculature to oxytocin and to test the effect of selected preparations on this process. In the submitted work the author investigated the effect of methyloxytocin, magnesium sulphate, seduxene, phenergan, plegomazine and DH ergotoxin on the uterine contractions of strips of rat and human uteri ted. Based on the results of model experiments in vitro, the author discusses the effect of the mentioned substances on the spasmogenic activity of oxytocin. PMID- 2766368 TI - [Detection of hCG serum levels in choriocarcinoma using monoclonal antibodies]. AB - hCG values and those of its alpha- and beta-subunits are assessed in the serum of all patients treated in the Centre of trophoblastic disease. Commercial RIA kits with conventional antibodies are used. There was an opportunity to work with kits of Serono Co. with monoclonal antibodies, the so-called hCG MAIA clone kit which assesses hCG and its beta-subunit. In this IRMA-MAIA system 240 sera of patients with choriocarcinoma were processed. Comparison of hCG values found in the IRMA MAIA test with values assessed with kits from Kosice revealed the following: 33% of the values in MAIA were higher, 57% were in agreement. 10% of the specimens were MAIA negative, while the Kosice values were low (50-100 i.u./l) and a negative finding was assumed. The authors investigated low (or false positive) hCG values and values obtained during the so-called residual reaction. According to the obtained results in this system of three highly sensitive monoclonal antibodies no cross reaction with LH occurs. PMID- 2766369 TI - [Injuries of the urinary tract in gynecologic surgery: diagnosis, therapy and prevention]. PMID- 2766370 TI - [Interception--3 years' experience]. PMID- 2766371 TI - [Ectopic pregnancy in the uterine wall and its clinical course]. PMID- 2766372 TI - [War among obstetrical facilities?]. PMID- 2766373 TI - [Another comment on the present state of artificial insemination and some of its consequences]. PMID- 2766374 TI - [A questionnaire on the satisfaction of obstetrical and surgical patients]. PMID- 2766375 TI - [Prevention of carcinoma of the uterus. Selected abstracts of papers presented at the 9th Prague Oncology Seminar for Gynecologists. Prague, 8 December 1987]. PMID- 2766376 TI - [Theory and prognosis--aspects of prediction in basic research]. PMID- 2766377 TI - [Changes in immune reactivity in mice in relation to age]. PMID- 2766378 TI - [Differences in age characteristics of laboratory rats]. PMID- 2766379 TI - [Pharmacokinetic parameters in old rats as a possible cause of side effects of drugs in old age]. PMID- 2766380 TI - [Teratologic and cytogenetic study of the local anesthetic, pentacaine, in rabbits]. PMID- 2766381 TI - Conserved sequence elements at putative processing sites in plant mitochondria. AB - About 50 nucleotides are conserved in two distinct sequence elements at the 5' termini of abundant short transcripts from plant mitochondrial genes with complex transcription patterns. These sequence motifs are found in both structural RNA and protein-coding precursor transcripts, for example, upstream of the mature 26S rRNA and the shortest transcript of the ATPase subunit 9 genes in different plant species. The high degree of sequence similarity in these plant mitochondrial loci suggests a common functional significance in 5' processing site determination and selection. PMID- 2766382 TI - Conserved tRNA gene cluster in starfish mitochondrial DNA. AB - Partial sequencing of mtDNA from four long-diverged species of starfish reveals the existence of a conserved cluster of 13 tRNA genes, organized in a manner similar to that of the tRNA cluster of sea urchin mtDNA, but located at a position distant from the presumed replication origin. These findings suggest that a clustered organization of tRNA genes may have been present in the ancestral mitochondrial genome, and raise the possibility that tRNAs may have catalyzed the dispersal rather than the accumulation of the genes which encode them. PMID- 2766383 TI - Two small open reading frames are co-transcribed with the pea chloroplast genes for the polypeptides of cytochrome b-559. AB - The genes encoding the 9 kDa and 4 kDa polypeptides of cytochrome b-559 have been located in pea chloroplast DNA by coupled transcription-translation of cloned restriction fragments of chloroplast DNA in a cell-free extract of Escherichia coli and by nucleotide sequence analysis. The genes (psbE and psbF) are located approximately 1.0 kbp downstream of the gene for cytochrome f and are transcribed in the opposite direction, similar to the arrangement in the chloroplast genomes of other higher plants. Nucleotide sequence analysis of this region revealed four open reading frames encoding hydrophobic proteins of 83 (psbE), 39 (psbF), 38 and 40 amino acid residues, which are co-transcribed as a single major RNA of 1.1 kb. The 5' and 3' ends of this RNA have been located by primer extension and S1 nuclease mapping. The 5' end of the RNA is located 140 bp upstream of the initiating ATG codon of psbE and is preceded by typical chloroplast promoter sequences. The 3' end of the RNA is located approximately 515 bp downstream of the TAA stop codon of psbF close to a stable stem-loop structure. PMID- 2766385 TI - Update on measles in Quebec. PMID- 2766386 TI - Measles in Ontario--overview of 1989 cases. PMID- 2766384 TI - Chloroplast ribosomal DNA organization in the chromophytic alga Olisthodiscus luteus. AB - There are almost no data describing chloroplast genome organization in chromophytic (chlorophyll a/c) plants. In this study chloroplast ribosomal operon placement and gene organization has been determined for the golden-brown alga Olisthodiscus luteus. Ribosomal RNA genes are located on the chloroplast DNA inverted repeat structure. Nucleotide sequence analysis, demonstrated that in contrast to the larger spacer regions in land plants, the 16S-23S rDNA spacer of O. luteus is only 265 bp in length. This spacer contains tRNA(Ile) and tRNA(Ala) genes which lack introns and are separated by only 3 bp. The sequences of the tRNA genes and 16S and 23S rDNA termini flanking the spacer were examined to determine homology between O. luteus, chlorophytic plant chloroplast DNA, and prokaryotes. PMID- 2766387 TI - Incidence of Staphylococcus aureus infections in a chronic care facility-Nova Scotia. PMID- 2766388 TI - Dengue hemorrhagic fever (DHF). DHF situation and activities in the WHO South East Asia Region in 1988. PMID- 2766389 TI - HIV-2 detected in newborn study--Quebec. PMID- 2766390 TI - HIV-1 infection in a medium security prison for women--Quebec. PMID- 2766391 TI - Influenza activity in Canada, 1988-1989. PMID- 2766392 TI - [Sulpiride in psychiatric practice]. AB - Sulpiride is a substituted benzamide which blocks selectively D-2 receptors. The authors tested its clinical effectiveness in schizophrenia, anorexia nervosa and bulimia nervosa. In schizophrenia its action was compared with that of haloperidol. It was revealed that sulpiride is an effective drug, in particular in schizophrenia with abulic and depressive symptoms without productive symptoms and in psychoaffective psychoses. In the treatment of anorexia nervosa and bulimia nervosa its therapeutic action was not superior to that of other preparations used in these diseases. PMID- 2766393 TI - [The intelligence level of patients undergoing protective sex therapy]. AB - Based on examinations of the intelligence of 251 deviant patients hospitalized within the framework of compulsive sexuological in-patient treatment, the authors revealed in the above group a roughly normal distribution of intellectual abilities (26.7% patients feeble-minded and below average, 48.6% in the average zone, 24.7% above average and markedly above average). The best results were achieved by exhibitionists, where the authors found also the highest standard of occupational training. The lower level of education and professional training in the investigated group as a whole provides evidence that deviant development of the sexual instinct makes the implementation of intellectual dispositions of deviant subjects very difficult. PMID- 2766394 TI - [Initial experience with the administration of 7-methoxyacrine to patients with psychological disorders]. AB - The cholinomimemtic substance 7-methoxyacrine was administered to eight patients, incl. 5 patients with tardive dyskinesias after neuroleptic drugs. In all patients an europhorizing effect was recorded, all five patients with tardive dyskinesias improved markedly after a single dose, in one female patient after repeated administration symptoms of tardive dyskinesia were eliminated. The incidence of side effects is minimal. Based on our modest experience we consider 7-methoxyacrine an important extension of therapeutic possibilities, in particular in tardive dyskinesias. The authors plan to test 7-methoxyacrine also in other indications, in particular in Alzheimer's disease and in side-effects caused by psychopharmaceutical preparations. PMID- 2766395 TI - [Hospitalization of minors at a psychiatric clinic for adults]. AB - The authors analyzed the case-sheets of 45 minors examined and treated in departments for adults at the Psychiatric Clinic, Medical Faculty Comenius University, Bratislava in 1974-1980. The patients comprised 21 girls and 24 boys. Sixty-two case-sheets were analyzed because of repeated hospital admissions. Forty-three hospitalizations concerned adolescents aged 16-17 years. During the last two years of the observation an increase of enforced hospital admissions associated with suicidal attempts and drug dependence was observed. Suicidal attempts occurred in 23.2% of the cases and were demonstrative, affective and seriously meant according to A. E. Licek's classification. All hospital admissions were necessary, frequently urgent and life saving. Hospitalization of adolescents in departments for adults is not an optimal variant of specialized care of youth. PMID- 2766396 TI - [Results of the treatment of neuroses at a day-care psychiatric sanatorium in Bratislava]. AB - The authors give an account in the effect of seven weeks of comprehensive regime therapy and psychotherapy of neuroses under conditions of partial hospitalization. They processed data from 390 patients who participated in 1977 1986 in a complete therapeutic immediately after treatment. substantial symptomatic improvement occurred in 65%, when those with slight improvement were added the percentage was 90%. As regards views, 81% reported a substantial gain and as regards change of attitudes and behaviour 60%. A general substantial improvement after therapy is reported by 82% patients. Catamnestic evaluation of the achieved effect by the patients six months after termination of treatment (200 patients returned filled in questionnaires) confirms substantial symptomatic improvement in 70%, as regards views in 80%, in change of attitudes and behaviour in 64%. The data provide evidence of the stability of the achieved effect. After termination of treatment the consumption of psychopharmaceutical drugs declines markedly. PMID- 2766397 TI - [The influence of the therapist's personality on the effect of group psychotherapy]. AB - The paper is based on an all-year survey in the course of which the therapists of the psychotherapeutic department for neuroses were divided into two teams of four which differed significantly in some personality characteristics, in particular dominance, extroversion, directiveness and warmth. The authors investigated the influence of differences in these personality variables on the therapeutic results of eight closed patient groups. The results of the work provide evidence that the investigated differences in personality and behaviour of the therapists did not significantly influence the symptomatic effect of six-week group therapy of neurotic patients. Only differences in self-recognition of patients were found. A significantly greater gain in this sphere was recorded in patient groups which had more permissive therapists. PMID- 2766398 TI - [Sexual maturation in present-day trainees and students]. AB - By means of a structured interview the author examined the sociosexual development of 303 single girls aged 16-18 years born in 1967-1970. 130 were apprentices and 173 secondary school students. Comparison revealed significant differences only in the group of 16-year-old ones. There the sexual development of apprentices was more rapid, they had more frequently sexual intercourse and more sexual partners. At the ages of 17 and 18 years the differences between the groups disappeared. These findings confirm the hypothesis that in this country the differences in sexual behaviour between different social groups are diminishing and disappearing. PMID- 2766399 TI - [Aspects of the 10th decennial revision of the international statistical classification of diseases (ICD-10)]. AB - The author gives a critical account of some general principles of the project of classification ICD-10, changes in the classification of items in the area of endogenous psychoses, neuroses psychogenic conditions and personality disorder respectively. Changes in the mentioned groups may at first cause some embarassment, in advocates of defined schools even indignation. The author evaluates positively the shift of schizoaffective psychoses to affective disorders; omission of neurotic depression is probably premature. Simple schizophrenia could be classified as it was so far. The problem of latent schizophrenia is more complicated. The classification will enrich clinical thinking by progressive elements of operational diagnosis and partly also by multiaxial diagnosis by introduction of the code which records the importance of psychosocial stress ("Z"). It may stimulate the declining interest in phenomenology and nosology. In general the ICD-10 project is considered a necessary and in some instances useful compromise with principles of DSM-III classification. Its introduction will cause transient difficulties. Only after some experience with the new classification and validating studies it will be possible to express a more responsible opinion on the project. PMID- 2766400 TI - [Gonadal steroids and emotional stability in women]. PMID- 2766401 TI - [Discussion of the article by M. Vichnar: Experience with the administration of group B vitamins to children with hyperkinetic syndrome]. PMID- 2766402 TI - Utilizing clinical research findings in nursing practice: an interview with Jane Llewellyn, DNSc, RN. PMID- 2766403 TI - Analyses of specific and total antibody responses of rabbits to four kinds of immunogens. AB - As a basic study to investigate suitable conditions to immunize rabbits with drug immunogens, two highly sensitive and accurate enzyme immunoassays (EIAs) for specific antibody to viomycin (VM) and blasticidin S (BLS) were developed using the corresponding standard antibody, the solid-phase antigens, and enzyme-labeled goat anti-rabbit immunoglobulin G (IgG) antibody as immunological reagents. The accuracy of the assay results with these newly developed EIAs was demonstrated. The new EIAs as well as two previously developed EIAs, EIA for antibody specific to neocarzinostatin (NCS) and a sandwich EIA for rabbit IgG, were applied for analyses of the changes in contents of total and specific antibodies in rabbit antisera samples collected during immunizations with four antigens. Total IgG levels increased from 7.0-9.9 mg/ml to 30-50 mg/ml in all rabbits immunized under the same immunizing schedule, despite the use of four kinds of antigens. The highest level of specific antibodies, anti-BLS, anti-VM and anti-NCS, was 0.5 mg/ml in each case. PMID- 2766404 TI - Isolation of galactosaminoglycan moiety (CO-N) from protein-bound polysaccharide of Cordyceps ophioglossoides and its effects against murine tumors. AB - A galactosaminoglycan moiety was obtained from an antitumor polysaccharide fraction (SN-C) isolated from Cordyceps ophioglossoides culture. SN-C was subjected to sonication, then a protein-bound galactosaminoglycan (CO-N) was isolated specifically by precipitation with 10% ammonium hydroxide. When given intraperitoneally to mice, CO-N inhibited the proliferation of sarcoma 180 cells inoculated into the peritoneal cavity and exhibited a marked life-prolonging effect against ascitic tumors such as Ehrlich carcinoma and IMC carcinoma. CO-N also showed an inhibitory effect against solid Ehrlich carcinoma when given intratumorally and significantly inhibited the growth of a syngeneic solid tumor (MM46 mammary carcinoma) upon intravenous administration at a low dose. CO-N showed a cytocidal effect against cultured cells of IMC and P388D1 in vitro. Flow cytometric analysis demonstrated that fluorescein isothiocyanate-CO-N binds to the surface of Ehrlich cells. PMID- 2766405 TI - A nonlinear least squares program, MULTI(FILT), based on fast inverse Laplace transform for microcomputers. AB - A nonlinear curve fitting program MULTI(FILT) into which the fast inverse Laplace transform (FILT) is incorporated was developed on a microcomputer. FILT is an algorithm for the numerical inversion of Laplace-transformed equations (image equations) to generate the corresponding real time courses. The pharmacokinetic models can be defined in the form of Laplace-transformed equations as a subroutine in MULTI(FILT). MULTI(FILT) achieves the numerical inversion of the defined image equations according to FILT and the subsequent curve-fitting of the inverse-transformed time courses to the experimental data points to estimate the pharmacokinetic parameters by the nonlinear least-squares method. MULTI(FILT) has a function to impose constraints on the pharmacokinetic parameters. In order to verify the reliability of MULTI(FILT), the pharmacokinetic parameters estimated by MULTI(FILT) were compared with those by MULTI using 100 time courses which were artificially generated according to the Monte Carlo method, based on data for theophylline and bishydroxycoumarin. The estimated pharmacokinetic parameters by MULTI(FILT) agreed with those by MULTI. Thus, it is suggested that FILT, developed in the field of electronic technology, is also useful in the pharmacokinetic field. PMID- 2766406 TI - Inhibitory activities and inhibition specificities of caffeic acid derivatives and related compounds toward 5-lipoxygenase. AB - Various caffeic acid derivatives were synthesized, and their effects on 5 lipoxygenase (5-LO), 12-lipoxygenase (12-LO) and prostaglandin (PG) synthase activities were investigated. Among them, caffeic acid octyl amide (5) and 1-(3,4 dihydroxyphenyl)-1-octen-3-one (11) showed very potent inhibitory activities toward 5-LO with IC50 values of 4.2 x 10(-8) and 3.5 x 10(-8) M, respectively. They were very selective inhibitors for 5-LO. Compound 11 showed non-competitive inhibition, and the two adjacent hydroxy groups attached to the benzene ring, as well as the hydrophobic alkyl side chain, were required for its strong binding to 5-LO. PMID- 2766407 TI - Preparation of zein microspheres conjugated with antitumor drugs available for selective cancer chemotherapy and development of a simple colorimetric determination of drugs in microspheres. AB - Zein microspheres conjugated with antitumor drugs (mitomycinc (MMC), daunomycin hydrochloride (DM), peplomycin sulfate (PEP] were prepared by using a dimethyl sulfoxide (DMSO)-H2O system. MMC with low solubility in H2O was easily entrapped by the standard procedure, whereas some modifications were required for moderately and highly soluble drugs such as DM and PEP. Colorimetric determination of the drugs in microspheres was easily achieved by use of the phenol-sulfuric acid method for drugs with sugar moieties in their molecules, such as DM and PEP, while a simple treatment of the microspheres with concentrated sulfuric acid was applied in the case of drugs having a chromophore in their molecules, such as DM and MMC. PMID- 2766408 TI - Some pharmaceutical properties of 3-hydroxypropyl- and 2,3-dihydroxypropyl-beta cyclodextrins and their solubilizing and stabilizing abilities. AB - 3-Hydroxypropyl- and 2,3-dihydroxypropyl-beta-cyclodextrins (3-HP- and DHP-beta CyDs) with different degrees of substitution (D.S.) were prepared and their pharmaceutical properties were investigated. The aqueous solubility of 3-HP- and DHP-beta-CyDs was much higher than that of the parent beta-CyD and the dissolution of DHP-beta-CyD in water was endothermic. The acid- and alpha-amylase catalyzed hydrolysis rates of 3-HP- and DHP-beta-CyDs were slower than those of the parent beta-CyD. The hemolytic activity (human erythrocytes) and local irritancy (rabbit muscle) of DHP-beta-CyD were considerably less than those of natural, methylated or other hydroxyalkylated beta-CyDs, and decreased with increasing D.S. The ability of the hydroxyalkylated beta-CyDs to remove cholesterol and proteins from human erythrocytes decreased with increasing D.S., and correlated well with their hemolytic activity. 3-HP-beta-CyD was a more effective solubilizer for poorly water-soluble drugs than the parent beta-CyD, and its stabilizing effect on chemically instable drugs was higher than that of the parent beta-CyD. The above data suggest a considerable pharmaceutical potential of 3-HP- and DHP-beta-CyDs as parenteral carriers. PMID- 2766409 TI - Effect of chemical constituents from plants on 12-O-tetradecanoylphorbol-13 acetate-induced inflammation in mice. AB - The induction of edema in the mouse ear has been established as a reliable in vivo assay for tumor promoters. Therefore, inhibitors of 12-O tetradecanoylphorbol-13-acetate (TPA)-induced ear edema are most likely to be inhibitors of skin tumor promotion. Besides the application for this assay for the screening of compounds, it also allows comparison of the activities of groups of related compounds such as flavonoids. Results obtained in this way showed that the double bond at C-2 and C-3 of the flavonoid structure is a prerequisite for anti-tumor-promoting activity, and indicated that activity in this screening assay for inhibitors of TPA-induced ear edema reflects the anti-tumor-promoting effect in two-stage carcinogenesis. PMID- 2766410 TI - Screening for molluscicidal activity in crude drugs. AB - Thirty-four extracts of crude drugs and medicinal plants have been screened for activity against Oncomelania nosophora, the intermediate host of the Japanese strain of Schistosoma japonicum. Strong molluscicidal activity was found in the MeOH extract of Anemarrhenae Rhizoma. Although timosaponin A-III, one of the main saponins of Anemarrhenae Rhizoma, showed very strong killing activity, markogenin 3-O-beta-D-glucopyranosyl (1-2)-O-beta-D-galactopyranoside having the same glycosidic linkage was found to be inactive. PMID- 2766411 TI - Synthesis of alpha-deuterium-labelled cyclohexylamine and its deamination by rabbit liver microsomes. AB - In order to investigate the isotope effect on the microsomal oxidative deamination of cyclohexylamine, alpha-deuterium(D)-labelled cyclohexylamine was synthesized. The deuterium labelling was found exclusively at the alpha-position with a purity of greater than 99 atom percent. Metabolic studies in vitro indicate that a significant deuterium isotope effect operates in the oxidative deamination of alpha-D-labelled cyclohexylamine. On incubation with rabbit liver microsomes in the presence of reduced nicotinamide adenine dinucleotide phosphate (NADPH) and oxygen, the ratio of apparent deamination rate constants (kH/kD) was 2.0 +/- 0.2 (mean +/- S.D.). PMID- 2766412 TI - Synthesis of polymeric derivatives of isoniazid: characterization and in vitro release from a water-soluble adduct with polysuccinimide. AB - Coupling of isoniazid with polysuccinimide afforded a water-insoluble polymeric pro-drug; by reaction with ethanolamine it was chemically transformed in a water soluble adduct. The in vitro release of isoniazid from the drug-polymer adduct was studied by using an artificial stomach wall lipid membrane. The transfer rate constant from simulated gastric juice to simulated plasma was defined and compared with that of an equivalent dose of pure drug. PMID- 2766413 TI - Submitochondrial distribution of basic drugs in the isolated perfused lung. AB - To clarify the mechanism by which basic drugs accumulate in the lung mitochondria, the binding selectivity of drugs to different submitochondrial components of the perfused rat lung was examined. The accumulation of basic drugs was the highest in the mitochondrial outer membrane fraction. The drug accumulation in this fraction increased with lipid solubility and was dose dependent. It appears then that selective binding sites for basic drugs are present in the mitochondrial outer membrane. PMID- 2766414 TI - Enhancing effect of cetyl lactate on the percutaneous absorption of indomethacin in rats. AB - The enhancing effect of cetyl lactate (CL) on the percutaneous absorption of indomethacin (ID) from test solutions in propylene glycol (PG) was investigated by using the abdominal skin of rats in vivo. The percutaneous absorption rate of ID from 1 or 3% CL-PG test solution through the intact skin of rats was observed to be faster than that from the control solution (without CL). The bioavailability of ID was about 0.04% for the control solution, 2.2% for 1% CL-PG and 6.8% for 3% CL-PG test solutions. These results suggest that CL functions as an enhancer for the percutaneous absorption of ID. Furthermore, marked enhancing effects on percutaneous absorption of ID were obtained at a concentration greater than 1% CL in PG. In order to elucidate the mode of action of CL as an absorption enhancer, the percutaneous absorption of ID from the control solution and 3% CL PG test solution through damaged skin from which the stratum corneum had been stripped was additionally investigated. It was confirmed that CL acts on the stratum corneum to produce its effect. PMID- 2766415 TI - A new pharmacological testing method--different effects of levamisole and the serum of mice orally treated with levamisole on mitogenic activity of lipopolysaccharide. AB - The direct addition of levamisole to murine splenic lymphocytes had no effect on the mitogenic activity of lipopolysaccharide. However, the addition of serum of mice orally treated with levamisole increased the mitogenic activity, and this increased activity using serum was similar to the result obtained in an in vivo experiment. These results suggest that the new in vitro experimental method using serum may be able to reproduce the in vivo effect of drugs. PMID- 2766416 TI - Biological component microanalysis by laser photoacoustic imaging immunoassay. AB - Computerized laser photoacoustic microscopy was developed and applied to the immuno-selective imaging of the microdistribution of a biological component. Human lambda-type light-chain was chosen as a model target protein and its peroxidase conjugated antibody was used for selective binding to the target protein and its staining. Using a microscopic calibration curve which was obtained from the images of homogeneously dispersed standard samples, the total quantities of randomly dispersed artificial standard samples were estimated to evaluate the reliability of this method. Finally, the method was applied to a tissue section sample, a human fetal pancreas section, to get the local and total quantitative images of the lambda-type light-chain. PMID- 2766417 TI - Synthesis and antitumor activity of a novel water soluble mitomycin analog; 7-N [2-[[2-(gamma-L-glutamylamino)ethyl]dithio]ethyl]mitomycin C. AB - Introducing the mercaptoethyl group at the 7-N position of mitomycin C 1 has led to the isolation of 7-N,7'-N'-dithiodiethylenedimitomycin C 2. The compound 2 showed excellent antitumor activity against sarcoma 180 (sc-ip) and leukemia P388 (ip-ip) in mice. As an extension of this study, we synthesized mitomycin dimers with symmetrical disulfide and mitomycin derivatives with unsymmetrical disulfide at the 7-N side chain. Among these compounds, the water soluble conjugate 3 with ethyl gamma-L-glutamyl-L-cysteinylglycinate was far more effective against sarcoma 180 and leukemia P388 than 1. During the subsequent stage of inquiry for the potent congeners of 3, the compound 4 (water solubility: greater than 500 mg/ml), designated as KW2149, with the gamma-L-glutamylcystamino group at the 7th position was finally selected for further evaluation. PMID- 2766418 TI - Application of dibutyltin oxide method to regioselective acylation and alkylation of tylosin at C-4''. AB - 4''-O-Acyl-, 4''-O-alkyl- and 4''-deoxy-tylosin derivatives were synthesized using 2'-O-acetyl-3'',4''-O-(dibutyl-stannio)tylosin as a synthetic intermediate. The in vitro biological evaluation showed that the new derivatives were active against macrolide-resistant clinical isolates of bacteria and mycoplasmas, and that they were resistant to hepatic esterase. PMID- 2766419 TI - Studies on gastric antiulcer active agents. III. Synthesis of 1-substituted 4-(5 tetrazolyl)thio-1-butanones and related compounds. AB - Many 1-substituted 4-(5-tetrazolyl)thio-1-butanones were synthesized and tested for antiulcer activity against acetic acid-induced gastric ulcer in rats. These compounds were prepared by the reaction of 5-mercaptotetrazoles and 4-halogeno-1 butanones. Among them, 1-cyclohexyl-4-(1-phenyl-5-tetrazolyl)thio-1-butanone (VIIIp) was found to have the most potent activity. The structure-activity relationships are discussed. PMID- 2766420 TI - [Clinical study on "liver yang exuberance syndrome"]. AB - In order to study the nature of Liver Yang Exuberance Syndrome (LYES), and find new effective drug prescription to treat diseases with the syndrome, the authors chose 97 cases with LYES of hypertension, climacteric syndrome and hyperthyroidism. A clinical study was carried out on different diseases with the syndrome including the stagnancy of Liver Qi, excess of Liver Wind and rising of Liver Fire with a new prescription according to TCM theory. While another 83 cases with Yin Deficiency Yang Excess Syndrome (YDYES) of the same three diseases were employed as control group. The results showed that their total effective rates were 81.4% (in lowering blood pressure), 100% and 88.9% respectively. The marked effective rate of LYES of hypertension group was significantly higher than that of the control group (P less than 0.05), which showed the special characteristics of the TCM syndrome. Before and after treatment, the patients with LYES of the three diseases were examined in certain laboratory tests including function of autonomic nervous system, urinary MHPG-SO4, CA, plasma cAMP and TXB2, 6-keto-PGF1 alpha etc. The similar changes were found in different diseases with the same syndrome. The laboratory results of the cases got markedly improved with the improvement of their symptoms, which showed that these tests had active significance for comprehending the nature of LYES. PMID- 2766421 TI - [Tinnitus treated with combined traditional Chinese medicine and Western medicine]. AB - Cases of annoying tinnitus were selected for this observation. They were examined by general physical examination, otoscopy and some of them by audiometry and tinnitus masking patterns test, and/or Ecoch G and BSER. Two groups, TCM-WM and controls, were designed with patient's sexes, ages, severity of tinnitus almost evenly distributed. Different kinds of medicines were given to the patients of 2 groups with single blind trial. For the controls, only western medicines such as valium, nicotinic acid, mixture bromides, vitamin B Co, ATP and carbamazepine (if 100 mg of lidocaine added to 50% glucose solution intravenously was effective) were taken orally. For TCM-WM group patients, besides the drugs used above, herbal decoctions were given twice a day, and observed for 5 days per therapeutic course. The medicinal herbs consist of: Rhizoma Gastrodiae, Ramulus Uncariae cum Uncis, Poria cocos, Flos Chrysanthemi, Akebia quinata, Radix Polygoni Multiflori, Fructus Liquidambris, Radix Rehmanniae, Rhizoma Alismatis, Radix Scrophulariae, Fructus Lycii, Radix Glycyrrhizae, Semen Plantaginis and Semen Vaccariae. Of the therapeutic results in 32 cases of TCM-WM group, 11 cases (34.4%) showed absence of tinnitus, 16 (50%) improved, and 5 (15.6%) failed. The total effective rate was 84.4%. In 27 cases of the controls, 5 cases (18.6%) showed absence of tinnitus, 10 (37%) improved, and 12 (44.4%) failed. The total effective rate was 55.6%. It showed that the therapeutic results of TCM-WM group was better than those of the controls (P less than 0.05). PMID- 2766422 TI - [A clinical study on the treatment of acute upper digestive tract hemorrhage with wen-she decoction]. AB - This paper deals with the prospective clinical study on treatment of acute upper digestive tract hemorrhage with Wen-She decoction (WSD). An opened sequential controlled trial method of simple orientation quality reaction was adopted in this study. 7 cases were treated and all of them were cured. It was concluded that WSD was an excellent therapy to treat the middle or small amount hemorrhage of acute upper digestive tract. The effective rate of WSD of the stool OB (+) becoming (-) within 5 days was more than 95%. WSD consists of Codonopsis pilosulae, Atractylodes macrocephala, Poria cocos, Glycyrrhiza uralensis, Zingiber officinale, Os sepiae Halloysitum rubrum and Astragalus membranaceus. It is effective in stopping bleeding by warming the Spleen and tonifying Qi. PMID- 2766423 TI - [Fixation of the forearm in a neutral position in the treatment of Monteggia's fracture in adults--a report of 77 cases]. AB - Close reduction and fixation neutral position were used for the treatment of 77 cases of fresh adults Monteggia's fracture during 1974-1985. The methods used were extreme flexion plaster fixation to extension fracture, extension plaster fixation to flexion fractures and then change into splint fixation after 2-3 weeks. 77 cases were followed up with an average of 2.5 years and satisfactory results were obtained in 72 cases (93.5%). This article points out the clinical types, the diagnosis and the treatment of manipulation. PMID- 2766424 TI - [Clinical and experimental research on lutongning in treating vascular headache]. AB - Observing the therapeutic effect of 350 cases of vascular headache patients treated with oral Lutongning decoction and goat horn compound separately, and comparing the effects of these two groups' patients, they showed that the former was much better than the latter. The author found that cure rates of these two groups were 75.3% and 56% respectively (P less than 0.01). The medicinal action of the former was also faster than that of the latter, and the time to recover was shorter. So, Lutongning was an effective prescription in the treatment of vascular headache. In order to research the effective mechanism of Lutongning on vascular headache, the animal experiment was carried out. The hot-plate method and acetic acid body-turning method were used for the experiment in rats. After perfusing Lutongning into the rat's stomach, the author found that the reaction times by hot-plate method and the turning times by acetic acid body-turning method were less than those of the control animals. The result showed that the analgetic effect of this decoction was more obvious. PMID- 2766425 TI - [A clinical study of guan mai Le in the treatment of coronary heart disease]. AB - After finding that Fomitiporia Runctata Murr had been used to treat angina pectoris as a folk remedy, medical workers of Fujian Sanming Fongous Institute engaged in the separation and identification of flora, and made out sugar-coated tablets of GML. This article reports clinical observation of tablets of GML treating 270 cases of CHD. Among the control group, 31 cases were treated by Persantine, 20 cases by Huo Xin Dan, 30 cases by compound Salviae miltiorrhizae. Among 222 cases of angina pectoris, 80 cases acquired evident effect (36%), 98 cases acquired improvement (44%), 42 cases failed to respond to the treatment (19%) and 2 cases became worse (1%). Total effective cases were 178 and total effective rate was 80%. There were 250 cases who had ECG evaluation: 37 cases acquired evident effect (15%), 95 cases showed improvement (38%), 116 cases had no change (46%) and 2 cases became worse (1%). Total effective cases were 132 and total effective rate was 53%. There was no significant difference between the effect of tablets of GML and that of Persantine, Huo Xin Dan and compound Salviae miltiorrhizae. According to the clinical laboratory observation, there were many functions of GML, such as antimyocardial ischemia, regulating heart rate, antiectopic cardiac rhythm and improving cardiac function and disorder in hemorrheology. The authors also used GML to treat 90 cases of arrhythmia.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2766427 TI - [Application of the law of synthetical judgment of fuzzy mathematics in clinical curative effect analysis]. PMID- 2766426 TI - [Effect of yin zhi huang on bilirubin excretion in animals with unconjugated hyperbilirubinemia]. AB - Yin Zhi Huang (YZH) given stomach perfusion daily for three days in rabbits accelerated plasma clearance of infused unconjugated bilirubin. A similar but less dramatic effect could be obtained by using YZH or phenobarbital i. p. daily for three days in rats employing simultaneously with the method of bile duct ligation, plasma indirect bilirubin levels was lower but hepatic bilirubin content and plasma direct bilirubin levels were higher in both YZH and phenobarbital treated rats than those in the control animals. These observations suggested that YZH and phenobarbital shared a common mechanism of acting in lowering the indirect bilirubin levels of serum. PMID- 2766428 TI - An asymmetric synthesis of (R) and (S)-1-alkoxy-2,3-propanediols including precursors to platelet activating factor. AB - The titanium-assisted nucleophilic opening of glycidol with primary aliphatic alcohols gives 1-alkoxy-2,3-propanediols. The titanium alkoxide used in the reaction should be the alkoxide of the alcohol used for the reaction. When optically active (S)-glycidol is used in the reaction, (S)-1-alkoxy-2,3 propanediols are obtained without loss of optical activity. When the reaction is carried out at 70-75 degrees C without solvent, the 1-alkoxy-2,3-propanediols are obtained in yields of 45-59%. The regioisomeric 2-alkoxy-1,3-propanediols are found to the extent of 4-6% in the reaction. The optical purity of glycidol can be measured from the high field (500 MHz) nuclear magnetic resonance spectrum of the Mosher ester. PMID- 2766429 TI - Conversion of methylallyl alcohol into C2-methyl-1,2-di-O hexadecylglycerophosphocholine, a conformationally restricted phospholipid. AB - The synthesis of C2-methyl-1,2-di-O-hexadecylglycerophosphocholine from methylallyl alcohol is described and the 13C-NMR assignments of all glycerol backbone and headgroup resonances are provided. Bond rotations in the glycerol backbone of this diether phospholipid derivative are impeded by steric hindrance exerted by the methyl group. We discuss the utility of this conformationally restricted C2-alkyl phospholipid analog for study of the influence of conformational changes at the lipid-water interface of bilayers on the interactions between lipids and other membrane components. PMID- 2766430 TI - A second generation global analysis program for the recovery of complex inhomogeneous fluorescence decay kinetics. AB - A fluorescence spectroscopy global data analysis environment is described. Within this analysis environment, multidimensional fluorescence decay data (time and frequency domains) can be analyzed in terms of a wide variety of photophysical models. A generalized compartmental analysis structure is utilized, where one can specify the functions used to link the various compartments together. All fitting parameters may be characterized by either discrete or distributed values. Applications of these new analysis programs to the examination of phase transitions in lipid/membrane systems are described. PMID- 2766431 TI - The effects of calcium channel blocking drugs on the thermotropic behavior of dimyristoylphosphatidylcholine. AB - The effects of four calcium channel blocking drugs, diltiazem, verapamil, nimodipine and nisoldipine, on the main phase transition of dimyristoylphosphatidylcholine have been studied by high resolution differential scanning calorimetry. In all cases, the phase transition temperature is lowered, though much more effectively by nimodipine and nisoldipine than by the other two drugs. Nimodipine and nisoldipine markedly reduce the enthalpy of transition while diltiazem and verapamil have no significant effect on the enthalpy within the drug concentration range studied. Analysis of the data in terms of ideal solution theory is presented. X-ray and neutron scattering studies indicate that nimodipine and verapamil differ significantly with respect to their location within a lipid bilayer, and this difference suggests a partial rationalization of the experimental results presented here. PMID- 2766432 TI - A gas-liquid chromatographic method for steric analysis of epoxy acids. AB - A gas-liquid chromatographic method for determination of the absolute configuration of the two chiral carbon atoms of epoxy fatty acids was developed. The method involved (1) conversion of the saturated epoxy ester into a pair of regioisomeric allylic alcohols by consecutive treatments with selenophenoxide anion and hydrogen peroxide, (2) oxidative ozonolysis performed on the (-) menthoxycarbonyl derivatives of the allylic alcohols, and (3) steric analysis of the resulting two 2-hydroxy acids (methyl esters, (-)-menthoxycarbonyl derivatives) by gas-liquid chromatography using appropriate reference compounds. Application of the method for steric analysis of several synthetic epoxyoctadecanoates as well as (+)-vernolic acid derived from Vernonia galamensis is described. PMID- 2766433 TI - Infrared study of phospholipid hydration. New thermodynamic data about the main phase transition of saturated phosphatidylcholine water multidispersions. AB - Infrared spectra measurements are performed with fully hydrated phospholipid multilamellar dispersions. The temperature profiles of the delta (OH) bending vibration at 1645 cm-1, corresponding to the water molecules, show three marked transitions in such temperature ranges that they can be respectively associated with the fusion of free water molecules, with pretransition phenomena and with the main phase transition. From absorbance variations and calorimetric data, main phase transition enthalpies and entropies were calculated for both the acyl chains and the polar head-water regions. Negative contributions of the polar head water region are consistent with previous results, indicating a more ordered water layer in the fluid phase. On the other hand, a decrease of the amount of bound water molecules with increasing chain length is pointed out. PMID- 2766434 TI - Analysis of dimeric species derived from the reaction of phosphatidylethanolamine with dimethylsuberimidate. AB - Phosphatidylethanolamines of various fatty acyl species in vortexed lipid dispersions were reacted with dimethylsuberimidate to produce dimeric products. The yield was 34% at pH 10 and 2% at pH 7. The crosslinked phosphatidylethanolamine species were separated from minor products and the reactants by extraction and two-dimensional thin-layer chromatography on silica gel G, gel filtration on lipophilic Sephadex, or C18-reversed phase high performance liquid chromatography (HPLC). Reversed phase HPLC was also used to resolve the dimers into individual molecular species. Analysis of the dimers revealed the extinction coefficients at 205 nm to be higher than those of the reactant phosphatidylethanolamines. Proton nuclear magnetic resonance spectroscopy and chemical analysis implied that the dimers contain an amidine group. PMID- 2766435 TI - Pressure study on thermal transitions of oleic acid polymorphs by high-pressure differential thermal analysis. AB - Transition temperatures for oleic acid polymorphs (alpha, beta and gamma) and the melt were measured under various pressures up to 200 MPa by means of high pressure differential thermal analysis. The pressure dependences of the transition temperatures were analyzed by applying the Clapeyron equation, and the volume changes associated with the phase transitions were estimated as follows; delta V gamma-alpha = 5.9 cm3/mol, delta V alpha-melt = 29.2 cm3/mol and delta V beta-melt = 41.1 cm3/mol. The volume changes for the gamma-alpha and alpha-melt transitions were discussed in relation to the crystal structures of the alpha and gamma modifications. The experiments showed that the beta modification, whose structural data are lacking, is the most dense. This correlates with the fact that the beta form is thermodynamically most stable among the three modifications of oleic acid. PMID- 2766436 TI - The effect of n-alcohols on vesicular permeability induced at the lipid phase transition temperature: a 1H-NMR study. AB - The effect of a series of n-alcohols on the permeability of small, unilamellar dipalmitoyl phosphatidylcholine (DPPC), dimyristoyl phosphatidylcholine (DMPC) and distearoyl phosphatidylcholine (DSPC) vesicles at the gel-to-liquid crystal phase transition temperature was investigated. It was found that the permeability took the form of the transient lysis of a fraction of the population of vesicles. The effect on this lysis of the n-alcohols was seen to be very chain-length dependent, with a minimum at n = 8 (octan-1-ol) for DPPC vesicles. A similar minimum was observed in the presence of 0.1 mM Triton X-100, but the detergent could then interact with certain of the alcohols to produce permanent channels. The results are discussed in terms of the semi-empirical model of Brasseur et al. (1985) Biochim. Biophys. Acta 814, 227-236, for the interaction of the n-alcohols with a DPPC membrane. The effect of various n-alcohols on the outer and inner monolayers of DPPC vesicles was also studied and the results related to their fluidising effect, allowing channels to open at the phase transition temperature. PMID- 2766437 TI - Effect of glycosaminoglycans and divalent cations on the thermal properties of dipalmitoylphosphatidylcholine. AB - The effect of glycosaminoglycans (GAG) and divalent cations on the thermal properties of dipalmitoyl-phosphatidylcholine (DPPC)-water systems was examined in order to model some interactions taking place on low density lipoprotein (LDL) surfaces. The thermal properties of these systems were measured by differential scanning calorimetry (DSC). According to the results, all three glycosaminoglycans used (chondroitin-4-sulfate, chondroitin-6-sulfate and heparin) were effective but to a different extent. Calcium ions enhance the interaction more than magnesium ions, probably because divalent cations form bridges between the negatively charged groups of GAGs and the headgroups of lipids. It is conceivable that similar processes might occur in the case of LDL. PMID- 2766438 TI - Synthesis of 6,6'-di-O-mycoloyl- and corynomycoloyl-(alpha-D-galactopyranosyl alpha-D-galactopyranoside) via triflates. AB - Tritylation of 2,3,2',3'-tetra-O-benzyl-(alpha-D-galactopyranosyl alpha-D galactopyranoside) (4) (A. Liav, H.M. Flowers and M.B. Goren (1984) Carbohydr. Res. 133, 53-58) followed by benzylation and acid hydrolysis gave 2,3,4,2',3',4' hexa-O-benzyl-(alpha-D-galactopyranosyl alpha-D-galactopyranoside) (6). Triflation of 6 with triflic anhydride gave the ditriflate 7. Treatment of 7 with potassium mycolate or potassium corynomycolate in toluene, followed by catalytic hydrogenolysis afforded the respective cord-factor analogs 6,6'-di-O-mycoloyl (alpha-D-galactopyranosyl alpha-D-galactopyranoside) (10) and 6,6'-di-O corynomycoloyl (alpha-D galactopyranosyl alpha-D-galactopyranoside) (11). An alternative approach, based on the debenzylation of 2,3,2',3'-tetra-O-benzyl-6,6' di-O-p-tolylsulfonyl- (alpha-D-galactopyranosyl alpha-D-galactopyranoside) (1) and conversion of the latter into the corresponding 3,4,3',4'-diisopropylidene derivative 3 failed to yield satisfactory results. PMID- 2766439 TI - [The biological control of insects of medical importance]. PMID- 2766440 TI - [Neurologic and psychiatric manifestations of AIDS in Central African Republic]. AB - To describe and evaluate the frequency of neurological and psychiatric manifestations in African patients with AIDS, 93 in patients at the National Hospital Center, Bangui, were chosen according to the WHO clinical definition of AIDS and were confirmed to be HIV-1 positive (92/93) or HIV-2 positive (1/93) by Western blot. Patients were given both neurologic and psychiatric examinations. Cortico-spinal fluid (CSF) analysis was performed in case of neuro-psychiatric signs. 11 patients presented neurologic symptoms: 5 had focal processes associated in 2 cases with deep coma, 4 had cryptococcal meningitidis, 1 demonstrated peripheral facial paralysis, and there was one case of abnormal movement, choreo-athetotic type. 4 patients presented frank psychiatric symptoms (3 dementia syndromes, one of whom was HIV-2 positive, and 1 case of hallucinatory psychosis). CSF analysis was only helpful in the etiologic diagnosis of cryptococcal infection. The mortality rate in these 15 patients was 60% during the 2-month study. In this series, neurologic and/or psychiatric symptoms were detected in 16 (15/93)% of African patients with AIDS. PMID- 2766441 TI - [Seroprevalence of anti-HIV antibodies in a rural Haitian population]. AB - A sero-epidemiological study was conducted from July to August 1988, in a haitian population living in rural area. Out of 116 serum samples searched for H1V1 antibodies and anti-HTLV1, 5.2% and 4.3% were reactive, respectively. Both positivity H1V1/HTLV1 was observed in one case. HBs Ag carriers were 13%. Analysis of seroreactive people in this population enhances the epidemiological trends of AIDS in Caribbean (rural spreading, heterosexual transmission, sex ratio levelling) which relate to african type AIDS. PMID- 2766442 TI - [Parasites, etiologic agents of diarrhea in AIDS. Significance of duodenal aspiration fluid test]. AB - A research was made on one hundred cases of diarrhoeas in Aids-patients by stool examination including examination of duodenal aspirated liquid. Concerning the examination of duodenal fluid, we founded the parasites in almost one hundred patients of the cases. Among parasites observed, Isospora belli was the most frequent (20% of cases), followed by Cryptosporidium (15%). Strongyloides stercoralis represented 10% of the cases. The majority of other parasites was miscellaneous protozoa and some helminths. PMID- 2766443 TI - [Epidemiology of Rift Valley fever in western Africa. I. Serologic survey in domestic ruminants of Burkina Faso]. AB - A serosurvey of Rift valley fever virus infection has been conducted among 2,410 domestic ruminants (sheep, goats and cattle) from Burkina Faso in 1985, 1986 and 1987. An active circulation of virus was demonstrated and 26.7% of the total animal tested had Rift valley fever virus reacting antibodies. An epizootic was demonstrated retrospectively for 1987 and appears to correspond to the RVF outbreak observed in the same type of sahelian environment during the same year in Mauritania. Analogous ecoclimatic and environmental risk factors are discussed. Others phleboviruses such as Arumowot, Gordil, Saint-Floris, Gabek Forest and Odrenisrou seem to be active in some areas but no evidence of pathogenesis for domestic ruminants was demonstrated. PMID- 2766444 TI - A study of Salmonella typhi isolated in Suez Canal area. Biotyping, phage typing and colicinogenic property. AB - In this work a total of 82 strains of Salmonella typhi were isolated from Egyptian patients diagnosed as quiry enteric fever. These cases were from Ismalia, Suez and port Said Areas. The strains fell in 16 phage types. Phage types N, 40, E1, and degraded Vi were the commonest phage type in Ismailia, while phage types degraded Vi and C1 were the commonest in Port Said. Phage types Di-N, degraded Vi, A and C1 were the commonest in Suez. Chemotyping of Salmonella typhi showed that the majority of the strains belonged to chemotype I (82%), and the rest belonged to chemotype II (18%). Colicin production was negative and all the strains were susceptible to the currently used antibiotics. PMID- 2766445 TI - [Apropos of 45 cases of cutaneous tuberculosis in Tlemcen (western Algeria)]. AB - The cutaneous tuberculosis (CTB) is still frequent in Algeria. From March 81 through December 87, forty-five cases were observed in our service of Dermato Venereology (CHU Tlemcen), something like 6.4 cases per year. The two sexes are equally represented; 66.6% aged under 40; 66.6% are living in cities and have modest social and economical conditions; 20% were inoculated with BCG; previous CTB (personal 8.8% of family 11.1%) were hardly seen. It took some 44% of the patients less than a year to ask for a diagnosis, after receiving several non specific treatments. The rest took longer to come for consultation and in one case, the disease evaluated for 28 years. One explanation is that sometimes the affection causes very little annoyance. The clinical aspects observed were often evocative: Lupus vulgaris, 28.8%, scrofuloderma, 28.8%, specific adenitis, 13.3%, tuberculosis verrucosa cutis, 13.3%, gum, 13.9%, ulcerous CTB, 2.2%. Tuberculin skin test was positive for 86% of the cases and was taken into consideration when it reaches over 15 mm (46%), and with discomfort (4.4%). The treatment was efficient in the large majority of the cases. However, 29.5% of the patients gave up before the end of the cure. We insist upon the priority of the relationship doctor-patient in the case of a chronicle affection, which is less uneasy for some and shameful for a great many. PMID- 2766446 TI - [Leprosy in Vanuatu]. AB - Leprosy is commonly thought to have been introduced during the 19th century and can still be considered as a public health problem in Vanuatu. From 1965 to 1984, 651 cases were notified throughout the country, with a total incidence rate of 5.85%. The 1984 survey reported 273 active cases and 190 inactive cases, most of them were paucibacillary cases. Sex ratio H/F is 1.7. Geographical distribution is clustered into two major and two minor foci. Prevalence rate is 2.1%. Annual incidence rate is decreasing with 21 cases in 1985 and 15 cases in 1986. Reported figures are smaller than those reported in the neighbouring countries. PMID- 2766447 TI - [Toxoplasmosis in pregnant women in Niamey (Niger)]. AB - An investigation of antitoxoplasma antibodies was performed with ELISA among 218 pregnant women in Niamey (Niger). The overall prevalence is of 15.1%. Low prevalence rates are found like in most of the studies conducted in Sahelian Africa. PMID- 2766449 TI - [Nutritional anemias of iron deficiency origin: etiological approach, means of control adapted to Vietnam]. AB - Among nutritional anaemias caused by the lack of erythropoietic nutriments, iron deficiency is the most frequent. In developing countries, it mainly comes from supply deficiencies. It can also be due to multiple and successive pregnancies, to pathological iron loss, to absorption defects. The study of the iron content of the main kinds of nutriments available in Vietnam and of their absorbability allows nutritionists to give useful advice to the population. Other means (use of drugs, foodstuffs enrichment) together with nutritional and health education are essential to fight efficiently against this major nutritional disease. PMID- 2766448 TI - [Visceral and ocular Larva migrans: epidemiologic study, clinical and immunologic findings on 20 cases, adult and child]. AB - The authors report a case-study of 20 subjects affected by visceral Larva migrans (VLM) and ocular Larva migrans (OLM). Of the 20 patients, 11 were male, and 9 female (mean age: 45 years); 7 were children, from 1 to 8 years old. Seventeen patients presented clinical and bio-humoral features which could be correlated with VLM syndrome; alongside cases with clearly suggestive symptomatology, in some patients the infection by Toxocara sp. was found to show few or minor symptoms, or even to be asymptomatic and occasionally it was suspected because of a marked peripheral eosinophilia. In 3 cases the infection was exclusively ocular. So far as immunology is concerned, serological tests confirmed in all 20 cases the clinico-epidemiological and/or bio-humoral suspicion; in particular the ELISA IgG test showed high titres in 16 cases, while the RAST showed significant levels of specific IgE in 17 cases. From the therapeutic point of view, the subjects treated were exclusively those presenting a manifest clinical picture: in 5 patients the first choice drug was thiabendazole, with clinical cure in only 2 cases; diethylcarbamazine resolved the clinico-parasitological picture in 1 case; 1 patient is still under treatment with albendazole. PMID- 2766450 TI - Costs of treating diarrhoea in a children's hospital in Mexico City. AB - The treatment received by children aged under 5 years with diarrhoea was studied in the Hospital Infantil de Mexico (Federico Gomez), Mexico City. The costs of treatment were calculated and estimates were made of how these had changed since the establishment of an oral rehydration unit in the hospital in 1985. The results indicate that drug treatment of outpatients was generally appropriate and inexpensive. In contrast, the cost of drugs for inpatients was considerably higher. The seriousness of the cases justified much of this additional expense for inpatients, but there is evidence that the costs could be reduced further without jeopardizing the quality of the care. Diagnostic tests were relatively expensive, frequently failed to identify diarrhoeal etiology, and their results correlated poorly with the treatment prescribed. The oral rehydration unit resulted in significant savings by causing a 25% fall in the number of inpatients with diarrhoea. PMID- 2766451 TI - Adaptations of the Saker-Solomons test: simple, reliable colorimetric field assays for chloroquine and its metabolites in urine. AB - Two field-adapted colorimetric methods for measuring the antimalarial drug chloroquine in urine are described. Both are modifications of the method of Saker and Solomons for screening urine for phencyclidine and other drugs of abuse, using the colour reagent tetrabromophenolphthalein ethyl ester. One method is semiquantitative, detecting the presence of chloroquine (Cq) and its metabolites in urine with a 1 microgram/ml detection limit; it is more sensitive and reliable than the commonly used Dill-Glazko method and is as easy to apply in the field. The second method uses a hand-held, battery-operated filter photometer to quantify Cq and its metabolites with a 2 microgram/ml detection limit and a linear range up to 8 micrograms/ml. The first method was validated in the field using a published quantitative colorimetric method and samples from a malaria study in Nigeria. The second method was validated in the laboratory against high performance liquid chromatographic results on paired samples from the Nigerian study. Both methods may be used in remote locations where malaria is endemic and no electricity is available. PMID- 2766452 TI - [Integration of African human trypanosomiasis control in a network of multipurpose health centers]. AB - The authors relate their experience of integrating screening for African human trypanosomiasis (AHT) caused by T.b. gambiense in a network of multi-purpose health centres at Nioki, Zaire. Since 1983 the health centre nurses have been trained in the laboratory techniques for AHT screening and have been given the essential equipment (microscope, slides, coverslips). The strategy used was that of passive screening of patients who came of their own accord to the health centre: systematic palpation and aspiration of lymph nodes, and examination of wet and/or thick blood films from patients with AHT-like symptoms (fever not responding to antimalarials, headache for over a week, somnolence, arthralgias, pruritus, weight loss). When a trypanosome was detected, the patient was referred to the hospital for confirmation and lumbar puncture. From 1983 to 1987 the proportion of new cases detected by the health centres rose from 0% to 31.1%, while the returns of the mobile teams diminished as the disease regressed. Nevertheless, only 22.1% of the new cases detected by the health centres had normal CSF, as opposed to 64.8% of the new cases detected actively by the mobile teams. These two approaches therefore seem to be complementary: 83% of the new cases detected by the health centres were diagnosed on lymph node aspirates and/or wet films, and it is likely that better use of thick blood films could improve the performance of the health centres.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2766453 TI - Inositol-phosphate-induced enhancement of natural killer cell activity correlates with tumor suppression. AB - In recent studies, we have demonstrated that inositol hexaphosphate (InsP6) inhibits experimental colon carcinogenesis. Since natural killer (NK) cells are involved in tumor cell destruction, we investigated the effect of InsP6 on murine NK cell activity. We show that; (i) 1,2-dimethylhydrazine (DMH), a colon carcinogen, depresses NK activity; (ii) in vivo treatment of mice with InsP6 enhances baseline NK activity and reverses DMH-induced depressed NK activity with an inverse correlation (r = -0.9811) with tumor incidence, (iii) short-term in vitro treatment of spleen cells and NK-enriched fraction with InsP6 also enhances NK cytotoxicity in a dose-dependent manner, (iv) inositol potentiates the action of InsP6. Our data suggest yet another important role of inositol phosphates in the regulation of cellular activity. PMID- 2766454 TI - Increased resistance to transforming growth factor beta accompanies neoplastic progression of rat tracheal epithelial cells. AB - Transforming growth factor beta (TGF beta) is an inhibitor of normal epithelial cell growth. To investigate the role of TGF beta in respiratory epithelial cell neoplasia, normal, preneoplastic, tumorigenic and tumor-derived rat tracheal epithelial (RTE) cells were plated in serum-free medium and grown in the presence of 0-300 pg TGF beta 1/ml. TGF beta 1 markedly inhibited the formation of colonies by primary RTE cells and some preneoplastic RTE cells. However, tumor derived RTE cells were relatively resistant to TGF beta 1-induced growth inhibition. Resistance to TGF beta 1-induced growth inhibition, therefore, accompanies neoplastic progression of RTE cells. PMID- 2766455 TI - Carcinogenic activity of endogenously synthesized N-nitrosobis(2 hydroxypropyl)amine in rats administered bis(2-hydroxypropyl)amine and sodium nitrite. AB - The carcinogenic activity of endogenously synthesized N-nitrosobis(2 hydroxypropyl)amine (BHP) was investigated in male Wistar rats administered bis(2 hydroxypropyl)amine (BHPA) mixed in powder diet at a concentration of 1%, and sodium nitrite (SN) dissolved in distilled water at concentrations of 0.15 and 0.3%, for 94 weeks. Urinary excretion of BHP was detected in rats given 1% BHPA and 0.3% SN but not in the groups receiving either of these precursors alone. Nasal cavity, lung, esophagus, liver and urinary bladder tumors were found in animals treated with combinations of 1% BHPA and 0.15 or 0.3% SN, suggesting that the target organs of the endogenously synthesized BHP are similar to those affected when the carcinogen is administered exogenously. The incidences of nasal cavity and lung tumors reached 74 and 58% in rats given 1% BHPA and 0.3% SN, respectively. Tumors at sites other than target organs were only found at levels similar to those previously reported for spontaneous tumors in male Wistars. The present results clearly indicated the tumor inducibility of a nitrosatable amine, BHA, through an endogenous nitrosation by feeding to rats in conjunction with nitrite, and provide further suggestive evidence that endogenous nitrosations of environmental nitrosatable amines can be a potential risk factor in human cancer development. PMID- 2766456 TI - Expression of mammalian O6-alkylguanine-DNA alkyltransferase in a cell line sensitive to alkylating agents. AB - Chinese hamster ovary cells (CHO) were co-transfected with pSV2neo and sheared DNA from either a human cell line (HT29) expressing high levels of O6 alkylguanine-DNA alkyltransferase (AGT) or from a cell line (BE) deficient in this activity. Cells expressing the selectable marker were obtained by exposure to G418 and colonies resistant to alkylation damage isolated by growth in the presence of 1-(2-chloroethyl)-3-cyclohexyl-1-nitrosourea (CCNU). The number of colonies of cells expressing AGT activity arising after transfection with DNA from BE cells was similar to the number arising from cells exposed to HT29 DNA. Although the amount of AGT repair protein expressed in the transfectant colonies from this experiment was relatively low, these results indicate that repair of alkylation damage can be restored in AGT-deficient cells by transfection of human DNA from both repair-deficient and proficient cells. A separate transfection of CHOMG cells [a mutant of CHO cells resistant to the drug, methylglyoxal bis(guanylhydrazone) (MGBG)] with HT29 DNA and pSV2neo followed by selection of G418 and 1,3-bis-(2-chloroethyl)-1-nitrosourea (BCNU) resulted in three colonies with high AGT levels. These transfectants had different growth rates and expressed levels of the AGT protein between 230 and 300 fmol/mg protein. The transfectants were as resistant to the cytotoxic effects of BCNU, Clomesone, methylnitrosourea (MNU) and 1-methyl-3-nitro-1-nitrosoguanidine (MNNG) as HT29 cells which were much more resistant than the parental CHOMG cells. Pretreatment of transfectant cells with 0.4 mM O6-methylguanine for 24 h reduced AGT activity to 14% basal levels, which upon removal of the base increased to approximately 74% basal level within 8 h. The sensitivity to the cytotoxic effects of both the chloroethylating and methylating agents was enhanced by treatment with O6 methylguanine. In the same manner, the number of BCNU-induced DNA interstrand cross-links increased in transfectant cells pretreated with O6-methylguanine. These results provide further evidence that the formation of methyl or chloroethyl adducts at the O6-position contribute significantly to cell lethality. PMID- 2766457 TI - Responses of rat urine and urothelium to bladder tumor promoters: possible roles of prostaglandin E2 and ascorbic acid synthesis in bladder carcinogenesis. AB - An investigation of sequential changes in urine composition, levels of DNA synthesis and morphology of bladder epithelium following administration of the tumor promoters sodium ascorbate (AsA-Na) or butylated hydroxyanisole (BHA) and the non-promoter ascorbic acid (AsA) for 36 weeks was performed. In addition, prostaglandin E2 (PGE2), cAMP and AsA content were assessed in bladder tissue after 16 weeks. While AsA-Na caused increase in pH, sodium content and volume, and a decrease in osmolality of the urine throughout the study, these changes were not observed with AsA administration which resulted in a decrease in urinary pH. BHA treatment was not associated with any urinary changes. AsA-Na brought about a significant elevation of DNA synthesis in the bladder epithelium from weeks 2 to 16 and was associated with simple hyperplasia at week 8, which, however, decreased by week 16 and was no longer evident at weeks 24 and 36 when DNA synthesis returned to normal. Under the scanning electron microscope (SEM), morphologic alterations of the urothelial surface in rats given AsA-Na were observed at weeks 8 and 16, but the appearance at week 36 was almost normal. AsA did not cause any changes in these parameters at any time point. BHA induced a significant elevation of DNA synthesis throughout the study, produced simple hyperplasia at week 36 and alterations of the epithelial surface from weeks 4 to 36. Significant increases of PGE2 and AsA in bladder tissue were noted for the AsA-Na or BHA, but not AsA groups. Moreover, cAMP levels in bladder tissue of rats exposed to AsA-Na or BHA were slightly higher than in the controls. The results suggest that changes in PGE2, cAMP and AsA may be involved in promotion of rat bladder carcinogenesis. PMID- 2766458 TI - Promotional effect of lithocholic acid and 3-hydroxyanthranilic acid on transformation of X-ray-initiated BALB/3T3 cells. AB - X-ray-irradiated BALB/3T3 A31-1-1 cloned cells were post-treated with lithocholic acid (LCA), one of the bile acids, and 3-hydroxyanthranilic acid (3HOA), a tryptophan metabolite, in order to examine their potential to promote cell transformation. Insulin was added to the medium so as to increase the sensitivity of the cells to transformation. A dose-dependent increase in the number of transformed foci was observed with LCA. 3HOA had a very weak, though significant, activity. Transformation frequency was increased only a little, if any, by the treatment with cholic acid, which is structurally related to LCA. Anthranilic acid, an analogue of 3HOA, had no such effect. The results are discussed in view of the importance of endogenous promoters. PMID- 2766459 TI - Inactivation of O6-alkylguanine-DNA alkyltransferase in HeLa cells by cisplatin. AB - Inactivation of O6-alkylguanine-DNA alkyltransferase (O6-AGT) in HeLa CCL2 cells by cisplatin was studied. HeLa CCL2 cells treated with cisplatin showed a dose dependent decline in O6-AGT activity. After cisplatin was removed and replaced with fresh medium, the transferase level began to rise slowly. By 72 h slightly more than 80% of the activity was recovered. It seems that the activity of the alkyltransferase can be inactivated by platinated DNA adducts. The data suggest that the O6-platinum-guanine formation and the O6-alkyltransferase depletion are not responsible for cytotoxicity but may result in a base substitution mutation in mammalian cells. PMID- 2766460 TI - DNA damage and repair in normal, xeroderma pigmentosum and XP revertant cells analyzed by gel electrophoresis: excision of cyclobutane dimers from the whole genome is not necessary for cell survival. AB - Human fibroblasts were embedded in microscopic-sized agarose beads and lysed in situ to produce chromosome-sized DNA trapped inside the beads. Conventional alkaline agarose gel electrophoresis of trapped DNA from cells damaged by X-rays before embedding gave mol. wts similar to those obtained with alkaline sucrose gradients. When cells were irradiated with UV light before embedding in agarose and incubated with UV endonuclease to cleave cyclobutane pyrimidine dimer sites, UV damage was detectable by gel electrophoresis over a range of 2.6-52 J/m2 as a linear function of dose, and repair was detectable within 6 h of irradiation. Two independently derived UV-resistant xeroderma pigmentosum (XP) revertants did not remove cyclobutane dimers up to 48 h after irradiation. Incubation of normal and XP revertant cells with cytosine arabinoside after UV irradiation resulted in similar numbers of single-strand breaks; these breaks represent repair of non dimer photoproducts. Evidently, excision of cyclobutane pyrimidine dimers from the whole genome is not necessary for survival of human cells after UV irradiation; rather, repair of non-dimer photoproducts such as photoproducts in the genome as a whole or cyclobutane dimers in a small number of genes may be more biologically important. PMID- 2766461 TI - Effects of glutathione transferase activity on benzo[a]pyrene 7,8-dihydrodiol metabolism and mutagenesis studied in a mammalian cell co-cultivation assay. AB - This study deals with the role of glutathione transferase (GST)-mediated conjugation of (+)-7 beta,8 alpha-dihydroxy-9 alpha,10 alpha-oxy-7,8,9,10- tetrahydrobenzo[a]pyrene (BPDE) in two mammalian cell lines, human mammary carcinoma cells (MCF-7) and rat hepatoma cells (H4IIE), in relation to their capacity to metabolize (-)-trans-7,8-dihydroxy-7,8-dihydrobenzo[a]pyrene [(-)-BP 7,8-diol] to products that induce mutations in co-cultivated V79 cells. Both MCF 7 and H4IIE cells metabolized (-)-BP-7,8-diol to BPDE, but mutations in co cultivated V79 cells were only detected with MCF-7 cells. However, depletion of glutathione (GSH) in H4IIE cells increased the mutagenicity of (-)-BP-7,8-diol to a similar level to that found with MCF-7 cells. Measurements of GST activity using GSH and post-microsomal supernatants from H4IIE, V79 and MCF-7 cells indicated a substantial difference in conjugation capacity. Although preparations from all three cell-lines showed GST activity with 1-chloro-2,4-dinitrobenzene as the substrate, GST activity towards BPDE could only be detected in supernatants from H4IIE cells. This is consistent with the presence of GST 7-7 an isoenzyme highly efficient in catalysing BPDE-GSH conjugation. The difference in GSH conjugation activity towards BPDE was confirmed using intact H4IIE and MCF-7 cells in culture. These results indicate that GSH-conjugation plays a pivotal role in mutagenesis induced by polycyclic aromatic hydrocarbons (PAH). Accordingly, a deficiency in GSH-conjugation capacity may be regarded as one important factor in defining a target cell population with an increased risk for tumour initiation following exposure to PAH. PMID- 2766462 TI - Influence of cell cycle on glutathione-S-transferase, selenium-dependent glutathione peroxidase, superoxide dismutase and glutathione levels in human myeloid leukaemia cell lines. AB - An important biological function of glutathione (GSH) resides in the detoxication reactions mediated by enzymes such as glutathione-S-transferase (GSTs) and glutathione peroxidase (GPX). An increasing body of evidence implies that GSH and these enzymes play important roles in determining the sensitivity of tumours against cytotoxic drugs like quinone antibiotics, in particular adriamycin (Adr). In the present study, we have analysed the effects of cell-cycle on GSH and GSH dependent enzymes in an attempt to explain cell-cycle specificity of these antileukaemic drugs which were shown to be involved in free-radical-type reactions. Determination of GSH, GST, GPX and superoxide dismutase in cell-cycle enriched fractions of five different human myeloid leukaemia cell lines (KG1, K562, U937, ML-1 and ML-2) yielded results identical to those obtained in random cultures, which implies that neither GSH nor GSH-related enzymes are cell-cycle regulated. These findings argue against the presumption that cell-cycle specificity of cytotoxic drugs like Adr could be due to the glutathione-dependent metabolism in myeloid leukaemia cell lines. PMID- 2766463 TI - Immunochemical characterization of cytochrome P-450 isozymes responsible for benzene oxidation in the rat liver. AB - The contribution of cytochrome P-450 isozymes to benzene metabolism in liver microsomes from fed, fasted, pyrazole-, phenobarbital (PB)- and ethanol-treated rats and in respective isocaloric controls was investigated using monoclonal antibodies (mAbs). Clone 1-7-1 mAb did not inhibit benzene metabolism, whereas clone 2-66-3 inhibited only in PB-induced microsomes at a high concentration of benzene (6.26 mM), and clone 1-91-3 mAb inhibited benzene metabolism in all cases. The degree of inhibition was as follows: fed congruent to isocaloric control congruent to PB less than fasted less than pyrazole congruent to ethanol. The pattern of inhibition was similar with clone 1-91-3 for low (0.23 mM) and high concentrations of benzene, except in PB-induced microsomes. Western blot analysis showed that clone 1-7-1 mAb did not bind any liver microsomal protein in the region of cytochrome P-450s, whereas with clone 2-66-3 a clear-cut band was seen only in liver microsomes from PB-treated rats, with clone 1-98-1, a band was detected in microsomes from all treated groups, in the following order: PB = isocaloric control less than fed less than fasted less than pyrazole less than ethanol. These results indicate that (i) cytochromes P-450b,e and P-450j contribute to benzene metabolism in rat liver; (ii) the former has a low affinity to benzene and is induced by PB; and (iii) P-450j has a high affinity to benzene and is induced by 1-day fasting, pyrazole and ethanol, but decreased by PB treatment. PMID- 2766465 TI - Identification and analysis of a nicotine-derived N-nitrosamino acid and other nitrosamino acids in tobacco. AB - Research on carcinogenic, tobacco-specific N-nitrosamines (TSNA) led to the identification and analysis of 4-(methylnitrosamino)-4-(3-pyridyl)butyric acid (iso-NNAC) in tobacco and tobacco smoke. In order to isolate iso-NNAC, an aqueous tobacco extract at pH 4 was partitioned with ethyl acetate after the other N nitrosamino acids and TSNA were removed at pH 2 and pH 9 respectively. The structure of iso-NNAC was confirmed by GC-MS after enrichment of the methylated pH 4 fraction by chromatography on an alumina column. Iso-NNAC, 3 (methylnitrosamino)propionic acid, 4-(methylnitrosamino)butyric acid, N nitrosoproline and TSNA were determined by GC-TEA in various smokeless tobaccos as well as in reference cigarettes. The levels of iso-NNAC in tobacco products ranged from 0.01 p.p.m. in chewing tobacco to 0.95 p.p.m. in dry snuff. The transfer rate of unchanged iso-NNAC into the mainstream smoke of a non-filter cigarette amounted to 0.85%. Iso-NNAC does not induce DNA repair in primary rat hepatocytes and is inactive as a tumorigenic agent in strain A mice. PMID- 2766464 TI - Lack of promoting effect of clonazepam on the development of N nitrosodiethylamine-initiated hepatocellular tumors in mice is correlated with its inability to inhibit cell-to-cell communication in mouse hepatocytes. AB - The tumor-promoting ability of clonazepam (CZP), a widely used benzodiazepine anticonvulsant, was investigated in an in vivo mouse liver tumor promotion assay and an in vitro mouse hepatocyte intercellular communication assay. The development of preneoplastic hepatocellular foci of cellular alteration and hepatocellular neoplasms was studied in male B6C3F1 mice initiated, at 5 weeks of age, with a single i.p. injection of N-nitrosodiethylamine (NDEA; 90 mg/kg body weight) in tricaprylin, followed by administration of either phenobarbital (PB; 0.05%) or CZP (0.068% or 0.136%) in diet beginning 2 weeks after carcinogen injection and continuing to 60 weeks of age. Several mice from each group were killed after 9, 21, 33 or 53 weeks on test diet, and portions of liver and other organs were fixed in formalin and examined histologically. Unlike PB, CZP did not promote the development of preneoplastic hepatocellular foci or neoplasms (adenomas and carcinomas) in NDEA-initiated mice. Following limited (2 weeks) dietary exposure at 0.15%, CZP was a potent inducer of hepatic P450IIB1-mediated alkoxyresorufin O-dealkylase activities. In contrast, the degree of induction in hepatic tissue from mice fed 0.136% CZP for 53 weeks was markedly lower than that in mice fed 0.05% PB for 53 weeks. In the in vitro assay, diazepam, a strong tumor promoter in mouse liver, significantly inhibited mouse hepatocyte gap junctional intercellular communication, while CZP had no significant effect on this parameter. Thus, CZP, a drug structurally related to diazepam, is inactive as a liver tumor promoter in mice. PMID- 2766466 TI - The lectin binding characteristics of spontaneous and phenobarbitone induced hepatic lesions in C3H/He mice. AB - The surface membrane glycoprotein patterns of spontaneous hepatic nodules, phenobarbitone induced nodules and hepatocellular carcinoma were studied in the C3H mouse using lectin histochemistry. The lectin binding patterns of hepatocellular carcinoma cells were markedly different to those of non-tumour cells and similar to the pattern in chemically induced hepatocellular carcinomas. This supports the hypothesis that changes in surface glycoprotein are a consistent feature associated with malignancy. Similar changes in the distribution of lectin binding sites were also seen in the phenobarbitone induced eosinophilic nodules and in a proportion of spontaneous basophilic nodules. Two populations of early basophilic nodules were identified on the basis of their lectin binding patterns, and this may indicate a link between one nodular type and carcinoma. PMID- 2766467 TI - Enhancement of gap junctional communication by retinoids correlates with their ability to inhibit neoplastic transformation. AB - Retinoids that cause inhibition of methylcholanthrene-induced neoplastic transformation of C3H/10T1/2 cells enhance gap-junctional communication in carcinogen-initiated cells. Dose-response studies using retinoids of diverse structures and potency demonstrated a good correlation between these two events. Junctional permeability was enhanced by retinol and tetrahydrotetramethylnaphthalenyl propenylbenzoic acid (TTNPB) at concentrations from 10(-10) to 10(-6) M, and by retinoic acid between 10(-8) and 10(-6) M, the same concentrations that inhibited neoplastic transformation. Retinoic acid inhibited permeability at 10(-10) M, at which concentration transformation was enhanced. Retinoids caused similar alteration sin communication in parental 10T1/2 cells. Communication between initiated and 10T1/2 cells was not influenced by TTNPB. The tumor promoter 12-O-tetradecanoylphorbol-13-acetate (TPA) inhibited junctional communication in initiated cells, in 10T1/2 cells and between these two cell lines. After repeated exposure of 10T1/2 cells to TPA only retinoid enhanced communication was blocked; in contrast, basal communication became refractory. It is proposed that much of the chemopreventive action of retinoids can be explained by the enhanced junctional communication of growth regulatory signals. PMID- 2766468 TI - Effects of alkyl chain length on the inhibition of NNK-induced lung neoplasia in A/J mice by arylalkyl isothiocyanates. AB - Six homologous arylakyl isothiocyanates were evaluated for their abilities to inhibit pulmonary adenomas induced by the tobacco-specific nitrosamine 4 (methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK) in A/J mice. Four consecutive daily doses (5 mumol/mouse) of phenyl isothiocyanate (PITC), benzyl isothiocyanate (BITC), phenethyl isothiocyanate (PEITC), 3-phenylpropyl isothiocyanate (PPITC), 4-phenylbutyl isothiocyanate (PBITC), 4-oxo-4-(3-pyridyl) butyl isothiocyanate (OPBITC) and corn oil were administered to mice by gavage. Two hours following the final dosing, mice were administered saline or 10 mumol of NNK in saline i.p. Pulmonary adenomas were counted at 16 weeks after NNK administration. The mice administered only corn oil prior to NNK developed an average multiplicity of 9.2 tumors/mouse. Pretreatment with PITC, BITC and OPBITC had no significant effects on NNK-induced lung neoplasia. However, PEITC pretreatment resulted in a 64% reduction of lung tumor multiplicity, but did not affect the percentage of mice that developed tumors. Both PPITC and PBITC decreased tumor multiplicity by 96% and the percentage of tumor-bearing animals by greater than 60%. These results, in conjunction with our previous work, demonstrate a general trend of increasing inhibition of NNK-induced lung neoplasia by arylalkyl isothiocyanates with increasing alkyl chain length. This study also demonstrates the remarkable inhibitory activities of PPITC and PBITC, two isothiocyanates that had not previously been tested as chemopreventive agents. PMID- 2766469 TI - Prostaglandin derivatives inhibit the growth of malarial parasites in mice. AB - New prostaglandin oligomeric derivatives, termed MR-256 and MR-356, were found to inhibit the growth of murine malarial parasites, P. chabaudi and P. vinckei, within red blood cells in vivo. When mice were infected with P. chabaudi, both MR 256 and MR-356 suppressed the growth of parasites, but MR-356 had a greater inhibitory effect than MR-256. With P. vinckei, MR-356 also inhibited the growth of parasites, and improved the survival rate. The effect of MR-256 was much less. A possible inhibitory mechanism of action of these drugs is discussed. PMID- 2766470 TI - Methotrexate: studies on cellular metabolism. II--Effects on mitochondrial oxidative metabolism and ion transport. AB - Effects of methotrexate (MTX) on mitochondrial oxidative metabolism and ion transport were studied. MTX decreases the membrane potential (delta psi) upon energization of the mitochondrial membrane by NAD+-linked substrates and decreases the amplitude and velocity of swelling induced by glutamate and alpha ketoglutarate. MTX also has an inhibitory effect on the activities of the oxidation enzymes of NAD+-linked substrates without interfering with the oxidation systems of FAD-linked substrates. The effects of MTX could be interpreted as a consequence of a decrease in the ionic conductivity of the mitochondrial inner membrane. PMID- 2766472 TI - A polyclonal antiserum against the rabbit progesterone receptor recognizes the human receptor: immunohistochemical localization in rabbit and human uterus. AB - A polyclonal antiserum, raised in guinea pigs immunized with the 116,000 Mr rabbit uterine progesterone receptor (PR), was used to demonstrate immunoreactive PR in frozen fixed sections of rabbit and human uterus. In both species, PR localization was exclusively nuclear. For the rabbit uterus, staining intensity was greatest in the myometrium, followed by endometrial stroma, glands, and luminal epithelium. In premenopausal human endometrium and myometrium there was intense staining of nuclei from proliferative phase glands and myometrium. In the secretory phase the glands failed to stain, yet immunostaining persisted in the myometrium. PMID- 2766471 TI - A polyclonal antiserum against the rabbit progesterone receptor recognizes the human receptor: biochemical characterization. AB - Polyclonal antiserum was generated in guinea pigs immunized with the 116,000 Mr rabbit uterine progesterone receptor (PR). The PR antigen was partially purified by DEAE-cellulose chromatography and preparative sodium dodecyl sulphate polyacrylamide gel electrophoresis, transferred to nitrocellulose, and the 116,000 Mr band excised and injected into guinea pigs. The antiserum recognized on protein blots rabbit uterine PR of Mr 116,000 and 81,000. The antiserum was judged to be specific for PR from normal and malignant human tissues as determined by sedimentation shift on sucrose gradients, immunoprecipitation studies, protein blotting, and fluorographic analysis using photolabelled samples. Comparison of protein blots probed with this polyclonal antiserum or with a recently obtained monoclonal antibody to human PR indicated that similar PR structures were recognized in rabbit and human samples by both antisera. Characterization of the polyclonal antiserum has demonstrated its suitability for investigating the immunolocalization or PR in normal and malignant human tissues as well as the receptor structure detected on protein blots. PMID- 2766473 TI - Clofibrate feeding increases cytoplasmic but not mitochondrial malic enzyme activity in rat kidney cortex. AB - Administration of clofibrate for 21 days to rats increased the malic enzyme activity in the kidney cortex by about 80 per cent. This effect seems to be specific since the drug did not alter significantly the activity either of lactate dehydrogenase, citrate synthase or total mitochondrial protein content in this organ. The increase in activity of malic enzyme in the 13,000 g supernatant (extramitochondrial) fraction in rats treated with the drug was about 80 per cent, whereas in the pellet (mitochondrial fraction) it was about 40 per cent. The specific activity of malic enzyme in the kidney cortex cytosol from clofibrate-treated rats was about twice that in controls. In contrast clofibrate treatment did not affect its specific activity in isolated mitochondria. Calculations showed that 0.57 and 0.53 mumoles min-1 g-1 wet tissue of mitochondrial malic enzyme was obtained in control and clofibrate-treated rats respectively. Thus, clofibrate feeding increases the amount of cytoplasmic but not mitochondrial malic enzyme activity. PMID- 2766474 TI - Psychosocial and background factors in emotional abuse of children. AB - Seven parents legally established as emotionally abusing their children were compared with a closely matched control group of seven 'problem' parents in a day nursery. The experimental group parents showed significantly more psychosocial and background factors associated with undifferentiated abuse or physical abuse and neglect; specifically, these factors included poor coping skills, difficulty in building relationships, and poor child management techniques. In addition, the emotionally abusing parents reported a significantly higher incidence of behavioural deviancy in their children than the control caregivers. Perceived stress and lack of support also appeared critical in differentiating the two groups. The results suggest that a background of emotional abuse or deprivation may predispose an adult to have inadequate or absent coping strategies to handle difficult child behaviour, resulting in a negative parent-child interaction and failure to make use of outside support. PMID- 2766475 TI - The Bereweeke Skill-Teaching System in a residential setting for children with severe and profound learning difficulties. AB - The Bereweeke Skill-Teaching System is described and experiences resulting from its (currently successful) introduction and implementation in the context of a residential setting for children with severe and profound learning difficulties are reported and analysed. Some tentative conclusions are drawn regarding pitfalls and difficulties with the system which may aid potential users of this or related systems. PMID- 2766477 TI - Microvascular exchange during burn injury: II. Formulation and validation of a mathematical model. AB - A mathematical model of microvascular exchange in the rat following a burn injury was developed by extending an existing model of normal microvascular exchange to include perturbations characteristic of burn injuries without fluid resuscitation. The changes anticipated for small (10% body surface area) and large (40% body surface area) burns are incorporated systematically into the model until there is no improvement in the statistical fit of the simulation predictions with the experimental data of Lund and Reed (Circulatory Shock 20:91 104, 1986). The "best fit" perturbations for the small burn include the experimentally measured changes in mean arterial pressure and injured tissue pressure as well as changes to plasma protein and fluid transport coefficients in the injured tissue. The larger burn "best fit" simulation required changes to the plasma protein transport coefficients in the intact tissues as well as all of the changes listed above. The simulation results are compared with the available experimental information on burn injuries as well as with the specific data of Lund and Reed (Circulatory Shock 20:91-104, 1986). PMID- 2766476 TI - What do health visitors gain from behavioural workshops? AB - Health visitors' ratings of their role, competence, methods and effectiveness in resolving each of seven common types of preschool behaviour problem were obtained both prior to attending a behavioural training workshop and about 9 months later. At follow-up a structured interview examined their current practice in relation to preschool behaviour problems. Results suggest that these experienced health visitors perceived themselves as reasonably self-sufficient in dealing with these problems prior to training. Training had a significant but consolidating effect on these views. Possible mismatches between the health visitor's view of herself as a behaviour change agent and her training experiences in behavioural methods are examined and some suggestions are made regarding future liaison between health visitors and clinical child psychologists. PMID- 2766478 TI - Microvascular exchange during burn injury: III. Implications of the model. AB - The present work investigates the implications of the predictions of a dynamic mathematical model of microvascular exchange following a nonresuscitated burn injury in a rat (Bert et al.: Circulatory Shock 28:199-219, 1989). Transport coefficients, transmicrovascular pressures, and the resultant fluid and protein fluxes were examined in order to assess their quantitative importance to the dynamic behavior of small (10% body surface area) and large (40% body surface area) burns. Edema accumulation in the injured tissue is dependent not only on events occurring in that tissue but is influenced strongly by interaction with the plasma and the noninjured tissue compartments. PMID- 2766480 TI - Norepinephrine-induced phosphorylation of a 25 kd phosphoprotein in rat aorta is altered in intraperitoneal sepsis. AB - An attenuation of the contractile response to norepinephrine (NE) has been previously demonstrated in rat aorta during intraperitoneal sepsis and endotoxemia. In this study, we determined whether NE-induced protein phosphorylation is altered in septic rat aorta as compared to control rat aorta. We found that the NE-induced phosphorylation of a 25 kd phosphoprotein was decreased. NE increased phosphorylation of the 25 kd band by 54% (P less than .01) in the control aorta but only 12% (not significant) in the septic aorta. Pyrophosphate gel purification of phosphorylated myosin showed that this 25 kd band was not related to the myosin-phosphorylated (P) light chain. Two dimensional polyacrylamide gel electrophoresis analysis revealed that this 25 kd band represents two proteins with distinct isoelectric points of 6.5 and 6.2. These results further document that intrinsic alterations occur in the NE mediated signal transduction system in rat aorta during sepsis and that such alterations could contribute to depressed aortic contractility. PMID- 2766479 TI - Alterations in Gc levels and complexing in septic shock. AB - Septic shock involves increased generation of eicosanoids from arachidonic acid. Gc (vitamin D-binding protein) has been recently found to bind the parent molecule arachidonic acid but can also complex actin released as a result of tissue damage which causes displacement of bound arachidonic acid. Possible changes in serum levels of Gc and extent of complexing were therefore investigated in patients with gram-negative sepsis. As compared to healthy controls, serum levels of Gc were significantly decreased in patients with septic shock (P less than 0.01). Moreover, the percentages of Gc circulating in complexed form were significantly increased (P less than 0.01) and correlated strongly with disease severity, with levels often greater than 90% in patients who died (normal mean 8% +/- 3). These results suggest a hitherto unsuspected role for Gc in septic shock syndrome. PMID- 2766481 TI - Cloricromene improves survival rate and peritoneal macrophage function in splanchnic artery occlusion shock in rats. AB - Splanchnic artery occlusion (SAO) shock, induced by a transient occlusion of splanchnic arteries for 45 min, was performed in male rats, treated with vehicle or cloricromene, a coumarin derivative, 15 min before surgery. Survival rate, plasma levels of myocardial depressant factor (MDF), macrophage phagocytosis and killing of Candida albicans, and thromboxane B2 (TxB2) synthesis by peritoneal macrophages were evaluated. Of the SAO-shocked animals, 10% survived for 6 hr after the release of the occlusion of the splanchnic arteries, whereas none of the sham-shocked rats died. Peritoneal macrophages of shocked animals exhibited decreased phagocytosis (24.7 +/- 2.7%) and killing (8.0 +/- 2.1%) and increased TxB2 levels (3.23 +/- 0.27 ng/ml) with respect to those collected from sham shocked animals (phagocytosis 48.8 +/- 3.0%; killing 16.5 +/- 2.4%; TxB2 0.30 +/- 0.18 ng/ml). MDF was also increased (114.3 +/- 21.5 U/ml) compared with sham shocked animals (31.5 +/- 3.7 U/ml). Cloricromene, given intravenously (i.v.) at doses of 1, 2, and 4 mg/kg, significantly increased survival rate and lowered MDF in shocked rats. Lower doses (0.25 and 0.5 mg/kg/i.v.) were without effect. Doses that were able to reduce mortality partially reverted shock-induced macrophage impairment of phagocytosis, killing of C. albicans, and TxB2 synthesis. In addition, cloricromene (5, 10, and 25 microM) added in vitro to peritoneal macrophages, collected from shocked rats, significantly enhanced their phagocytic activity depressed by shock. PMID- 2766482 TI - Alterations in plasma levels and complexing of Gc (vitamin D-binding protein) in rats with endotoxic shock. AB - Septic shock is known to involve increased metabolism of arachidonic acid and generation of certain eicosanoids. Recently, a new extracellular pool of unsaturated fatty acids including arachidonate has been found in relation to group-specific component (Gc), a vitamin D-binding plasma protein that sequesters monomeric G-actin. Since complexing with G-actin displaces fatty acids, possible alterations in plasma levels of Gc and extent of complexing were sought in serial samples obtained from rats with shock induced by Salmonella enteritidis endotoxin (12.5-15 mg kg-1). Gc levels in animals receiving endotoxin exhibited bimodal alterations, with a significant reduction (P less than 0.001) at 1 hour, followed by a progressive elevation to 160% of starting concentrations at 6 days in animals that survived, whereas in sham-injected animals the change observed was a continuous rise to 147% at 6 days. A statistically significant increase in the percentage of Gc complexed was observed in all endotoxemic rats from 2 hours onward (P less than 0.01), in contrast to sham-injected animals, in which the percentage of Gc complexed remained at less than 5%. Levels in survivors peaked at 30 +/- 5.2% at 8 hours and then decreased to normal (2 +/- 0.9%) by 6 days (n = 7), whereas in nonsurvivors complexed Gc continued to rise until time of death (66-80%) at 6-12 hours (n = 4). Correlation of these results with glucose, transaminases, and immunoreactive TXB2 and 6-keto-PGF1 alpha indicated that decreased absolute levels of Gc represent a consistent early change in endotoxic shock and that the percentage of Gc complexed is an accurate prognostic indicator of severity. PMID- 2766483 TI - Intracellular pH of canine subendocardial Purkinje cells surviving in 1-day-old myocardial infarcts. AB - A large reduction of intracellular potassium activity in depolarized subendocardial Purkinje fibers 24 hours after coronary artery ligation is accompanied by a much smaller increase in intracellular sodium activity. Similar intracellular ionic changes also occur during acute ischemia in ventricular muscle and are consistent with mechanisms based on intracellular acidification, which is known to occur in acutely ischemic muscle. To determine if canine subendocardial Purkinje cells 24 hours after myocardial infarction are also acidic, their intracellular pH, surface pH, and maximum diastolic potential (MDP) were measured with double-barrel pH-sensitive microelectrodes and compared with control fibers in noninfarcted hearts. In 12 mM bicarbonate Tyrode's solution (5% CO2-95% O2), the average intracellular pH was not significantly different (p greater than 0.25) for normal tissue (6.83 +/- 0.08, SD, MDP = -83.5 +/- 3.2 mV), for depolarized Purkinje fibers in infarct preparations during the first hour of superfusion (6.88 +/- 0.11, MDP = -47.8 +/- 11.8 mV), and for partially recovered Purkinje fibers in infarcts averaged over the third to sixth hours of superfusion (6.85 +/- 0.12, MDP = -74.5 +/- 9.6 mV). In 24 mM bicarbonate Tyrode's solution, infarct intracellular pH during both the first hour of superfusion (7.08 +/- 0.13, MDP = -57.6 +/- 15.7 mV) and during the third to sixth hours of superfusion (7.06 +/- 0.15, MDP = -76.5 +/- 9.6 mV) was significantly alkaline (p less than 0.0005) compared with average control pH (6.92 +/- 0.12, MDP = 82.1 +/- 3.7 mV). In 24 mM bicarbonate Tyrode's solution, the intracellular pH did vary with MDP (0.0032 pH units/mV). During superfusion of normal Purkinje fibers with hypoxic Tyrode's solution, intracellular pH acidified by 0.22 pH units as they depolarized. Therefore, intracellular acidification does not seem to be a cause of the depolarization of subendocardial Purkinje cells 24 hours after myocardial infarction. PMID- 2766484 TI - Determinants of sensitization of carotid baroreceptors by pulsatile pressure in dogs. AB - The threshold pressure of single baroreceptor units is decreased after compared with before exposure to pulsatile pressure according to previous studies in our laboratory. The purpose of the present study is to characterize the determinants of sensitization of arterial baroreceptors by pulsatile pressure. Carotid sinus nerve activity was recorded in dogs anesthetized with chloralose. Two indexes of baroreceptor "sensitivity" were obtained by comparing nerve activity before and immediately after exposure of the isolated carotid sinus to pulsatile pressure for periods up to 10 minutes. Sensitization occurred 1) when the threshold pressure of single baroreceptor units determined with a slow nonpulsatile ramp decreased after as compared with before pulsing and 2) when multiple unit activity increased after as compared with before pulsing at various mean levels of static pressure. Sensitization was evident after pulsing at mean pressure of 50 and 100 mm Hg, but not at 150 and 200 mm Hg, and was caused by the pulsatile change in diameter or deformation and not by the pulsatile change in wall tension. The magnitude of the effect was directly related to the duration of the pulsing period and to the frequency and amplitude of the pressure pulses. The sensitization could not be explained by increased diameter (sonomicrometers) or strain of the carotid sinus at the same pressure after pulsing; thus, there was an increase in "strain sensitivity" that outlasted the period of pulsing by up to several minutes. In most experiments the shift from static to pulsatile pressure at 50 and 100 mm Hg caused an increase in nerve activity, yet sensitization occurred after pulsing when one would have expected postexcitatory hyperpolarization or depression of activity upon return to static pressure. The sensitization was not caused by the release of prostacyclin from the endothelium since it was not reduced after endothelial denudation or inhibition of cyclooxygenase with indomethacin (30-80 microM) or ibuprofen (250 microM). We speculate that sensitization of baroreceptors by pulsatile pressure may contribute to the decreased sympathetic activity after periods of elevated pulse pressure (e.g., after exercise). We also propose that the decreased sensitivity of baroreceptors after acute elevation of arterial pressure (acute resetting) may be offset in part by the sensitizing effect of increased pulsatile stretch. PMID- 2766485 TI - Fractal nature of regional myocardial blood flow heterogeneity. AB - Spatial variation in regional flows within the heart, skeletal muscle, and in other organs, and temporal variations in local arteriolar velocities and flows is measurable even with low resolution techniques. A problem in the assessment of the importance of such variations has been that the observed variance increases with increasing spatial or temporal resolution in the measurements. This resolution-dependent variance is now shown to be described by the fractal dimension, D. For example, the relative dispersion (RD = SD/mean) of the spatial distribution of flows for a given spatial resolution, is given by: RD(m) = RD(mref).[m/mref]1-Ds where m is the mass of the pieces of tissue in grams, and the reference level of dispersion, RD(mref), is taken arbitrarily to be the RD found using pieces of mass mref, which is chosen to be 1 g. Thus, the variation in regional flow within an organ can be described with two parameters, RD(mref) and the slope of the logarithmic relationship defined by the spatial fractal dimension Ds. In the heart, this relation has been found to hold over a wide range of piece sizes, the fractal Ds being about 1.2 and the correlation coefficient 0.99. A Ds of 1.2 suggests moderately strong correlation between local flows; a Ds = 1.0 indicates uniform flow and a Ds = 1.5 indicates complete randomness. PMID- 2766486 TI - Effect of phalloidin on structure and permeability of rete capillaries in the normal and hypoxic state. AB - The effects of 10(-6) M phalloidin on reperfusion-injured blood capillary structure and permeability were studied in the countercurrent perfused rete mirabile of the eel swim bladder. In the normal rete, the addition of phalloidin to the perfusion medium did not induce morphological or functional changes. When flow was arrested for 30 minutes, during which time the capillaries were exposed to inhibitors of ATP generation, and flow was then resumed with an oxygenated medium, cell membrane blebs and vacuolization, mitochondrial swelling, pericyte shrinkage, and interstitial space edema were observed. The permeability coefficients for labeled albumin, sucrose, and sodium increased to three to four times baseline values, whereas the permeability to water was not significantly modified. When the same protocol was repeated with phalloidin present in the medium throughout the experiment, the structural integrity of the endothelial cells was completely preserved and pericyte shrinkage was abolished, but interstitial space edema still occurred. The permeability to albumin, sucrose, and sodium increased only to 1.5 times baseline values, a significantly decreased increment in comparison with the experiments performed without phalloidin. We concluded that although phalloidin does not improve the capillary barrier of the normal rete, it provides protection against the structural and functional damage induced by hypoxia and reperfusion. PMID- 2766487 TI - Effect of left ventricular volume on right ventricular end-systolic pressure volume relation. Resetting of regional preload in right ventricular free wall. AB - Effect of left ventricular (LV) volume on right ventricular (RV) end-systolic pressure-volume relation (ESPVR) was investigated, and the mechanism was examined from a standpoint of the alteration of RV free wall mean fiber length. Twelve cross-circulated isovolumically contracting canine hearts in which both ventricular volumes were controlled independently were used, and RV-ESPVR was determined at three different LV volume levels. At small (10.2 +/- 0.6 ml), middle (15.3 +/- 1.0 ml), and large (20.5 +/- 1.4 ml) LV volume, the slope of the RV-ESPVR was 2.63 +/- 0.13, 2.74 +/- 0.13, and 2.89 +/- 0.12 mm Hg/ml, respectively, and each value was significantly different from the others (p less than 0.01). The volume intercept (V0) of the relation (RV-V0) was significantly decreased with the increment of LV volume (RV-V0 in small, middle, and large LV volume; 3.92 +/- 0.68, 3.39 +/- 0.67, and 2.87 +/- 0.71 ml, respectively; p less than 0.01). In nine hearts, RV free wall lengths in latitudinal and meridional direction were measured at three LV volume levels when RV volume was held constant (16.1 +/- 1.1 ml). RV latitudinal end-diastolic length was significantly augmented with increasing LV volume (latitudinal length in small, middle, and large LV volume; 9.68 +/- 0.55, 9.81 +/- 0.56, and 9.92 +/- 0.55 mm, respectively). RV meridional end-diastolic length also increased significantly with increasing LV volume.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2766489 TI - Intermittent coronary sinus occlusion after coronary arterial ligation results in venous retroperfusion. AB - Coronary sinus occlusion retards necrosis of ischemic myocardium. To test the hypothesis that coronary sinus occlusion induces retrograde venoarterial flow, the coronary arteriovenous pressure gradient and the coronary arterial oxygen saturation were measured distal to a left anterior descending coronary artery ligature in dogs. In parallel, we constructed a mathematical model of known coronary physiology to characterize pressure and flow patterns during coronary sinus occlusion. In dogs, coronary sinus occlusion produced a systolic pressure gradient between the coronary artery and the coronary sinus of -20 +/- 9 mm Hg (higher venous pressure, p less than 0.0001) and a positive diastolic gradient of 3 +/- 5 mm Hg (lower venous pressure p less than 0.01). An average reduction in the oxygen saturation in the ligated coronary artery of 20 +/- 13% was also observed (p less than 0.005) consequent to admixture of venous (desaturated) blood. By graded inflation of the coronary sinus balloon, it was demonstrated that desaturation of arterial blood typically occurs above a coronary sinus systolic pressure of 40-50 mm Hg. The mathematical model indicates the possibility of venoarterial pressure gradients and reversal of flow at the microcirculatory level during coronary sinus occlusion. These studies provide evidence that retrograde flow into the ischemic zone occurs in association with intermittent coronary sinus occlusion. Thus, alternating flow over the ischemic territory may be the mechanism of myocardial salvage during intermittent coronary sinus occlusion. PMID- 2766488 TI - Quantification of myocardial infarct size after coronary reperfusion by serum cardiac myosin light chain II in conscious dogs. AB - The effects of early coronary artery reperfusion on the relation between the extent of myocardial infarction and serum levels of cardiac myosin light chain II or plasma creatine kinase levels were evaluated in the conscious dog. Hydraulic occluders were placed on the left anterior descending arteries of 38 dogs. Seven to 10 days later, myocardial infarction was produced. Coronary reperfusion was performed 3 hours (group A1, n = 13) and 6 hours (group A2, n = 12) after the occlusion. In the other 13 dogs, coronary occlusion was sustained throughout the course of the experiment (group B). Seven days after the occlusion, the heart was cut from the apex to the base into 4-mm slices, and infarct size was determined macroscopically. Rapid appearance and early peaking of creatine kinase were observed in group A. Cumulative release of creatine kinase significantly correlated with infarct size in group A (infarct size ranged from 0.1 to 20.1 g, r = 0.90) and group B (from 0.6 to 26.8 g, r = 0.91). However, since creatine kinase release in group A was greater in comparison with that from infarcts of the same size in group B, the slope of the regression line for group A was significantly steeper (p less than 0.05). Cardiac myosin light chain II appeared as early as creatine kinase did and continued to be elevated for 7 days. A very close relation was observed between infarct size and total cardiac myosin light chain II release (r = 0.87 for group A, and r = 0.88 for group B) or peak level of light chain II (r = 0.85 for group A, and r = 0.81 for group B). In addition, the slopes of the regression lines for infarct size and both peak and total release of light chain II did not differ between group A and group B. On histological examination, viable myocardium was frequently observed in the epicardium of the ischemic area in group A1; therefore, infarct size was greater in group B than in group A1 (p less than 0.05). Also, myocardial creatine kinase content in the epicardium of the center of the ischemic area in group A1 was greater than that in group B. Cardiac myosin light chain II release in group A1 was less than that in group B, whereas no difference was found in plasma creatine kinase release among groups A1, A2, and B.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2766490 TI - Current fluctuations and oscillations in smooth muscle cells from hog carotid artery. Role of the sarcoplasmic reticulum. AB - Electrical activity of enzymatically isolated, smooth muscle cells from hog carotid arteries was recorded under current clamp and voltage clamp. Under the experimental conditions, membrane potential usually was not stable, and spontaneous hyperpolarizing transients of approximately 100-msec duration were recorded. The amplitude of the transients was markedly voltage dependent and ranged from about 20 mV at a membrane potential of 0 mV to undetectable at membrane potentials negative to -60 mV. Under voltage clamp, transient outward currents displayed a similar voltage dependency. These fluctuations reflect a K+ current; they were abolished by 10 mM tetraethylammonium chloride, a K+ channel blocker, and the current fluctuations reversed direction in high extracellular K+ concentration. Modulators of intracellular Ca2+ concentration also affected electrical activity. Lowering intracellular Ca2+ concentration by addition of 10 mM EGTA to the pipette solution or suppressing sarcoplasmic reticulum function by superfusion with caffeine (10 mM), ryanodine (1 microM), or histamine (3-10 microM) blocked the rapid voltage and current spikes. However, caffeine and histamine induced a much slower hump of outward current before blocking the rapid spikes. This slower transient outward current could be elicited only once after external Ca2+ was removed and is consistent with an activation of K+ channels by Ca2+ released from internal stores. In contrast, removal of external Ca2+ alone failed to abolish the rapid spikes. These results suggest that 1) a Ca2+ dependent K+ conductance can markedly affect the electrical behavior of arterial smooth muscle cells and 2) internal Ca2+ stores, probably the sarcoplasmic reticulum, can support rapid and frequent releases of Ca2+. Exposure to a low concentration of histamine (3 microM) caused synchronization of the irregular, rapid fluctuations giving rise to slow, periodic oscillations of Ca2+-activated K+ conductance with a frequency of 0.1-0.3 Hz. These regular oscillations are reminiscent of periodic Ca2+-induced Ca2+ release, were inhibited by 10 mM caffeine, and point to a modulation of sarcoplasmic reticulum Ca2+ release by histamine. PMID- 2766491 TI - Ionic basis and analytical solution of the wenckebach phenomenon in guinea pig ventricular myocytes. AB - The ionic mechanisms of slow recovery of cardiac excitability and rate-dependent activation failure were studied in single, enzymatically dissociated guinea pig ventricular myocytes and in computer simulations using a modified version of the Beeler and Reuter model for the ventricular cell. On the basis of our results, we developed a simplified analytical model for recovery of cell excitability during diastole. This model was based on the equations for current distribution in a resistive-capacitive circuit. A critical assumption in the model is that, in the voltage domain of the subthreshold responses, the sodium and calcium inward currents do not play a significant role, and only the two potassium outward currents, the delayed rectifier (IK) and the inward rectifier, are operative. The appropriate parameters needed to numerically solve the analytical model were measured in the guinea pig ventricular myocyte, as well as in the Beeler and Reuter cell. The curves of recovery of excitability and the rate-dependent activation patterns generated by numerical iteration of the analytical model equations closely reproduced the experimental results. Our analysis demonstrates that slow deactivation of the delayed rectifier current determines the observed variations in excitability during diastole, whereas the inward rectifier current determines the amplitude and shape of the subthreshold response. Both currents combined are responsible for the development of Wenckebach periodicities in the ventricular cell. The overall study provides new insight into the ionic mechanisms of rate-dependent conduction block processes and may have important clinical implications as well. PMID- 2766492 TI - Constitutive relations and finite deformations of passive cardiac tissue II: stress analysis in the left ventricle. AB - We present a new approach for estimation of transmural distributions of stress and strain in the equatorial region of a passive left ventricle. We employ a thick-walled cylindrical geometry, assume that myocardium is incompressible, and use a three-dimensional constitutive relation that yields a material symmetry consistent with observed transmural variations in muscle fiber orientations. Moreover, we consider finite deformations including inflation, extension, twist, and transmural shearing and suggest a new method for determination of the requisite deformation parameters directly from experimental strain data. We show representative transmural distributions of stress and strain, and perform a parametric study to illustrate differing predictions of stress induced by varying boundary conditions, muscle fiber orientations, or modes of deformation. Our analysis can be used to guide and check future predictions of cardiac stresses, and to guide experimentalists by suggesting the accuracy of measurements essential for stress analysis in the heart. PMID- 2766493 TI - Volatile anesthetics block intercellular communication between neonatal rat myocardial cells. AB - The effects of halothane and ethrane on gap junction-mediated intercellular communication and on membrane excitability were examined in cultured neonatal rat cardiac myocytes using whole-cell voltage-clamp and current-clamp techniques. Excitability was maintained at doses of both anesthetics that reversibly abolished current flow through junctional membranes. The degree of reduction of junctional conductance was a steep function of the dose of anesthetic; complete block occurred at lower aqueous concentrations of halothane than ethrane. The time course for loss of communication was rapid; 90% reduction of initial junctional conductance occurred in less than 15 seconds after exposure to 2 mM halothane or 4 mM ethrane. Recovery of junctional conductance and junctional permeability to intracellularly injected Lucifer yellow was rapid and complete on washout of the anesthetics. As junctional conductance was reduced by halothane or ethrane exposure, unitary conductance of the gap junctional channels remained constant at about 50 pS. Uncoupling by these anesthetics is thus attributable to a decrease in the number of conducting channels rather than to reduction of the channel's unitary conductance. The data are discussed with regard to the possible role of this intercellular communication pathway in the arrhythmias and alterations of conduction velocity and contractility produced by volatile anesthetics. PMID- 2766494 TI - Reduction of lipid peroxidation in reperfused isolated rabbit hearts by diltiazem. AB - The calcium-channel inhibiting agent, diltiazem, has been shown to enhance salvage of reperfused myocardium independent of effects on coronary blood flow or myocardial work. Because lipid peroxidation may be a mediator of reperfusion injury and modifiable by calcium-sensitive pathways, we evaluated the effects of diltiazem on the formation of malondialdehyde (MDA), a product of lipid peroxidation, in isolated rabbit hearts perfused with buffer under control conditions or after 60 minutes of ischemia with or without 3 minutes of reperfusion. Diltiazem (5 x 10(-7)M) reduced tissue MDA content in seven reperfused hearts compared with levels measured in 14 hearts reperfused without drug (1.54 +/- 1.09 [SD] compared with 3.57 +/- 1.88 nmol/g, p less than 0.05). Superoxide dismutase and catalase were ineffective in reducing tissue MDA content in reperfused hearts (n = 8; MDA concentration, 3.88 +/- 2.82 nmol/g) although they were effective in preventing lipid peroxidation in separate studies in which oxygen-centered free radicals were generated directly by an infusion of xanthine oxidase and hypoxanthine. These results suggest that the salutary effects of diltiazem in the setting of reperfusion may be mediated by reduction of lipid peroxidation at a locus not accessible to scavengers of oxygen-centered free radicals or by a mechanism not mediated by free radical pathways. PMID- 2766495 TI - [Scanning electron microscopic observations on adults of Angiostrongylus cantonensis]. AB - Scanning electron microscopic observations were made on adult Angiostrongylus cantonensis, The apex of the head has a round mouth with two rows of 6 sensory papillae each around it. The papillae of the outer row are more rudimentary and inconspicuous. A pair of amphidial pores are visible on the external side of lateral papillae of the inner row. The surface of the body is covered with a circular striated cuticle and short longitudinal ridges lying between two circular cuticles. The two copulatory spicules at the posterior end of male worms are obviously different in morphology. According to their morphological characteristics, we named them "tube-like" copulatory spicule and "grooves-like" copulatory spicule. The former, when enclosed in the latter, appeared as a single one. The copulatory bursa of the males and the structures of the tail part of the female are also described. PMID- 2766496 TI - [Comparative studies on diapause responses between Culex tritaeniorhynchus and Culex pipiens pallens]. AB - By comparing the diapause responses between locally hibernating species, C. pipiens pallens, and C. tritaeniorhynchus the overwintering way of which is yet unknown, we found the relative identities of these 2 species in their ovarian diapause criteria, change of the mid-gut and the behaviour of refusing blood feeding. The increases in body weight and fatty contents in the dispersed tritaeniorhynchus were much less than those in diapause pipiens species. Moreover, their ability to resist low temperature was also found significantly weaker. In Shanghai area, the date of the critical photoperiod for C. tritaeniorhynchus was found around the 25th of September with a daylight exposure length (including twilight) of about 13 hours and 43 minutes, being 20 days earlier than that of the locally hibernating species C. pipiens pallens. The gonotrophic dissociation during critical photoperiod occurred more frequently in tritaeniorhynchus than in pipiens mosquitoes. In contrast to pipiens species, it is extremely difficult to obtain diapause tritaeniorhynchus in nature post critical photoperiod. The possibility of a seasonal migratory behaviour of C. tritaeniorhynchus was discussed. PMID- 2766497 TI - [Mebendazole-medicated-salt in the control of hookworm infection]. AB - From 1984-1987, mass application of mebendazole-medicated salt was studied for the control of hookworm infection in 5 pilot areas (Wuming, Shanlin, Bobai, Guilin and Rongxian Counties) in Guangxi Zhuang Autonomous Region. The dosages of mebendazole (mixed with salt) administered were 15mg, 25mg, 30mg, 40mg, 50mg, 30mg, 70mg, 80mg, 100mg or 200mg per person per day for 15, 20 or 30 days. The results showed that 40mg/day for 15-20 days could result in stool egg negative conversion rates of 92.3 to 94.4%, while 50mg/day for 30 days resulted in 96.9 to 100%. Concurrently, the hookworm infection rate in pilot areas dropped by 57.9 71.7% in a short time; whereas the stool egg negative conversion rate of Ascaris lumbricoides was as high as 99.1% to 100% at the same dosage, when the dosage of 100mg/day for 30 days was given, the egg negative reversion rate for Trichuris trichiura was 97.6%. Promising result was also recorded concerning the tolerance of the medicated salt, as the side effects in the inhabitants were mild. In conclusion, the authors considered that the application of mebendazole-medicated salt was a simple and effective measure in controlling hookworm infection, especially in the light of solving the problem of incomplete mass detection and selected mass treatment. Furthermore, it is much more economic from the cost effect point of view. PMID- 2766498 TI - [The discovery of Melanoides tuberculata as the first intermediate host of Echinochasmus japonicus]. AB - This paper reports on the discovery of cercariae which are similar to those of Echinotomatidae in Melanoides tuberculata in Yunxiao and Zhaoan Counties of Fujian. Encysted metacercariae were found in the gills of fresh-water fish after experimental infection with the cercariae for 3 to 4 hours. Adult worms identified as Echinochasmus japonicus were obtained from Mesocricetus auratus and dove after infection with the metacercariae. Melanoides tuberculata was recorded for the first time as the first intermediate host of E. japonicus and its natural infection rate was found to be 1.1%. The morphological characteristics of the cercaria are described. PMID- 2766499 TI - [Scanning electron microscopic observations of ookinete formation of Plasmodium yoelii yoelii in vitro]. AB - The ookinete formation and mature ookinete of Plasmodium yoelii yoelii were described. During the development from zygote to ookinete, at first a finger shaped or a stick-shaped projection protruded from one side of zygote. The anterior end of the projection assumed a truncated cone shape. Following enlargement of the projection, the body of zygote gradually wrinkled and shrank and became smaller. An annular structure developed between the newly formed ookinete and the remaining body of zygote, which ultimately separated from the ookinete. The ookinete was banana-shaped. The surface of mature ookinetes was smooth. On the tip there was an apical complex showing truncated cone shape. Behind the apical end there were a few pellicular folds. Through the course of development of the ookinete the parasite constantly showed obvious movement. As the parasites protruding forward, longitudinal and spiral wrinkles appeared on their body surface. PMID- 2766500 TI - [Cryopreservation of microfilariae and third-stage larvae of Brugia malayi and subsequent development in the hosts]. AB - Methods are studied for the cryopreservation of microfilariae (mf) and third stage larvae (L3) of periodic Brugia malayi. RPMI-1640 tissue culture medium containing 6% dimethyl sulfoxide (DMSO) and 15% newborn calf serum were used as cryoprotectant. The larvae survived best when specimens were frozen at the rate of -0.5 degrees C to -1.0 degrees C per minute using the vapor phase of liquid nitrogen, when the temperature reached -70 degrees C to -90 degrees C the specimens were placed directly into the liquid nitrogen (-196 degrees C). After the thawing of the mf which had been stored for 6,212 and 375 days in cryogen, 96.2% of the mf were shown to be viable and developed in Aedes togoi. It was also shown that the survival rate of L3 cryopreserved for 28-321 days was also 96.2% and that, when 107 L3 frozen for 321 days were inoculated after being thawed into one jird, one live female adult was recovered at autopsy 71 days after inoculation, its morphology being the same as the unfrozen specimens. There was no correlation between the time of cryopreservation and the survival rate of the larvae. PMID- 2766501 TI - [Observations on the growth dynamics of 4 strains of Toxoplasma gondii in HeLa cells]. AB - Growth dynamics of PP, CN and ZS2 strains of Toxoplasma gondii isolated in China was studied and compared with that of RH strain. HeLa cells were used in this work. It took only 2 min for the organisms of RH strain to infect the HeLa cells when contacting with the cells. By contrast, the CN strain requires 5 min, the ZS2 and PP strains, 10 min. Toxoplasma began its multiplication after a lag time of about 6 h in the HeLa cells. The mean generation time of the 4 strains was assessed by calculating the number of the parasites in the parasitophorous vacuoles at different incubation times and by the linear regression equation. The results showed that the mean generation time was 5.2 h for RH strain, 5.98 h for CN strain, 6.78 h for ZS2 strain and 7.69 h for PP strain. Among the 3 strains of Toxoplasma gondii isolated in China. CN strain was similar to RH strain in their infectivity and proliferation. PMID- 2766502 TI - Prognostic importance of dipyridamole-echocardiography test in coronary artery disease. AB - We studied the value of dipyridamole-echocardiography test in comparison with clinical, resting electrocardiogram and echocardiogram variables in predicting cardiac events occurring in 539 consecutive patients referred for dipyridamole echocardiography test from 1984 to 1987. There were 118 cardiac events: 11 cardiac deaths, 12 nonfatal myocardial infarctions, and 95 coronary revascularization (bypass or angioplasty) procedures. A Cox survival analysis identified echocardiographic positivity after dipyridamole administration as the best predictor of cardiac events (relative risk ratio, 2.7). The next most powerful predictor was angina after dipyridamole administration (relative risk ratio, 1.9). Cardiac events occurred in 14 (6%) of 253 patients with normal high dose dipyridamole echocardiographic test results, in 21 (26%) of 82 patients with high-dose dipyridamole echocardiographic positivity (0.84 mg/kg during 10 minutes), and in 83 (41%) of 204 patients with low-dose dipyridamole echocardiographic positivity (0.56 mg/kg during 4 minutes) (p less than 0.0001). In a subset of 341 patients, exercise electrocardiography stress test and coronary angiography were also available. A Cox survival analysis again identified echocardiographic positivity after dipyridamole as the best predictor of cardiac events (relative risk ratio, 1.9) followed by a pathologic coronary arteriography (relative risk ratio, 1.2). We conclude that the presence and timing of a transient dyssynergy during dipyridamole stress are useful predictors of subsequent cardiac events. PMID- 2766503 TI - Flow-dependent coronary artery dilatation in humans. AB - To determine the role of endothelium-mediated flow-dependent coronary dilatation in humans, we studied the coronary dilatation exerted by maximal pharmacologic increase of coronary flow in 14 patients with normal coronary arteries. Biplane views of the circumflex (Cx) and left anterior descending (LAD) coronary arteries were obtained before and 80 seconds after inducing a maximal increase in flow selectively in the Cx by injecting 7 mg papaverine through a 2F infusion catheter in the midportion of the Cx (n = 10). The diameter of the proximal Cx segment (exposed to increased flow but not to papaverine directly) increased with papaverine by 11.1 +/- 4% (range, 5.2-16.4%, p less than 0.001 vs. control), whereas the LAD diameter did not change. LAD and Cx diameters increased by 18.3% and 21.2% after nitroglycerin given into the left main artery, which showed the preserved capability of the LAD to dilate. In four patients with normal coronary arteries and six patients with coronary artery disease (CAD, non-flow-limiting stenosis), a similar protocol was applied with the LAD for the assessment of flow dependent dilatation. Simultaneously, intracoronary blood flow velocity was measured by an intracoronary Doppler catheter. Papaverine-induced coronary flow reserve (peak/resting velocity ratio) in the LAD was 4 +/- 0.7 (range, 3.5-5) in normal arteries and was 3.5 +/- 0.6 (range, 2.7-4.4) in CAD.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2766504 TI - Ultrasonic tissue characterization with integrated backscatter. Acute myocardial ischemia, reperfusion, and stunned myocardium in patients. AB - We have previously shown in studies of experimental animals that myocardium exhibits a cardiac cycle-dependent variation of integrated backscatter that reflects regional myocardial contractile performance and that is blunted promptly after arterial occlusion and recovers after reperfusion. To define the clinical utility of ultrasonic tissue characterization with integrated backscatter for detection of acute myocardial infarction and reperfusion, 21 patients (14 men and seven women) were studied in the cardiac care unit within the first 24 hours (mean time, 11.3 hours; range, 3.5-23.8 hours) after the onset of symptoms indicative of acute myocardial infarction with conventional two-dimensional and M mode echocardiography and with analysis of integrated backscatter. The magnitude of cyclic variation of integrated backscatter was measured from several sites within acute infarct regions and normal regions remote from the infarct zone for each patient. The average magnitude of cyclic variation among all patients (n = 21) was 4.8 +/- 0.5 dB in normal regions compared with 0.8 +/- 0.3 dB in infarct regions (p less than 0.05) within the first 24 hours after the onset of symptoms. Among the patients who had two studies, 15 (mean, 7.1 days; range, 2-31 days for second study) underwent coronary arteriography to define vessel patency. In patients with vessels with documented patency (n = 10), the magnitude of cyclic variation in infarct regions increased over time from 1.3 +/- 0.6 to 2.5 +/- 0.5 dB from the initial to final study (p less than 0.05). Patients with occluded infarct-related arteries (n = 5) exhibited no significant recovery of cyclic variation (0.3 +/- 0.3-0.6 +/- 0.3 dB). A blinded analysis of standard two dimensional echocardiographic images revealed no significant recovery of wall thickening in either group over the same time intervals. Ultrasonic tissue characterization promptly detects acute myocardial infarction and may delineate potential beneficial effects of coronary artery reperfusion manifest by restoration of cyclic variation of integrated backscatter in the presence of severe wall motion abnormalities. PMID- 2766505 TI - Continuous wave Doppler echocardiographic measurement of prosthetic valve gradients. A simultaneous Doppler-catheter correlative study. AB - Studies correlating prosthetic valve gradients determined by continuous wave Doppler echocardiography with gradients obtained by cardiac catheterization have, to date, been limited to patients with mitral and tricuspid prostheses or have compared nonsimultaneous measurements. Simultaneous Doppler and catheter pressure gradients in 36 patients (mean age, 63 +/- 13 years) with 42 prosthetic valves (20 aortic, 20 mitral, one tricuspid, and one pulmonary) were studied. Catheter gradients were obtained using a dual-catheter technique. The simultaneous pressure tracings and Doppler flow velocity profiles were digitized at 10-msec intervals to derive the corresponding maximal and mean gradients. The correlation between the maximal Doppler gradient and the simultaneously measured maximal catheter gradient was 0.94 (SEE = 6), and that between the Doppler gradient and the simultaneously measured mean catheter gradient was 0.96 (SEE = 3). There were no significant differences in correlation between gradients for the 32 mechanical valves (maximal gradients: r = 0.95, SEE = 6; mean gradients: r = 0.96, SEE = 3) and the 10 bioprosthetic valves (maximal gradients: r = 0.89, SEE = 6; mean gradients: r = 0.93, SEE = 3). In patients with mitral prostheses, Doppler gradients correlated well with the corresponding catheter gradients obtained with direct measurement of left atrial pressure (maximal gradients: r = 0.96, SEE = 2; mean gradients: r = 0.97, SEE = 1.2). A close correlation between corresponding Doppler and catheter gradients also was found in patients with aortic prostheses (maximal gradients: r = 0.94, SEE = 6; mean gradients: r = 0.94, SEE = 3). Thus, continuous wave Doppler echocardiography can accurately predict the pressure gradient across prosthetic valves. PMID- 2766506 TI - Influence of mitral valve morphology on double-balloon catheter balloon valvuloplasty in patients with mitral stenosis. Analysis of factors predicting immediate and 3-month results. AB - To determine if mitral valve morphology influences the results of double-balloon catheter balloon valvuloplasty (CBV) for mitral stenosis, two-dimensional echocardiography was performed in 33 patients before CBV. The two-dimensional echocardiographic features of leaflet motion, leaflet thickness, subvalvular disease, and commissural calcium and 14 pre-CBV clinical and hemodynamic variables were then correlated to the immediately post-CBV mitral valve area (MVA). At 3 months after CBV, the two-dimensional echocardiographic features of patients with a 25% or greater decrease in MVA were analyzed to determine whether mitral valve morphology had influenced early results. Leaflet motion had a significant relation with the immediately post-CBV MVA (r = 0.67, y = 4.5x + 0.29, and SEE = 0.45). Leaflet thickness had a weak and negative relation (r = 0.48, y = -0.17x + 2.6, and SEE = 0.53) with the immediately post-CBV MVA. Subvalvular disease and commissural calcium had no significant relation to the immediately post-CBV MVA. When leaflet motion and leaflet thickness were considered as grades of mild, moderate, and severe and assigned a score of 0-2, patients with more severe disease (total score, 3 or 4) had a significant lower MVA immediately after CBV (1.4 +/- 0.4 cm2) than patients with moderate disease (score, 1-2; MVA, 2.0 +/- 0.5 cm2; p less than 0.05) or mild disease (score, 0; MVA, 2.6 +/- 0.6 cm2; p less than 0.05). In 96% of patients with a total score of 0-2, the immediately post-CBV MVA was more than 1.4 cm2, whereas only 29% of patients with a total score of 3-4 had an immediately post-CBV MVA of more than 1.4 cm2. Analysis of all two-dimensional echocardiographic features showed that leaflet motion score had the strongest influence on the post-CBV MVA (p less than 0.001). When all two-dimensional echocardiographic, clinical, and hemodynamic variables were included, leaflet motion, effective balloon dilating area, and cardiac output were the strongest predictors of the immediate post-CB MVA.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2766507 TI - Recovery-phase patterns of ST segment depression in the heart rate domain. Identification of coronary artery disease by the rate-recovery loop. AB - Although the time course of ST segment depression after exercise has been related to the presence and severity of coronary artery disease, recovery-phase patterns of ST segment depression with reference to changing heart rate have not been quantified. We have found distinct recovery loop patterns of ST segment depression that distinguish subjects without coronary disease from patients with coronary artery disease when ST segment depression is examined in the heart rate domain. Continuous plots of ST segment depression and heart rate were constructed throughout treadmill exercise and recovery in 100 clinically normal subjects, in 124 patients with coronary artery disease proven by catheterization, and in 17 patients with no significant coronary disease at catheterization. Among clinically normal subjects, 95% (95 of 100) had normal (clockwise) rate-recovery loops, and 5% (five of 100) had abnormal (counterclockwise) rate-recovery loops. In these normal subjects, the resulting 95% specificity of a normal rate-recovery loop was similar to the 93% (93 of 100) specificity of standard end-exercise ST segment depression criteria. Among patients with coronary disease proven by angiography, 93% (115 of 124) had abnormal (counterclockwise) rate-recovery loops, and 7% (nine of 124) had normal rate-recovery loops. In contrast was the significantly lower 74% (92 of 124) sensitivity of standard ST segment criteria (p less than 0.001 vs. the rate-recovery loop). Specificity of a normal rate recovery loop (71%, 12 of 17) and standard ST segment depression criteria (71%, 12 of 17) were similar in the patients with normal coronary arteries at angiography.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2766508 TI - Diagnostic value of QRST isointegral maps in detecting myocardial infarction complicated by bundle branch block. AB - The clinical usefulness of QRST isointegral maps (IQRST map) for detecting myocardial infarction that was complicated by intraventricular conduction disturbances was evaluated in patients with right bundle branch block (group RBBB, 64 patients) and left bundle branch block (group LBBB, 40 patients) by comparison with the normal mean IQRST map derived from 50 normal subjects. Myocardial infarction complicated the conduction disturbances in 24 of the 64 RBBB and in 18 of the 40 LBBB patients. A correlation coefficient was used for assessing the similarity of each map pattern with the normal mean IQRST map. The difference map was made by subtracting the average normal IQRST map from each abnormal IQRST map, and those differences that were less than 2 SD from the mean were retained as a significant area. The number of leads and their sum of differences were used to represent the size of the difference map. Correlation coefficients were significantly (p less than 0.001) smaller in patients with bundle branch block complicated by myocardial infarction than in patients with conduction disturbances not complicated by myocardial infarction. A significant area emerged in the difference map in all patients with myocardial infarction complicated by conduction disturbances. The emergence of a significant area revealed high diagnostic accuracy for detecting myocardial infarction in group RBBB (89.1%). The size of a significant area in a difference map was significantly larger in cases with complicated myocardial infarction than in cases with uncomplicated myocardial infarction in either group RBBB or group LBBB (p less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2766509 TI - Epidemiology of idiopathic dilated and hypertrophic cardiomyopathy. A population based study in Olmsted County, Minnesota, 1975-1984. AB - Using the records linkage system of the Mayo Clinic and of the Rochester Epidemiology Project, which accesses diagnostic data on the entire population of Olmsted County, Minnesota, we identified 45 new cases of idiopathic dilated cardiomyopathy (DCM) and 19 new cases of hypertrophic cardiomyopathy (HCM) among county residents for the years 1975-1984. Overall age- and sex-adjusted incidence rates were 6.0/100,000 and 2.5/100,000 person-years, respectively. The incidence of DCM doubled from 3.9/100,000 in the first 5 years to 7.9/100,000 person-years in the last 5 years of study. The corresponding change for HCM was from 1.4 to 3.6/100,000 person-years. Age- and sex-adjusted prevalence rates as of January 1, 1985, for DCM and HCM were 36.5/100,000 and 19.7/100,000 population, respectively. The prevalence of DCM in persons less than 55 years old was 17.9/100,000, over a third of whom were New York Heart Association functional Class III or IV at diagnosis. These estimates may be of value in determining the potential use of health care resources, particularly cardiac transplantation. PMID- 2766510 TI - Magnesium content of serum, circulating mononuclear cells, skeletal muscle, and myocardium in congestive heart failure. AB - Deranged magnesium concentrations in serum and cardiovascular structures have been implicated in the pathophysiology of hypertension, ischemic heart disease, arrhythmias, and sudden death. This study was conducted to determine the status and interrelation of serum and tissue concentrations of magnesium in patients with congestive heart failure, a clinical setting purportedly predisposed to the development of depleted levels of this cation. Magnesium concentrations of serum, circulating mononuclear cells, skeletal muscle, and myocardium were measured in 23 patients with heart failure on standard therapy. Two patients were hypomagnesemic (less than 1.6 meq/l). Poor or no correlations were found between serum and tissue magnesium concentrations and among the magnesium concentrations of the three tissues studied. Strong direct correlations were, however, noted between magnesium and potassium concentrations of the tissues examined. The prevalence of hypomagnesemia in this typical ambulatory heart failure population is relatively low (9%) and serum, circulating mononuclear cell, skeletal muscle, and myocardial magnesium concentrations correlate poorly with each other. Serum, circulating mononuclear cell, and skeletal muscle magnesium concentrations are thus of little predictive value in assessing the status of myocardial magnesium in humans with heart failure. PMID- 2766511 TI - Three-dimensional echocardiographic reconstruction of the mitral valve, with implications for the diagnosis of mitral valve prolapse. AB - Mitral valve prolapse has been diagnosed by two-dimensional echocardiographic criteria with surprising frequency in the general population, even when preselected normal subjects are examined. In most of these individuals, however, prolapse appears in the apical four-chamber view and is absent in roughly orthogonal long-axis views. Previous studies of in vitro models with nonplanar rings have shown that systolic mitral annular nonplanarity can potentially produce this discrepancy. However, to prove directly that apparent leaflet displacement in a two-dimensional view does not constitute true displacement above the three-dimensional annulus requires reconstruction of the entire mitral valve, including leaflets and annulus. Such reconstruction would also be necessary to explore the complex geometry of the valve and to derive volumetric measures of superior leaflet displacement. A technique was therefore developed and validated in vitro for three-dimensional reconstruction of the entire mitral valve. In this technique, simultaneous real-time acquisition of images and their spatial locations permits reconstruction of a localized structure by minimizing the effects of patient motion and respiration. By applying this method to 15 normal subjects, a coherent mitral valve surface could be reconstructed from intersecting scans. The results confirm mitral annular nonplanarity in systole, with a maximum deviation of 1.4 +/- 0.3 cm from planarity. They directly show that leaflets can appear to ascend above the mitral annulus in the apical four chamber view, as they did in at least one view in all subjects, without actual leaflet displacement above the entire mitral valve in three dimensions, thereby challenging the diagnosis of prolapse by isolated four-chamber view displacement in otherwise normal individuals. This technique allows us to address a uniquely three-dimensional problem with high resolution and provide new information previously unavailable from the two-dimensional images. This new appreciation should enhance our ability to ask appropriate clinical questions relating mitral valve shape and leaflet displacement to clinical and pathologic consequences. PMID- 2766512 TI - Time-dependent risk of and predictors for cardiac arrest recurrence in survivors of out-of-hospital cardiac arrest with chronic coronary artery disease. AB - One hundred one consecutive patients with chronic coronary artery disease who had survived out-of-hospital cardiac arrest in the absence of acute myocardial infarction underwent electrophysiologic evaluation and were followed prospectively. Ventricular tachyarrhythmias were inducible in 76 patients (75%) in the control state and were suppressed by antiarrhythmic drugs or surgery in 32 of the 76 patients (42%). During a mean follow-up of 27 months, cardiac arrest recurred in 21 patients: in two of the 25 patients in whom ventricular tachyarrhythmias were not inducible in the control state, three of the 32 in whom inducible ventricular tachyarrhythmias were suppressed after treatment, and 16 of the 44 in whom inducible ventricular tachyarrhythmias could not be suppressed after treatment. Actuarial rate of cardiac arrest recurrence was 11.2% during the first 6 months of follow-up ("high-risk early phase") and then decreased to less than 4% in each subsequent 6-month period. Multivariate Cox proportional hazards analysis identified an ejection fraction less than 35% (p = 0.0013) and persistent inducibility of ventricular tachyarrhythmias (p = 0.0025) as independent predictors of cardiac arrest recurrence for the entire follow-up period. Separate analysis of variables within and after the first 6 months showed that an ejection fraction less than 35% was the strongest predictor for early phase recurrence (p = 0.0078) but had only marginally significant predictive value for late phase recurrence (p = 0.0516). Persistent inducibility of ventricular tachyarrhythmias had no significant predictive value for early phase recurrence (p = 0.1382) but was the strongest predictor for late phase recurrence (p = 0.0061). These data suggest that, in patients with chronic coronary artery disease who survive out-of-hospital cardiac arrest, poor ejection fraction and persistent inducibility of ventricular tachyarrhythmias have a different predictive influence on early and late phase recurrence. Time-dependent risk factor analysis may have great clinical relevance in assessing an individual's changing risk over time. PMID- 2766513 TI - Dietary alcohol, calcium, and potassium. Independent and combined effects on blood pressure. AB - To determine whether or not the previously reported association between alcohol intake and high blood pressure is influenced by differential intake of calcium and potassium in drinkers compared with nondrinkers and to assess the magnitude of the independent contributions of alcohol, calcium, and potassium to blood pressure, these associations were evaluated in 7,011 men of Japanese descent. Categorical analyses and multiple linear regression techniques were used to test the hypotheses that alcohol, calcium, and potassium were independent predictors of blood pressure. Alcohol consumption above a threshold of approximately 20 ml/day was found to be positively, strongly, and independently correlated with systolic and diastolic pressures, and this effect was completely independent of the effects of calcium and potassium. Calcium and potassium intake were highly correlated (r = 0.59) and were inversely related to blood pressure, and their combined effect was greater than the effect of either alone. However, in the subgroup of moderate and heavier drinkers, only potassium was inversely related to blood pressure. This finding is compatible with previous reports of malabsorption and increased excretion of calcium at higher levels of alcohol intake, and it indicates that a small portion of the alcohol-induced blood pressure elevation may be mediated through calcium depletion. In the range of dietary intake in this cohort, the effect of alcohol on blood pressure was stronger than was either the separate or combined effects of calcium and potassium. PMID- 2766514 TI - Details of coronary stenosis morphology influence its hemodynamic severity and distal flow reserve. AB - Differences in coronary flow reserve with anatomically similar coronary artery stenoses have been attributed to 1) nonstandard physiologic conditions, 2) inadequacies of measurements of coronary artery stenosis dimension and/or coronary blood flow, and 3) inadequate hyperemic stimulus. Our study tested the hypothesis that details of coronary artery stenosis geometry, which may or may not be apparent on coronary angiograms, also may contribute importantly to such differences. A simple and complex coronary artery stenosis, each of which reduced vessel cross-sectional area by 84%, was introduced in random order into the left anterior descending coronary artery of nine closed-chest, sedated swine. The simple stenosis had a single lumen while the complex stenosis had five small lumena whose combined area equaled that of the single lumen stenosis. Measurements of hemodynamics and regional myocardial blood flow (microspheres) were made at control and after 10 minutes of adenosine infused at 400 micrograms/min and then at 800 micrograms/min distal to each stenosis. Both heart rate and aortic mean pressure were controlled and thus did not change versus initial baseline (129 +/- 4 minutes and 120 +/- 10 mm Hg, mean +/- SD, respectively) during the study. Baseline total flow (ml/sec) distal to the stenosis was similar at each control (1.05 +/- 0.35 vs. 0.92 +/- 0.34, simple versus complex, respectively; p = NS). At maximal adenosine, total flow with the simple stenosis was 3.44 +/- 0.92 versus 2.77 +/- 0.51 for complex (p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2766515 TI - Endothelium-dependent inhibition of ergonovine-induced contraction is impaired in porcine coronary arteries with regenerated endothelium. AB - The inhibitory effects of the endothelium against ergonovine-induced contraction were examined in isolated porcine coronary arteries under normal conditions and after endothelial regeneration. Endothelium-dependent responses were examined in vitro in normal Yorkshire pigs (n = 16) and in pigs that had undergone balloon endothelium removal of the left anterior descending coronary artery (LAD) 4 weeks before the study (n = 10). The presence of a complete endothelial lining was confirmed histologically. In rings from normal arteries contracted with prostaglandin F2 alpha in the presence of indomethacin and ketanserin (a 5-HT2 serotonergic blocker), ergonovine caused endothelium-dependent relaxations. They were attenuated by rauwolscine (an alpha 2-adrenergic blocker), inhibited by methiothepin (a combined 5-HT1- and 5-HT2-serotonergic blocker) or by pertussis toxin (an inhibitor of several G proteins) and abolished by oxyhemoglobin (a selective inactivator of endothelium-derived relaxing factor). In quiescent rings from normal arteries, ergonovine caused contractions that were inhibited by the presence of the endothelium; this endothelium-dependent inhibition was abolished by oxyhemoglobin. The direct contractions were not affected by prazosin (an alpha 1-adrenergic blocker), rauwolscine, 6-hydroxydopamine (an agent causing chemical sympathetectomy), or diphenhydramine (an H1-histaminergic blocker) but were inhibited by ketanserin. In rings with regenerated endothelium contracted with prostaglandin F2 alpha, the endothelium-dependent relaxations to ergonovine were reduced significantly and were not inhibited by pertussis toxin. In quiescent rings with regenerated endothelium, the endothelium-dependent inhibition of ergonovine-induced contraction was less.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2766517 TI - GSH and reperfusion injury. PMID- 2766516 TI - Kinetics of myoglobin release and prediction of myocardial myoglobin depletion after coronary artery reperfusion. AB - To better define the usefulness of blood myoglobin measurements in evaluating the effectiveness of attempted thrombolysis, we studied the kinetics of myoglobin entry into and removal from the circulation after coronary artery reperfusion and the relation between directly measured depletion of myocardial myoglobin after coronary occlusion and reperfusion and the amount of depletion predicted from plasma myoglobin concentration-time curves. Initially, canine myoglobin was administered to 11 dogs by both bolus injection and 40-minute infusion, and the subsequent disappearance patterns of myoglobin from plasma monitored by radioimmunoassay. A monoexponential regression line (corresponding to a one compartment model) and a biexponential regression line (corresponding to a two compartment model) were determined for each set of washout data, the kinetic parameters were calculated, and the goodness of fit of each model was assessed. Results were similar after both methods of myoglobin administration. In five of 11 animals, the one-compartment model described the myoglobin kinetics better; in the other six animals, the two-compartment model was statistically superior, but values for the volume of distribution and elimination rate constant differed by only 10% from the one-compartment estimates. After bolus administration of myoglobin and with a one-compartment model, the volume of distribution of myoglobin was determined to be 1,601 +/- 77 (SEM) ml, representing 6.8 +/- 0.2% of total body weight; the elimination rate constant averaged 0.132 +/- 0.006/min and corresponded to a mean half-time of disappearance of 5.5 +/- 0.2 minutes.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2766518 TI - Cardiovascular surgery 1988, Part 1. Council on Cardiovascular Surgery, American Heart Association, scientific sessions. Washington, November 14-17, 1988. PMID- 2766519 TI - Influence of mitral valve prosthesis or rigid mitral ring on left ventricular pump function. A study on exposed and isolated blood-perfused porcine hearts. AB - We have studied the effects on cardiac function of a Bjork-Shiley mitral prosthesis or a rigid mitral ring implanted in pigs for as long as 6 weeks. We studied these effects first in the exposed heart and subsequently in the isolated heart. The coronary arteries were cannulated and perfused with fresh whole blood. The left ventricle was filled with an electrolyte solution and was allowed to pump against an artificial load. Studies were completed in 37 of 45 animals (19 controls, 12 with mitral prostheses and six with mitral rings). In the open thorax situation, surgically treated hearts differed little from controls, apart from a higher pressure drop over the mitral ostium. Compared with controls, isolated hearts with a prosthesis showed a 28% lower peak isovolumic pressure and a 25% lower unloaded maximal stroke volume; hearts with a mitral ring showed 14% and 25% lower values, respectively. Prosthetic valve or ring implantation causes obstruction of the mitral ostium, impedes pressure development, and restricts movement of the basal ventricular wall. Resection of the native valve doubles the loss of contractile function. PMID- 2766521 TI - Reactivity of human isolated internal mammary artery to constrictor and dilator agents. Implications for treatment of internal mammary artery spasm. AB - Perioperative spasm of the internal mammary artery (IMA) may occur after coronary artery bypass surgery. To establish the most appropriate dilator agent, we tested the reactivity of ring segments of human IMA in organ baths to various constrictor and dilator agents. We found that the thromboxane mimetic U46619 was the most potent IMA constrictor agent, followed by norepinephrine, serotonin, phenylephrine, and potassium chloride (K+). In K+- or U46619-precontracted IMA, glyceryl trinitrate and papaverine caused full relaxation. In K+-precontracted arteries, nifedipine, verapamil, and diltiazem caused full relaxation, but nifedipine was 15-fold more potent than the other calcium antagonists. In contrast, pretreatment of vessels with glyceryl trinitrate failed to alter subsequent contraction to U46619 or K+ while nifedipine pretreatment abolished subsequent contraction to K+ and reduced sensitivity of the IMA to U46619. We conclude that perioperative IMA spasm could be treated with the rapid-onset, nonspecific, vasodilator glyceryl trinitrate, but for prophylaxis of IMA spasm, calcium antagonists or specific receptor antagonists should be tested in the clinical setting. PMID- 2766520 TI - Mechanisms responsible for inhibition of vein-graft arteriosclerosis by fish oil. AB - Favorable changes in lipoproteins, inhibition of platelet aggregation, reduction of serum thromboxane (TX), altered plasma-membrane fluidity, and reduced production of growth factors (mitogens) have all been implicated as possibly being involved in the inhibition of arteriosclerosis by fish oil (FO), which is rich in omega 3 fatty acids; however, causal relations are mostly lacking. Several putative mechanisms responsible for the salutary effects of FO were investigated in a canine model of accelerated vein-graft arteriosclerosis. Venoarterial autografts (N = 192) were implanted in 48 hypercholesterolemic dogs divided into six groups: group A, control; B, FO (as MaxEPA, 200 mg/kg/day eicosapentaenoic acid); C, aspirin (ASA, 50 mg/kg/day); D, TX synthetase inhibitor (TXSI [CGS-12970], 10 mg/kg/day); E, FO + ASA; and F, FO + TXSI. At sacrifice 3 months later, there was no significant difference in plasma lipoproteins, hepatic low density lipoprotein-receptor concentration, red blood cell fragility, bleeding time, or platelet count compared with controls; the decrease in platelet aggregation (30 +/- 5% [mean +/- SEM]) was similar in all treatment groups. Arterialized vein-graft intimal thickening was significantly inhibited by FO (with or without ASA), while ASA alone was ineffective. Conversely, serum TX was significantly lower only in the ASA and FO + ASA groups. Serum mitogenic activity was higher at 3 months in the control group versus all treatment groups. Compared with baseline values, serum mitogenic activity rose significantly over time in the control and the TXSI groups, and an increase or rising trend was present in all other treatment groups except for the FO-treated animals. Thus, the salutary biologic effect of FO in this hypercholesterolemic model of arterialized vein grafts may have been more related to in vivo inhibition of platelet-mitogen growth factor release than to changes in lipoproteins, low density lipoprotein receptors, platelet function, or eicosanoid metabolism. These observations underscore the need for further studies to clarify the interactions between FO (omega 3 fatty acids) and paracrine cellular mitogenic factors in the context of atherosclerosis prevention. PMID- 2766522 TI - Rest and exercise evaluation of St. Jude Medical and Medtronic Hall prostheses. Influence of primary lesion, valvular type, valvular size, and left ventricular function. AB - To compare St. Jude Medical and Medtronic Hall mechanical prosthetic heart valves, we prospectively randomized 90 consecutive patients requiring mechanical valve replacement and studied their rest and exercise hemodynamics by Doppler echocardiography. Fifty-six aortic and 42 mitral valves were implanted. All patients were examined preoperatively and postoperatively, and follow-up studies were obtained at rest and immediately after upright, treadmill exercise at 6 months (n = 68). Clinical parameters (mortality, morbidity, and congestive heart failure classification), as well as rest and exercise hemodynamics (valvular area, gradients, and left ventricular ejection fraction), were examined, and their relation to exercise duration was defined. Mortality (perioperative, 8.8% and late, 2.4%) was similar between patients in the two valve groups (five in each group). There was one late thromboembolic episode with each valve. Improvement in New York Heart Association congestive heart failure class was seen in 85% of patients at 6 months. There were no significant differences in calculated aortic valve areas (2.2 vs. 2.0 cm2), resting (24 vs. 21 mm Hg) and exercise (41 vs. 35 mm Hg) peak aortic gradients, and exercise duration between patients with the St. Jude Medical and Medtronic Hall aortic prostheses. In patients with aortic prostheses, valvular size was correlated with exercise duration (r = 0.41, p less than 0.05). In patients with mitral prostheses, we observed no significant differences between St. Jude Medical and Medtronic Hall prostheses in calculated mitral valve areas (3.4 cm2 vs. 3.4 cm2) and rest (2.5 vs. 3.0 mm Hg) and exercise (5.1 vs. 7.0 mm Hg) mean gradients.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2766523 TI - Late functional deterioration after atrial correction for transposition of the great arteries. AB - Late anatomic and functional results were evaluated in 220 consecutive survivors who underwent surgery in 1964-1984 for atrial correction of transposition of the great arteries (TGA). Actuarial survival was 87% at 10 years and 83% at 20 years and was higher in patients with simple than in those with complex TGA (92% vs. 84% at 10 years). Although 83% of simple TGA and 78% of complex TGA survivors belong to the oligosymptomatic or asymptomatic group, failure of the systemic ventricle occurred in 17 (7.7%) patients. This failure was more common in patients with complex than in those with simple TGA (12.1% vs. 4.1%, p less than 0.05); actuarial incidence of such failure was 3% at 5 years and 11% at 15 years, and it caused 10 of 25 (40%) of late deaths. Late dysrhythmias necessitating pacemaker implantation had an incidence of 9.8% at 10 years. Reoperations were performed in 20 (9.1%) patients, with 12 of 23 (52%) reoperations occurring in the first 2 years after correction. Stenosis of caval inflow (eight patients), or residual atrial or ventricular septal defects (eight patients) were the most common causes of reoperation. Systemic atrioventricular valve incompetence necessitating surgery occurred in only three patients. Atrial correction gives good late results, but late functional deterioration occurs in some patients. PMID- 2766524 TI - Determinants of survival in endomyocardial fibrosis. AB - This study describes the clinical course of 108 patients with endomyocardial fibrosis. There were 76 females and 32 males, with a mean age of 35 years. All patients underwent cardiac catheterization. The angiographic data show that 64 (59%) patients had biventricular involvement. From a clinical point of view, 91 (84%) were in New York Heart Association functional classes III and IV. According to the right and left ventricular intensity of fibrosis, the patients were classified as mild (40 [37%]), moderate (36 [33%]), or severe (32 [30%]) for the right ventricle and mild (19 [18%]), moderate (61 [56%]), or severe (28 [26%]) for the left ventricle. Tricuspid regurgitation was observed in 63 (58%) patients and mitral regurgitation in 65 (60%) patients. Fifty patients in functional classes III and IV underwent surgical treatment. Survival curves constructed according to functional classes showed better prognosis for those in classes I and II (p = 0.0452). Survival curves for patients in classes III and IV for clinical and surgical treatment showed a trend toward better results for the surgical group. Analysis of factors that may have influenced the course of endomyocardial fibrosis showed that biventricular involvement (moderate or severe), right ventricular fibrosis, and presence of tricuspid and mitral regurgitation were associated with greater mortality. PMID- 2766525 TI - Growth of fresh-frozen pulmonary allograft conduit in growing lambs. AB - To investigate the fate of cryopreserved pulmonary conduit allografts, an experimental model was used in lambs. The lambs underwent resection of the pulmonary trunk and valve to the level of the bifurcation of the pulmonary arteries and then were replaced by cryopreserved (CryoLife, Incorporated, Laboratories) pulmonary conduit allografts obtained from lambs of similar size. Lambs were operated on at 4 weeks of age and followed up with cardiac catheterization and cineangiography every 3 months for a period of 18 months. Lambs were electively sacrificed in the following order: two at 1 month, two at 3 months, one at 6 months, two at 12 months, and five at 18 months. To assess the structure of the conduit tissue, sections for light microscopy were obtained from the proximal, midportion, and distal ends of the conduit. While the lambs grew from a weight of 11.7 kg at the time of implant to more than 70 kg at 18 months, the diameter of the pulmonary conduit distended from 16 mm at the time of implant to 17.7, 19.1, 24.9, 34.3, and 33.7 mm at 1, 3, 6, 12, and 18 months, respectively. The length of the conduit also extended from an original inner length of 25 mm and an original outer length of 32 mm to the following dimensions: inner lengths of 27.9, 32.7, 38.8, 43.6, and 45.3 mm, respectively, at 1, 3, 6, 12, and 18 months.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2766526 TI - Results of operation for hypertrophic obstructive cardiomyopathy in children and adults less than 40 years of age. AB - Forty-seven consecutive patients aged 1-38 years underwent operation for hypertrophic obstructive cardiomyopathy (HOCM) between 1972 and 1986. Isolated myectomy-myotomy was performed in 43 patients, three patients underwent myectomy and concomitant aortic valve repair, and one patient underwent concomitant mitral valve replacement. The peak systolic pressure gradient from the left ventricle to the aorta decreased from 70 +/- 33 mm Hg (mean +/- SEM) preoperatively to 10 +/- 15 mm Hg immediately after repair (p less than 0.001). Moderate or severe mitral insufficiency was identified in 16 patients preoperatively and was corrected by myectomy alone in 15. There was no operative mortality; two late deaths occurred during follow-up (median, 5 years; maximum, 16 years) for estimated 5- and 10 year survivals of 97 +/- 2% and 88 +/- 10%, respectively. Reoperation was required for aortic valve replacement (n = 2), remyectomy (n = 2), and permanent pacemaker implantation (n = 3). Preoperative symptoms were relieved in 24 of 29 (83%) patients with dyspnea, in 18 of 19 (95%) with angina, and in six of 10 (60%) with syncope. These results support myectomy-myotomy for symptomatic children and young adults with HOCM. Also, it appears that late survival after myectomy-myotomy in these young patients may be improved over that observed in historical controls treated with medications alone; operation should be considered for asymptomatic children and adults less than 40 years of age with large (greater than 80 mm Hg) left ventricular outflow gradients. PMID- 2766527 TI - Echocardiography and color-flow mapping evaluation of a new reconstructive surgical technique for Ebstein's anomaly. AB - Eight patients with Ebstein's anomaly, corrected by the Carpentier technique between 1984 and 1987, were evaluated by echocardiography and by conventional Doppler and color-flow Doppler mapping. Because this technique aims at restoring not only tricuspid valve function but also right ventricular size and geometry, the following parameters were studied: 1) right ventricular size, by measuring the apex-annulus distance compared with that of a group of 30 normal volunteers; and 2) tricuspid valve motion and function. The apex-annulus distance ranged from 5.8 to 8 cm (mean, 6.4 cm) in the Ebstein group and 3.8 to 5.1 cm (mean, 4.3 cm) in the control group. There was no tricuspid stenosis. Right ventricular filling was normal as documented by color-flow mapping. Tricuspid regurgitation was trivial in three patients, mild in four, and severe in only one, in whom a significantly restricted motion of the leaflets was demonstrated. PMID- 2766528 TI - Rapid, two-stage arterial switch for transposition of the great arteries and intact ventricular septum beyond the neonatal period. AB - Optimal management of dextrotransposition of the great arteries with intact ventricular septum is currently an arterial switch procedure performed in the first 2 weeks of life. However, a subgroup of patients presents for surgery beyond this time for reasons of sickness, size, or late referral. Experience with 11 such patients (mean age at first-stage procedure, 4.5 months) has revealed that the left ventricle can be prepared by a surprisingly short interval period (median, 9 days) between a first-stage preparatory operation (pulmonary artery band with or without a shunt) and a subsequent second-stage arterial switch procedure. Serial two-dimensional echocardiography showed that left ventricular mass increased by a mean of 85% during this short interval. Mean left ventricular right ventricular-pressure ratio as measured by cardiac catheterization increased from 0.5 +/- 0.08 a median of 7 days before the first stage to 1.04 +/- 0.29 a median of 7 days after the first stage. One patient underwent a Senning procedure because of an intramural left coronary artery. The other 10 patients underwent an arterial switch, with no early deaths. Median hospitalization after the arterial switch was 8 days. There has been one late death at 5 months. No patient has been detected to have abnormal ventricular function, although trivial to mild aortic regurgitation has been commonly observed with color flow mapping. These results have encouraged us to offer a two-stage arterial switch procedure to appropriate infants with an interval period of approximately 1 week. Both stages can be performed at one hospitalization, with important psychosocial, logistic, and financial advantages. PMID- 2766529 TI - Effects of cardiopulmonary bypass on cerebral blood flow in neonates, infants, and children. AB - Cardiopulmonary bypass (CPB) management in neonates, infants, and children requires extensive alterations in temperature, pump flow rate, and perfusion pressure, with occasional periods of circulatory arrest. The effect of these alterations on cerebral blood flow (CBF) are unknown. This study was designed to determine the relation of temperature and mean arterial pressure to CBF during hypothermic CPB (18 degrees-32 degrees C), with and without periods of total circulatory arrest. CBF was measured before, during, and after hypothermic CPB with xenon-clearance techniques in 67 pediatric patients, aged 1 day-16 years. Patients were grouped based on different CPB techniques: group A, repair during moderate-hypothermic bypass at 25 degrees-32 degrees C; group B, repair during deep-hypothermic bypass at 18 degrees-22 degrees C; and group C, repair with total circulatory arrest at 18 degrees C. There was a significant correlation of CBF with temperature during CPB. CBF significantly decreased under hypothermic conditions in all groups compared with prebypass levels under normothermia. In groups A and B, CBF returned to baseline levels in the rewarming phase of CPB and exceeded baseline levels after bypass. In group C, no significant increase in CBF was observed during rewarming after total circulatory arrest (32 +/- 12 minutes) or after weaning from CPB. During moderate-hypothermic CPB (25 degrees-32 degrees C), there was no association between CBF and mean arterial pressure. However, during deep-hypothermic CPB (18 degrees-22 degrees C), there was an association between CBF and mean arterial pressure.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2766530 TI - Pulmonary artery index. A nonpredictor of operative survival in patients undergoing modified Fontan repair. AB - The importance of pulmonary artery size and the value of a standardized pulmonary artery index (PAI) in predicting outcome after Fontan's repair have previously been reported and questioned. We retrospectively reviewed 29 patients undergoing modified Fontan repair at The Children's Hospital of Philadelphia to examine the relation between preoperative PAI (determined echocardiographically) and operative mortality. Twenty-four of these 29 patients underwent pulmonary artery augmentation at the time of Fontan repair. PAIs ranged from 48 to 541 mm2/m2. Operative mortality was 21%. PAI ranged from 68 to 233 mm2/m2 in nonsurvivors and from 48 to 541 mm2/m2 in survivors. There was no statistically significant difference in PAI between survivors and nonsurvivors; the lowest PAI associated with survival (48 mm2/m2) was one fourth of the lowest PAI value previously reported. There was a trend, not statistically significant, toward increased survival in those with larger PAIs. We conclude that patients should not be excluded from consideration for Fontan's repair solely on the basis of pulmonary artery size. PMID- 2766531 TI - Impact of cardiovascular operation on survival in the Marfan patient. AB - This report is concerned with the surgical treatment of cardiovascular manifestations of Marfan syndrome in 151 patients by 280 operations, 70 before referral, 203 by the authors during a 16-year period, and seven by others in the follow-up interval. This therapy resulted in mitral valve replacement in 13, aortic valve replacement in 135, aortic segment replacement in 151 (including total aortic replacement in 10), nearly total aortic replacement in 26, entire thoracic aortic replacement in seven, and replacement of the entire descending and abdominal aorta in 20 patients. The early (30-day) survival was 94%, and the 5- and 10-year Kaplan-Meier survival was 75% and 56%, respectively. Fusiform aneurysms were present in the ascending aorta, aortic arch, or both in 135, the descending aorta in two, the thoracoabdominal aorta in four, and the abdominal aorta in seven. Aortic dissection occurred in 102 (67%) patients, and 34 (22%) patients with ascending aortic operations required reoperation. This study suggests that the results of current techniques warrant a more aggressive approach to these problems to permit better long-term results. PMID- 2766532 TI - Global and regional left ventricular systolic performance in the in situ ejecting canine heart. Importance of the mitral apparatus. AB - The importance of the intact mitral apparatus in left ventricular (LV) systolic performance has been indirectly suggested by clinical studies of chordal preserving mitral valve replacement (MVR) or reconstruction. The importance of the intact mitral apparatus has been clearly demonstrated in isovolumic experimental preparations but has not been demonstrated unequivocally in ejecting hearts. Therefore, this question was assessed independently of load in an in situ, open-chest ejecting canine heart preparation (n = 9). Three orthogonal LV dimensions were measured by sonomicrometry. During MVR with complete chordal preservation, snares were placed around the anterior and posterior papillary muscles. After the hearts were weaned from cardiopulmonary bypass, LV function was assessed by caval occlusion to alter LV preload abruptly. The slopes of the end-systolic--pressure-volume (end-systolic elastance, Ees) and stroke-work--end diastolic volume (preload-recruitable stroke work, PRSW) relations were used to measure global LV systolic function; similarly, the slopes of the end-systolic- pressure-dimension (regional end-systolic elastance, rEes) and stroke-work--end diastolic dimension changes in regional LV systolic performance. All chordae were then divided by pulling the snares. Immediate reassessment revealed deterioration of global LV function: Ees declined by 72% (14.1 +/- 11.2 mm Hg/ml [mean +/- SD] vs. 3.9 +/- 3.5 mm Hg/ml, p less than 0.001), and PRSW declined by 39% (129 +/- 37 vs. 79 +/- 29 mm Hg, p = 0.0001). Regional LV function was also adversely affected but somewhat selectively: rEes decreased significantly in all three LV dimensions (p less than or equal to 0.03), but rPRSW decreased significantly ( 21%) only in the anteroposterior minor LV axis (89 +/- 19 vs. 70 +/- 15 mm Hg, p = 0.005) and in the septal-lateral axis (-19%, p = NS). These data demonstrate the importance of the intact mitral apparatus on LV systolic performance in ejecting hearts, particularly in the LV regions subtended by the papillary muscles. PMID- 2766533 TI - Surgery for aortic arch aneurysm with selective cerebral perfusion and hypothermic cardiopulmonary bypass. AB - Deep-hypothermic cardiopulmonary bypass with selective cerebral perfusion (SCP) was used in 34 consecutive patients with aneurysms involving the aortic arch or the adjacent part of the aorta. The ages ranged from 25 to 79 years (mean, 56 years). Atherosclerotic aneurysms were present in 14 patients, dissecting aortic aneurysms in 16, and other lesion types in four. Replacement of the ascending aorta was performed in 10 patients, replacement of the ascending aorta and arch in 12, replacement of the distal arch in two, and other procedures in 10. Perfusion techniques consisted of femoral artery perfusion and SCP to the brachiocephalic trunk and the left common carotid artery. The blood temperature was maintained at 16 degrees-20 degrees C. SCP time ranged from 25 to 214 minutes (mean, 123 minutes). Operative death occurred in three (9%) patients. Neurological sequelae occurred in one patient (cerebral infarction), but significant respiratory and hemorrhagic problems were not encountered. For the SCP protocols, we advise that perfusion pressures at bilateral superficial temporal arteries be kept at approximately 50 mm Hg and that venous oxygen saturation of the superior vena caval line or internal jugular vein be kept at above 90%. With appropriate monitoring, this method can be performed in aortic arch or related surgeries with low morbidity results. PMID- 2766534 TI - Surgical management of acute aortic dissection complicated by stroke. AB - Although patients with acute type A aortic dissection are best managed by emergency surgical intervention, preoperative stroke is known to be an independent predictor of late mortality and is considered by some to be a contraindication to operation because of the risk of precipitating hemorrhagic cerebral infarction and poor long-term outcome. In a series of 272 consecutive, unselected patients with aortic dissection undergoing surgical treatment during a 25-year span (1963-1987), 128 (47 +/- 3% [+/- 70% confidence level (CL)]) had an acute type A dissection. A total of seven patients with acute type A dissection (2.6 +/- 1% of all patients, 5.5 +/- 2% of the acute type A cohort) developed a new stroke preoperatively. Thirteen (4.8 +/- 1%) patients had a diminished or absent carotid pulse, only four (31 +/- 13%) of whom sustained a stroke. One patient died in the immediate postoperative period due to severe brain injury, yielding an operative mortality rate of 14 +/- 14%. Two patients had persistent neurological deficits and died within 4 months of operation; the actuarial survival estimate at 1 year was 57 +/- 19% (mean +/- SEM). One patient recovered function of one upper extremity (preoperative left hemiparesis compounded by paraplegia) but died 6 years later. The remaining three long-term survivors (43 +/- 19%) had major resolution of their neurological deficits and are clinically well 2-8 years postoperatively.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2766535 TI - Use of surgical glue without replacement in the treatment of type A aortic dissection. AB - Between 1984 and 1988, 15 patients with type A aortic dissection were treated by direct suturing of the intimal tear and extensive sticking of the dissected aortic layers with surgical (gelatin-resorcin-formaldehyde) glue without prosthetic graft replacement. Aortic incompetence was present in 10 patients, a situation that required valvular replacement in five and valvular repair in five. In 10 patients, the dissection extended to the transverse aortic arch, requiring profound hypothermia and circulatory arrest. All patients survived the operation. Follow-up ranged from 6 to 44 months. All patients were monitored by Doppler echocardiographic studies. In addition, 10 underwent angiography; six, a computed tomographic scan; and five, magnetic resonance imaging. In all patients but two, the ascending aorta and transverse arch had a normal appearance. In three patients, a limited dissection persisted that did not require reoperation. Dissection of the descending aorta was present in 10 patients. One patient required a valvular replacement 18 months after surgery, and one underwent heart transplantation for an associated cardiomyopathy 14 months after surgery. These preliminary results indicate that surgical glue can be used safely and efficiently in type A aortic dissection as an alternative to aortic replacement. PMID- 2766536 TI - Surgical treatment of aortic root abscess. AB - A significant number of patients with infective aortic valve endocarditis develop aortic annular abscess. Although antibiotics may occasionally sterilize an aortic root abscess, most patients require surgical intervention. A review of our experience with 21 consecutive patients surgically treated for aortic root abscess disclosed that 13 patients had prosthetic valve and eight had native aortic valve endocarditis. The predominant microorganism was Staphylococcus aureus, particularly in those patients with native aortic valve endocarditis. The abscess was limited to the aortic annulus in 10 patients and was either multiple or had perforated the left ventricular outflow tract in 11 patients. Most patients were desperately ill at the time of operation. Repair was accomplished by aggressive debridement of all apparently infected tissue and reconstruction of the left ventricular outflow tract with autologous pericardium. Although postoperative complications were common, only one patient died in hospital. Operative survivors have been followed up from 3 to 68 months (mean, 29 months). One patient died of complications of repair of a thoracoabdominal aneurysm 34 months after surgery; his prosthetic aortic valve and patch were intact at autopsy. No patient has experienced recurrent infection, pericardial patch aneurysm, or prosthetic valve dehiscence. PMID- 2766537 TI - Ten-year experience with the Medtronic Hall valvular prosthesis. A study of 1,104 patients. AB - The Medtronic Hall valvular prosthesis was introduced in 1977 and was used for the first time in Oslo in June of that year. We report here our 10-year experience with this prosthesis, based on studies of all 1,104 consecutive patients who were operated on from June 1977 to August 1987. There were 816 aortic (AVR), 187 mitral (MVR), and 101 combined mitral and aortic (double, DVR) valve replacements. Cumulative follow-up was 5,061 patient-years, with a mean follow-up of 4.6 years. Early mortality was 3.8% after AVR, 7.5% after MVR, and 10.0% after DVR. The probability of surviving 10 years after AVR was 72%; after MVR, 56%; and after DVR, 60%. Early and late survival reflected the patient's preoperative status and nonvalvular cardiac disease. Thromboembolism occurred at linearized rates of 1.3%, 1.3%, and 1.8%/yr after AVR, MVR, and DVR, respectively. There were five cases of valvular thrombosis, none fatal, resulting in a linearized rate of 0.1%, 0.1%, and 0.2%/yr after AVR, MVR, and DVR, respectively. There were no instances of structural failure. Morbidity from anticoagulant-related hemorrhage was 0.7%/yr, with seven fatal events, all of cerebral origin. The long-term experience with the Medtronic Hall valve indicates that, in addition to its previously demonstrated excellent hemodynamic performance, there are low risks of thromboembolism and thrombosis and no instances of primary structural failure. PMID- 2766538 TI - Octogenarians with aortic stenosis. Outcome after aortic valve replacement. AB - To assess the outcome of aortic valve replacement for aortic stenosis in octogenarians, we retrospectively studied 64 patients, aged 80-89 years, who underwent aortic valve replacement for aortic stenosis from 1974 to 1987. Mean aortic valve gradient was 61 +/- 22 mm Hg, and valve area was 0.5 +/- 0.2 cm2. Concurrent coronary artery bypass grafting was performed in 29 patients, mitral valve replacement in two, and both procedures in two. Serious, comorbid, noncardiac conditions were infrequent. In-hospital mortality was 9.4%. Outcomes were classified as 1a) uncomplicated; 1b) complicated (technically complicated surgery, temporary encephalopathy, discharge to a rehabilitation facility, or some combination thereof) but with ultimately good results; or 2) unfavorable (death or permanent, severe neurological deficit). There were 28 (44%) patients in group 1a, 24 (38%) in group 1b, and 12 (19%) in group 2. Of 18 patients with preoperative left ventricular ejection fraction less than 50%, two (11%) were in group 2. Of 31 patients undergoing aortic valve replacement only, two (6%) were in group 2, compared with 10 of 33 (30%) patients who had concomitant coronary artery bypass grafting, mitral valve replacement, or both (p = 0.02). Late follow up at 28 +/- 5 months revealed four cardiac and seven noncardiac deaths, with actuarial 1- and 5-year survival rates of 83 +/- 5% and 67 +/- 10%, respectively. With few exceptions, survivors were free of cardiac symptoms. Thus, short- and long-term outcomes after aortic valve replacement for aortic stenosis in otherwise healthy octogenarians is generally favorable, even in the presence of preoperative left ventricular systolic dysfunction.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2766539 TI - Septal myotomy-myomectomy versus mitral valve replacement in hypertrophic cardiomyopathy. Ten-year follow-up in 185 patients. AB - Between 1963 and 1985, 185 patients with hypertrophic cardiomyopathy (HCM) were treated with septal myotomy-myomectomy (MM) or mitral valve replacement (MVR) at our institution; 127 of these underwent septal MM, and 58 underwent MVR alone. The 1-month mortality was 4.7% for the septal MM group and 6.9% for the MVR group (p = NS). The mean time of postoperative follow-up was 118 months, ranging between 1 and 196 months. The annual mortality was 0.7% for the septal MM group and 1.3% for the MVR group (p = NS). In the MVR group, 98% of patients had been assigned to New York Heart Association (NYHA) functional classes III and IV before surgery; only 24% were classified as such at 10-year follow-up (p less than 0.001). In the septal MM group, 90% were in NYHA functional classes III and IV before surgery whereas only 27% were in these two classes postoperatively (p less than 0.001). A comparison of preoperative and postoperative hemodynamic findings revealed a significant reduction in left ventricular outflow gradient at rest: from 69 +/- 41 mm Hg preoperatively to 10 +/- 22 mm Hg postoperatively (p less than 0.001) in the septal MM group and from 75 +/- 45 mm Hg preoperatively to 10 +/- 21 mm Hg postoperatively (p less than 0.001) in the MVR group. In addition, the MVR group had a significant postoperative reduction in mean left ventricular end-diastolic pressure, from 21 mm Hg preoperatively to 15 mm Hg postoperatively (p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2766540 TI - Survival and bioprosthetic valve failure. Ten-year follow-up. AB - Between 1976 and 1982, 413 consecutive patients underwent valvular replacement with a bioprosthesis. Aortic valve replacement was performed in 240 patients, mitral valve replacement in 132, and multiple-valve replacement in 41. Four prostheses were employed: Carpentier-Edwards porcine (n = 336), Angel-Shiley porcine (n = 23), Hancock porcine (n = 11), and Ionescu-Shiley pericardial (n = 43). Follow-up was conducted between 5 and 12 years postoperatively and was 98% complete. Survival was 65 +/- 4% at 10 years and was independently influenced by advancing age, poor ventricular function, male sex, concomitant coronary artery bypass surgery, and valvular type. The risk of structural valvular dysfunction, reoperation, and any valve-related mortality and morbidity was significantly increased with the Ionescu-Shiley pericardial prosthesis. Long-term survival after valvular replacement was influenced by patient- and valve-related factors. The Ionescu-Shiley pericardial valve had an unusually high incidence of premature failure. PMID- 2766541 TI - Diagnosis and treatment of lower-extremity arteriosclerosis. PMID- 2766542 TI - Aggressive prevention is key to osteoporosis control. PMID- 2766543 TI - Methotrexate treatment of rheumatoid arthritis. PMID- 2766544 TI - Outpatient antibiotic therapy for urinary tract infections in women. AB - Culture may not be required to confirm the diagnosis of urinary tract infections in young women with symptoms; antimicrobial therapy usually resolves symptoms. While relapse may occur more frequently with single-dose therapy, late recurrence rates are the same and side effects are less than with multiple-dose therapy. Patients with relapsing infection or frequent recurrence are candidates for chronic prophylaxis with low-dose antimicrobial or prompt self-administered therapy. PMID- 2766545 TI - Anterior uveitis and multiple sclerosis. AB - Three patients with clinically definite multiple sclerosis and uveitis were studied. The uveitis presented as inflammation of the anterior segment of the eye (iridocyclitis) and was characterized by large keratic precipitates and posterior synechiae, consistent with a granulomatous iridocyclitis. Clinical and laboratory evidence militated against other central nervous system diseases often associated with uveitis including neurosarcoidosis, Behcet's syndrome, Vogt-Koyanagi-Harada disease, neurosyphilis, and tuberculosis. Further attention should be directed to the possibility of granulomatous anterior uveitis in patients with multiple sclerosis. PMID- 2766546 TI - Response of CSF IgG to steroids in an 18-month-old with chronic inflammatory polyradiculoneuropathy. AB - During recovery from a upper respiratory infection, an acquired chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) developed in a previously healthy 18-month-old girl. The CIDP followed a monophasic course and left her severely quadriparetic. One year after her neurologic deficit had stabilized, the cerebrospinal fluid (CSF) IgG synthesis rate was markedly elevated, and oligoclonal bands were identified in her CSF, suggesting ongoing inflammation. Her electromyogram (EMG) and nerve biopsy were consistent with a severe acquired segmental demyelinating polyradiculoneuropathy. A course of corticosteroid therapy resulted in dramatic, sustained, clinical and electromyographic improvement, normalization of CSF IgG synthesis rate, and disappearance of the oligoclonal bands. We are not aware of any previous reports that correlate serial measurements of CSF IgG synthesis rate and oligoclonal bands with clinical and electromyographic responses to corticosteroids in a child with acquired CIDP. We suggest that these CSF parameters are potentially useful in demonstrating active inflammation in cases of acquired CIDP even after clinical stabilization of neurologic deficits, predicting response to therapy, and monitoring resolution of the pathologic process. PMID- 2766547 TI - Re: Hypocomplementemic urticarial vasculitis in a patient with chronic obstructive pulmonary disease and pulmonary silicosis. PMID- 2766548 TI - The effects of Oradexone and Ambroxol pretreatment of the oxidative sensitivity of the red blood cells in preterm infants. AB - The antioxidant enzyme activities and lipid peroxidation in the red blood cells of cord blood were investigated and compared at different gestation times in preterm and full-term neonates, with and without pretreatment of the pregnant mothers with Oradexone (Dexamethasone) or Ambroxol. Administration of the two drugs not only stimulated the lung surfactant system, but also exerted favourable effects on the antioxidant enzyme activities while the lipid peroxidation was decreased. PMID- 2766549 TI - A simple, rapid assay for plasma oxalate in uraemic patients using oxalate oxidase, which is free from vitamin C interference. AB - An enzymatic assay for the determination of oxalate in plasma was developed which is specific, simple, rapid and requires no specialised equipment; interference from vitamin C was removed by incubation of acidified plasma ultrafiltrate with ascorbate oxidase prior to oxalate estimation. Recoveries were 93 +/- 11% and the inter-batch coefficient of variation for 31 determinations at an oxalate level of 24 mumol/l was 10%. The assay is linear up to 300 mumol/l with a detection limit of 2 mumol/l. The reference range, based on results from 25 healthy volunteers, was defined as less than 2-5 mumol/l which is similar to levels established for the in vivo isotope dilution technique. The assay has an added advantage over the latter method, which requires a urine collection, in that it can be applied to plasma from anuric patients. A linear correlation (r = 0.68, p less than 0.001) was found between plasma oxalate and serum creatinine in individuals with varying degrees of renal failure. PMID- 2766550 TI - Binding of calcium by organic anions, determined by perturbation of the equilibrium solubility of [14C]calcium oxalate. AB - Confirmation is needed of the reported binding of calcium ions (Ca2+) by bile salts, which is believed to decrease the activity of free calcium ions [Ca2+] available for precipitation of insoluble calcium salts of organic anions in pigment gallstones. We report a new method to determine the association constants (K'f) of calcium for organic anions, from the perturbation by the added anion of the equilibrium solubilization of calcium [14C]oxalate monohydrate crystals (CaOx*). CaOx* crystals were prepared by stepwise conversion of [14C]oxalic acid to its K+ and Ca2+ salts. Structure and purity were confirmed by X-ray diffraction of the crystals. CaOx* was incubated (37 degrees C, under N2) in 0.15 M NaCl in CO2-free deionized H2O at pH 6.3. Dissolution of CaOx*, estimated by radioassay of the 0.22-micron Millipore filtrate, attained equilibrium at 3 days, with K'sp = [Ca2+] * [Ox=] = 2.34 X 10(-8) M2, calculated using known affinity constants for the soluble complexes of NaOx- (K'NaOx = 3.215 M-1) and CaOx (K'CaOx = 195.0 M-1). Keeping total [Na+] = 0.15 M, we added anions that formed soluble complexes with Ca2+. This decreased free [Ca2+], causing more CaOx* to dissolve in amounts related to the concentration of added anion and its K'f for Ca2+. With this method, K'f values for citrate, malonate and malate were similar to the values we determined with the Ca2+ ion electrode, and to published values obtained with the Ca2+ ion electrode and other methods. The sensitivity of the CaOx method permits determination of K'f values with small quantities and low concentrations of the anions and calcium. PMID- 2766552 TI - N-acetyl-beta-glucosaminidase and albuminuria in normal and diabetic pregnancies. AB - Fourteen diabetic women without signs of nephropathy were examined during pregnancy. Serum fructosamine concentration indicating short-term metabolic control of diabetes was normalized at the beginning of the second trimester and was within the normal limits till the delivery. A gradual increase of N-acetyl beta-glucosaminidase activity in serum and urine has been found during pregnancy in diabetic and healthy women. No significant differences of N-acetyl-beta glucosaminidase activities were observed between the above groups. A successive increase of albuminuria during pregnancy was present in diabetic and healthy women with about 10-times higher values at delivery. A significant positive correlation was observed between albuminuria and urinary NAG activity in both groups of pregnant women (r = 0.77). We did not find any deterioration in N acetyl-beta-glucosaminidase activities and albuminuria in seven diabetic women one year after delivery. PMID- 2766551 TI - Reference values for amino acids in cerebrospinal fluid of children determined using ion-exchange chromatography with fluorimetric detection. AB - One thousand specimens of CSF were collected from subjects ranging in age from newborn to 18 yr, who were undergoing a diagnostic lumbar puncture. Sixty-two samples were judged retrospectively as being suitable for calculating reference age-related values. The analyses were performed by an amino acid analyser using ion-exchange chromatography with fluorimetric detection giving a tenfold increase in sensitivity, thereby enhancing the diagnostic capabilities. As many as 36 known compounds could be detected, additionally 10 we could not identify. In children older than 3 yr nine of the identified compounds showed age-dependency. We found 22 amino acids to be significantly higher in infants younger than 1 yr, with only gamma-aminobutyric acid being significantly lower in infants. Alpha aminoadipic acid showed a sex difference, being slightly higher in girls. PMID- 2766553 TI - Identification of octadeca-9,11-dienoic acid and its significance in the diagnosis of cervical intraepithelial neoplasia. AB - In 1987 it was claimed using high performance liquid chromatography (HPLC) that the molar ratio of octadeca-9,11-dienoic acid to its parent linoleic acid (18:2 (9,12)) was raised in malignant and premalignant conditions of the cervix. In this study based on a gas chromatographic procedure which prevents autoxidation and avoids the detection limitations of HPLC, we have shown that assay of these fatty acids has no role to play in the assessment of cervical neoplasia. PMID- 2766554 TI - Sickle cell screening using a rapid automated HPLC system. PMID- 2766555 TI - C18 cartridge extraction method to measure calcitonin in human cerebrospinal fluid. PMID- 2766556 TI - Serum phospholipase A in hospitalized patients. AB - Threehundred and thirty sera from hospitalized patients were analyzed for phospholipase A (PLA) activity. About 30% of unselected patients showed values above the normal range (0 to 10 U/l). The ratio of pathological to normal results was even higher in intensive care patients (around 1:1) and in patients with severe infections (2:1). 'Hyperphospholipasemia' was not typical for any defined organ system. From an etiological viewpoint, infectious diseases were most often related to increased PLA, followed by myocardial infarction and insufficiency and by malignant diseases. It is suggested that phospholipase A is a marker enzyme for the phagocytic activity in inflammation and necrosis. PMID- 2766557 TI - Increase of creatine kinase and lactate dehydrogenase in the serum of rats submitted to experimental intestinal infarction. AB - Acute intestinal ischemia is a severe condition for which no early biochemical index exists at present. We have investigated the effect of experimental intestinal infarction in the rat on the serum concentration of total creatine kinase, creatine kinase BB and total lactate dehydrogenase. Suppression of blood supply from the superior mesenteric artery resulted in marked increases of total creatine kinase, of its BB isoenzyme, and of total lactate dehydrogenase. Whereas total creatine kinase and total lactate dehydrogenase cannot be regarded as specific markers of the intestine, creatine kinase BB could prove to be more specific in view of its limited tissue distribution. PMID- 2766558 TI - A familial chromosomal translocation t(6q;7q) with habitual abortions. AB - A familial balanced translocation between the long arms of chromosomes 6 and 7 is described. The break points are localized to 6q27 and 7q23. No phenotypical abnormalities were found in any of the three carriers, but spontaneous abortions were frequent and might be associated with the translocation due to unbalanced segregation. PMID- 2766559 TI - Perception of burden among at-risk women of raising a child with fragile-X syndrome. AB - On a self-administered questionnaire 31 women at-risk for bearing children with fragile-X syndrome (FXS) were asked to judge the magnitude of the problems they perceived to be associated with raising an affected child. An age- and education matched group of women with no family history of FXS was asked to predict the seriousness of problems they might encounter were they to bear a child with a handicapping condition. Mothers of children with FXS reported that they were experiencing fewer and different problems than FXS relatives who did not have affected children predicted they themselves would experience. The perceptions of the burden of raising a handicapped child of FXS relatives without affected children were more similar to those of the comparison group than to those of FXS mothers. This suggests that women who raise a child with FXS learn to cope with an unchangeable situation, and consequently their perceptions of the burdens ease with time. A direct relationship between the acceptability of selective abortion and the perceived seriousness of the problems associated with having an affected child was observed. PMID- 2766560 TI - The inactivation of the fragile X chromosome in female carriers of the Martin Bell syndrome as studied by two different methods. AB - Female heterozygotes for the fragile X syndrome show variable levels of mental handicap from normal to severely retarded. The degree to which they are affected may depend upon whether the fragile or the normal X chromosome is preferentially inactivated, but one of the problems with the use of BUdR for the study of Lyonisation in fragile-X heterozygotes is that it reduces the level of expression of the fragile site. Results obtained by this method will be biased if the suppression occurs preferentially in either the active or the inactive X chromosome. To confirm that BUdR does not preferentially cause repair of the fragile site on either the late or the early replicating X chromosome, a comparison was made between the percentage of active or early fragile-X obtained using BUdR, and that obtained using tritiated thymidine in cells from the same heterozygote. PMID- 2766561 TI - A survey of manifesting carriers of Duchenne and Becker muscular dystrophy in Wales. AB - Manifesting carriers of Duchenne and Becker muscular dystrophy are uncommon but well described. Such patients are of particular importance with regard to the differential diagnosis from autosomal recessive limb-girdle muscular dystrophy. All mothers of affected males known to the Genetic Register of Muscular Dystrophy Families in Wales were contacted, and 167 out of a possible 190 were examined. It was estimated from pedigree and creatine kinase analysis that 119 out of the 167 were carriers of the Duchenne/Becker gene. Three manifesting carriers were identified, giving the proportion affected as 3/119 = 2.5%. We estimate the prevalence of manifesting carriers to be 1 in 100,000 of the female population, a figure comparable to the prevalence of autosomal recessive limb-girdle muscular dystrophy. During the period of the survey, several other women with similar clinical findings but without an appropriate family history were seen. We strongly suspect that some of these are also manifesting carriers of the Duchenne/Becker gene. PMID- 2766562 TI - Albinism and skin cancer in Southern Africa. AB - The presence of skin cancer was investigated in 111 albinos belonging to the black (Negro) population of Johannesburg, South Africa. The overall rate was 23.4%, the risk increasing with age. Identifiable risk factors included: environmental exposure to ultraviolet radiation; inability to produce ephelides ('freckles'); and possibly ethnicity. The head was the site most commonly affected, and squamous was far more common than basal cell carcinoma. No melanomas were detected. Recommendations are made regarding prevention of skin cancer in the at-risk group. PMID- 2766564 TI - De novo Robertsonian D/D type translocations: the Leuven experience. AB - In this paper we report a de novo 13/14 Robertsonian type translocation with apparent loss of band 14q11 in a mentally retarded, blind 24-year-old male. The findings in 10 other patients with a de novo Robertsonian D/D type translocation diagnosed in this center are reviewed. PMID- 2766563 TI - An aetiological study of isochromosome-X Turner's syndrome. AB - In an attempt to resolve conflicting evidence from the literature concerning the existence of a paternal age effect in 46,X,i(Xq) Turner's syndrome, we have analysed data on all known cases ascertained in the main population centres of Scotland and on others ascertained in England, using population controls matched for year of birth. There was a significant (P = 0.02) increase of 2.3 years in the mean paternal age of the Scottish cases, and a smaller and non-significant increase in their mean maternal age. Logistic regression analysis confirmed that the primary association was with paternal, rather than maternal, age. For the English cases, however, there were small and non-significant decreases in their mean maternal and paternal ages. The differences between the two groups were also significant, but cannot be explained by any likely source of ascertainment bias. We therefore conclude that there is no evidence for a universal paternal age effect in this condition, but that at least one mechanism of origin, occurring with variable frequency, may be associated with increased paternal age. Using data from this and earlier published studies, we estimate the incidence of individuals with a 46,X,i(Xq) cell line to be between 3.3 and 13 per 10(5) female livebirths. PMID- 2766565 TI - Holt-Oram syndrome associated with the hypoplastic left heart syndrome. AB - We present the first case of Holt-Oram syndrome associated with the lethal congenital heart defect of hypoplastic left heart syndrome. The possible pathophysiological link is explored and the need for careful genetic and cardiologic evaluation in these patients is reiterated. PMID- 2766566 TI - Trisomy 1q. PMID- 2766567 TI - Another case of Bloom's syndrome in Japan. PMID- 2766568 TI - A genetic epidemiologic investigation of breast cancer in families with bilateral breast cancer. II. Linkage analysis. AB - We conducted genetic linkage analyses of breast cancer in 20 pedigrees, each having at least one case of bilateral breast cancer diagnosed before 50 years of age. We tested for linkage using inheritance models from previous segregation analyses, incorporating differences in risk based on menopausal status into the analyses. We tested for heterogeneity by predividing the data set based on the interval between diagnoses of the proband's two primaries (less than 1 year (synchronous) versus at least 2 years (asynchronous], and on the histological types of breast cancer in the pedigrees. Very tight linkage could be excluded between breast cancer and ABO, GC, GPT, MNS, and PGM1 for some of the different linkage analyses. A maximum lod score of +1.01 (at theta = 0.001) between ACP1 and a breast cancer susceptibility locus was seen in the asynchronous all-cases subsample. PMID- 2766569 TI - Osteogenesis imperfecta with congenital joint contractures (Bruck syndrome). AB - Five children from three unrelated families were born with symmetrical contractures of the knees, ankles and feet. An initial diagnosis of arthrogryposis multiplex was made, but frequent fracturing occurred after walking commenced and it was then recognised that the children had osteogenesis imperfecta. The pathogenesis of the congenital contractures is unknown, but the symmetry and lack of evidence of prior fracturing is suggestive of articular immobility during early intra-uterine development. The consistency of the anatomical distribution of the contractures, in the setting of a uniform OI phenotype, is suggestive of syndromic identity. A similar case was documented by Alfred Bruck in 1897 and we propose that the eponymous designation "Bruck syndrome" should be applied to the disorder. PMID- 2766570 TI - Familial steatocystoma multiplex: HLA, Gm, Km genotyping and chromosomal analysis in two unrelated families. AB - Steatocystoma Multiplex (S.M.) is an inherited condition characterized by the appearance of cysts during the first or second decade of life. Familial cases have occasionally been reported. We studied 13 patients affected by S.M. from two unrelated families, focusing our attention on HLA, Gm and Km genotypes and on chromosomal analyses. Although we failed to correlate the syndrome with a particular HLA, Gm or Km haplotype, we report some peculiarities and differences between these two families and the healthy Italian population. PMID- 2766571 TI - Holoprosencephaly, polydactyly and normal chromosomes: pseudo-trisomy 13? PMID- 2766572 TI - Chromosome studies and fertility treatment in women with ovarian failure. AB - In vitro fertilization and embryo transfer or gamete (or zygote) intra-Fallopian transfer after ovum donation were performed in 16 patients with primary or secondary amenorrhea, associated with chromosome abnormalities. The patients showed the wide range of (mostly X) chromosome abnormalities characteristic for women with primary or premature ovarian failure. Four of these patients became pregnant and three of them have delivered healthy infants with a normal karyotype. This pregnancy rate is far superior to the accepted fertility figure in these patients. When these results were compared with the fertility treatment results of three other groups of women with absent ovarian function (1. ovarian dysgenesis; 2. surgical castration; 3. premature menopause) but with a normal 46,XX karyotype, no difference in treatment efficiency could be detected. These results offer a promising approach for the treatment of infertility in agonadal patients with chromosome aberrations. PMID- 2766573 TI - Linkage studies of Myotonia congenita and Paramyotonia congenita. AB - Six German families segregating for Myotonia congenita (MC) and eight families from Germany and Great Britain with Paramyotonia congenita (PC) were tested for linkage relationships using 35 serological and biochemical markers. No linkage of MC to any of the markers was evident, but a positive sum of lod scores for PC vs. the HP locus (z = 1.16, theta = 0.16) was found. The results encourage further investigations involving chromosome 16 markers. PMID- 2766574 TI - In vivo clearance studies of the terminal fluid-phase complement complex in rabbits. AB - The present study was directed at obtaining information on the in vivo elimination rate of SC5b-9, the terminal fluid-phase product of complement activation. A sandwich ELISA based on the use of mono- and polyclonal antibodies was constructed that permitted quantitation of rabbit SC5b-9 in plasma. Rabbit serum was activated with inulin in vitro to generate SC5b-9, and the activated serum was applied intravenously in normal and C6-deficient rabbits. Elimination of SC5b-9 in normal rabbits was rapid, half-life in the range of 30-50 min. No differences were noted between the clearance of homologous rabbit and heterologous human SC5b-9, SC5b-9 concentrations returned to basal levels 2-3 h after application. Plasma of C6-deficient rabbits contained no SC5b-9 and these animals displayed an even more effective clearance capacity for the complex. Quantitative considerations indicated that basal plasma SC5b-9 levels in healthy animals result from a spontaneous turnover rate of approximately 0.2% of C5-C9 components per h. When multiple doses of SC5b-9 were injected in sequence, the same half-life and total elimination time were found as with single-dose experiments. The results demonstrate the existence of an effective clearance mechanism for SC5b-9, consistent with recent findings that SC5b-9 plasma levels are very low not only in healthy adults, but also in the majority of patients with complement-consuming diseases. PMID- 2766575 TI - Selective autoimmune response to the chicken-specific structures of thyroglobulin in Obese strain chickens. AB - The characteristics of thyroglobulin (Tg) autoantibodies in Obese strain (OS) chickens with thyroiditis have been defined and compared with those of polyclonal antibodies to chicken Tg produced by immunizing normal chickens and a rabbit, and with mouse monoclonal antibodies (MoAb) to chicken Tg. Chicken Tg autoantibodies (aAb), when tested against Tg from 24 species all showed specificity for chicken Tg which ranged from absolute to limited although in most instances cross reactions with Tgs of other species were either absent or at a low level. Antibodies to chicken Tg produced by immunization showed a similar limited range of cross-reactions. Four of five chTg-MoAbs were specific for chicken Tg and the fifth was almost so. In competitive experiments, the polyclonal rabbit antibody could fully inhibit binding of all chicken Tg-aAb to chicken Tg but not vice versa. It was inferred that polyclonal rabbit Tg antiserum includes antibodies to all the epitopes seen by chicken Tg-aAb and many more besides. In similar experiments with four chicken Tg-MoAbs, the binding of one chicken Tg-aAb was unaffected, and three other patterns of inhibitions were defined. The binding to chicken Tg of a fifth chicken Tg-MoAb was enhanced rather than inhibited by chicken Tg-aAb. Some but not all chicken Tg-aAb preparations could differentiate between Tgs containing different amounts of thyroxine. We conclude that the autoantibodies to Tg in OS chickens are directed in the main against determinants unique to the species. Not all the species-specific determinants are involved in the autoimmune response but the number of epitopes involved is at least four. In these respects the immune response to Tg in OS chickens resembles that in autoimmune thyroid disease in humans. The conformation of chicken Tg may be affected by combination with antibody or by the content of thyroid hormone. PMID- 2766576 TI - Terminal complement complexes and C1/C1 inhibitor complexes in autoimmune thyroid disease. AB - The potential role of complement activation and the membrane attack complex in the pathogenesis of Graves' disease and Hashimoto's thyroiditis has been investigated by measuring serum concentrations of the C1r-C1s-C1 inhibitor complex (C1/C1-inh) and the terminal complement complex (TCC), and by studying the binding to thyroid tissue of monoclonal and polyclonal antibodies against TCC neoantigens. Serum C1/C1-inh and TCC concentrations were significantly increased in 29 patients with untreated Graves' disease compared with 47 healthy subjects (P less than 0.001 for both), and decreased significantly after carbimazole treatment in 18 of these patients for whom post-treatment samples were available (P less than 0.01 and P less than 0.02, respectively). The serum TCC concentration, but not that of C1/C1-inh, was also significantly increased in 15 patients with Hashimoto's thyroiditis compared with the 47 healthy subjects (P less than 0.001). TCCs were identified by immunohistochemical staining around the thyroid follicles in thyroidectomy specimens from patients with Graves' disease (six out of six) and Hashimoto's thyroiditis (two out of two); normal thyroid tissue from two subjects showed no staining. These results suggest a role for complement, in particular the membrane attack complex in the pathogenesis of autoimmune thyroid disease. PMID- 2766577 TI - Circulating colony-forming units of granulocytes and monocytes/macrophages in systemic lupus erythematosus. AB - In systemic lupus erythematosus (SLE) patients, in vitro bone marrow (BM) colony forming units of granulocytes and monocytes/macrophages (CFU-GM) are decreased, suggesting that granulomonopoietic failure may play an important role in the mechanism of peripheral blood (PB) depletion of neutrophils and monocytes. No information concerning CFU-GM in PB of patients with SLE is available. The present study was undertaken in order to determine whether SLE itself and the inactive or active stage of disease would modify the number of GFU-GM in PB samples from 20 treatment-free SLE women, 12 inactive and eight active. CFU-GM growth was significantly decreased in both inactive (P = 0.018) and active (P = 0.008) SLE patients as compared with controls (n = 8). The difference in CFU-GM growth between SLE groups was not significant. These results indicate that the number of circulating CFU-GM is significantly reduced in patients with SLE regardless of disease activity or remission. PMID- 2766578 TI - Rheumatoid factors in cystic fibrosis: associations with disease manifestations and recurrent bacterial infections. AB - Serum IgM and IgA rheumatoid factor (RF) levels were measured by ELISA in 71 adolescent and adult patients with cystic fibrosis (CF) and 69 control subjects. IgM RF values from 15 (21%) CF patients greater than 2 s.d. of control subjects (P less than 0.001). Elevated IgM RF values were significantly associated with worse spirometric measurements of pulmonary function (P less than 0.01) and with more frequent exacerbations of respiratory tract infection (P less than 0.001). A characteristic episodic arthropathy occurred in 27% of IgM RF positive patients, compared with 4% of IgM RF negative patients (P = 0.015). IgA RF values from 26 (37%) CF patients were elevated (P less than 0.001). Pulmonary function was significantly worse in patients with elevated IgA RF values (P less than 0.001). However, IgA RF was not associated with exacerbations of respiratory tract infection or episodic arthropathy. Both IgM and IgA RF values correlated significantly with their corresponding Ig levels, suggesting that RF synthesis was the result of polyclonal B cell activation. It is concluded that serum IgM RF values in CF are associated with worse lung disease and recurring bacterial antigenic stimulation. IgM RF may contribute to the development of arthropathy in some patients. Induction of IgA RF synthesis and its pathogenic potential may differ from IgM RF. PMID- 2766580 TI - Effect of furazolidone and nitrofurazone on brain gamma-amino butyric acid and glutamate concentrations in chickens. AB - 1. The concentrations of gamma-amino butyric acid (GABA) and glutamate were measured in the brains of chickens which were treated with furazolidone (FZ) or nitrofurazone (NF) at oral doses of 12.5, 25 or 50 mg/kg for 5 days. 2. At the end of the treatment, the birds lost about 9% of their bodyweight when on the small dose of FZ or NF and about 18% when on the high doses. 3. Both drugs produced dose-dependent increases in the concentrations of GABA and glutamate which were statistically significant at doses of 25 and 50 mg/kg of NF, and 50 mg/kg of FZ. PMID- 2766579 TI - Defective antibody-dependent tumour cell lysis by neutrophils from cancer patients. AB - Neutrophil antibody-dependent cellular cytotoxicity (ADCC) against Raji target cells was studied in 32 patients with lung or gastro-intestinal carcinoma and 25 healthy controls. Seventeen of the patients (53%) had defective ADCC. Moreover, neutrophils obtained from patients with defective ADCC were found to bind IgG coated target cells normally. Thus, the defect responsible for the impaired lysis appears to be distal to the Fc receptor (FcR)-mediated target cell binding by neutrophils. PMID- 2766581 TI - Cortical control of tongue contractility in the rat under ketamine anaesthesia. AB - 1. Cortico-lingual and linguo-cortical interconnectivity was investigated in ketamine-anaesthetized rats mounted onto a stereotaxic apparatus. The tip of the tongue was tied to a force displacement transducer to monitor tongue retrusions. The tongue cortical area was exposed in one or both hemispheres to record evoked potentials or spontaneous electroencephalographic (EEG) activity, or to stimulate electrically with single square pulses of up to 50 V and 0.25 ms pulse width. 2. The results showed that (i) tongue retrusions elicited by electrical stimulation were identical to those induced by ketamine; (ii) ketamine-induced tongue contractions correlated in time with cortical EEG potentials which were easily distinguished from the background noise; (iii) haloperidol (2.5 mg/kg, i.m.) suppressed the cortically evoked tongue contractions as well as the ketamine induced contractions. 3. These results suggest that ketamine-induced tongue retrusions may involve the cortex in their mediation if not their generation and that this may provide a basis for the suppression of dyskinetic activity during sleep or unconsciousness. PMID- 2766582 TI - Proconvulsant effect of papaverine on theophylline-induced seizures in rats. AB - 1. The effects of papaverine, an adenosine uptake inhibitor, were tested against theophylline-induced seizures. 2. Rats were infused with a constant intravenous infusion of theophylline at 10.3 mg/min immediately following intraperitoneal pretreatment with either papaverine 35 mg/kg or saline vehicle. 3. Papaverine produced a potent proconvulsant effect towards theophylline seizures, reducing the onset time and cumulative dose to seizure and theophylline concentrations in arterial serum, cerebrospinal fluid and brain, respectively, at onset of maximal seizures. PMID- 2766584 TI - Systemic mycoses and parasitic diseases. PMID- 2766583 TI - Does peripheral collateralization also cause collateralization in the canine heart? AB - 1. Experiments were conducted in chronically prepared dogs to determine if gradual obstruction of the proximal femoral arteries would also cause collateralization in the coronary circulation. 2. Peripheral coronary pressure was measured before and after peripheral collateralization as an index of coronary collateral function. Coronary collateral blood flow was measured with radioactive microspheres after peripheral collateralization. 3. Peripheral coronary pressure was not significantly altered by peripheral collateralization. Coronary collateral blood flow measured after peripheral collateralization was similar to that reported in non-collateralized hearts. 4. Results indicated that the mechanism(s) responsible for peripheral collateralization do not act systemically, at least not on the coronary circulation. PMID- 2766585 TI - Idiopathic lobular glomerulonephritis (nodular mesangial sclerosis): a distinct diagnostic entity. AB - Lobular glomerulonephritis is an entity first thought to have represented a primary disease of uncertain histogenesis, but more recently has generally been considered to represent a morphologic variant of membranoproliferative glomerulonephritis. We have encountered five patients who were found to have a lobular glomerulonephritis by renal biopsy, but in whom features of membranoproliferative glomerulonephritis types I, II, or III, could not be demonstrated and in whom alternate known diagnostic categories could be excluded. We suggest that lobular glomerulonephritis, or alternately, idiopathic nodular mesangial sclerosis, is an uncommon but persistent disease entity with a distinctive pathologic appearance and unknown pathogenesis. PMID- 2766586 TI - Baroreceptor, not left ventricular, dysfunction is the cause of hemodialysis hypotension. AB - Many patients with chronic renal failure experience profound hypotension during hemodialysis. This has been attributed both to autonomic and ventricular dysfunction. In an attempt to distinguish which, if either, is important in this role, we assessed both autonomic and left ventricular function in 10 such patients. Cardioactive medication was stopped 24 hours prior to the investigations. Autonomic function was assessed from day/night blood pressure and heart rate variation and from the hemodynamic response to tilting and the Valsalva maneuver using an intra-arterial ambulatory monitoring technique. Left ventricular function was assessed scintigraphically both before and during hemodialysis. Day/night variation was significantly reduced in the patients with chronic renal failure (BP 13/7 +/- 8/6 mmHg, HR 5 +/- 4) compared with a control population (BP 36/28 +/- 10/5 mmHg, HR 19 +/- 6). Nine patients had a "square wave" response to the Valsalva maneuver. Both of these abnormalities are usually seen in patients with heart failure and are attributed to volume overload and a consequent failure of baroreceptor response. Blood pressure fell during hemodialysis (mean fall 40/22 +/- 20/10 mmHg) in all patients, but heart rate did not change (-2 +/- 16) despite the hypotension. All patients had a normal or high resting ejection fraction (mean 66%, range 55-79%), and there was no change during dialysis. This indicates that the hypotension was not due to left ventricular dysfunction in this group of patients, but to a failure of the baroreceptor response to volume depletion during hemodialysis. PMID- 2766587 TI - Calcium alginate, an aluminum-free phosphate binder, in patients on CAPD. AB - Since dialysis solutions in CAPD are now nearly aluminum free, the only source for elevated aluminum levels are aluminum-containing phosphate binders. Elimination with CAPD is insufficient to prevent aluminum accumulation. Therefore, we investigated a phosphate binder consisting of calcium alginate, a natural polyuronic acid, containing 100 mg calcium/g substance in 14 patients on CAPD over a period of one year. The patients had previously been treated with aluminum-containing phosphate binders for a period of 24.3 +/- 21.3 months. During a period of 3 weeks before changing to the new phosphate binder the mean (+/- SD) serum phosphorus concentration was 1.8 +/- 0.4 mmol/l, while at the end of one year of treatment with calcium alginate the concentration was 1.6 +/- 0.4 mmol/l. In order to lower serum phosphorus to this level, it was necessary to increase the mean (+/- SD) amount of calcium alginate from 6.9 +/- 1.3 g per day at the beginning of the study to 8.3 +/- 2.1 g per day at the end. The mean (+/- SD) serum calcium concentration did not change throughout the study period. Serum levels of alkaline phosphatase, 1.25 (OH)2 vitamin D3, and intact parathyroid hormone did not change as well. The mean (+/- SD) serum aluminum level declined from 36.0 +/- 20 to 14.0 +/- 11.3 micrograms/l after 6 months (p less than 0.001). In conclusion, calcium alginate is a good alternative to aluminum containing phosphate binders and to phosphate binders on a calcium base as it does not lead to hypercalcemia. It prevents aluminum intoxication and has no serious side effects. PMID- 2766588 TI - Nicardipine, a new calcium channel blocker: role for vascular selectivity. PMID- 2766589 TI - Separation of afterload reduction and a direct beneficial cardiac effect of nifedipine in congestive cardiomyopathy. AB - To assess whether the calcium antagonist nifedipine has a specific, direct effect on left ventricular diastolic function separate from its vasodilatory action, we studied 10 patients with idiopathic congestive cardiomyopathy (ages 28-69, New York Heart Association Class III or IV) at 30 min, 2 h, and 6 h after administration of 10 mg of sublingual nifedipine. Hemodynamic parameters were assessed with Swan-Ganz catheter and two-dimensional echo images were processed with computer-assisted analysis (Quantic 1200) to obtain left ventricular chamber areas and an index of rapid diastolic filling. Indices of left ventricular systolic performance (cardiac index and left ventricular area change fraction) improved during the early (30 min and 2 h) observation periods as afterload (estimated by systolic blood pressure and systemic vascular resistance) was reduced (p less than .05 vs. baseline). Pulmonary capillary wedge pressure fell from 17 mmHg to 11 mmHg and rapid diastolic filling index increased from .28 (% area change/ms) to .37 (% area change/ms) (p less than .05 vs. baseline) during the early observation periods. Indices of left ventricular systolic performance and afterload had returned to baseline at the late (6 h) observation period. However, pulmonary capillary wedge pressure remained reduced significantly at 10 mmHg after 6 h (p less than .05 vs. baseline). Preload (estimated by left ventricular end-diastolic chamber area) did not vary throughout the study period. Reduction of pulmonary capillary wedge pressure at 6 h, despite return of afterload reduction to baseline and no change in preload, suggests improved left ventricular chamber compliance after sublingual nifedipine, not related to alteration of left ventricular loading conditions. PMID- 2766590 TI - Hypertrophic cardiomyopathy: two-dimensional echocardiographic score versus clinical and electrocardiographic findings. AB - The severity and site of hypertrophy is important in determining the clinical picture and the natural history of hypertrophic cardiomyopathy (HCM). We evaluated left ventricular hypertrophy by means of two-dimensional echocardiographic score and score index, and correlated these findings with symptoms, electrovector-cardiographic data, and ventricular arrhythmias. A total of 42 patients with HCM were studied by clinical examination, ECG, VCG, M-mode and 2D echocardiography, and 24-h Holter monitoring. The extent and severity of the hypertrophic process were calculated by a score system. The left ventricle was divided into 11 segments and a hypertrophic score (HS) was given to each segment. A hypertrophy score index (HSI) was also calculated by dividing the number of hypertrophied segments by 13. No correlation was found between symptoms and HS and HSI, nor ECG-VCG abnormalities and HS and HSI. A statistically significant relationship between the severity of ventricular arrhythmias and HS and HSI was found (p less than 0.01). The mechanism responsible for ventricular tachyarrhythmias in severe and diffuse hypertrophy might reside in the high intraventricular pressures which produce or worsen areas of myocardial ischemia. PMID- 2766592 TI - Increased Ca2+ influx into platelets induced by thromboxane A2 analog in patients with ischemic heart disease. AB - We compared platelet aggregation and intracellular free calcium concentrations [( Ca2+]i) following stimulation with STA2, an analog of thromboxane A2 between patients with ischemic heart disease (IHD) showing significant stenosis in coronary angiograms and controls. In the presence of extracellular calcium, platelet aggregation and intracellular Ca2+ increase were enhanced by STA2 stimulation in a dose-dependent fashion and were higher in the IHD patients than in the controls. However, in the absence of extracellular calcium, no difference in intracellular Ca2+ increase was observed due to its total dependence on release from intracellular stores. These results suggest that thromboxane A2 increases platelet intracellular Ca2+-inducing aggregation, and this increase and aggregation, which is enhanced by thromboxane A2 in IHD patients, is due to promotion of Ca2+ influx by thromboxane A2. IHD patients appear to have an abnormality in the platelet membrane which may explain such thromboxane A2 dependent increased permeability to Ca2+. PMID- 2766591 TI - Assessment of the intracardiac left to right shunts with a single scintillation probe. AB - In order to assess the accuracy of pulmonary time-activity curves obtained at bedside with a single scintillation probe and Technetium-99m-labelled erythrocytes, pulmonary to systemic flow ratio (Qp:Qs) was calculated for radionuclide and hemodynamic investigations in 104 patients with suspected intracardiac left to right shunts. Cardiac catheterization confirmed the presence of shunts in 76 patients. Pulmonary time-activity curve was 100% sensitive, 88% specific, and 96% accurate in detecting the shunt. Correlation between the radionuclide and hemodynamic Qp:Qs was excellent (r = 0.93). Results were classified in four quantitative categories according to the Qp:Qs values. In 76 patients (73%) radionuclide and hemodynamic data fell in the same category. We conclude that radionuclide pulmonary time-activity curves generated with a scintillation probe is a reliable method in quantitative assessment of intracardiac left to right shunts. PMID- 2766593 TI - Mesothelioma of the atrioventricular node and congenital complete heart block. AB - Congenital complete heart block (CCHB) has heterogeneous etiologies. It may occur as an isolated entity with no associated congenital cardiac malformations and is difficult to diagnose even with modern technology. Mesothelioma of the atrioventricular (AV) node is a benign tumor that causes CCHB. The occurrence of this tumor is rare, and a definitive diagnosis of the entity is made only at autopsy. The conduction disturbance caused by the mesothelioma is potentially treatable and should be considered in the differential diagnosis of CCHB. We present a case report of a 38-year-old female with CCHB caused by such a tumor. Clinical diagnosis and treatment of CCHB are reviewed. PMID- 2766594 TI - Probable triggers of onset of acute myocardial infarction. AB - Three cases of acute myocardial infarction are presented in which a probable triggering mechanism can be identified. The presence of triggering physical and mental stresses is consistent with recent documentation of a morning increase in frequency of acute myocardial infarction. This documentation suggests that the onset of acute myocardial infarction is not a random event. Recent advances in knowledge of the pathophysiology of acute myocardial infarction provide a background to the understanding of the probable triggering mechanism in these three cases. Further prospective study of patients with acute myocardial infarction in whom detailed information is collected sufficient to identify triggering activities may provide important insight into the pathophysiology of myocardial infarction and improved strategies for prevention. PMID- 2766595 TI - Advances in Greece. PMID- 2766596 TI - Use of skin incisions in the application of halo skeletal fixator pins. AB - A halo skeletal fixator was studied prospectively in 51 patients using two different pin insertion techniques. One technique consisted of a stab incision prior to pin placement and the second technique used no incision. There was no difference in infection, loosening, or resultant scars between the two groups. Incision for halo pins may increase initial bleeding and seems unnecessary. PMID- 2766598 TI - Anterior acromioplasty for subacromial impingement in patients younger than 40 years of age. AB - The indications and results of anterior acromioplasty in patients older than 40 years of age are well documented; however, little is reported concerning this procedure in younger patients because the majority are treated conservatively. Over the last seven years, 26 patients younger than 40 years of age were treated by anterior acromioplasty for subacromial impingement resistant to conservative therapy. The indication for surgery was failed conservative therapy in 17 patients. Six patients had impingement despite previous surgery, such as failed acromioplasty, biceps tenolysis, and biceps tenodesis. Two patients had impingement secondary to greater tuberosity malunion. The average duration of symptoms was 27 months and of conservative therapy, 17 months. All patients had a bursectomy and anterior acromioplasty. In addition, eight had a complete acromioclavicular arthroplasty for concurrent acromioclavicular arthritis, four had a modified acromioclavicular arthroplasty for impingement under the acromioclavicular joint, three had calcium excisions, and one had a rotator cuff repair. The greater tuberosity malunions were advanced in one patient and excised in one. The results were 81% (21) excellent and good, 15% (four) fair, and 4% (one) poor. The average follow-up period was 33 months. The majority of younger patients with subacromial impingement can be successfully treated conservatively. In those patients with persistent symptoms, open acromioplasty can reliably give good results with regard to pain and function. PMID- 2766597 TI - Ganglioneuroma of the sacrum. AB - Ganglioneuromas (GNs) are benign, slow-growing, rare soft-tissue tumors that arise from the sympathetic nervous system and comprise less than 1% of all soft tissue neoplasms. Although GNs are slow-growing, they can and will invade bone and pressure local adjacent structures by their continued growth. In a 20-year old woman, GN produced a large presacral mass. This case illustrates the diagnostic features at various stages of growth, histopathology, and treatment of GN. PMID- 2766599 TI - Primary tendinitis of the long head of the biceps. AB - Seventeen patients with chronic painful shoulders who showed evidence of isolated bicipital tendinitis involving only the extracapsular, intertubercular portion of the long head of the biceps were chosen for surgical treatment when conservative treatment failed. The patients were thought to have primary bicipital tendinitis. The latter condition is secondary to other shoulder pathologies. Thirteen patients had tenodeses and four patients had transfer of the long head of the biceps to the origin of the conjoined tendon. Overall, excellent and good results were noted in 94% of both groups of patients when the long head of the biceps was tenodesed or transferred. Whether or not the long head of the biceps is a significant depressor of the humeral head requires further investigation. PMID- 2766600 TI - Dislocations of the elbow and intraarticular fractures. AB - Of 23 patients with an elbow dislocation associated with at least one displaced fracture of the radial head, 19 patients had the radial head extirpated two days range, 0-16 days) after injury. In four elbows, redislocation occurred. All four redislocations were associated with a displaced fracture of the coronoid process. A follow-up examination was performed in 19 patients between three and 34 years after the injury. Severe osteoarthritis with reduced joint space developed in 12 elbows. Reduced range of motion was the most common complaint, and reduced extension was the most common finding. To lower the risk and prevent severe instability, the radial head should be preserved if possible. If the radial head must be resected, suturing of torn ligaments and muscles at the epicondyles is essential. PMID- 2766601 TI - Recurrent radial head subluxation treated with annular ligament reconstruction. A case report and follow-up study. AB - Radial head subluxation secondary to traumatic rupture of the annular ligament has been well described in the literature. Annular ligament reconstruction utilizing fascia lata graft has been proposed and described, but no follow-up reports have been published. A 21-year-old man was treated by annular ligament reconstruction for recurrent radial head subluxation with a good result and no recurrent subluxation at more than four years postoperatively. The operative technique is as follows: a fascia lata graft 1.5 x 12 cm was anchored through a drill hole in the posterolateral ulna, passed around the radial neck, and sutured back onto itself to reconstruct an annular ligament. PMID- 2766602 TI - Quantitative measurements of hip strength in different age groups. AB - The purpose of this study was to develop a clinically useful method of assessing the strength of the hip musculature and to develop a normal data base with this technique. The strength of 72 subjects aged 20-81 years (37 women and 35 men) was measured through the use of a modified Cybex II with an upright stabilization frame for testing sagittal and frontal plane motions; transverse plane motions of internal and external rotation were tested in the seated position. The subjects were tested at multiple isokinetic speeds and isometric angles. Regardless of age or gender, hip extensors were the strongest muscle group, following by flexors, adductors, abductors, and rotators. As the velocity of exercise increased, the magnitude of the torques produced decreased. Demographically, younger men produced the greatest torques and older women the lowest. The strength values of older men and younger women were similar. The results have clinical implications for objective assessment of strength in pathologic patient populations. PMID- 2766603 TI - Pyogenic sacroiliac joint infection. AB - Sacroiliac joint infection is relatively uncommon. Since 1974, Staphylococcus aureus was the pathogen in 11 of 12 cases of pyogenic infection of the sacroiliac joint. Ten of the 12 cases were acute. All were treated with at least six weeks of antibiotics. Surgery was necessary in 11 of the 12 cases. Intraoperative specimens gave positive cultures in ten of 11 cases. All had a satisfactory result. This condition may be more common than previously thought. A careful history and physical examination are especially important. It should be treated early and aggressively to give optimum results. The indications for surgery are still uncertain. PMID- 2766604 TI - Axial loading studies of unstable intertrochanteric fractures of the femur. AB - An experimental four-part unstable intertrochanteric (IT) femoral fracture was created with either a large or small posteromedial fragment (PMF). Sixty-eight adult embalmed femoral anatomic specimens were fractured and subjected to axial loading after fixation. The maximum load prior to failure for femora from the same anatomic specimen was compared to differentiate between different methods of fixation. In the presence of the large PMF variation, anatomic reduction and fixation allowed the femur to resist an average maximum load 57% greater than identical fractures with the fragment excluded. Fixation of the small PMF increased construct strength by an average of 17% over no fixation. The PMF is the keystone to mechanical stability for IT fractures of the femur. When anatomic reduction is possible, its fixation becomes progressively more critical as its size increases. PMID- 2766605 TI - Wedge osteotomy of the lower end of the radius in the treatment of painful pseudarthrosis of the carpal scaphoid bone. AB - The present authors have had encouraging results in the treatment of painful pseudarthrosis of the carpal scaphoid bone using wedge osteotomy on the lower end of the radius. After the operation, patients experienced restoration of joint movement, less painful or pain-free joints, and, in a few cases, sound union of the established pseudarthrosis of the carpal scaphoid bone. Osteotomy is a simple procedure of short duration and is without complications. In addition, in cases of failure, osteotomy does not exclude other forms of therapy. PMID- 2766606 TI - Stabilization of sacroiliac joint disruption with threaded compression rods. AB - Eleven cases of sacroiliac dislocation and/or fracture (Malgaigne pattern) were successfully reduced and stabilized using two threaded compression rods. The mean follow-up period was 26.1 months (range, seven to 45 months). None of the implants failed and there was no subsequent displacement. Two patients had mild residual lower back pain, and one was treated with implant removal without subsequent relief of pain. One patient, in whom the operation was done 110 days after dislocation, had extension of an incomplete preoperative peroneal nerve palsy. After anterior pelvic ring stabilization has been performed, two threaded 3/16-inch diameter rods are driven from the normal posterior iliac wing superficial to the sacrum and through the reduced opposite iliac wing. Compression is obtained with washers and nuts. This procedure can be performed safely and effectively, providing stable fixation and allowing early mobilization to help lessen or prevent the complications associated with prolonged bed rest. PMID- 2766607 TI - A microangiographic study of idiopathic osteonecrosis of the femoral head. AB - Microangiography was performed on 31 femoral heads with idiopathic osteonecrosis to investigate the pathogenesis of this disease from the aspect of circulation disturbance. Microangiography showed the following: (1) the interruption of the superior retinacular arteries in the extraosseous area; (2) the presence of numerous newly formed vessels of varying diameter arising from the stumps of the interrupted superior retinacular arteries; (3) compensatory hypertrophy and large area invasion of the inferior retinacular arteries and the ligamentum teres arteries, both of which medially enter the affected head; and (4) the blockage of revascularization, which occurred along the area of subchondral fracture and collapse at the weight-bearing region. These findings strongly suggest that revascularization is aborted by the subchondral fracture and collapse caused by weight bearing. It was assumed that interference with revascularization occurred repeatedly in the repair process of affected heads due to the influence of subchondral fracture and collapse caused by weight bearing. PMID- 2766609 TI - Arthroscopic observations of autogeneic quadriceps and patellar tendon grafts after anterior cruciate ligament reconstruction of the knee. AB - Fifty-six arthroscopic observations on 53 knees at various periods after anterior cruciate ligament (ACL) reconstruction using the autogeneic quadriceps and patellar tendon were analyzed to clarify the morphologic maturation process of such grafts in human patients. Arthroscopic observations of the grafts were divided into four types, excluding one rerupture case. Type I was observed in three knees less than six months after ACL reconstruction and in one knee six to 12 months after; Type II, in seven knees six to 12 months after; Type III, in six knees six to 12 months after, in 13 knees 12-18 months after, and in five knees more than 18 months after; and Type IV, in eight knees 12-18 months after and in 12 knees more than 18 months after. The types and the intervals after reconstruction were correlated with four phases of healing, including the maturation process of the implanted autogeneic grafts: (1) synovial envelopment, (2) fibrous tissue ingrowth, (3) transformation into ligamentlike tissue, and (4) hypertrophy or maturation of striated ligamentlike structure. PMID- 2766608 TI - Natural history of the posterior cruciate ligament-deficient knee. AB - This paper documents the clinical course of the posterior cruciate ligament deficient knee. By obtaining an understanding of the natural history of this lesion, the indications for surgical repair, reconstruction, and conservative treatment will be more clearly defined, and the clinician will be able to more critically evaluate the results of both acute repair and reconstruction of this ligament. Forty-three patients with an average interval of 6.3 years (range, one to 37 years) between injury and evaluation were included in this study. Fourteen patients had a straight unidirectional posterior instability and 29 had a combined multidirectional instability. The follow-up evaluation included functional assessment, physical and roentgenographic evaluation, arthrometric laxity measurement, and isokinetic dynametric testing of quadriceps function. Statistical treatment of the data, utilizing both nonparametric methods and logistic modeling, clearly delineated the natural history of the injury to the posterior cruciate ligament (PCL). It was established that the functional outcome can be predicted on the basis of the instability type. Specifically, those knees with PCL disruption without associated ligamentous laxity will probably remain symptom-free. However, when PCL disruption is associated with combined instabilities, a less than desirable functional result will probably occur. Application of logistic modeling to the data demonstrated that the functional result was not due to the type of instability per se, but rather to associated factors, i.e., chondromalacia of the patella, meniscal derangement, quadriceps atrophy, or degenerative changes. A direct correlation has been established between combined multidirectional instability and the occurrence of those associated secondary problems resulting in the patient's complaints and functional disability.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2766610 TI - Congenital dislocation of the hip. Observations on the early diagnosis and results of treatment with an abduction brace in infants two to nine months of age in Greece. AB - In Greece, despite efforts toward early diagnosis of congenital dislocation of the hip (CDH) during the last 20 years, treatment of 75% of infants so diagnosed has not been begun until they are 2 to 9 months of age, with an average treatment onset age of 4.6 months. Five hundred eighty-seven infants (947 hips) two to nine months of age with typical CDH or subluxation were treated with a specially designed abduction brace. This brace, which has been in use for more than 22 years, proved simple and reliable. The follow-up period ranged from two to 20 years (average, 4.5 years). Excellent results were found in 862 hips (91.0%), good results in 44 hips (4.5%), fair results in 32 hips (3.5%), and poor results in nine hips (1.0%). Changes due to ischemic necrosis were noted in 6.8% of the hips, with severe changes present in 3.0%. The most recent results have improved as a result of greater attention to very gentle and gradual abduction of the hips before the application of the brace and the avoidance of extreme abduction positioning in the brace. PMID- 2766611 TI - The estimation of femoral condyle size. An important component in osteochondral allografts. AB - An important component of successful osteochondral allograft surgery of the knee is securing a donor with a femoral condyle (FC) of the appropriate size. The purposes of the present investigation were to analyze the effect of femoral rotation on measurement of FC size and to determine if easily measured variables, such as manual caliper measurements, height, weight, and gender, are useful in matching donors and recipients. Three separate investigations were conducted to accomplish these purposes. The results indicated that femoral rotation has a significant negative effect on accurate sizing of the FC. Height and gender provide an acceptable prediction of femoral condyle size and can be used effectively in the donor selection process. PMID- 2766612 TI - A conservative approach to anterior knee pain. AB - Eight-five patients with sole anterior knee pain were treated with a physical therapy program and a nonsteroidal antiinflammatory medication. Physical therapy consisted of regimented stretching exercises, quadriceps electrical stimulation, isometric quadriceps sets, ice application after treatment, progressive straight leg raising, and short-arc quadriceps sets. After a disciplined progression of physical therapy and daily activity, patients were questioned about the amount of their knee dysfunction secondary to pain and their level of activity. Eighty seven percent of these patients described their knee symptoms as improved immediately after a physical therapy program. Sixty-eight percent believed their symptoms were improved when reviewed at follow-up interview (mean duration, 16.0 months). All follow-up information was obtained via phone interview using a checksheet question form to eliminate subject bias. At the time of interview, 57% believed that their level of activity substantially increased from their level at initial evaluation. These data dictate that a trial of physical therapy and nonsteroidal antiinflammatory medication should be used as initial treatment for anterior knee pain. PMID- 2766613 TI - Proximal tibial osteotomy. A new fixation device. AB - A new internal fixation device was applied to 41 proximal tibial osteotomies to ensure against loss of postoperative correction. An oblique osteotomy was stabilized by two screws and a five-hole one-half tubular plate. Thirty-six patients with 41 proximal tibial osteotomies were reviewed for an average roentgenographic follow-up time of 22.6 months (range, six to 48 months) with no loss of correction. In addition, 16 patients with 19 osteotomies and a minimum clinical follow-up time of two years were reviewed using the Hospital for Special Surgery knee scoring system; these early results demonstrated a similar outcome to previously published series. The new fixation device is simple to use, permits early postoperative motion, and maintains the exact correction obtained at the time of surgery. PMID- 2766614 TI - Wear and deformation of patellar components in total knee arthroplasty. AB - Clinical experience has shown that deformation of patella components can lead to loosening or excessive particulate debris, requiring revision. Factors affecting patella performance are the degree of congruity, the shear forces occurring due to tracking variations, and the excessive patellofemoral forces, particularly at higher flexion angles. A method was devised to load the patella with a constant force against the femoral component. The load was applied through a range of flexion. The deformation and wear patterns resembled those of retrieved clinical specimens. All-plastic components suffered from local deformation and underlying bone failure, whereas metal backing led to eventual penetration of the metal onto the femoral flange. Increased conformity of the patella component onto the femoral flange improved the situation for all-plastic and metal-backed designs by increasing the contact area and the available thickness of plastic. PMID- 2766615 TI - Assessment and management of pes cavus in Charcot-Marie-tooth disease. AB - The sequential approach to evaluating the cavus foot is integrated with a description and assessment of the various treatment options. Decision making in the treatment of these cases is complicated by the progressive neurologic condition that underlies many of these deformities. An effort is made to recommend the most appropriate surgical intervention based on the nature of the deformity and its rigidity. Although these principles apply to all cavus feet, the deformity in Charcot-Marie-Tooth disease is the most difficult to treat and the most prone to recurrence because of the progressive nature of the muscular imbalance causing it. PMID- 2766616 TI - Bilateral avascular necrosis of the first metatarsal head in adolescence. A case report. AB - A 12-year-old girl developed bilateral avascular necrosis of the first metatarsal heads. This condition of the foot seems not to have been previously reported in the literature. Initially, joint debridement and metaphyseal decompression were unsuccessful in relieving pain. Two years later abnormal articular cartilage was surgically removed and the subchondral bone plates were perforated to allow for fibrocartilaginous healing. Pain was diminished, and an excellent clinical result was noted at the follow-up examination two years after the excisional surgery. PMID- 2766617 TI - Reduction of stress shielding beneath a bone plate by use of a polymeric underplate. An experimental study in dogs. AB - Plating of fractures results in osteopenia beneath the plate because of the stress-shielding effect. This study was performed to determine if a dynamic compression plate fixed to a bone with a low-density polyethylene underplate would loosen over time and with cyclic loading (due to creep and/or accumulated plastic deformation of the underplate) and thus decrease its stress shielding of the bone. Three groups of ten canine femora each were plated and tested in vitro. A nonosteotomized control group (without an underplate) and an experimental group (with an underplate) were cyclically loaded 10(6) times in compression under identical conditions. The third group of bones was osteotomized and plated with underplates and cyclically loaded 10(5) times to ensure that the construct would not fail before early fracture union could occur. The plate screws of the experimental group were significantly looser than those in the control group. This corresponded to a decrease in the underplate thickness that was more than sufficient to account for the looseness of the screws. Strain readings from the plate and bone were highly variable and not conclusive. Therefore, a transfer of load, reflected in the strain magnitude, from the plate to the bone during loosening of the screws could not be documented. None of the osteotomized bones in the third group had fixation failure. This experiment demonstrated that this plate-underplate construct provided strong initial fixation of an osteotomized bone in the laboratory setting without failure of fixation. This construct gradually loosened with time and cyclic loading in vitro and therefore should decrease the stress-shielding effect when applied in vivo. PMID- 2766618 TI - One-stage surgical procedure for congenital dislocation of the hip in older children. Long-term results. AB - The one-stage procedure described in this article, which has been used in children older than three years of age, is the method of choice in the treatment of late-diagnosed congenital dislocation of the hip. The present authors and their patients have been more than satisfied with the results of this procedure. With femoral shortening as the fundamental step, this method can be applied in high dislocations, as well as in cases of subluxation in which a pelvic osteotomy is indicated, to restore the depth of the acetabulum and to prevent undue pressure on the femoral head, which is the main cause of avascular necrosis, joint stiffness, and failures. Evaluation of the results is confusing but should rely on resistance of the hip in daily function, clinical appearance, range of hip motion, and the patient's opinion. Roentgenologic evaluation seems to be even more difficult, because numerous parameters need to be taken into consideration and correlated with the preoperative appearance of the hip. Certainly, it is reasonable to expect the majority of patients to develop osteoarthritic changes eventually, but nearly all patients can live a normal or satisfactory life for a number of years. The present authors are convinced that many patients will remain symptom-free for a long period. PMID- 2766620 TI - Porosity of rat femora following intramedullary reaming and nailing. AB - The present study evaluated cortical porosity and thickness of intact rat femora 12 weeks after intramedullary reaming and nailing. The right femora were reamed and received either flexible polyacetal nails or rigid stainless steel nails. A third group was reamed but not nailed. The left femora were used as controls. The anterior cortical wall was analyzed at the mid-diaphyseal level. Neither reaming nor reaming combined with nailing influenced porosities with a diameter less than 10 microns. For larger pores, polyacetal nailing doubled the porosity, whereas steel nails increased porosity by a factor of 4.5. A slightly increased porosity was observed for the reamed group. Reduced cortical thickness was found in both nailed groups, whereas cortical thickness was increased in the reamed group compared with the control side. Implantation of rigid and flexible intramedullary nails in rat femora increased porosity along the anterior cortical wall. PMID- 2766619 TI - Prostaglandin-induced hyperostosis. A case report. AB - The use of prostaglandin-E1 (PGE1) to maintain patency of the ductus arteriosus in infants with ductal-dependent congenital heart disease is now well established. A 2.5-month-old child with cyanotic heart disease who required long term PGE1 infusions; developed widespread periosteal reactions during the course of therapy. Prostaglandin-induced subperiosteal hyperostosis should now be considered in the differential diagnosis of neonatal cortical proliferation. PMID- 2766621 TI - Experience with total hip arthroplasty in Greece, the first 20 years. A particular reference to long-term results with the McKee-Farrar technique. AB - Total hip arthroplasty was introduced early in Greece (1966-1967) and was initially performed in very small numbers. However, even after the difficult early period, statistics are low compared to other countries. An estimate brings the total number of operations during a 20-year period to 9000 with a rate in recent years of 1000 per year. An early series of 143 arthroplasties (122 patients), mainly of the McKee-Farrar metal-to-metal technique, was reviewed. A final group of 52 arthroplasties, all primary prostheses of the McKee-Farrar type, were assessed with a follow-up period ranging from 12 to 20 years postoperatively. In the surviving cases, 53% were pain-free, and, in 79%, useful motion was maintained. The roentgenographic results were less satisfying but a fair roentgenographic picture did not preclude a good or very good clinical and functional outcome. Although the metal-to-metal technique now appears to be more of historic value, long-term results with this type of implant offer grounds for comparison with current cemented techniques. PMID- 2766622 TI - Fifteen years' experience with Charnley low-friction arthroplasty. AB - In the years from 1973 to 1986, 359 low-friction hip arthroplasties were performed by the precise Charnley technique in 310 patients. Three hundred seventeen hips were reexamined both clinically and roentgenologically. Clinical evaluation was performed according to follow-up time, separating the total number of hips into three groups. In Group A, 78.49% of the reevaluated hips remained asymptomatic ten to 14 years postoperatively, a percentage that has risen to 92.02% in Group B (studied five to nine years postoperatively) and 98.38% in Group C (studied one to four years postoperatively). The infection rate was 9.6% in Group A hips, 4.7% in Group B hips, and inconsequential in Group C hips. The roentgenographic study included 96 asymptomatic hips with a follow-up period of six to 11 years (mean, 8.3%). A radiolucent line was present in the acetabulum in 40.6% of cases; cortical hypertrophy at the tip of the stem was present in 48.8% of cases. Cup wear of more than 1 mm was measured in 41.3% of hips and was correlated with longer follow-up times and younger patient age. The results are encouraging for the continuation of arthroplasty by this method. PMID- 2766623 TI - Surgical treatment of central acetabular fractures. AB - Surgical treatment is indicated in most displaced acetabular fractures in young adults. The fractures are generally intraarticular and almost invariably involve the weight-bearing area of the acetabulum. Complete or near anatomic reduction is essential for an excellent and long-standing recovery of the hip joint, and this is extremely difficult to accomplish by conservative management. Fifty-eight displaced central acetabular fractures treated surgically were followed from one to 12 years. They were evaluated by anteroposterior and oblique roentgenograms and classified according to the Judet-Letournel system. Although surgical treatment was somewhat delayed and the experience in approaching and dealing with these fractures was limited in many of the early cases, excellent or satisfactory reduction to a less than 3-mm displacement at the articular surface was achieved in 81% of cases. A close agreement was found between the quality of surgical reduction and clinical results as well as between roentgenographic and clinical results at the final follow-up examination, which were satisfactory in 72% and 74%, respectively. The surgical complications were infection in 2% of cases, peroneal nerve palsy in 8.5%, and moderate to severe ectopic ossification in 10% of the patients. PMID- 2766624 TI - Evolution and present status of orthopedic microsurgery in Greece. AB - Replantation of complete or incomplete nonviable amputations of digits, hands, and major limbs along with a number of reconstructive microsurgical procedures reflect the work that has been done in the field of orthopedic microsurgery in Greece during the last ten years. The history of trauma microsurgery in Greece starts in the mid-1970s, when the first attempts were directed toward patients with complete or incomplete nonviable amputations of digits and hands. Few cases of major limb replantations without the aid of an operating microscope or other means of magnification have been reported for the years 1965-1975. The first successful digital replantation was performed in 1979 on a female patient with multiple digit amputations; only the little finger was successfully replanted. More than 310 replantations and revascularization procedures have been performed during the past decade, mainly in two major replantation centers, with an overall success rate of 85% for complete and 90% for incomplete nonviable amputations. Reconstructive microsurgical procedures are mainly related to free skin flaps, vascularized bone grafts, toe-to-thumb transfer, and peripheral nerve microsurgery. PMID- 2766625 TI - Lumbar spinal stenosis syndrome. AB - Seventy-six operations were performed by the author for lumbar spinal stenosis syndrome over 25 years. The characteristic symptoms of pain, sensory changes, and intermittent pseudoclaudication in connection with the extent of nerve root compression confirmed by laboratory examinations and the operative findings allow the author to stress the following points. (1) In Greece, lumbar spinal stenosis syndrome is not a very common entity. (2) Spinal stenosis cases of acquired type are the most common while those of developmental character are very rare, only two in this series, (3) Surgical intervention, which is the treatment of choice, includes a generous decompressive procedure that must free all the neural elements. Sometimes it is necessary to remove part or all of the facets in one or more levels. (4) The rate of complications is low, and complications are of minor character. (5) The results on the whole are very satisfactory and lasting, provided the planning and execution of the operation are based on sound preoperative assessment using both clinical examination and laboratory investigation. (6) Development of the acquired form of stenosis of the spine seems not to be preventable. The pathogenesis of the syndrome has not been fully established. PMID- 2766626 TI - Reconsideration of the Putti-Platt procedure and its mode of action in recurrent traumatic anterior dislocation of the shoulder. AB - The Putti-Platt procedure and its mode of action were investigated clinically and by work on anatomic specimens. The clinical work comprised 72 cases (Group A) of recurrent traumatic anterior dislocation of the shoulder operated on by the classic Putti-Platt technique from 1961 to 1985 and 92 cases (Group B) treated by the simplified operation from 1966 to 1979. Sixty-five patients from Group A and 83 (85 shoulders) from Group B were reexamined. There were two recurrences in Group A and three in Group B. In Group A, lateral rotation of the arm was restored in 19 of the 65 patients; it was increased in 44 patients by 60 degrees to 70 degrees compared with immediate postoperative rotation, which was 20 degrees to 30 degrees from the neutral position. On anatomic specimens in which the classic Putti-Platt technique was used, lateral rotation could not reach neutral without disruption of the lateral stump from the labrum. Since the lateral stump of the subscapularis is tendinous and inelastic, the postoperative increase in lateral rotation among Group A patients could be explained if the lateral stump had become gradually detached from the labrum. Therefore, it seems that this difficult part of the classic Putti-Platt procedure may be omitted, rendering the operation simpler and shorter than the original technique but just as successful.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2766627 TI - Experience with knee arthroplasty. AB - Knee arthroplasty is a suitable way of treating severely affected joints. During the years 1976-1987, 160 knee arthroplasties were performed at the author's institution. Of 142 followed. 41 cases were of the unconstrained type (Marmor, Bechtol, and Oxford), while 101 cases were of the constrained type (St. Georg hinge and Endo-Model). In the unconstrained group, two infected cases were encountered (one cured, one fused) and three loosenings requiring revision. Prompt and intensive physiotherapy was necessary in this younger and less affected group of patients in order to achieve a functioning knee joint. The average improvement of range of motion was 15 degrees. In the constrained group, full restoration of the normal axis was achieved with full extension; flexion was greater than 100 degrees, and there was a stable joint. Three infections occurred, all in rheumatoid patients. There were two early deaths from unrelated causes. Three late dislocations of the patella, with the knees still functioning, were encountered in this older group of patients with more severely affected joints. Proper function of the unconstrained prosthesis is also questionable in relation to the average geometry of the artificial models in use and the geometry of the human body. This relation, if not accurate, might result in loosening even in a well-installed prosthesis. The constrained artificial joint possessing its own mechanism of function allows full restoration of the leg axis and early ambulation and weight bearing, which are essential for the elderly. Bearing in mind the method of fixation, the function, and the results of the prosthesis used, the implantation of a constrained prosthesis more suitable to the elderly is strongly advised. PMID- 2766628 TI - Anterior cervical fractional interspace decompression for treatment of cervical radiculopathy. A review of the first 66 cases. AB - Anterior cervical fractional interspace decompression (ACFID) is an anterior cervical partial discectomy that provides adequate neuroforaminal decompression but avoids segmental collapse and spontaneous fusion. Of 63 patients, 55 were followed from six to 49 months postoperatively (mean, 23 months). Good or excellent results were obtained in 64% of the patients and in 70% of the non Workers' Compensation patients. Eighty-five percent of the patients and 91% of the non-Workers' Compensation patients were satisfied with the results of surgery. Eighty-seven percent of the patients returned to their original work status. An average of only 1 mm of disc space height was lost. Only two (4%) disc spaces spontaneously fused. ACFID is indicated for radiculopathy due to both soft and hard discs and can be particularly valuable in treating patients with disc herniation adjacent to a previous fusion or radiculopathy with multiple-level myelographic filling defects. PMID- 2766629 TI - Ventilation/perfusion mismatch caused by emphysematous bullae. AB - A case of ventilation/perfusion mismatch caused by emphysematous bullae is presented. The presumed mechanism for the mismatch was vascular displacement of the pulmonary arterial tree by bullae with apparently normal ventilation. The latter may have been related to the circumferential distribution of the bullae around each lung. This entity represents an addition to the differential diagnostic list of causes of ventilation/perfusion mismatch on radionuclide lung images. PMID- 2766630 TI - Detection of impending pericardial tamponade during skeletal imaging. AB - Bone imaging using Tc-99m MDP was performed on a 68-year-old man with a newly diagnosed adenocarcinoma of the lung. The image unexpectedly showed increased activity in the heart area. Emergent echocardiography demonstrated impending pericardial tamponade. A malignant pericardial effusion was verified by pericardiocentesis. PMID- 2766631 TI - Thallium-201 imaging in anomalous left coronary artery originating from pulmonary trunk. AB - A 3-month-old infant with anomalous origin of the left main coronary artery (LMCA) from the pulmonary trunk was evaluated using resting thallium imaging. The imaging findings were consistent with myocardial scar and ischemia of the anterolateral and posterolateral walls in the distribution of the LMCA. PMID- 2766632 TI - Scintigraphic features of malignant epithelioid hemangioendothelioma. AB - The scintigraphic features of malignant epithelioid hemangioendothelioma of the liver have not been previously documented. In particular, there are no reports on the nature of gallium uptake in these rare tumors. The case reported is a young woman with primary hepatic epithelioid hemangioendothelioma. Metastatic disease in the skull was detected on a Tc-99m MDP bone scan. A Ga-67 study demonstrated that this tumor was not gallium avid. PMID- 2766633 TI - Neuroblastoma: imaging evaluation by sequential Tc-99m MDP, I-131 MIBG, and Ga-67 citrate studies. AB - Fourteen children with histopathologically confirmed neuroblastoma underwent sequential correlative imaging studies using I-131 MIBG, Tc-99m MDP, and Ga-67 citrate during various stages of the disease. Of the patients 86% showed I-131 MIBG accumulation in the primary tumoral site, whereas 71% showed Tc-99m MDP and 79% Ga-67 citrate uptake. In 86% at least one of the two latter radiopharmaceuticals concentrated in the primary tumor. The use of all three radiopharmaceuticals raised the detection rate to 93%. Of the osseous or extraosseous metastases 100% were detected by Tc-99m MDP studies. The I-131 MIBG studies were positive in 71% of the osseous metastases and in 70% of the extraosseous metastases. No Ga-67 citrate uptake was demonstrated in osseous metastases, although one extraosseous lung metastasis concentrated this radiopharmaceutical. Tc-99m MDP bone imaging was the best method for diagnosing metastatic spread of the disease and for monitoring the results of treatment. Primary tumor uptake was best indicated by I-131 MIBG. Both Ga-67 citrate and I 131 MIBG were superior to Tc-99m MDP with regard to accurately demonstrating the extent of primary tumors. Only Tc-99m MDP indicated the relationship of these tumors to the kidneys and neighboring osseous structures, providing early screening of kidney compression. Ga-67 citrate study was mainly indicated in tumors with catecholamine depletion, which failed to concentrate the other two radiopharmaceuticals. I-131 MIBG proved especially useful in detecting neuroblastoma with negative Tc-99m MDP and Ga-67 citrate studies and also proved to be helpful with those cases in which I-131 MIBG was planned for therapy. The following strategy is suggested for evaluating neuroblastoma.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2766634 TI - Patterns of gallium uptake in amebic liver abscesses. AB - Imaging with Ga-67 and Tc-99m sulfur colloid was performed in ten patients with amebic liver abscesses. The most common imaging pattern appeared to be with the sharp identification of a "rim" sign on delayed Ga-67 imaging, from 48-72 hours. PMID- 2766635 TI - Incidental discovery of a large duplication cyst during Meckel's scintigraphy. PMID- 2766636 TI - Ga-67 scintigraphy of ischiorectal fossa horseshoe abscess. PMID- 2766637 TI - Spontaneous reduction of testicular torsion during scrotal imaging. PMID- 2766638 TI - Indium-111 WBC imaging in a pericardial abscess. PMID- 2766639 TI - Adenocarcinoma of the prostate presenting as a single focus of radionuclide accumulation in the mandible on bone and gallium images. PMID- 2766640 TI - Quantification of bone mineralization by dual photon absorptiometry in osteopetrosis. PMID- 2766642 TI - Flank incisional hernia noted on radionuclide dynamic/static images. PMID- 2766643 TI - Auditory dysfunction in children with school problems. AB - One hundred thirty-three children with school problems referred to a hospital based multi-disciplinary clinic were screened audiologically to determine the frequency of auditory problems, and to determine whether one could predict auditory problems from clinical data. Ninety-three (69.9%) failed one or more parts of the screening procedure. Twenty-two children (7.9% of the total group) had abnormal hearing acuity, 33 (30.6%) abnormal speech discrimination in noise, and 73 (62.4%) abnormal short term auditory memory. These figures are significantly higher than those found in a representative sample of school children. Not one of 16 items from parent and teacher questionnaires and neurodevelopmental findings predicted auditory acuity or speech in noise problems; there were correlations between short term auditory memory items and parental and teacher rating of a language problem, teacher rating of reading and sequencing problem, and neurodevelopmental finding of auditory sequencing problem. In view of this inability to clinically predict auditory processing deficits, the authors suggest that a full audiological assessment, including short term memory and speech in noise testing, is warranted as part of the evaluation of children with learning difficulties. PMID- 2766641 TI - A case of false-positive bone imaging. PMID- 2766644 TI - Capillary blood glucose monitor. Evaluation in a newborn nursery. AB - The performance of a rapid capillary blood glucose monitor, the Glucoscan 2000, was evaluated in a neonatal patient population by comparison with a reference method on 283 paired patient samples. The median glucose was 56 mg/dL (3.1 mmol/L). The slope of the regression line was .93 with a correlation coefficient r of .82. The average error in Glucoscan values at low, intermediate and high glucose ranges was 43%, 20% and 12% respectively. Precision analysis by replicate determinations also showed an increased coefficient of variation, 7.4%, at low glucose values. PMID- 2766645 TI - Evaluating child sexual abuse. Observations regarding ano-genital injury. AB - The records of 944 children who had been examined by one pediatrician for alleged sexual abuse were analyzed. Sixty-four percent of the females and 34 percent of the males had positive findings suggestive of ano-genital injury. The data indicated that in girls with no evidence of injury, the hymenal opening diameter varied directly with age, but in those with evidence of injury, the opening size could not be correlated with age. PMID- 2766647 TI - Mixed fusobacterium and actinomyces pulmonary infection. Case report. AB - This is a report of a twelve-year-old black male who presents a history of left neck pain, left shoulder pain, weight loss and minimal fever. The admission diagnosis was a malignancy, supported by radiographic findings of consolidation of left lower and left upper lobes and periosteal new bone formation along the inferior aspects of the left second, third and fourth ribs. Open biopsy of the chest wall revealed a large abscess cavity. Subsequent cultures on anaerobic blood agar plates grew Actinomyces and Fusobacterium. The patient was treated with penicillin and improved clinically. This case emphasizes the need to culture tissue specimens for a wide array of organisms, including those not commonly seen today. A high index of suspicion is required for the diagnosis of anaerobic infections. Mixed anaerobic infections, including actinomyces, although uncommon in children, should be considered in the etiology of an intrathoracic mass. PMID- 2766648 TI - Paranasal sinus mucocele in cystic fibrosis. AB - The relationship between cystic fibrosis, nasal polyposis and chronic sinusitis is clearly defined. Mucoceles of the paranasal sinuses, however, are a well described complication of chronic sinusitis in adults; but they rarely occur in the pediatric age group. We report a three-year-old who presented with epiphora and fullness at the right medial canthus. Computed tomography confirmed a right ethmoid mucocele which was surgically drained, with resolution of symptoms. Approximately 12 other cases of mucoceles have been reported in the pediatric age group. Although many of these patients had recognized cystic fibrosis, some were previously undiagnosed. Only after presentation with a mucocele, did sweat testing reveal their underlying pathology. No pediatric patients in the literature were found with mucoceles and normal sweat tests. Paranasal sinus mucoceles may be diagnostic of cystic fibrosis and may be the presenting sign in some patients. PMID- 2766646 TI - Fusiform bacterial sepsis. Metastases with osteomyelitis and hepatic abscess occurring in a chaotic family. AB - Cases of fusiform bacteria sepsis have been reported infrequently in the pediatric literature. This case demonstrates the severe metastatic complications of fusiform bacterial sepsis including osteomyelitis, with multiple pathological fractures, sepsis, and abscesses of the liver. In the diagnostic evaluation of the etiology for this uncommon infection, child abuse was discovered in all children of this family. In children with uncommon infections and no underlying etiology, child abuse should be considered. PMID- 2766649 TI - Are certain HLA haplotypes responsible for low testosterone levels in males? AB - The level of testosterone on 138 HLA typed healthy males and 71 male rheumatoid arthritis patients were analysed. HLA-B15 was associated with a lower mean serum testosterone level in males than any other tissue type. This was observed in both the normal and RA groups. PMID- 2766650 TI - Molecular analysis of structural chromosome changes affecting chromosome band 11q23. AB - Involvement of the ets-1 proto-oncogene located at chromosome band 11q23 was studied in six tumors and in a congenital chromosome abnormality affecting the 11q23 region, in order to determine whether the breakpoint of these rearrangements was identical at the molecular level. In multiple restriction digestions a 5.4 kb EcoRI genomic probe of the c-ets-1 gene did not detect rearrangements in any of these samples. Thus, in these tumors the break in DNA was not within the domain of c-ets-1 recognized by this probe. However, after digestion with XbaI enzyme the probe detected a 2.4 kb polymorphic allele in placental DNA. One tumor DNA sample showed homozygosity for this polymorphic allele. In order to determine the frequency of this polymorphic allele, DNA from 50 additional tumors and from the blood of nine healthy donors was analyzed. DNA from one tumor showed homozygosity for the polymorphic allele. In the 67 DNA samples studied, 17.9 per cent were heterozygous for the polymorphic site and 3 per cent were homozygous for the polymorphic site. Thus, the overall frequency of the polymorphic allele in these samples was 0.111. PMID- 2766651 TI - Non random cytogenetic changes characterize Merkel cell carcinoma. AB - Merkel cell carcinoma is a rapidly proliferating neoplasm of neuroectodermal origin presenting in skin. Karyotypes obtained in direct preparations of three Merkel cell carcinomas were analyzed and compared with six other tumors which were reported in the literature. Of the nine tumors studied so far, eight (89 per cent) showed structural abnormalities of chromosome 1. These abnormalities were in the form of trisomy for chromosome 1q22----ter. Furthermore, it was also observed that the breaks of these rearrangements on chromosome 1 occurred at the bands to which c-oncogenes N-ras (p31), L-myc (p32), c-src (p36), c-ski (q22-22), and the beta-subunit of the nerve growth factor (NGF) (p22) were localized. In addition to structural changes, five out of the nine tumors (55.5 per cent) were trisomic for chromosome 1. Merkel cell tumors are often confused with small cell carcinoma of lung or peripheral neuroepithelioma. The cytogenetic abnormalities such as rearrangement of chromosome 3p and t(11;22)(q23;q12) which characterize lung carcinoma and peripheral neuroepithelioma, respectively, were not seen in any of the nine Merkel cell tumors studied. Thus it appears that rearrangement of chromosome 1 was non-randomly associated with Merkel cell carcinoma. It is of interest to note that genes involved in neuronal development and or differentiation have been mapped to the bands at which breaks occurred in these tumors. The significance of these changes is briefly discussed. PMID- 2766652 TI - The distribution of blood groups and HLA types in 59 cases of congenital dislocation of the hip. AB - One-hundred-and-eight patients with congenital dislocation of the hip (CDH) were ABO and Rh(D) typed. Fifty-nine of these patients were also HLA-A, -B, and -DR typed whenever technically possible and in addition the Rhesus, MNSs, Lutheran, Kell, Duffy, and Kidd groups were determined as part of a wider study into hereditary factors in CDH. No association was found between CDH and any of these red cell groups and HLA types. A slight trend towards a decrease of the HLA antigens B7 and DR2 was noted, and a slight increase of B27 and DR7. The increase in frequency of group B present in Italian children was not found in this British study, nor did we find an increase of HLA-A1 as previously reported in Greek children with CDH. PMID- 2766653 TI - Diet-induced thermogenesis in patients with gastrointestinal cancer cachexia. AB - 1. Indirect calorimetry has been used to measure resting energy expenditure (REE) and the thermogenic response to a test meal (diet-induced thermogenesis) in groups of weight-stable and weight-losing patients with gastrointestinal adenocarcinoma. Average daily intakes of energy and protein were computed from dietary assessment for the week before hospitalization. Results were compared with a control group of patients with benign gastrointestinal disease. 2. Weight losing cancer patients had a significantly reduced mean total energy and protein intake. 3. There was no significant difference in REE between the groups when results were normalized in terms of metabolic body size (kJ/kg 0.75) and lean body mass (kJ/kg). 4. Diet-induced thermogenesis was reduced in weight-losing cancer patients. 5. It is suggested that the reduction of diet-induced thermogenesis in weight-losing cancer patients is another element of starvation adaptation, subsequent to their weight loss, and that altered thermogenesis does not contribute to the weight loss seen in cancer cachexia. PMID- 2766654 TI - Problems in measuring human leucocyte cation content: effects of cell preparation and handling. AB - 1. Previous published measurements of leucocyte cation content are inconsistent, with sodium concentrations having particularly high coefficients of variation. We have measured the effects of recovery time after isolation, different types of handling, and centrifugation on leucocyte sodium and potassium content. 2. Sodium content fell markedly during the first 30 min after isolation and was stable from 1 to 3 h of incubation. There was a small but significant rise in potassium content over the same time period. 3. During incubation, occasional gentle resuspension of the cells gave optimal sodium contents, whereas mixing by inversion caused large falls in sodium and potassium content. 4. Centrifugation of stable cells at 200 g for 6 min caused marked increases in sodium content. PMID- 2766655 TI - An investigation of the role of possible neural mechanisms in cholera toxin induced secretion in rabbit ileal mucosa in vitro. AB - 1. Cholera toxin stimulates intestinal secretion in vitro by activation of mucosal adenylate cyclase. However, it has been proposed that cholera toxin promotes secretion in vivo mainly through an indirect mechanism involving enteric neural reflexes. 2. We examined this hypothesis further by studying the influence of neuronal blockade on cholera toxin-induced changes in fluid transport across rabbit ileum in vitro. Mucosa, stripped of muscle layers, was mounted in flux chambers and luminal application of crude cholera toxin (2 micrograms/ml) caused a delayed but sustained rise in the short-circuit current, electrical potential difference and Cl- secretion. Pretreatment with the nerve-blocking drug, tetrodotoxin (5 x 10(-6) mol/l serosal side), failed to influence the secretory response to cholera toxin, and addition of tetrodotoxin at the peak response to cholera toxin also had no effect. 3. That tetrodotoxin could block neurally mediated secretagogues was confirmed by the demonstration that the electrical responses to neurotensin (10(-7) mol/l and 10(-8) mol/l) were blocked by tetrodotoxin (5 x 10(-6) mol/l). Furthermore, the response to cholera toxin of segments of ileum, which included the myenteric, submucosal and mucosal nerve plexuses, was not inhibited by tetrodotoxin. 4. We conclude that cholera toxin induced secretion in rabbit ileum in vitro is not mediated via a neurological mechanism. PMID- 2766657 TI - Vitamin D deficiency and muscle strength in male alcoholics. AB - 1. Chronic alcoholism may be complicated by proximal muscle weakness associated with a selective atrophy of type II skeletal muscle fibres. The histopathological findings are non-specific as identical changes are seen in proximal muscle weakness associated with various metabolic myopathies, including osteomalacia. 2. The maximum voluntary contraction (MVC) of the dominant quadriceps and plasma 25 hydroxycholecalciferol [25-(OH)D] were measured in male alcoholics and control subjects to determine whether vitamin D deficiency contributed to proximal muscle weakness. 3. In both groups MVC declined with age and was related to body build. The distribution of plasma 25-(OH)D was skewed in alcoholics, with the mean significantly lower than in control subjects. Seventeen per cent of patients (but none of the control subjects) had pronounced biochemical deficiency [plasma 25 (OH)D less than 10 nmol/l]. 4. Alcoholics were significantly weaker than control subjects, even after correcting for the effects of age, height and weight. The severity of associated liver disease (cirrhosis vs no cirrhosis) did not influence muscle strength. Variation in plasma 25-(OH)D and albumin made an insignificant contribution to the difference in MVC observed between patients and control subjects. 5. We conclude that proximal muscle strength is reduced in chronic alcoholism but that this is not due to associated vitamin D [25-(OH)D] deficiency or alcoholic cirrhosis. PMID- 2766656 TI - Evidence for a decreased noradrenaline sensitivity in mesenteric resistance vessels from rats with chemical renal medullectomy. AB - 1. Chemical renal medullectomy was performed in Wistar rats by intraperitoneal injection of 2-bromoethylamine hydrobromide (200 mg/kg body weight). The effect of this treatment upon blood pressure and mesenteric vascular reactivity and morphology was studied 3 weeks after treatment. 2. Blood pressure was significantly raised in medullectomized rats. The indirect systolic pressures (means +/- SEM) were 112 +/- 2.4 mmHg (14.9 +/- 0.32 kPa) and 123 +/- 3.5 mmHg (16.4 +/- 0.5 kPa) (P less than 0.02) for control (n = 12) and medullectomized (n = 12) rats, respectively. However, there were no significant changes in the morphology of the mesenteric resistance vessels. 3. Maximum pressor responses and Ca2+ sensitivities were unchanged in these vessels compared with controls, but the sensitivity to noradrenaline was significantly reduced. Noradrenaline pD2 (= log ED50) values (means +/- SEM) were 5.87 +/- 0.03 and 5.69 +/- 0.08 (P less than 0.05) for control (n = 12) and medullectomized (n = 12) rats, respectively. 4. This study demonstrates that in this model of hypertension the noradrenaline sensitivity is reduced in mesenteric resistance vessels, but there are no detectable morphological changes associated with the rise in blood pressure. PMID- 2766658 TI - Platelet cytosolic free calcium in essential hypertension: responses to vasopressin. AB - 1. Resting and stimulated free calcium concentrations have been measured in platelets loaded with the fluorescent probe quin2 from 30 patients with essential hypertension and from 30 age-matched controls. 2. Cytosolic free calcium concentrations were 94.6 +/- 2.7 (mean +/- SEM) in the hypertensive group and 91.7 +/- 2.8 nmol/l in the normotensive group, the difference was not significant. 3. Arginine vasopressin caused a transient increase in platelet free calcium concentration in all subjects. In the presence of extracellular calcium the increase was significantly higher in the control subjects than in the hypertensive patients (P = 0.005). In the absence of extracellular calcium, arginine vasopressin caused much smaller increases, and there was then no difference between the responses of the two groups. 4. Platelet free calcium concentrations were measured again in 13 patients after 8 weeks treatment with either verapamil (n = 6) or atenolol (n = 7). The reductions in systolic pressure after drug treatment were correlated with the changes in cytosolic free calcium concentrations (r = 0.75, P less than 0.01). PMID- 2766659 TI - Time course of development of changes in the structure and reactivity of small veins from portal hypertensive rabbits. AB - 1. Myographic and histological techniques were used to study the mechanical and morphological properties of oesophageal and mesenteric veins from rabbits subjected to 0, 4, 14 and 90 days of partial portal vein stenosis. 2. The stenosis caused an immediate increase in portal pressure from 10.5 mmHg (1.4 kPa) to 20.5 mmHg (2.7 kPa); the pressure returned to the control level by 90 days. 3. The lumen diameter of oesophageal veins was increased by 76% after 4 days and by 147% after 90 days, while that of the mesenteric veins was unchanged. The media thickness in both veins increased rapidly, reaching a maximum at 14 days (82%, oesophageal; 56%, mesenteric) and thereafter decreasing. 4. The contractility of oesophageal veins was transiently decreased (at 4 days), while that of the mesenteric veins was transiently increased (at 14 days). 5. In further experiments, sclerosing of the oesophagus, which is believed to restrict flow without reducing pressure, restricted the increase in lumen diameter of oesophageal veins caudal to the sclerosing site, but did not affect the media thickness. 6. The results suggest that, in oesophageal and mesenteric veins, portal pressure is a primary determinant of media thickness but not of lumen diameter. PMID- 2766660 TI - Altered erythrocyte cation permeability in familial pseudohyperkalaemia. AB - 1. Erythrocyte cation transport pathways have been investigated in a family with pseudohyperkalaemia. 2. Ouabain- and bumetanide-resistant Na+ and K+ effluxes in three pseudohyperkalaemic patients were not different from those of control subjects when assessed at 37 degrees C. 3. When the temperature was decreased to 20 degrees C and 9 degrees C, K+ passive permeability markedly increased and Na+ permeability remained unchanged in these patients. In contrast, in control subjects a reduction in temperature caused a marked reduction in Na+ and K+ passive permeability. 4. These findings could account for the marked increase in plasma K+ concentration observed at subphysiological temperatures. 5. The Na+-K+ co-transport pathway was reduced in all members of the family, but the Na+-K+ pump was reduced in only two of them. These alterations were independent from the pseudohyperkalaemic state. PMID- 2766661 TI - The antihypertensive and renal activities of potassium canrenoate are associated with increased renal prostaglandin excretion. AB - 1. In a double-blind, randomized, cross-over study the effects of potassium canrenoate administration (100 mg twice daily for 10 days orally) on renal prostaglandin synthesis (prostaglandin E2 and prostaglandin F2 alpha) were evaluated in 10 normotensive females and in 10 females with essential hypertension. 2. When compared with normotensive subjects, hypertensive patients in baseline conditions showed a reduced excretion of urinary prostaglandin E2 associated with an excessive prostaglandin F2 alpha production. 3. Potassium canrenoate significantly reduced mean blood pressure in hypertensive patients [from 118.9 +/- 8.7 mmHg (1.62 +/- 0.12 kPa) to a peak minimum value of 104.7 +/- 9.8 mmHg (1.42 +/- 0.13 kPa) on the seventh day of treatment; P less than 0.01 for the whole period] but not in control subjects [from 88 +/- 9.4 mmHg (1.20 +/- 0.13 kPa) to 84.3 +/- 8.3 mmHg (1.15 +/- 0.11 kPa) on the eighth day, NS] even though potassium canrenoate significantly increased sodium excretion in both groups. Renal prostaglandin excretion was affected differently in the two groups: in control subjects excretion of both prostaglandin E2 and prostaglandin F2 alpha was increased after drug administration, whereas in hypertensive patients only prostaglandin E2 excretion was enhanced. PMID- 2766663 TI - The safety of blood transfusions. PMID- 2766662 TI - A modified method of quantifying the carotid baroreceptor-heart rate reflex in man: the effect of age and blood pressure. AB - 1. Carotid baroreceptor-heart rate sensitivity has been measured non-invasively by a modified neck-chamber method that utilizes all cardiac intervals recorded in 6 min during 84 respiratory cycles. 2. In a replication study in 10 subjects the mean baroreflex sensitivity was 5.52 ms/mmHg and the mean (SD) difference between determinations was 0.70 (0.74) ms/mmHg. 3. Baroreflex sensitivity was measured in 48 untreated subjects of mean age 43 (range 20-71) years with blood pressures ranging from 104 to 202 mmHg (13.9 to 26.9 kPa) systolic and 52 to 120 mmHg (6.9 to 16.0 kPa) diastolic [average 142/87 mmHg (18.9/11.6 kPa)]. Both systolic and diastolic pressures correlated with age (r = 0.53, P less than 0.001 and r = 0.44, P less than 0.01). 4. Baroreflex sensitivity determined throughout respiration was log-normally distributed with a median value of 2.24 ms/mmHg, which declined with age (r = -0.63, P less than 0.001). 5. After allowing for the effects of age, baroreflex sensitivity throughout respiration was not independently related to either systolic or diastolic blood pressure. PMID- 2766664 TI - CMS challenged on (pro-choice) resolution 23P. PMID- 2766665 TI - The Colorado Indigent Care Program: an update. PMID- 2766666 TI - Coagulation disorder due to apparent inadvertent heparin administration. AB - A new competitive binding assay, which measures the concentration of heparin rather than its activity, was used to confirm the presence of a high concentration of heparin in blood samples from a patient which showed unexpected gross prolongation of thrombin time (TT) and activated partial thromboplastin time (APTT). Extrapolation of the heparin concentration enabled estimation of the likely time of administration and the probable dose given. It is possible that an error in dosage may have arisen due to the striking resemblance of vials containing different amounts of heparin marketed by different manufacturers. There is a need for the adoption by manufacturers of a standard coding scheme for vials containing different amounts of heparin (as is adhered to in the case of some drugs, e.g. warfarin), in order to pre-empt this possible source of error. PMID- 2766667 TI - Red blood cell morphology after a 100-km run. AB - We studied the red blood cells of male athletes competing in a 100-km run. The RBC, haematocrit, and red cell indices were unaffected. The red cell morphology was studied in a wet preparation with light microscopy. A slight stomatocytosis was observed after the run compared to a control day (12.4 +/- 1.8% vs 4.3 +/- 1.8%, P less than 0.05). This difference persisted when runner red cells were incubated in buffer. Red cells from a normal donor did not undergo stomatocytic transformation when incubated in runner plasma. These data indicate that stomatocytosis after long-distance running is not caused by a plasmatic factor but is a change in the red cell membrane itself. PMID- 2766668 TI - Identification of blast cells in the peripheral blood of patients with acute leukaemia using the Technicon H-1. AB - The Technicon H-1 counter represents a refinement of the cytochemistry-based technology of its predecessors, the H6000 and the Hemalog-D. It also has a new channel, the basophil-lobularity channel, which is said to enhance the sensitivity of leukaemic blast detection in comparison with previous instruments. To evaluate this facility, 35 adult patients with acute leukaemia at different phases of their disease were monitored for the presence of circulating leukaemic blasts during a 4-week period. The ability of the H-1 to detect blasts was compared to a careful manual review of a blood and bone marrow smear. Using the latter review as the standard, the sensitivity was 83.8% with a specificity of 78%. Exclusion of patients with severe leucopenia (less than 1.0 x 10(9)/l) increased the specificity to 89%, with little alteration in the sensitivity. We were unable to confirm the high degree of sensitivity claimed in previous reports. The H-1 blast flag, however, would appear useful for screening patients who are off therapy or on maintenance regimens. PMID- 2766669 TI - Change in red blood cell distribution width with iron deficiency. AB - Red cell volume distribution width (RDW-CV) was examined as a means of diagnosing iron deficiency. Iron deficiency was classified as iron deficiency anaemia, prelatent or latent iron deficiency in 1648 students. MCV and RDW-CV (mean +/- ISD) in each group were 89 +/- 4 ft, 12.7 +/- 0.7% in normal individuals, 89 +/- 4 fl, 13.2 +/- 0.8% in prelatent deficiency, 86 +/- 6 fl, 14.0 +/- 1.5% in latent deficiency, and 79 +/- 7 fl, 15.6 +/- 1.7% in iron deficiency anaemia, respectively. Although microcytosis was evident only in iron deficiency anaemia, RDW-CV showed larger values concomitant with the development of iron deficiency. The sensitivity of RDW-CV for the diagnosis of iron deficiency anaemia was 77.1%, and for iron deficiency anaemia and latent deficiency 49.2%, the specificity being 90.6%. In countries with a high prevalence of iron deficiency and low thalassaemia, iron deficiency should be screened by RDW-CV determination without serum iron or ferritin measurements. PMID- 2766670 TI - Severe haemolytic anaemia associated with fatal cholestatic liver disease. PMID- 2766671 TI - Atypical presentation of the hyperleucocytic syndrome: acute myeloid leukaemia with iliac artery occlusion. PMID- 2766672 TI - Spontaneous (pathological) rupture of the spleen in non-Hodgkin's lymphoma. PMID- 2766673 TI - Noramidopyrine-induced agranulocytosis. PMID- 2766674 TI - Apparent warfarin resistance due to poor compliance. PMID- 2766675 TI - Radioisotope studies in monitoring of Gaucher's disease and its treatment. AB - Radioisotope studies (blood volume, spleen function, and ferrokinetics) were performed in seven patients with chronic (type 1) Gaucher's disease. Interestingly, the 52Fe scans and spleen histology demonstrated extramedullary haemopoiesis in the liver and spleen. Radioisotope measurements (red cell volume, plasma volume, red cell pool, damaged cell clearance, spleen blood flow, 59Fe clearance, red cell utilization and 52Fe scans) provide methods for accurate measurement of the bone marrow and spleen function, thereby enabling prediction of the most suitable time for splenectomy, in the treatment of patients with Gaucher's disease. PMID- 2766676 TI - Prevention of urate nephropathy in the tumour lysis syndrome. AB - Patients with acute lymphoblastic leukaemia and a high tumour burden are at risk of developing acute renal failure when given chemotherapy. Rapid cell lysis releases a high urate load which may result in an obstructive urate nephropathy. This complication should be prevented by establishing an alkaline diuresis before initiating steroid or other chemotherapy. PMID- 2766678 TI - Variability in muscle fibre areas in whole human quadriceps muscle: how to reduce sampling errors in biopsy techniques. AB - A single biopsy is a poor estimator of the muscle fibre cross-sectional area (CSA) for a whole human muscle because of the large variability in the fibre area within a muscle. To determine how the sampling errors in biopsy techniques can be reduced, data on the CSA of type 1 and type 2 fibres obtained from cross-sections of whole vastus lateralis muscle of young men, have been analysed statistically. To obtain a good estimate of the mean fibre CSA in a biopsy, measuring all fibres in that biopsy gives the best result. To obtain a good estimate of the mean fibre CSA for a whole muscle, the number of biopsies has a much greater influence on the sampling error than the number of fibres measured in each biopsy, but the number of biopsies needed to obtain a given sampling error can vary by a factor of two. If the fibre CSA in three or more biopsies is measured, it is sufficient to measure only 25 fibres in each biopsy. If less than three biopsies are taken, there is no worthwhile reduction in sampling error when more than 100 fibres are measured. To determine the mean fibre CSA for a whole group of individuals, our preference is to maximize the number of individuals, and only take single biopsies. In conclusion, to determine the mean fibre CSA for this particular muscle with a certain precision, we suggest analysis of three biopsies, taken from different depths of the muscle, and measurement of 25 fibres in each biopsy. PMID- 2766677 TI - Beta-adrenergic blockade does not influence the thermogenic response to a mixed meal in man. AB - The sympathetic nervous system has been implicated in the regulation of glucose induced thermogenesis in man. The present study was undertaken to examine the influence of a pharmacological beta blockade on the thermogenic response after ingestion of a mixed meal. Ten healthy male volunteers were examined on two occasions, once during intravenous administration of beta-blocking agent (Series 1) and once without (Series 2). Five subjects received propranolol and the other five atenolol. Two subjects were also studied on a third occasion after 1 week of other propranolol medication (Series 3). Continuous respiratory gas exchange measurements were carried out for 1 h in the basal state and then for 3 h postprandially. The subjects ingested a standardized test meal in liquid form. After the meal oxygen uptake and energy expenditure both rose markedly during the first hour and then reached a relatively stable plateau. The average increase in oxygen uptake above basal during the whole study period was 27.0 +/- 1.4 vs. 26.7 +/- 1.4% (NS) in Series 1 and 2, respectively. The corresponding values for energy expenditure were 28.6 +/- 1.4 vs. 28.6 +/- 1.6%. Also in absolute terms, the increments above basal did not differ between the two series. Moreover, the basal measurements and the response to the meal were no different in the subjects in Series 1 receiving the selective beta-1 antagonist and the non-selective blocker, respectively. In conclusion, the present findings indicate that in healthy man, beta-adrenergically mediated sympathetic nervous system activity does not significantly influence the magnitude of the thermogenic response to a mixed meal. PMID- 2766679 TI - Body composition measurement by dual photon absorptiometry: comparison with body density and total body potassium measurements. AB - Body composition was measured in 29 healthy adults (12 men and 17 women) by three different methods: Dual photon (153Gd) absorptiometry (DPA), body density measurements (BD) and measurements of total body potassium (TBK). Correlation and regression analysis with the body fat percentage (Fat%) measured by the three different methods gave r values between 0.83 and 0.90 and SEEs between 4.0 and 6.0 (Fat%). We conclude that DPA provides a new method of measuring body composition with precision and accuracy errors in the same range as the more established methods. PMID- 2766680 TI - Vasodilatation in human skin induced by low-amplitude high-frequency vibration. AB - Vasomotor effects in human skin induced by vibration of low amplitude (10-25 microns) and high frequency (150-250 Hz) have been studied by using skin temperature changes as an approximative measure of variations in skin blood flow. In all tested areas of the body surface, including the face, low-amplitude high frequency vibration regularly induces vasodilatation. The spatial distribution of the temperature changes induced from different sites of stimulation was studied by infrared thermography. The latencies of the temperature changes, determined by thermistor recordings, were found to vary with site of stimulation and stimulus parameters. The increase in temperature to a given stimulus is greater the lower the prevalent skin temperature, i.e. the increase in blood flow is larger the greater the initial vasomotor tone. The results are in accordance with the view that the vasodilatation is due to a reflex inhibition of pre-existent vasomotor tone in the skin by the afferent inflow from vibration-sensitive mechanoreceptors. High-amplitude vibration (100-200 microns), performed in a few comparative experiments, caused vasoconstriction. PMID- 2766681 TI - Determination of blood pressure level and changes in physiological situations: comparison of the standard cuff method with direct intra-arterial recording. AB - Blood pressure changes during a test series (sitting, supine, standing, bicycle ergometer test, recovery) were determined in a group of normotensive and borderline hypertensive subjects simultaneously with the continuous intra arterial registration (Oxford method) and the indirect cuff methods. The mean method difference between the direct and indirect method varied considerably in tests, from -2.3 to 12.9 mmHg in systolic pressure and from -4.3 to 18.2 mmHg in diastolic pressure. There was also a large scatter in the method difference between subjects. Analysis of the blood pressure responses to the other tests using values measured in the sitting position as the reference also revealed considerable variation between the methods. The accuracy of the indirect method was also tested by classifying the population in two subgroups along the median (high/low group) in all tests by each method. The classification discrepancy between the methods varied from 9 to 33% in systolic pressure and from 0 to 25% in diastolic pressure. The results indicate that the data gathered using the indirect measuring method from the arterial blood pressure level and changes in varying physiological conditions may differ considerably from direct intra arterial readings. On the other hand, the repeatability of the indirect method in stabile conditions was found to be acceptable indicating that the indirect method is useful in blood pressure follow-up. PMID- 2766682 TI - Single and multiple breath nitrogen wash-out--closing volume and volume of trapped gas for detection of early airway obstruction. AB - Thirty-eight patients with varying degrees of peripheral airway involvement were studied by flow-volume curves and two nitrogen wash-out techniques in an on-site study. Closing capacity (CC), closing volume in percentage of vital capacity (CV%), slope of the alveolar plateau (phase III), volume of trapped gas (VTG), and maximum expiratory flow at 50 and 75% of vital capacity (MEF50, MEF25) were determined and correlation analyses were performed. A biphasic or exponential correlation was noted between the degree of airway closure and VTG with rapidly increasing VTG at high CC. Although there were correlations between spirometry and the two nitrogen wash-out techniques, a large scatter precluded the use of the flow-volume variables to predict CC, CV% and VTG. The coefficient of variation was lower for the measurements of CV% than for the recording of VTG. Since the single breath nitrogen wash-out technique is also technically simpler it is recommended prior to the multiple breath technique. PMID- 2766683 TI - Plasma concentrations of adrenaline, noradrenaline and dopamine during forearm dynamic exercise. AB - In six healthy volunteers plasma concentrations of adrenaline, noradrenaline and dopamine were measured at rest and during dynamic forearm exercise at submaximal and maximal intensities. Arterial and venous concentrations of adrenaline and noradrenaline increased with forearm exercise at all workloads. Dopamine concentrations did not change. The increases in adrenaline and noradrenaline were almost linearly related to the increase in heart rate with no levelling off at maximal exercise intensities. It is concluded that dynamic exercise with the forearm muscle group causes a small but significant activation of the sympatho adrenal system as reflected by increases in plasma concentrations of adrenaline and noradrenaline. PMID- 2766684 TI - Renal function, aging, and drug therapy. PMID- 2766685 TI - Family understanding of psychiatric illness. AB - Family members of patients with a diagnosis of schizophrenia were surveyed to ascertain their understanding of their relative's illness. This paper reports on deficits in knowledge of family members as they struggle to absorb the repercussions of chronic illness. It was useful for the development of a psycho education treatment curriculum while dramatically demonstrating the need for it. PMID- 2766686 TI - Predicting community tenure after psychiatric hospitalization. AB - Seventy-seven state psychiatric hospital patients were interviewed six months following discharge in order to examine the relationship between a set of client variables and community length of stay (CLOS), but with a measure of client perceived general well-being included as a possible mediator of relationships. A study of the relationship between CLOS and general well-being, using hierarchical regression analysis and path analysis, was expected to provide a more complete picture of client community functioning. Results demonstrated a strong relationship between CLOS and general well-being and, also, a number of measures predictive of community success related to CLOS only through general well-being. These findings indicated the importance of considering how clients perceive their general well-being in optimizing chances for community success. PMID- 2766687 TI - Capitated payments for mental health care: the Rhode Island programs. AB - Capitation financing for the delivery of mental health care under public programs is receiving increasing attention from policymakers. Most initiatives in this respect are in the planning or early implementation stages. This paper describes five years of experience with capitated financing for mental health care in the state of Rhode Island. It discusses the motivation for the programs, their design, and the issues that have arisen with respect to their operation. The Rhode Island experience demonstrates that capitated financing for mental health care is feasible and that Community Mental Health Centers can operate effectively as providers of care under these arrangements. It also suggests that capitated programs can have unanticipated impacts on the operation of community-based mental health service delivery programs. PMID- 2766688 TI - Geographic location and mental health services utilization among the chronically mentally ill. AB - This study examined the relationship between geographic location and use of mental health services using data collected on 1053 Community Support Program (CSP) clients. Multiple regression analyses revealed that geographic location (i.e., urban, suburban, rural) influences mental health services utilization even when service availability and accessibility, socio-demographic and need factors are controlled. The results do not support the assumption that rural residence has uniformly negative effects on service use. Rural CSP clients, for example, were more likely to use crisis and supportive housing services than their urban counterparts. The findings suggest that models of service utilization must be carefully specified with regard to residential location. PMID- 2766689 TI - Model services for treatment/management of the mentally retarded-mentally ill. AB - Mental illness affects nearly 25-30% of America's mentally retarded population. While a small number of these individuals will require institutional care, it is clearly possible to serve the majority in community-based residential settings. This paper will provide an overview of the various types of mental illness found in the mentally retarded population currently served by the Eastern Nebraska Community Office of Retardation (ENCOR), examine the treatment challenges which the provision of services to this special population have presented, and share recommendations as to how the ENCOR model can assist other communities in serving similar complex subpopulations in a developmental and cost-efficient manner. PMID- 2766690 TI - Protection and advocacy for the mentally ill: new hope for emotionally disturbed children? AB - A study was conducted to ascertain the potential effect of recent federal protection and advocacy legislation (Public Law 99-319) on the lives of mentally ill children. Findings indicate a strong potential, especially regarding efforts to improve community based services. Implications for mental health professionals and CMHCs are examined. PMID- 2766692 TI - VIth Complement Genetics Workshop and Conference. July 27-29, 1989, Mainz, FRG. Abstracts. PMID- 2766691 TI - Social support and self-esteem as intervening variables in the relationship between social roles and women's well-being. AB - The effects of social roles on women's well-being are explored in an analysis which incorporates social support and self-esteem as intervening variables. The impact of roles on well-being is expected to occur primarily through these intervening variables. An analysis of a national sample of adult women reveals that the only social roles to impact well-being through effects on social support or self-esteem are employment and parenthood. Results indicate that parenthood has a weak positive effect on support and marriage reduces levels of distress. Employment does not enhance well-being via social support but does have a positive effect on self-esteem. Community programs which encourage social participation and which involve esteem enhancing activities are recommended. PMID- 2766693 TI - Effects of breed and wintering diet on growth, puberty and plasma concentrations of growth hormone and insulin-like growth factor 1 in heifers. AB - Twenty-five Brangus (BR) and 15 Angus (AN) heifers were used to study the effects of breed and wintering diet on average daily gain (ADG), onset of puberty and plasma concentrations of growth hormone (GH) and insulin-like growth factor 1 (IGF-1). Wintering diets (fed for 107 days beginning November 15) consisted of the following: 1) native grass hay (NGH), 2) ammoniated NGH, 3) NGH plus cottonseed meal, 4) Diet 3 plus corn and 5) Diet 4 plus monensin. After wintering, heifers were transferred to ryegrass pasture for 70 days. Mean ADG during the wintering phase were -.20, -.10, .17, .29 and .39 kg for heifers fed Diets 1 through 5, respectively (P less than .01). ADG was greater (P less than .05) for BR than for AN heifers. Plasma concentrations of GH were higher (P less than .05) in heifers fed Diets 1 and 2 than in heifers fed Diets 3, 4 or 5. Plasma concentrations of IGF-1 were lowest in heifers fed Diet 1 and highest in heifers fed Diets 4 and 5. During ryegrass grazing, GH concentrations were similar for all groups. However, concentrations of IGF-1 were higher (P less than .05) in heifers fed Diets 3, 4 and 5 than in heifers fed Diets 1 and 2. Age at puberty (onset of cyclic progesterone concentrations) was greatest in heifers fed Diet 1 and lowest in heifers fed Diet 5. Weight at puberty was not affected (P greater than .10) by wintering diet but was greater (P less than .01) in BR than in AN heifers. Therefore, negative ADG appears to be associated with elevated plasma GH concentrations in heifers, and plasma IGF-1 concentration appears to be a more accurate indication of nutritional status than plasma concentrations of GH. PMID- 2766694 TI - Temporal pattern of insulin-like growth factor-I response to exogenous bovine somatotropin in lactating cows. AB - The effect of exogenous bovine somatotropin (bST) treatment on the temporal pattern of insulin-like growth factor-I (IGF-I) in serum of four multiparous Holstein cows was examined. Cows (190 +/- 24 days postpartum) were treated with daily subcutaneous injections of recombinant bST (40 mg) or excipient for 12-day periods in a crossover experimental design. During excipient treatment, concentrations of IGF-I in serum were relatively constant throughout the day and averaged 70 ng/ml. Following the first bST injection, serum IGF-I began increasing after a lag of 5 to 7 hr and progressively increased over the first 2 days of treatment. Serum IGF-I levels were approximately 2-fold greater than control values at the end of day 1 of bST treatment, with a 3-fold elevation observed at the end of day 2. Concentrations of IGF-I in serum plateaued by day 3 of bST treatment. Serum concentrations of IGF-I did not follow the oscillating pattern of bST in serum resulting from daily bST injections. Milk yield (3.5% fat corrected) plateaued after 6 days of bST treatment and was increased 61% (+15.3 kg). Both IGF-I and milk yield remained essentially constant across days for the remainder of treatment. Following cessation of treatment, serum IGF-I and milk yield gradually declined, returning to control values after approximately 4 days. The temporal pattern of circulating concentrations of IGF-I is consistent with a role for IGF-I in mediating a portion of the effects of exogenous bST in lactating cows. PMID- 2766695 TI - Pain and wound management. PMID- 2766697 TI - Health visitors: in the balance. PMID- 2766696 TI - The vital link-up. PMID- 2766698 TI - A model project. PMID- 2766699 TI - Patch testing in prurigo nodularis. AB - 32 patients with prurigo nodularis evaluated at the Mayo Clinic from 1975 to 1987 have been patch tested for sensitivity to appropriate allergen series; 25 of these had relevant positive reactions and subsequent follow-up to 5 to 14 years was available for 11. 6 patients had persistent disease and 5 had resolution or marked improvement. 3 of these latter patients noted a strong positive correlation between improvement and avoidance of contact allergens. Screening for contact sensitivity may be helpful in the management of this refractory dermatosis, particularly if there is a coexistent dermatitis. PMID- 2766700 TI - Sunflower allergy. On the constituents of the trichomes of Helianthus annuus L. (Compositae). AB - Sesquiterpene lactones (STL) of the sunflower, occurring in fragile multicellular capitate glandular hairs, have been shown to display a remarkable sensitizing capacity when investigated by experimental sensitization in guinea pigs. The strongest response was induced by the hemiketal form of 1-O-methyl-4,5 dihydroniveusin A. The STL content of 50 capitate glands was sufficient to elicit a remarkable response in the guinea pigs. Thus, touching a sunflower plant (with up to 1000 capitate glands per cm2) may lead to the release of sufficient STL to sensitize humans, and these substances can be considered to be responsible for the cases of allergic contact dermatitis described in sunflower growers since 1906. PMID- 2766701 TI - Prediction of susceptibility to an irritant response by transepidermal water loss. AB - The roles of the natural permeability of the stratum corneum to water, and the changes in that permeability effected by a single patch test, were investigated as parameters to predict the susceptibility of the skin to repeated exposures of an irritant. One site on the forearm skin of 27 non-atopic healthy subjects was exposed to a 0.5% concentration of sodium lauryl sulphate by a single occlusive 24-h patch. Another site was exposed to a twice daily 4-day repeated occlusive patch with the same irritant solution. The effects were evaluated by transepidermal water loss measurements made prior to the applications (baseline) on day 1 (BASE), following the single 24-h patch on day 2 (SINGL), and following the 4-day repeated applications on day 5 (REPET). Individuals with higher BASE had higher SINGL (R = 0.80, P less than 0.001) and higher REPET (R = 0.76, P less than 0.001). There was also a significant linear correlation between SINGL and REPET (R = 0.63, P less than 0.001). Multiple linear regression analysis of results, however, indicated that a high baseline TEWL is better indication of an individual's increased susceptibility (high REPET) to weak irritants than a high TEWL value following a single 24-h patch test. Baseline TEWL may therefore be used as a reasonably accurate preliminary "predictive" screening test for susceptibility to irritants. PMID- 2766702 TI - Allergic contact dermatitis from 3-(aminomethyl)-pyridyl salicylate. AB - 2 patients with acute allergic contact dermatitis from 3-(aminomethyl)-pyridyl salicylate are described. Both patients were females with histories of urticaria and showed cross-sensitization to substances of the para group. Clinical manifestations included eczema, angioedema and respiratory effects. In 1 patient, airborne elicitation was suspected. A lymphocyte transformation test confirmed the allergy, with an extremely high response index. 35 normal controls were negative. PMID- 2766703 TI - Condoms as a source of latex allergen and cause of contact urticaria. AB - To examine the occurrence of latex allergen in condoms and to study the symptoms caused by contact with condoms, 46 patients with latex-glove contact urticaria (LGCU) were investigated. 7 (24%) of the 29 patients with a history of condom use had experienced local swelling and/or pruritus during intercourse, confirming that condoms can cause local symptoms in latex allergic subjects. Prick tests performed on 16 different condom brands showed that 4 brands caused positive reactions in 52-67% of patients. The remaining 12 brands were not as allergenic and 1 brand was totally negative on prick testing. 1 highly allergenic condom brand was examined by high-pressure liquid chromatography (HPLC), which showed similar protein profiles to those detectable in latex gloves and natural rubber. These results show that, in addition to rubber gloves and balloons, condoms should also be considered as possible sources of latex, and that patients with LGCU should be advised to avoid condoms. PMID- 2766704 TI - Allergic contact dermatitis from nickel in eyeshadow. PMID- 2766705 TI - Allergic contact dermatitis from Euxyl K 400. PMID- 2766706 TI - A case of contact dermatitis from 'hypoallergenic' nail varnish. PMID- 2766707 TI - The significance of the zein test in the classification of cationic tensides. PMID- 2766708 TI - Recent unexplained patch test reactions to palladium. PMID- 2766709 TI - Sensitivity to amikacin. PMID- 2766710 TI - Bumetanide allergy in factory workers. PMID- 2766711 TI - Contact sensitization to acyclovir. PMID- 2766713 TI - Accidental occupational sensitization to p-nitrobenzoyl chloride in a chemistry student synthesizing procaine. PMID- 2766712 TI - Contact allergy to cistoran, an intermediate in ranitidine synthesis. PMID- 2766714 TI - Blunt hollow viscus injuries of the digestive tract: a poorly recognized phenomenon. AB - A review of records from admission to the trauma center at Yale-New Haven Hospital for a five year period (July 1981 through June 1986) revealed 41 blunt hollow viscus injuries in 31 patients. Organs injured included small intestine (18), large intestine (14), duodenum (6), stomach (2), and gall bladder (1). The most accurate predictors of blunt hollow viscus injury were peritoneal lavage (91%, n = 14) and abdominal tenderness (50%). Seventeen patients underwent early celiotomy with morbidity and mortality rates of 16% each. Nonetheless, 13 patients had delay in diagnosis with substantially higher morbidity (46%) and mortality (31%). Blunt hollow viscus injuries are uncommon, are difficult to diagnose, and can lead to major morbidity and mortality when diagnosis is delayed. PMID- 2766715 TI - AIDS cases with no identified risk: artifact or reality? The Connecticut example. AB - Connecticut's 66 AIDS cases initially reported with no identified risks (NIRS) were reviewed and intensively investigated. Investigation resulted in reclassification of 45 cases (68.2%) to categories of known risk; one case (1.5%) was misdiagnosed as AIDS. Twenty cases (30.3%) remain NIRS because no risk could be established at this time. Evidence that NIRS represent reporting artifact, rather than unknown or new modes of transmission, was found. (1) NIRS are cases for which information on sexual behavior is highly sensitive or difficult to obtain. After investigation, 72% of reclassified Connecticut NIRS were determined to have risks related to sexual transmission. (2) The percentage of NIRS fluctuates according to reporting source and method of investigation. Within Connecticut, major reporting sources vary from a high of 15% to a low of 0% NIRS among their cases. The most effective method for establishing risks was to obtain information from reporting sources. PMID- 2766717 TI - An experience in social medicine: the Jardin Mafalda in Bogota, Colombia. PMID- 2766718 TI - South Park Inn medical student clinic. PMID- 2766716 TI - The ethos of public health. PMID- 2766719 TI - Harper's Fifth Reader: common ground. PMID- 2766720 TI - After McConnell: the process continues. PMID- 2766721 TI - Risk factors for breast fibroadenoma in young women. AB - In a case-control study, 178 women diagnosed with fibroadenoma (FA) between 1976 and 1982 were compared with 178 age-matched controls in order to assess the risk factors for FA. Women who had a previous diagnosis of breast disease were excluded. The odds ratios (OR) of FA were calculated for different risk factors of breast disease from bivariate analysis as well as multivariate regression analysis. The highest ORs were found for a previous premenstrual mastalgia before first childbirth and a familial history (FH) of breast cancer (BC). Oral contraceptive (OC) use before a first full-term pregnancy (FFTP) does not modify this risk. Also current use of standard oral contraceptives (SOC) containing 50 micrograms of ethinyl estradiol per pill appeared to be protective and the correlation with FA was negative. These findings underline: (a) the predictive value of premenstrual mastalgia for the subsequent development of breast disease; (b) only current high-dose OC use is protective. PMID- 2766722 TI - Pharmacokinetics of three bioequivalent norethindrone/mestranol-50 micrograms and three norethindrone/ethinyl estradiol-35 micrograms OC formulations: are "low dose" pills really lower? AB - We have examined the pharmacokinetic parameters derived from the analysis of plasma ethinyl estradiol (EE) and norethindrone levels after administration of a single dose of three bioequivalent norethindrone-1mg/mestranol (ME)-50 micrograms formulations (Ortho-NovumR 1/50, NorinylR 1/50 and Norcept-MR 1/50) and three norethindrone-1mg/ethinyl estradiol-35 micrograms formulations (Ortho-Novum 1/35R, NorinylR 1/35, Norcept-ER 1/35) in a randomized crossover design involving 24 women for the 35 micrograms and 27 women for the 50 micrograms agents. Differences between the AUC-EE of pairs from the same manufacturer (1 + 35 and 1 + 50) were not significantly different, indicating that 50 micrograms of mestranol was equivalent to 35 micrograms ethinyl estradiol with respect to this pharmacokinetic parameter. The Cmax values were also similar. Inter-individual coefficients of variation (C.V.) for the AUC-EE were 47% and 57% for the 1 + 35 and 1 + 50 agents, respectively. Intra-individual C.V.s were 41% and 42%, respectively. For norethindrone, the AUC was larger with the 1 + 50 formulations than with the 1 + 35 group (87.9 vs. 72.8 pg hr/ml). Additionally, the Cmax values were larger for the 1/50 group (17.7 vs. 14.0). Since the amount of norethindrone in the two dosage groups was the same, this difference in the pharmacokinetics between the 35 micrograms EE and the 50 micrograms ME formulations remains unexplained. The inter-individual C.V. averaged 56% for both dosage groups. The intra-individual C.V.s were 17% and 46% for the 1 + 35 and 1 + 50 groups, respectively. The large variation in blood levels of ethinyl estradiol and norethindrone between and within individuals may overshadow clinical differences attributable to differences in dosage. PMID- 2766723 TI - Development and application of a radioimmunoassay of the new progestagen gestodene. AB - A radioimmunoassay for the determination of gestodene (17-ethinyl-13-ethyl-17 beta-hydroxy-4,15-gonadien-3-one) in human plasma is described with regard to procedure, specificity, accuracy and reproducibility. Antiserum was raised against gestodene-3-O-(carboxymethyl)oxime-BSA in rabbits and [9,11-3H]-gestodene tracer was used with a specific radioactivity of 2.16 TBq/mmol. The final antiserum dilution was 1: 200,000. RIA was performed according to routine methods using diethylether plasma extracts and the charcoal separation technique. Cross reactivity of antiserum with cortisol, 17 beta-estradiol, progesterone, testosterone and ethinylestradiol was less than 0.03%; levonorgestrel exhibited a 5% cross-reactivity. No cross-reactivity with metabolites of gestodene or ethinylestradiol was found. Accuracy and precision of the assay were tested using human plasma samples spiked with 1, 5 and 10 ng/ml gestodene. Accuracy was within 94 to 104% of the nominal values. Within-assay and between-assay coefficients of variation were in the range of 4.7-6.5% and 10.3-13.1%, resp. This RIA was used to follow plasma gestodene levels after single oral administration of 75 micrograms of gestodene combined with 30 micrograms ethinylestradiol as tablet and coated tablet in a cross-over design in 6 female test subjects. Plasma gestodene levels were equivalent after both treatments. PMID- 2766724 TI - The Prentif cervical cap and Pap smear results: a critical appraisal. AB - An analysis from a randomized study has suggested that a larger percentage of Class III Pap smears appears among Prentif cervical cap users three months after initiation of use of the method than among diaphragm users. This suggestion has been the basis of a U.S. Food and Drug Administration (FDA) requirement that women seeking to use the cap have Pap smears taken before initiating use and again after three months of use. The data from the pivotal randomized study are reanalyzed here. No significant differences exist in the distributions of smears between cap and diaphragm users at three months or throughout the first year. The majority of cap users with "Class III" smears at three months did not have even mild dysplasia when subsequently evaluated by biopsy or colposcopy. This was also the case for diaphragm users classified as having grade III smears at three months. Other studies of the Prentif cap have not found conversions to Class III smears at one year. The requirement of a 3-month Pap smear is not only economically burdensome to potential users of the cap but appears to be without firm foundation in the original data or in our current views of cervical carcinogenesis. PMID- 2766725 TI - A study of breastfeeding and the return of menses and pregnancy in Karachi, Pakistan. AB - A longitudinal study of breastfeeding women was conducted to determine whether breastfeeding frequency is associated with the length of postpartum amenorrhea. The data are also conducive to testing the guidelines of the "Bellagio Consensus" (i.e., that there is no more than a 2% chance of pregnancy during breastfeeding in the first six months postpartum in the absence of vaginal bleeding and regular supplements). Twenty-eight breastfeeding women were followed-up weekly in Karachi, Pakistan. The frequency of breastfeeding was found to be a poor correlate of the duration of amenorrhea. Thirty-six percent of the women became pregnant during the study. However, all were having menses and/or giving regular supplements before the estimated date of conception, consistent with the Bellagio Consensus. In countries such as Pakistan, where contraceptive use is low, active promotion is needed to prevent the further decline of breastfeeding in order to retain its contraceptive as well as other maternal and child health benefits. PMID- 2766726 TI - Ethics in nephrologic progress. PMID- 2766727 TI - The natural history of IgA disease. PMID- 2766728 TI - Educational implications of nephrology progress. PMID- 2766729 TI - The role of myofibroblasts in renal interstitial fibrosis and their relationship with fibronectin and type IV collagen. PMID- 2766730 TI - Tubular ultrastructural findings in glomerulonephritis. PMID- 2766732 TI - Glomerular hemodynamics and salt balance in pregnant rats. PMID- 2766731 TI - Prevention of acute renal failure after aortic surgery. PMID- 2766734 TI - Uraemic toxins and blood purification strategies. PMID- 2766733 TI - Urinary sediment analysis: a useful tool? PMID- 2766736 TI - Potential contribution of artificial intelligence to nephrology. PMID- 2766737 TI - New trends in membrane development. PMID- 2766738 TI - Peritoneal dialysis in Italy. PMID- 2766735 TI - Growth in uremic children. PMID- 2766739 TI - Selective peritoneal protein loss. PMID- 2766740 TI - Peritonitis prevention in CAPD by intraperitoneal IgG. PMID- 2766741 TI - The ideal continuous ambulatory peritoneal dialysis connector. PMID- 2766743 TI - Problem solving skills versus problem based learning. PMID- 2766742 TI - On the pathophysiology of functional acute renal failure. PMID- 2766744 TI - Cecal torsion in a horse as a consequence of cecocolic fold hypoplasia. AB - Cecal torsion in horses is relatively rare. This clinical report describes cecocolic fold hypoplasia, producing increased cecal mobility, as a predisposing cause of cecal torsion in a horse. PMID- 2766745 TI - A hospital-based study of the relationship between retained placenta and mastitis in dairy cows. AB - We investigated the relation between retained placenta and mastitis in Holstein dairy cows admitted to the New York State College of Veterinary Medicine. Cows with retained placenta were three times more likely to develop mastitis during hospitalization than animals without retained placenta. Since the hospital population was not representative of the general population, the possibility of a bias existed; a large bias was not likely because most distorting variables occurred equally in animals both with and without retained placenta. The literature suggests that the relationship between retained placenta and mastitis may be mediated through activity of the peripheral leukocytes. Further research is necessary to test this hypothesis. PMID- 2766746 TI - The epidemiological control of nematodes in New England lambs. AB - Epidemiological control of nematodes in weaned lambs in New England was investigated over three grazing seasons (n = 58, n = 52 and n = 62 lambs, respectively). Spring prophylactic treatment, clean pasture and mid-summer treat and-move to hayfield strategies were compared to traditional fall treatments (control). In these studies when lambs were weaned prior to grazing, the most abundant nematodes were Nematodirus sp. Under these conditions, where only low levels of Haemonchus contortus were present, no significant improvement in body weight gain was observed for the epidemiologic approaches compared to the traditional fall treatments. No untreated control was used, and fecal egg counts and pasture larval counts indicate low total worm burdens with a controllable fall rise in pasture infectivity. These results indicate the importance of hypobiosis for the survival of H. contortus and suggest that weaning lambs prior to grazing can be an effective epidemiological control practice. PMID- 2766747 TI - Subclinical lumbar polyradiculopathy in aged domestic, laboratory, and exotic mammalian species--a light and selected electron microscopic study. AB - Lumbar polyradiculopathy, characterized by ballooning myelin sheaths and axonal distortion, was documented in multiple, aged, domestic, laboratory, and exotic mammalian species. Animals studied that exhibited this nerve rootlet change included the goat, sheep, pig, white-tailed deer, gerbil, vole, ferret, beaver, hedgehog, chinchilla, North Chinese leopard, lion, cheetah, mountain lion, llama, East African eland, Uganda giraffe, polar bear, and drill. Ultrastructurally, lumbar nerve rootlets from the North Chinese leopard revealed prominent and often multiple lamellar separations in the area of myelin bubbling. Clefts in myelin sheaths contained macrophages with engulfed fragments of myelin. Axons were sometimes variously attenuated, and the axoplasm contained densely packed neurofilaments. In all species, the lesion was subclinical and considered an incidental age-related finding. PMID- 2766748 TI - Abomasal volvulus in cattle following correction of left displacement by casting and rolling. AB - Seven adult cows developed abomasal volvulus immediately following correction of left displacement by casting and rolling. Three cows were rolled to provide temporary relief from left displaced abomasum because of concurrent disease and 4 were rolled as the principal therapy for left displacement. In each animal surgical correction of abomasal volvulus was accomplished via right paralumbar fossa celiotomy and inclusion of an omentopexy during abdominal closure. Surgery was performed within 24 hours of casting and rolling. All 7 cows recovered after surgery and were reported to have satisfactory milk production and appetite 6 weeks later. PMID- 2766749 TI - Chronic ileocecal intussusception in horses. AB - Ten young horses with signs of simple partial obstruction of the small intestine were found upon surgical exploration of the abdomen to have chronic intussusception of the distal ileum into the cecum. Poor general physical condition, intermittent or continual abdominal pain of varying degree, depression, and poor appetite were consistent clinical findings. Rectal palpation in eight animals was suggestive of an incomplete or intermittent obstruction of the small intestine. Laboratory determinations were not helpful in making a diagnosis. Dilatation and hypertrophy of the distal jejunum and ileum were associated surgical findings indicating chronicity of the problem. Surgical correction utilizing an end-to-side or a side-to-side anastomosis of small intestine to cecum resulted in recovery in 7 of 8 cases which could be followed long term. Failure to resect the abnormal segment of small intestine did not affect the outcome. PMID- 2766750 TI - A comparison of radionuclide and contrast left ventriculography and coronary angiography in patients after myocardial infarction. AB - 61 patients after myocardial infarction were investigated by selective coronarography, contrast (LVG) and gated radionuclide ventriculography (RNV, rest and mild exercise). Left ventricular ejection fraction (LVGEF and RNVEF, resp.) and regional contractility disturbances were determined (in RNV by Fourier transform and factor analysis). A high correlation of rest LVGEF and RNVEF was found, with lower RNVEF values. A significantly lower rest RNVEF with no change during exercise was observed in comparison to 29 control persons. The ability of RNV to detect regional wall contractility impairment was nearly the same as that of LVG. RNVEF was negatively influenced by LAD obstruction and furthermore in combination with other main coronary artery jeopardy. Gated RNV is a valuable noninvasive method that could replace contrast LVG in the assessment of left ventricular function. PMID- 2766751 TI - Regurgitation across an obviously normal valve orifice as a possible prerequisite for non-organic cardiac murmur. AB - Using pulsed and continuous wave Doppler echocardiography, the author examined 359 subjects referred to ultrasound examination for a variety of reasons. Thorough examination of persons with morphologically unchanged valves revealed regurgitation in the tricuspid, pulmonary, mitral and aortic valves in 49.4%, 20%, 14.5% and 0.8%, respectively. The degree of regurgitation was invariably haemodynamically insignificant. Some patients had a positive finding in several valves at a time. Overall, regurgitation was found in 247 subjects (69%). While it is evident from the study that the finding of regurgitation in normal valves is relatively frequent, evaluation of its clinical importance remains an open question. PMID- 2766752 TI - Parathyroid gland function and the possibility of its correction in patients with obliterative vascular disease of the lower limbs. AB - Parathyroid gland function and the possibility of its correction were studied in 43 patients with obliterative vascular disease of the lower limbs, and in 24 healthy, mostly male, controls. Parathormone (PTH) concentrations in blood plasma samples were determined by radioimmunoassay. Patients with obliterative vascular diseases of the lower limbs were found to have increased activity of parathyroid gland. The role played by hyperparathyroidism in the pathogenesis of obliterative vascular diseases of the lower limbs as well as the possibility of its correction by betablocker and encephalin analogue administration is discussed. PMID- 2766753 TI - Peripheral circulation in hypertensive and normotensive acromegalics. AB - Clinical examination and blood pressure measurement over the ankle in 31 patients with acromegaly, showing signs of active disease, did not reveal manifestations of obliterative arterial disease in the lower limbs. Sixteen of the patients had a normal blood pressure; in none of them did the authors find a deviation of blood flow in the foot and in the calf at rest and during reactive hyperaemia following 5-minute ischaemia. Fifteen patients with hypertension were found to have increased resting blood flow in the foot and calf and increased blood flow in the foot during reactive hyperaemia. PMID- 2766754 TI - Intrinsic and extrinsic sinus node dysfunction: diagnostic problems. AB - Based on clinical and experimental experience, pacemaker dysfunction in sick sinus syndrome can be differentiated into intrinsic and extrinsic. Sinus node activity is characterized electrophysiologically by automaticity, recovery and sinoatrial conduction. The automaticity of the sinus pacemaker cell groups and sinus recovery can be differentiated properly under experimental conditions. Studies of the electrophysiological characteristics have shown the basic functional parameters to be normal in extrinsic-autonomic sinus dysfunction. Diagnosis is either based on clinical observation or on the data of Holter monitoring, the electrophysiological methods being inadequate for diagnosing this neurovegetative form of sick sinus syndrome. On the other hand, intrinsic sinus dysfunction can be diagnosed by electrophysiological tests. If completed by complex pharmacological studies, in this organic form of sick sinus syndrome, even the severity of the intrinsic injuries can be assessed quantitatively. The above division provides a basis for selection and evaluation of the differential diagnostic procedures, while information on the aetiopathology of sinus dysfunction and on the degree of the functional injuries of the electrophysiological structure of the heart provides an adequate basis for therapy. PMID- 2766755 TI - Paradoxical elevation of pulmonary vascular resistance after nifedipine in primary pulmonary hypertension. A case study. AB - The case of a 55-year-old woman with primary pulmonary hypertension is described who developed 2 hours after sublingual administration of a 10 mg capsule of nifedipine a severe rise in pulmonary arterial and right atrial pressures accompanied with dyspnoea and cyanosis. The event lasted for two hours and subsided without intervention. With repeated nifedipine intake in the form of orally administered slow-release tablets no complications occurred. The authors ascribe the marked rise in pulmonary vascular resistance to rapid reduction of plasma nifedipine concentration after sublingual administration, due to a faster drug resorption compared to oral intake. The necessity of cautious introduction of vasodilating drugs in pulmonary hypertension and of gradual dosage increase is stressed. PMID- 2766756 TI - Evaluation of conventional criteria for predicting successful weaning from mechanical ventilatory support in elderly patients. AB - To assess whether the accepted weaning parameters (derived from middle-aged patients) are helpful in determining discontinuation of mechanical ventilatory support (MVS) in elderly patients, we retrospectively reviewed records of 269 patients greater than or equal to 70 yr who were weaned from MVS from January, 1984 through June, 1985 at one institution. Parameters studied included spontaneous respiratory rate, tidal volume, minute ventilation, maximal inspiratory pressure (MIP), pH, PaCO2, PaO2, and PaO2/FiO2. Two hundred forty-one patients (mean age 80 yr) were successfully weaned while 28 patients (mean age 80 yr) required reinstitution of MVS within 48 h. MIP and pH were statistically lower in the unsuccessfully weaned group, although the mean absolute differences were small (-32 vs. -38 cm H2O and 7.42 vs. 7.44 cm H2O, respectively). All parameters had good positive predictive values but poor negative predictive values (less than or equal to 22%) and only marginal diagnostic accuracy (58% to 86%). We conclude that strict adherence to previously published weaning parameters may not be applicable in deciding when to discontinue MVS in elderly patients. PMID- 2766757 TI - Prolongation of the half-life of lactate after maximal exercise in patients with hepatic dysfunction. AB - Decreased hepatic clearance of exogenous sodium lactate has previously been demonstrated in patients with hepatic dysfunction. The purpose of this study was to obtain a more precise understanding of the rate of metabolic normalization or decrease of endogenously produced lactate in patients with hepatic cirrhosis. The differential kinetics of lactate metabolism are of clinical interest. Male volunteer patients with hepatic cirrhosis (n = 7), who had survived acute hospitalization, were compared to healthy age-matched males with normal liver function (n = 7). After arterial cannulation, bicycle ergometry was performed at a workload of 25 watts (W); the load was increased by increments of 25 W at 2-min intervals to maximum aerobic capacity. Lactate was measured in arterial blood before, at 4-min intervals during, and on a minimum of 11 occasions in the 30 to 70 min after exercise. The time interval during which lactate declined linearly to half its maximal concentration (Lt50) was graphically computed. The Lt50 was 34.8 +/- 4.5 min (mean +/- SEM) in the experimental group and 14.1 +/- 1.3 min in the control subjects (p less than .005). Lactate disappears from the bloodstream almost three times more slowly in patients with hepatic cirrhosis. The implication for interpretation of changes in lactate during circulatory shock in the presence of liver dysfunction is addressed. PMID- 2766758 TI - Effect of flosequinan in patients with acute-onset heart failure complicating acute myocardial infarction. AB - We studied the hemodynamic effect of a single dose of the new direct-acting vasodilator, flosequinan, in ten patients with severe acute-onset heart failure complicating acute myocardial infarction (MI) resistant to high iv doses of diuretics, nitrates, and dobutamine. Flosequinan was added to conventional therapy at 3.8 +/- 0.5 days after infarction in the form of a single 100-mg oral dose. Hemodynamic measurements were performed every hour for 4 h after administration, without any other drug being added. The nitrate infusion rate was kept constant. Flosequinan produced hemodynamic improvement in this group. The effect peaked at 1 to 2 h and remained at this level at 4 h. Pulmonary capillary wedge pressure decreased from 27.2 +/- 5.4 to 16.4 +/- 3.0 mm Hg, and cardiac output increased from 3.5 +/- 0.3 to 4.1 +/- 0.4 L/min (p less than .001 for both). Cardiac index, stroke index, and left ventricular stroke work index were significantly increased. Pulmonary arterial and right atrial pressures, and systemic and pulmonary vascular resistances were also significantly reduced. Heart rate was not significantly altered. Mean systemic arterial pressure was slightly reduced. Flosequinan administration was not associated with symptomatic hypotension, cardiac arrhythmias, or other adverse events, and the hemodynamic effect was not related to the pretreatment serum sodium concentration. We conclude that flosequinan is effective in producing acute hemodynamic improvement in patients with heart failure complicating acute MI resistant to conventional therapy. PMID- 2766759 TI - Incidence and etiology of pneumonia acquired during mechanical ventilation. AB - A total of 77 consecutive patients submitted to mechanical ventilation (MV) for greater than 48 h in a respiratory ICU (RICU) were studied to investigate the incidence, etiology, and consequences of ventilator-associated pneumonia. Eighteen (23%) patients developed a bacterial pneumonia after 5.6 +/- 1.0 days (mean +/- SEM; range 2 to 17) of MV. Three additional cases were demonstrated at autopsy, raising the incidence to 27%. Overall, the mean duration of MV increased from 9.7 +/- 0.9 to 32.2 +/- 5.1 days (p less than .0001) when pneumonia developed. A longer period of hospital stay before RICU admission and the presence of chronic obstructive pulmonary disease were significant characteristics of patients with pneumonia when compared to patients without nosocomial pulmonary infection. One or more etiological agents were identified in 14 patients from the pneumonia group by means of a highly specific technique (protected brush catheter, transthoracic needle aspiration, pleural fluid, and/or blood cultures). The predominant pathogens isolated were Gram-negative bacilli (Acinetobacter sp. and Pseudomonas sp.). Half of the cases were polymicrobial. Compared to other series, our results may reflect with more accuracy the actual incidence of nosocomial pneumonia in mechanically ventilated patients, since we used highly accurate techniques along with autopsy findings which allowed us to confirm or discard the diagnosis of bacterial pneumonia. PMID- 2766760 TI - Sinusitis: hidden source of sepsis in postoperative pediatric intensive care patients. AB - Paranasal sinusitis is reported as a complication of prolonged nasal intubation and the source of sepsis in adult intensive care patients. In surgical neonates with congenital malformations, prolonged intubation with a nasotracheal (NT) or NG tube is often necessary, but sinusitis with complicating sepsis is seldom reported. Sinus x-rays may confirm the diagnosis; in infancy, prolonged nasal intubation delays the pneumatization of the sinuses and the mastoids, resulting in additional diagnostic problems. In a 1-yr period, we saw three patients with multiple septic episodes in which the source of sepsis was undetectable. Despite the absence of clinical symptoms and radiologic evidence of sinusitis or mastoiditis, surgical drainage revealed pus and led to the disappearance of septic episodes and ear, nose, and throat problems. There is an association between prolonged NT and NG intubation, and sinusitis or mastoiditis as an unrecognized source of sepsis in young infants. Absence of radiologic evidence of sinusitis or mastoiditis causes pitfalls in diagnosis and is related to delayed pneumatization of the sinuses and the mastoid in prolonged nasal intubation in young infants. PMID- 2766762 TI - Airway secretion electrolytes: reflection of water and salt states of the body. AB - Water and electrolyte content influences the rheology of respiratory mucus. Nasal secretions can be obtained from almost all patients and may be regarded as a possibly useful model of the electrolyte composition of lower airway secretions that are difficult to collect in most patients. Na, K, and Cl were determined from nasal secretions in 35 ICU patients. We studied the relationship of those values to the patients' water and salt states. Our study indicates that: a) lower K and Cl levels and higher Na levels than those found in plasma are common to both nasal and bronchial secretions; b) variations of electrolyte levels in nasal secretions are interrelated; c) patients with lower values of free-water clearance show lower Na and higher Cl levels in nasal secretions, possibly due to increased epithelial transport; d) the amount of K in nasal secretions appears correlated with its urinary fractional excretion (this could be explained by the variations in intracellular K levels); and e) in hyperchloremic patients, plasma/secretion differences of Na are decreased, possibly due to decreased epithelial transport. PMID- 2766761 TI - Interference with creatinine concentration measurement by high dose furosemide infusion. AB - Three patients had unmeasurable serum creatinine concentrations using a colorimetric method while receiving high doses of furosemide. The present study shows that enzymatic methods of measuring the serum creatinine concentration should be used in patients receiving high doses of furosemide. PMID- 2766763 TI - Effect of hemorrhage and resuscitation on subcutaneous, conjunctival, and transcutaneous oxygen tension in relation to hemodynamic variables. AB - Subcutaneous (PscO2), conjunctival (PcjO2), and transcutaneous (PtcO2) oxygen tension values were measured in anesthetized dogs subjected sequentially to hemorrhage and reinfusion of the shed blood. Intravascular pressure, hemodynamic variables, and oxygen transport variables were measured simultaneously. During hemorrhage, PscO2 was the first of the PO2 measurements, and among the first set of hemodynamic variables that differed significantly from control values. During continuous bleeding, PscO2 and PcjO2 fell rapidly, the decline of PscO2 and PcjO2 was similar and significantly higher than that found for PtcO2. After reinfusion of shed blood, PscO2 was the last of PO2 measurements, and among the last set of hemodynamic variables, to return to control values. While PaO2 remained constant, PvO2 decreased significantly during hemorrhage and normalized during resuscitation. Unheated instruments for measuring PscO2 and PcjO2 are reliable indicators of peripheral perfusion during hemorrhage and resuscitation. Subcutaneous oxygen monitoring, in particular, seems capable of assessing early blood loss and adequacy of resuscitation after acute hemorrhage, and may be clinically useful. PMID- 2766764 TI - High tidal volume ventilation produces increased lung water in oleic acid-injured rabbit lungs. AB - Repeated lung inflation with very high tidal volumes (VT) is associated with the production of permeability pulmonary edema in animal models using previously normal lungs. We studied the effect of mechanical ventilation, at VT values approaching those used clinically, on lung weight gain (lung water) in salt perfused rabbit lungs diffusely injured by the administration of oleic acid. Lungs ventilated at a VT of 18 ml/kg gained significantly more weight at 30 through 90 min than did lungs ventilated at 6 ml/kg. These differences in weight gain were not associated with differences in the evolution of thromboxane B2 in the perfusate. The impact of VT on lung water and outcome in patients with lung injury deserves further study. PMID- 2766765 TI - Effects of hyperventilation, hypothermia, and altered blood viscosity on cerebral blood flow, cross-brain oxygen extraction, and cerebral metabolic rate for oxygen in cats. AB - Therapies including hyperventilation (HV) and hypothermia (HT) are currently simultaneously used in brain-injured children at risk for cerebral swelling to reduce cerebral blood flow (CBF) and alter cerebral metabolic rate for oxygen (CMRO2). Since HV and HT may contribute to significant patient morbidity, we evaluated the effects of these treatments in combination on CBF, CMRO2, and cross brain oxygen extraction (CBO2) using the Kety-Schmidt technique before controlled bleeding to alter blood viscosity in 20 lightly anesthetized, paralyzed cats, and after bleeding in another 17 cats. The degree of HV (PaCO2 24 to 26 torr) and HT (32 degrees and 30 degrees C) used were representative of that employed in pediatric neurointensive care. HV at normothermia resulted in a significant decline in CBF (P less than .05) and an unchanged CMRO2. HV and HT together to 32 degrees C resulted in a further significant fall in CBF and CMRO2 (p less than .05), but an unchanged CBO2. Further cooling of the animal to 30 degrees C during HV, both before and after controlled bleeding, resulted in no further significant fall in CBF, CBO2, or CMRO2. This relationship was found despite a significant fall in Hgb (p less than .001), suggesting that blood viscosity did not significantly influence CBF at this temperature. Our data suggest that HT to 32 degrees C during HV may have therapeutic benefit by decreasing CBF and CMRO2, but further cooling to 30 degrees C may not result in further cerebral protective effects. PMID- 2766767 TI - Decreased flow accuracy from volumetric infusion pumps. AB - Accurate flow from infusion pumps should be maintained when exposed to a variety of clinical conditions. The intent of this study was to evaluate in vitro flow rate accuracy of three infusion pumps subjected to the influences of variable back-pressure, solution viscosity, and infusion rates. A factorial study design was selected to determine the influence of three flow rates (5, 10, and 20 ml/h), three back-pressures (100, 200, and 300 mm Hg), and two solution viscosities (5%, 25% dextrose in water) on flow rate accuracy from three infusion pumps (Abbott 4P, IVAC 560, and Travenol 6200) using a standard gravimetric technique. Mean +/- SD accuracy values were -9.4 +/- 6.4% (range -29.1 to -0.7), 0.5 +/- 2.2% (range 4.2 to 6.3), and -0.5 +/- 4.7% (range -8.5 to 9.9) of the desired rate for the Abbott, IVAC, and Travenol devices, respectively. Back-pressure was the only factor to influence significantly flow accuracy for the Abbott device (r = .81). All factors significantly influenced accuracy for the Travenol device (r = .55). No factor influenced accuracy for the IVAC infusion pump. Both the IVAC 560 and Travenol 6200 have acceptable flow accuracy values within the range of study factors examined. The Abbott 4P had significant decreases in flow accuracy in response to increasing back-pressure. PMID- 2766766 TI - Bedside blood gas and electrolyte monitoring in critically ill patients. AB - A major advantage of near-patient testing is time savings that facilitate important diagnostic and therapeutic decisions. Recent technologic advances have made available a number of systems that allow for near-patient testing. The reliability of these instruments must be validated in the clinical setting in the hands of their intended users. We evaluated the Gemstat blood gas, electrolyte, and Hct portable analyzer in the critical care setting when used by numerous individuals with no previous laboratory training. Blood gas, Na, K, and Hct results were highly correlated with those from the clinical laboratories (PaO2, r = .96; PaCO2, r = .92, pH, r = .96; Na, r = .93; K, r = .95; Hct, r = .91). The Gemstat represents a new generation of portable, rapid, safe, and accurate instruments that are well suited for ICU settings. The instrument can facilitate clinical management of patients, and may improve patient care. PMID- 2766769 TI - Fellowship programs in critical care medicine: 1989/1990. Compiled and edited by the Society of Critical Care Medicine. PMID- 2766768 TI - Hematocrit monitor. AB - The purpose of this study is to determine experimentally the optimal incident visible wavelength and light detector angle that yields the maximal change in optical density between an arterial or venous Hct of 20% and 40%. A universal monochromator allows incident wave-lengths in 8-nm increments over the visible range to be selected for the incident beam and a motorized shuttle allows the two samples (Hct 20% and 40%) to be placed reproducibly between the incident beam and photodiode detector. Runs performed with the light detector at a 30 degree, 90 degree, and 180 degree angle from the incident light beam revealed the greatest change in optical density between an Hct of 20% and 40% to occur at 624 nm and 90 degrees independent of sample cell configuration, light source profile, or light detector profile. This experimentally determined optimal wavelength and angle are utilized in a fiberoptic biosensor to monitor Hct successfully in dogs undergoing surgical procedures. PMID- 2766770 TI - Cardiac tamponade associated with drug-induced systemic lupus erythematosus. PMID- 2766771 TI - Chest wall necrosis secondary to hydrochloric acid use in the treatment of metabolic alkalosis. PMID- 2766772 TI - Seek and find. PMID- 2766773 TI - pH and blood gas measurements: discerning innovation from sophistication. PMID- 2766774 TI - Endotracheal intubation in massive hemoptysis: advantages of the orotracheal route. PMID- 2766775 TI - Improved subclavian introduction technique of the pulmonary artery catheter sheath. PMID- 2766776 TI - Some infant ventilators do not limit peak inspiratory pressure reliably during active expiration. PMID- 2766777 TI - Cardiac performance in pediatric near-drowning. PMID- 2766778 TI - False hypoxemia induced by leukocytosis. PMID- 2766779 TI - Survival of corneal endothelium following exposure to a vitrification solution. AB - Corneal endothelium, a monolayer of cells lining the inner surface of the cornea, is particularly susceptible to freezing injury. Ice formation damages the structural and functional integrity of the endothelium, and this results in a loss of corneal transparency. Instead of freezing, an alternative method of cryopreservation is vitrification, which avoids damage associated with ice formation. Vitrification at practicable cooling rates, however, requires exposure of tissues to very high concentrations of cryoprotectants, and this can cause damage through chemical toxicity and osmotic stress. The effects of a vitrification solution (VS1) containing 2.62 mol/liter (20.5%, w/v) dimethyl sulfoxide, 2.62 mol/liter (15.5%, w/v) acetamide, 1.32 mol/liter (10%, w/v) propane-1,2-diol, and 6% (w/v) polyethylene glycol were studied on corneal endothelium. Endothelial function was assessed by monitoring corneal thickness during 6 hr of perfusion at 35 degrees C with a Ringer solution supplemented with glutathione and adenosine. Various dilutions of the vitrification solution were introduced and removed in a stepwise manner to mitigate osmotic stress. Survival of endothelium after exposure to VS1 or a solution containing 90% of the cryoprotectant concentrations in VS1 (90% VS1) was dependent on the duration of exposure, the temperature of exposure, and the dilution protocol. The basic dilution protocol was performed at 25 degrees C: corneas were transferred from 90% VS1 or VS1 into 50% VS1 for 15 min, followed by 25% VS1 for 15 min and finally into isosmotic Ringer solution. Using this protocol, corneal endothelium survived exposure to 90% VS1 for 15 min at -5 degrees C, but 5 min in VS1 at -5 degrees C was harmful and resulted in some very large and misshapen endothelial cells. This damage was not ameliorated by using a sucrose dilution technique; but endothelial function was improved when the temperature of exposure to VS1 was reduced from -5 to -10 degrees C. Exposure to VS1 for 5 min at -5 degrees C was well tolerated, however, when the temperature of the first dilution step into 50% VS1 was reduced from 25 to 0 degree C. The large, misshapen cells were not observed under these conditions nor after exposure to VS1 at -10 degrees C. These results suggested that damage was the result of cryoprotectant toxicity rather than osmotic stress. Thus, corneal endothelium survived exposure to two solutions of cryoprotectants, namely, 90% VS1 and VS1, that were sufficiently concentrated to vitrify. Whether corneas can be cooled fast enough in these solutions to achieve vitrification and warmed fast enough to avoid devitrification remains to be determined. PMID- 2766780 TI - The effect of cryopreservation on ciliary beat frequency of human respiratory epithelium. AB - The effect of cryopreservation on ciliary activity of human nasal respiratory epithelium was evaluated. Samples were cryopreserved in a solution containing nutrient medium, 10% fetal calf serum, and two different concentrations (10 or 20%) of dimethyl sulfoxide and stored in liquid nitrogen at -196 degrees C for 2 weeks. Ciliary beat frequencies (CBF) of the samples before and after cryopreservation were compared. Mean CBF values did not differ significantly with both concentrations of dimethyl sulfoxide. The mean intrasample coefficient of variation of the CBF decreased significantly after cryopreservation. After thawing, CBF remained unchanged for at least 4 hr. It is concluded that normal ciliated epithelial cells can be frozen and stored in liquid nitrogen at 196 degrees C while maintaining their CBF. PMID- 2766781 TI - The bioenergetics of mitochondria after cryopreservation. AB - The functional characteristics of rat liver mitochondria after cryopreservation with and without the addition of the cryoprotectant dimethyl sulfoxide (Me2SO) were evaluated. As criteria of functional integrity, polarographic measurements of substrate-linked oxygen consumption and luminescent assay of adenosine triphosphate (ATP) synthesis were considered before and after cryopreservation. The results demonstrated that mitochondrial damage after freezing was indicated by the polarographic studies but was not evident when ATP synthesis was considered. Me2SO present during cryopreservation was partially protective for mitochondrial substrate-linked oxygen consumption; however, simple exposure to and dilution from Me2SO effected some changes in mitochondrial function. PMID- 2766782 TI - Effect of cryoprotective diluent and method of freeze-thawing on survival and acrosomal integrity of ram spermatozoa. AB - A multifactorial study analyzed the effects of freezing method, cryoprotective diluent, semen to diluent ratio, and thawing velocity on post-thaw motility, progressive status, and acrosomal integrity of ram spermatozoa. Although semen to diluent ratio (1:3 vs 1:6, v/v) had no effect (P greater than 0.05), overall post thaw spermatozoal viability was highly dependent on freezing method and cryoprotectant. Improved results were obtained by freezing semen in 0.5-ml French straws compared to dry ice pelleting. Manually freezing straws 5 cm above liquid nitrogen (LN2) was comparable to cooling straws in an automated, programmable LN2 unit. Of the two cryoprotective diluents tested, BF5F (containing the surfactant component sodium and triethanolamine lauryl sulfate) yielded approximately 50% fewer (P less than 0.05) spermatozoa with loose acrosomal caps compared to TEST. Thawing straws in a water bath at a higher velocity (60 degrees C for 8 sec) had no effect (P greater than 0.05) on spermatozoal motility, progressive status ratings, or acrosomal integrity when compared to a lower rate (37 degrees C for 20 sec). For the TEST group, thawing pellets in a dry, glass culture tube promoted (P less than 0.05) percentage sperm motility at 3 and 6 hr post-thawing, but for BF5F diluted semen this approach decreased the % of spermatozoa with normal apical ridges. The results suggest that the poor fertility rates often experienced using thawed ram semen likely result not only from reduced sperm motility, but also from compromised ultrastructural integrity. This damage is expressed by an increased loosening of the acrosomal cap, a factor which appears insensitive to freezing method but markedly influenced by the cryoprotective properties of the diluents tested. PMID- 2766784 TI - Statistical methods for measuring interactions between protectors and sensitizers for freeze-thaw survival data. AB - A statistical model is developed to generate the survival probabilities of cells subjected to freeze-thaw treatments using various sensitizing and/or protective agents. The purpose is to determine whether different freeze-thaw protective agents act independently or whether there is an interaction between the agents. The model permits a statistical analysis of the data to yield an objective quantitative assessment of the size and nature of the interaction. PMID- 2766783 TI - A study of the separate effects of influence factors and their coupled interactions on cryoinjury of human erythrocytes. AB - The separate effects of five influence factors and their coupled interactions on cryoinjury of human erythrocytes were investigated experimentally and statistically. The five factors, each having three levels, were as follows: (1) cooling rate: -0.5, -140, and -800 degrees C/min; (2) warming rate: +0.5, +25, and +200 degrees C/min; (3) hematocrit: 2, 11, and 60%; (4) concentration of cryoprotectant (glycerol): 1, 2, and 4 M in PBS; and (5) holding temperature at which the frozen samples were kept: no hold, -75 degrees C for 1.5 hr, and -196 degrees C for 1.5 hr. Twenty-seven special tests, which were chosen from the 243 possible tests by using the Fractional Factorial Design Technique, an optimum seeking technique, were performed. The conclusions are: (1) the cooling rate is the most significant or sensitive factor causing cryoinjury to the cells; (2) the main effects of the hematocrit and the concentration of cryoprotectant, the interaction between the cooling rate and the warming rate, and the interaction between the cooling rate and the concentration of cryoprotectant are next most significant; (3) the main effect of warming rate, and the interaction between the holding temperature and the cooling rate are less significant; (4) the holding temperature below -75 degrees C, and the remaining interactions between two factors are relatively not significant; and (5) in the present study, the optimal combination of the five factors for the survival of the cells is: cooling at -0.5 degrees C/min, warming at +0.5 degrees C/min, hematocrit at 11%, glycerol concentration at 4 M in PBS, and holding temperature below -75 degrees C. PMID- 2766785 TI - Experimental studies of combined therapy of severe frostbite. PMID- 2766787 TI - Neurasthenia in Asian cultures. PMID- 2766786 TI - Seasonal changes of the ovarian atretic follicles of the ground squirrel (Citellus citellus L.). AB - The ovaries of 84 ground squirrels (C. Citellus L.) were studied during the four seasons of the year. The ovarian atretic follicles were examined by histological methods and by electron microscopy. The histoenzyme activities of NAD.H2 tetrazolium reductase, glucose-6-phosphate dehydrogenase, and 3 beta-hydroxy delta 5-steroid dehydrogenase were photometrically demonstrated. The steroid producing atretic follicles were mainly described as they reached their highest enzyme activity during the lactation period in April. The atresia of the primordial and primary follicles was manifested by disappearance of the oocyte and preservation of the granulose cells surrounded by basal lamina. Atresia of follicles with two oocytes was a typical process for the ground squirrel. Later on the oocytes and the granulose cells around it disappeared. The remaining part of the follicle continued its development and reached maturity. Atresia was observed mainly in March, April, and May. PMID- 2766788 TI - Neurasthenia revisited: its place in modern psychiatry. PMID- 2766789 TI - Neurasthenia and related problems. AB - Neurasthenia is a diagnostic entity included in ICD-9 which is used in daily clinical practice in China and the Soviet Union, as well as some other Asian countries, so far as I know. Although it was eliminated from the psychiatric nosology in DSM-III of the United States and in several European countries, this disease has not disappeared. In my view, elimination of the category only indicates change of diagnostic concept without definite direction. Whether this change will be accepted by psychiatrists all over the world is still a question. The continued use of this diagnostic term in China is justifiable, I believe. The final resolution of these differences in views and practice remains for future development in psychiatric science. PMID- 2766790 TI - The necessity of retaining the diagnostic concept of neurasthenia. PMID- 2766791 TI - The diagnosis and phenomenology of neurasthenia. A Shanghai study. AB - Neurasthenia is one of the commonest diagnostic terms in psychiatric practice in China, but it is employed less and less by psychiatrists in the Western world. In order to investigate what diagnoses would be given in terms of modern Western standard diagnostic systems, 40 patients who were diagnosed as suffering from neurasthenia by two Chinese psychiatrists were rediagnosed according to ICD-9 descriptive criteria, using the Catego computerized system based upon PSE findings and DSM-III criteria based on findings of the Diagnostic Interview Schedule (DIS). Furthermore a set of self-report or observer rating scales, including the SAS, SDS, HAMA, HAMD and BPRS, were administered to evaluate their psychopathological characteristics. The main findings are the following: (1) the distribution of the results of rediagnosis is widely dispersed from mild character disorder to severe affective disorder; (2) most of these patients are diagnosed as having an anxiety or depressive illness in different diagnostic systems; (3) the majority of diagnoses belong to the field of neurosis in all systems except DIS/DSM-III; (4) there is a group of patients who do not belong to any diagnostic entity in these systems; (5) the prominent psychopathological features are anxiety and depression and often a combination of both, which adds to the complexity of the clinical picture; and (6) these patients tend to over report their suffering or symptoms, which results in a discrepancy of findings between objective assessment and self-reporting. The author suggests that the term neurasthenia represents a disease spectrum and should be refined in future study, but that it seems too early to discard it from psychiatric nosology. PMID- 2766792 TI - Neurasthenia in China: modern and traditional criteria for its diagnosis. PMID- 2766794 TI - The socio-cultural significance of the diagnostic label "neurasthenia" in Japan's mental health care system. AB - This paper is an attempt to explore the socio-cultural significance of deliberately disguising schizophrenia as neurasthenia, neurosis or malfunction of autonomic nervous system. To understand its significance, the socio-cultural background of Japanese attitudes toward mental illness and Japan's mental health care system is also examined from a non-Western standpoint. PMID- 2766793 TI - The concept of neurasthenia and its treatment in Japan. AB - The term neurasthenia, which had been widely used in Japan before the Second World War, came to be replaced by the term neurosis thereafter. With this change in terminology, there seems to have been a shift in the popular ideas of minor psychiatric disorders towards a more psychological view. Unlike in the West where psychoanalysis was a major contributing factor, in Japan it was Shoma Morita who contributed to this change by questioning the somatic basis of conditions then diagnosed as neurasthenia and by developing the concept shinkeishitsu in the early 1920's, rejecting the concept of neurasthenia. In his theory, the development of shinkeishitsu symptoms is explained in terms of certain psychic dispositions and as a vicious cycle of sensation and attention; he formulated a psychological treatment, Morita therapy, which has been very effective for that condition. With the advent of modernization in this country, doubts have been raised whether this form of psychotherapy will continue to be acceptable to modern Japanese. However, in reality many neurotic patients are still being treated with Morita therapy, although analytically oriented psychotherapy is coming to be practiced more and more in recent years. The indigenous psychotherapies represented by Morita therapy and Naikan therapy have deep-seated roots in Buddhist tradition: its values and ideas have been redefined and reformulated into forms of therapy acceptable to modern Japanese. PMID- 2766795 TI - Neurasthenia as nosological dilemma. AB - While researching concepts of neurasthenia as described by patients and physicians of various backgrounds, it was found that there is a great discrepancy between the two groups. In this study, questionnaires were administered to 70 psychiatric patients, 6 Chinese medicine men, 44 general physicians and 35 neuropsychiatrists, to inquire into the reasons for positive or negative attitudes toward neurasthenia. Half of the clinical patients believed that they were suffering from neurasthenia. Neurasthenia is a predominate term used for various types of distress arising mainly from psychiatric diseases. Chinese medicine men are aware that this term is a medical diagnosis introduced from the West. Through experience they regard neurasthenia as a kind of deficit of nerve. Apparently, the concept of neurasthenia has been integrated into the Chinese medical system, a fact substantiated by its longstanding, nosological use by the public. Younger generation physicians within both general and neuropsychiatric disciplines on the whole reject neurasthenia as a diagnostic term. However, one third of neuropsychiatrists and 40% of general physicians use this term in their practice in order to improve the treatment of and to establish good communication and rapport with the patients whom they treat. Most of them, however, do not use the term in their formal diagnosis. The concept of the illness, neurasthenia, is historically rooted and today presents a nosological dilemma. It will eventually be transformed conceptually and disappear from the public mind. PMID- 2766796 TI - The indigenization of neurasthenia in Hong Kong. AB - Despite its origin in Western psychiatry, neurasthenia has become a popular concept in Chinese folk medicine, referring to a variety of somatic and psychological symptoms. Review of Chinese medicinal materials and patent medicines shows that neurasthenia is associated more often with somatic symptoms in tonic type medicine and with psychological and psychosomatic symptoms in sedative and tranquilizer type medicine. Popular Chinese books on neurasthenia suggest that causes might be attributed to lifestyle, psychological factors, and health problems. Recommendations on treatment emphasize self-help approaches through changing lifestyle, examining attitudes, tonic care, and relaxation. As a broad term used loosely by professionals and the lay public in Hong Kong, neurasthenia serves the important function of destigmatizing psychiatric disorders. Psychosexual problems may also be conveyed discreetly through somatic presentation. The indigenization of neurasthenia exemplifies how an originally Western concept acquires cultural meaning. Implications of illness conceptualization and the medical paradigm are discussed. PMID- 2766797 TI - A surgical diary: concepts and tenets. AB - A surgical diary may be one of the most utilitarian mechanisms for acquiring, recalling, and reinforcing surgical knowledge and skills. A surgical diary facilitates capture of the subtlety of each operation as provided by a diarist's preceptors, incorporating and utilizing what is valid and rejecting and discarding what is otherwise. Use of a surgical diary could be an effective learning instrument. PMID- 2766798 TI - Attenuation of structural and functional damage from acute renal ischemia by the 21-amino steroid U74006F in rats. PMID- 2766799 TI - Barrier protection against the human immunodeficiency virus. PMID- 2766800 TI - The effects of pentoxifylline on bacterial peritonitis. PMID- 2766802 TI - In situ hybridization. PMID- 2766801 TI - Endotoxin concentrations following internal and external biliary drainage for obstructive jaundice. PMID- 2766803 TI - Strategies for ultrastructural visualization of biotinated probes hybridized to messenger RNA in situ. AB - A progressive development of the application of in situ methodology to ultrastructural procedures has resulted in the ability to detect individual molecules of mRNA with high probability. Beginning with whole-mount cells and then developing myotubes, both in culture and detergent extracted before fixation, we were able to progress to methods which allow detection of mRNA in tissue sections. Initial results confirm that the detection of mRNA in thin sectioned tissue is very similar to observations on the extracted, cultured cells, and that the same methods of data analysis apply. Current work is devoted to the application of the methodology to other cellular structures, such as the nucleus, and to other tissue-probe systems, such as brain. Acknowledgements. The authors appreciate the skilled help from John McNeil and Shirwin Pockwinse in the laborious and time-consuming preparations of material and photography. FS was on sabbatical leave from the Department of Pathology at Southwestern Medical Center. PMID- 2766804 TI - Tumor necrosis factor-alpha. A multifaceted mediator of inflammation. PMID- 2766805 TI - Serosanguineous pleural effusions in AIDS-associated Kaposi's sarcoma. AB - We describe the clinical course and pleural fluid findings in patients with AIDS associated pleural KS and survival analysis of cases from the Colorado registry with and without pleuropulmonary KS. Twenty-one of 105 (20 percent) of AIDS cases with KS had pleuropulmonary involvement with KS and 13 (62 percent) had pleural effusions. All cases were homosexual males with cutaneous lesions of KS that antedated pleural involvement by several months. Clinical presentation and physical examination findings were nonspecific. Chest roentgenograms generally showed nonloculated bilateral pleural effusions; concurrent parenchymal infiltrates were present in 90 percent. Pleural fluid analysis showed that most effusions were serosanguineous, mononuclear cell-predominant exudates. Pleural fluid was visibly blood-tinged in nine of ten cases, with median RBC counts of 52,000/microliters (range 16,000 to 803,000/microliters). Cytologic examination of pleural fluid or needle biopsy of the parietal pleura failed to establish the diagnosis. In two cases the effusions were chylous. Postmortem examination of the lungs typically showed multiple cherry red to purple lesions on the visceral but not parietal pleural surface. In half the cases progressive pleural effusions led to significant morbidity or mortality. Systemic chemotherapy for disseminated KS was minimally effective; chest tube thoracostomy with attempted tetracycline sclerosis was unsuccessful in controlling pleural effusions in three cases. Median survival from diagnosis of KS to death was 205 and 338 days, respectively, for patients with and without pleuropulmonary KS (p less than 0.01). Pleural effusions are common in AIDS-associated pleuropulmonary KS, and finding a serosanguineous exudative effusion in an AIDS patient with cutaneous KS is highly suggestive of the diagnosis of pleural KS. PMID- 2766806 TI - Efficacy of a pulsed oxygen delivery device during exercise in patients with chronic respiratory disease. AB - The ability of a pulsed oxygen delivery system (Puritan-Bennett Companion Oxygen Saver (COS-5) to track respiratory rate during exercise and the oxygenation achieved during the exercise while oxygen was being delivered by this system was compared to that attained while oxygen was delivered continuously in six patients with chronic obstructive pulmonary disease (COPD) and six patients with idiopathic pulmonary fibrosis (IPF). The COS-5 appeared to respond appropriately at respiratory rates between 15 and 45, even when there were minimal pressure changes at the nose. There was an excellent correlation in PaO2 at equivalent flow settings during the exercise in the patients with COPD and IPF. There were six instances (in four patients) of the 31 comparisons in which the PaO2 differed by more than 5 mm Hg. The PaO2 was higher with continuous oxygen delivery on two occasions in a patient with COPD who utilized pursed-lip breathing during the exercise. The PaO2 was higher with COS-5 delivery on two occasions in a patient with IPF who was breathing at the highest respiratory rates (44 and 45/min) during the exercise. PMID- 2766807 TI - Immediate chest roentgenography following fiberoptic bronchoscopy. AB - It is a common practice for some clinicians to obtain a chest roentgenogram immediately following FOB in an attempt to detect complications of the procedure, particularly pneumothorax; however, the roentgenogram adds substantially to the cost of FOB. It was our clinical impression that the diagnostic and therapeutic value of immediate chest roentgenography was minimal. Therefore, we reviewed 130 chest roentgenograms taken immediately after bronchoscopy that were obtained over 36 months. One hundred fourteen (88 percent) were unchanged from the most recent roentgenogram before bronchoscopy. Ten (8 percent) showed an increase in alveolar infiltrate due to bronchoalveolar lavage or hemorrhage. Five (4 percent) had changes presumably unrelated to the procedure. Only one patient had a pneumothorax on the roentgenogram taken immediately after bronchoscopy; however, the patient was symptomatic, and the pneumothorax was detected by fluoroscopy prior to the chest roentgenogram. Management of the patient's condition was not altered in a single case based upon findings on the chest roentgenogram. We conclude that the immediately postbronchoscopic chest roentgenogram rarely provides clinically useful information or detects a complication that is not suspected clinically; furthermore, it appears to have minimal impact, if any, on the management of a patient's condition. PMID- 2766808 TI - Respiration and abnormal sleep in patients with congestive heart failure. AB - We investigated the interaction between respiration and sleep in ten male outpatients with severe, stable, maximally treated congestive heart failure (CHF). Cheyne-Stokes respiration (CSR), defined as periodic breathing with apnea or hypopnea, was found in all patients with a mean duration of 120 +/- 87 minutes [50.2 +/- 34.4 percent total sleep time (TST)]. The CSR was found predominantly during stage 1 (20.6 +/- 6.7 percent TST) and stage 2 (25.8 +/- 6 percent TST) NREM sleep and occurred rarely during slow wave sleep (SWS) (1.6 +/- 1 percent TST) and REM sleep (1.6 +/- 0.5 percent TST). All apneas and hypopneas were central. Despite normal awake arterial oxygenation (SaO2) (96.1 +/- 1.6 percent), significant, severe hypoxemia was found during sleep in seven patients with SaO2 less than 90 percent for 9 to 59 percent TST (mean +/- SD, 23 +/- 23 percent TST), and this was significantly related to the duration of CSR (r = 0.66, p less than 0.05). The mean minimum SaO2 for sleep stage was lowest during stage 1 (82.1 percent +/- 2.6 percent) and stage 2 (78.9 percent +/- 2.8 percent) NREM sleep, intermediate during REM sleep (84.5 percent +/- 1.8 percent) and highest during SWS (87.6 percent +/- 2.7 percent). Sleep was disrupted to a variable extent in all patients with a short mean TST (287 +/- 106 minutes), a high proportion of stage 1 sleep (26 +/- 19 percent TST), virtual absence of SWS (5 +/- 7 percent TST) which was found in only four patients, and a high number of sleep stage changes (30 +/- 27/hour) and arousals (28 +/- 25/hour). Arousals occurred predominantly during stage 1 (17 +/- 20/hour) and stage 2 (10 +/- 7/hour) NREM sleep and the majority immediately followed the hyperpneic phase of CSR. The amount of CSR (percent TST) was inversely related to the length of TST (r = 0.73, p less than 0.05), and directly related to the number of sleep stage changes (r = 0.79, p less than 0.01) and the number of arousals (r = 0.66, p less than 0.05). We conclude that in severe, stable CHF, CSR occurs predominantly during light sleep, that despite normal awake arterial oxygen saturation, significant hypoxemia may develop during sleep due to CSR, and that sleep is unstable and disrupted due to frequent arousals caused by the hyperpneic phase of CSR. These sequelae of CSR may be important determinants of the clinical status and outcome of patients with severe CHF. PMID- 2766809 TI - Bronchial foreign body vs asthma. AB - Between January 1983 and June 1988, 30 unsuspected foreign bodies were extracted from the respiratory tracts of children. Twelve of them showed no roentgenologic findings and their histories revealed repeated hospitalization due to reactive airways disease (RAD) or croup syndrome. As a test-therapy, theophylline, corticosteroids and epinephrine were administered simultaneously to these patients in appropriate doses. No response was obtained in two patients with subglottic foreign bodies (SFB). In seven of the ten patients with bronchial foreign bodies (BFB), wheezing was either decreased or disappeared in the uninvolved lung, but no change was observed in the lung with a foreign body in its main bronchus. PMID- 2766810 TI - Hospitalizations for pulmonary reactions following nitrofurantoin use. AB - Acute pulmonary illness compatible with previously described nitrofurantoin toxicity and requiring hospitalization occurred three times among 16,101 first courses of therapy with nitrofurantoin. One case of fatal pulmonary fibrosis was ascribed to long-term use of nitrofurantoin among 742 observed recipients of ten or more prescriptions. PMID- 2766811 TI - Familial IgE deficiency associated with sinopulmonary disease. AB - Three generations of relatives of 58-year-old nonidentical twins with chronic bronchitis and fibrotic lung disease were evaluated. Sera of 23 family members, 14 with a history of excessive sinopulmonary infections, were examined for deficiencies of immunoglobulin classes, IgG subclasses, and specific antibody to tetanus toxoid and Hemophilus influenzae type b. Of 14 symptomatic family members, 12 had serum IgE concentrations less than 5 IU/ml. Four had values less than 1 IU/ml. Serum IgE was greater than 10 IU/ml in all nine asymptomatic individuals. Inheritance of low IgE appeared to be autosomal dominant, with variable penetrance. IgA was low normal (70-90 mg/dl) in three individuals. Two of these were IgE deficient. One symptomatic child had unmeasurable IgG2 (less than 10 mg/dl) and IgE (less than 0.5 IU/ml). This kindred demonstrates that IgE deficiency can be familial, and associated with sinopulmonary disease. PMID- 2766812 TI - Low-risk large-needle biopsy of chest lesions. AB - There were 210 chest lesions biopsied with large-bore cutting needles (14.5 to 18.0 gauge). The patients ranged in age from 13 to 84 years with a heavy preponderance of males (99 percent). Most of the lesions were pleural based lung masses (133). In the majority (140) only one pass was required for diagnosis. Certain technical considerations were employed which resulted in a low complication rate of 4.8 percent. Pneumothorax occurred in only eight cases (4 percent). There were eight false-negative biopsies and no false-positives. The key advantage of large needle biopsy (LNB) over skinny needle biopsy (SNB) is that a large tissue core is obtained that allows for more specific histologic diagnosis. With proper technique and careful patient and lesion selection, LNB can be performed as safely as thin-needle biopsy. PMID- 2766813 TI - Lung compartmentalization of increased TNF releasing ability by mononuclear phagocytes in pulmonary sarcoidosis. AB - The TNF is a monokine with cytotoxic and tumor-necrosing activities; in addition, TNF may play a role in inflammatory processes. The present study evaluates spontaneous and LPS-mediated release of TNF by AMs and autologous peripheral BMs of normal subjects and patients with pulmonary sarcoidosis. A recently developed cytotoxicity assay, specific for detection of TNF activity, was applied. This study demonstrates that (1) unstimulated mononuclear phagocytes released low levels of TNF with no differences between groups; (2) when effector cells were stimulated with LPS, AMs from patients with active pulmonary sarcoidosis released more TNF than AMs recovered from normal subjects and from patients with inactive disease; (3) this increase was compartmentalized to the lungs, since comparisons of TNF production by LPS-stimulated BMs failed to show any difference between study groups. These results suggest that TNF might play a role in the pathogenesis of the alveolitis of pulmonary sarcoidosis. PMID- 2766814 TI - Comparison of two-minute incremental threshold loading and maximal loading as measures of respiratory muscle endurance. AB - We performed a two-minute incremental threshold loading test (incremental test) in ten normal subjects on three occasions, and having ascertained the maximum load (max load) against which they could inspire for two minutes, measured how long this load could be tolerated by these same subjects on three further occasions (tlim test). We compared the reproducibility of the two tests. There were no significant differences found in the mean max loads in the three incremental tests, or in the endurance times in the three tlim tests. However, the intraindividual coefficients of variation of max load in the incremental test (0 to 14 percent) were much smaller than the intraindividual coefficients of variation of endurance time in the tlim test (20 to 65 percent). We found that the large variability in endurance time in our tlim tests was most likely accounted for by variability in breathing pattern, inspiratory flow rate and breath-by-breath mouth pressure generation. Differences in these parameters did not, however, explain why in the tlim test a given subject could tolerate for 19 minutes a load only 100 g less than that which he was unable to tolerate for two minutes in the incremental test. These findings emphasize the differences between these two tests of respiratory muscle endurance. Since there was less intraindividual variability in the two-minute incremental threshold loading test, we suggest that this test may be more useful than the tlim test. PMID- 2766815 TI - Applicability of a threshold loading device for inspiratory muscle testing and training in patients with COPD. AB - We evaluated application of a Pth device for testing inspiratory muscle endurance among patients with severe but stable COPD. Endurance time in five patients was reproducible. Magnitude of variability was +/- 1.26 minutes with a range of +/- 0.19 to +/- 2.28 minutes. Eleven inpatients completed inspiratory muscle training twice daily for four weeks in addition to their usual program of respiratory rehabilitation. The mean age of our experimental cohort was 65 years; FEV1, 33 +/ 12 percent predicted; and Dsb, 42 +/- 7 percent predicted. Baseline measurements showed no significant differences in pulmonary function, exercise tolerance, inspiratory muscle strength or inspiratory muscle endurance between control and study groups. Following training, the study group significantly improved inspiratory muscle endurance as evidenced by an increase in endurance time while breathing against the same absolute external Pth load used during baseline assessments. There were no associated changes in lung mechanics, muscle strength or exercise tolerance. PMID- 2766816 TI - Coordination of eating, drinking and breathing in adults. AB - The coordination of breathing and swallowing was studied in seven normal males at rest, as well as during eating and drinking. Ventilation was monitored using respiratory inductive plethysmography and swallowing was recorded by submental electromyogram. Swallowing occurred almost exclusively in expiration. Two hundred and seventy-one swallows were seen and only two occurred in inspiration. The mean expiratory duration (Te) of breaths containing a swallow was significantly greater than the mean Te of all breaths during the same period. There was no change in mean tidal volume (VT), inspiratory duration (Ti), expiratory duration (Te), mean inspiratory flow (VT/Ti) or minute ventilation (VE) between the periods of normal breathing, eating and drinking. However, breathing became more irregular during eating and drinking. The mean coefficient of variation of VT, Te, and VT/Ti was significantly greater during eating and drinking than at rest. The coefficient of variation for VT was 22 + 3 percent, 36 +/- 5 percent, and 41 +/- 5 percent during the initial period of resting breathing, eating and drinking. For VT/Ti it was 24 +/- 6 percent, 43 +/- 14 percent and 44 +/- 8 percent during resting breathing, eating and drinking. We conclude that swallowing is almost exclusively an expiratory activity. This may play a protective role in preventing aspiration. Although the level of ventilation is maintained constant during eating and drinking, the pattern of breathing becomes increasingly irregular. This may contribute to dyspnea during meals in some patients with lung disease. PMID- 2766817 TI - Speech dysfunction of obstructive sleep apnea. A discriminant analysis of its descriptors. AB - We have previously demonstrated a relationship between abnormal speech and obstructive sleep apnea in a small subject sample. The present study was designed to replicate the previous one with a much larger population, analyze the perceptual characteristics of the speech quality, and determine the degree to which each of three descriptors of speech abnormality contributed to the perception of speech abnormality. Ten graduate students in speech pathology listened in two 1.5 hour sessions to 252 random speech samples presented on a master tape. There were 81 subjects comprised of 27 sleep apnea patients, 27 matched chronic obstructive pulmonary disease control patients, and 27 matched normal control subjects. Rating the speech along an equally-appearing interval scale from 1 to 7, the judges heard abnormal resonance, articulation or phonation in 74 percent of the sleep apnea subjects, 53 percent of the COPD subjects, and 7 percent of the normal subjects (significant difference by chi 2 test at the .01 level of confidence). Discriminant function equations based on these speech descriptors correctly identified 96.3 percent of the normal subjects and 63.0 percent of the sleep apnea subjects. Analysis of abnormal speech resonance, articulation and phonation may identify obstructive sleep apnea or may provide insight into its pathology. PMID- 2766818 TI - Clinical significance of nonspecific bronchial hyperresponsiveness in asthma. AB - Measurement of nonspecific bronchial hyperresponsiveness remains largely a research tool in asthma, and its usefulness in the assessment and management of asthma is poorly defined. We studied the relationship of bronchial hyperresponsiveness to the clinical severity of asthma in 54 asthmatic subjects. In order to find out whether measurement of bronchial hyperresponsiveness could be used to predict future symptomatic status and requirements for drugs, ten patients were followed for three months. We found that there was no correlation between the clinical severity of asthma and the degree of bronchial hyperresponsiveness and, also, that the latter could not be used as a prognostic indicator of future symptomatic status and drug requirements. Measurement of nonspecific bronchial hyperresponsiveness, therefore, adds little to the assessment and management of asthma. PMID- 2766819 TI - Diastolic time during low-level exercise in the late phase of hospitalization for acute myocardial infarction. AB - To evaluate DT during a low-level exercise test, the relation between DT and heart rate was studied by ear densitography in the late phase of hospitalization for acute MI. None of the patients had an ischemic electrocardiographic response. The patients were divided into two groups: group 1 was comprised of nine patients with a resting left ventricular end-diastolic volume of 140 ml or more, and group 2 was comprised of nine patients with a left ventricular end-diastolic volume less than 140 ml. The QS2 and heart rate had an linear inverse relation during exercise, and DT and heart rate had an nonlinear inverse relation (DT = e(7.27 0.0166 x heart rate) and DT = e(7.11-0.0142 x heart rate) for groups 1 and 2, respectively). Significant prolongation of the QS2 with consequent shortening of DT (p less than 0.05) was observed in group 1. Thus, in addition to a larger decrease in DT with a small change in heart rate, particularly during low-level exercise, patients with increased left ventricular end-diastolic volume have a potential for initiating subendocardial ischemia which results in further prolongation of systole and, hence, greater abbreviation of DT. PMID- 2766820 TI - Increased hydrogen peroxide in the expired breath of patients with acute hypoxemic respiratory failure. AB - Acute hypoxemic respiratory failure (AHRF) can result from diverse lung insults. Toxic oxygen metabolites have been implicated in this clinical condition and in animal models of pulmonary edema. Hydrogen peroxide (H2O2), an oxygen metabolite, mediates tissue injury. We measured H2O2 levels by a spectrophotometric technique in the breath condensate of 68 mechanically ventilated patients; 13 patients with normal lungs undergoing elective surgery had no such detectable levels of H2O2. Fifty-five patients in the ICU meeting criteria for the adult respiratory distress syndrome (ARDS) had a higher concentration of H2O2 in the expired breath condensate than ICU patients without pulmonary infiltrates (2.34 +/- 1.15 vs 0.99 +/- 0.72 mumol/L, p less than 0.005). This marker had a sensitivity of 87.5 percent and a specificity of 81.3 percent in separating the two patient populations. Patients with AHRF and focal pulmonary infiltrates who did not meet criteria for ARDS also had higher concentrations of H2O2 (2.45 +/- 1.55 mumol/L) than patients without pulmonary infiltrates (p less than 0.001). No difference was observed between the expired H2O2 concentrations of patients with ARDS or patients with focal pulmonary infiltrates. Patients with brain injury or sepsis tended to have higher levels of H2O2 regardless of lung pathology. Increased levels of H2O2 are detected in the expired breath of ICU patients with focal lung infiltrates and in ARDS patients, which is consistent with the hypothesis that oxygen metabolites participate in the pathogenesis of ARDS and other forms of AHRF. PMID- 2766821 TI - Acute non-Q wave cocaine-related myocardial infarction. AB - Since our initial report in 1984 of six patients with AMI temporally related to cocaine use, we have observed 19 additional patients in whom ischemic chest pain syndromes occurred shortly after intranasal or IV use of cocaine or after smoking the drug. Seventeen patients (89 percent) developed non-Q wave infarction and two had Q-wave infarction. One patient manifested angina with striking ST-segment elevation. None of the patients had diabetes or hypertension, and all but one were cigarette smokers. The serum cholesterol level was 162 +/- 7 mg/dl. Four of the five patients who consented to coronary angiographic studies displayed normal coronary arteries, and one showed proximal stenosis of the right coronary artery. The cold pressor test was performed in seven patients; none had angina or ECG changes induced by cold stimulation. We conclude that T-wave infarction is a common form of an acute cardiac event related to cocaine abuse, and its pathogenesis may involve that of the cocaine-induced coronary vasospasm. PMID- 2766822 TI - In-hospital cardiopulmonary resuscitation during asystole. Therapeutic factors associated with 24-hour survival. AB - The most recent American Heart Association (AHA) guidelines for cardiopulmonary resuscitation (CPR) during asystole include ventricular defibrillation, intubation, and the administration of epinephrine and atropine. This study reports results from a retrospective analysis of clinical, demographic, and treatment data collected during in-hospital CPR efforts in 123 patients in whom the initial rhythm was asystole. Twenty-eight (22.8 percent) of these patients were alive 24 h after CPR initiation. Patients who received norepinephrine drip (N = 43) were more likely to survive than those who did not (39.5 percent vs 14.1 percent; p less than .01), and those who received lidocaine drip were more likely to survive than those who did not (47.6 percent vs 18.2 percent; p less than .01). The best survival rate (57.1 percent) occurred among those who received both norepinephrine and lidocaine (N = 14). Survivors did not differ significantly from nonsurvivors in terms of age, gender, primary diagnosis, location of arrest, or duration of CPR efforts. The results suggest that aggressive resuscitation efforts which include the addition of norepinephrine and lidocaine drips to the AHA-recommended regimen of epinephrine and atropine may substantially increase the number of 24-h survivors. A pharmacologic mechanism involving norepinephrine-induced myocardial irritability and peripheral vasoconstriction, combined with lidocaine-induced suppression of abnormal automaticity, is offered as a possible explanation of the obtained results. PMID- 2766823 TI - Fiberoptic bronchoscopy in the evaluation of acute chest and upper airway trauma. AB - To determine the utility of fiberoptic bronchoscopy (FFB) in the short-term evaluation of patients with trauma, we identified 53 consecutive patients (45 male patients; mean age, 36 years) seen over a ten-year period who had FFB performed within the first three days of trauma to the chest and upper airway. There were eight deaths. Fifty patients had blunt trauma to the chest. These were mostly due to motor vehicle accidents (38 patients), crushing injuries (three patients), and falls (three patients). In addition, there were three patients with trauma to the neck. Physical and radiographic findings included pneumothorax (37 patients), subcutaneous emphysema (31), pulmonary contusion (22), hemothorax (21), mediastinal emphysema (16), flail chest (ten), atelectasis (ten), and hemoptysis (five). The FFB was of diagnostic use in 28 patients (53 percent) by revealing complete tracheal transection (one patient), tracheal laceration (three), complete bronchial transection (one), bronchial laceration (two), bronchial contusion (two), ongoing distal hemorrhage/pulmonary contusion (seven), aspirated material (three), mucous plugging/thick secretions (eight), and supraglottic lesions (three). One of the cases of tracheal laceration was not fully appreciated as a complete transection. We conclude that FFB has value in the short-term evaluation of patients with trauma. PMID- 2766824 TI - Safe intrahospital transport of critically ill ventilator-dependent patients. AB - STUDY OBJECTIVE: To determine whether manual ventilation during intrahospital transport of mechanically ventilated critically ill patients results in blood gas and/or hemodynamic abnormalities. DESIGN: A single-blind prospective study evaluated arterial blood gas, blood pressure, heart rate, and arrhythmia changes during mechanical ventilation and manual transport ventilation. SETTING: University hospital ICUs and various diagnostic or treatment areas. PATIENTS: Twenty mechanically ventilated critically ill patients during intrahospital transport. INTERVENTION: Each patient received mechanical ventilation (MECH) with a volume ventilator while in the ICU and at the study/treatment area. They were manually ventilated (MAN) by a respiratory therapist during transport between areas. MEASUREMENTS AND MAIN RESULTS: The MECH settings were: VT = 0.75 +/- 0.17 L; f = 16 +/- 4; VE = 12.6 +/- 4.3 L/min; FIO2 = 0.46 +/- 0.2. Mean peak Paw = 31 +/- 12 cm H2O and mean effective Cst = 44 +/- 15 ml/cm H2O. No hemodynamic abnormalities were observed. Arterial blood gas values did not vary to any clinically significant degree, except in two patients: one patient had a reduced PaO2 and increased PaCO2 associated with an accidental O2 disconnection and clamped chest tube; another patient had an increased pH by 0.13 units with only a 9 mm Hg fall in PaCO2. CONCLUSIONS: Manual ventilation during intrahospital transport of critically ill mechanically ventilated patients is safe provided the person performing manual ventilation knows the inspired oxygen fraction and minute ventilation required before transport and is trained to approximate them during transport. PMID- 2766825 TI - ST elevation during exercise testing. PMID- 2766826 TI - Lithoptysis in a marathon runner. PMID- 2766827 TI - Bilateral cavitary lung disease in a 29-year-old woman. PMID- 2766828 TI - Approach to the diagnosis and treatment of pulmonary hypertension. PMID- 2766829 TI - Nailing down arsenic intoxication. PMID- 2766830 TI - Charcoal lung. Bronchiolitis obliterans after aspiration of activated charcoal. AB - Activated charcoal usually provides effective and safe treatment for drug overdose. We describe a patient who developed bronchiolitis obliterans and respiratory failure following aspiration of activated charcoal. This patient had a markedly reduced vital capacity with roentgenographic evidence of airtrapping. Chest roentgenograms did not demonstrate the large amount of charcoal identified at postmortem examination. PMID- 2766831 TI - Persisting hypereosinophilia and myocardial activity in the fibrotic stage of endomyocardial disease. AB - An unusual case of endomyocardial fibrosis is reported complicating an idiopathic hypereosinophilic syndrome. Persisting hypereosinophilia, degranulated eosinophils in the blood, and myocardial activity have been found accompanying the fibrotic phase of endomyocardial disease. This occurrence supports the unitarian theory on tropical and temperate endomyocardial disease and suggests in such a condition the use of steroids or cytotoxic drugs in addition to surgery. PMID- 2766832 TI - Cor triatriatum masked by coexisting COPD in an adult. AB - Cor triatriatum presenting in adulthood is extremely rare. We describe a case of adult cor triatriatum in which the diagnosis was initially masked by the concomitant existence of COPD. Cardiac catheterization revealed only slightly elevated pulmonary wedge pressure despite severe pulmonary arterial hypertension. Both the primary lung disease and cor triatriatum greatly accentuated the pulmonary vascular disease which led to a reduction of pulmonary blood flow. Consequently, pulmonary venous obstruction was masked and was not reflected by measuring pulmonary wedge pressure. The diagnosis was made by two-dimensional echocardiography and left ventriculography. PMID- 2766833 TI - Interrupted aortic arch in an asymptomatic adult. AB - Isolated interrupted aortic arch is a rare congenital cardiac disorder believed at one time to be incompatible with life once the ductus arteriosus closed. To our knowledge, only 12 cases have been reported in the literature and mostly in children. The diagnosis was made in all of them by catheterization. We report the first adult patient with an asymptomatic interrupted aortic arch diagnosed by computed tomography. PMID- 2766834 TI - Recurrent acute pulmonary emboli in association with acute myocardial infarction. AB - Left ventricular mural thrombi are a common complication of myocardial infarction, but right-sided mural thrombi have been reported only in blunt chest trauma, right ventricular catheterization, and pacemaker insertion. We describe a patient with AMI and subsequent right ventricular mural thrombi and ultimately pulmonary emboli. We believe a prospective study should be conducted first to evaluate the MI as a cause of right-sided mural thrombi and second to assess the right ventricle as a source of pulmonary emboli. PMID- 2766835 TI - Pleuroperitoneal shunt for pneumonectomy cavity malignant effusion. AB - Delayed mediastinal shift toward the remaining lung is an unusual cause of postpneumonectomy dyspnea. We report a patient who developed severe dyspnea when a malignant effusion occurred in the pneumonectomy cavity and caused a contralateral mediastinal shift. Repeated thoracentesis was needed until insertion of a pleuroperitoneal shunt effected palliation. PMID- 2766836 TI - Respiratory muscle fatigue from functional upper airway obstruction. AB - A case of functional upper airway obstruction is presented. The case is unusual because even though no identifiable organic cause could be found for dyspnea and stridor, the patient developed respiratory failure from respiratory muscle fatigue. PMID- 2766837 TI - Hydrochlorothiazide-associated pulmonary edema. AB - The findings in a patient who developed low-pressure pulmonary edema on two separate occasions immediately following the ingestion of a single triamterene hydrochlorothiazide tablet (Dyazide) are presented. It is postulated that this was related to the hydrocholorothiazide component of the drug. Although 12 cases have been reported, the pathophysiology remains obscure. Mitogenic stimulation of the patient's lymphocytes to concanavalin A, phytohemagglutinin, and pokeweed mitogen was assessed. Blastogenic responses to Staphylococcus aureus antigen, triamterene, and hydrochlorothiazide were also assessed. No hypersensitivity response could be demonstrated to either triamterene or hydrochlorothiazide. The initially low white blood cell count, associated with hemoconcentration, increased in the first 24 h in the hospital. This observation is consistent with intrapulmonary sequestration of granulocytes causing pulmonary edema. PMID- 2766838 TI - Foreign body aspirate extraction. PMID- 2766839 TI - Inspiratory resistance training for pulmonary rehabilitation. PMID- 2766840 TI - Response of nasal (and possibly bronchial) vasculature to physical exercise. PMID- 2766841 TI - Asbestos in lung cancer. PMID- 2766842 TI - Physical activity after viral illness. PMID- 2766843 TI - Treating pleural effusion. PMID- 2766844 TI - Weight loss in sleep apnea. PMID- 2766845 TI - Right ventricular volume assessment. An alternative perspective. PMID- 2766846 TI - CF and emphysema. PMID- 2766847 TI - Drug abuse and aneurysm. PMID- 2766848 TI - Chronic airways disease--distribution and determinants, prevention and control. Reports and recommendations from a conference. October 6-7, 1988, Dubrovnik, Yugoslavia. PMID- 2766849 TI - Epidemiology of chronic airways disease. PMID- 2766850 TI - Smoking as a risk factor for chronic airways disease. PMID- 2766851 TI - Acute respiratory infections as a risk factor for chronic airways disease. PMID- 2766852 TI - Asthma as a risk factor for chronic airways disease. PMID- 2766853 TI - Pollution (atmospheric, domestic, and occupational) as a risk factor for chronic airways disease. PMID- 2766854 TI - Risk factors and prevention strategies for asthma. PMID- 2766855 TI - Influence of environmental factors on the in vitro efficacy of ciprofloxacin against anaerobic bacteria. AB - The effects of alterations in pH, size of inoculum, addition of human serum, and repeated exposure to sub-minimum inhibitory concentration of ciprofloxacin against anaerobic bacteria were assessed. Increase in the size of the inoculum and human serum had no effect on the minimum inhibitory concentration, whereas decrease in pH and exposure to sub-MIC decreased the activity of ciprofloxacin against Bacteroides fragilis. We tested for synergism of ciprofloxacin with cefoxitin, clindamycin and metronidazole against B. fragilis. PMID- 2766856 TI - Susceptibility of Campylobacter pylori to the newer cephalosporin antibiotics. AB - The susceptibility of 23 strains (pediatric and adult) of Campylobacter pylori to eight cephalosporin antibiotics was determined. All strains were sensitive to cefoxitin, cefuroxime, ceftizoxime, latamoxef, and ceftriaxone. Ceftazidime and cefoperazone showed only moderate activity against C. pylori. C. pylori was resistant to cefsulodin. PMID- 2766857 TI - Mechanism of action of alpha-methylene-gamma-lactone derivatives of substituted nucleic acid bases in tumour cells. AB - Some alpha-methylene-gamma-lactone derivatives of substituted nucleic acid bases, which showed significant antitumour activity against experimental tumours, were tested for their possible mechanism of action. Derivatives 1, 4 and 7 strongly inhibit active transport of uridine through sarcoma-180 ascites tumour cells. Derivatives 1, 7 and 10 strongly inhibit a translation process in these cells, besides apparent inhibition in transcription. It appears that active transport and translation might be the primary steps inhibited by these drugs. PMID- 2766858 TI - In vitro sensitivity of various human tumors to 1-beta-D-arabinofuranosylcytosine and N4-behenoyl-1-beta-D-arabinofuranosylcytosine. AB - The sensitivities to 1-beta-D-arabinofuranosylcytosine (ara-C) and N4-behenoyl-1 beta-D-arabinofuranosylcytosine (BH-AC), a masked compound of ara-C, were determined in 33 human tumor tissues (11 gastric, 6 colorectal cancers and 16 malignant lymphomas), using the in vitro succinate dehydrogenase inhibition test. The succinate dehydrogenase (SD) activity of the tumor tissues was assayed following exposure to the drug at 8.8 or 88 microM for 3 days and the sensitivity was considered positive when the SD activity decreased to below 50% of that of the control cells at 88 microM. The SD activity decreased little at 8.8 microM and decreased individually at 88 microM. The mean of the SD activity at 88 microM was 65.7 +/- 11.5% for ara-C and 61.4 +/- 14.5% for BH-AC in gastrointestinal cancers, and 63.8 +/- 16.0% for ara-C and 58.3 +/- 18.3% for BH-AC in malignant lymphomas with a statistically significant difference (p less than 0.05). BH-AC is converted to ara-C for exertion of the cytotoxic effect and a positive correlation was noted between the SD activities of ara-C and BH-AC (r = 0.825 at 88 microM). The chemosensitivity varied with the tissue and 18% of the tissues were sensitive to ara-C, 27% to BH-AC and 15% were sensitive to BH-AC but resistant to ara-C. Our findings show that ara-C and BH-AC are equally cytostatic to human tumors. The sensitivity test of ara-C and BH-AC enables one to determine which drug is best suited for individual patients. PMID- 2766859 TI - Spectrum of the antimalarial activity of a new macrolide antibiotic midecamycin in mice and monkeys. AB - The antimalarial activity of a new macrolide antibiotic, midecamycin, has been evaluated against a sensitive strain of Plasmodium berghei, a chloroquine resistant strain of P. yoelii nigeriensis and a simian parasite, P. cynomolgi B. The ED50 and ED90 values of this antibiotic administered in two divided daily doses were found to be 37.15 +/- 3.51 and 100.84 +/- 7.54 mg/kg, respectively, against P. berghei and 362.34 +/- 85.33 and 878.04 +/- 10.02 mg/kg, respectively, against P. yoelii nigeriensis. Doses above 45 mg/kg for 4 days significantly extended the mean survival time of treated mice infected with either of the two parasites. However, no appreciable blood schizontocidal (at 100 mg/kg X 7 days), anti-relapse (at 100 mg/kg X 7 days) or causal prophylactic activities (at 200 mg/kg X 3 days) were observed against P. cynomolgi infection in rhesus monkeys. PMID- 2766860 TI - Artemisinin (qinghaosu)--a new gametocytocidal drug for malaria. AB - Gametocytocidal activity of artemisinin (qinghaosu) has been demonstrated against simian malaria parasite Plasmodium cynomolgi B. Colony-bred Anopheles stephensi were allowed to feed on gametocyte-carrying rhesus monkeys and the mosquito infectivity rate and oocyst count of the infected mosquito gut were recorded on day 8-9 postinfection. Control (pretreatment) feedings of mosquito on gametocyte carrying monkeys showed good infectivity in different batches of the mosquitoes ranging from 57.14 to 95.0%. Administration of single intramuscular injection of 5 mg/kg artemisinin (suspended in neutralised oil) resulted in complete loss of mosquito infectivity within 24 h of drug administration. This is the first report on the possible use of artemisinin to stop malaria transmission. The drug has no sporontocidal action. PMID- 2766861 TI - Integrated complex combinations for the treatment of opportunistic infections in AIDS. AB - In the present paper the 'serial combinations' (components of the combination offered separately), as used in conventional combination therapy, are compared with the 'integrated complex combination' (offered as fixed combinations). So far, three combinations have been worked out on the basis of this concept (RMP + SMZ + TMP + INH; RMP + SMZ + TMP + PTH; RMP + INH + PTH + DDS). They allow successful treatment of almost all mycobacterial infections and diseases (including tuberculosis and leprosy) and a number of infections caused by gram negative and gram-positive microorganisms and by Pneumocystis carinii. PMID- 2766862 TI - A randomized study of high-dose versus low-dose cis-platinum combined with cyclophosphamide in the treatment of advanced ovarian cancer. Hong Kong Ovarian Carcinoma Study Group. AB - A randomized clinical study of patients with advanced epithelial ovarian cancer after debulking surgery showed that high-dose (120 mg/m2) cis-platinum (DDP) in combination with cyclophosphamide (600 mg/m2) had a significantly higher response and survival rate than the low-dose DDP (60 mg/m2) and cyclophosphamide combination. The 3-year actuarial survival rate of the high-dose group was 60% and that of the low-dose group was 30%. Though moderate to severe marrow toxicity was evident in 80% of the patients in the high-dose group and 40% of the low-dose group, no serious sepsis or death developed as a result of the marrow depression. Mild neurotoxicity was observed in 55% of the patients in the high-dose group and only 20% in the low-dose group. Mild nephrotoxicity was seen in 25 and 17% of patients in the high- and low-dose groups, respectively. It was concluded that the 120 mg/m2 dose DDP and cyclophosphamide combination should be used in the treatment of carcinoma of the ovary in spite of its toxicities. However, it should only be used in institutions with supportive facilities in the management of patients with severe marrow depression. PMID- 2766863 TI - Worldwide clinical experience with ceftriaxone. PMID- 2766865 TI - In vitro activity of cefteram against predominantly enteropathogenic and glucose nonfermentative gram-negatives. AB - Cefteram (T-2525), the free acid of the orally active cephalosporin ester cefteram pivoxil, was tested in vitro against 355 gram-negative clinical isolates of enteropathogenic and nonfermentative species. The compound was several times more active (w/w) against isolates belonging to the enteropathogenic Enterobacteriaceae and Vibrionaceae than against those belonging to the nonfermentative rods (excluding Pseudomonas aeruginosa). PMID- 2766864 TI - Pharmacokinetics of cefsulodin in rat cerebrospinal fluid during experimental Pseudomonas aeruginosa meningitis. AB - Experimental meningitis was induced in rats with Pseudomonas aeruginosa. Bacteria were inoculated in the second ventricle. Twenty hours later cefsulodin penetration was studied in CSF by on-line cannula system which permitted sampling of CSF in the third ventricle. Comparison with healthy animals indicated breakdown of the blood-CSF barrier and high concentrations of cefsulodin were found in CSF. PMID- 2766866 TI - In vitro activity of multiple antimicrobial combinations against Pseudomonas cepacia isolates. AB - For 16 isolates of Pseudomonas cepacia from patients with cystic fibrosis, synergism was determined by the killing curve method, utilizing various combinations of antibiotics [ticarcillin (Ti), rifampin (Ri), tobramycin (To), imipenem (Im), ofloxacin (Of), polymyxin B (PB), and trimethoprim/sulfamethoxazole (S x T)]. All 16 isolates were resistant to Ti, To, Ri, and PB; 11 were sensitive to S x T, 13 were sensitive to Im, and 2 were sensitive to Of. The combination of Im/Ri was synergistic for 8 isolates. Several combinations (Ti/Ri/Im), (Ti/Im/To), (Ri/Im/To) also demonstrated synergism for these 8 isolates. The Im/Ri combination did not demonstrate synergism against the other 8 isolates. The Ti/Im/To combination was synergistic for 6 of these. The Ri/Im/To combination was synergistic for 5 and the Ti/Im/Ri combination was synergistic for 3. Synergism could also be demonstrated with several 4-drug combinations. This study suggests that multi-drug combinations may have a role in the treatment of P. cepacia infections if proven in clinical studies. PMID- 2766868 TI - Effects of cefbuperazone on the chemiluminescence of human neutrophils. AB - To investigate the in vivo effect of antimicrobial agent on neutrophil chemiluminescence and serum opsonic activity, cefbuperazone sodium (CBPZ) was administered to healthy male volunteers via an intravenous drip. A peripheral blood sample (10 ml) was collected 7 times: prior to injection, then 1, 3, 6, 9, 12 and 24 h after injection. Neutrophil chemiluminescence and serum opsonic activity was measured by the simultaneous multiple measurement system based on luminol-dependent chemiluminescence and indicated by peak height and peak time. Neutrophils were activated at hour 1 from the point of view of peak height and statistical significance was observed. The fluctuation of serum opsonic activity was small and statistical significance was not observed. CBPZ has an in vivo effect on neutrophils which was not supposed from in vitro study. PMID- 2766867 TI - Effects on the urinary level of gamma-carboxyglutamic acid caused by the administration of antibiotics with N-methyl thiotetrazole side chains to patients with infectious diseases. AB - A comparative study was conducted of the urinary level of gamma-carboxyglutamic acid (gamma-Gla) in patients with infectious diseases to investigate the mechanism of hemorrhagic diathesis occurrence resulting in post-administrative side effects of cephem-group antibiotics. The results showed that the group of administered antibiotics with N-methyl thiotetrazole (NMTT) side chains exhibited decreases in the urinary level of gamma-Gla. Especially, in the aged group of patients (over 65) with non-carcinoma infectious diseases, significant decreases in the urinary level of gamma-Gla were observed. From the above, it is considered that the administration of antibiotics with NMTT side chains has an effect of prohibiting the vitamin K function. PMID- 2766869 TI - Treatment of childhood bacterial meningitis with ceftriaxone once daily: open, prospective, randomized, comparative study of short-course versus standard-length therapy. AB - Fifty-two children were included in this study to evaluate and compare short- versus standard-length ceftriaxone therapy for bacterial meningitis. The duration of the short-course regimens was 4, 6 and 7 days for Neisseria meningitidis, Hemophilus influenzae and Streptococcus pneumoniae, respectively. The standard length regimens were twice as long. On the basis of a computer-generated randomization list, 26 children were assigned either to the short- or to the standard-treatment regimen. Ceftriaxone was given intravenously once daily in a dose of 60 mg/kg after an initial loading dose of 100 mg/kg. The population characteristics, the severity of disease and the cerebrospinal fluid (CSF) findings were similar in the two study groups at admission. Bacteriological and clinical response were comparable. There were no significant differences in the incidence of neurological complications, prolonged fever (greater than or equal to 10 days), persistent pleocytosis and side effects between the two groups. Hearing loss occurred in 3 patients in the standard-length group and in no patients in the short-course group. Diarrhea was the only side effect and occurred in 14% of the patients. The results of the study indicate that the short duration regimen was adequate for the treatment of meningitis caused by the three major meningeal pathogens. However, the small number of patients do not justify the adoption of the short-course regimen for all children with meningitis. At present, prolongation of ceftriaxone therapy or discontinuation of the drug under strict clinical observation of the patient should be considered in some cases. PMID- 2766870 TI - Clinical efficacy of perioperative antimicrobial prophylaxis in neurosurgery--a prospective randomized study involving 159 patients. AB - In a randomized study 87 patients received perioperative antibiotic prophylaxis with 2 x 2 g ceftriaxone (Rocephin) at the beginning of the operation and in the following morning. Seventy-two patients received no antibiotic prophylaxis. In patients receiving the prophylaxis, a lower incidence of infections was observed postoperatively in addition to a reduction in wound-healing disorders. Respiratory tract infections were more successfully prevented than urinary tract infections. The number of pathogenic bacteria detected in the group on receiving prophylaxis decreased. The positive effect of the perioperative administration of antibiotics was more evident in protracted operations, such as brain surgery, than in operations involving the spinal cord. PMID- 2766871 TI - Psychopathology and economic status in mother-only and mother-father families. AB - This paper reports evidence on the link between economic resources and psychiatric disorder in female-headed families with children. It has been assumed that a father's absence leads to augmented psychopathology in children and their mother through the disruption of roles, relationships, socialization and development. This study suggests that the absence of father/husband compounds the stress of family separation by diminishing household income, often to the point of poverty. PMID- 2766872 TI - Child abuse disposition: concurrences and differences between a hospital team, child protection agency and the court. AB - Ninety-six children admitted to a pediatric ward for maltreatment are described statistically using variables characterizing the child, the family and the type of abuse. Recommendations of the hospital's child protection team in 81 cases are compared to those of the county childrens Services Board and the court. Multiple regression analysis is used to identify which variables influenced the decisions of these three agencies. PMID- 2766873 TI - A comparison of sexually abused and nonsexually abused children's behavioral responses to anatomically correct dolls. AB - Groups of 16 girls referred for evaluation and treatment of sexual abuse and 16 nonreferred girls between the ages of 5 and 8 years were compared on aggression, avoidance, private parts reference, and freeplay over two conditions: playing alone with anatomically correct dolls and telling a story about the dolls to an adult. Results indicated that sexually abused children displayed more sexually oriented behavior when alone but more avoidance of the dolls when interacting with an adult. PMID- 2766874 TI - Effects of sexual and physical abuse: a comparison of adolescent inpatients. AB - The present study was designed to collect descriptive data on a sample of hospitalized adolescents who were victims of sexual and/or physical abuse and to compare these groups to patients without a history of abuse. A questionnaire was administered to 51 inpatient teenagers at Fort Logan Mental Health Center, a state psychiatric hospital in Denver, Colorado. Information was obtained about family background, type, extent and duration of abuse, drug and alcohol abuse and self-reported mental health and general adjustment problems. In addition, clinical staff completed the Revised Behavior Problem Checklist (1) for the subjects. The results indicated statistically significant differences (p less than .05) between groups with adolescents who were both physically and sexually abused reporting the most problems. The implications for the findings for treatment are discussed. PMID- 2766875 TI - Childhood victimization: desensitization effects in the later lifespan. AB - The hypothesis tested in this study was that young adults who report having been abused by parents or guardians as children would report less concern when confronted with hypothetical situations similar to the type of abuse they had reportedly experienced during childhood. In our study of nonclinical adults those who reported childhood victimization experiences showed diminished concern toward the specific kind of abuse situation encountered earlier in their lifespan. PMID- 2766876 TI - Sequence of centromere separation: characterization of multicentric chromosomes in a rat cell line. AB - The B1 cell line of rat cerebral endothelium origin exhibits several dicentric and multicentric chromosomes. These chromosomes, unlike multicentrics in mouse (Vig and Zinkowski 1986) do not show premature centromere separation. All centromeres deposit kinetochore proteins and appear to be functional. Even the centromeres which fail to migrate to the poles during anaphase and make side arm bridges bind to spindle microtubules. Some multicentric chromosomes show kinetochores spaced apart with intervening stretches of euchromatin while others are located adjacent to each other thus exhibiting tandem repeats and forming a "compound" kinetochore (Brinkeley et al. 1984). Also, unlike mouse multicentric chromosomes in which different pericentric regions and the centromeres replicate at different times, the rat chromosomes appear to replicate all pericentric and centric regions in a given multicentric simultaneously. The present studies indicate that centromeres in rat and mouse replicate during the last part of the S-phase and in continuation with the pericentric heterochromatin. PMID- 2766877 TI - Developmental changes in the responsiveness to ecdysterone of chromosome region I 18C of Chironomus tentans. AB - The presence of nascent RNA in chromosome region I-18C was revealed by the method of induced hybrid formation (IEH) and by use of anti-RNA:DNA antibodies. IEH signals were quantitated, and used as a measure of transcriptional activity in the region. The expansion of the I-18C region was also determined and used as an indication of local chromatin decondensation. Chironomus tentans larvae may undergo oligopause or they may develop subitaneously. It was found that the course of basal activity in I-18C differs substantially in these two modes of development. Most interestingly they also differ in activation of I-18C in response to in vitro ecdysterone treatment. Changes in hormonal responsiveness of I-18C parallel changes in the preexisting state of I-18C decondensation. Oligopause stage 5 animals, being most refractory in this respect, exhibit the most condensed I-18C chromosome region. PMID- 2766878 TI - Tension, microtubule rearrangements, and the proper distribution of chromosomes in mitosis. AB - The basis for stable versus unstable kinetochore orientation was investigated by a correlated living-cell/ultrastructural study of grasshopper spermatocytes. Mal oriented bivalents having both kinetochores oriented to one spindle pole were induced by micromanipulation. Such mal-orientations are stable while the bivalent is subject to tension applied by micromanipulation but unstable after tension is released. Unstable bivalents always reorient with movement of one kinetochore toward the opposite pole. Microtubules associated with stably oriented bivalents, whether they are mal-oriented or in normal bipolar orientation, are arranged in orderly parallel bundles running from each kinetochore toward the pole. Similar orderly kinetochore microtubule arrangements characterized mal-oriented bivalents fixed just after release of tension. A significantly different microtubule arrangement is found only some time after tension release, when kinetochore movement is evident. The microtubules of a reorienting kinetochore always include a small number of microtubules running toward the pole toward which the kinetochore was moving at the time of fixation. All other microtubules associated with such a moving kinetochore appear to have lost their anchorage to the original pole and to be dragged passively as the kinetochore proceeds to the other pole. Thus, the stable anchorage of kinetochore microtubules to the spindle is associated with tension force and unstable anchorage with the absence of tension. The effect of tension is readily explained if force production and anchorage are both produced by mitotic motors, which link microtubules to the spindle as they generate tension forces. PMID- 2766879 TI - Dynamic G- and R-banding of human chromosomes for electron microscopy. AB - Synchronized human lymphocytes were exposed to 5-bromo-2'-deoxyuridine (BrdUrd) for incorporation in either G- or R-bands. The substituted bands were revealed by monoclonal anti-BrdUrd antibodies disclosed with either gold-labeled antibodies or with the protein A-gold complex. Sharp G- or R-banding, specific for electron microscopy (EM), was obtained. These banding patterns, referred to as GB-AAu (G bands by BrdUrd using Antibodies and gold [Au]) and RB-AAu (R-bands by BrdUrd using Antibodies and gold [Au]), resemble dynamic band patterns (GBG and RBG) much more than they do morphologic band patterns (GTG and RHG). The G- and R-band patterns allow accurate chromosome identification and karyotyping. An actual karyotype of human GB-AAu-banded chromosomes at the 750 band level, photographed in the EM, is presented. The method produces excellent band separation and band contrast. Variations in band staining intensities were noted and correlated with BrdUrd enrichment. The C-band regions were positively stained after GB-AAu banding while they were negatively stained after RB-AAu banding. Telomeres appeared heterogeneous after GB-AAu banding suggesting that part of the telomeric bands might be late replicating. PMID- 2766881 TI - Evaluation of algorithms for ratio imaging in fluorescence microscopy. AB - Ratio imaging in fluorescence microscopy is used in measuring parameters such as pH, pCa, cytoplasmic porosity, and the relative concentration of fluorescent analogs within single cells. The fastest method for ratio imaging is to use lookup tables on special-purpose image processors. Since lookup tables store integers in integer addresses, using a lookup table will generate rounding errors. The magnitude of the error will depend on the transformation performed and on the number of levels used in the lookup table. We examined ratio imaging by lookup table and computed the errors generated by both inversion and log subtraction methods. Both uniformly fluorescing fields and fluorescing cell images were employed to provide data for use in confirming our calculations and illustrating both the magnitude and spatial incidence of errors. It is shown that, through proper design of lookup tables, a significant reduction can be made in the errors generated in comparison with common methods available in most image processors. PMID- 2766880 TI - The diameter of chromatin fibres depends on linker length. AB - We have studied the diameter of chromatin fibres embedded in epoxy resins for three different materials: mouse thymus, chicken erythrocytes and sea cucumber spermatozoa. We confirm that the diameter of chromatin fibres increases with linker length, both values being influenced by the protein composition of chromatin. PMID- 2766883 TI - Central values and variation of measured nuclear DNA content in imprints of normal tissues determined by image analysis. AB - A total of 109 slides derived from 37 normal tissues were analyzed for nuclear DNA content using the Cell Analysis Systems (CAS) model 100 image analysis system with the Quantitative DNA Analysis (QDA) software module in order to determine the central values of DNA content and define normal limits. Analysis of the 109 slides revealed an overall mean measured DNA index of 0.997 with a standard deviation of 0.04. Analysis of replicate samples was essentially constant. There were no differences between samples obtained from autopsy and surgical specimens. Small variations were detected among stain batches, individual patients, and tissue types. These results indicate a high degree of accuracy and reproducibility of DNA content determinations using this system. PMID- 2766882 TI - Automated detection and recognition of live cells in tissue culture using image cytometry. AB - An automated image cytometry device, the Cell Analyzer, was used to locate live V79 cells plated at low densities in a tissue culture flask. Cells and other objects were detected by moving the flask in steps across a linear solid-state image sensor. The step size was selected to be small enough to allow detection of all the cells in the area being scanned but sufficiently large so that most cells would be detected on only one image line. To distinguish cells from other detected objects, a recognition algorithm utilizing 18 characteristic cell signal features was developed. The algorithm first tests whether a set of feature values falls within specified upper and lower bounds, and then applies a linear discriminant function to the remaining data to further discriminate cells from debris. False-positive errors of 5% or less were achieved with this method, whereas 15-35% of cells were misclassified as debris. PMID- 2766884 TI - Differences in the flow and absorption cytometric DNA distributions of mouse hepatocytes and tumor cells. AB - We have determined the DNA content, the ploidy levels, and the percentages of different cell types present in small and large mouse mammary tumors as well as in young and old mouse livers by using absorption and flow cytometry. Absorption cytometry data indicated a significant increase in the proportion of transformed G0/G1 cells in the tumors as compared to that of the stromal G0/G1 cells with progressive tumor growth. This increase was not detected by flow cytometry. In both young and old mouse livers, a small number of cells of higher ploidy (8C and 16C) were detected by absorption cytometry but were not apparent in histograms obtained by flow cytometry. Furthermore, changes in the proportions of liver cells of different ploidy with age were apparent in absorption cytometry data but not in flow cytometry data. In one mouse liver experiment, a 6C cell peak appeared in the flow cytometry histogram, but a direct measurement of DNA content by absorption cytometry failed to detect cells with such a peak. We therefore believe that some caution may be warranted in the use of flow cytometry alone for evaluation of DNA distributions and of the proportions of different types of cells in complex solid tissues. PMID- 2766885 TI - Problem of size dependence in fluorescence DNA cytometry. AB - The relationship among fluorescence intensity, area, thickness, and DNA concentration of DNA-bearing polyacrylamide film, stained with 50 ng/ml DAPI, was studied using an epi-illumination cytofluorometer. Measurements and theoretical analysis suggest the inevitability of the size-dependent effect on human cell nuclei in which the order of the DNA concentration is approximately 10 mg/ml, and that this effect can be virtually negated if the nuclei are stretched and flattened to less than 0.33 microns in thickness on the smears. Alternative practical ways to minimize this effect are to decrease the dye concentration of a staining solution and to make smears as thin and uniform as possible by some means such as hypotonic treatment and/or using an automatic centrifuge smearing apparatus. The size-dependent effect, nevertheless, should be taken into account particularly when determining the DNA content of different cell types and the DNA aneuploidy of tumor cells, regardless of the technique used for measurement. PMID- 2766886 TI - Technique for cellular fluorescence distribution analysis. AB - The usefulness of multidimensional slit-scan flow cytometry in whole cell measurements is dependent on extracting relevant features from the cellular fluorescence distributions (slit-scan contours). In addition, the extraction of these features must be rapid to allow for real-time data processing during acquisition. This paper describes two algorithms that have been used successfully to count the numbers of local maxima (peaks) and to find nuclear boundaries in a cellular fluorescence distribution. These routines are efficient, use only simple integer arithmetic, and have been implemented on several different microprocessors. PMID- 2766887 TI - Measurement of S-phase fractions in lymphoid tissue comparing fresh versus paraffin-embedded tissue and 4',6'-diamidino-2 phenylindole dihydrochloride versus propidium iodide staining. AB - S-phase fractions for 62 lymphoid biopsies were calculated, by means of flow cytometry, from both fresh and paraffin-embedded tissue. The purposes of this study were to determine whether significant differences were seen between S-phase estimates obtained from fresh and fixed tissue and to compare results obtained with two DNA dyes, namely 4'-6'-diamidino-2 phenylindole dihydrochloride (DAPI) and propidium iodide (PI). The 62 cases consisted of 38 cases of non-Hodgkin's lymphoma (NHL), 19 reactive samples, and 5 cases of Hodgkin's disease. Fifty-four of the samples showed DNA diploid profiles. A good agreement between S-phase results from fresh and fixed tissue was seen, with technical factors accounting for around 20% of the total variance. Using a paired t test, no significant difference was seen between fresh and fixed tissue for diploid cases, but there was a trend for S-phase estimates from fixed tissue to be higher. If all cases (including the eight DNA aneuploid samples) were included in the analysis this difference just reached statistical significance (P less than .05). In a subgroup of 19 of the cases, a comparison was performed on both fresh and fixed tissue of staining with DAPI and PI. A good agreement between results with both DNA stains was found on fresh and fixed tissue, with no significant differences being apparent, and stain-related factors accounted for only 10% of the total variance. PMID- 2766888 TI - Autolysis is a potential source of false aneuploid peaks in flow cytometric DNA histograms. AB - Serial flow cytometric nuclear DNA content analyses were performed from normal human spleen, thyroid, liver, and pancreas removed from ten patients at autopsy and stored for up to 8 d without any preservative to study the effect of autolysis on DNA histograms. Fine needle aspiration biopsy (FNAB) samples were taken in diluted ethanol and tissue biopsies from the same area in formalin for embedding into paraffin at the time of autopsy and serially thereafter. Histograms obtained from samples taken within 10 h after death had a symmetrical G1 peak with a small coefficient of variance (CV) except histograms produced from paraffin-embedded pancreatic tissue, but bimodal distributions similar to those seen in aneuploid tumors were obtained from many samples stored longer than for 20 h. The DNA indices of the bimodal histograms were usually less than 1.3. The false peaks were more prominent in FNAB samples than in paraffin-embedded samples. The time of appearance of the false aneuploid peaks varied individually, and they were usually first seen in samples taken from the pancreas, followed by the liver, the thyroid and the spleen. Because neoplasms may become necrotic in vivo and fixation of fresh surgical samples may be slow and incomplete, increased DNA staining caused by autolysis may be a source of false aneuploid peaks in DNA content analysis. PMID- 2766889 TI - Resolving leukocytes using axial light loss. AB - Axial light loss (ALL) is the measurement of the total light lost from the laser beam at 0 degrees when a particle passes through the beam. Used in combination with the monoclonal antibody CD45, ALL can effectively resolve lymphocytes, monocytes, granulocytes, and dead cells in viable or fixed preparations of human peripheral blood. A bivariate display of ALL vs. CD45 clearly resolves all granulocytes from lymphocytes; although degranulated granulocytes cannot be resolved with forward-angle and right-angle light scatter, they are clearly resolved in right-angle scatter vs. CD45. A blood differential can be performed, with a single laser flow cytometer and three colors of fluorescence, when ALL is combined with fluoresceinated CD45 to resolve leukocytes, phycoerythrin-labeled NKH1 to resolve natural killer cells, and biotinylated CD3 in combination with DuoCHROME, the phycoerythrin/Texas red conjugate fluorochrome from Becton Dickinson, to resolve T-cells. B-cells are the only cells negative for both phycoerythrin and Texas red. When PE CD4 is included, the CD3+ CD4+ T-cell subset is resolved from the CD3+ CD4- subset comprising mainly the CD3+ CD8+ T-cell subset. The addition of propidium iodide is unnecessary since ALL clearly resolves dead cells in a viable preparation of human peripheral blood. Furthermore, since ALL resolves these cells even after fixation in paraformaldehyde, all samples can be fixed prior to analysis, thereby minimizing the potential biohazard risk. PMID- 2766890 TI - Accuracy of routine flow-cytometric bitmap selection for three leukocyte populations. AB - A double-blind study was performed with peripheral blood of 41 human subjects to check the accuracy of determination of lymphocyte, monocyte, and granulocyte windows with which every flow cytometric analysis of leukocyte markers starts. White blood cell suspensions were prepared according to the whole blood method and analyzed on an EPICS-C flow cytometer using the two-parameter 90 degrees light scatter vs. forward angle light scatter (granularity vs. cell size) data distribution. Windows (bitmaps) for lymphocytes, monocytes, and granulocytes were drawn and numbers of cells determined in each. The proportions of lymphocytes, monocytes, and granulocytes were calculated in relation to total cell number, counted and in relation to the sum of cells in three bitmaps, and then compared with proportions determined by microscopic whole blood cell (WBC) differential and a WBC differential determined in an automated hematology analyzer. Average proportions of lymphocytes obtained by the flow cytometer were significantly lower than those obtained by either microscopic or automated differential, suggesting that some of the relevant cells were not included in the bitmaps. Granulocyte proportion related to total cell number was lower and that related to bitmap cell number higher than that obtained by microscopic and automatic differentials, suggesting that nongranulocytic cells were included in the granulocyte bitmaps. Proportions of lymphocytes and granulocytes obtained by the flow cytometer correlated well with those obtained by both microscopic and automatic differential. In contrast, the proportions of monocytes showed a poor correlation, which is probably due to their low number and delicate position in the distribution, and which makes them difficult to delineate. PMID- 2766891 TI - A rapid and sensitive flow cytometric method for the detection of multidrug resistant cells. AB - Multidrug-resistant (MDR) cells are characterized by a defect in drug accumulation caused by activity of an energy-dependent rapid drug efflux pump. The action of this drug pump can be inhibited by specific agents, referred to as membrane transport modulating agents (MTMAs), resulting in a restoration of the intracellular drug accumulation. This paper presents a flow cytometric assay for the detection of MDR cells, which is based on the ability of these cells to respond to MTMAs. Daunorubicin net-uptake kinetics were measured of anthracycline sensitive (A2780/S) and -resistant (A2780/R) human ovarian carcinoma cells in vitro. A2780/R cells accumulated significantly less (about a factor of 5) daunorubicin as compared to A2780/S cells. Addition of verapamil or cyclosporin A to A2780/R cells at steady-state daunorubicin uptake led to a dose-dependent increase in cellular daunorubicin accumulation. The sensitivity of the assay was determined by testing mixtures of A2780/S and A2780/R cells. Analysis of A2780/S cells contaminated with A2780/R cells showed that as few as 2.5% MDR cells could readily be detected in the mixture. In conclusion, this functional assay enables the detection of MDR cells in a heterogeneous cell suspension and is ideally suited for the study of the occurrence of typical MDR in human cancer. PMID- 2766893 TI - Suggested corrections for Overton's PASCAL procedure. PMID- 2766892 TI - Flow cytometric analysis of mature adipocytes. AB - Flow cytometry is an excellent method for studying the physiological function in adipocytes because their response to hormones, especially insulin, varies with cell maturity and therefore size. Adipocytes present a unique technical challenge. A freshly prepared adipocyte suspension contains cells and fat droplets ranging from 10 to greater than 120 microns in diameter. Stored fat occupies 90-98% of the cell volume, making it difficult to distinguish cells from fat droplets. Other difficulties include buoyancy, large size, fragility, and tendency to aggregate and clog the sample tube and nozzle. These obstacles were overcome by 1) maintaining the sample, sample line, sheath fluid, reservoir, and nozzle assembly at 37 degrees C; 2) using a 200 microns diameter orifice; 3) using a short, 300 microns inside diameter Teflon sample delivery line; 4) injecting the sample at constant flow rate into the sheath fluid at low pressure; and 5) using the pH-sensitive vital stain, biscarboxyethylcarboxyfluorescein (BCECF) to distinguish cells from fat droplets. Stained cells are brightly fluorescent when excited at 488 nm. Because fat droplets do not fluoresce, they can be distinguished from fat cells by gating on the BCECF emission. The cytosolic pH of intact, viable, mature adipocytes was derived from the ratio of the fluorescent emission intensities at 520 and 620 nm and was estimated to be 7.2. Unlike BCECF, several other useful fluorescent probes of cell function, e.g., the intracellular calcium indicator, indo-1, label both fat cells and fat droplets.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2766894 TI - In-vivo effects of ivermectin on Rhipicephalus appendiculatus: the influence of tick feeding patterns and drug pharmacokinetics. AB - Sublethal effects seen amongst Rhipicephalus appendiculatus feeding on ivermectin treated rabbits were diverse and dependent both on drug dose, pharmacokinetics and tick feeding patterns: changes in drug formulation, the time of infestation relative to treatment, and the tick instar used, profoundly influenced acaricidal activity. Death was a sequel to paralysis only if tick feeding was interrupted for sufficient time to produce irreversible dehydration. Concurrent pharmacokinetic investigations revealed that, for the larvae of R. appendiculatus, the mean critical lethal dose of ivermectin imbibed over a 5-day engorgement period was 3500 micrograms/kg. This quantity of ivermectin was achieved in the blood-meals of larvae feeding on rabbits treated subcutaneously with a single dose of Ivomec injection (MSD)* greater than or equal to 800 micrograms/kg, provided infestation took place within 24 h of treatment. At lower drug doses, or if larval infestations were delayed for greater than 24 h post treatment, the quantity of circulating ivermectin (and thus imbibed by the tick larvae) fell below 3500 micrograms/kg and an increasing percentage of larvae successfully engorged and detached. More than 90% of such larvae moulted to the nymphal stage. Nymphae and larvae exhibited similar susceptibility to ivermectin on treated rabbits which could be explained by similar feeding patterns. However, adult female and male ticks were markedly less susceptible and interpretation of ivermectin-induced effects was more complex. PMID- 2766895 TI - Control of induced infestations of three African multihost tick species with sustained-release ivermectin. AB - The efficacy of ivermectin, released intraruminally from a 28-day-delivery device was evaluated in two titration studies against induced infestations of adult Rhipicephalus appendiculatus, R. evertsi and Hyalomma truncatum on cattle. Cattle were given a sufficient number of devices to release ivermectin at approximately 20, 40, 60 or 80 micrograms kg-1 day-1 at a steady-state rate 7-28 days after administration. Tick mortality was recorded, engorged female ticks were weighed and individually incubated, and reproductive data were recorded to determine a reproductive index for the species at various dose levels. Mortality of male and female ticks compared to that of controls was directly related to the daily dose of ivermectin, as was the number of ticks not engorging. Ticks fed on ivermectin treated cattle had a smaller mass when engorged and laid smaller egg-masses, both absolutely and as a proportion of engorged mass. The index of reproduction of R. appendiculatus was reduced by more than 99.9% at 20 micrograms kg-1 day-1, and the reproductive indices of R. evertsi and H. truncatum were reduced by more than 99.9% at dose rates of 40 micrograms kg-1 day-1 and above. Practical implications of the application of sustained-release ivermectin for the control of multihost ticks and tick-borne diseases are discussed. PMID- 2766896 TI - Monitoring of naturally acquired and artificially induced immunity to Amblyomma variegatum and Rhipicephalus appendiculatus ticks under field and laboratory conditions. AB - The ability of rabbits, goats and cattle to acquire immunity to the ixodid ticks Amblyomma variegatum and Rhipicephalus appendiculatus was studied under laboratory and field conditions. Rabbits were successfully immunized with crude salivary gland extract (SGE) and midgut extract (ME) obtained from flat or partly fed female R. appendiculatus ticks. The lowest numbers of larvae were produced by females fed on rabbits immunized with unfed midgut extract. Similar reductions in larval production could be induced after three infestations of rabbits with adult R. appendiculatus. Also, successive feedings of nymphs of R. appendiculatus on rabbits resulted in significantly reduced engorgement weights. Skin testing with SGE induced delayed-type hypersensitivity reactions, which could be correlated with immunity to R. appendiculatus in rabbits. Moreover, circulating antibodies were detected in rabbits with an ELISA using SGE of R. appendiculatus. Immunity to A. variegatum nymphs could be induced in rabbits by repeated infestations, but this failed in goats. Immunization of goats with midgut extract from adult A. variegatum did not protect against subsequent nymphal challenge, but strong skin reactions were noticed when adults ticks fed on immunized goats. Sodium dodecyl sulfate polyacrylamide gel electrophoresis of SGE and ME from A. variegatum revealed the presence of 48 protein bands in SGE and 29 bands in midgut extract. Western blotting employing serum from a rabbit immune to R. appendiculatus recognized a number of bands in SGE from R. appendiculatus, but also in SGE of A. variegatum. Immunity acquired by cattle to ixodid tick infestations under field conditions was monitored by skin testing with SGE and western blot analysis. In general, cattle with the lowest tick numbers manifested the strongest delayed type hypersensitivity responses. Finally, western blot analysis employing sera from tick-infested and tick-naive cattle could not be related to actual immune status. PMID- 2766897 TI - Formulation of medium for tick cell culture. AB - We examined the effectiveness of bovine cholesterol concentrate in reducing the high level (10-20%) of fetal bovine serum (FBS) necessary to promote tick cell growth in vitro. Tick cell lines isolated from embryos of Anocentor nitens (ANE 58), Boophilus microplus (BME 26), and Rhipicephalus appendiculatus (RAE 25) were used. They were incubated in L-15 (BME 26) or L-15B (ANE 58 and RAE 25) supplemented with 10% tryptose phosphate broth (TPB), 5% (ANE 58 and BME 26) or 3% FBS, 10-90 microns/ml cholesterol. A concentration of 10 micrograms/ml cholesterol stimulated the growth rate of all three lines but more than 30 micrograms/ml depressed growth in ANE 58 and RAE 25 cells, while multiplication of BME 26 cells was enhanced by all cholesterol concentrations tested. All three lines could be continuously grown in 5% FBS, provided that 10 micrograms/ml cholesterol was included. Nutrients added to L-15 in the formulation of L-15B were tested singly or in combination for their ability to support tick cell growth in medium supplemented only with 5% FBS and 10 microns/ml cholesterol. In L-15 alone, RAE 25 cells did not multiply. Adding glucose (Glc), glutamic acid (Glu), or alpha-ketoglutaric acid (alpha K) had little or no effect, and the same was true for combinations of Glc plus alpha K, aspartic acid (Asp) plus proline (Pro) and glutamine (Gln), and minerals plus vitamins (MV). When Asp, Gln, Pro, and alpha K were combined with Glc and/or MV and added to L-15, there was appreciable growth stimulation, but best results were obtained when Glu was also included. In this medium, i.e., L-15B with 5% FBS and 10 mu/ml cholesterol, lines BME 26 and RAE 25 could be continuously subcultured. PMID- 2766898 TI - Elevated gastric acid secretion in patients with Barrett's metaplastic epithelium. AB - Gastric acid secretion in response to a protein meal and to exogenously administered synthetic human gastrin 17-I was measured in patients with Barrett's esophagus, patients with uncomplicated gastroesophageal reflux, and normal age- and sex-matched controls. Acid secretion, both basally and in response to gastrin 17-I, was significantly greater in patients with Barrett's esophagus compared to normal individuals without reflux. Basal gastrin levels and meal-stimulated levels of the hormone were similar among all three groups. Sensitivity to gastrin, expressed as the concentration causing half-maximal acid secretion, was also similar among the study groups. It is speculated that elevated basal acid production in Barrett's esophagus may contribute to the pathogenesis of the disorder. PMID- 2766899 TI - Adenocarcinoma arising in Barrett's esophagus. AB - The main goal of this study was to evaluate the development of adenocarcinoma in patients with Barrett's esophagus. During the period from January 1975 to December 1985, a total of 134 patients had endoscopically severe esophagitis and/or Barrett's esophagus. In these patients, 32 (24%) met the macroscopic and histologic criteria for the diagnosis of Barrett's esophagus. A check-up study of these patients was performed in 1987. Adenocarcinoma developed in three patients during the follow-up period of 166.1 patient-years. Dysplasia in the columnar epithelium was found in two of these patients six and 15 months before the diagnosis of adenocarcinoma. The third patient with adenocarcinoma was detected in endoscopic follow-up in 1987. In addition, the endoscopic examination showed unchanged Barrett's epithelium in all but three patients despite the operative and/or medical treatment 3-12 years (mean 6.7 years) earlier. We conclude that Barrett's esophagus is a potential premalignant condition and careful endoscopic surveillance for dysplasia in the columnar epithelium of the distal esophagus is mandatory in patients with Barrett's esophagus. PMID- 2766900 TI - Cycling, a manometric phenomenon due to repetitive episodes of gastroesophageal reflux and clearance. AB - We studied intraesophageal pressure changes in patients with symptoms of gastroesophageal reflux and an abnormal 24-hr pH monitoring record (N = 52). Our method was simultaneous esophageal manometry and pH monitoring. We observed a three-component esophageal manometric sequence (EMS). When this sequence recurred over and over, we termed this phenomenon "cycling." We found cycling in 35% of the patients (18/52). Those with cycling had lower basal LES pressures, more acid exposure, and an increased incidence of endoscopic esophagitis. That cycling resulted from repeated reflux events and their esophageal clearance was documented by scintigraphy during simultaneous manometry and pH monitoring (N = 7 patients). Cycling was found on the routine esophageal manometry record of 25% of symptomatic patients (N = 112) with an abnormal 24-hr pH score. In conclusion, cycling represents an esophageal manometric phenomenon due to repetitive reflux events. Its recognition during esophageal manometry may denote a severe reflux diathesis. PMID- 2766901 TI - Effect of luminal perfusion rate on duodenal alkalinization in the rat in vivo and in vitro. AB - This study investigates the effects of luminal perfusion rate on the observed rate of alkalinization of an unbuffered saline by anesthetized rat distal duodenum. Increases in perfusion rate (range 0.3-22 ml/min) increased both alkalinization (3-15 mumol/cm hr) and intraluminal pressure (6-22 mm Hg). Increases in pressure (6-30 mm Hg) at constant perfusion rate (3 ml/min) did not change alkalinization. The effect of perfusion rate on alkalinization was rapid, reversible, and could be repeated several times. It was unaffected by indomethacin (10 mg/kg subcutaneously) or tetrodotoxin (1 mg/ml in perfusate). A limited in vitro study at two flow rates (0.3 and 22 ml/min) showed a similar enhancement of alkalinization. It is concluded that the rate of alkalinization is increased by raising the perfusion rate of the lumen both in vivo and in vitro. The mechanism remains to be established but may involve the reduction of a diffusion barrier between the mucosa and luminal bulk fluid. These results may have implications for the movement of other substances across intestinal segments. PMID- 2766903 TI - Absence of effect of 16,16-dimethyl prostaglandin E2 on reduction of gastric mucosal blood flow caused by indomethacin in rats. AB - The effects of 16,16-dimethyl prostaglandin E2 PGE2 on gastric mucosal blood flow and gastric mucosal damage were tested in rats given indomethacin. Blood flow was measured by hydrogen gas clearance. Indomethacin given intragastrically reduced the blood flow in nonlesion areas and the levels of PGE2 and 6-keto-PGF1 alpha in the gastric mucosa and caused mucosal damage in a dose-related way. Indomethacin (20 mg/kg) significantly reduced the blood flow 30 min after administration, and the reduction increased until 90 min. Then the flow plateaued until 240 min. Gastric mucosal damage caused by 20 mg/kg of indomethacin and evaluated by only gross observations, began at 60 min and developed with time until 240 min after administration. 16,16-Dimethyl PGE2 (5 micrograms/kg) did not affect the reduction of blood flow caused by indomethacin during 240 min of measurements, but it significantly inhibited the indomethacin-induced mucosal damage evaluated by gross observations. These results suggest that prevention by 16,16-dimethyl PGE2 of grossly observed gastric mucosal damage caused by indomethacin was not related by preservation of the gastric mucosal blood flow in the areas without lesions. PMID- 2766902 TI - Persistence of gastric ulcers caused by plain aspirin or nonsteroidal antiinflammatory agents in patients treated with a combination of cimetidine, antacids, and enteric-coated aspirin. AB - Twenty-three patients chronically ingesting plain aspirin or nonsteroidal antiinflammatory drugs, who had endoscopically proven solitary or multiple gastric ulcers, were treated for eight weeks with cimetidine and antacids. Plain aspirin and nonsteroidal antiinflammatory drugs were discontinued in all patients. Seven patients received enteric-coated aspirin throughout the treatment phase and continuously for the entire study period (2.5-12 months). The remainder of patients (N = 16) did not receive enteric-coated aspirin. An endoscopy was performed to assess ulcer healing. None of seven patients receiving enteric coated aspirin had complete healing of their ulcer(s) while 15 of 16 patients not receiving enteric-coated aspirin demonstrated complete healing of their ulcer(s) (P less than 0.001). An eight-week course of cimetidine and antacids is ineffective in completely healing gastric ulcers caused by plain aspirin or nonsteroidal antiinflammatory drugs while enteric-coated aspirin is continued. PMID- 2766904 TI - Gastric metaplasia in duodenal bulb and Campylobacter-like organisms in development of duodenal ulcer. AB - Multiple biopsies were taken from 50 patients with endoscopic appearance of duodenitis in order to study the relationship between gastric metaplasia in duodenum and the presence of Campylobacter-like organisms (CLOs) and the development of duodenal ulcer disease. Metaplasia was found in at least one biopsy specimen from 46 of the 50 patients; CLOs were seen in 25 of the 50 patients, only in metaplastic areas. In four cases a "transitional epithelium" with the presence of cells containing few apical mucoid granules and absorbent type brush border as well as goblet cells was seen. In two cases, this epithelium was colonized by a small number of CLOs. Gastric heterotopia appears to be a rare condition. PMID- 2766905 TI - Health-related quality of life in inflammatory bowel disease. Functional status and patient worries and concerns. AB - The assessment of health-related quality of life may be an adjunct to understanding the chronic illness experience and its effects on health outcomes. In this study, we evaluated health-related quality of life of 150 patients with inflammatory bowel disease (63 ulcerative colitis, 87 Crohn's disease). We used a standardized measure, the Sickness Impact Profile, and a questionnaire we developed that elicits and prioritizes the disease-related worries and concerns of patients with IBD. Our preliminary data indicate that: (1) IBD patients experience moderate functional impairment more in the social and psychological than in the physical dimensions; (2) Crohn's disease patients report psychosocial dysfunction to a greater degree than ulcerative colitis patients; (3) IBD patients report greatest concerns about having surgery, degree of energy, and body image issues such as having an ostomy bag; and (4) functional status and patient concerns correlate better with other measures of health status and previous health care utilization than the physician's rating of disease activity. We believe that questionnaires measuring health-related quality of life (HRQOL) can be used in research and patient care to extend the clinical assessment of patients with IBD. Further work is needed to determine the role of HRQOL relative to disease activity and other physician-based assessments in predicting health outcomes. PMID- 2766907 TI - Pulmonary excretion of H2 in calves with Cryptosporidium-induced malabsorption. AB - Pulmonary hydrogen gas (H2) concentrations were used to assess the malabsorption of dietary nutrients in preruminating calves inoculated with Cryptosporidium sp. Normal values were established in five control calves and seven calves (principals) were inoculated with 1.0 x 10(8) Cryptosporidium sp. oocysts. Hydrogen concentrations and wet fecal weights were measured at three stages: before Cryptosporidium sp. inoculation (stage 1), three days after the onset of diarrhea (stage 2), and after the resolution of diarrhea (stage 3). Mean end breath and total-breath H2 concentrations in the principal calves were higher (P less than 0.025 and P less than 0.05) for stage 2, when compared to control values. Both end-breath and total-breath H2 concentrations were increased (P less than 0.001 and P less than 0.025, respectively) in the principal calves during stage 2 when compared to values obtained for stages 1 and 3. Concurrently, Cryptosporidium sp. infection was associated with increased (P = 0.06) fecal output during stage 2, only. The increased H2 concentrations and cumulative fecal output show that Cryptosporidium sp. caused malabsorption of fermentable nutrients. PMID- 2766906 TI - Cyclosporin A treatment in inflammatory bowel disease. AB - The effect of cyclosporin A in acute and chronically active inflammatory bowel disease was tested in 11 patients with Crohn's disease and two with ulcerative colitis who had exhibited a poor response to at least eight weeks of conventional therapy. Trough levels of the drug in the therapeutic range were obtained in 12 of 13 patients. Cyclosporin A, which was usually added to the continued previous medication, including corticosteroids (11 of 13) or metronidazol (1 of 13), prompted an apparent clinical improvement in all but one patient. In six of the nine Crohn's disease patients with an initial Best index of greater than 150, a definite fall by at least 100 points was observed after 2-10 weeks of treatment, but the van Hees index declined only in two patients. All four patients with chronic perineal fistulation experienced symptomatic relief. Both patients with ulcerative colitis had a clinical remission. Erythrocyte sedimentation rate or serum albumin improved in eight of 13 patients. However, two of the nine responders with Crohn's disease relapsed during cyclosporin A therapy and three immediately after the medication was discontinued. Common side effects included hypertrichosis, tremor, and hyperesthesia; hypertension and epigastric pain each occurred only in one patient. PMID- 2766908 TI - Effects of cisapride on postcibal jejunal motor activity. AB - In the jejunum of fasting humans, cisapride induces a phase 2-like, highly propagative motor pattern. This study investigated cisapride's effects on the fed pattern of the jejunum. Starting 5 min after a phase 3 of the migrating motor complex, 18 healthy men received 5 or 10 mg cisapride or placebo orally in random double-blind fashion and ingested meals containing 1000 and 4200 kJ, respectively. Jejunal pressures were recorded pneumohydraulically with five catheter orifices 10-30 cm aboard the ligament of Treitz. After the 4200-kJ meal, total number and number of propagated contractions as well as area under the curve increased significantly more than after 1000 kJ. Following the 1000-kJ but not the 4200-kJ meal, 10 mg cisapride increased total number of contractions, number of propagated contractions, mean amplitude, and area under curve significantly more than placebo. Fed-pattern duration increased with the meal's caloric content but was not influenced systematically by cisapride. In conclusion, cisapride stimulates jejunal motor activity and induces a propagative pattern after a 1000-kJ but not after a 4200-kJ meal, suggesting that it can produce no further stimulation when motor activity is near maximally enhanced already. PMID- 2766909 TI - Alterations in biliary motility correlate with increased gallbladder prostaglandin synthesis in early cholelithiasis in prairie dog. AB - Abnormal biliary motility has been observed in humans with gallstones and in animal models; however, the mechanism by which these abnormalities occur remains unknown. In this study we investigated the relationship between cholesterol gallstone formation, changes in biliary motility, and rates of gallbladder prostaglandin synthesis in prairie dogs receiving a 0.34% cholesterol diet for two, four, or six weeks. Gallstones did not occur until four weeks, when the incidence was 14%; after six weeks the incidence was 64%. Gallbladder emptying increased slightly at two weeks before becoming significantly decreased at four and six weeks. In contrast, there was a near linear increase in basal cystic duct resistance which began by two weeks of cholesterol feeding, although sphincter of Oddi resistances remained normal throughout the period of study. The synthesis of prostaglandins E and F2 alpha by the gallbladder was also increased beginning at two weeks and rose to a plateau at four and six weeks. In view of the potent effects of prostaglandins on biliary smooth muscle, these findings suggest that prostaglandins may mediate early changes in gallbladder and cystic duct motility which ultimately result in impaired gallbladder emptying. PMID- 2766910 TI - Disruption of canine jejunal interdigestive myoelectrical activity by artificial ileocolonic sphincter. Studies of intestinal motor response to surgically fashioned sphincter substitute. AB - We studied the effects of an ileocolonic sphincter substitute on canine small intestine motor activity. Recordings of fasting and postprandial myoelectrical activity were performed in three groups of animals in whom the following procedures had been performed: (1) electrode placement alone, intestinal continuity undisturbed (controls); (2) ileocolonic sphincter substitute fashioned in mid-jejunum; and (3) transection and reanastomosis at a similar location in mid-jejunum. Transection alone resulted in a decrease in slow-wave frequency, a shortening of the period of the interdigestive myoelectrical complex (IDMEC) and a prolongation of phase III of the IDMEC in the jejunum distal to the site of transection. The IDMEC period was also shorter at proximal electrode sites, but the incidence of IDMEC phase III complexes was similar on either side of the transection. However, in those animals in whom a sphincter substitute had been fashioned at the site of the transection, the incidence of IDMEC phase III complexes was significantly suppressed in the proximal intestine; IDMEC phase III frequency per hour (mean +/- SD transection vs sphincter substitute) was 0.59 +/- 0.20 vs 0.23 +/- 0.24, P less than 0.002; 0.61 +/- 0.24 vs 0.28 +/- 0.30, P less than 0.006; 0.61 +/- 0.24 vs 0.29 +/- 0.30, P = 0.008, at electrodes 10, 35, and 85 cm proximal to the sphincter substitute, respectively. In addition, the sphincter-substitute animals alone demonstrated, during fasting, recurrent propagated bursts of spike clusters and occasional prolonged spike bursts in electrodes proximal to the sphincter substitute.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2766911 TI - Antibodies to glutaraldehyde-polymerized human albumin (anti-pHSA) in viral hepatitis. AB - The antibody to polymerized human albumin (anti-pHSA) was studied in normal subjects and in the course of infection from hepatitis A virus, hepatitis B virus, and hepatitis non-A, non-B virus. Results show that anti-pHSA antibody was never found in normal subjects, but it appeared during virus liver pathologies. The behavior of anti-pHSA differs in acute type A hepatitis that does not change to chronic form and in those forms which tend to become chronic (B and nonA, nonB). In the type-A infection anti-pHSA disappears after the acute phase; in the other two forms it persists all along as the infection develops. Specifically in non-A, non-B infection only the IgM type anti-pHSA is produced. PMID- 2766912 TI - Coombs-positive autoimmune hemolytic anemia in ulcerative colitis. AB - Coombs-positive autoimmune hemolytic anemia is a rare complication of ulcerative colitis, occurring in fewer than 1% of cases. We have found eight patients with autoimmune hemolytic anemia in a series of 1150 hospitalized patients with ulcerative colitis (0.7%). There was a marked preponderance of female patients F:M = 7:1, in accord with previous reports. The hemolytic anemia appeared at a mean of 10 years after the onset of colitis, apparently independent of the age of the patient. Although seven of the eight patients had active colitis at the time of diagnosis of anemia, there was no consistent relationship to the extent of the bowel disease. Seven of the eight patients survived. One patient showed a partial response to steroid therapy, two responded to splenectomy, but four required both colectomy and splenectomy. Steroids should be the first line of therapy followed by splenectomy, if necessary. For those patients who have severe colitis, which in itself would merit surgery, a total proctocolectomy combined with splenectomy seems advisable. PMID- 2766913 TI - Increased colonic mucosal mast cells associated with severe watery diarrhea and microscopic colitis. AB - A patient with microscopic colitis, clearly identifiable by its histologic characteristics, is presented in whom the histology also revealed large numbers of mast cells. The patient was treated with H1 antagonists with prompt resolution of the diarrhea. The histologic and therapeutic findings in this case suggest the diarrhea and inflammation of microscopic colitis may be mediated by the degranulation of excessive numbers of mast cells in the colon and small bowel. PMID- 2766914 TI - Endoscopic laser therapy for duodenal villous adenoma. AB - A 72-year-old woman had a 20-mm supraampullary villoglandular adenoma with a focal carcinoma in situ. The neurological status of the patient did not allow any major surgical procedure. Therefore laser therapy was performed using the Nd:YAG laser. Six laser sessions were necessary to destroy the whole adenoma. After 30 months of follow-up, there was neither endoscopic nor histologic recurrence. The laser therapy should be therefore considered in treating large sessile duodenal villous adenoma occurring in inoperable patients. However, a repeated endoscopic surveillance must be performed. PMID- 2766915 TI - Three other types of duodenal polyps: mucosal cysts, focal foveolar hyperplasia, and hyperplastic polyp originating from islands of gastric mucosa. AB - Seven cases are reported that initially presented on endoscopic examination as duodenal polyps originating from islands of gastric mucosa within the duodenal bulb. Microscopic examination revealed mucosal cysts (MC), focal foveolar hyperplasia (FFH), and hyperplastic polyp (HPP). These lesions must be added to the list of neoplastic and tumorlike lesions of the duodenum that may endoscopically present as polyps. PMID- 2766916 TI - Sclerosing peritonitis. AB - An unusual case of widespread peritoneal fibrosis of unknown cause ("sclerosing peritonitis") is described. The patient presented with ascites and bowel obstruction and was found to have numerous fibrous plaques involving primarily the serosa of the small bowel. The plaques were composed of bland spindle cells, ultrastructurally characterized as myofibroblasts, set within a collagenous stroma. Progressive involvement led to the patient's death 17 months after onset of symptoms. A literature review shows similar cases reported with a variety of names and a number of associated clinical conditions, none of which was present in this patient. The pathologic features seen in this case suggest that sclerosing peritonitis represents a nonspecific reaction of the peritoneal surface to a variety of insults and is characterized by florid reactive hyperplasia of submesothelial mesenchymal cells. PMID- 2766917 TI - Potential therapeutic effect of nitrendipine. PMID- 2766918 TI - Granular cell tumor. PMID- 2766919 TI - Giardia infection. PMID- 2766920 TI - Indomethacin therapy in premature infants with patent ductus arteriosus- determination of therapeutic plasma levels. AB - To determine the therapeutic range of plasma indomethacin levels for ductus closure, we evaluated the ductus response and renal side effects on two therapeutic regimens using different dosage; regimen I received 0.3 mg/kg q 24 h for a maximum of 3 doses, and regimen II received 0.1, 0.2 and 0.3 mg/kg at 24 hour intervals, for a maximum of 3 doses if needed. Infants in regimen I had significantly higher plasma indomethacin and higher ductus response rate than infants in regimen II. Urine output (U/O) was comparable between the regimens, but serum sodium was lower in regimen I than in regimen II. In both regimens, U/O and serum sodium return to normal by 72 h. The plasma indomethacin levels at 12 h after 1 dose correlated significantly with ductus response and hyponatremia. There appeared to be a minimal level of plasma indomethacin above which U/O decreased; with a plasma level greater than 170 ng/ml the majority (greater than 97%) of infants showed a decrease in U/O. While there was a 50% or greater chance that ductus would close when the plasma levels reached 600 ng/ml or more, a great proportion of infants would also develop renal side effects. Thus, a safe therapeutic range of plasma indomethacin appeared to be very narrow. However, when the dose of indomethacin is increased to optimize constrictive response, there is no significant increase in incidence and severity of renal adverse effects. In view of the transient nature of renal side effects, they should not hinder indomethacin therapy if ductus closure is indicated. PMID- 2766921 TI - Ontogenetic development of ketamine-induced sleeping time and electrocorticographic changes in rats. AB - Latency to the loss of righting reflex and sleeping time after ketamine were measured in 261 rats aged 7, 12, 18, 25 and 90 days. The sensitivity to ketamine was highest in 7-day-old animals and decreased with age. In the youngest group rats slept after the 20-mg/kg dose whereas not all adult animals lost their righting ability after a dose of 160 mg/kg. Electrocorticographic (ECoG) study demonstrated an age dependence of changes induced by ketamine. The youngest group exhibited only suppression of the originally discontinuous ECoG whereas signs of slow-wave sleep or depression appeared in older rats. PMID- 2766922 TI - Anemia during Haemophilus influenzae type b meningitis: lack of an effect of chloramphenicol. AB - We sought to determine whether chloramphenicol would worsen or mitigate the anemia associated with Haemophilus influenzae type b meningitis if administered in doses which produce 'therapeutic' serum concentrations. Seventy-four cases of H. influenzae meningitis were stratified by chloramphenicol cumulative doses (mg/kg body weight) of less than 300 and greater than 300. There was no significant difference in the decrease in blood hemoglobin concentration or in the increase in the FEP:Heme ratio between the two study groups. Plasma iron and transferrin saturation values indicated iron deficiency at days 1 and 5 of hospitalization; by day 10 mean values were within the normal range. These data suggest that H. influenzae type b meningitis, not chloramphenicol therapy in the presence of monitoring is causing the observed anemia. PMID- 2766923 TI - Effect of formula feeding on oral absorption of caffeine in premature infants. AB - The systemic absorption of orally administered caffeine was evaluated in 16 premature infants receiving therapy for recurrent apnea. An oral bolus dose of caffeine (10 mg/kg) was given during a fasted state (n = 8) or immediately preceding formula (n = 8). The first-order absorption rate constant (ka) was estimated from the rise in the plasma concentration-time curve and extent of absorption was estimated by the area under the concentration-time curve. Therapeutic concentrations of caffeine were achieved rapidly followed by very slow elimination of drug. No difference between the fasted and fed groups was found in the apparent rate or extent of caffeine absorption, suggesting that caffeine can be administered concomitantly with feedings. PMID- 2766924 TI - Does indomethacin affect the control of breathing in premature infants? AB - The effect of indomethacin on the control of breathing was simultaneously evaluated in 10 premature infants who had significant patent ductus arteriosus and received indomethacin therapy. In an attempt to maintain high plasma level in these infants of advanced postnatal age (greater than or equal to 6 weeks), indomethacin was administered intravenously at a dosage of 0.3 mg/kg, at 8-hour intervals, for a total of three doses. Following indomethacin therapy, there was a significant increase in tidal volume, minute ventilation, tidal volume/inspiratory time and in airway pressure (P0.1, Pmax) generated during airway occlusion. Seven infants required lower ventilatory rates after study. In spite of desirable plasma indomethacin level, there was no significant improvement in echo left atrium/aortic root dimension ratio, cardiovascular dysfunction score and in blood pH, PO2 and PCO2. None of the infants showed clinical evidence of ductus closure. The results of the study suggested that indomethacin may stimulate respiration and that endogenous prostaglandin may play a role in the regulation of breathing. PMID- 2766925 TI - Insulin resistance. PMID- 2766926 TI - Characterization of the hsp70 multigene family of Caenorhabditis elegans. AB - Our laboratory has been characterizing the hsp70 multigene family from the nematode Caenorhabditis elegans as the first step to the genetic characterization of the heat shock response in a relatively simple multicellular eukaryote. Two gene members, hsp-1 and hsp-2ps have already been characterized (Snutch et al., 1988; Heschl and Baillie, 1989). The third gene member, hsp-3, is expressed constitutively and is non-heat inducible; its mRNA is most abundant at the L1 larval stage. The hsp-3 protein (hsp70C) shares a high degree of identity with the rat grp78 protein and has a long, hydrophobic leader sequence. The carboxyl terminus of hsp70C has the putative ER-retention signal, KDEL. The fourth gene member, hsp-6 is expressed constitutively and moderately heat inducible. A partial hsp-6 protein (hsp70F) sequence shares a higher degree of identity with the Escherichia coli dnaK protein than with eukaryotic hsp70 proteins. The predicted amino-terminal half of the hsp70F polypeptide also contains a long, amphiphilic leader sequence similar to mitochondrial import leader sequences. These two genes encode proteins that potentially cross intracellular membranes. We compared the 5'-flanking DNA from the C. elegans hsp-3 gene to fragment containing enhancer activity from the rat grp78 gene regulatory region (Lin et al., 1986). A 23-nucleotide sequence was conserved between the two promoter regions. This sequence shares approximately 80% identity between these two evolutionary distant organisms. A comparison to other hsp70 genes did not reveal any conservation of this 23-nucleotide sequence. We propose that this sequence may be involved in a unique aspect of the regulation of the C. elegans' grp78 like gene and the rat grp78 gene. PMID- 2766927 TI - Activation of the erythropoietin gene due to the proximity of an expressed gene. AB - The erythroleukemic cell line IW32 has a normal erythropoietin (epo) gene and one which has undergone rearrangement and amplification. The rearranged epo locus consists of a breakpoint approximately 1 kb upstream from an otherwise structurally unchanged epo gene. DNase I hypersensitivity studies had suggested that the rearranged gene is the transcriptionally active one. To understand this transcriptional activation more fully we have sequenced the upstream regions of both the normal and the rearranged epo genes, the latter encompassing the rearrangement breakpoint. Sequence analysis showed that the new sequence past the breakpoint at the rearranged locus contained all the promoter components needed for a gene in opposite transcriptional orientation to the epo gene. Subsequent Northern blot analysis showed that this gene is transcriptionally active. No homology was found between this gene and any sequence in the data banks. It appears that the transcriptional activation of the rearranged epo gene in IW32 cells has been mediated by a translocation event which has served to bring the epo gene into close juxtaposition to this transcriptionally active gene. PMID- 2766928 TI - Transcriptional regulation of the gene encoding the 78-kD glucose-regulated protein GRP78 in mouse sertoli cells: binding of specific factor(s) to the GRP78 promoter. AB - We investigate the mechanism by which expression of the GRP78 gene is regulated using a mouse Sertoli cell line as an experimental system. We identify testosterone as a new inducer of the GRP78 gene in these cells. Furthermore, we show that despite their unusually low basal level of GRP78 mRNA, Sertoli cells retain the capacity to induce the GRP78 gene to high levels when challenged with the calcium ionophore A23187. Cellular factors present in whole-cell extracts isolated from Sertoli cells under noninduced and A23187-induced conditions bind specifically to a region of the GRP78 promoter previously identified as essential for maintenance of basal level expression and A23187 induction. We detect no difference in the binding of protein factors in the extracts prepared from noninduced versus induced cells. On the basis of this data, we propose models by which induction of the GRP78 gene may occur. PMID- 2766929 TI - A cis-acting sequence within the rat ribosomal DNA enhancer region can modulate RNA polymerase II-directed transcription of the metallothionein I gene in vitro. AB - Plasmids were constructed by inserting a 557-bp or 174-bp spacer fragment of rat ribosomal (r)DNA containing an enhancer element(s) at -148 bp upstream from a cloned mouse metallothionein gene (pMT-I). Transcription of these plasmids in a fractionated nuclear extract from a rat hepatoma resulted in 5 to 20-fold stimulation of MT-I gene transcription. This enhancement occurred independent of orientation of the enhancer or its distance from the metallothionein gene promoter or in the presence of the MT-I gene enhancer, and was sensitive to low levels of alpha-amanitin. Stimulation of MT-I gene transcription under the direction of the rDNA spacer element also occurred in HeLa nuclear extract, albeit to a smaller extent. Prior incubation of the nuclear extract with the 557 bp or 174-bp fragment resulted in as much as 5- to 10-fold stimulation of MT-I gene transcription. No significant effect on MT-I gene transcription was observed following preincubation with other DNAs. Preincubation of the extract with three subfragments of the 174-bp spacer inhibited MT-I gene transcription, which suggests that the majority of the 174-bp domain is required for binding to the negative regulatory factor(s) for MT-I gene transcription and that the subfragments can only interact with the positive core promoter-binding factor. The 37-bp subfragment, which has been shown to interact with a positive rDNA trans-acting factor, could also interact with a positive polymerase II (pol II) trans-acting factor. These studies have demonstrated that the 174-bp rat rDNA spacer element containing the pol I enhancer can also modulate pol II-directed transcription. PMID- 2766930 TI - Transient superinducibility of cytochrome P450c (CYP1A1) mRNA and transcription. AB - Simultaneous treatment of the rat hepatocyte-derived cell line LCS7 with cycloheximide and polycyclic aromatic compounds increased CYP1A1 (cytochrome P450c) gene transcription rate four- to sixfold and mRNA levels 20-fold relative to the levels in cells treated with inducers alone. When cycloheximide was added up to 1 hr after inducer, a similar degree of superinduction occurred. However, if cycloheximide was added at 1.5 hr or later, superinduction did not occur, even though an increased transcription rate continued at these times in cells treated with inducers alone. Thus, treatment with cycloheximide revealed two phases to the response of the CYP1A1 gene to inducer. During the early phase, inhibition of protein synthesis could amplify the effect of inducer. During the later phase, transcription rate and CYP1A1 mRNA levels remained elevated due to inducer treatment, but could not be further elevated by inhibiting protein synthesis. The superinduction of CYP1A1 mRNA was also examined in primary hepatocyte cultures and in explant cultures of three tissues. These varied substantially in their superinduction response. All of these exhibited elevated levels of CYP1A1 mRNA following simultaneous treatment with inducer and cycloheximide; transcription rate was superinduced three- to fourfold in primary hepatocytes, and CYP1A1 mRNA levels were superinduced 20- to 25-fold in both kidney and lung explants. However, the delayed addition of cycloheximide had varying effects in different culture systems. In primary hepatocytes, addition of cycloheximide as long as 4 hr after addition of inducer resulted in superinduction equal to that which occurred when these agents were added together. In contrast, adding cycloheximide only 2.5 hr after adding inducer resulted in undetectable superinduction in kidney explants and diminished superinduction 70% in lung explants. Although the time course of cycloheximide responsiveness following inducer treatment has been studied in detail only in LCS7 cells, it appears that the length of the cycloheximide-responsive phase is different in different cell culture systems in in explants from different tissues. This may be related to the previously reported tissue-specific differences in CYP1A1 gene expression. PMID- 2766931 TI - A human tRNA gene cluster encoding the major and minor valine tRNAs and a lysine tRNA. AB - A human genomic DNA clone hybridizing to mammalian valine tRNA(IAC) contained a cluster of three tRNA genes. Two valine tRNA genes with anticodons of AAC and CAC, encoding the major and minor cytoplasmic valine tRNA isoacceptors, respectively, and a lysine tRNA(CUU) gene were identified by Southern blot hybridization and DNA sequence analysis of a 7.1-kb region. At least nine Alu family members were interspersed throughout the 18.5-kb human DNA fragment, with three Alu elements in the intergenic region between the valine tRNA(AAC) gene and the lysine tRNA gene. Each of the five Alu family members in the sequenced region can be categorized into one of the four Alu subfamilies. The coding regions of all three tRNA genes contain characteristic internal split promoter sequences and typical RNA polymerase III termination signals in the 3'-flanking regions. The tRNA genes are accurately transcribed by RNA polymerase III in a HeLa cell extract, since the RNase T1 fingerprints of the mature-sized tRNA transcription products are consistent with the structural genes. The lysine tRNA(CUU) gene was transcribed only slightly more efficiently than the valine tRNA(CAC) gene in the homologous in vitro transcription system. Surprisingly, the valine tRNA(CAC) gene was transcribed about eightfold more efficiently than the valine tRNA(AAC) gene, implicating the presence of a modulatory element in the upstream region flanking the tRNA(CAC) gene. PMID- 2766932 TI - The rat clofibrate-inducible CYP4A gene subfamily. I. Complete intron and exon sequence of the CYP4A1 and CYP4A2 genes, unique exon organization, and identification of a conserved 19-bp upstream element. AB - The P450 CYP4A1 and CYP4A2 genes were isolated from a rat genomic library constructed in the vector lambda EMBL3 and their complete sequences were determined. The CYP4A1 and CYP4A2 genes spanned 14,144 and 10,576 bp and contained 13 and 12 exons, respectively. The CYP4A1 gene contained an additional intron that splits the exon corresponding to exon 12 of the CYP4A2 gene, resulting in a noncoding 13th exon in CYP4A1. The exon numbers of these genes were distinct among known P450 genes, and yet several intron-exon junctions along the P450 amino acid coding region were conserved with P450 genes in the CYP2, CYP11, and CYP21 gene families. On the basis of these data, the number of exons in the putative ancestral P450 gene was estimated. The evolutionary implications of this finding are discussed. No consensus TATA sequence was found upstream of either gene's transcription start site. Comparison of the CYP4A1 and CYP4A2 promoters with other genes that lack TATA boxes did not reveal any strong consensus sequence in their immediate upstream regions. However, a conserved 19 bp sequence was located at the positions of 42 and 48 bp upstream from the CYP4A1 and CYP4A2 genes' start sites, respectively. The CYP4A2 gene also contained two 378-bp direct repeats upstream from the start site; these repeats are derived from portions of the long interspersed middle repetitive element present in high copy numbers in the rat genome. PMID- 2766933 TI - The rat clofibrate-inducible CYP4A subfamily. II. cDNA sequence of IVA3, mapping of the Cyp4a locus to mouse chromosome 4, and coordinate and tissue-specific regulation of the CYP4A genes. AB - A novel P450 cDNA, designated IVA3, was isolated from a lambda gt11 cDNA library from clofibrate-treated rat liver by screening with the lauric acid omega hydroxylase, IVA1, cDNA probe. This cDNA encoded a protein with 507 amino acids and a calculated Mr of 58,239. The IVA3 cDNA shared 65% and 97% nucleotide and 72% and 96% DNA-deduced amino acid sequence similarities with IVA1 and IVA2, respectively. The CYP4A gene family, designated the Cyp4a locus, was mapped to mouse chromosome 4 using a panel of mouse-hamster somatic cell hybrids. Levels of the IVA mRNAs were analyzed in rat tissues and cell cultures after treatment with the hypolipidemic drug clofibrate. The IVA1, IVA2, and IVA3 mRNAs were present at very low levels in the livers of untreated rats and markedly induced in rats treated with clofibrate. Dose-response and time-course studies revealed that all three genes were regulated coordinately in liver. In contrast to the coordinate induction in liver, only the CYP4A3 gene was induced in the rat hepatoma cell line McA-RH7777. In the kidney, IVA1 and IVA3 mRNAs were present at low levels and were induced by clofibrate in a manner similar to that in liver. In contrast, the IVA2 mRNA was expressed in the kidney of untreated rats at a level similar to that of the maximally induced IVA2 mRNA in liver. These data indicate that the CYP4A1, CYP4A2, and CYP4A3 genes are regulated coordinately in liver while only CYP4A2 is activated constitutively in kidney. PMID- 2766934 TI - Transcriptional start site in the mouse Cyp1a1 (cytochrome P1450) gene. AB - Two transcriptional initiation sites have been described by different laboratories for the mouse Cyp1a1 (cytochrome P1450) gene: start site TI, at the beginning of the nontranslated 87-bp first exon, and start site TII, 635 bp downstream from site TI within the 2,380-bp first intron. Site TI was characterized in normal C57BL/6 mouse liver, whereas site TII was described in a high activity variant line (HAV cells) derived from the mouse hepatoma Hepa-1c1c7 wild type (wt) established cell line. It is conceivable that a tumor-specific promoter might be used in the Cyp1a1 gene in malignant tissue, as compared with an alternative transcriptional start site in normal tissue. To test this hypothesis, we constructed fusion plasmids containing the two putative transcription initiation sites and performed transcriptional mapping on the Cyp1a1 transcripts from control and tetrachlorobenzo-p-dioxin (TCDD)-treated wt and HAV cells; Cyp1a1 mRNA sequencing was also carried out in the TCDD-treated wt and HAV cell lines. We conclude that the Cyp1a1 transcription initiation site in both of these hepatoma-derived cell lines is the same (start site TI) as that used in normal mouse liver. PMID- 2766935 TI - [The diagnostic value of M-mode, 2D, and Doppler echocardiography in incomplete endocardial cushion defect]. AB - The diagnostic value of ultrasonography in cases with incomplete endocardial cushion defect which has been verified by subsequent operation was studied. By the M-mode ultrasound examination an enlarged right ventricle, a narrowed outflow tract of left ventricular and an abnormal pattern of mitral value were shown. By the aid of 2-DE its diagnostic accuracy in this disease was almost 100%. Characteristically the ostium primum (atrial septal) defect and anterior mitral cleft were demonstrated. And by pulsed Doppler the signs of mitral regurgitation and the spectral features of atrial shunt could be found. Therefore, it is proposed that ultrasonographic examination could readily take the place of traumatic angiocardiography in the diagnosis of this disease. PMID- 2766936 TI - [Experimental quantitative study of valvular regurgitation by color Doppler flow imaging]. PMID- 2766937 TI - [Evaluation of various types of balloon catheters and methods in dilating stenotic mitral valves]. PMID- 2766938 TI - [Aortoarteritis complicated by aortic insufficiency (with an analysis of 10 cases)]. AB - Ten cases of aortic regurgitation in the patients with aortoarteritis in our group were studied during the period 1958-1988. Nine out of 10 patients with aortoarteritis were performed by aortography. The incidence of aortic regurgitation is 2.2 per cent in 450 patients with aortoarteritis. In all the patients with aortic regurgitation diastolic murmurs were heard in the aortic valves. X-ray findings showed dilatation of ascending aorta with aortic regurgitation in 10 patients and enlargement of left ventricle in 7 patients. Subclavian artery and carotid artery were involved in all patients. Descending aorta or abdominal aorta were also involved in 6 of them. Two patients with angina pectoris were studied by coronary arteriography and the coronary arteries were normal. Clinically, these cases should be differentiated from aortic regurgitation of other etiology. PMID- 2766939 TI - [Activation sequence of the left atrium studied by esophageal leads]. AB - The intracardiac electrogram recorded in upper, middle and lower right atrium showed a positive, biphasic and negative P wave, respectively. This concept has been widely used in positioning the electrode in transesophageal atrial pacing (TEAP). However, in examination of the P wave figure in the unipolar lead along the esophagus by each two cm distance in 100 normal adults, we found that 32 subjects did not fulfill the above-mentioned criteria partially or completely. In order to study the underlying mechanism of such phenomenon, 190 patients undergone TEAP were examined by simultaneous recording of 2 unipolar esophageal leads (interelectrode distance 2-3 cm) with surface ECG. The patients were classified into 3 groups according to the morphology relation between the upper and lower esophageal P waves: Group A consisting of 155 cases (81.6%) in which the fashion of P wave changes was consistent with the usual criteria; Group B 17 cases (8.9%) was not consistent with the criteria; Group C 18 cases (9.5%) was in a reversed manner. The PEP-PED interval (measured from the peak of P wave in proximal esophageal lead to that in distal esophageal lead) was used as an indicator of left atrium activation sequence in vertical direction. Its value in these three groups was 6.3 +/- 10.1, -6.8 +/- 6.9 and -15.7 +/- 7.3 ms, respectively (P less than 0.001), suggesting in the latter two groups the left atrium activation was directed upward.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2766940 TI - [Comparison of thallium-201 images in dilated cardiomyopathy and ischemic cardiomyopathy]. AB - Comparison of thallium-201 image between 21 patients with dilated cardiomyopathy (DCM) and 12 patients with ischemic cardiomyopathy (ICM) was made in this study. All cases had abnormal thallium images. Multiple myocardial segments presenting with patchy pattern were seen in all 21 patients with DCM. 75.0% of patients with ICM also had patchy pattern on the thallium image, but the number of patchy pattern segments on image was significantly less in ICM than in DCM (P less than 0.001); complete defects on thallium image were noted in 75.0% of patients with ICM, however, only one case with DCM had complete defect on thallium scan (P less than 0.001). When the thallium image characterized by multiple patchy pattern segments without complete defects was used as a diagnostic criterion for DCM. 95.2% of patients with DCM coincide with the criterion. When the thallium image showing complete defect was used as a diagnostic criterion for ICM, 75.0% of patients with ICM coincide with the criterion. The characteristics of thallium 201 image are useful either for diagnosis of DCM and ICM or in differentiating DCM from ICM. PMID- 2766941 TI - [A survey on oxygen consumption during submaximal exercise and the classification of cardiac function]. PMID- 2766942 TI - [Quantitative assessment of pulmonary arterial diastolic and mean pressure using continuous wave Doppler]. AB - Continuous wave Doppler echocardiographic study was performed almost simultaneously with right heart catheterization in 24 patients with a variety of cardiovascular disorders and evidence of pulmonary regurgitation detected by pulsed wave Doppler. Their pulmonary arterial diastolic and mean pressure (PADP and PAMP) measured during catheterization were ranging from 5 to 70.6 (mean 30.26 +/- 18) mmHg and from 6.7 to 91.14 (mean 42.41 +/- 23.23) mmHg, respectively. The right ventricular end-diastolic pressure was within normal limit in all but one. The peak, mean and end-diastolic pressure gradients of pulmonary regurgitation (PPRPG, MPRPG and PRPGed) were calculated using simplified Bernoulli Equation and their correlations with PADP and PAMP were analysed using linear regression method. There were close correlations between all PRPGs and PADP or PAMP (r = 0.85 - 0.94, P less than 0.0001). The best equation for assessing PADP was MPRPG + 6 mmHg (r = 0.94, P less than 0.0001), for PAMP was PPRPG + 8 mmHg (r = 0.92, P less than 0.0001). It is evident that those constants in the equations should be adjusted in individual patient who has coexisting right heart failure. PMID- 2766943 TI - [Ventricular septal defect with aortic valve prolapse. Surgical pathologic and radiographic study of 45 cases]. PMID- 2766944 TI - [Acute hypotensive effect after sublingual verapamil]. PMID- 2766945 TI - [The immunologic state in coronary artery disease with angina]. PMID- 2766946 TI - [Variability of Apo B-containing lipoprotein in the plasma of experimental atherosclerotic rabbits]. AB - The effects of dietary cholesterol on plasma Apo B-containing lipoprotein was studied in 18 rabbits. When atherosclerosis was induced by dietary cholesterol, the cholesterol and peroxide lipids were increased in the intima of aortae (P less than 0.05). The increased plasma Apo B was positively correlated with hypercholesterolemia (r = 0.879, P less than 0.005). In the pre-stain lipoprotein electrophoresis and immunoelectrophoresis with Apo B antiserum, electrophoretic mobility of Apo B-containing lipoprotein was slower than those of the control rabbits and this band was wide and stained deeper. In Sephadex G-200 exclusion chromatography there was evidence showing that the reduction in electrophoretic mobility of Apo B-containing lipoprotein is due to the increase particle size. PMID- 2766947 TI - [Protection of the anaerobic heart in vitro by estradiol at its physiologic level]. PMID- 2766948 TI - [Quantitative evaluation of aortic stenosis using continuous wave Doppler]. AB - Thirteen patients with suspected aortic stenosis were studied with left-heart catheterization and 2 D, Doppler echocardiography. Thickness and abnormal motion of aortic valve was detected by 2 D Echo in 12 cases. One case had thick aortic valve with normal motion. The causes of lesions included rheumatic heart disease in one patient, bicuspid aortic valve in one, and senile calcific aortic valves in eleven. The left ventricular and aortic pressure were recorded simultaneously with left-heart catheterization. Peak-to-peak, instant peak and mean pressure gradients were measured. The aortic velocity was obtained with Continuous Wave (CW) Doppler. Instant peak and mean pressure gradients were calculated from Bernoulli equation. Both catheterization and Doppler demonstrated significant pressure gradient between LV and aorta in twelve patients. The instant peak and mean pressure gradients calculated from CW Doppler were compared with catheterization data. Doppler pressure gradients correlated well with that measured at catheterization: Doppler instant peak pressure gradient compared with that by catheterization, r = 0.89, P less than 0.001, Doppler instant peak pressure gradient compared with peak-to-peak pressure gradient by catheterization, r = 0.79, P less than 0.001, Doppler mean pressure gradient compared with that by catheterization, r = 0.75, P = 0.002. This study demonstrates that CW Doppler provides a valuable method for assessment of the severity of aortic stenosis. PMID- 2766950 TI - [The quality of life from the surgical viewpoint--a new assessment of old criteria?]. PMID- 2766949 TI - [An unusual course of thoracic actinomycosis]. AB - A 56-year-old farmer who had been suffering from exogenous allergic alveolitis developed, after a long prodromal period of illness, a granulocyte-rich pericardial effusion and bilateral pleural effusions in which Actinomyces aggregates were identified. Despite intensive treatment with clindamycin, erythromycin and tetracycline (he was allergic to penicillin) he died in septic shock. PMID- 2766951 TI - [Pancytopenia during low-dose oral methotrexate therapy of psoriatic arthritis]. AB - Pancytopenia and interstitial pneumonia occurred in a 70-year-old woman with psoriatic arthritis and compensated renal insufficiency while she was being treated with low doses of the folic-acid antagonist methotrexate (5 mg weekly). Despite the administration of platelets, red blood cells, antibiotics, acyclovir and folinic acid (100 mg daily), the pneumonia progressed, and the patient died of global respiratory failure. PMID- 2766952 TI - [Diagnosis of intervertebral disk prolapse: myelography, computed tomography or MR tomography?]. PMID- 2766953 TI - [Significance of proteinuria and hypertension in the prognosis of type 1 diabetes. Results of a 10-year follow-up study on micro- and macrovascular disease mortality]. AB - Among 163 insulin-dependent (type I) diabetics (average age 43.5 years; average duration of diabetes 17.5 years), 40 (24.5%) died within ten years from the consequences of micro- and (or) macro-angiopathies. The death-rate among hypertensives was twice that among normotensives: 21 of 53 patients (39.6%) with blood pressures above 160/95 mmHg, but 19 of 110 patients (17.3%) with normal pressures. Proliferative retinopathy at the onset of the study was also a predictive marker of a poor prognosis. The death-rate increased threefold for patients with retinopathy if they also had hypertension: 13 of 30 (43.3%) with background retinopathy and hypertension died, compared with 9 of 68 without hypertension (13.2%; P less than 0.01). Independently of hypertension the death rate for patients with persistent proteinuria (greater than 0.5 g/24 h) was about threefold that among those without it. The highest death-rate (56.7%) was among the 30 patients with proteinuria and hypertension. Stepwise linear regression analysis demonstrated that the correlation between death from micro- and macro vascular disease and the known risk factors was entirely determined by blood pressure and proteinuria. PMID- 2766954 TI - [Balloon catheter arterial occlusion before high-risk splenectomy and nephrectomy]. AB - Balloon catheter occlusion of the splenic or renal artery was undertaken in 10 patients (7 men and 3 women, aged 20-76 years) 30 to 120 min before a splenectomy (n = 8) or nephrectomy (n = 2), for the purpose of preventing a high intra- and post-operative blood loss and facilitating the technical procedure of removing an often markedly enlarged spleen. The operation time after balloon catheter occlusion was only 60-140 min; intra- and post-operative complications did not occur, other than one instance of pneumonia and one of subcutaneous haematoma. This method would seem to be suitable for reducing the operative risk of splenectomy or nephrectomy in the presence of a giant spleen or reduced tolerance of operation. PMID- 2766955 TI - [Pulmonary eosinophilic infiltration with pneumothorax during trimipramine treatment]. AB - Three weeks after starting treatment with the antidepressant trimipramine a 55 year-old man developed increasing cough, fatigue and lack of appetite. The blood count revealed marked eosinophilia (15%) and the chest X-ray showed bilateral pulmonary infiltrates. Later a left spontaneous pneumothorax occurred. When trimipramine was discontinued (as the suspected cause of the described changes) the symptoms quickly subsided and the infiltrate as well as the eosinophilia quickly disappeared. PMID- 2766956 TI - [Chronic diarrhea--new histological differential diagnoses]. PMID- 2766957 TI - [Europe against cancer. Thoughts on prevention]. PMID- 2766958 TI - [Device for one-man resuscitation]. PMID- 2766959 TI - [Collagenous gastroduodenitis]. PMID- 2766960 TI - The treatment of photoaged human skin by topical tretinoin. PMID- 2766961 TI - Hypertension in children. Patterns of inheritance and implications for screening and management. PMID- 2766962 TI - Survival of astroglial cell lineage from adult brain transplant. AB - We previously described a transplantation model which enables the selective identification of rabbit astroglial cells in sections of mouse brain tissue. In the present paper, we report that cells of the astroglial lineage from an adult transplant are able to survive after implantation into the brain of an immature host. Surviving xenogenic cells are found outside the graft, forming colonies in the host brain parenchyma. However, after 3 months, transplant-derived astrocytes are no longer detected. PMID- 2766963 TI - The cholinergic system in developing cerebellum: comparative study of normal, hypothyroid and underfed rats. AB - To overcome the deficiencies of previous findings, the activities of choline acetyltransferase (ChAT) and acetylcholinesterase (AchE) were studied at very short age intervals to allow a more precise definition of the shape and timing of their developmental curves in normal, hypothyroid and underfed rats. In addition, AchE expression in developing cerebellum was studied histochemically in these three neurological models. When compared with structural findings in the literature, the results provide the following information on the normal and abnormal developing cholinergic system, related or not to cerebellar neurotransmission (1) AchE activity, unlike ChAT, can be considered as a good marker of the developing cholinergic archicerebellum. (2) ChAT and AchE are transiently expressed together in functionally noncholinergic Purkinje cells. In contrast with most regions of the central nervous system, the high ratio of ChAT to AchE activities in the early stage of cerebellar development suggests an enhanced synthesis of acetylcholine (Ach). The level of ChAT activity correlates with Purkinje cell size, supporting the concept of a neurotrophic role of Ach in early maturing macroneurons. (3) The archicerebellar cholinergic network appears to be relatively well preserved from undernutrition and, to an even greater extent, from hypothyroidism, compared to other systems of neurotransmission formed later and more widely distributed throughout the cerebellum. The presynaptic compartment seems to be more affected than the postsynaptic compartment. (4) In disagreement with some data in the literature, the abnormalities induced by both abnormal thyroidal and nutritional states were found to be irreversible. PMID- 2766964 TI - Development of the human hypoglossal nucleus: a morphometric study. AB - Development of the human hypoglossal nucleus was studied using complete serial sections of the brains of 9 fetuses at 16, 18, 21, 23, 27, 32, 33, 35 and 40 weeks of gestation, a 2-month-old infant, a 16-year-old adolescent and a 63-year old adult. Morphometric analysis produced the following three findings pertaining to the development of the human hypoglossal nucleus: (1) development may accelerate after 32 weeks of gestation; (2) postnatal maturation is observable, and (3) natural cell death, as indicated by a decrease in the number of neurons and the appearance of degenerating neurons, may occur during fetal development. PMID- 2766965 TI - [Tracking the composition of pediatric drugs]. PMID- 2766966 TI - [Adenocarcinoma in Barrett's esophagus]. PMID- 2766967 TI - [Problems in differential diagnosis of panic disorder in psycho- motor epilepsy]. PMID- 2766968 TI - [Morton's symptoms--but which?]. PMID- 2766969 TI - [Measurement of the mineral composition of bones]. PMID- 2766971 TI - [Clinical and theoretical research]. PMID- 2766970 TI - [Dietary fat determination, plasma cholesterol and coronary artery disease]. PMID- 2766972 TI - [Whose competence should the Central Board of Medicine acknowledge?]. PMID- 2766973 TI - [Routinization of iron medication during pregnancy should not be abandoned]. PMID- 2766974 TI - [Should we continue with breast cancer screening?]. PMID- 2766975 TI - [Substance abuse among women--maternal care as a new risk group?]. PMID- 2766976 TI - [Subarachnoid hemorrhage associated with cardiac changes]. PMID- 2766977 TI - [Shortness of breath caused by a tracheal amyloid nodule]. PMID- 2766978 TI - [Ascites, abdominal pain and a marginally functioning liver in a young woman]. PMID- 2766979 TI - [Lightning and the heart]. PMID- 2766980 TI - [Self-medication regimes]. PMID- 2766981 TI - [Chronic anemia]. PMID- 2766982 TI - [Psyche and soma--friend or enemy?]. PMID- 2766983 TI - [PASCAP: an experience of technical cooperation among countries]. PMID- 2766984 TI - [Human resources for local health systems]. PMID- 2766986 TI - [Development of health services and the teaching of administration in Central America and Panama]. PMID- 2766985 TI - [Monitoring processes for continuing training. A working proposal]. PMID- 2766987 TI - [Continuing education in health. Problems and projections]. PMID- 2766988 TI - [Pedagogical training of those responsible for continuing education]. PMID- 2766989 TI - Electrophysiological study (EEG, VEPs, BAEPs) in patients with Charcot Marie Tooth (type HMSN I) disease. AB - A laboratory investigation consisting of EEG recordings, BAEPs and VEPs evaluation as well as estimation of the facial nerve distal latency was performed in 9 patients who had Charcot Marie Tooth (type HMSN I) disease. 3 patients showed VEP's abnormalities (2 of them had prolonged P100 latency and one had an abnormal interocular latency difference). Another patient showed an upper normal limit value in the interocular latency difference. Abnormal BAEPs were found in 8 patients (one had I-III/IPLD prolonged, 2 of them had the latency of wave I prolonged and the remaining 6 had no readable or repeatable responses unilaterely or bilaterally). 7 out of 9 patients had the facial nerve distal latency prolonged, without any evident clinical facial weakness. Abnormal EEG recordings were found in 2 of all tested patients. Our results provide some evidence that in Charcot Marie Tooth disease the involvement of the II, VII and VIII nerves is more frequent than clinically expected and is probably related to a demyelinated process. PMID- 2766990 TI - Extracellular potentials produced by a transition between an inactive and active regions of an excitable fibre. AB - A mathematical modelling was used to study effects of the length, duration, and propagation velocity of a transition formed between the inactive and active (depolarized at most) regions of an infinite homogeneous fibre, on the extracellular potentials (EPs) produced by the transition. In this case the sources generating the extracellular potentials may be thought of as a distributed sequence of unidirectional dipoles lying along the fibre axis. The results have shown that the EPs have the dipole nature. In the proximity of the fibre, an increase in the transition length leads to a strong reduction of the EP amplitude; the inter-peak time interval is proportional to the transition duration and is independent of the propagation velocity. At small and middle radial distances lengthening of the transition reduces the radial decline of the EP amplitude. At great radial distances the EP field produced by a distributed source coincides with that produced by a lumped dipole having an intensity equal to sum of the intensities of all the dipoles of the distributed sequence. In isotropic volume conductor, at radial distances greater than the transition semilength, the radial decline of the potential amplitude is independent of the transition length; the inter-peak time interval is equal to y x square root of 2/v. Some problems of analysis of extracellular single muscle fibre potentials are discussed. PMID- 2766991 TI - A noninvasive EMG technique for investigating the excitation propagation in single motor units. AB - A new EMG recording technique which is based on a spatially filtering surface multi-electrode array enables, with its high spatial resolution, the noninvasive investigation of single motor unit (MU) excitations. This recording technique was applied to study the propagation velocity within single, superficial MUs of lower arm muscles. The conduction velocity (CV) was estimated by time shifts between action potentials (APs) recorded at different positions along the muscle fibres. Several signal characteristics to define this time shift were compared in regard of their influence on the reliability of CV values. Best results were obtained by calculating the time shift between main peak maxima, with a standard deviation found for the CV values from single APs in the range of 4 to 25%. The disturbance by signal noise could be reduced by the application of approximating cubic spline functions. The CV values showed a remarkable variability between different sites along the single MU muscle fibres. PMID- 2766992 TI - A simple method for the routine assessment of heart-rate variation in autonomic neuropathy. AB - A simple method is described for the rapid assessment of respiratory heart-rate variation (HRV) by making use of an EMG machine to record the RR-interval of the electrocardiogram. The built-in software for single-fibre EMG usually incorporated in modern EMG equipment is sufficient for a rapid data analysis based on the difference between the shortest and longest RR-intervals recorded over a period of 60 to 100 s. Measurements of HRV obtained by our new method correlate well with those obtained by the more tedious conventional manual measurement of an ECG recording (r = 0.88). PMID- 2766993 TI - Somatosensory evoked potentials from posterior tibial nerve; normative data. AB - The somatosensory evoked potentials from posterior tibial nerve were studied in a group of normal adults. The latencies of popliteal fossa potential, L3, N33 and P40 waves as well as central conduction time were analyzed as a function of height and age. The correlation of the peripheral conduction velocity with the subject's age was also studied. The corresponding regression formulae were calculated and can be used to predict normal values of these parameters over a wide range of height and age. Standard error estimates are given for all parameters. PMID- 2766994 TI - Electromyographic study of the upper, middle and lower portion of the trapezius muscle in the circumduction movement of the arm on a shoulder wheel apparatus. AB - The upper, middle and lower portions of the trapezius muscle were analysed electromyographically (using a TECA TE-4 electromyograph and a single coaxial needle) in 20 healthy volunteers, during a circumduction movement of the arm, on a shoulder wheel apparatus. All three portions of the muscle were active, but the elevation phase of the arm was more pronounced in movements performed clockwise while the lowering phase was more manifest in movements performed counterclockwise. The position of the wheel gauntlet did not interfere significantly with the results. PMID- 2766995 TI - [Evaluation of the phagocytic activity of peripheral blood neutrophils in patients with hyperthyroidism]. AB - In 80 women with hyperthyroidism (40 with diagnosed Graves disease and 40 with hyperactive nodular goiter) the following tests related to the function of peripheral blood neutrophils have been carried out: 1. nitrotetrazolium blue (NRT) reduction test. 2. evaluation of phagocyting activity by using latex particles and living bacteria cells, and 3. determination of immunoglobulin concentration and the C3 component of the complement in blood serum. The following features were found in the patients with hyperthyroidism: 1. the elevated values of the index of spontaneous NBT reduction which return to normal following the treatment with propranolol or metizol lasting 14 days, 2. a decrease in the phagocyting activity of neutrophils occurring with stimulation of phagocytosis by both the latex particles and bacteria cells. 3. the return to normal values of the index of neutrophils phagocyting the latex particles following two-week treatment with propranolol or metizol. It was concluded that in patients with hyperthyroidism the changes in NRT reduction and phagocyting activity of peripheral blood neutrophils return to normal following the two-week treatment of these patients with both propranolol and metizol. PMID- 2766996 TI - The effect of thyroid hormones on lipid composition and activities of lipid synthesizing enzymes in the rat heart sarcolemma. PMID- 2766997 TI - Membrane bending energy and shape determination of phospholipid vesicles and red blood cells. AB - A procedure is developed to calculate red blood cell and phospholipid vesicle shapes within the bilayer couple model of the membrane. The membrane is assumed to consist of two laterally incompressible leaflets which are in close contact but unconnected. Shapes are determined by minimizing the membrane bending energy at a given volume of a cell (V), given average membrane area (A) and given difference of the areas of two leaflets (delta A). Different classes of shapes exist in parts of the v/delta a phase diagram, where v and delta a are the volume and the leaflet area difference relative to the sphere with area A. The limiting shapes are composed of sections of spheres with only two values allowed for their radii. Two low energy axisymmetrical classes, which include discocyte and stomatocyte shapes are studied and their phase diagrams are analyzed. For v= 0.6, the discocyte is the lowest energy shape, which transforms by decreasing delta a continuously into a stomatocyte. The spontaneous membrane curvature (C0) and compressibility of membrane leaflets can be incorporated into the model. A model, where delta A is free and C0 determines the shapes at given V and A, is also studied. In this case, by decreasing C0, a discocyte transforms discontinuously into an almost closed stomatocyte. PMID- 2766998 TI - The protein concentration gradient within eye lens might originate from constant osmotic pressure coupled to differential interactive properties of crystallins. AB - A protein concentration gradient exists from the center to the periphery of most lenses, the origin of which is still a matter of debate. The gradient, which contributes to the lens optical quality, seems to be accompanied by an uneven distribution of the crystallin classes, with the nucleus usually enriched in gamma- and the cortex in alpha-crystallins. Since the osmotic pressure within the lens seems to be constant and since a rather different interaction behaviour of alpha- and gamma-crystallins was demonstrated in previous studies, we propose that the maintenance of a constant osmotic pressure through the lens is sufficient to induce and stabilize a protein concentration gradient. The theoretical treatment has been worked out and the validity of the hypothesis has been demonstrated with colloidal osmotic pressure measurements of lens cortical and nuclear cytoplasmic extracts as a function of protein concentration. To account for the observed lens concentration gradient, however, a small additional concentration gradient in the opposite direction, involving an ion or small molecule, might be required. PMID- 2766999 TI - Observation of Brillouin scattering from single muscle fibres. AB - The propagation of sound waves along relaxed single fibres of glycerinated rabbit psoas muscle has been observed using Brillouin scattering at frequencies up to 1.6 GHz. Two types of waves were observed: one with a velocity of 1508 +/- 7 m s 1, which is attributed to sound waves in intra-cellular saline, the other with a velocity of 912 +/- 25 m s-1, which is attributed to waves propagating along the protein filaments within individual sarcomeres. The latter sound velocity is much higher than that which has been reported by Stienen and Blange (1985) for 50 microseconds tension transients, and the difference is attributed to the much higher stiffness of the protein filaments compared to the cross-bridges which determine the low-frequency elasticity of muscle fibres. PMID- 2767000 TI - Time-resolved fluorescence spectroscopy of lumazine protein from Photobacterium phosphoreum using synchrotron radiation. AB - Time-resolved fluorescence on lumazine protein from Photobacterium phosphoreum was performed with synchrotron radiation as a source of continuously tunable excitation. The experiments yielded structural and dynamic details from which two aspects became apparent. From fluorescence anisotropy decay monitoring of lumazine fluorescence with different excitation wavelengths, the average correlation times were shown to change, which must indicate the presence of anistropic motion of the protein. A similar study with 7-oxolumazine as the fluorescent ligand led to comparable results. The other remarkable observation dealt with the buildup of acceptor fluorescence, also observed with 7-oxolumazine although much less pronounced, which is caused by the finite energy transfer process between the single donor tryptophan and the energy accepting lumazine derivatives. Global analytical approaches in data analysis were used to yield realistic correlation times and reciprocal transfer rate constants. It was found that the tryptophan residue has a large motional freedom as also reported previously for this protein and for the related protein from P. leiognathi (Lee et al. 1985; Kulinski et al. 1987). The average distance between the tryptophan residue and the ligand donor-acceptor couple has been determined to be 2.7 nm for the same donor and two different acceptors. PMID- 2767001 TI - The influence of structural variations in the F- and FG-helix of the beta-subunit modified oxyHb-NES on the heme structure detected by resonance Raman spectroscopy. AB - The dispersion of the depolarization ratio of two prominent Raman lines (1,375 cm 1 and 1,638 cm-1) of oxyhemoglobin-N-ethyl succinimide have been examined for pH values between pH = 6.0 and 8.5. Both exhibit a significant pH dependence. Calculation of the Raman tensor in terms of a fifth-order time dependent theory provides information about the pH-dependence of parameters reflecting symmetry classified distortions of the prosthetic heme group. To correlate these distortions with the functional properties of the molecule the following protocol was used: 1) An allosteric model suggested by Herzfeld and Stanley (1974) has been applied to O2-binding curves measured at different pH values between 6.5 and 9.0. From this calculation one obtains both, the energy differences between different molecular conformations and the equilibrium constants of oxygen and proton binding. 2) A titration model was formulated relating each conformation of a molecule to a distinct set of distortion parameters of the heme group. 3) The distortion parameters resulting from the analysis of our Raman data were assigned as an effective value due to incoherent superposition of the distortion parameters related to the different titration states. The application of this procedure yields an excellent reproduction of the pH-dependent effective distortion parameters of both Raman lines investigated. It is shown that the protonation of two tertiary effector groups located in the beta-subunits affect the symmetry of the heme in a contrary manner: the protonation of a His-residue (pK = 8.2, probably His(FG4) beta) causes a symmetric position of the proximal imidazole thus lowering the perturbations of the heme core. Further it influences the interaction between amino acid residues of the heme cavity and pyrrole side chains (probably Val(FG5) beta-vinyl (pyrrole 3) thus causing a decrease of the distortions related to the peripheral part of the heme. In contrast, the protonation of Lys (EF6) beta causes a tilt position of the proximal imidazole and an increase of asymmetric perturbations of the heme core, whereas the interaction between the pyrrole side chains and the heme cavity is weakened. Our results are consistent with stereochemical predictions of Moffat (1971) concerning the existence of a H-bond between His(FG4) beta and Cys(F9) beta. PMID- 2767002 TI - Estimation of pH in individual alveolar macrophage phagolysosomes. AB - A method for measurement of phagolysosomal pH in individual alveolar macrophages based on a cytofluorometric technique with fluorescein-labeled silica particles (FSP) as a probe was developed. The size of the FSP, 3.0 or 5.0 microns, did not affect the result of the pH measurements. The average pH values, range 5.1-5.5, of individual particles in macrophages from three rabbits agreed well with the pH values obtained in a macrophage population using a fluorescence spectrometer and the FSP. The variation of pH in phagolysosomes in alveolar macrophages from five rabbits was investigated. Measurements were performed 3, 6, and 24 h after addition of the FSP in cells containing one particle as well as in cells containing two particles. The variation in pH was small, with a coefficient of variation less than 10% in all rabbits at all times. There was a significant correlation between values obtained from two phagolysosomes in the same cell, indicating a cell factor responsible for 10-30% of the total variance. The fact that the variation of pH is small in normal, untreated rabbit alveolar macrophages should be of importance when estimating alveolar clearance of inorganic particles due to dissolution in the acid phagolysosomal milieu. PMID- 2767003 TI - Smooth muscle isoactin and elastin in fetal bovine lung. AB - The formation of elastic fiber network in the lung is developmentally regulated. In this study we first demonstrated that tropoelastin mRNA per unit total RNA in the fetal bovine lung increased from 110 to 250 days of gestation (270 day term) as measured by Northern blot analysis. To examine the extent that smooth muscle (SM) type cells contribute to this gestational increase in elastin phenotype, we utilized a dual immunofluorescent staining technique on lung sections with anti elastin polyclonal and anti-SM isoactin monoclonal antibodies. Elastin staining was always found to localize in proximity to SM isoactin-positive cells at various stages of prenatal lung parenchymal development. Minimal, if any, elastin was seen at interstitial fibroblasts, which were negative for the SM isoactin staining. Distribution of SM (type) cells and elastic fiber together along the airways became sparse and discontinuous distally, and it seemed that formation of air sacs was between the discontinuous elastic fibers. We speculate that smooth muscle (type) cells may be the major elastogenic cells of distal airways and may play an important role in alveolar formation. PMID- 2767004 TI - Properties of isolated nonciliated bronchiolar cells from mouse lung. AB - Nonciliated bronchiolar cells (Clara cells) are thought to provide important respiratory secretions in the small airways and to have other metabolic functions. In mice, nonciliated bronchiolar cells have been the subject of special investigation because tumors of these cells can be specifically induced by chemical carcinogens. A method for isolating nonciliated bronchiolar cells from mice has been reported. However, we have developed a method to isolate these cells from the lungs of BDF1 mice with approximately 80% purity. Cells were identified by electron microscopy, nitroblue tetrazolium dye reduction in the presence of NADPH, immunocytochemical staining of cytochrome P450 isozymes, and mitochondrial staining with rhodamine 123. The isolated cells were examined in culture for synthesis and secretion of proteins and phospholipids. Protein synthesis and secretion were examined in cells labeled with [34S]methionine for 16 h. Fresh medium was added to washed cells and the cells were incubated for an additional 3h. The secreted proteins were precipitated with 10% trichloroacetic acid. Molecular weights of the most prominent radiolabeled secreted proteins were 6, 36, 43, and 45 kDa. Phospholipid synthesis and secretion were examined in cells labeled with [14C]acetate and 32P. Less than 1% of the radioactive lipids was found in the medium, and secretion of lipid was not stimulated by terbutaline or tetradecanoylphorbol acetate compounds, which stimulate phospholipid secretion by type II cells. These data support the hypothesis that nonciliated bronchiolar cells synthesize and secrete proteins but do not secrete phospholipids in any appreciable amount. PMID- 2767006 TI - Purification and characterization of fatty acid-binding proteins from human fetal lung. AB - Fatty acid-binding protein (FABP) was isolated, purified, and characterized from developing human fetal lung cytosol by gel filtration and ion-exchange chromatography. FABP exists in three immunochemically identical forms, DE-I, DE II, and DE-III, having Mr 15,200 +/- 200 each and isoelectric pH 7.8, 6.9, and 5.4, respectively. DE-I is almost lipid-free, DE-II binds mainly long-chain unsaturated fatty acids, and DE-III is an arachidonic acid carrier. One mole of DE-II and DE-III each binds 1 mol of fatty acids noncovalently. Concentrations of all these FABPs increase gradually from early gestation to term. Defatted lung FABP reverses the inhibitory effect of palmitoyl coenzyme A (CoA) (PAL-CoA) on lung glucose-6-phosphate dehydrogenase (G6PD), a key enzyme of the hexose monophosphate (HMP) shunt pathway. This protein when added alone activates the enzyme, suggesting that the original submaximal activity is probably due to the presence of endogenous long-chain fatty acyl CoA esters in the cytosols. As FABP is present in relatively high concentration in most mammalian cells, the potent inhibitory effects of long-chain acyl CoA esters on the HMP shunt pathway in vitro are not seen in intact cells. PMID- 2767005 TI - Effects of hyperoxia on surfactant morphology and cell viability in organotypic cultures of fetal rat lung. AB - Effects of hyperoxia in an organotypic model consisting of well-differentiated fetal rat type 2 pneumocytes have been studied by light and electron microscopy. In cultures exposed to 50% oxygen for 48 h, hyperoxia caused necrosis of cultured lung cells derived from 18- to 19-day gestation fetal rats, less damage in cells derived from 20- to 21-day gestation fetal rats, and no detectable damage of cells derived from newborn rats. After exposure to hyperoxia in organotypic cultures cocultured with fibroblast monolayers, ultrastructural abnormalities of surfactant (large lamellar bodies with disordered lamellae and abnormal shape) were detected in cells from 18- to 19-day gestation fetuses. These abnormalities were not noted when fibroblast monolayers were absent. Fibroblast conditioned medium from fibroblasts exposed to hyperoxia did not cause significant surfactant abnormalities at the ultrastructural level. These changes were less marked in cultures incubated with glutathione's constituent amino acids and with ascorbic acid during exposure to hyperoxia, and in cultures pretreated with dexamethasone (20 nM) before exposure to hyperoxia. PMID- 2767007 TI - Monoclonal antibodies specific for antigens expressed by rat type II alveolar epithelial and nonciliated bronchiolar cells. AB - Markers specific for various lung cells are useful for studies of cellular differentiation and function. We have produced monoclonal antibodies that bind to isolated rat type II alveolar epithelial cells in an ELISA. Two such antibodies, 2C1 and 3F9, specifically labeled type II cells and nonciliated bronchiolar cells by indirect immunofluorescence of rat lung. A third antibody, 2A3, recognized isolated type II cells by ELISA and immunofluorescence, but did not bind to sections of whole lung. Further immunofluorescence studies on adult rat tissue showed that neither 2C1 nor 3F9 labeled other lung cells or cells in kidney, small intestine, brain, or trachea. The antigen or antigens recognized by 2C1 and 3F9 was not detectable at day 15 of fetal lung gestation but was detectable by day 21. Immunofluorescence studies carried out on 0.5-microns frozen sections of lung tissue demonstrated that both 2C1 and 3F9 bound to cell surface antigens, which are expressed in a highly polarized fashion on the luminal surface of the alveolus and bronchiole. The rat cell line, L2, which displays some similarities to type II cells, did not display positive immunofluorescence to 2A3, 2C1, or 3F9. The antibodies 2C1 and 3F9 are distinct from and apparently more specific than previously described monoclonal antibodies raised to rat type II cells. Alveolar type II and nonciliated bronchiolar cells share several common features. Both cell types contain the surfactant apoprotein SP-A, proliferate in response to lung injury, develop in the late stages of gestation, take up and catabolize platelet-activating factor, contain high levels of cytochrome P-450, and can be induced to form tumors in response to chemical carcinogens. The recognition of highly specific surface antigen(s) on both nonciliated bronchiolar cells and type II cells demonstrates yet another characteristic shared by the two cell types. PMID- 2767008 TI - Pharmacokinetics and clinical use of parenteral phenytoin, phenobarbital, and paraldehyde. AB - Intravenous phenytoin, phenobarbital, and paraldehyde are effective and safe for the treatment of acute seizures such as status epilepticus. All of these drugs should be infused in a diluted solution and at a slow rate to minimize the occurrence of adverse effects. PMID- 2767009 TI - Antiepileptic drugs used in the emergency management of seizures and introduction of phenytoin prodrug. Proceedings of a symposium held in conjunction with the 1988 American Epilepsy Society meeting. San Francisco, California, October 15, 1988. PMID- 2767011 TI - Emergency management of seizures: an overview. AB - The drugs currently used in the emergency management of seizures are chiefly phenytoin, phenobarbital, diazepam, lorazepam, and paraldehyde. The combination of intravenous phenytoin and lorazepam has the advantages of rapid onset of action, sustained efficacy, and freedom from drug interactions. The intermittent oral or rectal administration of diazepam is especially useful for acute home treatment of recurrent seizures. Phenytoin prodrug (ACC-9653), an investigational new drug, is promptly absorbed after intramuscular injection. Unlike phenytoin, it does not require propylene glycol and high alkalinity for solubility and therefore does not produce soft-tissue injury after parenteral administration. It appears to be close to an ideal drug for the emergency management of seizures. PMID- 2767010 TI - Pharmacology of ACC-9653 (phenytoin prodrug). AB - ACC-9653, the disodium phosphate ester of 3-hydroxymethyl-5,5-diphenylhydantoin, is a prodrug of phenytoin with advantageous physicochemical properties. ACC-9653 is rapidly converted enzymatically to phenytoin in vivo. ACC-9653 and phenytoin sodium have equivalent anticonvulsant activity against seizures induced by maximal electroshock (MES) in mice following i.p., oral, or i.v. administration. The ED50 doses were 16 mg/kg for i.v. ACC-9653 and 8 mg/kg for i.v. phenytoin sodium. ACC-9653 and phenytoin sodium have similar antiarrhythmic activity against ouabain-induced ventricular tachycardia in anesthetized dogs. The total doses of ACC-9653 or phenytoin sodium necessary to convert the arrhythmia to a normal sinus rhythm were 24 +/- 6 and 14 +/- 3 mg/kg, respectively. Only phenytoin sodium displayed in vitro antiarrhythmic activity against strophanthidin-induced arrhythmias in guinea pig right atria. In anesthetized dogs, a high dose of ACC-9653 (31 mg/kg) was infused over 15, 20, and 30 min and the responses were compared to an equimolar dose of phenytoin sodium (21 mg/kg). The ACC-9653 and phenytoin sodium treatments produced similar marked reductions in diastolic blood pressure and contractile force (LVdP/dt). The maximum effects of each treatment occurred at the time of maximum phenytoin sodium levels. Acute toxicity studies of ACC-9653 and phenytoin sodium were carried out in mice, rats, rabbits, and dogs by i.v., i.m., and i.p. routes of administration. The systemic toxic signs of both agents were similar and occurred at approximately equivalent doses. Importantly, the local irritation of ACC-9653 was markedly less than phenytoin sodium following i.m. administration.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2767012 TI - gamma Vinyl GABA (vigabatrin) in epilepsy: the international experience. Proceedings of a symposium. Cincinnati, Ohio, April 16, 1988. PMID- 2767013 TI - Pharmacokinetic effects of vigabatrin on cerebrospinal fluid amino acids in humans. AB - A study was conducted to assess the impact of single dosing and different dosing intervals of vigabatrin [gamma vinyl GABA (GVG)] in 11 patients with drug resistant complex partial seizures. Cerebrospinal fluid (CSF) concentrations of total GABA, free GABA, homocarnosine, homovanillic acid (HVA), GVG, and 5 hydroxyindolacetic acid were measured up to seven days after a single dose. GVG levels were maximal within 24 h, suggesting that GVG acts to inhibit GABA transaminase, and may also increase biogenic amines. PMID- 2767014 TI - The neuropathology of vigabatrin. AB - Vigabatrin (gamma vinyl GABA, GVG), an enzyme-activated, irreversible inhibitor of GABA transaminase, was administered orally to rats, dogs, and monkeys to observe toxicologic reactions. Myelin vacuolation of the brain was observed. The vacuolation was limited to myelinated tracts and resulted from separation of the myelin sheath at the interperiod line. There was no evidence of demyelination, axonal degeneration, or damage uolation was histologically similar to that observed in association with other drugs such as triethyltin, isoniazid, or hexachlorophene. However, the distribution is limited to the brain and is reversible upon discontinuation of therapy. Two postmortem and three operative specimens from humans have revealed no evidence of vacuolation of myelin. PMID- 2767015 TI - Specificity of vigabatrin for the GABAergic system in human epilepsy. AB - The therapeutic action of vigabatrin (gamma vinyl GABA, GVG) has been reported to be mediated by GABAergic neurotransmission. In the present study, we evaluated different neurotransmitter systems in the cerebrospinal fluid (CSF) of patients with complex partial epilepsy, before and during GVG treatment. The markers of the GABAergic system (free GABA, total GABA, homocarnosine) showed a two- to threefold elevation. There was also an increase in glycine during the 6 months of GVG treatment. In contrast, we did not find any constant CSF changes in either excitatory amino acids or in markers of the cholinergic (acetylcholinesterase), dopaminergic (homovanillic acid), serotonergic (5-hydroxyindoleacetic acid), or peptidergic (somatostatin, prolactin, beta-endorphin) systems. This finding (except an elevation in glycine) was in agreement with previous studies which suggest a specific action of GVG on the GABAergic system. The role of glycine in antiepileptic efficacy of GVG needs further evaluation. PMID- 2767016 TI - Effects of long-term vigabatrin on somatosensory-evoked potentials in epileptic patients. AB - Vigabatrin (gamma vinyl GABA, GVG) has been shown to be an effective antiepileptic agent. GVG specifically and irreversibly inhibits GABA-transaminase (GABA-T). Long-term animal toxicology studies have demonstrated that GVG can induce nonprogressive, reversible intramyelinic edema in central white matter tracts. The response to GVG varies among species, with rodents being the most dramatic and monkeys showing an equivocal effect even at high doses. The response in dogs is marked and measurable. The detection of these subtle findings requires the use of sophisticated technology. Evoked potentials are becoming reliable and sensitive tools in clinical neurology. This study, involving 54 patients for 11 months, was undertaken to assess the effect and safety of GVG in humans with refractory epilepsy. No data from this investigation indicate prolongation of neuronal conduction time in CNS pathways, suggesting that this agent is safe in humans. PMID- 2767017 TI - Long-term evaluation of vigabatrin (gamma vinyl GABA) in epilepsy. AB - In studies spanning more than 5 years, more than 1,100 patients with epilepsy have been treated with vigabatrin (gamma vinyl GABA, GVG). Sixty-two patients with partial seizures with secondary generalization took part in this trial: 41 patients continued in the trial after 19 months of treatment. After 36 months, the median percentage of baseline seizures was less than 20%. GVG is a very potent antiepileptic drug. It is well tolerated in humans. The side effects are few. Skin rash and other allergic reactions have rarely been seen. Tolerance to the sedative effect is in contrast to the lack of tolerance to the anti-epileptic effect. PMID- 2767018 TI - gamma Vinyl GABA: current role in the management of drug-resistant epilepsy. AB - The goal of management in epilepsy is to make patients completely seizure-free without side effects. Currently, this goal can be achieved fully in only about one-half of the 50,000,000 people in the world with epilepsy. Epilepsy is not a benign condition. Uncontrolled epilepsy produces significant morbidity and mortality. Even infrequent seizures put a patient at risk of sudden death and compromise employability and other social functions. The potential risk of a new antiepileptic drug has to be weighted against the potential risk of continuing seizures and the potential for the new drug to control those seizures. Vigabatrin (gamma vinyl GABA, GVG) is one of the promising new antiepileptic drugs now under development. In four large clinical trials half of the patients in each trial had a greater than or equal to 50% reduction in seizure frequency when GVG was added to existing antiepileptic drug. This represents a significant response rate in add-on trials, which are a severe test of a new antiepileptic drug. Although microvacuoles have been seen in the white matter of the brains of rats and dogs treated with GVG, such pathological changes have not yet been observed in humans. Evoked potential studies have failed to reveal any evidence of microvacuolization in humans. Because of the potential efficacy of GVG in controlling previously therapeutic-resistant seizures and of the absence of evidence of significant toxicity in humans, carefully monitored clinical trials of GVG in therapy resistant patients with epilepsy should continue. PMID- 2767019 TI - Blood glucose monitoring by diabetic adolescents: compliance and metabolic control. AB - Self-monitoring of blood glucose (SMBG) is used in the management of diabetes to guide insulin and diet adjustments. However, SMBG has not achieved its potential impact on diabetic control, perhaps due to poor compliance. Research on SMBG compliance interventions has been hampered by a lack of reliable and practical methods of behavioral assessment. The appearance of reflectance meters with memory permits precise, yet efficient, measurement of SMBG behaviors, allowing more effective interventions. This study evaluated a behavioral contract for SMBG compliance among diabetic adolescents, using reflectance meters with memory to assess the target behavior. Thirty patients were randomized to either meter-alone or meter-plus-contract conditions; an additional 12 patients served in a conventional-therapy control group. Compliance for the meter-alone group declined sharply during the 16-week intervention, whereas it remained at or above baseline levels for the meter-plus-contract group. Despite the large between-groups differences in SMBG frequency, both groups showed equal, moderate improvement in measures of diabetic control, suggesting that SMBG frequency had little impact on health status in this sample. There were no intervention-specific effects on overall diabetes compliance or patient or parent adjustment to diabetes. Few of the measured patient characteristics were significant predictors of treatment response. Further research into maximizing the therapeutic impact of SMBG is needed. PMID- 2767020 TI - Diabetes-specific social learning variables and self-care behaviors among persons with type II diabetes. AB - This study assessed the relationship between diabetes-specific social learning factors and diabetes self-care. Predictor variables were collected within the categories of knowledge (e.g., behavioral demonstrations, pencil-and-paper tests), beliefs/expectations (e.g., self-efficacy, self-motivation), skills (e.g., problem-solving and refusal skills), and environmental support (e.g., barriers to adherence, family support). Different results emerged across the three areas of the regimen assessed: diet, exercise, and glucose testing. Multiple-regression analyses revealed that the social learning variables consistently improved the prediction of self-care beyond that attributable to demographic variables but that the categories of social learning variables most closely related to self-care varied across regimen areas. These findings suggest that programs to enhance diabetes self-care could beneficially focus on life style behaviors and employ strategies to increase regimen-related expectations and diabetes-specific social and problem-solving skills. PMID- 2767021 TI - Influence of regular aerobic exercise on psychological health: a randomized, controlled trial of healthy middle-aged adults. AB - Although a variety of psychological benefits have been attributed to regular exercise, few experimentally controlled studies of healthy individuals currently exist. One hundred twenty healthy, sedentary, middle-aged men and women were randomly assigned to either a 6-month home-based aerobic exercise training program or to an assessment-only control condition. Adherence across the 6-month period was found by both self-report and heart rate microprocessor methods to exceed 75% in both sexes. To assess changes in a variety of psychological variables over time, a 14-item Likert rating scale was completed and returned on a biweekly basis throughout the 6-month period. Slope analyses conducted on the 11 items attaining acceptable test-retest reliability coefficients showed significant between-groups differences on the 3 items most closely associated with the actual physical changes that occurred with exercise (all ps less than .004). Implications in relation to repeated measurement of psychological changes in nonclinical populations and the determination of the relevant population-, activity-, and program-specific parameters involved are discussed. PMID- 2767022 TI - Effects of alcohol abuse and familial alcoholism on physical health in men and women. AB - Detoxified alcoholic men (n = 76) and women (n = 72) and nonalcoholic control men (n = 50) and women (n = 51) were given a structured interview that assessed five categories of physical health: medical history, alcohol-related disorders, trauma history, drug use history, and, for females, female-related disorders. Approximately half the subjects in each group were family history positive for alcoholism. Significant differences between alcoholics and controls were found for all five categories; family history effects were significant for four of the five categories, and sex differences were present in two categories. The results indicate that (a) alcoholics suffer pervasive physical health difficulties, (b) a family history of alcoholism is predictive of health problems in both alcoholics and controls, (c) the effects of alcohol abuse and family history of alcoholism on health appear to be independent and additive, and (d) women may be more "illness prone" than men and exhibit an increased vulnerability to the adverse effects of alcoholism. PMID- 2767023 TI - Potential for hostility and dimensions of anger. AB - Recent reviews have linked Potential for Hostility derived from the Structured Interview (SI) to coronary artery disease, independent of the global Type A pattern. The present study examined the construct validity of Potential for Hostility ratings by correlating Potential for Hostility with 21 scales from four widely used anger/hostility measures: 7 scales from the Anger Self-Report, 8 scales from the Buss-Durkee Hostility Inventory, the total score from the Novaco Anger Inventory, and 5 scales from the Multidimensional Anger Inventory. The pattern of correlations revealed that Potential for Hostility was significantly related to scales reflecting awareness and arousal of anger, particularly the verbal expression of anger. To identify underlying anger dimensions, the 21 scales were factor-analyzed. Examination of two and three rotated principal components confirmed previous solutions. The first component, representing anger arousing and -eliciting situations and anger awareness, was labeled Experience of Anger. The second component, consisting of scales dealing with either physical assault or verbal expression of anger, was labeled Expression of Anger. When a third factor was retained, it contained scales of suspicion, mistrust-suspicion, and guilt: It was therefore labeled Suspicion-Guilt. Potential for Hostility was correlated only with the Expression of Anger factor in the two-factor solution; in the three-factor solution, Potential for Hostility was correlated equally with the Experience of Anger and Expression of Anger factors but was not correlated with the Suspicion-Guilt factor. The implications of these results for the assessment of hostility are discussed. PMID- 2767024 TI - Patterns of adaptation to Parkinson's disease. AB - Forty-four 50- to 80-year-old Parkinson patients were interviewed about the effects of the disease on their lives. The Q-sort technique was used to analyze the interview data. In addition, the Symptom Checklist 90, the Mini-Mental State, and physician ratings of disease severity were obtained. Four clusters of patients were identified. Cluster I patients were sanguine and engaged; Cluster III patients were depressed and apprehensive about the future; Cluster III patients felt depressed, ashamed, and misunderstood; and Cluster IV patients were passive and resigned. Disease severity, but not demographic or other health variables, discriminated the groups. Patients with a mild to moderate impairment who adjusted effectively to their illness (Cluster I) were distinguished by an ability to put negative thoughts out of mind, by their belief that there are worse fates than having Parkinson's disease, and by efforts to influence certain aspects of their illness. The particular patterns of adaptation of the patients who were depressed and misunderstood (Cluster III) and passive and resigned (Cluster IV) seemed primarily a function of physical condition. This suggest that the degree to which personal attitudes can influence adaptation to somatic disease is limited by specific realities of the disease. PMID- 2767026 TI - A retrospective study of 100 pelvic fractures in horses. AB - The records of 100 horses with clinical or radiographic diagnosis of a pelvic fracture were reviewed to determine prognostic indicators associated with clinical signs or radiographic fracture characteristics. Degree of lameness, soft tissue swelling, crepitis, muscle atrophy, skeletal external assymetry and palpable assymetry on rectal examination were evaluated. There was no significant relationship between the aforementioned clinical signs and the long-term cause outcome. Fracture sites or presence of an acetabular fracture were not related to prognosis. The positive outcome of 77 per cent of horses that were allowed to survive and were available for follow-up in this study warrants the effort of salvage of valuable individuals. PMID- 2767025 TI - Rhodococcus equi foal pneumonia: protective effects of immune plasma in experimentally infected foals. AB - The immunoprophylactic capacity of specific immune plasma was evaluated in pony foals infected experimentally with Rhodococcus equi. Immune plasma, produced by repeated parenteral administration of viable R. equi to adult horses, was harvested and frozen. Group I (six control foals) and Group II (six principal foals) received lactated Ringers solution and immune plasma respectively at three and five days of age. R. equi were aerosolised into a caudal lung lobe of all foals at seven days of age. Clinical signs, haematological alterations, immune responses, thoracic radiographs and technetium99m pulmonary perfusion scans were monitored. All foals were destroyed and complete post mortem examinations performed. All foals developed pneumonia as evidenced by clinical, radiographic and perfusion alterations, but the survival rate of principal foals was significantly (P less than 0.01) greater than that of control foals. Five control foals developed terminal disease, whereas all principal foals recovered. There was no significant (P greater than 0.05) difference in temperature response, or peripheral blood leucocyte, neutrophil or fibrinogen concentrations between groups. ELISA values for R. equi antibody were significantly (P less than 0.001) greater in principal foals following treatment, but there was no significant (P greater than 0.05) difference in IgG or IgM concentrations between groups. Results of the haemolysis inhibition assay indicated that equi factor neutralising antibodies were transferred by immune plasma to the principal foals. Post mortem examinations of five control foals destroyed at approximately three weeks post infection because of terminal disease, revealed severe pyogranulomatous pneumonia. One control and all principal foals were either free of lesions or had resolving lesions and/or minimal scar formation at three months post infection.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2767027 TI - Fever of unknown origin in the horse: a review of 63 cases. AB - Fever of unknown origin (FUO) is a syndrome characterised by prolonged, unexplained fever associated with non-specific signs of illness such as lethargy, inappetence and weight loss. This paper reviews the details of 63 horses affected by FUO. The cause was found to be infection in 43 per cent of the cases, neoplasia in 22 per cent, immune-mediated diseases in 6.5 per cent and miscellaneous diseases in 19 per cent; the cause remained undiagnosed in 9.5 per cent. PMID- 2767028 TI - Australian Stringhalt--epidemiological, clinical and neurological investigations. AB - An investigation of 78 cases of typical Australian Stringhalt from 52 properties in Victoria was carried out from 1985 to 1987. Horses were either examined in the field (n = 52), referred to the Veterinary Clinical Centre (n = 13) or clinical details were obtained verbally (n = 13). In addition 10 cases of false or atypical stringhalt were examined. Detailed soil and pasture analysis was carried out on 14 properties where Australian Stringhalt had occurred. Information was also obtained on epidemiology of the condition from a survey of practitioners. Fifty of the 52 cases examined in the field occurred in horses that were dependent upon poor quality unimproved dry pasture. In all but a few cases, there was no pasture improvement or fertiliser application, leading to the development of weed-dominated pastures, particularly by flatweed, Hypochaeris radicata. The range of clinical signs exhibited by horses with Australian Stringhalt was described and a grading system proposed to classify horses according to severity of signs. Laryngeal abnormalities were present in 10 of 11 cases examined endoscopically and these horses exhibited increased electromyographic (EMG) activity in the long digital extensor muscle at rest and during hindlimb flexion. To a large extent, the EMG changes disappeared and digital extensor muscle atrophy improved in two horses that were monitored to recovery. Deep peroneal nerve conduction studies in four horses with Australian Stringhalt showed a substantial reduction in nerve conduction velocity and when stimulated at 50 Hz were unable to sustain activation of the long digital extensor muscle. EMG and evoked responses appeared to be sensitive indicators of the state of the disease.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2767029 TI - Postprandial serum gastrin concentrations in normal foals. AB - Postprandial gastrin concentrations were assayed in serum samples from a group of six foals at one day, one week, one month and three months of age. Before sampling, each foal was prevented from feeding for 2 h and was then allowed to suck for 15 mins. Blood samples were taken at the start of the meal and at 30 min intervals for the next 3 h. Feeding increased serum gastrin concentrations at one day, one week and one month, with the greatest increases detected at one day. Mean pre-feeding gastrin concentrations were 25.2 +/- 2.3 pg/ml at one day, 22.8 +/- 3.9 pg/ml at one week, 15.2 +/- 2.3 pg/ml at one month and 15.6 +/- 7.5 pg/ml at three months. Highest mean post prandial concentrations were at 60 mins on Day one (47.4 +/- 15.2 pg/ml) and one month (25.2 +/- 4.1 pg/ml) old foals. There was no apparent post prandial increase in serum gastrin concentrations in foals at three months of age. Precise reasons for changes in postprandial serum gastrin concentrations remain unknown. Factors that could be important include maturation of G cell function, alterations in gastrin metabolism and excretion, and changes in gastrointestinal motility with increasing age. PMID- 2767030 TI - Analysis of post mortem aqueous humour chemistry in the horse, with particular reference to urea nitrogen and creatinine. AB - The concentrations of several post mortem aqueous humour chemical constituents were compared with ante mortem serum chemical values in the horse. Urea nitrogen and creatinine values in post mortem aqueous humour were good predictors of ante mortem serum values. Aqueous humour urea nitrogen increased only slightly and creatinine did not change significantly for up to 24 h after death. Formulae were derived for calculating estimated ante mortem serum urea nitrogen and creatinine from aqueous humour values obtained after death. These results from normal horses identify analytes that are accurate predictors of ante mortem serum values. Determination of post mortem aqueous humour urea nitrogen of creatinine may assist in interpretation of the functional significance of equivocal histological lesions in the kidney. PMID- 2767031 TI - Recognition of bronchopulmonary dysplasia in a newborn foal. PMID- 2767032 TI - Mechanobullous disease in two Belgian foals. PMID- 2767033 TI - Intrauterine death and onset of mummification of a single equine foetus. PMID- 2767034 TI - Diaphragmatic hernia as a cause of dyspnoea in a draft horse. PMID- 2767035 TI - Disposition of triclabendazole in horses, ponies and donkeys. PMID- 2767036 TI - Normal resting values of plasma free carnitine and acylcarnitine in horses predisposed to exertional rhabdomyolysis. PMID- 2767037 TI - Age differences in the haemogram of the National Hunt trained racehorse. PMID- 2767038 TI - DNA electrophoresis. PMID- 2767039 TI - Mobility surfaces for field-inversion gel electrophoresis of linear DNA. AB - The mobility of linear DNA during field-inversion gel electrophoresis was measured as a function of molecular weight Mr, pulse time t, and field strength E. Values of Mr between 48.5 and 194 kilobase pairs (kb), E from 5 to 14 V/cm and pulse times of 0.3 to 12 s were used. The data are presented as three-dimensional surfaces of mobility: E:t for fixed Mr or graphs of mobility: Mr:t for fixed E. The surfaces are not smoothly increasing functions of E, Mr, or t but instead show a valley with minimum mobility and a steep rise in mobility as t increases. For a field of 10 V/cm, 1% agarose gels, and 3:1 ratio of forward:back pulse time, the forward switching time t* at which the mobility changes most rapidly is given by t* = (0.034 +/- 0.003) Mr for Mr in kb and t* in seconds. The data and equations delineate the best conditions to achieve a particular separation. PMID- 2767041 TI - Effect of nonparallel alternating fields on the mobility of DNA in the biased reptation model of gel electrophoresis. AB - Chromosome-size DNA molecules can now be separated using a variety of pulsed field gel electrophoresis techniques. In this article, we study the predictions of the biased reptation model concerning the effect of two pulsed fields, making an arbitrary angle, on the power of separation of gel electrophoresis. Separation is predicted to be largely enhanced for obtuse angles, in agreement with experiments. Interestingly, very large molecules, which are not separated by pulsed fields, are predicted not to migrate along the gel diagonal for fairly long periods of time. Finally, we discuss the optimization of these techniques using the results of the theory, and the limitations of the latter when fluctuations and intramolecular modes probably dominate the system. PMID- 2767040 TI - Gel electrophoresis method for quantitation of gamma ray induced single- and double-strand breaks in DNA irradiated in vitro. AB - We describe a method based on gel electrophoresis for the quantitation of strand breaks in DNA and demonstrate its application to the measurement of single- and double-strand breaks formed by gamma-rays for DNA irradiated in vitro. For single strand breaks, our data span the dose range from 0.1 to 1 Gy, while for double strand breaks doses were from 3 to 15 Gy. In agreement with results obtained using other techniques, we find that the dose response function for single-strand breaks is linear while the dose response function for double-strand breaks is curved, indicating that it is the sum of both linear and quadratic components. We discuss factors that determine the sensitivity of the method and indicate approaches to make possible the quantitation of strand breaks in the DNA of cells irradiated with sublethal doses. PMID- 2767043 TI - Anthropometry of Korean female industrial workers. AB - This paper presents the results of an anthropometric survey conducted on Korean female workers in the garment industry. The data was collected as part of a project to modify work stations that utilized equipment from other countries. A set of 23 body dimensions were taken from a sample of 101 workers (aged 18-28 years). The anthropometric measurements are presented and compared with those of the Western and Japanese female. The results indicate that the body dimensions of the Korean female are different from those of both the Western and the Japanese female. The ratio of sitting height to standing height for the Korean female is closer to that of the Western female than it is the Japanese female. PMID- 2767042 TI - Symmetric and asymmetric manual materials handling. Part 1: Physiology and psychophysics. AB - To study the physiological and psychophysical costs of symmetric and asymmetric manual materials handling, two tasks were performed by 30 industrial subjects. In both tasks, box weight and handle position were varied. The symmetric task, lifting and lowering between floor and conveyor, showed handles to be beneficial. The asymmetric task was palletizing and depalletizing 36 boxes between a pallet and a conveyor. Both palletizing and depalletizing proved strenuous for females with heart rates exceeding 140b/min. All handle positions were better than No Handles, but the best handle position changed from asymmetric for 9 kg boxes to symmetric for 13 kg boxes. The effect of handles was equivalent to a weight change of 1-2 kg for Heart Rate and Rated Perceived Exertion, but much higher (2 14 kg) for Body Part Discomfort measures. PMID- 2767044 TI - Strength and cross-sectional area of the dorsal neck muscles. AB - The maximum isometric strength of cervical extensors was measured in a group of sixteen young healthy subjects. The cross-sectional area was obtained by computerized tomography. A significant positive correlation was found between muscle strength and cross-sectional area. The ratio of strength to cross sectional area is 10.17N/cm2. This value is similar to that estimated on the quadriceps using similar methods in other studies. Numerous factors are suggested to explain the individual variability of the results even within a homogeneous group; among them, neck morphology is important. PMID- 2767045 TI - Stair stepping efficiency of mentally handicapped and nonhandicapped adult females. AB - Net efficiency for stair stepping was compared between 15 mentally handicapped (MH) and 15 nonhandicapped (NH) women of comparable chronological age. Efficiency was computed as the percentage of the energy output divided by the energy expenditure. Energy expenditure was assessed by the performance of subjects on a double stair stepping apparatus, stepping at three work rates (14, 17, and 19 asc/min), repeated on four test days. Open-circuit spirometric techniques were used to measure oxygen uptake. The three-way (Group x Stepping Rates x Days) repeated measures ANOVA indicated that: (1) NH women stepped more efficiently than MH women (p less than 0.01). Mean stepping efficiency was 17.1% for the NH group, and 15.6% for the MH group; (2) MH women did not show improvement in stepping efficiency over the four days, although there was a 20% increase in the number of MH subjects capable of completing the fastest stepping rate over the four days; and (3) MH subjects were more efficient at 17 and 19 asc/min than at 14 asc/min. PMID- 2767046 TI - The effects of different pause types on neck and shoulder EMG activity during VDU work. AB - Surface electromyographic recordings on the right side from the descending part of the trapezius muscle and from the levator scapulae muscle and discomfort ratings were assessed for twelve female word processor operators. The operators were studied during three work periods of 30 min each. Three different kinds of pauses, active pauses with pause gymnastic movements, passive pauses with rest and diverting pauses, were introduced into the work every six minutes. The static muscular load was low and about the same for the three work periods. High contraction levels with a duration of at least 1% of the registration time differed significantly between the three types of pauses, reflecting the activity during the pauses itself. Active pauses could thus change the muscle activity pattern. There was a tendency to prefer pauses with activity to passive pauses. PMID- 2767047 TI - Joining of linear plasmid DNA is reduced and error-prone in Bloom's syndrome cells. AB - A linearized, replicating, shuttle vector plasmid, pZ189, was used to measure in vivo DNA joining ability of cells from patients with the cancer-prone, immunodeficient, chromosome breakage disorder, Bloom's syndrome (BS). The BS cell lines we studied were reported to contain reduced in vitro activity of DNA ligase I. We assessed in vivo joining ability by transfecting linear plasmids with overlapping or blunt ends (produced by EcoRI or StuI) into BS and normal fibroblast or lymphoblast host cells and measuring the amount of re-joined, replicated plasmids by their ability to transform bacteria. With plasmids having either overlapping or blunt ends we found a 1.3- to 3-fold lower (P less than 0.05) joining efficiency in BS cells than in the normal cells. The mutation frequency of the recovered plasmids was measured by screening for function of the suppressor tRNA contained in pZ189, for plasmid size, for presence of restriction sites, or by DNA sequencing. The spontaneous mutation frequency with the circular plasmid was 0.05-0.08% with both BS cell lines, values 2- to 21-fold higher (P less than 0.03) than with the normal cell lines. The mutation frequency with the linear plasmid passaged through both BS cell lines was 21-52%, values 1.4- to 5.4 fold higher (P less than 0.001) than with the normal lines. Detailed analysis of 210 recovered plasmids revealed an increase (P less than or equal to 0.001) in deletions, insertions or complex mutations at the joining sites, and in point mutations with the EcoRI cut plasmid with the BS cells in comparison to the normal cells.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2767049 TI - A phenylalanine ammonia-lyase gene from parsley: structure, regulation and identification of elicitor and light responsive cis-acting elements. AB - We demonstrate that phenylalanine ammonia-lyase (PAL) in parsley (Petroselinum crispum) is encoded by a small family of at least four genes. The levels of mRNA from three identified PAL genes increase considerably upon treatment of cultured parsley cells with UV light or fungal elicitor and upon wounding of parsley leaves or roots. In cultured cells these changes were shown to involve transcriptional activation. We present the first primary structure of a plant PAL gene (parsley PAL-1) and the deduced amino acid sequence of the enzyme. Inducible in vivo footprints in the PAL-1 promoter define two nucleotide sequences, within the motifs CTCCAACAAACCCCTTC and ATTCTCACCTACCA, involved in the responses to both UV irradiation and elicitor application. These motifs are conserved at similar positions in several elicitor or light-responsive genes from different species. In two cases they are found within short regions known to confer elicitor or UV-light inducibility. The conserved motifs in the parsley 4 coumarate:CoA ligase gene, which is coordinately regulated with PAL, also display UV-light inducible in vivo footprints. Taken together, our findings suggest a general role of these putative cis-acting elements in the responses of plants to such stresses. PMID- 2767048 TI - The transcriptional activation function located in the hormone-binding domain of the human oestrogen receptor is not encoded in a single exon. AB - Using GAL4 chimeric receptors, we have reported previously that the hormone binding domain (HBD) of the human oestrogen receptor (hER) contains an hormone inducible transcription activation function. We have extended that study here to show that this activation function represents the major activating domain in the hER in HeLa cells. In addition, we have expressed the various exons encoding the hER HBD as GAL4 fusion proteins and have shown that none contain a discrete activation function. Thus the activating domain of the hER HBD appears to be different from the recently characterized 'simple' activating domains, such as acidic 'blob' or amphipathic helix, and more likely corresponds to a protein surface created from dispersed elements and dependent upon the three-dimensional folding of the HBD. PMID- 2767050 TI - A base substitution in the exon of a collagen gene causes alternative splicing and generates a structurally abnormal polypeptide in a patient with Ehlers-Danlos syndrome type VII. AB - An unusual splicing mutation has been characterized in the pro alpha 1(I) collagen gene of a sporadic case of Ehlers-Danlos Syndrome Type VII. Cloning of primer extended cDNA in conjunction with R-looping experiments established that nearly half of the pro alpha 1(I) collagen gene transcripts are abnormally spliced, for they lack exon 6 sequences. Analysis of cloned genomic fragments revealed that one of the proband's alleles displays the substitution of an A for a G in the last nucleotide of exon 6. The change converts the normal Met (ATG) codon to Ile (ATA) and, in addition, obliterates a NcoI restriction site. The latter event was exploited to demonstrate the de novo nature of the mutation since DNA from the unaffected parents was fully digested with the enzyme, after in vitro amplification by the polymerase chain reaction. Further confirmation of the missplicing was obtained by transient expression into animal cells of allelic minigene constructs. Finally, Western blot analysis of cyanogen bromide cleaved collagen and nucleotide sequencing of appropriately selected cDNA clones demonstrated the production of relatively low amounts of correctly spliced molecules harboring the Ile substitution, as well. PMID- 2767051 TI - Multiple mRNAs encode peripherin, a neuronal intermediate filament protein. AB - Three cDNA clones of 1.6 (3u), 1.2 (5g) and 0.6 (5b) kbp, specific for peripherin, a neuronal intermediate filament protein (IFP), have been isolated from a murine neuroblastoma cell lambda gt11 library by immunoscreening using peripherin antiserum. Antibodies eluted from the fusion proteins produced by clones 3u and 5g recognize the peripherin spots on immunoblots. Where they overlap the three cDNAs have identical sequences. cDNA 5g exhibits the closest homology to type III IFP cDNAs. cDNA 3u is identical to the corresponding region of cDNA 5g, except for the insertion of a 96 bp fragment at a position corresponding to the junction of exons 4 and 5 in type III IFP cDNAs. cDNA 5b is also identical to the corresponding region of cDNA 5g, except for the deletion of a 62 bp fragment at the junction of exons 8 and 9 in type III IFP cDNAs. S1 mapping experiments performed with probes covering the 3' end of the two unexpected regions show that three distinct mRNAs correspond to the three cDNAs. Moreover, three peripherin products, two minor 61 and 56 kd products in addition to the major 58 kd peripherin, are observed when poly(A)+ RNA is in vitro translated, the 61 kd peripherin being translated from the 3u-selected RNA. The three RNAs originate from alternative splicing of a unique peripherin gene, thus generating polymorphism of peripherin. PMID- 2767052 TI - 'Allelic' forms of immunoglobulin V genes in different strains of mice. AB - A VH gene (Ox1) has a major role in the early antibody response of several mouse strains to hapten phenyloxazolone (phOx). Antibodies that are coded by this gene are positive for idiotype 495. Idiotype-positive monoclonal antibodies originating from the early primary response of nine strains were partially sequenced (mRNA). All 21 antibodies were coded by this gene, most of them also by one VL gene, VKOx1(H3). Very few somatic mutations were found, and the germ-line sequence of the two genes in several strains can be predicted. Four 'alleles' of the VHOx1 gene have 99-99.7% sequence homology to each other. One allele was found in Igh allotype j strains CBA and C3H, another in allotype c strains DBA/2 and RF, the third in allotype f strain CE and the fourth in BALB/c, 129, A/J and RIII mice (allotypes a, e or g). The VKOx1(H3) gene has the same sequence in eight strains. RF mice do not use this gene for the anti-phOx response. Our data suggest that antibody responses are inherited to a considerable extent and that immunoglobulin V genes are as stable as other genes in evolution. PMID- 2767054 TI - The DNA binding site of the Xenopus transcription factor IIIA has a non-B-form structure. AB - On the basis of nuclease digestion studies we proposed that the DNA binding site of transcription factor IIIA (TFIIIA) may have an overall structure with A-type rather than B-type characteristics. This proposal was substantiated by the crystal structure of a part of the TFIIIA binding site. Recently, however, it has been reported that the binding site for TFIIIA is B-form in solution, thus implying that the conformation present in crystals is not the structure in solution. We have carried out a study using comparative circular dichroism (CD) spectroscopy of a number of double stranded deoxyoligonucleotides of different sequence, and known crystal structure. The correlation we have found between CD characteristics and certain structural parameters indicates that the solution and crystal structures of the TFIIIA binding site are closely related. This structure may be classed as an intermediate type, between A-form and B-form DNA. PMID- 2767053 TI - Organization and structure of the Qa genes of the major histocompatibility complex of the C3H mouse: implications for Qa function and class I evolution. AB - We have determined the structure and organization of the entire Qa family of class I genes from the major histocompatibility complex of the C3H mouse. Restriction maps of overlapping lambda and cosmid clones reveal that there are only five Qak genes: Q1k, Q2k, Q4k, Q10k and a Q5/9 hybrid, presumably generated by unequal homologous recombination. The resulting deletion of Q6-Q9 is consistent with the Qa-2null phenotype of this mouse strain. We have sequenced the Qak genes, and predict that each may encode a class I molecule with a structure comparable with that proposed for the transplantation antigens. Furthermore, these Qa products should be able to bind peptides and interact with appropriate T-cell receptors. Interestingly, in comparing Qak and H-2k sequences, we find limited evidence of interlocus gene conversion between Qa and H-2 loci, suggesting that the Qa genes are not likely to serve as a reservoir of genetic information for the generation of H-2 diversity within this haplotype. PMID- 2767055 TI - Co-operative interactions between NFI and the adenovirus DNA binding protein at the adenovirus origin of replication. AB - The DNA-protein and protein-protein interactions proposed for the stability of nucleoprotein complexes at the origin of replication in prokaryotes are also thought to impart regulatory precision in eukaryotic DNA replication. This type of specificity can be observed, for example, during adenovirus DNA replication where efficient initiation requires that nuclear factor I (NFI) binds to the origin of DNA replication. Addition of purified NFI stimulates the initiation of adenovirus DNA replication in vitro in a reaction that is dependent on the concentration of the adenovirus DNA binding protein (DBP). However, the molecular basis for the synergistic action of NFI and DBP during replication is at present unknown. We report here that DBP increases the affinity of NFI for its binding site in the replication origin. DBP did not, however, increase the affinity of another eukaryotic sequence-specific DNA binding protein, EBP1, for its recognition site. Other single-stranded DNA binding proteins could not substitute for DBP in increasing NFI affinity for its binding site. In addition, DBP was found to alter the binding kinetics of NFI, both by increasing the rate of association and decreasing the rate of dissociation of NFI with the DNA template. The co-operativity between NFI and DBP was also demonstrated on another DNA template, a human NFI site (FIB2), suggesting that this interaction is of general occurrence and not restricted to the adenovirus origin of replication. PMID- 2767056 TI - Signals at the bacteriophage phi 29 DNA replication origins required for protein p6 binding and activity. AB - Protein p6 of Bacillus subtilis phage phi 29 binds specifically to the ends of the viral DNA that contain the replication origins, giving rise to a nucleoprotein structure. DNA regions recognized by protein p6 have been mapped by deletion analysis and DNase I footprinting. Main protein p6-recognition signals have been located between nucleotides 62 and 125 at the right phi 29 DNA end and between nucleotides 46 and 68 at the left end. In addition, recognition signals are also present at other sites within 200-300 bp at each phi 29 DNA end. Protein p6 does not seem to recognize a specific sequence in the DNA, but rather a structural feature, which could be bendability. The formation of the protein p6 DNA nucleoprotein complex is likely to be the structural basis for the protein p6 activity in the initiation of replication. PMID- 2767058 TI - Primate micronucleus study of L-selenomethionine. PMID- 2767057 TI - Flow cytometric analysis of bromodeoxyuridine-induced inhibition of cell proliferation in the human teratocarcinoma-derived cell line, P3. AB - We have developed methods in our laboratory whereby the effects of toxicant exposure on cell proliferation can be evaluated flow cytometrically. We sought to relate the flow cytometric analyses to other biological response measurements. Thus, we exposed P3 cells to increasing concentrations of bromodeoxyuridine (BRdU) and measured sister-chromatid exchange (SCE) frequency, average generation time (AGT), and relative cloning ability. Each of these is well documented (see introduction) to respond to BRdU exposure in a concentration-dependent manner. In this study, SCE frequency remained constant between the concentrations of 2.5 and 10 microM of BRdU. However, a small, but significant, increase in SCE frequency was observed between the concentrations of 10 microM and 50 microM BRdU. A significant increase in AGT was noted in 50 microM BRdU-exposed cells. Relative cloning efficiency decreased in a concentration-dependent manner when cells were cultured for 24, 48, or 72 hours with BRdU. When cell proliferation was assessed by flow cytometric analysis in cells exposed to 0, 10, or 50 microM BRdU, a statistically significant delay in the cell-cycle was observed in BRdU-exposed cells. These results may be interpreted to mean that inhibition of cell proliferation is detected by this type of analysis at toxicant concentrations that induce other biological endpoints. The inclusion of flow cytometric analysis in a test battery to evaluate toxicant effects is warranted. PMID- 2767060 TI - Intralitter variation in murine fetal sister chromatid exchange responses to the transplacental carcinogen ethyl carbamate. AB - Gravid Swiss Webster dams were injected via tail vein with a single (1.1, 2.2, or 3.3 mmol/kg) dose of ethyl carbamate (urethane) on days 13-17 of pregnancy. Relative sister chromatid exchange (SCE) responses in maternal bone marrow vs. individual fetal liver cells were assessed. In addition, in order to evaluate the significance of intralitter variability in fetal SCE responses, SCE in combined ("pooled") fetal liver tissue preparations were measured and compared with average individual responses. In contrast to maternal responses, average fetal SCE responses to ethyl carbamate varied with gestational age. In addition, significant variation was observed among individual littermate responses at all dose levels. Nonetheless, fetal SCE responses determined from "pooled" tissue preparations provided a valid estimate of average litter responses. Regardless of the method of SCE evaluation in fetal tissue or gestational age, maternal bone marrow exhibited greater sensitivity than fetal liver to SCE induction by ethyl carbamate. PMID- 2767059 TI - Long-term effects of triethylenemelamine exposure on mouse testis cells and sperm chromatin structure assayed by flow cytometry. AB - The toxic and potentially mutagenic actions of triethylenemelamine (TEM) on mouse body and testis weights, testicular cell kinetics, sperm production, sperm head morphology, and sperm chromatin structure were assessed in two experiments. The first experiment examined effects of four dose levels of TEM, assayed 1, 4, and 10 wk after toxic exposure. In the second study, effects from five dosage levels were measured at 1, 4, and 10 wk, and the highest dosage level was evaluated over 44 wk. TEM produced an expected dose related loss of spermatogenic activity and subsequent recovery as determined by dual-parameter (DNA, RNA) flow cytometry (FCM) measurements of testicular cells. Both testicular weights and caudal sperm reserves remained generally below controls after 44 wk recovery following exposure to the highest (1.0 mg/kg daily x 5) dosage. Chromatin structure alterations, defined as increased susceptibility to DNA denaturation in situ, and sperm head morphology were highly correlated (.87-.93, P less than .001) with dose and with each other. Data obtained from the sperm chromatin structure essay (SCSA) on fresh sperm was highly correlated with measurements of aliquots of the same sample collected over 44 wk, frozen, and then measured on the same day. Sperm head morphology and sperm chromatin structure remained abnormal at 44 wk for the 1.0 mg/kg TEM dosage, suggesting that the abnormalities, present long after the initial toxic response, may be a result of mutation. This study demonstrates that flow cytometry provides a unique, rapid, and efficient means to measure effects of reproductive toxins and potential mutagens. PMID- 2767061 TI - Habitual level of physical activity and cardiorespiratory endurance capacity in children. AB - A total of 257 healthy children (140 boys, 117 girls) varying in age from 5.7 to 18.5 years underwent graded exercise tests on a treadmill. Cardiorespiratory endurance capacity was assessed by determination of the ventilatory threshold, which was defined as the highest exercise intensity before a disproportionate increase occurred in pulmonary ventilation (VE) relative to oxygen uptake (VO2). The purpose of the present study was to investigate the relationship between the habitual level of physical activity (HLPA) and the cardiorespiratory endurance capacity in children. The HLPA was assessed by a standardized questionnaire. In boys and girls HLPA increased gradually with advancing age. For the group as a whole, the boys reached the highest values for HLPA. The most active boys reached the highest value for ventilatory threshold and the lowest value was found in the less active ones, except for the age span of 12-16 years. It is concluded that more active boys showed a higher cardiorespiratory endurance capacity, as assessed by the ventilatory threshold, compared to less active ones, except during puberty. It can be postulated that during puberty this effect may be overruled by the influence of other more dominant growth-related factors. In girls, because HLPA was rather low, there was no discriminative effect of HLPA on exercise performance, as would be expected. PMID- 2767062 TI - Effect of submaximal exercise at low temperatures on pulmonary function in healthy young men. AB - In order to understand more fully the effect on pulmonary function of whole body exposure to cold during submaximal exercise, we measured pulmonary function indices in ten healthy male students and ten healthy male forestry workers of similar age following submaximal treadmill walking at different temperatures in a climatic chamber. After measuring the maximal aerobic capacity with a cycle ergometer test, the subjects had to walk on four separate occasions in the climatic chamber at an intensity of 70%-75% of their individual maximal heart rate; the first at normal room temperature and then randomly, either at 0 degrees C or at -20 degrees C, and vice versa. The duration of each walk was 8 min. Finally, each subject had to walk in the chamber at -20 degrees C for 17 min. Flow volume spirometry was performed at room temperature 1, 5, 10, and 20 min after exercise and the values were compared to baseline values taken prior to the last walking test. There were only minor changes in pulmonary function indices following exercise at different temperatures. Only one student showed a reduction of over 15% in peak expiratory flow rate after an 8-min walk at -20 degrees C. It seems that submaximal exercise of short duration, even at a temperature as low as -20 degrees C, does not impair pulmonary function in healthy young men. PMID- 2767063 TI - Anaerobic threshold, muscle volume and hypoxia. AB - Ventilatory threshold, apparent mechanical efficiency, oxygen debt repayment, heart rate and perceptions of exertion at the ventilatory threshold have been examined in 8 men and 8 women during the performance of four types of exercise (2 leg, 1-leg, arm plus shoulder, and arm ergometry) under normoxic and hypoxic (12% oxygen) conditions. The ventilatory threshold (percentage of task-specific VO2peak at which a disproportionate increase of ventilation begins) was not significantly affected by the sex of the subject, by hypoxia, or by the volume of active muscle involved in the activity, but showed poor reproducibility in small muscle tasks. The apparent mechanical efficiency in 2-leg ergometry was increased from 25.7 to 28.1% under hypoxic conditions, presumably reflecting an increased contribution of anaerobic effort to sub-maximal work. However, oxygen debt repayment following exhausting exercise was much smaller for arm than for leg ergometry. The heart rate corresponding to the ventilatory threshold decreased as the volume of active muscle was reduced. General and respiratory perceptions of effort were rather light for self regulation of an exercise prescription to the ventilatory threshold, and particularly with tasks involving the arm muscles, prescription may best be regulated by the intensity of local muscular sensations. PMID- 2767064 TI - White blood cell response to uphill walking and downhill jogging at similar metabolic loads. AB - The object of this study was to determine whether leukocytosis would occur in response to eccentric exercise, to concentric exercise, and/or to possible increases in serum cortisol levels. Eight men performed 2 bouts of exercise at 46% VO2max for 40 min. Subjects initially walked up a 10% grade (UW); 2 weeks later they jogged down a 10% grade (DJ), a form of eccentric exercise known to induce delayed onset muscle soreness (DOMS). Venous blood samples were drawn before and after each exercise bout (0, 0.5, 1, 1.5, 2, 2.5, 3, 3.5, 4, and 5 h). Total and differential WBCc and serum cortisol levels were assessed. Results were analyzed using repeated measures ANOVA (2 x 11). Subjects experienced severe DOMS after DJ. There was a significant difference in TWBCc (p less than 0.0001) between UW and DJ. Post-hoc testing revealed no significant increase over baseline values for UW; after DJ there was a 46% increase over baseline values (p less than 0.05) initially seen at 1.0 h. These increases in TWBCc were predominantly a reflection of increases in neutrophils which were significant (p less than 0.0001) when compared to baseline values at 1.0, 1.5 and 2.0 h (approximately 60%). No significant neutrophil increases were seen after UW. Cortisol levels were similar for both groups pre-exercise (UW = 367.1 +/- 38.6, DJ = 320.2 +/- 44.16 nmol.L-1 means +/- SE) and decreased similarly for both groups after exercise, and thus were not related to the post-exercise neutrophilia.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2767065 TI - Maximal mechanical power output and capacity of cyclists and young adults. AB - The maximal average power output (Wmax) has been examined in 10 male students, 22 pursuit and 12 sprint cyclists. In 24 of these subjects (8 students, 10 pursuit and 6 sprint cyclists), estimates of the maximal capacity (Wcap) of the short term anaerobic energy yielding processes were made. The results show that the sprinters had a higher absolute Wmax (1241 +/- 266 W) and Wcap (16.7 +/- 4.9 kJ) than either the students (1019 +/- 183 W, 14.7 +/- 2.8 kJ) or the pursuit cyclists (962 +/- 206 W, 14.0 +/- 2.9 kJ). However, the differences were removed when the values were standardised for muscle size. In the sprinters the Wmax was attained at an optimal pedal frequency Vopt of 132 +/- 3 min-1 and the estimated maximal velocity of pedalling (V0) was 262 +/- 8 min-1. The comparable figures in the students and pursuit cyclists were 118 +/- 8 min-1, 235 +/- 17 min-1 and 122 +/- 6 min-1, 242 +/- 12 min-1 respectively. The coefficient of variation of duplicate measurements of Wcap was found to be +/- 9%. Using data of Wilkie (1968) for muscle phosphagen and glycolytic stores (27 mmol.kg-1), it was estimated that the probable efficiency of the anaerobic processes during maximal cycling was 0.22. It was concluded that Wmax and Wcap are largely determined by body size and muscularity. The efficiency of anaerobiosis appears to be of the same order of magnitude as found for oxidative work. PMID- 2767066 TI - Pattern of reflex responses in lower limb muscles to a resistance in walking man. AB - Reflex responses in the lower limbs were investigated using electromyographic and kinematic techniques in man walking on a treadmill. A momentary resistance was applied to one leg at three selected points in the step cycle. The responses to such stimuli, as well as the locomotor activity, were picked up electromyographically and displayed on a four channel oscilloscope. Four superficial muscles viz: gluteus medius, vastus lateralis, rectus femoris and tibialis anterior were studied in both ipsilateral and contralateral legs. In general it was found that the ipsilateral leg muscles produced a response throughout the step cycle regardless of whether the muscle was active or silent at the time the reflex occurred. In contrast, contralateral leg muscles showed a different pattern of response which depended on where the resistance was applied in the step cycle. The long reflex latency, of the order of 80 ms, was a consistent feature of the responses and suggests the possible involvement of supra-spinal pathways. The latencies for a particular muscle were identical on the ipsi- and contralateral sides. The durations of the swing and stance phases of the step cycle were also recorded but showed no change due to application of the resistance. In general, the results indicate that the body has the inherent ability to reinforce the ongoing locomotor muscle activity in response to external stimuli in order to maintain upright balanced walking. PMID- 2767067 TI - The effect of citrate loading on exercise performance, acid-base balance and metabolism. AB - Nine subjects (VO2max 65 +/- 2 ml.kg-1.min-1, mean +/- SEM) were studied on two occasions following ingestion of 500 ml solution containing either sodium citrate (C, 0.300 g.kg-1 body mass) or a sodium chloride placebo (P, 0.045 g.kg-1 body mass). Exercise began 60 min later and consisted of cycle ergometer exercise performed continuously for 20 min each at power outputs corresponding to 33% and 66% VO2max, followed by exercise to exhaustion at 95% VO2max. Pre-exercise arterialized-venous [H+] was lower in C (36.2 +/- 0.5 nmol.l-1; pH 7.44) than P (39.4 +/- 0.4 nmol.l-1; pH 7.40); the plasma [H+] remained lower and [HCO3-] remained higher in C than P throughout exercise and recovery. Exercise time to exhaustion at 95% VO2max was similar in C (310 +/- 69 s) and P (313 +/- 74 s). Cardiorespiratory variables (ventilation, VO2, VCO2, heart rate) measured during exercise were similar in the two conditions. The plasma [citrate] was higher in C at rest (C, 195 +/- 19 mumol.l-1; P, 81 +/- 7 mumol.l-1) and throughout exercise and recovery. The plasma [lactate] and [free fatty acid] were not affected by citrate loading but the plasma [glycerol] was lower during exercise in C than P. In conclusion, sodium citrate ingestion had an alkalinizing effect in the plasma but did not improve endurance time during exercise at 95% VO2max. Furthermore, citrate loading may have prevented the stimulation of lipolysis normally observed with exercise and prevented the stimulation of glycolysis in muscle normally observed in bicarbonate-induced alkalosis. PMID- 2767068 TI - Venous return from distal regions affects heat loss from the arms and legs during exercise-induced thermal loads. AB - To study the role of venous return from distal parts of the extremities in influencing heat loss from the more proximal parts, changes in mean skin temperature (Tsk) of the non-exercising extremities were measured by color thermography during leg and arm exercise in eight healthy subjects. Thirty minutes of either leg or arm exercise at an ambient temperature (Ta) of 20 degrees C or 30 degrees C produced a greatly increased blood flow in the hand or foot and a great increase in venous return through the superficial skin veins of the extremities. During the first 10 min of recovery from the exercise, blood flow to and venous return from the hand or foot on the tested side was occluded with a wrist or ankle cuff at a pressure of 33.3 kPa (250 mm Hg), while blood flow to the control hand or foot remained undisturbed. During the 10-min wrist occlusion, Tsk increased significantly from 28.3 degrees +/- 0.41 degrees C to 30.1 degrees +/- 0.29 degrees C in the control forearm, but remained at nearly the same level (28.0 degrees +/- 0.34 degrees C to 28.2 degrees +/- 0.25 degrees C) in the occluded forearm. In the legs, although Tsk on both sides was virtually identical (32.0 degrees +/- 0.31 degrees C, control vs 32.0 degrees +/- 0.36 degrees C, tested) before occlusion, Tsk on the control side (32.6 degrees +/- 0.27 degrees C) was significantly higher than that on the tested side (32.2 degrees +/- 0.21 degrees C) after ankle occlusion.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2767069 TI - Rates of energy substrates utilization during human cold exposure. AB - Although it is well established in animals that acute cold exposure markedly increases the oxidation of energy substrates, the absolute quality and quantity of substrate oxidation is poorly understood in humans. This study compared the rates of substrate utilization in seven healthy young men exposed to both the warm (control exposure at 29 degrees C; semi-nude, 14 h fasted) and to the cold for 2 h (10 degrees C, 1 m.s-1 wind velocity). Substrate utilization was calculated using indirect calorimetry and the nonprotein respiratory exchange ratio, which was derived from the urinary urea nitrogen output. Cold exposure induced a 3.1 +/- 0.2 degrees C drop in mean body temperature and a body heat debt of 825.9 +/- 63.3 kJ (p less than 0.01). These parameters remained essentially unchanged in the warm. Cold exposure elevated the 2 h energy expenditure 2.46-fold in comparison to the warm (p less than 0.01). This cold induced thermogenesis was accompanied by increases of 588% in carbohydrate oxidation (p less than 0.01) and 63% in fat oxidation (p less than 0.05), whereas protein oxidation remained unchanged. Although the greatest proportion of the energy expenditure in the warm was derived from lipid (59%), carbohydrate oxidation represented the major fuel for thermogenesis in the cold, since it accounted for 51% of the corresponding total energy expenditure. The results demonstrate that cold exposure causes a much greater increase in the utilization of carbohydrate than lipid. It is suggested that these substrates are directly utilized for thermogenesis in the shivering skeletal muscles. PMID- 2767070 TI - Plasma norepinephrine and heart rate dynamics during recovery from submaximal exercise in man. AB - The time course of heart rate (HR) and venous blood norepinephrine concentration [NE], as an expression of the sympathetic nervous activity (SNA), was studied in six sedentary young men during recovery from three periods of cycle ergometer exercise at 21% +/- 2.8%, 43% +/- 2.1% and 65% +/- 2.3% of VO2max respectively (mean +/- SE). The HR decreased mono-exponentially with tau values of 13.6 +/- 1.6 s, 32.7 +/- 5.6 s and 55.8 +/- 8.1 s respectively in the three periods of exercise. At the low exercise level no change in [NE] was found. At medium and high exercise intensity: (a) [NE] increased significantly at the 5th min of exercise (delta [NE] = 207.7 +/- 22.5 pg.ml-1 and 521.3 +/- 58.3 pg.ml-1 respectively); (b) after a time lag of 1 min [NE] decreased exponentially (tau = 87 s and 101 s respectively); (c) in the 1st min HR decreased about 35 beats.min 1; (d) from the 2nd to 5th min of recovery HR and [NE] were linearly related (100 pg.ml-1 delta [NE] congruent to 5 beats.min-1). In the 1st min of recovery, independent of the exercise intensity, the adjustment of HR appears to have been due mainly to the prompt restoration of vagal tone. The further decrease in HR toward the resting value could then be attributed to the return of SNA to the pre exercise level. PMID- 2767072 TI - Catheter ablation of ventricular tachycardia using defibrillator pulses: electrophysiological findings and long-term results. AB - Catheter ablation of ventricular tachycardia (VT) was attempted in 24 patients (mean age 49 +/- 15.1 years) with a history of recurrent sustained VT resistant to previous antiarrhythmic drug therapy. 14 patients (58.3%) had also failed to respond to long-term administration of amiodarone alone and in combination with class I antiarrhythmic drugs. Endocardial catheter mapping during induced or spontaneous VT and/or pacemapping were performed to identify the site of origin of VT. Direct-current high-energy anodal shocks were delivered from a conventional cardioverter with stored energies of 100, 200 or 400 J via the distal electrode of conventional catheters. A total of 139 shocks was delivered during the ablation procedure. One patient died from wall perforation. Within 1 week of ablation, nine patients developed spontaneous recurrences of monomorphic sustained VT, identical to the clinical VT, and one patient developed a VT with a new morphology. In addition, four patients had a recurrence of their clinical VT after several weeks. In seven of 14 patients with spontaneous recurrences after the first ablation procedure and in three patients in whom VT was again inducible at the end of the first week, a second ablation procedure was performed. One patient with inducible VT after the first and second ablation sessions was given a third ablation procedure, and was discharged from hospital on anti-arrhythmic drugs which were successful despite being previously ineffective. After a mean follow-up period of 14.1 +/- 9.1 months, there were no spontaneous recurrences of sustained VT in 17 patients (71%) (nine without antiarrhythmic drugs and eight on antiarrhythmic drugs). In the remaining patients, incessant non-sustained VT (n = 2) or recurrent sustained VT (n = 2) occurred, and two patients died suddenly (at 2 and 21 months). There was no correlation between catheter mapping data or the results of pre-discharge electrophysiological study and clinical outcome during long-term follow-up. Complications related to catheter ablation included pulmonary oedema, cardiac tamponade, femoral artery occlusion, multiple episodes of ventricular tachycardia/fibrillation and thrombus formation, each in one patient (major complications; n = 7,29.1%), as well as transient third degree AV block, transient right or left bundle branch block, transient marked ST elevation or transient atrial tachycardia (minor complications; n = 8, 33.3%). The results suggest that catheter ablation might become an effective procedure for the non pharmacological treatment of sustained VT.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2767071 TI - Control of sweating during the human menstrual cycle. AB - Thermoregulatory responses were studied in seven women during two separate experimental protocols in the follicular (F, days 4-7) phase and during the luteal (L, days 19-22) phase of the menstrual cycle. Continuous measurements of esophageal temperature (Tes), mean skin temperature (Tsk), oxygen uptake and forearm sweating (ms) were made during all experiments. Protocol I involved both passive heat exposure (3 h) and cycle exercise at approximately 80% VO2 peak during which the environmental chamber was controlled at Ta = 50.0 degrees C, rh = 14% (Pw = 1.7 kPa). In protocol II subjects were tested during thirty-five minutes of exercise at approximately 85% VO2 peak at Ta = 35 degrees C and rh = 25% (Pw = 1.4 kPa). The normal L increase in resting Tes (approximately 0.3 degrees C) occurred in all seven subjects. Tsk was higher during L than F in all experiments conducted at 50 degrees C. During exercise and passive heat exposure, the Tes threshold for sweating was higher in L, with no change in the thermosensitivity (slope) of ms to Tes between menstrual cycle phases. This rightward or upward shift in Tes threshold for initiation of sweating averaged 0.5 degrees C for all experiments. The data indicate the luteal phase modulation in the control of sweating in healthy women is also apparent during severe exercise and/or heat stress. PMID- 2767073 TI - Closed-chest ablation of left lateral atrioventricular accessory pathways. AB - Thirty patients with a left lateral accessory pathway and drug refractory tachycardia underwent attempted transcatheter ablation of the accessory pathway. Three had a concealed accessory pathway and 27 had the Wolff-Parkinson-White syndrome. A quadripolar electrode catheter was positioned within the coronary sinus in order to locate the earliest retrograde atrial activation during orthodromic reciprocating tachycardia. The appropriate bipole was used as the radiographic and electrophysiologic reference of the insertion of the accessory pathway. A catheter was then introduced into the left atrium, through a patent foramen ovale (six patients) or after transseptal catheterization (14 patients) according to Croft's technique, or using a retrograde transaortic approach (10 patients). The mitral annulus was mapped with the left atrial catheter in order to record a synchronous or earlier atrial deflection than reference during reciprocating tachycardia. VA' time at the preablation site was 82 +/- 12 ms. Two to seven 160 J cathodal shocks (650 +/- 205 J cumulative per patient) were delivered at this site in 38 sessions. No significant side-effects occurred except for one case of right coronary artery spasm leading to inferior wall infarction. Following fulguration, accessory pathway conduction was abolished in all patients but one with a second accessory pathway. During follow-up of 1-34 months, all patients but one were free of tachycardia: reciprocating tachycardia recurred in one patient, who had a concealed accessory pathway, on the third day. Accessory pathway conduction, assessed in 10 other patients 3-26 months after the procedure, was absent. Coronary arteriography performed in seven patients was normal.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2767074 TI - Relationship between QT interval duration and exercise-induced ventricular arrhythmias. AB - This study was performed to determine if QT prolongation before and during early exercise is related to the occurrence of exercise-induced ventricular arrhythmias (EIVA). EIVA occurred in 47 of 142 patients with angiographic evidence of coronary artery disease (CAD); no EIVA occurred among the 22 patients without CAD (OV). Resting QTc and QT intervals during early exercise were similar in patients without EIVA, irrespective of the presence or absence of CAD; however resting QTc was significantly longer in CAD patients who showed EIVA (443 +/- 40 ms; P less than 0.01) than in CAD patients without EIVA (424 +/- 37 ms) and in OV patients (421 +/- 32 ms). During early exercise, the QT interval remained significantly longer in patients with than in those without EIVA. There was a trend toward increasing resting QTc in patients who exhibited EIVA more severe than grade 3. When resting QTc was longer than 440 ms, subsequent EIVA were correctly predicted in CAD patients with a sensitivity of 43%, a specificity of 72% and a predictive accuracy of 63%. Thus, a trend toward longer resting QTc values exists in CAD patients who develop EIVA; however, a long resting QTc (greater than 440 ms) appears to be only a weak predictor of subsequent EIVA. PMID- 2767075 TI - Haemodynamic benefit of a rate-adapted A-V delay in dual chamber pacing. AB - In dual chamber pacing, an improvement of exercise capacity is expected when the atrial refractory period is shortened, because the 2/1 point is increased. This objective can be achieved by greatly reducing atrioventricular delay (AVD) on exercise. Are such variations (up to 100-120 ms) detrimental from a haemodynamic standpoint? This study was performed to analyse this particular aspect of DDD pacing. Three DDD pacing modes, differing by their AVDs (fixed 200 ms AVD, fixed 150 ms AVD, and rate-adapted AVD) were tested in random order, with a haemodynamic protocol including ten patients with chronic atrio-ventricular (A-V) block. For the rate-adapted AVD pacing mode, AVD was reduced by 20 ms every 10 beats min-1 increment (from 220 ms at 90 beats min-1 to 100 ms at 150 beats min 1). Pacing rate was increased from 90 to 150 beats min-1 by increments of 10 beats min-1 every 5 min. Cardiac performance was significantly improved with the rate-adapted AVD above the two fixed AVDs, despite a large AVD variation. When AVD was rate adapted, cardiac index, stroke volume index and left ventricular systolic work index were generally higher and pulmonary capillary wedge pressure, pulmonary arterial pressure and systemic vascular resistances were generally lower, especially at 120, 130 and 140 beats min-1. Comparing the two fixed AVDs, 200 AVD improved cardiac function more at lower heart rates, whereas 150 AVD improved cardiac function more at higher heart rates. Despite its limitations, this study demonstrates that the potential benefits of reducing AVD with increasing heart rates should be twofold in dual chamber pacing: (a) haemodynamic, optimizing cardiac performance on exercise for all heart rates, especially in cases of organic heart disease; (b) electrophysiologic, permitting a sufficiently rapid maximal tracking rate in cases with long post-ventricular atrial refractory periods, allowing a satisfactory level of exercise. PMID- 2767076 TI - The reliability of psychophysiological examinations under field conditions: results of repetitive mental stress testing in middle-aged men. AB - In an epidemiological examination outside specialized laboratories we investigated the test-retest stability of blood pressure (BP) and heart rate (HR) reactions to standardized mental stress in 136 men (mean age 44 +/- 7 years) with complaints of mental and physical fatigue. Repetitive stress testing was performed at 4-week intervals on four occasions. On all four occasions stress levels differed significantly from baseline levels (P less than 0.001). Baseline conditions for BP and HR were significantly correlated at 4-week and 8-week intervals (P less than 0.001). Cardiovascular reactivity to mental stress was also stable over a 4, 8, and 12-week period. We conclude that psychophysiological reactivity can be assessed with good reliability under field conditions. PMID- 2767077 TI - Familial aortic valve disease: evidence for a genetic influence? AB - It has been suggested that genetic factors may play a role in the aetiology of congenital bicuspid aortic valve disease. This report describes a family in which three male siblings with bicuspid aortic valves developed critical aortic stenosis. This provides further evidence that an hereditary mechanism may play a role in some patients with this condition. PMID- 2767078 TI - Kinetics of Tc-99m hexakis t-butyl isonitrile in normal and ischemic canine myocardium. AB - Hexakis 99mTc-tertiary butyl isonitrile (99mTc-TBI) was studied as a cardiac perfusion imaging agent in nine dogs with partial occlusion of the LAD. Thirty min after applying the stenosis, 99mTc-TBI was injected into the right atrium (RA) in five dogs and left atrium (LA) in four dogs. Normal and ischemic zone regional myocardial 99mTc-TBI activities were monitored continuously for 4 h. Dogs with LA injections had minimal and equivalent 4 h fractional clearance from the normal and ischemic zones. Dogs with RA injections had minimal, but significantly lower 4 h fractional 99mTc clearances in the ischemic zone (0.08 +/ 0.08) compared to the normal zone (0.16 +/- 0.07, P less than 0.05). The delayed ischemic zone clearance is probably due to the high initial lung uptake observed after RA injection. Despite the differences in clearance, this minimal amount of redistribution could not be detected on gamma camera images. The minimal myocardial washout and redistribution, and the 140 keV gamma make 99mTc-TBI a promising cardiac perfusion imaging agent. PMID- 2767080 TI - Labelling monoclonal antibodies with yttrium-90. AB - Using the cyclic DTPA derivatisation procedure developed by Hnatowich, conditions have been optimised for labelling three tumour-associated monoclonal antibodies with 90Y. High labelling efficiencies (greater than 95%) at modest specific activities (1 mCi/mg) could be routinely obtained. Radiochemical stability of the radiolabelled preparations in vitro was good, but radiolysis resulted in early losses of antibody immunoreactivity. PMID- 2767079 TI - Tc-99m-HMPAO labelled human platelets: in vitro and in vivo results. AB - The lipophilic 99mTc-HMPAO complex can be used for labelling platelets as well as granulocytes. Platelets were isolated according to standard isolation procedures for the evaluation of the optimal labelling parameters. The labelling efficiency (%) depends on incubation temperature (22 degrees C: 40%: 37 degrees C: 50%), incubation time (3 min: 20%, 25 min: 55%) and the incubation medium (plasma: 40%; saline 50%). The 60 min 99mTc elution out of the platelets ranged around 8%. The platelet recovery used as a quality control parameter is around 25% +/- 4% and is stable for at least 240 min. The high elution rate out of the platelets leads to renal excretion of the label and hence to significant kidney and bladder activity. Intestinal excretion of the label can also be frequently demonstrated. Fresh thrombotic lesions can normally be detected 4 h after reinjection of the labelled platelets, and in some patients as early as 1 h after reinjection. In conclusion, 99mTc-HMPAO seems to be a promising platelet label for imaging thrombotic lesions but not for platelet survival studies, because of the short physical half life of 99mTc. PMID- 2767082 TI - Persistent impairment of liver function caused by a pendulated accessory liver lobe. AB - A large pendulated accessory liver lobe and complete absence of the left lobe were discovered by liver scintigraphy and ultrasound scanning in a patient suspected of having an ovarian tumor. The patient had a history of fluctuating impaired liver function tests for many years, probably caused by intermittent torsion of the peduncle. Pedunculated accessory liver lobes are extremely rare and seldom diagnosed in vivo. Our patient seems to be the 11th published case, and the only 1 in which longstanding fluctuating impaired liver function tests have been observed. PMID- 2767081 TI - A rapid method for the determination of human CEA/mouse anti-CEA immune complexes in patients undergoing immunoscintigraphy. AB - We report here on a new and quick procedure to isolate human (hu) CEA mouse anti CEA immune complexes of sera from patients admitted for immunoscintigraphy with radiolabeled monoclonal anti CEA antibody. This method employs rabbit anti mouse IgG immune affinity chromatography together with a commercial CEA-IRMA kit for the specific isolation of immune complexes. By applying this procedure we were able to show that immune complex formation increased in parallel to CEA serum concentration. The formation of immune complexes did not significantly affect tumor detection by immunoscintigraphy. PMID- 2767083 TI - Muscular injury in a child diagnosed by 99mTc-MDP bone scan. AB - An 11-year-old boy had bone scanning to rule out an osseous lesion of the right arm. He presented progressive pain and hard swelling of the right arm. His past medical history and general physical examination were unremarkable. He trained for karate. The scan demonstrated considerable muscular uptake in both arms. CPK and CPK MB levels were both abnormally high, suggesting muscle injury. After a 10 day rest period the bone scan returned to normal. PMID- 2767084 TI - Lyme myocarditis diagnosed by indium-111-antimyosin antibody scintigraphy. AB - We report a new case of Lyme disease with cardiac manifestations, which has been possible to follow during the long period of 12 years. We have detected the usual ECG abnormalities, and concentric hypertrophic myocardiopathy, by echocardiography. The acute myocarditis was demonstrated by 111In-antimyosin scintigraphy, which showed global myocardial uptake of the tracer, constituting the first report, to our knowledge, of Lyme myocarditis diagnosed by this method. PMID- 2767085 TI - New linkage findings in affective disorders. AB - Identification of single-gene forms of manic-depressive illness, through linkage demonstrations in pedigrees, offers important opportunities for identification of pathophysiological mechanisms, and for genetic counseling in families with a valid marker of vulnerability. PMID- 2767086 TI - The Zurich Study. VII. Insomnia: symptoms, classification and prevalence. AB - This study describes sleep behaviour and insomnia in a representative cohort of a Swiss population. Interviews were carried out prospectively from age 20-21 to 27 28 years, starting with 292 males and 299 females. Females usually go to bed earlier and sleep 30 min longer than males. Taking into account length and periodicity of insomnia we can distinguish occasional insomnia (OI), repeated brief insomnia (RBI), and continued insomnia (CI), defined by operational criteria. The prevalence of sleep problems is stable from age 21-28, at 36%-40%. CI (prevalence 8%-10%) and RBI (13%-19%) are both medical problems in terms of treatment by professionals (10%-17%) or self-medication (7%-12%). The majority of insomniacs cope with sleep problems in various other ways. Frequency and patterns of symptoms of insomnia are described. PMID- 2767088 TI - Thioacetamide- and carbon tetrachloride-induced liver cirrhosis. AB - Two methods of inducing liver cirrhosis in the rat were studied. Intragastric administration of CCl4 for 16 weeks according to Proctor and Chatamra was compared to the administration of thioacetamide in the drinking water (0.3 g/l) for the same period. CCl4 administration induced micronodular cirrhosis in 6/8 animals with a 27% mortality. Thioacetamide induced cirrhosis in 6/8 animals without mortality. The histologic pictures differed somewhat in that the CCl4 group exhibited more necrosis and cellular swelling while the thioacetamide group had more nuclear atypias and proliferation. Biochemically both groups had elevated plasma levels of aspartate aminotransferase. The lysosomal enzyme beta hexosaminidase (beta-NAG) showed a transient increase in the thioacetamide animals, while beta-glucuronidase decreased. CCl4-induced cirrhosis led to an increase in beta-NAG. Plasma zinc decreased in both groups as well as liver zinc content in the CCl4 group, while there was a continuous elevation of liver zinc in the thioacetamide group. We conclude that oral administration of thioacetamide is a simple and reliable method of inducing experimental liver cirrhosis. The differences in histological appearances and some biochemical parameters may be caused by the different mechanisms of action of thioacetamide and CCl4. PMID- 2767087 TI - Coronary artery plaque rapidly induced by local electromagnetic stimulation in the baboon. AB - A reliable method has been developed to produce stenosis of the right coronary artery of baboons as a consequence of electrostimulation of the vessel at a chosen position. At that site a pair of electrodes were implanted and activated with a train of 9-volt pulses (length: 10 ms, separation: 100 ms) for 30 min, 5 days/week, up to 6 weeks. 13 animals were included in the experiment, 2 of those served as controls. Pathohistologically the structure of the artificially produced constrictions is similar to atherosclerotic lesions. On average the stenoses occupied 55% of the available lumen; total occlusion and no stenosis were observed in 1 case each. PMID- 2767089 TI - New intraoperative biliary manometric technique using a balloon catheter- selective evaluation of papillary function. AB - Papillary function in cholecystolithiasis patients was examined by intraoperative biliary manometry using a new balloon catheter. Pressure measurement was performed in each patient with the balloon deflated and inflated. When the balloon was inflated, the influence of the volume and compliance of the biliary tree was minimized to yield a precise evaluation of papillary function. From our analysis, resting pressure, residual pressure, onset time, and recovery time proved to be influenced by the volume and compliance of the biliary tree. Therefore, these four parameters could not reflect the papillary function exactly. On the other hand, perfusion pressure was not affected by the volume and compliance of the biliary tree. Perfusion pressure was thought to be generated by the resistance of the choledochal outlet and reflect the papillary function. In this study, our balloon catheter proved to be very useful in minimizing the influence of the volume and compliance of the biliary tree. And it is concluded that perfusion pressure is the best parameter to evaluate the resistance of the sphincter of Oddi or papillary function. PMID- 2767090 TI - Effects of partial deprivation of portal blood on arterial blood ketone body ratio in rabbits. AB - To examine the effects of portal blood deprivation on energy metabolism of the liver, we studied: (1) the ketone body ratio (acetoacetate/beta-hydroxybutyrate) in liver tissue, which is in equilibrium with the free NAD+/NADH ratio in liver mitochondria, in the ligated lobe (LL) and nonligated lobe (NLL), (2) the hepatic energy charge [EC = (ATP + 1/2 ADP)/(ATP + ADP + AMP)] in both LL and NLL, and (3) the arterial blood ketone body ratio (BKBR) after left portal vein branch ligation (PBL) in rabbits. As found in LL after PBL, portal blood deprivation decreased the tissue ketone body ratio. The EC in LL significantly decreased after PBL, but recovered 7 days after PBL since the LL became atrophic. The BKBR remained within the normal range, even when 60% of the total liver was deprived of portal blood. PMID- 2767091 TI - Ileal neobladder. Principles of function and continence. AB - Since April 1986, total bladder substitution, by the ileal neobladder in cases of radical cystoprostatectomy or bladder augmentation, proved to be a reliable alternative method of urinary diversion in 81 patients. The operative technique is standardized, comparably simple and safe to prevent upper urinary tract deterioration, reflux, as well as incontinence. The neurovascular bundle can be preserved, so potency might not be compromised. As preservation of the external urethral sphincter is possible, total day and night time continence is a result of residual sphincter function and abolishment of high pressure waves of the intestinal reservoir. Follow-up of the patients is between 1 and 28 months (mean 12.2 months). 64 patients had a follow-up of more than 3 months postoperatively and the evaluation included private micturition behavior and urodynamic investigation. Stress incontinence, which has to be corrected by an artificial sphincter, was found in 3 and night time incontinence needing some external device in 2 patients. There was no perioperative mortality. The special technique of creating the ileal neobladder by folding the ileal segment 4 times with complete detubularization, besides preserving urethral sphincter function, seems to be the most important reason why total continence during the day and night is achieved in more than 90% of the patients. PMID- 2767092 TI - Treatment of distal ureteral calculi with extracorporeal shock wave lithotripsy. Experience with 264 cases. AB - Ureteroendoscopy is used by most authors to approach distal ureteral calculi. With increasing experience extracorporeal shock wave lithotripsy (ESWL) of distal ureteral calculi has gained importance. The success rate of 96% in a large series of 264 consecutive patients treated in this manner, confirmed the results of other authors. Excluding women of child-bearing age and very large calculi (over 2 cm), ESWL is a suitable treatment modality for distal ureteral calculi. PMID- 2767093 TI - The use of distilled water as an irrigating fluid in patients undergoing transurethral resection of the prostate. AB - Thirty patients undergoing transurethral resection of the prostate using distilled water as an irrigating fluid were studied. There was no significant change in the serum concentration of the variables studied (preoperatively compared to postoperatively) as possible indicators of haemolysis or absorption of irrigating water such as sodium, potassium, albumin, total protein, creatinine, uric acid, urea, haemoglobin, haematocrit and haptoglobin. The mean value of plasma haemoglobin (P-Hb), observed immediately postoperatively and reflecting the magnitude of haemolysis, was delta 294.8 mg/l. There was a good correlation between P-Hb and the inflowing irrigating distilled water (r = 0.69). The P-Hb variation (delta) correlated with resection time and with the weight of the resected prostate (r = 0.54 and r = 0.52, respectively). A good correlation was also found between resection time and delta body weight which reflects the amount of water absorbed (r = 0.67) and between delta body weight and the inflowing irrigating water (r = 0.61). Our study shows that distilled water can be used as an irrigating fluid quite safely. The advantages of distilled water outweigh the disadvantages which can be avoided easily if proper attention is given. PMID- 2767094 TI - Management of patients with localized prostatic carcinoma. AB - Three groups of patients with localized prostatic carcinoma are presented. One group of 42 patients was treated with radiation therapy. The second group of 43 patients was subjected to radical prostatectomy. The third group consisted of 42 elderly men with focal, incidental carcinoma who received no therapy. The preliminary results of management and observation are presented. Comparison of the two forms of management shows that radical prostatectomy gives better results than radiation in terms of cure, survival and disease progression. The probability of recurrence or metastases is very high in T3 lesions, despite radical surgery. In the group with incidental untreated carcinoma, a high incidence of progression was seen. It is concluded that these patients are at a certain risk despite old age and focal disease. PMID- 2767095 TI - Management of the urethra in patients undergoing radical cystectomy for bladder carcinoma. AB - Urethral carcinoma recurrence after radical cystectomy for bladder carcinoma is a rare but devastating condition. Among 140 male patients submitted to radical cystectomy, urethral carcinoma recurrence occurred in 11. Nine of whom died. Nine other patients underwent urethrectomy at the time of cystectomy or shortly afterwards. Five are alive with no evidence of disease, 4 died of local recurrence or distant metastasis. Prophylactic urethrectomy should be performed in the presence of carcinoma in situ in the prostatic urethra or involvement of the prostatic urethra from the bladder tumor. These criteria should be considered as an absolute contraindication for substitution enteroplasty. PMID- 2767096 TI - Therapy and prognosis of carcinoma of the renal pelvis. AB - Forty-eight patients with carcinoma of the renal pelvis were treated between 1976 and 1986. 77% (n = 37) underwent nephrectomy; 4% (n = 2) open biopsy; 8% (n = 4) organ-preserving surgery, and 11% (n = 5) were treated conservatively. Major complications associated with the nephrectomies included: hemorrhage (11%); pulmonary embolism (5%); abscess (5%); ileus (5%), and pneumonia (5%). There was no postoperative mortality. Grade-III carcinoma, advanced tumor stage (T4N+M1), and generalized urothelial cancer worsened the prognosis. Such patients might benefit from adjuvant therapy. PMID- 2767097 TI - Impact of the category of early tumor recurrence on tumor progression in bladder tumors treated by transurethral resection. AB - Forty-six newly diagnosed patients with T1 and T2 bladder tumors were treated with transurethral resection. During a 6-months period more than 50% of the tumors recurred. Subsequent progression of tumors was seen within 24 months in 35 and 28% of the patients with T1 and T2 tumors, respectively. Prognosis with regard to progression was significantly better in patients with Ta recurrence at first control than in patients with invasive recurrent tumors, irrespective of category of tumor at a later recurrence. It is concluded that the continued transurethral treatment of patients with early recurrent invasive tumors may have to be reconsidered. PMID- 2767098 TI - Orchiopexy for intravaginal testicular torsion. Ring-shaped fixation of the lower part of the testis. AB - As a surgical therapy for intravaginal testicular torsion, we developed a testicular fixation method considering the testis in intravaginal testicular torsion in comparison with the normal one. With our method, the lower part of the testis is fixed in a ring form around the testicular long axis to show the wide extravaginal area similar to that of a normal testis. We believe that this method is simple, logical and effective to fix the testis in intravaginal testicular torsion. PMID- 2767099 TI - Method for securing a single-lumen urethral catheter in the female. AB - When a single-lumen urethral catheter (catheter coude) is applied for bladder catheterization in the female, secure fixation of such a catheter may present a problem. A simple method for fixation of a single-lumen urethral catheter in the female is described. PMID- 2767100 TI - Urinary retention due to catheter occlusion by worms. AB - Herein we report a very rare case involving acute occlusion of a Foley catheter by worms. The treatment consisted of removal of the occluded catheter followed by bladder washing with a Betadine solution mixed with normal saline and introduction of a new catheter. PMID- 2767101 TI - Secondary carcinoma of the penis. A report of three new cases. AB - Metastatic tumors of the penis are rare. They are usually secondary to primaries of the genitourinary and gastrointestinal tracts. Surgical therapy of lesions involving the corpora cavernosa can result in prolonged survival. However, rarely does the metastasis represent a true solitary event. We report 3 new cases with primary tumors in the bladder. PMID- 2767102 TI - Undiversion with ileocecal segment following high transureteroureterostomy. AB - A boy presenting with a small bladder and refluxing blind-ending ureteral stumps following multiple attempts at ureteral reimplantation and supravesical diversion with a high left-to-right transureteroureterostomy and right cutaneous ureterostomy underwent successful undiversion. Surgery consisted of bilateral ureterectomy and ileocecocystoplasty, with intussusception of the ileocecal valve and anastomosis of the ileal tail to the right renal pelvis. PMID- 2767103 TI - Monitoring of patients with nonseminomatous testicular cancer by nuclear magnetic resonance spectroscopy of plasma. PMID- 2767105 TI - Cell kinetics as a prognostic indicator in node-negative breast cancer. AB - The consistency of the prognostic role of cell kinetics (evaluated as the [3H]thymidine labeling index, LI) over a period of years has been assessed in 354 patients with resectable node-negative breast cancer subjected only to Halsted or modified radical mastectomy. The risk of disease recurrence and death was proportional to LI values and the pattern was superimposable, regardless of menopausal status, in the two consecutive case series entered in this retrospective study. In particular, tumors with high LI (greater than 2.8%) had a higher 6-year probability (41% vs. 25%, P less than 0.0001) of manifesting local regional and distant metastases and of dying (19% vs. 5%, P = 0.0005) as compared to tumors with low LI. In tumors with high LI the risk of relapse within the first 2 years from mastectomy was twofold compared to that of tumors with low LI. Multiple regression analysis showed that LI also retained its prognostic significance in both relapse-free and overall survival when tumor size and estrogen receptor status were considered. The present findings confirm that LI can substantially contribute to the selection of high risk node-negative patients who could be candidates for adjuvant chemotherapy. PMID- 2767104 TI - Neopterin and alpha-interferon in patients affected by Kaposi's sarcoma from Africa. AB - The presence of circulating alpha-interferon and neopterin was investigated in sera of 47 patients affected by African Kaposi's sarcoma, both HIV-seropositive (13 patients) and HIV-seronegative (34 patients). For comparison, analyses were also performed in 20 HIV-seropositive symptomatic African subjects as well as in 20 African and 20 Italian healthy individuals. Alpha-interferon and neopterin levels appeared significantly higher in comparison with healthy control groups (P less than 0.001) but not with HIV-seropositve African individuals without Kaposi's sarcoma. Moreover, alpha-interferon and neopterin levels were significantly higher in progressive Kaposi's sarcoma (27 patients) than in regressive Kaposi's sarcoma (20 patients) (P less than 0.001). A significant correlation between alpha-interferon and neopterin was observed (r = 0.57; P less than 0.01). Furthermore, alpha-interferon levels of HIV-seropositive Kaposi's sarcoma patients resulted significantly higher in comparison with the seronegative ones (P less than 0.05). It is concluded that alpha-interferon and neopterin may be reliable prognostic markers in Kaposi's sarcoma patients. PMID- 2767106 TI - The cytocidal effect of high energy shock waves on human prostatic tumour cell lines. AB - This report describes the effect of high energy shock waves (HESW) generated by a Siemens Lithostar on four human prostatic carcinoma cell lines in vitro. The effects of temperature, shock wave energy, cell density and the number of HESW were investigated. Pressure measurements were carried out in the focus of the lithotriptor and inside test tubes that were placed in the focus. Direct cell kill was inversely related to temperature, whereas a linear relationship was found with shock wave energy. Cell kill appeared to be independent of cell density. All four cell lines were sensitive to the treatment with HESW, but displayed a different dose-response pattern. In vitro treatment of PC-3 cells retarded their growth upon injection into nude mice. It is concluded that human prostatic tumour cells are killed by HESW. Therefore, HESW could be of potential value in tumour treatment. PMID- 2767107 TI - Acral erythema and systemic toxicity related to CHA induction therapy in acute myeloid leukemia. AB - Seventy-two adult patients with previously untreated acute myeloid leukemia received the CHA regimen as induction chemotherapy: CCNU 80 mg/m2 on day 1, Adriamycin 35 mg/m2 i.v. on days 1, 2 and 3, and continuous infusion of cytarabine 100 mg/m2/24 h from day 1 to 10. Forty-nine patients (68%) presented at least one of the following symptoms: acral erythema with dysesthesias in the palms and/or soles (39%); cholestatic hepatitis (39%); profuse sterile diarrhea associated with abdominal distention (33%); acute cerebellar dysfunction (32%) and non-cardiogenic pulmonary edema (21%). Most of these toxic symptoms appeared 8-20 days after the first dose. As these clinical features were absent or exceptional in patients treated with another regimen within a controlled trial, they are reported as toxic-side-effects of the chemotherapy regimen. Acral erythema was found to be predictive of complete remission (P less than 0.01, odds ratio: 6.33); neurotoxicity was prognostic for death in aplasia (P less than 0.05); the absence of any of the five symptoms was associated with failure of the induction regimen (P less than 0.02). PMID- 2767108 TI - CA 125 in the diagnosis of pelvic masses. AB - CA 125 was measured preoperatively in 184 female patients presenting with pelvic masses. Ovarian tumors were diagnosed in 151 cases (91 carcinomas, eight borderline, 52 benign) and non-ovarian tumors in 33 (19 malignant, 14 benign). The sensitivity of CA 125 in identifying the malignant and borderline ovarian tumors was 86%, the specificity 78%; and the positive and negative predictive values 82% and 83%, respectively. Increased antigen values (greater than 35 U/ml) were observed in 63% of the non-ovarian malignant tumors. Considering only the diagnosis of malignancy in pelvic masses (ovarian plus non-ovarian malignant tumors) the specificity improved to 89% and the positive predictive value to 93%; the sensitivity and the negative predictive value decreased to 82% and 74%, respectively. CA 125 in the normal range (less than or equal to 35 U/ml) was observed both in ovarian and non-ovarian carcinomas. Therefore, preoperative CA 125 values in the normal range should be interpreted with caution. However, increased preoperative CA 125 levels in patients with pelvic masses are highly suggestive of a malignant tumor and CA 125 should be an adjunct to the preoperative diagnostic armamentarium. PMID- 2767110 TI - Regression analyses of prognostic factors in metastatic malignant melanoma. AB - Patients entered into phase II trials in metastatic malignant melanoma should be carefully selected in order to ensure that they live long enough to permit a meaningful evaluation of the efficacy of a given drug. In this selection emphasis has been put on performance status. However, also for patients with a good performance status, survival is often short. The purpose of this study has been to identify supplementary prognostic factors as these could be of help in the design of phase II trials. From 1978-1986, 177 consecutive patients were given various chemotherapy regimens for metastatic malignant melanoma in the Norwegian Radium Hospital. About 92% had a performance status of ECOG 0-2. Median survival was 4.0 months (0-30 months). Multivariate survival analysis selected lactate dehydrogenase (LDH) greater than 450 U/l, presence of brain metastases, leukocyte count greater than 10 x 10(9)/l, and erythrocyte sedimentation rate (ESR) greater than 15 mm/h as significant prognostic factors indicating short survival with low probability of surviving 3 months. Patients with normal values of LDH, leukocyte count, and ESR had a median survival of 11.5 months with 94% surviving 3 months. We conclude that this information could have an impact on the design of phase II trials. PMID- 2767109 TI - Primary extranodal and nodal non-Hodgkin's lymphoma. A survey of a population based registry. AB - In a population-based registry, there were 580 patients with non-Hodgkin's lymphoma (NHL); 236 had primary extranodal lymphoma (41%). The initial localization of the primary extranodal lymphomas varied markedly, although 36% were primary gastrointestinal lymphomas. Histological classification was performed by a regional panel of pathologists according to the Kiel Classification and the International Working Formulation. Twelve per cent of the patients with nodal NHL had a localized disease in contrast to 40% with primary extranodal NHL. Low grade lymphomas were encountered in 30 and 10% of the patients with primary nodal and extranodal NHL, respectively. Recurrence-free survival rate for patients with localized low-grade malignancy and disseminated intermediate grade NHL is significantly better for extranodal lymphoma than for nodal NHL. Patients with disseminated high-grade extranodal NHL had the worst prognosis of all. We conclude that primary nodal and primary extranodal lymphomas should be considered as distinctive and separate entities. PMID- 2767111 TI - Quality control of validity of data collected in clinical trials. EORTC Study Group on Data Management (SGDM). AB - In a study initiated by the EORTC Study Group on Data Management, 15 site visits to main participating centers in ongoing cancer clinical trials have been carried out over a 1 year period. The aim was to evaluate the quality level of EORTC clinical trial data, to find out the order of magnitude of possible problems encountered and to test a technique to objectively assess the quality of data. The process of data collection and the quality of data transfer from hospital charts to EORTC case report forms (CRF) were checked. The data quality was scored and the causes of incorrectness were evaluated. Percentages of correct data ranged from 78% up to 98%; 11/15 centers had greater than 90% correct data. The median rate of error encountered in key data was 2.8% (range 0.5-7%). The main source of error was incorrect transfer of the information recorded in the patient chart to the CRF. Equally good overall results have been observed in the centers where data managers fill in the forms (DM) and those centers without an administrative trial structure (PH). The mean percentage of correct data for both types of centers is 91.4%. The wider range in percentage for incorrect data (DM mean value 3.0%, range 0.5-7%; PH mean value 2.3%, range 1.4-3.1) suggests the important impact of the knowledge and experience of the people involved in data management. The data quality evaluation was hampered by the impossibility of checking part of the data present on the CRF, 0.4-14.5%. Besides knowledge and experience, the main aspects influencing good data quality appeared to be the efficacy of the internal organization and good local data monitoring. The importance of the design of CRFs was also highlighted. As this study was run for on-going protocols, the site visiting team had the opportunity to point out and report to the trial coordinator all shortcomings and controversial points that could thus be corrected during the course of the trial. PMID- 2767112 TI - Mitozolomide in advanced renal cancer. A phase II study in previously untreated patients from the EORTC Genito-Urinary Tract Cancer Cooperative Group. PMID- 2767113 TI - Phase II trial of methylene dimethane sulphonate (MDMS) in advanced soft tissue sarcomas of the adult. A study of the EORTC Soft Tissue and Bone Sarcoma Group. PMID- 2767114 TI - Standardized objective criteria of response--comments on 'Important Prognostic Value of Standardized Objective Criteria of Response in Stage D2 Prostatic Carcinoma' by Labrie F. et al. PMID- 2767115 TI - Cerebral ischemia in gerbils: improvement of survival after postischemic treatment with oligo-prostaglandin B. AB - Gerbils were subjected to bilateral carotid artery occlusion for either 15 or 20 min. After ischemia the animals were injected i.p. with oligo-prostaglandin B (oligo-PGB; trimer of 16,16'-dimethyl-15-dehydro-prostaglandin B1) dissolved in 4% sodium-bicarbonate, or with the vehicle. The dosing regimen of oligo-PGB was 0.5, 1, 2, 5, 10 mg/kg injected 5 min postischemia, or 1 mg/kg injected 30, 60, 90, 120 min after ischemia, or 10 mg/kg injected 5 min and 24 h postischemia. Behaviour of the animals and their mortality were studied for 14 days after ischemia. Administration of the drug did not affect recovery of the electrical activity in the brain and did not reduce the number of postischemic seizures. Following 15 min ischemia, administration of oligo-PGB resulted in statistically valid improvement of survival (P less than 0.04 or better) in all treatment groups. After 20 min ischemia only the double injection (10 mg/kg at 5 min and 24 h postischemia) resulted in a substantial survival improvement (64%, P less than 0.005). The mechanism of the drug action is unknown but, based on the available data, the authors believe it to be related to the modification of arachidonic acid metabolism in the late postischemic period. PMID- 2767116 TI - Acute haemodynamic effects of ibopamine and dopamine on isovolumic relaxation. AB - The effects of intraduodenal ibopamine (a new orally active inotropic agent claimed to have haemodynamic effects similar to dopamine) on isovolumic relaxation were monitored for 90 min in eight closed-chest anaesthetized dogs. Dopamine and epinine (ibopamine active metabolite) were also infused at graded doses. After 15 min, ibopamine (12 mg/kg) shortened the time constant of isovolumic relaxation, and increased stroke volume and mean aortic pressure. Peak positive dP/dt increased significantly only 10 min later. Heart rate did not change. Dopamine (10 micrograms/kg per min) similarly reduced the time constant, and increased stroke volume, mean aortic pressure, peak positive dP/dt and heart rate. Epinine (10 micrograms/kg per min) caused similar changes in peak positive dP/dt, stroke volume, mean aortic pressure, and accelerated time constant without raising the heart rate. Ibopamine and epinine therefore significantly improved the isovolumic relaxation phase, like dopamine, without however affecting the heart rate. PMID- 2767117 TI - Anxiogenic-like effects of mCPP and TFMPP in animal models are opposed by 5-HT1C receptor antagonists. AB - 1-(3-chlorophenyl)piperazine (mCPP) and 1-[3-(trifluoromethyl)phenyl]piperazine (TFMPP) (0.1-1.0 mg/kg) reduce total interaction time in a rat social interaction test under low light familiar conditions and its following components; grooming, following, crawling over, fighting, sniffing. Locomotion was only reduced by the highest dose of mCPP. mCPP also reduced activity in the light but not total locomotion in a light/dark transition test. These results suggest that mCPP (and TFMPP) are anxiogenic but not sedative in these tests. The effect of mCPP on social interaction was blocked by three antagonists which share a high affinity for 5-HT1C and 5-HT2 receptors: mianserin, cyproheptadine and metergoline but not by the 5-HT2 antagonists ketanserin or ritanserin or the 5-HT1A and 5-HT1B antagonists cyanopindolol and (-)-propranolol. It was prevented by a low (0.05 mg/kg) but not by a high (1.0 mg/kg) dose of ICS 205,930 a specific 5-HT3 antagonist reported to be anxiolytic at low doses. It was also prevented by chronic pretreatment with the anxiolytic drug chlordiazepoxide. These results argue for an anxiogenic action of mCPP mediated by 5-HT1C receptors. Since the chronic chlordiazepoxide pretreatment did not prevent the hypolocomotion or hypophagia induced by mCPP at high dosage (5 mg/kg) these latter effects are unlikely to be secondary to anxiety. PMID- 2767118 TI - The differential effects of prazosin and hydralazine on sympathoadrenal activity in conscious rats. AB - The ability of the vasodilator hydralazine and the alpha 1-adrenoceptor antagonist prazosin to increase sympathoadrenal outflow was compared by measuring plasma norepinephrine and epinephrine concentrations, norepinephrine clearance and norepinephrine spillover rate into plasma in conscious Sprague-Dawley rats and spontaneously hypertensive rats (SHR). Even though the vasodepressor effect of 1 mg/kg (i.p.) of prazosin (-23 mm Hg) was significantly less than that caused by 1 mg/kg (i.p.) of hydralazine (-31 mm Hg) in normotensive rats, the increases in plasma norepinephrine concentration and norepinephrine spillover rate were significantly larger in prazosin-treated rats. In conscious SHR, 0.5 mg/kg (i.p.) of prazosin and 0.3 mg/kg (i.p.) of hydralazine lowered blood pressure to the same extent (-22 mm Hg), but prazosin again produced significantly larger increases in plasma norepinephrine concentration and norepinephrine spillover rate. Neither prazosin nor hydralazine affected norepinephrine clearance, and only prazosin elicited a significant rise in plasma epinephrine concentration. This differential effect of prazosin and hydralazine on sympathoadrenal activity is best explained by the differing effects of these drugs on venous return and thus the afferent activity of the cardiopulmonary baroreceptors. PMID- 2767120 TI - Pharmacological characterization of the algesic response to the subplantar injection of serotonin in the rat. AB - Subplantar injection of 0.10 micrograms of serotonin in the rat resulted in a brief period (0-20 min) of increased pain sensitivity to an applied force (hyperalgesia) which preceded a longer period (40-120 min) of decreased pain sensitivity (hypoalgesia). The magnitude of each of these changes and the duration of the hypoalgesia were dose-dependent. The development of hyperalgesia was selectively and dose dependently reduced by inhibitors of arachidonate cyclooxygenase. The hypoalgesia was selectively and dose dependently reduced by the serotonin antagonist methysergide. Selective inhibition of the hyperalgesia by aspirin and of the hypoalgesia by methysergide revealed that components of both hyperalgesia and hypoalgesia were present in the 10-120 min interval. These findings, the level of serotonin reported to be released in rat dermal tissue, and selective drug inhibition studies suggest that some irritant-induced changes in algesia measured in the rat hindlimb result from release of dermal stores of serotonin. Selective inhibition of the hypoalgesic component of the hindlimb irritant trypsin by the antiserotonin agent methysergide supports this hypothesis. The principal conclusion derived from these studies is that the algesic response to the subplantar injection of a single agent can be the resultant of independent, temporally overlapping hyperalgesic and hypoalgesic components each of different intensity and pharmacological sensitivity. PMID- 2767119 TI - Rate-dependent electrophysiological effects of OPC-8212: comparison to sotalol. AB - The rate-dependent effects of OPC-8212 (6 microM), a new positive inotropic drug which lengthens cardiac action potential duration were studied in dog cardiac Purkinje fibers and compared to the effects of sotalol (30 microM), a class III antiarrhythmic using conventional microelectrode technique. Both OPC-8212 and sotalol lengthened action potential duration in a frequency-dependent manner. Both had a greater effect at slower pacing frequencies than at fast. The maximum rising velocity of the action potential upstroke was not affected by either compound at any of the pacing cycle lengths applied (300-2000 ms). The effects of OPC-8212 and sotalol on action potential duration and maximum rising velocity were also compared following abrupt changes in pacing cycle length (i.e. coupling intervals ranging between approximately 250-3000 ms). The effects of both OPC 8212 and sotalol following abrupt changes in pacing cycle length were similar to one another. Neither OPC-8212 nor sotalol altered the time constants for restitution of action potential duration or the kinetics for recovery of the maximum rising velocity of the action potential upstroke. These results indicate that the rate-dependent electrophysiological effects of OPC-8212 closely mimic those of sotalol and suggest that OPC-8212 may be an effective class III antiarrhythmic in addition to being a positive inotropic compound. PMID- 2767121 TI - Low calcium and calcium antagonists potentiate the contraction of guinea-pig vas deferens induced by ATP: a permissive role for P2-purinoceptors. AB - ATP, noradrenaline and KCl induced contractions of the isolated guinea-pig vas deferens. The ATP-induced contraction was potentiated by decreasing the external calcium concentration and was reduced by increasing the external calcium concentration. The maximum potentiation was obtained at a low calcium concentration (0.8 mM), the dose-response curve for ATP was shifted to the left in a parallel fashion at this concentration. Calcium antagonists, such as verapamil and diltiazem and MnCl2, induced a similar potentiation. On the other hand, the noradrenaline- and KCl-induced contractions were reduced by calcium antagonists and by decreasing the external calcium concentration. The ATP- and KCl-induced contractions were slightly potentiated by the removal of Mg ions from the medium, but the contractile response to ATP was not potentiated by pretreatment with difluorodinitrobenzene, an ecto-ATPase inhibitor. These results suggest that the affinity of P2-purinoceptors for ATP may be regulated by calcium sites to which calcium and calcium antagonists can bind. PMID- 2767122 TI - Differential inhibitory effects of a 5-HT3 antagonist on drug-induced stimulation of dopamine release. AB - The effects of a potent and specific antagonist of 5-HT3 receptors, ICS 205-930, on the dopamine (DA)-releasing properties of morphine (1.0 mg/kg s.c.), nicotine (0.6 mg/kg s.c.), ethanol (1.0 g/kg i.p.) and amphetamine (0.25 and 1.0 mg/kg s.c.) were studied in rats. DA release was estimated by trans-cerebral dialysis in the nucleus accumbens of freely moving rats. ICS 205-930 (15-30 micrograms/kg s.c.) failed to modify the basal output of DA and its metabolites, however, ICS 205-930 dose dependently reduced the stimulation of DA release by morphine, nicotine and ethanol. Thus, at doses of 30 micrograms/kg s.c., ICS 205-930 completely prevented the morphine-, nicotine- and ethanol-induced stimulation of DA release in the nucleus accumbens; doses of 15 micrograms/kg s.c. partially prevented the morphine-, nicotine- and ethanol-induced stimulation of DA release while doses of 7.5 micrograms/kg s.c. were ineffective. In contrast, ICS 205-930 (up to 30 micrograms/kg s.c.) failed to affect the amphetamine-induced stimulation of DA release in the nucleus accumbens. The inhibitory effects of ICS 205-930 (15 and 30 micrograms/kg s.c.) on the drug-induced stimulation of DA release could also be extended to the neuroleptic haloperidol (0.1 mg/kg s.c.). The results indicate that blockade of 5-HT3 receptors selectively prevents the stimulation of DA release induced by drugs known to stimulate the firing activity of DA neurons. PMID- 2767123 TI - Effects of dantrolene sodium in rodent models of cardiac arrhythmia. AB - Dantrolene sodium has been compared with reference antiarrhythmic agents in rodent models of cardiac arrhythmia. In a coronary-artery-ligation model in rats, dantrolene sodium (3, 10 and 20 mg/kg i.v.) significantly decreased extrasystoles, episodes of ventricular tachyarrhythmia, and frequency, duration, and total episodes of ventricular fibrillation in a dose-dependent manner. In an electrically induced fibrillation model in rats, dantrolene sodium (10 and 20 mg/kg i.v.) significantly raised ventricular fibrillation threshold in a dose- and time-dependent manner. In contrast to its activity in these models, dantrolene sodium was not active in two chemically induced models involving automaticity. Aconitine-induced arrhythmias in rats and mice and ouabain-induced arrhythmias in guinea pigs were not suppressed by i.v. (10 or 20 mg/kg) or i.p. (100-3000 mg/kg) doses of the drug. These results show that the antiarrhythmic potential of dantrolene sodium, predicted by in vitro Class III and Class IV electrophysiological effects, is expressed in whole animal models. PMID- 2767124 TI - Correlation between fall in blood pressure and in vivo amine release after alpha methylDOPA. AB - Blood pressure (BP), hypothalamic tissue concentrations and the in vivo overflow of endogenous and alpha-methylated catecholamines were measured in urethane anaesthetised rats after alpha-methylDOPA (mDOPA) administration (200 mg/kg i.p.). Four hours after mDOPA, BP fell to its lowest value, 60% of control, and slowly returned towards control levels by 24 h. This was closely correlated with the evoked overflow of alpha-methylnoradrenaline (mNA, r = 0.9) and noradrenaline (NA, r = 0.7) but not dopamine (DA) or alpha-methyldopamine (mDA). However, the tissue content of mNA rose much more gradually and was not maximal until after 12 h while mDA content followed the development of the hypotension. The results provide direct evidence for a false transmitter role for mNA in the brain, and suggest that the release of newly synthesised mNA is responsible for the hypotensive effect of mDOPA. Differences in the time course of overflow and storage of NA and mNA suggest the presence of separate transmitter storage and releasable pools. PMID- 2767125 TI - The protective action of R56865 against ouabain-induced intoxication in rat heart isolated atria and ventricles. AB - The action of R56865 has been examined on the contractile effects produced by ouabain concentrations interacting with high (3 microM) and low (300 microM) affinity digitalis receptors on electrically stimulated ventricular strips isolated from rat. R56865 1 microM reduced the increase in resting tension produced by ouabain 300 microM and left unalterated the inotropic effect evoked by ouabain 3 and 300 microM that was reduced by higher concentrations (3 and 6 microM) of R56865. The action of R56865 was also studied on ouabain-induced intoxication in electrically stimulated and spontaneously beating atria of rat. On electrically stimulated (3 Hz) whole atria, R56865 0.3 microM reduced the maximal increase in resting tension produced by ouabain 300 microM and delayed the time to onset of the ouabain-induced arrhythmias but did not affect ouabain's inotropic effect. Higher concentrations of R56865 were required to reduce the inotropic effect of ouabain. The protective action of R56865 against ouabain induced intoxication was most pronounced on spontaneously beating atria where it reduced spontaneous rate of beats. Experiments in electrically driven left atria indicated that only a part of the protective effect of R56865 could be related to its bradycardic action. The effect of R56865 was also examined on ouabain-induced inhibition of sodium pump in human red blood cells. R56865 6 microM did not modify the inhibition produced by ouabain (from 0.3 to 10 nM), this indicates that the protective action of R56865 against ouabain-induced intoxication is not due to an interaction with the inhibitory effect of ouabain on sodium pump. PMID- 2767126 TI - Evidence that apomorphine induces penile erection and yawning by releasing oxytocin in the central nervous system. AB - Oxytocin (10 and 30 ng) injected into a lateral ventricle (i.c.v.) or the dopamine agonist apomorphine (40 and 80 micrograms/kg) injected subcutaneously induced repeated episodes of penile erection and yawning in male rats. The concomitant administration of the two substances did not produce any further increase in the number of penile erection and yawning episodes. Penile erection and yawning induced by either oxytocin or apomorphine were antagonized in a dose dependent manner by i.c.v. pretreatment with the oxytocin antagonists [d(CH2)5Tyr(Me)-Orn8]vasotocin, [Pen1,Phe(Me)2,Thr4,Orn8]oxytocin and [d(CH2)5Tyr(Me)-Arg8]vasopressin, with a rank order of potency that follows their antioxytocic activity. (i.e. [d(CH2)5Tyr(Me)-Orn8]vasotocin congruent to [Pen1,Phe(Me)2,Thr4,Orn8]-oxytocin greater than [d(CH2)5Tyr(Me) Arg8]vasopressin). The results suggest that apomorphine induces penile erection and yawning by releasing oxytocin in the central nervous system. PMID- 2767127 TI - Inhibition of antigen-induced contraction of guinea pig trachea by ICI 198,615. AB - We examined the extent of peptide leukotrienes involvement in ovalbumin-induced contraction of guinea pig trachea isolated from animals passively sensitized with antiovalbumin antibodies. Antigen challenge resulted in a concentration-dependent (EC50 = 10 +/- 3 ng/ml, X +/- S.E.M., n = 6) and prolonged (greater than 60 min) contraction of guinea pig trachea. The maximal contractile response was directly proportional to the quantity of sensitizing antibodies. The maximal response (but not EC50 for ovalbumin) was significantly (P less than 0.01) enhanced by indomethacin (20%), only slightly (10%) inhibited by the histamine H1-antagonist pyrilamine and unaffected by the platelet-activating factor (PAF) antagonist CV 3988. The potent and selective leukotriene antagonist ICI 198,615 partially (45%) inhibited the antigen-induced contraction in a concentration-related fashion (1 300 nM). Even at concentrations that abolish responses to leukotrienes, ICI 198,615 did not further inhibit the response, nor could other leukotriene antagonists (i.e. LY 171883 or FPL 55712) inhibit more than 50% of this response. In contrast, the 5-lipoxygenase inhibitors AA-861 and REV 5901, also a leukotriene antagonist, abolished the contractile response. Taken together, the results suggest that in guinea pig trachea, leukotrienes, in combination with other lipoxygenase metabolites, mediate a major part of the response to antigen. In contrast, PAF, histamine and prostaglandins appear to play only a minor role. PMID- 2767128 TI - Catecholaminergic and opioidergic mechanisms involved in the hypotensive response of pindolol. AB - The present study evaluated the involvement of opioidergic and catecholaminergic mechanisms in the hypotensive action of pindolol. Pindolol (1 mg/kg i.a.) was administered to unanesthetized spontaneously hypertensive rats (SHR) and Wistar Kyoto (WKY) rats instrumented for direct arterial pressure monitoring. Peripheral administration of pindolol produced a significant decrease in blood pressure in both SHR and WKY rats with SHR animals having a greater response. Heart rate was reduced in SHR; however, a tachycardia was observed in WKY rats. Pretreatment with naloxone (100 micrograms/kg i.a.) 10 min prior to pindolol administration prevented the hypotensive response. Similar pretreatment with yohimbine, an alpha 2-receptor antagonist, also prevented the pindolol-induced hypotensive response in both SHR and WKY rats. Neither naloxone nor yohimbine alone significantly affected blood pressure or heart rate. These results suggest that opioidergic and catecholaminergic mechanisms are involved in the hypotensive action of pindolol. PMID- 2767129 TI - 3-(Methoxycarbonyl)-amino-beta-carboline reduces both the sedative and anticonvulsant effects of diazepam. AB - The intrinsic effects of the benzodiazepine receptor ligand beta-CMC (3 (methoxycarbonyl)-amino-beta-carboline) and its interaction with the anticonvulsant and sedative effects of diazepam were assessed. beta-CMC (100 mg/kg i.p.) significantly elevated seizure threshold to bicuculline. beta-CMC (10 mg/kg) failed to alter the anticonvulsant action of diazepam (5 mg/kg i.p.), but significantly attenuated diazepam's sedative effect. A higher dose of beta-CMC (40 mg/kg) did attenuate diazepam's anticonvulsant action. The data suggest that beta-CMC is a partial agonist at benzodiazepine receptors. PMID- 2767130 TI - Termination of ouabain-induced ventricular tachycardia by flunarizine in conscious dogs. AB - The ability of flunarizine to terminate ouabain-induced ventricular tachycardia was investigated in conscious dogs. These arrhythmias result from triggered activity based on delayed afterdepolarizations. Sustained ventricular tachycardia was induced by ouabain (48 +/- 6 micrograms/kg) and pacing in 13 animals with surgically induced complete atrioventricular block. Flunarizine was administered i.v. when the arrhythmia had persisted for at least 20 min. Flunarizine induced an increase of the R-R interval from 300 +/- 30 to 410 +/- 50 ms (P less than or equal to 0.001) in all dogs. Flunarizine (2 mg/kg) terminated ventricular tachycardia with long R-R intervals (330 +/- 20 ms) in seven dogs. An additional dose of flunarizine (1 mg/kg) resulted in termination of the faster tachycardias (280 +/- 15 ms). The arrhythmias were not induced again by pacing for 27 +/- 18 min. Reinitiated tachycardias could be suppressed again by flunarizine. In conclusion, flunarizine (1) slows and terminates arrhythmias resulting from delayed afterdepolarizations, and (2) prevents their reinitiation. PMID- 2767131 TI - Effect of flunarizine on the attenuation of baroreflex by transient cerebral ischemia. AB - Baroreflex sensitivity assessed by phenylephrine-induced reflex bradycardia was markedly decreased by 5- an 10-min global cerebral ischemia in anesthetized dogs. Flunarizine, 0.1 and 1 mg/kg i.v., administered 5 min prior to 5-min ischemia, completely inhibited the decrease in baroreflex sensitivity while such a protective effect of the latter dose was incomplete against 10-min ischemia. In contrast, papaverine, 0.5 mg/kg per min i.v., infused for 5 min prior to 5-min ischemia, failed to protect the decrease in baroreflex sensitivity. Flunarizine may possess a certain direct cerebroprotective effect in addition to its cerebrocirculatory effect. PMID- 2767132 TI - Blocking effect of diltiazem in the isolated rat phrenic hemidiaphragm. AB - The effects of diltiazem on indirectly and directly elicited twitch were studied in the isolated rat phrenic hemidiaphragm preparation. Diltiazem (30-500 microM) blocked the indirectly elicited twitch response and this effect was not affected by reducing the extracellular calcium from 2.5 to 1.25 mM. An effect on the directly elicited twitch was also observed (100-300 microM). Diltiazem (30-300 microM) blocked the peak tetanic tension and tetanic fade was present. The results were consistent with an action of diltiazem on the nicotinic receptor-ion channel complex. PMID- 2767133 TI - Effect of flunarizine on ischemic myocardial metabolism in dogs. AB - The effect of flunarizine, a calcium entry-blocker, on the ischemic myocardial metabolism of the open-chest dog heart was examined and compared to that of diltiazem. During ischemia, initiated by ligating the left anterior descending coronary artery, the metabolism of the myocardium switched from aerobic to anaerobic; the levels of glycogen, fructose-1,6-diphosphate (FDP), adenosinetriphosphate and creatinephosphate decreased, and the levels of glucose 6-phosphate (G6P), fructose-6-phosphate (F6P), lactate, adenosine diphosphate and adenosine monophosphate increased during 3 min of ischemia. The calculated energy charge potential decreased, and the [( G6P] + [F6P]/[FDP] ratio and the lactate/pyruvate ratio were increased by ischemia. Flunarizine (0.3 or 1 mg/kg) or diltiazem (0.1 mg/kg) was injected i.v. 5 min before the start of ischemia. Pretreatment with either flunarizine or diltiazem reduced the decrease in the energy charge potential and the increase in the [( G6P] + [F6P]/[FDP] ratio during ischemia. Flunarizine (1 mg/kg) and diltiazem (0.1 mg/kg) reduced the accumulation of lactate due to ischemia, leading to a decrease in the lactate/pyruvate ratio. Flunarizine and diltiazem may lessen the influence of ischemia on the myocardial tissue. PMID- 2767134 TI - Cardiac and hemodynamic profile of the new cardiotonic agent, DPI 201-106, in the conscious dog. AB - The cardiac and hemodynamic effects of increasing doses (0.1-3 mg/kg i.v.) of the novel cardiotonic agent, DPI 201-106 (DPI), were investigated over a 60 min period in conscious dogs chronically instrumented for the measurement of arterial pressure, heart rate, left ventricular pressure (LVP), LV (+) dP/dtmax and cardiac output. LV (+) dP/dtmax, cardiac output and stroke volume were significantly increased by DPI whereas the total peripheral resistance was significantly decreased. These effects were dose-dependent in intensity and in duration. The mean arterial pressure and heart rate remained unaffected, except by the 3 mg/kg dose, which increased them slightly. Autonomic blockade with hexamethonium, atropine and propranolol did not alter the positive inotropic properties of DPI but unmasked its intrinsic bradycardic effect. At equipotent positive inotropic doses, DPI (0.3 mg/kg), milrinone (40 micrograms/kg) and dobutamine (5 micrograms/kg per min) induced similar increases in cardiac output and similar decreases in total peripheral resistance, but only dobutamine and milrinone accelerated the heart rate, whereas ouabain (17.5 micrograms/kg) induced a strong rise in the total peripheral resistance and markedly lowered the heart rate and cardiac output. After coadministration of DPI and ouabain, LV (+) dP/dtmax was further increased whereas the ouabain-induced bradycardia, the rise in the total peripheral resistance and the decrease in cardiac output were reinforced, halved and unaltered, respectively. We conclude that (a) DPI exhibits potent and direct positive inotropic properties, associated with a peripheral vasodilating action, and almost no positive chronotropic effects, and (b) coadministration of DPI and ouabain results in synergistic positive inotropic effects. PMID- 2767135 TI - Inhibitory effect of lithium on muscle contractions caused by various stimulants in guinea-pig ileum. AB - The tonic contractions induced in the guinea-pig ileal longitudinal muscle by 60 mM KCl, carbachol, histamine or A23187 were inhibited similarly by Li+ substituted solution. There was a good correlation between the Li+-induced inhibition of contractions induced by these stimulants and the intracellularly accumulated Li+ content. In the experiment with fura-2, Li+-substituted solution inhibited the high-K+-induced contraction without decreasing the cytosolic Ca2+ level elevated by high-K+ solution. The concentration-response curve for Ca2+ in the skinned fiber was shifted to the right by pretreatment with Li+-substituted solution. These results suggest that the inhibitory mechanism of Li+ on the contractions by various stimulants partly involves the direct inhibition of the contractile proteins in the guinea-pig ileal longitudinal muscle. PMID- 2767136 TI - Muscarinic receptor binding characteristics of a human neuroblastoma SK-N-SH and its clones SH-SY5Y and SH-EP1. AB - The present study examines the muscarinic receptor binding characteristics of parent human neuroblastoma (SK-N-SH) and its neuroblast (SH-SY5Y) and epithelial like (SH-EP1) clones using [3H]methylscopolamine [( 3H]NMS). Specific [3H]NMS binding to intact SK-N-SH and SH-SY5Y cells was saturable with a Kd of 0.2 nM and Bmax of 100-150 fmol/mg protein. Specific [3H]NMS binding to whole cell preparations of SH-EP 1 could not be detected. Pharmacological analysis of the binding site both in whole cells and membranes of SK-N-SH are indicative of an homogeneous receptor population possessing low affinity for the M1-selective antagonist pirenzepine. The muscarinic receptors expressed by the neuroblast clone, SH-SY5Y were further characterized and shown to have the properties of an homogeneous M3 subtype with low affinity for the M1-selective antagonist pirenzepine and the M2-cardioselective AFDX-116 but high affinity for 4 diphenylacetoxy-N-methyl piperidine methiodide (4-DAMP). In conclusion the SH SY5Y neuroblastoma should provide an important human neuronal cell model with which to define the regulation of post-receptor events driven by a single receptor population. PMID- 2767137 TI - Induction of phenylethanolamine N-methyltransferase mRNA expression by glucocorticoids in cultured bovine adrenal chromaffin cells. AB - The effects of glucocorticoids on the expression of phenylethanolamine N methyltransferase (PNMT) mRNA and proenkephalin A (ProEnk A) mRNA in cultures of bovine adrenal chromaffin cells were examined. The expression of PNMT mRNA (approx. 1.1 kilobases) was induced in the presence of glucocorticoids. This induction was of high potency with an EC50 in the range of 1-10 nM for dexamethasone, and was blocked by high concentrations of the glucocorticoid antagonist RU-38486. Cortisol, prednisolone and Reichstein substance S (11-deoxy 17-hydroxycorticosterone) were all effective in stimulating PNMT mRNA expression while cortisone, progesterone and beta-estradiol were without effect. These results indicate that the effects are mediated by specific glucocorticoid receptor activation and exhibited a strict structural requirement for the ability of glucocorticoids to induce PNMT mRNA expression. By contrast, glucocorticoids had no significant effect on the expression of ProEnk A mRNA. In summary, this study provides evidence that glucocorticoids act to regulate PNMT (but not ProEnk A) at the transcriptional level. This differential effect of glucocorticoids suggests that different mechanisms govern the expression of mRNAs required for synthesis of the co-stored secretory components, the enkephalins and adrenaline within the chromaffin cells of the adrenal medulla. PMID- 2767139 TI - Isoelectric focusing of monoamine oxidase subtypes as identified by MAO inhibitors. AB - Monoamine oxidase from various human tissues from several individuals was labeled with [3H]pargyline and solubilized by means of Triton X-100 or Triton X-100 and urea. The specificity of the labeling was assessed using various selective, reversible and irreversible inhibitors as pharmacologic tools in competition experiments. The labeled material was submitted to isoelectric focusing on polyacrylamide gels according to one- and two-dimensional electrophoretic procedures and with fluorographic detection. While the differences in electrophoretic mobility of the two subtypes, MAO-A and MAO-B, could be replicated the subtypes showed identical although heterogeneous charges in isoelectric focusing. This contrasts with recent findings of clear differences in the primary structure of monoamine oxidase subtypes and thus needs further clarification. PMID- 2767138 TI - Histamine activates proenkephalin A mRNA but not phenylethanolamine N methyltransferase mRNA expression in cultured bovine adrenal chromaffin cells. AB - The effects of histamine on the regulation of proenkephalin A (ProEnk A) and phenylethanolamine N-methyltransferase (PNMT) mRNA expression were examined in cultures of bovine adrenal chromaffin cells. Prolonged incubation with histamine resulted in a concentration-dependent increase in the levels of ProEnk A mRNA with little effect on the levels of PNMT mRNA. The activation of ProEnK A mRNA by histamine followed a slow time course, reaching 2-3 fold basal levels after 48 h incubation. This activation was antagonized by the H1-antagonist mepyramine but not by the H2-antagonist cimetidine indicating involvement of H1-histamine receptors. The histamine-induced activation of ProEnK mRNA was blocked by the RNA synthesis inhibitor actinomycin D, suggesting that the novo synthesis of ProEnkA mRNA is a requirement for activation. In the presence of the calcium channel blocker D600, the histamine-induced increase in ProEnk A mRNA was greatly reduced, though not abolished. Prolonged incubation with histamine also caused a substantial release of catecholamines and opioid peptides from these cells. These results suggest that the synthesis and release of opioid peptides is controlled by histamine via H1-receptors. The differential effects of histamine on ProEnk A mRNA and PNMT mRNA expression suggest that different regulatory mechanisms are called upon to regulate the synthesis of opioid peptides and adrenaline in response to stimulation of the chromaffin cells. PMID- 2767140 TI - Interaction of quaternary ammonium compounds with acetylcholinesterase: characterization of the active site. AB - The relation of the structure of 31 quaternary ammonium compounds (28 inhibitors; 3 substrate analogues) with their effects on the activity of acetylcholinesterase (EC 3.1.1.7; AChE) was studied. The compounds were structurally related to the natural substrate acetylcholine (ACh). All bear a trimethylammonium moiety as cationic head. The inhibitors include a variety of functional groups instead of an electrophilic ester group, making these substances suitable to probe the esteratic subsite. The inhibition constants and Km values were determined in kinetic experiments under steady state conditions (pH-stat method). Most of the substances acted as reversible, competitive inhibitors with KI in the range of 10(-6)-10(-3) M. The substrate analogues had Km values between (1.2-2.2) X 10(-4) M. The data allow the following main conclusions: (1) The quaternary trimethylammonium group of ACh is of high importance for substrate binding to AChE. It mediates association at the anionic site. (2) A poorer contribution to binding (two orders of magnitude lower) is attributable to the apolar methylene chain in ACh. It can be related to a hydrophobic interaction of the hydrocarbon chain at a region neighbouring the anionic site. (3) The ester group (both C = O and O) does not contribute to substrate binding. It is only responsible for reactivity. PMID- 2767141 TI - Influence of the molecular structure of N6-(omega-aminoalkyl)adenosines on adenosine receptor affinity and intrinsic activity. AB - The affinities of a series of N6-(omega-aminoalkyl)adenosines as probes for A1 and A2 adenosine receptors were determined in various radioligand binding assays and the intrinsic activities were measured in adenylate cyclase assays. Clear species differences were noticed for A1 receptor affinity of these adenosine receptor agonists, the compounds being more active in calf than in rat brain tissue. The affinity profile within the series was, however, rather similar in both membrane preparations, with N6-9-aminononyladenosine displaying highest affinity. The A2 receptor affinities were comparable to values measured for the A1 receptor in its low affinity state, as assessed with a radiolabelled antagonist in the presence of 1 mM GTP. Calculation of the intrinsic activities of the adenosine analogues from their modulating action on adenylate cyclase showed almost all the compounds to be equally effective to (-)-N6-(R phenylisopropyl) adenosine, on either A1 or A2 adenosine receptors. N6-3 Aminopropyl- and N6-12-aminododecyladenosine, however, proved to be partial agonists, the first on A1 and the second on A2 adenosine receptors. The data are used as the basis for a discussion of adenosine receptor subtype selectivity and intrinsic activity in general. PMID- 2767142 TI - Incidence of filled surfaces from 10-18 years of age in an orthodontically treated and untreated group in Norway. AB - The present study was conducted to examine the incidence and location of filled surfaces from 10-18 years of age in individuals subjected to and not subjected to treatment with fixed orthodontic appliances. Each group comprised 65 individuals. About 5 years had elapsed since the appliances were removed. No statistically significant difference in filled surfaces was found between the groups at age 10 to 18. The incidence in filled surfaces from 10-18 years was 6.34 in the orthodontic group, and 7.22 in the untreated group. The difference was not statistically significant. The distribution of fillings in the dentition in the two groups showed no significant differences. Most of the fillings were recorded in the fissures of the molars. In the first molars most of the fillings in the fissures were already present at the age of 10. It was concluded that in individuals with relatively low caries activity, the present fluoride regimes are sufficient to prevent any excess caries lesion development requiring filling during or after orthodontic therapy. PMID- 2767143 TI - The orthodontist in the team-treatment for children with rheumatoid arthritis. AB - In 160 children with rheumatoid arthritis (RA) functional and morphological disorders of the stomatognathic system were found in 65 per cent of the group. The functional TMJ examination revealed the early involvement of these joints. The age of children, the insidious and irreversible damage of the TMJ development and its consequences, indicate the need for functional treatment of these joints and associated malocclusions. Thus the orthodontist's participation in the team treatment of children with RA, from the early periods of the stomatognathic system development is necessary. PMID- 2767144 TI - Tooth development in children with cleft lip and palate: a longitudinal study from birth to adolescence. AB - Dental maturity was assessed in 131 children with cleft lip with or without cleft palate in two age groups from panoramic X-rays using the method of Demirjian. The subjects showed a mean delay of 6 months in the age group of 3-9 years (x = 6.4 years), which decreased to 2 months in the age group of 8-14 years (x = 11.0 years). Involvement of the palate made the delay longer than in children with cleft lip only. Geographical differences between parts of Finland were also found. To study tooth development longitudinally, the timing of the beginning of calcification of one maxillary central incisor was assessed from occlusal X-rays taken between the ages of 2 and 18 months in 107 of the above mentioned 131 subjects. Using rank-order correlations, the beginning of the calcification of the maxillary central incisor weakly predicted the subjects' tooth developmental status. The correlation of dental maturity between the ages of 6 and 11 years was, however, high. PMID- 2767145 TI - Muscle function and craniofacial morphology: a clinical study in patients with myotonic dystrophy. AB - The occlusal traits and the craniofacial morphology were studied in patients with an altered muscle function caused by myotonic dystrophy. Twenty-four adult patients were examined and compared with a matched group of healthy individuals. The condition of the masticatory muscles was evaluated by measuring the maximal bite force. The dental arches and the occlusal traits were analysed on dental casts. Lateral cephalograms were taken in the patients with myotonic dystrophy to study the craniofacial morphology. It was found that the patients suffering from myotonic dystrophy had weak masticatory muscles, which might be caused by the disease. A high prevalence of malocclusions (postnormal occlusion, anterior open bite and lateral cross bite) was found among these patients. Their craniofacial morphology showed a vertical aberration, characterized by a large angle between the mandibular and palatal planes and a steep mandible. These findings seem to be most pronounced in patients with an early onset of the disease and support the hypothesis that reduced muscle function may cause changes in the craniofacial morphology. PMID- 2767146 TI - Incisor edge-centroid relationships and overbite depth. AB - Interincisor angulation is commonly held to be a critical factor in determining overbite depth, where there is incisor contact. In this study significant correlations between these variables were found in Class II, division 2 malocclusions although interincisor angle explained less than a third of the variance in overbite depth. It was found that the anteroposterior relationship of the lower incisor edge to the upper incisor root centroid is more strongly related to overbite depth and it is suggested that this is a useful factor to take into account in planning treatment in Class II cases. PMID- 2767147 TI - Long-term results after childhood condylar fractures. A computer-tomographic study. AB - A computer-tomographic study of the remodelling process of the TMJ was made of 12 patients who had suffered condylar fractures during their growth period. The most interesting results were exhibited by patients with low fractures of the condyle and medial luxation of the small fragment. The remodelled condyles consisted of 2 parts, a medial part, probably the remainder of the small fragment and a lateral part, probably callus formation. In some patients a flattening of the fossa characterized by thickening of the roof was clearly observed. The case presentation additionally included one patient with post-traumatic ankylosis and one patient presenting a bifid condyle. PMID- 2767149 TI - Dentofacial morphology in children playing musical wind instruments: a longitudinal study. AB - Playing wind instruments requires increased ventilation and increased orofacial muscle activity. The aim of the present investigation was to study the longitudinal effects on the dentofacial morphology of increased ventilation and orofacial muscle activity associated with playing wind instruments. Lateral cephalograms and dental casts obtained from wind instrument players at the ages of 6, 9, 12, and 15 years were studied and compared to control groups. In addition information was obtained as to how many hours per day they practised their instruments. Significant differences between the musicians and controls were found. The musicians had a decreased anterior facial height and wider dental arches. The findings are interpreted as being due to increased orofacial muscle activity and increased intra-oral pressure resulting from wind instrument playing. PMID- 2767148 TI - A comparison between anamnestic, rhinomanometric and radiological methods of diagnosing mouth-breathing. AB - Three methods of evaluating the mode of breathing were applied in 119 children aged 7-15 years who were to start orthodontic treatment for various malocclusions. The three methods were: the history, rhinomanometric recording of the nasal airflow and determination of the size of the airway on profile and frontal cephalograms. The variables describing the mode of breathing were correlated with the facial morphology and the natural position of the head and the cervical spine as recorded with profile cephalometry. There were no correlations between the results of the evaluation of the mode of breathing obtained with the three methods. Nor were there any correlations between these and the position of the head or the cervical spine. A history of mouth-breathing, the rhinomanometrically determined airflow through the nose and the size of the airway on the profile cephalogram were, however, correlated with the long face morphology characteristic of mouth-breathing. A diagnosis of mouth-breathing should be based on different supplementary methods, the history and the size of the airway on the profile cephalogram being at least as valuable as the rhinomanometric recordina. PMID- 2767150 TI - Overbite and overjet correction in a Class II, division 1 sample treated with Edgewise therapy. AB - The purpose of this study was to compare the effect of overjet and overbite correction in non-extraction and extraction therapy in a sample of Class II malocclusions treated with the Edgewise appliance. The subjects were 20 children treated without extraction and 20 children treated with extraction of the four first premolars. During the post-treatment period a relapse of overjet and overbite occurred in both groups. However, there was a beneficial net effect of overjet and overbite correction in both groups with no significant difference between the two groups. The study showed that mandibular intercanine width, space conditions in the lower jaw and mandibular incisor position were important factors in treatment planning. PMID- 2767151 TI - The block of thyroglobulin synthesis, which occurs upon transformation of rat thyroid epithelial cells, is at the transcriptional level and it is associated with methylation of the 5' flanking region of the gene. AB - Transformation of rat thyroid epithelial cells by Kirsten murine sarcoma virus results in the block of certain thyroid differentiated functions, such as synthesis and secretion of thyroglobulin. Our studies, performed by a run-on assay, demonstrate that this block occurs at the transcriptional level. We also demonstrate the de novo methylation of two methylation-sensitive sites, located within the 5' end regulatory sequences of the thyroglobulin gene, in transformed cells, in the absence of any rearrangement of the gene. These two methylation sensitive sites were methylated also in a rat thyroid cell line transformed by another retrovirus and in two normal cell lines which do not express the thyroglobulin gene. PMID- 2767152 TI - Association of 3'----5' exodeoxyribonuclease activity with DNA replitase complex from S-phase Chinese hamster embryo fibroblast cells. AB - DNA replitase has been described as a complex of enzymes/proteins that are associated with both DNA precursor biosynthesis and DNA replication in mammalian cells [Reddy, G. P. V., and Pardee, A. B. (1980) Proc. Natl. Acad. Sci. USA 77, 3312-3316]. We demonstrate for the first time a 3'----5' exodeoxyribonuclease activity is associated with the replitase complex. As much as 60% of this exonuclease activity was similar to that associated with DNA polymerase delta based upon its sensitivity to inhibition by GMP and by butyl-phenyl deoxyguanosine triphosphate (BuPdGTP). Association of 3'----5' exonuclease activity with the DNA polymerase in the replitase complex was also demonstrated by analyzing dTTP turnover to dTMP in an in vitro DNA polymerase assay system. The DNA polymerase activity in replitase complex exhibited a sensitivity to BuPdGTP which both was similar to that of DNA replication in permeable cells and was intermediate between the BuPdGTP inhibition of purified DNA polymerases alpha and delta. These studies suggest that the replitase complex contains 3'----5' exonuclease activity associated with the DNA polymerase activity responsible for nuclear DNA replication in mammalian cells. Further studies are required to determine if these activities are at least partially attributed to DNA polymerase delta. PMID- 2767153 TI - Glutamine dependency of human skin fibroblasts: modulation by hexoses. AB - The combined effects of carbohydrates and glutamine were investigated in diploid strains of normal human skin fibroblasts cultured for 21 days under eight different culture conditions: hexose-free medium or medium containing D-glucose, D-galactose, or D-fructose, with or without added glutamine. Cell growth, hexose consumption, lactate production, intracellular glycogen content and extracellular amino acid levels were measured every third to fourth day. In the presence of glutamine, cells reached a higher saturation density in fructose medium than in glucose or galactose medium but per cell consumption of fructose and galactose was much less than that of glucose. Consumption of all three carbohydrates per unit cell growth exhibited three distinct phases: Days 1-3, 3-10, and 10-20, respectively. In the absence of glutamine the rate of cell growth was not altered in glucose or galactose medium, but slowed down considerably in fructose medium. Glutamine deprivation also led to changes in hexose consumption. In hexose-free media the cell growth rate at first was very slow, but rose after 2 or 3 weeks of culture. The levels of extracellular nonessential amino acids varied according to medium and growth phase. One of the most exciting findings was that human fibroblasts are able to maintain a slight excess of glutamine in all media not supplemented with glutamine and, more surprisingly, to synthesize it in a medium containing galactose and glutamine. PMID- 2767154 TI - Inhibitors for protein-tyrosine kinases, ST638 and genistein: induce differentiation of mouse erythroleukemia cells in a synergistic manner. AB - In order to investigate the biochemical nature of intracellular cascades leading to cellular differentiation in vitro, we examined the effect of inhibitors of protein phosphorylation on terminal erythroid differentiation of mouse erythroleukemia (MEL) cells. We have found that specific inhibitors of protein phosphorylation at tyrosine residues, ST638 and genistein, effectively induce differentiation in a synergistic manner with an agent which blocks DNA replication such as mitomycin C (MMC). Based upon these findings, the possible involvement of protein phosphorylation (and dephosphorylation) at tyrosine residues in differentiation is discussed. PMID- 2767156 TI - Growth-promoting effects of acidic and basic fibroblast growth factor on rabbit articular chondrocytes aging in culture. AB - Rabbit articular chondrocytes have a limited growth potential in vitro. After four passages in culture, chondrocytes have accomplished more than 50% of their life span. At this stage of culture, they are considered to be senescent-like, since a dramatic decrease in proliferative capacity and enhanced cell size and protein content are observed. These aged cells are, however, still able to respond to fibroblast growth factor (FGF). The addition of either acidic or basic FGF (10 ng/ml) to culture medium permitted an enhanced proliferation. The attenuation of FGF mitogenic activity during aging was not observed for both fractions. Moreover, when treated with acidic or basic FGF, aged chondrocytes had a smaller size and a lower protein content. The acidic FGF was less potent than the basic FGF in delaying the evolution of aged chondrocytes to senescence. PMID- 2767155 TI - In vivo crosslinking of nuclear proteins to DNA by cis-diamminedichloroplatinum (II) in differentiating rat myoblasts. AB - When cells are briefly exposed to cis-diamminedichloroplatinum (II) before lysis in high sodium dodecyl sulfate-urea solutions, the high molecular-weight nucleic acids pelleted by ultracentrifugation contain an increased level of bound proteins when compared to a similar fraction from untreated cells. Subsequent shearing of the pelleted DNA followed by treatment with DNase permits electrophoretic and immunoblot analysis of the crosslinked proteins. In the present study such experiments were carried out with reference to nuclear envelope pore complex proteins in the differentiating L8 rat skeletal muscle cells. The results show that (i) whereas the major lamin proteins crosslinked to DNA in both myoblast and myotubes, lamin B is crosslinked to a greater extent to DNA in myotubes; (ii) a 62-kDa lectin-binding glycoprotein is apparently situated differently with respect to DNA in myotube nuclei; and (iii) the crosslinking pattern of the nuclear matrix proteins to DNA is qualitatively similar in myoblast and myotubes. In addition, lamin C', a modified form of lamin C, not observed in intact nonmuscle cells previously [Glass et al. (1985) J. Biol. Chem. 260, 1895-1900], exists as a native component of the nuclear lamina in rat skeletal myotubes but not in myoblasts. These results point to significant structural alterations in the proteins of the nuclear lamina-pore complex during myogenesis. PMID- 2767157 TI - Dynamics of chromatin changes in live one-cell mouse embryos: a continuous follow up by fluorescence microscopy. AB - Conditions of minimal dye concentration and minimal irradiation which allow the continuous observation of pronuclei in live unicellular mouse eggs by fluorescence microscopy have been found with the use of Hoechst 33342 as fluorophore and a camera of high sensitivity coupled with an image processing system allowing true integration of weak fluorescent signals and further treatment and analysis. Under these conditions the developmental potential of the embryos is not affected. Using such an approach, which avoids eventual artifacts due to fixation procedure, we describe the changes in the nuclear organization and chromatin structure, from formation of pronuclei to mitosis, with particular attention to the chromatin associated with nucleoli and the timing process of chromatin condensation. PMID- 2767158 TI - Quantitation of the volume of liquid injected into cells by means of pressure. AB - The amount of TRITC-labeled bovine serum albumin (TRITC-BSA) released from the tip of standardized microcapillaries at different injection pressures and times was investigated. Three test systems were used: (a) formation of droplets of the test solution (TRITC-BSA) in paraffin oil, (b) injection of the test solution into buffer droplets suspended in paraffin oil, and (c) injection into living 3T3 cells. The amount of test substance released was determined by scanning fluorometry. The first procedure (a) allows the fluorometrically determined amount of TRITC-BSA to be related to the volume of released test solution. For this rather large pressures (about 700 hPa) are required to overcome the surface forces counteracting droplet formation. The volume of the spheres was evaluated from photomicrographs of the droplets. The values obtained correlate very well with those determined by measuring the fluorescence emitted by the droplets. Injection into preformed droplets of buffer (b) can be performed with pressures in the range used for injecting cells (50-400 hPa). High reproducibility in the volume released is obtained with a single microcapillary; however, large variations exist between different capillaries, although these should theoretically be of equal diameter. The volume injected into living cells (c) under a given condition may vary by a factor of 5 or more. This variation may be due to viscosity differences of cytoplasm. We recommend, therefore, injection of fluorescent marker substances together with the test substance, enabling the injected volume to be determined by scanning fluorometry or by image analysis. PMID- 2767159 TI - Electron microscopic studies on primary mesenchyme cell ingression and gastrulation in relation to vegetal pole cell behavior in sea urchin embryos. AB - Early morphogenetic events of primary mesenchyme cell (PMC) ingression and gastrulation were examined by scanning and transmission electron microscopy, with special attention directed to changes in the shape of vegetal pole cells, the length of their microvilli, and interactions between microvilli and the hyaline layer (HL). Eight cells (vegetal pole cells) with elongated microvilli remained in the vegetal pole region while surrounding cells ingressed into the blastocoel to form the primary mesenchyme. These vegetal pole cells indented with the surrounding cells at the stage of gastrulation. The outer surface area with elongated microvilli of vegetal pole cells expanded at the stage of PMC ingression, but was considerably reduced at gastrulation. Microvilli on vegetal pole cells continued to adhere to the HL up to the stage of PMC ingression, but ceased to do so at the time of gastrulation. Thus, the area with separated HL, which is restricted to the region of the PMC released at the stage of PMC ingression, spreads almost entirely throughout the area of the indenting vegetal plate at gastrulation. The apical lamina, apparently consisting of fibrous material intertwinning the stalks of the microvilli, filled the space between the HL and ectodermal cells. The cells surrounding those of the vegetal pole and indenting with those at the stage of gastrulation appeared to behave in the same way as ingressing PMCs in both cell-shape and loss of adhesion of microvilli to HL. The role of vegetal pole cells in early morphogenetic events is discussed. PMID- 2767160 TI - High yields of specific hybridomas obtained by electrofusion of murine lymphocytes immunized in vivo or in vitro. AB - We have studied the use of electrofusion to obtain hybridomas producing antigen specific antibodies after immunization of murine lymphocytes in vitro. Under optimal conditions fusion frequencies of the order of magnitude of 10(-3) were obtained, which is approximately 80-fold higher than the mean value obtained with fusion induced by polyethylene glycol. The number of antigen-specific hybridomas was also increased in a comparable way. The high yields of specific hybridomas observed with electrofusion were independent of the immunization procedure, the antigen or the hapten of interest, or the sources of the lymphocytes. The data presented in this paper indicate that electrofusion may be an extremely attractive alternative method for immortalization of human lymphocytes following immunization in vitro. PMID- 2767161 TI - The organization of the mouse satellite DNA at centromeres. AB - The mouse genome contains a major and a minor satellite DNA family of repetitive DNA sequences. The use of 5-azacytidine has allowed us to demonstrate that these satellite DNAs are organized in two separate domains at the centromeres of mouse chromosomes. The minor satellite is closer to the short arms of the acrocentric chromosomes than the major satellite. The major satellite is farther away, flanking the minor satellite and adjacent to the euchromatic long arm of each mouse chromosome. At the level of resolution afforded by the in situ hybridization technique it would appear that the organization of the centromeric domain of the mouse is similar to that in man. That is, both contain two repetitive DNA sequence families arranged in major blocks. PMID- 2767162 TI - Purothionin from wheat endosperm reversibly blocks myogenic differentiation of chick embryonic muscle cells in culture. AB - Purothionin from wheat endosperm is a cysteine-rich, basic polypeptide of about 5000 Da, which modifies membrane permeability of cultured mammalian cells. This peptide was found to block fusion of chick embryonic muscle cells in culture but allows proliferation and alignment. A purothionin concentration of 6 micrograms/ml (1.2 microM) was necessary for the complete prevention of myotube formation. Under similar conditions, incorporation of [35S]methionine occurred normally but the synthesis of muscle-specific proteins including creatine kinase and acetylcholine receptor was strongly inhibited. In addition, purothionin blocked the uptake of 86Rb+, immediately after its addition to the cultured myoblasts. No such effects were found with the purothionin chemically modified with acetic or succinic anhydride. Thus, the basic residues in purothionin appear to be associated with the inhibition of myogenic differentiation. These results suggest that purothionin exerts its regulatory effect on the transition from proliferative to differentiative myoblasts by interfering with membrane permeability or intercellular contact and recognition, which are necessary for the initiation of muscle differentiation. PMID- 2767163 TI - Cold-induced changes in amphibian oocytes. AB - Female Pleurodeles waltl newts (Amphibia, urodele), usually raised at 20 degrees C, were submitted to low temperatures; oocytes responded to this cold stress by drastic changes both in lampbrush chromosome structure and in protein pattern. Preexisting lateral loops of lampbrush chromosomes were reduced in size and number, while cold-induced loops which were tremendously developed, occurred on defined bivalents of the oocyte at constant, reproducible sites. A comparison of protein patterns in control and stressed oocytes showed two main differences: in stressed oocytes, overall protein synthesis was reduced, except for a set of polypeptides, the "cold-stress proteins"; second, there was a striking inversion of the relative amount of beta- and gamma-actin found in the oocyte nucleus before and after cold stress. Whereas beta-actin was the predominant form in control oocytes, gamma-actin became the major form in stressed oocytes. PMID- 2767164 TI - Raman microspectroscopy of fixed rabbit and human lenses and lens slices: new potentialities. AB - Raman spectroscopy is a non-invasive, non-destructive technique for the study of the macromolecular composition of tissues. Raman spectra were obtained from intact fresh and paraformaldehyde fixed rabbit lenses and from thin slices prepared from these lenses. In addition the Raman spectrum of an intact 82-yr-old human lens was compared with a slice of the same lens. It appeared that fixation with paraformaldehyde had only a minor qualitative effect on the Raman spectra and that Raman spectra of intact lenses and lens slices were comparable. It was also shown that in the slice of the old human lens the fluorescence, due to chromophores, could be reduced so that a reliable Raman spectrum could be obtained. The use of slices improves the accuracy of the position at which Raman spectra are recorded and fixation extends the time available for Raman analysis which is particularly important for the study of human lenses. Moreover, slicing enables Raman analysis of old human lenses, which up to now was thought to be impossible due to the overwhelming fluorescence of the chromophores present in these lenses. PMID- 2767165 TI - mRNA for interphotoreceptor retinoid-binding protein (IRBP): distribution and size diversity in vertebrate species. AB - Northern blots of total retinal RNA from a number of different vertebrate species were probed with a cDNA fragment corresponding to translated portions of bovine IRBP mRNA. A hybridizing band was detected in normal human retina (4.6 kb), Y-79 human retinoblastoma cells (4.4 kb), and in retinas of monkey (4.6 kb), guinea pig (4.9 kb), mouse (6.1 kb), rat (two bands at 5.4 kb and 6.6 kb), rabbit (6.3 kb), cow (6.5 kb), and hamster (7.6 kb). Thus, the IRBP gene is expressed in the retinas of a wide variety of mammalian species. The mRNAs could be readily detected in about 20 micrograms of total RNA, suggesting that, in these species, IRBP message is relatively abundant. In contrast, only very weak hybridization was detected on northern blots of the three bird species examined (chicken, duck, quail). IRBP mRNA is thus relatively well expressed in mammals, but not in birds. PMID- 2767166 TI - Lipid peroxidation and human cataractogenesis in diabetes and severe myopia. AB - To investigate the role of lipid peroxidation in human cataract, malondialdehyde, a breakdown product of lipid peroxidation, was measured in clear and cataractous lenses from normal subjects, and in cataractous lenses from diabetics and from subjects with severe myopia. The cataractous lenses contained more malondialdehyde than did clear lenses and the level was higher in diabetes and severe myopia than in the idiopathic forms. This indicates that lipid peroxidation may be involved in the development of senile cataract and, as a direct consequence of retinal damage, also in the pathogenesis of cataract in diabetes and in severe myopia. PMID- 2767168 TI - Photoreceptor physiology in the rat is governed by the light environment. AB - Albino rats were born and raised in one of three cyclic (12L: 12D) lighting conditions: (1) 5 lux for 9 weeks, (2) 800 lux for 9 weeks, or (3) 800 lux for 9 weeks, followed by 5 lux for 3 weeks (800:5). After the treatment, the following were determined: (i) retinal function as measured by the electroretinogram (ERG); (ii) retinal morphology, including rod outer segment (ROS) length and outer nuclear layer area; (iii) rhodopsin levels in whole retina and ROS preparations; (iv) fatty acid profile of ROS membranes and (v) retinal antioxidant levels. After 9 weeks, rats raised in 800 lux sustained an irreversible loss of photoreceptors which could not be reversed by then placing them in 5 lux. However, these rats displayed significant alterations in all other parameters measured after the 3 weeks in dim cyclic light. ERGs showed a 60% increase of b wave maximum amplitude in 800:5 rats at 12 weeks over the value at the time of their change to a dim environment, while a-wave amplitude in 800:5 rats increased more than 2.5 times. This increase can be explained by a combination of increased ROS length and increased ROS membrane concentration of rhodopsin during the three weeks in 5 lux. Polyunsaturated fatty acids predominated in the ROS of 5 lux rats and 800:5 rats, but not in 800 lux animals. Measurements of retinal glutathione enzyme activity and vitamin E and C levels were relatively low in 800:5 rats. Some rats from the 800:5 group were exposed to 2000 lux for 24 hr. Retinas of these rats sustained 50% loss of photoreceptors from this exposure. Comparisons are made to previous studies concerning the effect of cyclic light environments on the retinas of albino rats. PMID- 2767167 TI - Distribution of two metabolically related fluorophors in human lens measured by laser microprobe. AB - Automated Raman microprobe spectrometry revealed the distribution of a major fluorophor, 3-OH-L-kynurenine-O-beta-glucoside, in human lenses from 0.38 to 71 yr. A three-dimensional perspective grid map with fluorescence intensity as the third dimension shows maximum fluorescence in the infant lens nucleus. At 12 yr the fluorescence peak is broadened and a toroid-shaped maximum occurs also in the outer cortex, creating a toroid-shaped minimum between the two maxima. By 71 yr the nuclear maximum is lower but a new (green) fluorophor (excitation 488 nm: emission 530 nm) has appeared as a toroidal maximum in the same location as the blue minimum, suggesting the conversion of the blue fluorophor to the unidentified green fluorophor. PMID- 2767169 TI - Retinal pigment epithelial cells produce PDGF-like proteins and secrete them into their media. AB - Human retinal pigment epithelial cells at confluence were used to condition serum free Dulbecco's modified Eagle's medium. Conditioned media were exhaustively dialyzed against 0.5 N acetic acid, lyophilized, and subjected to Western blot analysis, using as primary antibody an IgG fraction prepared from goat antiserum directed against human platelet-derived growth factor. Native platelet-derived growth factor was resolved as a band with Mr of 30 kDa under non-reducing conditions, while bands with Mr of 36-38 kDa and 18.5 kDa were resolved from retinal pigment epithelial cell-conditioned media. Acid extracts of retinal pigment epithelial cells also contained bands at 36-38 kDa and media conditioned for 48 hr exhibited much denser bands than media conditioned for 24 hr. No bands were detected when non-immune goat IgG fractions were substituted for primary antibody and when conditioned media were prepared from several human fibroblast lines in the same manner as those prepared from retinal pigment epithelial cells, no detectable bands or only a faint shadow at 36 kDa were seen. Retinal pigment epithelial cell-conditioned media prepared in the presence of [35S]methionine were loaded on an anti-platelet-derived growth factor IgG affinity column, eluted, and subjected to SDS-polyacrylamide gel electrophoresis. Bands with Mr slightly less than 36 kDa and 18 kDa were visualized by autoradiography, demonstrating that the platelet-derived growth factor-like proteins in retinal pigment epithelial cell-conditioned media are newly synthesized. Two fractions eluted from the column also markedly stimulated fibroblast chemotaxis and incorporation of [3H]thymidine, both of which were neutralized by soluble anti platelet-derived growth factor IgG. These data suggest that retinal pigment epithelial cells in culture produce platelet-derived growth factor-like proteins and secrete them into their media where they are capable of stimulating fibroblast chemotaxis and proliferation. PMID- 2767170 TI - The optic fissure in the normal and microphthalmic mouse. AB - The gene for microphthalmia in the homozygous cinnamon mouse produces colobomatous microphthalmia due to failure of closure of the optic fissure. Optic fissure formation and closure were examined in control cinnamon and homozygous microphthalmic foetuses from the 10th to the 13th gestational day using light and electron microscopy. This study showed that basal lamina degeneration and cell death occurred in the area of fusion in the control eyes. Examination of the optic fissure in homozygous microphthalmic foetuses showed cell death in the fissure margins, but there was failure of optic fissure closure associated with persistence of the basal lamina. It is therefore suggested that absence or abnormality of programmed disintegration of the basal lamina prevents fusion in the mutant leading to the development of colobomatous microphthalmia. PMID- 2767172 TI - Hydrocortisone-induced DNA endoreplication in human trabecular cells in vitro. AB - Primary monolayer cultures of trabecular cells and organ cultures of trabecular meshwork, obtained from normal eyes of human subjects (age range, 40 to 70 yr) were exposed to hydrocortisone at concentrations ranging from 10(-4) M to 10(-6) M for periods up to 4 weeks. Phase-contrast microscopy of cultured cells showed an increase in the size of the nuclei (up to three times) and in the extent of the cell cytoplasm compared to those in control cultures, and vesicular structures frequently accumulated in the cytoplasm. Microdensitometry of Feulgen stained cell nuclei indicated that the cells of the trabecular meshwork in vivo have predominantly diploid levels (2C) of DNA. Many nuclei in the trabecular cell cultures were polyploid and contained DNA values of 4C, 8C, and 16C. Cultures which had been exposed to hydrocortisone showed a significant shift toward the higher DNA classes, in contrast to the untreated control cultures; the average increase in the amount of DNA per nucleus was 36%. We discuss the relevance of these findings to the disease glaucoma in man. PMID- 2767171 TI - Clinical photon correlation spectroscopy evaluation of human diabetic lenses. AB - Clinical research on cataract prevention requires an in vivo assessment of the lens of the eye that is non-invasive, quantitative and detects lens changes that precede lens opacification or cataract formation. The method of photon correlation spectroscopy or quasi-elastic light scattering spectroscopy provides such a non-invasive probe. The measurement, based on fluctuations in scattered light intensity caused by translational Brownian motion of the lens proteins, allows a determination of a protein diffusion coefficient and hence information on quaternary conformational changes of these protein scatterers. These protein changes have been observed in association with the presence of lens opacification. The occurrence of these changes prior to opacification, however, has still to be established. The analyses performed in this study were aimed at testing the hypothesis of an association between subclinical molecular changes in the lens as measured by quasi-elastic light scattering and the presence of selected risk factors for cataract. Measurements were made from 393 diabetics attending the Joslin Diabetes Center Eye Unit and 38 non-diabetic volunteers. Measurements at two different instrument sample times, 1.5 microseconds and 150 microseconds, allowed characterization of two different protein size distributions contributing to the quasi-elastically light scattered signal. Measurements performed at the 1.5 microseconds sample time demonstrated significantly decreased lens protein diffusivity in association with older age, higher grade of nuclear sclerosis and presence of diabetes. Statistically significant associations were also observed between lens protein diffusivity and diabetes related factors such as glycosylated hemoglobin level (diabetes control), duration of diabetes, age at onset of diabetes and type of diabetic therapy. The pattern of association exhibited between decreased protein diffusion coefficient and risk factor status is consistent with the patterns of increased risk previously demonstrated in cataract formation. Measurements performed at the 150 microseconds sample time demonstrated significantly decreased lens protein diffusivity in association with increasing age, female sex and glycosylated hemoglobin level. These associations differed significantly from those observed at the 1.5 microsecond sample time, thereby suggesting that these two sample times assess different species of lens proteins. The results of this analysis demonstrate the clinical utility of quasi-elastic light scattering as a rapid, non-invasive method to quantitate lens changes and assess methods of cataract prevention and treatment. PMID- 2767173 TI - Detection of glycated polypeptides in human aqueous humor by lectin-binding analysis. AB - The proteins from 30 samples of normal human aqueous humor were separated into major fractions by sodium dodecyl-sulfate polyacrylamide gel electrophoresis, transferred to nitrocellulose, and probed with lectins to characterize the glycated polypeptides. The lectins used were derived from Canavalia ensiformis (concanavalin-A), Phaseolus vulgaris (erythroagglutinin), Arachis hypogaea (peanut agglutinin), and Ulex europaeus agglutinin-I. Using this microanalytical technique, the glycated polypeptides in the aqueous humor were separated into nine major fractions with apparent molecular weights of 17, 41, 50, 55, 61, 77, 80, 120 and 151 kDa. The predominant oligosaccharides detected on these fractions were complex chains usually with sialic acid residues. The possible roles of the glycated polypeptides in the aqueous humor in health and disease are discussed. Our investigation of these molecules in human aqueous humor provides baseline data for a rapid diagnostic analysis of microsamples of this fluid obtained from diseased eyes. PMID- 2767174 TI - Generation of alpha-L-glycerophosphate in the lens. PMID- 2767175 TI - Comments on glucose profiles in the rabbit cornea. PMID- 2767177 TI - Additional evidence for remodelling of normal choriocapillaris. PMID- 2767176 TI - Effect of a cholinesterase inhibitor on salmonid lens: a possible cause for the increased incidence of cataract in salmon Salmo salar (L.). PMID- 2767178 TI - New isolation method of retina and interphotoreceptor matrix. PMID- 2767179 TI - Interfibrillar structures in fast-frozen, deep-etched and rotary-shadowed extracellular matrix of the rabbit corneal stroma. PMID- 2767180 TI - Relationship between levels of advanced-stage products of the Maillard reaction and the development of diabetic retinopathy. PMID- 2767181 TI - A four-step procedure for the purification of thrombopoietin. AB - The present work reports the preparation of a highly bioactive and stable thrombocytopoiesis-stimulating factor (TSF or thrombopoietin) by a four-step purification procedure, i.e., Sephadex column chromatography, ethanol precipitation, sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS PAGE), and reverse phase-high performance liquid chromatography. The molecular weight (MW) of the purified product depended upon the method of purification, i.e., using denaturing buffers at 56 degrees C for 10 min, the MW was approximately 30,000 daltons; whereas, after preparing in denaturing buffers and heating to 100 degrees C for 10 min, the purified protein had an apparent MW of approximately 15 kd. Both moieties had significant biological activity. The data indicate that TSF may exist normally as a dimer (30 kd), but can disassociate to 15 kd without loss of bioactivity. The present work illustrates that the purified TSF has an isoelectric pH of 4.47 and exists in trace amounts in human embryonic kidney (HEK) cell culture media. The final product prepared in the presence of Tween-20 had a specific activity of approximately 21,000 U of TSF per mg of protein, representing a purification factor of approximately 164,000. Using this four-step purification procedure, a homogeneous product was obtained as judged by SDS-PAGE and chromatofocusing. This purified material will be suitable for further studies, including amino acid sequencing. PMID- 2767182 TI - Enhancement of the adherence of hematopoietic stem cells to mouse bone marrow derived stromal cell line MS-1-T by a tetrapeptide acetyl-N-Ser-Asp-Lys-Pro. AB - The tetrapeptide acetyl-N-Ser-Asp-Lys-Pro (AcSDKP) has been shown to inhibit in vivo the hematopoietic stem cell (spleen colony-forming unit; CFU-S) entry into cell cycle in cytosine arabinoside-treated mice. Our data showed that AcSDKP has no effect on interleukin 3 (IL-3)-dependent DA-1 cell proliferation or on granulocyte-macrophage colony-forming cell and mast cell colony formation, whereas it enhances the adherence of CFU-S to the bone marrow-derived hematopoietic supportive stromal cell line MS-1-T. AcSDKP suppresses MS-1-T proliferation but does not modify granulocyte-macrophage colony-stimulating activity secretion by these cells. This suggests that the peptide does not counteract the activity of the IL-3 receptor on CFU-S but acts on MS-1-T and in particular at the level of CFU-S/MS-1-T interactions. PMID- 2767183 TI - The effect of partially purified thrombopoietin on guinea pig megakaryocyte ploidy in vitro. AB - Enriched populations of guinea pig bone marrow megakaryocytes were prepared by density gradient and velocity centrifugation and maintained in liquid cultures for 24 or 48 h. The resulting megakaryocyte preparations were of 86.1% +/- 5.5% purity. After 24 or 48 h in liquid culture, recovery of viable cells was 77% +/- 11% or 83% +/- 13%, respectively. Megakaryocyte cultures were supplemented with 100-200 micrograms/ml of either a lectin-fractionated preparation of thrombopoietin (TPO) from the plasma of thrombocytopenic rabbits or an identically prepared protein fraction from non-thrombocytopenic animals. Addition of TPO resulted in a significant increase (p less than 0.05) in both the proportion and total numbers of 32N megakaryocytes and a significant decrease (p less than 0.05) in the relative frequency of 8N megakaryocytes. In most experiments, a decrease in the total number of 8N megakaryocytes also was noted. These results indicate that partially purified TPO is able to increase the ploidy (DNA levels) of megakaryocytes in vitro. PMID- 2767184 TI - Erythropoietin controls heme metabolic enzymes in normal human bone marrow culture. AB - Erythropoietin (Epo) was found to act as a concentration-dependent inducer of aminolevulinic acid (ALA) synthase and porphobilinogen (PBG) deaminase in normal human bone marrow in culture. Epo increased enzymatic activities in individual plated nucleated cells. At a low concentration of Epo, heme oxygenase activity did not change in human bone marrow erythroid progenitor cells. However, Epo at a concentration of 2 U/ml increased heme oxygenase as demonstrated by an increase in both the enzyme protein and its mRNA. In experiments with an inhibitor of heme synthesis, succinylacetone (SA), Epo failed to stimulate erythroid colony-forming unit (CFU-E) growth, but this CFU-E inhibition by SA was completely overcome by the addition of hemin. Epo nevertheless potentiated induction of ALA synthase in the presence of SA. Hemin exerted its regulatory role by negative feedback on ALA synthase in the presence of SA and Epo. Heme potentiated Epo action and resulted in the increase of human marrow erythroid progenitor cell proliferation and differentiation and a concomitant stimulation of ALA synthase and PBG deaminase. The potentiating effects of hemin on CFU-E growth were observed in human bone marrow cells cultured in media supplemented with fetal calf serum or serum-free media with interleukin 3 (IL-3). These results indicate that Epo is a potent inducer of ALA synthase and PBG deaminase in normal human bone marrow. In addition, our results may explain the mechanisms by which heme potentiates Epo or IL-3 enhancement of erythropoiesis. 1) Heme may stimulate the translation of several globin and nonglobin mRNAs, including those of ALA synthase and PBG deaminase; 2) as endogenous cellular heme synthesis reaches optimal levels, heme exerts its regulatory role on ALA synthase by negative feedback inhibition. Additionally, an increase in cellular heme may lead to an increase in its own degradation by induction of heme oxygenase. PMID- 2767185 TI - Influences of lesions of parietal cortex on visual spatial attention in humans. AB - Several brain areas have been identified with attention, because damage to these regions leads to neglect and extinction. We have tested elements of visual attentional processing in patients with parietal, frontal, or temporal lesions and compared their responses to control subjects. Normal humans respond faster in a reaction time task when the spatial location of a target is correctly predicted by an antecedent stimulus (valid cue) than when the location is incorrectly predicted (invalid cue). The cue is hypothesized to shift attention towards its location and thereby facilitate or impede response latencies. The reaction times of individuals with damage to the parietal lobe are somewhat slowed for targets ipsilateral or contralateral to the side of the lesion if the targets are preceded by valid cues. These same patients are extremely slow in responding to targets in the visual field contralateral to the lesion when the cue has just appeared in the unaffected (ipsilateral) visual field. In addition, these individuals are especially slow in responding to targets in either visual field when the lights are preceded by weak, diffuse illumination of the entire visual field. Patients with lesions of the frontal lobe have very slow reaction times in general and, as is the case for patients with lesions of the temporal lobe, are slow in all conditions for targets in the field contralateral to the lesion. These patterns are probably not associated with attentional defects. For patients with parietal lesions, these studies demonstrate a further deficit in a cued reaction-time task suggesting abnormal visual attention. Since different sites of brain damage yield different patterns of responses, tests such as these could be of analytic and diagnostic value. PMID- 2767187 TI - Axis of preferred motion is a function of bar length in visual cortical receptive fields. AB - The responses of 82 simple cells and 41 complex cells in area 17 of anesthetized and paralysed cats were examined with light bars of different length. For 84% of the simple cells and 66% of the complex cells the preferred axis of orientation of a stationary flashing long bar (orientational selectivity) and the preferred axis of movement of a small spot were parallel. As a consequence, the axis of maximal response to a moving light spot was mostly orthogonal to the optimal axis of a moving bar. Thus, a single cell responds to two perpendicular axes of preferred movement one for a long bar and one for a light spot, respectively. For both axes independent direction preferences could be distinguished. Additional preferred axes of movement between the two orthogonal extremes could be found with moving bars of intermediate lengths. This can be explained by the fact that cells with a pronounced response to a moving spot showed a strong tendency for intermediate bar length to elicit responses consisting of a superposition of both components. Therefore, decreasing bar length resulted in a gradual rotation of the preferred direction of movement from orthogonal to parallel with respect to the orientational axis, rather than to a mere widening of the tuning curve. Accordingly, the change in orientation selectivity with decreasing bar length is a regular transition from the orientation dependent response to a response type that depends only on the movement axis of the spot. Thus, in a simple model, the resulting response characteristic can be interpreted as an average of both components weighted according to the length of the stimulus. PMID- 2767186 TI - Unit activity in monkey parietal cortex related to haptic perception and temporary memory. AB - The neural responses of 456 single units were recorded in parietal cortex of behaving monkeys during a haptic delayed matching-to-sample task. (1) In areas 2 and 5 together, 22% of the neurons were activated by the auditory cue that signalled the beginning of a trial. Virtually all of these cells were also activated during the arm movements required by the task. These neurons, showing both auditory-related and movement-related responses, may function in sensorimotor integration. (2) Responses related to arm projection frequently began before movement onset, sometimes as much as 320 ms before. Such "premovement" responses were approximately equally common, and showed the same latency distribution, in areas 2, 5a, and 5b. (3) There was a topographic rostral to-caudal gradient of decreasing neural responsiveness to the animal's manipulation of the cue (sample) objects. Eleven percent of manipulation activated cells responded preferentially to one of the sample objects. (4) Many cells showed sustained (greater than 3 s) activation during the delay period (the time between handling of the sample object and palpation of the choice objects), even though at that time the monkey was sitting quietly and without stimulation. (5) Cells with sustained activation throughout most or all of the 18-s delay period were rare in all areas tested except area 5a. These cells, especially those that were preferentially activated depending on which sample object was palpated, may function in the temporary retention of haptic attributes. (6) The population of cells activated during sample manipulation was largely distinct from the population of cells showing sustained activation during the delay period. These two cell populations may represent different but complementary aspects of haptic perception. (7) The most common response during the delay period was sustained inhibition. This may be an expression of a nonspecific mechanism for decreasing background noise and enhancing neural responses to an anticipated perceptual event. (8) Relatively little evidence was found to support a functional distinction between the neural response properties of areas 2 and 5a. This suggests that area 2 may be at a higher level in the somatosensory hierarchy of the posterior parietal cortex than usually considered. PMID- 2767188 TI - Olivary branching projections to the flocculus, nodulus and uvula in the rabbit. II. Retrograde double labeling study with fluorescent dyes. AB - The previous electrophysiological study reported that some of the Purkinje cells in the vestibulocerebellum were innervated by branching climbing fibers. To identify the cells of origin of these branching climbing fibers, a pair of retrograde fluorescent tracers, propidium iodide in combination with 4', 6 diamidino-2-phenylindole or diamidino yellow, were injected into two sites in the flocculus, nodulus and uvula. Proportions of double labeled neurons out of all labeled neurons in each subdivision of the contralateral inferior olive were studied. In cases of injections into the flocculus and nodulus, 13% (maximum 27%) of all the labeled neurons in the dorsal cap and 6% (maximum 12%) in the ventrolateral outgrowth were double labeled. In cases of injections into the nodulus and uvula, 20% neurons (maximum 34%) of the labeled neurons in the dorsal cap and 8% of those in the nucleus beta were double labeled. The present retrograde labeling study revealed that some dorsal cap neurons project to the uvula, which has not been reported previously in the rabbit. Injections into the flocculus and uvula caused only slight double labeling (0.4%) in the inferior olive. PMID- 2767189 TI - Hippocampal neurons transplanted into ischemically lesioned hippocampus: electroresponsiveness and reestablishment of circuitries. AB - Severe forebrain ischemia was used to damage selectively the CA1 region of the rat hippocampal formation. One week later the CA1 region was repopulated with suspensions of 18 day old fetal hippocampal tissue. Intracellular recordings were made from single units within the transplants by using the "in vitro" slice preparation, two to nine months following transplantation. Based on firing characteristics during depolarizing current injection, pyramidal-like and interneuron-like cells were identified within the transplants. Synaptic potentials could be evoked in the pyramidal-like neurons by stratum radiatum and stratum oriens stimulation demonstrating that normal afferent contacts had been made. Local inhibitory circuits were not obvious within the transplanted regions as demonstrated by prolonged EPSP's and the absence of early or late after hyperpolarization. This was supported by the lack of conductance fluctuation in the active membrane when compared with the resting cell. Antidromic spikes could be evoked by applying shocks to the stratum oriens, towards the fimbria and subiculum, suggesting that the transplanted neurons were projecting basal neurites, quite long distances, along the normal efferent pathways. Thus, the transplanted neurons have the capacity to reconstruct damaged circuitries and develop intrinsic properties similar to their normal counterparts. PMID- 2767190 TI - Sensory and motor responses of trigeminal and reticular neurons during ingestive behavior in rats. AB - Activities of 53 neurons in the brain stem were recorded with chronically implanted fine wires in freely eating and drinking rats. Twenty units were isolated from the trigeminal mesencephalic nucleus; 18 were spindle afferents and 2 periodontal afferents. The spindle units were classified into 4 types: 5 units showed rhythmical activity related only to the jaw opening phase during both licking and chewing, 8 units discharged at jaw opening phase during licking, but both at jaw opening and jaw closing phases during eating, 2 units increased phasic activity at jaw opening phase during licking, but increased tonically independent of jaw movements during eating, and the remaining 3 units responded only at jaw closing phase both in licking and eating behavior. Nine units were assumed to be alpha motoneurons isolated from the trigeminal motor nucleus; 2 innervating the temporalis muscle, 3 the masseter muscle, 2 the digastric muscle, and the remaining 2 presumably the pterygoid muscles. These units, with a mean tonic spontaneous rate of about 10 impulses/s, showed phase-related rhythmical burst activities during licking and eating. Four units were isolated from the trigeminal main sensory nucleus. Sixteen units were isolated from the medullary reticular formation and 1 from the pontine reticular formation. Of these 16 units, 3 from the parvocellular part of the medullary reticular formation were presumably premotor interneurons, and 3 units in the "intertrigeminal region", 2 units in the "juxtatrigeminal region", and 8 units in the "supratrigeminal region" were responsive to multiple sensory modalities. These results demonstrate that almost all the units sampled showed characteristic rhythmic activities associated with the position of the tongue or mandible during rhythmical jaw movements. PMID- 2767191 TI - Long-term potentiation of evoked and spontaneous neuronal activity in the grafted hippocampus. AB - Adult rats with unilateral fimbria-fornix lesion received fetal hippocampal grafts into the lesion cavity. Seven to ten months after the transplantation the graft was examined for long-term potentiation (LTP) in response to host hippocampus and direct graft stimulation. High frequency tetanizing trains delivered to either the host hippocampus or the graft resulted in augmented field potentials and prolonged neuronal discharges in the graft lasting several hours. Very low currents (10-30 microA) were required to induce LTP by direct graft stimulation. In addition to the enhancement of evoked responses, the frequency of occurrence of spontaneously occurring EEG spikes and concurrent population neuronal bursts in the graft increased significantly after the tetanizing trains. These findings suggest that the physiological-biochemical mechanisms required for plastic changes of synaptic efficacy are present in the grafted hippocampus. PMID- 2767192 TI - Cobalt-complex ATP enhanced regeneration in the dorsal horn of the rat spinal cord. AB - ATP, the energy source for axoplasmic transport, is indispensable for the transport of nerve growth factor (NGF). NGF regulates the regeneration of central processes of the primary sensory neurons, by means of transganglionic regulatory mechanisms. This central regeneration was investigated with the help of the histochemical detection of fluoride-resistant acid phosphatase (FRAP), one of the marker enzymes of the primary nociceptive neurons. Transganglionic degenerative atrophy (TDA) of the central terminals of primary sensory neurons was induced with sciatic nerve crush. Dynamics of central regeneration was studied in rats treated with a cobalt-ATP complex, and with commercially available Na-ATP, respectively, by means of histochemical detection of the restitution of FRAP activity in the Rolando substance. Disappearance of FRAP activity was complete on the 6th postoperative day in the medial two-thirds of the upper dorsal horn in segments L2-L6. The regeneration (i.e. replenishment of FRAP activity) began on the 14th day and was complete by the 31st day in animals treated with cobalt-ATP, while in the animals treated with Na-ATP the replenishment of FRAP activity began on the 20th day and was complete only by the 60th day. It is concluded that the cobalt-ATP-complex significantly enhances central regeneration. PMID- 2767193 TI - The cholinergic innervation of the rat cerebral cortex shows two distinct phases in development. AB - The cholinergic innervation of the rat cerebral cortex was examined in pre- and postnatal life using immunohistochemistry with a monoclonal antibody directed against choline acetyltransferase (ChAT). Our observations show that there are two separate phases in the development of the cholinergic innervation of the rat neocortex. The first, a transient phase, occurs in the late stages of gestation and in the perinatal period. During this time, ChAT-labelled cells (neuroblasts, as well as immature pyramidal and non-pyramidal neurons) are present throughout the entire rostro-caudal extent of the primordial cortex. The fate of these cells, which are not visible shortly after birth, is unknown as is their functional role in the developing cortex. The second phase in the development of the cholinergic innervation begins in the middle of the second postnatal week. At this stage only a few faintly stained neurons and fibres appear in the cortex. Their numbers and staining intensity increase gradually until the fifth postnatal week when ChAT-labelled neurons and axonal arbours appear indistinguishable from their adult counterparts. The pattern of development observed in the second phase parallels closely that shown in a recent analysis of cortical ChAT activity during postnatal life. PMID- 2767195 TI - Anterior and medial thalamic lesions, discriminative avoidance learning, and cingulate cortical neuronal activity in rabbits. AB - Four groups of male albino rabbits were trained to perform a conditioned response (CR, stepping in an activity wheel) to an acoustic (pure tone) conditional stimulus (CS+). A 1.5-2.0 mA shock unconditional stimulus (US) delivered through the grid floor of the wheel was administered 5 s after CS+ onset, but stepping during the CS-US interval prevented the US. The rabbits were also trained to ignore a second tone (a negative conditional stimulus or CS-) of different auditory frequency than the CS+, that was presented in an irregular order on half of the conditioning trials but never followed by the US. One group had bilateral electrolytic lesions in the medial dorsal (MD) thalamic nucleus, a second group had combined bilateral lesions in the MD and the anterior thalamic nuclei, and a third group had no lesions. The fourth group was composed of rabbits with combined lesions that resulted in only partial damage in the anterior and MD nuclei. In all rabbits, multi-unit activity and field potentials were recorded from the cingulate cortical projection targets of the MD and anterior nuclei. The average rate of acquisition in rabbits with MD and partial lesions was not significantly different from that in controls, but the asymptotic performance in rabbits with lesions was significantly impaired, relative to that in controls. None of the rabbits that had the combined MD and anterior thalamic lesions reached the acquisition criterion. The average proportion of trials in which these rabbits performed avoidance responses during their final training sessions was 0.3, compared to 0.8 in controls. The unconditioned response was not significantly affected by the lesions, nor was there any indication that the lesions impaired the sensory processing of the CSs. These results and the massive training-induced neuronal discharges shown in past studies to occur in the limbic thalamic neurons indicate that these neurons are importantly involved in the circuitry that mediates discriminative avoidance conditioning in rabbits. The training-induced neuronal activity in cingulate cortex was dramatically attenuated in rabbits with lesions. Differences in the degree of this attenuation between lesion conditions and with respect to training stages were discussed in relation to a theoretical working model of limbic thalamic and cingulate cortical associative functions. PMID- 2767196 TI - Neuronal activity in primate parietal cortex area 5 varies with intended movement direction during an instructed-delay period. AB - A monkey was trained to make arm movements to visual targets immediately after presentation of a GO signal, either in a visual reaction-time paradigm (CONTROL task), or after an instructed-delay period of variable duration, during which a CUE stimulus signalled the direction of the impending movement (DELAY task). The activity of 98 area 5 cells recorded in 2 hemispheres varied with movement direction in the CONTROL task. This included 60 "early" cells which showed directional activity changes prior to movement onset. In the DELAY task, 54/98 cells (55%) showed activity changes during the instructed-delay period which varied with the direction of the impending movement. Most of these (45/54, 83%) were "early" cells. Forty proximal arm-related cells were recorded in adjacent area 2. In contrast to area 5, only 2/40 area 2 cells showed any evidence of changes in activity varying with intended movement direction during the instructed-delay period. The origin of area 5 activity changes during an instructed-delay period which are related to intended direction of a delayed movement is uncertain, but its presence is consistent with a number of proposed roles for area 5. PMID- 2767194 TI - Sensory components facilitating jaw-closing muscle activities in the rabbit. AB - The role of oral and facial sensory receptors in the control of masticatory muscle activities was assessed from the effect of acute deafferentiation on cortically induced rhythmic jaw movements (CRJMs) in anesthetized rabbits. When a thin polyurethane-foam strip (1.5, 2.5 or 3.5 mm thick) was placed between opposing molars during CRJMs, masseteric activities were facilitated in association with an increase in the medial excursion of the mandible during the power phase. The effects varied with the pattern of CRJMs, and the rate of facilitation was greater for small circular movements than for the crescent shaped movements. Furthermore, the response of the masseter muscle was greater in the anterior half of the muscle, where muscle spindles are most dense, than in its posterior half. It was also demonstrated that the response increased with an increase in the thickness of the test strip. In contrast, the activities of the jaw-opening muscle were not affected significantly. The duration of masseteric bursts increased during application of the test strip and the chewing rhythm tended to slow down. However, the latter effect was not significant. After locally anesthetizing the maxillary and inferior alveolar nerves, the facilitative responses of the masseter muscle to the test strip was greatly reduced but not completely abolished. Lesioning of the mesencephalic trigeminal nucleus (Mes V) where the primary ganglion cells of muscle spindle afferents from jaw-closing muscles and some periodontal afferents are located, also reduced the facilitative effects. Similar results were obtained in the animals with the kainic acid injections into the Mes V 1 week before electrical lesioning of this nucleus. In these animals the effects of electrical lesioning of the Mes V could be attributed to the loss of muscle receptor afferents since the neurons in the vicinity of the Mes V were destroyed and replaced by glial cells, whereas the Mes V neurons are resistant to kainic acid. When electrical lesioning of the Mes V and sectioning of the maxillary and inferior alveolar nerves were combined in animals with a kainic acid injection into the Mes V, the response of the masseter muscle to application of the strip was almost completely abolished. From these findings, we conclude that both periodontal receptors and muscle spindles are primarily responsible for the facilitation of jaw-closing muscle activities.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2767198 TI - An improved device for continuous intraventricular infusions prevents the introduction of pump-derived toxins and increases the effectiveness of NGF treatments. AB - The recent demonstrations of the ability of nerve growth factor (NGF) to protect and promote the welfare of certain cholinergic neurons in the adult CNS have increased the need for safe, accurate, and reliable procedures for intracerebral administration of protein and other experimental agents. Osmotic minipumps have been used to infuse NGF into the lateral ventricle of adult rats, but a sustained and harmless performance of such infusions has not been fully evaluated. The study reported here has led to (i) the recognition that cytotoxic substances, released from some minipumps into the infusion fluid, may be responsible for various degrees of periventricular tissue damage, and (ii) the redesigning of an infusion device which, among other modifications, uses the osmotic pump to propel infusion fluid into the ventricle but prevents pump-derived materials from entering the infusate itself. Besides several other advantages, the modified infusion device has permitted the demonstration that NGF can fully protect experimentally axotomized medial septum cholinergic neurons and can do so with less variability than previously observed and without creating tissue damage. PMID- 2767199 TI - Glucocorticoid suppression of lesion-induced synaptogenesis: effect of temporal manipulation of steroid treatment. AB - Glucocorticoids are known to suppress lesion-induced axon sprouting in the hippocampal dentate gyrus following removal of the ipsilateral entorhinal cortex (ERC) projection to the outer molecular layer of the dentate granule cell dendritic field. This suppression is dose-dependent, but even at very high doses of glucocorticoids the sprouting is not completely suppressed. We varied the time of initiation of the glucocorticoid hydrocortisone (HYD), in relation to lesion of the ERC, and assessed the amount of sprouting in the system 15 days after surgery. Beginning treatment 6 days prior to surgery did not totally suppress sprouting, indicating that there is a nonsteroid-sensitive component to the sprouting response. Delaying treatment up to 3 days after ERC removal still led to suppression of sprouting. Delaying steroid treatment until the seventh postoperative day resulted in significant suppression of outgrowth but allowed more sprouting than that in the groups with earlier initiation of treatment. Administration of HYD for the first 8 days after ERC lesion, and then cessation of treatment for the remaining 7 days, also resulted in outgrowth lower than that of controls but higher than that of groups treated for the entire 15 days. A significant relationship between the total number of days of HYD treatment and the amount of suppression of sprouting was observed. Sprouting in this system has a steroid-responsive and a non-steroid-responsive component and the steroid sensitive component is both dose- and duration-dependent. PMID- 2767197 TI - Two classes of cortical GABA neurons defined by differential calcium binding protein immunoreactivities. AB - Calcium ions play a key role in many aspects of neuronal behavior and certain calcium binding proteins that may influence this behavior are differentially distributed in the central nervous system. In this study it is shown that immunoreactivity for calbindin-28 and for parvalbumin is localized in separate populations of inhibitory GABA interneurons in all areas of the neocortex of Old World monkeys. Virtually all GABA neurons show immunoreactivity for one or other calcium binding protein but, except for a few cells in layer IV, GABA cells do not show immunoreactivity for both proteins. Among the two cell populations, parvalbumin immunoreactivity characterizes basket neurons while calbindin immunoreactivity characterizes double bouquet neurons. These findings suggest that the two GABA cell types differ in their regulation of calcium homeostasis and may yield clues to their different roles in intracortical circuitry. PMID- 2767200 TI - Production and characterization of neglect in rats with unilateral lesions of ventrolateral orbital cortex. AB - Neglect is a clinical syndrome characterized by an inability to orient, report, or respond to novel or meaningful stimuli presented to one side of the body or in one hemispace. Neglect in humans and monkeys most often results from damage to one of several interconnected cortical areas, including limbic cortex. In rats damage to only one cortical area, medial agranular cortex (AGm), has been found to produce neglect. Thus, it remains to be determined if there is a cortical circuitry related to neglect in rodents. AGm has extensive bilateral reciprocal connections with the paralimbic area ventrolateral orbital cortex (VLO). The current study was conducted to determine if lesions of VLO also result in neglect in the rat. Male Long-Evans hooded rats with lesions of right VLO (n = 7), left VLO (n = 7), and sham operates (n = 23) were tested for a minimum of 4 weeks on the following: (i) motor asymmetry based on assessment of rotational behavior during a 2-minute period, (ii) neglect based on the degree of orientation to visual, tactile, and auditory stimuli presented in each hemispace, and (iii) tactile extinction based on the tendency to touch the ipsilesional tab first when adhesive tabs were attached to each wrist. Lesions of VLO resulted in no obvious motor asymmetry. Both right and left VLO operates showed significant overall contralesional neglect relative to shams. However, whereas left VLO operates showed significant contralesional neglect relative to shams in the auditory and visual modalities, right VLO operates showed significant neglect in the tactile modality. On the extinction measure only right VLO operates demonstrated an asymmetry, left VLO operates were unimpaired. PMID- 2767201 TI - Suppression of sensitivity to surround displacement during vergence eye movements. AB - Suppression was investigated psychophysically in three human observers by measuring their loss of sensitivity to brief (20 ms) simultaneous vertical displacement (up to 0.5 degrees) of horizontal lines during 4 degrees convergence eye movements. A two-alternative forced choice procedure was used in which the stimulus was presented either in the first or second portion of a trial. The amplitude of the displacement pulse, the time of the pulse relative to convergence onset, and the portion of a trial in which the stimulus was presented were randomized. The results showed that suppression began about 200 ms before, and continued until 350 ms after, convergence onset with maximum loss occurring at 25 to 125 ms after convergence onset. The maximum sensitivity loss was about 0.25 to 0.30 log units. Since peripheral factors were minimized by the use of a brief stimulus presentation and an eccentrically placed surround, the suppression found was primarily attributed to central neural mechanisms. Finally, the suppression of sensitivity to pulse displacement during the initial phase of the vergence movement is consistent with a recently developed dual-mode model of the vergence system, in which the initial transient portion of a step response is preprogrammed whereas the final sustained portion is maintained by continuous feedback control. PMID- 2767203 TI - Non-uniform fine structural alteration in the sinus node after cessation or reduction of blood flow. AB - The sinus node of the dog was examined, using a large-specimen resin-embedding method for combined light and electron microscopy, after 30-240 min of total in vitro ischaemia and after 15-180 min of reduced blood flow in hearts with 2:1 AV block. Although progressive fine structural alteration was observed in the in vitro series, not all cells developed changes at the same rate. Complete loss of glycogen stores and swelling of organelles could be seen in many after only 30 min, whilst others retained their glycogen and showed minimal alteration even after 90 min. Despite relatively severe alteration throughout the node after 120 or more min, some groups of cells showed more extreme degrees of swelling and surface bleb formation than others. In the partially ischaemic in vivo series focal alteration, consisting chiefly of mitochondrial swelling and/or gross dilatation of sarcoplasmic reticulum vesicles, was detectable after 20 min and increased little in extent or degree during longer periods of reduced blood flow. This non-uniform response of sinus nodal cells to ischaemic injury parallels that of contractile atrial muscle cells. PMID- 2767202 TI - Preservation of sensory cells by placing stumps of transected nerve in an impermeable tube. AB - It is known that transection of a major peripheral nerve results in the loss of a significant number of sensory cells whose axons travel in that nerve. The present study confirms this observation and shows that placement of the stump of such a transected nerve into an impermeable tube prevents this loss. We further show that this preservation does not depend on axonal regeneration. Further experiments to define the phenomenon and to obtain beginning insight into mechanisms are discussed. If these findings can be generalized to humans, they may have clinical significance. PMID- 2767204 TI - Glutathione synthesis and export in experimental liver cirrhosis induced by thioacetamide: relations to ultrastructural changes. AB - Micro-and macronodular experimental liver cirrhosis was induced in female rats by administration of 0.03% thioacetamide (TAA) in drinking water for 3 or 6 months, respectively. The glutathione (GSH) status (content, synthesis, export) and ultrastructural changes of liver were investigated 14 d after withdrawal of TAA. The hepatic level of GSH was increased after 6 months TAA treatment. The levels of oxidized glutathione (GSSG) were not changed after 3 months or 6 months TAA administration. The GSH synthesis was not disturbed in the cirrhotic livers; only the ratio between the 2 synthesizing enzymes was changed in macronodular liver cirrhosis. The plasma GSH content was reduced in both cases, independent of the stage of liver cirrhosis. The electron microscopic studies on cirrhotic rat livers revealed a series of characteristic structural changes, such as disorganization and total lack of the microvilli border, appearance of basement membrane-like deposits within the narrowed space of Disse, disappearance of the highly porous endothelial cell lining and partly an intensively detoriated blood supply within the pseudolobules. It is suggested that all these changes may contribute to a disturbance of the GSH export from the hepatocytes into the blood. It is very likely, however, that the alterations of the sinusoidal cell surface play the most important role. 1. The GSH/GSSG redox potential is shifted in favour of the reduced form in this cirrhosis model. This shift seems to be connected with later stages of cirrhogenesis. 2. A GSH export disturbance is responsible for the decreased plasma GSH level in liver cirrhosis. PMID- 2767205 TI - Influence of experimental hypoxia on content and composition of free fatty acids in cerebral white matter. AB - The content and spectrum of free fatty acids were studied in the cerebral white matter, on Wistar rats exposed to acute hypoxia (2% of oxygen in a respiratory mixture) for 3 min. The total content of fatty acids, especially of tetraenoic ones, rose sharply already 4 min after hypoxia and persisted elevated even 2 months after the hypoxia. The results showed that the degradation of phospholipids-containing biological membranes in the nervous tissue of the white matter starts immediately after hypoxia, and is continued for months. PMID- 2767206 TI - Relationship of embryotoxicity to genotoxicity of lead nitrate in mice. AB - Frequency of sister chromatid exchanges (SCEs), nucleolar organizing regions (NORs) and chromosomal aberrations were analysed, in maternal bone marrow and fetal liver and/or lung cells of ICR Swiss Webster mice, following maternal exposure to lead nitrate on gestational day 9. The number of implantations and morphological changes in day 18 fetuses, following the treatment, were also noted. Chemical analysis of lead in maternal and fetal tissues showed that it is readily transferred across the placenta. Lead caused a moderate, but statistically significant, increase in the frequency of SCEs in maternal bone marrow cells and significant reduction in NORs at the 2 highest dose levels (150 and 200 mg/kg b.w.). Lead treated animals showed several specific chromosomal aberrations, mostly deletions in maternal bone marrow and fetal cells. Aneuploidy was found to be frequently associated with the lowest dose levels of lead nitrate (100 mg/kg). Maternal treatment with lead nitrate also significantly increased embryonic resorptions and reduced placental weights. The results suggest that the embryotoxic effects of lead might be associated with the chromosomal changes. PMID- 2767207 TI - Embryotoxicity and in vivo cytogenetic changes following maternal exposure to cadmium chloride in mice. AB - Cadmium is a well-known teratogen in laboratory animals and a widespread environmental pollutant. The frequencies of sister chromatid exchanges (SCEs), nucleolar organizing regions (NORs) and chromosomal aberrations were analysed in maternal bone marrow and fetal liver and/or lung cells of mice, following maternal treatment with cadmium chloride, on gestational days 8 through 10. The embryotoxic effects and morphological changes on day 18 fetuses were also studied. Cadmium chloride is readily transferred across the placenta and significant levels were detected in both the placenta and fetus. No significant changes in the frequencies of SCEs or NORs in maternal and fetal cells were observed following exposure to cadmium chloride. Fetal tissues showed mitotic inhibition at the highest dose levels (8.4 and 11.4 mg/kg, b.w.). Maternal treatment with cadmium chloride increased embryonic resorptions and fetal lethality, as well as reduced placental weight; however, it did not produce significant chromosomal changes except at the highest dose level (11.4 mg/kg). PMID- 2767208 TI - Histological and immunohistochemical findings in experimental rhabdomyosarcomas. Comparisons between original tumors, tumor recurrences and allotransplants in nude mice. AB - Cellular heterogeneity, a regular property of malignant neoplasms, can constitute the basis for phenotypic shifting in malignant tumors. A disturbance of the balanced interactions as happens as result of all therapy measurements between tumor cell subpopulations and between tumor and host offers the possibility to profound changes on the basis of cellular heterogeneity. As tumor model we used methylcholanthrene-induced murine rhabdomyosarcomas, which were allotransplanted into nude mice. The original as well as the allotransplanted sarcomas were submitted repeated operative tumor mass reductions, comparable to an insufficient tumor surgery in man. The histology and the cellular differentiation were evaluated by light microscopy and immunohistochemical marker expression (vimentin, desmin and myoglobin). Our findings document that primary tumors, their recurrences after incomplete tumor removal, and allotransplants inclusive of their surgically induced recurrences were histologically and immunohistochemically not identical in every case when compared with each other, but despite the experimental procedures they retained basic criteria necessary for the rhabdomyosarcoma diagnosis. Changes in sarcoma histology and cellular marker expression are not only reflected by dedifferentiation but can also comprise differentiation (maturation) processes. After artificial breakdown of intratumoral cellular interactions and tumor/host relations, unknown sarcoma inherent factors directed to retaining basic properties obviously preponderate, at least for the moment, over accidental new cell clones with differing phenotypic characteristics, which could be expected by cellular heterogeneity and would result in a markedly changed tumor. PMID- 2767209 TI - Production of bronchial papilloma with calcitonin-like immunoreactivity in rats exposed to urban ambient air. AB - In order to assess the effect of prolonged inhalation of polluted ambient air on the respiratory tract, 30 Sprague-Dawley rats were kept in facilities built close to a street with heavy traffic in the City of Yokohama for 18 months in an atmosphere of either filtered (filtered group) or non-filtered polluted ambient air (exposed group), and the histology of the lung was examined. Scattered areas of chronic inflammation were seen from the nasal to bronchiolar mucosae in both the groups. Rats which inhaled the urban ambient air showed deposition of dust particles in the alveolar space and the peribronchiolar tissue, but no deposition was recognized in the filtered group. In both the filtered and exposed groups, papillary hyperplasia showing a positive immunoreaction to calcitonin was noted in the bronchobronchiolar epithelium. The hyperplasia was thus shown to have endocrine differentiation and this was considered to be pulmonary endocrine cell hyperplasia. In the exposed group, 2 bronchial papillomas were induced, and were shown to contain cells giving a positive immunoreaction to calcitonin. A histogenetical sequence was suggested in these 2 lesions because of their histological and immunohistochemical similarities. PMID- 2767210 TI - Severe sublimate intoxication in the rat. Influence of thyroxine on renal enzymes of fatty acid degradation and on the survival rate of intoxicated rats. AB - 1. The influence of thyroxine pretreatment on prognosis and some renal enzymes of fatty acid degradation of mercuric chloride intoxicated rats was studied. 2. Survival rates as observed over 10 d after 1.5 to 6.0 mg mercuric chloride/kg i.p. were not influenced by thyroxine pretreatment. 3. A quarter of survivors of both groups developed renal hypertrophy more pronounced in animals not treated with thyroxine. 4. Fatty acyl-CoA oxidase, the rate limiting enzyme of peroxisomal beta-oxidation was found to be depressed by about 50% 2 d after intoxication. This effect was prevented by thyroxine pretreatment. The other enzyme activities (carnitine acetyltransferase, carnitine-palmitoyltransferase and crotonoyl-CoA dependent NAD+ reduction) are essentially not influenced neither by intoxication nor by thyroxine pretreatment. 5. It is concluded that the prognosis of the intoxication is not correlated with fatty acid degradation enzymes. PMID- 2767211 TI - Promotive effect of elastase on regression of aortic atherosclerosis in cholesterol-fed quails. AB - In order to test the anti-atherosclerotic function of elastase, 44 Japanese quails, 40 d of age, were used in this study. An atherogenic diet contained 15% corn oil and 2% cholesterol. Elaszym was orally administered at a dose of 6,000 EL units per kg body weight 3 times a week for 3 months. After 3 months feeding the atherogenic diet was discontinued. Moderate hypercholesterolemia and marked lipid-rich aortic lesions were noted in the group which was fed the atherogenic diet for 3 months. The thickened intima was composed of fibroblasts and alpha-1 anti-trypsin, S-100 protein, calmodulin and elastase were strongly demonstrated. Withdrawal of the atherogenic diet resulted in marked improvement of the serum cholesterol level, and slight reduction of the degree of the intimal thickening of the thoracic aorta. Elastase treatment after the withdrawal of atherogenic diet induced significant regression of the aortic lesions of the thoracic aorta. These results suggest that Elaszym possesses the promotive effect on regression of atherosclerotic lesions. PMID- 2767212 TI - Tissue culture and experimental carcinogenesis. PMID- 2767213 TI - Light and scanning electron microscopic investigation of the laryngeal mucosa of Syrian golden hamsters. AB - The laryngeal epithelium of Syrian golden hamsters (SGH) at 8, 12.5 and 17 months was studied by scanning electron microscopy (SEM) and light microscopy (LM). Stratified squamous epithelium, covered with shallow microvilli or microplicae, was observed covering the upper two-thirds of the laryngeal epiglottis, the false folds, the vocal cords and the luminal protrusions of the arytenoid cartilages. Pseudostratified respiratory epithelium, characterized by mucus producing cells with microvilli and ciliated cells, covered the base of the epiglottis and the entire subglottis. Transitional zones between squamous and respiratory epithelium were composed of stratified cuboidal epithelium. Towards the base of the epiglottis cuboidal cells with a relatively large surface area were present which displayed short surface microvilli, while cells with a small surface area were covered with long microvilli. Age related changes were not observed. Degenerative changes of submucosal glands or cartilages occurred in almost every animal, but no epithelial lesions were found. The findings confirm a low incidence of spontaneous metaplasia in the laryngeal epithelium of the SGH. PMID- 2767214 TI - Spontaneous lesions in the respiratory epithelium of the Syrian golden hamster as seen by scanning electron microscopy. AB - The respiratory epithelium of 8, 12.5 and 17.5-month-old Syrian golden hamsters was investigated by scanning electron microscopy (SEM) and routine light microscopy (LM) of paraplast sections. In selected cases, SEM-specimens were embedded in Epon after SEM evaluation. The samples were cut in semithin sections and examined by light microscopy. The density of ciliated cells in the respiratory epithelium differs from hamster to hamster. Care must, therefore, be taken when diagnosing simple metaplasia by SEM alone unless a sufficient number of damaged cilia are present. Only 1 animal (8 months old) exhibited squamous metaplasia of the tracheal mucosa. However, surface polymorphism resembling squamous metaplasia was seen in almost every specimen. The polymorphism was caused by either submucosal calcifications or by cystic changes of hypertrophic submucosal glands. In addition, variously formed aggregations of mucus were seen protruding from duct openings of hypertrophic submucosal glands. To avoid false positive or negative diagnosis which can occur when screening is done by SEM alone, light-microscopical examination of sections cut from SEM identified lesions appears necessary. PMID- 2767215 TI - Quantitation of oil red O staining of the aorta in hypercholesterolemic rats. AB - A technique is described which provides morphologic and quantitative data on the amount of oil red O (ORO) staining in thoracic aortas of rats fed a high cholesterol diet. Samples are stained with ORO, the dye is extracted, and the concentration of ORO in the extract is measured colorimetrically. Wistar rats fed ad libitum either standard chow (control group: n = 15) or chow supplemented with 4% cholesterol, 1% cholic acid, and 0.5% thiouracil (CCT group: n = 23) were maintained on these diets for 1, 3, 6, 9, or 12 months. Plasma cholesterol levels averaged overall 87 and 737 mg/dl for the control and CCT groups, respectively. Animals were killed under anesthesia by perfusion fixation with formalin or glutaraldehyde, and samples of thoracic aorta were stained with ORO. After microscopic study en face and measurement of surface area, the ORO was extracted in chloroform-methanol (2:1). Concentrations of ORO (microM) were determined from a standard curve and expressed as microM/mm2 of aorta. Aortas of CCT animals showed progressive diet- and time-dependent increases in the amount of ORO staining compared to controls. We conclude that this method yields reliable quantitative data applicable to studying atherosclerosis in small animals. PMID- 2767216 TI - Immunoelectron-microscopic demonstration of elastase in emphysematous lungs of tight-skin mice. AB - The tight-skin (Tsk) mouse has recently been proposed as a genetic model of emphysema. A morphometric study has shown that emphysema develops quickly, between 15 days and 1 month after birth. Previous biochemical and ultrastructural investigations of the lungs of 1- and 2-month-old Tsk mice revealed the presence of an ongoing elastolytic process. The goal of the present study was to investigate the role of mouse leukocyte elastase (MLE) in the development of emphysema in 1-month-old Tsk mice. Using electron microscopy and an immunogold labeling technique with rabbit anti-MLE IgG, MLE was localized within the lung neutrophils of control and Tsk mice. MLE was also found associated with elastin in the alveolar septa of Tsk but not of control mice. Little or no labeling was associated with other components (collagen, pneumocytes, and endothelium) of alveolar septa of Tsk mice. Lung elastin of control mice, or of control mice rendered emphysematous with porcine pancreatic elastase, showed negligible gold particle density when incubated with gold-conjugated rabbit IgG. Thus, under the present experimental conditions, an aspecific labeling of elastin is unlikely. This study indicates that MLE may be one of the factors responsible for the rapid development of emphysema in Tsk mice. PMID- 2767217 TI - Prevention of hepatotoxic responses to chemicals by glycyrrhizin in rats. AB - To clarify whether glycyrrhizin, the aqueous extract of licorice root and a drug for treatment of chronic active hepatitis, prevents the development of hepatic injury induced by carbon tetrachloride, allyl formate, and endotoxin, the present study was undertaken in rats. The treatment with glycyrrhizin 20 hr before carbon tetrachloride administration protected the development of the pericentral hepatocellular necrosis. Glycyrrhizin treatment 2 hr prior to the administration of allyl formate also inhibited the development of the periportal hepatocellular necrosis. However, glycyrrhizin did not protect the development of endotoxin induced focal and random hepatocellular necrosis. These experimental results suggest that glycyrrhizin has no protective effect on hepatic injury following sinusoidal circulatory disturbance as seen in the case of endotoxin and that glycyrrhizin can protect against hepatotoxicity induced by the direct action on the hepatocytes due to hepatotoxins, such as carbon tetrachloride and allyl formate. PMID- 2767218 TI - Propranolol-induced changes in the catecholamine-containing cells and vesicles of SHR sympathetic ganglia. AB - The ultrastructural effects of long-term propranolol administration on the catecholamine-containing (CC) cells of cervical sympathetic ganglia were studied in spontaneously hypertensive rats. After 2 months of propranolol administration, there were hydrops of mitochondria, together with swelling and vesiculation of Golgi complex and rough endoplasmic reticulum. Such swollen organelles seemed to coalesce with each other, resulting in transformation of major parts of the cytoplasm into large membrane bound saccules. In that group of animals, the number of CC vesicles showed a significant decrease (P less than 0.025) compared to the control. Moreover, such vesicles looked more electron dense, with decreased electron-lucent haloes compared to the control. Blood pressure recording via rat tail cuff showed a significant drop (P less than 0.0001) of the mean systolic blood pressure in the treated animals. One month after stopping propranolol administration, resorption of the cytoplasmic saccules occurred, but the cytoplasm looked lighter and lost its granular appearance. The mitochondria regained their normal shape, though they appeared fewer in number. The CC vesicles were significantly reduced in number (P less than 0.001) and were less electron dense compared to the control. The possible implications of these findings on the mechanism of action of propranolol as an antihypertensive agent are discussed. PMID- 2767219 TI - Intrinsic focal variations of rabbit aortic hydrolase activities. AB - Normal arterial foci which take up Evans blue dye (EBD) in vivo are believed to represent atherosclerosis-prone, hemodynamically stressed foci compared to areas which exclude dye. We have used the rabbit EBD model to examine focal aortic hydrolases of blue areas versus white areas, and we report herein significant focal variations of hydrolase activities. Enzymes measured included neutral alpha glucosidase, N-acetyl-beta-glucosaminidase, alpha-mannosidase, acid alpha glucosidase, beta-galactosidase, beta-glucuronidase, cathepsin C, and acid cholesteryl esterase (ACE); specific activities were expressed on the basis of tissue DNA. In correlative areas of EBD uptake in normal rabbit aortic arch, ACE activity averaged 17% higher and cathepsin C activity averaged 37% lower than activities of areas free of EBD in the descending thoracic aorta (P less than 0.02). None of the glycosidases studied differed significantly between blue and white aortic areas. These findings indicate that discrete, intrinsic differences of hydrolytic enzyme activities exist in the normal rabbit aorta in areas delineated by in vivo EBD uptake, areas recognized as lesion-prone vs lesion resistant. PMID- 2767220 TI - Immunologic memory induced at birth by immunization with inactivated polio vaccine in a reduced schedule. AB - One hundred forty-one healthy newborns were immunized 24 hours after birth with one dose of inactivated polio vaccine (IPV) of enhanced potency. Following the administration of a second vaccine dose six months later, a considerable proportion of babies responded with neutralizing antibody (NA) to the three poliovirus types. The very rapid occurrence and high antibody titer were indicative of an anamnestic response. Twenty-one infants who still had NA less than 1:4 to one-more poliovirus types after the second vaccine dose responded with very high NA values 7-10 days after a supplementary dose of IPV. It appears that IPV of enhanced potency administered at birth is apt to induce immunologic memory, which should provide the basis for protection against paralytic poliomyelitis in case of exposure to wild poliovirus later in life. PMID- 2767221 TI - Mechanisms of macrolide resistance in Ureaplasma urealyticum: a study on collection and clinical strains. AB - Ureaplasma urealyticum is considered as a species which is intrinsically sensitive to macrolides (MIC less than 1 microgram/ml). Nevertheless, some of the strains recently isolated in our laboratories showed moderate to high levels of resistance (MICs ranging from 2 micrograms/ml to 100 micrograms/ml). In particular, a strain (CT28) isolated from a patient with nongonococcal urethritis long treated with erythromycin revealed a MIC greater than 100 micrograms/ml for this antibiotic. In order to investigate the mechanisms of resistance, strain CT28 and ten clinical and laboratory U. urealyticum strains were compared for the sensitivity to six antibiotics including three macrolides. Moreover the amount of macrolide uptake and the specific antibiotic binding to ribosomes were studied. Strain CT28 was resistant to josamycin, erythromycin, roxithromycin, lincomycin and clindamycin but sensitive to minocycline. When compared to a sensitive strain, strain CT28 showed a six-fold reduction in intracellular macrolide influx and accumulation and a reduction in antibiotic binding to ribosomes. The mechanisms implicated in these differences may be important for macrolide resistance in U. urealyticum. PMID- 2767222 TI - Extrapulmonary tuberculosis in a university hospital in Spain. AB - Pulmonary tuberculosis in Europe has been decreasing over the last decades. This study evaluates the current importance of extrapulmonary tuberculosis and its trend over the last 10 years. In a University Hospital in Spain, 20% of all bacteriologically confirmed tuberculosis cases were extrapulmonary. The most frequent site was the urinary tract (73.5%). Ziehl-Neelsen staining was positive in 50.6% of the cases. Lowenstein-Jensen cultures became positive, on average, after 4.6 +/- 1.4 weeks. The proportion of extrapulmonary tuberculosis among the total number of tuberculosis cases has steadily increased trend over the period of observation. PMID- 2767223 TI - Evaluation of seroepidemiological associations between HIV-infection, hepatitis B and other sexually transmitted diseases in African patients. AB - To assess the possible role of sexually transmitted diseases as cofactors for the spread of AIDS, 248 adult patients were tested for the presence of antibodies against human immunodeficiency virus (HIV), hepatitis B virus (HBV) and syphilis. The survey was conducted in a hospital at Kagondo, Kagera Region, Northwest Tanzania, Africa. Subjects were randomly chosen from the outpatient clinic to include those with and without sexually transmitted diseases, as well as AIDS/pre AIDS patients. The data were univariately and multivariately analysed by linear logit models, including interactions of demographic parameters. The results obtained reveal a strong association between the presence of antibodies against HIV, syphilis and HBV, respectively. The HBV/HIV-correlation remained stable in the multivariate analysis including interactions of social parameters, in contrast to the syphilis/HIV-correlation. We assume that this reflects the lower virulence of HBV as compared to that of syphilis. The prevalence of anti-HBV antibodies seems to be a more reliable marker for high sexual activity than those against syphilis. The possibility that HBV and HIV act as cofactors for each other's transmission could not be ruled out. PMID- 2767224 TI - Community control of hypertension at the worksite in a metallurgical factory: results of 1-year follow-up. AB - This study was designed to assess advantages and cost-effectiveness of community control of hypertension at the worksite in a metallurgical factory in Pavia. Under consent of managers and trade-unionists, a screening program was undertaken. 2701 subjects (95% of the total number of employees) were screened: 277 (10.2%) were hypertensive, 101 (38%) did not know to be hypertensive, 56 (22%) knew to be hypertensive but they were untreated and only 20 (8%) of those under treatment were adequately treated. Of the 277 essential hypertensives, 262 (94%) adhered to the program. They were assigned to beta-blocking or diuretic treatment following WHO rules. Then an aggressive follow-up was started (the hypertensives were periodically called to control at the worksite). 257 (98%) were participants 1 year later. Our worksite hypertension control program allowed us to identify many cases of undiagnosed or untreated hypertension and to start an early treatment. One year after entry, the percentage of hypertensives achieving a normal blood pressure (85%) was almost twice as that obtained by conventional clinical approach employing the same type of treatment. Besides, more than 95% of hypertensives remained under control at 1 year. Regarding the costs, it is difficult to generalize, but our study suggests that, if there is the will, it is possible to realize programs of hypertension community control at a very low cost (in our experience: 43 dollars per hypertensive per year). PMID- 2767225 TI - Deaths in winter: can Britain learn from Europe? AB - There is a substantial increase in the number of deaths in winter in the United Kingdom. This is also seen in some, but not all, European countries. Almost 60% of the variation among countries can be explained by the minimum average monthly temperature and the gross national product per capita. Seasonal variation is lowest in those countries with cold winters, suggesting that insulation may be important. It is also low in the more wealthy countries. The implications for health service policy of these finding are discussed. Some of the residual variation may be explained by known factors, such as low cost geo-thermal energy in Iceland, but much remains unexplained. There is a need for more research in this field. PMID- 2767226 TI - Curative and preventive treatment of uncomplicated malaria in public health institutions in Cameroon. AB - Chloroquine-resistant Plasmodium strains are found in certain foci in Cameroon. We do not know what contribution drug prescriptions and drug pressure had in bringing this about. We contacted 66 persons (39 doctors and 27 nurses) who prescribe antimalarial drugs in Cameroon regarding their prescription habits; 46 (69.7%) responded. The three most prescribed drugs for uncomplicated malaria were quinine (84.4%), chloroquine (80.4%) and amodiaquine (80.4%). The most common reason for prescribing the drugs was availability. The drug of choice for the treatment of uncomplicated malaria was chloroquine with amodiaquine and quinine being second best for doctors and nurses, respectively. The form of treatment preferred by most doctors (ie 46%) was tablets while most nurses (42%) preferred injections. Prophylatic antimalarials were prescribed by 73% of the doctors and by 83% of the nurses. Doctors prescribed mainly to children and pregnant women while nurses prescribed to everyone. The drugs used were chloroquine, amodiaquine, quinine and pyrimethamine. Ten doctors and four nurses had encountered at least one case of drug resistant malaria. The most common evidence on which the diagnosis had been based was the absence of improvement on the treatment prescribed. The implicated drugs were chloroquine, amodiaquine and quinine. There was evidence of major differences in the practice of the respondents regarding treatment, prophylaxis and the diagnosis of drug resistance. These results indicate an urgent need for a national antimalarial drug policy in Cameroon. PMID- 2767227 TI - Prevalence of Streptococcus mutans and dental decay in school children from Siena (Italy). AB - Epidemiological indexes of dental decay and prevalence of Streptococcus mutans in dental plaque were studied in a group of 255 schoolchildren aged 6-11 from a suburban area near Siena (Italy). Mutans streptococci were isolated from 17.4% of subjects: a significant correlation with dental decay indexes and with the presence of active caries was observed. PMID- 2767228 TI - Prevalence of dental caries in school children of the province of Granada (Spain). AB - A sample of 3,347 students between 5 and 14 years of age was selected from the entire student population in the province of Granada (Spain) to study the prevalence of dental caries and several risk factors for the disease. Decay was ascertained in the study population by means of the following indices: df, DMF, and DMFS. Risk factors considered were the level of oral hygiene, number of between-meal sugar-containing food, and flouride concentration in drinking water. The indices mentioned showed a clear relationship to the age of the participants in the study. The level of oral hygiene did not show a clear association with dental caries measured through the df and DMF indices. Curiously, a higher correlation was noted between the disease in deciduous teeth and fluoride concentration than between the disease in permanent teeth and the latter factor. PMID- 2767229 TI - Hepatitis B virus infection in children in Sardinia, Italy. AB - Possible hepatitis B immunization of all newborns, regardless of the mother's HBsAg status, is a strategy under consideration for selected hyperendemic areas in Italy. Sardinia is one such area. However, in 1987 in Sardinia, the prevalence of hepatitis B markers in children under 11 years was estimated at 1.7% and the prevalence of hepatitis B surface antigen (HBsAg) at 0.2%. A much higher prevalence of HBsAg was recently observed among adults in this area: 8.7% among men and 5.2% among pregnant women. This contrasting pattern is unlikely to be due to bias: the sampling procedures adopted were appropriate and the percentage of refusals was very low (2.2%). The observed low hepatitis B marker prevalence in young age groups might be the result of a cohort effect due to the improved socio economic conditions and changes in behaviour that have occurred in Sardinia over the last few years. The finding of only 3 HBsAg+ individuals out of 1,826 children tested, in spite of the 5.2% HBsAg prevalence among pregnant women in that region, is probably attributable to the low proportion of HBeAg positive individuals among the HBsAg+ carrier mothers in this area. At present, immunization of all newborns in Sardinia cannot be recommended. PMID- 2767231 TI - A serological survey of toxocariasis in patients and healthy donors in Barcelona (Spain). AB - The ELISA test, using excretory-secretory antigen from larvae II of Toxocara canis, was applied on 1018 sera (793 from adults and 225 from pediatrics) distributed in: A) patients with an hypereosinophilia where the ethiological agent was undetermined (99); B) patients with ocular complaints compatible with an ocular toxocariasis (116); C) patients with hidatidosis (97); D) patient with other non-toxocaral helminthiasis (34); E) patients with other clinical features (468) and F) healthy donors (204). Over 3,6% of sera showed elevated levels of antibodies reacting with T. canis antigen. The prevalence of seropositivity was statistically higher in patients with eosinophilia (14,1%) (a less than 0,001) and ocular complaints (6%) (0,025 greater than alpha greater than 0,01) than in the control group (1%). In the overall seropositivity from pediatrics did not differ from that of the adults. PMID- 2767230 TI - Influenza vaccination in elderly residents in nursing homes: immune response to trivalent and monovalent inactivated influenza virus vaccine in the season 1986 87. AB - Immune responses to trivalent inactivated whole virus and monovalent subunit influenza vaccines, used in the season 1986-87, were analyzed in elderly residents in nursing homes. Higher levels of induced antibody were found in the group receiving two doses of trivalent vaccine. This suggests that high risk aged patients should receive a booster dose of vaccine annually. The antibody response to administration of supplemental vaccination, using monovalent subunit preparation, did not reach the high level of antibodies found following trivalent influenza vaccine. PMID- 2767232 TI - Hepatitis B virus infection among health care workers at an urban teaching hospital in southern Italy: a low occupational hazard? AB - A prevalence study of HBV serologic markers was carried out among hospital employees of ten departments of the Second School of Medicine in Naples, an urban area with a high prevalence of HBV infection. Departments and occupational categories were selected to represent a spectrum of different exposure to B virus infection. Workers in a large electronic plant in the same geographical area were screened as controls. HBsAg prevalence was 4.8% in the hospital community and 4.0% in control group. It rises to 4.3% in the Campania Region, where all screened workers live, and in some specific areas of the same region it rises to 12%. But no significant difference among seropositivities for at least 1 marker of HBV, considered to be a better indicator of occupational hazard, was found among personnel of different departments or belonging to different occupational categories. None of the occupational and non-occupational risk factors studied was found to be significantly associated with HBV infection. Two years later, an incidence study was carried out among susceptible subjects. Seropositivity for 1 marker was 2.2% among hospital workers and 2.8% in the control group. These figures are lower than the annual attack rate (5%) required for an acceptable cost-benefit ratio of vaccination against hepatitis B. Our results indicate that in a geographical area with HBV endemicity the occupational hazard for B virus infection is low in hospital workers because of the high number of the high number of immunized subjects and the contacts with infected people out of the hospital. PMID- 2767233 TI - Is natural infection with M. tuberculosis protective against cancer? AB - In order to investigate the effect of natural infection with M. tuberculosis on cancer incidence, a case-control study was undertaken on 108 recently diagnosed cancer cases (all sites) and 317 controls. After removal of cancer cases or controls considered immunoincompetent (25% and 17% respectively), the remaining subjects were tested by intradermal injection of tuberculin (5 I.U.). Results were compared separately for each sex. It was observed that the proportion of tuberculin-negative subjects was higher in cancer patients than in controls within each sex (males 31.3% vs 20.1%, females: 59.2% vs 37.3%) the difference in females being statistically significant (p less than 0.02). Odds ratio for negative tuberculin test was 1.80 and 2.44 for males and females respectively. The results are discussed on the basis of cell-mediated immunity produced by infection with M. tuberculosis and its relations with tumor growth. PMID- 2767234 TI - Fungal air-borne spores as health risk factors among workers in alimentary industries. AB - A survey to evaluate the occurrence of air-borne fungal spores in two different food industries, dairies and bakeries, was conducted. Our data revealed considerable fungal pollution in the environments of both industries, as well as some differences in the distribution of the genera of fungi recovered. Noteworthy was the frequent finding of numerous fungi frequently responsible for allergic rhinitis, asthma and other diseases, or well-known for their production of mycotoxins in foods or characterized by their degradative activity against various substances. Aspergillus, Candida, Fusarium, Geotrichum, Mucor and Penicillium were the most common genera identified in dairies while Alternaria, Aspergillus, Botrytis, Candida, Cladosporium, Penicillium and Saccharomyces occurred more frequently in bakeries. The survey showed that fungi can play a significant role in allergic and non-allergic diseases in modern working environments. PMID- 2767236 TI - Abstracts of the scientific symposium on birth defects monitoring programmes and registries: their uses for epidemiologic research. Strasbourg, September 23, 1988. PMID- 2767235 TI - Inequity in health. A case study. AB - This article presents a particular case of inequity in health, that of two types of Israeli urban settlement: development towns and veteran towns. Inequity in health is demonstrated by the varying levels of resources allocated to each type of community, by the differences in health-care utilization (process), and by the diversity of external factors affecting the two categories of towns. Despite the existence of almost universal health insurance coverage in Israel, it is shown that inhabitants of less privileged development towns are more prone to inequitable health outcomes with respect to the wealthier populations living in veteran towns. This case illustrates an integrated approach to inequity in health, including the health-care system structure, utilization patterns, and the socio-demographic-economic background of different strata. PMID- 2767237 TI - Absence of antibodies to HIV in long term institutionalized psychiatric patients. PMID- 2767239 TI - Prognostic significance of peripheral blood S + G2/M phase size in adult acute non-lymphoblastic leukaemia. AB - Flow cytometric analysis of peripheral blood (PB) S + G2/M phase size was performed in 73 adult patients with untreated acute non-lymphoblastic leukaemia, to assess whether the results may correlate to response rate and patient prognosis. All patients were treated with the same induction chemotherapy regimen: ARA-C alone or in combination with an anthracycline antibiotic. Pretreatment PB S + G2/M phase size is significantly correlated to induction response rate (p less than 0.02), duration of response (p less than 0.02) and duration of survival. Patients with low PB S + G2/M phase size experience a longer survival, in patients over and below 50 yr (p less than 0.001). Lastly, early deaths tend to be more frequent in the high median age and high PB S + G2/M phase size group. Our study suggests that PB S + G2/M phase size has prognostic significance in obtaining response and duration of survival. PMID- 2767238 TI - Behenoyl cytosine arabinoside, aclacinomycin A, 6-mercaptopurine, and prednisolone combination therapy for acute non-lymphocytic leukaemia in adults. AB - 38 consecutive, previously untreated adult patients with acute non-lymphocytic leukaemia (ANLL) were treated with BHAC-AMP (N4-behenoyl-1-beta-D arabinofuranosyl-cytosine, aclacinomycin A, 6-mercaptopurine, and prednisolone) therapy between March 1980 and February 1985. 25 patients (65.8%) achieved complete remission (CR). Median CR duration and median survival of patients who achieved CR were 14, and 24 months, respectively. The Kaplan-Meier analysis revealed a probability for remaining in CR of 18.0% at 5 years. Analysis of failure cases revealed that most of them were due to resistant disease. Major toxicities were infection, diarrhoea, liver dysfunction, nausea and vomiting but these were acceptable. The results indicate that BHAC-AMP therapy is comparable to the regimen with daunorubicin and cytosine arabinoside and a further clinical trial is necessary for previously untreated adult patients with ANNL. PMID- 2767240 TI - Antibodies to platelet membrane glycoprotein antigens in three cases of infectious mononucleosis-induced thrombocytopenic purpura. AB - Infectious mononucleosis may occasionally be complicated by purpura, but the mechanism of the thrombocytopenia is not known in detail. In the present study, 3 children with mononucleosis-associated purpura were found to have marked elevations of platelet-associated immunoglobulins and circulating platelet binding IgG and IgM. Employing electrophoretically (SDS-PAGE) separated normal platelet membrane proteins in an immunoblot assay, serum IgG and IgM antibodies were found to be directed to antigenic determinants situated on glycoprotein GP IIb (140 kDa) in all patients, but also on smaller proteins of molecular weights between 30 and 52 kDa. 24 control sera were negative. Positive reactions were eliminated after absorption of sera with fresh platelets. These results demonstrate autoantibodies to platelet surface membrane proteins in infectious mononucleosis-induced purpura and suggest a transient autoantibody-mediated platelet destruction as the cause of thrombocytopenia in these patients. PMID- 2767241 TI - Preferential localisation of red cell vacuoles to pathologically shaped human red blood cells. AB - The percentage of pitted erythrocytes and Howell-Jolly bodies in peripheral blood samples of 51 individuals following posttraumatic splenectomy and 20 patients splenectomized because of various haematological diseases differed significantly from each other (p less than 0.001) and from that of healthy controls (p less than 0.001). The percentage of pitted erythrocytes was significantly higher in pathologically shaped red blood cells (RBCs) (acanthocytes, schizocytes, elliptocytes) than in normal discoid shaped RBCs (p less than 0.001). As the number of pits per RBC showed great individual variations, a scoring system for the evaluation of pitted RBCs is proposed. PMID- 2767242 TI - Antibody response to pneumococcal vaccine in patients with early stage Hodgkin's disease. AB - Antibody response to pneumococcal vaccination was studied in 76 patients with Hodgkin's disease (HD) before, during and at different time intervals after cessation of therapy. All patients were in pathological stage I and II following explorative laparatomy with splenectomy. The increase in antibody response was compared to the findings in 12 healthy volunteers with the aim of establishing the optimal time for vaccination. Serum antibodies against 6 of the pneumococcal polysaccharide antigens (types 1, 4, 7F, 14, 18C and 23F) contained in the vaccine were determined by an ELISA. Antibody response to pneumococcal type antigens was similar in healthy adults and in patients with early stage HD before therapy. After treatment, postvaccination antibody response became negligible. Even up to 7 years after cessation of therapy patients were not able to raise a significant antibody response. PMID- 2767243 TI - The splenomegaly of myeloproliferative and lymphoproliferative disorders: splenic cellularity and vascularity. AB - Employing radionuclide scanning, the volume of the spleen, its red cell pool and plasma pool have been measured in vivo, and the relative proportions of cellularity and vascularity of the spleen have been calculated in 51 patients with myeloproliferative and lymphoproliferative disorders. In primary proliferative polycythaemia (polycythaemia vera), the increase of spleen size was attributed mainly to the increase of splenic vascularity; in myelofibrosis and in hairy cell leukaemia, the increase of spleen size was associated with increase in both splenic vascularity and cellularity, whilst in CGL and CLL the increase was attributed more to cellularity than to vascularity. PMID- 2767244 TI - Increase of NK cell-mediated cytotoxicity of hairy cell leukemia patients after splenectomy. PMID- 2767245 TI - Infectious mononucleosis complicated by severe immune hemolysis. PMID- 2767246 TI - Enhancement of amyloidosis by high-dose prednisolone therapy in multiple myeloma. PMID- 2767247 TI - Chromosomal abnormalities in Sezary's lymphoma. PMID- 2767248 TI - The usefulness of the R-100 automated reticulocyte counter in a clinical hospital laboratory. PMID- 2767249 TI - Steroid-resistant immune thrombocytopenia of pregnancy: successful treatment using prolonged high-dose intravenous immunoglobulin. PMID- 2767250 TI - Exposure of infants and children to lead. Working document for the 30th meeting of the Joint FAO/WHO expert committee on Food Additives held in Rome, 2-11 June 1986. PMID- 2767251 TI - Street foods. Report of an FAO Expert Consultation, Jogjakarta, Indonesia, 5-9 December 1988. PMID- 2767252 TI - Collateral compensation of severe carotid stenosis. AB - In 516 patients who had endarterectomies for unilateral severe carotid stenoses, arteriography demonstrated no contralateral severe stenoses or occlusions. Pre and postoperative ocular pneumoplethysmography (OPG-Gee) measured simultaneous bilateral ophthalmic systolic pressures (OSP). Immediately after each OPG test a brachial systolic pressure (BSP) was measured with a stethoscope, cuff and manometer. Bilateral ophthalmobrachial systolic pressure (OBSP) indices were calculated from the three pressures measured with the combined testing. Analysis of these OBSP data indicates that the severe stenoses were relatively well compensated in 314 of the 516 patients (61%) whereas there was limited collateral compensation in the remaining 202 patients (39%). The data also suggest that the latter group incurs a greater element of compensatory central hypertension, which is reversed by carotid endarterectomy. PMID- 2767253 TI - Infections and antibiotic prophylaxis in reconstructive vascular surgery. AB - In 98 patients undergoing elective vascular surgery, specimens for bacterial cultures were obtained from urine, ischaemic ulcers, incisional wounds and the implanted grafts. Wound and graft infections were registered and compared with the results of these cultures and suspected risk factors in an attempt to find the source of infections. Antibiotic prophylaxis with cefuroxime was given for 24 h beginning at the start of surgery. Patients with ischaemic ulcers also received "spread prophylaxis", directed against isolated bacteria, for ten days. Three cases of graft infection and twelve cases of wound infection occurred. Positive postoperative cultures from wounds did not correlate with pre- or peroperative cultures. Peroperative cultures revealed small numbers of staphylococcus epidermidis in eleven patients, and none of them developed graft infection. Ischaemic ulcers, diabetes or re-do procedures were not accompanied by a significantly increased frequency of wound or graft infection, although each of three patients with graft infection had one of these risk factors. Bacteria, sensitive to cefuroxime, were found in one graft infection, six wound infections, and in two patients with urosepsis, whereas cefuroxime resistant organisms were isolated from one graft infection and three infected wounds. One of the three graft infections was probably caused by bacteria originating from the patient's ischaemic ulcer. In the other two patients the source of bacteria could not be determined. Cefuroxime seems to be an adequate alternative for prophylaxis of vascular graft infection, but in some patients with bacteriuria or indwelling catheters, a one day regimen may be too short. PMID- 2767254 TI - Fibre loss and distribution in skeletal muscle from patients with severe peripheral arterial insufficiency. AB - Cross-sections of whole calf muscles (m soleus and m gastrocnemius) were obtained from five previously clinically health individuals who had died accidentally (controls) and from amputated legs of five patients of similar age with severe peripheral arterial insufficiency. In the controls, but not in the patients, a characteristic distribution of different fibre types over the entire cross sections was found, with a relative increase in number of (slow twitch) type 1 fibres in the central parts of both m soleus and m gastrocnemius. A pronounced neuromuscular pathomorphology was found in the patients, especially in m gastrocnemius. The findings suggested widespread damage to the fibres. There was also a lower total number of fibres in these ischaemic muscles; about 50% of the fibres of m gastrocnemius seemed to have disappeared. The results suggested that the relative inactivity as such may be responsible for some of the structural changes, above all the dedifferentiated distribution of different fibres over the cross-section. However, repeated acute and chronic subacute ischaemia may also cause, in the long term, irreparable damage and loss of many individual fibres. This may explain why muscles of patients with peripheral arterial insufficiency are also weaker, during single contractions. The lack of corresponding muscular atrophy in these patients seems to a large extent to be explained by an increase in connective tissue. PMID- 2767256 TI - Morbidity and mortality in acute lower limb ischaemia: a 5-year review. AB - A series of 204 consecutive patients with acute lower limb ischaemia was treated over a 5-year period in a Regional Vascular Unit. The mean age was 70 years, with a range of 41-98 and a female to male ratio of 1:0.94. Eighty-eight percent were treated by operation. Twenty-one had simultaneous vascular reconstructive procedures. Fifty-three patients died within 30 days (mortality rate 26%), and 12 required major amputation. Of these, four died resulting in a limb salvage rate of 95% in the survivors. An analysis of factors affecting outcome has shown increasing age, level of occlusion, recent myocardial infarction, pre-existing peripheral arterial disease and cardiopulmonary functional class to be major determinants of morbidity and mortality. PMID- 2767255 TI - High density lipoprotein cholesterol and arteriography in intermittent claudication. AB - Overnight fasting plasma lipoprotein and lipid concentrations were measured in a group of 76 patients with peripheral arterial disease (PAD)--main symptom: intermittent claudication--and compared to those of 21 controls, matched with the patients according to age, sex, body-mass index, alcohol and tobacco consumption, but without any signs of peripheral arterial disease. Significantly lower median values of high density lipoprotein cholesterols (HDL-C) (P less than 0.01), and significantly higher median values of low density lipoprotein cholesterols (LDL C) (P less than 0.05) were found in the PAD group. The results also showed significantly lower ratios of HDL-C/LDL-C and HDL-C/total cholesterol in the PAD group when compared to the controls (both P less than 0.005). No significant differences were demonstrated concerning very low density lipoprotein, total cholesterol, or triglyceride plasma concentrations. Evaluation of arteriograms showed a significant negative correlation between HDL-C concentrations and the extent of arteriosclerotic lesions in the lower extremities (P less than 0.05). Thus, not only were the HDL-C and LDL-C levels different in the PAD group, but we also found a correlation between HDL-C and the severity of vascular disease. PMID- 2767257 TI - The value of skin temperature measurements in forecasting the healing of a below knee amputation for end-stage ischaemia of the leg in peripheral vascular disease. AB - In order to forecast the healing of a Burgess type below-knee amputation the skin temperature of the leg has been studied before operation in 39 instances using infra-red thermography in a 26 degrees C environment. Healing bore no relation to the mean skin temperature of the calf or that of the skin at the site of the anterior incision. However, when the skin temperature at the site of the incision for the long posterior flap was greater than 30.4 degrees C or when the ratio of the temperatures at the posterior and anterior incision sites (P/A) was greater than 0.98 healing was significantly more likely to occur. It is proposed that the temperatures at these sites should be used to assess the prospect of such an amputation healing. PMID- 2767258 TI - Is extracorporeal shock wave lithotripsy safe in patients with calcific arterial disease? AB - In an experimental model using calcified aortic and iliac vessels ex vivo it has been shown that extracorporeal shock wave lithotripsy (ESWL) does not produce radiologically detectable damage to the vessel wall using the treatment regimen required to destroy renal calculi in vivo. The wall of aneurysmal vessels differ in being both calcified and expanded, and whilst anecdotal evidence suggests that lithotripsy of these too may be safe, experimental evidence is not yet available. PMID- 2767259 TI - Cystic myxomatous degeneration of the right common and external iliac artery. PMID- 2767260 TI - Individual actions to improve nursing's image: a step toward surpassing tomorrow's expectations. PMID- 2767261 TI - Overtime: a professional responsibility? PMID- 2767262 TI - Aortic valvuloplasty: medical and critical care nursing perspectives. AB - Aortic valvuloplasty, an investigational alternative to valve replacement, is explained from the perspectives of a nurse in a cardiac catheterization laboratory, a nurse in a coronary care unit, and a cardiologist. A case study is presented along with a plan of care developed around three nursing diagnoses. A prevalvuloplasty nursing diagnosis includes a teaching plan to assist nurses in preparing patients for aortic valvuloplasty. PMID- 2767263 TI - Letter to families: effective public relations strategy. PMID- 2767264 TI - Legal issues in nursing. Nursing negligence. PMID- 2767265 TI - Family member perceptions of a cardiac surgery event. AB - The findings from this study reveal that family members have many perceptions related to the stress of a cardiac surgery event. It is essential for nurses to have knowledge of family member perceptions if they are to have therapeutic interactions with family members and have a basis on which to plan nursing care. Therapeutic interactions will be less stressful for the nurse and will result in improved quality of nursing care for both the patient and the family. PMID- 2767266 TI - Collaboration benefits critically ill patients. PMID- 2767267 TI - AACN position statement: use of nursing support personnel in critical care units. PMID- 2767268 TI - [The morphogenetic function of neuropeptides]. AB - Morphogenetic effects of neuropeptides on the regeneration of planarians and the development of grain beetle larvae, were investigated. Macromorphological parameters and the proportions of planarian body were estimated using the technique of vital computer morphometry; the weight and moulting intensity changes were measured in larvae. Vasopressin, dalargin, somatostatin and hydra activator (morphogen) activated, sleep-inducing peptide exerted no effect, and LH RH inhibited the planarian regeneration. The hydra morphogen and LH-RH stimulated normal development of grain beetle larvae. The dose- and structure-dependent action of neuropeptides on the morphogenesis were similar to those related to other physiological functions. PMID- 2767269 TI - [The role of the brain monoaminergic systems in the anti-alcohol action of dermorphin and the delta-sleep peptide]. AB - The effects of dermorphin and DSIP were studied in male Wistar rats chronically treated with ethanol. Both peptides (200 mg/kg, i. p., daily during 10 days) significantly reduced volitional alcohol intake for 3-4 weeks. These effects were associated with a marked decrease in serotonin and its metabolite 5-HIAA levels in the hypothalamus. The findings suggest that antialcoholic effects of both peptides are actualized through mechanisms involving serotoninergic system of the brain. PMID- 2767270 TI - [An analysis of the importance of low-molecular peptides in regulating human motor functions in diseases of the central nervous system]. AB - The clinical data obtained on the treatment of motor disorders with intrathecal administration of low-molecular peptides, suggest that the peptides are effective in Parkinsonian disease, extrapyramidal hyperkineses and in spinal cord disturbances. PMID- 2767271 TI - [The reciprocity of gastrin and cholecystokinin effects on the motor and evacuatory functions of the proximal section of the gastrointestinal tract in dogs]. AB - In dogs with fistulas in fundal and antral parts of the stomach and in the proximal part of jejunum, subcutaneous and i.v. administration of pentagastrin and i.v. administration of cholecystokinin caused reciprocal reactions in the stomach: pentagastrin suppressed the motility of fundal part and activated the contractions of antral part, whereas cholecystokinin activated the contractions of fundal part and suppressed the motility of antral part of the stomach. Excepting a more complex character of pentagastrin and cholecystokinin effects on the jejunum contractions, the responses were reciprocal as well. Pentagastrin exerts mainly a suppressing effect whereas cholecystokinin--an activating one. Possible biological significance of the hormones interactions while maintaining evacuatory function of the stomach, is discussed. PMID- 2767272 TI - [The role of oxytocin in realizing hypothalamic effects on the motor function of the digestive tract]. AB - Chronic experiments in dogs showed that, after i.v. injection of oxytocin, the latency of activation of gastrointestinal motility by the stimulation of median hypothalamic structures was increased and inhibitory effects of posterior hypothalamic structures on the contractile activity of the digestive tract were intensified. The data obtained suggests that oxytocin facilitates the manifestation of inhibitory effects of the hypothalamus on the motor function of gastrointestinal tract. PMID- 2767273 TI - Nurses need state's tender loving care at budget time. PMID- 2767274 TI - Acquiring equal pay for equal work: the process is slow. PMID- 2767275 TI - Putting it in perspective--the report of the Commission. PMID- 2767276 TI - A brief overview of forensic psychiatric nursing. PMID- 2767278 TI - Changes and needs of correctional nursing. PMID- 2767277 TI - Political influence is highest form of advocacy. PMID- 2767279 TI - Community health nursing: does the shoe fit? PMID- 2767280 TI - The lack of correlation between the rate of rRNA transport from nucleoli into cytoplasm and the duration of G1 and G2 phases in root meristem cells. AB - In root meristems of 3 species (Secale cereale L., Vicia faba L. subsp. minor, Allium cepa L.) the durations of cell cycles and their phases were calculated using 3H-thymidine labelling. In the above species and in Helianthus annuus L. (parameters of the cell cycle determined earlier) the G1 and G2 phase durations were different: G1 + 1/2 M from 3 h to 6.1 h, G2 + 1/2 M from 1.1. h to 8.3 h, depending on the species. The rate of rRNA transport from nucleoli into cytoplasm during recovery after cold treatment was calculated from our data presented earlier. The results indicate that in 4 species studied there is no correlation (at P = 0.05) between the rate of rRNA transport and the duration of G1 and G2 phases. PMID- 2767281 TI - The ultrastructure of the epicardium epithelium of the slug, Arion ater (Linnaeus, 1758), (Pulmonata, Stylommatophora). AB - In the present paper we investigated the fine structure of terrestial slug Arion ater (L.) Interacisternal microtubules were formed in Arion ater, however they do not correspond to interacisternal polycylinders because they differ in size and they are not continuous with the membrane cistern. From our study it may be concluded that these intracisternal microtubules suggest an accumulation of protein. PMID- 2767282 TI - The content of fatty acids in leukemic lymphocytes in vitro in cattle. AB - In leukemic lymphocytes in vitro obtained from cattle the fatty acids content has been determined employing the method of gas chromatography of methyl esters. Significant increase of linolic acid (C18 = 2) and of linolenic acid (C18 = 3) in leukemic lymphocytes have been noted, while reduced amounts of eicanoic acid (C20) and arachidonic acid (C20 = 4) have been observed. Fatty acids contribution in destabilization of biological membranes of leukemic cells has been discussed. It is very likely that the destabilization of biological membranes promotes the "induction" of various cancero- and cocancerogenetic changes, as well as enables the penetration of leukemovirus into the cell. PMID- 2767283 TI - Adrenal catecholamine synthesis rate changes induced by combined thermal and immobilization stress in fed and 24 hour fasted rats. AB - The combined stress of acute immobilization (IM) at high and low ambient temperature has been used to determine its influence on adrenal catecholamine (CA) content assassed histofluorimetrically in fed and 24 hour fasted rats. The general course of changes obtained after the arrangement of adrenal strips deriving from the adrenals of rats exposed to cold and IM stress (CIMS) at +10 degrees C to -25 degrees C during the different time fragments presented the adrenal CA depletion events followed sometimes by the adrenal CA content increase after the longer stress exposure or/and stronger CIMS and WIMS conditions. It was found that this depletion-stimulated increase of adrenal Ca synthesis rate had been accelerated in 24 h fasted rats compared to satiated ones exposed to the same stress conditions, especially after the CIMS exposure. Moreover the survival time duration at first lethal temperature (-5 degrees C and +45 degrees C) was significantly higher in fasted rats. The possible hypothalamic regulation of adrenal CA synthesis rate accordingly to the actual metabolism needs and beta adrenoceptor sensitivity changes depending on satiety state have been discussed and the necessity of further investigations concerning the specificity of stress induced metabolism changes in 24 h starved rats has been suggested. PMID- 2767284 TI - The development of activity of succinate dehydrogenase (EC.1.3.99.1) in the areas of the nigro-striatal pathway during the ontogenesis of a pig. AB - The development of activity of succinate dehydrogenase was investigated by histochemical methods under the light and electron microscopes and also by biochemical methods. The studies were carried out in the areas of the nigro striatal pathways of 7 foetal groups, two day-old piglets, three week-old piglets and adult pigs. It was demonstrated that the activity of succinate dehydrogenase appeared first in foetuses of about 86 days (180 mm). The highest activity in prenatal development appeared just before birth in about 112 days old (260 mm) foetuses. After birth in 2 day-old piglets the activity of the examined enzyme decreases, while in 3 week-old it increases however not reaching the activity level observed in adult pigs. PMID- 2767285 TI - [Study on the steroid sulfatase (STS) activity in normal individuals and patients with abnormal sexual differentiation]. AB - The STS (steroid sulfatase) gene which has been assigned to the short arm of human X chromosome (band p22) is thought to have escaped from Lyon's inactivation. For that reason, the STS enzyme activities differ between male and female according to the number of X chromosomes in cells. In this report, the STS enzyme activities were studied in different human tissues such as placentas, lymphocytes, and cultured fibroblasts of normal individuals and sex anomaly patients. Tritium labelled dehydroepiandrosterone sulfate (DHA-S) was used as the reaction substrate. The placental STS activities between normal male and female subjects showed a significant difference in spite of wide variances that were ascertained not to be the effects of methodological alterations involving enzyme purification, substrate concentration, and activity calculation (units per mg of protein or DNA). Further, lymphocytes and fibroblasts which had low levels of enzyme concentration compared with placentas, the STS enzyme activities were also significantly different between both sexes. These results confirmed that the STS gene in cells of tissue tested here seemed to be inactive at the gene level and followed the gene dosage effect to some extent. The enzyme activity was also studied in 17 patients with sex anomalies using lymphocytes and cultured fibroblasts. The cells of 45,X Turner Syndrome and of Klinefelter syndrome with 47,XXY or other karyotypes, showed slightly lower levels of enzyme activity when compared with control values of normal males or females. The enzyme activity in intersexual disturbances, especially XX male and XX true hermaphrodites, showed intermediate levels between normal male and female values. This result may give support to the concept that at least one X chromosome in these diseases is genetically abnormal due to X-Y interchanges, something that has been partly proved recently by analysis of H-Y antigen and Y-specific DNA probes. The present study on the STS enzyme activity revealed the presence of a gene dosage effect of STS gene between males and females not precise but rather rough in quantity, and it pointed out problem, some of which were related to genetic and environmental factors modifying the STS gene expression in normal individuals as well as sex anomaly patients. PMID- 2767286 TI - [Metabolic clearance rate of oxytocin in human subjects]. AB - Oxytocin metabolism seems to occur mainly in the kidney and the liver. Placental cystine amino peptidase (CAP), which inactivates oxytocin by cleavage of the bond between the N-terminal cystine residue and adjacent tyrosine, rises progressively with advancing gestation. The role of CAP in oxytocin metabolism is not clear. To clarify this issue, the authors measure oxytocin metabolic clearance rate(MCR) by the constant infusion of 3mU/min and 6 mU/min synthetic oxytocin in 14 adult subjects: 5 pregnant women (38 approximately 41 weeks gestation), 4 puerperal women and 5 nonpregnant women. Oxytocin MCR (mean +/- SE) during infusion of 3 mU/min was 20.9 +/- 2.6 ml/kg/min in pregnant women; 16.9 +/ 2.4 ml/kg/min in puerperal women; 19.7 +/- 3.3 ml/kg/min in pregnant women. Oxytocin MCR during infusion of 6 mU/min was 22.1 +/- 3.3 ml/kg/min in pregnant women and 22.7 +/- 3.1 ml/kg/min in nonpregnant women. These values were statistically similar. Mean (+/- SE) CAP values were 143.5 +/- 7.8 mU/ml in pregnant women, 60.8 +/- 3.0 mU/ml in puerperal women, and 13.8 +/- 2.7 mU/ml in nonpregnant women. CAP levels in pregnant women were significantly higher than others. 3H-oxytocin degradation was studied in vitro in pooled plasma of pregnant and nonpregnant women. 85% of original 3H-oxytocin was destroyed in pregnant plasma during 1 hour but only below 10% was destroyed in nonpregnant plasma in 2 hours. These results suggest that CAP in pregnant women may not play a role in the inactivation of oxytocin in vivo, thus differing from its role in vitro. PMID- 2767287 TI - Atopic dermatitis--ichthyosis vulgaris--hyperlinear palms--an ultrastructural study. AB - Some 30-50% of cases of atopic dermatitis (AD) are believed to be associated with autosomal dominant ichthyosis vulgaris (ADI). The diagnosis of ADI can be proved by the ultrastructural demonstration of fewer and abnormal keratohyalin (KH) granules in all ADI patients, even in clinically unaffected skin. To prove the suggested frequent association of ADI with AD, an ultrastructural investigation of dry skin of 49 AD patients was performed. Only in 2 (4%) patients ADI could be confirmed by electron microscopy. In 17 patients, including the 2 patients with abnormal KH, hyperlinear palms were clinically seen. The present study yields evidence that hyperlinear palms, if present, and dry skin are in most cases a phenotypic marker of AD and not a sign of concomitant ADI. A histologically absent stratum granulosum in AD does not signify by itself a manifestation of concomitant ADI. PMID- 2767289 TI - Subungual epidermoid inclusions: report of 8 cases. AB - Eight cases of subungual epidermoid cysts associated with distinctive nail abnormalities are reported. Toes and thumbs were the most frequent sites affected by this probably not rare condition. The most striking clinical features were subungual hyperkeratosis associated with shortened and dystrophic nail plate. A history of trauma was frequent. In all cases, the nail biopsy showed marked hyperplasia of the nail bed and epidermoid cysts in the dermis. The authors propose a new classification for subungual epidermoid cysts. PMID- 2767288 TI - Familial porphyria cutanea tarda with normal erythrocytic urodecarboxylase: an exception to the rule? AB - The possibility that the differentiation between sporadic and familial porphyria cutanea tarda cannot always be made on the basis of the measurement of the erythrocytic uroporphyrinogen decarboxylase activity has been examined. Two cases of porphyria cutanea tarda, with a normal erythrocytic enzyme activity in a father and son, are described. The authors exclude that these are 2 cases of sporadic or toxic porphyria cutanea tarda within the same family. These 2 cases provide additional evidence for the existence of a form of familial porphyria cutanea tarda in which erythrocytic uroporphyrinogen decarboxylase activity is normal. PMID- 2767290 TI - Chronic urticaria due to dental eugenol. AB - A case is reported of a patient with chronic urticaria. The correlation between the symptoms and dental treatment gave rise to the supposition that a root canal cement was causing the trouble. A causal relationship with eugenol, a cement constituent, could only be established through provocative oral ingestion. There is a high probability that the oral provocation tests to eugenol are relevant. Nevertheless, caution is needed when dealing with chronic urticaria. PMID- 2767291 TI - Normalization of skin appearance in a patient with scleromyxoedema after intensive chemotherapy for Hodgkin's disease. AB - A patient with scleromyxoedema was treated for 6 years with cytostatic drugs. During this time the skin lesions followed a fluctuating but progressive course. After 6 years she developed Hodgkin's lymphoma of the mixed cellularity type. Intensive cytostatic treatment given for Hodgkin's disease resulted in virtually complete disappearance of the scleromyxoedema lesions. The development of Hodgkin's disease is considered fortuitous and not due to the previous cytostatic drugs. PMID- 2767292 TI - What do you mean by dry skin? PMID- 2767293 TI - Histological and rheological grading of cutaneous sclerosis in scleroderma. AB - We report a combined method using histology and determination of mechanical properties of skin allowing the grading of cutaneous sclerosis in morphea and acroscleroderma. Four parameters appeared useful, i.e. the evaluation of the skin thickness and of the fibrocyte density by morphometry as well as the measurement in vivo of the deformability and of the biologic elasticity of the skin. Such evaluations of the cutaneous changes occurring in scleroderma can be used to monitor therapy. PMID- 2767294 TI - Phytohemagglutinin-binding sites in the skin. A useful histochemical marker of acrosyringium and distal portions of intradermal sweat ducts. AB - Phytohemagglutinin (PHA)-binding sites were histochemically investigated in normal adult skin and various skin tumors using peroxidase-labeled lectin. In the normal skin, acrosyringium and distal portion of intradermal duct of eccrine and apocrine sweat glands were intensely stained with PHA. Other elements of the skin were virtually negative. Among various kinds of sweat gland tumors and other skin tumors, syringoma and eccrine porocarcinoma were intensely stained with PHA. Small ductal structures of nodular hidradenoma and mixed tumor of the skin were also stained with PHA. No other skin tumors were positive with PHA staining. The present study clearly showed that PHA is a useful histochemical marker of distal portion of eccrine and apocrine sweat ducts. PMID- 2767295 TI - Treatment of cutaneous T cell lymphoma with intermediate doses of interferon alpha 2a. AB - In this study we treated 6 patients with epidermotropic cutaneous T cell lymphoma (CTCL) with intermediate doses of recombinant alpha 2a interferon (18-100 x 10(6) IU/week) for 2-6 months. One patient experienced complete clinical remission in spite of a persistent dense lymphocytic skin infiltrate. One patient was markedly improved and 2 patients were moderately improved. The clinical condition of the 2 remaining patients was unchanged by interferon treatment. In all cases lesions relapsed a few weeks after treatment was discontinued. This study shows that interferon can be used to treat epidermotropic CTCL. However, a 2- to 6-month treatment using moderate doses did not lead to the high percentage of remission previously reported by others with high doses of recombinant alpha 2a interferon, for longer periods. This result suggests that interferon should be used at high doses and/or for long time periods for clinical improvement of CTCL patients. PMID- 2767296 TI - Carcinoma cuniculatum of the buttock. An unusual case with an inverted growth. AB - A rare case of carcinoma cuniculatum involving the buttock in a 56-year-old male is presented. This case is uncommon in that the tumor was largely subcutaneous, while the usual carcinoma cuniculatum is an exophytic growth. Although carcinoma cuniculatum has a wide clinical and histological spectrum, to our knowledge there has been only 1 case with similar histological features, located in a pilonidal sinus, and another case located on the buttock. PMID- 2767297 TI - Granuloma formation in herpes zoster scars. AB - An 82-year-old male with chronic lymphocytic leukaemia developed an erythematous papular eruption over the trunk. Lesions occurred at the site of scars related to a disseminated herpes zoster infection 3 months previously. Biopsy of a lesion showed granuloma formation. The rash resolved spontaneously over 6-8 weeks. PMID- 2767299 TI - Rippling in lichen amyloidosus. PMID- 2767298 TI - Successive legionellosis in the course of lymphomatoid granulomatosis. AB - A 75-year-old male presented with typical cutaneous lesions and pulmonary involvement due to lymphomatoid granulomatosis. A legionellosis was associated with this condition. Though the radiological findings in lymphomatoid granulomatosis are suggestive, they are not specific, and set a difficult problem in distinguishing the two conditions. Monoclonal antibody studies indicated the predominance of CD8 T lymphocytes in the infiltrate of the skin, as well as in the bronchoalveolar fluid. PMID- 2767301 TI - Permanent renal impairment after treatment with ciclosporin. PMID- 2767300 TI - Nuchal nevi flammei and alopecia areata. PMID- 2767302 TI - Psoriasis and atopic dermatitis. PMID- 2767303 TI - Incidence of nuchal nevus flammeus. PMID- 2767304 TI - Marital state, psoriasis, urticaria, and asthma. PMID- 2767305 TI - Plasmatocyte depletion in larvae of Manduca sexta following injection of bacteria. AB - Injection of bacteria and bacterial cell walls into larvae of the tobacco hornworm elicits a rapid, specific depletion of plasmatocytes from circulation. Plasmatocyte depletion in response to injection of bacteria is dose dependent with a threshold for response between 10(3)-10(4) bacteria per insect and a maximal depletion at greater than 10(7) bacteria per insect. Injection of saline, latex beads that are phagocytized, or fragments of peptidoglycan that elicit antibacterial protein synthesis do not affect plasmatocyte abundance. PMID- 2767306 TI - Ontogeny of the lymphoid organs in an Antarctic teleost, Harpagifer antarcticus (Notothenioidei: Perciformes). AB - The effect of an evolutionary adaptation to low environmental temperature on the development of lymphoid organs was examined in Harpagifer antarcticus from Signy Island (South Orkney Islands; 60 degrees 43'S, 45 degrees 38'W). Thymus, pronephric kidney and spleen were typical, both in position and structural development, of those observed in warmer-water teleosts. The pronephric kidney was the first organ to be infiltrated by leucocytes, at 1 h post-hatch, though the infiltration of the thymic epithelia and the development of the splenic anlage were not observed until 4 weeks post-hatch. Full development of the lymphoid organs was not achieved until the juvenile stage. Although an increased infiltration of the thymus, by subepithelial connective tissues and epithelial mucous cells, occurred in the juvenile and adult stages, there was no evidence of an advanced stage of thymic regression or involution in the adult Harpagifer. Thus, a suppressive influence of the low temperature environment, on the onset and degree of lymphoid organ development and thymic involution, was indicated in this species. PMID- 2767307 TI - Purification of dolabellanin-C an antineoplastic glycoprotein in the body fluid of a sea hare, Dolabella auricularia. AB - An antineoplastic factor, dolabellanin C, inducing tumor lysis was purified to apparent homogeneity from the body fluid of the sea hare Dollabella auricularia. Purified dolabellanin C is a glyco-protein of 215 K daltons containing 3 subunits of 70 K daltons. The amino acid sequence of the amino terminal region was also determined. This factor was active even at 0.38 ng protein/ml, but did not lyse normal white or red blood cells. PMID- 2767308 TI - Dietary influences on disease resistance factors in channel catfish. AB - The effects of diet on selected disease resistance factors were studied in channel catfish (Ictalurus punctatus). Two commercial feeds and a "control," laboratory-prepared diet were compared. Macrophage function (phagocytosis and intracellular killing) was used to assess nonspecific disease resistance and serum antibody was measured as an indication of specific immunity. We measured the immune response to Edwardsiella ictaluri, a common bacterial pathogen of catfish, as well as the phagocytosis and killing of the bacteria. In the initial experiment fish were maintained on the experimental diets for 116 days, vaccinated and responses assayed 14 days later. Significant differences among the groups were observed in the phagocytic index as well as in circulating antibody. An additional study showed that even when fed the experimental diets for only 42 days there were significant differences in the ability of macrophages from both immunized and nonimmunized fish to kill E. ictaluri. PMID- 2767309 TI - The effect of laboratory environment on the morphology of the spleen and the thymus in the yellow-bellied toad, Bombina variegata (L.). AB - The morphological changes were observed in the spleen and the thymus of the yellow-bellied toad, Bombina variegata, kept under standard laboratory conditions. The mean splenic weights of toads studied soon after capture in July and September were 16.0 mg and 17.7 mg, respectively. In contrast, the mean splenic weights significantly decreased in animals maintained in the laboratory from July till September (to 11.6 mg) and from July till December (to 6.8 mg). In the spleen of toads kept in the laboratory the lymphocyte aggregations were diminished in the white pulp while the amount of connective tissues increased both in the white and in the red pulps. Melano-macrophages were more abundant in the red pulp of toads kept in the laboratory than in freshly collected ones. The thymuses of toads kept in the laboratory were decreased in size and depleted of the majority of their cortical lymphocytes. It is suggested that the morphological changes of the yellow-bellied toad lymphoid organs might be the results of stressful laboratory conditions and lower antigenic stimulation in the laboratory than in nature. PMID- 2767310 TI - Different sensitivity to the dexamethasone treatment of the lymphoid organs of Rana perezi in two different seasons. AB - Adult female frogs (Rana perezi) have been used to analyze structural and morphometrical changes which affect lymphoid organs after treatment with a single dose of dexamethasone (DX). Special attention was given to the distinct sensitivity observed during two different periods of the year. Morphological differences were found between adult control frogs sacrificed in November and February. In February, frogs showed degenerated thymic reticular epithelial cells but lesser numbers of cortical pycnotic and mitotic thymocytes than in November. Splenic lymphoid tissue was clearly less well developed in February. No significant variations were found in the morphometrical parameters of jugular bodies whereas the number of lymphocytes of both peripheral blood and bone marrow was significantly higher in February than in November. In contrast, frogs sacrificed in February exhibited less drastic variations as well as a more delayed response to DX-treatment than those of November. The reported differential changes could be attributed to possible distinct levels of circulating sexual and nonsexual steroids during both seasonal periods. PMID- 2767311 TI - Ontogeny of the GVH-R inducing capacity, in conventional and germ-free chickens. AB - Three strains of MHC homozygous chickens were used to study the ontogeny of the GVH-R. It was found that this function of the immune system was acquired with a delay in animals raised in germ-free conditions. In our previous work, we had shown that, contrary to expectation, bursal cells were capable of mounting a GVH R against embryos, and actually were particularly efficient in this regard when compared to spleen cells. The present experiments have disclosed that splenomegaly induction may be dissociated from the toxic effect that bursal cells also exert on recipient embryos. PMID- 2767312 TI - Immune response of a marsupial (Monodelphis domestica) to sheep red blood cells. AB - A study of the humoral immune response of a marsupial, Monodelphis domestica, was performed using sheep red blood cells as the immunogen and a hemolytic titration as the assay. The primary response to a single intramuscular injection was similar to that observed in other mammalian species, except that the titers remained high for as long as 37 weeks after the initial injection. The secondary response was weaker than the primary response and diminished as early as 15 weeks after the initial injection (and only 11 weeks after the single booster injection). The hyperimmune response was similar to the secondary response, except that the titers remained consistent for up to 10 weeks and then fell to very low levels at 35 weeks. The data support the view that the primary humoral response of this marsupial is similar to that of eutherian mammals. However, the secondary and hyperimmune responses appear to be very weak, if present at all. PMID- 2767313 TI - Immunostimulating influence of levamisole on nonspecific immunity in carp (Cyprinus carpio). PMID- 2767314 TI - Third meeting, European Association of Gynaecologists and Obstetricians. Nijmegen, The Netherlands, 15-19 June, 1988. PMID- 2767315 TI - Postnatal prevention and treatment of surfactant deficiency. PMID- 2767316 TI - Uterosacral ligament suspension of vaginal vault (McCall's culdeplasty). PMID- 2767317 TI - Transvaginal sacrospinous vaginal fixation. PMID- 2767318 TI - Receptors and gynaecological oncology. PMID- 2767319 TI - Fetal behaviour. PMID- 2767320 TI - Diagnostic and intraoperative immunoscintigraphy in ovarian cancer. AB - A new strategy for tumor detection using immunoscintigraphic techniques was used in an attempt to improve the diagnostic potential of conventional external immunoscintigraphy. Twelve patients who were strongly suspected to either suffer from primary or recurrent ovarian cancer were investigated as follows: radioimmuno-scintigraphy (RIS) by means of radiolabelled antibodies was performed in all patients prior to operation (first or second look). During the operative procedure, which always took place immediately after completion of the diagnostic RIS, a hand-held gamma-ray detection probe, especially developed for this purpose was used for the purpose of identifying radiolabelled tumor sites intra operatively in the open abdomen. In 10 out of 12 of the investigated patients, Radioisotope-Assisted Surgery (RAS) could be performed successfully. The count rates in cancer sites ranged from 150-250 cts per 6 s vs. 30-50 cts per 6 s in normal tissues. While the presence of malignant-tumor sites could always be predicted by conventional RIS, RAS failed twice, but revealed more accurate information concerning the real extent of the disease. PMID- 2767321 TI - EAGO consensus developmental statement on cesarean childbirth. PMID- 2767322 TI - Cytotoxicity of N6-cycloalkylated adenine and adenosine analogs to mouse hepatoma cells. AB - Cytotoxic effect(s) of N6-cycloalkylated adenine and adenosine derivatives, upon the viability of mouse hepatoma cells, were studied in vitro. N6-Cyclopropyl- and N6-cyclobutyladenine and adenosine derivatives (33 micrograms/ml; 24-48 h) exerted significant cytotoxic effects upon the cells. N6-Cyclopentyl- and N6 cyclohexyladenines exerted similar effects under different experimental conditions (133-166 micrograms/ml; 48-72 h), while no significant cytotoxic effect(s) were observed with the corresponding adenosine derivatives under these conditions. Observed physical changes in the treated cells included cell elongation, short stubby filaments, wide intracellular spaces and ruptured cell membranes. N6-Cycloalkylated nucleosides were usually more cytotoxic than the cycloalkylated bases. PMID- 2767323 TI - Behavior of in vitro grown normal human mucosal epithelial cells and tumorigenic rat cells inoculated into nude mice. AB - The present study describes the behavior of in vitro grown normal human oral mucosal epithelial cells and that of a tumorigenic epithelial cell line following subcutaneous inoculation into nude mice. A successful recovery of viable human epithelial cell inocula was seen in 25-90% of mice and there was no improvement in recovery rates after addition of fibroblasts. These inocula resulted in cyst formation lined by a 2-6 cell layer unkeratinized squamous epithelium without rete ridges. There was no increase in recovery rate or size of cysts when coinoculated with fibroblasts. The tumorigenic cell inocula were successfully recovered in all cases. Tumors established from these inocula had a low grade of differentiation and were without signs of metastasis. Inocula of tumorigenic cells showed an increased size after addition of fibroblasts to the inocula. The model may be useful in studies of interactions between inoculations of heterologous normal and pathologic cells as well as in studies of differentiation of carcinogen-treated epithelial cells. PMID- 2767324 TI - Hydrophobic modifications of membrane proteins by palmitoylation in vitro. PMID- 2767325 TI - Naturally occurring autoantibodies to cholesterol in humans. PMID- 2767326 TI - The pupillary light reflex in borderline diabetics. AB - Computerized IR videopupilography, using an open-loop photic stimulator, was used to compare the reflexes of borderline diabetics with overt non-insulin-dependent diabetics and with age- and sex-matched non-diabetic healthy controls. The patients were all male, aged 41-59 years. Overt non-insulin-dependent diabetics in their 40s had a smaller pupillary area and pupillary diameter prior to photic stimulus compared with borderline diabetics and healthy controls. Overt non insulin-dependent diabetics in their 50s had a lower pupillary area and pupillary diameter prior to photic stimulus, maximum velocity and acceleration of constriction and maximum velocity of dilation than did borderline diabetics or controls. The only abnormality observed among borderline diabetics compared to controls was a smaller amplitude of constriction in response to light in patients in their 50s. Amplitude of constriction in response to light and velocity of constriction measurements of borderline diabetics, however, were considerably more frequently abnormal than were those of controls. The frequency of abnormal pupillary diameter prior to photic stimulus, maximum velocity of dilation and acceleration of constriction was higher in overt non-insulin-dependent diabetics than in borderline diabetics. The results indicate that borderline diabetics have autonomic neuropathy before the disease becomes overt. The importance of the pupillary light reflex examination is discussed. PMID- 2767327 TI - The use of a biocompatible orthopaedic polymer in the treatment of loose total hip prostheses. AB - Seventeen cases of loose total hip prostheses were treated with biocompatible orthopaedic polymer, an osteoconductive co-polymer. Biocompatible orthopaedic polymer permits improved stability and secondary bone repair and may also act as a vehicle for adjunctive antibiotic therapy. The available forms of biocompatible orthopaedic polymer and their methods of application are described and the results obtained with their use are compared with the pre-operative clinical observations. Of the 17 patients studied, pain disappeared in 14, unlimited walking became possible in seven, while another eight patients were subsequently able to walk for over 300 m. Mobility became normal in 13 cases; full weight bearing on one leg became possible in 12 cases and became normal in another four. Radiological examination showed the development of a bony interface between the cortex and the prosthesis as the radiolucent biocompatible orthopaedic polymer material was converted into bone. It may, therefore, be concluded that, in this indication, biocompatible orthopaedic polymer appears to be an active interface for stabilizing loose total hip prostheses. PMID- 2767328 TI - An evaluation of diphtheria--tetanus (adult) vaccine in unselected human volunteers. AB - One hundred unselected adult volunteers received an adult diphtheria (less than 2 Lf)-tetanus (greater than or equal to 40 IU) adsorbed vaccine without prior Schick testing. No volunteer had a moderate or severe reaction although 39% complained of a transient sore arm. Only 10% reported local erythema. Of the study group, 37/43 (86%) patients who were initially seronegative for diphtheria attained levels normally considered as seropositive. The results confirm the safety and efficacy of adult diphtheria-tetanus vaccine and allow its recommendation for use in 'at risk' individuals without the need for prior Schick testing. PMID- 2767329 TI - Sustained-release verapamil as a first-step drug in the treatment of mild to moderate hypertension. AB - The efficacy of sustained-release verapamil as a first-stage treatment for mild to moderate, uncomplicated essential hypertension was studied. Nineteen patients aged 36-70 years (mean +/- SD 55 +/- 10 years) entered the study. Treatment with 240 mg sustained-release verapamil, once daily for 8 weeks, caused systolic and diastolic blood pressures to decline significantly during the first 2 weeks and this lower level was maintained until week 8. Heart rate decreased gradually during the treatment period reaching significance at week 8. After 2 weeks maximum systolic and diastolic blood pressures during isometric exercise were significantly reduced compared with pre-treatment values; there was no difference in the percentage increase occurring pre- and post-treatment. These measures for heart rate did not change significantly. Except for a significant reduction in cardiac index after 8 weeks left ventricular function and left ventricular mass were unchanged. The 24-h urinary Na+ excretion increased significantly after 2 and 8 weeks' treatment. Plasma renin activity, serum lipid concentrations and routine blood chemistries were not affected. Side-effects were transient and did not require discontinuation of therapy. In conclusion, sustained-release verapamil is an efficacious and well tolerated first-stage drug in the treatment of essential hypertension. PMID- 2767331 TI - Glycosaminoglycan variants in the C2 muscle cell line. AB - Using a replica technique, we have isolated and characterized five genetic variants of the C2 mouse muscle cell line that are defective in incorporation of radiolabeled sulfate into glycosaminoglycans (GAGs). The variants incorporate free sulfate into GAGs at 5-20% of wild-type levels. None of the variants is defective in sulfate transport across the cell membrane, and in no case could the deficit in incorporation of sulfate be reversed by addition of an artificial initiator of GAG biosynthesis, p-nitrophenyl beta-D-xyloside. Analysis of the incorporation of [3H]glucosamine into GAGs by the variants revealed three different patterns: one variant incorporated [3H]glucosamine at the wild-type level; one, S27, at a severely reduced level; and three at intermediate levels. Four of the five variants showed marked deficits in their ability to differentiate and fuse. The remaining variant, S27, formed multinucleated myotubes and expressed acetylcholine receptor with a normal time course. Differentiation of the first four variants could not be restored by addition of exogenous GAGs or extracellular matrix. Because of the important roles that GAGs and proteoglycans are thought to play in the differentiation of muscle, these genetic variants should serve as useful tools in functional analyses of these molecules. PMID- 2767330 TI - Sobrerol in the treatment of secretory otitis media in childhood. AB - The therapeutic activity and tolerability of sobrerol, a muco-active agent, were evaluated in 30 children (aged 5-10 years) with secretory otitis media. The drug was administered once daily by inhalation for 10 days consecutively at a dose of 40 mg/3 ml. Clinical assessments showed a significant improvement in the objective measures together with good tolerability. Moreover, sobrerol was shown to improve impedance values; this is an important aspect of the modifications induced by this drug in diseases involving the ear. PMID- 2767332 TI - Purification and characterization of a cortical secretory vesicle membrane fraction. AB - A membrane fraction has been prepared by sucrose density gradient fractionation of purified cortical secretory vesicles from the eggs of the sea urchin Strongylocentrotus purpuratus. The purified cortical vesicle membrane fraction has a phospholipid to protein ratio of 1.76 and exhibits a morphology typical of biological membranes as seen by electron microscopy. The protein composition of the purified membranes was analyzed by SDS-polyacrylamide gel electrophoresis and shown to be distinct from that of eggs, cell surface complex, cortical vesicles, fertilization product, and yolk platelets. Alkaline extraction (pH 11.0) of peripheral membrane proteins increased the phospholipid to protein ratio to 2.55 and removed several polypeptides. Immunoblot analysis of the isolated cortical vesicle membrane fraction revealed low levels of contamination with two major cortical vesicle content proteins. Fractions enriched in egg plasma membranes and yolk platelet membranes also have been isolated and compared with the cortical vesicle membranes by SDS-polyacrylamide gel electrophoresis. The protein compositions of the three membrane fractions were found to contain very little overlap, indicating that the cortical vesicle membrane preparation is relatively free of contamination from these likely noncortical vesicle sources of membrane. Both the plasma membrane and cortical vesicle membrane samples were found by immunoblotting to contain actin. PMID- 2767333 TI - Free calcium pulses following fertilization in the ascidian egg. AB - Using the calcium-specific, chemiluminescent photoprotein aequorin, we have measured changes in the concentration of free cytosolic calcium at fertilization in single eggs of the ascidians Phallusia mammillata and Ciona intestinalis. Shortly after insemination, the free calcium concentration rises within a minute from a resting level of about 90 nM in the unfertilized egg to a peak level of about 7 microM in Phallusia and about 10 microM in Ciona. The total duration time of this fertilization transient is 2-3 min. It is immediately followed by a series of 12 to 25 briefer calcium transients with peak levels of about 1-4 microM. These postfertilization pulses occur at regular intervals of 1-3 min during the completion of meiosis, and they stop as soon as the second polar body is formed at about 25 min. An interesting exception to this pattern was observed in eggs from Ciona that had been raised at lower temperatures during the winter months. Insemination in the absence of external calcium in Phallusia results in a pulse pattern very similar to the normal pattern. From this result we infer that the bulk (if not all) of the calcium required for both the fertilization pulse and the meiotic oscillations is released from internal sources. PMID- 2767334 TI - TGF-beta 1-induced inhibition of mouse mammary ductal growth: developmental specificity and characterization. AB - TGF-beta 1, implanted into growing mouse mammary glands, was previously shown to inhibit ductal growth in an apparently normal and fully reversible manner. In this report we extend these findings to show that TGF-beta 1 inhibition is highly specific. In pregnant or hormone-treated mice, doses of TGF-beta 1 that were capable of fully inhibiting ductal elongation had little effect on the proliferation of lobuloalveolar structures. Additionally, the inhibitory action of TGF-beta 1 on ducts is epithelium-specific, resulting in cessation of DNA synthesis in the rapidly proliferating epithelium of mammary end buds, but does not inhibit DNA synthesis in the stroma surrounding the end buds. At the cellular level, transplant studies showed that TGF-beta 1 inhibited the regeneration of mammary ductal cells when implanted into mammary gland-free fat pads by suppressing the formation of new end buds, without inhibiting maintenance DNA synthesis in ductal lumenal epithelium; this observation indicates the potential of TGF-beta 1 to maintain patterning by suppressing adventitious lateral branching. The time-course of TGF-beta 1 inhibition of end buds was rapid, with cessation of DNA synthesis by 12 hr, followed by loss of the stem cell (cap cell) layer. The question of glandular exposure to TGF-beta 1 administered in EVAc implants was also investigated. Incorporation of TGF-beta 1 into EVAc was found not to degrade the hormone, while the release kinetics of the ligand from implants, its retention in the gland, and the demonstrable zone of exposure were consistent with observed inhibitory effects. These results support the hypothesis that TGF-beta 1 is a natural regulator of mammary ductal growth. PMID- 2767335 TI - Structure and tissue-specific developmental expression of a sea urchin arylsulfatase gene. AB - Arylsulfatases are a group of enzymes that remove sulfate moieties from a diverse set of substrates including glycoproteins, steroids, and cerebrosides. We have isolated recombinant cDNA clones corresponding to an arylsulfatase (SpARS) message that encodes an abundant protein of pluteus larvae of the sea urchin Strongylocentrotus purpuratus. Although vertebrate arylsulfatases have broad tissue distributions, in situ hybridization with a probe for SpARS shows that the sea urchin message accumulates in the embryo only in the single cell type of aboral ectoderm and its precursors. The message is first detectable by RNase protection assays around hatching blastula stage and accumulates through pluteus larva stage. The open reading frame of cDNA clones is 1701 nt long and encodes a deduced protein with a predicted molecular mass of 61 kDa. Analysis of corresponding genomic DNA clones reveals that the pre-mRNA contains six exons. Consistent with the fact that arylsulfatase enzyme activity is extracellular, this polypeptide has a hydrophobic leader sequence and three potential glycosylation sites. Furthermore, hybridization in situ shows that in blastulae arylsulfatase message is preferentially concentrated around nuclei at the basal sides of cells. The S. purpuratus sequence is very similar to that recently reported for the same enzyme from Hemicentrotus pulcherrimus and 30% of the amino acid residues are also identical to those of both human arylsulfatase C (steroid sulfatase) and arylsulfatase A. Sequence relationships among these four mRNAs suggest that, assuming equal rates of evolution, the duplication separating the human genes occurred at about the time of separation of the echinoderm and vertebrate lineages. PMID- 2767336 TI - Tumor cell haptotaxis on covalently immobilized linear and exponential gradients of a cell adhesion peptide. AB - The movement of cells up an adhesive substratum gradient has been proposed as a mechanism for directing cell migration during development and metastasis. Critical evaluation of this hypothesis (haptotaxis) benefits from the use of quantifiable, stable substratum gradients of biologically relevant adhesion molecules. We report covalent derivatization of polyacrylamide surfaces with quantifiable gradients of a nonapeptide containing the adhesive Arg-Gly-Asp sequence. Cell migration was studied by seeding derivatized surfaces evenly with B16F10 murine melanoma cells. Within 8 hr, cells on gradients redistributed markedly; higher cell densities were found at gel positions having higher immobilized peptide densities. In contrast, cells seeded on control gels with uniform concentrations of adhesive peptide did not redistribute. Redistribution occurred on gradients in both serum-free and serum-containing media. Experiments with uniform density peptide-derivatized gels demonstrated that redistribution on gradients was not due to preferential initial cell attachment or preferential growth on the higher density of immobilized peptide, but must have been due to cell translocation. Cells on exponential gradients of immobilized peptide migrated to a position on the gel surface corresponding to the highest immobilized peptide density, while cells on linear gradients of the same peptide migrated to a position of intermediate peptide density. These data suggest that the B16F10 cells respond to proportional changes in immobilized peptide density rather than to absolute changes, implying a sensing mechanism which utilizes adaptation. These results demonstrate that (1) a gradient of a small adhesive peptide is sufficient to generate redistribution of cell populations and (2) controlled quantifiable substratum gradients can be produced and used to probe the underlying cellular mechanisms of this behavior. PMID- 2767337 TI - Demonstration of heterogeneity of autoantibodies to insulin receptors in type B insulin resistance by isoelectric focusing. AB - With isoelectric focusing, we examined heterogeneity of autoantibodies to insulin receptors in serums of two patients with insulin-resistant diabetes and one patient with hypoglycemia. Immunoglobulins were prepared by ammonium sulfate precipitation and ion-exchange chromatography with DEAE-Sepharose and subjected to isoelectric focusing for separation into 30 fractions. The fractions were tested for their ability to inhibit 125I-labeled insulin binding to human placental membranes, immunoprecipitate solubilized insulin receptor cross-linked with 125I-insulin, and mimic or inhibit the action of insulin in rat adipocytes. The results varied among the three patients. In the first patient, inhibition of 125I-insulin-binding activity (IBA) and insulin-receptor-precipitating activity (IPA) were distributed almost identically, but the distribution of insulinlike bioactivity (ILBA) was somewhat different. In the second patient, some fractions exhibited potent IBA without IPA, and these fractions inhibited the action of insulin in rat adipocytes. In the third patient, all of the isoelectric fractions showed IBA without IPA and were insulin antagonists. These observations indicate that some patients have antibodies with pure insulin-antagonist properties and provide further evidence that autoantibodies to insulin receptors are polyclonal and recognize different antigenic sites on insulin-receptor molecules. The findings also suggest that the ability of antibodies to elicit ILBA is linked to the ability to immunoprecipitate 125I-insulin-cross-linked and solubilized receptors, whereas antibodies that only inhibit insulin binding behave as insulin antagonists. PMID- 2767338 TI - Mean glomerular volume and rate of development of diabetic nephropathy. AB - We studied kidney glomerular structure and function in two groups of type I (insulin-dependent) diabetic subjects with 14-16 yr (group 1, n = 16) and 24-26 yr (group 2, n = 13) duration of diabetes and compared them to a group of 18 nondiabetic subjects with similar age ranges. Within each diabetic group, subjects were selected for normal kidney function (urinary albumin excretion less than 40 mg/24 h, normal blood pressure, creatinine clearance greater than 90 ml.min-1.1.73 m-2) or for nephropathy (urinary albumin excretion greater than 200 mg/24 h). Morphometric analysis of glomeruli revealed a significantly larger mean glomerular volume in subjects with nephropathy (group 2). Mesangial volumes were significantly greater in the nephropathic than the normoalbuminuric diabetic subjects in each group, but filtration surface per glomerulus was constant among all subjects. The percentage of sclerosed glomeruli was also significantly increased in the nephropathic subjects compared with the subjects with normal kidney function, in whom sclerosed glomeruli did not exceed 8%. In addition, there was a significant correlation between percentage of globally sclerosed glomeruli and glomerular volume in group 2 (rs = .79, P less than .01) but not group 1 (rs = -.20, NS) subjects. Thus, glomerular size or individual capacity for glomerular expansion may determine the rate of progression of the loss of kidney function in subjects destined to develop diabetic nephropathy. PMID- 2767339 TI - Antidepressant effects of tricyclic antidepressants and selective serotonin uptake blockers in diabetic rats. AB - Because it was reported that diabetic rodents were resistant to the effects of several tricyclic antidepressants in various psychopharmacological models, we decided to test the hypothesis that the serotonergic dysfunction seen in diabetes might participate in this phenomenon. The ability of three serotonin-uptake blockers to reverse the performance deficit in learning induced by previous uncontrollable stress (learned-helplessness paradigm) was investigated in streptozocin-induced diabetic rats. Three weeks after induction of diabetes, rats were subjected to a session of 60 inescapable electric foot shocks and, after 48 h, to three daily sessions of two-way shuttle-box training. Three serotonin uptake blockers were given intraperitoneally over 5 consecutive days. As with nondiabetic rats, citalopram (1 mg.kg-1. day-1), fluoxetine (2 and 4 mg.kg-1. day 1), and fluvoxamine (4 mg.kg-1.day-1) reduced the number of escape failures in diabetic rats. From these data, we suggest that it is unlikely that the impaired response of diabetic rats to tricyclic antidepressants is caused by serotonergic dysfunction. PMID- 2767340 TI - Hypoglycemia in IDDM. AB - Hypoglycemia causes substantial morbidity and some mortality in insulin-dependent diabetes mellitus (IDDM). It is often the limiting factor in attempts to achieve euglycemia. The prevention or correction of hypoglycemia normally involves both dissipation of insulin and activation of glucose counterregulatory systems. Among the latter, glucagon plays a primary role initially, whereas epinephrine is not critical, although it becomes critical when glucagon is deficient. Growth hormone and cortisol play demonstrable roles in recovery from prolonged hypoglycemia. Glucose autoregulation may be involved in defense against severe hypoglycemia. With respect to pathophysiology, counterregulatory systems are involved in at least five clinical glucoregulatory syndromes. Defective glucose counterregulation is associated with, and best attributed to, combined deficiencies of the glucagon and epinephrine responses to plasma glucose decrements. Almost assuredly in concert with hypoglycemia unawareness, it results in a markedly increased frequency of severe hypoglycemia, at least during intensive therapy of IDDM. Defined as a night to morning increase in plasma glucose concentration, the dawn phenomenon is thought to result from dissipation of insulin plus the effects of nocturnal growth hormone secretion. Despite a sound rationale, the clinical relevance of the Somogyi phenomenon has been recently questioned. The clinical impression of altered glycemic thresholds for symptoms, i.e., patients with poorly controlled IDDM suffer symptoms of hypoglycemia at relatively high plasma glucose levels, whereas those with very well-controlled IDDM often tolerate subnormal glucose levels, has received experimental support. Clearly, hypoglycemia in IDDM is a problem that needs to be solved. Numerous issues need to be addressed through both basic and clinical research.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2767341 TI - Clinical features, course, viral markers and follow-up in young versus adult nonalcoholic cirrhotics--a retrospective study. AB - To determine the presenting features and prognosis of nonalcoholic cirrhosis, retrospective analysis was done in 145 cases. Of the total, 48 patients (33%) belonged to the young (less than or equal to 35 years), and 97 (67%) to the adult age group (greater than 35 years) with no predominance of either sex. The etiology of cirrhosis and the positivity of viral markers were similar in both groups. Adults had on presentation a higher frequency of anorexia while hematemesis was more frequent in the young group (p less than 0.001). During a mean follow-up (+/- SE) of 31.7 +/- 5.5 and 16.3 +/- 2.2 months in the young and adult group, respectively, 68 and 63% cases survived 5 years. Liver failure (53.8 and 44.4%) and variceal bleeding (23 and 11.1%) were the main causes of death in both groups, accounting for 27% mortality in each group. PMID- 2767342 TI - Oesophageal function in patients with angina pectoris: a comparison of patients with normal coronary angiograms and patients with coronary artery disease. AB - Oesophageal function was assessed in 52 patients with angina pectoris whose coronary angiograms were completely normal and in 21 patients with angina pectoris who had significant coronary artery disease. During a standard oesophageal manometric study, abnormalities were found in 23 (44%) patients with normal coronary angiograms but in only 2 (10%) patients with coronary artery disease (p less than 0.01). Twenty-four (46%) patients with normal coronary angiograms were found to have gastro-oesophageal reflux disease during 24-hour oesophageal pH monitoring. Of the 52 patients with normal coronary angiograms, 19 (37%) had gastro-oesophageal reflux disease and abnormal oesophageal motility, 5 (10%) had gastro-oesophageal reflux disease alone, and 7 (13%) had oesophageal motility disorder alone. The use of provocation procedures, including intravenous edrophonium during oesophageal manometry and treadmill exercise testing during pH monitoring, enabled the oesophageal abnormality to be demonstrated simultaneously with chest pain in 25 of these 31 patients. Typical angina pectoris, coincident with abnormal oesophageal motility, was precipitated in a subgroup of patients who had been shown to have oesophageal manometric abnormalities and gastro oesophageal reflux disease by the infusion of hydrochloric acid into the oesophagus; both the chest pain and manometric abnormality resolved following the oral administration of antacid. PMID- 2767343 TI - Histamine and gastrin in plasma of patients with upper gastrointestinal diseases. AB - The etiology of peptic ulcer disease is completely unknown. However, gastric acid secretion plays an important role in the pathogenesis of the disease. Acetylcholine, gastrin and histamine are recognized as the main stimulators of the acid secretion. Extensive studies on blood gastrin have not incriminated this hormone in the pathogenesis of the disease. The present study was done to evaluate the role of circulating histamine in peptic ulcer disease using a sensitive and specific radioimmunoassay method. Since gastrin at least in some species seems to exert its stimulatory effect by releasing histamine, serum gastrin was also determined. There was no significant difference in plasma histamine between patients with duodenal or gastric ulcer, nonulcer dyspepsia or ulcer patients after proximal gastric vagotomy. However, patients taking a histamine-2 blocker (cimetidine or ranitidine) had significantly higher plasma histamine than those not taking these drugs. This effect was not due to interference in the histamine assay. There was no correlation between plasma histamine and plasma gastrin. Plasma gastrin was significantly increased in patients having been operated on with a proximal gastric vagotomy. In conclusion, plasma histamine is similar in patients with different upper gastrointestinal disorders. However, histamine-2 blockers may increase plasma histamine. PMID- 2767345 TI - Cimetropium bromide: in vitro and in vivo evaluation of spasmolytic activity on human and dog colon. AB - The present study investigates the spasmolytic properties of cimetropium bromide, compared to atropine, on human and canine large bowel. The drug behaved as a competitive antagonist of muscarinic-mediated contractions in isolated colonic preparations from both species, with affinity values (pA2) ranging between 7.41 and 7.82. When administered intravenously to conscious dogs provided with a colonic Thiry fistula, cimetropium was a potent inhibitor of large bowel motility evoked by both exogenous and endogenous stimuli. The compound (10-100 micrograms/kg) counteracted colonic motor response to neostigmine administration with an ID50 of 27.9 micrograms/kg; both tonic and phasic components of contractile response were affected. In a comparable range of doses (3-100 micrograms/kg), the drug inhibited motor activity elicited by intraluminal distension. PMID- 2767344 TI - Human pancreatic phospholipase A2 in acute necrotizing pancreatitis. AB - The activity and the content of phospholipase A2 (PLA2), a potential 'toxin' in pancreatitis, were determined separately by respective methods in pancreatic tissue resected from 22 patients treated for acute necrotizing pancreatitis. Correspondent enzyme assays were analyzed in the serum of 6 last patients. In cases with total necrosis in the tissue resected, the pancreatic PLA2 activity, but not the content, was almost totally lost. Serum PLA2 activity slightly decreased within the extension of pancreatic necrosis. The timing of sampling, number of positive Ranson signs or the course of the disease had no influence on the tissue PLA2 results. Serum PLA2 activity showed a correlation with tissue PLA2 activity. PMID- 2767346 TI - Endogenous, cutaneous vitamin D synthesis stimulation as an effective way of improving the vitamin D status in children with hepatobiliary malfunctions. AB - Repetitive (5 days) ultraviolet treatment was used to improve vitamin D status of 26 pediatric patients suffering from different hepatobiliary disorders. The treatment resulted in a significant improvement of patients' vitamin D and 25 hydroxyvitamin D levels regardless of their disease and other factors such as increased blood bilirubin content or jaundice. Presence of a dependence between the increase in 25-hydroxyvitamin D concentrations after treatment and its original levels was confirmed. PMID- 2767347 TI - Postprandial gastrin concentrations are higher in female patients with duodenal ulcers. AB - We compared plasma gastrin concentrations in male and female patients with duodenal ulcers because a group in Denmark reported a difference, but two groups in the Far East did not. Median basal gastrin was 23 pmol/l in males compared with 43 pmol/l in females. Median peak postprandial gastrin was 71 pmol/l in males, compared with 142 pmol/l in females (p less than 0.03). Elevated gastrin may reflect diminished sensitivity of parietal cells to gastrin in females. PMID- 2767348 TI - Effects of acute and chronic ethanol administration on the gastrointestinal hormones gastrin, enteroglucagon, pancreatic glucagon and peptide YY in the rat. AB - The effect of acute and chronic ethanol administration on the gastrointestinal hormones gastrin, enteroglucagon (EG), pancreatic glucagon (PG) and peptide YY (PYY) was studied in the rat alcohol model. Plasma levels of gastrin and PYY were not significantly changed under chronic and/or acute alcohol, while PG was stimulated by acute intraperitoneal ethanol injections in control animals as well as in chronically ethanol-fed rats (8 +/- 1 vs. 28 +/- 6 pmol/l, p less than or equal to 0.05, and 7 +/- 1 vs. 21 +/- 4 pmol/l, p less than or equal to 0.05). EG levels were significantly raised after chronic ethanol feeding (45 +/- 5 vs. 73 +/- 8 pmol/l, p less than or equal to 0.01) and even further elevated if an acute dose of alcohol was given to chronically ethanol-fed rats (73 +/- 8 vs. 168 +/- 29 pmol/l, p less than or equal to 0.05). The immunohistologically evaluated numbers of the respective hormone-producing cells were not significantly changed by alcohol feeding. The ethanol-dependent elevations of EG and PG may contribute, at least in part, to the intestinal hyper-regeneration, motility disturbances and altered glucose metabolism observed after alcohol consumption. PMID- 2767349 TI - Teratology of 2,3,7,8-tetrachlorodibenzo-p-dioxin in a complex environmental mixture from the love canal. AB - The organic phase of a 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 teratogenic potential of OPL was determined in two inbred and one hybrid mouse strain which differ in their sensitivity to aromatic hydrocarbon (Ah) receptor-mediated toxicity. OPL was orally administered in corn oil on Days 6-15 of gestation to C57BL/6J mice (Ahb/Ahb) at doses of 0, 0.1, 0.3, 0.5, and 0.7 g kg-1 day-1 and to DBA/2J (Ahd/Ahd) females, which were mated with either DBA/2J or C57BL/6J males, at 0, 0.5, 1, and 2.0 g kg-1 day-1. In C57BL/6J mice, which express a high-affinity Ah receptor that avidly binds TCDD, the ED50's of OPL for cleft palate and hydronephrosis were 0.44 and 0.11 g OPL kg-1 day-1, respectively. Maternal mortality was 5% at the highest dose. In DBA/2J fetuses, which express a low-affinity receptor, neither treatment-related cleft palate nor hydronephrosis was induced by dose levels that caused 36% maternal mortality. In hybrid D2B6F1 fetuses, the incidence of cleft palate reached only 8% at 2 g OPL kg-1 day-1 but the ED50 for hydronephrosis was 0.76 g OPL kg-1 day-1. TCDD was similarly administered to pregnant C57BL/6J mice at 0, 0.5, 1, 2, and 4 micrograms kg-1 day-1 and to DBA/2J mice at 0, 0.5, 2, 4, and 8 micrograms kg-1 day-1. In C57BL/6J fetuses, the ED50's for cleft palate and hydronephrosis were 4.6 and 0.73 microgram TCDD kg-1 day-1, respectively. In DBA/2J fetuses the ED50's for cleft palate and hydronephrosis were 15.0 and 6.4 micrograms TCDD kg-1 day-1, respectively. Both the OPL and TCDD caused maternal hepatomegaly and thymic atrophy in all strains, but increased only C57BL/6J fetal weights. OPL decreased the number of fetuses per C57BL/6J dam at the two highest doses but there were no other reproductive effects in any of the groups. It was concluded that the OPL is teratogenic and that hydronephrosis is a sensitive measure of TCDD toxicity in a complex organic mixture. Based on the ED50's of OPL- and TCDD induced cleft palate and hydronephrosis in the C57BL/6J strain, the OPL had TCDD equivalence of 6.6 and 10.5 ppm, respectively. These values compare closely with the chemical analysis of 3 ppm.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2767350 TI - Pharmacological and metabolic interactions between ethanol and methyl n-butyl ketone, methyl isobutyl ketone, methyl ethyl ketone, or acetone in mice. AB - Methyl n-butyl ketone (MnBK), methyl isobutyl ketone (MIBK), methyl ethyl ketone (MEK), and acetone are widely used industrial solvents to which certain groups of workers are exposed. Pharmacological and metabolic interactions between these solvents and ethanol were explored in male CD-1 mice. The effects of these solvents on the duration of ethanol-induced loss of righting reflex and on ethanol elimination in mice were studied. The solvents were dissolved in corn oil and injected intraperitoneally 30 min before ethanol 4 g/kg ip. The four solvents prolonged significantly the duration of ethanol-induced loss of righting reflex when given in the following doses (mmol/kg): MnBK, 3.75 and 5; MIBK, 5; MEK, 5 and 10, acetone, 20 and 40. This prolongation was dose related and increased as the dose of the solvent was increased. The concentrations of ethanol in blood or brain on return of the righting reflex were similar in solvent-treated and control animals, with the exception of the group of mice treated with 40 mmol/kg acetone in which the ethanol concentrations were significantly lower than in control animals. The mean elimination rate of ethanol was markedly reduced in mice treated with MnBK 5 mmol/kg, MEK 15 mmol/kg, and acetone 40 mmol/kg. All four solvents reduced the activity of mouse liver alcohol dehydrogenase in vitro. It is concluded that enhancement of the ethanol-induced loss of righting reflex by these solvents in mice is well correlated to reduced elimination rate of ethanol. PMID- 2767351 TI - Myopathic changes in diaphragm of rats fed pyridostigmine bromide subchronically. AB - To determine if alterations in muscle morphology occur after subchronic oral administration of pyridostigmine bromide, rats were fed 90 mg/kg continuously in meal and examined at 1, 2, 4, 7, and 15 days. Within the first day, cholinesterase activity was reduced by 87% and remained inhibited by 74-91% for the entire course of the feeding. Light microscopy demonstrated that by the first day approximately 1 in 100 myofibers was shrunken and contained centralized nuclei. Electron microscopic examination showed that while presynaptic areas of neuromuscular junctions were relatively unaffected by this dose, postsynaptic areas invariably showed maximal changes. Ultrastructural alterations included disruption of myofilaments, mitochondrial changes consistent with accumulation of calcium, and nuclear alterations. These effects appeared not to be cumulative and were greatly diminished by 15 days even under constant drug administration and inhibition of cholinesterase activity. We conclude that subchronic feeding of pyridostigmine bromide induces primarily myopathic rather than neurogenic changes in the diaphragm and that some mechanism of accommodation may be activated that minimizes continued muscle injury. PMID- 2767352 TI - Implementation of a primary screen for developmental neurotoxicity. AB - A battery of tests to evaluate physical growth/development and neurobehavioral function was conducted with 78 litters of control Sprague-Dawley rats given purified water by intubation. The objectives of this study were to optimize test methods and to document the range and variability of the experimental endpoints. Data are presented for maternal evaluations (body weight gain, food consumption), gestation length, litter size, and postnatal survival. Pup body weight was used to assess postnatal somatic growth rate from birth to 85 days of age, while whole and regional brain weight measurements at 7, 28, and 85 days provided a more specific measure of physical growth relevant to a neurobehavioral study. Physical landmarks of development evaluated were pinna unfolding, incisor eruption, and eye opening while reflex landmarks of development evaluated were the negative geotaxis and pupillary reflexes. The mean percentage of litters acquiring a physical trait or reflex increased sigmoidally with age, and the data suggest that the potential to detect developmental delays would be optimal when ca. 90% of control litters reach the test landmark. Functional evaluations were arranged according to four testing subsets so that each litter was evaluated in each test (1 pup/sex/litter), but repeated testing on pups was minimized. Auditory and tactile startle reflexes, as well as prepulse inhibition, were measured at ages 22 days and 60-64 days and found to increase with age. A passive avoidance paradigm (age 40-43 days) was used to assess exploratory behavior (approach) and memory (avoidance). Swimming performance in a water maze was used to evaluate learning. In this test, escape times and error rates improved to their highest level by five or six trials and showed acceptable degrees of variability. Spontaneous motor activity was monitored for 23 hr at age 54-61 days to evaluate exploratory activity, photoperiod entrainment, and catecholamine-induced locomotion (amphetamine challenge). Finally, landmarks of sexual maturation (balanopreputial separation evident at 45 days of age, vaginal perforation evident at 33 days) and estrous cyclicity (4.8 cycles per 21 days) were evaluated as measures of reproductive neuroendocrine function. In sum, the test battery provided an efficient yet comprehensive screen for evaluating effects on physical growth/development and neurobehavioral function which meets practical criteria for preclinical testing of pharmaceutical agents. PMID- 2767353 TI - Acute, distribution, and subchronic toxicological studies of succinate tartrates. AB - The estimated single-dose oral toxicity (50% lethality) of succinate tartrates (ST) was 2-3 g/kg in rats. ST produced minimal to moderate dermal irritation but no evidence of systemic toxicity in a standard acute percutaneous toxicity test in rabbits. ST was not an eye irritant in a standard rabbit low-volume eye irritation test. ST was not genotoxic in a series of six genotoxicity tests. A 14 day oral gavage study in rats at a dose range of 0.05-1.0 g ST/kg/day produced only gastric irritation. The no-observed-effect level (NOEL) for gastric irritation was 0.1 g/kg for males and 0.05 g/kg for females. A 28-day percutaneous toxicity study in rabbits produced minimal to moderate dermal irritation and no adverse systemic effects at a high dose of 450 mg ST/kg/day. Single-dose absorption, distribution, and elimination (ADE) studies in male rats showed that 10-15% of an oral dose and 1-3% of a dermal dose were absorbed. Approximately 98% of the orally administered ST was eliminated as 14C in urine, feces, or expired CO2 after 72 hr. Approximately 80% of the dermally absorbed 14C dose was eliminated in urine, feces, or expired CO2 after 72 hr. In conclusion, no adverse effects were noted in acute toxicity, genotoxicity, or subchronic toxicity studies conducted with ST. PMID- 2767355 TI - Influence of viral infections on body weight, survival, and tumor prevalence of B6C3F1 (C57BL/6N x C3H/HeN) mice in carcinogenicity studies. AB - Sendai virus (SV), mouse hepatitis virus (MHV), and pneumonia virus of mice (PVM) are common viral infections of mice. Influence of these viral infections on the prevalence of liver tumors, lung tumors, and lymphoma is of concern in chemical carcinogenicity studies. Body weight, survival, and tumor prevalence of B6C3F1 mice with and without viral infections in 33 male and 34 female untreated control groups and 32 male and 32 female low- and high-dose groups of 2-year chemical carcinogenicity studies were evaluated. In male mice, the SV infection was associated with significantly (p less than 0.05) higher survival of control, low dose, and high-dose groups, and higher prevalence of liver tumors and lymphoma. The increases in tumor prevalence are possibly due to an increase in the survival of male mice that had SV infection. However, when interlaboratory variability and time-related effects were taken into account, the number of significant effects was consistent with the expected false-positive rate inherent to the statistical procedures. The MHV and PVM infections did not cause consistent changes in body weight, survival, and tumor prevalences in the control and chemical treatment groups of male mice. Viral infections did not cause consistent increases or decreases in body weight, survival, or tumor prevalence in the control and chemical treatment groups of female B6C3F1 mice. PMID- 2767354 TI - Differential effects of cefmetazole sodium on the reproductive system of infant and pubertal male rats. AB - The effects of cefmetazole (CMZ), a cephem antibiotic which contains the N methyltetrazolethiol (NMTT) side-chain moiety, were compared in infant (6-42 days of age) and pubertal (6-10 weeks of age) male Sprague-Dawley rats. High doses of either CMZ or free NMTT caused reductions in testicular weight and delayed maturation of spermatogenic germ cells in the testes of infant rats, implicating NMTT as the active component in causing these effects. Pubertal rats expressed neither of these effects, even when treated with doses of CMZ far in excess of those used in infant rats. The effects of CMZ and NMTT on testicular weights and histologic features of testes of rats treated as infants were mainly reversed when these animals were examined 35 and 70 days after cessation of treatment. All reproductive functional parameters were normal in mating studies using male rats which had been treated with CMZ or NMTT as infants and allowed to recover. Because of the species differences in rates of sexual maturation and the greater rate at which rats metabolize CMZ to NMTT, the relevance to humans of the testicular effects of CMZ in infant rats is unknown. PMID- 2767356 TI - Effects of epichlorohydrin on male and female reproduction in Long-Evans rats. AB - Male and female Long-Evans rats were treated with epichlorohydrin (ECH) by oral gavage (males: 12.5, 25, and 50 mg/kg/day; females: 25, 50, and 100 mg/kg/day) for 21 and 14 days, respectively, prior to mating trials with untreated animals. Treated females were further dosed until delivery. Fertility was assayed in the high-dose males only and was found to be totally impaired. No measured parameters of female reproduction were changed relative to controls. Treated males showed normal copulatory behavior. Sperm morphology and percentage motile sperm were not statistically different from control values in both ejaculated and cauda epididymal samples from ECH-treated animals. The number of sperm in ejaculates was normal while cauda epididymal sperm count was slightly decreased in males at the 50 mg ECH/kg dose level. Mean curvilinear velocity, straight-line velocity, and amplitude of lateral head displacement of cauda epididymal sperm were significantly reduced by ECH at 12.5 mg/kg/day and above. Sperm track linearity was also reduced, but only at 50 mg/kg/day. Beat/cross frequency of sperm was significantly increased at 12.5 mg/kg/day and above. All of the above sperm motion parameters showed dose-dependent trends. These effects are consistent with the spermatozoal metabolic lesions reported for alpha-chlorohydrin, a metabolite of ECH. PMID- 2767357 TI - Comparative pathology of Prudhoe Bay crude oil and inert shell sealants in chicken embryos. AB - Pathological changes and body weights were compared in 9-day-old chicken embryos exposed to Prudhoe Bay Crude Oil (PBCO), pharmaceutical mineral oil, or a sealing film on the eggshell. Embryos exposed to 10 or 20 microliters PBCO developed marked ascites or subcutaneous edema, extensive liver necrosis, dilation of the heart, and cellular casts and mineralization in renal tubules. Wet and dry body weights were normal or above normal in embryos exposed to PBCO. No changes were found in embryos exposed to 10 microliters mineral oil; embryos exposed to 20 microliters mineral oil had slight dilation of the heart. Very few embryos survived in eggs that were wrapped in sealing film. All embryos that did survive had greatly reduced body weight and marked dilation of the heart. Four of these embryos had vacuolation of hepatocytes at the surface of the liver, one had superficial liver necrosis, and one embryo had slight ascites. These results indicate that the mechanism of the toxic action of PBCO on the avian embryo involves more than simple physical sealing of the shell. PMID- 2767358 TI - Effects of glycerol on lung and liver tumor development. AB - Mice of several strains (A/J, SWR, MaMyJ, BALB/cByJ, 129J, and C57BL/6J) were treated with the carcinogens 3-methylcholanthrene, urethane, and 4-nitroquinoline 1-oxide and then given 1 or 5% glycerol in the drinking water for up to 4 months. Effects of glycerol on lung tumor multiplicity and incidence were evaluated. The effects of glycerol were variable, and in the majority of experiments glycerol failed to enhance tumor development in mouse lung. Analysis of cell kinetics did not show a proliferative response of alveolar or bronchiolar cells to glycerol. In rats, glycerol did not enhance the appearance of putative preneoplastic liver foci, and in C3H mice it did not increase the incidence of spontaneously occurring liver tumors. It is concluded that glycerol does not increase number or incidence of lung tumors in the mouse strains used, whether the animals are pretreated with a carcinogen or not. Glycerol does not affect liver tumor development. PMID- 2767359 TI - 30-day oral toxicity study of L-selenomethionine in female long-tailed macaques (Macaca fascicularis). AB - Twenty female long-tailed macaques received nasogastric intubation of 0-600 micrograms/kg-day L-selenomethionine for up to 30 consecutive days. Selenium ingestion was well tolerated at all dose levels until the second to third week of the study at which time two animals given 600 micrograms/kg-day died. One animal from the 300 micrograms/kg-day group was removed from study on Treatment Day 19 due to selenium-induced hypothermia. In some cases, administered doses were reduced at the 300 and 600 micrograms/kg-day levels such that the final time weighted average doses were 0, 25, 62-117, 150, 188-203, and 300 micrograms/kg day. Six animals at the 188 micrograms/kg-day level or greater required nonscheduled fruit and dietary supplementation to prevent their impending demise. As the dose and duration of exposure increased, the incidence of anorexia, gastrointestinal distress, mucocutaneous toxicity, and frequency of reduced body temperature also increased. A dose-dependent reduction in body weight was also observed. At the greater doses, disturbances in menstrual function were evident, and were accompanied by the absence of serum progesterone concentrations above 1.0 ng/ml, reduced luteal phase lengths, increased intermenstrual intervals, and lowered estrogen excretion. A maximum tolerated dose of 150 micrograms/kg-day L selenomethionine for 30 days was identified based on mean body weight reduction, hypothermia, dermatitis, xerosis, cheilitis, disturbances in menstruation, and the necessity of dietary intervention to prevent death at doses of 188 micrograms/kg-day or greater. PMID- 2767360 TI - Chloroform inhibition of 1,2-dimethylhydrazine-induced gastrointestinal tract tumors in the Fisher 344 rat. AB - The effect of chloroform (CHCl3), administered at 0, 900, and 1800 mg/liter in the drinking water, on the carcinogenic potency of 1,2-dimethylhydrazine (DMH) was investigated. Groups of 40 male Fisher 344 rats were given one of the three drinking water solutions for 39 weeks following the subcutaneous injection of 200 mg/kg DMH, a known gastrointestinal (GI) tract carcinogen in this animal strain. When tumors from the GI tract were pooled there was a highly significant (p less than 0.001) decrease in total number of tumors per group with increasing concentration of drinking water CHCl3. In the control group (0 mg/liter CHCl3), 14/39 (36%) of the animals developed tumors of the GI tract, including the duodenum, jejunum, stomach, cecum, and colon. In contrast, the incidence of tumors in the two groups of rats given CHCl3 in the drinking water was significantly lower (p less than 0.001; 900 mg/liter CHCl3, 12.8%; 1800 mg/liter CHCl3, 12.5%). A similar relationship was obtained when colon tumors were analyzed independently (p = 0.01). The incidence of total colon tumors obtained in the control group of this study (10/39, 26%) agrees well with the previous study by B.S. Reddy, K. Watanabe, and J.H. Weisburger (1977, Cancer Res. 37, 4156 4159) conducted in the same rat strain (7/30, 23%). These results demonstrate that CHCl3 in the drinking water inhibits carcinogenesis in the rat GI tract. PMID- 2767361 TI - Cardiac, renal, and pulmonary toxicity of several mitomycin derivatives in rats. AB - The potential cardiotoxicity, nephrotoxicity, and pulmonary toxicity of several mitomycin (MMC) derivatives, BMY-25067 (N-7-[2-(4-nitrophenyldithio)ethyl]MMC), BMY-26107 (N-7-[2-(4-aminophenyldithio)ethyl]MMC), BMY-26605 (N-7 acetyl-MMC), BMY-25690 (7-N-(dimethylaminomethylene)-10-[1-morpholinomethyleneamino)carbo nyl- oxy]MMC), BMY-26646 (N-7-[2-(4-fluorophenyldithio)ethyl]MCC), and BMY-25551 (7-(2 hydroxyethyl)mitosane), were evaluated in rats. Groups of 10 male Sprague-Dawley rats were given single intravenous doses of the test compounds and were then observed for 10 weeks. Doses represented 67 and 33% of the respective mouse LD10 (corrected for body size on a mg/m2 basis) of each test compound. BMY-25282 (7-N (dimethylaminomethylene)MMC), a mitomycin derivative that produces cardiac, renal, and arterial lesions, was used as a reference drug. Hematologic and blood chemical parameters were monitored at 3 days and at 3, 6, and 10 weeks after drug administration. Heart, kidney, and lung were examined histopathologically. Drug related cardiac changes with late onset were seen histopathologically in rats treated with BMY-26605, BMY-25282, BMY-25551, and BMY-25690 (in order of decreasing severity). Drug-related renal changes, consisting of tubular degeneration and glomerulopathy, were seen in rats treated with BMY-25690, BMY 26107, BMY-25282, BMY-25551, BMY-26605, and BMY-25067 (in order of decreasing severity). Pulmonary arterial lesions were noted inconsistently in rats treated with BMY-26605, BMY-25282, and BMY-25551. Neither cardiac, renal, nor pulmonary changes were seen in rats administered BMY-26646, and only minor drug-related renal changes were seen in rats treated with BMY-25067. PMID- 2767362 TI - Reversible uranyl fluoride nephrotoxicity in the Long Evans rat. AB - Severity and duration of renal injury produced by low levels of uranyl fluoride (UO2F2) were examined in the rat. Rats received multiple ip injections of UO2F2 (cumulative dose: 0.66 or 1.32 mg U/kg body wt). Renal injury was characterized histologically by cellular and tubular necrosis of pars recta of proximal tubule (S2 and S3), with less severe cellular injury to thick ascending limb of loop of Henle and collecting tubule. Injury was evident when renal uranium levels were between 0.7 and 1.4 micrograms U/g wet kidney and was most severe when renal uranium burden was between 3.4 and 5.6 micrograms U/g. Repair of injury was rapid, with complete restoration within 35 days after exposure. Associated with injury were abnormalities in renal function, including impaired tubular reabsorption, proteinuria, and enzymuria, which appeared temporally related, to variable degrees, to progression of renal injury. Thus, reversible renal injury occurs in the rat at levels of uranium in kidney below the present Nuclear Regulatory Commission standard of 3 micrograms U/g kidney for renal injury in humans. PMID- 2767363 TI - The effects of inhalation exposure to sulfuryl fluoride on fetal development in rats and rabbits. AB - Sulfuryl fluoride is a fumigant insecticide used for soils and permanent structures. Pregnant Fischer 344 rats and New Zealand White rabbits were exposed to 0, 25, 75, or 225 ppm of sulfuryl fluoride vapor via inhalation for 6 hr/day on Days 6-15 and 6-18 of gestation, respectively. Among rats, maternal water consumption was increased in the 225 ppm exposure group, but there were no indications of embryotoxicity, fetotoxicity, or teratogenicity in any of the exposed groups. Among rabbits, maternal weight loss during the exposure period (Days 6-18) was observed in the 225 ppm group. Decreased fetal body weights, considered secondary to maternal weight loss, were also observed at 225 ppm. However, no evidence of embryotoxicity or teratogenicity was observed among rabbits in any exposure group. Thus, inhalation exposure to sulfuryl fluoride was not teratogenic in either rats or rabbits exposed to levels of up to 225 ppm, and fetotoxic effects (reduced body weights) were observed among fetal rabbits only at an exposure level that produced maternal weight loss. PMID- 2767364 TI - [The stomato-dermatologic manifestations of some internal diseases]. PMID- 2767365 TI - [Liver cirrhosis. Survival of a homogeneous population]. AB - The aim of the study was the evaluation of survival of 140 cirrhotic patients who had a liver biopsy between 1970 and 1987. It is interesting to point out that all the patients with cirrhosis were included in the study and that they were all coming from a limited geographic area. This justifies the limited drop-out (7/147 patients). The high survival rate could be due to the fact that only patients suitable to receive a liver biopsy were elected for the study. We found that factors critical for prognosis in the short term (6-12 months) are biochemical values such as prothrombin index, serum albumin, serum bilirubin, alkaline phosphatase, while the factors affecting long-term prognosis are age, sex, etiology of cirrhosis, high alcohol intake after biopsy, ascites and untreated portal hypertension. PMID- 2767366 TI - [Findings in relation to serum and urinary iron in heterozygotic beta thalassemia]. AB - Iron status (expressed as serum ferritin and iron levels) has been compared in normal and in heterozygous beta-thalassemic subjects. A higher serum ferritin concentration has been found in beta-thalassemic males, showing, therefore, a shift towards super-normal values of the balance between tissue iron and serum ferritin levels. In beta-thalassemic subjects the serum ferritin levels have been found in the normal range and this seems to be correlated with an adequate and ready iron supply by protein transferrin to hyperplastic bone marrow. The higher urinary iron values in normal male subjects can be explained in this way: a large iron supply from the transferrin to the thalassemic erythroid cells limits the contribution from this protein to the urinary iron. PMID- 2767367 TI - [Intranasal calcitonin]. PMID- 2767368 TI - [Clinical case (nephrotic syndrome associated with thrombosis of the inferior vena cava)]. PMID- 2767369 TI - [Cyclosporin]. PMID- 2767370 TI - [A case of polyneuropathy and ischemic lesion of the spinal arteries]. PMID- 2767371 TI - [Angiographic morphology of coronary lesions in various syndromes of ischemic cardiopathy]. AB - The angiographic morphology of coronary lesions is often completely ignored in the prognostic and decision-making process related to patients with coronary disease. We performed this study to evaluate the possibility of identifying complex or complicated atherosclerotic lesions by means of routine diagnostic coronary arteriography, and to assess their prevalence in the different syndromes of ischaemic heart disease. From an overall group of 200 successive cases studied using coronary angiography, 111 patients with significant coronary artery disease in whom a "culprit lesion" could be identified were retrospectively selected. The angiographic morphology of coronary lesions was defined according to an original classification as: 1) simple stenosis, 2) complex lesion, 3) thrombosis. Of the 111 patients, 36 had been studied for stable angina, 31 for unstable angina, 10 for a non-Q wave myocardial infarction, 34 for transmural infarction. The clinical groups did not show any significant differences when compared on the basis of number of vessels involved and degree of narrowing of the ischaemia producing artery. Significant differences were found when angiographic morphology was analyzed. In stable angina 78% of ischaemia producing lesions appeared as simple stenoses, while 92% of the unstable or more severely ischaemic patients exhibited complicated lesions (p less than 0.001). In unstable angina and non-Q infarction a complex lesion was present respectively in 71% and 60% of the cases; clear-cut intraluminal thrombosis was demonstrated in 23% of unstable angina, in 30% of non-Q wave infarction and in 39% of transmural infarction (p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2767372 TI - [Quantitative evaluation of left ventricular systolic function using bidimensional echocardiography: comparison with cineangiography]. AB - The aim of the study was to compare the evaluation of the left ventricular systolic function performed both by angiography and 2D-echocardiography on 80 subjects (31 with coronary artery disease, 18 with left ventricular volume overload, 10 with left ventricular pressure overload, 14 with mitral valve disease and 7 normal controls). The 2D-echocardiograms of the left ventricle with simultaneous measurement of the right arm systolic blood pressure was performed within 24 hours of the angiographic examination. The following parameters were obtained using the two methods: end-diastolic volume index, end-systolic volume index, ejection fraction, left ventricular mass index, mass/volume ratio, end systolic circumferential stress, contractility expressed as end-systolic circumferential stress/end-systolic volume ratio; the end-systolic circumferential stress/ejection fraction ratio was calculated only by 2D echocardiography. The afterload and contractility were not calculated in subjects with coronary artery disease and left ventricular outflow gradient. No statistically significant differences were shown between the two methods, except a slight under-estimation by echocardiography of the angiographic end-diastolic volume index (93.1 +/- 38.9 ml/m2 vs 115 +/- 39.9 ml/m2; p less than 0.01) and over-estimation of the mass/volume ratio (1.38 +/- 0.33 g/ml vs 1.2 +/- 0.44 g/ml; p less than 0.01) was shown between the two methods for all parameters. A depressed contractile state was also demonstrated by the end-systolic circumferential stress/ejection fraction ratio. The inter and intraobserver variability was 6.6 +/- 4.4% (range 0.16%) and 4.2 +/- 3% (range 1.11%) respectively.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2767373 TI - [Apical hypertrophic cardiomyopathy: variability of bidimensional echocardiographic and electrocardiographic expression]. AB - Apical hypertrophic cardiomyopathy is characterized by primary hypertrophy of the myocardium which is localized exclusively at the apex of the left ventricle. Previous studies have indicated that apical hypertrophic cardiomyopathy is characterized by a unique combination of cross-sectional echocardiographic and ECG findings ("giant" T wave inversion and high R wave voltage in the precordial leads). The aim of this study was to evaluate the possible relation between apical hypertrophy, quantitatively defined by cross-sectional echocardiography, and ECG findings in patients with apical hypertrophic cardiomyopathy. We studied 13 pts with apical hypertrophic cardiomyopathy, 10 men and 3 women (aged between 11 and 73 years, mean age 47). Apical hypertrophy was assessed quantitatively by determinating the muscle cross-sectional area in the apical region. From the end diastolic apical 4 chamber view, endocardial and epicardial contours were digitized in order to obtain the muscle cross-sectional area of the left ventricle. The walls of the left ventricle were then divided into 3 regions (basal, mid-ventricular, apical). Final values of planimetered muscle areas are given as the average of the calculations obtained blindly and independently by 4 observers. The comparison between cross-sectional echocardiographic and electrocardiographic findings showed that patients with giant T wave inversion (T wave greater than 10 mm) and high R wave voltages (R greater than wave 25 mm) had a more severe degree of apical hypertrophy. However there was no complete agreement between cross-sectional echocardiographic and electrocardiographic findings. This study in fact demonstrates a wide variation in the degree of severity of apical hypertrophy among patients with apical hypertrophic cardiomyopathy.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2767374 TI - [Atrial electrophysiologic properties in paroxysmal atrial fibrillation. Study conducted with the stimulation of 5 atrial sites]. AB - Programmed atrial stimulation at five atrial sites was performed to evaluate electrophysiologic atrial properties in 17 control patients (14 M, 3F, mean age 61 +/- 9 years) (Group A) and in 18 patients with paroxysmal atrial fibrillation (13 M, 5 F, mean age 61 +/- 5 years) (Group B) with normal sinus node function. The mean value of the P wave duration was similar in both groups. Programmed atrial stimulation was performed at five atrial sites: high, medium and low lateral wall, and high and low medial wall. We evaluated the following parameters: A) local conduction delay measured at the functional refractory period as the difference between A1-A2 and S1-S2 intervals; B) widening of local electrogram measured at the functional refractory period as the difference between A1-A2 interval measured at the end of each local electrogram and A1-A2 interval measured at the beginning of each local electrogram. We evaluated the mean and the maximum value of the two above-mentioned parameters; C) dispersion of effective refractory period and functional refractory period, determined as the longest minus the shortest refractory period from the range of refractory periods measured in each patient; D) the mean of effective refractory periods and functional refractory periods observed at five atrial sites. Mean and maximum local conduction delay, mean effective and functional refractory periods did not present significant differences in both groups.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2767376 TI - [Pulmonary arteriovenous aneurysm coexisting with rheumatic mitral valvulopathy in Rendu-Osler-Weber syndrome. Image diagnosis using bidimensional and Doppler echocardiography]. AB - The authors report a case of the rare association described in the title in which echocardiography played an important role in the recognition of the pulmonary arteriovenous aneurysm. By 2-D approach it was possible to visualize a wide anechogenic concamerated area containing an echodense mass and continuous with the left heart cavities. Pulsed Doppler interrogation at the level of the extra cardiac cavity showed a flow signal which gave the first diagnostic evidence of a vascular lesion. Direct visualization of pulmonary arteriovenous aneurysms has never before been obtained with echocardiography. This was possible in the present case due to contiguity with heart chambers and the large dimension of the aneurysm. Doppler examination gave the first confirmation of the vascular nature of the lesion. Angiography is still a mandatory pre-operative procedure but 2-D and Doppler echocardiography may play an interesting role in the diagnostic non invasive procedure of pulmonary arteriovenous aneurysms. PMID- 2767375 TI - [Acute myocardial infarct in a 14-year-old girl treated with contraceptives. Coronary arteriography and immediate thrombolytic therapy]. AB - A 14 year old girl on oral contraceptive treatment for menstrual disorders, was admitted with an acute anterior myocardial infarction and underwent immediate coronary arteriography and intracoronary thrombolysis (urokinase 350,000 units) within 4 hours of the onset of symptoms. A segmental occlusion of the left anterior descending artery with no evidence of coronary atherosclerosis elsewhere was shown. A successful re-canalization was documented after fibrinolytic therapy. The present is the first reported case, in a patient of this age, with an angiographic demonstration during the acute phase of the thromboembolic pathogenesis of myocardial infarction in contraceptive users. The potential benefit of early thrombolytic treatment in this rare clinical setting is thus suggested. PMID- 2767377 TI - [Paroxysmal tachycardia with long QRS (left branch block type) in a female patient with accessory nodo-ventricular pathway. Role of the anomalous pathway in the electrogenesis of the arrhythmia]. AB - The authors report a case of paroxysmal tachycardia with widened QRS (left bundle branch block morphology), where the electrophysiologic investigation shows an accessory nodo-ventricular pathway and suggests its involvement, as descendent (anterograde) pathway in a circular movement, the ascendant (retrograde) limb of which is the nodo-hisian pathway. PMID- 2767378 TI - [Changes in arterial pressure and adrenergic activity during a holiday at a mountain at low altitude]. AB - To answer the question often asked by hypertensive patients whether it is advisable for them to spend a holiday in the mountains for fear of a rise in blood pressure, 12 untreated mild hypertensive and 12 normotensive subjects underwent 24-hour non-invasive blood pressure monitoring, plasma catecholamines assay (HPLC) and plasma renin activity determination at home (sea level) and in a mountain resort (1210 m). The 2 evaluations (at home and in the mountains) were performed in a cross-over fashion. The ICR Spacelabs Pressuromaster and the Del Mar Avionics Pressurometer IV were used: blood pressure was measured every 8 minutes during daytime and every 15 minutes during sleep. Blood pressure was also recorded during a 1.5 to 3 hour excursion by cable-car to a height of 3006 m. Average 24-hour blood pressure at sea level was 134/86.7 mmHg in the hypertensive subjects and 115.8/73.6 mmHg in the normotensive ones. At 1210 m, it rose to 140.6/90.2 mmHg (n.s.) and to 120.8/74.9 mmHg (n.s.) respectively. Twenty-four hour profiles showed that the blood pressure difference was present only during waking hours, while during sleep blood pressure levels were similar at sea level and in the mountains.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2767379 TI - The role of school nurses in health promotion and prevention of illness. PMID- 2767380 TI - Snare cautery debridement prior to Nd:YAG photoablation improves treatment efficiency of broad-based adenomas of the colorectum. AB - Forty-six patients who underwent piecemeal resection of large, sessile villous adenomas followed by immediate laser photoablative therapy are presented. In contrast to previously published series utilizing laser alone, prior snare resection of such lesions provides copious tissue for histologic analysis, decreases the amount of residual neoplasm requiring laser treatment, and has the potential to improve treatment efficacy. PMID- 2767381 TI - Retrograde biliary ultrathin endoscopy enhances biopsy of stenoses and lithotripsy. AB - Forceps biopsies of biliary stenoses are difficult to direct under fluoroscopy and for this reason may give spurious results. In addition, fluoroscopy does not prevent the electrohydraulic lithotripsy (EHL) probe from damaging the bile duct wall. Retrograde biliary endoscopy with the ultrathin endoscope (UTE) was tested in 12 patients to guide biopsies and in 6 patients to guide EHL. Results of biopsies were confirmed by surgery or the disease course in each of the 12 patients. Only one stone could not be fragmented and removed because the EHL probe could not be properly placed. The diagnosis of biliary stenosis may be markedly enhanced by using a UTE although at the risk of an endoscopic sphincterotomy and subsequent biliary infection. EHL with UTE is difficult and time consuming but further technical development may make it more practical immediately following sphincterotomy. PMID- 2767382 TI - Early postoperative endoscopic sphincterotomy for retained common bile duct stones. AB - Endoscopic sphincterotomy was performed within 28 days after cholecystectomy in 20 patients with retained common bile duct stones, of whom 15 (75%) underwent endoscopic sphincterotomy within the first week of surgery. Stone extraction was successful in all patients and no immediate complications were noted. Early endoscopic sphincterotomy for retained common bile duct stones was safe and effective in the early postoperative period. PMID- 2767383 TI - Nine cases of acute gastric anisakiasis. AB - From 1983 to 1988, we treated 19 patients with acute gastritis which was highly suggestive of gastritis anisakiasis. Almost all of these patients complained of sharp, periodic, upper abdominal pains which occurred several hours after ingestion of raw fish. Among the 19 patients, 10 anisakis larvae from nine patients were successfully removed by endoscopic forceps. However, in the remaining 10 patients, who also showed the typical clinical course of anisakiasis, we could not find the anisakis larvae endoscopically. All 10 larvae were identified as stage III, anisakis type 1. The intolerable pain was relieved as soon as endoscopic removal of the larvae was accomplished in all nine patients. The purpose of this article was to report the clinical findings and emphasize the importance of early endoscopic management of acute gastric anisakiasis. PMID- 2767384 TI - Flexible fiberoptic sigmoidoscopy training for primary care physicians: results of a 5-year experience. AB - The first 5 years of a flexible fiberoptic sigmoidoscopy (FFS) training program for primary care physicians was analyzed in an attempt to assess clinical competence and develop a procedure learning curve. A total of 47 primary care physicians (26 third-year family practice residents, 15 family practitioners, and 6 internists) were successfully trained in 60-cm FFS by five gastroenterologists. Didactic teaching methods included 5 hours of videotapes, slides, endoscopic models, and the use of a photo atlas. Following a patient demonstration, each trainee completed 25 examinations supervised with a teaching attachment. Criteria used to assess trainee competence included unassisted length of scope insertion and examination duration. Mean depth of scope insertion was 35.9 cm for the first five examinations, increasing to a mean of 51.7 cm for the final five examinations. Average examination duration decreased from 19.1 min for examinations 1 through 5 to 17.0 min for examinations 21 through 25. Out of 1236 examinations, one or more polyps were found in 222 patients (18.0%). Carcinoma was found in 15 of 1236 examinations (1.4%). In summary, experienced endoscopists can teach primary care physicians to perform 60-cm FFS. Completion of 25 supervised cases appears to be adequate for achieving technical competence in flexible fiberoptic sigmoidoscopy. PMID- 2767385 TI - Endoscopic cytology of cancer of the esophagus and cardia: a long-term evaluation. AB - Between January 1979 and December 1986, 858 endoscopic cytological examinations of the esophagus were performed, including 309 patients with confirmed malignancies. A positive cytological diagnosis of cancer was made in 289 (93.5%). Adequate biopsies were obtained in 269 instances (87.0%), being positive in 238 cases (overall positivity of biopsy, 77.02%). The combined use of biopsy and cytology provided a correct diagnosis in 98.0% of cases. The cytological examinations were positive in 30 of 40 patients (75.0%) with obstructing lesions in whom no satisfactory biopsies could be obtained. No false positive diagnosis was made among the 550 patients with benign conditions. In this series, cytology increased the yield of biopsy by 20.8%. PMID- 2767386 TI - Usefulness of pediatric colonoscopes in adult colonoscopy. AB - Use of small diameter, extraflexible pediatric colonoscopes has proved to be valuable in adult endoscopy practice, not only for passing strictures and stomas but also where either fixation due to diverticular disease or postoperative adhesions, or unavoidably painful looping made passage of adult colonoscopes impossible. In 70 of 78 (92%) of the cases where the adult colonoscope could not be passed through the sigmoid colon by an expert endoscopist, the pediatric colonoscope passed through, often very easily. Fifteen of these patients were considered to have been saved surgery by successful passage. The "failure" rate for all colonoscopy examinations was only 2%; this low failure rate was attributable to the use of pediatric instruments whenever passage through the sigmoid colon proved to be impossible with standard colonoscopes. In our opinion every unit performing frequent colonoscopies should have a pediatric colonoscope available for selected adult patients as well as for use in children. PMID- 2767387 TI - Prospective evaluation of a small caliber upper endoscope for colonoscopy after unsuccessful standard examination. AB - Colonoscopy is unsuccessful in some patients because of a fixed sigmoid loop or anatomical stenoses. We prospectively evaluated 1600 patients undergoing colonoscopy at Virginia Mason Medical Center from December 1, 1986 to November 31, 1987. Thirty-one procedures (1.9%) failed to reach the splenic flexure because of functional or anatomic stenoses. Attempt at pancolonoscopy with a 9.8 mm diameter, 102-cm length endoscope (Olympus XQ) was successful to the right colon in 73% and cecum in 60% of these patients. Two thirds of the successfully intubated patients had clarification of radiographic abnormalities or delineation of additional colon pathology. There were no complications or instrument damages, but limitations included short scope length and small suction channel. We conclude that small diameter upper endoscopes can be used safely and effectively for colonoscopy in a subset of patients in whom conventional colonoscopy is unsuccessful. PMID- 2767388 TI - An endoscopic stapling device: the development of a new flexible endoscopically controlled device for placing multiple transmural staples in gastrointestinal tissue. PMID- 2767389 TI - Double gallbladder with transient cholestasis: preoperative demonstration by endoscopic retrograde cholangiopancreatography. PMID- 2767390 TI - Promptly fillet and keep the doctor away. PMID- 2767391 TI - Endoscopic laser therapy versus surgery for adenocarcinoma of the rectum. PMID- 2767392 TI - Suite in GI major. PMID- 2767393 TI - Endoscopic duodenal aspiration for diagnosis of giardiasis. PMID- 2767394 TI - Management of sump syndrome after choledochoduodenostomy. PMID- 2767395 TI - YAG laser treatment for radiation proctitis. PMID- 2767396 TI - Paraendoscopic balloon dilation of luminal strictures. PMID- 2767397 TI - Preoperative diagnosis of gallbladder perforation by ERCP. PMID- 2767398 TI - Endoscopic retrieval of ingested broken glass in the esophagus and stomach by end hood and suction technique. PMID- 2767399 TI - The localization of oxytocin and mesotocin in the reproductive tract of the male marsupial bandicoot Isoodon macrourus. AB - The cellular localization of oxytocin and mesotocin within the testis and prostate of the Northern brown bandicoot, Isoodon macrourus, was examined. Tissues were fixed in 4% paraformaldehyde and immunoreactive cells and tissues were detected with antibodies to oxytocin and mesotocin. Immunoreactive oxytocin was present in the Leydig cells and in the spermatids of the adult and the 263 day bandicoots and there was faint staining in the 123-day bandicoot. Mesotocin was not present in the testes of the bandicoot. Immunoreactive oxytocin and mesotocin were present in the ventral portion of the prostate. The oxytocin within the testis may play a role in spermatogenesis and in seminiferous tubule contractility whereas the hormones present in the accessory glands may have a role in sperm transport in the female reproductive tract. PMID- 2767400 TI - Plasma progesterone through pregnancy and the estrous cycle in the eastern quoll, Dasyurus viverrinus. AB - Plasma progesterone concentrations were measured every 2 or 3 days in eastern quoll, Dasyurus viverrinus, during pregnancy (20.5 +/- 0.8 days, n = 6, mean +/- SEM) and the estrous cycle (37.5 +/- 0.7 days, n = 20, mean +/- SEM). The pattern was not apparently different between the two reproductive states. There was a significant proestrus rise in progesterone (from 0.5 to 4 ng/ml) from 5 days before until 1 day after mating. For the next 4 to 6 days, levels were low, but after Day 9 or 10 increased to maximum concentrations of 4.5 to 15 ng/ml which were maintained until about Day 17 to 19. In all females, progesterone was basal (less than 1.0 ng/ml) by Day 20 to 21 and thereafter remained low in lactating females, but nonpregnant females showed a proestrous rise about 5 to 7 days before the next mating. The period of elevated concentrations of progesterone coincided with prominent corpora lutea (CL) on the ovaries. There was no evidence of CL of a previous cycle persisting into the next cycle. The results indicate that pregnancy occupies the luteal phase of the cycle and does not appear to influence the secretory life span of the CL. PMID- 2767402 TI - The effect of eel calcitonin on calcium influx and plasma ion levels in axolotls, Ambystoma mexicanum. AB - Plasma total calcium and calcium influx, measured during 4-h 45Ca influx experiments, were lower in control axolotls, Ambystoma mexicanum, during August when compared to those in July. A single intraperitoneal injection of 10 micrograms of synthetic eel calcitonin significantly reduced the calcium influx rates during both months but the effect was greater in July (P less than 0.001) than in August (P less than 0.05). Plasma levels of calcium, sodium, potassium, and magnesium were not affected. In neotonous wholly aquatic amphibians, eel calcitonin may work in the same way as it does in fish by reducing the uptake of dissolved calcium from the ambient medium. PMID- 2767401 TI - Gonadotropin stimulation of K+ secretion and Na+ absorption by brook trout (Salvelinus fontinalis) sperm duct epithelium. AB - The sperm duct epithelium from mature spermiating brook trout (Salvelinus fontinalis) was mounted in vitro to examine control of Na+ absorptive and K+ secretory transport. Na+ absorption (measured as the short-circuit current) and K+ secretion (measured using 86Rb+ as tracer) were stimulated by 3-isobutyl-1 methylxanthine and cyclic AMP while unstimulated tissues had no net ion transport. Purified chum salmon (Oncorhynchus nerka) Con AII carbohydrate-rich gonadotropin produced a rapid, sustained rise in Rb+ secretion and Na+ uptake in a log linear dose-dependent manner. Addition of gonadotropin to either apical (mucosal) or basolateral (serosal) sides evoked the response, but addition to the apical side produced the more rapid effect, indicating that receptors for the hormone are present on both sides of the transporting cells and suggesting that subepithelial tissue may slow the response to serosally added hormone. This is the first indication that gonadotropin may directly regulate ion transport functions of the blood-testis barrier of vertebrates and in this way regulate seminal plasma ionic composition. PMID- 2767403 TI - Effects of photoperiod and temperature on gonadal maturation, and plasma steroid and gonadotropin levels in a cyprinid fish, the honmoroko Gnathopogon caerulescens. AB - The honmoroko (Gnathopogon caerulescens), a small, spring-summer-breeding cyprinid fish, was exposed to various temperature and photoperiod regimes during different phases of its annual reproductive cycle. In autumn, a clear photoperiodism was seen, especially at warm temperatures (18-24 degrees). The gonadosomatic index, plasma gonadotropin (GtH), and gonadal steroids were higher in fish held at long photoperiod (15L/9D) than in those held at short photoperiod (12L/12D); the differences were greater as the temperature increased. In early spring, gonadal recrudescence progressed at temperatures above 7 degrees, regardless of photoperiod. Photoperiod did not affect plasma GtH and gonadal steroid levels at this time of the year. During its spawning season, a long photoperiod (15L/9D) was again required to maintain gonadal activity and high plasma GtH and gonadal steroid levels, especially at high temperature (25 degrees). In early summer, high temperatures (25 and 30 degrees) suppressed gonadal activity; however, gonadal steroid levels were not depressed, and plasma GtH levels actually increased. The data suggest that under natural conditions, high water temperatures in summer may act directly at the gonadal level, and is probably the factor which terminates the breeding season for this species. The results of these four experiments indicate that the honmoroko exhibits a photoperiodic response during the autumn month and its spawning season, and is dependent on the water temperature. The effects of photoperiod on gonadal maturation appear to be GtH mediated, whereas the suppressive effects of high temperature are not. PMID- 2767404 TI - Hormonal correlates of migration and territorial behavior in juvenile willow tits during autumn. AB - This study compared plasma levels of dihydrotestosterone, testosterone, corticosterone, luteinizing hormone, growth hormone, and prolactin in migrating juvenile willow tits with those in territorial juveniles. Both categories of birds were caught in late September. Migrating juveniles had higher plasma levels of corticosterone than territorial juveniles. Only corticosterone secretion was affected by "handling stress" in both migrating and territorial juveniles. However, territorial birds showed a much stronger relationship between these two variables. It is suggested that high corticosterone levels are involved in the emigration of juveniles out of the coniferous forest. Only juveniles were found among the migrating willow tits, and these birds were not well adapted for migration. Migrating juvenile males had less fat stored than did territorial ones. Furthermore, migrating juvenile males had higher liver/somatic index and higher plasma levels of growth hormone than did territorial males. These results indicate that migrating males had been, or were, exposed to food restrictions. The same proportion of migrating and territorial juveniles, males as well as females, had high plasma levels of testosterone. We suggest that these high levels were caused by recent aggressive interactions. To test the hypothesis that high plasma levels of testosterone are important for a juvenile to become a member of a territorial winter group, we performed a field experiment in which juveniles were given testosterone implants (controls were given empty silastic tubes) at the beginning of the territorial establishment period. The same proportion of testosterone-implanted birds and control birds succeeded in becoming members of territorial winter groups. Thus, testosterone does not seem to play an essential role in autumn territoriality, and it does not prevent autumn migration. PMID- 2767405 TI - Developmental and comparative aspects of nonsynaptic release by the egg-laying controlling caudodorsal cells of basommatophoran snails. AB - In an immunoelectron microscope study the postembryonic development of the cerebral caudodorsal cells (CDC) in the freshwater snail Lymnaea stagnalis was studied as well as the development of similar neurons in other basommatophoran families. The CDC of adult L. stagnalis control egg-laying and associated behaviors by releasing various peptides, including the ovulation hormone CDCH. The CDC release peptides from neurohemal axon terminals and from nonsynaptic release sites of axon collaterals. During postembryonic development the collateral system develops synchronously with the neurohemal area. The first collaterals appear in the cerebral commissure of juvenile snails (10 mm shell height; S = 10). Up to S = 30 they gradually increase in size and length and eventually run through the entire inner compartment. Secretory granules in both collaterals and neurohemal axon terminals increase in size as well. Immunoelectron microscopy combined with the TARI-method for the demonstration of exocytosis indicates that CDCH-release from collaterals and neurohemal terminals occurs already in S = 10; exocytosis of immunoreactive granule contents takes place from nonsynaptic release sites, unspecialized areas of the axolemma of the collaterals. Release activity in the collaterals gradually increases up to S greater than or equal to 20. Neurohemal release activity shows a similar picture except for a steep increase in adult snails. A distinct glial sheath, separating the neurohemal area from the collateral system, appears around S = 15. Representatives of three families of Basommatophora, viz. the lymnaeid L. ovata, the planorbid Planorbis planorbis, and the bulinid Bulinus truncatus possess a well-developed collateral system showing many signs of exocytosis. A glial sheath separates the collaterals from the neurohemal area. Secretory granules of the CDC in L. ovata stain weakly positive with the anti-CDCH antiserum. Since the other Basommatophora did not show immunoreactivity, the chemical structure of egg laying peptides in Basommatophora seems to be genus specific. Apparently the secretory activity of both the neurohemal area and the collateral system is not only important in the sexually mature animal, being involved in the control of egg laying and egg-laying behavior, but also in the juvenile snail. The finding of a collateral system in representatives of three basommatophoran families strongly indicates the importance of the system for the control of reproduction in basommatophoran snails in general. PMID- 2767406 TI - Immunocytochemical demonstration of a novel system of neuroendocrine peptidergic neurons in the pond snail Lymnaea stagnalis, with antisera to the teleostean hormone hypocalcin and mammalian parathyroid hormone. AB - Immunocytochemical staining with antisera raised against trout hypocalcin, the hypocalcemic hormone of the Stannius corpuscles and against bovine parathyroid hormone (bPTH1-84), revealed a new system of neuroendocrine neurons in the pond snail Lymnaea stagnalis. The neurons are located in small groups or single cells in the visceral, parietal, and pedal ganglia of the central nervous system. The axons of these cells are running to the periphery of the pleuroparietal, visceroparietal, and pleuropedal connections, the dorsopedal commissure, and to several nerves originating in the visceral, parietal, and pedal ganglia. The axons are ending with characteristic axonal distensions in the periphery of these connectives, commissure, and nerves. These regions probably act as neurohaemal areas. The affinity of this neuroendocrine system for both the anti-hypocalcin and anti-PTH sera is another indication for a special relationship between hypocalcin and PTH, which possess some immunological resemblance and similar biological activities, although no similarity in primary structure. PMID- 2767407 TI - Prolactin cell activity and sodium fluxes in tilapia (Oreochromis mossambicus) after long-term acclimation to acid water. AB - In tilapia exposed for 3 months to water of pH 4.5, prolactin cell activity, as estimated by ultrastructural morphometry and determination of prolactin synthesis in vitro, was significantly higher than in controls from neutral water. Sodium influx from the water was 50% lower than in the controls, indicating impaired branchial sodium uptake mechanisms. In contrast to predictions based on the results of short-term exposure to acid water--which is known to induce an increase of sodium efflux--the sodium efflux rate was reduced to 70% of the control value. It is concluded that tilapia are able to acclimate to acid water by successful control--probably via prolactin--of diffusional sodium losses across the integument, in particular the gill surface. This compensates for the impaired sodium uptake, and enables the fish to reestablish a positive sodium balance in acid water. PMID- 2767408 TI - Effect of environmental temperature and photoperiod on the melatonin levels in the pineal, lateral eye, and plasma of the frog, Rana perezi: importance of ocular melatonin. AB - Day-night melatonin concentrations were studied in the pineal body, lateral eye, and plasma of the frog Rana perezi in animals maintained in February and July under long (18L:6D) or short (6L:18D) photoperiod and high (25 +/- 1 degree) or low (6 +/- 1 degree) temperature in order to evaluate the influence of these environmental factors. When frogs were kept under short photoperiod and low temperature in February, no melatonin rhythm was observed in the pineal, ocular tissue, and plasma. High temperature at this period of the year induced a day night rhythm of melatonin levels in the lateral eye and plasma. In July, under long photoperiod and high temperature, animals showed pronounced rhythms of melatonin in the pineal, eye, and plasma. A decrease of environmental temperature in this season abolished the melatonin rhythm. When animals were maintained in August under high (25 +/- 1 degree) temperature and long (18L:6D) or short (6L:18D) photoperiod, the duration of high night time ocular melatonin levels was correlated to the length of the dark phase. In all experiments the high ocular melatonin concentrations and the close parallelism observed between ocular and circulating melatonin profiles suggest that in this species melatonin could be released from the eyes in the general circulation. PMID- 2767409 TI - Photoperiodic time measurement during the termination of photorefractoriness in the starling (Sturnus vulgaris L.). AB - Groups of photorefractory male European starlings have been kept under Nanda Hamner LD schedules ranging from LD 6:6 to LD 6:54 for about 6 weeks. Subsequently, when transferred to LD 13:11, all birds of groups LD 6:18 and LD 6:42 went through a complete cycle of testicular growth and regression. Furthermore, they carried out a postnuptial molt, indicating that they have been able to terminate photorefractoriness under these LD schedules. In contrast, no positive responses could be detected in groups LD 6:6, LD 6:30, LD 6:36, and LD 6:54. Groups LD 6:12, LD 6:24, and LD 6:48 were intermediate in their reactions. Only part of these birds showed gonadal recrudescence when tested for photosensitivity. Changes in plasma testosterone levels were closely related to variations in testicular diameter. These results clearly suggest a strong circadian component in photoperiodic time measurement during the termination of photorefractoriness in the starling. Positive or negative responses were completely in line with predictions derived from the model of external coincidence. A comparison with the results of a similar experiment previously done with photosensitive birds failed to detect basic differences in the interpretation of the various LD cycles. These findings suggest that the same photoperiodic time measurement system is used at both phases of the starling's annual cycle. PMID- 2767410 TI - Direct evidence that 17 alpha,20 beta-dihydroxy-4-pregnen-3-one functions as a goldfish primer pheromone: preovulatory release is closely associated with male endocrine responses. AB - This study directly tested the hypothesis that 17 alpha,20 beta-dihydroxy-4 pregnen-3-one (17,20 beta-P) is a goldfish preovulatory pheromone (pheromone released at peak levels during oocyte final maturation) which increases blood gonadotropin (GtH) and milt volume in males. During spontaneous ovulation, GtH and 17,20 beta-P in female blood and 17,20 beta-P released to the water increased dramatically 7-10 hr prior to ovulation, peaked 1-4 hr prior to ovulation, and then rapidly declined. Males held with these females, or exposed to their odors, had increased GtH levels and milt volumes at approximately the time when increased 17,20 beta-P release by ovulatory females commenced. Although these findings strongly support the hypothesis that 17,20 beta-P is a preovulatory female sex pheromone in goldfish which stimulates male GtH levels and milt production prior to spawning, the milt increases occurred earlier than predicted, suggesting either that preovulatory 17,20 beta-P release begins earlier than the data indicate or that other steroids known to have pheromonal activity are released before 17,20 beta-P. PMID- 2767411 TI - An homologous radioimmunoassay for coho salmon (Oncorhynchus kisutch) vitellogenin, with general applicability to other Pacific salmonids. AB - This paper describes an homologous radioimmunoassay for coho salmon vitellogenin that demonstrates parallel cross-reactivity for plasma vitellogenin of all Pacific salmonids tested (chinook, chum, coho, pink, and sockeye salmon, and cutthroat and rainbow trout), but not for Atlantic salmon or two nonsalmonids: common carp and sablefish. Plasma vitellogenin levels were high in ovulatory female Pacific salmonids (micrograms/ml to mg/ml range), but were mostly nondetectable in spermiating males of the same species. PMID- 2767412 TI - Estrogen-induced vitellogenin production by triploid coho salmon (Oncorhynchus kisutch), and its effect on plasma and pituitary gonadotropin. AB - Vitellogenin production was induced in immature diploid and triploid coho salmon by the weekly injection of 17 beta-estradiol at 1 mg/kg body wt. There was no significant difference between diploids and triploids for any of the results obtained, i.e., change in plasma vitellogenin and gonadotropin levels, hepatosomatic index, or pituitary gonadotropin content. Plasma vitellogenin levels were significantly higher in 17 beta-estradiol-treated fish than in sham injected fish within a week of the first injection, and continued to rise with each subsequent injection. Plasma gonadotropin levels, on the other hand, were slightly (but significantly) depressed. The 17 beta-estradiol-treated fish had higher hepatosomatic indices and pituitary gonadotropin contents than sham injected fish by 3 weeks after the first treatment. These data suggest that the occasional postmeiotic oocytes observed in triploids do not grow to full maturity due, in part, to an absent or diminished estrogen stimulus from the ovary on hepatic vitellogenin production. PMID- 2767413 TI - Immunocytochemical location of oxytocin and mesotocin within the hypothalamus of two Australian marsupials, the bandicoot Isoodon macrourus and the brushtail possum Trichosurus vulpecula. AB - The presence of oxytocin and mesotocin in the hypothalamus of two Australian marsupials, the bandicoot (Isoodon macrourus) and the brushtail possum (Trichosurus vulpecula), was examined by immunocytochemistry. Tissue was fixed in paraformaldehyde in phosphate buffer and immunoreactive cells were detected using highly specific rabbit antioxytocin and sheep anti-mesotocin as primary antisera. Immunoreactive oxytocin cells were demonstrated in the paraventricular and supraoptic nuclei of bandicoot and possum hypothalami, with greater density being observed in paraventricular nuclei. Immunoreactive mesotocin cells were also found in both hypothalamic nuclei of the possum but not of the bandicoot. The same cells appeared to stain for both peptides. PMID- 2767414 TI - Ultrastructure of the contractile apparatus of rat skeletal muscle embedded in an aqueous medium. AB - The method of tissue embedding in melamine resin was applied to rat skeletal muscle. This method does not require tissue dehydration with organic solvents; only aqueous solutions are used. Electron micrographs of muscles embedded in melamine differ from those embedded in the conventional epoxy resin. In melamine embedded muscles the actin and myosin filaments appear larger in diameter and subunits can be recognized in cross-sectioned myosin filaments. Within the Z line, the characteristic patterns described for muscles embedded in epoxy resin are not visible; the spaces between the actin filaments are filled with electron dense material. This suggests that the Z-line is more compact than could be concluded from epoxy resin-embedded muscle specimens. The M-line appears to be different from what is observed in epoxy-embedded muscle. The membranes appear as several clearly delineated layers. Dehydration rather than the action of the organic solvents per se is the main reason for the differences in the structure of the contractile apparatus between melamine- and epoxy-embedded muscles. PMID- 2767415 TI - Na+-Ca2+ exchanger in the soluble fraction of crayfish striated muscle. AB - Proteins with Na+-Ca2+ exchange activity from the soluble fraction of crayfish striated muscle were inserted into asolectin proteoliposomes. A pH dependent calcium uptake with an optimum at the alkaline side and inhibition in the presence of sodium or strontium ions in the external medium was observed. When expressed per tissue wet weight the capacity for Na+-Ca2+ exchange of proteoliposomes with inserted soluble proteins was by one half higher than that of the membrane fraction and more than twice higher in comparison with the reconstituted membrane bound exchanger. Using polyacrylamide gel electrophoresis two most prominent proteins with Mr over 200 and 43 kDa could be detected in proteoliposomes with the highest Na+-Ca2+ exchange. It is assumed that protein(s) with Mr 43 kDa could represent the soluble Na+-Ca2+ exchanger in crayfish striated muscle soluble fraction. PMID- 2767416 TI - Characterization of the base stacking interactions in DNA by means of Lennard Jones empirical potentials. AB - Three empirical potentials of the Lennard-Jones type taken from literature were used to calculate van der Waals contributions to the base-pair couples stacking energies in B-DNA and A-DNA type double helical conformations. The information obtained can be summarized as follows: (1) Purine-pyrimidine and purine-purine (pyrimidine-pyrimidine in the complementary strand) sequences preferred right handed helical arrangement, whereas pyrimidine-purine sequences favoured left handed (C-G) or unwound (T-A) stacking geometry; in the latter case this only held for B- but not A-DNA (the C-G sequence was not studied in A-DNA owing to difficulties (see below) with the G amino group in B-DNA); (2) Positive propeller twist of base-pairs was stable in both B- and A-DNA; the thymine methyl group promoted the propeller and this effect was strongest in the A-T step; (3) Tilt of base pairs occurred around zero in B-DNA and between 15-20 degrees C in A-DNA, in agreement with the experimental observations; (4) Vertical separation of base pairs was optimal within 0.33-0.34 nm for B-DNA and around 0.29 nm for A-DNA using the 9-6 potential. The 12-6 potential gave similar results with B-DNA as the 9-6 potential if, however, base pairs were separated by 0.35-0.36 nm; (5) The calculated effect of the guanine amino group was substantially stronger than expected on the basis of data derived from X-ray diffraction studies of oligonucleotide single crystals; (6) In comparison with the 9-6 potential, the 12 6 potential provided more strict energy minima. In summary, the empirical potentials reproduce, at least semiquantitatively, many but not all DNA properties; this should be taken into account whenever the potentials are used for prediction purposes. PMID- 2767417 TI - Enzyme release and mitochondrial activity in reoxygenated cardiac muscle: relationship with oxygen-induced lipid peroxidation. AB - The aim of this work was to precisely determine the sites of the peroxidative action on unsatured lipids by oxygen-derived free radicals and the lytic cell damage on reoxygenated perfused hearts. The cellular load of lipid peroxidation products (malondialdehyde) during the reoxygenation was dependent on PO2. This unfavorable biochemical response was linked to creatine kinase leakage, alteration of coronary flow and mitochondrial injury. When an enzymatic (superoxide dismutase, 290 IU/minute) or tripeptide scavenger of oxygen radicals (reduced glutathione, 0.5 mmol/l) was administered at the end of hypoxia and during reoxygenation, the abnormal intolerance of hypoxic heart to molecular oxygen was significantly weakened; the load of lipid peroxides load, enzyme release, and vascular alteration were all reduced. Moreover, mitochondrial activity was enhanced and the oxygen-induced uncoupling of mitochondrial remained limited: both the respiratory control ratio (RCR) and the ADP/O ratio were higher than in control reoxygenated hearts. The inhibition by rotenone (100 mumol/l) of reoxidation of electron chain transfer during oxygen readmission also reduced the unfavorable cardiac accumulation of lipid peroxidation products and the release of creatine kinase. These data demonstrate that in the oxygen paradox, the peroxidative attack on lipids plays an important role in inducing alterations of sarcolemmal permeability and mitochondrial activity. An uncontrolled reactivation of oxidative function of mitochondria during reoxygenation enhances the synthesis of oxygen-derived free radicals and triggers the peroxidation of cardiac lipids resulting in irreversible injury to cellular and intracellular membranes. PMID- 2767418 TI - Interactions of neurogenic responses of longitudinal and circular muscle in the guinea-pig ileum. AB - The relationship between neurogenic responses of longitudinal and circular muscle was studied by measuring contractions and EMG or nonadrenergic, non-cholinergic (NANC) relaxations and NANC inhibitory junction potentials in different preparations of the guinea-pig ileum. NANC relaxation of longitudinal muscle was observed also without any preceding or concomitant circular muscle contraction ruling out the possibility that the latter might be the cause of the NANC relaxation. Circular muscle twitches or powerful contractions were absent if there was no preceding neurogenic or myogenic excitation of longitudinal muscle; in preparations with myenteric plexus-longitudinal muscle layers removed only small residual responses were seen although still under neurogenic influences. Thus excitation of longitudinal muscle seemed a prerequisite for synchronized and powerful contractions of circular muscle to occur. Cholinergic contraction and NANC relaxation of longitudinal muscle evoked by field stimulation were partly inhibited if the submucous plexus was also present suggesting the involvement of a more complex neuronal circuitry in these responses. PMID- 2767419 TI - Children's solution strategies and mental rotation: evidence for a developmental shift. AB - We examined children's ability to anticipate the appearance of transformed multicomponents using visual stimuli with variations of a mental rotation task. We hypothesized that (a) performance would depend on the presence, location, and spatial relationship of specific stimulus features, and that (b) younger children would use a single component to make their predictions, whereas older children would be more likely to use multiple components. In Study 1, 40 first-, and fifth grade subjects were presented with 32 rotation problems consisting of varied stimulus characteristics; subjects selected the correct option from a field where foils were indicative of the strategy used. Analyses of variance and log linear analyses revealed the hypothesized stimulus effect differentially associated with the children's ages. In Study 2, sixty 5-, 7-, and 9-year olds confronted 64 mental rotation problems with multicomponent stimuli and a construction task. Results and implications confirmed those of Study 1. PMID- 2767420 TI - Cultural contributions to constructing locus-of-control attributions. AB - Locus of control attribution patterns have been demonstrated to predict a variety of behavioral and adaptational characteristics in a number of societies. As a consequence, questions concerning the comparability of those attributions across cultures have been of interest to social and personality theorists as well as to their more action-oriented colleagues. In the present study, the processes used by Indian college students to form those attributions have been studied and compared with those used by a similar sample in the United States. A structure factor approach was used, because it allowed for a comparison of attribution patterns within and between cultures as well as the drawing of inferences about locus-of-control attributions that are theoretically and practically important. Results supported the utility of such an approach, identified culturally syntonic patterns in both samples, and also identified cross-cultural similarities and differences in locus-of-control attributions. PMID- 2767421 TI - Prenatal, perinatal, and early childhood risk factors and drug involvement in adolescence. AB - This study examined prenatal, perinatal, and early childhood risk factors in relation to the etiology of adolescent involvement in cigarettes, alcohol, marijuana, and other illicit drugs. Over a span of 10 years, data were collected on 638 mainly White mother-child pairs at three points in time: at T1, when the children were 1 to 10 years old; at T2, when they were 9 to 18, and again at T3, when they were 11 to 20. Results showed that the early risks of an unwanted pregnancy and major illness were linked to all of the drug categories except "other illicit drugs." Aspects of mutual attachment in the mother-adolescent relationship were negatively correlated with adolescent drug use. Data on the interrelationship of the domains (i.e., sets of variables) of early risk factors and mother-adolescent relations supported an independent model with respect to cigarette and marijuana involvement, a finding in keeping with results showing that early risk did not significantly affect mother-adolescent relations. However, mother-adolescent protective factors were able to mitigate the impact of early risk factors on adolescent drug involvement. PMID- 2767422 TI - Mediators of clinical judgment: an exploration of the effect of therapists' locus of control on clinical expectations. AB - In this study, written case vignettes that manipulated locus of control symptoms, class, and sex of the clients were presented to 174 Australian clinical psychologists. Therapists' expectations of success with clients presented in the vignettes were found to be primarily a function of the interaction between the therapist's and the hypothetical client's locus of control. In addition, some variance was explained by the symptoms of clients in the vignettes. Clients with mild problems were generally rated more favorably than clients with severe problems. PMID- 2767424 TI - Pleiotropic stabilizing selection limits the number of polymorphic loci to at most the number of characters. AB - We demonstrate that, in a model incorporating weak Gaussian stabilizing selection on n additively determined characters, at most n loci are polymorphic at a stable equilibrium. The number of characters is defined to be the number of independent components in the Gaussian selection scheme. We also assume linkage equilibrium, and that either the number of loci is large enough that the phenotypic distribution in the population can be approximated as multivariate Gaussian or that selection is weak enough that the mean fitness of the population can be approximated using only the mean and the variance of the characters in the population. Our results appear to rule out antagonistic pleiotropy without epistasis as a major force in maintaining additive genetic variation in a uniform environment. However, they are consistent with the maintenance of variability by genotype-environment interaction if a trait in different environments corresponds to different characters and the number of different environments exceeds the number of polymorphic loci that affect the trait. PMID- 2767423 TI - Excision repair of UV radiation-induced DNA damage in Caenorhabditis elegans. AB - Radioimmunoassays were used to monitor the removal of antibody-binding sites associated with the two major UV radiation-induced DNA photoproducts [cyclobutane dimers and (6-4) photoproducts]. Unlike with cultured human cells, where (6-4) photoproducts are removed more rapidly than cyclobutane dimers, the kinetics of repair were similar for both lesions. Repair capacity in wild type diminished throughout development. The radioimmunoassays were also employed to confirm the absence of photoreactivation in C. elegans. In addition, three radiation sensitive mutants (rad-1, rad-2, rad-7) displayed normal repair capacities. An excision defect was much more pronounced in larvae than embryos in the fourth mutant tested (rad-3). This correlates with the hypersensitivity pattern of this mutant and suggests that DNA repair may be developmentally regulated in C. elegans. The mechanism of DNA repair in C. elegans as well as the relationship between the repair of specific photoproducts and UV radiation sensitivity during development are discussed. PMID- 2767425 TI - Antidiuretic hormone in acute asthma in children: effects of medication on serum levels and clinical course. AB - This study of seventeen patients presenting to the emergency room with acute severe asthma determined levels of antidiuretic hormone in serum as well as serum electrolytes and arterial blood gases serially. There was a progressive increase in plasma ADH concentration with severe asthma and ADH levels were substantially higher in those patients with PaCO2's higher than 45 Torr. Patients treated with intravenous aminophylline had a fall in ADH levels while those treated with injectable epinephrine showed an elevation of these levels. As the asthma improved, ADH levels decreased in all patients. In this series of children, sick for not more than 24 hours, serum sodium levels were normal. However, children who have been ill for longer periods than this or who are on prolonged intravenous fluid therapy need close monitoring of serum electrolyte concentrations. PMID- 2767427 TI - Chromosomal localization of the mouse gene coding for vimentin. AB - The chromosomal location of the mouse gene coding for vimentin, one of the intermediate filament subunits, was determined by in situ hybridization using specific H3-labelled DNA probes. There is only one copy of the vimentin gene and it is located on chromosome 2 region A2. PMID- 2767426 TI - Exercise-induced asthma: a difference in opinion regarding the stimulus. AB - There has been some controversy regarding the mechanism whereby exercise can provoke an attack of asthma. It is generally agreed that heat and water are lost from the respiratory tract in bringing the air inspired to body conditions. During strenuous exercise, there is a marked increase in ventilation rate and some of the burden to heat and humidify the inspired air is transferred to the intrathoracic airways. The net effect of the air conditioning process is to cool and dehydrate these airways. There have been two hypotheses put forward to account for the mechanism whereby these events lead to exercise-induced asthma (EIA). One hypothesis proposes that cooling of the airways followed by rapid rewarming, at the end of exercise, leads to a reactive hyperemia and edema of the bronchial vascular bed "which if sufficiently severe results in the airway obstruction of EIA." The other hypothesis proposes that the rate of loss of water from the periciliary fluid during exercise exceeds the rate of return and, as a result, there is an increase in ion concentration and subsequent hyperosmolarity of the periciliary fluid. Thus the events related to drying rather than cooling are the stimulus to EIA. This paper presents the case against rapid rewarming of the bronchial vasculature as the stimulus to EIA and puts forward an argument and data in support of the case for airway drying and an increase in osmolarity being the critical event which determines the presence and severity of EIA. PMID- 2767428 TI - Responses to divergent selection for plasma concentrations of insulin-like growth factor-1 in mice. AB - A divergent selection experiment with mice, using plasma concentrations of insulin-like growth factor-1 (IGF-1) at 42 days of age as the selection criterion, was undertaken for 7 generations. Lines were not replicated. To obtain sufficient plasma for the IGF-1 assay, blood from four individuals was volumetrically bulked to obtain a litter mean IGF-1 concentration. This necessitated the use of between family selection. Although inbreeding accumulated in a linear fashion in each of the high, control and low lines, the rates were different for each line (3.6, 1.6 and 5.3% per generation for the high, control and low lines, respectively). As a consequence, the effects of selection and inbreeding are confounded in this experiment. Divergence between the high and low lines in plasma concentrations of IGF-1 continued steadily until generation 5. In generations 6 and 7, there was a reduced degree of divergence and this contributed towards the low realized heritability value of 0.15 +/- 0.12. Six week liveweight showed a steady positive correlated response to selection for or against plasma concentrations of IGF-1 until generation 4 (high-low difference = 1.7 g = 12%). In generation 5, a substantial drop in 6-week liveweight in the low line relative to both the high and control lines occurred (high-low difference, 3.9; g, 25%). This difference was maintained until generation 7.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2767429 TI - X-inactivation of the Sts locus in the mouse: an anomaly of the dosage compensation mechanism. AB - The behaviour of the X- and Y-borne Sts locus has been studied in male and female mice. There was considerable heterogeneity in STS activity between inbred mouse strains, with a four fold difference in activity between the highest (101/H) and lowest (Ju/Ct) activity strains, which can be interpreted in terms of allelic differences. In all inbred strains male STS levels were higher than those of female STS levels and in the majority of strains tested male STS levels were nearly twice as high as female levels. Reciprocal crosses between C3H/HeH and the STS-deficient substrain, C3H/An, demonstrated that activities of the X- and Y borne genes in males are essentially the same and this suggested that the lower STS level in females derives from X-inactivation of the locus. The possibility that hormonal differences could instead be responsible for the lower activity in females was ruled out by the findings that (a) castration of males did not reduce their STS levels and (b) sex-reversed males, X/X Sxr, had STS levels typical of females. Final proof that the mouse Sts locus can be subject to the X inactivation process was provided by the observation that XX females had STS levels that were only slightly (20%) higher than those of XO females. The difference may indicate incomplete inactivation of the locus. Linkage data verifying the location of Sts on the distal end of the X chromosome are provided.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2767430 TI - Cytogenetic manifestations associated with the reversion, by gene amplification, at the HGPRT locus in V79 Chinese hamster cells. AB - Some HGPRT spontaneous revertants were isolated from a mutant line (E2) of V79 Chinese hamster cells and phenotypically characterized. Dot-Blot hybridization with a 32P-labelled HGPRT probe revealed an increase in the number of HGPRT sequences in some of these revertants, suggesting the occurrence of gene amplification. Cytogenetic analysis performed in three of these revertants showed a characteristic abnormally banding region (ABR) on the elongated p arm of the X chromosome. In situ hybridization in one revertant (RHE2) showed that the amplified sequences reside on the p+ arm of the X chromosome in two different localizations. Because of the very probably clonal origin of the revertant, these features indicate that the amplified sequences might rearrange after their integration into the chromosome. PMID- 2767431 TI - A genetic model of interpopulation variation and covariation of quantitative characters. AB - Evolutionary consequences of natural selection, migration, genotype-environment interaction, and random genetic drift on interpopulation variation and covariation of quantitative characters are analysed in terms of a selection model that partitions natural selection into directional and stabilizing components. Without migration, interpopulation variation and covariation depend mainly on the pattern and intensities of selection among populations and the harmonic mean of effective population sizes. Both transient and equilibrium covariance structures are formulated with suitable approximations. Migration reduces the differentiation among populations, but its effect is less with genotype environment interaction. In some special cases of genotype-environment interaction, the equilibrium interpopulation variation and covariation is independent of migration. PMID- 2767432 TI - A framework for the analysis of psychiatric health facility utilization. AB - Existing research that examines the general problem of health facility use often lacks sound theoretical specification. This problem is partly a function of conceptual difficulties in explaining health seeking behaviour and an absence of appropriate data with which to calibrate modelling endeavours. These problems are addressed in this paper where a logit model of health seeking behaviour and health facility use derived from discrete choice theory is presented. The structure of the model is general but in this case it is developed in the context of mental health facility use. A data set from Auckland, New Zealand is utilized to apply the modelling ideas presented. Results show that discrete choice theory can be adapted to the problem of mental health facility usage under conditions where the health care system offers real choice at any given level of care. In this case real choice implies a well-developed array of alternative facilities to choose from. PMID- 2767433 TI - Utilization behaviour patterns of Siddha clinics in Salem, Tamil Nadu. AB - In Tamil Nadu, indigenous Siddha medicine (SM) is officially recognized and extensively used. Yet very little research information or published material is available on the extent of utilization behaviour of Siddha medicine in urban settings. This study examines the current patterns of utilization and consumer behavioural characteristics of SM through a field-based questionnaire survey of a sample of 300 patients attending 15 Siddha clinics in Salem, Tamil Nadu. Four areas were investigated: Socio-economic characteristics of the users; utilization behaviour pattern of patients; reasons for choice of Siddha therapy; opinions, attitudes, perception and satisfaction of users regarding Siddha therapy. The survey points out there is an inverse relationship between the number of patients using SM and income, education and distance travelled. Various factors were cited in choosing SM-such as, effectiveness of treatment, social influences of a relative or friend. Survey indicates that both modern medicine and SM seem to act as supporting rather than as competitive systems in a setting like Salem. People tend to seek both the system in search of a permanent cure. PMID- 2767435 TI - The intra-urban variation in general practitioner provision: a comparative study of London and Warsaw. PMID- 2767434 TI - The Unani traditional medical system in India: a case study in health behaviour. AB - The study examines the practice of Unani traditional medicine in India. The case study is based on the Unani Clinic situated in Aligarh Town; patients, practitioner of Unani medicine, and para-medical staff were interviewed about their patterns of patients' health behaviour, of particular interest was the utilization of Unani medical facilities by people of different age groups and belonging to different socio-economic strata. Observations are made regarding effectiveness of the Unani medical system. PMID- 2767436 TI - Incidence of cancers of the brain, the lymphatic tissues, and of leukemia and the use of pesticides among Quebec's rural farm population, 1982-1983. AB - Massive use of pesticides in agriculture poses risks for the environment and for human health. Pesticides are toxic substances and the suggestion that some may be carcinogenic has been the source of much controversy. In this article we focus on the relation between the use of pesticides in agriculture and the incidence of cancers of the lymphatic tissues, the brain, and of leukemia in the rural farm population in 34 major drainage basins in the province of Quebec (Canada) for the period 1982-1983. The basins were grouped into three categories (low, intermediate and high exposure) based upon the amount of pesticide sold. The study of highly exposed basins shows an excessive incidence of leukemia (SMR = 1.69, p less than or equal to 0.05) for men in rural farm areas in the Yamaska river basin. This specific group's relative risk (RR) of incidence as compared to the urban male population is 2.27 (p less than or equal to 0.05). The RR is also high and statistically significant among the men in municipalities that draw their drinking water from wells (RR = 2.07, p less than or equal to 0.05) as compared to those where water is drawn from rivers. Most municipalities using wells are in the rural farm areas. These results suggest that there may be a relationship between leukemia and the use of pesticides in this drainage basin, and this hypothesis could be verified at the individual level in epidemiological studies. PMID- 2767437 TI - Family welfare planning programmes in Tamil Nadu: an appraisal of fertility trends. PMID- 2767438 TI - Health care provision and access opportunity in Madras city. AB - This short paper has reported on the health care provision and access opportunity in Madras city, India, using three city areas as sample areas. Maps have indicated that a general concentration of both GP and specialist practices, although access opportunities in the peripheries do not point up to paucity of services. The study is a report on private practices that is an important element in the health services provision. PMID- 2767439 TI - Solar ultraviolet radiation and regional peculiarities in skin malignant melanoma incidence. PMID- 2767440 TI - Transformation of Aspergillus niger with the homologous nitrate reductase gene. AB - A homologous transformation for Aspergillus niger was developed based on the nitrate reductase structural gene niaD. This system offered certain advantages over existing A. niger systems, such as the ease of recipient mutant isolation, absence of abortive transformants, convenient enzyme assay, ease of transformant stability testing, and complete absence of background growth. Transformation frequencies of up to 100 transformants per microgram DNA were obtained with the vector pSTA10 which carries the niaD gene of A. niger. Southern blotting analysis indicated that vector DNA had integrated into the genome of A. niger. Mitotic stability studies demonstrated that while some transformants were as stable as the wild-type (wt), others were markedly less so. No correlation was seen between plasmid integration, mitotic stability and nitrate reductase activity, which was markedly different from wt in only three of the transformants examined. PMID- 2767442 TI - Are your patients getting away with 'chronic suicide'? PMID- 2767441 TI - Analysis of IncF plasmids evolution: nucleotide sequence of an IncFIII replication region. AB - We determined the nucleotide sequence of RepFIII, the IncFIII replication region of the plasmid pSU316. Our data confirmed that RepFIII belongs to the RepFIIA family. The comparison of the nucleotide sequences from several RepFIIA-family plasmids revealed that pSU316 and R1 replicons are almost identical (96% similarity). Most of the differences between them are clustered in the incompatibility determinant. Analysis of the rest of the sequence suggested that the divergence between R1 and pSU316 replicons is very recent. PMID- 2767443 TI - Coping with the suicidal elderly: a physician's guide. AB - Advancing age is associated with a markedly increased risk of suicide. In the United States, one fourth of all suicides are carried out by citizens age 60 or older. The majority of American elders who commit suicide use a firearm to do so. Most suicidal elders look to their primary care physician for help, although they may not directly express their plan. Therefore, physicians must be alert to clues. By far the principal risk factor for suicide is major depression. The risk is heightened by recent losses, alcohol or drug abuse, psychosis, cognitive decline, and chronic disease. Hopelessness, anhedonia, self-reproach, guilt, and a formed lethal plan are signs of a life-threatening suicidal crisis which requires urgent intervention. Physicians must act decisively in recognition of the fact that suicidality is a transient, treatable condition. PMID- 2767444 TI - GI problems in the elderly, Part I: Aging-related considerations. AB - Gastrointestinal problems are very common in the elderly; they account for 20% of all geriatric deaths. The evaluation of gastrointestinal ailments is difficult in the aged due to variation in signs and symptoms, coexisting nutritional problems, lack of patient cooperation, presence of comorbidity, and effects of polypharmacy. Poor clinical histories are common and gastrointestinal ailments may be atypical. Non-compliance with therapy and testing is a common problem and unrealistic expectations from interventions are the rule rather than the exception. Iatrogenic disorders must be ruled out in all patients with gastrointestinal symptoms; an accurate drug and nutritional history is critical for achieving success in the management of the elderly. PMID- 2767445 TI - Conversation with... Dennis W. Jahnigen, MD: giving pressure ulcers the attention they deserve. Interview by Richard L. Peck. PMID- 2767446 TI - [Hygienic substantiation of physical load standards in physical education of schoolchildren]. AB - The research specific to the changes in body functioning under the effect of various loads of cyclic character was carried out. The results thus obtained made it possible to analyze sex- and age-specific characteristics of body functional capacities of schoolchildren aged 6-15 (yearly characteristics). It was pointed out that by 13-14 years the schoolchildren, primarily girls, lost some of their adaptation capacity to physical load. The problem could be solved due to additional physical training activities aimed at the development of endurance, the trait being of primary importance for health promotion in schoolchildren. PMID- 2767447 TI - [Age-related dynamics of physical development of schoolchildren with various patterns of motor activity]. AB - The longitudinal survey of schoolchildren's physical development was undertaken for 4 years with the 6-month interval. The schoolchildren of the 4th-7th grades were examined compared to swimmers of the same age (30 boys and 30 girls, 120 children all together). As a result nonuniform increase of growth and weight indicators, those of breast circumference and excursion, vital capacity and hand strength was established. The indicators' increase depended on age, sex, regime of motor activity and time of the year. because of girls' earlier puberty by the age of 12 they went ahead of boys by anthropometric indicators but by the age of 14 boys were again ahead of girls by all the indicators of their physical development. The highest growth of all morphologic indicators in sportsmen and others was established during the period from April till October, i.e., in spring and in summer. Regular swimming lessons promoted not only better physical but also harmonious development of adolescents. At the same time relatively early specialization in swimming hindered girls' puberty, especially at the age of 13. Thus it was necessary to set standards for physical load and to assess body functional capacity taking account not only of actual but also biological age. PMID- 2767448 TI - [Complex engineering and hygienic examination of railway facilities]. AB - Targets and problems of complex engineering and hygienic examination of railway facilities are presented along with the principles of its planning. The staff of specialists carrying out such examinations is described. The technique for assessing the state of sanitary service premises is set forth. The results of the proposed examination approval are given. PMID- 2767449 TI - [Percutaneous resorption of cesium-137 and strontium-89 in alkali solutions and inactivation of the burned surface]. AB - Experiments on white rats studied percutaneous resorption of 137Cs and 89Sr during their skin application in the form of 10 per cent and 40 per cent solutions of NaOH. The study also involved deactivation of the contaminated skin by means of traditional means of first aid recommended for alkali burn and the application of 5 per cent solution of boric acid with the addition of some detergent or 10 per cent solution of sodium hexametaphosphate. The dependence of deactivation efficacy on the time of beginning sanitary treatment, decontamination procedure and alkali concentration was established. PMID- 2767450 TI - [Methodologic approaches to the study of the effect of complex environmental factors on the population's health]. AB - The purpose of the study was to assess the dynamics of complex pollution of urban and occupational environment, territory design, air and water contamination and acoustic regime being taken into account. The technique for calculating the total load on the population was used for environment description. It was based on actual contamination in relation to standard one and the time of its effect. The ratio between total load and population's morbidity was defined. The impact of urban and occupational environment on adult and child morbidity rates was established. Environmental factors were ranked by their effect on population's morbidity rates. PMID- 2767452 TI - [Determining the level of ascorbic acid in the urine in hygienic studies]. PMID- 2767451 TI - [A method of evaluating reliable limits of lethal doses of harmful substances]. PMID- 2767453 TI - [Use of a method of atomic absorption spectroscopy for hygienic evaluation of the accumulation of lead and copper in plants]. PMID- 2767454 TI - [Gas-chromatographic determination of the formaldehyde level in atmospheric air]. PMID- 2767455 TI - [Photometric determination of cationic detergents]. PMID- 2767456 TI - [Gas-chromatographic analysis of N,N-diethylchloracetamide in the air]. PMID- 2767458 TI - [A fixed garbage container for hospitals]. PMID- 2767457 TI - [Sanitary control of the quality of distilled water]. PMID- 2767459 TI - [Estimation of the instability of emissions of chemical substances in evaluating sanitary and hygienic conditions]. PMID- 2767460 TI - [The role of pesticides in hygienic substantiation of the Danube- Dnieper water supply complex]. PMID- 2767461 TI - [Hygienic substantiation of the maximum permissible level of mono methyldichlorothiophosphate in reservoir water]. PMID- 2767462 TI - [Toxicologic evaluation of the effectiveness of decontamination of waste water from the production of dry galvanic cell by low-base aluminum hydroxychloride]. PMID- 2767463 TI - [Study of the biological effect of sumilex]. PMID- 2767464 TI - [Hygienic substantiation of the provisional permissible level of N,N bis(trimethyl)-2,5-dimethyl-N-xylilendiammonium chloride in reservoir water]. PMID- 2767465 TI - [Experimental studies for detecting the atherogenic hazard of the pesticide sumilex]. PMID- 2767466 TI - [Study of the biological effect of silicone organic polymer coating]. PMID- 2767467 TI - [Toxicokinetic characteristics of ortho-1-menthene after its single administration in albino rats]. PMID- 2767468 TI - [Cytogenetic and endocrinologic changes in experimental animals exposed to high frequency electromagnetic fields]. PMID- 2767469 TI - [Effect of bucid on oxidation-reduction processes in the microsomes and mitochondria of the animal liver]. PMID- 2767470 TI - [Study of the migration of transformation products of peroxide vulcanization agents from rubber]. PMID- 2767471 TI - [Effect of relative air humidity on the results of sanitaro-chemical studies of polymer materials]. PMID- 2767472 TI - [Improving mass screening of the personnel of marine transportation ships]. PMID- 2767473 TI - [Effect of correcting schoolchildren's nutrition on urinary excretion of catecholamines during increased mental and emotional stress]. PMID- 2767474 TI - [Various criteria of children's adaptation to educational load]. PMID- 2767475 TI - [Occupational morbidity of workers of the Krivbass iron ore works: ways of its reduction and prevention]. AB - The study was designed to explore occupational morbidity levels, dynamics and structure in workers of the Krivbas ore works during 1961-1985. Workers' profession, age and length of service were taken into account. It was shown that further decrease of occupational morbidity could be achieved due to carrying out of the proposed recommendations. PMID- 2767476 TI - [Comparative study of individual characteristics of patients with borderline arterial hypertension and more severe forms of hypertensive disease]. AB - In order to compare individual health characteristics of healthy people and patients with borderline arterial hypertension (BAH) and hypertensive disease (HD) 867 TASS employees aged 18-68 (365 men and 502 women) were examined. Abridged variant of a multifactor questionnaire MMPI was used for the determination of the psychologic profile. Those examined were divided into 3 groups, namely, the first group comprised 96 patients with BAH; the second group 41 patients with HD of the 1st stage, and the 3d group consisted of 70 persons with a normal level of arterial pressure (the control group). BAH was detected in 146 persons (17.1%) and HD of the 1st and IInd stages in III persons (13.0%). The analysis of individual characteristics showed that an average profile of the male population with normal blood pressure had no distinct peaks by separate scales, whereas the combination of the characteristics in patients with HD (a rise on the 1st and the 3d scale and a decrease on the 9th one) was regarded as R-factor. The latter revealed a decrease in general activity and the presence of depression and asthenia The above changes were also registered in patients with BAH but they were less distinct and characterized by intermediate indices in patients with HD and the healthy people. No reliable differences were noted among females. PMID- 2767477 TI - [Working conditions in manufacturing stable magnets using the powder metallurgy method]. AB - The data are presented on the conditions and the character of work when manufacturing samarium- and cobalt-based permanent magnets. Major unfavourable factors of samarium/cobalt-containing dusts are stressed, the chemical and disperse dust composition being described. Highlighted is the necessity of developing a set of preventive measures. PMID- 2767478 TI - [Bases of measures aimed at improving working conditions for women employed in manufacturing of television sets]. AB - Proceeding from hygienic, physiologic and ergonomic studies, a complex assessment of working conditions of female workers engaged in TV-set manufacture is presented. Major unfavourable occupational factors have been identified, among them there are work intensity, insufficient lighting of workplaces, their inadequate organization, induced posture during work at a conveyer with regulated movement rhythm. Profound computer-based studies of temporary disability rates have revealed a number of occupations for which temporary disability rates depend on female's length of service. The results obtained provide the basis for the development and introduction of health measures intended for further improvement of working conditions that promote reduction of temporary disability rates and have significant economic effect. PMID- 2767479 TI - [Thermal state of women working outdoors under conditions of Far North]. AB - New data on the thermal state of women working outdoors in the region beyond the polar circle are presented. A number of characteristics of female body heat exchange and their thermal state which should be taken into account when developing the cold-protective clothes have been determined. PMID- 2767480 TI - [Optimization of working conditions of medical personnel of radiodiagnostic departments]. AB - The study was undertaken to analyze the characteristics of the work of medical staff of isotopic diagnostic departments during the use of short-lived isotope generators. The data on the functional load of physicians and paramedical staff were given along with the description of radiation effect at various stages of work. The measures on optimization of labour conditions by means of the appropriate department's design, improvement of the regime of nurses' work and adequate allocation and utilization of medical equipment were developed. PMID- 2767482 TI - [Functional status of the visual analyzer in operators working with displays]. AB - The research was carried out at data processing sections of computer centres. The data on working conditions, psychologic work pattern and functional state of visual analyzer of 48 operators constantly working with displays were obtained. It was established that operators usually complained of visual fatigue, changes in colour perception, occurrence of retina angiodystonia. Recommendations on the optimization of labour conditions of those working with display terminals were given. PMID- 2767481 TI - [A complex study on the effects of workplace air pollution in acid-digestion plants manufacturing sulphite cellulose on the health status of workers]. AB - The study was designed to analyze working conditions in acid digestion shops of integrated pulp-and-paper mills employing sulphite technique of cellulose manufacture. It was established that workplace air pollution by sulphur epoxide appeared to be a major occupational hazard. MACs being exceeded, the workers experienced higher temporary disability rates compared to the control group. PMID- 2767483 TI - [A method for assessing reliability of different rates of morbidity with temporary disability in small contingents of workers]. AB - Suggested is the technique for mathematical processing of morbidity data proceeding from the replacement of common indicators per 100 workers by partial derivatives proportional to the number of work days a year. Reliability of changes in transforming indicators has been evaluated by means of statistical processing of small parts through Fisher's function phi. The advantages of the proposed technique lie in the fact that it has become possible to obtain important information on morbidity rates for the limited amount of investigation data and to reveal correlation of workers' health status to unfavourable occupational factors. PMID- 2767484 TI - [Quest for specific therapy in acute dichloroethane poisoning]. PMID- 2767485 TI - [Experience with the use of corporal electroacupuncture diagnosis in the evaluation of health status of persons exposed to electromagnetic fields]. PMID- 2767486 TI - [Effects of vitamin prophylaxis on morbidity with temporary disability in workers of locomotive teams of the Moscow metro]. PMID- 2767487 TI - [Hygienic assessment of working conditions at the experimental production line of semidry pressing of ceramic argillite bricks]. PMID- 2767488 TI - [Metrological problems of high-frequency radiation at naval radar stations]. PMID- 2767489 TI - [Evaluation of the feasibility of using dosimetric equipment for measuring long wave X-ray radiation]. PMID- 2767490 TI - [Significance of electrocardiographic studies in the detection of coronary pathology during prophylactic mass screening of miners working in polymetal mines]. PMID- 2767491 TI - [Byssinosis caused by mixed vegetable dust (jute, ambary and flax)]. PMID- 2767492 TI - [State of pulmonary circulation in dust-induced bronchitis as shown by perfusion pulmonary scintigraphy]. PMID- 2767493 TI - [Changes in lysozyme activity as a factor of natural immunity]. PMID- 2767494 TI - [Eye protection of reindeer breeders in the Far North from the dazzling brightness of solar radiation]. PMID- 2767495 TI - [Signs of chronic overheating in miners of deep coal mines]. AB - Both miners exposed to high temperature and excess heat and miners working under permissible temperature conditions (a control group) had similar nonspecific signs, i. e., complaints of heartache and headache, erethism, flaccidity, hydrosis, degradation of appetite and sleep, vertigo, dimness, the sense of air shortage, palpitation in rest, uncertain gait, muscle spasm. There were also presented the following objective data: tremor of close eyelids, asymmetry of tendon reflex, convergence weakness, emotional lability, changes in orthostatic test results, higher Kerdau index, instability of sensitizing Romberg's test. The above signs were more pronounced in miners exposed to high temperature, thus it was possible to regard them as indicators of miners' chronic overheating. PMID- 2767497 TI - Pancreatic Society of Great Britain and Ireland, 13th annual meeting. London, 16 December 1988. Selected abstracts. PMID- 2767496 TI - [Health problems related to the reconstruction of copper smelting plants]. AB - Reconstruction of a copper-smelting plant promoted the solution of some problems of the improvement of working conditions and environmental protection. As a result the atmospheric and workplace air emission of gaseous sulphur compounds, carbon and arsenic oxides and polymetallic dusts was intensified. In order to improve working conditions it was necessary to install new equipment positively assessed from the hygienic point of view, to perfect technological processes and to carry out a scientifically proved complex of sanitary, technological, organizational and preventive measures. PMID- 2767498 TI - 24 hour ambulatory oesophageal motility monitoring: how should motility data be analysed? AB - Ambulatory oesophageal motility/pH monitoring permits accurate detection of oesophageal events during spontaneous chest pain episodes. Opinions differ, however, about the methods to review the extensive motility data and the definition of abnormal motility changes. We studied 30 patients (18 women, age 46 years) with suspected oesophageal chest pain using a portable recording system attached to a 4.5 mm catheter with pressure transducers 3 and 8 cm and pH probe 5 cm above the lower oesophageal sphincter (LOS). An event marker was triggered by the patient for chest pain. In the patient's diary, pain was recorded on a scale of increasing severity 1-10. Two methods of analysis were used to assess 24 hour motility data. The 24 hour technique sampled five minute asymptomatic baselines throughout the study to define the patient's normal range of oesophageal motility. The second technique used only the 10 minute period immediately before each chest pain episode as the asymptomatic baseline. Chest pain episodes were defined as abnormal if associated with pH less than 4 or motility changes not present during the asymptomatic baseline analysis: 135 chest pain episodes were recorded. The method of motility analysis significantly (p less than 0.01) changed the number of chest pain episodes associated with abnormal motility: 24 hour technique - 14 episodes (10%) versus a 2.5-fold increase with the 10 minute baseline technique - 33 episodes (24%). Acid related pain episodes were similar in both groups - 13%. The majority of chest pain episodes had no association with abnormal motility or acid reflux. Increasing chest pain severity was inversely correlated with the presence of abnormal oesophageal events. We conclude that limited analysis of 24 hour motility data may over diagnose motility related chest pain events and lead to inappropriate medical or surgical therapy. PMID- 2767499 TI - Vertical banded gastroplasty in the treatment of morbid obesity: results of three year follow up. AB - Vertical banded gastroplasty has replaced jejunoileal bypass in the surgical treatment of morbid obesity. Although this procedure carries a low incidence of early postoperative complications there is little information on either longer term follow up or the impact on nutritional status. The present study describes the outcome in 42 patients with morbid obesity who underwent vertical banded gastroplasty and were followed up in a special nutrition clinic between nine and 36 months postoperatively. Body mass index (BMI) fell from a preoperative value of 47.4 (6.7) kg/m2 (mean (SD] to 37.5 (5.8), 35 (6.2), 33.9 (6.1), and 33.1 (5.7) kg/m2 at 6, 12, 24, and 36 months respectively. Immediate postoperative complications were minimal but during follow up four patients developed stenosis of the gastroplasty stoma and required reoperation. Plasma albumen concentrations were maintained but three patients developed iron deficiency anaemia. Most patients were able to eat a normal diet in reduced quantities and noted a marked improvement in the quality of life. The benefits and safety of vertical banded gastroplasty suggest an important role for this operation in the management of morbid obesity. PMID- 2767500 TI - Effect of the gastric balloon versus sham procedure on weight loss in obese subjects. AB - The mechanism by which intragastric balloons induce weight loss is not known, although they may act simply by reducing the amount of food needed to induce satiety. The knowledge that a balloon is present may influence the patients' eating patterns and reduce caloric intake and weight. In order to test whether the balloon or the secondary psychological effect caused weight loss, a double blind balloon versus sham procedure was devised with both groups receiving identical outpatient dietary advice (800 kcal/day). Twenty four obese women with body mass index greater than 30 kg/m2 from an obesity clinic were studied. Twelve had the balloon and 12 the sham procedure. The balloon was removed after three months and the patients were followed for a further three months. There was significantly greater weight loss in the balloon group, mean weight loss (SD) of 7.33 (6.12) kg compared with the sham group, mean weight loss (SD) of 3.33 (3.9) kg (p less than 0.05). Weight loss was not maintained in all patients after balloon removal. Side effects were more common in the balloon group (abdominal pain, nausea, and vomiting) but resolved by the second week. We conclude that the intragastric balloon is a safe and effective method of inducing weight loss in well motivated obese patients. PMID- 2767501 TI - Detection of Campylobacter pylori by the biopsy urease test: an assessment in 1445 patients. AB - The presence of C pylori infection was determined in 1445 patients undergoing upper gastrointestinal endoscopy over a 12 month period. The presence of C pylori was detected in gastric mucosal biopsy specimens by the biopsy urease test, microscopy (Gram stained smears and histology) and culture. Two media were used for the biopsy urease test: Christensen's urea broth (for the first 600 patients) and the Christensen's urea broth modified by increasing the concentration of phenol red and omitting the nutrients, glucose and peptone (for the remaining patients). Both the Christensen's urea broth and modified urea broth were almost 100% specific when compared with detection of C pylori by Gram, culture and histopathology. The modified broth was more sensitive (96% sensitivity compared with culture) than the Christensen's broth (92% sensitivity) but this difference was not statistically significant. The modified broth gave significantly more positive results (58%) in less than 30 minutes than the Christensen's broth (48%). Seventy four per cent of positive results were available in less than two hours. Specimens from patients with extensive C pylori infection gave more rapid results: 86% of specimens that yielded a profuse growth of C pylori and 76% that contained numerous organisms on histological sections had a positive urease test in less than one hour. There was no significant difference between the specificity and sensitivity of our modified urea broth and the other modified broths described in the literature. This test is a cheap and rapid alternative to the diagnosis of C pylori by Gram stained smears or culture. PMID- 2767502 TI - Early dinner reduces nocturnal gastric acidity. AB - This study examines whether eating food at different times has differential effects on intragastric pH. Experiments were done in 23 healthy volunteers (12 men). Intragastric acidity was monitored by ambulatory 22 hour pH-metry. Composition of meals was standardised: breakfast and lunch at 7 am and 12 noon respectively, and dinner at 6 or 9 pm, in random order. The time of going to bed and getting up was also standardised. With early dinner nocturnal pH was higher, than with late dinner (pH median: 1.67 and 1.39, p less than 0.001). During the remaining time periods, pH values were similar. Thus early dinner may be helpful in conditions where low intragastric acidity is desirable. PMID- 2767503 TI - Proline is not useful as a chemical probe to measure nitrosation in the gastrointestinal tract of patients with gastric disorders characterised by anacidic conditions. AB - Aspirated fasting gastric juice from patients with lesions of the gastrointestinal tract and from healthy controls was analysed for nitrite before and after (30, 90, and 240 min) oral administration of 200 mg nitrate. Wilcoxon's rank-sum tests showed no significant differences in fasting gastric juice nitrite concentrations between healthy controls and patients after proximal gastral vagotomy or with gastric/duodenal ulcer (median less than or equal to 0.7 ppm NO 2) and only moderate increases after nitrate administration. Chronic atrophic gastritis patients and patients with Billroth I or II gastric resections showed median concentrations of 2 ppm NO-2 which increased to 20 ppm (up to 200 ppm in one Billroth II patient) after administration of nitrate. Endogenous formation of N-nitrosoproline using the NPRO-test was determined in two groups with low (healthy control and proximal gastral vagotomy patients) and high (Billroth I and II patients) gastric nitrite concentrations. After 12 h fasting, 200 mg nitrate was orally administered, followed 30 min later by 500 mg L-proline. Endogenously formed N-nitrosoproline which is quantitatively excreted in urine was determined in urine over the following 24 hours. In over 80% of the urine samples collected from Billroth I and II patients no detectable NPRO was found whilst in over 85% of the healthy controls and proximal gastral vagotomy patients up to 33.5 micrograms NPRO was detected. In vitro nitrosation kinetics showed that at gastric pH greater than 4 present in both, patients with Billroth I and II resections and with chronic atrophic gastritis, nitrosation of proline does not occur. As alternative chemical probes for quantifying potential endogenous nitrosation in hypoacidic patients the methyl and ethyl esters of proline were investigated. In vivo nitrosation of these two new probes was established in animal experiments using rats and was shown to occur in vitro at pH 4-5. During incubation in human gastric juice, however, almost 30% ester cleavage by non specific gastric esterases occurred within the first five minutes, thus further limiting the use of these compounds in determining endogenous nitrosation in hypoacidic patients. PMID- 2767504 TI - Anamnestic and psychological features in diagnosis and prognosis of functional abdominal complaints: a prospective study. AB - Psychological and anamnestic data from 308 patients were collected to investigate whether patients with abdominal complaints from organic causes could be distinguished psychologically or by their case histories from patients with functional abdominal complaints. Two years later the same patients took part in a follow up study. Only 9% of the patients with functional abdominal complaints became symptom free. Most variables showed no significant difference between the organic and the functional group. The most important variables with predictive value were psychological factors, factors associated with the severity and factors associated with the duration of the complaints. PMID- 2767505 TI - 14C triolein breath test: an assessment in the elderly. AB - 14C triolein breath tests are highly sensitive in detecting fat malabsorption in adults, but experience in the elderly is sparse. We have evaluated 48 'normal' subjects over the age of 65 years and compared the results with those of 46 normal subjects under 65 from a previous study. Results were calculated as eight hour cumulative values and expressed as percentages of the administered dose. Reference ranges have been calculated separately for the following age groups: 65 years or less (201 to 460), 66 to 75 (182 to 405) and over 75 (141 to 336). A clear age related decline in eight hour cumulative values was noted. The values fell by 23% between the ages of 17 and 65 years and by 25% between the ages of 65 and 87 years. Pancreatic insufficiency or bacterial colonisation of the small bowel is unlikely, but delayed intestinal absorption or the effects of slower metabolic rate cannot be excluded. This test is simple and practicable in the elderly and the study emphasises the importance of age in the interpretation of results. PMID- 2767506 TI - Impaired bacterial flora in human excluded colon. AB - We compared the rectal microflora of 16 patients with surgically excluded colorectum with 16 healthy controls. The cause of diversion was inflammatory bowel disease (n = 10), colon cancer (n = 3), miscellaneous (n = 3). Six patients had a diversion colitis. In the excluded colorectum, the total bacterial count was only slightly lower than controls but the variety of the flora was significantly reduced. This reduction was confined to strict anaerobes, mainly the genus Eubacterium and Bifidobacterium. Among aerobes, enterobacteria were more often isolated than in controls. This altered microflora of excluded colorectum could be involved in the mucosal damage observed in some cases. PMID- 2767507 TI - Food intolerance and the irritable bowel syndrome. AB - Two hundred patients (156 women) with the irritable bowel syndrome were treated with dietary exclusion for three weeks. Of the 189 who completed this study, 91 (48.2%) showed symptomatic improvement. Subsequent challenge with individual foods showed that 73 of these 91 responders were able to identify one or more food intolerances and 72 remained well on a modified diet during the follow up period (mean (SD), 14.7 (7.98) months). Of the 98 patients who showed no symptomatic improvement after three weeks of strict exclusion only three were symptomatically well at follow up (mean (SD), 12.48 (8.09 months). There was no close correlation between response and symptom complex. There was a wide range of food intolerance. The majority (50%) identified two to five foods which upset them (range 1-14). The foods most commonly incriminated were dairy products (40.7%) and grains (39.4%). PMID- 2767508 TI - Bile acid glycine and taurine conjugates in serum of patients with primary biliary cirrhosis: effect of ursodeoxycholic treatment. AB - We have applied a specific and accurate high pressure liquid chromatographic technique to determine fasting serum glycine and taurine conjugates of individual bile acids in patients with primary biliary cirrhosis before and during ursodeoxycholic acid therapy. The study was carried out in nine patients in whom the diagnosis of primary biliary cirrhosis was established according to accepted criteria. After one year of UDCA therapy liver function tests significantly improved. Total serum bile acid concentration did not change significantly (29.2 (31.5) v 28.3 (26.4) microM). Total UDCA (1.7 (2.2) v 13.3 (14.5) microM) and glyco UDCA (0.8 (1.6) v 10.9 (11.4 microM) but not tauro UDCA levels increased significantly (p less than 0.01); UDCA (7.7 (12.6) v 40.2 (12.7)%) became the major species of the circulating bile acids. Primary bile acids (23 (28.3) v 11.2 (10.5) and their glycoconjugates fell significantly (p less than 0.01). There were no significant changes in the concentrations of conjugates of the secondary bile acids (4.5 (3.8) v 3.9 (3.0]. Our study shows that oral administration of UDCA to patients with primary biliary cirrhosis induced marked changes in the circulating pool of endogenous bile acids together with improvement in liver function test values. The data also suggest that the beneficial effect of longterm administration of UDCA in these patients might be mediated through changes in the circulating primary bile acids and UDCA rather than through changes in the circulating secondary bile acids, deoxycholate and lithocholate. PMID- 2767509 TI - Subclasses of antibodies to hepatitis B core antigen in chronic HBV infection: changes during treatment with alpha interferons and predictors of response. AB - Response to interferon therapy in chronic hepatitis B virus (HBV) carriers is preceded by the appearance of IgM class anti-HBc (antibody to hepatitis B core antigen). The temporal relationship and magnitude of the IgM anti-HBc response is variable suggesting that the antibody is not directly involved in hepatocyte lysis, but is merely a marker of a changed state of immunity to the nucleocapsid proteins, induced by interferon. IgG 1, 2, 3, and 4 class anti-HBc did not change during therapy, but IgG 3 anti-HBc was significantly lower in responders than non responders. IgG anti-HBc of all subclasses was absent in two Chinese HBV carriers. Lower than normal titres of anti-HBc (p less than 0.001) were detected in human immunodeficiency virus antibody positive (anti-HIV) HBV carriers. These data indicate the presence of altered immunity to the nucleocapsid antigens in these two types of chronic HBV carrier that are known to respond poorly to antiviral therapy. PMID- 2767510 TI - Late results of endoscopic sphincterotomy for bile duct stones in elderly patients with gall bladders in situ. AB - Endoscopic sphincterotomy was undertaken in 186 patients with common bile duct stones and an intact gall bladder who were considered unfit for surgery. One hundred and seventy one patients had jaundice of whom 18 also had clinical cholangitis. The mean age of treated patients was 79.7 years (range 27-92) and only 13 were aged less than 60. Sphincterotomy was successful in 185 (99%) and complete clearance achieved in 172 (92.5%). Early complications occurred in nine patients (4.8%) of whom three died (1.6%). The patients have been followed on average for 32 months (range six to 72 months). Eighteen patients have subsequently required cholecystectomy (9.6%), with six major complications, but no deaths. There have been 27 natural deaths and 156 patients remain alive and symptom free. Endoscopic treatment alone is safe and effective in the majority of frail and elderly patients and can reduce the need for surgery in this high risk group. PMID- 2767511 TI - CCK receptor antagonism by loxiglumide and gall bladder contractions in response to cholecystokinin, sham feeding and ordinary feeding in man. AB - The postprandial contractions of the gall bladder result from the interaction of neurohormonal factors but their relative contribution is unknown. This study was designed to determine the role of cholecystokinin (CCK) in gall bladder contractions using a highly selective and potent CCK-receptor antagonist, CR-1505 (loxiglumide) in healthy men either infused with exogenous CCK in graded doses (1.56-50 pmol/kg/h) or subjected to modified sham feeding (MSF) and ordinary feeding tests. The gall bladder volume measured by real time ultrasonography showed dose dependent decrease in the gall bladder volume in 10 subjects when CCK8 was infused iv in graded doses reaching about 15% at 1.56 pmol/kg/h and 91% at 50 pmol/kg/h. Close correlation between the decrease in gall bladder volume and the dosage of CCK or the increments in plasma CCK-bioactivity was observed. After pretreatment with loxiglumide, CCK resulted in similar increments in plasma CCK-bioactivity but failed to affect the gall bladder volume at CCK doses up to 6.25 pmol/kg/h and caused only 53% reduction at 50 pmol/kg/h. Modified sham feeding and real feeding reduced the volume of gall bladder by 20% and 70%, respectively and loxiglumide decreased these values to 15% and 30%, respectively. This study provides evidence that loxiglumide is highly potent and selective CCK antagonist and that endogenous CCK plays an important role both in the postprandial contractions of gall bladder. PMID- 2767513 TI - Epithelial dysplasia in Caroli's disease. AB - We report a young patient with a solitary intrahepatic cyst without demonstrable connection with the biliary tree. The operative appearances suggested hydatid disease but histological examination of the resected cyst showed that it was the result of Caroli's disease already complicated by severe dysplasia. This case provides further evidence for the premalignant nature of Caroli's disease. PMID- 2767512 TI - Influence of treatment with pancreatic extracts on pancreatic enzyme secretion. AB - We have evaluated the effects of porcine pancreatic extracts on human pancreatic secretion. Ten male volunteers were intubated with a 4-lumen jejunal tube to collect gastric and duodenal secretions separately via the first and third tube, to infuse PEG 4000 distal the pylorus via the second tube and to apply porcine pancreatic extracts via the fourth tube distal the ligament of Treitz. Pancreatic extracts were given four times at 40 minute intervals; the first two as active enzymes and subsequently as heat denatured proportions. Secretin was continuously infused intravenously (0.5 E/kg bw/h) to achieve minimal pancreatic flow. Lipase, amylase, trypsin, chymotrypsin, volume, and bicarbonate were measured in duodenal contents in eight pooled 15 minute fractions. Three subjects who received HEPES Ringer buffer instead of pancreatic enzymes served as controls. Plasma cholecystokinin (CCK) was measured using a sensitive bioassay. Both active and heat denatured pancreatic extracts caused a small but significant increase in amylase and chymotrypsin secretion. Basal plasma CCK values were 0.85 (0.05) pM. After intrajejunal instillation of either active or heat denatured pancreatic extracts plasma CCK rose to 3.25 (0.30) pM and to 3.28 (0.36) pM respectively. In a second group of five volunteers, plasma CCK concentrations were measured after a test meal. On day 1, volunteers received a liquid fat and protein rich meal and on day 2, the same test meal containing porcine pancreatic extracts. In both cases, a similar increase in plasma CCK was observed. We conclude that therapy with pancreatic extracts stimulate pancreatic enzyme secretion. This may be mediated through release of CCK. PMID- 2767514 TI - Leukaemoid reaction and ulcerative colitis. AB - We describe a patient who presented with a pronounced neutrophil leucocytosis and leukaemoid reaction in association with toxic dilatation of the colon secondary to ulcerative colitis. Although the patient had been previously investigated, the significance of bowel disturbance had not been recognised. Once the inflammatory bowel disease was treated the haematological abnormality subsided. PMID- 2767515 TI - Cleaning and disinfection of equipment for gastrointestinal flexible endoscopy: interim recommendations of a Working Party of the British Society of Gastroenterology. PMID- 2767516 TI - One score + 11 = 2000. PMID- 2767517 TI - Value of adjuvant whole-pelvis irradiation after Wertheim hysterectomy for early stage squamous carcinoma of the cervix with pelvic nodal metastasis: a matched control study. AB - In a retrospective study, 185 patients with previously untreated stage IB or IIA (International Federation of Gynecology and Obstetrics) squamous cell carcinoma of the cervix were found to have pelvic nodal metastasis at the time of Wertheim hysterectomy and bilateral pelvic lymphadenectomy. Of these patients, 103 received adjuvant whole-pelvis irradiation and 82 received no adjuvant therapy. Median dose of pelvic irradiation was 5000 cGy. Among the irradiated patients, in 75% the dose was 5000 cGy or greater. Matching irradiated and nonirradiated patients according to stage, tumor size, and number and location of positive nodes yielded 60 pairs. Mean length of follow-up was 3.9 years for the 60 irradiated patients and 5.8 years for the non-irradiated patients. Kaplan-Meier overall and cancer-specific survival estimates for the two groups were not significantly different (P greater than 0.30). During the follow-up period, 21 surgery-only patients and 22 patients treated with adjuvant radiotherapy had recurrence, but adjuvant radiotherapy decreased the proportion of recurrences occurring in the pelvis alone--27% compared with 67% in the surgery-only group (P = 0.01). PMID- 2767518 TI - Continent urinary diversion in gynecologic oncology. AB - Pelvic exenteration is a salvage procedure used primarily for recurrent gynecologic carcinoma. Up to the present time, an ileal or colon conduit has been used for urinary diversion and the patient remains incontinent of urine. This is a preliminary report of nine patients with gynecologic carcinoma in whom a continent urinary diversion procedure was performed. A segment of distal ileum, the ascending colon, and part of the transverse colon are used to create the colonic reservoir. The segment of colon is opened along the tenia and folded onto itself. The walls of the ascending and transverse colon are anastomosed to detubularize this segment of bowel and eliminate the transient high pressure of the colon. Surgical staples are used for the anastomosis. The segment of ileum is tapered and three purse-string sutures (2-O silk) are placed at the level of the ileocecal valve to achieve continence. The short segment of ileum is then exteriorized as a stoma through which the patient catheterizes. Antirefluxing, non-tunneled ureterocolonic anastomoses are performed. The anterior wall of the reservoir is closed with absorbable staples. Postoperative urodynamic studies have shown maximum capacity of 750 ml and the area of continence to be at the ileocecal valve where the purse-string sutures are placed. All patients are continent and postoperative radiographs were negative for reflux. Follow-up was 6 to 12 months. The colonic reservoir is a capacious low-pressure system and warrants further clinical trials in patients with gynecologic cancer. PMID- 2767519 TI - Photodynamic therapy of human choriocarcinoma transplanted to the hamster cheek pouch. II. Intra-lesional photosensitization. AB - Photodynamic therapy (PDT) uses light-activated compounds, such as hematoporphyrins, to produce cytotoxic effects after illumination. Human choriocarcinoma cells were transplanted into the hamster cheek pouch to study PDT. The transplanted choriocarcinoma secretes human chorionic gonadotropin (hCG) in proportion to tumor volume. Red light (630 nm) from an argon-pumped dye laser (100-200 J/cm2) was used to illuminate tumors sensitized with dihematoporphyrin ether (DHE). Previous work has demonstrated complete regression (CR) of 90% of tumors (18/20) after one or two PDT sessions, while contralateral cheek pouch tumors continued to grow despite intraperitoneal DHE. Neither DHE nor laser light alone resulted in significant CRs. In this study we evaluated intratumoral injection of DHE followed in 2 hr by laser treatment. In all tumors, localization of DHE was demonstrated by induced fluorescence with ultraviolet light or He:Cd laser. After a single treatment, 14 of 38 tumors (37%) completely regressed (hCG less than mIU/ml); 4 tumors regressed grossly with low-level hCG [partial regression (PR)]. After repeat treatment there were 10 additional CRs in 19 rapidly enlarging tumors. After a third treatment 3 CRs and 3 PRs were achieved in 6 tumors. Because of large volumes, 2 of 3 progressing tumors failed to fluoresce uniformly after intratumoral DHE and were treated after intraperitoneal DHE injection; both completely responded. Overall, 29 of 38 tumors (76%) completely responded to PDT, and 7 partially responded (18%) with no gross tumor remaining in 5 of the 7. Only 5% of tumors (2/38) were non-responders. Photodynamic therapy results in gross elimination of 90% of tumors (52/58) in this model after intraperitoneal or intratumoral DHE sensitization (P less than 0.0001). DHE in chorio-carcinomas is easily detected and may enable detection of occult foci of malignancy. Choriocarcinoma transplanted into the hamster cheek pouch is highly responsive to photodynamic therapy. Clinical trials of PDT in gynecologic cancers are warranted to confirm the high response rates observed in refractory nongynecologic cancers. PMID- 2767520 TI - Reliability of frozen section examination in identifying poor prognostic indicators in stage I endometrial adenocarcinoma. AB - Management of Stage I adenocarcinoma of the uterus includes hysterectomy, bilateral salpingo-oophorectomy, and selective paraaortic and pelvic lymphadenectomy. Postoperative radiation therapy (RT) is selectively employed in patients with histologically defined poor prognostic indicators. We attempted to identify these poor prognostic indicators by frozen section (FS) at primary surgery in 55 patients with Stage I endometrial adenocarcinoma; we found an excellent correlation between the results obtained on gross examination of the uterus with selected FS and the results after extensive sampling and microscopic examination of permanent section (PS). The depth of myometrial invasion was accurately predicted in 96.5%, and histologic grade in 94.5% of these patients. Sixty-six percent of patients with occult invasion of the cervix on PS were identified on FS. Using the above criteria, we identified by FS all patients (15/55) who required adjuvant RT obviating the need for pelvic lymph node dissection. On the basis of our preliminary data, we recommend the use of careful gross examination and selective FS to identify patients requiring selective pelvic and paraaortic lymphadenectomy and adjuvant therapy, thereby eliminating the need for staging lymph node dissection with its associated morbidity and complications. PMID- 2767521 TI - Value of squamous cell carcinoma antigen levels in invasive cervical carcinoma. AB - Squamous cell carcinoma (SCC) antigen (Ag) levels were measured by radioimmunoassay in 64 patients with invasive squamous cell cervical carcinoma and 9 patients with nonsquamous carcinoma before the initiation of treatment. The mean antigen level in the squamous group was 10.5 ng/ml compared with 1.3 ng/ml in the nonsquamous group. In the patients with squamous cell carcinoma, mean SCC Ag level correlated well with stage, except for bulky stage IB tumors (P less than 0.05), where mean level was much higher than expected. Patients with exophytic tumors had significantly higher SCC Ag levels than those with nonexophytic tumors. Follow-up on 62 evaluable patients ranged from 20 to 40 months. The mean pretreatment SCC Ag level for patients free of disease at last contact was 5.6 ng/ml, in contrast to 16.1 ng/ml for those with recurrent disease. Only 32% of patients free of disease had pretreatment levels of 4.0 ng/ml or greater, while 86% of those with recurrent disease had such values (P less than 0.05). Forty patients had follow-up samples drawn 1 to 14 months after treatment. Mean post-treatment SCC Ag levels dropped to 1.8 ng/ml in 21 patients free of disease (73% decrease), but remained elevated at 13.4 ng/ml (17% decrease) in 19 patients with recurrences. The specificity of follow-up SCC Ag levels as a predictive test for outcome was 90%, with a sensitivity of 63%. We conclude that pretreatment SCC Ag levels correlate well with tumor stage, lesion morphology, and extent of disease. SCC antigen levels may be used to follow patients to determine effectiveness of treatment. PMID- 2767522 TI - Flow cytometric DNA analysis of stage I endometrial carcinoma. AB - Flow cytometric DNA analysis was performed on 203 paraffin-embedded archival specimens obtained from patients with surgical stage I endometrial carcinoma. Primary therapy for those patients (1979-1983) had been definitive extirpation with adjuvant therapy determined by histologic grade, histologic subtype, myometrial invasion, and peritoneal cytologic findings. Diploid DNA patterns were identified in 171 (84%) specimens and nondiploid characteristics were observed in the remaining 32 (25 DNA aneuploid, 7 DNA tetraploid). Although DNA nondiploid specimens accounted for only 16% of all stage I patients, they accounted for 50% of all relapses. Regardless of treatment or other pathologic features, progression-free 5-year Kaplan-Meier survival estimates were 92 and 63% for patients with DNA diploid and DNA non-diploid patterns, respectively (P less than 0.001). Overall 5-year progression-free survival for patients with grade 1 or 2 lesions was 90%; stratification by DNA diploid and DNA nondiploid patterns revealed progression-free survivals of 94 and 64%, respectively (P less than 0.001). Peritoneal cytologic study was positive in seven patients; none of the five with a DNA diploid pattern had a relapse and both with the DNA nondiploid pattern had relapses. These studies suggest that DNA ploidy status may be an objective prognostic determinant for patients with stage I endometrial carcinoma. PMID- 2767523 TI - Cisplatin and adriamycin combination chemotherapy for uterine stromal sarcomas and mixed mesodermal tumors. AB - Twenty-eight patients with a uterine stromal sarcoma or mixed mesodermal tumor were treated with cisplatin 100 mg/m2 and Adriamycin 45-60 mg/m2, given with intravenous hydration every 3 to 4 weeks. Group I consists of 11 patients with measurable disease following initial surgery or with a recurrence. Eight of the eleven evaluable patients with measurable disease had a response (73%), and three of these patients have had a negative second-look procedure, and two are alive and disease free more than 24 months after initiation of treatment. Group II consists of 17 patients treated with adjuvant chemotherapy after primary surgery. The patients were selected for adjuvant therapy based on previous established poor prognostic features. Of the 17 patients in group II, 14 had invasion of the outer one-third of the myometrium and the other three had invasion to the middle one-third. Seven had documented positive pelvic and/or periaortic lymph nodes and five had positive peritoneal washings. With a median follow-up of 34 months, there have been only four recurrences in group II. Two of the recurrences occurred in patients who discontinued therapy after only two cycles of chemotherapy. There is a projected 5-year survival of 75% in these high-risk patients. Of the seven patients with documented nodal involvement, one patient died with a recurrence at 23 months, one patient died from a perforated diverticulum, and the other five are alive and disease free with a median follow up of 36 months (34-90 months). Two patients with multiple positive nodes are disease free at more than 5 years. Combination chemotherapy with cisplatin and Adriamycin has a high response rate with advanced measurable disease and improves survival in high-risk patients who receive it as adjuvant therapy. PMID- 2767524 TI - In vitro analysis of the anticancer potential of tumor necrosis factor in combination with cisplatin. AB - We have recently shown that cisplatin increases the natural cytotoxic (NC) cell mediated lysis of a variety of human adenocarcinoma cell lines that are resistant to cisplatin or NC activity alone. Because NC lysis is mediated by tumor necrosis factor alpha (TNF) bound to the surface of NC effector cells, we analyzed the ability of TNF in combination with cisplatin to increase the lysis of tumor cells. The in vitro anticancer potential of the combination of TNF and cisplatin was determined for both dividing and nondividing populations of two human ovarian carcinoma cell lines, SK-OV-3 and OVCAR-3. Nondividing SK-OV-3 and OVCAR-3 cells are resistant to cisplatin and TNF when used as single agents. Dividing OVCAR-3 cells are approximately two times more sensitive to TNF than dividing SK-OV-3 cells, whereas dividing SK-OV-3 cells are approximately ten times more sensitive to cisplatin than dividing OVCAR-3 cells. TNF at 1000 units/ml in the presence of clinically low concentrations of cisplatin (0.6-0.25 micrograms/ml) increased the lysis of dividing OVCAR-3 cells above the value expected for the sum lysis mediated by cisplatin alone and lysis mediated by TNF alone. Similar results were obtained with dividing populations of the SK-OV-3 cell line. The combination of cisplatin and TNF did not increase the lysis of the nondividing populations of either cell line. The increased lysis of tumor cells combined with the maintenance of specificity for only dividing cells indicates that the combination of cisplatin and TNF may be useful for the treatment of tumors that are resistant to either cisplatin or TNF. PMID- 2767525 TI - Secondary cytoreductive surgery for recurrent epithelial ovarian cancer. AB - Thirty patients with recurrent epithelial ovarian carcinoma who underwent secondary tumor-reductive surgery at M. D. Anderson Cancer Center were studied retrospectively. All had been initially treated by primary reductive surgery and postoperative chemotherapy and had a period of clinical remission of at least 6 months thereafter. Ninety percent of patients had grade 2 or 3 tumors. In 17 (57%), residual tumor volume was reduced to less than 2 cm. There were no postoperative deaths, but 40% of patients suffered postoperative morbidity, mostly prolonged ileus. Median survival after second surgery was 16.3-18 months for patients with residual tumor volume less than 2 cm and 13.3 months for those with residual volume greater than 2 cm (nonsignificant). When the second surgery followed the first by less than 18 months, survival was a median of 13.5 months after the second operation as compared with 19 months when the interval was 18 months or longer (nonsignificant). Twenty-two patients received postsurgical chemotherapy; only 11% of those who were evaluable responded. Although secondary tumor-reductive surgery for recurrent ovarian cancer is technically feasible, in the absence of an efficacious second-line medical therapy, its value is limited. PMID- 2767527 TI - Impact of cervical intraepithelial neoplasia diagnosis and treatment on self esteem and body image. AB - Most women commonly take an abnormal Pap smear to be indicative of invasive cancer. This fear can permeate their lifestyle to the degree that it may influence receptivity to medical procedures as well as promote cervical intraepithelial neoplasia (CIN) to invasive squamous cell carcinoma of the cervix. This longitudinal study was undertaken to provide baseline data on self esteem and body image as the patient progresses from the initial visit through the postsurgery visit. Twenty patients ranging in age from 15 to 40 years were followed through diagnosis and treatment with colposcopic biopsy showing 25% CIN I, 45% CIN II, and 30% CIN III. Concern for cancer overrode all other concerns except during the postsurgery visit, at which time loss of attractiveness was paramount. Loss of sexual functioning ranked high in all visits. Self-esteem was lowest and anxiety highest during the initial and postsurgery visits. Positive body image was greatest when the results of the biopsy were received and during the postsurgery visit. Patients and sexual partners exhibited similar patterns of anxiety about the medical condition. Psychological repercussions from CIN occurred even prior to diagnosis. PMID- 2767526 TI - Intraperitoneal radiolabeled OC 125 in patients with advanced ovarian cancer. AB - Twenty patients with recurrent or persistent epithelial ovarian cancer failing conventional therapies were treated with a single intraperitoneal injection of iodine-131-labeled OC 125 monoclonal antibody. Rare acute side effects were nausea and mild diarrhea. At doses up to 120 mCi of iodine-131, median white blood cell and platelet count nadirs were 3.6k/microliters and 187k/microliters, respectively. Two patients acquired thyroid toxicities despite thyroid blockage with "cold" iodine. One patient had transient TSH elevation while remaining clinically euthyroid, and 1 patient developed activation of a thyroid nodule and clinical hyperthyroidism. Dose-limiting toxicity has not yet been observed. Twelve of 20 patients are alive 3 to 17 months following therapy. Tumor progression was noted in the majority of patients, although 3 patients had documented decreases in tumor burden of short duration. We conclude that, at the doses examined, iodine-131 OC 125 can be safely administered intraperitoneally. PMID- 2767529 TI - Rectal J-pouch reservoir to decrease the frequency of tenesmus and defecation in low coloproctostomy. AB - Low anterior resection of the colon with very low coloproctostomy is a procedure occasionally required in the surgical management of the patient with gynecologic malignancy. Very low end-to-end anastomosis of the colon to the rectum has been associated with fecal frequency and tenesmus in up to 70% of cases. The construction of a rectal J-pouch low-pressure reservoir has been reported to have a salutary effect on these symptoms. Between March 1987 and April 1988, a pilot study was carried out in which 11 patients with primary or recurrent gynecologic malignancy who underwent low anterior resection of the colon requiring very low coloproctostomy (below 6 cm) had construction of a rectal J-pouch reservoir with a Strasbourg-Baker end-to-side coloproctostomy. No postoperative complications were noted in this small series of patients. No patient has had more than three stools per day since surgery. Antidiarrheal medication was not required. All patients denied tenesmus. It was concluded that the rectal J-pouch reservoir offered a surgical technique for avoiding tenesmus and fecal frequency in very low end-to-end anastomosis of colon to rectum. PMID- 2767528 TI - A phase II evaluation of cisplatin and 5-fluorouracil in patients with advanced squamous cell carcinoma of the cervix: a Gynecologic Oncology Group Study. AB - Cisplatin is one of the most active single agents in advanced squamous cell carcinoma of the cervix and is synergistic with 5-fluorouracil in the laboratory. The Gynecologic Oncology Group has conducted a phase II trial in which cisplatin at 50 mg/ml2 given intravenously on Day 1 was combined with 5-fluorouracil 1000 mg/m2 daily given as a 24-hr infusion on Days 1-5. Treatment was repeated every 21 days. Fifty-five patients were treated with this regimen, resulting in seven complete remissions (12.7%) and five partial remissions (9.1%). The median survival was 6.4 months. Toxic effects of grade 2 or greater were leukopenia in 10 patients (18.2%), thrombocytopenia in 2 patients (3.6%), gastrointestinal effects in 25 patients (45.5%), and renal effects in 1 patient (1.8%). On the basis of these results, the cisplatin and 5-fluorouracil regimen does not appear to have any advantage over cisplatin alone in advanced cervical cancer. PMID- 2767530 TI - A longitudinal study of antigen expression in epithelial ovarian cancer. AB - The extent to which the antigenic phenotype of human epithelial ovarian cancer changes during the course of the disease is an issue that must be addressed in order to maximize the potential of antibody-directed imaging and therapy. We have obtained tumor specimens at two separate operations from ten patients with epithelial ovarian cancer and typed these specimens with a panel of 19 monoclonal antibodies to cell surface glycoprotein and carbohydrate antigens including blood group antigens. Antibodies with relatively high specificity for malignant cells as well as those detecting more widely distributed epithelial antigens were used in the study. Mean time between the two operations was 8.5 months. Five patients received intraperitoneal therapy during the interval between the two operations, including platinum-based regimens (four patients) and tumor necrosis factor (one patient). Four patients received intravenous platinum-based chemotherapy; one received no treatment. Frozen sections of specimens were stained with the antibodies by the indirect immunoperoxidase technique. Antigenic phenotypes were found to be unrelated to the patient's age, stage, tumor grade, histologic cell type, prior chemotherapy, and interval between operations. Most significantly, little difference was seen in antigenic expression between tumors obtained at the two operations for either the cell surface or blood group markers. Variations in the staining pattern were seen with antibody B72.3 and, to some extent, with the anti-blood group antibodies, which are known for producing heterogeneous staining. The antigenic phenotype of the tumor specimens in a given patient as determined immunohistochemically by our panel of antibodies showed only minor variation between operations, even under the selective pressures of chemotherapy and immunotherapy. PMID- 2767532 TI - Pelvic exenteration in clear cell adenocarcinoma of the vagina and cervix. AB - Pelvic exenteration was performed in 29 of 527 cases of vaginal and cervical clear cell adenocarcinoma (CCA). Exenteration was the initial therapy in 21 cases (1 stage I, 15 stage II, 3 stage III, 1 stage IV, and 1 unknown stage) and was undertaken in 8 cases for central failure after primary radiotherapy. Of the 78 patients with stage II vaginal CCA, the 9 treated with primary exenteration were compared with the 69 who had other modalities of therapy; no significant difference in the survival experience was noted between the two groups. Among the 96 patients with stage II cervical CCA the survival experience was less favorable for those who underwent primary exenteration (n = 5) than for those who were treated with other varieties of therapy (n = 91). Of the 34 patients with central treatment failure, 8 had exenteration and 26 had other forms of therapy. The overall 5- and 8-year actuarial survival rates for the exenteration group (100 and 60%) do not differ significantly from those for the nonexenteration group (71 and 56%). Primary exenteration was used more frequently in the 1970s but has been predominantly reserved for the treatment of recurrent disease during the past decade. Survival statistics after exenteration for central failure are more favorable in cases of vaginal and cervical CCA than in cases of cervical squamous carcinoma. PMID- 2767531 TI - Concomitant cisplatin and radiotherapy in locally advanced cervical carcinoma. AB - Patients with locally advanced cervical cancer have a poor prognosis. The efficacy of radiotherapy is limited by the presence of large tumor volume and nodal disease. As cisplatin is a documented radiosensitizer and has activity in squamous cell carcinomas, a prospective study was designed to evaluate the toxicity and potential synergism of concurrent cisplatin (20 mg/m2 x 5 d every 21 days) and radiotherapy in locally advanced cervical cancer. Forty-three patients were studied, of which 14 were stage IB/IIA (bulky disease) and 29 were stage IIB/IIIB/IVA. Of the 32 evaluable patients, there were 29 complete responders. Of these 29 patients, 27 remain without evidence of disease, with a median follow-up of 12 months. There were no treatment-related deaths. Cisplatin and radiotherapy appear to be a well-tolerated and highly effective regimen for locally advanced cervical cancer. PMID- 2767533 TI - [At-risk pregnancy, a medical and organizational problem]. PMID- 2767534 TI - [Principles of cardiotocographic monitoring of the fetus in pregnancy]. PMID- 2767535 TI - [Spontaneous rupture of the extensor pollicis longus]. AB - A review of the literature is followed by the analysis of a series of forty-four patients who were treated by extensor indicis transposition. Twenty-five patients could be reached for a clinical follow-up examination, nine further patients were interviewed by telephone; of the remaining ten patients, seven could not be reached and three had died. Excluded from the series were patients with rheumatoid arthritis. Results were evaluated according to the scheme suggested by Geldmacher and coworkers. According to their evaluation scheme, we can report fourteen excellent, eight good, three satisfactory, and no bad results. Subjectively, the results were even better, with twenty-eight patients reporting excellent, four good, and two satisfactory results, including those nine patients contacted by telephone only. Strength of extension of the index finger was not diminished after the extensor indicis transposition when all fingers were extended simultaneously. However, there was a deficit of extension in a few cases when the remaining fingers were clenched to a fist. This indicates that an alternative method should probably be recommended in patients with professions where individual extension of the index finger is of paramount importance. It is also suggested that additional functional tests, convertible into score points, might render the evaluation more realistic than measurements only. Inclusion of these additional functional tests might also give an explanation for the discrepancy between patients' subjective results and those as a result of measurement only. PMID- 2767536 TI - [Long-term results of treatment of rare aseptic necrosis of the scaphoid bone (Preiser disease) with the Swanson implant]. AB - In 1911 Preiser described the avascular necrosis of the scaphoid bone, which is regarded as a relatively rare clinical and radiological condition. The diagnosis is not established easily, and a small, avascular proximal fragment, e.g. in a scaphoid pseudarthrosis, should not be confused with Preiser's disease. Two histologically diagnosed cases are described: one of thema at operation 42-year old woman received a scaphoid Swanson implant in 1980. At follow-up eight years later, she presented with very satisfying clinical and radiological findings. PMID- 2767537 TI - [Rhizarthrosis and thenar muscles. A clinico-anatomic study]. AB - Advanced osteoarthrosis of the first carpometacarpal joint is characterized by a subluxation (luxation) of the joint, by an adduction deformity and by hyperextension of the metacarpophalangeal joint of the thumb. This morphological and functional investigation aims to underline the importance of the intrinsic thumb muscles in this complex deformity of the thumb. The vector of the M. abductor pollicis brevis and the physiological cross-section of the thenar muscles were determined in eight osteoarthrotic and ten healthy hands. The superficial head of the M. flexor pollicis brevis and the M. abductor brevis were investigated electromyographically in patients as well as in healthy controls. There is disturbed function of the M. abductor pollicis brevis in cases of arthrosis, caused by a changed vector of the muscle. The physiological cross section of the superficial head of the M. flexor pollicis brevis is diminished by about fifty per cent. The electromyographic records of patients lead to the conclusion that there is a particular loss of activity in the short flexor and abductor muscles. The muscular alterations taken together cause functional imbalance of the thenar muscles. The abductor muscle is not able to maintain the coordinating system that consists of two straight and one oblique muscle and the Z-deformity of the thumb results. PMID- 2767539 TI - [Classification of polydactyly of the hand and foot]. AB - The authors present a classification for polydactyly of the upper and lower limb based on a follow-up examination of 177 patients with 336 polydactylies. The malformations are described in longitudinal and transverse directions. In the transverse axis the affected rays are designated with Roman numbers from I to V. The longitudinal axis from distal to proximal is used to differentiate the rays into ten types according to their duplication assessed both anatomically and radiologically. Triphalangism, rudimentary forms, and trifid rays can also be described by this system, so they can be correlated. Evaluation of the patient group according to this classification shows that the marginal rays of hand and feet are most affected. In the longitudinal axis the metacarpo- metatarsal joint type predominates in the upper and lower limb. Using this classification it seems possible to relate different forms of polydactyly to each other and to compare therapeutic procedures and their results. PMID- 2767538 TI - [Indications for computerized tomography of the wrist joint and carpal bones]. AB - Twenty-nine patients with thirty-one fractures of the distal radius and persistent pain or disability had computed tomography of the radio-carpal and distal radioulnar joint. We found incongruity of the distal radio-ulnar joint in six patients. Ten patients had a rotational malalignment in supination. Seven patients suffered from rotational malalignment in pronation. The ability to quantify rotational malalignment and to have images of the degenerative arthritis following these disorders without superimposition aids in selecting surgical treatment. PMID- 2767541 TI - [The dorsum of the nose as a problem in secondary rhinoplasties]. AB - The dorsum of the nose plays an important role in rhinoplasty. The specific texture of the skin, the cartilageneous structures, and the bony frame have to be regarded in operative procedures. According to the literature up to 15 percent revisions become necessary after rhinoplasty, mostly due to failures during the first operation. Therefore exact analysis and accurate planning as well as careful operation techniques are essentials to obtain good results. PMID- 2767540 TI - [Thibierge-Weissenbach syndrome]. AB - The author reports the case history of a female patient with a special form of progressive scleroderma, the Thibierge-Weissenbach-syndrome. The removal of the recurring calcifications in the fingers made ten operations within eleven years necessary. After description of the pathology possible differential diagnoses are discussed. PMID- 2767542 TI - [Morel-Fatio temporary management of the paretic eyelid]. AB - Various alloplastic materials have been used to reestablish proper function of paretic upper eyelids. Modifying Morel-Fatio's method, the spring had been bent in a W-fashion and located in such a position that three dimensional movement of the lower branch was possible. Complications of the original method like swelling and perforation could be explained by occasional allergies against chromium and nickel. Therefore we used a new titan-molybdaen alloy, which has a slightly higher elasticity modul than the chrom-nickel alloy. The new material's characteristics correlate well with our own in vivo measurements of the strength of the levator palpebrae superioris muscle. Clinical observations during the last 3.5 years show an improvement by the use of the titan-molybdaen alloy for the durability of elasticity as well as for tissue compatibility. PMID- 2767543 TI - Reducing household waste. PMID- 2767544 TI - Radiation damage--managing its effects (Part I) (continuing education credit). PMID- 2767545 TI - The ecology of Crepidostomum species (Allocreadiidae: Digenea) in the salmonoids of Lake Yli-Kitka in northeastern Finland. AB - Crepidostomum spp. were studied from 417 whitefish (Coregonus acronius Rapp, 1854), 220 vendace (Coregonus albula L.) and 38 brown trout (Salmo trutta m. lacustris (L.)) from Lake Yli-Kitka in northeastern Finland during 1980 1983.12.7% of the whitefish were infected with Crepidostomum with a mean intensity of 4.6 worms per infected fish. The species involvedare C. farionis (Muller, 1784) and Crepidostomum wikgreni Gibson et Valtonen, 1988, which differed from C. farionis in the number and size of the eggs. Both types were encountered in the gall-bladder and intestine, but were unable to be distinguished as immature stages. 21% of the brown trout harboured C. farionis in the intestine with a mean number of 1.5 worms per infected fish. Two C. farionis specimens occurred also in the intestine of one vendace. Whitefish smaller than 150 mm did not harbour Crepidostomum specimens, but in bigger fish the prevalence and the mean intensity of infection increased to a certain limit as the fish got larger. The prevalence of Crepidostomum infection also clearly increased during the three seasons in the three size-groups studied. The seasonal pattern of Crepidostomum in whitefish of the size greater than or equal to 150 mm was variable in that the lowest values, both in the prevalence and mean intensity of infection, occurred between September and December in 1980 and between April and August in 1982. Reinvasion was found throughout the year, although the main recruitment occurred during autumn and early winter. Eggs matured between late spring and early autumn. The smallest worms occurred mainly in the gall-bladder, and most of the gravid specimens were located in the intestine. Both the variance to-mean ratio and the low values of the parameter k of the fitted negative binomial distribution reveal the Crepidostomum specimens are overdispersed in the whitefish of Lake Yli-Kitka. PMID- 2767546 TI - Ultrastructural observations on the redia of Echinostoma revolutum (Froelich, 1802). AB - E. revolutum redia digestive and excretory system ultrastructure, as well as body wall tegument were studied in TEM. The body tegument protrudes in short microvilli and contains uni- and multiciliate sensory endings. The anterior part of the digestive system (pharynx, short oesophagus) is lined with body tegument, the caecum being covered with a flat epithelium with sporadic microvilli. Oesophageal gland cells are filled with minute electron-dense granules. The excretory capillaries joined to large flame cells are composed of spirally wrapped cells, in the cytoplasm of which there are clusters of microtubules. The special features of the digestive system of echinostome rediae, as well as their significance in the antagonistic relationship to the partenitae of other families of trematodes and their pathogenic effect on the intermediate host, are discussed. PMID- 2767547 TI - Porcine neonatal coccidiosis in Cuba. PMID- 2767548 TI - Occurrence of Proteocephalus percae and P. cernuae in the perch and ruff in northern Finland. AB - The occurrence of two palearctic Proteocephalus species, P. percae and P. cernuae, in the perch and ruff, respectively, was studied in two areas of northern Finland in 1977-1983. In the Bothnian Bay, 243 perch (Perca fluviatilis) and 406 ruff (Gymnocephalus cernuus) were studied, of which 60% and 40%, respectively, were infected, while in Lake Yli-Kitka the prevalences were 10% in 213 perch and 24% in 307 ruff. Higher mean intensities of infection were found in the Bothnian Bay fish than in those from the lake, but no infected fish had as many as 10 worms. Proteocephalus infection in the perch and ruff did not vary significantly according to the length of the fish in either area, except that no P. percae were found in perch smaller than 70 mm in the lake. There was a prominent seasonal variation in the occurrence of P. cernuae in the ruff in both areas, but especially in the lake, where no proteocephalids were found in the ruff in July-October. Overlapping of generations was evident in P. percae in the sea perch, although only by virtue of the lack of mature worms at the end of the summer. Some mature proteocephalids were also found in winter in both fish species in the sea and in the ruff of the lake. The higher mean intensity values in winter, especially in P. cernuae infection in the sea ruff, may be explained partly by the active feeding of the ruff at this time in spite of very low water temperatures. Feeding activity in the perch is lower in the winter, and hence a lower mean intensity of P. percae infection was seen especially in the lake material at that time. PMID- 2767549 TI - Orthoptera as intermediate hosts of Staphylocystis furcata (Stieda, 1862) (Cestoda: Hymenolepididae). AB - Cysticercoids of Staphylocystis furcata (Stieda, 1962), the adults of which parasitize the shrews (Soricidae), were found in the thoracic and abdominal cavities of orthopterous insects (Orthoptera, Acridioidea) belonging to five species: Chorthippus apricarius (L.), Chorthippus paralellus (Zett.), Omocestus viridulus (L.), Chrysochraon brachypterus (Ocsk.), and Chrysochraon dispar (Germ.). The cysticercoids are described and their incidence in both sexes of the examined intermediate hosts is compared. PMID- 2767550 TI - Dynamics of egg production of the cestode Diphyllobothrium dendriticum (Nitzsch, 1824) (Cestoda: Pseudophyllidea) and the concept of fecundity in helminths. AB - The dynamics of egg production of the tapeworm D. dendriticum has been estimated experimentally in nestlings of the herring gull Larus argentatus per day and per reproductive period. Numbers of eggs in strobilae have been estimated for the maturation period. Mean egg production, of one tapeworm per day (10.42 +/- 2.72 mln) is two orders of magnitude as high as the maximal number of eggs in a mature strobila (0.206 +/- 0.007). It is proposed to estimate the coefficient of reproduction intensity as the ratio of egg output per unit of time and maximum egg numbers in a mature strobila. PMID- 2767551 TI - Purification and properties of cytoplasmic malate dehydrogenase from Taenia crassiceps (Zeder, 1800) cysticerci. AB - Malate dehydrogenase (L-malate: NAD oxidoreductase, EC 1.1.1.37) from the cytoplasm of Taenia crassiceps cysticerci was purified and the basic kinetic parameters of this enzyme were determined. The pH optimum range of enzyme reaction was found to be very wide: 8.8-11.0 for malate oxidation and 6.0-8.5 for oxaloacetate reduction. KM values for oxaloacetate, malate, NAD, and NADH were 7.8.10(-5) M, 1.4.10(-4) M, 1.2.10(-4) M, and 6.10(-5) M, respectively. Malate dehydrogenase activity was inhibited by malate excess. Molecular weight of malate dehydrogenase was 70,800. A comparison of the data obtained with those from other organisms including vertebrates showed that the cytoplasmic malate dehydrogenase from T. crassiceps is almost identical with the enzymes from other sources in its kinetic and regulatory properties, as well as in its molecular weight. PMID- 2767552 TI - Neoascaris vitulorum (Goeze, 1782): a scanning electron microscopy study. AB - The surface structures of male and female head and tail ends of Neoascaris vitulorum were studied by means of scanning electron microscopy. Lips, denticles, spicules in male and caudal end of female were studied in detail. PMID- 2767553 TI - The morphology of Trianchoratus aecleithrium Price et Berry, 1966 (Dactylogyridae, Monogenea) from a new host Trichogaster trichopterus trichopterus (Pallas, 1777). AB - The monogenean parasite Trianchoratus aecleithrium Price et Berry, 1966 is comparatively described from the gills of Trichogaster trichopterus trichopterus from aquarium in Czechoslovakia. T. trichopterus trichopterus represents a new host record for this parasite. PMID- 2767554 TI - Antibody-mediated response of pigeons to Argas polonicus larval feeding and characterization of larval antigen. AB - Circulating antibodies to larval Argas polonicus antigen detected in the blood of pigeons by means of ELISA reach their highest level 3-6 days post-tick attachment. During 6-8 days post infestation when most larvae detach from their host, there is an abrupt drop of the antibody level in blood followed by second peak at day 10-15. During the secondary and subsequent infestations the dynamics of the antibody production is analogous, but the maximum absorbance values found are higher with each following infestation. This is in direct correlation with the growth of immune resistance of hosts. The transfer of immunoglobulins of resistant pigeons produces in naive hosts a partial resistance in a statistically significant (P less than 0.01) reduction of the number of engorged larvae, in the shortening of larval feeding period and in the decrease of their mean weight after feeding. However this resistance was significantly (P less than 0.01) less expressed than in naturally resistant pigeons during secondary infestation. The protracted effect on the duration of premoulting period and the percentage of moulted larvae manifested in larvae after secondary infestation was not apparent in molecular weight of approximately 19, 21, 23, 27, 45 and 165 kilodaltons, were recognized by serum of resistant pigeons. PMID- 2767556 TI - Effect of T-activin on the course of experimental infection with Taenia crassiceps (Zeder, 1800) in mice. AB - T-activin--an immunomodulating preparation of polypeptidic character prepared from calf thymus--was used for influencing the course of infection in a model system mouse-Taenia crassiceps. A single s.c. application of 100 micrograms of T activin at various intervals before and after infection resulted in a marked decrease in the number of cysticerci in peritoneal cavities of experimental mice (by 47.1-93.6%) compared to the controls. After s.c. application of T-activin and i.p. injection of antigen (crude T. crassiceps larvae homogenate from mice) the decrease in the cystricercus number was still more pronounced than in the mouse groups receiving only T-activin or homogenate (by 76.9% in comparison with 65.5% and 17.0%, respectively). A combination of T-activin with crude T. crassiceps homogenate from rats did not produce the same effect in experimental mice. The protective effect of individual combinations of T-activin with the homogenate does not correlate with the antibody level in the serum of infected mice. PMID- 2767555 TI - Results of the Czechoslovak-Cuban cooperation concerning investigations of ticks and arboviruses transmitted by ticks. PMID- 2767557 TI - Natural cryptosporidiosis in domestic geese, Anser anser L., in Czechoslovakia. PMID- 2767558 TI - A hybrid swarm of Ixodes dammini and Ixodes scapularis (Acari: Ixodidae). PMID- 2767559 TI - Introduction of the tick Rhipicephalus sanguineus to Czechoslovakia: an additional case. PMID- 2767560 TI - Life cycle of Eimeria coecicola Cheissin, 1947. AB - Life cycle of Eimeria coecicola was studied in experimentally infected rabbits by light microscopy and by transmission and scanning electron microscopy. First and second generation meronts developed in the vermiform appendix; third and fourth generation meronts were located in the epithelium of the ileum. Gametogony developed again in the vermiform appendix. The prepatent period was 9 days. New data were obtained by the study of asexual reproduction. First generation meronts were first observed 4 days post infection (DPI), which is relatively late in comparison with other species of rabbit coccidia. Sporozoites were found in lymphatic follicles of the vermiform appendix at 4 DPI by transmission electron microscopy. This suggests, together with selective location of first generation meronts in the epithelium adjacent to these follicles, that major part of sporozoites enter the epithelium cells through lymphatic follicles and not through the lumen of the vermiform appendix. The process of development of first generation merozoites is similar to endodyogeny. The differences are in formation of apical parts of daughter merozoites which is not coincidental with nuclear division and in formation of the outer membrane of pellicle which arises within the mother cell. Some first generation merozoites have 2-3 nuclei, second and fourth generation merozoites are only uninucleate, while third generation merozoites are only multinucleate. We found that further merozoites are formed in multinucleate third generation merozoites by endopolygeny. PMID- 2767561 TI - Equinovarus deformity in arthrogryposis and myelomeningocele: evaluation of primary talectomy. AB - As initial surgical management for rigid equinovarus deformities, 16 children with arthrogryposis (30 involved feet) and 16 myelodysplastic children (26 involved feet) underwent primary talectomies or extensive posterior-medial releases (PMR). When compared with primary PMRs in arthrogrypotic children, primary talectomies revealed a greater number of good and fair results, decreased recurrence rates, less procedures per foot, and maintenance of ambulatory status. Recurrent forefoot and cavus deformities were present after primary talectomies. Primary talectomy in arthrogrypotic children was more effective than posterior medial releases or secondary (salvage) talectomy. Because of the small number of feet involved, the role of primary talectomy in myelomeningocele was not clarified by this study. Radical PMRs in myelodysplastic children resulted in a significant number of hindfoot valgus deformities that required secondary procedures. PMID- 2767562 TI - Effect of the syndesmotic screw on ankle motion. AB - The purpose of this study was to determine the effect of syndesmotic screw fixation on ankle motion. Eight unpaired osteoligamentous cadaver ankles were tested. The study quantified ankle flexion, talar tilt, ankle drawer, and tibiotalar rotation for each specimen using an MTS biomechanical testing system. Each specimen was tested under a 15-kg and a 70-kg axial load. The testing was repeated after the placement of a syndesmotic screw, a 4.5-mm cortical screw, in accordance with AO technique. There was a statistically significant decrease (P less than .05) in tibiotalar external rotation. There was no statistical difference in ankle flexion. There was a significant decrease in the anterior and the posterior drawer tests with the foot in plantar flexion. These were the most significant results. Syndesmotic screw fixation is used for the internal fixation of certain unstable ankle fractures. Opinions differ as to whether the screw should be removed at 6 weeks (prior to weightbearing) or left in place indefinitely. It was concluded that the syndesmotic screw should be removed prior to the return to full activity. Leaving it in place will contribute to abnormal ankle motion; this may result in local discomfort and a possible fatigue fracture of the screw. PMID- 2767563 TI - Stabilizing effect of the tibiocalcaneal fascicle of the deltoid ligament on hindfoot joint movements: an experimental study. AB - The tibiocalcaneal fascicle of the deltoid ligament was studied in 10 lower leg amputation specimens to evaluate its stabilizing effect on movement in the tibiotalocalcaneal joint complex and the talocalcaneal joint complex. Cutting of the fascicle resulted in minor numerical increases in movement in all three planes in the tibiotalocalcaneal joint complex as well as in the talocalcaneal joint complex. The maximum median increase in the tibiotalocalcaneal joint complex was 6.1 degrees in abduction, whereas the maximum median increase in the talocalcaneal joint complex was 3.6 degrees in abduction. However, the percentage of increase in the total range of movement in a single plane was large for abduction-addition in both the tibiotalocalcaneal joint complex and the talocalcaneal joint complex, at 28% and 31%, respectively. The largest percentage of increase, 40%, was found in the total range of plantarflexion-dorsiflexion in the talocalcaneal joint complex. Our data suggest that the tibiocalcaneal fascicle is an important stabilizing structure of abduction, external rotation, and plantarflexion movements in the tibiotalocalcaneal joint complex, especially in the talocalcaneal joint complex. PMID- 2767564 TI - Posterior instability of the talus: an anatomic evaluation. AB - A cadaver study was conducted to evaluate the role of the posterior tibial margin or posterior malleolus, as well as medial and lateral supporting structures, in providing posterior stability for the talus. Posterior malleolar fractures consisting of approximately 30%, 40%, and 50% of the articular margin on the lateral radiograph were created in specimens that were then subjected to posterior stressing. No posterior talar subluxation was noted in any specimen. Repeat stressing following removal of the medial malleolus again revealed no subluxation in any specimen. The lateral supporting structures, primarily the posterior fibulotalar and fibulocalcaneal ligaments, appeared to be the key structures providing posterior talar stability. If the fibula is stable in an anatomic position, feared posterior instability of the talus would not appear to be an indication for internal fixation of posterior malleolar fractures. PMID- 2767565 TI - Fracture-dislocation of the articular surface of the third metatarsal head. AB - Fracture of the metatarsal head is uncommon, and reports are rare of isolated osteochondral fracture of the articular surface of the metatarsal head, as occurred in the 18-year-old man reported here. Good results were obtained with closed reduction by manipulation and traction, followed by cast immobilization for 6 weeks. PMID- 2767566 TI - Osteotomy of the first metatarsal. PMID- 2767567 TI - Relationship of metatarsophalangeal joint fusion on the intermetatarsal angle. AB - To evaluate the effect of fusion of the first metatarsophalangeal joint on the first intermetatarsal angle, a series of 62 consecutive first metatarsophalangeal fusions was reviewed. Of these, 47 had sufficient data to be included in this study. The results of this study showed that the change in the first intermetatarsal angle following a first metatarsophalangeal joint arthrodesis is directly proportional to the preoperative first intermetatarsal angle. Therefore, when a first metatarsophalangeal joint arthrodesis is performed on a patient with a wide intermetatarsal angle, a concomitant proximal first metatarsal osteotomy is usually not indicated. PMID- 2767568 TI - Objective evaluation of the human voice: clinical aspects. PMID- 2767569 TI - Haptoglobin phenotyping of bloodstains by horizontal electrophoresis on a compact polyacrylamide gradient gel. AB - A method is described for phenotyping haptoglobin by horizontal electrophoresis on a small polyacrylamide gradient gel. This method employs the same apparatus used in the separation of many red cell enzyme phenotypes and thereby eliminates the necessity for specialized vertical electrophoresis equipment. PMID- 2767570 TI - A, B and H group specific substances in human vitreous humor. AB - The presence of A, B and H group specific substances in vitreous humor taken from 105 human corpses was determined. Good agreement was obtained between these group substances and the ABO blood group. The relationship with the secretor type is discussed. PMID- 2767571 TI - Sex determination of blood stains with a recombinant DNA probe: comparison with radioactive and non-radioactive labeling methods. AB - A recombinant DNA probe hybridizing specifically to human repeat DNA sequence (pHY10) of which about 3000 copies are present on the Y chromosome was used for sex determination of degraded DNA samples of blood stains. Human blood stains of male and female origin were readily differentiated with the pHY10 DNA probe. This radioactive technique enabled reliable and sensitive sex determination from blood or dried blood stains greater than 20 years old. Less than 1 microliter of blood or 1 piece of 0.5 cm length thread of blood stain from cotton fabric was sufficient for the test using dot blot hybridization. Compared with the radioactive labeling method, the photobiotin labeling method showed one thirtieth to one fiftieth lower sensitivity and presented some problems which are expected to be resolvable. PMID- 2767572 TI - Direct analysis of anticonvulsant drugs in vitreous humour by HPLC using a column switching technique. AB - A method is described for the rapid HPLC analysis of a number of anticonvulsant drugs in vitreous humour by injection directly onto a preconcentration column without the need for prior extraction. The conditions for optimum precision and accuracy were investigated and the method was subsequently applied to the analysis of phenytoin in a number of overdose cases. Sensitivity was 0.05 microgram/ml on a 0.5 ml vitreous sample. The mean blood/vitreous ratio for phenytoin was found to be 2.8 (range: 1.4-5.1). The relationship between blood and vitreous levels had a correlation coefficient of 0.85. Vitreous was found to be a very clean, stable sample, ideally suited to this technique. PMID- 2767573 TI - Differences in the intracranial pressure caused by a 'blow' and/or a 'fall'--an experimental study using physical models of the head and neck. AB - In cases of a severe head injury caused by a fall, coup contusions are either absent or very minor, in contrast to presence of extensive contre-coup damage. In cases of a severe blow to head, however, the reverse occurs, with contre-coup lesions a rarity and coup damage extensive. To investigate this further, head injuries caused by a 'blow' or a 'fall' have been studied, using physical human models of the head and neck, both filled with distilled, degassed water and fixed onto a dummy torso. An impact of a constant magnitude was applied to the midoccipital region in 'blow' and 'fall' experiments, and the acceleration of the head and changes in the intracranial pressure were measured, with the resulting data analyzed by a computer. In both experiments, the peak amplitude of the acceleration pulse were almost the same. Similarly, the intracranial pressure curve at the impact site consisted of a positive pulse that hardly differed, nor did the peak amplitude of that pulse vary significantly. In the 'blow' experiment, however, the intracranial pressure curve at the site opposite the impact consisted of a negative pulse, whereas in the 'fall' experiment, the intracranial pressure recorded at the same area was negative but of a longer duration, with an absolute value that was slightly greater. Our results indicate that an impact to the head triggers a different response in the intracranial space, dependent on whether that impact force was caused by a 'blow' or a 'fall'. PMID- 2767575 TI - Injuries due to deliberate violence in areas of Denmark. III. Lesions. The Copenhagen Study Group. AB - As part of a transcultural investigation of violent behavior in Denmark and South America, the lesions from accidents involving deliberate violence registered in three Danish emergency wards during a 1-year period were studied. A quantity of 2211 lesions were diagnosed in 1316 patients (953 male and 363 female patients). Sixty-five percent of the lesions were in the head/neck region, 13% in truncus, 18% in the upper extremities and 5% in the lower extremities. The most frequent diagnosis was an open wound in the head/neck region. Adding contusions and fractures in the same region this amounted to more than half of the total number of lesions. In the upper extremities 62% of the lesions were contusions or open wounds. Serious lesions of internal arteries were few, however always caused by sharp instruments (knives). Serious lesions due to firearms were not recorded/reported. Strangulation had been used against 1.1% of the victims, the male/female ratio being 1:6. The main part of the lesions were of minor severity when assessed on the basis of the scores in the Abbreviated Injury Scale (AIS). The lesions were, however, more serious compared to other recent studies, and it appeared that the female victims had fewer but more serious lesions than the male victims. The need for treatment and hospitalization was in the range of other recent studies. PMID- 2767574 TI - Carbon monoxide poisoning. AB - This paper illustrates the remarkable fall of carbon monoxide poisoning due to the abolition of coal gas in the 1970 era and a corresponding decrease in suicide deaths. It enfolds the varying forms of suicide and accident according to age, sex and circumstance. PMID- 2767576 TI - Injuries due to deliberate violence in areas of Denmark. IV. Alcohol intoxication in victims of violence. The Copenhagen Study Group. AB - A material of 1316 victims of deliberate violence was collected prospectively during a one year period in three Danish emergency wards covering a provincial/rural area and two metropolitan areas. The frequency of alcohol intoxication was determined. Forty-one percent of the patients were intoxicated. The highest frequency was found in male victims, in the provincial/rural area, in restaurants or their vicinity, in the age group 35-49, during evenings and nights and in May. It is difficult to indicate specific preventive measures. However, a more restrictive attitude is suggested with regard to serving alcohol to intoxicated persons in restaurants. PMID- 2767577 TI - Double replica electroblotting for the simultaneous phenotyping of C6 and C7, and its application to the examination of bloodstains. AB - A new reliable and reproducible technique for the simultaneous determination of C6 and C7 types is presented, which employs double replica electroblotting after isoelectric focusing. It permitted clear discrimination of both C6 and C7 components, and the patterns were nearly comparable to those demonstrated separately. The population data obtained by this new technique fitted the genetic hypothesis. The present double replica electroblotting method was successfully applied to the combined phenotyping of C6 and C7 from bloodstains which were stored at room temperature for up to 4 weeks. The method is quite suitable for medicolegal examination of bloodstains particularly for the saving in the amount of sample. PMID- 2767578 TI - Drugs in hair: a new extraction procedure. AB - An enzymatic hydrolysis of hair for drug detection is described. The results obtained with the suggested method are compared with those observed by chemical hydrolysis. Enzymatic digestion provides a high recovery (80%) for cocaine metabolite, while alkaline hydrolysis causes its chemical destruction. The two hydrolytic procedures yielded comparable results for morphine. The outlined procedure is recommended when unstable compounds are to be detected in hair. PMID- 2767579 TI - Disposition of fluoride in a fatal case of unsuspected sodium fluoride poisoning. AB - A case of suicidal ingestion of sodium fluoride roach powder by a 33-year-old black woman is presented. Disposition of fluoride (mg/l or mg/kg) was: bile, 3.4; gastric content, 225; kidney, 16; liver, 8.6 and urine, 295. No history of roach powder ingestion was available at autopsy. This case illustrates the need for extensive toxicological screening to determine if fatal poisoning has occurred when histopathological findings are unremarkable. PMID- 2767580 TI - A comparative pharmacokinetic study of ethanol in the blood, vitreous humour and aqueous humour of rabbits. AB - The pharmacokinetics of ethanol in the blood, vitreous humour and aqueous humour of the rabbit after intravenous administration of single dose have been compared. Ethanol levels were determined by gas-liquid chromatography. Certain parallelism between ethanol levels in these body fluids were observed after 80 min. PMID- 2767581 TI - Rapid isolation with Sep-Pak C18 cartridges and wide-bore capillary gas chromatography of organophosphate pesticides. AB - A simple and rapid method for isolation of eleven organophosphate pesticides with Sep-Pak C18 cartridges from human urine and plasma, is presented. The detection of the pesticides was made by wide-bore capillary gas chromatography (GC) with flame ionization detection. The pesticide-containing samples, after mixing with water, were directly applied to the cartridges and eluted with chloroform/isopropanol (9:1). The recoveries with use of the cartridges were excellent for most pesticides. Separation of each pesticide peak from each other and from impurities on the gas chromatograms was also satisfactory with use of non-polar and slightly polar capillary columns. The isolation method with use of the cartridges, together with the wide-bore capillary GC, seems very useful in forensic and environmental chemistry and clinical toxicology. PMID- 2767582 TI - Identification and quantification of p-hydroxyethylamphetamine as a novel metabolite of ethylamphetamine in rat by gas chromatography-mass spectrometry. AB - Ethylamphetamine and two major metabolites in urine, obtained after intraperitoneal administration of the drug to rats, have been isolated by gas chromatography-mass spectrometry. We have also synthesized an authentic sample of p-hydroxy-N-ethylamphetamine by a simple method. In rat, the metabolic pathway of ethylamphetamine is similar to that of amphetamine and methylamphetamine according to quantitative analysis of the major metabolites using a selected ion monitoring (SIM) method. PMID- 2767583 TI - [Relation of the activation force and deflection in various orthodontic springs (closing-loops)]. AB - For ten different forms of orthodontic springs, comprising three commercially available preformed types, the relationship between load (force) and the resulting deflection was determined experimentally. The experimental set-up consisted of a micrometric microscope containing a scale which could be calibrated and an optical bench so the springs could be fixed and activated by means of a force gauge in increments of 12.5 p up to 200 p. Ten springs of each of the ten forms were measured once. The results can be summarized as follows: The load-deflection rate of orthodontic springs depends on the modules of elasticity of the utilized alloy and the geometric configuration of the spring. For a given loop configuration the load-deflection rate is proportional to the modulus of elasticity. The more wire length used for shaping the spring elements (loops), the lower the load-deflection rate. With the exception of the Ladanyi retractor and the Bull loop all the springs examined showed a linear relationship between load and deflection. Because of the higher accuracy of force application and the relative force constancy during tooth movement, it is usually preferable to choose springs with a low load-deflection rate of about 50 p/mm. PMID- 2767585 TI - [The prognosis of autologous tooth transplants in orthodontic treatment planning]. AB - Autogenous tooth transplantation is an alternative treatment for preserving continuity of the dental arch following early loss of teeth. The prognosis of transplants determines the indication as compared with other methods of space closure. Transplanted buds of upper premolars as well as of lower third molars continue their root growth. The clinical and roentgenological analysis of 81 autogenously transplanted upper canines, following different operative procedures, indicates, that 50% of the transplants remain in situ for five years and only 25% remain in situ longer than six years. The statistical chances of survival of vitally transplanted, apicoectomied teeth are more favourable. Short term prognosis is determined by inflammatory bone and/or tooth resorption due to odontogenic infection or occlusal trauma. Long-time prognosis is determined by different forms of tooth resorption. Regular radiographic examination as reveal early odontogenic infections which can then be treated endodontically. The doubtful prognosis necessitates strict indications. PMID- 2767584 TI - [Comparative studies of fiberglass and metal brackets]. AB - The demand by patients considered for better esthetics during treatment should be seriously considered. With the introduction of fiberglass brackets one has tried to solve that problem. The purpose of this investigation was: 1. a microscopic examination of the slots of these fiberglass brackets after various periods of wearing; 2. an in vitro investigation of the adhesion of the fiberglass brackets in comparison to metal brackets; The following results were obtained: 1. There are remarkable differences in the slot dimensions between new fiberglass brackets and those which have been in the mouth for varying periods of time. 2. Ligating wires into fiberglass brackets may be difficult because of wing fractures. 3. There are significant differences regarding the adhesion of fiberglass brackets compared with metal brackets. Results of tests carried out under defined conditions (bonding, storage, time-factor) concluded that metal brackets behaved much more favourably; the adhesion of metal brackets was nearly ten times greater than that for fiberglass brackets. PMID- 2767587 TI - [The design of removable appliances for tooth movement and tooth migration]. AB - Removable/functional appliance therapy can still be further expanded and developed. Retentive elements in the anterior region increase anchorage. Thereby, active forces can be utilised without anchorage loss. Functional appliances are indicated following extraction, to maximise on tooth migration. In first molar extraction cases, treatment with activators is relatively straightforward. When considering premolar extraction cases with possible need for extraction later of the third molars as well, then one should consider extraction of the first permanent molars. With correct use of the appliance, it is possible to optimally align the second molar teeth as well as favourably influencing the soft tissue profile. PMID- 2767586 TI - [Apical root resorption during orthodontic treatment]. AB - Pre- and posttreatment radiographs of 2050 orthodontically treated patients were examined and apical root resorptions of more than 2 mm were identified. 30 patients (211 teeth) were affected. Treatment characteristics and objectives of this group (with severe apical root resorption) were compared to a treated group of 30 patients (with no resorption) to determine clinical risk factors. Extrusion, but especially jiggling and a long treatment period were found to be significantly more frequent in the group exhibiting resorption than in the control group. Pathogenesis of treatment-induced root resorption is discussed in respect to histological results. PMID- 2767588 TI - [Longitudinal study of the gingival status during transitional dentition]. AB - 253 milk teeth with inflamed gingiva were observed for 19 months (on average) around the time of exfoliation and changeover to the secondary dentition. The criteria used were the gingival index by Loe and Silness, the intravital staining of glycogen with iodine solution by Zabinska and the plaque index by Quigley and Hein. In about one third of the cases, there was residual inflammation following loss of the milk teeth in the original area. With eruption of the permanent teeth, plaque level increased as did the degree of gingival inflammation. On full eruption of the permanent dentition the values fell under their former level. PMID- 2767589 TI - [Objectivization of the methods for recording the total contact surface and the number of occlusal contacts in static occlusion]. AB - The occlusal contacts of teeth in a dentition have been analysed metrically with the aid of a new method. The outstanding advantage of this method is offered by the fact that the contacts of teeth are registered immediately in the subject and then evaluated with the aid of the teleplanimetric measuring variant. From error computation it follows that the method leads to reproducible and largely objective results. In 84 subjects with an average age of 16.9 +/- 3.7 years the total contacting area and the number of contacts in static occlusion were determined and examined with respect to specific groups. PMID- 2767590 TI - [Microbial colonization and various cleaning procedures for orthodontic appliances]. AB - The cleaning of removable appliances was analysed in three groups: 1. cleaning with tooth-brush/toothpaste, 2. self-acting cleansing agent, 3. ultrasonic treatment. In the same patient group identical plates were fitted each for one month and cleaned by the different procedures. The microbial population and the cleansing effects were analysed by scanning electron microscopy. The findings shows clearly, that the toothbrush alone is unsatisfactory for achieving effective decontamination in the hygiene-critical areas of the plates. In contrast to this cleansing tablets and ultrasonic treatment were more effective in plaque-accumulating areas. None of the cleansing procedures effected complete decontamination of the removable appliances. PMID- 2767591 TI - [Risk of HIV transmission in nursing care]. PMID- 2767592 TI - [Acute non-traumatic paralysis. Immediate admission to the clinic--rapid diagnosis is decisive]. PMID- 2767593 TI - [Genetic counseling--not a short process. Gene diagnosis and the fate of the family--cystic fibrosis as an example]. PMID- 2767594 TI - [HIV infection caused by nursing care? HIV infection in the mother of a son with AIDS]. AB - The case of a 78-year-old woman with a 2-year history of chronic persistent oral candidiasis, in whom an HIV infection (stage III, Frankfurt Classification according to Brodt, stage 6 Walter Reed Staging Classification, stage IV WHO Classification, manifest AIDS according to the new 1988 Classification) was diagnosed, is reported. The 44-year-old son (since deceased) of the patient was known to have had the acquired immune deficiency syndrome since December, 1986. Transmission of HIV from son to mother seems likely. PMID- 2767595 TI - [Long-term ECG analysis systems. Comparison of current methods]. AB - Holter monitoring is now standard practice in the internal medical departments of many hospitals, and in doctors' offices. This has led to an increase in the number of companies producing Holter monitoring equipment over the last few years. The wide range of equipment manufacturers can be divided into three categories according to the principles they use in analysing the ECG. The continuous recording system may currently considered standard state of the art in Holter monitoring, since it provides the doctor with the most detailed information about his patient. Furthermore, it is this type of system which lends itself most readily to the incorporation of new hardware and software in this rapidly advancing technological sector. PMID- 2767597 TI - [AIDS vaccines. Is optimism justified?]. PMID- 2767596 TI - [Effectiveness of etofibrate in arteriosclerosis obliterans. Pilot study in hyperlipidemic patients with arteriosclerosis obliterans]. AB - In a pilot study the therapeutic effect of 2 x 500 mg etofibrate (Lipo Merz retard) on lipids and lipoproteins, fibrinolytic activity and clinical parameters was studied for four weeks in hyperlipidemic patients suffering from arteriosclerosis obliterans (Fontaine stage II/III). The study parameters were evaluated prior to and after the four weeks of treatment. Administration of etofibrate resulted in a significant decrease in serum cholesterol and triglyceride levels, the decrease in LDL-/HDL-cholesterol-ratio due mainly to an elevation of the HDL-cholesterol fraction, an increase in plasma fibrinolytic activity, an increased peripheral blood flow in the ischemic leg, and an increase in the pain-free walking distance. Thus, etofibrate applied twice daily might be recommended for the treatment of hyperlipidemic patients with signs of arteriosclerosis obliterans, Fontaine stage II/III. PMID- 2767598 TI - [HIV infection and driving ability]. PMID- 2767599 TI - [Dietary change aids in hyperuricemia. Kidney damage--denial of alcohol- allopurinol]. PMID- 2767600 TI - [AIDS in the drug scene. Less needle sharing]. PMID- 2767601 TI - [Therapeutic possibilities with moor components]. PMID- 2767602 TI - [Limb and joint pain in Lyme disease. An important differential neurologic diagnosis]. AB - On the basis of 4 cases, attention is drawn to the problem of early detection of Lyme disease. The occurrence of joint pain with fluctuating spread and unresponsive to the usual antiinflammatory therapy should prompt the physician to consider lyme disease, which can be confirmed or excluded only by lumbar puncture. The CSF shows a cell count of between 300/3 and 2,000/3 cells (90% lymphocytes) and usually moderately elevated protein. A demonstration of elevated antibody titers confirms the diagnosis. The condition can be cured with antibiotics (penicillins or cephalosporins) and also cerebral nerve involvement (usual the facial nerve) with or without impairment of taste also clears up completely. PMID- 2767603 TI - [HIV spread is dependent on cultural factors]. PMID- 2767604 TI - Pharmacological modulation of neurogenic inflammation. AB - A neurogenic inflammation was induced by electrical stimulation of the exposed saphenous or sciatic nerve of male rats. The increase in paw weight of the stimulated leg was used as parameter for degree of inflammation. The content of substance P decreased significantly in the skin supplied by the antidromic stimulated nerves. Substances were tested whose effectivity in neurogenic inflammation is as yet unknown. Inhibition of the angiotensin converting enzyme by the inhibitor captopril did not yield an indirect reference for a causative role of substance P in neurogenic inflammation. The activity of catecholamines refers to the possible importance of blood vessel and/or cyclic nucleotide level alteration in this special type of inflammation. PMID- 2767605 TI - Effects of cicletanine on histamine-induced contractions of isolated rabbit mesenteric arteries. AB - The antagonism by cicletanine of contractile responses to histamine has been examined in vitro on ring preparations of rabbit mesenteric arteries. Cicletanine (10(-8)-10(-6) M) caused a parallel rightward shift of histamine concentration response curve, with a pA2 value of 7.48 (slope = 0.89 +/- 0.19, not significantly different from unity). Histamine-induced contractions were nifedipine-sensitive and associated with cicletanine-sensitive increased 45Ca uptake. Endothelium removal resulted in enhanced contractile responses to histamine, but did not significantly modify cicletanine-induced antagonism: KB (dissociation constant) values for cicletanine antagonism in the presence or absence of endothelium were: 3.7 (+/- 0.1) X 10(-8) M and 3.6 (+/- 0.3) X 10(-8) M, respectively. Cicletanine (greater than 10(-4) M) also significantly attenuated 10 mM caffeine-induced contractions in rings exposed to Ca-free 100 mM K+ depolarizing medium. The results suggest that cicletanine-induced antagonisms of histamine H1 receptor-mediated contractions of rabbit mesenteric arteries is associated with interference with calcium entry as well as at high concentrations, release from intracellular stores. PMID- 2767606 TI - Comparative in vivo and in vitro study of the cardiac effects of midalcipran and imipramine. AB - Midalcipran is a new antidepressant drug inhibiting both noradrenaline and serotonin uptake without any postsynaptic and anticholinergic activities. Its cardiac effects were compared with those of imipramine, a tricyclic antidepressant drug. In anaesthetised guinea-pigs intravenous perfusion of imipramine and midalcipran (1 ml/min from a solution at 0.66 mg/ml) brought about ventricular arrhythmias, respectively at 16.5 and 26.4 mg/kg and cardiac arrest at 58 and 97 mg/kg. The safety index (ratio of i.v. lethal dose and ED50 evaluated by the yohimbine test) is 22 times wider for midalcipran than imipramine. In in vitro studies on guinea-pig ventricular myocardium, imipramine exerted a greater class 1 antiarrhythmic effect than midalcipran. The reduction of Vmax was significant at 3 X 10(-6) M for imipramine and 1 X 10(-5) M for midalcipran in normal (4 mM K+) and hyperpolarizing (2.7 mM K+) conditions. At the concentration of 1 X 10(-5) M midalcipran significantly lengthened, whereas imipramine non significantly shortened the action potential durations (APD50, APD90). The results provide confirmation of a lesser depression in sodium conductance with midalcipran as compared to imipramine. Therefore it is proposed that less adverse cardiac effects may be observed at therapeutic doses. PMID- 2767607 TI - Blood distribution of tenoxicam in humans: a particular HSA drug interaction. AB - Blood binding of tenoxicam was studied in vitro by equilibrium dialysis. Isolated human plasma proteins and blood cells were checked, and the distribution of the bound form was then calculated. The results showed that tenoxicam is mainly bound to HSA and that binding percentages are not different when measured in plasma (98.4%) and in an HSA solution at physiological concentration (704 microM, 98.15%). In these conditions, within the range of 1-150 microM, the tenoxicam binding percentage remained constant, evidence of a nonsaturable process. When a lower HSA concentration (10 microM) was used, the binding parameters of the tenoxicam interaction were calculated by using the same equilibrium dialysis data, by 3 methods of analysis- a stoichiometric method and site-oriented methods, fixing or not the number of HSA binding sites (n) as integer values. The best fit was observed with the first method, suggesting that two main interactions occurred. The site-oriented method gave lesser fits, the better being observed when n was not fixed. Its value, 1.77, suggest the possibility of two binding sites, one of them not preformed. The effects of known markers of site I, warfarin and apazone, of site II, diazepam and ibuprofen and of palmitic acid showed that tenoxicam is bound simultaneously to both sites I and II. The binding capacity of site I for tenoxicam is enhanced by diazepam: as this compound alone is bound to site II, this result suggests that the two HSA binding sites are not independent. PMID- 2767608 TI - Effects of isoproterenol and propranolol on pharmacologically induced depression of intraventricular conduction. AB - The cardiac adrenergic system is known to have practically no influence on conduction velocity in the ventricles under normal conditions. The effects of isoproterenol and propranolol were investigated on depression of intraventricular conduction induced by a class IC antiarrhythmic drug, cibenzoline, in anaesthetized, closed-chest dogs. In addition to electrocardiogram for measurement of QRS duration in sinus rhythm, conduction time was measured in the ventricular contractile tissue between an electrode advanced to the apex and a pacing electrode near the base, at 400- and 200-ms pacing periods. Effective refractory period (ERP) was measured concurrently according to the extrastimulus method. After intraventricular conduction had been slowed down by cibenzoline IV administered (loading dose of 3 mg/kg plus infusion of 0.2 mg/kg/min over 15 min), isoproterenol was infused or propranolol injected by the intravenous route also (0.5 mn/micrograms/kg/min over 5 min and 0.4 mg/kg, respectively). When conduction time has been raised by 75/150% (depending on the pacing rate), isoproterenol appears to attenuate and propranolol to aggravate substantially the impairment of conduction, whereas the reduction undergone by ERP does not differ from usual. Thus, reentrant arrhythmias might be prevented by isoproterenol and triggered by propranolol. Intraventricular conduction, when depressed, therefore, is sensitive to adrenergic drugs, probably because of the enhanced influence of polarization of the fibres in the presence of a sodium conductance impairment. PMID- 2767609 TI - Plasma catecholamines and adrenoceptors after chronic sinoaortic denervation in dogs. AB - Chronic sinoaortic denervation (SAD) performed by section of both carotid and aortic nerves induced a significant and sustained increase in blood pressure and heart rate in conscious dogs; under our experimental conditions, the values of systolic blood pressure and heart rate were never lower than 190 mmHg and 120 beats/min, respectively. The present long-term study (8 mo) investigated the time course of plasma catecholamine levels and circulating blood cell adrenoceptor (leukocyte beta 2 and platelet alpha 2) number. Catecholamine plasma levels were highly correlated with the variations of leukocyte beta adrenoceptors (measured by [125I]cyanopindolol binding and characterized as a beta 2 receptor in dogs). These two parameters followed a biphasic pattern after SAD: during the first 2 mo, significant increases in noradrenaline and adrenaline levels were associated with a decrease in leukocyte beta 2 adrenoceptor number; from the 4th month, they slowly returned to normal values, although blood pressure remained elevated. By contrast, platelet alpha 2 adrenoceptor number (measured by [3H]yohimbine binding) did not follow this pattern since it remained lower than before SAD during the whole experiment. Finally, the development (but not the maintenance) of SAD-induced hypertension is associated with an increase in sympathetic tone. Only leukocyte beta 2 (and not platelet alpha 2) adrenoceptors are directly regulated by the endogenous levels of catecholamines. PMID- 2767610 TI - [Recent advances in rhinomanometry]. PMID- 2767611 TI - [Vertical infections]. PMID- 2767612 TI - [Viral oncogenesis of brain tumors]. PMID- 2767613 TI - [Anti-tachycardiac effect of a direct-acting vasodilator, budralazine]. AB - The present study was undertaken to elucidate the anti-tachycardiac effect of a direct-acting vasodilator, budralazine, using an electrophysiological technique. Normotensive male Wistar rats were used. Rats were anesthetized intraperitoneally with urethane and alpha-chloralose. After immobilization with gallamine triethiodide, respiration was maintained through a tracheal cannula connected rodent respirator. Intravenous administration of budralazine (0.5, 1.0 and 5.0 mg/kg) produced a dose-dependent reduction of mean arterial pressure. At doses of 0.5 and 1.0 mg/kg, budralazine induced bradycardia accompanied with a decrease in cardiac sympathetic nerve activity. Plasma norepinephrine concentration was reduced by budralazine (0.5 mg/kg). Preganglionic adrenal sympathetic nerve activity was also reduced by budralazine (1.0 mg/kg). A 0.5 mg/kg of budralazine neither influenced carotid sinus nerve activity nor augmented aortic depressor nerve activity. On the contrary, at dose of 5.0 mg/kg, budralazine produced a tachycardia accompanied with increases in both cardiac sympathetic nerve activity. In addition, plasma epinephrine concentration was also increased at a dose of 5.0 mg/kg. The aortic depressor nerve activity was decreased by budralazine (5.0 mg/kg) significantly. When equi-hypotensive doses of budralazine and clonidine were compared, the renal sympathoinhibitory potency of budralazine was less than that of clonidine. These findings suggest that the central sympathoinhibitory action of budralazine may be responsible for the anti tachycardiac effect of budralazine. PMID- 2767614 TI - [Studies on development of radioimmunoassay for diazepam and it's medicolegal application]. AB - A sensitive radioimmunoassay was developed for the determination of diazepam. Detection of diazepam in tissues of rats and in blood from unnatural death victims and traffic accident victims was examined by this procedure. Antisera capable of binding [3H] diazepam were obtained by repeated immunization of rabbits with temazepam (oxydiazepam)-3-hemisuccinate conjugated to bovine serum albumin. The antibody of a 1: 10000 dilution could bind approximately 50% of the added radioactivity. The level at least as low as 1 pg of diazepam could be detected by this procedure. This antibody strictly recognized the existence of the methyl group at the position-1 and of the keto group at the position-2 of the benzodiazepine ring, and was highly specific for temazepam and diazepam among benzodiazepine derivatives. But other benzodiazepine derivatives had no cross reactivity with this antibody. The distribution of diazepam in biological fluids and tissues of rats 1, 2, 4 and 8 hr after intraperitoneal injection was examined. The level of diazepam in serum, saliva, brain and bone marrow declined within 2 hr, while the level in liver and kidney was maximum 2 hr after administration. The concentration of diazepam in each tissue leveled off 4 hr after administration. Among these results the remarkable finding was that the concentration in the bone marrow is much higher than that in serum, saliva and brain, appearing to be due to a high accumulation of diazepam in this tissue. This result indicates that the bone marrow is a very useful material for the detection of diazepam in skeletonized remains. There ware good correlations (gamma = 0.8595-0.9973) in the concentrations of diazepam between serum, saliva and brain, and bone marrow. Detection of diazepam in blood from unnatural death victims and traffic accident victims were examined. Diazepam was identified in 3 cases of 50 unnatural death victims and in 4 cases of 48 traffic accident victims. PMID- 2767615 TI - [Experimental studies of original valved conduit using glutaraldehyde-preserved equine pericardium (Xenomedica)]. AB - Extracardiac conduits, such as Dacron or homo-graft, have been utilized for the operative management of many patients with congenital right ventricular outflow obstruction. However, they have been recognized to become obstructed or calcified with time. As a new material for extracardiac conduit, an original valved conduit using glutaraldehyde-preserved equine pericardium (Xenomedica) was investigated. Various types of valved conduit were evaluated for the hydrodynamics by a circulation system. A flow-pressure gradient Lissajous was used for the evaluation. The conduit of 10 mm in diameter had a high resistance to flow. The monocusp-valved conduit had a diastolic regurgitation (DR) at any given pressures and heart rates. The bicusp-valved conduit had a DR at higher heart rates (greater than 153/min). In this experiment, the tricusp-valved conduit with a valvular vertical versus horizontal length ratio of 2:3 had utmost favorable results under any given conditions. The valved conduits were also evaluated using sixteen mongrel dogs in which the conduit were used for the reconstruction of continuity between right ventricle and pulmonary artery. Five dogs died of bacterial infection or thrombotic obstruction. Following hemodynamic studies, which were performed in eleven dogs 1, 6, and 12 months after the operation, the dogs were sacrificed to evaluate the histological changes in the conduits. The valvular function had been satisfactory until one month, however, it was lost in 6 months because the valvular leaflets were covered with neointimae grown over them. Thin neointimae were observed both at the sites of anastomosis and at the base of the valves in dogs sacrificed at one month. They spread from the proximal anastomotic site to distal one. They were organized and it was hard to remove them manually. Thrombi were found in six dogs at the proximal anastomotic site with intimal hyperplasia. There was no calcification in Xenomedica and its degenerative change was minimal. In conclusion, the equine pericardium valved conduit is thought to be an useful material for the reconstruction of right ventricular outflow obstruction to improve early hemodynamic changes after operation. PMID- 2767616 TI - [Studies on reperfusion injury of rat hindlimb]. AB - Using the isolated perfused rat hindlimb, we have examined the effect of superoxide dismutase (SOD) for protection against reperfusion injury. In vivo experiments, after the isolation of the rats hindlimb, we clamped their aorta and vena cava, and divided the rats into two groups. After occluding the aorta and vena cava of each rat for two hours, one group was administered physiological saline 0.4 ml/100 g, and the other SOD of 15,000 U/100 g. Their blood was sampled 5 and 30 minutes after the clamps were released. In the presence of SOD, the release of the creatine phosphokinase (CPK) was suppressed, but this was not significant. In vitro experiments, on the other hand, the isolated perfused rat hindlimb was prepared with Krebs-Henseleit bicarbonate buffer as a perfusate. Similar experiments in vivo were performed; one group was the control, the other was administered SOD 30,000 U/L in the perfusate. The peak of LACTATE and CPK in the effluent was clearly dissociated for 30 min after reperfusion of oxygen. This result showed that our experimental model was suited to the study of ischemia reperfusion injury, as differentiated from simple anoxia. The CPK release into the effluent was successfully suppressed when SOD was present (p less than 0.05). Using a spin trapping ESR technique, we detected DMPO-carbon centered adduct in the effluent. The adduct of the radical had 6 lines and was assigned as the lipid radical. In summary, this model is very useful to study metabolism of skeletal muscle. And we are convinced of that lipid peroxidation is involved in reperfusion-induced cell damage, and then SOD is effective to the protection against reperfusion injury. PMID- 2767617 TI - [Significance of multiple analysis of platelet Ca2+ mobilization by using some available methods measuring cytosolic Ca2+ concentration, membrane-bound Ca2+ and Ca2+ flux across the plasma membrane]. AB - Intracellular Ca2+ mobilization in the resting platelets undergoing Ca2+ influx and in the activated platelets stimulated by thrombin and phorbol ester (TPA) was investigated by measuring cytosolic Ca2+ concentration: [Ca2+]cyt (fura-2, aequorin), membrane-bound Ca2+ (chlortetracycline) and Ca2+ flux across the plasma membrane (45Ca2+ tracer). Some modified methods employed in this study concerning 45Ca2+ flux measurement and aequorin loading into platelets were very useful to elucidate the details of platelet Ca2+ mobilization in the combination with other Ca2+ assay methods. These combined and integrated assays on platelet Ca2+ showed some new interesting findings as follows; (1) The difference of the obtained values of [Ca2+]cyt and of the reaction pattern between fura-2 and aequorin method was responsible to the difference of the distribution of probe molecules in platelet. This was confirmed by the higher sensitivity of aequorin molecules to [Ca2+]cyt elevation induced by Ca2+ influx than by that of fura-2 molecules in thrombin- and TPA-activated platelets. (2) The membrane-bound Ca2+ release in activated platelets was found to be another intracellular Ca2+ movement distinct from organelle Ca2+ release and CTC molecules not to bind to the organelle membranes. (3) The plasma membrane Ca2+ pump was found to exist in both unstimulated platelets and stimulated platelets suggested by its specific time course of 45Ca2+ binding and [Ca2+]cyt increase in platelets. (4) There existed biphasic increase of [Ca2+]cyt in thrombin-stimulated platelets consisted of biphasic Ca2+ influx and biphasic intracellular Ca2+ release with alternating point at 10 seconds after activation. The initial changes seemed to be correlated with receptor operated Ca2+ channel and receptor-linked phospholipase C activation respectively, while both second phase increase seemed to be correlated with the plasma membrane phospholipid metabolisms evoked by phospholipase A2 activation. PMID- 2767618 TI - [Clinico-pathological studies of cytochrome P-450 on human hepatic disorders]. AB - Immunohistochemical examinations were carried out for the study of cytochrome P 450 implication in the human hepatic disorders. An isozyme of human hepatic P-450 (P-450-HM1) with the m.w. of 51,000 was purified from human autopsied liver. Antibody against P-450-HM1 was prepared in rabbits, of which specificity was confirmed by Western blot. Eighty-three livers (27 autopsies and 56 biopsies, M:F = 63:20), which were either normal or of various hepatic disorders such as acute or chronic hepatitis, cirrhosis and hepatocellular carcinomas, were examined by the method of avidin-biotin-complex technique. It was revealed that immunoreactive hepatocytes were diffused throughout the lobule of the fetal liver. In the normal livers as well as those of acute and chronic hepatitis, positive hepatocytes were found in the centrilobular zone. Three of the 4 cases treated with beta-interferon showed faint staining; and the presence of positive individual hepatocytes was considered to be induced by steroid therapy. In the livers with chronic hepatitis and cirrhosis, hepatocytes near the perifibrous region and those trapped in the portal triad by thin fibrous connective tissue, as well as in the regenerating nodules, were strongly stained, which indicate that P-450-HM1 is expressed in the regenerating hepatocytes. Hepatocellular carcinomas, however, were devoid of immunohistochemistry. From these results, the antibody might be a useful tool for differentiating regenerating nodule from hepatocellular carcinoma. PMID- 2767619 TI - Agnogenic myeloid metaplasia (AMM)--correlation of bone marrow lesions with laboratory data: a longitudinal clinicopathological study on 114 patients. AB - A clinicopathological study was performed on 114 patients (46 male/68 female, median age 67 years) with the diagnosis of agnogenic myeloid metaplasia (AMM) respectively primary osteo-myelofibrosis which was not preceded by any other or allied subtype of chronic myeloproliferative disorders. On admission patients revealed a striking variability of laboratory data as well as different histopathological features of initial bone marrow biopsies. For this reason discrimination was done into two groups based on bone marrow findings: group I patients (n = 46, 19 male/27 female) showed a hypercellular marrow without or only borderline (n = 24) to slight (n = 22) reticulin fibrosis and group II cases (n = 68, 27 male/41 female) displayed coarse bundles of collagen fibres (n = 18) frequently accompanied by osteosclerosis (n = 50). Statistical analysis of the corresponding initial hematological findings resulted in significant differences. These differences concerned also the complications occurring during the lengthy course of disease, which included a higher incidence of pancytopenia and severe marrow failure with hemorrhage and blast crisis in group II patients. However, overall survival time was not different in both groups. This may be related to the similarity of age distribution (64 resp. 65 years) and its significant association with arteriosclerotic vascular lesions. Consequently acute myocardial infarction and congestive heart failure were frequent causes of death in addition to infections due to marrow failure and blast crisis. Repeated bone marrow biopsies in 24 patients revealed an insidious transition from hypercellular lesions (group I) into advanced fibro-osteosclerotic changes (group II) concurring with laboratory data. Therefore our discrimination into two groups of patients represents variable stages or static histological and corresponding hematologic features in the evolution of a dynamic disease process in AMM. PMID- 2767621 TI - Cloacogenic polyps--clinical and pathological features. PMID- 2767620 TI - A risk factor for relapse in Hodgkin's disease: female gender? AB - A retrospective study of 163 patients with Hodgkin's disease treated between 1969 and 1987 was performed to identify adverse prognostic factors. One hundred and thirty-five patients (83 per cent) attained a complete remission and 42 (31 per cent) of these have relapsed (median follow-up--43 months). Using multivariate analysis, no independent factors predicted for the event of relapse. However, analysis of disease-free survival revealed that females fared significantly worse than males (p less than 0.05) and this was independent of other prognostic variables. Female sex has not been recognized as an independent prognostic factor predictive of inferior survival and inferior disease-free survival. PMID- 2767622 TI - Dysplastic naevi. PMID- 2767623 TI - Diffuse axonal injury in head injury: definition, diagnosis and grading. AB - Diffuse axonal injury is one of the most important types of brain damage that can occur as a result of non-missile head injury, and it may be very difficult to diagnose post mortem unless the pathologist knows precisely what he is looking for. Increasing experience with fatal non-missile head injury in man has allowed the identification of three grades of diffuse axonal injury. In grade 1 there is histological evidence of axonal injury in the white matter of the cerebral hemispheres, the corpus callosum, the brain stem and, less commonly, the cerebellum; in grade 2 there is also a focal lesion in the corpus callosum; and in grade 3 there is in addition a focal lesion in the dorsolateral quadrant or quadrants of the rostral brain stem. The focal lesions can often only be identified microscopically. Diffuse axonal injury was identified in 122 of a series of 434 fatal non-missile head injuries--10 grade 1, 29 grade 2 and 83 grade 3. In 24 of these cases the diagnosis could not have been made without microscopical examination, while in a further 31 microscopical examination was required to establish its severity. PMID- 2767624 TI - DNA flow cytometry of thymomas. AB - Forty-seven thymomas have been examined by DNA flow cytometry and results correlated with histology, stage, associated clinical features and survival. Twenty-five cases were DNA diploid, 14 were aneuploid and no results could be obtained for eight cases. The presence of aneuploidy correlated with more advanced (stage II and III) disease and the presence of myasthenia gravis and was more frequent in epithelial predominant thymomas. Tumour recurrence was more frequent in DNA aneuploid tumours, stage II/III disease and epithelial predominant neoplasms. Multifactorial analysis showed that DNA aneuploidy was predictive of tumour recurrence independent of the effects of stage and histology. PMID- 2767625 TI - Minute carcinoid arising in gastric tubular adenoma. AB - We report a minute carcinoid tumour forming multiple, endocrine nodules or glandular structures and located within a gastric tubular adenoma. The tumour cells were positive for the argyrophilic reaction and a few revealed serotonin immunoreactivity. This case may represent the third histogenetic type of gastric carcinoid tumour. PMID- 2767626 TI - Bereavement services: practice and problems. AB - Hospice bereavement services vary widely and are often loosely defined. This paper describes the results of a survey on the form and function of hospice bereavement services completed by NHO Provider Member hospices. It explores issues related to staffing, training, size, services provided, and service priorities. Additionally, data collection and research, referrals, funding, risk assessment, obstacles programs face and the limitations that are inherent in hospice structures are examined. These important elements are presented along with a discussion of critical issues and recommendations for future research and study. PMID- 2767627 TI - Bereavement groups in the hospice program. AB - This article reviews the nature of the therapeutic activity in bereavement groups -the rationale behind offering them in a hospice program for the general public- and then looks specifically at bereavement programs offered at Hospice House in Portland, Oregon. It covers eligibility, attendance, issues, methods used to consolidate the groups, blending of new members, and specifies the types of groups involved. Further, it explores the formation of a city-wide bereavement network, formed to provide mutual support for facilitators and counselors to exchange ideas, shape continuing education, encourage cross-referral and avoid duplication. PMID- 2767628 TI - Assessing grief among the bereaved elderly: a review of existing measures. AB - The assessment of grief in the elderly, bereaved population has received much attention in the research and clinical literature. Existing instruments vary widely in their complexity, the extent of their theoretical base and in the evidence of their reliability and validity for their intended uses. In this article, the authors describe important principles for the assessment of grief, and present a rating instrument for use in comparing potential measures for this assessment. Nine of the most widely cited measures are reviewed using this process. Their variations along critical dimensions of assessment quality are clearly demonstrated. The general status of available measures, and recommendations for using this rating process in specific clinical settings are discussed. PMID- 2767629 TI - Analysis of Bugen's model of grief. PMID- 2767630 TI - Grieving as a hero's journey. AB - The psychodynamics of transformation through grief and loss can be explained through a model of personal growth which encompasses both the individuation process of Jungian psychology and the hero's journey which Joseph Campbell explored through mythology. The model may provide a tool for hospice caregivers to use in assessing both their own responses to death and dying and their grieving patients'/families' needs for assistance. PMID- 2767631 TI - Market power key to upgraded hospitals' success. PMID- 2767632 TI - Vermont: small state tackles big quality challenge. PMID- 2767633 TI - New Canadian priority: cohesive tech assessment. PMID- 2767634 TI - Merit increases to average 5.1% in 1989. PMID- 2767635 TI - Well-informed employees are a valuable resource. PMID- 2767636 TI - The hospital cafeteria that employees built. PMID- 2767637 TI - AIDS precautions: compliance difficult to enforce. PMID- 2767638 TI - Do the right thing for the community. Interview by Howard Larkin. AB - When the area surrounding Greater Southeast Community Hospital, Washington, DC, changed from a middle-class commuter neighborhood to one populated mainly by the poor and elderly in the early 1970s, hospital officials decided to stay and serve where they were needed most. The 450-bed hospital now sponsors a wide variety of health and community development programs. In recognition of its commitment to community service, Greater Southeast Community Hospital was awarded this year's Foster G. McGaw Prize by the American Hospital Association, Chicago, and the Baxter Foundation, Deerfield, IL. Thomas Chapman, president of Greater Southeast Community Hospital, recently talked about the importance of community service with Hospitals finance coordinator Howard Larkin. PMID- 2767639 TI - Physician management key to making DRGs pay. PMID- 2767640 TI - Canadian hospitals to buy supplies via U.S. group. PMID- 2767641 TI - Geriatric care should address rehabilitation needs. PMID- 2767642 TI - Urgent care/primary care concept proves profitable. PMID- 2767644 TI - Health care CEOs want to be paid what they're worth. PMID- 2767643 TI - Wise CEOs know when to sell their computers. PMID- 2767645 TI - Personal computer use in hospitals soars: survey. PMID- 2767646 TI - Temporary CEOs take up the slack in hospitals. PMID- 2767647 TI - Women's health programs: a loss or a real leader? PMID- 2767648 TI - Panel allots only $20 million for outcomes research. PMID- 2767649 TI - Managed care plans don't shift risk to providers. PMID- 2767650 TI - Demo project could mean more data, less money. PMID- 2767652 TI - CAP (College of American Pathologists) program probes quality of lab performance. PMID- 2767651 TI - Hospital defaults haven't hurt bond market--yet. PMID- 2767653 TI - Scar wars: closing in on wounds that won't heal. PMID- 2767654 TI - Supreme Court to hear abortion, right-to-die cases. PMID- 2767655 TI - More than 98% of health care CEOs feel stressed. PMID- 2767656 TI - Radiology. Imaging shifts. PMID- 2767657 TI - Laboratories. Lab analysis. PMID- 2767658 TI - Critical care. Critical cost. PMID- 2767659 TI - Stress is nothing new to MDs who are CEOs. PMID- 2767660 TI - Surgeons lead specialties in practice size. PMID- 2767661 TI - Education centers are subtle marketing tools. PMID- 2767662 TI - Cut excess capacity, improve efficiency. Interview by Jeff Finn. PMID- 2767663 TI - Open-ended HMOs carry additional provider risk. PMID- 2767664 TI - Hiring standards: high quality still top priority. PMID- 2767665 TI - Hospitals examine automated operator systems. PMID- 2767666 TI - Supplier survives 140 years of change. PMID- 2767667 TI - Clan-structured migration and phenotypic differentiation in the Jirels of Nepal. AB - This paper examines the impact of clan-structured migration on the between village differentiation of the Jirels, a tribal population of eastern Nepal. The Jirel population is geographically restricted to nine villages, all of which were sampled to some extent for this study. Data on five head measurements, stature, and digital ridge counts are utilized to illustrate the patterns of phenotypic variation. Multivariate statistical techniques are used to assess the extent to which clan membership and associated patterns of marital exchange influence the population structure of the Jirels. The phenotypic characteristics of randomly generated migrant sets are compared to those of the observed clan-structured sets, demonstrating the clan-related phenotypic nonrandomness of migrants. The results indicate that clan-structured migration may significantly influence the amount of between-village variation. Clan structure may be a significant factor in determining patterns of variation and should not be ignored in studies of microdifferentiation in tribal populations. PMID- 2767668 TI - Ethnicity determination by names among the Aymara of Chile and Bolivia. AB - The importance of surnames in genetic studies has been recognized for a century or so. While the ethnic affiliations of individuals are ordinarily established in genetic studies by admixture analysis based on gene frequencies, often there are implicit assumptions in these attempts that are difficult to validate in the absence of detailed ethnohistories. In northern Chile and western Bolivia, where genetic admixture has been known to occur among the Aymara Indians and Spanish Caucasoids, the naming pattern (parental patriand matrinyms) allowed us to classify individuals on the basis of the frequency of Aymara names into 9 'ethnic' groups. From a sample of 2525 individuals it is shown that admixture occurred in lineages nonrandomly, implying assortative mating of surnames. Admixture and genetic distance analysis on the basis of 31 genetic markers on approximately 1700 of these individuals reveals that there is a reasonable agreement of ethnic classification of individuals by name and phenotype data on genetic markers. The Aymara-named groups are shown to be predominantly Amerindian (89%) in their genetic profiles. Individuals whose current naming pattern is basically Spanish also exhibit a substantial fraction of genes of Amerindian origin (67%). Presence of some rare alleles not found in Amerindian or Spanish Caucasoids in the admixed groups suggest infiltration of Negroid genes in the past. PMID- 2767669 TI - Evidence of genetic influence on central body fat in middle-aged twins. AB - The heritability of centrally and peripherally deposited subcutaneous body fat, as measured by thickness of subscapular and triceps skinfolds respectively, was examined in 173 monozygotic and 178 dizygotic pairs of white male twins, ages 54 to 65 years, who participated in the second examination of the National Heart, Lung, and Blood Institute's Twin Study. The heritability of two indices of body fat distribution (subscapular/triceps ratio and subscapular-triceps difference) and two indices of overall obesity (body mass index and sum of skinfolds) were also assessed. Evidence for a genetic influence on central deposition of body fat was suggested in that the classical estimate of heritability for subscapular skinfold thickness was 0.77 (p less than 0.0001). After adjusting subscapular skinfold for the overall level of obesity, heritability was reduced but remained highly significant (0.40, p = 0.003). Heritability estimates for triceps skinfold thickness and for the two fat distribution indices were substantially lower and were not statistically significant after adjustment for overall obesity. High classical estimates of heritability were also observed for both measures of overall obesity: 0.70 for BMI and 0.73 for sum of skinfolds. However, these two estimates were biased upward because of lower total variances among monozygotic compared to dizygotic twins in this sample. The more conservative and unbiased among-component estimates also suggested substantial heritability for each measure (0.35, p = 0.08 and 0.53, p = 0.01, respectively). The heritability of overall obesity emphasizes the importance of adjusting measures of fat distribution for overall obesity before assessing its heritability. PMID- 2767670 TI - Surnames and cancer genes. AB - The surname analysis of over 40,000 Wisconsin cancer mortalities for the period 1979 through 1985 partially reveals the relative genetic component of various major cancers. The surname frequencies and frequency distributions indicate that both tumor-promoting and tumor-suppressing genes may be involved. A number of cancers exhibit some probable genetic component, but genetic involvement seems marked in male and female leukemia and male lung cancer. Evidence is found for autosomal and sex-linked, dominant and recessive patterns. Most surprising is the strong evidence for tumor-suppressing genes for most cancers. Clustering of surnames across cancers evinces a number of Wisconsin surnames that may be involved in a cancer family syndrome. PMID- 2767671 TI - Height, weight, and blood pressures in ten-year-old children. AB - Multiple regression techniques were used to determine the most efficient combination of height, weight and body mass index in the prediction of systolic and diastolic blood pressures for a national sample of 13,723 10-year-old children. In every analysis an adjustment was made for the depth of sphygomomanometer cuff used when taking the blood pressure. The variables which together best predicted the systolic blood pressures in boys were weight, height and (height)2, and in girls weight/(height)2 and height. Diastolic blood pressures were predicted best by weight only for boys and by weight/(height)2 and height for girls. Once these factors had been taken into account there was no difference in blood pressures in those children for whom there were signs of puberty. PMID- 2767672 TI - Somatotypes of premenarcheal athletes and non-athletes. AB - One-hundred thirty-four premenarcheal girls between the ages of 7 and 15 years were somatotyped according to the Health-Carter technique. Sexual maturation was determined by self-assessed Tanner stages. Statistical analysis was completed on 50 athletes (representing seven sports) and 29 non-athletes over the age of 10 years. The mean somatotype for the athletes was calculated to be 2.4-3.6-3.9 and for the non-athletes 3.7-3.7-3.6. Single component ANOVA's revealed that the athletes were significantly less endomorphic (p less than 0.01) than the non athletes. The overall somatotype ratings and the equality of dispersion about the means were significantly different between the athletes and non-athletes. The single highest category for the athletes was mesomorph-ectomorph and for the non athletes, mesomorphic-endomorph. Significant negative correlations were obtained between mesomorphy and breast development (-0.33, p less than 0.05) and mesomorphy and pubic hair development (-0.44, p less than 0.01) for the athletes. Significant positive correlations were obtained between endomorphy and breast development (0.55, p less than 0.01) and endomorphy and pubic hair development (0.45, p less than 0.05) for the non-athletes. The mean somatotype for the gymnasts was 2.1-3.9-3.6 and for the swimmers 2.5-3.4-4.1. These two groups were significantly different from each other on each separate component and overall somatotype, but not in equality of dispersion. The results support the conclusion that premenarcheal athletes are morphologically different from non-athletes despite their youth and from each other based on sport specificity. PMID- 2767673 TI - Variation in the gene frequencies of three generations of humans from Monterrey, Nuevo Leon, Mexico. AB - Allele frequencies for the ABO, Rh, MNSs, Duffy, Kidd, Lutheran, P and Lewis blood group systems in 207 persons whose 4 grandparents were born in the Monterrey Metropolitan area (MMA), grouped into 3 generations, were ascertained along with other related population from the MMA, Mestizos from Saltillo, Coahuila and Tlaxcala, and from the populations thought to have contributed to their genetic constitution (native Mexican Indians and Spanish). Genetic admixture and distance estimates were calculated. Gene frequencies of the three generations from MMA are intermediate to those of the ancestral populations, indicating that they are Mestizo but with a genetic structure different from Mestizos of Saltillo and Tlaxcala. Both genetic admixture and distance estimates indicate that the oldest generation exhibits the greatest Spanish influence which decreases in the youngest generation and in the other MMA populations as a result of the immigration from the central states of Mexico. PMID- 2767674 TI - The effect of leg position on knemometric measurements of lower leg length. AB - Using the Valk knemometer, lower leg length (LLL) was assessed relative to changes in the positioning of the upper leg. Lowering the chair height of the knemometer resulted in a more acute angle between the upper and lower leg and a decrease in LLL. This decrease in measurement was attributed to changes in the anatomical surface of the knee underlying the measuring platform as a result of increasing the acuity of the leg angle. Based on four different leg positions, the average change in LLL per centimeter change in chair height was 0.607 mm in a child sample of 50, and 0.655 mm in an adult sample of 20. The difference in chair height with the leg angle at 90 degrees and the lowest chair height possible, ranged from 12.3 to 30.3 mm, relative to lower leg length. This meant the longest leg in the study had a LLL measurement differing by 19.8 mm between these two positions. Due to the effect of leg position, we advised the use of a standard method of measuring LLL with respect to leg angle. Given the difficulties in accurately measuring leg angle with current available tools, we advise the most acute angle. PMID- 2767675 TI - Trends in sibling correlations for height and weight: the effect of age changes (0-24 months) and spacing between siblings (0-10 years). AB - Familial correlations were studied in a sample of 618 sibships from a western neighborhood of Jerusalem, whose height (H) and weight (W) were measured longitudinally at the same age, from birth to 3 years of age. Covariate adjustments were applied to correct for change in mean of H and W with the sex of child and age of mother and for the effect of origin, education, and socioeconomic status of the mother, parity, and calendar year at birth. The highest sibling correlations were observed at birth or 1 month later (r = 0.45 0.46). Pooled sibling correlations were lower 6 months later (r = 0.33; r = 0.26 for H and W, respectively) and tended to increase again 12-18 months after birth. A clear trend of decline in sib-sib correlation for H and W measured 3 and 12 months after birth with increased spacing between siblings was observed. Our data provide evidence for transient environmental factors as possible sources of the observed temporal variation in sibling correlation for height and weight. PMID- 2767676 TI - Natural selection is not related to reduced body size in a rural subsistence agricultural community in southern Mexico. AB - Adult Zapotecs are among the shortest Indians in Mexico. This study investigated whether reduced body size was an effect of genetic selection or a developmental effect of very poor nutrition and health. Fertility, offspring survival, and offspring prereproductive mortality were regressed on stature and weight of 205 multiparous adults (ages 20 to 72). The statistical analyses suggest that the exceptionally short stature of Zapotec Indians in this community is due to poor environmental conditions and not to genetic selection or adaptation. PMID- 2767677 TI - How does inactivation change timing of replication in the human X chromosome? AB - The kinetics of replication of the inactive (late replicating) X chromosome (LRX) were studied in karyotypically normal lymphocytes and human amniotic fluid cells. Both cell types were successively pulse labeled with 1-h or 1/2-h thymidine pulses in an otherwise BrdU-substituted S phase after partial synchronization of the cultures at G1/S. For the first time with this technique, the entire sequence of replication was analyzed for the LRX from the beginning to the end of the S phase, with special reference to mid S (R-band to G-band transition replication). The inactive X is the last chromosome of the metaphase to start replication, with a delay of 1 or 2 h, after which time a thymidine pulse results in R-type patterns. In mid S, the inactive X is the first chromosome to switch to G-type replication (without overlapping of both types and without any detectable replication pause). Until the end of S, a thymidine pulse results in G-type patterns. To rule out artifacts that might arise by the synchronization of cultures in these experiments, controls were carried out with BrdU pulses and the BrdU antibody technique without synchronization. In the course of replication, no fundamental difference was seen between the two different cell types examined. In contrast to studies using continuous labeling, this study did not reveal an interindividual difference of replication kinetics in the LRXs of the seven individuals studied; thus it is concluded that the inactive X chromosome shows only one characteristic course of replication. PMID- 2767678 TI - Partial correction of chromosome instability in Fanconi anemia by desferrioxamine. AB - The action of the iron chelator desferrioxamine (DFO) on the cytogenetic pattern of cultured lymphocytes from Fanconi anemia (FA) patients was investigated. The addition of 10(-4) M DFO throughout the culture time resulted in a 50% reduction of the spontaneous chromosome breakage of FA cells. In addition, the clastogenic action of diepoxybutane on FA lymphocytes was also partly counteracted by DFO. The above findings support the assumption that one of the mechanisms involved in the pathogenesis of FA might be an impaired capacity of the cells from such patients to remove active oxygen species. The relationship between intraleukocyte chelatable iron pool and free radical formation in FA subjects is discussed. PMID- 2767679 TI - Autosomal dominant polycystic kidney disease and alpha -4.2 thalassemia in a Caucasian family. AB - We describe the first known association between autosomal dominant polycystic kidney disease (ADPKD) and alpha-4.2 thalassemia in a Caucasian family. Linkage studies have been carried out using two probes (3'HVR and 24-1) linked to ADPKD on locus PKD1 and two probes (alpha 1-PstI and BamH-I/EcoRI-zeta 2 fragment) allowing detection of alpha-thalassemia with either a 3.7-kb deletion or a 4.2-kb deletion. Our results show that to avoid misinterpretation it is important to investigate the occurrence of an alpha-gene deletion when polymorphisms situated in the alpha-globin locus are used for linkage studies on ADPKD. The studied family is one of the rare cases of leftward deletional thalassemia described in a non-Asian population. PMID- 2767680 TI - A novel delta zero-thalassemia arising from a frameshift insertion, detected by direct sequencing of enzymatically amplified DNA. AB - We describe a novel mutation in the delta globin gene of a compound heterozygote for delta o thalassemia and a deletion type G gamma + (A gamma delta beta) zero thalassemia. The delta was amplified using the polymerase chain reaction (PCR), and the amplified material was used in a direct sequencing experiment. The nucleotide sequence of the mutant delta gene showed that the insertion of an extra nucleotide at the third position of codon 91 in the second exon, which gives rise to a premature stop codon at position 94, leads to the silencing of this gene. The presence of the mutation in the carriers of delta-thalassemia in this family was confirmed by dot blot hybridization. A possible model for the insertion of the extra nucleotide is discussed. PMID- 2767681 TI - Cytogenetic investigations in a family with ataxia telangiectasia. AB - Cytogenetic findings on a family with ataxia telangiectasia (A-T) in which three of four sibs were affected are described. The affected individuals had approximately twice the level of spontaneous chromosome breakage of a normal control, while the parents and the normal sib had no significant increase. Lymphocytes from all three A-T homozygotes showed specific stable chromosomal rearrangements involving chromosomes 7 and 14. All of these abnormalities involved breakage at the usual four sites associated with A-T (7p14, 7q35, 14q12, and 14q32). Two rearrangements detected in the eldest and most severely affected patient were clones, one of which [t(14;14)(p11;q12)] is not commonly found in A T cells. No chromosomal rearrangements were encountered in lymphocytes from the control, the parents, or the normal sib. Lymphocytes from the A-T patients also were found to be 7-11 times more sensitive to the induction of chromatid aberrations by X-irradiation than control cells. Lymphocytes from the parents and normal sib showed a moderately increased frequency of X-ray induced aberrations compared with that of the control. PMID- 2767682 TI - Assignment of the human collagen alpha 1 (XIII) chain gene (COL13A1) to the q22 region of chromosome 10. AB - Type XIII collagen is a recently described collagen that resembles in structure the short-chain collagens of types IX, X, and XII. Unlike any other collagen, the type XIII is found in several different forms generated through alternative splicing. A 2.0-kb genomic fragment from the human alpha 1 (XIII) collagen gene was isolated and shown by DNA sequencing to contain exon 12 as counted from the 3' end. This fragment was used as a probe to localize the gene. The gene (COL13A1) was assigned to chromosome 10 by hybridization of the probe to DNA isolated from a panel of human-mouse somatic cell hybrids containing different human chromosomes. Furthermore, the gene was mapped to the q22 region by in situ hybridization to metaphase chromosomes. PMID- 2767684 TI - Human homologs of two testes-expressed loci on mouse chromosome 17 map to opposite arms of chromosome 6. AB - Our laboratory has recently cloned and characterized two testes-expressed loci- the Tcp-10 gene family cluster and the D17Si11 gene--that map to the proximal portion of mouse chromosome 17. Human homologs of both loci have been identified and cloned. Somatic cell hybrid lines have been used to map the human homolog of D17Si11 to the short arm of chromosome 6 (p11-p21.1) along with homologs of other genes from the (Pim-1)-(Pgk-2) region of the mouse chromosome. The human TCP 10 locus maps to the long arm of chromosome 6 (q21-qter) along with homologs of other genes from the mouse chromosome 17 region between the centromere and Pim-1. The mapping of large portions of the mouse t haplotype to unlinked regions on human chromosome 6 rules out the possibility that a t-haplotype-like chromosome could exist in humans. PMID- 2767683 TI - Loss of 3p or 11p alleles is associated with testicular cancer tumors. AB - Constitutional and tumor genotypes defined by polymorphic DNA markers were examined in 31 testicular cancer patients. Constitutional karyotypes were analyzed and clinical data presented. We analyzed 11 loci representing 8 chromosomes, including regions frequently deleted in other types of cancer. Loss of 3p or 11p sequences was detected in 8 of 28 heterozygotes (28%) and in 5 of 20 heterozygotes (25%). This gives a combined total loss of 40%. The other autosomal loci tested showed no loss or a loss of less than 10% of alleles. We suggest that this loss of heterozygosity for genetic material on chromosome 3p or on 11p is nonrandom and important in the development of a major subset of testicular neoplasms. PMID- 2767685 TI - The gene for human complement C9 is on chromosome 5. AB - By hybridizing a cloned cDNA coding for human complement factor C9 to hybrid cells containing subsets of human chromosomes on a rodent background, we have determined that the human gene for C9 is localized on chromosome 5. PMID- 2767686 TI - Localization of the gene for uridine monophosphate synthase to human chromosome region 3q13 by in situ hybridization. AB - The bifunctional enzyme uridine monophosphate (UMP) synthase catalyzes the last two steps in de novo pyrimidine biosynthesis. A genetic deficiency in the activity of this enzyme causes the inherited human disease orotic aciduria. We used a human cDNA probe to localize the gene for UMP synthase to human chromosome region 3q13 by the technique of in situ hybridization. PMID- 2767687 TI - Mapping of genes for inhibin subunits alpha, beta A, and beta B on human and mouse chromosomes and studies of jsd mice. AB - Inhibin (INH) is a gonadal glycoprotein hormone that regulates pituitary FSH secretion and may also play a role in the regulation of androgen biosynthesis. There are two forms of inhibin that strongly inhibit pituitary FSH secretion. These share the same alpha subunit that is covalently linked to one of two distinct beta subunits (beta A or beta B). However, dimers of two beta subunits are potent stimulators of FSH synthesis and release in vitro. The beta subunits share extensive sequence similarity with transforming growth factor beta. Recently isolated cDNAs for all three inhibin subunits have been used to map their cognate loci on human and mouse chromosomes by Southern blot analysis of somatic cell hybrid DNAs and by in situ hybridization. INH alpha and INH beta B genes were assigned to human chromosome 2, regions q33----qter and cen----q13, respectively, and to mouse chromosome 1. The INH beta A locus was mapped to human chromosome 7p15----p14 and mouse chromosome 13. The region of mouse chromosome 1 that carries other genes known to have homologs on human chromosome 2q includes the jsd locus (for juvenile spermatogonial depletion). Adult jsd/jsd mice have elevated levels of serum FSH and their testes are devoid of spermatogonial cells. The possibility that the mutation in jsd involves the INH alpha or INH beta B gene was investigated by Southern blotting of DNA from jsd/jsd mice, and no major deletions or rearrangements were detected. PMID- 2767689 TI - [Moving and eating--two activities which age well]. AB - The people who participate in courses and activities offered by the "Federation Vaudoise des Ligues de la Sante" are varied both in origin and age. The aged are not absent. Physical exercise, improved nutrition, among other communal activities are the occasion for creating contacts while learning to live better. For example, gentle gymnastics classes or physiotherapy in water allow persons suffering from articular diseases to minimize the negative effects due to inactivity, bad habits, and general aging. Nutrition is an important issue for the elderly as frequently their relationship to food changes; diminished appetite, difficulty chewing and digestive problems. A dietician provides instruction and advice on balanced meals adapted to the changing needs associated with aging. These courses, are also the opportunity for immediate and future contacts which can be beneficial for those encountering difficulty in overcoming the loss of their professional life or adapting to solitude after retirement or widowhood. PMID- 2767688 TI - Research in action: self health care and older people. AB - The Self Health Care in Old Age Project is an experimental health education and promotion programme running in Stoke-on-Trent. England. It is funded jointly by the Beth Johnson Foundation and by the European Economic Community under its Second Programme to Combat Poverty. This paper outlines the Project's four components and focuses, in particular, on the inter-relationship between the developmental and research aspects of the Project. PMID- 2767691 TI - HelpAge International from Sri Lanka to Bolivia via Kenya. PMID- 2767690 TI - Keep the bounce in your step. One perspective of health education for the aged in Australia. AB - Recognising the need to design, promote, market and manage health education programmes for the elderly people, the Department of Health of New South Wales (NSW), Australia, set in 1982, the infrastructure to foster a healthier aged population through the formation of the Senior Adult Unit. PMID- 2767692 TI - Intergenerational Health Education. The Adults Health and Development Programme. AB - The AHDP concept is seen as an action-approach to improving the quality of individual and global health. With its emphasis on friendship, the saliency of health, reinforcement of self-efficacy and control over one's health, health education, the ecological nature of health, and the need to preserve the quality of the future for children and grandchildren, the AHDP model has national and international implications. PMID- 2767693 TI - Health education and elderly people. PMID- 2767694 TI - Health promotion and elderly people. AB - By the year 2000, among the fastest growing population segment will be those over 60 years of age. The elderly population will be healthier and better educated than at any time in history. There will be many more elderly people who have both the capability and desire to continue leading a productive life at work. The World Health Organization recognizes both the importance of this growing segment of the world's population, their needs for services as well as health promotion. PMID- 2767695 TI - Body Recall. PMID- 2767696 TI - The theory behind health education and elderly people health maintenance. AB - The attainment of full health potential may be possible for all, through health education and health promotion. At all times, the concepts of normalisation, self determination, participation, motivation and, at such times when assistance is needed, coordination of services should be borne in mind. From womb to tomb, lifestyles can be shaped in a way that is more conducive to health. The basic messages will be the same worldwide but require to be tailored to the different needs and conditions appertaining to individuals as they become elderly. PMID- 2767697 TI - ICN report. PMID- 2767698 TI - Catherine. PMID- 2767699 TI - 1989 publishers directory. Resource books for nursing students. PMID- 2767700 TI - A tribute to Mike. PMID- 2767701 TI - Nursing opportunities. PMID- 2767702 TI - Emergency nursing. PMID- 2767704 TI - Making every minute count: effective time management. PMID- 2767703 TI - Introducing the National Student Nurses' Association. PMID- 2767705 TI - When Elizabeth Alexander was an undergraduate in college, she decided she wanted to be a nurse. Unfortunately, she was already almost an accountant. PMID- 2767706 TI - The life and times of a nursing student's spouse. PMID- 2767707 TI - BSN completion achievement with style. PMID- 2767708 TI - Reversible injury of cultured rat oligodendrocytes by complement. AB - Rat oligodendrocytes are lysed on exposure to normal homologous serum as a result of classical pathway complement activation and attack in the absence of anti myelin antibodies. The effect of non-lethal complement attack on oligodendrocytes in vitro was studied by exposing dissociated neonatal rat optic nerve cell cultures to low concentrations of complement alone and also in the presence of oligodendrocyte-specific monoclonal antibodies. Regardless of the mode of complement activation, non-lethal complement attack led to reversible cell injury, recovery following a transient rise in intracellular calcium and fall in ATP in the absence of membrane permeabilization to propidium iodide. A single episode of non-lethal injury had no effect on the ability of oligodendrocytes subsequently to express cell-specific antigens, but repeated episodes had a cumulative effect and ultimately resulted in cell death. Reversible and/or lytic complement-mediated oligodendrocyte injury has implications for the pathogenesis of human and experimental demyelinating diseases. PMID- 2767709 TI - Allergic arthritis induced by cationic proteins: role of molecular weight. AB - Previous studies have shown that chronic murine allergic arthritis can only be induced with cationized BSA, related to excellent retention of the cationic antigen in the joint. We now investigate the impact of size of cationic proteins on their potential to induce this form of arthritis. After intra-articular injection, antigen retention is much enhanced with high molecular weight cationized proteins, like albumin or immunoglobulin, compared to small-sized proteins like myoglobulin and lysozyme. Consequently, severe chronic arthritis was only found with the former ones. The role of size is further substantiated with poly-L-lysine-coupled lysozyme. This derivative shows excellent retention in vivo and causes a chronic destructive arthritis in preimmunized mice, in contrast to the poor arthritis seen with native cationic lysozyme. Control experiments made it clear that antigen retention is the most important denominator and that differences in chronicity are not related to gross variations in T-cell reactivity. Retention studies in vitro revealed that the potential to bind to joint structures is similar for the various proteins, suggesting that in vivo conditions determine size-related differences in antigen clearance. Our data indicate that cationicity per se does not make a protein a proper arthritogen. PMID- 2767710 TI - Natural cytotoxic activity is not necessarily mediated by the release of tumour necrosis factor. AB - Natural cell-mediated cytotoxicity is mediated by a family of effector cells that express cytolytic activities distinct from those generally attributed to B cells, T cells and macrophages; it includes both natural killer (NK) and natural cytotoxic (NC) activities. There is now convincing evidence to show that NC activity, but not NK activity, is mediated by tumour necrosis factor (TNF). Further, it has been argued that it is the release of TNF, as a freely diffusible factor, that causes NC-mediated target lysis. Here, we present evidence that the admixture of NC-sensitive target cells and spleen cells, under conditions that result in NC-mediated target cell lysis, does not necessarily result in the release of freely diffusible TNF into the culture medium. Also, it is demonstrated that the procedures used do not result in inactivation or loss of significant amounts of TNF during the assay period, which might account for our failure to detect free TNF. These results suggest that NC activity is mediated by either a membrane-associated TNF activity, similar to that described for some of the lytic activity of activated macrophages, or by the release of TNF that is capable of acting only over a very short distance. PMID- 2767712 TI - Natural cell-mediated cytotoxicity against syngeneic rat chondrocytes originating from different types of cartilage. AB - Natural anti-chondrocyte cytotoxicity of normal rat splenocytes, peritoneal cells and thymocytes was tested by means of 51Cr-release assay. Chondrocytes derived from epiphyseal, costal, nasal, and auricular cartilages were used as target cells. In some experiments, erythroleukaemic K-562 cells, known as typical natural killer cell targets, were also used. All types of chondrocytes were lysed equally well by splenocytes. Peritoneal cells exerted a low cytotoxic effect, whilst very low, almost negligible, cytotoxicity was noted with thymocytes. Negative selection with antibodies and complement showed that spleen-derived anti chondrocyte effector cells are endowed with surface ganglioside asialo-GM1. A similar result was obtained in parallel experiments with K-562 cells. Moreover, 'cold' target experiments demonstrated that the release of 51Cr from the labelled chondrocytes could be inhibited by addition of unlabelled chondrocytes and K-562 cells. PMID- 2767711 TI - Increased sensitivity of the chemoattractant-induced chemiluminescence in eosinophils isolated from atopic individuals. AB - Eosinophilia in peripheral blood is a common phenomenon associated with atopic condition. The present study illustrates the enhanced sensitivity of these eosinophils for formyl-methionyl-leucylphenylalanine (FMLP) and platelet activating-factor (PAF) (measured as luminol-enhanced chemiluminescence) compared with eosinophils isolated from the peripheral blood of normal individuals. The PAF-induced chemiluminescence, which is peroxidase dependent and of extracellular origin, is inhibited by the PAF antagonist BN52021. The enhanced sensitivity of eosinophils isolated from atopic patients for FMLP and PAF might reflect a 'primed' state of these cells, relevant for the pathogenesis of atopic disease. PMID- 2767713 TI - Expression of natural killer (NK) cell-specific alloantigens on a mouse NK-like cell line. AB - As part of the strategy for screening for natural killer (NK) cell-specific monoclonal antibodies (MoAb) we have raised a number of murine NK-like cell lines in media containing interleukin-2 (IL-2). The detection of specific NK cell alloantigens on a C57BL/6 cell line in long-term culture in IL-2 is the subject of this paper. The C57BL/6 cell line has the morphology of large granular lymphocytes (LGL) and exhibits strong cytolytic activity against the archetype NK cell target, YAC-1. Absorption of three anti-NK antiserum, NZB anti-BALB/c (anti NK-2.1), BALB/c anti-DBA/2 (anti-NK-3.1) and CE anti-CBA (anti-NK-4.1), with the C57BL/6 cell line removed the anti-NK activity from these antisera. Flow cytometric studies of the C57BL/6 cell line demonstrated significant binding of the anti-NK-1.1 MoAb produced by hybridoma PK136. Our results suggest that the C57BL/6 NK-like cell line exhibits some of the properties of naive NK cells and expresses all the known NK cell-specific alloantigens, NK-1.1, NK-2.1, NK-3.1 and NK-4.1 and therefore is potentially useful in selecting NK specific hybridomas and in studying the biology of NK cells. PMID- 2767714 TI - [Use of a cream based on 20% azelaic acid in the treatment of melasma]. AB - A 20% azelaic acid base cream (Skinoren-Schering) known in the treatment of acne has been used in melasma. The statistically processed results refer to 39 patients treated for 6 months with 2 applications/die. The reduction in melasma intensity was obtained in all patients bar two whose basal pigmentation situation was already compromised. Overall assessment on a graduated scale in cm evidences, after 6 months of treatment, a mean reduction in pigmentation of 51.3% understood as intensity and surface. The overall judgment of physician and patient on the preparation coincide with some 79% excellent and good on the part of the physician and 85% on the part of the patient. Noteworthy is the absolute absence of sensitisation or leukoderma or any of the other typical side-effects of the other depigmentants available thus far. PMID- 2767715 TI - [Sweet syndrome. Description of 12 cases]. AB - The clinical course of 12 patients (5 males, 7 females) with Sweet's syndrome is described. Clinical and histological features and the dramatic response to corticosteroids were suggestive of Sweet's syndrome. Four patients experience recurrences in previously involved sites, controlled with administration of prednisone. In no cases the dermatosis was associated with systemic diseases. PMID- 2767716 TI - [Verruciform xanthoma of the penis]. AB - Verruciform xanthoma is a solitary verrucous lesion, usually occurring on the oral mucosa. It is characterized histologically by the presence of foam cells within elongated dermal papillae. Only few extra-oral case of V.X. have been reported. An unusual location of verruciform xanthoma of the penis is described. PMID- 2767717 TI - [Cutaneous, muscular and cerebral cysticercosis]. AB - We present a case of cysticercosis with cutaneous subcutaneous muscular and cerebral involvement. The patient, a 34 years old man, developed over ten years multiple calcified cysts diffusely on the body. Analysis of a calcified cyst revealed the presence of cysticercus. A therapy with praziquantel proved successful. PMID- 2767718 TI - [Linear psoriasis (linear psoriatic epidermal nevus) in a patient with HIV infection]. AB - The Authors report a 24 year-old female who presented a linear localized epidermal nevus, from birth. Few months after a diagnosis of HIV infection (ARC WR 4) they observed the flaring-up of psoriasis both on the typical cutaneous sites, and on nevus, which looked like linear psoriasis. PMID- 2767719 TI - [Anti-cardiolipin antibodies in lupus erythematosus]. AB - Anti-cardiolipin antibodies (ACA) were investigated in the serum of 79 patients with lupus erythematosus by means of ELISA method. 34 patients (43%) had ACA in their serum. 63.6% of the patients with ACA had 4 or more ARA criteria and 75% of them had malar rash. None of our patients had the "anti-cardiolipin antibodies syndrome" but three of them with thrombocytopenia had ACA. PMID- 2767720 TI - [Sebaceous linear nevus syndrome with hemimegalencephaly. Report of a case]. AB - The case of a 7-year-old girl, born from a monochorionic biamniotic pregnancy (with healthy male twin) is presented. The patient showed a congenital brown yellowish, raised, rough and oval-shaped nevic neoformation of the right temporo zygomatic region. At 28 days of age she had a right hemiclonic status epilepticus, and from the 8th month of life she presented right sided partial motor seizures. Moreover from the beginning, her development milestones were delayed. When she was 5 years old an electroencephalogram displayed a sharp asymmetrical background activity, a continuous paroxysmal activity on the right hemisphere and independent focal irritative anomalies on the left posterior region. Her computed tomographic scan demonstrated megalencephaly on the right hemisphere. A biopsy specimen of her skin lesion showed the histological characteristics of a nevus sebaceous of Jadassohn. Taken together the clinical, neuroradiological and dermatological data led to the diagnosis of linear nevus sebaceous syndrome. PMID- 2767721 TI - [Bilateral lichen aureus. Report of a clinical case]. AB - A case of Lichen aureus in a 15-year old boy is presented. The case is particularly underlined due to lesions on both legs. PMID- 2767722 TI - [Thermographic study of the percutaneous absorption of corticosteroids]. AB - The results of a study on the percutaneous absorption of two corticosteroids, Halcinonide at 0.1% and Triamcinolone acetonide at 0.1%, employing an original thermographic method, are reported. In a first group of subjects treated with one application of the two corticosteroids a stronger activity of the Halcinonide was found than in a second group of subjects, after repeated applications, resulting progressively more evident and of longer duration in comparison with Triamcinolone. PMID- 2767723 TI - Antibody to poly(ADP-ribose) is an indicator of obstetric complications in pregnant patients with systemic lupus erythematosus. AB - Anti-poly(ADP-ribose) antibodies were measured by an enzyme-linked immunosorbent assay (ELISA) in 6 pregnant women with systemic lupus erythematosus (SLE), 11 normal pregnant women and 6 randomly selected female SLE patients. Four pregnant SLE patients who had either an abortion after 13 weeks of gestation or a premature delivery showed very high titers of anti-poly(ADP-ribose) antibodies in week 8 of pregnancy. However, the titers of anti-poly(ADP-ribose) antibodies of all the normal pregnant women were similar to those of non-pregnant female SLE patients, being slightly higher than those of normal non-pregnant women. The isotype of anti-poly(ADP-ribose) antibodies in pregnant SLE patients was IgG, which did not crossreact with either DNA or cardiolipin. The number of pregnant SLE patients tested was small, but the coincidence of abortion with high titers of anti-poly (ADP-ribose) antibody was very close. Therefore, a high titer of anti-poly(ADP-ribose) antibody in pregnant SLE patients seems useful as an indicator of abortion or fetal distress. PMID- 2767724 TI - Detection of antibodies to the antigens involving differentiation of myeloid cells in sera from patients with systemic lupus erythematosus. AB - The sera from 66 patients with systemic lupus erythematosus (SLE) were examined by the immunoblotting method to detect antibodies to the antigens on the cultured myeloid cell lines, fresh monocytes and granulocytes, and were compared with the sera from 26 healthy subjects sex- and roughly age-matched to the patients. The sera from SLE patients demonstrated antibodies to many antigens on myeloid cells at high frequencies, compared with healthy subjects. A high reactivity with similar patterns was demonstrated with K562, KG-1 and HL60 cells, while reactivity to U937, monocytes and granulocytes was rather low. In particular, the sera from SLE patients were found to contain the antibody to the antigens with Mr of 60K on K562, KG-1, and HL60 cells, which are known to express a good amount of c-myc products. However, the sera from healthy subjects demonstrated hardly any antibody to the 60K antigen on HL60 cells. After an incubation of HL60 cells with TPA or vitamin D3 to induce their monocytic differentiation, the SLE sera became able to detect the 55K antigen on the differentiated HL60 cells, while the 60K antigen turned to undetectable or only faintly detected. These findings suggested that the 60K antigen on HL60 cells may be related to a gene product involving cell growth or differentiation, such as c-myc protein. Actually, polyclonal antibody to myc-specific peptide could identify the 60K antigen as one of the cellular products of HL60.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2767725 TI - Production and secretion of recombinant soluble CD3 polypeptides by myeloma derived transfectant clones. AB - Soluble forms of three human CD3 proteins have been produced by recombinant DNA techniques. The extracellular domain of CD3-gamma, -delta or -epsilon has been linked to the constant region of mouse immunoglobulin kappa light chain to form gamma-kappa, delta-kappa and epsilon-kappa chimaeric proteins. These are secreted by mouse myeloma-derived transfectant cell lines and are immunoprecipitable by CD3- or kappa-specific polyclonal antisera. Yields of 100-500 micrograms secreted recombinant proteins per litre of culture medium were obtained, which could be purified by anti-kappa affinity chromatography. The production of soluble CD3 illustrates the applicability of this technology to a loosely associated protein complex. PMID- 2767726 TI - Excision products of immunoglobulin gene rearrangements. AB - We have isolated circular DNAs from splenocytes of euthymic and athymic mice, and prepared the DNA libraries of 1.5 X 10(6) clones. Hundreds of clones homologous to immunoglobulin (Ig) heavy chain segments (DSP2 and DQ52-JH) or light chain segments (J kappa and J lambda) have been identified. Southern hybridization predicted that three of 12 euthymic mouse clones homologous to DQ52-JH and four of 10 athymic mouse clones homologous to DSP2 contained reciprocal recombination products of D-J joining. Some of these clones were characterized by sequencing: two clones contained the precise excision product of the recombination of a DSP2 segment with either JH2 or JH3 segment; two clones showed imprecise ligation of the DSP2-JH2 coding joint and precise ligation of the DFL16.1-JH3 reciprocal joint in the same molecule. They seem to represent a replacement of the pre existing DSP2-JH2 rearrangement by joining an upstream DFL16 segment to a downstream JH3 segment. The presence in extrachromosomal DNA of a reciprocal recombination product of DH-JH joining is consistent with the view that immunoglobulin genes, like T cell receptor (TCR) genes, can be rearranged in B cell lineage by the looping-out and excision of chromosomal DNA. PMID- 2767727 TI - Normal IgG subclass levels in the hyperIgE syndrome. PMID- 2767728 TI - [Lobular carcinoma of the breast with neuroendocrine differentiation. Study of a case]. AB - A breast tumor with morphologic features of neuroendocrine differentiation and containing large amounts of estrogen receptor protein was associated with areas of typical infiltrating lobular carcinoma. The neuroendocrine areas were argyrophilic, NSE positive and ultrastructurally did not show dense granules. Results of flow cytometric analysis revealed aneuploid nuclear DNA. PMID- 2767729 TI - [Natural beta-interferon for local use in the treatment of metastatic pleural effusion caused by neoplasm of the breast]. AB - The authors intended verifying the effectiveness of natural beta-interferon in the treatment of metastatic pleural effusion from breast's cancer. 24 patient, with an average age of 54, were studied. The objective responses were: 2 Complete Responses, 8 Partial Responses, 6 Stationarity and 5 Progression. The responses seem independent from the association of systemic treatment. Clinical response has been observed in patients with initial pleural effusion less than or equal to 1000 cc. PMID- 2767731 TI - [Receptor status and ovarian function in carcinoma of the breast]. AB - The Authors have evaluated the relationship between the presence of estrogen (ER) and progesterone (PgR) receptors and the ovarian function in 321 consecutive and unselected women who have undergone surgery for breast cancer. A significant relationship was found between the presence and the concentration of steroid receptors (ER and PgR) in the neoplastic tissue and the ovarian function. The Authors confirm the importance of considering the menopausal status in the evaluation of the results of steroid receptor assay. PMID- 2767732 TI - [Cancer and pregnancy. Retrospective study on the frequency in 57,393 deliveries]. AB - Between 1950 and 1984 out of 57.393 women who delivered at the First Department of Obstetrics and Gynecology, Catania University Medical School, Catania, Italy, 40 cases of malignant neoplasia were diagnosed with an incidence of one case in 1.434 deliveries. The most frequent neoplasias is cervix carcinoma (21 cases; 52.5%), followed by breast cancer (6 cases; 15%), ovarian cancer (4 cases; 10%) and leukemia (4 cases; 10%). There was very rare association with Hodgkin disease (2 cases; 5%), osteosarcoma (1 case; 2.5%), medulloblastoma (1 case; 2.5%), and skin melanoma (1 case; 2.5%). Since cancer of the uterine cervix is the most frequent neoplasia (one cases out of 2.733 deliveries), cervical smear should be performed during pregnancy in women that never performed it. PMID- 2767730 TI - [Pretreatment evaluation of CA 72.4 in patients with carcinoma of the stomach (0 IV stage) versus CEA, TPA, CA 19-9, FER]. AB - Before surgical treatments, sera of 54 pts suffering from gastric cancer, histologically typed and clinically staged (from stage 0 to 4), were assayed to evaluate CEA, TPA, CA 19-9 and Ferritin versus a new tumoral marker called TAG 72, in order to determine the biological behaviour and the relation to the clinical stage of this last one. Starting from their results, Authors say that the new marker TAG 72 has an increasing sensibility according to the clinical stage (4 th more than 1 st), and that the association of the TAG-72 plus CEA and/or TPA is rather significant in order to evaluate the evolution of the gastric cancer than other markers. PMID- 2767733 TI - [Results of functional latero-cervical dissection associated with post-operative radiotherapy in 102 cases of carcinoma of the larynx with lymph node metastases]. AB - Our study analyze retrospectively 102 patients (96 male and 6 female), affected by laryngeal carcinoma with histological lymph node metastases, who came under observation from 1978 to 1984. All patients underwent partial (25 cases) or total (77 cases) laryngectomy with functional neck dissection and postoperative radiotherapy with functional neck dissection and postoperative radiotherapy. Irradiation to the neck was administered, employing Cobalt 60, through two lateral opposing fields or an anterior and two posterior fields for a total dose of 50-60 Gy (fraction of 2 Gy for 5 days/week). According to UICC classification (1982) the distribution of cases was as follow: 4 T1, 28 T2, 54 T3, 16 T4. Relatively to the localization of the tumours we had 63 supraglottic, 35 glottic and 4 subglottic involvement. The histological grading was certified in 68 cases: 12 G1, 39 G2, 17 G3; extracapsular spread was found in 20/54 cases (37%). The actuarial global and NED survivals of the whole study were respectively 68.5% and 59.8% for 3 years and 56.5% and 48.2% for 5 years. In relation to the T the global and NED survival for 5 years 67.7% and 61.8% for T1-T2 and 53.1% and 46.4% for T3. The recurrences, observed in 26 patients were found, after 3 years follow up, in 25% of G1, 20.5% of G2 and 47.1% of G3. With relation to the integrity of the nodal capsule N-recurrences were found in 20% of R+ and 5.9% of R-. At the end of the Authors underline the importance of postoperative radiotherapy in the treatment of histological N+ cancers of the larynx and the significance of histological grading and extra-capsular spread in cervical nodes as prognostic factors. PMID- 2767734 TI - [Leiomyosarcoma of the stomach: contribution to case reports]. AB - The authors illustrate two cases of gastric leiomyosarcoma (LMS) by themselves observed and they point out the anatomicopathologic and clinical appearances. Hemorrhagic sequels, presence of abdominal massa, canalization troubles often are the symptoms revealing a neoplasm, which therapy is a surgical exeresis composed by electric attitudes. PMID- 2767736 TI - IgA rheumatoid factor and IgG dietary protein antibodies are associated in rheumatoid arthritis. AB - This study sought to determine whether patients with rheumatoid arthritis (RA) were immunologically sensitised to dietary protein (DP). Using an enzyme linked immunosorbent assay (ELISA), antibodies to milk and wheat proteins were measured in 93 unselected out-patients with classical or definite RA. Of these 93, 53 had raised levels of IgG antibodies to one or both dietary proteins (DP). In the DP antibody positive group, 48 patients (90%) also had raised levels of IgA rheumatoid factor (measured by ELISA) while only 7 (17%) of the 40 DP antibody negative patients had detectable IgA RF; P less than 0.02. There was no association between IgM rheumatoid factor and dietary protein antibodies. These results demonstrate that in RA, raised levels of IgA RF are associated with an increased IgG response to antigens which enter the body through the gastrointestinal tract. A breakdown in gastrointestinal tolerance to dietary antigens may play a role in the immunopathogenesis of RA in these patients who might therefore benefit from dietary manipulation. PMID- 2767737 TI - Measurement of rheumatoid factor isotypes in the clinical laboratory. AB - In this study we assessed the clinical utility of measuring all major rheumatoid factor (RF) isotypes (IgG, IgA, and IgM) in the diagnostic immunology laboratory using an enzyme-linked immunoassay (ELISA). An improved method for IgG-RF was tested which employed a commercially available monoclonal anti-human IgG Fd antibody and did not require pepsin digestion of samples. We detected elevated levels of all three RF isotypes in a population of hospitalized rheumatoid arthritis patients (n = 109). We demonstrated a significant association between IgM and IgA RF which occurred in 36% of our subjects, while less than 6% had IgM + IgG RF or IgG + IgA RF. A comparison of the IgM ELISA with the Rheumaton revealed a statistically significant correlation (r = 0.65, p = 0.001). In addition, the two methodologies were equivalent in sensitivity (ELISA: 76%, Rheumaton: 78%). However, the ELISA procedure was more time consuming, costly, and required greater technical expertise. The following clinical and laboratory findings were significantly associated with RF isotypes: IgG RF and the presence of rheumatoid nodules (p = 0.03), elevated erythrocyte sedimentation rate (ESR) and IgG RF (p = 0.007), and elevated ESR and IgM RF (p = 0.0009). Our ELISA methodology did not provide significant advantages over existing techniques to justify its use as part of the routine laboratory assessment of rheumatoid factor. PMID- 2767738 TI - Seasonal differences in the rhythmicity of human male and female lymphocyte blastogenic responses. AB - To test the hypothesis that there are circannual differences in mitotic activity in males and females, normal human peripheral blood lymphocytes were stimulated with suboptimal concentrations of Phytohemagglutinin (PHA), Concanavalin A (Con A) and Poke weed mitogen (PWM) over two summer/winter cycles. Lymphocyte responses for the entire population were significantly higher in the summer than in the winter. The same results were observed when responses were compared between a summer and a successive winter. However, when male and child-bearing age female responses were compared, females showed a higher significant difference for PHA and Con A between summer and winter, but not for PWM. These different responses due to season may reflect a relationship between the neuroendocrine and immune systems. At the cell level, these results suggest that an inherent difference exists between female and male lymphocytes and that these lymphocytes are sensitive to seasonal changes. PMID- 2767735 TI - Purification of a suppressor lymphokine (SL) from a human T-cell line. AB - Human T leukemia cell line 81-66-45 spontaneously releases into the medium a suppressor lymphokine (SL), able to inhibit PHA-stimulated normal peripheral blood T cell proliferation. Ion exchange and gel filtration chromatography were used successfully to isolate and purify this immunosuppressive lymphokine from culture supernatants. When the purified suppressor lymphokine was characterized with SDS-polyacrylamide gel electrophoresis under reducing conditions, it was found to be a single protein chain of 66,000 daltons. Titration curves of the purified suppressor lymphokine indicated that the inhibitory activity is dose dependent. The suppressor lymphokine is cytostatic and its addition to the peripheral blood lymphocytes (PBL) did not change the cell number or cell viability. This factor was stable at pH 2.0-8.5 and at 56 degrees C for 30 minutes. The structural relationship of this lymphokine with other T cell factors is discussed. PMID- 2767739 TI - Platelet function in type I (insulin dependent) diabetes without vascular disease. AB - In 10 patients of type I diabetes who were free from clinically apparent vascular disease, platelet functions were studied prior to control, and 10 days and 3 months after strict metabolic control. Platelet hyperactivity, seen as significant shortening of latent period and increase in rate and degree of aggregation, present in patients in the initial uncontrolled state, but absent at the subsequent two periods did not correlate with glycosylation of haemoglobin. Thus control of diabetes mellitus, capable of reversing platelet hyperactivity, is reflected by blood sugar levels, and not by the glycosylation status of haemoglobin. PMID- 2767740 TI - Effect of mid-day meal programme on physical growth & mental function. AB - The effect of food supplementation in rural primary school children was studied on physical growth and mental functions. Children (146) received 450-500 calories with 10-12 g of protein for an average of 172 days a year, for 2 yr (1984-1986). Height was found not to differ significantly in the supplemented group as compared to controls. However, there was marginally better weight gain. More children in the supplemented group remained in grade I in contrast to the controls who shifted to grade II nutritional status after 2 yr. Children receiving the supplementation showed marginal increment in full scale, verbal and performance IQ. The improvement was significant for all subtests except for comprehension and maze tests. The observations on unstructured Piagetian developmental tasks also indicated that the performance of children on task conservation of liquid was improved marginally after supplementation. However, on Bender Gestalt test, no change was observed. The scores on arithmetic achievement test showed improvement of 12-14 points in the supplementation group. It appears that nutrition supplementation is beneficial for better school attendance, and reduction in the drop out rate; it also improves intelligence and cognitive function to a marginal extent. However, as this age group falls in the slow growth period, no catch up was observed in physical growth. PMID- 2767741 TI - Ultrastructure of spermatozoa & non spermatozoal cells in human semen in genital tract infections. AB - With a view to ascertain the possible etiology fo the morphological abnormalities seen in spermatozoa of semen from genital tract infections, 16 semen samples were studied. Samples were selected on the basis of each of them having 10-12 pus cells per high power field. Apart from routine semen analysis, the sperms were subjected to electron microscopic studies. Alterations in the ultrastructure of spermatozoa and non-spermatozoal constituents of the infected semen samples were studied. The possible etiology of a wide spectrum of abnormalities in semen found to be associated with genital infection is discussed. PMID- 2767742 TI - Glycerylphosphorylcholine levels in the coagulational groups of human ejaculates. AB - The amount of coagulum present in fresh ejaculates of men (among infertile couple) varied directly with the levels of seminal glycerylphosphorylcholine (GPC; P less than 0.001), which is secreted predominantly by the epididymis. GPC concentrations (mg/ml) of the normally and poorly coagulating ejaculates revealed close similarities with those of the presumably fertile (1.72 +/- 0.10) and infertile semen (1.13 +/- 0.08) respectively. The study suggests that the degree of coagulation of human ejaculates may be correlated with epididymal function. PMID- 2767743 TI - Monoamineoxidase activity in certain brain regions associated with xanthurenic acid excretion in rats on oral contraceptive steroids. AB - Monoamineoxidase (MAO) activity in some regions of brain and urinary xanthurenic acid were investigated in female rats administered with oral contraceptive (OC) steroids-ethynyl estradiol (Ees), lynestrenol (Ly) and both in combination (Cm) for 75 days. The MAO activity was reduced significantly in most regions specially in cortex-the extent of reduction being 65 per cent with Ees, 51 per cent with Ly and 69 per cent with Cm treatments. In the hypothalamus, the activity was decreased by 50 per cent with Ees, 38 per cent with Ly and by 40 per cent with Cm treatments. In the corpus striatum the activity was reduced by 14 per cent with Ly treatment, 25 per cent with Cm treatment and in the midbrain by 59 per cent with Ees treatment only. The concentration of xanthurenic acid in urine was higher by 55 per cent with Ees, 109 per cent with Ly and by 120 per cent with Cm treatments. These changes in MAO activity and level of xanthurenic acid excretion indicate the possible alteration in the metabolism of neurotransmitter, associated with prolonged use of OC. PMID- 2767744 TI - Mitoxantrone & adriamycin cytotoxicity enhanced by reserpine in human chronic myeloid leukaemia cells. AB - The effect of reserpine was studied alone and in combination with anticancer drugs on human chronic myeloid leukaemia (CML) cells. To study the effect of reserpine on anthracycline antibiotic adriamycin and anthracenedione mitoxantrone the extent of 3H-thymidine incorporation into the DNA was taken as the measure of cytotoxicity. The results indicate that reserpine enhances the cytotoxicity of mitoxantrone and adriamycin in mildly toxic concentrations (1 and 10 micrograms respectively), in CML cells. The mechanism of enhancement in drug sensitivity by reserpine in CML cells is due to enhanced intracellular accumulation of drug. PMID- 2767745 TI - Serum & cerebrospinal fluid ferritin levels in children with acute leukaemia. AB - Serum and CSF ferritin were estimated in 35 consecutive patients of acute leukaemia at the time of admission and on induction of remission. Serum ferritin levels were significantly raised in 94 per cent patients of acute leukaemia. The mean (+/- SD) serum ferritin (314.36 +/- 158.4 micrograms/1) was significantly higher when compared with control values (P less than 0.001). Remission induction resulted in significant fall in serum ferritin values to a mean of 149 (+/- 98.7) micrograms/l (P less than 0.05). Serum ferritin is thus of value in assessing the state of remission and is a sensitive indicator of the leukaemic cell mass and the state of activity of the disease. CSF ferritin levels in acute leukaemia were comparable to normal control values. CSF ferritin did not reflect CNS involvement in acute leukaemia and therefore its value as a tumour marker of CNS infiltration is doubtful. PMID- 2767746 TI - Preventive effect of trifluoperazine on atherosclerosis induced by cholesterol & adrenaline in rabbits. AB - Studies on the preventive role of trifluoperazine on cholesterol and adrenaline induced experimental atherosclerosis in rabbits, revealed that trifluoperazine completely prevented the development of atherosclerotic lesions in both the aorta and coronary arteries of animals administered atherogenic diet and adrenaline (im) despite the fact that this drug had no significant effect on the elevated serum lipid profile induced by atherogenic diet. These findings confirm earlier observations of the authors that trifluoperazine has an inherent capacity to prevent atherogenesis. PMID- 2767747 TI - Efficacy & dose-response of intrathecal pentazocine for post-operative pain relief. AB - With a view to assess the efficacy of intrathecal pentazocine for post-operative pain relief, 60 patients randomly divided into 6 equal groups were administered graded doses (0, 1, 2, 3, 4 and 5 mg respectively) of pentazocine lactate, intrathecally along with 1 per cent bupivacaine. The duration of analgesia was found to be dose related till 3 mg. Higher doses did not increase the duration of analgesia nor were any untoward effects observed. It is concluded that intrathecal pentazocine is safe and effective for post-operative pain relief and 3 mg is the minimum effective dose without side effect. PMID- 2767748 TI - Role of dopaminergic mechanisms in the central amygdalar nucleus in the regulation of stress-induced gastric ulcer formation in rats. AB - Microinjections (i/am) of dopamine (DA) antagonists, haloperidol or clozapine (1 and 5 micrograms) into the central amygdalar nucleus (CEA) produced dose-related aggravations in cold-restraint (3 h at 4 degrees C) stress-induced gastric ulcer formation in rats. On the other hand, DA (10 micrograms, i/am), its agonist, apomorphine (5 mg/kg, ip) and its precursor, l-Dopa (100 mg/kg, ip) significantly inhibited stress ulcerogenesis. Pretreatment of rats (i/am) with clozapine antagonized or reversed the gastric cytoprotective effects of DA, apomorphine and l-Dopa. The results indicate that the CEA is important for the observed gastric cytomodulatory effects of both centrally and peripherally administered dopaminergic agents during stressful experiences. PMID- 2767749 TI - Relationship of immunoglobulins with the number & duration of schizophrenic episodes. AB - The relationship of serum and CSF immunoglobulins with the number and duration of schizophrenic episodes was assessed in 40 schizophrenics. The mean IgA was increased in patients having 3 or more episodes as compared with those having the first episode (P less than 0.001). IgM showed a moderate increase in patients with the second episode and those having 3 or more episodes. IgG/TP per cent (IgG/total protein %) was found to be significantly increased in CSF of patients having the first episode, as compared with those having 3 or more episodes (P less than 0.001). IgG was increased (although insignificantly) in the CSF of patients with illness of five years duration as compared to patients having illness of one year duration or for illness between 1-5 yr. IgG/TP per cent was found to be significantly increased in patients having illness for 5 or more years when compared to patients having illness for less than 1 yr (P less than 0.001) and for 1-5 yr (P less than 0.01). PMID- 2767750 TI - Intravenous placement device and infusion thrombophlebitis. AB - The incidence of thrombophlebitis in the present study was 18.3%. It was of mild grade in all the cases. The incidence of thrombophlebitis was more (24%) when short teflon canula was used as intravenous placement device. Under similar infusion conditions with stainless steel needle, scalp vein needle and long teflon canula, the incidence was 16.6%, 13.3% and 16.6% respectively. Thrombophlebitis bears a direct relationship to the duration of infusion. The incidence was negligible at the end of 8 hours, whereas 14 patients developed thrombophlebitis by the end of 24 hours (63.7%). PMID- 2767751 TI - A practical test and its value in rheumatoid arthritis. AB - A practical test distinguishing some pathological conditions from the healthy state is described and a preliminary study on the value of this test for determining the disease activity in rheumatoid arthritis (RA) is presented. In this disease, the test was found positive in 97% of the cases, while rheumatoid factor (RF) was present in 57%, C reactive protein (CRP) in 83%, and elevated erythrocyte sedimentation rate (ESR) in 93% cases. When the activity of the disease disappeared, the test became negative. This test may be useful in RA for determining the active phase and evaluating treatment. PMID- 2767752 TI - Ossifying fibroma of the maxilla. Case report. AB - A rare case of ossifying fibroma presenting as a rapidly growing tumour of the maxillary antrum and causing destruction of its walls is described with a brief review of literature. PMID- 2767753 TI - Renal involvement in chronic pulmonary tuberculosis. AB - Fifty indoor patients of chronic pulmonary tuberculosis were studied for renal involvement. There were 36 (72%) males and 14 (28%) females. Age of the patients was ranging from 16 to 70 years. Most of the patients were receiving treatment for tuberculosis for more than 1 year. Frequency of micturition and dysuria were the commonest symptoms observed. Urine smear for mycobacteria was negative in all patients however culture was positive in 6% patients. Renal biopsy was attempted in all patients but was successful in 35 patients. It revealed interstitial nephritis in 28.5%; amyloidosis in 17.1%, glomerulonephritis in 17.1%, tubercular pyelonephritis in 5.6%; pyelonephritis combined with amyloidosis in 8.5% patients. Non-specific changes were observed in 14.3% patients and in 8.5% patients tissue was inadequate for biopsy study. PMID- 2767754 TI - Occupational lead poisoning among silver jewellery workers. AB - Seven male silver jewellery workers aged between 25 to 70 years complained of acute abdominal colic, sweet metallic taste, constipation and anorexia. Clinical, hematological examinations and urinalysis confirmed lead poisoning. Oral therapy with D-Penicillamine for seven days led to significant improvement in patients. PMID- 2767756 TI - Controlling hypertensive disease and its complications among black Americans. Current challenges. PMID- 2767755 TI - Impact of race on treatment response and cardiovascular disease among hypertensives. AB - To determine the effect of race on cardiovascular disease occurrence among treated hypertensive patients, the experience of 1,807 black and 2,962 white hypertensive patients who entered a union/management--sponsored, worksite-based treatment program (1973-1985), was evaluated. Participants had similar socioeconomic profiles, equal access to health benefits, and received standard treatment. Median duration of observation was 42 months. Blacks had 48, and whites 129, of the 177 morbid (strokes and heart attacks) or mortal cardiovascular disease outcomes. At baseline, blacks had more electrocardiographic abnormalities (32% vs. 19%, p less than 0.0001), lower mean cholesterol (218 vs. 230 mg%, p less than 0.001), smoked more (35% vs. 30%, p less than 0.001), and were less likely to be treated for hypertension before entering the program (53% vs. 58%, p less than 0.01) than whites. They were also more likely than whites to belong to unions employing less skilled workers (p less than 0.0001). Overall, all-cause mortality rates between the races were similar. However, total cardiovascular disease morbidity and mortality rates were 10.5 (whites) and 6.4 (blacks) per 1,000 person years (p less than 0.005); the difference was largely explained by higher myocardial infarction rates among older (55 years or older) white men (15.6 vs. 7.5, p less than 0.05). That advantage was not present amongst younger black persons. In fact, blacks lost more years of life before age 65 (102 vs. 64 years/1,000 persons, p less than 0.025).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2767757 TI - Blood pressure in four remote populations in the INTERSALT Study. AB - Four remote population samples (Yanomamo and Xingu Indians of Brazil and rural populations in Kenya and Papua New Guinea) had the lowest average blood pressures among all 52 populations studied in INTERSALT, an international cooperative investigation of electrolytes and blood pressure. Average systolic blood pressure was 103 versus 120 mm Hg in the remaining INTERSALT centers; diastolic blood pressure in these four population samples averaged 63 versus 74 mm Hg in the 48 other centers. There was little or no upward slope of blood pressure with age; hypertension was present in only 5% of the rural Kenyan sample and virtually absent in the other three centers. Also in marked contrast with the rest of the centers was level of daily salt intake, as estimated by 24-hour urinary sodium excretion. Median salt intake ranged from under 1 g to 3 g daily versus more than 9 g in the rest of INTERSALT populations. Average body weight was also low in these four centers, with no or low average alcohol intake, again unlike the other centers. The association within these four centers between the above variables and blood pressure was low, possibly reflecting their limited variability. While several other INTERSALT centers also had low average body weight or low prevalence of alcohol drinking, when this was accompanied by much higher salt intake (7-12 g salt or 120-210 mmol sodium daily), hypertension prevalence ranged from 8% to 19%. These findings confirm previous reports that in populations with a low salt intake, there is little or no hypertension or rise of blood pressure with age.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2767758 TI - Body fluid volume and angiotensin II in maintenance of one-kidney, one clip hypertension. AB - To investigate the possible role of body fluid volume or the renin-angiotensin system in the maintenance of high blood pressure in chronic one-kidney, one clip (1K1C) hypertension, we studied whether blood pressure remained high after removal of the clip while the body fluid volume was kept constant or when angiotensin II (Ang II) was infused in conscious 1K1C rats. Blood pressure fell 58 +/- 13 mm Hg in 1K1C rats after removal of the clip. When body fluid volume was kept at the same level as before "unclipping," blood pressure fell only 9 +/- 2 mm Hg after removal of the clip; if body fluid volume was then allowed to decrease, blood pressure fell an additional 55 +/- 8 mm Hg. When Ang II was infused after removal of the clip, blood pressure fell 26 +/- 7 mm Hg despite the fact that plasma Ang II increased to nonphysiological concentrations (1,161 +/- 353 pg/ml). After Ang II infusion was stopped, blood pressure fell an additional 44 +/- 13 mm Hg. When Ang II was infused and body fluid volume kept constant, blood pressure still did not change after removal of the clip, although plasma Ang II concentrations increased to nonphysiological levels (618 +/- 98 pg/ml). After the Ang II infusion was discontinued and the body fluid volume was no longer kept constant, blood pressure fell 78 +/- 9 mm Hg. These data further support the hypothesis that a volume factor, not the renin-angiotensin system, is important in the maintenance of high blood pressure in 1K1C hypertension. PMID- 2767761 TI - Abstracts of the Council for High Blood Pressure Research, 43rd annual fall conference and scientific sessions. September 26-29, 1989, Cleveland, Ohio. PMID- 2767759 TI - Impairment of baroreceptor reflex control of heart rate but not sympathetic efferent discharge by central neuroadministration of ethanol. AB - We investigated the acute hemodynamic effects of ethanol microinjection into brain areas known to influence cardiovascular function and reflexes. In chloralose-anesthetized rats, ethanol had no effect on baseline mean arterial pressure, heart rate, or sympathetic efferent discharge when microinjected into the nucleus tractus solitarius, the dorsal motor nucleus of the vagus, the rostral ventrolateral medulla, or the posterior hypothalamus. On the other hand, ethanol microinjection into the anterior hypothalamus caused a site-dependent pressor effect and an increase in sympathetic efferent discharge. Baroreceptor heart rate response but not sympathetic efferent discharge response was impaired by ethanol microinjection into the nucleus tractus solitarius, the dorsal motor nucleus of the vagus, and the rostral ventrolateral medulla, suggesting that ethanol involves one or more of these areas in its inhibitory effect on baroreceptor heart rate response and that ethanol has a selective action on baroreceptor reflex control of heart rate. The findings that 1) the effect was dose dependent and 2) injection of ethanol outside of, or an equal volume of cerebrospinal fluid into, the nucleus tractus solitarius had no effect on the response strongly suggest that the observed effect on baroreceptor heart rate response was ethanol mediated. Ethanol microinjection into the dorsal motor nucleus of the vagus impaired the heart rate response, thus raising the possibility that leakage of ethanol to that area from the nucleus tractus solitarius might have contributed to its effect. These findings show that ethanol has a pressor and sympathoexcitatory site of action within the anterior hypothalamus and that it selectively impairs baroreceptor heart rate response via a central site of action; the mechanisms by which ethanol produces these effects remain to be elucidated. PMID- 2767762 TI - [Solitude and finitude: two subtle aspects of life and death]. PMID- 2767760 TI - Aortic hypertrophy and "waterlogging" in the development of coarctation hypertension. AB - To study the mechanisms and roles of vascular structural changes during the development of hypertension, we coarcted or sham-coarcted the abdominal aorta of rats. At intervals of 3 to 56 days later, we obtained standardized segments of thoracic and abdominal aortas for measurement of dry weight, water content, and amino acid content. Carotid arterial pressure was elevated by day 5 in coarcted rats and remained elevated. Femoral and tail arterial pressures remained normal. Cardiac ventricular weight and dry weight of the thoracic aorta, normalized for body weight, rose rapidly over 3-10 days in coarcted rats, remaining constant at 50-60% above levels in sham-coarcted rats thereafter. In contrast, water content of thoracic aorta in coarcted rats peaked at 123% of control values on day 7 (p less than 0.001), falling rapidly thereafter to levels about half of peak. Increments in dry weight and water content of the normotensive abdominal aortic segments were of far lesser magnitude and occurred 1 to 2 weeks later, probably reflecting the effects of initial hypotension of the hindquarters. Percent hydroxyproline of intima-media segments of the thoracic aorta remained normal during the 8-week period, indicating that increases in aortic dry weight did not represent disproportional fibrosis and thus are attributable to muscular hypertrophy. These results provide support for the hypothesis that arterial wall "waterlogging" is primarily an early manifestation of the hypertensive process. The greatest magnitude of waterlogging coincides with the rapid early increase in aortic dry weight, representing hypertrophy, which suggests common mechanisms, such as activation of Na+-H+ antiport. PMID- 2767763 TI - High-dose intravenous penicillin G does not prevent further progression in early neurological manifestation of Lyme borreliosis. AB - We report two cases of Lyme borreliosis (LB) with erythema migrans (EM) and simultaneous meningopolyneuritis with radicular pain and lymphocytic pleocytosis in the cerebrospinal fluid (CSF). EM and pain disappeared completely under high dose penicillin G therapy within few a days. Pathological findings in CSF improved. Nevertheless, during and after therapy, neurological signs of LB developed: cranial nerve palsies as well as paresis of extremity muscles with radicular distribution. PMID- 2767764 TI - Rubella IgG total antibody avidity and IgG subclass-specific antibody avidity assay and their role in the differentiation between primary rubella and rubella reinfection. AB - The total rubella IgG antibody avidity ELISA, as described by Hedmann for differentiation between acute primary rubella and reinfection, persisting or non specific IgM antibodies were evaluated in 212 sera of four categories of patients with known history (n = 149) and in one group (n = 39) of patients with a history of unclear nature. The development of the IgG ratio (avidity) from low (less than 30%) to higher levels (greater than 30%) was determined in 146 sera from 96 cases with acute primary rubella between days 1 to 256 after onset of exanthem, with a borderline between low (less than 30%) and high (greater than 30%) avidity after four weeks after onset of exanthem. From seven days to 14 years following vaccination, the IgG ratio increased more slowly following vaccination, with a useful borderline at 2 1/2 months. In 80 sera from 13 women with reinfection during pregnancy, six infants with rubella embryopathy, and 19 pregnant women with rubella IgM antibodies detected during antenatal screening, the total IgG ratio ranged between 48% and 100%, indicating a previous infection. The diagnostic value of the IgG subclass-specific antibody avidity assay was investigated in 40 of the 251 sera. The results confirmed those of the total IgG avidity assay. Both tests are of additional help for differentiating serologically primary rubella from reinfection or recent from previous vaccination. PMID- 2767766 TI - Influence of milk on the bioavailability of doxycycline--new aspects. AB - This study was conducted to examine the pharmacokinetics of doxycycline in nine healthy volunteers who had fasted overnight. Single-dose cross-over design was used. Each subject received orally 0.2 g doxycycline. The subjects swallowed the antibiotic capsules with 300 ml of water or 300 ml of fresh milk. Simultaneous ingestion of milk diminished the peak plasma concentration by 24% and the absorption by 9-53% (mean 30%). It is concluded that, like the other tetracyclines, doxycycline should not be administered together with milk. PMID- 2767765 TI - Prevention of bacteremia caused by alpha-hemolytic streptococci by roxithromycin (RU-28 965) in granulocytopenic patients receiving ciprofloxacin. AB - We previously demonstrated that ciprofloxacin prevents infections caused by gram negative bacilli in patients with granulocytopenia. However, in patients with intensive cytotoxic treatment leading to severe mucosal damage a high incidence of bacteremias caused by alpha-hemolytic streptococci was seen. In the present study 45 consecutive patients undergoing intensive cytotoxic treatment received a short course of roxithromycin (10 days) in addition to ciprofloxacin for prevention of bacteremias caused by alpha-hemolytic streptococci. The results of this study were compared with the results obtained in previous comparable patients receiving ciprofloxacin alone. During the days with addition of roxithromycin no infections caused by alpha-hemolytic streptococci occurred, while in the control group of 80 patients 16 bacteremias (20%) were seen. Although roxithromycin was shown to antagonize bactericidal action of ciprofloxacin on gram-negative bacilli in vitro, in vivo study based on serum bactericidal titers and on results of surveillance cultures showed no antagonistic interactions. PMID- 2767768 TI - Hepatitis B core antibody-negative HBsAg carriers. PMID- 2767769 TI - The impact of microbial ecology on clinical problems. International symposium Weitenburg/Tubingen, June 1988. PMID- 2767770 TI - Clinical significance of changes of flora in the upper digestive tract. AB - Dysbiosis does not necessarily mean disease. Typical clinical picture of disease caused by metabolic activity of dysbiotic microflora is the microbial over-growth syndrome. We studied case histories of 434 patients without consideration of their basic illnesses and correlated them with types of dysbioses of duodenal juice. 55% of 314 patients with gastrointestinal disorders revealed a dysbiosis. A dysbiosis could also be found in up to 64% of pancreatic diseases, whereas intestinal dysfunctions and chronic inflammatory diseases usually show normal colonization. These cases express alteration of milieu conditions and disturbed interorganic connections. We only treated cases with objective pathological findings, obtaining best results with chemotherapeutic treatment of dysbioses with only one species. PMID- 2767771 TI - Recent studies on the microbial ecology of the upper gastrointestinal tract. AB - Microecological problems have escalated recently in clinical medicine. We studied the microecology of the upper small bowel. Duodenal flora was examined, displaying microbial growth in 90.8% of the 400 patients examined. The microflora was classified according to germ quality into definite types of colonization. Frequency of microbial colonization is normally 36.7% and 63.3% by overgrowth, indicating differing dysbioses. Simulation of microbial overgrowth in the duodenum is possible with a continuous-flow culture, demonstrating a biocenosis of several groups of micro-organisms with great metabolic activity. Continuous culture technique suggests possibilities for future studies of human gastrointestinal microecology. PMID- 2767767 TI - In vitro induction of ciprofloxacin resistance in coagulase-negative staphylococci. PMID- 2767774 TI - Risk management in anesthesia. PMID- 2767773 TI - In vitro activity of sulbactam plus ampicillin against hospital isolates of coagulase-negative staphylococci and Acinetobacter species. AB - The antimicrobial susceptibility of 54 recent clinical isolates of coagulase negative slime- and non-slime-producing staphylococci and 52 Acinetobacter spp. to sulbactam, ampicillin and the combination of both drugs with a 1:1 ratio was studied by means of an agar dilution test. The coagulase-negative staphylococci showed resistance against sulbactam alone, whereas ampicillin as a single agent was nearly as active as sulbactam plus ampicillin (mode of MIC and MBC 0.03 and 4 mg/l vs. 1 mg/l; geometric mean of MIC and MBC 0.38 and 0.56 vs. 0.26 and 0.38 mg/l, respectively). Among slime-producing or non-slime-producing strains, there was no difference in the susceptibility against ampicillin alone compared to the sulbactam/ampicillin combination, with the exception of the higher MBC (mode: 4 mg/l) for slime-producing strains. Both ampicillin and the sulbactam/ampicillin combination were more active against non-slime-producing than slime-producing strains with modes of MIC and MBC of 0.03 vs. 1 or 4 mg/l. Acinetobacter spp. were susceptible to sulbactam alone (mode of MIC and MBC 1 mg/l; geometric mean of MIC and MBC 1.51 and 2.98, respectively), but resistant to ampicillin. However, the sulbactam/ampicillin combination was highly active against Acinetobacter spp. (mode of MIC and MBC 0.5 and 2 mg/l; geometric mean of MIC and MBC 0.74 and 2.08 mg/l, respectively). PMID- 2767772 TI - The role of Actinobacillus actinomycetemcomitans in periodontal disease. AB - The different forms of periodontitis are all associated with a distinct bacterial flora. However, a clear relationship is described between localized juvenile periodontitis (LJP) and Actinobacillus actinomycetemcomitans. Eleven LJP patients all harboured A. actinomycetemcomitans. The arrest of LJP is often impossible, due to the inability to eliminate A. actinomycetemcomitans. Therefore, antibiotic treatment was introduced in combination with the initial treatment. We studied the effect of periodontal treatment on the microflora and clinical status of periodontal disease patients using different therapies. Group 3 attained the best results (initial treatment and a combination metronidazole and amoxicillin), the group to eliminate A. actinomycetemcomitans effectively. PMID- 2767775 TI - Risk management in anesthesia. Introduction. PMID- 2767776 TI - In-depth analysis of anesthetic mishaps: tools and techniques. AB - In-depth analysis of an anesthetic mishap requires the acquisition and analysis of a complex body of data. These tasks are facilitated by specific tools and approaches. At the outset, the reviewer should create a registry for documents and seek a factual overview of events. Basic information about case management should be obtained with a structured survey instrument. Critical pieces of information must be explicitly indexed for later examination. Timelines are particularly effective for organizing and displaying key events. The process of data analysis can be expedited by starting with broad concerns and moving to finer distinctions in a stepwise manner. Preparation of a short summary is the first analytic task. Next, the relationships between the injury, the mechanism of injury, and the contributory actions of the caretakers are formally linked as a hypothesis of injury. Finally, each contributory action is examined individually to determine if it represents a deviation from the standard of care. Contradictory information is an expected feature of in-depth analysis. This problem can often be resolved by testing for clinical relevance, identifying obvious inaccuracies, and emphasizing findings from the most reliable sources. Recent work suggests that practicing anesthesiologists can analyze mishaps with a significant degree of interrater reliability. Thus, aggregate data obtained from in-depth analysis may play an increasingly important role in research, risk management, and peer review. PMID- 2767777 TI - Stability of sperm characteristics in men with disturbances in sperm quality. AB - Sixty-one men referred to our laboratory for semen analysis, and subsequently judged to exhibit some form of sperm pathology, were asked to return for a second analysis, not less than 2 months after the first, in order to assess the stability of the pathological changes observed. In almost half of the cases, the referring physician had, on his own initiative, started hormone or antibiotic treatment. The sperm parameters studied included sperm count, sperm motility judged by laser-Doppler spectroscopy, and sperm morphology and viability. The motility characteristics included percentage motile, their average velocity, and percentage swimming in a progressive manner, and their progressive velocity. In untreated subjects, there was no significant difference between the first and second analysis in any of the sperm parameters measured. This was also true for both oligozoospermic individuals (less than 20 x 10(6) sperm/ml) and the group with higher sperm concentrations. All parameters were highly correlated on the two occasions. The average coefficients of variation of the paired observations were highest for sperm count (approximately 25%) and lowest for sperm velocities and the proportion of abnormal and viable cells in the ejaculate (1-9%). No major differences in the extent of variation could be detected between the low and high sperm density groups. In general, the unsystematic antibiotic and hormone regimens (clomiphene or androgen) used by the referring physicians had no discernable effect on any aspect of sperm quality, indicating the need for more controlled and standardized programmes of treatment. PMID- 2767779 TI - Seminal plasma biochemistry. IV: Enzymes involved in the liquefaction of human seminal plasma. AB - A significant positive correlation was found between the liquefaction time of human seminal coagula and bound sialic acid. There was also a similar relationship between bound sialic acid and the enzyme sialyl-transferase. This suggests that the degree of sialylation of the components of seminal coagulum are important in determining the liquefaction time of the coagulum. These results support previous findings. The coagulum is considered to be composed of glycoprotein-metal ion complexes, and the initial stage of liquefaction results from the reduction of these metal ions by L-ascorbic acid. The removal of hydrogen peroxide, generated by the oxidation of L-ascorbic acid, requires the presence of glutathione peroxidase and glutathione reductase. These enzymes have been identified in human seminal plasma and their possible physiological importance is discussed. PMID- 2767778 TI - Localization of lactoferrin in the male reproductive tract. AB - The immunohistochemical localization of lactoferrin in the normal human prostate, seminal vesicle, vas deferens, epididymis and testis was studied using the peroxidase-antiperoxidase method at the light and electron microscopical level. Lactoferrin immunoreactivity was localized in the glandular epithelial cells and granulocytes in the prostate and seminal vesicle. In the prostate, lactoferrin showed an uneven distribution; some of the glands contained exclusively positive cells and others were completely lactoferrin negative, while the rest contained scattered positive cells. The seminal vesicles were divided into three segments, and their lactoferrin content varied significantly although it was always epithelial. The ductus deferens, epididymis and testis contained no lactoferrin. In conclusion, lactoferrin was found in the prostate and seminal vesicles, but not in the testis. PMID- 2767780 TI - A simple spot test for the detection of fructose deficiency in semen. AB - The concentration of fructose in seminal plasma is an important variable that should be measured in the assessment of fertility status. The current method requires the boiling of diluted seminal plasma with resorcinol. The present study offers a new two-point spot test which uses the metol method. The results of analysis of 104 seminal plasma samples are in excellent correlation with the resorcinol method. The reported method is easy to use, inexpensive, and can be introduced into any laboratory. PMID- 2767781 TI - Comparison of two techniques used to collect normal and motile sperm. AB - To improve the quality of sperm for intra-uterine insemination (IUI) or in-vitro fertilization (IVF) swim-up (SU) and migration-sedimentation (MS) methods were compared, for the selection of morphologically normal and motile sperm. In 74 patients consulting for couple infertility, it was shown that MS gave a better yield of motile sperm than did SU. An improvement in morphology and motility was achieved, especially in asthenospermia (motility less than 40%) and/or teratospermia (normal shape less than 40%). The percentage of midpiece and tail abnormalities was lowered by the MS technique. It is proposed that the MS method be used for IUI and IVF, adapting the number of tubes to the initial sperm concentration. PMID- 2767782 TI - Microvascular permeability to IgG in the rat testis at puberty. AB - Immunoglobulin G (IgG) spaces and permeability surface area products (PS) were calculated separately in the testis parenchyma, capsule and interstitial tissue in four age groups of rats to see if there were regional differences in microvascular permeability in the rat testis and if there were changes in PS with age. The results demonstrated a marked increase in PS to IgG at 27 days of age in the testicular interstitial tissue, whereas PS in the capsule did not show such consistent changes. Blood volumes per gram, as indicated by the 3 min IgG spaces, were considerably greater in the testicular capsule than in the interstitial tissue, although the weight of the capsule was only about one-third of the interstitial tissue weight. Maximal IgG spaces were reached at 5 h in the testicular parenchyma, but in most groups only at 20 h in the capsule. IgG was demonstrated immunohistochemically in the testicular interstitial tissue from 33 days of age onwards. PMID- 2767783 TI - Developmental pattern of androgen-regulated proteins in seminal vesicles from the mouse. AB - Proteins from secretions or homogenates of mice seminal vesicles were analysed by polyacrylamide gel electrophoresis. In homogenates about 15 bands were differentially induced with molecular weights (MW's) of 12, 13, 14, 15, 15.5, 71, 120 and 140 kD, or repressed molecular weights of 12.5, 14.3, 28, 30, 53, 73, 90 105 kD). The effects of castration were reversed by testosterone and dihydrotestosterone but not by oestradiol, progesterone or corticosterone. When the androgen-dependence of proteins was investigated using radioactive methionine the protein spectra showed that about 12 bands with molecular weights of 13, 13.7, 14, 15, 15.5, 16, 20.5, 24, 37, 38.5, 56, 68, 96 and 180 kD were differentially induced or repressed by androgens. Of the induced proteins, those with low molecular weight (12-15.5 kD) were accumulated in significant amounts between 20 days and 30 days, coincident with the pubertal increase of androgens in the seminal vesicles. Those induced proteins with high molecular weight (71, 120 and 140 kD) appeared between 40 days and 60 days. The androgen-repressed proteins were strongly evident in immature males, but disappeared after day 40. PMID- 2767784 TI - Synthesis of extracellular matrix components by somatic testicular cells from immature and pubertal rats. AB - Total testicular cells derived from immature and pubertal rats were cultured under long-term conditions. Somatic adherent cells proliferated in culture and produced collagen and proteoglycans. Collagen synthesis accounted for 25% and 5% of total protein synthesized by adherent cells derived from immature, and pubertal rats, respectively. Proteoglycan synthesis was higher in cells from immature than from pubertal rats. The proportion of different types of glycosaminoglycan chains (particularly hyaluronic acid and chondroitin sulphate) also varied according to the age of the donor. The results suggest that the synthesis of extracellular matrix components by somatic testicular cells is an age-related process which probably plays an active role in spermatogenesis. PMID- 2767785 TI - New approaches to the pathophysiology of male infertility. 11-14 September, Tegernsee, FRG. Abstracts. PMID- 2767786 TI - The post: pre-dialysis plasma urea nitrogen ratio to estimate K.t/V and NPCR: mathematical modeling. AB - The mathematical basis of the relationship between K.t/V and the ratio of the postdialysis (Ct) to predialysis (Co) plasma urea nitrogen levels (Ct/Co = R) is the urea kinetic model. The R vs. K.t/V relationship is modulated by the patient's normalized protein catabolic rate (NPCR), the dialysis session length, and the predialysis plasma urea nitrogen level, due to urea generated during the dialysis session; the latter increases Ct and hence raises R. The relationship between R and K.t/V is also affected by the amount of ultrafiltrate removed during the dialysis session, because convective urea removal, which is a part of K, does not result in a lowering of the (Ct). In stable adult maintenance dialysis patients receiving 3 treatments/week, with an NPCR of less than or equal to 1.1 g/kg/day and zero residual renal function, the target K.t/V is 1.05 and the target R will be about 0.41. In patients who require different K.t/V values, corresponding values of R can be computed. Based on an empiric examination of the urea kinetic equations, several formulas are proposed for estimating K.t/V from R and vice versa, which depend only on the dialysis session length t, the amount of ultrafiltrate UF, and the postdialysis weight W or V; e.g., K.t/V = - ln (R - 0.008.t-UF/W). After K.t/V has been estimated from R, t, UF and W, one can then estimate the NPCR in the residual renal urea clearance (Kru) has also been measured. From the estimated K.t/V, the Kru, and an estimated V, the total urea clearance over time corrected for V ("KT") is computed.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2767787 TI - Continuous flow peritoneal dialysis in pigs, using a silicone rubber double lumen catheter. AB - Continuous flow (CFPD) and intermittent (IPD) peritoneal dialysis were compared in pigs, using a double lumen silicone rubber peritoneal dialysis catheter. For CFPD, after instillation of 30 ml/kg into the peritoneal cavity, dialysate was continually infused and drained at approximately 25 ml/kg/h. A dwell volume of 30 ml/kg was also used for IPD. Similar length cycles of each technique were compared in Experiment 1. In Experiment 2 total solute clearance and ultrafiltration achieved over two consecutive IPD cycles were compared with CFPD of a similar duration. The catheter functioned well with few complications. In Experiment 1, CFPD produced greater ultrafiltration and significantly improved the clearance of urea, potassium and phosphate compared to IPD. No significant difference between the techniques was observed in Experiment 2. Our data suggest that for CFPD to retain its advantage over IPD intermittent complete drainage of the peritoneal cavity may be necessary. PMID- 2767788 TI - Lipoprotein and apoprotein levels in different types of dialysis. AB - Cardiovascular disease is common in chronic renal failure and its progression during dialysis has been described. We evaluated lipoprotein and apoprotein profiles in 30 male and 28 female uremic patients on dialysis in order to compare the results with 30 male and 19 female non-uremic controls and to detect any differences in lipemic pattern due to different types of dialysis. The dyslipidemic picture typical of uremia was observed in both sexes, coupled with significant hypertriglyceridemia and an increase in the lipid components of the very low density lipoprotein (VLDL). There was also a significant reduction in high density lipoproteins (HDL) cholesterol and HDL2 cholesterol. Apo C levels were increased, whereas Apo AI and AII were diminished. Apo B levels were unchanged. We also evaluated their lipid profile in relation to three types of dialysis: hemodialysis, hemofiltration and continuous ambulatory peritoneal dialysis. Analysis of variance of three different types of dialysis performed for comparable periods of time showed that the parameters typically altered in uremia (Tg, VLDL, ApoC, ApoE) were uniform, whereas differences were observed in the variables indicative of cholesterol and phospholipid metabolism. The alterations of cholesterol metabolism in some subjects, in addition to the specific alterations of Tg metabolism, help explain the elevated prevalence of atherosclerotic complications in dialysed uremic patient. PMID- 2767789 TI - Changes in intracranial pressure during machine and continuous haemofiltration. AB - Nine consecutive patients with both fulminant hepatic failure and acute oliguric renal failure were treated either by daily machine haemofiltration (MHF), or by continuous arterio-venous haemofiltration (CAVHF). Six patients received a total of twenty treatments by MHF and four CAVHF, mean duration of treatment 56 hours, range 24-160. Intracranial pressure (ICP) was measured using a subdural catheter. During treatment with MHF, the mean ICP increased from 8.9 +/- 1.4 mmHg at the start of filtration to 14.8 +/- 2.1 mmHg at the end of treatment (p less than 0.05), whereas there was no corresponding increase during the same period of time with CAVHF treatment, the mean ICP fell, but not significantly from 19.4 +/- 4.8 mmHg to 11.2 +/- 2.3 mmHg. The mean ICP increased to greater than 25 mmHg on eleven occasions during treatment with MHF, requiring treatment with bolus mannitol or propofol, during the same period of treatment with CAVHF no such surges in ICP were recorded. This suggests that continuous haemofiltration is to be preferred to intermittent machine haemofiltration in the management of patients with acute hepatorenal failure. PMID- 2767790 TI - Normalization of serum prolactin levels in hemodialysis patients on recombinant human erythropoietin. AB - Correction of anemia in long-term hemodialysis patients by recombinant human erythropoietin (r-HuEPO) has been reported to improve sexual function. As elevated serum prolactin levels are believed to contribute to altered sexual function in uremia, we followed serum prolactin and testosterone levels during four months of r-HuEPO therapy. Within these four months, hematocrit values rose from 23.7 +/- 1.2 to 35.7 +/- 0.2% and hemoglobin from 7.3 +/- 0.3 to 11.3 +/- 0.4 g/100 ml. In parallel, serum prolactin values decreased significantly, from 66.9 +/- 9.3 to 9.6 +/- 2.6 ng/ml in females and from 39.5 +/- 10.5 to 10.3 +/- 1.0 ng/ml in male dialysis patients. Testosterone concentrations were in the lower normal range in male patients and remained unchanged during r-HuEPO therapy. Sexual function improved in four out of seven males, and five out of nine female patients started to have regular menstruations again. It appears that treatment of anemia in end-stage renal disease by r-HuEPO may improve sexual function by lowering elevated serum prolactin concentrations. PMID- 2767792 TI - Influence of plasticised poly(vinyl chloride) on platelet adhesion and platelet aggregates. AB - The most widely used plasticiser for poly(vinyl chloride) (PVC) is di-(2-ethyl hexyl) phthalate (DEHP), which is extracted in contact with blood. One approach to reducing plasticiser extraction is to incorporate the higher molecular weight plasticisers trioctyl trimellitate (TOTM) and polymeric adipate (PA). This investigation has compared the influence of these plasticisers with that of DEHP on platelet adhesion and platelet aggregate formation. PVC tubing was tested in the absence of anticoagulants and in the presence of heparin. Our results demonstrate the influence of plasticisers on platelet response and support the view that evaluation of such plasticisers should be extended from an examination of toxicological properties to a comprehensive blood compatibility assessment. PMID- 2767791 TI - Plasma albumin and calcium levels following cardiopulmonary bypass. AB - A significant fall in the levels of plasma albumin and a corresponding fall i in the levels of extracellular calcium occurred following cardiopulmonary bypass with the crystalloid prime. Postoperative hypoalbuminaemia was well tolerated, except in the patients with poor left ventricular function. Postoperative hypocalcaemia may increase digoxin sensitivity and may augment the negative inotropic effect of verapamil. PMID- 2767793 TI - Fixed subaortic stenosis: the value of cross-sectional echocardiography in evaluating different anatomical patterns. AB - We present a study using cross-sectional echocardiography in 39 patients (29 male and 10 female) with discrete subaortic stenosis. Five parameters were evaluated in the study: the morphology of the obstruction, the distance of the stenosis from the aortic valve, the type of insertion, the base of implantation, and any associated anomalies. The lesion could be divided into groups with either fibrous or fibromuscular shelves. In the group of 14 patients with fibrous shelves, the distances from the stenotic lesion to the aortic valve was less than 15% of the length of the left ventricle. The obstructive fibrous tissue was inserted on the septum and extended onto the aortic leaflet of the mitral valve (circumferential lesion) in 12 cases. The base of implantation was narrow in all 14 of them. In the 25 patients having fibromuscular lesions, the distance between obstruction and valve was greater than 18.4% of the length of the left ventricle. The insertion of the obstructive lesion was circumferential in 18 cases and its base of implantation was wide in 20 of the patients. Nineteen patients, 16 of whom had fibromuscular lesions, showed associated anomalies. Statistical analysis showed a good correlation between the type of stenosis and the base of implantation of the stenotic lesion (P less than 0.001) or associated anomalies (less than 0.01), but there was no distinction between the groups with regard to the type of insertion (less than 0.38). Twenty-five patients underwent surgical correction which was carried out between the ages of 4-14 years. Prosthetic valves (3 aortic and 1 mitral) were inserted in 4 patients.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2767794 TI - Analysis of survival in patients with pulmonary atresia and intact ventricular septum treated surgically. AB - The epidemiology of 98 children who underwent surgical intervention for pulmonary atresia and intact ventricular septum is presented. Sixty-one (62.2%) of the children died. Survival time from the date of the first operation ranged from 0 to 17.76 years. Analysis of the survivors revealed that an estimate of the probability of surviving for two years is 47% (95% confidence limits of 37%, 57%). An estimate of the median survival time is 1.43 years. In a Cox proportional hazards model, using survival time in days as the outcome variable (n = 73, using complete data), operative weight at first operation (P = 0.0019), right/left ventricular pressure ratio (P = 0.0185), and absence of ventriculo coronary arterial connections (P = 0.0362) were identified as significant predictors of survival. PMID- 2767795 TI - Influence of propranolol on high energy phosphate and tissue acidosis in regional ischemic myocardium of pigs: assessment with arterial pressure and respiration gated in vivo 31-phosphorus magnetic resonance spectroscopy. AB - In an attempt to define the metabolic abnormalities of the ischemic myocardium, the changes in high energy phosphates, inorganic phosphate and intracellular pH were serially and quantitatively evaluated in ischemic porcine hearts having no collateral circulation, using arterial pressure and respiration gated in vivo 31P magnetic resonance spectroscopy. The protocol was also modified for propranolol pretreatment (0.6 mg/kg intravenously) to define its effect on the metabolism of ischemic myocardium. In the non-treated group, creatine phosphate was rapidly depleted by 10 minutes after ischemia; by 40 minutes, ATP and intracellular pH gradually decreased to 10 +/- 11% of control and to 5.90 +/- 0.26, respectively, and inorganic phosphate rose to 303 +/- 43% of control. In the propranolol treated group, the concentrations of creatine phosphate and ATP were higher, and those of inorganic phosphate and tissue pH were similar compared with controls during 40 minutes of ischemia. This suggests that the beneficial effect of propranolol on the ischemic myocardium is due to the preservation of ATP, an essential energy resource for numerous enzymatic reactions in viable myocardium. PMID- 2767796 TI - Efficacy of aortic balloon valvoplasty: direct measurement of orificial area in a model with pulsatile flow. AB - The efficacy of balloon valvoplasty of calcific aortic stenosis remains controversial. We studied, therefore, 5 human aortic valves obtained at necropsy in a positive-displacement pulse duplicator which delivered stroke volumes of 40 100 ml with a quasiphysiological waveform of flow. All valves had three leaflets without commissural fusion and were preserved in antibiotic solution before study. Orificial area was planimetered from videotape of opening of the valve and varied with flow in all cases. Valvoplasty with a 20 mm diameter balloon had no effect on the orifice of the normal valve but increased the orifice of 2 mildly calcified valves from 0.70-1.77 cm2 (range) at baseline to 1.06-1.95 cm2. In 2 valves with severe calcification of the leaflets, the orifice was increased from 0.31-0.82 cm2 to 0.73-1.07 cm2. Dual balloon valvoplasty achieved a variable but small further increase in orificial area. No valve showed tears of the leaflets or fracture of calcific deposits after valvoplasty. We conclude that balloon valvoplasty can acutely increase orificial area, independently of any change in stroke volume. In valves without commissural fusion, its mechanism appears to be an increase in the pliability of the leaflets which does not require macroscopic fracture of calcific deposits. PMID- 2767797 TI - Short-term and long-term prognosis after myocardial infarction: prognostic value of coronary anatomy and left ventriculography. AB - To assess prospectively short-term (1 year) and long-term (4 years) prognostic variables from heart catheterization, 325 consecutive patients of 65 years or less who survived a myocardial infarction were studied. In all coronary angiography and left ventriculography was performed 4-6 weeks after infarction. First year mortality rate was significantly higher in patients with an ejection fraction less than 0.30 (20%) than in patients with an ejection fraction greater than or equal to 0.30 (2%, P less than 0.001). During 4-year follow-up cumulative mortality was 44% in patients with an ejection fraction less than 0.30 vs 11% in patients with an ejection fraction greater than or equal to 0.30 (P less than 0.001). In patients who survived the first year after infarction, however, a low ejection fraction less than 0.30 was not associated with higher mortality rate during the subsequent 3 years. Mortality in patients with one-, two- or three vessel disease was equally distributed in the first year. After 4 years patients with three-vessel disease had a significant higher mortality (32%) than patients with two- or one-vessel disease (12 and 11%, respectively; P less than 0.05). Reinfarction rate was higher in patients with an ejection fraction less than 0.30 (14%) than in patients with an ejection fraction greater than or equal to 0.30 (3%, P less than 0.05) in the first year. During 4-year follow-up reinfarction rate was 38% in patients with an ejection fraction less than 0.30 vs. 13% in patients with an ejection fraction greater than or equal to 0.30 (P less than 0.05). Again, in patients who survived the first year without reinfarction, an ejection fraction less than 0.30 had no prognostic value for recurrent myocardial infarction during the subsequent three years. Three-vessel disease had no higher reinfarction rate in the first year of follow-up: during 4 years, patients with three-vessel disease had a reinfarction rate (32%) compared to patients with two- and one-vessel disease (14 and 11%, respectively; P less than 0.05). It is concluded that an ejection fraction less than 0.30 is a major risk factor for cardiac death and reinfarction only in the first year after myocardial infarction. Beyond the first year, a subgroup of patients with three-vessel disease is at risk for both cardiac death and reinfarction during the three subsequent years. PMID- 2767799 TI - Aortic origin of right pulmonary artery: early detection by cross-sectional and color-Doppler-echocardiography in two infants submitted to successful surgical repair. AB - The aortic origin of the right pulmonary artery was recognized in two infants by cross-sectional echocardiography. The sub-costal short axis view was sufficient to make the diagnosis. The Doppler and color-Doppler techniques were useful in adding the hemodynamic information to the anatomical diagnosis. Early surgical correction was performed in the infants with success without needing to resort to cardiac catheterization. PMID- 2767798 TI - Hemodynamic and prognostic value of thallium-201 myocardial imaging in patients with dilated cardiomyopathy. AB - We studied 70 patients with dilated cardiomyopathy to determine whether extent of perfusion defect on thallium imaging could be related to the hemodynamics and prognosis of the patients. Patients were divided into three groups according to the extent of perfusion defect, i.e., Grade I: no perfusion defect (n = 19), Grade II: apical perfusion defect (n = 22), and Grade III: extensive perfusion defect (n = 29). The patients of Grade III demonstrated marked hemodynamic deterioration compared with those of Grade I and II. Three-year survival rate showed lower value in proportion to the extent of perfusion defect (P less than 0.05). Death from progressive heart failure tended to occur in patients with extensive perfusion defect (P less than 0.05). In patients of Grade III, the perfusion defect extended mainly to the posterolateral segment. Although autopsy studies showed increased fibrosis in the left ventricular wall in these patients, the extension of the fibrosis was not related to that of fibrosis. Moreover, the perfusion defect had regressed in three of 18 patients in the follow-up examination. These results indicate that the extent of perfusion defect on thallium imaging may be of value in non-invasive evaluation and prediction of the prognosis in patients with dilated cardiomyopathy. Distribution of the perfusion defect was, however, not related to that of myocardial fibrosis. PMID- 2767800 TI - Primary fibrosarcoma of the heart presenting as obstruction at the tricuspid valve: diagnosis by cross-sectional echocardiography. AB - We report a case of primary fibrosarcoma of the heart which presented with features of obstruction to the tricuspid valve and superior caval vein. It was correctly diagnosed by cross-sectional echocardiography. PMID- 2767801 TI - Myocardial infarction with normal coronary arteries complicated by rupture of the left ventricular free wall. AB - We report the case of a 73-year-old woman successfully treated for a subacute rupture of the ventricular free wall which occurred on the fourth day after a postero-lateral myocardial infarction. Angiography performed prior to surgical repair revealed the presence of normal coronary arteries. The pathogenetic mechanism of such a happening remains uncertain, but the role of abrupt recanalization must be considered. PMID- 2767802 TI - Left axis deviation in healthy infants and children. AB - In a series of 1036 routine electrocardiograms, 14 children, without clinical and echocardiographic evidence of heart disease, showed a left axis deviation in the standard electrocardiogram. Six children also had an incomplete right bundle branch block. Left axis deviation is defined as a mean frontal QRS complex axis being -30 degrees or less. The age varied from three months to 10 years, with a clear predominance of males (13/14). The unusual finding of left QRS axis deviation in normal children is emphasized. PMID- 2767803 TI - Echocardiographic diagnosis of interrupted aortic arch with an aortopulmonary communication. AB - The association of interrupted aortic arch and an aortopulmonary communication is extremely rare and represents a diagnostic challenge. We report the case of a 15 hour-old infant presenting with these malformations with emphasis on the echocardiographic diagnosis. We conclude that cardiac catheterisation is not mandatory and indeed, is best avoided. PMID- 2767804 TI - Tricuspid and pulmonary atresia with coarctation of the aorta: a rare combination possibly explained by persistence of the fifth aortic arch with a systemic-to pulmonary arterial connection. AB - A ten-day old baby was found to have tricuspid and pulmonary atresia, and a "ductal-dependent" pulmonary circulation that was prostaglandin-sensitive. An unusual coarctation of the aorta was not recognised until an autopsy was performed, some 11 days after construction of an aortopulmonary shunt. A previously undefined anomaly in this neonate was persistence of the fifth aortic arch with a systemic-to-pulmonary artery connection on the same side as the definitive aorta. The histology of the fifth aortic arch is consistent with the pattern of an arterial duct. PMID- 2767805 TI - Single balloon valvotomy for rheumatic mitral restenosis. AB - Four male patients aged 22 to 35 years (mean 29 +/- 5.6) with mitral restenosis following closed mitral valvotomy 6 to 12 years (mean 8.5 +/- 2.5) ago were subjected to percutaneous single balloon valvotomy. There was significant increase in the area of the mitral valve accompanied by a substantial reduction in the transmitral gradient (P less than 0.01). Mitral regurgitation of grade +1 developed in one patient. Balloon valvotomy may be safely and effectively performed in selected patients with mitral restenosis after surgical commissurotomy. PMID- 2767806 TI - The vectorcardiogram in 4 children undergoing the arterial switch repair. AB - Four children with complete transposition (concordant atrioventricular and discordant ventriculo-arterial connections), aged 1.2 to 16.4 years, underwent a delayed repair by the arterial switch procedure from March 1985 to October 1986. Three children had undergone previous atrial diversion repairs in early childhood. Two of these children had developed right ventricular dysfunction with tricuspid incompetence as well as having recurrent and symptomatic supraventricular tachyarrhythmias. They underwent banding of the pulmonary trunk 0.7 and 1 year prior to the final repair. The third child had dynamic obstruction of the left ventricular outflow tract and prior banding was not performed. A fourth child had right ventricular dysfunction on initial assessment in early infancy and then had banding of the pulmonary trunk. Two patients survived the arterial switch operation. Vectorcardiograms were performed on these 4 children before arterial switch repair. The left maximal spatial voltage did not correlate with elevated left to right ventricular pressure ratio at cardiac catheterization before arterial switch repair nor did it relate to survival after operation. The horizontal loop was clockwise in all patients preoperatively. The vectorcardiogram in these children was not a useful indicator that the left ventricle was suitably prepared for the arterial switch repair. PMID- 2767808 TI - Evaluation of spatial R maximum cardiac vector changes in exercise testing: pre exercise versus post-exercise measurements. AB - R wave amplitude changes during exercise have been a controversial issue as both increase and decrease in amplitude have been reported in patients with coronary arterial disease. This variability in response is attributed to change in position and heart axis on exercise. In view of this limitation, this study evaluated the change in spatial R maximum amplitude on exercise, which should not be affected by the above factors. Twenty patients with ischaemic heart disease (male 20, age 38-61 years) and 9 control subjects (male 9, age 32-65 years) were studied. Orthogonal leads, X, Y, Z were recorded using corrected Frank lead system on a stereokinematic vectorcardiograph (Tonnies). The magnitude of spatial R maximum cardiac vector increased from 0.1 to 0.6 mV in 8/9 control subjects and decreased or showed no change in 18 of the 20 patients with coronary arterial disease. In the control group, the mean value at the end of exercise (0.98 +/- 0.34 mV) was significantly less (P less than 0.01) as compared to pre-exercise value (1.09 +/- 0.2 mV). Our preliminary observations thus indicate that, with exercise, the magnitude of spatial R maximum cardiac vector decreases or shows no alteration in height in patients with coronary arterial disease whereas it increases in normal subjects. PMID- 2767807 TI - Electrocardiographic abnormalities in childhood spinal muscular atrophy. AB - Tremors of the isoelectric line in routine electrocardiograms have been described in patients with spinal muscular atrophy and have been interpreted as fasciculations of denervated muscles. In order to evaluate this phenomenon, 13 patients with spinal muscular atrophy have been studied (average age: 37.3 months). A first electrocardiogram was recorded routinely; a second tracing was then recorded with double sensitivity and double speed. In addition, all patients were evaluated clinically and had M-mode and cross-sectional echocardiography. Regular and constant spikes on the isoelectric electrocardiographic line were recorded in 12 patients (93.4%); their frequency ranged from 39 to 48 cycles/sec (average: 42.08 +/- 2.64). Contrary to previous reports, we found an "abnormal" electrocardiogram in all our patients with severe spinal muscular atrophy. The only patient with a normal electrocardiogram had a mild and clinically stable form of spinal muscular atrophy. We did not find any significant structural cardiac abnormality by clinical and echocardiographic evaluation. We conclude that continuous tremor on the isoelectric line of electrocardiogram represents a characteristic of spinal muscular atrophy in these patients. It is a result of muscle fasciculations and does not imply any abnormality of the heart. PMID- 2767809 TI - Impaired parasympathetic control of heart rate after myocardial infarction. AB - We measured the variation in heart rate during deep breathing, a sensitive non invasive measure of cardiac parasympathetic activity, in 95 patients 3 weeks after myocardial infarction and in 40 asymptomatic healthy controls. The variation in rate was significantly lower (11.6 +/- 6.1 vs 17.6 +/- 7.3 beats/min, P less than 0.001) in patients with myocardial infarction than in controls. Forty-nine patients (52%) and 5 controls (13%) were considered to have diminished (less than or equal to 10 beats/min) variation of rate. The diminution in this variation was not related to the type or location of myocardial infarction, to maximum release of CK-MB or to cardiovascular medication. Our results suggest that impairment of vagal control of heart rate is common after myocardial infarction. The impairment cannot be predicted by any specific feature of the disease. PMID- 2767810 TI - Age variation in the association between angiographic coronary disease and angina from the Coronary Artery Surgery Study (CASS) AB - Between July 1974 and May 1979, 19,153 non-randomized patients without prior cardiac surgery and with chest pain were studied angiographically and enrolled in the Coronary Artery Surgery Study (CASS). The primary question addressed by this paper is: for fixed levels of coronary artery disease, are the presence and severity of angina pectoris greater for older than for younger patients? For those with the same extent of disease, older patients were more likely to have angina and to exhibit more severe symptoms. After adjustment for covariates using logistic regression analysis, age was found to be an important, independent predictor of the presence and severity of angina. There are many possible explanations for these findings, although physiologic factors related to aging, the disease process, and deconditioning associated with an increased sedentary life style seem most reasonable. Another possibility has to do with referral patterns for study and the prevalence of angina in the different age groups. PMID- 2767812 TI - Abnormalities in position of left ventricular papillary muscles in congenital aortic stenosis. AB - Subclinical structural abnormalities may accompany some congenital cardiovascular abnormalities. Echocardiographic observations led us to hypothesize that the positions of the left ventricular papillary muscles are abnormal in hearts with aortic valvar stenosis. To test this hypothesis, we examined 6 normal heart specimens and hearts with congenital cardiovascular malformations, including 5 with pulmonary atresia and an intact ventricular septum, 6 with tetralogy of Fallot and 5 with aortic valvar stenosis. We marked the papillary muscles and the mitral commissures, X-rayed the hearts, and measured the angular positions of the papillary muscles using the midpoint of a chord drawn between the mitral commissures as a reference point. The direction from the midpoint to the lateral commissure was designated as 0 degrees. The data (mean +/- SEM) were analyzed using a computer program (ANOVA). In normal hearts, the anterolateral and posteromedial papillary muscles were positioned, respectively, at 43 +/- 19 degrees and 126 +/- 26 degrees. The positions of the papillary muscles were similar to normal in the hearts with pulmonary atresia (62 +/- 38 degrees and 128 +/- 27 degrees) and tetralogy of Fallot (40 +/- 13 degrees and 130 +/- 37 degrees). In aortic stenosis, the locations of the papillary muscles (-76 +/- 42 degrees and 71 +/- 25 degrees) were significantly different from normal (P less than 0.05). The arc between the papillary muscles was 83 +/- 16 degrees in normals and 147 +/- 45 degrees in aortic stenosis (P less than 0.05). The length of the arc was similar to normal in other heart specimens. Thus, the papillary muscles were abnormally positioned in aortic stenosis.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2767811 TI - Electrophysiologic effects of intravenous dipyridamole. AB - We evaluated the electrophysiologic effects of dipyridamole given intravenously to 24 patients during intracardiac electrophysiologic study. Electrophysiologic parameters were measured before and 5 minutes following infusion of 0.5 mg/kg of dipyridamole. The drug significantly shortened the sinus cycle length by 26 per cent (P less than 0.001), sinuatrial conduction time by 15 per cent (P less than 0.01), maximal sinus node recovery time by 21 per cent (P less than 0.001), atrial and atrioventricular nodal effective refractory period by 8 and by 11 per cent, respectively (both P less than 0.01), ventricular effective refractory period by 4 per cent (P less than 0.001), paced cycle length to atrioventricular nodal Mobitz type II block by 5 per cent (P = 0.046), and QT interval during sinus rhythm by 10 per cent (P less than 0.01). After dipyridamole, the PA interval increased by 16 per cent (P less than 0.001), the AH interval by 11 per cent (P less than 0.01), and the corrected QT interval by 5 per cent (P less than 0.01). During retrograde conduction we observed a shortening of the ventriculoatrial interval by 6 per cent (P = 0.036), retrograde atrioventricular nodal effective refractory period by 5 per cent (P less than 0.001), paced cycle length to atrioventricular nodal Wenckebach and atrioventricular nodal Mobitz type II block both by 8 per cent (P less than 0.01). We conclude that intravenous dipyridamole increases sinus node automaticity and reduces atrial, atrioventricular nodal and ventricular refractory periods, prolongs intra-atrial and atrioventricular nodal conduction, but does not produce any changes in His Purkinje system conduction times.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2767813 TI - A rare case of tetralogy of Fallot with unusual blood supply to the left lung. AB - We present a rare case of tetralogy of Fallot with absence of the leaflets of the pulmonary valve and anomalous blood supply of the left lung from the transverse aortic arch. Although embryologic considerations would suggest that the anomalous vessel is not the arterial duct, there was a good response to prostaglandin therapy. PMID- 2767814 TI - Anomalous origin of the left coronary artery from the pulmonary trunk with multiple valvar incompetence. AB - A 63-year-old woman, operated upon for anomalous origin of the left coronary artery from the pulmonary trunk, developed complaints of dyspnea several years later. Echocardiography and angiography showed incompetence of all four cardiac valves. Possible causes of the multiple valvar incompetence are discussed. PMID- 2767815 TI - Biventricular perforation by a temporary pacing electrode: recognition from the lateral chest radiograph. AB - A temporary pacing electrode was inserted in a patient with severe calcific aortic stenosis complicated by complete atrioventricular block. Despite normal pacing and sensing function, a diagnosis of myocardial perforation was made on the basis of a lateral chest radiograph. Neither the surface electrocardiogram nor the frontal chest radiograph suggested evidence of myocardial perforation, and echocardiographic diagnosis was limited by poor echogenicity of the patient. Biventricular perforation with pericardial effusion were documented at operation. PMID- 2767816 TI - Chest pain--no difference in severity between those having a myocardial infarction and chest pain from other causes. AB - In considering nonpleuritic chest pain, the severity of the maximal pain as indicated by the patients on a visual analogue scale does not significantly differ for myocardial infarction or chest pain of other origin. There is also no significant change with time in the severity score of the maximal pain for either group. Thus, the time course is not diagnostically useful. PMID- 2767817 TI - Anomalous origins of left anterior descending and circumflex coronary arteries from separate orifices in the right coronary sinus. AB - A case is described of a 69-year-old man with angina pectoris who was found at coronary angiography to have all three coronary arteries arising by separate orifices from the right coronary sinus. This appears to be a previously unreported anomaly. The embryological origin and mechanisms of angina in coronary arterial anomalies are discussed. PMID- 2767818 TI - Spontaneous resolution of pulmonary stenosis. AB - Pulmonary stenosis diagnosed in infancy usually increases in severity with age or, if it is mild, may remain so for many years. We report the case of a child in whom moderately severe pulmonary stenosis in infancy appeared to completely resolve by the age of 8 years. PMID- 2767819 TI - Traumatic left ventricular aneurysm: report of a case with normal coronary arteries. AB - A 26-year-old male had an anterior myocardial infarction following blunt chest trauma. He developed a left ventricular aneurysm despite coronary angiography being normal. PMID- 2767820 TI - A congenital aneurysm of the non-coronary sinus of Valsalva extending into the wall of the left ventricle. AB - We describe a congenital aneurysm of the non-coronary sinus of Valsalva which extended into the posterior wall of the left ventricle. PMID- 2767821 TI - Drinking beliefs and behaviors among Irish adolescents. AB - Drinking beliefs and behaviors were investigated in a survey of 2,700 Irish postprimary students. Overall, 47% of the students reported drinking within the month prior to the survey. Drinking was most frequent among older students and males. A regression analysis indicated that perceived peer drinking was the primary predictor of current alcohol use. Smoking and involvement with other problem behaviors were also important, and parental disapproval had a small effect. This pattern of results is similar to that found in other countries and provides evidence for the applicability of social learning and problem behavior theories to an understanding of adolescent drinking in another cultural context. PMID- 2767822 TI - Survival analysis to explore the characteristics of employee assistance program (EAP) referrals that remain employed. AB - This study examined characteristics of referrals to employee assistance programs (EAP) associated with subsequent termination of employment. As well, relationships between characteristics of the referrals and program characteristics were explored. Longitudinal data were collected at several time periods for 163 referrals to EAPs from five organizations. Survival analysis was conducted to determine which variables were associated with termination of employment. Females, cohabitating couples, and employees who worked for the organization for 5 or more years were most likely to remain employed. One interesting finding was that people with alcohol problems were significantly more likely to be formal referrals. PMID- 2767823 TI - From theory to practice: the planned treatment of drug users. Interview by Stanley Einstein. PMID- 2767824 TI - Maternal alcoholism and anorexia nervosa: a possible association? AB - The use of modern epidemiological and biostatistical methods has been lacking in the research literature on anorexia nervosa. The present study utilized a retrospective case control design in which 40 cases of anorexia nervosa were matched to two separate control series, one being population based and one being clinic based. Odds ratio of 4.00 (p less than 0.006) and 7.67 (p less than 0.001) were obtained for family history of alcoholism and family history of psychological disorders, respectively, among the families of anorexia nervosa cases. The implications of this result for treatment planning and implementation are discussed. PMID- 2767825 TI - Sensation seeking, state and trait anxiety, and depressive mood in adolescent substance users. AB - The following hypothesis has been tested: sensation seeking, A-state and A-trait, and depressive mood should positively affect adolescent substance use. The personality variables and alcohol and drug use were assessed among 1,900 Israel adolescents, 14 to 19 years old. The major findings were as follows: (a) Sensation seeking and availability significantly affected the "ever" and "current" substance use among adolescents. On the other hand, contrary to our hypothesis, neither A-trait nor depressive mood significantly affected substance use. (b) A-State affected the use of alcoholic beverages and nonprescribed medications. (c) The data emphasized the significant role of availability of drugs in the understanding of adolescents' substance use. The implications of these findings for interventions among adolescents are discussed. PMID- 2767826 TI - Group psychotherapy of the characterologically difficult patient. AB - A broad range of characterologically difficult patients present for treatment in psychotherapy groups. Despite different clinical presentations, including features of the schizoid, borderline, and narcissistic personality disorders, these patients share a common developmental failing. Specifically, these individuals have failed to attain object constancy and the associated stable internalization of tolerably ambivalent representations of the self, and of the other, in relationship with one another. Splitting mechanisms predominate over integrative ones, as primitive defenses are utilized to deal with the individual's powerful needs and fears related to engagement and intimacy. These maladaptive interpersonal styles are clearly illuminated in group therapy, but often to the exclusion of the latent, intrapsychic derivatives of this behavior, with detrimental effects. This paper examines the group therapy of such patients from the perspective of object relations and self psychology theories, models that provide the essential link between the interpersonal and the intrapsychic worlds. PMID- 2767827 TI - Apparent and hidden changes in group members according to the different phases of group psychotherapy. AB - On a psychological-motivational-vertical axis, the more or less covert experiences of members of a therapeutic group are determining factors, whereas on a sociological-interactional-horizontal axis, the system approach, or the network of preponderantly apparent interactions, is the object of therapeutic interventions. The psychological view is directed toward the individual members, whereas the sociological approach means grasping the group as a whole. In group treatment a shifting resultant is mostly observed, at times stressing the individual-psychological approach and at other times the systemic-interactional approach. Five phases of group psychotherapy are discussed in which childhood conflicts and deficiency experiences are activated, and insight and social learning are furthered; the psychodynamics and interactions between the members go on in the described phases on individually different levels, apparent or hidden. PMID- 2767828 TI - A comparative study of six different inpatient groups with respect to their basic assumption functioning. AB - Seventy-five group therapy sessions of six different inpatient team groups in one short-term, one intermediate term, and one long-term psychiatric ward were studied with Group Focal Conflict Analysis and the Group Emotionality Rating System. The majority of the group sessions (41) functioned as fight-flight groups, twenty-four sessions functioned at a "pseudogroup" level, and ten sessions were dependency groups. The differences between the fight-flight groups and the dependency group on the variables aggression and dependency were highly significant statistically. A mixture of fight-flight groups and pseudogroups were found in the short-term ward with emergency obligations. The author discusses the assets and shortcomings of fight-flight and dependency cultures within psychiatric wards. PMID- 2767829 TI - Predicting positive goal attainment and symptom reduction from early group climate dimensions. AB - The general thesis of this paper is that interactional variables are the most promising way to forecast the results of psychological treatment. In particular we believe that perceived group climate dimensions early in group psychotherapy might be valuable predictors. The group atmosphere-climate dimensions, cohesion and relationship, were significant predictors of positive goal attainment and/or symptom reduction (affiliation, involvement-engagement) and so was the subscale, submission-conformity. In addition, the dimensions avoidance and anxiety were negatively correlated with the same outcome indexes. A multiple linear regression analysis suggests, however, that these significant predictions reflect the pretherapy levels of therapy projects-targets and symptoms to be reduced. This study is so promising that group therapy researchers and clinicians are recommended to exploit group climate dimensions to predict outcome. PMID- 2767830 TI - Existential and psychopathological evaluation of group psychotherapy of neurotic and psychotic patients. AB - General problems in researching group psychotherapy are reviewed, especially for those with similar theoretical and methodological approaches. The sample consisted of 100 subjects, 26 of whom were neurotic and 24 of whom were psychotic. They were treated in small groups, headed by the author (the experimental group). An equal number and the same categories of patient attended control psychiatric sessions (the control group). All subjects were tested twice. With three instruments: the semantic differential (with twelve existential categories, five general therapy, and three ego psychology categories), the Kotchen test, and MMPI (midiform). A discriminative analysis of tests and the repeated test data, statistically significant, revealed experiential changes in existential categories, such as "Freedom," "Sex," and "Love" amongst psychotics; and in the case of both psychotic and neurotic patients, treated in groups and compared with the controls, such categories as "Understanding among people." With the help of MMPI, a statistically significant reduction of hysteria in neurotic subjects was established, as well as the preventive effects of group psychotherapy regarding the emergence of psychopathy in psychotic patients. Correlation calculations indicated a greater discrimination in the perception of changes using existential categories in the experiencing of psychotic and depressive patients. Finally, the results obtained are discussed from the viewpoints of clinical experience, results obtained in similar research studies, and unanswered questions resulting from such research. PMID- 2767831 TI - The dialectical approach in group therapy. AB - A dialectical therapeutic approach has been used in treating individuals and families. Its application in group therapy is described with the aid of several anecdotal examples. PMID- 2767832 TI - Rejoinder to the critique of "group psychotherapy with schizophrenic patients: the pairing group" (January, 1986). PMID- 2767833 TI - Critique of "Support Groups for Youth with the AIDS Virus". PMID- 2767834 TI - The modern story of anthralin. PMID- 2767835 TI - Subacute cutaneous lupus erythematosus associated with hydrochlorothiazide therapy. PMID- 2767836 TI - The prestige of dermatologists. Are they "last among equals"? AB - Dermatology generally has been rated low in past studies of the prestige of medical specialties when the raters have been doctors and/or medical students. This investigation considers whether dermatologists maintain their relatively unfavorable position in the specialty prestige hierarchy when the raters are members of the lay public. Four hundred respondents ranked dermatology last out of ten specialties in ascribed esteem, perceived income, and assigned social value, suggesting that dermatologists are less well regarded by the public than are other doctors. Moreover, the relatively low prestige of dermatology appears to be largely independent of a rater's personal experience. PMID- 2767837 TI - The vulvo-vaginal-gingival syndrome. A new form of erosive lichen planus. AB - The vulvo-vaginal-gingival syndrome, a new form of erosive lichen planus, has recently been described. The clinical features of this condition are reviewed and summarized based on the personal examination of 19 affected patients. Each of these patients demonstrated erosive or desquamative disease on some combination of vulvar, vaginal, or gingival mucosal surfaces, but often, at a single point in time, only one or two of the three areas were involved. Clinical features supporting the diagnosis of lichen planus included the regular presence of a narrow white reticulated border at the periphery of the eroded vulvar lesions and the occasional presence of nonerosive lichen planus lesions elsewhere on the skin or mucous membranes. Biopsy specimens taken from the white reticulated border generally revealed the typical histology of lichen planus, whereas biopsy specimens taken from the central eroded surface more often showed only a nonspecific inflammatory reaction. Recognition of the vulvo-vaginal-gingival syndrome as part of the lichen planus spectrum will likely reduce the frequency of otherwise unclassifiable cases of vulvo-vaginal desquamative and erosive mucositis. PMID- 2767838 TI - Disseminated lupus vulgaris presenting as granulomatous folliculitis. AB - A 69-year-old man presented with a 3-year history of scattered, grouped, asymptomatic follicular papules, pustules, and nodules tending toward coalescence into large geographic aggregates. Repeated cutaneous biopsy specimens showed granulomatous folliculitis with negative Ziehl-Neelsen stains. Finally, biopsy material submitted for mycobacterial culture grew Mycobacterium tuberculosis. No evidence of active systemic tuberculosis was found. The patient had a very rare form of tuberculosis, disseminated lupus vulgaris, presenting with granulomatous folliculitis, which is usually not seen in lupus vulgaris. The lesions resolved after an 18-month course of isoniazid and rifampin. The unusual clinical and histologic presentation as well as occasional partial remissions following a variety of nonspecific empiric therapies delayed diagnosis despite multiple evaluations. This case illustrates the importance of obtaining mycobacterial cultures from skin biopsy specimens in addition to special stains whenever cutaneous tuberculosis is suspected. PMID- 2767839 TI - Intrauterine herpes simplex virus infection. Hydranencephaly and a nonvesicular rash in an infant. AB - Herpes simplex virus (HSV) infection in a pregnant woman may have profound adverse effects on the fetus or neonate. A rare congenital syndrome has been associated with intrauterine infection with HSV. An infant with the congenital herpes syndrome is described, the characteristic clinical and laboratory features associated with this syndrome are summarized, and other possible manifestations of herpes virus infection in the newborn are reviewed. PMID- 2767840 TI - Localized acquired cutis laxa in one of identical twins. PMID- 2767841 TI - Dermatology in a besieged community. PMID- 2767843 TI - Combined oral contraceptives and gallbladder cancer. The WHO Collaborative Study of Neoplasia and Steroid Contraceptives. AB - The relationship between combined oral contraceptives and primary gallbladder cancer was examined in 58 cases and 355 controls participating in an international hospital-based, case-control study. Use of combined oral contraceptives at any time was not associated with the risk of developing gallbladder cancer (RR = 0.6, 95% Cl 0.3, 1.3), and no clear patterns of risks were observed according to the duration of use, or time since first or most recent use. There was also no evidence that oral contraceptives effected risk of gallbladder cancer in women with or without a prior history of gallbladder disease. A history of gallbladder disease or gallstones was a strong risk factor for gallbladder cancer (RR = 2.3,95% Cl 1.2,4.4). PMID- 2767842 TI - Early abortion and breast cancer risk among women under age 40. AB - In New York State, incidence of cancer and fetal death are reportable health events mandated by state law. These data enabled a population-based record linkage study of the effect of early pregnancy termination on breast cancer risk to be conducted. In upstate New York 1451 cases under age 40 were reported to the Cancer Registry during 1976-1980. Cases were matched with 1451 population controls by year of birth and by residence using zip codes. All names including those changed by marriage were matched with the reports of fetal deaths occurring between 1971 and 1980. Matched pairs analyses revealed an excess of early pregnancy terminations among cases in all categories. Odds ratios (OR) were significantly elevated among those with an induced abortion (OR = 1.9) and a spontaneous abortion (OR = 1.5). Elevated risks were also noted for consecutive abortion events without intervening livebirths. PMID- 2767844 TI - An analysis of gastric and oesophageal cancers found with 'epidemiological necropsy' during 1953-1982. AB - The 'epidemiological necropsy' is a newly proposed research strategy in which the size and composition of the epidemiological reservoir of undetected disease is estimated from the relative frequency of necropsy surprise patients, in whom the disease was not suspected during life. The current study was done to help validate a basic premise of the strategy. We examined the surprise necropsy discovery of two upper gastrointestinal malignancies: oesophageal cancer, for which an undetected reservoir would not be expected because the cancer has little room to grow, and gastric cancer, for which a sizeable reservoir might be anticipated. In a review of 15,812 necropsies during 1953-1982 at Yale-New Haven Hospital, 70 cases of oesophageal cancer were identified postmortem. Except for five surprise cases, located at the gastro-oesophageal junction where there is room to grow, no oesophageal cancer reservoir was found during the 30-year period. In the same secular period, however, a distinctive set of reservoir cases was found among 162 necropsy instances of gastric cancer. About two-thirds of these gastric cancers had been previously diagnosed during life, but the remainder consisted of either necropsy surprise cases or patients with wrong primary cancer diagnoses during life. The secular rates of occurrence remained stable and similar in both sexes for surprise gastric cancer cases during the three 10-year periods from 1953-1982, but no wrong primary diagnoses occurred during 1978-1982, after the introduction of improved methods of premortem diagnosis. The results help validate the cancer reservoir theory for malignancies that have room to grow, and confirm the concept that the 'epidemiological necropsy' can reflect qualitative and quantitative changes in cancer reservoirs. PMID- 2767845 TI - Mesothelioma in South Africa, 1976-84: incidence and case characteristics. AB - Malignant mesothelioma is a rare tumour known to be associated with prior exposure to asbestos. Previous studies have described the occupational and clinical features of cases of mesothelioma in the Republic of South Africa (RSA) but none has set out to determine incidence of this disease. To estimate incidence, a case register was compiled for 1976-84 by contacting all medical practitioners and institutions likely to have seen cases of mesothelioma in this period; demographic, diagnostic and exposure details were sought. Cases were accepted if they provided evidence of histological diagnosis of mesothelioma. Fifty-two per cent of 1347 cases identified were in whites, 31% in blacks, 16% in coloureds and 1% in Asians. Seventy-three per cent of cases occurred in males. The majority of whites were aged 51-70 years, while the majority in other race groups were aged 41-60 years. The ratio of only pleural to only peritoneal mesothelioma was 11:1, although there were marked differences by race. Eighty five per cent of males with exposure information available had prior exposure to asbestos, mostly occupational. A similar proportion of women had contact with asbestos but mostly through other types of exposure. Standardized incidence rates per million population aged 15 years and over were calculated for sex-race subgroups and were highest in white males (32.9 per million per year, 95% Cl 22.7 46.4), coloured males (24.8 per million per year, 95% Cl 16.2-36.9) and coloured females (13.9 per million per year, 95% Cl 7.7-23.5). These incidence rates are amongst the highest ever reported for a national population. Age-specific standardized incidence rates were highest in white males (over 100 per million per year in men over 55 years). Reasons for the differing rates by population group are likely to include differential access to health services. More rigorous control of asbestos exposure in the RSA is recommended. PMID- 2767846 TI - Multiple myeloma: epidemiological features in a well-defined population in Burgundy, France. AB - Epidemiological features of multiple myeloma were studied over a seven-year period (1980-86) in the department of Cote d'Or (population 478,000). The crude annual incidence rates were 3.7/100,000 for males and 4.0/100,000 for females. The corresponding age-standardized rates were 2.5 and 2.1. The sex ratio was 1.2. Cumulative rates were 0.3% for both sexes. Age and specific incidence were low before 50 and increased with advancing age up to 85 years in males and females. There was no significant variation in incidence over the seven-year period. The risk of multiple myeloma was slightly higher in urban than in rural areas (the variations were not significant). The period between the beginning of the symptoms and the diagnosis was often short, less than one month in 56% of the cases. When compared to other population based registries the incidence rates are similar to those reported all over the world (except for registries with a high proportion of blacks in the population). Cases have been staged according to Durie and Salmon classification: 32% of the cases were classified as Stage I. This result suggests that globally cases diagnosed in a well-defined population are less severe than those reported in hospital statistics. Survival showed significant differences: there were better rates for patients under 75 and for patients at stage I and II compared with stage III patients. Percentage and morphology of plasma cells also influenced prognosis. PMID- 2767848 TI - Blood pressure, cigarette smoking and heart attack in the WHO co-operative trial of clofibrate. AB - In the WHO sponsored trial of clofibrate and its follow-up, about 15,000 men were observed for a mean period of 13.2 years. As expected, incidence of heart attacks (HA) was directly related to serum cholesterol, blood pressure (BP) and cigarette smoking. The previously reported lower incidence of HA in men receiving clofibrate compared with controls was most noticeable in hypertensive heavy smokers (P less than 0.01). BP was slightly lower in smokers than non-smokers (P less than 0.01). The difference in BP was greater in the trial visit before HA. Smokers also had higher plasma fibrinogen levels (P less than 0.05). The combination of reduced diastolic BP, and therefore myocardial perfusion pressure, with an increased thrombogenic tendency, might explain the high incidence of HA in smokers. Clofibrate apparently reduced fibrinogen levels, which might account for its specially good effect in preventing HA in smokers. However, the ill effects of smoking are still evident at a lower level in the men taking clofibrate and the drug is no substitute for giving up the habit. Clofibrate is not recommended for widespread use, except in subjects with marked lipid and/or blood fibrinogen abnormalities after dietary measures have been tried. PMID- 2767847 TI - Respiratory symptoms and lung function in relation to passive smoking: a comparative study of American and French women. AB - Results are reported from a parallel analysis of the association of passive smoking with respiratory symptoms and lung function (FEV1, FVC and FEV1/FVC) in 2220 US and 3855 French women from the general population examined over the same time period using similar methods. Age, city, educational level, occupational exposure and height (for lung function) were taken into account. In the US survey, being a never smoker married to a current or former smoker was significantly associated only with wheezing compared to being a true never smoker. A borderline significant association between passive smoking and dyspnoea was observed among women older than 40 in the French survey. No association was observed with cough or phlegm production. Passive smoking was significantly related to lower FVC and FEV1 values among French women 40 years or more, even among those without a history of wheeze or asthma. However, even among US women older than 40 years of age, there was no significant association between passive smoking and level of lung function. Better housing conditions, higher divorce rates, more frequent exposure to passive smoking in childhood, and different selection factors for active smoking in the US compared to France might explain the lack of association of current spousal smoking habits with lower lung function in American women. PMID- 2767849 TI - Body fat distribution and self-reported prevalence of hypertension, heart attack, and other heart disease in older women. AB - The associations of self-reported body mass and fat distribution with self reported prevalence rates of hypertension, heart attack, and other heart disease were examined in a sample of 40,000 women, aged 55-69 years. Fat distribution was measured by the waist-to-hip circumference ratio (WHR), which had a mean +/- SD of 0.838 +/- 0.085. Prevalence of hypertension was significantly and positively associated with both body mass index (BMI) and waist-to-hip ratio. The prevalence rate ratio for hypertension in the highest versus the lowest tertile of body mass index and waist-to-hip ratio (considered jointly) was 2.7. Prevalence rates of heart attack and other heart disease were significantly and positively associated with waist-to-hip ratio but not with body mass index. The prevalence rate ratios were 2.2 for heart attack and 1.4 for other heart disease in the highest versus the lowest tertile of body mass index and waist-to-hip ratio. Findings were substantiated using multiple logistic regression. These results support the hypothesis that a significant relationship exists between body fat distribution and the occurrence of cardiovascular disease in older women. PMID- 2767850 TI - Effects of body fat and its development over a ten-year period on glucose tolerance in euglycaemic men: the Zutphen Study. AB - The relationship between body fat and different aspects of glucose tolerance was examined within the Zutphen Study. In 1970 an oral glucose tolerance test (OGTT) was carried out in 404 non-diabetic men aged 50-70. None of the subjects could be classified as having impaired glucose tolerance. Body mass index (BMI), subscapular and triceps skinfold were positively related with fasting and 60 min serum glucose. Weak positive associations were found between 30 min glucose, BMI, and subscapular skinfold. For 120 min glucose, only the relationship with subscapular skinfold was significant. After adjustment for age and the other body fat indicators, the positive associations between body fat and fasting, 60 min and 120 min glucose were confirmed for subscapular skinfold only. Correlations between these glucose measurements and measurements of subscapular skinfold in the years between 1960 and 1970 were also significant and increased with time. Independent from subscapular skinfold in 1970 and age, changes in skinfold during the period 1960-70 were in general not significantly associated with glucose levels, except for 30 min glucose. The findings could to a large extent be explained by current knowledge of glucose metabolism. PMID- 2767851 TI - Serum fatty acids and fish intake in rural Japanese, urban Japanese, Japanese American and Caucasian American men. AB - To examine the relationship of fish intake with serum fatty acids cross culturally, we surveyed a total of 136 men aged 34 to 55 years in four different populations: rural Japanese (RJ), urban Japanese (UJ), Japanese Americans (JA), and Caucasian Americans (CA). Mean levels of estimated total fish intake per day were 124.9 g in RJ, 70.8 g in UJ, 45.7 g in JA, and 32.3 g in CA. The percentage of total serum fatty acids contributed by omega-3 polyunsaturated fatty acids in these populations was 11.8% in RJ, 9.0% in UJ, 3.4% in JA and 2.5% in CA. Means of omega-3 fatty acids and intake of fish were correlated at the population level; this relationship was strongest when intake of dark-meat fish was considered (n = 4, r = 0.979, p = 0.02). Within each population, except for UJ, individual omega-3 fatty acid levels and dark-meat fish intake were significantly associated (p less than 0.05). A 20 g increase in dark-meat fish consumption was associated with an estimated relative increase in omega-3 fatty acid content of serum by 0.76% in RJ, 0.75% in UJ, 0.64% in JA, and 0.22% in CA. The association between fish intake and serum omega-3 fatty acids at the individual level was not explained by other coronary risk factors. Mortality from coronary heart disease is much lower in Japan than in the US. Population differences in fish intake and serum omega-3 fatty acid levels may contribute to the population difference in the risk of coronary heart disease. PMID- 2767852 TI - Chronic non-specific lung disease and occupational exposures estimated by means of a job exposure matrix: the Zutphen Study. AB - Information gathered in the Zutphen Study, the Dutch contribution to the Seven Countries Study that started in the 1960s, was used in this study. Of the 1266 men invited to take part in the 1985 survey, 939 (74%) participated. All participants were interviewed according to the BMRC chronic non-specific lung disease (CNSLD) questionnaire and medically examined for CNSLD complaints by a trained physician. The physician also filled in a questionnaire containing questions concerning previous treatments for asthma, bronchitis and emphysema. Exposures were generated by means of a job exposure matrix on the basis of the longest performed job and the gain and grouped into 12 exposure categories. A logistic regression analysis was performed using the occupational exposures as the sector of industry dependent variables in allowing for smoking habits, age and socioeconomic status. For the diagnosis by the physician and treatment for emphysema and or bronchitis, the strongest elevated odds ratios were found, indicating an adverse effect of the occupational exposures. In contrast, the variable 'ever treated for asthma' had odds ratios smaller than one with most of the exposure variables indicating a selection effect. In an analysis in which everyone who was ever treated for asthma was excluded an increase in the odds ratios compared with the first analysis was seen. The relationships between occupational exposures as generated by the job exposure matrix and CNSLD were stronger than those recently reported in the literature. PMID- 2767853 TI - The effect of domestic factors on respiratory symptoms and FEV1. AB - This study was conducted to determine whether indoor air pollution factors affected respiratory function and symptoms in 1357 non-smoking Caucasian children. Interviews were conducted to determine: exposure to pets and to gases, vapours and dusts from hobbies; the use of gas stoves; fireplaces, air conditioners and humidifiers; type of heating systems; and the number of residents, and the number of smokers in the home. The forced expiratory volume in one second (FEV1) was obtained from maximum expiratory flow volume curves, and symptoms from the application of a standardized questionnaire. Indoor pets and the use of fireplaces and humidifiers had no consistent relationships with FEV1 when considered individually or in combination with the other factors. Hobbies, the use of gas stoves, the absence of air conditioning, the use of hot water heating, crowded homes, and the presence of smokers in the home all had negative relationships with FEV1. The largest effect on lung function was observed in children from homes with hot water heating systems, whereas the smallest effect was observed in children with smokers in the home. Children who lived in homes with hot water heating systems with no air conditioning had mean FEV1 of up to 0.4 litres lower than did their counterparts who lived in homes with forced air heating and air conditioning. Pets, heating systems, cooking fuel, crowding and passive smoking showed no consistent effects on the reporting of any of the symptoms. Girls who were exposed to the emissions from indoor hobbies reported more phlegm, wheeze and dyspnoea. PMID- 2767854 TI - A mortality analysis of Native American in New York State, 1980-86. AB - This investigation examined the mortality experience of Native Americans in New York State, exclusive of New York City, between 1980 and 1986. Compared to the general population of New York State, exclusive of New York City, deaths among Native Americans occurred an average of nine years earlier. Among Native males, elevated risk of death was noted for tuberculosis, diabetes mellitus, pneumonia and cirrhosis. Native females demonstrated an excess of deaths due to diabetes mellitus and cirrhosis. Fewer than expected malignant neoplasm deaths occurred among both Native males and females. A deficit of deaths was observed for colon and lung cancer deaths among Native males and for colon and breast cancer deaths among Native females. While these results are generally in agreement with previous reports, this study did not identify an excess of deaths due to accident related mortality. Findings from this study, while limited, do serve as crude indicators of the overall health status of Native Americans in New York State and may prove useful in the context of planning and evaluating future health care services among this population. PMID- 2767855 TI - The epidemiology of infantile hypertrophic pyloric stenosis in a Danish population, 1950-84. AB - The epidemiology of Infantile Hypertrophic Pyloric stenosis (IHPS) was studied in a geographically well-delineated and demographically representative Danish region (The County of Funen), covering the period 1 January 1950 to 31 December 1984. Based upon 679 cases, the cumulative incidence from birth of IHPS was found to be virtually unchanged during the study period at a level of 4.8 per 1000 liveborn boys and 1.3 per 1000 liveborn girls. In an analysis of clinical and demographic variables, the development of IHPS was found to be associated with low parity status (regardless of maternal age). The preterm cases had a longer interval from birth to onset of symptoms, compared with those born at term. No statistically significant associations were found between IHPS and seasonal variations at onset of symptoms, ABO and Rhesus blood groups, and maternal age. PMID- 2767856 TI - Pattern of poisoning in rural Sri Lanka. AB - An epidemiology study of poisoning was done in a geographically defined area in rural Sri Lanka, a developing agricultural country. The incidence of poisoning was 75 per 100,000 population and the death rate was very high (22 per 100,000 population). Both were highest in the age group 15-34 and there were significant ethnic differences in the incidence of poisoning. Agrochemicals were responsible for 59% of all poisonings. Paraquat was the commonest poisoning agent with a high fatality rate of 68%. Use of highly toxic agents may have resulted in deaths where there was no intention to commit suicide. Strict legislation regarding the sale, distribution and storage of agrochemicals could result in the reduction of mortality and perhaps the incidence of poisoning, in developing agricultural countries. PMID- 2767857 TI - Dental caries at five and twelve years in a South African Indian community: a longitudinal study. AB - In 1979, 515 of 767 available Indian children born in Lenasia in 1974 were examined and their dental caries status was described. In 1986, 515 of the original 715 were re-examined in order to determine the pattern of dental caries in the primary and permanent dentitions of the same individuals. In contrast to studies in the literature in which treatment records have been used, both investigations were formal epidemiological field studies using calibrated examiners and WHO (1971) caries diagnostic criteria. A firm association was found between caries in the primary and permanent dentitions (r = 0.34). PMID- 2767858 TI - Evaluation of factors influencing vaccine uptake in Mozambique. AB - A pulse immunization project was started in Mozambique to compensate for the decrease in routine immunization caused by destabilization. A study was conducted to evaluate the project and identify determinants of vaccination in urban and rural areas of Mozambique. Vaccine coverage based on a documented record, the 'Road to Health' card, was 53% in urban and 60% in rural project areas, and 12% higher if a verbal history of vaccination was considered. A further 17% of children would have received effective vaccination if the correct schedule had been followed for all vaccines given and all preventive health services contacts had been used for vaccination. Factors relating to the individual mother and child and factors relating to the clusters were investigated for their association with vaccine uptake. Those which showed a strong negative association included vaccination on offer at the nearest vaccination post for only a small number of days per week; cancellation of an outreach session; knowing a child with a post-vaccination abscess; child born at home; at least five children in the family; mother's inability to speak Portuguese and her inability to name at least two target diseases. Improving the supervision of health services and immunizing at least three days per week at permanent immunization clinic sites may be the most important measures to improve coverage further. PMID- 2767859 TI - Malaria in Nicaragua: community-based control efforts and the impact of war. AB - This descriptive study of temporal trends and geographical distribution examines the effects of prolonged low-intensity warfare on the community-based malaria control efforts. Nicaragua's post-1979 malaria control programme is based on community participation in health education and in mosquito breeding site drainage, expanded case finding, and increased availability of chemotherapy. Mosquito resistance and increasing costs have forced a reduction in the use of residual pesticides. The number of reported malaria cases in the country fell from 25,465 in 1980 to 15,702 in 1984, while the ratio of blood smears to total population increased from 86 to 137 per 1000 people. Malaria incidence in the eight states of the country under heaviest military attack in the current war was compared to incidence in the eight states least affected by the war. In the war zone there was a 17% excess in cases from August 1983-April 1985 above a 1974-82 baseline average, while there was a 62% decline in the number of cases in the non war zone. PMID- 2767860 TI - Exclusion of clinically atypical or microbiologically mixed diarrhoeal episodes from outcome events in a field trial of oral cholera vaccines. AB - We investigated whether alternative clinical and microbiological criteria for outcome events affected estimates of vaccine efficacy in a randomized, double blind field trial of B subunit-killed whole cell (BS-WC) and killed whole cell only (WC) oral cholera vaccines among 62,285 rural Bangladeshi participants. At one year of follow-up estimates of vaccine protective efficacy (PE = 60%, P less than 0.0001 for BS-WC; PE = 54%, P less than 0.0001 for WC) against all treated diarrhoeal episodes associated with V. cholerae 01 were similar to estimates of efficacy against only those episodes which were clinically typical and unassociated with additional enteric pathogens (PE = 62%, P less than 0.0001 for BS-WC; PE = 52%, P less than 0.0001 for WC). In contrast, estimates of vaccine cross-protection against episodes associated with each of several agents antigenically related to V. cholerae 01 (LT-ETEC, non-cholera Vibrio sp, Aeromonas sp) were substantially reduced when mixed infections with V. cholerae 01 were excluded. We conclude that restrictive criteria intended to improve the specificity of the definition of cholera did not increase the detectability of vaccine efficacy against V. cholerae 01, but that exclusion of mixed infections with V. cholerae 01 was necessary to avoid false-positive conclusions about vaccine cross-protection against other potential target pathogens. PMID- 2767861 TI - Skin test reactions to a phenol-soluble antigen of Brucella abortus among veterinary students, Lyon, France, 1984. AB - In December 1984, 424 students at the National Veterinary College, Lyon, France, were skin-tested with a phenol-soluble antigen of Brucella abortus B19. Of all students, 2.6% had a positive intradermal reaction indicating previous contact with Brucella. Prevalence of positive reactions was significantly lower among students from the three first school years (less than 2%) compared with students in their last school year (5.9%). These results are discussed and compared to the prevalence of brucellosis among cattle. Specificity (94%) of the intradermal testing resembles that of serological testing but its sensitivity (75%) seems to be better. PMID- 2767862 TI - Validation of a self-report inventory for the measurement of visual acuity. AB - Previous attempts to assess visual acuity via self-report survey items have shown low sensitivity. This may be due to use of dichotomous response formats, too few items, and reliance upon face valid, rather than laboratory-validated items. On the basis of a preliminary sample of 164 individuals, we developed a self-report inventory, suitable for group testing or survey administration. The inventory was then validated against laboratory measures of acuity in a separate sample of 570 subjects. The resulting, brief, ten-item scale was shown to be a reliable and valid predictor of visual acuity. Conversion tables were developed which allow scale totals to be used to predict Snellen acuity. For 91% of the sample, the inventory predicts objectively measured acuity within plus or minus one Snellen line. A copy of the inventory and scoring procedure is appended to this report. PMID- 2767863 TI - Calculation of power for matched pair studies when randomization is by group. AB - A formula is given for the calculation of the statistical power of paired intervention trials in which the units of randomization are groups rather than individuals. Factors affecting the power of such trials are also investigated and an example is given where the power of group randomization is compared to that of individual randomization. PMID- 2767864 TI - Diethylstilboestrol exposure and testicular cancer. PMID- 2767866 TI - Smoking behaviour in Nepal. PMID- 2767865 TI - Seasonal variation in CHD mortality. PMID- 2767867 TI - Maternal mortality in various Italian regions. PMID- 2767868 TI - Immunogenicity and safety of measles vaccine in ill African children. PMID- 2767870 TI - Epithelial hyperplasia of the fallopian tube. Its association with serous borderline tumors of the ovary. AB - We examined sections of fallopian tube from 99 patients with serous borderline tumors of the ovary (SBT) to determine the prevalence of epithelial hyperplasia. Fifty-eight patients with carcinoma of the cervix (CC) and 30 with grade 2 or 3 ovarian carcinoma (OC) served as controls. Patient ages were similar in each group. Epithelial hyperplasia was identified in 68 of 99 patients with SBT (68.7%), compared with 15 of 58 with CC (25.9%) and 4 of 30 with OC (13.3%). Epithelial thickness and nuclear crowding were greater in hyperplastic than in normal fallopian tubes. There was no correlation between hyperplasia and menstrual cycle. In patients with SBT, the presence of epithelial hyperplasia correlated with tumor stage. Hyperplasia was present in 38 of 60 (63%) patients with Stage I tumors. In Stage II and III tumors, hyperplasia was present in 18 of 25 (72%) patients with noninvasive peritoneal implants and 12 of 14 (86%) with invasive implants. Fallopian tube epithelial hyperplasia may represent an example of a field effect in mullerian carcinogenesis. PMID- 2767869 TI - Complex endometrial hyperplasia and carcinoma in adolescents and young women 15 to 20 years of age. A report of 10 cases. AB - The clinical and histologic findings in 10 patients, 15-20 years of age, with complex hyperplasia or well-differentiated adenocarcinoma of the endometrium are presented. The morphologic distinction between the two lesions is discussed, and the frequency of misdiagnosis of this form of hyperplasia as carcinoma in this age group is emphasized. No difference was found in the behavior of the two lesions in this series of cases whether or not a hysterectomy was performed. PMID- 2767871 TI - The morphologic characteristics of menstrual hemostasis in patients with unexplained menorrhagia. AB - The endometrium in uteri removed by hysterectomy in patients with unexplained menorrhagia was compared with the endometrium in patients with normal menstruation who had a hysterectomy for uterine prolapse. The vascular ultrastructure and hemostatic plug formation were examined from the late secretory phase throughout menstruation to day 9 of the proliferative phase of the menstrual cycle. Endothelial defects, with and without hemostatic plugs, were more common and were present longer in the endometrial blood vessels of patients with unexplained menorrhagia than in patients with normal menstruation. In normal menstruation, no vascular defects were observed after day 3 of the cycle, whereas vascular defects were observed up to day 9 in the blood vessels of patients with unexplained menorrhagia. These morphologic features are likely to play a major role in the increased menstrual bleeding in such patients without uterine pathologic findings. PMID- 2767872 TI - A suggested columnar cell morphological equivalent of squamous carcinoma in situ with early stromal invasion. AB - Cervical squamous carcinoma in situ with early stromal invasion has recently been defined as a strict histologic entity. Two cases of extensive classical adenocarcinoma in situ of the uterine cervix and one of very early invasive adenocarcinoma are reported that showed foci indistinguishable from squamous early stromal invasion arising directly from unequivocally glandular in situ malignant foci. This finding is further evidence in support of the theory that glandular and squamous intraepithelial neoplasia in the cervix are closely related conditions, possibly with a common origin in the subcolumnar reserve cell. PMID- 2767873 TI - Nucleolar organizer regions in the normal and carcinomatous epithelium of the uterine cervix. A morphometric study. AB - Nonhistone nucleoproteins associated with the nucleolar organizer regions (NORs), the genes coding for the ribosomal RNA precursor, can be visualized by silver staining. The black dots (AgNORs) appearing on the nuclei are thought to reflect cell differentiation. In this study, AgNORs were counted and their area was measured and compared with the area of the nuclei in normal and carcinomatous cells of the uterine cervix. The number of AgNORs per nucleus was significantly higher in the endocervical than in the basal exocervical epithelium (p less than 0.005) and in the carcinomatous epithelium, either in situ or invasive, than in both normal epithelia (p less than 0.002). Individual AgNORs were significantly smaller in carcinoma in situ than in endocervical epithelium (p less than 0.05) or in invasive carcinoma (p less than 0.01). Significant differences were also found in the total AgNORs area per nucleus between the following groups: basal exocervical versus endocervical epithelium (p less than 0.01), basal exocervical and endocervical epithelium versus invasive carcinoma (p less than 0.001), and in situ versus invasive carcinoma (p = 0.02). The conclusions are that the number and the total area of AgNORs per nucleus increase with the differentiation of the cell or with its carcinomatous transformation, but no prognostic significance can be drawn so far from our measurements. PMID- 2767874 TI - Histopathologic findings in ectopic tubal pregnancy. AB - In 141 consecutive cases of tubal ectopic pregnancy at Hermann Hospital in Houston, Texas, the histologic appearance of 129 surgically removed fallopian tubes containing ectopic pregnancies was reviewed and compared with an age- and race-matched control population. There was a higher incidence of chronic salpingitis (88 versus 2%) and salpingitis isthmica nodosa (SIN) (43 versus 5%). The ectopic pregnancy patients had a higher incidence of pelvic inflammatory disease, gonorrhea, previous abortions, bitubal ligation, intrauterine device use, and previous abdominal surgery. In our population, chronic salpingitis was the most commonly associated finding. The increase in SIN was associated with postinflammatory changes (89%). We also found that ectopic tubal pregnancies may grow either intratubally or extratubally by villous invasion into the wall and blood vessels; therefore, surgical salvage of the fallopian tube by extracting the products of conception will not always be curative. PMID- 2767875 TI - Liesegang rings in the female genital tract. A report of three cases. AB - Three cases of Liesegang rings (LRs) within the female genital tract are reported; only one similar case has been previously documented. The patients were 32-57 years of age and underwent operations for ovarian endometriosis (two cases) and uterine leiomyomas (one case). Innumerable eosinophilic, acellular, ring-like structures, similar to previously described LRs, were found on microscopic examination and were confined to an endometriotic cyst (two cases) or the mucosa of a fallopian tube involved by chronic salpingitis (one case). Liesegang rings within the female genital tract, as in other sites, occur within cysts or within areas of inflammation. These structures have been confused with and should be distinguished from parasites and foreign material on histologic examination. PMID- 2767876 TI - Trisomy 12 and translocation (7;9) in an ovarian immature teratoma. AB - We report a case of an immature malignant ovarian teratoma with peritoneal implants diagnosed in an 18-year-old woman. The tumor was brought into remission after surgery (three laparotomies) and adjuvant chemotherapy. A residual peritoneal implant showed a mature epithelial and glial configuration. Histologically, the neuroectodermal component was dominant in the original tumor as well as in the metastases, being confirmed by immunohistochemistry and electron microscopy. A stem cell line has been obtained with cell culture, having a germ cell character and a yolk sac configuration. This line possessed a trisomy 12 and a translocation (7;9) similar to other chromosomal abnormalities described in immature teratomas of the testes and ovaries. PMID- 2767877 TI - Clear cell carcinoma of the endometrium with lipid-producing activity. Histologic and ultrastructural study suggesting a unique neoplasm. AB - A case of clear cell carcinoma of the endometrium with lipid-producing activity in a 59-year-old woman was studied by light and electron microscopy. Following a modified radical hysterectomy, the plasma level of cancer antigen 125 (CA125) decreased abruptly. Histologically, the tumor was composed of clusters of large, polygonal cells with either clear or eosinophilic cytoplasm, showing distinct borders and bizarre, pleomorphic nuclei divided into many groups by the connective tissue elements. Abundant lipid droplets in the neoplastic cells were observed by Sudan III stain, and the CA125 antigen was demonstrated in the neoplastic cells. Mitotic figures were difficult to find. Electron microscopically, the tumor cell nuclei were oval or polygonal and sometimes slightly invaginated, with a few prominent nucleoli. The cytoplasm contained abundant lipid droplets, rough endoplasmic reticulum, rod-shaped to round mitochondria, Golgi apparatus, glycogen particles, and free ribosomes. A few small lumina containing microvilli were recognized. These observations suggest that this lesion is a unique type of clear cell carcinoma of the endometrium originating from Mullerian epithelium and possessing lipid-producing activity. PMID- 2767878 TI - Apolipoprotein concentrations in obese subjects with upper and lower body fat mass distribution. AB - In order to assess the relationship between obesity and serum lipids, a homogenous group of adult men and premenopausal women is assessed for body mass index, body fat distribution reflected by the waist/hip ratio (WHR), serum lipid parameters and apolipoproteins. Body fat distribution is distinguished in an abdominal and gluteal-femoral type using a cut-off point of 1.00 for the ratio of waist-to-hips girth for men. In women the cut-off value is considered as 0.80 but was also evaluated when considered as 0.85. In the next step tertiles for WHR are created to show a graded relationship between WHR and lipoprotein fraction. The results indicate that WHR is an important determinant for most atherosclerosis related lipids and apoproteins: in both men (P less than 0.05) and women (P less than 0.005) WHR is significantly correlated with apolipoprotein B. Using multiple regression analysis, in women WHR seems to be the most important dependent variable, where body mass index is not significantly contributing to the explained variance. In men, however, besides WHR age is the most significant variable, although age distribution is similar in men and women. Using tertiles of WHR, we show a clear graded relationship with most lipids and lipoproteins; this gives additionally an argument to confirm that in women WHR = 0.80 is the most accurate cut-off value for abdominal obesity. This study demonstrates that both obese men and women with an abdominal fat mass distribution show a lipid and apoprotein profile that is less favorable than that seen in gluteal-femoral obese subjects insofar as the risk of coronary artery disease is concerned. PMID- 2767879 TI - Changes in intraventricular septal thickness, left ventrical wall thickness and left ventricular volume in obese adolescents on a high protein weight reducing diet. AB - Ten obese adolescents (153 percent ideal body weight) underwent significant weight reduction over a two to three month period using a low calorie, low carbohydrate, protein diet. The subjects lost a mean of 13.9 +/- 4.3 kg, representing a decrease of 15.5 +/- 5.0 percent of initial body weight. Serial measures of intraventricular septal thickness (ST), left ventricular wall thickness (LVWT) and left ventricular volume (LVV) were determined by standard m mode echocardiographic methods over 14 weeks to determine the effect of weight reduction on these indicators of cardiac size. The ST changed over the study period from 8.2 +/- 1.9 mm to 7.3 +/- 2.0 mm; the LVWT from 7.6 +/- 1.8 mm to 6.3 +/- 1.1 mm; and the LVV from 47.1 +/- 4.0 mm to 42.0 +/- 2.8 mm. These numerical decreases were not significantly different. Over this study period, the diet allowed weight loss with no apparent effect on the cardiac size (ST, LVWT, LVV) as measured by echocardiography in these obese adolescents. PMID- 2767880 TI - Body weight and cardiovascular response to sympathetic stimulation in childhood. AB - The possible relationship between cardiovascular response to adrenergic stimulation and body weight has been studied in 166 eleven-year-old students (103 male, 63 female). Resting blood pressure (BP) by random-zero machine, heart rate (HR) and body weight (BMI) were measured four times in the school at 3-week intervals. On the third visit a mental arithmetic stress was carried out and a 24 h urine specimen was collected for the measurements of catecholamine excretion. On the fourth visit students carried out an isometric exercise (handgrip). Girls were more frequently found in the last quintiles of BMI (10/33 in the first vs 19/33 in the fifth). This might be due to a more advanced sexual maturation. BP at rest significantly increased with body weight (from 105/81 +/- 11/13 mmHg in the first to 119/87 +/- 10/12 in the fifth quintile). In each quintile no sex related difference was observed in BP or HR. A marked cardiovascular response was observed during both tests without significant difference among quintiles. The 24 h urinary excretion of total catecholamines slightly increased with body weight (from 26.2 +/- 11 micrograms/24 h in the first to 34.5 +/- 19.5 micrograms/24 h in the fifth quintile). These data in a population of 11-year-old students therefore support the hypothesis that although BP at rest is influenced by BMI, the cardiovascular response to adrenergic stimulation is independent of body weight. PMID- 2767881 TI - Effects of weight loss and weight maintenance on the serum lipids, lipoprotein lipase and hepatic triglyceride lipase activities in obese rats. AB - The effects of obesity, weight loss and weight maintenance on the serum lipid levels and lipoprotein lipase and hepatic triglyceride lipase were investigated in rats. Obesity induced by high-fat (HF) feeding was associated with decreased serum triglyceride levels (HF: 70.3 +/- 8.2, control (CON): 140.0 +/- 26.9 mg/dl, P less than 0.05), increased lipoprotein lipase (LPL, HF: 593.2 +/- 10.6 vs CON: 280 +/- 19.5 nmol FFA/min per mg tissue, P less than 0.05) and suppressed hepatic triglyceride lipase activities (HTGL, HF: 14.2 +/- 0.5 vs CON: 18.0 +/- 0.4 nmol FFA/min per mg tissue, P less than 0.01). After a weight loss to the level of control rats, weight maintenance was achieved either by high-protein (HP) or chow feedings (CH). Both high-protein (HFHP) and chow (HFHC) groups had similar weights but only high-protein feeding restored the normal body compositions. Both groups of rats had higher total (TC, HFHP: 146 +/- 10.7; HFCH: 104.8 +/- 5.1 mg/dl), and high density lipoprotein cholesterol levels (HDL-C, HFHP: 100.8 +/- 15.6; HFCH: 75.5 +/- 5.5 mg/dl) and lower lipoprotein lipase (HFHP: 238.2 +/- 15.8, HFCH: 354.8 +/- 34.9 nmol FFA/min per mg tissue) and hepatic triglyceride activities (HFHP: 16.3 +/- 1.1; HFCH: 14.5 +/- 0.6 nmol FFA/min per mg tissue) than control rats (TC: 70.1 +/- 4.7 mg/dl; HDL-C: 14.2 +/- 4.3 mg/dl; LPL: 742.4 +/- 82.3 nmol FFA/min per mg tissue; HTGL: 20.5 +/- 1.0 nmol FFA/min per mg tissue, P less than 0.05 to 0.005) or the rats who regained weight by resuming high-fat feeding (TC: 59.5 +/- 6.7 mg/dl; HDL-C: 10.2 +/- 6.7 mg/dl; LPL: 1284.3 +/- 90 nmol FFA/min per mg tissue; HTGL: 22.2 +/- 1.9 nmol FFA/min per mg tissue, P less than 0.05 to 0.005). The high protein-group had significantly higher total and high-density-lipoprotein cholesterol levels than the chow fed animals despite comparable body weights in both groups. The findings of this study suggest that weight maintenance induced by high protein feeding is more successful in restoring the normal body composition. However, high protein feeding is also associated with high serum cholesterol levels. The clinical applications of these findings need to be evaluated further. PMID- 2767883 TI - The prediction in boys and girls of the weight/height index and various skinfold measurements in adults: a two-decade follow-up study. AB - Prediction of adiposity in adults from anthropometric measurements (arm and trunk skinfolds, weight/height) made during childhood and adolescence was assessed in a two-decade follow-up study. Weight/height showed the best correlation between childhood and adulthood values in both sexes. The child-adult correlations for skinfolds were better in males than in females and their value varied according to body site. In males, trunk skinfolds showed slightly better correlations than arm sites, and the weakest correlations were observed for the biceps. In females arm skinfolds, especially the biceps, showed a better predictive value than trunk skinfolds for which the child-adult correlation was almost nil. Trunk skinfolds, which are more often associated with metabolic complications of obesity than limb skinfolds, are predictable from childhood measurements in males and not in females. The prediction of adiposity development in different body sites may help identify children most susceptible to various pathologies in later life. PMID- 2767882 TI - Regional distribution of muscle and fat mass in men--new insight into the risk of abdominal obesity using computed tomography. AB - We studied 24 healthy men (25-50 years old) covering a wide range of fatness (body mass index range: 21-34 kg/m2) and fat distribution (waist/hip range: 0.75 1.06). Computed tomography scans were taken at five levels (thigh, hip, waist, arm, and liver) from which fat, muscle and bone areas were calculated. Both waist/hip and BMI were correlated with fat areas in the thigh, arm and waist scans. BMI showed stronger correlations with peripheral fat areas, whereas waist/hip showed stronger correlations with fat areas in the waist scan (particularly with visceral fat area: r = 0.88, P less than 0.001). BMI was correlated with muscle and bone areas in the thigh scan. In multiple regression BMI was, independently of waist/hip and age, positively correlated with fat areas in the arm, thigh, and waist (not with visceral fat) and muscle and bone areas in the thigh. Waist/hip was independently of BMI and age correlated with fat areas in the arm and waist, including visceral fat area (but not with fat areas in the thigh). Moreover, waist/hip showed an independent negative correlation with muscle area in the thigh, muscle endurance and physical activity. Serum triglycerides, plasma insulin, glucose, uric acid and diastolic and systolic blood pressure were associated with visceral fat area but also to anthropometric indicators of abdominal fat distribution (especially waist/hip ratio). Liver attenuation, but not the liver/spleen attenuation ratio, was associated with some liver enzymes and BMI but not with waist/hip or metabolic parameters. We conclude that a higher BMI is associated with increased central and peripheral fat stores (but not visceral fat) and increased thigh muscle whereas waist/hip is primarily associated with increased central fat stores (noteably with visceral fat), decreased thigh muscle and reduced physical fitness. It is suggested that physical training might be an important element in the treatment of abdominal obesity in men. PMID- 2767884 TI - Growth hormone treatment reduces total body fat accumulation in Zucker obese rats. AB - Lean and obese Zucker rats were injected daily intraperitoneally with high doses (5-10 mg/kg) of human growth hormone (GH) for 3 weeks. In the obese rats after GH treatment, carcass lipid was decreased by 50 percent, and bone weight increased to levels of lean controls. During the last two weeks of GH treatment, food intake was increased in lean rats and not significantly affected in obese rats. Loss of body weight in obese animals was masked by water retention. Serum insulin concentrations were doubled in obese animals but unchanged in lean phenotypes after GH treatment. Hepatic fatty acid oxidation in obese animals was stimulated 5-fold by treatment, while hepatic lipid synthesis was stimulated 2-fold and adipose lipid synthesis was reduced 3-fold. These results suggest that growth hormone induces a partitioning of nutrients in obese rats which results in less lipid accumulation. PMID- 2767885 TI - Re-examination of prediction of body fat from body weight and height. PMID- 2767886 TI - Crystal structure and conformation of L-pyroglutamyl-L-alanine. AB - Crystals of the dipeptide, pyroglutamyl-alanine (C8H12N2O4) grown from aqueous methanol are monoclinic, space group P2(1) with the following cell parameters: a = 4.863(2), b = 16.069(1), c = 6.534(2)A and beta = 109.9(2) degrees, V = 480.0A3, Mr = 200.2, Dc = 1.385 g cm-3, and Z = 2. The crystal structure was solved by the application of direct methods and refined to an R value of 0.044 for 699 reflections with I greater than 2 sigma. The amide of the pyroglutamyl side chain is cis, omega 1 = 2.6(7) degrees; the peptide unit is trans and appreciably non-planar (omega 2 = 167.4(5) degrees). The backbone torsional angles are: psi 1 = 166.1(5), phi 2 = -90.3(6), and psi 2 = -22.4(6) degrees. This structure contains a short (2.551(5)A) intermolecular hydrogen bond between the carboxyl OH and the N-acyl oxygen, a feature common to most acyl amino acids and acyl peptides. PMID- 2767887 TI - Crystal structure and conformation of glycyl-glycyl-sarcosine. AB - Crystals of the tripeptide, glycyl-glycyl-sarcosine (C7H13N3O4) from aqueous methanol are orthorhombic, space group Pbcn with cell parameters at 294 K of a = 8.279(1), b = 9.229(4), c = 24.447(5)A, V = 1868.0 A3, M.W. = 203.2, and Z = 8. The crystal structure was solved and refined using CAD-4 data (1171 reflections greater than or equal to 3 sigma) to a final R-value of 0.053. The first peptide linkage is trans and planar whereas the second peptide link between Gly and sarcosine is cis and appreciably non-planar (w = 7.4 degrees). The peptide backbone has an extended conformation at the N-terminal part but adopts a polyglycine-II type of conformation at the C-terminal part. The backbone torsion angles are: psi 1 = -173.9, w1 = -177.8, (phi 2, psi 2) = (-178.8, -170.8), w2 = 7.4, (phi 3, psi 3) = (-81.6, 165.6 degrees). PMID- 2767888 TI - Vascular resistance vs. perfusate osmolarity: the short term microvascular effect of hypotonic and hypertonic perfusion in the isolated kidney. AB - Vascular resistance changes were measured in response to alteration in perfusate osmolarity in isolated rabbit kidneys perfused at 10 degrees C. The data obtained were found to fit a simple mathematical model of the vascular resistance of the microcirculation in which it was assumed that variation in this parameter depended solely upon osmotic alterations in the size of the cells within and around the blood vessel walls. The model predicts that the volumetric changes due to the different osmolarities are produced in a tissue layer whose thickness is 30% relative to a fixed outer radius. This result is compatible with the hypothesis that the effects are predominantly due to changes of endothelial cell volume and other perivascular capillary cells. The analysis illustrates the significance of perfusate osmolarity as a determinant of vascular resistance, can be used to investigate the hemodynamic effects that occur during the introduction and removal of cryoprotective agents, and is relevant to the interpretation of results obtained with hypertonic solutions in blood volume restoration after hypovolemic shock. PMID- 2767889 TI - Response of the arteriolar network in rat cremaster muscle to intraarterial infusion of nicotine. AB - The response of the arteriolar network in rat cremaster muscle to continuous intraarterial infusion of nicotine was studied. Measurements were made of mean femoral arterial pressure, inside vessel diameter, red blood cell velocity and volumetric flow rate in each of four series-coupled arteriolar segments. Nicotine was continuously infused in a cumulative fashion in doses of 12.5, 25, 50 and 100 micrograms/kg/min. After a 10 min infusion of each dose, measurements were made again in each arteriole and compared with the values obtained prior to infusion of nicotine. Arterial pressure increased in a graded fashion with increasing dose of nicotine up to 50 micrograms/kg/min. The smaller arterioles demonstrated a dose dependent vasoconstriction and reduction in flow rate which were maximal at a dose of 50 micrograms/kg/min. In another series of experiments, the microvascular responses to nicotine infusion were obtained in the acutely denervated microvasculatured. The nicotine-induced flow reduction was significantly diminished by denervation. In a separate series of experiments nicotine was infused at doses of 25 and 50 micrograms/kg/min, and plasma catecholamine concentrations were determined. Plasma norepinephrine and epinephrine were significantly elevated at only the higher dose. Responses in denervated tissues suggest that plasma catecholamine concentrations were approximately threshold for arteriolar responses. It is concluded that the nicotine-induced flow reduction in rat skeletal muscle is due primarily to enhanced release of norepinephrine from vasomotor nerves with little or no influence from circulating catecholamines. PMID- 2767890 TI - Computer assisted leukocyte adhesion measurement in intravital microscopy. AB - The pathogenetic role of the leukocytes in the development of postischemic injury is not yet understood. Therefore a model was developed which allows for in vivo quantification of leukocyte-endothelium interaction in the awake animal. The velocity of leukocytes was measured by means of intravital microscopy and interactive digital image analysis. An adhesion coefficient (AC) was calculated which characterizes the degree of the leukocyte-endothelium interaction. A special procedure of automatically taking image samples for the leukocyte velocity measurement reduces observer bias. As shown in a validation experiment, this procedure yields reproducible results and therefore allows to quantify the influence of prophylactic and therapeutic measures on postischemic leukocyte endothelium interaction. PMID- 2767891 TI - A microcomputer-based system for mapping microvascular networks. AB - A new method has been developed for mapping microvascular networks using an IBM AT microcomputer and a video-microscope. After recording a vascular network on video tape, it can be reconstructed off-line using frame by frame analysis. A software tool, developed for mapping and editing networks, is used to prepare a montage of the network using a video cursor and mouse. Vessel lengths and diameters can also be measured from the video image using the same methodology. When the analysis is completed, the vessel network, together with a tabulation of lengths and diameters of individual vessels, can be displayed on a TV monitor or reduced to hard copy. This system provides a simple method for quantitative studies of arteriolar, venular and capillary networks. PMID- 2767892 TI - Abstracts presented at the 19th annual meeting of the Nordic Microcirculatory Society. Are, Sweden, February 2-4, 1989. PMID- 2767893 TI - Abstracts presented at the 4th annual meeting of the Benelux Society for Microcirculation. Amsterdam/The Netherlands, February 10, 1989. PMID- 2767894 TI - Independent effects of denervating the cricothyroid muscle and stenting on the anterior cricoid split: canine model. AB - The anterior cricoid split (ACS) has gained in popularity since its introduction in 1980, for the treatment of the difficult to extubate child. The procedure allows a successful extubation and avoids a tracheotomy about 75% of the time. How the ACS allows extubation remains poorly understood. Animal research has shown that in the canine model the ACS results in a gap in the cricoid cartilage with a subjective increase in the subglottic space (Senders and Eisele, 1978). This gap in the cricoid cartilage develops whether or not an endotracheal tube stent is used. This experiment was designed to quantitatively evaluate the effect of the ACS on the subglottic space with or without the use of the stent, and to evaluate the effect of the cricothyroid muscle on the ACS procedure. The results show that the ACS does result in an increase in the subcricoid space, and that the use of an endotracheal tube stent does result in a larger increase. The cricothyroid muscle has a strong immediate effect on the gap in the cricoid cartilage, which is eliminated by sectioning the external laryngeal nerve. The long-term effects of sectioning the external laryngeal nerve on the gap in the cricoid cartilage were not conclusive. PMID- 2767895 TI - Are click-evoked BAEPs useful in case of neonate hyperbilirubinemia? AB - There is still controversy about the usefulness of click-evoked brainstem auditory evoked potentials (BAEPs) for the investigation of neonatal hyperbilirubinemia. The present work concerns the study of click-evoked BAEP responses in a population of 72 hyperbilirubinemic children (conceptional age between 33 and 42 weeks). Their bilirubinemia rates were between 219 and 600 mumol/l. The waves I, III and V were always present, and click BAEP thresholds were normal in all subjects. Latency anomalies were found only for 8 of the 72 subjects. The comparison of subjects having the higher (greater than 307 mumol/l) bilirubin levels with the group having the lower ones failed to show any significant differences for the I-III and I-V intervals. The influence of prematurity in BAEP alteration has not been demonstrated in this study. These data show, on the one hand, normal click-BAEP thresholds but, on the other hand, alterations of central conduction time in some hyperbilirubinemic newborns. It seems that other factors than hyperbilirubinemia might be operating. PMID- 2767896 TI - Pneumococcal serum antibody concentrations during the first three years of life: a study of otitis-prone and non-otitis-prone children. AB - One hundred and thirteen children were followed prospectively from birth until the age of 3, serum being obtained from cord blood, and at the ages of 3, 6, 12, 18, 24, 30 and 36 months. Thirteen children developed recurrent acute otitis media (rAOM), 29 remained very healthy and the remaining children formed an intermediate group. Cord serum concentrations were determined of total IgG class, of IgG1 and IgG2 subclasses, as well as of specific IgG antibodies against the pneumococcal capsular types, 3, 6A and 19F. The specific pneumococcal IgG as well as IgA and IgM antibodies were also followed in the sequential serum samples up to the age of 3 in the rAOM and healthy children. Despite total IgG class and IgG1 and IgG2 subclass concentrations being of the same magnitude in cord serum of rAOM (median: 11.15, 7.48 and 2.16 g/l for IgG, IgG1 and IgG2, respectively) as in that of healthy children (median: 10.21, 8.16 and 2.16 g/l, respectively), both in cord serum and in most serum samples drawn during the first year of life, specific IgG antibodies against types 6A and 19F, but not against type 3, were significantly lower in the rAOM group than in the healthy children. In the intermediate group, cord serum concentrations of specific IgG antibodies to type 6A were of the same magnitude as in the healthy children. The only significant difference in specific IgM and IgA antibody concentrations against types 3, 6A and 19F between the two groups was noted for type 6A antibodies at 36 months of age where rAOM children exhibited lower values. The results indicate an association between pre-existing low specific IgG antibody levels against AOM associated pneumococcal types and the development of rAOM. PMID- 2767898 TI - Functional hearing loss in children. AB - This report reviewed 39 school-age children diagnosed as having a functional hearing loss utilizing auditory brainstem response (ABR) audiometry during the past 5 years at the Department of Otolaryngology, Kyushu University Hospital in Japan. Twenty-seven cases were females and 12 were males. Seven cases had a hearing loss unilaterally and 32 bilaterally. Although pure-tone audiometry revealed a variety of audiogram shapes, two-thirds of the cases had a flat or saucer-shaped audiogram with a mild to moderately severe hearing loss. ABR audiometry for the frequencies of 1, 2 and 4 kHz indicated a normal hearing threshold in 65 ears of 35 patients, and mild threshold elevations of at least one frequency in the remaining 6 ears of 4 patients. Three illustrative cases were demonstrated, and a discussion was held regarding the features in audiometric tests, and environmental factors surrounding the children with this condition. We emphasized that the physiological hearing measurement such as ABR audiometry should be performed when any discrepancy was noted between the patient's history and results of pure-tone audiometry, because of not infrequent occurrence of functional hearing loss. PMID- 2767897 TI - Extramedullary leukemia with central facial palsy originated from poorly differentiated abdominal lymphoma. AB - An 8-year-old boy was presented with central facial palsy caused by extramedullary leukemia which had originated from poorly differentiated abdominal lymphoma. On cerebral tomographic scanning, there were adherences in the basal area of the brain. The occurrence of central facial palsy is very rare in childhood leukemia. However, in this case facial palsy was central in type and appeared as the presenting sign. The occurrence of central facial palsy was confirmed by the absence of clinical, radiological and audiological signs of peripheral involvement. The contralateral stapedius reflex test (500, 1000, and 2000 Hz) was present in this case. PMID- 2767900 TI - Laryngotracheal involvement in epidermolysis bullosa. AB - Epidermolysis bullosa (EB) is a rare hereditary skin disease of infancy that can involve the mucous membranes of the oral cavity. Laryngotracheal involvement is rare. The disease is characterized by bullae formation in response to minor trauma. There are at least 18 described types of EB, however, there are 3 basic categories. These are simplex (with disruption above the basement membrane), dystrophic (in which disruption is below the basement membrane), and junctional (in which the split is within the lamina lucida). The prognosis of the different types ranges from early death usually secondary to overwhelming sepsis, to long term survivals with lack of growth retardation or significant dystrophic scarring. Presently, survival appears to be the only reliable criteria for distinguishing the benign and lethal forms of EB. Airway obstruction secondary to laryngotracheal involvement should be considered in any child with epidermolysis bullosa presented with symptoms of respiratory distress. Because there are few predictive prognostic indicators in the neonatal period, tracheotomy should be considered early in an effort to prevent further laryngeal injury from intubation, in those patients that will survive. PMID- 2767899 TI - Laryngotracheoplasty in the management of subglottic stenosis. AB - Laryngotracheoplasty (LTP) has revolutionized the surgical management of subglottic stenosis in children. A 10-year review of patients at the Children's Hospital of Philadelphia yielded 27 patients who had undergone a LTP. LTP with an anterior cartilage graft was utilized in over 80% of procedures. Morbidity was minimal, and there were no deaths. In this series, 78% of patients have been successfully decannulated. LTP has reduced the time necessary for decannulation in children with chronic tracheostomies as a result of subglottic stenosis. PMID- 2767901 TI - Abstracts of the Sixth International Australasian Winter Conference on Brain Research. Queenstown, New Zealand, 19-24 August 1988. PMID- 2767903 TI - Effect of forced unilateral nostril breathing on blink rates: relevance to hemispheric lateralization of dopamine. AB - The involuntary blink rate is a clinical monitor of dopaminergic activity. Since there is disagreement in the literature on the relative neurochemical hemispheric asymmetry or laterality of dopamine, we studied the effects of differential forced unilateral nostril breathing on blink rate. This technique has been demonstrated to induce selective contralateral hemispheric stimulation as measured by relative increases in the EEG amplitude as well as alternating lateralization of plasma catecholamines. We used the artifact of the two-channel electro-oculogram to measure the endogenous eyeblink in an N = 1 design with 11 reversals of left vs. right hemisphere activation. There was a significant increase in blink rate (p less than .01) with right hemisphere activation, and this suggests that dopamine may be lateralized to the right cerebral hemisphere. PMID- 2767902 TI - On the use of fibroblasts in tissue culture to study the neurochemistry of brain mechanisms controlling blood pressure. AB - Fibroblasts grown in tissue culture from skin biopsies taken from the genetic model of spontaneously hypertensive rats (SHR), show a reduction in the accumulation of choline when compared to fibroblasts grown from skin biopsies taken from normotensive Wistar Kyoto rats. Choline uptake by fibroblasts from both strains of rats is sodium dependent but there is no difference between the strains in the effects of sodium depletion. These results suggest that fibroblasts in tissue culture may be a useful source of tissue for analyzing differences between hypertensive and normotensive individuals that are genetically determined rather than due to prolonged exposure to elevated blood pressure. In addition, the fibroblast shares several biochemical characteristics with the neuron and, at least as far as these common characteristics are concerned, appears to be a good model for neurochemical study. PMID- 2767904 TI - The protective function of beta-endorphin in movement disorders. PMID- 2767905 TI - Short latency somatosensory evoked responses to median nerve stimulation in healthy humans: electric and magnetic recordings. AB - Somatosensory Evoked Potentials (SEPs) and Somatosensory Evoked magnetic Fields (SEFs) to median nerve stimulation at wrist were recorded in 5 healthy subjects and the components between 15 and 30 ms after the stimulus were evaluated on the hemiscalp contralateral to the stimulated wrist. SEPs were measured by means of a 32-channel recorder and compared with SEFs obtained via multiple measurements with a 4-channel sensor. Equivalent dipole localization was carried out for the magnetic components peaking at about 15, 20 and 24 ms. The scalp distribution of SEPs, illustrated by bit mapped color images, were qualitatively explained by three separate sources. The first is described as a tangentially oriented dipole placed behind the Central Sulcus and responsible for the parietal N20-"late P25" waves and for the frontal P20-N30 ones. The second is represented by a radieal dipole placed just in front of the Central Sulcus and pointing towards the motor strip, responsible for the rolandic P22 component. The third is just behind the Central Sulcus and is radieally oriented towards the surface of the postcentral sensory area for the "early P25" parietal wave. The SEFs distributions, illustrated by color isofield contour maps, were quantitatively explained by a unique tangential dipole localized, with good resolution, well behind the Sulcus for the 15 ms waves and slightly frontal to this site for the waves peaking at around 20 and 24 ms. The equivalent dipole has been localized at a depth of about 5 cm (15 ms component), 2 cm (20 ms components) and 4 cm (24 ms component), across the studied subjects. It is stressed that the dipole responsible for the magnetic pattern is likely to be the same tangential dipole responsible for a part of the electric pattern. Due to their radieal orientation, the other two dipoles, proposed for the SEPs maps, would be mostly undetectable by a magnetic investigation. PMID- 2767908 TI - An approach to evaluating the introduction of primary nursing in an acute medical unit for the elderly--I. Principles and practice. AB - The paper reviews the research literature on primary nursing and some of the problems in research methodology which have been identified. It sets out the 10 principles which are the basis on which primary nursing will be introduced in an acute elderly care ward. The problem of outcome measures is discussed and a research design proposed. PMID- 2767907 TI - Primary nursing: opinions of nursing staff before and during implementation. AB - The aim of this investigation was to consider the opinions of the nursing staff concerning the effects of primary nursing before and after the transition to this mode. Data were collected using a self-administered questionnaire which was answered by 62 registered nurses and practical nurses before the introduction of primary nursing and 58 such nurses five months after its introduction. The nursing staff reported both more favourable and detrimental effects during primary nursing than beforehand, the former including the improved opportunities for nurses to get to know their patients and to provide individual care, and the latter the increase in paperwork. The role of the primary nurse was mainly felt to be positive, but sometimes difficult and laborious. PMID- 2767909 TI - An approach to evaluating the introduction of primary nursing in an acute medical unit for the elderly--II. Operationalizing the principles. AB - The first paper set out the 10 principles which formed the basis on which primary nursing has been introduced in an acute elderly care ward. This paper explores the problems of expressing these principles in terms which make it possible to demonstrate that changes in the way nurses approach their patients and their work have really taken place and suggest some of the research strategies which might be appropriate. PMID- 2767906 TI - The effect of education and written material on compliance of pediatric clients. AB - One hundred and fifty babies and their mothers, presenting to the Well Baby Clinic of the Pediatric Outpatient Department were studied for compliance. They were divided randomly into three groups, one serving as a control (n = 55) and two as experimental groups (n = 48 and 47). The latter were exposed to two different intervention methods; teaching and written material respectively, in addition to the routine care given to the control group. The three groups were compared in terms of compliance and improvement in knowledge. The results showed that reinforcement of the doctor's advice by a nurse, or written instructions to the patients, did not improve knowledge or compliance. Possible explanations for such results are given and suggestions for other modes of intervention are made. PMID- 2767910 TI - The effect of play on immobilized children in hospital. AB - Organized play is not always given a high priority in the hospitalized child's total care with the result that insufficient time is allocated to its provision in the nursing care plan. The effects of such incomplete patient care are far reaching for the immobilized child in hospital. The study was designed to determine if a difference existed in the perception of time, social space and self for two groups of immobilized children in hospital. An experimental design was used. Sixty immobilized children were randomly assigned to the experimental or control group. Children in the control group were exposed to the regular ward stimuli while the experimental group participated in four periods of planned play designed to expand the child's life space. Children were interviewed following the play periods and data analysed using quantitative and qualitative analysis. Findings indicate that immobilized children exposed to planned play periods expressed more positive feelings toward themselves and significant others than the control group. As well, findings indicated that hospitalized immobilized children were in a state of waiting and increased vigilance which resulted in the dragging of time and loss of temporal integrity. PMID- 2767911 TI - The competency quagmire: clarification of the nursing perspective concerning the issues of competence and informed consent. AB - Selected issues involved in informed consent and the patient's competence to give it are examined. A discussion of tests of competence reveals some of the problems encountered in using them. There are differences in medical and nursing functions and responsibilities in the informed consent process. One nursing framework, self care, is used to discuss whether informed consent should be obtained from patients when they receive specific nursing care. PMID- 2767913 TI - Health education in the scientific production of the graduate program of the Nursing School of Ribeirao Preto, University of Sao Paulo, Brazil. AB - There are eight institutions offering a total of 10 masters courses in nursing in Brazil. The Nursing School of Ribeirao Preto, University of Sao Paulo (EERP-USP) offers a doctoral course in nursing. The school has been recognized as an Investigation Reference Center for Latin America by the WHO. The purpose of the study was to determine how health education has been studied in the production of graduates at the Nursing School of Ribeirao Preto, USP. The study field consisted of 87 thesis and dissertations produced since the inception of the graduate course (1977-1987). Studies in the educational function category represented 20% (18) of the sample. Among them six studies envolved the situation of nursing student education, 10 patient/client education, and two education of the nursing staff. The results showed the learning process is not covered the learning process. The findings suggested future studies will move from the 'diagnosis' of information needs to analysis of changes. PMID- 2767912 TI - Depression, somatization and steroid use in chronic obstructive pulmonary disease. AB - Steroid therapy has become part of the adjunctive treatment for COPD patients in some settings. Emotional changes have been reported in some patients while on these medications, but whether these changes are associated with the pathophysiological state or a side effect of the medication is not known. In this study self-reports of depression and somatic complaints were compared between two groups of COPD patients, 20 not receiving steroids and 20 receiving steroids. Both groups demonstrated comparable levels of disease and somatic complaints. Mean FEV1 value for those not receiving steroids was 34% of predicted while the mean for those receiving steroids was 30% of predicted. Depression was found to be significantly higher (t = 11.21, df = 38, p less than 0.01) in the group receiving steroids when compared to those not receiving steroids using a Student's t test. The higher degree of depression among steroid treated COPD patients has implications for clinical practice. The emotional status of this group of patients needs to be monitored and interventions initiated when necessary. PMID- 2767914 TI - Making the case for nurses as managers of health services. AB - Her experience with the restructuring of the health service in the UK as general manager of Waltham Forest Health Authority places Christine Hancock in an ideal position to demonstrate nurses' efficiency in the health service and the necessity of putting them in charge. Below, she follows the evolution of the UK's National Health Service and British nursing to prove her point. PMID- 2767915 TI - Making the case for nurses as managers of nursing resources. AB - The management of nursing services is challenging, fascinating, demanding and creative, but becomes more so in a country organizing its health care infrastructure from scratch and looking for new innovative solutions. Zimbabwe is such a country. And with nurses comprising 75-80% of its health care personnel and being increasingly given more responsibilities, the task of managing this valuable resource becomes formidable. Below, the author reports on how nurse managers are meeting their new challenge. PMID- 2767916 TI - AIDS: the threat to children. PMID- 2767917 TI - The changing scene in health care management. AB - Health care systems aren't what they used to be...and are changing, as is current thinking on how a health care organization should be administered. Below, Gillian Biscoe looks at today's health care scenario and finds a place for nurses in it. PMID- 2767918 TI - Preparation of nurse managers. AB - What special skills do nurses require to become effective managers? And how can these skills be developed? Below, Dorothy del Bueno presents the challenges and proposes some ways on how nurses can acquire management expertise. PMID- 2767919 TI - The outlook for nursing in India. AB - Nursing in India is probably at the most critical stage in its history, its future hinging on many factors--i.e. major nursing education reforms, a budget for development, improved working conditions/staffing norms and a higher status in the health care system. Below, Prem Mehra examines nursing development in India and urges nurses and the public to push for the changes needed to attain Health for All by the year 2000. PMID- 2767921 TI - Nonresponse on the Center for Epidemiological Studies-Depression Scale in Chinese Americans. AB - This paper examines the phenomenon of nonresponse on the CES-D in a group of Chinese-American. Of the 403 respondents, 43 missed 1 to 4 CES-D items and 43 missed more than 4 items. The completers were likely to be younger and better educated men. Those who missed up to four items were likely to be middle-aged men, and missed the positive items most frequently. This was discussed within the context of Chinese cultural values. The group who missed more than four items were likely to be older women. For them, nonresponse may be a result of unfamiliarity with survey research and reluctance to share personal experiences with strangers. Implications of this investigation are discussed. PMID- 2767920 TI - The profile of parasucide repeaters in Kuwait. AB - A one-year cohort of 92 parasuicides was followed up at 6 monthly intervals for a period of 2 years since their index parasuicide to study the outcome and evaluate the level of social readjustment. One male patient died of suicide (1.1%) and 18 (19.6%) individuals repeated parasuicide using self-poisoning. The rate of repeated parasuicidal behaviour in this investigation was considerably higher than that reported in comparable studies from developing countries but similar to that from a number of western European cities. The data indicated that the probability of further episodes of parasuicidal behaviour increased in the few months after the index episode. Although the repeaters and non-repeaters were essentially similar in most of their sociodemographic characteristics, the former were a distinctive group in many respects. The factors found to be significantly associated with subsequent parasuicide included self-poisoning by prescribed drugs at the index parasuicide, previous parasuicidal behaviour prior to the index, occupational status of a housewife, past history of depression and/or dependence and precipitating life events in the family environment. Contrary to our hypothesized theory, none of the types of attitudes received by the patients from their family members at the index parasuicide related to outcome. The global level of social readjustment of non-repeaters was about three times higher than that of repeaters of parasuicide. The implications of these findings for future policy making were discussed with respect to prevention of parasuicide. PMID- 2767922 TI - Which neurotic patients are treated with psychotherapy? AB - Of 336 newly referred cases of neurosis 170 (51%) were offered psychotherapy. The factors associated with being offered this treatment were: a diagnosis of anxiety neurosis or phobic neurosis, not having had a history of deliberate self harm, living not more than 20 miles from the hospital, being less than 51 years of age, and being either married or single. Sex, duration of disorder, socio-economic status, employment status, a history of alcohol abuse and a family history of mental disorder had no significant bearing on whether or not patients were offered psychotherapy. PMID- 2767923 TI - Attitudes towards psychoses and psychotic patients in Beijing. AB - The issue of public health education regarding mental illnesses has been relatively low profile in the People's Republic of China. A questionnaire study was carried out on 3,028 lay members of the Beijing population to ascertain their knowledge of opinions concerning and attitudes towards the mentally ill. Very few subjects had systematic knowledge about mental illness and nearly half had no acquired knowledge at all. On the whole they were sympathetic towards the mentally ill and towards provision of high quality mental health care. Despite this sympathy a small proportion still attributed mental illness either to 'ghosts', 'retribution for ancestors' evil deeds' or 'bad thoughts'. Superstitious ideas were clearly related to low educational attainment. The attitudes of family members of psychotic patients were explored in greater detail. PMID- 2767924 TI - Psychiatric referrals in a neuropsychiatric centre. AB - Consecutive new cases were screened to identify those referred by other specialties. The referred cases were compared with a randomly selected control group from the non referred cases. Referred cases constituted 16.4% of all the clinic new cases but the demographic characteristics were similar to those of the other clinic cases. Functional somatic complaints were significantly more often (p less than 0.01) reported by the referred cases. Depressive and anxiety symptoms were also significantly more often observed in the referred group (p less than 0.01). Most of the referred cases had identifiable psychiatric problems which could be managed in an out-patient setting. Studies on referral patterns and modes of clinical presentation are useful in planning and organising consultation liaison services in general and specialist centres. PMID- 2767925 TI - Self poisoning in Sri Lanka: motivational aspects. AB - Sri Lanka is a developing Asian country with high suicide rate due to self poisoning, related to a high fatality rate. A study of motivational aspects of self poisoning in 97 consecutive patients showed that there is no greater intention of suicide in them than those from the developed countries. Interpersonal disputes involving domestic problems and love affairs are the main precipitating causes. Improving family relations may help in the prevention of self-poisoning. However the impulsive nature of the act might prove prevention a difficult task. PMID- 2767926 TI - Comparison of tumor cell invasion assays: human amnion versus reconstituted basement membrane barriers. AB - This study compares two well-known tumor cell invasion assays: the human amnion model versus the reconstituted basement membrane (RBM) system in the membrane invasion culture system (MICS). Our purpose was to present the quantification of tumor cell invasion using visual counts and radioactivity assessment in a side-by side comparison and then to determine reasons for discrepancies in data collection and reporting. Basically, the data showed that: (1) fewer tumor cells invade the amnion membrane compared with the RBM, and substantially more variability exists among the data generated from the amnion assay (probably due to differences in membrane thickness); and (2) the invasive ability of the tumor cells appears to be greater using the radiolabel technique in both the amnion and RBM assay, a portion of which appears to be artifactual. Using the RBM, it was possible to sequentially select several subpopulations of highly invasive tumor cells, which was not possible with the human amnion. The invasive and metastatic potentials of these subpopulations were compared with those of established cell lines (selected in vivo). When analyzed independently, a direct relationship was shown between an increase in invasive ability and an increase in metastatic potential for the sublines selected in vitro and the established lines. However, collectively, it is more difficult to correlate the invasive and metastatic profiles of the sublines versus the established lines, which can probably be attributed to selection factors present during the establishment of the individual cell populations. PMID- 2767927 TI - Mechanisms of platelet activation by cultured human cancer cells and cells freshly isolated from tumor tissues. AB - We studied the effects on platelet function of cells isolated from freshly dissociated human tumor tissues (11 breast carcinomas, 9 colon carcinomas and 1 lymph node metastasis from melanoma) obtained at surgery as compared with cultured human tumor cells: namely, human melanoma 1402 cell line derived from a primary tumor and two lines derived from lymph node metastases (ME 7110/2 and Me 665/1) as well as a human hepatoma cell line (Hep G2). The three melanoma cell lines activated platelets by producing ADP, as evidenced by the inhibitory effect of apyrase and by the direct measurement of the agonist in the supernatants of tumor cell suspensions; this production was much greater by the cells derived from metastases than by the cells derived from the primary tumor. On the other hand, aggregation induced by Hep G2 hepatoma cells was unaffected by apyrase and was inhibited by hirudin or concanavalin A, suggesting that the cells aggregate platelets by producing thrombin, probably through tissue factor activity of the cells themselves. Cells isolated from 16 of the 21 human tumor tissues possessed a potent platelet-aggregating effect, which was not inhibited by apyrase, hirudin or concanavalin A, but was virtually abolished by the cysteine protease inhibitors iodoacetic acid or p-hydroxymercuri-phenylsulfonate. Collectively, our data demonstrate that cells isolated from freshly dissociated tumor tissues activate platelets through tumor-associated cysteine proteinases rather than by the ADP- or thrombin-dependent mechanisms characteristic of cultured human tumor cell lines. PMID- 2767928 TI - Invasion and metastasis of Lewis lung carcinoma in the mouse uterus. AB - Patterns of Lewis lung carcinoma (LLC) cell invasion, colonization and metastasis were studied in C57 mouse uteri. LLC cells (5 X 10(4) in 0.05 ml) were infused nonsurgically into nonpregnant and pregnant uteri, 3 days postcoitum. The fate of cells was studied histologically on days 2, 5 and 18 posttreatment (PT). Despite a large degeneration of LLC cells in the lumina of both the pregnant and nonpregnant mice, in 38% of these uteri, tumor cells had invaded the endometrium by day 2 PT. However, subsequent distribution of tumor cells differed remarkably between the pregnant and the nonpregnant uteri. By day 5 PT, in 66% of the nonpregnant mice, tumor cells were common in the endometrium and metastases in other organs were seen in 40% of the animals. But in the pregnant mice only 40% uteri showed tumor cells and no metastasis was recorded. On day 18 PT tumor cells were rare in the nonpregnant uteri, but significantly, 75% of those animals showed lung and liver metastases. In pregnant mice, tumor cells neither survived in the uteri nor metastasized to other organs. LLC cells, infused into nonpregnant uteri, promptly metastasized to lungs without colonizing the uteri: this unique system may provide insight into the effects of organ-specific host factors on the growth and metastatic potential of tumor cells. PMID- 2767929 TI - Endoscopic treatment of urinary tract calculi. AB - Removal of urinary tract calculi by endourological techniques is now widely practised and has reduced the indications for open surgical removal to a minority of cases. A review of 270 consecutive patients who presented to the Meath Hospital Urology department with urinary tract calculi and were treated by percutaneous or transurethral endoscopy is herein reported. The rates of successful clearance of renal (95%) and ureteric (78%) calculi compare well with previous reports. The majority of complications were minor and a low overall complication rate was experienced at ureterorenoscopy. In our experience, endourological treatment of urinary tract calculi is successful, efficient and safe and is the recommended approach to urinary tract calculi that require surgical intervention. PMID- 2767930 TI - A study of emotion and behaviour in children attending a normal school in an urban area. AB - Anxiety, depression, self-esteem, behavioural deviance and prosocial behaviour were studied in children attending a normal school in a disadvantaged urban area, using self-rated and teacher-rated questionnaires. The prevalence of depression was rated as 5%. 15% described frequent suicidal thoughts. 40% scored as behaviourally deviant. Significant correlations were found between the variables studied. The rates of depression and behavioural deviance were higher than in comparable British populations. PMID- 2767931 TI - Perinatal mortality 1986 & 1987. PMID- 2767932 TI - Analysis of night-time and weekend otolaryngology service. AB - The night-time and weekend otolaryngology service provided to an urban population slightly in excess of half a million people in analysed over a six month period. During this time, 147 calls were received, of which 116 (79%) required a hospital visit by the Registrar-on-call. Children accounted for 39% of patients seen and adults 61%. The problems encountered were in keeping with traditional perceptions of otolaryngology. The most common diagnosis necessitating a hospital visit was a suspected foreign body in the upper aerodigestive tract (39 cases), followed by epistaxis (28 cases) and some form of ear sepsis (12 cases). There was a noticeable lack of primary involvement in such areas as facial and neck trauma. PMID- 2767933 TI - A case of IgA nephropathy associated with vitiligo, primary hypothyroidism and primary adrenocortical insufficiency. AB - A 14 year old boy presented with recurrent attacks of macroscopic haematuria preceded by tonsillitis. Clinical examination revealed generalised vitiligo. Renal function was normal with microscopic haematuria. Percutaneous renal biopsy showed mesangial proliferation on light microscopy with deposition of IgA and IgM in a granular pattern in the mesangium and glomerular basement membrane compatible with a diagnosis of IgA nephropathy. Biochemical investigations revealed primary hypothyroidism and primary adrenocortical insufficiency with negative organ specific autoimmune screen. Renal function has not deteriorated after three years follow-up. This particular association has not been previously described to our knowledge. PMID- 2767934 TI - A case of Graves' disease associated with autoimmune haemolytic anaemia. AB - This report describes simultaneous autoimmune thyrotoxicosis and autoimmune haemolytic anaemia. Autoimmune haematological abnormalities should be excluded in patients with Graves' disease and thyroid function and thyroid antibody status should be evaluated in patients with autoimmune haemolytic anaemia. PMID- 2767935 TI - Small batch control projects. PMID- 2767936 TI - Role of the cerebellum in complex human behavior. AB - Thirty-three outpatient epileptics with normal CT scans (group 1) and 31 patients with cerebellar and brain stem (CBS) atrophy (group 2) were randomly included in this study. There were no significant statistical differences between the groups with regard to age, education, and number of grand mal and other seizures. Statistical analyses showed that group 2 had a longer history of epilepsy with a consequently longer duration of phenytoin (PHT) consumption. Neuropsychological assessment revealed lower performance by this group on the following measures: full I.Q. scale, verbal I.Q. scale, performance I.Q. scale, information, arithmetic, block design, object assembly, digit symbol, Stroop test forms I and II, the B-M dexterity test, and the simple visual and auditory reaction time. No significant differences were observed between the two groups for the remaining 5 subtests from the WAIS scale, for the immediate recall and the delayed recall subtests belonging to Wechsler memory scale as well as for visual and auditory movement time. Analysis of the composite scores of neuropsychological performance showed that the cerebellum interferes with the following complex behavioral functions: (i) visuo-spatial organization for a concrete task, a function related to the cerebello-parietal loops' (ii) planning and programming of daily activities, a function related to the cerebello-frontal loops; and (iii) the speed of information processing, a mainly subcortical function. PMID- 2767938 TI - A parkinsonian kindred. AB - We report 8 cases of clinical idiopathic Parkinson disease in one kindred. None of the patients presented anomalous symptoms and all responded normally to routine L-Dopa therapy. On the basis of these findings we analyse the possible etiological role of heredity in Parkinson disease. PMID- 2767937 TI - Multinucleated giant cells in AIDS encephalopathy: an immunohistochemical study. AB - We report the neuropathological findings of 5 post-mortem cases of AIDS. The most common causes of the death were multiple opportunistic infections associated with cutaneous and/or visceral Kaposi sarcoma in two cases. Cerebral edema, demyelination and spongiosis of the white matter were present but the most remarkable finding was the presence of multinucleated giant cell (MGC) within and nearby microglial nodules. On immunohistochemical investigation MGC and microglial cells exhibit positive stain only for RCA I and Ferritin, while immunohistochemical markers for astrocytes, neurons, macrophages, histiocytes, lymphocytes and endothelial cells were negative. No microrganism, nor viral inclusions were detected. These results support the hypothesis that MGC may be derived from microglial cells. PMID- 2767939 TI - Peripheral nerve conduction velocity in normal infants and children. AB - Maximum motor conduction velocity of the median, ulnar and peroneal nerves and maximum sensory conduction velocity of the median nerve have been studied in 635 children, below 12 years of age, free from peripheral nervous system disease. The children fell into four age-group: from 0 to 1 year; from 1 to 3 years: from 3 to 6 years; from 6 to 12 years. No normal values were recorded for the sensory conduction velocity of the median nerve under the age of one year. The motor conduction velocity values significantly rise for the median and ulnar nerves up to 1 year, for the peroneal nerve up to 3 years. The sensory conduction velocity values of median nerve increase significantly up to 6 years. PMID- 2767940 TI - Considerations after intraoperative monitoring of somatosensory evoked potentials during carotid endarterectomy. AB - Somatosensory evoked potentials (SEPs) following median nerve stimulation were used to monitor cerebral function during 26 carotid endarterectomies. The patients with minor SEP variations had no neurological deficits on regaining consciousness while the one with more serious SEP variations had a transient deficit. The method thus seems useful in the early detection of ischemic brain impairment. PMID- 2767941 TI - Effect of subconvulsive doses of bicuculline on the incorporation of radioactive precursors into glycerolipids in rat brain areas. AB - Bicuculline (either 25 mumol or 12.5 mumol/kg body wt) was administered to rats by intraperitoneal route. Animals treated with 25 mumol/kg experienced convulsions, whereas those receiving 12.5 mumol/kg did not. Controls received saline instead of the drug. Radioactive precursors [2-3H] glycerol and/or [1,2 14C] ethanolamine were injected into cerebral ventriculi simultaneously with bicuculline and the rats were killed 12 min afterwards. Their brains were dissected by hand into four parts (cerebellum, brain stem, hippocampus, cerebral cortex) and the labeling of lipid classes determined after extraction and separation. Although glycerol was incorporated into lipid better than ethanolamine in all areas, the fate of the injected radioactive precursors varied according both to area and treatment. The lowest uptake of radioactivity was in the cerebral cortex and the highest in the brain stem and hippocampus. Moreover, the administration of bicuculline influenced the distribution of radioactivity among lipid classes; these variations, however, were not dependent on the administered doses of bicuculline. We conclude that the effects on glycerolipid metabolism observed in convulsing animals are due to several causes including alterations of systemic parameters (hypertension, hypoxia, etc.). The distribution of glycerol label between phospholipid and neutral lipid is proposed as a biochemical model for the study of convulsive and subconvulsive states. PMID- 2767942 TI - Recurrent inhibition in human spinal spasticity. AB - The study was performed on a group of 17 patients with spastic paraparesis: 12 with hereditary spastic paraparesis, 3 with cord compression and 2 with complete spinal transection. 10 healthy volunteers acted as controls. Recurrent inhibition of the soleus alpha-motoneurones was estimated at rest and during voluntary contraction of triceps surae. At rest, there was evidence for a substantial decrease in the excitability of Renshaw cells in 9 out of the 12 patients with hereditary spastic paraparesis; this was also observed in the 2 patients with complete spinal transection, while the 3 patients with cord compression exhibited a normal Renshaw cell activity. In 3 out of 4 patients with hereditary spastic paraparesis, the changes in Renshaw cell excitability expected to occur during voluntary contraction were not found, whereas in one patient with hereditary spastic paraparesis and one with spastic paraparesis due to cord compression recurrent inhibition was normally influenced by the motor command. Our results indicate that recurrent inhibition is likely to be differently affected according to the type and/or localization of the lesion. It is also suggested that the central nervous system might control the excitability of Renshaw cells at rest and during voluntary contraction via partly separate pathways. The role of recurrent inhibition in spasticity is discussed. PMID- 2767943 TI - Neurological complications of Schoenlein-Henoch syndrome: contribution of MR to the diagnosis. Case report. AB - In the protean clinical pattern of the Schoenlein-Henoch syndrome the central and peripheral nervous system signs and symptoms are of most uncertain epidemiological importance and of most debatable physiopathological status. In the case reported the contribution of nuclear magnetic resonance to the diagnosis proved to be greater than that of computed tomography because it imaged the CNS lesions. PMID- 2767944 TI - Spontaneous recanalization of carotid artery occlusion following non traumatic dissection. AB - We studied 7 patients with internal carotid occlusion following spontaneous arterial dissection. All presented strokes, in one associated with Horner's syndrome. The doppler examination showed carotid occlusion, but only angiography established the diagnosis of vascular disease. Spontaneous recanalization was observed in 6 cases, treated only by antiplatelet drugs. PMID- 2767946 TI - Parkinson disease in farm workers. PMID- 2767947 TI - Nonvenereal treponemal disease. PMID- 2767945 TI - Neurophysiological follow-up in a case of chronic progressive epilepsia partialis continua of childhood. AB - We report the waking and sleeping polygraphic and evoked potential data recorded during the follow-up of a child with chronic progressive epilepsia partialis continua of childhood (Bancaud's type II). The findings that emerged from these investigations coupled with the clinical pattern enabled us to delineate the course of this rare condition and provided clues for a tentative interpretation of the pathogenesis of the repetitive myoclonic jerks typical of epilepsia partialis continua, on which there is as yet no consensus. In our case involvement of cortico-subcortical systems seems probable. PMID- 2767949 TI - The renal carcinogenic effect of Merpafol in the Fischer 344 rat. AB - Three groups of Fischer 344 rats were fed Merpafol (Makhteshim, Israel), an agricultural fungicide, in increasing concentrations for a period of 2 years. A control group was maintained under identical conditions, but without the addition of the fungicide in the diet. A range of nonneoplastic and neoplastic lesions were observed in the kidneys of rats fed Merpafol. The histogenesis of the renal tumors is discussed in relation to chemical-induced epithelial hyperplasia and cystic tubular dilation. Comparative aspects of renal cyst development and carcinoma in humans are also discussed. PMID- 2767948 TI - Benzene-derived free radical--a possible mediator of its carcinogenicity. I. Ultrastructural and functional studies on the effect of benzene on human white blood cells and its possible prevention. AB - The assumption that benzene exerts its leukemogenic action on cell components after being converted to a transient and relatively stable free radical is supported by the in vitro effect of benzene on the ultrastructure of human peripheral blood polymorphonuclear (PMN) cells, lymphocytes and monocytes. The effect was examined with a transmission and scanning electron microscope and was found to affect both the internal and external architecture of PMN cells and monocytes in a dose-dependent manner. No effect was observed on lymphocytes. Benzene did not affect the phagocytic activity of PMN cells or monocytes. Preincubation with 2-aminoethylthiosulfuric acid, a free radical scavenger, prevented the observed effects of benzene. PMID- 2767950 TI - End-stage renal disease replacement therapy in Israel: demographic and regional differences. AB - Incidence (by sex and ethnic group), prevalence and mortality rates (by age) of end-stage renal disease (ESRD) replacement therapy in Israel were calculated for the periods 1975-78 and 1979-82. Rates were higher for males (relative risk male/female 1.70 for the first period and 1.83 for the second). Incidence and prevalence rates increased with age among men; among women the maximal rates were attained by the 45-64 age-group. Incidence and prevalence rates were higher during the second period. Among the Jewish population, rates of treatment were higher in the Asian and African-born groups, and European-American and Israeli born Jews showed the lowest rates. Mortality rates during treatment were lower among Arabs. Rates of therapy rose with age, were higher for males and had a well defined ethnic pattern. In order to assess differences in ESRD replacement therapy between districts, rates of incidence, prevalence and mortality during treatment (for the Jewish population) were computed by district and adjusted by age and continent of birth for both periods. Significant differences in ESRD therapy coverage were detected only during the second period. Prevalence rates were considerably higher in the central, Tel Aviv and southern districts, and incidence rates were considerably elevated in the central and Tel Aviv districts and low in Jerusalem. Mortality during treatment was lowest in Haifa. It seems improbable that these findings are due to differences in accessibility to ESRD replacement therapy; however, early diagnosis and prevention of disabling kidney conditions at the primary care level may play an important role. PMID- 2767951 TI - Erythema multiforme minor associated with Mycoplasma pneumoniae infection. AB - A young Bedouin woman with serologically proven Mycoplasma pneumoniae infection is presented. Along with pulmonary involvement, fever and bullous myringitis, she presented with erythema multiforme minor, a rare complication of mycoplasma infection of which many physicians may not be aware. The skin participation in mycoplasma infections is discussed. Mycoplasma infection should be considered in the differential diagnosis of erythema multiforme. PMID- 2767952 TI - Treponemal bone disease in an Ethiopian immigrant. PMID- 2767953 TI - Serum amyloid-A protein concentrations in sarcoidosis. PMID- 2767954 TI - Blood pressure measurements in Druze children. An extension of the Nahariya Study. PMID- 2767955 TI - Annual meeting of the Israel Heart Society. 24 January 1989, Tel Aviv, Israel. Abstracts of papers. PMID- 2767956 TI - Protection from O,O,S-trimethyl phosphorothioate-induced immune suppression. AB - Acute administration of nontoxic doses of an impurity in technical malathion, O,O,S-trimethyl phosphorothioate (OOS-TMP), was able to block the in vitro generation of cytotoxic T lymphocytes (CTL) to alloantigen and antibody-secreting cells (Ab) to sheep red blood cells (SRBC). The effects of an antagonist of the delayed toxicity and lung damage of OOS-TMP, O,O,O-trimethyl phosphorothionate (OOO-TMP), and pretreatment of tolerance-inducing doses of OOS-TMP on OOS-TMP induced immune suppression were examined. Treatment groups included (A) acute administration of OOO-TMP, (B) coadministration of OOO-TMP with OOS-TMP (at concentrations which have been shown previously to block lung toxicity). (C) repeated (4 x on consecutive days) administration of OOS-TMP (which was shown previously to block a lung toxicity which occurs following a challenge with OOS TMP) and (D) repeated administration of OOS-TMP followed by a challenge dose of OOS-TMP 24 h before death. There was no change in lymphoid organ size following any of these treatments. However, splenocytes from animals that were exposed to treatment regimes A, B and D had significantly elevated proliferative responses to mitogens concanavalin A (ConA) and lipopolysaccharide (LPS). The ability of splenocytes to generate an Ab response to SRBC was significantly elevated following treatment regime A and at the lower dose in treatment regime D. All other treatment protocols did not alter this immune parameter. There was no difference in the ability of splenocytes to generate a CTL response following these treatment regimes. In conclusion, the degree of protection from immune suppression by these treatments which have been shown to protect against lung toxicity varied with the sensitivity of the immune parameters to suppression by acute administration of OOS-TMP. PMID- 2767957 TI - Ovarian hormones, antiestrogen and pregnancy effects on the expression of class II histocompatibility antigens by N-nitroso-N-methylurea-induced rat mammary carcinomas. AB - Hormonal modulation of Class II histocompatibility antigen expression was studied in female Sprague-Dawley rats with N-nitroso-N-methylurea-induced mammary tumors. The effects of ovarian hormones, pregnancy and lactation were examined when cancers appeared. At this time, rats with tumors were divided into several groups. Different groups received respectively 17 beta-estradiol alone, 17 beta estradiol in association with progesterone, and tamoxifen alone. Other groups were selected to undergo pregnancy. The control group received carcinogenic treatment only. For all removed tumors, Class II histocompatibility antigens were radiolabeled, specifically immunoprecipitated with monoclonal antibody and quantified by chromatofocusing. The amount of Class II histocompatibility antigens measured in NMU-induced rat mammary tumors without any hormonal treatment decreased significantly after treatment with estrogen alone or in association with antiestrogen and during the pregnancy. Nevertheless, Class II histocompatibility antigen expression was not changed in mammary carcinoma from rats receiving progesterone, but increased significantly during the lactation. These results demonstrated clearly that ovarian hormones change the Class II histocompatibility antigen expression of NMU-induced mammary tumors in female Sprague-Dawley rats. PMID- 2767958 TI - Suppression of lymphocyte mitogenesis by tamoxifen. AB - Tamoxifen (at 0.1-1 microM concentrations) inhibited significantly the response of rat spleen cells to phytohemagglutinin, concanavalin A, pokeweed mitogen and lipid A in a dose-dependent manner. To achieve this inhibition, it was sufficient to expose the lymphocytes for 4 h to tamoxifen prior to mitogenic stimulation. Estradiol did not have a consistent effect on lymphocyte mitogenesis under the same conditions and did not modify the suppressive effect of tamoxifen, even when the lymphocytes were treated first with estradiol followed by tamoxifen. It is suggested that the inhibitory effect of tamoxifen on these in vitro lymphocyte reactions is not mediated by the estrogen receptor. PMID- 2767959 TI - The modified Wagner method for surgical lengthening of the limbs. AB - The method proposed by Wagner in 1971 for surgical lengthening of the limbs was widely used by the authors for the treatment of dysmetria and (since 1976, for the first time in Italy) for disharmonic hypometria. The limitations of this method were revealed, however, by increasing knowledge in this field and the advent of new biological concepts of bone regeneration. The authors report 51 lengthenings carried out between 1982 and 1987 according to their own modification of the Wagner method. They conclude that the Wagner external fixator associated with corticotomy achieves excellent results, decreasing the number of surgical stages as well as the risk of infection and delay in consolidation. PMID- 2767960 TI - Stable osteosynthesis by the AO method in comminuted intra-articular fractures of the distal humerus. AB - The authors report their experience between 1982 and 1986 in 16 cases of comminuted supraintercondylar fractures of the elbow treated by stable osteosynthesis using the AO method with immediate or early mobilisation. They illustrate the technical possibility of obtaining stable synthesis even in fractures with numerous fragments and analyse the long-term functional results. Because of the severity of the fracture, none of the patients recovered full flexion and extension of the elbow; nonetheless in all the patients there was recovery of at least 90 degrees of movement and, most importantly, this occurred in the most useful range of movement. These results, and the time required for healing, amply justify the use of solid synthesis in fractures where the alternative would be arthroplasty. PMID- 2767961 TI - Breakage of the Grosse-Kempf nail: causes and remedies. AB - Eleven cases of breakage of the Grosse-Kempf nail were observed in a series of 297 operations performed at the Rizzoli Orthopaedic Institute in Bologna. Seven of the 9 femoral nails were not the latest available model, which is capable of supporting more stress because areas of less resistance have been eliminated. However, breakage is still a possibility as a result of errors of technique and incorrect planning of weightbearing. PMID- 2767962 TI - Reconstruction of the heel by a medial plantar flap. AB - Reconstruction of the heel is a complex problem for which many methods have been proposed. The authors describe a method of applying a medial plantar flap with particular reference to special clinical situations of a vascular nature. Based on their clinical experience, they recommended the medial plantar flap as the method of choice in the reconstruction of the heel, particularly in view of the trophic, mechanical and sensory features of the transposed skin and the absence of a significant morphological or functional deficit in the donor site. Moreover, the method involves a single surgical stage and a brief period of hospitalisation. PMID- 2767963 TI - Considerations on deformity of the foot and suprasegmental pathology in infantile cerebral palsy. AB - The authors conducted a clinical and CT scan study of the lower limbs of patients with infantile cerebral palsy in a search for correlations between deformities of the foot and pathological conditions in other parts of the limb. This revealed that the keystone in the system is the knee, in which flexion deformity or recurvatum associated with varus or valgus and torsional deformity of the femur and tibia leads to repercussions in the foot which are reasonably predictable and constant. This contrasts with similar situations in non-neurological deformities, where repercussions in the foot are unpredictable. PMID- 2767964 TI - An analysis of the changes in the surfaces of metallic femoral components in hip prostheses. A study of 60 prostheses removed after 1-20 years. AB - A study of 60 femoral prosthetic components removed after 1-20 years allowed us to study the behaviour of the metallic surface in real life conditions. Changes were observed exclusively in cemented prostheses. They consisted of corrosion phenomena characteristic of the components of steel EN 58 J and 316 S, and wear phenomena secondary to mobilisation. The latter were observed in steel components as well as in those in Co-Cr alloy. The areas of corrosion in the steel prostheses were characteristically distributed, indicating a combination of causal factors, including an insufficient capacity of passivation of the metal and the particular situation of the cement-to-metal interface. PMID- 2767965 TI - Vertebral needle biopsy with CT scan monitoring. AB - The authors report the method used and the results obtained in 42 vertebral needle biopsies with CT scan monitoring. Material sufficient for a positive histological diagnosis was obtained in 67% of the cases. Indications for the use of this method are conditioned by a suitable clinical and instrumental evaluation, and limited to cases where a histological monomorphous lesion or when en bloc resection are predicted. The need to follow precise rules in terms of technique and manual skill is emphasized. PMID- 2767966 TI - Neuropathy due to entrapment of the long thoracic nerve. A case report. AB - The author describes a case of severe paresis of the serratus anterior in a young volleyball player due to entrapment of the long thoracic nerve. This etiology is very rare, but if diagnosed and treated in the early stage, the lesion is reversible. The patient was completely cured 6 months later after the suspension of sports activity. PMID- 2767967 TI - Career development of women in health care administration: a preliminary consideration. AB - As greater numbers of women enter health care administration, it is important to understand their career perceptions so that organizations can assist them in becoming effective leaders. This article reports findings from focused interviews of women administrators regarding their career development and expectations and suggests issues that require attention. PMID- 2767969 TI - HCMR interview: Dean Grout. PMID- 2767968 TI - From the editor ... hospital administrators committed to the best interests of their communities. PMID- 2767970 TI - HCMR interview: Rodney Wolford. PMID- 2767971 TI - Looking between the lines of the White Paper. PMID- 2767972 TI - Campaigning for safer food. Interview by Christina Potrykus. PMID- 2767973 TI - Resource management. PMID- 2767974 TI - GP receptionists: their work and training. AB - A postal questionnaire was circulated to 90 receptionists working in general practices in a single health unit and produced an 80 per cent usable return rate. The questions asked included items relating to their work and training. Over half the respondents gave advice to patients on medicine matters for which they were not trained. Deciding upon the urgency of home and surgery appointments were the two tasks which were most disliked by the receptionists. Receptionists thought patients would find them helpful and few receptionists found patients aggressive. Many receptionists agreed that they should have training before they start work and even more agreed that they needed in-service training. PMID- 2767976 TI - Public health nursing in North Carolina: a brief glimpse. PMID- 2767975 TI - Vaccination viewpoints. AB - Liverpool is an area of lower than average immunisation uptake. A survey of health visitors, school nurses and clinical medical officers suggests that professional disagreements and lack of belief are contributory factors. PMID- 2767978 TI - When traditional health visiting becomes impossible. PMID- 2767977 TI - The baby and the bath-water. PMID- 2767979 TI - Whither health visiting? The blueprint already exists. PMID- 2767980 TI - Ringing the changes in child health. Interview by Christina Potrykus. PMID- 2767981 TI - Contract capers. PMID- 2767982 TI - Who uses child health clinics and why: a study of a deprived inner city district. AB - The role of child health clinics in an inner London district was examined by a survey of attenders at 52 baby clinic sessions run by the health authority and a review of the uptake of screening. Differences between social groups were examined using A Classification of Residential Neighbourhoods (ACORN) which is based on census data and requires only the full postcode to classify people. Clinic attendance was frequent among all social groups when a child was aged under six months but then declined, mainly reflecting changing needs. About one half of the attenders saw the clinic doctor, often following referral by the health visitor, with 15% consulting about physical health problems. Differences occurred between ACORN groups in their frequency and reasons for clinic attendance after six months of age and rates of referral following developmental screening. This suggests that ACORN may be of value in monitoring service use and identifying groups with particular needs for services. PMID- 2767983 TI - The health visitor and the prisoner's child. AB - This paper comments on the relevance to health visitors of research carried out to establish the number of children in England and Wales whose fathers' are imprisoned, the impact of this on the children concerned and the need for intervention by health and social welfare agencies. Men received into prison during two separate three month periods were surveyed, a sample of wives interviewed and health visitors and teachers questioned. The findings suggest that in one year more than one hundred thousand children have a father sent into custody. Because of the current concentration of crime in areas of high deprivation, imprisonment of a father is a relatively normal occurrence in some districts, frequently adding pain, confusion and worry to the child's social, economic and educational disadvantage. Health visitors and teachers reported disturbed behaviour, ill health and problems at school. The role of the health visitor can be crucial in some of these cases yet frequently she is unaware of the family's predicament. PMID- 2767984 TI - The future of health visiting. AB - In recent months there has been a wealth of articles and speeches which have documented the need for changes to the current practice of health visiting. This paper reviews the current discussion on the future of health visiting and offers some alternative strategies. PMID- 2767985 TI - Benefits update. Missing the target. PMID- 2767986 TI - Characterization of heterochromatic regions in two Triturus alpestris subspecies (Urodela: Salamandridae). AB - The fluorescence analysis carried out in Triturus alpestris alpestris and Triturus alpestris cyreni subspecies has revealed differences related to the content and distribution of AT-rich, GC-rich and non-fluorescent heterochromatic bands. These results provide new evidence on the chromosome differentiation undergone in their phylogenetic splitting. PMID- 2767987 TI - Quinidine-induced immune thrombocytopenia. AB - We have identified six cases of quinidine-induced immune thrombocytopenia based on clinical evidence and in association with elevated amounts of platelet surface IgG. The degree of thrombocytopenia did not correlate with severity of clinical symptoms, nor did it predict the amount of IgG on the platelet surface. Three of the patients recovered promptly after drug discontinuation alone whereas the other patients received additional corticosteroid therapy. The clinical presentation, mode of diagnosis, and therapeutic considerations in the treatment of drug-induced thrombocytopenia are discussed. PMID- 2767989 TI - Surgical management of spinal epidural disease: an update. AB - Management of spinal cord compression from metastatic malignant disease remains unsatisfactory. Results of surgical decompression are at best less than those of radiation therapy alone. However, new surgical approaches now focus on removing the anterior-situated tumor tissue which produces neural compression in about 85% of the cases. The results of these procedures that allow removal of the ventrally compressing tumor show significant improvement in the management of patients with spinal epidural disease. We review the surgical strategy of these new approaches and the attendant results. PMID- 2767990 TI - Adenocarcinoma of the prostate: an overview. PMID- 2767988 TI - Primary fibrinolysis in acute monocytic leukemia. AB - We present the case of a young man with acute monocytic leukemia (French-American British classification:M5) and systemic hyperfibrinolysis with severe bleeding. Although fibrinolysis is usually mild and secondary to disseminated intravascular coagulation, its role as a primary and dominant factor in rare cases of leukemia warrants that its presence be sought as a cause of abnormal bleeding. Decreased serum plasminogen and increased serum plasmin determined by synthetic substrate assay and a negative protamine paracoagulation test are crucial findings. Use of high-dose epsilon-aminocaproic acid was effective in treating this complication. A transient increase in fibrinolytic activity coincident with the early effect of antileukemic treatment suggested that plasminogen activator and/or fibrinolytic protease substances were released from leukemic cells. Fibrinolytic activity subsequently disappeared with reduction in the population of leukemic cells. PMID- 2767991 TI - Echo-Doppler features of pulmonary valve endocarditis. AB - Three patients with fever and pneumonitis were found to have pulmonary valve vegetations by echocardiography. Pulsed and color flow Doppler studies demonstrated mild to moderate pulmonary valve insufficiency in these patients. All patients responded to the appropriate antibiotics without requiring valve surgery. Echocardiography is of value in diagnosing pulmonary valve endocarditis and should be considered in every patient with recurrent pneumonitis. PMID- 2767992 TI - Digitalis intoxication or intrinsic conduction system disease. PMID- 2767993 TI - Improvement in left ventricular systolic function after pericardiocentesis: case report. PMID- 2767994 TI - Pleural effusion in Michigan caused by Coccidioides immitis after travel to an endemic area. AB - Primary coccidioidal disease is rarely diagnosed in the midwest in the nonimmunocompromised host. Since coast-to-coast travel is common today, many patients may become exposed to Coccidioides immitis while traveling in endemic areas. We present a case of acute coccidioidal pleural effusion in a Michigan woman who had recently visited northeastern Arizona. Her travel history was the single most important factor in the eventual diagnosis of coccidioidal pleural effusion. PMID- 2767995 TI - Cerebral infarction associated with cocaine use. AB - We report the case of a young man with an acute infarction of the left putamen and caudate nucleus, whose symptoms appeared six hours after intranasal use of approximately 0.5 g of cocaine hydrochloride. It seems probably that in this patient cocaine consumption played a role in the development of stroke. PMID- 2767996 TI - Fair is fair. PMID- 2767997 TI - Localization of acid phosphatase in lysosomes of pituitary folliculo-stellate cells following estrogen withdrawal from primed male rats. AB - Acid phosphatase was localized in lysosomes of non-granulated, folliculo-stellate pituitary cells 72 h after estrogen was withdrawn from primed male rats. The appearance of lysosomes and the accumulation of lipid droplets in folliculo stellate cells coincide with the clearance of lipid from pituitary mammotropes. Positive identification of lysosomes supports our proposal in a previous study that folliculo-stellate cells are phagocytic. PMID- 2767998 TI - Immunocytochemical detection of luteinizing hormone in epididymis of mature mouse. AB - Luteinizing hormone (LH) binds to the Leydig cells of several mammalian species where it stimulates steroidogenesis, protein synthesis and protein phosphorylation. In the present study, standard immunoperoxidase (PAP) and avidin biotin complex (ABC) techniques were used to detect the binding of endogenous and exogenous LH to the epididymis of the mature mouse. Throughout the epididymal duct, a positive reaction for peroxidase, indicating LH binding, occurred in the Golgi area of principal cells. In segment 1, positive reactions were also visualized in the perinuclear area and in the region located between the Golgi area and the apical surface of the principal cells (supra-Golgi area). In the corpus and cauda epididymidis, scattered entire principal cells were also positive. Throughout the epididymal duct, the reactions indicating the binding of exogenous LH were more intense than those of endogenous LH. The significance of LH binding to the epididymis is uncertain but LH may perform the same functions in epididymal principal cells as it does in Leydig cells. PMID- 2767999 TI - Calcium ion uptake, somatotropin release, and fine structure of somatotrophs in cultures of the rat anterior pituitary upon the action of an oligopeptide (Boc Gln-Leu-Lysinal). AB - Cultured cells from the anterior pituitary glands of adult rats were treated with the tripeptide aldehyde proteinase inhibitor, Boc-Gln-Leu-Lys-H. The oligopeptide had a profound releasing effect on growth hormone, whereas the prolactin release remained unchanged at 10(-3) mol/l drug concentration after an incubation for 2 h. In the presence of the oligopeptide a time- and dose-dependent calcium influx into cultured cells has been shown which was proved to be almost completely antagonized with magnesium ions but not with Nifedipine. In addition, radioactive calcium ions could be detected in a number of cells by light microscopic autoradiography when cultures were treated with Boc-Gln-Leu-Lys-H for short periods. The selective Gel action of the oligopeptide on growth hormone producing cells has been demonstrated also in fine structural investigations: multigranular and single exocytotic profiles have been observed. Accordingly, we have postulated that Boc-Gln-Leu-Lysinal mimics the effects of the known ionophores. Its mode of action needs, however, further studies especially on isolated somatotrophs. PMID- 2768000 TI - Demonstration of GABA-like immunoreactivity in myenteric plexus of frog stomach. AB - The GABAergic innervation of the frog stomach was studied by means of an indirect immunohistochemical method. Whole mount preparations were obtained from frog stomachs after the animals had been perfused with a mixture of picric acid, glutaraldehyde and glacial acetic acid. Samples were incubated with an antiserum specific for GABA coupled to BSA with glutaraldehyde. Anti-rabbit IgG-HRP was processed by the two step method (Eckert and Ude 1983). GABA-positive varicose fibers and also nerve cell bodies were revealed within the myenteric plexus. The density of GABA-immunoreactive neurons was not higher than 4-8 cell/cm2, which is approximately 1% of the total nerve cell number in the myenteric plexus. PMID- 2768001 TI - Changes in lectin binding pattern of gonads of developing mice. AB - Changes in lectin binding of developing fetal mouse testes and ovaries were examined by light and electron microscopy, with much attention paid particularly to those in carbohydrates of germ cells. Characteristic binding patterns were observed with three lectins (BPA, GS-I, and GS-II) in the germ cells and the somatic cells during the process of testicular and ovarian development. GS-I and BPA, which showed similar binding patterns, preferentially bound to the plasma membrane and small dense bodies (SDB) of germ cells in both testes and ovaries during the 12th to 14th day post coitum (p.c.). In the fetal testes on day 16 p.c., the reaction with both GS-I and BPA completely disappeared. While, in the ovaries, a weak reaction with these lectins was retained as it was in germ cells until the 16th day p.c. The reaction with GS-II was restricted to Sertoli cells in the fetal testes during the 12th to 14th day p.c., and thereafter disappeared on day 16 p.c. The distribution of GS-II binding sites was in agreement with that of the glycogen granules. No positive staining with GS-II was seen in the ovaries throughout their development. These results indicate that certain glycoconjugates containing D-galactose and N-acetyl-D-galactosamine residues are expressed on the cell surface and in the SDB of germ cells during the period of the 12th to 14th day p.c., and that striking changes in function as well as in structure may take place in both germ cells and somatic cells during the 14th to 16th day p.c. in association with testicular and ovarian development. PMID- 2768002 TI - Indoleamine accumulation by retinal neurons exposed to blood. AB - Exposing rabbit retinas for one minute to an incubation medium containing 10 microliters of blood diluted in 20 ml of medium was sufficient to produce serotonin-like immunoreactivity in some of the retinal indoleamine-accumulating neurons. Retinas from rabbits that had been perfused before the eyes were removed had no detectable immunoreactivity. Our results support the conjecture that the serotonin sometimes detected in the retina originates in the blood. Why the cells have a carrier for a molecule that they do not normally contain remains unclear. PMID- 2768003 TI - Sex differences of the influence of T3 on the topical distribution of phosphoenolpyruvate carboxykinase activity in the liver acinus. AB - Phosphoenolpyruvate carboxykinase (PEPCK) activity was investigated in livers of triiodothyronine (T3) treated male and female rats with special regard to its intraacinar localization. In untreated controls of both, male and female rats, the activity was heterotopically distributed within the acinus with highest values in the periportal zone, and with lowest values in the perivenous zone. This periportal to perivenous activity gradient revealed to be under the influence of T3. Application of T3 resulted in a relative increase of PEPCK activity which was much greater in the livers of females than in males. The extent of T3-induced augmentation of PEPCK activity was dependent on the intraacinar position. In both sexes greatest relative activation was found in the perivenous zone. In female animals, the perivenous activity of T3 treated livers was comparable to that observed in the periportal zone of controls. PMID- 2768004 TI - Ultrastructural study of the distribution of calcium in the pineal gland of the rat subjected to manipulation of the photoperiod. AB - Using the pyroantimoniate technique, a study was conducted at electron microscope level on the distribution of the calcium ion in the pineal glands of normal adult Sprague-Dawley rats with initial weights of 150-200 g subjected to a 12:12 light dark cycle and others under the same conditions were subjected to modifications in the noradrenergic signal, such as continuous illumination over 7 days, blinding by bilateral enucleation (7 or 90 days) before sacrifice and bilateral superior cervical gangliectomy at 21 days before sacrifice. All the animals were sacrificed by decapitation, half of them at midday and the other half at midnight. Abundant fine precipitations of calcium were found in the intercellular spaces of the pineal glands of the normal rats. By contrast, in the gangliectomized animals subjected to constant illumination and chronic binding these precipitations were few in number. Additionally, two types of pinealocytes were observed regarding the distribution and concentration of intracytoplasmic calcium in both the normal and experimentally manipulated animals. Type I correspond to the classic light pinealocytes, with an absence of intracytoplasmic precipitations, although in the normal and gangliectomized animals sacrificed at midnight it was possible to observe fine deposits inside the mitochondrial matrix. Type II correspond to the classic dark pinealocytes, with a dense cytoplasmic matrix and numerous deposits of intracytoplasmic and intranuclear calcium; these were never seen in the type I pinealocytes. PMID- 2768005 TI - Evaluation of the pyroantimonate method for detecting intracellular calcium localization in smooth muscle fibers by the X-ray microanalysis of cryosections. AB - The validity of the pyroantimonate method, which has been used for detecting intracellular Ca localization and translocation in smooth muscles, was examined by making cryosections of the relaxed anterior byssal retractor muscle (ABRM) of Mytilus edulis at various stages of procedures for preparing ordinary Epon embedded sections and determining the elemental concentration ratios of the pyroantimonate precipitate, localized along the inner surface of the plasma membrane, with an energy dispersive X-ray microanalyzer. The concentration of Ca (relative to that of Sb) in the precipitate stayed constant after the procedures of fixation, dehydration and Epon-embedding, while the concentrations of K, Mg, Na and Os showed their respective characteristic changes after the above procedures, being lower than that of Ca in the Epon-embedded sections. The presence of Ca in the precipitate was also demonstrated with an electron energy loss spectrometer. The localization of Ca underneath the plasma membrane was also observed in the cryosections of the ABRM fibers prepared after mild fixation with acrolein vapor without using pyroantimonate. These results indicate that the pyroantimonate precipitate serves as a valid measure of intracellular Ca localization. PMID- 2768007 TI - Chronic cervical dysfunction: correlation of myoelectric findings with clinical progress. AB - In this pilot study, four patients with motion impairment and chronic cervical pain after cervical spine injury received osteopathic manipulative treatment for spinal dysfunction for periods in excess of 3 months. Records were compared for changes in the patient's subjective complaints, in the physician's findings, and in the standardized measurement of electrical activity of the cervical spine musculature. All three measures demonstrated parallel improvement in the health status of these patients. Attention to functional aspects of a neuromusculoskeletal problem appears to provide reliable indicators for directing treatment of somatic dysfunction and registering both subjective and objective change. PMID- 2768006 TI - HLA-DQ alpha polymorphisms: oligonucleotide probes characterize the contribution of first and second domains to electrophoretic variants. AB - Polymorphism is known to exist within the HLA-DQ alpha locus in the human major histocompatibility complex, although such polymorphism may be "silent" in standard HLA typing. However, DQ alpha polymorphism may be functionally significant, either through DQ alpha epitopes functioning directly in the immune response or by affecting tertiary conformation of Ia molecules through differential alpha/beta pairing. We have previously defined a particular DQ alpha polymorphism through reactivity with a monoclonal antibody and restriction fragment length polymorphism pattern. We now characterize this DQ alpha polymorphism through two-dimensional gel electrophoretic analysis and identify a subset of DQ alpha molecules with unique characteristics. Investigation of these allelic variants using synthetic oligonucleotide probe analysis of genomic DNA suggests a localization of the DNA region encoding the DQ alpha 5 epitope and suggests possible evolutionary mechanisms accounting for these unique patterns. PMID- 2768008 TI - Fibrosarcoma of the nose and the paranasal sinuses. AB - We report a case of fibrosarcoma of the nose and paranasal sinuses and give a brief review of the literature. Fibrosarcoma of the nose and paranasal sinuses is uncommon, and few cases have been reported to date. Previously these tumors may have been overdiagnosed secondary to inadequate diagnostic procedures. Because histologic diagnosis is difficult, these tumors have been confused with other lesions of the head and neck. Thus, the improvement in diagnostic procedures has significantly reduced the reported incidence of fibrosarcoma. Because histologic diagnosis is difficult, this tumor has often been confused with other lesions of the head and neck. To ensure proper handling of the tissue, the pathologist should be informed if fibrosarcoma is suspected. It may be necessary to use electron microscopy or staining techniques such as immunoperoxidase stains to distinguish fibrosarcoma from other lesions. Unfortunately, the early signs and symptoms of the tumor are vague and sometimes misleading. Thus, at the patient's initial visit, it is important that the physician consider the possibility of fibrosarcoma. PMID- 2768009 TI - Clear cell renal carcinoma in a pregnant DES-exposed patient. AB - Several decades ago, diethylstilbestrol (DES) was prescribed to support the pregnancy of women who were diabetic, who had had consecutive abortions, or who were threatening to abort. The use of this estrogen substitute to support human gestation had ceased by the 1960s. In 1971, the first report was published in which DES exposure was linked with clear cell carcinoma of the vagina and cervix. Since then, many other documentations have been published on upper genital tract anomalies, poor reproductive performance, and the high incidence of fetal wastage in DES-exposed women. The author describes a case of clear cell carcinoma of the kidney in an 18-year-old pregnant woman with a prior history of vaginal adenosis who had been exposed to DES in utero. PMID- 2768010 TI - Acute carpal tunnel syndrome secondary to septic arthritis of the wrist. AB - A case of acute carpal tunnel syndrome secondary to septic arthritis of the wrist is reported. Treatment consisted of carpal tunnel release, incision and drainage of the wrist joint, intravenous injection of antibiotics, and delayed primary closure. The infection resolved and median nerve function promptly returned to normal. We believe this is the first report of septic arthritis of the wrist as a cause of acute carpal tunnel syndrome. PMID- 2768011 TI - Endometriosis arising in abdominal incisions. AB - The differential diagnosis of an incisional mass arising in a female includes endometriosis. The occurrence of abdominal scar endometriosis following hysterotomy is uncommon, being reported in less than 0.5% of patients undergoing cesarean section. Three cases of this unusual problem are reported, the experience at David Grant USAF Medical Center evaluated, and pertinent literature reviewed. The principles of surgical management include obtaining an accurate diagnosis and adequate excision. PMID- 2768012 TI - A tick, in time, may cause Lyme (disease). PMID- 2768013 TI - Living wills improve patient-physician communication. PMID- 2768014 TI - Shoulder pain and repetition strain injury to the supraspinatus muscle: etiology and manipulative treatment. AB - Chronic inflammation and degenerative tendonitis of the supraspinatus muscle is an important cause of intrinsic shoulder pain. Injury to this muscle is usually caused, not by a single event, but by slight to moderate trauma repeatedly to the same anatomic area. The term repetition strain injury is used to describe this form of microtrauma. Repetition strain injury of the supraspinatus muscle is not an isolated event, but rather a form of microtrauma that affects the entire shoulder girdle. This functional unit must be evaluated and considered in the treatment plan. The authors discuss the diagnosis of this pain syndrome, which is based on the patient's work history, motion and strength testing, and palpation for trigger points. They also provide instruction in treatment involving manipulation with functional and counterstrain techniques combined with home exercise and modification of work posture. PMID- 2768015 TI - In vitro preservation of traumatic human skin autografts in a massive degloving injury. AB - The in vitro preservation of human skin autografts is a valuable technique in the management of severe degloving injuries. The authors describe the storage of traumatically induced human skin autografts involving nearly one third of the total body surface of a patient. These autografts were preserved in tissue culture medium for 19 days and then transplanted onto the patient's prepared wounds, successfully acting as biologic dressings and permanent grafts. To the authors' knowledge, this is the largest clinical application of skin-storage techniques for the preservation of traumatic human skin autografts that is known to have been reported. PMID- 2768016 TI - Inflammatory aneurysm: a cause of obstructive nephropathy. AB - Inflammatory aortic aneurysms are aneurysms that are surrounded by a variable amount of periaortic fibrosis. This periaortic fibrosis may involve abdominal viscera, such as the duodenum, inferior vena cava, renal veins, or ureters, to a variable degree. On ultrasonographic images, the periaortic fibrosis appears as a hypoechoic mass surrounding the anterior and anterolateral aspects of a dilated aorta. Computed tomography scans reveal a periaortic mass of inflammatory tissue surrounding a dilated atherosclerotic and thickened aorta. The inflammatory mass may enhance to the same extent or slightly less than the aortic lumen following intravenous administration of a contrast agent. Magnetic resonance imaging scans may show the periaortic mass of inflammatory tissue to have a pseudocapsule of compressed fat at its periphery. Recognition of this entity and the extent of the inflammatory process is important to the definitive management of this condition, as illustrated by the case presented. PMID- 2768017 TI - Erythromycin therapy for cryptosporidiosis? PMID- 2768018 TI - Proceedings of the American Society for Therapeutic Radiology and Oncology, 31st annual meeting. October 1-6, 1989, San Francisco, California. Abstracts. PMID- 2768019 TI - Education for psychoanalysts in the nineties. PMID- 2768020 TI - Confusion of tongues: the Ferenczian metaphor for childhood seduction and emotional trauma. PMID- 2768021 TI - Analysis of two adult female patients who had been victims of incest in childhood. PMID- 2768022 TI - The paraconscious. AB - A new concept, the paraconscious, is presented as the third complementary member of the conscious/unconscious paradigm. A form of cognition dating from early intrauterine existence to sometime in the first year of life, the nature of the paraconscious is determined by the incompleteness of developing cognitive structures, giving rise to a form of knowing that does not allow for the generation of voluntarily retrievable mental representations. The paraconscious provides a conceptual framework for the understanding of "conflict-free" psychic development, thereby linking such apparently disparate phenomena as Stoller's core gender identity and primary transsexualism, Bruch's primary anorexia nervosa, night terrors, and ubiquitous convictions such as the belief in telephathy and the survival of death by human consciousness. It has profound implications for the treatment (or nontreatment in the case of primary male transsexualism) of significant psychiatric syndromes and raises crucial questions about the nature of learning during the earliest moments of our cognitive existence, about the nonlinguistic transmission of information and about the origin of certain widely held beliefs. PMID- 2768023 TI - The fate of the father representation in adolescent sons. PMID- 2768024 TI - The two-woman phenomenon revisited. PMID- 2768025 TI - The "holding function" of the therapist in the treatment of borderline patients. AB - In this paper, I have attempted to show that during crises in the therapy of borderlines it is crucial not to respond, needless to say in reality, but neither by confrontation nor with interpretation to the apparently impulse-ridden transference. To interpret to the patient, during such periods, the vicissitudes of the object hunger in the transference often intensifies the turmoil, confuses the issue, and precipitates further regression. It is of primal importance to recognize that during these crises the patient needs a holding environment to restore and enhance the observing, anxiety-containing, and integrative capacity of the ego. This holding environment rests not only on the stability of the therapeutic setting, including the reliability and acceptance of the therapist, but on helping the patient acknowledge and process the precipitants of the emotional crises. PMID- 2768026 TI - Power, gender, and money. PMID- 2768028 TI - Human anthrax. PMID- 2768027 TI - Bovine somatotropin and nutrient density. PMID- 2768030 TI - Veterinary education programs for the 21st century. PMID- 2768029 TI - Challenges to veterinary constituencies flowing from the PNVEP study: an epilogue. PMID- 2768031 TI - How do employees feel about working in a veterinary practice? PMID- 2768032 TI - National Board Examination revisited. PMID- 2768033 TI - AVMA guidelines for dealing with AIDS-infected persons in the veterinary workplace. AB - Acquired immune deficiency syndrome (AIDS) is a human disease; human immunodeficiency virus (HIV) does not infect animals other than nonhuman primates. Veterinarians and their employees are no more at risk by reason of their employment than are workers in offices. Cautions for health care workers do not generally apply to animal health care workers, but they are good rules to follow if it is necessary to render first aid for human injuries in the workplace. Veterinarians are advised to have properly equipped first aid kits available in case of need. Employees with HIV infection or AIDS should be treated in the same way that any other ill or disabled employee would be treated. They should be given the opportunity to continue work as long as they are able to perform most of the essential functions of their jobs. Their privacy must be respected, but if their condition becomes known, they must not be discriminated against by employers or other employees. All employees should be instructed in basic information regarding HIV infection and AIDS, so they understand what is and is not a hazard. They should also be trained to deal safely with human injuries and be informed of their rights and the rights of other employees in case one of them is infected with HIV. PMID- 2768034 TI - The previous veterinarian. PMID- 2768035 TI - Zoologic medicine, comparative medicine, and veterinary medical education. PMID- 2768036 TI - Risk factors for lower respiratory tract disease in a cohort of feedlot cattle. AB - Using data collected from company lot records, potential risk factors related to feedlot management, the cattle, and climate were determined. The risk factors were analyzed by use of weighted multiple regression techniques to determine their effects on the incidence of lower respiratory tract disease in a cohort of 95 lots containing 17,696 cattle. The gender of the cattle, the number of days that groups of cattle filled a lot, pregnancy checking of heifers, and the average temperature change in the first 14 days in which the cattle were on feed significantly influenced the incidence of lower respiratory disease. The incidence of lower respiratory tract disease was most influenced by risk factors in the first 30 days on feed. PMID- 2768037 TI - Clinical use of the neuromuscular blocking agents atracurium and pancuronium for equine anesthesia. AB - Neuromuscular blocking agents (muscle relaxants) are useful and common adjuncts to general anesthesia for human beings, but have not been used extensively during anesthesia of large animal species. Over a 3-year period, atracurium or pancuronium were used as adjuncts to general anesthesia for 89 anesthetic procedures in 88 equids (of 18 breeds and age ranging in age from 5 weeks to 25 years) at the teaching hospital. Forty-one of the anesthetic procedures were for abdominal surgery, and orthopedic (n = 19), ophthalmologic (n = 17), thoracotomy (n = 1), and soft tissue (n = 14) procedures composed the rest. Most equids were given atracurium because it was less expensive than pancuronium. Initial dosage of either relaxant ranged from 0.12 to 0.2 mg/kg of body weight IV, and repeat doses ranged from 10 to 30 mg. Relaxants were used for as long as 205 minutes. Muscles of the face or hind limb digital extensor muscles were used to monitor relaxation. Muscles of the hind limb were more sensitive to the effects of relaxants than were muscles of the face. At the end of a surgical procedure, just prior to being taken to the recovery stall, a relaxant antagonist, edrophonium (0.5 to 1 mg/kg), was administered IV to each equid. Edrophonium caused blood pressure to increase in most of the equids. Heart rate change was variable, with approximately half the equids having no change or increased heart rate and the remainder having decreased heart rate. Recovery to standing after anesthesia was rated excellent or good for 72 equids, fair for 11, and poor for 2.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2768038 TI - Use of radionuclide imaging to identify malignant mammary tumor bone metastases in dogs. AB - Radionuclide imaging techniques were used to indicate the location and incidence of bone metastases in 30 dogs with malignant mammary tumors. The method was successful in distinguishing mammary tumor metastases in the sternum of one dog. PMID- 2768040 TI - Bilateral conjunctival masses in two dogs. AB - Bilateral conjunctival masses in 2 dogs were excised. In one dog, the masses represented hemangiomas that may have been related to exposure to UV radiation. In the other dog, they represented conjunctival inclusion cysts of probable congenital origin. PMID- 2768039 TI - Caval syndrome in a Dirofilaria immitis-infected dog treated with dichlorvos. AB - In the dog of this report, lesions found were compatible with death attributable to acute circulatory collapse induced by caval syndrome and compounded by microfilarial death. Hepatic centrilobular hemorrhage and necrosis were suggestive of circulatory collapse, renal hemosiderosis was suggestive of disseminated intravascular coagulopathy, and multifocal subacute hepatic inflammation associated with microfilariae was similar to lesions attributed to microfilarial death. Treatment with dichlorvos may have precipitated these events. Previous descriptions of dichlorvos toxicity in microfilaremic dogs have suggested that death is attributable to shock, but pathogenic mechanisms have not been established. Although generalizations from a single case must be made with caution, lesions in this dog suggest that toxic effects may be mediated through effects on adult and larval heartworms. PMID- 2768042 TI - Atlantoaxial subluxation and absence of transverse ligament of the atlas in a dog. AB - Absence of the transverse ligament of the atlas was diagnosed at necropsy in an 8 month-old Shih Tzu with radiographic signs of atlantoaxial subluxation. Symmetric ataxia, tetraparesis, and signs of pain in the vertebral canal suggested a lesion in the cervical portion of the spinal cord. Necropsy revealed absence of the transverse ligament of the atlas and malformation of dens and atlas. In addition, the alar ligaments were distinct and thick, and the atlanto-occipital and atlantoaxial joint capsules were markedly thicker than normal. Histologic examination revealed focal compressive myelopathy of the spinal cord at the level of the atlantoaxial joint. PMID- 2768041 TI - Pulmonary atresia with intact ventricular septum and agenesis of the ductus arteriosus in a pup. AB - A 7-week-old Wire Fox Terrier was admitted with pulmonary atresia with intact ventricular septum. The right ventricle and tricuspid valve were hypoplastic, and venous return to the right atrium reached the left side through an atrial septal defect. Oxygenation was via hyperplastic bronchial arteries. There was no evidence of the ductus arteriosus. Physical examination, plain and contrast radiography, and electrocardiography were performed. Clinical findings for this combination of defects were similar to those of more common defects (tetralogy of Fallot, patent ductus arteriosus. PMID- 2768043 TI - Primary teat neoplasia in two yearling heifers. AB - Two yearling heifers developed rapidly growing soft tissue masses attached to the base of the right hind teat. In each heifer, the solitary mass was raised, firm, and attached to the overlying skin. En bloc removal was accomplished in each by positioning the heifer in dorsal recumbency and by using local infiltration analgesia. Histologic examination revealed one of the masses to be fibroma and the other, fibrosarcoma. Neither tumor has recurred, and normal function of the teat was retained. PMID- 2768044 TI - Tarsal fractures in a heifer and a bull. AB - Tarsal fractures were diagnosed in a heifer and a bull. In both cases, radiography confirmed intra-articular fractures, with subluxation of the fracture fragment. Sudden, nonreducible hock flexion was a clinical sign in both cases. This sign may be highly suggestive of intra-articular fracture when diagnosis must be made without radiography. PMID- 2768045 TI - Neurologic abnormalities as the predominant signs of neoplasia of the nasal cavity in dogs and cats: seven cases (1973-1986). AB - Neurologic abnormalities were the predominant historic and physical findings in 5 dogs and 2 cats with primary nasal cavity tumors that had invaded the cranial vault. Seizures, behavior changes, and obtundation were the most common signs. Other neurologic signs included paresis, ataxia, circling, visual deficit, and proprioceptive deficit. Although 1 dog and 2 cats had historic findings of mild respiratory disease, no physical abnormalities related to the respiratory tract were found in any of the 7 animals. Nasal cavity neoplasia was suggested by radiographic and computed tomographic studies and was confirmed histopathologically in each case. The nasal tumor types in the 5 dogs were epidermoid carcinoma (n = 1), adenocarcinoma (n = 2), solid carcinoma (n = 1), and anaplastic chondrosarcoma (n = 1). An esthesioneuroblastoma was found in each cat. Radiation therapy was effective for 3 months in palliating the clinical signs in the 2 dogs in which it was used. Neoplasia of the nasal cavity should be considered in the differential diagnosis for animals with neurologic signs suggestive of cerebral disorders. PMID- 2768046 TI - Pulmonary thromboembolism associated with immune-mediated hemolytic anemia in dogs: ten cases (1982-1987). AB - Pulmonary thromboembolism was confirmed at necropsy in 10 (32.2%) of 31 dogs treated for immune-mediated hemolytic anemia. Radiographic findings associated with thromboembolism included pronounced interstitial lung pattern and small amounts of pleural effusion. Variables associated with significantly higher incidence of pulmonary thromboembolism included hyperbilirubinemia (P = 0.023), negative Coombs test result (P = 0.032), and presence of an indwelling catheter (P = 0.04). There was a tendency (P = 0.06) for association of higher number of whole blood transfusions with pulmonary thromboembolism. PMID- 2768047 TI - Size and practice density of local veterinary service areas, 1988. PMID- 2768048 TI - What is your diagnosis? Impacted lower left third premolar with nearly 180 degrees rotation. PMID- 2768049 TI - Coping with a buildup of waste anesthetic gases. PMID- 2768050 TI - BST milk safety. PMID- 2768052 TI - Edge of education. Learning to learn. PMID- 2768051 TI - Animals in research. PMID- 2768053 TI - Canine and feline immunization guidelines. AB - This report, prepared by the AVMA Council on Biologic and Therapeutic Agents, summarizes information available on important diseases affecting dogs and cats, and includes recommendations for immunization to control these diseases. The revision was necessary to account for new knowledge and new products. The guidelines are for the usual situation of one or a few animals in a single environment. The veterinarian must use judgement and modify the guidelines for animals with special risks, for example, those in kennels, catteries, and shows. Some of these factors are discussed in the text. The Council recommends only those vaccines licensed by the USDA. Every effort was made to make the guidelines consistent with currently available products. The specific manufacturer's recommendations supplied with the vaccine should be consulted, particularly with new or revised products. PMID- 2768054 TI - Why do we become veterinarians? PMID- 2768055 TI - Veterinary medical associations, state government, and the courts. PMID- 2768056 TI - ECG of the month. Organophosphate intoxication in a cat. PMID- 2768057 TI - Combined Kirschner-Ehmer device and dorsal spinal plate fixation technique for caudal lumbar vertebral fractures in dogs. AB - A new surgical technique was developed for the fixation of caudal lumbar vertebral fractures in dogs. The technique provides optimal stabilization, can be used in combination with dorsal decompression, and does not require an intact spinous process on the fractured vertebra or attachment of the fixation devices to the fractured vertebra. The fixation consists of a Kirschner-Ehmer device and dorsal spinal plates. After fracture healing, only mild sedation of the dog is needed to allow removal of the external hardware used in the fixation. The technique, its indications, and its use in 5 cases are described. PMID- 2768058 TI - Black walnut toxicosis in ten horses. AB - Black walnut toxicosis was diagnosed in 10 horses at one stable. The time from exposure to shavings to development of clinical signs was 8 to 12 hours. Most common clinical signs were moderate to severe laminitis (Obel grade 2 or 3), pitting edema of the distal portion of the limbs, and rapid respiratory rate. Two horses had clinical signs of colic and 2 other horses had anorexia and lethargy. All 10 horses recovered without complications. PMID- 2768059 TI - Delayed phalaris grass toxicosis in sheep and cattle. AB - A phalaris grass (Phalaris caroliniana) caused neurologic signs and lesions in cattle and sheep. The sheep were hyperexcitable and uncoordinated, with severe muscle twitching, stiff gait, and head nodding. The cattle were thin, nervous, and ataxic. One feature of chronic phalaris toxicosis in these cases was onset of signs weeks or months after removal of the animals from the forage. PMID- 2768060 TI - Combined immunodeficiency in a calf. AB - Combined immunodeficiency was documented in a 6-week-old Angus calf. The calf had lymphopenia, undetectable serum IgM or IgA, and low concentrations of serum IgG (420 mg/dl). The calf was treated for diarrhea, pneumonia, and shock, and was given antimicrobial drugs, fluids, and plasma. The calf died of systemic candidiasis and Escherichia coli bacteremia. Aggregated lymphatic folliculi (Peyer patches), lymph nodes, and thymic and splenic lymphoid tissue could not be identified at necropsy. PMID- 2768061 TI - Use of cisplatin for control of metastatic malignant mesenchymoma and hypertrophic osteopathy in a dog. AB - Cisplatin (cis-diammine-dichloroplatinum) treatment induced partial remission of pulmonary metastatic malignant mesenchymoma and nearly complete radiographic remission of hypertrophic osteopathy in a 14-year-old Beagle. Cisplatin was given once every 3 weeks. Clinical signs of hypertrophic osteopathy resolved one week after initiation of treatment. Partial remission of pulmonary metastases and partial radiographic remission of hypertrophic osteopathy was seen 6 weeks after initiation of treatment. Previous treatment of neoplasia-related hypertrophic osteopathy has consisted of removal of the initiating mass or vagotomy. In this case, appropriate chemotherapy was used to control clinical signs and progression of hypertrophic osteopathy. PMID- 2768062 TI - Cryosurgery for treatment of recurrent proliferative keratoconjunctivitis in five dogs. AB - Cryosurgery was used for treatment of recurrent proliferative keratoconjunctivitis in 5 dogs that had been treated with combined medical and surgical procedures without success. Four dogs recovered completely after one application of cryosurgery. The fifth dog did not respond to cryosurgery until after oral administration of corticosteroids was stopped, indicating a possible immune-mediated mechanism of action of cryosurgery on proliferative keratoconjunctivitis. PMID- 2768063 TI - Clinicopathologic findings in dogs with renal amyloidosis: 59 cases (1976-1986). AB - The medical records of 59 dogs with renal amyloidosis were reviewed. Most dogs with amyloidosis were greater than 6 years old, and females were affected more often than males. Beagles, Collies, and Walker Hounds were at increased risk, whereas German Shepherd Dogs and mixed-breed dogs were at decreased risk. Common historical findings were anorexia, polyuria, polydipsia, lethargy, vomiting, and weight loss. Common laboratory findings were leukocytosis, lymphopenia, nonregenerative anemia, hypercholesterolemia, azotemia, hyperphosphatemia, metabolic acidosis, isosthenuria, cylindruria, and proteinuria. Proteinuria was moderate to severe in most dogs, as assessed by qualitative determination of urine protein concentration, urine protein/urine creatinine ratio, and 24-hour urine protein excretion. Conservative medical management was of little value, and survival ranged from 3 to 20 months in 12 dogs for which this information was available. Moderate to severe diffuse global glomerular amyloidosis was detected in all dogs. Medullary amyloid deposition was multifocal and less severe, but was evident in most dogs. Secondary tubulointerstitial and glomerular lesions were mild or absent in most dogs. Thromboembolism was identified in approximately 14% of affected dogs, underlying inflammatory disease in 37%, and neoplasia in 20%. Laboratory indicators of renal function correlated poorly with histologic lesions, with the exception of glomerular amyloid deposition and "chronic renal disease" index with endogenous creatinine clearance. PMID- 2768065 TI - Horner's syndrome in dogs and cats: 100 cases (1975-1985). AB - The medical records of 74 dogs and 26 cats with Horner's syndrome (HS) that were admitted to the New York State College of Veterinary Medicine between January 1975 and October 1985 were reviewed. In dogs, but not cats, HS was associated significantly (P less than 0.01) with increasing age. Dogs with hypothyroidism (defined liberally but not rigorously), intracranial neoplasia, or thoracic neoplasia, cats with otitis media/interna (defined liberally), and dogs and cats with brachial plexus root avulsion were at greater risk for developing HS than were animals that were hit by a car. Dogs and cats with otitis externa were at less risk of developing HS than were animals that were hit by a car. The cause of HS could not be determined in 50% of dogs and 42.3% of cats. The results of topical adrenergic drug testing in dogs were inconclusive in localizing lesion site. In dogs and cats, HS appeared to be unassociated with gender, breed, or right vs left side. The important causes of HS in dogs and cats were trauma (hit by car), brachial plexus root avulsion, intracranial and thoracic neoplasia, and otitis media/interna. PMID- 2768064 TI - Central nervous system toxicosis associated with metronidazole treatment of dogs: five cases (1984-1987). AB - Metronidazole, administered to 5 dogs for periods ranging from 3 to 14 days, was associated with acute development of CNS dysfunction. Metronidazole dosage ranged from 67.3 to 129.0 mg/kg of body weight/d. Clinical signs of toxicosis began with anorexia and intermittent vomiting and progressed rapidly to include pronounced, generalized ataxia and vertical, positional nystagmus. These signs were consistent with lesions of the vestibular nuclei and/or cerebellum. High CSF protein content was detected in 2 of 3 dogs from which CSF was collected. Two dogs were euthanatized because of severe neurologic dysfunction. Three dogs improved slowly and recovered completely over several months. These findings suggest that currently recommended dosages of metronidazole may be too high for some dogs. PMID- 2768066 TI - Thoracic neoplasia in equids: 35 cases (1967-1987). AB - Thirty-two horses and 3 ponies had neoplasia involving the thoracic cavity. Lymphosarcoma of the thorax was found in 19 (54.2%) of the equids. The other 16 equids had metastatic adenocarcinoma (7 horses; 20%), metastatic squamous cell carcinoma (5 equids; 14.3%), metastatic hemangiosarcoma (3 equids; 8.6%) or undifferentiated sarcoma (1 horse; 2.9%). Thoracic neoplasia was diagnosed before death in 15 equids (42.9%). PMID- 2768068 TI - What is your diagnosis? Radiolucent foreign body extending from the sole of the hoof to the middle portion of the diaphysis of the proximal phalanx. PMID- 2768067 TI - What is your diagnosis? Retropharyngeal abscess and cellulitis associated with a metallic foreign body. PMID- 2768069 TI - The challenge of leadership in allied health for the twenty-first century. PMID- 2768070 TI - Research productivity of allied health faculty in academic health centers. AB - As colleges of allied health become a more integral part of the academic community, faculty will increasingly be expected to contribute to the research mission of their respective institutions. The purpose of this study was to identify characteristics associated with research productivity of allied health faculty. A survey was mailed to 1444 full-time faculty members in 50 academic health centers nationwide, representing 10 of the most prevalent allied health fields. Research productivity was defined as the total number of publications produced by a faculty member over his/her academic career. Data from 579 respondents (40%) were analyzed. Results of the regression analysis showed that 44% of the variance in total publications was explained by an earned doctorate, hours spent in research, and salary. As a group, the study results showed that allied health faculty were not prolific researchers and did not publish extensively. Although faculty distributed their time among teaching, research, service, consulting, and practice, the greater percentage of faculty time was spent in teaching and service. PMID- 2768071 TI - Utilization of allied health personnel in HMOs. AB - Health Maintenance Organizations (HMOs) have become a significant component of the health care delivery system and thus provide employment opportunities for allied health professionals. This study investigated the utilization of selected allied health services and personnel in a national sample of HMO settings. Significant utilization of allied health services were reported both through provision of services in-house and through contractual arrangements. Smaller HMOs tended to use several allied health services in-house, while larger HMOs used both in-house and contractual services. Younger HMOs tended to utilize contractual arrangements while older HMOs utilized in-house services. Staff and group HMOs tended to have the highest utilization of health manpower with the larger, older HMOs employing more of those personnel. PMID- 2768072 TI - Interdisciplinary activity between occupational therapists and speech language pathologists. AB - The interdisciplinary activities between occupational therapists (OTs) and speech language pathologists (SLPs) were studied by conducting a national mail survey. Analysis of data gathered from 344 OTs and 262 SLPs (n = 1250 and n = 1130, respectively), indicated strikingly similar responses. Results showed that OTs and SLPs in the medical setting had frequent informal contacts, but interdisciplinary activity was not typical of formal job descriptions. According to 84% of OTs and 91% of SLPs, the most common activity involved exchange of diagnostic information, while 66.6% of both groups identified cooperative planning as typical of their interactions. Only 33.3% of each professional group responded that team treatment characterized interactions. Approximately 50% of the respondents felt that interactions were self-motivated and that the amount of interdisciplinary activity was satisfactory. The data suggested improvement needs are primarily qualitative rather than quantitative, and the primary limiting factors reported by both groups included staff shortages, financial constraints, and physical locations. PMID- 2768073 TI - The recruitment and retention of minority and disadvantaged allied health students. AB - Student recruitment and retention has been given high priority over the last several years. The School of Allied Health Sciences at the University of Texas Medical Branch at Galveston has been involved in recruitment and retention programs that have produced minority student enrollment of over 20% over the past seven years. The programs are supported by federal grants that have provided seed money to design, develop, and implement three specific recruitment and retention programs. These programs have assisted in enrolling over 575 minority students with a retention rate above 90%. Graduation, licensure, and certification rates have been at or above the majority population. These programs are adaptable at other allied health professions schools and have been used as models for several programs across the United States. PMID- 2768074 TI - The 1988 Mary E. Switzer lecture scholarship in the university: perspectives for the allied health professions. PMID- 2768075 TI - The endolymphatic sac and inner ear homeostasis. I: Effect of glycerol on the endolymphatic sac with or without colchicine pretreatment. AB - The combined effects of glycerol and colchicine on the endolymphatic sac were investigated in mice. Glycerol induced signs of secretion from the epithelium with formation of secretory granules in the light epithelial cells. Other characteristics of the epithelial lining were also changed resulting in an increased widening of the lateral intercellular spaces, a partial collapse of the lumen and with a deposition of a stainable substance within the lumen. This reaction lasted from 30 min to 24 h following the injection. Pretreatment with colchicine was found to decrease or inhibit the glycerol-induced secretion of macromolecules into the sac. The lumen collapsed but frequently there was no presence of stainable substance. Animals treated with both glycerol and colchicine showed marked signs of inner ear malfunction which could indicate that the secretory activity in the sac might be closely related to the regulation of inner ear fluid homeostasis and that functional disturbances in this system may lead to disorders of inner ear function. PMID- 2768077 TI - Immunocytochemical localization of myosin, tropomyosin and actin in vestibular hair cells of human fetuses and cats. AB - Semithin sections (1 micron) of human fetuses and young cat vestibular epithelium embedded in Epon were reacted with primary antibodies raised against myosin, tropomyosin, and actin. The results were very similar in the two species. Myosin and tropomyosin were colocalized and strictly limited to an apical superficial corona arranged in a punctiform pattern. The stereocilia and cuticular plate were unreactive to myosin and tropomyosin antibodies. Actin antibodies stained the stereocilia, cuticular plate, and a marginal ring surrounding and underlying the cuticular plate. At this level, myosin and tropomyosin were not detected. This result suggests that the circumferential actin ring has a structural role. Colocalization of myosin, tropomyosin, and actin in a superficial area around the stereocilia bundle and along the apical surface of the hair cell imply that active processes could exist at the apex of certain sensory vestibular hair cells. The specificity of myosin antibodies and their cross-reactivity with different types of myosin are discussed. PMID- 2768076 TI - Electrochemical profile for calcium ions in the stria vascularis: cellular model of calcium transport mechanism. AB - The d.c. potential and the Ca2+ concentration in the stria vascularis of the chincilla were measured using double-barreled Ca2+-selective microelectrodes with fine tips. The impalement of the microelectrode through the stria vascularis indicated two or three regions showing low Ca2+ concentrations. The first region with a low Ca2+ concentration, presumably corresponding to the basal cell, showed a Ca2+ concentration of 2.5 +/- 1.9 microM. The low Ca2+ region, adjacent to the endolymph, showed 0.31 +/- 0.15 microM and presumably corresponds to the marginal cell. In contrast, the Ca2+ concentrations in the spiral ligament, intrastrial space and endolymph were 1.6 +/- 0.2 mM, 0.75 +/- 0.12 mM, and 17 +/- 7 microM, respectively. Based upon the electrochemical profile for Ca2+ ions, we hypothesize mechanisms of cellular Ca2+ transport where Ca2+ ions from perilymph are accumulated into endolymph via the action of Ca2+-ATPase located in apical membranes of both the basal and marginal cells. PMID- 2768078 TI - Timing of spike discharges in cat auditory cortex neurons: implications for encoding of stimulus periodicity. AB - Neurons at more central stations in the central auditory pathway show progressively poorer responses to high-frequency stimulus periodicities. This has been attributed to the relatively poorer spike timing in forebrain auditory neurons. This study directly examined the timing of spikes evoked by brief tone pulses which were varied in peak level and repetition rate. The experiments revealed that at tone repetition rates which produced progressively poorer entrainment, the timing of spike discharges remained sufficiently precise to support entrained responses. The fact that responses were poor indicates that imprecision in spike timing may not be the only factor limiting the encoding of temporal frequency. The data are discussed in relation to evidence on the temporal tuning of central neurons seen in studies using continuous amplitude modulations. PMID- 2768079 TI - Glycine-immunoreactivity in the auditory brain stem of the chick. AB - Glycine-immunoreactivity (Gly-I) was studied in the auditory brain stem of chick using a polyclonal antiserum to glycine conjugated to bovine serum albumin (Wenthold et al., 1987). During embryonic development, little Gly-I is present in nucleus magnocellularis (NM), nucleus laminaris (NL), or nucleus angularis (NA). In posthatch chicks, a few Gly-I terminals are found on nerve cell bodies in NM. Gly-labeled terminals are rare in NL and NA. When present in NL, they appear to be apposed to neuronal somata and not to dendrites. Occasionally, a Gly-labeled cell can be found in NM. After unilateral cochlea removal, Gly-labeled terminals are still present in NM. Thus, the cochlea does not appear to be the source of the glycinergic afferents to NM. The pattern of staining of Gly-I contrasts sharply with that of gamma-aminobutyric acid-immunoreactivity (GABA-I). The number of Gly-I terminals in NM, NL and NA appears to be much less than that of GABA-I. In addition, GABA-I terminals are very abundant around both the cell bodies and dendrites of neurons in NM and NL, whereas Gly-I terminals are found only on neuronal somata. Gly-I in NM also appears to be much less than that in its mammalian homologue, the anteroventral cochlear nucleus. PMID- 2768080 TI - Threshold functions for electrical stimulation of the human cochlear nucleus. AB - Thresholds to sinusoidal and biphasic pulsatile electrical stimuli were measured in two patients with electrodes positioned on the cochlear nucleus. The threshold functions differ from those observed in patients with scala tympani electrodes, primarily at low sinusoidal frequencies and long pulse widths. This difference is probably due to differences in the biophysical properties of the stimulated neural tissues in the two regions. PMID- 2768081 TI - Influence of age on hair cell loss in the rabbit cochlea. AB - The surface preparation technique was used for a study of cochlear hair cell loss as a function of age in rabbits 1 week, 6 months, 1 year, and 4 years old. Cytocochleograms from these animals were prepared which indicated damaged or missing hair cells over the entire spiral organ from the apical to the basal coil. The loss in the mean percentage of total outer hair cells (OHC) and inner hair cells (IHC) appeared to increase linearly with increasing age, with a statistically significant correlation. The cell loss was similar in all three rows of OHC in each of the age groups. In animals up to 1 year of age, areas of OHC loss were localized in the apical and basal coils. In 4-year-old rabbits, OHC degeneration had become progressively accentuated and widespread. The pattern of IHC loss was somewhat similar to that of OHC. Age-related hair cell loss in the rabbit is comparable to that in the rat, monkey, and human cochlea. PMID- 2768082 TI - Evaluation of the effect of ototopical neomycin on spiral ganglion cell density in the guinea pig. AB - The development of a reproducible unilateral deafness animal model was the primary objective of this study. Because of its importance in the function of cochlear prostheses, the status of the VIIIth nerve was used as the measure of deafness. The effect of a concentrated neomycin solution applied locally to the middle ear of the guinea pig was evaluated. Spiral ganglion cell survival was quantitated at 1, 2, 4, 6 and 10 weeks after exposure. Although the intermediate time periods showed moderate inter-animal variability, by ten weeks, consistent spiral ganglion cell loss was seen with maximum cell loss at the extreme apex (18.8% of control) and base (30.3% of control) and maximum cell survival in the lower middle turns of the cochlear spiral (53% of control). PMID- 2768083 TI - A temporal bone preparation for the study of cochlear micromechanics at the cellular level. AB - An in vitro preparation of the guinea pig temporal bone was developed for studying the micromechanical behaviour of the cochlea. The preparation consists of the cochlea opened at the apex, allowing observation of cellular structures within the cochlear partition with an optical sectioning microscope and measurements of cellular vibration with laser interferometry. The middle ear ossicles and the tympanic membrane are left intact as well as the bony part of the external auditory canal, which is used for delivering a sound stimulus to the cochlea. PMID- 2768085 TI - Variables affecting the auditory brainstem response: audiogram, age, gender and head size. AB - Correlations between the ABR (auditory brainstem response) and the variables of hearing loss, gender, head size and age were determined in simple and multiple regression analyses in 334 ears. The stepwise multiple regression analyses for waves I, III and V of the ABR was used to determine the relative importance of the variables. Regression equations were calculated for the latency of each wave. Wave I latency for all subjects is best predicted by hearing threshold at 8 kHz, gender and age, in that order. Wave III latency depends upon hearing threshold at 4 kHz, age and gender. The latency of wave V is best predicted by gender, age and head diameter with threshold at 4 kHz being of minor importance. The I-V interval depends upon head diameter and threshold at 8 and 4 kHz with age of minor importance. Hearing loss at 8 kHz would shorten the I-V interval, while a loss at 4 kHz would be expected to lengthen the interval. Correlations of these variables with the amplitude of I, III and V are also described. Latency and amplitude are correlated with different subject variables suggesting differences in their generation. PMID- 2768084 TI - The effects of kainic acid on the cochlear ganglion of the rat. AB - The effects of locally applied kainic acid on cells and fibers in the rat cochlea were examined in a quantitative and ultrastructural study. Doses of 5 nM per microliter of artificial perilymph destroyed part of the spiral ganglion type I cell population, with no ototoxic effects on cochlear hair cells or supporting cells. Type II cells also appeared unaffected. A quantitative evaluation of the cell loss with the 5 nM dosage showed that 34% of spiral ganglion neurons were lost 10 days after treatment. Doses of 20 nM per microliters and 40 nM per microliters did not result in increasing neuronal loss. This differential toxicity could reflect the presence of a sub-population of spiral ganglion cells with an increased number of KA receptors. PMID- 2768086 TI - ABR threshold is a function of blood oxygen level. AB - In order to determine if there is a relation between auditory threshold and oxygen availability, cats were anesthetized, paralyzed and ventilated with room air and with hypoxic gas mixtures. Auditory nerve-brain stem evoked response (ABR) thresholds and arterial blood oxygen levels [partial pressures (PaO2) and percent saturation (SaO2)] were determined. The ABR threshold was unchanged as long as PaO2 was above 30 mm Hg (SaO2 greater than 45%). Below PaO2 20 mmHg (SaO2 less than 25%) the animal was not viable. Between these values, the hypoxia caused ABR threshold elevations which were reversible when the animal was again respirated with room air. ABR threshold was an inverse function of blood O2 level with an approximate 3.05 dB elevation for every mmHg decrease in PaO2 (2.89 dB/% SaO2). These findings are probably due to hypoxia induced depression of the endocochlear potential. Since ABR could be recorded in premature human neonates after at least 28 weeks gestation and since the human fetus in utero is also hypoxic, these results indicate that the fetus (greater than 28 weeks gestational age) has a sensorineural hearing loss in addition to a conductive loss. PMID- 2768087 TI - Morphology and response properties of single olivocochlear fibers in the guinea pig. AB - Cochlear efferent and afferent units were recorded from the spiral ganglion in anesthetized guinea pigs. Efferent units were identified by their regular discharge patterns and their long response latencies to tone bursts. In some cases these physiological criteria were confirmed by anatomical tracing of single axons labeled with horseradish peroxidase. Labeled efferent axons traveled in the vestibular nerve root and the intraganglionic spiral bundle, and crossed the tunnel to innervate up to 61 outer hair cells over longitudinal distances of 0.15 to 2.1 mm. Efferent units were subdivided into classes by their excitatory responses to monaural tone bursts. Fifty-seven percent responded only to ipsilateral-ear sound, 28% only to contralateral-ear sound, and 15% to sound in either ear. Tuning curves from efferent units were generally similar in shape to afferent units, often having equally low thresholds and equally high Q10s. Efferent Q10s were somewhat lower from preparations anesthetized with a Urethane/Innovar combination than from preparations anesthetized with a Nembutal/Innovar combination. Efferent units with spontaneous activity were uncommon at the start of the recording sessions but were more frequently encountered later in the experiments. Spontaneous activity could often be suppressed by tonal stimuli, even sometimes to the non-excitatory ear of Ipsi and Contra units. PMID- 2768088 TI - Gender, health, and illness. The case of nerves. PMID- 2768089 TI - The burden of responsibility: duty, depression, and nervios in Andean Ecuador. AB - Saraguro Indian women possess relatively high status in their community. Nevertheless, they experience high rates of the culturally interpreted illness nervios. This syndrome produces symptoms characteristic of stress-induced depression and is identified by Saraguros as the product of suffering and misfortune. Descriptive and quantitative interview data indicate that episodes of nervios correlate with experiences of gender role failure, and the condition is identified as a coping mechanism for excessive responsibility and unrealistic social expectation. This syndrome also appears to serve as an effective strategy for enhancing power and social status. PMID- 2768090 TI - Notes on nervios: a disorder of menopause. AB - The condition of nerves among women in the small Peruvian town of Puente Piedre is described. Both nervios (a symptom) and Nervios (a disorder) describe a woman's difficulty with nerves. In Puente Piedre, the identification of an anxiety condition among women depends only on the women's age. Younger women with anxiety symptoms are diagnosed as nervios, a temporary condition ascribed to a single episode of high blood pressure. Menopausal women with similar symptoms, on the other hand, are thought to have a specific disorder, Nervios. In Puente Piedre, Nervios clearly is a folk illness limited to women of menopausal age. PMID- 2768091 TI - Nerves and psychosomatic illness: the case of Um Ramadan. AB - Belief in the unity of mind and body among poor working class women in metropolitan Cairo is exemplified by the "state of being upset." The Egyptian women of this study use physical symptoms that they believe derive from emotional causes to negotiate and give meaning to relationships with neighbors, friends, and relatives; to jockey for power; to fill emotional needs; to manage presentation of self; and to weave the political fabric of interpersonal life. A detailed case study of Um Ramadan, a woman whose misuse by her husband made her nerfiza, illustrates the relationship between emotional upset and physical illness and the use of psychosomatic illness to gain sympathy and exact revenge. The expression of Um Ramadan's symptoms is further analyzed in terms of the underlying cultural constraints placed on Muslim women and the tensions inherent in local gender role relations. PMID- 2768092 TI - Nevra in a Greek village: idiom, metaphor, symptom, or disorder? AB - The folk model for nevra (nerves) in Methana, Greece, is discussed in terms of the contradiction between the ideal of solidarity, central to the local family ideology, and the reality of interpersonal conflict in daily life. Contradictions in values resulting from rapid socioeconomic change are also considered. Nevra, a broad, ambiguous, negotiated concept, expresses a wide range of symptoms and serves as a culturally condoned medium for expression of otherwise unacceptable emotions. The notion of nevra provides a metaphor for social disorder such as interpersonal conflict between close kinfolk and value conflicts between generations. Case studies of social interaction demonstrate the relationship of nevra to various kinds of social disorder as well as to what Western psychiatry labels emotional disorders. Nevra is also related to other idioms of distress: the evil eye, possession by the devil, excessive drinking, and pilgrimages to religious shrines. PMID- 2768093 TI - Living on their nerves: nervous debility in Northern Ireland. AB - Divis Flats was a high-rise public housing project on the Falls Road in Belfast, Northern Ireland. It was frequently described as the worst ghetto in Western Europe, and was widely reputed to be a political hotbed, an Irish Republican Army stronghold, and one of the most violent housing estates in the United Kingdom. The complex exhibited some of the worst manifestations of Northern Ireland's considerable political, economic, social, health, and housing problems, and had been the scene of some of the worst violence that had occurred since the outbreak of the political "troubles" (as the war in Northern Ireland is euphemistically called) in 1969. Generalized ghetto conditions in combination with political violence created a powerful environment for the development of nervous complaints, and many people in Divis Flats, but particularly women, suffered from "nervous debility" or "bad nerves." Although this problem derived from multiple causes--political, economic, and social--terror stands out as the single most important causal factor. This article describes and analyzes the causes and experience of "nerves" and explores the relationship between gender and nerves in a Northern Irish ghetto. PMID- 2768094 TI - Experience of nervousness and anxiety disorders in Puerto Rican women: psychiatric and ethnopsychological perspectives. AB - Analyses of case materials describe variations in the experiences of Puerto Rican women diagnosed as having an anxiety disorder, in treatment with mental health clinicians, physicians, or traditional healers. Their common complaints are examined as core symbolic elements in culturally patterned complexes of meanings focused around personal trauma, stressful life events, personal and social reactions, expectations about treatment, and the course of illness. Many of these women report themselves to be "nervous," to be "sick from nerves," or to have had an "ataque de nervios." "Nervousness" is the base symbolic domain in Puerto Rico of what psychiatry labels "anxiety disorder," although it is also a common complaint of many disorders. What "nervousness" means to patients/clients and their clinicians or healers is examined within the frames of multilayered popular and biomedical interpretations. The special difficulties of women in Puerto Rico are highlighted, and psychiatric and ethnopsychological (Spiritist) models of etiology and treatment are compared. PMID- 2768095 TI - Nervios and dysphoria in Mexican American widows. AB - One hundred widows participating in experimental research entitled Efficacy of Support Groups for Mexican American Widows were studied to learn how they express the loss of their husbands. Mourning practices, acknowledged symptoms of dysphoria, and somatic reactions were studied to learn if the syndrome of nervios subsumes their reaction to bereavement. In addition, their responses to instruments designed to measure depression, the Spanish version of the Beck Depression Inventory and the Center for Epidemiologic Studies Depression Scale, were examined for correlation with nervios and relationships to Mexican American acculturation. Nervios seems to be a manifestation of dysphoria rather than a specific syndrome for these women. PMID- 2768096 TI - Nerves, worriation, and Black women: a community study in the American south. AB - The experience of nerves among women in a low-income Black neighborhood was examined. Research conducted in the neighborhood revealed nerves as a formal classification of folk illness linked with life stress, yet in-depth interviews with a purposeful sample of 24 residents showed that a greater manifestation of nerves among women contributes to tendencies among family members to ignore the severity of its symptoms and to equate experiences of nerves with life conditions deemed inevitable for women. Lack of support for nerves among female sufferers was also evident among friends and physicians. These findings are analyzed against a background of gender-specific concepts of nerves and "worriation" operating in the neighborhood. Residents aver that women's "naturally" weaker constitutions and a moral imperative to worry places them at greater risk for nerves. Implications for clinical care of low-income Black women with nerves are discussed, and specific recommendations for culturally appropriate interventions are outlined. PMID- 2768097 TI - Conception rate at first insemination in beef cattle: effects of season, age and previous reproductive performance. AB - The effects of season, age at previous parturition, and whether the female was retained because she failed to conceive or be detected in estrus during the previous breeding season were analyzed for first-service conception rate in beef cattle. Twelve years of reproductive data on females that were at least 50% Simmental were obtained from a single farm. All females detected in estrus were artificially inseminated during 42-d breeding seasons (52 d for heifers), starting either in June or November. The data, consisting of 9,071 first-service records, were described by a logit model and parameters were estimated using weighted least squares procedures. Age and previous reproductive performance (whether the female had failed to conceive or be detected in estrus during the previous breeding season) significantly affected first-service conception rate, as did the interaction between the two factors. Season of insemination, when considered across all other effects, did not influence first-service conception rate, but the interaction of season and previous reproductive performance was significant, as was the three-way interaction between season, age and previous reproductive performance. Except for those calving at 2.5 yr of age, females that were inseminated in the winter subsequent to parturition in the fall had the highest first-service conception rates. Those that did not conceive during the breeding season subsequent to parturition and were carried over to the following season had lower first-service conception rates, with the lowest being for females carried over to the winter breeding season. PMID- 2768098 TI - Effect of dietary potassium chloride on feeder pig performance, market shrink, carcass traits and selected blood parameters. AB - A total of 288 commingled crossbred feeder pigs were purchased and transported 1,050 km in two trials to investigate the effect of added dietary potassium chloride in receiving and finishing diets on feeder pig shrink recovery, performance and pre-slaughter shrink. Diets containing 0, .48%, .96% or 1.44% added potassium chloride were fed for 2 wk post-arrival and again from 12 wk post arrival until slaughter. There was no effect (P greater than .1) on gain (22.9 kg pay weight) or feed conversion or on plasma or red blood cell potassium for the 2-wk post-arrival period due to the inclusion of potassium chloride in the 2 wk receiving diet. Also, there was no effect (P greater than .1) of potassium chloride in diets from 12 wk post-arrival until slaughter on gain, feed conversion, market shrink, carcass dressing percentage and plasma or red blood cell potassium concentration at slaughter. These results suggest that corn soybean meal-based diets contain sufficient potassium for pigs following a period of stress associated with marketing and transport. PMID- 2768099 TI - Grazing selectivity and in vivo digestibility of switchgrass strains selected for differing digestibility. AB - Animal selectivity and digestibility differences among switchgrass strains selected for different in vitro dry matter digestibilities (IVDMD) were measured in a grazing trial with esophageally fistulated steers and a sheep digestion trial. Extrusa selected by esophageally fistulated steers grazing high-IVDMD (Trailblazer), Pathfinder and low-IVDMD strains of switchgrass were compared, as were top and whole plant hand-clipped samples from each strain. Trailblazer extrusa had higher (P less than .1) in vitro organic matter disappearance (IVOMD) and lower (P less than .1) NDF and ADF than Pathfinder extrusa. Extrusa from all three strains appeared to be of higher quality than top or whole plant hand clipped samples. In vitro organic matter disappearance tended to be highest for Trailblazer top hand-clipped samples. Composition of hand-clipped samples among strains was not significantly different. Mature crossbred wethers were used to compare Trailblazer and Pathfinder switchgrass hay in a digestion trial. No differences (P greater than .1) were detected between strains for DMI or apparent digestibility of DM, NDF, ADF and CP. Extrusa from Trailblazer switchgrass that had been selected for whole plant IVDMD had higher IVOMD; however, there was no indication that steers selected a differentially higher IVOMD for one strain than another. PMID- 2768100 TI - Genetic correlations between test station and on-farm performance for growth rate and backfat in pigs. AB - Record of performance data taken on Yorkshire pigs on-farm in 123 breeder herds and at a central test station were used to estimate genetic correlations between measures of backfat depth and days to 90 kg on boars at the test station and boars and gilts on-farm. The data involved records on 3,513 station-tested boars, 13,760 farm-tested boars and 28,203 farm-tested gilts from 838, 2,098 and 2,339 sires, respectively. For backfat depth, estimates of genetic correlations were .85 for test station and on-farm boars and 1.04 for test station boars and on farm gilts. Estimates of genetic correlations between test station and on-farm measures of days to 90 kg were .80 for boars and .74 for boars and gilts. Based on these results, selection of boars on the basis of test station performance for backfat and growth rate would be expected to result in genetic improvement on farm in both sexes under North American testing and management conditions. PMID- 2768101 TI - Estimating parameters of growth curves of bulls. AB - Parameters were estimated for nonlinear growth curves for bulls of five straightbred and 20 crossbred breed-types produced in two generations of a diallel. The primary intent of this study was to use the estimates obtained for mature size and maturing rate to define male growth in manner that would be appropriate for use in the Texas Agricultural Experiment Station (TAES) Beef Cattle Simulation Model. The results that were obtained from the nonlinear regressions made on the male growth data indicated that the relation between the mature sizes of males and females of the same breed-type is consistent with the assumption for that relation contained in the model (a ratio of 1.5). However, the inverse relationship between mature size and maturing rate that is assumed in the model was not consistent with the results of the present study. That contradiction presumably arose due to the different environment imposed on the males relative to their female counterparts. This condition prohibits direct application of the results of this study because live weights cannot be directly related to the principal growth curve contained in the model. However, such a relationship can be developed when information regarding the composition of bulls considered in this study becomes available. PMID- 2768102 TI - Fluid distribution in pork, measured by x-ray diffraction, interference microscopy and centrifugation compared to paleness measured by fiber optics. AB - Moderately PSE (pale, soft, exudative) and moderately DFD (dark, firm, dry) pork was examined by x-ray diffraction for interfilament separation, by differential interference contrast microscopy for interfiber area, and was centrifuged to measure water holding capacity (WHC). Internal reflectance spectra were measured by fiber optics. For PSE to DFD pork, filament separation ranged from 39 to 48 nm, interfiber area from 42 to 3%, and WHC from 49 to 64%, respectively. The correlation of reflectance with interfilament separation varied considerably with wavelength (reaching r = -.83 at 680 nm, P less than .005). The correlation of reflectance with interfiber area was more uniform across the spectrum (reaching r = .90 at 450 nm, P less than .005), as was the correlation of reflectance with WHC (reaching r = -.80 at 400 nm, P less than .005). At 24 h postmortem, fiber optic spectrophotometry may be used as a rapid, nondestructive method to predict WHC and potential fluid losses from commercial pork with a moderate range from PSE to DFD. Interfiber area was correlated negatively with filament lattice area and WHC, but no significant correlation was found between filament lattice area and WHC. Filament separation was decreased only slightly by centrifugation. These results indicate that at 24 h postmortem the extra fluid released from PSE pork already has been lost from the myofilament lattice and is awaiting release from compartments downstream such as interfiber and interfascicular spaces. PMID- 2768103 TI - Effects of biotin and high copper levels on performance and immune response of weanling pigs. AB - Weanling crossbred pigs (n = 216, 6.9 kg initially) were used in three 5-wk trials to evaluate the effect of supplemental biotin (0, 220, 440 and 880 ppb) and Cu (0, 200 and 400 ppm) on performance, hemoglobin concentrations, serum and liver Cu levels and immune response (humoral and cell-mediated). Feeding 200 ppm Cu increased growth rate (P less than .01) and feed intake (P less than .01) during the 5-wk trials; 400 ppm Cu depressed growth and feed intake after wk 2. Efficiency of feed utilization, however, was improved (P less than .05) when either 200 or 400 ppm Cu diets were fed. Whereas supplemental biotin generally did not affect pig performance, an interaction (P less than .01) during the first 2 wk was detected; ADG and feed intake were highest for 200 and 400 ppm Cu dietary levels in combination with the 440 and 880 ppb biotin levels. Hemoglobin concentration was depressed (P less than .01) when 400 ppm Cu was fed, and liver Cu levels were increased (P less than .01) 8- and 35-fold for pigs fed 200 and 400 ppm supplemental Cu, respectively. Although the magnitude of the immune response was small and inconsistent, diets containing 220 and 440 ppb biotin seemed to increase the immune response to sheep red blood cells, but 880 ppb biotin appeared to depress the response; there was no effect of biotin level on lysozyme titers. Addition of Cu to the diet tended to depress the immune response to lysozyme and phytohemagglutinin but did not affect sheep red blood cells. PMID- 2768104 TI - Influence of energy and protein intake during lactation on body composition of primiparous sows. AB - The effects of energy and protein intakes by 32 primiparous sows during a 28-d lactation on sow and litter performance and sow body composition and bone properties were examined. Dietary treatments were energy intakes of 8 (LE) and 16 (HE) Mcal of ME/d and protein intakes of 380 (LP) and 760 (HP) g of CP/d in a 2 x 2 factorial arrangement. Sows fed diets that were inadequate in either energy or protein lost more weight than did sows fed the HE-HP diet, but backfat losses were greater when energy intake was deficient than when protein was deficient. Carcass measurements were influenced in a similar manner, with energy intake affecting (P less than .001) backfat thickness and protein intake affecting (P less than .05) longissimus muscle area. Heart, kidneys and liver of sows fed LP diets weighed less (P less than .01) and contained less water and protein (P less than .05) than those of sows fed HP. Sows fed LE had heart, liver and viscera that weighed less (P less than .05) than those of sows fed HE. There was less fat (P less than .05) in the heart, lung, liver and viscera of sows fed LE than in those of sows fed HE. Carcass components of the supraspinatus muscle and standardized sections through the longissimus muscle and right shoulder weighed less (P less than .05) from sows fed LP rather than HP, and these components contained less water and protein. Sows fed the LE diets had less fat in the loin soft tissue section, right shoulder section and supraspinatus muscle than sows fed HE. Bone composition and strength were not influenced by dietary treatment. The composition of weight lost during lactation was diet-dependent. Sows fed diets that were deficient in protein but adequate in energy lost large amounts of protein from muscles and internal organs. Energy deficiency resulted primarily in fat loss. PMID- 2768106 TI - Long-term liquid storage of porcine spermatozoa separated using a discontinuous bovine serum albumin gradient. AB - Two experiments were conducted to determine efficacy of a discontinuous bovine serum albumin (BSA) gradient for isolating viable porcine spermatozoa more tolerant to 5-d liquid storage in Beltsville Thawing Solution (BTS) at 15 degrees C. The gradient, contained in a 500-ml separatory funnel, consisted of 4% BSA (60 ml) over 10% BSA (60 ml). Spermatozoa were extended in 26 ml of BTS, layered on top of the gradient, and allowed to migrate through the BSA. The quality of spermatozoa separated by the gradient varied among boars. However, populations of spermatozoa isolated from the bottom 30 ml of the gradient (Fraction 4) consistently contained a high percentage of spermatozoa with acrosomes possessing normal apical ridges (NAR; 89.6%) and progressively motile spermatozoa (MOT; 84.0%), as well as spermatozoa with high velocity (VEL; 336.5 mu/s). Increasing sperm migration time, but not gradient temperature, increased the number of spermatozoa recovered in Fraction 4, but it did not reduce quality of the separated spermatozoa. Spermatozoa isolated in Fraction 4 had greater NAR, MOT and VEL after 5-d storage in BTS than did unseparated spermatozoa. Boar spermatozoa isolated on a discontinuous BSA gradient were more tolerant to storage at 15 degrees C than were unseparated spermatozoa. Such a population may be desirable for use in artificial insemination programs. PMID- 2768105 TI - Fate and residues of trenbolone acetate in edible tissues from sheep amd calves implanted with tritium-labeled trenbolone acetate. AB - In order to study the fate and residues of trenbolone acetate in edible tissues, two groups of six animals from two ruminant species (ewes and calves) were implanted with [3H]trenbolone acetate. The distribution of extractable radioactive residues was measured in liver, kidney and muscle. We found that the largest proportion of residues was not extractable and thus was considered as covalently bound residues. The proportion of the main extractable metabolites (17 alpha-trenbolone, trendione, 17 beta-trenbolone) was measured. The evaluation of the distribution of trenbolone acetate metabolites directly soluble in water showed that unknown metabolite(s) were predominant. The covalent binding to nucleic acids was measured. It was so low that it was not detectable. The results are discussed in light of the data presented in the scientific report on anabolic agents in animal production from the European scientific working group. PMID- 2768107 TI - Pig blastocyst development in vitro is affected by amino acids. AB - Pig embryos were removed 5 d after onset of estrus and cultured in modified Krebs Ringer bicarbonate (mKRB) medium containing bovine serum albumin (BSA; 1 mg/ml). Media in Exp. 1 and 2, but not in Exp. 3, contained 10% heat-inactivated lamb serum (LS). In Exp. 1, embryos were cultured in 1) mKRB + LS or mKRB + LS supplemented with 2) glutamine (2 mM); 3) phenylalanine (.1 mM), methionine (.05 mM) and isoleucine (.2 mM); or 4) phenylalanine, methionine, isoleucine and glutamine. Embryos cultured in media with supplemental phenylalanine, methionine and isoleucine attained larger (P less than .05) volumes during culture and initiated hatching at an increased (P less than .05) frequency compared with embryos cultured without additional amino acids. In contrast, adding glutamine depressed (P less than .05) the maximum volumes observed during culture. In Exp. 2 mKRB + LS was compared with mKRB + LS plus phenylalanine (.1 mM), methionine (.05 mM) and isoleucine (.2 mM); methionine and isoleucine; phenylalanine and isoleucine, or phenylalanine and methionine. Embryos cultured in media supplemented with phenylalanine and methionine attained larger (P less than .05) volumes than embryos cultured in either media without added methionine. Fewer (P less than .05) embryos cultured without methionine initiated hatching (56%) compared with embryos provided methionine (89%). In Exp. 3, we evaluated the addition of glutamine (1 mM) with or without phenylalanine (.1 mM), methionine (.05 mM) and isoleucine (.2 mM) to serum-free mKRB. Adding glutamine alone, but not in combination, increased (P less than .05) blastocyst volumes on d 3 and maximum volume attained during culture compared with embryos cultured in mKRB alone.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2768108 TI - Relationships among prolactin binding, prolactin concentrations in plasma and metabolic activity of the porcine mammary gland. AB - The current studies were designed to investigate relationships among prolactin (PRL) binding, PRL concentrations in plasma and metabolic activity of porcine mammary glands. Preliminary studies revealed specific high-affinity binding of oPRL to porcine mammary gland. Conditions for optimal specific binding were similar to those observed for other species. To address the main objectives of the study, four mammary biopsies and blood samples were obtained from each of four gilts during lactogenesis and lactation (d-11, 4, 21 and 42 of lactation) to measure in vitro rates of metabolic activity, PRL binding to mammary membranes and PRL concentrations in plasma. Metabolic activity, as measured by oxidation of glucose or acetate to CO2 and incorporation into lipid, was low during pregnancy, increased two- to five-fold on d 4, and then paralleled the lactation curve for sows. There were highly significant positive correlations between PRL binding and all measures of mammary metabolism when data from pregnancy and lactation were utilized. Coefficients were positive but generally not statistically significant when lactation data only were utilized. During lactation, significant negative correlations were observed between concentrations of PRL in plasma and PRL binding and between PRL in plasma and mammary metabolic rate. These data provide evidence that binding of PRL to its receptor is an important effector of milk production in sows. Furthermore, oPRL is a suitable ligand to quantify PRL binding to porcine mammary tissue. PMID- 2768109 TI - Nutritional anestrus in beef cows: body weight change, body condition, luteinizing hormone in serum and ovarian activity. AB - Multiparous Hereford cows (n = 22) with moderate to good body condition scores (BCS) were randomly allotted to maintenance (M) or restricted (R) diets under drylot conditions. Cows on M diets received adequate feed to maintain initial BW, whereas R cows were fed to lose 1% of their initial BW weekly until luteal activity ceased. When most of the R cows became anestrous, their diet was increased to allow BW gain and resumption of ovarian cyclicity. Body weights and BCS were recorded weekly and luteal activity was assessed by weekly determination of progesterone in plasma. Concentrations of LH in serum were quantified in weekly samples and in samples obtained frequently at four selected times. Restricted cows had reduced BW (P less than .01) by 5 wk and reduced BCS (P less than .01) by 15 wk compared with M cows. Luteal activity ceased after 26 +/- 1 wk of reduced nutrient intake in 91% of the R cows; R cows had lost 24.0 +/- .9% of their initial BW and had a BCS of 3.5 +/- .3. Lack of luteal activity was associated with absence of behavioral estrus. Estrous cycles resumed 9 +/- 2 wk after the diet of R cows was increased, at which time R cows weighed 12 +/- 3% less than at the start of the experiment and had a BCS of 4.6 +/- .2. Concentrations of LH in serum samples obtained weekly were reduced (P less than .01) in R cows compared with M cows. In addition, LH pulse frequency was reduced (P less than .05) when R cows were initiating anestrus.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2768110 TI - Specific binding of naloxone to ovine brain tissue: comparison of brain regions and endocrine states. AB - Binding of [3H]naloxone ([3H]NAL) to brain membranes was quantified by Scatchard analysis using two methods of separating bound from free [3H]NAL. In the centrifugation method, membranes that were soluble at 1,000 x g, but sedimented at 20,000 x g, were incubated with [3H]NAL. For filtration, all membranes that sedimented at 20,000 x g were incubated and filtered through glass filter fibers. Nonspecific binding was estimated using greater than 500-fold excess of unlabeled naloxone (10(-6) M). Specific binding of [3H]NAL was used to generate linear multiple-point Scatchard plots, which indicated a single class of high-affinity sites. In Exp. 1, 10 ovariectomized (OVX) ewes were injected with estradiol-17 beta alone or in combination with progesterone. Compared with OVX controls, these hormonal treatments did not affect binding of [3H]NAL (centrifugation method) to combined hypothalamus (HYP) + preoptic (POA) tissues. In cyclic ewes (Exp. 2, filtration method), affinity constants (2.4 +/- .2 x 10(8) M-1) did not differ among HYP, POA and basal forebrain (BF) tissues, but BF had more sites (39 +/- 3 fmol/mg) than either HYP (14 +/- 1) or POA (17 +/- 1). Binding affinity and concentration of sites within each brain area (HYP, POA, BF) did not differ between d 8 and d 16 (preovulatory but after luteolysis) in normally cycling ewes. Overall, neural tissue dissected from BF had a greater concentration of binding sites than HYP or POA. Exogenous and endogenous fluctuations in ovarian steroids did not affect binding of [3H]NAL to these tissues. PMID- 2768112 TI - Relationship between endogenous estradiol-17 beta and estrous behavior in heifers. AB - Thirty-five Holstein heifers were used to examine the relationship between endogenous estradiol-17 beta and estrous traits. During a non-superovulation period (NSP), estrous cycles were synchronized and during the periovulatory stage blood samples were collected every 6 h for 120 h for subsequent determination of estradiol-17 beta and progesterone. In addition, continuous observation for estrous behavior was performed for 98 h. A gonadotropin-induced superovulation period (SP) was begun 12 d after estrus was detected during NSP. Heifers were injected with FSH twice daily for 4 d and single injections of prostaglandin were given on d 14 and 15. Beginning at d 14, blood samples were collected every 6 h for 120 h for subsequent determination of estradiol-17 beta and progesterone. Continuous observation for estrous behavior was performed for 98 h. Peak estradiol-17 beta was greater during SP than during NSP (49.0 +/- 3.1 vs 12.9 +/- 3.0 pg/ml serum). Thirty-three and 31 of the 35 heifers were in estrus during NSP and SP, respectively; duration of estrus was 2.3 h longer during SP than during NSP. However, number of behavioral interactions during estrus did not differ between NSP and SP. In conclusion, estrous traits were similar, whereas peak estradiol-17 beta concentrations were markedly different between NSP and SP. PMID- 2768111 TI - Differential growth factor content of uterine luminal fluids from large white and prolific Meishan pigs during the estrous cycle and early pregnancy. AB - Uterine luminal fluids (ULF) from Large White (LW) and prolific Chinese Meishan (MS) gilts were compared with respect to their peptide growth factor content during an estrous cycle and early pregnancy. Insulin-like growth factor-I (IGF-I) was quantitated by RIA; in vitro growth promoting properties of uterine luminal fluid mitogen (ULFM) were measured by [3H]thymidine incorporation into DNA of quiescent AKR-2B fibroblastic cells in culture. Peak concentrations (pg/microgram ULF protein) of IGF-I in ULF of Large White and Meishan gilts, respectively, were: estrous cycle, 9.8 +/- 1.4 (on d 10) and 39.7 +/- 7.8 (on d 12); gestation, 13.1 +/- 3.2 (on d 8 and 10) and 11.9 +/- 2.1 (on d 12), with differences among days (except d 10, P greater than .5) being affected by breed (P less than .10). For both breeds, there was a rapid decline in IGF-I concentrations by d 14 of the cycle and of pregnancy. Uterine luminal fluid mitogen activity was greater (P less than .01) for LW than for MS gilts on d 10 to 14 of an estrous cycle and gestation and diminished in a time-dependent manner in both breeds. No correlation was observed between IGF-I concentrations and uterine weights for either breed. In contrast, a negative correlation between uterine weight and ULFM activity was detected for cyclic (MS: r = -.855, P less than .10; LW: r = -.834, P less than .05) and pregnant (MS: r = -.806, P less than .10; LW: r = -.928, P less than .05) gilts.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2768113 TI - Effect of termination of pregnancy or long-term progestogen exposure on subsequent estrous cycle length and concentration of progesterone in plasma of heifers. AB - An experiment was conducted to determine whether short estrous cycles following abortion of heifers between 70 and 75 d of gestation are due to factors associated with the previous presence of a conceptus or long-term exposure of the uterus and(or) ovaries to a progestogen. Fifty crossbred heifers were randomly allotted at estrus (d 0) to five groups: control (n = 10), pregnant (Preg.; n = 14), progestogen (norgestomet) implant (Norg.; n = 9), progesterone-releasing intravaginal device (PRID; n = 9), or hysterectomy (Hyst.; n = 8). Control heifers were injected during the mid-luteal phase of an estrous cycle with 25 mg prostaglandin F2 alpha (PGF2 alpha) and length of the subsequent estrous cycle was determined. Beginning 6 to 8 d after estrus, heifers in the Norg. or PRID groups were given norgestomet ear implants or intravaginal coils, respectively, every 10 d for 70 d. Heifers were hysterectomized 5 to 8 d after estrus. Seventy to 75 d after conception, progestogen treatment or hysterectomy, heifers were injected (i.m.) with 25 mg PGF2 alpha and the last norgestomet ear implants or PRIDs were removed. Interval from PGF2 alpha injection to first estrus (means +/- SE) ranged from 2.5 +/- .2 to 4.4 +/- .7 d (P greater than .05). Length of the first estrous cycle means +/- SE) following PGF2 alpha-induced luteolysis or progestogen withdrawal was shorter (P less than .01) for the Preg. group (8.2 +/- .4 d) than for the control, Norg. and PRID groups (21.5 +/- .6 d; 19.3 +/- 1.4 d; and 18.2 +/- 1.3 d, respectively).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2768114 TI - Effect of progesterone supplementation on pregnancy and embryo survival in ewes. AB - Two hundred eighteen ewes were used in experiments 1) to develop a progesterone supplementation regimen capable of sustaining serum concentrations of progesterone at about 2.0 ng/ml for a period of 50 d (Exp. 1) and 2) to determine the effects of progesterone supplementation (d 6 to 50 after mating) on pregnancy and embryo survival rates in mated ewes (Exp. 2). In ovariectomized ewes in Exp. 1, s.c. administration of four cylindrical (9.5 x 60 mm) silastic implants, containing 20% (1.1 g) progesterone by weight, sustained mean serum concentrations of progesterone of 1.9 +/- .07 ng/ml compared with 1.03 +/- .05 ng/ml in ewes bearing two implants. In Exp. 2 each ewe (n = 159) was mated to two fertile rams at a spontaneous estrus (d 0) during mid-breeding season. Mean ovulation rate, determined on a subgroup of 46 ewes, was 1.45 +/- .05. On d 6, ewes were assigned randomly to control (two implants containing no progesterone) or progesterone-treated (four implants similar to those used in Exp. 1) groups. From d 7 to 50 after mating, progesterone concentrations in serum were greater (P less than .001) in progesterone-treated (four implants similar to those used in Exp. 1) groups. From d 7 to 50 after mating, progesterone concentrations in serum were greater (P less than .001) in progesterone-treated (3.50 +/- .06) than in control (2.65 +/- .05) ewes. Pregnancy rates (86% and 83%) and calculated embryo survival rates (77% and 78%) were similar (P greater than .05) for the control and progesterone-treated groups, respectively.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2768115 TI - Systemic progesterone concentration following human chorionic gonadotropin administration at various times during the estrous cycle in beef heifers. AB - In Trial 1, 26 heifers were allotted randomly to a control group or one of four groups to receive a single injection of 3,000 IU hCG on d 1, 4, 7 or 10 of an estrous cycle. Heifers next completed a nontreated cycle, and at their third estrus were reallotted to one of the five groups described previously. Estrous cycle length was extended in cycle 1 but was not altered during the nontreated cycle or in cycle 3. Administration of hCG on d 4 or 7 increased (P less than .05) mean serum progesterone (P4) over the first 16 d of the estrous cycle by .9 and .8 ng/ml, respectively. In Trial 2, 23 heifers were allotted randomly to one of two groups to receive a placebo or a single injection of 3,000 IU hCG on d 4 of an estrous cycle. Heifers were inseminated artificially at subsequent estrus. On d 4 postbreeding, treatments were repeated. Administration of hCG on d 4 of the prebreeding estrous cycle increased (P less than .05) mean P4 over the first 16 d by .9 ng/ml, whereas mean P4 over the first 16 d postbreeding was not affected by a second injection of hCG on d 4 postbreeding. Administration of hCG increased (P less than .05) first-service pregnancy rate (92 vs 55%). In conclusion, progesterone concentrations were enhanced by hCG given on d 4 or 7 of the estrous cycle, and pregnancy rate was increased when hCG was administered both on d 4 of the prebreeding cycle and d 4 postmating. PMID- 2768116 TI - Effect of phenylephrine, ergonovine, oxytocin and norepinephrine as an extender ingredient on viability of bovine spermatozoa. AB - We evaluated effects of three concentrations of phenylephrine, ergonovine, oxytocin and norepinephrine (myometrial stimulants) on viability of spermatozoa when they were included in a seminal extender. Using a split ejaculate technique, ejaculates from each of 10 bulls were extended in egg-yolk citrate to a final concentration of 35 x 10(6) sperm/ml, including 20 mg/ml, 2 mg/ml and .2 mg/ml, of phenylephrine or ergonovine, 20 IU/ml, 2 IU/ml and .2 IU/ml oxytocin or 200 micrograms/ml, 20 micrograms/ml and 2 micrograms/ml norepinephrine prior to freezing. Extended semen without a myometrial stimulant served as the control. Percentage of intact acrosomes was determined prior to freezing for all treatments. Motility and percentage of intact acrosomes were determined immediately after thawing (0 h) and again after 4 h incubation at 37 degrees C. Percentage of intact acrosomes was reduced (P less than .05) prior to freezing by phenylephrine (20 mg/ml) and ergonovine (20 mg/ml) (phenylephrine = 56%; ergonovine = 63%; control = 74%). The same doses of phenylephrine and ergonovine reduced (P less than .05) post-thaw motility and percentage of intact acrosomes at both 0 and 4 h compared with controls. Sperm exposed even to the intermediate concentration (2 mg/ml) of ergonovine had lower (P less than .05) motility 4 h post-thaw. No other compound or concentration of compound or concentration of compound affected percentage of intact acrosome or motility. There were no two or three-way bull x compound and concentration interactions (P greater than .2).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2768117 TI - Factors affecting the in vitro production of volatile fatty acids by mixed bacterial populations from the bovine rumen. AB - Factors affecting in vitro ruminal bacterial VFA production were examined. Treatments consisted of high and low initial pH (6.7, 5.7), osmolality (600, 400 mOsm) and concentrations of acetic (40, 0 mM) and propionic acids (20, 0 mM). Response variables measured included the production of acetic, propionic and total VFA, total gas and methane. Initial pH affected (P less than .05) most variables either independently or in combination with one or more of the other factors. Acetic acid production was reduced 40% (P = .03) when initial acetic acid concentrations were 40 mM compared with 0 mM. Also, acetic acid production was less (P less than .01) at low initial pH (5.7) than at high initial pH (6.7). Propionic acid production was greater (P = .05) at high vs low initial acetic acid concentrations. Propionic acid production was greater in response to low vs high initial osmolality, although the magnitude of this difference depended on initial pH (interaction P = .02). Total production of VFA was greater (P less than .01) at high than at low initial pH; however, at low initial pH, no difference (P greater than .05) was observed due to initial osmolality, whereas at high pH, production was greater (interaction P = .04) for low than for high initial osmolality. The diminished production of total VFA at pH 5.7 occurred primarily due to reduced acetic acid production, although increased production of propionic and butyric acids was noted.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2768118 TI - Effects of corn grinding and time of corn feeding on growth, starch utilization and digesta passage characteristics of growing steers fed hay-based diets. AB - Two forms of corn, whole (WC) and ground (GC), were fed with hay (WH; 900) or 4 h after hay (AH; 1300) feeding to evaluate their effects on growth, starch utilization and digesta passage characteristics in growing steers. Twenty-four Angus steers with ad libitum access to fescue hay were individually limit-fed ground or whole corn (2.27 kg/d) in a 2 x 2 factorial arrangement of treatments: GC- WH, GC-AH, WC-WH and WC-AH. Average daily gain was improved with feeding GC (P less than .08), especially when fed at the same time as hay. Fecal starch (%) was less (P less than .001) for GC (7.07) than for WC (15.68). No difference was observed in rate of liquid or solid (hay) passage. Mean retention time (MRT) of whole corn (stained with neutral red and crystal violet) was decreased (P less than .07), and rate of corn passage tended to be faster for steers fed WC-AH than for those fed WC-WH. Although time of corn feeding had no effect on performance, steers fed WC-AH had more whole corn particles recovered from the feces and the MRT for whole corn particles was reduced, indicating that time of supplementation may affect passage characteristics. Altering time of supplement feeding may have applications in other feeding situations, such as with protein supplementation where ruminal escape would be advantageous. PMID- 2768119 TI - Ruminal metabolism in nonlactating cows fed whole cottonseed or extruded soybeans. AB - Five nonlactating Holstein cows (average weight 574 kg) with cannulas in the rumen and duodenum were fed five total mixed diets at 2.14% (DM) of BW for seven 2-wk periods to estimate the ruminal degradation of protein and fatty acids in whole cottonseed (WCS) and extruded soybeans (ESB). Lanthanum was used as an indigestible marker. Ruminal propionic acid (molar proportion) was larger and butyric acid was smaller for WCS diets than for control or ESB diets. Total VFA (mM) and acetic acid (molar proportion) were similar for all diets. Duodenal flow of nonammonia nitrogen (N) was 13% higher for ESB diets than for WCS diets, but was similar for the control and diets with WCS. The percentage of intake protein that was undegraded was 19% higher for ESB diets than for WCS diets. Ruminal and total apparent digestibilities of ADF were not reduced by the addition of oil seed. In conclusion, the protein from ESB was less degraded in the rumen of cows than protein from WCS. The addition of ESB at 12.7% (DM) or WCS at 25.3% of the diet did not reduce the apparent digestibility of fiber. The unsaturated fatty acids in WCS were not protected from ruminal biohydrogenation, presumably due to mastication of the seed coat. PMID- 2768120 TI - Combinations of high-moisture harvested sorghum grain and dry-rolled corn: effects on site and extent of digestion in beef heifers. AB - To determine the effects of blends of high-moisture harvested sorghum grain (HMS) and dry-rolled corn (DRC) on site and extent of digestion, high-grain diets were fed to Angus-Hereford heifers (315 kg) in a 5 x 5 latin square. The grain portion consisted of ratios (HMS:DRC) of 0:100, 25:75, 50:50, 75:25 and 100:0. Heifers were equipped with ruminal, duodenal and ileal T-type cannulas. Digestibilities of OM (P less than .05) and non-ammonia nitrogen (NAN; P less than .01) in the total tract declined linearly as HMS replaced DRC. Chyme flow (liters/d) through the duodenum increased linearly (P less than .01), and true ruminal OM disappearance tended to decline linearly (P less than .10) as HMS replaced DRC. A quadratic response (P less than .05) in extent of starch disappearance (g/d) in the rumen was noted; blends were lower than either individual grain. Ruminal escape of feed N tended to be quadratic (P less than .10); values for individual grain types were greater than blends. Microbial efficiency increased linearly (P less than .05) as HMS replaced DRC. Extent of starch digestion in the rumen averaged 82.7% compared to only 2.9% in the small intestine and 5.7% in the large intestine. Altering the ratio of HMS to DRC appeared to have more effect on ruminal fermentation than on digestion in the small intestine; most starch and nitrogen responses were quadratic. Increases in ruminal pH and chyme flow, potentially caused by increased salivary flow, may cause non-linear changes in the solubility of proteins in HMS and DRC, when fed as blends, altering the digestibility of protein and starch from values predicted from the individual grains. PMID- 2768121 TI - Substitution of milk protein with isolated soy protein in calf milk replacers. AB - The influence of replacement of milk protein by isolated soy protein on digestion and pancreatic enzyme secretion was determined in nine Holstein male calves. Calves (average weight 47 kg) were fitted with permanent re-entrant pancreatic and a T-type cannula in the distal ileum at 6 to 10 d of age. Following a 2-wk recuperation period, the calves were fed three milk replacers in a triplicated 3 x 3 latin square. Experimental diets consisted of a control, in which 100% of the CP originated from spray-dried skim milk powder (SM), and the test diets, in which 50% (SM/ISP) or 100% (ISP) of the skim milk protein was replaced by isolated soy protein. Each experimental period lasted 2 wk. Replacement of SM protein by ISP decreased (P less than .05) the digestibilities of protein and most amino acids. Ileal digestibilities of total indispensable amino acids for SM, SM/ISP and ISP diets were 82.1, 75.8 and 61.8%, respectively, and total tract digestibilities of total indispensable amino acids were 90.0, 82.6 and 74.0%, respectively. Including ISP did not affect (P greater than .05) the volume of secretion of pancreatic juice, protein or chymotrypsin; however, the secretion of trypsin decreased (P less than .05). Reduction in trypsin secretion may be responsible, in part, for the lower amino acid digestibilities in milk replacers containing isolated soy protein. PMID- 2768122 TI - Influence of helminth parasite exposure and strategic application of anthelmintics on the development of immunity and growth of swine. AB - Infection of pigs with the intestinal roundworm parasite Ascaris suum and strategic application of anthelmintic drugs during the growing phase of development were observed for specific effects on 1) development of immunity in feeder pigs and 2) growth rate during the finishing phase. Management treatments included maintenance in a parasite-free concrete environment, maintenance in a concrete environment and inoculation with 1,000 infective A. suum eggs every other day over a 52-d period, and maintenance on a dirtlot contaminated with A. suum and Trichuris suis eggs. Within each management environment, pigs were either untreated, treated with ivermectin or treated with fenbenzadole at strategic times during parasite exposure. Protective immunity, assessed by a challenge inoculation with A. suum eggs following management treatments, was not affected by ivermectin or fenbenzadole treatment during exposure, but adult worm burdens were reduced and the pattern of A. suum larval antigen serum antibody responses were different from those in control pigs not treated with drugs. Exposure to A. suum and treatment with anthelmintics during the growing phase reduced adult worm burdens following the finishing phase of growth. Rate, but not efficiency, of gain was significantly improved by anthelmintic treatment following natural exposure to parasites. Strategic treatment of pigs with anthelmintics following inoculation with A. suum eggs in a concrete management environment had no effect on rate of gain. Results suggest that natural exposure to parasites during the growing phase without therapeutic treatment causes permanent damage to growth potential. PMID- 2768124 TI - Efficacy of methods used to test fertility of beef bulls used for multiple-sire breeding under range conditions. AB - A study was conducted during the 1982, 1983 and 1984 breeding seasons with 277 crossbred bulls, 1 to 3 yr of age, that were evaluated for physical soundness, testicular development, seminal quality, and both sexual and social behavior immediately before exposure to crossbred cow herds ranging in size from 89 to 329 cows. Crossbred cow herds were exposed to 4 to 24 bulls per breeding group (mean of 14) at a mean female: male ratio of 21.2 +/- .6:1 under extensive range conditions for 31 to 62 d (mean 46.6 d). All resulting calves were blood-typed to determine the number of calves sired by each bull as an estimate of his fertility. The mean number of calves sired by 1- (n = 116), 2- (n = 126) and 3-yr old (n = 35) bulls was 4.7 +/- .1, 8.2 +/- .1 and 10.5 +/- .1, respectively. A regression model for predicting bull fertility under multiple-sire, range breeding conditions was selected that accounted for 29% of the total variance in fertility. Similar models accounted for a greater proportion of variance in fertility of 1-yr-old (37%) than of 2-yr-old bulls (22%). Due to the large amount of unexplained variation, the model could not predict individual bull fertility precisely. However, this study demonstrated that selection of herd sires with large scrotal circumference, low backfat thickness, low levels of primary sperm defects, and a low number of mounts in combination with a moderate number of services during libido testing would be expected to improve fertility of beef bulls used under extensive range conditions. PMID- 2768123 TI - Effect of zeranol on sexual development of crossbred bulls. AB - Three groups of 1/2 Simmental X 1/4 Brahman X 1/4 Hereford bull calves were used during two different years to study effects of zeranol on sexual development. At 154 d of age, half the calves were implanted with 36 mg zeranol and half, not implanted, served as controls. Implanted calves were reimplanted at 90-d intervals throughout the trial (9 mo) each year. Trial 1 was conducted with 24 calves and Trial 2 was conducted the following year with 10 bulls. Twenty-four days after weaning (200 d of age) and at 28-d intervals thereafter, bulls in drylot in Trial 1 were weighted, scrotal circumference (SC) was measured and an ejaculate of semen was collected by electroejaculation to determine puberty. At these times, bulls were given 200 micrograms of GnRH i.m. and blood was collected at 0, 1, 2, 3, 4 and 5 h after GnRH. Serum concentrations of LH and testosterone (TEST) were determined. At slaughter, testis weight, length and circumference and pubertal status were recorded. Bulls implanted with zeranol had smaller SC than control bulls during the entire 9-mo period (P less than .0001). More control bulls reached puberty than did implanted bulls (82.4 vs 23.5%, respectively; P less than .001). Control bulls had larger testis measurements at slaughter (P less than .0001). Implants did not alter total weight gain or ADG (P greater than .10).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2768125 TI - Effect of initial length of uterus per embryo on fetal survival and development in the pig. AB - Influence of initial length of uterus available to each embryo on its subsequent survival and development was determined by systematic restriction of the length available to each potential embryo. Fifty-seven pregnant crossbred gilts were laparotomized at d 3 of gestation, length of uterine horns was measured in situ and corpora lutea (CL) were counted. In Exp. 1, uterine space available to each potential embryo was restricted by ligating one uterine horn 5 cm from the tip per CL. Uteri were examined at d 20, 25 or 50. In Exp. 2, one uterine horn was ligated on d 3 at 10, 20 or 30 cm from the tip per CL and uteri were examined at d 50. Embryos in the restricted section (RS) had a specific mean uterine length available to each potential embryo of 5, 10, 20 or 30 cm. Embryos in the nonrestricted section (NRS) had a variable mean uterine length available to each potential embryo of 44 +/- 4 cm. When embryos were restricted to 5 cm, the proportion of surviving fetuses at d 20, 25 and 50 was 61, 12 and 8%, respectively, whereas in combined NRS it was 82%. When the uterus was examined at d 50 after restricting embryos to 10, 20 or 30 cm/CL, 25, 33 and 52% of fetuses survived; in combined NRS survival was 71%. Each fetus surviving to d 50 in RS was associated with 36 cm of initial uterine length but fetal survival was not associated with number of CL. In RS, 59% were female fetuses and in NRS 50% were females.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2768126 TI - Effects of time of day and monensin on the size distribution of particles in digestive tract sites of heifers fed corn silage. AB - Effects of time of day and dietary monensin in the distribution of size of digesta particles in different digestive tract sites and their intersite relationships were examined in six heifers (290 kg BW) with ruminal, duodenal and ileal cannulas given ad libitum access to corn silage, with or without 100 mg monensin.head-1.d-1, in a two-period crossover design. Ingestive masticate and digesta of corn silage were collected via esophageal, ruminal or intestinal cannulas. The distribution of particulate matter retained on sieves with apertures larger than 20 microm was determined by wet-sieving. The cumulative distribution of particulate matter on a series of sieves was regressed on retaining sieve aperture to estimate the sieve aperture that would retain 50% weight of the particulate matter (median retaining aperture, MRA). The MRA of masticate was 6,494 microm. The MRA of digesta particles decreased (P less than .05) from ventral rumen (1,847 microm) to dorsal rumen (1,797 microm) to duodenum (346 microm), but increased to the rectum (359 microm). The MRA was lower (P = .044) for the monensin treatment only in feces. The MRA of particulate matter in the dorsal and ventral rumen, duodenum and rectum all changed (P less than .05) over 24 h. An inverse pattern between the MRA of ruminal and duodenal digesta occurred, presumably the result of a nycterohemeral pattern of eating and ruminating activity. Across sampling times, an inverse relationship existed between MRA of ventral rumen and duodenal digesta. This relationship suggests that a ruminal digesta raft composed of larger particles (immediately following major meals) is more effective than a raft of smaller particles (prior to such meals) in preventing flux of large particles to the duodenum. PMID- 2768127 TI - The influence of pregnancy and source of supplemental protein on intake, digestive kinetics and amino acid absorption by ewes. AB - Three experiments were conducted with ewes to determine the effects of pregnancy and(or) supplemental protein source on amino acid absorption and digestive criteria. In Exp. 1, four mated and five nonmated ewes fitted with abomasal and ileal cannulas were offered 272 g of cracked corn/d and ad libitum alfalfa hay (22% CP). Mated ewes absorbed greater quantities (P less than .10) and percentages (P less than .05) of amino acids presented to the abomasum than did nonmated ewes between d 121 and 124 of gestation. In Exp. 2, three nonmated ewes were used in a latin square design experiment to compare amino acid absorption when timothy hay (6% CP; 67% NDF) was offered alone or with supplements of corn plus either alfalfa hay (ALF) or soybean meal (SBM). Supplementation increased total, essential and nonessential amino acid flow to the abomasum and amino acid disappearance. In Exp. 3, 12 mated and 12 nonmated ewes were assigned to treatments in a 2 x 2 factorial arrangement to compare the effects of production status (gestation followed by lactation vs nonmated) and supplemented protein source (ALF vs SBM) on voluntary intake and digestive criteria. Ewes were pulse dosed with Yb-marked NDF from hay on d 124 and 137 of gestation and d 26 of lactation. During lactation (d 7 to 28), dietary DM intakes were greater (P less than .05) by ewes consuming ALF compared with SBM and by lactating ewes compared with nonmated ewes. Flow rates were greater (P less than .05) from mated ewes throughout the experiment. It appears that pregnant ewes met their increased nutrient demands by increasing flow rates and by more efficient apparent absorption of amino acids. PMID- 2768128 TI - Effect of dietary soybean meal on the microscopic anatomy of the small intestine in the early-weaned pig. AB - Two experiments were conducted to determine the effect of soybean meal in postweaning diets on villus height (VH), villus shape and lamina propria depth (LPD) in the small intestine. Intestinal samples were taken at 25, 50 and 75% of the small intestine's length. The first experiment determined the normal effects of age on these structures in nursing pigs from 9 to 36 d of age. Villus height decreased (P less than .01 at the 50 and 75% locations) and LPD increased (P less than .01 at the 25% location) in a quadratic fashion with increasing age. In the second experiment, pigs were weaned at 21 d of age and fed one of three 20% protein diets: 1) protein from hydrolyzed casein (CAS), 2) soybean meal (SBM) or 3) a conventional corn-soybean meal diet (CSBM). Intestinal samples were taken 0, 3, 6, 9, 12 and 15 d post-weaning. Villus height decreased dramatically the first 3 d postweaning, with a continuing decline until 12 d post-weaning. Averaged over the d 3 to 15 interval, VH were generally greater for pigs fed CAS than for pigs fed CSBM or SBM. Pigs fed SBM or CSBM had deformed villi, and pigs fed SBM had greater (P less than .05) LPD at all intestinal locations, suggesting less mature enterocytes on the villi. These data suggest that feeding high concentrations of soybean meal to the pig post-weaning has a detrimental effect on the small intestine, but this effect was minimized when soybean meal was fed as part of a corn-based diet. PMID- 2768129 TI - Cytotoxic activity of disulfur decafluoride (S2F10), a decomposition product of electrically-stressed SF6. PMID- 2768130 TI - Rat pancreatic interlobular duct epithelium: isolation and culture in collagen gel. AB - Interlobular duct fragments from the pancreas of the rat were isolated by collagenase digestion and filtration, embedded in a matrix of rat-tail collagen, and cultured in a 1:1 mixture of Dulbecco's minimal essential and Ham's F12 media supplemented with cholera toxin (CT, 100 ng/ml) and epidermal growth factor (EGF, 10 ng/ml) in addition to supplements used previously, thereby improving the yield of ducts by a factor of two compared with previous results. The ducts were harvested by digestion of the collagen matrix with collagenase and were then dissociated by treatment with EDTA in divalent cation-free salt suspended in collagen and cultured as were the ducts. Numerous cysts appeared as a function of time and some of these enlarged dramatically. Some of the larger cysts exhibited secondary tubular processes extending into the surrounding collagen. The addition of bovine pituitary extract (BPE, 50 micrograms/ml) doubled the number of cysts, whereas omission of serum or CT + EGF reduced the number. BPE or forskolin could substitute effectively for CT. Agents that stimulate (secretin) or inhibit (e.g., ouabain or acetazolamide) fluid-electrolyte secretion in vivo had no effect on the number or average diameter of the cysts. The cysts were 83 to 88% epithelial with the balance of the cells being fibroblastic in appearance. Some cysts consisted only of epithelium. The proliferative capacity of the cystic epithelium was shown by the presence of mitotic figures and by an autoradiographic labeling index of 22 to 30% after a 24-h exposure to [3H]thymidine. The labeling index was reduced by the omission of CT + EGF. Transmission electron microscopy showed that the cysts exhibited morphologic features of duct epithelium in vivo, including apical microvilli, lateral interdigitations of the plasma membrane, and typical cytoplasmic organelles. PMID- 2768131 TI - Maintenance of dihydrofolate reductase enzyme after disappearance of DHFR mRNA during muscle cell differentiation. AB - Terminally differentiating mouse muscle cells were used to examine the relationship between myogenic withdrawal from the cell cycle and the levels of dihydrofolate reductase (DHFR) mRNA and DHFR activity. Differentiation was induced by removal of fibroblast growth factor activity from the medium. DHFR mRNA was measured by a RNase protection assay. DHFR activity was measured by a spectrophotometric assay and by a [3H]methotrexate binding assay. Proliferative myoblasts contained four DHFR mRNA molecules and 1.8 X 10(5) DHFR enzyme molecules. By 12.5 h after induction, when [3H]thymidine labeling indices showed all cells had withdrawn from the cell cycle, DHFR mRNA levels had declined to 0.7 copies per cell. In contrast, myogenic withdrawal did not result in reduced DHFR activity. Qualitatively similar results, i.e. down-regulation of mRNA and constitutive expression of activity, were observed in a methotrexate-selected muscle cell line with greater than 50-fold amplification of the DHFR gene. Enzyme synthesis rate and stability measurements indicated that persistence of DHFR activity in postreplicative cells was due to a long enzyme lifetime rather than to continued synthesis from residual normal DHFR mRNA or an alternative mRNA species not detected by the RNase protection assay. Unlike DHFR, thymidine kinase (TK) activity disappeared rapidly as muscle cells differentiated. Both DHFR mRNA and TK mRNA are expressed in a replication-dependent manner; however, the enzymes encoded by these messages are subject to different fates in postreplicative cells. PMID- 2768132 TI - Establishment of five human myeloma cell lines. AB - Five human myeloma cell lines, KMM-1, KMS-5, KMS-11, KMS-12-PE, and KMS-12-BM, have been established at Kawasaki Medical School since 1980. As the KMS-12-PE and KMS-12-BM lines were obtained from the same patient, these five cell lines have been derived from four patients with multiple myeloma. The five myeloma cell lines are stably growing at present in RPMI 1640 medium supplemented with 10% fetal bovine serum. They can also grow in a defined culture medium without serum. That these cell lines were human myeloma cells was confirmed by the following findings. Ultrastructurally, all five cell lines showed features characteristic of plasma cells. KMM-1 and KMS-11 cells secreted lambda and kappa chains into the culture medium, respectively, but the other cell lines produced no immunoglobulins. KMM-1 expressed cytoplasmic lambda antigen, KMS-5 showed cytoplasmic delta, and KMS-11 expressed surface kappa, whereas KMS-12-PE and KMS 12-BM cells showed no surface or cytoplasmic immunoglobulins. Regarding reaction with a monoclonal plasma cell antibody (PCA-1), four of the five lines were positive, the exception being KMS-5. Another monoclonal antibody (CD38), which also recognizes plasma cells, responded to KMM-1, KMS-12-PE, and KSM-12-BM. KMS-5 cells expressed acute lymphoblastic leukemia antigens (CALLA). These data suggest that such lines as KMM-1, KMS-11, KMS-12-PE, and KMS-12-BM represent later stages of B-cell differentiation, and that KMS-5 represents a relatively early stage of B-cell differentiation. All the cell lines lacked Epstein-Barr virus nuclear antigen, showed abnormal karyotypes of human origin, and differed from each other in the isozyme patterns examined. Only KMS-5 was tumorigenic when transplanted subcutaneously into nude mice. PMID- 2768133 TI - Culture of human neoplastic gastrointestinal smooth muscle cells. AB - Due to limited growth potential of primary cultures and the absence of continuous lines of healthy enteric smooth muscle, we have studied the culture behavior of neoplastic gastrointestinal smooth muscle cells. Forty-six human enteric smooth muscle neoplasms (leiomyomas and leiomyosarcomas) were studied while fresh and/or after culture in vitro and growth in vivo in athymic nude mice, with assessments made of morphology, growth characteristics, and biochemical markers of differentiation. The state of differentiation of the tumors varied, with well differentiated tumors tending to express binding sites for the gastrointestinal hormone cholecystokinin, whereas less well-differentiated tumors did not. Poorly differentiated tumors were the easiest to establish in culture in vitro and to grow in vivo in nude mice. When the cells placed directly into culture proliferated to confluent density, they underwent morphologic differentiation from a spread, fibroblastlike shape to a slender spindle morphology, with these cells possessing fewer biosynthetic organelles and arranging themselves in characteristic "hill and valley" arrays. However, the highly differentiated characteristics of expression of desmin or cholecystokinin-binding sites were not observed in cultured cells. In contrast, cells that had been passaged in nude mice before culture displayed a proliferative phenotype and failed to undergo morphologic differentiation on reaching confluent density. Four human enteric smooth muscle cell lines (documented by chromosomal analysis) originating in stomach, jejunum, ileum, and rectum were established using this strategy. PMID- 2768135 TI - Treatment of visual perceptual deficits after stroke: four single case studies. AB - The transfer of training approach to the treatment of visual perceptual deficits was evaluated with three left hemiplegic and one bilateral hemiplegic stroke patients, using single case designs. The results showed little evidence of effective treatment for perceptual deficits, although there was a slight response to treatment for inattention deficits. Overall the changes were minimal. The importance of monitoring treatment is discussed. PMID- 2768136 TI - Remedial therapy and functional recovery in a total population of first-stroke patients. AB - A consecutive series of 155 patients with a first-ever stroke and who were registered with the Oxfordshire Community Stroke Project (OCSP) were followed up. Their receipt of remedial therapy was recorded and their functional recovery was measured using the Barthel index of activities of daily living. Only a minority of patients received remedial therapy during the first 6 months after stroke. Those who were admitted to hospital during the first month following their stroke, or who were severely dependent, were significantly more likely to receive remedial therapy than those who remained in the community or were less dependent. A comparison of functional recovery amongst a matched subsample of patients who received remedial therapy and those who did not showed that there was comparable recovery amongst patients who did not receive remedial therapy. PMID- 2768138 TI - The parkinsonian and driving. AB - A survey of 15 members of branches of the Parkinson's Disease Society was undertaken by a medical student as part of a course in social medicine. Most of the individuals had given up driving a car but only a third of the group had notified the Driving and Vehicle Licensing Centre of their disorder, which they are required to do; similarly, most had neglected to inform their insurance companies of the diagnosis. Four people admitted that Parkinson's disease had been a contributory factor in an accident involving another vehicle, and anxiety over being a hazard was admitted by most of the group. Giving up driving exacerbated the premature social ageing encountered in Parkinson's disease, and those afflicted should be encouraged to liaise more closely with arrangements for re-education in methods of safe driving. PMID- 2768137 TI - How stroke patients spend their days. An observational study of the treatment regime offered to patients in hospital with movement disorders following stroke. AB - A number of studies have suggested that early intensive rehabilitation will promote recovery after stroke. If this is so then how far does current National Health Service provision succeed in delivering this? This observational study looks at how 15 stroke patients in a general hospital spent their days. Only 12.9% of the working day, or 62 minutes, were spent in therapy. Patients spent most of their working day, 38.6%, in 'recreation', and most of this time was spent on the ward. For much of this time they could have been available for therapy sessions or involved in self-directed exercise. The impact of a new regime aimed at increasing intensity of therapy for the hemiplegic arm is examined. PMID- 2768134 TI - Mechanism of action of the migration stimulating factor produced by fetal and cancer patient fibroblasts: effect on hyaluronic and synthesis. AB - We have previously demonstrated that confluent fetal fibroblasts migrate into three-dimensional collagen gels to a significantly greater extent than their normal adult counterparts. Recent studies have revealed that this behavioral difference results from the secretion by fetal fibroblasts of a soluble migration stimulating factor (MSF) which acts on these cells in an autocrine fashion. Adult fibroblasts do not produce MSF but remain responsive to it. Skin fibroblasts from cancer patients resemble fetal fibroblasts (rather than normal adult cells) with respect to their migratory behavior on collagen gels and continued production of MSF. This communication is concerned with elucidating the biochemical basis of MSF activity. Data are presented indicating that a) hyaluronic acid is required for the elevated migratory activity displayed by confluent fetal and breast cancer patient skin fibroblast; b) adult fibroblasts exhibit a bell-shaped dose response to MSF, with maximal stimulation of migration observed at a concentration of 10 ng/ml; c) the migratory activity of adult fibroblasts pre incubated with MSF remains high in the absence of additional factor: and d) MSF affects both the quantity and size class distribution of hyaluronic acid synthesized by adult fibroblasts. We have previously speculated that the persistent fetal-like fibroblasts of breast cancer patients play a direct role in disease pathogenesis by perturbing normal epithelial-mesenchymal interactions. The observations reported here suggest that MSF-induced alterations in hyaluronic acid synthesis may contribute to the molecular basis of such perturbations. PMID- 2768139 TI - An interprofessional approach to the planning of rehabilitation services. PMID- 2768140 TI - Survival of social relationships following head injury. AB - A retrospective search through the medical records at a rehabilitation hospital in Melbourne, Australia, identified 38 subjects (within the age range 19-34 years) suffering the effect of a severe closed-head injury 2-10 years post trauma. In regard to social relationships, availability of post-trauma close attachment figures and looser social networks were markedly reduced for the head injured group in relation to a matched community control group. However, they did not generally perceive these social relationships as inadequate when compared to a normal control sample. Moreover, within the head-injured group the perception of inadequate social relationships was not significantly associated with minor psychiatric disturbance. The implications of these results in terms of the social bond theory of depression are discussed, and issues in long-term social support of this population are raised. PMID- 2768141 TI - Postponing pregnancy after perinatal death: perspectives on doctor advice. AB - The Perinatal Loss Interview was administered to 24 mothers who had experienced perinatal loss and were raising a child born subsequent to the loss; mothers were asked about postponing subsequent pregnancy, including what their doctors advised. Mothers were dissatisfied with doctor advice, reporting that the timing of a subsequent pregnancy was a personal decision and many factors influenced their decision. Furthermore, regardless of timing, most mothers reported overprotective and replacement feelings toward the subsequent child. These results imply that physicians may be most effective by educating mothers about advantages and disadvantages of postponing pregnancy so that an informed decision can be made. PMID- 2768142 TI - Diagnosis of attention deficit disorder with hyperactivity in Chinese boys. AB - Parental and teacher ratings of adjustment on the Achenbach Child Behavior Checklist and Teacher Rating Form were obtained on 39 subjects diagnosed as having attention deficit disorder with hyperactivity (ADDH), 31 subjects with ADDH plus learning disability (ADDH-LD), and 29 controls. Subjects were all males between the ages of 9 and 11 years and resided in Changsha, People's Republic of China. Significant group differences were found between the two clinical groups and the control group. Ratings by parents and teachers of the ADDH and ADDH-LD groups indicated more behavior problems and poorer social adjustment than controls. ADDH and ADDH-LD groups were not significantly different from one another except on ratings of school and learning problems. PMID- 2768143 TI - A three-year follow-up of Cambodian young people traumatized as children. AB - Twenty-seven Cambodian young people, who were severely traumatized at ages 8 to 12, were followed up 3 years after an original study. A structured interview and self-rating scales showed that post-traumatic stress disorders (PTSD) were still highly prevalent (48%). Depression existed in 41%. Those with PTSD differed significantly from those without PTSD on the Global Adjustment Scale, the Social Adjustment Scale, the Beck Depression Inventory, and the Impact of Event Scale. Eight subjects had PTSD at both interviews, while 11 had none at either time. Eight showed a variable course. Avoidance behavior was highly prevalent, even among those without PTSD diagnosis. Although functioning relatively well, these youths continued to show symptoms related to their trauma of 8 to 12 years before. PMID- 2768144 TI - Transition from East to West: Vietnamese adolescents and their parents. AB - A 28-item questionnaire assessing family values was completed by 191 Vietnamese and 639 Caucasian adolescents in Oklahoma City Public Schools and by about half their parents. Vietnamese refugee parents, regardless of time in the United States, strongly endorsed traditional family values. Vietnamese adolescents tended to reject traditional values. This generation gap increased with time in the United States and was greater for girls than for boys. Despite wholehearted endorsement of traditional family values, Vietnamese parents tended to approve certain adolescent privileges. The results suggest that Vietnamese adolescents may receive conflicting messages from their parents. On the one hand, parents endorsed such traditional values as absolute obedience to parental authority but on the other, they registered relative approval of adolescent freedom of choice regarding dating, marriage, and career. Such ambivalence suggests that Vietnamese refugee families may experience considerable strain while adjusting to American values. PMID- 2768145 TI - Problems reported for clinically referred American and Dutch children. AB - Child Behavior Checklists completed by parents of 50 children of each sex at each age from 4 to 16 seen in 28 American and 21 Dutch mental health services (N = 2,600) were examined. Analyses controlling for sex, age, and socioeconomic status showed somewhat higher total problem scores for American than Dutch children, with a mean of 57.27 versus 53.18 on a scale ranging from 0 to 240. This nationality difference accounted for less than 1% of the variance in total scores. American children obtained higher scores on more externalizing items than Dutch children. Small but significant differences in total, externalizing, and internalizing problems found between the two samples may reflect nationality differences in referral patterns. Competence scores were significantly higher for American than Dutch referred children, but did not differ as much as in comparable normative samples. Competence scores may reflect cultural differences more than problem scores do. PMID- 2768146 TI - Obsessive-compulsive symptoms in childhood inflammatory bowel disease and cystic fibrosis. AB - The Leyton Obsessional Inventory-Child Version was administered to 33 children with Crohn's disease, 11 with ulcerative colitis, and 46 with cystic fibrosis. Subjects with ulcerative colitis scored significantly higher on total number of obsessional symptoms and degree of resistance to symptoms than subjects with Crohn's disease. Scores of subjects with cystic fibrosis were intermediate between those of the ulcerative colitis and Crohn's disease groups. However, neither the ulcerative colitis group nor the Crohn's disease group differed significantly from the cystic fibrosis group that were statistically significant. Duration of illness was negatively correlated with symptoms in Crohn's disease and ulcerative colitis. The results suggest that obsessive-compulsive symptoms are not specific to Crohn's disease or ulcerative colitis and that obsessive compulsive symptoms in pediatric chronic illness may be secondary to the demands of the illness. PMID- 2768147 TI - Childhood obsessive compulsive disorder: a two-year prospective follow-up of a community sample. AB - A 2-year prospective follow-up of a community-based sample of adolescents previously diagnosed as having obsessive compulsive disorder (OCD) or "obsessive compulsive spectrum" disorder and a control sample was completed by clinicians experienced with OCD but blind to prior diagnosis. An initial diagnosis of OCD or "other psychiatric disorder with OC features" was most likely to predict a diagnosis of OCD at follow-up. Subclinical OCD at baseline did not strongly predict continuing psychopathology. A prior diagnosis of obsessive-compulsive personality predicted continued obsessive-compulsive symptoms but its relationship to OCD remains obscure. PMID- 2768148 TI - Forebrain structure in infantile autism. AB - Researchers implicate central nervous system dysfunction in infantile autism, but postmortem examinations and in vivo brain imaging studies have produced conflicting results concerning the neuronal systems involved. Magnetic resonance imaging--a new modality of in vivo brain imaging--was used to investigate the cerebral and thalamic structure of 105 autistic patients. Compared with the control group, there was an overall difference in the forebrain morphology of the autistic subjects due to subtle but statistically significant differences in the anterior ventricular horns, lateral ventricles, and the right lenticular nucleus. These results, when considered with previous studies of cerebral structure, suggest that there are subtle alterations in the forebrain of autistic patients. PMID- 2768149 TI - Use of the childhood autism rating scale with autistic adolescents and adults. AB - The suitability of the Childhood Autism Rating Scale (CARS) for diagnosing adolescents and adults with autism was tested and CARS ratings over time were examined to assess how the characteristics of autism change during adolescence. Subjects (N = 89) had been rated with the CARS before age 10 and again after age 13. A cutoff score of 27 was used; of 59 diagnosed as autistic prior to age 10, 92% were diagnosed as autistic after age 13. Moreover, 9 CARS categories showed significant improvements over time; only 1 showed a significant decrement. The CARS is thought to be a useful screening device for adolescents and adults with autism. Implications of this research for the understanding of autism and how it changes with development are discussed. PMID- 2768150 TI - The use of signal detection theory to assess DSM-III-R criteria for autistic disorder. AB - Sixty cases from the DSM-III-R field trials for autistic disorder (AD) were studied to derive an optimally sensitive and specific combination of scoring criteria based on the 16 DSM-III-R criteria for AD. Signal detection theory, a statistical method new to psychiatric research, was applied. Two of the sixteen criteria tested with this methodology yielded a sensitivity of 0.82, a specificity of 0.89, and a total predictive value of 0.91 relative to clinical diagnosis. Excluded criteria were redundant; unrelated to diagnosis; or highly correlated with degree of mental retardation, mental age, and/or chronological age. PMID- 2768151 TI - The Yale Global Tic Severity Scale: initial testing of a clinician-rated scale of tic severity. AB - Despite the overt nature of most motor and phonic tic phenomena, the development of valid and reliable scales to rate tic severity has been an elusive goal. The Yale Global Tic Severity Scale (YGTSS) is a new clinical rating instrument that was designed for use in studies of Tourette's syndrome and other tic disorders. The YGTSS provides an evaluation of the number, frequency, intensity, complexity, and interference of motor and phonic symptoms. Data from 105 subjects, aged 5 to 51 years, support the construct, convergent, and discriminant validity of the instrument. These results indicate that the YGTSS is a promising instrument for the assessment of tic severity in children, adolescents and adults. PMID- 2768152 TI - Methylphenidate treatment of attention-deficit hyperactivity disorder in boys with Tourette's syndrome. AB - The effects of methylphenidate on four boys diagnosed as attention-deficit hyperactivity disorder (ADHD) and Tourette's syndrome (TS) were examined under single-blind, placebo-controlled conditions. Clinical ratings and playroom observations showed improvement in ADHD symptoms with methylphenidate. Results also indicated that methylphenidate had no untoward effects on the frequency of tic occurrence. In all four children, the highest dose resulted in improved classroom ratings of tics compared with initial placebo treatment. In three cases, mild tic exacerbation was reported for a lower dose. Because variability of tic status was observed in the experimental conditions, the findings suggest the possibility that tic response was independent of clinical doses of methylphenidate. The findings were also consistent with the theory that methylphenidate, a dopamine agonist, might effect tic status by altering dopamine receptor sensitivity. Further investigation of these effects is indicated, given the efficacy of methylphenidate in treating ADHD symptoms of TS patients. PMID- 2768153 TI - Transient exacerbation of tics in treatment of Tourette's syndrome with clonidine. AB - An 11-year-old boy with a history of behavioral problems was admitted to the inpatient Child Development Program of St. Louis University Medical Center. A diagnosis of Tourette's syndrome was made, and when family objected to a trial of haloperidol for fear of tardive dyskinesia, clonidine was initiated. A temporary period of worsening of motor and phonic tics ensued, while dose adjustments were made. When a maintenance level was achieved, approximately 2 weeks after initiating treatment, remission of symptoms was observed. PMID- 2768154 TI - Psychiatric outcome of burned children and adolescents. AB - Recent medical and surgical advances allow many severely burned patients to survive who formally would have died. Assessment of psychiatric outcomes with these patients may provide ways of measuring effects of acute burn care methods on later quality of life, specify more accurately their emotional needs during rehabilitation, and stimulate further research. Thirty children, aged 7 to 19, with severe burns are compared with 30 nonburned subjects matched for age, sex, SES, and parents' marital status according to DSM-III criteria. The burned children had significantly higher levels of overanxious disorder, phobias, and enuresis, but they had the same rates of present depressive disorders. PMID- 2768155 TI - Psychiatric response to HIV spectrum disease in children and adolescents. AB - Five clinical situations involving children and adolescents exposed to human immunodeficiency virus illustrate the psychosocial spectrum of the disease. For at-risk gay youth, anxiety and stigma complicate developing sexual practices. Children with perinatal infection may survive for years with a chronic illness, management of which is complicated by parental illness or death. Hemophiliac families must deal with the intrusion of a lethal virus into a long illness course. "Street" adolescents and substance-abusing youth pose particular challenges to public health and education. The range of child psychiatric responses described includes individual and family therapy, neuropsychological assessment, psychopharmacological management, and consultation liaison work. PMID- 2768156 TI - Acute intermittent porphyria in a children's psychiatric hospital. AB - Acute intermittent porphyria (AIP) is a rare autosomal disease that presents with gastrointestinal, psychiatric, and neurological symptoms. Bizarre behaviors are common to several illnesses present in a psychiatric setting. Most often these are manifestations of psychotic illness such as schizophrenia or manic-depressive illness, but they can also be seen in cases of organic mental dysfunction and toxic psychotic states. The author describes the disorder and reports on two cases of AIP in children who were initially diagnosed as atypical psychosis in an inpatient children's psychiatric hospital over a 3-year period. PMID- 2768157 TI - Mania in a girl with Cushing's disease. AB - A 13-year-old girl with Cushing's disease suffered a manic episode. An adenoma of the pituitary gland was found to be the cause. After the adenoma had been removed, the girl's condition returned to normal. The affective disorder was classified as an organic mood disorder (DSM-III-R). PMID- 2768158 TI - Sex difference and social competence. PMID- 2768159 TI - Adaptive functioning at home and in the classroom. PMID- 2768160 TI - 44th annual conference of the Association of Physicians of India. Calcutta, 19-23 January 1989. Abstracts. PMID- 2768161 TI - Platelet transfusion therapy in thrombocytopaenia of haematologic malignancies. AB - Thirty thrombocytopaenic patients of acute leukaemias and myelodysplastic syndrome were transfused platelets collected from ABO-matched donors using Haemonetics V30 and V50 blood processors. Twenty-seven patients had septicaemia and/or splenomegaly; 2 patients had disseminated intravascular coagulation (DIC). Pre-transfusion platelet count was 11.0 +/- 4.0 X 10(9)/L. The mean corrected count increments (CCI) 1 hour and 18 hours post-transfusion were 13.02 X 10(9)/L and 3.88 X 10(9)/L respectively, in the absence of DIC. Active bleeding stopped when platelet count was above 15.0 X 10(9)/L. There was no difference between the platelet yield from two blood processors. PMID- 2768162 TI - Geriatric tuberculosis in Himachal Pradesh--a clinico-radiological profile. AB - Clinico-radiological profile of 100 geriatric pulmonary tuberculosis cases hailing from hilly areas of Himachal Pradesh was studied. The clinical presentation was altered due to associated smoking as well as chronic obstructive pulmonary disease. Breathlessness was the main presenting feature. Sixty-five cases had exudative lesions radiologically. Both conventional and short course regimens were equally effective. Drug toxicity was not a major problem. Delayed action taken and poor compliance were main handicaps in such cases. Need for individualized care for geriatric patients is stressed. PMID- 2768163 TI - "Top of the basilar" syndrome: a clinical and CT analysis. AB - Fifteen patients presenting with visual, oculomotor and behavioural disturbances were diagnosed to be suffering from "top of the basilar" syndrome. Computed tomography confirmed the distribution of infarctions in the vascular territory of the rostral basilar artery. The clinical profile comprised cortical blindness and visual field defects, vertical gaze paresis, memory and behavioural disturbances and in one patient, the paramedian diencephalic syndrome. PMID- 2768164 TI - Assessment of progression of chronic renal failure--using reciprocal of serum creatinine. AB - Twenty-seven patients with chronic renal failure (CRF) were studied over a period of 6 to 57 months. The mean serum creatinine (Scr.) was 4 mg/dl. All patients were started on conservative therapy. The rate of progression of renal failure was assessed by least square linear regression analysis using reciprocal of Scr. (1/Scr.) versus time plots. Group I (13 patients) showed steady progression to end-stage renal failure (mean slope 0.013328). 7 of 13 patients had chronic glomerulonephritis. 11 had nephrotic proteinuria. In group II (14 patients), the regression line remained static indicating arrest of progression of renal disease (mean slope 0.0087858). 6 of 14 had nephrosclerosis. 3 had nephrotic proteinuria. We conclude that (1) assessment of progression of CRF by linear regression analysis of 1/Scr. vs time is a useful method. (2) persistent nephrotic proteinuria is an adverse longterm risk factor. (3) conservative therapy has a definite role in the management of CRF. PMID- 2768165 TI - Spot diagnosis of aluminium phosphide ingestion: an application of a simple test. AB - Silver nitrate impregnated paper test was performed with the gastric fluid and in breath in 50 patients of aluminium phosphide poisoning. The test was 100% positive with gastric fluid but was positive in 50% patients in breath. The test is simple, reliable and sensitive method to detect phosphine (PH3) for bed side diagnosis of aluminium phosphide (AIP) ingestion. PMID- 2768166 TI - Conversion of arteriovenous shunts to fistulae for maintenance haemodialysis: its applicability in a developing country. AB - Arteriovenous shunts in the forearm of 30 patients with end-stage renal disease were converted to arteriovenous fistulae using the same, previously cannulated blood vessels. The shunts were done because these patients needed immediate dialysis. After 2-4 weeks when the cephalic veins had dilated sufficiently shunts were converted to fistulae. In 28 patients fistulae were usable within 24-48 hours without interruption of the dialysis schedule and without loss of access site. In one patient the use was delayed for 20 days while a local skin infection was treated. In another patient the fistulae did not function. PMID- 2768167 TI - Pseudohypertension with calcific aortic stenosis and angina pectoris. AB - A case of pseudohypertension as demonstrated by a very high systolic blood pressure (more than 280 mm of Hg) by sphygmomanometry and low blood pressure (148/30 mm of Hg) as evidenced by intra-arterial recording who also had severe calcific aortic stenosis, calcified right brachial artery and angina pectoris is described. This case is reported because of the unusual combination of lesions and the therapeutic challenge it poses. PMID- 2768168 TI - Non-Hodgkin's lymphoma in AIDS. A case report. AB - We are reporting the first clinical case of AIDS from South India. The disease was diagnosed in a patient of non-Hodgkin's lymphoma. The source of infection was blood transfusion. After the diagnosis of this case, we undertook routine screening of all patients of non-Hodgkin's lymphoma for evidence of HIV infection. Out of a total of 20 patients of non-Hodgkin's lymphoma screened 2 other patients showed evidence of HIV infection. PMID- 2768170 TI - Carcinoma oesophagus--an unusual presentation. AB - We report a 32 years old female who had carcinoma of the oesophagus and who presented with unusual features. PMID- 2768169 TI - Carcinoma developing in a patient with longstanding lye stricture of oesophagus. PMID- 2768171 TI - Adrenal carcinoma with reactive plasmacytosis. AB - An 18 year old boy presented with anaemia, congestive cardiac failure and a 'renal mass'. Preoperative and post-operative investigations demonstrated "reactive plasmacytosis" with antibodies directed against a non-functioning adrenal carcinoma. Existing literature on reactive plasmacytosis and anti-tumour antibodies is summarised. PMID- 2768172 TI - A case of pre-leukaemia masquerading as haemolytic anaemia due to multi enzymopathy of the red cell. AB - A 19 year old woman presented as a case of haemolytic anaemia due to multi-enzyme deficiency of the erythrocyte. After a transient improvement with folic acid therapy, she developed acute myeloblastic leukaemia. This is the second reported case of a myelodysplastic syndrome presenting with a haemolytic picture and subsequently developing an acute myeloblastic leukaemia. PMID- 2768173 TI - Kidney on sale. PMID- 2768174 TI - Infranuclear facial nerve paralysis following viral conjunctivitis. PMID- 2768175 TI - Aconite intoxication and cardiac arrhythmias. PMID- 2768176 TI - A comparative study of CT densitometry of vertebral cancellous bone, abdominal aorta, paravertebral fat and the relative fat volume. AB - Fluctuations are observed in CT densitometry of cancellous bone of the lumbar vertebra in relation to age and sex and also per age/sex group. An investigation was carried out in 119 patients to possibly detect comparable fluctuations in CT measurements of other tissues. The spongiosa of the fourth lumbar vertebra, the abdominal aorta, paravertebral fat and the ratio fat volume/total irradiated volume were compared in the slice plane through the middle of the fourth lumbar vertebra. Calibration was performed using a water phantom. A correlation between the mentioned parameters could not be demonstrated. The relation between Bone Mineral Density (BMD) and age and sex showed the same values as known from the literature, being representative for a normal population. Using the aorta as a reference (which in fact is related to water) a similar curve is found as in Cann and Cann et al. The density of the aorta showed a constant value, varying between 38 and 50 HU with a mean of 45 HU. Extreme values were only found with streak artefacts. It seems useful to use the aorta values as a reference to measure the relative value of vertebral cancellous bone. PMID- 2768177 TI - [Pneumonitis following amiodarone therapy]. AB - Amiodarone (Cordarone) is an antiarrhythmic drug that may cause toxic pulmonary reactions. Clinical symptoms include dyspnea on exertion, cough and weight-loss. On chest X-ray diffuse interstitial and patchy alveolar disease are noted. The patient's condition improves after discontinuation of amiodarone and administration of corticosteroids. PMID- 2768178 TI - [Osteoid osteoma of the spine]. AB - High resolution CT has become crucial to the definite diagnosis, accurate localisation and extension of benign spinal tumors. An osteoid osteoma mostly suspected by X-ray or scintigraphy, located in the axial skeleton--mainly of spongious content and with a complex anatomical structure--will be definitely more distinctly visualized on CT. Post-operative evaluation also requires CT. PMID- 2768179 TI - MR imaging of the brain: preliminary results with a gradient echo sequence after paramagnetic contrast enhancement. AB - In a series of 15 patients with contrast enhancing lesions of the brain, a gradient echo sequence (TR = 400 ms; TE = 10 ms; flip angle 90 degrees, one excitation) after IV administration of a paramagnetic contrast agent provided equal diagnostic information and image quality to conventional T1 weighted spin echo images. Imaging time for one sequence could be reduced by two thirds to 1 min 45 sec. Susceptibility artifacts caused only slight image degradation in the bitemporal region and the region of the sella turcica. This gradient echo sequence can be useful in combination with paramagnetic contrast enhancement, as a complement to conventional T1 and T2 weighted spin-echo sequences. PMID- 2768180 TI - Developmental regulation of a Rhizobium cell surface antigen during growth of pea root nodules. AB - A monoclonal antibody, AFRC MAC 203, was used to examine the expression of a nodule-induced cell surface antigen associated with lipopolysaccharide in Rhizobium leguminosarum bv. viciae 3841. Silver-enhanced immunogold-labeled tissue sections revealed that, in very young tissues of pea root nodules, the nodule-induced form of lipopolysaccharide antigen was not expressed either by rhizobia in the infection thread or by bacteria recently released into the plant cell cytoplasm. In the more mature regions of the nodule, the antigen was expressed by membrane-enclosed bacteroids, including immature forms that had not yet expressed the enzyme nitrogenase and were not yet Y shaped. Immunogold labeling of thin sections revealed that the MAC 203 antigen, but not the nitrogenase, was also expressed by bacteria in infection threads situated in and between bacteroid-containing plant cells in mature nodule tissue. PMID- 2768181 TI - Expression of a cell surface antigen from Rhizobium leguminosarum 3841 is regulated by oxygen and pH. AB - Rhizobium leguminosarum bv. viciae 3841 was grown in liquid suspension culture to investigate how culture conditions could affect the expression of a developmentally regulated cell surface antigen associated with lipopolysaccharide. The antigen, which is recognized by monoclonal antibody AFRC MAC 203, was expressed when cultures were grown at neutral pH under low-oxygen conditions (less than 7.5% [vol/vol] O2 in the gas phase). Antigen was also expressed in aerobically grown cultures at pH values below 5.3. The nature of the nitrogen and the carbon sources had no effect on antigen expression except by indirect changes on the pH of the culture medium; similarly, growth in 0.3 M NaCl did not result in antigen expression. The induction of MAC 203 antigen by low oxygen or low-pH culture conditions is discussed in the context of tissue specific expression within the legume root nodule. PMID- 2768182 TI - Genetic derepression of a developmentally regulated lipopolysaccharide antigen from Rhizobium leguminosarum 3841. AB - Monoclonal antibody AFRC MAC 203 recognizes a developmentally regulated lipopolysaccharide antigen in Rhizobium leguminosarum bv. viciae 3841. Transposon induced mutants that constitutively expressed MAC 203 antigen were isolated. These strains were morphologically normal, showed no gross abnormalities in lipopolysaccharide size distribution on sodium dodecyl sulfate-polyacrylamide gels, and induced normal nitrogen-fixing nodules. However, the mutants lacked lipopolysaccharide epitopes recognized by another rat monoclonal antibody, AFRC MAC 281, suggesting that the corresponding epitopes may be interconverted or share a common precursor. In conjugational crosses, the transposon insertion associated with both the loss of MAC 281 antigen and the constitutive expression of MAC 203 antigen showed linkage to the chromosomal rif allele. A derivative of strain 3841 with a deletion spanning the nod-fix region of the symbiotic plasmid showed no altered expression pattern for MAC 203 antigen, suggesting that the relevant genetic determinants map to genomic sites that are not associated with nifA or any known genes on the symbiotic plasmid. PMID- 2768183 TI - Component A3 of the methylcoenzyme M methylreductase system of Methanobacterium thermoautotrophicum delta H: resolution into two components. AB - Component A3 of the methylcoenzyme M methylreductase system of Methanobacterium thermoautotrophicum (strain delta H) has been resolved into two fractions. One, named component A3a, was defined as the fraction required along with components A2 and C to produce methane from 2-(methylthio)ethanesulfonate when titanium(III) citrate was used as the sole source of electrons. The second one, named component A3b, was required when H2 and 7-mercapto-N-heptanoyl-O-phospho-L-threonine were provided as the dual source of electrons. Component A3a was a large iron-sulfur protein aggregate (Mr 500,000) and is most likely involved in providing electrons at a low potential for the reductive activation of component C. PMID- 2768184 TI - Immunogold localization of the NodC and NodA proteins of Rhizobium meliloti. AB - Monospecific, polyclonal antibodies to the nodC and nodA gene products of Rhizobium meliloti were used in combination with immunogold labeling and transmission electron microscopy to localize the NodC and NodA proteins in cultures of R. meliloti. Both NodC and NodA were detected in the cytoplasm and cell envelope in thin sections of free-living rhizobia treated with luteolin, a known inducer of nod gene expression; however, only NodC was detected on cell surfaces when immunolabeling was performed with intact induced cells. In view of biochemical data characterizing NodC as an outer membrane protein with a large extracellular domain, the pattern of immunolabeling on thin sections suggests that NodC is produced on free cytoplasmic ribosomes prior to assembly in the membrane. The pattern of NodA labeling on thin sections is consistent with biochemical data detecting NodA in both soluble and membrane fractions of NodA overexpressing strains of R. meliloti. PMID- 2768185 TI - Interference reflection microscopic study of sites of association between gliding bacteria and glass substrata. AB - Sites of close contact between gliding Cytophaga sp. strain U67 cells and glass were examined by interference reflection microscopy. Site patterns changed during translocation and moved relative to the substratum, in contrast to previous interference reflection microscopy observations of fibroblast and amoeboid motility. Sinistral rotation around the long axis of the cell was coupled with gliding, except when curved cells traversed curvilinear pathways. Close contact was temporary, since cells flipped up off the substratum on one pole, pivoted, or were displaced laterally in collisions. Other members of the order Cytophagales and Myxococcus sp. demonstrated similar patterns of close association with substrata. PMID- 2768186 TI - A methyl-accepting protein is involved in benzoate taxis in Pseudomonas putida. AB - Pseudomonas putida is attracted to at least two groups of aromatic acids: a benzoate group and a benzoylformate group. Members of the benzoate group of chemoattractants stimulated the methylation of a P. putida polypeptide with an apparent molecular weight of 60,000 in sodium dodecyl sulfate-polyacrylamide gels. This polypeptide is presumed to be a methyl-accepting chemotaxis protein for several reasons: its molecular weight is similar to the molecular weights of Escherichia coli methyl-accepting chemotaxis proteins, the amount of time required to attain maximal methylation correlated with the time needed for behavioral adaptation of P. putida cells to benzoate, and methylation was stimulated by benzoate only in cells induced for chemotaxis to benzoate. Also, a mutant specifically defective in benzoate taxis failed to show any stimulation of methylation upon addition of benzoate. Benzoylformate did not stimulate protein methylation in cells induced for benzoylformate chemotaxis, suggesting that sensory input from this second group of aromatic-acid attractants is processed through a different kind of chemosensory pathway. The chemotactic responses of P. putida cells to benzoate and benzoylformate were not sensitive to external pH over a range (6.2 to 7.7) which would vary the protonated forms of these weak acids by a factor of about 30. This indicates that detection of cytoplasmic pH is not the basis for aromatic-acid taxis in P. putida. PMID- 2768187 TI - An osmoregulated dipeptide in stressed Rhizobium meliloti. AB - One common mechanism of cellular adaptation to osmotic stress is the accumulation of organic solutes in the cytosol. We have used natural-abundance 13C nuclear magnetic resonance to identify all organic solutes that accumulate to significant levels in Rhizobium meliloti. Our studies led to the discovery of a new dipeptide, N-acetylglutaminylglutamine amide (NAGGN), which is accumulated during osmotic stress. Only rarely have peptides been shown to function in bacteria, and furthermore, this is the first example of a peptide playing a role in osmoregulation. Evidence for the biological role of NAGGN in osmotic-stress protection is presented. PMID- 2768189 TI - Cell-cycle-dependent polar morphogenesis in Caulobacter crescentus: roles of phospholipid, DNA, and protein syntheses. AB - During swarmer cell differentiation in Caulobacter crescentus, morphogenesis at the swarmer pole is characterized by the loss of the flagellum, by the loss of phage receptor activity (PRA) (the ability of the cell to adsorb phage phi CbK), and finally by the initiation of stalk outgrowth at the site formerly occupied by the flagellum and the PRA. We show here that each of these events is a cell cycle dependent event requiring continuous protein synthesis for its execution but occurring normally in the absence of DNA synthesis or phospholipid synthesis. During stalked-cell differentiation, the flagellum and PRA reappear and the stalk elongates considerably. We show here that these events are also cell cycle dependent, requiring not only de novo protein synthesis but also DNA and phospholipid syntheses. When synchronous cells dividing 160 min after collection were used, PRA reappearance occurred at 110 min. This PRA reappearance was dependent on a phospholipid synthesis-requiring event occurring at 70 min, a DNA synthesis-requiring event occurring at 95 min, and a protein synthesis-requiring event occurring at 108 min. In the absence of net phospholipid synthesis, stalk elongation appeared more or less normal, but the stalks eventually became fragile, and by 240 min, most of the stalks had broken off, leaving only stubs attached to the cell body. PMID- 2768190 TI - Induction of anaerobic gene expression in Rhodobacter capsulatus is not accompanied by a local change in chromosomal supercoiling as measured by a novel assay. AB - In the photosynthetic bacterium Rhodobacter capsulatus, the enzyme DNA gyrase has been implicated in the expression of genes for anaerobic metabolic processes such as nitrogen fixation and photosynthesis. To assess the involvement of supercoiling in anaerobic gene expression, we have developed an assay to detect in vivo changes in superhelicity of small regions of the bacterial chromosome. Our method is based on the preferential intercalaction of psoralen into supercoiled versus relaxed DNA, and we have demonstrated the sensitivity of the assay in vivo on chromosomal regions from 2 to 10 kilobases in size. In experiments with inhibitors of gyrase, the reactivity of individual chromosomal fragments to psoralen decreases by a factor of 1.8 compared with DNA from control cultures. We used our assay to determine whether there is a change in superhelicity near the genes coding for essential proteins for photosynthesis upon a shift from respiratory to anaerobic photosynthetic growth. For comparison, we also examined a restriction fragment containing the fbc operon, which codes for the subunits of cytochrome bc1, a membrane-bound electron transport complex utilized during both aerobic and anaerobic photosynthetic growth. During this shift in growth conditions, the puf and puh mRNAs, coding for structural polypeptides of the photosynthetic apparatus, underwent a six- to eightfold induction, while the amount of mRNA from the fbc locus remained constant. However, we detected no change in the superhelicity of either the genes for photosynthesis or those for the bc1 complex during this metabolic transition. Our data thus do not support a model in which stable changes in chromosomal superhelicity regulate anaerobic gene expression. We suggest instead that the requirement for DNA gyrase in the transcription of photosynthesis genes results from the requirement for a swivel near heavily transcribed regions of the chromosome. PMID- 2768188 TI - Region of the streptococcal plasmid pMV158 required for conjugative mobilization. AB - The nonconjugative streptococcal plasmid pMV158 can be mobilized by the conjugative streptococcal plasmid pIP501. We determined the sequence of the 1.1 kilobase EcoRI fragment of pMV158 to complete the DNA sequence of the plasmid. We showed that an open reading frame, mob (able to encode a polypeptide of 58,020 daltons), is required for mobilization of pMV158. An intergenic region present in the EcoRI fragment contains four lengthy palindromes that are found also in one or more of the staphylococcal plasmids pT181, pE194, and pUB110. One palindromic sequence, palD, which is common to all four plasmids, also appeared to be necessary for mobilization. Circumstantial evidence indicates that this sequence contains both an oriT site and the mob promoter. The Mob protein is homologous in its amino-terminal half to Pre proteins encoded by pT181 and pE194 that were shown by others to be essential for site-specific cointegrative plasmid recombination; their main biological function may be plasmid mobilization. PMID- 2768191 TI - Temporal expression of transcription and relative copy number of plasmid pSFB-1 in Scytalidium flavo-brunneum. AB - Wild-type cultures of Scytalidium flavo-brunneum produce a 15-azasterol antifungal agent and a reddish brown pigment as secondary metabolites. Spontaneous mutants of S. flavo-brunneum that had simultaneously lost the ability to produce the 15-azasterol and the pigment were transformed with plasmid pSFB-1, which was obtained from wild-type S. flavo-brunneum. Each transformant possessed the plasmid and coincidentally reacquired azasterol and pigment production. Regulation of transcription and relative plasmid copy number was determined as a function of the culture cycle of the organism. Twenty-five-fold amplification of the plasmid was observed in the fungus during the stationary phase. RNA transcripts of 0.9, 1.0, 1.5, 2.0, and 2.5 kilobases were expressed from the plasmid by the organism. While differences in the temporal regulation of the transcripts were seen, all except the 1.0-kilobase transcript increased in abundance on entry of the culture into the stationary phase of growth. PMID- 2768192 TI - Gene cluster containing the genes for tyrocidine synthetases 1 and 2 from Bacillus brevis: evidence for an operon. AB - From a genomic library of the tyrocidine producer Bacillus brevis ATCC 8185 constructed in the bacteriophage vector EMBL3, a recombinant phage which contains the structural genes coding for tyrocidine synthetases 1 and 2, TycA and TycB, was identified. The location of the tycA gene within the 16-kilobase insert of this clone, EMBL25-1, was mapped by hybridization studies by using the previously isolated tycA DNA as a probe. Restriction analyses, the construction of subclones, and the analysis of proteins encoded by the subclones located the tycB gene at the 3' end of the tycA gene and revealed that the two genes are transcribed in the same direction. Nuclease S1 protection studies and DNA sequencing studies of the intergenic region indicated that tycA and tycB are separated by a 94-base-pair noncoding region and suggested that these genes are organized as an operon. PMID- 2768193 TI - Dual mechanism for stimulation of glutamate transport by potassium ions in Streptococcus mutans. AB - An ATP-driven primary transport system operative for L-glutamate or L-aspartate in Streptococcus mutans is, through the entire pH range from 5.5 to 8.5, specifically stimulated by extracellular potassium ions. The stimulation by potassium ions observed in the low pH range between 5.5 and 7 has been interpreted to be due to potassium ion-dependent regulation of the intracellular pH (the first mechanism). In the high pH range from 7 to 8.5, on the other hand, the present study demonstrates that potassium stimulation is essentially not associated with such intracellular pH regulation. This conclusion is based on our observation that potassium stimulation in the high pH range is insensitive to a proton conductor, carbonyl cyanide-p-trifluoromethoxy-phenyl-hydrazone. Since none of the other monovalent cations, including sodium, rubidium, ammonium, and Tris ions, could replace potassium ions in significantly stimulating glutamate transport, it is most likely that the influx of potassium ions specifically cancels the membrane potential derived by movement of glutamate with the net negative charges across a membrane and thus facilitates transport (the second mechanism). The second mechanism appears to be operative even in a low pH range, in addition to the first mechanism. PMID- 2768194 TI - Transformation of the archaebacterium Halobacterium volcanii with genomic DNA. AB - We describe optimization of a transformation system for the halophilic archaebacterium Halobacterium volcanii. Transformation of spheroplasts in the presence of polyethylene glycol permits the uptake and expression of high molecular-weight linear fragments of genomic DNA as well as plasmid or bacteriophage DNA. Transformations can be performed with either fresh or frozen cell preparations. Auxotrophic mutants were transformed to prototrophy with genomic DNA from wild-type cells with efficiencies of 5 x 10(4)/micrograms of DNA and frequencies of 8 x 10(-5) per regenerated spheroplast. The overall efficiency of transformation with genomic DNA implies that genetic recombination is an efficient process in H. volcanii. PMID- 2768195 TI - Isolation, characterization, and biological activity of ferredoxin-NAD+ reductase from the methane oxidizer Methylosinus trichosporium OB3b. AB - A ferredoxin-NAD+ oxidoreductase (EC 1.18.1.3) has been isolated from extracts of the obligate methanotroph Methylosinus trichosporium OB3b. This enzyme was shown to couple electron flow from formate dehydrogenase (NAD+ requiring) to ferredoxin. Ferredoxin-NAD+ reductase was purified to homogeneity by conventional chromatography techniques and was shown to be a flavoprotein with a molecular weight of 36,000 +/- 1,000. This ferredoxin reductase was specific for NADH (Km, 125 microM) and coupled electron flow to the native ferredoxin and to ferredoxins from spinach, Clostridium pasteurianum, and Rhodospirillum rubrum (ferredoxin II). M. trichosporium ferredoxin saturated the ferredoxin-NAD+ reductase at a concentration 2 orders of magnitude lower (3 nM) than did spinach ferredoxin (0.4 microM). Ferredoxin-NAD+ reductase also had transhydrogenase activity which transferred electrons and protons from NADH to thionicotinamide adenine dinucleotide phosphate (Km, 9 microM) and from NADPH to 3-acetylpyridine adenine dinucleotide (Km, 16 microM). Reconstitution of a soluble electron transport pathway that coupled formate oxidation to ferredoxin reduction required formate dehydrogenase, NAD+, and ferredoxin-NAD+ reductase. PMID- 2768196 TI - Evidence for unlinked rrn operons in the Planctomycete Pirellula marina. AB - Southern hybridization of rRNAs to chromosomal BamHI-digested DNA of the eubacterium Pirellula marina revealed the presence of two sets of 16S and 23S rRNA genes. The two copies of the 23S rRNA genes, located on 11- and about 13 kilobase (kb) inserts, were isolated from a lambda bacteriophage Charon 35 library. The 11-kb fragment was cloned directly into pBR322, while a 5.4-kb BamHI PstI rDNA subfragment of the approximately 13-kb insert was cloned into pUC18. Both recombinant plasmids, pPI1100 and pPI540, were characterized by restriction enzyme mapping and Southern hybridization with the large rRNA species. Restriction fragments from both inserts were subcloned into phage M13 mp18 and mp19. Correlation of genomic hybridization data with physical characterization of recombinant plasmids showed that, in contrast to the general organization of rrn operons in eubacteria, the 16S rRNA genes of P. marina are separated by at least 8.5 (pPI540) and 4.4 (pPI1100) kb, respectively, from the closely linked 23S-5S rRNA genes. Comparison of the flanking regions from both 23S-5S rRNA genes with published consensus sequences of structural elements indicates the presence of putative transcription signals, i.e., a single Pribnow box, discriminator, antitermination boxes A, B, and C, and a Rho-independent terminator. PMID- 2768197 TI - The predicted protein product of a pathogenicity locus from Pseudomonas syringae pv. phaseolicola is homologous to a highly conserved domain of several procaryotic regulatory proteins. AB - A ca. 20-kilobase (kb) region (hrp) that controls the interaction of Pseudomonas syringae pv. phaseolicola with its host (pathogenicity) and nonhost plants (hypersensitive reaction) was previously cloned and partially characterized. In this study we defined the limits and determined the nucleotide sequence of a hrp locus (hrpS), located near the right end of the hrp cluster. The largest open reading frame (ORF302) in hrpS has a coding capacity for a 302-amino-acid polypeptide. The predicted amino acid sequence of the translation product of ORF302 (HrpS) shows significant similarity to several procaryotic regulatory proteins, including the NtrC, NifA, and DctD proteins of Rhizobium spp., the NtrC and NifA proteins of Klebsiella pneumoniae, and the TyrR protein of Escherichia coli. These proteins regulate diverse operons involved in nitrogen fixation, transport and metabolism of amino acids, and transport of C-4 dicarboxylic acids. The HrpS protein appears to be the shortest naturally occurring member of this family of proteins, corresponding for the most part to the highly conserved central domain of these proteins, which contains a putative ATP-binding site. A C terminal segment analogous to the less-well-conserved domain, involved in DNA binding of NtrC and NifA, is also present in HrpS. These similarities suggest that HrpS is a regulatory protein. In line with this prediction is the finding that a functional hrpS gene is necessary for the activation of another hrp locus during the plant-bacterium interaction. PMID- 2768198 TI - Topology and acylation of spiralin. AB - Of the 51 polypeptides detected by sodium dodecyl sulfate-polyacrylamide gel electrophoresis in the plasma membrane of the helical mollicute Spiroplasma melliferum, 21 are acylated, predominantly with myristic (14:0) and palmitic (16:0) chains. This is notably the case for spiralin, the major membrane protein of this bacterium, which contains an average of 0.7 acyl chains per polypeptide, attached very probably by ester bonds to alcohol amino acids. The amphiphilicity of spiralin was demonstrated by the behavior of the protein in charge-shift electrophoresis, its incorporation into liposomes, and its ability to form in the absence of lipids and detergents, globular protein micelles (diameter, approximately 15 nm). The presence of epitopes on the two faces of the cell membrane, as probed by antibody adsorption and crossed immunoelectrophoresis, and the strong interaction between spiralin and the intracytoplasmic fibrils show that spiralin is a transmembrane protein. The mean hydropathy of the amino acid composition of spiralin (-0.30) is on the hydrophilic side of the scale. Surprisingly, the water-insoluble core of spiralin micelles, which is the putative membrane anchor, has a still more hydrophilic amino acid composition (mean hydropathy, -0.70) and is enriched in glycine and serine residues. Taking into account all these properties, we propose a topological model for spiralin featuring a transbilayer localization with hydrophilic domains protruding on the two faces of the membrane and connected by a small domain embedded within the apolar region of the lipid bilayer. In this model, the membrane anchoring of the protein is strengthened by a covalently bound acyl chain. PMID- 2768199 TI - Degradation of phenol and m-toluate in Pseudomonas sp. strain EST1001 and its Pseudomonas putida transconjugants is determined by a multiplasmid system. AB - The utilization of phenol, m-toluate, and salicylate (Phe+, mTol+, and Sal+ characters, respectively) in Pseudomonas sp. strain EST1001 is determined by the coordinated expression of genes placed in different plasmids, i.e., by a multiplasmid system. The natural multiplasmid strain EST1001 is phenotypically unstable. In its Phe-, mTol-, and Sal- segregants, the plasmid DNA underwent structural rearrangements without a marked loss of plasmid DNA, and the majority of segregants gave revertants. The genes specifying the degradation of phenol and m-toluate were transferable to P. putida PaW340, and in this strain a new multiplasmid system with definite structural changes was formed. The 17-kilobase transposable element, a part of the TOL plasmid pWWO present in the chromosome of PaW340, was inserted into the plasmid DNA in transconjugants. In addition, transconjugant EST1020 shared pWWO-like structures. Enzyme assays demonstrated that ortho-fission reactions were used by bacteria that grew on phenol, whereas m toluate was catabolized by a meta-fission reaction. Salicylate was a functional inducer of the enzymes of both pathways. The expression of silent metabolic pathways of phenol or m-toluate degradation has been observed in EST1001 Phe- mTol+ and Phe+ mTol- transconjugants. The switchover of phenol degradation from the ortho- to the meta-pathway in EST1033 also showed the flexibility of genetic material in EST1001 transconjugants. PMID- 2768200 TI - High-frequency variation in Mycoplasma pulmonis colony size. AB - Heterogeneity in colony size of the murine pathogen Mycoplasma pulmonis was examined. Subcloning experiments showed that colony size variation resulted from high-frequency genetic changes. About 3% of the colonies from any given subclone were variants, with as much as a fourfold change in colony diameter. When the variants were propagated in liquid broth, their doubling times in logarithmic growth phase reflected the colony sizes obtained on agar. Colony size variation correlated with changes in the electrophoretic properties of the V-1 surface antigen. PMID- 2768201 TI - Comparative sequence analysis of a genus-common rickettsial antigen gene. AB - The genes encoding the 17-kilodalton genus-common antigen have been cloned and sequenced from Rickettsia conorii, Rickettsia prowazekii, and Rickettsia typhi. Compared with the R. rickettsii sequence, this sequence had a high degree of homology within the coding and control regions (R. conorii, 99.8%; R. prowazekii, 88.1%; R. typhi, 88.7%). The 5' flanking regions, including the promoter and the transcription initiation sites, were extremely well conserved for all four species, suggesting that control and expression of this locus are important to the survival of the rickettsiae. PMID- 2768203 TI - Depression as a manifestation of obstructive sleep apnea: reversal with nasal continuous positive airway pressure. AB - Fifty-five patients with obstructive sleep apnea each completed a Zung Self Rating Depression Scale (SDS), Twenty-five patients (45%) had SDS scores greater than or equal to 50, consistent with depression. The SDS scores did not correlate with age, the number of respiratory events per hour sleep, antihypertensive medication, or the oxygen saturation baseline or nadir. The group with SDS scores of 50 or greater, however, had 68.0 +/- 8.8 respiratory events per hour compared with 47.9 +/- 4.7 in the group with SDS scores under 50 (p less than .05). Nineteen patients who were treated with nasal continuous positive airway pressure completed a follow-up SDS Inventory. After treatment, the SDS scores fell from 60.5 +/- 1.9 to 44.4 +/- 2.6 (p less than .001) in the 11 patients with baseline elevated scores. The authors conclude that obstructive sleep apnea can produce prominent symptoms of depression that appear to be related to the severity of the underlying apnea; furthermore, treatment of obstructive sleep apnea may result in alleviation of these symptoms in certain patients. PMID- 2768204 TI - Naproxen reversal of nortriptyline-induced orthostatic hypotension. PMID- 2768202 TI - L-arabinose metabolism in Herbaspirillum seropedicae. AB - The pathway for L-arabinose metabolism in Herbaspirillum seropedicae was shown to involve nonphosphorylated intermediates and to produce alpha-ketoglutarate. The activities of the enzymes and the natures of several intermediates were determined. The pathway was inducible by L-arabinose, and two key enzymes, L arabinose dehydrogenase and 2-keto-glutarate semialdehyde dehydrogenase, were present in all strains of H. seropedicae tested. PMID- 2768205 TI - Refractory rapid cycling unipolar depression responds to lithium and carbamazepine treatment. PMID- 2768206 TI - Exacerbation of fever by psychotropic drugs in an elderly demented man. PMID- 2768207 TI - Properties of L-lysine epsilon-dehydrogenase from Agrobacterium tumefaciens. AB - Lysine epsilon-dehydrogenase, which has been purified to homogeneity from the extract of Agrobacterium tumefaciens ICR 1600, had a molecular weight of approximately 78,000 and consisted of two subunits identical in molecular weight (about 39,000). The enzyme showed a high substrate specificity. In addition to L lysine, S-(beta-aminoethyl)-L-cysteine was deaminated by the enzyme, but to a far lesser extent. NAD+ and some NAD+ analogs (deamino-NAD+ and 3-acetylpyridine NAD+) served as a cofactor. The pH optimum was at about 9.7 for the deamination of L-lysine. Although the NAD+ saturation curve was hyperbolic, a sigmoid saturation curve for L-lysine was obtained with the diluted enzyme solution, in which the dimeric enzyme was predominant. The reversible association of the enzyme to the tetramer was induced either by increasing the enzyme concentration or by addition of L-lysine. The preincubation of the enzyme with 5 mM L-lysine resulted in a 2-fold increase in the activity and gave a hyperbolic saturation curve for L-lysine. Upon modification of SH groups of the enzyme with DTNB, neither the interconversion between the dimer and the tetramer nor the activation by L-lysine occurred. These results indicated that the dimeric enzyme was activated by L-lysine and the activation resulted from the association of two dimeric enzymes to form a tetramer. PMID- 2768208 TI - Modification of the contractile properties of rabbit skeletal muscle by ethylene glycol. AB - The effect of ethylene glycol on the contractile properties of skeletal muscles was studied using glycerinated rabbit psoas muscle fibers. Measurements were made at an ionic strength of 0.2 M, pH 7.0, and at 10 degrees C. Ethylene glycol reversibly reduced isometric tension, active stiffness, the tension-to-stiffness ratio, and the shortening velocity at zero load (Vo) in a dose-dependent fashion. Ethylene glycol also reduced the Ca sensitivity for contraction. The extent of the reduction in Vo by ethylene glycol was much larger than that in the actomyosin ATPase activity reported by Travers and Hillaire (Eur. J. Biochem. 98, 293-299 [1979]). Although ethylene glycol reduced tension and Vo, the MgATP concentration dependence of these two quantities was almost unaffected. These results suggest that in the presence of ethylene glycol, force produced by crossbridges in the principal force-producing state is reduced and/or the relative population of the attached crossbridges in the low-force state increases. The results also suggest that the reduction in Vo by ethylene glycol is caused not only by a reduction in the actomyosin ATPase activity but also by a reduction in the shortening distance per mole of ATP split. PMID- 2768209 TI - Independent removal of two identical or different introns from mRNA precursors in vitro. AB - In vitro splicing of 11 different RNA transcripts carrying two introns was performed to determine whether the removal of an intron was dependent on its position or removal of the other intron. The original RNA transcript carried two identical units, each consisting of the first exon-first intron-a major part of the second exon of the human beta-globin gene. Five transcripts carrying a mutation in one of the two introns of the original RNA and one carrying mutations in both introns were prepared. One of the other RNA transcripts had a shorter middle exon than did the original transcript. The remaining three RNAs had at least one shortened form of the human beta-globin second intron. The results can be summarized as follows. 1) There was no obligatory order in the excision of the two identical or different introns, although the 5' proximal intron may be removed more rapidly in some cases. The efficiency of removal of the 5' proximal intron seems to be higher than or similar to that of the distal intron. 2) Excision of a mutated intron was inhibited, but no mutation significantly affected the excision of the other intact intron. 3) Except in an RNA transcript with two mutated introns, significant splicing between exon 1 and exon 3 (exon jumping) did not take place. 4) These results support the proposal that the two introns are basically independent of each other as to their removal. PMID- 2768210 TI - Binding of activated macrophages to tumor cells through a macrophage lectin and its role in macrophage tumoricidal activity. AB - A 45-60 kDa Gal/GalNAc-specific macrophage lectin was found to participate in the interaction between tumor cells and tumoricidal macrophages activated by an antitumor streptococcal preparation, OK-432, and in the tumoricidal activity of the activated macrophages. The binding between OK-432-elicited activated macrophages and murine mastocytoma P-815 cells was inhibited on preincubation of the macrophages with a neoglycoprotein (Gal-BSA) or a complex-type glycopeptide (unit B) which was a specific inhibitor of the macrophage lectin. This binding of the macrophages to P-815 cells was also inhibited on the addition of anti macrophage lectin antiserum. Contrary to the case of OK-432-elicited macrophages, the binding of thioglycolate-elicited (responsive) macrophages to P-815 cells was inhibited only a little by Gal-BSA and unit B, and not inhibited by the antiserum. Furthermore, the tumoricidal activity of the activated macrophages was inhibited by the addition of the anti-macrophage lectin antiserum. These results suggest that the binding of activated macrophages to tumor cells through the Gal/GalNAc-specific macrophage lectin is an important part of the tumor cell killing mechanism. PMID- 2768211 TI - Interactions of monodispersed and micellar substrates with a phospholipase A2 from Trimeresurus flavoviridis. AB - Bindings of the phospholipase A2 from Trimeresurus flavoviridis to the monodispersed and micellar n-alkylphosphorylcholines (n-CnPC) were studied at 25 degrees C and ionic strength 0.2 by the aromatic CD and tryptophyl fluorescence methods, respectively. The bindings to micelles of the substrate analog were analyzed by assuming that the micellar surface has multiple binding sites for the enzyme and that these sites are identical and mutually independent. The enzyme binding site was found to accommodate a constant number of the substrate (monomer) molecules, N = 9-13. The binding constant to the micelle was about 40 times greater than it was to the monodispersed substrate. The binding constant to the micellar substrate analog increased on the binding of Ca2+ to the enzyme and decreased on modification of the N-terminal alpha-NH2 group, whereas the binding to the monodispersed substrate analog was independent of pH, of the Ca2+ binding, and of the chemical modification of the alpha-NH2 group. The kinetics of the hydrolyses of monodispersed and micellar dihexanoylphosphatidylcholines (diC6PC) were studied at 25 degrees C and ionic strength 0.2 by the pH-stat method in the presence of saturating amounts of Ca2+. The catalytic center activity, kappa cat, as well as the binding constant, 1/Km, for the micellar substrate, were found to be much greater than those for the monodispersed substrate. The binding constant, 1/Km, of the monodispersed substrate was independent of pH; this was in good agreement with that of the substrate analog described above. The pH-dependence curve of kappa cat for the monodispersed substrate exhibited two transitions, one below pH 6.5 and the other above pH 9.5.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2768212 TI - Isolation of profilin from embryonic chicken skeletal muscle and evaluation of its interaction with different actin isoforms. AB - An actin-binding protein of 16 kDa was isolated from embryonic chicken skeletal muscle. The protein had the same properties as profilin, exhibited a much higher affinity for cytoskeletal (beta- and gamma-) actins than for sarcomeric (alpha-) actin in the embryonic muscle, and inhibited the polymerization of beta- and gamma-actins more efficiently in a physiological salt solution. These results indicate that the assembly of cytoskeletal and sarcomeric actins is regulated differently by profilin in the developing skeletal muscle, and that the former may not be involved in myofibril assembly. PMID- 2768213 TI - Ca2+/calmodulin-dependent phosphorylation of ciliary beta-tubulin in Tetrahymena. AB - The ciliary axoneme is the minimal structure responsible for Ca2+-dependent modulation of ciliary movement. We demonstrated that, in Tetrahymena ciliary axonemes, beta-tubulin was exclusively phosphorylated by an endogenous Ca2+/calmodulin-dependent protein kinase(s). The phosphorylation of beta-tubulin also occurred in the outerdoublet microtubule fraction, suggesting that the responsible enzyme(s) was tightly associated with outerciliary motility, Ca2+ dependent phosphorylation of beta-tubulin was also found to occur exclusively. From these results, it is inferable that the phosphorylation of beta-tubulin is involved in Ca2+-dependent ciliary reversal. PMID- 2768214 TI - Possible role of a 36 kDa protein induced by respiratory inhibitors in cyanide resistant respiration in Hansenula anomala. AB - The antimycin A or cyanide-dependent appearance of a 36 kDa protein in the particulate fraction was observed in L-[35S]methionine pulse-labeling experiments on cells of Hansenula anomala, in which cyanide-resistant respiration was induced. The combined addition of cycloheximide or anaerobiosis, which block the induction of cyanide-resistant respiration, repressed the synthesis of this protein. These results suggest the involvement of the particulate 36 kDa protein in cyanide-resistant respiration. PMID- 2768215 TI - Application of 13C nuclear magnetic resonance spectroscopy to molecular structural analyses of antibody molecules. AB - A 13C nuclear magnetic resonance study of a mouse anti-dansyl monoclonal antibody is reported. The antibody molecule was specifically labeled with [1 13C]methionine by growing hybridoma cells in serum-free medium. It was possible to observe all the carbonyl carbon resonances of the antibody. Fab and Fc fragments have been obtained from the antibody and used successfully for the assignment of each of the carbonyl resonances to either the Fab or Fc region. It has been shown that the spectrum of the intact antibody is simply those of Fab and Fc superimposed. It has also been shown that site specific assignments of carbonyl resonances can be made by means of a double labeling technique developed by Kainosho and coworkers. PMID- 2768216 TI - Conformational change of skeletal muscle troponin. AB - The fluorescence titration curve of skeletal muscle troponin containing TnI with 2-[4'-iodoacetamido)anilino)naphthalene-6-sulfonic acid-labeled Cys-48 and/or Cys 64 was composed of two transition curves. One transition occurred at the pCa region higher than 8.0, and the other between pCa 8.0 and 6.0. The transition at the lower pCa region had a midpoint of pCa 6.85, and the midpoint did not depend on Mg2+. The time course of the fluorescence change subsequent to the rapid pCa jump of the solution was biphasic. The fast phase was due to the transition at the lower pCa region, and the rate constant of the process was characteristic of the conformational change of the protein induced by Ca2+ binding to the low affinity Ca2+-binding sites of TnC. The slow phase was from the transition at the higher pCa region, and its rate constant was characteristic of the conformational change of the protein induced by Ca2+ binding to the high affinity Ca2+-binding sites of TnC. Therefore we can conclude that the fluorescence probe bound to Cys 48 and/or Cys-64 of TnI detects the conformational change of the Tn complex induced by Ca2+ binding to both the low and high affinity Ca2+-binding sites of TnC. The fluorescence probe bound to Cys-133 of TnI or Met residues of TnT detected the conformational change of the Tn complex induced by Ca2+ binding to the low affinity Ca2+-binding sites of TnC. PMID- 2768218 TI - Production and characterization of monoclonal antibodies to rat liver arginase. AB - Rat liver arginase was purified and five monoclonal antibodies were produced by fusion of spleen cells from a Balb/c mouse and the myeloma cell line P3-X36-Ag U1. One, R2D19, of five antibodies belonged to the IgG2a subclass, the other four, R1D81, R1G11, R2E10, and R2G51, were of the IgG1 type. The R1D81 cross reacted with human liver arginase. This antibody inhibited the arginase activity, competing with arginine. These results suggest that R1D81 binds to the catalytic site of arginase. The R2D19 also inhibited the enzyme activity but acted as a noncompetitive inhibitor. With the use of R1D81 and a polyclonal anti-human liver arginase antibody conjugated with alkaline phosphatase, a sandwich enzyme-linked immunosorbent assay (ELISA) was developed for the quantification of human arginase. Specificity of monoclonal antibodies for rat liver arginase was examined by means of the sandwich ELISA. Eight pairs of monoclonal antibodies could form a sandwich with the arginase. Only the R2E10 could be used for both the first and the second antibody in the sandwich system. In other cases, monoclonal antibodies could not be interchanged between solid and liquid phase. PMID- 2768217 TI - Binding of both Ca2+ and mastoparan to calmodulin induces a large change in the tertiary structure. AB - The technique of small-angle X-ray scattering has been employed to examine the solution conformation of calmodulin and its complexes with Ca2+ alone, and with both Ca2+ and mastoparan. The radius of gyration decreased by 3.1 +/- 0.3 A upon binding of both 4 mol Ca2+/mol of protein and 1 mol mastoparan/mol of protein to form the ternary complex. A smaller increase was found for the separate binding of 4 mol Ca2+/mol of protein in the absence of mastoparan (0.6 +/- 0.3 A). The analyses of pair distance distribution function showed that the maximal pair distance in calmodulin complex with both Ca2+ and mastoparan decreased by 20-30% in comparison with calmodulin or its complex with Ca2+, and a shoulder near 40 A, which characterizes the dumbbell-shaped molecule of calmodulin, disappeared. These results indicate that the two globular domains of the calmodulin complex with Ca2+ and mastoparan come close together by 8.0-9.5 A on average, if the size and the overall shape of the globular domains are the same in Ca2+-calmodulin mastoparan complex as in calmodulin or Ca2+-calmodulin complex. PMID- 2768219 TI - Tissue-specific DNA binding of nuclear proteins that bind to the adenovirus inverted terminal repeat. AB - Adenovirus (Ad) DNA replication requires nuclear factor I (NFI), a cellular sequence-specific DNA binding protein which binds to the Ad DNA inverted terminal repeat (ITR). The NFI binding consensus sequence, TGGN6-7GCCAA, possibly includes the CCAAT-box which is often observed in regulatory elements of transcription. Adjacent to the NFI binding site on the Ad ITR is the binding site for nuclear factor III (NFIII), another cellular factor that stimulates Ad DNA replication in a cell-free system. Using gel retardation assay, we have examined the tissue specificity of these DNA binding activities in mouse. High NFI activity was detected in nuclear extracts from mouse liver, kidney, and spleen. Competition gel retardation assay with double-stranded oligonucleotides containing herpes simplex virus thymidine kinase (HSV-TK) gene or hsp70 gene CCAAT-box showed no effect on mouse NFI binding to its binding site. In the course of competitive DNA binding assay, we detected a novel DNA binding protein in mouse kidney nuclear extracts, designated nuclear factor K (NFK). The NFK binding site is included in the NFIII binding site on the Ad ITR. NFK seems to be different from NFIII, in mode of binding to its binding site. PMID- 2768220 TI - Expression of four phenobarbital-inducible cytochrome P-450s in liver, kidney, and lung of rats. AB - Specific antibodies were prepared against cytochromes P450 PB-1, PB-2, PB-4, and PB-5 purified from hepatic microsomes of male rats treated with phenobarbital. With these antibodies, the levels of these four cytochrome P450s in hepatic, renal, and pulmonary microsomes of male rats that were untreated, treated with phenobarbital, or treated with 3-methylcholanthrene were examined. P450 PB-1 and PB-2 were present in moderate amounts in hepatic microsomes of untreated male rats and were induced 2- to 3-fold with phenobarbital. Also, the expression of these forms was suppressed by 3-methylcholanthrene. These forms were not detected in the renal or pulmonary microsomes of untreated rats or rats treated with phenobarbital or 3-methylcholanthrene. P450 PB-4 and PB-5 were found in the hepatic microsomes of untreated male rats at a low level but were induced with phenobarbital more than 50-fold. P450 PB-4 and PB-5 were not detected in renal microsomes; only P450 PB-4 or a closely related form was present in the pulmonary microsomes of untreated male rats, and its level was not changed by phenobarbital treatment. The constitutive presence of P450 PB-4 in pulmonary microsomes was confirmed by the investigation of testosterone metabolism. Purified P450 PB-4 had high testosterone 16 alpha- and 16 beta-hydroxylation activity in a reconstituted system. The testosterone 16 beta-hydroxylation activity of hepatic microsomes was induced with phenobarbital, and more than 90% of the testosterone 16 beta hydroxylation activity of hepatic microsomes from rats treated with phenobarbital was inhibited by anti-P450 PB-4 antibody.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2768221 TI - X-ray analysis of a thrombin inhibitor-trypsin complex. AB - The three-dimensional structure of a thrombin inhibitor-trypsin complex has been determined by an X-ray analysis at 2.5 A resolution. The result has given experimental support to the mechanisms previously proposed by the authors for the selective inhibition of trypsin, thrombin, factor Xa, and plasmin by inhibitors with an arginine or lysine backbone. The differences in the amino acid sequences at the positions corresponding to Ilc63, Leu99, and Ser190 of trypsin give each enzyme different binding affinities toward inhibitors and result in the selective inhibition. Furthermore, the X-ray analysis has revealed a novel type of interaction between the inhibitor and trypsin. The hydrogen bonds between the inhibitor main chain and trypsin Gly216 play an essential role in the complex formation. PMID- 2768222 TI - Purification and characterization of human microsomal dipeptidase. AB - Human microsomal dipeptidase (MDP, formerly referred to as dehydropeptidase-I or renal dipeptidase) [EC 3.4.13.11] was solubilized from the membrane fraction of kidney by treatment with octyl-beta-D-glucoside and purified by a procedure including ion exchange chromatography and affinity chromatography on cilastatin immobilized Sepharose. The purified human MDP was found to be homogeneous on sodium dodecyl sulfate (SDS)-polyacrylamide gel electrophoresis. The apparent molecular weight (Mr) was estimated by SDS-polyacrylamide gel electrophoresis under non-reducing conditions to be 130 kDa, comprising a homodimer of two subunits. After treatment with endoglycosidase F, human MDP showed a single band with an apparent Mr of 42 kDa on SDS-polyacrylamide gel electrophoresis. Human MDP was found to bind to Con A-Sepharose and the activity was eluted with methyl alpha-D-mannopyranoside, suggesting that human MDP is a glycoprotein. We also examined the substrate specificity of human MDP and found that human MDP catalyzed the hydrolysis of S(substituent)-L-cysteinyl-glycine adducts such as L cystinyl-bis(glycine) and S-N-ethylmaleimide-L-cysteinyl-glycine, as well as the conversion of leukotriene D4 to leukotriene E4. These results suggest that MDP might play an important role in the metabolism of glutathione and leukotriene. PMID- 2768223 TI - Protection of glutathione S-transferase from bilirubin inhibition. AB - Inhibition of the enzyme activity of glutathione S-transferase (GST) by a physiological concentration of bilirubin was studied using various substrates. When rat liver cytosol was used as an unfractionated GST, its GSH-conjugation activity toward 1-chloro-2,4-dinitrobenzene was decreased to one-half by bilirubin, while the activity toward 1,2-dichloro-4-nitrobenzene, p-nitrobenzyl chloride, or 1,2-epoxy-(p-nitrophenoxy)propane and also the non-selenium dependent GSH-peroxidase activity toward cumene hydroperoxide (CHPx activity) were hardly affected under the same conditions. In contrast, bilirubin inhibited each of the purified GST isozymes and no remarkable difference in bilirubin inhibition was observed with any of the substrates tested. From the chromatographic analysis of the cytosol incubated with [3H]bilirubin, it was found that a major part of the added bilirubin binds to subunit 1 (Ya) of GST isozyme, leaving not only the conjugation activity derived from 3-4 type GST but also the CHPx activity of subunit 2 (Yc) quantitatively intact. The bilirubin inhibition of both the conjugation activity of GST 3-4 and the CHPx activity of GST 2-2 was prevented almost completely by addition of a 3-fold molar excess of GST 1-1. From these results, it was assumed that the enzyme activities of both 3 4 type GSTs and subunit 2 (Yc) were protected from the inhibitory action of bilirubin by the scavenger effect of subunit 1 (Ya). PMID- 2768224 TI - Comparative studies on the primary structure of human cystatin as from epidermis, liver, spleen, and leukocytes. AB - We have studied the primary structure of human cystatin As from epidermis, liver, spleen, and leukocytes. These molecules were indistinguishable on PAGE in the presence and absence of SDS, by fast protein liquid chromatography (FPLC) chromatofocusing on a Mono P column, and in amino acid composition. The NH2- and COOH-terminal amino acid sequences of human cystatin As from epidermis, liver, and spleen were identical with those of human leukocyte cystatin A previously reported except for the lack of the NH2-terminal methionine residue in human epidermal cystatin A. The peptides obtained upon digestion of four human cystatin As with Achromobacter protease I (AP) showed identical peptide maps on HPLC except for different retention times of the NH2-terminal peptides. Furthermore, the amino acid compositions of corresponding separated peptide quartets were identical. We also determined the complete amino acid sequence of human epidermal cystatin A by sequencing peptides obtained from AP digestion and cyanogen bromide (CNBr) cleavage. It consisted of 97 amino acid residues, and was identical with those of human cystatin As from liver, spleen, and leukocytes except for the lack of the NH2-terminal methionine residue. PMID- 2768225 TI - Existence of associated, non-associated, and oligomeric forms of human chorionic gonadotropin subunits in placental extracts. AB - The molecular sizes of human chorionic gonadotropin (hCG) subunits in the native state in normal first trimester placental extracts were determined by gel filtration on Sephacryl S-300, followed by SDS-polyacrylamide gel electrophoresis, protein blotting, and immunobinding analysis using anti-alpha and - beta antibodies. Mature forms of hCG subunits in the extracts were only found in the same fraction as that which contained standard urinary hCG, indicating an alpha beta dimer. On the other hand, immature forms were detected with a wide range of molecular weights, which were higher than that of standard hCG, suggesting oligomerization of associated or non-associated immature subunits. In order to determine the associated state of these subunits, various forms of associated subunits (hCG alpha beta) in placental extracts were immunoprecipitated with anti-hCG antiserum, which only recognized hCG alpha beta, and Protein A-Sepharose. They were then analyzed by SDS-polyacrylamide gel electrophoresis under reducing and non-reducing conditions, followed by immunobinding assaying. It has been suggested that there are three kinds of hCG alpha beta S (one mature and two immature). To confirm the above results and to clarify the existence of free subunits, placental extracts were subjected to two dimensional SDS-polyacrylamide gel electrophoresis. With this technique, high molecular weight forms of immature hCG subunits were found to be present in placental cells as an oligomer of not only the alpha beta dimer but of each subunit as well. PMID- 2768226 TI - Membrane anchors of alkaline phosphatase and trehalase associated with the plasma membrane of larval midgut epithelial cells of the silkworm, Bombyx mori. AB - The larval midgut epithelial cell of the silkworm, Bombyx mori, has two forms of alkaline phosphatase and trehalase, soluble and membrane-bound. Alkaline phosphatase and trehalase of the latter form are found in the brush border membrane and the basolateral membrane, respectively. In this work we studied the membrane anchors of these membrane-bound enzymes. Alkaline phosphatase was solubilized by phosphatidyl-inositol-specific phospholipase C, but not by papain. Conversely, trehalase was released from the membrane by papain, but not by phosphatidylinositol-specific phospholipase C. Both enzymes were solubilized in an amphiphilic form with 0.5% Triton X-100 plus 0.5% sodium deoxycholate (pH 7.0). The detergent-solubilized alkaline phosphatase and trehalase were converted to hydrophilic form on incubation with phosphatidylinositol-specific phospholipase C and papain, respectively. The effects of papain on solubilization and conversion of trehalase were completely inhibited by leupeptin. These results suggest that, in the silkworm larvae, alkaline phosphatase is anchored in the brush-border membrane via a glycosyl-phosphatidylinositol, while trehalase is associated with the basolateral membrane through a hydrophobic segment of the polypeptide. PMID- 2768227 TI - Structural and ultrastructural study of the teeth in a suspected case of pseudohypoparathyroidism. AB - Two premolars removed from a 14 year old girl, with suspicion of pseudohypoparathyroidism (PHP) have been studied, using several of the correlated techniques applied to the study of calcified tissues (light microscopy, microradiography and scanning electron microscopy). Enamel gross and micro hypoplasia, hypomineralization of the enamel surface and dentin hypocalcification were similar to dental abnormalities observed in pseudohypoparathyroidism. Microradiography showed for the first time calcifications present in blood vessels of the dental pulp. Light microscopy and SEM revealed dystrophic globular calcifications within enamel hypoplastic pits. Cemental changes consisting of hypoplasia, aplasia, localized hyperplasia and cementicules were described for the first time. It is suggested that enamel, dentine and pulp abnormalities observed in the present case might be pathognomonic of PHP. PMID- 2768228 TI - Evaluation of a model for short-term clinical testing of cariogenicity. AB - Conventional mirror and probe examination and laser fluorescence were used to score caries-like alterations on the buccal surfaces of posterior teeth in 60 panelists, allotted to one of three groups. All subjects refrained from oral hygiene for five days. In one group each subject consumed 12 sucrose candies daily between meals and in the second group each subject similarly consumed 12 palatinose (isomaltulose) candies. The third group served as a control. At the end of the experimental period the tooth surfaces reexamined. Conventional and laser fluorescence scoring techniques showed an increase in the number of caries like alterations for all groups, but there were no significant differences between the groups. For all groups, the laser method gave significantly greater scores throughout. The findings imply that certain aspects of the early development of enamel caries in subjects regularly using fluorides must be considered in the design of a short-term cariogenicity test. It is concluded that sensitive quantitative methods for the registration of caries are necessary in such tests. PMID- 2768229 TI - [An epidemiologic study of the oro-dental health status of children in the region of Ile de France]. AB - An epidemiological survey was conducted of the oral conditions in the region of lle de France of a representative sample of 2,062 children aged 6 to 15 years. The sample was selected among the population of Paris and the departments of Hauts de Seine, Seine St-Denis, Val-de-Marne, Val d'Oise and Seine et Marne; 1,962 children came from urban zones. The mean DMFT increased with age and was 0.98, 4.46 and 6.6 at the ages of 6, 9 and 12 years respectively. At 6 years of age, 65.9% of the children were free of caries in their permanent teeth decreasing to 17.4% and 11.9% at the ages of 12 and 15 years respectively. The pits and fissures were the most frequent sites of caries. The highest mean values of plaque and gingival indices were observed at the age of 11 years. PMID- 2768230 TI - Interaction of human salivary mucins with hydroxyapatite. AB - The interactions between hydroxyapatite (HAP) and several types of mucins (human whole salivary mucins, HWSM; ovine submandibular mucin, OSM; porcine gastric mucin, PGM) were compared using a quantitative assay. Of these mucins, HWSM displayed by far the highest binding to hydroxyapatite, followed by PGM and OSM, respectively. HWSM binding to hydroxyapatite was measured at pH 6.3 and 7.0. Data obtained appeared to fit empirically the Langmuirian adsorption isotherm. Apparent affinity constant (K-value) and maximum binding capacity (N-value), derived from these isotherms, indicated that upon lowering the pH the K-value increased from 0.7 to 0.8 ml/mg and the N-value from 2,050 to 2,640 micrograms/m2 hydroxyapatite. The pH-dependence of the HWSM-HAP interaction, measured over a large pH-range, at a fixed concentration of HWSM, indicated a two- to three-fold increase in binding upon lowering the pH from 7.5 to 5.5 At pH 5.5 the presence of HWSM induced an increased solubilization of hydroxyapatite, as deduced from the amounts of Ca2+ and phosphate-ions released. Addition of Ca2+ - and Mg2+ ions (1mM) resulted in a decrease, both of HWSM binding and of the hydroxyapatite solubilization. These effects were more pronounced at the lower pH-values (pH less than 6.0). PMID- 2768231 TI - Periodontal and femoral bone status in periodontitis-affected hamsters receiving a high dose indomethacin treatment. AB - The aim of this study was to test the effect of a high dose (6 mg/kg/d) of indomethacin, a PG-synthesis inhibitor, on hamster periodontitis and to verify a possible systemic skeletal action. Thirty animals were separated into three groups: control, untreated periodontitis-affected, and indomethacin treated groups. Compared to affected untreated animals, indomethacin reduced the number of osteoclasts (p less than 0.001) to the control level, and accordingly the extent of resorption (p less than 0.01). A partial decrease in reversal (p less than 0.05) was also obtained; the persistence of aborted reversal lacunae was the scar of the pretreatment period. The extent of formation was markedly increased by indomethacin (p less than 0.01). Bacterial plaque accumulation was not modified but PMNLs investing plaque were dramatically decreased (p less than 0.02). Indomethacin had no influence on the femoral periosteal remodeling, nor on metaphyseal and epiphyseal trabecular density, nor on growth plate thickness. These results confirm the positive effect of indomethacin on hamster periodontitis and emphasize the role of PGs on periodontitic bone disturbances, particularly on the uncoupling of the remodeling sequence. The reduction in PMNL migration is an important feature, which possibly participates in the improvement of the bone status. The lack of femoral changes indicates that a mid-term treatment with indomethacin has no detrimental action on ordered skeletal growth and bone mass. PMID- 2768232 TI - Reversion of the maple syrup urine disease phenotype of impaired branched chain alpha-ketoacid dehydrogenase complex activity in fibroblasts from an affected child. AB - Branched chain alpha-ketoacid dehydrogenase is a heteroprotein complex of mitochondria and commits the branched chain alpha-ketoacids to their catabolic fate. Inherited nuclear mutations in humans decrease the activity of this complex and result in maple syrup urine disease. Here we demonstrate the restoration of branched chain alpha-ketoacid dehydrogenase activity to fibroblasts from a child with this disorder by transfection with a cDNA for the prebranched chain acyltransferase. Prior to transfection these fibroblasts contained the prebranched chain acyltransferase gene but failed to transcribe the gene and thus lacked the protein. Regulation of the restored complex by phosphorylation mechanisms resembles that of wild-type cells. These results describe a human cell modeling system for testing engineered proteins and support the possibility of gene replacement therapy for this human disorder. PMID- 2768233 TI - Thyroid hormone inhibition of human thyrotropin beta-subunit gene expression is mediated by a cis-acting element located in the first exon. AB - Thyroid hormone regulation of the human thyrotropin beta-subunit gene (TSH beta) was examined in a human embryonal cell line (293). Transient expression studies were performed with chimeric plasmids containing the reporter gene, chloramphenicol acetyltransferase. Sequences in the first exon between +9 and +37 base pairs (bp) enhanced gene expression from the human TSH beta promoter in the absence of thyroid hormone as well as mediated a concentration-dependent triiodothyronine (L-T3) decrease in gene expression. Thyroid hormone inhibition of expression was also conferred to the herpes simplex virus thymidine kinase promoter by inserting +3 to +37 bp of the human TSH beta gene downstream from the start of transcription. Primer extension analysis of RNA from transfected cell cultures revealed accurate transcription initiation in only those constructs which contained sequences between +9 and +37 bp. Moreover, RNA analysis confirmed that L-T3 inhibition of chloramphenicol acetyltransferase activity from chimeric pTSH beta CAT constructs occurred at a pretranslational level. In addition, a nuclear thyroid hormone receptor, c-erbA-beta, bound to this region in an avidin biotin DNA binding assay. These data suggest that L-T3, bound to its receptor, may inhibit human TSH beta expression by interfering with an element that functions to enhance gene expression. PMID- 2768234 TI - Primary structure of a putative receptor for a ligand of the insulin family. AB - Nucleotide sequence analysis of human and guinea pig genomic DNA encoding a new member of the insulin receptor (IR) family revealed that the predicted primary structure of this IR-related protein is as similar to the IR and insulin-like growth factor (IGF) I receptor as the IR and IGF-IR are to each other. The conservation of this IR-related sequence among mammals and with the IR and IGF-IR suggests that this IR-related protein is a novel receptor for insulin, IGF-I, IGF II, or an as yet unidentified peptide hormone or growth factor belonging to the insulin family. PMID- 2768235 TI - A novel peptide, vasoactive intestinal contractor, of a new (endothelin) peptide family. Molecular cloning, expression, and biological activity. AB - A new peptide family (endothelin (ET] consisting of three members in mammals appears to be present in mice according to genomic Southern blot analysis. Two ET related genes were identified by cloning and sequence analysis of a mouse genome. One encoded a peptide identical to porcine and human vasoconstrictor peptide ET, and the other encoded a novel peptide differing from ET in 3 amino acid residues, with 4 cysteines in the same positions as in ET. This novel peptide was synthesized and confirmed to have in vivo pressor activity similar to that of ET. Northern blot analysis, however, indicated the gene of this novel peptide to be expressed only in the intestine, and not in other tissues or cell lines, or endothelial cells. Furthermore, the peptide evoked a strong contractile response in the guinea pig ileum. This peptide may thus be reasonably classified as a gastrointestinal peptide, vasoactive intestinal contractor. PMID- 2768236 TI - DNA ring closure mediated by protein HU. AB - The histone-like protein HU serves as an accessory factor that can facilitate the interaction of certain proteins with their specific DNA binding sites. Examples occur in different systems for prokaryotic DNA replication, transcription, and gene regulation. The protein-DNA interactions that are stimulated by HU generally involve coiling or looping of the DNA, and the possibility has been considered that HU exerts its effect by contributing flexibility to different DNA binding sites, but there has been no direct demonstration of this. To explore the possibility that HU can mediate tight DNA curvatures, we studied its effect on the formation of DNA circles when DNA ligase cyclizes short linear DNA fragments. It is demonstrated that HU greatly increases the cyclization rates of all fragments that were examined having lengths greater than 98 base pairs. Fragments of 99, 108, 120, or 126 base pairs could not cyclize in the absence of HU, but cyclization went rapidly with HU, showing that HU can mediate very tight DNA curvatures. PMID- 2768237 TI - Alterations in the polypyrimidine sequence affect the in vitro splicing reactions catalyzed by HeLa cell-free preparations. AB - The polypyrimidine tract, located at the 3' end of intron 1 of the adenovirus major late transcript, was studied for its role in splicing using cell-free preparations isolated from HeLa cells. A plasmid (pIz) was constructed in which seven purine bases were substituted for pyrimidine bases within the 14-nucleotide polypyrimidine sequence. Runoff transcripts extending to the middle of intron 2 were tested for their ability to support in vitro splicing. The efficiency of these reactions was compared with pre-mRNA transcripts made from the wild-type nonmutated plasmid (p1-2). Neither spliced products nor splicing intermediates were detected in reactions with the pIz pre-mRNA. The formation of the nucleoprotein complexes involved in splicing was examined with this altered pre mRNA. No 55 S splicing complex was detected and only low levels of the 30 S presplicing complex formed (30-fold less than with wild-type pre-mRNA). However, when a longer runoff transcript was prepared from the polypyrimidine mutated plasmid pIz, spliced RNA was formed. This activity required specific downstream sequences, since transcripts produced from pIz which contained substituted downstream sequences were not spliced. Although intron 2 of the adenovirus major late transcript does not contain a discernible 3' polypyrimidine sequence, pre mRNA (p2-3) containing this intron was efficiently spliced. However, when the 3' region of intron 2 was substituted for the polypyrimidine sequence of intron 1, the resulting pre-mRNA did not support efficient splicing in vitro. However, when the polypyrimidine sequence of intron 1 was substituted for the sequence at the 3' end of intron 2, efficient splicing occurred, and the rate of formation of splicing intermediates and the accumulation of nucleoprotein complexes was greater than with the wild-type pre-mRNA (p2-3). PMID- 2768238 TI - Reaction of lecithin cholesterol acyltransferase with water-soluble substrates. AB - To separate the interfacial and catalytic reactions of lecithin cholesterol acyltransferase (LCAT), we carried out the first investigation of its reaction with water-soluble substrates. We used a continuous spectrophotometric assay for the hydrolysis of p-nitrophenyl esters of fatty acids to determine the chain length specificity of the enzyme and its modulation by anions and apolipoproteins in solution. By chemical modification of amino acid residues, we demonstrated that the active site serine and histidine residues participate in both the esterase and acyltransferase reactions but that cysteine residues are not involved in the esterase reaction. The kinetics of the LCAT reaction were measured for p-nitrophenyl esters of fatty acids having up to six (C-6) carbons in length. With increasing acyl chain lengths the optimal reaction rates occurred for the C-5 ester and Km and Vmax values decreased progressively, while the specificity constant, kcat/Km, increased. The same series of substrates and longer chain esters, up to C-16, were also reacted with LCAT in the presence of Triton X-100 in order to determine the general trends for the reaction rates as a function of chain length. The observed trends for the reaction rates and kinetic constants were attributed to an increasing binding affinity for the longer acyl chains in a large hydrophobic cavity, with a concomitant restriction in the motions of the substrates and a decreased probability for the correct positioning of the ester bond for hydrolysis, resulting in a decreased substrate turnover. Since the kinetics of the interfacial reactions of LCAT are very sensitive to the presence of anions and apolipoproteins, in particular apoA-I, we investigated the effects of these modulators on the reactions of LCAT in solution. Unlike the interfacial reactions, the hydrolysis of the p-nitrophenyl esters was not affected by 0.1 M concentrations of anions nor by water-soluble apolipoproteins (apoA-I, apoA-II, and apoCs). Thus the regulation of the activity of LCAT is mediated largely by the interfaces on which it acts. PMID- 2768239 TI - Purification and characterization of pituitary bovine somatotropin. AB - Bovine somatotropin (bST) has been isolated from pituitary glands and compared in a variety of chemical analyses and bioassays with somatotropin derived from recombinant Escherichia coli. Comparison of pituitary extracts and purified bST by Western blot analysis of two-dimensional gels suggested that the immunoreactive somatotropin species present in the extract were also present in the purified material, with no significant losses or degradation as a result of the purification method. NH2-terminal sequence analysis indicated the presence of equal quantities of Ala-Phe-Pro-Ala-Met-Ser-Leu-Ser- and Phe-Pro-Ala-Met-Ser-Leu Ser- sequences. The Met-Ser-Leu-Ser-NH2-terminal sequence, a degradation product observed in NIH standard lots, was not detected. Assay of bioactivity in a bovine liver receptor-binding assay and in a female rat growth assay showed pituitary bST and recombinant methionyl-bovine somatotropin to be equipotent. Tryptic maps and sequence analysis of pituitary-derived somatotropin suggest the presence of isoaspartate derivatization at Asp128. PMID- 2768240 TI - Phospholipid functional groups involved in protein kinase C activation, phorbol ester binding, and binding to mixed micelles. AB - The specificity of the phospholipid cofactor requirement of rat brain protein kinase C was investigated using Triton X-100 mixed micellar methods. Sixteen analogues of phosphatidylserine were prepared and tested for their ability to support protein kinase C activity, [3H]phorbol 12,13-dibutyrate binding, and protein kinase C binding to mixed micelles. Phosphatidylserinol, -L-serine methyl ester, -N-acetyl-L-serine, -2-hydroxyacetate, -3-hydroxypropionate, and -4 hydroxybutyrate did not activate protein kinase C in mixed micelles containing 2 mol % of sn-1,2-dioleoylglycerol. This indicates that both the carboxyl and amino moieties are important for activation. Phosphatidyl-D-serine and -L-homoserine were incapable of supporting full activation; this demonstrates stereospecificity and the importance of the distance between the phosphate and carboxyl and amino moieties. Since 1,2-rac-phosphatidyl-L-serine and 1,3-phosphatidyl-L-serine fully supported protein kinase C activity, the stereochemistry within the glycerol backbone at the interface was not necessary for maximal activation. Neither lysophosphatidyl-L-serine nor 1-oleoyl-2-acetyl-sn-glycero-3-phospho-L-serine supported protein kinase C activity implying that the interfacial conformation is critical to the activation process. The phospholipid dependencies of [3H]phorbol 12,13-dibutyrate binding and of protein kinase C binding to mixed micelles containing sn-1,2-dioleoylglycerol did not mirror those for activation. The data demonstrate that protein kinase C possesses a high degree of specificity with respect to phospholipid activation and implicate several functional groups within the phospho-L-serine polar head group in binding and activation. PMID- 2768241 TI - Biochemical characterization of the eta chain of the T-cell receptor. A unique subunit related to zeta. AB - The T-cell antigen receptor is a multisubunit complex consisting of at least seven chains. Based upon structural and genetic considerations, we have divided these chains into three groups. The alpha and beta subunits (Ti) are the clonotypic chains responsible for antigen recognition. Three chains that are invariant among all T-cells define the CD3 complex. These include the CD3 gamma, delta, and epsilon chains. The zeta chain is a distinct component that, like the CD3 chains, is invariant among all T-cells. In the majority of receptors, zeta is found as a disulfide-linked homodimer. We have recently shown that approximately 10% of zeta is disulfide-linked to a chain which we have called eta. A preliminary model has been proposed, suggesting that there are two subclasses of receptors, depending upon the presence within the complex of either the zeta-zeta homodimer or the zeta-eta heterodimer. Evidence has been presented that these two subclasses may perform distinct signaling functions. In this paper the eta chain is characterized to determine whether it is structurally related to the zeta chain and, in particular, whether it might represent a post-translational modification of zeta. We can identify specific antigenic epitopes that are shared by both zeta and eta. However, not all antibodies raised against zeta can directly recognize eta. The apparent molecular mass of eta is 22 kDa, whereas zeta has a molecular mass of 16 kDa. We are unable to demonstrate any post translational covalent modifications of eta to explain the difference in apparent molecular weight. These include phosphorylation, glycosylation, or sulfation. Amino acid incorporation studies demonstrate that the amino acid composition of eta is distinct from that of zeta. All of the eta in a T-cell is found in association with the rest of the components of the T-cell receptor. In addition, our anti-eta antibodies allow us to directly recognize human eta, which has an apparent molecular mass of approximately 23 kDa. Thus, eta and zeta appear to be related but distinct proteins, and we would propose that eta is the second member of the zeta group of components of the T-cell receptor. PMID- 2768242 TI - The mouse porphobilinogen deaminase gene. Structural organization, sequence, and transcriptional analysis. AB - The porphobilinogen deaminase gene encodes the third enzyme of the heme biosynthetic pathway. This gene is expressed in a tissue-specific manner and gives rise to two isoenzymatic forms encoded by mRNA species differing in their 5' extremity. Recent studies in human demonstrated that the tissue-specific expression of the porphobilinogen deaminase gene is determined in erythropoietic cells, by the utilization of a specific promoter situated 3' to the housekeeping promoter used in other cell types. This results, through differential splicing, in the mutually exclusive presence of either exon 1 or exon 2 in mature mRNAs. Here, we report the cloning and sequencing of the porphobilinogen deaminase gene from mouse. The overall organization of the mouse gene is similar to that of the human one. In the housekeeping promoter, only a short stretch of homology is found including two potential Sp1 binding sites; in contrast, more extensive similarity appears in the erythroid-specific promoter including two motifs also found in globin gene, a CACCC box, and a recently described Ery F1 consensus binding sequence. We derived a set of single-stranded probes corresponding to different parts of the mouse gene to carry out a detailed analysis of the transcriptional unit in various cell types, using a run-on transcription assay on isolated nuclei. In liver cells, the first (non-erythropoietic) exon is more actively transcribed than parts of the gene situated downstream, suggesting that the elongation of transcripts is blocked within the 5' part of the first intron. In erythropoietic cells, the downstream promoter becomes activated; surprisingly, the initiation of transcription is also enhanced from the upstream (housekeeping) promoter and most of the transcripts initiated at the housekeeping promoter stop downstream of the first exon, between the two promoters. PMID- 2768243 TI - Thyroid hormone regulates the mouse thyrotropin beta-subunit gene promoter in transfected primary thyrotropes. AB - In TtT 97 cells, a thyrotropin-producing mouse pituitary tumor, thyroid hormone rapidly inhibits the transcription rate of both the thyrotropin alpha- and beta subunit (TSH beta) genes, and this closely parallels the increase in nuclear thyroid hormone receptor occupancy. In this study, we have identified regions of the mouse TSH beta gene which are involved in mediating tissue-specific and thyroid hormone-regulated expression. Transient expression studies were performed using a series of chimeric plasmids in which 5'-flanking DNA was ligated to the firefly luciferase gene. Following transfection by electroporation, efficient expression of TSH beta 5'-flanking luciferase constructs occurred only in cells derived from TtT 97 tumors which express the endogenous TSH beta gene. Deletion analysis demonstrated that the region of the 5'-flanking DNA between positions 271 and -80 relative to the major transcriptional start site is important for TSH beta promoter activity in thyrotropes. No expression was measurable in mouse L cells, a fibroblast line, whereas a low level of expression was seen in MGH 101A cells derived from a thyrotropic tumor which no longer expresses the TSH beta gene. Reduced expression of TSH beta constructs was also found in GH3 and GH4 pituitary tumor lines. Addition of thyroid hormone effectively inhibited the level of transient TSH beta promoter activity in TtT 97 cells in a dose-dependent manner. The inhibitory effect was more pronounced and more accurately reflected the transcription rate data when transfected cells were derived from tumors treated with thyroid hormone for 5 days prior to transfection. Deletion of all but 46 base pairs of TSH beta gene 5'-flanking DNA and 3 base pairs of the first exon had no effect on thyroid hormone inhibition. This indicates that signals sufficient for transcriptional regulation of the TSH beta gene by thyroid hormone reside in the vicinity of the proximal promoter and may act by interfering with basal transcriptional factors. PMID- 2768244 TI - Normal fibroblasts responding to anoxia exhibit features of the malignant phenotype. AB - Cancer has two fundamental features: neoplasia, representing the aberrant expression of a normal cell proliferation response, and malignancy, an ability to penetrate normal tissue boundaries. Although the role of oncogenes in neoplastic transformation is becoming clearer, malignancy remains far less well understood. Normal rat fibroblasts exhibit a staged response to anoxia which, if expressed in an uncontrolled fashion, may contribute vital aspects to the malignant phenotype. The response begins with induction of retrotransposon-like VL30 element transcription, progresses through induction of several intracellular proteins, and is followed by secretion of three major proteins including the protease cathepsin L. The induced VL30 element RNA encodes a 61-kDa secretory protein of unknown function. The response of fibroblasts to anoxia is evidently not a survival response. Instead, the response represents a close match to the role of fibroblasts during the early stages of wound healing where they are active under near-anoxic conditions. Malignant cancer cells are known to exhibit several of the characteristics we find induced in fibroblasts by anoxia. Conversion to the malignant phenotype may represent coordinate loss of control of this normal cellular response. PMID- 2768245 TI - Molecular cloning and characterization of the human folate-binding protein cDNA from placenta and malignant tissue culture (KB) cells. AB - Human folate-binding proteins (FBPs) are single chain glycoproteins that contain a high affinity binding site for folates and methotrexate and occur in a soluble or membrane-associated form. The membrane-associated FBP is involved in the uptake of physiologic folates and methotrexate. In this study, human FBP cDNA clones were isolated from human malignant nasopharyngeal carcinoma (KB) cell and placental cDNA libraries by means of oligonucleotide probes derived from determined internal amino acid sequences. The longest cDNA nucleotide sequence is 1126 base pairs and encodes a polypeptide that contains 257 amino acid residues (calculated molecular mass = 29,817). The deduced amino acid sequence is 80% homologous to a bovine soluble FBP, is greater than 99% homologous to the reported partial amino acid sequence of the human soluble FBP, contains three potential N-linked glycosylation sites, and has hydrophobic amino- and carboxylterminal regions which are consistent with a signal peptide and a potential membrane-anchoring domain, respectively. On Northern blot analysis, radiolabeled cDNA probes hybridize to a single 1100-base pair mRNA species that is expressed to a variable degree in human KB cells, placenta, brain, and epithelial mRNA but is not detectable in human liver mRNA. In vitro translation of RNA transcripts from the FBP cDNA inserts yields a 30-kDa and a 42-kDa polypeptide in the absence and presence of microsomal membranes, respectively. PMID- 2768246 TI - High cooperativity, specificity, and multiplicity in the protein kinase C-lipid interaction. AB - The number of phosphatidylserine molecules involved in activating protein kinase C was determined in a mixed micelle system where one monomer of protein kinase C binds to one detergent:lipid micelle of fixed composition. Unusually high cooperativity, specificity, and multiplicity in the protein kinase C-phospholipid interaction are demonstrated by examining the lipid dependence of enzymatic activity. The rates of autophosphorylation and substrate (histone) phosphorylation are specifically regulated by the phosphatidylserine content of the micelles. Hill coefficients of 8-11 were calculated for phosphatidylserine dependent stimulation of enzyme activity, with a maximum occurring in micelles containing greater than or equal to 12 phosphatidylserine molecules. The high specificity that exists is illustrated by the fact that phosphatidylethanolamine and phosphatidylglycerol, but not phosphatidylcholine or phosphatidic acid, can replace only some of the phosphatidylserine molecules. We propose that Ca2+ and acidic phospholipids cause the protein to undergo a conformation change revealing multiple phosphatidylserine binding sites and resulting in the highly cooperative and specific interaction of protein kinase C with phosphatidylserine. Consistent with this, the proteolytic sensitivity of protein kinase C increases approximately 10-fold in the presence of phosphatidylserine and Ca2+ compared to Ca2+ alone. The high degree of cooperativity and specificity may provide a sensitive method for the physiological regulation of protein kinase C by phospholipid. PMID- 2768247 TI - Modulation of the expression of chondroitin sulfate proteoglycan in stimulated human monocytes. AB - Proteoglycan biosynthesis was studied in human monocytes and monocyte-derived macrophages (MDM) after exposure to typical activators of the monocyte/macrophage system: interferon-gamma (IFN-gamma), lipopolysaccharide (LPS), and phorbol 12 myristate 13-acetate (PMA). By morphological examination, both monocytes and MDM were stimulated by these activators. Treatment with IFN-gamma resulted in a slight decrease in the expression of [35S]chondroitin sulfate proteoglycan (CSPG) in both monocytes and MDM, whereas LPS treatment increased the [35S]CSPG expression 1.8 and 2.2 times, respectively. PMA, in contrast, decreased the CSPG expression 0.4 times in monocytes, whereas MDM were stimulated to increase the biosynthesis 1.9 times. An increase in the sulfate density of the chondroitin sulfate chains was evident following differentiation of monocytes into MDM due to the expression of disulfated disaccharide units of the chondroitin sulfate E type (CS-E). However, monocytes exposed to PMA did also express disaccharides of the chondroitin sulfate E type. Furthermore, the expression of CS-E in MDM was increased 2 times following PMA treatment. An inactive phorbol ester, phorbol 12,13-diacetate, did not affect the expression of CS-E in either monocytes or MDM when compared with control cultures, suggesting that protein kinase C-dependent signal pathways may be involved in the regulation of sulfation of CSPG. Exposure to LPS or IFN-gamma did not lead to any changes in the sulfation of the chondroitin sulfate chains. PMID- 2768248 TI - Purification and characterization of methylmalonate-semialdehyde dehydrogenase from rat liver. Identity to malonate-semialdehyde dehydrogenase. AB - Methylmalonate semialdehyde dehydrogenase was purified from rat liver in order to define the distal portion of valine catabolism and related pathways in mammals. The purified enzyme is active with malonate semialdehyde and consumes both stereoisomers of methylmalonate semialdehyde, implicating a single semialdehyde dehydrogenase in the catabolism of valine, thymine, and compounds catabolized by way of beta-alanine. The oxidation of malonate and methylmalonate semialdehydes by this enzyme is CoA-dependent, the products being acetyl-CoA and propionyl-CoA, respectively. Expected activity with ethylmalonate semialdehyde as substrate was not found. Methylmalonate semialdehyde dehydrogenase was separated on DEAE Sephacel into two isoforms which differ in mobility during nondenaturing polyacrylamide gel electrophoresis. The two forms are immunologically cross reactive and exhibit the same N-terminal sequence, suggesting that one form is the product of the other. The monomer molecular mass, determined by polyacrylamide gel electrophoresis in the presence of sodium dodecyl sulfate, was 58 kDa. The native molecular mass, estimated by gel filtration, was 250 kDa, suggesting a tetrameric structure. PMID- 2768249 TI - Nucleotide sequence and regulation of a human 90-kDa heat shock protein gene. AB - In order to define the mechanisms responsible for the regulated expression of a human 90-kDa heat shock protein (HSP90) gene, we have determined the complete genomic sequence of the gene encoding HSP90 beta, including 1102 base pairs upstream of the transcription initiation site. This gene consists of 12 exons and 11 introns. The exons range in size from 99 to 396 base pairs and the introns range from 91 to 1433 base pairs. Analysis of the 5' promoter region revealed TATA and CAAT consensus sequences. Additionally, Sp1 factor binding sites and presumptive heat shock element consensus sequences were found surrounding the transcription initiation site. Three out of the six identified potential heat shock elements reside within the first intron. The ability of the promoter region to respond to heat shock was examined by constructing a plasmid containing the 5' end of the HSP90 beta gene driving a neomycin phosphotransferase reporter gene. This plasmid was used to stably transform human K562 erythroleukemia cells. With heat shock, the abundance of HSP-neo transcripts increased, demonstrating that the promoter region of this gene contains the cis-acting DNA elements required for the heat shock response. PMID- 2768250 TI - Characterization of two glucuronic acid-containing glycosphingolipids in larvae of the green-bottle fly, Lucilia caesar. AB - Two glucuronic acid-containing glycosphingolipids were purified from larvae of the green-bottle fly, Lucilia caesar by DEAE-Sephadex and Iatrobeads column chromatography. Structures of these acidic glycolipids, glycolipids X and Y, were elucidated by means of sugar analysis, permethylation, enzymatic hydrolysis, negative-ion fast atom bombardment mass spectrometry, and NMR studies. Glycolipid X was determined to have the following structure: GlcA beta 1-3Gal beta 1-3GalNAc alpha 1-4 GalNAc beta 1-4 GlcNAc beta 1-3Man beta 1-4Glc beta 1-1 ceramide. The other acidic glycolipid, glycolipid Y contains a phosphoethanolamine residue linked through the 6-hydroxy group of the N-acetyl-glucosamine unit of glycolipid X. The ceramide moieties were composed of saturated fatty acids (16:0-22:0) and tetradeca- and hexadeca-4-sphingenines. Based on the structural similarity of the ceramide moieties it appears likely that glycolipid X is an intermediate from which glycolipid Y is synthesized by addition of a phosphoethanolamine residue. PMID- 2768251 TI - Human H4 histone gene transcription requires the proliferation-specific nuclear factor HiNF-D. Auxiliary roles for HiNF-C (Sp1-like) and HiNF-A (high mobility group-like). AB - The proximal promoter of the human H4 histone gene F0108 contains two in vivo protein binding domains, sites I and II. In this report we show that these sequences interact with three nuclear factors: HiNF-D, HiNF-C, and HiNF-A. HiNF-C is a metal ion-requiring protein that binds to an Sp1 consensus binding site. HiNF-C and HiNF-A bind independently to the distally located site I, possibly in conjunction with other proteins, and deletion of site I reduces transcription rates 4- to 6-fold in vitro. Factor HiNF-D binds to an H4 histone-specific element (5'-dGGTPyPyTCAATCNG-GTCCG, where Py indicates pyrimidine) present in site II that has previously been shown to be essential for in vivo expression of this H4 histone gene. All three binding activities are present in human HeLa S3 cells throughout the cell cycle and in exponentially growing mouse C127 and human HL60 cells. This result is consistent with the transcription of H4 histone genes throughout the cell cycle. However, unlike HiNF-A and HiNF-C, HiNF-D is not present in terminally differentiated HL60 cells, in which histone gene transcription is down-regulated. These findings suggest a crucial role for HiNF D, with an auxiliary role for HiNF-C and possibly HiNF-A, in the regulation of H4 histone gene transcription. Furthermore, the conservation of potential HiNF-D binding sites in mammalian H4 histone gene promoters suggests that HiNF-D has an essential role in the coordinate transcriptional down-regulation of the H4 histone multigene subfamily during the shutdown of proliferation. PMID- 2768252 TI - Isolation and electron microscopic characterization of the high molecular mass aminoacyl-tRNA synthetase complex from murine erythroleukemia cells. AB - A high molecular mass aminoacyl-tRNA synthetase complex has been isolated from a murine erythroleukemia cell line. This multienzyme complex contains activities for the arginyl-, aspartyl-, glutamyl-, glutaminyl-, isoleucyl,- leucyl-, lysyl-, methionyl-, and prolyl-tRNA synthetases. This enzyme composition, the polypeptide pattern observed upon sodium dodecyl sulfate-polyacrylamide gel electrophoresis, and the relative stoichiometry of the component polypeptides are characteristic of high molecular mass complexes of aminoacyl-tRNA synthetases isolated from a variety of mammalian tissues and cell types. Negatively stained preparations of native complex and of glutaraldehyde-treated material have been examined by electron microscopy. In both cases, a distinctive particle is observed which appears in several orientations. The most common views are of two different projections of a squarish particle that measures approximately 27 x 27 nm. Other commonly observed views are of a "U" shape, a rectangle, and a triangle. All of these views are seen in both gradient-purified samples and those prepared directly from material as isolated. These data are consistent with a model for the multienzyme aminoacyl-tRNA synthetase complex as a "cup" or elongated U structure. These studies demonstrate that the high molecular mass complex of eukaryotic aminoacyl-tRNA synthetases does have a coherent structure that can be visualized by electron microscopy. PMID- 2768253 TI - Biosynthesis of a repressor/nuclease hybrid protein. AB - The phage T7 endonuclease gene was fused to the 3' end of the lac repressor gene. The hybrid protein exhibits repressor and nuclease functions in a manner dependent on the conformation of the DNA. With supercoiled DNA, nuclease activity is directed to the major cruciform, whereas with linear DNA, the enzyme cleaves preferentially restriction fragments carrying the operator. These properties render the hybrid protein a unique probe of DNA conformation in vitro and in vivo. PMID- 2768254 TI - HSP100, a 100-kDa heat shock protein, is a Ca2+-calmodulin-regulated actin binding protein. AB - The 100-kDa heat shock protein, HSP100, was purified from mouse lymphoma cells. Amino acid sequences of three peptide fragments which were obtained from the purified protein by lysylendopeptidase digestion were completely or nearly identical with those of a mouse endoplasmic reticulum protein, ERp99, of a hamster glucose-regulated protein, GRP94, and of a chicken heat shock protein, HSP108, all of which have been known to have strong homology with the 90-kDa heat shock protein, HSP90. HSP100 bound to actin filaments and an apparent Kd for the binding was determined to be 8 x 10(-7) M in 2 mM MgCl2 + 100 mM KCl. Calmodulin inhibited the binding in a Ca2+-dependent manner. Equilibrium gel filtration demonstrated that HSP100 has an ability to bind to calmodulin only in the presence of Ca2+. Moreover, HSP100 competed with HSP90 for binding to actin filaments. These results together with our previous findings that HSP90 and HSP100 have similar physicochemical properties (Koyasu, S., Nishida, E., Kadowaki, T., Matsuzaki, F., Iida, K., Harada, F., Kasuga, M., Sakai, H., and Yahara, I. (1986) Proc. Natl. Acad. Sci. U.S.A. 83, 8054-8058) and HSP90 is a calmodulin-regulated actin-binding protein (Nishida, E., Koyasu, S., Sakai, H., and Yahara, I. (1986) J. Biol. Chem. 261, 16033-16036), strongly suggest that HSP100 is structurally and functionally related to HSP90. PMID- 2768255 TI - Multiple drug resistance and conservative amplification of the H region in Leishmania major. AB - Amplification of the H region has been previously observed in methotrexate (MTX) resistant strains of Leishmania major and in unselected laboratory stocks of L. tarentolae. We now show that selection of L. major with the structurally unrelated drugs primaquine or terbinafine generated resistant lines exhibiting H region amplification and 23- and 12-fold cross-resistance to MTX, respectively. These and other drug-resistant lines bearing H region amplification also exhibited weak cross-resistance to primaquine and terbinafine, associating the amplified H region with pleiotropic resistance to MTX and other drugs. In contrast, lines selected for chloroquine or pentamidine resistance did not show H region amplification or this pattern of drug cross-resistance. The primaquine- and terbinafine-selected lines exhibited wild-type levels of dihydrofolate reductase-thymidylate synthase and normal uptake and accumulation of MTX, and the MTX resistance of these lines was not reversed by verapamil. These data suggest that the mechanism of MTX cross-resistance associated with H region amplification is novel and distinct from that mediated by overexpression of MDR genes in multidrug-resistant mammalian cells. Structural studies indicated that the amplified H region DNA in these L. major lines was largely (possibly exclusively) extra-chromosomal and consisted of circular inverted repeats joined at two DNA rearrangement junctions. Southern blot analyses showed that these rearrangement junctions were identical in four independent cell lines, suggesting that these sites are "hotspots" for DNA rearrangement. H region amplification in all of these lines was conservative, defined as retention of the chromosomal H region locus without structural alteration or reduction in copy number. This finding is consistent with an over-replication/recombination model for amplification of the H region. PMID- 2768257 TI - Recognition of oxidized low density lipoprotein by the scavenger receptor of macrophages results from derivatization of apolipoprotein B by products of fatty acid peroxidation. AB - Uptake of cholesterol-containing lipoproteins by macrophages in the arterial intima is believed to be an important step in the pathogenesis of atherosclerosis. There are a number of possible mechanisms by which macrophages might accumulate cholesterol, and one that has attracted much interest recently involves the uptake of oxidatively modified low density lipoprotein (LDL) via a specific cell surface receptor, termed the scavenger or acetyl-LDL receptor. Previous studies have shown that chemical derivatization of LDL with reagents that result in neutralization of the charge of lysine amino groups also allows recognition by this receptor. As well, it has been shown that oxidation of LDL is accompanied by a decrease in free lysine groups and binding of lipid products to apolipoprotein B. The present studies were done to further characterize the receptor-binding domain on oxidized LDL. It was found that LDL could be modified by incubation with water-soluble products derived from autoxidized unsaturated fatty acids under conditions that inhibited oxidation of the LDL itself. The LDL modified in this way had increased electrophoretic mobility but showed no evidence of the oxidative damage that typifies LDL oxidized by exposure to metal ions. Furthermore, the oxidation product-modified LDL was rapidly degraded by cultured macrophages through the scavenger receptor pathway. Bovine albumin modified by oxidation products also showed greatly accelerated degradation by macrophages. When analyzed by reverse-phase high pressure liquid chromatography, the reactive oxidation products appeared less polar than fatty acids or simple medium-chain aldehydes. When treated with the carbonyl reagent 2,4 dinitrophenylhydrazine, the reactive fractions yielded derivatives, some of which were identified by mass spectrometry as hydrazones of nonenal, heptenal, pentenal, and crotonaldehyde. A series of 2-unsaturated aldehydes (acrolein to 2 nonenal) were all found to modify LDL, but none of these aldehyde-modified LDLs were recognized by the scavenger receptor of macrophages and all were degraded much more slowly by these cells than LDL modified with oxidation products. Furthermore, copper-oxidized LDL had only very slight immunoreactivity toward a panel of antibodies specific for adducts of simple 2-unsaturated aldehydes. Analysis of underivatized autoxidized fatty acids by coupled liquid chromatography/thermospray mass spectrometry revealed compounds with m/z corresponding to M+17, M+31, and 2M+31 in fractions that were capable of modifying LDL. The unoxidized fatty acids showed a dominant peak at M-1. These results indicate that the scavenger receptor of macrophages can recogn PMID- 2768256 TI - Role of tropoelastin fragmentation in elastogenesis in rat smooth muscle cells. AB - Neonatal rat aortic smooth muscle cell cultures produce two major soluble elastin molecules termed protropoelastin (77 kDa) and tropoelastin (71 kDa). Cell layer extracts are protroproelastin-enriched, while protropoelastin, tropoelastin, and significant amounts of discrete elastin fragments (Mr of 66,000, 61,000, 56,000, and 45,000) are present in preparations from the medium of these cultures. To determine the role of the various elastin molecules in the metabolism of elastin in neonatal rat aortic smooth muscle cell cultures, the amino termini of these proteins were sequenced. All soluble elastin components present in the medium were purified as a single peak by high performance liquid chromatography; further separation of the components was achieved by polyacrylamide gel electrophoresis and electroblotting. The bands were excised and sequenced. The amino-terminal sequences of protropoelastin, tropoelastin, and the 66-kDa, 61-kDa, and 56-kDa fragments were identical: Gly-Gly-Val-Pro-Gly-Ala-Val-Pro-Gly-Gly. This sequence is identical with published amino-terminal sequences of tropoelastins from several other species. As expected, when the cell cultures were pulsed with [3H]valine, all the soluble elastin molecules were radioactive, while only protropoelastin appeared radioactive after [35S] cysteine pulsing. Since cysteine is present only in the carboxyl-terminal end of the molecule, all the data indicate that the cleavage of the elastin fragments identified in the culture are occurring at the carboxyl end of protropoelastin. These results are consistent with the original hypothesis that a precursor-product relationship exists between the 77-kDa and 71-kDa soluble elastin molecules. Based on known tropoelastin sequences and the molecular weights of the discrete fragments, additional fragmentation of protropoelastin and/or tropoelastin most likely occurs at the lysine/alanine-enriched domains presumably involved in cross-link formation. PMID- 2768258 TI - Multinuclear NMR studies of the Langendorff perfused rat heart. AB - The quantitation of intracellular sodium ion concentration [Na+]in perfused organs using NMR spectroscopy requires a knowledge of the extent of visibility of the 23Na resonance and of the intracellular volume of the organ. We have used a multinuclear NMR approach, in combination with the extracellular shift reagent dysprosium (III) tripolyphosphate, to determine the NMR visibility of intra- and extracellular 23Na and 35Cl ions, intracellular volume, and [Na+]in in the isolated Langendorff perfused rat heart. Based on a comparison of the extracellular volumes calculated using 2H and 23Na, 35Cl, or 59Co NMR of the perfused heart we conclude that resonances of extracellular sodium and chloride ions (including ions in interstitial spaces) are fully visible, contrary to assumptions in the literature. Furthermore, prolonged hypoxia or ischemia caused a dramatic increase in intracellular Na+ and [Na+] in rose to approach that in the external medium indicating full visibility of the intracellular 23Na resonance. Resonance intensities of intra- and extracellular 23Na ions, along with a knowledge of the extracellular space as a fraction of the total organ water space, yielded an average [Na+] in of about 10 mM (10 +/- 1.5 mM) for the rat heart at 37 degrees C. Double-quantum filtered 23Na NMR of the perfused rat heart in the absence and presence of paramagnetic reagents revealed, contrary to assumptions in the literature, that both intra- and extracellular sodium ions contribute to the detected signal. PMID- 2768259 TI - HTLV-I tax gene product activates transcription via pre-existing cellular factors and cAMP responsive element. AB - Human T-cell leukemia virus type I (HTLV-I) is the etiological agent of adult T cell leukemia. The 3' end of HTLV-I proviral DNA encodes the synthesis of two regulatory proteins, tax and rex. The 40-kDa tax protein is a nuclear protein which positively stimulates transcription from the U3 region of the viral long terminal repeat sequence. Three 21-base pair sequences in the U3 region have been found to serve as the cis-element for tax-mediated trans-activation. We now report that the tax protein can trans-activate HTLV-I LTR in the absence of de novo cellular protein synthesis. Saturated mutagenesis of the 21-base pair repeat sequence showed that specific mutations clustered in sequences homologous to the cAMP responsive element (TGACGTCA) abolish trans-activation by tax. Furthermore, although the TGACGTCN element is nearly palindromic, the mutations that abolish trans-activation are localized exclusively in the 5' 6 bases, suggesting the orientation of this element may play a role in transcription. That the purified tax protein does not bind the 21-base pair repeats or nonspecific DNA lends further support to the notion that tax protein does not directly interact with the 21-base pair repeats to activate transcription. Instead, tax most likely acts via cellular transcriptional factor(s) to bring about trans-activation. PMID- 2768260 TI - Conversion of soluble dopamine beta-hydroxylase to a membrane binding form. AB - We have shown that purified bovine soluble dopamine beta-hydroxylase can reconstitute onto preformed phosphatidylserine containing vesicles. The binding is dependent on pH and vesicle phosphatidylserine composition but does not require calcium. Reconstitution appears to be irreversible, with the lipid-bound enzyme possessing hydroxylase activity. Additionally, [14C] phosphatidylserine binds to soluble dopamine beta-hydroxylase and remains bound after several detergent washes. Thus the reconstituted soluble form of the enzyme appears to be functionally analogous to the membranous form. Both the reconstitution data and the lipid binding data suggest that multiple phosphatidylserine molecules bind to the soluble hydroxylase. We propose that noncovalently bound phosphatidylserine moieties, which copurify with the membrane bound form of the enzyme, alone are responsible for anchoring membranous dopamine beta-hydroxylase to chromaffin granule and model membranes. PMID- 2768261 TI - Characterization of a proton-driven carrier for sialic acid in the lysosomal membrane. Evidence for a group-specific transport system for acidic monosaccharides. AB - Highly purified lysosomal membrane vesicles, obtained from rat liver lysosomes, were used to study characteristics of NeuAc transport across the lysosomal membrane. Uptake of [14C]NeuAc was found to be strongly influenced by a pH gradient across the membrane. When a proton gradient (pHin greater than pHout) was generated by impermeable buffers, NeuAc uptake above equilibrium level (overshoot) was observed. The influence of membrane diffusion potentials was ruled out by experiments where K+ and valinomycin were present. The overshoot appeared to be specifically produced by protons, since gradients of other cations (Na+ and K+) did not give stimulation. Proton-driven uptake was saturable (Kt = 0.24 mM) and mediated by a single system, as shown by linearity of the Scatchard plot. Stimulation of transport was also obtained by preincubation of vesicles with MgATP and the effect was blocked by 4,4'-diisothiocyanostilbene-2,2' disulfonic acid, but not by the protonophore carbonyl cyanide p trifluoromethoxyphenyl hydrazone. Monocarboxylic sugars like glycuronic acids were competitive inhibitors of sialic acid transport. Transstimulation of [14C] NeuAc uptake was observed when vesicles were preloaded either with unlabeled NeuAc or with glucuronic acid. The data demonstrate that lysosomal membrane vesicles from rat liver are a suitable system for kinetic studies of solute transport events. The presence of a proton-driven carrier in the lysosomal membrane specific for sialic acid and other acidic sugars, including glucuronic acid, is shown. The possible physiological significance of these findings for the human lysosomal carrier and the patients with a sialic acid transport defect is discussed. PMID- 2768262 TI - Isolation and characterization of cDNA clones encoding rat skeletal muscle peptidylarginine deiminase. AB - Various mammalian tissues contain protein-arginine deiminases (EC 3.5.3.15), which convert the arginine residues in normal peptide bonds to the citrulline residues in calcium ion-dependent manners. Here, we describe the complete primary structure of rat skeletal muscle peptidylarginine deiminase deduced from the sequences of its cDNA clones isolated by recombinant DNA technology. We have isolated three overlapping cDNA clones which constitute a 4,507-base pair cDNA sequence including a 2,452-base pair 3'-untranslated region. The coding region consists of 1,995 base pairs encoding 665 amino acid residues. A potential N linked glycosylation site is present at asparagine-534. The molecular weight of the enzyme calculated from the deduced amino acid sequence is 75,122. Direct repeat sequences resembling the rodent B2 type repetitive sequences appear in the 3'-untranslated region (nucleotides 3,090-3,198 and 3,270-3,391). Northern hybridization demonstrated the presence of its mRNA in poly(A)+ fractions of spinal cord, cerebrum, cerebellum, and submaxillary gland as well as skeletal muscle. The sizes of peptidylarginine deiminase mRNAs in these tissues were estimated to be 4.5-5.0 kilobases. No positive bands were detected on the blots of the corresponding RNA fractions of liver and kidney. Possible similarity of the amino acid sequence of peptidylarginine deiminase to those of other calcium binding proteins is discussed. PMID- 2768264 TI - The chloride-activated peroxidation of catechol as a mechanistic probe of chloroperoxidase reactions. Competitive activation as evidence for a catalytic chloride binding site on compound I. AB - Chloride ion (Cl-) effects on chloroperoxidase (CPO)-catalyzed peroxidation of catechol were used to probe the involvement of Cl- in CPO reactions. High concentrations of Cl- inhibit catechol peroxidation by competing with hydrogen peroxide (KI = 370 mM). However, at lower concentrations, Cl- is a linear competitive activator versus catechol (KDC = 35 mM). Addition of good halogenation substrates to the peroxidatic reaction mixture converts Cl- from a competitive activator to a competitive inhibitor. The KI (10 mM) for this halogenation substrate promoted Cl- inhibition is equivalent to the KM (11 mM) for Cl- in CPO-catalyzed halogenation reactions. During this inhibition, the halogenation substrate is consumed and, at the point where its consumption is complete, Cl- again becomes an activator. Also, at 2.0 mM hydrogen peroxide, CPOs chlorination reaction and its Cl- -activated peroxidatic reaction have similar apparent kcat values. All data are consistent with a mechanism in which Cl- competes with catechol for binding to CPO Compound I. Catechol binding initiates the Cl- -independent path, in which Compound I acts as the oxidizing agent for catechol. When Cl- binds to Compound I, it reacts to yield the enzymatic chlorinating intermediate which is responsible for either the oxidation of catechol in the Cl- -dependent path or the chlorination of substrates in the halogenation pathway. Cl- activation of the peroxidatic reaction is due to a shift from the Cl- -independent pathway to the Cl- -dependent process. The mechanism is unique in that exclusion of the substrate from its primary binding site leads to an increase in the catalytic efficiency of the reaction. This catechol-Cl- system also offers further potential for probing the specificity and chemistry of the key enzymatic intermediates in haloperoxidase-catalyzed reactions. PMID- 2768265 TI - Biosynthesis of monoterpenes. Stereochemical implications of acyclic and monocyclic olefin formation by (+)- and (-)-pinene cyclases from sage. AB - (+)-Pinene cyclase from sage (Salvia officinalis) catalyzes the isomerization and cyclization of geranyl pyrophosphate to (+)-alpha-pinene and (+)-camphene, and to lesser amounts of (+)-limonene, myrcene, and terpinolene, whereas (-)-pinene cyclase from this tissue catalyzes the conversion of the acyclic precursor to (-) alpha-pinene, (-)-beta-pinene, and (-)-camphene, and to lesser quantities of (-) limonene, myrcene, and terpinolene. The bicyclic products of these enzymes (pinene and camphene) are derived via the cyclization of the cisoid, anti-endo conformers of the bound, tertiary allylic intermediates (3R)-linalyl pyrophosphate [+)-pinene cyclase) and (3S)-linalyl pyrophosphate [-)-pinene cyclase). When challenged with either enantiomer of linalyl pyrophosphate or with neryl pyrophosphate (cis-isomer of geranyl pyrophosphate) as substrate, both pinene cyclases synthesize disproportionately high levels of acyclic olefins (myrcene and ocimene) and monocyclic olefins (limonene and terpinolene), compared with the product mixtures generated from the natural geranyl precursor. Resolution of the limonene derived from linalyl pyrophosphate and neryl pyrophosphate demonstrated that this monocyclic olefin was formed via conformational foldings in addition to the cisoid,anti-endo-pattern. These results indicate that the alternate substrates are ionized by the cyclases prior to their achieving the optimum orientation for bicyclization. In the case of geranyl pyrophosphate, a preassociation mechanism is suggested in which optimum folding of the terpenyl chain precedes the initial ionization step. PMID- 2768263 TI - Internucleosomal DNA cleavage precedes diphtheria toxin-induced cytolysis. Evidence that cell lysis is not a simple consequence of translation inhibition. AB - Diphtheria toxin (DTx) is an extremely potent inhibitor of protein synthesis. Cell death has been generally accepted as a straightforward effect of translation inhibition. Using human U937 cells, we found that DTx intoxication leads to cytolysis; indeed, release of 51Cr- and 75Se-labeled proteins could be detected within 7 h. However, little or no cell lysis was observed over a 20-50-h period when human U937 cells were exposed to cycloheximide, amino acid-deficient medium, or metabolic poisons even though protein synthesis was rapidly inhibited to levels observed with DTx. Likewise, investigations with human K562 cells revealed full resistance to the cytolytic action of DTx over a 50-h period despite a severe reduction in translation activity. These observations establish that inhibition of protein synthesis per se is not sufficient to provoke cell lysis. A characterization of DTx-induced cytolysis revealed a long lag period (6-7 h) which could be shortened considerably by a short exposure to low pH. NH4Cl and metabolic poisons blocked the cytolytic action of DTx, indicating that endocytic uptake of toxin is required for lytic activity. Surprisingly, DTx also induced extensive internucleosomal degradation of cellular DNA, a characteristic feature of apoptosis or programmed cell death. DNA-fragmentation preceded cell lysis and did not occur in DTx-treated K562 cells or in U937 cells that were treated with the other protein synthesis inhibitors. From these observations, we conclude that DTx-mediated cytolysis is not a simple consequence of translation inhibition and that internucleosomal DNA fragmentation is a newly identified and relatively early step in the cytolytic pathway of DTx. PMID- 2768266 TI - Defective lysosomal egress of free sialic acid (N-acetylneuraminic acid) in fibroblasts of patients with infantile free sialic acid storage disease. AB - Egress of free NeuAc from normal lysosome-rich granular fractions was assessed at NeuAc concentrations of up to 221 pmol/hexosaminidase unit, achieved by exposure of growing fibroblasts to 40-125 nM N-acetylmannosamine for up to 7 days. The normal velocity of NeuAc egress increased with NeuAc loading and with temperature, exhibiting a Q10 of 2.4, characteristic of carrier-mediated transport. Fibroblasts cultured from five patients with infantile free sialic acid storage disease (ISSD) contained approximately 139 nmol of free NeuAc/mg of whole cell protein, or 100 times the normal level. Differential centrifugation, as well as density gradient analysis using 25% Percoll, showed that the stored NeuAc cosedimented with the lysosomal enzyme beta-hexosaminidase. The velocity of appearance of free NeuAc outside ISSD granular fractions was negligible, even at initial loading levels of up to 3500 pmol/hexosaminidase unit. The lack of egress from ISSD granular fractions was found for both endogenous and N acetylmannosamine-derived NeuAc. Fibroblasts from ISSD parents did not accumulate excess free NeuAc and did not display a velocity of NeuAc egress significantly different from normal. The defect in ISSD, like that in Salla disease, appears to be an impairment of carrier-mediated transport of free NeuAc across the lysosomal membrane. Clinical and biochemical differences between Salla disease and ISSD may reflect differences in the amount of residual NeuAc transport capacity. PMID- 2768267 TI - Response of rat liver glutaminase to pH. Mediation by phosphate and ammonium ions. AB - The activity of rat liver glutaminase from sedimented fractions of freeze-thawed mitochondria is strongly affected by variation in pH over a physiologically relevant range at approximate physiological concentrations of activators. As pH increases from 7.1 to 7.7 at 0.7 mM ammonium and 10 mM phosphate, the S0.5 for glutamine decreases 3.5-fold, from 38 to 11 mM. This results in an 8-fold increase in reaction velocity at 10 mM glutamine. In addition, the M0.5 for phosphate activation decreases from 21 to 8.9 mM as pH increases from 7.1 to 7.7. This apparent effect of pH on the affinity of glutaminase for phosphate is similar to previous reports of the pH effect on activation by ammonium (Verhoeven, A. J., Van Iwaarden, J. F., Joseph, S. K., and Meijer, A. J. (1983) Eur. J. Biochem. 133, 241-244; McGivan, J. D., and Bradford, N. M. (1983) Biochim. Biophys. Acta 159, 296-302). Glutaminase does not respond to variation in pH between 7.1 and 7.7 when phosphate and ammonium are saturating. The effects of the two modifiers are additive. Each is still effective, as is pH, when the other is saturating. Therefore, it appears that the effects of pH on the apparent affinity of the enzyme for ammonium and phosphate account for the enzyme's response to pH. These results may help explain previous reports of minimal effects of pH on glutaminase at saturating concentrations of related substances (McGivan, J. D., Lacey, J. H., and Joseph, K. (1980) Biochim. J. 192, 537-542; Horowitz, M. L., and Knox, W. E. (1968) Enzymol. Biol. Clin. 9, 241-255; McGivan, J. D., and Bradford, N. M. (1983) Biochim. Biophys. Acta 759, 296-302). Glutaminase binds glutamine cooperatively with Hill coefficients ranging from 1.7 to 2.2, which suggests at least two and probably three or more interacting binding sites for glutamine. The strong response of liver glutaminase to pH and the fact that the reaction can supply metabolites for urea synthesis suggest a possible regulatory role of glutaminase in ureagenesis. PMID- 2768268 TI - Phosphorylation of ferredoxin and regulation of renal mitochondrial 25 hydroxyvitamin D-1 alpha-hydroxylase activity in vitro. AB - The kidney is the principal physiologic site of production of biologically active 1,25-dihydroxyvitamin D. The 25-hydroxyvitamin D-1 alpha-hydroxylase (1-OHase) activity found in renal mitochondria is under tight hormonal control. Parathyroid hormone stimulates the renal conversion of 25-hydroxyvitamin D to 1,25 dihydroxyvitamin D in young animals, which is accompanied by dephosphorylation of ferredoxin (Fx), a component of the mitochondrial 1-OHase enzyme complex (Siegel, N., Wongsurawat, N., and Armbrecht, H. J. (1986) J. Biol. Chem. 261, 16998 17003). The present study investigates the capacity of Fx to be phosphorylated in vitro and to modulate the 1-OHase activity of a reconstituted system. Fx was phosphorylated by renal mitochondrial type II protein kinase. Phosphorylation did not alter Fx mobility on sodium dodecyl sulfate gels but did decrease the pI as measured by isoelectric focusing. Amino acid analysis demonstrated that 1 mol of serine and 1 mol of threonine were phosphorylated per mol of Fx. Peptide mapping of phosphorylated Fx was consistent with phosphorylation of serine 88 and threonine 85 or 97. Fx was selectively dephosphorylated by rabbit skeletal muscle protein phosphatase C2 but not C1. Phosphorylation of Fx significantly inhibited the 1-OHase activity of a reconstituted system consisting of Fx reductase, Fx, and renal mitochondrial cytochrome P-450. These findings suggest that phosphorylation/dephosphorylation of Fx may play a role in modulating renal 1,25 dihydroxyvitamin D production. PMID- 2768269 TI - Ascorbic acid within chromaffin granules. In situ kinetics of norepinephrine biosynthesis. AB - Ascorbic acid requirements for norepinephrine biosynthesis were investigated in intact bovine chromaffin granules using the physiologic substrate dopamine and a novel coulometric electrochemical detection high pressure liquid chromatography system for ascorbic acid. 10 mM external dopamine, 1 mM Mg-ATP, and 1 mM ascorbic acid produced maximal norepinephrine biosynthesis without granule lysis. When external ascorbic acid was omitted, intragranular ascorbic acid was consumed in a 1:1 ratio with respect to norepinephrine biosynthesis. The initial concentration of intragranular ascorbic acid was 10.5 mM, which was depleted in stepwise fashion to 15 lower concentrations over the range of 9.2-0.2 mM. Chromaffin granules containing these varying concentrations of intragranular ascorbic acid were then incubated with 1 mM exogenous ascorbic acid, and norepinephrine biosynthesis from dopamine was determined. The apparent Km of norepinephrine biosynthesis for intragranular ascorbic acid was 0.57 mM by Eadie-Hofstee analysis and 0.68 mM by Lineweaver-Burk analysis. These data indicate that intragranular ascorbic acid is available and required for norepinephrine biosynthesis, that ascorbic acid is a true co-substrate for dopamine beta monooxygenase, and that intragranular ascorbic acid is maintained by extragranular ascorbic acid. Continued norepinephrine biosynthesis in granules is dependent on both intragranular and extragranular concentrations of the vitamin. Furthermore, in situ kinetics of dopamine beta-monooxygenase for ascorbic acid may be most accurately determined using intact granules and the true physiologic substrate. PMID- 2768270 TI - Kinetic properties of hexokinase under near-physiological conditions. Relation to metabolic arrest in Artemia embryos during anoxia. AB - Previous analyses of glycolytic metabolites in Artemia embryos indicate that an acute inhibition of glucose phosphorylation occurs during pHi-mediated metabolic arrest under anoxia. We describe here kinetic features of hexokinase purified from brine shrimp embryos in an attempt to explain the molecular basis for this inhibition. At saturating concentrations of cosubstrate, ADP is an uncompetitive inhibitor toward glucose and a partial noncompetitive inhibitor toward ATP (Kis = 0.86 mM, Kii = 1.0 mM, Kid = 1.9 mM). With cosubstrates at subsaturating concentrations, the uncompetitive inhibition versus glucose becomes noncompetitive, while inhibition versus ATP remains partial noncompetitive. The partial noncompetitive inhibition of ADP versus ATP is characterized by a hyperbolic intercept replot. These product inhibition patterns are consistent with a random mechanism of enzyme action that follows the preferred order of glucose binding first and glucose-6-P dissociating last. We propose that inhibition by glucose-6-P (Kis = 65 microM) occurs primarily by competing with ATP at the active site, resulting in the formation of the dead-end complex, enzyme-glucose-glucose-6-P. Versus glucose, inhibition by glucose-6-P is uncompetitive at pH 8.0 and noncompetitive at pH 6.8. Over a physiologically relevant pH range of 8.0 to 6.8 alterations in Km and Ki values do not account for the reduction in glucose phosphorylation, and no evidence suggests that Artemia hexokinase activity is modulated by reversible binding to intracellular structures. Total aluminum in the embryos is 4.01 +/- 0.36 micrograms/g dry weight, or, based upon tissue hydration, 72 microM. This concentration of aluminum dramatically reduces enzyme activity at pH values less than 7.2, even in the presence of physiological metal ion chelators (citrate, phosphate). When pH, aluminum, citrate, phosphate, substrates, and products were maintained at cellular levels measured under anoxia, we can account for a 90% inhibition of hexokinase relative to activity under control (aerobic) conditions. PMID- 2768271 TI - Temperature effect on endocytosis and exocytosis by rabbit alveolar macrophages. AB - Endocytosis of 125I-mannose-bovine serum albumin (BSA) and exocytosis of 125I mannose-poly-D-lysine by rabbit alveolar macrophages were examined as a function of temperature. A plot for total ligand uptake (cell-associated ligand plus degraded ligand) versus time shows a single inflection point at 20 degrees C. Ligand degradation does not occur below 20 degrees C. Internalization of surface bound 125I-mannose-BSA is negligible below 10 degrees C. The rate constant for internalization increases dramatically above 20 degrees C: 0.02 min-1 at 20 degrees C, 0.05 min-1 at 25 degrees C, 0.13 min-1 at 30 degrees C, and 0.29 min-1 at 35 degrees C. 125I-Mannose-N-acetyl-poly-D-lysine preloaded in lysosomes is exocytosed in a temperature and time-dependent fashion. Even at lower temperatures (2-10 degrees C), secretion of 125I-mannose-N-acetyl-poly-D-lysine was detected, indicating that movement of lysosomal content to plasma membrane and beyond cannot be suppressed at these temperatures. Thus, the temperature dependence of exocytosis of an 125I-labeled ligand is quite different from that of endocytosis, suggesting that the two processes are controlled by different mechanisms. Stimulation of secretion of preloaded 125I-mannose-N-acetyl-poly-D lysine by mannose-BSA was more pronounced at lower temperatures with a sharp inflection point at 10 degrees C. These findings suggest that endosomes containing newly internalized mannose-BSA interact with the exocytosis pathway and enhance secretion of 125I-mannose-N-acetyl-poly-D-lysine from lysosomes. PMID- 2768272 TI - The sidedness of the COOH terminus of the acetylcholine receptor delta subunit. AB - The nicotinic acetylcholine receptor from Torpedo sp. occurs as a dimer, disulfide-cross-linked between delta subunits. We determined the sidedness of the COOH terminus of the acetylcholine receptor delta subunit by locating the delta delta disulfide relative to the membrane and by identifying the Cys residue forming the disulfide. We used receptor-rich native membrane vesicles isolated from Torpedo californica electric tissue and characterized as to orientation and intactness. These vesicles had not been extracted and retained v ("43-kDa protein") as a marker of the cytoplasmic surface. Using the reduction of v as an assay of permeability, we showed that two reductants, 2-mercaptoethanesulfonate and reduced glutathione, were relatively impermeant. Both of these reductants reduced the delta-delta disulfide in sealed right-side-out vesicles equally in the presence and absence of saponin, and 2-mercaptoethanesulfonate reduced this disulfide equally in the presence and absence of Triton X-100. By contrast, surfactants enhanced the reduction of dimer in inside-out and sequestered vesicles. We conclude that the disulfide is extracellular. To identify the Cys residue forming the disulfide, we labeled the sulfhydryls both in receptor dimer and in monomer generated by mild reduction of dimer. By high performance liquid chromatography and NH2-terminal sequencing of cyanogen bromide fragments of labeled delta-delta dimer and delta monomer, we found that the penultimate residue, delta-Cys-500, uniquely formed an intersubunit disulfide and that this disulfide was uniquely reduced when receptor dimer was reduced to monomer. Therefore, the delta COOH terminus is extracellular. PMID- 2768273 TI - Molecular defects in Drosophila rhodopsin mutants. AB - Four well characterized Drosophila rhodopsin (ninaE) mutants possess low levels of rhodopsin in their major class of photoreceptors. The molecular defect present in each strain was determined by isolating and sequencing the mutant genes. Two missense mutants encode proteins which have arginine residues positioned within membrane-spanning domains. The third missense mutant eliminates a proline found near an extracellular domain/membrane-spanning domain interface. Thus, the low levels of rhodopsin protein found in these mutants result directly from changes in protein structure which likely affect the positioning and stability of membrane-spanning domains. The fourth and most severe mutation is a nonsense mutation. PMID- 2768274 TI - Transfer of monoclonal antibodies into mammalian cells by electroporation. AB - A simple rapid and reproducible procedure for transferring monoclonal antibodies into mammalian cells by electroporation is described. Two functionally different monoclonal antibodies (Mab 3F3 and Mab 2B4) specific for asparagine synthetase (EC 6.3.1.1) were used for electroporation into HeLa, HT-5, and L5178Y D10/R (L asparaginase-resistant) cells. The conditions were optimized so that the viability of the electroporated cells was very high (80-90%), and 90% of the viable cells had antibody incorporated. Electropermeabilized cells were structurally intact, and the high voltage electric pulse had no inhibitory effect on overall cellular DNA and protein synthesis. Incorporated immunoglobulins showed unaltered structural integrity and were functionally active. L5178Y D10/R cells incorporated with an antibody (Mab 3F3) known to be a potent inhibitor of tumor asparagine synthetase showed increased dependence on an exogenous source of asparagine in the culture medium, while the growth of cells incorporated with a control (noninhibitory) antibody (Mab 2B4) remained unaffected. These studies demonstrate that electroporation can be employed successfully for large scale transfer of antibodies into cultured mammalian cells for the study of cellular metabolism. PMID- 2768275 TI - Nuclear factor ETF specifically stimulates transcription from promoters without a TATA box. AB - Transcription factor ETF stimulates the expression of the epidermal growth factor receptor (EGFR) gene which does not have a TATA box in the promoter region. Here, we show that ETF recognizes various GC-rich sequences including stretches of deoxycytidine or deoxyguanosine residues and GC boxes with similar affinities. ETF also binds to TATA boxes but with a lower affinity. ETF stimulated in vitro transcription from several promoters without TATA boxes but had little or no effect on TATA box-containing promoters even though they had strong ETF-binding sites. These inactive ETF-binding sites became functional when placed upstream of the EGFR promoter whose own ETF-binding sites were removed. Furthermore, when a TATA box was introduced into the EGFR promoter, the responsiveness to ETF was abolished. These results indicate that ETF is a specific transcription factor for promoters which do not contain TATA elements. PMID- 2768276 TI - Inhibitors of translation induce low density lipoprotein receptor gene expression in human skin fibroblasts. AB - The effect of protein synthesis inhibitors on low density lipoprotein (LDL) receptor gene expression was examined in human skin fibroblasts. Incubations in cycloheximide led to a marked increase in LDL receptor mRNA abundance as detected by Northern or slot-blot hybridization analyses. Incubation in puromycin had a similar effect. After the addition of cycloheximide, induction of LDL receptor mRNA levels was rapid (peaking between 2 and 3 h) and transient (falling to control levels by 24 h). This incubation could not be accounted for by the modest stabilization of mature LDL receptor mRNA species produced by cycloheximide and was completely abolished by concurrent addition of actinomycin D. Nuclear run-off transcription assays demonstrated increased LDL receptor gene transcription after 20-min incubations in cycloheximide. Induction of LDL receptor mRNA by cycloheximide was partially resistant to sterol suppression and was at least additive with induction produced by growth activation of cells using platelet derived growth factors. These results indicate that inhibition of protein synthesis leads to rapid stimulation of LDL receptor gene transcription by a mechanism which is partially resistant to sterol suppression. We further conclude that early stimulation of LDL receptor gene expression associated with growth activation of quiescent cells is independent of new protein synthesis. PMID- 2768277 TI - Evidence for the association of the heme-regulated eIF-2 alpha kinase with the 90 kDa heat shock protein in rabbit reticulocyte lysate in situ. AB - Inhibition of protein synthesis initiation in rabbit reticulocyte lysates occurs in response to a variety of conditions including heme deficiency, addition of oxidants, and heat stress. The inhibition of translation occurs due to the activation of a heme-regulated protein kinase (HRI), which specifically phosphorylates the alpha-subunit of the eukaryotic initiation factor eIF-2. How the activation of HRI in hemin-supplemented lysate occurs in response to oxidants and heat stress is not well understood. Recently, the 90-kDa heat shock protein (hsp 90) has been reported to co-purify with HRI activity. In this report, we have used monoclonal antibodies directed against hsp 90 to determine whether HRI and hsp 90 are functionally associated in the reticulocyte lysate in situ. The AC88 antibody recognizes only free hsp 90 and only bound significant amounts of hsp 90 upon prolonged incubation in the absence of heme or upon N-ethylmaleimide treatment of hemin-supplemented lysates. HRI activity is not absorbed by the AC88 antibody. The 8D3 monoclonal antibody, which binds to both free hsp 90 and hsp 90 complexed to steroid hormone receptors, absorbed the hsp 90 present in hemin supplemented lysates and reduced the HRI activity by 70-95%. Progressively more HRI activity is not adsorbed by the 8D3 antibody the longer the reticulocyte lysate is incubated in the absence of hemin. The HRI that is adsorbed from heme deficient lysates by the 8D3 antibody is also more active. The sedimentation rate of HRI was analyzed by glycerol gradient centrifugation. HRI present in hemin supplemented lysate was found to have a sedimentation coefficient of approximately 7.5-8 S and was adsorbed from fractions by the 8D3 antibody in association with hsp 90. A second peak of HRI activity with a sedimentation coefficient of approximately 4.5-5 S was detected upon glycerol gradient centrifugation of heme-deficient lysates. Upon Western blot analysis, heme deficient lysates were found to have less hsp 90 in the 7.5-8 S region of glycerol gradients than hemin-supplemented lysates. The data suggest that HRI is associated with hsp 90 in an inactive form in hemin-supplemented lysates and dissociates from hsp 90 upon activation. There also appears to be an intermediate of active HRI which is associated with hsp 90 or which can reversibly associate with hsp 90. Similarities between the stages of HRI activation and steroid hormone receptor activation and transformation are discussed. PMID- 2768278 TI - An enzymatically active cross-linked complex of calmodulin and rabbit skeletal muscle myosin light chain kinase. AB - The interaction between bovine testes calmodulin and rabbit fast skeletal muscle myosin light chain kinase was investigated with the zero-length cross-linking reagent N,N'-dicyclohexylcarbodiimide. A cross-linked product of 110 kDa was produced only in the presence of Ca2+. The reaction mixture was separated on diethylaminoethyl cellulose, and a fraction containing the cross-linked complex of calmodulin and myosin light chain kinase was found to have an elevated kinase activity in the absence of Ca2+, which constituted approximately 50% of the maximally stimulated kinase activity of control, and additional kinase activity in the presence of Ca2+, which constituted the remaining 50% of control activity. Calmodulin added exogenously to the cross-linked complex had no effect on the measured Ca2+ dependence or the maximal extent of kinase activity, which is consistent with the cross-linking of calmodulin in close proximity to a regulatory region of myosin light chain kinase. Moreover, the results are consistent with a mechanism whereby the association of calmodulin is sufficient to stimulate kinase activity and the binding of Ca2+ to bound calmodulin increases catalytic efficiency. PMID- 2768279 TI - Multiple tachykinins are produced and secreted upon post-translational processing of the three substance P precursor proteins, alpha-, beta-, and gamma preprotachykinin. Expression of the preprotachykinins in AtT-20 cells infected with vaccinia virus recombinants. AB - The rat preprotachykinin I gene mRNA is alternatively spliced to yield three different mRNA species differing in their protein coding regions. We have produced recombinant vaccinia viruses expressing alpha-, beta-, and gamma preprotachykinin to examine the tachykinin-related peptides produced upon post translational processing of each individual precursor. Infection of BSC-40 or AtT 20 cell lines with a beta-preprotachykinin-encoding vaccinia virus recombinant results in the expression of the precursor protein. The pro-form (signal peptide removed) can be immunoprecipitated from extracts of infected cells. Infected cells of both types secrete into the culture medium a product(s) which reacts in radioimmunoassay with an antiserum shown to recognize precursor as well as mature substance P. Infected AtT-20, but not BSC-40, cells secrete into the culture medium a processed form(s) of beta-preprotachykinin which reacts in radioimmunoassay with an anti-serum which recognizes the amidated carboxyl terminus of substance P. The molecular nature of the tachykinin products produced in and secreted from AtT-20 cells infected with alpha-, beta-, and gamma preprotachykinin-encoding recombinants was analyzed by combined high performance liquid chromatography and radioimmunoassay. Peptides were identified based on comigration with synthetic standards and antisera cross-reactivity. We determined that alpha-preprotachykinin is processed to the mature undecapeptide, substance P. beta-Preprotachykinin was processed into multiple products, including substance P, neurokinin A, neurokinin A(3-10), and neuropeptide K. gamma Preprotachykinin was processed into substance P, neurokinin A, neurokinin A(3 10), and neuropeptide gamma. These five tachykinin peptide products were all routed through the regulated secretory pathway and were secreted into the medium in a cAMP-stimulatable fashion. Since all of these peptides have been shown to be biologically active, it is important to consider the biological consequences of their co-secretion in vivo. PMID- 2768280 TI - A putative processing enzyme for proenkephalin in bovine adrenal chromaffin granule membranes. Purification and properties. AB - A putative processing enzyme for proenkephalin, with activity directed toward basic residues, was purified over 2000-fold from washed bovine adrenal medullary chromaffin granule membranes. The molecular mass of this membrane-bound adrenal trypsin-like enzyme (mATLE) is 31 kDa as determined by sodium dodecyl sulfate polyacrylamide gel electrophoresis, and the enzyme is extremely basic, binding to carboxymethyl-Sephadex at pH 8.5. The pH optimum of mATLE using t-butoxycarbonyl Glu-Lys-Lys-aminomethylcoumarin as a substrate is 8.5-8.7, and its Km value for this substrate is 2.2 mM. mATLE activity was inhibited by soybean trypsin inhibitor, lima bean trypsin inhibitor, and aprotinin but not by metal chelators or thiol-directed reagents. Sequencing of cleavage products released from Peptide B revealed that the enzyme preferentially cleaves between and following the paired basic residues at positions 23 and 24 of Peptide B (thus generating [Met enkephalin]-Arg-Phe and Arg-[Met-enkephalin]-Arg-Phe). Dynorphin A was cleaved following a single lysine at position 11 but not at the paired arginine site. Our results suggest that mATLE is a trypsin-like serine protease with the specificity appropriate to that of a proenkephalin processing enzyme. PMID- 2768281 TI - The monocytic differentiation of HL60 induced by rat kidney NADPH-linked high-Km aldehyde reductase protein. AB - The human promyelocytic leukemia cell line HL60 differentiates to monocyte/macrophage cells when incubated with NADPH-linked high-Km aldehyde reductase (EC 1.1.1.2) purified from the cytosol of rat kidney. Differentiation was assessed by cell growth, morphology, adhesiveness, nitro blue tetrazolium reduction, and nonspecific esterase activity. The extent of differentiation induced by the reductase and measured at 4 days by nitro blue tetrazolium reduction is dose-dependent with an ED50 (dose required for half-maximal effect) of 71 nM. In the presence of 10 nM retinoic acid the ED50 for reductase is reduced to 18 nM and an isobologram analysis of this effect indicates that the combination is synergistic. Inactivation of the enzymatic activity is not associated with a decrease in differentiation-induced activity. These results suggest that the structure of the enzyme protein and not its enzymatic activity is involved with induction of differentiation. This view is supported by the demonstration that aldehyde reductase binds specifically to HL60 cells with a KD of 70 nM and that there are 13,000 binding sites/cell. Thus, the extent of differentiation induced by various concentrations of aldehyde reductase are directly related to the expected level of receptor occupancy. PMID- 2768282 TI - The structure of the guanine-rich polypurine:polypyrimidine sequence at the right end of the rat L1 (LINE) element. AB - We report here that the 64-base pair (bp) guanine-rich polypurine:polypyrimidine tract derived from the right end of the rat long interspersed DNA element is reactive in a supercoil-dependent manner with a variety of chemical probes of non B DNA structure. At pH 5.0 in the presence of Mg2+, part of the sequence (position 10-40) forms the following two types of triplexes: a G.G.C triplex, and an unusual C.G.C triplex. The latter structure is much more prevalent than the former and is unusual in that the resultant free purine strand forms a hairpin loop. In the absence of Mg2+ the G.G.C triplex disappears and the amount of C.G.C triplex is diminished, and at pH 7.5 in the presence or absence of Mg2+, little or no triplex is observed. Deletion of the 24-bp region just 3' of the triplex forming region greatly reduces the amount of triplex formed. In this region, which includes an 18-bp polypurine:polypyrimidine sequence, both strands exhibit a moderate symmetric reactivity with the chemical probes tested, independent of pH and Mg2+. The implications of this structurally complex region for the properties of the rat L1 element are discussed. PMID- 2768283 TI - Translocation of diphtheria toxin A-fragment to the cytosol. Role of the site of interfragment cleavage. AB - Diphtheria toxin contains a trypsin-sensitive region with 3 closely spaced arginines in the sequence (Asn189, Arg190, Val191, Arg192, Arg193, Ser194). Cleavage of the toxin to yield A- and B-fragments ("nicking") appears to occur in a stochastic manner after either of these arginine residues. Isoelectric focusing of A-fragment prepared in vitro showed four bands of varying intensity with pI between 4.5 and 5.0, three of which could be accounted for by the three different cleavage sites. Exposure of cells with surface-bound toxin to pH less than 5.3 induces translocation of A-fragment to a position where it is shielded from external Pronase, presumably in the cytosol. A-fragment translocated in this manner had the same pI as the most acidic A-fragments, indicating that only A fragments lacking both Arg192 and Arg193 are translocation-competent. This was confirmed by amino acid sequencing. Treatment of A-fragment with carboxypeptidase B eliminated the two bands with the highest pI while there was a concomitant increase in the bands corresponding to the two most acidic A-fragments. Such treatment of nicked diphtheria toxin increased the amount of translocated A fragment and the ability of toxin to form cation-selective pores in the cell membrane. The site of trypsin cleavage therefore appears to be one of the factors limiting toxin entry to the cytosol. PMID- 2768284 TI - Characterization of proteoglycans synthesized by a rat parathyroid cell line. AB - The structure, biosynthesis, and distribution of cell-associated proteoglycans in a clonal line of parathyroid cells, which exhibit differentiated characteristics such as calcium-regulated hormone secretion and cell growth, were studied by metabolic labeling with [3H] glucosamine and [35S]sulfate as precursors. Proteoglycans were isolated by two consecutive ion exchange chromatography steps and then analyzed by gel filtration, polyacrylamide gel electrophoresis, and specific enzyme and chemical reactions. The cells synthesize almost exclusively (greater than 95%) heparan sulfate (HS) proteoglycans with a glycosaminoglycan synthesis rate of approximately 0.5 micrograms/10(6) cells/24 h. Two major HS proteoglycan species were identified. HS proteoglycan-I has a mass of approximately kDa with a single HS chain (approximately 12 kDa) and a core protein of approximately 150 kDa including oligosaccharides. HS proteoglycan-II has a mass of approximately 170 kDa with 3-4 HS chains (approximately 30 kDa) and a core protein of 70-80 kDa including oligosaccharides. In the medium with low ionized calcium (0.05 mM), HS proteoglycan-I is synthesized at approximately 1.6 times the rate and HS proteoglycan-II at a similar rate as for cells cultured in the medium with high ionized calcium (2.1 mM). The distribution of proteoglycans, examined by the accessibility of the molecules to trypsin, was dramatically influenced by environmental calcium concentration; at low calcium levels 70-80% of the HS proteoglycans are trypsin-accessible while only 20-30% are accessible at high calcium levels. This suggests that the proteoglycans are primarily on the cell surface in low calcium and in trypsin-inaccessible compartments in high calcium conditions. PMID- 2768285 TI - Functional studies on the cholinergic and sympathetic innervation of the rat proximal urethra: effect of pelvic ganglionectomy or experimental diabetes. AB - 1. Isolated rings of rat proximal urethra contracted in response to acetylcholine, noradrenaline, phenylephrine, tachykinins or field stimulation. In the presence of field stimulation-induced contractions, isoprenaline or CGRP produced an inhibitory effect on evoked contractions. 2. Electrical field stimulation produced frequency-related contractions which, when using trains of stimuli, consisted of a phasic and a tonic response. These contractions were abolished by tetrodotoxin (1 microM) but unaffected by hexamethonium (10 microM). 3. Atropine (3 microM) produced a partial inhibition of these nerve-mediated contractions, slightly more evident on the tonic than the phasic response. In the presence of atropine (3 microM), phentolamine (3 microM) or prazosin (1-10 nM) produced an almost complete inhibition of the response to field stimulation. 4. After bilateral removal of the pelvic ganglia, electrical field stimulation was still able to induce tetrodotoxin-sensitive contractions of the rat proximal urethra. However, the inhibitory effect of atropine was much reduced as compared to controls, while the phentolamine-sensitive portion of the response was increased. 5. DMPP (0.1 mM) a nicotinic receptor agonist, produced a contraction (phasic and tonic components) which was strongly inhibited by hexamethonium (10 microM), abolished by prazosin (1 microM) and reduced by tetrodotoxin (3 microM). 6. In urethral rings from diabetic rats (i.v. streptozotocin 7-9 weeks before) the contractile response to acetylcholine or noradrenaline as well as the response to field stimulation were unchanged as compared to controls. 7. Capsaicin (1 microM) produced an inhibitory effect on the nerve-mediated contractions of the rat proximal urethra. This response was abolished by pelvic ganglionectomy but was unaffected in streptozotocin-treated rats. 8. These findings provide functional evidence that both cholinergic and noradrenergic nerves mediate the contractions of the rat proximal urethra. In addition, capsaicin-sensitive sensory nerves can produce certain local motor responses through release of endogenous neuropeptides. In vivo studies are needed to examine the interplay between these differents sets of motor nerves in the regulation of proximal urethra motility. PMID- 2768286 TI - Family planning programmes in ten developing countries: cost effectiveness by mode of service delivery. AB - The cost effectiveness of various modes of family planning service delivery based on the cost per couple-year of protection (CYP) is assessed using 1984 data for 63 projects in ten countries (three each in Africa and Asia, and four in Latin America). More than 4.8 million CYPs were provided through these projects during the year studied. Programmes with the highest volume of services delivered corresponded to lowest average costs: social marketing (2.8 million CYPs) and sterilization projects (960,000 CYPs) cost about $2 per CYP, on average; highest costs were for full service clinics and community-based distribution projects ($13-14 per CYP). Costs of clinics combined with community-based distribution services fell approximately midway between these two extremes. PMID- 2768287 TI - Men's attitudes about family planning in Dakar, Senegal. AB - A survey of men's behaviour and opinions with respect to family planning, undertaken in Dakar in 1986, shows that contrary to popular belief, acceptance of contraception at least for the purpose of spacing births is substantial, even among men from the most conservative backgrounds. Actual use of contraceptives varied considerably across occupations. Among functionaries and students, it ranges between 25 and 49%. Among the working class, prevalence is low, especially within marriage. Uncertainty about the position of Islam regarding fertility control is apparent even among the highly educated and is given as a reason for rejecting use of contraceptives. PMID- 2768288 TI - Timing of first birth and second birth spacing in Canada. AB - In Canadian society the influence of first birth timing on the subsequent birth interval has been eroded over time, as shown by the Canadian Fertility Survey of 1984. The influence of first birth timing is significant for second births among women married during the baby boom period, but not for those married thereafter. Religiosity, marital status, and place of residence are significant factors in second birth timing in Canada. PMID- 2768289 TI - Determinants of birth intervals in Sudan. AB - Using individual birth history data from the Sudan Fertility Survey, 1979, parity related differences in fertility are demonstrated, as well as differences between socioeconomic groups. Rural women, women with no education and those married to uneducated husbands show rapid parity progression and its cumulative effects on fertility which are consistent over all birth intervals. Urban women, women with some education and those married to educated husbands, however, go rapidly through their second and third birth intervals and then more slowly at higher parities. A limitation of the study was the inability to control fully for the effects of breast-feeding and contraception. There is evidence for a reduction in high parity births, starting in the 1970s. PMID- 2768290 TI - The seasonality of births in Canada. AB - Earlier studies on the seasonality of births indicate that a major peak occurs in August and September and a minor peak in January and February. This study uses the 1984 Canadian Fertility Survey data on reproductive history to examine birth and pregnancy seasonalities, and shows that the 'worst' months for births are January and February and the 'best' months are March, April and May. There is no systematic pattern in the seasonality of pregnancies, possibly because effective birth control allows couples to plan the timing of births. PMID- 2768291 TI - Menstrual characteristics of mothers of twins. AB - The menarcheal age and frequency of menstrual disorders in mothers of dizygotic (DZ) and monozygotic (MZ) twins born in Denmark in 1984 or 1985 were compared with a control sample of mothers of singleton infants born in the same period. Compared to control mothers, mothers of DZ twins had a lower menarcheal age and a lower frequency of menstrual irregularities--menstrual cycles exceeding 5 weeks duration, varying length of menstrual cycles and episodes of menostasia. Mothers of MZ twins had a higher frequency of intermenstrual bleeding compared to mothers of singletons. All results were adjusted for maternal age and parity. The findings are relevant to the interpretation of aetiological factors leading to twin births and support the hypothesis of differences in sex hormone activity of the mothers of DZ twins in comparison with other women. PMID- 2768293 TI - Malnutrition and child mortality: are socioeconomic factors important? AB - The influences of household economic condition, maternal education, sex, and nutritional status of children on mortality were examined using multivariate analytical techniques. Weights of around 1700 children aged 2 60 months in five villages of Matlab, Bangladesh, were taken during the first half of 1981. The children were followed for 18 months and their survival was recorded. The severely malnourished children had a risk of death nine times that of their counterparts with better nutritional status. Female children had a higher risk of death than the males. Mother's education and economic condition of household also showed negative relationships with the risk of death, but the effect of mother's education was modified by economic condition and sex of the children. PMID- 2768292 TI - Child mortality differentials in Ghana: a preliminary report. AB - The relationship is examined of child mortality in Ghana with six socioeconomic factors: mother's type of place of residence, education, occupation and work status, and current husband's education and occupation. Using data from the 1979 80 Ghana Fertility Survey, Trussell's marriage duration model was employed to estimate probabilities of dying at exact ages 2 and 5 in different population subgroups. The two education variables (mother's and husband's education) have the largest effect on child mortality, followed by husband's occupation and mother's occupation, in that order. In order to reduce child mortality to tolerable levels, expansion is urgently required of the medical and health services, balanced by an equal development of education, particularly of girls, help being given especially to the rural areas where the majority of the population live. PMID- 2768294 TI - Determinants of breast-feeding and post-partum amenorrhoea in Orissa. AB - A life table analysis is made of the duration of breast-feeding and post-partum amenorrhoea in Orissa, India, taking one variable at a time using data from a baseline survey of fertility and mortality (BSFM) conducted on the lines of the World Fertility Survey. Then a multivariate (proportional hazard) analysis showed that socioeconomic factors including residence, caste status and education influence the breast-feeding and post-partum amenorrhoea periods. There was no effect of maternal age on the length of breast-feeding, but mean length of post partum amenorrhoea varied with age. The durations of breast-feeding and post partum amenorrhoea are strongly related. PMID- 2768295 TI - The choice of an experimental model. A guide for research workers. PMID- 2768296 TI - Upper tibial osteotomy for secondary osteoarthritis of the knee. AB - Of 34 consecutive proximal tibial osteotomies for secondary degenerative arthritis in patients under 40 years of age, 33 were evaluated at least three years (mean 7.5 years) after operation. In all 73% were satisfactory, with four failures in 21 procedures in men and five failures in 12 procedures in women. The primary abnormalities were medial meniscectomy (11), medial and lateral meniscectomy (4), osteochondritis dissecans (3), osteochondritis dissecans with medial meniscectomy (4) and fracture (11). All four knees with both medial and lateral meniscectomy had unsatisfactory results despite obtaining anatomical alignment. Eight patients needed subsequent surgery; five of them had total knee replacement, four within four years of the osteotomy. Proximal tibial osteotomy in younger patients with secondary arthritis gives similar results to those for older patients with primary osteoarthritis. If it fails, this is generally within the first four years after the operation. PMID- 2768297 TI - Surgical implications of varus deformity of the knee with obliquity of joint surfaces. AB - Some arthritic knees with varus deformity show excessive valgus angulation of the femoral joint surface with proximal tibia vara. This causes a downward and medial inclination of the articular surfaces in the coronal plane. The patients we studied had a medial shift of the standing load-bearing axis, and arthritic changes mainly in the medial compartment. Some also had lateral tibial subluxation with twisting of the distal femur and proximal tibia in opposite directions. We assessed the articular geometry by precise radiographic analysis, and compared the results with those in normal volunteers and a group of osteoarthritic patients. The prevalence of this type of deformity in our osteoarthritic patients was 11.5%; its recognition allows the use of specific operative correction that may include double osteotomy or the precise orientation of prosthetic components. PMID- 2768298 TI - Arthroscopy after anterior cruciate reconstruction with the Leeds-Keio ligament. AB - The healing of anterior cruciate ligaments reconstructed with the Leeds-Keio artificial ligament was observed by arthroscopy in 42 knees and biopsy in 19 knees at intervals from 3 to 24 months after implantation. By three months the implant was covered with immature new tissue, and a dense vascular network crossed its surface. At 12 months a new ligament had developed and matured, looking like the natural one in most cases. Histology at this stage showed abundant collagenous fibres running parallel and longitudinally, while the synovial membrane showed no more than very slight inflammatory changes. By 18 to 24 months, the new ligament often had the arthroscopic appearance of a normal anterior cruciate ligament. These results suggest that this scaffold type of artificial ligament is effective for cruciate reconstruction, giving satisfactory healing without significant complications. PMID- 2768299 TI - Aggressive granulomatous lesions after hip arthroplasty. AB - We reviewed 19 patients who presented with aggressive granulomatosis around the femoral stem after hip replacement. All had experienced stress pain and had required revision arthroplasty on average 8.8 years after the primary operation. Fifteen patients were men and four were women; none had rheumatoid arthritis. One patient had an uncemented Moore hemiprosthesis; the others all had cemented total hip replacements. When first detected, the granulomatous lesions were multifocal in 13 patients. The first granuloma was in the region of the lesser trochanter in 10, and near the tip of the stem in only two. Speed of growth varied but on average there was doubling of the area on anteroposterior films in 2.2 years (range 6 months to 4.6 years). Aggressive granulomatous lesions in replaced hips are a distinct condition, different from simple loosening or infection; the lesions may grow rapidly, so revision surgery is indicated soon after diagnosis. PMID- 2768301 TI - Core decompression of the distal femur for avascular necrosis of the knee. AB - From 1974 to 1981, we performed 28 core decompressions of the distal femur for pathologically confirmed avascular necrosis. At a mean follow-up of 54 months (range 20 to 140 months) and using the Ficat stages, all seven cases in stage I and stage II had good results. Of 21 cases in stage III, 11 cases had good results, four had poor results, and six needed total knee replacement. There were no significant orthopaedic complications. The procedure is worthwhile and will be more accurate with new methods of imaging. PMID- 2768300 TI - The effect of immunosuppression on vascularised allografts. A preliminary report. AB - Five vascularised allografts of the knee joint were performed in dogs immunosuppressed with cyclosporin A and azathioprine. Three survived with normal function for 3 to 4 months after operation. One of the unsuccessful grafts had a failed vascular anastomosis, the other an inadequate blood level of cyclosporin A. All three successful grafts healed well. In two, bone scans, radiographs and biopsies were indistinguishable from successful autografts; in the third the blood supply to the graft failed despite patent anastomoses but the graft healed well with good function. All three grafts were rejected within 2 to 3 weeks of withdrawal of cyclosporin A and azathioprine. In non-immunosuppressed dogs, allografts of the knee, both vascularised and non-vascularised, were rejected within a few days of operation. In two non-vascularised allografts, administration of cyclosporin and azathioprine had no apparent effect on the rate of rejection of the graft. PMID- 2768302 TI - Curved Kuntscher nail arthrodesis after failure of knee replacement. AB - We report the use of long curved Kuntscher nails to maintain stability during arthrodesis of nine infected and five uninfected failures of total knee replacement. The curvature of the nail helps positioning and avoids the need for cortical perforation. A single-stage operation was possible in most cases. Union rates are comparable with those of other series and even patients with delayed union have satisfactory function. PMID- 2768303 TI - Pain after total knee arthroplasty caused by soft tissue impingement. AB - The usual causes of pain after total knee replacement are well known, but there are a small number of patients in whom its aetiology is obscure. We report three patients with a specific pain syndrome caused by hypertrophic fibrous tissue in the intercondylar notch. Excision of this tissue relieved the symptoms completely. PMID- 2768304 TI - Treatment of chronic osteomyelitis of the leg by peroneal myocutaneous island flap transfer. AB - We treated 11 patients with chronic osteomyelitis of the tibia or the foot by local excision and transfer of a peroneal myocutaneous island flap. This flap, pedicled proximally or distally on the peroneal artery and veins, provides viable muscle to fill the dead space in bone and skin to close the defect. Ten patients reviewed more than three years after operation were all free of drainage with no clinical or radiographic evidence of recurrence. PMID- 2768305 TI - Sagittal flaps in below-knee amputations in Chinese patients. AB - Forty-five Chinese patients had below-knee amputation by a sagittal flap technique; 84% for ischaemia. Satisfactory healing was obtained in over 90%, but complications and failure were more common in patients with diabetes mellitus. A modified sagittal flap is recommended. PMID- 2768306 TI - Prong plate fixation for displaced intracapsular fractures of the femoral neck. AB - The design and use of a prong plate for the treatment of displaced fractures of the femoral neck is described. The prongs hold the femoral head, and the plate is screwed to the anterior cortex of the femoral neck and trochanteric region. The new plate has been used in 32 patients with Garden stage III or IV fractures and 29 had a good result. Bony union was seen within 11 weeks in all patients in whom bleeding of the femoral head was noted at operation, but was much delayed in patients without bleeding. Late segmental aseptic necrosis was seen in four patients after follow-up of at least two years, and successfully treated. The prong plate allows accurate reduction, impaction and strong rigid fixation with less disturbance of the intramedullary blood flow than other fixation methods. PMID- 2768307 TI - Tibial shaft fractures treated with functional braces. Experience with 780 fractures. AB - We have reviewed our recent results with functional bracing of tibial shaft fractures in adults in order to define its role in management. We also analysed several parameters of these fractures to discover those which influence healing. A total of 780 tibial fractures treated in prefabricated functional braces were followed to union; shortening of less than 10 mm and angulation of less than 5 degrees in any plane were our parameters for successful treatment. The average time before applying a brace was 3.8 weeks for closed fractures and 5.2 weeks for open ones. Closed fractures healed in an average of 17.4 weeks and open fractures in an average of 21.7 weeks, 90% of them with 10 mm of shortening or less. Varus angulation and posterior angulation were the most common deformities encountered at union. There were 20 nonunions (2.5%) and 46 braces were discontinued during treatment. We found no association between fracture healing and the patient's age, the mechanism of injury or the fracture location. The degree of soft tissue injury appeared to have most influence on the speed of fracture healing. Fracture comminution and initial displacement, the condition of the fibula and the time from injury to bracing also appeared to affect the speed of union. PMID- 2768308 TI - Abnormalities of proximal femoral growth after severe Perthes' disease. AB - We studied the pattern of proximal femoral growth after severe Perthes' disease (Catterall grade III or IV) by retrospective analysis of serial radiographs in 52 hips (46 patients). Our aim was to determine the relationship between proximal femoral growth abnormalities and metaphyseal cysts, epiphyseal extrusion, physeal narrowing, and extensive epiphyseal necrosis. The average follow-up after treatment was 9.8 years (range 4 to 16 years), and 37 of the hips were followed to skeletal maturity. Slowing of proximal femoral growth was common: symmetrical abnormality was seen in 26 hips and asymmetrical abnormality in nine. However, definite premature closure of the proximal femoral physis was seen in only three hips. Abnormality seemed to be due to altered growth velocity rather than to bar formation in most cases. Metaphyseal cysts, epiphyseal extrusion and physeal narrowing during the active stage of the disease, alone or in combination, were found to be neither sensitive nor specific predictors of the subsequent growth pattern. PMID- 2768309 TI - Leg length discrepancy after femoral shaft fractures in children. Review after skeletal maturity. AB - We reviewed and radiographed 30 skeletally-mature patients after isolated closed femoral shaft fractures in childhood which had been treated conservatively. When the fracture had occurred between the ages of 7 and 13 years, the limb overgrew about 1 cm regardless of sex, upper limb dominance, age, fracture site or configuration. Excessive fracture overlap at the time of injury, but not at union, increased limb overgrowth. Angulation of the fracture remodelled in children injured under 10 years of age, but in older patients this sometimes added to limb shortening. Rotational deformities were minor and gave no symptoms. Treatment of the 7- to 13-year-old patient should aim at 1 cm overlap at union, with correction of angular deformity being more important in children over 10 years of age. This management of fractures will give a maximum leg length discrepancy of 1 cm at skeletal maturity. PMID- 2768310 TI - Subsidence of the femoral component related to long-term outcome of hip replacement. AB - We compared the clinical outcome with femoral subsidence and radiographic changes in 102 patients at 9 to 13 years after low friction arthroplasty. In 92 cases with a satisfactory outcome there was an average of 2.3 radiological signs and mean subsidence of less than 5 mm. An unsatisfactory outcome was associated with 3.4 signs per film and with subsidence of more than 5 mm. The radiological signs we describe are often the hallmark of successful load transmission, but if they increase with time or are associated with subsidence of over 5 mm, then clinical failure is likely. Fracture of the cement tip is associated with increased subsidence and adversely affects the long-term clinical outcome. PMID- 2768311 TI - The measurement of migration of the acetabular component of hip prostheses. AB - Individual components of a total hip replacement are difficult to evaluate and quantify. We have studied the assessment of the acetabular component, and conclude that the measurement of migration allows the comparison of implants, although there is no established link between migration and significant loosening. A method of measurement based on clinical radiographs has been developed, and its limitations estimated. The accuracy of the technique was calculated to be +/- 3 mm. PMID- 2768312 TI - The diagnostic value of C-reactive protein in infected total hip arthroplasties. AB - In 50 patients with non-infected total hip arthroplasties (THA), 233 C-reactive protein (CRP) values were obtained over a three-year period. Six of these 50 patients occasionally had CRP values of over 20 mg/l. The erythrocyte sedimentation rate (ESR) and CRP concentration were measured in 23 patients with deep infections of THA before revision. In 11 patients the infections were caused by coagulase-negative staphylococci. CRP exceeded 20 mg/l in 18 patients and the ESR was more than 30 mm/hr in 14. In only one infected patient were both CRP and ESR below these levels. All of 33 patients with non-septic loosening had CRP less than 20 mg/l and ESR less than 30 mm/hr before revision. C-reactive protein seems to be a valuable supplement to the ESR in the monitoring of infection after THA. PMID- 2768313 TI - Results of drilling osteochondritis dissecans before skeletal maturity. AB - We report the arthroscopic drilling of classical lesions of osteochondritis dissecans in 11 knees in 10 children with at least six months history and no sign of clinical or radiological improvement. There were eight boys and two girls and the average age at operation was 12 years 11 months. Relief of pain was noticed within days of operation; radiological healing occurred within 12 months in nine of the 11 knees. PMID- 2768314 TI - Spontaneous healing of aneurysmal bone cysts. A report of three cases. AB - We report three cases of spontaneous healing of aneurysmal bone cysts (ABC). In one case histological material was obtained after resection of the already ossified expansile mass discovered as a lytic lesion seven months previously. In the two other patients, spontaneous ossification of a radiologically presumed ABC in the lytic and expansile phase was observed after nine and seven months respectively. The healed lesions have remained stable at 12, 32, and 36 months respectively. These findings suggest that when the diagnosis can be made with confidence, and the lesion is in a location and at a stage that does not entail any risk of fracture or compression, expectant management should be considered. Our three patients were aged 22, 19 and 18 years, older than usual for developing ABC. This is also true for many of the few other reported cases of spontaneous or almost spontaneous healing and suggests that ABC has a greater tendency to stabilise in older patients. PMID- 2768315 TI - Epiphyseal distraction monitored by strain gauges. Results in seven children. AB - Ten epiphyses in seven children underwent fixed-rate distraction of 0.25 mm twice daily in an attempt to achieve percutaneous leg lengthening by chondrodiatasis. The forces generated across the growth plate were recorded by means of strain gauges incorporated into the distractors. All epiphyses fractured before 33 days of lengthening. An average gain of 6.75 cm was achieved. Epiphyseal distraction at the lower femur produced many complications, but at the upper tibial epiphysis planned lengthening was achieved, with excellent bone production and few complications. PMID- 2768316 TI - Energy metabolism in fracture healing. Measurement of adenosine triphosphate in callus to monitor progress. AB - We measured the adenosine triphosphate (ATP) content of callus at various intervals during healing in 78 fractured tibiae in 10- to 12-week-old rabbits. The results, compared with the level in normal tissues, showed a high rate of energy metabolism in the early phase of fracture healing, which persisted until the callus was corticalised and remodelling had started. The ATP content could provide a more sensitive index to monitor fracture healing in animal studies. Our findings lend support to the need for nutritional supplements for patients with multiple fractures. PMID- 2768318 TI - Synovectomy of the elbow in rheumatoid arthritis. Long-term results. AB - We reviewed 61 elbow synovectomies in 50 patients with rheumatoid arthritis, with follow-up varying from 4 to 10 years (mean 6.5 years). The results were graded as satisfactory in 70%, with no significant difference in the results between joints which were radiologically good before operation and those which had been destroyed. Longer term results were analysed of 27 elbow synovectomies in 22 patients followed up for over six years. The results were satisfactory in 67% of the patients in both 1981 and in 1987, with no deterioration over this period. PMID- 2768317 TI - The measurement of osteoporosis in clinical practice. Comparison of histological and radiological methods. AB - In a prospective study of the measurement of osteoporosis in patients with fracture of the femoral neck, we compared a histological with a radiological method. We found no significant correlation between histological planimetry and the radiological six metacarpal hand index in patients with either cervical or trochanteric fractures. This demonstrates that metacarpal morphometry cannot predict histological osteoporosis of the iliac crest. PMID- 2768319 TI - Pentalateral osteotomy for cubitus varus. Clinical experiences of a new technique. AB - Several methods for the correction of cubitus varus have been described, but most reported series are small and show a high rate of complications. We report a six year personal experience of 77 osteotomies by a new technique which provides rigid fixation and allows correction of both varus and rotation deformities. It also prevents lateral bulging at the level of the osteotomy. In 58 cases followed up for an average of 16 months, there were no serious complications, a satisfactory carrying angle and no significant loss of movement, giving 88% excellent or good results. PMID- 2768321 TI - Donor site pain from the ilium. A complication of lumbar spine fusion. AB - Chronic pain at the donor site was reported by 25% of 290 patients who had undergone anterior lumbar spine fusion for low back pain. Donor site pain has characteristic clinical features, may be severely disabling and is stubbornly resistant to treatment. The highest prevalence was in patients who had a tricortical full thickness graft taken through a separate incision overlying the iliac crest. Patients with a clinically unsatisfactory result from the spine fusion also had a significantly higher prevalence of donor site pain. PMID- 2768320 TI - Inflammatory cell changes in haversian canals. A possible cause of osteoporosis in rheumatoid arthritis. AB - We studied the morphology of the haversian canals in the osteopenic cortical bone of the medial femoral neck from patients with rheumatoid arthritis and compared the findings with those in patients with osteoarthritis and with uncomplicated coxa valga. In the rheumatoid bone, the diameters of the canals were larger and many more contained osteoclasts. Fewer haversian canals showed only lining cells than in the osteoarthritic or coxa valga patients. In bone from rheumatoid patients, especially in canals with osteoclasts, small blood vessels were frequently lined by tall endothelial cells with an infiltration of mononuclear cells. These morphological differences are discussed with reference to the possible mechanisms of loss of cortical bone in rheumatoid arthritis and other conditions. PMID- 2768322 TI - Scoliosis surgery in the Prader-Willi syndrome. AB - There is a high incidence of spinal deformity in children with the Prader-Willi syndrome. We have encountered major complications following spinal surgery in this condition. We report our experience and conclude that spinal surgery is a formidable undertaking and the risks should be appreciated by the surgeon and the parents. PMID- 2768323 TI - Dwyer-Hartshill transpedicular fixation for spinal fusion. AB - We report the technique and early results of the Dwyer-Hartshill method for segmental fixation of the spine. This uses pedicular screws wired to a rectangular frame and is indicated after laminectomy. PMID- 2768324 TI - Multilevel spinal injuries. Incidence, distribution and neurological patterns. AB - Spinal injury at more than one level is not uncommon. Awareness of multilevel injury of the spine and associated neurological patterns is important for the proper initial management of the patient. This study presents the incidence, pattern of signs and the neurological consequences of multilevel spinal injury. A review of 935 patients with spinal injuries revealed that lesions occurred in multiple levels in 9.7%; in over half of the cases, neurological lesions were incomplete. Multiple level non-contiguous lesions at more than two levels had the worst prognosis with 70% of patients suffering complete paraplegia. PMID- 2768325 TI - Passive ankle mobility. Clinical measurement compared with radiography. AB - We compared goniometric assessment of passive ankle movement with radiographic measurements in 100 normal ankles. Significant differences were recorded in both dorsiflexion and plantarflexion; clinical measurements overestimated the range of movement. For scientific documentation of tibiotalar mobility, radiographic measurements should be used. PMID- 2768326 TI - Delayed rupture of false aneurysm following a femoral fracture. PMID- 2768327 TI - Cement augmentation of pathological fracture fixation. PMID- 2768328 TI - Bilateral central dislocation of the hip following a cerebrovascular accident. PMID- 2768329 TI - Unexpected second arterial injury in the lower limb. PMID- 2768330 TI - Chondroma of the scaphoid. PMID- 2768331 TI - The natural history of ganglia in children. PMID- 2768332 TI - Girl with three legs. PMID- 2768333 TI - Analysis of angular deformities on radiographs. PMID- 2768334 TI - Three-dimensional image reconstruction of insect flight muscle. I. The rigor myac layer. AB - We have obtained detailed three-dimensional images of in situ cross-bridge structure in insect flight muscle by electron microscopy of multiple tilt views of single filament layers in ultrathin sections, supplemented with data from thick sections. In this report, we describe the images obtained of the myac layer, a 25-nm longitudinal section containing a single layer of alternating myosin and actin filaments. The reconstruction reveals averaged rigor cross bridges that clearly separate into two classes constituting lead and rear chevrons within each 38.7-nm axial repeat. These two classes differ in tilt angle, size and shape, density, and slew. This new reconstruction confirms our earlier interpretation of the lead bridge as a two-headed cross-bridge and the rear bridge as a single-headed cross-bridge. The importance of complementing tilt series with additional projections outside the goniometer tilt range is demonstrated by comparison with our earlier myac layer reconstruction. Incorporation of this additional data reveals new details of rigor cross-bridge structure in situ which include clear delineation of (a) a triangular shape for the lead bridge, (b) a smaller size for the rear bridge, and (c) density continuity across the thin filament in the lead bridge. Within actin's regular 38.7-nm helical repeat, local twist variations in the thin filament that correlate with the two cross-bridge classes persist in this new reconstruction. These observations show that in situ rigor cross-bridges are not uniform, and suggest three different myosin head conformations in rigor. PMID- 2768335 TI - Three-dimensional image reconstruction of insect flight muscle. II. The rigor actin layer. AB - The averaged structure of rigor cross-bridges in insect flight muscle is further revealed by three-dimensional reconstruction from 25-nm sections containing a single layer of thin filaments. These exhibit two thin filament orientations that differ by 60 degrees from each other and from myac layer filaments. Data from multiple tilt views (to +/- 60 degrees) was supplemented by data from thick sections (equivalent to 90 degrees tilts). In combination with the reconstruction from the myac layer (Taylor et al., 1989), the entire unit cell is reconstructed, giving the most complete view of in situ cross-bridges yet obtained. All our reconstructions show two classes of averaged rigor cross-bridges. Lead bridges have a triangular shape with leading edge angled at approximately 45 degrees and trailing edge angled at approximately 90 degrees to the filament axis. We propose that the lead bridge contains two myosin heads of differing conformation bound along one strand of F-actin. The lead bridge is associated with a region of the thin filament that is apparently untwisted. We suggest that the untwisting may reflect the distribution of strain between myosin and actin resulting from two headed, single filament binding in the lead bridge. Rear bridges are oriented at approximately 90 degrees to the filament axis, and are smaller and more cylindrical, suggesting that they consist of single myosin heads. The rear bridge is associated with a region of apparently normal thin filament twist. We propose that differing myosin head angles and conformations consistently observed in rigor embody different stages of the power stroke which have been trapped by a temporal sequence of rigor cross-bridge formation under the constraints of the intact filament lattice. PMID- 2768336 TI - Guanine nucleotide-induced polymerization of actin in electropermeabilized human neutrophils. AB - The effects of exogenous guanine nucleotides on the polymerization of actin in human neutrophils were tested in an electropermeabilized cell preparation. Close to 40% permeabilization was achieved with a single electric discharge as measured by nucleic acid staining with ethidium bromide or propidium iodide with minimal (less than 2%) release of the cytoplasmic marker lactate dehydrogenase. In addition, electropermeabilized neutrophils retained their capacity to produce superoxide anions and to sustain a polymerization of actin in response to surface receptor dependent stimuli such as chemotactic factors. Electropermeabilization produced a rapid and transient permeabilization that allowed the entry of guanine nucleotides into the cells. GTP and, to a larger extent, its nonhydrolyzable analog guanosine 5'-O-2-thiotriphosphate (GTP[S]), induced a time- and concentration-dependent polymerization of actin, as determined by increased staining with 7-nitrobenz-2-oxa-1,3-diazolylphallacidin. The effects of the aforementioned guanine nucleotides were antagonized by GDP[S], but were insensitive to pertussis toxin. Cholera toxin potentiated to a small degree the amount of actin polymerization induced by GTP[S]. These results provided direct evidence for the involvement of GTP-binding proteins in the regulation of the organization of the cytoskeleton of neutrophils, an event that is of crucial importance to the performance of the defense-oriented functions of these cells. PMID- 2768337 TI - Influence of botulinum C2 toxin on F-actin and N-formyl peptide receptor dynamics in human neutrophils. AB - Stimulation of human neutrophils with the chemotactic N-formyl peptide causes production of oxygen radicals and conversion of monomeric actin (G-actin) to polymeric actin (F-actin). The effects of the binary botulinum C2 toxin on the amount of F-actin and on neutrophil cell responses were studied. Two different methods for analyzing the actin response were used in formyl peptide-stimulated cells: staining of F-actin with rhodamine-phalloidin and a transient right angle light scatter. Preincubation of neutrophils with 400 ng/ml component I and 1,600 ng/ml component II of botulinum C2 toxin for 30 min almost completely inhibited the formyl peptide-stimulated polymerization of G-actin and at the same time decreased the amount of F-actin in unstimulated neutrophils by an average of approximately 30%. Botulinum C2 toxin preincubation for 60 min destroyed approximately 75% of the F-actin in unstimulated neutrophils. Right angle light scatter analysis showed that control neutrophils exhibited the transient response characteristic of actin polymerization; however, after botulinum C2 toxin treatment, degranulation was detected. Single components of the binary botulinum C2 toxin were without effect on the actin polymerization response. Fluorescence flow cytometry and fluorospectrometric binding studies showed little alteration in N-formyl peptide binding or dissociation dynamics in the toxin-treated cells. However, endocytosis of the fluorescent N-formyl peptide ligand-receptor complex was slower but still possible in degranulating neutrophils treated with botulinum C2 toxin for 60 min. The half-time of endocytosis, estimated from initial rates, was 4 and 8 min in control and botulinum C2 toxin-treated neutrophils, respectively. PMID- 2768338 TI - Centrosome movement in the early divisions of Caenorhabditis elegans: a cortical site determining centrosome position. AB - In Caenorhabditis elegans embryos, early blastomeres of the P cell lineage divide successively on the same axis. This axis is a consequence of the specific rotational movement of the pair of centrosomes and nucleus (Hyman, A. A., and J. G. White. 1987. J. Cell Biol. 105:2123-2135). A laser has been used to perturb the centrosome movements that determine the pattern of early embryonic divisions. The results support a previously proposed model in which a centrosome rotates towards its correct position by shortening of connections, possibly microtubules, between a centrosome and a defined site on the cortex of the embryo. PMID- 2768339 TI - Differential expression and subcellular localization for subunits of cAMP dependent protein kinase during ram spermatogenesis. AB - The expression of mRNAs for the RI alpha, RII alpha, and C alpha subunits of cAMP dependent protein kinase has been studied in different ram germ cells. The sizes of the specific RI alpha, RII alpha, and C alpha mRNAs, observed in germ cells were 1.6, 2.0, and 2.6 kb, respectively. RI alpha and C alpha mRNAs were mainly expressed in primary spermatocytes. A postmeiotic expression predominating in early spermatids was unique to RII alpha mRNA. The location of RI, RII alpha, and C subunits in well-defined organelles of ram spermatids and epididymal sperm was assessed by immunogold electron microscopy. In spermatids, RI, RII alpha, and C were essentially present in the forming acrosome and, to a lesser extent, in the nucleus. During sperm epididymal maturation, the protein kinases disappeared from the acrosome and were detected in a variety of sperm functional areas, such as the tip of the acrosome, the motility apparatus, and the membrane network. The present study on subunits of cAMP-dependent protein kinase supports the concept that specific functions are attached to the different subunits in that it shows differential expression and differential subcellular localization in germ cells. PMID- 2768340 TI - Simultaneous measurements of cytosolic calcium and secretion in single bovine adrenal chromaffin cells by fluorescent imaging of fura-2 in cocultured cells. AB - The cytosolic free calcium concentration ([Ca2+]i) and exocytosis of chromaffin granules were measured simultaneously from single, intact bovine adrenal chromaffin cells using a novel technique involving fluorescent imaging of cocultured cells. Chromaffin cell [Ca2+]i was monitored with fura-2. To simultaneously follow catecholamine secretion, the cells were cocultured with fura-2-loaded NIH-3T3t cells, a cell line chosen because of their irresponsiveness to chromaffin cell secretagogues but their large Ca2+ response to ATP, which is coreleased with catecholamine from the chromaffin cells. In response to the depolarizing stimulus nicotine (a potent secretagogue), chromaffin cell [Ca2+]i increased rapidly. At the peak of the response, [Ca2+]i was evenly distributed throughout the cell. This elevation in [Ca2+]i was followed by a secretory response which originated from the entire surface of the cell. In response to the inositol 1,4,5-trisphosphate (InsP3)-mobilizing agonist angiotensin II (a weak secretagogue), three different responses were observed. Approximately 30% of chromaffin cells showed no rise in [Ca2+]i and did not secrete. About 45% of the cells responded with a large (greater than 200 nM), transient elevation in [Ca2+]i and no detectable secretory response. The rise in [Ca2+]i was nonuniform, such that peak [Ca2+]i was often recorded only in one pole of the cell. And finally, approximately 25% of cells responded with a similar Ca2+-transient to that described above, but also gave a secretory response. In these cases secretion was polarized, being confined to the pole of the cell in which the rise in [Ca2+]i was greatest.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2768341 TI - Novel alpha-D-mannosidase of rat sperm plasma membranes: characterization and potential role in sperm-egg interactions. AB - During the course of a study of glycoprotein processing mannosidases in the rat epididymis, we have made an intriguing discovery regarding the presence of a novel alpha-D-mannosidase on the rat sperm plasma membranes. Unlike the sperm acrosomal "acid" mannosidase which has a pH optimum of 4.4, the newly discovered alpha-D-mannosidase has a pH optimum of 6.2, and 6.5 when assayed in sperm plasma membranes and intact spermatozoa, respectively. In addition, the two enzymes show different substrate specificity. The acrosomal alpha-D-mannosidase is active mainly towards synthetic substrate, p-nitrophenyl alpha-D-mannopyranoside, whereas the sperm plasma membrane alpha-D-mannosidase shows activity mainly towards mannose-containing oligosaccharides. Evidence is presented which suggest that the sperm plasma membrane alpha-D-mannosidase is different from several processing mannosidases previously characterized from the rat liver. The newly discovered alpha-D-mannosidase appears to be an intrinsic plasma membrane component, since washing of the purified membranes with buffered 0.4 M NaCl did not release the enzyme in soluble form. The enzyme requires nonionic detergent (Triton X-100) for complete solubilization. The enzyme is activated by Co2+ and Mn2+. However, Cu2+ and Zn2+ are potent inhibitors of the sperm plasma membrane alpha-D-mannosidase. At a concentration of 0.1 mM, these divalent cations caused nearly complete inactivation of the sperm enzyme. In addition methyl-alpha-D mannoside, methyl-alpha-D-glucoside, mannose, 2-deoxy-D-glucose, and D mannosamine are inhibitors of the sperm surface alpha-D-mannosidase. The physiological role of the newly discovered enzyme is not yet known. Several published reports in three species, including the rat, suggest that the sperm surface alpha-D-mannosidase may have a role in binding to mannose-containing saccharides presumably present on the zona pellucida. PMID- 2768343 TI - Expression of mRNAs coding for the alpha 1 chain of type XIII collagen in human fetal tissues: comparison with expression of mRNAs for collagen types I, II, and III. AB - This paper describes the topographic distribution of the multiple mRNAs coding for a novel human short-chain collagen, the alpha 1 chain of type XIII collagen. To identify the tissues and cells expressing these mRNAs, human fetal tissues of 15-19 gestational wk were studied by Northern and in situ hybridizations. The distribution pattern of the type XIII collagen mRNAs was compared with that of fibrillar collagen types I, II, and III using specific human cDNA probes for each collagen type. Northern hybridization showed the bone, cartilage, intestine, skin, and striated muscle to contain mRNAs for type XIII collagen. An intense in situ hybridization signal was obtained with the type XIII collagen cDNAs in the epidermis, hair follicles, and nail root cells of the skin, whereas the fibrillar collagen mRNAs were detected in the dermis. Cells in the intestinal mucosal layer also appeared to contain high levels of alpha 1(XIII) collagen mRNAs, but contained none of the fibrillar collagen mRNAs. In the bone and striated muscle, alpha 1(XIII) collagen mRNAs were detected in the mesenchymal cells forming the reticulin fibers of the bone marrow and endomycium. The hybridization signal obtained with the alpha 1(XIII) collagen cDNA probe in cartilaginous areas of the growth plates was similar, but less intense, to that obtained with the type II collagen probe. A clear hybridization signal was also detected at the (pre)articular surfaces and at the margins of the epiphyses, whereas it was weaker in the resting chondrocytes in the middle of the epiphyses. The brain, heart, kidney, liver, lung, placenta, spleen, testis, tendon, and thymus did not appear to contain alpha 1(XIII) collagen mRNAs. PMID- 2768342 TI - Thrombospondin modulates focal adhesions in endothelial cells. AB - We examined the effects of thrombospondin (TSP) in the substrate adhesion of bovine aortic endothelial cells. The protein was tested both as a substrate for cell adhesion and as a modulator of the later stages of the cell adhesive process. TSP substrates supported the attachment of some BAE cells, but not cell spreading or the formation of focal adhesion plaques. In contrast, cells seeded on fibrinogen or fibronectin substrates were able to complete the adhesive process, as indicated by the formation of focal adhesion plaques. Incubation of cells in suspension with soluble TSP before or at the time of seeding onto fibronectin substrates resulted in an inhibition of focal adhesion formation. Furthermore, the addition of TSP to fully adherent cells in situ or prespread on fibronectin substrates caused a reduction in the number of cells, which were positive for focal adhesions, although there was no significant effect on cell spreading. In a dose-dependent manner, TSP reduced the number of cells with adhesion plaques to approximately 60% of control levels. The distribution of remaining adhesion plaques in TSP-treated cells was also altered: plaques were primarily limited to the periphery of cells and were not present in the central cell body, as in control cells treated with BSA. The observed effects were specific for TSP and were not observed with platelet factor 4, beta thromboglobulin, or fibronectin. The TSP-mediated loss of adhesion plaques was neutralized by the addition of heparin, fucoidan, other heparin-binding proteins, and by a monoclonal antibody to the heparin binding domain of TSP, but not by antibodies to the core or carboxy-terminal regions of TSP. The interaction of the heparin-binding domain of TSP with cell-associated heparan sulfate appears to be an important mechanistic component for this activity of TSP. These data indicate that TSP may have a role in destabilizing cell adhesion through prevention of focal adhesion formation and by loss of preformed focal adhesions. PMID- 2768346 TI - Preliminary studies on phospholipase A2-induced mouse paw edema as a model to evaluate antiinflammatory agents. AB - Phospholipase A2 (PLA2) is a key component of the inflammatory process because of its role in the generation of eicosanoids and platelet-activating factor (PAF). Manipulation of PLA2 activity offers a novel therapeutic approach for the development of antiinflammatory agents; however, there is a need for a suitable in vivo model. Injection of 1 microgram of snake venom PLA2 (A. piscivorus piscivorus, D-49) into the mouse hind footpad produced a significant three- to four-fold rise in paw edema within 10 min, compared to the saline control. Edema formation depended on enzyme concentration and appeared specific for PLA2 since edema was negated by enzyme pretreatment with p-bromophenacyl bromide, a nonspecific PLA2 inhibitor. Moreover, injection of a protein such as bovine serum albumin did not result in significant edema. Coinjection of phenidone (lipoxygenase inhibitor, 50 micrograms), indomethacin (cyclooxygenase inhibitor, 50 micrograms), cyproheptadine (antihistamine/antiserotonin, 50 micrograms), aristolochic acid (putative PLA2 inhibitor, 100 micrograms), or kadsurenone (PAF antagonist, 50 micrograms) with PLA2 (1 microgram/paw) resulted in partial reduction (44.5, 34.2, 54.7, 64, and 50% inhibition, respectively) of edema formation. Oral administration of cyproheptadine (10 mg/kg), indomethacin (10 mg/kg), BW 755c (100 mg/kg), or dexamethasone (1 mg/kg) 1-3 h before challenge also decreased PLA2-induced edema (63.0, 30.1, 47.8, or 62.5% inhibition, respectively). The data suggest that mouse paw edema resulting from PLA2 injection is a multicomponent event, influenced by both autacoids and lipid mediators of inflammation. PMID- 2768344 TI - Interactions and structure of the nuclear pore complex revealed by cryo-electron microscopy. AB - Nuclear pore complexes (NPCs) play a central role in mediating nucleocytoplasmic transport and exchange processes in eukaryotic cells. The arrangement and interactions of NPCs within amphibian nuclear envelopes have been studied using cryo-electron microscopy of unfixed and frozen hydrated specimens. The nuclear lamina in Necturus forms an orthogonal network with crossover distances which vary between 1,600 and 4,000 A and which may be related to the basic filament repeat of lamins. Furthermore, the NPCs are attached randomly within the confines of the lamin network, presumably by their nucleoplasmic rings. Image analysis of edge-on and en face projections of detergent-extracted NPCs has been combined with data on the coaxial thin rings to provide a quantitative evaluation of the triple ring model of NPC architecture proposed previously (Unwin, P. N. T., and R. Milligan. 1982. J. Cell Biol. 93:63-75). Additional details of the complex have been visualized including an intimate association of the inner spoke domains as an inner spoke ring, extensive domains within the spokes and coaxial thin rings, and interestingly, a central channel-like feature. Membrane-associated NPCs and detergent-extracted NPCs both possess peripherally located radial arms resulting in an effective diameter of approximately 1,450-1,500 A. In projection, the radial arms possess approximate mirror symmetry suggesting that they originate from both sides of the assembly. Moreover, membrane-associated NPCs are asymmetric at most radii and right-handed as viewed from the cytoplasm; detergent extracted NPCs appear to be symmetric and have approximately 822 symmetry. Taken together, the data suggests that the framework of membrane-associated NPCs is perturbed from a symmetrical configuration, either during isolation of nuclei or by interactions with the lamina and the nuclear envelope in vivo. However, detergent extraction of nuclei appears to result in a more symmetrical alignment of components in apposing halves of the assembly. PMID- 2768345 TI - Molecular analysis of pleckstrin: the major protein kinase C substrate of platelets. AB - Activation of protein kinase C (PKC) in platelets causes the immediate phosphorylation of pleckstrin, an apparent Mr 40-47,000 protein previously called 40K or P47. Pleckstrin presumably plays an important but as yet unknown role in mediating cellular responses evoked by agonist-induced phosphoinositide turnover. We have cloned the cDNA for pleckstrin from the HL-60 human promyelocytic leukemia cell line by immunological screening of a lambda gt11 expression library (Tyers et al.: Nature 333:470-473, 1988) and now report further analysis of the pleckstrin sequence. Pleckstrin has a deduced Mr of 40,087 and is encoded by a 1,050-bp open reading frame which is preceded by a short open reading frame that terminates before the correct initiator methionine. A single polymorphic site was found in the coding region. An unusual pattern of sequence heterogeneity occurred about a poly(A) tract in the 3' untranslated region. The 3.0-kb pleckstrin mRNA induced upon differentiation of HL-60 cells apparently has heterogeneous 5' ends which undergo differential regulation during HL-60 cell maturation. Analysis by multiple sequence alignment with known PKC substrates identified a strong candidate site for phosphorylation by PKC and a potential Ca2+-binding EF-hand motif. No other similarities to proteins in current databases were found. PMID- 2768347 TI - Competence growth factors can cause modification in higher-order chromatin structure in mouse embryo 3T3 fibroblasts. AB - The authors compared sedimentation rates of nucleoids from mouse embryo 3T3 fibroblasts cultured in the presence or absence of different cell growth factors. The results clearly showed that rapidly sedimenting nucleoids are obtained only when cells are supplied with any of the following competence growth factors: platelet-derived growth factor (PDGF), fibroblast growth factor (FGF), or the product of the oncogene v-sis (a peptide homologous to PDGF). The tumor promoter phorbol 12-myristate 13-acetate, an activator of protein kinase C and a partial mitogen, shares this property with the competence growth factors. Removal of these factors from the medium causes cells to enter Go and nucleoids to sediment at a slower rate. Protein synthesis is required for growth factor induction of change in nucleoid sedimentation, but inhibition of either DNA synthesis or DNA repair does not antagonize the effect of growth factors. Titration of nucleoids with ethidium bromide indicates that one possible mechanism for the nucleoid change is the unwinding of DNA in supercoiled loops. The results indicated that the nucleoid change constitutes a cell response to competence factors that might have an important role in cell proliferation. PMID- 2768348 TI - Competitive, uncompetitive, and mixed inhibitors of the alkaline phosphatase activity associated with the isolated brush border membrane of the tapeworm Hymenolepis diminuta. AB - Several compounds were tested as inhibitors of the alkaline phosphatase (AlkPase) activity associated with the isolated brush border membrane of the tapeworm, Hymenolepis diminuta. Molybdate, arsenate, arsenite and beta-glycerophosphate (BGP) were competitive inhibitors of the hydrolysis of p-nitrophenyl phosphate, while levamisole and clorsulon were uncompetitive and mixed inhibitors, respectively. Molybdate was also a competitive inhibitor of the hydrolysis of BGP and 5'-adenosine monophosphate, and levamisole was an uncompetitive inhibitor of BGP hydrolysis. The apparent inhibitor constants (Ki') for molybdate and levamisole were virtually identical regardless of the substrate, and these data support the hypothesis that the AlkPase activity is represented by a single membrane-bound enzyme with low substrate specificity. Quinacrine, Hg2+, and ethylenediaminetetraacetate were also potent inhibitors of the AlkPase activity, but the mechanisms by which these latter three inhibitors function were not clear. PMID- 2768350 TI - Spirituality and healing. PMID- 2768349 TI - Multinuclear magnetic resonance studies on serine protease transition state analogues. AB - 31P Nuclear Magnetic Resonance (NMR) studies were performed on mono- and diisopropylphosphoryl derivatives of alpha-chymotrypsin, trypsin, and subtilisin. Questions addressed included the pKa of the active center Asp...His...Ser triad in both species. While the pKa in the diisopropylphosphoryl derivatives is near 7.4 (found in this and other laboratories earlier) and reflects a nearly normal imidazolium titration curve, the apparent pKa in the monoisopropylphosphoryl enzymes (obtained by "aging" of the diisopropylphosphoryl derivatives and monitored by 31P NMR) is between 9.7 and 11.4 depending on the protease. This latter "titration" of the 31P NMR signal is reversible and presumably reflects the interaction of the imidazolium positive charge with the monoanionic phosphodiester. Of the two tetrahedral intermediates, the properties of the monoisopropylphosphoryl enzyme are probably more representative of the tetrahedral oxyanionic intermediate invoked during peptide hydrolysis. The same NMR technique was used to determine the action of PAM (pyridine-2-aldoxime methiodide, a known "antidote" for acetylcholinesterase inactivated by diisopropylfluorophosphate), on the inactivated enzymes. It was clear that the "antidote" could reverse the diisopropylphosphorylation but was ineffective on the monoisopropylphosphoryl ("aged") enzyme. 11B NMR studies were performed on phenylboronic (PBA) acid and 3,5-bis-trifluoromethylphenylboronic acid in the absence and presence of chymotrypsin and subtilisin. At 22 degrees C the former, but not the latter, compound was in fast exchange between the free and enzyme bound states. The relaxation parameters could be calculated for the bound PBA in chymotrypsin and the fluorinated analogue in subtilisin and clearly indicated that the boron nucleus was tetrahedral in the active centers, a good analogue for the tetrahedral oxyanionic intermediate. PMID- 2768351 TI - The spirit of nursing. AB - The essence of nursing is not doing or manipulating but is being open to whatever arises in the interaction with the client. It is being fully present, with an unconditional acceptance of the client's experience. The nurse offers his or her whole self so that the client can resonate with an authentic person. The nurse is like a tuning fork through which the client can begin to resonate with the consciousness of the universe. PMID- 2768352 TI - Spirituality: cornerstone of holistic nursing practice. AB - Practitioners of holistic nursing seek to be part of an environment that is healing, recognizing that healing occurs on many levels. Suffering and pain are viewed as part of larger life experience and may be sources of growth and transformation. Understanding that spirituality has to do with all of life and is expressed in a variety of ways, the practitioner of holistic nursing is open to the spirituality of self and others, as manifested in the ordinary as well as the dramatic, and in gentle ways encourages its experience and expression. PMID- 2768353 TI - Creating a context for self-healing: the transpersonal perspective. PMID- 2768354 TI - Nursing and the comic mask. PMID- 2768355 TI - Blood-lead levels and children's behaviour--results from the Edinburgh Lead Study. AB - The effect of blood-lead on children's behaviour was investigated in a sub-sample of 501 boys and girls aged 6-9 years from 18 primary schools within a defined area of central Edinburgh. Behaviour ratings of the children were made by teachers and parents using the Rutter behaviour scales. An extensive home interview with a parent was also carried out. Multiple regression analyses showed a significant relationship between log blood-lead and teachers' ratings on the total Rutter score and the aggressive/anti-social and hyperactive sub-scores, but not the neurotic sub-score when 30 possible confounding variables were taken into account. There was a dose-response relationship between blood-lead and behaviour ratings, with no evidence of a threshold. PMID- 2768356 TI - The psychological, educational and auditory sequelae of early, persistent secretory otitis media. AB - Previous studies have suggested an association between chronic middle ear disorders due to secretory otitis media and adverse effects on auditory, educational and psychological development in children. Experimental design of such studies has often been poor. In this study, attempts were made to control extraneous variables more rigorously, using matched pairs. A group of children (n = 10) without current hearing problems but with a history of recurrent early secretory otitis media, aged 7-11 yrs, were compared on auditory, educational and psychological measures with a matched group of children with no history of otitis media. The results indicated weak but distinct differences between the two groups on the educational and psychological measures in favour of the control group. The implications for medical and educational services are outlined. PMID- 2768357 TI - The response of young, non-sexually abused children to anatomically correct dolls. AB - Ninety-one children aged 3-6 yrs were observed and video-recorded playing with the anatomically correct dolls in unstructured play settings. Parental permission had been obtained. The children's emotional, behavioural and overall play responses were rated. Whilst the dolls' difference from other dolls was clearly noticed, they did not traumatise the children, most of whom incorporated the dolls in imaginative play. Only five children's play with the dolls showed any sexualized quality, in three the source of sexual knowledge becoming apparent. Whereas the absence of sexualized play does not reliably exclude abuse, we suggest that explicit sexual play with the dolls may well arise from previous exposure to explicit sexual information or activity. PMID- 2768358 TI - An examination of the relationship between childhood depression and social competence amongst primary school children. AB - Forty-three primary school children who scored in the clinical range of the Children's Depression Inventory were compared with 43 children who were categorized as fearful but not depressed and a control group of 43 children who were classed as nondepressed-nonfearful. Subjects were matched across groups on the basis of grade and sex. The analyses were performed twice, initially with a depressed sample that excluded any depressed-fearful children and again with a depressed group that included such children. The results revealed that, independent of whether the depressed category included children who were also fearful, the depressed group reported lower levels of assertiveness and greater submissiveness, less adequate social skills performance, received lower ratings of peer popularity, fewer positive nominations from peer sociometry and more negative nominations. Depressed children were much more likely to be rejected or isolated by their peers than were their fearful or control counterparts. PMID- 2768359 TI - Stability of assessment results of autistic and non-autistic language-impaired children from preschool years to early school age. AB - The predictability, consistency in group means, and intra-individual stability of developmental quotients and performance IQs were assessed from preschool to school age for 71 autistic children and 71 non-autistic communication-handicapped children, matched on chronological age, sex and initial performance IQ/DQ. DQs/performance IQs at age 4 yrs were found to be highly correlated with performance IQ at age 10 yrs for both groups. Absolute difference scores and group means were also equivalent for both samples, with no difference in patterns of change or the relationship between performance IQ and language status, as measured on the PPVT. Differences between diagnostic groups occurred only for scores on the Vineland Social Maturity Scale and the relationship between these scores and IQ. PMID- 2768360 TI - Facial perception in autism. AB - Disturbances in gaze and patterns of facial interaction are prominent aspects of social dysfunction in autism; the nature of this disturbance has up to the present been unclear. This study examined the ability of autistic subjects to use the human face as a source of information. Autistic and age- and MA-matched retarded control subjects assembled a series of puzzles displaying photographs of human faces; puzzles differed in complexity, familiarity of the faces and configuration (normal vs scrambled faces). Significant effects of all three factors, but not of diagnostic group, were observed. The autistic subjects did not exhibit specific deficits in perception of faces. PMID- 2768361 TI - Body-image disturbances in adolescent female binge-purgers: a brief report of the results of a national survey in the U.S.A. AB - A sample (N = 114) of adolescent female binge-purgers were among the respondents to a nationwide survey on body-image. Relative to female controls (N = 114) who were matched on age, height and weight, binge-purgers evaluated their physical appearance, fitness and health much less favourably. However, they reported being more appearance-oriented and fitness-oriented than controls. Regardless of actual weight, binge-purgers more often distorted their body size as heavier than did controls, displayed more anxious preoccupation about their weight and weight gain and reported much more frequent eating restraint to lose weight. Binge-purgers also considered themselves to be more poorly psychosocially adjusted, with a reported childhood history of appearance-related conflicts. Discriminant function analysis indicated that the above variables were very accurate in classifying the two groups. PMID- 2768362 TI - Comparative studies of conversion disorders in childhood and adolescence. AB - In a syndrome validation study, four groups of patients suffering from conversion disorders, anxiety states, obsessive-compulsive disorder and emotional disorders, as well as a healthy control group, were compared. The following findings emerged: besides female preponderance and greater age, a higher rate of low SES subjects and social migration patients suffering from conversion disorders displayed a greater proportion of psychiatric and medical diseases in their parental heritage. PMID- 2768363 TI - Autistic children's ability to interpret faces: a research note. AB - Ten autistic children were compared with 10 non-autistic children matched for chronological age and performance IQ on two tests of finding the odd face out of a set of photographs of faces, two tests of labelling photographs of faces, and a test of labelling photographs of common objects. The autistic children were significantly worse than the non-autistic children at finding the odd person out and the odd facial expression of emotion out, and at labelling facial expressions of emotion. They did no worse than the non-autistic children at labelling upside down faces or at labelling objects. The results, which replicate the findings of Hobson (J. Child Psychol, Psychiat. 27, 321-342, 671-680, 1986; Communication, 20, 12-17, 1986) are consistent with other evidence for a specific perceptual abnormality in at least some children with autism, the nature of which is discussed. PMID- 2768364 TI - Comment on paper by Gibbs et al. PMID- 2768365 TI - Study of the lipophilic character of a series of beta-carbolines. AB - The lipophilic character of a series of beta-carbolines has been studied. The RM values were measured by means of a reversed-phase thin-layer chromatographic (TLC) technique and compared with the RM values obtained by high-performance TLC (HPTLC), the log k' obtained by high-performance liquid chromatography (HPLC), and the log P values. The best equation shows a very good linear relationship between our RM values and the classical log P values obtained using an octanol water system. The choice of a pH of 13.0 for the TLC system allowed the measurement of the RM values of molecules in their non-ionized form. The deviations from the linear relationship shown by the RM(HPTLC) and log k' values of two compounds were due to the fact that both compounds were at least partially ionized at the pH of 7.0 at which the HPTLC and HPLC determinations were carried out. PMID- 2768366 TI - Analysis of solvent residues in pharmaceutical bulk drugs by wall-coated open tubular gas chromatography. AB - A simple general method for the determination of solvent residues in drugs is described. The procedure is based on wide-bore wall coated open tubular (WCOT) gas chromatographic analysis of bulk drug solutions. The use of wide-bore WCOT columns with chemically crosslinked methyl silicone stationary phases offers improvements in specificity and sensitivity over earlier packed-column methods. The factors that influence method accuracy are discussed, including a consideration of instrumental and matrix contributions to the linearity and bias of the method. Some problems with interferences peculiar to benzyl alcohol are reported. PMID- 2768367 TI - Chromatographic approaches to the quality control of chiral propionate anti inflammatory drugs and herbicides. AB - The chiral analysis of a range of propionate anti-inflammatory drugs and herbicides was accomplished by gas chromatographic separation of their R-alpha phenylethylamide diastereomeric derivatives. Using a packed column (3% OV-l on Chromosorb G) good separations were obtained but analysis times were rather long. Examination of the same crystalline derivatives using a capillary column (bonded methylsilicone) resulted in good separations together with much reduced total analysis times. The technique was validated through the analysis of several derivatives prepared on a micro scale and examined directly by gas chromatography without any crystallisation step. Racemic materials all gave virtually 50:50 response ratios while the analysis of optically pure samples produced no evidence of significant racemization. Derivatives of phenoxyacetic acid and myristic acid were also prepared and chromatographed as potential internal standards. PMID- 2768368 TI - Derivatization of N-methyl and cyclic amino acids with dimethylformamide dimethyl acetal. AB - Six amino acids containing either an N-methyl or a cyclic secondary amine were converted to volatile derivatives by reaction with dimethylformamide dimethyl acetal. The amine functionalities were formylated by way of an amide acetal intermediate while the carboxylic acid groups were esterified directly. The resulting N-formyl esters were stable to solvent extraction and exhibited gas chromatography-mass spectrometry properties suitable for assay development. PMID- 2768369 TI - Mass spectral investigations on trichothecene mycotoxins. VII. Liquid chromatographic-thermospray mass spectrometric analysis of macrocyclic trichothecenes. AB - Thermally labile, polar toxic roridins and biologically active, isomeric baccharinoids were separated on a reversed-phase high-performance liquid chromatography column and effectively ionized under thermospray ionization conditions. The mass spectra indicated the formation of corresponding molecular ion-ammonium adducts in great abundance. Experiments designed for monitoring specific ions of these analytes at predesignated intervals were utilized for the accurate analysis of these macrocyclic trichothecenes in real, crude samples. A synthetically modified macrocyclic trichothecene, 8-ketoverrucarin A, was used as the internal standard for the detection and quantification of these compounds. Minimum detectable limits, during this first reported method for the unambiguous analysis of these structurally related macrocyclic trichothecenes, were determined to be 2-5 ng. PMID- 2768371 TI - Adsorption chromatography on cellulose. IV. Separation of D- and L-tryptophan and D- and L-methyltryptophan on cellulose with aqueous solvents. AB - Differences in RF values between D- and L-tryptophan on cellulose paper, developed with water, were observed already in 1954 and now several variables of this separation, such as modifications to the tryptophan molecule, the temperature and salting-out have been examined. Differences were found in the mechanism of the process compared with the systems described by Yuasa et al. [Chromatographia, 21 (1986) 79], who separated amino acid enantiomers on cellulose with pyridine-ethanol-water mixtures. PMID- 2768370 TI - Formic acid as a milder alternative to trifluoroacetic acid and phosphoric acid in two-dimensional peptide mapping. AB - In reversed-phase chromatography of peptides, formic acid has been shown to successfully replace the stronger traditional trifluoroacetic and phosphoric acids. Detection of non-aromatic peptide at lower wavelength is not impaired and being volatile the acid is easily removed, enabling further studies of the peptides. Also in ion-exchange chromatography (the first step of a two dimensional approach) formic acid works well with a sulphonic acid ion-exchange resin. PMID- 2768372 TI - Separation of major phospholipid classes by high-performance liquid chromatography and subsequent analysis of phospholipid-bound fatty acids using gas chromatography. AB - A sensitive high-performance liquid chromatographic method for the separation of major phospholipid (PL) classes in biological materials is described. Using this method it was easy to separate P-cholin, P-ethanolamine, P-serine, P-inositol, cardiolipin, sphingomyelin, lyso-P-choline and lyso-P-ethanolamine from skeletal and cardiac muscle samples. The method is based on the simultaneous use of a pH gradient and a polarity gradient. This procedure can easily be modified to optimize the separation of PLs from very different tissues. Subsequent analysis of the PL-bound fatty acids (FAs) by gas chromatography resulted in a well separated FA pattern. Following this FA separation it was possible to recalculate the specific PL content in the original sample. PMID- 2768373 TI - Analysis of warfarin and its metabolites by reversed-phase ion-pair liquid chromatography with fluorescence detection. AB - A high-performance liquid chromatographic method was developed for the determination of warfarin and its metabolites (diastereomeric warfarin alcohols and 6-, 7-, 8-, 4'- and 3'-hydroxywarfarin) in microbial cultures. Ion-pair chromatography with tetrabutylammonium ion as the counter ion allowed for the complete resolution of all compounds at pH 7.5 on a reversed-phase (C18) column, thus permitting direct fluorescence detection without the use of post-column pH switching techniques. Analysis of cell suspension cultures of the fungus Cunninghamella elegans (ATCC 36112) indicated that this organism metabolizes warfarin to all known mammalian metabolites, plus the previously unreported 3' hydroxywarfarin. Detection limits for all compounds were in the low nanogram range. PMID- 2768374 TI - Interplay of hydrophobic and electrostatic interactions in biopolymer chromatography. Effect of salts on the retention of proteins. AB - The effect of salt on the retention behavior of proteins in electrostatic and hydrophobic interaction chromatography is described by a three-parameter equation, log k' = A - B log ms + Cms, where k' is the retention factor and ms is the molality of the salt in the eluent. Parameter B, termed the electrostatic interaction parameter, depends on the characteristic charge of the protein and the salt counterion and governs the change of retention with the salt concentration in ion-exchange chromatography. According to the model the magnitude of the hydrophobic interaction parameter C is determined by the hydrophobic contact area upon protein binding at the stationary phase surface and the properties of the salt as measured by its molal surface tension increment. Retention data measured at different salt concentrations in the eluent on a variety of ion exchangers can be fitted to the above equation which yields U shaped plots of log k' against log ms. The limiting slopes of the appropriate plots at sufficiently low and high salt concentrations can be used to evaluate the electrostatic and hydrophobic interaction parameters, respectively. The approach, which is based on a combination of established treatments of electrostatic and hydrophobic interactions offers a convenient framework for analyzing retention data in biopolymer high-performance liquid chromatography and for the characterization of stationary phases. Furthermore, it may facilitate some characterization of protein molecules on the basis of their retention behavior as a function of the concentration and nature of the salt in the eluent. In the treatment of electrostatic interactions use is made of the counterion condensation theory that is believed to make possible a more comprehensive analysis than the traditional stoichiometric ion-exchange model which assumes binding of the proteins by coulombic interactions at discrete sites. The treatment of hydrophobic interactions is based on an adaptation of the solvophobic theory which predicts that the hydrophobic portion of the free energy of binding is proportional to the hydrophobic contact area and the microthermodynamic surface tension of the aqueous salt solution. Despite its simplicity the theory was successful in explaining the observed effect of the nature and concentration of salt in the eluent, the pH and the effect of the density of fixed charges at the surface of the stationary phase in the absence of specific salt effects. PMID- 2768375 TI - Use of liquid chromatography in the synthesis of isoluminol-labeled medroxyprogesterone acetate and zeranol. AB - A high-performance liquid chromatographic (HPLC) method for monitoring the syntheses of two isoluminol-labelled drugs, medroxyprogesterone acetate (MPA) and zeranol, has been developed. MPA and the ketone derivative of zeranol, zearalanone, were conjugated to N-(4-aminobutyl)-N-ethylisoluminol through the carboxymethyloxime derivative of the drug by using the N-succinimide ester as an intermediary. Reaction mixtures were sampled periodically and chromatographed directly by HPLC on a silica gel column, by using isocratic elution with mixtures of hexane-ethanol-acetic acid in several different proportions. The degree of reaction completion was determined by comparison of the peak area of the initial reactant to that present at sampling time. MPA oxime production was found to be complete after 15 min; 97.0% of the oxime was converted to succinimide ester in 24 h; 99.0% of the available ester reacted within 2.5 h to form the final labelled product. Zearalanone oxime production was found to be complete after 2 h; 93.3% of the oxime was converted to the activated ester within 24 h; 89.6% of available ester had reacted in 30 min to form the final labelled product. The chromatography can be performed in real time, permitting modification in the conditions of the reaction while in progress. PMID- 2768376 TI - Determination of preservatives in cosmetic products. II. High-performance liquid chromatographic identification. AB - A high-performance liquid chromatographic (HPLC) procedure is presented for the separation and identification of preservatives that are listed in the current EEC Council Directive on cosmetic products or have been permitted in the past. The method consists of an extraction of acidified cosmetics with methanol, and separation of the extracts by HPLC. Using two isocratic and two gradient reversed phase HPLC systems, 47 preservatives were characterized by their retention times. The preservatives in three commercial cosmetic products were tentatively identified by the procedure described. The HPLC procedure is suitable for confirmation of the presence of preservatives in cosmetic products as indicated by a previously reported thin-layer chromatographic procedure. In general this method will permit the routine detection of preservatives in cosmetics in an approximate concentration of 0.01% (w/w). PMID- 2768377 TI - Capillary gas chromatographic-mass spectrometric determination of acid herbicides in soils and sediments. AB - A capillary gas chromatographic method with selected-ion monitoring (GC-SIM) was applied to eight common herbicides: 2-(4-chloro-o-tolyl-oxy)propionic acid, 3,6 dichloro-2-methoxybenzoic acid, 2-methyl-4-chlorophenoxyacetic acid, 2,3,6 trichlorobenzoic acid, 2,4-dichlorophenoxyacetic acid, 3,5,6-trichloro-2 pyridyloxy-acetic acid, 2,4,5-trichlorophenoxyacetic acid and alpha-(2-methyl-4 chlorophenoxy) butyric acid. The method involves extraction with saturated calcium hydroxide solution, esterification with pentafluorobenzyl bromide, clean up with a silica gel column and determination by capillary GC-SIM. Recoveries from soil and sediment are over 89% (with the exception of 77% for TBA) with coefficients of variation below 5% (n = 7). The method is suitable for the simultaneous determination of the eight herbicides in environmental samples with high sensitivity and accuracy. PMID- 2768378 TI - Use of absorbance ratios in densitometric measurements for the characterization and identification of natural products of pharmacological interest. PMID- 2768379 TI - Large-volume spotting apparatus and its application to the semi-quantitative determination of organochlorine pesticides in tea. PMID- 2768380 TI - Traditional oriental medicines. I. Black pearl: identification and chromatographic determination of some undeclared medicinal ingredients. PMID- 2768381 TI - Resolution of neuroactive non-protein amino acid enantiomers by high-performance liquid chromatography utilising pre-column derivatisation with o-phthaldialdehyde chiral thiols. Application to 2-amino-omega-phosphonoalkanoic acid homologues and alpha-amino-beta-N-methylaminopropanoic acid (beta-methylaminoalanine). PMID- 2768382 TI - Application of correlation chromatography to the investigation of biopolymers in wines. PMID- 2768383 TI - Field-flow fractionation of macromolecules. AB - Field-flow fractionation (FFF) is a versatile family of techniques, applicable to macromolecules, colloids, and cell-sized particles. This paper focuses specifically on the applicability of FFF to macromolecules. Following a brief description of the principles of FFF, the characteristics of FFF that bear on its efficacy in separating macromolecules are summarized. The basis of selectivity is established. The general applicability of FFF to macromolecules is then surveyed. For this purpose macromolecular substances are divided into four classes, distinguished by a molecular weight cutoff of 10(6) and by aqueous versus organic solubility. The capabilities of different FFF subtechniques in fractionating these classes of macromolecules is then discussed. PMID- 2768385 TI - Isotachophoresis of proteins. AB - The analytical separation of proteins by isotachophoresis (ITP) was achieved in a short electrophoretic path and with a resolution comparable to that of isoelectric focusing by the appropriate selection of (1) a mixture of ampholytes as spacers to generate linear gradients of electrophoretic mobility and (2) the counter ions chosen to buffer the complete pH gradient generated. This ITP technique is exemplified by the analysis of plasma proteins in agarose gels. Upto 46 samples in the same gel plate were analysed. The resolution was such that at least 30 clear and discrete bands per sample could be observed after staining with Coomassie Brilliant Blue. The resolving power of ITP could be further increased for the study of a particular protein or zone by the selection of suitable spacers and counter ions. PMID- 2768384 TI - Detection of trypsin- and chymotrypsin-like proteases using p-nitroanilide substrates after sodium dodecyl sulphate polyacrylamide gel electrophoresis. AB - Specific chromogenic p-nitroanilide substrates have proved useful for localizing proteolytic enzymes, such as trypsin, chymotrypsin and elastase after separation by agarose gel electrophoresis and when immobilized on nitrocellulose. This procedure was further developed for use with sodium dodecyl sulphate polyacrylamide gel electrophoresis (SDS-PAGE). After SDS-PAGE, proteins were transferred electrophoretically to a nitrocellulose membrane. The membrane was incubated for 10-60 min with Bz-Ile-Glu-Gly-Arg-p-nitroanilide as a substrate for detection of trypsin-like proteases and with MeO-Suc-Arg-Pro-Tyr-p-nitroanilide for detection of chymotrypsin. The yellow p-nitroanilide released at the site of proteolytic activity was converted into a visible and stable red azo dye. By this method was identified and determined the molecular weight of a trypsin-like protease that occurs at high concentrations in mucinous ovarian tumour cyst fluid together with its specific inhibitor peptide, tumour-associated trypsin inhibitor (TATI). The method was also used to visualize trypsin and chymotrypsin in human pancreatic juice. Using the trypsin substrate, three proteolytic bands, corresponding to Mr of 22,000, 24,000 and 26,000 daltons, were visualized in pancreatic juice, while the proteolytic zones in cyst fluid had Mr of 25,000 and 28,000 daltons. With the chymotrypsin substrate, a band of 29,000 daltons was visualized in pancreatic juice, whereas no activity was detected in cyst fluid. By incubation of the blotted cyst fluid proteins with 125I-labelled TATI, a pattern of bands at 25,000 and 28,000 daltons was detected identical to that obtained with the chromogenic substrate. PMID- 2768386 TI - Quantitative high-resolution gas chromatography and mass spectrometry of toxaphene residues in fish samples. AB - This report describes an analytical method which permits the determination of ppb (1 microgram/kg) level of toxaphene in fish tissues. Interferences both from biogenic and from xenobiotic substances are reduced even with low-resolution mass spectrometry. The methodology has a low susceptibility to false positive determinations, which could result from the presence of a wide variety of co contaminants. The method is based on the measurement of a signal representative of the toxaphene residue (m/z 158.9) relative to a known amount of an internal standard 37Cl-labelled compound. A modular approach to toxaphene enrichment has permitted a moderately simple procedure, significantly reducing analytical time requirements and the number of sample manipulations, and making the procedure amenable to automation. The reliability and accuracy of the procedure are demonstrated by the results of intra- and interlaboratory studies. The methodology has been validated and the presented data indicate that the detection limit is 1 microgra/kg of total toxaphene. Toxaphene recovery from fish at concentration levels between 0.1 and 10 micrograms/g is 84 +/- 12%. PMID- 2768387 TI - Relative gas-liquid chromatographic retention factors of trimethylsilyl ethers of diradylglycerols on polar capillary columns. AB - Gas-liquid chromatography (GLC) on polar capillary columns provides a highly reproducible resolution and quantitation of molecular species of diradylglycerols when analyzed as the trimethylsilyl (TMS) ethers. In the absence of peak collection and determination of fatty acids or mass spectrometry, peak identification is obtained on the basis of relative retention times of reference standards or of relative retention times calculated from the additive contributions of component fatty chains. Unlike simple esters, complex mixtures of diradylglycerols present special problems in GLC peak identification, which must be attended to by auxiliary separations prior to GLC analysis. In the present study the positional sn-1,2(2,3)- and X-1,3-isomers were resolved by borate thin-layer chromatography (TLC) while the alkenylacyl-, alkylacyl- and diacylglycerols were separated as their TMS ethers by normal-phase high performance liquid chromatography. The diradylglycerol nature of the sample was further verified by GLC determination of the carbon number distribution, which must be consistent with the composition of the fatty chains of the sample. Under these conditions the identification and quantitation of the molecular species on the polar capillary columns was always consistent with the total fatty acid composition of the sample, as well as with the fatty acid composition of any argentation TLC fractions isolated from some of the samples prior to the polar capillary GLC. Due to the great complexity of the natural diradylglycerol mixtures some peak overlaps occurred, which were reflected in their relative retention times. Nevertheless, a determination of diradylglycerol peak identity from relative retention times proved very satisfactory provided the above described procedures were employed. PMID- 2768388 TI - International Symposium on Coupled Column Separations. Techniques for integrated multistage separation in liquid, gas and supercritical fluid chromatography and electrophoresis. Uppsala (Sweden), October 26-27, 1988.Proceedings. PMID- 2768389 TI - Automated liquid chromatographic analysis of drugs in urine by on-line sample cleanup and isocratic multi-column separation. AB - A multi-column system has been developed for automated analysis of basic drugs in urine. Two polymeric pre-columns, containing PRP-1 and Aminex A-28, were used to isolate the drugs. A short reversed-phase column, coupled to a 150 x 4.6 mm I.D. silica column, produced the analytical separation. Sample preparation consisted of dilution and centrifugation. The entire procedure required less than 30 min. Careful optimization of mobile phase conditions led to retention of benzoylecgonine and barbiturates. For most drugs, levels of 0.3 mg/l were sufficient to produce peaks that could be matched against stored spectra with a computerized library search program. PMID- 2768390 TI - Coupled-column chromatography on immobilized protein phases for direct separation and determination of drug enantiomers in plasma. AB - Columns packed with immobilized alpha 1-acid glycoprotein and albumin were used in coupled-column chromatography to increase their utility for determining low concentrations of enantiomers in biological samples. The two enantiomers eluted from the protein columns were trapped and compressed on two separate columns, packed with hydrophobic stationary phase, and subsequently transferred to a fourth column for final separation. The overall effect was an increase in efficiency and selectivity. Examples are given of separations of the enatiomers of terbutaline, metoprolol, oxazepam and bupivacaine in plasma. For quantitative determination a single calibration can be used for both enantiomers. PMID- 2768391 TI - Analysis of 5-fluorouracil in plasma by precolumn derivatization with 4 bromomethyl-7-methoxycoumarin, followed by multi-dimensional high-performance liquid chromatography. AB - An assay for 5-fluorouracil (5-FU) has been developed that utilizes a double extraction with ethyl acetate, followed by precolumn derivatization with 4-bromo methyl-7-methoxycoumarin. The reaction mixture was quenched with 5% acetic acid, extracted with hexane, and analyzed by multi-dimensional high-performance liquid chromatography. Derivatized 5-FU was injected into a cyanopropyl column and a heart cut containing the analyte was then switched to an octadecyl column and quantitated by fluorescence detection. The assay had a limit of detection of 0.5 ng 5-FU/ml plasma and was linear to 20 micrograms/ml. It was shown to be free of interferences from the other anticancer agents commonly used in combination with 5-FU. This assay should have the sensitivity needed to measure the low levels that occur after low-dose, continuous infusion of 5-FU. PMID- 2768392 TI - Fifth (Montreux) Symposium on Liquid Chromatography-Mass Spectrometry, Supercritical Fluid Chromatography-Mass Spectometry and Tandem Mass Spectometry. Freiburg i.Br. (F.R.G.), November 2-4, 1988. Proceedings. PMID- 2768393 TI - Use of thermospray liquid chromatography-mass spectrometry for characterization of reactive metabolites of 3'-hydroxyacetanilide, a non-hepatotoxic regioisomer of acetaminophen. AB - 3'-Hydroxyacetanilide (AMAP) is a non-hepatotoxic regioisomer of acetaminophen that nonetheless does form reactive metabolites that are trapped as glutathione thioether adducts. These reactive intermediates are, 4-acetamido-o-benzoquinone, 2-acetamido-p-benzoquinone and N-acetyl-3-methoxy-p-benzoquinone. Thermospray liquid chromatography mass spectrometry (TSP LC-MS) was used to characterize products of reactions of these reactive compounds with cysteine or N-acetyl cysteine. The TSP spectra of the mono- and bis-thioether adducts showed protonated molecular ions and characteristic fragmentation patterns. The chromatographic resolution together with the MS selectivity allowed for unequivocal identification of these conjugates in the urine of mice treated with AMAP. PMID- 2768394 TI - Application of thermospray liquid chromatography-mass spectrometry to the simultaneous quantification of tracer concentrations of isotopically labelled carbamazepine epoxide and steady-state levels of carbamazepine and carbamazepine epoxide. AB - A thermospray high-performance liquid chromatography-mass spectrometry method for the separation and quantification of tracer concentrations of isotopically labelled carbamazepine epoxide ([15N, 13C]CBZE) in the presence of steady-state levels of the anticonvulsant carbamazepine (CBZ) and its epoxide metabolite (CBZE) has been developed. The technique does not require derivatization, demonstrates little or no thermal degradation of the analytes, provides increased specificity not available from conventional high-performance liquid chromatography, and has a detection limit of 500 pg for CBZE on-column. The method, incorporating d4-CBZ and d4-CBZE as internal standards, allows precise and accurate determination of the analytes with good reproducibility and stability. PMID- 2768395 TI - Characterization of solution-phase and gas-phase reactions in on-line electrochemistry-thermospray tandem mass spectrometry. AB - Electrochemistry was used on-line with high-performance liquid chromatography thermospray tandem mass spectrometry to provide insight into the solution-phase decomposition reactions of electrochemically generated oxidation products. Products formed during electrooxidation were monitored as the electrode potential was varied. The solution reactions which follow the initial electron transfer at the electrode are affected by the vaporizer tip temperature of the thermospray probe and the composition of the thermospray buffer. Either hydrolysis or ammonolysis reactions of the initial electrochemical oxidation products can occur with pH 7 ammonium acetate buffer. Both the electrochemically generated and the synthesized disulfide of 6-thiopurine decompose under thermospray conditions to produce 6-thiopurine and purine-6-sulfinate. Solution-phase studies indicate that nucleophilic and electrophilic substitution reactions with purine-6-sulfinate result in the formation of purine, adenine, and hypoxanthine. Products were identified and characterized by tandem mass spectrometry. This work shows the first example of high-performance liquid chromatography used on-line with electrochemistry to separate stable oxidation products prior to analysis by thermospray tandem mass spectrometry. In addition, solution-phase and gas-phase studies with methylamine show that the site of the nucleophilic and electrophilic reactions is probably inside the thermospray probe. Most importantly, these results also show that the on-line combination of electrochemistry with thermospray tandem mass spectrometry provides valuable information about redox and associated chemical reactions of biological molecules such as the structures of intermediates or products as well as providing insight into reaction pathways. PMID- 2768396 TI - Utility of solution electrochemistry mass spectrometry for investigating the formation and detection of biologically important conjugates of acetaminophen. AB - On-line formation and detection of glutathione and cysteine conjugates of acetaminophen were accomplished by the interfacing of a coulometric electrochemical cell with a thermospray mass spectrometer in a flow-injection experiment using a liquid chromatographic pump. Formation of the conjugates occurred only after acetaminophen was oxidized electrochemically by a two electron transfer to N-acetyl-p-benzoquinoneimine and reacted in a mixing tee with either glutathione or cysteine. The newly formed conjugate was detected by thermospray mass spectrometry by observing the [M + H]+ ion for the acetaminophen glutathione conjugate at m/z 457, or the [M + H]+ ion for the acetaminophen cysteine conjugate at m/z 271. Both the glutathione and cysteine conjugates produced a common fragment ion at m/z 184. The on-line reaction of glutathione and electrochemically generated N-acetyl-p-benzoquinoneimine was monitored at varying pH. At pH 8.5 the ion intensity for the acetaminophen-glutathione conjugate was greater than at lower pH, indicating that lower proton concentration enhanced the reaction of glutathione with N-acetyl-p benzoquinoneimine. This on-line electrochemical-thermospray mass spectrometric method demonstrated that acetaminophen conjugates may be formed and detected in the time frame of 1 s. PMID- 2768397 TI - Liquid chromatography-mass spectrometry of trace compounds with a moving-belt interface and multi-dimensional chromatography. AB - A high-performance liquid chromatographic method with on-line mass spectrometric detection is described for the structural analysis of a number of synthetic impurities, present at trace levels in almitrine. To obtain mass spectra with various ionization methods and high-resolution mass measurements, a moving-belt liquid chromatograph-mass spectrometer interface is used. A two-column switching system allows the injection of large amounts of almitrine, from which the trace compounds are trapped on a second column, while discarding the major component. This permits the introduction of the impurities into the mass spectrometer by elution of the second column, without the risk of introducing too large an amount of the major compound into the mass spectrometer. The mass spectra thus obtained are of sufficient quality to permit a correct structural assignment of the impurities. PMID- 2768398 TI - Liquid chromatographic-mass spectrometric studies on rifamycin antibiotics. AB - The use of a direct liquid introduction type liquid chromatographic-mass spectrometric interface to study highly thermally labile rifamycin antibiotics is described. Using negative ionization, abundant molecular ions were observed, and the spectra, also contained structurally significant fragments. Variation of the high-performance liquid chromatographic parameters did not change the spectra, thus making it easy to change chromatographic conditions. In quantitative studies, a surprising correlation was found, indicating that the mass spectrometric signal was proportional to the square of the sample concentration. PMID- 2768399 TI - Applicability of continuous-flow fast atom bombardment liquid chromatography-mass spectrometry in bioanalysis. Dextromethorphan in plasma. AB - Continuous-flow fast atom bombardment (CF-FAB) is an interface for combined liquid chromatography-mass spectrometry using FAB as the ionization method. The applicability of CF-FAB for quantitative bioanalysis was studied for a model compound, dextromethorphan, in plasma samples using conventional high-performance liquid chromatography. The flow-rate reduction was achieved either by splitting or by the phase-system switching approach. The features of both systems are discussed. PMID- 2768400 TI - Biological detectors in liquid chromatography. AB - The applicability of isolated organ preparations as chromatographic detectors was demonstrated. An appropriately designed detector cell (biological detector) applicable in both on-line and off-line modes was developed. Deproteinized sera from healthy volunteers and schizophrenic patients and human amniotic fluid were fractionated by gel-permeation, ion-exchange and reversed-phase liquid chromatography. Ultraviolet absorption and biological activity were compared. The results show that isolated organ preparations selected according to the needs of particular experiments meet the essential criteria of conventional chromatographic detectors. The use of isolated organs allows the detection of biologically active substances in a matrix of physicochemically closely related, but biologically distinct, fluid components. Biological detectors may also provide valuable additional information concerning the chemical structure of biologically active agents in an early stage of isolation. PMID- 2768401 TI - High-performance liquid chromatographic determination of tauro- and glyco conjugated bile acids in human serum. AB - A method for the identification and individual determination of the ten tauro- and glyco-conjugated bile acids is described. It consists in a specific three step extraction from small serum samples (500 microliters), high-performance liquid chromatographic separation and direct spectrophotometric detection at 119 nm. Extraction can be checked by the use of an internal standard. The reproducibility, recovery and separation of fractions were satisfactory. PMID- 2768402 TI - High-performance liquid chromatographic preparation of galactosyl-hydroxylysine, a specific bone collagen marker. AB - Galactosyl-hydroxylysine, a specific bone collagen marker, has been prepared directly from human urine samples by high-performance liquid chromatography (HPLC) on a preparative column. The compound is the didansyl derivative, as proved by HPLC and mass spectrometry under fast atom bombardment conditions. Since this compound is not commercially available, the procedure reported appears to be the simplest way to prepare it, which is necessary to measure the urinary excretion of this collagen metabolite by HPLC. PMID- 2768403 TI - Analysis of aspartylglucosamine at the picomole level by high-performance liquid chromatography. AB - A sensitive method for quantitative analysis of aspartylglucosamine as its dabsyl chloride derivative by high-performance liquid chromatography is described. Precolumn-derivatized aspartylglucosamine and internal standard (carboxymethylcysteine) are separated on a reversed-phase column with a mobile phase consisting of phosphate buffer and acetonitrile and monitored by UV-VIS detection at 436 nm. Aspartylglucosamine acts in the assay like a polar amino acid, and it can be separated from interfering substances in urine with a retention time of ca. 13 min. Its detection limit is ca. 0.3 microM in water and 0.5-1.0 microM in urine and other biological samples, which permits its quantitation in normal urine, for example. The within-day coefficient of variation is less than 4.7% and the day-to-day coefficient of variation is less than 8.3%. The present method is applicable to the direct analysis of aspartylglucosamine in body fluids and tissues without any prepurification and, in combination with automated liquid chromatography, allows rapid assay of a large number of samples in the detection of aspartylglycosaminuria. The sensitivity of the assay also allows direct quantitation of aspartylglucosamine in normal urine and leukocytes of aspartylglycosaminuria patients, and may thus be used in metabolic studies of the compound. PMID- 2768404 TI - Chromatographic analysis, isolation and partial characterization of two photocatalysed reaction products of haem and quinone. AB - Quinone was reacted in vitro with free haem under ultraviolet light. Two principal products were detected by liquid chromatography and purified by column chromatography. Mass spectral and Fourier transform infrared analyses showed that both products contained pyrroles and that the first product was probably an ether formed after reaction with the haem vinyl moieties. This product was entirely different from the known N-alkyl intermediates in the haem-catalysed epoxidation reactions of porphyrin dimerization by quinone. PMID- 2768405 TI - Improved gas chromatography with electron-capture detection using a reaction pre column for the determination of blood cyanide: a higher content in the left ventricle of fire victims. AB - We developed a head-space method for the determination of blood cyanide by gas chromatography with electron-capture detection. In this technique, a reaction pre column, packed with chloramine-T, was used for the conversion of hydrogen cyanide into cyanogen chloride. Since the reaction pre-column eliminated the necessity for trapping hydrogen cyanide from the biological samples, blood cyanide was quickly analysed by acidification only. The reaction pre-column was durable for at least several months. The calibration curve gave good linearity when dichloromethane was used as the internal standard, and the lower detection limit taken from this plot was ca. 0.05 micrograms/ml. The relative standard deviation of spiked blood samples was in the range 0.6-3.9%. We determined blood cyanide levels at autopsy in victims who had died from fire using this method. A significantly higher cyanide content was detected in the left ventricular blood than in the right. There was a positive correlation between blood cyanide and carboxylhaemoglobin contents. This simple and sensitive technique could be very useful for the determination of cyanide in various samples. PMID- 2768406 TI - Assay of 1-hydroxy-3-aminopropylidene-1,1-bisphosphonate and related bisphosphonates in human urine and plasma by high-performance ion chromatography. AB - A method is described for the analysis of 1-hydroxy-3-aminopropylidene-1, 1 bisphosphonate and related bisphosphonates in human urine and plasma. Samples are spiked with 1-hydroxy-5-aminopentylidene-1,1-bisphosphonate as an internal standard and calcium chloride is added to precipitate the bisphosphonates. Following centrifugation the precipitate is redissolved in acetic acid, and the bisphosphonates are separated by high-performance ion chromatography on a Dionex AS7 column using nitric acid as mobile phase. The bisphosphonates are oxidised to orthophosphate using post-column addition of ammonium persulphate and this is followed by post-column reaction with molybdenum-ascorbate to yield the phosphomolybdate chromophore which is detected at 820 nm. A detection limit of 10 ng/ml is possible. PMID- 2768407 TI - High-performance liquid chromatographic method for determining thiopental concentrations in twelve rat tissues: application to physiologic modeling of disposition of barbiturate. AB - A sensitive, selective and reproducible high-performance liquid chromatographic assay of thiopental concentrations in twelve rat tissues was developed using thiamylal as the internal standard. Samples were homogenized in phosphate buffer, extracted into pentane and chromatographed on a microparticulate octadecyl reversed-phase column using ultraviolet detection at 290 nm. A simple digestive step with collagenase prior to homogenization facilitated analysis of thiobarbiturate in skin. Thiopental extraction recovery from fat exceeded 90%. Assay sensitivity was greater than 1 microgram/ml for tissue and plasma samples as small as 50 microliters. This assay has been applied to physiologic pharmacokinetic studies. The paper also presents typical concentration-time profiles of thiopental in four tissues taken from 74 rats given 20 mg/kg thiopental. PMID- 2768408 TI - Simple high-performance liquid chromatographic method for the determination of tolbutamide and its metabolites in human plasma and urine using photodiode-array detection. AB - A high-performance liquid chromatographic method has been developed for the determination of tolbutamide and its metabolites in human plasma and urine. The compounds examined were extracted with diethyl ether from the acidified biological fluid. Chlorpropamide was used as internal standard, and 235 nm was chosen as the wavelength for diode-array detection. A study of the relationship between the capacity factor and the mobile phase composition and pH showed that acetonitrile-2-propanol-0.1% orthophosphoric acid (17: 17: 66, v/v) was the best eluent on a C8 reversed-phase column. The method is precise, sensitive and suitable for pharmacological investigations. PMID- 2768409 TI - Determination of diltiazem in human whole blood and plasma by high-performance liquid chromatography using a polymeric reversed-phase column and utilizing a salting-out extraction procedure. AB - A rapid, simple and sensitive reversed-phase high-performance liquid chromatography method for the separation and measurement of the concentration of diltiazem in human whole blood and plasma has been developed. The method involves a simple one-step solvent extraction of the drug from biological samples followed by salting-out the organic solvent using ammonium sulfate. A 15 cm x 4.1 mm, PRP 1, pH-stable (pH 1-13) polymeric reversed-phase column was used with an isocratic elution of acetonitrile-0.01 M tetrabutylammonium hydroxide (60:40, v/v). Diltiazem was monitored at 254 nm and 0.50-0.005 a.u.f.s. The completion time for assay was less than 15 min, and the limit of detection was 10 ng/ml at a signal to-noise ratio of 3 for a 50-microliters injection volume. Using this method, the pharmacokinetic parameters (elimination rate constant, elimination half-life and area under the curve) were calculated from a whole blood concentration versus time profile of diltiazem. PMID- 2768410 TI - Determination of pioglitazone in dog serum using solid-phase extraction and high performance liquid chromatography with ultraviolet (229 nm) detection. AB - An analytical method is described for the determination of the free base of pioglitazone hydrochloride (U72, 107A, AD-4833) in dog serum. The method used solid-phase extraction of pioglitazone from serum followed by high-performance liquid chromatographic analysis on an octadecylsilane column with an eluent of acetonitrile-water (41:59, v/v) containing 1.2 ml/l acetic acid (pH 6.0 +/- 0.05). The column effluent was monitored at 229 nm. The analytical procedure has a linear range of 25 ng/ml to 20 micrograms/ml, a minimum quantifiable level of 25 ng/ml, absolute recovery of greater than 90% (n = 15), and precision of less than or equal to 8.8% (n = 45). The method was used in a preliminary dose proportionality study in the dog. PMID- 2768411 TI - Simple high-performance liquid chromatographic method for the measurement of toloxatone in rabbit cerebrospinal fluid and plasma. AB - A simplified, rapid high-performance liquid chromatographic procedure has been developed for the measurement of toloxatone in rabbit plasma and cerebrospinal fluid. The method involves a single-step extraction of the alkalinized sample with diethyl ether and analysis of the evaporated extract on a C8 column. Detection was performed by ultraviolet absorbance monitored at 240 nm. The overall run-time of the assay was 8 min at a flow-rate of 1 ml min-1. The sensitivity limit of toloxatone was 70 ng ml-1 at a signal-to-noise ratio of 3:1 in rabbit cerebrospinal fluid and plasma. The assay has been used to define plasma toloxatone concentration-time profiles and to quantitate cerebrospinal fluid toloxatone levels after a single intravenous injection in rabbits. PMID- 2768412 TI - Thin-layer chromatographic separation and in situ fluorimetric determination of ofloxacin in plasma and pleural fluid. AB - A thin-layer chromatographic assay for the determination of ofloxacin in human plasma and pleural fluid is described. After extraction of ofloxacin from samples with dichloromethane, chromatography was performed on thin-layer plates (silica gel) with a mobile phase consisting of ethanol and water; the tank atmosphere was equilibrated with concentrated ammonia. The precision of the assay could be considerably increased along with the measured fluorescence intensity of ofloxacin by spraying the plate with a citric acid solution and dipping it into paraffin or using a mixture of both components. Peaks were quantified by densitometric evaluation of the chromatograms. The method shows a very low limit of detection (1 ng/ml) as well as good precision and linearity in the range 0.001 2.0 micrograms/ml for both plasma and pleural fluid. PMID- 2768413 TI - High-performance liquid chromatography of cystathionine, lanthionine and aminoethylcysteine using o-phthaldialdehyde precolumn derivatization. PMID- 2768414 TI - Affinity chromatography of anti-mannan antibodies on mannan-acrylamide copolymers. PMID- 2768415 TI - Measurement of vitamin E in premature infants by reversed-phase high-performance liquid chromatography. PMID- 2768416 TI - Measurement of intracellular diacylglycerols by acetylation and thin-layer chromatography. PMID- 2768417 TI - Gas chromatographic-mass spectrometric determination of morphine, codeine and 6 monoacetylmorphine in blood extracted by solid phase. PMID- 2768418 TI - Assay of ambroxol in human plasma by high-performance liquid chromatography with amperometric detection. PMID- 2768419 TI - Determination of buspirone and 1-(2-pyrimidinyl)piperazine in plasma samples by high-performance liquid chromatography. PMID- 2768421 TI - Special topics in biomedical chromatography and electrophoresis. PMID- 2768422 TI - Clinical practice evaluation. PMID- 2768420 TI - Automated high-performance liquid chromatographic analysis of tetracycline in urine. PMID- 2768423 TI - Clinical evaluation: research or quality assurance. PMID- 2768424 TI - Clinical practice evaluation in an oncology setting. AB - Clinical practice must be evaluated for efficiency and effectiveness using a logical, step-by-step methodology. Problem-solving models can serve as a guide to help clinicians systematically evaluate and answer the question, "Do nursing interventions make a difference?" Ultimately, this type of clinical practice evaluation will contribute to improving quality patient care as well as the efficiency of nurses' time. PMID- 2768425 TI - Monitoring to ensure reliability of hemodynamic pressure readings. AB - Work is currently being done to make sure that other factors affecting reliable and valid pulmonary artery readings do not exist. Nurses have a tremendous responsibility to their patients who have pulmonary artery catheters. They must not only be knowledgeable but also must have good surveillance skills. Because there is such a discrepancy between the amount of knowledge deemed necessary in the literature and that which is actually demanded in practice, this study should be expanded and replicated. Intensive care nurses must do all they can to maintain a critically ill patient's health, and one way in which to attempt this is through adequate knowledge and treatment using pulmonary artery catheters. PMID- 2768426 TI - Pain control in children following tonsillectomies: a retrospective study. AB - Children in this documentation study were found to receive adequate analgesia that led to adequate pain control most of the time. Fewer analgesic doses were given during the night shift compared to the day and afternoon shifts. Nonanalgesic methods of pain control were consistently used for the children studied. Nurses measure pain relief in children based on verbal and behavioral indicators. The findings of this study will be presented to staff at a future unit practice council meeting. Recommendations will include: (1) administer analgesics at regular intervals throughout the hospital stay, (2) continue to consistently provide nonanalgesic methods of pain control, and (3) conduct a follow-up study using the same tool and guidelines. The results of both studies will be compared. Others who provide nursing care to children following tonsillectomies are encouraged to study the effectiveness of pain relief measures for children in their respective institutions. Pain relief is a measure of quality care. PMID- 2768427 TI - A process method for clinical practice evaluation in the home health setting. PMID- 2768428 TI - Evaluation of clinical indicators in i.v. home care. PMID- 2768429 TI - Evaluating the clinical practice of flight nurses: complexities and innovations. AB - The evaluation of the clinical practice of the flight nurse is difficult from a methodologic standpoint. Innovative approaches are required in order to get the true picture of the actual quality of the nurse's care. While the retrospective approach is certainly the most convenient, it is certainly not the best approach. A more varied and comprehensive approach to evaluating care, using an assortment of methodologies, is required to adequately quantify the quality of care provided by the flight nurse. PMID- 2768430 TI - QA Forum. Unit-based nursing quality assurance. PMID- 2768431 TI - Anticardiolipin antibodies in homosexual men: prevalence and lack of association with human immunodeficiency virus (HIV) infection. AB - Tests for anticardiolipin antibodies (ACL) on sera from 100 male homosexuals and 60 male heterosexuals showed that 57% of the homosexuals, in contrast to none of the heterosexuals, were ACL positive. The ACL were predominantly of the immunoglobulin G isotype and, in a high proportion of cases tested (82%), were reactive with other phospholipids, especially those with a negative charge. ACL were not related to the clinical status of the homosexuals, being evenly distributed among 40 with acquired immunodeficiency syndrome (AIDS), 20 with AIDS related complex (ARC), 20 with asymptomatic infection with human immunodeficiency virus (HIV) and/or lymphadenopathy syndrome, and 20 who were HIV-antibody negative. Nor were they associated with thrombocytopenia, thrombosis, neurologic disease, a biological false-positive test for syphilis (BFP), or antibodies to DNA. It is concluded that factors other than infection with HIV are responsible for ACL positivity in homosexual males and that the epitopes recognized by ACL in this group are distinct from those associated with thromboembolism or the BFP reaction or cross-reactive with DNA. PMID- 2768433 TI - Immunoglobulin levels in saliva in individuals with selective IgA deficiency: compensatory IgM secretion and its correlation with HLA and susceptibility to infections. AB - Total levels of IgA, IgM, and IgG were measured in unstimulated whole saliva and serum from 63 individuals with selective IgA deficiency. Values were compared with the incidence of upper respiratory tract infections, antibiotic treatments (necessitated by upper respiratory tract infection), and HLA antigens. A statistically significant increase in salivary IgM and IgG levels was noted in individuals with selective IgA deficiency compared to healthy normal individuals. Healthy individuals with selective IgA deficiency did not have increased concentrations of salivary IgM compared to infectious-prone patients. Nor was there any correlation found between proneness to infections and HLA antigens or between salivary IgM or IgG levels and HLA antigens in this patient material. PMID- 2768434 TI - Limited usefulness of quantitative culture of blood drawn through the device for diagnosis of intravascular-device-related bacteremia. AB - The use of a differential quantitative blood culture technique (Isolator) to diagnose intravascular-device-related bacteremia (IDRB) was studied prospectively. During septic episodes in 44 patients, blood was obtained simultaneously through the suspected infected device and from a peripheral venipuncture. The blood samples were processed by the Isolator technique, which enables easy quantification of microorganisms. The cannula was removed, and its tip was cultured semiquantitatively. Of the 52 cannulas studied, 15 were the cause of IDRB, but only 7 of these showed a significantly higher bacterial count in blood obtained through the device compared with peripheral blood. The bacterial count was higher in blood drawn through the device than in peripheral blood in four of six cases that did not fulfill the definition of IDRB. Some blood cultures obtained through the device were positive despite negative cultures of peripheral blood and cannula tips (six cannulas). Quantitative blood cultures were not useful in diagnosing IDRB in this study. PMID- 2768432 TI - In vitro immune responses to hepatitis B surface antigen (Pre-S2 and S) following remote infection by hepatitis B virus in humans. AB - In this report we evaluate the human immune response to hepatitis B surface antigen (HBsAg) following remote infection with hepatitis B virus (HBV). HBsAg reactive lymphocytes can be readily demonstrated in the peripheral blood of individuals with established immunity following infection with HBV. In vitro stimulation with small doses of plasma-derived HBsAg, yeast-derived HBsAg (S region) or pre-S2 peptide will induce specific IgG to HBsAg (anti-HBs) in the absence of a polyclonal increase in total IgG. The pre-S2 peptide will stimulate, in a T cell-dependent fashion, the in vitro production of anti-HBs with specificity for the S domain. This anti-HBs production is mediated by pre-S2 stimulated soluble T-cell factors. Peripheral blood mononuclear cells from individuals with established immunity proliferate to the yeast-derived HBsAg but not to the plasma-derived HBsAg or pre-S2 peptide. The chronic HBsAg carriers do not produce anti-HBs following stimulation with HBsAg regardless of the source or component of antigen used. Different study protocols failed to demonstrate HBsAg specific responses in the peripheral blood mononuclear cells of chronic carriers. PMID- 2768435 TI - Evaluation of human immunodeficiency virus seroprevalence in population surveys using pooled sera. AB - The pooling of individual serum samples to determine human immunodeficiency virus (HIV) seropositivity was examined to assess whether testing pooled sera was technically feasible, cost-effective, and accurate for estimating seroprevalence in large population surveys. The sensitivities and specificities of three commercially available HIV enzyme-linked immunosorbent assay (ELISA) kits were tested using 65 serum pools of 15 individual serum samples each (975 total serum samples) at two different dilutions. With pooled sera, the Organon Teknika Bio EnzaBead ELISA at half the dilution recommended by the manufacturer showed the best agreement with ELISA and Western blot results of individual sera. In subsequently testing 92 pools, each containing 15 individual serum samples from a population of American patients attending a sexually transmitted diseases clinic, the estimated seroprevalence was 5.27 compared with 4.93% in a test of 1,380 individual serum samples and 5.19% in a test of 4,028 individual serum samples from the same population. In an evaluation of 1,380 African patients using 10 serum samples per pool, the estimated seroprevalence was 5.79 compared with 6.16% in a test of individual sera. These results indicate that ELISA testing with pooled sera is highly sensitive and specific and appears to be a cost-effective means for estimating HIV seroprevalence in large population-based surveys. PMID- 2768436 TI - Location of double bonds in monounsaturated fatty acids of Campylobacter cryaerophila with dimethyl disulfide derivatives and combined gas chromatography mass spectrometry. AB - Location of the double-bond position of monounsaturated fatty acids in Campylobacter cryaerophila was accomplished with combined gas chromatography-mass spectrometry analysis of dimethyl disulfide (DMDS) derivatives. The monoenoic fatty acids from whole bacterial cells were converted to methyl esters and then to DMDS adducts and analyzed by capillary gas chromatography-mass spectrometry. The mass spectra of DMDS adducts gave an easily recognizable molecular ion (M+) and two major diagnostic ions attributable to fragmentation between the two CH3S groups located at the original site of unsaturation. Two previously unidentified acids that distinguish C. cryaerophila from other bacteria were identified as C14:1 omega 7 and C16:1 omega 7 from their mass spectral fragmentation patterns. Resolution of cis and trans isomers by capillary column gas chromatography permitted assignment of the trans isomer to the C16:1 omega 7 acid. PMID- 2768437 TI - Staff carriage of epidemic methicillin-resistant Staphylococcus aureus. AB - Twenty-six nurses were repeatedly screened for carriage of epidemic methicillin resistant Staphylococcus aureus (EMRSA) immediately before and after duty periods in which they solely attended six patients widely colonized with two EMRSA strains distinguishable by plasmid analysis. EMRSA carriage was detected in 13 nurses. Three EMRSA carriage patterns emerged: transient carriage in 12 nurses, when the EMRSA was isolated from noses or fingers of nurses after duty but was gone before their next day's duty; short-term nasal carriage, seen on occasion in 4 of these 12 nurses, when EMRSA carriage was detected on two consecutive screens; and persistent nasal carriage, seen in 1 nurse only, when the EMRSA was seen on more than two consecutive occasions. All but one of these incidents of carriage could be explained by close patient, rather than environmental, exposure and occurred despite an intensive control programme. Transient or short-term carriage in nurses probably resulted in transfer of the EMRSA between patients. Staff decontamination should be considered following a period of cohort nursing of EMRSA patients, especially if staff members are shortly to nurse unaffected patients. Our findings may explain some of the difficulties in controlling EMRSA. PMID- 2768438 TI - Growth and endotoxin production of Yersinia enterocolitica and Enterobacter agglomerans in packed erythrocytes. AB - Since 1987, the Centers for Disease Control investigated six cases of transfusion associated sepsis. All six patients developed septic shock after receiving units of packed erythrocytes (PRBCs) contaminated with Yersinia enterocolitica (five patients) and Enterobacter agglomerans (one patient); three of the blood recipients died. We studied the growth and endotoxin production of Y. enterocolitica and E. agglomerans in units of PRBCs stored at 4 degrees C for 60 days. When PRBCs were inoculated with 0.1 to 1.0 CFU of these organisms per ml, both Y. enterocolitica and E. agglomerans entered log-phase growth 2 to 3 weeks after inoculation; generation times were 15 and 22 h, respectively. Endotoxin was first detected at 3 weeks following inoculation, and the concentration paralleled the log phase of growth of the strains tested. These data show that prolonged storage of PRBCs at 4 degrees C provides conditions that allow these two organisms to grow and subsequently produce high concentrations of endotoxin. PMID- 2768439 TI - Quantitative determination of staphylococcal enterotoxin A by an enzyme-linked immunosorbent assay using a combination of polyclonal and monoclonal antibodies and biotin-streptavidin interaction. AB - A sandwich enzyme-linked immunosorbent assay to detect staphylococcal enterotoxin A (SEA) was developed by using monoclonal antibodies (MAb) to SEA as primary capture antibodies. The antigen was detected with purified rabbit anti-SEA antibody as the secondary antibody. The secondary antibody was identified by direct conjugation with biotin or via biotinylated sheep F(ab')2 fragments to rabbit antibody. The biotin was then reacted with avidin-alkaline phosphatase (AP) conjugate, avidin-biotin-AP conjugated complex, or streptavidin-AP conjugate. The enzyme was identified by using p-nitrophenylphosphate. The incorporation of the avidin-biotin-AP conjugated complex or streptavidin-AP conjugate augmented the sensitivity 32-fold over that of the enzyme-linked immunosorbent assay without these reagents. Controls were run by substitution of the anti-SEA MAb with unrelated MAb of the same isotype. Sample values were considered positive when the A405 exceeded those of the negative controls by 3 standard deviations (greater than 99% confidence interval). The toxin could be quantitated with purified SEA standards through linear regression analysis with lower detection limits of 4 ng/ml (r = 0.99) and 0.25 ng/ml (r greater than or equal to 0.98). Concentrations of protein A up to 10 micrograms/ml did not cause interference. Analyses of crude growth extracts of SEA-secreting strains of Staphylococcus aureus were reproducible and were expressed in terms of 95% confidence intervals. Lack of cross-reactivity was seen with extracts of other toxigenic and nontoxigenic strains of S. aureus. The assay can be completed in one working day, provided that MAb-coated plates are available. PMID- 2768440 TI - Comparison of hemagglutinin and agglutinin schemes for the serological classification of Haemophilus paragallinarum and proposal of a new hemagglutinin serovar. AB - Ninety-five isolates of Haemophilus paragallinarum were classified serologically by a hemagglutinin serotyping scheme, and the results were compared with results from agglutinin serotyping of the same isolates. Of the isolates, 65 were from Australia, 5 were from Japan, 6 were from the Federal Republic of Germany, 7 were from the United States, and 12 were from South Africa. Seven hemagglutinin serovars, HA-1 to HA-7, corresponding to agglutinin serovars A (HA-1, HA-2, and HA-3), C (HA-4, HA-5, and HA-6), and B (HA-7) have been described. Only one of the seven hemagglutinin serovars was found among the Australian isolates. This was serovar HA-5, comprising 49 isolates. Fifteen Australian isolates, all from southeast Queensland and northern New South Wales, were found to belong to a new hemagglutinin serovar. This was designated HA-8 and represented a fourth subgroup of agglutinin serovar A. Of the 95 isolates examined, only 1 did not produce a hemagglutinating antigen and was nonserotypeable by the hemagglutinin system. This compared favorably with the agglutinin scheme, which serotyped only 60 of the 95 isolates, with 29 nonserotypeable and 6 autoagglutinating. PMID- 2768441 TI - Clinical and epidemiologic aspects of members of Aeromonas DNA hybridization groups isolated from human feces. AB - Between June 1982 and May 1987 Aeromonas species were isolated from 208 of 34,311 (0.61%) fecal samples submitted to a Regional Public Health Laboratory in The Netherlands. Aeromonas isolates were found most frequently in summer and rarely in winter. Of 169 Aermonas isolates that were available for further study, 19% were isolated from patients with a mixed infection, 5% from patients with underlying diseases, and 15% from patients who used medication that could predispose the intestinal tract to colonization with Aeromonas species. Aeromonas species that produced cytotoxins to Vero cells (cytotoxigenic) were found in hybridization groups 1 (11% of all isolates), 2 (1%), 3 (2%), and 8 (25%) and were identified phenotypically as A. hydrophila or A. sobria. Aeromonas species that did not produce cytotoxins to Vero cells (noncytotoxigenic) were found in hybridization groups 4 (57%) and 5A (4%) and were identified phenotypically as A. caviae. Distribution of Aeromonas species by age showed a predominance of noncytotoxigenic strains in children under the age of 5 years (46% of all noncytotoxigenic strains), while cytotoxigenic strains were mainly cultured from patients aged 50 years or older (54% of all cytotoxigenic strains). Significant correlations were found between cytotoxigenic strains and hospitalization, foreign travel, and contact with surface water. Cytotoxigenic strains were isolated significantly more often than noncytotoxigenic strains from patients with diarrhea, but in a multivariate analysis including age, previous medication, underlying disease, and foreign travel, this association was not significant. PMID- 2768442 TI - Application of gas-liquid chromatography to the routine identification of nonfermenting gram-negative bacteria in clinical specimens. AB - A total of 430 strains of glucose-nonfermenting gram-negative bacteria representing 35 species were analyzed for their cellular fatty acid composition by gas-liquid chromatography (GLC). On the basis of qualitative differences in their cellular fatty acid composition, these bacteria could be divided into 19 distinct chromatographic groups. Eight Pseudomonas species, Achromobacter xylosoxidans, group Vd, and Agrobacterium radiobacter were identified from their fatty acid compositions alone. The other glucose-nonfermenting gram-negative bacterial species studied here, classified within nine distinct GLC groups, were easily recognized by using the GLC fatty acid analysis supplemented with a limited number of conventional biochemical tests. The results support the hypothesis that bacterial fatty acid composition is rather specific and that qualitative GLC fatty acid analysis can be adapted in the clinical laboratory either to provide additional criteria for differentiation of closely related groups or to serve as a rapid and highly reproducible method for their routine identification. PMID- 2768443 TI - Is ingestion of milk-associated bacteria by premature infants fed raw human milk controlled by routine bacteriologic screening? AB - Expressed human milk is often used to feed premature infants. Raw milk contains bacteria which may be a source of infection. Milk banks have developed screening programs which combine periodic quantitative milk cultures with arbitrary rules specifying limits of bacterial concentration. It is unknown whether such programs succeed in preventing infants from being fed milk containing bacteria. At the Health Sciences Centre (Winnipeg, Manitoba, Canada), milk is screened once weekly. When a woman's milk is found to have excess bacteria, it is discarded only if she is an unrelated donor (as opposed to an infant's mother). To assess the effectiveness of this screening program, we determined the frequency at which infants fed raw human milk were exposed to milk-associated bacteria and compared the bacterial contents of donor and maternal milk. From February 1986 to April 1987, all human milk fed to 98 premature infants during the first 2 weeks of feeding (n = 10,128 feeds) was cultured quantitatively. Among study infants, 100% were exposed at least once to coagulase-negative staphylococci, 41% were exposed to Staphylococcus aureus, and 64% were exposed to gram-negative bacilli. The proportions of feeds containing bacteria and the quantities (log10 CFU [mean +/- standard deviation]) ingested per positive feed were: 39% and 5.9 +/- 0.5 for coagulase-negative staphylococci; 2.4% and 5.1 +/- 1.0 for S. aureus; and 5.2% and 4.8 +/- 1.1 for gram-negative bacilli. There were no adverse events attributable to ingestion of milk-associated bacteria. Milk coagulase-negative staphylococcal isolates were multiply antibiotic susceptible, whereas infant isolates were antibiotic resistant. Donor milk was significantly less likely than maternal milk to contain coagulase-negative staphylococcal species in any quantity (40 versus 93% of samples, respectively [P < 0.001]) or in concentrations exceeding 10(8) CFU/liter (3 versus 27% of samples, respectively [P < 0.0001]). There was no difference between milk from either source in terms of S. aureus or gram-negative bacterial content (4 to 6%). These results suggest that the Health Sciences Centre screening program is effective in limiting the number of harmless coagulase-negative staphylococcal species but has no impact on the quantity of potentially pathogenic bacteria ingested by premature infants. Implications for screening donor milk are discussed. PMID- 2768444 TI - Subclass compositions of immunoglobulin G to pertussis toxin in patients with whooping cough, in healthy individuals, and in recipients of a pertussis toxoid vaccine. AB - The subclass composition of serum immunoglobulin G (IgG) antibodies against pertussis toxin was studied in 108 serum samples obtained during various stages of disease from 75 patients with whooping cough. IgG1 and IgG3 antibodies were detected in 92 and 42% of the samples, respectively, while only a few contained IgG2 or IgG4 antibodies. Similarly, IgG1 antibodies were predominant in serum samples from healthy children and adults, many of whom had a history of whooping cough several years earlier. Of 85 children and 30 adults with detectable levels of total IgG, 65 and 14 had IgG1 antibodies, respectively, while only 9 of them had IgG3 antibodies. Again, very few sera contained IgG2 or IgG4 antibodies. In contrast, 13 children vaccinated with an acellular aluminum-adsorbed pertussis toxoid vaccine responded mainly with IgG1 and IgG4 antibodies. In conclusion, this study showed that the subclass composition of IgG antibodies to pertussis toxin after natural infection consists mainly of IgG1 and to a certain extent of IgG3, while an aluminum-adsorbed pertussis toxoid induces IgG1 and IgG4 antibodies. PMID- 2768445 TI - Development of a diagnostic test for Johne's disease using a DNA hybridization probe. AB - A DNA probe, M13 mpHAW71, that detects Mycobacterium paratuberculosis in the fecal material of infected animals was developed for use in the diagnosis of Johne's disease. The probe detected as few as 10(5) M. paratuberculosis when hybridized under stringent conditions to total genomic DNA purified from bovine fecal material. When the probe was used diagnostically, it did not differentiate members of the Mycobacterium avium-M. intracellulare-M. paratuberculosis complex. Compared with culturing, the DNA probe identified 34.4% more mycobacterium containing fecal samples, and testing took only 72 h to complete. PMID- 2768446 TI - Xenorhabdus luminescens (DNA hybridization group 5) from human clinical specimens. AB - An unusual isolate from a human leg wound was identified as Xenorhabdus luminescens. This finding led to the discovery or isolation of four additional strains, two from blood and two from wounds. Three of the five strains were from patients in San Antonio, Tex. Three strains were studied by DNA-DNA hybridization (S1 nuclease-trichloroacetic acid method) and were 77 to 100% related to each other, 34% related to the type strain of X. luminescens, 35 to 40% related to three of Grimont's other DNA hybridization groups of X. luminescens, and 9% related to the type strain of Xenorhabdus nematophilus. The new group of five strains was designated X. luminescens DNA hybridization group 5. All five strains were very inactive biochemically and fermented only D-glucose and D-mannose. The key reactions for recognizing this new organism are yellow pigment production, negative test for nitrate reduction to nitrite, weak bioluminescence (10 to 15 min of dark adaptation is required to see the weak light produced), and a unique hemolytic reaction on sheep blood agar plates incubated at 25 degrees C. Two case histories of strains from wounds are given; these suggest that X. luminescens DNA hybridization group 5 may be a new bacterial agent that causes wound infections. The two cases of wound infection, along with the two blood isolates, suggest that the new organism is clinically significant. PMID- 2768447 TI - Antigen-antibody reaction in solution in capture competition immunoassay for human immunodeficiency virus antibodies. AB - In the capture competition immunoassay, undiluted serum was reacted in solution with purified human immunodeficiency virus (HIV) antigen in wells of microtest plates coated with anti-HIV immunoglobulin G antibodies (HIV capture antibodies). HIV antibodies present in the serum being tested combined with the HIV antigen and thus blocked (completely or partially) the fixation of the antigen to the capture layer. Unblocked antigenic activity was measured in subsequent steps by the use of biotinylated anti-HIV immunoglobulin G and peroxidase-conjugated avidin. The assay was evaluated in comparison with indirect enzyme-linked immunosorbent assay and Western (immuno-) blot (WB). A total of 180 serum samples which reacted repeatedly as positive in indirect enzyme-linked immunosorbent assay but negative in WB were found to be negative by the capture competition assay. Of 54 serum samples showing dubious reactions (single p24 bands in WB), 53 were clearly separated into positive or negative reactions, whereas 1 serum sample gave a borderline reaction. It was concluded that a characteristic feature of this kind of inhibition assay is a very low frequency of equivocal results. PMID- 2768448 TI - Long-term colonization of spinal cord injury patients with Klebsiella pneumoniae. AB - The duration of colonization of the human perineum, bowel, and urethra with Klebsiella pneumoniae was studied in 10 male patients with spinal cord injury while they were undergoing rehabilitation in the hospital. Colonization defined as persistence of klebsiellae of the same serotype occurred on 13 occasions in five of the patients for up to 55 days. Colonization was less marked with Klebsiella than with Pseudomonas spp. The presence of quadriplegia correlated with Klebsiella colonization and also with the presence of positive Klebsiella cultures from the urethra and perineum. Seven episodes of significant bacteriuria occurred with or after the finding of positive cultures from body sites. PMID- 2768449 TI - Haemophilus infection in a colony of laboratory rats. AB - During routine quality control of laboratory rodents, short gram-negative rods with satellite growth adjacent to a Staphylococcus strain were isolated from rats. They proved to be members of the family Pasteurellaceae. On the basis of their dependence on V factor they were classified as Haemophilus sp. Systematic investigations in our laboratory rat colony revealed a high prevalence of these bacteria. They were isolated from 75 of 446 rats (16.8%) which were monitored by culture during a 2-year investigation. Most strains were isolated from the lungs and the trachea; some were cultured from the nasal cavity and the female genital tract. Antibodies to these bacteria were detected in sera from 385 of 829 rats (46.5%) by using an indirect immunofluorescence test. The majority of culturally and serologically positive animals came from three separate holding areas; they all came from the same breeder. Investigation of rats immediately on receipt from the breeder showed that they were culturally and serologically positive for Haemophilus sp. Histological examination of rats which were monoinfected with Haemophilus sp. showed a mild inflammatory cell infiltration in the lungs and a light diffuse hyperemia. In the physiological and biochemical investigations of 53 isolates, all strains had an identical biochemical profile. On the basis of the 35 criteria examined, a definite classification is not possible. These Haemophilus bacteria are probably members of a hitherto unknown species. PMID- 2768451 TI - T-mod pathway, a reduced sequence for identification of gram-negative urinary tract pathogens. AB - In this paper, we describe a reduced sequence of identification that includes T mod medium, a selective and differential isolation medium which allows accurate presumptive identification of the most common gram-negative bacteria encountered in urine samples. The present study, performed on bacteria isolated from 1,762 independent urine samples, has shown that a few selected tests (lysine and ornithine decarboxylase, urease and trehalose fermentation tests) improve the identification accuracy of T-mod, making it possible both to identify the less frequent species and to prevent some misidentifications of Klebsiella pneumoniae and Proteus mirabilis. The proposed work flow agreed with conventional identification protocols to a 99.3% extent and allowed identification of 87.4% of the isolates directly from the primary plate, 11.4% after 1 to 3 additional tests, and 1.2% after an identification gallery. PMID- 2768452 TI - Long-term storage of Campylobacter pylori. AB - A reproducible method for long-term storage of Campylobacter pylori has been previously described. We cultured 10 strains of C. pylori in brucella broth that was supplemented with 10% fetal bovine serum. After incubation for 24 h, 10% glycerol and an additional 10% fetal bovine serum were added to the cultures, which when then held in storage at -70 degrees C. After 6 months, each of the strains remained viable. This technique, therefore, represents an excellent method for long-term storage of C. pylori isolates. PMID- 2768450 TI - Immunoblot detection of class-specific humoral immune response to outer membrane proteins isolated from Salmonella typhi in humans with typhoid fever. AB - The studies reported here were undertaken to assess the ability of the outer membrane proteins (OMPs) of Salmonella typhi to induce a humoral immune response in humans with typhoid fever. OMPs were isolated with the nonionic detergent Triton X-100 and were found to be contaminated with approximately 4% lipopolysaccharide. Sodium dodecyl sulfate-polyacrylamide gel electrophoresis patterns showed protein bands with molecular size ranges from 17 to 70 kilodaltons; the major groups of proteins were those that correspond to the porins and OmpA of gram-negative bacteria. Rabbit antiserum to OMPs or to S. typhi recognized OMPs after absorption with lipopolysaccharide. Sera from patients with typhoid fever contained immunoglobulin M antibodies which reacted with a protein of 28 kilodaltons and immunoglobulin G antibodies which reacted mainly with the porins, as determined by immunoblotting. These results indicate that the porins are the major immunogenic OMPs from S. typhi and that the immune response induced in the infection could be related to the protective status. PMID- 2768453 TI - Recovery of human immunodeficiency virus type 1 from supernatant fluid of routine viral cultures. AB - Peripheral blood mononuclear cell samples from human immunodeficiency virus (HIV) antibody-positive subjects were inoculated into cell cultures used for routine viral isolation to determine if HIV could survive in them. HIV was recovered from 5 (19%) of 26 day 1 supernatants and from four of the five samples in all three types of cell cultures. We conclude that HIV may survive for at least 24 h in standard virology cell culture systems and therefore is a potential risk for laboratory personnel. PMID- 2768455 TI - Rahnella aquatilis, an unusual gram-negative rod isolated from the bronchial washing of a patient with acquired immunodeficiency syndrome. AB - Rahnella aquatilis, a rare enteric gram-negative rod which is usually found in fresh water, was isolated from the bronchial washing of a patient with acquired immunodeficiency syndrome. Although few clinical isolates have been reported, this is the second isolation of R. aquatilis from a human in North Carolina. A case report and discussion of R. aquatilis is presented. PMID- 2768454 TI - Development and testing of a synthetic oligonucleotide probe for the detection of pathogenic Yersinia strains. AB - A 24-base oligonucleotide probe specific for a region of the Yersinia enterocolitica virulence plasmid (pYV) associated with HEp-2 cell cytotoxicity and the Sereny reaction was constructed by using sequences flanking critical TnphoA insertions in a subcloned fragment of pYV. This probe, highly specific and sensitive for virulent yersiniae, detected pathogenic Y. enterocolitica isolates in artificially inoculated foods. PMID- 2768456 TI - Isolation of Neisseria canis in mixed culture from a patient after a cat bite. AB - We report a case of identification of Neisseria canis in a human patient after a cat bite. This organism was isolated from a mixed culture together with Pasteurella multocida and Eikenella corrodens. It is the second case report of a human infection. PMID- 2768457 TI - Characteristic bacteriolytic activities of Staphylococcus hyicus. AB - Staphylococcus hyicus demonstrated characteristic bacteriolytic activities towards a Micrococcus luteus reference strain. This lytic activity was demonstrated on medium containing M. luteus cells as large zones of transparency around the culture streak. Smaller zones of transparency were observed with Staphylococcus intermedius, Staphylococcus chromogenes, and some strains of Staphylococcus aureus but not with other coagulase-negative staphylococcal species. The distribution and extent of the bacteriolytic activity could be useful as additional criteria for differentiation of S. hyicus. PMID- 2768459 TI - Passive hemagglutination test for detection of antibodies to human immunodeficiency virus type 1 in developing countries. PMID- 2768458 TI - Campylobacter cinaedi is normal intestinal flora in hamsters. AB - During the course of studies to reproduce proliferative enteritis in hamsters, Campylobacter cinaedi was recovered from the feces of the majority of healthy hamsters obtained from two commercial sources. The organisms were cultured by using filtration, a nonselective medium, and a microaerophilic atmosphere containing hydrogen. Isolation was hindered by the fastidious nature of C. cinaedi and by the presence of other Campylobacter species in the hamster intestine. All hamster C. cinaedi isolates were phenotypically similar to C. cinaedi ATCC 35683. Comparison of whole-cell protein profiles of one hamster isolate with a reference strain of C. cinaedi by sodium dodecyl sulfate polyacrylamide gel electrophoresis and immunoblotting with C. cinaedi-specific rabbit antiserum supported the phenotypic identification of these isolates. Hamsters may be an animal reservoir for human C. cinaedi infections. PMID- 2768460 TI - Elevated levels of immunoglobulin A to Giardia lamblia during a waterborne outbreak of gastroenteritis. AB - During an outbreak of diarrheal illness among residents of a trailer park in rural Vermont, 37 (30%) of 122 residents met the case definition of outbreak related giardiasis. Convalescent-phase sera from 24 residents and 20 nonresident control subjects were tested by enzyme-linked immunosorbent assay for immunoglobulin G (IgG), IgM, and IgA antibodies to Giardia lamblia. Residents showed higher levels of parasite-specific antibody than did nonresident controls for IgG and IgA but not IgM. Nine residents with giardiasis had a higher median level of G. lamblia-specific IgA but not IgG or IgM than 15 healthy residents (0.61 versus 0.16 optical density units; P = 0.004). Moreover, parasite-specific IgA levels were higher in those consuming tap water than in those who did not (0.31 versus 0.08 optical density units; P = 0.03) and increased with increasing water consumption. Levels of serum antibody to G. lamblia, particularly IgA, may be useful in determining exposure to G. lamblia-contaminated water and illness from G. lamblia during waterborne outbreaks of diarrheal illness. PMID- 2768461 TI - Ear punch biopsy method for detection and isolation of Borrelia burgdorferi from rodents. AB - An ear punch biopsy method for the detection and isolation of Borrelia burgdorferi from rodents was developed. The ear punch biopsy proved to be extremely sensitive, detecting spirochetes in 100% (11 of 11) of laboratory hamsters infected by tick bite and 95.8% (23 of 24) of hamsters infected by intraperitoneal inoculation. When cultured at 4 to 6 weeks postinfection, 92 to 100% of the ear punches taken from individual hamsters yielded viable spirochetes. B. burgdorferi was detected in sequential cultures from animals as early as 4 days postinfection and as late as 20 weeks postinfection. A total of 86% (6 of 7) of field-collected white-footed mice (Peromyscus leucopus) which were positive for B. burgdorferi as determined by xenodiagnosis were also positive by the ear punch method. The ear punch biopsy method allows individual rodents to be sampled for B. burgdorferi serially over a long period and thus should prove useful for both field and laboratory experiments. PMID- 2768462 TI - Identification of Borrelia burgdorferi and B. hermsii using DNA hybridization probes. AB - Fragments of plasmid DNA from Borrelia burgdorferi and B. hermsii were cloned and tested for specificity as hybridization probes to identify these two species of pathogenic spirochetes. Three fragments from the 49-kilobase-pair linear plasmid of B. burgdorferi were tested: a 500-base-pair (bp) HindIII fragment (probe 49A), a 445-bp PstI-HindIII fragment (probe 3G), and a 320-bp HindIII fragment (probe 16H). When hybridized to purified DNA or whole spirochetes, all of the probes distinguished B. burgdorferi from the other species examined, including B. hermsii, B. parkeri, B. turicatae, B. coriaceae, B. crocidurae, and B. anserina. Probe 49A was the most useful, however, hybridizing with all strains of B. burgdorferi originating from both North America and Europe while not cross hybridizing with B. hermsii. A 790-bp HindIII fragment of B. hermsii DNA hybridized with DNA and whole spirochetes of this species and also with B. parkeri, confirming the close relatedness of these two species. These probes provide a new method of identifying these Borrelia species once the organisms have been grown in culture. PMID- 2768463 TI - Improved growth of Campylobacter pylori in a biphasic system. AB - The recovery of Campylobacter pylori from clinical specimens is difficult, even when done with an optimal medium, atmosphere, and temperature. The growth of this organism was investigated by comparing a biphasic system with broth culture. The effects of gyration, inoculum, and pH were studied. Brucella agar and broth supplemented with 2.5% fetal bovine serum were used. Growth in the biphasic system was an average of 2 log units (7 X 10(8) versus 5 X 10(6) CFU/ml) greater than that in the broth system (P less than 0.01), and this occurred 12 to 24 h sooner in the biphasic system. When gyration was added, an average of 1 log unit of growth improvement was seen in comparable systems. Improved growth was also seen with low inoculum levels, in which stationary-phase cells in the broth system reached 10(5) CFU/ml compared with 10(7) CFU/ml in the biphasic system. At the three pH ranges studied, growth was best at pH 8 to 9 (6 X 10(9) CFU/ml), averaging 2 log units greater growth than that at pH 6 to 7 and 4 log units greater growth than that at pH 4.5 to 5.5 (P less than 0.01). The improved recovery of the organism for low inoculum levels in a biphasic system may be important for long-term storage and clinical isolation. PMID- 2768464 TI - Pulmonary persistence of Haemophilus somnus in the presence of specific antibody. AB - Chronic experimental Haemophilus somnus pneumonia was produced in five 8- to 12 week-old calves to investigate host-parasite relationships in the respiratory tract. Calves were depressed and pyrexic and coughed intermittently for 3 days and then recovered except for sporadic coughing. Bacteria persisted in the lung for 6 to 10 weeks or more. Immunoglobulin G1 (IgG1), IgG2, and IgM but no IgA antibodies specific for H. somnus were detected in serum. Bronchoalveolar lavage samples contained detectable IgG1, IgG2, IgM, and IgA antibodies specific for H. somnus throughout most of the experiment. The kinetics of the isotypic antibody response against H. somnus in serum and bronchoalveolar lavage fluids differed, suggesting that both local and systemic antibody responses had occurred. Persistence of pulmonary infection for 10 weeks or more in the presence of antibody may be due to an inappropriate distribution of isotypes, toxicity of H. somnus for bovine macrophages, and perhaps other factors. Three of the calves were challenged with a 10-fold-higher dose of H. somnus at 10 weeks after the original inoculation. Immunity against H. somnus was indicated by the rapid clearance of bacteria from the lungs and the presence of minimal pneumonia at necropsy 3 days after bacterial challenge. PMID- 2768465 TI - Identification of EF group 22 campylobacters from gastroenteritis cases as Campylobacter concisus. AB - EF (E. Falsen) group 22, a group of Campylobacter strains sorted out by routine immunotyping among unidentified or misidentified human nonoral clinical specimens, was characterized by numerical analysis of gel electrophoretic protein profiles and immunotyping. The protein electrophoretic and immunotyping analyses, DNA:DNA hybridizations, and the DNA base composition demonstrated unambiguously that all EF group 22 strains belong to Campylobacter concisus. EF group 22 strains have DNA binding values of at least 42% with the type strain of C. concisus, showing a considerable degree of genomic heterogeneity. The isolation from blood, esophagus, stomach, duodenum, and feces of humans in association with different gastrointestinal disorders considerably extends the clinical significance of this species. Our results indicate that sodium dodecyl sulfate polyacrylamide gel electrophoresis and immunotyping are excellent tools for the identification of the fastidious C. concisus strains and relatives. PMID- 2768466 TI - Characterization of Aeromonas sobria hemolysin by use of monoclonal antibodies against Aeromonas hydrophila hemolysins. AB - Aeromonas sobria produces hemolysin in a form activable with trypsin under defined cultural conditions. In immunoblotting analyses with the culture supernatant of A. sobria, the monoclonal antibody reacting specifically to Aeromonas hydrophila CA-11 hemolysin bound to the 53,000- and 49,000-dalton bands before and after trypsinization, respectively. The monoclonal antibody reacting to A. hydrophila AH-1 hemolysin did not bind either band. A. sobria hemolysin is, therefore, related antigenically to CA-11 hemolysin, while the molecular weights before and after activation differ from those of A. hydrophila hemolysins, being 54,000 and 51,000, respectively. The hemolytic and enterotoxigenic activities of A. sobria hemolysin were both neutralized by the monoclonal antibody against CA 11 hemolysin. It seems, therefore, that the same site on A. sobria hemolysin is responsible for both biological activities. PMID- 2768467 TI - Direct and sensitive detection of a pathogenic protozoan, Toxoplasma gondii, by polymerase chain reaction. AB - We applied the polymerase chain reaction to detection of the pathogenic protozoan Toxoplasma gondii based on our identification of a 35-fold-repetitive gene (the B1 gene) as a target. Using this procedure, we were able to amplify and detect the DNA of a single organism directly from a crude cell lysate. This level of sensitivity also allowed us to detect the B1 gene from purified DNA samples containing as few as 10 parasites in the presence of 100,000 human leukocytes. This is representative of the maximal cellular infiltration (10(5)/ml) in 1 ml of cerebrospinal fluid obtained from patients with toxoplasmic encephalitis. The B1 gene is present and conserved in all six T. gondii strains tested to date, including two isolates from patients with acquired immunodeficiency syndrome. No signal was detected by using this assay and DNAs from a variety of other organisms, including several which might be found in the central nervous system of an immunocompromised host. This combination of sensitivity and specificity should make detection of the B1 gene based on polymerase chain reaction amplification a very useful method for diagnosis of toxoplasmosis both in immunocompromised hosts and in congenitally infected fetuses. PMID- 2768469 TI - New datum handling methods for the quality control of antibiotic solutions and plates used in the antimicrobial susceptibility test. AB - Quality control programs are described for monitoring both the antibiotic solutions and the plates used in the dilution antimicrobial susceptibility test. For the quality control of antibiotic solutions, a simple comparative disk diffusion assay is used in which the data are expressed as zone ratios calculated from the following formula: zone ratios = mean zones of inhibition for disks impregnated with antibiotic under test/mean zones of inhibition of previously prepared quality control disks impregnated with the same antibiotic. The rejection limits set for this method are twice as stringent as for MIC estimation, and its precision is four times greater. For quality control of the antibiotic agar plates, fluid was absorbed directly into filter paper disks placed on the surface of the medium. These disks were then transferred to a seeded plate to produce zones of inhibition. These zones of inhibition were then converted to zone ratios by dividing the zone of inhibition for the individual antibiotics by the mean of the total zones of inhibition for all the antibiotics tested on the same plate. We further normalized these data by expressing each entry as a standard normal deviate calculated from the mean and standard deviation of the cumulative data for each individual antibiotic. The use of zone ratios reduced batch-to-batch variation, and standard normal deviate values gave a uniform result for convenience. The method has a sensitivity equal to that of an MIC estimation if it were possible to estimate the MICs of antibiotics at these low levels. PMID- 2768468 TI - Surface properties and ultrastructure of Edwardsiella species. AB - Twenty-two strains of Edwardsiella representing the three currently recognized species were evaluated for surface characteristics and ultrastructural morphology. All isolates tested possessed a high surface cell charge as detected by DEAE-cellulose chromatography; surface hydrophobicity was variable and strain but not species dependent. Two major types of adhesins detected by hemagglutination assays were identified: one was inhibited by D-mannose (mannose sensitive hemagglutinin) and found on all three species, and a second was not inhibited by D-mannose (mannose-resistant hemagglutinin) and was principally associated with Edwardsiella tarda. The results of physiologic and ultrastructural studies suggest that both hemagglutinins are afimbrial adhesin proteins. The results of these studies suggest that there are a number of distinct surface and ultrastructural properties associated with each of the three Edwardsiella species. PMID- 2768470 TI - Characterization of Aeromonas schubertii strains recently isolated from traumatic wound infections. AB - Recent studies have resulted in the proposal of a new species, Aeromonas schubertii (mannitol, sucrose, and indole negative), formerly termed Enteric Group 501, on the basis of the study of seven strains isolated from the southeastern and southwestern United States and Puerto Rico. We have isolated two phenotypically similar A. schubertii strains from infected human wounds sustained in the Chesapeake Bay area. Their identification was confirmed by DNA-DNA hybridization to the Centers for Disease Control definition strain 2446-81 (ATCC 43700) for group 12. The strains were further examined for the presence of virulence-associated markers: hemolysin, hemagglutinins, cytotoxin production, agglutination in acriflavine, resistance to normal human serum, and autoagglutination phenotype. Both strains were positive for hemolysin by the plate assay, cytotoxin production at 1:10, and DNase and protease. They were resistant to human serum and negative for acriflavine agglutination, and only one of the strains was autoagglutination positive. Both strains were negative for cell-free hemolysin, hemagglutinins, pectinase, and chitinase. These isolations of A. schubertii further extend its previously described geographic distribution and reinforce its role as a primary causative agent of cellulitis with possible increased antimicrobial resistance. PMID- 2768471 TI - Use of an rRNA probe and restriction endonuclease analysis to fingerprint Pasteurella multocida isolated from turkeys and wildlife. AB - Twenty-five isolates of the bacterium Pasteurella multocida were characterized (fingerprinted) phenotypically and genotypically in order to compare the abilities of various techniques to differentiate strains for epidemiologic studies of fowl cholera. Isolates were obtained over a 16-month period from turkeys dying from fowl cholera (six outbreak flocks) and from wildlife captured on premises with a history of the disease. The characteristics compared included (i) serotype, (ii) subspecies, (iii) antibiogram, (iv) presence of plasmid DNA, (v) restriction endonuclease analysis patterns of whole-cell DNA, and (vi) ribotype. Ribotyping, a method of highlighting DNA restriction site heterogeneity by using an rRNA probe, worked well for differentiating the strains of P. multocida when the majority of the other techniques could not. Ribotyping results correlated directly with and confirmed results obtained from restriction endonuclease analysis. Ribotyping demonstrated the presence of up to three strains of P. multocida in one outbreak flock, recurrence of a single strain in five of the flocks over an 11-month period, and the presence of common strains in turkeys and wildlife on the premises. PMID- 2768472 TI - Levels of the Candida metabolite D-arabinitol in sera of steroid-treated and untreated patients with sarcoidosis. AB - We measured the Candida metabolite D-arabinitol and its enantiomer L-arabinitol in 42 serum samples from 33 patients with sarcoidosis and compared the results with those from 27 healthy adults and 4 patients with candidiasis. The D- and L arabinitol concentrations and the D- and L-arabinitol/creatinine ratios did not differ significantly in the sarcoidosis patients and the controls; the D arabinitol concentrations and the D-arabinitol/creatinine ratios were much higher in the patients with candidiasis. Among the patients with sarcoidosis, the D- and L-arabinitol levels in the steroid recipients did not differ significantly from those in patients not receiving steroids. Higher D-arabinitol/creatinine ratios were associated with roentgenographic evidence of pulmonary fibrosis and low forced vital capacities, but not with disease activity as determined by the proportion of lymphocytes to total nucleated cells in bronchoalveolar lavage fluid or the CD4/CD8 ratio in bronchoalveolar lymphocytes. We conclude that neither sarcoidosis nor corticosteroid treatment is associated with high levels of D-arabinitol in serum. PMID- 2768473 TI - Use of nasal and pharyngeal swabs for rapid detection of respiratory syncytial virus and adenovirus antigens by enzyme-linked immunosorbent assay. AB - Nasal and pharyngeal swabs from 134 children with acute respiratory diseases were examined for the presence of respiratory syncytial (RS) virus and adenovirus antigens by enzyme-linked immunosorbent assay (ELISA). The results were compared with those obtained by virus isolation and serology. Altogether, 56 RS virus positive (prospective study), 51 adenovirus-positive (retrospective study), and 27 negative (prospective study) samples were examined. The sensitivities of ELISA were 96 and 98% for RS virus and adenovirus antigen detection, respectively. No false-positive results were observed. It is concluded that the joint eluate from a nasal and a pharyngeal swab, properly taken and handled, serves well for the detection of RS virus and adenovirus acute respiratory infections by ELISA. PMID- 2768474 TI - Vibrio cholerae non-serogroup O1 cystitis. AB - We report a case of a patient who developed cystitis caused by non-serogroup O1 Vibrio cholerae after swimming in the Chesapeake Bay. Treatment was empirical, with complete symptomatic resolution. Genitourinary tract infections by Vibrio spp. are uncommon but should be considered when cystitis occurs after saltwater exposure in appropriate geographic regions. PMID- 2768475 TI - Evaluation of neutralizing antibodies to type A, B, E, and F botulinum toxins in sera from human recipients of botulinum pentavalent (ABCDE) toxoid. AB - Twenty-five serum specimens from personnel immunized with botulinum pentavalent toxoid (ABCDE) had titers of neutralizing antibodies to type A (5.7 to 51.6 IU/ml), type B (0.75 to 18 IU/ml), and type E (0.61 to 10 IU/ml) botulinum toxins. Titers for one type could not be used to predict titers for another type in individuals receiving the toxoid. Cross-neutralizing antibodies to type F botulinum toxin were not detected (less than 0.0125 IU/ml). PMID- 2768476 TI - Determination by enzyme-linked immunosorbent assay of immunoglobulin G (IgG), IgM, and IgA to Brucella melitensis major outer membrane proteins and whole-cell heat-killed antigens in sera of patients with brucellosis. AB - An enzyme-linked immunosorbent assay was used to compare Brucella melitensis major outer membrane proteins (MOMP) and whole-cell heat-killed antigens (HK) in measuring antibrucella immunoglobulin G (IgG), IgM, and IgA in sera of brucellosis patients and controls. Antibodies to MOMP were generally similar to those against HK, and the correlation coefficients between the two antigens and IgG, IgM, and IgA in patients varied between 0.73 and 0.94. Both antigens are comparably suitable in detecting antibrucella immunoglobulin isotypes for the serologic diagnosis of patients with brucellosis, with high (greater than or equal to 95%) sensitivity and specificity. PMID- 2768477 TI - Case report of Plesiomonas shigelloides-associated persistent dysentery and pseudomembranous colitis. AB - An adult Bangladeshi woman had persistent bloody diarrhea. Repeated stool cultures yielded Plesiomonas shigelloides in pure growth. Tissue specimens of the colon were consistent with pseudomembranous colitis. Treatment with tetracycline, to which the isolate was susceptible, brought prompt recovery; the stool cultures became negative and the serum antibody titer against P. shigelloides lipopolysaccharide, as measured by hemagglutination inhibition with P. shigelloides lipopolysaccharide-sensitized sheep erythrocytes, declined from 1:160 to 1:40. PMID- 2768478 TI - An alternative pathway of actin filament elongation. The condensation of small oligomers. PMID- 2768480 TI - Tongue flap repair of oro-nasal fistulae in cleft palate patients. A review of 20 patients. AB - At University College Hospital, between 1980 and 1985, sixty patients with cleft lip and palate deformity underwent transpalatal maxillary advancement for the correction of mid-face hypoplasia. One third of these patients subsequently required closure of oro-nasal fistulae and we present the results of these twenty cases where anteriorly based dorsal tongue flaps were used. Seventeen were successful and the causes of three failures are discussed. PMID- 2768479 TI - Orbital measurements in 63 hyperteloric patients. Differences between the anthropometric and cephalometric findings. AB - Anthropometric and cephalometric orbital measurements were compared in 63 North American Caucasian patients (24 males, 39 females) aged 3 to 29 years who had 13 craniofacial syndromes involving hypertelorism. The hypertelorism, which was diagnosed anthropometrically, was mild in 11 patients, moderate in 25 and severe in 27. The surface intercanthal width was larger than the bony interorbital distance in all patients (mean 12.2 mm). The differences were smaller in mild cases and larger in severe cases. The soft-tissue binocular width was shorter than the bony lateral orbital distance in 53 patients, by a mean of 4.4 mm; in the other 10 patients the two measurements were identical. The hypertelorism was confirmed by cephalometry in 8 of the 11 cases identified as mild by anthropometry (72.7%), 24 of the 25 moderate cases (96.0%) and 25 of the 27 severe cases (92.6%). The abnormally wide surface intercanthal distance was matched by an abnormally wide bony interorbital distance in 57 of the 63 patients (90.5%). In the other six patients (3 with the mild form, 1 with the moderate form and 2 with the severe form) the bony widths were near the upper limit of the normal range (mean + 2 standard deviations). PMID- 2768482 TI - Patient information and patient preparation in orthognathic surgery. The role of an information brochure a medical audit study. AB - In a retrospective study on 166 patients who had undergone orthognathic surgery, the influence of an information brochure on patient information, satisfaction and dissatisfaction was investigated. Although the use of an information manual was appreciated by the patients and can be recommended, its influence on patient preparation for surgery was poorer than was expected. Verbal information by effective communication between the surgeon and the patient remains the key to patient preparation. PMID- 2768481 TI - Facial growth after treatment of unilateral temporomandibular joint ankylosis in childhood without growth centre transplantation. A serial cephalomorphometric study. AB - Our aim was to study the influence of early surgical treatment of temporomandibular joint ankylosis on further facial growth and development. At the Department of Maxillo-Facial Surgery, Zurich, 11 children with a unilateral TMJ-ankylosis met the criteria of a maximal preoperative interincisal mouth opening of 15 mm, of a minimal long-term postoperative interincisal mouth opening of 30 mm, and of excellent documentation. 30 anatomical landmarks were defined on the copies of the follow-up cephalograms using the structure-superimposition technique. The points were perforated and digitized. Analysis and graphic plotting were followed by computer. The hypothesis that mandibular growth continues once the ankylosis was successfully treated (without transplantation of a growth centre) and mandibular function definitely restored, was confirmed. The treatment does normalize the growth rate, but it seems that abnormal growth patterns cannot be influenced by it. As a consequence, the surgical release of the ankylosis should be performed as early as possible. PMID- 2768483 TI - Anxiety reduction in children receiving medical care: developmental considerations. AB - The present investigation examined the importance of considering age-related conceptual abilities when designing preparation interventions for hospitalization and medical procedures. Forty-eight children, ages 3-5 years and 7-10 years, viewed videotaped information about an upcoming medical procedure. The children were assigned to one of three treatment conditions: control, developmentally appropriate information, developmentally advanced information. Results suggest that information which is designed to match the age-related conceptual abilities of the recipient more effectively reduces anxiety and increases cooperation. Implications for future research evaluating efficacy of preparation strategies are noted. PMID- 2768485 TI - Smokeless tobacco use among adolescents: correlates and concurrent predictors. AB - Seventh grade students (N = 1539) from three regions of New York State were surveyed to determine the prevalence of smokeless tobacco use and its relationship to seven background variables, 13 substance use variables, and 19 psychosocial variables. Significant correlations with smokeless tobacco use were found within each of these variable domains. Concurrent predictors for each domain were determined using logistic regression analysis. The resulting three models were combined in a stepwise fashion in an effort to determine the most complete prediction model. The final model indicated that individuals at the highest risk for using smokeless tobacco were rural males who had smoked more than four cigarettes in their lifetime, were more heavily involved with alcohol, had a lower degree of assertiveness and social anxiety, and had reported eating as a coping response. Implications for prevention are discussed. PMID- 2768484 TI - Television's influence on children's diet and physical activity. AB - Understanding the impact of TV on children's diet and physical activity is important for developing strategies to prevent obesity and sedentary lifestyles. Determining parents' perceptions of television's influence on children's dietary intake and physical activity may provide useful information on this important topic. A questionnaire was developed to assess viewing habits and child requests for food and sport items advertised on TV. It was administered to 66 mothers of children, ages 3-8. Foods that children requested because they had seen them on TV paralleled the frequencies with which these foods were advertised on TV. Weekly viewing hours correlated significantly with (a) reported requests by children and purchases by parents of foods influenced by TV, and (b) children's caloric intake. Children's requests for sport items and physical activities were not significantly correlated with the number of hours of TV viewing. It appears from these data that parents perceive that television influences family purchasing patterns through the mechanism of their children's requests. PMID- 2768486 TI - Pediatric burn prevention: an evaluation of the efficacy of a strategy to reduce tap water temperature in a population at risk for scalds. AB - The efficacy of a strategy to prevent tap water scalds was evaluated in a population at risk. Educational pamphlets and liquid crystal thermometers for testing water temperature were distributed to 12 families, each of which had at least one child under the age of 3 and one child over the age of 3. Participants were visited individually by an investigator who monitored tap water temperature in a standardized manner and personally provided the educational material. No statistically significant decrease in hot water temperature occurred as a result of the intervention. The number of heaters operating at a safe temperature was not statistically different pre- and postintervention. Whether participants altered their thermostat settings or not, there was a tendency to maintain postintervention settings at 1-month follow-up. Capitalizing on this tendency by installing heaters at preset safe temperatures was discussed, as were changes in heater design and areas for additional research. PMID- 2768487 TI - Mothers' attitudes and their children's behaviors in 3-year-olds born prematurely and at term. AB - A sample of 94 mothers and their 3-year-old children participated in a cross sectional study to measure maternal overprotective attitudes and children's behavior problems. Mothers in the full-term group (n = 47) were matched to mothers in the preterm group (n = 47) on maternal age, maternal education, and marital status. The groups were balanced for the child's gender, birth order, and mother's nationality. The subjects answered the Mother-Child Relationship Evaluation (MCRE) to measure maternal attitudes and the Behavior Screening Questionnaire (BSQ) to measure behavior problems in preschoolers. Overall, children born prematurely have the same incidence of behavior problems as children born full-term. However, the subgroup of preterms who had respiratory distress syndrome (RDS) had a higher incidence of behavior problems. Conversely, the results suggest that mothers of children born prematurely without RDS have more overprotective attitudes towards their children. Maternal overprotection is minimally associated with behavior problems. PMID- 2768488 TI - Coordination of care for pediatric AIDS: the development of a Maternal-Child HIV Task Force. AB - As of 1988, 78% of all reported pediatric human immunodeficiency virus (HIV) infections were secondary to maternal transmission. With blood screening and treatment of Factor 8 essentially eliminating transfusion as a vector for HIV, the issues of obstetrical and pediatric HIV infections are functionally identical. This paper describes one institution's approach to the coordination of clinical care and research between obstetrics and pediatrics. The development of a Maternal-Child HIV Task Force has facilitated cooperative submission of studies, and the mutual education and support required to sustain competent and caring clinical care. Direct patient care is similarly coordinated through the Maternal-Child Immunology Clinic, where an interdisciplinary group of medical and clinical specialists provide comprehensive care for these children and mothers. Suggestions are made for other institutions encountering similar issues. PMID- 2768490 TI - DSM-III diagnosis and code types of the Diagnostic Inventory of Personality and Symptoms in public hospital settings. AB - The relationships of high-point code types of the Diagnostic Inventory of Personality and Symptoms (DIPS) to the Diagnostic and statistical manual III of the American Psychiatric Association (DSM-III) were explored for public hospital patients (N = 448). Nineteen DIPS code types that relate code types to Axis I diagnoses are prepared. The three DIPS personality disorder cluster scales and the eight combinations thereof are presented as well. Eight of the personality disorder cluster scale code types that relate to DSM-III Axis II categories are identified. Finally, a narrative summation of each of the code types is given. PMID- 2768489 TI - The contributions of self-defeating philosophies, perceived helplessness, and repression to anxiety among psychiatric patients. AB - Four of the most influential psychological explanations for the development of anxiety attribute it to (1) repressed awareness of undesirable emotions; (2) the emergence of unacceptable feelings from the unconscious; (3) adherence to irrational, self-defeating philosophies; and (4) perceived helplessness/lack of control over one's affairs. To test these theories, the authors administered the Trait Anxiety, Denial, Irrational Beliefs, and Locus of Control scales to 190 psychiatric inpatients. Appropriate zero-order, attenuation-corrected, multiple, and partial correlations were run. Denial was correlated negatively with Trait Anxiety; this is consistent with the view that awareness of unpleasant emotions generates anxiety, but does not support the claim that it is the result of repression. The correlations of Trait Anxiety with the Irrational Beliefs scale were substantial. However, its relationships with Locus of Control were limited and nonsignificant after the effects of the Denial and Irrational Beliefs scales were removed statistically. The findings lend support to the positions that anxiety results from self-defeating philosophies and/or the emergence of unpleasant thoughts about oneself, but give only modest support to the "perceived helplessness" hypothesis and seem to contradict the "excessive repression" explanation. PMID- 2768491 TI - Anger, hostility, and depression in assaultive vs. suicide-attempting males. AB - Hostility and depression were examined in male psychiatric patients who exhibited either assaultive (n = 40) or suicide-attempting behavior (n = 20). Both groups were compared to a sample of nonviolent males (n = 22) to provide a basis for interpreting the absolute as well as relative magnitude of these variables in relation to their violent behavior. Both suicide-attempting and assaultive patients were characterized by high levels of hostility and depression, as evidenced by significantly higher scores than those of the nonviolent group on almost all indices. Assaultive subjects evidenced relatively greater overt expression, frankly assaultive impulses, and verbalized anger and hostility. Suicide-attempting subjects tended to experience anger and hostility in a more intropunitive and covert manner and displayed higher levels of guilt and depression. Covariance analyses indicated that anger and depression contributed separately to the affective configuration of the assaultive and suicide attempting groups. PMID- 2768492 TI - Clinical meaning of the Keane PTSD Scale. AB - A correlational study that included 82 male inpatient alcoholics was conducted to determine the clinical meaning of the Keane PTSD Scale of the MMPI. The PTSD Scale was correlated with the variables of the Shipley Institute of Living Scale, the Life Purpose Questionnaire, the Existential Depression Test, and the standard MMPI measures, plus the A, R, Es and MacAndrew Scales. The pattern of correlations suggested that the PTSD scale measures general psychological maladjustment and dysphoric feelings rather than any specifiable syndrome. The strong correlation with the Welch A, which measures a general level of maladjustment, suggests that the PTSD and Welch A scales are measuring the same factor. The PTSD scale, therefore, appears to provide very little information about this population beyond that available from the overall clinical profile and the Welch A scale. PMID- 2768493 TI - Treatment outcomes of Vietnam veterans with PTSD and the consistency of the MCMI. AB - This study addresses two issues: treatment changes on the MCMI of Vietnam veterans with PTSD and test-retest reliability of the Millon Clinical Multiaxial Inventory (MCMI). Fifty Vietnam veterans carefully were identified for the diagnosis Post-Traumatic Stress Disorder (PTSD). They were admitted to a Special PTSD Treatment Unit that consisted of an intense 5-week period with focus on the revivified Vietnam experience. They also were given the MCMI at two points in time, treatment inception and 35 days later at discharge. Results show that 17 of 20 scales on the MCMI changed in the negative direction as a result of treatment. Also, the MCMI has adequate test-retest reliability, and the personality scales (with the exception of Borderline) have higher reliability coefficients than do symptom scales. The use of the MCMI is encourged both as a monitor of treatment for these veterans and for its stability. PMID- 2768494 TI - Replicated item level factor structure of the MMPI: racial and sexual differences. AB - Item-level factor studies of the MMPI date back to the work of Comrey (1957). Surprisingly, there are no extant studies of the items that clinicians use most in the course of daily MMPI interpretive reporting, namely, the 399 x 399 matrix that represents all of the items that comprise the traditional clinical and validity scales. Furthermore, there are no prior studies with adequate Ns that have examined the replicability of MMPI factor structure via available factor comparison techniques (Harman, 1976). In this study, 20,000 MMPIs were factored by the principal components method, followed by Varimax rotations of 6 through 25 factors. The coefficient of congruence was used to compare the factor structures of randomly divided subsamples, as well as males vs. females and Blacks vs. Whites. Differences in factor structure were found, and suggestions are made with regard to the significance of these findings in clinical and applied settings. PMID- 2768495 TI - An external validity study of the MMPI Personality Disorder Scales. AB - This study examined the external validity of the MMPI Personality Disorder (PD) scales. Patients diagnosed with personality disorders (n = 23), according to a structured interview, were contrasted with medical control subjects and psychiatric patients with no personality disorder (n = 33). The MMPI PD scales could discriminate patients with any personality disorder and patients with specific clusters of personality disorders. Convergent validity was demonstrated by high correlations between the MMPI PD scales and the comparable Millon Clinical Multiaxial Inventory scales, as well as the number of DSM-III personality disorder symptoms. This study represents a preliminary step in the external validation of the MMPI PD scales. PMID- 2768497 TI - Disguise and the structured self-report assessment of psychopathology: II. A clinical replication. AB - Previous research on the use of disguise in structured tests of psychopathology is extended to a clinical population. Based on a sample of 112 adult psychiatric patients for whom clinical criterion ratings were obtained, psychopathological test item validities were calculated and related to indices of test item disguise. Data contraindicated the use of disguise and were interpreted in terms of the various philosophies of test construction that underlie the structured assessment of psychopathology. In particular, results suggested the merit of a rational test construction strategy that emphasizes the use of relevant test item content. PMID- 2768496 TI - The utility of MMPI subtle, obvious scales for detecting fake good and fake bad response sets. AB - The MMPI was administered twice to 40 graduate students to determine the utility of the Weiner subtle and obvious scales (D, HY, PD, PA, MA) for estimating how fake good and fake bad response sets might influence full scale scores. The first time, the MMPI was administered under standard conditions. Subjects then were divided randomly into two groups: fake good (complete MMPI for job application) and fake bad (qualify for psychotherapy). There were significant multivariate test effects (standard vs. response set) for the raw scores of all five obvious, subtle, and full scales. However, when raw scores were converted to T scores to ascertain practical significance, the obvious scales appeared to provide the most useful information to enhance the interpretation of full scale scores in normal populations. PMID- 2768498 TI - Psychological kinship, love, and liking: preliminary validity data. AB - Psychological kinship refers to valuing significant others as though they were members of one's own family. This construct has many implications for human relationships, including the client-therapist relationship (Bailey, 1988). A 60 item Kinship Scale was developed and administered to 63 undergraduates (39 females; 24 males), along with several other independent measures of sociality (Rubin Love and Liking scales; EPPS Affiliation, Nurturance, and Succorance scales; abbreviated UCLA Loneliness Scale) and the Spiritual Well-Being scales. Subjects took the Kinship, Love, and Liking scales under two cognitive sets, "closest family member" and "acquaintance," while the other scales were taken in regular fashion. The Kinship, Love, and Liking scales were all sensitive to the cognitive sets and appropriately yielded higher mean values and higher correlations with the independent measures vis-a-vis the "closest family member" as opposed to "acquaintance." Significant sex differences were noted, with stronger correlation patterns for males than females. Overall, the Kinship Scale performed very well and shows considerable promise for future research. PMID- 2768499 TI - What does the Beck Depression Inventory measure in college students? Evidence from a non-western culture. AB - This investigation of the factor structure of the Beck Depression Inventory (BDI) was designed to assess Gotlib's (1984) claim that the BDI is more a measure of general psychopathology than a specific measure of depression when administered to student samples. The data were collected from Iranian students and provide further information about the performance of the BDI in a non-Western culture. Principal components analysis of the responses to items 1-20 of the BDI (N = 405) revealed five factors with different degrees of similarity to findings of Hill, Kemp-Wheeler, and Jones (1986). Within subsamples, the factor scores were predicted in multiple regression analysis from Eysenck Personality Inventory subscales (N, P, E, L), James' I-E scale, and two measures of self-esteem. Results indicated that the five factors had distinctly different relationships to the other personality scales. The most general factor seemed to be a measure of helplessness and self-devaluation. These results confirm the usefulness of the BDI as a measure of depression in college student populations, even in non Western cultures. PMID- 2768500 TI - The prevalence of borderline personality symptomatology among women with eating disorders. AB - This study assessed the prevalence of borderline personality symptomatology among women with eating disorders. The Diagnostic Interview for Borderlines, Millon Clinical Multiaxial Inventory, and Borderline Syndrome Index were administered to 28 women in a hospital-based eating disorders program. Results revealed that 39% were classified as borderline on at least one measure, 29% on at least two measures, and 18% on all three. Recovered restricters were particularly prone to borderline personality symptomatology. This study improves upon previous work in this area by employing multiple measures of borderline personality, assessing eating disorder subgroup differences, and recruiting subjects from a single eating disorder treatment program. PMID- 2768501 TI - Full moon: does it influence agitated nursing home residents? AB - This study examined the effect of the full moon on agitation manifested by nursing home residents (N = 24). Observations of agitation were recorded on a behavioral mapping instrument, and occurrence of the full moon was operationalized in the three ways most commonly cited in the literature. The hypothesis that elderly nursing home residents become increasingly agitated during a full moon was not supported by this study. In all analyses, agitation was observed less often when the full moon was full than during the other three lunar phases, although differences were not statistically significant. PMID- 2768502 TI - Performance of inattentive-overactive children on selected measures of prefrontal type function. AB - Several theorists have suggested that childhood inattention-overactivity ("attention deficit disorder," "hyperactivity") may arise from a deficit in the inhibitory mechanisms of the prefrontal cortex. Accordingly, it was hypothesized that inattentive-overactive children would exhibit prefrontal-type deficits on several relevant neuropsychological measures. Subjects were 21 elementary school pupils who had been referred for disruptive behavior problems and who had been rated as high in inattention-overactivity. Controls were 26 age-matched normal children from the same school. It was found that the Inattentive-Overactive group, relative to the Control group, performed in the direction of prefrontal type deficit on three measures that have an empirical history of discriminating patients with prefrontal lesions from controls: Perseverative errors on the Wisconsin Card Sorting Test, errors on the sequential Matching Memory Task, and Necker Cube reversals. On three theoretical indices of prefrontal-type deficit- Trailmaking, the Stroop Color-Word Test, and a sequential memory task for children--the Inattentive-Overactive group also exhibited predicted deficits. There were no differences between groups on the WISC-R Vocabulary subtest. The results of the study are generally compatible with a prefrontal-deficit theory of inattention-overactivity. However, the presence of other deficits cannot be ruled out nor can an organic cause be inferred from these findings alone. PMID- 2768503 TI - The equivalence of the WAIS-R and the WISC-R at age 16. AB - Two studies were conducted in which the Wechsler Intelligence Scale for Children- Revised (WISC-R) and the Wechsler Adult Intelligence Scale--Revised (WAIS-R) were administered in a counterbalanced design to 144 (72 in each study) randomly selected high school students between the ages of 16 years, 0 months and 16 years, 11 months in order to determine their equivalence by testing the equality of (a) means; (b) variances; and (c) validity coefficients based on the scaled scores and IQs. Results indicated that the two scales, with the possible exception of the Verbal IQ, were not equivalent (either with respect to subtest scores or IQs) because they did not satisfy the necessary criteria. These findings contradict those reported by Wechsler in 1981 concerning these two scales for a similar age group. PMID- 2768504 TI - Gifted and nongifted race and gender effects on item functioning on the Kaufman Assessment Battery for Children. AB - This study examined differential item function on the K-ABC for gifted and nongifted subjects on the basis of race and gender using the technique for partial correlation proposed by Stricker (1982) and Reynolds, Willson, and Chatman (1984). It was determined that there were no items biased against gifted Black children and that 8 items were biased against gifted White children. Three items were found to be biased against nongifted Black children, while 4 items were biased against nongifted White children. When gender was considered, 2 items were found to be biased against gifted males, and 2 items also were found to be biased against gifted females. There were 10 items that were biased against nongifted Black males and 6 items biased against nongifted females. Systematic bias against race or gender was not found. It appears that the K-ABC is a relatively nonbiased test suitable for the evaluation of both gifted and nongifted children regardless of race or gender. PMID- 2768505 TI - Pattern analysis of Wechsler Intelligence Scale for children-revised profiles of delinquent boys. AB - To help meet the prescriptive needs of juvenile delinquents more effectively, an analysis of the Wechsler Intelligence Scale for Children-Revised (WISC-R), utilizing Lutey's model of Factor Analytic measures, was performed on 82 profiles obtained from male subjects (aged 13-16) in a Wisconsin correctional facility. Results support the trends of previous studies of juvenile delinquency; a significant 70% of the subjects (chi 2 6.4, p less than .05) had a higher Performance than Verbal score (M = 13.2). The Performance-Verbal results were also significant (t = 4.824, p less than .001). Object Assembly, Picture Completion, and Picture Arrangement were the three highest subtests and Information, Vocabulary, and Coding/Comprehension the lowest. Clusters that measure perceptual and psychomotor abilities yielded high scores, while most verbal ability clusters, Memory, Verbal Comprehension, Freedom from Distractability, and General Factor scores were the lowest. Results indicate that prescriptive models should consider these findings in planning successful educational programs for this population. The need for further studies that involve extensive assessments which include neurological testing for various age groups and gender populations is stressed. PMID- 2768506 TI - The effects of cognitive complexity and arousal on client perception of counselor nonverbal behavior. AB - This analogue study examined the interaction between cognitive complexity and arousal in client discrimination of counselor positive and negative nonverbal behavior. Thirty university students, divided into low, medium, and high arousal conditions, viewed a videotaped counseling interview in which the counselor nonverbal behaviors were varied systematically and then rated counselor perceived expertness. The results showed that subjects discriminated counselor positive and negative nonverbal behaviors in the early portion of a 30-minute interview, but this tendency deteriorated quickly as the interview progressed. Also, there was a significant interaction between subject cognitive complexity and arousal level. Implications of the findings are discussed. PMID- 2768507 TI - Stereotypic beliefs about women as moderators of stress-distress relationships. AB - Health psychologists have begun to examine the mediating effect of gender roles in stress-distress relationships. One particular area in which attention has been focused concerns the impact of "stereotypic" beliefs about women on the distress that individuals experience in response to stressful life experiences. The present investigation examined the extent to which the gender stereotypes measured by the Beliefs About Women Scale (BAWS; Belk & Snell, 1986) intensify the impact of stressful life experiences. The results indicated that among individuals with a recent history of stressful experiences in their lives, a personal adherence to the gender stereotypes assessed by the BAWS was associated with elevated distress. PMID- 2768508 TI - MMPI profiles of malingerers diagnosed in pretrial forensic evaluations. AB - The MMPI has several indices associated with exaggeration of symptomatology, but they have seldom been researched with actual malingering subjects. Based upon interview behavior during pretrial forensic evaluations, samples of malingering (n = 18), psychotic (n = 17), and nonpsychotic (n = 36) criminal defendants were assembled for the present study. Both the malingerers and the psychotics either were untestable or produced incomplete or random MMPIs in about 50% of the cases. Comparisons of remaining profiles revealed significant differences between malingerers and other groups on several MMPI scales and F-K index. Discriminant analysis accurately classified malingerers and psychotics on the basis of MMPI variables. The MMPI may have considerable utility to detect malingering when subjects cooperate with testing. PMID- 2768509 TI - Who needs cutting points? AB - Individual scores of discriminative tests can be connected to an estimate of the confidence of classification, which obviates the need for cutting points. Such estimates can be corrected for base rate conditions. It is suggested that, while base rates are largely imponderable, the prior probabilities of individual cases are not. PMID- 2768510 TI - Stuttering severity and treatment outcome. AB - This study evaluated a multidimensional treatment of stuttering (awareness training, regulated breathing, cognitive restructuring and relapse prevention) for mild, moderate and severe stutterers. Behavioral measures (percentage of syllables stuttered and rate of speech) and cognitive measures (self-efficacy perception, locus of control and Erickson Scale) were taken. Using three multiple baseline designs across subjects, results showed that all mild stutterers and most moderate stutterers were clinically improved at the end of treatment and at six months follow-up. No severe stutterers (more than 15% of syllables stuttered) achieved clinical improvement. Self-efficacy perceptions were quite accurate in predicting the performance of successfully treated patients. No consistent changes were observed on the locus of control or the Erickson Scale. The clinical and theoretical implications of the results are discussed. PMID- 2768511 TI - A self-monitoring technique for increasing productivity in multiple media. AB - During the baseline condition the number of lines written on a word processor and the amount of time spent on studio art were recorded. During Phase I self recording of the number of lines written were graphed. Additional baseline information was obtained concerning the time spent on studio art. In Phase II both the number of lines written and time spent on art were recorded. Treatment effects were maintained at a 10 months follow-up. PMID- 2768512 TI - Behavioral treatment of night bingeing and rumination in an adult case of bulimia nervosa. AB - A 24-year-old female, diagnosed as bulimia nervosa with night bingeing and rumination, was treated by individual and group behavior therapy. A changing criterion design progressively adjusted the criterion for reinforcement as the treatment obtained diminution of night bingeing. Night bingeing was finally eliminated, without evidence of recurrence at 3 month and 2 year follow-ups. Rumination was regarded as a collateral behavior and diminished in tandem with reduction of night bingeing. Other improvements in bulimia nervosa were observed over the course of treatment. PMID- 2768513 TI - Teaching socially appropriate behavior to eliminate hoarding in a brain injured adult. AB - A brain injured male hoarded large quantities of unuseable items at every opportunity. The treatment consisted of two phases. First, he was taught to collect baseball cards. Second, after each meal, the client was provided with an apron and a glove and asked to pick up trash in the area and deposit the trash in an appropriate receptacle. If he hoarded, he was told not to pick up trash without his apron and glove and escorted to a quiet area for about 10 seconds. The procedure was successful in suppressing the behavior within 8 days. PMID- 2768514 TI - The review of "anxiety": a comment. PMID- 2768516 TI - Polydipsia in schizophrenic patients. PMID- 2768515 TI - Polydipsia, water intoxication, and psychiatric illness. PMID- 2768517 TI - Preventing water intoxication: a reply. PMID- 2768518 TI - Lack of significant effect of therapeutic propranolol on measurable platelet function in healthy subjects. AB - Propranolol, a non-selective beta blocker, was administered orally in therapeutic doses. The effects of a single dose (160 mg) and one week's treatment (80 mg twice a day) on platelet function were compared in healthy young subjects. There were no significant changes in circulating platelet aggregates, template bleeding time, platelet factor 3 availability and thromboxane beta 2 (TX beta 2) generation. Platelet aggregation responses as assessed by angle of slope and maximal percentage aggregation (all agonists) and lag phase (collagen) showed no changes of biological importance, although minor changes reaching significance were observed with some agonists. These findings suggest that propranolol does not significantly affect platelet function when taken at doses commonly encountered in clinical practice. PMID- 2768519 TI - Chromosome 22 abnormalities in Ewing's sarcoma. AB - A child with disseminated Ewing's sarcoma underwent cytogenetic investigations which showed different structural rearrangements of chromosome 22 at diagnosis (?ring22), and at relapse [t(10;22)], but the classic translocation t(11;22) was not detectable. This case provides further evidence of the importance of chromosome 22 in this disease, while raising some questions about the central importance of the translocation between chromosomes 11 and 22. PMID- 2768520 TI - Peptic (contact ulcer) granuloma of the larynx. AB - Review of published work and analysis of clinical data and pathology of four biopsy specimens from two patients with laryngeal contact granuloma showed that its peptic origin was derived from a gastro-oesophago-laryngeal reflux. It is proposed that the term "peptic granuloma" should be given to this phenomenon. This term is given further support on account of the spectacular recovery of the laryngeal lesion following antacid and antireflux treatment, rather than the traditional method of using vocal rest and speech therapy, assumed to be the best way of treating a result of mechanical irritation, the previously accepted cause of laryngeal contact granuloma. PMID- 2768521 TI - Variation in histomorphometric estimates across different sites of the iliac crest. AB - Bone specimens were obtained from four different sites in the ilium of necropsy cases using a Jamshidi 8G trephine needle. Undecalcified histological sections were prepared and two structural histomorphometric parameters were estimated. Estimates of the percentage of trabecular bone volume (%TBV) deviated systematically, with variation of the biopsy site around the usual location, increasing in magnitude from the anterior to the posterior ilium. Such differences highlight the importance of understanding the degree of variation which exists in histomorphometric data. The histomorphometry of a vertical biopsy specimen of the iliac crest did not differ significantly from that of a transilial biopsy specimen of similar diameter taken from an adjacent site. When taken at the standard site, and when providing a long core of cancellous bone, with minimal discomfort to the patient, the vertical biopsy specimen compares well with the transiliac biopsy specimen for use for investigating metabolic bone disorders. PMID- 2768522 TI - Use of subcutaneous abdominal fat biopsy specimen for detailed typing of amyloid fibril protein-AL by amino acid sequence analysis. AB - A simple technique for the purification of amyloid fibril proteins from patients with systemic amyloidosis was used on a 45 year old woman. The method is based on the use of a surgical subcutaneous fat tissue biopsy specimen which was used for the characterisation of the amyloid as a kappa I AL-protein by amino acid sequence analysis. The method permits the exact typing of amyloid in many patients with systemic amyloidosis, which, until now has been almost exclusively confined to necropsy tissue. PMID- 2768523 TI - Topographic association between active gastritis and Campylobacter pylori colonisation. AB - One thousand biopsy specimens obtained from 10 sites in the stomachs of 50 patients were examined for the presence of active chronic gastritis and Campylobacter pylori. All 32 patients with active chronic gastritis at 234 out of 320 sites were positive for C pylori: 227 showed colonisation with C pylori by the Warthin-Starry stain; and 222 were positive by culture. C pylori was not found in 18 patients with inactive chronic gastritis or histologically normal mucosa. The area of C pylori colonisation was larger than the area of active chronic gastritis in 289 positive specimens on culture and 261 on staining, respectively, suggesting that C pylori colonisation may precede the development of active chronic gastritis. It is concluded that patchy distribution of active chronic gastritis and C pylori colonisation must be considered, particularly in serology or breath test studies where the histological examination serves as a reference. Furthermore, it may have important implications for the follow up of patients after antibacterial treatment. The topographic and specific association of C pylori and active chronic gastritis provides further evidence for the pathogenic role of C pylori in active chronic gastritis. PMID- 2768524 TI - Use of protein profiles to identify Acinetobacter calcoaceticus in a respiratory care unit. AB - The presence of acinetobacters in a respiratory care unit was prospectively studied because of an increase in the number of isolations of Acinetobacter calcoaceticus. Cell envelope protein electrophoresis was used to distinguish strains. Eleven protein patterns were observed in isolates from patients and their environment. One pattern (pattern 1) was seen in several patients and environmental samples. Another pattern (pattern 2) was identified repeatedly in samples from skin and mucous membranes of patients in the same ward. After thorough cleaning was undertaken throughout the unit, the pattern 1 strain was no longer cultivated from clinical samples. It is concluded that cell envelope protein electrophoresis is a useful method for tracing epidemic strains of A calcoaceticus. PMID- 2768525 TI - ACP Broadsheet 122: August 1989. Platelet function testing. PMID- 2768526 TI - Pathology of the spleen in large granular lymphocyte leukaemia. PMID- 2768527 TI - Diagnosis of intestinal microsporidiosis in patients with AIDS. PMID- 2768528 TI - Visual aid for quick assessment of coronary artery stenosis at necropsy. PMID- 2768529 TI - Elimination of parallax error in haematocrit readings using reflexion haematocritometry. PMID- 2768530 TI - Epithelioid haemangioendothelioma of terminal ileum after therapeutic irradiation. PMID- 2768531 TI - Staphylococcus lugdunensis endocarditis. PMID- 2768532 TI - Comparison of latex and haemolysin tests for determination of anti-streptolysin (ASO) antibodies. PMID- 2768533 TI - Marking planes of surgical excision on specimens with mixture of India ink and acetone. PMID- 2768534 TI - Adhesion of stainable, calcium-rich deposits on substrata with different surface free energies. An in vivo study in beagle dogs. AB - Calculus plays an important role in chronic inflammatory periodontal disease and tooth loss. Patients can suffer from calculus formation despite good oral hygiene. The strength of adhesion between calculus and the enamel surface, though not determinant for the formation of calculus itself, determines whether calculus remains on the teeth during eating and toothbrushing. In this study, the amount and the strength of adhesion of calcium-rich deposits formed in vivo on different materials are related to substrate surface free energies (sfe). In 4 beagle dogs, fenestrated crowns were made on the upper fourth premolars. Smooth facings of glass (sfe 120 mJ.m-2), polished bovine enamel (sfe 85 mJ.m-2), polymethylmethacrylate (PMMA sfe 56 mJ.m-2) and polytetafluorethylene (PTFE sfe 20 mJ.m-2) were inserted in the crowns for 1, 3, 7, 14 or 28 days. The amount of deposit was evaluated both gravimetrically and planimetrically using Alizarin Red S for staining. Adhesion of calcium-rich deposits was evaluated planimetrically by studying their removal in a brushing machine. Dry weight increased linearly with time (approximately 0.18 mg.cm-2 per day) and was slightly less on PTFE than on the other materials. After 1 to 3 days, staining already revealed a 100% coverage by calcium-rich deposits. The number of strokes required to reduce the planimetric scores by 63% was extremely small on PTFE and PMMA and related with substrate surface free energies. This study shows that a possible way to reduce calculus formation in vivo is to decrease the surface free energy of the enamel using appropriate surfactants in, e.g., toothpastes. PMID- 2768535 TI - A 10-year retrospective study of periodontal disease progression. AB - The purpose of this study was to record the rate of periodontal disease progression over a 10-year period with respect to individual subject, age and tooth type. 283 subjects, who had undergone a full-mouth radiographic examination in 1974-76 and at that time were 25-70 years old, were randomly selected from a larger patient sample for a new radiographic examination in 1985-86. 201 subjects (71%) agreed to participate. For each respondent, tooth loss over the 10-year period was calculated. The radiographic bone height at the mesial and distal aspect of all teeth was assessed by measuring the distance between the cemento enamel junction and the bone crest. Difference in periodontal bone height between the 2 examinations was calculated for each tooth site. The results revealed that the mean number of teeth lost over the 10-year period was 3.8 (SD 4.6). Tooth mortality, expressed as a % of the no. of teeth present at the initial examination, increased with age and varied between 2.9%-28.5%. In all age groups, molars had the highest and canines the lowest rate of tooth mortality. The frequency of subjects with loss of greater than 10 teeth was highest for the initially 45-year old individuals (20%). 7 individuals (3%) had become edentulous. The mean annual reduction of alveolar bone height varied between 0.07 0.14 mm in the age groups 25-65 years. The initially 70-year old subjects showed a statistically significant higher annual rate of bone loss (0.28 mm).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2768536 TI - Direct and immune-cell-mediated effects of Bacteroides gingivalis on bone metabolism in vitro. AB - We investigated direct and immune-cell-mediated effects of Bacteroides gingivalis on bone metabolism in vitro. Fetal mouse long-bone rudiments were cultured under aerobic conditions in the presence of (a) intact bacteria, (b) low molecular weight (MW less than 1000) metabolic products of the bacteria, or (c) conditioned media of mouse spleen cells activated by whole bacteria. A suspension of intact bacteria, added directly to the bone culture, had no effect on bone resorption or bone formation. Low molecular weight (MW less than 1000) excretion products of the bacteria inhibited bone resorption and transiently reduced mineralization of the diaphysis, while the growth in length of the bones was not affected. However, conditioned media of bacteria-activated spleen cells strongly enhanced bone resorption and increased osteoclast numbers in the bone culture, while inhibiting mineral formation in the diaphysis. This led to a strongly negative mineral balance. These data do not support a direct effect of either bacteria or bacterial products on bone tissue as a likely explanation for bone loss in periodontal disease. Rather, they favour the concept that the loss of bone in this disease is an indirect effect of the host response, resulting from the contact of immune cells with the bacteria. This implies that bacterial invasion of the connective tissue of the gingiva may not be a prerequisite for alveolar bone loss. PMID- 2768537 TI - Comparison of manual and power toothbrushing, with and without adjunctive oral irrigation, for controlling plaque and gingivitis. AB - We compared the effects of four oral hygiene methods (manual tooth-brushing, power toothbrushing, manual toothbrushing plus irrigation, and power toothbrushing plus irrigation) on plaque and periodontal disease. These methods were tested both when used alone and when used in conjunction with professional mechanical oral hygiene. 108 subjects were clinically assessed for plaque, stain, gingival inflammation, bleeding to probing, probing depth and attachment loss, and randomly assigned to one of the 4 oral hygiene groups. Subjects were carefully instructed in the use of their assigned method and asked to discontinue all other forms of oral hygiene. After 3-months, subjects returned for re examination and full-month professional mechanical oral hygiene care. 3 months later, subjects returned for a final oral examination. All subjects kept a diary of use of their assigned method and were called every 2 weeks to monitor discomfort, provide reinforcement and answer questions. Results showed that all the oral hygiene methods were equally effective in reducing plaque and stain accumulation, gingival bleeding, bleeding to probing ratio and the % of pockets 4 mm or deeper. None of the oral hygiene methods was associated with injury to soft or hard tissues. PMID- 2768538 TI - Reproducibility of microscopic and cultural data in repeated subgingival plaque samples. AB - In association studies, micro-organisms can only be recognized as suspects for playing a major role in the development of a pathological environment, if their destructive action goes along with a marked proportional increase of their numbers or if their first detection can be related to the clinical onset of the disease. Limitations in the reproducibility of repeated samples have to be taken into account, when changes of the microbial composition of subgingival environments are to be studied, and when local clinical changes are to be related to shifts in the composition of the pertaining microbiological compartment. To study reproducibility, a total of 109 sites was sampled repeatedly with sterile paperpoints at an interval of 7 to 10 days in 24 patients suffering from periodontal disease and 12 edentulous patients wearing successful and failing osseointegrated titanium implants. Using continuous anaerobic techniques, the samples were cultured on nonselective and selective media and were studied by darkfield microscopy. Both the intertest-agreements of frequencies of detection (kappa-statistics) as well as the discrepancies of proportions of bacterial groups and selected bacterial species were determined. The standard deviation of proportional differences between first and second samples ranged between 6.4% (fusiform organisms) and 17.2% (coccoid cells) for darkfield parameters, between 4.3% (B. melaninogenicus on ETSA/Kana.) and 14.0% (B. gingivalis on ETSA/Kana.) for selected bacterial species and between 6.9% (gram-negative anaerobic cocci) and 24.0% (gram-positive facultative cocci) for bacterial groups classified according to gram stain characteristics and atmospheric growth conditions.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2768539 TI - Gingival health and gingivitis development during puberty. A 4-year longitudinal study. AB - The purpose of this investigation was to follow the development of the gingival conditions during puberty and to correlate oral clinical parameters with chronological age as well as with parameters used for the determination of the pubertal development. In 22 boys and 20 girls pubertal and skeletal development, as well as plaque index (PlI) and gingival index (GI) were monitored at 1-year intervals between the ages of 11 and 15 years. During this time, the papillary bleeding index (PBI) was assessed 10 times in all interdental spaces of the dentition. The bleeding tendency, represented by whole mouth mean PBI values, as well as the % of bleeding interdental sites, was found to increase significantly with the start of the pubertal phase. It reached a peak value after 1-5 years in 35% of the children. A significant trend of decrease was noted after the age of 14 years in boys and girls. In boys, mean PBI and the % of interdental sites with bleeding were correlated with testes growth, in girls with the Tanner index for secondary sex characteristics (breast development). PlI and GI, which were only recorded annually, did not show a significant trend of increase or decrease. PMID- 2768540 TI - Gingivitis in the deciduous and permanent dentition. An experimental study in the dog. AB - The present investigation was performed in order to study the reaction of the gingiva in the deciduous and permanent dentition of dogs to 3 weeks of plaque accumulation. The study was carried out in 10 beagles, divided into 2 groups of 5 dogs each; group I and group II. When the dogs of group I were 10 weeks old, a meticulous plaque control regimen was initiated in order to establish clinically healthy gingiva. After 6 weeks of plaque control, the gingivae of the lower deciduous molars was exposed to a clinical examination, and biopsies as well as bacterial plaque samples were harvested from tooth 03P and 02P. A second plaque control regimen was initiated when the same dogs were 15 months old. After 6 weeks of plaque control, the gingiva of the permanent dentition was examined and biopsies sampled from tooth P3 and P4. In the dogs of group II, plaque control regimens of 3 weeks duration were initiated when the animals were 10 weeks and 15 months old. Clinical examinations were performed at the end of each 3-week period. Immediately after the clinical examinations. 3-week periods of plaque accumulation were initiated. Examinations and plaque sampling were performed after each of these 3-week periods and biopsies were sampled from the deciduous and permanent dentition as described for group I. The biopsies were processed for histometric and morphometric measurements. The findings from the experiment showed that careful plaque control resulted in the establishment of clinically healthy gingiva. In both the deciduous and permanent dentition, however, a clinically healthy gingiva was found to contain a small inflammatory cell infiltrate (ICT). 3 weeks of plaque accumulation resulted in both dentitions in the development of clinical signs of gingivitis and in the formation of comparatively large ICT. The large ICT of the permanent gingiva resided in the coronal portion of the free gingival unit, while in the deciduous dentition, the inflammatory lesion occupied a narrow tissue portion along the entire border of the dento-gingival epithelium. The ICT of the permanent gingiva harbored a larger portion of plasma cells than the inflammatory lesion studied in the deciduous dentition. PMID- 2768541 TI - The microbiota of early periodontitis lesions in adults. AB - The predominant cultivable microbiota of shallow progressive (active) periodontal lesions in 4 adults (29-40 years) was compared to that of shallow inactive sites. Periodontal attachment levels were monitored longitudinally, and sites showing 2 3 mm attachment loss in the previous 1-2 months were considered disease active. Inactive sites showed no change in attachment level. The microbiota of shallow sites was dominated by gram negative rod species including Wolinella recta, Bacteroides forsythus, and Fusobacterium nucleatum. W. recta was isolated in higher incidence and proportions from the active compared to inactive sites, and showed a positive relationship to bleeding on probing. Cluster analysis of species isolated from sites grouped sites from each individual together. This preliminary investigation suggested that a similar range of pathogens may be related to early periodontitis in adults as that previously reported for advanced diseased sites, and that different subjects may demonstrate different periodontal infections. PMID- 2768543 TI - Plasma trazodone concentrations and clinical response in elderly depressed patients: a preliminary study. AB - Steady-state plasma levels of trazodone were determined by HPLC in 11 elderly depressed patients who underwent a 5-week pharmacological treatment with 150 mg/day trazodone in three oral administrations. Clinical antidepressant response, assessed with three different clinical improvement criteria, was significantly correlated with steady-state plasma trazodone concentrations. Moreover, the steady-state plasma trazodone concentration of 650 ng/ml was identified as the threshold value for a good antidepressant response. No correlation was found between the occurrence of side effects and plasma levels of trazodone. PMID- 2768542 TI - Amitriptyline versus haloperidol in borderlines: final outcomes and predictors of response. AB - The authors report the final results of a 4-year study of amitriptyline and haloperidol in 90 symptomatic borderline inpatients. Medication trials were double-blind and placebo controlled and lasted 5 weeks. Haloperidol (4-16 mg/day) produced significant improvement over placebo in global functioning, depression, hostility, schizotypal symptoms, and impulsive behavior. Significant effects of amitriptyline (100-175 mg/day) were generally limited to measures of depression. Factor analysis identified three symptom change patterns: a global depression, hostile depression, and schizotypal symptom pattern. Medication effects favoring haloperidol were most prominent for hostile depression. Variables predicting favorable response to haloperidol included severity of schizotypal symptoms, hostility, and suspiciousness. Schizotypal symptoms and paranoia predicted poor outcome on both depression patterns with amitriptyline. Placebo effects were most prominent on acute state symptoms, with severe character traits predicting poor response. PMID- 2768544 TI - Trazodone treatment of bulimia nervosa. AB - Thirteen consecutive referrals of bulimic patients who met DSM-III criteria for bulimia were treated in an open-label, flexible-dose study with trazodone. Three of the 13 dropped out before the fourth week of treatment, the minimum duration of treatment for evaluable subjects, and hence were not included in the analyses. For the 10 evaluable patients, the mean duration of treatment was 6.9 weeks and the mean maximum dose of trazodone was 410 mg (range, 250-600 mg). The number of binge eating and vomiting episodes was significantly decreased (p = 0.05 and 0.06, respectively). These episodes were reduced to zero in four patients and by 55-99% in two patients. Carbohydrate cravings and urges to binge eat were significantly diminished in intensity (p less than 0.02 and 0.008, respectively). The total score (p = not significant) and three subscale scores (p = 0.04, 0.09, and 0.10) of the Eating Disorders Inventory decreased. The mean Hamilton Depression Scale score fell from 10.4 to 3.3 (p = 0.002). Only mild side effects were noted: five subjects complained of morning drowsiness and two of headache. Mean weight was essentially unchanged: pretreatment, 58.5 kg; posttreatment, 57.3 kg. The lack of weight gain represents an advantage of trazodone over other currently prescribed antidepressants, particularly for this group of patients whose fear of becoming fat is a part of their basic pathology. PMID- 2768545 TI - Manic psychosis associated with appetite suppressant medication, phenylpropanolamine. PMID- 2768546 TI - Phenelzine-associated inappropriate ADH secretion. PMID- 2768547 TI - Pharmacokinetic properties of maprotiline in geriatric depression. PMID- 2768548 TI - Sex-specific neuronal respecification during the metamorphosis of the genital segments of the tobacco hornworm moth Manduca sexta. AB - At metamorphosis, the terminal abdominal segments of larvae of the moth Manduca sexta transform into either male or female genitalia. At the start of this transformation, the larval muscles degenerate but their remains may persist to form the scaffolding on which the new adult muscles differentiate. The survival and subsequent orientation of larval muscle remnants is determined by the sex of the individual and is independent of motor innervation at the start of metamorphosis. Many of the larval motoneurons persist through metamorphosis and innervate the skeletal muscle of the adult. The survival of particular motoneurons is also sex-dependent and correlated with the survival of its respective muscle remnant. No new skeletal motoneurons arise postembryonically, so all of the adult skeletal muscle motoneurons are derived from preexisting larval skeletal muscle motoneurons. The fates during metamorphosis are more complex for the visceral muscle motoneurons. Those innervating the adult hindgut of both sexes are identical and are derived from the larval hindgut motoneurons. Other hindgut motoneurons in the larva switch targets during metamorphosis and come to innervate the oviduct in adult females or perish in adult males. Other regions of the reproductive tract become innervated by adult-specific cells that differentiate during metamorphosis. These cells come from distinct lineages in males and females. PMID- 2768549 TI - Development of GABA immunoreactivity in brainstem auditory nuclei of the chick: ontogeny of gradients in terminal staining. AB - The development of gamma-aminobutyric acid-immunoreactivity (GABA-I) in nucleus magnocellularis (NM) and nucleus laminaris (NL) of the chick was studied by using an antiserum to GABA. In posthatch chicks, GABA-I is localized to small, round punctate structures in the neuropil and surrounding nerve cell bodies. Electron microscopic immunocytochemistry demonstrates that these puncta make synaptic contact with neuronal cell bodies in NM; thus, they are believed to be axon terminals. GABAergic terminals are distributed in a gradient of increasing density from the rostromedial to the caudolateral regions of NM. The distribution of GABA-I was studied during embryonic development. At embryonic days (E) 9-11, there is little GABA-I staining in either NM or NL. Around E12-14, a few fibers are immunopositive but no gradient is seen. More GABA-I structures are present at E14-15. They are reminiscent of axons with varicosities along their length, preterminal axonal thickenings and fiber plexuses. At E15, terminals become apparent circumscribing neuronal somata and are also discernible in the neuropil of both nuclei. In E16-17 embryos, terminals are the predominantly labeled GABA-I structures and they are uniformly distributed throughout NM. The density of GABAergic terminals increases in caudolateral regions of NM such that by E17-19, there is a gradient of increasing density of GABA-I terminals from the rostromedial to caudolateral regions of NM. The steepness of this gradient increases during development and is the greatest in posthatch (P) chicks. Cell bodies labeled with the GABA antiserum are located around the borders of both NM and NL and in the neuropil between these two nuclei. Occasionally, GABA-I neurons can be found within these auditory brainstem nuclei in both embryonic and posthatch chicks. Nucleus angularis (NA) contains some GABAergic cells. The appearance of GABA-I terminals around E15 is correlated in time with the formation of end-bulbs of Held on NM neurons. Thus, the ontogeny of presumed inhibitory inputs to chick auditory brainstem nuclei temporally correlates with, and could modulate the development of, excitatory auditory afferent structure and function. PMID- 2768550 TI - Neuronal and glial changes in the rat phrenic nucleus occurring within hours after spinal cord injury. AB - The present study describes specific morphological changes in the normal ultrastructure of the rat phrenic nucleus which occur within 4 hours after an ipsilateral spinal cord hemisection rostral to the nucleus. Phrenic neurons were identified at EM levels by retrograde HRP labeling. Ultrastructural features of the phrenic nucleus in uninjured animals and at 4 hours and 1, 2, and 4 days after injury were qualitatively analyzed and then quantitated with a computerized morphometric system. Our results indicated that by 4 hours posthemisection, there was a significant increase in the number of double synapses. Furthermore, the number of double synapses remained significantly higher than normal at all the other posthemisection periods. A significant increase in the length of dendrodendritic membrane appositions was also noted as early as 4 hours posthemisection. The mean normal appositional length of 1.42 +/- 0.09 microns increased to 1.89 +/- 0.12 microns at 4 hours and further increased to 2.20 +/- 0.20 microns by 1 day posthemisection. The increase in the length of membrane appositions was most likely due to an active retraction of astroglial processes from their normal position in between the dendrites. Although there was an increase in the mean length of the dendrodendritic appositions, the mean percentage of the appositions (expressed as the total number of appositions divided by the total number of dendrites in each sample) was not increased significantly over normal values during the early posthemisection periods. By 2 and 4 days posthemisection, however, the percentage of dendrodendritic appositions increased to significantly higher values than normal. Normally, 4.68 +/- 0.69% of the dendrites in the phrenic nucleus were found to be in apposition, and this number increased significantly to 7.27 +/- 1.06% by 2 days and 7.46 +/- 0.79% by 4 days posthemisection. At these later posthemisection periods, the mean length of the appositions decreased to levels which were no longer significantly higher than normal. A distribution analysis of the length of each dendrodendritic apposition in both the normal and spinal hemisected rats showed that there were more dendrodendritic appositions in the phrenic nucleus at the later posthemisection periods. It also showed that their mean length was decreased because many of the new appositions were relatively short. The above neuronal and glial alterations of the phrenic nucleus have never before been described as a response to injury of the mammalian spinal cord. Furthermore, the possibility that the above changes could represent the morphological substrate for the unmasking of functionally ineffective synapses in ou PMID- 2768551 TI - Development of the rat thalamus: IV. The intermediate lobule of the thalamic neuroepithelium, and the time and site of origin and settling pattern of neurons of the ventral nuclear complex. AB - Short-survival, sequential, and long-survival thymidine radiograms of rat embryos, fetuses, and young pups were analyzed in order to examine the time of origin, settling pattern, migratory route, and site of origin of neurons of the ventral nuclear complex of the thalamus. Quantitative examination of long survival radiograms established that the bulk of the neurons of the ventral nuclear complex are generated between days E14 and E16 but with statistically significant differences between its three nuclei. The ventrobasal nucleus is the oldest component (97% of the cells are generated on days E14 and E15); the ventrolateral nucleus is next (82% of the cells are generated on days E14 and E15); and the ventromedial nucleus is last (51% of the cells are generated on days E14 and E15). In addition to this caudal-to-rostral (from the ventrobasal nucleus to the ventrolateral nucleus) and lateral-to-medial (from the ventrobasal nucleus to the ventromedial nucleus) internuclear gradients, there are lateral-to medial and ventral-to-dorsal intranuclear neurogenetic gradients within the ventrobasal and ventrolateral nuclei. Qualitative examination of short and sequential survival thymidine radiograms indicate that the neurons of the ventral nuclear complex originate in the unique intermediate thalamic neuroepithelial lobule, which is distinguished from the rest of the thalamic neuroepithelium by the presence of a mitotically active secondary neuroepithelial matrix. Two sublobules can be distinguished in the intermediate lobule during the early stages of thalamic development. On the basis of their location and chronological pattern of cell production and differentiation, it is inferred that the neurons of the ventrobasal nucleus originate in the earlier differentiating, posteroventrally situated inverted sublobule, and the neurons of the ventrolateral nucleus are produced in the later differentiating, anterodorsally situated everted sublobule. The neurons of the ventromedial nucleus appear to originate from the intermediate neuroepithelial lobule after its two sublobules are no longer distinguishable. The heavily labeled neurons generated soon after injection on day E15 form a wave front that translocates in a lateral direction at a steady rate of 215 microns/day. Examination of methacrylate-embedded materials showed that, in day E15 rats the actively migrating cells are spindle shaped, with their long axis oriented horizontally. The far-laterally situated differentiating cells (the oldest neurons) become vertically oriented by day E16. Associated with this change in polarity, vertically oriented fibers appear among the cells. These fibers can be traced to the inte PMID- 2768552 TI - Development of the rat thalamus: V. The posterior lobule of the thalamic neuroepithelium and the time and site of origin and settling pattern of neurons of the medial geniculate body. AB - Long-survival, sequential, and short-survival thymidine radiograms of rat embryos, fetuses, and young pups were analyzed in order to examine the time of origin, site of origin, migratory route, and settling pattern of neurons of the medial geniculate body (MG). Quantitative evaluation of long-survival radiograms established that the bulk of MG neurons are generated between embryonic (E) days E13 and E15, with a pronounced peak on day E14. There is an overall lateral-to medial and caudal-to-rostral chronological gradient in MG neurogenesis. On the basis of significant regional differences in the birth dates of neurons, the MG was divided into several chronoarchitectonic areas. The earliest-generated neurons (with close to 20% of the cells produced on day E13 and a negligible proportion on day E15) form the dorsal and ventral clusters far laterally. Next in sequential order are the neurons of the lateral shell, intermediate shell, and medial shell of the MG. The medial shell with it latest-generated neurons (with over 30% produced rostrally on day E15) corresponds to the medial (magnocellular) subnucleus of the MG. There were no neurogenetic differences between the traditional dorsal and ventral divisions of the MG. Examination of sequential radiograms in rats labeled with 3H-thymidine on day E14 or E15 and killed on successive days brought supportive evidence for our earlier identification, in short-survival radiograms, of a posteroventral thalamic neuroepithelial evagination as the putative source, or committed cell line, of MG neurons. Wave fronts of apparently migrating unlabeled and labeled cells could be traced from this sublobule in a posterolateral direction to the future site of the MG. PMID- 2768553 TI - Development of the rat thalamus: VI. The posterior lobule of the thalamic neuroepithelium and the time and site of origin and settling pattern of neurons of the lateral geniculate and lateral posterior nuclei. AB - Short-survival, sequential, and long-survival thymidine radiograms of rat embryos, fetuses, and young pups were analyzed in order to determine the time of origin, site of origin, migratory route, and settling pattern of neurons of the dorsal lateral geniculate (LGD), ventral lateral geniculate (LGV), and lateral posterior (LP) nuclei of the thalamus. Quantitative examination of long-survival radiograms established that the neurons of the LGD are produced on days E14 and E15. Within the LGD there is an external-to-internal neurogenetic gradient; the majority (77%) of neurons of the external half are generated on day E14, while in the internal half the majority (64%) of neurons originate on day E15. The late generated LGD neurons are located in the termination field of the uncrossed fibers of the optic tract. Examination of short-survival radiograms indicated that the neurons of the LGD originate in a discrete neuroepithelial eversion situated ventral to the pineal rudiment and dorsal to the putative neuroepithelium of the ventral nuclear complex. In sequential radiograms from rats injected with 3H-thymidine on day E15 and killed on days E16 and E17, the migration of young LGD neurons was followed in a posterolateral direction to the formative lateral geniculate body. By day E17, the day when the optic tract fibers begin to disperse over the lateral surface of the posterior diencephalon, the distribution of early and late-generated neurons of the LGD resembles that seen in young pups. As a whole, the neurons of the LGV are produced earlier than the neurons of the LGD. The bulk of LGV neurons are generated on days E14 and E15 in a caudal-to-rostral intranuclear neurogenetic gradient. Caudal LGV neurons are generated mainly on day E14 (82%), while a substantial proportion of rostral neurons (32%) are generated on day E15. Examination of short-survival and sequential radiograms suggest that the LGV neurons originate in an inverted sublobule situated beneath the putative neuroepithelium of the LGD. At anterior levels the putative inverted sublobule of the LGV merges imperceptibly with the neuroepithelium that produces the neurons of the lateral habenular nucleus. Like the neurons of the LGD and LGV, so also those of the LP are generated on days E14 and E15, but the neurogenetic gradients are different. There is a lateral-to medial gradient within the LP as a whole. Peak production of neurons is on day E14 laterally (58%) and on day E15 medially (59%).(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2768554 TI - Red nucleus of Macaca fascicularis: an electron microscopic study of its synaptic organization. AB - The parvicellular and magnocellular divisions of the red nucleus of the old world monkey, Macaca fascicularis, were analyzed at an electron microscopic level to examine the morphology of the synaptic profiles terminating on rubral neurons and to categorize them by their individual characteristics. The parvicellular division, or anterior two-thirds of the nucleus, is composed of small (10-15 microns) and medium-size (20-30 microns) cells, which are uniformly distributed with high packing density throughout this portion of the nucleus. These cells have invaginated nuclei and are often indented by blood vessels and glial cell somata (satellite cells) that lie in close proximity. The magnocellular portion, occupying the caudal one-third of the nucleus, is composed of an additional population of large cells, ranging from 50-90 microns in diameter, which often contain prominent lipofuscin granules and are frequently indented by blood vessels. Satellite glial cells are not a prominent feature in the magnocellularis portion of the nucleus. The large cells are separated one from the other by fields of myelinated axons either coursing through the nucleus or projecting to and from the nucleus itself. Although the divisions of the nucleus in the Macaca fascicularis are spatially distinct, each possesses a morphological similarity in regard to the categories of synaptic profiles seen at the electron microscopic level. These synaptic profiles are classified as follows: large terminals containing numerous, predominantly rounded vesicles (LR), which can often be seen to form the central profile in a synaptic glomerular arrangement; terminals of similar size with predominantly rounded vesicles but with a pale axoplasmic matrix (LRP); small profiles with rounded vesicles (SR); profiles containing granular dense-cored vesicles (DCV); profiles with numerous flattened vesicles (F); profiles containing pleomorphic vesicles (PL), some of which can be interpreted as presynaptic dendrites (PSD) because they are seen to be postsynaptic and contain ribosomes; and profiles with rounded synaptic vesicles, which are associated with subsynaptic Taxi bodies (T). Most of the various synaptic profile types were found to have similar distributions on the dendritic arbors of rubral neurons in both divisions of the nucleus. However, the LRP-type terminal predominates on the cell bodies and proximal dendrites of the large neurons in magnocellularis. Unlike other regions in the nervous system, F type terminals are rarely seen to contact neuronal somata. This study provides a basis for future experimental studies of afferents to the nucleus in this species.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2768556 TI - Alpha and delta ganglion cells in the rat retina. AB - In the rat retina a distinctive class of large ganglion cell was demonstrated by intracellular staining with Lucifer Yellow and with reduced silver staining. They are referred to as alpha cells because they resemble the alpha cells of other mammalian retinae. A second class, called delta cells, is also described. Both classes belong to the type I group defined by Perry (Proc. R. Soc. Lond. [Biol.] 204:363-375, '79). The dendritic trees of both classes stratify in either an inner or outer lamina of the inner plexiform layer which presumably corresponds to an on/off dichotomy in the response to light. Rat alpha cells constitute 2-4% of all ganglion cells, and their density, size, and detailed morphological appearance change with retinal location. Inner and outer stratifying alpha cells of the rat show significant differences compared to those of other mammals. In central retina (at the large cell density maximum) the densities and dendritic field sizes of inner and outer alpha cells are approximately equal. However, in peripheral retina outer alpha cells are up to three times more numerous and have dendritic field areas only one-third the size of those of the inner alpha cells. The maximal density is about 110 alpha cells/mm2; peripheral densities are about 30/mm2. The smallest central dendritic field diameters are 220 microns. Peripheral dendritic field diameters are 350-550 microns for outer and 570-790 microns for inner alpha cells. Each subpopulation is distributed in a regular mosaic, and the territorial arrangement of the dendritic fields provides a homogeneous coverage of the retina. The dendritic coverage is three- to 3.6-fold for each subpopulation, irrespective of their other quantitative differences. Eccentricity-dependent receptive field sizes of the alpha cells are predicted from the morphological data. PMID- 2768555 TI - Development of vasoactive-intestinal-polypeptide-immunoreactive neurons in the rat occipital cortex: a combined immunohistochemical-autoradiographic study. AB - The postnatal development of vasoactive intestinal polypeptide (VIP) immunoreactive neurons, previously labeled with [3H]thymidine on embryonic days E14-E22, has been studied in the rat occipital cortex. Immuno-histochemistry combined with autoradiography showed very little evidence of an "inside-out" pattern of maturation. Most VIP neurons are generated between E17 and E21 and are found in layers II-IV of the cortex, but their position within these layers is not dictated by their date of birth. There is evidence of a temporal maturation since E17 VIP neurons were seen first (at day 7) and E21 last. Peak numbers of VIP neurons were generated on E19. The numbers of VIP-immunoreactive neuronal somata detected in the cortex increased from the first week after birth to the third week and declined thereafter. However VIP-immunoreactive dendrites were still visible, suggesting that VIP levels in the cell bodies were very low, and not that there was a loss of neurons. PMID- 2768557 TI - EM autoradiographic study of the projections from the dorsal nucleus of the lateral lemniscus: a possible source of inhibitory inputs to the inferior colliculus. AB - The fine structure of the projection from the dorsal nucleus of the lateral lemniscus (DNLL) to the inferior colliculus is examined in the cat. Anterograde axonal transport of 3H-leucine and EM autoradiographic techniques are used to label axonal endings from DNLL. The primary finding is that axonal endings from DNLL contain pleomorphic synaptic vesicles and make symmetrical synaptic contacts. This morphology is associated with inhibitory synapses. The projection from DNLL is the source of approximately one-third of the axonal endings with pleomorphic vesicles in the central nucleus of the inferior colliculus. In the contralateral central nucleus, only labeled endings with pleomorphic vesicles are found. By comparison, on the ipsilateral side, both endings with pleomorphic vesicles and, to a lesser degree, endings with round vesicles are labeled. Endings from DNLL are more numerous per unit area on the contralateral side. About half of the labeled axonal endings from DNLL terminate upon small dendrites, and another third terminate upon more proximal dendrites and several types of cell bodies. Many axonal endings form multiple synaptic contacts, sometimes on more than one postsynaptic structure. Sites of termination for axonal endings include dendritic spines and branch points of dendrites. These data support the hypothesis that the DNLL pathway to the inferior colliculus may have an inhibitory function. Previous studies show that DNLL neurons exhibit immunoreactivity to GAD and GABA antibodies. The crossed projection of DNLL to the inferior colliculus forms tonotopically organized bands that terminate as endings with pleomorphic vesicles. These endings may supply GABAergic inputs to the inferior colliculus. Thus, bands from DNLL could provide inhibitory inputs and overlap with bands from other sources that provide excitatory inputs. Overlapping bands may form unique synaptic domains in the inferior colliculus. The uncrossed projections from DNLL may provide the inferior colliculus with a more diffusely organized projection that could include excitatory and inhibitory inputs. Since the DNLL on one side may inhibit the opposite DNLL and the inferior colliculus, the DNLL pathway may regulate ascending inhibition to the midbrain. Presumed inhibitory inputs from DNLL to the inferior colliculus could be involved in binaural information processing and contralateral dominance. PMID- 2768558 TI - Histochemistry of acetylcholinesterase and immunocytochemistry of an acetylcholine receptor-like antigen in the brain of the honeybee. AB - A histochemical staining method for acetylcholinesterase (AChE) and an antiserum raised against nicotinic acetylcholine receptors (AChR) of locust nervous tissue were applied in order to reveal certain candidates of cholinergic pathways in the brain of the honeybee. The AChE staining marked layers in the optic lobes, fibers connecting the two brain hemispheres, and fiber tracts as well as soma clusters within the protocerebrum. The calycal input regions of the mushroom bodies were labelled, whereas the intrinsic Kenyon cells showed no staining. Although the antennal afferents projecting into the dorsal lobe showed strong AChE activity, projections into the antennal lobe showed rather weak staining. Application of the antiserum against the AChR showed immunoreactivity in neuropiles, tracts, somata, and the antennal nerve. The immunoreactivity of the optic lobes coincided with the banding pattern of the AChE staining. A particularly striking overlap of AChR immunoreactivity and AChE staining was found in the lip neuropile of the mushroom bodies, which would suggest a cholinergic input into this neuropile via fibers of the median antennoglomerular tract. Because the antiserum against locust AChR binds in neuropiles displaying AChE activity, we conclude that this antiserum also cross-reacts with the bee's receptor. This interpretation is supported by experiments showing alpha-bungarotoxin (alpha-BTX) binding sites in some areas of strong immunoreactivity. PMID- 2768559 TI - Descending pathways to the spinal cord: II. Quantitative study of the tectospinal tract in 23 mammals. AB - To study the early evolution of the mammalian motor systems, we have collected quantitative data on the nuclear origins of tracts descending into the spinal cord in 99 individuals representing 23 species of mammals and one species of reptile. In each individual, the spinal cord was hemisected at the C1-C2 junction and raw HRP immediately applied to the cut fibers. After a 3-day survival period, brain and spinal cord sections were treated with conventional tetramethylbenzidine procedures. In every case, this procedure resulted in heavy retrograde labeling of neural somata throughout the neuraxis from coccygeal cord to cerebral neocortex. Many thousands of supraspinal neurons were vividly labeled within at least 27 discrete cell groups in every mammal (Nudo and Masterton, '88). Despite the vast number and wide diversity of heavily labeled neurons, however, relatively few labeled somata were found in the superior colliculus. The total number of labeled cells in the tectum contralateral to the hemisection was highest in the cat (909) and second highest in the raccoon (628). In the remaining animals, the number was considerably less--averaging only 243 in the 23 mammalian species, 193 in the 21 noncarnivores, and 95 in the iguana. In 7 species of primates the average was 220, and in 3 species of Old World monkeys the average was 142. This wide variation in the number of tectospinal neurons is not related to body size, brain size, or absolute and relative tectum size. Arranging the animals in order of their kinship or recency-of-last-common ancestor with Man, the average number of labeled tectal cells tends to decrease slightly, whereas arranging the same animals in order of their kinship with the cat or raccoon shows a marked and statistically reliable increase. Neither the evolutionary increase in the tectospinal tract along the Carnivora lineage nor the slight decrease along Man's lineage is altered by mathematical corrections for allometric or scaling factors. Of an array of morphological, visual, motor, and ecological traits tested statistically as a possible source of the variation in size of the tectospinal tract, only a primarily carnivorous feeding preference was found to be reliably related. The relatively small number of tectospinal fibers in most mammals in our sample, including the primates, suggests that the tectospinal tract in Man may be quite small, perhaps far too small to warrant continuing description as a "major descending tract." PMID- 2768560 TI - Histaminergic system in the tree shrew brain. AB - This study mapped the histamine-immunoreactive neuronal system in the brain of the tree shrew (Tupaia belangeri) and compared its structure with that of the rat and guinea pig. The histamine-containing cell bodies lay in the posterior ventral hypothalamus in the tuberomammillary complex, as in the rodents. The morphology of this complex resembled that of the rat. The histaminergic axons projected to nearly all parts of the brain. The main ascending bundle ran ventromedially: the densest innervation was found in the ventral hypothalamus, preoptic area, septum, medial part of nucleus accumbens, and bed nucleus of the stria terminalis. High fiber densities were present in the amygdaloid nuclei and claustrum. Another pathway ran dorsomedially along the periventricular hypothalamus and sent fibers to all parts of the diencephalon. Part of these fibers followed the central gray to the midbrain and spread laterally below the inferior colliculus. Another descending pathway ran through the interfascicular and medial raphe nuclei to meet the pontine central gray. The densest fiber networks were seen in the dorsal tegmental and parabrachial nuclei, and around the locus coeruleus. Also the substantia nigra, interpeduncular and mesencephalic reticular nuclei, colliculi, and vestibular and raphe nuclei received a dense histaminergic innervation. The organization of the fibers in the tree shrew brain resembled more that in the guinea pig than that in the rat. As compared with the guinea pig, more fibers were present, particularly in the globus pallidus, central thalamus, and deep cerebellar nuclei. No fibers were seen in the outer layer of the piriform cortex. In Tupaia, a laminar organization of the fibers was evident in the hippocampus, in contrast to the rodents. Also, a dense periventricular fiber plexus was prominent. PMID- 2768561 TI - Morphometric and freeze-fracture studies on peripheral nerve in shiverer mice. AB - Observations have been made on the peripheral nerves of shiverer (shi/shi) mice in comparison with control animals. Although this mutant lacks P1 myelin basic protein in peripheral and central myelin, myelin is defective only in the central nervous system. No ultrastructural abnormalities were observed in the shiverer nerves. Myelin spacing was normal. The density and distribution of intramembranous particles on the E and P faces of myelin and in the axolemma of myelinated and unmyelinated axons did not differ between the shiverer and control mice. Morphometric studies showed that external myelinated fiber diameter was significantly less and that myelin thickness was slightly but significantly greater in relation to axon diameter in the shiverer mice, suggesting a minor degree of axonal atrophy. It is concluded that P1 protein is not necessary for the formation and maintenance of the normal structure of peripheral myelin. The failure to detect differences in intramembranous particle density in myelin between shiverer and control mice indicates that P1 protein is not detected in freeze-fracture preparations. PMID- 2768562 TI - Origin of retinal astrocytes in the rat: evidence of migration from the optic nerve. AB - To test recent ideas on the origin of retinal astrocytes, we have studied the spread of astrocytes in the developing retina of the albino rat. Astrocytes were identified with antibodies to their intermediate filaments, glial fibrillary acidic protein (GFAP). Astrocytes were first detected at E(embryonic day) 18, forming a corona of processes around the optic disc. Over subsequent days, astrocytes extended over the retina, covering approximately 35% of the retina at birth (typically E21-22) and reaching the edge of the retina by P(postnatal day)8. As they spread, astrocytes were closely associated with the developing vasculature, spreading ahead of patent vessels by a small but distinct margin. The most peripheral astrocytes assumed a bipolar morphology and extended processes towards the margin of the retina. Astrocytes nearer the optic disc showed the stellate shape characteristic of mature cells. The appearance of astrocytes at the optic disc at E18, 2 days after the appearance of type-1 astrocytes in the optic nerve (Miller et al.: Dev. Biol. 111:35-41, '85), suggests that retinal astrocytes may be type-1 astrocytes generated in the optic nerve. Watanabe and Raff (Nature 332:834-837, '88) have recently reported an independent study supporting the same conclusions. PMID- 2768563 TI - Architecture and intrinsic connections of the prefrontal cortex in the rhesus monkey. AB - An investigation of the architectonic organization and intrinsic connections of the prefrontal cortex was conducted in rhesus monkeys. Cytoarchitectonic analysis indicates that in the prefrontal cortex there are two trends of gradual change in laminar characteristics that can be traced from limbic periallocortex towards isocortical areas. The stepwise change in laminar features is characterized by the emergence and gradual increase in the width of granular layer IV, by an increase in the size of pyramidal cells in layers III and V, and by a higher cell packing density in the supragranular layers. Myeloarchitectonic analysis reveals that the limbic areas are poorly myelinated, adjacent areas have a diffuse myelin content confined to the deep layers, and in isocortices the myelinated fibers are distributed in organized horizontal bands (of Bail-larger) and a vertical plexus. Using the above architectonic criteria, we observed that one of the architectonic trends takes a radial basoventral course from the periallocortex in the caudal orbitofrontal region to the adjacent proisocortex and then to area 13. The next stage of architectonic regions includes orbital areas 12, 11, and 14, which is followed by area 10, lateral area 12, and the rostral part of ventral area 46. The last group includes the caudal part of ventral area 46 and ventral area 8. The other trend takes a mediodorsal course from the periallocortex around the rostral portion of the corpus callosum to the adjacent proisocortical areas 24, 25, and 32 and then to the medially situated isocortical areas 9, 10, and 14. The next stage includes lateral areas 10 and 9 and the rostral part of dorsal area 46. The last group includes the caudal part of dorsal area 46 and dorsal area 8. The interconnections of subdivisions of the basoventral and mediodorsal cortices were studied with the aid of anterograde and retrograde tracers. Within each trend a given area projects in two directions: to adjoining regions belonging to succeeding architectonic stages on the one hand, and to nearby regions from the preceding architectonic stage on the other. In each direction there is more than one region involved in this projection system, paralleling the radial nature of architectonic change. Periallo- and proisocortices have widespread intrinsic connections, whereas isocortices situated at a distance from limbic areas, such as area 8, have restricted connections. Most interconnections are limited to areas within the same architectonic trend. However, there are links between cortices from the two trends, and these seem to occur between areas that are at a similar stage of architectonic differentiation.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2768564 TI - Location of forelimb motoneurons in the Japanese toad (Bufo japonicus): a horseradish peroxidase study. AB - To label the spinal motoneurons innervating the forelimb muscles of the Japanese toad, horseradish peroxidase (HRP) was injected into these muscles or applied to the cut end of the brachial nerves (N. radialis and N. ulnaris). Spatial distribution of the HRP-labeled motoneurons was reconstructed from serial frontal sections of the spinal cord and their location was examined. Motoneurons innervating forelimb muscles were distributed in the lateral cell column from segment 3 to segment 5 of the ipsilateral brachial spinal cord. In the transverse plane of the spinal cord, motoneurons innervating the medial forearm muscles (innervated by N. ulnaris) were located in the more medial part of the lateral cell column, whereas those innervating the lateral forearm muscles and the upper arm muscle (innervated by N. radialis) were located in the more lateral part of the lateral cell column. Along the longitudinal axis of the spinal cord, motoneurons innervating the more anterior (flexor side) forearm muscles were located in the more rostral part of the spinal cord, whereas those innervating the more posterior (extensor side) forearm muscles were located in the more caudal part of the spinal cord. Thus, motoneurons innervating forearm muscles were well organized somatotopically not only in the transverse plane, but also along the longitudinal axis of the spinal cord. Such a somatotopic organization of motoneurons along the longitudinal axis could also be regarded as a functional one; the flexor motoneurons were located rostrally to the extensor motoneurons. PMID- 2768565 TI - Axon-myelin relationships in rat cranial nerves III, IV, and VI: a morphometric study of large- and small-fibre classes. AB - The primary objectives of this study were to determine (1) if quantitative axon myelin relationships are similar for large- and for small-fibre classes within individual nerves and (2) if the same axon-myelin relationships hold for equivalent fibre classes in closely similar nerves. The oculomotor, trochlear, and abducent nerves of the rat were examined since they each contain distinct large- and small-fibre classes and are similar in a wide range of anatomical and developmental respects. Accordingly, morphometric analyses of axon-myelin relationships were performed separately on large and small fibres of each of the three nerves. Within each nerve, the setting of the relationship between the two parameters was found to be different for the two fibre classes: Scatterplots relating sheath thickness to axon perimeter for large fibres were shifted upwards relative to those for small fibres. These differences were also reflected in the positions of the regression lines fitted to the plots and in the g-ratios. Significant differences were found between nerves in relation to their large fibres: Those of the abducent nerve had significantly thicker sheaths, those of the oculomotor nerve had significantly smaller axon perimeters, and the myelin sheath-axon perimeter relationship of the abducent nerve differed significantly from that of the other two. This study therefore shows that morphometric axon myelin relationships may differ significantly between equivalent fibre classes of nerves that are closely similar in respect of morphological class, central origin, peripheral distribution, developmental environment, and function. PMID- 2768566 TI - Mormyromast electroreceptor organs and their afferent fibers in mormyrid fish: I. Morphology. AB - Mormyromast electroreceptor organs are the most numerous type of electroreceptor organs in mormyrid electric fish and provide the sensory information necessary for active electrolocation. Mormyromast organs and their primary afferent fibers have not been studied very extensively. Both morphological and physiological questions remain to be answered before the neural basis of active electrolocation in mormyrids can be understood. This paper examines four different aspects of the morphology of mormyromast organs and afferent fibers: 1) Mormyromast organs in the skin. The innervation patterns for the two types of separately innervated sensory cells in the mormyromast organ are described on the basis of silver stained whole mounts of skin. The number of sensory cells per mormyromast organ increases linearly with fish growth for both types of sensory cells. 2) Relation between peripheral sensory cell innervated and central zone of termination for mormyromast afferent fibers. The afferent fibers arising from the two types of sensory cell in the mormyromast organ project to separate zones of the electrosensory lateral line lobe, as shown by using retrograde labeling with horseradish peroxidase. 3) Central trajectories and terminal arbors of mormyromast afferent fibers. These aspects of mormyromast fibers are described by using intracellular staining of individual fibers as well as whole nerve staining of an electrosensory nerve. 4) Fine structure of mormyromast afferent terminals in the electrosensory lateral line lobe. Afferent fibers make various synaptic contacts, including contacts of a mixed type, gap junction-chemical, onto a restricted class of granule cells. The fine structure is described based on electron microscopy of horseradish-peroxidase-labeled fibers. The results provide an anatomical base for current physiological studies on mormyromast afferent fibers. PMID- 2768567 TI - Topical all-trans-retinoic acid prevents corticosteroid-induced skin atrophy without abrogating the anti-inflammatory effect. AB - We tested the ability of all-trans-retinoic acid to prevent corticosteroid induced skin atrophy without lessening the anti-inflammatory effect of the steroids. Histologic study and skin-fold thickness in hairless mice treated topically with various steroids, followed by topical all-trans-retinoic acid, were used to measure prevention of atrophy. By both assessments, all-trans retinoic acid prevented atrophy. Noninterference with the anti-inflammatory property of steroids was tested in a phorbol ester-induced mouse ear edema model and by histologic assessment of croton oil-induced inflammation of mouse dermis. We found that all-trans-retinoic acid did not interfere with steroid suppression of either edema or dermal inflammation. Thus all-trans-retinoic acid was effective in preventing steroid-induced atrophy without affecting the steroid's anti-inflammatory property. PMID- 2768568 TI - Treatment of skin ulcers with cultured epidermal allografts. AB - Thirty-six skin ulcers in 23 patients were treated with cultured allogeneic epidermal sheets derived from neonatal foreskin. In 73% of ulcers, there was complete healing within 8 weeks, with a mean healing time of 3.3 weeks. In the other 27%, there was reduction in ulcer size of 35% to 93% by 8 weeks after grafting. In 30 painful ulcers, pain was markedly relieved within 24 hours of grafting. The healing pattern suggested that the cultured epidermal sheets acted by stimulation of host keratinocytes to divide and migrate rather than by permanent acceptance of the allograft. Of the 26 ulcers that healed within 8 weeks, 23 (88.5%) remained healed for follow-up periods of 10 to 18 months (mean 13.7 months), with an overall mean duration of healing of 13 months. PMID- 2768569 TI - Treatment of scleroderma skin ulcers with a hydrocolloid membrane. AB - The purpose of this study was to determine the usefulness of hydrocolloid membrane dressings in the treatment of finger and hand ulcers of scleroderma (progressive systemic sclerosis). Ten pairs of ulcers occurring in seven patients were studied. The ulcers in each patient were treated in a paired comparison trial: one ulcer in each pair was treated with a hydrocolloid membrane; the other was a control. Treatment was continued until at least one ulcer of each pair was healed. The rate of healing of the hydrocolloid membrane-treated ulcers was significantly faster than that of the control ulcers. Pain was rapidly and dramatically reduced in all hydrocolloid membrane-treated ulcers. An infection caused by Pseudomonas aeruginosa occurred in a hydrocolloid membrane-treated ulcer but rapidly responded to topical therapy. Hydrocolloid membrane treatment of sclerodermatous hand ulcers appears to be an effective method of accelerating healing and reducing pain. PMID- 2768570 TI - Actinic reticuloid. A clinical photobiologic, histopathologic, and follow-u study of 16 patients. AB - We report a detailed clinical, histopathologic, and photobiologic study of 16 Dutch patients with actinic reticuloid. All were middle-aged or elderly men who had persistent plaques on light-exposed skin only (two patients), extension of lesions to nonexposed areas (four patients), or prolonged or persistent episodes of erythroderma (10 patients). They were sensitive to UVB, UVA, and visible light. In 10 of 13 patients tested, the dermal infiltrate contained predominantly suppressor T cells. Many also had a reversed helper-suppressor T cell ratio. Circulating lymphocytes with deeply indented nuclei were present in all but were most pronounced in the most photosensitive erythrodermic patients. Tolerance induction therapy with UVB irradiation produced an excellent or good response in 13 of 15 patients. One patient responded to cyclosporine therapy. PMID- 2768572 TI - A review of 79 cases of eyelid dermatitis. AB - Seventy-nine patients with eyelid dermatitis and 1012 patients with dermatitis at other sites were assessed with patch tests. Eighty-nine percent of the eyelid cases involved women. Only the eyelids were involved in 78.5% of cases. Of the patients with eyelid dermatitis 46% had allergic contact dermatitis, 15% had irritant contact dermatitis, and 23% had atopic dermatitis. Only 13% were work related. Positive reactions to patch tests for cinnamic alcohol, diazolidinyl urea, and neomycin sulfate occurred more frequently, whereas those for cobalt and nickel occurred less frequently, in patients who had eyelid dermatitis when compared to the reactions of patients who did not have eyelid dermatitis. PMID- 2768571 TI - Clobetasol-induced milia. AB - Milia developed in two patients with different chronic dermatoses after 2 weeks of treatment with clobetasol propionate ointment. Routine histologic and immunohistochemical analysis showed the cysts to be of eccrine gland origin. PMID- 2768573 TI - Effect of indomethacin on UVB- and UVA-induced erythema in polymorphic light eruption. AB - The effect of topical indomethacin on the intensity of UVB- and UVA-induced erythema was measured by reflectance spectrophotometry in 23 patients with polymorphic light eruption. Thirteen patients showed a response to indomethacin that was identical to that seen in normal subjects (i.e., inhibition of UVB induced erythema; no effect on the intensity of UVA-induced erythema). In the remaining 10 patients indomethacin caused abnormal augmentation of UVB- and UVA induced erythema. These results show for the first time that the term polymorphic light eruption embraces at least two disease states that have different mechanisms of photosensitivity and that can be distinguished on the basis of clinical features and results of photobiologic investigation. PMID- 2768574 TI - Metastases from squamous cell carcinoma of the skin and lip. An analysis of twenty-seven cases. AB - Of 365 consecutive squamous cell carcinomas treated by Mohs surgery, 27 (7.4%) later metastasized. Tumors of the temple, the dorsa of the hands, and the lips were more likely to metastasize than tumors located elsewhere. None of the metastatic lesions developed in antecedent inflammatory or degenerative conditions. No single factor was useful in predicting metastasis, but metastatic lesions, on average, were significantly larger and deeper than nonmetastatic lesions. It was much more difficult to control the primary lesion of patients with metastases. Five of the 27 patients died of metastatic disease despite aggressive surgery, radiation therapy, or both. PMID- 2768575 TI - Transplantation of in vitro-cultured epidermis bearing melanocytes for repigmenting vitiligo. AB - A new method for repigmenting vitiligo by transplantation of in vitro-cultured epidermis bearing melanocytes is described. The artificially grown epidermis was implanted after vitiliginous skin was denuded with liquid nitrogen. Satisfactory repigmentation was attained. This technique offers a new approach for treating refractory vitiligo. PMID- 2768577 TI - Dermatofibrosarcoma protuberans of the scalp: a series of cases. AB - Three cases of dermatofibrosarcoma protuberans on the scalp of young women are presented. The scalp is a rare but important anatomic site for this tumor because of the possibility of direct invasion into the skull and brain. The use of DNA analysis to predict biologic aggressiveness of a tumor is discussed. PMID- 2768576 TI - Topical capsaicin treatment of chronic postherpetic neuralgia. AB - Uncontrolled studies have indicated that topically applied capsaicin may be a safe and effective treatment for postherpetic neuralgia. In a double-blind study 32 elderly patients with chronic postherpetic neuralgia were treated with either capsaicin cream or its vehicle for a 6-week period. Response to treatment was evaluated by visual analogue scales of pain and of pain relief, together with changes in a categoric pain scale and in a physician's global evaluation. Significantly greater relief in the capsaicin-treated group compared with vehicle was observed for all efficacy variables. After 6 weeks almost 80% of capsaicin treated patients experienced some relief from their pain. Because capsaicin avoids problems with drug interactions and systemic toxicity, we suggest that topical capsaicin be considered for initial management of postherpetic neuralgia. PMID- 2768578 TI - Lichenoid dermatitis: a clinicopathologic and immunopathologic review of sixty two cases. AB - We reviewed 62 cases (26 men and 36 women, median age 55 years) of previously diagnosed lichenoid dermatitis and correlated the histologic and immunodermatologic findings with the clinical diagnosis and course. The clinical diagnostic groups were contact dermatitis (6 cases), drug eruption (14), lupus erythematosus (6), lichen planus (3), cutaneous T cell lymphoma (3), chronic dermatitis or neurodermatitis (19), and miscellaneous dermatologic disorders (11). With the use of individual histologic features, a correlation with specific clinical conditions was possible, and the clinical groups of dermatitis, drug eruption, lupus erythematosus or lichen planus, and T cell infiltration could be selected histologically. Direct immunofluorescence studies were of most help in the diagnosis of lupus erythematosus and atypical lichen planus, but these studies should be performed in all cases involving lichenoid inflammation. Although previously the nonspecific term lichenoid dermatitis was used to classify the histologic features in these cases, we found that by careful correlation of histologic, immunodermatologic, and clinical features, we were often able to provide a specific diagnosis. PMID- 2768580 TI - Papular pruritic eruption of Demodex folliculitis in patients with acquired immunodeficiency syndrome. PMID- 2768579 TI - Acral persistent papular mucinosis. AB - Acral persistent papular mucinosis has recently been proposed as a distinct form of cutaneous mucinosis. We describe a patient and review the literature. We conclude that acral persistent papular mucinosis is a distinct clinical entity, clearly separable from most other forms of cutaneous mucinosis except for one variant of lichen myxedematosus, from which it is less easily distinguished. PMID- 2768581 TI - Liposuction surgery for a buffalo hump caused by Cushing's disease. PMID- 2768582 TI - Actinic reticuloid: response to cyclosporine. PMID- 2768583 TI - Atrophia maculosa varioliformis cutis with extrahepatic biliary atresia. PMID- 2768585 TI - The "priming phenomenon" in the acute phototoxicity of erythropoietic protoporphyria. PMID- 2768584 TI - Granuloma annulare temporally associated with carcinoma of the breast. PMID- 2768586 TI - Milia en plaque. PMID- 2768587 TI - Giant clear cell acanthoma in an atypical location. PMID- 2768588 TI - Ehlers-Danlos syndrome type IV: another temperature-dependent skin disorder? PMID- 2768589 TI - Risk of virus transmission and sterilization practices of dermatologists. PMID- 2768590 TI - Chemical warfare. PMID- 2768592 TI - Extracorporeal photochemotherapy: a theoretic consideration as a treatment modality for severe erythrodermic and pustular psoriasis. PMID- 2768591 TI - Trichomycosis axillaris: a different view. PMID- 2768593 TI - Adenoid (acantholytic) squamous cell carcinoma of the skin. AB - Cutaneous adenoid squamous carcinoma (ASCC) is a distinctive neoplasm featuring tumor cell acantholysis. Because this lesion occasionally may prove troublesome diagnostically, we studied the clinical, histologic, and immunohistochemical features of 55 examples in order to further elucidate its characteristics. ASCC most often occurred in the skin of the head and neck in elderly patients. Of 49 patients in this series, 46 were men and 3 were women; their ages at diagnosis ranged from 25 to 90 yr, with a mean of 71. Six individuals had 2 metachronous neoplasms. ASCC generally behaved in an indolent manner, although 19% of cases did metastasize widely and prove fatal. Tumor size of greater than 1.5 cm appeared to correlate with the risk of an adverse clinical outcome. In addition, 10 patients with ASCC of the skin subsequently developed visceral malignancies. The cutaneous neoplasms were typified by invasive, tubular or pseudoglandular profiles of polygonal cells in the dermis, with glassy eosinophilic cytoplasm and focal squamous pearl formation. Connections to the overlying epidermis were commonly apparent. Immunohistochemically, ASCC demonstrated uniform reactivity for cytokeratin, but lacked markers of specialized glandular cells. These findings militate against the interpretation that such tumors demonstrate partial adnexal differentiation, and show that immunohistology may prove helpful in the differential diagnosis between ASCC and primary or metastatic adenocarcinomas of the skin. PMID- 2768594 TI - Cytophagic histiocytic panniculitis is not always fatal. AB - Two patients with benign cytophagic histiocytic panniculitis are presented and compared with the one benign and ten fatal cases previously reported. Benign appearing histiocytes which engulf blood cells, nuclear debris, and platelets are the most characteristic feature of the disease. This cytophagia tends to be massive in the subcutaneous tissue and involves extracutaneous organs only in the fatal cases. The course is chronic in the benign form. Patients with the fatal form tend to have fever, hepatosplenomegaly, serosal effusions, ecchymoses, peripheral adenopathy, and mucosal ulcers. Anemia, leukopenia, elevated liver enzyme levels, and coagulopathy are present in almost all and hypocalcemia in many patients with a fatal course. Cytophagic histiocytic panniculitis may represent a form of regional histiocytosis primarily involving subcutaneous tissue. It is midway in the spectrum of the cytophagic histiocytoses. PMID- 2768595 TI - Verrucous trichoadenoma. AB - Two cases of verrucous trichoadenoma are reported. Clinically, both lesions were diagnosed as seborrheic keratoses, but histopathologically no areas of basaloid cell proliferation were seen in the numerous sections and there were many small, epidermoid cysts in the dermis which contained one or more vellous hairs. Some of these cysts expelled their horn material into the surface keratin layer in a "boiling pattern". We propose the term "verrucous trichoadenoma" for these tumors. PMID- 2768596 TI - Juvenile colloid milium. Immunohistochemical and ultrastructural studies. AB - A 7-year-old Italian girl with juvenile colloid milium was studied with histological, immunohistochemical, and electron microscopic methods. This patient had a well-documented history of severe sunburn and developed the lesions on the face shortly afterward. Numerous apoptotic keratinocytes were observed in the lower epidermis. These cells began their degeneration with filamentous whorl formation (or filamentous degeneration) of tonofilaments. In the papillary dermis the colloid substance was resolved by the electron microscopy into either wavy, thin filaments derived from the epidermal keratinocytes or typical amyloid filaments. Many desmosomes and gap junctions were found in the colloid substance. Polyclonal antikeratin antibody (DAKO) was positive in the colloid substance, particularly in the parts close to the epidermis. These findings suggested that juvenile colloid milium is different from adult colloid milium despite clinical similarities and that the former belongs to the group of actinic amyloid K, i.e. amyloidoses due to actinic degeneration of keratinocyte and its keratin. PMID- 2768597 TI - Adolescent images of adolescence. AB - This study examines the extent to which a group of Scottish adolescents are influenced by negative images of adolescence present in our culture, and investigates their self-image by means of a Q sort. Forty 15- and 16-year-old school students took part in the study, half of whom were female. Half of the sample were staying on at school to take higher examinations, the other half being school leavers. Eleven factors emerged from the analysis, the first six of which met the criterion that distinguishes common factors. Participants defining common factors were re-interviewed, and their responses to factor interpretations noted. Little evidence was found to suggest that adolescents are influenced by newspaper images. Some descriptions hint at conflict, while others do not. If the results of the present study were to be replicated, a more pluralistic view of adolescence may be required. PMID- 2768598 TI - West Indian adolescents' perceptions of family functioning. AB - A total of 424 Barbadians aged 13-15 years completed the Family Functioning in Adolescence Questionnaire, developed in Australia by Roelofse and Middleton (1985). Findings revealed most adolescents, like their Australian peers, reported fairly favourable perceptions of their families. However, neither total nor sub scale scores served to discriminate between sub-groups based on sex, age or household structure to any great extent. A re-grouping of items based on results of Varimax analysis also failed to yield many significant group differences, although some directions for future research were indicated. Adolescents not living with their fathers seemed to have a somewhat lower sense of personal security, but in other respects did not report their family life any less favourably than did those living with both natural parents. PMID- 2768599 TI - Reasons for admission to an adolescent unit. AB - Three years admissions to a regional adolescent unit are analyzed to obtain information on the referral, the adolescent and family, and the behaviours leading to admission. The findings are discussed with particular relevance to the N.H.S. Health Advisory Service report on services for disturbed adolescents. Possible implications of the report which are not described by the H.A.S. are described. PMID- 2768600 TI - Adolescents' dropout from individual psychotherapy--is it true? AB - Although adolescent patients are said to have a propensity to drop out from psychotherapy, and clinical experiences seem to support this view, few studies have systematically examined this issue. However, a review of researches on adults' dropout shows that dropout is a serious problem for psychotherapy with adult patients. Moreover, available evidence on adolescents' dropout suggests that there is no significant difference in the rates of dropout from psychotherapy between adolescent patients and adult ones. In order to understand the specific quality of adolescents' dropout, the termination of psychotherapy with an adolescent patient is described and discussed. The view is put forward that it is because of the strong counter-transference feelings evoked in the therapist, when his adolescent patient leaves him prematurely, tends to maintain the impression of adolescents' proclivity to drop out from psychotherapy. PMID- 2768601 TI - Complex role experiences and personal differentiation: a real-life experiment. AB - This paper analyses the relationship between the complexity of role experiences and personal differentiation. "Complex role experiences" are defined by high levels of voluntarism, multiplexity, quasi-responsibility and trial-and-error behaviour. The ability to differentiate between diverse principles of role enactment and various criteria of interpersonal relations is conceptualized as "personal differentiation". Our hypothesis is that a pre-designed educational programme providing complex role experiences enhances personal differentiation. This hypothesis was tested in an experimental study on Israeli adolescents participating in summer camps. The results show that the active exposure to and assumption of variegated roles in different settings on a voluntaristic basis, while performing meaningful and quasi-responsible actions by means of trial-and error behaviour, enhances role and interpersonal differentiation, and hence personal differentiation, among adolescents. PMID- 2768602 TI - Self-destructive tendencies and depression as predictors of suicidal ideation in teenagers. AB - In male teenagers, scores on a self-destructive inventory were more strongly associated with the presence of suicidal ideation than scores on a depression inventory. For female teenagers, scores on the depression inventory were more strongly associated with suicidal ideation. PMID- 2768603 TI - Objective and subjective attractiveness and early adolescent adjustment. AB - Using data from the Pennsylvania Early Adolescent Transitions Study (PEATS), this study assessed how objective physical attractiveness (PA), indexed by appraisals from others, and subjective PA, indexed by self-appraisals, relate to each other and, in turn, to early adolescent adjustment (indexed by self-esteem and anxiety). Findings indicated a low relationship between objective and subjective PA. Only subjective PA was associated with adjustment. PMID- 2768604 TI - Over- and undercontrolled clinic referral problems of Jamaican and American children and adolescents: the culture general and the culture specific. AB - Child behavior problems and corresponding clinic referral patterns may be significantly influenced by cultural factors. Prevailing values and childrearing practices within a culture may discourage development of some child problems while fostering others. We explored this possibility, focusing on clinic referral problems of two different societies: (a) Jamaica, where the Afro-British culture discourages child aggression and other undercontrolled behavior and possibly fosters inhibition and other overcontrolled behavior, and (b) the United States, where undercontrolled child behavior is seemingly more generally accepted. We coded clinic-referred problems listed by parents of Jamaican and American youngsters (N = 720). Cross-cultural differences were striking: Overcontrolled problems were noted more often for Jamaican than American youngsters, whereas the converse was true for undercontrolled problems. These and other findings suggest that factors such as culture and sex may be linked to substantial differences in the problems for which youngsters of different countries are treated in clinics. PMID- 2768605 TI - Dimensions of assertiveness: differential relationships to substance use in early adolescence. AB - We tested a multidimensional formulation of assertiveness and substance (tobacco, alcohol, and marijuana) use in 3 metropolitan-area school samples of adolescents aged 12-14 years. Three studies (N = 675, N = 1,430, and N = 5,545) included inner-city and surburban settings and included White, Black, and Hispanic students. Factor analysis of versions of the Gambrill-Richey Assertion Inventory indicated five independent dimensions of assertive behavior. Multiple regression analysis indicated that a dimension of Substance-specific Assertiveness was inversely associated with substance use, whereas dimensions of Social Assertiveness and Dating Assertiveness were positively associated with substance use. A dimension of General Assertiveness was unrelated to substance use. Interaction effects indicated that relations were stronger for girls for Substance and Social Assertiveness and for boys for Dating Assertiveness. Implications of the findings for models of assertive behavior and for design of primary prevention programs are discussed. PMID- 2768606 TI - A comparison of group treatments of women sexually abused as children. AB - We randomly assigned 65 women who had been sexually abused by a father, stepfather, or other close relative to 1 of 3 treatment conditions: a 10-week interpersonal transaction (IT) group, a 10-week process group, or a wait list condition. Subjects were evaluated at pretreatment, posttreatment, and (if assigned to a group) a 6-month follow-up on measures of social adjustment, depression, fearfulness, and general distress. Results suggested that both the IT and process group formats were more effective than the wait list condition in reducing depression and in alleviating distress; changes were maintained at follow-up. Subjects in the process group format exhibited improvement in social adjustment, whereas subjects in the wait list condition actually deteriorated. PMID- 2768608 TI - Relapse crises and coping among dieters. AB - We examined situational antecedents of dieting relapse crises and dieters' attempts to cope with temptations to overeat. We analyzed posttreatment interviews with 57 obese Ss with Type II diabetes, comparing situations in which Ss lapsed with those in which they overcame temptation to overeat. Cluster analysis yielded 3 categories of relapse crises: mealtime, low-arousal, and emotional upset situations. The clusters differed in outcome: Upset situations almost always resulted in overeating; situational factors, especially food related cues, increased relapse risk; but performance of coping was the strongest correlate of outcome. Cognitive and behavioral coping responses were each equally associated with positive outcomes. When Ss reported combining both types of coping, they were less likely to report overeating. The dynamics of relapse crises among dieters resemble those that govern relapse crises in addictive behaviors. PMID- 2768607 TI - Preparation for cesarean delivery: a multicomponent analysis of treatment outcome. AB - We evaluated the effects of sensory information about cesarean delivery on prenatal maternal anxiety and on recovery subsequent to delivery by cesarean section. The 42 participants were recruited from a population of obstetric patients. Patients were assigned to either treatment or control groups and identified as sensitizers or repressors. Treatment groups viewed a slide/tape program presenting procedures involved in cesarean delivery. Control groups viewed a program presenting neutral information. Prepared patients classified as sensitizers showed less physiologic arousal during surgery and enhanced postsurgical recovery. Physiologic and self-report measures of anxiety indicated that the intervention itself was not a stressful event. The relations among arousal, subjective anxiety, coping styles, and treatment outcome are discussed and recommendations are made for further investigation. PMID- 2768609 TI - Levels of hopelessness in children and adolescents: a developmental perspective. AB - We investigated hopelessness at 3 age levels (8-, 12-, and 17-year-olds) in 210 children and adolescents from a community sample derived from public school listings of 4,810 children in a midwestern college town. The sample included 105 boys and 105 girls, and there were 70 subjects in each age group. The major finding was that children with high hopelessness scores are at greater risk not only for suicide and depression as revealed by the Child Assessment Schedule and the Birleson Depression Scale but also for overall psychopathology. This study suggests that hopelessness does not increase from preadolescence to adolescence in a general population. PMID- 2768610 TI - Suicide, hopelessness, and social desirability: a test of an interactive model. AB - We examined the relationships among suicidal indices, hopelessness, and social desirability. Both hopelessness and a measure of social desirability that reflected a sense of general capability were significant indicators of suicidal manifestations. In particular, hierarchical multiple regression procedures demonstrated that hopelessness and social desirability interacted in the prediction of suicide variables. Results generalized across various clinical diagnostic subgroups of psychiatric patients and a sample of prisoners and across different clinically evaluated and self-reported indices of suicidal behavior. Findings are interpreted to mean that a sense of general capability buffers the link of hopelessness to suicidal behavior. Implications for understanding the cognitions associated with suicide and for improving prediction of persons at risk are discussed. PMID- 2768611 TI - Comparison of programs for teaching personal safety skills to preschoolers. AB - We compared the relative effectiveness of two educational approaches for teaching personal safety skills with 100 preschoolers. A behavioral skills training program was compared with a feelings-based program, which instructs children to trust their feelings when making safety decisions. Children's abilities to discriminate between appropriate- and inappropriate-touch requests, their prevention skills, and levels of emotional distress were assessed before, immediately, and one month after program participation. Parents and teachers were surveyed regarding children's reactions. Compared with a control presentation, both programs were effective in enhancing children's knowledge and prevention skills without making them fearful, suggesting that preschool children can benefit from such programs. However, children in the feelings-based program had difficulty recognizing the appropriateness of certain touch requests, suggesting that this approach may have limited utility with preschool-age children. PMID- 2768612 TI - Personality characteristics of the mothers of children with disruptive behavior disorders. AB - The biological mothers of 100 outpatient children aged 6-13 years completed the Minnesota Multiphasic Personality Inventory (MMPI). Mothers of children given DSM III diagnoses of conduct disorder (CD; n = 13) had significantly higher scores on MMPI scales associated with antisocial behavior (Pd and Ma), histrionic behavior (Hs and Hy), and disturbed adjustment (Sc). In contrast, the children's diagnosis of attention deficit disorder with hyperactivity (ADD/H; n = 22) was not significantly associated with any maternal MMPI elevations, and the CD x ADD/H interactions were not significant for any MMPI scale. These results indicate that CD is linked to maternal personality disorder, but ADD/H is not. PMID- 2768613 TI - Behavioral correlates of maternal depressive symptomatology in conduct-disorder children. AB - We contrasted two predictive models of the impact of maternal depressive symptomatology on child behavior in a study of 51 mothers and their conduct disorder children. Relations between global measures of maternal distress and child adjustment and observational measures of mother-child interaction were examined. Children of distressed mothers were more maladjusted than children of nondistressed mothers, when maladjustment was measured on the basis of a global rating, but "better" adjusted when measured on the basis of interactional measures. Measures of maternal indiscriminate responding to the child may account for these findings. Results suggest that (a) although conduct-disorder children are generally more maladjusted when their mothers are distressed, they display this maladjustment in a selective fashion, and (b) maternal distress acts as an adverse contextual factor that maintains mother-child interactional difficulties by disrupting the attentional and monitoring skills required for contingent responding. PMID- 2768614 TI - Cognitive-behavioral therapy and relationship therapy in the treatment of children referred for antisocial behavior. AB - The present study evaluated alternative treatments for children (N = 112, ages 7 13) referred for severe antisocial behavior. Children were randomly assigned to one of three treatments: problem-solving skills training (PSST), problem-solving skills training with in vivo practice (PSST-P), which included therapeutically planned activities to extend training to settings outside of treatment, or client centered relationship therapy (RT). PSST and PSST-P children showed significantly greater reductions in antisocial behavior and overall behavior problems, and greater increases in prosocial behavior than RT children. These effects were evident on measures obtained immediately after treatment and at a 1-year follow up, and on measures of child performance at home and at school. PSST-P children showed greater changes than PSST children on measures of functioning at school at posttreatment, but these differences were no longer evident at follow-up. Children in both PSST conditions showed significant reductions in deviant behavior and improvements in prosocial behavior from pretreatment to follow-up, whereas RT children tended to remain at their pretreatment level of functioning. Notwithstanding the significant improvements, comparisons with nonclinic (normative) samples revealed that the majority of youth remained outside of the normal range of deviant behavior. Possible directions for improving treatment for antisocial youth are highlighted. PMID- 2768615 TI - An introduction to survival analysis: statistical methods for analysis of clinical trial data. AB - The randomized controlled clinical trial (RCT) is a prospective study using random assignment of subjects to treatment groups to compare the effect and value of a therapeutic intervention against a control. The RCT is the most definitive clinical research tool for evaluating the efficacy of a new therapy in human subjects. Often the outcome of interest in an RCT is the length of time until an event occurs after treatment or intervention. In this article we introduce statistical methods for evaluating differences in the patterns of time to response between two groups of subjects to determine whether one therapy is better than another. The collection of methods for analyzing such data, known as survival data, is called survival analysis. Using data from a hypothetical clinical trial for the prevention of the recurrence of depression, we illustrate two elementary methods for analyzing survival data. We also discuss generalizations of these methods to incorporate covariates and conclude with a general discussion of clinical trials of psychiatric therapies. PMID- 2768616 TI - Does stimulant medication improve the peer status of hyperactive children? AB - Although stimulants improve the social behaviors of hyperactive children, analogous changes in peer status have not been previously demonstrated. We compared peer appraisals of hyperactive boys (N = 25) after placebo, 0.3 mg/kg, and 0.6 mg/kg methylphenidate (Ritalin). With the higher dose generally producing stronger effects, methylphenidate enhanced social standing, increasing nominations of hyperactive boys as best friends, cooperative, and fun to be with. These medication-related improvements, although important, did not normalize peer appraisals, and there was marked interindividual variability in medication response. PMID- 2768617 TI - Videotaped modeling and film distraction for fear reduction in adults undergoing hyperbaric oxygen therapy. AB - We used a combined videotaped coping model and film distraction technique to reduce the distress of patients undergoing hyperbaric oxygen (HBO) therapy. Five experimental patients ranging in age from 34 to 68 were shown a videotape that depicted a coping model and then viewed a feature film as a distraction during their first exposure to HBO. In comparison with 6 control patients ranging in age from 17 to 53, the experimental patients experienced less arousal and rated themselves as significantly more relaxed before treatment, completed significantly more prescribed treatments without complication, and required fewer days in the hospital. These results support the use of modeling and distraction techniques as a cost-effective means of reducing distress and improving patients' compliance with HBO therapy. PMID- 2768618 TI - Unusual alveolar clefts: report of cases. AB - Four cases with atypical alveolar clefts are presented. In the first, a sixteen year-old boy had an alveolar cleft in the region of the left lateral incisor, a submucous cleft palate and a narrowed left nostril. The alveolar cleft was corrected with a bone graft. In the second case, an eleven-month-old boy had an alveolar cleft in the region of the normal lateral labial frenulum between the left canine and the first premolar, and an ordinary microform of cleft lip on the right side. A six-month-old boy has a complete cleft lip, alveolus and palate on the left side in the third case, and bilateral alveolar clefts in the region between the canine and the first premolar both in the maxilla and the mandible. In case four, an eight-month-old boy has an alveolar cleft in the region of the normal lateral labial frenulum between the right canine and first premolar. Lip and palate were fused normally. PMID- 2768619 TI - Tooth germ transposition: report of cases. AB - Six patients with transposed tooth germ before root formation are reported in cases with cleft lip or palate. A boy with complete bilateral cleft lip and palate had a maxillary permanent canine displaced posteriorly in the vomer. A girl with cleft palate had an upwards and distally transmigrated maxillary canine. Two girls with cleft palate had a transposed maxillary canine with the first premolar. One patient had a maxillary second premolar migrated between the first and second permanent molar, and another had the germ of a supernumerary maxillary premolar between the first and second permanent molars. The follow-up findings concerning the development of the teeth and treatment are described; they are also discussed in the light of present theories on the etiology of tooth transposition. PMID- 2768620 TI - Bilateral mandibular dentigerous cysts in a five-year-old child: report of a case. AB - This is the youngest patient reported in the literature with bilateral mandibular dentigerous cysts. This report confirms the importance of a panoramic radiographic examination in diagnosing bony lesions of the jaws. Early diagnosis and aggressive treatment of these lesions is essential to avoid the undesirable sequelae that could occur without treatment. Dentigerous cysts are bony lesions that have the potential to produce neoplasms. PMID- 2768621 TI - Periodontal health as related to preformed crowns: report of case. AB - General studies have suggested that clinical gingivitis might be associated with radiographically detectalble deficiencies around the margins of stainless steel crowns, or with cement remaining in the gingival sulcus, or with a combination of these. The case of a nine-year-old girl reported here is an example of the high toleration potential of young periodontal tissues--even when a significant amount of zinc phosphate cement had been pushed into the lingual sulcus during cementation. PMID- 2768622 TI - The finishing and early marginal fracture of clinical amalgam restorations. AB - One operator placed 249 Tytin amalgam restorations in Class I and II preparations in the permanent teeth of 60 patients each of whom received a minimum of three restorations. At least one of these restorations was carved-only, at least one was immediately finished (at 8 or 10 min after trituration), and at least one restoration was polished (more than 24 h after placement). Restorations were principally assessed for marginal fracture at baseline and 1 year using the 11 unit scale for the evaluation of photographs developed by Mahler. Five factors were also assessed clinically at 1 year. Amalgam restorations, polished using finishing burs and rubber points at least 24 h after placement, exhibited more initial marginal fracture than carved-only or immediately finished restorations. At 1 year, the three techniques were comparable except for the superior surface texture of the polished restorations. The technique of immediate finishing of amalgam restorations has nothing to commend it in preference to existing techniques. PMID- 2768623 TI - Taking time out: a study of women dentists who have experienced career breaks. AB - Data on the careers and work patterns of women dentists were established in 1975. Social and economic changes, as well as change within the profession, such as the fact that almost half the students entering dental schools are now female, pointed to the necessity of a further survey in 1985. Questionnaires were sent off to 4513 women dentists resident in England and Wales, with a resultant response of 76 per cent. Part of the questionnaire concentrated on the length of career breaks experienced by/taken by women dentists in order to determine whether there has been any change in the pattern of taking time out in dentistry over the decade. At the time of the survey, 388 women (12 per cent) were retired, in addition, just over half of the women who replied had experienced a break at some stage during their career. These breaks from practice are described and discussed. PMID- 2768624 TI - Dynamic mechanical properties of an inlay composite. AB - A visible light-cured composite resin (Brilliant DI) has been studied over a wide range of temperature and frequency by a dynamic mechanical flexural method. The derived data of logarithmic modulus and loss tangent (tan delta) show considerable changes following a secondary-cure process applied to the material. This involved the application of heat and intense light with temperatures rising to 120 degrees C in 7 min. Following this oven-cure the resin phase exhibited enhanced stiffness with the activation-energy barrier for molecular motion at the glass-transition rising from 220 to 291 kJ/mol. This study clarifies the nature and extent of the internal molecular changes which may be produced in the fabrication of a composite inlay. PMID- 2768625 TI - A study of the use of autoclave bags in non-vacuum autoclaves. AB - Two types of autoclave bags have been tested in five commonly used dental, non vacuum autoclaves. The bags did not prevent the sterilization of instruments provided that most of the air was removed and the bags of instruments were not stacked. The use of a sterilization indicator in the bag is mandatory. PMID- 2768626 TI - Biocompatibility testing of a posterior composite and dental cements using a new organ culture model. AB - Mandibular first molars from day 14 and 17 mouse embryos were cultured in vitro for 7 days in chemically defined Pratt's medium in a submerged culture system. Ameloblast and odontoblast polarization and morphogenesis occurred in the control tooth germs. Discs of Occlusin, Silicate, ChemFil, IRM and Dycal were exposed to the culture system as either fresh material, leached discs (by pre-incubation in media) or the leachate from the incubated discs. Their effects on dental differentiation were assessed histologically. Day 17 tooth germs were slightly more sensitive to the effects of the exogenous agents than day 14 tooth germs. In general, silicate and ChemFil were toxic, IRM was slightly less toxic and the major effect was from the leachate. Dycal was toxic but most of this effect resulted from pH changes in the leachate. Occlusin was the most biocompatible material tested. Only a very mild adverse effect was detected, and this appeared to be caused by an agent (not a pH change) released into the leachate. PMID- 2768627 TI - Some factors connected with alveolar bone resorption. AB - In this study correlations are described between alveolar bone resorption, patient's age, duration of edentulousness, the number of dentures which have been worn, and dentures being worn day and night. The sample of patients for this study consisted of 92 edentulous persons treated with complete dentures at a dental school clinic. The test subjects were asked to fill in a questionnaire to obtain data regarding the research factors. A method for the classification of alveolar bone resorption was developed and the test subjects were divided into classes for alveolar bone resorption according to this method. All data were processed by means of a computer program. The longer the test subjects had been edentulous and the more dentures they had worn, the more intensive was the alveolar bone resorption, particularly in the lower jaw. No significant correlation was found between alveolar bone resorption and dentures being worn day and night. PMID- 2768628 TI - Prevention of bacterial adhesion to denture acrylic. AB - A range of non-toxic polysaccharides were screened for their ability to prevent bacterial adhesion to denture acrylic in vitro. Sodium alginate, karaya gum and carrageenan were found to be the most effective, reducing adhesion of Streptococcus salivarius by 98.7, 97.9 and 99.2 per cent respectively. These three polysaccharides were then tested for their ability to reduce the number of bacteria adhering to dentures in vivo. Sodium alginate was the most effective, reducing the attachment of bacteria to the palate-contacting surface of the denture after 5 h of normal wear by 84 per cent compared with uncoated controls. The results of this investigation suggest that the accumulation of denture plaque may be prevented by frequent application of a renewable, sacrificial coating of a non-toxic polysaccharide. PMID- 2768629 TI - The rheology of silicone rubber impression materials. AB - A selection of silicone rubber impression materials were studied for their rheological properties prior to and following mixing. The techniques used were a cone and plate viscometer and a capillary viscometer. All the impression materials were found to show pseudoplastic behaviour which is readily described by a power law function. For the mixed materials the onset of molecular entanglement, whilst theoretically establishing the absolute end of the working time, gave a gross overestimate of the clinical working time. The capillary viscometer is more useful than the cone and plate viscometer in providing information on the clinical working time. PMID- 2768631 TI - The effect of an elevated level of residual monomer on the whitening of a denture base and its physical properties. AB - It has been suggested that incomplete or faulty processing leading to a high level of residual monomer is a factor in denture whitening. Laboratory tests which simulate the cleaning procedures used by patients presenting with whitened dentures have been carried out on specimen strips of acrylic denture base material with high or low levels of residual monomer. The results show that these samples exhibit similar changes and that the high level of residual monomer had no effect on the whitening process, this being attributable to the cleaning method. The major factor responsible for whitening is confirmed as a high water temperature irrespective of the presence of the denture cleaning agent. However, some physical properties were adversely affected by a high residual monomer content (due to the processing method) which has serious consequences for denture wearing patients. The use of short/low temperature curing cycles now common in many dental laboratories should be avoided. PMID- 2768630 TI - The effects of gamma radiation on the properties of composite restorative resins. AB - The effects of gamma radiation at therapeutic dosage levels on the physical properties of three anterior (two light-cured and one autocure) composites and a light-cured posterior composite were studied. Gamma radiation had no effect on the autocured composite but had varied effects on the light-cured systems. The diametral tensile strength and dimensional stability were unaffected, water sorption and solubility were reduced but surface and bulk hardnesses were increased with the hardness increases linearly related to the radiation dosage. These effects may arise from continued polymerization of the air-inhibited surface layer and possibility of low molecular weight entities within the matrix. Overall, therapeutic levels of gamma radiation had no detrimental effects on the physical properties of the composite resins. PMID- 2768632 TI - Kinetic studies on improved phosphate dental cement: the measurement of some improved dental cements containing phosphate polymers by an electric conductance method. AB - The rate of the setting process of zinc phosphate dental cement with organic phosphate polymers as additives was measured by a conductance technique. There are two rate-determining parameters, namely an induction period and a first-order reaction constant. The values of the latter constant are not affected by the additives. PMID- 2768633 TI - Rethinking dental education: taking the road less traveled. PMID- 2768634 TI - Proceedings of the joint AADS-AADR symposium: Dentistry's response to AIDS. San Francisco, California, March 14, 1989. PMID- 2768635 TI - AIDS-related changes in public programs. PMID- 2768636 TI - Infection control in North American dental schools. AB - A questionnaire concerning infection control issues was sent to all North American dental schools in 1987. The results were compared with a similar survey conducted by the same authors in 1982. The purposes of the survey were to identify changes that have occurred in dental school infection control policies in the past six to seven years, and to study strengths and weaknesses of current policies. The results of the survey indicate a much greater emphasis on instrument sterilization and the use of barriers during dental treatment than in 1982. Compliance with the policy is not always satisfactory, however. It also shows some inconsistency and confusion in areas dealing with hepatitis B and HIV carrier patients and dental school personnel. Several respondents included written infection control protocols with the questionnaire. Information gained from the survey and the enclosures were used to develop guidelines to help schools improve and update their infection control policies. PMID- 2768638 TI - Attitudes of dental students toward individuals with AIDS. PMID- 2768637 TI - Cognitive style as related to emotional empathy. AB - This study examined relationships among two measures of FDI (the hidden figure test (HFT) and the portable rod and frame test (PRFT) and a measure of interpersonal sensitivity (the questionnaire measure of emotional empathy (QMEE] in a group of dental hygiene students. All measures were administered to 44 dental hygiene students and 42 students enrolled in an introductory psychology course. While the dental hygiene students were more field independent than a previously reported normative sample (t = 24.6 p less than 0.002), they were not characteristically different than a representative group of college students on any of the measures. For students enrolled in the psychology course, but not the dental hygiene students, the more field independent students were, the less empathic they appeared to be. These results do not entirely support previous research indicating that dental hygiene students typically are more field independent. PMID- 2768639 TI - Physical health and stress in entering dental students. PMID- 2768640 TI - Summary of the AADS/AoA special meeting on geriatric dentistry. PMID- 2768641 TI - The dental education experience: seniors see a marked improvement. PMID- 2768643 TI - Age determination in the adult screwworm (Diptera: Calliphoridae) by pteridine levels. AB - Fluorescence spectrophotometry was used to assess the possible use of pteridines in the compound eyes to estimate the age of adult screwworms, Cochliomyia hominivorax (Coquerel). Factors affecting the quantities of pteridines include temperature and head size. No difference in pteridine levels was found among flies fed protein or carbohydrate. A regression model for estimating the age of female screwworms was constructed. The model uses head capsule size and relative pteridine quantities and assumes a constant body temperature of 30 degrees C. This regression formula has an r2 of 0.74. Our study extends the use of pteridine accumulation for age determination from obligate sanguinivorous Diptera to an autogenous species that feeds facultatively on nectar and wound exudates. The technique appears to provide a valid means to determine age of these flies. PMID- 2768642 TI - Effect of experimental bedding treatments on the density of immature Musca domestica and Stomoxys calcitrans (Diptera: Muscidae) in outdoor calf hutches. AB - Experimental bedding materials and a novel delivery method of cyromazine (Larvadex) were evaluated as replicated treatments in outdoor calf hutches for effect on the density of immature Musca domestica L. and Stomoxys calcitrans (L.). In 6-wk trials, overall density of Musca domestica L. and Stomoxys calcitrans (L.) in straw bedding averaged 36.2 and 52.6 maggots/liter, respectively, compared with respective average densities of 9.0 and 16.2 for wood chips and 10.4 and 20.0 for wood chips over a hydraulic fabric filter system. These values represent average reductions of 80 and 69% and 77 and 68%, respectively. Densities of M. domestica and S. calcitrans in ground corncob over the filter system averaged 13.3 and 4.1 maggots/liter in 3.2-mm size corncob particles, and 1.7 and 1.2 for 6.4-mm size corncob particles (average reductions of 62 and 87% and 90 and 96%, respectively) relative to straw bedding. Densities of these two species in sand bedding averaged 2.8 and 0.4 maggots/liter (average reductions of 93 and 99%), but sand became compacted and soiled with calf urine and feces after several weeks. Cyromazine excreted in calf urine limited density of both species in straw to an average of 11.0 and 15.6 maggots/liter, respectively (a 58 and 79% suppression relative to untreated straw). These data confirm that straw bedding promotes muscoid maggot growth and illustrate that alternative calf hutch bedding systems and urine delivery of cyromazine may improve muscoid fly management on dairy farms by limiting the development of muscoid maggots. PMID- 2768644 TI - Costs of existing and recommended manure management practices for house fly and stable fly (Diptera: Muscidae) control on dairy farms. AB - Costs of fly control practices were estimated for 26 New York and Maryland dairy farms. Objectives were to characterize existing practices, compare them with the cost of more frequent and complete manure removal to reduce fly breeding, and to compare costs of manure removal and insecticide application. Information was collected in scouting visits and personal interviews of farm operators. Equipment, labor, and bedding costs were included for manure removal. Insecticide application costs included chemicals and labor for application. A typical farm with a stanchion barn had manure removal costs of $0.348 per cow per day. Recommended changes would increase costs by $0.016-0.033 per cow per day. Insecticide costs averaged $0.021 per cow per day. It may be possible to eliminate many of the insecticide applications on the farms by using the recommended 7-d manure removal practice. Even if insecticides are not eliminated entirely, increased manure removal costs would be offset by some reduction in insecticide cost. This also would have the additional benefit of greatly slowing the development of insecticide resistance by the flies. PMID- 2768645 TI - Community-acquired pneumonia of diverse aetiology: prognostic features in patients admitted to an intensive care unit and a "severity of illness" core. AB - In a retrospective study of 73 patients with community-acquired lobar pneumonia of diverse aetiology admitted to an intensive care unit, an attempt was made to identify those factors among the demographic and clinical features and results of initial laboratory investigations that were predictive of the ultimate outcome. A lower mean white cell count (p = 0.03), platelet count (p = 0.02), total serum protein (p = 0.005) and albumin (p = 0.02) and a higher mean serum creatinine (p = 0.03) and phosphate level (p = 0.02) appeared to be predictive of a poor prognosis. The most significant variable predictive of mortality, was the presence of bacteraemia (p = 0.0005). Severity of illness scoring systems by omitting microbiological data appear to underestimate predicted patient mortality. The mortality rate of critically ill patients with community-acquired lobar pneumonia remains high, despite advances in antimicrobial chemotherapy and intensive care unit facilities, particularly in the presence of certain negative prognostic factors of which the presence of bacteraemia is the most important. PMID- 2768646 TI - Single breath N2 washout in papain-induced pulmonary emphysema. AB - Single breath nitrogen washout tests were analyzed in dogs (n = 8) with healthy lungs and after development of emphysema. The animals were in the supine position and studied during anaesthesia and mechanical ventilation (FiO2 = 0.4, FiN2 = 0.6). During controlled expiration with constant flow (VE = 0.15 l/s) onset of phase IV of the alveolar plateau was related to airway closure of dependent lung regions (closing volume CV). In the control state, CV accounted for 6.2 +/- 1.5% VC, and closing capacity (CC) was lower than functional residual capacity (FRC). Likewise, gas exchange was normal in all animals (PaO2 = 24.7 +/- 3.32 kPa, PaCO2 = 5.18 +/- 0.53 kPa, PA-aO2 = 2.6 +/- 0.3 kPa). Panlobular emphysema (PLE) was induced by inhalation of papain (100 mg/kg). After three weeks development of PLE was documented by measurements of lung volumes (functional residual capacity (FRC), expired vital capacity (EVC), total lung capacity (TLC), residual volume (RV], pulmonary mechanics (dynamic and static compliance (Cdyn, Cstat), mean airway resistance (Raw], gas exchange (PaO2, PaCO2, PA-aO2), and by radiomorphological analysis. In the PLE-group, FRC and RV (p less than or equal to 0.05), and Cstat (p less than or equal to 0.01) were significantly elevated. CV increased to 16.2 +/- 2.7% VC (p less than or equal to 0.01) and CC exceeded FRC by 80 ml, indicating that tidal volume breathing took place within the range of closing volume. Oxygenation was significantly impaired (PaO2 = 18.6 +/- 3.72 kPa, PA-aO2 = 6.5 +/- 1.1 kPa, p less than or equal to 0.05), but not CO2 elimination. Pathological analysis by radiomorphological means showed dissiminate parenchymal lesions compatible with emphysema of grade II severity located predominantly in subpleural areas. In dogs with papain-induced PLE, premature closure of dependent airways is enhanced, which is due to structural changes and a loss of elastic recoil in the lungs. PMID- 2768647 TI - Massive pulmonary haemorrhage due to leptospirosis. AB - A young man with leptospirosis developed massive pulmonary haemorrhage. This was remarkable both in its severity and in its occurrence early in the clinical course - before the onset or presence of jaundice, renal failure or of a serological diagnosis. It occurred in the absence of a coagulopathy or thrombocytopenia and presumably was a consequence of the capillary fragility characteristic of the disease - perhaps precipitated in this instance by mechanical ventilation. PMID- 2768648 TI - Hyperkalemic cardiac arrest, prolonged heart massage and simultaneous hemodialysis. AB - A 53 year old diabetic patient underwent CABG and aortic valve replacement in another institution and developed postoperative oliguric and hyperkalemic acute renal failure. Shortly after transferring to our unit a cardiac arrest occurred. Immediate resuscitative measures were ineffective. The serum potassium level was 10.2 mmol/l. Conventional arteriovenous hemodialysis was initiated while the patient was still undergoing cardiac massage. When the serum potassium level was lowered to 6.5 mmol/l, 90 min later, the heart began to beat. After hemodialysis was discontinued the patient was reactive and fully conscious. The use of simultaneous hemodialysis with prolonged mechanical heart massage as a reliable method for recovery in hyperkalemic cardiac standstill is stressed. PMID- 2768649 TI - Humidification of dry inspired gases. PMID- 2768650 TI - Sequential hemofiltration in MOF associated with paracetamol intoxication and gram-negative sepsis. PMID- 2768651 TI - Muscle weakness associated with prolonged continuous high flux haemofiltration. PMID- 2768652 TI - Correlation between severity of septic conditions and circulating levels of ionized calcium. PMID- 2768653 TI - Errors in biochemical and haemodynamic data obtained using introducer lumen and proximal port of Swan Ganz catheter. PMID- 2768655 TI - Interpersonal concomitants and antecedents of depression among college students. AB - Depressed college students were compared with other-psychopathology and normal controls regarding the relationship they developed with dormitory roommates during a 9-month period. Diagnostic status was periodically assessed via SADS interviews, thus also permitting identification of new cases of depression during the year. Psychosocial characteristics found to be uniquely associated with current depression were: (a) low social contact with roommates, (b) low enjoyability of these contacts, and (c) high life-event stress. Roommates of depressives reported low enjoyability of the relationship and high levels of aggressive behavior towards the depressive. No features were found to be uniquely associated with new cases before they became depressed; however, several antecedents of general psychopathology were identified. PMID- 2768654 TI - A taxometric analysis of cognitive and neuromotor variables in children at risk for schizophrenia. AB - A taxometric model was applied to detect a subgroup or taxon of children conjectured to be at highest risk for developing schizophrenia or related disorders in a sample of offspring of schizophrenic, depressed, and normal parents. Measures of cognitive and neuromotor performance in childhood were used as indicator tests in the analyses. A taxon consisting chiefly of children of schizophrenic parents was detected. Forty-seven percent of those children were assigned to the taxon, compared with 16% of the children of depressed parents and 4% of the children of normal parents. Assignment to the taxon is assessed in relation to the current functional status of the subjects in young adulthood. PMID- 2768656 TI - Impact of distressed and aggressive behavior. AB - Two studies examined the hypothesis that distressed behavior induces negative emotions in others but also prompts solicitousness and deters aggression. In Study 1, 48 marital dyads rated various behaviors in terms of their feelings and reactions toward a spouse engaging in each behavior. Distressed behavior prompted both negative and solicitous emotions, but deterred hostile reactions. Aggressive behavior prompted negative feelings and hostile and argumentative reactions. In Study 2, 41 couples rated videotaped examples of a woman engaging in distressed, aggressive, or neutral behavior, with variations in verbal content and nonverbal affect. Examples of distressed behavior prompted more negative feelings and more solicitous feelings than neutral behavior. Aggressive examples prompted more negative feelings and hostile reactions. The studies indicate the importance of distinguishing between distressed and aggressive behavior. PMID- 2768657 TI - Predictors of relapse in unipolar depressives: expressed emotion, marital distress, and perceived criticism. AB - The predictive validity of expressed emotion (EE) and two conceptually related but more easily measured alternatives--marital distress, and patients' perceptions of criticism from spouses--were examined in a sample of hospitalized unipolar depressives. All three psychosocial variables were significantly associated with 9-month relapse rates. Expressed emotion and marital distress predicted the same proportion of variance in patients' outcomes. The single best predictor of relapse, however, was a patient's response to the question "How critical is your spouse of you?" Patients who relapsed rated their spouses as significantly more critical than did patients who remained well. Alone, the perceived criticism variable accounted for more of the variance in relapse rates than that explained by EE and marital distress combined. The results suggest that asking depressed patients how critical they believe their relatives are may facilitate the identification of individuals at high risk for relapse subsequent to hospital discharge. PMID- 2768659 TI - Differential effects of performance demand and distraction on sexually functional and dysfunctional males. AB - Sexually functional and sexually dysfunctional male subjects viewed an erotic film while experiencing two different types of distraction. During a neutral distracting condition, subjects were asked to estimate the length and width of a straight line appearing on an adjacent video monitor. During the "performance demand" distraction condition, subjects viewed video feedback of their genital responses and were asked to estimate percentage of full erection. These conditions were compared to a no distraction control condition. Performance demand distraction significantly elevated the responding of functional subjects compared to the neutral distraction condition. The responding of dysfunctional subjects, on the other hand, decreased during the performance demand distraction and was significantly lower than arousal in functional subjects in this condition. Post hoc analyses examined possible cognitive and affective mediating factors of this differential response. PMID- 2768658 TI - Implicit and explicit memory bias in anxiety. AB - Previous investigations of recall and recognition for threatening information in clinically anxious subjects have yielded equivocal results. The present study contrasts implicit (word completion) with explicit (cued recall) memory and shows that indices of bias for emotional material derived from the two types of memory are independent of one another. The explicit measure was correlated with trait anxiety scores, but did not clearly distinguish between subjects with clinical anxiety states and normal control subjects. On the implicit memory measure, clinically anxious subjects produced more threat word completions, but only from a set to which they had recently been exposed. These results are taken as evidence that internal representations of threat words are more readily or more persistently activated in anxiety states, although they are not necessarily better elaborated. PMID- 2768660 TI - Psychopathology of adolescent suicide: hopelessness, coping beliefs, and depression. AB - Two studies of adolescents examined the relation of several cognitive variables and depression to suicide-related behaviors. Study 1 compared hopelessness and depression in 281 high school students. Unlike research with adults, depression was significantly related to suicidal behaviors, even after hopelessness was statistically controlled. When depression was controlled, hopelessness was unrelated to suicidal behaviors for boys and only modestly related for girls. Study 2 examined depression, hopelessness, survival-coping beliefs, fear of social disapproval, and social desirability in relation to suicidal behaviors in 53 male juvenile delinquents. Again, hopelessness did not account for a significant proportion of the variance in suicide. Depression was uniquely related to past suicide attempts. Survival-coping beliefs were associated with self-predicted future suicide and other suicidal behaviors. Survival-coping beliefs are discussed as a cognitive buffer to suicidal ideation in adolescence. PMID- 2768661 TI - Cognitive mediators in the reduction of pain: the role of expectancy, strategy use, and self-presentation. AB - Eighty subjects underwent three trials of cold-pressor pain. The first cold pressor trial served as a baseline. Next, subjects in a neutral (no expectancy information) condition were taught a distraction strategy (shadowing letters) before one cold-pressor trial and an imagery strategy before the other. Subjects in other conditions received positive expectancy information about one of the strategies and negative expectancy information about the other. Negative information reduced expectancy ratings and decreased the magnitude of reported pain reductions. Both pretested levels of social desirability and degree of absorption in strategy use made contributions to the prediction of pain reduction that were independent of expectancy ratings. Theoretical implications are discussed. PMID- 2768662 TI - Topographic electroencephalographic alpha in recovered depressed elderly. AB - Late-middle-aged and elderly normal volunteers with past histories of Major Depression according to the Diagnostic and Statistical Manual of Mental Disorders (third edition-revised) criteria were compared with sex- and age-matched control subjects using topographic electroencephalographic (EEG) indices. Healthy, euthymic recovered depressed subjects showed greater alpha amplitudes than controls. Delta, theta, and beta amplitudes did not reliably distinguish the groups. Considered in the context of previous research indicating that actively depressed subjects exhibit elevated EEG alpha compared to controls, these findings raise questions concerning state and trait conceptualizations of depression and EEG alpha. PMID- 2768663 TI - Infants of postpartum depressed mothers: temperament and cognitive status. AB - This study examined the association of postpartum depression with specific infant characteristics. Twenty-five diagnosed depressed and 25 nondepressed mothers and their 2-month-old infants participated in the study. The mothers completed measures of infant temperament and difficulty associated with infant care, and the infants were assessed using the Bayley Scales of Infant Development. Group comparisons indicated that, compared with the infants of the nondepressed mothers, the infants of the depressed women were less competent cognitively and expressed more negative emotions during the testing. The depressed mothers perceived their infants as more difficult to care for and more bothersome than did the nondepressed mothers, but did not attribute these difficulties to the temperament of their infants. These findings suggest that postpartum depression is associated with an identifiable pattern of infant behavior that may exacerbate depressed women's mood. PMID- 2768664 TI - Hypnosis, suggestion, and placebo in the reduction of experimental pain. AB - Two experiments compared placebo and hypnotic analgesia in high and low hypnotizable subjects. Experiment 1 demonstrated that hypnotic and placebo analgesia were equally ineffective in low hypnotizables, but that hypnotic analgesia was much more effective than placebo analgesia in high hypnotizables. Experiment 2 replicated these results, but also included low and high hypnotizables who were given a nonhypnotic suggestion for analgesia. Both the low and high hypnotizables in this group reported greater suggested than placebo analgesia and as much suggested analgesia as high hypnotizable hypnotic subjects. Both experiments found substantial discrepancies between the amount of pain reduction subjects expected from the various treatments and the amount of pain reduction they actually reported following exposure to those treatments. In Experiment 2, subjects in all treatments who reduced reported pain engaged in more cognitive coping and less catastrophizing than those who did not reduce pain. Theoretical implications are discussed. PMID- 2768665 TI - Levels of adult alcohol consumption induced by interactions with child confederates exhibiting normal versus externalizing behaviors. AB - Investigated levels of distress and alcohol consumption in Ss interacting with problematic vs non-problematic child confederates. Social drinkers were randomly assigned to interact with boys trained to enact behaviors characteristic of either normal or attention-deficit disorder/conduct disorder (ADD/CD) children. Mood data were collected before and after the interaction. Ss engaged in ad lib beer consumption for 20 min, while anticipating another interaction with the same boy. Children in the ADD/CD role produced comparably distressed moods for both male and female Ss. However, only men drank to higher blood-alcohol levels in the ADD/CD vs. normal child condition. Results suggest that higher rates of drinking observed in fathers of ADD/CD children may be partly a function of their particular response to the distress associated with interactions with such children. PMID- 2768666 TI - Neuropsychological correlates of psychopathology in an unselected cohort of young adolescents. AB - Members of a birth cohort were assessed for psychopathology and neuropsychological dysfunction at age 13. Ss who met DSM-III criteria for a single disorder, multiple disorders, and no disorder were compared on 5 composite neuropsychological measures. The multiple disorders group performed significantly worse than did the nondisordered group on the Verbal, Visuospatial, Verbal Memory, and Visual-Motor Integration factors. They also showed the highest rate of neuropsychological impairment. The attention-deficit disorder group performed significantly worse than did the nondisordered group on the Verbal Memory and Visual-Motor Integration factors, and the anxiety disorder group performed significantly worse than did the nondisordered group on the Visual-Motor Integration factor. Results suggest that neuropsychological dysfunction is more often associated with multiple rather than single, psychiatric disorders in adolescents. The problem of comorbidity in studies of neuropsychological function in childhood and adolescent psychopathology is highlighted. PMID- 2768667 TI - Presenting problems of sexually abused girls receiving psychiatric services. AB - Twenty-three behaviors among those suggested in the literature to be associated with sexual abuse were studied in 195 girls, ages 2-18 years, who were consecutive admissions to three Midwestern mental health agencies. Results indicated that sexually inappropriate behaviors, sleep disturbance, depressed mood, and delinquent behavior occurred more frequently in young abuse victims than in clinic comparisons. Sexually inappropriate behaviors and running away appeared more often in older sexually abused girls, than they appeared in older clinic comparisons. These comparisons of the presenting problems of sexually abused and nonabused girls suggested there are few behavioral "markers" of sexual abuse in clinical samples and that sexual abuse may not be a unique contributing factor in the ontogeny of childhood psychopathology. PMID- 2768668 TI - Panic onset and major events in the lives of agoraphobics: a test of contiguity. AB - Major life events were reported in greater numbers and by a higher percentage of 50 index agoraphobics during a time period around panic onset than during either a within-subjects or a between-subjects control period. These differences were found for analyses of life events in general, events that preceded panic, and foreseeable events that occurred shortly after panic onset. Though many events involved separation or interpersonal conflict, other types of events were frequently reported. Results provide more convincing evidence than prior studies of a contiguous relationship between life events and onset of panic attacks associated with agoraphobia. PMID- 2768669 TI - Depression and bulimia: the link between depression and bulimic cognitions. AB - This study assessed the link between bulimic and depressive cognitions. Twenty nine bulimics and 16 controls from the general population were first assessed on levels of depression using the Schedule for Affective Disorders and Schizophrenia Change Version and the Beck Depression Inventory (BDI). Bulimics were significantly more depressed than controls. Bulimics differed significantly from controls on all cognitive measures associated with depression (Automatic Thoughts Questionnaire, Dysfunctional Attitude Scale, and Attributional Style Questionnaire), but differences on these measures were nonsignificant when depression, as measured by the BDI, was controlled. Bulimics differed from controls regardless of level of depression on the three scales of the Restraint Inventory, the Rationalization and All-or-None scales of the Thoughts About Eating Inventory, and most of the eight scales of the Eating Disorders Inventory. Bulimics showed more maladaptive thinking associated with depression, but these differences likely reflect the levels of depression for each group. The differences on the measures of cognitive and behavioral symptoms of bulimia remained when the level of depression was controlled statistically. This suggests that although depression can be frequently diagnosed in a bulimic sample, specific maladaptive cognitions and behaviors reflect a distinct disorder (bulimia) and are not simply the expression of an affective disorder. PMID- 2768670 TI - Visual conversion disorder: a case analysis of the influence of visual information. AB - We examined the influence of visual information on a decision task that was administered to an individual with monocular visual conversion disorder. Findings indicated that his performance was influenced by the visual information and by motivation instructions. The findings are discussed in terms of a model of hysterical blindness that recognizes the interplay of cognitive and motivational processes. PMID- 2768671 TI - The acoustical input impedance of excised human lungs--measurements and model matching. AB - The input impedance at primary bronchi of excised human lungs was measured in the frequency range from 2-5000 Hz. For the measurements, a self-developed acoustic impedance head and a narrow-band measuring system with sinusoidal excitation were used. The lungs were inflated and deflated by using an arrangement called respiratory state controller. The impedances were thus measured at different states of lung inflation. An already existing mathematical model was developed further to cover not only fairly inflated lungs, but also deflated ones. The parameter sensitivity of this model is investigated. The acoustomechanical parameters of the model were fitted to match the impedances measured. It turns out that some of these parameters are hardly calculable. The values given in this paper were chosen to agree with the measurements and to be physically reasonable. Although the measurements were performed at primary bronchi, the model is able to predict also impedances at the top end of the trachea (at different respiratory states). This impedance is useful for speech signal processing applications. The model prediction of the trachea impedances agrees well with previous results of other authors. PMID- 2768672 TI - Detection and discrimination of synthetic English vowels by Old World monkeys (Cercopithecus, Macaca) and humans. AB - Abilities to detect and discriminate ten synthetic steady-state English vowels were compared in Old World monkeys (Cercopithecus, Macaca) and humans using standard animal psychophysical procedures and positive-reinforcement operant conditioning techniques. Monkeys' detection thresholds were close to humans' for the front vowels /i-I-E-ae-E), but 10-20 dB higher for the back vowels /V-D-C-U u/. Subjects were subsequently presented with groups of vowels to discriminate. All monkeys experienced difficulty with spectrally similar pairs such as /V-D/, /E-ae/, and /U-u/, but macaques were superior to Cercopithecus monkeys. Humans discriminated all vowels at 100% correct levels, but their increased response latencies reflected spectral similarity and correlated with higher error rates by monkeys. Varying the intensity level of the vowel stimuli had little effect on either monkey or human discrimination, except at the lowest levels tested. These qualitative similarities in monkey and human vowel discrimination suggest that some monkey species may provide useful models of human vowel processing at the sensory level. PMID- 2768673 TI - Discrimination of frequency transitions by human infants. AB - Difference limens (DLs) for linear frequency transitions using a 1.0-kHz pulsed tone standard were obtained from 6- to 9-month-old human infants in a series of three experiments. A repeating standard "yes-no" operant headturning technique and an adaptive staircase (tracking) procedure were used to obtain difference limens from a total of 71 infants. The DLs for 300-ms upward and downward linear frequency sweeps were approximately 3%-4% when the repeating standard was an unmodulated 1.0-kHz pulsed tone of 300-ms duration. These DLs for frequency sweeps were not significantly different from DLs for frequency increments and decrements using 330-ms pulsed tones [J. M. Sinnott and R. N. Aslin, J. Acoust. Soc. Am. 78, 1986-1992 (1985)]. The DLs for frequency sweeps of 50 ms appended to the beginning or the end of a 250-ms unmodulated 1.0-kHz tone were approximately 6%-7%. This greater DL for brief frequency sweeps was confirmed by varying the duration but not the extent of the sweep. Finally, DLs were greater than 50% when the repeating standard was a 50-ms rising or falling frequency sweep appended to the beginning of a 250-ms unmodulated 1.0-kHz tone. These results suggest that rapid frequency transitions are much more difficult to discriminate from frequency transitions of the same category (rising or falling) than from either a frequency transition of the opposite category (falling or rising) or an unmodulated tone.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2768674 TI - Infants' monaural localization of sounds: effects of unilateral ear infection. AB - The aim in this study was to examine the impact of unilateral ear infection (i.e., otitis media with effusion) on infants' localization of sounds in the horizontal place. Twenty eight infants 6 to 18 months of age were tested at the time of an ear infection, as well as 2 weeks later. Sound localization was measured using a two-alternative forced-choice procedure to examine infants' abilities to discriminate a sound shift of 8 degrees, 12 degrees, 16 degrees, and 20 degrees off midline and along the horizontal axis, either ipsilateral or contralateral to the infected ear. A head and/or eye movement in the direction of the sound was designated as a correct response and was visually reinforced. Results revealed significant negative effects of unilateral ear infection on sound localization performance. All infants showed more correct localization responses for sounds shifted ipsilateral to the problem ear 2 weeks following their ear infection than at the time of the infection. Localization of sounds shifted contralateral to the infected ear did not vary with test date, and significantly exceeded ipsilateral performance when tested at the time of an ear infection. Results are consistent with adult data which indicates that, with unilateral hearing loss, a sound ipsilateral to the problem ear is displaced in location along the horizontal axis toward the well-functioning ear. These findings indicate the importance of balanced binaural functioning for horizontal localization and highlight the plasticity of the developing human auditory system. PMID- 2768675 TI - The effect of varying the amplitude-frequency response on the masked speech reception threshold of sentences for hearing-impaired listeners. AB - In an evaluation of frequency-dependent automatic gain-control systems in hearing aids, the effect of varying the amplitude-frequency response on the speech reception threshold (SRT) for sentences in noise is studied for 20 hearing impaired listeners. The noise has a spectrum identical to the long-term average spectrum of the sentences. Speech and noise are shaped by the same amplitude frequency response; their spectra are varied relative to the bisector of the individual's dynamic range. In four experimental conditions, the effect of a steady-state amplitude-frequency response is studied. Steepening the negative spectral slope of speech and noise appears to cause an increase of masked SRT, possibly due to increased effect of upward spread of masking. The effect of a single transition of the amplitude-frequency response between 10 and -10 dB/oct halfway through the sentence seems to be related to the effect for the fixed -10 dB/oct condition. Two transition times are tested. For a transition time of 0.25 s, the SRT is only a little higher than for 1 s. The results suggest that the amplitude-frequency response may be varied in time without having a detrimental effect on the masked SRT of sentences for hearing-impaired listeners as long as strongly negatively sloping spectra are avoided. PMID- 2768676 TI - Indoor human response to blast sounds that generate rattles. AB - The two major noise sources that cause environmental problems for the U. S. Army are helicopters and large weapons such as artillery, tanks, and demolition. These large weapons produce blast sounds that contain little energy above 200 Hz and that are particularly troublesome to deal with because they excite rattles in structures. The purpose of this study was to systematically test subjective response to the presence or absence of rattles in otherwise similar blast sound environments. A second purpose of the study was to test if there were structural changes that could reduce annoyance within the indoor blast sound environment. This study was done using a specially constructed test house and highly repeatable shake table to generate the blast sounds. The data clearly show that no commonly used environmental noise measure adequately describes the indoor environment when the blast excites rattles. Although the indoor blast ASEL changes by only about a decibel or so (and the indoor blast CSEL changes by even less), the subjective response changes by up to 13 dB. At low blast levels, the increase in human annoyance response is largest, and this annoyance response offset decreases to about 6 dB when the outside, flat-weighted peak sound pressure level of the blast increases from 112 to 122 dB. PMID- 2768678 TI - Patient/client advocates. PMID- 2768677 TI - Forward-masking properties of multicomponent signals in normal and hearing impaired subjects. AB - The forward-masking properties of inharmonic complex stimuli were measured both for normal and hearing-impaired subjects. The signal threshold for a 1000-Hz pure tone probe was obtained for six different maskers, which varied in the number of pure-tone components. The masking stimuli consisted of 1, 3, 5, 7, 9, or 11 components, logarithmically spaced in frequency surrounding the signal and presented at a fixed level of 80 dB SPL per component. In most normal-hearing subjects, the threshold for the probe decreased as the number of masking components was increased, demonstrating that stimuli with more components tended to be less effective maskers. Results from hearing-impaired subjects showed no decrease in threshold with increasing number of masking components. Instead, the thresholds increased as more components were added to the first masker. These results appear to be consistent with suppression effects within the multicomponent maskers for the normal subjects and a lack of suppression effects for the hearing-impaired subjects. The results from the normal-hearing subjects are also consistent with "across-channel" cuing. PMID- 2768679 TI - District nurses' patients--issues of caseload management. AB - Current pressures on all community services mean that practitioners must give more detailed attention to evaluation of patient outcomes and caseload review. District nursing caseloads in one health authority have been examined using a patient-focused approach. Random samples of patients who were either physically disabled, frail elderly, or elderly mentally infirm (n = 202) were examined for the distinctive and differing characteristics, if any, of recently referred and long-stay patients. Recently referred patients in our sample were either terminally ill, or had more chronic physical disorders. Patients who stayed on the books received either injections, general care from qualified staff or baths from nurse auxiliaries. Although covering similar areas of the health authority, nursing teams varied in the proportions of recently referred and long-stay patients, suggesting that individual nurses' caseload management is a crucial determinant of length of time on the books. In particular, nursing and medical review of all patients receiving vitamin B12 injections is urgently called for. In order for caseload monitoring to be facilitated, practitioners need relevant local and patient based data in order to make inter-team comparisons. The findings also have training and management support implications. PMID- 2768681 TI - Caring for a child with diabetes: the effect of specialist nurse care on parents' needs and concerns. AB - One hundred and sixty parents of 10- to 18-year-old children with diabetes were interviewed using Hymovich's Chronicity Impact and Coping Instrument (CICI: PQ). Eighty-two parents had access to a specialist nurse service; 72 parents did not. Regardless of the age of the child or the duration of diabetes, parents expressed a need for advice and support with child care. Parents with a specialist nurse needed information on more topics tending to focus on activities of daily living and child development rather than physical care and illness. They were also more likely to seek and receive help from nurses. Their level of concern was greater and, it is argued, may be the price parents pay for greater awareness. The findings of this study suggest that a systematic assessment of parent coping is necessary if specialist nurses are to help parents in their role as primary health carers. PMID- 2768680 TI - Nursing the statistics: a demonstration study of nurse turnover and retention. AB - This paper demonstrates how a health authority can use personnel records of nurses' working histories as an effective tool in manpower planning. Suggestions are given as to how these histories might be analysed and interpreted. Methods described range from the use of simple summary statistics and graphical methods to advanced statistical modelling techniques. Data from a study by researchers at the Centre for Applied Statistics and Department of Sociology at Lancaster University are used to give examples of these approaches. A description is also given of the practical difficulties experienced when attempting to extract the appropriate data from the health authority's personnel records. PMID- 2768682 TI - An evaluation of a communication skills course for health visitor students. AB - This paper presents part of the findings of an extensive empirical evaluation of a communication skills training programme for health visitor students. The programme was designed to develop the health visitors' ability to communicate with clients. A wide range of interpersonal skills were addressed and the training format involved skill analysis, roleplay practice and video-recorded feedback. The method of evaluation included an appraisal of the health visitors' social behaviour in a roleplay of a home-visit to a pregnant client. Data were collected, both before and following training, in an attempt to assess changes in trainee behaviour. The analysis took the form of a detailed frequency measurement of behavioural elements of health visitor performance, and a global rating of social competence by independent judges. Results of the analyses indicated that 14 out of the 20 behavioural variables changed in the desired direction. Thus, for example, following training the health visitors used significantly more open questions and verbal encouragers, and significantly fewer multiple questions and interruptions when communicating with the client. They were also rated significantly higher on the rating scale for social competence following training. These findings would seem to suggest that the training programme had a considerable degree of success. The findings are discussed in terms of the implications for development of health visitors' social skills, the need for more sophisticated measures of social behaviour and for the formulation of a model of competent professional practice in this area. PMID- 2768683 TI - Burnout and coping strategies among hospital staff nurses. AB - This study examined the relationship between use of coping strategies and burnout among 150 randomly selected staff nurses from four hospitals. The instruments used were the frequency dimension of the Maslach Burnout Inventory (Maslach & Jackson 1981) and the Ways of Coping (Revised) (Folkman & Lazarus 1985). In the canonical correlation analysis, two significant canonical variate sets differentiated nurses on the dimension of burnout. Nurses who experienced increased levels of burnout used the coping strategies of escape/avoidance, self controlling and confronting (P less than 0.001). Nurses who experience decreased levels of burnout used the coping strategies of planful problem solving, positive reappraisal, seeking social support, and self-controlling (P less than 0.003). Self-controlling coping, although present in both variate sets, was used to a lesser extent by nurses with decreased burnout levels. The positive relationship between planful problem solving and reduced burnout levels supports the theoretical framework of Lazarus. This framework asserts that during the appraisal process, persons evaluate the harmfulness of an event and their own coping resources. Persons with lower levels of burnout may perceive the event as amenable to change or they may perceive their coping resources as adequate. Either perception may promote the view that the situation is amenable to problem solving. Another rationale for the effectiveness of particular coping strategies may lie in the reactions that these strategies engender in others. The use of planful problem solving, seeking social support and positive reappraisal has been reported to result in the offering of greater social support than when confronting and self-controlling coping were used.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2768685 TI - The theoretical basis for nursing at the community level: a comparison of three models. AB - Although literature on community health nursing identifies a nursing role at the community level, there is a lack of clarity about the elements and expected outcomes of this role. In this paper three models of community health practice are presented and discussed in terms of their effectiveness as a basis for nursing practice at the community level. These models are (1) the public health model, (2) community participation model, and (3) community change model. Factors that affect the effectiveness of nursing to work at the community level are also discussed and questions for reflection and debate raised. PMID- 2768684 TI - Evaluating labour ward services: the art of the possible. AB - Midwives have contended that midwifery and obstetric workloads could not be measured and that only a 1:1 ratio of mother to midwife should occur, at least in the labour ward environment. This would appear to be true if traditional hospital statistics are used. However, this project set out to measure workload and staffing requirements. Using clinically based process and outcome criteria, dependency classification enabled daily, weekly and monthly workload and patterns of workload to be studied. Contrary to widely held beliefs it was demonstrated that mothers could be classified according to levels of need which form consistent patterns of distribution. A mean average of the total time spent on the labour wards by mothers was calculated for each level of need using 11 months' data. This produced a positive correlation with the dependency classification. Dependency classification and total time spent on the labour wards provides a mechanism for measuring workloads. To enable economic use of resources, a level of dependency for which a 1:1 ratio of staff:mother is considered essential has to be agreed. To assist with this decision two surveys designed to collect information concerning the percentage of the mothers' time spent in contact with the nursing/midwifery staff was conducted. The results were remarkably similar and again demonstrated a positive correlation with dependency classification. It was recognized that midwifery is a chronically understaffed service and that midwives working within the service felt unable to give the care they considered a woman in labour deserves.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2768686 TI - Nurses' perception of stress in preoperative surgical patients. AB - It is generally recognized that the stress of hospitalization and hospital treatment can impede the recovery of patients and in some cases cause potentially life-threatening physiological changes. Previous studies have indicated that nurses do not accurately perceive worry, anxiety and stress in patients. In order to assess how accurately nurses perceive worry, anxiety and stress in their patients, questionnaires were designed and distributed to a group of preoperative patients and nursing staff from general surgical wards, in order to discover how closely these two groups considered various situations and events as causing worry in preoperative patients. The results showed that whilst there was a considerable level of agreement between the two groups for the rank order of the 26 items in the questionnaire, nursing staff consistently assessed patients as worrying considerably more than the patients actually reported themselves. The nurses in the study were therefore over-estimating the degree of worry, anxiety and stress in their patients. PMID- 2768687 TI - The entrepreneurial nurse consultant: a Marxist analysis. AB - Consultation based on an entrepreneurial model is becoming an increasingly popular career choice for nurses. Marx's theoretical formulations were selected as a framework for examining various aspects of the entrepreneurial model of consultation in nursing. Areas addressed include the growing alienation of nurses from their work in institutional settings, entrepreneurial practice as an escape from alienation, and the inherently conservative nature of entrepreneurial consultant practice. PMID- 2768688 TI - For better. PMID- 2768689 TI - Where are we going? PMID- 2768690 TI - Root resorption. PMID- 2768692 TI - The importance of CPR. PMID- 2768691 TI - A pseudo-syndrome. PMID- 2768693 TI - Tripartite system: working together for a common goal. PMID- 2768694 TI - Mucosal burn resulting from chewable aspirin: report of case. AB - A 4-year-old female patient with juvenile rheumatoid arthritis received a mucosal burn from chewable-aspirin therapy. She was given five chewable aspirin tablets before bedtime, and fell asleep before swallowing them. Mucosal burns from incomplete aspirin ingestion can be prevented by not administering aspirin at bedtime, and by cleaning the buccal vestibules with a cotton swab to ensure complete removal of all aspirin. PMID- 2768696 TI - Well-circumscribed mixed-density lesion coronal to an unerupted permanent tooth. AB - The case reported is that of an ameloblastic fibro-odontoma in an 11-year-old male. The radiographic and clinical findings were typical, appearing as a well defined radiolucent-radiopaque lesion coronal to an erupting permanent tooth. Treatment consisted of surgical removal (enucleation) of the hard and soft tissue mass. Recurrence of the lesion is not anticipated. PMID- 2768695 TI - Effect of toothbrushing with 0.4% stannous fluoride and 0.22% sodium fluoride gel on gingivitis for 18 months. AB - This study determined the effect of brushing with 0.4% stannous fluoride (SnF2) or 0.22% sodium fluoride (NaF) on clinical and microbial parameters associated with gingivitis. The study included three groups of 281 subjects. Subjects in all three groups were instructed to brush twice daily with an ADA-accepted fluoride dentifrice, rinse their mouths with water, and subsequently brush with 0.4% SnF2, 0.22% NaF, or a fluoridefree placebo gel. More stain was detected in the SnF2 group than in the other two groups at all periods except at baseline. However, no differences were observed in gingivitis, bleeding, or mean proportions of microbial forms in the SnF2 or NaF groups when compared with the placebo group at 18 months. Results indicate that 0.4% SnF2, or 0.22% NaF is no more effective than a placebo in reducing gingivitis. PMID- 2768697 TI - Patient referral. PMID- 2768698 TI - Adverse reaction to retin-A. PMID- 2768699 TI - Here today, gone tomorrow. PMID- 2768700 TI - The casual user. PMID- 2768701 TI - Forensic dentistry. PMID- 2768703 TI - The mature practice. PMID- 2768702 TI - Dental identification in serial homicides: the Green River Murders. AB - At least 40 young women have died at the hands of a serial killer in what has been called the Green River Murders. Because most of the victims' remains were severely decomposed with partial or complete skeletonization and little or no personal effects were recovered, forensic odontologic methods played a key role in their identifications. Although numerous methods were used to accumulate leads to the identities of the badly decomposed skeletonized remains, leads generated through traditional investigative methods established the identities in most cases. Of 40 victims, 36 have now been identified, mainly by means of dental evidence. This article details the challenges presented by serial homicides and the key role of forensic odontologic methods in the Green River Murders investigation. PMID- 2768704 TI - The endo-antral syndrome: an endodontic complication. AB - Infection of pulpally involved teeth near the maxillary sinus sometimes spreads into the sinus and causes serious complications. This pathological complex, involving both antral and periapical tissues, is referred to as the endo-antral syndrome (EAS). It includes diagnostic difficulties, treatment considerations, and occasionally persistent pathological antral alterations after nonsurgical endodontic therapy. Surgical measures are occasionally required to stimulate healing and preserve the teeth. PMID- 2768705 TI - Exophytic mass of the floor of the mouth. AB - A tissue mass in the floor of the mouth was found to be an unusual, exophytic squamous cell carcinoma. The patient also had synchronous hepatic metastasis from an occult primary adenocarcinoma. The case is discussed from the standpoint of the differential diagnosis of lesions that may appear as masses of the floor of the mouth. Individuals with one primary cancer are at increased risk for developing second malignancies which may be in either the same anatomic area or in other organ systems. This case report emphasizes the need for the clinician to periodically follow-up any patient with a history of malignancy. PMID- 2768706 TI - Coronary heart disease morbidity and mortality in hypercholesterolemic men predicted from an exercise test: the Lipid Research Clinics Coronary Primary Prevention Trial. AB - A positive exercise electrocardiogram (ECG) has been proved to predict cardiovascular events in asymptomatic normolipidemic men. To study whether it is also predictive for hypercholesterolemic men, data from 3,806 asymptomatic hypercholesterolemic men in the Lipid Research Clinics Coronary Primary Prevention Trial were analyzed. All the men had performed a submaximal treadmill exercise test at baseline, before they were assigned to the cholestyramine or placebo treatment group. Because of missing or inconclusive data, 31 men were excluded from the analyses. A test was positive if the ST segment was displaced by greater than or equal to 1 mm (visual code) or there was greater than or equal to 10 microV-s change in the ST integral (computer code), or both. The prevalence of a positive test was 8.3%. During the 7 to 10 year (mean 7.4) follow-up period, the mortality rate from coronary heart disease was 6.7% (21 of 315) in men with a positive test and 1.3% (46 of 3,460) in men with a negative test (placebo and cholestyramine groups combined). The age-adjusted rate ratio for a positive test, compared with a negative test, was 6.7 in the placebo group and 4.8 in the cholestyramine group. With use of Cox's proportional hazards models, it was found that the risk of death from coronary heart disease associated with a positive test was 5.7 times higher in the placebo group and 4.9 times higher in the cholestyramine group after adjustment for age, smoking history, systolic blood pressure, high density lipoprotein cholesterol and low density lipoprotein cholesterol. A positive test was not significantly associated with nonfatal myocardial infarction.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2768707 TI - Predictors of total mortality and sudden death in mild to moderate heart failure. Captopril-Digoxin Study Group. AB - The relation between baseline clinical variables and subsequent mortality was examined in 295 patients with mild to moderate heart failure who participated in a multicenter trial comparing the effect on treadmill exercise tolerance of captopril, digoxin and placebo given in addition to a diuretic drug. At baseline study, all patients had a left ventricular ejection fraction less than or equal to 40%; 81% were in New York Heart Association functional class II. The etiology of heart failure was ischemic in 62% and nonischemic in 38%. During an average follow-up period of 16 months, 47 patients (16%) died and 24 deaths were classified as sudden. By univariate analysis, left ventricular ejection fraction, ventricular premature beat frequency, couplet frequency, ventricular tachycardia frequency, functional class, treadmill exercise time and nonischemic heart disease were statistically associated with mortality. With multiple logistic regression analysis, left ventricular ejection fraction was identified as the variable most closely associated with total mortality (p = 0.006). Twenty-seven percent of patients with an ejection fraction less than or equal to 20% died compared with 7% with an ejection fraction greater than or equal to 30%. Ventricular tachycardia frequency on Holter monitoring was independently associated with both total mortality (p = 0.008) and sudden death (p = 0.003). Patients with a ventricular tachycardia frequency of greater than 0.088 events/h had a mortality rate of 34% compared with 12% in those without ventricular tachycardia. In the multivariate model, functional class (p = 0.02) and etiology of nonischemic heart disease (p = 0.04) remained as independent predictors of mortality, whereas treadmill exercise duration did not.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2768708 TI - Increased fibrinopeptide A during anginal attacks in patients with variant angina. AB - It is not known whether coronary vasospasm is associated with coronary thrombosis. In this study, plasma levels of fibrinopeptide A during anginal attacks in 24 patients with variant angina were examined. A hyperventilation test was used to induce angina. Hyperventilation induced angina and ST segment elevation (AST: 0.32 +/- 0.14 mV, p less than 0.01) in eight patients with variant angina. Fibrinopeptide A increased from 0.75 +/- 0.27 at control to 7.8 +/- 4.4 ng/ml (p less than 0.01) during anginal attacks in these eight patients. In addition, four patients had spontaneous attacks of angina; they also had elevated levels of fibrinopeptide A during attacks (from 2.0 +/- 1.2 at control to 21.9 +/- 18.0 ng/ml [p less than 0.01] during attacks). Hyperventilation did not induce either angina or ST segment elevation in 12 of the patients with variant angina. Fibrinopeptide A levels did not change with hyperventilation in these patients. To determine whether elevated plasma levels of fibrinopeptide A were associated with angina, the plasma levels of fibrinopeptide A were examined during exercise-induced angina in seven additional patients with stable effort angina. They all developed angina with treadmill exercise; however, plasma fibrinopeptide A did not change. Therefore, only the patients with variant angina demonstrated elevated levels of fibrinopeptide A during anginal attacks. These findings suggest that coronary vasospasm associated with myocardial ischemia may induce stasis of blood, resulting in fibrinogen-fibrin conversion in the coronary vessels. PMID- 2768709 TI - Urinary fibrinopeptide A levels in ischemic heart disease. AB - Because acute coronary thrombosis can cause unstable coronary artery disease, fibrinopeptide A, a reliable marker of coagulation activity, may play a role in the evaluation of unstable ischemic syndromes. A new method of fibrinopeptide A sampling, spot urine normalized to urinary creatinine, was evaluated in patients with stable and unstable angina pectoris and acute myocardial infarction. Serial samples were obtained to characterize the changes in urinary fibrinopeptide A levels over time in patients with ischemic heart disease. Admission values (mean +/- SD) were similar in the control group (3.3 +/- 1.4 ng/mg creatinine) and the stable angina group (3.2 +/- 1.1 ng/mg creatinine) (p = NS). Values in the unstable angina group (5.7 +/- 2.6 ng/mg creatinine) were higher than those in the control (p = 0.008) and stable angina (p less than 0.001) groups. Myocardial infarction admission values (8.4 +/- 10.0 ng/mg creatinine) were higher than those in the control (p = 0.005) and stable angina (p less than 0.001) groups, but not higher than those in the unstable angina group. Peak values (the highest of multiple samples) were higher in the unstable angina group (7.6 +/- 5.9 ng/mg creatinine) than in the stable angina group (4.0 +/- 1.0 ng/mg creatinine) (p = 0.04), but not in the control group (4.5 +/- 1.9 ng/mg creatinine) (p = 0.056). The two patients with unstable angina with the highest peak values subsequently exhibited infarction. Peak values in patients with infarction (44.5 +/- 60.0 ng/mg creatinine) were significantly higher than those in patients with unstable (p = 0.03) or stable (p = 0.002) angina and control patients (p less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2768710 TI - Significance of coronary artery tone in patients with vasospastic angina. AB - To investigate the relation between basal coronary artery diameter and development of coronary artery spasm, the diameters of the proximal, middle and distal segments of the three major coronary artery branches, together with that of the left main trunk, were measured on a control angiogram and after ergonovine and nitrate administration in 30 patients with vasospastic angina without significant organic stenosis, and in 35 patients without ischemic heart disease. The percent change in coronary diameter after ergonovine and nitrate administration compared with the control diameter was used as an index of coronary vasoreactivity. In patients with vasospastic angina, coronary artery responses to both ergonovine and nitrate were greater in the spastic segments than in the other segments (p less than 0.05), and those of the coronary arteries without spasm were greater than those of the coronary arteries in patients without ischemic heart disease (p less than 0.01). There were no significant differences between the coronary artery diameters in the two groups after nitrate administration, and the control diameters were less in patients with vasospastic angina than in patients without ischemic heart disease. These observations indicate that a coronary vasomotion disorder, which involves increased basal coronary artery tone and hypersensitivity to vasoconstrictive stimuli, not only at a localized segment but also in the entire coronary artery tree, is present in patients with vasospastic angina. Clinically, evaluation of basal coronary artery tone may be useful for predicting the occurrence and location of coronary artery spasm. PMID- 2768711 TI - Functional and structural abnormalities in patients with dilated cardiomyopathy. AB - Passive diastolic properties of the left ventricle were determined in 10 control subjects and 12 patients with dilated cardiomyopathy. Simultaneous left ventricular angiography and high fidelity pressure measurements were performed in all patients. Left ventricular chamber stiffness was calculated from left ventricular pressure-volume and myocardial stiffness from left ventricular stress strain relations with use of a viscoelastic model. Patients with dilated cardiomyopathy were classified into two groups according to the diastolic constant of myocardial stiffness (beta). Group 1 consisted of seven patients with a normal constant of myocardial stiffness less than or equal to 9.6 (normal range 2.2 to 9.6) and group 2 of 5 patients with a beta greater than 9.6. Structural abnormalities (percent interstitial fibrosis, fibrous content) in patients with dilated cardiomyopathy were assessed by morphometry from right ventricular endomyocardial biopsies. Heart rate was similar in the three groups. Left ventricular end-diastolic pressure was significantly greater in patients with cardiomyopathy (18 mm Hg in group 1 and 22 mm Hg in group 2) than in the control patients (10 mm Hg). Left ventricular ejection fraction was significantly lower in groups 1 (37%) and 2 (36%) than in the control patients (66%). Left ventricular muscle mass index was significantly increased in both groups with cardiomyopathy. The constant of chamber stiffness (beta*) was slightly although not significantly greater in groups 1 and 2 (0.58 and 0.58, respectively) than in the control group (0.35). The constant of myocardial stiffness beta was normal in group 1 (7.0; control group 6.9, p = NS) but was significantly increased in group 2 (23.5). Interstitial fibrosis was 19% in group 1 and 43% (p less than 0.001) in group 2 (normal less than or equal to 10%). There was an exponential relation between both diastolic constant of myocardial stiffness (beta) and interstitial fibrosis (IF) (r = 0.95; p less than 0.001) and beta and fibrous content divided by end-diastolic volume index (r = 0.93; p less than 0.001). It is concluded that myocardial stiffness can be normal in patients with dilated cardiomyopathy despite severely depressed systolic function. Structural alterations of the myocardium with increased amounts of fibrous tissues are probably responsible for the observed changes in passive elastic properties of the myocardium in patients with dilated cardiomyopathy. The constant of myocardial stiffness (beta) helps to identify patients with severe structural alterations (group 2), representing possibly a more advanced stage of the disease. PMID- 2768712 TI - Echocardiography in infective endocarditis: reassessment of prognostic implications of vegetation size determined by the transthoracic and the transesophageal approach. AB - In 105 patients with active infective endocarditis, disease-associated complications defined as severe heart failure (New York Heart Association class IV), embolic events and in-hospital death were correlated to the vegetation size determined by both transthoracic and transesophageal echocardiography. A detailed comparison between anatomic and echocardiographic findings, performed in a subgroup of 80 patients undergoing surgery or necropsy, revealed that true valvular vegetations can be reliably identified by echocardiography in the vast majority of patients; the detection rate was significantly higher for the transesophageal (90%) than for the transthoracic (58%) approach, particularly when infected prosthetic valves were evaluated. However, an accurate echocardiographic differentiation between true vegetations and other endocarditis induced valve destruction (ruptured leaflets or chordae) is impossible. The correlation of vegetation size with endocarditis-associated complications showed that patients with a vegetation diameter greater than 10 mm had a significantly higher incidence of embolic events than did those with a vegetation diameter less than or equal to 10 mm (22 of 47 versus 11 of 58; p less than 0.01). Particularly for patients with mitral valve endocarditis, a vegetation diameter greater than 10 mm was highly sensitive in identifying patients at risk for embolic events. Vegetation size, however, was not significantly different in patients with and without severe heart failure or in patients surviving or dying during acute endocarditis. In addition, no significant correlation was found between vegetation size and location of endocarditis or type of infective organism.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2768713 TI - Assessment of myocardial systolic wall thickening using nuclear magnetic resonance imaging. AB - A quantitative nuclear magnetic resonance (NMR) imaging method of evaluating regional left ventricular function was compared with histochemical evidence of infarction in dogs and functional measurements in patients. Short-axis images of the heart were obtained at end-diastole and at 100 ms intervals thereafter. Regional diastolic left ventricular wall thickness and maximal percent systolic wall thickening were measured at the level of the papillary muscles in each of six segments. In six normal dogs, the mean end-diastolic wall thickness was 9 +/- 1.6 mm, and the mean maximal percent thickening was 61 +/- 11%. In eight dogs with a 4 day old infarct, maximal percent thickening was 5 +/- 8% (p less than 0.001) in the infarcted segments. In 10 normal human volunteers, the mean end diastolic wall thickness was 10.1 +/- 1 mm, and the mean maximal percent systolic wall thickening was 60 +/- 18%. Reduced maximal percent systolic wall thickening was defined as a value greater than or equal to 2 SD below the mean value obtained in normal volunteers. Seven patients with regional wall motion abnormalities were independently assessed by NMR imaging and biplane ventriculography. With a sensitivity of 94% and a specificity of 80%, NMR imaging demonstrated reduced maximal percent systolic wall thickening in the same segments identified as akinetic or dyskinetic by biplane ventriculography. Thus, abnormalities of regional systolic wall thickening are accurately identified with this quantitative imaging technique. PMID- 2768714 TI - Myocardial perfusion imaging by contrast echocardiography with use of intracoronary sonicated albumin in humans. AB - Sonicated albumin has been proposed as a near ideal echocardiographic contrast agent with little myocardial toxicity or hemodynamic effect. Its use has not yet been reported in humans, partly because of difficulties in preparation. With use of the newly modified sonication method, 10 ml of 5% albumin was sonicated for 75 s with a 5.0 ml slow infusion of air. This resulted in microbubbles with a mean diameter (+/- SD) of 5 +/- microns). Fourteen patients undergoing routine coronary angiography were studied. One patient had normal coronary arteries; the other 13 had significant coronary artery disease. In a subgroup of nine patients, sonicated albumin and sonicated diatrizoate meglumine sodium (microbubble diameter 9 +/- 3 microns) were injected several minutes apart, using the same technique. Videodensity-time curves were obtained from a region of interest in the myocardium. Corrected peak contrast intensity (baseline contrast intensity subtracted from peak contrast intensity, gray scale U/pixel) for sonicated albumin and for sonicated diatrizoate meglumine sodium was 51 +/- 26 and 52 +/- 19, respectively (p = 0.89). Washout half-time (T1/2) for the two agents was 5.5 +/- 4.5 and 16.0 +/- 12.2 s, respectively (p = 0.01). One patient with unstable angina experienced transient chest pain after repeated albumin injections. No electrocardiographic changes, blood pressure changes or wall motion abnormalities were observed. Administered by intracoronary injection, sonicated 5% albumin is a safe and effective echocardiographic contrast agent for myocardial perfusion imaging, yielding excellent myocardial contrast with physiologic washout time. PMID- 2768715 TI - Quantitative texture analysis in two-dimensional echocardiography: application to the diagnosis of myocardial amyloidosis. AB - Qualitative and subjective analysis of two-dimensional echocardiographic images of the myocardial wall allows one to identify amyloid heart disease; the quantitative analysis of regional image texture might be an accurate method to differentiate normal from amyloid myocardial structures. To test this hypothesis, two-dimensional echocardiograms of nine normal subjects and six patients with histologically documented amyloid heart disease were evaluated. Quantitative texture measurements of the first order (mean gray level, skewness, kurtosis, energy and entropy) overlapped between the two groups. Among the second order statistics variables, entropy was significantly and consistently higher in amyloid versus normal patient data (septum in parasternal long-axis view: 6.3 +/- 0.3 versus 5.9 +/- 0.4; septum in apical four chamber view: 6.2 +/- 0.2 versus 5.8 +/- 0.3). Therefore, amyloid-involved myocardial walls show ultrasound image texture alterations that may be quantified with digital image analysis techniques. PMID- 2768716 TI - Reproducibility of left ventricular mass measurements by two-dimensional and M mode echocardiography. AB - Both two-dimensional and M-mode echocardiography provide accurate estimates of left ventricular mass. However, their reproducibility in serial studies has not been compared, although this issue is critical to evaluation of regression of hypertrophy. To determine which technique provides more reproducible estimates of left ventricular mass, three serial studies were performed prospectively in each of eight normal adults over 5 months. Both two-dimensional and M-mode echocardiograms were obtained at each of these 24 studies. Measurements were performed by two independent observers who did not know patient identity. For the two-dimensional method, left ventricular mass was determined with use of a computer light-pen system and the truncated ellipsoid formula. For the M-mode method, mass was calculated from Penn convention measurements with use of the cube formula. At study 1 the group mean left ventricular mass by two-dimensional echocardiography (115 +/- 20 g) did not differ from that by M-mode study (127 +/- 37 g, p = NS). However, serial estimates of left ventricular mass were more reproducible by two-dimensional echocardiography. The mean difference among the three serial two-dimensional studies in each individual was 4.8 +/- 4 g (4.2 +/- 3%) by the two-dimensional method, but was 18.5 +/- 13 g (14.9 +/- 10%) by the M mode method (p = 0.01). Interobserver results for left ventricular mass by two dimensional echocardiography correlated closely (r = 0.95, n = 24, p less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2768717 TI - Serial assessment of mitral regurgitation by pulsed Doppler echocardiography in patients undergoing balloon aortic valvuloplasty. AB - Mitral regurgitation was serially assessed by pulsed Doppler echocardiography in 144 patients undergoing balloon aortic valvuloplasty for symptomatic aortic stenosis. Regurgitant scores of 0, 1, 2 and 3 were assigned to pulsed Doppler patterns corresponding to no, mild, moderate and severe mitral regurgitation, respectively. Before balloon aortic valvuloplasty, mitral regurgitant score correlated significantly (p less than 0.005) but weakly with aortic valve area (r = -0.24), left ventricular ejection fraction (r = -0.34) and left ventricular systolic pressure (r = 0.23). There was no significant correlation between mitral regurgitation and either mean catheterization or mean Doppler aortic valve gradient. Balloon aortic valvuloplasty produced significant decreases in both catheterization and Doppler mean transvalvular aortic valve gradients (56 +/- 19 to 31 +/- 12 and 60 +/- 19 to 48 +/- 16 mm Hg, respectively; both p less than 0.0001) and a significant increase (p less than 0.0001) in aortic valve area assessed by catheterization (0.6 +/- 0.2 to 0.9 +/- 0.3 cm2). Left ventricular ejection fraction did not change, but cardiac output increased (p less than 0.001) and pulmonary capillary wedge pressure decreased (p less than 0.0001). Pulsed Doppler findings of mitral regurgitation were present in 102 of the 144 patients. Eighty-eight patients had a score compatible with mild or more severe degrees of mitral regurgitation, and 49 had a score indicative of moderate or severe valvular insufficiency. In the entire group of 144 patients, mitral regurgitant score decreased significantly from 1.1 +/- 1.0 to 1.0 +/- 1.0 (p less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2768718 TI - Effects of active muscle mass size on cardiopulmonary responses to exercise in congestive heart failure. AB - Previous studies from this laboratory demonstrated that in healthy young men, cardiac output is closely coupled to oxygen uptake during dynamic exercise, regardless of its mode or relative intensity, whereas other physiologic responses such as heart rate, blood pressure and ventilation are inversely related to the size of the active muscle mass when expressed as functions of oxygen uptake. The purpose of the current investigation was to determine whether congestive heart failure alters the pattern of physiologic responses to various modes of arm and leg exercise in proportion to the size of the active muscle mass. Cardiopulmonary responses to four modes of dynamic work (one arm curl, one arm cycle ergometry, one leg cycle ergometry and two leg cycle ergometry) were characterized in terms of absolute and relative intensities (oxygen uptake and mode-specific percent of peak oxygen uptake, respectively) in middle-aged men with congestive heart failure and control groups of healthy subjects and patients after myocardial infarction without heart failure. Peak oxygen uptake was reduced to the greatest extent in patients with heart failure for large muscle mass work (-13% for curl, 32% for one arm and one leg cycle ergometry and -37% for two leg cycle ergometry; p less than 0.05 versus the normal group for the three modes of ergometry). This finding was paralleled by a markedly blunted slope for the cardiac output-oxygen uptake relation for leg but not arm exercise that was only partially compensated for by a widened arteriovenous oxygen difference. Blood pressure expressed as a function of oxygen uptake remained inversely related to active muscle mass size in all groups of subjects despite attenuation of systolic pressure for heavy large muscle mass effort in the group with heart failure. Pulmonary ventilation at a given metabolic rate was not influenced by active muscle mass size. Thus, saturation of capacity for systemic oxygen transport occurs in conjunction with blunted cardiac output reserve in patients with heart failure during exercise involving a smaller muscle mass than in healthy subjects. The basic inverse relation between size of the active muscle mass and blood pressure at a given metabolic rate is not altered by aging or reduced cardiac reserve. The muscle mass effect on ventilation seen in young healthy subjects disappears with aging. PMID- 2768719 TI - Derived epicardial potentials differentiate ischemic ST depression from ST depression secondary to ST elevation in acute inferior myocardial infarction in humans. AB - It was hypothesized that in acute inferior wall myocardial infarction, an additional ischemic area in the subendocardium of the noninfarcting territory would produce a selective current dipole between the infarcting and ischemic regions. A resistance network model to calculate epicardial potentials from body surface electrocardiographic potentials was developed and used to examine the hypothesis in 219 patients with acute inferior myocardial infarction. In the learning set of 110 patients, two characteristic dipole patterns were observed, each associated with a high mortality rate in the ensuing 15 months when compared with that in the remaining patients. In the test set of 109 patients, a double blind analysis of the patterns showed that the 34 patients with a dipole pattern had a collective mortality rate of 35% at 15 months compared with a 15 month rate of 5% in the remaining patients. In the total group of 219 patients, the magnitude of ST segment elevation and both the magnitude and integral of the area voltage of ST depression on the epicardium were significantly correlated with the mortality rate (p less than 0.0002 for all variables against death at 15 months). This study strongly suggests that ST depression due to ischemia can be differentiated from ST depression secondary to the ST elevation in acute inferior infarction by the examination of epicardial potential distributions. PMID- 2768720 TI - Isoproterenol reversal of antiarrhythmic effects in patients with inducible sustained ventricular tachyarrhythmias. AB - Seventeen patients (16 men and 1 woman) were challenged with isoproterenol after their initially inducible sustained ventricular tachyarrhythmia (monomorphic tachycardia in 14 patients and fibrillation in 3) was completely suppressed by class I antiarrhythmic drugs. Coronary artery disease was documented in 11 patients, dilated cardiomyopathy in 2 and no structural heart disease in the remaining 4 patients. The initial presentation was aborted sudden cardiac death (five patients), syncope (eight patients) and symptomatic nonsustained ventricular tachycardia (four patients). The antiarrhythmic drug that rendered the initial ventricular tachyarrhythmias noninducible was class IA in 11 cases, class IC in 5 and combined class IA and IB in 1. The original ventricular tachyarrhythmia became reinducible in 10 patients (group A) and remained noninducible in 7 patients (group B) after isoproterenol infusion at a rate necessary to achieve a 20% increase in heart rate. Despite the results of isoproterenol challenge, all patients were maintained on their electrophysiologically guided antiarrhythmic regimen. During a mean follow-up period of 13 +/- 9 months, 3 of the 10 patients in group A experienced clinical recurrence of tachyarrhythmia; no recurrence was noted in group B. In conclusion, reinducibility of ventricular tachyarrhythmia after beta-adrenergic stimulation seems to identify a subgroup of patients at high risk of subsequent arrhythmic events. Beta-adrenergic blockade or surgical therapy may be indicated in some patients with a positive isoproterenol challenge. PMID- 2768721 TI - A prospective randomized evaluation of biphasic versus monophasic waveform pulses on defibrillation efficacy in humans. AB - Biphasic waveforms have been suggested as a superior waveform for ventricular defibrillation. To test this premise, a prospective randomized intraoperative evaluation of defibrillation efficacy of monophasic and biphasic waveform pulses was performed in 22 survivors of out of hospital ventricular fibrillation who were undergoing cardiac surgery for implantation of an automatic defibrillator. The initial waveform used in a patient for defibrillation testing, either monophasic or biphasic, was randomly selected. Subsequently, each patient served as his or her own control for defibrillation testing of the other waveform. The defibrillation threshold was defined as the lowest pulse amplitude that would effectively terminate ventricular fibrillation with a single discharge delivered 10 s after initiation of an episode of ventricular fibrillation induced with alternating current. Each defibrillation pulse was recorded oscilloscopically, and defibrillation pulse voltage, current, resistance and stored energy were measured. Fifteen (68%) of the 22 patients had a lower defibrillation threshold with the biphasic pulse, 3 (14%) had a lower threshold with the monophasic pulse and 4 (18%) had equal defibrillation thresholds (within 1.0 J) regardless of waveform. The mean leading edge defibrillation threshold voltage was 317 +/- 105 V when the monophasic pulse was used and 267 +/- 102 V (16% less) when the biphasic pulse was used (p = 0.008). Mean leading edge defibrillation threshold current was 7.9 +/- 3.7 A when the monophasic pulse was used and 6.8 +/- 3.8 A (14% less) when the biphasic pulse was used (p = 0.051).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2768722 TI - Aortic aneurysm after patch aortoplasty repair of coarctation: a prospective analysis of prevalence, screening tests and risks. AB - Twenty-nine children were evaluated prospectively for the presence of an aortic aneurysm at the repair site 1 to 19 years after patch aortoplasty repair of coarctation of the aorta. In each child, noninvasive evaluation included a chest X-ray film, computed tomography of the chest and two-dimensional echocardiography. The presence and size of an aortic aneurysm were determined quantitatively by measuring the ratio of the diameter of the thoracic aorta at the repair site to the diameter of the aorta at the diaphragm (aortic ratio). An aortic ratio of greater than or equal to 1.5 was judged abnormal and was shown to be significantly greater than the aortic ratio of a normal control group. An aortogram was obtained in each child if any noninvasive screening test was found to be abnormal. As assessed by the aortogram, the prevalence of aortic aneurysm was 24% in this patient group. The sensitivity of echocardiography and chest computed tomography for detecting an aneurysm was 71% and 66%, and the specificity 76% and 85%, respectively. The chest X-ray film was 100% sensitive and 68% specific in determining the presence of an aneurysm. Although the data are not statistically significant, they suggest that children undergoing patch aortoplasty as the primary procedure (rather than a reoperation after earlier resection), and children in whom a Dacron patch is utilized may be at increased risk for aneurysm formation.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2768723 TI - Congenital cardiovascular malformations: questions on inheritance. Baltimore Washington Infant Study Group. AB - The Baltimore-Washington Infant Study, an epidemiologic investigation of congenital heart disease, searches for genetic and environmental risk factors. Among 2,102 infants with heart disease, 17.5% had a noncardiac abnormality of chromosomal or genetic origin, whereas among 2,328 control infants, only 0.7% had a genetic abnormality. Familial cardiovascular malformations encountered can be grouped into five distinct etiologic mechanisms. Single gene effects may be responsible for the specific histologic and biochemical changes in familial atrial septal defect with conduction disturbance and also in idiopathic ventricular hypertrophy. Left heart lesions showed familial concordance by the presumed morphogenetic mechanism of abnormal embryonic blood flow with phenotypes of varying severity. Pulmonary stenosis appeared with familial heritable disorders, as well as a partially concordant lesion with tetralogy of Fallot. Ventricular septal defect with transposition of the great arteries (one sibling pair) and with truncus arteriosus (two sibling pairs) indicate forme fruste expression of conotruncal defects. Endocardial cushion defect occurred with and without Down's syndrome in members of three families, suggesting inheritance of a defect affecting cellular migration. Heritable blood coagulopathies occurred in case families and not in control families. The associated of hemophilia and transposition, observed also by others, is extremely unlikely by chance and suggests genetic errors of endothelial cell function. The description of specific families from a population-based study emphasizes biologic questions on the nature of the inheritance of cardiovascular malformations. PMID- 2768724 TI - Influence of infarct age on reproducibility of ventricular tachycardia induction in a canine model. AB - The inducibility and reproducibility of ventricular tachycardia were evaluated in 97 dogs after myocardial infarction produced by single stage coronary artery ligation. Arrhythmia induction was performed with use of an endocardial electrode catheter positioned at the right ventricular apex before each study. An aggressive protocol of programmed stimulation was used, employing up to seven extrastimuli and three attempts at arrhythmia induction in each study. Electrophysiologic study was performed in individual dogs at the following times after infarction: 1) 7.7 +/- 0.3 and 15 +/- 0.2 days (34 consecutive dogs); 2) 14 +/- 0.6 and 26 +/- 1.7 days (24 selected dogs); 19 +/- 2 and 43 +/- 3 days (12 selected dogs); 4) 36 +/- 2 and 60 +/- 6 days (8 selected dogs); and 5) 59 +/- 12 and 130 +/- 10 days (3 selected dogs). Inducibility of ventricular tachycardia decreased significantly from 74% 1 week after infarction to 41% 2 weeks after infarction. Thus, early reproducibility was low (48%). Reproducibility increased thereafter, with 88% of the dogs having reproducible ventricular tachycardia between 2 and 4 weeks (p less than 0.025) and 100% having reproducibly inducible ventricular tachycardia between 4 weeks and 4 months after infarction. Dogs with no inducible arrhythmia early after infarction did not develop inducible ventricular tachycardia or fibrillation at later studies. Twelve dogs developed spontaneous ventricular tachycardia or sudden arrhythmic death late after infarction. Overall, 22% of dogs with inducible ventricular tachycardia with a cycle length greater than 140 ms developed spontaneous ventricular tachycardia or sudden death. Arrhythmia induction decreases significantly during the 1st 2 weeks after myocardial infarction, but long-term reproducibility of ventricular tachycardia induced greater than or equal to 2 weeks after infarction is very high. This canine model of long-term, reliably inducible ventricular tachycardia is suitable for investigation of antiarrhythmic drugs, surgery and other interventions. PMID- 2768725 TI - Aortic diameter and pressure-flow sequence identify mechanism of blood flow during external chest compression in dogs. AB - Aortic flow and pressure relations and aortic diameter were examined during sinus rhythm, internal cardiac massage, vest cardiopulmonary resuscitation, conventional manual cardiopulmonary resuscitation and high impulse manual cardiopulmonary resuscitation in 14 anesthetized large dogs. During sinus rhythm and during internal cardiac massage, ascending aortic flow and pressure increased simultaneously and the rise in ascending aorta pressure preceded the rise in descending aortic pressure by (mean +/- SEM) 28 +/- 4 and 30 +/- 1 ms, respectively. In contrast, during vest, conventional and high impulse cardiopulmonary resuscitation, ascending aortic flow lagged behind the initial rise in aortic pressure by 40 +/- 4 to 46 +/- 4 ms and ascending and descending aortic pressure increased simultaneously (p less than 0.001 for each external compression mode versus sinus rhythm and internal massage). The ratio of pulse pressure to stroke volume increased by an order of magnitude during all modes of external chest compression (p less than 0.001 versus sinus rhythm and internal massage) and aortic diameter decreased during vest and high impulse cardiopulmonary resuscitation (p less than 0.05 versus sinus rhythm and internal massage). The hemodynamics of external chest compression depart from the normal physiologic sequence of stroke volume-induced increase in aortic pressure and diameter. The rise in aortic pressure precedes flow into the aorta, stroke volume does not fully account for pulse pressure, and aortic diameter decreases during chest compression. These data support the hypothesis that blood flow is due to fluctuations in intrathoracic pressure for high impulse as well as vest and conventional cardiopulmonary resuscitation. PMID- 2768726 TI - Characteristics of lymphocytes cultured from murine viral myocarditis specimens: a preliminary and technical report. AB - Long-term culture of lymphocytes from myocardial biopsy specimens has been reported. To test the usefulness of this technique in experimental models of murine myocarditis, the culture and characterization of lymphocytes from mice infected with encephalomyocarditis virus or coxsackievirus B3 were studied. Lymphocytes were successfully cultured from three hearts of encephalomyocarditis virus-infected mice in interleukin 2-containing culture. After approximately 10 days, lymphocytes migrated out of myocardium in the chronic stage of myocarditis and gradually increased in numbers. More than half of the exuding cells were Thy 1.2-positive. None of the myocardial samples from coxsackievirus B3-infected mice grew out lymphocytes. Pathologic examination of all specimens showed myocardial necrosis with lymphoid infiltration. Although further studies are needed, this preliminary study suggests that the technique of lymphocyte culture may promote new insights into the pathogenesis of experimental myocarditis. PMID- 2768727 TI - The American College of Cardiology and World Cardiovascular Medicine. PMID- 2768728 TI - Future imperfect: the limitations of clinical prediction models and the limits of clinical prediction. AB - Stepwise regression procedures are often used to identify a small set of variables that serve as important predictors of clinical outcome and to construct prediction models based on those variables. Several theoretical and practical limitations of this process are discussed and highlighted with a variety of examples from published reports. Wider appreciation of these limitations should encourage the development of more relevant models, and thereby improve the quality of clinical prediction. PMID- 2768729 TI - Development and analysis of observational data bases. AB - Medical data bases have become an increasingly popular tool in clinical research. The observational data can be used to generate hypotheses for the development of clinical prediction rules and confirmation or extension of findings from other studies. When the analyses are carefully performed, the results from observational data bases generally have confirmed and complemented the findings of major randomized trials. In recent years, important clinical insights have been derived from analyses of data bases of large scale epidemiologic investigations; such insights may provide significant information on the impact of health policy decisions on patient care. To maximally and carefully use observational data, certain principles in both study design and the data collection and analysis phases should be applied. PMID- 2768730 TI - Data for cardiovascular modeling. AB - Data are required for a meaningful approach to quality and cost-conscious cardiovascular care. How to identify the types of data available and their sources, advantages and limitations to their use, issues involved in combining data from different sources for decision modeling and some possible solutions are discussed in this summary of the Working Group on Data for Cardiovascular Modeling. PMID- 2768731 TI - Medical quality assessment and the American College of Physicians. PMID- 2768732 TI - Changes in clinical dietetics: a physician's suggestions. PMID- 2768733 TI - International viewpoint: educating medical students, standardizing the term "dietitian". PMID- 2768734 TI - Using plasma proteins for nutrition assessment. PMID- 2768735 TI - Entry-level practice: challenges, obligations, and opportunities. AB - Each of us has a unique and varied set of experiences, ideas, and skills that we bring to dietetic practice. This diversity is the strength of the profession. With a strong commitment to provide nutrition services to the public, entry-level practitioners can successfully meet the challenges, fulfill the obligations, and maximize opportunities in a way that will make the vision of the future a reality for the profession of dietetics. PMID- 2768736 TI - Food science instruction in undergraduate dietetic education. AB - To assess the current status of food science instruction in undergraduate dietetic education, a survey was conducted of those persons responsible for teaching this subject in 267 Plan IV and 65 Coordinated Undergraduate Programs. Responses were received from 155 institutions offering a total of 177 programs. Factors examined included the number and academic background of faculty members teaching food science, the structure of the first course in food science, the structure of advanced food science courses required or offered to undergraduate dietetic students, and perceived adequacy of course content. Fifty-eight percent of the respondents had or were candidates for doctoral degrees, and 37% had master's degrees. The results indicated that although all programs offered a beginning course in food science, the required prerequisites and level of difficulty of subject matter varied. Fifty-three percent of the programs required at least one advanced food science course. More than 95% of both beginning and advanced courses are structured to include both lecture and laboratory. Although a majority of respondents indicated satisfaction with the adequacy of course content currently being offered, many made recommendations for improvements. Other concerns included difficulty in locating textbooks and other suitable instructional materials, isolation from others teaching food science, and a lack of standards for content to be included in basic and advanced courses. PMID- 2768737 TI - Freedom from fat: a contemporary multi-component weight loss program for the general population of obese adults. AB - This report summarizes results for the first 2,037 participants in the Freedom from Fat (FFF) weight loss program. FFF combined nutrition education, a low-fat dietary pattern, exercise, behavioral self-management, and social support in a program designed to serve the general population of overweight and obese adults. Participants ranged in age from 18 to 84 and from ideal weight to massively obese. After enrolling, program participants attended professionally led weekly meetings as long as they wished. Participants were encouraged to keep daily food diaries, to reduce the proportion of calories from fat to 30% or less, to exercise at moderate intensity for 30 minutes a day 5 days a week, to keep graphic records of weight change and exercise, and to display their graphs at each weekly group meeting. Attrition rates were comparatively low for a large scale program, with half of the participants still active in the fifth month and 22% still active after 1 year. Mean weight loss for obese participants (BMI 30 or greater) at 6 months was 7.3 kg (16.2 lb) for men and 5.3 kg (11.6 lb) for women. The best predictors of weight loss at 6 months were number of days per week in which food diaries were kept, baseline body mass index, number of minutes of exercise per week, and age. PMID- 2768738 TI - Long-term follow-up of weight status of subjects in a behavioral weight control program. AB - Few studies have examined the long-term effectiveness of behavioral weight control programs. Interpretation of the results from these studies has been limited due to small sample size, use of only one sex, and the number of evaluation parameters. A 2-year follow-up study was designed to assess the effectiveness of a behavioral weight control program on 123 obese male and 386 obese female subjects. Body weights were measured by dietitians at baseline and after an 8-week treatment program. Two-year follow-up weights were self-reported from a mailed questionnaire. The subjects' mean weight at baseline was 185.6 +/- 43.4 lb (no. = 509). Their mean percent over ideal body weight at baseline was 29.7%. Following an 8-week treatment period, mean weight was 176.4 +/- 41.3 lb (no. = 509), yielding a mean weight loss of 9.2 +/- 6.4 lb. Weight change after the 8-week treatment period ranged from a loss of 37 lb to a gain of 5 lb. The 2 year follow-up study showed that mean weight of the 498 subjects was 179.8 +/- 42.9 lb, yielding a mean weight loss of 5.8 +/- 15.5 lb. Weight change ranged from a loss of 71 lb to a gain of 47 lb. After 2 years, 325 subjects (65.3%) were still below their baseline weights, 182 subjects (36.6% of the entire study group) had maintained or enhanced the weight loss achieved during treatment, and 80 subjects (16.1%) weighed at least 10% less than their baseline weight.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2768739 TI - Dietary and weight control practices among persons with hypertension: findings from the 1986 Behavioral Risk Factor Surveys. AB - The National Heart, Lung, and Blood Institute has concluded that reducing sodium intake, controlling weight, and moderating alcohol consumption can help patients with hypertension control their blood pressure. To determine whether such patients have adopted recommended dietary practices, we analyzed data collected in 1986 from telephone surveys of adults in 26 states (no. = 34,395). The self reported dietary practices that we evaluated were: use of table salt, alcohol consumption, and weight control practices. In comparison with persons who did not have hypertension (no. = 26,848), those with hypertension who were receiving pharmacological therapy ("treated hypertensives," no. = 5,025) were more likely to report limiting their use of table salt (odds ratio [OR] = 2.5) and were less likely to have their weight controlled (OR = 0.4). Although overweight persons with hypertension were more likely than persons with normal blood pressure to attempt to lose weight, most have not included exercise in their weight loss efforts. There was no difference between persons who do not have hypertension and treated patients with hypertension in their use of alcohol. Untreated persons with hypertension (no. = 2,378) were less likely to limit their use of table salt and less likely to moderate their use of alcohol than treated persons with hypertension but otherwise reported similar dietary practices. Dietetic practitioners may need to emphasize moderation of alcohol use and the use of physical activity to lose weight when counseling patients with hypertension. PMID- 2768741 TI - Inclusion of geriatric nutrition in ADA-approved undergraduate programs. AB - All ADA Plan IV programs were surveyed to determine whether geriatric nutrition was included in their curriculums. Of the 268 Plan IV programs, 66% responded. Less than one-fifth of the programs offered or planned to offer a specific geriatric nutrition course. An overview of geriatric nutrition occurred most frequently in a human nutrition course. A practicum/clinical experience or a course other than nutrition most frequently provided in-depth study, if such was available. Nursing homes and congregate meal sites were the primary locations for experiences with the geriatric population. Major activities with that age group included (a) taking diet histories, (b) making nutrition assessments, and (c) providing diet instruction. In some programs, didactic and experiential training with the geriatric population may not be adequate to prepare dietetic undergraduate students to meet the health care needs of that growing segment of society. PMID- 2768740 TI - Demographic profile and nutrient intake assessment of individuals using emergency food programs. AB - A dietary assessment of food pantry and soup kitchen users was conducted. A demographic and socioeconomic profile of participants was developed. One hundred ninety-one persons completed 30- to 40-minute interviews while in line to receive food assistance. Dietary status was determined from 24-hour recall data. Intakes of calcium, iron, thiamin, riboflavin, niacin, protein, vitamin A, and vitamin C were compared with the 1980 RDAs for age and sex. A dietary adequacy score was developed to evaluate nutrient quality by calculation of a nutrient density ratio (total intake for a nutrient divided by the RDA). A value of one was considered the norm. A score of 0.67 or less was considered an inadequate nutrient intake. Sixty-eight percent of the sample demonstrated some degree of inadequate nutrient intake. Nutrients that tended to be the lowest were calcium (76% inadequate), vitamin C (74% inadequate), and thiamin (74% inadequate). Inadequate nutrient intake was significantly associated with a lack of cooking facilities, lower monthly incomes, and lesser amounts of money spent on food. Comparison of food pantry users with soup kitchen participants indicated calcium was a problem nutrient for both groups. PMID- 2768742 TI - Broadening students' perspectives on literature review. AB - Student dietitians, in our experience, have demonstrated a very narrow perspective in using professional literature. The limited scope of reference journals used and the lack of ability to critically review the literature and abstract the essentials of a study were identified as problem areas. An assignment designed to address those inadequacies was developed, implemented, and evaluated. Following scientific guidelines, 11 students from the coordinated program in dietetics each reviewed three to five non-nutrition-specific journals and abstracted all nutrition-related articles published for the current 16-month period. The resulting 339 abstracts were compiled and distributed to faculty and facility preceptors. Improvement was evident in students' ability to critically evaluate and abstract an article. Faculty members, facility preceptors, and students evaluated the project as being worthwhile. PMID- 2768743 TI - A strategy for designing effective patient education materials. AB - Health care professionals have long voiced a concern about the mismatch between patients' reading skills and the readability of printed educational materials. The gap between patients' reading levels and the readability of diet education materials has not been closed in the past 20 years. This article details a strategy for developing effective printed educational materials that was used to develop and revise dietetic materials for patients at a university medical center. The process includes the use of a computerized readability software program to assess reading levels. Three major steps are to (a) analyze patient education needs, (b) develop the instructional plan and materials, and (c) evaluate the materials. Examples are given of the application of the readability program in the development of one diet booklet and in the simplification of four other booklets. Without the readability formulas, the reading level of the materials would have remained above the stated educational levels of the target population, and the objectives of the booklets would not have been achieved. Cautions against overreliance on the readability formulas without other assessment steps are given. A systematic approach including readability assessment is needed to ensure the effectiveness of dietetic educational materials. PMID- 2768744 TI - A computer-assisted management information system for nutrition services. AB - A computer-assisted management information system was created to facilitate effective management of clinical nutrition services and labor resources in a 330 bed teaching and research hospital. Standards were developed for the quality and quantity of nutrition care, time required to provide nutrition care, and utilization of dietitians' time. Computer software was developed to report the volume of services provided, the need for services, and the utilization of labor hours. Data were evaluated to determine whether services were consistent with standards and to calculate a recommended number of clinical dietitian full-time equivalents for the hospital. Furthermore, the management information system was instrumental in developing a fee-for-service structure, for evenly distributing work loads among dietitians, and for monitoring adherence to standards of care. PMID- 2768745 TI - Student dietitians' experiences with dietary compliance. AB - The majority of students (91%; no. = 10) thought that following a modified diet was a very valuable experience. The student who did not think the assignment was valuable had been following a diet similar to that assigned, although she did not report this on the pre-test diet evaluation form. Overall, students thought they were better able to identify what it was like to make major dietary changes, especially when those changes are imposed by someone else. They had an increased awareness of the feelings of deprivation that patients might experience when foods become restricted. The students also believed that they would be more understanding when counseling patients and make more diligent efforts to individualize the diet as much as possible. Some thought they had a better understanding of noncompliance and would now be more empathic toward their patients. Assessing the changes required and the degree of difficulty experienced helped the students bring what had been learned conceptually to a conscious awareness. PMID- 2768746 TI - Computerized nutrition analysis: a nutrition education model for cardiovascular health. PMID- 2768747 TI - The influence of diet, body fat, menstrual cycling, and activity upon the bone density of females. PMID- 2768748 TI - Dietary and exercise practices of college-aged female bodybuilders. AB - The college-aged female bodybuilders in this study consumed nutrient-dense, low fat foods and participated in strenuous exercise to develop their physiques. Non competitors maintained consistent energy intake, exercise patterns, and body weight throughout the study period. In contrast, competitors exhibited periods of caloric restriction and excess associated with the pre- and post-competition events. This study indicates that college-aged female bodybuilders have food intake and exercise patterns that are unique to the sport. PMID- 2768749 TI - A multi-intervention weight management program for low-income rural women. PMID- 2768750 TI - Food stamp use and the nutrition practices of participants in the Colorado Expanded Food and Nutrition Education Program. PMID- 2768752 TI - Visions become realities: you make the difference! The American Dietetic Association, 72nd annual meeting. October 23-27, 1989, Kansas City, Missouri. Abstracts. PMID- 2768751 TI - Noneconomic and economic benefits of continuing education for dietitians. AB - This research evaluated the expected and actual noneconomic and economic benefits from continuing education as perceived by registered dietitian members of the Kansas Dietetic Association in 1986. A random sample of 180 dietitians was selected from the 550 members of the association; 83.9% of the sample responded to the research questionnaire. Thirteen possible noneconomic or personal benefits and six possible economic or professional benefits were rated on a scale of 1, little or no benefit, to 5, great benefit. The highest ratings on noneconomic benefits were 4.43 expected and 3.95 actual on the benefit of "becoming informed about some subject". On economic benefits, the highest ratings were 4.36 expected and 3.82 actual on "learning recent job knowledge." The overall noneconomic ratings were 2.85 expected and 2.78 actual. On economic benefits, the overall ratings were 3.46 expected and 3.07 actual. Dietitians ranked "expertise of instructors" and "instructor's ability to explain or demonstrate" as the two highest perceived strengths of the continuing education experience. Obviously, the instructor is viewed as an important factor in continuing education. Dietitians rated their degree of participation in continuing experiences in the following descending order: "contributing to the evaluation process", "sharing experiences with others," and "developing goals and ideas." PMID- 2768753 TI - The UV problem: have the rules changed? AB - In summary, the increase in numbers and longevity of the population is clearly demonstrated by the census records. The facts that human behavioral patterns have drastically changed to permit ever-increasing exposure to sunlight is a matter of history. The changes in the environment will have a profound effect on the world in which we live. Our food supply could be severely disrupted, the incidence of skin cancer is likely to increase substantially, and ocular radiation trauma to the cornea, lens and retina will be expected to increase in prevalence. This alarming information has been acknowledged by the national press in the newspapers and magazines, and by the radio and TV networks. The attention has resulted in a striking awareness of the public to the UVR hazard. Likewise, the scientific community has devoted considerable attention to the harmful nature of UVR exposure to the skin and the eye. The brief survey of UV research presented in this paper consistently demonstrates that the cornea, lens and retina are all vulnerable to permanent UVR damage. Our survey of available facts indicates that the "rules have changed dramatically on all counts." Ocular protection against UVR exposure must be provided to our patients in the form of contact, ophthalmic or intraocular lenses. The additional cost of UV protection is insignificant when compared to the cost in visual loss over a lifetime. We are truly talking about trivial costs when UV protection is contrasted to what people spend on getting extra UV exposure at the solarium, spa, ski slopes, beach, mountains, etc.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2768754 TI - Management of intermittent exotropia using a combination of vision therapy and surgery. AB - Vision therapy has been shown to provide higher success rates than surgery in the treatment of intermittent exotropia, but vision therapy is not successful in all cases. A case of intermittent exotropia is presented that illustrates the use of vision therapy in combination with surgery. Issues that should be considered when selecting this treatment option are discussed. PMID- 2768755 TI - Retrocorneal pigmentation. AB - Retrocorneal pigmentation was originally described as a rare congenital condition. Today it is primarily recognized as an uncommon, acquired condition secondary to surgery, trauma, or inflammation, and it may become more common as ocular surgery is being performed more frequently. Although visual loss is rarely a direct result of retrocorneal pigmentation, it may occur from secondary glaucoma, so patients with retrocorneal pigmentation must be regarded as glaucoma suspects. Presented here is a case report followed by a discussion of recent studies which have created a better understanding of the mechanisms of retrocorneal pigmentation, frequency of occurrence, and associated ocular findings. PMID- 2768756 TI - Visual perception and learning: issues and answers. AB - The role of the optometrist in treating children who are identified as learning disabled is not always understood by members of an interdisciplinary team. It is the purpose of this paper to develop a brief philosophical foundation for optometric intervention and to review some of the literature which supports the validity of optometric therapy. Correlational studies are cited to establish a basic relationship between perceptual dysfunctions and learning readiness in normal children. After establishing that perceptual training does indeed improve perceptual skills, we cite a number of investigations where intervention enabled children who had been classified as learning disabled to respond more effectively to school learning. The role of the optometrist as a member of an interdisciplinary team is addressed. PMID- 2768757 TI - The eye-opening case of Keir v. United States. AB - In a case involving a 4-year-old esotrope with retinoblastoma, a federal appellate court has held that, as a matter of law, the standard of care expected of an optometrist requires a dilated fundus examination conducted with the binocular indirect ophthalmoscope at the initial visit and periodically thereafter. PMID- 2768758 TI - Thyroid function tests in ageing and their relation to associated nonthyroidal disease. AB - Thyroid function tests of 179 euthyroid geriatric inpatients (83 +/- 6 yr) unaffected by acute diseases or malnutrition were investigated and compared with those of 76 ambulatory healthy younger subjects (42 +/- 13 yr). Elderly population was divided in three groups, respectively: group G I (n = 37, 65-78 yr), group G II (n = 64, 79-85 yr) and group G III (n = 78, over 85 yr). Severity of-illness index of the patients was evaluated at entry in the study protocol. While total thyroxine (TT4), free triiodothyronine (FT3) and TSH levels remained unchanged, circulating total triiodothyronine (TT3) was significantly lower (113 +/- 32 vs 150 +/- 31 ng/dl, p less than 0.05) and free thyroxine (FT4) was significantly higher (12.4 +/- 2.7 vs 10.3 +/- 2.3 pg/ml, p less than 0.05) in aged people. Furthermore, TT3 decreased significantly from 130 +/- 36 in G I to 110 +/- 33 in G II and to 108 +/- 25 in G III (p less than 0.01), and FT4 increased progressively although not significantly in the same groups. A close correlation was found between TT3 and severity index in male observations only (r = -0.43, p less than 0.01), as well as between FT4 and severity index in both sexes (r = 0.51, p less than 0.001 for men, r = 0.21, p less than 0.01 for women). These data suggest that thyroid function tests have to be cautiously interpreted in a geriatric population, particularly in relation to the severity of the clinical state, and reference values should be determined for TT3 and FT4 in the ageing process. PMID- 2768759 TI - Human growth hormone stimulates liver regeneration in rats. AB - To study the effect of human growth hormone (hGH) on liver regeneration in rats, 200 micrograms hGH was administered to partial hepatectomized rats twice a day for three days. The bw of hGH-treated rats was higher than that in untreated rats. After three day administration, the liver weight was 3.18 +/- 0.13 g, significant higher than that of untreated rats (2.68 +/- 0.17 g). Human GH also stimulated the mitosis in the liver. Serum insulin-like growth factor I (IGF-I) and albumin levels were significantly increased and urea nitrogen levels were significantly decreased in hGH-treated rats compared with those in untreated rats. When 120 micrograms/day IGF-I was continuously administered to partial hepatectomized rats for three days, the bw and the liver weight were not higher than those of controls. These data indicate that hGH directly stimulates liver regeneration and recover liver dysfunction in rats. PMID- 2768760 TI - What is meant today by Hashimoto's thyroiditis? PMID- 2768761 TI - Meal-stimulated gastrin release and calcitonin secretion. AB - In order to study the effects of a physiologic meal on calcitonin (CT) secretion we studied 6 normal male volunteers (aged 28-34 yr). Each subject was given, on two separate days, either a mixed meal or 200 ml of distilled water, in random order. Gastrin (G) was effectively stimulated by the meal (F = 8.82; p less than 0.001) and reached a peak (with an average 100% increase) 30 min after the end of the meal, slowly decreasing thereafter; no increase was seen after water ingestion. On the other hand, CT levels remained stable throughout the observation period on both occasions. Ionized and total calcium did not show significant variations either after the meal or after water ingestion. These findings suggest that G alone, at the concentrations usually reached after a physiologic meal, is unable to stimulate CT secretion, at least in the absence of calcium increases. PMID- 2768762 TI - Late-onset hypocalcemia appearing years after thyroid surgery. AB - We revised four cases of hypocalcemia diagnosed yr after thyroid surgery, including 1 man and 3 women, operated 5-23 yr before the onset of symptoms, which ranged from mild paresthesia to convulsive seizures. Total serum calcium levels ranged from 1.1 to 2.05 mmol/l, and PTH levels were low in the 3 cases in which they were measured. Hypoparathyroidism appearing as late-onset hypocalcemia after extense thyroid surgery is a poorly understood condition, perhaps not as unfrequent as it is considered. PMID- 2768764 TI - Magnetic resonance imaging for the assessment of lingual thyroid. AB - A 43-year-old woman was evaluated because of a round tumor at the base of the tongue. Scintigraphy with 131I showed radionuclide uptake over the posterior part of the tongue but no uptake at all at the usual pretracheal location. Magnetic resonance imaging revealed a well defined round mass of high signal intensity, which was clearly delineated from adjacent muscular tissue. PMID- 2768763 TI - Thyroid hormone autoantibodies (THAA) in three sisters: a four-year follow up. AB - We have found three sisters who had thyroid hormone autoantibodies (THAA) in serum. Two of them were hypothyroid due to Hashimoto's thyroiditis. They were treated with synthetic thyroxine (T4) (Case 1) or T4 and triiodothyronine (T3) (Case 2). The other sister (Case 3) was euthyroid throughout the investigation period. Changes in the titers of THAA, antithyroglobulin (Tg) antibodies as well as in the concentrations of thyrotropin (TSH), and total and free thyroid hormones (T3, T4, FT3, and FT4) in sera from each patient were examined for four years. A significant positive correlation was observed between titers of THAA and anti-Tg antibodies in both Case 1 (anti-T3 and anti-T4) and 2 (anti-T4). On the other hand, a significant negative correlation between titers of anti-T3 and anti Tg antibodies was observed in Case 3. These results suggest that antigen of THAA might be Tg in Case 1 and 2 and mechanism(s) of the production of THAA of Case 1 might be different from that of Case 1 and 2 in terms of their antigen or immune recognition of Tg. PMID- 2768765 TI - Endemic goiter and iodine deficiency in Yugoslavia. PMID- 2768766 TI - Reduction of alkali-induced white blood cell DNA unwinding rate: a potential biomarker of aging. AB - The modification of DNA with aging or in diabetes mellitus has been proposed as a possible mechanism of cellular senescence. To test this hypothesis, we measured DNA strand breaks in human white blood cells (WBC) by fluorometric analysis of DNA unwinding in alkaline solutions. In a nondiabetic population with an age range 22-80 years, there was a significant negative correlation between the rate of DNA unwinding and the age of the individual with an r of 0.60 (p less than .001). The rate of alkaline digestion of double-stranded DNA (ds DNA) in the elderly diabetics (n = 26, 65-80 yrs) was significantly lower than that in the nondiabetic, age-matched ambulatory elderly. Within the healthy group studied, there was a statistically significant correlation between the rate of DNA unwinding and plasma glucose concentration (p less than .05) or glycosylated hemoglobin A1C levels (p less than .0001). The availability of WBC and the relative ease and rapidity of the technique employed make this a potentially useful biological marker of aging. PMID- 2768767 TI - Physical performance measures in aging research. AB - Evaluation of physical functioning plays a valuable role in clinical geriatrics as well as in aging research. Physical functioning has generally been assessed through self- or proxy-report. An important addition to this form of assessment is the use of performance measures of physical function, in which individuals are asked to actually perform specific tasks and are evaluated using standardized criteria. Although there has been limited methodological work on physical performance instruments, this approach offers a number of potential advantages. Several performance assessments have been developed that correlate highly with other measures of health status and predict need for long-term care and mortality. It is suggested that more widespread use be made of physical performance assessments and that they be evaluated as measures of functioning in cross-national studies, as indicators of change in functioning over time, as endpoints in intervention studies, as tools for identifying persons functioning at high levels, and as sources of relevant information for the clinician. PMID- 2768768 TI - Cardiovascular and behavioral effects of aerobic exercise training in healthy older men and women. AB - The cardiovascular and behavioral adaptations associated with a 4-month program of aerobic exercise training were examined in 101 older men and women (mean age = 67 years). Subjects were randomly assigned to an Aerobic Exercise group, a Yoga and Flexibility control group, or a Waiting List control group. Prior to and following the 4-month program, subjects underwent comprehensive physiological and psychological evaluations. Physiological measures included measurement of blood pressure, lipids, bone density, and cardiorespiratory fitness including direct measurements of peak oxygen consumption (VO2) and anaerobic threshold. Psychological measures included measures of mood, psychiatric symptoms, and neuropsychological functioning. This study demonstrated that 4 months of aerobic exercise training produced an overall 11.6% improvement in peak VO2 and a 13% increase in anaerobic threshold. In contrast, the Yoga and Waiting List control groups experienced no change in cardiorespiratory fitness. Other favorable physiological changes observed among aerobic exercise participants included lower cholesterol levels, diastolic blood pressure levels, and for subjects at risk for bone fracture, a trend toward an increase in bone mineral content. Although few significant psychological changes could be attributed to aerobic exercise training, participants in the two active treatment groups perceived themselves as improving on a number of psychological and behavioral dimensions. PMID- 2768769 TI - Long-latency enhancement of quadriceps excitability from stimulation of skin afferents in young and old adults. AB - This study examined the role of cutaneous input on spinal excitability in young and old adults. Patellar tendon reflexes were elicited in 15 old adults (M = 75 yrs) and 25 young adults (M = 26 yrs) at intervals ranging from 15 to 175 ms following cutaneous stimulation to one of four skin sites: (a) ipsilateral calf, (b) contralateral calf (old adults only), (c) ipsilateral anterior thigh, and (d) contralateral anterior thigh. The younger adults had a more vigorous reflex response than the older adults, as indicated by peak force. Force latencies were also faster for the younger adults than the older adults. However, both age groups showed a long-latency facilitation of quadriceps excitability regardless of cutaneous stimulation site. Thus, it seems that low threshold cutaneous afferents contribute an excitatory input to the extensor motoneuron pool that is maintained with age. PMID- 2768770 TI - Nerve conduction and creatinine clearance in aged subjects with periodic movements in sleep. AB - Periodic leg movements during sleep (PLMs) are non-epileptiform, repetitive limb movements that are highly prevalent among the geriatric population. The mechanisms underlying these movements are poorly understood. In this study we evaluated PLMs of 24 aged volunteers. We hypothesized that the high prevalence of PLMs seen in the aged would be related to (a) lower creatinine clearance and (b) slowed velocities/delayed latencies in the nerve conduction studies of such individuals. Results did not support hypothesis (a) but offered some equivocal support for hypothesis (b), inasmuch as aged subjects with higher levels of PLMs had delayed motor and sensory latencies in the upper limbs (median n., ulnar n.). Results are discussed in terms of central vs peripheral mechanisms involved in the generation of PLMs in elderly persons. PMID- 2768771 TI - Dimensions of the OARS mental health measures. AB - A measurement model of mental health for the Older Americans Resources and Services (OARS) questionnaire is described. Using confirmatory factor analysis on noninstitutionalized elderly from Cleveland (N = 1834) and Virginia (N = 2146), the 21 OARS mental health items were fit to a 15-item model. In addition to the second-order construct of mental health, there were four first-order dimensions: life satisfaction, psychosomatic symptomatology, alienation, and cognitive deficit. Analyses were further replicated by splitting both samples in half. The model fit well and compared favorably to other alternative specifications. In addition to this analysis of internal structure, the model was also examined in relation to several exogenous factors including age, sex, race, education, and physical health. While the model again fit well, a model with cognitive deficit separate from the other factors seemed more reasonable. PMID- 2768772 TI - Alzheimer patient evaluation and the mini-mental state: item characteristic curve analysis. AB - To develop a tool for precisely assessing dementia severity, items should be selected according to their relationship to the overall progression of the disease. Using an item characteristic curve analysis (ICC), items were examined from the Folstein Mini-Mental State Exam (MMSE), a useful clinical tool for evaluating dementia. MMSE data were available for 86 patients who met DSM-III criteria for primary degenerative dementia -- possible or probable Alzheimer's disease (AD). A logistic regression analysis of the probability of correct performance on an item, given the total MMSE score, yielded statistics for difficulty and discrimination. These statistics were interpreted respectively as indicators of the point in the progression of the illness at which the mental function tested by that item is lost and the rapidity of that loss. The data indicated a systematic progression of the development of symptoms in AD related to decline of memory function. Temporal orientation was lost before spatial and object orientation, and recollection of words was lost before ability to repeat them. ICC can help to delineate the loss of mental functions during the course of AD. PMID- 2768773 TI - Age differences in perceiving the direction of self-motion from optical flow. AB - Patterns of optical flow produced at the eye of a moving observer are important for the guidance of locomotion. This study examined age-related changes in the ability to perceive one's direction of self-motion, or heading, from optical flow, using computer displays that simulate translational or curvilinear movement parallel to a random-dot ground surface. We found small but significant decrements in performance with age, such that the mean heading threshold rises from 1.1 degrees in younger observers to 1.9 degrees in older observers for translation, and from 1.4 degrees to 2.9 degrees for curvilinear movement, under comparable dot density and speed conditions. The absence of an age by dot density interaction indicates that there is no age-related shift in strategy, but rather a general decline in the ability to detect and localize global optical flow patterns. The decrement appears to be due to higher level losses in the visual system rather than ocular or low-level sensory losses. The results may have implications for the control of high-speed locomotion and falls in older adults. PMID- 2768774 TI - Psychosocial distress and perceived health status among elderly users of a health maintenance organization. AB - A variety of measures was used to assess the relationship of psychosocial distress and perceived health status among 1,034 older (65+) members of an HMO. Distress was measured by recent life events, four types of social strain, and the CES-D, a measure of depression/demoralization. The distributions of these measures and perceived health status indicate that this sample was relatively healthy and undistressed. The strength of the associations within each group of variables is significant but generally modest. Using hierarchical multiple regression analysis with demographic variables, social support, and religiosity as controls, the strongest associations are between health status and the CES-D, life events, financial strain, and the strain of being single (unmarried respondents only). PMID- 2768775 TI - Age differences in manual versus vocal reaction times: further evidence. AB - Old and young adults responded to the spatial location of a stimulus, either by moving a lever in the direction of the stimulus or by saying the word corresponding to the direction into a microphone. For subjects of both ages, vocal responses were slower than manual responses, and reaction times increased with increased alternatives (1, 2, or 4 directions). In addition, the slopes of the functions relating reaction times to alternatives were steeper for vocal responses, a finding that is contrary to the report of smaller age differences in reaction time for vocal responses. The slopes of the vocal functions were similar, however, a finding suggesting that age differences in central processing rates are less for vocal than manual responses. PMID- 2768776 TI - Social isolation and well-being. AB - We examined 10 common indicators of social isolation and assessed which, if any, are related to subjective well-being among elderly individuals. The quantitative measures (no daily contact and minimal weekly contact), no children, having no children plus being unmarried, and having no children plus living alone, were unrelated to either global happiness or life satisfaction. The combined indicators of living alone and being unmarried as well as single indicators of having no companions or having no confidants were related at the bivariate level to both measures of well-being. When controlling for demographic, economic, and health factors, having no confidants and no companions were significantly and independently related to subjective well-being. These findings suggest that practitioners who seek information on living arrangements or marital status as proxy measures of lower psychological well-being are utilizing the wrong predictors. PMID- 2768777 TI - Aberrant behaviors and Alzheimer's disease: mental health effects on spouse caregivers. AB - The relationships between well-being of 262 caregivers of Alzheimer's disease patients and forgetful, asocial, and disoriented behaviors on the part of the impaired spouse were examined using three one-way MANOVAs. Results indicate that asocial and disoriented behaviors have linear relationships with levels of burden, specific mental health problems attributed to caregiving, and the extent to which caregivers sacrificed aspects of their social life. Asocial behaviors were also linearly related to overall level of caregiver depression. Forgetful behaviors, on the other hand, have relationships with burden, specific mental health problems attributed to caregiving, and social change that are nonlinear. Data are interpreted in terms of the predictable course of Alzheimer's disease and associated role expectations. PMID- 2768778 TI - Age differences in religious participation among black adults. AB - Age differences in level of religious participation were examined using data from the National Survey of Black Americans (N = 2107). Seven indicators of organizational, nonorganizational, and attitudinal forms of religious involvement were examined. For women, age was positively associated with each of the religiosity measures; among men, requests for prayer from others was the only indicator for which age was not a significant predictor. The findings are discussed in relation to previous work on age and religious participation. PMID- 2768780 TI - Some applications of latent trait analysis to the measurement of ADL. AB - The use of latent trait methods for detection of biased items used in scales is discussed and two examples given. In the first, items measuring functional impairment in elderly community residents are tested for possible sex bias, and items predicted on the basis of clinical judgment to be clearly sex-biased are correctly identified. In the second example, taken from a cross-national study of elderly residents in long-stay institutions in New York and London, scale items suspected of bias due to interviewer variability and to cross-national differences in institutional environments are identified. It is shown that estimated rates of impairment are affected by presence of variant (biased) items. We argue that latent trait methods are useful for identifying biased items and may have wide application in gerontological research. PMID- 2768779 TI - The impact of worker age on unemployment and earnings after plant closings. AB - This study examined how older workers who lost jobs due to a plant closing or plant move fared in the reemployment market. The data are from the January 1984 Current Population Survey, which included special questions focusing on displaced workers. Accelerated failure time equations are estimated to determine the relationships between age and duration without work following job loss. Regression equations explaining subsequent earnings also are estimated. Although older workers have lower overall unemployment rates than younger workers, those displaced due to a plant closing or move do not fare as well as their younger counterparts. Median length of unemployment for those age 55 and over was 27 weeks, which compared unfavorably to the 13 weeks found for workers under age 45. When controlling for other worker characteristics, older workers were found to experience more than four additional weeks of unemployment and earn less upon reemployment than younger workers. PMID- 2768781 TI - Fatal infantile muscle phosphorylase deficiency. AB - A premature female infant born of a consanguineous union exhibited joint contractures and signs and symptoms of perinatal asphyxia. A muscle biopsy examined by light microscopic, histochemical, and electron microscopic techniques exhibited changes of muscle phosphorylase deficiency and glycogenosis, identical to those of McArdle's disease. Postmortem ultrastructural examination of liver and heart did not reveal lysosomal storage. This case and one previously reported example of fatal infantile phosphorylase deficiency suggest that the clinical spectrum of McArdle's disease may be broader than previously recognized. PMID- 2768782 TI - Autosomal recessive cerebellar hypoplasia. AB - Cerebellar hypoplasia is found in association with a variety of neurologic and systemic disorders. It is the primary finding in the uncommonly reported condition of autosomal recessive cerebellar hypoplasia. We describe two siblings with cerebellar hypoplasia documented in both by magnetic resonance imaging (MRI) and review the clinical features of previously reported cases of autosomal recessive cerebellar hypoplasia. The most common findings in this disorder are nonprogressive ataxia, strabismus, mental retardation, and speech delay with dysarthria. Previously reported cases have been confirmed by autopsy, pneumoencephalography, or computed tomographic (CT) scans. MRI clearly documents diffuse cerebellar hypoplasia and aids in distinguishing autosomal recessive cerebellar hypoplasia from other disorders. The pathophysiology of this disorder is uncertain, however, studies of the weaver mutant mouse (an animal model of autosomal recessive cerebellar hypoplasia) suggest that an abnormality of the Bergmann glia may lead to the observed granule cell layer deficiency in these patients. This diagnosis should be considered for children with nonprogressive ataxia and families should be made aware of the 25% recurrence risk. PMID- 2768783 TI - Congenital myopathy with progressive external ophthalmoplegia. AB - Progressive external ophthalmoplegia is associated with an increasingly heterogeneous group of neuromuscular disorders. We describe a 16-year-old girl with delayed motor milestones and onset of progressive external ophthalmoplegia at age 3 years and proximal muscle weakness at age 10 years. Muscle biopsy specimen demonstrated type I myofiber predominance and type II myofiber atrophy. Although the pathological features of this congenital myopathy are quite nonspecific, the case further illustrates the pathogenetic heterogeneity of the progressive external ophthalmoplegia phenotype. PMID- 2768784 TI - Deficiency of carnitine palmitoyltransferase I. AB - Defective activity of carnitine palmitoyltransferase I was demonstrated in fibroblasts derived from a patient with hypoketotic hypoglycemia. The level of activity observed was approximately 10% of the control mean. Oxidation of palmitate by intact fibroblasts was reduced to 5% of control values. The patient presented at age 14 months with seizures and was found to have marked hypoglycemia and no ketones in the urine. In response to fasting, she developed hypoglycemia, but the curves for acetoacetate and 3-hydroxybutyrate were flat. Administration of medium-chain triglycerides relieved the hypoglycemia and generated a brisk ketogenesis. PMID- 2768785 TI - Reversible treatment-related leukoencephalopathy. AB - We present two children with acute lymphocytic leukemia who developed leukoencephalopathy following administration of a combination of intravenous ara = C and methotrexate during the consolidation phase of chemotherapy. Cranial magnetic resonance imaging showed widespread, abnormally high signal intensity in the deep white matter in both patients, though one patient had normal cranial computed tomographic scan. Treatment was modified, symptoms resolved in 1 to 2 weeks, and the white-matter changes resolved over 6 to 12 months. Intravenous cytarabine and methotrexate appear to act synergistically to enhance the potential for central nervous system toxicity. Awareness of this potentially serious complication of chemotherapy can facilitate timely recognition of leukoencephalopathy with the use of magnetic resonance imaging. PMID- 2768786 TI - Subtle encephalomyelitis in children: a variant of acute disseminated encephalomyelitis. AB - Four children with chronic, mild, nonspecific symptoms are described in whom magnetic resonance imaging (MRI) showed the presence of multifocal white-matter lesions suggestive of acute disseminated encephalomyelitis. The children ranged in age from 14 months to 15 years. The clinical picture was vague and inconclusive and consisted of several months of headaches, irritability, clumsiness, and personality change. Physical examinations were noncontributory. Laboratory investigation revealed no other cause of the demyelination. All of the patients have done well without any treatment, with a disappearance of symptomatology. The white-matter lesions on MRI scan in these children may indicate subtle exposure to a myelinolytic antigen. It has been suggested that such an exposure may create a state of complete or partial resistance to the encephalitogenic potential of the next infection or immunization. With complete resistance, the patient remains healthy and with partial resistance progressive demyelination results. Verification of these findings by others would suggest a possible benefit of a multicenter study of such patients, with virological, HLA testing, and long-term follow-up, in understanding the etiopathogenesis of multiple sclerosis. PMID- 2768787 TI - Progressive dystonia with diurnal fluctuation. PMID- 2768788 TI - The role of environmental factors and pollutants in combination with genetic predisposition in the etiology of multiple sclerosis: possibilities for prevention? PMID- 2768789 TI - Arnold-Chiari malformation in Jarcho-Levin syndrome. PMID- 2768790 TI - Dysmaturation neuromyopathy. PMID- 2768792 TI - Selected abstracts from the meeting of the British Association for the Study of the Liver. London, U.K., 16 and 17 February, 1989. PMID- 2768791 TI - Neuroleptic malignant syndrome in a child treated with metoclopramide for chemotherapy-related nausea. PMID- 2768793 TI - Taurocholate increases the biliary output of bilirubin pigments in the rat, due to haemolysis. AB - In order to investigate the effect of bile salts on the biliary transport of bilirubin, we infused rats with taurocholate at 1-3 mumol/min/kg body weight. When administered in saline, taurocholate induced haemolysis, and a dose dependent increase in biliary excretion and serum concentration of all bilirubin pigments. The addition of human or rat serum albumin to the infusate, at an albumin:taurocholate molar ratio equal to or above 200, completely prevented haemolysis and the above-mentioned alterations in bilirubin transport, without any change in the bile acid output. In order to mimic a haemolytic condition, an erythrocyte haemolysate was further added to the taurocholate-albumin solution. This again resulted in an increased bilirubin output. We suggest that taurocholate treatment increases bilirubin output due to the increased load of the pigment on the liver, as a result of the bile acid-induced haemolysis. PMID- 2768794 TI - Indocyanine green intrinsic hepatic clearance as a prognostic index of survival in patients with cirrhosis. AB - The prognostic value of quantitative liver function tests in patients with cirrhosis is not clearly established. Indocyanine green intrinsic hepatic clearance (ICG-IHC) is a quantitative liver function parameter independent of liver blood flow, which was shown to correlate strictly with the Child-Turcotte Pugh (CTP) classification of severity of liver disease. Few data are available on its prognostic value. One hundred and five patients with cirrhosis were studied. ICG-IHC was measured according to the 'sinusoidal perfusion' model. Median ICG IHC in the whole series was 374 ml/min (interquartile range: 214-496 ml/min). During follow-up (mean 31 months; max. 48 months) 38 patients died. The probability of survival was lower in patients with ICG-IHC lower than 300 ml/min (35% at 48 months) than in patients with ICG-IHC between 300 and 1000 ml/min (70%), or with ICG-IHC over 1000 ml/min (80%) (P = 0.02). Also s-albumin (P less than 0.01), ascites (P = 0.001) and CTP class (P less than 0.001) were significant predictors of survival. On incorporation of age, sex, etiology of cirrhosis, ICG-IHC, s-albumin, s-bilirubin, prothrombin index, ascites and encephalopathy, into a multiple regression analysis according to the Cox's model, the results showed only ascites and s-albumin to be independent significant predictors of survival, while ICG-IHC was not among the covariates independently predictive of survival. When CTP class was added to the investigated covariates, the results showed it as the only independent predictor of survival.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2768795 TI - Detection of hepatitis delta virus RNA in chronic liver disease. AB - A series of 120 patients with chronic delta hepatitis virus (HDV) were investigated using a newly developed assay for the detection of serum delta RNA and this marker was correlated with other markers of HDV infection. The assay was shown to be both specific and sensitive and provides a direct non-invasive measurement of HDV infectivity. Serum HDV RNA was detected in 51.2% of all patients and in about 64% of those who were liver HDV antigen positive. Its presence was particularly associated with the early stages of the disease where it was found in 83% of cases with chronic active hepatitis (CAH) and progressively less common in CAH associated with cirrhosis and in inactive cirrhosis. The presence of both HBeAg (and HBV DNA) and high levels of HDV RNA in the sera of 5 of the patients analysed, clearly demonstrates simultaneous replication of both HBV and HDV. The serum HDV RNA 'slot blot' assay described in this study should prove invaluable in elucidating further the natural history of delta hepatitis and in monitoring antiviral therapy. PMID- 2768796 TI - Hepatitis B virus DNA forms in the liver of chronically infected individuals. Relation to replication profile. AB - To analyze the profile of HBV-DNA forms in the liver in relation to different levels of virus replication, liver biopsies from 52 chronic HBsAg carriers were studied by Southern blot analysis. Quantitative evaluation of the major HBV-DNA molecules was carried out by densitometry in 27 patients with ongoing hepatitis B virus (HBV) replication in the liver. Significant variations in the intensity of the different bands were noted in individual cases, but statistical correlation between the amount of single stranded forms and levels of serum HBV-DNA was not observed. In contrast, the amount of linear 3.2 kb HBV-DNA appeared to have an inverse correlation with levels of circulating virions. Only the 3.2 kb form was detected in three patients negative for serum HBV-DNA. In these cases with 'inactive' state of episomic HBV genome seroconversion to anti-HBe occurred from 12 months before to 4 months after the time of liver biopsy testing. This 3.2 kb form can therefore be interpreted as a pattern of transition from the replicative to the non-replicative state of the virus. PMID- 2768797 TI - Effects of glucagon on systemic and splanchnic circulation in conscious rats with biliary cirrhosis. AB - To elucidate the relationship between the haemodynamic changes and glucagon in cirrhosis, we infused physiologic and supraphysiologic doses of this hormone in conscious rats with portal hypertension due to biliary cirrhosis. Cardiac output and splanchnic organ blood flows were measured by the radioactive microsphere method before and 30 min after glucagon infusion at doses of 2, 5 and 10 ng/min. Serum glucagon increased from a basal level of 92 +/- 17 pg/ml (mean +/- S.E.) to 399 +/- 89, 1151 +/- 136 and 2064 +/- 328 pg/ml, respectively, in sham-operated rats, and from 743 +/- 75 pg/ml to 1497 +/- 197, 1583 +/- 356 and 2957 +/- 649 pg/ml, respectively, in cirrhotic animals at 2, 5 and 10 ng/min doses. In both groups, cardiac output did not change after glucagon infusion at 2 and 5 ng/min doses, suggesting that factors other than glucagon are primarily responsible for the systemic hyperdynamic circulation in cirrhosis. Portal tributary blood flow increased significantly after glucagon infusion in sham-operated rats by 34 and 65% at doses of 5 ng/ml and 10 ng/ml, respectively, and in cirrhotic rats by 29% at a dose of 10 ng/ml. However, portal tributary blood flow did not change after glucagon infusion at the physiologic dose of 2 ng/min. This study shows that glucagon infused at a physiologic dose does not increase splanchnic blood flow, although it increases portal tributary blood flow at supraphysiologic doses. The discrepancy between blood glucagon levels and splanchnic haemodynamic responses suggests that glucagon plays only a minor role and that other factors are primarily responsible for the hyperdynamic state of the splanchnic circulation in rats with biliary cirrhosis. PMID- 2768798 TI - Intrahepatic cholestasis of pregnancy in twin pregnancies. AB - To clarify whether the increase in estrogen levels occurring during twin pregnancies (TP) is associated with a greater risk of developing intrahepatic cholestasis of pregnancy (ICP), we followed up 62 consecutive patients with TP and compared them with single pregnancies delivered in our hospital during 1 year. The prevalence of ICP was significantly higher in twin than in single pregnancies (20.9% versus 4.7%, respectively; P less than 0.001). Urinary estriol excretion was also significantly higher in twin compared to single pregnancies, although no quantitative differences were detected in TP with or without ICP. In multiparous patients with a proband TP affected by ICP, the disease recurred only in further TP, emphasizing the important role that estrogens seem to play in the pathogenesis of ICP. In contrast, in multiparous patients with a proband single pregnancy affected by ICP, the disease occurred in 70.5% of their other single pregnancies, suggesting the presence of a metabolic predisposition in these cases. However, in both groups of multiparous women a notable number of single pregnancies were not affected by the disease, supporting the postulate that the pathogenesis of ICP is multifactorial and that some as yet unidentified environmental factor needs to be present in order to develop the disease and also to modulate its expressivity. PMID- 2768799 TI - Percutaneous recanalization and dilatation of a thrombotically occluded superior vena cava in a patient with a peritoneovenous shunt. AB - A superior vena cava syndrome developed in a patient with liver cirrhosis 6 months after implantation of a peritoneovenous shunt. Local fibrinolytic therapy resulted only in a transient improvement of clinical symptoms. Persistent patency of the superior vena cava and shunt function was regained only after percutaneous recanalization and balloon dilatation of the thrombotically occluded caval vein. PMID- 2768801 TI - Satellite infection control committees within the hospital: decentralizing for action. PMID- 2768802 TI - Surgeon-specific wound surveillance: the family or the bean counters? PMID- 2768800 TI - The lessons from in vitro lithotripsy for the clinical treatment of gallstones. AB - Fifty-eight gallbladder stones were treated in vitro, using a Wolf Piezolith 2300 lithotripter, to discover whether complete fragmentation (i.e., no particles greater than 2 mm diameter) could be achieved by lithotripsy alone. In 16 stones this was accomplished with up to 6000 shocks being administered. The degree of fragmentation was judged first by eye during the experiment and then by both microscopy and sieving of the debris. Eye judgement proved to be an unreliable indicator with 23 of the 42 stones in the failed lithotripsy group receiving 6000 shocks or less. Cholesterol analysis and high resolution radiography revealed no significant differences between the successfully and unsuccessfully fragmented stones, but X-ray diffractometry did show a higher incidence of inorganic calcium salts in the latter group. This study shows that lithotripsy can successfully fragment gallbladder stones, but that a minimum of 6000 shocks, using the Piezolith 2300, should be given to ensure adequate treatment. Additionally, the presence of radiopaque stones does not necessarily preclude successful treatment by this method. PMID- 2768803 TI - Antibacterial agents: pharmacodynamics, pharmacology, new agents. PMID- 2768804 TI - Some observations and opinions on the present state of American medical historiography. PMID- 2768805 TI - Flow cytofluorometric analysis of enzyme reactions based on quenching of fluorescence by the final reaction product: detection of glucose-6-phosphate dehydrogenase deficiency in human erythrocytes. AB - We developed a method for accurate cytofluorometric analysis of the final reaction product of enzyme reactions in individual cells. Glucose-6-phosphate dehydrogenase (G6PD) activity in human erythrocytes was demonstrated cytochemically, and the amount of final reaction product (formazan) per cell was detected indirectly by quenching of autofluorescence generated by glutaraldehyde fixation. Formazan quenches fluorescence in a dose-dependent manner. The method has been used for detection of G6PD deficiency. Heterozygous and homo(hemi)zygous deficiency could easily be established, even in cases of extreme "Lyonization" where microscopic inspection failed to discriminate between either normal individuals and heterozygously deficient patients or heterozygously and homozygously deficient patients. The principle of quenching of fluorescence by final reaction products of enzymes can be applied to flow cytofluorometric analysis of enzyme activity in individual cells in general. PMID- 2768806 TI - Standardization of tritium-sensitive film for quantitative autoradiography. AB - A method for the calibration of plastic tritium standards for use with LKB Ultrofilm is described and validated. This method uses 12-microns cryostat slices of frozen liver which have been labeled with [3H]-formaldehyde and extracted with chloroform-methanol to remove lipids. Quantitative autoradiographic measurement of 3H radioactivity in the liver slices was underestimated by 35% when lipids were not extracted. Plastic sections impregnated with tritium were calibrated in terms of lipid-extracted, tissue-equivalent radioactivity content. Calibrated standard curves for these plastic standards were closely fit (p = 0.99) by second order polynomial equations for exposures of 1, 4, 7, 13, 28, and 104 days. The equations are generally useful for any plastic tritium standards. PMID- 2768807 TI - Simultaneous immunoelectron microscopic visualization of protein B23 and C23 distribution in the HeLa cell nucleolus. AB - The intranucleolar distribution of phosphoproteins B23 and C23 was visualized simultaneously by post-embedding immunoelectron microscopy in HeLa cell nucleoli, using specific antibodies. The data show that proteins B23 and C23 co-localize to the same nucleolar compartments, i.e., the dense fibrillar component and the granular component. Neither of the two antibodies is significantly associated with the fibrillar centers in these cells, although the fibrillar centers appear positive after silver staining. These findings suggest that other unidentified components must be responsible for the silver staining observed in the fibrillar centers of interphase nucleoli. The results are discussed in the light of previously reported data obtained by preembedding immunolabeling techniques and by silver staining, which both suggested a localization of protein C23 inside the fibrillar centers. PMID- 2768808 TI - Intracellular accumulation of basement membrane components during morphogenesis of rat submandibular gland. AB - The distribution of two basement membrane (BM) components, laminin (LN) and type IV collagen (COLL IV), during acino-tubular morphogenesis of rat submandibular gland was examined immunohistochemically to determine the role of BM in the development of acino-tubular structures. On day 14 of gestation, LN could be found only in the BM separating an undifferentiated cell cluster of gland epithelium from surrounding mesenchyme. However, during a short period through days 15 to 17, LN was detected not only in the BM but also in intracellular vesicles of the cells of the terminal cluster. Immunoelectron microscopy showed the intracellular immunoreactive sites to be rough endoplasmic reticulum, indicating that active LN synthesis occurs in the cells of the terminal cluster. Intracellular immunostaining of LN disappeared completely on day 19 with the development of simple epithelium from the cell cluster, even though BM remained reactive. COLL IV also was accumulated in the intracellular vesicles of terminal cluster cells on day 16 of gestation but not on day 19. These results indicate that synthesis of certain BM components is transiently stimulated in gland epithelium before the formation of simple epithelial structure, and that these components are significantly involved in morphogenesis of the submandibular gland. PMID- 2768809 TI - Cortical granule-specific components are present within oocytes and accessory cells during sea urchin oogenesis. AB - The coordinate expression of cortical granule-specific components in sea urchin oogenesis was studied using antibody probes. The components used to generate the organelle-specific antibodies included the whole cortical granule exudate, fertilization envelopes, hyalin, beta, 1-3,glucanase, and Ig8. Using immunolocalization techniques at both the light and electron microscopic levels, these molecules were found to be specific to cortical granules in three distinct cell types: developing oocytes, eggs, and accessory cells. In early oocytes, each of the cortical granule components are coordinately accumulated in the developing cortical granules dispersed throughout the cytoplasm. No other organelle within the developing oocytes or eggs contained detectable levels of any of these epitopes. In the somatic interstitial tissue of the ovary, cortical granule components also were accumulated specifically within cortical granule structures. Found only in select accessory cells, these cortical granules were indistinguishable in morphology and epitope composition from eggs and were contained within cytoplasmic aggregates termed mosaic globules. The mechanism of cortical granule concentration into mosaic globules is unknown, but this demonstration of common organelle constituents between oocytes and accessory cells may provide insight for such an understanding. PMID- 2768810 TI - Alignment of cholesterol in the membrane bilayer. AB - Freeze-fracture replicas of filipin-treated samples of guinea pig colon mucosa reveal areas in the membrane of the goblet cell granules labeled by filipin cholesterol complexes (FCC) intermingled with regions patterned by "lines." The FCC and "lines" are arranged in an approximately rhombic pattern. Other membranes of the same cell or of other cells display either FCC only, aligned and occasionally ordered in "rhombs," "lines" only, with a similar pattern, or randomly distributed FCC. Optical diffraction was used to analyze and compare replicas of membranes with ordered FCC and "lines", as well as randomly distributed FCC. The results demonstrate that all these structures are reciprocally related through a common distribution pattern in the membrane. This observation supports the assumption that cholesterol has a preferential ordered distribution within the membrane bilayer. PMID- 2768811 TI - Occurrence of FMRF amide-like immunoreactive nerve fibers in guinea pig small intestine. AB - We investigated the distribution of FMRF amide-like immunoreactivity in the small intestine of the guinea pig. Immunoreactive nerve fibers were found mainly in the myenteric and submucous plexuses and in the inner circular muscle layer. The labeled processes contained variable proportions of small clear vesicles 30-40 nm in diameter and large granular vesicles 80-120 nm in diameter. The large granular vesicles showed heavy immunoreactivity. The antisera against FMRF amide crossreact with peptides belonging to the pancreatic polypeptide family; it has therefore been suggested that the FMRF amide immunoreactivity demonstrated in the small intestine is caused by a peptide that is biosynthetically related to, but not necessarily a member of, the pancreatic polypeptide family. PMID- 2768813 TI - Electron microscopy of gold-labeled human and equine chromosomes. AB - We present an immunochemical technique for the detection of 5-bromo-2' deoxyuridine (BrdU) incorporated discontinuously into the chromosomal DNA. A monoclonal anti-BrdU antibody and a protein A-gold complex were used to produce chromosome banding of human and equine chromosomes, specific for electron microscopy (EM). Well-defined bands, symmetry of sister chromatids, concordance between homologues, and band patterns similar to those observed by light microscopy facilitate chromosome identification and karyotyping. From prophase to late metaphase, chromosomes condense and bands appear to fuse. The fusion appears to be owing to chromatin reorganization. Our results underline the value of using immunogold reagents, which are ideal probes for antigen localization on chromosomes. PMID- 2768812 TI - Acute action of DSP-4 on central norepinephrine axons: biochemical and immunohistochemical evidence for differential effects. AB - Previous immunohistochemical studies of the long-term effects of the noradrenergic neurotoxin DSP-4 have demonstrated a remarkably selective vulnerability of norepinephrine (NE) axons of the locus coeruleus (LC). NE axons originating in non-LC NE neurons appear to be largely resistant to the neurotoxic action of DSP-4. We conducted this study to evaluate the acute effects of DSP-4 on NE axons in four different brain regions: cerebral cortex, cerebellum, ventral forebrain, and hypothalamus. NE levels were determined by high-performance liquid chromatography (HPLC) 6 and 24 hr and 14 days after DSP-4 administration. NE axons in these brain regions were visualized in brain sections at 6 and 24 hr after drug treatment, using a specific antiserum to NE. HPLC assays revealed profound reductions of NE levels in cerebral cortex and cerebellum, but only minor decreases in ventral forebrain and hypothalamus. NE immunohistochemistry showed dramatic differences in the acute effects of DSP-4 on NE axon staining: nearly complete loss of staining in cortex and cerebellum, in contrast to an almost unchanged staining pattern in ventral forebrain and hypothalamus. This study demonstrates that NE immunohistochemistry is a valuable tool to assess the acute effects of DSP-4 on NE axons in different brain regions. The results provide the first direct evidence that NE axons are not uniformly acted on by DSP 4 and suggest that the acute effects of DSP-4 are restricted to LC axons. PMID- 2768814 TI - Cell kinetics of human tumors by in vitro bromodeoxyuridine labeling. AB - We labeled active S-phase cells in primary breast carcinomas with a modified 5 bromo-2'-deoxyuridine (BrdU) procedure using a silver-enhanced colloidal gold visualization step. Separate samples of 29 tumors were labeled with BrdU or tritiated thymidine ([3H]-dThd), and the labeling indices (LI) from the two methods were equivalent (Spearman's correlation coefficient = 0.96). Three breast carcinomas were incubated in various mixes of both BrdU and [3H]-dThd and developed sequentially for each. Paired photomicrographs showed that the same nuclei were labeled by either precursor. The in vitro method yielded LIs similar to those reported after in vivo pulse BrdU labeling for tumors of the central nervous system. The BrdU LI correlated significantly (r = 0.76, p less than 0.001) with % S-phase by DNA flow cytometry in 33 breast carcinomas. The BrdU labeling method is simpler and more rapid than the [3H]-dThd procedure (1-2 days for completion for the former, 7-10 days for the latter), and it provides an equivalent measurement of proliferative index. PMID- 2768815 TI - Immunity and effects of the environment--an attempt at generalization. AB - The authors address themselves to the issues of functional capacity of the immune system and various factors exerting positive and negative effects on it. An attempt is made at graphic representation describing differences in the immune capacity of healthy and deficient organisms in normal living conditions and under challenge, thus forming the basis for a putative generalization of the addressed relationships. PMID- 2768816 TI - Blood and placental concentrations of cadmium, lead, and mercury in mothers and their newborns. AB - Placental transfer of cadmium, lead and mercury was studied under the conditions of environmental exposures of pregnant women to these heavy metals. Fifty pregnant women from industrial area and a similar control group from a semirural area were examined. Cadmium, lead and total mercury levels were determined in maternal erythrocytes and plasma, in placenta, and in erythrocytes and plasma of umbilical cord blood using atomic absorption spectrophotometry. Except for the cadmium plasma concentration in the control area, levels of the three metals were higher in maternal than in cord blood. The mean plasma values (arithmetic mean) of cadmium, lead, and mercury in industrial area were 0.53, 6.37, and 0.37 micrograms.100 ml-1 in maternal blood and 0.30, 4.82, and 0.31 micrograms.100 ml 1 in cord blood. Highest values of the correlation coefficients were found between the cadmium and mercury concentrations in maternal and cord blood erythrocytes. No striking effect of the place of residence of pregnant women on the heavy metal concentrations in biological materials could be found. PMID- 2768817 TI - Effect of static magnetic field on some enzymes activities in rats. AB - The magnetic field of 0.008 T and 0.15 T inductions influence lasting 7 weeks (7 days a week), 1 h daily determines the increase of the activity of cytoplasmatic enzymes (glutamic pyruvic transaminase, glutamic oxalacetic transaminase, lactic dehydrogenase), the decrease of cholinesterase activity and the growth of alkaline phosphatase activity in the plasma of the examined animals. The observed changes were reversible. 2 months after the exposure had been stopped, the tested parameters were back to normal. PMID- 2768818 TI - Viral hepatitis among the hospital staff. AB - The paper compares the incidence of viral hepatitis, the frequency of occurrence of antigen HBs, as well as the clinical course of the disease in medical staff in relation to patients in the general population. The analysis has shown that the incidence rate in the Lublin district in the years 1979-1984 was 453.7 per 100,000 medical employees, and was 3.4 times higher than in the general population. No differences, however, were stated in the severity of the clinical course of the illness and in the activity of selected index enzymes indicating impaired liver functions among the medical staff and the other patients. PMID- 2768819 TI - Serological survey of rubella in Yemen in 1985. AB - 476 sera from subjects of 6 age groups were investigated using the HI test for rubella, the sera originating from 5 distinct regions of Yemen, namely highland, coastal the agricultural area Abijan, Vadi Hadramot and the capital Aden. The positivity rate among children aged 1-6 ys was 46.2%, the values obtained for girls aged 15-18, women in the 19-24 and 25-29 ys age group being 81%, 86.3% and 89.9%, respectively. When the findings of the immunological survey were evaluated with respect to the five different regions studied, the positivity rate in the highlands was found to be significantly higher among girls under 18 ys of age. The geometric means of HI titres for rubella antibodies proved to be the lowest in 1-3-year-old children (1: 59) and the highest in girls aged 15-18 ys (1: 163). The authors discuss the comparatively high risks of contracting rubella during pregnancy in four regions of Yemen. PMID- 2768821 TI - Serovars of Vibrio parahaemolyticus. AB - Seashore water samples collected along the coastline in Bulgaria and Rumania contained in large numbers OK serovars of V. parahaemolyticus; some of these had been isolated repeatedly over an extended time period: 01 K32, 03 K30, 03 K48, 04 K37, 04 K53, 05 K17, 05 K30. The serovar 05 K17 was virtually present in all water samples and was also isolated from a case of purulent ear infection in a child from Burgas. In contrast, strains recovered from Asian and African coastal water had different K antigens and were never identified in Europe. Two strains of V. parahaemolyticus (serovars 05 K15 and 07 K10) had positive swarming growth resembling that of V. alginolyticus. The first of these was Kanagawa-positive and was isolated from a case of severe diarrhea in Brazzaville. Vibrio parahaemolyticus isolates came from marine or brackish water specimens collected on sand banks, 3 strains were recovered from marine or brackish water in Africa. Vibrio harveyi, a sucrose-negative species important from differential diagnostic aspects, has been isolated from seashore water samples collected on coarse-sand or pebbly beaches. PMID- 2768822 TI - Changes in the activity of oxygen-dependent metabolism in polymorphonuclear leukocytes and macrophages from a primary focus during experimental Y. pestis infection in the mouse. AB - The activity of oxygen-dependent metabolism (OM) was investigated in phagocytosing cells from a primary focus in plague infection using a mouse model. Experimental animals were given various i.p. doses of a virulent culture of Y. pestis. Changes in the OM of neutrophils and macrophages derived from peritoneal exudate after Y. pestis administration were phased and identical to non-specific post-aggression fluctuating reaction (PFR) comprising: 1. immediate depression phase, 2. overexertion phase and 3. exhaustion phase. PMID- 2768820 TI - Diagnostic significance of the coagglutination reaction in patients with the diarrhoea syndrome. AB - Specific soluble Shigella, Salmonella and Yersinia enterocolitica antigens were determined in biological fluids (saliva, urine, coprofiltrate) from 268 patients with the diarrhoea syndrome using the coagglutination reaction. The findings suggest that the coagglutination reaction (COA) is a simple and efficient method suitable for the fast diagnosing of acute intestinal infection (AII) in the early days from the onset of the disease. COA enables the identification of specific antigens associated with the causative agents of intestinal infections in 79-54% of patients with shigellosis and salmonellosis. COA was shown to possess a high diagnostic potential in AII of unknown etiology. Shigella, Salmonella and Yersinia antigens were determined in 47.7, 23.4 and 10.8% of cases respectively where no bacterial excretion could be confirmed. Two and less frequently three antigens being identified simultaneously in 10.8% cases. The identification of opportunistic microorganisms in AII using the COA does not appear to be sufficient to confirm their etiological significance as Shigella and Salmonella antigens were simultaneously determined in most patients. PMID- 2768823 TI - Plasma noradrenaline response to a multistage exercise test in young men at increased risk of developing essential hypertension. AB - Venous plasma noradrenaline (PNA) was recorded during a multistage exercise test in order to assess the possible role of excess sympathetic nervous system activity in young men at increased risk of developing essential hypertension, and to analyse whether any such involvement was associated with heredity and/or borderline hypertension. Four groups were evaluated: 28 normotensive (NTO) and 20 borderline hypertensive (BHO) offspring of hypertensives, 12 borderline hypertensives with normotensive parents (BH) and 28 normotensives with normotensive parents (NT). Analysis of variance showed that heredity per se was associated with an increased PNA response to light exercise. In NT, PNA correlated with age at rest and light exercise (r = 0.39-0.58, P less than 0.05 0.005). When the influence of age was controlled for by dividing the subjects into two age groups a more pronounced increase in PNA response to light exercise was found in the youngest age group of offspring hypertensives (17-26 years), whereas no differences between the groups were observed in the upper age group (27-40 years). Our results indicate the presence of a hyperreactivity of the sympathetic nervous system during light exercise in young offspring of hypertensives. PMID- 2768824 TI - Central action of sodium chloride on whole body pressor responsiveness in the DOCA-treated rat. AB - This study investigated the effect of chronic intracerebroventricular (IVT) infusion of a hypertonic NaCl (400 mmol/l) artificial cerebrospinal fluid (aCSF) on blood pressure and whole body pressor responsiveness, in control rats (CH) and in rats implanted with deoxycorticosterone acetate (DOCA; DH). An isotonic aCSF was infused into another group of control (Cl) and DOCA (Dl) rats. Indirect systolic blood pressure (SBP) was measured using a tail-cuff technique once a week prior to and during the infusion period. Following 2 weeks of infusion, SBP increased significantly only in the DH and CH groups. In urethane-anaesthetized rats, the pressor response to intravenous infusions of norepinephrine and angiotensin II (Ang II) increased significantly in DH rats. When compared with Cl and Dl rats, those from the CH group also exhibited an enhanced response to norepinephrine and Ang II. However, this increase was not as great as in the DH animal. These results show that whole body pressor responses to norepinephrine and Ang II, increase in rats receiving chronic IVT infusion of hypertonic NaCl. These responses coincide with moderate but significant increases in SBP. These data indicate that sodium chloride acts at a central site to increase norepinephrine and Ang II pressor responsiveness in mineralocorticoid hypertension. PMID- 2768825 TI - Effects of chronic alcohol consumption and alcohol withdrawal on blood pressure in stroke-prone spontaneously hypertensive rats. AB - The development of blood pressure was monitored by the tail-cuff method in normotensive (WKY) and stroke-prone spontaneously hypertensive rats (SHRSP) receiving ethanol (alcohol) in drinking water from weaning (approximately 1 month of age). Alcohol administration over a 3-month period attenuated the development of hypertension in SHRSP and also caused a small reduction of the initial blood pressure rise in WKY. This was accompanied by a reduction of fluid intake and an increase of circulating antidiuretic hormone (arginine vasopressin; AVP). Circulatory volume remained constant. Direct measurement of arterial blood pressure in conscious rats before and after autonomic blockade confirmed the antihypertensive effect of alcohol in SHRSP and indicated that it is at least partly dependent on altered activity of neural mechanisms. Sudden withdrawal of alcohol caused an immediate increase of fluid intake followed by a rise of blood pressure lasting several days in both WKY and SHRSP. This withdrawal hypertension could not be attributed to changes in plasma catecholamines or AVP. PMID- 2768826 TI - Changes in potassium content and membrane potassium channels in circulating cells from normal volunteers treated with cromakalim. AB - The effect of cromakalim, a K+-channel activator, on the intracellular concentration and transmembrane fluxes of Na+ and K+, was studied in 18 normal male subjects, using a double-blind parallel study design. After a run-in period on placebo for 1 week the subjects were treated with either placebo (n = 6) or cromakalim (n = 12) for 1 week. Blood pressure was not changed during cromakalim administration in these normal male subjects but heart rate was increased. The intraerythrocyte and intraleucocyte K+ concentration was decreased during cromakalim administration while the Ca2+-dependent K+ channels in the red blood cells were increased. No significant effect of cromakalim could be demonstrated on the intracellular Na+ and Mg2+ concentration, on the ouabain-sensitive or bumetanide-sensitive 86Rb uptake and on the maximal 3H-ouabain binding in erythrocytes and leucocytes. The red cell Na+Li+ countertransport, anion carrier and ground membrane leak of Na+ and K+ were also not changed in the cromakalim treated subjects. PMID- 2768827 TI - Ventricular arrhythmia in untreated newly presenting hypertensive patients compared with matched normal population. AB - There is evidence to suggest that hypertensive patients are at increased risk of sudden death. However, to date this evidence is restricted to treated hypertensives and it is not clear whether this risk is due to the hypertension itself, its treatment, or its long-term consequences. This study has investigated, by 24-h ambulatory electrocardiography, a total of 58 newly diagnosed hypertensive patients who have never previously been treated and compared the first 50 of them with 50 matched control subjects. The results show that there is an increased prevalence of ventricular arrhythmia in hypertensive patients, compared with normal controls, and that this arrhythmia is present from the outset and thus not dependent on treatment or the development of long-term complications. Multivariate analysis showed that age (positive correlation) and potassium (negative correlation) made the most important independent contributions to the prevalence of arrhythmia in these patients, but even so only accounted for about 33% of the observed arrhythmia. This suggests that the precursors of arrhythmia in hypertension are multifactorial. One other factor appeared to make an important contribution to ventricular arrhythmia in these patients. In contrast to recent evidence from the study of treated hypertensives, the prevalence of ventricular arrhythmia was significantly lower in patients exhibiting electrocardiographic evidence of left ventricular hypertrophy. However, left ventricular hypertrophy did also appear to sensitize the myocardium to the arrhythmogenic effect of low serum potassium levels. These findings may help to explain some of the previous confusion surrounding treatment, hypertension and ventricular arrhythmia. PMID- 2768828 TI - The concentration of neuropeptide Y immunoreactivity falls with age selectively in microdissected regions of the ventrolateral medulla of spontaneously hypertensive and normotensive Wistar-Kyoto rats. AB - The concentrations of neuropeptide Y immunoreactivity were measured in microdissected regions enriched in noradrenergic (A1, A2, A6) and adrenergic (C1, C2, C3) nuclei of the brainstem, and in the nucleus of the spinal tract of the trigeminal nerve (Sp5C) of spontaneously hypertensive rats (SHR) and Wistar-Kyoto (WKY) rats at 8, 18 and 31 weeks of age. The aim of this study was to compare the manner in which changes in neuropeptide Y immunoreactivity levels related to increases in blood pressure with ageing in each rat strain. The concentration of neuropeptide Y immunoreactivity in the A1 nucleus progressively fell with increasing age in both SHR and WKY. In contrast, the levels of neuropeptide Y immunoreactivity in the C1 region fell at 18 weeks of age but did not fall further by 31 weeks. No significant age-related changes occurred in the concentrations of neuropeptide Y immunoreactivity in the A2, C2, A6 and Sp5C nucleus. The levels of neuropeptide Y immunoreactivity in the C3 region were below assay sensitivity. The neurochemical changes that occur in the A1 nucleus are consistent with the increase in blood pressure observed with ageing in both rat strains. However, this observation alone does not account for the elevated blood pressure measured in the SHR strain. PMID- 2768829 TI - Low-calcium diet increases blood pressure and alters peripheral but not central angiotensin II binding sites in rats. AB - The mechanism by which low-calcium (Ca) diet causes hypertension is unknown. We investigated angiotensin II (Ang II) receptor binding in brain, adrenals and urinary bladders in male Sprague-Dawley rats pair-fed a low-Ca (0.005% Ca; 0.5% P) and normal-Ca (1.4% Ca) diet for 8 weeks beginning at 4 weeks of age. The Ang II receptor sites in hypothalamus-thalamus-septum (HTS), adrenal glands and urinary bladder smooth muscle were measured by saturation isotherm binding using 125I-sarcosine1isoleucine8 Ang II (125I-SI Ang II). Systolic blood pressure was determined at 2-week intervals by tail-cuff method. Serum total Ca, Na+, K+ aldosterone and Ang II and bone density and mineral content were determined at the time of sacrifice. Chronic Ca deficiency in rats raised blood pressure and decreased Ang II receptor density in bladder smooth muscles and tended to increase adrenal Ang II receptors. Serum Ca. bone density and mineral content were significantly lower in the Ca-deficient rats, while serum Na+ was elevated in this group. Serum Ang II and aldosterone were unaltered after the 8-week dietary regimen. Possible mechanisms for the hypertensive actions of reduced dietary Ca intake involving the renin-angiotensin-aldosterone system are discussed. PMID- 2768830 TI - Differential adherence of M line Biomphalaria glabrata hemocytes to Schistosoma mansoni and Echinostoma paraensei larvae, and experimental manipulation of hemocyte binding. AB - The ability of M line strain Biomphalaria glabrata hemocytes to adhere to mother sporocysts (MS) of PR1 Schistosoma mansoni or to MS or daughter rediae (DR) of Echinostoma paraensei was studied using an in vitro hemocyte adherence assay. Hemocytes were significantly more likely to bind to S. mansoni MS than to E. paraensei MS or DR. Hemocyte adherence to E. paraensei MS or DR was significantly increased if glutaraldehyde-fixed larvae were used as targets. Also, E. paraensei MS pretreated with the lectin concanavalin A (Con A) were more likely to be bound by hemocytes than MS pretreated with Con A in the presence of the competing sugar, alpha-methyl mannoside. Pretreatment of hemocytes with Con A increased their ability to bind E. paraensei sporocysts, but the effect was small compared to that achieved by pretreatment of MS with Con A. The lectin probably did not function as a bridging molecule between hemocytes and MS but, rather, altered the MS surface in a way that facilitated adherence. Similarly, adherence to E. paraensei MS was significantly increased if the MS were pretreated with cell-free M line plasma prior to use in adherence assays. Our results indicate that the two parasites provoke fundamentally different responses from M line hemocytes in vitro and that the living tegument can be modified by host humoral factors and by lectins such that hemocyte binding is significantly increased. PMID- 2768831 TI - Changes in plasma opsonization of yeast after isolation of Biomphalaria glabrata in small volumes of water. PMID- 2768832 TI - Erythrocyte uroporphyrinogen decarboxylase activity in porphyria cutanea tarda: a study of 40 consecutive patients. AB - We measured uroporphyrinogen decarboxylase (UROD) activity in erythrocyte lysates obtained from 40 consecutive patients with porphyria cutanea tarda (PCT) without selection for family history. Enzyme determinations indicated that 28% of the patients had abnormally decreased UROD activity in erythrocytes; this finding did not always correlate with family history. Two siblings with PCT and normal erythrocytic, but abnormally decreased hepatic UROD activities, were encountered. This finding suggests that familial PCT may occur not only with decreased erythrocyte UROD activity, but also with a normal UROD activity in erythrocytes. PMID- 2768833 TI - Fibroblast matrix and surface components that mediate cell-to-cell interaction with lymphocytes. AB - The interaction between lymphocytes and fibroblasts in vitro has been examined using a quantitative ELISA assay to measure the binding of T and B cells to monolayer cultures of human dermal fibroblasts. This was carried out on microtiter culture plates, using an anti-Thy-1 monoclonal antibody, to determine the attachment of murine T lymphocytes and an affinity-purified polyclonal anti IgM antibody to measure B cell binding. Both types of lymphocyte were found to adhere strongly to intact human fibroblasts, and also had high levels of attachment to purified fibroblast plasma membranes and extracts of the fibroblast extracellular matrix. Attachment, particularly of B lymphocytes, also took place onto plastic surfaces coated with fibronectin, but not to collagens or to intact fibroblasts that had been fixed with a low concentration of paraformaldehyde. Lymphocyte binding to fibroblasts was partially prevented by a monoclonal antibody against fibroblast MHC class II antigens, but not against the class I membrane complex, or by polyclonal antiserum to the cell surface mannose 6 phosphate receptor. In addition, although both lymphocyte types were able to adhere to fibro-nectin, the presence of antibody against fibronectin or the synthetic peptide Arg-Gly-Asp-Ser, had no effect on their attachment to fibroblasts. Thus, lymphocyte adhesion may occur by fibronectin, but other types of interactions with fibroblasts also appear to take place. PMID- 2768834 TI - Cyclobuta-dithymidine induction by solar-simulating UV radiation in human skin: II. Individual responses. AB - The purpose of this study was to examine cyclobuta-dithymidine (T*T) photoproduct induction and persistence in human skin exposed in situ to simulated solar UV radiation. Small areas of untanned skin in nineteen individuals were exposed using a solar UV apparatus that simulates both the spectrum and intensity of the UV portion of summer midday sunlight at 39 degrees N latitude. The equivalent of approximately 60 min of sunlight exposure (72KJ/m2) was administered, and T*T photoproducts were quantitated by enzyme-linked immunosorbent assay (ELISA) of DNA extracted from skin punch biopsies. Net yields of T*T photoproducts were determined in 10 individuals, with the majority (7 of 10) between 0.02 and 0.12 T*T per kilobase (Kb). The three remaining individuals had higher levels of photoproducts but were not unusually sensitive to solar UV as determined by minimal erythema dose (MED). Percentage loss of T*T photoproducts 4 h after exposure was determined in nine individuals to be 80.2 +/- 14.0%. PMID- 2768836 TI - Age-related mechanical properties of human skin: an in vivo study. AB - We have investigated in vivo how various viscoelastic parameters that describe the mechanical properties of the human skin may vary with age. Accordingly, we have used a mechanical device that records the torsional extensibility of the skin. When submitted to a low torque, the time-response curve of the skin affords the determination of the immediate extensibility (UE), the immediate recovery (UR), the viscoelastic part of the deformation (UV), the elastic recovery (UR/UE), and the creep relaxation time (tau). Because the skin thickness varies with age and primarily governs the mechanical properties, it was measured through an ultrasound technique at the same sites (forearm) where the torque was applied. The results show that the skin maintains its thickness and extensibility up to the seventh decade as opposed to its elasticity or recovery capacities, which decrease from an early age. The viscous part of the deformation is constant through life, whereas the creep relaxation time decreases linearily with age. Except for skin thickness, no differences in these parameters between men and women were detected. The significance of these results are discussed in terms of structure alterations. The determination of the elastic recovery (UR/UE) appears to be a parameter of choice for illustrating skin aging. PMID- 2768835 TI - Studies on the efficacy of methyl esters of n-alkyl fatty acids as penetration enhancers. AB - The efficacy of the methyl esters of medium chain n-alkyl fatty acids as penetration enhancers was evaluated in vitro using various animal and human skins with minoxidil as the test drug. Both methyl nonanoate and methyl caprate at a 10% concentration were found to be effective penetration enhancers for a 2% solution of minoxidil in alcohol USP. The percent of the applied radioactive dose of minoxidil penetrated after 17 h was 5-8 times greater for methyl non-anoate and methyl caprate enhanced solutions than for a 2% solution of minoxidil in alcohol USP alone or with the addition of 10% Azone, dimethylsulfoxide (DMSO) or N,N-diethyl-m-toluamide (DEET). The penetration enhancing activity of methyl caprate was effective for human, mouse, and hamster skins. Methyl caprate also enhanced the penetration of vitamin D3, erythromycin, triamcinolone acetonide, testosterone, and hydrocortisone. PMID- 2768837 TI - Effects of retinoids on phorbol ester-stimulated epidermal DNA synthesis and hyperplasia in hairless mice. AB - We investigated the effects of the retinoids, all-trans retinoic acid (t-RA), 13 cis retinoic acid, etretinate, and arotinoid ethyl ester, on 12-O-tetradecanoyl phorbol-13-acetate (TPA)-induced DNA synthesis, and epidermal hyperplasia in hairless mouse skin. Topical application of these retinoids produced dose dependent inhibition of the TPA-induced epidermal DNA synthesis as measured by [3H]thymidine incorporation at 15 h after TPA application. However, this inhibition was only transient and did not affect the corresponding increase in epidermal cell layers measured at 40 or 70 h after TPA application. Fluocinonide also inhibited the epidermal DNA synthesis and failed to block TPA-induced epidermal hyperplasia. However, fluocinonide did effectively suppress the inflammation caused by TPA. In this paper we have shown that the suppression of TPA-stimulated DNA synthesis is a general property of topically applied retinoids. The biologic significance of a temporary suppression of TPA-stimulated epidermal DNA synthesis by the retinoids and fluocinonide is not understood at this time. PMID- 2768838 TI - Reactive hyperemic responses in systemic sclerosis patients and healthy controls. AB - Hyperemic responses after arterial occlusion were investigated in patients with Raynaud's phenomenon due to systemic sclerosis (SSc) and in healthy controls. The hyperemia due to arterial occlusion for 2 min was measured by laser-Doppler flowmetry. If the hyperemic response was absent, the measurements were repeated after vasodilatation was induced by hand warming in warm water. Reactive hyperemia was absent in 12 patients when investigations were performed on the unwarmed hand, and these patients had very low resting blood flows. After vasodilatation was induced in these patients, and also in those patients whose resting blood flow was normal, hyperemic responses were comparable in magnitude with those in the controls. The slope of the hyperemic response was significantly less in the patients (1.11 +/- 0.02 V/s) than in the controls (1.28 +/- 0.03 V/s), and therefore, the time course of the hyperemia was lengthened in the patients with SSc, with a delay to achieving maximum blood flow of 2 min. Peak blood flow was directly related to the level of the initial blood flow. These findings support the view that reactive hyperemia is principally a mechanical phenomenon, and also that vessel wall reactivity is abnormal in SSc, producing delayed hyperemic responses. The magnitude of the hyperemia depends on initial flow rates, and the apparent lack of these responses in SSc is a result of their low, but reversible, resting blood flow. PMID- 2768839 TI - Improved detection of aneuploidy in malignant melanoma using multiparameter flow cytometry for S100 protein and DNA content. AB - DNA aneuploidy has been demonstrated to be an independent parameter of prognostic significance in malignant melanomas. In order to improve the detection of DNA aneuploidy in malignant melanomas, and to minimize diploid non-tumor cells in the sample, we developed a two-color staining strategy for S100 protein and DNA content in paraffin embedded samples. The ability to detect aneuploidy, defined as DNA ploidy index less than or equal to 0.90 or greater than or equal to 1.10, in 37 stage I malignant melanoma samples by flow cytometry analysis was significantly improved from 10.8% of cases using traditional one-color analysis for DNA content only (propidium iodide) to 32.4% of cases using two-color analysis for simultaneous measurement of both DNA (propidium iodide) and S100 protein (fluorescein conjugated antibody) (Chi-square with Yates' correction; p less than 0.05). The largest increase in sensitivity was found in level I and II melanomas less than or equal to 0.76 mm in thickness. In addition, we report the new observation that multiple S100 protein-positive subpopulations were found significantly more frequently in malignant melanomas (23/37 cases) than in compound melanocytic nevi (5/22 cases) (Chi-square with Yates' correction; p less than 0.01). These findings suggest that there is a previously unsuspected degree of tumor heterogeneity even in thin, presumably early, malignant melanomas. PMID- 2768840 TI - Studies of connective tissue mast cell-mediated cytotoxicity. AB - Although mast cells have been implicated in mediating antitumor activity, the kinetics, mechanism(s), and suspectibility of different tumors to mast cell mediated cytotoxicity have not been defined. Rat connective tissue mast cells (CTMC) of greater than or equal to 99% purity were investigated in vitro and found to express maximal spontaneous cytotoxicity against the mouse fibrosarcoma cell line WEHI-164 (56.0% +/- 2.1 SEM), the ultraviolet B (UVB)-induced, cutaneous fibrosarcoma 5C25 (34.7% +/- 3.4 SEM), and the human renal cell tumor Currie (26.8% +/- 2.0 SEM) at an effector to target (E:T) ratio of 80:1. Kinetic studies of CTMC-mediated cytotoxicity demonstrated significant detectable lysis against these tumors within 8 h, which was maximal by 16 h. Binding experiments showed that CTMC formed conjugates with all three lytic-sensitive targets; however, CTMC also attached to the lytic-resistant target YAC-1, indicating that conjugate formation alone is not sufficient for mast cell-mediated cytotoxicity. At two different concentrations, mast cell granules (MCG) lysed WEHI-164 (36.5% +/- 6.8 SEM) and 5C25 (34.4% +/- 6.9 SEM), but were only slightly cytotoxic (5.7% +/- 2.9 SEM) against Currie. A potential role for tumor necrosis factor-alpha (TNF-alpha) in CTMC-mediated cytotoxicity also was investigated. Polyclonal antibodies to TNF-alpha greatly reduced CTMC and TNF-mediated lysis of WEHI-164, but only partially inhibited CTMC killing of the slightly TNF-sensitive 5C25 tumors, and had no effect on CTMC cytolysis of Currie. Thus, this study demonstrates that CTMC mediate cytotoxicity in vitro by both TNF-associated and TNF-independent mechanisms. We conclude that CTMC are capable of mediating antitumor activity and that this effect may be important for tumor surveillance in the skin and other sites. PMID- 2768841 TI - Comparison between clonogenic and cytotoxic assays for measuring LAK cell activity. AB - The antiproliferative effect of lymphokine-activated killer (LAK) cells was studied using a clonogenic assay in an attempt to find a model for predicting this effect in vivo or ex vivo (in the case of purging) in cancer treatment. The results were compared with the standard 51Cr-release cytotoxic assay. Cells from clonogenic neoplastic cell lines (K562 and HL-60) were plated in methylcellulose with LAK cells obtained from ten different donors in various effector-to-target (E:T) ratios. At E:T ratios of 16:1, elimination of greater than 90% of the clonogenic cells was seen in 20 of 21 experiments, whereas such lysis was incidentally found in the 51Cr-release assay. In almost all paired combinations, clonogenic cells tested in a colony assay were more sensitive to kill by LAK cells than the whole tumor cell suspensions measured in the 51Cr-release assay. PMID- 2768842 TI - Growth inhibition of human nasopharyngeal carcinoma in athymic mice by anti epidermal growth factor receptor monoclonal antibodies. AB - Monoclonal antibodies (MoAbs) were developed against epidermal growth factor (EGF) receptor on the human epidermoid carcinoma cell line A431. The A431 antigen recognized by the MoAbs has an apparent molecular weight of approximately 170,000, with the same molecular weight as the CNE-2 cell line (poorly differentiated nasopharyngeal carcinoma). Administration of anti-EGF receptor MoAbs inhibited tumor formation, caused by the CNE-2 and A431 cell lines, in athymic mice. When the same MoAbs were used in therapy against Tca8113 (a human tongue carcinoma) and HeLa cells (a human cervical carcinoma), tumor growth was not affected. The number of EGF receptors and the apparent dissociation constants for 125I-EGF on CNE-2 and A431 were 1.3 x 10(5)/cell (Kd 7.7 x 10(-8) M) and 1.4 x 10(6)/cell (Kd 2.4 x 10(-9) M), respectively. Three anti-EGF receptor MoAbs were used in these studies. MoAbs 3 and 176, capable of competing with EGF for receptor binding, showed significant tumor growth inhibition. MoAb 101 was incapable of blocking the binding of EGF to its receptor and was not as effective as MoAbs 3 and 176 in tumor growth inhibition. Our observation is that in vitro, MoAb anti-EGF receptor is cytostatic, rather than cytocidal, against CNE-2 and A431. PMID- 2768843 TI - Effects of recombinant human erythropoietin on hematopoietic progenitors of chronic hemodialysis patients in vitro and in vivo. AB - Erythroid progenitors were assayed in 20 chronic hemodialysis patients before and after administration of recombinant human erythropoietin (rhEpo) using a methylcellulose culture method. Hemoglobin concentrations, hematocrit values and the proportion of marrow erythroblasts increased significantly during rhEpo treatment. The numbers of erythroid progenitors (CFU-e and BFU-e) in the patients' marrow also increased following rhEpo administration. Our data suggest that rhEpo is an effective drug for treating anemia caused by chronic renal failure and the administration of rhEpo results in an increase in the numbers of erythroid progenitors. PMID- 2768844 TI - Microcapillary clonogenic assays for human marrow hematopoietic progenitor cells. AB - The capillary clonogenic cell assay was developed and adapted to culture myeloid and erythroid colonies from human bone marrow cells. The plating efficiencies for femoral bone marrow granulocyte-macrophage progenitors (CFU-gm), erythroid colony forming units (CFU-e) and erythroid burst-forming units (BFU-e) were 0.143%, 0.229% and 0.141%, respectively. Standard bone marrow progenitor Petri dish assays require a total culture volume of 1 ml per dish, and as such are not suitable for the small numbers of cells often obtained from human bone marrow samples. The microcapillary assay as developed and standardized in our laboratory has the unique advantage of being able to utilize small numbers of cells. This technique is suitable for evaluating the myelotoxicity of investigational new anti-cancer and anti-HIV agents and for further investigation of the mechanisms underlying chemotherapy-induced bone marrow toxicity. PMID- 2768845 TI - Rapid decline of clonogenic hemopoietic progenitors in semisolid cultures of bone marrow samples derived from patients with chronic myeloid leukemia. AB - Bone marrow samples, from newly diagnosed patients with chronic myeloid leukemia (CML) and normal individuals, were grown in methylcellulose and serially recultured under identical conditions. Specimens derived from normal individuals gave rise to multilineage and megakaryocyte colonies for one to two sequential cultures. Erythroid bursts and granulocyte-macrophage colonies were observed for three to five sequential cultures. Cultures initiated from samples of patients with CML showed a rapid decline of all types of colonies. Colonies were rarely seen for more than two sequential cultures. When pooled colonies and background cells were recloned separately, secondary colonies were mainly seen in cultures of background cells. This observation is consistent with the view that secondary colonies are more likely to arise from dormant clonogenic progenitors, rather than through cells that have formed primary colonies through a self-renewal process. PMID- 2768846 TI - Capillary cloning of primary human tumor cells: assay miniaturization for drug efficacy testing. AB - The conventional double-layer agar method of cloning human tumor cells requires a substantial number of viable tumor cells and 14-21 days of culture. These prerequisites frequently limit its utility as an assay. In an attempt to circumvent these limitations and to reduce the amount of drug that is needed in the assay, we have further developed and miniaturized the assay in which human tumor cells are cloned in glass microcapillary tubes. Cultures consisted of 50 microliters containing 15,000 nucleated cells in 975 mm capillary tubes which were incubated for seven days. The results from 50 consecutive tumor biopsies resulted in cloning efficiencies, ranging from 0.007% to 1.0% with an overall successful cloning of 88% of all tumors tested and a good linear growth relationship and chemotherapy sensitivity. This miniaturized assay offers distinct advantages for drug efficacy testing including high cloning efficiencies, small tumor sample and drug requirements, quicker assay turnaround time and a general conservancy of reagents and incubator space. PMID- 2768847 TI - Immunodiagnostics of visceral toxocariasis. AB - Twenty five suspected cases of visceral toxocariasis and 25 apparently healthy controls, were tested in four serological tests, namely precipitin absorption test (PAT), counter immunoelectrophoresis (CIEP), indirect fluorescent antibody test (IFAT), and enzyme linked immunosorbent assay (ELISA). Adult Toxocara worm antigen was used in PAT & CIEP as saline extract and as frozen sections (FS) in IFAT while the embryonated eggs (EE) were used as saline extract in ELISA and as a whole in IFAT. The percentages of positivity reported were 44% by PAT, 24% with CIEP, 52% with IFAT (EE), 48% with IFAT (FS), and 52% in the ELISA. In the apparently healthy control group, only one subject gave positive result with PAT, and ELISA at titres of 1/16 and 1/64 respectively. The EE antigen proved to be more sensitive than adult worm antigen, where it was used in IFAT & ELISA and gave the highest percentage of positivity and the highest titre (1/256 & 1/4096 respectively). It was noticed that the children below the age of 10 years, were statistically significant (P less than 0.05) by all tests except CIEP. PMID- 2768848 TI - Sensitivity of crude and purified Fasciola antigens in immunological diagnosis of human fascioliasis. AB - A study has been done to find the effect of purification of crude antigens, extracted from adult Fasciola gigantica and Fasciola hepatica worms on the sensitivity of some serological techniques in diagnosis of fascioliasis. Using C.I.E.P. test, the partially purified antigens of both Fasciola species were less sensitive than their corresponding crude ones. Using I.H.A., the difference between results of crude and partially purified antigens for the two species were statistically insignificant, both (P greater than 0.05). So in applying this test, there is no need for the partially purification of antigen. On using E.L.I.S.A. the partially purified antigens showed higher sensitivities for detection of fascioliasis than their corresponding crude ones. Partially purified F. gigantica and F. hepatica antigens gave nearly the same results whether using C.I.E.P., I.H.A. or E.L.I.S.A. However, E.L.I.S.A. was the most sensitive technique followed by I.H.A. then C.I.E.P. PMID- 2768849 TI - An investigation into the riboflavin status of young Egyptians from the oasis with glucose-6-phosphate dehydrogenase deficiency. AB - The erythrocytic glutathione reductase activity was studied among 40 normal and G 6 PD-deficient males without or with intestinal parasitic infection. The results showed that the incidence of vitamin B2 deficiency was significantly higher (chi 2 P less than 0.05) among G 6 PD deficient subjects compared to corresponding incidence obtained with normal. Intestinal parasitism led to deterioration of the B2-status among both the normals and the subjects with G 6 PD deficiency. PMID- 2768850 TI - Culicoides bedfordi Ingram and Macfie (1923). A new record in Egypt. AB - C. bedfordi was described as a new recorded species. The Egyptian species of Culicoides were reviewed. PMID- 2768851 TI - Some aspects of sandflies of the genus Phlebotomus in El Agamy, Alexandria. AB - Leishmaniasis presents a health problem in several countries of the old world. Cutaneous and now visceral leishmaniasis have been reported in Egypt. Visceral leishmaniasis has been reported in El Agamy, Alexandria. In this paper, the seasonal and daily hours of activities of both P. papatasi and P. langeroni as well as the blood preference were studied over two successive years. The results showed a bi-model or two peaks a year. The sandflies started to appear in the last of March or beginning of April and ended in last of November or beginning of December. The indoor hours of activity standard earlier and ended later than the outdoors one. The blood of the females of P. papatasi was mainly human blood, while that of P. langeroni was mainly non-human blood. PMID- 2768852 TI - Ultrastructure of penetrating Giardia trophozoite and the possible mechanism of invasion. AB - The ultrastructure of penetrating Giardia lamblia trophozoites in immunosuppressed albino rats is described for the first time. Recorded changes in the general contour of the parasite; loss of flagellae, and suction disc, disappearance of the endoplasmic reticulum, appearance of abundant electron dense coarse granules as well as large sized vacuoles opening to outside, are probably modifications associated with penetration and accommodation to the new environment. Penetration appears to be due to activity of the trophozoite rather than passive transfer by tissue macrophages. PMID- 2768853 TI - Effect of some anthelmintics on Hymenolepis nana in albino mice. AB - Mebendazole and emetine (orally and parenterally) were used to treat mice infected with H. nana. Yomesan, in a single oral dose, was also used as a standardized well-known cesticidal drug. Emetine had a marked effect on cysticercoids leading to highly significant reduction in their number. Also, it caused complete removal of adult worms in infected mice. Mebendazole had no effect on the cysticercoid stage, but it caused significant reduction in the number of adult worms. Yomesan, showed a marked lethal effect on both the cysticercoids and adult worms leading to highly significant reduction in their number. PMID- 2768854 TI - The influence of infection with Steinernema feltiae Filipjev on the haemocyte picture of the cotton leaf worm (Spodoptera littoralis Boisduval). AB - Infection of Spodoptera littoralis Boisduval larvae with Steinernema feltiae Filipjev nematodes caused sharp variation in proportional percentages of differential haemocyte counts. The mean total haemocyte count per mm3 of haemolymph in control larae of S. littoralis was 6000 haemocyte mm3. After infection with 50, 100, 200 and 500 parasitic nematodes of S. feltiae, the mean total count was significantly increased to 17,250, 18,600, 21,000 and 24,000 haemocyte mm3 respectively. PMID- 2768855 TI - Cheatotaxic characters of an Egyptian strain of Schistosoma mansoni cercariae. AB - The pattern of argentophilic sensory papillae of an Egyptian human strain of Schistosoma mansoni cercariae was studied by light microscopy and their cheatotaxic characters were described. PMID- 2768856 TI - Prolactin imbalance as a result of bilharzial hepatosplenomegaly. AB - Prolactin is an important hormone for maintenance of normal sexual life in human. Prolactin is produced in the lactotropic cells in the lateral wing of the anterior pituitary gland. Prolactin imbalance associated with bilharzial hepatosplenomegaly with subsequent infertility was carried out on sixty female patients and 30 normal controls. In bilharzial patients and 30 normal controls. In bilharzial patients with hepatosplenomegaly, there was hyperprolactinaemia in 13.33% of cases. 10% of patients suffering from bilharzial hepatosplenomegaly had primary infertility and 70% had secondary infertility more than 5 years. Galactorrhea was present in 10% of cases with bilharzial hepatosplenomegaly. There was irreversible relationship between the duration of bilharzial infection and serum prolactin level and inability to conceive, and also between the duration of bilharzial infection and endocrine manifestations as infrequency and irregularity of menstruation. PMID- 2768857 TI - Effect of ambient temperature changes on chronic toxoplasmosis in rats. AB - The effect of excess heat and cold on chronic toxoplasmosis was studied on rats. That was evident from the average increase in body weight, the effect on blood picture, deleterious effect of the pathology recorded in various organs, increased Toxoplasma brain cyst count, long persistence of parasites in the viscera, high antibody titre by I.H.A.T. in infected animals exposed to excess heat and its decrease in animals exposed to excess cold. PMID- 2768858 TI - Observations on the swarming habits and aggregation of Culicoides schultzei Enderlein (Diptera--Ceratopogonidae) in Egypt. PMID- 2768859 TI - Determination and seasonal abundance of mite predators of the house fly eggs in Cairo and Giza, Egypt. AB - Mite predators on the house fly eggs were collected from manure in two slaughterhouses in Cairo and Giza for 2 successive years. Macrochelidae, Parasitidae and Uropodidae were generally collected in that order of abundance. Macrochelidae was represented by 3 species: M. mascaedomesticae (Scopoli), M. merdarius (Berlese) and Glyptholaspis confusa (Foa). Parasitidae and Uropodidae were represented by P. consanguineus (Oudemans & Voigts) and U. (Fuscuropoda) Marginata (C.L. Koch), respectively. The macrochelid and parasitid species generally attained their highest populations in winter and/or spring from December to May. However, the highest populations of the uropodid species were reached mainly in late spring, summer and autumn from May to October. PMID- 2768860 TI - Liver injury associated with N-acetylcysteine administration. AB - 90 adult male albino rats, were divided into two groups each comprising 45 rats out of which 15 were used as controls. N-acetylcysteine was given orally in a doses of 300 and 600 mg/Kg body weight respectively for three weeks. At the end of each week 10 rats from each experimental group as well as 5 rats from control animals were sacrificed and biochemical and pathological studies for hepatic functions and structure were performed. NAC in the high dose group induced significant changes in the liver function tests suggestive of liver dysfunction and damage. Histopathological studies revealed cell ballooning portal dilatation with round cell infiltration, portal tract fibrosis and proliferations. It was concluded that NAC in small dose is safe and can be used, while in large dose it has a hepatotoxic potential. PMID- 2768861 TI - Effect of diet on experimental giardiasis. AB - Protein and fat deficiency diet produced significant reduction of Giardia cysts in rats, while vitamin A, D and iron deficiency diet had no effect on cyst count. On the other hand pathological changes due to Giardia infection encountered in small intestine and liver were aggravated by the diet deficiency induced. PMID- 2768862 TI - The intestinal parasitic infections among children in Riyadh, Saudi Arabia. AB - A total of 5421 children, 2726 apparently healthy and 2695 with clinical manifestations suggestive parasitic infection were subjected to stool examinations. Giardia lamblia was found to be the most common intestinal parasitic infection among both groups. Enterobius vermicularis followed among the patient group. Abdominal pain and pruritus ani were the most common causes of referral in the patient group. Other causes of referral were mainly associated with G. lamblia infection. PMID- 2768863 TI - Serological and clinical diagnosis of hydatid disease in schistosomal patients. AB - Indirect haemagglutination test (I.H.A.T.), Latex test (L.A.), and Complement Fixation test (C.F.T.), were performed on 100 serum samples obtained from Egyptian patients suspected clinically to have Hydatid disease and 50 healthy controls. The results of clinical, laboratory and serologic investigations revealed Hydatid infection in six cases. PMID- 2768864 TI - Schistosomiasis and transient nephritis in children. AB - Transient nephritis, manifested by albuminuria may be caused by the deposition of the circulating schistosomal antigen in the kidney glomeruli. PMID- 2768865 TI - Histological and histochemical studies on the digestive gland of Bulinus truncatus infected with Schistosoma haematobium. AB - The structure of the uninfected and infected digestive gland of the fresh-water snail, Bulinus truncatus, was studied histologically and histochemically. The digestive gland consists of two types of cells: digestive and secretory cells clearly differentiated from each other. The pathological effects of infection of the snail with cercariae of Schistosoma haematobium have resulted in considerable structural and histochemical alterations in the digestive gland. Generally, the main effects were reflected by increased cellular vacuolation and marked diminution of carbohydrates, proteins and lipids of the gland cells. PMID- 2768866 TI - Biological studies on Dirhinus wohlfahrtiae Ferriere (Hym: Chalcididae). AB - The daily production of progeny and longevity of the ectoparasitoid Dirhinus wohlfartiae (F.) was determined at 25 +/- 2 degrees C and 60-70% R.H. using Parasarcophaga aegyptiaca (Salem) pupae as hosts. The number of produced females progeny was greater than that of males. In presence of Wohlfahrtiae nuba, Musca domestica, Chrysomyia albiceps and Parasarcophaga aegyptiaca, females parasitoid preferred the two former species for oviposition. PMID- 2768867 TI - Keys for identification of species of family Calliphoridae (Diptera) in Egypt. AB - The present taxonomic study assists in the recognition of all known Egyptian species of Calliphoridae by keys to genera and species accompanied by synonyms in the light of modern taxonomic concepts. Eight genera are recorded in A.R. Egypt including 14 species. Hemipyrellia pulchra (Wied) is recorded for the first time in Egypt. Chrysomyia chloropyga (Wied) was recorded by Pont (1979) in his study of Synanthropic flies in Saudi Arabia, this species was not recorded or mentioned before him in Egypt and is not represented in our collections. PMID- 2768868 TI - Effect of lead nitrate administration on liver and kidney structure in rats. AB - A study was conducted on male albino rats ranging in weight between 150-180 g. The animals were given a single and repeated intravenous injections of lead nitrate (100 mu mol/kg body weight) once every 10 days for one, two, three and four injections respectively. Histopathological examination revealed that induction of hepatic and renal cellular proliferation without cellular necrosis occurred with single and repeated administration. No biochemical alterations in liver function tests and serum creatinine were detected throughout the whole period of study. These changes are suggested to be an adaptive response rather than a toxic effect. PMID- 2768869 TI - Cryptosporidiosis among children suffering from diarrhea in Benha, Egypt. AB - 213 infant and child attending Pediatric clinic of Benha University Hospital suffering from diarrhea; were studied for the presence of cryptosporidial infection. Modified Ziehl Neelsen method was used for staining of smears and for confirmation of positive cases safranin-methylene blue method was also used Cryptosporidial oocysts were seen in the faeces of seven patients (3.2%). The results were discussed. PMID- 2768870 TI - The effect of xiphidiocercarial infection on the ventricular blood pressure of Lanistes carinatus. AB - Measurements of the blood pressure from within the ventricle of both uninfected Lanistes carinatus and those parasitized with xiphidiocercariae were made in order to determine whether the infection affects the circulatory pressure in L. carinatus. Using ink writing oscillograph (Washington 400 MD 2) the ventricular blood pressures were recorded for 22 uninfected specimens and 16 parasitized with xiphidiocercariae. Parasitized L. carcinatus show a significantly lower ventricular pressure than uninfected ones. The mean ventricular pulse pressure of uninfected snails was 7.79 cm of water compared with a mean of 5.76 cm of water for parasitized specimens. PMID- 2768871 TI - Effect of gamma radiation on the biology of the flesh fly, Parasarcophaga argyrostoma. I. Following larval exposure. AB - One and seven days old larvae of the flesh fly, Parasarcophaga argyrostoma were exposed to doses ranging from 1-90 Gy. Lower doses ranging from 1-9 Gy applied to young larvae accelerate larval development whereas old larvae responded to doses from 10-90 Gy by a remarkable retardation of the larval and pupal development. Reduction in percentage pupation and adult emergence were noticed with increment in the radiation doses applied. This reduction was higher for irradiated seven days old larvae than the one day old larvae at all doses applied, indicating that young larvae were more susceptible to gamma radiation than the older one. At higher doses (30-70 Gy) the pupae could not continue their development and died within 17 days after pupation. The longevity of adults resulted from irradiated larvae was decreased by increasing the radiation dosage and it was found that adults emerging from irradiated young larvae lived shorter than those from irradiated young ones, the fecundity of adults resulted from irradiated larvae was also decreased by gamma irradiation exposures. The percentage reduction of larviposition was 100% for irradiated females with 8 Gy while that of irradiated males was 97.5% indicating that females were more sensitive to radiation than males. PMID- 2768872 TI - Cutaneous leishmaniasis in the peace keeping force in East Sinai. AB - During the period from October 1982 to July 1985 cutaneous leishmaniasis was diagnosed in 113 Multinational Force and Observers (MFO) soldiers from various nations, East Sinai. Leishmania was isolated from twelve of these patients and maintained in vitro using Tanabe's medium. Intrasplenic inoculation of promastigotes from isolate cultures into hamsters resulted in dissemination patterns typical of cutaneous leishmaniasis. The excreted factor in culture when serotyped against known marker strains indicated subserotype A1B2. They also exhibited similar banding patterns to L. major L-137 for GPI, G 6-PD, MDH, NH, MPI, PGM and variant B for 6-PGDH. This leishmaniasis focus appears epidemiologically similar to that of nearby Mid Western Negev where transmission involves Phlebotomus papatasi, Psammomys, and Meriones. PMID- 2768873 TI - Coagulation equilibrium in bilharzial hepatic fibrosis. AB - Twenty patients with confirmed bilharzial hepatic fibrosis and similar number of matched normal controls were investigated for their plasma protein C activity, prothrombin time and partial thromboplastin time. The results showed marked decrease in plasma protein C activity together with the expected prolongation in prothrombin and partial thromboplastin times. Since protein C exhibits a controlling mechanism on haemostasis by inhibition of activated factor V, changes in plasma protein C activity will necessarily impart an effect on blood coagulation. PMID- 2768874 TI - Uncommon complications of human fascioliasis in Alexandria. AB - Fascioliasis is becoming more frequently discovered among citizens of Alexandria. The main presenting clinical manifestations including hepatic pain, colics, fever, anorexia, discomfort with meals and hepatomegaly. We select here 4 cases with unusual presentation from patient's record of the last year: one case developed liver abscess due to F. hepatica infection. Two cases were encountered during cholecystectomy in patients suffering from cholecystitis with cholelithiasis; in one of them the gall bladder had ruptured and the patient developed an abscess in the liver related to the gall bladder bed. In both cases F. hepatica worms were found in the bile duct. The fourth case presented with acalcular cholecystitis with empyema of the gall bladder. PMID- 2768875 TI - Aural myiasis caused by Wohlfahrtia magnifica. PMID- 2768876 TI - On Phlebotomus langeroni in the North Coastal Zone. PMID- 2768877 TI - Antibodies against brucellosis cross react in IHAT for antileishmanial antibodies. PMID- 2768878 TI - On the flagellate parasite of uncertain identity from the Egyptian brown rats and stray dogs. PMID- 2768879 TI - Anti-Toxoplasma antibodies in some patients with fever. PMID- 2768880 TI - Comments on an editorial by B. R. Chatterjee "On Multi-Drug Combinations in the Treatment of Leprosy". PMID- 2768881 TI - Drug resistance and multi-drug therapy in leprosy. PMID- 2768882 TI - Leprosy in low endemic areas of India: an appraisal and suggested measures for control. AB - Prevalence of leprosy in the low endemic areas of India is described based on the observations of patients attending an Urban Leprosy Centre in the Union Territory of Delhi from the neighbouring states. The rising incidence in these so-called low to moderate endemic places is closely linked to factors related to urbanisation, movement of people in search of employment, etc., which necessitate fresh surveys in these areas. A significant number of leprosy patients attending the Centre were irregular (37.7%) in therapy and many absconded after the initial visit (35.3%), the reasons for which are discussed. These figures are compared to that from similar low endemic areas and known high endemic parts of the country. Suitable modifications to the control programme in these areas are suggested under the purview of the National Leprosy Eradication Programme. PMID- 2768883 TI - Clinical assessment of paucibacillary leprosy under multidrug therapy-three years followup study. AB - 408 skin smear negative paucibacillary leprosy cases who had completed six months MDT were kept under surveillance for three years. The clinical assessment at the end of surveillance showed that 276 (82%) of all the cases attained inactivity. Two patients who were inactive showed signs of relapse. Five patients showed more activity though they were regressing under treatment. The inactivity rate was much higher amongst the patients with 1 to 3 skin lesions (88%) as compared to the patients with greater than or equal to 4 lesions (60%). The difference was statistically significant (P less than 0.001). The past treatment before MDT did not appear to influence the clinical course of the disease. 17% of the patients essentially border-line type continued to show signs of activity even after 3 years surveillance indicating the need for triple drug therapy (to be treated as multibacillary). However large scale data on relapse rate would be essential before the efficacy of WHO short-term therapy for paucibacillary leprosy is evaluated. PMID- 2768884 TI - Leprosy survey in industries in Bombay. AB - Population surveys for leprosy in industrial cities like Bombay revealed that about 60% of adult subjects especially males could be examined. The fact that the prevalence rate of leprosy particularly multibacillary type is much higher in this segment of population as compared to other groups indicates the importance of examining this population at their workspot like industries. 22287 industrial workers were examined for leprosy by paramedical auxiliaries in their establishments and 270 leprosy cases were detected (P.R. 12/1000). However, only 13 multibacillary cases (P.R. 0.5/1000) could be unearthed. 12 patients were with grade II and above. 184 (83%) were untreated. 161 (60%) patients reported for treatment. With available resources, case holding of patients who are not within the control area of the project becomes a challenging job for paramedical workers though large number of leprosy cases are detected amongst industrial workers. If industrial management arranges treatment for leprosy patients without dislocating them from their service, the pool of infection in the urban community will be reduced and can contribute tremendously towards urban leprosy control programme. PMID- 2768885 TI - Dapsone drug compliance study among leprosy patients: a comparison between qualitative and quantitative methods. AB - The methods currently employed to monitor self-administration of dapsone have been evaluated by comparing the results of the qualitative spot test and quantitative DDS/creatinine ratio test. Random urine samples of 242 leprosy patients, periodically attending the Leprosy Clinic were tested. Although a good correlation between the results of the two tests was evident, the DDS/creatinine ratio technique appeared to be more sensitive than the spot test. The concentration of DDS and its metabolites in urine specimens found to be negative by the spot test, ranged from 3.32-12.37 micrograms of DDS/mg creatinine. The spot test was found to be more specific and stays to be the method of choice, when rapidity and reproducibility are the prime objectives, and sensitivity can be marginally compromised. Acidification of urine prior to the spot test was found to be desirable to rule out false negative and false positive reactions. PMID- 2768886 TI - Prognostic value of the lepromin test--further information on the subject. PMID- 2768887 TI - Additional structures seen in leprosy smears. PMID- 2768888 TI - Diagnosis of bone and liver metastases in breast cancer comparing tumor markers and imaging techniques. AB - One hundred and forty-seven patients were examined by bone scintigraphy, ultrasonography and scintigraphic scan of the liver, at different times after surgical removal of a breast cancer, to rule out skeletal and hepatic metastases. At the same time as imaging procedures, serum levels of tumor markers (CEA, TPA and CA 15-3) were determined using radioimmunometric methods. One or more markers were elevated in all 13 patients with hepatic metastases; 9 out of 46 patients with bone metastases had all serum markers normal, with a sensitivity of 80%. Combined assay of the markers proved useful, TPA and CA 15-3 showing the best sensitivity in bone metastases, and all three markers in liver metastases. PMID- 2768889 TI - Tissue polypeptide antigen (TPA) in bronchoalveolar lavage. PMID- 2768890 TI - CA 72.4 serum levels in 298 patients with non-malignant diseases. PMID- 2768891 TI - Distribution of CA 125 in placental tissues. AB - The presence of the tumor marker CA 125 was studied in different compartments of the human placenta. Levels of CA 125 in the cytosol of chorionic villi ranged from 27-17100 U/g (median 560 U/g). In the placental amnion and chorion concentrations ranged from 175-29000 U/g, median 1060 U/g and were not statistically different. In the umbilical cord values were significantly lower (range 44-7600 U/g; median 180 U/g). Maternal serum probes were above the upper limit of normal in all cases (range 48-500 U/ml; median 131 U/ml). Immunohistochemistry detected CA 125 exclusively within the amniotic cells of the placenta and the umbilical cord. This might be because CA 125 fixes more to insoluble structures in the amnion or because of contamination of chorionic villi with the underlying decidua. PMID- 2768892 TI - Preoperative and longitudinal serum levels of CA 125 and CA 15.3 in patients with breast cancer. AB - Serum levels of ovarian carcinoma antigen (CA 125) and breast carcinoma antigen (CA 15.3) were determined in 237 patients with breast carcinoma, 121 before any therapy and 116 after initial treatment, during uneventful follow-up or at the time of relapse. The aim was to assess how often the CA 125 test failed, i.e., was false-negative in patients in whom the CA 15.3 test was true-positive and, more important, whether it gave diagnostic information in patients in whom the CA 15.3 test failed. Before surgery or other initial therapy, serum CA 125 and CA 15.3 gave similar information in 85.1 percent of the patients: true-positive in 4.1 percent and false negative in 81.0 percent: CA 125 gave less information in 13.2 percent; and more information in only 1.7 percent. During follow-up, serum CA 125 and CA 15.3 gave similar information in 73.3 percent of the patients: true positive (i.e., rising persistently from a nadir or elevated above 65 U/ml) in 23.3 percent, true-negative in 36.2 percent, and false-negative in 13.8 percent; CA 125 gave less information in 25.0 percent: false negative in 22.4 percent and false-positive in 2.6 percent; and more information in only 1.7 percent. Therefore, the CA 125 test appears useless for staging and is redundant when the CA 15.3 test is employed, for management of patients with breast cancer. PMID- 2768893 TI - The effect of calmodulin antagonists on hyperthermic cell killing and the development of thermotolerance. AB - The role of calmodulin (CaM) in hyperthermic cell killing, and the development of thermotolerance in rat 13762NF mammary adenocarcinoma cells, was investigated by using the CaM antagonists W-7 [N-(6-aminohexyl)-5-chloro-1-naphthalene sulphonamide] and W-13 [N-(4-aminobutyl)-2-chloro-naphthalenesulphonamide] and their less active analogues W-5 [N-(6-aminohexyl)-1-naphthalenesulphonamide] and W-12 [N-(4-aminobutyl)-2-naphthalenesulphonamide]. The CaM antagonists W-7 and W 13 potentiated 43 degrees C cell killing (and the less active analogues did not) at a concentration compatible with CaM inhibition, thus hyperthermic perturbation of CaM-regulated processes may contribute to cellular lethality. The potentiation of hyperthermic killing by antagonists appeared to be temperature-dependent, sensitizing much more effectively to 43 degrees C than to 42 degrees C killing. The effect may be related to differing primary mechanisms of hyperthermic killing activated at the two temperatures, or simply to differences in incorporation or localization of the antagonists. The presence of the CaM antagonists throughout fractionated 42 degrees C or 43 degrees C heating, or during continuous 42 degrees C heating, did not significantly inhibit or potentiate the triggering and development of thermotolerance or alter the rates of heat stress protein (HSP) synthesis. Studies using CaM-agarose isolation of CaM-binding proteins indicated that binding of some HSP to CaM-agarose occurred and was Ca2+-dependent. The specificity and physiological relevance of these HSP binding to CaM was not clear, since their affinity was not high in these cells. Presumably W-7 would perturb any physiologically relevant CaM-protein interactions in cells but W-7 concentrations that reduced HSP and other protein binding to CaM-agarose columns by 50 per cent or more, had no effect on thermotolerance development in cells. These observations, combined with the studies that showed little effect of CaM antagonists on HSP synthesis at concentrations which potentiated cell killing, suggested that events leading to triggering or developing thermotolerance were not strongly dependent on any putative HSP binding to CaM. These studies also suggest some targets of hyperthermic cell killing at 43 degrees C are different from those that lead to the triggering and development of thermotolerance. PMID- 2768894 TI - Influence of limb restraint on the thermal response of bone marrow CFU-GM heated in situ. AB - The method used to restrain anaesthetized (sodium pentobarbital) mice for in situ heating of tibial marrow affects the survival response of CFU-GM. Three methods of limb restraint, in addition to ischaemia induced by tourniquet, were examined for their relative effect on the thermal response of CFU-GM. The three methods of restraint were to secure only the toes with suture material to a submersion post in the water bath, to tape the foot, or to tape the leg. Temperatures in the lumen of the tibia were measured with a 100 micron (tip diameter) microthermocouple during representative experimental conditions. After heating in situ, bone marrow was extruded and CFU-GM cultured in standard soft agar conditions in lung-conditioned medium. The most restrictive restraining method, i.e. taping the leg, produced the greatest thermal response among the three restraining methods examined. The D0 (+/- 95% CI) of the 42 degrees C survival curve for CFU-GM was 22 +/- 4, 46 +/- 8, or 94 +/- 53 min for restraint of leg, foot, or toes, respectively. Survival reached a plateau by 100 min of heating indicative of the development of thermotolerance. The D0 of the 44 degrees C survival curve was 3 +/- 1, 6 +/- 2 and 16 +/- 6 min for restraint of leg, foot, or toes respectively. Ischaemia produced the most pronounced effect on the thermal response of tibial CFU-GM with D0 values of 2 +/- 1 or 3.6 +/- 1.5 min after exposure to 44 degrees C or 42 degrees C, respectively. The method of limb restraint affects the thermal sensitivity of CFU-GM most probably by blood flow obstruction and resultant pH decrease. Thus, precautions must be taken to ensure that limb restriction does not introduce artifacts in the hyperthermia response of normal tissues or tumours during heating in situ. PMID- 2768895 TI - Effect of hyperthermia and X-irradiation on survival and occurrence of metastases in mice bearing P388 tumor. AB - Survival of P388 lymphoid tumor-bearing mice and the occurrence of metastasis was studied after combined modality treatment with hyperthermia and X-irradiation. P388 ascites tumor cells were treated at 42 degrees C or 43.5 degrees C for 1 hr in vitro and transplanted on B6D2F1 mice intraperitoneally (i.p.) or intramuscularly (i.m.). Hyperthermic treatment at 43.5 degrees C increased the median survival time (MST). Increased life-span (ILS) was found after i.p. transplantation (54%) and after i.m. transplantation (30%). During the life-span of tumor-bearing animals, significantly fewer metastases were observed in liver and spleen after hyperthermia and 5-10% metastasis occurred after transplantation of ascites tumor cells treated at 43.5 degrees C in vitro compared with 90% in the untreated control animals. The lower occurrence of metastasis could not be ascribed to the higher cell-killing effect of hyperthermia. When both modalities were combined the best tumor growth retardation effect was obtained when ascites tumor cells were treated at 43.5 degrees C for 1 hr before being transplanted i.m. and 1 day later locally X-irradiated with 6 Gy. In this case, 77% ILS was found demonstrating a synergistic effect of the two modalities. While X irradiation alone did not change the occurrence of metastasis, after combined modality treatment it was as low as with hyperthermia alone (5-10%). In connection with the significantly lower occurrence of metastasis, the possible alterations of P388 tumor cell membrane and surface proteins induced by in vitro hyperthermic treatment are discussed. PMID- 2768896 TI - The effect of preirradiated tumour bed on the response of a murine fibrosarcoma to elevated temperatures. AB - The effect of pretransplantation irradiation of tumour beds (tumour bed effect or TBE) on the response of tumours to elevated temperatures and on the kinetics of thermo-tolerance was studied. Animal tumours were early generation isotransplants of a fibro-sarcoma, FSa-II in C3Hf/Sed mice. The tumour bed or murine foot was irradiated with 0.8 or 16 Gy in air, and tumour cell suspensions were transplanted 1-35 days thereafter. Hyperthermia of various durations was given in a 45.5 degrees C water bath when tumours reached an average diameter of 6 mm (110 mm3), and the tumour growth (TG) time to reach 500 mm3 was obtained. Dose response curves between the TG time and the treatment time were less steep for tumours in preirradiated tumour beds than for tumours in non-irradiated tumour beds, indicating that the tumours in preirradiated tumour beds were more resistant to hyperthermia compared to the tumours in normal tumour beds. This resistance appeared to increase with increasing preirradiation dose. Thermotolerance was equally developed in tumours in normal and preirradiated tumour beds. The time required to develop the maximum thermotolerance was identical for both tumours. This indicated that the TBE has no effect on the kinetics of thermotolerance. The implication of these results in clinical trials may be that the tumour which recurred after radiotherapy may not be a good candidate for hyperthermia. PMID- 2768897 TI - Factors governing hyperthermia-induced pH changes in Yoshida sarcomas. AB - The impact of various factors modulating the acidification of tumour tissue upon localized ultrasound hyperthermia (1.7 MHz) at 44 degrees C for 60 min was investigated. Yoshida sarcomas were implanted into the hind foot dorsum of Sprague-Dawley rats. Frequency distributions of tumour tissue pH values were measured with miniaturized needle glass pH electrodes (diameter of the sensitive tip: 650 microns). During normothermia the average tumour pH is 6.87 +/- 0.21. No relationship is found between tumour pH and tumour size (range: 0.6-5.4 g). A pH gradient exists from the tumour periphery (0.5-3.5 mm) to more central tissue layers (7.5-10.5 mm; delta pH = 0.17). During hyperthermia with heating-up rates greater than 1.5 degree C/min, mean tumour pH drops to 6.71 +/- 0.20 considering all tumours. The pH reduction observed is size-dependent being most pronounced in medium-sized tumours (wet weights around 2.4 g, delta pH = 0.26). Using the same tumour sizes, but heating-up rates less than 0.7 degree C/min, the tissue acidification is more severe (delta pH = 0.40). To a small extent, pH changes also depend on the tumour region investigated (e.g. central vs. peripheral tissue layers) leading to a flattening of the pH gradient from the tumour shell to the centre during heat treatment. During hyperthermia an interstitial oedema occurs, being mostly marked in small tumours (around 1.4 g). Considering systemic changes, a transient increase in perfusion pressure (leading to a change in blood flow), as well as a slight elevation of blood glucose levels (leading to a higher glucose supply), during hyperthermia may contribute to the pH drop. PMID- 2768898 TI - Estimation of tissue blood flow from hyperthermia treatment data. AB - During hyperthermia treatment of patients the delivered heat and the temperatures at several points in the tissue are often measured and recorded. These data contain information about thermal tissue parameters. A method for extracting this information, i.e. estimating the tissue parameters--in particular the blood perfusion rate--is described. The method applies a system identification technique, adjusting the unknown parameters in a thermal tissue model, until the predicted model output (temperature) coincides well with the measured temperature. Data from a number of patient treatments have been used to test the method, and although the accuracy of the method remains to be established conclusively it appears to give a good estimate of the model parameter representing blood flow. The obvious advantage of the method is that it requires no special transducers or experiments. The weak aspect is that it depends on the correctness of a thermal model of the perfused tissue. PMID- 2768899 TI - Thermal dose and thermal isoeffect dose. PMID- 2768900 TI - [Surgical treatment of the malignant mediastinal tumors--with special reference to prosthetic reconstruction of superior vena cava]. AB - Sixteen patients with the malignant mediastinal tumors compromising the superior vena cava (SVC) and brachiocephalic veins (BCV) were treated from April 1974 to March 1987. SVC reconstruction by prosthesis combined with or without tumor resection were performed in 6 cases and removal of the tumor with partial resection of SVC and right BCV in one case. Two patients died within one month and two patients survived over 5 years postoperatively. Tumor resection, removal of the right lung and SVC wall, and patch angioplasty were performed in one patient who died three and one half months postoperatively. Resection of the tumor and left BCV were performed in 4 patients. Segmentally resected left BCV was reconstructed with interposed graft in two, prosthesis was implanted between left BCV and right atrium in one and no venous reconstruction was attempted in one. Three patients are alive and one patient died six and one half years after operation. Exploratory mediastinotomy was carried out in 3 cases and radiation therapy alone in one case. All but one patients died within one year after diagnosis. Though the long term results of the surgical treatment for malignant mediastinal tumor was not satisfactory, extensive resection of the tumor was worth attempting, as the patency rate of the prosthetic venous reconstruction was improved. PMID- 2768901 TI - [New selection criterion for Fontan procedure: pulmonary artery clamping test and pulmonary vascular resistance in increased pulmonary blood flow]. AB - A new selection criterion for Fontan procedure, pulmonary artery clamping test (PACT) was developed and employed in 13 candidates for Fontan procedure. PACT was aimed to evaluate the response of pulmonary vascular bed to increased pulmonary blood flow and calculate the pulmonary vascular resistance in the increased pulmonary blood flow as a selection criterion for Fontan procedure, preoperatively. After a median sternotomy incision, an electromagnetic flow meter was employed for measuring the pulmonary blood flow (Qp) on the pulmonary trunk. By clamping the left pulmonary artery and the right pulmonary artery, right pulmonary vascular resistance and the left pulmonary resistance in the pulmonary blood flow of Qp were calculated respectively. By means of electrical analogue, right and left lungs were simulated as resistors in parallel. And the equivalent pulmonary vascular resistance Rpc was calculated as the predicted pulmonary vascular resistance in the increased pulmonary blood flow of two times Qp. Fontan procedure was performed in 9 cases with a Rpc of less than 3 unit.m2 with a successful result and no death. Postoperative cardiac index ranged from 2.6 to 3.7 L/min.m2 with a mean of 2.8 L/min.m2. Postoperative pulmonary vascular resistance ranged from 1.6 to 3.2 unit.m2. Postoperative cardiac index was correlated with postoperative pulmonary vascular resistance. And postoperative pulmonary vascular resistance was well correlated with equivalent pulmonary vascular resistance but was not correlated with preoperative pulmonary vascular resistance measured by Fick's method at the preoperative catheterization. In Fontan procedure, the pulmonary blood flow frequently increases to a certain degree postoperatively. And pulmonary vascular resistance is not a static resistance, but a dynamic resistance. Hence, in discussing a pulmonary vascular resistance as a selection criterion for Fontan procedure, the pulmonary blood flow in which the pulmonary vascular resistance stand should be taken into account. Equivalent pulmonary vascular resistance Qpc is a theoretical selection criterion for Fontan procedure and well reflects the postoperative pulmonary vascular resistance. Fontan procedure can be successfully performed with a Rpc of less than 3 unit.m2. PMID- 2768902 TI - [Topographical anatomy of the atrioventricular node of Tawara--findings by macro microscopic dissection under dissecting microscope]. AB - The atrioventricular node of Tawara was dissected macroscopically under dissecting microscope with scalpel and microforceps. The node is a flat and fan shape mass of the specialized cardiac muscular tissue, which is sandwiched between the floor of the right atrium and the right fibrous trigone as an epi- or extra-myocardial structure, in the center of the heart as a whole. The node is situated in the apical (anterior) angle of the triangle of Koch, and does not show any individual variation in its location, occupying the same site topographically. Orifice of the coronary sinus is not proper to indicate the location of the node, because orifice of the coronary sinus changes its position individually. Clinically, the location of the node can be presumed correctly by identifying the important anatomical landmarks; postero-inferior angle of the membranous portion of the interventricular septum, commissure between the septal and the accessory (or anterior) cusps of the tricuspid valve, attachment line of the septal cusp, and the tendon of Todaro. PMID- 2768903 TI - [A study on hemodynamics in the brain death in dogs, with particular reference to left ventricular pressure-volume relationship]. AB - The hemodynamics of the brain death state still remains unknown in many respects. With special reference to the left ventricular pressure-volume relationship, hemodynamics was analyzed in 26 dogs which were subjected to complete cerebral destruction and catecholamine administration to prevent marked hypotension caused by brain death. The catecholamine used was dopamine (5-15 gamma; DA group), dobutamine (5-15 gamma; DOB group), noradrenaline (0.5-1.5 gamma; NAD group) and adrenaline (0.5-1.5 gamma, AD group). Left ventricular volume was calculated according to the approximate formula by Suga et al., using a pair of sonomicromanometers installed at the maximum internal transverse diameter. The indices determined were end systolic elastance (Ees), effective arterial elastance (Ea), ejection fraction (EF), mean Vcf, peak dP/dT and other hemodynamic parameters routinely used. The results were as follows: 1) the effect of catecholamine on Ees prior to brain death was DA = DOB greater than NAD = AD. 2) Peak dP/dT after brain death was significantly reduced to 56-73% of the pre brain-death value. 3) Ees after brain death was significantly reduced to 56-73% of the pre-brain-death value (except for NAD 1.0 & 1.5 gamma: not significantly reduced), whereas Ea was significantly reduced to 43-70% (except for AD group: unchanged). As a result, Ea/Ees was reduced in both DA group (10 & 15 gamma) and NAD group (1.0 & 1.5 gamma) compared with their pre-brain-death values. 4) EF in DA and NAD groups was higher than the pre-brain-death value, showing a tendency dissociating from Ees. 5) EF was found to be mainly dependent on Ea/Ees according to the formula by Sunagawa et al. 6) AD was the only catecholamine which neither decreased peripheral vascular resistance nor changed Ea. It was concluded in the author's study using the above brain death model that 1) responses of catecholamine to the peripheral vascular system were of lesser grade than those to the heart, and 2) Ea/Ees (ventriculo-arterial coupling) should be extremely useful in evaluating left ventricular performance on the basis of the cardio vascular hemodynamic relationship, and was strongly suggested to be a reliable index of left ventricular performance in brain death. PMID- 2768904 TI - [Noninvasive and quantitative evaluation of pulmonary regurgitation by pulsed Doppler echocardiography--a study in patients with tetralogy of Fallot after corrective surgery]. AB - A noninvasive and quantitative evaluation of pulmonary regurgitation (PR) using pulsed Doppler echocardiography (PDE) was performed in 25 patients with tetralogy of Fallot (TOF) after corrective surgery. Considering a possibility of the presence of the difference in regurgitant flow velocity in pulmonary artery, four sampling points for detecting the pulmonary regurgitant flow were designed as follows: point 0 was positioned at the right ventricular outflow tract; point 1, at the pulmonary annulus; point 2, at mid-portion of the pulmonary trunk; point 3, at bifurcation of the pulmonary artery. The values of maximum Doppler shift determined by analysing the sonograms recorded at point 1, 2 and 3 were examined in comparison with the grades of PR estimated by pulmonary arteriography and the results obtained were as follows. In a retrospective study in 18 patients with PR, the values of maximum Doppler shift were highest at point 1, and followed by point 2 and point 3 in order (p less than 0.005), indicating that the velocity gradient of regurgitant flow existed in the pulmonary artery. The values of maximum Doppler shift were highest in the group of PR grade III estimated by pulmonary arteriography, and followed by the group of PR grade II and grade I in order. At point 2, the group of grade III-PR showed significantly higher Doppler shift than the group of grade I-PR (p less than 0.05). Following above data, a new criteria for estimating the severity of PR by PDE according to the velocity gradient of regurgitant flow in the pulmonary artery was proposed. In a prospective study in a separate group of other 7 patients, the grade of PR estimated by PDE corresponded well with these of pulmonary arteriography, with a significant Spearman rank correlation coefficient (rs = 0.90, p less than 0.01). An experimental study using a dog with surgically induced PR of different grades confirmed the presence of higher Doppler shift in pulmonary artery corresponding to the grade of PR. These results indicated the usefulness of a newly proposed method evaluating PR by PDE applying a concept of Windkessel model for PR regurgitant flow. PMID- 2768905 TI - [Total repair of complete atrioventricular canal: relationship between age at operation and late results]. AB - Twenty five consecutive patients with complete atrioventricular canal (CAVC) underwent one-stage operation from April 1981 to Aug. 1987. Average ages at operation was 18 months (2 to 72) and average weight was 7.0 kg (2.8 to 13.8). Fifteen patients were infants and fifteen had Down syndrome. Conventional cardiopulmonary bypass with pulsatile bypass pump (PBP) and moderate hypothermia at 28 degrees C was utilized in all patients. Single patch technique (SPT) was adopted for initial five patients and two patch technique for the latter twenties. Two patients died perioperatively (operative mortality 8.0%), one of whom from mitral stenosis after SPT and the other from misdiagnosis of large subpulmonary VSD. There was no hospital death. Mean pulmonary artery pressure (mPA), pulmonary systolic pressure to systemic systolic pressure ratio (Pp/Ps) and pulmonary vascular resistance index (PVRI) were decreased remarkably from preoperative values of 56 +/- 14 mmHg, 0.92 +/- 0.13 and 6.2 +/- 4.9 WU.m2 to postoperative of 31 +/- 16 mmHg (p less than 0.001), 0.54 +/- 0.20 (p less than 0.001) and 4.6 +/- 4.0 WU.m2 (NS), respectively. Six patients had residual pulmonary hypertension in which mPA was more than 40 mmHg. One patient who was complicated with severe mitral regurgitation due to dehiscence of suture line and torn chordae had mitral valve replacement. Mean follow-up period was 26 months (5 to 63). The mean weights of 67%N at operation catched up with 87%N 3 years after operation. There were two late deaths, 4 and 20 months after operation between age at operation, both of whom had residual pulmonary hypertension.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2768906 TI - [Retrograde coronary sinus perfusion of cardioplegic solution in Jatene operation in neonates and infants]. AB - The clinical benefits of retrograde coronary sinus perfusion of a cardioplegic solution were investigated in 7 neonates and 23 infants undergoing Jatene operation. After an initial infusion of albumin-containing crystalloid cardioplegic solution via the aortic root, 21 patients received additional solution delivered by retrograde coronary sinus perfusion (retrograde group) and 9 patients received by selective antegrade coronary perfusion (antegrade group) every 20 to 30 minutes. There were no differences in age, weight, and left ventricular preoperative pressure and morphology between the two groups. Aortic cross-clamping time was 130 +/- 18 minutes in retrograde group and 147 +/- 20 minutes in antegrade group. Postoperative assays of CPK-MB, GOT and LDH, and hemodynamic measurements immediately after cessation of cardiopulmonary bypass (CPB) were carried out in all patients. Although there was no significant difference between the two groups in terms of enzyme indexes, retrograde group showed a greater variation of sigma CPK-MB from patient to patient than antegrade group. However, hemodynamic parameters of CVP, left atrial pressure and rate pressure product at 20-30 minutes after CPB were similar in the two groups. Six neonates in retrograde group also demonstrated the similar enzyme indexes and hemodynamic state immediately after CPB to other older patients. We concluded, therefore, that retroperfusion of cardioplegic solution in neonates and infants provides satisfactory myocardial protection as well as antegrade perfusion, and it was a useful means of cardioplegic delivery in Jatene operation, because of its simplicity. PMID- 2768907 TI - [Clinical study of blood cardioplegia--for aerobic metabolism during aortic cross clamping]. AB - Blood cardioplegia is considered to be superior in oxygenating potential, buffering potential, oncotic, and other physiologic effects. In clinical cases, however, it is unproven whether aerobic metabolism can be obtained by using blood cardioplegia during aortic cross-clamping. Aerobic metabolism during aortic cross clamping was therefore evaluated in patients with valvular heart disease who underwent relatively long periods of ischemic arrest. Myocardial metabolism of oxygen, lactate and pyruvate was studied in 14 patients under 126 +/- 41.2 min of cardiac arrest, and intramyocardial carbon dioxide tension (PmCO2) was also monitored continuously in 23 patients who received 121 +/- 29.8 min of aortic cross-clamping. After aortic cross-clamping, 4 degrees C St. Thomas solution was infused for immediate cooling, followed by blood cardioplegia for replenishment every 20-25 min. Blood cardioplegia and myocardial temperature were maintained within 15-20 degrees C by using an automatic cardiac hypothermia control system. Myocardial oxygen extraction during the pre-ischemic period was 26.8 +/- 13.3%. At 15 and 30 min after reperfusion, it was 30.0 +/- 10.8% and 33.8 +/- 8.2%, respectively. During ischemic arrest, myocardial oxygen extraction decreased, but the infusion of blood cardioplegia kept it above 14.0 +/- 9.3% at all times. As for lactate metabolism, although some cases showed lactate production even before the aortic cross-clamping, lactate extraction was attained in some cases during blood cardioplegia perfusion. Changes in excess lactate and redox potential of lactate and pyruvate (delta Eh) showed that aerobic metabolism could be obtained in 13/32 (41%) infusions of blood cardioplegia. PmCO2 at the aortic cross-clamp was 47.0 +/- 27.7 mmHg, and gradually rose during the ischemic arrest, but only as far as 68.4 +/- 64.8 mmHg at the time of cross-clamp release. PmCO2 decreased with each infusion of blood cardioplegia, and the decrease lasted up to 10 minutes. Though PmCO2 began to rise thereafter, the effect of blood cardioplegia continued as long as 20-25 min after the infusion. In conclusion, blood cardioplegia provides aerobic metabolism during aortic cross-clamping even in clinical setting, provided that cardiac hypothermia and delivery of cardioplegic solution are maintained appropriately. PMID- 2768908 TI - [Ultrastructural study of left ventricular myocardium in mitral regurgitation- correlations with postoperative cardiac functions]. AB - Light and electron microscopic examination was carried out in tissue samples which were obtained from the left ventricular free wall in 21 patients with mitral regurgitation during open-heart surgery. Their correlations with postoperative cardiac functions were also studied. The area of the interstitial fibrosis (%fib) was calculated from the light microscopic examination of the tissue samples, and changes of intracellular structures were expressed in scores by means of electron microscopy (EM-SCORE). Postoperative hemodynamics were studied with echocardiography before and after exercise. The hemodynamic parameters consisted of SVI, CI, EF, FS, mVcf and percent changes of these parameters before and after exercise. 1. EM-scores correlated with EF, FS and mVcf at rest with correlation coefficient of -0.653, -0.629 and -0.712 respectively and their significant levels were all less than 0.005. They also correlated with EF, FS and mVcf after exercise with correlation coefficient of 0.665 and -0.708 respectively and their significant levels were all less than 0.005. They also correlated with %delta EF, %delta FS and %delta Vcf with correlation coefficient of -0.79, -0.76 and -0.811 respectively and their significant levels were all less than 0.005. 2. Percent fibrosis did not correlated with the hemodynamics at rest. But they correlated with EF, FS after exercise with correlation coefficient of -0.577 and -0.599 respectively and their significant level reached less than 0.01. They also correlated with %delta EF, %delta FS and %delta mVcf with correlation coefficient of -0.584, -0.599 and 0.571 respectively and their significant levels were all less than 0.01. 3. There were no correlations between EM-score and %fib. 4. There were significant correlations between left ventricular function and myocardial morphology, in patients with mitral regurgitation. The patients with EM-score over 7 and %fib. over 14% showed poor left ventricular function and poor cardiac reserve postoperatively. PMID- 2768909 TI - [The result of extended thymectomy in patients with myasthenia gravis of pure ocular type]. AB - We studied postoperative status of 14 patients with myasthenia gravis of ocular type who underwent extended thymectomy. Nine patients were in remission, three improved, and two unchanged. No patient became worse and died. The remission rates at one, three, five, and ten years after operation were 50.0%, 58.3%, 60.0%, and 80.0%. The palliation rates at one, three, five, and ten years after operation were 64.3%, 75.0%, 80.0%, and 100%. The remission rate at one year after operation in patients of ocular type was significantly (p less than 0.05) higher than that in generalized type (191 patients). The mean preoperative duration of symptoms in patients who obtained remission after surgery was 7.2 +/- 6.5 months, while mean duration was 85.6 +/- 45.8 months in those patients who could not obtain remission, indicating a significant difference (p less than 0.05) of duration of symptoms between two groups. Among 89 patients with generalized as well as ocular symptoms before extended thymectomy, 62 patients (69.7%) still complained of ocular symptoms and 48 patients (53.9%) had generalized symptoms with or without ocular symptoms in 1 to 12 years after operation. This result shows that ocular symptoms do not disappear more easily than generalized ones. We conclude that extended thymectomy should be performed even in patients with myasthenia gravis of pure ocular type. PMID- 2768910 TI - [Clinical analysis of postoperative recurrent nerve palsy in patients undergoing operation of carcinoma of the thoracic esophagus]. AB - From January 1976 to April 1987, 325 cases of carcinoma of the thoracic esophagus were resected in our department. Among these cases, 25 cases were not included because of direct operative deaths or early hospital deaths, and 300 cases were selected for clinical analysis of postoperative recurrent nerve palsy, which occurred in 75 cases (25.0%). The rate of occurrence of this palsy in the last 6 year period was higher than that in the first 6-year period (34.0% and 15.3%, respectively). It was suggested that the extension of surgical procedures to the cervix and upper mediastinum had contributed to this increase in rate. The sides affected by palsy were as follows: left, 56.0%, right 12.0%, bilateral, 24.0%; unknown, 8.0%. The importance of gentle handling of the left recurrent nerve during operation should be emphasized. The rate of occurrence of palsy in the cases of "Iu" was higher than in cases of "Im" and "Ei" (53.3%, 31.6%, 26.8%, respectively). The rate of occurrence of this palsy was significantly higher in the cases in which cervical anastomosis was performed than in cases in which intrathoracic anastomosis was performed (31.9% and 2.8%, respectively; p less than 0.01). Of the cases complicated by this palsy (Group A), tracheostomy was done in 12.0% of the cases and long-term transnasal tracheal tube cannulation or tube reinsertion done in 29.3%. These rates were significantly higher than the rates for cases who did not develop this palsy (Group B). The rates of occurrence of postoperative pulmonary complications within one month after surgery in Group A and Group B were almost same (24.3% and 21.8%, respectively).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2768911 TI - [Surgical treatment of pulmonary metastases from osteogenic sarcoma-significance of aggressive resection of bilateral multiple metastases and tumors invading adjacent organs]. AB - The results of surgical treatment of pulmonary metastases from osteogenic sarcoma were analyzed. Total cases were 23 with mean age of 17.0 +/- 9.1. The number of operations were 46, and operative procedures consisted of pneumonectomy in 1, lobectomy in 3, partial resection in 37 and resection of adjacent organs in 5. The overall five-year survival rate from the first thoracotomy was 21%. This was significantly higher than prognosis of the previous cases with pulmonary metastases which were not resected (p less than 0.001). Three-year survival rate for the group with 5 or less metastases was 57%, whereas that for the group with 6 or more metastases was 0% (p less than 0.02). To assess both the number and the diameter of metastases, an index called number-size score (NS score) was introduced, which was the sum of the diameters of each metastatic lesion. The three-year survival rate for the group with NS score 6 or less was 73%, whereas that for the group with NS score 7 or more was 9% (p less than 0.001). Disease free interval, the time of operation and histological effect of chemotherapy were not significantly related with prognosis. There was no long-term survivor among the patients with resection of adjacent organs. In conclusion, an aggressive resection of pulmonary metastases from osteogenic sarcoma should be performed with intensive chemotherapy, but significance of the resection of multiple metastases more than 20 or tumors invading adjacent organs is doubtful. PMID- 2768912 TI - [A case of biventricular assist with centrifugal pumps after operation of ventricular septal perforation following acute myocardial infarction]. AB - We applied biventricular assist using centrifugal pumps on a 64-year-old male who has undergone an operation against post-myocardial infarction with ventricular septal perforation. The pump flow was maintained at the level of 2.5 l/m2 in CI, and the pulse pressure 30 to 50 mmHg with IAPB. Complete hemostasis has been achieved prior to use heparin to control the patient's ACT around 200 sec. on the third pumping day. The patient's cardiac function improved in a few days at the beginning, but did not recover enough for weaning from the assist devices. He died on the 8th pumping day, and the autopsy revealed massive old myocardial infarction which is considered to be the major obstacle against the recovery of the cardiac function. There was no edema in any organs. Centrifugal pumps are very useful for ventricular assist in availability and in economy. Its efficacy is comparable with pulsatile ventricular assist devices especially when applied with IABP though there still exists controversy as for the superiority of pulsatile flow in ventricular assist. PMID- 2768913 TI - [A case report of compression of right pulmonary artery and bronchus by aneurysmal dilated ascending aorta in tetralogy of Fallot--suspension of ascending aorta]. AB - The patient was a 63-days-old boy who was admitted to our hospital because of moderate cyanosis and tachypnea. After admission, severe respiratory distress and emphysematous change of the right lung on the chest X-ray developed progressively. Echocardiogram and angiocardiogram demonstrated that a tetralogy of Fallot associated with right aortic arch and absence of pulmonary valve, and revealed remarkably dilated ascending aorta which compressed the right pulmonary artery and bronchus. Therefore, the emergency operation in that the ascending aorta was suspended to the 2nd rib was performed through a right thoracotomy. After surgery, his respiratory distress and emphysema of the right lung completely disappeared. To our knowledge, this is the 2nd reported case in which suspension of ascending aorta was successfully performed for pulmonary complication in congenital cardiovascular anomalies as this patient. PMID- 2768914 TI - [The diagnostic value of computed tomography during lymphangiography on the postoperative chylothorax in lung cancer]. AB - A successfully operated case of postoperative chylothorax in a lung cancer was reported, under the diagnosis of computed tomography during lymphangiography demonstrating the disruption of the thoracic duct. The computed tomography during lymphangiography is considered to be very useful for deciding the surgical indication of postoperative chylothorax and prompt surgical treatment is recommended when the main truncus of the thoracic duct is lacerated. PMID- 2768915 TI - [Surgical treatment of stage III and IV thymoma]. AB - During past 15 years, 39 cases of thymoma were underwent surgical intervention. In these cases, invasive type, so called stage III and IV in Masaoka's classification were 19 cases. This report documents the results of extended operation in 19 patients treated for malignant thymoma. All patients had neoplasm which invaded adjacent structures; superior vena cava, pericardium, and lung. Eight patients had disseminated lesions in the pleural or pericardial cavities. All patients were underwent surgical exploration through median sternotomy (18 patients) or left thoracotomy (1 patient). Our surgical management to malignant thymoma is to have complete resection, even if tumor invades the great veins. Of 8 patients, superior vena cava and left innominate vein were resected with tumor and reconstructed with ringed PTFE. Mediastinal pleura and pericardium should be widely opened and intrapericardial or intrapleural disseminated lesions should be removed as far as possible. Malignant thymoma could be resected completely applying technique of vascular surgery. Good results were expected when tumor was resected with invading adjacent structures completely. Reoperation to the recurrent tumor is also important. PMID- 2768916 TI - [The prognosis and the surgical indications of DeBakey type III dissecting aortic aneurysm]. AB - In order to determine the indications of operation for dissecting aortic aneurysm of DeBakey type III, therapeutic results obtained from 60 cases (11 with type IIIa and 49 with type IIIb) treated at our department during the 19-year period until the end of 1984 were analyzed as well as their distant prognosis. Since 12 cases (20%), who visited our department during the acute phase, were all abated to the subacute phase by hypotensive treatment, and since only one of the 12 cases died from pneumonia 5 weeks after the onset, it was thought that the operation during the acute phase is in most cases not necessary. We applied operation when there was a large false lumen, a regional protrusion, rupture or impending rupture. Out of the 60 cases, 25 (42%; 7 with type IIIa and 18 with type IIIb) underwent operation, and 3 of them (12%), including one ruptured case during the chronic phase, died due to the operation. Among cases with type IIIa, a non-operated case died of a related cause (rupture) during distant period, but none of operated cases died. Among discharged cases with type IIIb, 4 of 16 operated cases (25%) died of related causes during distant periods. This mortality did not differ from that of non-operated cases; namely, 8 of 30 non operated cases died (27%). A 5-year survival rate was also identical between the non-operated and operated cases with type IIIb; namely, about 50% in the 2 groups.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2768917 TI - [Surgical treatment of lung cancer with chest wall invasion]. AB - From 1955 through 1987, 64 cases underwent operation at Mie University Hospital for carcinoma of the lung invading the chest wall (p-T3). According to the classification by Mishina et al, the extent of tumor invasion of the chest wall was p3a-b in 63%, p3c in 18%, and p3d in 19%. Histologically, the tumors were epidermoid carcinoma in 565, adenocarcinoma in 31%, large cell carcinoma in 11%, and small cell carcinoma in 2%. The post surgical staging of N factor was N0 in 39%, N1 in 33%, and n2 in 28%. Extrapleural resection was performed in 27 cases and extended resection (en block resection of chest wall and lung) was performed in 30 cases with an operative mortality of 0%. The actuarial three-year survival rate (Kaplan-Meier method) for patients with p3d was 18.2% but three-year survival for patients with p3a-b and p3c was more than 30%. In spite of p3a-b, however, four-year survival for patients without extended resection was decreased to 11.6%. Four-year survival of patients with adenocarcinoma, epidermoid carcinoma, and large cell carcinoma was 5.9%, 28.4% and 75% respectively, lymphatic metastases reduced survival, with a three-year survival rate of 52.8% for patients with N0 disease and 8.35 for those with N2 disease. Among patients with extended resection, four-year survival for patients 60 years of age of less was 50.8%, greater than the 13.3% four-year survival for the patients more than 61 years of age. We conclude that long-term survival can be influenced by the extent of tumor invasion. In factor, histologic type, and the patient's age, and that extended resection and adjuvant therapy should be applied for treatment of lung cancer with chest wall invasion. PMID- 2768918 TI - [Clinical assessment of prosthetic valve replacement of the right-sided cardiac valves: mechanical or bioprosthesis?]. AB - Clinical results with mechanical and bioprosthetic valve replacements for tricuspid and/or pulmonary positions were reviewed. Between February 1975 and December 1985, 34 bioprostheses (B) (22 Hancock, 9 Ionescu-Shiley and 3 Carpentier-Edwards pericardial) and 18 mechanical prostheses (M) (St. Jude Medical) were implanted in our institute excluding hospital death. Group with B included 29 tricuspid valve replacements and 5 pulmonary valve replacements. Group with M included 9 tricuspid valve replacements, 7 pulmonary valve replacements and 1 both valve replacements. The cumulative follow-up period was 207.2 patient-years (p-t) in group B and 55.0 p-y in group M. The incidence of valve failure was 0.48 +/- 0.48% per p-y in group B and 7.27 +/- 3.64% per p-y in group M (p less than 0.001). The incidence of valve-related events was 1.93 +/- 0.97% per p-y in group B and 9.09 +/- 4.07% per p-y in group M (p less than 0.001). At 3 years, the percent free of valve failure was 100 +/- 0% in group B and 76.8 +/- 10.2% in group M (p less than 0.05). Fourteen bioprosthetic valves (B') and 10 mechanical valves (M') were implanted at the right-sided cardiac valve position alone. The cumulative follow-up period was 94.2 p-y in group B' and 32.3 p-y in group M'. The incidence of valve-related events was 1.06 +/- 1.06% per p-y in group B' and 12.4 +/- 6.19% per p-y in group M' (p less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2768919 TI - [Experimental study on the mechanism of serum leakage from expanded polytetrafluoroethylene (EPTFE) vascular prosthesis]. AB - Even in recent years, the Blalock-Taussig (B-T) shunt operation has been carried out in order to increase pulmonary blood flow in patients of low pulmonary flow congenital heart disease. In such a case, a modified B-T shunt using an EPTFE vascular prosthesis would be employed in order to prevent blood flow obstruction in the upper extremity, and occasionally serum leakage from EPTFE vascular prosthesis is a complication. This has often troubled cardiovascular surgeons the world over, and we attempted to elucidate the mechanism of serum leakage and to discover how to prevent the situation from occurring. Using scanning electron microscopy, the structure of EPTFE vascular prosthesis was found to consist of an average of 0.5 micro meter polytetrafluoroethylene (PTFE) fibers arranged in parallel 5.0 micro meters from each other. The reason why serum does not usually leak from these widely spaced fibers is due to the presence of a repellent force derived from the surface tension and the contact angle between the solid surface of PTFE and the liquid. When the contact angle is over 90 degrees, the repellent force is in effect, while when it is below 90 degrees, this force is decreased. The surface tension and contact angle of physiological saline on the surface of PTFE showed values of 71.6 dyn/cm and 114.0 degrees, respectively, while demonstrating a strong repellent force. On the other hand, the surface tension of heparinized blood on the surface of the PTFE was 56.5 dyn/cm and the contact angle was 90.6 degrees. Thus, heparinized blood was assumed to act on the surface of the PTFE with a weak repellent force and for that reason had a tendency to easily leak from the EPTFE vascular prosthesis. When the surface of the PTFE was in contact with blood, blood protein was fixed to the surface of the PTFE and the contact angle of blood was thereby decreased. When the inner pressure of the vascular prosthesis was increased, the wall was stretched easily in a circumferential direction but with great difficulty in a longitudinal direction. With the PTFE stretched and released repeatedly, the expanded circumference was enlarged progressively due to the plastic character of the PTFE and because the spaces between the PTFE fibers were widened. In order to examine the relationship between the space between fibers and the critical pressure leading to serum leakage, computer simulation was carried out and the results showed a reversed linear correlation between the density of the fibers and the minimal pressures responsible for serum leakage.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2768920 TI - [Study on indication of unilateral pulmonary artery occlusion test in patients undergoing pneumonectomy]. AB - We tried to establish an indication of unilateral pulmonary artery occlusion test (UPAO), by analyzing the preoperative data of UPAO, overall and regional pulmonary function tests, and arterial blood gas in 55 patients who were intended for pneumonectomy. Our limits of functional indication for pneumonectomy were PPA less than or equal to 25 mmHg or TPVRI less than or equal to 700 dyne.cm-5.m2. PPA correlated with the inverse of contralateral FEV1.0/BSA (FEV section 1.0) and DLCO/BSA (section DLCO), which were calculated by multiplying preoperative values by contralateral ventilation fraction. TPVRI correlated with age, the inverse of PaO2, the inverse of FEV section 1.0, and the inverse of section DLCO. Multiple regression analysis yielded the equation, TPVRI approximately p = 1120/section DLCO + 24800/PaO2 + 6.40 X Age -506. In order to make false negative zero, the values of each parameter were as follows: age greater than or equal to 55, PaO2 less than or equal to 85 mmHg, FEV section 1.0 less than or equal to 0.8 L/m2, section DLCO less than or equal to 6.0 ml/min/mmHg/m2 and TPVRI approximately p greater than or equal to 450 dyne.sec.cm-5.m2. The specificities of each parameter were 18.6%, 20.9%, 39.2%, 40.4% and 59.0%. Therefore, in order to make false positive patients least, the criteria of TPVRI approximately p greater than or equal to 450 dyne.sec.cm-5.m2 should be used. PMID- 2768921 TI - [Combined aortic and mitral valve replacement with or without preservation of posterior mitral apparatus]. AB - Seventy patients who underwent aortic and mitral valve replacement were reviewed. 37 patients had the mitral valve replaced with preservation of posterior mitral apparatus (AVR and modified MVR; modified group), and the others without (AVR and conventional MVR; conventional group). Hospital deaths occurred in 4 patients (12.1%) in conventional group and in only 1 patient (2.7%) in modified group. Four out of these five hospital deaths were due to low output syndrome (LOS). The other one died of unknown cause. Severe LOS, necessitating intra-aortic balloon pumping, occurred in 4 (12.1%) in conventional group and in 2 (5.4%) in modified group. In the early postoperative period modified group showed better left ventricular function than conventional group in terms of cardiac index and left ventricular stroke work index. Cardiac performance was evaluated by means of echocardiography at the time of discharge. Modified group showed better fractional shortening and shorter PEP/ET (pre-ejection period/ejection time). These findings suggest that the lower mortality of modified group is due to better left ventricular function preventing LOS in the early postoperative period, and that preserving the posterior mitral apparatus has a more beneficial effect on postoperative left ventricular function even in combined valve disease. PMID- 2768922 TI - [Long-term results of the 19 mm low-profile bileaflet valve prosthesis in the small aortic anulus]. AB - Between April, 1979, and November, 1986, 20 patients underwent aortic valve replacement (AVR) in the small aortic anulus with either 19 mm St. Jude Medical valve prosthesis or 19 mm Duro-Medics valve prosthesis, which are relatively new, low-profile bileaflet valve prostheses. There were two male and 18 female patients ranging from 35 to 69 years old (mean, 54.7 years). Average body surface area was 1.37 +/- 0.11 m2 (range 1.20 to 1.55 m2). One patient died of arrhythmia at 22 postoperative day. The 19 survivors have been followed up for as long as 61 months (mean, 31.2 months). There were two late complications, cerebral infarctions, and event free ratio was 0.85 at five years. All long-term survivors were in New York Heart Association Functional Class I (15 patients) and Class II (three patients). Preoperative and postoperative echocardiograms demonstrated significant decreases in mean left ventricular end-diastolic diameter (LVDd) (48.9 +/- 8.3 mm vs 42.2 +/- 5.7 mm; p less than 0.01) and in left ventricular end-systolic diameter (LVDs) (32.2 +/- 8.2 mm vs 25.7 +/- 4.9 mm; p less than 0.01). Mean left ventricular wall thickness was decreased to 24.5 +/- 3.7 mm from 25.8 +/- 6.4 mm. The average peak systolic gradient at rest with Doppler ultrasound was 26.0 +/- 9.3 mmHg (range nine to 36 mmHg). Though transprosthetic gradient did occur in patients who received 19 mm low-profile bileaflet valves in narrow aortic roots, progressive prosthetic stenosis was not observed and small aortic prostheses provide acceptable palliation for long-term results clinically. PMID- 2768923 TI - [Surgical treatment of patients with triple valvular heart disease--a clinical study of triple valve replacement]. AB - Triple valve replacement were performed on 14 cases from 1972 to 1987 in our department in Nihon University School of Medicine. Hemodynamic data and the function of other organs were analysed. 5 cases were dead. Causes of death were LOS in four and respiratory failure in one. Although preoperative clinical status were class III and IV in NYHA, postoperative clinical status improved in I and II except dead cases. There were significant differences between pre and postoperative valves of PAm, PCWP and CI, but of RAm RVEDP and EF. The reason why these cardiac function did not recover enough was myocardial degeneration. The respiratory, renal and liver function was clearly improved after operation except hemolysis. In conclusion, it is recommended that, in cases of severe triple valve disease, triple valve replacement should be performed with SJM valve to get satisfactory hemodynamic improvement. PMID- 2768924 TI - [Study of postoperative bronchopleural fistulas--analysis of factors related to bronchopleural fistulas]. AB - Postoperative bronchopleural fistulas, although reduced in incidence, remain as a grave complication of pulmonary resection. In our department, cases of lung cancer have been rapidly increasing and those of infectious diseases have been decreasing. In light of this trend, the causes of bronchopleural fistulas may have changed, and thus we studied recent cases of postoperative bronchopleural fistulas from 1982 to 1986. Bronchopleural fistulas were seen in 5 (7.8%) of 64 cases of inflammatory diseases and in 19 (4%) of 481 cases of lung cancer. In lung cancer, bronchopleural fistulas were more frequently seen with advanced cases, especially in cases of residual tumors on the stump and in cases of intrathoracic use of anticancer drugs. The highest incidences of bronchopleural fistulas were seen with right pneumonectomy and right lower lobectomy. Bronchoscopic examination showed bronchopleural fistulas to be mainly located on the stump beside the residual lobe. When Sweet's procedure is employed, this is the point with the most tension on the stump. Clinical and retrospective analysis of preoperative data revealed the following factors to be significantly higher in cases of bronchopleural fistulas than in cases of non-bronchopleural fistulas: fever, use of steroid hormone, Haemophilus influenzae in sputum, elevation of erythrocyte sedimentation ratio and anemia. Such analysis of postoperative data showed the following factors to be significant: fever, use of steroid hormone, leucocytosis, tracheostomy and bronchoscopy for sputum suction. PMID- 2768925 TI - [Results of tricuspid valve replacement using xenograft bioprostheses]. AB - Thirty-two cases of tricuspid valve replacement were done with bioprostheses during the period from 1979 to 1986 at our institution. In these cases there were 19 cases of acquired valvular diseases, 10 cases of congenital types of heart diseases and other 2 cases were another genesis. Seven different kinds of bioprostheses were utilized: 30 were bovine pericardial xenografts and 2 were porcine xenografts. In postoperative hemodynamic study, right ventricular end diastolic pressure and right atrial pressure significantly decreased after tricuspid valve replacement. RV ejection fraction were reduced but there was no statistic significance when compared to the preoperative data. There were 5 patients who showed postoperative atrio-ventricular block and two of them needed permanent pacemaker implantation. Six patients died in postoperative period and other 3 died in late follow-up period. However, these was no mortality directly related to prosthetic valvular failure. In follow-up study, there was no episode of valve thrombosis nor pulmonary embolism. Prosthetic endocarditis was not encountered during this observation period. One patient showed mild degree of tricuspid regurgitation who had severe pulmonary hypertension even after the operation. Based on our experience, we concluded that the bovine pericardial xenograft may be the best choice for the TVR because of its anti-thrombogenicity. However, mechanical valve will be better choice for the patients who are complicated with severe pulmonary hypertension. PMID- 2768926 TI - [Malfunction of the Bjork-Shiley valve prosthesis due to disc defacement--report of two cases of successful reoperation]. AB - Derlin-disc model Bjork-Shiley valve prosthesis was reoperated due to the disc defacement. One had admitted cerebral embolism which was suggested due to the prosthetic valve malfunction of aortic position and the other had congestive heart failure due to the malfunction of mitral position. These patients had implanted Derlin-disc model Bjork-Shiley valve prosthesis in the aortic and mitral position 10 and 11 years ago. One's cineangiocardiography showed mild aortic regurgitation and the other showed mitral regurgitation due to the malfunction of the prosthesis. The episode of cerebral embolism in one patient was suggested due to the malfunction of aortic prosthetic valve, and congestive heart failure in the other patient was due to the malfunction of mitral prosthetic valve. These prostheses which removed at the reoperation were observed with strat shape indentation and distinct of the disc which resulted the malfunction of the prostheses. In patient who replaced with Derlin-disc model Bjork-Shiley valve prosthesis should be carefully followed up. PMID- 2768927 TI - [Systemic origin of the sole artery to the basal segments of the left lung without pulmonary sequestration]. AB - A sixty-one year-old man with squamous cell carcinoma of the left upper lobe had an aberrant systemic artery to the left basal segments without pulmonary sequestration. Physical examination revealed neither cardiac murmur nor any sign of heart failure, which was at variance with reported cases in the literature. Chest X-ray film showed no abnormal density suggesting sequestrated lung. Bronchogram disclosed obstruction of the left upper lobar bronchus by the tumor and normal segmental bronchi of the lower lobe. Left pulmonary angiogram showed normal arterial distribution of the left upper lobe and the superior segment of the lower lobe, but the basal segmental arteries were not visualized. The aberrant pulmonary artery arising from the descending aorta was visualized by computed tomography. Following dissection of the abnormal vessel pneumonectomy was performed. Pathological examination of the left basal segments revealed prominent atheromatous changes in the aberrant systemic intrapulmonary artery and irreversible obstructive lesions in its tributaries. These arterial lesions in this patient would have precluded plastic operations such as transfer of the origin of the aberrant vessel to the left pulmonary artery even if other circumstances had been favorable for preservation of the left lower lobe. PMID- 2768928 TI - [Successful simultaneous repair of tetralogy of Fallot and congenital tracheal stenosis in a 5-year old child]. AB - Congenital cardiac anomaly combined with severe obstructive lesion of airway remains a surgical challenge. A case of 5-year old child with tetralogy of Fallot associated with congenital tracheal stenosis (cartilagenous ring) was reported. The patient had history of cyanosis and stridor since age 3 months and had been hospitalized repeatedly for recurrent respiratory distress. The diagnosis was first established and emergent Blalock-Taussig shunt was carried out during first admission at age 1 year and 7 months. On the fourth admission at age 5 year, a definitive surgical intervention was decided following re-evaluation of the patient by cardiac catheterization, bronchoscopy and bronchography. Trachea and heart were exposed through cervical collar and presternal skin incision and median sternotomy. Tracheal resection and end-to-end anastomosis combined with total correction of tetralogy of Fallot was carried out under cardiopulmonary bypass. Utmost care was paid to avoid contamination during the operation. He was extubated at 9th postoperative day and has been free from symptom 9 months after the operation. PMID- 2768929 TI - [Re-operation of pectus excavatum]. AB - We performed surgical reconstruction on 1655 cases of deformed thoracic cage, we later operated again on 11 of these to repair postoperatively re-deformed anterior chest walls. Based on these experiences, we have concluded as follows. 1: Postoperative recurrence of funnel chest deforming is mainly due to insufficient resection of costal cartilages. In particular transection of the sternum at low levels during sternal turn-over procedure results in postoperative recurrence of depression in the upper anterior chest wall. 2: In young children who have undergone sternal turn-over procedure, the first and second costal bones and cartilages overgrow and protrude anteriorly, and in compensation their junctions to the sternum recess posteriorly. This results in a depression in the upper anterior chest wall. 3: We recommend sternal turn-over with overlapping of the sternum for repair of postoperative funnel chest deformity. Through this procedure, the extent of resection of costal cartilages can easily be determined and the depression of the anterior chest wall satisfactorily reconstructed. 4: In re-do surgery, we obtained pathological evidence confirming our clinical experience that our sternal turn-over technique does not interfere with blood circulation or development of the turned-over sternum even though the sternum is not connected to the rectus abdominus muscle pedicle, preserved internal mammary vessels, or anastomosis of the internal mammary vessels. PMID- 2768930 TI - [Progressive pulmonary hypertension following repair of pseudotruncus arteriosus with major aorto-pulmonary collateral arteries in a 20-year-old patient]. AB - External conduit operation was performed for a 20 year-old woman with pseudotruncus arteriosus with major aorto-pulmonary collateral arteries (MAPCAs). Immediate postoperative pulmonary to systemic peak pressure ratio was 0.70, and decreased to 0.53 on the second postoperative day. She had episodes of pulmonary hypertensive crisis soon after the operation, and injection of tolazoline hydrochloride was effective on them. Seven months after surgery, cardiac catheterization revealed severe pulmonary hypertension (PH) above the systemic level. Pulmonary arterial pressure did not respond to any drug nor to inhalation of oxygen. The progression of PH may be due to the pulmonary obstructive disease, and its causes were thought to be the repetition of constriction of pulmonary arterioles, hypoxia due to the giant bullae, diminished pulmonary vascular beds due to ligation of arborized MAPCAs, and relatively high age at operation. PMID- 2768931 TI - [A case of concomitant surgery of advanced valvular disease and lung cancer under cardiopulmonary bypass]. AB - We successfully performed a concomitant operation in a patient with severe valvular heart disease with a giant left atrium and a pulmonary cancer. The operation was done via a median sternotomy under cardiopulmonary bypass. The patient was a 62-year-old man with congestive heart failure, NYHA class III. The CT ratio was 76%, and the volume of the left atrium estimated by a CT scan was above 900 ml. An abnormal shadow was recognized in the left upper lung field. Mitral valve replacement with St. Jude Medical valve (31 mm), and tricuspid annuloplasty with a Bex Reducer were performed. After an autonomous cardiac rhythm and a decrease in the size of the left atrium were confirmed, we went on to remove the upper lobe of the left lung under cardiopulmonary bypass. Twelve months postoperatively, the patient was doing well. For a complex case such as the present one, we recommend lobectomy via a median sternotomy using cardiopulmonary bypass as the technique of choice. This method assures good hemodynamic control and provides improved visibility of the pulmonary hilus. PMID- 2768932 TI - [A case report of Rastelli operation in 2-month-old infant with truncus arteriosus (type II)]. AB - A two-month-old girl with heart failure from truncus arteriosus (Collett & Edwards Type II) underwent a total correction by the Rastelli procedure using 12 mm-diameter Hancock valved conduit. The orifice of pulmonary arteries was closed from inside without detachment of the pulmonary artery from truncus. The distal anastomosis of the conduit was made to left pulmonary artery. Primary sternal closure was difficult and delayed closure was performed using splint with a resin plate. The skin was primarily closed using bilateral advancement myocutaneous flaps. Complete closure of the sternum was made on the 11th postoperative day. A rotation flap of the right abdominal rectal muscle was used to cover the partially necrotic skin over the sternum. The patient had persistent respiratory and cardiac problems, but was discharged 14 months after surgery. PMID- 2768933 TI - [Graft versus host disease in a human T cell leukemia virus-I carrier]. AB - A 24 year-old woman developed severe congestive heart failure due to combined aortic and mitral valve failures associated with infectious endocarditis. She was operated on double valve replacement. At the open heart surgery, 7 units of blood were transfused. Her postoperative course was complicated with LOS and renal failure. She recovered gradually with assistance of intraaortic balloon pumping and hemodialysis. High fever, diarrhea, skin rash and impaired liver function appeared on the 10th postoperative day. Neither leukocytopenia or pancytopenia was seen. In blood cultures, organism was negative and endotoxemia was also negated after operation. Erythroderma developed rapidly after desquamation of skin rash. The skin sample showed the typical features which were observed in a graft-versus-host (GVH) disease. The patient died of cerebral bleeding on the 32nd postoperative day. In the HLA typing, two unmatched antigens of class II were exhibited in her lymphocyte sample but all of class I were matched. Y chromatin was not detected in her lymphocytes. Anti-nuclear antibody was positive. The fact is noteworthy that she and her parents were human T lymphotropic virus-I (HTLV-I) carriers. In the literature, HTLV-I is activated in the immunocompromised state and yields alien antigens of major histocompatibility complex (MHC) in T cells, then the reaction is very similar to it in autoimmune disease. That mechanism may be involved in the cause of GVH reaction in our case. These results suggested that the GVH reaction in our case.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2768934 TI - [Effect of myocardial preservation and preoperative left ventricular end diastolic pressure upon the early postsurgical cardiac function after prosthetic cardiac valve replacement]. AB - We investigated the effect of myocardial preservation and preoperative stroke work index (SWI) and left ventricular end-diastolic pressure (LVEDP) upon the early postsurgical kinetics of left ventricular function in thirty-four patients after prosthetic cardiac valve replacement. They received both-sided cardiac catheterization and measurement of cardiac output by dye dilution method in a standard fashion. Myocardial temperature was measured simultaneously and consecutively during aortic cross-clamping period (greater than 70 min) on open heart surgery. Thereafter, each postsurgical left ventricular function was estimated at three, six, twenty-four and forty-eight hours after weaning from cadiopulmonary bypass (CPB) by using Swan-Ganz catheter. SWI0 X 1000/AnI was used as an improved index of postsurgical cardiac function, because it was incorporated with the preoperative left ventricular stroke work index (SWI0) and anoxic index (AnI), which was the integral of myocardial temperature during aortic cross-clamping period. Otherwise, we regarded LVEDP as an estimate of preoperative cardiac function. So we compared them with the early postsurgical left ventricular SWI, respectively. As a result, the relation between SWI0 and the postsurgical SWI (SWI24 and SWI48) showed positive correlations with correlation coefficients 0.52 and 0.70, and the relation between AnI and the early postsurgical SWI (SWI3 and SWI6) showed negative correlations with correlation coefficients -0.56 and -0.52. While the relation between SWI0 X 1000/AnI and postsurgical SWI (from SWI0 to SWI48) showed positive correlations with correlation coefficients decreasing from 0.76 to 0.57. LVEDP showed negative correlations to SWI0 and SWI48 with correlation coefficients -0.48 and 0.45.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2768935 TI - [Clinical evaluations of surgical treatment of infective endocarditis]. AB - This paper shows the clinical evaluations of surgical and medical treatment of infective endocarditis (IE). IE occurred in 33 cases (10.1%) among 372 cases of valve replacement. Of all the 33 patients, IE was consisted of native valve endocarditis (NVE) and prosthetic valve endocarditis (PVE). IE was evaluated as for the microorganism, complication, operative indication and operative mortality. At first, all of NVE underwent surgical treatment, active phase endocarditis 4 and healed endocarditis 14. Microorganism was streptococcus aureus in an overwhelming majority. Operative indications was congestive heart failure in almost all cases, next to vegetation and infection resistant to medical treatment. Operative mortality was 5.6% (1 out of 18 cases), which case was in the septic shock and cerebral bleeding prior to the surgical treatment. The others was satisfactory condition postoperatively. Next of PVE, PVE happened in 15 cases, in which there were 5 cases of bioprosthetic PVE and 10 cases of mechanical valve PVE. Microorganism for PVE was staphylococcus epidermidis in the major part (60%). Mortality in PVE was 53.3% (8 out of 15), but mechanical valve PVE was worse in prognosis than bioprosthetic PVE. Cerebral complications occurred in 3 cases of mechanical valve PVE, on the other hand there was no cerebral complication in bioprosthetic PVE. As for the hemodynamic change in PVE, mechanical valve PVE had the tendency to take the prompt or sudden deterioration of hemodynamics caused by endocarditis surrounding the suture ring, especially in mitral position, on the contrary hemodynamic deterioration was gradually proceeded in bioprosthetic PVE. UCG made much of the diagnosis of PVE, especially in mechanical valve PVE, in which cases endocarditis was recognized only surrounding the suture ring. PVE takes the miserable outcome in many cases, so carefully observation is necessary in order not to lose the timing of the surgical treatment. PMID- 2768936 TI - [Assessment of myocardial oxygen consumption during hypothermic perfusion on arrested heart with perfluorochemical and blood cardioplegia]. AB - Perfluorochemicals (PFC) have been utilized attempting to improve the myocardial protective effect of hypothermic cardioplegia (CP). This study was performed to evaluate the efficacy of PFC against blood in oxygen utilization under hypothermic continuous perfusion of chemically arrested heart and to estimate the maximum oxygen consumption (max MVO2) under unlimited oxygen delivery. Canine hearts isolated hemodynamically were perfused continuously using either PFC-CP or blood-CP. In experiment A (n = 8 in PFC-CP, 7 in blood-CP), perfusion temperature was dropped from 25 to 4 degrees C at a constant perfusion pressure of 40 mmHg at aortic root. MVO2 showed gradual falls as temperature dropped in both groups, and significant difference in MVO2 between two groups was obtained at 10 degrees C (PFC-CP 15.0 +/- 6.5 (SD), blood-CP 9.7 +/- 4.3 microliters/min/g dry wt, p less than 0.05) and 4 degrees C (PFC-CP 11.3 +/- 3.7, blood-CP 7.6 +/- 3.3 microliters/min/g dry wt, p less than 0.05). There was no significant difference in MVO2 between two groups at 25 degrees C (PFC-CP 24.6 +/- 3.5, blood-CP 24.0 +/ 6.6 microliters/min/g dry wt) and 20 degrees C (PFC-CP 19.9 +/- 4.7, blood-CP 18.6 +/- 4.9 microliters/min/g dry wt). In experiment B, the perfusion temperature was kept constant at either 20 degrees C (n = 6 in PFC-CP, 6 in blood CP) or 4 degrees C (n = 8 in PFC-CP, 7 in blood-CP), and oxygen delivery was increased until the plateau in MVO2 was obtained by increasing the perfusion flow. The asymptote in a hyperbolic relation between oxygen delivery and MVO2 was estimated and considered as max MVO2. At 20 degrees C, max MVO2 was 20.4 microliters/min/g dry wt with PFC-PC and 21.4 microliters/min/g dry wt with blood CP, without significant difference. At 4 degrees C, max MVO2 was significantly higher (p less than 0.05) in PFC-CP (20.8 microliters/min/g dry wt) than blood-CP (13.9 microliters/min/g dry wt). In conclusion, there seems no significant fall in maxMVO2 below 20 degrees C under unlimited oxygen delivery by PFC-CP and the superiority in oxygen utilization by PFC-CP can be obtained at the myocardial temperature less than 20 degrees C. PMID- 2768937 TI - [The usefulness of two-dimensional transesophageal echocardiography in follow-up studies of dissecting aortic aneurysm]. AB - Two-dimensional transesophageal echocardiography (2D-TEE) facilitates clear imaging of the thoracic aorta, and we have already reported the diagnostic value of this procedure for detecting dissecting aortic aneurysm (DAA). Recently, we performed preoperative and postoperative 2D-TEE in nine surgically treated patients with DAA (Debakey type I: 2 cases, type II: 1 case, type IIIa: 2 cases, type IIIb: 4 cases), and repeated 2D-TEE in six medically treated patients (DeBakey type IIIa: 2 cases, type IIIb: 4 cases), and the usefulness of 2D-TEE in the follow-up study of DAA was evaluated. Two types of ultrasound probe (radial scan type, and sector type with a color-Doppler system) were used in this study. Of the surgically treated patients, four of nine cases in which the initial tears were excised or repaired showed neither leakage nor pseudoaneurysm at the site of graft insertion. Other surgically treated patients showed residual intimal tears and continued to harbor patent false lumen. One patient with type I dissection demonstrated localized saccular aneurysm in the proximal arch of the aorta, but no evidence of aortic regurgitation. Of the six medically treated patients, further extension of the initial dissection was observed in one of the two type IIIa cases. False lumen narrowing was recognizable in three of the four type IIIb patients, and complete obliteration of false lumen was observed at necropsy in one of these three cases. Double-channeled aorta was seen in another case of type IIIb dissection.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2768938 TI - [Late results after heart valve surgery in the elderly]. AB - Heart valve surgery was performed in 133 patients over the age of 60 between 1976 and 1981. There were 54 men and 79 women. Their ages ranged from 60 to 74 years (mean age 64.3 years). In this study, 54 valve prostheses (15 porcine and 39 mechanical) in the aortic position, 79 prostheses (69 porcine and 10 mechanical) in the mitral position and 3 prostheses (3 porcine) in the tricuspid position were implanted in 121 patients. Fifteen patients (11.3%) died in the hospital. The hospital mortality was high in the cases of MVR (14.6%), MVR + TAP (12.5%) and emergency (50%). The mean follow-up was 37.2 months (range 4 to 129 months, total 367.3 patient-years). There were 10 late deaths (8.5%). Actuarial survival for hospital survivors at 5 years was 89.2 per cent. At follow-up, 95.8% of the surviving patients were in New York Heart Association functional class I or II. Valve-related complications were thromboembolism (2.0% pt/year), periprosthetic leak (1.7% pt/year), primary tissue failure (0.5% pt/year) and thrombosed valve (0.3% pt/year). Anticoagulant-related hemorrhage necessitating hospitalization occurred in 2 patients (1.0% pt/year). The freedom from all events at 5 years was 72.8 per cent. This study suggests that heart valve surgery in the elderly can be performed with an acceptable mortality. Advanced age alone should not be a contraindication to surgical management. PMID- 2768939 TI - [Surgical treatment of acute aortic dissection]. AB - Sixty-seven patients subjected to this study composed of 32 patients treated surgically, 15 patients treated medically and 20 patients examined by autopsy for the past 8 years. Out of 32 surgical cases, 16 were operated on in an acute stage, within 2 weeks after onset and 9 out of these 16 acute cases belonged to DeBakey type I or II and 11 out of 15 autopsy cases belonged to type I or II either. Contrarily most of the medical cases were type III. Both causes of death in the acute autopsy group and operative indications in the acute surgical group were cardiac tamponade, heart failure due to aortic insufficiency, myocardial infarction and aortic rupture. Operative mortality rate was 12.5% in the acute cases and 19% in the chronic cases, late mortality rate was 19% in the acute cases and 0% in the chronic cases. Two cases of operative death had massive bleeding due to aortic rupture and massive myocardial infarction. These were the most dangerous complications of acute aortic dissections. We conclude that all patients with type I or II dissections should be operated on before fatal complications occur. PMID- 2768940 TI - [Time-related degeneration of Carpentier-Edwards bioprosthesis in mitral position]. AB - Carpentier-Edwards bioprostheses have been shown to provide a low incidence of valve-related complications, especially thromboembolism, but the durability has caused the serious concern. This report suggests that Carpentier-Edwards prostheses have been gradually degenerative, and stenotic degeneration and the year after operation are well correlative. In Osaka National Hospital, Carpentier Edwards prostheses were implanted in 89 patients in mitral position from 1973 to 1981. Of all the patients, 50 patients were undertaken to single valve replacement in mitral position and could be followed up in our department. For a total of 50 patients, materials are 30 patients who could be detected by clinical findings, pulsed Doppler echocardiography, cardiac catheterization and soft X-ray evaluation in explanted prostheses at reoperation. Follow-up duration was ranged 4.2 to 12.1 years with a mean duration of 7.94 years. The age ranged from 32 to 71 years of age. The initial diagnosis of the time-related degeneration was the appearance of newly acoustic rumbiling murmur. Furthermore, regurgitant murmur, arrythmia (atrial fibrillation) and cardiac enlargement were followed in addition to rumbling murmur. The assess of the transmitral flow such as pressure half time and peak pressure gradient by pulsed Doppler echocardiography was the easy way to evaluated the time-related degeneration. Time-related stenotic change by pulsed Doppler was expressed as a linearized curve. At 6 years and below valve function seemed not to be impaired but stenotic dominant degeneration with the cusp tear was prominent beyond 7 years. Cardiac catheterization data could make sure of the pulsed Doppler findings by assessing mitral valve gradient and mitral valve area.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2768941 TI - [External conduit repair with "valved pericardial roll"]. AB - External conduit repair was performed in 20 patients with "valved pericardial roll (VPR)" made of own pericardium (one case) or porcine pericardium (19 cases). Intraoperative measurement of peak pressure gradients across the valve ranged from 0 to 8 mmHg (mean 1), and that from the pulmonary ventricle to the pulmonary artery ranged from 0 to 38 mmHg (mean 20). Re-evaluation of 7 patients one year after surgery shows no increase in the pressure gradient except the first case, in which VPR was made of own pericardium. In pulsed Doppler echocardiographic study, no regurgitation was found in 4 patients, mild in 6, moderate in 4, severe in 1. VPR is functioning well with longest follow up at 16 months. PMID- 2768942 TI - [The discussion of the need of mediastinal lymph node dissection in the surgical treatment of lung cancer]. AB - The need of lymph node dissection in the case of operative lung cancer with negative mediastinoscopy was discussed. As a preliminary study, the N-number obtained from the mediastinoscopy and that of postoperative examination was compared. The rate of agreement of N-number was as high as 96%. Secondary, 183 cases of lung cancer with squamous-or adenocarcinoma pathologically T-1 or 2. N-0 and P-0 or 1 were picked up and examined. In those cases, the result of 3 years survival rate was 80% in the cases of absolute curative operation and 60% in that of relative non-curative cases, and 5 years survival rate was 70% and 52% respectively, and the cases of absolute curative operation was statistically excellent than that of another group. However, the background of the two groups was different to some degree on account of the advancement of the cancer and the age of the patients. Therefore, the randomized study as for the lymph node dissection in the cases of negative mediastinoscopy was finally performed. In the 30 cases of squamous cell carcinoma where dissection was carried out in 13 cases and not done in 17 cases, the result of 3 years survival was 84% (dissecting group) and 89% (non-dissecting group), and 5 years survival was 73% and 63% respectively. In 23 cases of adenocarcinoma (13; dissecting, 10; non-dissecting), the result of 3 years survival was 100%, 63% and that of 5 years survival rate was 100%, 63% respectively.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2768943 TI - [Effect of immune response during cardiopulmonary bypass on post-operative infections]. AB - To study the effects of extracorporeal circulation on the post operative infections, the relationship between the influences of the immunologic change during cardiopulmonary bypass (CPB) and post operative change of neutrophilia was evaluated in 52 patients. These patients were divided into two groups: group A (non-infected), 19 patients whose neutrophil count increased within 15,000/microliters in peripheral blood after operation. Group B (infected), 33 patients whose neutrophil count increased 15,000/microliters or more within one week after operation. Immunoglobulins (IgG, IgA, IgM) and complement fraction (C3, C4, CH50) levels decreased significantly during CPB, but there was no significant difference between the two groups. The amount of lymphocyte subsets of helper/inducer T cell and suppressor/cytotoxic T cell showed similar change in both groups. On the contrary the amount of lymphocyte subset of Natural Killer cell showed significant increase in A group during CPB when compared with B group, suggesting immunological activation, however, in the group which showed less than 40% increase of NK cell during CPB, there was significant increase of neutrophils after operation compared with the other group which showed high increase of NK cell. These findings suggested the increased activation of the Natural Killer cell during CPB is a favorable response, especially for preventing infections after operation. PMID- 2768944 TI - [Increased lipid peroxides generation and calcium fluxes in hearts during reperfusion]. AB - To investigate the evidence for free radical generation and calcium influx as reperfusion injury, we studied the time course of lipid peroxides generation and calcium content in hearts during reperfusion. The study was performed in patients who had valve or coronary disease, and underwent open heart surgery. Lipid peroxides activity in plasma during reperfusion showed a significant (p less than 0.01) rise to a peak on 5 minutes of reperfusion (1.45 +/- 0.07 nmol/ml; mean +/- sem) compared to the level before reperfusion (1.37 +/- 0.07 nmol/ml) (n = 20). The lipid peroxides generation well correlated with aortic cross-clamp time (r = 0.6384, p less than 0.01). On the other hand, the atrial calcium content after 5 10 minutes of reperfusion was 118.5 +/- 14.9% of the level before cardiopulmonary bypass (n = 15), calcium/magnesium was 124.5 +/- 8.9% (p less than 0.05). That increase ratio well correlated with aortic crossclamp time (r = 0.5948, p less than 0.05). These results have produced evidence of increased oxidant activity and calcium influx in hearts during reperfusion. These results suggested that abnormal lipid peroxidation happened during reperfusion, and these peroxidation of the cell membrane might cause the membrane damage and then calcium influx. PMID- 2768945 TI - [The results of experimental study of six-hour heart-lung preservation by autoperfusion method--its evaluation of optimal conditions and lung function after preservation]. AB - Up to date, it has been reported that the maintenance of ideal function of the preserved lungs were much more difficult than that of the hearts in heart-lung preservation. In this communication the authors have reported the results of experimental study for optimal conditions for preserving better function of the lungs by autoperfusion method by means of heart-lung preparation using 43 dogs. In this study the conditions of the preservation were fixed as following: perfusing blood temperature 29 degrees C, blood flow 30 ml/kg/min., FiO2 30%, FiCO2 5%, tidal volume 15 ml/kg, ventilation rate 10/min., and PEEP 5 cmH2O. Glucose-Insulin-Potassium (0.03 gm., 0.05 U., 0.02 mEq/kg/hr. respectively) were administered continuously by an infusion pump. The results showed that extravascular lung water contents after 6 hours of preservation was 0.79 (mean) +/- 0.01 (SD), which was increased only 1% over than the control group: 0.78 +/- 0.01. There was no significant difference of static lung compliance in two groups: the preserved group was 0.47 +/- 0.02 ml/gm.cmH2O compared to 0.51 +/- 0.06 in the control group. These results suggest that the autoperfusion method on our preserving conditions seems to be very promising and very effective to keep much better condition of the lungs in heart-lung preservation. PMID- 2768946 TI - [Superselective bronchial arterial catheterization via a sheath catheter (SS BAC)]. AB - Bronchial artery infusion therapy including embolization of the artery has been widely used in the treatment of lung cancer and also for the treatment of hemoptysis due to various lung diseases. However, some serious complications such as spinal cord lesion, tracheobronchial fistula formation and so on have been documented in the literature and these complications are attributed to anatomical characteristics of the bronchial artery having a common trunk with feeding arteries to the spinal cord, esophagus and trachea. To prevent these hazardous events we attempted to infuse and embolize the proper bronchial artery with high selectivity by using catheter-in-catheter technique. A Cook green catheter, 7.2 Fr. size, was wedged in the intercostobronchial trunk artery by a Seldinger technique and then a small catheter, 3.0 Fr. size, was passes through the former catheter to the proper bronchial artery beyond the orifices of other feeding arteries. In 26 out of 30 patients who underwent this procedure we successfully performed this superselective bronchial artery catheterization and the 26 patients consisted of 15 patients with lung cancer and one with metastatic lung tumor who were treated with bronchial artery infusion therapy and ten with various lung diseases who were treated with bronchial artery embolization because of hemoptysis. Bronchial artery infusion therapy including embolization has gained higher safety and effectiveness by means of this superselective catheterization. PMID- 2768947 TI - [A case of adenocarcinoma of the thymus]. AB - A case of adenocarcinoma of the thymus is reported in this paper. To the best of our knowledge, this is the first case of thymic adenocarcinoma in the world literature. A 51-year-old female was admitted to our hospital because of hyperthyroidism and anterior mediastinal tumor. After control of hyperthyroidism, thoracotomy was performed and the tumor was located in the right lobe of the thymus macroscopically. The tumor was extirpated and the specimen was revealed to be multiple thymic cyst with papillo-tubular adenocarcinoma proliferating in one of the cysts. The variability of the lining cells i.e. squamous, cuboidal, columnar, and transitional cell, suggest that the thymic cyst is of congenital origin and the adenacarcinoma is originated from multipotential lining cells of the cyst. She has no evidence of recurrence for 14 years postoperatively, therefore there is almost no possibility of metastasis from other organ to the anterior mediastinum. PMID- 2768948 TI - [Successful removal of ball thrombus in the left atrium]. AB - Two cases of left atrial ball thrombus associated with severe mitral stenosis in which echocardiography provided the clue to the diagnosis preoperatively were reported. First case was a 58 years old man who was admitted because of dyspnea and frequent syncopal attacks. An echocardiographic examination revealed a tight mitral stenosis and a floating ball thrombus in the left atrium. Under the extracorporeal circulation, the ball thrombus, 30 X 40 mm in size, weight 20 g was taken out. The other case was a 51 years old woman who had undergone surgery for closed mitral commissurotomy 14 years ago. She had a episode of syncope attack and a sudden loss of consciousness. The removed thrombus was 20 X 26 mm in size and weighed 5 g. Their cut surfaces showed an laminated structure in both cases. These mitral valves were replaced by Bjork-Shiley prosthetic valves. PMID- 2768949 TI - [Surgical treatment of ventricular tachycardia caused by abnormal muscle band]. AB - A 57-year-old male was introduced to our hospital for his drug resistant non ischemic ventricular tachycardia causing faintness attack. Preoperative electrophysiological studies led to a diagnosis of ventricular tachycardia originating from the right ventricular outflow tract. After ventriculotomy, an abnormal muscle band was noticed in the right ventricular outflow tract, which seemed to be a focus of tachycardia by endocardial mapping. Myocardial excision with the abnormal muscle band was performed. In addition to, cryoablation was performed surrounding this area. After the operation, the ventricular tachycardia disappeared completely. No antiarrhythmic drug have been required at 18 months postoperative months. PMID- 2768950 TI - [Ewing sarcoma originated from rib in 3-year-old child--a case report]. AB - A 3-year-old girl was admitted to our hospital with a 3-month history of moderate fever, cough and dyspnea. Chest X-ray and C-T scan showed huge mass with high density, occupying right anterior thoracic cavity. Tumor marker including CEA, AFP, NSE in serum and VMA in urine revealed within normal data. Cytological finding obtained by percutaneous fine needle aspiration demonstrated neuroblastoma. 4 days after admission, urgent operation was performed, because of reinforced dyspnea. Huge tumor was successfully dissected, with combined resection of 2nd and 3rd ribs. Pathological diagnosis showed Ewing sarcoma originated from rib. This case is the youngest case of Ewing sarcoma of bone in Japan, and the patient is alive with disease free at the postoperative period of 21 months. PMID- 2768951 TI - [A case of intractable hepatic hydrothorax treated by pleuro-venous shunt]. AB - A 64-year-old woman with Idiopathic Portal Hypertension was hospitalized for severe respiratory distress. Chest X-ray film showed a massive pleural effusion in the right hemithorax. Though repeated thoracentesis was performed, the patient was suffering from dyspnea frequently. A pleurovenous shunt was inserted. Follow up chest X-ray films showed resolution of pleural effusion and the patient remained free of symptoms. Two months after the placement of the shunt pleural effusion again began to develop with systemic edema caused by development of chronic renal failure. Reduction of effusion was obtained by hemodialysis. Pleurovenous shunting may provide satisfactory palliation for intractable pleural effusions. PMID- 2768952 TI - [A case of unroofed coronary sinus with mitral and tricuspid valve regurgitation]. AB - A case of successfully treated unroofed coronary sinus associated with mitral and tricuspid valve regurgitation was reported. A 68 year-old male presented with congestive cardiac failure and pancytopenia due to hypersplenism. Investigation by cardiac catheterization and left ventricular angiography showed unroofed coronary sinus (left atrial to coronary sinus fenestration) combined with mitral and tricuspid valve regurgitation without persistent left superior vena cava. The atrial septum was intact. A large left-to-right shunt resulted in right heart failure. Direct suture closure of a coronary sinus defect and double valve replacements by using the SJM prosthetic valves were performed successfully. PMID- 2768953 TI - [Intracardiac repair in anatomically corrected malposition of the great arteries (SDL): report on 2 successful repair]. AB - Two cases of anatomically corrected malposition of the great arteries (SDL) with aorto-mitral fibrous continuity and pulmonary-tricuspid discontinuity are presented. Case 1 was a 24-year-old male with an associated ventricular septal defect (VSD) and pulmonary stenosis. Case 2 was a 1-year-old boy also with VSD. Both cases successfully underwent total correction. The aorto-mitral fibrous continuity was verified in both cases through right ventriculotomy during the operation. The postoperative course was uneventful in both cases and they have remained asymptomatic 5 years after operation. We believe this report to be the first one of anatomically corrected malposition of the great arteries with aorto mitral fibrous continuity. PMID- 2768954 TI - Hemodynamic alterations in hemiplegic patients as a cause of edema in lower extremities. AB - The purpose of the study is to investigate the relationship between the hemodynamic change and the production of edema in the hemiplegic leg. This study was designed to compare the hemodynamics in the involved edematous leg with that in the unaffected non-edematous leg in hemiplegic patient using straingauge plethysmography and photo-plethysmography. Examinations were undertaken in 20 patients with hemiplegia. Arterial Inflow Ratio [healthy side; hemiplegic side (100/ml ml/min)]: 19.2 +/- 16.2; 27.6 +/- 23.4. Venous Distensitivity: 1.5 +/- 0.8; 1.9 +/- 1.0. Maximum Venous Outflow: 90.8 +/- 43.1; 120.0 +/- 52.9. Tissue Flow Ratio: 1.1 +/- 0.5; 1.6 +/- 0.6. The values for hemiplegic side were significantly higher than those for healthy side in all patients. It was confirmed by using photo-plethysmography that none of the patients had arterial obliterative disease. It was suggested that one of the causes of the production of edema in a hemiplegic limb was due to the dilated capillary vessels and congested lower extremity. PMID- 2768955 TI - Incidence and diagnostic significance of paraneoplastic thromboembolism disorders. A survey from a community hospital. AB - The incidence of paraneoplastic thromboembolic disorders (PTD) at first presentation of cancer and its diagnostic significance as a cancer marker are unknown. Fourteen thousand two hundred and eighty-seven patients were admitted to the department of medicine during the period 1978-1987. Nine amongst those patients had thromboembolic disorders (TE) as the initial clinical disturbance. In another 2 patients TE was the first sign of recurrence in apparently cured cancer. PTD patients were elderly (median age 70 years), the clinical variants of PTD included solitary venous thrombosis in 3, migratory thrombophlebitis in 4, pulmonary TE in 1, arterial occlusion in 2, and associated arterial and venous occlusion in 1 case. PTD antedated the diagnosis of neoplasia by 3-180 days (median 21 days). Analysis of the impact of TE on the initiation of search for occult malignancy (PTD-cancer relevance) and on patient survival (PTD-cancer prognosis) demonstrated high PTD-cancer relevance scores in 9 among 11 cases, but favorable PTD-cancer prognosis scores in only 3 cases. This is consistent with the significance of TE for the earlier diagnosis of a, usually, disseminated cancer. The present study demonstrated a higher than usually stated association of TE with occult cancer (4.6%). It differs from recent studies by including not only venous thrombosis, but a variety of venous and arterial TE disorders as well. By studying the population from a community hospital, we believe that these data would reflect the situation in the general population at large. In this way our study differs from those of tertiary care hospitals in that our patients were not preselected. PMID- 2768956 TI - Localisation and risk factors of peripheral arterial occlusive disease in the female. AB - Peripheral arterial occlusive disease has been described frequently as a disease affecting predominantly men. There is only a few information available concerning peripheral vascular disease in the female. Therefore, the aim of the present study was to examine risk factors in relation to localisation and symptoms of peripheral arterial occlusive disease in female patients. A retrospective study has been performed in 48 female patients (52-82 years with a mean age 69.5 years). Finally 45 patients were witheld because they had all a doppler examination and an oscillography of the lower limbs. The majority of the patients, namely 22 patients (49%) had combined ileofemoral and distal lesions. There were 15 patients (33%) who had isolated distal lesions, while only 8 patients (18%) had isolated ileofemoral vascular lesions. With respect to the symptoms the population could be divided in three groups: 16 patients (36%) were asymptomatic, 19 patients (42%) had intermittent claudication and 10 patients (22%) had rest pain and necrosis. Smoking was not the predominant risk factor in this group. Diabetes mellitus seemed to enhance distal vascular lesions, while arterial hypertension, obesity and lipids were predictive risk factors in peripheral vascular disease in the female. A high incidence of cardiovascular disease (31 patients, 69%) and cerebrovascular disease (13 patients, 29%) was concomitant. PMID- 2768957 TI - Peripheral occlusive arterial disease in longstanding diabetes mellitus. A population study. AB - One hundred and seventy-five diabetic patients belonging to the same cohort were investigated. They were all inhabitants of a suburb of Athens and were initially identified during a diabetes detection drive conducted 11 years earlier. The study comprised a full physical examination, answering of a detailed questionnaire--with emphasis on signs of intermittent claudication (IC)--and a 12 lead ECG (analyzed according to the Minnesota code). It was shown that clinical signs of peripheral occlusive arterial disease were significantly associated to male sex, increased duration of diabetes, type of treatment and major ECG signs of coronary heart disease, while increased age, current smoking and existence ease, while increased age, current smoking and existence of hypertension were not significantly associated to POAD. PMID- 2768958 TI - Pharmacodynamic effects on blood coagulation of a new low molecular weight heparin (alfa-LMWH) in healthy volunteers and gynecological surgery patients. AB - The pharmacodynamic properties of a new LMWH (alfa-LMWH) were investigated in 8 healthy volunteers after single subcutaneous administrations of 7,500, 15,000 and 30,000 anti-XaU doses at weekly intervals. Anti-Xa and anti-IIa heparin activities were monitored together with aPTT, thrombin time, bleeding time and euglobulin lysis time. No relevant changes in bleeding time or major side-effects were ever recorded. A group of 26 patients submitted to gynaecological surgery were then investigated to determine the dosage schedule for prophylaxis of post operative deep vein thrombosis. Two subgroups received daily subcutaneous doses of 7,500 and 15,000 anti-XaU alfa-LMWH respectively, beginning 2 h before surgery; the third subgroup received 5,000 IU calcium heparin three times daily over the seven postoperative days. The following tests were peri-operatively monitored: anti-Xa heparin activity, aPTT, PT, fibrinogen, Antithrombin III. No differences in intra-operative bleeding or side-effects were recorded. On the basis of the levels of anti-Xa heparin activity and the negligible effects on aPTT, the dose of 7500 anti-XaU was selected at single daily administration for thromboprophylaxis in gynecological surgery. PMID- 2768959 TI - Endoarterial treatment of acute ischemia of the limbs with urokinase. Italian Cooperative Study "Bologna". AB - Authors report the results of the treatment of acute ischemia of the limbs with urokinase in patients included in a polycentric study group called "Bologna". A total of 111 patients affected with acute ischemias of the limbs caused by arterial or graft thromboses were treated with intra-arterial urokinase with a loading dose of 200,000 U.I., followed by 75,000 I.U./hour maintenance dose for 72 hours at the most. With this treatment 83.5% of clinically positive results was obtained. Complications and angiographic results are discussed. PMID- 2768960 TI - Experimental prosthetic vein valve. AB - Medical and surgical management of venous insufficiency syndrome (VIS) has produced disappointing results despite the recent introduction of new surgical techniques. This has prompted the investigation of a sutureless prosthetic vein valve. Ten prosthetic sutureless vein valves have been tested to date. The valves are of two types, one constructed of platinum, the other of titanium. Fourteen to eighteen months post-insertion into the femoral vein or vena cava of mongrel dogs, five valves remain patent as shown be venography. The sutureless prosthetic vein valve is a promising development in the treatment of venous insufficiency. PMID- 2768961 TI - [The influence of increased uterine resting tonus on renal sympathetic nerve activity in pregnant rabbit]. AB - We have shown that an increase in uterine resting tonus causes an increase in maternal blood pressure and a decrease in renal blood flow, and a neural factor may control this phenomenon through a Utero-Renal Reflex in pregnant rabbits. To explore this possible neural factor, we examined the changes in renal sympathetic nerve activity (R-SNA) in late pregnant rabbits under urethane anesthesia. SNA was measured with a bipolar electrode and renal cortical blood flow (RBF) was measured by a thermocouple method. An increase in uterine resting tonus was made by inserting a small balloon into the uterine cavity on the ovarian or cervical side. An increase in resting tonus on the ovarian side caused an increase in maternal blood pressure, increases in R-SNA and renal vascular resistance (RVR), and a decrease in RBF. However, an increase in resting tonus on the cervical side resulted in an increase in maternal blood pressure, slight increases in R-SNA and RVR, and an increase in RBF. These data indicate that an increase in uterine resting tonus can stimulate R-SNA, which in turn causes the deterioration of renal circulation. PMID- 2768962 TI - [The study of bioenergetics of mouse pregnant uterine muscle by magnetic resonance spectroscopy (MRS)]. AB - To investigate the bioenergetics of uterine muscles in vivo, we examined the energy state of mouse preterm uterus by means of magnetic resonance spectroscopy. Full-term mouse uterus contained ATP, PCr, phospho-di and mono ester (PDE and PME) and inorganic phosphate (Pi). The oxytocin-induced uterine muscle contraction peaks level and positions changed. Multiple peak analysis indicated a muscle contraction induced increase in the Pi concentration and decrease in the PCr concentration. The peak position of Pi was shifted in the contractive state also, indicating that the intracellular pH was lower than in the non-contractive state and this low pH level was recovered within several minutes. There was no change in the AMP peak height in the contractive and non-contractive states. These data indicated that the energetics of mouse uterine muscle was maintained by the ATP-PCr system and acidosis of muscle was recovered within several minutes at rest. The constant AMP peak levels may indicate that phosphorylase is not regulated by AMP, but the phosphorylated phosphorylase kinase and pH levels in the contractive and non-contractive states also may indicate that phosphorylase kinase is not regulated by proteolysis or by the intracellular pH level but by the elevated intracellular calcium ion and calmodulin system. PMID- 2768963 TI - [Studies on renal sympathetic nerve activity related to the existence of a utero renal reflex in pregnant rabbit]. AB - We have shown that the changes in renal blood flow (RBF) and renal sympathetic nerve activity (R-SNA) in metreurysis are different on the ovarian side from those on the cervical side. We examined their dissimilar mechanisms, and the changes in noradrenaline in the renal vein under metreurysis as an indicator of SNA and we also explored the pathway of Utero-Renal Reflex. In pregnant rabbits, SNA was measured by using bipolar electrode and renal cortical blood flow was measured by the thermocouple method. Noradrenaline was measured by HPLC. A small balloon was inserted into the uterine cavity on the ovarian or cervical side to increase the uterine resting tonus (URT). Noradrenaline increased under metreurysis with the increase in R-SNA. After protecting the abdominal large vessels an increase in URT in the cervical side caused the elevation of mean blood pressure, an increase in R-SNA and a decrease in RBF. After blocking the nerve around the suspensory ligaments an increase in URT in ovarian side did not cause an increase in R-SNA or a decrease in RBF. These data indicate that an increase in URT can stimulate R-SNA through the Utero-Renal Reflex, which in turn causes the deterioration of renal circulation. PMID- 2768964 TI - [The influence of green tea upon the improvement of iron deficiency anemia with pregnancy treated by sodium ferrous citrate]. AB - Green tea is indispensable to our everyday life. In Japan it has long been common knowledge that the ingestion of green tea should be avoided before and after the intake of iron preparations. There have recently been some reports, however, that deny the effect of green tea on iron preparations. A study was conducted on pregnant patients with anemia, using sodium ferrous citrate (Ferromia). The drug was administered to a group of patients taking green tea and a group taking water. Our results can be summarized as follows. 1. Hemoglobin, serum iron and total iron binding capacity were markedly improved after the administration of the iron preparation, and there was no difference between these parameters in the two groups of patients. 2. There was a tendency for patients with hypochromia to show a more marked improvement in hemoglobin in both groups. 3. Anemia cured in 96.7% of patients in the green tea group and in 93.4% of patients in the water group after the oral administration of the iron preparation. 4. The incidence of side effects stood at 18.3% for the green tea group and 21.9% for the water group, there being no significant difference. No serious side effects were elicited in the present study. PMID- 2768965 TI - [Cervical cancer after subtotal hysterectomy (so called "stump cancer")--clinical studies on 226 cases]. AB - The Department of Gynecology of the Cancer Institute Hospital diagnosed and treated 226 cases of stump cancer between 1950 and 1983. We obtained the following results. 1) The age of the subjects ranged from 32 to 78 years. The highest frequency age group was 50 to 59 (44.7%) with 101 cases, giving an average age of 53.8 years. 2) Subtotal hysterectomy was performed at ages 23 to 64, the average age being 39.5. 105 patients (46.5%) underwent subtotal hysterectomy between the ages of 40 and 49. 3) The major reasons for subtotal hysterectomy were myoma in 181 cases (80.1%), benign ovary tumor in 12 cases (5.3%), ectopic pregnancy in 10 cases (4.4%), cystic mole in 6 cases (2.7%) and cesarean section in 5 cases (2.2%). 4) Major subjective symptoms of stump cancer were metrorrhagia in 164 cases (72.6%) and fluor in 30 cases (13.3%). 24 cases (10.6%) were asymptomatic. 5) The hystological types were squamous cell carcinoma in 208 cases (92.0%), adenocarcinoma in 17 cases (7.5%), and adenosquamous cell carcinoma in 1 case (0.4%). These ratios were similar to those of cervical cancer cases treated over the same period. 6) The stages of cancer advancement were stage 0 in 24 cases (10.6%), stage I in 51 cases (22.6%), stage II in 96 cases (42.5%), stage III in 50 cases (22.1%), and stage IV in 5 cases (2.2%). The percentage of stage 0 cases was lower than that for general cervical cancer of the uterus.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2768966 TI - [Quantitative evaluation for murine oocyte toxicity following intraperitoneal treatment with chemotherapeutic agents]. AB - The ovarian toxicity induced with 12 oncostatics was evaluated using syngeneic mice, 6-week-old C57BL/6. Each drug diluted with saline to 0.2ml was intraperitoneally infused twice at 6 and 7 weeks old. Mice were sacrificed 2 weeks after the second treatment, the ovaries removed and fixed for serial sectioning, and the small oocytes of Pedersen and Peters counted. Small oocytes were destroyed in a dose-dependent fashion, and ED50, an effective dose of which produced 50% destruction of small oocytes in each mice group, was significantly divided into 4 groups of statistical difference (F = 5.77, p less than 0.0213). The smallest dose of ED50 (mg/mouse) (the strongest in oocyte toxicity): Actinomycin D 0.0064, doxorubicin 0.0184, peplomycin 0.021; the second: Bleomycin 0.107, mitomycin 0.0707, CDDP 0.120; the third: Cyclophosphamide 0.427; and the largest (the weakest): Ifosphamide 3.01, 5FU 6.17, etoposide 6.11, methotrexate 2.0 much less than, vinblastine 0.1 much less than. The most toxic included those which could attack not only DNA, but also RNA biosynthesis and the least included those which could have an effect on enzymes or proteins with no direct action on DNA. The ratio of ED50 to HUD, the single usual dose for human cancer chemotherapy, were smallest for doxorubicin (2.23), cyclophosphamide (2.59) and CDDP (5.19). Although these three are very useful oncostatics for ovarian cancer, they might have serious potential toxicity for human ovarian oocytes. PMID- 2768967 TI - [An analysis of nuclear DNA histogram of adenocarcinoma of the uterine cervix]. AB - To evaluate the clinical behaviour of adenocarcinoma of the uterine cervix, the nuclear DNA content was microspectrophotometrically measured. And the relationship between the DNA histogram and histologic features (the extension of the tumor, histologic differentiation, histologic type, and size of lesion) was examined. The results were as follows: (1) The incidence of aneuploidy in cases with carcinoma extending beyond the cervix (group A) was 58.5% (10/17), significantly more than the 11.8% (2/17) in cases with carcinoma confined to the cervix (group B). And the DNA content was distributed more widely in group A than in group B. (2) As the degree of histologic differentiation decreased, the incidence of aneuploidy became higher and DNA content was distributed more widely. (3) Concerning the histologic type and size of the lesion, no definite tendency was noted in the ploidy pattern or in the distribution of DNA content. In conclusion, it was thought that aneuploidy and the wide distribution of DNA content in cervical adenocarcinoma suggests that the carcinoma may have extended beyond the cervix. PMID- 2768968 TI - [A case of pregnancy with congenital hypofibrinogenemia]. PMID- 2768969 TI - [Dysgerminoma and gonadoblastoma in a phenotypic female with 45, X/47, XYY mosaicism]. PMID- 2768970 TI - [Multiple epidermal cysts of the labia majora]. PMID- 2768971 TI - [Study of multiregression analysis on NK activities and related clinical factors in patients with head and neck neoplasms]. AB - NK activity in patients with head and neck neoplasms treated with radiation and chemotherapeutics was studied on the influence of 19 factors by using the method of multiregression analysis. Of these factors, BUN, WBC, the size of radiation portal, chemotherapy, radiation doses, total protein (T.P.), age and GOT were significantly influenced on the fluctuation of NK activity (p less than 0.05). In the studies of the size of radiation portal and its doses, NK activity showed a tendency to increase with radiation dose in small size of radiation portal and a tendency to reduce in large size of it. PMID- 2768972 TI - [Transplantation of gynecologic tumor in nude mice]. AB - Seventy-four cases of gynecologic tumor; 29 of the endometrium, 20 of the ovary, 9 of the trophoblastic, 7 of the cervix, 2 of the fallopian tube and one of the vulva, and 6 of malignant ascites, were transplanted into nude mice. 1. Overall success rate at the trial of primary transplantation revealed 35.1% or 26 cases out of 74. Trophoblastic neoplasia appeared the highest in the rate among each tumors, showing 55.5% of 9 trials. 2. Out of 26 successful cases of the primary trials, 14 or 53.8% are serially transplantable. These consisted of 7 endometrial, 2 ovarian, 3 choriocarcinoma and 2 cervical carcinomas. 3. The serially transplantable tumors are reproducible of the morphology of each original tumor. 4. The doubling times of the tumor size in choriocarcinoma are evenly short although life span of the tumor-bearing mice varies from each other. Endometrial and ovarian carcinomas spend the time longer than choriocarcinoma. The doubling times differ from each case of endometrial carcinoma with the same histological grade. 5. Choriocarcinoma lines preserve hCG secreting ability. Tumor size of the choriocarcinoma originated from the kidney correlates well with its serum hCG titer. These lines of gynecologic malignancy serially transplantable in nude mice will be useful for further cancer research. PMID- 2768973 TI - [The combination therapy of local administration of OK-432 and radiation for 2 cases of lower bile duct carcinoma]. AB - The combination therapy of local administration of OK-432 and radiation was performed for two patients with lower bile duct carcinoma. Initially, 10KE of OK 432 was given locally, and irradiation was performed according to the schedule of 180-200 rad/5 fractions/week and given 5,000-5,220 rad totally. One case received 5KE of OK-432 locally 17 days after first injection. Both cases showed complete response and survived 4 months and 59 months without any sign of recurrence, respectively. PMID- 2768974 TI - [The combined therapy of local administration of OK-432 and radiation in carcinoma of the trachea]. AB - A CASE REPORT: A newly developed treatment method of local administration of OK 432 bronchoscopically combined with irradiation was applied to a patient with carcinoma of the Trachea complaining dyspnea and dysphagia. The tumor showed extra-wall growth. Dyspnea was improved in a week and the tumor disappeared after the treatment. A patient became to take food orally and could discharge in well condition. PMID- 2768976 TI - [Abstracts of the 26th meeting of the Japan Society for Cancer Therapy]. PMID- 2768975 TI - [Successful treatment of a patient with recurrent ovarian cancer by lentinan combined with intraarterial 5FU]. AB - A patient with ovarian cancer recurrent in the pelvis showed partial response to consecutive intraarterial (IA) cisplatin (CDDP) combined with continuous IA 5FU treatment and received third look operation in which the recurrent tumor could not be completely removed. The biopsied specimen revealed that the histologic type of the recurrent tumor was papillary adenocarcinoma. Postoperative IA CDDP could not produce further effect against the remaining tumor. Thereafter, the patient has been treated ambulatorily with intravenous (IV) lentinan (2mg/wk) combined with IA 5FU (without CDDP) to date. Four months after the start of this therapy, the persistent tumor which became refractory to IA CDDP disappeared completely (CR). Such a remarkable effect was accompanied by the concurrent induction of significantly enhanced IL-2 production and increased ratio of Leu3a/Leu2a possibly by lentinan. At present, performance status of the patient is 0 (normal activity) and she has been free of disease for 6 months, which is confirmed by clinical assessment including physical examination, cytologic examination, CT, scintigraphy and B scope. PMID- 2768977 TI - [Severe liver damage in acute circulatory failure. A clinical study of 40 cases]. PMID- 2768978 TI - [Cheiro-oral syndrome, pontine hallucination and MLF syndrome in recurrent idiopathic pontine hemorrhage: a case report]. PMID- 2768979 TI - [A case of carrier of Duchenne's muscular dystrophy complicated with myocardial disease]. PMID- 2768980 TI - [Clinical, pathological and immunohistological features of a case of localized nodular myopathy]. PMID- 2768981 TI - [A case report of the hypereosinophilic syndrome with eosinophilic peritonitis, revealing abnormal imagings of the liver scintigram and brain computed tomography]. PMID- 2768982 TI - [Cryptococcus meningoencephalitis presenting slowly progressive cerebellar ataxia]. PMID- 2768983 TI - [An autopsy case of juvenile muscular atrophy of unilateral upper extremity (Hirayama's disease)]. PMID- 2768984 TI - [A case of thoracic kidney with documented renal elevation in adulthood]. PMID- 2768985 TI - [A case of congenital intercoronary communication]. PMID- 2768986 TI - [A case of empty sella syndrome with panhypopituitarism following acute meningoencephalitis]. PMID- 2768987 TI - [Cerebral venous angioma complicated by pontine hemorrhage]. PMID- 2768988 TI - [Two cases of untreated Graves' disease associated with anti-thyroid hormone antibodies]. PMID- 2768989 TI - [Improvement of severe diarrhea by dimethylsulfoxide in a case of AA type secondary amyloidosis]. PMID- 2768990 TI - [A patient with temporal arteritis presenting corneal ulcer as his first symptom]. PMID- 2768991 TI - [A new statistical method for the evaluation of the circadian blood pressure variance]. PMID- 2768992 TI - [Parkinsonism caused by chronic subdural hematoma. A case report]. PMID- 2768993 TI - [A case of systemic lupus erythematosus after taking oral contraceptives]. PMID- 2768994 TI - [Evaluation of diagnostic criteria for acute myocardial infarction]. PMID- 2768995 TI - Epidural anaesthesia and postoperative colorectal motility--a possible hazard to a colorectal anastomosis. AB - The effects of epidural anaesthesia (EDA, mepivacaine) and EDA in combination with atropine and neostigmine on postoperative intestinal motility were studied in 17 patients undergoing operation for cancer of the rectum or sigmoid colon. Motility was recorded by a volumetric technique. Epidural anaesthesia (EDA) increased motor activity in the small bowel as well as in the left colon and rectum. Phasic motility dominated in the small intestine whereas tonic and segmental contractions were recorded from the large bowel. EDA induced a powerful tonic contraction with a concomitant shortening of the rectum. This effect was inhibited by atropine. The influence of atropine/neostigmine on left colonic motor activity was studied in six patients before and during EDA in a cross-over fashion. When administered alone, atropine/neostigmine did not cause any motility increase. Atropine/neostigmine administered during EDA, however, elicited a significant increase of motility. The increase of intestinal motor activity induced by EDA may expose a newly constructed colorectal anastomosis to undue strain in the immediate postoperative period. When EDA is used in combination with general anaesthesia, particular attention should be directed towards the use of neostigmine for reversing the effect of nondepolarizing muscle relaxants. Atropine appears under such circumstances not to protect from the excitatory effects of this drug on colorectal motility. PMID- 2768996 TI - Manovolumetric characteristics and functional results in three different pelvic pouch designs. AB - Different pouch designs and techniques for the perineal approach have been on trial in an attempt to improve results after restorative proctocolectomy. The 1 year results of two currently advocated procedures, the J-pouch and the S-pouch, were compared with the results obtained in patients with a pelvic pouch fashioned according to the folding technique used for the Kock continent ileostomy, all pouches having been constructed from equal 30 cm lengths of ileum. The maximal volume of the S- and Kock pouches at one year was 420 ml (250-570) (median and (range] and 410 ml (244-490) respectively, while it was significantly less, 305 ml (200-445) in the J-pouch (p less than 0.05). The compliance of the J-pouches was also significantly lower at all distension pressures. The median day-time defaecation frequency was four and was equal in the three groups. Although there was a tendency towards a more favourable overall functional result with less soiling, and less need for night evacuations among patients with a Kock-folded pouch compared to the other pouch types these differences failed to reach statistical significance. The favourable properties of the Kock pouch, well-known also from the conteinent ileostomy and urostomy, suggest that its design should be considered an interesting alternative even for restorative proctocolectomy. These encouraging results have yet to be confirmed in a comparative randomized trial. PMID- 2768997 TI - Rectodynamics--quantifying rectal evacuation. AB - A new technique is described which allows the graphic quantitation of voluntary rectal evacuation. The subject is asked to evacuate 100 ml of barium sulphate paste as rapidly and completely as possible. Using a weight transducer it is possible to determine the maximum emptying rate, time to achieve maximum emptying and proportion of barium evacuated. Normal subjects evacuate quickly and completely. Patients with severe constipation demonstrate a variable evacuation disturbance. PMID- 2768998 TI - Conservative management of Bowen's disease of the anus. AB - Bowen's disease of the anus is usually treated by wide local excision including macroscopic normal areas if random biopsies show dysplasia. Skin grafting will often be necessary, since areas of microscopic dysplasia may be found at a considerable distance from the gross affected site. In this study of 11 patients with Bowen's disease of the anus we report the results of a more conservative approach. All patients were treated by local excision of the gross affected areas only, and none of the patients required skin grafting. Seven patients were followed for a median of 34 months without macroscopic recurrence, including 3 patients with histologically proven dysplasia in the resection margins. Two patients, one with and one without dysplasia in the resection margins, developed recurrence within a year. One patient with an area of invasive carcinoma was first treated by local excision, but required an abdominoperineal excision 3 months later. One patient lost to follow-up had invasive carcinoma after 3 years. It is concluded that a conservative surgical approach in Bowen's disease of the anus is justified, provided the patients are followed closely. PMID- 2768999 TI - Endo-rectal repair of rectocele. AB - Rectocele may cause colorectal symptoms particularly difficulty in evacuation. It is readily identified on clinical examination of the perineum but the pathophysiological abnormality can easily be defined by defaecography. Between 1984 and 1988 we have operated on 16 patients who presented with difficulty in evacuation associated with rectocele. We have used a simple endo-anal repair aimed to restore a firm recto-vaginal septum. Excellent functional results were obtained in 11 patients, 4 were considerably improved and one patient had a poor result. PMID- 2769000 TI - Enhanced growth of tumour cells in healing colonic anastomoses and laparotomy wounds. AB - In the past, it has been noted that experimental tumour cells inoculated into the peritoneal cavity or into the lumen of the bowel will grow at a recently formed colonic anastomosis. However, it has previously been unclear whether the healing process enhances tumour growth or whether the presence of a suture line merely allows the tumour cells to gain access to the tissues. In the present study, using the hooded Lister rat, we have confirmed these findings by showing that growth of the syngeneic MC28 sarcoma and OES5 breast carcinoma occurs preferentially at colonic anastomoses and laparotomy wounds after intraperitoneal injection, and at colonic anastomoses after intraluminal injection. In previous studies using the MC28 sarcoma and the OES5 breast carcinoma injected by the intracardiac route (so that tumour cells reach normal and healing tissues in approximately equal numbers) we have shown that tumour growth is enhanced in healing wounds but not in the surrounding normal tissues when cells reach a healing colonic anastomosis or laparotomy wound within 2 h of its formation. Furthermore, by studying the distribution of radiolabelled tumour cells after intracardiac injection, we have calculated that the probability of a tumour cell leading to a deposit in a healing anastomosis or laparotomy wound is increased 1,000 fold compared to normal tissue. No previous studies have combined the data for intracardiac, intraluminal and intraperitoneal injection of tumour cells using the same animal model. We conclude that the same phenomenon of tumour growth enhancement in colonic anastomoses and laparotomy wounds reported after intracardiac injection of tumour cells may well be enhancing tumour growth after intraperitoneal and intraluminal injection.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2769001 TI - Ileal pouch-anal anastomosis without rectal muscular cuff. AB - Twenty patients underwent proctocolectomy followed by an ileal pouch-anal anastomosis. The rectum was mobilized in the intersphincteric plane and transected at the level of the dentate line. As a consequence, a rectal cuff, which is considered by some to be important for the maintenance of anal continence, was not left behind. All patients were continent. Manometric data demonstrated no difference compared to a group of 21 patients with a conventional mucosectomy. Nearly half of the patients in both groups had a positive recto-anal inhibitory reflex. As a rectal cuff is not essential for maintaining continence, the receptors of the rectoanal inhibitory reflex are probably located outside the rectal wall. PMID- 2769002 TI - Preoperative prediction of late cancer-specific deaths in patients with rectal and rectosigmoid carcinoma. AB - The possibility of predicting late cancer-specific deaths from (a) the preoperative serum levels of three tumour markers, carcinoembryonic antigen (CEA), tissue polypeptide antigen (TPA) and an antigen defined by the C-50 antibody (CA-50), from (b) one clinical factor of independent prognostic relevance, polypoid tumour growth, and from (c) Dukes' stage was evaluated in 276 patients with rectal carcinoma operated upon with curative intent ("potentially curable"), and in the 251 of those patients who were considered to be "potentially cured" after surgery. Using the Cox regression model, the preoperative serum levels of the tumour markers strongly predicted the cancer specific mortality within the first year after surgery. This ability of S-CEA and S-CA-50 diminished for the mortality during the second year after surgery, and virtually disappeared thereafter. The ability of S-TPA to predict cancer-specific deaths did not change as dramatically with time as that of the other two markers, particularly in the group of "potentially cured" patients. Patients with polypoid tumour growth had a good prognosis which did not appear to change with time. Similarly, the prognostic information provided by Dukes' staging system was valid at all studied time intervals after surgery, although it declined after the second year. The importance of these results in relation to the selection of patients for adjuvant treatment is discussed. PMID- 2769003 TI - Anorectal function in normal human subjects: effect of gender. AB - Multiport anorectal manometry and external anal sphincter (EAS) and internal anal sphincter (IAS) electromyography were conducted in 15 males (41 +/- 3 years) and 20 females (43 +/- 2 years; 5 nulliparous) during rest, maximum conscious sphincter contraction, rectal distension and increases in intra-abdominal pressure. The basal pressure declined within 15 minutes of insertion of the manometric probe to a stable plateau, 55 +/- 4% of the initial value. The maximum basal (91 +/- 5 vs 61 +/- 6 cm water; mean +/- SEM), minimum basal (43 +/- 7 vs 27 +/- 3 cm water) and the maximum squeeze pressures (257 +/- 20 vs 107 +/- 13 cm water) were higher (p less than 0.05) in males than females. Distension of a rectal balloon caused a reduction in pressure in all anal channels, that increased in depth and duration as the distending volume was increased. These anal relaxations were associated with rectal contractions and transient increases in the electrical activity of the EAS. Upon deflating the balloon, the anal pressure increased to values that exceeded the pre-inflation values. The pre inflation (89 +/- 4 vs 49 +/- 4 cm water), post-inflation (104 +/- 9 vs 62 +/- 7 cm water) and residual (47 +/- 4 vs 30 +/- 2 cm water) pressures during rectal distension were significantly higher in males than in females (p less than 0.05). The higher residual pressure in males was associated with a higher EAS index during rectal distension (0.94 +/- 0.10 vs 0.65 +/- 0.10 mv s; p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2769004 TI - The histology of anal skin tags in Crohn's disease: an aid to confirmation of the diagnosis. AB - We have investigated excision biopsy of anal skin tags as an adjunct to rectal biopsy in the diagnosis of Crohn's disease. Twenty-six patients with proven Crohn's disease of the large and/or small bowel were studied. All had perianal skin tags removed under local anaesthesia as outpatients, when rectal biopsies were also obtained. Three sections from each skin tag and three from each rectal biopsy were examined for granulomas. The rectal biopsies were also examined for changes 'suggestive' of Crohn's disease. Anal skin tags from 26 patients without Crohn's disease acted as controls. Of the patients with Crohn's disease, granulomas were found in both anal skin tags and rectal biopsies in five patients, in anal skin tags only in four, and in rectal biopsies only in three. When present, granulomas were more plentiful in anal skin tags than in rectal biopsies, being seen in all 3 sections in 7 of 9 'positive' tags (i.e.: in 31% of 78 sections), compared to only 1 of 8 'positive' rectal biopsies (i.e.: in 13% of 78 sections). No granulomas were seen in control anal skin tags. The procedure provides a simple technique which is complementary to rectal biopsy, by which histological confirmation of Crohn's disease may be obtained. PMID- 2769005 TI - Emergency colectomy in colitis. PMID- 2769006 TI - Primary hyperparathyroidism. AB - Primary hyperparathyroidism is a pathological entity due to excessive secretion of parathormone from a single or multiple parathyroid glands. The biochemical hallmark of this disorder is an elevated serum calcium. The relationship of the parathyroid glands with the thymus gland in fetal development accounts for the occasional aberrant location of the parathyroids. By utilizing computed tomography or nuclear scanning or both preoperatively, the surgeon can isolate the hyperfunctioning adenoma and resect it, thus minimizing potential complications. PMID- 2769007 TI - Endourologic management of ureteroscopic complications. AB - Ureteroscopic injuries can be treated with endourologic techniques avoiding the morbidity of open operation. We report two cases of ureteral injury following ureteroscopy: one with extravasation, and the other, diagnosed one month postoperatively, with fistula and retroperitoneal urinoma. Both cases were successfully treated by percutaneous approaches. Possible etiology, preventive measures, and treatments are discussed. PMID- 2769008 TI - Amaurosis fugax: carotid endarterectomy without an angiogram. AB - The risks of carotid angiography--technical, allergic, cardiac, renal, or emotional--may be lessened or absented by the use of real-time B-mode ultrasound to evaluate carotid artery disease. A patient with amaurosis fugax, a positive fluorescein angiogram, ulceration on ultrasound, and an unremarkable computed tomography scan was operated on without angiography. The pathology was correct and the patient did well. PMID- 2769009 TI - ECG of the month. The plot thickens. Second-degree AV block and ventricular escape rhythm. PMID- 2769010 TI - Cow's milk-induced pulmonary hemosiderosis. AB - Cow's milk protein-induced pulmonary disease is a serious condition which, if recognized, can be treated effectively by avoidance of milk protein; untreated it may lead to early death. It should be considered in any child who suffers recurrent episodes of pneumonia and anemia. PMID- 2769011 TI - School-based adolescent health clinics. AB - School-based clinics are a relatively new concept in the United States. Presently, three clinics exist in Louisiana. The primary purpose of the school based clinics is to provide comprehensive health care to an underserved adolescent population. Society, recognizing the complex health care needs of adolescents, has formed community-wide coalitions to support school-based clinics. To maximize visability and accessibility, the clinics have been placed in public schools. Qualified health care professionals are responsible for a clinic's operation and networking with existing community health care services. In communities with school-based clinics, private physicians have actually seen an increase in visits by adolescents and their families. High-risk adolescent behavior, such as alcohol and drug abuse, crime, smoking, unprotected sexuality, and running away has been curtailed. Problems associated with school-based clinics include vehement opposition to sex education, financing, and the sheer magnitude of the adolescents' health needs. PMID- 2769012 TI - Teen Advocate Program: a unique assessment of case management. AB - The Teen Advocate Program is a case management demonstration project developed with a block grant from the Maternal and Child Health Section of the Louisiana Department of Health. Family Counseling of East Baton Route Parish, a community based agency, was contracted to develop outreach services for high risk adolescents. The purpose of the program is to provide structure, advocacy, and coordination, empowering teens to use primary and preventive health care providers. The initial referral base of clients was provided from a clinic of teen mothers and their infants, and an adolescent family planning clinic, both located at the East Baton Rouge Parish Health Unit. This interdisciplinary case management outreach services makes this model unique because it offers an organized, structured preventive health care intervention to teens at high risk of becoming pregnant. Goal attainment scales developed revealed that 96% of the study population improved. Sixty-seven percent have good attendance at clinics. Among the client population of teen mothers, there has only been a 4% repeat pregnancy rate. For the first six months of existence, there were no documented pregnancies among the adolescent seeking contraceptive counseling. The study results confirmed the positive influence of case management in preventing adolescent pregnancy. This model is being expanded to address other high risk adolescent behaviors. PMID- 2769013 TI - Improving interviewing of and compliance by the adolescent. AB - Effective interviewing of adolescents rests upon a knowledge of developmental processes and biopsychosocial approach to care. The effective interviewer, by building a satisfactory relationship with the adolescent, is much more likely to obtain compliance with therapy. This article contains tips on how to improve interviewing of and compliance by your adolescent patients. PMID- 2769014 TI - Vulnerability, gratuitous service, and trust. PMID- 2769015 TI - ECG of the month. Better late than never. Atrioventricular and intraventricular conduction disorder. PMID- 2769016 TI - Effects of cyclosporine on magnesium metabolism in rats. AB - Earlier studies have revealed hypomagnesemia with cyclosporine treatment in renal and bone marrow transplant recipients. The present study was designed to investigate the possible effect of cyclosporine on Mg metabolism in normal rats. Sprague-Dawley rats were randomized into the cyclosporine group, which was given 15 mg/kg/day cyclosporine by gastric gavage, and the control group, which received the vehicle alone. Food intake, body weight, serum concentration, urinary excretion, fecal excretion, and tissue content of Mg were determined weekly for 3 weeks. In addition, intestinal absorption of Mg was determined by using in vivo perfusion. Serum Mg concentration fell significantly after 1 week of cyclosporine treatment and remained low throughout the observation period. This was associated with reduced food intake and renal Mg conservation during the first week but normal food intake and severe renal Mg wasting thereafter. In vivo perfusion studies performed at 1 and 3 weeks showed no significant difference in intestinal absorption of Mg between the two groups, thereby excluding intestinal malabsorption as a possible culprit. Likewise, fecal Mg excretion showed no significant difference in the two groups. It was surprising that tissue Mg content (in muscle, liver, and kidney) was increased in the cyclosporine-treated group at 3 weeks. We conclude that cyclosporine administration in rats leads to a fall in serum Mg concentration primarily as a result of renal Mg wasting and possibly as a result of a shift of Mg to the tissue compartments with no discernible effect on gastrointestinal handling of Mg. PMID- 2769017 TI - Effect of solubility on the gastrointestinal absorption of aluminum from various aluminum compounds in the rat. AB - The present study was carried out to determine whether the insoluble property of most aluminum compounds was the reason for the limited absorption of this element from the gastrointestinal tract. Aluminum compounds of varying degrees of solubility were studied. At pH 3, more than 25% of the aluminum from all of the compounds studied (with the exception of sucralfate [13%]) was in solution. At pH 6, the solubility of aluminum in Al(OH)3 and sucralfate was less than 1%; it was 15% in AlCl3 and 33% in aluminum lactate. Aluminum solubility did not change with a change in pH for the citrate compounds, which varied between 38%, with sucralfate plus citric acid, and 91%, with aluminum citrate. The fraction of the administered dose of aluminum absorbed as estimated by urinary excretion after gastric gavage was 0.015% for sucralfate and Al(OH)3, 0.037% for AlCl3 and aluminum lactate, and greater than 0.80% for all aluminum compounds administered with citrate. A similar relationship was found between the solubility of the aluminum compounds and absorption, as determined by calculated absorption from the changes in plasma aluminum levels. Solubility alone, however, could not totally explain the effect of citrate on aluminum absorption. The solubility of aluminum in aluminum lactate and sucralfate plus citric acid were the same at pH 6. Absorption of aluminum from aluminum lactate, however, was only 1.6% as much as that found for sucralfate plus citric acid.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2769018 TI - Iron loading modifies the fatty acid composition of cultured rat myocardial cells and liposomal vesicles: effect of ascorbate and alpha-tocopherol on myocardial lipid peroxidation. AB - Increased generation of free radicals and accelerated lipid peroxidation are important manifestations of iron toxicity. We have studied the effect of iron loading on lipid peroxidation in cultured rat myocardial cells by direct measurement of the fatty acid composition of cellular lipids. Iron loading produced by 24-hour incubation of cultured cells with 0.36 mmol/L ferric ammonium citrate resulted in a moderate reduction in polyunsaturated fatty acids (PUFAs) such as 22:5 and 22:6. A more drastic reduction in PUFAs and an apparent reciprocal increase in the proportion of saturated fatty acids were both obtained after 24 hours of incubation of liposomal vesicles prepared from whole cell lipid extracts with iron at between pH 4.5 and pH 5.5. Reduction of 22:5 and 22:6 was first noticed at 3 hours, and undetectable levels were reached by 12 and 24 hours of incubation. Ascorbate had a biphasic effect on liposomal PUFA levels: at low concentrations (0.057 mmol/L) it enhanced the iron-induced changes in liposomal fatty acid composition, but at higher concentrations (0.57 and 5.7 mmol/L), it inhibited these changes. Unlike ascorbate, alpha-tocopherol (0.023 to 2.3 mmol/L) inhibited the iron-induced reduction in PUFAs in a dose-dependent manner, with complete inhibition of the iron effect at 2.3 mmol/L. These observations underline the particular sensitivity of PUFAs to iron-induced lipid peroxidation. They also illustrate the ability of ascorbate and alpha-tocopherol to modify iron induced lipid peroxidation. Further studies are required to explore the possible therapeutic implications of these observations in clinical iron overload. PMID- 2769019 TI - Falsely elevated plasma aldosterone concentration by direct radioimmunoassay in chronic renal failure. AB - Plasma aldosterone concentration (PAC) in patients with chronic renal failure was measured by radioimmunoassay with and without dichloromethane extraction before the assay. Blood samples were obtained from patients with chronic renal failure who were undergoing maintenance hemodialysis, from patients with chronic renal failure who were not undergoing hemodialysis, and from age-matched normal subjects. With the three radioimmunoassay kits tested, the direct assays without extraction in normal subjects gave PAC values comparable to those obtained after the dichloromethane extraction; in contrast, in patients with chronic renal failure, the direct plasma radioimmunoassays yielded consistently higher values than those obtained after the extraction (p less than 0.001). When various plasma steroid metabolite fractions were separated by high-pressure liquid chromatography (HPLC) with a reverse-phase column, and each fraction was assayed for PAC with the three radioimmunoassay kits, high immunoreactivities were found in the polar fractions in the plasma from patients with chronic renal failure but not in normal plasma. The ratios of the immunoreactivities of these polar fractions to that of the aldosterone fraction, determined after HPLC separation, showed a significant positive correlation (r = 0.746, p less than 0.001) with serum creatinine concentrations in plasma from patients with chronic renal failure who were not undergoing hemodialysis. These results indicate that the values for PAC are falsely elevated in chronic renal failure when PAC is measured by radioimmunoassay kits without prior extraction. Furthermore, plasma from patients with chronic renal failure contains a polar substance(s) that cross reacts with antialdosterone antibodies. This so far-unidentified substance increases with advancing renal impairment.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2769020 TI - Surgery for otitis media with effusion in children and its relationship to parental smoking. AB - A study was conducted to ascertain whether there is any relationship between parenteral smoking and various factors in children undergoing surgery for otitis media with effusion. Information was recorded on 115 children admitted to hospital for grommet insertion. Details of parenteral smoking habits, previous surgery for otitis media with effusion and operative findings were noted. A group of 36 children with healthy ears attending an orthoptic clinic were used as controls. Those children with at least one parenteral smoker were found to have a higher change of being admitted to hospital for grommet insertion and were more likely to have had previous surgery for otitis media with effusion. PMID- 2769021 TI - An avoidable occupational hazard during mastoid surgery. AB - Conjunctival innoculation is a previously unrecognized hazard for the otologist during mastoid surgery. This experiment assess the spread of droplet contamination during temporal bone dissection. The results suggest that otologists and assistants should wear eye protection during exposure of the mastoid antrum by drilling. PMID- 2769022 TI - Results of surgery to the damaged facial nerve. AB - Neurological surgery of the paralysed face can be rewarding if performed early using appropriate surgical techniques. The results of 32 operations are analyzed. Excellent restoration of facial function is achieved with early surgical intervention but some results are poor. The reasons for failure are analyzed. PMID- 2769023 TI - Surgical reduction of the inferior turbinate in children: extended follow-up. AB - The effectiveness and safety of surgical reduction of the inferior turbinate was assessed in 22 children of 15 years and below. All were interviewed and assessed by means of a questionnaire seven to 51 months post-operatively. Sixty-eight per cent of the children reported a sustained improvement in their nasal airway. There were no significant post-operative complications in this series. In particular there were no cases of serious post-operative haemorrhage, excessive dryness or crusting of the nose. It is concluded that surgical reduction of the inferior turbinate is a safe and effective option in the treatment of children with severe nasal obstruction. PMID- 2769024 TI - Manipulation of the fractured nose using topical local anaesthesia. AB - Simple fracture of the nasal bone can be reduced under local or general anaesthesia. A combination of topical anaesthetic (EMLA cream) and cocainization of the nasal mucosa was used successfully in manipulation of fractured nasal bones in twelve patients without discomfort. PMID- 2769025 TI - Maxillary antral lavage--infiltration and surface anaesthesia compared. AB - A prospective study on 210 patients was conducted to determine the relative efficacy of infiltration anaesthesia as against surface anaesthesia for antral lavage. The patients were categorized into three groups and comparisons were made on patient response and our observations. This study confirms that infiltration technique is superior to surface anaesthesia and is, also, less time consuming. PMID- 2769026 TI - Endoscopic transnasal dacryocystorhinostomy. AB - The rigid Hopkins endoscope has been applied to simplify the operation of dacryocystorhinostomy, preventing unnecessary trauma to the medial orbital tissues. The success of the surgical technique is absolutely dependent on a thorough knowledge of the relevant surgical anatomy. PMID- 2769027 TI - Role of irradiation in the suppression of parotid secretions. AB - Suppression of salivary flow is of value in the management of salivary fistulae and sialectasia. It may also be beneficial in mentally defective patients and those with neurological palsies lacking control of their salivation. Nine patients were treated by irradiation to the parotid gland to control salivary flow; eight had complete resolution of symptoms and one had partial relief. Irradiation was effective as primary treatment and after failed surgery and/or drug treatment. Low doses were effective and there were no significant acute or long-term side effects. Its use avoids long-term medication and their potential side effects and may reduce the need for surgery. PMID- 2769028 TI - Metastasis to the temporal bone, secondary to carcinoma of the bladder. AB - An 80-year-old man was seen in the clinic with a two month history of pain, bleeding and deafness in his left ear; accompanied by a left facial palsy. Six months earlier, anaplastic carcinoma of the bladder had been diagnosed and treated with radiotherapy. On examination there was a mass in his left external auditory canal and VII, VIII, IX and X left cranial nerve palsies. Histology of a biopsy was identical with his original bladder tumour. He received a course of palliative radiotherapy but died shortly after. Post-mortem demonstrated the left temporal bone metastasis extending into the middle and posterior cranial fossae. There was no evidence of residual bladder tumour, or other primary tumour. Temporal bone metastases are probably more common than generally thought. Presentations like this may become more common as cancer therapy improves, with patients surviving longer and presenting later with metastatic disease. PMID- 2769029 TI - Metastatic squamous cell carcinoma of the paranasal sinuses from a primary squamous cell carcinoma of the urinary bladder. AB - Metastatic tumours of the paranasal sinuses from primary lesions of the urogenital tract are rare, with about 50 cases so far being reported in the literature. The most frequent primary lesions is a renal carcinoma. We have experienced a case of paranasal sinus malignancy. There were no symptoms of urinary tract carcinoma preceding those in the paranasal sinuses. This case was later revealed at autopsy to be a metastasis from a diverticulum of the urinary bladder. PMID- 2769030 TI - Invasive pituitary adenoma presenting with nasal obstruction. AB - We report two cases of massive invasive pituitary adenoma with the unusual presentation of nasal obstruction. In both cases the diagnosis was only made when the obstructing tissue was removed. Cases reported previously have usually presented with severe focal neurological signs or a long history of neurological symptoms. These two cases are unusual in having minimal neurological deficits despite the extension of tumour into the nasopharynx and the middle and posterior cranial fossae. These extensions were well illustrated by computerised tomography. This unusual presentation is discussed with reference to the literature. PMID- 2769031 TI - Snoring as a presenting feature of the Shy-Drager syndrome. AB - A 67-year-old man with a progressive snoring habit is presented. Fluctuant bilateral abductor vocal cord paralysis was later recognized together with autonomic features suggesting a diagnosis of Shy-Drager syndrome. Snoring as a presenting feature of this condition has been infrequently described. This case highlights the importance of careful assessment of snorers. PMID- 2769032 TI - Dermoids ('hairy polyps') of the oro-nasopharynx. AB - Dermoids, or hairy polyps, are rare lesions affecting the head and neck region. To date approximately 120 cases have been recorded. They arise during early embryogenesis and are invariably benign. Unlike the more differentiated types of teratoma, hairy polyps are derived from only two germinal layers, ectoderm and mesoderm. Most originate in the oro-nasopharyngeal region, either as pedunculated or sessile masses. They usually present at, or soon after, birth with signs of upper aerodigestive tract obstruction. Treatment consists of surgical removal. In young children with airway compromise, the expertise of an experienced paediatric anaesthetist is essential. Three new cases of hairy polyp are described to add to the present literature. Two originated in the nasopharynx and one in the oropharynx. Interestingly, one patient, a neonate, also suffered from severe osteopetrosis. All lesions were removed by simple surgical excision under general anaesthesia. There were no operative or post-operative complications. PMID- 2769033 TI - Nasopharyngeal Warthin's tumour: a metaplastic lesion. AB - Warthin's tumour arising from minor salivary glands of the nasopharynx is described in a patient with eosinophilic rhinitis and nasal polyposis. The microscopical features of this lesion were indistinguishable from those of Warthin's tumours of the parotid gland. The present case supports the histogenetic theory that the epithelial component of extraparotid Warthin's tumours represents reactive oncocytic metaplasia and hyperplasia induced by chronic inflammation rather than genuine neoplasia. It is suggested that the term Warthin's tumour is preferable to designations indicating neoplasia of these extraparotid lesions which are indistinguishable histologically and ultrastructurally from parotid and juxtaparotid adenolymphomas. PMID- 2769034 TI - Glial teratoma thought to be a lingual thyroid. AB - A case of a glial teratoma occurring in the tongue of a twelve week old male child is presented. This lesion was thought clinically to be a lingual thyroid. Histopathological examination revealed the true nature of the lesion. The mother had noticed the lesion since birth but only sought medical attention when the child developed difficulty in breathing. Teratomas in the head and neck region are uncommon and are commonly diagnosed wrongly as lingual thyroid. These lesions are usually benign. PMID- 2769035 TI - Long term pathological sequelae of neonatal endotracheal intubation. AB - In neonates, acquired subglottic stenosis (SGS) is the most serious long term complication of endotracheal intubation. In this case report, we describe the pathological changes in the larynx of a child who died two years after successful treatment, involving corrective surgery, for neonatally acquired SGS. Stenosis, due to dense fibrous connective tissue, was still present at death. However, there was evidence that there had been growth of the laryngeal cartilages. Disruption of the laryngeal cartilages was present anteriorly due to the antecedent surgery but major cricoid cartilage injury secondary to intubation was not seen. The crico-arytenoid joints demonstrated ankylosis and to this was attributed the abnormal quality of voice noted in the child at follow-up. The pathological changes are considered in relation to the pathology of endotracheal intubation and pathogenesis of acquired subglottic stenosis. PMID- 2769036 TI - Vocal cord paralysis with Ebstein's anomaly. AB - Left recurrent laryngeal nerve runs a long intrathoracic course in close relationship to the aortic arch and adjacent heart structures and, hence, is liable to be injured by diseases affecting the heart and its great vessels. We report a case of Ebstein's anomaly causing left recurrent laryngeal nerve paralysis in a neonate. To our knowledge, this is the first reported case of vocal cord paralysis associated with this condition. PMID- 2769037 TI - Hypopharyngeal involvement by thyroid cancer. AB - Direct upper airway infiltration by thyroid neoplasia is a rare occurrence, a unique case of papillary thyroid neoplasia presenting as a pyriform fossa mass is described and the management of these problem patients is discussed, emphasising the controversy between radical and conservative surgery. The possibility that the thyroid tumour resulted from previous radioactive iodine prescribed for thyrotoxicosis is also considered. PMID- 2769038 TI - Rare submandibular swelling (capillary haemangioma). AB - The diagnosis of submandibular lumps is usually straightforward, using a combination of history, examination and simple investigation. Most will turn out to be submandibular salivary gland enlargement or lymph node swellings. We present a case in which conventional investigation failed to help in the diagnosis, and was eventually found to be what we believe is the first capillary haemangioma described in the anterior belly of the digastric muscle. PMID- 2769039 TI - Intracranial pneumocephalus (secondary to frontoethmoidal osteoma). PMID- 2769040 TI - Invention of flexible fibreoptic endoscope. PMID- 2769041 TI - Otological disease in Turner's syndrome. AB - 1988 was the 50th anniversary of Henry Turner's original publication of the constellation of physical features which were subsequently recognized to be associated with a deprivation of X chromosomal material. The abnormalities of phenotype and karyotype are now eponymously associated with his name. Very many phenotype stigmata have now been recognized to be associated with Turner's syndrome. However, a survey of females with the syndrome revealed that they consider that a major disability associated with the abnormal karyotype results from otological disease and that this is poorly recognized as a significant feature of the syndrome. The incidence of otological disease in patients with this syndrome has been difficult to evaluate because of ascertainment bias and the apparent diversity of otological disorders previously reported. This report reviews the literature and details a study of otological disease and hearing impairment in a sample of Turner's syndrome females enrolled from a defined area. PMID- 2769042 TI - Patulous eustachian tube syndrome: the relationship with sensorineural hearing loss. Treatment by eustachian tube diathermy. AB - The patulous Eustachian tube syndrome has previously been regarded as a troublesome but benign condition. Nine out of 13 patients reported here had evidence of cochlear damage similar to that caused by acoustic trauma. These patients also had vestibular symptoms which improved with treatment of the patulous tube. It is postulated that abnormal patency of the Eustachian tube may allow excessive middle ear pressure changes to occur which may be transmitted by abnormal ossicular movement to the cochlea. Eustachian tube diathermy using a ureteric diathermy probe is a safe and effective method of treating this condition. PMID- 2769043 TI - Antroscopy: current practice--a survey of UK otolaryngologists. AB - The use of antroscopy by otolaryngologists in the UK was assessed by means of a postal questionnaire. A response of 70 per cent was obtained. Thirty-three per cent of otolaryngologists currently perform antroscopy; the principal reason for not using the technique being lack of suitable equipment. Twenty-four per cent of non-users believed that antroscopy would not alter their management of patients, and 19 per cent of all responders thought that antroscopy had no proven clinical role. Few surgeons recognized a role for antroscopy in the treatment of antral disease. Antroscopists preferred to operate on in-patients (73 per cent), under a general anaesthetic (60 per cent) and via the inferior meatus (66 per cent); 76 per cent consider that morbidity is insignificant. There is clearly a need for studies clarifying the role of antroscopy in clinical practice and to establish the cost-effectiveness of the technique. PMID- 2769044 TI - Nasal polyps and sinusitis in children with cystic fibrosis. AB - Eighteen children suffering from cystic fibrosis and nasal polyps were studied. Two patients presented with nasal polyps at two years of age; the remaining patients had an initial polypectomy at any age up to fifteen years (mean age of seven and a half years). There were no obvious correlations between the cultures of the sinus washouts and the corresponding sputum samples. Organisms were only grown from five of the fifteen wash outs and from nine of the sputum samples. The patients with severe polyposis were not obviously more atopic. PMID- 2769045 TI - Carcinomas ex monomorphic adenoma of salivary glands. AB - A clinicopathological analysis of eight examples of carcinomas arising from salivary gland monomorphic adenomas, carcinomas ex monomorphic adenoma, is presented. These uncommon to rare neoplasms have a predilection for the parotid glands, are diagnosed about a decade later than their benign precursors, and most often arise from the dermal analogue type of monomorphic adenoma. As judged by follow-up periods of two to 16 years, carcinomas ex monomorphic adenoma are locally aggressive neoplasms with the clinical course marred by recurrences but without regional or distant metastases. PMID- 2769046 TI - Radical neck dissection: a 19-year experience. AB - A series of 394 radical neck dissections performed over the 17 year period 1969 1986 is presented. The shortest period of follow-up is two years. Of the major complications reviewed, wound breakdown was associated with T stage, prior radiotherapy and incision used but not with age or N stage. Cervical recurrence was associated with N stage, prior radiotherapy and surgical incision and inversely associated with age. Wound breakdown and recurrence were lowest in parotid primary tumours. Carotid artery rupture occurred in 17 patients (4.3 per cent), was fatal in all cases and was strongly associated with wound breakdown and previous radiotherapy. The importance of the choice of incision, clearance of the posterior belly of the digastric muscle and carotid artery protection are discussed. PMID- 2769047 TI - Rheumatoid nodule of the temporal bone. AB - A 69-year-old woman with severe rheumatoid arthritis presented with a history of chronic otitis and a facial nerve paralysis. She was found to have a rheumatoid nodule involving the mastoid and mesotympanum. This is believed to be the first reported case of a rheumatoid nodule involving the temporal bone. PMID- 2769048 TI - Primary chondroid chordoma of the base of the petrous temporal bone. AB - The authors describe an unusual case of a primary chondroid chordoma arising from the base of petrous temporal bone. The patient, a young male, presented with a left sided jugular foramen syndrome. The CT findings of a tumour arising from the base of the left petrous temporal bone were confirmed at infratemporal exploration. The clinical and histopathological and immunohistochemical differences between classical (typical) chordoma and its chondroid variant are highlighted. The rarity of primary chordomas at this site is stressed. PMID- 2769049 TI - Co-existent inverted papilloma and squamous carcinoma of the nasal septum. AB - Inverted papilloma is an uncommon benign nasal tumour which usually occurs on the lateral nasal wall and is prone to recurrence and malignant change. Inverted papilloma of the nasal septum is rare. A case of inverted papilloma and coexistent squamous carcinoma of the nasal septum in an adult male is described. The biology and treatment of these lesions are discussed. PMID- 2769050 TI - Cholesterol granuloma of the paranasal sinuses. AB - Cholesterol granulomata of the middle ear occasionally accompany chronic middle ear diseases with diminished ventilation. In the paranasal sinuses, especially in the frontal sinus, they have occasionally been mentioned in the literature. Disordered ventilation and impaired drainage are decisive pathogenic factors in the causation of cholesterol granuloma. Views remain divided on the source of the cholesterol and on the importance of bleeding in the development of cholesterol granuloma. Two patients with a cholesterol granuloma of the frontal sinus are presented and discussed. PMID- 2769051 TI - Two malignant melanomas in skin and tonsil during consecutive pregnancies. AB - A patient is described with two primary malignant melanomas which developed during consecutive pregnancies four years apart. The first melanoma was of the cutaneous nodular type located on the arm. The second, of the superficial spreading type, was located in the oral mucosa near the right tonsil. The influence of pregnancy on the development and outcome of malignant melanomas is discussed, and the risk of a subsequent pregnancy is emphasised. PMID- 2769052 TI - Paediatric laryngeal tuberculosis presenting with stridor. AB - A rare case of laryngeal tuberculosis in a 15-month-old Indian child is described. The unusual mode of presentation with stridor, suspicious radiological signs and papillomatous nature of the laryngeal lesion are highlighted. PMID- 2769053 TI - Synchronous extra-parotid Warthin's tumour. AB - Warthin's tumour (also known as adenolymphoma or papillary cystadenoma lymphomatosum) is benign and accounts for 12 per cent of all neoplasms of the parotid gland. A case of extra-parotid Warthin's tumour occurring synchronously in a peri-parotid lymph node is described. This is not a metastatic phenomenon and occurs as a result of salivary gland inclusions of local lymph nodes during the embryological development of the parotid. Extra-parotid Warthin's tumour should be regarded as a benign incidental finding and the prognosis is excellent. PMID- 2769054 TI - Multiple synchronous carcinoma of the aero-digestive tract. AB - Multiple carcinoma of the upper aerodigestive tract is an increasingly recognized problem, and a concept of 'field cancerization' has been proposed to explain this phenomena. The initial assessment of a patient with an isolated aerodigestive carcinoma must be extensive so as not to miss any synchronous lesions, and may include radiography and endoscopy. Treatment cannot be standardised but must be tailored to suit individual problems and because of the high incidence of metachronous tumours, follow-up must be both thorough and 'lifelong'. A case of three primary synchronous squamous carcinomas of the upper aerodigestive tract is presented. The relevant literature is reviewed. PMID- 2769055 TI - Thrombosis of the internal carotid artery due to soft palate injury. AB - Thrombosis of the internal carotid artery is a rare complication of soft palate injury, only 16 cases having been previously documented. We present the case of a 5 1/2 year-old-boy who sustained an apparently trivial laceration to the right aspect of the soft palate. However, 48 hours after injury, a right cerebral infarct occurred with subsequent left hemiparesis. On supportive and rehabilitative management he made a good recovery over a period of one year. PMID- 2769056 TI - A coin as a tracheal foreign body for 30 years. AB - A rare case of long-standing tracheal foreign body, a coin retained in the trachea for over 30 years, is presented. A 35-year-old female patient came to the hospital complaining of recurring cough and sensation of a lump in the throat since childhood. A round radiopaque shadow between the clavicles was found in routine chest X-ray film. She recalled swallowing a coin at about the age of five. Reviewing an old film taken for her cough problem at another hospital 11 years previously, we noted the same shadow at the same level. A rusty coin was removed through a ventilating bronchoscope from the trachea, where a narrow sulcus and some granulation tissue were found. Her complaints disappeared thereafter. PMID- 2769057 TI - A revealing C.T. examination in nasopharyngeal carcinoma. PMID- 2769058 TI - Comments related to Professor Heshusius' application of paradigm change to special education. PMID- 2769059 TI - Natural science approaches to questions of subjectivity. PMID- 2769060 TI - Paradigm accountability (reaction paper to Heshusius' "The Newtonian Mechanistic..."). PMID- 2769061 TI - Differences that make a difference: comparisons of metacomponential functioning and knowledge base among groups of high and low IQ learning disabled, mildly mentally retarded, and normally achieving adults. AB - To determine if cognition among persons with learning disabilities (LD) and mild mental retardation (MMR) is similar, we compared metacomponential functioning and knowledge acquisition across groups of incarcerated adults with LD and high IQ (HIQLD), with LD and low IQ (LIQLD), with normal achievement (NA), and with MMR. The Slosson Intelligence Test Computer Report (Nicholson, 1984) formula established criteria for group inclusion. Metacomponential functioning among 77 males and 26 females was measured by a confidence test (Echternacht, Boldt, & Sellman, 1971) designed for the general knowledge subtest of the SRA Achievement Battery (Naslund, Thorpe, & Lefever, 1982). Knowledge base and group membership were significantly related to metacomponential ability (R2 = .84). Persons with HIQLD and LIQLD performed better than those with MMR on both measures. The HIQLD, however, did not outperform their peers with NA. Results show that (a) knowledge base is the best predictor of metacomponential skill, (b) metacomponential orchestration differentiates persons with HIQLD from those with LIQLD and both groups from persons with MMR, and (c) IQ mediates metacognition, but does not explain it. Education should emphasize knowledge acquisition for people with HIQLD; people with LIQLD and MMR require more attention to metacognition. PMID- 2769062 TI - The effectiveness of a multisensory alphabetic phonetic approach with college students who are learning disabled. AB - College students diagnosed as learning disabled were studied to determine whether they would make more progress in a summer program if taught by an adaptation of the Orton-Gillingham (O-G) approach. Progress of those exposed to this approach was compared to progress of those exposed to (a) a nonphonetic approach or (b) no educational activity. Pre- and posttest results are reported for the Wide Range Achievement Test-Revised and Woodcock Reading Mastery Tests. The subjects were 30 college students aged 17 to 24, who were diagnosed as LD. They were divided into groups of 10 and exposed to the indicated educational intervention. The O-G group was found to achieve statistically significant improvement in reading when compared to the group using the nonphonetic approach or no educational activity. No statistically significant difference was noted between the latter two groups. This study indicates that a modified O-G approach is useful in the teaching of reading to college students who are LD. PMID- 2769063 TI - The influence of level of discrepancy on the identification of students with learning disabilities. AB - This study investigated the relationship between a statistically determined severe discrepancy between expected and actual achievement levels and subsequent labeling of students with learning disabilities. Subjects were 733 students referred for possible special education services. The results demonstrate that while a slight majority of students who were determined to have learning disabilities manifested a severe discrepancy, much evidence exists to indicate that this criterion is inconsistently applied in making eligibility decisions. The implications of these findings for current practice are discussed. PMID- 2769064 TI - Perceptions of control at school among students in special education programs. AB - Data are reported on special and regular education students' perceptions of control at school and the importance to the students of having such control. For both special and regular education populations, comparisons were made between students enrolled in experimental and nonexperimental programs. Findings indicate comparability among the four groups with regard to areas in which control is valued. Perceptions of control at school for those in the standard special education group were lower than the ratings of regular education students and lower than those given by special education students in the experimental program. PMID- 2769065 TI - Piagetian cognitive functioning in students with learning disabilities. AB - This study investigated the cognitive abilities as measured by the Inventory of Piaget's Developmental Tasks (IPDT) (Furth, 1970) of male and female fourth and fifth graders with learning disabilities. In addition, their cognitive abilities were compared to their reading and mathematics achievement, as measured by the Peabody Individual Achievement Test (PIAT) (Dunn & Markwardt, 1970). A two-way analysis of covariance revealed a significant mean difference in cognitive ability between students with learning disabilities and nondisabled students. No significant differences existed in performance between males and females. Multiple regression showed that a linear combination of reading and mathematics achievement yielded a significant positive correlation to cognitive ability. PMID- 2769066 TI - Study skills and the education of students with learning disabilities. AB - This article discusses an area of education for students with learning disabilities that is often neglected. The topic of study skills education, although not new to education in general, has only recently been emphasized in the literature for students with handicaps. An overview of the study skill proficiency (or lack of it) of students with learning disabilities is provided, followed by the presentation of 15 student study skill strategies designed to assist students in their use of various study skills. These strategies may be employed appropriately and effectively with many students with learning disabilities provided that individual needs and abilities are considered. The article concludes with a discussion about the implementation of a study skills program, including guidelines to follow in this process. PMID- 2769067 TI - A survey of postsecondary programs for students with learning disabilities. AB - Four-year colleges and universities identified as offering special programs for post-secondary students with learning disabilities were surveyed to determine the types of services provided. Results related to students served, assessment and referral procedures used, academic and nonacademic services offered, and procedures employed for staff training are discussed in this article. PMID- 2769068 TI - Conformity to peer pressure by students with learning disabilities: a replication. AB - This study assessed the reported responses of junior high school students with learning disabilities and normally achieving classmates to peer pressure to conform in prosocial and antisocial activities. The results replicate those of an earlier study in finding that students with learning disabilities indicated more willingness than their classmates to conform to peer pressure to engage in antisocial actions. PMID- 2769069 TI - Social competence and problem behavior of adolescent girls with learning disabilities. AB - Estimates of social competence and problem behavior were obtained using the Child Behavior Checklist (Achenbach & Edelbrock, 1983) for a sample of 51 adolescent girls with learning disabilities. Results identified poor social competence and elevated problem behaviors, in comparison to a normative group of nonhandicapped adolescents. Implications for both diagnosis and research are addressed. PMID- 2769070 TI - Assessing differences in children with learning disabilities and normally achieving students with a new measure of creativity. AB - This study investigates the creative abilities of children with learning disabilities by employing a new measure designed to assess creativity without the use of verbal or analytic skills. Sixteen normally performing and 16 children with learning disabilities were administered this task and a control task of verbal fluency. The children with learning disabilities scored significantly higher on the nonverbal but not the verbal control task. PMID- 2769071 TI - Regulation of bile acid synthesis. III. Correlation between biliary bile salt hydrophobicity index and the activities of enzymes regulating cholesterol and bile acid synthesis in the rat. AB - Hepatic bile acid synthesis is thought to be under negative feedback control by bile salts in the enterohepatic circulation, acting at the level of cholesterol 7 alpha-hydroxylase (C7 alpha H), the initial and rate-limiting step in the bile acid biosynthetic pathway. Bile salts also suppress the activity of the rate limiting enzyme for cholesterol synthesis, 3-hydroxy-3-methylglutaryl-coenzyme A reductase (HMG-CoA-R). The mechanisms of these regulatory effects are poorly understood, and one or both may be indirect. Previous data suggest that the hydrophilic-hydrophobic balance of bile salts, a major determinant of their cholesterol solubilizing properties, also determines their potency as regulators of bile acid and cholesterol synthesis. To further evaluate the relationship between the physicochemical and regulatory properties of bile acids, we altered the composition of the bile salt pool of rats by feeding one or more of seven different bile acids (1% w/w for 14 days). We then determined the mean hydrophilic-hydrophobic balance (hydrophobicity index) of the bile salts in bile, and correlated this with the specific activities of C7 alpha H and HMG-CoA-R, and of acyl-CoA:cholesterol acyltransferase (ACAT), a third hepatic microsomal enzyme which regulates cholesterol esterification. In all instances following bile acid feeding, conjugates of the fed bile acid(s) became the predominant bile salts in bile. Highly significant negative linear correlations (each P less than 0.0001) were found between the hydrophobicity indices of biliary bile salts and the activities of C7 alpha H (r = 0.79) or HMG-CoA-R (r = 0.63). By contrast, no significant correlation could be demonstrated between ACAT activity and the hydrophobicity index of biliary bile salts. The correlation between activities of HMG-CoA-R and C7 alpha H was also highly significant (r = 0.81; P less than 0.0001). No significant correlation existed between ACAT and either HMG-CoA-R or C7 alpha H. Microsomal free cholesterol was not consistently altered by bile acid feeding. Thus, the potency of circulating bile salts as suppressors of the enzymes regulating bile acid and cholesterol synthesis increases with increasing hydrophobicity. The hydrophobic-hydrophilic balance of the bile salt pool may play an important role in the regulation of cholesterol and bile acid synthesis. PMID- 2769072 TI - Effect of linoleic acid-rich infant formula feeding on brain synaptosomal lipid accretion and enzyme thermotropic behavior in the piglet. AB - The effects of a vegetable oil-based infant formula, virtually devoid of n-6 and n-3 long chain polyenoid fatty acids (LCP) and high in 18:2(n-6) and 18:2(n 6)/18:3(n-3) ratio, on brain synaptosome lipid composition and enzyme thermotropic behavior were studied in neonatal piglets. Term gestation piglets were fed either sow milk (SMF) or formula (FF) from birth for 5, 10, 15, or 25 days. Synaptosomal cholesterol, total lipid phosphorus, and phospholipid class composition did not differ between SMF and FF piglets. Synaptosomal fatty acid composition, however, was influenced by diet. The proportion of n-3 LCP, especially 22:6(n-3), was decreased, while the n-6 LCP, especially 22:4(n-6) and 22:5(n-6), were increased in FF compared to SMF piglets. These diet-related changes were most pronounced in the ethanolamine glycerophospholipid fraction and increased with the duration of feeding. FF thus reversed an apparent developmental increase in the synaptosomal n-3/n-6 LCP ratio. The monoene content, especially 18:1, was also reduced in the synaptosomes of FF compared to SMF pigs. FF had no effect on the activity of synaptosomal acetylcholinesterase. However, higher transition temperatures for this enzyme, indicating decreased membrane fluidity, were found in the FF compared to SMF piglets. The data suggest that exclusive feeding of proprietary formulae, devoid of LCP and high in 18:2(n 6) and/or the 18:2 (n-6)/18:3(n-3) ratio, may compromise normal fatty acid accretion and physical properties of brain synaptosomal membranes. PMID- 2769073 TI - Relationship of decreased hepatic lipase activity and lipoprotein abnormalities to essential fatty acid deficiency in cystic fibrosis patients. AB - Polyunsaturated fatty acids are known to affect plasma lipids and lipoproteins but there is no information on the effect of essential fatty acid (EFA) deficiency on lipoprotein composition. The purpose of this study was to characterize lipoproteins from 17 cystic fibrosis (CF) patients in relationship to their EFA status (eicosatrienoic/arachidonic acid ratio) and compare them with those of 10 healthy siblings (SIB) and of 10 unrelated controls. In 7 EFA deficient (EFAD) and 10 EFA-sufficient (EFAS) patients, hypocholesterolemia was associated with a decrease of HDL-cholesterol and of LDL-cholesterol which was more marked in the EFAD group. Similarly, although triglyceride enrichment of VLDL, LDL, HDL2, and HDL3 with a concomitant reduction of cholesteryl esters from all particles except HDL2 was observed in both CF groups, it was more sizable in the EFAD patients. These changes led to an increase in the particle size of VLDL, LDL, and HDL2 whereas the distribution of HDL3 was skewed to smaller particles. Alterations in the apoprotein composition of particles were greater in EFAD than in EFAS. A decrease of total postheparin lipolytic activity was observed in the two groups of CF patients as well as in siblings. It was entirely accounted for by hepatic lipase (mumol FFA/ml per h) which was more severely diminished in EFAD (2.8 +/- 0.6) than in EFAS (4.4 +/- 0.7) and SIB (5.1 +/- 0.5). Although the two groups of CF children differed in terms of growth, severity of malabsorption, and vitamin E status, these data suggest that disturbance of lipoprotein concentration, composition, size, and metabolism (hepatic lipase) may be in part related to EFA deficiency. Further studies are necessary to explore the effect of EFA deficiency on hepatic lipase activity. PMID- 2769074 TI - Chronic dietary fat and cholesterol inhibit the normal postprandial stimulation of plasma cholesterol metabolism. AB - The response of parameters of plasma cholesterol metabolism was studied in baboons adapted either to a low-fat, low-cholesterol diet or a high-fat, high cholesterol diet. Animals adapted to the low-fat diet responded to a single low fat or high-fat meal, as do normal humans, by a stimulation of cholesterol transport from blood cells to plasma, a stimulation of esterification of cholesterol, and a stimulation of cholesteryl ester transfer to very low and low density lipoproteins. While fasting rates of esterification and transfer increased as a result of diet-induced hypercholesterolemia, the postprandial response was reversed, so that postprandial metabolism was characterized by a movement of cholesterol from plasma to blood cells, an inhibition of cholesterol esterification, and a net transfer of cholesteryl esters from VLDL and LDL to HDL. These data indicate that the effects of postprandial lipemia on plasma cholesterol metabolism critically depend upon fasting plasma cholesterol levels. PMID- 2769075 TI - Concurrent occurrence of 3 beta,12 alpha-dihydroxy-5-cholenoic acid associated with 3 beta-hydroxy-5-cholenoic acid and their preferential urinary excretion in liver diseases. AB - 3 beta-Hydroxy-(delta 5-3 beta-ol), 3 beta,12 alpha-dihydroxy-(delta 5-3 beta,12 alpha-ol), 3 beta,7 alpha-dihydroxy-(delta 5-3 beta,7 alpha-ol) and 3 beta,7 beta dihydroxy-(delta 5-3 beta,7 beta-ol) 5-cholenoic acids were identified in patients with liver diseases by gas-liquid chromatography-mass spectrometry (GLC MS). Of these unusual 3 beta-hydroxy-5-en-metabolites, delta 5-3 beta-ol and delta 5-3 beta,12 alpha-ol were found as major components in the urine of patients with liver diseases (cholestasis, liver cirrhosis, chronic hepatitis, acute hepatitis). Other 3 beta-dihydroxy-5-en-metabolites, delta 5-3 beta,7 alpha ol and delta 5-3 beta,7 beta-ol, were found as minor components in the urine. The levels of delta 5-3 beta-ol and delta 5-3 beta,12 alpha-ol in urine were correlated with their levels in serum, with total bile acids in the urine, and with liver function, implying that the degree of their increment correlated well with the severity of liver diseases. The most abundant amounts of delta 5-3 beta ol and delta 5-3 beta,12 alpha-ol were found in the urine as sulfate conjugates in comparison with bile, portal and hepatic venous sera, and liver tissue of the patients. The biliary excretion and hepatic extraction of these 3 beta-hydroxy-5 en-unsaturated bile acids were more impaired and inefficient than those of cholic and chenodeoxycholic acids. PMID- 2769076 TI - Plasma lipoprotein metabolism in lean and in fat chickens produced by divergent selection for plasma very low density lipoprotein concentration. AB - Plasma lipoprotein metabolism was studied in vivo in two lines of chickens produced by selection for high and low plasma very low density lipoprotein (VLDL) concentration. Rates of VLDL secretion were measured by determining the rate of accumulation of triglyceride in the plasma after intravenous injection of anti lipoprotein lipase antibody. The clearance of VLDL-triglyceride and its uptake into liver and adipose tissue was examined using radioactively labeled VLDL synthesized in vivo. The rate of VLDL secretion was about threefold higher in the high-VLDL line as compared to the leaner, low VLDL-line (6.7 vs 2.1 mumol VLDL triglyceride/h per ml of plasma). The clearance of VLDL from the circulation of the low VLDL line was much faster than that of the high VLDL line (t1/2 of 3.7 and 13.6 min, respectively). The proportion of administered radiolabel taken up by the abdominal fat pad was substantially greater in the fat line than in the lean line (11.9 vs 4.8%, respectively). Lipoprotein lipase activities in leg muscle and heart were consistently greater in the low-VLDL line and beta hydroxybutyrate concentrations in the plasma of the low-VLDL line were significantly greater than those in the high-VLDL line (0.86 vs 0.48 mumol/ml). The results show that the approximately tenfold difference in plasma VLDL concentration between lines is primarily due to markedly different rates of hepatic VLDL production and that selection has made a major effect on partitioning of VLDL triglyceride between adipose and other tissues.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2769077 TI - Anabolic sialosylation of gangliosides in situ in rat brain cortical slices. AB - Radiolabeling of the sialic acid residues of gangliosides was examined in thin slices of rat brain cerebral cortex incubated under physiologic conditions in the presence of either [14C]N-acetyl-mannosamine (ManNAc) or cytidine 5' monophosphoryl-[14C]N-acetyl-neuraminic acid (CMP-NeuAc). CMP-NeuAc is the direct donor substrate in the transfer of sialic acid to gangliosides by sialosyl transferases (SATs), including ectosialosyl transferases at the cell surface. ManNAc must be internalized by the neural cells (neuronal or glial) where it serves as an obligate precursor for the biosynthesis of the NeuAc moiety of intracellular CMP-NeuAc, via multiple reactions in the cytosol and nucleus. When exogenous [14C]ManNAc was supplied, there appeared to be a 2-h lag period before label was incorporated measurably into ganglioside sialic acid. That was followed by rapid ganglioside labeling continuing up to 6 h. There was high incorporation into ganglioside GM1. Labeling by ManNAc was inhibited by monensin, a monovalent cationophore that blocks anabolic transport in medial and trans Golgi. Extracellular CMP-NeuAc was not internalized by the cells. CMP-[14C]NeuAc labeling of gangliosides had no lag period, reached a maximum within 2 h, and then began to level. The label distribution among gangliosides was high in GD3, but quite low in GM1. CMP-NeuAc labeling was not inhibited by 10(-7) M monensin. These findings support a model in which ManNAc labels gangliosides by an intracellular route involving monensin-sensitive, Golgi-associated SATs. In this intracellular system, the major labeled products are gangliosides of the gangliotetraosyl series (GM1, GD1a, etc.).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2769078 TI - Potential bile acid metabolites. 14. Hyocholic and muricholic acid stereoisomers. AB - The complete set of the eight theoretically possible stereoisomeric 3,6,7 trihydroxy-5 beta-cholanic acids, four of which are new, related to hyocholic and muricholic acids were prepared from chenodeoxycholic acid. The principal reactions used were 1) cis-dihydroxylation of delta 6-compounds with osmium tetroxide/N-methylmorpholine N-oxide; 2) trans-dihydroxylation of 6 alpha, 7 alpha-epoxy compounds with boron trifluoride etherate in N,N-dimethyl-formamide; 3) inversion of equatorial 3 alpha-hydroxylated compounds to the corresponding 3 beta-epimers with diethyl azodicarboxylate/triphenylphosphine/formic acid; and 4) stereoselective reduction of 7-keto derivatives with zinc borohydride (or sodium borohydride) and by metallic potassium/tert-amyl alcohol. PMID- 2769079 TI - 3-Diazirine-derivatives of bile salts for photoaffinity labeling. AB - New carbene-generating photolabile bile salt derivatives, 3,3-azo-7 alpha,12 alpha-dihydroxy-5 beta [7 beta-3H]cholan-24-oic acid and (3,3-azo-7 alpha,12 alpha-dihydroxy-5 beta [7 beta-3H]cholan-24-oyl)-2- aminoethanesulfonic acid were synthesized with high specific radioactivity. These 3-diazirine-derivatives could be activated to the corresponding carbenes by irradiation with ultraviolet light at 350 nm with a half-life time of 2 min. The 3-diazirine derivatives behaved in enterohepatic circulation like the natural bile salts. The uptake of [3H]taurocholate into isolated hepatocytes was competitively inhibited by (3,3 azo-7 alpha,12 alpha-dihydroxy-5 beta-cholan-24-oyl)-2- aminoethanesulfonic acid indicating that the 3,3-azo-derivative of taurocholate shares the hepatic transport systems for natural bile salts. It was demonstrated that the radioactively labeled 3-diazirine bile salt derivatives are useful probes for photoaffinity labeling of bile salt binding proteins especially in intact cells and tissues. PMID- 2769080 TI - A rapid method to assess the hydrophobicity of the intestinal microvillus membrane in vivo. AB - Absorption rates for many biologically important compounds are determined by the relative hydrophobicity of the jejunal microvillus membrane. An estimate of this parameter may be obtained by measuring the incremental change in free energy that occurs when a methylene group partitions into the bilayer form an external aqueous solution. Although sensitive, this measurement has been difficult to quantitate in vivo; therefore, these studies have historically been performed in vitro. We describe a rapid, simple technique to measure this parameter in vivo. Furthermore, this method directly quantitates the resistance of aqueous unstirred layers that lie external to the microvillus membrane. PMID- 2769081 TI - Evidence for proliferation and differentiation of endosteal cells into hemopoietic cell lines in short-term liquid culture. AB - To study the ability of endosteal cells to spontaneously differentiate in vitro, cells isolated from the endosteal bone surface (endosteal cells) were incubated in liquid suspension cultures containing fetal calf serum and antibiotics, but without chemical inducers of differentiation. Cultures were examined daily for the appearance of morphologically recognizable mature and differentiated hemopoietic cells. Culture outcomes were uniformly consistent, showed an almost complete disappearance of the endosteal cells (which appeared as stimulated lymphoid and late stage normoblast-like cells once they are separated from the bone surfaces), and their replacement by differentiated and mature hemopoietic cells. The ability of endosteal cells to fully differentiate into mature hemopoietic cells in vitro indicates that endosteal cells represent the multipotential hemopoietic stem cells in vivo, and are equivalent of embryonal stage undifferentiated mesenchymal cells. PMID- 2769082 TI - Plasma ferritin in an elderly population living in the community. AB - Plasma ferritin was measured in 420 apparently healthy active elderly subjects living in the community. Mean values were comparable to other published results for elderly subjects. Higher values were obtained in men and in diabetic subjects. Mean values for men and women after exclusion of subjects with diabetes and other diseases were not significantly lower. It is concluded that a) the age related rise in plasma ferritin observed in other studies represents a physiologic change, with pathologic processes only playing a small part in contributing to the increase, b) reference intervals appropriate to the elderly should be used, and c) plasma ferritin may not be a useful screening test for iron deficiency anemia or hemochromatosis in the elderly. PMID- 2769083 TI - A good outcome pregnancy in a patient with paroxysmal nocturnal hemoglobinuria. AB - In this report, the maternal and fetal risks in a patient with paroxysmal nocturnal hemoglobinuria (PNH) were evaluated. A patient with PNH carried a pregnancy to successful delivery, with a healthy male infant, and suffered from postpartum cerebral subcortical, but not hepatic, thrombosis followed by recovery. An elevation of serum levels of lactate dehydrogenase isoenzyme, alpha hydroxybutyrate dehydrogenase, was observed during pregnancy. The level was ameliorated to the non-pregnant level by delivery. However, hemoglobin concentrations during pregnancy and post-partum were at least 8 g/dl. This is a first report that shows tight coupling between an onset of intravenous hemolysis and pregnancy. The management of pregnancies in such patients is also discussed. PMID- 2769084 TI - The effect of exercise on seizure frequency. AB - The effect of exercise on seizure frequency is uncertain. While some investigators have reported an increase in the normal background frequency of EEGs after exercise, other investigators believe that exercise increases EEG epileptiform activity in the recovery period following exercise. We asked all patients over a two month period at our outpatient Epilepsy Clinic to complete a questionnaire regarding their exercise habits. Those who were not otherwise healthy, were non-compliant with their medications, or whose blood levels were not therapeutic were eliminated from the analysis. Utilizing the complex Chi square method, it was determined that patients who participated in some form of exercise had significantly fewer seizures than those who did not exercise (p less than 0.05). Conclusions from this brief study indicate the need for a more comprehensive trial, including EEGs, biochemical studies, and fitness evaluations, to determine the effects of an exercise program on seizure frequency. PMID- 2769085 TI - On the role of long incubation periods in the dynamics of acquired immunodeficiency syndrome (AIDS). Part 1: Single population models. AB - In this study, we investigate systematically the role played by the reproductive number (the number of secondary infections generated by an infectious individual in a population of susceptibles) on single group populations models of the spread of HIV/AIDS. Our results for a single group model show that if R less than or equal to 1, the disease will die out, and strongly suggest that if R greater than 1 the disease will persist regardless of initial conditions. Our extensive (but incomplete) mathematical analysis and the numerical simulations of various research groups support the conclusion that the reproductive number R is a global bifurcation parameter. The bifurcation that takes place as R is varied is a transcritical bifurcation; in other words, when R crosses 1 there is a global transfer of stability from the infection-free state to the endemic equilibrium, and vice versa. These results do not depend on the distribution of times spent in the infectious categories (the survivorship functions). Furthermore, by keeping all the key statistics fixed, we can compare two extremes: exponential survivorship versus piecewise constant survivorship (individuals remain infectious for a fixed length of time). By choosing some realistic parameters we can see (at least in these cases) that the reproductive numbers corresponding to these two extreme cases do not differ significantly whenever the two distributions have the same mean. At any rate a formula is provided that allows us to estimate the role played by the survivorship function (and hence the incubation period) in the global dynamics of HIV. These results support the conclusion that single population models of this type are robust and hence are good building blocks for the construction of multiple group models. Our understanding of the dynamics of HIV in the context of mathematical models for multiple groups is critical to our understanding of the dynamics of HIV in a highly heterogeneous population. PMID- 2769086 TI - A quantitative genetic model for growth, shape, reaction norms, and other infinite-dimensional characters. AB - Infinite-dimensional characters are those in which the phenotype of an individual is described by a function, rather than by a finite set of measurements. Examples include growth trajectories, morphological shapes, and norms of reaction. Methods are presented here that allow individual phenotypes, population means, and patterns of variance and covariance to be quantified for infinite-dimensional characters. A quantitative-genetic model is developed, and the recursion equation for the evolution of the population mean phenotype of an infinite-dimensional character is derived. The infinite-dimensional method offers three advantages over conventional finite-dimensional methods when applied to this kind of trait: (1) it describes the trait at all points rather than at a finite number of landmarks, (2) it eliminates errors in predicting the evolutionary response to selection made by conventional methods because they neglect the effects of selection on some parts of the trait, and (3) it estimates parameters of interest more efficiently. PMID- 2769087 TI - Convergence to stationary distributions in two-species stochastic competition models. AB - Two sets of sufficient conditions are given for convergence to stationary distributions, for some general models of two species competing in a randomly varying environment. The models are nonlinear stochastic difference equations which define Markov chains. One set of sufficient conditions involves strong continuity and phi-irreducibility of the transition probability for the chain. The second set has a much weaker irreducibility condition, but is only applicable to monotonic models. The results are applied to a stochastic two-species Ricker model, and to Chesson's "lottery model with vacant space", to illustrate how the assumptions can be checked in specific models. PMID- 2769088 TI - First and second moments and the mean Hamming distance in a stochastic replication-mutation model for biological macromolecules. AB - In this work first and second moments for a many species Moran model are calculated. The model describes by means of a time-continuous birth- and death process the evolution of an ensemble of N macromolecules out of n possible species. The molecules may replicate (correct or erroneous, in the latter case producing mutants) and may undergo elimination. Replication and elimination will be coupled in order to keep population size constant. In the case of arbitrary replication rates an expansion of the moments in powers of 1/N is found. For equal replication rates exact calculation of the moments is possible. In the case of a v-cube model (binary macromolecules) the second moments may be used to find a simple expression for the mean Hamming distance in the system. This quantity provides a measure for the localization of the ensemble. PMID- 2769089 TI - A preliminary investigation of the relationship between certain practice characteristics and practice location: chiropractor-population ratio. AB - Two surveys of 121 preselected Victorian and South Australian chiropractors were conducted during the period of December 1986 to February 1987 in order to investigate whether practice location (metropolitan area and country town) and chiropractor/population ratio (number of chiropractors per 10,000 inhabitants) have any effect on patient numbers, practice procedures and practitioner attitudes. Practitioners' response rates to the first and second questionnaires were 82% and 61%, respectively. Analysis of data revealed that metropolitan chiropractors utilized more adjunctive therapies than their country town colleagues. Most chiropractors felt that the number of chiropractors in their area was sufficient. However, there appeared to be no difference in patient numbers (patient visits and new patients) and ratio of new patients to patient visits as related to practitioner density or practice location. Patient volume appeared to be practitioner-induced; fewer new patients corresponded to a higher number of revisiting patients, and maintenance care corresponded to a higher number of patient visits. PMID- 2769090 TI - Relative efficacy for radiation reducing methods in scoliotic patients. AB - Radiation dosages to sensitive organs in full spine radiography have in recent years been a concern of physicians as well as the general public. The spine is the prime target for exposure in scoliosis radiography, though the exposure usually necessitates irradiation of several radio-sensitive organs. In recent studies, various protection techniques have been used including various lead and aluminum filtration systems, altered patient positioning and varied tube-film distances. The purpose of this study was to evaluate the efficiency for radiation dosage reduction of three filtration systems used frequently in the chiropractic profession. The systems tested were the Nolan Multiple X-ray Filters, the Clear Pb system and the Sportelli Wedge system. These systems were tested in seven configurations varying breast shielding, distance and patient positioning. All systems tested demonstrated significant radiation reductions to organs, especially breast tissue. The Clear-Pb system appeared to be the most effective for all organs except the breast, and the Sportelli Wedge system demonstrated the greatest reduction to breast tissue. PMID- 2769091 TI - Cybernetic model of psychophysiologic pathways: III. Clinical impairment of tension and kinesthesia. AB - It is unclear whether peripheral, subcortical or intracortical loops are directly involved between receptors in muscles and tendons and the cerebral cortex in signaling movement magnitude and muscular tension information. Previous experiments have indicated that this information does reach consciousness. Data from voluntary compression of springs and strain-gauge were analyzed in patients with unilateral focal lesions of the cerebral hemispheres. It was found that the perception of signals of muscular tension is abolished by lesions of the contralateral cortex near the central sulcus. It was concluded that the possibility exists of separate cortical projection areas for kinesthetic signals from muscles and from joints. PMID- 2769092 TI - Detection of stress fractures in athletes and nonathletes. AB - Stress fractures are considered a relatively common athletic injury. Some authors also feel this disorder may be overlooked in many nonathletic patients. Three cases of stress fractures are presented. All had classical clinical pictures; however, two were athletes and one was not. The athletes' stress fractures were suspected early in the disease evolution, confirmed with a bone scan and proper care instituted to prevent extended morbidity. The nonathlete's case was misdiagnosed by another practitioner and allowed to progress to the level of a true fracture. Extended morbidity followed this case. The infrequent report of nonathlete stress fractures in the literature may have played a major role in this oversight. Stress fractures do occur in athletes and nonathletes. The history is the key to making an early diagnosis. Scintigraphy (bone scan) or plain films may be used to confirm the diagnosis and rule out other disorders. PMID- 2769093 TI - Myofascial trigger points as a cause of headaches. PMID- 2769094 TI - Osteochondrosis of the tibial tuberosity (Osgood-Schlatter's disease) PMID- 2769095 TI - Chiropractic management of chronic obstructive pulmonary disease. PMID- 2769096 TI - Reliability of the Derifield-Thompson test for leg length inequality, and use of the test to demonstrate cervical adjusting efficacy. PMID- 2769098 TI - Of clay courts and rivers. PMID- 2769097 TI - Commentary: beyond the theosophy of chiropractic. PMID- 2769099 TI - Physicians supply in Georgia. PMID- 2769100 TI - A Gothic tale: rural hospitals in Georgia. PMID- 2769101 TI - Peer review in the 1990s. A look at the Georgia Medical Care Foundation. AB - Although it is not possible to completely summarize all of the policies and procedures of a program as complex as the PRO program in one article (or even three), it is useful for establishing the framework of these activities over the next 3 years. Many of us are skeptical of the government's role in the medical review process, and some of us can recall specific instances where problems, e.g., backlogs, have diverted us from our primary mission--to insure quality care. It is imperative, as we begin this new PRO contract, that we all recognize what the PRO program is and what it is not. Specifically, it is not a program of quotas wherein GMCF is required to produce a certain number of denials, quality problems, sanctions, etc. It is a peer review program funded by Medicare but implemented by Georgia physicians with a primary focus on quality review. A second point that needs to be made here concerns the scope of PRO findings relative to the volume of cases reviewed. As with any quality assurance program, it is necessary to look at many cases to determine if there are problems. It is important to note here that GMCF recognizes that most health care delivered in Georgia is appropriate. In fact, Mr. Thomas Morford, National PRO Program Director of the Health Care Financing Administration, recently testified to Congress as follows "clearly, the most important observation thus far is that the PROs have not uncovered any systemic quality problems in the Medicare program.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2769102 TI - Physician supply and distribution in Georgia. AB - Physician supply in Georgia must be considered an urgent issue. Several important points must be recognized and addressed. The lowest physicians rates are in the more rural county population groupings. The only county population grouping with a surplus of physicians is in the over 150,000 population. The majority of physicians are concentrated in the metropolitan counties. Sixteen percent of all physicians practice in the 134 counties having less than 50,000 population. The majority of physicians are in primary care specialties. Family practice is the most dominant specialty in rural areas. By the year 2000, Georgia can expect to add 5,600 physicians due to growth. By the year 2000, Georgia can expect to lose 2,600 physicians due to retirement. Family practitioners are the most uniformly distributed of the specialties examined. They are also the specialty most needed. The average age of Georgia physicians is 46. General surgeons are in the oldest average age group (50), whereas internists are in the youngest (44). Older physicians are concentrated in the more rural areas. A significant number of all physicians are over age 55. The majority of these will be retired by the year 2000. Physicians over age 65 represent 9.2% of all physicians from the survey. In Georgia, 13.6% of all physicians were Foreign Medical School Graduates. They tend to locate their practices in medically underserved areas. The specialty choices most frequently favored by FMGs are: pediatrics, internal medicine, family practice, and obstetrics/gynecology. A total of 71.2% of all physicians accept Medicare patients; 83.8% accept Medicare patients. Ninety-two percent of all obstetricians accept obstetric patients, but this participation is threatened by problems with malpractice insurance. PMID- 2769104 TI - Safeguarding your medical license after retirement. PMID- 2769103 TI - Why family practice residents choose not to practice obstetrics. PMID- 2769105 TI - Management of pain in patients with malignancy. PMID- 2769106 TI - Harvesting cells, tissues, and organs from fetuses and anencephalic newborns. PMID- 2769107 TI - Brain life, brain death, fetal parts. PMID- 2769108 TI - The use of fetal and anencephalic tissue for transplantation. AB - Advances in transplantation have extended the life and relieved the suffering of thousands of individuals. The prospect of being able to use tissues from embryos, as well as from anencephalic newborns, offers the promise of further relief of suffering. However, these possibilities raise significant moral and public policy issues. The question arises of the extent to which those who disapprove of abortion may make use of tissues derived from abortion in order to treat serious diseases. This essay argues that, with proper safeguards, such tissue can be used without cooperating in abortion. That is, even those who oppose abortion can benefit from the use of tissue procured during abortion. Questions also arise regarding the probity of maintaining a pregnancy in order to produce an anencephalic newborn whose biological existence will be maintained so as better to secure organs once death is declared. It is argued that, since no harm can be done to a being that has neither a sense of self or the capacity to feel pain, and since women have a right to forego abortions, there is no legitimate ground for opposing women's seeking meaning in their pregnancy through maximizing the opportunity of others to use the organs of their anencephalic newborn once death has been declared. Finally, it is argued that, since the capacities for sentience, a minimal condition for personhood, are never realized by an anencephalic, the entity has never been alive as a person. Therefore, there should be no opposition in principle to aborting anencephalics nor, after proper declaration, to making their organs available as one would after whole-brain death, despite the continued functioning of the brain stem. PMID- 2769109 TI - Anencephalic infants as organ donors and the brain death standard. PMID- 2769110 TI - Moral pluralism and the use of anencephalic tissue and organs. PMID- 2769111 TI - Foundations of a misunderstanding of the ultrastructural basis of myocardial failure: a reciprocation network of oversimplifications. AB - A misconception regarding the ultrastructural basis of myocardial failure has been observed in laboratory studies involving medical students and practicing physicians, in medical textbooks, and in clinical instruction of students. This misconception attributes heart failure to overextension of individual cardiac muscle fibres and their sarcomeres, resulting in a mechanically based decline in contractile force production. The basis of the misconception is a set of component misconceptions which interact in reciprocally supportive ways. The interlocking nature of the component misunderstandings strengthens the overall misconception, making it difficult to undermine. A contributor to many aspects of the faulty account of heart failure is a tendency toward oversimplification of complex phenomena in learning, instruction, and scientific research. Implications for medical education are considered. PMID- 2769112 TI - Health science, natural science, and clinical knowledge. AB - The epistemological status of health science, natural science, and clinical knowledge is explored. It is shown that 'health science', a term increasingly used in association with the clinical knowledge of the therapies, nursing, and other health occupations, is not fully a science in the sense of the natural sciences. It is rather a hybrid which relates applications of natural science, behavioral science, and the humanities to problems in health. The same may be said of clinical knowledge which entails, as essentials, humanistic considerations involving the personal concerns of the patient, in addition to the more evident external aspects of diagnosis and treatment. The recent introduction of the term 'health science' reflects scientism in its approach to health issues. It also reflects confusion about the nature of clinical knowledge. PMID- 2769113 TI - A science of individuals: medicine and casuistry. AB - Clinical medicine is the application of scientific principles, rules of thumb, and a store of practical wisdom embodied in narratives of individual cases to the care of a person who is ill. Physicians are taught to observe and report the individual case both as a means of fitting nomothetic generalizations to the given circumstances and as a way of refining those generalizations. This narrative construction of illness is a principal way of knowing in medicine. In this view, disease is not so much an entity as an identifiable chronological organization of the events of illness, and medicine, rather than a science, a rational science-using activity in the service of the ill. PMID- 2769114 TI - The difference between interfaced and integrated systems. AB - The definitions of an "integrated system" and an "interfaced system" are unclear. Consequently, purchasers and developers of systems are often unable to judge the degree to which a system is integrated. This paper presents definitions of integrated systems and interfaced systems, describes the differences between the two, and reviews resulting conclusions. PMID- 2769115 TI - Computer based information systems in primary health care--why? AB - The delivery of health care is information based. A host of computer-based information systems have been developed and implemented in the health care environment. The mere availability of the computer as a tool for information handling should, in itself, not be the cause for developing computer-based information systems. The earlier assumption of a cost-benefit impact with the development of such systems has not been effectively shown in all cases, and as seen in a report by van Bemmel, the recent trend is to apply other criteria in systems evaluation. Information is essential in health care related decision making. The properties of information are described to present a case for a computer-based information system to support primary health care delivery. PMID- 2769116 TI - A final adjustment for staff allocation under environmental uncertainty. AB - Through understanding the relationships between the previous day's (Sunday) demand and the remaining days' demand, a prediction model can be constructed. The staff level can be determined based on this prediction model. This model can also be applied in different hospital units or a staff environment other than hospitals. PMID- 2769117 TI - The natural language processing of medical databases. AB - The consideration of natural language as a domain for computer processing has been one of the long-term projects in the history of data processing. Computers were developed in the late 40's and early 50's in the United States and from the very beginning there was a desire and intent that someday the computer would handle speech and be able to understand normal English literature and text with the coherency of a student or perhaps even an expert. Such breakthroughs have also been anticipated in the medical area. This paper will present a series of design specifications that facilitate the processing of natural language medical databases. Using these techniques it will be possible to expand the use of our traditional tools and exploit the effort that has been invested in these literary creations. PMID- 2769118 TI - Lethal midline granuloma and lymphoproliferative disorders. AB - Seventeen patients, who presented with unhealing ulcers or destructive lesions of the upper aero-digestive tract at Ramathibodi hospital from 1977 to 1985 were reported. Lesions caused by infection, Wegener's granulomatosis or non hematopoietic malignancy were excluded. A spectrum of histopathologic findings were evident in our patients, ranging from acute and chronic inflammatory changes with or without necrosis, polymorphic reticulosis or lymphamatoid granulomatosis, and malignant lymphoma of the non-Hodgkin's type (NHL). Although some initial histopathologic findings were non-specific, evidence of lymphoproliferative disorders finally emerged. These malignant lymphoid cells had a predilection for the GI tract and skin. Lymphoma staging should thus be done. Bleeding from the lesion, treatment-induced leucopenia, and sepsis were common in these patients. Early aggressive treatment including adequate antibiotic coverage for superimposed infection, improved nutritional status, and early radiation to the primary lesion are suggested for those diseases. PMID- 2769119 TI - Susceptibility to current antimicrobial agents of Bacteroides fragilis. AB - Agar dilution technique susceptibility test of isolated Bacteroides fragilis from the normal healthy women's and infected gynecological patients' cervical areas were studied with current antimicrobial agents. Among the N H W group, imipenem had the lowest MIC90 while cefoxitin had the highest value. Metronidazole, chloramphenicol, imipenem and piperacillin had differentiated-lower values of MIC90 and MIC90 than the others. In the I G P group, imipenem also had the lowest value of MIC90 while benzylpenicillin had the highest value. The different values of MIC90 and MIC50 less than "1" were seen in metronidazole, chloramphenicol and imipenem. The significant role of MIC90 and MIC50 was discussed in this article. Although the isolated strains had beta-lactamase enzymes, the antimicrobials resistances were not correlated with the specific enzymes. Also in this article, the significant role of anaerobic component in mixed infection was also discussed. PMID- 2769120 TI - Endoscopic sphincterotomy and removal of common bile duct stones in Police General Hospital. AB - Endoscopic sphincterotomy was attempted in 75 CBD stone patients. The procedure was successful in 62 patients (82.7%), and all duct stones were removed successfully in 59 patients (95.2% of successful EST). Immediate complications occurred in 7 patients (9.3%), who required no operation. No patient died. This procedure is a major therapeutic advance in the treatment of choledocholithiasis. PMID- 2769121 TI - Autopsy proven cases of pulmonary thromboembolism: 18-year study at Ramathibodi Hospital. AB - Twelve cases of pulmonary embolism were found among 4,896 autopsies during 18 years in Ramathibodi hospital. This gives an incidence of 0.24 per 100 necropsies. Deep vein thrombosis occurred in two of the twelve cases and was not the main cause of pulmonary embolism in this series. PMID- 2769122 TI - The effects of protamine on hemodynamics and oxygenation during cardiac surgery. AB - The cardiopulmonary effect of protamine for heparin reversal was investigated in 100 patients, undergoing cardiac surgery, using cardiopulmonary bypass (CPB) at Siriraj hospital. Protamine sulfate at approximately equal to the amount of heparin was intravenously administered over 3 minutes after termination of CPB, together with rapid blood transfusion to establish the optimal level of central venous pressure. Following protamine administration, the heart rate was measured at 5, 15 and 30 minutes, and was not significantly different from the preoperative and post CPB values. The blood pressure was significantly decreased in the initial post CPB (P less than 0.05) and remained unchanged 5 minutes following intravenous protamine, thereafter, significantly rose to preoperative values. The arterial oxygen tension post CPB revealed shunting effect, but showed no significant change following protamine administration. The occurrence of cardiopulmonary adverse effect was not demonstrated in this study. PMID- 2769123 TI - Endometriosis during pregnancy: report of 3 cases. AB - Three cases of asymptomatic pelvic endometriosis during pregnancy were reported. All cases denied abnormal vaginal bleeding, dyspareunia or dysmenorrhea; but only one case was noted to have a problem of infertility. Conservative operations were performed at the second trimester and during cesarean section with an uneventful postoperative course. Cyclic menses have been resumed. PMID- 2769124 TI - Movement disorder in hypothyroidism: a case report. AB - A case of primary hypothyroidism with hemichoreoathetoid movement was presented. After thyroid hormone replacement therapy for a few weeks, the movement disorder decreased dramatically. This abnormal movement may be one of the neurological manifestations of hypothyroidism. PMID- 2769126 TI - Proceedings of the Second Workshop on Nosocomial Infection Control. Bangkok, Thailand, July 13-15, 1988. PMID- 2769125 TI - Multiple cranial nerve palsies as a presenting symptom in primary Sjogren's syndrome. AB - A 28-year-old woman who presented with multiple cranial nerve palsies was eventually proven, pathologically, to be a case of primary Sjogren's syndrome. The presence of this syndrome was not initially suspected until the onset of its neurological manifestation. The paucity of sicca syndrome can cause a delay and/or over looking in such a diagnosis. Therapeutic response to corticosteroids was rather impressive in this particular case. PMID- 2769127 TI - An epidemic of Pseudomonas cepacia bacteraemia in Ramathibodi Hospital. AB - An outbreak of P. cepacia bacteraemia involving 16 patients in Ramathibodi hospital from February to May 1988 was reported. The sources of infection were contaminated intravenous succinyl choline and metaraminol used by anaesthetists. Multiple dose preparations of the drugs were used. The drugs were prepared in bulk in an unhygienic room. Contamination occurred during or after the preparation. The outbreak was terminated by the improvement of hygiene in the anaesthetic preparation room, and the discontinuation of multiple-dose drugs. PMID- 2769128 TI - Bacterial contamination of re-usable and disposable syringes and needles. AB - Re-usable glass and disposable plastic syringes and needles were tested for their sterility. Ninety-one re-usable glass, 111 disposable plastic syringes, 105 re usable and 91 disposable needles were determined for microbial contamination by direct method using soy-bean-casein digest and fluid thioglycolate media. The positive results were 2.2 per cent (2/91), 0.9 per cent (1/111), 2.9 per cent (3/105) and 3.3 per cent (3/91) for re-usable and disposable syringes and needles, respectively. It is concluded that there is no difference in the rates of contamination of re-usable and disposable items. PMID- 2769129 TI - A model for testing antiseptic efficacy: a preliminary study on Betadine and Germidine. AB - Efficacy of povidone iodine antiseptic, betadine and germidine, was tested against normal skin flora and four pathogenic bacteria namely S. aureus, S. epidermidis, E. coli and Pseudomonas aeruginosa by a new model. The study was performed on the volar surface of forearms of ten patients. First of all, the skin flora was cultured then 10(8) cu/ml of the tested organisms was applied by a cotton swab and left to dry for 1 minute before the culture was repeated. Betadine or germidine was applied over the area previously painted with the organism. The culture was taken 1 to 2 minutes thereafter. The results showed that this model was feasible and convenient. Betadine and germidine are efficacious against normal skin flora and pathogenic bacteria. PMID- 2769130 TI - Patients colonized by antibiotic resistant bacteria--a potential source of infections in the medical wards. AB - Bacterial colonization was studied in 12 non-infected female patients admitted into one medical ward, Siriraj hospital, Bangkok, from March to June 1988. Swabs were taken on the first day of admission, then every other day until discharge, from six sites; i.e. anterior nares, vault of axilla, hands, anterior chest, abdomen and toe web. The times and total number of swabbing were 52 and 312 respectively. All patients were colonized with bacteria. S. epidermidis was found in all patients. S. aureus was found in 9 patients, 48 times (15.4%). Methicillin resistant S. aureus (M.R.S.A.) was identified in 4 patients on 10 occasions (3.2%). Gram-negative bacilli were isolated in 11 of 12 patients, and the number of positive samples was 60 (19.2%). All bacteria were highly resistant to the commonly used antimicrobials. The study failed to show that colonization increased with the duration of hospitalization. It is concluded that the majority of patients who had been colonized with pathogenic bacteria were important sources of infections in the medical ward. PMID- 2769131 TI - Comparison of effects of alcohol, chlorhexidine cream, and iodophore cream on venous catheter-associated infections. AB - The effects of alcohol, chlorhexidine cream and iodophor cream on the infectious complications associated with intravenous catheters were studied. One hundred and fifty patients were randomly allocated into each antiseptic group. Daily cleansing and disinfecting the cut down wounds were done with the above antiseptics. Minor surgical wound infections were found in one patient in the alcohol and iodophor group compared to five in the chlorhexidine group. Phlebitis complicated four patients, two in the iodophor group and one in each of the remaining groups. Only one patient in the chlorhexidine group had septicaemia due to A. antitratus. Thirty-four catheter tips (22.7%) yielded bacteria on culture. Incidence of positive tip cultures was significantly higher in the chlorhexidine group than in the other two. The rates of positive tip cultures correlated with duration of catheterization. It is concluded that alcohol is the antiseptic of choice for cut down wounds. Application of antiseptic cream to the wounds was less effective than alcohol and this practice should be discouraged. PMID- 2769132 TI - The control of nosocomial infections in Thailand in the future. PMID- 2769133 TI - Sterilization and disinfection. AB - Sterilization and disinfectant are the most important measures to control nosocomial infections. Their indications and instructions must be followed strictly to ensure efficacy. However, other measures should not be neglected. They include proper hospital planning, aseptic techniques, antimicrobial treatment, surveillance, guidelines for various procedure, and education of health personnel. PMID- 2769134 TI - Symposium: policy and implementation of nosocomial infection control. PMID- 2769135 TI - Antibiotic policy. The Hospital Infection Control Group of Thailand. PMID- 2769136 TI - Isolation policy. The Hospital Infection Control Group of Thailand. PMID- 2769137 TI - Guidelines on administration of intravenous (i.v.) fluids. The Hospital Infection Control Group of Thailand. PMID- 2769139 TI - Guidelines on tracheostomy. The Hospital Infection Control Group of Thailand. PMID- 2769138 TI - Guidelines on urethral catheterization. The Hospital Infection Control Group of Thailand. PMID- 2769140 TI - Guidelines for the prevention of nosocomial pneumonia. The Hospital Infection Control Group of Thailand. PMID- 2769141 TI - Guidelines for the prevention of surgical wound infections. The Hospital Infection Control Group of Thailand. PMID- 2769142 TI - High voltage electron microscopic studies on mitral, tufted, and granule cells in the mouse olfactory bulb. AB - High-voltage electron microscopic observations have been performed on intraglomerular dendritic branches of mitral and tufted cells and spines of granule cells in the Golgi-impregnated mouse olfactory bulb. The observations revealed that intraglomerular tufts of mitral and tufted cells have a very similar structure consisting of four morphologically distinct parts: (i) thick, smoothly outlined proximal parts; (ii) relatively thick varicose parts; (iii) very thin varicose parts, which form terminal branches; and (iv) spine-like small appendages. Granule cell spines in the external plexiform and mitral body layer have terminal swellings of various shapes and sizes, whose width is between 0.4 and 1.5 microns. Spines in the granule cell layer usually have swellings smaller than 0.4 micron in width. In addition, the density of spines per proximal 10 microns length of a deep dendritic trunk was estimated in 10 granule cells and proved to vary greatly from cell to cell--from 7 to 28 spines. PMID- 2769143 TI - Visualization and identification of cytoskeletal filaments in embryonic chick heart by the quick-freeze deep-etch method combined with immunocytochemistry. AB - Cytoskeletal filaments in myocardial cells of chick embryo (stage 18-20, day 3) were studied by immunocytochemical and rapid-freeze deep-etch methods. A three dimensional network of cytoplasmic filaments surrounding nascent myofibrils was visualized in saponin-treated myocardial cells. The major part of the network was composed of 12 to 14 nm filaments in platinum replicas. To identify the filaments, the myocardial cells were permeabilized with Triton X-100 and treated with myosin subfragment-1 (S1) for actin or immunogold-labeled antibody for desmin. A large number of filaments in myofibrils and a few cytoplasmic filaments were decorated with S1. A loose network surrounding the myofibrils was not decorated with S1 but with gold particles. This finding means that the majority of filaments occupying the interfibrillar space were desmin-containing filaments. PMID- 2769144 TI - Two- and three-dimensional ultrastructure of endothelium and pericyte interdigitations in capillary of human granulation tissue. AB - Two- and three-dimensional electron microscopic observation in the immature capillary of the human granulation tissue revealed cytoplasmic interdigitations (CID) between the endothelium and the pericyte. These were composed of a cytoplasmic projection and indentation, and there was a gap space without basement membrane-like components between the two cell membranes. Plasmalemmal vesicles were frequently found locating beneath and/or attached to the cell membranes at the indentated side of the interdigitation. Two kinds of cytoplasmic interdigitation, each having a characteristic configuration, were demonstrated. The CID which was composed of a cytoplasmic projection from the endothelium to the pericyte had a dull-shaped cytoplasmic projection, while the CID which was composed of a cytoplasmic projection from the pericyte to the endothelium had a slender and long finger-like configuration. PMID- 2769145 TI - Exocytosis of bovine chromaffin granules in Ficoll captured by rapid freezing. AB - Exocytosis of cultured bovine adrenal chromaffin cells was examined in a balanced salt solution containing Ficoll using rapid freezing followed by freeze substitution. In solution without Ficoll, exposure to Ba2+ produced many exocytotic lumina between the cells; in most cases, these lumina were large and empty. When chromaffin cells were exposed to Ba2+ in Ficoll, it was possible to observe a small pore between the plasmalemma and each granule. The granule retained the dense contents when the pore was approximately 20 nm in diameter, and became empty when the pore was widened in 14% Ficoll. The addition of Ficoll made it easy to catch the events occurring during exocytosis of individual bovine chromaffin granules. PMID- 2769146 TI - In utero changes of the plasma membrane in the head region of the rat spermatozoa. AB - The plasma membrane of the head of the rat spermatozoa was observed by deep-etch, surface replica, and freeze-fracture methods. The spermatozoa were from three experiments: 1) incubation in Hepes buffer, 2) natural coition, and 3) insemination. The spermatozoa used for experiments 1) and 3) were obtained from the ductus deferens. No change in ultrastructure was observed in the incubation experiment. Randomly oriented rows of particles were observed on the plasma membrane of the ejaculated spermatozoa in the deep-etch replicas. The surface replicas showed a similar structure on the plasma membrane. The surface of the inseminated spermatozoa was smooth. This study shows that the plasma membrane changes in the uterus. PMID- 2769147 TI - Scanning electron microscopic study of the red pulp of ferret spleen. AB - Scanning electron microscopy of the red pulp of ferret spleen showed areas of relatively wide splenic cord and rather poorly developed splenic sinuses of two different types. The inner aspect of most sinuses was covered with rod-shaped cells running in the longitudinal direction of the sinus. Stomata of these sinuses were recognized between the rod-like cells in a relatively regular lattice-like arrangement. The lining of other sinuses showed characteristics of the poorly differentiated sinuses, having a remarkable irregularity in form, size, and distribution of the lining cells and the stomata. The outer surface of the splenic sinuses was covered with attenuated reticular cell processes supporting the sinus. Sheathed capillaries which have a well-developed sheath structure were frequently found in the cordal area. Cordal capillaries were exclusively open into labyrinthine reticular tissue space of the cord with a funnel-shaped or a perforated saccular or ampullar terminal. PMID- 2769148 TI - Scanning electron microscopic study of periendothelial cells of the rat cerebral vessels revealed by a combined method of corrosion casting and KOH digestion. AB - A combined method of corrosion casting and KOH digestion was used for the scanning electron microscopic (SEM) observation of the external walls of the blood vessels running on the surface and in the parenchyma of the rat cerebral cortex. The plastic resin which was preliminarily injected into the cerebral vessels reinforced the preservation of the vessel walls during the chemical digestion. Using the present method, the walls of blood vessels running on the surface and in the parenchyma of the cerebral cortex were clearly seen with SEM. The arterioles showed a rich arrangement of smooth muscle cells embracing the external surface of the endothelia, and the venules had sparse, flat smooth muscle cells. The capillaries were surrounded by many pericytes which were extremely similar to those seen in the other organs of the animals. There were observed two different kinds of pericyte. One type of the pericytes in the present specimens extended very long cytoplasmic processes parallel to the long axis of the capillaries. Another type of the pericytes had relatively short, broad and flat cytoplasmic processes radiated to embrace the capillary walls. The former was frequently seen in the capillaries on brain surface and in the parenchyma, whereas the latter was relatively rare. The availability of the present method was also discussed in comparison with the previous descriptions. PMID- 2769149 TI - Neurotransmitters and lymphatic-vascular transfer of prostaglandin F2 alpha stimulate ovarian oxytocin output in sheep. AB - The mechanisms of lymphatic-vascular transfer across the ovarian vascular pedicle were studied in anaesthetized sheep 8-15 days after ovulation. [3H]Prostaglandin F2 alpha (PGF2 alpha), [14C]mannitol and [36Cl]Na were infused continuously into either a uterine lymphatic or a uterine vein and the kinetics of transfer into the adjacent utero-ovarian vein or ovarian plasma were studied. Transfer occurred according to the sequence [36Cl] greater than [14C] greater than [3H] indicating that PGF2 alpha is not transferred by rapid diffusion, as with [36Cl]Na, nor by a paracellular route, as with [14C]mannitol, but by a slower process probably involving facilitated diffusion. Transfer into the adjacent utero-ovarian vein or ovarian blood was greater when compounds were infused into a uterine lymphatic than into a uterine vein. Substantially more [3H]PGF2 alpha occurred in the adjacent corpus luteum than either of the other compounds after a lymphatic infusion. Intra-lymphatic infusion of PGF2 alpha stimulated the release of ovarian oxytocin but the effect was not confined to the adjacent ovary. Intravenous (jugular) infusion of PGF2 alpha failed to stimulate ovarian oxytocin secretion whereas close-arterial infusion into the ovaries was effective, and the possibility was investigated that any systemic effect of PGF2 alpha was mediated through neural mechanisms. Noradrenaline and acetylcholine were both effective in causing the release of ovarian oxytocin when infused close-arterially into the ovary. With infusions of acetylcholine, ovarian oxytocin secretion rate was increased over fivefold without any change in posterior pituitary release. Noradrenaline and acetylcholine produced a concomitant fall in ovarian blood flow, and neurotransmitter-induced ischaemia may have played a role in ovarian oxytocin release. The finding that PGF2 alpha infused into a uterine lymphatic stimulates ovarian secretion of oxytocin, and that the effect is bilateral whereas PGF2 alpha accumulation in ovarian tissue is unilateral, implies that its mechanism of action may not be solely directed at the luteal cell. PMID- 2769150 TI - Differential regulation by thyroid hormones of myosin heavy chain alpha and beta mRNAs in the rat ventricular myocardium. AB - The effect of tri-iodothyronine (T3) treatment on myocardial levels of alpha and beta myosin heavy chain (MHC) mRNAs in the rat was defined in vivo and in vitro. Dose-response experiments were performed in intact hypothyroid and euthyroid rats; in addition, studies in vitro examined the effect of T3 on MHC mRNAs in neonatal cardiac myocytes in primary culture. Specific alpha and beta MHC mRNAs were determined by Northern blot and dot hybridization to oligonucleotide probes complementary to the 3' untranslated regions of the MHC genes. An increase in myocardial beta MHC mRNA was demonstrated in hypothyroidism, accompanied by a reduction in alpha MHC mRNA. Marked differences in the sensitivity of alpha and beta MHC mRNAs to T3 replacement were found; a dose-dependent increase in alpha mRNA was evident at 6 h after T3 treatment, in the absence of consistent effects on beta mRNA, whereas 72 h after T3 replacement was commenced, stimulatory effects of T3 on alpha MHC mRNA, evident at all doses, were accompanied by a dose dependent inhibition of beta MHC mRNA. No effect of thyroid status on actin mRNA was found, indicating the specificity of MHC gene regulation. T3 treatment of cardiac myocytes in vitro exerted similar actions on MHC mRNAs to those found in vivo, with a more marked influence on alpha than beta MHC mRNA. These studies of the action of T3 in vivo and in vitro have thus demonstrated specific effects of T3 on pretranslational regulation of the alpha and beta MHC genes, influences which differ not only in terms of stimulation or inhibition, but also in magnitude of effect. PMID- 2769151 TI - Cross-reaction of eye muscle antibodies with thyroid tissue in thyroid-associated ophthalmopathy. AB - The nature of the association of ophthalmopathy with autoimmune thyroid disease is not understood. Serum autoantibodies to eye muscle have previously been identified and in this study we have explored the hypothesis that there may be shared antigenic determinants between orbital and thyroid tissues. Sera were obtained from patients in whom eye muscle antibodies (EMAb) had been detected by an enzyme-linked immunosorbent assay (ELISA); the sera were preincubated with membrane preparations of thyroid or eye muscle, hepatic membranes being used as control. Tissue-binding antibodies were removed from serum by centrifugation and the supernatant serum was analysed using an indirect ELISA and by immunoblotting. In the ELISA, all sera gave a positive response for EMAb. In one serum, the binding was entirely non-specific. All sera showed significant neutralization of EMAb by eye muscle. In six sera there was reduction of EMAb after exposure to thyroidal antigens, indicative of cross-reaction. Western blotting confirmed the non-specific nature of the binding in one serum. In five of the remaining nine sera, protein bands were identified which interacted specifically with eye muscle and, in two of these, the same determinants were neutralized by preincubation with thyroid tissue. The Western blots confirmed the findings in the ELISA. The determinants recognized by IgG were variable between patients and no common antigen could be identified. This study demonstrates that, in some cases of thyroid-associated ophthalmopathy, there is cross-reaction of EMAb with thyroidal antigens, but this is variable and not found in every case. This may explain the association of the disease with autoimmune thyroid disease, at least in some cases. PMID- 2769152 TI - Peripheral metabolism of [35S]parathyroid hormone in vivo: influence of alterations in calcium availability and parathyroid status. AB - Parathyroid hormone (PTH) is rapidly metabolized, mainly by liver and kidney, to smaller fragments that are believed to be biologically inactive. The significance of this peripheral metabolism in the overall actions of PTH is unclear. Generation of circulating biologically active amino-terminal PTH fragments during metabolism in vivo has been suggested by certain observations in vitro, and what are believed to be amino-terminal fragments may be detectable in blood under pathological circumstances in vivo (such as renal failure and coexistent hyperparathyroidism) when highly sensitive assays are employed. We recently reported, however, that administration to normal rats of [35S]bovine PTH ([35S]bPTH) directly labelled at amino-terminal methionines, followed by high resolution chromatographic analysis of extracted [35S]peptides, does not result in appearance of radioactive amino-terminal fragments in blood, even when the tracer is continuously infused to near-physiological plasma concentrations. We have now employed these techniques to address a second question regarding hormonal metabolism: is hormonal metabolism modified during metabolic perturbations such as changing calcium availability or altered levels of calciotrophic hormones? Metabolism of [35S-Met]bPTH (900 Ci/mmol), either alone or together with [3H-Pro]bPTH, however, did not lead to alterations in the rate of hormonal clearance nor to detectable circulating amino-terminal fragments, either in calcium-deprived or thyroparathyroidectomized rats or when animals were first rendered intoxicated with vitamin D or maintained on a high calcium intake. Likewise, tissue localization and specific cleavage patterns of intact hormone in liver or kidney were all unaltered by these various manoeuvres.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2769153 TI - Regulation of the onset of the breeding season of the ewe: importance of long days and of an endogenous reproductive rhythm. AB - Three experiments were conducted to evaluate the role that the increasing day lengths of late winter and spring play in timing the breeding season of the Suffolk ewe. In the first experiment, ewes were denied their normal complement of increasing day length by maintaining them on the photoperiod experienced at the winter solstice. This prevented the breeding season from occurring the subsequent autumn. In the second experiment, ewes were exposed to increases in day length at different time-intervals after the winter solstice: the normal time, later than normal or earlier than normal. Once the summer solstice photoperiod was reached, it was maintained until the end of the study. When increasing photoperiod was provided early, the breeding season was advanced; when it was provided late, reproduction was delayed. In the third experiment, ewes were exposed to a continuously increasing photoperiod matching the maximal rate of rise in natural conditions; this treatment was begun on the spring equinox and continued until mid-autumn. The steadily increasing photoperiod did not alter the time of reproductive onset in the autumn. These findings support the following conclusions for timing of the breeding season of the Suffolk ewe. (1) The lengthening photoperiod between the winter and summer solstices is required for the occurrence of the breeding season in the autumn. (2) The time of initial exposure to this lengthening photoperiod provides an important cue for determining when the reproductive period occurs. (3) The time of onset of the breeding season does not depend upon the decreasing photoperiod after the summer solstice, nor does it require the photoperiod to stop increasing as the summer solstice approaches. These findings have been incorporated into a conceptual model for temporal regulation of the annual reproductive cycle of the ewe. An important component of this model is a critical role for increasing photoperiod to initiate a process in the late winter-spring which ultimately leads to an obligatory reproductive onset in the autumn. PMID- 2769154 TI - Cellular basis of luteal steroidogenesis in the human ovary. AB - A primary monolayer cell culture system was developed to investigate human corpus luteum (CL) function in vitro. Steroidogenic cells were isolated by collagenase dispersal and Percoll density-gradient fractionation from CLs enucleated at progressive stages of the luteal phase (tubal surgery patients). 'Pure' granulosa lutein cells were aspirated from ovulatory follicles at mid-cycle (in-vitro fertilization patients). The steroidogenic capacity (progesterone/20 alpha dihydroprogesterone biosynthesis and aromatase activity) of isolated luteal cells was assessed in relation to CL development. Basal luteal cell steroidogenesis was maximal at around the expected time of ovulation and declined with CL age during the luteal phase. Conversely, human chorionic gonadotrophin (hCG)-responsive steroidogenesis was initially undetectable but developed as the luteal phase progressed. These results show that luteal cell steroidogenesis becomes increasingly dependent upon gonadotrophic support with CL age. This is evidence that functional luteolysis in human ovaries (1) is pre-programmed to occur at the cellular level, (2) is initiated automatically at the time of ovulation and (3) is reversed at the time of CL 'rescue' in early pregnancy by the direct action of trophoblastic hCG on steroidogenic luteal cells. The culture system described should be of value in further defining the control of human CL form and function at the cellular level. PMID- 2769155 TI - Post-translational processing of oxytocin-neurophysin prohormone in the ovine corpus luteum: activity of peptidyl glycine alpha-amidating mono-oxygenase and concentrations of its cofactor, ascorbic acid. AB - Peptidyl glycine alpha-amidating mono-oxygenase (PGA), the terminal enzyme in the pathway of oxytocin synthesis, was measured in extracts of ovine corpora lutea throughout the oestrous cycle. Activity of PGA was low early in the cycle but increased between days 2 and 10 (from 2.3 to 9.0 pmol/mg protein per h) and remained high until day 15. Thereafter, activity declined rapidly at structural luteolysis and was low in corpora albicantia collected 18 and 20 days after ovulation (1.28 and 1.07 pmol/mg protein per h respectively). Luteal concentrations of ascorbic acid, a cofactor for PGA, were high (4.7 mumol/g wet wt tissue) by day 4 after oestrus; concentrations fell rapidly after day 15 (to 2.1 mumol/g on day 16). Concentrations of ascorbic acid were also high in the pituitary gland and in the adrenal medulla and cortex. Concentrations of oxytocin in luteal tissue, which were low (0.3 nmol/g wet wt) on day 2 after oestrus, were highest (2.73 nmol/g) on day 6 and declined thereafter (0.56 nmol/g on day 10, 0.08 nmol/g on day 15 and not detectable on days 18 and 20). Concentrations of oxytocin, progesterone, PGA and protein were measured in subcellular fractions obtained after density gradient centrifugation of extracts of corpora lutea collected on days 6, 7 and 12 of the oestrous cycle, and on day 7 from an anaesthetized ewe before and after treatment with the prostaglandin F2 alpha analogue, cloprostenol. PGA colocalized with particle-associated oxytocin in fractions of density 1.049-1.054 g/ml. Exogenous [3H]oxytocin and [3H]progesterone and endogenous progesterone localized in fractions of density 1.035 g/ml. Oxytocin and PGA were depleted from fractions of density 1.049-1.054 g/ml following cloprostenol treatment in vivo. Fractionation of extracts of ovine corpora lutea by high-performance liquid chromatography (HPLC) followed by radioimmunoassay and radioreceptor assay for oxytocin demonstrated the presence of at least two cross-reacting substances with elution characteristics distinct from oxytocin. Concentrations of these peptides increased as the cycle progressed. These compounds differed from the putative C-terminally extended post translational processing intermediates, oxytocinyl-glycine, oxytocinyl-glycine lysine and oxytocinyl-glycine-lysine-arginine, as indicated by their elution positions on HPLC and the specificities of the assays used to detect them, and no conclusions could be drawn on which post-translational processing step was rate limiting in oxytocin synthesis. These data are consistent with the suggestion that post-translational processing of oxytocin-neurophysin prohormone takes place in secretory granules in luteal cells.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2769156 TI - Dynamics of testosterone secretion by the rat testis: implications for measurement of the intratesticular levels of testosterone. AB - Testosterone concentrations have been measured in testicular interstitial fluid (IF), and in blood plasma sampled from various parts of the rat testis and spermatic cord, to assess (1) the most accurate method for determination of the intratesticular levels of testosterone, and (2) the route of secretion of testosterone from the testis. In untreated adult rats, testosterone concentrations were highest in blood collected from veins on the surface of the testis (269.50 +/- 30.63 (S.E.M.) nmol/l), but were reduced by 56% on average in blood collected from veins at the proximal end of the spermatic cord (123.06 +/- 24.75 nmol/l), and were reduced considerably in peripheral venous blood (4.55 +/- 0.55 nmol/l). Similar changes occurred in adult rats in which steroidogenesis was either stimulated (by treatment with human chorionic gonadotrophin; hCG) or inhibited (by treatment with aminoglutethimide; AMG), and in rats of various ages during sexual maturation. The reduction in testosterone levels during passage of blood from the testis up the spermatic cord is probably due mainly to dilution by incoming arterial blood which transfers to venous blood via anastomoses in the spermatic cord. Venous-arterial transfer of testosterone in the cord contributed to this in only a minor way. Concentrations of testosterone in testicular IF were always greater than testicular venous concentrations in control, developing and hCG-stimulated rats, but were comparable in rats treated with AMG to suppress Leydig cell steroidogenesis. These and other results demonstrate that the method of drip-collection of IF results in over-estimation of the actual intratesticular levels of testosterone.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2769157 TI - The inter-relationships between ovarian-independent growth, tumorigenicity, invasiveness and antioestrogen resistance in the malignant progression of human breast cancer. AB - Among the processes contributing to the progressive acquisition of the highly malignant phenotype in breast cancer are ovarian-independent growth, antioestrogen resistance and increased metastatic potential. We have previously observed that increased invasiveness and development of ovarian-independent growth occur independently. In an attempt to define the inter-relationships between these processes further, we have compared the phenotypes of ovarian independent, invasive and antioestrogen-resistant sublines of the ovarian dependent human breast cancer cell line MCF-7. Cells acquiring ovarian independent growth can retain sensitivity to anti-oestrogens. One clone of MCF-7 cells selected for stable antioestrogen resistance has become non-tumorigenic but its invasive potential remains unaltered. Thus, acquisition of some characteristics of the progressed phenotype can occur independently. This phenomenon of independent parameters in phenotypic progression could partly explain the considerable intra- and intertumour heterogeneity characteristic of breast tumours. PMID- 2769158 TI - Endocrine regulation of cytochrome P-450 in the rat brain and pituitary gland. AB - In an effort to understand the physiological functions of cytochrome P-450 in the central nervous system and pituitary gland, we evaluated changes in the level of the enzyme as a function of the endocrine status of rats and the ability of these tissues to synthesize or degrade steroids. The P-450 content of microsomes prepared from the hypothalamic preoptic area (HPOA), the olfactory lobes and the cerebrum was 0.040 +/- 0.009 and in the pituitary gland 2.2 +/- 0.6 (S.D.) nmol/g tissue. The P-450 content of the HPOA and olfactory lobes, but not of the rest of the cerebrum, was influenced by the endocrine status of rats. In microsomes it increased five- to tenfold over control levels during late pregnancy in the olfactory lobes and during lactation in the HPOA, and in both brain regions treatment of rats with 5 alpha-dihydrotestosterone (DHT) caused an eight- to tenfold increase in the P-450 content. Androstenedione was not a good substrate for brain P-450. The level of androstenedione 19-hydroxylase in the olfactory lobe microsomal fraction was 0.50 +/- 0.06 nmol 19-hydroxyandrostenedione formed/g tissue per h. This activity was tenfold lower in other brain areas and was not detectable in the pituitary gland. The rate of aromatization of androstenedione to oestradiol in the HPOA and olfactory lobe of lactating rats was 0.46 +/- 0.14 and 0.38 +/- 0.05 pmol/oestradiol formed/g tissue per h respectively. 5 alpha-Androstane-3 beta,17 beta-diol (A-5 alpha-3 beta,17 beta diol) was a much better substrate for P-450 throughout the brain and pituitary gland.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2769159 TI - The use of cells doubly labelled with [14C]inositol and [3H]inositol to search for a hormone-sensitive inositol lipid pool with atypically rapid metabolic turnover. AB - Some, though not all, previous studies have suggested that the inositol lipid which is hydrolysed during transmembrane signalling in response to receptor activation might be drawn from a metabolically discrete and relatively small hormone-sensitive lipid pool that turns over more rapidly than the bulk of membrane inositol lipid. In order to seek evidence for the existence of this putative hormone-sensitive lipid pool, we have double-labelled cells by growing them for 3 days in a medium containing [14C]inositol and then supplying them with [3H]inositol for the final 2 h before stimulation. We anticipated that stimulation of these doubly labelled cells might provoke the formation, from the postulated hormone-sensitive pool, of small quantities of relatively 3H-enriched inositol phosphates, and that these could be harvested from cells (provided that the cytosolic inositol monophosphatase and inositol 1,4-bisphosphate/inositol 1,3,4-trisphosphate 1-phosphatase activities are first inhibited by Li+). Experiments of this type, using both vasopressin-stimulated WRK1 rat mammary tumour cells and 3T3 mouse fibroblasts stimulated by prostaglandin F2 alpha, have largely failed to demonstrate the formation of relatively 3H-enriched inositol phosphates. There was a tendency for phosphatidyl-inositol 4-phosphate and phosphatidylinositol 4,5-bisphosphate to have slightly higher 3H: 14C ratios than phosphatidylinositol, but the 3H: 14C ratios of the inositol phosphates formed in stimulated cells were not substantially greater than the 3H: 14C ratios of the inositol lipids. We therefore conclude, at least for the two cell lines that we studied, that hormone-stimulated inositol lipid hydrolysis can call, either directly or indirectly, upon the majority of the inositol lipid complement of the stimulated cell. PMID- 2769160 TI - Cytosolic free calcium oscillates in single bovine adrenal glomerulosa cells in response to angiotensin II stimulation. AB - The characteristics of the change in cytosolic free Ca2+ concentration ([Ca2+]i) in response to agonist stimulation were studied in individual cells of the bovine adrenal zona glomerulosa. Following digestion and dispersion, the cells were loaded with the fluorescent Ca2+ indicator fura-2. The cells adhered to Concanavalin A-coated coverslips and were studied using dual excitation wavelength microfluorimetry. In this procedure individual cells under constant perfusion are visualized by microscopy and excited with light alternating rapidly between 340 and 380 nm. The ratio of fluorescence (F) emitted from the cell (F340/F380) correlates directly with [Ca2+]i. Continuous stimulation with angiotensin II (AII; 10 nmol/l) resulted in a brisk transient rise in [Ca2+]i within 8 s of application of the stimulus. In 50% of cells studied, this initial peak was followed by a series of oscillations in [Ca2+]i lasting up to 13 min, with an average period of 33.0 +/- 5.9 (S.E.M.) seconds. [Ca2+]i did not return to prestimulation levels and, subsequent to the oscillatory phase, the [Ca2+]i remained increased for several minutes. Upon removal of extracellular Ca2+ the oscillations ceased almost immediately although [Ca2+]i remained increased. However, in Ca2+-free medium, a single peak of [Ca2+]i still occurred in response to AII. Cells remained refractory to restimulation over a 15-min period. In contrast, stimulation with K+ (8 mmol/l) rapidly increased [Ca2+]i to a level similar to that induced by AII but without inducing oscillations. Moreover, the effect lasted only while K+ was present and was highly reproducible over multiple stimulations during a 15-min period. These results corroborate, at the single cell level, the known action of AII of causing release of intracellular Ca2+, but reveal a more complex mechanism of action on Ca2+ influx than previously recognized, possibly invoking a role for a putative second messenger-operated membrane Ca2+ channel. PMID- 2769161 TI - Glucocorticoid regulation of human growth hormone expression in transgenic mice and transiently transfected cells. AB - A mouse metallothionein-I/human growth hormone fusion gene was microinjected into fertilized mouse eggs, the embryos were implanted into pseudopregnant foster mothers, and the offspring analysed. Five of twenty-six mice born after one series of injections contained from one to eight copies of the fusion gene stably integrated into their genomes and had human growth hormone in their serum. When several of these transgenic mice and transgenic offspring were treated with glucocorticoids, serum growth hormone levels were elevated from 1.5- to 6.3-fold. A fourfold induction in fusion gene mRNA in the liver of one of the five mice was also observed after treatment with glucocorticoids. When the fusion gene was transiently transfected into mouse L cells, dexamethasone caused a three- to fourfold induction of fusion gene mRNA and secreted human growth hormone. A deletion analysis of regulatory elements required for inducibility in L cells shows that DNA sequences responsible for the observed inductions are located within the transcribed region of the human growth hormone gene. However, a previously described glucocorticoid receptor binding site in the first intron of the gene is not required for response to the hormone. PMID- 2769162 TI - The role of hypothalamic vasoactive intestinal polypeptide in the maintenance of prolactin secretion in incubating bantam hens: observations using passive immunization, radioimmunoassay and immunohistochemistry. AB - The role of chicken vasoactive intestinal polypeptide (cVIP) as a prolactin releasing factor was investigated in incubating bantam hens. Specific antibodies were raised against cVIP (anti-cVIP) for passive immunization studies, to develop a radioimmunoassay and to localize VIP neurones immunohistochemically in the hypothalamus. The concentration of plasma prolactin decreased after i.v. injection of anti-cVIP: this low concentration being maintained by daily injection of anti-cVIP. Incubating hens injected daily with anti-cVIP deserted their nests after 4.5 +/- 0.6 days and returned to lay after 20 +/- 1 days. This disruption of incubation behaviour with anti-cVIP was prevented by concomitant, twice daily, injections of 30 IU ovine prolactin. The concentration of plasma LH was not immediately affected after injection of anti-cVIP but increased when the hens deserted their nests. The amount of cVIP, measured by radioimmunoassay, was significantly higher in the median eminence (P less than 0.01) and medial basal hypothalamus (P = 0.05) in incubating than in laying hens. No differences were seen in the amounts of cVIP in the preoptic hypothalamus or in a part of the forebrain including the nucleus accumbens, between laying and incubating hens. Morphological observations were made on immunohistochemically identified cVIP cell bodies in the medial basal hypothalamus. These showed that cVIP cell number, cell area and density of immunoreactive product were significantly (P less than 0.05) greater in incubating than in laying hens. Further, the density of cVIP reaction product in the anterior median eminence was also significantly (P less than 0.01) greater in incubating than in laying hens.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2769163 TI - Demonstration of growth hormone receptors in cultured rat epiphyseal chondrocytes by specific binding of growth hormone and immunohistochemistry. AB - Growth hormone has been reported to exert direct effects on rat and rabbit epiphyseal chondrocytes in vitro, indicating that GH interacts with specific receptors on these cells. To investigate this possibility, binding of GH to cultured rat epiphyseal chondrocytes was studied under various experimental conditions. Chondrocytes were isolated enzymatically from epiphyseal growth plates of the proximal tibia of 20-day-old male rats and were cultured in monolayer in Ham's F-12 medium supplemented with 10% calf serum and 1% of a serum substitute. The cells were seeded at various densities (25,000-200,000 cells/well) and cultured for 5-16 days. Twenty-four hours before binding experiments, the medium containing calf serum was changed for one containing serum obtained from hypophysectomized rats, in order to avoid binding of GH present in the calf serum. Binding was studied by incubating 125I-labelled human GH (hGH) with the cells in the presence or absence of various concentrations of unlabelled hGH, bovine GH (bGH), rat GH (rGH) and ovine prolactin (oPRL). Specific binding could be demonstrated in cells cultured for 5-16 days. Binding was dependent upon time and temperature, and maximal binding was obtained by incubating the labelled hormone for 4-6 h at 24 degrees C. An increase in binding was noted between 7 and 12 days in culture. In cells cultured for 12 days, addition of unlabelled hGH, bGH or rGH caused a dose-dependent displacement of 125I-labelled hGH, whereas oPRL was ineffective. Scatchard analysis resulted in a linear plot, and the number of binding sites/cell was approximately 5700, with a dissociation constant of 0.46 nmol/l.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2769164 TI - Inhibition of neonatal rat growth and circulating concentrations of insulin-like growth factor-I using an antiserum to rat growth hormone. AB - Treatment of rats for 24 h on day 2, 10 or 20 of age with a specific antiserum to rGH (anti-(rGH], GH, bromocriptine (CB-154) or prolactin failed to influence body weight gain or serum concentrations of insulin-like growth factor-I (IGF-I). On day 28 of age, however, anti-(rGH) completely inhibited body weight gain and markedly reduced circulating IGF-I concentrations, effects which were completely prevented by exogenous ovine GH (oGH). When administered to control rats on day 28 oGH caused supranormal weight gain and serum IGF-I concentrations. These results suggested that GH does not play a significant role in growth or regulation of serum IGF-I until after day 20 of age. By contrast, when anti-(rGH) was given for 4 consecutive days beginning on day 2 of life, body weight gain was reduced within 48 h and remained so until at least 28 days of age. Tail length was also significantly reduced. The effect was due to inhibition of GH effects since serum GH concentrations were low and exogenous GH prevented the effect. Inhibition of growth during the first 14 days of life occurred in the absence of any effect on serum IGF-I although by 21 days of age serum IGF-I was considerably lower than in control rats. The prolonged reduction in growth after treatment has stopped appeared to be due to a cytotoxic effect on the pituitary gland since pituitary weight and GH but not prolactin content were significantly decreased.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2769165 TI - Absence of circadian patterns of secretion of melatonin or cortisol in Weddell seals under continuous natural daylight. AB - Blood samples were obtained from adult female Weddell seals in McMurdo Sound, Antarctica, utilizing four different seals every 2 h for 24 h on two occasions in November 1987. Plasma levels of melatonin were mostly near zero, whereas the values for cortisol were high (2101 +/- 54 and 1908 +/- 108 (S.E.M.) nmol/l, n = 52). For both hormones there was no evidence of a diurnal pattern of secretion. Juvenile seals sampled in December 1985 also had no evidence of a diurnal secretion pattern of melatonin, but blood levels of melatonin were higher than in adults. The results indicate that secretion of melatonin in adult Weddell seals ceases during the Antarctic summer. PMID- 2769166 TI - Testes are asymmetric in the testicular hemicastration response of the male rat. AB - An enquiry was made into variability in the testicular hemicastration response of the mature rat (doubling of testicular vein testosterone concentration from the remaining testis 24 h after hemicastration). The response was shown to be asymmetric, being more reliable and more robust when the left testis was removed first. Apparently the testicular hemicastration response, which has been shown to be neurally controlled, shares the asymmetry which has been reported recently in the neural regulation of unilateral ovariectomy. PMID- 2769167 TI - Reduced responses of prolactin and catecholamine to stress in the lactating rat. AB - Prolactin, GH, TSH, adrenaline and noradrenaline responses to the stress of immobilization were compared between lactating and non-lactating dioestrous rats. The concentrations of GH in plasma were reduced to a similar degree by the immobilization of lactating and non-lactating rats, and TSH levels were unchanged in both groups. The increases in plasma concentrations of adrenaline and noradrenaline induced by stress were significantly smaller in lactating than in non-lactating rats. Immobilization caused a marked increase in prolactin levels in the plasma of non-lactating rats but no increase in lactating rats. These changes may help to save energy and maintain milk production during the period of lactation. PMID- 2769168 TI - Circadian rhythms of calcitonin gene expression in the rat. AB - The daily changes in rat thyroid calcitonin and its specific mRNA concentrations, and the relationship between their dynamics and the plasma levels of calcitonin, calcium and phosphate over a 24-h period were investigated. The circulating calcitonin concentration rose during the daily dark period when plasma calcium and phosphate levels were minimal, indicating that plasma calcitonin rhythm cannot be generated directly by a linear effect of calcium on hormone secretion. Moreover, we established that the expression of the calcitonin gene also exhibited periodic dynamics observable at the pretranslational level: the gland content of hybridizable specific calcitonin RNA displayed daily rhythms; specific RNA levels peaked during the light period and were minimal during the first part of the dark period. Significant changes in thyroid calcitonin concentrations also occurred over a 24-h period. Statistical analyses which distinguished between variations over the 24-h period and residual variations were performed to test the relationships between the various parameters. The daily rhythms of hybridizable RNA, thyroid calcitonin and plasma minerals appeared to be in phase, while the plasma calcitonin concentration displayed variations out of phase with these rhythms. The implication of the correlations observed on the residual variations is discussed in comparison with the temporal relationship between the daily variations. The results fit the hypothesis that hormone production and secretion are self-oscillating processes. Plasma concentrations of calcium and phosphate might play a role in the synchronization of the calcitonin metabolism periodicity. PMID- 2769169 TI - Melatonin specifically stimulates type-II thyroxine 5'-deiodination in brown adipose tissue of Syrian hamsters. AB - The response of type-II thyroxine 5'-deiodinase (5'-DII) to melatonin treatment was studied in the Syrian hamster. Male hamsters were treated for 15 days with a s.c. pellet containing melatonin, and 5'-DII activity in brown adipose tissue, anterior pituitary gland, Harderian gland and pineal gland was measured using a radioenzymatic technique. Melatonin-treated animals exhibited enhanced 5'-DII activity restricted to brown adipose tissue; the increase was threefold above the values measured in the control group. Serum concentrations of thyroid hormones were unaffected by melatonin treatment. We conclude that the stimulatory effect of melatonin on type-II thyroxine 5'-deiodination is specifically directed to the isoenzyme located in brown adipose tissue and is not accompanied by changes in serum thyroid hormones. PMID- 2769170 TI - Aromatase, 5 alpha- and 5 beta-reductase in brain, pituitary and skin of the sex role reversed Wilson's phalarope. AB - While intrasexual competition for mates is generally considered to be an androgen dependent characteristic of reproductively active males, in the Wilson's phalarope (Phalaropus tricolor) it is the female that acquires the brighter nuptial plumage and aggressively competes for access to the less aggressive males. Despite this pronounced sex-role reversal, circulating sex steroid hormones of breeding phalaropes are similar to those of avian species displaying traditional male-female reproductive roles. To investigate whether these behavioural and morphological steroid-dependent differences may be due to differences in target organ metabolism of circulating androgen, [3H]androstenedione in the presence of an NADPH-generating system was incubated with homogenates of brain, pituitary and skin of male and female Wilson's phalaropes collected from a naturally breeding population. Oestrone, 5 alpha androstanedione and 5 beta-androstanedione were measured as endpoints of aromatization, 5 alpha-reduction and 5 beta-reduction respectively. Aromatase activity in the anterior hypothalamus/preoptic area (AHPOA) and posterior hypothalamus was greater in breeding males with high circulating concentrations of testosterone than in females, and activity in the AHPOA was greater in breeding than in non-breeding males (with low circulating testosterone). Aromatase levels did not differ in septum, archistriatum, hyperstriatum or pituitary. 5 alpha- and 5 beta-reductase were detected in all neuroendocrine tissues sampled and although there were no significant male-female differences, 5 alpha-reductase was greater in the AHPOA of breeding than of nonbreeding males.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2769171 TI - The effects of knife cuts in the sub-paraventricular zone of the female rat hypothalamus on oestrogen-induced diurnal surges of plasma prolactin and LH, and circadian wheel-running activity. AB - To investigate the role of suprachiasmatic efferent connections in the expression of diurnal hormone rhythms, the efferent pathway from the suprachiasmatic nucleus (the putative circadian generator in the rat) to the subparaventricular zone (the main terminal area of suprachiasmatic efferents) was disrupted using bilateral horizontal knife cuts in ovariectomized oestrogen-treated rats. The position of the knife cut was assessed by observing its effect on vasoactive intestinal polypeptide immunoreactivity (a marker for suprachiasmatic efferents into the sub paraventricular zone). The size of both the diurnal plasma LH and prolactin surges was markedly and consistently reduced over the 3-week period following the lesion in animals with a total deafferentation of the subparaventricular zone, compared with sham-operated animals or lesioned animals with an intact subparaventricular zone. When lesioned animals were grouped according to the presence or absence of damage to the preoptic area, no significant differences were found in the sizes of the plasma hormone surges. When similar knife cuts were given to animals whose activity cycles were observed, no significant effects were noted in the ability of the animals to synchronize to a light/dark regime or to free-run in constant light conditions. These results suggest that the suprachiasmatic nucleus influences the diurnal surges of plasma LH and prolactin in oestrogen-treated ovariectomized rats, initially by an interaction with the subparaventricular zone and not by a direct influence on gonadotrophin-releasing hormone neurones or other more rostral structures. PMID- 2769172 TI - Conditional discrimination in mentally retarded adults: the effect of training the component simple discriminations. AB - Two subjects with retardation who exhibited generalized identity matching, but who had extensive histories of failure to acquire arbitrary matching, were exposed to a series of conditions designed to train separately the components of a two-choice conditional discrimination. First, the successive discrimination between the sample stimuli was established by programming a different schedule of reinforcement in the presence of each sample stimulus. Schedule performance was acquired and maintained by both subjects, but neither acquired arbitrary matching. To train the simultaneous discrimination between the comparison stimuli, 1 subject was then exposed to a series of simple discrimination reversals and subsequently failed to acquire arbitrary matching. Both subjects acquired arbitrary matching under a procedure that maintained both the sample and the comparison discrimination by first presenting entire sessions composed of one sample-comparison relation and then gradually reducing the number of consecutive trials with the same sample until sample presentation was randomized (schedule performance was maintained). Removal of the schedule requirement had no effect on arbitrary matching accuracy. Both subjects subsequently demonstrated control by relations symmetric to the trained relations. PMID- 2769173 TI - The effects of dietary phosphorus and parathyroid hormone (PTH) infusion rates on the avian phosphaturic response to PTH. AB - Experiments were performed to evaluate the effects of dietary available phosphorus (aP) and PTH infusion rates on avian urinary inorganic phosphate (Pi) excretion. In experiment I, female domestic fowl were fed diets containing low (0.45%) or high (0.83%) aP for 2-4 weeks prior to renal function studies. Pi excretion was significantly higher for birds fed the high-aP diet than for birds fed the low-aP diet. PTH was infused (60-240 units kg body mass-1 h-1) unilaterally into the renal portal system. Para-aminohippuric acid (PAH), included in the unilateral infusate as a marker for effective renal portal perfusion, indicated that PTH must have been delivered to the peritubular surfaces of the infused kidney. However, bilateral but not unilateral phosphaturia occurred, and there were no significant differences in the phosphaturic responses to PTH when low- and high-aP diet treatment groups were compared. In experiment II, PTH was infused at rates of 1-5 units h-1. Infusing PTH at 5 units h-1 caused a unilateral increase in urine flow but the phosphaturic response was still bilateral. It appears unlikely that unilateral renal portal PTH infusions can be used to trigger unilateral phosphaturia in domestic fowl. PMID- 2769174 TI - Primary ventricular fibrillation in acute myocardial infarction. AB - Primary ventricular fibrillation is an acute life-threatening event if not treated promptly. The ability to predict this event during the course of an acute myocardial infarction could therefore have an important impact on the mode of treatment and monitoring. In the present study, clinical and laboratory information available at the initial evaluation of patients with an acute myocardial infarction was tested for its ability to predict subsequent primary ventricular fibrillation. Multiple logistic regression analysis was employed to select the predictors. Serum potassium, serum creatinine and no smoking were significant predictors of subsequent ventricular fibrillation. Although the prediction was statistically significant, the clinical value of the prediction is quite limited. PMID- 2769175 TI - An evaluation of the accuracy of clinical diagnosis at admission in a population with epidemic meningococcal disease. AB - The accuracy (sensitivity and positive predictive value) of the clinical diagnosis given by the general practitioner before admission to hospital was evaluated retrospectively in a population with epidemic meningococcal disease. The study population consisted of approximately 32,000 subjects. In a 12-year period, 344 patients were discharged from hospital with CNS infections, 274 of whom were admitted with a diagnosis suspecting a CNS infection. A further 401 patients were admitted with suspicion for, but discharged without a CNS infection. Overall, the sensitivity was 79.7% and the positive predictive value was 40.6%. There were no significant changes in the accuracy during the study. The sensitivity differed significantly between the age groups (P less than 0.001) and was lowest among the adults (15+ years, 67.9%) and the 0-2-year-old children (72.7%). Also among the 0-2 year-olds, the positive predictive value was low (34.1%) and not significant, indicating that it was more difficult to obtain the correct clinical diagnosis in this group. PMID- 2769176 TI - Benzodiazepine poisoning: experience of 702 admissions to an intensive care unit during a 14-year period. AB - A retrospective study covering a 14-year period was carried out to estimate the incidence and assess the clinical features of benzodiazepine (BZD) poisoning. The annual contribution of BZDs to the total number of drug overdose cases admitted to an intensive care unit displayed an increasing trend over the period, and during the last years BZDs were involved in nearly one-third of all cases. Among the 702 cases of BZD overdosage, 144 had ingested BZD alone, 200 had poisoned themselves with BZD combined with alcohol and 358 had taken BZD with other miscellaneous drugs. In 56% of all the cases the patients had severe central nervous system depression on admission. In 47% orotracheal intubation was performed and in 18% artificial ventilation was administered. Complications were recorded in 69 of the 702 cases (9.8%) and five cases were fatal. These clinical features were essentially the same in the group that had overdosed with just BZD. In conclusion, patients with drug overdosage involving BZD have a low hospital mortality, but the acute somatic risk is not negligible. Moreover, they consume a substantial proportion of the resources in the emergency room and the intensive care unit. PMID- 2769177 TI - Global assessment of patients--a bedside study. I: The influence of physical findings on the global assessment. AB - Three physicians selected ten basic physical findings for a study of diagnostic decision making in the global assessment of patients. The physicians independently examined 201 hospital in-patients for the presence of each of the findings and concluded their assessment with a global evaluation of whether the patient appeared ill. Each of the ten findings were used by at least one of the physicians in his overall assessment of the patient. All the observers considered 'looking older than age', 'trouble with breathing', 'cyanosis', and 'anaemia' important, but disagreed in their use of the remaining findings (P less than 0.01). Agreement in the global clinical assessment is an essential prerequisite to uniformity in the approach to the patient. PMID- 2769178 TI - Coffee and tea consumption, dietary fat intake and serum cholesterol concentration of Finnish men and women. AB - The association between the consumption of coffee and tea and serum cholesterol concentration was studied in a population sample of 653 men and 695 women from east and south-west Finland. Cholesterol and high density lipoprotein (HDL) cholesterol were determined from fresh serum samples. Smoking and the intake of coffee, tea and alcohol were assessed by a questionnaire, and nutrient intake was determined from 3-day food records. Serum cholesterol and non-HDL cholesterol showed a positive and linear association with coffee consumption in men. In women, no such significant linear association was evident, although the highest mean serum cholesterol levels were found in subjects consuming seven to nine cups of coffee daily. Both in men and in women coffee consumption was positively associated with smoking and the intake of saturated and monounsaturated fatty acids and cholesterol. Serum cholesterol values, adjusted for age, body mass index, smoking, dietary cholesterol, fatty acids, alcohol and physical activity, showed a significant linear association with coffee consumption in men but not in women. Although coffee consumption and high intake of saturated fatty acids and cholesterol were related both in men and in women, adjustment for dietary and other confounding factors did not remove the association between coffee consumption and serum cholesterol concentration in men. PMID- 2769179 TI - Can villous atrophy be induced by chronic alcohol consumption? AB - A 43-year-old man presented with loose stools, abdominal pain and a weight loss of 15 kg. Investigations revealed a pancreatic insufficiency and an enteropathy with villous atrophy. Coeliaki was suspected. In spite of treatment with a gluten free diet in hospital the patient did not improve and the villous atrophy remained unchanged. Other causes than coeliaki to villous atrophy were ruled out. The patient had a heavy consumption of alcohol and after prolonged abstinence the patient gained weight, the pain disappeared and the stools were normalized. The jejunal biopsy was now normal. This case report raises the possibility that enteropathy and villous atrophy may be causally related to alcohol overconsumption. PMID- 2769180 TI - Clinical relevance of pedal pulse palpation in patients suspected of peripheral arterial insufficiency. AB - Previous studies in patients with peripheral arterial disease (PAD) have shown that the prognosis is relatively good when the distal systolic ankle index (ankle systolic pressure/arm systolic pressure) is above 50% and the distal toe systolic pressure is above 40 mmHg. In 132 patients suspected of PAD in the legs we investigated the relationship between the presence of pedal pulse and the distal systolic pressure in order to discover what diagnostic and prognostic information could be found from pulse palpation alone. The prospective study consisted of three consecutive series (A, 51 patients; B, 42 patients; and C, 39 patients); three of the authors palpated the arteries of the patients' feet: one author in each series. The palpatory findings were related to the distal systolic pressures. When pedal pulses were present we found: (a) ankle indices above 50%; and (b) toe systolic pressures above 40 mmHg. These minimal pressure values were reproducible in the three series. Furthermore, patients lacking palpable pulses in both feet had ankle indices below 90%. We conclude: (a) if pulses are palpable on both feet of a patient the prognosis for progression is relatively good regarding the patient's PAD; (b) if pedal pulse is palpable an arteriosclerotic ulcer on the foot will heal; and (c) patients lacking palpable pulses in both feet actually suffer from PAD. PMID- 2769181 TI - Interaction of lymphokine-activated killer cells with susceptible targets does not induce second messenger generation and cytolytic granule exocytosis. AB - CTL activation by specific targets leads to a rapid rise of inositol phosphates (InsPs) and of cytoplasmic-free Ca2+ concentration ([Ca2+]i). While these events are considered necessary to trigger granule secretion, Ca2+-independent cytolytic mechanisms have been recently proposed in addition or as an alternative to the classical Ca2+-dependent exocytosis model. We observed that lymphokine-activated killer (LAK) cells, obtained after stimulation with supraoptimal concentrations of IL-2 in short- or long-term cultures, kill susceptible targets in the absence of a [Ca2+]i rise and InsP3 formation. Moreover, LAK cell-mediated lysis was not associated with an increase in cytotoxic granule exocytosis, as evaluated by BLT esterase release into the culture supernatant. Furthermore, using an antigen specific CTL clone, which acquires LAK-like activity when cultured in medium containing high IL-2 doses, second messenger generation and cytolytic granule content secretion were not detected during lysis of unrelated target cells, while killing of specific targets triggered both these processes. These findings suggest that two lytic pathways may coexist in the same effector cells: a second messenger-dependent pathway involving degranulation, which is activated after TCR interaction with specific targets, and another pathway, independent of any known second messenger generation, responsible for unrelated target cell lysis. PMID- 2769182 TI - The contribution of mutant amino acids to alloantigenicity. AB - The I-Abm12 mutation has been used extensively to study the relationship between structure and function of murine class II major histocompatibility molecules. I Abm12 differs from I-Ab by three amino acid replacements in the A beta chain, and the proposed structural model of the I-Abm12 molecule places these three amino acid substitutions along one of the alpha-helices where they may affect both antigen and TCR binding. Two of the substitutions, Ile----Phe67 and Thr----Lys71, are thought to point into the binding site, whereas the third substitution, Arg-- -Gln70, is thought to point up and hence, be available for binding to the TCR. These predicted orientations are consistent with serologic analysis of the bm12 molecule, which demonstrates that residue 70 is uniquely accessible to mAbs distinguishing I-Ab from I-Abm12. In this study we have determined the influence of each of these amino acid substitutions on the ability of the resulting molecules to stimulate a panel of I-Abm12 (allo) reactive T cell hybridomas. Our experiments indicate that reversion of the amino acid at position 70 from Gln (I Abm12) to Arg (I-Ab) interferes with allorecognition by 33 of 35 I-Abm12-reactive hybridomas. On the other hand, many hybrids can tolerate amino acid substitutions at positions 67 or 71. Single amino acid substitutions at position 67, 70, or 71 are recognized by only a minority of I-Abm12-specific hybrids and usually the reactivity is greatly diminished. These data are most consistent with the idea that the amino acid at position 70 directly interacts with the TCR during allorecognition. The additional effects of residues 67 and 71 are consistent with a contribution by bound peptide to the allorecognition process. PMID- 2769183 TI - Enhanced responsiveness of endothelium in the growing/motile state to tumor necrosis factor/cachectin. AB - Some in vivo observations have suggested that growing or perturbed endothelium, such as that which occurs during angiogenesis, is more sensitive to the action of cytokines (TNF/cachectin, TNF, or IL-1) than normal quiescent endothelial cells. This led us to examine the responsiveness of endothelium to TNF as a function of the growth/motile state of the cell. TNF-induced modulation of endothelial cell surface coagulant function was half-maximal at a concentration of approximately 0.1 nM in subconfluent cultures, whereas 1-2 nM was required for the same effect in postconfluent cultures. Perturbation of endothelial cell shape/cytoskeleton was similarly more sensitive to TNF in subconfluent cultures. Consistent with these results, radioligand binding studies demonstrated high affinity TNF binding sites, Kd approximately 0.1 nM on subconfluent cultures, whereas only lower affinity sites (Kd approximately 1.8 nM) were detected on postconfluent cultures. The mechanisms underlying this change in the affinity of endothelium for TNF were studied in four settings. Crosslinking experiments with 125I-TNF and endothelium showed additional bands corresponding to Mr approximately 66,000 and approximately 84,000 with subconfluent cultures that were not observed with postconfluent cultures. Experiments with X-irradiated endothelium, whose growth but not motility was blocked, indicated that proliferation was not required for induction of high affinity TNF sites. Postconfluent endothelium, triggered to enter the proliferative cycle by microbutuble poisons, expressed high affinity TNF binding sites together with changes in cell shape/cytoskeleton well before their entry into S phase. Using wounded postconfluent monolayers, cells that migrated into the wound and those close to the wound edge displayed enhanced TNF binding and modulation of coagulant properties. These results suggest a model for targetting TNF action within the vasculature; regulation of high affinity endothelial cell binding sites can direct TNF to activated cells in particular parts of the vascular tree. PMID- 2769184 TI - A unique sequence of the NZW I-E beta chain and its possible contribution to autoimmunity in the (NZB x NZW)F1 mouse. AB - The (NZB x NZW)F1 mouse strain develops a syndrome of accelerated autoimmunity including severe renal disease and early death. Evidence suggests that class II molecules play a central role in this process. Previous studies have suggested that the NZW strain contributes at least one gene to the development of accelerated autoimmunity that is linked to the H-2 complex, and antibodies to murine class II molecules have been used to ameliorate disease in (NZB x NZW)F1 mice. We therefore wished to sequence the class II molecules from NZW mice to identify any unique sequences that may contribute to disease development. We constructed oligonucleotide primers corresponding to the 5' and 3' regions of the second exon of class II genes from a variety of haplotypes, and used these primers in a polymerase chain reaction to sequence the second exon of the NZW I-A alpha, I-A beta, and I-E beta genes. We report that the second exons of NZW I-A alpha, I-A beta, and I-E alpha are identical to their counterparts of the previously sequenced u haplotype, and that the second exon of NZW I-E beta is identical to its counterpart from u except for a single base change that results in a substitution of arginine for threonine at amino acid 72. This base and amino acid are identical to those found at the same positions in the s haplotype. PMID- 2769185 TI - Diagnosis of Candida vulvovaginitis. PMID- 2769186 TI - Obstetrics in family practice. PMID- 2769187 TI - Smoking and glycosylated hemoglobin. PMID- 2769188 TI - Serum cholesterol and glycosylated hemoglobin. PMID- 2769189 TI - Spontaneous hypertensive-arteriosclerotic intracerebral hemorrhage. PMID- 2769190 TI - Breast cancer screening. A curious problem in primary care. PMID- 2769191 TI - Endometrial sampling: analysis of 310 procedures performed by family physicians. AB - Endometrial sampling has become an accepted office procedure. Safety and clinical usefulness have been well established but not specifically studied in family practices. To address the safety and clinical usefulness of endometrial sampling, a chart review of 310 endometrial sampling procedures performed by practicing family physicians was undertaken. Cases were identified by billing records and chart auditing to assure complete recording of all procedures performed by study practitioners since the beginning of their practices. A prestudy survey revealed that 26% of rural family physicians and none of the urban family physicians in western New York were doing endometrial sampling. Practitioners were doing an average of 1.2 per month. Of the 310 procedures 14.5% were unsuccessful because of cervical stenosis or inadequate sample. There were no reported complications, and three cases of endometrial carcinoma were discovered. Endometrial sampling is safe and clinically useful when performed by family physicians. PMID- 2769192 TI - Microcomputer-generated reminders. Improving the compliance of primary care physicians with mammography screening guidelines. AB - Recent studies have documented that physician compliance with recommended periodic health screening improves with reminders to physicians. These reminders, however, are often costly to maintain and modify. This study investigates the influence of a microcomputer tickler system on the ordering of mammograms. All women (N = 1262) aged 40 years and older who made visits to an outpatient office during a 6-month period were randomly assigned to one of two groups. For the experimental group, the date of the last mammogram ordered and recorded in the clinical database was printed on the encounter form generated for each patient visit. No information regarding previous mammograms was printed for patients in the control group. Women in the experimental group were more likely to have a mammogram ordered during the study period (19% compared with 12%, P = .001) and, as a result, were more likely to be in compliance with mammography guidelines at the study's completion (27% compared with 21%, P = .011). Microcomputerized data storage and retrieval systems may help increase physicians' attention to preventive health screening recommendations. PMID- 2769193 TI - Physician interest in breast cancer screening education. A survey of Vermont family physicians. AB - A mailed survey of 141 Vermont family physicians (74% participating) was conducted to determine their breast cancer screening practices and beliefs and their interest in receiving training in breast cancer screening. Of these, only 12% reported that at least three fourths of their female patients older than 50 years received mammograms at least once a year, compared with 33% who reported providing breast self-examination instruction and 35% who administered clinical breast examination with at least three fourths of these patients at least once a year. Nevertheless, 55% of the physicians rated mammography as a very effective breast-screening procedure; 28% rated breast self-examination and 16% rated clinical breast examination as very effective. Three fourths of the physicians showed great interest in learning more about breast palpation, breast self examination instruction, and mammography. Individual instruction in the office was preferred over a group workshop format, and a trained nonphysician health professional was considered as acceptable as a physician to provide the instruction. Results suggest that breast cancer screening education for family physicians is a high priority, and that physicians will welcome such training, particularly if it is office-based. PMID- 2769194 TI - Prescription-writing patterns and errors in a family medicine residency program. AB - Copies of 1814 prescriptions written by 20 residents were reviewed to determine prescribing patterns and the incidence of prescription-writing errors. An average of 0.69 prescriptions were written per patient visit at an average cost (to the pharmacist) of $13.35. Over one third of all prescriptions were written using the generic name, and "dispense as written" was specified on only 3.25%. On average, 21% (n = 373) of all prescriptions collected contained at least one prescription writing error. Errors were characterized as omissions (6%), unfulfilled legal requirements (1%), incomplete directions (1%), dose or direction errors (3%), unclear quantity to be dispensed (3%), or prescriptions written for nonprescription products (5%). A correct diagnosis and treatment plan can be undermined by a written prescription that is incorrect or miscommunicates the intention of the prescriber. PMID- 2769195 TI - Who is the family doctor? Relating primary care to family care. AB - Many families receive care as intact family units. To determine which specialists provide this family care, a subset of families (N = 447) enrolled in the Rand Health Insurance Experiment were examined. Among families designating a single primary care physician, family physicians and general practitioners provided 65.9% to 89.7% of their family care. Internists provided 20.0% and 27.3% of family care for younger and older couples, respectively. The remaining specialties, including pediatrics and obstetrics-gynecology, each provided less than 5% of family care; these small proportions of family care may reflect the specialists' self-imposed limits in primary care roles. As family members matured, families used fewer pediatricians and obstetrician-gynecologists for primary care and concurrently increased their use of family physicians or general practitioners. Care for intact families is provided predominantly by family physicians or general practitioners, although in families without children, internists also play an important role. Self-defined limits in primary care roles by physicians in various specialties and the changing use of specialties during the family life cycle largely determined which specialties provided family care. PMID- 2769196 TI - Gonococcal endocarditis. PMID- 2769197 TI - Infectious mononucleosis presenting as Raynaud's phenomenon. PMID- 2769198 TI - Community screening for cervical cancer in New Hampshire. PMID- 2769199 TI - Organization of positional information in the axolotl limb. AB - We have used the phenomenon of position-dependent growth stimulation, brought about by the confrontation of cells with dissimilar positional values, to reveal the organization of positional information in the center of the upper and lower arms of axolotls. When either humerus or radius was transplanted into either dorsal or posterior positions, extra growth leading to the formation of supernumerary digits occurred following amputation through the graft. However, transplants of humerus or radius into anterior or ventral positions did not lead to the formation of any additional digits. The ulna by contrast was capable of stimulating supernumerary digit formation when transplanted into anterior, posterior, dorsal, or ventral positions. We interpret these results to indicate that the humerus and radius are surrounded by symmetrically arranged anterior and ventral positional values, whereas the ulna is surrounded by a complete asymmetrical set of angular positional values. We use our proposed arrangement for the positional information in the limb center to explain a number of previous experimental findings. In addition, we provide an explanation, in terms of the underlying positional information, for the structural and developmental relationships between the different skeletal elements of the vertebrate limb, and in particular for the anatomical pattern known as Gregory's pyramid. PMID- 2769200 TI - Changes in the testicular binding of luteinizing hormone and plasma testosterone concentrations in the Djungarian hamster subjected to different photoperiods and temperatures and effects of long-term testosterone treatment on the binding. AB - The effects of artificial photoperiod, temperature, and long-term testosterone treatment on testicular luteinizing hormone (LH) binding were studied in adult male Djungarian hamsters. In hamsters transferred to long-day (LD; 16 hr light, 8 hr dark) photoperiod 8 weeks after adaptation in short-day (SD; 8 hr light, 16 hr dark) photoperiod of 25 degrees C, testicular growth was associated with an increase in the total LH binding per two testes and a decrease in LH binding per unit testicular weight. Plasma testosterone levels reached a peak 47 days after transfer to LD and tended to decrease thereafter, while the testes continued growing. In contrast, when hamsters reared under LD conditions at 25 degrees C for 12 weeks were transferred to SD, testicular regression was associated with a decrease in plasma testosterone and the total LH binding per two testes and an increase in LH binding per unit testicular weight. A significant decrease in LH binding per unit weight compared to SD controls was observed in those hamsters exposed to SD with continuous testosterone treatment. The testosterone treatment tended to induce decrease in the total LH binding. Scatchard plot analyses of the binding suggested that changes in LH binding were due to changes in the number of binding sites. When sexually mature male hamsters were subjected for 8 weeks to two different ambient temperatures (7 degrees C and 25 degrees C) and photoperiods (LD and SD), the difference between the two temperature groups was statistically not significant regarding the weights of testes, epididymides, and prostates; plasma testosterone levels; and LH binding in either LD or SD group. These results suggest that photoperiod is a more important environmental factor than temperature for the regulation of testicular activity and LH receptors and that testosterone reduces the number of LH receptors per unit testicular weight in adult male Djungarian hamsters. PMID- 2769201 TI - Cell intercalation during notochord development in Xenopus laevis. AB - Morphometric data from scanning electron micrographs (SEM) of cells in intact embryos and high-resolution time-lapse recordings of cell behavior in cultured explants were used to analyze the cellular events underlying the morphogenesis of the notochord during gastrulation and neurulation of Xenopus laevis. The notochord becomes longer, narrower, and thicker as it changes its shape and arrangement and as more cells are added at the posterior end. The events of notochord development fall into three phases. In the first phase, occurring in the late gastrula, the cells of the notochord become distinct from those of the somitic mesoderm on either side. Boundaries form between the two tissues, as motile activity at the boundary is replaced by stabilizing lamelliform protrusions in the plane of the boundary. In the second phase, spanning the late gastrula and early neurula, cell intercalation causes the notochord to narrow, thicken, and lengthen. Its cells elongate and align mediolaterally as they rearrange. Both protrusive activity and its effectiveness are biased: the anterioposterior (AP) margins of the cells advance and retract but produce much less translocation than the more active left and right ends. The cell surfaces composing the lateral boundaries of the notochord remain inactive. In the last phase, lasting from the mid- to late neurula stage, the increasingly flattened cells spread at all their interior margins, transforming the notochord into a cylindrical structure resembling a stack of pizza slices. The notochord is also lengthened by the addition of cells to its posterior end from the circumblastoporal ring of mesoderm. Our results show that directional cell movements underlie cell intercalation and raise specific questions about the cell polarity, contact behavior, and mechanics underlying these movements. They also demonstrate that the notochord is built by several distinct but carefully coordinated processes, each working within a well-defined geometric and mechanical environment. PMID- 2769202 TI - Different subsets of axonal guidance cues are essential for sensory neurite outgrowth to cutaneous and muscle targets in the dorsal ramus of the embryonic chick. AB - The dorsal ramus nerve diverges dorsally from each spinal nerve to innervate the epaxial muscle and dermis that are derived in situ from each dermamyotome. The outgrowth of both the sensory and motor components of this nerve are sensitive to the proximity of the dermamyotome. Motoneurons display a direct target response that is not dependent upon the concurrent outgrowth of sensory neurites (Tosney: Dev. Biol. 122:540-588, 1987). Likewise, the outgrowth of sensory neurites could be directly dependent on the dermamyotome. Alternatively, sensory neurites could be dependent on motor axons that in turn require the dermamyotome for outgrowth. To distinguish between these possibilities, motor outgrowth was abolished by unilateral ventral neural tube deletion and the patterns of subsequent sensory neurite outgrowth were assessed. The cutaneous nerve branch formed in all cases. In contrast, neither of the epaxial muscle nerves formed in the absence of epaxial motoneuron outgrowth. Furthermore, sensory neurites could not be detected diverging into muscle from the cutaneous nerve or entering muscle via other novel routes. We conclude that motoneurons are essential for sensory outgrowth to epaxial muscle but not to cutaneous targets. It is clear that different subsets of navigational cues guide sensory afferents to muscle and to cutaneous destinations. PMID- 2769203 TI - Regional identity is established before gastrulation in the Xenopus embryo. AB - Regional differences in cell recognition properties along the animal-vegetal axis of Xenopus laevis embryos were investigated by using an in vitro cell sorting assay. Dissociated cells were obtained from defined regions of blastula- and early gastrula-stage embryos. Binary combinations of cells from different regions, or from the same region at different ages, were aggregated in stationary culture. Labelling of one population in each pair with a cell-autonomous dye allowed the degree of sorting out in the resulting aggregates to be scored. In combinations of cells from animal caps (prospective ectoderm) and vegetal masses (prospective endoderm), sorting was detectable at the equivalent of late blastula stage and increased with developmental age to the gastrula stage. In addition, cells from the same region but different stages sorted from each other, indicating temporal changes in regional identity. Marginal cells (prospective mesoderm) sorted strongly from vegetal cells but only weakly from animal cells. These results indicate the presence of regional identity in the form of specific recognition properties in cells of the Xenopus blastula. We suggest that these properties act to establish and maintain coherent cell populations, corresponding to the primary germ layers, prior to gastrulation. These results account for the gradual restriction in developmental capacity of blastomeres seen previously in single-cell transplantation experiments from this laboratory. PMID- 2769204 TI - Invagination of the otic placode: normal development and experimental manipulation. AB - The inner ear forms from paired ectodermal primordia that lie to either side of the developing hindbrain. Initially each primordium forms a shallow depression in the ectodermal surface. Invagination to form an otic pit coincides with the formation of several deep folds in the epithelial surface. An initial fold appears parallel to the embryonic axis and at the junction of the rhombencephalon with somitomeric mesoderm. This is followed by formation of cranial and caudal folds perpendicular to the axis and minor folds that are within the pit formed by earlier folding. The central region of the otic primordium remains in close apposition to the lateral surface of the neural tube during the process of fold formation, until the otic pit becomes quite deep. At that time, mesenchymal cells penetrate between the two layers. Experimental analysis of invagination supports the conclusion that otic invagination is controlled differently from that of similar organ primordia, such as the eye and thyroid. Whereas these other primordia can be stimulated to undergo normal morphogenetic shape changes precociously by treatments that presumably activate motile processes in the cytoskeleton, the same conditions have little effect on the otic placode. Similarly, neither inhibitors of calcium transport nor inactivators of calmodulin activity prevent otic pit formation, while these drugs block invagination of other primordia. These results suggest that otic invagination may be caused by changes in the surrounding tissues rather than by an activation of motility within the primordium. PMID- 2769205 TI - Free amino acids and cell volume regulation in the euryhaline ciliate Paramecium calkinsi. AB - Paramecium calkinsi was isolated from a tidal marsh in which the salinity fluctuated widely on a daily basis. In the laboratory, this ciliate survived for days in sea water ranging in osmotic strength from 10 to 2,000 mOsm and divided in nutritive media of 1,000 mOsm or less. When transferred from 750 to 250 mOsm, cells swelled but regained 78% of the original volume within 60 min and the original volume within 1 day. Cells acclimated to 250 mOsm and transferred to 750 mOsm shrank, regained 40% of the original volume in 60 min, and regained little more volume during the next 24 hr. Free amino acids (FAA), principally proline and alanine, are osmolytes in P. calkinsi. In cells that have been acclimated for more than 1 month, Pro is undetectable at 10 mOsm but at 250 mOsm is present in substantial amounts and is still higher at 750 mOsm. Ala is found in cells at all three salinities and increases dramatically with increasing salinity. A complex pattern of amino acid changes occurs during the 4 hr following a transfer from 250 to 750 mOsm, resulting in a marked increase in Ala but no change in Pro. Thus the metabolic changes that lead to the increased FAA levels of acclimated cells are apparently long-term and complex. After transfer of cells from 750 to 250 mOsm there is a rapid and selective loss of Pro and Ala from the cells to the medium. PMID- 2769206 TI - Autonomous death of amphibian (Xenopus laevis) cranial myotomes. AB - The death of cranial myotomes during Xenopus laevis embryogenesis is employed as a model system to study programmed cell death. The first primary myotomes to differentiate and functionally develop are in the occipital region of the embryonic head. Between stages 27 (tailbud) and 48 (feeding tadpole), they degenerate and disappear in a craniocaudal sequence. Descriptive and experimental studies were undertaken to establish whether this apparent cell (myotome) death program is autonomous or whether it depends on interactions with surrounding tissues (e.g., otic vesicle). Removal of the adjacent otic vesicle did not affect cranial myotome death. Likewise, grafting the otic vesicle to a novel location along the somite file did not induce local myotome degeneration (death). Cranial myotome primordia grafted into the trunk region degenerated on schedule. Trunk myotome primordia grafted to the cranial myotome location did not degenerate. It is therefore concluded that the cranial myotome death program has become autonomous by the time the cranial myotomes reach the developmental stage of segmentation. PMID- 2769207 TI - Identification of puberty-accelerating pheromones in male mouse urine. AB - Gas chromatography-mass spectrometry was employed to identify the two volatile amines in male mouse urine. These amines were much less concentrated in urine of castrated males. The identified amines, isobutylamine and isoamylamine, were assayed for the potential of puberty acceleration in postweaning female mice. A total of 105 young female mice were exposed to one of the following five odors: distilled water (control), 0.1 M isobutylamine, 0.1 M isoamylamine, a mixture of 0.05 M isobutylamine and 0.05 M isoamylamine, or fresh male mouse urine. The mixture of these amines accelerated the vaginal opening of young females. Except for the control, all experimental odors accelerated the first vaginal estrus in ICR strain mice. PMID- 2769208 TI - Functional organization of cerebral microvasculature in a marsupial, the northern quoll (Dasyurus hallucatus). AB - Capillaries within the central nervous system (CNS) of eutherian mammals form meshworks with numerous anastomoses, whereas capillaries in the CNS of marsupials consist entirely of hairpin-like loops, without anastomotic interconnections. Counter-current blood flow in capillary loops may have been important in the evolutionary development of a cerebral vascular supply. However, loops are not found in eutherian mammals, perhaps because of a limited benefit to the diffusive conductance of gases. PMID- 2769209 TI - Greatly elevated and sustained secretion of oxytocin by bovine granulosa cells in serum-free culture. AB - Bovine granulosa cells were cultured in collagen (Vitrogen 100)-pretreated wells using defined medium to study the secretion of oxytocin and progesterone under serum-free conditions. Secretion of oxytocin began spontaneously after the first day and was maintained at a high level during a 1 week culture period. Addition of serum to the medium reduced oxytocin concentrations by up to 90%. There were positive exponential relationships between oxytocin and progesterone concentrations and the inoculated cell density (range, 1.67 to 23.4 X 10(5) cells/ml/well). The results indicate that neither serum nor gonadotrophins are required for in vitro differentiation of bovine granulosa cells and that addition of serum may attenuate subsequent hormone secretion. This culture system should provide a better in vitro model for the study of ovarian oxytocin secretion than those previously described. PMID- 2769210 TI - Adult non-Hodgkin's lymphoma in Taiwan area: a clinicopathologic study of 123 cases based on working formulation classification. AB - To elucidate the clinicopathologic features of non-Hodgkin's lymphoma (NHL) in Taiwan, 123 adult patients with proven NHL were studied. They were classified according to the international working formulation as: low grade (LG), 12.2%; intermediate grade (IG), 42.3%; and high grade (HG) lymphoma, 45.5%. The most common subtypes were diffuse large cell (26.8%) and large cell immunoblastic (26.8%) lymphomas. Follicular lymphoma accounted for only 8.9% (11 cases). Complete remission rates for LG, IG and HG lymphomas were 53%, 35% and 34%, respectively. LG lymphoma had a significantly better survival than that of IG and HG lymphomas. The IG lymphoma encompassed a heterogeneous group of patients with varying prognoses but the overall survival curve was indistinguishable from that of HG lymphoma. Clinically, 66% of HG, 77% of IG and 86% of LG lymphoma presented with advanced disease. LG lymphoma had high frequencies of hepatosplenomegaly (30 50%) and bone marrow involvement (53%), whereas skin, bone and central nervous system involvement occurred exclusively in IG and HG lymphomas. Mild anemia was common and occurred in 40-50% of the patients. Hyperimmunoglobulinemia was found in 50-60% of all 3 grades of lymphoma, monoclonal gammopathy in 3 cases of IG lymphoma, and hypercalcemia in 4 cases of IG and HG lymphomas. Elevated serum lactate dehydrogenase occurred mainly in IG and HG lymphomas and was an important prognostic factor. In conclusion, the characteristic features of NHL in Taiwan include: (1) a high proportion of HG lymphoma and low proportions of LG and follicular lymphomas; (2) a heterogeneous patient composition of IG lymphoma with an unfavorable overall prognosis.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2769211 TI - Bone marrow involvement in non-Hodgkin's lymphoma. AB - The frequency, pattern, extent and clinical features of bone marrow involvement in 94 cases of non-Hodgkin's lymphoma, classified according to the International Working Formulation, were reviewed. In 30% of cases there was bone marrow involvement by lymphoma at the time of diagnosis. Marrow involvement was most frequently found in the follicular small cleaved cell (57%), diffuse mixed small and large cell (56%), and lymphoblastic (56%) lymphomas. A paratrabecular pattern of marrow involvement tended to occur in low or intermediate grade lymphomas. High grade lymphomas tended to show an interstitial or diffuse pattern of marrow involvement. The results of marrow aspiration and biopsy were of equal value and complementary to each other. In 43% of cases with marrow lymphoma there was peripheral blood involvement at the time of diagnosis. Blood involvement was most frequently found in the lymphoblastic lymphoma (70%). In general, the degree of blood involvement was related to the extent of marrow involvement. Patients with marrow involvement often presented with "B" symptoms and hepatomegaly. Abnormalities in at least one of the blood counts were quite common (93%). A normal blood count made marrow involvement unlikely but not impossible. Other common laboratory findings included hyperimmunoglobulinemia (47%) and elevated serum levels of lactate dehydrogenase (56%). Patients with marrow involvement showed a significantly higher frequency of hepatomegaly and abnormal blood counts, as compared to those with negative marrows (p less than 0.05 and less than 0.001, respectively).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2769212 TI - Human chorionic gonadotropin and its subunits in pre-eclampsia. AB - The serum levels of hCG and its subunits were studied in 11 cases of pre eclampsia (8 cases of severe pre-eclampsia and 3 cases of mild pre-eclampsia) and 72 normal pregnant women. The hCG (human chorionic gonadotropin) immunoactivity measured by H80 RIA (radioimmunoassay) and Sb6 RIA showed no significant difference between pre-eclampsia and normal pregnancy. This result suggests that no significant amount of free hCG-beta existed, since H80 RIA measured intact hCG but not hCG-beta, and Sb6 RIA measured both hCG and hCG-beta. Furthermore, from the result of elution behavior of gel HPLC (high performance liquid chromatography), hCG of pre-eclampsia and comparison of the Sb6 RIA/H80 RIA ratio between pre-eclampsia and normal pregnancy, it was evident that there was little amount of free hCG-beta secretion in pre-eclampsia as in normal pregnancy. However, the free hCG-alpha was significantly higher in severe pre-eclampsia, probably caused by placental dysfunction. In summary, free hCG-alpha is increased in pre-eclampsia, but its role as a marker of placental function in pre-eclampsia requires further investigation. PMID- 2769213 TI - Alterations in thyroid function tests in major depression. AB - Most clinically euthyroid patients with acute or chronic nonthyroid illness have abnormal thyroid function which is called the euthyroid sick syndrome. To assess the euthyroid sick syndrome in depression, we examined levels of total thyroxine (TT4), total triiodothyronine (TT3), T3 uptake (T3U) by radio-immunoassay and thyrotropin (TSH) by immunoradiometric assay in a group of 46 patients with major depression (diagnosed according to DSM-III), 44 normal control subjects and 39 schizophrenics. As compared with the normal controls and schizophrenics, depressed patients showed the following significant differences: a reduction of the mean TT3 level by 26% (89.6 +/- 26.9 ng/dl versus 121 +/- 21.4 ng/dl, p less than 0.05), an increase in the mean T3U level by 6% (35.4 +/- 4.1 versus 33.1 +/- 3.0%, p less than 0.05), and a rise in the mean FT4I level by 15% (2.96 +/- 0.59 versus 2.50 +/- 0.40, p less than 0.05). However, both the mean TSH and TT4 levels in depressed patients were not significantly different from those in normal subjects and schizophrenics, though there was a trend toward high mean TT4 levels in depressed patients. Among the 46 depressed patients who had normal basal TSH levels, 7(15%), 3(6%) and 11 (23%) had the low T3 syndrome, low T3 plus low T4 syndrome and high T4 syndrome, respectively. The clinical implication of the low T3 or/and T4 low syndrome was discussed. All the abnormal thyroid indices in the 21 depressed patients were normalized after recovery of depression. These findings suggest that the euthyroid sick syndrome in depression might be a state dependent phenomenon. PMID- 2769214 TI - Infectivity in asymptomatic hepatitis B carriers: its correlation with HBeAg/anti HBe status. AB - Sera collected from 190 asymptomatic HBsAg carriers with varying status of HBe markers were tested for HBV DNA using the slot-blot hybridization method and the results were compared with serum alanine aminotransferase (ALT) levels. No significant difference was observed in the positive rate of serum HBV DNA between patients showing either HBeAg (+)/normal ALT or HBeAg (+)/high ALT. On the other hand, in cases with positive anti-HBe or negative for both HBeAg and anti-HBe, statistically significant differences could be shown in HBV DNA positivity between normal and high ALT subjects. In the group of 100 patients possessing anti-HBe antibody, 50% of the cases with high ALT levels were positive for serum HBV DNA, whereas all of the cases with normal ALT levels were negative for serum HBV DNA (p less than 0.0002). In 21 patients showing HBeAg (-)/anti-HBe(-), HBV DNA could be detected in the serum of 60% of the cases with high ALT levels, but in none of the cases with normal ALT levels (p less than 0.05). Our results suggest that HBeAg alone is a reliable marker in the prediction of infectivity in asymptomatic carriers. In cases showing anti-HBe (+), loss of infectivity could be ascertained if the patient had normal serum ALT, but, continuous viral replication should be suspected in cases with high serum ALT values. PMID- 2769215 TI - Clinical observations on occlusion myopia. AB - The authors studied the refractive errors and axial lengths on thirty patients. A retrospective analysis suggests some degree of monocular vision deprivation early in life. Axial myopia was found in most of the cases, indicating that emmetropization is a vision-dependent phenomenon. But, some exceptions were found, supporting the concept that multiple factors are involved in the pathogenesis of myopia. PMID- 2769216 TI - Acute mitral regurgitation secondary to blunt chest trauma: report of a case. AB - A 24-year-old male patient who sustained blunt trauma to the chest resulting in a flail chest, myocardial contusion and injury to mitral valve is reported. An emergency surgical correction of the mitral lesion was performed. A high index of suspicion, prompt diagnosis and aggressive intervention of such injuries can lead to successful repair of such a potentially fatal cardiac trauma. PMID- 2769217 TI - A case of acute superior mesenteric embolism successfully treated by embolectomy. AB - Superior mesenteric artery embolism is undoubtedly fatal unless operative intervention is promptly performed. The first case successfully managed by embolectomy in Taiwan is reported in this communication. The key to successful management lies in the early suspicion in patients with atrial fibrillation or recent myocardial infarction, presenting with sudden abdominal pain and an unremarkable physical examination. Abdominal angiography is strongly recommended; however, immediate laparatomy should not be postponed if angiography is not available. Early embolectomy is the only useful means of treatment to restore mesenteric circulation, preserve the bowel and rescue the patient. A 56-year-old woman was admitted with a 5-year history of rheumatic heart disease and atrial fibrillation. She had a sudden attack of severe abdominal pain 8 hours after cardiac catheterization. Abdominal examination was not remarkable and plain abdominal X-ray was negative, while bloody stools and leukocytosis developed 7 hours later. Superior mesenteric embolism was highly suspected and emergency laparotomy was performed. Successful embolectomy was carried out through the distal approach and the patient recovered completely without requiring small bowel resection. All branches of the superior mesenteric artery were demonstrated patent upon postoperative angiography. PMID- 2769218 TI - Reiter's syndrome in uremia: report of a case. AB - A 35-year-old male uremic patient developed the classical presentation of Reiter's syndrome after 3 years of regular hemodialysis. He had painful swelling of the left knee, sacroilitis, urethritis, balanitis, painless oral ulcers, acute uveitis and positive HLA-B27. Disease activity persisted and was aggravated although immune function studies showed depressed cellular immunity. The clinical course of this patient seemed to contradict our belief that activity of immunologically mediated disease will abate after uremia, but it concurred with the report that Reiter's activity was unchanged in AIDS despite the significant immunodeficiency of AIDS patients. PMID- 2769219 TI - Superior mesenteric vein severance from blunt abdominal trauma: report of a case. AB - Injury of the superior mesenteric vein from blunt abdominal trauma is an uncommon but frequently fatal injury. A 63-year-old man was injured in a motorcycle accident. He was admitted to our hospital in profound shock. Immediate celiotomy revealed superior mesenteric vein injury which was repaired by end-to-end anastomosis. Rapid fluid resuscitation and expeditious exploration are the key in saving patients with this condition. Indications for exploration of retroperitoneal hematomas, techniques of exposure, modes of reconstruction of the injured vein and the importance of a second-look operation are discussed. PMID- 2769220 TI - Nocardial cerebral abscess: report of a case. AB - Cerebral nocardiosis is an uncommon disease which has not been previously reported in Taiwan. We describe a 70-years-old man who, known to have a history of rectal cancer, developed a cerebral nocardial abscess. The patient was admitted with a week history of gradual weakness of the left limbs. There was neither fever nor headache. Neurological examination disclosed left hemiparesis. Computed tomography of the brain revealed a decreased density in the right parietal region with a ring enhancement. Biopsy of the cerebral lesion showed Nocardia asteroides. PMID- 2769221 TI - [Multiple pulmonary fibroleiomyomatous hamartoma: report of a case]. PMID- 2769222 TI - Spatial properties of goldfish ganglion cells. AB - We systematically classified goldfish ganglion cells according to their spatial summation properties using the same techniques and criteria used in cat and monkey research. Results show that goldfish ganglion cells can be classified as X , Y-, or W-like based on their responses to contrast-reversal gratings. Like cat X cells, goldfish X-like cells display linear spatial summation. Goldfish Y-like cells, like cat Y cells, respond with frequency doubling at all spatial positions when the contrast-reversal grating consists of high spatial frequencies. There is also a third class of neurons, which is neither X- nor Y-like; many of these cells' properties are similar to those of the "not-X" cells found in the eel retina. Spatial filtering characteristics were obtained for each cell by drifting sinusoidal gratings of various spatial frequencies and contrasts across the receptive field of the cell at a constant temporal rate. The spatial tuning curves of the cell depend on the temporal parameters of the stimulus; at high drift rates, the tuning curves lose their low spatial frequency attenuation. To explore this phenomenon, temporal contrast response functions were derived from the cells' responses to a spatially uniform field whose luminance varied sinusoidally in time. These functions were obtained for the center, the surround, and the entire receptive field. The results suggest that differences in the cells' spatial filtering across stimulus drift rate are due to changes in the interaction of the center and surround mechanisms; at low temporal frequencies, the center and surround responses are out-of-phase and mutually antagonistic, but at higher temporal rates their responses are in-phase and their interaction actually enhances the cell's responsiveness. PMID- 2769223 TI - Two K+ channel types, muscarinic agonist-activated and inwardly rectifying, in a Cl- secretory epithelium: the avian salt gland. AB - Patches of membrane on cells isolated from the nasal salt gland of the domestic duck typically contained two types of K+ channel. One was a large-conductance ("maxi") K+ channel which was activated by intracellular calcium and/or depolarizing membrane voltages, and the other was a smaller-conductance K+ channel which exhibited at least two conductance levels and displayed pronounced inward rectification. Barium blocked both channels, but tetraethylammonium chloride and quinidine selectively blocked the larger K+ channel. The large K+ channel did not appear to open under resting conditions but could be activated by application of the muscarinic agonist, carbachol. The smaller channels were open under resting conditions but the gating was not affected by carbachol. Both of these channels reside in the basolateral membranes of the Cl- secretory cells but they appear to play different roles in the life of the cell. PMID- 2769224 TI - Modulation of K channels in dialyzed squid axons. ATP-mediated phosphorylation. AB - In squid axons, internally applied ATP potentiates the magnitude of the potassium conductance and slows down its activation kinetics. This effect was characterized using internally dialyzed axons under voltage-clamp conditions. Both amplitude potentiation and kinetic slow-down effects are very selective towards ATP, other nucleotides like GTP and ITP are ineffective in millimolar concentrations. The current potentiation Km for ATP is near 10 microM with no further effects for concentrations greater than 100 microM. ATP effect is most likely produced via a phosphorylative reaction because Mg ion is an obligatory requirement and nonhydrolyzable ATP analogues are without effect. In the presence of ATP, the K current presents more delay, resembling a Cole-Moore effect due to local hyperpolarization of the channel. ATP effect induces a 10-20 mV shift in both activation and inactivation parameters towards more depolarized potentials. As a consequence of this shift, conductance-voltage curves with and without ATP cross at approximately -40 mV. This result is consistent with the hyperpolarization observed with ATP depletion, which is reversed by ATP addition. At potentials around the resting value, addition of ATP removes almost completely K current slow inactivation. It is suggested that a change in the amount of the slow inactivation is responsible for the differences in current amplitude with and without ATP, possibly as a consequence of the additional negative charge carried by the phosphate group. However, a modification of the local potential is not enough to explain completely the differences under the two conditions. PMID- 2769225 TI - Kinetics and stoichiometry of coupled Na efflux and Ca influx (Na/Ca exchange) in barnacle muscle cells. AB - Coupled Na+ exit/Ca2+ entry (Na/Ca exchange operating in the Ca2+ influx mode) was studied in giant barnacle muscle cells by measuring 22Na+ efflux and 45Ca2+ influx in internally perfused, ATP-fueled cells in which the Na+ pump was poisoned by 0.1 mM ouabain. Internal free Ca2+, [Ca2+]i, was controlled with a Ca EGTA buffering system containing 8 mM EGTA and varying amounts of Ca2+. Ca2+ sequestration in internal stores was inhibited with caffeine and a mitochondrial uncoupler (FCCP). To maximize conditions for Ca2+ influx mode Na/Ca exchange, and to eliminate tracer Na/Na exchange, all of the external Na+ in the standard Na+ sea water (NaSW) was replaced by Tris or Li+ (Tris-SW or LiSW, respectively). In both Na-free solutions an external Ca2+ (Cao)-dependent Na+ efflux was observed when [Ca2+]i was increased above 10(-8) M; this efflux was half-maximally activated by [Ca2+]i = 0.3 microM (LiSW) to 0.7 microM (Tris-SW). The Cao dependent Na+ efflux was half-maximally activated by [Ca2+]o = 2.0 mM in LiSW and 7.2 mM in Tris-SW; at saturating [Ca2+]o, [Ca2+]i, and [Na+]i the maximal (calculated) Cao-dependent Na+ efflux was approximately 75 pmol#cm2.s. This efflux was inhibited by external Na+ and La3+ with IC50's of approximately 125 and 0.4 mM, respectively. A Nai-dependent Ca2+ influx was also observed in Tris SW. This Ca2+ influx also required [Ca2+]i greater than 10(-8) M. Internal Ca2+ activated a Nai-independent Ca2+ influx from LiSW (tracer Ca/Ca exchange), but in Tris-SW virtually all of the Cai-activated Ca2+ influx was Nai-dependent (Na/Ca exchange). Half-maximal activation was observed with [Na+]i = 30 mM. The fact that internal Ca2+ activates both a Cao-dependent Na+ efflux and a Nai-dependent Ca2+ influx in Tris-SW implies that these two fluxes are coupled; the activating (intracellular) Ca2+ does not appear to be transported by the exchanger. The maximal (calculated) Nai-dependent Ca2+ influx was -25 pmol/cm2.s. At various [Na+]i between 6 and 106 mM, the ratio of the Cao-dependent Na+ efflux to the Nai dependent Ca2+ influx was 2.8-3.2:1 (mean = 3.1:1); this directly demonstrates that the stoichiometry (coupling ratio) of the Na/Ca exchange is 3:1. These observations on the coupling ratio and kinetics of the Na/Ca exchanger imply that in resting cells the exchanger turns over at a low rate because of the low [Ca2+]i; much of the Ca2+ extrusion at rest (approximately 1 pmol/cm2.s) is thus mediated by an ATP-driven Ca2+ pump.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2769226 TI - Partial cleavage of sweet potato feathery mottle virus coat protein subunit by an enzyme in extracts of infected symptomless leaves. AB - The coat protein of particles of sweet potato feathery mottle potyvirus (SPFMV) extracted from Ipomoea spp. migrated in SDS-PAGE mainly as bands of M(r) 38,000 (38K), 36K, 32K, 30K. Trypsin treatment of the particles resulted in the appearance of only one 30K polypeptide. The inclusion of protease inhibitors in the extraction procedure did not alter the heterogeneity of SPFMV coat protein. A partially purified fraction of extracts from recovering, symptomless, but not from healthy leaves of I. nil had a proteolytic activity similar to that of trypsin. Amino acid sequencing showed that the trypsin-cleaved 30K polypeptide had some sequence homology with other potyvirus coat proteins. The site at which the Ipomea extract cleaved the protein was five amino acids nearer the N terminus than trypsin cleavage site. PMID- 2769227 TI - Molecular cloning of a potato virus Y genome: nucleotide sequence homology in non coding regions of potyviruses. AB - An aphid-transmissible field isolate of potato virus Y, strain MM, was purified from a pepper host and cloned. All but 18 terminal nucleotides of the 9.7 kb genome are apparently contained in two overlapping cDNA clones. The library of cDNA clones is likely to be representative of the viral RNA population present in infected plants because restriction endonuclease maps derived from cloned and uncloned cDNA are colinear, each region of the genome is represented by several independent clones, and nucleic acid sequencing of 5' and 3'-terminal regions revealed small AU-rich non-coding domains with blocks of nucleotide sequence homology between this strain of PVY and three other potyviruses. The efficient application of cDNA cloning techniques to a large positive-stranded RNA virus is described. PMID- 2769228 TI - Examination of eight cases of multiple sclerosis and 56 neurological and non neurological controls for genomic sequences of measles virus, canine distemper virus, simian virus 5 and rubella virus. AB - In situ hybridization studies have been carried out on brain samples from eight cases of multiple sclerosis (MS) and 56 non-neurological and neurological controls, using single-stranded 35S-labelled RNA probes prepared against genomic RNA sequences of measles virus, canine distemper virus, rubella virus and simian virus 5. Foci of hybridization were found using probes against the measles virus nucleocapsid protein (N), phosphoprotein and fusion protein gene sequences in two of the MS cases, and also in one control, a case of disseminated cytomegalovirus infection with spinal cord necrosis. This result was confirmed using biotinylated probes prepared against the measles virus N genomic sequence. No hybridization was found in any of the MS or control cases using any of the other viral genome specific probes. PMID- 2769229 TI - Complete cloning and molecular organization of a rabies-related virus, Mokola virus. AB - Mokola virus is a rabies-related virus responsible for both animal and human encephalitis cases in Africa. We report here the construction of a genomic library containing overlapping cDNA clones encompassing the entire genome. Five overlapping clones were sufficient to cover the genome (about 12 kb in size). Mokola virus was shown to share the same genomic organization as the rabies virus genome and also identical transcription signals. cDNA probes characterized six different transcripts by Northern blotting experiments; five of them corresponded in size and location to rabies virus mRNAs, and one of particular interest corresponded to a bicistronic RNA which included the genes for the phosphoprotein and the matrix protein. Comparison of the 3' and 5' end sequences of the Mokola genome with those of other members of the Lyssavirus genus showed a high homology and led us to propose a genus-specific consensus sequence. However, the latter appeared to vary widely throughout the Rhabdoviridae family. PMID- 2769230 TI - Protection of woodchucks from infection with woodchuck hepatitis virus by immunization with recombinant core protein. AB - Woodchucks were immunized with recombinant woodchuck hepatitis virus (WHV) core antigen (WHcAg) to investigate whether such immunization protects against WHV infection. The C gene was cloned into a pUC12 vector and expressed in Escherichia coli. Core particles purified by sucrose and CsCl gradient centrifugation had a buoyant density of 1.37 g/ml which corresponded to the density of WHcAg particles present in chronically infected liver. Two animals immunized with the recombinant antigen developed high antibody titres and were protected against infection after challenge with WHV. The surface antigen (WHsAg) and WHV DNA were not detected in the sera of immunized animals after challenge and these animals did not develop anti-WHs. Three control animals developed a typical WHV infection. The protection from WHV infection may depend not on the presence of antibodies against the core protein but on a cellular immune response to WHcAg. PMID- 2769231 TI - IgG-neutralized influenza virus undergoes primary, but not secondary uncoating in vivo. AB - Even when neutralized by saturating amounts of monoclonal IgG directed against the haemagglutinin, influenza virus attaches to cells with kinetics similar to those of infectious virus. It then enters those cells and is uncoated; its RNA becomes localized within the nucleus and its lipid envelope and associated proteins remain in the cytoplasm. In this report we show that despite the apparent normality of these early stages of virus-cell interaction, neutralized virus underwent no detectable primary transcription. In contrast, there was only a slight inhibition of transcription by neutralized virus in vitro which was insufficient to account for the loss in infectivity, despite using mRNA to measure the production of capped oligonucleotides or to prime the elongation step. To test whether the absence of primary transcription in vivo resulted from non-accessibility of the genome rather than an effect on the transcriptase complex itself, we examined the susceptibility to RNase of virion RNA after inoculation of cells with neutralized virus. Data clearly show that, unlike RNA of infectious virus, RNA of neutralized virus did not become sensitive to RNase and we conclude that neutralization of influenza virus by IgG results in failure of virus to undergo a secondary uncoating process which is necessary for the activity of the virion transcriptase complex. Finally we show that by treatment of virions in vitro with detergent it is possible to produce a core structure which is stable and has some of the properties expected of a structure resulting from primary uncoating. PMID- 2769232 TI - Biological and genetic evolution of the nucleoprotein gene of human influenza A viruses. AB - There is a significant difference in the ability of human influenza A virus H1N1 strains isolated up to 1977 and those isolated later to rescue temperature sensitive mutants of fowl plague virus with a defect in the nucleoprotein (NP) gene. Therefore the NP genes of five human H1N1 and H3N2 influenza A virus strains, isolated between 1950 and 1978, have been sequenced. By comparison with previous and more recent isolates, an evolutionary pathway has been established. Three amino acid replacements were found which might be responsible for the functional difference between the USSR (1977) and the Brazil (1978) strains. The California (H1N1) strain isolated in 1978 had acquired by reassortment the NP gene of a human H3N2 virus circulating at about 1977 as had been previously suggested by investigations involving RNase fingerprint or hybridization techniques. PMID- 2769233 TI - Differential sensitivity of macrophages from herpes simplex virus-resistant and susceptible mice to respiratory burst priming by interferon-alpha/beta. AB - Herpes simplex virus primes mouse macrophages for a genetically determined respiratory burst mediated in an autocrine manner by interferon (IFN)-alpha/beta. We have analysed the effect of IFN-alpha/beta on the respiratory burst capacity of mouse peritoneal macrophages by luminol-dependent chemiluminescence using phorbol myristate acetate as trigger. Crude macrophage-produced IFN-alpha/beta as well as purified IFN-alpha and -beta regularly augmented the respiratory burst capacity of peritoneal cells in a concentration-dependent manner. The augmented response was exclusively mediated by macrophages and was manifest after 4 h incubation with IFN-alpha/beta, peaked after 8 h and gradually declined to near background levels after 24 h. The effect of macrophage-produced IFN-alpha/beta was completely abolished by preincubation of IFN with antiserum to IFN alpha/beta. The data obtained with this antiserum indicated that endogenous IFN, undetectable by a standard cytopathic effect-inhibition assay, was sometimes spontaneously produced by the peritoneal cells. Furthermore, the crude macrophage preparation seemed to contain a macrophage deactivating factor counteracting the effect of IFN-alpha/beta. Genetic analysis of the sensitivity of macrophages for the respiratory burst-priming effect of IFN-alpha/beta revealed that the trait is inherited as a co-dominant autosomal feature. Macrophages from herpes simplex virus-resistant C57BL/6 mice were more sensitive than macrophages from virus susceptible BALB/c mice and cells from mice of the reciprocal crosses showed an equal sensitivity intermediate between those of the parental strains. A physiological role of differential IFN sensitivity in the context of resistance to virus infections is suggested. PMID- 2769234 TI - Antibody responses and protection in mice immunized with herpes simplex virus type 1 antigen immune-stimulating complex preparations. AB - The formation of immune-stimulating complexes (iscoms) obtained by mixing the glycoside Quil A with an antigen preparation derived from herpes simplex virus type 1 (HSV-1)-infected cell cultures using a zwitterionic detergent is described. The HSV-1 antigen preparation incorporated into iscoms elicited significantly greater antibody responses in mice than the same preparation administered together with aluminium hydroxide gel, and provided complete protection against HSV-1 or HSV-2 lethal, systemic challenge infection in animals given a single dose containing 5 micrograms of protein. The HSV-1 iscom preparation also provided significant protection in mice against local reactions following challenge with HSV-1 by skin scarification. PMID- 2769235 TI - Matrix protein of cell-associated subacute sclerosing panencephalitis viruses. AB - The nucleotide sequence has been determined for the matrix (M) protein gene of three strains, Niigata-1, ZH and Biken, of cell-associated subacute sclerosing panencephalitis (SSPE) virus. The M proteins of the Niigata-1 and ZH strains were found to terminate prematurely as a result of nonsense mutations at nucleotide positions 68 and 96 respectively. On the other hand it was predicted that the Biken strain would express M protein with 22 amino acid differences and eight additional amino acids at its C terminus in comparison to the M protein of the Edmonston strain of measles virus. Radiolabelling of cells carrying the Biken strain showed the production of an M protein with considerably altered immunoreactivity and a marked reduction in intracellular stability. Either premature termination or rapid degradation of the M protein may underlie the defectiveness of these three strains of SSPE virus. PMID- 2769236 TI - The design and use of specific genetic probes to identify closely related bunyaviruses and to determine the genotype of their recombinants. AB - Viruses that are very closely related to each other at the genetic and gene product level can prove difficult to distinguish, although they may differ in phenotype (for example in their virulence or vector preferences). A chimeric genetic probe has been developed and tested to distinguish the S RNAs of two closely related bunyaviruses, snowshoe hare and La Crosse viruses. The technique is applicable to other RNA species of these two bunyaviruses. PMID- 2769237 TI - Comparison of RNAs and polypeptides of infectious pancreatic necrosis virus isolates from eel and rainbow trout. AB - Thirteen isolates of infectious pancreatic necrosis virus (IPNV) from eel and rainbow trout in Taiwan were compared with the selected serotypes AB, SP and VR 299 by PAGE analysis of their RNA genomes and early polypeptides. All the IPNV isolates from eels (1984 to 1986) from Lu Kang and Ping Tung, and from rainbow trout eggs and fry from Dan Sway (1985 to 1986) were most closely related to the AB serotype. However four rainbow trout isolates from Dan Sway (1984) had a similar RNA pattern to that of VR-299, whereas their early polypeptides were different, showing evidence of some mutations. Both RNA and polypeptide PAGE patterns were used to distinguish the isolates from known selected IPNV strains showing that this approach can be used for epizootiological studies. PMID- 2769238 TI - Isolation and morphological characterization of El Tor cholera phages. AB - Five bacteriophages have been isolated for phage typing of Vibrio cholerae biotype El Tor. The morphology of these phages has been studied by electron microscopy. PMID- 2769239 TI - Twins' responses to pleasant, unpleasant, and life events. AB - Pairs of monozygotic (n = 41) and same-sex dizygotic (n = 29) twins were administered the Pleasant Events Schedule, the Unpleasant Events Schedule (Lewinsohn & Amenson, 1978), and the Life Experiences Survey (Sarason, Johnson, & Siegel, 1978). These provided indices of both the frequency of and the emotional response to mood-related events. Monozygotic twins resembled one another more than dizygotic twins on all subscales of these measures, and the greater similarity was statistically significant for most of the subscales. This suggests that there may be a genetic influence on affect, which is expressed through both the frequency of engagement in and the emotional response to mood-related events. The results are discussed in the context of studies of genetic influences on subclinical levels of depression and other emotions. PMID- 2769240 TI - Eating-problem patients' conceptions of normality. AB - Three groups of people--anorexic patients, helping professionals, and a control group--filled out the Eating Attitude Test (Garner & Garfinkel, 1979) three times. The control subjects were asked to fill it out honestly for themselves; as they imagined an ordinary person might complete it; and, finally, as they would expect a patient with an eating disorder to fill it out. The anorexic patients were asked to complete it honestly for themselves; as they imagined an ordinary person might fill it out; and, finally, as they would expect to fill it out when fully recovered. The professionals filled out the questionnaires as they imagined the typical patient with eating disorders might; as they imagined the ordinary person might complete it; and as a recovered patient might complete it. The results provided support for some but not all hypotheses, the most central of which was that there would be a difference between how the patients rated the ordinary person and how control subjects (supposedly ordinary people) rated themselves. PMID- 2769241 TI - Psychological factors, immunocompetence, and health of breast-feeding mothers and their infants. AB - We investigated whether the use of humor as a coping device and psychological hardiness were related to IgA levels in the saliva and breast milk of mothers, and if these factors were related to the incidence of upper respiratory infection (URI) in the mothers and their newborns. Nineteen mothers volunteered to participate and met the qualifications; however, only 17 completed all phases of the study. Prior to the birth of their child, mothers filled out demographic questionnaires and the psychological inventories. Saliva and milk samples were taken within 1 week after delivery, and follow-up questionnaires were mailed out 2 months after delivery. Coping humor was inversely related to URI incidence in both the mothers and the infants. Hardiness was directly related to coping humor and inversely related to URI incidence in the infants. Older mothers had higher coping humor and hardiness scores and fewer URIs in themselves and their infants. PMID- 2769242 TI - Children's engagement in antidepressive activities. AB - The relationship between depressive symptomatology and engagement in activities designed to cope with depression was examined among 42 children (8 to 14 years old), their parents, and 167 college students. The Beck Depression Inventory and Children's Depression Inventory were used to assess depression in adults and children, and adult and child forms of Rippere's (1977) Antidepressive Activity Questionnaire were employed to assess the frequency of engagement in and helpfulness of antidepressive activities. For children, depression was more strongly correlated with the helpfulness of than with the frequency of engagement in antidepressive activities; for adults, depression was more strongly related to the frequency than to the helpfulness of antidepressive activities. Girls reported that antidepressive activities were more helpful in combating depression than did boys; women engaged more frequently in antidepressive activities and found such activities more helpful in alleviating depression than did men. Little similarity was observed between the antidepressive activities of children and their parents. PMID- 2769243 TI - Sex, ethnic, and social differences in test anxiety among Israeli adolescents. AB - The effects of sex, ethnicity, and social class on levels of test anxiety were examined among a sample of 416 adolescent students in Israel. Significant sex differences in mean levels of test anxiety were found, with girls scoring consistently higher than boys across ethnic, social, and grade categories. Pupils of low socioeconomic status (SES) also scored consistently higher than pupils of high SES across grades. Nevertheless, this study provides little support for the commonly held view that sociocultural or sex group differences in school achievement are due, in any meaningful way, to differences in test anxiety. The group differences, though significant for SES and sex, were of negligible magnitude, and the correlation between test anxiety scores and grade point average was minimal for the group as a whole and nonsignificant for students of Eastern background, who have been purported to be particularly affected by high levels of test anxiety. The findings do support other cross-cultural studies, which have found only a modicum of shared variance between test anxiety and grades. It is concluded that test anxiety is not a particularly valid predictor of achievement or ability. PMID- 2769244 TI - Development of thinking about things and people: social and nonsocial cognition during adolescence. AB - Among a group of 90 adolescents, the tendency to use organizing terms in free descriptions of persons was positively associated with a measure of formal operations. This association endured when age and mental age were statistically partialled out of the relationship. The results are taken to support the notion that basic cognitive developments also manifest themselves in the social cognitive area. PMID- 2769245 TI - Creativity and schizotypal thinking. PMID- 2769246 TI - Antisocial and related disorders in a southern community. An application of grade of membership analysis. AB - Symptoms of antisocial personality disorder (ASPD) and of psychiatric conditions reported to be related to ASPD were subjected to grade of membership analysis, a relatively new procedure for medical classification, to identify the pure types that would empirically emerge in the absence of prior assumptions about the clustering of those symptoms. The sample consists of 914 respondents who participated in the NIMH Epidemiologic Catchment Area Program at the North Carolina site. Symptom and diagnostic data were obtained using the Diagnostic Interview Schedule. Seven pure types emerged from the grade of membership analysis. Two pure types closely resemble the DSM-III portrait of ASPD. Two other pure types consisted of alcohol abuse/dependence symptoms and indicators of illicit drug use for recreational purposes. Only two of the symptomatic pure types were common among women. The first of these was characterized by marital instability, other domestic problems, and employment difficulties; as such this type resembles the DSM-III description of borderline and/or histrionic personality disorder. The other female pure type was characterized by multiple symptoms of depression and selected symptoms of other axis I disorders. The final pure type was characterized by an absence of psychiatric symptoms and served as a comparison group against which the symptomatic pure types were compared. PMID- 2769247 TI - Clonidine in Cambodian patients with posttraumatic stress disorder. AB - Some symptoms of posttraumatic stress disorder (PTSD) are related to central nervous system adrenergic hyperarousal. It has been suggested that an adrenergic receptor-blocker could be used to diminish, if not alleviate, the target symptoms of PTSD. Severely traumatized Cambodian refugee patients (N = 68) who suffered from chronic PTSD and major depression improved symptomatically when treated with a combination of clonidine and imipramine. A prospective pilot study of nine patients using this combination of an alpha-2 adrenergic agonist and a tricyclic antidepressant resulted in improved symptoms of depression in six patients, five to the point that DSM-III-R diagnoses were no longer met. The average decrease in the Hamilton Rating Scale for Depression score was 16. PTSD global symptoms improved in six patients but only in two to the point that DSM-III-R diagnoses were not met. There was no further sleep disorder in five and the frequency of nightmares lessened in seven patients. Startle reaction improved only in four patients; avoidance behavior showed little improvement in any of the nine. The imipramine-clonidine combination was well tolerated and presents a promising treatment for severely depressed and traumatized patients, although further studies are needed. PMID- 2769248 TI - Network television news stories about suicide and short-term changes in total U.S. suicides. AB - A number of recent reports have documented a positive association between mass media news stories about suicide and subsequent short-term increases in total U.S. suicides. However, the estimated magnitude of this association varies considerably across these published reports and tends to be smaller in the more comprehensive studies. A detailed investigation of all network television suicide news stories broadcast between January 1, 1973, and December 31, 1984, was undertaken to resolve this inconsistency. The information about television coverage of suicides was more comprehensive than in previous studies. The analyses show that there was no reliable association between news stories and suicides among adults at any time over the 12 years investigated. A reliable association existed among teenagers between 1973 and 1980. This association reversed in 1981, however, and the relative risk of suicide associated with network news stories was consistently less than 1.0 through the end of the study period. PMID- 2769250 TI - Dreams as a possible reflection of a dissociated self-monitoring system. PMID- 2769249 TI - Birth order, psychological well-being, and social supports in young adults. AB - Enduring aspects of childhood family structure that reflect emotional and interpersonal ties throughout development are assumed to affect the psychological well-being and social relatedness of the mature individual. This study examined one facet of family structure--birth order--and its effects on psychological well being (PWB) and social networks in young adult high school graduates 17 to 23 years old (N = 2886; male = 76%, female = 24%). PWB was measured as an overall score with positive feelings and negative feelings subscores. First-born males scored greater on the negative feelings subscale of PWB, and male later borns had higher total psychological well-being. No differences were found for females. First borns and later borns did not differ in positive feelings or social relatedness. Further study is needed on the relationship of birth order and social relatedness in young adults, particularly females. PMID- 2769251 TI - Relationship between plasma and cerebrospinal fluid norepinephrine and dopamine metabolites in a nonhuman primate. AB - Major and minor pathways of metabolism in the mammalian CNS result in the formation of 3-methoxy-4-hydroxyphenylethylene glycol (MHPG) and normetanephrine (NMN) from norepinephrine (NE), and homovanillic acid (HVA) and 3-methoxytyramine (3-MT) from dopamine (DA), respectively. The correlational relationships between HVA and 3-MT and between MHPG and NMN in primate CSF and plasma have not been described. These relationships may help to elucidate the usefulness of CSF and plasma metabolites as indices of CNS NE and DA activity. In addition, because NMN is unlikely to cross the blood-brain barrier. CSF NMN concentrations would not be confounded by contributions from plasma, which is a major issue with CSF MHPG. We have obtained repeated samples of plasma and CSF from drug-naive male squirrel monkeys and have measured the concentrations of MHPG, HVA, NMN, and 3-MT to define their correlational relationships. For the NE metabolites, significant correlations were obtained for CSF MHPG and NMN (r = 0.806, p less than 0.001), plasma MHPG and CSF NMN (r = 0.753, p less than 0.001), and plasma and CSF MHPG (r = 0.776, p less than 0.001). These results suggest that CSF and plasma MHPG and CSF NMN may reflect gross changes in whole brain steady-state noradrenergic metabolism. Only a single significant relationship was demonstrated for the DA metabolites, with CSF 3-MT correlating with plasma HVA (r = 0.301, p less than 0.025). The results for the DA metabolites probably reflect regional differences in steady-state brain dopaminergic metabolism. PMID- 2769252 TI - Predominant low-molecular-weight proteins in isolated brain capillaries are histones. AB - Blood-brain barrier (BBB) function is endowed by the expression of unique proteins within the brain capillary endothelium. In the absence of knowing the function of BBB-specific proteins, one strategy for identification of these proteins is the purification and amino acid sequencing of proteins within the brain capillary that are not found in other cells. Earlier studies have shown that a 16-18K triplet of low-molecular-weight proteins in isolated brain capillaries is not found in either erythrocytes or in capillary-free preparations of synaptosomal proteins. Therefore, the present studies describe the purification of the 16-18K triplet of proteins as well as a 14K protein in isolated brain capillaries using sodium dodecyl sulfate (SDS)-polyacrylamide gel electrophoresis (PAGE) and C4 reverse-phase HPLC. Amino acid sequencing of the N terminus of the 14K, 17K, and 18K proteins and of two tryptic peptides of the 16K protein showed that these proteins are alpha-globin, histone 2B, histone 3, and histone 2A, respectively. SDS-PAGE of subcellular fractions of bovine brain capillaries demonstrated that the 16-18K triplet of histone proteins migrated in the nuclear fraction. In addition, a 34K doublet and a 200K protein were localized in the nuclear pellet. Therefore, the present studies demonstrate that the predominant 14-18K proteins seen on SDS-PAGE of isolated brain capillaries are known proteins and provide a general scheme for purification of brain capillary proteins isolated following SDS-PAGE. PMID- 2769253 TI - Inositol hexakisphosphate (phytic acid) enhances Ca2+ influx and D-[3H]aspartate release in cultured cerebellar neurons. AB - Inositol hexakisphosphate (InsP6) increased 45Ca2+ uptake in cultured cerebellar granule cells. This increase was concentration dependent (EC50 = 20 microM), exhibited slow kinetics, and was present after 5 days of cell maturation in culture. InsP6 also enhanced D-[3H]aspartate release in cerebellar granule cells at 11-12 days in vitro. Stimulation of 45Ca2+ uptake was also produced by inositol pentakisphosphate but not by inositol 1,3,4,5-tetrakisphosphate. The increase in 45Ca2+ influx induced by InsP6 was independent of extracellular Na+ and was only partially reduced by the organic calcium channel blocker nifedipine. The intrinsic action of InsP6 was not affected by competitive or noncompetitive glutamate receptor antagonists. In addition, stimulations of 45Ca2+ uptake by InsP6 and glutamate were additive. These data provide evidence that InsP6 directly activates a specific population of neurons in the CNS. PMID- 2769254 TI - Reduced glucose transporter at the blood-brain barrier and in cerebral cortex in Alzheimer disease. AB - We studied the hexose transporter protein of the frontal and temporal neocortex, hippocampus, putamen, cerebellum, and cerebral microvessels (which constitute the blood-brain barrier) in Alzheimer disease and control subjects by reversible and covalent binding with [3H]cytochalasin B and by immunological reactivity. In Alzheimer disease subjects, we found a marked decrease in the hexose transporter in brain microvessels and in the cerebral neocortex and hippocampus, regions that are most affected in Alzheimer disease, but there were no abnormalities in the putamen or cerebellum. Hexose transporter reduction in cerebral microvessels of Alzheimer subjects is relatively specific because other enzyme markers of brain endothelium were not significantly altered. The low density of the hexose transporter at the blood-brain barrier and in the cerebral cortex in Alzheimer disease may be related to decreased in vivo measurements of cerebral oxidative metabolism. PMID- 2769255 TI - Oligosaccharide composition, localization, and developmental changes of a CNS specific (F3-87-8) glycoprotein. AB - The F3-87-8 glycoprotein was isolated from rat brain by immunoaffinity chromatography after biosynthetic labeling by intracerebral administration of [3H]glucosamine, and the oligosaccharide composition of pronase-derived glycopeptides was determined by sequential lectin affinity chromatography and alkali treatment. Triantennary complex oligosaccharides (65%) and O-glycosidic oligosaccharides (18%) were the predominant types present, accompanied by 7-10% each of biantennary and high-mannose oligosaccharides. Twenty-two percent of the complex oligosaccharides had a fucose residue linked to the proximal N acetylglucosamine of the chitobiose units. No poly(N-acetyllactosaminyl) or hybrid oligosaccharides were detected. Immunocytochemical studies on the localization of this glycoprotein in developing rat brain demonstrated that in 1 week postnatal cerebellum, there is light staining of the internal granule cell layer and surrounding the Purkinje cells. By 2 weeks, an intense staining of myelinating fiber tracts appears, accompanied by much lighter staining in the granule cell layer and at the base of the molecular layer. Staining of the white matter remains strong at 3 weeks postnatal, together with significant staining throughout the molecular layer, and then decreases in both areas by 1 month. In adult brain there is relatively uniform staining of approximately equal intensity in the white matter, granule cell layer, and molecular layer, whereas the Purkinje cell bodies appear unstained throughout development. In agreement with a previously reported immunochemical analysis, no staining was seen in other tissues, confirming the CNS-specific localization of this glycoprotein. PMID- 2769256 TI - The novel neuropsychotropic agent milacemide is a specific enzyme-activated inhibitor of brain monoamine oxidase B. AB - The novel neuropsychotropic agent milacemide hydrochloride (2-n pentylaminoacetamide HCl) is a highly selective substrate of the B form of monoamine oxidase (EC 1.4.3.4; MAO). Under the in vitro conditions used in the present study, milacemide acts as an enzyme-activated, partially reversible inhibitor of MAO-B. A reversible inhibition of MAO-A activity is also observed at high concentrations. The inhibitory activity of milacemide is significantly greater for MAO-B. In vivo, after single or repeated oral administration, a specific inhibition of MAO-B is apparent in brain and liver, with a lack of inhibition of the MAO-A activity. In contrast to the irreversible inhibitory action of L-deprenyl, the recovery of MAO-B activity in vivo after milacemide administration is significantly faster, a result suggesting that it is a partially reversible inhibitor. The selective inhibitory effect of milacemide for MAO-B in vivo is confirmed by its potentiation of phenylethylamine-induced stereotyped behavior, whereas vasopressor responses to tyramine were not affected. These observations suggest that milacemide could enhance dopaminergic activity in the brain and could be used as therapy for Parkinson's disease in association with L-3,4-dihydroxyphenylalanine. PMID- 2769257 TI - A rapid purification of L-glutamic acid decarboxylase from the brain of the locust Schistocerca gregaria. AB - L-Glutamic acid decarboxylase (GAD; EC 4.1.1.15) was purified to apparent homogeneity from the brain of the locust Schistocerca gregaria using a combination of chromatofocusing (Mono P) and gel filtration (Superose 12) media. The homogeneity of the enzyme preparation was established by native polyacrylamide gel electrophoresis (PAGE) with silver staining. The molecular weight of the purified enzyme was estimated from native gradient gel electrophoresis and gel filtration chromatography to be 97,000 +/- 4,000 and 93,000 +/- 5,000, respectively. When analysed by sodium dodecyl sulphate-PAGE, the enzyme was found to be composed of two distinct subunits of Mr 51,000 +/- 1,000 and 44,000 +/- 1,500. Tryptic peptide maps of iodinated preparations of these two subunits showed considerable homology, suggesting that the native enzyme is a dimer of closely related subunits. The purified enzyme had a pH optimum of 7.0-7.4 in 100 mM potassium phosphate buffer and an apparent Km for glutamate of 5.0 mM. The enzyme was strongly inhibited by the carbonyl-trapping reagent aminooxyacetic acid with an I50 value of 0.2 microM. PMID- 2769258 TI - Characterization and regional distribution of peptides derived from the vasoactive intestinal peptide precursor in the normal human brain. AB - To study the biosynthetic processing of the precursor for vasoactive intestinal peptide (prepro-VIP) in the human brain, we have developed antisera against the five functional domains of the precursor molecule: prepro-VIP 22-79, peptide histidine methionine (PHM), prepro-VIP 111-122, VIP, and prepro-VIP 156-170. The antisera were used in radioimmunoassays in combination with HPLC to identify and quantify the peptides in regions of the human brain. All five peptides were expressed, but mainly in nonequimolar ratios. In only three regions were the same amounts of VIP and PHM found; in the remaining areas the concentration of PHM was two-thirds that of VIP. The concentrations of prepro-VIP 22-79, prepro-VIP 111 122, and prepro-VIP 156-170 were considerably lower than the corresponding VIP concentrations, and the relative concentration of prepro-VIP 111-122 differed between cortical and subcortical areas. A small proportion of the VIP precursor followed a pathway in which the dibasic conversion site after PHM is not cleaved, as evidenced by the presence of a C-terminally extended form of PHM. Finally, it was found that the C-terminal lysine residue of prepro-VIP is not removed during processing. The findings indicate that differences in the posttranslational processing of prepro-VIP exist in subpopulations of neurons in the human brain. PMID- 2769259 TI - Allosteric activation of brain mitochondrial Ca2+ uptake by spermine and by Ca2+: developmental changes. AB - Kinetic analysis of 45Ca2+ uptake by rat brain mitochondria in Ca2+ - 1,2-bis(o aminophenoxy)ethane-N,N,N',N'-tetraacetic acid buffers indicated that spermine both increased the apparent affinity for Ca2+ and decreased the cooperativity of uptake. Both effects are consistent with an allosteric activation of uptake by spermine. The stimulating effect of spermine on 45Ca2+ uptake was maximal with mitochondria from postnatal day 10 animals and then steadily decreased with increasing age to reach adult values by approximately 30 postnatal days; this was observed independently of the substrates used to fuel mitochondria. Mitochondrial Ca2+ buffering was also analyzed by use of a Ca2+-selective electrode. Addition of a large bolus of Ca2+ produced a decrease in the subsequent equilibrium extramitochondrial Ca2+ concentration (or a "rebound overshoot") under some conditions. It is proposed that this effect is the result of an allosteric activation of Ca2+ uptake by Ca2+. This effect was slowly reversible, or hysteretic, and was blocked by spermine. The overshoot was increased in the presence of higher concentrations of Mg2+ and was absent when mitochondria were incubated with 0.3 mM Mg2+. It was maximal in mitochondria prepared from early postnatal brain, and changes in the magnitude of the effect during development paralleled those obtained with spermine stimulation of 45Ca2+ uptake. The data suggest that spermine produces an allosteric activation of Ca2+ uptake by binding to the same regulatory sites that are involved in the Ca2+-induced activation. The results as a whole suggest that spermine could modulate mitochondrial buffering of the intracellular Ca2+ concentration in brain, particularly during the early postnatal period. PMID- 2769260 TI - Allosteric activation of brain mitochondrial Ca2+ uptake by spermine and by Ca2+: brain regional differences. AB - Analysis of the initial rates of 45Ca2+ uptake by rat brain mitochondria in Ca2+ 1,2-bis(o-aminophenoxy)ethane-N,N,N',N'-tetraacetic acid buffers indicated that nontelencephalic mitochondria exhibited both a much less pronounced stimulatory effect of spermine and significantly more hyperbolic kinetics of Ca2+ uptake than telencephalic mitochondria. Nontelencephalic mitochondria were also markedly less susceptible to a Ca2+-induced hysteretic allosteric activation of the Ca2+ uniporter. A new Ca2+ loading procedure, which strikingly illustrates differences in mitochondrial Ca2+ buffering characteristics, is also described. In this procedure, low concentrations of Ca2+ (1, 2, or 5 microM) were repetitively added to mitochondria every 30 s while changes in free Ca2+ concentration were recorded. Spermine induced a marked attenuation of the rise in free Ca2+ level under these conditions. Steady-state rates of Ca2+ uptake were determined by a quantitative analysis of the buffering of repetitive Ca2+ additions, and, again, brain regional differences were qualitatively similar to those observed in the initial rate kinetics; Ca2+ uptake by nontelencephalic mitochondria in the steady state was markedly less responsive to stimulation by spermine and appeared to have a more hyperbolic dependence on Ca2+ in the absence of spermine. These results also suggest that there is a lag time in the activation of the uniporter by Ca2+, in addition to the hysteresis that has previously been observed in the deactivation of the uniporter.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2769261 TI - Calcium/diacylglycerol-dependent protein kinase and its major 87-kilodalton protein substrate are differentially distributed in rat basal ganglia. AB - When brain tissue is subjected to subcellular fractionation, both calcium/diacylglycerol-dependent protein kinase (protein kinase C) and an 87 kilodalton (kDa) protein substrate for this enzyme are enriched in the crude nerve terminal fraction. The present study, using chemical and surgical lesions of neurons in the rat neostriatum and substantia nigra, has examined whether the 87-kDa protein is colocalized with protein kinase C in identified neurons and nerve terminals. Our results show that, in the basal ganglia, protein kinase C is highly enriched in local striatal neurons and the striatonigral fibers and terminals. In contrast, the 87-kDa protein appears to be widely and evenly distributed in both neuronal and nonneuronal cells. The 87-kDa protein may therefore mediate functions of protein kinase C not restricted to nerve terminals. PMID- 2769262 TI - Effects of phorbol esters and forskolin on basal and histamine-induced accumulation of inositol phosphates in cultured bovine adrenal chromaffin cells. AB - The effect of phorbol esters and forskolin pretreatment on basal and histamine induced accumulation of inositol phosphates and catecholamine release was examined in cultures of bovine adrenal chromaffin cells. Histamine caused a dose dependent, Ca2+-dependent accumulation of total inositol phosphates with an EC50 at approximately 1 microM and an eight- to 10-fold increase at 100 microM within 30 min of incubation. Histamine (10 microM) also caused the release of cellular catecholamines amounting to some 2.8% of cellular stores released over a 20-min period. Both the inositol phosphate and catecholamine responses were completely blocked by the H1-antagonist mepyramine and were insensitive to the H2-antagonist cimetidine. Examination of the time course of accumulation of the individual inositol phosphates stimulated by histamine revealed an early and sustained rise in inositol 1,4-bisphosphate content but not inositol 1,4,5-trisphosphate content at 1 min and the overall largest accumulation of inositol monophosphate after 30 min of stimulation. Pretreatment with the tumor-promoting phorbol ester phorbol 12-myristate 13-acetate (PMA) resulted in a dose-dependent, time-dependent inhibition of histamine-induced inositol phosphate formation and catecholamine secretion. In this inhibitory action, PMA exhibited high potency (IC50 of approximately 0.5 nM), an effect not shared by the inactive phorbol ester 4-alpha phorbol 12,13-didecanoate. Pretreatment with forskolin, on the other hand, only marginally inhibited the histamine-induced inositol phospholipid metabolism and catecholamine secretion. These data suggest that protein kinase C activation in chromaffin cells may mediate a negative feedback control on inositol phospholipid metabolism. PMID- 2769263 TI - Inhibition of amino acid transport and protein synthesis by HgCl2 and methylmercury in astrocytes: selectivity and reversibility. AB - The previously reported observation that submicromolar concentrations of HgCl2 inhibit glutamate uptake reversibly in astrocytes, without effect on 2 deoxyglucose uptake, suggested that elemental mercury vapor, which is oxidized to mercuric mercury in the brain, might cause neurodegenerative change through the mediation of glutamate excitotoxicity. Here, selectivity is explored further by measuring the inhibition of other amino acid transporters and protein synthesis as a function of HgCl2 concentration. The properties of MeHgCl were compared under identical conditions, and some morphological correlates of function were examined. Inhibition of amino acid transport by HgCl2 was selective, whereas MeHgCl was nonselective. The 50% inhibitory concentrations of HgCl2 for uptake of alpha-aminoisobutyric acid by system A, uptake of alpha-aminoisobutyric acid or kynurenine by a system L variant, and uptake of gamma-aminobutyric acid were all two- to fourfold greater than that for uptake of glutamate. The submicromolar concentrations of HgCl2 that inhibited glutamate transport also inhibited protein synthesis, but in a rapidly reversible fashion, and elicited only discrete ultrastructural changes (heterochromatin, increased numbers of lysosomal bodies, and increased complexity of cell surface). In contrast, inhibition of protein synthesis by MeHgCl was acutely (1-h) irreversible and became marked only at concentrations higher than those that elicited gross morphologic change in the form of "bleb"-like swellings. The results lend support to the proposed excitotoxic mediation of mercury vapor neurotoxicity and reveal a sharp contrast between the effects of HgCl2 and MeHgCl on astrocytes. PMID- 2769264 TI - Protein phosphorylation in astrocytes mediated by protein kinase C: comparison with phosphorylation by cyclic AMP-dependent protein kinase. AB - The protein kinase C activator, phorbol 12-myristate 13-acetate (PMA), has been found recently to transform cultured astrocytes from flat, polygonal cells into stellate-shaped, process-bearing cells. Studies were conducted to determine the effect of PMA on protein phosphorylation in astrocytes and to compare this pattern of phosphorylation with that elicited by dibutyryl cyclic AMP (dbcAMP), an activator of the cyclic AMP-dependent protein kinase which also affects astrocyte morphology. Exposure to PMA increased the amount of 32P incorporation into several phosphoproteins, including two cytosolic proteins with molecular weights of 30,000 (pI 5.5 and 5.7), an acidic 80,000 molecular weight protein (pI 4.5) present in both the cytosolic and membrane fractions, and two cytoskeletal proteins with molecular weights of 60,000 (pI 5.3) and 55,000 (pI 5.6), identified as vimentin and glial fibrillary acidic protein, respectively. Effects of PMA on protein phosphorylation were not observed in cells depleted of protein kinase C. In contrast to the effect observed with PMA, treatment with dbcAMP decreased the amount of 32P incorporation into the 80,000 protein. Like PMA, treatment with dbcAMP increased the 32P incorporation into the proteins with molecular weights of 60,000, 55,000 and 30,000, although the magnitude of this effect was different. The effect of dbcAMP on protein phosphorylation was still observed in cells depleted of protein kinase C. The results suggest that PMA, via the activation of protein kinase C, can alter the phosphorylation of a number of proteins in astrocytes, and some of these same phosphoproteins are also phosphorylated by the cyclic AMP-dependent mechanisms. PMID- 2769265 TI - Binding of crotoxin, a presynaptic phospholipase A2 neurotoxin, to negatively charged phospholipid vesicles. AB - Crotoxin, isolated from the venom of Crotalus durissus terrificus, is a potent neurotoxin consisting of a basic and weakly toxic phospholipase A2 subunit (component B) and an acidic nonenzymatic subunit (component A). The nontoxic component A enhances the toxicity of the phospholipase subunit by preventing its nonspecific adsorption. The binding of crotoxin and of its subunits to small unilamellar phospholipid vesicles was examined under experimental conditions that prevented any phospholipid hydrolysis. Isolated component B rapidly bound with a low affinity (Kapp in the millimolar range) to zwitterionic phospholipid vesicles and with a high affinity (Kapp of less than 1 microM) to negatively charged phospholipid vesicles. On the other hand, the crotoxin complex did not interact with zwitterionic phospholipid vesicles but dissociated in the presence of negatively charged phospholipid vesicles; the noncatalytic component A was released into solution, whereas component B remained tightly bound to lipid vesicles, with apparent affinity constants from 100 to less than 1 microM, according to the chemical composition of the phospholipids. On binding, crotoxin or its component B caused the leakage of a dye entrapped in vesicles of negatively charged but not of zwitterionic phospholipids. The selective binding of crotoxin suggests that negatively charged phospholipids may constitute a component of the acceptor site of crotoxin on the presynaptic plasma membrane. PMID- 2769266 TI - Isolation and partial characterization of an 80,000-dalton protein kinase from the microvessels of the porcine brain. AB - A novel serine/threonine-specific protein kinase was isolated from the microvessels of porcine brains. The molecular mass of the protein is 80,000 daltons, as judged by gel electrophoresis under denaturing conditions, or 122,000 daltons, on high-resolution gel permeation chromatography in the native state. The activity of this enzyme is stimulated by various histones or polyamines, like spermine or spermidine, but not by any of the common second messengers. The amino terminal sequence data show no homologies to any of the published kinases, but rather to a heat-shock protein of unknown function. PMID- 2769267 TI - Isolation and characterization of a rat brain triakontatetraneuropeptide, a posttranslational product of diazepam binding inhibitor: specific action at the Ro 5-4864 recognition site. AB - This report describes the purification and characterization from rat brain of triakontatetraneuropeptide (TTN, DBI 17-50), a major biologically active processing product of diazepam binding inhibitor (DBI). Brain TTN was purified by immunoaffinity chromatography with polyclonal octadecaneuropeptide, DBI 33-50) antibodies coupled to CNBr-Sepharose 4B followed by two reverse-phase HPLC steps. The amino acid sequence of the purified peptide is: Thr-Gln-Pro-Thr-Asp-Glu-Glu Met-Leu-Phe-Ile-Tyr-Ser-His-Phe-Lys-Gln-Ala-Thr-Val - Gly-Asp-Val-Asn-Thr-Asp-Arg Pro-Gly-Leu-Leu-Asp-Leu-Lys. Synthetic TTN injected intracerebroventricularly into rats induces a proconflict activity (IC50 0.8 nmol/rat) that is prevented by the specific "peripheral" benzodiazepine (BZ) receptor antagonist isoquinoline carboxamide, PK 11195, but not by the "central" BZ receptor antagonist imidazobenzodiazepine, flumazenil. TTN displaces [3H]Ro 5-4864 from synaptic membranes of olfactory bulb with a Ki of approximately 5 microM. TTN also enhances picrotoxinin inhibition of gamma-aminobutyric acid (GABA)-stimulated [3H]flunitrazepam binding. These data suggest that TTN, a natural DBI processing product acting at "Ro 5-4864 preferring" BZ binding site subtypes, might function as a putative neuromodulator of specific GABAA receptor-mediated effects. PMID- 2769268 TI - 13C nuclear magnetic resonance evidence for gamma-aminobutyric acid formation via pyruvate carboxylase in rat brain: a metabolic basis for compartmentation. AB - The compartmentation of amino acid metabolism is an active and important area of brain research. 13C labeling and 13C nuclear magnetic resonance (NMR) are powerful tools for studying metabolic pathways, because information about the metabolic histories of metabolites can be determined from the appearance and position of the label in products. We have used 13C labeling and 13C NMR in order to investigate the metabolic history of gamma-aminobutyric acid (GABA) and glutamate in rat brain. [1-13C]Glucose was infused into anesthetized rats and the 13C labeling patterns in GABA and glutamate examined in brain tissue extracts obtained at various times after infusion of the label. Five minutes after infusion, most of the 13C label in glutamate appeared at the C4 position; at later times, label was also present at C2 and C3. This 13C labeling pattern occurs when [1-13C]glucose is metabolized to pyruvate by glycolysis and enters the pool of tricarboxylic acid (TCA) intermediates via pyruvate dehydrogenase. The label exchanges into glutamate from the TCA cycle pool through glutamate transaminases or dehydrogenase. After 30 min of infusion, approximately 10% of the total 13C in brain extracts appeared in GABA, primarily (greater than 80%) at the amino carbon (C4), indicating that the GABA detected is labeled through pyruvate carboxylase. The different labeling patterns observed for glutamate and GABA show that the large detectable glutamate pool does not serve as the precursor to GABA. Our NMR data support previous experiments suggesting compartmentation of metabolism in brain, and further demonstrate that GABA is formed from a pool of TCA cycle intermediates derived from an anaplerotic pathway involving pyruvate carboxylase. PMID- 2769269 TI - Modulation of tryptophan hydroxylase activity by phospholipids: stimulation followed by inactivation. AB - The activity of tryptophan hydroxylase from the rat brainstem was stimulated rapidly three- to fourfold by the addition of phosphatidylinositol or phosphatidylserine. However, the activity of the enzyme once stimulated was decreased gradually by subsequent incubation with the phospholipid at 37 degrees C, reaching a level below the original activity after 1 h of incubation. The presence of ferrous ion almost perfectly protected the enzyme against this phospholipid inactivation. The activity of the enzyme inactivated by incubation with the phospholipid was not only restored, but also increased further by incubation at 37 degrees C with ferrous ion and dithiothreitol. Gel filtration analysis revealed that the enzyme stimulated by phosphatidylinositol was eluted in a void volume together with the phospholipid vesicles, but the enzyme inactivated by incubation with phosphatidylinositol was eluted at a later region apart from the vesicles. These results, taken together, suggest the possible involvement of cellular membranes in the regulation of tryptophan hydroxylase in the central nervous system. PMID- 2769270 TI - Potassium-stimulated release of [3H]taurine from cultured GABAergic and glutamatergic neurons. AB - The effect of depolarizing concentrations of potassium (56 mM) on the release of [3H]taurine was examined in two types of cultured neurons from mouse brain: cerebral cortex neurons, which are largely GABAergic, and cerebellar neurons, which after treatment with kainate consist almost entirely of glutamatergic granule cells. The release of [3H]taurine was compared to that of gamma [3H]aminobutyric acid [( 3H]GABA) in cortical neurons and to that of D [3H]aspartate in granule cells. Cortical neurons responded to potassium stimulation (1 min or continuously) by an immediate increase in [3H]GABA efflux of more than six times over the basal efflux, followed by a sharp decline despite the persistence of the stimulatory agent. The potassium-induced release of [3H]GABA was largely calcium-dependent. The release of [3H]taurine was considerably less in magnitude, only doubling after the stimulus, with a time course delayed in both onset and decline. The release of [3H]taurine was partially calcium-dependent and was also decreased in low-chloride solutions. In cerebellar granule cells, exposure to potassium resulted in a large (sixfold) and prompt release of D-[3H]aspartate, largely calcium-dependent. A totally different pattern was observed for the release of [3H]taurine. A stimulatory effect occurred only when cells were exposed continuously to potassium. Taurine efflux was very delayed, with a broad stimulus plateau reached after 15-20 min of stimulation. Taurine release was unaffected by omission of calcium, but it was abolished in a low-chloride medium. These results suggest that taurine is released from cells handling other neuroactive amino acids as neurotransmitters.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2769271 TI - Thymopoietin, a thymic polypeptide, specifically interacts at neuronal nicotinic alpha-bungarotoxin receptors. AB - alpha-Bungarotoxin (alpha-BGT), a snake venom polypeptide, interacts potently and specifically with a nicotinic receptor population in neuronal tissue. However, the identity of this site is unclear, because, unlike at the neuromuscular junction and in electroplax, in nervous tissue the toxin does not block nicotinic cholinergic responses. Therefore, we sought endogenous compounds other than acetylcholine that could interact with the neuronal alpha-BGT site. In the present experiments, thymopoietin, a polypeptide isolated from the thymus, is shown to inhibit potently alpha-BGT binding to brain membranes in a dose dependent manner (IC50 = 3.1 nM). This effect was not shared by a wide variety of other peptides, including thysplenin, a closely related polypeptide. Thymopoietin did not inhibit the binding of other radioligands known to interact with different populations of cholinergic receptors, such as [3H]nicotine and [3H]methylcarbachol, which bind to nicotinic receptors, or [3H]quinuclidinylbenzilate, which binds to muscarinic receptors. These results show that thymopoietin potently and specifically affects 125I-alpha-BGT binding to brain membranes and suggest that thymopoietin might be an endogenous ligand for alpha-BGT receptors in neuronal tissue. PMID- 2769272 TI - The odds ratio: a useful tool in neurosciences. AB - The odds ratio is very useful; when used as a measure of association (or to describe the results of a randomised controlled treatment trial) it expresses both the strength and direction of the association (or size and direction of treatment effect). Its 95% confidence interval estimates the likely degree of sampling error and provides a test of significance at the 5% level. Authors, when reporting the results of descriptive studies, case-control studies and randomised controlled trials, should consider presenting their results this way rather than by simple significance testing with a chi squared test. PMID- 2769273 TI - Computed tomography in the diagnosis of malignant brain tumours: do all patients require biopsy? AB - A proportion of patients with computed tomographic (CT) scan appearances of malignant brain tumour undergo conservative management, despite the absence of histological confirmation of the diagnosis. Concern that this policy risked misdiagnosing a benign tumour prompted us to examine the accuracy of CT scanning in diagnosing malignant lesions. The study was designed to determine whether within a group of 300 patients with intracerebral mass lesions of known pathology, two sub-groups existed: one with appearances so specific for malignant glioma that biopsy was unnecessary, and the other in which the appearances were characteristic of malignancy, though not specific for glioma. Three neuroradiologists independently reviewed the CT scans, together with brief clinical details. When diagnosing malignant tumours, all made errors: nine benign lesions were considered to be malignant. When diagnosing malignant glioma, one neuroradiologist made errors, but the other two adopted a more cautious approach and were accurate. The restricted a "certain" diagnosis to about one in five scans considered to show malignant tumour. Those diagnosed specifically as malignant glioma were intrinsic, irregular, mixed density lesions, exhibiting variable enhancement and infiltrating the peri-ventricular tissues, especially the corpus callosum. Using these criteria, they could correctly identify a small proportion of patients with malignant gliomas. In all other patients, biopsy remains the only means of obtaining a definitive diagnosis. PMID- 2769274 TI - Xanthochromia after subarachnoid haemorrhage needs no revisitation. AB - Recently it was contended that it is bloodstained cerebrospinal fluid (CSF) that is important in the diagnosis of subarachnoid haemorrhage (SAH) and not xanthochromia, and also that a normal CT scan and the absence of xanthochromia in the CSF do not exclude a ruptured intracranial aneurysm. The CSF findings were therefore reviewed of 111 patients with a proven SAH. All patients had xanthochromia of the CSF. Lumbar punctures were performed between 12 hours and one week after the ictus. Xanthochromia was still present in all (41) patients after 1 week, in all (32) patients after 2 weeks, in 20 of 22 patients after three weeks and in 10 of 14 patients after four weeks. In six years we identified only 12 patients with sudden headache, normal CT, bloodstained CSF, and no xanthochromia. Angiography was carried out in three and was negative. All 12 patients survived without disability and were not re-admitted with a SAH (mean follow up 4 years). It is concluded that it is still xanthochromia that is important in the diagnosis of SAH and not bloodstained CSF. Furthermore a normal CT scan and the absence of xanthochromia do exclude a ruptured aneurysm, provided xanthochromia is investigated by spectrophotometry and lumbar puncture is carried out between 12 hours and 2 weeks after the ictus. PMID- 2769275 TI - Anticoagulation-related intracranial extracerebral haemorrhage. AB - From January 1981 to June 1986 116 patients with anticoagulation-related intracranial haemorrhage were referred to hospital. Seventy six of these haemorrhages were extracerebral, 69 were in the subdural and seven in the subarachnoid space. No epidural haemorrhages were identified. Compared with non anticoagulation-related haematomas, the risk of haemorrhage was calculated to be increased fourfold in men and thirteenfold in women. An acute subdural haematoma, mostly due to contusion, was more frequently accompanied by an additional intracerebral haematoma than a chronic subdural haematoma. Trauma was a more important factor in acute subdural haematomas than in chronic. Almost half of the patients (48%) had a history of hypertension, more than a third (35%) had heart disease and about one fifth (18%) were diabetic. Headache was the most frequent initial symptom. Later decreased level of consciousness and focal neurological signs exceeded the frequency of headache. Three patients with subarachnoid haemorrhage and nine patients with acute subdural haematomas died, while those with chronic subdural haematomas all survived and had at the most mild, non disabling sequelae. Myocardial infarction (22%), pulmonary embolism (20%), and arterial disease (20%) were the most frequent reasons for anticoagulant treatment. Critical review based on established criteria for anticoagulation treatment suggests there was no medical reason to treat a third of these patients. The single most useful measure that could be taken to reduce the risk of anticoagulation-induced intracranial haemorrhage would be to identify patients who are being unnecessarily treated and to discontinue anticoagulants. PMID- 2769276 TI - Diffuse axonal injury in head trauma. AB - Diffuse axonal injury (DAI) as defined by detailed microscopic examination was found in 34 of 80 consecutive cases of head trauma surviving for a sufficient length of time to be clinically assessed by the Royal Adelaide Hospital Neurosurgery Unit. The findings indicate that there is a spectrum of axonal injury and that one third of cases of DAI recovered sufficiently to talk between the initial head injury producing coma and subsequent death. The macroscopic "marker" lesions in the corpus callosum and dorsolateral quadrants of the brainstem were present in only 15/34 of the cases and represented the most severe end of the spectrum of DAI. PMID- 2769277 TI - Laypersons' knowledge about the sequelae of minor head injury and whiplash. AB - Even minor head injuries can result in the post traumatic syndrome, a symptom complex that includes physical discomfort and sleep, sexual, affective, and memory disturbance. Little is known about the layperson's knowledge of the syndrome but this may influence judgements about malingering and attitudes towards victims of minor head injury. Descriptions of rear-end automobile accidents were presented to two groups. One group (n = 22) rated the likelihood of a variety of physical, affective, cognitive, and distractor (never or rarely reported by trauma victims) symptoms. A second group (n = 21) judged the speed necessary to cause each of the symptoms. The results indicated that highly exaggerated speeds were thought necessary to produce even the most common physical symptoms. Moreover, cognitive symptoms were thought to be no more likely than were distractor symptoms. In contrast, the knowledge about physical symptoms, the effects of loss of consciousness and whiplash versus direct head injuries was consistent with what is known from research literature. PMID- 2769278 TI - Risk factors for the syndrome of ventricular enlargement with gait apraxia (idiopathic normal pressure hydrocephalus): a case-control study. AB - A case-control study was performed to verify the association between the risk factors for cerebrovascular disease and the syndrome of ventricular enlargement with gait apraxia (VEGAS). This syndrome was defined on the basis of clinical and CT criteria alone; however, it may be representative of patients with idiopathic normal pressure hydrocephalus in whom gait disturbance is the initial symptom. Seventeen patients were matched for age and sex with one hospitalised and two general population controls. Among the risk factors considered we found a significant statistical association between VEGAS and hypertension (odds ratio = 3.14; p = 0.032), ischaemic heart disease (odds ratio = 4.20; p = 0.013), ECG ischaemic changes (odds ratio = 3.67; p = 0.029), low HDL-cholesterol levels (odds ratio = 3.75; p = 0.028) and diabetes (odds ratio = 6.00; p = 0.018). Our findings indicate that risk factors for cerebrovascular disease may play a role in the development of VEGAS. PMID- 2769279 TI - The natural history of the Guillain-Barre syndrome in 18 children and 50 adults. AB - Plasma exchange (PE) is indicated in adult patients with a severe Guillain-Barre syndrome (GBS). For children this has not been proven. If the disease runs a milder course in children, the problems experienced with PE might outweight the benefit. In order to evaluate the need for such a specific treatment in children, we compared the severity of the disease between 18 children and 50 adults; no significant differences were found. The mean duration of hospitalisation of all children was 84 days, four children needed artificial ventilation for a mean of 21.5 days and two children died. We conclude therefore that PE is indicated in children with a severe GBS. The final decision, however, depends also on the practical feasibility of the procedure. PMID- 2769280 TI - A fulminant case of Guillain-Barre syndrome: topographic and fibre size related analysis of demyelinating changes. AB - In a necropsy case of early fulminant Guillain-Barre syndrome, demyelinating changes were observed throughout the peripheral nervous system, most conspicuous in the spinal nerve roots. The central/peripheral nervous system transition regions and most proximal zones of the roots escaped damage. In some root areas there were widespread early changes in myelin sheaths in the absence of significant infiltrates of inflammatory cells. In the fibre size analytical study, small myelinated fibres were preferentially involved. PMID- 2769281 TI - Chronic relapsing idiopathic polyneuropathy with primary axonal lesions. AB - Idiopathic polyradiculoneuropathy with primary axonal lesions is rarely encountered. Two cases are reported with a chronic relapsing course and a fatal outcome. Neuropathological examination of biopsied peripheral nerve in the two patients and in a necropsy case showed loss of myelinated fibres, but neither active demyelination nor inflammatory cells were observed. Acute and chronic relapsing axonal polyradiculoneuropathies appear to be two clinical forms of a peculiar entity different from GBS. PMID- 2769282 TI - Developmental spinal canal stenosis and somatotype. AB - The hypothesis that somatotype and cervical spine developmental canal stenosis may be associated has been investigated by anthropometry and measurement of lateral projection cervical spine radiographs. A significant association of canal size with somatotype has been found such that those with developmentally narrow canals are more likely to have relatively shorter long-bones, particularly in the upper arm, and longer trunks. PMID- 2769283 TI - Abnormalities of the blink reflex in Gilles de la Tourette syndrome. AB - The blink reflex and it's recovery cycle were studied in 26 patients with Gilles de la Tourette syndrome and 10 controls. There was a significant increase in the mean duration of the R2 response. The amplitude of the R2 response following paired shocks (mean R2[T]/R2[C]%) was 11%, 40% and 52% of the conditioning stimulus with intervals of 200 ms, 500 ms and 1 second in the patients, compared with 10%, 17% and 32% respectively in the controls. Half the patients, however, had normal recovery cycles and voluntary suppression of tics and blinks reduced the amplitude of R2 in all patients. These results suggest increased excitability of brainstem interneurons in Gilles de la Tourette syndrome. PMID- 2769284 TI - Blindness in eclampsia: CT and MR imaging. AB - Three cases of cortical blindness complicating eclampsia are described, with magnetic resonance imaging (MRI) and X-ray computed tomography (CT). The correspondence of MRI lesions (hyperintense on T2 weighted, and hypointense on T1 weighted sections) and low attenuation lesions on CT scan indicated ischaemia rather than haemorrhage as the pathological mechanism. PMID- 2769285 TI - CT ring sign imitating tumour, disclosed as multiple sclerosis by MRI: a case report. AB - A 21 year old woman with subacute onset of moderate left hemiparesis showed on CT scanning a left parietal ring shaped enhancing lesion indicative of tumour or abscess, while MRI revealed bilateral white matter lesions highly suggestive of MS. In none of the few similar cases reported was MRI available and most patients underwent biopsy or operation. The few reports of a CT-ring sign in MS are reviewed and the value of MRI in avoiding operation is stressed. PMID- 2769286 TI - Clinical features of the exploding head syndrome. AB - Fifty patients suffering from the "exploding head syndrome" are described. This hitherto unreported syndrome is characterised by a sense of an explosive noise in the head usually in the twilight stage of sleep. The associated symptoms are varied, but the benign nature of the condition is emphasised and neither extensive investigation nor treatment are indicated. PMID- 2769287 TI - Does idiopathic parkinsonism in Aberdeen follow intrauterine influenza? AB - A study is presented which fails to replicate a recent report that peak years of birth of patients later developing Parkinson's disease are related to the influenza pandemics of the period 1890-1930. The years of birth of a whole population cohort of 243 patients suffering from Parkinson's disease examined in Aberdeen in 1983 and reexamined in 1986/7 were compared with deaths due to influenza in the City of Aberdeen in the years 1900-1930. Although a significant peak of Parkinson births (compared with the age profile of the Aberdeen population in 1983) occurred in 1902, there appeared to be no systematic relationship between Parkinson births and influenza deaths. In addition, no season of birth effect could be detected in a comparison with 232 matched controls. The presence of peaks of birth years, for whatever aetiological reason, is of significance to epidemiological studies in that prevalence estimates may be influenced by the year of study relative to these mini-cohorts. PMID- 2769288 TI - Benign intracranial hypertension and essential thrombocythaemia. PMID- 2769289 TI - Epidural haematoma of the posterior fossa: good results after prompt diagnosis with CT. PMID- 2769290 TI - Exercise induced diplopia as a presentation of midline cerebral tumour. PMID- 2769291 TI - Effect of tropatepine, an anticholinergic drug, on regional cerebral blood flow in patients with Parkinson's disease. PMID- 2769292 TI - Benign recurrent multiple mononeuropathy in Wegener's granulomatosis. PMID- 2769293 TI - Progressive systemic sclerosis presenting as a case of trigeminal neuropathy. PMID- 2769294 TI - Psychiatric disturbance in mitochondrial encephalomyopathy. PMID- 2769295 TI - Proceedings of the 113th meeting of the Society of British Neurological Surgeons and the joint meeting with the British Society of Neuroradiologists. Glasgow, 22 24 September 1988. Abstracts. PMID- 2769296 TI - Could Parkinson's disease follow intra-uterine influenza? A speculative hypothesis. PMID- 2769297 TI - Morphological and physiological properties of neurons after long-term axonal regeneration: observations on chronic and delayed sequelae of peripheral nerve injury. AB - Axonal regeneration has been the focus of extensive investigation of mechanisms which mediate structural and functional recovery after injury to mammalian peripheral nerves and has proven to be a valuable model for development and plasticity in the nervous system. Although details of the acute morphological and physiological responses to nerve injury are well-described, less information is available to nerve injury are well-described, less information is available about long-term alterations which persist or develop after regenerated axons have established connections with their targets. The present paper briefly discusses the mammalian neuron's initial response to peripheral nerve injury and subsequent events which occur during regeneration. Morphological and physiological alterations observed in neurons after long-term axonal regeneration are described and are considered in the context of their potential implications for clinical recovery after nerve injury, as well as their potential contribution to the appearance of delayed neurological dysfunction. Selective responses to neuronal injury during development and in different fiber populations are discussed. PMID- 2769298 TI - Differential diagnosis between amyotrophic lateral sclerosis and spinal muscular atrophy by skin involvement. AB - Amyotrophic lateral sclerosis (ALS) and spinal muscular atrophy (SMA) might be clinical variants caused by the same etiology, or different diseases altogether. We studied the skin in 12 patients with ALS and 7 patients with SMA. The "delayed return phenomenon" (DRP) was observed only in ALS patients. On light microscopy, collagen bundles in ALS dermis were seen to be less numerous, thinner and more loosely woven than in SMA. Electron microscopy revealed that in ALS (1) collagen fibers became thinner as the disease lasted longer, and (2) collagen bundles were separated by much more amorphous material. These findings were not observed in SMA. Our observations show that ALS may be distinguished from SMA by the presence of abnormal dermal collagen. Therefore, we suggest that comparable clinical and pathological skin analysis is the most important diagnostic tool in differentiating between ALS and SMA. PMID- 2769299 TI - Fatty acid composition of lipids in tongue and hindleg muscles of muscular dystrophic mice. AB - In order to understand the pathogenesis of mouse muscular dystrophy, fatty acid and lipid compositions in tongue and hindleg muscles of dystrophic mice were analyzed. The phospholipid contents in tongue and hindleg muscles were 71-73% and 23-24% of the total lipids, respectively. The content of triglyceride in tongue and hindleg muscles was 8% and 66% of the total lipids, respectively. There were no significant differences in the phospholipid content of the tongue or hindleg muscles between normal and dystrophic mice. However, analyses of the fatty acid composition in phospholipids showed that the content of 16:0 and 22:6 in the hindleg muscles of dystrophic mice decreased significantly, while the content of C-18 fatty acids (18:0, 18:1 and 18:2) increased. In addition, the fatty acid composition in phospholipids of tongues of dystrophic mice was identical to that of normal mice. This latter result supports the bone-muscle imbalance hypothesis for the pathogenesis of mouse muscular dystrophy. PMID- 2769300 TI - Changes in tetrodotoxin-resistant action potentials after passive transfer of myasthenia gravis patient sera. AB - Muscle electrical activity has been studied in mice after intraperitoneal injection of sera from myasthenia gravis (MG) patients. Myasthenic serum did not modify the electrical properties of innervated muscle fibres. The resting membrane potential and the action potential parameters remained unchanged. However, tetrodotoxin (TTX)-resistant action potentials of denervated muscles were reduced by myasthenic serum, possibly in association with receptor endocytosis induced by the immunoglobulin. However, a direct effect of MG serum on TTX-resistant sodium channels cannot be ruled out. PMID- 2769301 TI - Neurotoxicity of human eosinophils towards peripheral nerves. AB - The toxicity of eosinophils towards peripheral nerves was examined using cultures of posterior ganglion cells from chick embryos. Eosinophils were also derived from a patient with significant "hyper-eosinophilia", peripheral neuropathy, bronchial asthma, myocardial damage and skin involvement. A sural nerve biopsy showed a severe to almost complete loss of myelinated fibers without pathological changes suggesting necrotizing vasculitis. Surviving neurons in a culture containing the patient's eosinophils or serum were markedly decreased in number as compared with those in normal subjects. These results support the possibility that the peripheral neuropathy in the patient caused by toxic agents derived from eosinophils. PMID- 2769302 TI - Quantitative measures of neurological function in chronic neuromuscular diseases and ataxia. AB - Interexaminer and intraexaminer reliability were determined for 30 quantitative measures of neurological function, including sensory threshold, tendon reflexes, maximum isometric strength, and timed tests and coded ratings of functional ability, in patients with Charcot-Marie-Tooth disease (n = 30), idiopathic polyneuropathy (n = 16) and spinocerebellar degeneration (n = 30). Five of 6 sensory and reflex measures had interexaminer reliability greater than 0.80 when the neurologists' examinations were 1 h apart; 2 of 7 achieved this level when the examinations were separated by 1 month. Interexaminer reliability between physical therapists was greater than 0.80 for 19 of 20 measures of strength and functional ability. Intraexaminer reliability coefficients greater than 0.80 were found for 13 of 24 sensory and reflex measures, 28 of 30 isometric strength measures, 24 of 30 timed tests and 5 of 6 coded ratings of functional ability. Electro-oculography, oral diadochokinetic syllable rates, hand and foot accelerometry, and tracings of sine and square waves were examined as quantitative indices of ataxia for patients with spinocerebellar degeneration. Of 11 measures of ataxia, only the oral diadochokinetic syllable rate test had acceptable reliability. PMID- 2769303 TI - Vascularized muscle fibers: etiopathogenesis and clinical significance. AB - Contrary to common assumption, internal vascularization of muscle fiber occurs independent of muscle fiber splitting. Review of 1091 cases who underwent muscle biopsies demonstrated muscle fibers with internal blood vessels in a wide variety of chronic neuromuscular disease states, predominantly in patients with chronic neurogenic diseases. Many of these cases show evidence of internal disorganization or focal degeneration of muscle fibers, in particular, formation of targets, targetoids or similar structural alterations. Internal vascularization of muscle fiber probably occurs as a "healing" or "reparative process" in such fibers. Myopathic features, especially secondary myopathic changes (as seen in chronic denervation-reinnervation) are common and appear to be a necessary accompaniment of this phenomena. The vascularized muscle fiber is more likely to be seen in a distal lower extremity muscle than in a proximal limb muscle biopsy. PMID- 2769304 TI - Patterns of neuronal loss in the cerebral cortex in chronic alcoholic patients. AB - A loss of neurones from the frontal cortex of chronic alcoholic patients has recently been documented. In addition to this loss of neurones there was found to be a reduction in the mean size of the neuronal soma in both the superior frontal and motor cortices. This could be explained on the basis of a selective loss of larger neurones rather than a general shrinkage of all neurones. This population of large neurones (greater than 90 microns 2) has been recognised as being more vulnerable in both Alzheimer's disease and the normal ageing process. Neurones in 2 size categories (41-90 microns 2 and greater than 90 microns 2) were counted in the superior frontal and motor cortices of age- and sex-matched controls and alcoholics. There was found to be a significant reduction in the number of large neurones in the superior frontal cortex, whilst no change in number was seen in the motor cortex. The possibility that neurones in particular layers of the cortex are more severely affected in alcohol abuse was also considered. The cortex was divided into 3 layers and the number of neurones and glia in each determined. No pattern of regional neuronal loss could be distinguished. PMID- 2769305 TI - Regional distribution of rabies viral antigen in central nervous system of human encephalitic and paralytic rabies. AB - We studied the distribution of rabies viral antigen in the brain and spinal cord of 7 patients with rabies by immunohistochemical techniques. Four patients presented with encephalitis, the remaining 3 had paralysis. Neither the rabies viral antigen distribution nor inflammation paralleled clinical presentations. Patients who had survival times of 7 days or less (4/7) had a greater amount of antigen-positive neurons in brainstem and spinal cord regardless of the clinical type. Neuroglial cells were also found to contain rabies antigen. Our findings suggest that virus localization may not account for the difference in clinical manifestations. PMID- 2769306 TI - Remyelination in the human central nervous system. AB - Remyelination, albeit incomplete, has been demonstrated in human central nervous system (CNS). However, information about the initial stage and the final extent of such remyelination is not available. We describe the morphologic findings of a demyelinating lesion with evidence of early remyelination in a biopsy obtained from a 15-year-old boy about two weeks after the onset of neurologic symptoms. The demyelinated area appeared hypercellular with a relatively large number of oligodendrocytes frequently seen in the process of new myelin formation. In addition to the usual reactive changes, the astrocytes were often seen to contain otherwise normal-looking oligodendrocytes within their cytoplasm. In the ensuing months, the patient made apparently total functional recovery accompanied by nearly complete resolution of the white matter lesions demonstrated by the subsequent magnetic resonance studies. These observations suggested that the initial remyelination seen in the biopsy eventually succeeded in producing extensive remyelination in the lesion. Although the exact nature of the demyelinating disorder in our patient remains undetermined, this study indicates that clinically significant remyelination is possible in human CNS. Also, our findings appeared strikingly similar to those described in certain experimental animal models in which widespread remyelination is known to occur. PMID- 2769307 TI - Trophic changes in the arteries at the base of the rat brain in response to bilateral common carotid ligation. AB - A rat model was developed to examine changes in the posterior circle of Willis and the basilar and intracranial vertebral arteries after bilateral common carotid ligation. This procedure produced a major redistribution of blood to the head, with increased flow through the vertebral and basilar arteries. Changes in the vertebral, basilar, posterior communicating and proximal segments of the posterior cerebral arteries and neck vessels were assessed by postmortem barium sulfate arteriography and by histology of the middle portion of the basilar arteries serially at four days, and one, two, four and 15 weeks post-ligation. The changes noted were basilar and vertebral artery tortuosity, enlargement, and duplication of the vertebro-basilar junction. By 15 weeks, these intracranial vascular changes had largely regressed toward normal, commensurate with the appearance of multiple collateral vessels which were scattered throughout the soft tissues of the neck and shunted the original ligation sites. A mechanism that could explain these trophic vessel changes in response to increased blood flow is discussed. Some possible correlates of these findings with several brain vascular diseases are presented. PMID- 2769308 TI - Quantitation and distribution analysis of glial fibrillary acidic protein in human glioma cells in culture. AB - The amount and distribution of glial fibrillary acidic protein (GFAP) were determined by flow cytometry (FCM) and an enzyme-linked immunosorbent assay (ELISA) in five human glioma cell lines stained by the indirect immunofluorescence method using anti-GFAP monoclonal antibody. Standard reference beads containing a known amount of fluorescein were used to calibrate the flow cytometer; however, the intensity of fluorescence from these beads was too weak to allow direct comparison with the fluorescence from the stained cells. Therefore, the flow cytometer was recalibrated using reference beads with a fluorescence intensity similar to that of the glioma cells. By comparing the fluorescence intensities of the two types of reference beads, it was possible to determine the fluorescein content of the stained cells directly from the relative fluorescence intensity (channel number). Glioma cell lines 343 MGA, SF 126, SF 188, U 251, and U 87 had fluorescein concentrations of 72.0 +/- 6.8, 8.1 +/- 0.3, 52.6 +/- 3.1, 86.4 +/- 4.0, and 56.2 +/- 2.9 x 10(5) (mean +/- standard error) Eq Sol Mol (equivalent solution of mole), respectively. The GFAP content of these cell lines, determined by ELISA, was 15.7 +/- 5.2, 0.5 +/- 0.1, 11.1 +/- 2.0, 20.8 +/- 4.6, and 9.5 +/- 2.7 pg GFAP/cell, respectively, and correlated closely with the results of FCM (R = 0.983, p less than 0.0028). A linear regression analysis yielded the following equation: pg GFAP/cell = -2.3376 + 0.2518 x FCM integrated mean channel number (fluorescein concentration: 10(5) Eq Sol Mol).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2769309 TI - Prelabeled red nucleus and sensorimotor cortex neurons of the rat survive 10 and 20 weeks after spinal cord transection. AB - To demonstrate definitively the fate of the somata of rubrospinal and corticospinal neurons axotomized by a complete spinal cord transection at T-9, in young adult rats we prelabeled the neurons by injection into the lumbar enlargement of a retrogradely transported fluorescent dye, Fluoro-Gold, and four days later transected the cord. We found no loss in cell number ten or 20 weeks after axotomy. The average size of the neurons in each case is slightly but significantly reduced. These findings unequivocally demonstrate that the somata of long tract neurons of the rubrospinal and corticospinal systems persist in an atrophic and presumably inactive state for at least 20 weeks, and raise the possibility that treatment of spinal cord injury may normalize cell activity and allow long tract regeneration. PMID- 2769310 TI - Spontaneous spongy degeneration of the brain stem in SAM-P/8 mice, a newly developed memory-deficient strain. AB - A spontaneous spongy degeneration of the brain stem and spinal cord was discovered in a murine model of accelerated senescence (SAM), cared for under both conventional (SAM-P/8) and specific pathogen-free (SAM-P/8/Ta) conditions. SAM-P/8 and SAM-P/8/Ta showed no clinical neurological abnormalities, yet there was a deterioration in learning and memory abilities. Light microscopic examination revealed a spongy degeneration in the brain stem and spinal cord, in the reticular formation, and proliferation of hypertrophic astrocytes in the spongy area. The spongiform degeneration progressed with advancing age from four to eight months, after which the entire brain was involved. Astrocytosis increased with advancing degeneration. Ultrastructurally, mild dendritic swelling occurred at one month of age. At two months of age, moderate postsynaptic swelling and a widening of intracellular membrane structure were observed, and at age five months there were large vacuoles circumscribed by membranous lamellae, identifiable as myelin. Vacuoles in SAM-P/8 proved to be swollen neuronal processes and oligodendroglial processes. These SAM-P/8 and SAM-P/8/Ta strains of mice are new memory-deficient strains with spontaneous spongy degeneration associated with aging. PMID- 2769311 TI - EPA's perspective on risks from residential radon exposure. AB - Indoor radon has been judged to be the most serious environmental carcinogen which the EPA must address for the general public. The optimal strategy for dealing with this problem depends on the magnitude of the risk, how the risk is distributed within the population, as well as the effectiveness and costs of mitigation measures. Based on current exposure and risk estimates, radon exposure in single-family houses may be a causal factor in roughly 20,000 lung cancer fatalities per year. Most of these projected fatalities are attributable to exposures in houses with average or moderately elevated radon levels (below 10 pCi/L). Hence to appreciably reduce radon-induced lung cancers, remediation efforts must include houses not highly elevated in radon. From either an individual risk or a cost-benefit standpoint, reduction of a few pCi/L per home appears to be justified. The optimal strategy for dealing with the indoor radon problem depends on the magnitude of the risk per unit exposure, the distribution of exposures in houses, and the effectiveness and costs of mitigation. EPA's current views with respect to these factors and the associated uncertainties are discussed. PMID- 2769312 TI - Administration's clean air plan called "New era in environmental protection". PMID- 2769313 TI - Evaluation of a continuous noninvasive blood pressure monitor in obstetric patients undergoing spinal anesthesia. AB - A noninvasive blood pressure monitor (Finapres) that continuously displays the arterial waveform using the Penaz methodology has recently been introduced into clinical practice. We compared this device with an automated oscillometric blood pressure monitor (Dinamap 1846SX) in 20 patients during spinal anesthesia for nonemergency cesarean section according to a procedure suggested by the Association for the Advancement of Medical Instrumentation. After administration of the spinal anesthetic, the Finapres monitor produced systolic, mean, and diastolic pressure measurements greater than those of the Dinamap monitor (6.6 +/ 12.5, 3.3 +/- 10.4, and 7.2 +/- 9.8 mm Hg, respectively). In most patients, the Finapres measurements were similar to those determined by the Dinamap; however, in 4 patients, mean systolic differences were greater than 20 mm Hg. These patients did not differ from the others in age, height, weight, or baseline blood pressure, and the pressure values recorded by the Finapres monitor were substantially higher than those measured by auscultation in the labor room. In 30% of the patients, the offset between Dinamap and Finapres blood pressure measurements changed markedly over the course of the surgical procedure. The Finapres monitor occasionally stopped working and had to be restarted. In 1 patient (not included in this analysis), the Dinamap monitor was unable to determine the blood pressure due to patient shivering; this did not appear to interfere with the Finapres. We conclude that the Finapres monitor does not consistently provide blood pressure information equivalent to that of the Dinamap in obstetric patients undergoing spinal anesthesia.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2769314 TI - Is lower esophageal contractility a reliable indicator of the adequacy of opioid anesthesia? AB - Assessing the adequacy of anesthesia in the patient who is without neuromuscular blockade is usually based on somatic as well as sympathetic and hemodynamic responses to stimulation. Because somatic responses are lost in the patient with neuromuscular blockade, a method is needed to replace these signs as an indicator of inadequate anesthesia. This study attempted to determine the relationship between lower esophageal contractility and somatic signs in detecting inadequate fentanyl anesthesia in 20 patients who were undergoing coronary artery surgery and who were hemodynamically stable in the preoperative period. Premedication included midazolam, 0.05 mg/kg intramuscularly, and ranitidine, 2 mg/kg orally. Anesthesia was induced with fentanyl, 50 micrograms/kg, and maintained by an infusion of fentanyl, 0.2 microgram.kg-1.min-1. After endotracheal intubation, a disposable 24-F esophageal monitoring probe equipped with provoking and measuring balloons was inserted, and both the amplitude of provoked and the rate of spontaneous lower esophageal contractions were displayed and recorded. Inadequate anesthesia was indicated by defined somatic signs in response to noxious stimulation. The presence of these responses was correlated with the amplitude of the provoked and the rate of the spontaneous contractions at five specific times during the period preceding initiation of cardiopulmonary bypass. A total of 208 episodes of stimulation were recorded: at insertion of the nasal temperature probe (n = 8), at skin penetration by towel clips (n = 25), at skin incision (n = 20), at sternotomy (n = 20), and during multiple episodes of electrocauterization (n = 135). These provoked 23 somatic responses. The fentanyl concentration in plasma of the 20 patients during the study period was 30 +/- 10 ng/ml (mean +/- SD).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2769315 TI - Computerized artifact detection for ventilatory inductance plethysmographic apnea monitors. AB - Ventilatory inductive plethysmography allows noninvasive monitoring of patient ventilation. Patient movements unrelated to breathing introduce severe errors in ventilator inductive plethysmographic measurements and restrict its usefulness. The purpose of this research was to develop and test a microprocessor-based real time digital signal processor that uses an adaptive filter to detect patient movements unrelated to breathing. The adaptive filter processor was tested for retrospective identification of artifacts in 20 male volunteers who performed the following specific movements between epochs of quiet, supine breathing: raising arms and legs (slowly, quickly, once, and several times), sitting up, breathing deeply and rapidly, and rolling from a supine to a lateral decubitus position. Flow was simultaneously measured directly with a pneumotachography attached to a mouthpiece. A multilinear regression was used to continuously calculate the calibration constants that relate the pneumotachographic and ventilatory inductive plethysmographic signals. Ventilatory inductive plethysmographic data were then processed, and results scored. There were a total of 166 movements. The calibration coefficients changed dramatically in 146 (88%) of the 166 movements. These movements would have significant errors on ventilatory inductive plethysmographic flow calculation. The changes lasted for the duration of the movements and returned to baseline within two to three breaths. The changes in the coefficients were five or more times larger than the variability around baseline during quiet, supine breathing. All of the total body movements and changes in breathing patterns were detected accurately. The filter detected 46 of 53 upper body movements, 34 of 36 lower body movements, 38 of 38 total body movements, and 19 of 19 breathing pattern changes where the calibration changed.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2769316 TI - A comparison of two microcomputer-based programs for bibliographic retrieval and formatting. AB - We evaluated two representative microcomputer-based programs for organizing a biomedical literature filing system. With a bibliography of 100 anesthetic references, a series of benchmark tests was developed to measure the speed and accuracy of typical searching, sorting, and formatting tasks. Each program performed the searching tasks accurately and at about the same speed. One program performed sorting without errors, provided the field order of the template used to enter references was unchanged. Both programs used "punctuation files," that is, templates for controlling author presentation; punctuation to suit style requirements of individual journals; and order of particular fields, such as publisher and year of publication. Each program was able to format journal, book, and chapter references correctly, but the resulting output required some refining in a word processor. Both require a major time commitment to learn and to create custom punctuation files for journals not included in the predesigned punctuation files. Once mastered, both programs are quite competent at organizing reprints and formatting journal references. PMID- 2769317 TI - Panel on practical alarms: Fifth International Symposium on Computing in Anesthesia and Intensive Care. Introduction. PMID- 2769318 TI - Semipractical alarms: a parable. AB - Current alarms protect the manufactures of medical equipment from liability but do little to improve the quality of patient care. Existing alarms are so intrusive that the response of the anesthesiologist and others in the operating room is to want the offensive noise to go away, rather than to address potentially life-threatening situations. Alarms need to be refined so that only those whose attention is required (e.g., the anesthesiologist) are disturbed. It should always be immediately clear which particular variable is outside accepted limits, and alarms for different variables should operate independently so that if one alarm fails, others will still work. PMID- 2769319 TI - Structured alarm systems for the operating room. AB - The administration of anesthesia may be viewed as a closed-loop control system consisting of three major components: the anesthesia system, the patient, and the system operator. A monitoring and alarm system during anesthesia should not be limited to only one of the three major components but must include monitoring of the patient, the performance of the anesthesia system, and the action of the system operator. For an alarm system to be successful when an adverse condition occurs, an alarm must be generated and identified, the problem identified and corrected, and the patient stabilized before injury results. The authors describe the characteristics of a structured alarm system that maximizes the time available to correct a potential problem before injury begins, that clearly identifies the cause of the problem, and that prioritizes alarms according to the urgency of the required response. Alarms should be easy to temporarily silence, have built-in alarm default settings to prevent the inadvertant use of settings meant for a previous patient, and have a graphic display that enables the operator to detect problems or trends before an alarm sounds. PMID- 2769320 TI - Intravascular electrocardiography--a resurrected technique. PMID- 2769321 TI - Computer-based video paging. PMID- 2769322 TI - Preservation of ischemic myocardium. PMID- 2769323 TI - "Sudden cardiac death and resuscitation". PMID- 2769324 TI - Nursing delivery of sublingual nifedipine. AB - Nifedipine is often administered sublingually, although the drug is not manufactured in this form. A group of 150 nurses were surveyed to determine how they deliver sublingual nifedipine to functionally independent and dependent patients. Functionally independent patients were most frequently instructed to place the capsule under their tongues or to perforate the capsule before placing it in their mouths. Nifedipine was administered to functionally dependent patients most frequently by cutting the capsule, squeezing its contents into the patient's mouth, and discarding the capsule. These findings raise several questions about the methods nurses commonly use to administer nifedipine. PMID- 2769325 TI - Combined modality therapy for localized aggressive lymphoma: enough or too much? PMID- 2769326 TI - Moving towards a uniform staging for human immunodeficiency virus-associated Kaposi's sarcoma. PMID- 2769327 TI - High-dose cytarabine and daunorubicin as consolidation therapy for acute myeloid leukemia in first remission: long-term follow-up and results. AB - In an effort to increase the proportion of patients with acute myeloid leukemia (AML) remaining in continued complete remission (CCR), we administered intensive postremission consolidation therapy with high-dose cytarabine (Ara-C) and daunorubicin. Eighty-seven patients, with a median age of 38 years (range, 7 to 71), received consolidation therapy after first complete remission was obtained with standard induction chemotherapy that included conventional doses of Ara-C. Consolidation therapy consisted of from one to three cycles of high-dose Ara-C (3 g/m2 intravenously [IV] over 1 hour every 12 hours for 12 doses) followed by daunorubicin (30 mg/m2/d IV bolus for 3 days). After completion of the high-dose Ara-C and daunorubicin, no further therapy was administered. Myelosuppression encountered with consolidation resulted in a median duration of neutropenia and thrombocytopenia of 3 weeks. Four patients (5%) died during consolidation due to infection and/or hemorrhage; 59% of patients experienced severe but nonfatal infectious or extramedullary organ toxicity. With a median follow-up of more than 3.5 years from diagnosis, the proportion of patients, by Kaplan-Meier product limit estimate, remaining in CCR is 49% (95% confidence limits, 37% to 61%). In a Cox multivariate analysis, only age significantly (P less than .001) influenced the probability of remaining in CCR. The probability of remaining in CCR was 83%, 50%, and 23% for age groups of 25 or less, 26 to 45, and more than 45 years, respectively. These survival curves all have stable long-term plateaus, suggesting cure. In this study, the administration of brief, intensive nonmarrow ablative chemotherapy resulted in a large proportion of patients with AML remaining in CCR, results similar to those reported with allogeneic bone marrow transplantation. Relapse of acute leukemia was still the major reason for therapy failure, suggesting that more effective or additional postremission therapy will be required to further improve the likelihood of cure especially for older patients. PMID- 2769328 TI - Primary lymphoma of bone in children. AB - Primary lymphoma of bone (PLB) occurs infrequently in children. Between January 1962 and November 1988, 395 children with non-Hodgkin's lymphoma (NHL) were treated at St. Jude Children's Research Hospital. Eleven of these patients (2.8%) presented with a bone primary, usually in the femur (eight of 11 patients). The median age of these seven boys and four girls at presentation was 13 years (range, 5.5 to 19 years). Seven patients had one or more additional bones involved. All patients had high-grade lymphomas based on the National Institutes of Health (NIH) Working Formulation. The histologic subtypes included six large cell lymphomas, three lymphoblastic lymphomas, one small-noncleaved, non Burkitt's lymphoma, and one unclassifiable lymphoma. Treatment consisted of multiagent chemotherapy combined with local radiation therapy in seven of 11 patients. Six of 10 children who received chemotherapy as a component of their initial therapy, including all who presented with localized tumor, are alive with no evidence of disease 2+ to 85+ months (median, 42.5 months) after cessation of treatment; one patient has just completed chemotherapy. Each of the four patients who died showed leukemic conversion 5 to 11 months after diagnosis, and three died of progressive disease. One patient died of sepsis during chemotherapy induced neutropenia with no evidence of disease at necropsy. We conclude that optimal therapy for PLB, as with all other forms of NHL, should focus on the histologic subtype and stage of disease. PMID- 2769329 TI - A comparative study of the nodular and diffuse variants of lymphocyte-predominant Hodgkin's disease. AB - A clinical comparison of the nodular and diffuse variants of lymphocyte predominant Hodgkin's disease (HD-LP) has shown them to be similar in all respects, including survival and relapse-free survival (RFS). In addition, they appear similar to mixed cellularity (MC) and nodular sclerosing Hodgkin's disease (HD-NS) with regard to clinical course. Thus, the reported phenotypic differences between nodular lymphocyte predominant Hodgkin's disease (HD-LP[N]) and other forms of the disease do not appear to be reflected in clinical behavior. PMID- 2769330 TI - Preoperative chemotherapy in locally advanced and nonresectable gastric cancer: a phase II study with etoposide, doxorubicin, and cisplatin. AB - Thirty-four patients with locally advanced, nonresectable gastric cancer (staged by laparotomy) received etoposide, Adriamycin (doxorubicin; Adria Laboratories, Columbus, OH), and cisplatin (EAP). Thirty-three patients were evaluable for response and toxicity. Second-look surgery with removal of residual tumor by gastrectomy and lymphadenectomy was performed in case of complete/partial remission (CR/PR) after EAP. After successful resection (R0- and R1-resection), two cycles of EAP were administered for consolidation therapy. Patients refusing reoperation received up to six cycles of EAP. The response rate (CR/PR) after EAP was 70% (23/33), including a 21% (7/33) rate of clinical CRs (CCRs). Two patients had minor remission (MR)/no change and seven had progressive disease. There was one early death. Nineteen of 23 responders (5 CCRs, 14 clinical PRs [CPRs]) and one patient with MR underwent second-look surgery. Five CCRs were pathologically confirmed; 10 patients with CPR were without evidence of disease (NED) after resection. In three patients (CPR), R1-resections (microscopically tumor-cell positive proximal margin) were performed; two patients are disease-free, 22+ and 33+ months after consolidation chemotherapy. In two patients, the tumor was again considered nonresectable. Twenty patients were disease-free after EAP +/- surgery +/- consolidation chemotherapy. Toxicity was primarily hematologic. Leukopenia and thrombocytopenia of World Health Organization (WHO) grade 3 occurred in 30% and 9%, respectively and grade 4 in 18% and 9% of the patients, respectively. There was no increased peri- or postoperative morbidity. After a median follow-up of 20 months for disease-free patients, the relapse rate is 60% (12/20). The median survival time for all patients is 18 months and for disease-free patients 24 months. EAP is highly effective in locally advanced gastric cancer, and offers a chance for surgery with curative intention in patients with an otherwise fatal prognosis. PMID- 2769331 TI - Psychological effects of breast conservation versus mastectomy. PMID- 2769332 TI - Bolus fluorouracil for metastatic colorectal carcinoma? PMID- 2769333 TI - Effects of preventing reinnervation on axotomized spinal motoneurons in the cat. I. Motoneuron electrical properties. AB - 1. The intent of this study was to determine the effect on the electrical properties of axotomized spinal motoneurons when motor axons are allowed to regenerate but are denied the opportunity to reinnervate muscle. 2. The nerve supplying the medial gastrocnemius (MG) muscle in cats was served close to its entry into the muscle and sutured onto the surface of the lateral gastrocnemius (LG) muscle. The MG muscle was excised to prevent availability of vacant end plates to the regenerating MG axons. The electrical properties of antidromically identified MG motoneurons were studied using intracellular recording at various postoperative intervals. 3. In 9 of 12 experimental animals, no sign of functional innervation by MG axons of the LG muscle could be detected. In three experimental animals, electrical and contraction activity in the LG muscle was observed following electrical stimulation of the transplanted MG nerve. The observed electrical and contraction activity was, however, negligible compared to the effects of electrical stimulation of the intact LG-soleus nerve. 4. At the earliest postoperative interval studied (20 days), MG motoneuron electrical properties [input resistance, afterhyperpolarization (AHP) duration, conduction velocity, time constant, rheobase current, and sag] exhibited significant changes that were nearly identical to those described for spinal motoneurons following section of ventral roots or motor nerves or in the earliest stages of reinnervation. 5. At the 44-60 day postoperative (DPO) intervals, several motoneuron electrical properties showed signs of recovery to control levels. At 44 DPO, average values of input resistance, time constant, and AHP duration declined from the significant increases observed at 20 DPO and could not be distinguished statistically from control mean values. 6. These indications of an early recovery of normal electrical properties were not sustained. At subsequent postoperative intervals (90, 120, and 150-180 DPO), average values of motoneuron electrical properties tended to be similar to those observed at 20 DPO. 7. Correlations observed among control motoneuron electrical properties were weakened and the pattern of correlation was disrupted at all postoperative intervals. 8. In conjunction with previous results demonstrating recovery of normal electrical properties following reinnervation (Foehring et al. 1986b), our findings suggest that functional contact with muscle is required for the full expression of the normal range of motoneuron electrical properties.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2769334 TI - Organizing principles for single-joint movements. I. A speed-insensitive strategy. AB - 1. Normal human subjects made discrete elbow flexions and extensions in the horizontal plane from a stationary initial position to visually defined targets at different distances with a constant inertial load or made flexions to a visually defined target with different inertial loads. We measured joint angle, acceleration, and electromyograms (EMGs) from two agonist and two antagonist muscles. 2. Subjects were instructed to move their limbs accurately but quickly to the targets. Movements of greater distances or lesser loads were performed at higher velocities. 3. Peak inertial torque, acceleration and velocity, movement time, and integrated, rectified EMG were all highly correlated with the task variables, distance and inertial load. We show that peak inertial torque can be used as a linking variable that is almost sufficient to explain all correlations between the tasks, the EMG, and movement kinematics. 4. The rate at which subjects initially developed torque to accelerate their movements was invariant over changes in the value of either task variable. The rising phase of the agonist EMG was also independent of the distance or load moved. 5. Two components were distinguished in the antagonist EMG. The first had a relatively constant latency and amplitude. It terminated on the onset of the second and larger component at a latency that was delayed as both distance and load increased. 6. The integrated, rectified antagonist EMG was proportional to inertial load and peak decelerating torque for changes in inertial load. When target distance varied, proportionality between peak decelerating torque and antagonist EMG could be found if correction was made for the effects of muscle length on the torque EMG relationship. 7. We propose organizing principles for the control of single joint human movements in which tasks are performed by one of two strategies. These are called speed-insensitive and speed-sensitive strategies. 8. A model is described in which movements made under a speed-insensitive strategy are executed by controlling the duration and the relative timing of amplitude invariant patterns of activation to the spinal motoneuron pools. PMID- 2769335 TI - Organizing principles for single-joint movements. II. A speed-sensitive strategy. AB - 1. Normal human subjects made discrete flexions of the elbow over a fixed distance in the horizontal plane from a stationary initial position to a visually defined target. We measured joint angle, acceleration, and electromyograms (EMGs) from two agonist and two antagonist muscles. 2. Changes in movement speed were elicited either by explicit instruction to the subject or by adjusting the target width. Instructions always required accurately stopping in the target zone. 3. Peak inertial torques and accelerations, movement times, and integrated EMGs were all highly correlated with speed. We show that inertial torque can be used as a linking variable that is almost sufficient to explain all correlations between the task, the EMG, and movement kinematics. 4. When subjects perform tasks that require control of movement speed, they adjust the rate at which torque is developed by the muscles. This rate is modulated by the way in which the muscles are activated. The rate at which joint torque develops is correlated with the rate at which the agonist EMG rises as well as with integrated EMG. 5. The antagonist EMG shows two components. The latency of the first is 30-50 ms and independent of movement dynamics. The latency of the second component is proportional to movement time. The rate of rise and area of both components scale with torque. 6. We propose organizing principles for the control of single-joint movements in which tasks are performed by one of two strategies. These are called speed-insensitive and speed-sensitive strategies. 7. A model is proposed in which movements made under a speed-sensitive strategy are executed by controlling the intensity of an excitation pulse delivered to the motoneuron pool. The effect is to regulate the rate at which joint torque, and consequently acceleration, increases. 8. Movements of variable distance, speed, accuracy, and load are shown to be controlled by one of two consistent sets of rules for muscle activation. These rules apply to the control of both the agonist and antagonist muscles. Rules of activation lead to distinguishable patterns of EMG and torque development. All observable changes in movement kinematics are explained as deterministic consequences of these effects. PMID- 2769336 TI - Deep neurons in piriform cortex. I. Morphology and synaptically evoked responses including a unique high-amplitude paired shock facilitation. AB - 1. Synaptic responses of cells in layer III of the piriform cortex and the subjacent endopiriform nucleus (layer IV) were analyzed with intracellular recording techniques in a slice preparation from the rat, cut perpendicular to the pial surface. 2. Micropipettes containing Lucifer yellow (LY) were used to correlate response properties with morphology. An antiserum to LY was used to intensify staining and to prevent fading during detailed morphological study. Response properties were also examined with potassium acetate-containing electrodes. 3. Morphologically, two cell types were identified: pyramidal cells that were confined to layer III of the piriform cortex and multipolar cells that were in layer III and the endopiriform nucleus. 4. In morphology, deep pyramidal cells in layer III closely resembled superficial pyramidal cells in layer II, with the exception that primary apical dendritic trunks were longer and basal dendritic arborizations were more extensive than apical. Like superficial pyramidal cells, apical dendrites of all deep pyramidal cells stained extended through the afferent fiber termination zone in layer Ia and gave rise to local axonal arbors that were concentrated in layer III and the endopiriform nucleus. 5. Multipolar cells were morphologically indistinguishable in layer III and the endopiriform nucleus. All gave rise to nonvaricose spiny dendrites that never extended into layer II and local axonal arbors. 6. Response properties of deep pyramidal and multipolar cells were similar; responses of both of these populations were very different from those of superficial pyramidal cells. The primary difference between responses of deep pyramidal and multipolar cells was a shorter latency of postsynaptic potentials evoked in deep pyramidal cells by stimulation of afferent fibers, consistent with the extension of their dendrites into layer Ia. 7. Responses of most deep cells to stimulation of afferent and association fibers at sufficiently high strength consisted of an initial excitatory postsynaptic potential (EPSP), followed by a fast Cl- -mediated and a slow K+-mediated inhibitory postsynaptic potential (IPSP). 8. A characteristic feature of deep cells, which was only rarely observed in superficial pyramidal cells, was the presence of variable EPSPs evoked at long latencies (greater than 100 ms) by stimulation of afferent or association fibers. 9. A striking finding for deep pyramidal and multipolar cells, when studied with LY-containing pipettes, was a variable slowly rising depolarizing potential triggered at depolarized membrane potentials by stimulation of afferent or association fibers.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2769337 TI - Deep neurons in piriform cortex. II. Membrane properties that underlie unusual synaptic responses. AB - 1. Membrane properties of deep pyramidal and multipolar cells in layer III of the rat piriform cortex and multipolar cells in the underlying endopiriform nucleus (layer IV) were studied in a slice preparation with the primary goal of elucidating the origin of the unusual synaptic responses described in the companion paper. 2. Micropipettes containing either Lucifer yellow (LY) for combined morphological-physiological analysis or potassium acetate (KAc) were used for the analysis. Comparison of membrane properties of pyramidal cells measured with these two electrolytes revealed significant differences. With LY and other Li+ salts, resting membrane potentials were more depolarized, input resistances higher, spike amplitudes lower, and spike durations longer. 3. As measured with KAc-containing electrodes, membrane properties of deep pyramidal and multipolar cells were similar to each other, but differed from those of superficial pyramidal cells. Resting membrane potentials were more depolarized, thresholds lower, input resistances higher, membrane time constants slower, and spikes smaller and slower. 4. In response to depolarizing current pulses, both deep pyramidal and multipolar cells exhibited an initial depolarizing peak of graded amplitude that fell to a steady state within 150 ms. Current-voltage (I-V) relationships displayed a large increase in slope resistance during the depolarizing peak, but were relatively linear in the depolarizing direction at steady state. In cells with relatively hyperpolarized resting membrane potentials, threshold for the depolarizing peak could be -65 mV or below. Based on a reduction by steady depolarization, reduction by Co2+ and potentiation by Ba2+, it is postulated that the peak is generated in part by a low threshold inactivating Ca2+ current. A partial blockage of this peak by tetrodotoxin (TTX) suggests that a Na+ current also contributes. 5. In response to hyperpolarizing current pulses, especially at depolarized membrane potentials, there was usually a sag from an initial maximum and a depolarizing rebound after current offset in both deep pyramidal and multipolar cells. Based on the dependence on membrane potential (Vm), insensitivity to TTX and blockage by carbamylcholine chloride (carbachol), it is postulated that an M-current contributes to the sag and rebound. 6. The depolarizing rebound that followed offset of hyperpolarizing current pulses could trigger a Ba2+-potentiated local response that resembled the depolarizing peak triggered by depolarizing current, suggesting that the postulated low-threshold inactivating Ca2+ current contributes to its generation.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2769338 TI - Quantitative analysis of visual receptive fields of neurons in nucleus of the optic tract and dorsal terminal nucleus of the accessory optic tract in macaque monkey. AB - 1. The visual receptive field properties of neurons in the nucleus of the optic tract (NOT) in the pretectum and the dorsal terminal nucleus (DTN) of the accessory optic tract were analyzed quantitatively in anesthetized, paralyzed macaque monkeys. 2. Visual latencies to reversals in direction of stimulus movement ranged from 40 to 80 ms [61 +/- 13.5 (SD) ms]. 3. All neurons increased their discharge rate during ipsiversive movement and decreased their ongoing activity during contraversive movement of single stimuli or whole-field random dot patterns. The population of neurons in the left NOT-DTN was excited most strongly by leftward movement pointing 4 degrees down; neurons in the right NOT DTN were excited most strongly by rightward movement pointing 6 degrees down. The mean angle between the directions yielding the highest and the lowest discharge rate in the two populations of NOT-DTN neurons was 177 degrees. 4. The deviation of the preferred excitatory directions from the horizon in individual neurons varied with recording depth. Within the first 500 microns below the midbrain surface, neurons preferred near-horizontal directions, whereas neurons recorded more deeply preferred more oblique directions of stimulus movement. 5. The tuning widths of NOT-DTN neurons in the preferred excitatory direction were very broad. The mean halfwidth defined as the range of directions eliciting responses greater than 50% of the maximum was 127 +/- 25 degrees. 6. Moving a random dot pattern and a single bar of light simultaneously but in opposite directions caused NOT DTN neurons to increase their discharge rate as soon as one of the two stimuli moved in the ipsiversive direction. The reduction in overall discharge rates when two stimuli moved in opposite directions indicates mainly inhibitory interactions. 7. All NOT-DTN neurons could be activated from both eyes. Interactions between the two eyes were modest and unspecific. Misalignment of the visual axes of the two eyes had no influence on response strength. 8. Optimal speeds of stimulus movement varied widely for different NOT-DTN neurons. The effective range of speeds to elicit direction-selective responses in the total population was very broad (0.1400 degrees/s. With oscillating horizontal stimulation, NOT-DTN neurons followed repetition rates up to 4 Hz at excursions of 40 degrees. Speeds greater than 500 degrees/s were either not effective or resulted in a suppression of ongoing activity in all directions of movement.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2769339 TI - The detection and perceived intensity of noxious thermal stimuli in monkey and in human. AB - 1. The magnitude of the sensations produced by small increases in thermal stimuli superimposed on noxious levels of heat stimulation was studied by the use of a simple reaction-time task. Noxious thermal stimuli were presented on the face of three monkeys, the forearm volar surface of three monkeys, and the face of four human subjects. The subject, either monkey or human, initiated a trial by pressing an illuminated button. Subsequently, a contact thermode increased in temperature from a base line of 38 degree C to temperatures of 44, 45, 46, or 47 degrees C (T1). After a variable time period lasting between 4 and 10 s, the thermode temperature increased an additional 0.1, 0.2, 0.4, 0.6, or 0.8 degrees C (T2). The subject was required to release the button as soon as the T2 stimulus was detected. Detection latency, expressed as its reciprocal, detection speed, was defined as the time interval between the onset of T2 and the release of the button. 2. The monkeys' detection speed to stimuli presented on the upper lip was dependent on the intensity of both T1 and T2. Increases in the intensity of T2 between 0.1 and 0.8 degrees C produced faster detection speeds. In general, as the intensity of T1 increased, the detection speed increased to identical T2 stimuli. The monkeys' T2-detection threshold was also dependent on the intensity of T1. 3. The psychophysical functions obtained from stimulation of the monkey's face were compared with those obtained from the volar surface of the monkey's forearm. Whereas the T2 thresholds obtained from stimulation of the monkey's forearm and face were similar, the psychophysical functions obtained from stimulation of the face were significantly steeper than those obtained from stimulation of the forearm. 4. The humans' detection speed of T2 stimuli presented on the face was monotonically related to the intensity of T2 and was dependent on the level of T1. The psychophysical functions obtained from the human's face were equivalent to those obtained from the monkey's faces. 5. A cross-modality matching procedure was used to examine the perceived intensity of pain sensation produced by T2 stimuli in human subjects. The magnitude estimates of these stimuli were dependent on the level of T1, as well as the intensity of T2. Detection speed, plotted as a function of the estimated magnitude of pain, independent of T1 and T2 temperature, was best fit by a logarithmic function.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2769340 TI - Responses of monkey medullary dorsal horn neurons during the detection of noxious heat stimuli. AB - 1. We examined the activity of thermally sensitive trigeminothalamic neurons and nonprojection neurons in the medullary dorsal horn (trigeminal nucleus caudalis) in three monkeys performing thermal and visual detection tasks. 2. An examination of neuronal stimulus-response functions, obtained during thermal-detection tasks in which noxious heat stimuli were applied to the face, indicated that wide dynamic-range neurons (WDR, responsive to innocuous mechanical stimuli with greater responses to noxious mechanical stimuli) could be subclassified based on the slope values of linear regression lines. WDR1 neurons exhibited significantly greater sensitivity to noxious heat stimulation than WDR2 neurons or nociceptive specific neurons (NS, responsive only to noxious stimuli). 3. In one behavioral task, the monkeys detected 1.0 degrees C increases in noxious heat from preceding noxious heat stimuli ranging from 44 to 48 degrees C. WDR1, WDR2, and NS neurons increased their discharge frequency as a function of the intensity of the first noxious heat temperature (T1) as well as the final temperature (T2). The responses of WDR1 neurons were greater than those produced by WDR2 or NS neurons across all the temperatures examined. The order of stimulus presentation affected the responses of WDR1 neurons to 1.0 degrees C increases in the noxious heat range but not those of WDR2 or NS neurons. 4. In a second behavioral task, the monkeys detected small increases in noxious heat (0.2-0.8 degrees C) from a first temperature of 46 degrees C. Although the responses of all three classes of neurons were monotonically related to stimulus intensity, WDR1 neurons exhibited greater sensitivity to small temperature increases than either WDR2 or NS neurons. 5. Subpopulations of all three classes of neurons exhibited responses that were independent of thermal stimulus parameters or sensory modality and that only occurred during the behavioral task. These task-related responses were time locked to specific behavioral events associated with trial initiation and trial continuation. 6. These data provide evidence that a subpopulation of WDR neurons is the dorsal horn cell type most sensitive to small increases in noxious heat in the 45-49 degrees C temperature range and provides the most information about stimulus intensity. The findings support the view that nociceptive neurons have the capacity to precisely encode stimulus features in the noxious range and that WDR neurons are likely to participate in the monkeys' ability to perceive the intensity of such stimuli. PMID- 2769341 TI - The correlation of monkey medullary dorsal horn neuronal activity and the perceived intensity of noxious heat stimuli. AB - 1. We examined the relationship between the activity of medullary dorsal horn nociceptive neurons and the monkeys' ability to detect noxious heat stimuli. In two different detection tasks, the temperature of a contact thermode positioned on the monkey's face increased from 38 degrees C to temperatures between 44 and 48 degrees C (T1). After a variable time period, the thermode temperature increased an additional 0.2-1.5 degrees C (T2), and the monkeys' detection speed from the onset of T2 was determined. We previously have established that detection speed is a measure of the perceived intensity of noxious thermal stimuli. Nociceptive neurons were classified as wide-dynamic-range (WDR, responsive to innocuous mechanical stimuli with greater responses to noxious mechanical stimuli) and nociceptive-specific (NS, responsive only to noxious stimuli). WDR neurons were subclassified as WDR1 and WDR2 based on the higher slope values of the stimulus-response functions of WDR1 neurons. The monkeys were trained to detect small increases in noxious heat, and their detection speeds were correlated with the responses of WDR1, WDR2, and NS neurons. 2. Detection speeds to T2 temperatures of 1.0 degrees C from preceding T1 temperatures of 45 and 46 degrees C were faster during a preceding ascending series of stimuli than during a descending series. Similarly, the peak discharge frequencies of WDR1 neurons in response to the same stimuli were greater during the ascending series of T2 temperatures. In contrast, the responses of WDR2 and NS neurons showed no significant differences during the ascending and descending series of stimuli. 3. Detection speeds following 0.4, 0.6, and 0.8 degrees C T2 stimuli were higher when the preceding T1 temperature was 46 degrees C as compared with detection speeds to the identical stimuli when the preceding T1 temperature was 45 degrees C. WDR1 neurons also exhibited a significant increase in peak discharge frequency to these same T2 stimuli when the preceding T1 temperature was 46 degrees C. In contrast, the neuronal activity of WDR2 and NS neurons did not differ on 45 and 46 degrees C T1 trials. 4. The relationship between detection speed and neuronal peak discharge frequency was examined in response to different pairs of T1 and T2 stimuli when T1 was either 45 or 46 degrees C. There was a significant correlation between detection speed and neuronal discharge for WDR1 and WDR2 neurons. No correlation was observed for NS neurons. 5. The magnitude of neuronal activity on correctly detected and nondetected trials was compared when T1 was 46 degrees C and T2 was 0.2 degree C.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2769342 TI - Influence of somatosensory cortex on different classes of cat motor cortex output neuron. AB - 1. Multiple output pathways originate from motor cortex. In this study on cats, six classes of corticofugal neurons were identified by antidromic activation. Corticocallosal neurons of layer III were activated antidromically by stimulation of contralateral motor cortex. Layer V neurons were identified by antidromic activation from cerebral peduncle, red nucleus, lateral reticular nucleus of medulla, or spinal cord. Corticothalamic neurons were identified in layer VI. All the identified neurons were tested for input from primary somatosensory cortex. 2. Neurons of all corticofugal groups received excitatory inputs from primary somatosensory cortex. The shortest latency corticocortical effects of 1.2-2.5 ms were found for corticocallosal neurons of layer III, and for layer V neurons which projected axons through the cerebral peduncle, to red nucleus, and to spinal cord. 3. Nearby neurons, projecting to the same of different targets, were affected nonuniformly by corticocortical inputs. This finding supports the conclusion that specificity of afferent connections within cerebral cortex is not determined by anatomic segregation of cell bodies nor by projection target of efferent neurons. 4. These selectively distributed input connectivities suggest that even a small region of motor cortex could send different signals to its diverse targets. PMID- 2769343 TI - Cross-correlation analysis of taste neuron pairs in rat solitary tract nucleus. AB - 1. Experiments were conducted to examine the possibility that the taste-sensitive neurons with similar taste-selectivity are preferentially innervated by common driving neurons whose taste-selectivity is also similar. 2. Multiple microelectrodes, in most cases a pair of glued electrodes, were inserted into the unilateral solitary tract nucleus (NTS) of the rat, and simultaneous recordings were made in neuron pairs responding to the four basic taste stimuli. The spike response density (RD) of each neuron during tastant stimulation was determined. Correlation coefficients of spike occurrence were calculated for each neuron pair during application of tastants and distilled water and also during spontaneous background activity. The frequency of correlated discharge (FC) of a neuron pair was measured as the area of the peak appearing on the cross-correlogram (CC). The FC value was divided by the RD value to calculate the weight of the correlated discharges in the output of each neuron (WC value). 3. Eleven pairs showed peaks in the CC constructed during tastant stimulation, whereas in other 11 pairs no peaks were found. The cross-correlation-positive group with peaks was composed of 18 NaCl-best (responding most vigorously to NaCl) and 4 HCl-best neurons, whereas the negative group without peaks included 9 NaCl-best, 9 HCl-best, and 4 sucrose best neurons. 4. In the cross-correlation-positive pairs the taste quality most effective for one of the component neurons was often (13 NaCl-best and 2 HCl best, 15/22 = 0.681) identical to the taste quality giving the highest probability of correlated discharge, i.e., highest FC value, in the neuron pair. 5. There were five cross-correlation-positive pairs (5/11 = 0.455) in which both of the component neurons were NaCl-best and the FC value was highest during NaCl stimulation. 6. The CCs constructed during water application exhibited peaks for all the pairs which gave positive cross-correlation in response to stimulation with tastants, whereas all pairs with negative cross-correlation during tastant stimulation never gave a detectable peak during water application. 7. In three pairs of the cross-correlation-positive group, the CCs constructed during spontaneous background activity without application of any liquid showed a small peak. 8. During NaCl stimulation some neurons exhibited relatively high FC values, but the WC values were always low. In contrast, during sucrose stimulation, the FC value was always low, but the WC value was quite high in some neurons.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2769344 TI - Nociceptive neurons in rat superior colliculus: response properties, topography, and functional implications. AB - 1. Extracellular recordings were made from single superior colliculus neurons in urethane-anesthetized rats in response to mechanical and/or thermal stimulation of the skin. In addition to those activated by low-threshold (LT) tactile stimuli, many neurons responded preferentially, or solely, to noxious stimuli. Two functionally defined subtypes of nociceptive neurons were distinguished: wide dynamic-range (WDR) neurons, which responded optimally to noxious stimuli but also to innocuous stimuli; and nociceptive-specific (NS) neurons, which responded solely to frankly noxious stimuli. The thermal thresholds were 42-45 degrees C, and the stimulus-response relationships were positively accelerating power functions with exponents of 2.9 (WDR) and 3.1 (NS). 2. WDR neurons also responded to cooling of the skin to temperatures below 24 degrees C. Like noxious heat responses, cold responses were monotonically graded as the intensity of the cold stimulus was increased. Thus the temperature sensitivity of thermal-sensitive neurons in the superior colliculus appeared to be tuned to detect large deviations from ambient skin temperature in either direction once threshold is reached. 3. LT neurons were somatotopically organized, with the head and forelimbs rostral and the trunk and hindlimbs caudal. The limbs were generally represented further lateral in the structure, whereas more proximal body parts were more medial. Nevertheless, there was extensive overlap of body parts especially in areas of transition. Thus, a "block-to-block" or "area-to-area" rather than a "point-to-point" representation of the body surface was evident. 4. The nociceptive representation did not violate the general LT somatotopy but neither was it coextensive. Virtually all nociceptive neurons had trigeminal receptive fields and were thus heavily represented in the rostral superior colliculus, where the LT face representation was also located. No nociceptive neurons were present in the caudal one-third of the structure. A general dorsal to-ventral segregation of somatosensory neurons also was noted, so that in a given electrode penetration, LT neurons usually were the most superficial, WDR neurons were just below these, and NS neurons were deepest of all. 5. The presence of overlapping LT and nociceptive trigeminal representations in the superior colliculus seems particularly adaptive in view of the fact that rodents use their vibrissae for exploring their environment and thus put rostral body parts at risk during such behaviors.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2769345 TI - Binocular interactions in the cat's dorsal lateral geniculate nucleus. I. Spatial frequency analysis of responses of X, Y, and W cells to nondominant-eye stimulation. AB - 1. X, Y, and W cells in the A and C layers of the cat's dorsal lateral geniculate nucleus (LGN) were tested for responses to stimulation of the nondominant eye. The main purpose was to determine the incidence of nondominant-eye excitation and inhibition among different classes of cells and to examine the spatial-frequency tuning of responses to the nondominant eye. 2. Of 198 cells that were tested with drifting sine-wave gratings presented to the nondominant eye, 109 (55%) showed statistically significant responses. Four types of responses were observed: an increase in the mean discharge rate (F0 excitation), a decrease in the mean discharge rate (F0 inhibition), an increased modulation at the fundamental frequency of the grating (F1 excitation), and a decreased modulation at the fundamental frequency of the grating (F1 inhibition). Overall, 29% of the cells responded with inhibition, 24% responded with excitation, and 2% showed both excitation and inhibition, depending upon the spatial frequency and/or the harmonic response component. The relative incidence of excitation and inhibition was similar for X, Y, and W cells, for cells with on-center and off-center receptive fields, for cells with different receptive-field eccentricities, and for cells in each LGN layer. In addition, within layers A and A1, responses were similar for cells at different distances from the laminar borders. 3. Spatial frequency response functions indicated that cells could have band-pass or low pass spatial-frequency tuning through the nondominant eye. Band-pass cells tended to be narrowly tuned (less than or equal to 1 octave), and low-pass cells responded to a broader range of spatial frequencies. These properties were similar for X, Y, and W cells. Spatial resolution tended to be low (less than or equal to 0.8 c/deg for most cells), although a few cells responded to the highest spatial frequency tested (5.4 c/deg). Likewise, optimal spatial frequency was low (less than or equal to 0.2 c/deg) for most cells. These properties were similar for X and Y cells, and there was a weak tendency for X and Y cells to have higher optimal spatial frequencies and spatial resolutions than W cells. 4. In terms of absolute change in activity, responses to drifting gratings were weak. However, cells that were inhibited generally showed 20-60% decreases in activity to the optimal spatial frequency, and cells that were excited generally showed 40-100% increases. Response amplitudes were similar for X, Y, and W cells.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2769346 TI - Monocular and binocular response properties of cells in the striate-recipient zone of the cat's lateral posterior-pulvinar complex. AB - 1. We have studied response properties of single cells in the striate-recipient zone of the cat's lateral posterior-pulvinar (LP-P) complex. This zone is in the lateral section of the lateral posterior nucleus (LP1). Our purpose was to determine basic response characteristics of these cells and to investigate the possibility that the LP-P complex is a center of integration that is dominated by input from visual cortex. 2. The majority (72%) of cells in the striate-recipient zone respond to drifting sinusoidal gratings with unmodulated discharge. 3. Cells in the LP1 are selective to the orientation of gratings, and tuning functions have a mean bandwidth of 31 degrees. More than one-half of these units are direction-selective. The preferred orientation and the tuning widths for the two eyes are generally well matched. However, a few cells exhibited the interesting property of opposite preferred directions for the two eyes. Orientation tuning for a small group of cells was different for the mean discharge and first harmonic components, suggesting a convergence from different inputs to these cells. 4. Two-thirds of LP1 cells are tuned to low spatial frequencies (less than 0.5 c/deg). The tuning is broad with a mean bandwidth of 2.2 octaves. The remaining one-third of the units are low-pass because they show no attenuation of their responses to low spatial frequencies. Both eyes exhibit the same spatial frequency preference and the same spatial frequency tuning. There is a high correlation between spatial frequency and orientation selectivities. 5. All cells tested are tuned for temporal frequency with a sharp attenuation for low frequencies. The optimal values range between 4 and 8 Hz, and the mean bandwidth is 2.2 octaves. 6. Cells in LP1 are mostly binocular. When monocular, cells are almost always contralaterally driven. Dichoptic presentation of gratings reveals the presence of strong binocular interaction. In almost all cases, these interactions are phase specific. The cell's discharge is facilitated at particular phases and inhibited at phases 180 degrees away. These binocular interactions are orientation dependent. 7. Twenty-five percent of the cells with phase-specific binocular facilitation appear to be monocular when each eye is tested separately. For three cells, we observed a non-phase-specific inhibitory effect of the silent eye. 8. Our findings indicate that LP1 cells form a relatively homogeneous group, suggesting a high degree of integration of multiple cortical inputs.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2769347 TI - Serotonergic/cholinergic muscle receptor cells in the crab stomatogastric nervous system. I. Identification and characterization of the gastropyloric receptor cells. AB - 1. Serotonin (5-hydroxytryptamine) immunohistochemistry was used to locate and anatomically describe a set of four muscle receptor cells in the stomatogastric nervous system of the crabs Cancer borealis and Cancer irroratus. We found that these sensory cells, which we named gastropyloric receptor (GPR) cells, are the sole source of serotonergic inputs to the stomatogastric ganglion (STG) in these species. Thus any endogenous serotonergic modulation of the central pattern generators (CPGs) in the STG must be afferent and not descending from other ganglia. 2. There are two bilateral pairs of GPR cells. Each pair consists of two cell types (GPR1 and GPR2) based on differences in muscle innervation and physiological response characteristics. GPR2 responds in a mostly tonic fashion to increases in muscle tension caused by passive stretch or motor neuron-evoked contraction, whereas GPR1 responds more phasically and adapts more rapidly. Both GPR cell types project to the midline STG and terminate in each of the bilaterally paired commissural ganglia (COGs). 3. The GPR cells have sensory endings unlike any described for other muscle receptor cells: the terminals enter invaginations of the muscle surface and end near the z-bands of the muscle. These novel structures may be involved in the sensory transduction process. 4. The GPR cells may contain acetylcholine in addition to serotonin, as indicated by the presence of choline acetyltransferase (ChAT) in GPR2 (Table 1) and probably GPR1 as well. 5. The GPR cells have no direct effect on muscle properties or neuromuscular transmission: excitatory junctional potential (EJP) amplitude and motor neuron-evoked tension are unaffected by GPR stimulation. However, very low concentrations of exogenously applied serotonin do cause an increase in motor neuron-evoked muscle tension, probably reflecting a hormonal action of the amine. 6. The activity of GPR2 was monitored in a semi-intact preparation. GPR2 is active in phase with normal movements of the gastric mill. GPR2 is also capable of endogenous rhythmic activity. This indicates that even in the absence of mechanical stimulation, the GPR cells may still provide patterned input to the CPGs in the STG. 7. The GPR cells are proprioceptive cells that use serotonin and acetylcholine as cotransmitters. It is important to characterize these cells to understand the role of serotonergic modulation in the production of motor programs by stomatogastric CPGs. PMID- 2769348 TI - Serotonergic/cholinergic muscle receptor cells in the crab stomatogastric nervous system. II. Rapid nicotinic and prolonged modulatory effects on neurons in the stomatogastric ganglion. AB - 1. The gastropyloric receptor (GPR) cells, which are described in the preceding paper, are a set of proprioceptive cells in the crabs Cancer borealis and Cancer irroratus that contain serotonin (5-hydroxytryptamine, 5-HT) and choline acetyltransferase. These cells have a variety of synaptic effects on cells in the stomatogastric ganglion (STG). We used pharmacologic methods to distinguish the effects that were due to acetylcholine (ACh) from those that could be due to serotonin. 2. The GPR cells evoke excitatory postsynaptic potentials (EPSPs) in two gastric mill motor neurons [lateral and dorsal gastric (LG and DG)] in the stomatogastric ganglion. The EPSPs exhibit nicotinic pharmacology, indicating that they may be due to the release of ACh from the GPR cells. 3. A train of GPR action potentials induces plateau potential properties in the DG motor neuron. This plateau potential induction is not blocked by nicotinic or muscarinic antagonists, suggesting it might be due to serotonin released from the GPR cells. Bath-applied serotonin induces a tonic depolarization of DG with high-intensity spiking. 4. In the accompanying paper, it is shown that DG-evoked muscle contraction leads to the excitation of GPR2 through mechanical coupling of the muscles. Because GPR2 also excites DG, a positive feedback loop exists between GPR2 and DG. This reflex loop may be involved in the control of the medial tooth of the gastric mill. 5. GPR stimulation initiates or enhances rhythmic pyloric cycling. This is due at least in part to a direct enhancement of bursting in the pyloric dilator/anterior burster (PD/AB) pacemaker cell group and can outlast the period of GPR stimulation by up to 1 min. GPR-induced PD burst enhancement continues in the presence of nicotinic and muscarinic antagonists, indicating that the effect is probably not due to the release of ACh. Bath application of serotonin mimicks the neuromodulatory effect of GPR stimulation on the PD/AB group by inducing or enhancing bursting. 6. Thus the GPR cells elicit at least three different synaptic actions in the stomatogastric ganglion: 1) classical, fast nicotinic cholinergic EPSPs that may be important for reflex functions in the gastric mill; 2) noncholinergic, cycle-by-cycle plateau potential induction that might be critical for the timing and operation of the gastric mill, and 3) prolonged, noncholinergic burst enhancement in pyloric neurons that is mimicked by serotonin, lasts many cycles, and may act to assure that the pyloric central pattern generator (CPG) is activated and cycling strongly. PMID- 2769349 TI - Sensorimotor representations for pointing to targets in three-dimensional space. AB - 1. The accuracy with which subjects pointed to targets in extrapersonal space was assessed under a variety of experimental conditions. 2. When subjects pointed in the dark to remembered target locations, they made substantial errors. Errors in distance, measured from the shoulder to the target, were sometimes as much as 15 cm. Errors in direction, also measured from the shoulder, were smaller. 3. An analysis of the information transmitted by the location of the subject's finger about the location of the target showed that the information about the target's distance was consistently lower than the information about its direction. 4. The errors in distance persisted when subjects had their arm in view and pointed in the light to remembered target locations. 5. The errors were much smaller when subjects used a pointer to point to the target or when they were asked to reproduce the position of their finger after it had been passively moved to the target. 6. From these findings we conclude that subjects have a reasonably accurate visual representation of target location and are able to effectively use kinesthetically derived information about target location. We therefore suggest that errors in pointing result from errors in the sensorimotor transformation from the visual representation of the target location to the kinematic representation of the arm movement. PMID- 2769350 TI - Errors in pointing are due to approximations in sensorimotor transformations. AB - 1. We define an extrinsic frame of reference to represent the location of a point in extrapersonal space relative to a human subject's shoulder, and we define an intrinsic frame of reference to represent the orientation of the arm and forearm. 2. We examined the relations between coordinates in the extrinsic and intrinsic frames of reference under two experimental conditions: when subjects made inaccurate movements by pointing to virtual targets in the dark and when they made accurate movements by pointing to actual targets in the light. 3. When subjects made inaccurate movements, there was a close-to-linear relationship between the orientation angles of the arm (intrinsic coordinates) at its final position and the extrinsic coordinates of the target. When they made accurate movements, these relationships were more nonlinear. 4. Specifically, arm and forearm elevations depended principally on target distance and elevation, whereas the two yaw angles depended mainly on the target's azimuth. 5. We propose that errors in pointing occur because subjects implement a linear approximation to the transformation from extrinsic to intrinsic coordinates and that this transformation is one step in the process of transforming a visually derived representation of target location into an appropriate pattern of muscle activity. PMID- 2769351 TI - Analysis of motion of the visual field by direction, expansion/contraction, and rotation cells clustered in the dorsal part of the medial superior temporal area of the macaque monkey. AB - 1. The dorsal part of the medial superior temporal area (MST) is characterized by clusters of three types of visually responsive cells: Direction cells, which respond to a straight frontoparallel movement in a particular direction; Expansion/contraction cells, which selectively respond to either an expansion or contraction; and Rotation cells, which selectively respond to either a clockwise or counterclockwise rotation. To study their functional role, experiments were carried out on immobilized monkeys, anesthetized with N2O. 2. The areal extent of stimulation was crucial for activation: movements of a pattern extending over a wide visual field elicited a larger response than those elicited by a local pattern. 3. The shape, exact size, and sign of contrast of the texture components of the pattern were not important in determining the magnitude of response. 4. Different cells responded to different ranges of speed of movement. 5. Expansion/contraction cells were activated more strongly by a real (isotropic) expansion/contraction than by an "axial expansion/contraction" in which a pattern expanded or contracted along a particular axis. Rotation cells were activated more strongly by a circular rotation in the frontoparallel plane than by a shearing movement. 6. We discuss the possibility that the cells are involved in the detection and analysis of wide-field movements, which are generally caused by a movement of the animal itself. The mode (straight transfer, expansion/contraction, or rotation), direction, and speed of the relative movement of the animal and the external space may be represented by the activity of the cells. PMID- 2769352 TI - Underlying mechanisms of the response specificity of expansion/contraction and rotation cells in the dorsal part of the medial superior temporal area of the macaque monkey. AB - 1. The dorsal part of medial superior temporal area (MST) has two unique types of visually responsive cells: 1) expansion/contraction cells, which selectively respond to either an expansion or a contraction; and 2) rotation cells, which selectively respond to either a clockwise or a counterclockwise rotation. In addition to selectivity for the mode of motion, both types of cells respond preferentially to movements over a wide field rather than over a small field. With the aim of understanding the underlying mechanisms of these selectivities, we carried out experiments on immobilized monkeys anesthetized with N2O. 2. Expansion/contraction and rotation of a pattern extending over a wide field contain three stimulus factors: 1) the spatial arrangement of different directions of movement, 2) the gradient in the speed of regional movement from the center to the periphery of the stimulus, and 3) the size change of texture components of the pattern in the expansion/contraction and the acceleration of movement of texture components toward the center of the stimulus in the rotation. The contribution of each factor to the activation of the cells was evaluated by comparing the response before and after removing the factor from the stimulus. The moving stimuli that lacked one or two of the factors were produced by the use of a cinematographic animation technique. 3. Withdrawal of the first factor, the spatial arrangement of different directions of movement, reduced the response of both Expansion/contraction and Rotation cells much more severely than either of the other two factors. We concluded that the first factor is far more important for activation than the other two. 4. These results are consistent with the model that Expansion/contraction and Rotation cells receive converging inputs from many directional cells with relatively small receptive fields in different parts of the visual field. Because MST receives strong fiber projections from MT, MT cells are candidates for the input cells. According to the model, if the convergence is organized so that the preferred directions of the input cells are arranged radially, the target cell will be an Expansion/contraction cell; if the input cells are arranged circularly, a Rotation cell will result. PMID- 2769353 TI - Interlimb coordination of leg-muscle activation during perturbation of stance in humans. AB - 1. Electromyographic (EMG) responses were recorded in both legs, along with corresponding joint movements, after uni- and bilateral perturbations during stance on a treadmill with split belts. Displacements were directed forward, backward, or in opposing directions. They were induced by randomly timed ramp impulses at one of four different rates of treadmill acceleration. 2. Unilateral perturbations directed backward were followed by a bilateral gastrocnemius-EMG response, forward-directed perturbations by a bilateral tibialis anterior-EMG response. The amplitude of these responses was dependent on the rate of treadmill acceleration. Relative to the response of the displaced leg, the amplitude of the EMG response on the nondisplaced side was smaller when a gastrocnemius EMG response was induced, and about equal when the tibialis anterior muscle was activated. The onset latencies were shorter on the displaced side (displaced leg 75-96 ms, non-displaced leg 93-112 ms). 3. Bilateral perturbations in one direction were followed by larger EMG responses in both legs (in the gastrocnemius for backward-directed impulses, in the tibialis anterior for forward-directed impulses). For a given acceleration rate, their amplitude was about equal to the sum of the EMG amplitude of the displaced leg and that of the nondisplaced leg obtained during unilateral displacement. The inverse result was obtained when the legs were simultaneously displaced in opposite directions: EMG responses in both legs were significantly smaller than those obtained after unilateral displacement. 4. It is concluded that a unilateral displacement evokes reflex EMG responses in the synergistic muscles of both legs, which are graded according to the size of the proprioceptive input from the primarily displaced joint. During bilateral displacements, the activity induced by the respective contralateral leg is linearly summed or subtracted, depending on whether the legs are displaced in the same or in opposite directions. In view of the short latencies of these bilateral responses, it would seem that they are mediated by a spinal mechanism. 5. Distinct differences in the behavior of the antagonistic leg muscles were observed: 1) the coactivation of the contralateral leg muscle was significantly smaller when the gastrocnemius was stretched unilaterally, whereas it was about equal for the tibialis anterior; and 2) the gastrocnemius EMG responses were closely correlated with the displacement velocity, whereas the tibialis anterior response was more closely correlated with acceleration, i.e., the tibialis anterior response was more dynamic in nature.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2769354 TI - Human cortical potentials evoked by stimulation of the median nerve. I. Cytoarchitectonic areas generating short-latency activity. AB - 1. The anatomic generators of human median nerve somatosensory evoked potentials (SEPs) in the 40 to 250-ms latency range were investigated in 54 patients by means of cortical-surface and transcortical recordings obtained during neurosurgery. 2. Contralateral stimulation evoked three groups of SEPs recorded from the hand representation area of sensorimotor cortex: P45-N80-P180, recorded anterior to the central sulcus (CS) and maximal on the precentral gyrus; N45-P80 N180, recorded posterior to the CS and maximal on the postcentral gyrus; and P50 N90-P190, recorded near and on either side of the CS. 3. P45-N80-P180 inverted in polarity to N45-P80-N180 across the CS but was similar in polarity from the cortical surface and white matter in transcortical recordings. These spatial distributions were similar to those of the short-latency P20-N30 and N20-P30 potentials described in the preceding paper, suggesting that these long-latency potentials are generated in area 3b of somatosensory cortex. 4. P50-N90-P190 was largest over the anterior one-half of somatosensory cortex and did not show polarity inversion across the CS. This spatial distribution was similar to that of the short-latency P25-N35 potentials described in the preceding paper and, together with our and Goldring et al. 1970; Stohr and Goldring 1969 transcortical recordings, suggest that these long-latency potentials are generated in area 1 of somatosensory cortex. 5. SEPs of apparently local origin were recorded from several regions of sensorimotor cortex to stimulation of the ipsilateral median nerve. Surface and transcortical recordings suggest that the ipsilateral potentials are generated not in area 3b, but rather in other regions of sensorimotor cortex perhaps including areas 4, 1, 2, and 7. This spatial distribution suggests that the ipsilateral potentials are generated by transcallosal input from the contralateral hemisphere. 6. Recordings from the periSylvian region were characterized by P100 and N100, recorded above and below the Sylvian sulcus (SS) respectively. This distribution suggests a tangential generator located in the upper wall of the SS in the second somatosensory area (SII). In addition, N125 and P200, recorded near and on either side of the SS, suggest a radial generator in a portion of SII located in surface cortex above the SS. 7. In comparison with the short-latency SEPs described in the preceding paper, the long-latency potentials were more variable and were more affected by intraoperative conditions.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2769355 TI - Human cortical potentials evoked by stimulation of the median nerve. II. Cytoarchitectonic areas generating long-latency activity. AB - 1. The anatomic generators of human median nerve somatosensory evoked potentials (SEPs) in the 40 to 250-ms latency range were investigated in 54 patients by means of cortical-surface and transcortical recordings obtained during neurosurgery. 2. Contralateral stimulation evoked three groups of SEPs recorded from the hand representation area of sensorimotor cortex: P45-N80-P180, recorded anterior to the central sulcus (CS) and maximal on the precentral gyrus; N45-P80 N180, recorded posterior to the CS and maximal on the postcentral gyrus; and P50 N90-P190, recorded near and on either side of the CS. 3. P45-N80-P180 inverted in polarity to N45-P80-N180 across the CS but was similar in polarity from the cortical surface and white matter in transcortical recordings. These spatial distributions were similar to those of the short-latency P20-N30 and N20-P30 potentials described in the preceding paper, suggesting that these long-latency potentials are generated in area 3b of somatosensory cortex. 4. P50-N90-P190 was largest over the anterior one-half of somatosensory cortex and did not show polarity inversion across the CS. This spatial distribution was similar to that of the short-latency P25-N35 potentials described in the preceding paper and, together with our and Goldring et al. 1970; Stohr and Goldring 1969 transcortical recordings, suggest that these long-latency potentials are generated in area 1 of somatosensory cortex. 5. SEPs of apparently local origin were recorded from several regions of sensorimotor cortex to stimulation of the ipsilateral median nerve. Surface and transcortical recordings suggest that the ipsilateral potentials are generated not in area 3b, but rather in other regions of sensorimotor cortex perhaps including areas 4, 1, 2, and 7. This spatial distribution suggests that the ipsilateral potentials are generated by transcallosal input from the contralateral hemisphere. 6. Recordings from the periSylvian region were characterized by P100 and N100, recorded above and below the Sylvian sulcus (SS) respectively. This distribution suggests a tangential generator located in the upper wall of the SS in the second somatosensory area (SII). In addition, N125 and P200, recorded near and on either side of the SS, suggest a radial generator in a portion of SII located in surface cortex above the SS. 7. In comparison with the short-latency SEPs described in the preceding paper, the long-latency potentials were more variable and were more affected by intraoperative conditions. PMID- 2769356 TI - Classification of turtle retinal ganglion cells. AB - 1. Receptive fields of 78 retinal ganglion cells were analyzed for their responses to moving and stationary lights that were presented under a variety of stimulus conditions. All cells were sensitive to moving stimuli, and their receptive fields often comprised excitatory and inhibitory sub-regions. 2. Properties used in the classification included responses to stationary flashed stimuli, receptive-field organization, changes in stimulus wavelength and adaptation, movement velocity, and direction of stimulus movement. Eight functional cell classes were derived: simple, ON-sustained, annular, wavelength sensitive, directionally selective, bar-shaped, large-field, and velocity. 3. Simple cells, representing 21% of the sample, had circular or oval receptive fields of 3-22 degrees that gave transient responses to stationary, flashed lights. Many of these cells, but not all, showed antagonistic center-surround organizations. ON-sustained cells responded for the duration of the stimulus flash or for the duration of a light flash moving through the receptive field. These units comprised 8% of the sample; they had small, circular, non-directional receptive fields and they were most sensitive to red light. Their field sizes did not vary with changes in adaptation level. 4. Annular cells (4% of the sample) gave no responses to any stimulation in the field center, but they responded strongly to stimulation in the surround area, especially to stimuli that moved very slowly through the region. Annular cells were nondirectional, with circular centers of 5-6 degrees diam and annular surround widths of 2-4 degrees. They responded best in light adaptation. 5. Wavelength-sensitive cells, similar to most of the cells sampled, were sensitive to red light when light-adapted. Some cells in addition showed input from rods under dark adaptation. Intensity response curves for these latter cells showed clear changes from one input to the other as the cells' functional ranges were explored. Some cells responded best to short- or middle-wavelength light, but these were more rarely met. Where multiple receptor inputs could be identified, long-wavelength stimuli evoked transient responses, whereas short-wavelength stimuli favored more sustained spike trains. Wavelength-sensitive cells in this category comprised 5% of the sample. PMID- 2769357 TI - Bifurcation analysis of nonlinear retinal horizontal cell models. I. Properties of isolated cells. AB - 1. Bifurcation theory is used to study properties of nonlinear analytical and computational models of isolated retinal horizontal cells. The analytical model is based on the published data of Shingai and Christensen describing steady-state I-V characteristics of horizontal cells isolated from catfish (Ictalurus punctatus) retina. The computational model is based on I-V characteristics of distinct macroscopic membrane currents observed in horizontal cells isolated from goldfish (Carassius auratus) retina. Slow-model dynamics are analyzed assuming that excitatory processes occur rapidly with respect to the time course of inactivation of the inward Ca2+ and outward K+ currents. 2. A global bifurcation diagram plotting the location and stability properties of critical points as a function of photoreceptor-evoked horizontal-cell postsynaptic membrane conductance Gsyn is derived for the analytical model. The automated bifurcation analysis software AUTO is used to compute global bifurcation diagrams for the computational model. Bifurcation diagrams exhibit a bistable regime at small Gsyn values characterized by two stable and one unstable critical point and a monostable regime at larger Gsyn values characterized by a single globally attracting stable critical point. The transition between bistable and monostable behavior occurs at a Gsyn value of roughly 0.9 nS for the computational model and 1.7 nS for the analytical model. Estimates of horizontal-cell glutamate-channel conductance suggest that this transition corresponds to the activation of as few as 400-700 glutamate channels. Dark-evoked release of neurotransmitter from photoreceptors may therefore set horizontal-cell synaptic conductance Gsyn to a value within the monostable regime. 3. Photoreceptor-evoked horizontal-cell membrane conductance, total Ca2+ channel conductance, and inactivation of the inward Ca2+ current are shown to be the major factors controlling the bifurcation structure of the computational model. Inactivation of the inward Ca2+ current is required to account for the dark resting potential of horizontal cells as well as light-evoked hyperpolarizing responses. Inactivation of the outward K+ current has little effect on model properties. 4. Isolated horizontal cells generate Ca2+ action potentials whereas cells in the intact retina normally do not. Simple procedures for modeling the slow dynamics of isolated horizontal-cell Ca2+ action potentials are described.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2769358 TI - Responses of primate spinothalamic tract neurons to renal pelvic distension. AB - 1. Experiments were performed to examine responses of spinothalamic tract (STT) neurons to distension of the renal pelvis. Nineteen monkeys (Macaca fascicularis) were anesthetized with alpha-chloralose, paralyzed, and artificially ventilated. Fifty-four STT neurons in the T11-L2 segments were studied. Each cell was excited by renal nerve stimulation and had a somatic receptive field in the left flank and/or the abdomen. 2. Distension of the left renal pelvis to 50 mmHg for 20-30 s increased activity of 40 STT neurons. Two types of responses were observed. Six cells responded rapidly to the increase in renal pelvic pressure. Thereafter activity of these cells completely adapted. The other 34 cells also responded rapidly to the distension: however, the subsequent adaptation was not complete. Average activity before distension was 13 +/- 1 (SE) spikes/s. Distension increased activity to a peak of 42 +/- 3 spikes/s. Mean activity just before the end of the distension was 27 +/- 3 spikes/s. 3. The pelvic pressure-cell response relation was determined for 16 cells. Only one cell responded to a pressure of 20 mmHg. Three responded to 30 mmHg, and all others responded to 40 mmHg and higher. The average response threshold was 32 +/- 1 mmHg. Peak responses increased as distending pressure increased from 40-80 mmHg. Responses to a pressure of 100 mmHg were no greater than to 80 mmHg. Adapted levels of activity were also a function of distending pressure in the 40-80 mmHg range. 4. Probability of responses was unrelated to somatic input. However, cells with A delta- and C fiber renal input were significantly more likely to respond to renal pelvic distension than cells with only A delta-renal input. Magnitude of responses to a pressure of 50 mmHg was not related to the type of renal input to the cells; however, among the cells tested at all pressures, cells with A delta- and C-fiber input had significantly greater responses to pressures of 80 and 100 mmHg. 5. Cells were studied in laminae I and IV-VII: responses were unrelated to laminar location. None of the 6 cells located in L2 responded to renal pelvic distension; 8 of 12 in L1 responded; 24 of 28 in T12 responded; and all 8 cells in T11 responded. 6. Stimulation of inhibitory receptive fields on the right hindlimb reduced activity of four cells to a significantly greater extent during pelvic distension than before pelvic distension.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2769359 TI - Unilateral auditory cortex ablation in macaques results in a contralateral hearing loss. AB - 1. The behavioral audiograms of four Japanese macaques (Macaca fuscata) were assessed before and after unilateral ablation of auditory cortex. The tones were presented via insertion earphones so that each ear could be tested separately. 2. Each animal had a hearing loss in the ear contralateral to the lesion, whereas the ipsilateral ear showed no change in sensitivity. The hearing loss initially appeared as a large shift in thresholds followed by rapid but incomplete recovery during the first 3-5 wk after surgery. The initial hearing loss ranged as high as 68 dB at some frequencies, although thresholds at other frequencies were occasionally unchanged. A threshold shift could be demonstrated with broadband noise as well as with tones. Although thresholds for some tones returned to normal within a few weeks, most were still elevated 16 wk after surgery when testing was discontinued. The largest long-term hearing losses occurred at frequencies from 4 to 25 kHz. 3. Analysis of the animals' psychophysical functions suggested that the hearing loss resembled a sensory deficit, as opposed to a nonsensory deficit in attention or vigilance. 4. Testing with binaural stimuli indicated that the hearing loss could best be described as a contralateral "ear" deficit, as opposed to a contralateral "auditory field" deficit. 5. It is suggested that a similar hearing loss occurs in humans after unilateral damage to auditory cortex. PMID- 2769360 TI - Functional anatomy of the second visual area (V2) in the macaque. AB - To study the functional organization of secondary visual cortex (V2) in the primate, 14C-2-deoxy-d-glucose (DG) was injected while macaque monkeys were shown specific visual stimuli. Wherever possible, patterns of DG uptake were compared with the position of dark and light cytochrome oxidase (cytox) stripes (Tootell et al., 1983). Often, the DG effects of 2 different stimuli were compared in the same hemisphere to eliminate ambiguities inherent in between-animal comparisons. Data were obtained from a large number of animals in conjunction with related DG studies in area V1 (primary visual or striate cortex). The following conclusions were reached: (1) in some macaque monkeys, dark cytox stripes were faint or absent. Although this could conceivably be due to poor staining technique, some evidence suggests that the lack of enzyme stripe pattern is real. In all animals, including those that showed poor or no cytox staining evidence for stripes, the functional architecture revealed by the DG was consistently present and robust. (2) Uniform gray stimuli produce a relatively uniform pattern and minimal stimulus-related DG uptake. (3) Eye movements per se produce some uptake in the V2 stripes. (4) Very generalized visual stimulation conditions (e.g., binocular stimulation with a grating of varied orientation and varied spatial frequency) produced a pattern of uptake that is greatest in both sets of dark cytox stripes and lighter in the light cytochrome stripes. (5) In both the DG and cytox results, the V2 "stripes" are more accurately described as stripe-shaped collections of patches. (6) In almost all cases, DG patterns were columnar in shape, extending from white matter to cortical surface. The boundaries of the columns were most sharply defined, and the contrast was highest, in layers 3B/4, becoming slightly more blurry and lower in contrast in other layers. Laminar differences between DG patterns in V2 were almost negligible, compared with the profound laminar differences in macaque V1. (7) There is no DG evidence for, and much against, the possibility of an ocular dominance architecture in V2. (8) There are orientation columns in macaque V2. DG-labeled orientation columns are spaced further apart than those in V1, by a factor of about 1.6, but the columns are not correspondingly wider. (9) Spatially diffuse variations in color produce high uptake confined, at least largely, to the thin cytox stripes. (10) There is evidence for spatially antagonistic color surrounds in color cells in the thin stripes.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2769361 TI - Dopamine transport sites selectively labeled by a novel photoaffinity probe: 125I DEEP. AB - The dopamine transporter was labeled using a photosensitive compound related to GBR-12909, 125I-1-[2-(diphenylmethoxy)ethyl]-4-[2- (4-azido-3 iodophenyl)ethyl]piperazine (125I-DEEP). 125I-DEEP bound reversibly and with high affinity to the dopamine transport protein in the absence of light and could be covalently attached to the protein following exposure to UV light. In rat striatal homogenates, 125I-DEEP was found to incorporate covalently into a protein with apparent molecular weight of 58,000 Da. The properties of this binding protein were characteristic of the dopamine transporter since covalent attachment could be inhibited by dopamine-uptake blockers with the proper pharmacological rank order of potencies. Covalent binding was also inhibited in a stereospecific manner by (+) and (-) cocaine, as well as other cocaine analogs. The protein was not found in the cerebellum. The dopamine transporter appears to exist in a glycosylated form since photoaffinity-labeled transport sites could adsorb to wheat germ-agglutinin and could be specifically eluted from the column by beta-N-acetylglucosamine. PMID- 2769362 TI - Specificity of circadian function in transplants of the fetal suprachiasmatic nucleus. AB - Fetal tissues obtained from specific regions of the developing hypothalamus were transplanted to determine whether the precursor neurons of the suprachiasmatic nucleus (SCN) can be distinguished from those of the presumptive paraventricular nucleus (PVN) on the basis of the functional capacity to generate circadian rhythms. The presumptive SCN, the PVN, and a portion of the neocortical primordium were dissected from the developing forebrains of normal Long-Evans fetuses, separated, and selectively transplanted into the periventricular-third ventricle region of adult, vasopressin (VP)-deficient Brattleboro rats. In host animals that received grafts containing the precursor population of SCN neurons, the temporal profile of VP levels in the cerebrospinal fluid (CSF) oscillated with a circadian periodicity in a manner similar to that observed in normal Long Evans rats. CSF collected serially from animals with grafts of the presumptive PVN also contained VP, but no circadian variation was manifested in peptide levels. VP was undetectable in CSF samples obtained from Brattleboro rats with cortical grafts. In association with their circadian functional capacity, grafts of the SCN primordium were characterized by clusters of parvicellular neurons immunopositive for VP or vasoactive intestinal polypeptide (VIP) that resembled the cell groups of the in situ SCN. In contrast, transplants of the presumptive PVN did not contain neurons immunoreactive for VIP, and the VP neurons in these grafts resembled the neurosecretory cells of the PVN.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2769363 TI - A nerve terminal protein with a selective distribution in spinal cord and brain. AB - A monoclonal antibody, designated S-7B8, recognizes a protein antigen localized to highly selected populations of nerve terminals in spinal cord and brain. The antibody produces dense immunocytochemical staining of primary afferent endings that synapse in superficial laminae of the spinal cord dorsal horn. Electron microscopy shows staining to be localized in nerve terminals where reaction product is associated primarily with spherical vesicles. In brain, S-7B8 immunoreactivity occurs in nerve terminals in sensory relay nuclei, most thalamic nuclei, and other selected areas, including the cerebellar molecular layer, the substantia nigra, the globus pallidus, and certain synaptic layers of the hippocampus and dentate gyrus. Endocrine glands and other tissues do not exhibit S-7B8 immunoreactivity. Although the antibody localizes to certain populations of nerve terminals that may use excitatory amino acid neurotransmitters, the distribution of S-7B8 immunoreactivity in the CNS does not correspond to that of any previously identified nerve terminal protein. Experiments to characterize the S-7B8 antigen indicate it may be an integral membrane component since extraction of synaptosomes with alkaline pH or high ionic strength does not release the antigen from the membranes. To identify the molecular weight of the S-7B8 antigen, synaptosomal membranes were solubilized in CHAPS and sequentially chromatographed on hydroxylapatite and then on DEAE anion-exchange resin to produce enriched fractions. When enriched fractions were separated on SDS-PAGE and Western blotted, the S-7B8 antibody specifically stained a protein migrating at 75,000 Da. This protein has been designated NT75. Preliminary studies of developing pathways show that the appearance of S-7B8 immunoreactivity in growing nerve endings corresponds closely to the time when synaptic connections are formed. Thus, the NT75 protein recognized by the S-7B8 antibody may have a role in the development and maintenance of specific synaptic endings. PMID- 2769364 TI - Spatial and behavioral correlates of hippocampal neuronal activity. AB - The firing rate of hippocampal neurons in rats was related both to spatial location and to multiple behavioral variables as rats performed 2 kinds of tasks that rely on hippocampal function: a spatial navigation task similar in performance demands to the radial-arm maze task and a simultaneous cue odor discrimination task. In the place task, most cells had distinct single or multiple place fields, that is, neurons increased firing when the rat was in a particular location or locations. However, in most of these cells, firing rate also varied systematically in relation to behavioral variables, including the speed, direction, and turning angle of the rat as it moved through the place field. In addition, the activity of most cells was time-locked to task-relevant approach movements. In the odor task, most cells fired as the rat sampled discriminative cues or when it executed specific, task-relevant approach movements. Some cells fired selectively in relation to which odors were presented, the configuration of odor cues, the locus of the response, or a combination of these variables. Many cells with spatial correlates in the place task also had striking behavioral correlates when rats performed the odor task in the same environment, and the locus of the increased firing associated with behavior in the odor task was not the same as the place field in the place task. Thus, while the complex stimuli that compose spatial cues are reflected in hippocampal neuronal activity, hippocampal processing is not limited to the representation of spatial location. Rather, the domain of hippocampal representation includes both spatial and nonspatial relations among multiple cues and the actions directed in relation to these cues, across cue modalities, and across behavioral paradigms. PMID- 2769365 TI - The organization of spatial coding in the hippocampus: a study of neural ensemble activity. AB - Neural activity was recorded from local groups of hippocampal single units in rats performing a spatial-memory task. The organization of functional correlates in these neural ensembles was investigated by examining the spatial relationships among the place fields of single units in each ensemble. The distance and overlap between place fields were determined together with the tuning of cellular activity to behavioral variables, including direction, speed, and turning angle during movements within place fields. The place fields of recorded neural ensembles were significantly clustered: closer in space and considerably more overlapped than chance when compared statistically with Monte Carlo simulations. Just as single units often have significant firing in more than one distinct location in the environment (subfields), the ensembles had multiple and distinct clusters of overlapping subfields. In addition, proximity and overlap between place fields were significantly, but weakly, correlated with similarity in optimal movement tuning parameters. These results suggest that the hippocampus maintains a local organization with respect to place fields despite having no apparent large-scale isomorphism with the spatial environment. The organization of multiple, clustered place fields with correlated movement tuning properties in small neural ensembles suggests the existence of functional neural ensembles serving to encode multiple sensory and behavioral aspects of a place or event. Such an organization is similar to that observed for neocortical association areas afferent to the hippocampal system. PMID- 2769366 TI - Regulation of muscarinic receptors in hippocampus following cholinergic denervation and reinnervation by septal and striatal transplants. AB - The regulation of hippocampal muscarinic M1 and M2 receptors was studied by autoradiographic methods following cholinergic denervation and reinnervation from embryonic septal transplant. In young adult male rats the density of M1 sites, labeled either with 3H-pirenzepine (PZ) or 3H-N-methylscopolamine (NMS, in the presence of excess carbachol), exceeded by 4- to 5-fold the density of M2 sites, labeled with 3H-NMS in the presence of excess PZ. Both receptors appeared to be densest in hippocampal regions lowest in acetylcholinesterase or 3H-hemicholinium 3 binding. The distribution of M1 receptors did differ from the distribution of M2 receptors within subregions of the hippocampus. Along the mediolateral axis from the subiculum to the lateral CA 1, the density of M1 receptors is uniform, but the density of M2 receptors decreases. Also apparent is the relatively small difference in density between the CA1 and dentate gyrus for M1 receptors but a significantly greater difference for M2 receptors. However, the response of M1 and M2 receptors to long-term cholinergic denervation following fimbriafornix transection of the septal cholinergic input and to cholinergic innervation by embryonic septal transplants was similar. Long-term denervation (40-60 d) resulted in a 30-60% increase in both M1 and M2 receptors within regions of the hippocampal formation. Receptor levels were reduced to normal in regions innervated by septal transplants. For both receptors, the changes in the density of sites were due to alterations in the Bmax and not the Kd for the radioligands. The specificity of this regulation is supported by the evidence that (1) the degree and topography of the normalization of muscarinic receptor density was entirely dependent on the degree and pattern of cholinergic reinnervation by the fibers of the septal transplant, (2) cholinergic fiber reinnervation by embryonic striatal grafts also down-regulated the density of M1 and M2 receptors, and (3) successfully surviving transplants (e.g., cerebellar and striatal) that did not provide innervation to the hippocampus did not induce down-regulation of muscarinic receptors. Changes in the density of sites were not related to changes in the width of the hippocampus following denervation and reinnervation. The data support the view that the majority of M1 and M2 receptors are located postsynaptically on neurons within the hippocampus and not presynaptically on cholinergic fibers. PMID- 2769367 TI - Transneuronal regulation of protein synthesis in the brain-stem auditory system of the chick requires synaptic activation. AB - The cellular mechanisms by which afferents influence their target neurons were investigated using a slice preparation of the chick brain-stem auditory system. Each brain slice contained portions of the auditory nerve and the second-order auditory nucleus, nucleus magnocellularis (NM), bilaterally. NM neurons on one side of the slice were stimulated either orthodromically, via activation of the ipsilateral auditory nerve, or antidromically, via electrical stimulation of their axons. NM neurons on the other side of the slice were not stimulated and served as a within-animal control population. Evoked activity was monitored extracellularly in all preparations. Orthodromic activation of NM neurons for either 1.5 or 3.5 hr resulted in enhanced protein synthesis by these neurons. This result is similar to those of previous in vivo experiments (Steward and Rubel, 1985; Born and Rubel, 1988). When slices were maintained in a medium having low Ca2+ and high Mg2+ concentrations, both synaptic transmission from the auditory nerve to NM and also the difference in protein synthesis between the stimulated and unstimulated sides of the brain were blocked. Antidromic activation of NM neurons did not enhance protein synthesis, but rather resulted in reliably less synthesis by the stimulated cells. Together, these results suggest that activity-dependent release of some "trophic" substance from the auditory nerve is necessary for this form of transneuronal regulation. Electrical activity of the postsynaptic neuron per se is not sufficient for increasing protein synthesis in these cells. PMID- 2769368 TI - A hyperpolarization-activated inward current in heart interneurons of the medicinal leech. AB - Heart interneurons (HN cells) in isolated ganglia of the medicinal leech were voltage-clamped with single microelectrodes. Hyperpolarizing voltage steps elicited a slow inward current (Ih), which underlies the characteristic depolarizing response of HN cells to injection of prolonged hyperpolarizing current pulses (Arbas and Calabrese, 1987a). The conductance underlying Ih begins to activate near -mV and is fully activated between -70 and -80 mV. The activation kinetics of Ih are slow and voltage dependent. The activation time constant (tau h) ranges from approximately 2 sec at -60 mV to near 700 msec at 100 mV. Ih persists in low Ca2+ (0.1 mM), 5 mM Mn2+ saline and exhibits a reversal potential of -21 +/- 5 mV. The reversal potential is shifted by altering [Na+]o or [K+]o but is unaffected by changes in [Cl-]o. Ih is blocked by extracellular Cs+ (1-5 mM) but not Ba2+ (5 mM) or TEA (25 mM). Low concentrations of Cs+ (100-200 microM) cause a partial block that exhibits strong voltage dependence. Temperature changes were also shown to affect Ih. Both the rate of activation and the steady-state amplitude of Ih are enhanced by temperature increases. HN cells are interconnected by inhibitory chemical synapses, and their normal electrical activity consists of bursts of action potentials separated by periods of inhibition. During the inhibitory phase of rhythmic bursting activity, HN cells hyperpolarize to a voltage range where Ih is activated. Block of Ih with extracellular Cs+ (4 mM) disrupted the normal bursting activity of HN cells. These results are consistent with the hypothesis that Ih contributes to escape from inhibitory inputs during normal bursting activity. PMID- 2769369 TI - Induction of rhythmic jaw movements by stimulation of the mesencephalic reticular formation in the guinea pig. AB - This study was designed to investigate whether stimulation of the mesencephalic reticular formation (MRF) induces rhythmic jaw movements (RJMs) and, if it does so, to determine the RJM-inducing region in the MRF in ketamine-anesthetized guinea pigs. The results were as follows: (1) Repetitive electrical stimulation of the MRF at the level of the red nucleus induced rhythmic EMG bursts in the anterior digastric muscle (DIG). (2) The duration and cycle time of the rhythmic DIG EMG burst induced from the medial MRF were longer than those induced from the lateral MRF. (3) Repetitive MRF stimulation after paralysis still induced rhythmic multiple-unit activities in the anterior digastric motoneuron pool. (4) Neither precollicular decerebration nor cerebellectomy affected the MRF induction of RJMs. (5) Transverse hemisection at the rostral border of the pons abolished the RJMs induced from the contralateral, but not ipsilateral, MRF. Midline section of the midbrain abolished RJMs induced from the MRF on either side. (6) A lesion in the pontine pyramidal tract abolished the RJMs induced by stimulation of the ipsilateral cortical masticatory area (CMA), but not those induced from the contralateral MRF. (7) A unilateral lesion of the oral portion of the gigantocellular reticular nucleus, where the rhythm generator for the CMA-induced RJMs is located, abolished RJMs induced from not only the CMA, but also MRF on the contralateral side. (8) Microinjection of L-glutamate into the lateral, but not medial, MRF induced RJMs similar to those elicited by repetitive electrical stimulation of the same site.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2769370 TI - Influences of hippocampal place cell firing in the awake state on the activity of these cells during subsequent sleep episodes. AB - Rat hippocampal (CA1) complex spike "place cells" of freely behaving rats were recorded in pairs continuously during a series of waking (exploration and still alert), drowsy (quiet-awake), and sleeping (slow-wave, pre-rapid-eye-movement and rapid-eye-movement sleep) behaviors. Pairs of units were selected that had nonoverlapping place fields. The rats were restricted from entering the place field of either cell overnight, and on the day of recording cells were exposed to their individual place fields independently and in a counterbalanced manner. Following exposure, recordings were made in the subsequent sleep episodes and the firing characteristics of both cells were analyzed. Following exposure, significant increases in the spiking activity of the exposed cell were observed in the subsequent sleeping states that were not evident in the unexposed cell. The increased activity was observed in the rate of firing (spikes/sec), the rate of occurrence of bursts with multiple spikes, as well as the number of bursts displaying short (2-4 msec) interspike intervals. The findings suggest that neuronal activity of hippocampal place cells in the awake states may influence the firing characteristics of these cells in subsequent sleep episodes. The increased firing rates along with the greater number of multiple spike bursts and the shorter interspike intervals within the burst, following exposure to a cell's place field, may represent possible information processing during sleep. PMID- 2769371 TI - Quantitative lineage analysis of the origin of frog primary motor and sensory neurons from cleavage stage blastomeres. AB - The average number of primary motoneurons and Rohon-Beard neurons that descend from each "identified" blastomere of the 16- and 32-cell stages of the frog Xenopus laevis was determined. The dorsal, animal blastomeres are the major motoneuron progenitors, and the ventral, animal blastomeres are the major Rohon Beard progenitors. Cells along the midline primarily give rise to only one of these phenotypes, whereas cells along the frontal plane, which separates dorsal from ventral, give rise to both phenotypes. Each blastomere produces a characteristic number of each type of neuron, with only small variations between embryos. The mean values were used to construct quantitative retrospective lineage diagrams for the first 5 cell cycles after fertilization. These diagrams illustrate that the fate to become a major neuronal progenitor is segregated as early as the 4-cell stage. The lineage patterns of which sister cell makes the majority of primary neurons at each cleavage after the 4-cell stage are quite similar for both neurons in the D lineage but only moderately similar for both neurons in the V lineage. The pattern of predominant Rohon-Beard neuron fate is very similar in the D and V lineages. Analysis of the axial distribution of the primary motoneurons and Rohon-Beard neurons that descend from each blastomere indicates that the major progenitors contribute neuronal descendants periodically, to nearly every segmental bin, but the minor progenitors distribute neuronal descendants randomly along the axis. These data demonstrate that primary neuronal phenotype, cell number, predominant lineal pattern, and in some cases segmental distribution are highly regular across a large population of embryos. This population consistency suggests that several features of neuronal fate may be influenced either by cell position or lineage. PMID- 2769372 TI - Synaptic organization of individual neurons in the macaque lateral geniculate nucleus. AB - Parvocellular and magnocellular neurons in the dorsal lateral geniculate nucleus of macaque monkeys were recorded electrophysiologically and then injected with HRP. The injected neurons were examined with the electron microscope. Synaptic terminals contacting the dendrites of individual neurons were classified and the synapses counted to estimate the number and distribution of each type over the entire dendritic tree. Seven parvocellular and 2 magnocellular neurons were analyzed. Two of the parvocellular neurons had presynaptic dendrites and no axons. These interneurons had electro-physiological characteristics much like those of relay neurons with the exception that their receptive field center responses had the opposite sign; i.e., they had OFF centers, while most neurons around them had ON centers. All of the relay neurons had similar types and distributions of terminal contacts. However, the distribution of each synaptic type along the dendrites of an individual neuron was not homogeneous. Retinal and F terminals were located predominantly on proximal dendrites whereas RSD terminals, either from the cortex and/or brain stem, predominated on the intermediate and distal dendrites. Parvocellular neurons were estimated to have about 500 total synapses on their dendritic trees, while magnocellular neurons had about 3000 total synapses on their dendritic trees. The retinal terminals making synaptic contacts with magnocellular neurons were also presynaptic to terminals containing flattened vesicles; these latter terminals also had synapses onto the magnocellular neuron's dendrites. Such a synaptic arrangement is called a triadic arrangement, or triad. Parvocellular neurons rarely had such triadic arrangements. In comparing these data with those of the cat, it was concluded that the major synaptic difference between relay cell types in both species (Class 1/Class 2 cells for the cat and parvo/magno cells for the monkey) was the frequent occurrence of triads for Class 2 cells and magnocellular cells versus the infrequent occurrence of triads for Class 1 cells and parvocellular cells. Although these triadic arrangements have been studied for over 2 decades, their function has yet to be determined, but probably relates to inhibition of retina signals at dendrites of magnocellular neurons in the monkey and Class 2 cells in the cat. PMID- 2769373 TI - Asymmetry in voltage-dependent movements of isolated outer hair cells from the organ of Corti. AB - The electrically induced movements of outer hair cells (OHC) were studied using the whole-cell voltage-clamp technique and video analysis. Cell shortening occurs during depolarization and elongation occurs during hyperpolarization from holding potentials near -70 mV. However, a marked asymmetry in response magnitude exists such that depolarization produces larger cell length changes than do comparable levels of hyperpolarization. The response is such that at normal resting potentials in vivo, displacements are about 2 nm/mV, but increase to about 15 nm/mV as the cell is depolarized. This mechanical rectification in the depolarizing direction manifests itself during symmetrical sinusoidal voltage stimulation as a "DC" reduction in cell length superimposed upon "AC" length changes. The observed OHC mechanical rectification may be involved in the reported production of "DC" basilar membrane displacements during suprathreshold acoustic stimulation (LePage, 1987). Estimates of the magnitude of OHC movements at acoustic threshold levels induced by receptor potentials in the high-frequency region of the cochlea indicate a disparity between basilar membrane and OHC movements on the order of 21 dB. Thus, it appears questionable whether OHC mechanical movements solely underlie the "active process" thought to be responsible for the high degree of neural tuning at sound pressures near 0 dB. PMID- 2769374 TI - GABA-mediated inhibition of locus coeruleus from the dorsomedial rostral medulla. AB - Recent anatomic studies in our laboratory (Aston-Jones et al., 1986) identified the nucleus prepositus hypoglossi (PrH) in the dorsomedial medulla as a major afferent of the locus coeruleus (LC). In the present studies, the influence of projections from PrH to LC was assessed in anesthetized rats. Focal electrical stimulation of PrH inhibited the spontaneous discharge of 42 of 47 LC neurons; the latency to onset of such inhibition was 19.8 +/- 2.5 msec and its duration was 172.4 +/- 10.4 msec. PrH-evoked inhibition of LC neurons was unaffected by administration of the opiate receptor antagonist naloxone or the alpha 2-receptor antagonist idazoxan but was substantially reduced by systemic picrotoxin, an antagonist of GABA. The GABAA receptor antagonist bicuculline methiodide blocked the inhibition from PrH, whether applied by local microinfusion or iontophoresis into the LC. These results lead us to propose that PrH provides a direct inhibitory synaptic input to LC, for which GABA is the likely transmitter. PMID- 2769375 TI - Dendritic spines of CA 1 pyramidal cells in the rat hippocampus: serial electron microscopy with reference to their biophysical characteristics. AB - Serial electron microscopy and 3-D reconstructions of dendritic spines from hippocampal area CA 1 dendrites were obtained to evaluate 2 questions about relationships between spine geometry and synaptic efficacy. First, under what biophysical conditions are the spine necks likely to reduce the magnitude of charge transferred from the synapses on the spine heads to the recipient dendrite? Simulation software provided by Charles Wilson (1984) was used to determine that if synaptic conductance is 1 nS or less, only 1% of the hippocampal spine necks are sufficiently thin and long to reduce charge transfer by more than 10%. If synaptic conductance approaches 5 nS, however, 33% of the hippocampal spine necks are sufficiently thin and long to reduce charge transfer by more than 10%. Second, is spine geometry associated with other anatomical indicators of synaptic efficacy, including the area of the postsynaptic density and the number of vesicles in the presynaptic axon? Reconstructed spines were graphically edited into head and neck compartments, and their dimensions were measured, the areas of the postsynaptic densities (PSD) were measured, and all of the vesicles in the presynaptic axonal varicosities were counted. The dimensions of the spine head were well correlated with the area of PSD and the number of vesicles in the presynaptic axonal varicosity. Spine neck diameter and length were not correlated with PSD area, head volume, or the number of vesicles. These results suggest that the dimensions of the spine head, but not the spine neck, reflect differences in synaptic efficacy. We suggest that the constricted necks of hippocampal dendritic spines might reduce diffusion of activated molecules to neighboring synapses, thereby attributing specificity to activated or potentiated synapses. PMID- 2769376 TI - Magnetic resonance imaging in the exploration of dissection of the internal carotid artery. AB - Five patients with recent spontaneous or post-traumatic dissection of the internal carotid artery (ICA) were explored by magnetic resonance imaging (MRI), using T1-weighted axial sections in all cases. In four patients examined during the subacute phase (after 7 days) the diagnosis of ICA dissection was strongly suspected on the association of a very high intensity signal produced by the parietal haematoma with a contiguous signal void area corresponding to the lumen of the ICA. A control MRI examination performed in two patients 2 months after the onset of dissection showed that it had regressed and that the carotid arteries were patent, which was confirmed by angiography. In the fifth patient MRI provided evidence for the evolution of a post-traumatic dissection towards thrombosis. The MRI image of carotid dissection at the subacute phase seems to be characteristic. MRI is also useful to follow up dissections under treatment and to postpone angiography. The latter, however, remains necessary to investigate for associated arterial dysplasia and to evaluate the sequelae of dissection. PMID- 2769377 TI - Magnetic resonance imaging in ischaemic accidents of the brain stem. AB - Seven cases of ischaemic accident affecting the brain stem are reported. There were two lacunar infarctions and five infarctions due to occlusion of major arteries (two lateral medullary infarctions, one pontine infarction and two thalamo-mesencephalic infarctions). In every case the abnormalities detected at MRI were concordant with the clinical findings. The authors underline the value of MRI in establishing clinico-topographic correlations in vivo and in differentiating lacunar infarctions from infarctions due to stenosis of major arteries in the vertebro-basilar system. PMID- 2769378 TI - Apparently isolated, spontaneous haematomas of the brain stem. Seven cases explored by CT and MRI. AB - The authors present seven cases of apparently isolated spontaneous haematomas of the brain stem detected by computerized tomography (CT). Magnetic resonance imaging (MRI) was performed in all patients, and in three of these on two occasions at different stages of the lesion. Changes in MRI signal according to the moment this examination was carried out (acute, subacute or chronic stage) are described. In two of three patients operated upon the haematoma was found to be due to an occult vascular malformation. PMID- 2769379 TI - Radio-functional analysis of the cervical spine using the Arlen method. A study of 699 subjects. Part One: Methodology. AB - The authors describe successively the radiological technique and measurement method of Arlen's radio-functional analysis of the cervical spine, the characteristics of antero-posterior cervical spine mobility in a control population and the variations observed in these characteristics according to age and sex. A few typical diagrams of radio-functional analysis obtained in various types of pathology are offered as examples. The ease with the Arlen method can be used in routine practice; its diagnostic and prognostic value and its role in the follow-up of patients with cervical diseases or injuries are emphasized. PMID- 2769380 TI - Radio-functional analysis of the cervical spine using the Arlen method. A study of 699 subjects. Part Two: Paradoxical tilting of the atlas. AB - The authors describe a peculiar movement of the first cervical vertebra: the so called paradoxical tilting of the atlas, which consists of extension in relation to McGregor's line during flexion of the cervical spine. This physiological phenomenon has already been reported by several authors. The purpose of this study was to determine the mean amplitude and frequency of paradoxical tilting of the atlas in subjects with no known cervical pathology and to evaluate some of the factors that may influence it. The younger the subject the more frequent and more ample this paradoxical tilting: it occurs very often before the age of 40 years and is present in more than 93% of subjects under 20. Its amplitude diminishes with age, until it is replaced by mobility in flexion. PMID- 2769381 TI - Aneurysm of the posterior inferior cerebellar artery: nonselective endovascular treatment. One case. AB - The authors report a case of aneurysm of the right posterior inferior cerebellar artery which was successfully treated by endovascular occlusion of the vertebral artery at C1 level. This treatment was justified by the failure of neurosurgery. PMID- 2769382 TI - Who manages the managers? The 1989 Harvey Cushing oration. AB - New medical knowledge is emerging at a tremendous rate. Diseases such as Alzheimer's disease. Parkinson's disease, cancer, and others (diseases once considered beyond the scope of medicine) are receiving a great deal of attention. Yet it is a paradox that, at a time when we are learning more about the biology of the human being, it is more difficult to creatively develop the new knowledge into diagnostic tests, surgical interventions, and preventive strategies. The pace of biomedical innovation is being slowed by an increase in the intervention of nonmedical "managers of care." The driving force behind managed care is concern over cost. The managers of medical care have sought to control costs by controlling the doctor's decision making. This is the focus of managed care. The physicians of today, therefore, face a remarkable challenge. They must respond to the needs of patients while being held accountable to an increasing number of overseers in the public and private sectors. These managers of care justify their activities on the notion that the patient will be better off and the cost less if the doctor-patient encounter is regulated by protocols, statistical comparison, utilization review, and fee schedules. While doctor's decisions are being managed by others, who is managing the managers? The answer should be the medical community, principally doctors. Unfortunately, the answer at the moment is the payors--governmental reimbursement agencies, intermediaries, employers, hospitals, or new corporations designed to manage medical costs. The challenge to the physician is to retain the responsibility for those things for which he or she is held accountable. The challenge should not be ignored. PMID- 2769383 TI - Cortical language localization in left, dominant hemisphere. An electrical stimulation mapping investigation in 117 patients. AB - The localization of cortical sites essential for language was assessed by stimulation mapping in the left, dominant hemispheres of 117 patients. Sites were related to language when stimulation at a current below the threshold for afterdischarge evoked repeated statistically significant errors in object naming. The language center was highly localized in many patients to form several mosaics of 1 to 2 sq cm, usually one in the frontal and one or more in the temporoparietal lobe. The area of individual mosaics, and the total area related to language was usually much smaller than the traditional Broca-Wernicke areas. There was substantial individual variability in the exact location of language function, some of which correlated with the patient's sex and verbal intelligence. These features were present for patients as young as 4 years and as old as 80 years, and for those with lesions acquired in early life or adulthood. These findings indicate a need for revision of the classical model of language localization. The combination of discrete localization in individual patients but substantial individual variability between patients also has major clinical implications for cortical resections of the dominant hemisphere, for it means that language cannot be reliably localized on anatomic criteria alone. A maximal resection with minimal risk of postoperative aphasia requires individual localization of language with a technique like stimulation mapping. PMID- 2769384 TI - Short-term psychological outcome of anterior temporal lobectomy. AB - The purpose of this investigation was to determine the short-term behavioral and emotional effects of anterior temporal lobectomy (ATL). Forty-one patients who underwent ATL were administered a standardized measure of emotional adjustment (Mental Health Inventory) on four occasions: preoperatively, and 1, 3, and 6 months postoperatively. Patients who were rendered totally seizure-free by ATL showed significant improvements on multiple indices of psychological distress and psychological well-being, improvement that continued up to 3 months after surgery and remained constant at 6 months postoperatively. Patients who were significantly improved (greater than 75% reduction in seizure frequency) but continued to experience some seizure activity showed no significant improvements in behavioral or emotional adjustment. The clinical and theoretical significance of these findings is discussed, and it is suggested that functional outcome (for instance, mental health) following ATL may be best predicted by a binary seizure outcome classification (seizure-free or not seizure-free). PMID- 2769385 TI - The prediction of recurrence in meningiomas. A flow cytometric study of paraffin embedded archival material. AB - Despite the complete macroscopic excision of meningiomas, there is a significant rate of recurrence approaching 20% at 20 years. The prediction of recurrence by clinical and histopathological means is inadequate. Flow cytometric analysis of deoxyribonucleic acid (DNA) in meningiomas has shown a correlation between a high proliferative index based on tumor cell-cycle stage (%S + %G2/M) and clinically aggressive behavior. Accordingly, the DNA analysis of meningioma tissue may be of value in predicting recurrence of these tumors. To test this hypothesis, the DNA of paraffin-embedded archival tissue from known recurrent meningiomas was compared with an age- and sex-matched nonrecurrent group. Both groups had comparable follow-up periods. Forty patients with total macroscopic removal at the time of surgery were analyzed. The paraffin blocks of these tumors were retrieved and reclassified histologically according to the World Health Organization system. Sections were then taken for flow cytometric study. The DNA analysis showed that the proliferative index of the recurrent group was significantly higher than that of the nonrecurrent group (p less than 0.002), although the histological subtyping of the two groups was similar. These results support the suggestion that flow cytometry may be of value in the prediction of recurrence of histologically benign, macroscopically removed meningiomas. PMID- 2769386 TI - Complex dural arteriovenous fistulas. Results of combined endovascular and neurosurgical treatment in 16 patients. AB - Of the 88 patients evaluated for symptomatic dural arteriovenous (AV) fistula over the past 8 years, 16 had large or complicated lesions that could not be treated with standard transvascular approaches or in which such treatment had been unsuccessful. Eleven fistulas were located in the transverse sinus, two in the cavernous sinus, two in the straight sinus, and one in the falx-tentorial region near the vein of Galen. The patients were treated with a combination of endovascular and neurosurgical techniques. Fourteen patients underwent preoperative transarterial embolization; this procedure closed the fistula in one patient. In the remaining 15 patients, surgery was performed to provide access to the fistula for embolization from either the venous or the arterial side, or for excision of the fistula. Transvenous embolization completely obliterated the fistula in seven of nine patients; the fistulas were embolized incompletely through the feeding arteries in two patients; and complete surgical resection of the lesion was accomplished in four patients. Complications related to venous occlusion occurred in two patients and one patient suffered communicating hydrocephalus that was effectively treated by shunting. There were no deaths. The results suggest that combined endovascular and neurosurgical techniques are a safe and effective means for the treatment of selected complex dural AV fistulas. PMID- 2769387 TI - Evaluation of microvascular decompression and partial sensory rhizotomy in 252 cases of trigeminal neuralgia. AB - Outcome after 252 posterior fossa explorations for the treatment of trigeminal neuralgia was determined by a retrospective review. Patients with distortion of the fifth nerve root caused by extrinsic vascular compression underwent microvascular decompression, those with no compression underwent partial sensory rhizotomy, and those with vascular contact but no distortion of the nerve root underwent decompression and rhizotomy. The mean follow-up period was 5.1 years. An excellent (75%) or good (8%) clinical outcome was achieved in 208 patients; 13 patients (5%) experienced little or no pain relief. Thirty-one patients (12%) suffered recurrent trigeminal neuralgia an average of 1.9 pain-free years after operation; recurrence continued at a rate of approximately 2% per year thereafter. Reoperation for recurrent or persistent pain provided excellent or good results in 85% of reoperated patients, but partial sensory rhizotomy was required in most of these patients. Outcome was affected by previous surgical procedures. A previous percutaneous radiofrequency lesion was associated with a significantly greater incidence of fifth nerve complications and a worse outcome after posterior fossa exploration. Because of this finding, the authors recommend that percutaneous radiofrequency rhizolysis be reserved for patients who have failed posterior fossa exploration or who are not candidates for surgery. Patients with compressive nerve root distortion and a short duration of symptoms before surgery had a significantly better outcome than patients with a longer duration of symptoms. In contrast, there was no relationship between the duration of symptoms and outcome of patients without nerve root distortion. Vascular decompression may cause dysfunction of the trigeminal system in tic douloureux, but in patients who remain untreated for long periods an intrinsic abnormality develops that may perpetuate pain even after microvascular decompression. Posterior fossa exploration is recommended as the procedure of choice for patients with trigeminal neuralgia who are surgical candidates. PMID- 2769388 TI - Parapontine trigeminal cryptic angiomas presenting as trigeminal neuralgia. AB - Posterior fossa microvascular decompression surgery was attempted in 1257 patients with trigeminal neuralgia (TN), of whom seven had a very unusual cryptic angioma. The lesions were not visualized on preoperative enhanced computerized tomography scans, and serial angiography demonstrated a small vascular stain in only one case. The character of the facial pain was indistinguishable from TN caused by vascular compression and there was no other specific symptomatology. The patients' age and sex distributions were also compatible with classical TN. Cryptic angiomas presenting as typical TN without other symptoms have not been reported before, but they should be kept in mind in the differential diagnosis and surgical management of TN. PMID- 2769389 TI - Subtorcular occipital encephaloceles. Anatomical considerations relevant to operative management. AB - Three cases of occipital encephalocele, one with associated myelomeningocele, are presented. All received preoperative evaluation with magnetic resonance imaging. Such studies provide optimal demonstration of the cerebral and hindbrain anatomy to guide operative treatment and formulate prognosis. Review of available radiographic, operative, and pathological information suggests that most, if not all, occipital encephaloceles are associated with an anomaly of the hindbrain, and the usual anomaly is a rhombic roof encephalocele. In such cases, the site of cranial herniation is caudal to the torcula, regardless of the presence or absence of occipital lobe tissue within the sac. Experimental and clinical analysis suggests that occipital encephaloceles most likely arise from abnormalities in the development of the skull base. PMID- 2769390 TI - Liposomes coupled with monoclonal antibodies against glioma-associated antigen for targeting chemotherapy of glioma. AB - Liposomes have a variety of attributes as a drug delivery system. Targeting of liposomes to specific cells has been investigated by using appropriate cytophilic ligands such as monoclonal antibodies (MAb's). In the present study, liposomes with selective cytotoxicity toward glioma cells were obtained. An MAb which reacts with a glioma-associated antigen, G-22-MAb, was coupled with liposomes by the cross-linking reagent dipalmitoyl L-alpha-phosphatidylethanolamine 3-(2 pyridyldithio)propionate. Interaction of the liposomes with glioma cells was morphologically observed by fluorescence microscopy, and uptake of liposomal contents into glioma cells was analyzed by flow cytometry using carboxyfluorescein as a marker. It was demonstrated that G-22-MAb could be coupled with liposomes without altering its specificity toward glioma cells and that coupling with the MAb led to a significant increase in the uptake of liposomal contents into glioma cells. Liposomes containing an antitumor drug, methotrexate (MTX), were prepared and their cytotoxicity was examined by a colorimetric growth assay. Upon incorporation of MTX into the MAb-coupled liposomes, the cytotoxicity toward glioma cells was increased 100-fold as compared with free MTX. These results indicate that G-22-MAb-coupled liposomes containing MTX have selective cytotoxicity toward glioma cells and could be utilized for targeting the chemotherapy of gliomas. PMID- 2769391 TI - Heterogeneity and modulation of tumor-associated antigens in human glioblastoma cell lines. AB - Seven human glioblastoma cell lines established in vitro from primary tumor explants were studied. A marked heterogeneity of glial fibrillary acidic protein was observed whereas vimentin was uniformly expressed by all cell lines. Indirect immunofluorescence and flow cytofluorometry revealed a heterogeneous distribution of surface GE 2 and CG 12 tumor-associated antigens (TAA's): three cell lines were positive (greater than 69% TAA-positive cells) and three cell lines were negative (less than 9% TAA-positive cells). One cell line (Hu 228) was moderately positive at early culture passages and subsequently acquired a TAA-negative phenotype. The difference in the relative amounts of surface TAA's of the three positive cell lines was less than twofold. In spite of the heterogeneous distribution of surface TAA's, all cell lines exhibited considerable amounts of intracellular TAA. Treatment with phorbol esters and density-dependent growth arrest decreased the percentage of the TAA-positive cells and the amount of cell surface TAA's in one cell line (Hu 195). Interferon-gamma treatment in vitro increased the percentage of CG 12-positive cells by 12% and the amount of cell surface CG 12 antigens by 38% as compared to untreated cells. The percentage of TAA-positive cells among phorbol ester-treated cells of the Hu 195 cell line was lowest 48 hours after treatment, but returned to normal values within the next 48 hours. Reduction of 3H-thymidine incorporation preceded the decrease in number of TAA-positive cells by about 18 hours. Two-color fluorescence analysis performed in positive cell lines for simultaneous determination of surface TAA's and deoxyribonucleic acid content or reactivity with the proliferation-associated Ki67 intracellular marker indicated that GE 2 and CG 12 antigens are expressed preferentially by actively proliferating glioma cells. The results of this study indicate the existence of two different phenotypes in cultured human glioblastoma cells: surface TAA-positive/cytosol TAA-positive and surface TAA-negative/cytosol TAA-positive cell populations. In addition, modulation of TAA expression was dependent on the cell-cycle differentiation stage, culture conditions, and proliferative state of the cells. PMID- 2769392 TI - Lipid peroxidation in focal cerebral ischemia. AB - To verify whether lipid peroxidation is associated with focal cerebral ischemia, a unilateral middle cerebral artery occlusion was carried out in rats. The concentrations of various endogenous antioxidants in the ischemic center were measured, including alpha-tocopherol and ubiquinones as lipid-soluble antioxidants and ascorbate as a water-soluble antioxidant. At 30 minutes after ischemia, alpha-tocopherol decreased to 79% of baseline, reduced ubiquinone-9 to 73%, ubiquinone-10 to 66%, and reduced ascorbate to 76%. Six hours after ischemia, alpha-tocopherol decreased to 63% and reached a plateau, whereas reduced ubiquinones and reduced ascorbate declined further to 16% and 10%, respectively, 12 hours after ischemia and then reached plateau levels. These results suggest functional and durational differences between antioxidants and lipid peroxidation in this ischemic model. Although the reciprocal increase in oxidized ubiquinones during ischemia was not observed, that of oxidized ascorbate was noted. The complementary antioxidant system between cytoplasmic and membranous components, the combination alpha-tocopherol/ascorbate, was estimated from the calculated consumption ratio of these antioxidants on the basis that the loss of these reduced antioxidants is due to neutralization of free radicals. This system is suggested to play an important role in the early ischemic period. Urate also increased during ischemia. The possible involvement of the xanthine xanthine oxidase system in initiating free radical reactions in cerebral ischemia is also discussed. PMID- 2769393 TI - Alterations of mechanical properties in canine basilar arteries after subarachnoid hemorrhage. AB - The purpose of this study was to examine the hypotheses that structural stiffening of the arterial wall contributes to chronic cerebral vasospasm, and that alteration in properties of smooth muscle takes place after subarachnoid hemorrhage (SAH). Subarachnoid hemorrhage and subsequent chronic vasospasm were induced in dogs by two cisternal injections of autologous blood (on Day 0 and Day 2). Vasospasm was confirmed by angiography performed on Day 0 and Day 7. Animals in the control group underwent angiography only. On Day 8, the mechanical properties of the basilar arteries were studied in vitro. Passive compliance, measured under total inhibition of spontaneous myogenic tone with diltiazem (10( 4) M) plus papaverine (10(-4) M) was smaller in the SAH group. The length contraction curve was shifted to the left and the optimum length for maximum contraction (Lmax) was significantly shorter in the spastic blood vessels. The spontaneous myogenic tone was augmented in the SAH group, resulting in an increase in resting tension at each length. By contrast, the maximum contractions in response to KCl and uridine 5'-triphosphate were markedly reduced in the SAH group, without changes in sensitivity to these agents. These differences in mechanical properties were observed in rings both with and without endothelium. The results indicate that, in chronic vasospasm, stiffening of the noncontractile component of the vasculature takes place as well as alterations in the contractile component, both of which presumably contribute to the shift in resting length-tension relationship and length-contraction relationship of the artery. The decreased distensibility, the increase in resting tension, and the shortening of the Lmax all favor a smaller diameter of the artery after SAH, possibly contributing to vasospasm. PMID- 2769394 TI - Brain kininogen following experimental brain injury: evidence for a secondary event. AB - Previous studies have shown that following experimental brain injury cerebral arterioles dilate and display endothelial lesions and reduced responsiveness to hypocapnia. These abnormalities are caused by cyclo-oxygenase-dependent free radical generation. There is evidence that the kallikrein-kinin system may in part stimulate the cyclooxygenase-dependent damage since bradykinin is a powerful stimulator of prostaglandin formation and it has recently been shown that a specific kinin receptor blocker decreases the arteriolar abnormalities caused by injury. In order to further examine the hypothesis that the kallikrein-kinin system is important in inducing damage, rat brain tissue was examined for kininogen, the precursor of kinins, at 10 minutes and 1, 3, 6, 15, 24, 48, and 72 hours after injury. A fluid-percussion brain injury device was attached over the right cerebral cortex of rats and a 1.6-atmosphere pressure injury was administered. The kininogen content was determined by a radioimmunoassay procedure in tissues which were free of intravascular blood. After injury, bleeding was confined mainly to the right hemisphere. The kininogen content in the right hemisphere was significantly elevated by one hour after injury, continued to rise until 15 hours after injury, then was significantly decreased by 2 days after injury. In the left hemisphere, kininogen was significantly elevated at 1 hour postinjury, returned toward control levels over the 3- to 6 hour period after injury, then was again elevated at 15 hours after injury. These studies also show that brain water and cerebrovascular permeability were greater at 15 hours postinjury than at earlier time points. The data further support a role for the kallikrein-kinin system in brain injury and, when considered with the results of other studies, suggest that a secondary event is occurring in the 12- to 24-hour period after neural injury. The authors hypothesize that this secondary event is related to endothelial and vascular repair and may be important for the return of normal cerebrovascular function. PMID- 2769395 TI - Malignant pseudotumor cerebri. Report of two cases. AB - Two young Arab women presented with a very rapid loss of vision, ophthalmoplegia, florid papilledema, areflexia of the lower limbs, and normal mentation. Lumbar puncture pressure was above 60 cm H2O, but no intracranial structural lesion was found in either patient. An exhaustive evaluation as to an etiology was negative in both. Under continuous lumbar cerebrospinal fluid drainage and administration of steroids, furosemide, and acetazolamide, both patients had significantly improved vision and ocular movement. In both, lumboperitoneal shunting was considered but only one eventually underwent this procedure. These two patients with pseudotumor cerebri are unique in their fulminant clinical course and severely increased intracranial pressure. Virtually inevitable blindness was prevented by timely intervention. PMID- 2769396 TI - Paraplegia caused by brown tumor in primary hyperparathyroidism. Case report. AB - A brown tumor is a secondary disorder of bone associated with hyperparathyroidism that arises predominantly in the metacarpals, phalanges, jaw, pelvis, or femur. Rarely does this tumor involve the spine. The authors describe a case of brown tumor in primary hyperparathyroidism, causing spinal cord compression. The first step in diagnosing this lesion in an unusual site is a high index of suspicion. Essentially, this tumor is benign but emergency surgery for tumor removal is recommended in patients showing acute spinal cord compression. PMID- 2769397 TI - Lazarus sign and extensor posturing in a brain-dead patient. Case report. AB - A man was declared brain dead after having sustained a gunshot wound to the head. All clinical criteria for the diagnosis of brain death were met. The electroencephalogram was isoelectric, and four-vessel angiography demonstrated the absence of cerebral blood flow. However, stereotypic spontaneous movements were observed which persisted for several hours. The possible mechanism is discussed and a short review of the literature is given. PMID- 2769398 TI - Preparation of adrenal medullary tissue for transplantation in Parkinson's disease: a new procedure. Technical note. AB - The authors describe a technique by which adrenal medullary tissue can be easily dissected from the adrenal cortex. The method involves perfusion with Locke's modified buffer, dissection of adrenal gland in buffer free of calcium or magnesium, and storage in a culture medium before implantation into the caudate nucleus of patients with Parkinson's disease. This method seems to increase the viability and purity of adrenal medullary tissue. The results obtained in 15 parkinsonian patients implanted with perfused adrenal medulla indicate the potential value of this technique. PMID- 2769399 TI - Views on microvascular compression. PMID- 2769400 TI - EC-IC bypass in hemodynamic cerebrovascular disease. PMID- 2769401 TI - Med-waste regulations pose backdoor threat to nuclear medicine. PMID- 2769402 TI - EPA's proposed radionuclide emission standards stir up opposition. PMID- 2769403 TI - Alterations of iodine-131 MIBG biodistribution in an anephric patient: comparison to normal and impaired renal function. AB - Iodine-131 metaiodobenzylguanidine (MIBG) is an effective agent for the scintigraphic portrayal of pheochromocytomas of all types. Iodine-131 MIBG is a relatively stable radiopharmaceutical that is primarily excreted in the urine. Therefore, impaired renal function would be expected to alter [131I]MIBG pharmacokinetics which would thus affect blood levels, as well as scintigraphy. An 18-yr-old anephric male presented with hypertension and suspected pheochromocytoma. We have compared the [131I]MIBG scintigraphy and blood clearance kinetics in this anephric patient, two patients with renal insufficiency and four patients with normal renal function. The degree of renal insufficiency was directly correlated to the CPM/image (an index of whole-body retention) on all 3 days of imaging and the slower clearance of radioactivity from the blood. The relative distribution of radioactivity between the plasma and cell fractions was greatest in the patients with renal insufficiency. We therefore suggest that attention be paid to plasma creatinine levels prior to the administration of [131I] MIBG to permit accurate interpretation of scintigraphy. In addition, the effect of renal insufficiency on radiation dosimetry should be considered. It may thus be prudent to reduce the administered dose of [131I]MIBG given to anephric or renally insufficient patients to decrease radiation dose. PMID- 2769404 TI - Tracer kinetic modeling approaches for the quantification of hepatic function with technetium-99m DISIDA and scintigraphy. AB - Serial scintigraphic images following injection of [99mTc]iminodiacetic acid compounds such as [99mTc]diisopropyl-iminodiacetic acid (DISIDA) provide qualitative information about liver function. We have investigated approaches for quantitatively describing liver function in terms of the kinetics of DISIDA extraction and excretion by the liver. Several compartmental model configurations were evaluated. A three-compartment model (blood, hepatic parenchyma, intrahepatic bile) was found to fit the data best and was used in conjunction with dynamic image data to obtain estimates of rate constants for liver extraction and excretion of DISIDA, and mean residence time (MRT) of DISIDA in the liver. A noncompartmental approach based on a parametric deconvolution technique was also used to estimate the noncompartmental mean residence time (MRTnc). To assess limitations of the noncompartmental approach, computer simulations were performed using the three-compartment model to generate time activity curves followed by analysis of these curves by the noncompartmental method. The effect of plasma total bilirubin level on DISIDA uptake and MRT was also investigated. These techniques are readily adaptable to standard nuclear medicine computing facilities, and could be used in the clinical setting to numerically describe serial DISIDA studies (especially in liver transplant patients) efficiently and noninvasively. PMID- 2769405 TI - Is lung sequestration of indium-111-labeled granulocytes organ specific? AB - Transient sequestration of polymorphonuclear leukocytes (PMN) in the normal lungs of animals occurred immediately following intravenous injection of 111In-labeled PMN. We investigated the organ specificity of this process. Equal amounts of homologous PMN, derived from the intravascular space and labeled with [111In]oxine, were infused either intravenously (i.v.) or intraarterially (i.a.) into pairs of rats. Changes in radioactivity emitted from three regions- representing lung, liver and spleen, and lower body--were determined from images during the following hour. A nonspecific character was demonstrated by the transient sequestration of activity in the lower body following i.a. infusions. However, the rate of initial clearance of activity (first 30 min) from the lungs of i.v.-infused rats was relatively slower than from the lower body of i.a. infused rats. This suggests the presence of a lung-specific as well, which may be important for localization of PMN-related events to the lung. PMID- 2769406 TI - Splenic dynamics of indium-111 labeled platelets in idiopathic thrombocytopenic purpura. AB - Splenic dynamics of 111In-labeled platelets and platelet-associated IgG in 33 patients with idiopathic thrombocytopenic purpura (ITP) were studied. Two half lives were calculated for the biexponential splenic time-activity curve after i.v. injection of 111In-labeled platelets. There was no difference in the mean half-life of the rapid component of the splenic curve (ST1) when patients with negative or slightly positive platelet suspension immunofluorescence test (PSIFT) were compared to those with strongly positive PSIFT (3.0 +/- 0.7 min vs. 3.6 +/- 0.4, p greater than 0.05). Mean half-life of the slow component of the splenic curve (ST2) was found to be longer in patients with a strongly positive than a negative or weakly positive PSIFT (26 +/- 5 min vs. 13.2 +/- 1.0 min, p less than 0.01). It seems that determination of the two components of the splenic time activity curve provides a useful method for studying platelet kinetics in ITP. PMID- 2769407 TI - A rapid method for estimating mean platelet survival time. AB - Platelet survival studies were performed in 27 consecutive subjects, and mean platelet life span was derived by computerized calculations of radioactivity in blood samples obtained daily for 9-11 days. These computer derived estimates were then correlated with the raw whole blood radioactivity data obtained for the first 3 days of each study. Data from the 48-hr point correlates with the computer estimates so that platelet survival data can now be reported in 2 days with 93% precision of the long method and without visual curve fitting. Thus, one may take a "quick look" at the probable platelet lifespan, under steady state conditions, in order to evaluate therapy while avoiding problems of patient compliance. PMID- 2769408 TI - Evaluation of a clinical scintillation camera with pulse tail extrapolation electronics. AB - The performance of a new scintillation camera, designed for high event rate capability, was evaluated. The system consisted of a 400 mm field-of-view Nal(T1) camera with 61 photomultiplier tubes and modified General Electric Starport electronics. A significant feature of the system was circuitry for performing pulse tail extrapolation and separation of individual pulses involved in pulse pile-up events. System deadtime, flood field uniformity, energy resolution, linearity, spatial resolution, and bar phantom image quality were evaluated for count rates up to 200 kcps in a 20% photopeak window. Our results indicate that this camera design does not compromise image quality at normal clinical count rates and at higher event rates can provide better image quality and increased sensitivity over many Anger cameras currently employed in nuclear medicine. PMID- 2769409 TI - Phantom feet on digital radionuclide images and other scary computer tales. AB - Malfunction of a computer-assisted digital gamma camera is reported. Despite what appeared to be adequate acceptance testing, an error in the system gave rise to switching of images and identification text. A suggestion is made for using a hot marker, which would avoid the potential error of misinterpretation of patient images. PMID- 2769410 TI - Long-lived radioactive contaminant of a krypton-81m gas generator. PMID- 2769411 TI - On the accumulation in liver of 111In following administration of the B72.3 antibody. PMID- 2769412 TI - Effects of mentoring on job satisfaction, leadership behaviors, and job retention of new graduate nurses. AB - Findings from a study on the effects of using mentors to help new graduate nurses adjust to professional nursing revealed improved job satisfaction and increased leadership behaviors. The use of mentors over longer periods to help new nurses make the transition from school to nursing practice is a successful orientation strategy receiving increased attention by nursing staff educators. PMID- 2769413 TI - Interventions for nursing practice problems. AB - This study examined the effect of designated interventions in nursing practice problems on levels of burnout in nurses. A battery of tests measuring burnout, self-esteem, depression, personal accomplishment, depersonalization, and emotional exhaustion were given to nurses in experimental and control groups. Pre and post-test data were gathered for both groups. The treatment included a 2-day conference which was designed as a respite experience to address problems specific to the nursing profession. Results indicate significantly less burnout, less frequency of depersonalization, and significantly greater frequency of personal accomplishment in the scores of the experimental group relative to the control group. This study shows that specific interventions can be used to benefit the emotional well-being of nurses by providing them with a respite opportunity and the skills to manage key stressors in their professional environment. PMID- 2769414 TI - Collaborative application of the nursing process to staff development challenges. The professional nurse and patient education. AB - Greater patient acuity and decreased length of stay for episodic care in hospitals increase the complexity of integrating patient education responsibilities into professional nursing practice. This article describes a problem-solving approach paralleling the nursing process developed through a regional, collaborative, experimental, action research approach. The process tool developed through this year-long activity can be applied to a variety of staff development challenges. PMID- 2769415 TI - Improving management skills through staff development. AB - It is the responsibility of nurse educators to improve the management skills of nurses in their institutions. Professional retention and recruitment are enhanced when staff development programs offer information relevant to function in today's competitive marketplace. PMID- 2769416 TI - A patient care training program for volunteers. AB - Properly trained and interested volunteers can perform basic nursing skills in a clinical setting. Staff development educators should 1) assess the needs of the area; 2) assess the skills of the volunteers available to them; 3) construct goals and objectives for a thorough orientation program geared to people with nonmedical backgrounds; 4) select appropriate course content and methods of presentation based on the framework provided by the goals and objectives and on the regulations governing the institution in which the volunteer will work; 5) implement the course; and 6) evaluate the adequacy and thoroughness of the program and the competency of the volunteers trained. The potential service that qualified and adequately trained volunteers could offer in patient care areas that are understaffed in nursing personnel is great. Similar programs can be used to supply needed assistance in facilities with limited nursing personnel. PMID- 2769417 TI - Nursing preceptors--looking back--looking ahead. AB - With existing staffing shortages, it is time to rethink positions on important issues affecting nursing practice. One of these issues is the use of preceptors for orientation needs. Nurse educators need to decide if preceptor programs, complete with a well-defined selection, preparation, and reward process are in place. PMID- 2769418 TI - Computer competencies identified for nursing staff development educators. AB - As part of a national study, eleven staff development/inservice educators identified, critiqued, and ranked present and future (1990) computer competencies needed by nurse educators teaching in basic and continuing education. Now, nursing staff development/inservice educators can compare their present level of knowledge of the technology to the important competencies ranked by their peers. Based on this assessment, continuing education strategies can be designed so the educator can be a responsive decision-maker regarding computer technology in the information-based health care delivery system. PMID- 2769419 TI - Socialization of inactive non-employed nurses returning to the professional nursing role. AB - Several conclusions were reached as a result of a study of nurses who had enrolled in an RN refresher course between 1981 and 1987. 1. An RN refresher course with both a theory and clinical component is a viable means for preparing registered nurses to return to work. 2. Seventy-one percent of those responding to a mailed questionnaire had returned to active employment, with the majority seeking work in a hospital setting. 3. Forty-seven percent were interested in continuing their education through seminars, workshops, and in-service programs. Of this 47%, 21% expressed interest in obtaining a baccalaureate degree. Although some of the positive results appear intangible, respondents identified a real sense of peer relations, mutual support, lasting friendships, as well as feelings of enhanced self-esteem. And, they experienced an enhanced personal role within the family. Inactive nurses are capable of assuming roles and responsibilities of adult learners and professional caregivers. PMID- 2769420 TI - Training staff to work effectively with the mentally impaired in a geriatric facility. PMID- 2769421 TI - Perspectives on research. Power in numbers. PMID- 2769422 TI - Impaired nurses: a cost analysis. AB - Although the literature reflects a continuing concern about impaired practice and its associated costs, no attempt has yet been made to examine those costs in a comprehensive manner. This analysis was undertaken to determine the specific economic impact of impaired nursing practice on the employing agency, the individual nurse, and the state regulatory body. It will provide valuable data for policy development and for planning cost-effective approaches to early recognition and intervention. PMID- 2769423 TI - Redesigning hospital nursing practice: the Professionally Advanced Care Team (ProACT) model, Part 2. AB - The pressures of the current nursing shortage have created an unparalleled opportunity to restructure hospital nursing practice and care delivery. The potential exists to create new systems which simultaneously advance the goals of the profession and solve the problems of the shortage. Part 1 of this article (JONA, July/August, 1989) examined the similarities and differences among existing models and described the Robert Wood Johnson University Hospital ProACT model. Part 2 outlines the process of developing and implementing ProACT, an alternative nursing practice and care delivery model. PMID- 2769424 TI - Nurses, nuances, and non-communication: a humorous look at language. PMID- 2769425 TI - The emotional and behavioral process of staff nurse turnover. AB - Nurses who leave their jobs proceed through stages of disengagement, some of which are quite intense. Yet 88% of the nurses in this study say that an appropriate managerial intervention early in their leave-taking decision process would have halted their decision to leave. The authors describe stages of nurses' leave-taking decisions, their experiences, and their behaviors. PMID- 2769426 TI - The quality management maturity grid: a diagnostic method. AB - "Quality is free. It's not a gift, but it is free. What costs money are the unquality things--all the actions that involve not doing the job right the first time." Nurse executives can benefit from the challenge of this statement, the basis of Philip Crosby's Quality Management Maturity Grid. The authors discuss the Grid, used successfully in business as a diagnostic tool to assess organizational quality management, and its use in the health care setting. PMID- 2769427 TI - Take time to touch. PMID- 2769428 TI - Mentor program for high school students. AB - As the nation grapples with the latest shortage of registered professional nurses, a creative solution, with an eye toward nursing in the 21st century, is the Mentor Program in Nursing for high school students at The Mount Sinai Medical Center in New York City. The registered professional nurses on staff at the medical center have made a commitment to this program as a way of encouraging a continuous supply of future nurses. PMID- 2769429 TI - Ownership imbalance. PMID- 2769430 TI - A design for recruitment and feedback. PMID- 2769431 TI - A multiple-strategy based research program for staff nurse involvement. PMID- 2769432 TI - The business of nursing: management traps. PMID- 2769433 TI - The adrenal medulla and paraganglia. PMID- 2769434 TI - Ultrastructural demonstration of exocytosis in the intact rat adrenal medulla. AB - Evidence is presented for morphological proof of exocytosis in the rat adrenal medulla in situ. Techniques were modified to allow perfusion of the intact adrenal gland with secretagogues (or electrical stimulation) followed by tannic acid. Unstimulated specimens demonstrated exocytotic (omega-shaped) profiles filled with flocculent material. This flocculation was also seen in the intercellular space. Stimulation of the adrenal medulla also resulted in the appearance of exocytotic profiles and an accumulation of the flocculent mass. This was often most evident in the subendothelial space. This is the first demonstration of exocytosis in the rat adrenal medulla by electron microscopy. The techniques used in this study will be useful for studying the pathway of secretory products of the adrenal chromaffin cell before they enter the vascular system. PMID- 2769435 TI - Mitotic cell division in the extraadrenal chromaffin system of various species. AB - Mitotic activity often has been reported in embryonic and fetal sympathetic neuroblasts, principal sympathoblasts, and primitive sympathetic cells in various species at different stages of development. Postnatal adrenal medullary cells also are known to undergo mitosis, but such dividing capabilities rarely have been observed in the true postnatal extraadrenal chromaffin system. Although few in number, this work nevertheless has clearly identified such cells in varying stages of the mitotic cycle in the young dog, Syrian hamster, mouse, rabbit, and rat. The dividing cells were noted in paraaortic chromaffin organs, paraganglia, and within the inferior mesenteric ganglion as well. They displayed the morphological character usually associated with their adrenal medullary catecholaminergic counterparts, including numerous dense-cored vesicles known to be the harbingers of catecholamines and various peptides. Nerve endings were not noticed upon the mitotic cells. The phenomenon of dividing extraadrenal chromaffin cells augments existing data and perhaps suggests that these cells are more endocrine than neural in type and subservient to the adrenal medulla in its classic endocrine function. PMID- 2769436 TI - The cytoplasmic matrix of the adrenal chromaffin cells of rats under normal and stressed conditions. AB - In embedment-free electron microscopy with polyethylene glycol embedding and subsequent deembedding, the conventional cytoplasm of the chromaffin cells was revealed to consist of a three-dimensional lattice of microtrabeculae and gives the impression that the chromaffin granules are held in place by the lattice. After the restraint stress, a substantial number of chromaffin cells were almost free of granules, and the microtrabecular lattice was much more compact than that in cytoplasmic regions occupied with remaining granules or increased mitochondria. In immunocytochemistry, actin immunofluorescence was confined to the subplasmalemmal regions, while tubulin and tropomyosin immunofluorescence appeared throughout the entire cytoplasm of normal chromaffin cells. After the stress, the immunofluorescence for actin and tubulin increased in intensity, while that for tropomyosin decreased. Immunogold labelings for actin and tubulin were found mainly on the thinner subplasmalemmal microtrabeculae and the thicker perikaryal ones, respectively, while some were deposited in the form of small aggregates on portions of microtrabeculae. No specific association between the gold labelings for actin or tubulin and the chromaffin granules was found, even in the subplasmalemmal regions. A hypothetical interpretation was proposed in which a more compact lattice of the microtrabeculae in spatial association with a looser lattice represents a gelated state of the cytoplasm. The significance of the gel-sol transition of the cytoplasmic matrix in relation to the secretory mechanism was discussed. PMID- 2769437 TI - Electron microscopic localization of enkephalin-like immunoreactivity in the human adrenal medulla. AB - Enkephalin-like immunoreactivity in human adrenomedullary cells was studied at the light and electron microscopic levels. Enkephalin immunostaining was associated with chromaffin granules and, in a few cells, with the rough endoplasmic reticulum as well. The relative number of stained granules varied from cell to cell, and a correlation with a particular granular population was not noted. Both large and small granules were labelled. It is concluded that in the human the ability to store enkephalin immunoreactive peptides is a general property of chromaffin granules and, furthermore, is not correlated with specific granular subpopulations or the particular type of catecholamine stored within the cell. PMID- 2769439 TI - Method for obtaining thin sections for EM from different areas of the same block. PMID- 2769438 TI - Glucocorticoid-induced PNMT-immunoreactive sympathetic cells in the superior cervical ganglion of the rat. AB - Light and electron microscopic immunocytochemical techniques were used to study the effect of glucocorticoids on the development of phenylethanolamine-N methyltransferase (PNMT)-immunoreactive cells in the superior cervical ganglion (SCG) of early postnatal rats. Rats were injected daily with hydrocortisone acetate on postnatal days 2-6. The first PNMT-immunoreactive cells were detected 6 hours after the first glucocorticoid injection and their number increased after subsequent injections. No PNMT-immunoreactive cells were detected in uninjected controls. PNMT-immunoreactive fibres were seen in the ganglion 6 hours after the first glucocorticoid injection. The PNMT-immunoreactive cells consistently showed processes 2 days after beginning the glucocorticoid treatment, and long processes and fibre networks were seen in ganglia of 7-day-old rats. However, no PNMT immunoreactive fibres were seen in the iris, which is innervated by the SCG. Ultrastructurally, most of the PNMT-immunoreactive cells had the look of small granule-containing (SGC) cells, including heterochromatin clumps along the nuclear envelope and in the center of the nucleoplasm as well as dense core vesicles. SGC cells, nonimmunoreactive to PNMT antiserum, also were seen. However, some PNMT-immunoreactive cells showed ultrastructural characteristics of nerve cells. In contrast to the SGC cells, these cells were characterized by a voluminous cytoplasm, dispersed nuclear heterochromatin, and a lack of granular vesicles. These results demonstrate that glucocorticoids induce PNMT immunoreactivity both in SGC cells and also in cells with characteristics of principal neurons. PMID- 2769440 TI - Improved method for electron microscopy immunocytochemistry of muscle. PMID- 2769441 TI - Acupressure therapy for morning sickness. A controlled clinical trial. AB - A prospective, controlled clinical trial examined the efficacy of acupressure therapy for morning sickness, using a two group, random assignment, crossover design. Subjects in Group 1 (N = 8) used acupressure wristbands for five days, followed by five days without therapy. Subjects in Group 2 (N = 8) had no therapy for five days, followed by five days use of wristbands. The Multiple Affect Adjective Checklist and Sickness Impact Profile were used, and extent of nausea was assessed at baseline, day five, and day ten. Use of acupressure wristbands relieved morning sickness for 12 of 16 subjects (chi 2 = 5.31 with Yates' correction factor, df = 1, p less than .025). Acupressure therapy resulted in statistically significant (p less than .05) reductions in anxiety, depression, behavioral dysfunction, and nausea. Limitations of the study and suggestions for future research are presented. PMID- 2769442 TI - VBAC program in a nurse-midwifery service. Five years of experience. AB - Vaginal birth after cesarean (VBAC) is well documented by research studies to be safe and, in many cases, better for women with a previous cesarean birth than a repeat cesarean. The article describes one nurse-midwifery service's policies and procedures for helping women to prepare for and have a trial of labor. During the intrapartal period women with a uterine scar are managed similar to those without a scar except for closer monitoring, lab studies, and intravenous heparin lock. An obstetrician is always in the hospital and available for consultation. Of 53 women attempting VBAC, 83% had a vaginal birth. Those with a previous cesarean for failure to progress had the lowest vaginal birth after cesarean rate of 65%. Maternal and newborn morbidity was low. The authors conclude that nurse-midwifery management of vaginal birth after cesarean candidates is safe and very successful when appropriate physician consultation and hospital services are readily available. PMID- 2769443 TI - Outcomes of mature primiparas in an out-of-hospital birth center. AB - This is a retrospective chart review of perinatal outcomes of all primiparas over the age of 24 delivering at Maternity Center Associates, an out-of-hospital birth center, from January 1985 through May 1988 (N = 228). Chi-square analysis was used to determine whether mature primiparas, aged 35 to 43 (n = 27), had significantly more adverse outcomes than younger primiparas, aged 25 to 34 (n = 201). There was a significant difference between the groups in rate of transfer to hospital; however, there were no significant differences in rate of cesarean section, infant birth weight, apgar scores, and length of second stage labor. Implications for practice and future study are examined. PMID- 2769444 TI - Water birth: a European perspective. PMID- 2769445 TI - Incorporating water birth into nurse-midwifery practice. PMID- 2769446 TI - Recent innovations in childbirth. Dangerous proposals, harmless fads, or wave of the future? AB - In recent years, consumers have become increasingly involved in their own health care and increasingly assertive vis a vis the medical profession. Nowhere has this been more apparent than in the area of childbirth. A number of individuals both within and outside of the medical profession have advocated changes in traditional childbirth practices. This article focuses upon these proposed changes and discusses both the true issues and the pseudo-issues involved. Problems in existing research are described and the type of research that is needed is outlined. PMID- 2769447 TI - Innovations in Nurse-Midwifery Education. PMID- 2769448 TI - Lectin histochemistry in ulcerative colitis and Crohn's disease. AB - The glycoconjugate composition of intestinal goblet cell mucin was characterized according to the anatomical distribution of lectin-binding sites in surgically resected intestinal tissues and mucosal biopsy specimens obtained from 38 control subjects, and from 32 patients with the active phase of ulcerative colitis, and 12 with Crohn's disease. Immunoperoxidase labeling studies found that in control tissues binding by Soybean Agglutinin (SBA), Dolichos Biflorus Agglutinin (DBA), Wheatgerm Agglutinin (WGA), and Ricinus Communis Agglutinin-120 (RCA-120) was consistently higher than that of Peanut Agglutinin (PNA), Ulex Europaeus Agglutinin-1 (UEA-1), Concanavalin A (ConA) and Helix Pomatia Agglutinin (HPA). Tissues from ulcerative colitis and Crohn's disease patients, showed increases in DBA and SBA binding, a reduction in HPA binding, and changes in the distribution of PNA, UEA-1, RCA-120, and HPA labeling sites. These results demonstrated that the expression of lectin-binding sites on human intestinal goblet mucin was specifically altered in ulcerative colitis and Crohn's disease, thus possibly providing another approach to the assessment of neoplastic risk on these diseases. PMID- 2769449 TI - Visualization of vascular platelet aggregation by plastic embedding and light microscopy. AB - Previous studies have indicated that platelets play a role in inflammation and microvascular damage but routine histologic preparations do not permit clear visualization of the platelets in tissues. Plastic embedding was used in this study to demonstrate platelet aggregates in the pulmonary vasculature of mice exposed to complement activation. The degree of platelet aggregation in the excised lungs was graded semiquantitatively in a total of 75 mice. Control Balb/c mice had a mean aggregation score of 0.16 while mice which received 0.3 ml zymosan-activated plasma (ZAP) intravenously (iv) had a score of 2.2. Injection of 0.3 or 0.4 ml of ZAP to which epsilon-aminocaproic acid was added prior to incubation with zymosan resulted in a score of 2.6 or 4.7 respectively. Balb/c (C5 sufficient) and AKR/J (C5 deficient) mice injected iv with 1 mg zymosan had scores of 2.9 and 3.2, respectively. Cobra venom factor (CVF) injected iv to Balb/c mice induced a dose-dependent aggregation. Taken together, these results confirm that complement activation products can mediate intrapulmonary platelet aggregation and they also demonstrate the suitability of plastic embedding for visualization of intravascular platelet aggregates under light microscopy. PMID- 2769450 TI - Age related correlation between serum TSH and thyroid C cell hyperplasia in Long Evans rats. AB - The purpose of the present investigation was to determine whether there is a correlation between the serum levels of thyroid stimulating hormone (TSH), parafollicular cell (C) population in the thyroid and calcitonin (CT) secretion in aging Long-Evans (L-E) rats. Serum TSH and CT values were determined in 50 male rats at ages 2, 6, 12, 18 and 24 months and 50 female rats at 18, 21 and 24 months. The animals were sacrificed at the end of the experiment to evaluate thyroid C cell pathology. Male rats showed an increase in the serum TSH values at 6 and 12 months of age, a decline at 18 months and a significant increase from 18 to 24 months of age. In female rats, a significant increase in serum TSH concentration was also noted from 18 to 24 months of age. In both sexes, 24 month old animals with thyroid C cell hyperplasia (CH+ group) had a significantly higher level of serum TSH as compared to animals with normal distribution of C cells (CH- group). Concentration of serum CT showed a progressive increase with age in both sexes. Male rats with thyroid C cell pathology had significantly higher levels of serum CT at 24 months of age as compared to rats with normal C cell distribution. In female rats, however, serum CT concentrations in two groups were not statistically significant. We conclude from these studies that in aged L E rats, serum TSH concentration has an influence on thyroid C cell population. PMID- 2769451 TI - Matrix vesicles and calcification of rachitic rat osteoid. AB - Tibiae from rachitic weanling rats were studied during healing to examine the mechanism of bone mineralization. Rickets was induced by feeding the animals a low phosphate, low vitamin D diet for five weeks. Calcification was reinstituted in three ways; group I animals received 1.0 ml of NaH2PO4 i.p. and the rachitogenic diet in a darkened room; group II animals were placed in a lighted room and given standard laboratory chow; group III animals were placed in lighted room, given standard laboratory chow and received 1.0 ml of 0.1M NaH2PO4 i.p. Group I healed slowly while II and III were found to heal rapidly and at nearly identical rates. Groups II and III revealed a significantly elevated serum alkaline phosphatase activity and became hyperphosphatemic as the rickets healed suggesting a more vigorous recovery. Ultrastructurally, numerous matrix vesicles were noted in unhealed rachitic bone matrix and these structures acquired mineral upon initiation of healing. Vesicle-associated mineral aggregates increased in size penetrating through and beyond the vesicle membrane and were incorporated into the advancing mineralization front. By 48 hrs. post-healing initiation, the osteoid borders were almost completely mineralized in groups II and III. These observations suggest that in addition to pre-existing mineral, matrix vesicles can also serve as nucleating sites in the osteoid of post-fetal bone. PMID- 2769452 TI - Reye syndrome: rate of oxidation of fatty acids in leukocytes and serum levels of lipid peroxides. AB - We examined the oxidation of different chain length fatty acids in the leukocytes and the quantity of lipid peroxides in the plasma of two Reye syndrome patients. We have found that the oxidation of [1-14C] octanoic acid in homogenates of leukocytes from one of the Reye syndrome patients was only 38 percent of the control, whereas oxidation of [1-14C] palmitic and [1-14C] lignoceric acid was slightly increased. The level of lipid peroxides in the serum of both of the Reye Syndrome patients was 4.42 and 3.04 times higher than the control level. These results suggest that impaired oxidation of medium chain fatty acids (octanoic acid) and higher levels of lipid peroxides may contribute to the pathogenesis of cellular toxicity in Reye Syndrome. Reye Syndrome (RS) was first described by Reye et. al. in 1963 and is now recognized as an important cause of morbidity and mortality in infants and children. The clinical course in RS consists of an antecedent viral illness with subsequent encephalopathy and hepatic dysfunction. Laboratory findings in RS include hypoglycemia, hyperammonemia, free fatty acidemia, elevated organic acids and amino aciduria. The ultrastructural findings in RS patients include changes in mitochondria, smooth endoplasmic reticulum morphology, and an increase in the number of peroxisomes. The elevation of serum free fatty acids in RS and their decrease in patients who improve clinically suggests a disturbance in fatty acid metabolism. To understand the role of free fatty acids in the pathogenesis of RS, we examined the levels of lipid peroxides in plasma and catabolism of fatty acids of different chain lengths in leukocytes from RS patients. PMID- 2769454 TI - Cancer and coal tar epoxy resins. PMID- 2769453 TI - Potential role of Kupffer cells in initiating liver injury during endotoxemia. AB - The potential contribution of Kupffer cells (KCs) to endotoxin-induced liver damage was evaluated by measuring the functional changes of KGs [Superoxide (O2-) generation, and chemotaxis (CTx)] isolated from such livers and comparing them with biochemical and histological changes of liver damage. Sublethal doses of endotoxin was daily administered to rats for 4 days. Liver damage was apparent in the rats treated with single administration of endotoxin and the maximal change was observed in the rats treated with endotoxin for 2 days in association with the marked enhancement of O2- release and CTx in vitro by KCs from these animals. However, liver injury decreased in the rats treated with endotoxin for 3 days and the rats treated with endotoxin for 4 days had shown almost no detectable injury. KCs' biological functions also diminished in group treated for 3 and 4 days. In particular, oxidative and chemotactic responses of KCs from rats treated for 4 days significantly decreased, compared with the cells from those treated for only two days. These results indicate that KCs are pivotal in the pathogenesis of liver injury during endotoxemia. PMID- 2769455 TI - Interpretation and communication of the results of medical field investigations. AB - Since the controversy over cytogenetic test results at the Love Canal in New York State, there has been increasing concern about the communication of medical test results to participants in field studies. To identify the range of issues that arise and to present examples of practices that might be useful for consideration, we have drawn from 15 years of experience in interpreting and communicating the results of medical field investigations by the National Institute for Occupational Safety and Health. The investigations were qualitatively characterized according to study type and design, substances involved, language used in the notification of results, and the nature of the efforts to put results in perspective. Based on this evaluation, the following recommendations are made: (1) provide a comprehensible consent form, (2) interpret results for study participants, (3) use clear language, (4) be explicit about uncertainty of findings, (5) where appropriate, indicate the need for medical follow-up, (6) provide results promptly, (7) provide overall study results, (8) evaluate the impact of the notification, (9) train investigators in the practice of communicating results. PMID- 2769456 TI - Risk factors in the psychosocial work environment for neck and shoulder pain in secretaries. AB - The relationship between psychologic work variables and reported neck and shoulder pain was examined among secretaries. A battery of questionnaires concerning the experienced psychologic work environment as well as musculoskeletal pain symptoms was completed by 420 secretaries at a large medical center. A relatively "poor" psychologic work environment was compared with an environment that was experienced as "good." A "poorly" experienced psychologic work environment was related to a higher frequency of neck and shoulder pain. The relative risk for frequent neck pain was 2.85 (95% confidence interval 1.28 to 6.32) and for frequent shoulder pain 3.32 (95% confidence interval 1.53 to 7.23). Furthermore, the subindexes of work content and social support at work were found to be related to pain, whereas no clear relationship was found for work demands. The results of this study demonstrate the possible importance of the psychologic work environment in the development of musculoskeletal pain disorders. Future investigations should replicate these findings as well as isolate specific mechanisms so that preventive measures may be instituted. PMID- 2769458 TI - Paternal military service in Vietnam and risk of spontaneous abortion. AB - To investigate the relationship between paternal military service in Vietnam and the risk of spontaneous abortion, we compared the military service history among husbands of 201 women having a spontaneous abortion through 27 weeks' gestation with that of women having full-term live-born infants at Boston Hospital for Women from July 1976 until February 1978. Paternal military veterans were identified by cross-matching identifying information from obstetric records with state and national military records. Compared with men with no known military service, the adjusted relative odds of spontaneous abortion through 27 weeks' gestation was 0.88 for the wives of Vietnam veterans (95% confidence interval, 0.42 to 1.86) and 0.74 (95% confidence interval, 0.46 to 1.17) for wives of non Vietnam veterans. These data suggest that the risk of spontaneous abortion was not increased in this population of married US Vietnam veterans. PMID- 2769457 TI - Mortality patterns among workers exposed to acrylamide. AB - A cohort of 8854 men, 2293 of whom were exposed to acrylamide, was examined from 1925 to 1983 for mortality. This cohort consisted of four plant populations in two countries: the United States and The Netherlands. No statistically significant excess of all-cause or cause-specific mortality was found among acrylamide workers. Analysis by acrylamide exposure levels showed no trend of increased risk of mortality from several cancer sites. These results do not support the hypothesis that acrylamide is a human carcinogen. PMID- 2769459 TI - Occupational allergic rhinitis reaction to psyllium. AB - We report studies that document a specific rhinitic reaction that developed as a result of occupational exposure to a psyllium-based powdered laxative. This nurse had a nonatopic family history, personal evidence of atopy (skin test reactions to pollen, cat dander, and house dust), and a significant elevation of antipsyllium IgE. Measurements of nasal and lower airway resistance documented only nasal obstruction to brief inhalational challenge to the laxative. Symptomatic relief was achieved with prior treatment with cromolyn. We suggest that nasal airway challenge can document and assess treatment for occupational rhinitis. PMID- 2769461 TI - Career options of occupational physicians. PMID- 2769460 TI - Patterns of mortality in pulp and paper workers. AB - A proportionate mortality ratio (PMR) analysis utilizing death certificates and work histories was performed on 201 white male decedents who had been employed in pulp and paper production plants and had died between 1970 and 1984. PMRs for all malignant neoplasms (PMR = 131) and lung cancer (PMR = 151) were significantly elevated, whereas PMRs for lymphopoietic system cancer (PMR = 190) and cancer of the large intestine (PMR = 147) showed nonsignificant excesses. Most of the excess cancers of the lung and large intestine were limited to those with greater than 30 years between initial employment in a pulp and paper plant and death. Excess lung and lymphopoietic system cancers have been found in other studies of paperworker mortality, although this study failed to support previous findings of excess stomach cancer. These results continue to raise concerns that paperworkers are at elevated risk for some occupational cancers. PMID- 2769462 TI - Black spectral responsivity. AB - Six subjects induced blackness within a circular broadband field by increasing the radiance of a surrounding monochromomatic annulus, which varied in wavelength. Between the central field and the annulus was a thin dark ring. Half of the subjects were instructed to increase the radiance of the annulus until the central field just turned black, and the other half were instructed to increase the radiance of the annulus until the contour between the central field and the dark ring disappeared. Spectral luminous efficiency functions measured by the methods of heterochromatic flicker photometry (HFP) and brightness matching (HBM) were determined for each subject and compared with the subject's blackness induction functions. The hypothesis that the contour-disappearance instruction would yield blackness-induction curves best fitted by flicker photometric functions and that the absolute-blackness instruction would yield blackness induction curves best fitted by HBM functions was not confirmed. There was only one subject for whom the spectral efficiency of blackness was represented better by HFP than by HBM. There was one subject for whom blackness spectral efficiency was fitted better by HBM than by HFP. For the remaining four subjects, there was no difference in fits. PMID- 2769463 TI - O death, where is thy dignity? PMID- 2769464 TI - Town vs gown. PMID- 2769465 TI - 5-Fluorouracil-induced angina. AB - 5-Fluorouracil-induced cardiac ischemia is rare and poorly understood. We present the second known case of catheterization data and provide new information regarding possible mechanisms. PMID- 2769466 TI - Survival data on breast cancer patients accepted for radiotherapy, 1966-1977. AB - The survival data presented here include the stage of breast cancer, location of the primary cancer in the breast, type of surgery, and dose and location of radiotherapy. PMID- 2769467 TI - The prevalence and risk of diabetic retinopathy among Indians of southwest Oklahoma. AB - The overall prevalence of diabetic retinopathy was 49.3% among 142 diabetic Indians examined at the Indian Health Service at Clinton, Oklahoma. Univariate analysis suggested a positive relationship between duration of diabetes and prevalence of retinopathy. This Indian diabetic population should be examined yearly for diabetic retinopathy. PMID- 2769468 TI - Evaluation and use of advanced i.v. technology. Part 1: Central venous access devices. PMID- 2769469 TI - Lake Region Hospital: case study in rural hospital intravenous therapy updating. AB - Rural hospitals, like large metropolitan hospitals, are constantly facing the challenge of updating and revising their patient care policies and procedures. Using information and guidelines formulated by professional nursing societies, rural hospitals keep pace with fast changing technological advances. During the past year-and-a-half, Lake Region Hospital (LRH) has worked hard to improve its I.V. policies and procedures. The guidance available through the Intravenous Nursing Society (INS) and the INS Network System has been central to these improvements. These changes were instituted by the I.V. resource nurse at LRH in collaboration with a multidisciplinary team. This paper describes these changes in a nursing process format. PMID- 2769470 TI - Standardized care plans for i.v. therapy. AB - The use of standardized care plans by nurses has become an efficient tool for communicating special needs of patients. We at Good Samaritan Hospital and Medical Center recognized that our I.V. Team and the patients we service could benefit from the use of such a care plan. Improved communication and documentation were accomplished by developing a standard care plan addressing problems that may be encountered in I.V. therapy. This form has become a valuable part of our care to patients receiving I.V. therapy. PMID- 2769471 TI - [A proposal for endonasal middle meatal antrostomy]. AB - With increase of cases with mild chronic sinusitis, especially the cases combined with nasal allergy, endonasal sinus surgery has been substituted for Caldwell-Luc or some other modified sinus surgery in recent years. The classical inferior meatal antrostomy for maxillary sinusitis is one of the treatments of choice, though this opening is easily closed and is somewhat different from normal sinus physiology. In the middle meatal antrostomy, the opening was made via the inferior turbinate or the middle meatal wall perforated with nasal forceps. Reported here is a new technique for middle meatal antrostomy which can be easily and safely performed. At the beginning, mucosal incision is made from the agger nasi to the anterior of the inferior turbinate, dividing the mucous membrane inferomedially. Then the mucous membrane of the inferior turbinate is cut along the upper margin of it and reflected downwards. With this procedure, the frontal process of the maxilla, lacrimal bone and inferior turbinate are well exposed and well oriented in the surgical field. The pars membranacea is then cut from anterior to inferior, and removed with the uncinate process, thus entering the maxillary antrum. The antrostomy opening is made at least 1 by 1.5 cm wide. Then, the intranasal ethmoidectomy is usually done and the reflected mucous membrane of the inferior turbinate returned to its normal position. This surgery was applied to 34 patients (7 children, 27 adults), (2 antrochoanal polyps, 5 optic neuritis, 3 maxillary sinusitis, 17 pansinusitis, and 7 pansinusitis associated with nasal allergy). We have not experienced surgical complications and none of them also had closure of the antrostomy opening.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2769472 TI - [Middle ear dynamic characteristics of patients obtained by a newly developed measuring apparatus]. AB - A tympanometer is well known to be a valuable apparatus for the diagnosis of secretory otitis media (SOM). However, it is insufficient for the diagnosis of ossicular chain disorders. Therefore, an attempt was made to develop a new measuring apparatus, which had a function of sweeping both frequency and pressure and was measurable the absolute sound pressure variations at the external auditory canal, owing to the carefully designed probe. In the previous papers, the middle ear dynamical characteristics of normal subjects were measured by this apparatus, and the measurement results were compared with the theoretical analysis. In this paper, the middle ear dynamical characteristics of patients were measured, and the effects of various kinds of middle ear diseases upon its dynamical characteristics were examined. The measurement results of the patients with ossicular chain separation, ossicular chain fixation, SOM and tympanic membrane perforation had their own distinctive patterns, and were also clearly different from those of normal subjects. Therefore, this apparatus seems to have a high degree of the clinical applicability to the diagnosis of these diseases. PMID- 2769473 TI - [Types and treatments of blow-out fractures]. AB - A total of ten cases of blow-out fractures of the orbit was investigated as to the signs and symptoms, image findings of conventional views of Caldwell and Waters' and of coronal CT. According to the locations of fractures, medial, floor and medial-floor types were classified. Fractured bone tips were classified to depressive and trapdoor types. Fractures often occur posterior to the eyeball, the inferior rectus muscle showed dislocation and cylinder-like hypertrophy. Contrary to the reports in the past, the inferior rectus muscle did not show entrapment in the herniated portion. Caldwell view is superior to Waters' view in demonstrating fractures at the medial orbital wall. As to the choice of treatment in the majority of cases, conservative methods are indicated. Images by CT are used in determining surgical methods, the depressive type without clinical improvement after two weeks is the indication for the surgical treatments. PMID- 2769474 TI - [The effect of intravenous administration of xylocaine for the treatment of tinnitus]. AB - One hundreds and forty-nine patients (221 ears) suffering from tinnitus were treated by an intravenous administration of Xylocaine. Xylocaine, 1mg per kg, was administered once a week. The immediate effect of Xylocaine on tinnitus was evaluated subjectively for all the patients. The long term effect in 57 patients who received Xylocaine administration more than 12 times was also analyzed. The results can be summarized as follows. 1. Short and long term relief of tinnitus was obtained in 165 of 221 ears (74.7%) and in 35 of 57 cases (61.4%), respectively. 2. This therapy was more effective in old patients and in the patients with low pitch tinnitus, or with positive residual inhibition. 3. The numbers of the effective cases increased after the 8th time administration of Xylocaine. Thus we recommend the Xylocaine administration at least 8 times. 4. The results of the loudness balance test were not correlated with the change of the subjective improvements. 5. The suppressive effect of tinnitus by injecting saline solution intravenously was recognized in 24 of 73 cases. At present, repeated administration of Xylocaine would be one of the most significant therapies of tinnitus. PMID- 2769475 TI - [The onset of sudden deafness and Bell's palsy--statistical analysis]. AB - Existing studies on sudden deafness and Bell's palsy have shown no statistically significant differences in the numbers of patients by the times of the onsets, namely, days of the week, weeks of the month, months of the year and seasons of the year. However, accumulation of collective data in various areas and years may produce averaged data. Correlation between the occurrence of sudden deafness and that of Bell's palsy has not been studied so far. The yearly differences in the onsets of these diseases for the past 10 years were investigated using the Kendall's coefficient of concordance. In sudden deafness, very slight but statistically significant differences were found, when the numbers of patients and the onsets were analyzed by monthly basis, trimonthly basis (Nov-Jan, Feb Apr, May-July and Aug-Oct) and quarterly basis. In Bell's palsy, no statistically significant differences were found in the times of onset of Bell's palsy and that of sudden deafness. PMID- 2769476 TI - [Clinical evaluation of immunosuppressive factors (IAP-immunosuppressive acidic protein, IS-immunosuppressive substance) in head and neck cancer]. AB - It is reported that the levels of serum IAP and IS are useful parameters to evaluate the prognosis along with the clinical course of tumor bearing patients. Serum IAP and IS were examined in 149 patients with head and neck cancer. The level of serum IAP and IS increased in patients with not only advanced stages, but also poor prognosis. In general, the patients with death or recurrence had higher levels of serum IAP and IS than those with good prognosis. It is concluded that serum IAP and IS well reflect the immunological condition and clinical course of patients with cancer and may be one of the useful parameter for them. PMID- 2769477 TI - [Tree pollens and nasal allergy (XI). Relationship of age to the total IgE level, Japanese cedar RAST score, Japanese cedar-specific IgG antibodies and IgG subclass]. AB - Japanese cedar pollinosis occurs most frequently in the twenties and thirties. To understand this phenomenon, total serum IgE, frequency of positive RAST reactions to Japanese cedar and Japanese cedar-specific IgG antibody were examined in serum samples from a general population consisted of 1,491 subjects and their age related changes were investigated. The difference of mean value of total serum IgE was not significant between age groups. Positive RAST's to Japanese cedar were found in 13.9% of cases. The frequency of positive RAST reactions showed a peak in the twenties and decreased thereafter with aging. The amount of Japanese cedar-specific IgG antibodies was 244.7 +/- 373.2 GRU/ml (mean +/- S.D.) and there was no significant difference between males and females. There was no difference in the amount of specific IgG antibodies among the subjects giving RAST scores of 0-3, whereas those giving RAST scores of 4 had lower specific IgG antibodies. The amount of Japanese cedar-specific IgG antibodies increased from the fifties. Specific antibody of IgG1 subclass to Japanese cedar increased with age, whereas IgG4 antibody increased slightly without statistically significant difference. Based on the above result, we discussed why Japanese cedar pollinosis occurs most frequently in the twenties and thirties. PMID- 2769478 TI - [Infiltration of India ink from subarachnoid space to nasal mucosa along olfactory nerves in rabbits]. AB - The mode of the transportation of India ink to the nasal cavity was studied when it was given to the subarachnoid space chiefly through facial nerve sheath and partly by cisterna magna injection. From subarachnoid space India ink infiltrated through perineurium, epineurium and perineural space of the fila olfactoria and of olfactory nerve fibers to lamina propria of the olfactory mucosa and spread also to the respiratory mucosa. It was further taken into lymphatic vessels and accumulated in bilateral cervical lymph nodes. In normal rabbits, India ink didn't penetrate the basement membrane into the epithelial layer at all, but in rabbits with chronic rhinitis showing edema, degeneration and destruction of mucosa, India ink was found to pass easily through the basement membrane into the epithelial layer and further to leak into the nasal cavity in all cases. It was a new finding that in cases with rhinitis large particles like India ink could infiltrate from the subarachnoid space to the nasal cavity passing through the nasal mucosa, and was considered to be a possible cause of idiopathic cerebrospinal fluid rhinorrhea. PMID- 2769479 TI - The polymerase chain reaction and histopathology. PMID- 2769480 TI - Comparison of histopathological and flow cytometric parameters in prediction of prognosis in gastric cancer. AB - Flow cytometric analysis was performed retrospectively on material from 76 patients having potentially curative resection for gastric carcinoma between 1968 and 1984. The prognostic significance of DNA aneuploidy was compared with that of conventional histological grading and staging of the tumour. The presence of DNA aneuploidy was associated with a significantly poorer prognosis when compared with diploid tumours (P less than 0.02), but was not found to be predictive of survival when the presence of lymph node metastases (P less than 0.0001) and resection margin involvement (P less than 0.003) were allowed for using multiple regression analysis. When intestinal and diffuse types of gastric carcinoma were analysed separately, DNA aneuploidy was associated with a significantly shorter survival only in patients with intestinal type tumours. PMID- 2769481 TI - The relationship between growth fractions and oestrogen receptors in human breast carcinoma, as determined by immunohistochemical staining. AB - Measurements of the growth fraction (GF) and oestrogen receptor (OR) status were performed by immunohistochemical staining, using the monoclonal antibodies Ki-67 and anti-OR, in consecutive cryostat sections of biopsies from 74 women with primary breast cancer, and 12 women with benign breast disease. A significant inverse correlation was identified between the GF and OR status (r = -0.452, P less than 0.0001), but a group of OR-positive tumours with high GFs was also observed. There was a strong positive correlation between immunocytochemically determined OR percentages and values obtained with a cytosolic OR biochemical assay for the 70 cases in which both techniques were performed (r = 0.801, P less than 0.0001). A significant relationship was also revealed between the histological grade of infiltrating ductal carcinomas and their associated GFs (r = 0.622, P less than 0.0001). No correlation was found between the GF and the number of positive axillary nodes. Our findings suggest that GF and OR status are useful independent prognostic parameters in breast cancer, but the former probably has an overriding influence. Both parameters may be useful guides for selection of appropriate endocrine and/or adjuvant chemotherapy. PMID- 2769482 TI - Null cell adenomas of the pituitary gland. An immunohistochemical study. AB - Fourteen null cell adenomas of the pituitary gland were examined immunohistochemically with antisera against three general neuroendocrine markers and 22 hormones. All cases showed positive immunostaining for neuron-specific enolase, ten cases for synaptophysin, and six cases expressed chromogranin immunoreactivity. Hormone immunoreactivity was detected in a few cells in ten of the 14 cases studied and the number of hormones demonstrated in each case was one or two. Thyroid-stimulating hormone was detected in five of the 14 cases, gastrin in four, beta-endorphin in two, calcitonin gene related peptide in one, prolactin in one, and follicle-stimulating hormone in one. PMID- 2769483 TI - Spindle cell and pleomorphic lipoma: an immunohistochemical study and histogenetic analysis. AB - Twenty-two spindle cell lipomas and seven pleomorphic lipomas were investigated immunohistochemically in order to study the differentiation of the non-adipocytic elements. In all cases, neither spindle cells nor pleomorphic cells reacted with antibodies to a monocyte/macrophage antigen (MAC-387), fibronectin, laminin or type IV collagen. The absence of demonstrable basement membrane material argues against the possible prelipoblastic nature of these cells. With the antibody to S 100 protein, spindle cells were immunonegative, whereas pleomorphic cells sometimes revealed an intracytoplasmic weak to moderate staining reaction. In the light of what is known about the development of adipose tissue, our results would support the hypothesis of Bolen and Thorning (Am J Surg Pathol 1981; 5: 435-441) that spindle cell lipoma is composed of adipocytes and non-fat storing immature mesenchymal cells. It would appear that pleomorphic lipoma is similarly derived but that in some cases adipocytic differentiation is also abnormal. The characteristic clinical distribution of these two types of tumour may be of relevance in determining the cause of these unusual benign patterns of differentiation. PMID- 2769484 TI - Vascular changes in irradiated lungs: a morphometric study. AB - The lungs from eight patients who had received thoracic irradiation for the treatment of malignant disease have been studied and a morphometric analysis of the vascular changes present has been made. We found a marked difference between the changes we observed in the pulmonary vessels and those described in systemic vessels after exposure to irradiation. In the former the changes are more pronounced in the venous circulation, and in the latter they are described as being almost confined to the arteries. This difference is a reflection of the difference in oxygen saturation of the blood in the two types of vessels. We suggest that this difference can be explained by the possible role of super-oxide free radicals in the generation of these effects. PMID- 2769485 TI - Short-term effects of extracorporeal shock wave lithotripsy on the human gallbladder. AB - Extracorporeal shock wave lithotripsy (ESWL), whereby shock wave energy is focused upon gallstones causing their disintegration into fragments sufficiently small to be passed via the biliary system, offers a promising non-invasive alternative to surgery for gallstone disease. The tissue effects in humans of ESWL are poorly characterized and no systematic study of the tissue effects of ESWL by piezoelectrically generated shock waves has been published. Sixteen patients for elective cholecystectomy were therefore subjected to ESWL before surgery and detailed histology of the gall-bladders (including scanning electron microscopy of the mucosa) was compared with that from 20 age/sex-matched control cases. The gall-bladders treated by ESWL, in addition to showing the histological changes associated with chronic cholecystitis, showed serosal vasodilatation, mural oedema, and serosal and mucosal petechial haemorrhages focally over the entire surface. Between 10 and 90 per cent epithelial denudation was observed, but all cases showed surviving columnar epithelial cells in the crypts. No case showed vascular thrombosis, tissue necrosis, or acute inflammation. These tissue effects are likely to be reversible and unlikely to present a risk of perforation, although the long-term clinicopathological effects await investigation. PMID- 2769486 TI - Apoptosis--the mechanism of cell death in dimethylnitrosamine-induced hepatotoxicity. AB - Dimethylinitrosamine (DMN) induces an acute haemorrhagic centrilobular necrosis when given as a single dose to rats. In this study, the progression of the lesion was studied at the ultrastructural level in order to elucidate the precise mechanisms of hepatic injury. Within 3 h of a single dose of DMN there was disruption of endothelial lining cells. In areas of endothelial cell loss, the exposed hepatocyte sinusoidal membranes became simplified and flattened. In the centrilobular area, hepatocytes became apoptotic and by 16 h apoptotic bodies, formed from degenerate hepatocytes, were engulfed by intact hepatocytes or by circulating macrophages. This progressive degeneration of hepatocytes and endothelial cells gave rise, by 24 h, to the classically recognized centrilobular haemorrhagic necrosis. The damage to the endothelial cells was concurrent with, or in some areas prior to, significant morphological changes in adjacent hepatocytes. This contrasts with other hepatotoxins such as carbon tetrachloride where the primary target is the hepatocyte, giving rise to hydropic degeneration and coagulative necrosis. DMN, however, results in apoptosis, a mechanism of cell death not normally associated with chemically induced injury. PMID- 2769487 TI - Expression of parathyroid hormone related protein in normal skin and in tumours of skin and skin appendages. AB - Parathyroid hormone related protein (PTHrP) has been demonstrated in the tumour cells of squamous cell carcinomas originating in a variety of organs, in undifferentiated small cell tumours of the bronchus, and in carcinoma of the kidney. The protein hormone is thought to produce the hypercalcaemia which may complicate some of these malignancies. By using an antibody raised in rabbits against the N-terminal portion of the molecule, the polypeptide may be demonstrated in cells of the prickle cell layer of normal skin and in the cells of hair follicles. Skin tumours showing squamous or hair follicle differentiation are shown to contain the protein antigen, while basal cell carcinomas and tumours with sweat gland differentiation do not. The hormone may be primordial in origin and the progenitor of parathyroid hormone. PMID- 2769488 TI - A non-parametric grading system for intestinal metaplasia: correlations with gastric tissue enzymes. AB - A novel method for grading intestinal metaplasia, with general applicability, is described. Highly significant agreement was found by kappa analysis both for intra-observer (k = 0.90) and for inter-observer (k = 0.85) variation, confirming the reproducibility of the method. The ranks derived by this method were correlated with gastric tissue levels of the enzymes beta-glucuronidase, lactic dehydrogenase (LDH), and %m-LDH. A significant (P less than 0.05) positive correlation was found between intestinal metaplasia and %m-LDH, but there was no correlation between intestinal metaplasia and beta-glucuronidase or LDH. PMID- 2769489 TI - Superficial gastritis and Campylobacter pylori in dyspeptic patients--a quantitative study using computer-linked image analysis. AB - The purpose of this study was the quantitative assessment of mucosal inflammation and its relationship to Campylobacter pylori in gastric antral and body biopsies from patients with dyspepsia and controls. The study groups comprised patients with duodenal ulcer (DU; n = 20), duodenitis (DUN; n = 20), non-ulcer dyspepsia (NUD; n = 20). Using a semi-automatic, computer-linked image analyser (Kontron: MOP Videoplan), mucosal acute and chronic inflammatory cell densities were measured in defined gastric sites for each patient group and expressed as number per mm2 of lamina propria and number per mm length of epithelium. Measurements were also made on a group of asymptomatic controls (n = 9) who fulfilled strict exclusion criteria. All biopsies were analysed for the presence of Camplyobacter pylori (CP) with a Giemsa stain. Data between groups were compared using the Mann Whitney U-test. In the antrum and body, the mononuclear cell count was significantly higher in lamina propria in DU patients than in DUN, NUD and controls. In the body, DU laminia propria mononuclear cell counts were higher than those of DUN and controls. Prevalence rates for CP for DU, DUN, and NUD were 94, 89, and 50 per cent for antral and 88, 83, and 56 per cent for body biopsies. Significant differences were present between CP-positive and negative subjects in the NUD group. Antral and body inflammation within these clinical groups shows a wide variation. Higher inflammatory cell counts in the DU group may reflect the prevalence of CP colonization. PMID- 2769490 TI - Cytoskeletal features of immature pulmonary vascular smooth muscle cells: the influence of pulmonary hypertension on normal development. AB - Using an immunohistochemical technique, the development of the cytoskeletal proteins desmin, vimentin, and actin (using alpha isotype and non-isotype specific antibodies) was assessed using a semi-quantitative grading system in the pulmonary vascular smooth muscle of nine normal pigs and 19 normal humans at different ages, and in 13 children with pulmonary hypertensive congenital heart disease. In the normal of both species, immunostaining for vimentin decreased after birth and then increased gradually while immunostaining for desmin and alpha actin increased steadily with age. In pulmonary hypertension, immunostaining for alpha actin and vimentin showed an accelerated increase at between 2 and 8 months. Also, the media showed regional differences in immunostaining which preceded the development of intimal proliferation. The inner media showed less immunoreactivity for all cytoskeletal proteins studied than did the outer media. Within areas of intimal proliferation many cells were immunonegative. These results suggest that the cytoskeletal features of medial smooth muscle cells are remodelled in the normal infant; that this process is altered from at least 2 months in the pulmonary hypertensive infant; and that the smooth muscle cells immediately beneath the internal elastic lamina are remodelled before migrating to form intimal proliferation. Changes in cytoskeletal composition can be related to the previously described postnatal maturation of pulmonary vascular smooth muscle cells. PMID- 2769491 TI - Transfer of anti-glomerular basement membrane antibody-induced glomerulonephritis in inbred rats with isologous antibodies from the urine of nephritic rats. AB - Anti-glomerular basement membrane antibody-induced glomerulonephritis (anti-GBM nephritis) was transferred from nephritic rats to normal recipient rats with isologous antibodies obtained from the urine of the nephritic rats. The original actively-immunized anti-GBM nephritis was induced in inbred WKY/NCrj rats by injecting the nephritogenic antigen from bovine renal basement membranes. Excreted urinary antibodies were collected, purified, and then injected into recipient rats of the same strain. Haematuria and proteinuria appeared on day 2 and day 3, respectively; both became heavier and reached a plateau by day 5. Endocapillary hypercellularity of mononuclear cells in glomeruli was the first histological change, which was observed from day 2, and later extracapillary changes such as fibrin deposition, capsular adhesion, and crescent formation were observed. These histological changes were the same as those seen in the actively immunized nephritis. The results demonstrate that anti-GBM nephritis is clearly induced by autoantibodies. This new passively-immunized model of anti-GBM nephritis makes it possible and easier to analyse further the mechanism of anti GBM nephritis because only isologous antibodies are used. This study also indicates that the urine of the nephritic rat is a good source of autoantibodies. PMID- 2769492 TI - Pathological Society of Great Britain and Ireland, 159th meeting. 5-7 July 1989, Aberdeen. PMID- 2769493 TI - Intracranial injury after moderate head trauma in children. AB - We retrospectively evaluated the records of 459 children who had normal findings on a neurologic examination after moderate head injury characterized by brief loss of consciousness. Skull x-ray examination had been performed in 358 children, and 52 (14%) had fractures. Intracranial complications developed in six children (1.3%); five had extradural hematomas and one had bifrontal contusions. All six had skull fractures. Three children required surgical evacuation of hematomas between approximately 24 and 72 hours after injury. On the basis of these results, we conclude that in the absence of a skull fracture, most alert children without symptoms who have sustained moderate head injury may be safely discharged from the emergency department in the care of a competent observer. PMID- 2769494 TI - Relationship between nutrition and development in Kenyan toddlers. AB - The relationship between mild to moderate malnutrition, as measured by food intake and anthropometric status, and developmental outcome was explored in 110 Kenyan toddlers. Developmental outcome was assessed at 30 months of age by the Bayley Mental and Motor scales and by evaluation of play behaviors. Verbalization and play during months 15 to 30 were also evaluated. Family background and home rearing conditions were assessed, and these variables were separated from the correlations between nutrition and outcome by partial correlation methods. Food intake was related to anthropometric status, play behaviors, and total amount of verbalization and play even when the potentially confounding effects of certain family background and home rearing variables were covaried. Food intake was not related to Bayley Mental and Motor scores, but measures of length and weight were, even when family background and home rearing variables were held constant. Mild to moderate malnutrition does appear to affect the child's development adversely even when other environmental characteristics, which also relate to development, are considered. PMID- 2769495 TI - Accelerated growth after recombinant human growth hormone treatment of children with chronic renal failure. AB - We studied the effect of recombinant human growth hormone treatment on five boys, aged 4.6 +/- 1.8 years, who had chronic renal failure secondary to congenital renal diseases (mean creatinine clearance (+/- SD): 18.3 +/- 6.3 ml/min/1.73 m2 (0.32 +/- 0.11 ml/sec/1.73 m2]. Patients received 0.125 mg/kg of growth hormone three times per week for 1 year. Before beginning treatment, the children had a mean annual growth velocity of 4.9 +/- 1.4 cm/yr (range 3.0 to 6.3 cm/yr), with a mean standard deviation score for a height of -2.98 +/- 0.73 (range -2.16 to 3.59). At the end of therapy, the mean growth velocity had increased to 8.9 +/- 1.2 cm/yr (range 7.5 to 10.7 cm/yr), and the mean height standard deviation score improved to -2.36 +/- 0.83 (range -1.15 to -3.18). Bone age advancement was consistent with the period of growth. Routine laboratory determinations, including results of glucose tolerance testing, did not vary significantly from pretreatment levels. These preliminary data indicate that growth-retarded children with chronic renal failure can respond to exogenous growth hormone therapy with a marked acceleration in growth velocity. PMID- 2769496 TI - Erythrocyte membrane lipid peroxidation before and after vitamin E supplementation in children with cholestasis. AB - In 10 children with chronic cholestasis and without neurologic signs, we evaluated lipid peroxidation and vitamin E levels in serum and in the erythrocytes before and after a therapeutic trial with alpha-tocopherol. We also studied the effects of vitamin E administration on hematocrit and hemoglobin values and on reticulocyte and erythrocyte counts. Plasma and erythrocyte malonyldialdehyde (MDA) values were significantly higher compared with normal control values, whereas plasma and erythrocyte tocopherol measurements were lower. Oral administration of high doses of vitamin E (300 mg/day for 15 days) resulted in lower serum MDA levels, whereas serum vitamin levels did not change significantly. In erythrocytes, the MDA decreased but not to control levels, and vitamin E increased but to lower values than normal. Hematologic values also improved. We conclude that longer treatment might be necessary to completely reverse the oxidative damage associated with vitamin E deficiency in children with cholestasis. PMID- 2769497 TI - Factors affecting clearance of hepatitis B e antigen in hepatitis B surface antigen carrier children. AB - To understand the natural history of chronic hepatitis B virus infection in children, we studied factors affecting the clearance of hepatitis B e antigen (HBeAg). One hundred sixty-nine apparently healthy children whose sera were positive for HBeAg and hepatitis B surface antigen (HBsAg) and who were recruited by screening were followed prospectively to delineate the HBeAg clearance rate. Another 59 carrier children visiting the outpatient clinic because of symptoms or abnormal liver function were studied for comparison. The annual HBeAg clearance rate was low (less than 2%) during the first 3 years of life but increased with age. The HBeAg clearance rate in children older than 6 years of age was lower in those whose mothers had HBsAg positivity (14.3%) than in those whose mothers had no detectable HBsAg (35.3%). Children who were brought for medical care had higher HBeAg clearance rates (42.4%) than those who were recruited by screening (14.6%) because immune clearance of hepatitis B virus and hence HBeAg often led to hepatocellular damage manifested by abnormal liver function profiles or by symptoms that had caused the parents to seek medical care for their children. We conclude that age, source of subject recruitment, and maternal HBsAg status are important factors affecting HBeAg clearance rate in HBsAg carriers. PMID- 2769498 TI - Priorities for the use of finite resources: now may be the time to choose. PMID- 2769499 TI - What defines DiGeorge anomaly? PMID- 2769500 TI - Growth hormone treatment accelerates growth of short children with neural tube defects. PMID- 2769501 TI - Impaired neutrophil function in children with seizures treated with the ketogenic diet. PMID- 2769502 TI - Urinary erythrocyte volume analysis: a simple method for localizing the site of hematuria in pediatric patients. PMID- 2769503 TI - Cerebrospinal fluid protein elevation secondary to a subdural fluid collection in a child receiving multiple lumbar punctures. PMID- 2769504 TI - Chronic varioliform gastritis in childhood. PMID- 2769505 TI - Ventilatory changes in convalescent infants positioned in car seats. AB - Because premature infants have been shown to be at risk for hypoxia and bradycardia when positioned in standard car seats, this study was done to confirm this finding in a larger sample, to investigate convalescent term infants in the neonatal intensive care unit for respiratory compromise in car seats, and to determine the physiologic mechanism or mechanisms responsible. Extensive multichannel polygraph recordings were obtained and pulmonary function tests were performed on 50 convalescent infants from the neonatal intensive care unit before, during, and after placement in a Cosco-Peterson First Ride car seat. Mean total dynamic compliance, total pulmonary resistance, and work of breathing improved in the car seat. Thirty percent of premature infants experienced hypoxia, bradycardia, or both in a car seat; in this group, tidal volume was lower (p = 0.02). In 11 of 16 infants with abnormal findings, oxygen desaturation was temporally related to episodes of short and mixed apnea. No term convalescent infant experienced respiratory difficulty in a car seat regardless of primary diagnosis. We conclude that premature infants may have respiratory compromise of a multifactorial nature when in car seats. Further development of car seats is necessary if such respiratory problems are to be avoided. PMID- 2769506 TI - Hypoxic airway constriction in infants of very low birth weight recovering from moderate to severe bronchopulmonary dysplasia. AB - We hypothesized that infants recovering from severe bronchopulmonary dysplasia have airway constriction that is, at least in part, related to borderline hypoxia. If this hypothesis were correct, pulmonary resistance should decrease with the administration of oxygen. To test this hypothesis, we studied 10 infants recovering from severe bronchopulmonary dysplasia (study weight 2490 +/- 275 gm; birth weight 1010 +/- 89 gm; postnatal age 73 +/- 7 days; postconceptional age 38.5 +/- 1.6 weeks) and 10 matched control infants (study weight 2430 +/- 179 gm; birth weight 2320 +/- 195 gm; postnatal age 25 +/- 4 days; postconceptional age 37.5 +/- 0.8 weeks). Resistance and compliance were measured by means of a mask with a flowmeter and an esophageal balloon (with the PEDS computer program). Measurements in both groups were made in quiet sleep, without sedation, during the inhalation of room air and during the fifth minute of oxygen inhalation. We found that (1) total pulmonary resistance, significantly higher in infants with bronchopulmonary dysplasia than in control infants, decreased from 206.1 +/- 47 cm H2O.L-1.sec-1 during inhalation of room air to 106.5 +/- 20.9 during inhalation of 100% oxygen (p less than 0.05) and (2) pulmonary dynamic compliance, lower in infants with bronchopulmonary dysplasia than in control infants, increased significantly with the administration of 100% oxygen. The results suggest that infants with bronchopulmonary dysplasia have airway constriction and that this is alleviated by inhalation of oxygen. PMID- 2769507 TI - Diagnostic errors in neonatal polycythemia based on method of hematocrit determination. PMID- 2769508 TI - Cholestasis in infants supported with extracorporeal membrane oxygenation. PMID- 2769509 TI - Plasma amino acid profiles during the first three days of life in infants with respiratory distress syndrome: effect of parenteral amino acid supplementation. PMID- 2769510 TI - Drug screening of meconium in infants of drug-dependent mothers: an alternative to urine testing. AB - Meconium specimens (first 3 days' stool) obtained from 20 infants of drug dependent mothers and five control infants were analyzed by radioimmunoassay for the metabolites of three commonly abused drugs, heroin, cocaine, and cannabinoids. Control stools contained no drug. Meconium from the infants of drug dependent mothers showed the presence of at least one drug metabolite: 80% of the infants of drug-dependent mothers showed cocaine (range 0.14 to 19.91 micrograms/gm stool), 55% showed morphine (range 0.41 to 14.97 micrograms/gm stool), and 60% showed cannabinoid (range 0.05 to 0.67 micrograms/gm stool). The concentrations of metabolites were highest during the first 2 days; some stools tested positive up to the third day. In contrast, only 37% of the infants had positive results on a urine screen (fluorescent polarization immunoassay method). Paired urine and meconium specimens, both analyzed by radioimmunoassay, showed a higher concentration of drug metabolites in the latter; eight urine samples had no detectable drugs despite a corresponding positive stool test result. We conclude that meconium is useful for drug screening in the neonate. PMID- 2769511 TI - Cerebrospinal fluid concentrations of ethionamide in children with tuberculous meningitis. AB - Cerebrospinal fluid ethionamide concentrations were determined in 18 children (median age 26.5 months) with tuberculous meningitis complicated by raised intracranial pressure. Lumbar spinal fluid specimens were obtained before and after weekly hour-long monitoring of intracranial pressure. Thirty-five paired and four single specimens were evaluated. A dosage schedule of 15 mg/kg was used on 26 occasions, and a spinal fluid ethionamide concentration of 2.5 micrograms/ml, the in vitro minimal inhibitory concentration for Mycobacterium tuberculosis, was exceeded on only seven occasions (27%). A dosage of 20 mg/kg was administered on 13 occasions, and in only two instances (15%) was a concentration of 2.5 micrograms/ml not achieved. Ethionamide in a single daily dosage of 20 mg/kg should be considered for the initial treatment of tuberculous meningitis when the presence of isoniazid-resistant M. tuberculosis cannot be excluded. PMID- 2769512 TI - Differences in biologic maturation, sexual behavior, and sexually transmitted disease between adolescents with and without cervical intraepithelial neoplasia. AB - Because several cofactors may influence the development of cervical intraepithelial neoplasia (CIN) in young women, we compared differences in behaviors (sexual activity, contraception, and cigarette use), sexually transmitted disease (STD) infection rates (Chlamydia trachomatis, Neisseria gonorrhoeae, Trichomonas vaginalis, and herpes simplex virus), and cervical maturation (age of menarche and percentage of cervical ectopy) in groups of sexually active female adolescents with and without CIN. Those with CIN were compared with three non-CIN groups: (1) teenagers who were referred to a teen colposcopy clinic but had no evidence of CIN (high-risk group), (2) teenagers seen at a gynecology clinic without STD symptoms (asymptomatic group), and (3) teenagers seen at the gynecology clinic with STD symptoms (symptomatic group). The percentage of cervical ectopy was measured by colpophotography. Subjects with CIN had more lifetime sexual partners than the asymptomatic group (p less than 0.001) and were more likely to smoke cigarettes than either gynecology clinic group (p less than 0.01). No differences in behaviors existed between the CIN and high-risk groups. The mean age of menarche in those with CIN was 1 year older than all three non-CIN groups (p less than 0.05), and those with CIN had a greater area of ectopy than those without CIN (p less than 0.02). Those with CIN were more likely to have a past or present history of C. trachomatis infection than the two gynecology clinic groups; no difference was found between the CIN and high-risk groups. We conclude that cofactors such as smoking, sexual promiscuity, and C. trachomatis infection may influence cervical vulnerability. However, cervical biologic immaturity is an important risk factor for development of CIN in adolescent girls. PMID- 2769513 TI - Comfort of male adolescents during general and genital examination. PMID- 2769514 TI - Cachectin in hemorrhagic shock and encephalopathy syndrome. PMID- 2769515 TI - Infantile colic and lactose intolerance. PMID- 2769516 TI - Immunologic therapy for hemolytic-uremic syndrome. PMID- 2769517 TI - Need for ventriculoperitoneal shunt in preterm infants with posthemorrhagic hydrocephalus. PMID- 2769518 TI - Cerebrovascular injury during extracorporeal membrane oxygenation. PMID- 2769519 TI - Hypertriglyceridemia in infants with bronchopulmonary dysplasia. PMID- 2769520 TI - Biotechnology--ten years later: PDA's role. PMID- 2769521 TI - Physicochemical properties of binary organic cosolvent-water mixtures and their relationships to muscle damage following intramuscular injection. AB - Using an in vitro model for the assessment of muscle damage after intramuscular injection of pharmaceutical preparations, we examined the muscle damage caused by three series of binary cosolvent mixtures as functions of their dielectric constant, apparent pH, surface tension, and viscosity. The cosolvent systems we examined were propylene glycol-water, ethanol-water and polyethylene glycol 400 water mixtures. Muscle damage was measured by the in vitro release of creatine kinase from the isolated rat skeletal muscle. Although isolated correlations exist between muscle damage and the physicochemical properties of a particular series of cosolvent mixtures, no single property, or combination of those examined, can provide a unified prediction of the degree of muscle damage incurred. This result suggests that muscle damage caused by the organic cosolvents may arise from complex interactions of a given cosolvent with the biochemical processes occurring in the skeletal muscle rather than from the four physicochemical factors examined. PMID- 2769522 TI - Design and use of a novel peracetic acid sterilizer for absolute barrier sterility testing chambers. AB - Increasing use is being made of absolute barrier chambers in the pharmaceutical industry for sterility testing of sterile pharmaceuticals. Since these barriers are designed to form a microbial-tight enclosure to eliminate laboratory microbial contamination derived from the operator and the environment,it is important that the method used to sterilize these barriers, product containers, and articles used within, provide a high degree of sterility assurance. A major part of incorporating absolute barriers in the sterility testing laboratory at the Upjohn Company was to design an automated sterilization system to facilitate the spraying of a liquid sterilant, e.g., peracetic acid, inside these barriers. This article focuses on general design considerations, specific details of the apparatus, and the operational steps. The sterilization efficacy of this method is also described, with particular emphasis on validation criteria and results. Finally, operational sterility testing results are discussed. PMID- 2769523 TI - In vitro dynamic method for evaluating the hemolytic potential of intravenous solutions. AB - An in vitro dynamic method for evaluating the hemolytic potential of intravenous solutions has been developed. The method utilizes an in vitro flow system that provides a reasonable simulation of blood circulation at sites for intravenous injections. Physical variables such as internal diameter of tubing, flow rate of red blood cell (RBC) suspension and injection rate were found to significantly influence the degree of hemolysis caused by the intravenous injection of solutions. For example, injection of 50% v/v propylene glycol (PG) in 0.9% w/v aqueous sodium chloride (NaCl) solution at the rate of 5 mL/30 seconds caused 78.4 percent hemolysis when the flow rate of RBC suspension at the injection site was 12 mL/min. Increasing the flow rate of the RBC suspension at the injection site to 48 mL/min resulted in a decrease in the percent hemolysis (33.5%) caused by the above solution when injected at 5 mL/30 seconds. PMID- 2769524 TI - A procedure to verify the lower counting limit of optical particle counters. AB - A procedure has been developed to verify the particle counter lower counting limit (LCL) specified by the manufacturer for a laser particle counter (LPC). The procedure uses existing commercially available products to confirm an LPC lower size counting limit. The procedure involves the use of NBS traceable polystyrene latex (PSL) particles and an electrostatic classifier to generate highly monodisperse (single size) particles near the lower size limit of the LPC. A condensation nucleus counter (CNC) is used as a standard for particle concentration, since its lower size limit is far below the LPC's. By comparing the LPC concentration with that of the CNC, the lower counting limit of the LPC can be verified. This is especially well suited for certifying that pharmaceutical and electronics clean room counters are operating according to manufacturer specifications. The method is unique in that it specifies the LCL as an efficiency curve rather than as a single efficiency point. PMID- 2769525 TI - An automated method for vacuum testing pharmaceutical vials. AB - A new automated vacuum tester which applies a high voltage, high frequency electric field and a stroboscopic flash to conveyorized vials was found to yield zero percent false rejections of lyophilized vials with internal pressures of less than 62 Torr. The hand-held testing device used until now was found to produce, on extended contact with vials containing sensitive protein product, excessively high numbers of particulates upon drug reconstitution. In the automated machine operating at rates between 150 and 30 vials per minute, each vial is exposed for only 0.3 to 1.4 seconds and sensitive products emerge undamaged. PMID- 2769526 TI - The effect of refrigeration and mixing on detection of endotoxin in parenteral drugs using the Limulus Amebocyte Lysate (LAL) test. AB - Prior to testing for the presence of bacterial endotoxin, parenteral products are handled and stored in a variety of ways. Two incidents, detected by the U.S. Food and Drug Administration, revealed that differences in product handling and storage may have played a role in causing analytical discrepancies in the testing of identical samples. The testing procedure was the USP Bacterial Endotoxin test using Limulus Amebocyte Lysate (LAL) reagent. Consequently, an evaluation was made at the two principal factors that contributed to the suspected analytical anomaly. The factors were sample storage and the degree of agitation prior to sample analysis. Additional variables such as bacterial growth medium and adsorption potential of endotoxin by rubber stoppers were also evaluated. It was found that neither the medium employed to grow the E. coli endotoxin nor the storage temperature of the spiked solutions were problematic. However, it was shown that 20-40% of the spiked endotoxin was lost due to non-agitation of solution in vials in which the solution was in contact with the rubber stoppers. A suggested remedy for this problem is to store intact product containers in an upright position and to establish a uniform mixing procedure prior to endotoxin assay. PMID- 2769527 TI - Preservative efficacy: compendial and regulatory issues. PMID- 2769528 TI - The Parenteral Drug Association Foundation for Pharmaceutical Sciences: past, present, and future. PMID- 2769529 TI - Public statement on advancing biomedical technology. PMID- 2769530 TI - Anabolic steroid use: indications of habituation among adolescents. AB - The use of anabolic steroids (AS) by adolescent males is argued to be more widespread than currently acknowledged. Although the long-term physiological and psychological ramifications of use are not well established, current research and anecdotal information suggest that there is reason for concern. In addition, very little is known about the attitudes and behaviors of these adolescent AS users. While the debate concerning the physiological versus the psychological dependence liability of various drugs continues to evolve, there seems to be a consensus that drug dependence is not a per se phenomenon and that the characteristics of dependence differ in accordance with the drug being used. The following article attempts to identify characteristics of the adolescent male AS user and suggests that AS use does have a dependence potential. The AS user population was found to be significantly different from nonusers in several areas such as self perceptions of health and strength, interest in controlling AS use, and perceptions of peer AS use. The AS user group was also found to contain several subgroups (heavy users [greater than or equal to 5 cycles] versus other users, and those who initiated use prior to age sixteen who reported significantly different attitudes and/or behaviors. These differences suggest that prevention efforts will have to focus on different motivations for AS use. PMID- 2769531 TI - Evaluating the effectiveness of a school drug and alcohol prevention curriculum: a new look at "Here's Looking at You, Two". AB - The article reports on the results of an evaluation of a school drug and alcohol prevention curriculum marketed under the title, "Here's Looking at You, Two." Previous evaluations, unreported in the literature and having unresolved methodological problems, have found that while the program appears effective at transmitting information regarding drug and alcohol abuse, it has not been effective at changing the underlying attitudes and behaviors that, in part, explain substance abuse. Employing a more rigorous methodology, our examination of a relatively large sample across five school districts provides support for previous findings. Over the short-term of one year, the program was particularly effective at transmitting substance information to primary and middle school students. The program, however, produced very little of the expected effect on the underlying attitudes that are critical to changing substance abuse behaviors. PMID- 2769532 TI - Job satisfaction among military prevention specialists. AB - The relationships between role perceptions and job satisfaction were studied. Such perceptions included perceived importance of the military prevention specialist role vis-a-vis substance abuse prevention, organizational efficiency, and supervisory interest. Perceived importance of the prevention duty for substance abuse prevention and organizational efficiency were primarily related to job satisfaction. Perception of the supervisor's emphasis upon the prevention duty was significant but secondary. PMID- 2769533 TI - A path analytic examination of differential social control theory. AB - Differential social control theory was investigated with survey data from 860 adolescents using path analytic techniques. Peer non-use expectations, peer use, and the adolescent's own attitude each have a direct influence on drug use. Peer non-use expectations have the largest total effect on drug use and are directly influenced by parental, peer, and school attachments. Student's attitude has a direct effect on drug use, however, a majority of the association is spurious. Peers' drug use has the largest, direct influence on drug use. The likelihood of adolescents' associating with drug using friends is reduced by a close relationship with their parents and by knowing that their friends disapprove of drug use. The model explained 60 percent of the variance. Students do not use drugs if they are unwilling to jeopardize their relationship with their parents and non-using friends. They are also less likely to use drugs if they think their parents and friends disapprove of drug use and if their friends do not use drugs themselves. PMID- 2769534 TI - Adolescents' perceptions of cannabis use by their peers: does it have anything to do with behavior? AB - Young people perceive there are many more people using cannabis than any surveys can document. As part of an education program, students were exposed to survey data to influence their perceptions and in turn to affect their use and intentions to use cannabis in the future. This large study showed that perception has no relationship to use or intentions to use, and that changing perceptions of use is very difficult. PMID- 2769535 TI - Do parents today need drug education programs as badly as their parents needed them? AB - The purpose of this article was to determine if being socialized in a drug culture has increased knowledge levels and eliminated the need for adult drug education programs. A large group of parents was surveyed and it was found that the parents of the late 1980s had knowledge levels only slightly higher than the parents of the early 1970s. Today's parents significantly lack the knowledge and resources to informatively educate their children. Parental knowledge of and attitude toward drugs and alcohol were assessed in relationship to the ages of their children, parental educational level, parent's age and parent's past drug experience. PMID- 2769536 TI - Cholangitis after the Kasai operation for biliary atresia. AB - One hundred seventy-nine episodes of cholangitis in 28 consecutive patients having a Kasai operation for biliary atresia during the past 3 1/2 years were analyzed. The diagnosis was made primarily on the basis of unexplained fever (greater than 38.0 degrees C). An increase in serum bilirubin or a decrease in bile volume and in bile bilirubin concentration were often confirmatory, but other laboratory data including serum hepatic enzymes and blood and bile culture data were of little or inconsistent value. All patients were treated with systemic antibiotics. The best results were obtained with third-generation cephalosporins or imipenemcilastatin with the addition of aminoglycosides in recalcitrant cases. Antibiotic therapy was modified if defervescence did not occur within the first 24 hours. Cholangitis refractory to antibiotics was aggressively treated with pulse steroid therapy, and in some cases, operative intervention, both with good clinical success (60% and 73%, respectively). PMID- 2769537 TI - Papers presented at the 37th annual meeting of the Surgical Section of the American Academy of Pediatrics. San Francisco, California, October 15-17, 1988. Part 2. PMID- 2769538 TI - A variant of the split notochord syndrome. AB - Split notochord syndrome has been described in several previous case reports; however, we recently treated a patient with a previously undescribed variant of this syndrome. A 2.5-g baby girl was admitted to the neonatal intensive care unit with a skin-covered mass on the back, and a portion of intestine, with meconium being passed, attached to it. The legs were equino varus, and the anus was anteriorly displaced. Radiographs were consistent with a lumbar split notochord, and the patient was taken to the operating room for closure. During surgery, the skin-covered mass was opened and found to contain loops of small intestine leading to an intussuscepted cecum and an open ended duplication of the cecum attached to the end of the spinal cord. The small intestinal loops exited the abdomen from a peritoneal-lined opening to the back. The loops were returned to the abdomen after releasing the duplication from the cord. The peritoneal connection was closed with a purse string suture, and the abdomen was opened. The duplication of the cecum was partially amputated and the rest was used to create a chimney-type stoma. The intraabdominal exploration was significant for nonrotation as well as a normal rectum. The postoperative course was uneventful. This case is unique because most cases of split notochord only involve a fistula to the rectum. In this case, a major part of the small bowel had herniated. Moreover, there was an open duplication similar to that found in extrophy. In approaching such a situation, it is also important to have the neurosurgeon available to provide adequate closure of the back similar to a myelomeningocele. PMID- 2769539 TI - Esophageal adenocarcinoma 20 years after esophageal atresia repair. AB - We report a case of esophageal adenocarcinoma 20 years after esophageal atresia repair. From one case report it is premature to recommend cancer surveillance for all esophageal atresia patients. However, the first survivors are now reaching an age when esophageal cancer related to chronic esophagitis may become more prevalent. PMID- 2769540 TI - Successful management of esophageal strictures without resection or replacement. AB - Esophageal resection or replacement has become the standard therapy for severe esophageal strictures chiefly because less aggressive methods generally have failed. We hereby report our experience with 12 consecutive infants and children who have been managed successfully by means of Stamm gastrostomy and string guided esophageal dilatation, coupled with endoscopically guided four-quadrant intralesional steroid injection, protected by Nissen fundoplication when gastroesophageal reflux has been demonstrated. In six patients, the stricture(s) were caused by ingestion of lye. In five, they were associated with repair of esophageal atresia. In one, the etiology was never determined. The strictures averaged 3.5 cm in length (range, 1 to 10 cm); the severity of the lesions was indicated by the fact that, in all instances, patients were completely intolerant of solids, and was confirmed fluoroscopically by demonstration of significant luminal narrowing. A mean of 4.3 steroid injections (range, 1 to 8) was required to obtain complete remission of symptoms; there have been no complications except in one lye ingestion patient who developed a tiny perforation following the initial dilatation, which responded to antibiotics alone. All patients remain symptom-free; the mean length of follow-up is 6.2 years (range, 1 to 11 years). We conclude that string-guided esophageal dilatation, when coupled with endoscopically guided steroid injection, is a safe and reliable method for treatment of severe esophageal strictures, which should obviate the need for esophageal resection or replacement in most patients. Moreover, even if treatment should ultimately fail, a procedure of lesser magnitude than esophageal replacement will likely be possible.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2769541 TI - Cardiac performance in children with pectus excavatum. AB - Fourteen children with pectus excavatum and 14 normal control patients underwent graded exercise testing using a cycle ergometer and the James protocol. All the subjects were preoperative. The children were exercised to exhaustion during the test. The pectus and control groups were broken down into subgroups consisting of subjects less than or equal to 10 years of age and subjects greater than or equal to 11 years of age (pectus and controls less than or equal to 10 years old, PI and CI, respectively; pectus and controls greater than or equal to 11 years old, PII and CII, respectively). Maximal workload, oxygen consumption, cardiac output, and stroke volume were not significantly different when comparing the total groups or when each of the respective subgroups were compared. However, maximal diastolic BP was significantly elevated when the entire pectus and control groups were compared. When the subgroups were compared, maximal diastolic BP was elevated only in the older pectus patients (PII) and remained so until five minutes after exercise. Additionally, left ventricular systolic time intervals were measured immediately after exercise in all the children. The ratio of preejection period to left ventricular ejection time (P/L) was significantly shortened in the total pectus group. When the subgroups were compared, the P/L ratio was significantly decreased only in the older patients. Also, the preejection period (PEP) was significantly shortened in the older pectus patients. It appears that children with pectus excavatum have a normal exercise tolerance and oxygen transport. However, older pectus children develop an increased diastolic BP and a shortened P/L and PEP in response to exercise.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2769542 TI - Factors affecting urea clearance during continuous hemodiafiltration in the canine model. AB - Continuous hemofiltration (CH) for the treatment of hypervolemia and electrolyte abnormalities in critically ill patients with acute renal failure has been shown to be an effective mode of therapy. This technique offers several advantages over peritoneal dialysis or hemodialysis: it is technically less complex, provides efficient ultrafiltration, and produces fewer hemodynamic disturbances. Recently, continuous hemodiafiltration (CHD) using a flow of dialysate fluid into the ultrafiltration chamber has been reported to augment urea clearance. The purpose of this study was to determine the blood flow and dialysate flow characteristics for optimal clearance of urea and creatinine using this technique. Six mongrel dogs (mean weight, 8.0 +/- 1.1 kg) underwent bilateral nephrectomy to induce anuric renal failure. Postoperatively, the animals were fluid resuscitated and fed ad libitum. Twenty-four hours following nephrectomy, venovenous hemofiltration was instituted. Blood flow was regulated via a roller pump, while dialysate flow was regulated using an infusion controller. An Amicon-30S hemofilter was used in the circuit. Blood flow rates of 5, 10, 15, 20, 25, and 30 mL/kg/min were used. Hemodiafiltration using Dianeal 1.5% solution was used in each animal. Net fluid losses via ultrafiltration were replaced using lactated Ringer's solution. Three of six animals survived for the complete five-hour hemofiltration period. No marked disturbances in electrolyte serum concentrations, including hyperkalemia, were observed. BUN concentrations were reduced by 35% and creatinine by 26%. Variation of the dialysate flow rate did not influence clearance of either urea or creatinine. Instead, clearance appeared to be flow dependent, and it was markedly increased at flow rates greater than 15 mL/kg/min.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2769543 TI - In vivo transmural potential difference: an early monitor of rejection in small bowel transplantation. AB - To determine if serial measurements of transmural potential difference (TMPD) can serve as an early monitor of rejection in small bowel transplantation, three groups of rats were studied. The groups are defined as follows: (1) group 1, isolated loop (N = 5): 20 cm of distal jejunum was defunctionalized (Thiry-Vella loop); (2) group 2, isotransplant (N = 5): 20 cm of distal jejunum was isotransplanted between inbred Lewis rats, as a Thiry-Vella loop; the native bowel remained in continuity; (3) group 3, allotransplant (N = 8): allotransplantation as in group 2 but between outbred Sprague-Dawley rats. Using luminal and peritoneal electrodes, TMPD was measured serially every third day. Biopsies of the stoma were taken on the same days for histologic examination of rejection. Group 1 animals (isolated loop) did not show a significant decrease in TMPD from day 1 to day 20. Group 2 (isotransplant animals) had a significant decrease in TMPD as compared with group 1 on day 5 (P less than .01), but by day 8, TMPD returned to baseline. Biopsies in groups 1 and 2 showed no signs of rejection. Group 3 (allotransplant animals) showed a significant decrease in TMPD as compared with group 1 on day 5 (P less than .01). The severity of the histologic signs of rejection parallelled the TMPD decrease throughout the remainder of the study. Monitoring TMPD is a sensitive method of detecting early rejection in small intestine transplantation. PMID- 2769544 TI - Pancreatic disorders in infancy and childhood: experience with 92 cases. AB - Ninety-two children with pancreatic disorders were treated over a 10-year period. Thirty-three had blunt trauma, while 69 had medical, metabolic, or neoplastic diseases. Children with trauma had either duct disruption (3), gland fracture (4), or pseudocysts formation (26). Operation was required in 30. Pseudocysts were treated with observation alone in three cases, ultrasound-guided percutaneous aspiration in three, surgical external drainage in two, distal pancreatectomy in four, cyst gastrostomy in ten, and cyst-Roux-en-Y jejunostomy in six. Other disorders included pancreatitis (44), neoplasms (10), nesidioblastosis (4), and pancreaticosplenic abscess (2). Treatment for neoplasms included surgical excision in nine and biopsy in one (adenocarcinoma). Patients with nesidioblastosis underwent 95% (near total) pancreatic resection (two after previous unsuccessful 80% resection). Pancreatitis was familial in two cases, necrotizing in two, idiopathic in 11, and secondary to medications in six cases (steroids, 2; L-asparaginase, 4), gallstones in 17, and choledochal cysts in 6. Pancreatitis resolved after observation and conservative therapy in ten idiopathic cases, 4/6 medication-related cases, and following correction of biliary tract disease (15/17) or choledochal cysts (6). Pancreatic resection or drainage was required in the remaining cases. Pancreatic disorders can be accurately detected with computed tomography (CT) scan in most cases (excluding insulinoma). Ultrasound (US) is useful in cases of biliary tract disease and pseudocyst formation. Traumatic pseudocysts can resolve spontaneously or with US guided percutaneous drainage (in the presence of normal ducts). Children with neoplasms, abnormal pancreatic ducts, or recurrent pancreatitis require resection or appropriate drainage procedures. Overall survival was 95%. PMID- 2769545 TI - Malrotation of the intestines in children: the effect of age on presentation and therapy. AB - Because of the devastating consequences of midgut volvulus as a result of malrotation, we reviewed the charts of 70 consecutive children to define the spectrum of presentation. Although 27 patients (39%) had presenting symptoms within the first ten days of life, 35 (50%) were older than 2 months of age. In general, the older children had a longer course of vague, antecedent symptoms such as intermittent, nonbilious vomiting and chronic abdominal pain. Associated congenital anomalies were common, with 32 patients (46%) presenting with 56 anomalies, the most prevalent of which were intestinal atresia, imperforate anus, duodenal web, and cardiac and orthopedic anomalies. Upper gastrointestinal (GI) series revealed the diagnosis in 29 cases (41%), as did contrast enema in 24 (34%). It is important to note that volvulus, intestinal gangrene, and mortality occurred regardless of age or chronicity of symptoms. Fifteen patients (21%) were discovered serendipitously while being evaluated and treated for seemingly unrelated conditions. No morbidity of mortality occurred in those patients who underwent subsequent semielective Ladd's procedure. The majority of morbidity and all seven mortalities occurred in patients with volvulus and intestinal necrosis. This study emphasizes the need for consideration of Ladd's procedure for children of all ages. In addition, due to the broad range of initial symptoms, a high index of suspicion is required in evaluating children with possible malrotation. Because it remains impossible to predict which patients will have catastrophic complications (based on age or type of presentation), we urge that even incidentally discovered patients with intestinal malrotation undergo Ladd's procedure. PMID- 2769546 TI - Malignant mesenchymoma of the liver in children. AB - Four children, aged 5 to 13 years, were treated for malignant mesenchymoma of the liver. Two survived longer than 5 years with complete resection and adjuvant chemotherapy. Two children who had incomplete resection with microscopic residual mesenchymoma both had tumor recurrence and died of disease progression despite radiation therapy and chemotherapy. Although previous reports emphasize a poor prognosis for children with this tumor, our experience would indicate that long term survival can be achieved using complete surgical extirpation and adjuvant chemotherapy. PMID- 2769547 TI - Studies in fetal wound healing: I. A factor in fetal serum that stimulates deposition of hyaluronic acid. AB - Fetal wound healing without scar formations, fibrosis, or contracture might be accompanied by major differences in the wound extracellular matrix. The matrix of fetal wounds is rich in hyaluronic acid, a glycosaminoglycan found in high concentrations whenever there is tissue proliferation, regeneration, and repair. Although hyaluronic acid is a critical molecule for both embryonic development and wound healing, no factor has yet been identified that modulates hyaluronic acid in a consistent manner. We describe here a substance present in fetal sheep serum that stimulates hyaluronic acid synthesis by cultured fibroblasts. This glycoprotein factor appears to be ubiquitous, present in fetal sheep and bovine serum, reaching a peak in each at 40% of the way through gestation. This factor is also present in amniotic fluid. It might control hyaluronic acid deposition. In turn, hyaluronic acid, by creating an extracellular environment permissive for cell motility and proliferation, might be critical for fetal development. We suggest that the same sequence of events underlie the unique properties observed in fetal wound healing. PMID- 2769548 TI - Studies in fetal wound healing: II. A fetal environment accelerates fibroblast migration in vitro. AB - We have used an in vitro model of wound healing using scratches made in a confluent monolayer of fibroblasts. The effects of fetal calf and postnatal calf serum on the migration of fibroblasts were compared. Differences between fetal and calf serum-incubated fibroblasts grown on coverslips were observed within 15 minutes of exposure. Cells in fetal serum began to change both shape and orientation and to move into the trough created by the scratch. The fibroblasts incubated in fetal calf serum completely filled in the trough within 16 hours while those incubated in calf serum did not do so even after 24 hours. We estimate that, at any point, there was a 50% lag time in the migration of the fibroblasts in the presence of postnatal calf serum. This difference in migration and filling was not a function of mitogenesis; the mitogenicity of the two sera were comparable. The results suggest that fibroblast migration in vitro is accelerated by the fetal serum. A similar mechanism may occur in vivo and may underlie the ability of the fetal wound to heal more rapidly. PMID- 2769549 TI - Studies in fetal wound healing: III. Early deposition of fibronectin distinguishes fetal from adult wound healing. AB - Wound healing in the fetus proceeds through a series of steps that differ in the fetus and the adult. At each phase of this complex process, there is signaling between the tissue cells and the wound microenvironment, signals that are mediated by and through the extracellular matrix. We postulate that these signals occur earlier in fetal wounds, resulting in more rapid repair. To investigate this, we compared the first 24 hours of wound healing in the rabbit fetus and adult, using antibodies against key extracellular matrix macromolecular components: laminin, fibronectin, and type-specific collagens I, III, IV, and V. Fibronectin was the first matrix component to be deposited, and was visualized as early as four hours after fetal wounding and 12 hours after adult wounding. There was no evidence of new laminin or collagen deposition in either the fetal or adult wounds at any time point examined. The early deposition of fibronectin, a matrix adhesion molecule that provides a scaffolding for epithelial migration, may underlie the rapid reepithelialization observed in fetal wounds. PMID- 2769550 TI - Improved myocardial oxygen utilization following propranolol infusion in adolescents with postburn hypermetabolism. AB - The purpose of this study was to determine if propranolol (0.5 mg/kg and 1 mg/kg), administered intravenously (IV) at the height of the postburn hypermetabolic response, would decrease myocardial oxygen requirements, without adversely affecting overall oxygen delivery or total body oxygen consumption. To test this hypothesis, six nonseptic patients age 17 +/- 3 years with burns over 82% +/- 11% total body surface area were given propranolol with continuous hemodynamic monitoring. Propranolol was administered to these patients 20 +/- 15 days postburn. Two clinically derived indices of myocardial oxygen consumption, pressure-work index (PWI) and rate-pressure product (RPP), were used to estimate the energy expenditure of the working heart. Both PWI and RPP were significantly decreased from baseline after 0.5 mg/kg propranolol, 31% for PWI (P less than .001) and 30% for RPP (P less than .01). Similarly, a decrease from baseline was seen after 1.0 mg/kg propranolol, 32% for PWI (P less than .001) and 35% for RPP (P less than .01). Cardiac index (L/min/m2) demonstrated no significant change [7.4 +/- 1.1 (prepropranolol), 6.5 +/- 1.3 (after 0.5 mg/kg propranolol), and 6.8 +/- 1.0 (after 1.0 mg/kg propranolol)] and exceeded the upper limits of normal (hyperdynamic state) throughout the study. Oxygen delivery index (962 +/- 209 mL/min/m2) and oxygen consumption indices [(254 +/- 78 mL/min/m2 by Fick method and 236 +/- 78 mL/min/m2 by inspired and expired gases)] were elevated at baseline and unaffected by propranolol. The decrease in PWI and RPP was achieved mainly by propranolol's effect to lower both heart rate and BP.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2769551 TI - Resting energy expenditure in children following major operative procedures. AB - Resting energy expenditure (REE) is reported to increase by 24% in adults following elective operations; however, similar data are not available for children. We studied REE in 12 children (14 operative procedures) to test the hypothesis that children experience a similar rise in REE as adults following operation. The operations included endorectal pull-through, gastric resection, ileostomy closure, and other major abdominal procedures. REE was measured daily by indirect calorimetry using a computerized bedside metabolic cart. All subjects (7 males, 5 females; age range, 8 to 19 years; mean age, 14.7 years) were measured supine, in bed, and after an overnight fast. REE was expressed as kilocalories per unit body surface area (BSA) per day. In addition, respiratory quotient (RQ) was calculated for each patient. Contrary to adults, these children did not demonstrate a significant increase in REE following major operative procedures. Furthermore, there was no change in RQ postoperatively. These data demonstrate that children might have a different response to surgical stress than adults. We theorize that children are able to convert energy expended on growth to energy spent on wound repair and healing, thus avoiding the overall increase in energy expenditure seen in the adult population. PMID- 2769552 TI - Body fluid compartment changes following neonatal surgery. AB - The neonate is born with an excess of total body water (TBW) in the range of 75% to 85% of body weight (v 60% in the adult), which is due to a large extracellular fluid volume (ECF) of 40% to 50% of body weight (v 20% in the adult). In an attempt to define the changes that occur in TBW and ECF following neonatal surgery, the following prospective study was carried out. Twenty newborns with major congenital anomalies (gastroschisis, 10; esophageal atresia, 4; ileal atresia, 3; omphalocele, 2; and malrotation, 1) were studied weekly for 4 weeks following surgery while being maintained on a standard protocol of total parenteral nutrition (TPN). Total body water was measured using deuterium oxide, and extracellular fluid volume was assayed with sodium bromide; both were expressed as percent body weight (BW). Weight gain or maintenance was observed in all infants. TBW remained unchanged (from 85.4% to 83.0%), and ECF decreased from 51.2% to 36.7% during the observation period. The TBW in the ten gastroschisis infants decreased from 87.3% to 78.0% v the ten other newborns, in whom there was no change (84.0% to 85.0%). The ECF changes were more dramatic, decreasing from 51.6% to 32.3% in the gastroschisis infants, v 50.8% to 45.5% in the other neonates (P = .0156). There were no differences between the two groups in the intake and output of fluids. The following conclusions were drawn: (1) Following major surgery, newborns show a steady decrease in ECF and minimal change in TBW in spite of adequate weight gain while receiving TPN.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2769554 TI - Long-term stability and change in personality. PMID- 2769553 TI - A 40-year multinational retrospective study of 880 Swenson procedures. AB - This report reviews the experience of pediatric surgeons in seven cities in North American and Western Europe where the Swenson procedure was performed on 880 patients. Information on the diagnosis, treatment, complications, and long-term results was collected by reviewing the hospital records, the treating physicians' office records, and by interviewing the patients in person or by telephone. A follow-up evaluation was obtained on 814 patients. The patients' ages at the time of the resection ranged from four days to 50 years. The length of follow-up averaged 10.3 years, while the longest follow-up was 39.5 years. The overall postoperative mortality was 2.4% during the entire 40 years of the study. The postoperative mortality has decreased to 1.25% for the last 20 years. Significant factors influencing postoperative mortality included Down's syndrome, the patient's age at the time of the operation, and leak of the distal colonic anastomosis. Most of the patients followed for over 5 years have normal bowel habits, report one to three bowel movements per day, and have no soiling. No patient has urinary incontinence or impotence. PMID- 2769555 TI - Children's behavioral inhibition over age and across situations: genetic similarity for a trait during change. AB - Ratings of behaviors pertaining to inhibition were observed for 130 twins participating in a longitudinal study. Ratings were available for four ages (12, 18, 24, and 30 months) and from three sources at each age: direct observations obtained in a laboratory setting, direct observations obtained in conjunction with infant mental testing, and a temperament measure from a questionnaire completed by parents. For the individual twins, the age-to-age correlations were in the moderate range (.26 to .64). The situation-to-situation correlations were generally in the same range (.17 to .64). When the twins were recombined into twin pairs, within-pair (intraclass) correlations indicated that monozygotic (MZ) twins were more concordant than dizygotic (DZ) twins for each of the behaviors at each of the ages. Also, the MZ twins were more concordant for the direction and degree of behavioral change from age to age or from situation to situation. These data provide additional evidence for the biological influence on behavioral inhibition, a characteristic that has been studied in temperament and personality research. The results suggest that the trait of behavioral inhibition and a change in the trait are genetically conditioned. In addition, it is suggested that the concept of trait be expanded to include the person-centered biological regulation of change. PMID- 2769556 TI - Sociability and social withdrawal in childhood: stability and outcomes. AB - The stability and long-term correlates of both social withdrawal and sociability were investigated in a longitudinal study of normal children in kindergarten through the fifth grade. Both observational and peer assessment indices of withdrawal and sociability were considered; furthermore, a distinction was made between observed active versus passive solitude. Of particular interest was whether social withdrawal in early childhood was predictive of subsequent internalizing problems, as assessed by self-reports of social competence, overall self-worth, loneliness, and depression as well as teacher ratings of shy/anxious behavior, in later childhood. Results indicated a modest degree of stability for observed social withdrawal but not for observed sociability, nor for active or passive forms of solitude. Somewhat higher stability correlations were obtained for peer assessments of both sociability and withdrawal. In terms of predictive outcomes, significant relations were found between early social withdrawal in kindergarten and Grade 2 and subsequent internalizing problems in Grades 4 and 5, although the pattern of results was mixed. These data suggest that social withdrawal in early childhood may be predictive of risk for internalizing difficulties in later childhood. PMID- 2769557 TI - Early childhood antecedents of aggression and passive-withdrawal in early elementary school. AB - Early childhood antecedents of elementary school aggression and passive withdrawal were evaluated in a large longitudinal study (N = 191). With teacher ratings as outcome measures, a variety of predictor variables were selected from a comprehensive data base. Predictors were selected to represent several major factors: (a) a developmental history of insecure attachment and poor adjustment; (b) inadequate or hostile parental care; and (c) stressful or chaotic life circumstances. Support was found for the prediction of these behavior problems from early childhood measures (up to one third of the variance), with results varying with sex and outcome measure. Results were stronger for boys than girls, and stronger for aggression than for passive-withdrawal. Boys' outcome was strongly related to attachment classification at 18 months. It is suggested that these findings support Bowlby's view that early acquired "working models" of self and other affect later interpersonal functioning. PMID- 2769558 TI - Self-concepts, domain values, and self-esteem: relations and changes at early adolescence. AB - We assessed how children's self-concepts of ability for mathematics, English, social, and physical skills activities, ratings of the importance of these activities, and general self-esteem change across the transition to junior high school. Three types of change were assessed: change in mean levels, change in stability, and change in relationships. Twice each year during the sixth and seventh grades, 1,450 children completed questionnaires. Mean levels of children's self-esteem were lowest immediately after the transition, but recovered during seventh grade. Self-concept of ability and importance ratings for math and sports activities showed linear declines. Self-concept of ability for social activities showed a cubic trend, but importance ratings for social activities declined in a linear fashion. Children's self-concepts of ability for math and English became less stable across the junior high transition, whereas beliefs about other activities and general self-esteem were more stable in seventh grade. PMID- 2769559 TI - Combat experience and emotional health: impairment and resilience in later life. AB - War's influence on emotional health includes potential psychological gains as well as losses. In a sample of 149 veterans from longitudinal samples at the Institute of Human Development, University of California, Berkeley, this study explores two questions on the legacy of combat in World War II and the Korean conflict. The first concerns the subjective experience or meanings of combat that veterans hold in later life, with particular attention to how such accounts are linked to the severity of combat and postwar adaptations. The second question links these accounts to the psychosocial functioning of veterans before the war and in later life using reports from veterans and their spouses and Q-sort ratings in adolescence and at age 40. Findings center on veterans of heavy combat. Compared to the noncombatants and light combat veterans, these men were at greater risk of emotional and behavioral problems in the postwar years. In mid life, they hold mixed memories of painful losses and life benefits associated with military experience. Clinical ratings show that heavy combat veterans became more resilient and less helpless over time when compared to other men. As in the case of life events generally, short- and long-term effects may impair and enhance personal growth. PMID- 2769560 TI - Conceptual issues in studying continuity and discontinuity in personality development across life. AB - In this article, we argue that the continuity-discontinuity of personality development is not just an empirical issue, but is also a metatheoretical and theoretical issue. Stances taken in regard to one of three metatheories (or models)--the organismic, the mechanistic, and the developmental contextual- determine theoretical ideas about (a) the units of analysis thought to be relevant to personality development; (b) the processes believed to govern these units; and (c) whether changes in these units are continuous or discontinuous. Theories associated with the models also differ in regard to whether they describe and/or explain intra-individual personality changes as quantitatively or qualitatively continuous or discontinuous. Developmental contextual theories seek to identify the organismic and contextual conditions under which any instance of continuity-discontinuity occurs. These conditions involve both nomothetic and idiographic processes. Organism-context relations must be studied longitudinally in order to understand how these processes function across life. PMID- 2769561 TI - Continuities and consequences of interactional styles across the life course. AB - Behavior patterns can be sustained across the life course by two kinds of person environment interaction. Cumulative continuity arises when an individual's interactional style channels him or her into environments that themselves reinforce that style, thereby sustaining the behavior pattern across the life course through the progressive accumulation of its own consequences. Interactional continuity arises when an individual's style evokes reciprocal, sustaining responses from others in ongoing social interaction, thereby reinstating the behavior pattern across the individual's life course whenever the relevant interactive situation is replicated. Using archival data from the Berkeley Guidance Study (Macfarlane, Allen, & Honzik, 1954), we present evidence for the operation of these two continuity-promoting processes by identifying individuals who were ill-tempered, shy, or dependent in late childhood and then tracing the continuities and consequences of these interactional styles across the subsequent 30 years of their lives in the domains of work and family. The importance of the sociocultural context in mediating these continuities and consequences is stressed. PMID- 2769562 TI - Continuities and discontinuities in self-regulatory and self-evaluative processes: a developmental theory relating self and affect. AB - This article presents a developmental theory of the relation between self and affect. Self-discrepancy theory (Higgins, 1987) is used as a framework for considering developmental and individual differences in children's self-concepts, self-regulation, and self-evaluation. Developmental changes in children's representational capacities are described that produce developmental shifts in this self-system. Different modes of caretaker-child interaction are distinguished in terms of how features of the interaction impact psychologically on the child. The implications of these differences for children's self-system and emotional/behavioral vulnerabilities are discussed. The development of self regulatory and self-evaluative processes are distinguished with respect to developmental continuities and discontinuities. Patterns of sex differences in socialization, conduct, and emotional problems are described to exemplify the need for distinguishing these two processes developmentally. The question is raised whether children can be socialized to maximize the positive conduct valued by society and the positive self-regard valued by individuals. PMID- 2769563 TI - On the measurement of stability in over-time data. AB - In this article, autoregressive models and growth curve models are compared. Autoregressive models are useful because they allow for random change, permit scores to increase or decrease, and do not require strong assumptions about the level of measurement. Three previously presented designs for estimating stability are described: (a) time-series, (b) simplex, and (c) two-wave, one-factor methods. A two-wave, multiple-factor model also is presented, in which the variables are assumed to be caused by a set of latent variables. The factor structure does not change over time and so the synchronous relationships are temporally invariant. The factors do not cause each other and have the same stability. The parameters of the model are the factor loading structure, each variable's reliability, and the stability of the factors. We apply the model to two data sets. For eight cognitive skill variables measured at four times, the 2 year stability is estimated to be .92 and the 6-year stability is .83. For nine personality variables, the 3-year stability is .68. We speculate that for many variables there are two components: one component that changes very slowly (the trait component) and another that changes very rapidly (the state component); thus each variable is a mixture of trait and state. Circumstantial evidence supporting this view is presented. PMID- 2769564 TI - Patterns of personality consistency and change from childhood through adolescence. AB - Consistency and change in personality development is typically studied through examination of correlations indexing the consistency of individual differences over time. Despite well-known difficulties which inherently limit this approach, few empirical efforts take advantage of alternative methods. We utilize a "person centered" approach which permits separate and independent measurement of consistency and change for each person studied. Such measures were obtained covering four intervals between ages 3 and 18 in a longitudinally studied sample. These analyses and subsequent results extend and elaborate earlier results reported in Lives through Time (Block, 1971). It is apparent that there are wide individual differences in the degree of personality consistency and change manifested by subjects, and that the degree and timing of change permit the description of various different developmental trajectories. These pathways are described and compared to results obtained by Block (1971). This research is intended as an illustration of the possibilities obtained through person-centered approaches to the study of personality consistency and change. PMID- 2769565 TI - Life history prototypes in the study of human individuality. AB - Using biographical data collected in late adolescence and young adulthood, prototypes or subgroups of individuals with similar patterns of prior behaviors and experiences were empirically identified. The prototypes are described, and the pathways taken by the prototypes from adolescence to adulthood are examined. Focusing on the various pathways or trajectories followed by different prototypes, we discuss implications of prototype membership for continuity and change in personality. PMID- 2769566 TI - Melatonin profile in marmots: the influence of catecholamines, hibernation, and light. AB - The aim of this study was to determine the effects of circulating catecholamines and light on the daily melatonin rhythm in the marmot. Endogenous levels of circulating catecholamines and plasma melatonin were measured during arousal from hibernation in light and studies were performed on the circadian melatonin rhythm in two photoperiods (LD 4:20 and LD 8:16). In addition, studies were done on the capacity of broad-band white light at normal room intensities (32 muW/cm2 or 108 Ix) and of low-intensity monochromatic green light (500 nm; 1.4muW/cm2 or 3.1 Ix) to suppress high nocturnal melatonin levels. We conclude that high levels of plasma catecholamines that occur during arousal from hibernation do not influence the production and secretion of pineal melatonin. During the nocturnal portion of its light/dark cycle, the marmot plasma melatonin rhythm is suppressed by both white light and low-intensity green light. PMID- 2769567 TI - Presence of a distinct 24-hour melatonin rhythm in the ventricular cerebrospinal fluid of the goat. AB - Melatonin profiles in the cerebrospinal fluid (CSF) of conscious goats were examined under long-day (16L:8D) and short-day (8L:16D) environments. CSF melatonin, collected from the lateral ventricle, showed distinct 24 h rhythms with high concentrations being restricted to the dark phase, which averaged 1,320.6 pg/ml under 16L:8D and 660.6 pg/ml under 8L:16D. On the contrary, the nocturnal rise in CSF melatonin was totally absent in the pineal sympathetically denervated animals. Night interruption by 1 h lighting (about 400 lux at the height of goat's head) resulted in an abrupt decline of CSF melatonin to the basal level within 30 min and immediate recovery to the previous high level after reestablishment of the dark phase. The CSF/plasma ratio was 10.8-18.4 during the dark phase and 1.7-1.8 during the light phase. CSF and plasma melatonin levels were also examined after exogenous melatonin given either peripherally or intraventricularly. Continuous subcutaneous infusion of melatonin (5 micrograms/h) maintained melatonin levels in the plasma about 3 times higher than that in the CSF during its application. On the other hand, an intraventricular injection of 2 micrograms melatonin elevated plasma melatonin by 100 pg/ml within 1 min. These results indicate that turnover of CSF melatonin is fairly rapid and favor a hypothesis for direct access of pineal melatonin to the brain ventricular system in the goat. PMID- 2769568 TI - Melatonin-induced suppression of human lymphocyte natural killer activity in vitro. AB - One of the important immune functions influenced by neuroendocrine factors is natural killer (NK) activity, which is directed against neoplastic and virus infected cells. The effects of melatonin (Mel) and N-acetylserotonin (NAc-5HT) on NK activity of human peripheral blood lymphocytes were investigated. Leukocytes of healthy human subjects were used in the experiment. NK activity was estimated by measurement of radioactive chromium (51Cr) release from human leukemia cells K 562 (target cells). The previous exposure of human lymphocytes (effector cells) to Mel in concentrations of 10(-6) M and 10(-10) M resulted in an inhibition of NK activity (P less than 0.01) for all the examined effector-target cell ratios (10:1; 20:1, 40:1). NK activity was also suppressed by Mel (10(-8) M), but only if effector-target ratio equal to 20:1 was used (P less than 0.02), and by Mel (10(-12) M) for effector-target ratio equal to 40:1 (P less than 0.05). In none of the examined concentrations did NAc-5HT inhibit NK activity of human lymphocytes. On the basis of the data reported above, a direct suppressive effect of Mel (but not of NAc-5HT) on NK activity of human peripheral blood lymphocytes can be assumed. PMID- 2769569 TI - Neonatal melatonin administration advances rat vaginal opening and disrupts estrous cyclicity and estrogen-dependent regulatory mechanisms of luteinizing hormone and prolactin. AB - Melatonin (100 micrograms/rat) was administered to female rats on day 5 of life, 3 hours prior to the onset of darkness or at 12:00 hours. Melatonin administration induced precocious puberty in both cases, as indicated by the advance of the time of the vaginal opening and the appearance of the first estrous smear as compared with controls (P less than 0.01), together with an increase in the number of estrous smears (P less than 0.05) and a reduction in the number of diestrous smears (P less than 0.05). Decreased serum prolactin levels were observed on day 21 of age (P less than 0.05) in melatonin-treated rats with both of the melatonin injection times as compared with controls. No differences were apparent in basal luteinizing hormone (LH) levels either at 30 or at 60 days of age comparing melatonin- and vehicle-treated rats with either of the scheduled melatonin injection times. As to serum follicle-stimulating levels (FSH) levels, there was a marked decrease in circulating FSH levels in melatonin treated rats in both cases on days 21, 30, and 45 (P less than 0.05) as compared with controls. A marked increase of serum prolactin at both 48 and 55 hours after estradiol benzoate (EB) administration was detected in 30-day-old melatonin treated rats as compared with controls (P less than 0.05 for both points). Also, an increased responsiveness of prolactin to EB was found on the first day post administration. At 60 days of age, an increase in prolactin responses to EB was observed on the first day post-administration (31 and 48 hours after, (P less than 0.01), whereas no differences were detected at any other studied time. The LH burst that occurs 31 hours after EB administration in 30-day-old rats was decreased in melatonin-treated animals as compared with controls (P less than 0.05). In 60-day-old melatonin-treated rats, a marked increase in the LH response to EB administration, 31 hours after injection (P less than 0.01), was observed. These data suggest that neonatal melatonin administration in pharmacological amounts induces precocious puberty as measured by vaginal opening and, furthermore, it advances the appearance of the first estrous smear with age dependent modifications of estrous cyclicity and prolactin and LH responses to EB. PMID- 2769570 TI - Melatonin response to exercise training in women. AB - Previous human studies have indicated that daytime melatonin levels increase when the organism is subjected to the stress of fasting and exercise. Melatonin, epinephrine, and norepinephrine levels were measured during a mock run and in the course of treadmill exercise performed before (T-1), during (T-2), and following (T-3) a progressive conditioning (running) program. Hormonal responses to the training program were determined by comparing values at T-1 and T-3. Plasma melatonin, epinephrine, and norepinephrine levels rose significantly (P less than .01) from baseline values for each exercise intensity during all three treadmill runs. While a dose-response trend was observed in each of the norepinephrine and epinephrine trials, there appeared to be a progressive diminution of this relationship in melatonin between intensities. Further, as training progressed, the peak melatonin concentration was decreased by 52% from T-1 to T-3, while peak epinephrine and norepinephrine values diminished only 19% and 8%, respectively. These results suggest that vigorous exercise training may attenuate rather than augment the secretion of pineal melatonin. Development of a human model of pineal responsiveness to exercise may contribute to the elucidation of exercise associated reproductive disorders. PMID- 2769571 TI - Melatonin content of the pineal gland in different mouse strains. AB - Pineal melatonin content at several times during the day and night was measured in 36 inbred strains of mice (Mus musculus) kept under LD 12:12 cycles. The results have indicated that only five inbred strains have pineal melatonin content, with higher levels during the night and lower levels during the day; the other 31 strains do not contain detectable melatonin in their pineal gland at any of times examined. The former group includes two commonly used strains (C3H/He and CBA/Ms) and three wild-derived strains (Mol-A, Mol-Nis, MOM). C3H and CBA mice showed a similar pattern of pineal melatonin rhythm with a peak at 2 hours before lights on. The peak levels were about 150 pg/gland in both strains. The rhythmic patterns of melatonin content in Mol-A, Mol-Nis, and MOM were slightly different from those in CBA and C3H. In the wild-derived strains, the peak of melatonin content did not occur at 2 hours before lights on but tended to occur at midnight. The peak levels were 67-91 pg/gland at the highest point in these strains. PMID- 2769572 TI - Antigonadal activity of the melatonin analogs 2-iodomelatonin and 2 chloromelatonin in the juvenile Djungarian hamster, Phodopus sungorus campbelli. AB - The antigonadal effects of daily (20 micrograms, s.c.) injection of melatonin and two analogs, 2-iodomelatonin and 2-chloromelatonin, were compared in juvenile Djungarian hamsters housed under long photoperiod (L:D 16:8). Melatonin, 2 iodomelatonin, and 2-chloromelatonin injected 3 h before lights off for 16 days (17-34 days of age) significantly inhibited testis growth compared to vehicle injected hamsters. In addition, melatonin and both analogs significantly reduced body weight gain. These 2-substituted analogs appear to be melatonin agonists with a potency in vivo similar to the parent compound, melatonin. PMID- 2769573 TI - Effect of pinealectomy, eye enucleation, and melatonin treatment on ovarian activity and vitellogenin levels in the catfish exposed to short photoperiod or long photoperiod. AB - To investigate the relative importance of pineal, and eyes, and melatonin treatment on ovarian activity, catfish. Heteropneustes fossilis subjected to pinealectomy, eye enucleation, or both were exposed to short (LD 9:15) or long (LD 14:10) photoperiod during the different stages of the annual reproductive cycle. During the preparatory period, pinealectomy accelerated ovarian recrudescence under long photoperiod, but no effects of pinealectomy were observed under short photoperiod. Pineal has no influence on ovarian activity during the prespawning and spawning periods of the reproductive cycle. In the late postspawning period, ovarian recrudescence is accelerated after pinealectomy in catfish maintained under short photoperiod (LD 9:15 at 25 degrees C). But under long photoperiod (LD 14:10 at 25 degrees C), pinealectomy delayed ovarian recrudescence. An investigation into the role of the eyes revealed that eye enucleation nullifies the inhibitory effects of LD 9:15 and represses the stimulatory effects of LD 14:10. Combined surgery inhibited ovarian development under both the regimes. It is significant that pinealectomy and/or blinding neither counteracted nor delayed the postspawning ovarian regression. The findings suggest that the role of the pineal in catfish reproduction is variable and depends upon the photoperiod to which they are exposed as well as on the time of the year and the stage of the reproductive cycle. It is concluded that extraretinal and extrapineal photoreceptors also are involved in influencing seasonal reproduction. Further, no effects of melatonin treatment on ovarian activity or on vitellogenin levels during the preparatory or prespawning periods were observed, indicating that the pineal effects on gonadal activity in catfish may not be mediated through the secretion of melatonin. PMID- 2769574 TI - Free living elderly. PMID- 2769575 TI - A nutrition education workshop for managers of nutrition centers for the elderly utilizing videotaped simulations for assessment. AB - As funds become increasingly scarce, an effective nutrition education method which reaches large numbers of elderly individuals is appropriate. A nutrition workshop was provided for 30 managers of government-sponsored nutrition centers for the elderly in a 5-county area. The workshop curriculum, determined after interests of both center managers and participants at the nutrition centers were assessed, was presented in a packet of materials to each workshop attendee and supplemented with explanations and demonstrations. A pre- and post-test evaluation instrument, which included videotaped simulations of typical nutritional situations encountered with elderly persons at the centers, was used to measure attitudes and knowledge before and after the workshop. As a result of the workshop, knowledge increased significantly as measured by the test instrument and 75% of the managers reported use of materials and ideas during the 5 months following the workshop. PMID- 2769576 TI - Predictors of nutrition supplement use in the elderly. Part II: The role of beliefs, attitude, subjective norm and intention. PMID- 2769577 TI - Predictors of nutrition supplement use in the elderly. Part I: A review of the literature. PMID- 2769578 TI - The relationship between a nutrition education program and nutrition knowledge and eating behaviors of the elderly. AB - An experimental study was conducted to examine the relationship between a nutrition education program and nutrition knowledge and eating behaviors of older adults. Twenty-four subjects were randomly assigned to an experimental or a control group. Prior to any intervention, all subjects completed a demographic data sheet, a 25-item True/False questionnaire and a 24-Hour Dietary Recall interview. The experimental group attended four one-hour nutrition education classes over a two-week period. Following the educational intervention, both groups of subjects again completed the True/False questionnaire and the 24-Hour Dietary Recall interview. Controlling for pretest, posttest differences on the two dependent variables were tested using repeated measures analysis of variance. No significant differences were found between the two groups. PMID- 2769579 TI - Nutrient intakes of a group of independently-living elderly individuals in Toronto. AB - A cross-sectional survey of an age-stratified random sample of 619 independently living adults (307 males, 312 females) aged 60 years and over, living in Toronto was conducted. Detailed dietary data was collected from three sets of 3-day food records. The mean energy and nutrient intakes appeared to be adequate. However the energy intake of many participants was low, while their fat intake was high. The nutrients of concern for inadequate intakes were calcium, vitamin D and vitamin A. Intakes of zinc, vitamin C and protein were low for a smaller group. Nutrition education is recommended to provide guidance for choosing healthy diets. PMID- 2769580 TI - Attitudes of rural and urban elderly concerning supplement use. AB - To examine supplement purchase practices and attitudes toward supplements of rural and urban elderly, two questionnaires were designed. One questionnaire included demographic questions, an attitude scale, and questions concerning supplements purchases and sources of information about nutrition. The second questionnaire contained an advertisement about calcium supplements followed by questions regarding means to "improve calcium" and health concerns. The rural elderly had a significantly lower mean education level and a significantly higher number of misconceptions. The average expenditures on supplements were $52.00 per month for the total group and sources of information were media, physicians, family and friends. In response to the advertisement, nearly one-third of the respondents reported that they would be unlikely to take calcium supplements to improve calcium even though 86.7% stated they would take calcium supplements to prevent health problems and 51.7% believed there could be dangers in taking calcium supplements. The most commonly reported means to improve calcium were to increase milk and to eat cheese (86.7% each). Contradictions in the responses may indicate that these elderly are susceptible to advertising implying supplements are needed to prevent health problems. PMID- 2769581 TI - Acetylsalicylic acid dose fails to affect energy intake of osteoarthritic elderly. AB - The objective of the study was to determine the effect on energy intake and appetite of acetylsalicylic acid (ASA), commonly used by the elderly to treat arthritis. In a double blind cross-over study, 23 free-living osteoarthritic patients 60 years of age or older were treated for two-weeks intervals with a mean daily ASA intake of 2.44 and 1.29 grams, respectively. Twenty healthy persons similar in age, taking no medication, and matched in sociocultural characteristics were included as a control group. Appetite was measured directly, using a visual analogue scale, and indirectly by calculating energy intake from three-day food records. Varying the dose of ASA was without effect on appetite and food energy intake; however, as appetite was rated lower by the medicated osteoarthritic than by the healthy group, although the energy intakes were not significantly different, the former should be considered as potentially at nutritional risk. PMID- 2769582 TI - The Human Nutrition Research Center on Aging. PMID- 2769583 TI - The value of undergraduate electives for recruitment in psychiatric and mental health nursing. AB - The current nursing shortage has focused attention upon the need for the recruitment and retention of nursing students, as well as practitioners, to increase the available supply of nurses. Specialties such as psychiatric nursing which historically have not attracted a large percentage of graduates are at particular risk for nurse shortages. The nursing literature of the past 15 years has demonstrated that undergraduate electives have served to interest students in particular areas of nursing. The experience of one baccalaureate nursing program which used a grant to institute electives for recruitment into employment and graduate study is described in this article. PMID- 2769584 TI - Mentally ill mothers of young children. Analysis of in-patient chart reviews. AB - When a mother is hospitalized for psychiatric treatment, nurses are presented with an opportunity to assess parenting disorders and identify early parent-child disturbances. The purpose of this article is to discuss the parenting issues recorded in 21 charts of hospitalized, mentally ill mothers who had a child less than 6 years old. Based on this chart review, three themes related to parenting young children emerged: (1) how psychiatric symptoms affected the mother's ability to parent her children; (2) the difficulty the mother had finding the energy to care for her children; and (3) the mother's need to be with her children in spite of her difficulty caring for them. None of the charts contained assessments of the quality of the mother-child relationship or the mother's ability to resume her maternal role following discharge. The implications of these findings for nursing practice, education and research are discussed. PMID- 2769585 TI - Simultaneous parent and child post-discharge groups. PMID- 2769586 TI - Portrait of Jan: multifactor assessment and intervention with a depressed adolescent. PMID- 2769587 TI - Diagnoses for child and adolescent psychiatric nursing. Combining NANDA and the DSM-III-R. AB - The classification system of the North American Nursing Diagnosis Association and a revised axial system, such as appears in the DSM-III, offer a solution to combining nursing and psychiatry in the practice of child and adolescent psychiatric nursing. A historical perspective of the major diagnostic systems in nursing and psychiatry help focus on alternatives toward developing a meaningful method of diagnostic-based intervention. PMID- 2769588 TI - A school-based primary prevention group for children with alterations in health status. AB - The implementation of primary prevention measures for the positive mental health of children has been identified by psychiatric nursing leaders as a priority for child psychiatric nurses. Promoting positive mental health behaviors in school aged children is facilitated by establishing a helping relationship within the context of small-group activity situated in the child's natural school setting. The authors describe the theory and process of establishing a time-limited, closed group in a school setting, for 10 children who were experiencing some alteration in health status. PMID- 2769589 TI - Children and the elderly. PMID- 2769590 TI - Gardening as therapy for children with behavioral disorders. AB - A gardening program was implemented by the nursing staff for in-patients on a children's psychiatric unit. By establishing and maintaining the garden and participating in garden group discussions, patients practiced teamwork, coped with delays in gratification, studied life cycles and discussed topics of therapeutic significance. The success of this program provides anecdotal evidence for the efficacy of gardening as a supplemental therapy for children with behavioral disorders. PMID- 2769591 TI - Autism: psychobiological perspectives. AB - The purpose of this article is to discuss the syndrome of autism and review current research findings related to this disorder. Emphasis is placed on autism as a disorder of brain function. In this context, theory and treatment approaches, including new pharmacological interventions, are explored. Implications for nursing practice also are discussed. PMID- 2769592 TI - America's invisible children need visible services: an executive view. PMID- 2769593 TI - Establishment and characterization of an epithelial cell line from the rat submandibular gland. AB - An epithelial cell line, RSMTx, has been established from the submandibular gland of weanling Fisher 344 rats by treatment of explanted tissue clumps with 3 methylcholanthrene. These cells exhibit a polygonal shape on light microscopy and a polar appearance, with desmosomes, terminal bar-like structures, surface microvilli and cytoplasmic interdigitations, when examined by electron microscopy. The cells react positively with an antiserum to cytoskeletal keratin, and a commercial monoclonal antibody to an "epithelial membrane antigen." An antiserum, prepared against early passage cells in hamsters, reacts primarily with ductal elements in tissue sections of submandibular gland, as does an antiserum prepared in mice with late passage cells. The cells are easily passaged and have been maintained for more than two years in continuous culture. PMID- 2769594 TI - Cell culture and characterization of human minor salivary gland duct cells. AB - In order to facilitate studies on human salivary glands, a method was developed for the culture of minor salivary gland duct cells from tissues obtained from oral surgery protocols. Minor salivary glands were isolated from such tissues, and a serum-free growth medium was developed which supported the growth of the ductal component of these glands. The ductal origin of these cells was confirmed through immunohistochemical localization of replicating nuclei through incorporation of BrdU. The presence of epidermal keratin in replicating cells and the absence of smooth muscle myosin further substantiated the ductal origin of cells. Using normal growth medium calcium concentrations (1.05 mM), these cells produced a keratinized multilayer of cells unable to undergo routine subculture procedures. A reduction in calcium ion concentration to 0.1 mM resulted in a cell monolayer, without evidence of terminal keratinization, which could undergo at least eight serial passages (1:3 ratio) under cell culture conditions. It is advanced that these minor salivary gland duct cell cultures will be of use to those studying diseases and disorders of the salivary glands. PMID- 2769595 TI - Effects of systemic administration of nicotine on capillaries in rat oral mucosa. AB - This study examined the reaction of the local vasculature of the oral mucosa in 16 Sprague Dawley rats receiving systemic nicotine delivered (1.5 mg/kg/day) via subcutaneous minipumps for 24 h or 2wk. Control animals received saline. After treatment animals were killed and biopsies taken from palate, maxillary gingiva and buccal mucosa, frozen and cryostat sections incubated to demonstrate alkaline phosphatase, which is a capillary marker. The total length of the capillary fragments in the nicotine treated groups was significantly less than of the control group. There was also a decrease in capillary height in both of the nicotine groups when compared to the control animals. This study indicates that morphologic alterations occur in the microvasculature of the oral mucosa following systemic nicotine administration. This may have implications for the role of chronic tobacco use in the etiology of oral mucosal disease, including periodontal disease. PMID- 2769596 TI - Awareness and acceptance of the hepatitis B vaccine by dental practitioners in Malaysia. AB - A postal survey of 730 Malaysian dental practitioners was undertaken to assess their awareness and acceptance of the plasma derived hepatitis B vaccine. Only 32% of the 325 practitioners who responded had been vaccinated, 41% intended to be and 15% categorically refused vaccination. The main reservations about vaccine acceptance were fear of side effects including AIDS, cost of the vaccine and lack of information. Vaccine efficacy was not confirmed by serology in two-thirds of the vaccinees and two-fifths of the respondents were unaware that 5% of the vaccinees do not develop a successful antibody response after vaccination. Seventy-eight percent of dentists believed that their risk of contracting hepatitis B was high or very high while 71% recalled having received needle stick injuries in the 3 yr prior to the survey. Only 13% of respondents were aware of delta hepatitis while 63% were aware of non-A non-B hepatitis. The survey has highlighted the need for dissemination of information on hepatitis B vaccine among dentists in Malayasia. PMID- 2769597 TI - Cyclosporine-induced gingival overgrowth in beagle dogs. AB - Development of gingival overgrowth during daily long-term cyclosporine A treatment was studied in 2-yr-old beagles. Gingival enlargement developed in five of 12 dogs (42%), primarily in the mandibular anterior area. The earliest gingival changes occurred by 3 wk as an increase in the size of the interdental papillae. The lesions progressively became more severe, in some cases obscuring portions of teeth by wk 6. The redundant tissue exhibited an increase in connective tissue components and an inflammatory infiltrate primarily of plasma cells. Severity of the overgrowth varied in responding animals; both incidence and severity were related to the CSA concentration in blood. The mean CSA blood levels of responders were significantly greater than nonresponders at wk 3, 6 and 10. Since beagles develop gingival overgrowth similar to humans, they provide an excellent model to investigate the roles of local and systemic factors in the induction of gingival overgrowth. PMID- 2769598 TI - Replacement of Langerhans cells in murine palate. AB - Palates from C3H mice were implanted onto prepared graft beds in histocompatible F1 hybrid mice. Biopsies taken 1, 2, 4, 8, and 16 wk later were prepared to demonstrate Langerhans cells (LC) of C3H and F1 (host) origin. After 1 wk only occasional LC (all of C3H origin) were present. By 2 wk total LC numbers had increased to a level approximately 50% greater than in control (non-implanted) palate, with most of this increase due to C3H LC proliferation. From 4 through 16 wk total LC numbers were not significantly different from those of control palate. During weeks 2 through 16 the percentages of LC of F1 origin were 31, 70, 39, and 19% respectively. These results indicate an increased proliferation of C3H LC with an initial migration of F1 LC which stops as C3H LC numbers increase. PMID- 2769599 TI - Epithelial-myoepithelial duct carcinoma of salivary glands: a follow-up and cytophotometric study of 21 cases. AB - The Salivary Gland Registry provided 21 cases of epithelial-myoepithelial duct carcinoma of salivary glands from 1965-1980 which were evaluated retrospectively for clinical follow-up and cytophotometric data; 81% were localized in the major, 19% in the minor salivary glands. The male:female ratio was 1:1.1, 10 patients (47.6%) being men and 11 (52.4%) women. The youngest patient was 27, the oldest 91 y old. The mean age was 59.3 y (overall), 57.9 y (women) and 61.0 (men). The clinical course was characterized by lymph node metastases present at initial diagnosis and local recurrences in 23.5%. No patient died of the tumor. In 12 cases, cytochemical assessment of nuclear DNA by means of single cell scanning cytophotometry yielded diploid histograms. According to clinical and cytophotometrical data, epithelial-myoepithelial duct carcinoma of salivary glands can be regarded as a proper tumor entity of low grade malignancy. PMID- 2769600 TI - A highly sensitive method for diagnosis of secondary amyloidosis by labial salivary gland biopsy. AB - Both labial salivary gland and gingival biopsies were taken from 19 patients with clinical findings suggestive of secondary amyloidosis. Amyloid deposits were present in all salivary gland biopsies (19/19) while amyloid deposits in gingiva were observed only in three cases (16%). No amyloid was found in similar biopsies from 11 control patients. Periductal amyloid involvement was found along the basement membrane in all salivary gland samples; additionally, 16 cases had periacinar infiltration (84%), 13 had perivascular (68%) and 7 (37%) showed interstitial deposits. Amyloid in gingiva was seen along the epithelial basement membrane, as in salivary glands, although in isolated areas and scattered at the top of some dermal papillae and small blood vessels. In secondary amyloidosis it therefore appears that amyloid is deposited along the epithelial basement membrane before perivascular deposition occurs. This study presents a new highly sensitive and reliable method for the diagnosis of secondary amyloidosis, a method which is technically simple, free from complications and well-accepted by the patients. PMID- 2769601 TI - [Somatotopic representation of climbing fiber projections from limb cutaneous afferents to the paramedian lobule of the cat cerebellum]. AB - Climbing fiber projections to the cerebellar paramedian lobule were investigated electrophysiologically by stimulation of bilateral superficial radial nerve (SR) and superficial peroneal nerve (SP) in the cat anesthetized with pentobarbitone. In the medial zone of the paramedian lobule, short latency climbing fiber responses to stimulation of the ipsilateral SR were recorded rostrally from the top caudal part of the intermediate folia and short latency responses to stimulation of the ipsilateral SP were obtained caudally from the bottom caudal part of the folia. In the central zone, long latency responses to stimulation of the bilateral SR and SP were obtained. "Four limbs area" in which these responses were recorded was 1.0-1.2 mm in width. Short latency responses to stimulation of the ipsilateral SR were observed rostrally from this area, and short and long latency responses to stimulation of the ipsilateral SP were distributed caudally from this area. In the lateral zone, short and long latency responses to stimulation of the ipsilateral SR were recorded rostrally from the rostral part of the intermediate folia, and long latency responses to stimulation of the ipsilateral SP were observed caudally from the caudal part of the folia. In the most lateral zone, short and long latency responses to stimulation of the ipsilateral SR were obtained rostrally from the rostral part of the intermediate folia, and long latency responses to stimulation of ipsilateral SP were recorded only in the bottom caudal part of the folia caudally from the caudal part of the folia. PMID- 2769602 TI - The fine structure of secretion by Plasmodium knowlesi merozoites during red cell invasion. AB - The secretory organelles of Plasmodium knowlesi were studied ultrastructurally to examine their mode of action during invasion. The formation of lamellar structures in merozoite rhoptries within late stage schizonts is prevented by the protease inhibitors chymostatin and leupeptin. Under normal conditions vesicles lined by 6-nm membranes are formed in rhoptries during erythrocyte invasion. Stereoscopic viewing of tilted sections shows that where the merozoite apex contacts the parasitophorous vacuole (PV) membrane during invasion, a domed elevation of the PV surface lies within the mouth of the rhoptry duct in contact with the secretory matrix. The membrane of the early invasion pit is thinner (6 nm) than the red cell membrane elsewhere, and sheets of lamellar material are frequently present on the invasion pit surface. These findings support the proposal that the rhoptry-microneme complex is capable of generating membranous material and inserting it into the red cell surface in a controlled manner to create the parasitophorous vacuole. On the basis of this model, measurements from serial sections show that the rhoptries could provide enough material to create a membrane lining the parasitophorous vacuole, and, with the contribution of the microspheres, could double it to accommodate the early ring stage of the parasite. PMID- 2769603 TI - Analysis of Paramecium macronuclear DNA using pulsed field gel electrophoresis. AB - We have analyzed the macronuclear DNA of Paramecium tetraurelia using orthogonal field-alternation gel electrophoresis. The mean size of the linear macronuclear DNA molecules is approximately 450 kb. Less than 6% of the macronuclear DNA is larger than 800 kb. Using pulse times of 20, 40, 60 and 90 s we show that the macronuclear fragment containing the A type variable surface antigen gene migrates reproducibly as a 320-kb linear DNA. Over the same pulse times we describe the unusual migration of the ribosomal RNA gene (rDNA) of P. tetraurelia. At pulse times of 20 and 40 s the rDNA migrates at limit mobility (300 and 500 kb, respectively) whereas with 60- and 90-s pulse times, 2 components of rDNA are observed; 1 fraction independent of pulse time migrating at limit mobility, and a 2nd component migrating between 100-kb and 400-kb linear markers. Based upon previous electron micrographic studies of Paramecium rDNA as well as data presented here we conclude that the majority of Paramecium rDNA molecules are a circular DNA form. PMID- 2769604 TI - Coccidiosis in Sudanese camels (Camelus dromedarius): 1--First record and description of Eimeria spp. harboured by camels in the eastern region of Sudan. AB - Coccidial oocysts were detected in 40 (17.4%) out of 230 faecal samples obtained from camels in the Eastern Region of Sudan during June 1985-June 1986. These oocysts were identified as Eimeria rajasthani, Eimeria dromedarii and Eimeria cameli. A detailed description of sporulated oocysts is given in this study and variations from previous authors' findings are discussed. PMID- 2769605 TI - Differentiation, multiplication and control of bloodstream form Trypanosoma (Duttonella) vivax in mice. AB - The growth and differentiation of Trypanosoma vivax was studied in intact and irradiated C3H/He and C57Bl/6 mice. In irradiated (800 R) or intact C3H/He and irradiated (800 R) C57Bl/6 mice, T. vivax parasitaemia increased rapidly then entered a plateau phase and thereafter declined in an antibody-independent remission phase. Throughout the infection, variations were observed in parasite morphology, density, DNA content, number of organisms with 2 nuclei and 2 kinetoplasts and infectivity of parasites for mice. Parasites in exponential phase had the highest number of members in the S, G2 and M phases of the cell cycle as determined by staining with the interchalating dye Chromomycin A3 and analysis on a flow cytometer. During this phase there were numerous parasites with 2 nuclei and 2 kinetoplasts and infectivity was high for mice. As the parasitaemia approached and entered the plateau phase, the proportion of organisms in the S, G2 and M phases of the cell cycle as well as the number of those with 2 kinetoplasts decreased slightly; the number of organisms with 2 nuclei decreased rapidly; and parasites had a considerably reduced capacity to infect mice. Organisms from the remission phase contained only 1 nucleus and 1 kinetoplast and were not infective for mice. The study suggests that T. vivax organisms transit from dividing to committed non-dividing forms and that some non diving, non-infective T. vivax organisms remain trapped in the S, G2 and M stages of the cell cycle and die without completing binary fission.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2769606 TI - Physiology and morphology of projection neurons in the antennal lobe of the male moth Manduca sexta. AB - 1. We have used intracellular recording and staining, followed by reconstruction from serial sections, to characterize the responses and structure of projection neurons (PNs) that link the antennal lobe (AL) to other regions of the brain of the male sphinx moth Manduca sexta. 2. Dendritic arborizations of the AL PNs were usually restricted either to ordinary glomeruli or to the male-specific macroglomerular complex (MGC) within the AL neuropil. Dendritic fields in the MGC appeared to belong to distinct partitions within the MGC. PNs innervating the ordinary glomeruli had arborizations in a single glomerulus (uniglomerular) or in more than one ordinary glomerulus of one AL (multiglomerular) or in one case, in single glomeruli in both ALs (bilateral-uniglomerular). One PN innervated the MGC and many or all ordinary glomeruli of the AL. 3. PNs with dendritic arborizations in the ordinary glomeruli and PNs associated with the MGC typically projected both to the calyces of the ipsilateral mushroom body and to the lateral protocerebrum, but some differences in the patterns of termination in those regions have been noted for the two classes of PNs. One PN conspicuously lacked branches in the calyces but did project to the lateral protocerebrum. The PN innervating the MGC and many ordinary glomeruli projected to the calyces of the ipsilateral mushroom body and the superior protocerebrum. 4. Crude sex-pheromone extracts excited all neurons with arborizations in the MGC, although some were inhibited by other odors. One P(MGC) was excited by crude sex-pheromone extract and by a mimic of one component of the pheromone blend but was inhibited by another component of the blend. 5. PNs with dendritic arborizations in ordinary glomeruli were excited or inhibited by certain non-pheromonal odors. Some of these PNs also responded to mechanosensory stimulation of the antennae. 6. The PN with dendritic arborizations in the MGC and many ordinary glomeruli was excited by crude sex-pheromone extracts and non-pheromonal odors and also responded to mechanosensory stimulation of the antenna. PMID- 2769607 TI - Audition in the praying mantis, Mantis religiosa L.: identification of an interneuron mediating ultrasonic hearing. AB - 1. The praying mantis possesses a single ear located in the ventral midline of the metathorax. We have studied the mantis' auditory nervous system using both extracellular and intracellular techniques and have identified anatomically and physiologically a mirror-image pair of interneurons (MR-501-T3) in the metathoracic ganglion that mediates ultrasonic hearing. 2. MR-501-T3 is tuned broadly to ultrasound with best sensitivity (55-60 dB SPL) between 25 and 45 kHz. Its tuning matches closely that of the whole tympanal nerve. 3. The physiological responses of MR-501-T3 are characterized by: (1) a phasic-tonic firing pattern with a distinctive initial burst at 500-800 spikes/s; (2) minimum latencies of 8 12 ms; (3) no spontaneous activity; (4) sigmoid intensity response curves with a small (10 dB) dynamic range; (5) accurate coding of stimulus duration and of repetition rates up to 60 pps. 4. The ascending axon of MR-501-T3 conducts action potentials at 4 m/s, a rate comparable with some giant fiber systems. 5. MR-501 T3 shows no directional capability. Sound from right and left produce identical responses in both cells of the pair. Neither cutting one tympanal nerve nor removing one hemi-ear leads to different responses in the two cells indicating that they must receive a common input, either from the auditory afferents or from interneurons. We present evidence that the two cells are not directly connected. 6. MR-501-T3 is a large, symmetrical cell with its processes primarily in the intermediate neuropil (lateral ring tract). Its integration segment crosses the midline in the supramedian commissure, and the cell body lies dorsally near the entrance of the leg nerve. The axon travels in the dorsal lateral tract and is one of the largest (17 microns) in the connective. 7. Given the strong anatomical similarities between MR-501-T3 and the G and B cells of the locust, these cells may be homologous. 8. We present arguments based on our physiological results and existing behavioral data that MR-501-T3 is part of an ultrasonic warning/escape system in the mantis. As in moths, lacewings, and crickets, this system may provide a defense against nocturnally foraging bats. PMID- 2769608 TI - Adult children of alcoholics. PMID- 2769609 TI - Caring: commitment to excellence or condemnation to conformity? AB - The art of caring to alleviate illness and to promote health is nursing's unique commitment to society and the health-care industry. How this practice is implemented dictates the success or failure of prescribed strategies. In addition, the way in which caring is implemented defines emotional maturity on both a personal and professional level. Several goals to rehabilitate the psychologically codependent person include: Developing an awareness of the origins of codependency and how early family experiences affect subsequent behavior and beliefs about oneself; Identifying the personal price and payoffs for continuing codependent behaviors; The ability to openly express personal needs, wishes, feelings, and opinions while respecting the rights of others; Learning to discriminate between loving/caring and the destructive control of codependency; and The ability to take responsibility for another rather than being responsible to another. Codependent behaviors are prevalent within professional nursing practice, as evidenced by examples provided from three specialty areas in nursing and the fact that women (who are traditionally assigned the cultural role of caring) constitute the majority of professional nurses. Therefore, it is a professional challenge to each nurse to ascertain whether practices are functional or dysfunctional: is the professional interpretation of caring a commitment to excellence or a condemnation to conformity in the unique delivery of health-care practice? PMID- 2769610 TI - Intervening in interventions. PMID- 2769611 TI - How do you keep charting and documenting from interfering with direct patient care? PMID- 2769612 TI - A world AIM. PMID- 2769613 TI - Black looks...at diagnosis. PMID- 2769614 TI - Presentation of infective endocarditis in childhood and adolescence. PMID- 2769615 TI - Clinical problems with temporary pacemakers prior to permanent pacing. PMID- 2769616 TI - Diverse endocrine presentations of the syndrome of acanthosis nigricans and insulin resistance. PMID- 2769617 TI - Blood lead and carbon monoxide levels in Mersey Tunnel workers. PMID- 2769618 TI - The potential use of a 5-day ward in a medical unit: audit by peer review. PMID- 2769619 TI - Arms or health: a role for medical colleges? PMID- 2769620 TI - Abstracts of the thirty-first annual meeting of the Japan Radiation Research Society. Hiroshima, October 5-7, 1988. PMID- 2769621 TI - Induction of malignant transformation in mouse 10T1/2 cells by low-dose-rate exposure to tritiated water and gamma-rays at two different temperatures, 4 degrees C and 37 degrees C. AB - Cultured mouse (C3H 10T1/2) cells in contact-inhibited state were subjected to protracted exposure at 4 degrees C or 37 degrees C to either beta-rays from HTO or 60Co gamma-rays. The duration of exposure was 20 h and the total dose was varied by changing the dose-rate. The dose-survival and dose-transformation curves for gamma-irradiation at 4 degrees C were close to those obtained after a single acute X-ray dose (0.5 Gy/min). When gamma-irradiation was administered at 37 degrees C, both the lethality and transformation induction were lower than those after the corresponding doses at 4 degrees C, presumably owing to repair of lethal and transformational damage during gamma-irradiation at 37 degrees C. The same effect of temperature was observed in the case of HTO exposure, indicating again the existence of repair of damage during beta-irradiation at 37 degrees C but not at 4 degrees C. These facts strongly suggest that when irradiated at a low temperature such as 4 degrees C, both the dose-lethality and dose transformation induction relationships were independent of the dose-rate for either gamma- or beta-exposure, at least the dose-rates used in this experiment. Thus, the comparison of radiation effectiveness between beta- and gamma-exposures at 4 degrees C gave reliable values of relative biological effectiveness (RBE) of tritium beta-rays which were ca. 1.4 at the D0 for lethality and 1.6 for cell transformation within the dose range examined (1 to 6 Gy of beta-rays). The comparison between exposures at 37 degrees C resulted in RBE values (1.4 and 1.7, respectively) very close to those at 4 degrees C. PMID- 2769622 TI - Whole-body hyperthermia-induced renal atrophy of mice as evinced by obstruction and degeneration of renal tubules caused by acute ischemia. AB - Effects of microwave-induced whole-body hyperthermia (WBH) on the mouse kidney were examined histologically for acute and late effects up to 150 days after WBH treatment at 43.5 degrees C (rectal temperature) for 20 min or 42 degrees C for 40 min. As a whole the damage could be divided into two types. One was the damage to distorted epithelial cells in the subcapsular region. This lesion was common in most animals, possibly caused by direct hyperthermic effect of microwave. The other was general renal atrophy accompanied with aqueous or protein-rich cysts due to a chain of physiological reactions of the whole body to WBH. The first reaction was characterized by general stasis of the blood stream in all parts of the kidney, which resulted in acute ischemia of some tissues. This was seen immediately by dilatation of the renal and interlobular veins as well as the bundles of capillaries in the medulla region. The subsequent event was rather specific cell necrosis of distal and collecting tubular epithelium as compared to proximal tubules. The cell destruction induced cell proliferation of the proximal tubular epithelia after two days. Later on, in accord with the recovery of the blood circulation, the proliferated cells were carried away into the lumen, these processes then resulting in obstruction of tubules through formation of protein casts in the lumen. The block incidentally led to the destruction of nephrons. The degenerated area sometimes consisted of aqueous or protein-rich cysts of various sizes after 7 to 30 days. Thereafter these cysts degenerated, decreasing in both number and size. Thus irreversible atrophy of the kidney developed after WBH. PMID- 2769623 TI - Resistance of STS/A mice to lymphoma induction by X-irradiation. AB - While fractionated X-irradiation induced a high incidence lymphomas in BALB/cHeA mice (77% in females and 86% in males), it induced the disease at an extremely low incidence in STS/A mice (8% in females and 9% in males). The latent period of lymphoma development was short in BALB/cHeA mice, but relatively long in STS/A mice. No significant difference of incidence of the disease between sexes in either strain was observed. F1 hybrid mice showed an intermediate incidence of radiation-induced lymphomas. This suggests that neither resistance of STS/A mice nor susceptibility of BALB/cHeA mice to radiogenic lymphomas is dominant. PMID- 2769624 TI - Free abdominal flaps: variations in design and application to soft tissue defects of the head. AB - The use of free abdominal flaps in the reconstruction of soft tissue defects of the head is described. The vascular supply of these flaps is from perforating vessels stemming from the deep inferior epigastric vessels. Variously modified flaps can be elevated in the same way as vascular island flaps, with a small part of the rectus abdominis muscle and deep inferior epigastric vessels attached. There are three main types of such flaps; a transversely-shaped type, a blunt U shaped type, and an L-shaped type. The technique has been successfully used for electrical injury, surgically-created defects, and traumatic soft tissue losses. PMID- 2769625 TI - The internal oblique-iliac crest osseomyocutaneous microvascular free flap in head and neck reconstruction. AB - The iliac crest osseocutaneous free flap, based on the deep circumflex iliac artery and vein, was a landmark contribution to head and neck reconstruction. Two major problems associated with this flap are the lack of flexibility in placement of the skin paddle with relation to the bone graft, and the excessive thickness of the skin paddle when used in the oral cavity. The scapular osseocutaneous flap has achieved recent popularity for mandibular reconstruction based, in part, on its thin skin paddle that is easily positioned in three dimensions with relation to the bone graft. However, the segment of bone that can be harvested from the iliac crest is superior to that of the lateral border of the scapula because of its increased length, thickness, and natural contour. In 1984 the internal oblique free muscle flap based on the ascending branch of the deep circumflex iliac artery was described for use in reconstruction of the extremities only. The authors introduce the application of the internal oblique-iliac crest osseomyocutaneous free flap for mandibular reconstruction. The mobility of the internal oblique muscle with relation to the iliac bone graft has permitted its use for inner mucosal defects or outer cutaneous defects when covered with a skin graft. Following denervation atrophy, the muscle component becomes a thin, pliable piece of tissue that easily conforms to three-dimensional defects of the head and neck. This increased flexibility, the established benefits of the iliac bone, and the ease of intraoperative positioning for a two-team approach make this composite flap an outstanding tool for mandibular reconstruction. Two representative cases and a detailed description of flap harvesting, insetting, and donor-site closure are presented. PMID- 2769626 TI - Experimental study of vascularized muscle: multifactorial analysis of muscle regeneration following denervation. AB - An experimental study on regeneration of vascularized muscles after denervation was carried out on a total of 73 adult rat gastrocnemius muscles. A vascularized muscle graft harvested from the gluteal region was transplanted orthotopically with its vascular pedicle. A transected motor nerve of the graft was sutured under the operating microscope. The rats were sacrificed at intervals throughout 12 postoperative months, and biopsied muscles were processed for histologic, immunohistochemical, and composing protein analysis studies. After degeneration of the originally transplanted muscle fibers, regenerating cells such as myoblasts and myotubes developed into mature muscle fibers up to week 8 after surgery. These results suggest that in the regenerating mechanism of vascularized muscle grafts, there are both degenerating and regenerating processes in the transplanted muscles. PMID- 2769627 TI - Pedicled and "flow-through" venous flaps: clinical applications. AB - Recently, the pedicled venous flap and "flow-through" venous flap have been the focus of increasing attention for skin defects of the fingers and hands. For successful venous flap use, the following approaches have been suggested: (1) a pedicled venous flap with preservation of the draining veins alone; (2) a "flow through" flap with preservation of a flow-through vein in the flap; and (3) an arterialized "flow-through" venous flap which ensures arterial blood flow into the flap. Based on findings that venous blood is helpful in flap survival, the authors made use of the first two flap types, the pedicled venous flap and the "flow-through" venous flap and attempted to establish and clarify reasonable conditions for flap survival. Venous pressure of the finger and elbow was measured and venographies of the finger and hand were also carried out. The following conditions are regarded as essential in successful venous flap procedures: (a) use of a venous flap with a rich venous network; (b) preservation of many "flow-through" veins; (c) harvesting a pedicled venous flap where the veins have afferent (reversed) venous pressure; and (d) anastomosing veins of the "flow-through" flap with recipient veins where high efferent venous pressure exists and differential pressure is observed. Clinical cases are presented and the authors attempt to explain flap failure from previously unknown causes. Conditions for flap harvesting are also discussed. PMID- 2769628 TI - Total penile and urethral reconstruction with an expanded sensate lateral arm flap: case report. AB - The use of cutaneous or musculocutaneous flaps for total phalloplasty requires the lack of hairy skin; otherwise urethral strictures most likely will occur. A case of simultaneous total penile and urethral reconstruction using an expanded lateral arm sensory free flap is presented. The use of an expander in a small area of hairless skin on the lateral arm results in a free flap of sufficient size. This procedure proves to be a useful addition to the reconstructive armamentarium in dealing with similar challenging cases of penile reconstruction. PMID- 2769629 TI - Experimental studies of skin flaps with subcutaneous veins. AB - The authors have previously reported that skin flaps with subcutaneous veins nourished by arterial or venous inflow survived, despite being sited on recipient beds with poor circulation. In these previous studies, experimental models were based on axial pattern flaps of rabbit ears. However, for clinical application, there are problems in the use of axial pattern flaps with central vessels. This report classifies skin flaps with subcutaneous veins and produces experimental models that are suitable for clinical application and investigation of survival rates. Thirty-seven rabbits (74 ears) were used in this study. A 3.0-cm x 4.5-cm skin flap with only a "passing" vein (one that traveled through the tissue without major branches to that tissue) was raised at the level of the perichondrium on the dorsum of the auricular cartilage. The flaps were divided into three groups: Group A--composite flaps (n = 10); Group B--totally venous perfused flaps (n = 30); and Group C--afferent arterialized venous perfused flaps (n = 34). More than 80 percent of the flaps became necrotic in Group A. In Group B, 18 of 20 survived with partial superficial necrosis and two became more necrotic. In Group C, 18 of 21 flaps survived with superficial necrosis and three became more necrotic. Microangiographically, as concerns the "passing" veins in Groups B and C flaps, all of the flaps survived with only superficial necrosis. The skin flaps with subcutaneous veins survived as total venous perfusion flaps (TVPF) and as arterialized afferent venous perfusion flaps (AAVPF) even though the artery was not included in the flap. The experimental model is suitable for the investigation of the clinically unconventional flap. PMID- 2769630 TI - The fourth annual meeting of the American Society for Reconstructive Microsurgery. Baltimore, Maryland, September 17-19, 1988. Abstracts. PMID- 2769631 TI - Water fluoridation. PMID- 2769632 TI - Utilization of dental services: 1986 patterns and trends. AB - Data from the 1986 Access to Health Care Survey of the Robert Wood Johnson Foundation, a nationwide telephone survey, were used to provide information on changes and trends in dental utilization in the United States. Sixty-three percent of the respondents five years or older (N = 9,352) had had a dental visit within the past year. Being elderly, having lower socioeconomic status, and being black were independent risk factors for having fewer dental visits. Persons who had dental check-ups during the past year also demonstrated higher rates of other preventive health procedures (i.e., Pap smears, mammograms, breast examinations, and routine medical examinations). Among those without a dental visit within the past year, a financial barrier to receiving such care was reported by 12 percent of those surveyed, compared to 37 percent in 1976. We concluded that during the past decade there has been a continued trend toward increased dental visits and decreased financial problems relating to receiving dental care; however, the poor, ethnic minorities, and those with less education continue to have much lower rates of dental care utilization compared to the general population. PMID- 2769633 TI - Relationships between price and two components of quality of dental services. AB - Failure to account for differences in service attributes can lead to biased estimates and erroneous inferences regarding relationships between price and quality in studies of the dental care delivery system. This study examined relationships between prices of several common dental procedures and two components of the structure and process dimensions used in quality of care assessments. Results from ordinary least squares regression analysis demonstrated a significant positive relationship between price and an index of technical quality for two restorative services provided by general practitioners, even when controlling for market area characteristics. Additional analyses revealed that prices charged by general practitioners for specific services typically were lower on average and demonstrated greater variation than those charged by specialists for the same procedures. These findings highlight the need to consider service differentiation, including quality variation, in empirical studies involving the pricing of dental services. PMID- 2769634 TI - Utility of the dental aesthetic index in industrialized and developing countries. AB - To be truly useful, an index must be applicable universally without modification. The data presented in this article support the use of the standard DAI without modification to assess need for orthodontic treatment in both developing and industrialized countries. When students from Thailand, Australia, the German Democratic Republic, and Native Americans residing on Indian reservations rated the same 25 occlusal stimuli (photographs of dental configurations) for dental aesthetics, their ratings of these stimuli when arranged in rank order were highly correlated with those of US students. These 25 occlusal stimuli were a subset of the original 200 occlusal stimuli used in deriving the standard DAI regression equation. This article presents data indicating that when a Native American DAI was derived based on Native American ratings of the same 200 occlusal stimuli used in deriving the standard DAI, the Native American DAI and the standard DAI had the same ten components (orthodontic measurements) and strikingly similar regression coefficients (weights). Further analysis indicated that the two equations were sufficiently similar to justify using the standard DAI to obtain DAI scores on Native Americans and to estimate the relative social acceptability of their dental aesthetics. If ratings for dental aesthetics for the full set of 200 stimuli were available for each of the countries where only 25 were rated, we expect that, as in the case of Native Americans, a country specific DAI, if computed, would be sufficiently similar to the standard DAI that no modification would be needed to allow use of the standard DAI in that country.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2769635 TI - Dental caries assessment of Mississippi Head Start children. AB - This study assessed the dental caries status and treatment needs of Mississippi Head Start children during the 1987-88 school year. The 2,393 children examined, representing a 10 percent random sample of all Mississippi Head Start children, were three to six years old with a majority being four to five years old. The mean deft ranged from 1.34 for three-year-olds to 4.32 for six-year-olds; the mean defs ranged from 2.33 to 9.99. More than 50 percent of primary teeth of three-year-olds with dental caries experience required treatment, whereas less than one-quarter of similarly affected teeth of six-year-olds were in need of treatment. PMID- 2769636 TI - A win for fluoridation in Squamish, British Columbia. PMID- 2769637 TI - Factors contributing to the perioperative death rate. PMID- 2769638 TI - Double gallbladder diagnosed by T-tube cholangiogram. PMID- 2769639 TI - Liposarcoma of the cord presenting at vasectomy counselling. AB - A case of liposarcoma of the cord is reported in a patient presenting for vasectomy. This paper discusses such tumours and illustrates the importance of a careful clinical examination during counselling. PMID- 2769640 TI - Probable late congenital syphilis presenting as Clutton joints. AB - A patient who presented with recurrent bilateral knee effusions was found to have positive serum syphilis serology. She was treated with oral erythromycin to a total of 40 grams and intra-articular injection of steroids in the right knee joint. Late congenital syphilitic arthritis is discussed with a review of the literature. PMID- 2769641 TI - Lockerbie air disaster. PMID- 2769642 TI - Management of sucking chest wounds. PMID- 2769643 TI - Selection of soldiers. Physical build as an entry factor. PMID- 2769644 TI - Packaging of resuscitation fluids. PMID- 2769645 TI - A possible structure for the nicotinic acetylcholine receptor. PMID- 2769646 TI - Differential estrogenic responsiveness of MCF-7 cells. Relationship to the presence of two different estrogen receptors. AB - Estradiol stimulation of thymidine incorporation and progesterone receptor synthesis is at a maximum in exponentially growing cells. These activities are found to disappear in confluent MCF-7 cells. Since no significant differences in the binding of estradiol to its receptor site (Kd = 10(-10) M, Bmax = 150 fm/mg protein) are observed in these two conditions, receptor structure was analyzed in both cell populations. Various methods demonstrated that receptor size is related to the state of confluence. The hydrodynamic properties of estradiol receptors complexed with 3H-estradiol from cells in the two different growth phases are similar in low ionic strength but different in high ionic strength media. Moreover, when the cell extracts are analyzed in denaturing conditions, cells which are sensitive to estradiol are found to contain a monomeric binding entity of 62 kD, whereas the unresponsive cells have a 47 kD binding entity. PMID- 2769647 TI - Oestrogen induced suppression of collagen arthritis. IV: Progesterone alone does not affect the course of arthritis but enhances the oestrogen-mediated therapeutic effect. AB - The effects of 17 beta-oestradiol and progesterone on the development of type II collagen-induced arthritis (CIA) and the anti-type II collagen (CII) autoantibody response were investigated. Treatment with physiological doses of 17 beta oestradiol, inducing serum levels below the estradiol peak at the end of pregnancy, abrogated the development of arthritis and suppressed the anti-CII autoantibody response. Treatment with progesterone alone did not have significant effects on the development of arthritis or on the anti-CII autoantibody response. However, a combined treatment with both progesterone and oestrogen in physiological doses induced a more pronounced suppression of CIA than the suppression induced with oestrogen treatment alone. These findings suggest that oestrogen, but not progesterone, may be the critical factor to explain the pregnancy-related down-regulation of CIA. PMID- 2769648 TI - Association between recurrent spontaneous abortions and circulating IgG antibodies to sperm tails in women. AB - The isotype and regional specificity of antisperm antibodies in the circulation of women with recurrent spontaneous abortions was examined. There was a statistically significant association (P less than 0.005) between the presence of IgG tail-directed antisperm antibodies and a history of unexplained recurrent spontaneous abortion. These antibodies were detected in 36.4% of 44 women with recurrent abortions and 14.6% of 616 female partners of infertile marriages. In contrast, no differences in IgG sperm head-directed antibodies or in IgA and IgM antisperm antibodies were observed between the two groups. Husbands of women in the miscarriage or infertile groups had similar semen evaluations. Antisperm antibodies may be a marker for defective immunosuppression in women with recurrent miscarriages. Alternatively, exposure of sperm-sensitized pregnant women to sperm may activate the maternal immune system to respond to paternal antigens present on the embryo. PMID- 2769649 TI - Pregnancy-maintaining antibodies: workshop report (Giessen, 1988). AB - To analyse the nature of antibodies which are purported to be essential for the maintenance of normal human pregnancy, six centers participated in a workshop of "blind" tests on 19 allosera. Fc-receptor dependent assays detected antibodies with specificity only for HLA. In addition to cytotoxic antibodies, the Fc receptor dependent immune phagocytosis inhibition test revealed two non-cytotoxic alloantibodies with HLA specificity. These antibodies had high titers and may, therefore, be essentially non-cytotoxic. Murine monoclonal antibodies to HLA-A, B, C or DR (W6/32 and 2MC3) were used to evaluate the methods. These antibodies inhibited immune rosette formation as well as immune phagocytosis. Diluted to concentrations below the threshold of complement-dependent cytotoxicity, the monoclonal antibodies still inhibited the mixed lymphocyte reaction and the immune phagocytosis. A human monoclonal immunoglobulin M with specificity for monomorphic non-HLA lymphocyte antigens inhibited the mixed lymphocyte reaction. The immune rosette inhibition test exhibited several false positive reactions, e.g. three out of four with a serum that did not contain alloantibodies to blood cells. Non-cytotoxic antibodies were therefore rare in the selected sera of the workshop and they exhibited HLA specificity only. No participant was able to identify pregnancy-maintaining non-HLA-antibodies. PMID- 2769650 TI - Influence of immunization with allogeneic spleen cells on the number of viable neonates in mice. AB - Female CBA/J (H-2k) mice mated with male DBA/2J (H-2d) mice show a high level of fetal resorption, which can be reduced by immunization with BALB/c (H-2d) spleen cells. The morphologically defined fetal resorption rate upon which evaluation of the outcome of pregnancy has previously been based in this strain combination is not equivalent to the rate of production of viable neonates. PMID- 2769651 TI - Resectoscopic removal of symptomatic intrauterine lesions. AB - In order to avoid major surgical intervention in women who refused or were poor risks for hysterectomy or myomectomy, a hysteroscopic resectoscope was used for 90 women with uncontrollable uterine bleeding due to submucous fibroids or large polyps or with menorrhagia with normal endometria. Of those patients followed for more than three months, 90% of endometrial ablation patients had an improvement in menstrual flow, with 79% having scant or no periods. For patients with submucous fibroids or polyps, 91% had resumption of normal menses. For the 15 patients who were infertile and underwent submucous fibroid or polyp resection the term pregnancy rate is 33% to date. With only two complications in the series (perforation and endometritis), the conclusion is that resection of submucous lesions and endometrial ablation using the resectoscope is a safe and highly effective alternative to hysterectomy for those conditions. PMID- 2769652 TI - Microsurgical reversal of female sterilization. Long-term follow-up of 117 cases. AB - A prospective study of 117 consecutive microsurgical reversals of female sterilization from April 1981 to December 1984 was carried out to determine which factors affected the pregnancy outcome. Nylon sutures, 8-0, were placed through the muscularis and mucosal layers. A short abdominal incision was made. The patients were followed for 3.5 to 7.0 years. The term delivery, intra-uterine pregnancy, spontaneous abortion and ectopic pregnancy rates were 81.2%, 83.8%, 1.7% and 1.7%, respectively; two ectopic pregnancies occurred 14 and 24 months after the reversal procedures. We found that the time interval between sterilization and reversal and the methods of sterilization affected the pregnancy outcome. The success rate with intervals of less than five years was much higher than with intervals of more than five years; Pomeroy cases were more reversible than Uchida cases. We did not observe any influence of the anastomosis site on the pregnancy results. The term delivery rates for isthmus-isthmus, isthmus-ampulla and ampulla-ampulla anastomoses were 78.8%, 80.0% and 84.6%, respectively. Patients should be followed for two years at least to determine the pregnancy outcome as well as the occurrence of ectopic pregnancy. PMID- 2769653 TI - An animal model for learning Nd:YAG laser ablation of the endometrium. AB - Gynecologists must have a good model for practice before performing Nd:YAG laser ablation on humans. The New Zealand white rabbit has been used as a teaching model in courses. Knowing the anatomy and technique enables gynecologists to acquire the skill and dexterity needed to perform this useful procedure. PMID- 2769654 TI - Conservative management of Cushing's syndrome in pregnancy. A case report. AB - A woman with clinical and laboratory findings of Cushing's syndrome was managed during pregnancy without the use of surgery or drugs to lower her serum cortisol. A good maternal and infant outcome was achieved with conservative measures, and surgical removal of an adrenal adenoma was delayed until the postpartum period. PMID- 2769655 TI - Spinal claudication in systemic amyloidosis. AB - We describe a patient with hereditary amyloidosis who developed the syndrome of spinal claudication. Myelography and computerized tomography of the lumbar spine demonstrated stenosis of the spinal canal and surgical exploration confirmed dense amyloid infiltration of ligamentous structures compressing the nerve roots. Two cousins of our patient and 2 patients with immunoglobulin amyloidosis had similar clinical syndromes. Spinal stenosis can be demonstrated by myelography or by computerized tomography. Diagnosis of this syndrome is important since wide decompression may be needed to relieve symptoms. Patients who had only disc extraction did not improve after the operation; their symptoms persisted and even worsened. PMID- 2769656 TI - The "repetitive strain injury syndrome" is referred pain from the neck. PMID- 2769657 TI - Severe reversible interstitial pneumonitis induced by low dose methotrexate. PMID- 2769658 TI - Teratogenesis and iv cyclophosphamide. PMID- 2769659 TI - Diplopia due to 4th nerve palsy and enlargement of the right medial rectus muscle. PMID- 2769660 TI - EMG-biofeedback in fibromyalgia syndrome. PMID- 2769661 TI - Outcome studies, mortality versus quality of life. PMID- 2769662 TI - Felty's syndrome: a therapeutic dilemma? PMID- 2769663 TI - Postmenopausal hormones and the incidence of rheumatoid arthritis. AB - This case-control study assessed whether postmenopausal use of hormones reduces the incidence of rheumatoid arthritis (RA). Cases had classical or definite RA. Controls were patients with primary osteoarthritis or soft tissue rheumatism. Information on exposure was obtained by telephone interview. Compared to women who had never used postmenopausal hormones before onset of rheumatologic symptoms, adjusted relative risk (95% confidence limits) for past and current users were 0.95 (0.56-1.60) and 0.89 (0.49-1.63), respectively. Among current users, the association was not related to the duration of use. Our results provide little support for the hypothesis that use of postmenopausal hormones has a protective effect on the development of RA. PMID- 2769664 TI - Pulmonary hypertension in systemic lupus erythematosus. AB - A prospective study was performed in our center on 60% (n = 36) of patients with systemic lupus erythematosus (SLE) to determine the prevalence and severity of pulmonary hypertension. Twenty-six healthy subjects of similar age and sex served as controls. Pulmonary artery systolic pressure was calculated from the sum of the peak tricuspid insufficiency Doppler pressure gradient and an estimate of right atrial pressure based on inferior vena cava size and its degree of inspiratory collapse. Five patients with SLE (14%) had pulmonary hypertension, defined as pulmonary artery systolic pressure greater than 30 mm Hg. Cardiac indices determined by planimetry of biplane apical 2-dimensional echocardiographic images were low or normal in the patients with pulmonary hypertension implying increased pulmonary vascular resistance as the etiology for elevated pulmonary artery pressure. The mean pulmonary artery systolic pressure in patients with SLE was 25 +/- 10 mm Hg vs 20 +/- 2 in controls (p = 0.002). No control had a pulmonary artery systolic pressure greater than 23 mm Hg. Patients with pulmonary hypertension had a shorter duration of SLE and steroid therapy and a higher prevalence of cytotoxic treatment and Raynaud's phenomenon in comparison to those with normal pulmonary artery pressures. The prevalence of systemic hypertension, interstitial lung disease, pleurisy, pericarditis, cutaneous manifestations, arthritis, renal disease, central nervous system involvement, and hematologic abnormalities was similar in patients with SLE with normal and elevated pulmonary artery pressure. Our study suggests that pulmonary hypertension in SLE is common but usually mild. PMID- 2769665 TI - Hemocytopenia in systemic lupus erythematosus. Relationship to antiphospholipid antibodies. AB - We studied 500 consecutive patients with systemic lupus erythematosus (SLE) for antibodies to phospholipids (APLA) by an ELISA method using cardiolipin as antigen and antiimmunoglobulins G, M and A to determine their isotype. Once entered into this prospective study the patients were followed for up to 16 months (mean 7.7 +/- 4.72 SD) with periodic determinations of APLA. Of the 500 patients with SLE, 88 had had thrombocytopenia, 25 had had hemolytic anemia, 25 had had both, and 362 had no history of these hemocytopenias. If we considered the odds ratio of these 362 patients for having high titer APLA as 1, patients with a history of thrombocytopenia, hemolytic anemia or both had significantly higher odds ratios of having APLA than did those without hemocytopenia. Patients with thrombocytopenia had significantly higher levels of IgG APLA, those with hemolytic anemia had significantly higher titers of IgM APLA and patients with both had significantly higher titers of both of these APLA isotypes, than did patients without hemocytopenias. A correlation between positive direct Coombs' tests and IgM APLA was also found. We conclude that APLA is associated with these hemocytopenias in SLE. This might be due to their interaction with negatively charged phospholipids in the cell walls of the respective cells. PMID- 2769666 TI - The outcome of 138 total hip replacements and 12 revisions in ankylosing spondylitis: high success rate after a mean followup of 7.5 years. AB - The outcome of total hip replacement (THR) in ankylosing spondylitis (AS) is unclear. Concern has often been voiced by both surgeons and physicians regarding potential reankylosis, mechanical failure and poor function. We present an independent review of the patients' perception of outcome in 150 total hip replacements (138 primary + 12 revisions) in 87 subjects with AS. The mean followup was 7.5 years (1-34 years). Twelve were followed for greater than 15 years and 33 for greater than 10 years. Bilateral replacements were performed in 51 of the 87 patients (59%), 33 (65%) of whom had bilateral surgery within a 12 month period. Failures were early and rare. Twelve of 138 (9%) were revised (8 patients, mean of 3.6 years postoperatively) and 3 of the 12 were rerevisions. Twelve total hip replacements followed for 15 years or more resulted in only 2 failures (same patient: reankylosis) while 3 failed out of 33 followed for 10 years or more. Overall, for the 138 total hip replacements in situ (including the revisions), the patients considered outcome to be good or very good in 86%, while 89% had no (63%) or mild (26%) pain. Mobility was good or very good in 44%. On a scale of 1-5 (very poor to very good) patients followed for up to 5 years scored 4.7, as did those followed for greater than 15 years. Sixty-nine percent of the male recipients under age 60 are at work. Reankylosis occurred in only 1 patient (4 hips). In general the first and second hips replaced had an equally good outcome. The long-term outcome of total hip replacement in AS is very good. The few failures occurred early, and patients were as satisfied with the outcome more than 15 years postoperatively as they were within the first 5 years. PMID- 2769667 TI - Magnetic resonance imaging identifies early femoral head ischemic necrosis in patients receiving systemic glucocorticoid therapy. AB - Ischemic necrosis of bone, a frequent complication of glucocorticoid therapy, can result in disability due to bone collapse and destruction. Some investigators have suggested that core decompression of involved marrow benefits patients with early disease. As radiographs are normal in early disease, identification of patients has been dependent on nonspecific radionuclide imaging or more specific but invasive hemodynamic studies. In order to define a sensitive, noninvasive diagnostic tool, we compared magnetic resonance imaging (MRI) to 99mtechnetium diphosphonate and 99mtechnetium sulfur colloid scintigraphy in 10 consecutive glucocorticoid treated patients with suspected femoral head ischemic necrosis of bone but normal roentgenograms. MRI identified the ischemic necrosis (defined by characteristic radiographic progression or histology) in 13/13 femoral heads. Both scans together identified only 5/13 of the cases. Only 1/20 osteoarthritic femoral heads had MRI patterns similar to those seen in ischemic necrosis of bone. We conclude that MRI is a sensitive and relatively specific method to detect early femoral head ischemic necrosis of bone. PMID- 2769668 TI - Urinary hydroxy-pyridinium crosslinks provide indices of cartilage and bone involvement in arthritic diseases. AB - The urinary concentrations relative to creatinine of the collagen crosslinks, pyridinoline (PYD) and an analogue derived specifically from bone collagen, deoxy pyridinoline (DPD), were measured using a high performance liquid chromatography (HPLC) technique in 41 patients with rheumatoid arthritis (RA) and 45 patients with osteoarthritis (OA), and were compared with values of 118 healthy control individuals. The levels of DPD were increased significantly in both RA and OA suggesting accelerated bone degradation in both disease groups. PYD concentrations were also significantly increased in both diseases, but larger increases were detected in patients with RA, for which this index correlated with clinical measures of joint involvement and biochemical variables of inflammatory activity. Cross-sectional studies showed that treatment with disease modifying drugs (gold and D-penicillamine) led to decreased crosslink levels but longterm corticosteroids resulted in increased urinary crosslinks, probably due to the induction of bone resorption. Measurement of both pyridinium crosslinks in urine may therefore provide information on the stage, activity, level of bone involvement and efficacy of drug therapy in arthritic diseases. PMID- 2769669 TI - Hereditary symphalangism. Association with osteoarthritis. AB - A pedigree is described with 5 generations affected by hereditary symphalangism of the proximal interphalangeal joints of the hands. In the proposita, osteoarthritis was present proximal and distal to the symphalangitic segment, possibly due to altered mechanical forces in these joints. PMID- 2769670 TI - Multiple rheumatoid bursal cysts. AB - We have encountered a patient with rheumatoid arthritis (RA) who developed multiple subcutaneous swellings containing sterile milky fluid. The resected material showed chronic granulomatous changes compatible with rheumatoid inflammation. We suggest that multiple chronic rheumatoid inflammation may occur in the bursae as well as joint synovium as one of the extraarticular manifestations of RA. PMID- 2769671 TI - Gelatinous transformation of bone marrow in systemic lupus erythematosus. AB - Gelatinous transformation of marrow is a rare disease entity described in cachexia and various other disorders. Its association with systemic lupus erythematosus (SLE) has never been reported. We found gelatinous transformation in 3 of 30 patients with SLE with pancytopenia. Two of these patients were cachetic, one of whom also had active tuberculosis. We propose that gelatinous transformation can be associated with SLE, and its detection calls for an evaluation of nutritional status, and a search for chronic debilitating infections such as tuberculosis. PMID- 2769672 TI - Primary malignant lymphoma of the spleen in systemic lupus erythematosus. AB - Malignant lymphoma has been infrequently reported in the course of systemic lupus erythematosus (SLE). We report a case of primary malignant lymphoma of the spleen, an unusual site of primary lymphoma, complicating the course of systemic lupus erythematosus (SLE). Our patient had been treated with low dose prednisone and hydroxychloroquine only, and her lupus was quiescent at the time of presentation with the lymphoma. Thus primary malignant lymphoma should be considered in the differential diagnosis of splenomegaly in SLE. PMID- 2769673 TI - Assessment of left ventricular filling in patients with systemic hypertension. A Doppler echocardiographic study. AB - To assess left ventricular (LV) diastolic function in patients with hypertension, a Doppler echocardiographic study of transmitral blood flow (TBF) was performed in 46 hypertensive patients (H), 18 without (H1) and 28 with (H2) left ventricular hypertrophy and in 25 age-matched normal subjects (N). All patients showed normal systolic function. The following indices of Doppler TBF were measured: peak flow velocity during early filling (Evel), atrial systole (Avel) and their ratio (E/Avel); area under early filling phase (Earea), area under atrial systole (Aarea), expressed as a percentage of total diastolic area and their ratio (E/Aarea); deceleration half-time (DHT) of early filling phase. When compared with N, H1 and H2 showed significant reductions in early filling indices and an increase in atrial contribution parameters. (Evel = 0.62 +/- 0.1(N), 0.52 +/- 0.1(H1) P less than 0.01, 0.44 +/- 0.1(H2) P less than 0.001; Earea = 56 +/- 5(N), 48 +/- 5(H1) P less than 0.001, 43 +/- 6(H2) P less than 0.001; Avel = 0.49 +/- 0.1(N), 0.59 +/- 0.1(H1) P less than 0.01, 0.69 +/- 0.14(H2) P less than 0.001; Aarea = 26 +/- 5(N), 41 +/- 4(H1) P less than 0.001, 47 +/- 7(H2) P less than 0.001). Also DHT was significantly prolonged, compared with N (80 +/- 12 msec), in H1 (90 +/- 12 msec, P less than 0.01) and H2 (105 +/- 20 msec, P less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2769674 TI - Drug treatment of high blood pressure in the community--experience in eastern Finland. AB - The effects of antihypertensive drug therapy were assessed in 8,459 patients (2,801 men and 5,658 women) from the hypertension register of the North Karelia Project in 1978-1979. Fifty-two per cent of the men and 56% of the women were taking one drug only. The most common drugs used were diuretics and beta blockers. Women were on diuretics more often than men, but beta-blockers were more common in men. The effect of the treatment was assessed in terms of the BP means and percentage of patients whose DBP was below 100 mmHg. BP was controlled better in women than men. The best BP control was obtained in groups of patients who were on a single drug. Adequate BP control was achieved in 71% of men and 83% of women on diuretics, in 75% of men and 83% of women on beta-blockers, in 85% of both sexes on fixed combinations of a diuretic + reserpine + vasodilator, and 79% of men and 89% of women on a diuretic + reserpine. Fixed combinations containing only low doses of each drug are a good alternative for some patients. PMID- 2769675 TI - Occlusion of unilateral stenosed renal arteries--relation to medical treatment. AB - In 78 patients we studied retrospectively the occurrence of occlusion in unilateral renal artery stenosis during antihypertensive drug treatment. Complete occlusion occurred in 14 patients (18%). In a multivariate analysis the following characteristics were included: blood pressure, aetiology of the stenosis, serum creatinine, the degree of the stenosis, anti-hypertensive medication, standing renal vein renin ratio and age. In this analysis the combination of a diuretic and an ACE-inhibitor, during the observation period, showed an independent relation to the development of an occlusion (P less than 0.05). Also the ACE inhibitor alone showed a relation (P = 0.06). In the 14 patients who developed an occlusion only three showed a significant rise in serum creatinine. We conclude that special attention should be given to the follow-up of patients with renal artery stenosis who have ACE-inhibitors in their treatment regimen, especially when in combination with a diuretic. PMID- 2769676 TI - Effect of long-term nifedipine treatment on body fluid composition in essential hypertension. AB - The antihypertensive efficacy and effects on body fluid composition of monotherapy with the calcium antagonist nifedipine were investigated in 15 patients with essential hypertension. The systolic as well as the diastolic blood pressure decreased significantly, by approximately 12%, during nifedipine treatment with a mean dose of 56 mg. Glomerular filtration rate, plasma volume, extracellular fluid volume, and the ratio plasma to interstitial fluid volume did not change significantly. The most frequently observed side-effects were flushing and peripheral oedema which occurred in four and three patients, respectively. These results indicate that sodium and water retention, which is often observed during long-term treatment with vasodilators, does not seem to be the explanation of the development of peripheral oedema seen with nifedipine. PMID- 2769677 TI - A potent, tissue-selective, synthetic inhibitor of HMG-CoA reductase. PMID- 2769678 TI - 7-Heteroaryl-1,2,3,5-tetrahydroimidazo[2,1-b]quinazolin -2(1H)-one derivatives with cardiac stimulant activity. AB - A series of 7-heteroaryl-1,2,3,5-tetrahydroimidazo[2,1-b]quinazolin++ +-2 (1H) ones was synthesized and evaluated in dogs for cardiac stimulant activity. Compounds were obtained by a palladium-catalyzed cross-coupling reaction between a heteroarylzinc chloride and a 7-iodo-1,2,3,5-tetrahydroimidazo [2,1 b]quinazolin-2(1H)-one or by cyclization of an N-[(2-aminophenyl)methyl]glycinate with cyanogen bromide. Compared to the parent ring system (3), introduction of a 2,6-dimethylpyridin-3-yl (6), 2,4-dimethylimidazol-1-yl (7), or 1,2,4-triazol-1 yl (8) moiety at the 7-position led to a 13-17-fold increase in positive inotropic activity (percentage increase in dP/dtmax) in anesthetized dogs. Potency could be further enhanced with a 9-methyl substituent (10-12). The most potent member of the series, 7-(2,4-dimethylimidazol-1-yl)-9-methyl-1,2,3,5 tetrahydroimidaz o [2,1-b]quinazolin-2(1H)-one (11) (23% increase in dP/dtmax, 2 micrograms/kg), was 80 times more active than 3 and displayed a 5-fold advantage over milrinone. In conscious dogs, 6 elicited marked and sustained positive inotropic activity (decrease in QA interval) after oral administration (1 mg/kg), whereas 10-12 were 10 times more potent. 11 produced an obvious increase in cardiac contractility (20% increase in dP/dtmax) at low dose levels (25 micrograms/kg) while, after 100 micrograms/kg, the marked response (50% increase in dP/dtmax) was maintained for the whole 7-h test period. In these experiments, 11 had no effect on heart rate, and the compound also displayed exceptional selectivity for increasing the force rather than the rate of cardiac contraction (greater than 150% increase in dP/dtmax) in the Starling heart-lung preparation. These studies demonstrate that the tetrahydroimidazoquinazolinone nucleus is an effective bioisostere for the 2(1H)-quinolinone system and that 11 displays improved cardiac stimulant activity and duration of action when compared to milrinone. PMID- 2769679 TI - Synthesis and anthelmintic activity of a series of pyrazino[2,1-a][2]benzazepine derivatives. AB - A series of 1,2,3,4,6,7,8,12b-octahydropyrazino[2,1-alpha][2] benzazepine derivatives was prepared and the cestocidal activity of the compounds evaluated in an in vitro Taenia crassiceps screen. Many of these derivatives proved to be highly active, and 2-(cyclohexylcarbonyl)-4-oxo-1,2,3,4,6,7,8,12b- octahydropyrazino[2,1-alpha][2]benzazepine, epsiprantel (BAN) (22), was selected for further development. The structure-activity relationships are discussed. PMID- 2769680 TI - New anticancer agents: chiral isomers of ethyl 5-amino-1,2-dihydro-2-methyl-3 phenylpyrido[3,4-b]pyrazine-7-car bamate . AB - Racemic ethyl 5-amino-1,2-dihydro-2-methyl-3-phenylpyrido[3,4-b]pyrazine-7- carbamate (1a) has shown antitumor activity in a variety of in vivo experiments. The preparation of the R and S isomers gave compounds with significant differences in potency in several biological tests. PMID- 2769681 TI - Effect of triphenylacrylonitrile derivatives on estradiol-receptor binding and on human breast cancer cell growth. AB - In a study of a series of 26 triphenylacrylonitrile derivatives (TPEs), we investigated the influence of several possibly interrelated factors on the proliferation of human breast cancer cell lines. (1) Chemical substituents: the test compounds were for the most part para-hydroxylated with increasingly bulky hydrophobic and/or basic side chains [isopropyloxy or (diethylamino)ethoxy] or standard reference compounds. (2) Relative binding affinities (RBAs): they competed diversely for [3H]estradiol (E2) binding to calf uterus cytosol and little, if at all, for binding to the [3H]tamoxifen-labeled antiestrogen binding site (AEBS) in lower speed supernatant. A multiparametric comparison of RBAs recorded for calf, rat, and mouse uterus cytosol estrogen receptor (ER) revealed a possible influence of species-specific receptor conformation and/or environment on binding. (3) Estrogen/antiestrogen potency: their stimulation and inhibition of the proliferation of the ER-positive human breast cancer cell line (MCF7) was measured. Compounds with only hydroxy substituents stimulated proliferation more markedly than methylated derivatives and had a maximum effect at 10(-11)-10(-6) M. Stimulation was related to the RBA for ER. Compounds with isopropyloxy or (diethylamino)ethoxy side chains only weakly stimulated MCF7 cell growth and more powerfully antagonized E2-promoted growth. The extent of inhibition depended upon the bulk of the side chain and could be reversed by 10(-7) M E2. Within the same concentration ranges, the test compounds were without effect on the BT20 ER negative cell line. (4) Cytostatic and/or cytolytic activity: most compounds could arrest the proliferation of both MCF7 and BT20 cells at concentrations above 3 x 10(-6) M. This activity was thus independent of ER. Nevertheless, those compounds with a charged hydrophobic side chain, which were the most powerful antagonists of E2-promoted cell growth, were also the most cytotoxic. The overall results for all molecules on all parameters were submitted to a multivariate analysis (correspondence analysis) which revealed the progressive influence of increasing substitution by hydroxy and more bulky groups on the generation of antagonist activity and cytotoxicity. PMID- 2769682 TI - Iodoaryl analogues of dioctanoylglycerol and 1-oleoyl-2-acetylglycerol as probes for protein kinase C. AB - Analogues of dioctanoylglycerol (diC8) and 1-oleoyl-2-acetylglycerol (OAG) containing an iodoaryl group have been synthesized and shown to compete with [3H]phorbol dibutyrate [( ([3H]PDBu) for binding to protein kinase C in a crude rat brain preparation. Phorbol diesters have been shown to bind specifically to protein kinase C and the PDBu receptor has been copurified with protein kinase C activity. All three diacylglycerol analogues were comparable to OAG in binding affinity. In an assay of protein kinase C activation, the diC8 analogue was more active than the OAG analogues, thus demonstrating greater structural specificity under the conditions of this assay. PMID- 2769683 TI - Carbohydrate biguanides as potential hypoglycemic agents. AB - A series of monosaccharides containing a biguanide functionality was prepared and evaluated for hypoglycemic activity. Among the analogues prepared were those involving D-glucose substituted on the 6- or 1-position (19 and 24), D-galactose substituted on the 6-position (7), and D-arabinose (31). The target compounds were evaluated in a modified rat glucose-tolerance test (oral glucose load/oral drug, 100 mg/kg). Compounds 8 [6-biguanidino-1,2:3,5-bis-O-(1-methylethylidene)-6 deoxy-al pha-D- glucofuranose] and 23 [methyl 6-biguanidino-6-deoxy-2,3,4-O tribenzyl-alpha-D-glucopyra nos ide] were the most active, exhibiting nearly equivalent hypoglycemic activity to that of phenformin (1) and metformin (2), as measured by the inhibition of the rise of blood glucose. Compound 31 was somewhat less active with 26% inhibition, as compared to 64% inhibition with 1 and 41% inhibition with 2. PMID- 2769684 TI - 2-(Fluoromethyl)-3-phytyl-1,4-naphthoquinone and its 2,3-epoxide. Inhibition of vitamin K epoxide reductase. AB - 2-(Fluoromethyl)-3-phytyl-1,4-naphthoquinone (7) was synthesized from the known compound 2-bromo-3-methyl-1,4-dimethoxynaphthalene by N-bromosuccinimide bromination of the 3-methyl group, conversion to the corresponding 3-fluoromethyl compound with silver fluoride, attachment of the 3-phytyl substitutent via the lithium diaryl cuprate and phytyl bromide, and then silver oxide oxidation to 7. Epoxidation with basic hydrogen peroxide gave the corresponding 2,3-oxide (1) in a very low yield. Compound 1 was not a time-dependent inhibitor of beef liver microsomal vitamin K epoxide reductase, but it was a competitive, reversible inhibitor. It was not possible to determine if 1 was a substrate for the enzyme because the expected product of reduction, namely 7, rapidly decomposed under the assay conditions. PMID- 2769685 TI - Potential tumor or organ-imaging agents. 30. Radioiodinated phospholipid ethers. AB - A radioiodinated analogue of a naturally occurring alkyl lysophospholipid (ALP) was synthesized for evaluation as a potential tumor-localizing imaging agent. rac 1-[12-(m-Iodophenyl)dodecyl]-2-methylglycero-3-phosphocholine (ET-12IP-OMe, 14) was radiolabeled with iodine-125 via an isotope-exchange procedure. Tissue distribution studies with [125I]ET-12IP-OMe in tumor-bearing rats revealed an immediate tumor uptake of radioactivity. Although radioactivity was also present in nontarget tissues at this time, clearance of tracer from the tumor was much slower and thus provided a suitable tumor to nontarget tissue ratio at 24 h. As a result of this selective accumulation, it was possible to clearly delineate the tumor with gamma-camera scintigraphy. PMID- 2769686 TI - Polyfluoro 1,3-diketones as systemic insecticides. AB - A series of aryl polyfluoro 1,3-diketones were examined for systemic ectoparasiticidal activity in cattle. The compounds demonstrated efficacy against several economically important species of insects and acarina. At dosages of 5 mg/kg X1 or 0.35 mg/kg per day intraruminally, activity was observed against blowfly larvae (Phormia regina), adult stable fly (Stomoxys calcitrans), and lone star tick (Amblyomma americanum). In vivo activity was not directly related to in vitro activity, showing a stronger dependence on perfluoroalkyl-chain length and aryl-group substitution. PMID- 2769687 TI - Squalene analogues containing isopropylidene mimics as potential inhibitors of pig liver squalene epoxidase and oxidosqualene cyclase. AB - Several squalene analogues containing 1,1-dihaloalkene, acetylene, allene, diene, and cyclopropane functionalities were synthesized and evaluated as potential inhibitors of pig liver squalene epoxidase and oxidosqualene cyclase. Both monofunctionalized and bisfunctionalized analogues were prepared. Poor inhibition of squalene epoxidase and oxidosqualene cyclase was found for most compounds (IC50 much greater than 400 microM), with the exception of the monofunctionalized alkynol (IC50 = 300 microM). This alkynol showed mixed-function inhibition with KI = 0.95 mM. Oxidation of the alcohol to the alkynone resulted in loss of epoxidase activity, indicating that the hydroxyl group is necessary for inhibition and that the alkynol is not a proinhibitor. Molecular mechanics calculations indicated that a good inhibitor should possess hydrophobic substituents on an unpolarized, unsaturated system; additionally, the presence of a pro-C-3 hydroxyl group can confer inhibitory potency. PMID- 2769688 TI - In vitro metabolic transformations of vinblastine: oxidations catalyzed by human ceruloplasmin. AB - The dimeric Vinca alkaloid vinblastine (VLB) undergoes metabolic transformation to three products in a reaction catalyzed by the human serum copper oxidase ceruloplasmin. The enzyme reaction requires chlorpromazine as a shuttle oxidant, and the course of the oxidation reaction appears to be subject to the nature of the shuttle oxidant used. Preparative-scale incubations have resulted in the isolation of three products, which were characterized by chemical and spectral analyses. The metabolites were identified as the ring fission product catharinine, obtained by oxidation of the Iboga ring system; an enamine/ether derivative obtained by oxidation of the Aspidosperma portion of VLB; and a metabolite embodying the same structural changes in both parts of the vinblastine dimeric structure. Catharinine is identical with the product of VLB oxidation obtained by peroxidase oxidation. The other two products are new metabolites and are derivatives of VLB. All of the metabolites are less active than VLB when tested in vitro vs the human T-cell leukemic cell line (CRFF-CEM). PMID- 2769689 TI - 2-Arylindenes and 2-arylindenones: molecular structures and considerations in the binding orientation of unsymmetrical nonsteroidal ligands to the estrogen receptor. AB - We have studied how 2-arylindene systems, unsymmetrical nonsteroidal estrogens, orient themselves within the binding site of the estrogen receptor, relative to estradiol, by making a comprehensive comparison of the binding affinity of 16 analogues. These analogues are representatives of two major classes, those substituted at C-3 with an ethyl or with a phenyl substituent; within each class there are members that have different patterns of hydroxyl group substitution and C-1 oxo or alkyl substitution. Orientational preferences were inferred from the relative binding affinities and were supplemented by computer graphic molecular overlap studies that utilized crystal structures of selected representative compounds and the known tolerance of the estrogen receptor to substituents on the steroidal ligand estradiol. 2-Arylindenes with a 3-aryl substituent appear to orient with the indene system mimicking the A- and B-rings of estradiol (indene/AB mode). This orientation is supported by the fact that hydroxyl substitution at C-6 in the indene markedly elevates binding relative to hydroxyl substitution at the para position of the 2-phenyl substituent. A C-1 oxo substituent increases binding further, but a C-1 alkyl group has little effect. By contrast, the 2-arylindenes with a C-3 ethyl substituent appear to bind with the pendant C-2 ring, mimicking the A-ring of estradiol (pendant/A mode), as hydroxyl substitution in this ring elevates binding relative to the C-6 hydroxy analogues. C-1 alkyl substitution elevates binding affinity in this series; such a substituent in a C-1 S configuration would be projected into the receptor region normally occupied by the high-affinity 7 alpha- or 11 beta-alkyl estradiols. A C-1 oxo substituent produces only a modest binding enhancement in the C-3 ethyl series. A thermodynamic evaluation of receptor fit suggests that the smaller 3-ethyl-2-arylindenes are more efficient than the 2,3-diarylindenes in the use of the molecular bulk to achieve receptor binding. This analysis of the orientational preference of 2-arylindene nonsteroidal estrogens has important implications in the design of donor/acceptor-substituted 2-arylindenes as fluorescent ligands for the estrogen receptor. PMID- 2769690 TI - Synthesis and biological activity of 3-substituted imidazo[1,2-a]pyridines as antiulcer agents. AB - New imidazo[1,2-a]pyridines substituted at the 3-position have been synthesized as potential antisecretory and cytoprotective antiulcer agents. The synthetic routes began with cyclization of aminopyridines 5a,b and chloro ketones 6a,b to give imidazo[1,2-a]pyridines 7-9. The side chain at the 3-position was elaborated to give primary amines 12a-c, which were treated with either butoxyaminocyclobutenedione 13 or methoxyaminothiadiazole 1-oxide (15) to give 14a,b and 16a-c, respectively. Thiadiazole 1-oxides 16a-c were converted to thiadiazoles 19a-c in a two-step process which involved extrusion of the sulfoxide in 16a-c to afford diimidamides 17a-c, which were subsequently treated with thiobisphthalimide (18). None of the compounds displayed significant antisecretory activity in the gastric fistula rat model, but several demonstrated good cytoprotective properties in both the EtOH and HCl models. 8-(Benzyloxy)-3 [1-[[2-[(4-amino-1,2,5-thiadiazol-3- yl)amino]ethyl]thio]ethyl]-2 methylimidazo[1,2-a]pyridine (19c) showed comparable cytoprotective activity to SCH-28080 (4). PMID- 2769691 TI - Quinones. 4. Novel eicosanoid antagonists: synthesis and pharmacological evaluation. AB - A new series of omega-phenyl-omega-quinonylalkanoic acids and related compounds was synthesized. The compounds were tested for their inhibitory effects on U 44069-induced contraction of the rabbit aorta. (+/- )-7-(3,5,6-Trimethyl-1,4 benzoquinon-2-yl)-7-phenylheptanoic acid (4d) (AA-2414) with pA2 value of 8.28 was one of the most potent compounds. Compound 4d inhibited U-46619-induced contraction of the guinea pig lung (pA2 = 8.29) and U-44069-induced aggregation of the guinea pig platelet (IC50 = 3.5 x 10(-7) M). Compound 4d displaced the binding of [3H]U-46619 to guinea pig platelets (IC50 = 7.4 x 10(-9) M). Compound 4d also showed very potent inhibitory effects with an MED of 0.3 mg/kg (po) on U 46619-, LTD4-, PAF-, or IgG1-induced bronchoconstriction in guinea pigs. The enantiomers of 4d were prepared. The R-(+) isomer 8a was active in both in vitro and in vivo tests, but the S-(-) isomer 8b was much less active. We concluded that the antiasthmatic effects of 4d were based mainly on the TXA2 receptor antagonistic action. In addition, compound 4d showed potent inhibitory effects on PGD2-, PGF2 alpha-, and 11-epi-PGF2 alpha-induced contraction of the guinea pig tracheal strips. The diverse inhibitory effects might be expressed in terms of eicosanoid-antagonistic activity. PMID- 2769692 TI - Genetically engineered V79 Chinese hamster cell expression of purified cytochrome P-450IIB1 monooxygenase activity. AB - Chinese hamster V79 fibroblasts, frequently used as target cells in short-term tests for mutagenicity, do not possess measurable monooxygenase activity; in particular, enzymatic oxidation of testosterone (T) cannot be demonstrated. If these V79 cells, however, had been transfected with the cDNA-encoding rat liver cytochrome P-450IIB1 under control of the SV40 early promoter, they stably expressed monooxygenase activity. These so-called SD1 cells then oxidatively metabolized T at a rate of 27 pmol/mg protein/min, converting it to 16 alpha- and 16 beta-hydroxy-T as well as 4-androsten-3,17-dione as sole metabolites in a ratio of 1.1:1.0:1.6. The regio- and stereoselective conversion of T by SD1 cells, as well as the quantitative distribution of the metabolites, corresponds well with the results reported for pure cytochrome P-450IIB1 in a reconstituted system. PMID- 2769693 TI - Neuropathy target esterase in hens after sarin and soman. AB - To estimate the potential of small doses of sarin (types I and II) and soman to cause delayed neuropathic effects, 400, 200, 61, and 0 micrograms/kg of sarin-I, 280, 140, 70, and 0 micrograms/kg of sarin-II, and 14.2, 7.1, 3.5, and 0 micrograms/kg of soman by gavage were compared with 510 mg/kg tri-o-cresyl phosphate (TOCP) in 14- to 18-month-old SPF white leghorn hens (4/dose) protected with atropine (100 mg/kg). The neuropathy target esterase (NTE) activity 24 hr after dosing was determined in brain, spinal cord, and lymphocytes and in plasma and brain for cholinesterase and carboxylesterase. None of the compounds showed statistically significant NTE decreases. Sarin-II showed a dose-related trend in the lymphocyte NTE (to 33% of control at 280 micrograms/kg), suggesting that longer exposure to lower doses might cause a cumulative neurotoxic insult. All of the agents decreased the activity of plasma and brain cholinesterase and carboxylesterase. Using more than 70% inhibition of brain NTE as a biochemical predictor of delayed neuropathy, sarin and soman appear unable to cause delayed neuropathy at nonlethal doses within this protocol. PMID- 2769694 TI - The inactivation of rhodanese by nitrite and inhibition by other anions in vitro. AB - Cyanide detoxification in mammals occurs, in part, by sulfur transfer by rhodanese to form the less toxic thiocyanate. Thiosulfate and nitrite are often used in combination for the treatment of cyanide intoxication. This report shows that nitrite can inhibit the rate of sulfur transfer by rhodanese in vitro. Nitrate, chloride, sulfate, and acetate were also examined as inhibitors. Inhibition by nitrite appeared to be more complex than for the other anions tested. Closer examination showed that nitrite can inactivate the sulfur-free rhodanese. Our observation leads to the suggestion that, in vivo, either rhodanese is maintained in its more stable sulfur-substituted form or cellular compartmentalization prevents inactivation by nitrite. PMID- 2769695 TI - Effect of verapamil on glycogenolysis and gluconeogenesis in the perfused rat liver. AB - In perfused livers from fed rats, rates of glucose production (glycogenolysis) were 133 +/- 12 mumol/g/hr. Infusion of 2 microM verapamil into these livers decreased the rates of glucose production significantly to 97 +/- 15 mumol/g/hr within 10 min. Conversely, rates of production of lactate plus pyruvate (glycolysis) of 64 +/- 6 mumol/g/hr were not significantly altered by verapamil (60 +/- 3 mumol/g/hr). When 50 microM verapamil was infused, however, rates of both glycogenolysis and glycolysis were diminished to 56 +/- 11 and 43 +/- 5 mumol/g/hr, respectively. In perfused livers from fasted rats, infusion of 20 mM fructose increased the rates of production of glucose (gluconeogenesis) significantly from 11 +/- 7 to 121 +/- 17 mumol/g/hr. These rates reached 138 +/- 7 mumol/g/hr upon the simultaneous infusion of verapamil (2 microM). In these livers, fructose also increased rates of production of lactate from 6 +/- 2 to 132 +/- 11 mumol/g/hr, which were further increased to 143 +/- 8 mumol/g/hr when 2 microM verapamil was infused. The results show that calcium-dependent processes involved in hepatic carbohydrate metabolism respond differently to the calcium channel blocker verapamil. Low concentrations of verapamil inhibited glycogenolysis significantly while having no effect on either glycolysis or gluconeogenesis. These data suggest that these two processes have different sensitivities to changes in intracellular calcium concentrations and/or different sources of regulatory calcium. PMID- 2769696 TI - The interaction of phenyldichloroarsine with erythrocytes. AB - The purpose of the study was to identify binding sites of organic arsenic in the erythrocyte and to explain species differences in binding. Washed erythrocytes were exposed to graded concentrations of [U-14C]phenyldichloroarsine (PDA) in phosphate-buffered saline containing 0.1% glucose and 0.1% bovine serum albumin. At low PDA concentrations, all cells bound the arsenical rapidly (within 10 min) and quantitatively. Human, pig, hamster, guinea pig, and mouse erythrocytes approached saturation at 0.02-0.3 mumol PDA/10(9) cells, depending on the species. Saturation points correlated well with each respective species' erythrocyte glutathione content. In contrast, rat erythrocytes showed no sign of saturation at PDA loads as high as 3.0 mumol/10(9) cells. Hemolysates of PDA treated erythrocytes were subjected to Sephadex G-75 gel filtration chromatography. 14C from rat hemolysate was distributed between the hemoglobin and small molecular weight (glutathione-containing) fractions. In all other species, the 14C eluted almost exclusively with the glutathione-containing fractions. In equilibrium dialysis experiments, human hemoglobin did not bind PDA, whereas rat hemoglobin bound 2 PDA/mol with Kd approximately 5 microM. In conclusion, glutathione is the principal binding site of phenyldichloroarsine in erythrocytes. In most species, the arsenical does not bind to hemoglobin, even though it has free (titratable) sulfhydryls considerably in excess of the glutathione concentration. In rat erythrocytes, phenlydichloroarsine binds both to glutathione and to hemoglobin. Arsenical binding by rat hemoglobin is presumably due to the unique location of the extra titratable cysteine in that protein. PMID- 2769697 TI - Lack of inducibility of brain monooxygenase activities including parathion desulfuration. AB - The ability of phenobarbital and beta-naphthoflavone to induce parathion desulfuration, aminopyrine N-demethylation, and NADPH-cytochrome-c reductase activity in the brain and liver of male and female rats was investigated. Activities of all three enzymes were found in similar levels in both the mitochondrial and microsomal fractions of brain. There were no sex differences in brain activities. Liver activities were from 10- to 30-fold higher than brain activities when computed on a tissue-wet-weight-equivalent basis. Although exposure to both inducers increased all three enzyme activities and cytochrome P 450 in liver, neither inducer increased the enzyme activities in mitochondrial or microsomal brain fractions of either sex. Thus, these brain monooxygenase activities appear to be refractory to induction by two classical types of cytochrome P-450 inducers. This lack of inducibility could serve to protect the animal against environmentally enhanced increases in the activation of xenobiotics to neurotoxic metabolites, such as parathion desulfuration to paraoxon. PMID- 2769698 TI - Modulations in the biotransformation of tobacco extract and N'-nitrosonornicotine under differential dietary protein status. AB - The modulation of the phase I and phase II biotransformation enzymes upon treatment with tobacco extract (TE) and N'-nitrosonornicotine (NNN) was investigated using male Sprague-Dawley rats fed differential protein diets. It was observed that the animals fed a low protein diet showed an overall decrease in the basal levels of hepatic and pulmonary phase I and II enzymes. TE and NNN significantly decreased the detoxifying system in the low-protein-fed animals. Animals fed 20% protein, however, showed significant increases in glutathione and glutathione S-transferase upon treatment. Furthermore, TE and NNN treatment brought about a significant depletion in the hepatic pool of vitamin A with a concomitant increase in the vitamin C levels. PMID- 2769699 TI - Sensitivity of selected drug biotransformation enzymes to dietary protein levels in adult F344 male rats. AB - Adult male Fischer 344 rats were fed inadequate, adequate, and excessive quantities of dietary protein (8, 12, and 22%, respectively) for a period of 14 days. An increase in dietary protein did not increase liver weight but resulted in an increase in cytochrome P-450 content and 7-ethoxycoumarin O-deethylase activity. No significant difference in glutathione S-transferase activity was observed at the three protein levels. The in vivo hepatotoxicity of bromobenzene increased with an elevation in dietary protein intake from 12 to 22%. These data from mature rats follow trends similar to findings we have reported previously with juvenile rats. PMID- 2769700 TI - Experimental infection of Old and New World phlebotomine sand flies (Diptera: Psychodidae) with Ascogregarina chagasi (Eugregarinorida: Lecudinidae). AB - The aseptate gregarine, Ascogregarina chagasi (Adler and Mayrink), found in a Colombian strain of Lutzomyia longipalpis (Lutz and Neiva), was fed to the larvae of seven species of laboratory-bred sand flies: Phlebotomus papatasi (Scopoli), P. argentipes Annandale and Brunetti, P. perniciosus Newstead, L. serrana (Damasceno and Arouck), L. abonnenci (Floch and Chassignet), L. columbiana (Ristorcelli and Van Ty), and a gregarine-free Brazilian strain of L. longipalpis. Trophozoites of the gregarine were recovered from adult sand flies of four species: P. papatasi, L. serrana, L. columbiana, and the Brazilian strain of L. longipalpis; the parasites were able to complete their life cycle only in the Brazilian strain of L. longipalpis. The infection rate and parasite density of A. chagasi were higher in the Colombian strain of L. longipalpis than in the Brazilian strain. Infection with A. chagasi significantly reduced adult longevity of the Brazilian strain of L. longipalpis, but it had little effect on fecundity. PMID- 2769701 TI - Quantitative studies of host immunoglobulin G in the hemolymph of ticks (Acari). AB - A radioimmunoassay was used to measure the concentration of host immunoglobulin G (IgG) in the hemolymph of female hard and soft ticks. Hyalomma excavatum Koch, Rhipicephalus sanguineus Latreille, Ornithodoros tholozani (Laboulbene and Megnin), and O. moubata (Murry) were fed on rabbits immunized with ovalbumin; Argas persicus (Oken) was fed on chickens immunized with cytochrome 'C.' At 24 h after feeding, the concentration of antiovalbumin IgG in the hemolymph was 7 micrograms/ml for H. excavatum, 5 micrograms/ml for R. sanguineus, and 0.15 micrograms/ml for O. moubata; the percentage of intact IgG molecules was 30, 44, and 100%, respectively. Host IgG was not detected in the hemolymph of O. tholozani and A. persicus. There was no increase in the concentrations of host IgG in the hemolymph of the soft ticks during the first week following the blood meal. The potential contribution to the resistance of hosts against ticks by host antibodies that cross into the tick hemocoel is discussed. PMID- 2769702 TI - Changes in the concentration of globulins in naive guinea pigs during feeding by the immature stages of Rhipicephalus evertsi evertsi (Acari: Ixodidae). AB - The weight of Rhipicephalus evertsi evertsi Neumann nymphs, which as larvae and nymphs completed the entire blood meal on the same individual guinea pig, was significantly lower than the weight of those that as larvae and nymphs fed on two separate naive hosts. Nymphs of the latter category spent 1 wk (from unfed larvae to unfed nymphs) on one animal before their transfer to the second host to complete the blood meal. The albumin concentration of the host blood decreased and was related to the time that the immature ticks spent on the hosts. The albumin/globulin ratio also decreased. The alpha 1 globulin fraction increased soon after the guinea pigs were infested with ticks. No further changes in the levels of the alpha 1 globulin fraction were observed with time. The concentration of serum beta globulins increased only in guinea pigs infested with immature ticks for the entire larval and nymphal feeding period. A second infestation of those guinea pigs with larvae of R. e. evertsi resulted in further increases in the levels of serum beta globulins. The relationships among serum beta globulin levels, the weight of engorged nymphs, and host immunity are discussed. PMID- 2769703 TI - Egg of Aedes (Gymnometopa) mediovittatus (Diptera: Culicidae). AB - The egg of Aedes mediovittatus (Coquillett) is described from scanning electron micrographs. The egg is black, slightly tapered toward the posterior pole, and is approximately 771 microns long and up to 175 microns wide. On the entire egg surface there are about 970 polygonal outer chorionic cells, each bounded by a raised outer chorionic reticulum which forms a wall around each cell. Incorporated into the inner surface of this wall are 13-18 relatively small, poorly defined and variably shaped tubercles. In the center of each cell there is a large, buttonlike, more or less round tubercle with a pitted upper surface. Over most of the egg surface, the walls of this tubercle are connected by spokelike bridges of variable diameter to the cell floor or reticulum wall. The structure of the outer chorionic cells is somewhat modified in areas approaching the anterior and posterior poles. PMID- 2769704 TI - Laboratory study of competition between United States strains of Aedes albopictus and Aedes aegypti (Diptera: Culicidae). AB - Mosquito abatement workers in Houston, Tex., and New Orleans, La., have observed that the recent introduction of Aedes albopictus (Skuse) has been accompanied by a decline and virtual disappearance of Ae. aegypti (L.). This suggests competitive displacement but contradicts the direction of displacement observed in native habitats of Ae. albopictus. The paper reports a series of laboratory studies on competition between U.S. strains of the two species. Larval survivorship, size, and development time were monitored in increasing densities of pure and mixed cultures of the two species under limited and optimal diets. Oviposition preferences were examined by offering gravid females cups containing first or fourth instars of either species. Ethological isolation was studied by simultaneously offering virgin females of one species to males of both species and monitoring courtship behavior as well as rates of oviposition, percentage of hatch, and embryonation. The results of the larval competition studies suggest that interspecific competition increased development time only slightly and had no effect on survival of Ae. albopictus. Competition increased survival in Ae. aegypti. Size of both species was influenced by interspecific competition, but the magnitude and direction of the effect was inconsistent between strains and diets such that neither species emerged consistently larger. The results of the oviposition study indicated a higher fecundity in Ae. aegypti but otherwise demonstrated that both species oviposit without regard to the presence, age, or species of larvae in the oviposition container. The ethological isolation tests demonstrated that Ae. aegypti males were more sexually aggressive than males or Ae. albopictus. However, Ae. albopitus females placed with increasing densities of Ae. aegypti males demonstrated no decrease in rates of oviposition, and eggs laid showed equal rates of hatch and embryonation. In general, the results do not suggest that the U.S Ae. albopictus population is inherently more competitive in the laboratory than Ae. aegypti. Other reasons for the observed decline in Ae. aegypti in the United States are discussed. PMID- 2769705 TI - Lyme disease in California: interrelationship of Ixodes pacificus (Acari: Ixodidae), the western fence lizard (Sceloporus occidentalis), and Borrelia burgdorferi. AB - The relationship of immature western black-legged ticks, Ixodes pacificus Cooley and Kohls, to the western fence lizard, Sceloporus occidentalis Baird and Girard, and to the Lyme disease spirochete, Borrelia burgdorferi, was investigated in chaparral and woodland-grass habitats in northern California from 1984 to 1986. Immature ticks were found on lizards in spring and summer, but the prevalence and abundance of ticks on this host were considerably greater in spring. The peak of larval abundance preceded that of nymphs by several weeks, but there was considerable seasonal overlap between these parasitic stages. Larvae and nymphs attached primarily to the lateral nuchal pockets of lizards in chaparral (99.5%) and woodland-grass (91.8%). The numbers of larvae infesting lizards in spring fit the negative binomial distribution in woodland-grass but not in chaparral; insufficient data precluded similar analyses for nymphs. Tick loads did not differ significantly with respect to age or gender of the lizard. Spirochetal infection rates (range, 0-3.7%) in I. pacificus immatures were comparable in both habitats and were similar to those reported previously for adults of this tick. Overall, 1 (0.9%) of 117 larvae and 10 (1.8%) of 552 nymphs were infected with spirochetes resembling B. burgdorferi. Spirochetes were not observed in blood smears prepared from 261 wild-caught lizards, including five lizards fed upon by infected ticks at the time of collection. These and other findings suggest that S. occidentalis, although an important host of I. pacificus immatures, may be less important as a source for infecting ticks with B. burgdorferi. PMID- 2769706 TI - Population structure and seasonal intra-burrow movement of Ornithodoros turicata (Acari: Argasidae) in gopher tortoise burrows. AB - Burrows of the gopher tortoise, Gopherus polyphemus Daudin, were sampled for Ornithodoros turicata (Duges) infestation using carbon dioxide baits and vacuum extraction. Ticks were captured, marked, released, and recaptured, and population estimates were made using the Lincoln index. Estimated population ranged from 47 to 1,338 ticks per burrow. The tick population consisted predominantly of nymphs, with a significant increase in the larval population during the months of June and July. Adult sex ratio was slightly male-biased, but numbers of adults collected were consistently low. Ticks exhibited a low interburrow movement, but depth preferences fluctuated with season; more ticks occurred in the upper strata of the burrows during the hot, humid months. PMID- 2769707 TI - Immunoblot analysis of digestion of human and rodent blood by Aedes aegypti (Diptera: Culicidae). AB - The digestion of human and rodent blood by Aedes aegypti (L.) was investigated by immunoblot analysis, using polyclonal antisera produced against serum proteins. Rates and patterns of digestion of the principal proteins in serum (albumin and immunoglobulin G) appeared to differ depending on the source of blood. Overall, most intact proteins disappeared 24-48 h after blood ingestion by Ae. aegypti, and albumin and immunoglobulin G appeared to be the most persistent proteins, irrespective of the source of blood. PMID- 2769708 TI - Culex tritaeniorhynchus and Aedes albopictus (Diptera: Culicidae) as natural vectors of Dirofilaria immitis (Spirurida: Filariidae) in Miki City, Japan. AB - Natural infections with Dirofilaria immitis (Leidy) in a population of mosquitoes and dogs and its antibodies in a human population were surveyed in Miki City, a rural area of Japan, to reveal ecological features of this arthropod-borne zoonotic parasite. Microfilaremic and amicrofilaremic infection rates in 190 dogs were 52.6 and 9.0%, respectively, as determined by the hematocrit centrifuge method and the indirect fluorescent antibody test. An enzyme-linked immunosorbent assay (ELISA) test for antibodies to D. immitis showed that almost all of 917 inhabitants had antibodies in varying degrees, indicating frequent exposure of this parasite to the human population. Among the six species of wild mosquitoes sampled from 1985 through 1987 by attraction with dry ice, Culex tritaeniorhynchus Giles was the most abundant in two sites and Aedes albopictus (Skuse) in another two sites. Filarial infections were found every year in Cx. tritaeniorhynchus and Ae. albopictus collected between July and September, as examined by ELISA for detecting larval antigens in mosquito homogenate, suggesting that these species are important natural vectors in this survey area. PMID- 2769709 TI - Activity of insecticides against the preemerged adult cat flea in the cocoon (Siphonaptera: Pulicidae). AB - The activity of insecticides against the adult cat flea, Ctenocephalides felis (Bouche), inside the cocoon (preemerged) was determined by spraying the cocoons directly and observing subsequent emergence of adults over the next 14 d. Direct sprays of 0.5% trimethacarb wettable powder (WP) and chlorpyrifos emulsifiable concentrate (EC) and WP provided greater than 70% kill. The order of activity against the preemerged adult exposed to direct sprays was organophosphates greater than carbamates greater than pyrethroids. In general, pyrethroids and proprietary aerosols failed to kill preemerged adults. Even though most sprays did not kill preemerged adults, they stimulated adult emergence from cocoons. Preemerged adults placed in the nap of carpet were not killed by chlorpyrifos, diazinon, or propetamphos sprays; the carpet protected them effectively. PMID- 2769710 TI - Changes in the parity rate of Tabanus fuscicostatus (Diptera: Tabanidae) populations associated with controlling available hosts. AB - The parity rates of Tabanus fuscicostatus Hine populations were monitored at two areas of a wildlife management complex for 24 d using canopy traps baited with dry ice. Overall, 1,235 flies were dissected. Three cows placed in Area T were sprayed with 0.05% fenvalerate, and three cows placed in Area U were not sprayed. The parity rate in Area T decreased from 43.6 to 31.2% following the introduction of cattle. Conversely, the parity rate in Area U increased from 30.3 to 43.7% following the introduction of cattle. These results indicate that a segment of T. fuscicostatus populations returns to the previous location for a subsequent blood meal. PMID- 2769711 TI - Clearance of African swine fever virus from infected tick (Acari) colonies. AB - Three laboratory colonies of the argasid tick Onithodoros moubata porcinus van der Merwe were started from collections made in 1983 at three different sites in Zimbabwe. All of the colonies contained ticks infected with African swine fever (ASF) virus that was readily transmitted by bite to domestic pigs. Although they were maintained on virus-free pig blood, ASF virus infections persisted in the colonies for at least 1 yr. Despite the fact that ASF virus passes transstadially, sexually, and transovarially in this tick species sometime during the following year, the virus disappeared from the colonies. Studies comparing fecundity in infected and uninfected lots of O. moubata porcinus showed that mortality rates were considerably higher among the infected ticks. A similar study with Ornithodoros erraticus Lucas, a tick that harbors and transmits ASF virus on the Iberian Peninsula, gave essentially the same results. This is probably a factor involved in the clearance of ASF virus from tick populations that are not subjected to reinfection. How this information may be applied in the eradication of African swine fever in Portugal and Spain is discussed. PMID- 2769712 TI - Inability of diapausing Culex pipiens (Diptera: Culicidae) to use blood for producing lipid reserves for overwinter survival. AB - Diapausing Culex pipiens L. females fed 10% sucrose for 7 d following eclosion contained significantly more lipids (P less than 0.05) than nondiapausing females reared and maintained at the same temperature (22 degrees C) but at a longer photophase (14:10 [L:D] instead of 9:15). Diapausing females with limited lipid reserves failed to increase their reserves after blood feeding. The average lipid content of 56 females tested decreased significantly (P less than 0.05) by day 6 after feeding and there was no correlation (r = -0.06) between lipid content at this time and original bloodmeal volumes of individual females. These results refute the contention that blood meals taken by diapausing Cx. pipiens result in fat body development when females are incubated at 18 degrees C during bloodmeal digestion. Diapausing Cx. pipiens with limited lipid reserves were unable to obtain sufficient energy from a single blood meal to survive extended hibernation. Although none became gravid, only 50% remained alive after 20 d in hibernation. In contrast, nonblood-fed females fed only 10% sucrose for 7 to 10 d before being placed in hibernation on a water diet survived for 6 mo with only 50% mortality. There was no evidence for gonotrophic dissociation. Failure of blood-fed, diapausing females to initiate vitellogenesis was correlated with the significantly smaller blood meals taken by most diapausing females and not with hypertrophy of the fat body or temperature during digestion. PMID- 2769713 TI - Fay-Prince trap baited with CO2 for monitoring adult abundance of Aedes sierrensis (Diptera: Culicidae). AB - The Fay-Prince trap augmented with carbon dioxide (F-P/CO2) collected high numbers of male and female Aedes sierrensis (Ludlow). The F-P/CO2 trap collected 15-20 times more males, but statistically similar numbers of females as did a rabbit-baited CO2 trap (R/CO2). Carbon dioxide was essential to the successful operation of the F-P/CO2 trap for the collection of male and female Ae. sierrensis. A repeated measures ANOVA with polynomial contrasts found no significant differences in the population trends of female Ae. sierrensis measured by the two traps. Trap location also was a major source of variability, with one of the four locations accounting for 50% of all Ae. sierrensis collected. These results indicated that the F-P/CO2 trap was a simple but effective method for sampling Ae. sierrensis. PMID- 2769714 TI - Fate of the blood meal in force-fed, diapausing Culex pipiens (Diptera: Culicidae). AB - Diapausing Culex pipiens L. do not display host-seeking behavior and can be induced to take blood only by being placed in contact with or in proximity to a host for prolonged periods. Such "force-fed" females do not use the blood for lipogenesis, and only some of them use the blood to initiate vitellogenesis. Diapausing Cx. pipiens that are induced to feed eject an average of 4.2-4.6 microliters of blood during overnight feeding periods compared with an average of 0.1 microliters for nondiapausing controls. The reduced avidity of diapausing females for blood, even under optimum conditions, and the ejection by fed females of blood volumes in excess of volumes usually retained indicate that such females are not physiologically programmed for taking and retaining blood. Data for uric acid and hematin excretion and bloodmeal volumes retained by diapausing females are positively correlated with diapause termination and yolk deposition. The occurrence of gonotrophic dissociation need not be invoked to explain the failure of some diapausing females to initiate vitellogenesis following a blood meal. Instead, this is explained by retention of small quantities of blood followed by incomplete digestion and is the expected result of a dose-dependent phenomenon determined by threshold blood volumes. Our data support the concept that the overwintering strategy of Cx. pipiens is limited to gonotrophic concordance in which overwintering females in nature do not take blood or develop eggs until diapause is terminated. PMID- 2769715 TI - Use of DNA hybridizations probes for detection of the plague bacillus (Yersinia pestis) in fleas (Siphonaptera: Pulicidae and Ceratophyllidae). AB - The detection of active plaque in nature relies primarily on demonstration of the etiologic agent of the disease. Yersinia pestis, in the flea vectors and susceptible mammalian hosts. A live animal assay is currently used for identification of a Y. pestis virulence antigen that is not expressed in the flea. We have found that DNA hybridization probes specific for Y. pestis, used in very simple sample preparation schemes, allow detection of Y. pestis in three species of fleas as well as tissues of experimentally infected mice at minimum concentrations of 1 x 10(6) bacilli/ml. We detected Y. pestis in 22 of 90 (24%) experimentally infected Xenopsylla cheopis (Rothschild), 13 of 25 (52%) Thrassis bacchi (Rothschild), and 9 of 25 (36%) Diamanus montanus (Baker), but no hybridization signals were observed from fleas that had fed on normal mice. The probe technique indicated infection in 9 of 10 potentially infected liver and spleen samples and none of the 5 control samples. Our techniques permit definitive diagnosis in 48 h. PMID- 2769716 TI - Vaginal eversion in a bat tick, Argas (Chiropterargas) boueti Roubaud and Colas Belcour (Acari: Argasidae). AB - Vaginal eversion was observed in Argas (Chiropteragas) boueti. During eversion, both cervical and vestibular parts of the vagina are fully everted so that the former is anteriorly oriented, whereas the latter occupies the posterior end of the everted organ. The histology of normal and everted vaginas is described and correlated with its functional and biological significance. Vaginal eversion most likely occurs while the tick is ovipositing and may be involved in the wax coating process of eggs by Gene's organ. PMID- 2769717 TI - Survey of medically important true bacteria found associated with carrion beetles (Coleoptera: Silphidae). AB - Thirty-six carrion beetles (Silphidae: Nicrophorus tomentosus Weber, Oiceoptoma noveboracense (Forster), Necrophila americana (L.] collected in the Great Swamp National Wildlife Refuge, Basking Ridge, N.J., were dissected and the midgut, hindgut, and associated hemolymph were cultured for bacteria. Analytical profile index rapid biochemical systems were used for bacterial identifications. Nineteen bacteria were identified to species and four to the genus level. Although frank pathogens were not found, several of the identified coliform and staphylococci bacteria were known opportunistic pathogens. More than 20 additional morphologically distinct bacteria were cultured, but these could not be identified using the rapid biochemical test strips because of data base limitations. PMID- 2769718 TI - Seasonal abundance of Muscidae (Diptera) associated with cattle on a northern Transvaal farm. AB - Face flies were collected from cattle over a 14-mo period in an area where Parafilaria bovicola Tubangui was prevalent. Three species of Musca known to be vectors of P. bovicola were found. Two of the species (Musca lusoria Wiedeman and M. xanthomelas Wiedeman) were collected throughout the year, and M. nevilli Kleynhans was abundant only in autumn. PMID- 2769719 TI - Female mediation of feeding time on cattle in adult lone star ticks (Acari: Ixodidae). AB - The extended feeding time response on cattle of adult lone star ticks, Amblyomma americanum (L.), during November through December is facultative and is mediated by the female. Mean feeding time (11.8 d) in female ticks taken from the field and held at 14:10 (L:D) photoperiod and 25 degrees C for greater than or equal to 15 d was significantly shorter (P = 0.05) than for females taken directly from the field and fed on cattle (14.6 d). Mean feeding times of females from the field paired to males from the field, males from the field held for 30 d at 14:10 (L:D) and 10 degrees C, or males from the field held for 30 d at 14:10 (L:D) and 25 degrees C were not significantly different (15.7, 16.3, and 16.2 d, respectively). When males from the field were paired with females from the field that had been held at 14:10 (L:D) and 10 degrees C or 14:10 (L:D) and 25 degrees C for 30 d, mean feeding time of the females was significantly longer (17.2 d) or shorter (14.0 d), respectively, than for all other groups. PMID- 2769720 TI - An exclusion map for facioscapulohumeral (Landouzy-Dejerine) disease. AB - By using the genetic linkage data between the facioscapulohumeral muscular dystrophy (FSHD) gene and 57 markers on various autosomes, we have constructed an exclusion map for this disorder. The maximum likelihood location of the FSHD gene and the percentage of the excluded areas on each chromosome are presented here. This exclusion map shows that more than 80% of the genome has been excluded as a likely location of any locus responsible for FSHD in the majority of families. Chromosomes 3, 5, 10, 11, 15, and 19 remain largely unexcluded. Concentration on the highlighted areas of the genome should facilitate the identification of the site of the FSHD gene. PMID- 2769721 TI - Linkage analysis of French families with facioscapulohumeral muscular dystrophy. AB - Linkage analysis was undertaken in seven French families with facioscapulohumeral muscular dystrophy (FSHD). Six polymorphic DNA probes were studied, including random DNA sequences, coding sequences, and a hypervariable marker. No evidence for linkage of these probes to the disease was detected, and the results exclude probable location of the FSHD gene from three chromosomal regions (16p, proximal 19q, and 21q). PMID- 2769722 TI - Cone-rod congenital amaurosis associated with congenital hypertrichosis: an autosomal recessive condition. AB - Two female cousins were found to be affected with severe retinal dystrophy characterised by visual impairment from birth and profound photophobia in the absence of night blindness. Minimal fundus changes with a small foveal atrophy in the older cousin and slight macular pigment epithelial changes suggestive of early bull's eye appearance in the younger were detected, indicative of a cone rod type of congenital amaurosis. This was associated with trichomegaly, bushy eyebrows with synophyrys, and excessive facial and body hair (including hypertrophied circumareolar hair on the breasts of the older cousin). The mode of inheritance appears to be autosomal recessive. PMID- 2769723 TI - Evidence for genetic heterogeneity in tuberous sclerosis. AB - The question of genetic heterogeneity in tuberous sclerosis (TSC) was addressed by genetic linkage studies in eight affected families using nine polymorphic markers (EFD126.3, MCT136, ABO, ABL, AK1, and MCOA12 from distal 9q, and PBGD, MCT128.1, and 1CJ52.208M from distal 11q). The data as a whole supported a TSC locus on distal 9q, the peak lod score on multipoint analysis being 3.77 at 6 cM proximal to the Abelson oncogene locus (ABL). However, analysis of two point lod scores using the HOMOG programs showed significant evidence for genetic heterogeneity (p = 0.01), linkage to ABL being unlikely in one family. After exclusion of the unlinked family, multipoint analysis gave a peak lod score of 6.1 in the vicinity of ABL. The family unlinked to ABL showed no recombinants with two chromosome 11 probes, but was too small to provide significant evidence for linkage. Genetic heterogeneity in TSC will complicate efforts to clone the causative genes and severely limit the use of linked probes for carrier detection and prenatal diagnosis. PMID- 2769724 TI - Pitfalls in counselling of the blepharophimosis, ptosis, epicanthus inversus syndrome (BPES) AB - Non-penetrance or minimal expression as a genetic counselling problem in the blepharophimosis syndrome is discussed. PMID- 2769725 TI - Hypohidrotic ectodermal dysplasia, primary hypothyroidism, and agenesis of the corpus callosum. AB - In this report we present the unique combination of hypohidrotic ectodermal dysplasia, primary hypothyroidism, and agenesis of the corpus callosum in a two year old, severely mentally retarded boy. PMID- 2769726 TI - Auralcephalosyndactyly: a new craniosynostosis syndrome or a variant of the Saethre-Chotzen syndrome? AB - A mother and son are reported with bilateral, symmetrical syndactyly of the third, fourth, and fifth toes, mild craniosynostosis of the coronary sutures, and small pinnae. The same combination of malformations was recently described as a new syndrome by Kurczynsky and Casperson in a mother and her daughter. In addition, in the present family, the mother had fusion of two cervical vertebrae and a partial duplication of the first metatarsal. The child had a bilateral cleft lip and palate. The question is raised whether these patients represent a new syndrome or a variant of the Saethre-Chotzen syndrome. PMID- 2769727 TI - Angelman's syndrome and 15q11-13 deletions. PMID- 2769728 TI - Anencephaly: a vanishing problem in Bedouins? PMID- 2769729 TI - Autosomal dominant sneezing disorder provoked by fullness of stomach. PMID- 2769730 TI - An instrument for X-ray set quality assurance measurements. PMID- 2769731 TI - A shunt-excited inductive power link. AB - An alternative derivation of the separation-insensitive property of series excited self-oscillating inductive power transfer circuits is presented. This analysis is based on network theory and does not include the explicit determination of frequency as a step in the derivation. The separation insensitivity principle is extended to shunt-excited links which exhibit a theoretical voltage transfer function of unity while the coupling factor exceeds the reciprocal of the secondary quality factor. This requires the inclusion of a series resistor in the primary resonator's capacitive arm. Series RC elements are replaced by parallel forms in both the primary and secondary; this provides a more convenient output impedance level without the need for another transformer. A demonstration circuit is described and tested. It is found that separation insensitivity occurs while the coupling factor exceeds the reciprocal of the loaded secondary quality factor. Somewhat inferior response is obtained from a simpler circuit having no added resistances in the primary. PMID- 2769732 TI - A novel cervical dilatation force measurement instrument. AB - A simple and robust instrument for cervical dilatation force measurement is described which measures axial insertion force but is not affected by lateral loads. The instrument is battery-powered, self-contained and displays actual axial force and peak axial force on digital liquid crystal displays. PMID- 2769733 TI - A simple disconnect alarm. AB - We describe a simple anaesthetic ventilator disconnection alarm which is switched on automatically. PMID- 2769734 TI - Evaluation report: defibrillators. AB - As part of the continuing evaluation programme of medical equipment sponsored by the UK Health Departments, the evaluation of defibrillators is being carried out within the Sheffield and Rotherham District Health Authorities. The following is a version of 'Health Equipment Information' ('HEI') Number 186, published in September 1988, which contains evaluation details on a further five defibrillators. These are the Cardiac Recorders CR26, the Hewlett-Packard HP43120A, the Physico-Control Lifepak 8, the PPG Hellige SCP 852 and the Simonsen & Weel Defi 2. A further model, the Seward Medical 9922 is covered very briefly as it has, as a result of the evaluation, been withdrawn from the market. Earlier summaries of evaluation reports have appeared in 'Journal of Medical Engineering and Technology', together with a review of debrillator design and development. PMID- 2769735 TI - Interaction of the B subunit of cholera toxin with endogenous ganglioside GM1 causes changes in membrane potential of rat thymocytes. AB - The fluorescent anionic dye, bisoxonol, and flow cytometry have been used to monitor changes in the membrane potential of rat thymocytes exposed to the B subunit of cholera toxin. The B subunit induced a rapid hyperpolarization, which was due to activation of a Ca2+-sensitive K+ channel. Reduction of extracellular Ca2+ to less than 1 microM by the addition of [ethylene bis(oxyethylenenitrilo)]tetraacetic acid immediately abolished the hyperpolarization caused by the B subunit. Cells treated with quinine and tetraethylammonium lost their ability to respond to the B subunit, whereas 4 aminopyridine did not have any effect. Thus, calcium-sensitive and not voltage gated K+ channels appeared to be responsible for the hyperpolarization. The results of ion substitution experiments indicated that extracellular Na+ was not essential for changes in membrane potential. Further studies with ouabain, amiloride and furosemide demonstrated that electrogenic Na+/K+ ATPase, Na+/H+ antiporter and Na+/K+/Cl- cotransporter, respectively, were not involved in the hyperpolarization process induced by the B subunit. Thus, crosslinking of several molecules of ganglioside GM1 on the cell surface of rat thymocytes by the pentavalent B subunit of cholera toxin modulated plasma membrane permeability to K+ by triggering the opening of Ca2+-sensitive K+ channels. A role for gangliosides in regulating ion permeability would have important implications for the function of gangliosides in various cellular phenomena. PMID- 2769736 TI - Activation of K+ channels in renal medullary vesicles by cAMP-dependent protein kinase. AB - ADH, acting through cAMP, increases the potassium conductance of apical membranes of mouse medullary thick ascending limbs of Henle. The present studies tested whether exposure of renal medullary apical membranes in vitro to the catalytic subunit of cAMP-dependent protein kinase resulted in an increase in potassium conductance. Apical membrane vesicles prepared from rabbit outer renal medulla demonstrated bumetanide- and chloride-sensitive 22Na+ uptake and barium sensitive, voltage-dependent 86Rb+ influx. When vesicles were loaded with purified catalytic subunit of cAMP-dependent protein kinase (150 mU/ml), 1 mM ATP, and 50 mM KCl, the barium-sensitive 86Rb+ influx increased from 361 +/- 138 to 528 +/- 120 pM/mg prot.30 sec (P less than 0.01). This increase was inhibited completely when heat-stable protein kinase inhibitor (1 microgram/ml) was also present in the vesicle solutions. The stimulation of 86Rb+ uptake by protein kinase required ATP rather than ADP. It also required opening of the vesicles by hypotonic shock, presumably to allow the kinase free access to the cytoplasmic face of the membranes. We conclude that cAMP-dependent protein kinase-mediated phosphorylation of apical membranes from the renal medulla increases the potassium conductance of these membranes. This mechanism may account for the ADH mediated increase in potassium conductance in the mouse mTALH. PMID- 2769738 TI - Role of substrate binding forces in exchange-only transport systems: I. Transition-state theory. AB - An analysis of transition-state models for exchange-only transport shows that substrate binding forces, carrier conformational changes, and coupled substrate flow are interrelated. For a system to catalyze exchange but not net transport, addition of the substrate must convert the carrier from an immobile to a mobile form. The reduction in the energy barrier to movement is necessarily paid for out of the intrinsic binding energy between the substrate and the transport site, and is dependent on the formation of two different types of complex: a loose complex initially and a tight complex in the transition state in carrier movement. Hence the site should at first be incompletely organized for optimal binding but, following a conformational change, complementary to the substrate structure in the transition state. The conformational change, which may involve the whole protein, would be induced by cooperative interactions between the substrate and several groups within the site, involving a chelate effect. The tightness of coupling, i.e., the ratio of exchange to net transport, is directly proportional to the increased binding energy in the transition state, a relationship which allows the virtual substrate dissociation constant in the transition state to be calculated from experimental rate and half-saturation constants. Because the transition state is present in minute amount, strong bonding here does not enhance the substrate's affinity, and specificity may, therefore, be expressed in maximum exchange rates alone. However, where substrates largely convert the carrier to a transport intermediate whose mobility is the same with all substrates, specificity is also expressed in affinity. Hence the expression of substrate specificity provides evidence on the translocation mechanism. PMID- 2769737 TI - Feet, bridges, and pillars in triad junctions of mammalian skeletal muscle: their possible relationship to calcium buffers in terminal cisternae and T-tubules and to excitation-contraction coupling. AB - The structure of the triad junction was examined in thin sections of mammalian fast-twitch skeletal muscle. The aims of the experiments were twofold: first, to examine relationships between the contents of the junctional gap and the terminal cisternae that could be significant in excitation-contraction coupling and, second, to look for structures in the transverse tubules that could support a calcium buffer system. Procedures known to stabilize cytoskeletal elements were used in an attempt to retain the original structure. "Feet," "pillars" and "bridges" were often seen side by side in the same junction. In one such junction, the average center-to-center spacing between four bridges was 30.9 +/- 1.7 nm and between five foot-like structures was 29.2 +/- 1.4 nm. The subunit structure of the feet could be seen in many sections. The lumen of the terminal cisternae was filled with a tetragonal network of calsequestrin which formed parallel strands near the junctional membrane, in register with the feet. The strands overlay the area occupied by "rods" seen in freeze-fracture replicas of terminal cisterna membrane. The contents of the transverse tubules were aggregated into bands, or "tethers," which extended across the short axis of the tubule at regular intervals of about 30 nm. The tethers consisted of flattened discs, stacked across the long axis of the tubule, aligned with the junctional feet. Lanthanum staining of the tethers indicated cationic binding sites that could buffer luminal calcium ion concentration in the vicinity of the voltage sensor for contraction. It is suggested (i) that the control of calcium concentration near the voltage sensor is necessary for normal activation, (ii) that feet, pillars and bridges are different images of a spanning structure, and (iii) that the regular alignment of tethers, feet and calsequestrin is functionally significant in excitation-contraction coupling. PMID- 2769739 TI - Reconstitution of the lipid matrix of the outer membrane of gram-negative bacteria as asymmetric planar bilayer. AB - This paper is a report on the reconstitution of the lipid matrix of the outer membrane of Gram-negative bacteria as an asymmetric planar bilayer. This is the first time that a planar membrane is described, which consists on one side of a phospholipid (PL) mixture and on the other side of lipopolysaccharide (LPS). Therefore, strong emphasis is placed on a physical characterization of this membrane via its electrical properties. The membranes were prepared from spread monolayers or from vesicle-derived monolayers. Contrary to observations for symmetric phospholipid membranes, specific capacitances of (0.67 +/- 0.02) mu F.cm-2, breakdown voltages between 200 and 400 mV and specific conductances between 10(-8) and 2 x 10(-7) S.cm-2 were obtained independent of the preparation method. The LPS-containing membranes were stable up to 3 hr if they were formed and kept at temperatures above the hydrocarbon chain melting temperature of the LPS. For the specific capacitance, a dependence on the aperture radius was observed. This is explained by assuming a toroidal transition zone at the rim of the aperture. First results on the action of the pore-forming alpha-toxin from Staphylococcus aureus on bilayers of different composition demonstrate particular characteristics of this asymmetric bilayer system. The pore-formation rate is highest in symmetric phospholipid bilayers, considerably lower in asymmetric PL/LPS systems and fully inhibited in LPS/LPS systems. PMID- 2769740 TI - S+ versus S- fading in teaching visual discriminations to severely mentally handicapped children. AB - Twenty-seven severely mentally handicapped children in three matched groups were trained on both a complex and a simple visual discrimination task with: (1) prompt fading on S+; (2) prompt fading on S-; or (3) no prompting (trial-and error training). On the complex discrimination task, differences between groups were obscured by a floor effect. Only one subject from each group acquired the discrimination. However, on the simple discrimination task all nine S+ fading, eight S- fading and six trial-and-error training subjects attained criterion. Both S+ and S- fading groups made significantly fewer errors than the trial-and error group but did not differ significantly from each other. Sixteen children who failed to acquire the complex discrimination in Experiment 1 also participated in Experiment 2. Subjects received additional training on the task by one of four procedures. Neither continued trial-and-error training, continued S+ or S- fading, reversals of the prompt between S+ and S-, or intensity fading resulted in acquisition of the task. Results are discussed in terms of overshadowing and task difficulty. PMID- 2769741 TI - The social reception of mainstreamed children in the regular classroom. AB - The purpose of the present study was to learn how a mainstreamed mentally retarded or emotionally disturbed child is received in a regular classroom by the other pupils in the class. Each of 36 fifth grade boys interacted with one of three male confederates and 36 eighth grade boys interacted with one of three other male confederates. In each case the confederate was of the same age and grade as the subjects. He was presented to the subject as an ordinary child, as a mentally retarded child, or as an emotionally disturbed child who might soon attend their school and the subject was asked to estimate how the confederate would fit into the school. The confederate was always blind to condition and, after the interaction, the subject was questioned about the confederate by an experimenter also blind to condition. Behavioural measures taken from the sound recordings of the interaction showed that the subjects in the mentally retarded and emotionally disturbed conditions behaved in a less friendly and more anxious manner than in the control condition. They also wanted more social distance from the 'retarded' and the 'disturbed' confederate and expected their peers to be more rejecting toward them relative to the control condition. Essentially the same results were obtained for fifth and eighth grade boys and little difference was found between the two types of mental handicaps. The implication of the study for deinstitutionalization are discussed. PMID- 2769742 TI - Polycystic ovary disease, manic-depressive illness and mental retardation. AB - Presence of polycystic ovary disease is described in a mentally retarded woman who later developed features of manic-depressive illness. The possibility that the three conditions might interrelate pathophysiologically is discussed. PMID- 2769743 TI - Neuroleptic malignant syndrome with hypomania and mental retardation. AB - A case of neuroleptic malignant syndrome is described in a 37-year-old man with mental retardation, hypomania and a history of recent hepatitis B infection. The NMS is reviewed and the potential importance of this iatrogenic emergency in mental handicap practice is emphasized. PMID- 2769744 TI - Lattice fringe studies of (100) defects in enamel crystallites. AB - Lattice imperfections in the structure of shark (Nataprion brevirostrais) enamel crystallites have been studied by means of lattice-imaging in a high-resolution transmission electron microscope. Line defects exhibiting various lengths (100 2500 A) and widths (10-30 A) and demonstrating phase behaviour different from that of the host crystal were observed along the fringes representing (100) lattice planes. When defect sites were subjected to an electron beam, an annealing process was observed in which the difference in phase contrast eventually disappeared and the defect itself became an intricate part of the (100)-type lattice planes. A through-focal series of the defects show a reversal in phase contrast. By examining the contrast behaviour under certain focal conditions and by adopting the Fresnel diffraction mode, the refractive index of the defect regions was determined to be lower than that of the apatite crystal. Present findings suggest that the interlayering structure along the (100) planes is responsible for the line defects observed in enamel apatites. PMID- 2769745 TI - Elemental concentrations in air-exposed and vacuum-stored cryosections of rat liver cells. AB - Elemental concentrations in different compartments of cryosections of isolated rat liver cells cryotransferred and freeze-dried were compared with those obtained after storage under vacuum for 12 or 60 h and after exposure to room air for 2 min. Poorer image contrast and segregation artefacts are frequently found in air-exposed sections, together with a slight but significant decrease of the K concentration in the cytoplasm and an increase of the S concentration in the liver cell nuclei and the extracellular medium. Extreme distortions of both ultrastructure and elemental distributions are observed if the sections are even slightly colder than the surrounding atmosphere. While storage of frozen-dried cryosections under vacuum for less than 12 h does not lead to alterations in the sections, gross changes are found both in morphology and elemental distribution in sections stored under vacuum for about 60 h. Long-time vacuum storage of frozen-dried cryosections is, therefore, not recommended. PMID- 2769746 TI - Tomographic reconstruction from energy-filtered images of thick biological sections. AB - Energy filtration makes it possible to image an approximately 0.5 microm biological section at 80 kV in the electron microscope. Based on spectra taken at different tilt angles, we chose the most probable energy loss, deltaEp +/- 10eV for each tilt angle, as the imaging energy window. A complete tilt series from +60 degrees to -60 degrees at 2.5 degree intervals was collected on the Zeiss EM902 and used in a tomographic reconstruction of transcriptionally active chromatin in the Balbiani ring of Chironomus tentans. PMID- 2769747 TI - Optimizing sampling designs for volume measurements of components of human brain using a stereological method. AB - Measurements of the cerebral cortical volume used to be very laborious, due to the 3-D complexity of the gyral pattern. Using stereological methods, which allow the quantification of 3-D structures from measurements on 2-D cross-sections, the difficulties have been overcome. In thirty formalin-fixed normal human brains the total volumes were measured by saline displacement. The brains were serially sliced in coronal sections and the fractional areas of the cortex, white matter, central grey structures and ventricles were determined by point-counting. Using Cavalieri's principle the volumes of these structures were calculated. The average cortical fixed volume was 549 ml (SD +/- 107) corresponding to 54% of the total volume of the hemispheres. The coefficient of error of the cortical volume determinations was 2.6%. The efficiency of the design and the possibilities for optimizing the design are discussed. This point-counting method was preferred to the use of an automatic image analyser, being precise, easy to handle and not interfering with further tissue processing for histological preparation. PMID- 2769748 TI - Protein structure alignment. AB - A new method of comparing protein structures is described, based on distance plot analysis. It is relatively insensitive to insertions and deletions in sequence and is tolerant of the displacement of equivalent substructures between the two molecules being compared. When presented with the co-ordinate sets of two structures, the method will produce automatically an alignment of their sequences based on structural criteria. The method uses the dynamic programming optimization technique, which is widely used in the comparison of protein sequences and thus unifies the techniques of protein structure and sequence comparison. Typical structure comparison problems were examined and the results of the new method compared to the published results obtained using conventional methods. In most examples, the new method produced a result that was equivalent, and in some cases superior, to those reported in the literature. PMID- 2769749 TI - Structures of D-xylose isomerase from Arthrobacter strain B3728 containing the inhibitors xylitol and D-sorbitol at 2.5 A and 2.3 A resolution, respectively. AB - The structures of D-xylose isomerase from Arthrobacter strain B3728 containing the polyol inhibitors xylitol and D-sorbitol have been solved at 2.5 A and 2.3 A, respectively. The structures have been refined using restrained least-squares refinement methods. The final crystallographic R-factors for the D-sorbitol (xylitol) bound molecules, for 43,615 (32,989) reflections are 15.6 (14.7). The molecule is a tetramer and the asymmetric unit of the crystal contains a dimer, the final model of which, incorporates a total of 6086 unique protein, inhibitor and magnesium atoms together with 535 bound solvent molecules. Each subunit of the enzyme contains two domains: the main domain is a parallel-stranded alpha beta barrel, which has been reported in 14 other enzymes. The C-terminal domain is a loop structure consisting of five helical segments and is involved in intermolecular contacts between subunits that make up the tetramer. The structures have been analysed with respect to molecular symmetry, intersubunit contacts, inhibitor binding and active site geometry. The refined model shows the two independent subunits to be similar apart from local deviations due to solvent contacts in the solvent-exposed helices. The enzyme is dependent on a divalent cation for catalytic activity. Two metal ions are required per monomer, and the high-affinity magnesium(II) site has been identified from the structural results presented here. The metal ion is complexed, at the high-affinity site, by four carboxylate side-chains of the conserved residues, Glu180, Glu216, Asp244 and Asp292. The inhibitor polyols are bound in the active site in an extended open chain conformation and complete an octahedral co-ordination shell for the magnesium cation via their oxygen atoms O-2 and O-4. The active site lies in a deep pocket near the C-terminal ends of the beta-strands of the barrel domain and includes residues from a second subunit. The tetrameric molecule can be considered to be a dimer of "active" dimers, the active sites being composed of residues from both subunits. The analysis has revealed the presence of several internal salt-bridges stabilizing the tertiary and quaternary structure. One of these, between Asp23 and Arg139, appears to play a key role in stabilizing the active dimer and is conserved in the known sequences of this enzyme.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2769750 TI - Solvent effects on protein motion and protein effects on solvent motion. Dynamics of the active site region of lysozyme. AB - The stochastic boundary molecular dynamics methodology is applied to the active site of the enzyme lysozyme. A comparison is made of in vacuo dynamics results from the stochastic boundary method and a full conventional molecular dynamics simulation of lysozyme. Excellent agreement between the two approaches is obtained. The influence of solvent on the residues in the active site region is explored and it is shown that both the structure and dynamics are affected. Of particular importance for the structure of the protein is the solvation of polar residues and the stabilization of like-charged ion pairs. The magnitude of the fluctuations is only slightly altered by the solvent; the overall increase in the root-mean-square fluctuations, relative to the vacuum run, is 11%. The solvent effect on dynamical properties is found not to be simply related to the solvent viscosity. Both the solvent exposure and dynamic aspects of protein-solvent interactions, including the relative time scales of the motions, are shown to play a role. The effects of the protein on solvent dynamics and structure are also observed to be significant. The solvent molecules around atoms in charged, polar and apolar side-chains show markedly different diffusion coefficients as well as exhibiting different solvation structures. One key example is the water around apolar groups, which is much less mobile than bulk water, or water solvating polar groups. PMID- 2769751 TI - Functional mapping of an entomocidal delta-endotoxin. Single amino acid changes produced by site-directed mutagenesis influence toxicity and specificity of the protein. AB - Mutagenesis has been used to investigate the toxicity and specificity of a larvicidal protein from Bacillus thuringiensis aizawai IC1 that is toxic to both lepidoptera and diptera and differs by only three residues from a monospecific lepidopteran toxin from B. thuringiensis berliner. Site-directed mutagenesis was used to investigate the contribution of these residues to the dual specificity of the aizawai protein. The results suggest that changes in the identity of residues adjacent to Arg544 and Arg567 on the C-terminal side may convert a monospecific toxin into a dual specificity toxin by altering the protease sensitivity of the arginyl peptide bond. A series of deletion mutants was constructed and their protein products analysed for toxicity in vitro and in vivo and for their ability to perturb phospholipid bilayers. The results indicate a different functional role for various protein segments in the toxin's mode of action and suggest that two separate regions close to the C terminus of the active toxin are important in conferring dual specificity on the aizawai IC1 toxin. A model suggesting a basis for the activity of monospecific and dual-specificity B. thuringiensis toxins is presented, which postulates that association of sequences at the C terminus of the active toxin with regions near the N terminus may be responsible for determining toxin specificity. PMID- 2769752 TI - Complementary peptide sequences in partner proteins of the adenovirus capsid. AB - Peptides quite similar to the signal peptide of secretory proteins were found in adenovirus serotype 2 fibre. This was surprising because this protein does not have this property. Because the N-end fibre is implicated in the penton base fibre interaction and complementary peptides to the N-sequence fibre were found in penton base protein, these complementary peptides might be involved in the protein-protein recognition and interaction process. So far, known structural data agree with such an hypothesis. PMID- 2769753 TI - Regulatory and essential light-chain-binding sites in myosin heavy chain subfragment-1 mapped by site-directed mutagenesis. AB - Site-directed mutagenesis of the cloned subfragment-1 (S-1) region of the unc-54 gene, encoding the myosin heavy chain B (MHC B) from Caenorhabditis elegans, has been used to locate binding sites for the regulatory and essential light chains. MHC B S-1 synthesized in Escherichia coli co-migrated with rabbit skeletal muscle myosin S-1 (Mr 90,000), was recognized by anti-nematode myosin antiserum on immunoblots, and specifically bound to 125I-labelled regulatory and essential light chains in a gel overlay assay. Deletion of 102 residues from the C terminus (mutant 655) reduced regulatory and essential light-chain binding to about 30% and 20% of wild-type levels, respectively. Similar reductions in relative binding of the two light chains were seen with mutant 534, in which 38 residues were deleted from the C terminus. Potential binding sites within 75 residues of the C terminus of S-1 were mapped by construction of five other mutant S-1 clones (398, 399, 400, 409 and 411) containing internal deletions of ten to 12 amino acid residues. These showed up to 30% reductions in their ability to bind essential light chains, but did not differ significantly from wild-type in their ability to bind regulatory light chains. Another mutant, 415, containing a deletion of a conserved acidic hexapeptide, E-D-I-R-D-E, showed enhancement of binding of regulatory and essential light chains to 150% and 165% of wild-type levels. Hence, the major binding sites for both light chains are within 38 amino acid residues of the C terminus. PMID- 2769754 TI - Preliminary crystallographic studies on duck ovotransferrin. AB - Crystals of duck ovotransferrin and duck apo-ovotransferrin have been grown from polyethylene glycol solutions. For both crystals, the space group is P2(1)2(1)2(1), the unit cell dimensions for the ovotransferrin are a = 49.6 A, b = 85.6 A, c = 178.7 A and for the apo-ovotransferrin a = 77.6 A, b = 98.8 A, c = 127.0 A, giving four molecules in the unit cell. PMID- 2769755 TI - HeLa nuclear protein recognizing DNA termini and translocating on DNA forming a regular DNA-multimeric protein complex. AB - Employing an exonuclease III protection assay we detected a protein in crude HeLa nuclear extracts binding, with apparent sequence specificity, to molecular ends of adenovirus type 2 (Ad2) DNA. This protein, designated nuclear factor IV (NFIV), was purified to homogeneity and was shown to be a hetero-dimer of 72,000 and 84,000 Mr. Binding to terminal Ad2 sequences was strongly enhanced by the presence of either of the sequence-specific DNA-binding proteins nuclear factor I and nuclear factor III. These proteins appeared to function as blockades for translocation of NFIV on DNA, thus producing apparent sequence specificity. In the absence of such a blockade, NFIV moved freely, without energy input, on any double-stranded DNA forming a regular DNA-multimeric protein complex as shown by methidiumpropyl EDTA footprinting and electron microscopy. Binding is completely dependent upon the presence of molecular ends. Evidence was obtained for a two step mechanism in which termini are recognized by NFIV and used as a starting point for subsequent translocation. The possible functions of the protein in adenovirus DNA replication and in cellular processes requiring DNA termini are discussed. PMID- 2769756 TI - Sindbis virus core protein crystals. AB - The core protein of Sindbis virus has been crystallized. Three different crystal forms have been observed. They diffract variously from 2.5 A to 3.5 A resolution. PMID- 2769757 TI - Refined structure of baboon alpha-lactalbumin at 1.7 A resolution. Comparison with C-type lysozyme. AB - The solution of the structure of alpha-lactalbumin from baboon milk (Papio cynocephalus) at 4.5 A resolution using the isomorphous replacement method has been reported previously. Initial refinement on the basis of these low-resolution studies was not successful because of the poor isomorphism of the best heavy-atom derivative. Because of the striking similarity between the structure of lysozyme and alpha-lactalbumin, a more cautious molecular replacement approach was tried to refine the model. Using hen egg-white lysozyme as the starting model, preliminary refinement was performed using heavily constrained least-squares minimization in reciprocal space. The model was further refined using stereochemical restraints at 1.7 A resolution to a conventional crystallographic residual of 0.22 for 1141 protein atoms. In the final model, the root-mean-square deviation from ideality for bond distances is 0.015 A, and for angle distances it is 0.027 A. The refinement was carried out using the human alpha-lactalbumin sequence and "omit maps" calculated during the course of refinement indicated eight possible sequence changes in the baboon alpha-lactalbumin X-ray sequence. During the refinement, a tightly bound calcium ion and 150 water molecules, of which four are internal, have been located. Some of the water molecules were modelled for disordered side-chains. The co-ordination around the calcium is a slightly distorted pentagonal bipyramid. The Ca-O distances vary from 2.2 A to 2.6 A, representing a tight calcium-binding loop in the structure. The calcium binding fold only superficially resembles the "EF-hand" and presumably has no evolutionary relationship with other EF-hand structures. The overall structure of alpha-lactalbumin is very similar to that of lysozyme. All large deviations occur in the loops where all sequence deletions and insertions are found. The C terminus appears to be rather flexible in alpha-lactalbumin compared to lysozyme. The experimental evidence supports the earlier predictions for the alpha lactalbumin structure that were based upon the assumption that alpha-lactalbumin and lysozyme have similar three-dimensional structures, with minimal deletions and insertions. A detailed comparison of the two structures shows striking features as well as throwing some light on the evolution of these two proteins from a common precursor. PMID- 2769758 TI - A kinetic hairpin transfer model for parvoviral DNA replication. AB - The DNAs encapsidated by parvoviruses show distinctly different patterns with respect to the ratio of plus-to-minus strands and sequence heterogeneity at the ends. A kinetic model, based on differential rates of hairpin transfer at 3' termini, is described and shown to account for all known parvoviral DNA distributions. PMID- 2769759 TI - Competitive nucleosome reconstitution of polydeoxynucleotides containing oligoguanosine tracts. AB - The ability of synthetic polydeoxynucleotides composed of oligoguanosine tracts of increasing length to form nucleosomes has been determined by several reconstitution procedures. When the presence of nucleosomes is determined by resistance to nuclease digestion, a protected band of approximately 150 base pairs is detected only with difficulty for polymers containing long tracts of contiguous guanosines. However, when assayed by a shift in the electrophoretic mobility of radiolabeled polymers exchanged at 0.7 M-NaCl with authentic nucleosomes, all polymers tested are seen to form nucleosomes. Quantitative competitive reconstitution shows that the length of the tracts per se does not adversely affect their propensity to form nucleosomes, since even 150 base-pair poly(dG).poly(dC) forms nucleosomes as well as heterogeneous-sequence DNA. However, the ability to form nucleosomes does depend on the length of the polymer repeating unit. PMID- 2769760 TI - Visualization of protein-nucleic acid interactions in a virus. Refined structure of intact tobacco mosaic virus at 2.9 A resolution by X-ray fiber diffraction. AB - The structure of tobacco mosaic virus (TMV) has been determined by fiber diffraction methods at 2.9 A resolution, and refined by restrained least-squares to an R-factor of 0.096. Protein-nucleic acid interactions are clearly visible. The final model contains all of the non-hydrogen atoms of the RNA and the protein, 71 water molecules, and two calcium-binding sites. Viral disassembly is driven by electrostatic repulsions between the charges in two carboxyl carboxylate pairs and a phosphate-carboxylate pair. The phosphate-carboxylate pair and at least one of the carboxyl-carboxylate pairs appear to be calcium binding sites. Nucleotide specificity, enabling TMV to recognize its own RNA by a repeating pattern of guanine residues, is provided by two guanine-specific hydrogen bonds in one of the three base-binding sites. PMID- 2769761 TI - Analysis of hemoglobin oxygen equilibrium curves. Are unique solutions possible? AB - As a hemoglobin tetramer is oxygenated, it converts from a form with low ligand affinity to a high-affinity structure. This allosteric transition occurs in partially liganded molecules, typically after two or three ligands are bound. As a result of the co-operative nature of the process, the populations of the partially liganded forms are low. The relative proportions and precise properties of these intermediate substrates are therefore difficult to measure and are subject to controversy. The problem is compounded by compensating effects; for example, over-estimation of the oxygen affinity of triply liganded forms will result in under-estimation of the proportion of these species. Specifically, published values for the oxygen affinity of the triply liganded species vary for identical conditions by a factor of more than 6. In analyses based on the highest affinity values, the triply liganded species virtually disappears. However, this affinity is usually calculated from the last few per cent of the oxygenation curve, and this part of the curve is extremely sensitive to the normalization of the data. We conclude that unique solutions for the ligand affinity and substrate populations may be impossible to achieve, and that unusual mechanisms based on particular combinations of parameters, therefore, should be viewed with caution. PMID- 2769762 TI - Temperature-jump studies on hemoglobin. Kinetic evidence for a non-quaternary isomerization process in deoxy- and carbonmonoxyhemoglobin. AB - Temperature jumps on mixtures of hemoglobin and pH indicators give rise to relaxation signals in the microsecond range. The pH and concentration dependences of the reciprocal relaxation time, 1/tau, may be rationalized on the basis of a reaction scheme in which a slow isomerization process in the protein moiety is coupled to a rapid co-operative ionization of two protons. At 11 degrees C the rate constants of the isomerization are kr = 4.2(+/- 1.8) x 10(4) s-1 and kf = 1.3(+/- 0.1) x 10(4) s-1 in deoxyhemoglobin; in carbonmonoxyhemoglobin they are kr = 3.9(+/- 1.3) x 10(4) s-1 and kf = 5.3(+/- 1.8) x 10(3) s-1. The pKa values of the coupled ionizing groups are 5.3 in deoxy- and 6.0 in carbonmonoxyhemoglobin. Modification of the CysF9(93) beta sulfhydryl group with iodoacetamide abolishes the pH dependence of 1/tau, suggesting that this sulfhydryl is involved in the isomerization process. Consideration of the X-ray structure of oxyhemoglobin allows a structural interpretation of the results. It is concluded that the isomerization may be important for the physiological function of hemoglobin, but that it is not identical with the quaternary structure transition. PMID- 2769763 TI - Protozoan myoglobin from Paramecium caudatum. Its unusual amino acid sequence. AB - A protozoan myoglobin (or monomeric hemoglobin) was isolated from Paramecium caudatum, and its complete amino acid sequence determined. It consists of 116 amino acid residues with a molecular mass of 12,565 daltons, this being much smaller than sperm whale myoglobin by 37 residues and even smaller than a bacterial hemoglobin from Vitreoscilla by 30 residues in terms of the monomer unit. A computer search showed no notable sequence homology with other hemoproteins. It contains two histidine residues at positions 68 and 84, but other lines of evidence seem to be needed to complete their final alignment. This is the first protozoan myoglobin to be sequenced. It may provide us with a new molecular basis for a further understanding of myoglobin-hemoglobin chemistry and their evolution. PMID- 2769764 TI - Structural changes in the thin filament during activation studied by X-ray diffraction of highly stretched skeletal muscle. AB - The actin layer-lines were recorded from a frog semitendinosus muscle stretched to a sarcomere length greater than 4.4 microM. On activation of the muscle, the equator, the second layer-line at 1/18 nm-1 and the 5.9 nm layer-line increased in integrated intensity. On the other hand, the integrated intensity of the first layer-line at 1/36 nm-1 decreased markedly on activation. This decrease was not fully attributable to shifts of tropomyosin strands and therefore suggested a structural change in the actin subunit. The decrease may account for the apparent lack of an intensity increase of this layer-line on activation at normal muscle lengths where attachment of myosin heads to actin increases the intensities of other layer-lines. PMID- 2769765 TI - Preliminary crystallographic analysis of a plant pathogenic factor: pectate lyase. AB - Pectate lyase is a saccharide-binding enzyme that lyitically depolymerizes polypectate in higher plant cell walls, thus causing soft-rot diseases in food crops. A pectate lyase from Erwinia chrysanthemi, EC16 (PLe), crystallizes in the orthorhombic space group P2(1)2(1)2(1) with unit cell dimension of a = 39.0 A, b = 91.0 A and c = 103.4 A. The asymmetric unit consists of one molecule with a molecular mass of 38,118 daltons and the X-ray diffraction extends to a resolution of 1.8 A. The crystals reproducibly grow to large dimensions and are suitable for a high-resolution X-ray diffraction analysis. PMID- 2769766 TI - Crystallization of GST2, a human class alpha glutathione transferase. AB - Single crystals of human GST2, a class alpha glutathione transferase have been grown in polyethylene glycol 2000 by the hanging-drop vapour diffusion method. The crystals belong to space group C2 and have cell dimensions a = 100.8 A, b = 95.4 A, c = 105.2 A and beta = 92.4 degrees. The X-ray diffraction pattern extends to better than 3 A resolution. PMID- 2769767 TI - Nursing approaches in local anesthesia for ophthalmic surgery. AB - 1. Traditionally, local anesthesia has only been used in patients with coexisting diseases that jeopardize the safety of general anesthesia. Local anesthesia, however, provides a number of advantages which make it suitable for ophthalmic surgery of both the anterior and posterior segment. 2. Preoperative emotional and physical assessment and patient counseling is essential to the successful use of local anesthesia. 3. Anxiety that exists intraoperatively can be relieved by sedentary social diversions such as listening to music, handholding, and other holistic approaches. 4. Discomfort caused by draping can be eliminated by using a drapeholder which lifts the drapes away, providing the patient with a high flow of air. PMID- 2769768 TI - Slab-off prisms. AB - 1. There are three grinding techniques for slab-off prism effects: front surface slab-off; bicentric grinding; and reverse slab-off. 2. The front surface slab-off and bicentric produce base-up prism in the lower section of the lens. Reverse slab-off produces base-down prism in the inferior portion of the lens. 3. The slab-off prism process is used to correct vertical diplopia in the reading position. Use of slab-off prism in glasses is expensive and should only be considered for stable deviations. PMID- 2769769 TI - Tuberous sclerosis (Bourneville's disease). AB - 1. Tuberous sclerosis is a hereditary disorder characterized by mental retardation, epilepsy, skin papules, and multiple developmental tumors, which involve every organ of the body including the eye. 2. Treatment is directed to control seizures and eliminate surface and systemic lesions by dermabrasion and surgery. 3. Genetic counseling is important for patients, their parents, and their siblings. PMID- 2769770 TI - Changing philosophies in rigid lens fitting. PMID- 2769771 TI - Effect of D, alpha-tocopheryl succinate and polyethylene glycol on performance tests after fluid percussion brain injury. AB - One hundred and one rats were administered either D, alpha-tocopheryl succinate plus polyethylene glycol (PEG), PEG, or saline 30 min prior to or 5 min after moderate fluid percussion brain injury. Mortality rates, performance on beam balance and beam-walking tasks, and body weight were assessed daily for 10 days. With preinjury administration, mortality rate was reduced from 31% with saline to 9% with PEG and 9% with D, alpha-tocopheryl succinate plus PEG. With postinjury administration, mortality rate was reduced from 36% with saline to 20% with PEG and to 10% with the D, alpha-tocopheryl succinate plus PEG combination. With administration prior to injury, PEG and D, alpha-tocopheryl succinate plus PEG reduced the deficits seen on beam balance testing on days 1-3 after injury. On beam walking, PEG and D, alpha-tocopheryl succinate plus PEG reduced deficits compared to those in saline-injected animals on days 1 and 2 and on day 1 after injury, respectively. A strongly protective effect of PEG and of D, alpha tocopheryl succinate plus PEG was seen with preinjury administration. With postinjury administration, D, alpha-tocopheryl succinate plus PEG reduced deficits on beam balance testing compared to animals receiving both saline and PEG on days 1-3 after injury. On beam-walking latencies, D, alpha-tocopheryl succinate plus PEG reduced deficits on days 1 and 2 after injury compared to saline and to PEG. Both PEG and D, alpha-tocopheryl succinate plus PEG reduced weight loss after injury compared to saline. The protective effects of these agents and their relatively low toxicity and high lipid solubility give them potential for the treatment of human head injury. PMID- 2769772 TI - The role of the Grafenberg Spot and female ejaculation in the female orgasmic response: an empirical analysis. AB - Despite earlier contrary claims, researchers have found evidence that a sensitive area (Grafenberg Spot) exists in the vaginal barrel. This area is a potential source of orgasm independent of clitoral stimulation. Other researchers have reported that some women experience a sudden spurt of fluid at the moment of orgasm. In the interest of contributing to further understanding of physiological and psychological sexual satisfaction, and alleviation of concerns about perceived urination during orgasm, the investigators explored a series of variables thought to be associated with perceptions of the Grafenberg Spot and its relationship, if any, to the female orgasmic response and female ejaculation. An anonymous questionnaire was distributed to 2,350 women in the United States and Canada, with a subsequent 55% return rate. A number of factors were found to be associated with perceived existence of a sensitive area in the vaginal barrel which, when properly stimulated, activates orgasm. Women who reported sensitive area orgasms were also more likely to report a spurt of fluid at moment of orgasm. PMID- 2769773 TI - Why do so many people drop out from auto-injection therapy for impotence? AB - Although intracavernous injection of vasoactive substances has been shown to be a reasonable and reliable method of reversing impotence, studies assessing patient acceptance of this new technology are lacking. By prospectively following patients and willing partners over a 2-year period, this study sought to document patient utilization rates and the reasons why patients decline or discontinue injection therapy. The cumulative dropout rate was 46%, with patients being most at risk for leaving the program after evaluation or during the trial dose phase. Patients decline treatment because they are unable to accept the idea of injecting themselves or because of potential side effects. Patients discontinue treatment because of perceived lack of efficacy. Patient and programatic obstacles to utilization of self-injection therapy are analyzed. PMID- 2769774 TI - Premature ejaculation: clinical subgroups and etiology. AB - Forty-six patients suffering from premature ejaculation (PE) were subdivided into primary premature ejaculators (PPE)--those who suffered from PE since the beginning of their sexual lives--and secondary premature ejaculators (SPE)--those who suffered from PE after years of normal sexual functioning. It is postulated that these two groups can be clinically differentiated by: bulbocavernosus reflex (BCR) latency time; sequential natural history of PPE vs. nonsequential development of SPE; and nondemonstrable organic illness vs. demonstrable organic cause in the great majority of SPE. This classification appears to be helpful in formulating appropriate treatment plans. PMID- 2769775 TI - Assessing sexual aversion in college students: the Sexual Aversion Scale. AB - This study describes a 30-item questionnaire, the Sexual Aversion Scale, that was used to assess sexual fears and avoidance in college students. The construct of sexual aversion was based on the newly listed DSM-III-R criteria for sexual aversion disorder. Results were obtained from 382 college students. The questionnaire was shown to have good internal consistency and test-retest reliability. Female students reported significantly more sexual anxiety. They expressed more fear of intercourse and the negative social consequences of their sexual behavior. They were also more inclined to avoid situations where they might become sexually involved. Conversely, males appeared to be more sexually frustrated and said they would become more sexually active were it not for fear of catching a sexually transmitted disease. It is concluded that sexual fears are fairly widespread among college students and are being fueled by the current AIDS crisis. One implication of these findings is that sexual aversion disorder may become a prevalent problem, especially if the AIDS epidemic continues to spread to the heterosexual population. PMID- 2769776 TI - Cognitions and sexual expression in the aging. AB - This study investigated the relation of cognitions to sexual expression in aging couples where the male had undergone transurethral prostatectomy. Cognitive factors explored were sexual efficacy expectations, value of sex, sexual attitudes, and sexual knowledge. Sexual expression was defined in terms of the following three dimensions: couple sexual frequency, desired sexual frequency, and quality of sexual functioning. Subjects consisted of 32 married couples whose ages ranged from 50 to 77 years. In this sample of sexually active couples, the cognitive variables most highly correlated with all the dimensions of sexual expression were efficacy expectations for the male's sexual performance and individual sexual drive. High sexual efficacy expectations predicted high couple sexual frequency and good male and female sexual functioning. High individual sexual drive predicted high actual and desired couple sexual interaction. In general, it was the male partner's sexual confidence and drive that was highly related to couple sexual expression. PMID- 2769777 TI - Cancer charities agree to halt sweepstakes mailings--refunds offered. PMID- 2769778 TI - Researchers flood USDA with comments on proposed animal welfare regulations. PMID- 2769779 TI - America's kids say they know they should eat better--but don't know why. PMID- 2769780 TI - Congress considers eliminating nearly all tobacco advertising. PMID- 2769781 TI - Presence of PAF-acether in human breast carcinoma: relation to axillary lymph node metastasis. AB - PAF-acether (PAF; formerly platelet-activating factor), a potent lipid mediator of inflammation, is involved in multiple cellular functions. To evaluate the role of PAF in human cancer, we obtained specimens from patients with localized breast carcinoma and assayed them for PAF. PAF was found in almost all carcinoma, although it was not detected in most of the matched, nontumor breast tissue samples. Intratumor PAF level was elevated when axillary lymph node involvement was low. Greater axillary extension (two or more positive lymph nodes) was associated with a decreased intratumor PAF level. These findings, along with the independence of other prognostic factors, indicate that PAF is a tumor marker of axillary lymph node involvement. PMID- 2769782 TI - Growth-inhibition effects of oleic acid, linoleic acid, and their methyl esters on transplanted tumors in mice. AB - We investigated the effects of oleic acid and linoleic acid on transplanted Ehrlich ascites carcinoma and Ehrlich solid carcinoma in ACR mice. Both acids significantly prolonged the life spans of Ehrlich ascites carcinoma-bearing mice and inhibited the growth of Ehrlich solid carcinoma in mice compared with the findings in untreated control mice. Methyl esters of these acids also prolonged the survival of Ehrlich ascites carcinoma-bearing mice, but they were less effective in lengthening the survival of mice given transplants of Ehrlich ascites carcinoma. In addition, gas-chromatography analysis of tumor cell lipids showed that appreciable changes occurred in the fatty acid composition of the tumor cell grown in mice treated with oleic acid or linoleic acid. Linoleic acid caused more pronounced alterations in fatty acid composition of tumor cell lipids than did oleic acid, a feature that parallels the intensity of the cytotoxicity potential of the two free fatty acids. These results suggest that (a) the free carboxyl group of free fatty acids plays a role in killing tumor cells and (b) the modification of the fatty acid composition of tumor cells also correlates with the antitumor effects of oleic and linoleic acids. In addition, these results indicate that free fatty acids may be of tumor-oriented distribution; as a consequence, free fatty acids selectively inhibit the growth of tumor cells. PMID- 2769783 TI - Breast cancer in women with scoliosis exposed to multiple diagnostic x rays. AB - Although exposure to ionizing radiation is a recognized risk factor for breast cancer, the potential hazard from low-dose, fractionated exposures during early breast development has not been thoroughly evaluated. Women with scoliosis represent a valuable population for studying this issue because they are exposed to multiple diagnostic x rays during childhood and adolescence, times when the breast may be highly sensitive to the carcinogenic effects of radiation. A study was conducted of 1,030 women with scoliosis who were seen at four Minneapolis area medical facilities between 1935 and 1965. The average age at diagnosis was 12.3 years; 60% of the women had idiopathic scoliosis. Individual x-ray films were counted and the number per patient ranged from 0 to 618 films (mean, 41.5). On average, the x-ray exposures were given over an 8.7-year period. Ninety percent of the women were located, of whom over 92% responded to a mail questionnaire or telephone interview. The average period of observation was 26 years. Overall, 11 cases of breast cancer were reported, compared with six expected (standardized incidence ratio = 1.82, 90% confidence interval = 1.0 3.0). Excess risk increased with time since exposure and was highest among those followed for more than 30 years (standardized incidence ratio = 2.4). Risk also increased with the number of x rays and with the estimated radiation dose to the breast (mean, 13 rad). These data suggest that frequent exposure to low-level diagnostic radiation during childhood or adolescence may increase the risk of breast cancer. PMID- 2769784 TI - Prospective study of oral contraceptive use and risk of breast cancer in women. AB - In 1976, 118,273 female nurses 30-55 years of age with no history of cancer completed a questionnaire regarding possible risk factors. By 1986, after 1,137,415 person-years of follow-up, we had documented 1,799 newly diagnosed cases of breast cancer. Compared with the risk of breast cancer for nonusers of oral contraceptives, the multivariate relative risks were 1.07 (95% confidence interval, 0.97-1.19) for all users, 1.06 (95% confidence interval, 0.96-1.18) for past users, and 1.53 (95% confidence interval, 1.06-2.19) for current users- women who used oral contraceptives up to 2 years before diagnosis of breast cancer. We conclude that overall past use of oral contraceptives is not associated with a substantial increase in the risk of breast cancer. Although we did not find women who used oral contraceptives before the first pregnancy to have an increased risk of breast cancer, the number of women who used oral contraceptives for a long duration in early reproductive life was too small to permit firm conclusions regarding the risk in this subgroup. PMID- 2769785 TI - 5-Iodo-2-deoxyuridine administered into the lateral cerebral ventricle as a radiosensitizer in the treatment of disseminated glioma. AB - A rat brain tumor model (Fischer 344 rats) with the clinical and pathological features of dissemination via the cerebrospinal fluid (CSF) pathways was used to demonstrate the efficacy of 5-iodo-2-deoxyuridine (IUDR) as a radiosensitizer when it is administered directly into the CSF. Stereotaxic implantation of 9L gliosarcoma cells (5 X 10(5) into the CSF of the lateral cerebral ventricle resulted in widespread dissemination and median survival of 18.5 and 20 days (range, 10-22) in two experiments. A continuous 7-day infusion of IUDR into the CSF starting on the day of tumor implantation did not provide any beneficial effect. Irradiation of the cranial spinal axis with 800 rad on days 4, 6, and 7 after implantation achieved an increase in survival time that was modest but statistically significant. However, the combination of IUDR infusion and radiotherapy resulted in marked improvement in survival time and a 10% cure rate (two of 20 rats). This is the first demonstration in vivo that IUDR administered into the CSF can be a potent radiosensitizer. PMID- 2769786 TI - Local toxicity of piroxantrone: an anthrapyrazole with irritant and vesicant properties similar to those of doxorubicin. PMID- 2769787 TI - The animal research issue. PMID- 2769788 TI - Drug abuse and AIDS in women and their affected offspring. PMID- 2769789 TI - Anatomy of the abdomen, back, and pelvis as displayed by magnetic resonance imaging: part three. AB - In April 1986, magnetic resonance imaging (MRI) of the thorax and shoulder girdle was presented at the 99th Annual Meeting of the American Association of Anatomists. These images were the authors' first attempt to correlate the magnetic resonance display of the muscles and soft tissues of the chest in the coronal plane with surface gross anatomy. The original purpose of this study was to introduce the role of magnetic resonance imaging to anatomists, medical students, and the specialty of radiology. However, this approach has been expanded by imaging other sections of the body and applying the display of surface anatomy to augment the teaching of anatomy to surgical oncology, pathology, and kinesiology. This three-part article will display magnetic resonance images and will explain how magnetic imaging of the soft tissues can visually augment the teaching of gross anatomy without dissecting surface tissues. PMID- 2769790 TI - Rapid healing of sickle cell leg ulcers treated with collagen dressing. AB - Chronic leg ulcers in sickle cell anemia occur mainly around the ankles. The prevalence is up to 75% in adults. These ulcers are painful and debilitating, yet medical treatment is unsuccessful. Surgical treatment consists of repeated skin grafting procedures, which eventually deplete the patient's available donor sites. Thus, in vitro generation of human epidermal autograft for potential treatment of leg ulcers in sickle cell anemia was initiated. However, because epidermal cells need a supporting matrix in order to be applied to the ulcer, the authors decided to assess the independent effect of a collagen matrix alone in promoting healing of sickle cell leg ulcers. Collistat (Hellistex, Inc) dressing was applied directly to the ulcers. The ulcers were reviewed every 2 weeks, and the dressing reapplied every 4 weeks. Collagen matrix caused the chronic ulcers to heal completely in fewer than 3 months. This encouraging performance of collagen alone should be greatly enhanced by the in vitro epidermal autograft. PMID- 2769791 TI - Contained thoracic empyema presenting as an anterior chest wall abscess: empyema necessitatis revisited. AB - Protean manifestation of pulmonary and pleural space infections can be expected in drug addicts. Because of the need to establish strict environmental protection for staff and patients, even simple drainage procedures should be performed in the operating room. Without testing, these patients should be considered as potential carriers of the AIDS virus. If a subcutaneous abscess is found to extend into the pleural space, drainage and full lung expansion are attempted through a limited rib resection. If this is unsuccessful, a full thoracotomy should be done to meet these surgical objectives. PMID- 2769792 TI - TIS gene expression in cultured rat astrocytes: multiple pathways of induction by mitogens. AB - Accumulation of TIS1 and TIS11 (Lim et al.: Oncogene 1:263-270, 1987) mRNAs in secondary cultures of rat neocortical astrocytes was much greater in response to tetradecanoyl phorbol acetate (TPA) than in response to either epidermal growth factor (EGF) or fibroblast growth factor (FGF). In contrast, EGF, FGF, and TPA were equally effective in inducing accumulation of TIS8 and TIS28/c-fos mRNAs. These data suggested that TPA and the polypeptide mitogens might induce TIS gene expression by distinct pathways. When maximally inducing concentrations of EGF and FGF were co-administered to astrocyte cultures, TIS mRNA accumulations were no greater than those observed for the individual growth factors, suggesting that EGF and FGF saturate a common, limiting step in their induction pathways. In contrast, when either EGF or FGF was presented to astrocytes in combination with maximally inducing levels of TPA, the resulting levels of accumulation of TIS mRNAs were at least as great as the sum of the levels induced by the individual mitogens. Stimulation of [3H]-thymidine incorporation demonstrated an identical pattern of interaction; EGF and FGF co-administration was no more effective than either polypeptide mitogen alone, but, when presented to astrocyte cultures along with maximally inducing concentrations of TPA, either EGF or FGF was able to increase incorporation of [3H]-thymidine. Superinduction of all the TIS genes occurred if cycloheximide (CHX) was present during TPA exposure. Once again, two distinct classes of responses of the various TIS genes occurred; superinduction of TIS1, TIS7, TIS11, and TIS28/c-fos mRNA accumulation ranged from 10- to 20 fold, while CHX superinduction of TIS8 and TIS10 was far more modest, ranging from 2- to 3-fold.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2769793 TI - Basic fibroblast growth factor released from synthetic guidance channels facilitates peripheral nerve regeneration across long nerve gaps. AB - Basic fibroblast growth factor (b-FGF) has been shown to enhance the in vitro survival and neurite extension of various types of neurons including dorsal root ganglia (DRG) cells. Alpha-1 glycoprotein (alpha 1-GP), an acute phase reactant, has been reported to enhance the in vitro neuritic extensions of chick DRG cells. In the present study, we investigated the ability of synthetic nerve guidance channels, which release sustained controlled amounts of b-FGF and/or alpha 1-GP, to support the regeneration of a transected peripheral nerve over a 15 mm long gap, a distance that does not permit regeneration in conventional polymeric tubes. Tubes releasing bovine serum albumin (BSA), cytochrome C, BSA and b-FGF, BSA and denatured b-FGF, BSA and alpha 1-GP, or BSA, b-FGF, and alpha 1-GP were fabricated by a dip-molding technique. In vitro kinetic studies of protein release from these channels showed an initial burst during the 1st day, followed by a linear release for at least 2 weeks thereafter. In vitro studies indicated that the b-FGF released from the polymer was biologically active as assessed by the ability of channels releasing b-FGF to induce neurite extensions in PC12 cells. For in vivo studies, the various types of tubes were used as nerve guidance channels for the repair of a 15 mm nerve gap in the sciatic nerve of rats. Four weeks postimplantation, only the tubes releasing b-FGF or b-FGF and alpha 1-GP displayed regenerated cables bridging both nerve stumps, which contained nerve fascicles with myelinated and unmyelinated axons.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2769794 TI - Quantitative analysis of the localization of adrenergic binding sites in chick brain. AB - In the present work [3H]-WB4101, [3H]-DHA, and [3H]-clonidine were used for the study of the localization of alpha 1, alpha 2, and beta adrenergic receptors in the chick brain. The highest concentration of [3H]-WB4101 was observed in the nucleus pretectalis, followed by the nucleus brachium conjunctivum descendens. The superficial layers of stratum griseum fibrosum superficiale, the nucleus mesencephalis lateralis pars dorsalis, and the locus coeruleus showed concentrations of [3H]-WB4101 binding higher than 300 fmoles/mg protein. Concentrations of [3H]-DHA binding higher than 300 fmoles/mg protein were observed in the paleostriatum, the external part of nucleus pretectalis, the nucleus isthmi parvocellularis, the nucleus mesencephalis lateralis pars dorsalis, the dorsal nucleus of oculomotor center, and the molecular layer of cerebellum. Locus coeruleus was the only area of chick brain which showed concentration of [3H]-clonidine binding higher than 300 fmoles/mg protein. With few exceptions, [3H]-clonidine binding was very low and in the telencephalon it was undetectable. PMID- 2769795 TI - Heme precursor 5-aminolevulinic acid alters brain tryptophan and serotonin levels without changing pineal serotonin and melatonin concentrations. AB - The daytime administration of the heme precursor 5-aminolevulinate (5-ALA) has been shown to reduce brain tryptophan and serotonin levels owing to saturation of liver tryptophan pyrrolase. Saturation of this enzyme with heme results in enhanced activity, leading to increased catabolism of tryptophan and thus making less tryptophan available to the brain. Tryptophan is also the precursor of melatonin, a primary secretory product of the pineal gland. Reduced melatonin levels, which could be a consequence of altered tryptophan metabolism, have been associated with depressive disorders in humans. In view of this, in the present study we examined the effects of 5-ALA administration on forebrain tryptophan and serotonin levels as well as pineal serotonin, melatonin, and the pineal melatonin forming enzymes N-acetyltransferase (NAT) and hydroxyindole-O-methyltransferase (HIOMT). 5-ALA induced a reduction in forebrain tryptophan and serotonin levels during the light phase and caused the opposite effect in the dark phase. Allopurinol, an inhibitor of hepatic tryptophan pyrrolase activity, prevented the reduction in the indole levels induced by 5-ALA. Although 5-ALA induced these changes in the forebrain, it did not alter either daytime or nighttime pineal NAT, HIMOT, serotonin, or melatonin levels. It appears that high serotonin levels and melatonin production in the pineal are conserved even in the face of low circulating tryptophan levels, changes which alter brain tryptophan and serotonin concentrations. PMID- 2769796 TI - Human brain microvascular DR-antigen. AB - Antigen presentation within the human central nervous system by the class II histocompatibility DR-antigen may take place at either the brain capillary endothelial interface or at perivascular cells, such as smooth muscle or pericytes. The present studies employ a new sensitive immunoperoxidase technique, a mouse monoclonal antibody to the human DR-antigen, and microvessels isolated from autopsied human brain. The experiments show that the DR-antigen is readily detectable in human microvasculature of normal brain and is found in the smooth muscle pre-capillary arterioles and capillary pericytes with minimal, if any, staining of capillary endothelium. These results are consistent with the hypothesis that antigen presentation in the CNS occurs primarily at a site immediately distal to the blood--endothelial interface. PMID- 2769797 TI - Increase of transferrin receptors and iron uptake in regenerating motor neurons. AB - After injury, motor neurons exhibit a number of metabolic and protein changes that are assumed to be part of an inherent neuronal regeneration program, which, when activated, eventually leads to functional restitution. The mechanisms underlying this regeneration are unclear, but it may be expected that factors supporting neuronal growth or survival play an important role in the restoration of neuronal integrity. A number of neuronal growth-associated proteins have been identified, but their functional roles remain unclear. This paper shows that axotomy results in a strong increase in transferrin receptors (TfRs) in regenerating motor neurons and that this phenomenon is functionally associated with an elevated uptake of exogenous iron. The association of TfR expression in regenerating motor neurons with direct uptake of iron into the brain provides evidence that iron uptake into neural tissue may be related to neuronal metabolic activation. We suggest that the enhanced capacity of regenerating motor neurons to bind transferrin and to take up iron plays an important role in neuronal repair. PMID- 2769798 TI - Neuronal modulation of Schwann cell glial fibrillary acidic protein (GFAP). AB - Adult rat sciatic nerves contain cytoskeletal peptides that resemble CNS glial fibrillary acidic protein (GFAP) in immunoreactivity and molecular weight. Immunohistological examination of teased nerve fascicles indicated that these peptides are expressed selectively by Schwann cells related to small axons. Radiolabelled mouse and rat CNS GFAP cDNA probes hybridized with a single, 2.7 kb RNA band in Northern blots prepared from total RNA from both rat sciatic nerve and rat brain. Sciatic nerve GFAP mRNA was detectable by this means in adult, 2 month, or 21 day postnatal rats, but not in 3,6, or 10 day postnatal rats. Sciatic nerve transection caused a marked reduction in the level of GFAP mRNA in the axotomized distal stump. We conclude that Schwann cell synthesis of GFAP is developmentally regulated and that Schwann cells, unlike astroglia, require continued trophic input from small axons in order to express GFAP. PMID- 2769799 TI - Thiamine-like molecules in the cerebellar cortex of the rat: light and electron microscopic immunocytochemical investigation. AB - Immunocytochemical methods were used for studying the location of thiamine-like molecules in the cerebellar cortex of the rat. A positive reaction was observed in several synapses and in several dendrites. This reaction was associated with tubular formations and synaptic vesicles. A positive reaction was also found in several mitochondria and in glial cells. The possible role of thiamine-like molecules in cerebellar cortex is discussed. PMID- 2769800 TI - Increase in cathepsin D activity in rat brain in aging. AB - Cathepsin D-like activity in homogenates of five brain areas of 3-month-old and 24-month-old Fischer 344 rats was measured. With hemoglobin as substrate at pH 3.2, more than 90% of the activity was inhibited by pepstatin. In each area studied, activity was more than twice as high in the old rat brain: 140-160% higher in the cortex, cerebellum, pons-medulla, and striatum and 90-100% higher in the hippocampus and spinal cord. The greatly increased metabolic capacity in the absence of an increase in protein turnover may have a role in age-related pathological degeneration in the brain. PMID- 2769801 TI - Muscarinic receptor subclasses in retinal cultures: effect of corticosterone. AB - We have previously shown that exogenously administered corticosterone affects muscarinic receptor binding in the chick embryo retina. Analysis with the selective antagonist pirenzepine has shown that both muscarinic receptor subclasses M1 and M2 are present in treated retinas. On the contrary, only M2 is detectable in controls. Moreover, receptor affinity for agonists is modified by hormone treatment. Since these studies did not show whether or not the hormone directly influences retinal cells, a similar study was performed on retinal tissue cultures. Cells were treated at day 5 in vitro for 24 hr with 1.10(-8) M corticosterone. Scatchard analysis of results obtained with 3H-quinuclidinyl benzilate (3H-QNB) binding showed no difference between treated and control cultures. However, displacement experiments demonstrated that both M1 and M2 were present in treated cultures, whereas controls had only M2. Also, receptor affinity for the agonist carbachol was modified, as already observed with in vivo studies. In addition, a new phenomenon was observed: treated cultures had a significantly higher number of cells. The possibility that the hormone can prevent cell death or stimulate cell mitosis is considered. PMID- 2769802 TI - Acetyl-L-carnitine reduces the age-dependent loss of glucocorticoid receptors in the rat hippocampus: an autoradiographic study. AB - Brain autoradiography in adrenalectomized rats injected with 3H-corticosterone 2 hr before sacrifice was used to study the effect of aging and long-term acetyl-l carnitine treatment on the hippocampal glucocorticoid receptor. Densitometric analysis of silver grains in individual nerve cells of the hippocampus showed that pyramidal neurones of the CA1 field and granular cells of the dentate gyrus are richest in 3H-corticosterone binding sites, whereas pyramidal neurons of the CA3 field have the lowest number of binding sites. There was a significant decline in the number of glucocorticoid receptors within the various hippocampal areas, both as the total number of 3H-corticosterone binding sites and as the number per single pyramidal or granule neuron associated with aging and perhaps due to loss of adrenocorticoid-competent neurons. The dentate gyrus and the CA1 region were mostly affected by the age-dependent decrease in glucocorticoid receptors of the hippocampus. Twenty-eight-month-old rats, treated with acetyl-l carnitine for 7 months, showed a significantly higher number of 3H-corticosterone binding sites within the various hippocampal regions examined than did age matched controls. The CA1 and the dentate gyrus were the regions most susceptible to amelioration by acetyl-l-carnitine treatment. These findings suggest a positive effect of acetyl-l-carnitine treatment on age-related changes which occur in the hippocampus. PMID- 2769803 TI - Carrier-mediated Cl- transport in cultured mouse oligodendrocytes. AB - We studied the steady state and the regulation of intracellular Cl- activity (aCl i) and the mechanisms of KCl uptake in cultured oligodendrocytes from mouse spinal cord using Cl(-)-selective microelectrodes. The majority of oligodendrocytes actively accumulated Cl- above passive distribution (2-3 mM), few cells showed a passive Cl- distribution. To identify the carriers mediating Cl- uptake, oligodendrocytes were maintained in a solution with low extracellular Cl- concentration ([Cl-]o) which resulted in a rapid decrease in aCl-i. The recovery of aCl-i above its passive distribution in normal [Cl-]o was blocked in the absence of Na+ or in the presence of furosemide and of bumetanide, which has been reported to inhibit Na+/K+/Cl- cotransport. We therefore conclude that Cl- uptake is primarily due to the activity of a Na+K+/Cl- transport system. Cl- uptake above passive distribution was not affected in HCO3(-)-free solution or in the presence of SITS and DIDS, indicating that Cl-/HCO3- exchange is not involved in Cl- uptake by oligodendrocytes. Elevation of [K+]o induced an increase in aCl i and, as shown earlier, intracellular K+ activity. This K+-induced Cl- uptake was not blocked by bumetanide, furosemide, SITS, or DIDS, suggesting that under conditions of raised [K+]o the combined uptake of K+ and Cl- is not mediated by a carrier, but can be explained by the entry through channels driven by Donnan forces. PMID- 2769804 TI - Mortality of patients with head injury and extracranial injury treated in trauma centers. AB - The types and severity of injuries of 49,143 patients from 95 trauma centers were coded according to the 1985 version of the Abbreviated Injury Scale (AIS). This paper analyzes the causes, incidence, and mortality in 16,524 patients (33.6% of the trauma center patients) with injury to the brain or skull and compares them to patients without head injury. Relative to its incidence, patients with head injury composed a disproportionately high percentage (60%) of all the deaths. This was due to the high mortality rate for head-injured patients. Overall mortality of patients with head injury (18.2%) was three times higher than if no head injury occurred (6.1%). This mortality was little influenced by extracranial injuries except when minor and moderate head injuries were accompanied by very severe (AIS levels 4 to 6) injuries elsewhere. The cause of death in head-injured patients was approximated and it was found that 67.8% were due to head injury, 6.6% to extracranial injury, and 25.6% to both. Head injury is thus associated with more deaths (3,010 vs. 1,972) than all other injuries and causes almost as many deaths (2,040 vs. 2,170) as extracranial injuries. Because of its high mortality, head injury is the single largest contributor to trauma center deaths. PMID- 2769805 TI - Institutionally shared trauma rotations are viable solutions to deficiencies in trauma training. AB - Numerous national trauma leaders have expressed concern about the lack of uniformity of trauma training in this country. In 1984 we instituted a trauma rotation between the University of Louisville (U.L.), with a large trauma volume, and Loyola University (L.U.) in the planning stages of trauma center development. Third year L.U. residents rotated at U.L. in 3-month blocks with an increased level of responsibility monthly, culminating in major decision-making roles and operative treatment under the chief resident's direction. The L.U. residents functioned as full members of the team and not as passive observers. Fifteen L.U. residents and 12 U.L. residents rotated during this period. Yearly major trauma visits, helicopter flights, and trauma service admissions average 1,908, 700, and 1,520, respectively. U.L. chief residents averaged 136 major operative trauma cases and 115 nonoperative trauma cases each were managed during this time period (RRC records greater than 85th percentile for all U.L. residents). L.U. residents performed an average of 30 major operative cases, nine as teaching assistant, in 3 months. Each managed more than 75 nonoperative cases. Several elements are critical in such a multi-institutional rotation: 1) active communication among the program directors, 2) commitment to one sharing arrangement only, 3) financing and malpractice for off-site residents, 4) housing, and 5) the ability to assimilate off-site residents as true trauma team members. The resident-to resident interplay is crucial and has succeeded because both residency staffs have had excellent early training.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2769806 TI - Pulmonary antipneumococcal defenses after hemisplenectomy. AB - Conservative splenic surgery such as partial splenectomy is advocated for splenic injuries, since splenectomy predisposes individuals to overwhelming sepsis with encapsulated organisms, of which Streptococcus pneumoniae is the most frequently isolated. The respiratory route is argued to be the most likely portal of entry of pneumococci; however, little data exist on the interaction of the spleen and pulmonary defense mechanisms against pneumococcal invasion. We studied the effect of splenectomy, 50% splenectomy (hemisplenectomy), 25% splenectomy, and sham operation on in vivo clearance of live pneumococci from the lungs of male CD-1 mice following an aerosol challenge of pneumococci. Splenectomy impaired pneumococcal clearance from mouse lung pairs and allowed for increased translocation of live pneumococci to tracheobronchial lymph nodes compared to sham-operated controls. Preservation of splenic mass by partial splenectomy improved lung clearance and allowed for fewer bacteria to be cultured from tracheobronchial lymph nodes compared to splenectomized animals. Clearance of live pneumococci from the lungs and survival were directly proportional to the amount of splenic tissue remaining. Splenic factors probably exist which regulate reticuloendothelial cell function throughout the host. Maintaining adequate splenic mass, therefore, is an important consideration when operating for splenic trauma. PMID- 2769807 TI - Trauma and forensic medicine. AB - Trauma physicians are frequently involved in the evaluation and treatment of patients who are victims of crimes or themselves criminals. These physicians usually have little or no training in the forensic aspects of emergency medical care and therefore necessary evidence may often be overlooked, lost, inadvertently discarded, or its admissibility denied because of improper handling or documentation. Criteria were developed to evaluate the forensic medical aspects of such trauma cases and to discern the magnitude of the problem. The majority of the cases reviewed demonstrated significant forensic medical deficiencies primarily in the areas of documentation and/or handling or securing of evidence. Trauma physicians have the responsibility and potential liability to insure that necessary evidence is properly secured and preserved while caring for their patients. Educational programs should be developed for this purpose. PMID- 2769808 TI - The role of abdominal CT in the evaluation of stab wounds to the back. AB - Two hundred five patients with stab wounds to the back were evaluated with CT scans using both oral and IV contrast material. One hundred sixty-nine patients had a negative scan. Thirty (17.8%) of the 169 patients were operated upon because of clinical concern. Injuries were found in two of these patients: a diaphragmatic injury in one and a combined diaphragmatic and liver injury in the other. None of the 139 patients observed developed any sequelae. Twenty of the 33 patients with a positive CT were taken to the operating room where 16 were found to have a significant injury. Seven of these 16 patients had additional injuries not identified on CT. There were four false positive scans. Thirteen patients with a positive scan and two patients with an equivocal scan were observed based upon clinical judgment. Ten of these 15 patients had minor isolated renal or hepatic injuries seen on scan. None of these developed complications. It is concluded that abdominal computed tomography, with a sensitivity of 89%, specificity of 98%, and accuracy of 97% is a reliable study in the evaluation of patients with stab wounds to the back. PMID- 2769809 TI - Genetic susceptibility to mucosal damage leads to bacterial translocation in a murine burn model. AB - Since genetic factors may be important in host resistance to infections after thermal injury, we screened the susceptibility of three mouse strains (CD-1, Balb/c, and C57/bl) to thermally induced bacterial translocation from the GI tract. Bacteria translocated to the MLNs of Balb/c but not the CD-1 or C57/bl mice receiving 25% body burns. The increased incidence of bacterial translocation in the burned Balb/c mice appeared to be due to a burn-induced gut mucosal injury, since the intestinal mucosa of the Balb/c but not the CD-1 or C57/bl mice was damaged 24 hr after the thermal injury. The mucosal injury appears to be mediated, at least in part, by xanthine oxidase-generated oxygen-free radicals, since inhibition of xanthine oxidase activity with allopurinol, or inactivation of xanthine oxidase activity by a molybdenum-free tungsten diet, prevented the mucosal injury and reduced the extent of bacterial translocation. PMID- 2769810 TI - The mortality of childhood falls. AB - Falls accounted for 5.9% of the childhood deaths due to trauma in a review of the medical examiner's files in a large urban county. Falls represented the seventh leading cause of traumatic death in all children 15 years of age or younger, but the third leading cause of death in children 1 to 4 years old. The mean age of those with accidental falls was 2.3 years, which is markedly younger than that seen in hospital admission series, suggesting that infants are much more likely to die from a fall than older children. Forty-one per cent of the deaths occurred from "minor" falls such as falls from furniture or while playing; 50% were falls from a height of one story or greater; the remainder were falls down stairs. Of children falling from less than five stories, death was due to a lethal head injury in 86%. Additionally, 61.3% of the children with head injuries had mass lesions which would have required acute neurosurgical intervention. The need for an organized pediatric trauma system is demonstrated as more than one third of the children were transferred to another hospital, with more than half of these deteriorating during the delay. Of the patients with "minor" falls, 38% had parental delay in seeking medical attention, with deterioration of all. The trauma system must also incorporate the education of parents and medical personnel to the potential lethality of "minor" falls in infants and must legislate injury prevention programs. PMID- 2769811 TI - Cervical spine injury in patients with facial skeletal trauma. AB - The records of 2,555 patients admitted to hospital with facial fractures were reviewed for concomitant neck injury. Cervical spine injury occurred in 1.3% of all patients with facial fractures, the incidence rising to 5.5% with facial fractures resulting only from MVA's. Neck injuries occurred most frequently in the setting of MVA's (85%) and multisystem trauma (70%) and tended to involve two main levels of the cervical spine: C2 (31%) and the two lower cervical vertebrae C6 and C7 (50%). Examination of the pattern of cervical spine injury with respect to the pattern of facial skeletal injury does not support the premise of a direct causal relation between them. PMID- 2769812 TI - Lumbar seatbelt injury in a child: case report. AB - Spinal injuries are uncommon in children and quite rare in the lumbar spine. A case report of an 8-year-old child sustaining a lumbar seatbelt injury with successful surgical treatment consisting of reduction and stabilization with two small Harrington compression rods, and fusion with an iliac crest autologous graft is presented. PMID- 2769813 TI - Sarns centrifugal pump for repair of thoracic aortic injury: case reports. AB - A new centrifugal pump (Sarns), originally designed for ventricular assist, was successfully used in two patients during repair of traumatic pseudoaneurysm of the descending thoracic aorta. The distal thoracic aorta was perfused without heparinization to avoid spinal cord and visceral ischemia, reduce afterload on the heart, and avoid clamp injury to the aorta. Distal mean aortic pressure was maintained above 50 mm Hg with a mean pump flow of 1.75 liter/minute. Proposed structural advantages of the Sarns centrifugal pump for perfusion of the distal thoracic aorta without heparin are resistance to thrombus formation, air embolus, and hemolysis. PMID- 2769814 TI - An unusual cause of massive non-surgical pneumoperitoneum: case report. AB - A case of pneumoperitoneum due to cocaine abuse is presented. Although most commonly associated with surgical disease, pneumoperitoneum may actually be a manifestation of non-surgical intrathoracic pathology. In this patient percutaneous diagnostic peritoneal lavage resulted in return of a large quantity of air and was negative for bleeding or contamination. PMID- 2769815 TI - Successful limb reperfusion by temporary arterial shunt during a 950-mile air transfer: case report. AB - Plastic vascular shunts successfully reperfused a trauma victim's severely ischemic leg for 16 hours during a 950-mile transfer to a regional trauma center. Although the limb ultimately was lost, this case suggests the potential value of temporary shunts in managing complex extremity vascular injuries in settings remote from the trauma center. PMID- 2769816 TI - Delayed intraperitoneal ureteric rupture following blunt abdominal trauma: case report. AB - Ureteric injury is uncommon and mostly follows penetrating trauma or surgical injury. Ureteric rupture following blunt abdominal trauma is rare, there being only a few reported cases. The case described here, in which blunt abdominal trauma resulted in delayed intraperitoneal rupture, appears to be the first report of this type of injury in blunt trauma. PMID- 2769817 TI - Dual extensor tendon entrapment in Galeazzi fracture-dislocation: a case report. AB - A rare case of blocked reduction of the distal radio-ulnar joint in a Galeazzi fracture-dislocation is presented. In this case both the extensor carpi ulnaris and extensor digiti minimi tendons were displaced on either side of the ulnar head. After relocation of these tendons the distal radio-ulnar joint could be easily reduced. PMID- 2769818 TI - The debate goes on. PMID- 2769819 TI - A method to increase recovery of fentanyl from urine. AB - Fentanyl, a highly lipophilic drug (pk(a) 7.7), is a common drug of abuse. The current standard techniques to detect fentanyl in urine have low recovery rates and poor sensitivity. We report a modified solvent extraction technique that can recover between 63 and 86% of the drug with a detection limit of 0.2 ng/10 ml of urine. In addition, we report the duration of urinary fentanyl excretion in 11 adolescent patients administered either low (less than 10 mg/kg) or high (20-40 mg/kg) doses of fentanyl as part of anesthesia. The mean duration of urinary fentanyl excretion was similar in the two groups, with duration ranging from 1 to 5 days, and urine fentanyl concentration ranging from 0.1 ng to 10.3 ng/10 ml of urine. PMID- 2769820 TI - The effect of "superactive" charcoal and magnesium citrate solution on blood ethanol concentrations and area under the curve in humans. AB - Eleven healthy males between 21 and 37 years of age were enrolled into a non randomized crossover study comparing superactive charcoal (SAC) given after ethanol administration. After receiving 0.6 gm/kg ethanol orally (95% V/V diluted in orange juice), blood was sampled at 0, 0.5, 1.0, 1.5, 2.0, 3.0, and 4.0 hours. Area under the curve (AUC) was calculated and the highest ethanol level was recorded. After a minimum of 1 week washout, the volunteers ingested an identical ethanol dose but in addition received 60 grams of SAC and 300 ml of 5.8% magnesium citrate solution 1 and 3 hours post ingestion. The data was compared using the paired t-test with p less than 0.05 considered significant. Nine volunteers completed the study. Volunteers had difficulty ingesting the full second 60 gram SAC dose. The AUC (mean 1184 mcg x hr/ml) and highest ethanol concentrations (mean 46.3 mg/dl) for the control group were not significantly greater than in the SAC group (mean AUC 1167 mcg x hr/ml and highest ethanol concentration of 49.0 mg/dl). The ethanol concentration in the SAC group was significantly less than control only at 2.0 hours (31.6 mg/dl vs 36.6 mg/dl, p less than 0.01). The peak ethanol concentration in the SAC group occurred at 1.0 hours in 7 of 9 volunteers, while in the control group, peak concentration occurred randomly between 0.5 and 2.0 hours. We conclude SAC in the dose used is not effective in decreasing AUC, highest ethanol concentration, and blood ethanol levels when given 1 and 3 hours after ethanol ingestion. PMID- 2769821 TI - Tricyclic antidepressant-specific Fab fragments alter the distribution and elimination of desipramine in the rabbit: a model for overdose treatment. AB - The effects of tricyclic antidepressant (TCA)-specific Fab fragments (Fab) on total and free desipramine (DMI) levels in serum and urine of DMI-treated rabbits were studied to determine the feasibility of using these Fab for antidotal treatment of TCA overdoses in humans. Serial samples of blood and urine were collected from two 3 kg rabbits after arterial injection of 2 mg 3H-DMI and, about 1.5 hr later, after injection of approximately 1 g Fab (prepared from sheep total IgG). Protein-free filtrates of serum and urine samples were obtained by ultrafiltration; concentrations of apparent total and apparent free DMI (apparent DMI, aDMI = DMI + metabolites) were calculated based on the radioactivity in the sample and ultrafiltrate, respectively. Treatment with Fab induced significant changes in the absolute and relative concentrations of free and total aDMI in both serum and urine. Changes in the serum included increases in the total and free aDMI levels. Changes in the urine included the appearances of a protein bound aDMI fraction and Fab, and an increase in the percent of unmetabolized DMI. These results demonstrate that TCA-specific Fab influence the distribution and elimination of desipramine in DMI-treated rabbits and suggest that further studies on the use of TCA-specific Fab for antidotal treatment of TCA overdose are warranted. PMID- 2769822 TI - Disposition of acetone, methyl ethyl ketone and cyclohexanone in acute poisoning. AB - A case of coma due to the drinking of a liquid cement for polyvinyl chloride resin, containing acetone, methyl ethyl ketone, cyclohexanone and polyvinyl chloride is described. The patient also simultaneously ingested the alcoholic beverage, sake. After gastric lavage, plasma exchanges and direct hemoperfusions, the patient recovered. The concentrations of these chemicals in plasma and urine were analyzed at various time intervals to estimate the clearance. The elimination half lives for acetone and methyl ethyl ketone were 18 hours and 10 hours, respectively. Although cyclohexanone made up the largest component in the solvents, the blood level was extremely low and a large amount of cyclohexanol, a metabolite of cyclohexanone was detected in the blood and urine. The glucuronide metabolite of cyclohexanol was also estimated after the hydrolysis with beta glucuronidase. Since the conversion of cyclohexanone to cyclohexanol is known to be catalyzed by alcohol dehydrogenase, possible interactions between sake ingestion and cyclohexanone metabolism is proposed. PMID- 2769823 TI - Chlorophacinone intoxication. A biological and toxicological study. AB - Plasma chlorophacinone determinations were performed in three cases of intoxication. The data collected in this study confirm the particularly prolonged anticoagulant effect of this compound and show that the knowledge of plasma concentrations may be very useful for clinicians since it allows to confirm the diagnosis and to evaluate the duration of the treatment. The determination of half-lives was investigated and the results indicate that the greater the quantity absorbed, the longer the half-life. The effect of phenobarbital on the elimination of cholorophacinone could be studied in one case. An increased elimination was noted when phenobarbital was administered. PMID- 2769824 TI - Gastrointestinal transit times of a charcoal/sorbitol slurry in overdose patients. AB - Gut decontamination with a slurry of activated charcoal and sorbitol is one of the methods presently available to decrease total body burden of ingested drug. This one year retrospective audit of patients presenting with a history of recent toxic ingestion was designed to determine the time to stool of a charcoal/sorbitol slurry (CSS) when used for differing ingestants. A total of 69 patients received a CSS. 50.7% took less than 6 hours for their first charcoal stool, while 26.1% had emesis of the CSS within 30 minutes of administration. Ingestion of drugs which may increase gastrointestinal transit time (i.e. opioids, cyclic antidepressants) correlated with prolonged time to stool despite treatment with the CSS. Though a prospective, controlled study needs to be performed, variation in dosage of the CSS may be appropriate in select patient groups to offset the effects of the ingestant on bowel motility. PMID- 2769825 TI - [Clinical experience of treatment of urethral stricture]. AB - The records of 53 patients treated for urethral stricture at Kaohsiung Medical College Hospital over a 8-year period were reviewed. Young men those affected and trauma appeared to have been the most frequent etiological cause. Of the 53 patients 12 were treated by filiform dilatation , 33 were treated by metal sound dilatation , and 8 underwent a pull-through technique. Good results were noted in 29 cases (54.7%), fair in 10 (18.9%) and poor results in 14 (26.4%). When the results were analyzed according to the method of treatment, poor results were most common among those who had underwent the pull-through technique and the metal sound dilatation as compared to filiform dilation group. PMID- 2769826 TI - [Dissolution profiles of powdered inclusion compounds of sulfonamide drugs with beta-cyclodextrin]. AB - The interactions of beta-cyclodextrin (beta-CD) with three sulfonamide drugs were studied. Observations were made on the effects of beta-CD on the solubility and the dissolution rate of these drugs in aqueous solution when comparing two different methods. The solubility of these three drugs was found to increase with the addition of beta-CD. This increase in solubility when using beta-CD was considered to be due to the formation of inclusion compounds. The dissolution rate of drugs increased with beta-CD, and was similar in tendency to the solubility data. These effects on both solubility and dissolution rates were similar regardless of which method was used. The X-ray diffraction pattern of the drug/beta-CD freeze-drying powder showed a clear difference from the physical mixture of intact drugs. PMID- 2769827 TI - [Congenital anomalies of the brain in computed tomography]. AB - From June. 1987 to Dec. 1988, data was collected from 12 cases with Congenital Brain Anomalies. The cases involved 7 girls and 5 boys with ages ranging from 2 days to 15 years old. Abnormalities diagnosed were Cavum-septi pellucidi; Cavum vergae; Cystic dilated cavum; Cavum veli interpositi; Lissencephaly with dysgenesis of the corpus callosum; Dysgenesis of the corpus callosum associated the midline dorsal cyst; Holoprosencephaly, alobar type; Schizencephaly associated with Hydranencephaly; Encephaloclastic porencephaly; Severe hydrocephalus; Variant type of Dandy-Walker cyst with dysgenesis of the corpus callosum; Arnold-Chiari malformation. The patients were initially seen OPD primarily for seizures and other complaints such as nystagmus with visual impairment, hypotonia, facial anomalies, Yolk-sac tumor, prematurity, dyspnea and hydrocephalus. Among these, Holoprosencephaly was easiest to diagnose because it was combined with facial anomalies. However the others required evaluation by CT. CT offers very efficient diagnostic modality which is better than a Cranial Echo. It is also safer than the invasive angiography and not as expensive as MRI. PMID- 2769828 TI - [Comparative pharmacokinetics of two sulpiride formulations in healthy volunteers]. AB - Six healthy male volunteers (age: 27.6 +/- 4.7; weight: 74.6 +/- 7.7) participated in a "repeated measure" design for comparing the bioavailability and pharmacokinetic behaviours of the brand-name drug of Dogmatyl and a generic sulpiride formulation. Each subject received a single 400-mg dose of Dogmatyl in tablet form during the first dosing period. After two weeks of washout period, the same dose of a generic preparation was then administered. Blood samples were obtained at 0, 0.5, 1, 1.5, 2, 4, 6, 12 and 24 hours after initial dosing. The concentration of sulpiride was measured by a high pressure liquid chromatographic method using a UV detector. All the data were processed by Keith K.H. Chan and Kenneth Wnuck's method which utilizes KMCP computer software. Pharmacokinetic parameters were calculated, based on one compartment model. The results revealed that the maximal concentration (Cmax) of Dogmatyl and the generic preparation was 1.468 +/- 0.631 and 1.472 +/- 0.608 mcg/ml, the time to reach maximal concentration (Tmax) was 1.5 +/- 0.63 and 1.25 +/- 0.61 hours, the half life (T 1/2) was 8.369 +/- 1.953 and 8.013 +/- 2.602 hours, the area under curve (from 0 to 24 hours) (AUC0-24 hr) was 11.03 +/- 6.78 and 8.27 +/- 2.99 mcghr/ml, and the area under curve (from 0 hour to infinity) (AUC0-hr) was 13.56 +/- 9.09 and 10.11 +/- 4.61 mcghr/ml, respectively. Based on the data, there was no significant difference found between the two groups after statistical analysis with paired t test (p greater than 0.05). Therefore, the similarity of these two formulations is then suggested by the authors.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2769829 TI - A simple and rapid method for obliteration of patent ductus arteriosus in the small infant. AB - There was a 45-day old small baby with 2,650 g of body weight undergoing surgical operation of patent ductus arteriosus because of congestive heart failure and severe pulmonary hypertension. A simple and rapid method as proposed by Traugott et al for obliteration the ductus with two ligaclips (Ethicon LC300) is presented. PMID- 2769830 TI - Microcomputer program in Chinese to manage and analyze antimicrobial susceptibility results. AB - A chinese microcomputer program which analyzes the minimal inhibitory concentration (MIC) of antimicrobial susceptibility and presents the results in tabular and chart forms is described. This program also computes MIC50, MIC90, and geometric mean MIC and displays these values for a large number of antimicrobials in a summary table. The set of MIC values used for different groups of organisms or antimicrobial agents can be altered without changing the program. A text file of the results is written into the disk to enable editing before final presentation. The program features several major enhancements over previously published ones. PMID- 2769831 TI - Electrophysiology of the electrically and mechanically damaged cochlea. AB - Electrical and mechanical stimuli were used in an attempt to cause cochlear deafness in a preparation with a rich supply of afferent cochlear neurons. Hearing sensitivity was assessed by electrocochleography and neuron survival was estimated by evaluating electrically induced auditory brainstem responses (EABR). Charge balanced sinusoidal alternating currents between 1 and 30 kHz for up to 15 hours produced a limited high frequency hearing loss when applied through the intact round window. A similar permanent threshold shift (PTS) could be induced by mechanical irritation with a scala tympani electrode through a round window fenestration. There is a summation of electrical and mechanical damage; however, complete deafness never occurred and the EABR provided no evidence for a major retrocochlear damage. These results suggest that deafness associated with perilymph leakage or induced during certain types of ear surgery should not be accepted as inevitable. PMID- 2769832 TI - Role of probe tone parameters in frequency selectivity for normal listeners. AB - The objective of this research was a determination of the role of probe tone parameters in frequency selectivity. Frequency selectivity is the ability of the auditory system to analyze a complex sound into its frequency components, and is typically evaluated by measuring the psychophysical tuning curve. Generally this entails documenting the effect of varying the center frequency of a narrowband noise masker for a given pure tone probe, 10 dB above threshold. In the present study, a new approach was taken. A family of tuning curves were generated for a series of tone probes which differed in frequency, duration and intensity, but which remained constant in energy. The results for three normal-hearing subjects indicated that the critical parameter for the shape of the tuning curve was the energy of the probe. Decreasing the energy below values generally tested resulted in aberrant shapes across subjects, which bore some resemblance to those documented in hearing-impaired listeners. Temporal summation was suggested as the unifying principle. PMID- 2769833 TI - Changes in the time constants of the vestibulo-ocular reflex and optokinetic afternystagmus following unilateral ablative vestibular surgery. AB - Changes in the time constants and gains of the vestibulo-ocular and optokinetic systems were studied in seven patients. Angular acceleration pulse and optokinetic stimuli were administered to three normal subjects and also to seven patients at specific intervals after unilateral ablative vestibular surgery. The gains and the time constants of the two systems were compared. Regression analysis showed that the vestibulo-ocular and optokinetic time constants for slow phase eye movements away from the ablated ear declined significantly after surgery in the patient group, but that the gains did not. A theory based upon variability of system parameters by the CNS is outlined to explain the changes in the dynamics of the two systems after surgery. The data from this study suggest that the time constant may be a useful parameter in clinical vestibular testing. PMID- 2769834 TI - Bilateral vestibular loss and oscillopsia. AB - The electronystagmographic (ENG) records of 5,499 patients were reviewed so as to note the level of caloric activity. Bilateral caloric reduction or loss was found in only 1.6%. Although no diagnosis could be made with a high degree of confidence in the majority of patients, bilateral Meniere's disease and exposure to ototoxic drugs were identified most frequently. The degree of caloric reduction or loss did not correlate with the subjective symptom of oscillopsia, oscillopsia test findings or results of low frequency harmonic sinusoidal rotation tests. In a few patients with bilateral caloric loss, no oscillopsia was demonstrated. Many mechanisms other than the vestibulo-ocular reflex exist to provide visual stability, and we assume these become effective in some patients with bilateral caloric reduction or loss. PMID- 2769835 TI - [Deafness in juvenile relapsing polychondritis. A case report]. AB - Relapsing polychondritis is an autoimmune disease that affects all body cartilages. The disease may also involve the audio-vestibular system, usually bilaterally. Most of the reported cases were adults 20 years old or more. This is a case report of a 12-year-old girl with unilateral sensorineural hearing loss, and a review of the literature. PMID- 2769836 TI - Osteoma of the incus. AB - Osteomas of the temporal bone are rare. Osteomas of the middle ear have been reported but none involving an ossicle. We describe a case of a 28-year-old man who had a conductive hearing loss caused by an osteoma of the incus. PMID- 2769837 TI - Aspiration of middle ear effusions prior to grommet insertion an etiological factor in tympanosclerosis. AB - Fifty-five children with bilateral middle ear effusions were entered into a prospective randomized double blind trial to determine whether aspiration of middle ear effusions prior to ventilation tube insertion influences ventilation tube extrusion time or the development of tympanosclerosis. Following myringotomy, aspiration of the left or right ear only was performed randomly prior to ventilation tube insertion. The tympanic membranes were inspected six monthly to determine whether ventilation tube extrusion had occurred, and at 24 months after surgery for the presence of tympanosclerosis. Results showed no significant difference in extrusion time between aspirated and non-aspirated ears. Aspiration was found to be a factor in the development of tympanosclerosis. We conclude that routine aspiration of the middle ear effusion prior to ventilation tube insertion is associated with an increased risk of tympanosclerosis. PMID- 2769838 TI - Objective tinnitus associated with abnormal mastoid emissary vein. AB - Tinnitus may be defined as the perception of sound in the absence of environmental input. It can be subjective. Objective tinnitus may be caused by clearly definable mechanical or vascular abnormalities, and as such may be amenable to specific management. We report a case of objective tinnitus associated with an abnormal mastoid emissary vein. A review of the literature identified only one other report of objective tinnitus associated with an emissary vein. That report involved a posterior condylar emissary vein. The venous drainage of the sigmoid sinus was studied on 50 human skulls demonstrating three possible emissary veins of each sigmoid sinus. The postauricular region was dopplered on 30 asymptomatic human subjects. None was found to have dopplered emissary vein flow. PMID- 2769839 TI - Anterior skull defect reconstruction with methyl methacrylate. AB - A case of squamous cell carcinoma of the fronto-ethmoid complex in an 18-year-old man is presented. At the time of resection both the anterior and posterior tables of the frontal sinus had to be removed. The resulting surgical defect left a marked cosmetic deformity. CT scan five months after the resection suggested calcification with possible ossification of the dura. Exploration of the area confirmed these findings. Because of the firmness of the dura it was possible to contour a methyl methacrylate template to fill the defect. This was wired to the surrounding bone and provided an excellent cosmetic result. The principle of dural osteogenesis is described, and cranioplasty methods are reviewed. PMID- 2769840 TI - Amyloid goiter. AB - A case of a 50-year-old patient suffering from secondary amyloidosis presenting with amyloid goiter is described. The diagnostic and therapeutic implications are reviewed. PMID- 2769841 TI - Unusual CT appearance of a thyroglossal duct cyst carcinoma. AB - This is the first report to describe the CT appearances of a solid midline cervical mass that proved to be a papillary carcinoma associated with a thyroglossal duct cyst. PMID- 2769842 TI - Extracorporeal shock wave lithotripsy monotherapy: experience with piezoelectric second generation lithotriptor in 642 patients. AB - Extracorporeal shock wave lithotripsy monotherapy was performed in 642 patients for 1 year with an EDAP-LT01 piezoelectric lithotriptor. Of 642 patients 398 completed extracorporeal shock wave lithotripsy treatment and 244 still are undergoing multiple extracorporeal shock wave lithotripsy sessions. The 398 patients had renal (64.6 per cent) or ureteral (35.4 per cent) stones 0.6 to 4.8 cm. in diameter (mean 1.4 cm.). No general or regional anesthesia was required except in 7 children. Among 398 patients who completed extracorporeal shock wave lithotripsy the rate free of stones was 73.4 per cent and the rate of clinically insignificant residual fragments was 12.8 per cent. The success rate (rate free of calculi plus that of clinically insignificant renal fragments) ranged from 95.6 per cent for stones 0.6 to 1.0 cm. in diameter to 52.6 per cent for stones larger than 3.0 cm. (mean 86.2 per cent). The number of treatment sessions in 343 patients with successful results increased in accordance with the stone size, with an average of 1.6 sessions. Double-J* stents were placed in 7 patients and ureteral catheterization was performed in 11 as post-extracorporeal shock wave lithotripsy adjunctive measures. The steinstrasse phenomenon was noted in 14 patients, of whom only 1 required Double-J stenting. There were no significant complications. Therefore, extracorporeal shock wave lithotripsy monotherapy with the piezoelectric lithotriptor is considered to be a safe and efficient outpatient procedure for the initial treatment of urinary stones regardless of stone sizes. PMID- 2769843 TI - Clinical experience using the Wolf Piezolith device at 2 British stone centers. AB - Machines using the principle of piezoelectric extracorporeal shock wave lithotripsy have been developed. This has allowed the prospect of painless treatment for renal and ureteral calculi. The experience with use of 2 Wolf Piezolith machines for 1 year is presented. Different second generation lithotriptors have varying techniques of production of shock waves and different imaging methods. The Wolf Piezolith device uses ultrasound imaging and piezoelectric crystals for shock wave generation. Between June 1987 and May 1988, 545 patients 5 to 84 years old were treated with the Wolf Piezolith device. Of these patients 2-month followup data are available for 367 (398 renal units). Outpatient treatment was used routinely. For renal calculi complete fragmentation (into particles less than 2 mm. in size) was achieved in 94 per cent of the patients, with 53 per cent being completely free of stone at 2 months. For ureteral stones treated in situ the best results were obtained in the upper and lower ureter. Over-all, 62 per cent of the patients required more than 1 treatment, with the number of treatment sessions required increasing with the size of the stone treated. Morbidity was low. Ultrasound imaging has proved to be as effective as x-ray imaging. Compared to Dornier HM-3 lithotripsy, installation and running costs were low. The machine offers a favorable alternative to first generation lithotriptors. PMID- 2769844 TI - Extracorporeal shock wave lithotripsy treatment of calculi in horseshoe kidneys. AB - From June 1985 to November 1986, 17 patients with calculi in horseshoe kidneys presented to our hospital for evaluation and possible treatment with extracorporeal shock wave lithotripsy. Of these patients 14 were treated with extracorporeal shock wave lithotripsy; the calculi in 2 could not be localized and focused at the F2 focal point, and 1 was asymptomatic and has been followed conservatively. Four patients required repeat extracorporeal shock wave lithotripsy. Adjunctive procedures included preoperative retrograde catheter placement (5 patients), postoperative percutaneous nephrostolithotomy (1), ureteroscopy for ureteral fragments (2) and placement of a double pigtail stent (1). Of 14 patients 11 (79 per cent) have been rendered free of fragments with extracorporeal shock wave lithotripsy and adjunctive measures as needed. We conclude that most patients with calculi in a horseshoe kidney can be managed primarily with extracorporeal shock wave lithotripsy. PMID- 2769845 TI - Cytogenetics of bilateral renal cell carcinoma. AB - We analyzed cytogenetically 6 tumors from 4 patients with bilateral renal cell carcinoma. Comparison among findings in these patients with bilateral disease and previously reported cases of unilateral tumor demonstrates that bilaterality is associated with a more frequent loss of a sex chromosome, and gain of chromosomes 7 and 3, whereas unilateral tumors often are associated with loss of chromosome 3 material. It is proposed that bilateral tumors are distinct genetically from unilateral tumors and that most bilateral tumors have a genetic propensity to either enhanced metastatic spread to other renal tissue or spontaneous degeneration. PMID- 2769846 TI - The split-cuff ureteral nipple reimplantation technique: reliable reflux prevention from bowel segments. AB - The split-cuff nipple ureteral implantation technique is described in 18 patients undergoing lower urinary tract reconstruction or supravesical diversion. This technique provides a simple and reliable antireflux mechanism into large and small bowel segments. No reflux or upper tract deterioration was seen initially, and only 1 case of mild reflux has occurred after 30 months of followup. PMID- 2769847 TI - Long-term results of intravesical bacillus Calmette-Guerin therapy for superficial bladder cancer. AB - Between January 1978 and February 1984, 120 patients with superficial bladder tumors and/or carcinoma in situ were enrolled in previously reported therapeutic trials of bacillus Calmette-Guerin. Of all treated patients 78 per cent responded to initial therapy, with a followup of 13 to 120 months (median 67 months). Of the 18 patients who failed 10 were treated with repeat, intensified courses. Nine patients who had recurrent tumors within 3 to 30 months after initiation of bacillus Calmette-Guerin therapy (median 6 months) eventually ceased having recurrence. Status free of disease in the 9 patients ranged from 25 to 90 months since the last recurrence (median 64 months). With retreatment of some of the early failures, the initial success rate of 78 per cent was increased to 89 per cent. These data support the concept that intravesical immunotherapy with bacillus Calmette-Guerin should be repeated in patients who initially appear not to respond. The data also suggest that bacillus Calmette-Guerin induces a durable beneficial response rather than simply delays eventual tumor recurrence. PMID- 2769848 TI - Electrical activity of corpus cavernosum during flaccidity and erection of the human penis: a new diagnostic method? AB - We investigated 7 normal men and 1 diabetic patient with erectile dysfunction. Electromyography electrodes were placed in the corpus cavernosum of the penis and electrical activity was recorded during flaccidity. With sexual arousal the activity decreased and tumescence was initiated. During tumescence and full erection the electrical activity of the corpus cavernosum almost ceased but in the diabetic patient (neurogenic impotence) an increase was observed. This discoordination might be the cause of the erectile dysfunction. Recording the electrical activity of the corpus cavernosum in patients with suspected neurogenic erectile dysfunction could become clinically valuable, since this is the first test possible to study the function of the autonomic motor system that normally regulates penile function. PMID- 2769849 TI - Negative pressure devices in the explanted penile prosthesis population. AB - Of 402 penile prosthesis implanted at our institution between 1980 and 1987, 20 required explantation due to infection, erosion, pain or tissue necrosis. Of these 20 patients 14 were available for a prospective trial using a negative pressure device in an attempt to restore potency. Among these 14 patients 11 used the device at home for a minimum of 30 days after an acceptable office demonstration. Three patients did not desire the negative pressure device after an office visit test. Of the 11 home users 10 (91 per cent) reported at least satisfactory erections and successful intercourse. Interestingly, 5 of 6 patients in whom explantation was due to infection were able to use the negative pressure device successfully. Over-all, 10 of the 14 explant patients (71 per cent) engaged in regular successful intercourse using the device. The negative-pressure device can be a useful therapy for erectile impotence even in the sometimes challenging explant population. Despite previous corporeal infection and presumed fibrosis, negative pressure devices can provide patients with a functional erection-like state. PMID- 2769850 TI - Combined implantation of artificial sphincter and penile prosthesis. AB - Concurrent sphincteric incontinence and organic impotence are not uncommon; they can be caused by many congenital and acquired conditions. In the past simultaneous implantation of the artificial sphincter and penile prosthesis was met with skepticism. Of 65 patients who had concurrent implantation of the artificial sphincter and various categories of penile prosthesis 60 were followed for a mean of 35.74 months (range 8 to 55 months). Continence was graded as good or satisfactory in 95 per cent of the patients and poor in 5 per cent. The penile implants were functional in 98 per cent of the patients. Of the 60 patients 33 required 59 corrections, for an average of 0.98 correction per patient. These results indicate that staged or concurrent implantation of dual prostheses is feasible technically, functionally and cosmetically, and without increased risk for surgical or mechanical problems. PMID- 2769851 TI - Erosion of penile prostheses: a complication of urethral catheterization. AB - We studied 9 patients with indwelling urethral catheters or who were using intermittent clean catheterization and who had received a penile prosthesis. A 56 per cent (5 of 9) incidence of urethral erosion was found in this population. Urethral erosion was a late complication, 80 per cent (4 of 5) of the time in our series, that usually presented several months after implantation of the prosthesis. We believe that the etiological factors that contributed to this disastrous complication were the friction and inflammation associated with catheterization. We currently construct a perineal urethrostomy in patients who desire a penile prosthesis and who perform intermittent catheterization. If intermittent catheterization is not feasible, insertion of a suprapubic tube is recommended. We additionally recommend insertion of an inflatable penile prosthesis, since this type is relatively soft most of the time and will not cause as much pressure at the end of the penis. Since instituting these procedures we have not encountered any erosion. PMID- 2769852 TI - Peyronie's disease: surgical experience and presentation of a proximal approach. AB - A total of 29 patients underwent 32 operations for correction of penile curvature. Of these patients 22 underwent placement of a semirigid prosthesis and 94 per cent of those available for followup were able to resume coitus. Of the 8 patients who underwent operative correction of penile curvature and who maintained potency only 3 (38 per cent) were able to resume intercourse. Vascular compromise and/or skin slough after degloving of the penile skin was noted in 3 patients. A proximal approach to penile reconstruction is presented. PMID- 2769853 TI - Elevation of intratesticular and scrotal skin surface temperature in men with varicocele. AB - A possible mechanism of varicocele-induced infertility is believed to be elevation of testicular temperature. Sensitive needle thermistors were used to measure directly intratesticular and bilateral scrotal surface temperatures simultaneously in anesthetized infertile men with varicocele and control subjects. We found that intratesticular temperature is elevated significantly in humans with varicocele. In addition, we have shown that scrotal skin surface temperature is elevated in men with varicocele. Furthermore, we demonstrate that unilateral varicocele is associated with bilateral elevation of scrotal surface temperature. These findings confirm the results of animal studies revealing elevation of intratesticular temperature associated with varicocele and suggest bilateral elevation in unilateral varicocele. PMID- 2769854 TI - Testicular salvage and age-related delay in the presentation of testicular torsion. AB - Testicular torsion represents a continuing source of morbidity among male patients. Early diagnosis and surgical exploration improve testis salvage but even this approach will result in orchiectomy if there is excessive delay in patient presentation. A 10-year retrospective review of testicular torsion was performed. The interval between onset of scrotal pain and presentation to the emergency department was determined. A specific age-related delay in presentation was identified between patients less than 18 years old (group 1, median delay 20 hours) and those greater than 18 years old (group 2, median delay 4 hours, p less than 0.001). At exploration 44 per cent of the group 1 patients required orchiectomy versus 8 per cent in group 2. Patients less than 18 years old are a high risk group for testicular loss after torsion and represent more than 90 per cent of the orchiectomies performed. We believe that this group should be targeted for improved health education, emphasizing early evaluation of scrotal pain to improve testicular salvage. PMID- 2769855 TI - The intraprostatic spiral: a new device for insertion with the patient under local anesthesia and with ultrasonic guidance with 3 months of followup. AB - Acute or chronic urinary retention (median retention volume 1,000 ml.) was relieved successfully in 41 of 45 consecutive patients by insertion of an intraprostatic spiral with the patient under local anesthesia and with ultrasonic guidance. Insertion guided by ultrasound was successful in 35 patients (77 per cent). In 6 patients the spiral was inserted via the traditional endoscopic technique. During 3 months of followup the spiral remained in situ in 27 patients and in 6 it was repositioned. These 33 patients had free voiding with a median maximum flow rate of 13.6 ml. per second. Residual urine volume 1 month after insertion of the spiral was low (median 27 ml.). In 8 patients the spiral was removed during the observation period due to urinary incontinence or retention. The intraprostatic spiral is a favorable alternative to an indwelling catheter in patients awaiting an operation and in those with a high operative risk. PMID- 2769856 TI - Deoxyribonucleic acid flow cytometry of benign prostatic disease. AB - Deoxyribonucleic acid flow cytometry was performed on aspirated prostatic cells from 198 patients who had benign cytological or histological findings. Unsatisfactory acellular histograms were obtained from 10.6 per cent of the cases. Three-fourths of the satisfactory samples (more than 5,000 cells after subtracting debris) showed the expected single peak deoxyribonucleic acid diploid to near diploid histograms. Unexpectedly, the remaining samples were deoxyribonucleic acid aneuploid, most having 2 peridiploid peaks (deoxyribonucleic acid index 0.82 to 1.31). Usually, proliferation was low with less than 20 per cent hyperdiploid cells and with 2.5 +/- 1.5 per cent G2 cells. In 10 per cent of the single peak histograms there was evidence of inflammation, identified as an increase in hyperdiploid cells without an increased percentage of G2 cells but with a tail of high channel values. The aforementioned histogram features were considered to be benign findings. Seven per cent of the samples had deoxyribonucleic acid histograms suggestive of prostate cancer. Of these samples 7 had diploid or peridiploid aneuploid histograms with high proliferation (more than 20 per cent hyperdiploid cells with 8.5 +/- 3.8 per cent G2 cells), while 5 had histograms with deoxyribonucleic acid aneuploidy other than peridiploidy. PMID- 2769857 TI - The role of perineural space invasion in the local spread of prostatic adenocarcinoma. AB - In 176 radical prostatectomy specimens areas of capsule penetration by cancer and positive surgical margins were quantified and located over the prostate surface. The presence of cancer within the perineural space was sought in these areas and compared to the normal distribution of prostatic nerve branches. Capsule penetration was found in 78 of 156 stage B carcinomas, and in 39 of these 78 (50 per cent) it occurred entirely by cancer extension through the capsule within perineural spaces. In the remaining 39 prostates capsule penetration by perineural space invasion predominated but direct spread also was found. Most often, perineural space invasion followed the oblique vertical course of nerve branches that extended superiorly to the superior pedicle near the prostate base. In such cases capsule penetration areas were localized near the superior margin of the cancer, and in 11 per cent positive superior pedicle margins resulted from continued perineural space invasion outside the capsule. In cancers near the prostate apex capsule penetration by perineural space invasion produced positive margins in 89 per cent of 18 cases because of the short inferior pedicle. The role of perineural space invasion by cancer was less prominent in 4 of 20 stage A cancers that showed capsule penetration. PMID- 2769858 TI - Approaches to the superior calix: renal displacement technique and review of options. AB - A new percutaneous approach to the superior calix has been implemented with reduced morbidity. To avoid intercostal or retrograde punctures or triangulation methods an Amplatz sheath passed through a central or lower pole calix can be pushed caudally while descent of the kidney is viewed fluoroscopically. An 18 gauge TLA needle passed through the initial skin puncture then is used to form a Y with the original tract. This method has been successful in 21 of 25 cases without complications. The only failures occurred in patients with immobile kidneys secondary to a previous operation. PMID- 2769859 TI - A new technique for retrograde stone displacement in the tortuous ureter before extracorporeal shock wave lithotripsy. AB - A tortuous ureter can prevent a ureteral calculus from being manipulated into the kidney before extracorporeal shock wave lithotripsy. We describe a technique using a floppy-tip guide wire and a double channel cystoscope to manipulate a stone from a tortuous ureter into the kidney. PMID- 2769860 TI - Ambulatory monitoring of bladder and detrusor pressure during natural filling. AB - We have developed a system to perform fully ambulatory monitoring studies of the bladder. Bladder and rectal pressures are recorded during natural filling of the bladder for up to 6 hours. This system has been evaluated in 19 studies performed on 15 patients. The mean duration of the studies was 3 hours 51 minutes (standard deviation +/- 1 hour 3 minutes) and the mean number of voids per patient was 3.8 +/- 2.2. Visual inspection of the recorded data showed that subtraction of the rectal trace from the bladder trace provided a useful detrusor trace when subjects were ambulant as well as resting. When ambulant, movement caused typical peak-to-peak pressure variability in the bladder and rectal traces of approximately 30 +/- 20 cm. water (mean and standard deviation of peak-to-peak pressure for typical ambulant 5-minute sections for each patient), which after subtraction was reduced on the detrusor trace to 10 +/- 5 cm. water. The equivalent figures when resting were 9 +/- 5 cm. water, subtracting to less than 5 cm. water for the detrusor. Further measurements also were calculated for the whole of each trace. The system provided good quality recordings and should prove useful in future evaluations of natural fill urodynamic studies. PMID- 2769861 TI - Long-term followup of 207 patients with bladder exstrophy: an evolution in treatment. AB - Between 1945 and 1985 a total of 207 patients (male-to-female ratio 2:1) was treated at our institution for exstrophy of the bladder. Primary anatomical bladder closure was performed in 137 patients, of whom 42 (31 per cent) eventually required urinary diversion. Primary urinary diversion was the initial treatment in 70 patients, including ureterosigmoidostomy in 40, ileal conduit in 17, colon conduit in 11 and cutaneous ureterostomy in 2. Secondary urinary diversion was necessary in 35 patients and included continent diversion in 7. Primary anatomical bladder closure, done within 72 hours of birth and followed by staged reconstruction of the bladder neck, was the most successful surgical regimen for the treatment of bladder exstrophy. Acceptable urinary continence was achieved in 82 per cent of our patients with this approach. However, multiple procedures often were required to achieve continence. PMID- 2769862 TI - 47,XXY/48,XXY,+21 chromosomal mosaicism presenting as hypospadias with scrotal transposition. AB - The syndrome of 47,XXY/48,XXY,+21 chromosomal mosaicism, double aneuploidy, is extremely rare and characterized by combined manifestations of Klinefelter's and Down's syndromes. We report a case of XXY/XXY,+21 mosaicism presenting with hypospadias associated with scrotal transposition. PMID- 2769863 TI - Total ablation of the penis after circumcision with electrocautery: a method of management and long-term followup. AB - Four patients who had traumatic loss of the penis were managed after the initial injury with a feminizing genitoplasty. Patient reconstruction ranged from 6 months to 3 years. The technique of feminizing genitoplasty is described. There were no instances of flap necrosis, urinary tract infection or urinary incontinence. Immediate results were considered to be cosmetically satisfactory in all patients. Followup ranged from 8 months to 23 years, with a median of 10.5 years. The long-term results have been particularly gratifying in 2 individuals who have been observed for more than 18 years. Early feminizing genitoplasty offers an excellent method of reconstruction of the external genitalia in the child with traumatic loss of the penis who is assigned a female sex of rearing. PMID- 2769864 TI - The prune belly syndrome: a comprehensive approach to management. AB - Our approach to management of the prune belly syndrome entails a program of comprehensive early reconstruction, including abdominoplasty, bilateral orchiopexy, reduction cystoplasty, and selective ureteral tailoring and reimplantation. Of 20 patients with the prune belly syndrome treated at our institution during the last 18 years 15 underwent comprehensive reconstruction. Abdominoplasty was performed in 16 patients. Results were evaluated as to cosmetic appearance, functional performance, and preoperative and postoperative electromyography. Immediate good results were obtained in 9 patients. Of 16 patients 6 required more than 1 abdominal wall tailoring and 3 had minor complications that did not compromise the ultimate result. Transabdominal orchiopexy was performed on 32 testes; 28 (88 per cent) are in the scrotum and growing. Of the 4 failures 3 occurred in patients greater than 2 years old at repair. Selective urinary tract reconstruction has been performed; 13 patients underwent tapering and reimplantation of 1 or both ureters. Reduction cystoplasty was done in all 15 patients. Functional assessment of the upper urinary tract by improved radiological techniques and the necessity for long-term antibiotic prophylaxis have led to a more conservative approach in 5 recent patients. Renal function as measured by serum creatinine and/or glomerular filtration rate has remained stable in 12 of 15 patients (92 per cent) undergoing comprehensive reconstruction. Aggressive surgical management of patients with the prune belly syndrome provides improved abdominal wall function and appearance, and offers excellent testicular salvage. Surgical reconstruction of deformed ureters should be selective and decided on longitudinal studies of renal function. PMID- 2769865 TI - Renal loss following extracorporeal shock wave lithotripsy. AB - A patient with life-threatening retroperitoneal hemorrhage after extracorporeal shock wave lithotripsy is presented. Despite angioinfarction of the involved renal unit, nephrectomy ultimately was required to control bleeding. The urological and hematological aspects of the management are discussed. PMID- 2769866 TI - Bilateral complete ureteral obstruction and renal insufficiency secondary to granulomatous disease. AB - Chronic granulomatous disease is a rare disorder of neutrophil function that impairs the ability of phagocytes to react to infection and produces inflammatory lesions that may involve many organ systems. A young man recently presented with bilateral mid ureteral obstruction and renal insufficiency secondary to inflammation due to chronic granulomatous disease. To our knowledge, we believe this to be the only case of complete bilateral ureteral obstruction due to chronic granulomatous disease reported to date. A review of the disease, its pathogenesis and potential involvement of the urinary tract is presented. PMID- 2769867 TI - Serendipitous diagnosis of appendicovesical fistula by bone scan: a case report. AB - A 71-year-old patient had recurrent urinary tract infections for 7 years after sigmoid colectomy via a Hartmann procedure. Extensive radiological and endoscopic tests were inconclusive as to the cause of bacteriuria. Chronic back pain led to performance of a radionuclide bone scan with the incidental demonstration of a vesicoenteric fistula, confirmed at exploration. Appendectomy with resection of the involved bladder resulted in cessation of bacteriuria. PMID- 2769868 TI - Endoscopic management of urethrovesical anastomotic obliteration following radical retropubic prostatectomy. AB - Urethrovesical anastomotic obliterative strictures are uncommonly reported sequelae of radical retropubic prostatectomy. We report a method to re-establish endoscopically continuity between the bladder and urethra after this complication. PMID- 2769869 TI - Fournier's gangrene in hypersensitivity vasculitis. AB - Fournier's gangrene in IgE positive hypersensitivity vasculitis demands concurrent high dose immunosuppression, radical surgery and intensive treatment of septic sequelae. Even extended autologous skin grafting is possible with immunosuppression. A case of fulminant necrotizing infection of the genitalia, perineum and abdominal wall during the acute generalization phase of IgE positive hypersensitivity vasculitis is described. Apart from the radical surgical approach, medical treatment demands a different strategy than in classical Fournier's gangrene. The favorable outcome in a 21-year-old man after several months of intensive care could be realized only by close cooperation of internal specialists, urologists and plastic surgeons. PMID- 2769870 TI - Small bowel intussusception: an unusual complication of retroperitoneal lymph node dissection. AB - Modified bilateral retroperitoneal lymph node dissection is used widely in the staging and treatment of patients with nonseminomatous germ cell testis tumors. Complications are uncommon and include vascular injury, infertility and small bowel obstruction from fibrous adhesions. Small bowel intussusception following retroperitoneal lymph node dissection has not been reported previously. We report 2 cases of small bowel intussusception after retroperitoneal lymph node dissection, and discuss the etiology and possible preventive measures. PMID- 2769871 TI - Chronic hemospermia due to mullerian duct cyst: diagnosis by magnetic resonance imaging. AB - Hemospermia usually is considered of minor consequence. It rarely is identified with a specific pathological disorder. A case of hemospermia secondary to a mullerian duct cyst diagnosed by magnetic resonance scanning is reported. PMID- 2769872 TI - Re: Spontaneous rupture of the renal collecting system during pregnancy: successful management with a temporary ureteral catheter. PMID- 2769873 TI - Re: The renal sinus: an imaging review and proposed nomenclature for sinus cysts. PMID- 2769874 TI - Re: Penile pharmacocavernosography and cavernosometry in the evaluation of impotence. PMID- 2769875 TI - Re: Priapism associated with trazodone therapy. PMID- 2769876 TI - Re: The natural course of prostatic carcinoma in relation to initial cytological grade. PMID- 2769877 TI - Re: Management of stage a prostate cancer with a high probability of progression. PMID- 2769878 TI - Re: Intermediate-term survival results in clinically understaged prostate cancer patients following radical prostatectomy. PMID- 2769879 TI - Re: Is antibiotic administration indicated after outpatient cystoscopy. PMID- 2769880 TI - Stone composition is no guide to strength: changing the direction of research? PMID- 2769881 TI - Re: Distribution of patients with 2,8-dihydroxyadenine urolithiasis and adenine phosphoribosyltransferase deficiency in Japan. PMID- 2769882 TI - Growth and differentiation of the gubernaculum testis during testicular descent in the pig: changes in the extracellular matrix, DNA content, and hyaluronidase, beta-glucuronidase, and beta-N-acetylglucosaminidase activities. AB - The gubernaculum testis is a loose connective tissue organ that plays an essential mechanical role in testicular descent. In the pig, the first phase of descent (transabdominal migration) is brought about by growth of the gubernaculum through the inguinal canal into the scrotum and simultaneous somatic growth of the fetus. During the second phase the gubernaculum condenses, thus allowing the testis to descend into the scrotum. The nature of gubernaculum development (growth and differentiation) was investigated with respect to cell proliferation, extracellular matrix (ECM) composition, and acid hydrolases. Deoxyribonucleic acid (DNA) was used as a measure of cell number and hydroxyproline (HYP) was an estimate of interstitial collagen. The first phase of gubernaculum development was characterized by rapid cell proliferation and concomitant synthesis of sulphated glycosaminoglycans (S-GAG), hyaluronic acid (HA) and collagen. During the second phase cell proliferation ceased and DNA concentration increased. The amount of S-GAG remained closely related to the amount of DNA while HYP increased further. However, HA decreased during the second phase and thus HA metabolism seems to play a crucial role in biphasic development of the gubernaculum. The activities of the enzymes that are needed for biodegradation of HA (hyaluronidase, beta-glucuronidase and beta-N-acetylglucosaminidase) were measured in gubernaculum homogenate from animals during the first and second phase of testicular descent. These enzymes were detectable in gubernaculum and rose during the second phase of testicular descent. It was concluded that a very distinct dichotomy in the nature of gubernaculum development during the first and second phase could be discerned with respect to cell proliferation rate and ECM synthesis and degradation. These observations provide useful tools for future in vivo and in vitro investigations into the process and regulation of testicular descent. PMID- 2769883 TI - Qualitative analysis of the four-channel, high-resolution urethral pressure profile of the female dog. AB - Four-channel urethral pressure profiles (UPP's) were measured on six female dogs with an improved perfused open tip technique. A four-channel catheter with one side-hole per channel was used to measure four UPP's simultaneously in different directions. The dynamic properties of the system have been improved significantly by replacing the conventional perfusion system by a pneumo-hydraulic perfusion system, according to the design of Arndorfer. The UPP's thus obtained consistently show multiple peaks which depend on catheter orientation. These observations are explained in terms of the presence of several symmetrical as well as asymmetrical muscles in and around the canine urethral wall. Clinical application of the developed technique is expected to yield new information on the functional anatomy of the human urethra. PMID- 2769884 TI - Muscarinic cholinergic receptors in the normal and neurogenic human bladder. AB - Bladder dysfunction secondary to neurologic conditions occurs in all age groups and is associated with significant morbidity. The role of neuroreceptors in the development of detrusor dysfunction has not been studied previously. Control bladder tissue specimens were obtained from eight children with ureterovesical reflux undergoing ureteral reimplantation and 14 adults with bladder carcinoma undergoing cystectomy. Neurogenic bladder specimens were obtained from 10 children with myelomeningocele and five adults with neurogenic bladder dysfunction undergoing augmentation cystoplasty. Saturation experiments using 3H N-methylscopolamine (3H-NMS) were performed in these control and neurogenic bladder homogenates. The mean equilibrium dissociation constants in the neurogenic and control bladders were 0.41 nM and 0.55 nM, respectively. The mean density of muscarinic cholinergic (MCh) receptor binding sites in the neurogenic and control bladders was 0.34 fmol/mg wet wt. and 0.65 fmol/mg. wet wt., respectively. Competitive binding experiments with 3H-NMS and various unlabelled MCh antagonists indicated that the pharmacology of MCh binding sites was similar in neurogenic and control bladders. Age was not significantly correlated with MCh receptor density in the control and neurogenic bladders. Muscarinic cholinergic binding sites are homogeneous in neurogenic and control bladders. The lower density of MCh receptors in the neurogenic bladders may represent down regulation of MCh receptors or a replacement of smooth muscle by fibrosis. PMID- 2769885 TI - Two circulatory routes within the human corpus cavernosum penis: a scanning electron microscopic study of corrosion casts. AB - The microvascular architecture of the human corpus cavernosum penis was studied by scanning electron microscopy of vascular corrosion casts. The corpus cavernosum was supplied by the penile deep artery. It gave off branches to become either arteries distributed within the corpus cavernosum or those directly supplying the corpus spongiosum urethrae. The former arteries further divided into small arteries which fell into two categories: 1) arteries breaking up into capillaries, and 2) arteries draining directly into the cavernous sinuses. The capillaries were collected into venular networks just beneath the tunica albuginea (the subalbugineal venular plexus), while the cavernous sinuses were collected into venules at the periphery of the corpus cavernosum. These postcavernous venules also received venules from the subalbugineal venular plexus, and left the corpus cavernosum. Thus, two circulatory routes are evident within the corpus cavernosum. These findings suggested that the penile erectile cycle is controlled by hemodynamic changes between these two routes within the corpus cavernosum. PMID- 2769886 TI - Researchers amass abortion data. PMID- 2769887 TI - Preventive cardiologists unready to declare victory in war against coronary heart disease. PMID- 2769888 TI - From the Alcohol, Drug Abuse, and Mental Health Administration. PMID- 2769889 TI - From the Centers for Disease Control. First 100,000 cases of acquired immunodeficiency syndrome--United States. PMID- 2769890 TI - Will bleach decontaminate needles during cocaine binges in shooting galleries? PMID- 2769891 TI - Dependence on cyanocobalamin injections. PMID- 2769892 TI - Tobacco use by American Indian youth. PMID- 2769893 TI - Protection of an insulin pump in the Amazonian jungle. PMID- 2769894 TI - Testing source patient blood for HIV antibodies after accidental exposure of health care workers to blood and body fluids. PMID- 2769896 TI - Learning theories and medical lectures: add little to little and there will be a big pile. PMID- 2769895 TI - Intravenous cocaine and HIV infection. PMID- 2769897 TI - Increasing cesarean section rates in very low-birth weight infants. Effect on outcome. AB - Examination of a linked birth and death certificate file from Missouri revealed a remarkable increase in the use of cesarean section for very low-birth weight infants (500 to 1499 g) from 24% to 44% in the years 1980 to 1984. In the same years the rate for 1500- to 2499-g infants went from 21% to 26% and the rate for 2500- to 7000-g infants went from 14% to 18%. We studied first-day death rates in very low-birth weight infants as an indicator of potential benefit from this increase in cesarean sections. During the 5-year period first-day deaths averaged 10% and 22% in the cesarean and vaginal birth groups, respectively. This difference was explained almost entirely by deaths in the 500- to 740-g birth weight group, where the death rates were 33% and 59%, respectively. Although this difference remained statistically significant after adjustment for gestational age and other factors that differed between the groups, it was nullified by an excess of deaths in the succeeding 6 days of life. Overall, the odds of death in the first week in these infants weighing 500 to 749 g was 0.85 (95% confidence interval, 0.52 to 1.39) in the cesarean vs vaginal deliveries. We conclude that there is little evidence that the use of cesarean section for the delivery of very low-birth weight infants, independent of maternal or fetal compromise, improves overall survival. We were unable to find reasons to justify the sharp increase in the use of cesarean sections for these small infants. PMID- 2769898 TI - Epidemiologic study of sleep disturbances and psychiatric disorders. An opportunity for prevention? AB - As part of the National Institute of Mental Health Epidemiologic Catchment Area study, 7954 respondents were questioned at baseline and 1 year later about sleep complaints and psychiatric symptoms using the Diagnostic Interview Schedule. Of this community sample, 10.2% and 3.2% noted insomnia and hypersomnia, respectively, at the first interview. Forty percent of those with insomnia and 46.5% of those with hypersomnia had a psychiatric disorder compared with 16.4% of those with no sleep complaints. The risk of developing new major depression was much higher in those who had insomnia at both interviews compared with those without insomnia (odds ratio, 39.8; 95% confidence interval, 19.8 to 80.0). The risk of developing new major depression was much less for those who had insomnia that had resolved by the second visit (odds ratio, 1.6; 95% confidence interval, 0.5 to 5.3). Further research is needed to determine if early recognition and treatment of sleep disturbances can prevent future psychiatric disorders. PMID- 2769899 TI - Are racial differences in the prevalence of diabetes in adults explained by differences in obesity? AB - To determine whether the higher prevalence of diabetes found among blacks in the United States is explained by racial differences in obesity, we examined the prevalence of diabetes adjusted for adiposity, education, and income in a cohort of US Army veterans from the Vietnam era. Among 12,558 white men and 1677 black men, aged 30 to 47 years, blacks were more likely than whites to have diagnosed diabetes (adjusted prevalence ratio, 1.9; 95% confidence interval, 1.3 to 2.7). Within every age, adiposity, and socioeconomic stratum, blacks had a higher prevalence of diagnosed diabetes than whites. In a subgroup of veterans for whom fasting serum glucose values were measured, blacks were more likely than whites to have fasting hyperglycemia (fasting serum glucose value greater than or equal to 7.8 mmol/L) (adjusted prevalence ratio, 5.7; 95% confidence interval, 2.7 to 12.0). These data provide evidence that the higher prevalence of diabetes found among blacks is not explained by differences in obesity. PMID- 2769900 TI - Dog bite-related fatalities from 1979 through 1988. AB - By combining data from the National Center for Health Statistics and computerized searching of news stories, we identified 157 dog bite-related fatalities that occurred in the United States from 1979 through 1988. Of the 157 deaths, 70% occurred among children who were less than 10 years of age. The death rate for neonates was almost 370 times that of adults who were 30 to 49 years of age. Pit bull breeds were involved in 42 (41.6%) of 101 deaths where dog breed was reported, almost three times more than German shepherds, the next most commonly reported breed. The proportion of deaths attributable to pit bulls increased from 20% in 1979 and 1980 to 62% in 1987 and 1988. Pit bull attacks were almost twice as likely to be caused by strays as attacks by other breeds. Extrapolated estimates suggest 183 to 204 dog bite-related fatalities from 1979 through 1988. To prevent such deaths, we recommend stronger animal control laws, public education regarding dog bites, and more responsible dog ownership. Parents and physicians should be aware that infants left alone with a dog may be at risk of death. PMID- 2769901 TI - Adrenoleukodystrophy. PMID- 2769902 TI - The 'aging game'. An approach to education in geriatrics. PMID- 2769903 TI - The implications of Webster for practicing physicians. PMID- 2769904 TI - The search for a lower cesarean rate goes on. PMID- 2769905 TI - From the Office of the General Counsel: a new JAMA column. PMID- 2769906 TI - The implications of sleep disturbance epidemiology. PMID- 2769907 TI - A piece of my mind. Roe v. Wade. PMID- 2769908 TI - Sudden infant death syndrome: resurgent research offers hope. PMID- 2769909 TI - Nontherapeutic problems of generic drugs lead to call for FDA, legislative diagnosis and cure. PMID- 2769910 TI - Capture of elusive cystic fibrosis gene prompts new approaches to treatment. PMID- 2769911 TI - Walking, jumping, collaboration, and competition characterize race to cystic fibrosis gene. PMID- 2769912 TI - From the Centers for Disease Control. Measles outbreak--Chicago, 1989. PMID- 2769913 TI - From the Centers for Disease Control. National Mortality Followback Survey: characteristics of persons who died from diseases of the heart--United States, 1986. PMID- 2769914 TI - HIV-1 infection in patients with penetrating trauma in San Antonio, Tex. PMID- 2769916 TI - Luxurious cars: should physicians flaunt their wealth? PMID- 2769915 TI - Choice of specialty: it's money that matters in the USA. PMID- 2769917 TI - Smoking and cervical cancer: cause or coincidence. PMID- 2769918 TI - Proposition 65: more warning about the risks of tobacco. PMID- 2769919 TI - The epidemiology of injuries in Atlanta day-care centers. AB - From June 1987 through May 1988, we collected reports of injuries among 5300 children who attended 71 day-care centers in Atlanta, Ga. One hundred forty-three injuries severe enough for the child to require medical or dental care were reported, including 63 lacerations (44.1%), 23 fractures (16.1%), 5 crush injuries (3.5%), 4 dislocations (2.8%), 2 human bites (1.4%), and 2 concussions (1.4%). The head was the site of 98 (68.5%) injuries. Peak hours for injuries were 11 AM and 4 PM, the peak day was Monday, and the peak season was summer. After adjustment for hours and dates of attendance, the rate was 1.77 injuries per 100,000 child-hours in day care; among preschool-aged children, infants had the lowest rate (0.77) and 2-year-old children had the highest rate (2.26). Almost 47% of injuries occurred on the playground; falls were involved in 70% of such injuries. Because 33% of all injuries resulted from falls on the playground, impact-absorbing playground surfaces may be a possible intervention to reduce injuries. PMID- 2769920 TI - In-flight medical emergencies. One year of experience with the enhanced medical kit. AB - Recent regulations require commercial US aircraft to carry an enhanced medical kit. We reviewed kit use on United Airlines during the initial year of the regulations. We also surveyed passengers who became ill during flight and health care providers who used the new kit. The medical kit was used 362 times on 361 flights (once in every 1900 flights or one use for every 150,000 air travelers). Health care providers indicated that the kit was useful in more than 80% of emergencies and was occasionally lifesaving. In the emergencies in which the kit was used, 70% fell into one of seven major diagnostic groupings, including syncope/near syncope (29%), cardiac/chest pain (16%), asthma/lung disease/shortness of breath (10%), and allergic reactions (5%). With 450 million domestic air travelers per year, we would expect 3000 in-flight medical emergencies annually, and conclude that the enhanced medical kit is beneficial and propose that its effectiveness would be improved by the addition of a bronchodilator for inhalation. PMID- 2769921 TI - Comparative longevity in a college cohort of Christian Scientists. AB - The cumulative death rate of Christian Scientists who received an undergraduate college education at Principia College in Elsah, III, a liberal arts college for Christian Scientists, was compared with that of a control population that received an undergraduate college education in the College of Liberal Arts and Sciences at the University of Kansas in Lawrence. In this study, the cumulative death rate is expressed as the percentage of the graduating class known to have died as of June 1987. The study included the graduating classes from 1934 to 1983. The graduates from Principia College had a significantly higher death rate than the control population. PMID- 2769922 TI - Infectious medical wastes. Council on Scientific Affairs. AB - A number of recent incidents involving improper handling and disposal of hospital waste have prompted the demand for more stringent legislation to cover the management of infectious hospital waste. Resolution 53 (December 1987 Interim Meeting) called for the American Medical Association to promote the passage of federal legislation for the proper disposal of infectious hospital waste. This resolution has prompted a Council on Scientific Affairs report on the current status of infectious hospital waste management and of state and federal regulations to control such waste. The Council has concluded that existing federal and state regulations for the management of hazardous waste--in conjunction with the accreditation program of the Joint Commission on Accreditation of Healthcare Organizations and the guidelines of the Environmental Protection Agency and the Centers for Disease Control, if adhered to and properly enforced--should be adequate to ensure that the public and environment are not endangered. Therefore, the Council does not favor additional federal legislation at this time and recommends that this report be accepted in lieu of Resolution 53. PMID- 2769923 TI - Alcoholism treatment research: new directions for an old problem. PMID- 2769924 TI - Methadone treatment and the acquired immunodeficiency syndrome epidemic. PMID- 2769925 TI - A piece of my mind. Last rounds. PMID- 2769926 TI - Clinical significance of symptomatic and silent myocardial ischemia during exercise test in patients with effort angina pectoris--investigation of hemodynamic responses during supine ergometer exercise test. AB - Thirty one patients with stable effort angina who had no prior myocardial infarctions underwent symptom-limited ergometer exercise test. Hemodynamic responses during exercise were assessed to determine whether or not the limiting symptoms were related to the severity of exercise-induced myocardial ischemia. Twenty-two subjects (Group I) were limited by angina and nine (Group II) were limited by other symptoms. There were no differences in age, sex distribution, prevalence of diabetes mellitus, and left ventricular ejection fraction between the two groups. Multivessel coronary artery diseases, however, were more frequent in group I (16/22 vs 3/9: p less than 0.05). Maximal work load (46.6 +/- 16.0 vs 62.5 +/- 13.4 W: p less than 0.05), exercise duration (4.7 +/- 2.0 vs 7.2 +/- 1.4 min: p less than 0.005), and maximal oxygen consumption (12.4 +/- 4.1 vs 19.3 +/- 3.3 ml/kg/min: p less than 0.005) were significantly lower in group I. The magnitude of ST depression was not different between the two groups (2.0 +/- 0.8 vs 1.8 +/- 0.7 mm: NS). At maximal exercise, heart rate, mean blood pressure, cardiac index, and stroke work index (SWI) were significantly lower in group I (p less than 0.05) and pulmonary capillary wedge pressure was significantly higher in group I (31.1 +/- 6.1 vs 25.1 +/- 5.6 mmHg: p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2769927 TI - The development and reversal of tolerance to antianginal effect of isosorbide dinitrate in patients with effort angina. AB - The development and reversal of tolerance to the hemodynamic and anti-anginal effects of isosorbide dinitrate in a sustained release form (ISDN-SR) were investigated in 11 male patients (mean age 58.9 y.o.) with stable effort angina. Treadmill exercise test, evaluation of hemodynamic parameters and measurement of plasma ISDN concentrations were performed during the control period, on the 1st, 7th and 14th days of therapy with 40 mg of ISDN-SR orally every 8 h and, subsequently, on the day when ISDN-SR was re-administered after a 72 h placebo period (17th day). Initially, exercise tolerance time (ETT) was prolonged significantly (p less than 0.001) by ISDN-SR from 257 +/- 50 sec in the control period to 434 +/- 55 sec on day 1. This prolongation was significantly reduced with sustained therapy and ETT was shortened to 332 +/- 69 sec on the 7th day (p less than 0.01 vs day 1) and 326 +/- 73 sec on the 14th day (p less than 0.01 vs day 1). The effects of ISDN-SR initially observed were restored after a 72 h placebo period and ETT was prolonged to 432 +/- 57 sec on the 17th day. The resting heart rate was increased significantly (p less than 0.01 vs control) and systolic blood pressure was decreased (p less than 0.001 vs control) by ISDN-SR on day 1. These changes were also diminished significantly (p less than 0.01 vs day 1) with sustained therapy and were restored after a 72 h nitrate-free interval.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2769928 TI - Prognostic evaluation of congestive heart failure in patients with Duchenne muscular dystrophy--retrospective study using non-invasive cardiac function tests. AB - The relation between heart function and the prognosis of patients with Duchenne muscular dystrophy (DMD) was analyzed in 27 non-survivors and 40 survivors by fractional shortening (FS) of the left ventricle from M-mode echocardiogram, and by the PEP/ET ratio from the systolic time interval. The patients were divided into 5 groups; (1) patients who died of congestive heart failure (group 1), (2) those who died of congestive heart failure and respiratory failure (group 2), (3) those who died of respiratory failure (group 3), (4) those who died suddenly of undefined etiology (group 4), and (5) survivors (group 5). Data from non-invasive cardiac function tests were analyzed retrospectively for 2 years and compared at 2 years, 1 year and about 3 months before their deaths in cases of group 1, 2, 3 and 4, and the data obtained at the same period were also compared with those of survivors (group 5). The age at death in group 1 (17.3 +/- 4.9 years) was significantly younger than that in group 2 (25.3 +/- 4.2 years), however, it did not statistically differ from group 3 (19.8 +/- 3.3 years old). The values of FS in group 1 were significantly lower than those in group 3, 4 and 5 at three examinations, whereas no difference in PEP/ET was observed among them. Cardiothoracic ratio (CTR) on chest X-ray in group 1 was not significantly different from other groups in each period, but the left ventricle dilated rapidly in the terminal stage of congestive heart failure which could be more precisely detected by the M-mode echocardiogram. These results indicate that in DMD, early development of congestive heart failure was associated with a poor prognosis. FS was a most sensitive non-invasive tool in predicting the prognosis. A significant reduction in FS was detectable 2 years before death. Progression in abnormality of left ventricular dimension as well as in FS may be another useful index for evaluating the prognosis of patients dying from congestive heart failure. PMID- 2769929 TI - Tuberculosis on regular hemodialysis--a case of pericardial tamponade. AB - The patient presented in this paper had been stable for 3 months after the induction of hemodialysis, when nausea, vomiting and hepatomegaly suddenly developed. A chest film revealed rush cardiomegaly, and massive pericardial effusion was demonstrated by echocardiography. One liter of hemorrhagic fluid was removed by pericardiocentesis and subsequent pericardial drainage under echocardiography. The patient received chemotherapy against pulmonary tuberculosis 30 years ago and calcification on chest film was apparent. Although sputum smear and pericardial effusion was negative for acid-fast organisms, combination therapy was initiated for suspected tuberculosis. The patient recovered completely and 2 months later it was demonstrated that cultures of sputum grew mycobacterium tuberculosis. Tuberculin skin test (PPD), which was negative 2 months previously, converted to positive. Tuberculosis must be considered as a potential cause of pericardial tamponade in patients on regular hemodialysis, and prompt therapy for both cardiac tamponade and the occult infection is warranted. PMID- 2769931 TI - Progress in anti-hypertensive vasodilative therapy. Satellite symposium of the 50th annual scientific meeting of the Japanese Circulation Society. March 29, 1986, Kyoto. Abstracts. PMID- 2769930 TI - The control of macro- and microcirculation in the mesentery and intestine. AB - The total blood flow and microvessel blood flow in the mesentery and the intestine anesthetized rabbits were measured while systemic hemodynamics were altered by baroreceptor stimulation and by noradrenaline injection. The percent change of the total peripheral resistance (Rt) was greater than the change in resistance in the intestinal vascular bed (Ri) during baroreceptor stimulation. The capillary blood flow in the intestinal muscle layer (Qs) and villus (Qv) increased slightly while the intestinal arterial flow (Qa) and the arteriolar flow in the mesentery (Qm) decreased. These data indicated that Qs and Qv were not controlled by the sympathetic vasoconstrictor system. The percent change of Ri was greater than that of Rt during noradrenaline injection. Noradrenaline decreased Qa, but Qs and Qv were decreased while Qm was increased. These results show that noradrenaline stimulates alpha-adrenoceptors on small arteries and arterioles in the intestine. The observed Qm changed was in response to the systemic hemodynamic change caused either by the baroreceptor input or by noradrenaline. PMID- 2769932 TI - Diagnostic imaging '86. Satellite symposium of the 50th annual scientific meeting of the Japanese Circulation Society. March 29, 1986, Kyoto. Abstracts. PMID- 2769933 TI - [Cefotiam concentration in the peritoneum in infants during surgery]. AB - 1. Supposing the hernia sac to be peritoneum, intraperitoneal transition of cefotiam (CTM) was examined on 57 cases of infantile inguinal hernia subdivided into 7 groups. 2. After one shot intravenous injection, CTM showed rapid transition into the blood and the peritoneal tissue and even at a dose of 40 mg/kg and 120 minutes later. CTM exhibited an excellent antibacterial activity considering of MIC80 against clinically isolated bacterial strains. 3. Healing by first intention of operative wounds was obtained in all of the cases given CTM without any case suggestive of postoperative infection. No clinical side effect was observed in any one of the cases. PMID- 2769934 TI - [Studies of lomefloxacin in biliary tract infections]. AB - Lomefloxacin (NY-198), a new antimicrobial quinolone, was examined for its antimicrobial activities against clinical isolates and clinical efficacies to biliary tract infections. The following results were obtained. 1. The MICs of NY 198 against Escherichia coli (20 strains) and Klebsiella pneumoniae (20 strains) were good and similar to those of ofloxacin (OFLX) or norfloxacin (NFLX). The MICs of NY-198 against Pseudomonas aeruginosa (20 strains) were inferior by 1 dilution factor to OFLX or NFLX, and against Enterococcus faecalis (10 strains), they were similar to NFLX and slightly inferior to OFLX. 2. NY-198 was administered to 8 patients with biliary tract infections (acute cholecystitis 7 cases, chronic cholangitis 1 case). The results were good in 7 and unevaluable in 1 case because the duration of the therapy was too short. 3. As for side effects, mild urticaria was observed in 1 case and epigastralgia with nausea in another. As for abnormal laboratory test values slight elevations of GOT and GPT were recognized in 1 case. 4. In conclusion, we consider NY-198 is a useful oral drug for the treatment of biliary tract infections. PMID- 2769935 TI - [Cytotoxicity studies on T-3262 in cultured Chinese hamster cells]. AB - T-3262 is an antibacterial drug which belongs to the group of pyridonecarboxylic acids. In this study, we investigated cytotoxicity of T-3262 for inhibition of cell growth and effects on viability of, and morphological changes in cultured Chinese hamster cells (V79 cells). The following results were obtained. 1. The 50% inhibition dose of T-3262 for cell growth (ID50, cultured for 48 hours) was 12 micrograms/ml, showing that the inhibitory effect of T-3262 on the cell growth was stronger than that of enoxacin (ENX: ID50 44 micrograms/ml), norfloxacin (NFLX: ID50 105 micrograms/ml) or ofloxacin (OFLX: ID50 145 micrograms/ml). 2. The number of cells increased and dead cells were scarcely seen at the highest concentration tested in culture medium (40 micrograms/ml of T-3262 for 48 hours). At this concentration, degeneration of cytoplasm (atrophy and round shape) and decrease of mitotic cells were observed. These morphological changes were similar to those of the cells treated 400 micrograms/ml of NFLX or OFLX for 48 hours. 3. After the removal of T-3262 from culture medium, the cells began to grow actively and recovered from the morphological changes. The similar phenomenon was observed with ENX treated cells but not with fluorouracil or mitomycin C treated cells. PMID- 2769936 TI - [Nephrotoxicity test on T-3262 in rats with experimental nephropathy]. AB - The present study was carried out to examine the effect of orally administered T 3262, a new synthetic antibacterial agent, on the kidney of male rats with experimental nephropathy. These rats had been treated with single intramuscular injection of mercuric chloride (HgCl2, 3 mg/kg) or daily subcutaneous administration of puromycin-aminonucleoside (PAN, 15 mg/kg) for 11 days. T-3262 was administered orally to these pretreated rats at a dose of 1,000 mg/kg/day for 2 or 6 days. Twenty-four hours after the second or the sixth day of T-3262 administration, the kidneys of these rats disclosed similar biochemical and pathological findings as observed in the kidneys of the rats treated with HgCl2 alone. Thus, no T-3262-related alterations were demonstrated in renal functional test, kidney weight or histopathological examinations at a dose of 1,000 mg/kg of T-3262. The HgCl2-induced nephropathy was not enhanced by the oral administration of T-3262. Twenty-four hours after the second or the sixth day of T-3262 administration, the kidneys of the PAN-pretreated rats disclosed the biochemical and pathological findings largely similar to those with PAN-induced nephropathy. Enhancement of PAN-induced nephropathy by the oral administration of T-3262 was hardly evident. PMID- 2769937 TI - [General pharmacology of T-3262, a new pyridonecarboxylic acid]. AB - General pharmacological activities of (+/-)-7-(3-amino-1-pyrrolidinyl)-6-fluoro-1 (2,4-difluorophenyl)-1,4- dih ydro- 4-oxo-1,8-naphthyridine-3-carboxylic acid p toluenesulfonate hydrate (T-3262), which is a new pyridonecarboxylic acid, were examined with the following results. 1. Central nervous system: T-3262 did not show any significant pharmacological effects at oral doses of 100-1,000 mg/kg but caused slow waves in spontaneous EEG in cats at intravenous doses of 10-30 mg/kg. 2. Respiratory and cardiovascular system: T-3262 produced little effect in normotensive rats and anesthetized rabbits at oral doses of 100-1,000 mg/kg and intravenous doses of 3-30 mg/kg, respectively. But T-3262 caused, dose dependently, an increase of respiratory rate, hypotension, decrease of heart rate and changes in ECG patterns (elevation of T waves, slow amplitudes of QRS complexes and prolongation of RR interval, etc.) in anesthetized dogs at intravenous doses of 3-10 mg/kg. 3. Renal functions: T-3262 increased electrolyte excretions at oral doses of 300-1,000 mg/kg but did not affect PSP excretion in rats. 4. Autonomic nervous system and smooth muscle organs: T-3262 exerted slight inhibition of gastric output in rats and slight miosis in mice at an oral dose of 1,000 mg/kg. But T-3262 did not affect the contraction of nictitating membrane in anesthetized cats at intravenous doses of 1-30 mg/kg. T-3262 increased spontaneous motilities of isolated stomach, ileum and uterus, but decreased that of isolated colon at concentrations of 10(-5)-10(-4) g/ml. 5. Hematological examinations: T-3262 did not show any significant effects on bleeding time, blood coagulation, platelet aggregation and blood glucose level in rats at oral doses of 100-1,000 mg/kg. 6. Miscellaneous effects: T-3262 exerted slight inhibitions of gastric secretion and of carrageenin-induced hind paw edema in rats at a dose of 1,000 mg/kg administered intraduodenally and orally, respectively. T-3262 did not affect neuromuscular junction and bile secretion in rats at intravenous doses of 3-30 mg/kg and oral doses of 100-1,000 mg/kg, respectively. From these results, it can be assumed that T-3262 has a wide safety margin as an oral antibacterial agent. PMID- 2769938 TI - [Studies on absorption, distribution and excretion of 14C labeled (+-)-7-(3-amino 1-pyrrolidinyl)-6-fluoro-1-(2,4-difluorophenyl)-1,4- dihydro-4-oxo-1,8 naphthyridine-3-carboxylic acid p-toluene-sulfonate hydrate (14C-T-3262) in rats and mice]. AB - Absorption, distribution and excretion of T-3262 were studied in rats and mice after oral administration of 14C-T-3262. The obtained results are summarized as follows. 1. 14C-T-3262 was absorbed from the upper small intestine such as duodenum in rats. 2. Serum levels of radioactivity in rats reached the highest concentration at 1 hour after an oral administration, then gradually diminished. 3. Urinary excretion was 35% and 42% of the dosed radioactivity in rats and mice, respectively, and fecal excretion was about 65% and 56% of the dosed radioactivity in rats and mice, respectively. 4. Biliary excretion in rats was about 27% of the dosed radioactivity after an oral administration of 14C-T-3262, and a half amount of excreted radioactivity was reabsorbed from the intestine. 5. Radioactivity was distributed the most into the kidney and the liver among all organs other the stomach and the intestine. Radioactivity was widely distributed into other organs such as spleen, adrenal, pancreas, lung, heart and thymus. But the distribution of radioactivity into the brain was little. 6. The distribution of 14C-T-3262 was also studied with whole body autoradiography in normal male mice and pregnant mice. The radioactivity was distributed widely to whole tissues except brain, spinal cord and eye ball. In pregnant mice, radioactivity levels in the fetuses were the same as the blood level of the mother mice. 7. The binding rate of 14C-T-3262 to rats and mice serum proteins was 63-66%. 8. Urinary and fecal excretion patterns of radioactivity in mice after multiple oral administration of 14C-T-3262 for 10 days were similar to those after a single administration. This result suggests that T-3262 did not accumulate in body. 9. After oral administration of 14C-T-3262 to nursing rats, the secreted radioactivity level in the milk was higher than the blood level. PMID- 2769939 TI - [Study on metabolism of pyridonecarboxylic acid. I. Isolation and identification of metabolites of (+-)-7-(3-amino-1-pyrrolidinyl)-6-fluoro-1- (2,4 difluorophenyl)-1,4-dihydro-4-oxo-1,8-naphthyridine-3-carboxylic acid p toluenesulfonate hydrate (T-3262) in urine]. AB - Metabolism of (+-)-7-(3-amino-1-pyrrolidinyl)-6-fluoro-1-(2,4-difluorophenyl)-1,4 dihydro-4- oxo-1,8-naphthyridine-3-carboxylic acid p-toluenesulfonate hydrate (T 3262) was studied. Metabolites were isolated from urine of mouse, rat, rabbit, dog and monkey following oral administration of T-3262, and identified using high performance liquid chromatography and mass spectrometry. Two metabolites, other than unchanged (+-)-7-(3-amino-1-pyrrolidinyl)-6-fluoro-1-(2,4-difluorophenyl) 1,4- dihydro-4-oxo-1,8-naphthyridine-3-carboxylic acid (T-3262 base), in which 3 aminopyrrolidinyl ring of T-3262 was metabolized, were identified as: (+-)-7-(3 acetyl-amino-1-pyrrolidinyl)-1-(2,4-difluorophenyl)-6-fluoro- 1,4- dihydro-4-oxo 1, 8-naphthyridine-3-carboxylic acid (T-3262A) in all animals: (+-)-1-(2,4 difluorophenyl)-6-fluoro-7-(3-hydroxy-1-pyrrolidinyl)-1,4- dihydro- 4-oxo-1,8 naphthyridine-3-carboxylic acid (T-3262B) in monkey. The glucuronide of T-3262 was detected in mouse, dog and monkey, the glucuronides of T-3262A and T-3262B were detected in monkey. M-I, unidentified metabolite, was detected only in mouse. PMID- 2769940 TI - [Study on metabolism of pyridonecarboxylic acid II. Determination of metabolites of (+-)-7-(3-amino-1-pyrrolidinyl)-6-fluoro-1-(2,4-difluorophenyl)- 1,4-dihydro-4 oxo-1,8-naphthyridine-3-carboxylic acid p-toluenesulfonate hydrate (T-3262) in blood, urine, bile, and feces]. AB - The fate of (+-)-7-(3-amino-1-pyrrolidinyl)-6-fluoro-1-(2,4-difluorophenyl-1,4- dihyro-4-oxo-1,8-naphthyridine-3-carboxylic acid p-toluenesulfonate hydrate (T 3262) was studied using T-3262 and 14C-T-3262 in various animals. 1. Metabolites in serum and urine were assayed for mouse, rat, rabbit, dog and monkey following oral administration of T-3262. In serum, besides unchanged T-3262 base, T-3262A (N-acetylated) was detected in rat, rabbit and monkey; T-3262B (deamino hydroxylated) was detected in monkey. In urine, unchanged T-3262 base was excreted mainly. But a few of metabolites (T-3262A, T-3262B, T-3262 glucuronide, T-3262A glucuronide, T-3262B glucuronide, and unknown compound M-1) were detected, and species difference existed in types of metabolites. 2. Metabolites in bile and feces were assayed for mouse and rat following oral administration of T-3262 and 14C-T-3262. Metabolites in bile were similar to the urine, but the volume of T-3262A and T-3262A glucuronide was larger than in urine. In feces, the excreted compounds mainly consisted of unchanged T-3262 base. 3. p Toluenesulfonic acid, which is the counter acid for T-3262 base, was absorbed following the oral administration of T-3262, and excreted in urine in the unchanged form. PMID- 2769941 TI - [Effects of sulbactam on the activity of cefoperazone against various clinical isolates]. AB - Sulbactam/Cefoperazone (SBT/CPZ) have been used in clinical infusion at ratios of 1:1 and 1:2 in Japan and U.S.A., respectively. After an administration of these drugs as a 1:1 parenteral formulation, the ratio of levels of CPZ and SBT in blood was 1:1/4 to 1:1/5 for 1 to 2 hours, whereas the ratio of free, unbound drug levels was 1:1.4 to 1:1.5. In urine these drugs were excreted at a ratio between 1:1 and 1:4 during 6 hours after the infusion. Antimicrobial interaction studies using various combinations of CPZ and SBT were performed to obtain information with respect to the effect of SBT on the antimicrobial activity of CPZ in vivo and the most appropriate ratio of these drugs for the in vitro test system. Antimicrobial activities were determined using the agar dilution method and the disk diffusion susceptibility test. SBT increased the activity of CPZ against various clinical isolates tested except Enterococcus faecalis. CPZ-SBT at a fixed ratio of 1:1/5 significantly increased the antimicrobial activity of CPZ, resulting in decreases in MIC values and increases in disk inhibitory zone diameters. These drugs at ratios 1:1 to 1:3 maximized the synergistic enhancement of the activity. Therefore, a fixed ratio between 1:1/5 and 1:1 would be appropriate for the in vitro antimicrobial test system using either the agar dilution method or the disk susceptibility test. Based on pharmacokinetic data for CPZ and SBT, results of the present study on antimicrobial activity would support that the parenteral formulation of CPZ-SBT at the fixed ratios of 1:1 and 2:1 for the intravenous infusion used in Japan and U.S.A., respectively, are appropriate. The effect of SBT on the activity of CPZ was more marked against clinical isolates with greater production abilities of beta-lactamase than against those with less production abilities. SBT/CPZ, however, exerted a synergistic effect against methicillin-resistant Staphylococcus aureus without beta-lactamase production. The MIC80 of SBT/CPZ (1:1) against various clinical isolates with 10(6) CFU/ml inoculum size were as follows: S. aureus 12.5 micrograms/ml, Staphylococcus epidermis 3.13 micrograms/ml, and E. faecalis 50 micrograms/ml. Those of Gram-negative bacilli were: Escherichia coli 0.20 microgram/ml, Klebsiella pneumoniae 0.20 micrograms/ml, Proteus mirabilis 0.78 microgram/ml, Proteus vulgaris 0.78 microgram/ml, Pseudomonas aeruginosa 12.5 micrograms/ml, Serratia marcescens 25 micrograms/ml, Enterobacter spp. 3.13 micrograms/ml, Citrobacter spp. 12.5 micrograms/ml and Acinetobacter spp. 0.78 microgram/ml. PMID- 2769943 TI - [Antibacterial activity of cervical mucus in pregnant or non-pregnant women]. AB - Antibacterial activities of human cervical mucus obtained from non-pregnant and pregnant women were tested using standard blood agar plates. The combined effect of cervical mucus with cefmetazole (CMZ) was also investigated. Obtained results are summarized as follows. 1. Cervical mucus specimens obtained from 6 subjects at 9 to 36 weeks of pregnancy showed antibacterial activity to only one strain of Bacillus subtilis among organisms tested. The cervical mucus enhanced the activity of CMZ against 1 strain of Streptococcus pyogenes and 2 strains of Micrococcus luteus, but no effect was observed against other organisms tested. 2. Cervical mucus specimens obtained from non-pregnant women showed antibacterial activities to 8 of 11 strains (72.7%) of B. subtilis tested. The cervical mucus enhanced the activities of CMZ against 1 strain of S. pyogenes and 3 strains of B. subtilis. The tested organisms included Staphylococcus aureus, Escherichia coli, Bacteroides fragilis, S. pyogenes, B. subtilis, M. luteus, Streptococcus agalactiae, Enterococcus faecalis, and Candida albicans, but, as described above, cervical mucus samples showed antimicrobial activities only against B. subtilis (9/17, 52.9%), and specimens obtained only from non-pregnant women or pregnant women with less than 11 weeks of pregnancy showed any antimicrobial activities. PMID- 2769942 TI - [Effects of sulbactam/cefoperazone in patients with respiratory infections in aged and/or with underlying respiratory diseases]. AB - Sulbactam/cefoperazone (SBT/CPZ), a new antibacterial drug, was administered to 14 cases with respiratory infections for a duration of 5 approximately 13 days at a daily dose of 4 g. Diagnoses of these patients were 7 respiratory tract infections, and 7 bronchopneumonias. The underlying diseases were chronic pulmonary emphysema in 6 cases, bronchial asthma in 2 cases, and one each of bronchiectasis, diffuse panbronchiolitis and lung cancer with bronchoesophageal fistula. All patients had underlying respiratory diseases and/or were more than 70 years old. The rate of clinical efficacy was 78.6%. The incidence of penicillinase production by isolated bacteria was 18.2% and that of cephalosporinase was 63.6%. SBT/CPZ was expected to be more effective than CPZ alone in 3 cases judging from the susceptibility of the bacterial strains concerned, to antibiotics. No side effects were observed. We conclude that SBT/CPZ is useful in the treatment of respiratory infections of patients of advanced age and/or with underlying respiratory diseases. PMID- 2769944 TI - [Abstracts of papers presented at regional meetings of the Japanese Society for Bacteriology. 1988]. PMID- 2769945 TI - [Three cases of thyroid cancer, including a component of squamous cell carcinoma]. AB - A squamous cell carcinoma of the thyroid gland is rare and its prognosis is poor. Three cases of a rare thyroid cancer are reported, the first case being an adenosquamous cell carcinoma of a 75-year-old male and the second case being a pure squamous cell carcinoma of a 64-year-old male. These two cases were pathologically diagnosed on autopsy. The overall duration of these two cases was 6 months. The third case involved a 62-year-old male. His pathological diagnosis was a mixed squamous cell carcinoma and an undifferentiated carcinoma. Postoperatively 50 Gy of irradiation was performed. This patient is still alive and has shown no evidence of recurrence for 16 months. PMID- 2769946 TI - [A case of superficial squamous cell carcinoma of the esophagus showing multicentric development]. AB - A 43-year-old male was admitted to the hospital with a complaint of mild dysphagia. A barium esophagogram showed an annular narrowing in the lower esophagus. Further, an endoscopic examination revealed erosive mucosa of the esophagus about 35 cm anal to the incisor. Lugol staining also revealed a geographical unstained lesion. The histologic diagnosis of a biopsy specimen indicated a squamous cell carcinoma and a total resection of the esophagus was performed. The operated material macroscopically showed a tumor of a superficially mixed type (IIa + IIc + IIb). The resected specimen histologically consisted of 18 squamous carcinomas that were separated with the normal squamous epithelium from each other. The major part of these lesions were limited to the epithelium, and only a few specimens microscopically showed an invasion of cancer nests in the propria mucosae. Great permeation of cancer cells into lymph vessels and the metastasis of one regional lymph node also were noted. Taken together, these findings indicated that the squamous cell carcinomas of this case seemed to have multicentrically developed from the normal esophageal mucosa. PMID- 2769947 TI - [Successful CYVADIC combination chemotherapy of metastatic pulmonary lesions involving a mediastinal leiomyosarcoma--a case report]. AB - Discussed is a 34-year-old man who hospitalized for manifesting the superior vena cava syndrome. Chest radiograph and chest CT scan revealed a gross tumor shadow in the superior mediastinum and a tiny shadow in the right lung. Superior vena cavography showed intimal stenosis, irregularities, and stiffness of the superior vena cava. Thus, radiotherapy applied to primary lesion of the mediastinum was provided to relieve his complaints. One year later, predominant metastatic pulmonary lesions and skin lesions developed. Light and electron microscopic findings of a biopsied specimen of the skin lesion were consistent with leiomyosarcoma. CYVADIC combination chemotherapy reduced the pulmonary metastatic lesions dramatically. The literature of mediastinal leiomyosarcoma is reviewed and the origin of this tumor is discussed. PMID- 2769948 TI - [A case of invasive thymoma in the left hilus of the lung]. AB - Reported is the case of a 62-year-old man who was admitted to our hospital because of the presence of a left hilar mass found during a routine chest X-ray examination. Shortly thereafter, a left thoracotomy was performed. The tumor was located under the aortic arch in the left hilus of the lung and had invaded the pericardium and pulmonary trunk. There was no connection, however, to the anterior mediastinum. A histological examination revealed an invasive thymoma of epithelial cell of the predominant type. Seen scattered abroad were thymic tissue in the adipose tissue around the tumor of the left hilus. Postoperatively, a distant metastasis of the right lung was observed and the patient died due to respiratory failure. PMID- 2769949 TI - [Well-differentiated adenocarcinoma of the papilla of vater--report of a case]. AB - Reported is the case of a 64-year-old female who was admitted to our clinic because of hyperamylasemia. Duodenal endoscopic examination revealed a tumor at the papilla of Vater. A biopsy specimens taken from the top of the tumor showed a well-differentiated adenocarcinoma. Under the diagnosis of cancer of the papilla of Vater, pancreaticoduodenectomy was performed. The first histological diagnosis was carcinoma in adenoma, but from the results of nucleus-gland ratio examined from 6 parts of the "adenoma", all of which were over 0.50, we finally concluded this case as de nove well-differentiated adenocarcinoma, and not carcinoma in adenoma. Thus, there is a possibility that past reports of adenoma or carcinoma in adenoma of the papilla of Vater might contain de novo well-differentiated adenocarcinoma. PMID- 2769950 TI - [The treatment of brain metastasis from breast cancer]. AB - From 1975 through 1988, 25 patients with a brain metastasis from a breast cancer received treatments that varied, according to their systemic condition. Of this number, 13 patients were selected for a surgical removal followed by radiation and inoperable patients (3 of this number had meningeal carcinomatosis) with a serious widespread metastasis were treated by radiation only. The median survival time in the former group was 12 months with a 1-year survival rate of 58.3% and that of the latter group (excluding the meningeal carcinomatous cases) was 7 months with a 1-year survival rate of 20%. The median survival of all 25 patients was 7 months with a 1-year survival rate of 33%. At the diagnosis of the brain metastasis, 88% had metastasis to organs other than intracranial sites and most patients died because of the progression of the metastasis at these other sites. Thus, surgical removal of the brain metastasis, followed by radiation therapy, should be considered for patients without a widespread systemic metastasis. Survival for such cases would be more than 1 year. PMID- 2769951 TI - [Clinical evaluation of various tumor markers in pleural effusion and in the serum]. AB - Various tumor markers and enzymes in the pleural effusion and serum have been measured in 47 patients with carcinoma and in 43 patients with benign disease, by means of a radioimmunoassay and biochemical methods. CEA in the pleural effusion showed a high specificity and sensitivity for the detection of the malignancy. In patients with a lung cancer, measurement of the NSE in the serum was more useful than in the pleural effusion. Further, both CA19-9 and SCC in the pleural effusion showed a high specificity in a differential diagnosis of cancer and benign diseases. On the other hand, CA 125, TPA and IAP in the pleural effusion and in the serum showed a high sensitivity, but a low specificity for diagnosing the malignancy. The levels of ADA were significantly higher in tuberculous pleural effusions than in carcinomatous effusions. Therefore, this suggests that measurement of the various tumor markers in both the pleural effusion and in the serum is useful in achieving a differential diagnosis of malignant and benign diseases. PMID- 2769952 TI - [The role of drugs and lymphocytes in granulocyte-macrophage colony formation in patients with drug induced agranulocytosis]. AB - The in vitro effects of the causative drugs and lymphocytes from the patients with agranulocytosis were tested against granulocyte-macrophage colony formation (CFU-C) of bone marrow cells from normal individuals and the patients in recovery stage. A semisolid culture system was used for CFU-C assay. The drug concentrations were adjusted to the therapeutic levels in sera, and the lymphocytes were obtained from the patient's peripheral blood. Three patients with agranulocytosis and one patient with pancytopenia caused by disopyramide, methimazole, sodium valproate, and Towasaal, respectively, were examined. Each of the four drugs except disopyramide suppressed the CFU-C of normal and patient's bone marrow cells in a dose-dependent manner. When the patient's bone marrow cells were cultured with respective drugs and their own lymphocytes or with the culture supernatant of the drug and lymphocytes, CFU-C suppressions was significantly augmented. Phenacetin, an agent of Towasaal, significantly suppressed CFU-C and also CFU-E. These results indicate that humoral factor(s) produced from patient's lymphocytes by reacting with the drugs may function as an immunological mechanism in the patients with drug-induced agranulocytosis. PMID- 2769953 TI - [Evaluation and quantification of complement-sensitive red cells in PNH and aplastic anemia-PNH syndrome]. AB - In order to clarify the erythropoiesis of complement-sensitive red cells in paroxysmal nocturnal hemoglobinuria (PNH), the proportion of complement-sensitive red cells and compositional classification of examined red cells were investigated by means of complement lysis sensitivity test in 27 patients with initial diagnosis of PNH and 17 patients with aplastic anemia-PNH syndrome, and their bone marrow nucleated cell counts were also compared. The proportion of complement-sensitive erythrocytes was 41.0 +/- 22.0% (n = 26) in PNH and 29. 5 +/ 15.0% (n = 17) in aplastic anemia-PNH syndrome, and no significant difference was recognized between them. The nucleated cell count at the time of PNH diagnosis was 19.1 +/- 12.5 X 10(4)/microliters (n = 21) in PNH and 12.6 +/- 8.8 X 10(4)/microliters (n = 12) in aplastic anemia-PNH syndrome, and no significant difference between them was apparent. These findings suggest that the erythropoiesis of complement-sensitive red cells shows a similarity between PNH at initial occurrence and aplastic anemia-PNH syndrome, once PNH has occurred. PMID- 2769954 TI - [Evaluation of the response of advanced diffuse large cell lymphomas (LSG classification) to weekly CHOP therapy]. AB - "Weekly CHOP" therapy characterized by reduced dosages of cyclophosphamide, doxorubicin and vincristine, was evaluated in 33 patients with advanced diffuse large cell lymphomas (LSG classification). There were 19 complete responders (59%) and 8 partial responders (25%) with a response rate of 84%. A prolonged disease-free survival rate (survival plateau) of 60% was considered comparable to the results of second-generation chemotherapies. The response was poor in patients with high grade malignancy (large cell, immunoblastic category in Working Formulation for Clinical Usage) as well as in patients with bone marrow invasion. PMID- 2769955 TI - [Studies of IgG subclasses of anti-erythrocyte antibodies contained in human plasma preparation products]. AB - Anti-A and anti-B antibodies (1: 1-1: 1, 024) of IgM or IgG type of the titers 1: 1-1: 1, 024 were detected in all of the lots of heat-treated human plasma protein (38 Lots), albumin (15 Lots), factor VIII or IX products (9 Lots) and immune globulin preparations for intravenous use (IVIG) (20 Lots) examined. Twelve out of 20 lots of IVIG contained unexpected anti-erythrocyte antibodies of IgG type. Though IgG1 antibody was detected in all of these 12 lots, antibodies composed of all subclasses including IgG3 could be detected in only 8 lots of them, all showing the anti-erythrocyte antibody titer of IgG type over 1:64. Conversely, none of the lots, in which the titer was less than 1:32, contained IgG3 antibodies. A patient of chronic ITP, 28-year-old female of blood type A and Rh positive, showed contradictive results between the main (A type) and the accessory test (O type) of red blood cell grouping, accompanied with hemolytic anemia, following intravenous high-dose immune globulin therapy (400 mg/kg x successive 5 days), which was attributable to the anti-A antibody of IgG type composed of IgG1,2,3,4 in the IVIG administered. For high dosage administration of human plasma preparation products, those containing only low titer of unexpected anti-erythrocyte antibody should be selected. PMID- 2769956 TI - [Comparative study on in vitro lymphocytotoxicity and mitogenicity of different antilymphocyte globulin (ALG) preparations]. AB - The lymphocytotoxicity and mitogenicity between six different ALG preparations on the clinical use world wide were compared. No significant difference in the lympholytic activity was observed between preparations and 100% cell lysis was achieved at a concentration of 50 micrograms/ml in the presence of complement. On the other hand, four preparations now in use in European countries and USA showed variable mitogenic activities on lymphocytes in the absence of complement, whereas two ALGs used in Japan did not. As the stimulatory effects of ALG on lymphocytes may contribute to the clinical outcome in the treatment of severe aplastic anemia (Kawano et al, 1988), these date can explain the poor clinical results of ALG therapy with those two preparations in Japan. Careful measures should be paid in the construction of treatment protocol and selection of ALG preparations to yield the best results. PMID- 2769957 TI - [Essential thrombocythemia with Philadelphia chromosome]. AB - Essential thrombocythemia is a myeloproliferative disorder not known to have consistent cytogenetic abnormalities. A 38-year-old woman with essential thrombocythemia having Philadelphia chromosome (Ph1) is reported. The patient first presented with gastrointestinal bleeding, accompanied by thrombocytosis. Treatment of the gastrointestinal bleeding did not influence the elevation of platelet counts. The patient's clinical and hematological manifestations were consistent with essential thrombocythemia, but not with any other myeloproliferative diseases. Ph1 chromosome was constantly proved in bone marrow preparations from this patient over two years and four months and gave us a certain impression that Ph1 chromosome might have had some relation to development of essential thrombocythemia to chronic myelogenous leukemia in this patient. PMID- 2769958 TI - [Leukemic Burkitt's lymphoma with an initial symptom of ocular motor disturbance]. AB - A 58-year-old male was admitted to Osaka City University Hospital because of diplopia in May, 1987. Hematological examinations revealed abnormal blastoid cells in his peripheral blood and bone marrow. We found many mitochondria and polysomes in the cytoplasm of the blastoid cells by the electron microscopy. Moreover, left axillary lymph node biopsy specimen disclosed the typical "starry sky" pattern. The blastoid cells in the bone marrow had chromosomal abnormality; 47XY, 8q-, 14q+, 22q-, +mar. Therefore, the diagnosis of Burkitt's lymphoma (leukemic change) was performed. He was treated with chemotherapy, but the blastoid cells resisted many anticancer agents and he died in September 30. On admission left ocular motor disturbance was revealed. Generally, it was reported that meningitis with CNS involvement of lymphoma is accompanied by cranial nerves palsy. However in this case lymphoma cells was not found in the cerebrospinal fluid. The cause of ocular motor disturbance was the adhesion to the medial rectus muscle and compression to the ocular motor nerves of the lymphoma mass. PMID- 2769959 TI - [A case of RAEB in transformation successfully treated by low-dose Ara-C treatment]. AB - A 65-year-old male admitted to the Anjo Kosei Hospital due to pancytopenia. The findings at the time of admission were; leukocyte count 2,000/microliters, erythrocyte count 1,580,000/microliters, and platelet count 88,000/microliters. Bone marrow specimen revealed mild hypocellularity with 26% of the blast cells. He was diagnosed RAEB in transformation. Chromosome analysis showed 46, XY, -7, +8, -17, + marker in three cells and 45, XY, -7, -17, + marker in two cells out of five cells. He was treated with the low-dose Ara-C (20mg/body s.c. injections every 12 hrs) for 9 days. Twenty five days later, the blast cells in the bone marrow decreased to 4%, and the complete remission was obtained. The duration of remission is 27+ weeks. At the time of complete remission, the bone marrow cells showed the normal karyotype. In this case, the effect of low-dose Ara-C to the blast cells may have not resulted from induction of differentiation but cytocydal action. PMID- 2769960 TI - [RAEB in transformation in continuing complete remission by small doses of cytarabin]. AB - Two patients with refractory anemia with excess of blasts in transformation having entered remission and in continuing complete remission with the small-dose cytarabine therapy (SDCA) are reported. SDCA was the only chemotherapy used in these two patients. Cytarabine was injected subcutaneously every 12 hours at doses 15 mg and 10 mg, respectively, in cases 1 and 2. Case 1, a 60-year-old woman, achieved remission after a 14-day course of SDCA. Thereafter, she received SDCA for seven consecutive days every month or every other months in the first year and every two or three months in subsequent years. Her remission has been maintained for 57 months. Case 2, a 76-year-old man, attained a remission after three courses of SDCA, each consisting of 16, 11 and 14 days, respectively. SDCA was then repeated every month for 6 consecutive days. He is still in remission after 33 months. Whereas SDCA caused severe bone marrow suppression during induction, it was well tolerated when given in remission without necessitating any supportive measure. PMID- 2769961 TI - [Monocytic crisis in chronic myeloid leukemia: a case report]. AB - We report a 17-year-old female with chronic myeloid leukemia (CML) who developed monocytic crisis. She was diagnosed as chronic phase of Ph1-chromosome positive CML at 14 years old. Three years after the diagnosis of the disease, she was admitted to the hospital because of low grade fever, lethargy and marked splenomegaly. Small dose of Ara-C relieved her symptoms and splenomegaly. Six months later, however, a marked leukocytosis over 70,000/microliters were observed, and the peripheral blood smear disclosed that about 80% of the leukocytes were relatively mature monocytoid cells. Chromosomal analysis revealed additional abnormalities (double Ph1, +8, +9, +19). Lysozyme levels in serum and urine were high and NAP score was elevated. These monocytoid cells expressed receptors for IgG-Fc and C3, phagocytic activity, and monocytoid antigens which were determined by monoclonal antibodies (MY4, Mo2, OKM5). Cytochemically, almost all of monocytoid cells were positive for peroxidase and naphthol-ASD chloroacetate esterase (CAE), but the monocytoid cells positive for non-specific esterase were limited. These data suggested that this case was monocytic crisis in CML with proliferation of CAE positive monocytoid cells. Among several types of blast crisis, monocytic crisis is extremely rare condition. The definite monocytic crisis demonstrated by this case may support the hypothesis that target cells of CML are pluripotent hematopoietic precursors. PMID- 2769962 TI - [Seizure and tremor occurring in acute leukemia patients treated with imipenem/cilastatin]. AB - We report here four patients with acute leukemia, who developed seizure or tremor following treatment with imipenem, a new broad-spectrum antibiotic. All four patients had no renal dysfunction and recovered after discontinuation of the drug. Two patients who developed seizure had a past history of cerebral hemorrhage with symptoms of meningitis in one and the other had received frequent intrathecal injections of methotrexate. Seizure also occurred in another patient who was given multiple intrathecal injections of methotrexate. The remaining old patient developed tremor after the first administration of imipenem which did not progress to convulsion. Cerebral hemorrhage or meningitis is known to predispose patients for convulsion following imipenem treatment. In addition, the present study suggests that central nervous system damage related with intrathecal injections of methotrexate may be a predisposing factor. Thus, imipenem should be given with caution to acute leukemia patients who often have risk factors for developing imipenem-related complications. PMID- 2769963 TI - [Eosinophilic lymphofolliculosis (Kimura's disease) complicated with aortitis syndrome]. AB - A 47 year-old-man was admitted because of mild congestive heart failure. A differential white blood cell count revealed eosinophilia and a biopsied inguinal lymph node showed well-developed lymphoid follicles with germinal centers, eosinophil infiltration and marked proliferating vessels with swollen endothelial cells. He was diagnosed as eosinophilic lymphfolliculosis (Kimura's disease). He also was hypertensive and vascular murmur was pointed out in his abdomen. Angiography revealed the complication of aortitis syndrome. Renal complication in eosinophilic lymphfolliculosis was reported in some cases and it was though that the disease had a clinical aspect of systemic diseases. The complication of aortitis syndrome in our case is interesting from a point of view of eosinophilic lymphfolliculosis as a systemic disease. PMID- 2769964 TI - [Thrombocytosis in chronic myelogenous leukemia (CML) controlled by interferon alpha (IFN-alpha)]. AB - A 39-year-old Japanese female who had been followed as chronic myelogenous leukemia (CML) since 1984 was admitted to our hospital because of dizziness. On admission, platelet count markedly increased (245 X 10(4)/microliters) in spite of daily administration of busulfan 2 mg. She was diagnosed as accelerated phase CML with thrombocytosis. So we tried to use interferon alpha (IFN-alpha) finally given in a dose of 9 X 10(6) U daily by subcutaneous injection. After that, platelet count decreased to 70 X 10(4)/microliters and megakaryocyte count in bone marrow decreased from 887.5/microliters to 395.7/microliters. But we had to stop IFN-alpha because of severe side effects. PMID- 2769965 TI - [The continuous-DCMP therapy for acute nonlymphocytic leukemia in elderly patients--comparison with younger patients]. AB - Twenty seven previously untreated patients of acute nonlymphocytic leukemia with age ranging from 30 to 77 years, received a 7-day remission induction regimen consisting of daunorubicin, cytosine arabinoside, 6-mercaptopurine and prednisolone (continuous-DCMP). Patients who achieved complete remission were given ten courses of consolidation therapy and followed without any maintenance therapy. The complete remissions were obtained in 7 of 15 patients (46.6%) 60 years and older, and in 11 of 12 patients (91.7%) 30-59, years of age. Although a high mortality during periods of marrow hypoplasia after the intensive induction therapy, and early relapses in the 60 years and older patients remain major problems, our data suggest the elderly patients deserve a trial of intensive combination chemotherapy. PMID- 2769966 TI - [In vitro effects of high titers of recombinant human erythropoietin on the bone marrow erythroid progenitors in patients with aplastic anemia]. AB - To investigate the role of erythropoietin in aplastic anemia, the effects of high titers of recombinant human erythropoietin (rh-Ep) on CFU-E and BFU-E in patients with aplastic anemia were studied in vitro. Colony assays were performed by methylcellulose culture methods added with 1 to 500 units of rh-Ep. In normal bone marrow, the maximum CFU-E colony formation was observed at 2 to 5 units of rh-Ep, and BFU-E at 2 to 10 units. Colonies did not increase by addition of higher titer of rh-Ep to the cultures. In aplastic anemia, the numbers of CFU-E and BFU-E were low at 2 units of rh-Ep in culture system. In most patients with aplastic anemia studied, erythroid colonies were increased in accordance with the increase of rh-Ep added to cultures. These results suggest that the administration of high titers of rh-Ep in vivo may be useful for the improvement of anemia in aplastic anemia. PMID- 2769967 TI - [Clinical analyses on 10 patients with follicular lymphoma]. AB - Clinicopathologic analyses were done on 10 patients with follicular lymphoma including 8 patients with low grade malignancy. The complete response rate to chemo- and combined modality therapy was 80% with no deaths occurring in patients in complete remission with median follow-up of 73 months. The 5-years' survival for these 10 patients was 86%. There were two patients with second primary neoplasm, one with gastric cancer detected one year after initiation of chemotherapy, the other with leiomyosarcoma detected 3 years after cessation of chemotherapy. Histologic transformation from follicular medium sized cell to diffuse large cell was noted in one patient. PMID- 2769968 TI - [Hodgkin's disease under twenty years of age--clinicopathological study]. AB - Twenty two cases with Hodgkin's disease under 20 years of age who were diagnosed and treated in National Cancer Center during 1962-1986 were studied retrospectively. The most common initial symptom was swelling of lymph nodes (86%) and only 5 cases (23%) showed "B" symptoms. Laboratory findings showed that there were some cases with increased WBC counts but only 2 cases with an elevated LDH value. In 2 out of 4 cases serum copper value correlated well with their clinical state. Histologically lymphocyte predominance type, mixed cellularity type and nodular sclerosis type almost equally occurred in children younger than age 15 years. On the other hand nodular sclerosis type with mediastinal mass was predominantly encountered in older patients (especially female). The ten years' survival rate in stage I and II patients was 59% compared with 21% in stage III and IV patients. As for the results of initial treatment, complete remission and 10 years' survival rate were 91% and 87% in recent 12 years (1975-1986) compared with 55% and 36% in the preceding 13 years (1962-1974) respectively. Autopsy findings revealed rare involvements of the central nervous system and kidneys. Various late effects which may be caused by escalating doses of radiotherapy occurred in 6 out of 9 cases under the age of 15 years who survived. On the basis of these results lower-doses of radiotherapy combined with systemic chemotherapy appeared to be advisable for the treatment of childhood Hodgkin's disease. PMID- 2769969 TI - [Paroxysmal cold hemoglobinuria complicated with acute hemolysis in a child]. AB - An 8 year-old girl with paroxsmal cold hemoglogunuria (PCH) is reported. She was referred to our clinic because of acute anemia, and found to have PCH after clinical and laboratory examination. Anti-P1 antibody and Donath-Landsteiner (D L) antibody were detected. In Coombs' test with variable incubation temperatures, positive IgG on her erythrocytes changed to negative as temperature of incubation was elevated. Also activation of complement was detected on the surface of her erythrocytes. Clinical improvement was obtained by blood transfusion, and positive Coomb's test and D-L test turned to negative. PMID- 2769970 TI - [The use of MCNU to a patient of primary myelofibrosis complicated with pericardial effusion and proteinuria]. AB - A case of primary myelofibrosis complicated with pericardial effusion and proteinuria is described. A 66-year-old female was admitted to our hospital because of abdominal fullness and shortness of breath. On admission, hepatosplenomegaly and pericardial effusion were observed. Blood examination revealed leukoerythroblastic anemia and thrombocytosis with tear drop cells and giant platelets. Bone marrow aspiration was dry tap and its biopsy showed remarkable myelofibrosis. Urinalysis indicated severe proteinuria. Although neutrophilic alkaline phosphatase score was low, no signs of acute blastic crisis of chronic myelogenous leukemia was found. The diagnosis of an atypical type of primary myelofibrosis was obtained. Administration of MCNU was started in August 1987. Hepatosplenomegaly, pericardial effusion and proteinuria were gradually improved after the administration. The etiology of the pericardial effusion and proteinuria were not obvious, however, these facts suggest that these abnormal findings might be related to PMF itself and MCNU was effective to PNF. PMID- 2769971 TI - [So-called Ph1-negative chronic myelogenous leukemia with a mosaic pattern of trisomy 8 and normal karyotypes--report of 2 cases]. AB - Two cases of Ph1-negative chronic myelogenous leukemia (CML) are described, they were 66-year-old female and 73-year-old male. Both patients shared all of the following features: presence of anemia, thrombocytopenia and leukocytosis with every stage of neutrophilic differentiation, hypercellular bone marrow with hyperplasia of the degranulated neutrophilic series, diminished neutrophilic alkaline phosphatase, elevated serum lysozyme and vitamin B12 level, mosaic pattern of trisomy 8 and normal karyotypes in chromosome analysis, and markedly increased number of CFU-GM. In addition, bcr rearrangement by Southern blot hybridization was not demonstrated in these patients. The diagnosis of chronic myelomonocytic leukemia was not verified, however, because of the absence of monocytosis in peripheral blood. The existence of so-called Ph1-negative CML like these two cases as a diagnostic entity must be further studied. PMID- 2769972 TI - [Factor V inhibitor with double cancer]. AB - A 84-year-old man was admitted with palpitation, edema of legs and anemia during a long course of diabetes mellitus, prostatic hypertrophy and prostatic cancer. He revealed purpura on the hands and massive microhematuria. He had received antibiotic therapy for a urinary tract infection for a period of time, but he had no history of hemorrhagic tendency or blood transfusion. Coagulation studies showed the prolongation of whole blood clotting time and PT (prothrombin time). Activity of factor V was 14% of that normal control plasma. The titer of factor V inhibitor was 4.9 Bethesda units/ml. The inhibitor of the patient was supposed to belong to IgA and IgG judging from inhibitor neutralization test. PT was improved after discontinuance of administration of antibiotics and administration of azathioprine. Moreover, even after administration of prednisolone with antibiotics, PT and activity of factor V recovered to normal range. He died from respiratory failure. Autopsy revealed double cancer of prostate and descending colon. The appearance of factor V inhibitor was likely caused by antibiotics, double cancer, and age-related immune disorders. PMID- 2769973 TI - [Consumption coagulopathy found in mitral stenosis associated with atrial thrombus]. AB - Two cases of consumption coagulopathy found in the patients having mitral stenosis with atrial thrombus were reported. In case 1, although anticoagulant (Warfarin) administration did not correct the hemostatic abnormality, combination of tranexamic acid with anticoagulant was effective. In case 2, atrial thrombus found in the echocardiography prior to the onset of thromboembolism in the lower limbs has been disappeared after embolism. Anticoagulant was effective for the improvement of hemostatic abnormality. We considered mitral stenosis with atrial thrombus as one of causes of the consumption coagulopathy. PMID- 2769974 TI - [Refractory anemia complicated by Behcet's disease--report of three cases]. AB - Three cases of refractory anemia (RA) are presented. They developed a complete, an intestinal, and an incomplete type of Behcet's disease after 13 years, 6 months, and 4 years of illness, respectively. They showed normal or only slightly reduced neutrophil counts in spite of anemia and thrombocytopenia. Although the precise etiology of Behcet's disease is still obscure, it is suggested that immunological reactions against Streptococcus viridans in chronic infection, and auto-oxidative damage induced by oxygen intermediates derived from stimulated neutrophils may play an important role in causing endothelial injury in the disease. Therefore, it is possible to speculate in our cases that the known susceptibility to bacterial infections in myelodysplastic syndromes, and the absence of neutropenia may have been responsible for the association of RA with Behcet's disease. It is also suggested that neutrophils are necessary for endothelial cell damage. PMID- 2769975 TI - [Therapeutic effect of interferon-alpha on hairy cell leukemia]. AB - Hairy cell leukemia (HCL) is characterized by slow proliferation of special mononuclear cells. Although splenectomy has been evaluated to be the most effective traditional treatment for HCL, the response of patients to splenectomy is not necessarily satisfactory. Recently, the treatment of HCL with Interferon alpha has been reported to be effective, and we report a female case of HCL who showed marked improvement in her hematological findings with this therapy. PMID- 2769976 TI - [Acute myeloid leukemia after the treatment of Hodgkin's disease]. AB - A 55-year-old woman developed a secondary leukemia following 1-year treatment of Hodgkin's disease. She was admitted to our hospital because of the celiac lymphadenopathy. Open laparotomy was performed. Biopsy specimens of the lymph node demonstrated Reed Sternberg cells with mature lymphocytes. She was diagnosed as having Hodgkin's disease (lymphocyte predominant type). She was treated by the combination chemotherapy consisting of mitoxantrone, cyclophosphamide, vincristine and prednisolone for Hodgkin's disease in November 1986. Hodgkin's disease achieved complete remission and she was regularly followed. No abnormal findings were observed in the peripheral blood and bone marrow. But thrombocytopenia and the blastoid cells appeared in the peripheral blood in February 1988. The bone marrow specimen was hypercellular and occupied by 90% of blastoid cells that were positive for peroxidase staining. She was diagnosed as having AML from the bone marrow aspiration and biopsy specimens. She did not respond to several chemotherapy regimens and now she is treated by low dose Ara C. PMID- 2769977 TI - [Thrombotic thrombocytopenic purpura (TTP) associated with chromosomal aberration and treated with plasma exchange]. AB - We reported a case of 69-year-old female presenting with clinically typical TTP which was treated with Ticlopidine and plasma exchanges four times in total and resulted in successful improvement of her clinical state. The first chromosomal analysis of lymphocytes in the peripheral blood of the patient revealed abnormal patterns of 45, XO/46, XX/47, XXX, the second, 45, XO/46, XX/47, XXX/47.XX, + 21. Measurement of FITC-labelled fibrinogen antibody against the fibrinogen combined with platelet glycoprotein GP IIb/IIIa complex using flow cytometry showed an apparently increased positive rate 76.2% for the platelet of the patient, compared with that of 31.9% for the control. From the comparative study of the platelet agglutination of the platelet rich plasma (PRP) derived from the citrated-added complete blood taken from the patient to whom Ticlopidine was given, added with adenosine-5'-diphosphate (ADP), collagen or acetyl glyceryl ether phosphoryl choline (AGEPC) as the reagents and that of normal control, it was shown that for AGEPC increased. Thus, increased reaction specific to AGEPC in addition to activated platelet was demonstrated in the present study. PMID- 2769978 TI - [Triploid clone observed at blastic crisis in chronic myelogenous leukemia with complex Ph1 translocation (9; 22; 12)]. AB - A 56-year-old female, who was diagnosed as CML in 1983 and had been well controlled with busulfan, was admitted to our hospital because of fever and iliac bone pain. Peripheral blood showed leukocytosis (WBC 70,000/microliters and bone marrow was normocellular with 53% leukemic cells, suggesting that she was in the blastic crisis. Chromosomal analysis of bone marrow cells at that time revealed t (9; 22; 12) and some additional abnormalities. The number of chromosomes ranged from 44 to 131 and the mode of chromosome number was 65. She was treated with combination regimen consisting of vincristine, 6-mercaptopurine and prednisolone and right iliac tumor was irradiated. Three months after admission, she died of DIC and pulmonary insufficiency due to leukemic infiltration. PMID- 2769979 TI - [Successful management of massive hemoptysis, following pulmonary mycosis by bronchial artery embolization in a patient with acute lymphoblastic leukemia]. AB - In June 1987, a 20-year-old man was diagnosed as T-cell acute lymphoblastic leukemia. In August, at a nadir period of the remission induction chemotherapy, he complained of high fever and dry cough. A chest roentgenogram also showed a nodular area of increased density in the left upper lobe. Since his clinical state deteriorated progressively despite the administration of broad-spectrum antibiotics, amphotericin B was administered intravenously (with an initial dose of 5 mg/day, increased up to 25 mg/day). Concomitant with bone marrow recovery and continued antifungal therapy, he became soon afebrile and improved over the next 2 months. The infiltrates also began to resolve. Then he abruptly coughed up about 800 ml of blood and suffered from acute respiratory failure. Bronchial arteriographic studies demonstrated active extravasation of contrast medium in the region of the cavity. After therapeutic embolization with Gelfoam, the extravasation was no longer observed. Active bleeding abruptly ceased and had not recurred until the left upper lobectomy which was performed 10 days after the embolization. This case typically demonstrates the value of bronchial arterial embolization in treating massive hemoptysis. PMID- 2769980 TI - [Malignant lymphoma of the central nervous system in a boy with immotile cilia syndrome]. AB - Malignant lymphoma of the central nervous system in a thirteen-year-old boy with immotile cilia syndrome (ICS) is reported. He had frequent upper respiratory tract infections, chronic sinusitis and pneumonia during in childhood. Bronchiectasis was demonstrated by bronchography. The diagnosis of ICS was confirmed by the lack of dynein arms of cila in the nasal mucosa with electronmicroscopy. In 1987, he complained of headache and vomiting and a space occupied mass lesion in the left frontoparietal lobe was found by head CT scan, which was subtotally resected. Histological studies showed large cell type non Hodgikin lymphoma of B-cell phenotype. He received radiotherapy (41Gy) to the whole brain and systemic chemotherapy consisting of adriamycin, cyclophosphamide, vincristine, prednisolone, L-asparaginase and intrathecal methotrexate, and the patient maintained complete remission for eight months. However, relapse occurred and the patient died twelve months after the initiation of treatment. PMID- 2769981 TI - [Advances in biopharmaceutics and drug delivery system]. PMID- 2769982 TI - [Clinical medicine and DDS]. PMID- 2769983 TI - [Functional components of DDS: controlled release and targeting]. PMID- 2769984 TI - [Classification of drug-release control systems and releasing profiles]. PMID- 2769985 TI - [Theory and methods of drug targeting]. PMID- 2769986 TI - [Theory and practice in design of gastrointestinal DDS]. PMID- 2769987 TI - [Theory and practice for design of transdermal and transmucosal drug delivery systems]. PMID- 2769988 TI - [Injectable and implantable drug delivery systems]. PMID- 2769989 TI - [Chemical DDS: prodrugs and antedrugs]. PMID- 2769990 TI - [Treatment of infectious diseases with liposome-encapsulated antibiotics]. PMID- 2769991 TI - [Clinical application of DDS, steroid therapy and NSAIDs]. PMID- 2769992 TI - [Clinical application and significance of drug delivery systems. An immunosuppressant, cyclosporin A]. PMID- 2769993 TI - [Transmucosal delivery system of calcitonin]. PMID- 2769994 TI - [Clinical application and significance of drug delivery systems. Targeting SOD by gene and protein engineering]. PMID- 2769995 TI - [Clinical application and significance of drug delivery systems. Progestasert, an intrauterine progesterone contraceptive system]. PMID- 2769996 TI - [Clinical application and significance of drug delivery systems. The Ocusert system]. PMID- 2769997 TI - [Influence of the diameter of the drug carriers for accumulation to tumors]. PMID- 2769998 TI - [Targeting therapy of gastrointestinal cancers with sulfatide-inserted liposomes entrapping adriamycin]. PMID- 2769999 TI - [Chemoembolization with microsphere of silicon-adriamycin composite]. PMID- 2770000 TI - [Chemoembolization using microencapsulated anticancer drugs]. PMID- 2770001 TI - [Drug delivery system of anticancer agent entrapped in temperature-sensitive liposomes combined with local hyperthermia]. PMID- 2770002 TI - [Targeting to tumor site by the conjugate of antitumor drug with synthetic polymer]. PMID- 2770003 TI - [Targeting therapy of cancer, using hormones as carriers]. PMID- 2770004 TI - [Targeting of magnetically responsive drug carriers to cancer]. PMID- 2770005 TI - [Induced hypertension chemotherapy by angiotensin II for solid tumor]. PMID- 2770006 TI - [Cancer-associated carbohydrate antigens in digestive cancers]. PMID- 2770007 TI - [Discrepancy of apolipoprotein B values measured by two turbido-immunometric assays. Differences of turbido-immunometric reactivities between apolipoprotein B in VLDL and in LDL]. PMID- 2770008 TI - [Isolation studies of folate binding protein in serum]. PMID- 2770009 TI - [Estimation of corrected plasma fructosamine by plasma protein concentration]. PMID- 2770010 TI - [Lactate dehydrogenase isoenzyme in human white blood cells]. PMID- 2770011 TI - [Radioimmunoassay of pancreatic phospholipase A2 in human serum]. PMID- 2770012 TI - [Latent cancer of the prostate]. PMID- 2770013 TI - [Effect of periventricular lucency on central conduction time in patients with multiple cerebral infarcts]. PMID- 2770014 TI - [Roles of intrinsic prostaglandins and leukotrienes in gastric mucosal damage]. AB - While gastric mucosa contains prostaglandins and leukotrienes, the roles of these substances in the gastric mucosal protection and damage are not clarified. Using AA-861, a specific 5-lipoxygenase inhibitor, and indomethacin, a cyclooxygenase inhibitor, we investigated the roles of intrinsic prostaglandins and leukotrienes in the gastric circulatory change and the development of gastric lesion induced by ethanol. Rats were fasted for 48 hours and allowed free access to water. After light ether anesthesia, rats were orally given AA-861 (gift from Takeda Chem. Industry; 2.5, 10, 40 or 640 mg/kg), indomethacin (20 mg/kg), and the both or AA 861 (40 mg/kg) and indomethacin (20 mg/kg). Thirty min after the treatment, 2 ml of ethanol (30, 40, 70, 99.5%) was orally administered. Sixty min later, the rats were killed to measure the area of mucosal lesions. The gastric mucosa was damaged by ethanol (greater than or equal to 40%) in a dose-dependent manner. The treatment with AA-861 prohibited the gastric mucosal damage. However, the treatment with indomethacin did not show a significant influence to the mucosal damage. Combined treatment of AA-861 and indomethacin yielded no significant difference from that of single treatment with AA-861 in acute gastric mucosal ulceration. The mucosal blood flow velocity was monitored by laser doppler velocimetry before and after the ethanol administration in the groups treated with vehicle, AA-861 or indomethacin. The blood flow velocity decreased after the administration of 40% ethanol in the group treated with indomethacin, and in a group treated with vehicle.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2770015 TI - [Risk factors for peptic ulcers treated surgically]. AB - To elucidate the risk factors of peptic ulcer which require surgical treatments, we examined the influences of following factors such as sex, age, smoking, and alcohol in 308 peptic ulcer patients. In the group with gastric ulcers, high age group was likely to be operated. On the contrary, young patients with duodenal ulcers were likely to be treated surgically. Sex, smoking and alcohol were not regarded as risk factors. The correlations between the degree of neurosis and the amounts of smoking and alcohol were analyzed in the cases with duodenal ulcers. In the cases treated surgically, the degree of neurosis showed no or little correlations. In the cases treated conservatively, however, the degree of neurosis showed positive correlation with the amounts of smoking and alcohol. PMID- 2770016 TI - [Fecal fat excretion rate in patients with Crohn's disease--comparison of a diet containing 50 g/day of fat with elemental diet with an addition of 50 g/day butter fat]. AB - Fecal fat excretion rate was determined by the method of Van de Kamer in 31 patients with Crohn's disease and six healthy controls, when fed by the diet containing 50 g/day of fat. Patients with jejuno-ileitis and those with partial and extensive resection showed a significantly greater excretion rate compared with patients with ileitis and healthy controls, however, there was no significant difference between patients with ileitis and healthy controls. In this study, the fecal excretion rate was less than 10 g/day in non-operated cases. Our results seems to be smaller than those in previous studies from the western countries. Fecal fat excretion rate was determined in 12 patients with non-operated Crohn's disease and six healthy controls, when fed by the additional 50 g/day butter fat during the elemental diet. With ingestion of the additional 50 g/day butter fat during elemental diet, fecal fat excretion rate was significantly increased in the patients with non-operated Crohn's disease than the results of the diet containing 50 g/day fat, but not significantly changed in the healthy controls. This result suggest that determination of fecal fat excretion rate with fed by the additional 50 g/day butter fat during elemental diet is a useful test for detecting a mild fat malabsorption in non-operated Crohn's disease. PMID- 2770017 TI - [Analysis of hepatic hemodynamics by a new method of per-rectal portal scintigraphy using 99mTcO4- (direct intramural administration of radioisotope)]. AB - To depict of porto-systemic collaterals clearly, and to analyze of hemodynamics of liver, we developed new method of per-rectal portal scintigraphy (direct intramural administration of 99mTcO4- by 23G needle). And we used this method in patient with liver diseases (acute hepatitis: 5, chronic hepatitis: 7, liver cirrhosis: 25 cases). From time activity curve of the liver and the heart, liver/heart ratio; index of porto-systemic shunt via inferior mesenteric vein (IMV) and first flow ratio(k); index of portal blood flow from IMV pathway/index of hepatic total blood flow were calculated. In our method, the images of portal vein, liver, heart, especially porto-systemic collaterals were visualized more clearly than enema methods. The liver/heart ratio was significantly lower in patients with liver cirrhosis than that in non-cirrhotic patients (p less than 0.01), which indicated that patients with liver cirrhosis had more porto-systemic collaterals than non-cirrhotic diseases. The k was more lower in liver cirrhosis than in acute hepatitis (p less than 0.01). And the k was also more lower in chronic hepatitis than in acute hepatitis (p less than 0.1), which indicated that portal blood flow via IMV reduced in early stage of chronic liver diseases. In conclusion, new method of per-rectal portal scintigraphy has more advantage for analysis of hepatic hemodynamics than enema methods. PMID- 2770018 TI - [Changes in production of platelet activating factor by adherent hepatocytes of mice with experimental liver failure]. AB - It is thought that the platelet activating factor (PAF) enhances the immune response and inflammatory reaction. We studied the production of PAF from liver adherent cells. As a result, liver adherent cells produced PAF, when they were stimulated with calcium ionophore. In addition, when mice were treated with heat killed Propionibacterium acnes and the mononuclear cells were infiltrated into the liver, a significantly larger amount of PAF was produced compared to normal mice. PMID- 2770019 TI - [Basic analysis of extracorporeal shock wave lithotripsy of gallstones]. AB - Influence of extracorporeal shock wave lithotripsy (ESWL) on human gallstones placed in dog gallbladders was investigated. After irradiation of shock wave more than 600 times, maximal diameter of residual stones of 10 mm before irradiation was destroyed to 2 mm or less. Levels of serum transaminase (GOT.GPT) were elevated, in parallel with times of shock waves. These results suggested that 600 times of shock waves were enough to destroy one cholesterol stone, diameter of which was about 1 cm. Data of elevation of serum transaminase showed that more than 600 times of shock waves were possible to induce the damage of liver. PMID- 2770020 TI - [Normoglycemic control by artificial pancreas in patients with pancreatic diabetes or with primary diabetes mellitus--analysis of patterns of insulin infusion and nocturnal glucose infusion]. AB - It has been reported that patients with pancreatic diabetes (PD) show nocturnal hypoglycemia frequently when compared to patients with diabetes mellitus (DM). Present study was carried out to compare patterns of insulin infusion and nocturnal glucose infusion under normoglycemic control in between PD and DM. Eleven PD patients whose onset of diabetes mellitus appeared after the onset of chronic pancreatitis (PD group), and 10 patients with insulin-dependent diabetes mellitus without pancreatic disease (DM group) were studied. To control the blood glucose level, a closed loop insulin delivery system (Biostator GCIIS, Miles Laboratories) was used. 24 hours infused amount of insulin in PD group was not different from that in DM group, while patterns of insulin infusion in both groups were different. Thus, most of 24 h-infused insulin were given during 2 hours postprandial period in PD group, while in DM group, insulin was given mostly as a basal infusion. In this study glucose infusion occur in a state of hypoglycemia (less than 90 mg/dl). 7 of 11 in PD group and 2 of 10 in DM group had glucose infusion which mostly occurred at a night time. PMID- 2770021 TI - [A case of asymptomatic intrahepatic primary sclerosing cholangitis associated with atypical ulcerative colitis]. PMID- 2770022 TI - [A case of chronic idiopathic intestinal pseudoobstruction]. PMID- 2770023 TI - [A case of malignant abdominal mesothelioma with remarkable leukocytosis]. PMID- 2770024 TI - [Clinical evaluation of the prehospital phase of acute myocardial infarction in the elderly]. AB - In order to clarify the clinical characteristics of the prehospital phase of acute myocardial infarction (AMI) in the elderly, we studied 92 elderly (65 years old or more) and 41 younger patients with first AMI. Fifty eight elderly (63.1%) and 30 younger (72.7%) patients had typical symptoms such as chest pain at onset. There were 5 elderly cases who had no symptom, although all of the younger had some symptoms at onset. More than 70% of the younger cases developed their symptoms either between 6 am and noon or between 6 pm and midnight, whereas the elderly showed no such tendency. Intervals between the onset of symptoms and hospital admission (admission time) averaged 6.8 hours (hr) in the younger and 7.7 hr in the elderly. Approximately one half of the elderly and a quarter of the younger showed admission time more than 6 hr, respectively. Elderly cases with atypical symptoms tended to have a longer admission time than younger cases (7.2 vs 3.1 hr), although there was no significant difference between the elderly and the younger with typical symptoms (8.0 vs 7.9 hr). Younger patients with heart failure had significantly shorter admission time than those without heart failure (3.6 vs 8.6 hr). However, the elderly with heart failure showed a prolonged admission time (6.1 hr). Although there was no difference on admission time between survivors and non-survivors within 28 days after admission in the elderly (7.5 vs 8.4 hr), the elderly non-survivors with atypical symptoms had the longest admission time (13.0 hr).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2770025 TI - [Age-related cerebral white matter changes on computed tomography]. AB - Changes of cerebral white matter on computed cranial tomography related to aging were studied in 70 subjects aged 30 to 94 years. The subjects had no histories of cerebrovascular accidents and no abnormalities in the central nervous system were shown by physical examinations nd CT scans. We measured the average attenuation values (CT numbers) of each elliptical region (165 pixels, 0.39 cm2) in the bilateral thalamus and twelve areas of deep white matter. Multiple regression analysis was used to assess the effects of age, cranial size and cranial bone CT numbers on the brain CT numbers. We also studied the association between brain CT numbers and brain atrophy, hypertension, diabetes mellitus. CT numbers of frontal white matter surrounding anterior horns decreased with aging in 70 subjects aged 30 to 94 years. No significant correlation between age and brain CT numbers was found in any other region by multivariate analysis, because of the prominent effect of cranial bone CT numbers on brain CT numbers. Although no age-related changes of white matter CT numbers was found in 41 subjects aged 30 to 65 years, there were significant negative correlations between age and white matter CT numbers at all regions in 29 subjects aged 66 to 94 years. Brain atrophy was associated with brain CT numbers. No association was found for hypertension or diabetes mellitus. Brain CT numbers decreased with aging even in neurologically healthy persons in older age. Brain CT numbers also decreased as cerebral atrophy advanced. PMID- 2770026 TI - [The effect of smoking habit on aortic pulse wave velocity using a new method for data analysis]. AB - We measured aortic pulse wave velocity (PWV) in 168 male adult cases of various arteriosclerotic diseases. In order to evaluate the effects of age, smoking habits, alcohol intake, and blood pressure, we applied the least median of squares (LMS) regression which was considered to be very useful for data analysis. The results showed that PWV level increased with age. Furthermore smoking was associated with increasing PWV level and this effect was also related to age. We concluded that the PWV was valuable as an index of arteriosclerosis, and instead of the classical least squares method, LMS regression was very useful for analysis of medical data. PMID- 2770027 TI - [Changes in normal reference ranges for serum chemical analyses with ageing]. AB - To get normal reference ranges for blood chemistry in elderly subjects, laboratory data on serum chemical analytes obtained from 1822 male and 1870 female outpatients were statistically analyzed with a non-parametric method with iterative truncation. Regarding the difference in the test data between male and female, the values for most analyses except for inorganic phosphorus and total protein were significantly higher in male than in female when an adult group including subjects of age ranging from 21 to 50 years was compared. The values for lactic dehydrogenase, albumin, sodium and calcium were higher in female of over 50 years of age than in their counterpart. When male and female were combined, the normal reference ranges for lactic dehydrogenase, alkaline phosphatase, uric acid, blood urea nitrogen, creatinine and potassium tended to be elevated while those for total protein, albumin and calcium to be declined with ageing. The values for total cholesterol and triglyceride reached a peak at a certain age. Total and direct bilirubin, sodium and chloride values were constant throughout whole age categories. PMID- 2770028 TI - [Analysis of factors affecting prognosis of bed-bound elderly at home using the life-table technique]. AB - Survival data analysis was carried out in a community to aim at linking the home visit survey of the 106 chronically bed-restricted elderly aged 60 and older to whom care was given exclusively by their coresidents, to deaths certified within 40 months of the baseline interviews. The questionnaire in the baseline survey included items concerning demographic attributes, functional status, activity of daily living, mental status and family contact. During the 40-month observation interval 59 deaths were registered in this population. The association of 16 independent variables with fatal outcome derived from the above survey was evaluated using two kinds of life-table analyses. First, a non-parametric technique was applied to estimate the survival distribution and computing rank tests for association. Subsequent multivariate analysis made with the step-wise method revealed the significant importance of being stimulated everyday by TV or radio and that of the relationship of caregivers to the elderly as well as good physical function and mental well-being for longevity of chronically bed-bound elderly. PMID- 2770029 TI - [The safety and diagnostic accuracy of dipyridamole-loading myocardial tomography with thallium-201 in the elderly with coronary artery disease]. AB - To test the diagnostic accuracy and safety of dipyridamole-loading myocardial imaging with thallium-201 (T1) in the elderly, we performed myocardial tomography in 42 patients with coronary artery disease (CAD). While monitoring of ECG and blood pressure, dipyridamole was infused at a rate of 0.57 mg/kg body weight over 4 minutes, and 4 minutes later T1 (3 mCi) was injected. Five minutes later (initial) and 3 hours after T1 injection (redistribution) myocardial images were obtained from 32 projections by a rotating gamma camera. After low-pass filtering, images were reconstructed into short-axis, horizontal long-axis and vertical long-axis tomograms. Myocardial T1 distribution both on initial and redistribution images and myocardial T1 washout rate's (WOR) of the entire left ventricle were expressed into two-dimensional polar maps by using short-axis cuts (bull's-eye maps). In addition to visual interpretation, abnormal WOR (less than 18%) was used as a criteria of dipyridamole induced myocardial ischemia. Patients were divided into 2 groups. Group I consisted of 24 patients more than 70 years of age and Group II consisted of 18 patients less than 65 years of age. The clinical and coronary angiographic characteristics of the two groups did not differ. The sensitivity of this method for the detection of CAD was identical (83%) between the 2 groups, and the detection of coronary artery stenosis was 73% in Group I and 74% in Group II (NS).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2770030 TI - Abstracts of the 33rd annual meeting of the Japan Society of Human Genetics, 1988. PMID- 2770031 TI - Serogenetic investigations of Tibetans and Himachalis from Himachal Pradesh, India: genetic relationship between Tibetans and certain selected mongoloid populations. AB - Twenty two serogenetic systems were investigated in 115 Tibetans and 128 Himachalis from the state of Himachal Pradesh, northwest India. For eight of the loci (ABO, Rh, MNSs, P, Fy, 6PGD, EsD, and AK) the two populations showed conclusive heterogeneity and their frequency distribution showed that the serogenetic differences between two populations are due to their different racial affiliations. The Tibetans were also analysed for their genetic relationship with certain selected populations from the Cis-Himalayan, far east and south Asian regions. The calculations of the Harpending's kinship matrix R and the genetic distances showed that the Tibetans are closer to the mongoloid populations of the Cis-Himalayan region and the differences in the present day population structure of the mongoloid groups of this region are more likely to be due to differential migration, admixture and racial affiliation although there is a slight possibility of disruptive selection for certain loci such as 6PGD and AK which showed an exceptionally high value of Canning (6PGD*C) and AK*1 genes. PMID- 2770032 TI - Radiographic measurements of metacarpophalangeal lengths in Japanese children. AB - The lengths of 19 tubular bones of the hand were measured on radiographs of 1,585 Japanese children aged 0 to 17 years. The means and standard deviations related to age and sex were calculated and presented in tables. Using the standards, examples of the metacarpophalangeal pattern profile analysis are presented. PMID- 2770033 TI - Inhibition of phytoagglutinin potency of Korean vicia unijuga by human urine. AB - Human urines are often examined for individual identification in medicolegal field, therefore, authors attempted to classify the urines by inhibition of agglutination potency of phytoagglutinin Korean vicia unijuga which is known as a panphytoagglutinin to human red blood cells, and demonstrated that some individuals excrete urine which has ability to interfere with the agglutination potency of vicia extracts. The inhibiting substance appears to be either a protein or a glycoprotein, for it can be eliminated by boiling the urine sample. This substance is not present in human serum, semen and saliva. Presence or absence of the inhibiting substance in the urine has no relation to the individual's blood type and a sample urine spot test yielded a high rate of inhibitory property. PMID- 2770034 TI - [Studies on sex determination using human dental pulp. II. Sex determination of teeth left in a room]. AB - The appearance rate of Y chromatin was calculated in the dental pulp with the staining by Quinacrine Mustard. The morphological findings of the tissue were observed with the HE stained section and the change of the appearance rate of Y chromatin was studied along with the morphological change of the tissue. The average of the appearance rate of Y chromatin in the male dental pulp was 42.2% immediately after the tooth extraction, 34.8% after one month, 27.9% after 3 months, 20.8% after 6 months, 20.6% after 1 year, 19.1% after 18 months and 11.4% after 2 years, respectively. On the other hand, the appearance rate of the pseudo Y chromatin spot in the female pulp was below 4.2% through the two years' observation which enabled to determine the sexuality. By the HE staining observation about the dental pulp, left at a room temperature, it was revealed that the pulp tissue can be well preserved for a long time because of the natural drying. The degree of the staining declined with the lapse of time after the removal of tooth. Degeneration of tissue did not offer any discrete criteria for the estimation of the lapse of time after the removal of tooth. PMID- 2770035 TI - [A histological study of striated muscle and nerve fiber in the human caused by a high voltage electric current]. AB - A case of an electrocution is reported, involving a 37-year-old man who while engaged in an electrical work, received an electric shock by touching an electric wire of 11,000 volts. Both of his arms had to be amputated. A piece of muscle tissue was removed from the amputated arm to be examined by light and electron microscopy. Under light microscopy, the muscle tissue, after myoglobin staining, showed a particular pattern that closely resembled the pattern on the skin of a python. Thus the author has named the pattern seen in this case as the "Python pattern". The electron microscopy inspection revealed on myoglobin staining excessive stretching and fragmentation of the myofibrils where the myoglobin staining was negative in the slide. PMID- 2770036 TI - [A homicidal strangulation by ligature, disguised as a suicidal hanging]. AB - A naked 38-year-old woman was found dead, lying beside a bed in a guest room of a hotel. A cotton cord was looped around her neck, with one end tied to a bedpost. Thus it seemed that she had hanged herself in a lying position. Yet, certain suspicious factors gave rise to doubts. The hair and a necklace were intertwined with the cord and a man that had been staying in the same room had fled. On the postmortem examination, marked congestion and many petechial haemorrhages were seen in the face and the upper area of the neck, also in conjunctiva. A light brown and highly dry ligature mark, about one centimeter in width, was found on the neck. The mark, crossing the front of the neck, was clearly evident from the back to the right side of the neck. The lower borders of the congestion and petechial haemorrhages in the face and neck were located 1 or 2 centimeters above the ligature mark. On the left side of the neck, another pale ligature mark with slight subcutaneous haemorrhages was seen between the dry mark and the lower border of the congested part of the neck. A similar ligature mark also was found on the back of the neck. On internal examination, congestion of the cervical lymph nodes and haemorrhages in the cervical muscles were recognized in the areas of the cutaneous congestion. These findings supported suspicions that the dry ligature mark had been caused by hanging after her death, and that the light ligature mark with slight subcutaneous haemorrhages on the left side and back of the neck had been caused by strangulation, which had brought on the victim's death. Therefore, it was decided that her death had been disguised as a suicidal hanging, after she had been strangled by ligature. A week later, her former husband was arrested and confessed his crime. PMID- 2770037 TI - [Unusual calcification in brain suspected to be caused by toxoplasmosis: a report of an autopsy case]. AB - A very rare case of severe calcification in brain is reported. A 49-year-old man was hit and run by a motorcar in acrossing a road on foot, and he died 1 hour later in an emergency hospital. Medico-legal autopsy was done at 5 hours after his death. The cause of death was cerebral contusion caused by a struck on partieto-occipital region. Unusually severe calcification was observed in the right and left cerebral hemispheres, especially basal ganglia, in the border areas between grey and white matters of frontal, parietal and occipital lobes, as well as in the cerebellar nucleus, cortex and medulla. Histological examination showed severe multiple calcification in the brain tissue. Dispersed deposit of pseudocalcium-Ca and edema were observed around the calcifications. Proliferation of glia cells and decrease of nerve cells were also noted. In his past history, he began to speak distinctly and to stagger since 8 years ago. Three years ago, he collided with guardrail while driving his motorcycle, and he was hospitalized. Calcification in the brain was already revealed in the roentogenographic examination. In the laboratory findings, the data of serum calcium, serum phosphorus and Ellsworth-Haward test were normal. The antibody of toxoplasma, however, showed high level more than X 1,024. After he was discharged, dementia, instability of trunk and dysarthria still continued, and he used to across a crowded road unconcernedly. The cause of the calcification might be suspected to be toxoplasmosis, although neither trophozoites, cysts nor oocysts were found in the brain tissue. PMID- 2770038 TI - [Application of a nonisotopic southern hybridization method for sex determination from bloodstains found in criminal spots]. AB - Bloodstains collected from criminal spots were submitted to the nonisotopic Southern hybridization (NISH) method for sex identification (Kobayashi et al., J. Forens. Sci., 33, 613-620, 1988). A RNA probe, transcripted from a Y-chromosome specific DNA sequence (Nakahori et al., Nucl. Aci. Res., 14, 7569-7580), was used for this series of investigations. Among the 95 bloodstain specimens studied, in which the sex of each was previously known, 54 (88.5%) of 61 male stains were appropriately determined to be male by the NISH method, and 28 (82.4%) of 34 female bloodstain specimens were estimated to be female. The sex of the 13 remaining stain specimens were unable to be determined by this method, but no specimen was erroneously misidentified. With regard to 12 specimens, in which the sex of each was unknown at the time of the NISH test, 5 were determined as being male and 3 were estimated as being female, though the sex of the remaining 4 specimens could not be determined. The causes in the stains that made determination impossible were analyzed using patterns of ethidium bromide fluorescence of electrophoresed gel and/or NISH, and it was concluded that this could be due to an insufficient quantity of extracted DNA (12 cases), the resistance against a restriction enzyme (EcoRI) (3 cases), and the depolymerization of the Y-chromosome specific fragment (2 cases). PMID- 2770039 TI - [The clinical usefulness of portal venous flow ratio by hepatic angiography with 99mTc-Sn colloid in chronic liver diseases: a comparison with histological finding]. AB - The ratio of portal venous to hepatic blood flow was measured in chronic liver diseases by radionuclide angiography with 99mTc-Sn colloid and its clinical value was discussed. The ratio was proportionally decreased to the progression of the diseases (normal 74.5 +/- 7.3%, chronic hepatitis 58.8 +/- 9.2%, compensated liver cirrhosis 29.3 +/- 19.3%). In alcoholic liver diseases, the standard deviation of the ratio was large as 52.7 +/- 23.7%, and the low ratio in the early period of the disease increased within one or two months as the disease recovered. In comparison with the histological findings of the liver, the ratio in the alcoholic liver diseases was well correlated with the severity of liver fibrosis and liver cell swelling. In conclusion, this noninvasive and simple method is valuable in diagnosing the chronic liver disease, especially alcoholic liver diseases, and also in estimating its clinical course. PMID- 2770040 TI - [Clinical assessment of uneven ventilation by factor analysis of Xe-133 washout scintigram]. AB - Factor analysis (FA) was applied to 50 consecutive Xe-133 washout lung scintigrams, and its findings were compared with dynamic scintigrams of Xe-133 washout (DSW). Mean transit time (MTT) of radioactive xenon measured by FA also was compared with that measured by height/area (H/A) or two-compartment analysis (2CA). In 12 patients with normal DSW, FA separated and located two factors: one represented background activity, and the other uniform washout from the lung. In 31 out of 38 patients (82%) with abnormal DSW, FA separated the same areas where the washout was delayed on DSW. In 5 (13%) patients, FA diagnosed more areas of delayed washout than DSW. FA failed in 2 (5%) patients, but this failure was due to small number of counts of pixels. Diagnosis by FA was seemed easier than diagnosis by DSW in 95% of all patients by the authors' impression. MTT by FA (y) correlated with MTT by 2CA (x) in small groups of patients: in 9 patients in whom only one MTT was obtainable by FA (r = 0.75, p = 0.02, y = 4.2x + 1.9), and in 8 patients of normal DSW in whom two MTT's were obtainable by FA (r = 0.77, p = 0.02, y = 0.69x + 6.2, y; shorter MTT by FA between the two). MTT by FA did not correlate with MTT by H/A. In conclusion, FA is useful for diagnosing uneven Xe 133 washout from the lung. PMID- 2770041 TI - [Evaluation of lung scintigraphy using N-isopropyl-p-[123I]-iodoamphetamine]. AB - N-isopropyl-p-[123I]-iodoamphetamine (123I-IMP) was examined for its relevancy as a labeling medium of lung scintigraphy in 30 patients with lung diseases and 20 healthy subjects. Lung diseases were classified into carcinoma and diffuse lung disease, and the all subjects with normal lung were classified into smokers and nonsmokers. To assess the reduction curve of 123I-IMP, mean transit time was calculated. Forced spirography was performed and spirographic values were analyzed. Spirographic parameters examined were vital capacity percent (%VC), forced expiratory volume in 1 sec divided by forced vital capacity (%) (FEV1.0%), and blood gas data. In the correlation matrix, the mean transit time was correlated with blood gas data, and not with %VC or FEV1.0%. In patients with lung diseases, the mean transit time was significantly prolonged; however, the difference was not significant between groups of carcinoma and benign disease, and between groups of smokers and nonsmokers. Wash-out images were obtained by the subtraction technique using the first frame image and 100-min delayed image. In patients with lung carcinoma, 87.5% of the tumors were depicted on wash-out images. The lesions were also depicted well in benign lung diseases. But among findings of wash-out image by 123I-IMP, air trapping image by 133Xe study and XCT study, there are some discordances to be clarified. PMID- 2770042 TI - [A case of cardiac metastasis from non-Hodgkin's lymphoma demonstrating interesting findings through radionuclide studies]. AB - We have presented a quite rare case of non-Hodgkin's lymphoma developing cardiac metastasis which was demonstrated and confirmed by radionuclide studies and autopsy. A 57-year-old male with SVC syndrome underwent radionuclide angiography using 99mTc-HSA prior to 67Ga-citrate and 201Tl-chloride studies for suspected right atrial metastasis from non-Hodgkin's lymphoma. The radionuclide angiography revealed a filling defect in the right atrium. 67Ga and 201Tl studies showed increased accumulations of both nuclides in the right atrium, in congruence with the region showing a filling defect through the radionuclide angiography. These results suggest that combined radionuclide studies, such as radionuclide angiography, 67Ga and 201Tl studies, might be useful in detecting metastatic tumor in the heart. PMID- 2770043 TI - [Clinical significance of right ventricular ejection fraction in cases with atrial septal defect]. AB - Right ventricular ejection fraction (RVEF) assessed by cardiac radionuclide angiography has been applied to evaluate right ventricular function such as ischemic, valvular and congenital heart disease. Using this modality, previous reports also suggest that there is good correlation between RVEF and mean pulmonary arterial pressure (mPA) from catheterization findings in mitral valvular disease and chronic obstructive lung disease. In this study, cardiac RI angiography were performed on 33 adult patients with atrial septal defect (ASD), RVEF is not so good correlation (r = -0.42) with mPA, but in cases within pulmonary to systemic ratio (Qp/Qs) less than 2.0 limits, there is good correlation between RVEF and mPA (n = 9, r = -0.71). As a conclusion, in ASD, both afterload assessed by mPA and preload assessed by Qp/Qs decrease RVEF. PMID- 2770044 TI - [Long-term follow-up of thallium-201 myocardial scintigraphy in acute myocardial infarction--clinical significance of reverse redistribution during acute period]. AB - To clarify the viability of myocardium in acute myocardial infarction, we examined 18 patients scintigraphically. They underwent rest or stress imaging and delayed imaging of thallium-201 during acute, convalescent and chronic periods. During acute period, a scintigraphic finding of the delayed filling in was observed in 9 cases (50%; Redistribution group). Worsening of the delayed image was observed in 6 cases (33%; Reverse redistribution group). No scintigraphic change of the perfusion defect was observed in 3 cases (17%; No change group). In reverse redistribution group, a remarkable improvement of the delayed image was observed through acute, convalescent and chronic periods. In redistribution group and no change group, no significant improvement was observed. We conclude that the myocardium of the reverse redistribution region during acute period may be viable. In the reverse redistribution region, recanalization of the coronary artery possibly protects myocardial damage from necrosis. PMID- 2770045 TI - [Study of 201Tl uptake by bone and bone marrow on 201Tl scintigraphy--with special reference to bone marrow abnormalities]. PMID- 2770046 TI - [Accumulation of 99mTc-phosphorous compounds uptake by liver tumors]. PMID- 2770047 TI - [The tenth report on survey of the adverse reaction to radiopharmaceuticals (the 13th survey in 1987). Subcommittee of Safety Issue for the Radiopharmaceuticals Medical and Pharmaceutical Committee Japan Radioisotope Association]. PMID- 2770048 TI - Stimulation of rat liver growth by a 1,3-dithiole derivative, KZ-1026. AB - The oral administration of 2-(1,3-dithiol-2-ylidene)-1-phenyl-1,3-butanedione (KZ 1026) to normal rats at doses of 50, 100 and 200 mg/kg/day for 3 days accelerated liver enlargement in association with a dose-dependent increase in the total amounts of protein, RNA and DNA in the liver. The liver weight at 24 hr after the third dose of 200 mg/kg reached 174% of the control. With respect to the effect on liver enlargement, KZ-1026 differed from phenobarbital, since KZ-1026, unlike phenobarbital, increased hepatic DNA content without significant effects on P-450 and aminopyrine-N-demethylase. Incorporation of [3H]thymidine into liver DNA was stimulated by a single dose of KZ-1026 (200 mg/kg), and it peaked at 24 hr post dose (18 times the control), followed by an increase in the number of liver nuclei. Liver growth was also accompanied by an increasing hepatic reserve cell mass, expressed by the capacity of eliminating exogenous galactose from the blood stream. Pretreatment with KZ-1026 (200 mg/kg/day) for 3 days significantly improved the survival rate of subtotally hepatectomized rats from 39% to 78%. These findings indicate that KZ-1026 accelerates hepatocyte proliferation, resulting in an enhancement of liver functional mass in normal rats. PMID- 2770049 TI - Ethanol inhibits vestibular and caloric nystagmus without affecting optokinetic nystagmus in rabbits. AB - Effects of ethanol on optokinetic, vestibular and caloric nystagmus were investigated in pigmented rabbits to determine whether or not it affects a specific site involved in the induction of various nystagmus. Optokinetic nystagmus was produced by rotation of the drum with vertical stripes at an angular velocity of 0.85 degrees/sec. Vestibular nystagmus was induced by horizontal rotation at an angular velocity of 30 degrees/sec and caloric nystagmus by infusion of cold water into the external meatus. Cumulative injection of ethanol into the auricular vein to doses of 0.1, 0.2, 0.4 and 0.8 g/kg inhibited both vestibular and caloric nystagmus dose-dependently, but did not affect the optokinetic nystagmus. These results suggest that relatively low doses of ethanol mainly act on the peripheral vestibular organ and impair the vestibular function without affecting the optokinetic system. PMID- 2770050 TI - Dependency of histamine induced phasic and tonic contractions on intracellular and extracellular calcium in guinea pig tracheal smooth muscle. AB - Dependency of histamine induced phasic and tonic contractions on intracellular and extracellular calcium in guinea pig tracheal smooth muscle was investigated. In Ca++-free Krebs-Ringer solution, the phasic contraction caused by 10(-5)M histamine was not affected, but the tonic contraction declined much faster than that in normal Krebs-Ringer solution (KR). The phasic contraction in KR containing 3 x 10(-4) M dantrolene was depressed, but reached a level similar to that in normal KR, and the tonic contraction was maintained similarly with or without dantrolene. In KR containing organic calcium channel blockers, 10(-5) M nilvadipine (FR34235), 10(-5) M verapamil or 10(-5) M diltiazem, neither phasic contraction nor tonic contraction was affected. No contraction was observed in Ca++-free KR containing 3 x 10(-4) M dantrolene. These results suggested that the phasic contraction by histamine depended on the intracellular calcium and the tonic one, on the extracellular calcium, and the organic calcium channel blockers had no effect on both phasic and tonic contractions caused by histamine. PMID- 2770051 TI - Effect of NC-1100 [1-(3,4-dimethoxyphenyl)-2-(4-diphenylmethylpiperazinyl) ethanol dihydrochloride] on gamma-aminobutyric acid (GABA) metabolism in rat brain: analysis using stroke-prone spontaneously hypertensive rat. AB - Effects of oral administration of NC-1100 on the metabolism of neuroactive amino acids in rat brain were studied using stroke-prone spontaneously hypertensive (SHR-SP) and Wistar Kyoto rats. The repeated administration of NC-1100 induced a significant increase of gamma-aminobutyric acid (GABA) content in the cerebellum and medulla oblongata of SHR-SP. The decrease of aspartic acid contents in the cerebellum and medulla oblongata of SHR-SP was also noted following NC-1100 administration. Although the activity of L-glutamic acid decarboxylase did not change in these cerebral areas, the activity of GABA-transaminase:succinic semialdehyde dehydrogenase was found to be significantly reduced in the cerebellum of SHR-SP following the repeated administration of NC-1100. The turnover rate of GABA was also significantly reduced in the cerebellum and medulla oblongata of SHR-SP. It was also found that the spontaneous release of preloaded [3H]GABA from cerebral cortical slices was significantly retarded by the continuous oral administration of NC-1100. These results suggest that NC-1100 may be a drug inducing the increase of GABA in the cerebellum and medulla oblongata following continuous administration, especially in animals having hypertension associated cerebrovascular disorders such as SHR-SP. PMID- 2770052 TI - Effects of calcium channel blockers and hydralazine on epinephrine-induced hyperglycemia in vivo. AB - Effects of calcium channel blockers from structurally different classes and hydralazine on epinephrine-induced hyperglycemia were studied in vivo. Nifedipine (0.05-0.20 mg/kg, i.p.) and nicardipine (0.40-0.80 mg/kg, i.p.) markedly potentiated the epinephrine-induced hyperglycemia in a dose-dependent manner. In contrast to these dihydropyridine calcium channel blockers, verapamil and diltiazem did not significantly affect the epinephrine-induced hyperglycemia at doses of 0.10-1.0 mg/kg, i.p. At higher doses (10 mg/kg, i.p.), significant potentiation of epinephrine-induced hyperglycemia was observed by these non dihydropyridine calcium channel blockers. Hydralazine also markedly increased the epinephrine-induced hyperglycemia. These calcium channel blockers and hydralazine had no significant effect on the basal plasma glucose levels at any dose used here. As judged from the rates of glucose disappearance (K values), dihydropyridines significantly impaired the glucose tolerance in much lower doses than those of non-dihydropyridines and hydralazine. Furthermore, epinephrine induced impairment of glucose tolerance was markedly potentiated by these calcium channel blockers and hydralazine at doses which potentiated the epinephrine induced hyperglycemia. These results suggest that, at least in part, the potentiation of epinephrine-induced hyperglycemia by dihydropyridines, non dihydropyridines and hydralazine is related to the inhibition of peripheral glucose utilization produced by insulin. PMID- 2770053 TI - Effect of N-methyltetrazolethiol on liver microsomal vitamin K reductase. AB - NADH-dependent vitamin K reductase activity in rat liver microsomes was measured by detecting the amount of the reduced form of vitamin K from the oxidized form of the vitamin. The enzyme activity was not detected when intact microsomes were employed as the enzyme source, but the solubilization of the microsomal enzyme with 1.5% Triton X-100 caused a development of the activity. Although the enzyme activity decreased gradually with time after the solubilization, the enzyme was stabilized by the addition of 20% glycerol and 2 mM vitamin C. Some optimal assay conditions for the vitamin K reductase were determined using the solubilized enzyme, and the standard assay method is described. Vitamin K reductase activity was not affected by warfarin and N-ethylmaleimide (NEM), but pyridoxal-5 phosphate (PAL-P) inhibited the activity, especially when microsomes were preincubated with PAL-P. The enzyme activity was not inhibited by N methyltetrazolethiol (NMTT) and NMTT-containing antibiotics, suggesting that the hypoprothrombinemia caused by beta-lactam antibiotics was not due to the inhibition of NADH-dependent vitamin K reductase. PMID- 2770054 TI - Central effects of the neurotropic mycotoxin fumitremorgin A in the rabbit (I). Effects on the spinal cord. AB - Effects of a potent neurotropic mycotoxin, fumitremorgin A (FTA), on the spinal cord were studied, using rabbits lightly anesthetized with urethane and chloralose. Spontaneous discharges of L7 spinal ventral roots and common peroneal nerves were increased after intravenous injection of 100-200 micrograms/kg of FTA. Their abnormal discharge pattern represented the convulsive effect of FTA. Spinal monosynaptic reflexes became irregular in amplitude, with a slight predominance of smaller reflexes. Polysynaptic reflexes were inhibited in many cases. These FTA-induced changes in ventral root discharges and spinal reflexes were abolished by spinal transection at a segment of the upper level. These results suggest that FTA may have no direct facilitatory action on spinal motoneurons and that its remarkable motor effect has its origin in the supraspinal central nervous system. PMID- 2770055 TI - Enhancement of ambulation-increasing effect of methamphetamine by peripherally administered 6R-L-erythro-5,6,7,8-tetrahydrobiopterin (R-THBP) in mice. AB - Behavioral effects of 6R-L-erythro-5,6,7,8-tetrahydrobiopterin (R-THBP), a co factor for tyrosine hydroxylase and tryptophan hydroxylase, were investigated by means of ambulatory activity in mice. Single administration of R-THBP (50 and 100 mg/kg, s.c.) showed no significant effect on the mouse's ambulatory activity for 5 hr. The ambulation-increasing effect of methamphetamine (2 mg/kg, s.c.) was dramatically enhanced and prolonged by the pretreatment with R-THBP (100 mg/kg, s.c.) 0, 2, 6, 12 and 24 hr before, but not 18 or 36 hr before, the methamphetamine administration. However, when combined administration of R-THBP (100 mg/kg, s.c., 2 hr before) with methamphetamine (2 mg/kg, s.c.) was repeated at intervals of 3-4 days, the enhancement by R-THBP of the methamphetamine effect was observed only in the 1st and 2nd administration, but not in the later administration. The pretreatment with R-THBP (100 mg/kg, s.c., 2 hr before) enhanced the ambulation-increasing effect of ephedrine (80 mg/kg, i.p.), but failed to modify those of cocaine (20 mg/kg, s.c.), mazindol (2.5 mg/kg, s.c.), bromocriptine (8 mg/kg, i.p.), morphine (20 mg/kg, s.c.) and scopolamine (0.5 mg/kg, s.c.). It is noteworthy that R-THBP differentially modifies the ambulation increasing effect of the above-mentioned drugs. PMID- 2770056 TI - Effect of oxitropium bromide (Ba253) on isolated respiratory smooth muscle and release of chemical mediators from passively sensitized lung fragments. AB - The effect of oxitropium bromide (Ba253), a quaternary scopolamine derivative, on the resting tonus and agonist-induced contraction of isolated guinea pig airway smooth muscle and on the anaphylactic release of histamine and immunoreactive leukotrienes (i-LTs) from lung fragments were investigated and compared with those of Sch1000, atropine and isoproterenol. Ba253 dose-dependently inhibited the acetylcholine (ACh)-induced contraction of the isolated trachea and lung parenchyma. The degree of inhibitory potency was similar to that of Sch1000 and 10 times higher than that of atropine. Ba253 minimally influenced the resting tonus or contractions induced by other agonists including histamine, serotonin and LTD4. Sch1000 and atropine had similar or slightly stronger inhibitory effects on the tonus and contractions than Ba253. On the other hand, low concentrations of isoproterenol solely relaxed the resting tonus and inhibited the the agonist-induced contractions of both preparations. Neither Ba253 nor Sch1000 inhibited the anaphylactic release of histamine and LTs from both guinea pig and human lung fragments, but both mediator releases from either species were slightly inhibited with dose-dependency by atropine and potently inhibited by isoproterenol. From these results, it is suggested that Ba253 is a relatively specific antagonist to cholinergic receptors and might be possibly effective as an inhalant for asthma. PMID- 2770057 TI - 1H-NMR studies of calmodulin: the character of the calcium binding sites. AB - The effects of various divalent cations on the Ca2+-binding sites of calmodulin were observed by 400 MHz 1H-NMR. The first and second Ca ions bound to sites III and IV (stage I), while the third and fourth bound to sites I and II (stage II). Zn2+, Hg2+ and Mn2+ bound to the first and third Ca2+-binding sites, but not to the second and fourth. Zn2+, Hg2+ or Mn2+ could bind to the first Ca2+-binding site by themselves and could bind to the third site only after the conformational change which occurs when two Ca2+ ions bind to first and second sites. Although Mg2+ did not bind to the first, second or fourth Ca2+-binding sites, it did bind to the third site. These results suggest that the order of Ca2+-binding and the order of affinity of the binding sites are not parallel; the first and third Ca2+ binding sites have high Ca2+-affinity, with the third being highest, whereas the second and fourth sites are of lower affinity. Also, we suggest in this study that the first and second sites are exposed on the surface of the protein, while the third and fourth ones are buried in the interior; the latter are exposed by the conformational change accompanying the binding of calcium to the first and second sites. Furthermore, the form of the interface by which calmodulin binds to target enzyme was altered slowly and continuously by the calcium-induced conformational change. The target enzyme was chosen and bound selectively to calmodulin among various enzymes by each interface form. PMID- 2770058 TI - Preventive effect of taurine against acute paraquat intoxication in beagles. AB - The continuous infusion of taurine markedly protected against paraquat (PQ) induced oliguria in beagles. Pharmacokinetic studies revealed that taurine infusion increased the blood concentration of PQ and reduced the net content in the kidney and, to a lesser extent, in the lung. The excretion of PQ into the urine was unaltered. The infusion of glycine did not have such effects. PMID- 2770059 TI - Effects of diltiazem on plasma uric acid level and renal uric acid excretion in rats. AB - The effects of diltiazem on plasma uric acid level (PUA) and renal uric acid excretion were investigated in oxonate-loaded rats. Diltiazem (0.5 mg/kg, i.v.) decreased PUA without producing uricosuria, and it decreased fractional excretion of uric acid and renal blood flow. The present results suggest that diltiazem produces hypouricemia not accompanied by uricosuria, probably by affecting uric acid metabolism, and it may also cause an alteration in the renal handling of uric acid partly due to changes in renal hemodynamics. PMID- 2770060 TI - Reversed effects between crude and processed ginger extracts on PGF2 alpha induced contraction in mouse mesenteric veins. AB - The effects of crude and processed ginger extracts and pungent components, S-(+) [6]-gingerol and [6]-shogaol, on noradrenaline (NA)- and prostaglandin (PG) F2 alpha-induced contraction were investigated using mouse mesenteric veins. Both spicy constituents inhibited the contractile responses to NA. Crude ginger extract and S-(+)-[6]-gingerol potentiated the PGF2 alpha-induced contraction, whereas processed ginger extract and [6]-shogaol inhibited the contraction. PMID- 2770061 TI - Cerebral vasospasm model produced by subarachnoid blood injection in dogs. AB - Subarachnoid hemorrhage (SAH) was simulated in dogs by injecting blood into the cisterna magna. Time-dependent development of spasm of the basilar artery was angiographically determined. One week after SAH, the diameter of the basilar artery decreased by 15.5 +/- 5.4% and 46.4 +/- 3.0% in the single and double injection model, respectively. Thereafter, the artery diameter gradually returned to normal. The time course of diameter changes in the double injection model resembles that seen in the clinical setting, and the double injection model seems to be useful for the experimental study of cerebral vasospasm. PMID- 2770062 TI - Potentiation of cisplatin-induced lipid peroxidation in kidney cortical slices by glutathione depletion. AB - Effects of cis-diamminedichloroplatinum II (cisplatin), an antitumor agent with a dose-limiting effect of nephrotoxicity, on lipid peroxides and glutathione (GSH) were examined in rat kidney cortical slices treated with or without diethylmaleate (DEM), a GSH depletor, in vitro. DEM (3 mM) decreased the GSH level to about 16% of the control with a concomitant increase in lipid peroxides after 90 min of incubation. The same effects were obtained with 1 mM cisplatin 90 min later. Cisplatin (1 mM) with DEM (2 mM) stimulated both the decrease in GSH and the increase in lipid peroxides 90 min after incubation. However, cisplatin with DEM markedly stimulated lipid peroxidation with a small effect on the GSH decrease by cisplatin alone 30 min after incubation, while each drug by itself did not affect lipid peroxidation. The antioxidants N,N'-diphenyl-p-phenylene diamine (DPPD), promethazine, and ascorbic acid abolished cisplatin-induced lipid peroxidation in the presence of DEM. DPPD had no effect on the depletion of GSH caused by cisplatin and DEM. Ascorbic acid and promethazine caused only a slight return towards the control level. The results suggested that cisplatin-induced lipid peroxidation is due to another mechanism in addition to the GSH depletion caused by the antitumor drug. PMID- 2770063 TI - [Improvement of operative result of Stanford type A aortic dissection]. AB - 21 cases of Stanford type A aortic dissection (15 acute and 6 chronic) were treated with or without surgery in the last 38 months. Out of seven cases who were admitted before October, 1986, three cases were treated medically and all died suddenly within 30 days. The remaining four cases were operated upon as emergency with only one survival. Extensive hemorrhage was the cause of operative deaths. After November 1986, substantial reduction in hospital mortality (one death in eight acute cases) was accomplished by the following strategy for acute aortic dissection, i.e., (1) urgent operative intervention for cases with cardiac involvement, and initial medical treatment followed by elective operation at chronic stage for those without cardiac involvement, (2) routine use of open distal anastomosis, (3) preferential adoption of simple surgical intervention limited to the ascending aorta. There was no operative death in six chronic cases in spite of more extensive approach. These results suggest that the strategy mentioned above is reasonable in treatment for Stanford type A dissecting aneurysm. PMID- 2770064 TI - [Direct arrhythmia surgery in ventricular tachycardia: an experience with 18 consecutive patients]. AB - 18 patients with ventricular tachycardia (VT) underwent direct arrhythmia surgery between 1984 and 1988. There were 8 patients with ischemic VT, and 10 with nonischemic VT. Operative technique consisted of ablative procedures of the arrhythmogenic area determined by pre- and intraoperative mapping. Induced VT was usually unstable and transient during operation, so that instantaneous multi point mapping was necessary in almost cases. For VT originated in the left ventricle or interventricular septum, the earliest excitation point determined by the epicardial mapping did not always predict the endocardial arrhythmogenic focus. Pre- and/or intraoperative endocardial mapping was important in this regard. Cryocoagulation (-150 degrees C, 120 sec) was mainly used as an ablative procedure; for ischemic VT, endocardial resection was added, and in nonischemic VT originated in the right ventricular outflow tract, transmural resection was combined with the cryoablation. In performing surgery for nonischemic VT, care must have been taken to make transmural cryocoagulation because the arrhythmogenic focus could exist intramurally. There were no operative deaths. In one patient with nonischemic VT, reoperation was required. After a mean follow-up of 17 month, all the patients are free from sustained VT. PMID- 2770065 TI - [Traumatic diaphragmatic hernia]. AB - Five cases of traumatic diaphragmatic hernia were reported and 495 cases reported in Japan were reviewed. Analysis of cases of hernia following blunt trauma in the present study provided a simple classification of fissure of the diaphragm, i.e., "tension type (indirect type)" and "impact type (direct type)". In the former type, the fissure occurs in the central tendon or its vicinity in the diaphragm as a result of distortion of the bony thorax without direct force on the diaphragm, while in the latter type, the fissure occurs in the diaphragm close to the struck bony thorax as a result of blunt force on the bony thorax to which the diaphragm is attached. PMID- 2770066 TI - [Pulmonary valve replacement using the right ventricle-pulmonary artery bypass without cardiopulmonary bypass]. AB - We underwent pulmonary valve replacement using the right ventricule pulmonary artery bypass without cardiopulmonary bypass. This right heart bypass was consisted of the vascular graft and the polystyrene tube. The vascular graft was anastomosed to the main pulmonary artery and the polystyrene tube was inserted into the free wall of the right ventricle. These were connected with a cannulating magnetic flow probe. After the bypass was established, the pulmonary artery was clamped and divided. The pulmonary valves were excised and the pulmonary valve replacement was undergone with a pulmonary valve homograft. Hemodynamics during the pulmonary valve replacement was stable and the postoperative course was uneventful. One month later, the cardiac catheterization and cineangiography showed that the implanted homograft was effective sufficiently. We concluded that this right heart bypass was useful for the pulmonary valve replacement. PMID- 2770067 TI - [The value of recent non-invasive medical imagings in diagnosis of dissecting aortic aneurysm; further investigation on transesophageal echocardiography and MRI]. AB - The value of non-invasive medical imagings in diagnosis of dissecting aortic aneurysm was evaluated in 23 patients by two-dimensional transesophageal echocardiography (TEE) and in 23 patients by MRI. An intimal flap was demonstrated in all 23 cases by TEE and in 21 of 23 cases (91.3%) by MRI. DeBakey type classification could be recognized in 20 of 23 cases (87.0%) by TEE and in 21 of 23 cases (91.3%) by MRI. The entry of aortic dissection could be identified in 20 of 23 cases (87.0%) by TEE in 9 of 23 cases (39.1%) by MRI. The differentiation between true and false lumen could be performed in all 23 cases by TEE and in 21 of 23 cases (91.3%) by MRI. The capability of TEE to visualize the lesion of descending aorta was superior to any other conventional diagnostic method, however, there were difficulties in scanning the distal part of the ascending aorta and aortic arch. MRI could not detect the small lesion such as entry in almost all cases, but was superior in diagnosis of the lesion of aortic arch and in recognition of the whole imagings. Since transthoracic echocardiography has an additional value in diagnosis of dissecting aortic aneurysm, the diagnostic method of a combination of transthoracic and transesophageal echocardiography seems to be more valuable. We believe that operation could be carried out solely on the basis of diagnosis of dissecting aortic aneurysm by echocardiography in emergency cases. PMID- 2770068 TI - [Tricuspid valve replacement in the true annulus of Ebstein's anomaly without involvement of atrioventricular conduction disturbance]. AB - Two female patients with Ebstein's anomaly, aged 12 and 45 years, underwent new procedures of tricuspid valve replacement in the true annulus without involvement of atrioventricular conduction disturbance. The first patient had a relatively small atrialized right ventricle. A Dacron patch was sutured on the atrialized portion from the right ventricular side. Buttress stitches were placed on the whole of the atrialized ventricle except at the part of the His' bundle. A porcine valve was sutured in the true annulus of the tricuspid valve and on the top of the patch. The second patient had a fairly large atrialized ventricle, and plication was made only in the inferior part of the atrialized ventricle form the coronary sinus. A porcine valve was sutured in the true tricuspid annulus except at the part of Koch's triangle, where the porcine valve was placed on the false annulus. PMID- 2770069 TI - [A case of two staged operation of pericardial abscess after left-ventricular aneurysmectomy]. AB - A 54-year-old man who had undergone the left ventricular aneurysmectomy and double saphenous vein bypass grafting for the old myocardial infarction suffered from the pericardial abscess 6 years after the first operation. He was operated upon the persistent drainage of the lesion and returned to his daily life. Two years after the 2nd operation, he recognized pulsatile bleeding from the fistula and was admitted to our hospital. He underwent the radical operation for the cardio cutaneous fistula under the cardiopulmonary bypass. The post operative course was uneventful and he has continued to do well. We discussed the treatment for this kind of complication and stressed the limited usage of Teflon felt and other artificial materials. PMID- 2770070 TI - [Successful surgical treatment of patent ductus arteriosus with severe pulmonary hypertension using temporary long external bypass in an adult]. AB - A 22-year-old man with patent ductus arteriosus with severe pulmonary hypertension was operated upon successfully. The operation, trans-aortic direct closure of ductus, was done using temporary long external bypass. Postoperative course was uneventful, and the patient is now well 6 years and 8 months after operation. Postoperative cardiac catheterization revealed decreased pressure of pulmonary artery from 116 to 44 mmHg. The details of the operative procedure and postoperative course were described and a brief review of literatures was also done. PMID- 2770071 TI - [Complete occlusion both left main coronary artery and right coronary artery]. AB - A 67-year-old man, who had complete occlusion both of left main coronary artery (LMCA) and right coronary artery (RCA), underwent coronary revascularization. He had been suffering from severe angina pectoris preoperatively. Exercise electrocardiogram (single Master) showed myocardial ischemia. On cardiac catheterization, he showed extensive collaterals from right main coronary artery, and well-preserved left ventricular function. At operation, coronary arteries revealed severe sclerosis, especially in RCA, but there was no evidence of old myocardial infarction. Three saphenous vein grafts were bypassed to LAD, LCX, and RCA. Postoperatively, he remained free of angina pectoris at 6 months after uneventful surgery. PMID- 2770072 TI - [A case report of successful surgical treatment of fungal endocarditis]. AB - A successfully treated case of fungal endocarditis for native aortic and mitral valves was reported. A 56-year-old male was admitted with high fever, dyspnea on exertion and oliguria. Infective endocarditis, urinary tract infection and acute renal failure were most suspected by findings of physical examination and urinalysis, but repeated blood cultures were sterile. In the course of treatment for urinary tract infection, high fever and leucocytosis recurred and then blood cultures were positive for Candida parapsilosis. Despite intensive antifungal therapy, blood cultures were consistently positive for Candida parapsilosis. Echocardiogram showed vegetation on the aortic and mitral valve. Aortic and mitral valve replacements with prosthetic heart valves were carried out on April, 1986. Cultures of the vegetation on the mitral valve revealed Candida parapsilosis. Intensive administration of antifungal drug was done postoperatively. Postoperative course was uneventful and he was discharged in excellent condition on the 84th postoperative day. During follow-up period of 1 year, the patient has been doing very well and there were no sign of recurrence of fungal infections. PMID- 2770073 TI - [Scimitar syndrome with left pulmonary hypertension and right pulmonary artery stenosis in childhood--report of a case of successful surgical repair]. AB - An one-year old child with Scimitar syndrome (anomalous drainage of the right pulmonary vein to inferior vena cava with right lung hypoplasia) associated with left side pulmonary hypertension and right pulmonary artery stenosis underwent surgical repair. The anomalous pulmonary vein was anastomosed to right atrium with 10 mm PTFE graft interposition and drained to left atrium through equine pericardial intra-atrial baffle. The stenotic portion of right pulmonary artery was enlarged with porcine pericardial patch. To our knowledge, this is the first successful surgical case of Scimitar syndrome with pulmonary hypertension in childhood reported in literature. A repair of anomalous pulmonary venous drainage to inferior vena cava in childhood is difficult, and a meticulous selection of surgical procedure is necessary. PMID- 2770074 TI - [Use of electric cardiac stimulation in patients with Kearns syndrome]. PMID- 2770075 TI - [A case of cardiac tamponade and pneumothorax during electric cardiac stimulation]. PMID- 2770076 TI - [Diagnosis of familial hypercholesterolemia by a method of determining the number of low-density lipoprotein receptors on the fibroblasts]. PMID- 2770077 TI - [Morphologic changes of the heart conduction system in the late period after transvenous electrodestruction of the atrio-ventricular junction]. PMID- 2770078 TI - [Adverse effects of anti-arrhythmia drugs: possibilities of their prevention and correction]. PMID- 2770079 TI - [Nifedipine pharmacokinetics in patients with exertion-induced stenocardia after its single and long-term administration]. AB - A study of the causes of tolerance to antianginal effect of nifedipine++, conducted in 12 patients with angina of effort, examined serum pharmacokinetics of nifedipine++ and its primary metabolite (puridine analogue of nifedipine++), after a single 20 or 30 mg dose and at the end of a treatment course (20-40 mg 3 4 times daily for 2 to 6 months). In addition, the effect of nifedipin treatment on nonspecific microsomal hepatic oxidase activity was assessed by means of the antipyrin test. Pharmacokinetics of both unchanged nifedipin and its primary metabolite showed no change through the nifedipin course, suggesting that tolerance to the antianginal effect of nifedipin may be based on altered systemic pharmacologic response rather than altered pharmacokinetics of nifedipin. Nifedipin treatment caused no induction or inhibition of nonspecific microsomal hepatic oxidase activity in the patients so the drug may be expected to have no substantial effect on pharmacokinetics, and hence, efficacy, of combined drugs that are eliminated by oxidation inside the liver. PMID- 2770080 TI - [Changes in central hemodynamics and gas exchange after a single and scheduled administration of obsidan in patients with exertion-induced stenocardia and various types of blood circulation]. AB - Sixty-two patients with angina of effort and different circulation types were investigated to assess the pattern of changes in hemodynamics and gas exchange following an acute obsidan test and a course of obsidan treatment. A relationship was demonstrated between the effect of obsidan on central hemodynamics and gas exchange, on the one hand, and the baseline circulatory type, on the other. In patients with hyper- and eukinetic circulation, the drug increased the maximum oxygen uptake and total performance volume in the presence of a variety of hemodynamic changes; such as the negative inotropic and chronotropic effects in the hyperkinetic-type patients, and the negative chronotropic effect in the eukinetic-type ones. In hypokinetic-type patients, the drug had no effect on hemodynamics. The lack of changes in physical working capacity parameters was due to a shift in the conditions of stress exposure towards anaerobic metabolism. A correlation was demonstrated between changes in some hemodynamic and gas exchange parameters following both a single dose and a treatment course of obsidan. PMID- 2770081 TI - [The rate of formation of necrotic focus and the severity of clinical picture in the acute period of myocardial infarction]. AB - The relationship between necrotic focus characteristics (weight and rate of necrotization) and the clinical pattern of myocardial infarction was examined. Necrosis weight was shown to have no significant effect on the course of myocardial infarction, while maximum necrotization rate was found to be a valuable predictive factor: the higher the necrotization rate, the higher the risk of fatal outcome and various complications. Prognosis, based on necrotization rate and patient's age, can be made, using an equation, derived for early prediction of myocardial infarction outcome. PMID- 2770082 TI - [General and regional functions of the right ventricle in idiopathic ventricular arrhythmias]. AB - Various aspects of the diagnosis of idiopathic ventricular arrhythmias, seen in cases where no heart changes can be detected by noninvasive investigation are discussed. Total and regional right-ventricular myocardial activity was assessed in 10 patients with moderate idiopathic right-ventricular arrhythmias. All patients underwent electrophysiologic investigation with endocardial mapping and right ventriculography. In 9 cases, biopsy from unexamined arrhythmogenic zones was taken intraoperatively for histologic studies. Arrhythmogenic foci were located in the right-ventricular outflow department in most cases of idiopathic ventricular arrhythmias. The outflow and inflow right-ventricular departments commonly demonstrated regional myocardial dysfunctions and disordered sequence of contractions of the appropriate myocardial portions during intermediate intervals of the ejection phase. PMID- 2770083 TI - [Atrial fibrillation in alcoholic lesion of the heart]. AB - Sixty chronic alcoholic patients, aged 35.6 +/- 0.7 years and an average alcoholic history of 9.3 +/- 0.5 years were examined. Atrial fibrillation was detected at 24 h ECG monitoring in 2 (3.45%) patients, and paroxysms of atrial fibrillation or flutter were detected by intracardiac electrophysiologic investigation in 6 (22.2%). Fourteen (44.8%) patients with alcoholic heart damage demonstrated atrial vulnerability, indicative of a predisposition to atrial fibrillation even at earlier stages of alcoholic heart damage. PMID- 2770084 TI - [ECG changes in subarachnoid hemorrhage of non-traumatic origin]. AB - The assessment of ECG in patients with nontraumatic subarachnoid hemorrhages demonstrated 5 characteristic patterns of ECG change. They were shown to be secondary to cerebral pathology. Preoperative heart rhythm changes are not stable or life-threatening, whereas intraoperative arrhythmias, high-grade ventricular extrasystoles in particular, may prove fatal. Preoperative ECG changes, including "pseudoinfarction" ones, do not affect cardiac output or arterial blood pressure, so that no special treatment is required, nor is surgery contraindicated. PMID- 2770085 TI - [Diagnosis of ischemic heart disease based on the data of precordial mapping]. AB - To improve the efficiency of electrocardiographic diagnosis of coronary heart disease, a search for new meaningful ECG parameters has been carried out, using precordial mapping and automated analysis of the maps. The study included 95 coronary patients, whose diagnosis was verified by visual techniques (coronaroangiography and left ventriculography). ECG-12 showed no signs of past focal/scarry lesions in any of the patients, and detected ischemic changes in 23% only. A group of 95 normal subjects was taken as controls. A classifying function was constructed, using mathematical procedures, stepwise discriminant analysis in particular. Used for the diagnosis of coronary disease, it yielded an 83% sensitivity and an 85% specificity. PMID- 2770086 TI - [Current possibilities of bloodless quantitative evaluation of the pumping function reserve of the heart based on the study of oxygen consumption during the treadmill test]. AB - Estimations of minute circulation volume (MCV) and the recovery coefficient (RC) as a parameter of oxygen debt were compared during the treadmill test in 83 cardiologic patients and 32 normal subjects in order to assess their pumping activity. At every stage of exercise, MCV was calculated on the basis of oxygen uptake, using Hossak's formula. MCV values were similar in the patients and normal subjects at similar stages of the treadmill test, and in patients belonging to different severity classes. RC variation was, on the contrary, different and depended on the magnitude of hemodynamic disorders: as pumping insufficiency developed, there was an abrupt drop in RC. A method is proposed for the quantitative assessment of pumping functional reserve on the basis of the ratio of oxygen uptake (at the stage where RC change occurred) to the maximum achievable by a normal subject of the same age, sex and body weight. PMID- 2770087 TI - [Value of pharmacokinetic studies in cardiology]. PMID- 2770088 TI - [Normal indicators of spiroergometry in young persons]. AB - The stepwise bicycle ergometric test was conducted in 57 normal untrained individuals (30 females and 27 males) in order to estimate their maximum oxygen uptake. To make the results more reliable, individual variations in subjects' maximum working capacity should be considered. Cardiac stroke volume was shown to be different at the peak of exercise. The same stress capacity, shown in a heterogeneous sample, may be indicative of both normal and abnormal conditions, or signify different functional classes. PMID- 2770089 TI - [Effects of tetrodotoxin and verapamil on abnormal ventricular activity at the late stage of experimental myocardial infarction in dogs]. AB - An in situ experimental study of the heart has demonstrated that verapamil++ (0.3 mg/kg), administered intravenously to dogs with complete transverse heart block one day after two-step occlusion of the left descending coronary artery either produced a 15-30% drop in the incidence of abnormal ventricular activity (AVA) in some experiments, or had no effect on the latter in others. Tetrodotoxin (3 micrograms/kg) produced a 20-44% drop in AVA in all experiments. Combined administration of 0.2 mg/kg verapamil++ and 2 micrograms/kg tetrodotoxin completely suppressed AVA. At an early phase of its development (5-10 hours after the occlusion of the left descending artery), AVA was completely suppressed both by 0.3 mg/kg verapamil and 3 micrograms/kg tetrodotoxin. Mechanisms of AVA and its progress following coronary-artery occlusion in dogs are discussed. PMID- 2770090 TI - [Changes in systemic and regional hemodynamics in the acute period of myocardial infarction in conscious rabbits]. AB - Systemic and regional hemodynamics (radioactive microspheres of 15 mcm) were studied in 7 conscious immobilized rabbits 30 min, 24 and 72 hours after left coronary artery occlusion (group 1) and 30 min and 24 hours after the occlusion in 5 rabbits who died the next day (group 2). Significant changes in myocardial blood flow, white cerebral matter and kidneys were only observed 24 h after coronary artery occlusion in group 2, simultaneously with a significant (29%) decrease in cardiac output. It is suggested that significant regional blood flow changes associated with acute experimental myocardial infarction only occurred in the presence of heart failure in rabbits. PMID- 2770091 TI - [Effect of medicinal leech preparations on indicators of atherogenesis]. AB - Medicinal leech salivary gland secretion, administered intravenously to rats on an atherogenic diet, reduces fibrinogen level and plasma heparin tolerance and diminishes lipid deposits in the intima of large vessels. Long-term chronic oral administration of dried medicinal leech powder to rats, kept on an atherogenic diet, reduces the area of local edema in the intima of large vessels, although blood lipid composition, fibrinogen level and plasma heparin tolerance remain basically unchanged, as compared to respective values in the control animals. The salivary gland secretion reduces the 3H-thymidine incorporation into the human atherosclerotic intimal cell culture. PMID- 2770092 TI - [Morphofunctional study of the myocardium in alcoholic intoxication]. AB - An experimental model of acute and chronic ethanol poisoning is described. Electrocardiographic and morphologic changes in the hearts of white rats, exposed to alcoholic intoxication, have been assessed. Typical ECG features as well as muscle-cell and neuron ultrastructure have been identified, so that they could be used for morphologic and functional assessment of alcoholic poisoning. PMID- 2770093 TI - [Prognosis of the course of ischemic heart disease in patients with a history of macrofocal and transmural myocardial infarction in relation to the degree of blood pressure in the pulmonary artery]. PMID- 2770094 TI - [Clinico-biochemical equivalent of stromal destruction in acute myocardial infarction]. PMID- 2770095 TI - [Transesophageal electric cardiac stimulation: discomfort and impulse parameters]. PMID- 2770096 TI - [Experience using transesophageal electric cardiac stimulation under ambulatory conditions]. PMID- 2770097 TI - [Possibilities of echocardiography in epidemiologic studies]. PMID- 2770098 TI - [The role of thyroid hormones and prolactin in the development of disorders of arterial blood pressure in girls 11-12 years of age]. PMID- 2770099 TI - An in vivo study of voltage-dependent renal tubular acidosis induced by amiloride. AB - It has been proposed that most forms of hyperkalemic distal renal tubular acidosis (dRTA) result from a voltage-dependent acidification defect in the cortical collecting tubule (CCT) in which hydrogen and potassium secretion are decreased secondary to a reduced, transepithelial potential difference (PD) arising from impaired sodium reabsorption. The present in vivo study examines one model of hyperkalemic dRTA, induced by chronic amiloride administration, to examine the relationship between urinary excretion of hydrogen and potassium ions and CCT PD in the rat kidney. Chronic administration of amiloride produced a significant metabolic acidosis with a plasma bicarbonate of 21.3 mmol/liter compared to 25.9 mmol/liter in control rats. Plasma potassium was higher in experimental animals (4.9 mmol/liter vs. 3.3 mmol/liter in controls) and was associated with a significantly reduced fractional excretion of potassium of 11.2% versus 37.4% in controls. When animals were loaded with DOCA and infused with 4% sodium sulphate to maximize urine acidification, urine pH was significantly higher in the experimental group (6.35 vs. 5.55 in controls) while the mean PD in cortical collecting tubules was markedly lower at -21.1 mV versus 58.9 mV in controls. These results support a voltage dependent mechanism to explain the defect in hydrogen and potassium ion secretion induced by amiloride. PMID- 2770100 TI - Visualization of renal autoregulation in the split hydronephrotic kidney of rats. AB - The autoregulatory ability of the renal vascular system in the split hydronephrotic kidney was quantitated with intravital microscopy. The luminal diameters of the arcuate and interlobular arteries as well as the afferent and efferent arterioles were measured. Glomerular blood flow was determined by the dual slit technique. In the first series of experiments, the renal perfusion pressure was reduced by graded clamping of the abdominal aorta. Pressure reduction from 118 mm Hg to 95 mm Hg induced dilation of all preglomerular vessels except for the distal afferent arteriole; there was no change in the efferent arteriole and the blood flow was maintained. Further pressure reductions to 71 and 43 mm Hg caused additional dilations of the preglomerular vessels, a marginal reduction in diameter of proximal efferent arterioles and flow reductions by 15% and 41%, respectively. In the second series, systemic blood pressure was increased by continuous i.v. infusions of norepinephrine (NE). NE constricted pre- and postglomerular vessels except for the distal afferent arteriole; glomerular flow was decreased. Reduction of renal perfusion pressure during NE infusion to the preinfusion value did not diminish glomerular blood flow, but reduced the constrictor response to NE in preglomerular vessels. In a third series of experiments we examined the effect of atrial natriuretic factor (ANF) on renal autoregulation. Addition of ANF (10(-9) to 10(-7) M) to the renal bath induced a dose-dependent dilation of all preglomerular vessels and a constriction of the efferent arteriole. Pressure reduction from 120 to 95 mm Hg resulted in a further preglomerular vasodilation. These experiments demonstrate that autoregulation is mediated primarily by diameter changes in all preglomerular vessels excluding the distal segment of the afferent arteriole. Further, these data suggest that ANF induced dilation of preglomerular vessels does not impair the myogenic response of these vessels. PMID- 2770101 TI - Interactions of low density lipoprotein with rat mesangial cells. AB - Hyperlipidemia may contribute to the pathogenesis of glomerular sclerosis. We therefore studied binding and uptake of low density lipoprotein (LDL) by cultured rat mesangial cells. In addition effects of LDL on PGE2 synthesis and cell proliferation were determined. At 4 degrees C mesangial cells bound [125I] LDL in a time- and concentration-dependent manner with half-maximal binding observed at 5 micrograms/ml of LDL protein. Binding was blocked by excess unlabeled LDL and by heparin. Uptake (binding plus internalization) of LDL at 37 degrees C markedly exceeded binding at 4 degrees C, continued to increase even with longer periods of incubation, and showed no saturability, consistent with uptake of LDL by mesangial cells. Further evidence for LDL uptake by mesangial cells was obtained by use of the fluorescent probe 1,1'-dioactadecyl-3,3,3', 3' tetramethylindocarbocyanine perchlorate-labeled LDL (Dil-LDL). Incubation of mesangial cells with Dil-LDL at 37 degrees C showed positive fluorescence for all mesangial cells, indicating uptake of the Dil-LDL. LDL had a biphasic effect on mesangial cell proliferation as determined by [3H] thymidine incorporation. LDL at 10 micrograms/ml enhanced [3H] thymidine uptake modestly, but significantly, whereas a progressive and marked inhibition occurred at LDL concentration from 100 to 500 micrograms/ml. While LDL at 10 and 100 micrograms/ml significantly stimulated PGE2 production, inhibition of PGE2 by meclofenamate did not influence the effects of LDL on [3H] thymidine incorporation. We conclude that mesangial cells show specific binding and uptake of LDL and that high concentrations of LDL markedly decrease mesangial cell proliferation. These findings may pertain to the pathogenesis of glomerular lesions in hyperlipidemia of renal disease. PMID- 2770102 TI - Glomerular hemodynamics in cyclosporine nephrotoxicity following uninephrectomy. AB - Experiments were performed to determine the cause of the reduced glomerular filtration rate (GFR) in cyclosporine nephrotoxicity during compensatory renal growth. Sprague-Dawley rats were uninephrectomized and given daily injections of cyclosporine (30 mg/kg, i.m.) or vehicle (olive oil), and studied 7 or 14 days later. In cyclosporine treated rats GFR was lower seven days (1.34 +/- 0.10 vs. 1.68 +/- 0.07 ml/min) and 14 days (1.19 +/- 0.08 vs. 1.58 +/- 0.04, P less than 0.025) following uninephrectomy. Arterial blood pressure, cardiac output and renal blood flow (RBF) were not different in cyclosporine and control rats. Kidney mass increased to the same extent in cyclosporine and control rats. Micropuncture of the glomerular microcirculation in similarly prepared Munich Wistar rats demonstrated low whole kidney GFR (1.10 +/- 0.07 vs. 1.55 +/- 0.13 ml/min, P less than 0.01), and single nephron GFR (31.07 +/- 2.27 vs. 42.36 +/- 2.47 nl/min, P less than 0.005) in cyclosporine treated rats as compared to controls. Single nephron plasma flow, afferent and efferent arteriolar resistance, the transglomerular hydrostatic pressure gradient, and arterial blood pressure were the same in both groups. The glomerular capillary ultrafiltration coefficient (Kf) was lower in cyclosporine treated rats compared to controls [0.039 +/- 0.002 vs. 0.075 +/- 0.013 nl/(sec.mm Hg), P less than 0.025]. We conclude that in this model of cyclosporine nephrotoxicity the low GFR is caused solely by a reduction in Kf, and that cyclosporine can reduce GFR without causing renal vasoconstriction. PMID- 2770103 TI - CAPD with an amino acid dialysis solution: a long-term, cross-over study. AB - This prospective cross-over study was undertaken to evaluate the safety and efficacy of a 1% amino acid dialysis solution on the nutritional and metabolic changes, plasma amino acid profiles and peritoneal membrane function of patients on CAPD. Six CAPD patients had one exchange a day with two liters of this solution over a six month period. Every month there was a medical examination, anthropometric measurements and dietary inquiry were made, blood biochemistry tests were done. Every three months renal function, peritoneal function, aminograms of plasma and dialysate and nitrogen balance were determined. Data were compared with those obtained one month prior to and three months after withdrawal of amino acid administration. Nitrogen balance, which was negative ( 1.3 g/day) became positive (+3.1 g/day). Patients who were already overweight increased in weight, both in fat and lean mass. Plasma cholesterol and triglycerides significantly decreased and the amino acid profile moved towards normal; plasma urea levels increased and pH and bicarbonate decreased slightly but significantly (P less than 0.05). Plasma protein concentrations did not change. All the above parameters turned towards basal values when amino acids were discontinued. We conclude that amino acids can be used as osmotic agents for CAPD since they do not cause toxic effects or impair peritoneal membrane function. Moreover, they can help the nutritional status, provided that an increase in weight is prevented and the slight worsening of systemic acidosis is corrected. PMID- 2770104 TI - Plasma and muscle free amino acids during continuous ambulatory peritoneal dialysis. AB - Free amino acids (AA) were determined in plasma and in muscle tissue of 29 patients undergoing continuous ambulatory peritoneal dialysis (CAPD) for 2 to 38 months. Muscle biopsies were taken in the morning after an overnight dwell with 1.36% glucose dialysis fluid. Muscle intracellular water was calculated using the chloride method. The intracellular (ic) and extracellular (ec) concentration and the ic/ec gradient for each AA was calculated and compared with values in matched healthy controls. Most of the essential and several non-essential AA were low in plasma. By contrast, none of the essential AA were low in muscle, and methionine was increased as were ornithine, asparagine, and aspartic acid; however, muscle taurine was markedly reduced. The ic/ec gradient was increased for most essential and several non-essential AA. In plasma, taurine precursors, methionine and cysteine, were not reduced and the ratios taurine/cysteine and taurine/methionine were low. Muscle taurine/methionine was also low. Thus, during CAPD muscle free AA are, in general, well maintained, suggesting that marked reductions of plasma AA levels in CAPD patients may reflect an ec to ic shift rather than depletion. The finding of low muscle taurine, but normal or increased cysteine and methionine pools, suggests that taurine depletion during CAPD is caused by blocked synthesis or low intake of taurine. PMID- 2770105 TI - Simulations of peritoneal solute transport during CAPD. Application of two-pore formalism. AB - Blood peritoneal clearances of various endogenous solutes in patients undergoing continuous ambulatory peritoneal dialysis (CAPD) were evaluated according to recent developments of the two-pore theory of membrane permeability, using a non linear transport formalism for the analysis. Based on results obtained from these calculations and taking lymphatic drainage into account, transport from peritoneal cavity to the blood was also simulated. With respect to solute transport the data were compatible with a functional blood-peritoneal barrier consisting of a two-pore membrane containing a large number of paracellular "small pores" of radius 40 to 55 A and a small number of "large pores" of radius 200 to 300 A. Solutes smaller than 25 A in radius were found to be permeating across the peritoneal membrane mainly by means of diffusion across the small pores, whereas solutes larger than 40 A were calculated to reach the peritoneal cavity exclusively by unidirectional convection across the large pores. In addition, water was simulated to be transported through transcellular "ultrapores" (radius less than 8 A) not accessible to hydrophilic solute permeation. Small solute absorption from the peritoneal cavity was found to occur by diffusion across small pores. Molecules larger than 25 to 30 A in radius (molecular weight above 25,000) were simulated to be absorbed from the peritoneal cavity exclusively via non-size-selective lymphatic drainage. PMID- 2770106 TI - 87-rubidium NMR: a novel method of measuring cation flux in intact kidney. PMID- 2770107 TI - Pathogenesis and therapy of interstitial nephritis. PMID- 2770108 TI - Early events in ischemic renal failure in the rat: effects of antioxidant therapy. AB - Renal ischemia followed by two hours of reperfusion produces a complex form of acute renal failure characterized by a reduction in nephron filtration rate (SNGFR) and moderate proximal tubular damage. We have examined glomerular hemodynamics, SNGFR and histologic changes after renal ischemia and two hours of reperfusion in untreated (I) rats and rats pretreated with the antioxidant, probucol (IP). SNGFR decreased significantly by 47% in I rats. Reduction in SNGFR was primarily the result of a major decrease in the glomerular capillary hydrostatic pressure gradient, delta P, and a decrease in nephron plasma flow (SNPF). The glomerular ultrafiltration coefficient remained equal to control valves. In IP rats SNGFR was improved to values 89% of control rats due to higher values of delta P and SNPF. Histologic evidence of modest damage to cells of the proximal tubule was equal in both untreated and probucol treated ischemic animals. These studies demonstrate that: (a) primary reductions in nephron filtration rate at the glomerulus result from decreases in delta P and nephron plasma flow; b) pretreatment with the antioxidant, probucol, increases nephron plasma flow and SNGFR, and maintains more normal values for delta P; and c) tubular damage was equivalent in I and IP rats in spite of differences in SNGFR. PMID- 2770109 TI - Cytochalasin B binding to rabbit proximal tubular basolateral membranes. AB - Cytochalasin B binds to the Na+-independent D-glucose transporter in non-renal tissues. We have shown previously that the Na+-independent D-glucose transporter of the rabbit renal proximal tubular cell is localized exclusively in the basolateral membrane. To determine whether cytochalasin B binds to this renal transporter we measured binding of [3H]cytochalasin B to proximal tubular basolateral membranes isolated from rabbit kidneys. A steady state of binding is reached by 15 minutes at 20 degrees C over a concentration range of 0.01 to 50 microM. Non-linear regression analysis of cytochalasin B binding from 0.01 to 20 microM plotted according to Scatchard reveals two classes of binding sites with Kd 5.88 x 10(-8) M, Bmax 16.1 pmol/mg protein; and Kd 5.62 x 10(-5) M, Bmax 2816 pmol/mg protein. [3H]cytochalasin B (0.1 microM) binding to basolateral membranes is a reversible process; it is displacable by excess unlabeled cytochalasin B with a time course similar to binding of [3H]cytochalasin B. Binding of [3H]cytochalasin B is inhibited by 500 mM D-glucose (21%), 2-deoxy-D-glucose (57%) and 3-O-methyl-D-glucose (64%), but not by L-glucose. [3H]cytochalasin B binding is reduced 71% by 0.1 mM phloretin, but only 26% by 0.1 mM phlorizin. Such substrate specificity and inhibitor sensitivity are similar to those previously demonstrated in non-renal tissues by others as well as in rabbit renal proximal tubular basolateral membranes by us. Our data suggest that cytochalasin B binds to the Na+-independent D-glucose transporter or a component of the transporter in the renal proximal tubular basolateral membrane. PMID- 2770110 TI - Adenosine induces mesangial cell contraction by an A1-type receptor. AB - Adenosine is known to decrease renal blood flow and glomerular filtration rate. We have tested the hypothesis that adenosine exerts contractile effects on mesangial cells. Furthermore, we have studied, using selective agonists and antagonists for adenosine, which kind of adenosine receptor, A1 or A2, is mainly implicated in this response. We also investigated whether calcium is involved in adenosine-induced mesangial cell contraction. Rat cultured mesangial cells were exposed to adenosine (10(-7) to 10(-3) M) and the contraction was measured as changes in planar cell surface area (PCSA). Adenosine induced a time- and dose dependent reduction of PCSA. This reduction in PCSA was prevented by incubation with the A1 blocker PD116,948 but not with the A2 blocker PD115,199. Adenosine-5' ethylcarboxamide (NECA), an A2 agonist, did not induce significant changes in PCSA whereas N6-S-1-methyl-2-phenylethyl adenosine (S-PIA), an A1 agonist, induced a dose-dependent decrease in PCSA. Adenosine-induced mesangial contraction was prevented by verapamil or by incubation in a calcium-free medium. These results suggest that adenosine induces a specific contraction of cultured rat mesangial cells that seems to be mediated by its binding to the adenosine A1 type receptor. This contraction seems to be dependent on the influx of extracellular calcium. PMID- 2770111 TI - Gene expression in response to acute unilateral ureteral obstruction. AB - Acute unilateral ureteral obstruction results in differential growth characteristics of both the ipsilateral and contralateral kidney. The obstructed kidney undergoes cellular atrophy following an initial phase of interstitial proliferation while the contralateral kidney hypertrophies. To evaluate the molecular events occurring in both kidneys after obstruction, we examined the expression of growth related (c-fos, c-myc, cH-ras, HSP 70), cell maintenance (beta-actin), and cellular damage (TRPM-2) genes at the mRNA level. In the contralateral kidney an early and transitory induction of c-fos and c-myc expression occurred while a bimodal induction was noted in the obstructed kidney. The patterns of cH-ras, HSP 70 and actin expression also differed in both kidneys. Induction of TRPM-2 was noted only in the obstructed kidney. Rapid gene activation is evident in both the contralateral and obstructed kidney following unilateral ureteral obstruction. The patterns of expression are distinct and may reflect the cellular response to stress (cell death and stromal proliferation) in the obstructed kidney versus a response to a systemic stimulus resulting in cellular hypertrophy in the contralateral kidney. PMID- 2770112 TI - Renal kallikrein mRNA localization by in situ hybridization. AB - Tissue kallikrein gene expression in rat kidney was examined by in situ hybridization histochemistry. A rat tissue kallikrein cDNA probe, 534 bases in length and complementary to the 3' end of kallikrein mRNA was first used in Northern blot analysis to demonstrate the existence of tissue kallikrein mRNA in rat kidney. Then, kallikrein mRNA's localization in rat kidney sections was studied in situ hybridization histochemistry using the same probe. Positive signals were concentrated in the renal cortex at the vascular pole of the glomeruli and to a lesser degree, the distal tubular cells. Prehybridization with the unlabeled probe can abolish the positive signal; the same result can also be achieved by pretreatment of the tissue section with ribonuclease. By using the same technique, tissue kallikrein mRNA was also localized in granular convoluted tubule and striated duct cells of rat submandibular gland. The results suggest a new site of renal kallikrein synthesis at the vascular pole of the glomerulus. These findings, coupled with the previous studies that tissue kallikrein can participate in activation and releasing of renin, raise a potential physiological role of kallikrein in renin release or prorenin processing at juxtaglomerular cells. PMID- 2770113 TI - Intraperitoneal deferoxamine therapy for iron overload in children undergoing CAPD. AB - We treated three children with renal failure and chronic iron overload with intraperitoneal deferoxamine therapy. Each child had an elevated serum ferritin level, a dense liver as measured by computerized tomography (Hounsfield Units) and one had dialysis related porphyria cutanea tarda. Deferoxamine therapy (10 to 17.5 mg/kg) was given in the overnight exchange for three to six months. Prior to therapy, iron was not detected in the dialysate; during the course of therapy, daily dialysate iron removal averaged 5652 micrograms, 2241 micrograms and 4028 micrograms in the three children. The serum ferritin level fell during the course of therapy in two children who were estimated to be in negative iron balance, and was unchanged in the third who was estimated to be in positive iron balance due to frequent transfusions. In 10 children with chronic renal failure, there was a linear correlation (r = 0.855; P less than 0.01) between the serum ferritin and the liver density, suggesting that an increased serum ferritin correlates with hepatic iron content. Interestingly, in each of the three children who received deferoxamine therapy, the liver density increased during therapy regardless of the estimated iron balance and the change in the serum ferritin level. We conclude that intraperitoneal deferoxamine therapy results in substantial iron losses in peritoneal dialysate, can result in negative iron balance but, in this study, did not result in lower liver iron content as measured by density on computerized tomography scan. PMID- 2770114 TI - Pathology of HIV-associated nephropathy: a detailed morphologic and comparative study. AB - Clinical and pathologic findings in the kidneys of 30 consecutive acquired immunodeficiency syndrome (AIDS) autopsies and in 34 consecutive renal biopsies performed on HIV infected patients at our institution between 1983 and 1987 were studied. To determine if the lesions of HIV-associated nephropathy have morphologic specificity, a subgroup of 13 biopsies with a diagnosis of HIV associated nephropathy (HIVN) were compared to 13 biopsies each of heroin associated nephropathy (HAN) and of idiopathic focal segmental glomerulosclerosis (IFSGS) matched for patient age, proteinuria and serum creatinine. A diagnosis of HIVN was made in 1 of 30 (3.3%) AIDS autopsies and 26 of 34 (76.5%) renal biopsies. When compared to HAN and IFSGS, HIVN had more globally "collapsed" glomeruli (P less than 0.001), less glomerular hyalinosis (P less than 0.02), more severe visceral epithelial cell swelling (P less than 0.05), more numerous visceral epithelial cell droplets (P less than 0.002), more prevalent and severe tubular microcystic dilatation (P less than 0.02), and tubular cell degenerative changes (P less than 0.001). Focal glomerular electron-dense deposits were present in 14 of 26 cases. Tubuloreticular inclusions were extremely numerous in glomerular and interstitial capillary endothelial cells as well as in interstitial leukocytes (P less than 0.001). Granular degeneration of nuclear chromatin was present in 10 of 26 cases. Nuclear bodies were more numerous in tubular and interstitial cells of HIVN (P less than 0.01), particularly type 3 (P less than 0.001). Reversal of tissue T4/T8 ratio was observed. We conclude that while no single morphologic feature of HIVN is specific, the combination of clinical and pathologic findings is quite distinctive and permits a presumptive diagnosis of HIVN in otherwise asymptomatic carriers. PMID- 2770115 TI - Desferrioxamine therapy in hemodialysis patients with aluminum-associated bone disease. AB - Aluminum toxicity in dialysis patients is associated with decreased bone turnover and a relative parathyroid hormone (PTH) deficiency. Desferrioxamine (DFO), a chelating agent, has been reported to improve bone histology in aluminum associated, low turnover bone disease in dialysis patients not subjected to parathyroidectomy. Information on the effect of DFO therapy on parathyroid gland function is lacking. In the present study, in addition to changes in bone histology, parathyroid gland function was evaluated in 18 hemodialysis patients with aluminum associated, low turnover bone disease (osteomalacia and aplastic bone disease) before and after one year of DFO treatment (1 to 6 g/week). Parathyroid gland function was assessed by using a calcium free and high calcium (3.5 to 4 mEq/liter) hemodialysis bath.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2770116 TI - Chemical modification of cell proliferation and fluid secretion in renal cysts. AB - We used an in vitro model, MDCK cyst, to determine the extent to which pharmacologic compounds known to inhibit plasma membrane solute transport mechanisms could alter the enlargement of renal epithelial cysts. Solitary MDCK cells cultured within collagen gel undergo clonal growth to form true epithelial cysts in which a single layer of polarized cells (apex toward lumen) encloses a fluid-filled cavity. Repeated observations by light microscopy were used to quantitate the rate of cyst growth in diameter, and demonstrated that cyst enlargement involved an increase in cell number (proliferation) and a net increase in intracystic volume (fluid secretion). Intracyst pressure was greater than the interstitium (6.7 mm H2O +/- 3.1 SD), indicating that fluid entry was secondary to net solute accumulation. Amiloride and seven amiloride analogs that inhibited to different degrees conductive Na+ transport, Na+-dependent H+ transport and Na+-dependent Ca++ transport reversibly decreased the rate of cyst enlargement. The effectiveness of these agents to retard cyst enlargement correlated with their relative potencies to inhibit Na+-dependent Ca++ transport. Morphologic examination indicated that amiloride and amiloride analogs decreased cell proliferation and fluid secretion to the same degree. Ouabain and vanadate (Na+K,ATPase inhibitors), and L-645,695 (Na+-dependent Cl-/HCO3- inhibitor) potently slowed cyst expansion. In contrast to amiloride and amiloride analogs, these agents caused an unusual degree of cellular stratification within the cyst walls, a finding consistent with the notion that fluid secretion was inhibited to a greater extent then cellular proliferation. We conclude that chemical inhibitors of primary and secondary active solute transport can diminish or halt the enlargement of epithelial cysts in vitro by decreasing the rate of cellular proliferation and/or net fluid secretion. PMID- 2770117 TI - Elective total parathyroidectomy without autotransplant in end-stage renal disease. AB - Ten patients are reported following parathyroidectomy (PTX). In 9 all identifiable parathyroid tissue in the neck was deliberately removed, and in the tenth (operated 14 years ago) the remnant which had been left probably did not function. Their post-operative course resembled that of patients treated conventionally, and their subsequent course was likewise uneventful with disappearance of all symptoms associated with their osteodystrophy. All patients required oral calcium supplementation but none were given vitamin D compounds after the initial period of repletion following surgery. Mean serum values were (before PTX and current) for calcium 2.63 +/- 0.14 and 2.33 +/- 0.08 mmol/liter, P = NS, for phosphorus 1.96 +/- 0.13 and 1.38 +/- 0.09 mmol/liter, P less than 0.01, and for alkaline phosphatase 713 +/- 191 and 101 +/- 14 IU, P less than 0.05. Evidence for residual parathyroid tissue was present in each case; one patient remained mildly hyperparathyroid and several were mildly hypoparathyroid by the IRMA PTH assay. Bone histomorphometry in five subjects post-PTX showed either normal or low turnover. Radiologically, striking remineralization was seen with disappearance of all erosive changes. We suggest that residual areas of parathyroid tissue are stimulated and continue to secrete hormone even when all the discrete glands have been removed. It is recommended that when indicated, and in the absence of aluminum excess, total PTX without autotransplant should be the preferred form of therapy for long-term dialysis patients. PMID- 2770118 TI - Elevated production of polymeric and monomeric IgA1 by the bone marrow in IgA nephropathy. AB - In bone marrow cultures of 15 patients with primary IgA nephropathy we found significantly (P = 0.02) increased synthesis of both monomeric and polymeric IgA1 compared to 23 controls, by using high performance liquid chromatography (HPLC) fractionation of culture supernatants. The relative contribution of polymeric to total IgA1 produced was not different for the two groups. Two-color immunofluorescence studies of the percentage of bone marrow IgA1 plasma cells able to bind secretory component in vitro showed no difference between patients and controls. In the sera of patients with primary IgA nephropathy the relative contribution of IgA1 polymers to total IgA1 was also similar to controls. These results indicate that in IgA nephropathy, the increased IgA production in the bone marrow is restricted to the IgA1 subclass. The production of both monomeric and polymeric IgA1 is increased in patients during a quiescent phase of the disease. PMID- 2770119 TI - Analysis of anionic charge of the glomerular basement membrane in aminonucleoside nephrosis. PMID- 2770120 TI - Markedly increased clearance of vancomycin during hemodialysis using polysulfone dialyzers. PMID- 2770122 TI - Abstracts. Dutch Society of Nephrology, 34th scientific meeting. Groningen, The Netherlands, October 15, 1988. PMID- 2770121 TI - Influence of dietary constituents on intestinal absorption of aluminum. PMID- 2770123 TI - Abstracts. Fifth Hellenic Congress of Nephrology. Crete, Greece, June 1-3, 1988. PMID- 2770124 TI - [Purulent meningitis in childhood caused by Haemophilus influenzae with ampicillin and chloramphenicol resistance]. AB - A report is given on two children suffering from meningitis caused by ampicillin- and chloramphenicol-resistent Haemophilus influenzae. Since effective therapy has been started with delay, recovery was affected with complications. The need for the early determination of minimal inhibitory concentrations and detection of beta-lactamase-production is emphasized as well as for repeated measurement of C reactive protein in serum. Cefotaxime is recommended in case of presence of resistent Haemophilusstrains. PMID- 2770125 TI - [Primary bronchial tumor in childhood--a case report]. AB - Primary bronchial tumors are a rarity in childhood. According to the WHO classification of 1981 Bronchial Carcinoid tumors and Mucoepidermoid carcinoms are listed as the most frequent histological types of the malignoma group and will be not longer associated with attributed benign tumors. In the literature especially the prognostic important early diagnosis and the difficulty of histological differentiation ist emphasized. In this paper is described a 12-year old girl suffering from a bronchial tumor. Throughout the 3 months of disease the diagnosis had been establisted by endoscopy. Surgically the resection of right middle and lower lobe was necessary. 7 years after bilobectomia the patient is without trouble of problems. The classification of the tumor ist problematic within the frame of in the WHO-classification and was discussed. PMID- 2770126 TI - The changes of glycosaminoglycan in the growth of urethane-induced mouse mammary tumors. AB - The changes of glycosaminoglycan (GAG) in the growth of urethane-induced mammary tumors in BALB/c mice were investigated. The artificial mammary tumor was chemically induced by urethane. Successive homo-transplantations of this artificial mammary tumor were successfully achieved at the rate of 100%. Histologically, this artificially induced transplantable mammary tumor (MC) line maintained the characteristics of adenoacanthoma of primary tumors in each successive generation. MC in each generation showed a logarithmic growth beginning from about the 5th day after transplantation, and their growth became slow about the 30th day. Histochemically, GAG components in MC were distributed into the interstitial tissue and into some of the squamous metaplastic epithelial cell layers. Biochemically, GAG components consisted primarily of hyaluronic acid (HA), dermatan sulfate (DS) and chondroitin sulfate (ChS), but there were also small amounts of components which could not be identified. The HA content of MC increased during the logarithmic growth phase and decreased during the stationary phase. However, DS and ChS contents increased during the stationary phase of MC. These increases, histologically, corresponded with propagations in fibrous interstitial tissue. In the final analysis, it is surmised that HA is involved in the take and growth of MC (adenoacanthoma) in mice, while DS and/or ChS are involved in the proliferation of the fibrous interstitial tissue cells of the tumor. PMID- 2770127 TI - Antibodies against allantoic fluid of chick embryos detected in Japanese sera. AB - Japanese sera were shown by enzyme-linked immunosorbent assay (ELISA) to contain frequently antibodies against allantoic fluid, confirming the results obtained in our previous study on ELISA for the detection of mumps antibodies. Chromatographic analysis with Sephacryl S-300 of the allantoic fluid antigen used for ELISA suggested the antigens for these antibodies in Japanese sera to be macromolecular proteins. Comparative absorption tests with allantoic fluid and ovomacroglobulin were therefore carried out on serum samples positive in ELISA with allantoic fluid antigen, and ovomacroglobulin was identified to be the antigenic component for antibodies to allantoic fluid antigen in Japanese sera. PMID- 2770128 TI - Cross reactivity of Mycoplasma pulmonis and Mycoplasma arthritidis antigen strains to anti-Mycoplasma pulmonis antibody in the sera of Mycoplasma pulmonis infected rats. AB - Reactivity of Mycoplasma pulmonis (Mp) antigen strains to anti-Mp antibody in the sera of Mp infected rats was examined by enzyme linked immunosorbent assay (ELISA). Antibody titers to 7 kinds of Mp antigens were measured in the sera of 20 Mp isolated rats and 20 Mp free rats by ELISA and complement fixation test (CF test). ELISA showed that there was no difference in the antibody titer of the same serum among 7 Mp antigen strains employed, and the main cross reaction to anti-Mp antibody took place on the common recognition site (common antigen) in all the Mp antigens. The CF test suggested that the antibody titers largely differed due to the kind of Mp antigen strains, and the detection rate was between 0 and 60%, presumably due to the difference in the reactivity or binding ability of complements but not due to the difference in the cross reactivity of Mp antigen to anti-Mp antibody. When the cross reactivity of anti-Mp antibody to Mycoplasma arthritidis (Ma) antigen was examined in the sera of 33 Mp isolated rats, the CF test exhibited the negative results, but ELISA showed 4 positive cases to support the cross reactivity of anti-Mp antibody to Ma antigen. PMID- 2770130 TI - Symposium on Structure, Function and Product of Genes. Part I. July 23th, 1988, Kitasato. Abstracts. PMID- 2770129 TI - Comparative test for cytotoxicity of hexavalent and trivalent chromium in primary cultures of hepatocytes. PMID- 2770131 TI - [Stages of appendicular peritonitis in children]. AB - In compensated stage of peritonitis in children, the degree I endotoxicosis, hyperdynamic type of circulation without impairment in the immune status were revealed. In subcompensated stage of peritonitis, the degree II endotoxicosis, normodynamic type of circulation were noted. The values of the indices of the cellular link of immunity were at the lower normal limit. In decompensated stage of peritonitis, the degree III endotoxicosis, hypodynamic type of circulation and immunodepression of the cellular link of the immunity were noted. PMID- 2770132 TI - [Differential diagnostic signs of hypoglycemic acetonuria and acute appendicitis in children]. AB - The clinical course of hypoglycemic acetonuria (in 27 children) and acute appendicitis accompanied by acetonuria (in 12) was analysed. The signs permitting to perform the differential diagnosis were distinguished. PMID- 2770133 TI - [Variants of the Duhamel operation in Hirschsprung's disease and idiopathic megacolon in children]. AB - The results of 71 Duhamel operation in children with Hirschsprung's disease and idiopathic megacolon are presented. Seven modifications of the operation were used, including those with the use of constant magnets, staplers, without application of the crushing clamps and with leaving a stump of the brought down intestine under the anus. A purposeful choice of a method for completion of the Duhamel operation permits to reduce the number of complications. PMID- 2770134 TI - [Functional results of the surgical treatment of Hirschsprung's disease in children]. AB - Analysis of the data of observation of 198 patients after the operation for Hirschsprung's disease has shown, that the functional disorders retained in children with sharp suprastenotic distention of all the colonic portions, and as well in patients with concomitant lesion of the central nervous system and other organs and systems. The excellent result of the treatment was noted in 104 (52%) patients, good--in 63 (32%), satisfactory--in 31 (16%). PMID- 2770135 TI - [Morphohistochemical study of the large intestine in Hirschsprung's disease in children]. AB - The morphohistochemical study of the biopsy specimens of the large intestine and operative material, obtained in 41 children with Hirschsprung's disease, in 34 children with combination of the Hirschsprung's disease and dolichosigmoid, and in 25--with dolichosigmoid, was carried out. It is shown, that the presence of a thick network of neural fibers with positive response to acetylcholinesterase (ACE) in the biopsy specimens of the large intestine and positive, or sharply positive response to ACE in the lamina propria and lamina muscularis of the mucosal layer is a precise morphologic marker of the Hirschsprung's disease. PMID- 2770136 TI - [Creation of an artificial smooth muscle rectal sphincter in children]. AB - A method for creation of the artificial smooth muscle anal sphincter, which was used in 18 children with high forms of anorectal atresia and in 9 children with associated incompetence of the external and internal anal sphincters developed after repeated operations, severe traumas of the perineum and rectum and suppurative processes, has been developed. The effectiveness of the developed method is shown on the basis of clinical, functional and experimental morphologic methods of investigation. PMID- 2770137 TI - [Long-term results of the treatment of acute suppurative destruction of the lungs in children]. AB - The results of the treatment of acute purulent destruction of the lungs were studied. The period of follow-up ranged from 6 mos to 10 yrs. Unsatisfactory results were obtained in 4.8% of the patients, satisfactory--in 27%, good--in 68.2%. PMID- 2770138 TI - [The effect of troxevasin on the aggregation capability of thrombocytes in children under 3 years of age with various forms of acute suppurative destructive pneumonia]. AB - In children at the age under 3 years with different forms of acute purulent destructive pneumonia, the positive effect of troxevasin on the platelet aggregation correlating with the pronounced positive clinical effect was revealed. PMID- 2770139 TI - [Prognosis of the transition of acute hematogenous osteomyelitis to it chronic form in children]. AB - Examined were 134 children with acute hematogenous osteomyelitis. It was established, that the different outcomes of acute hematogenous osteomyelitis were conditioned by the different in quality variants of the course of the disease with originality of immunologic reactions. In transition of acute hematogenous osteomyelitis to the chronic form at the period of stabilization of acute inflammation in patients, the number of T- and B-lymphocytes, the index of completed phagocytosis remains significantly decreased, and the lysozyme and IgG content of the blood serum--significantly increased. PMID- 2770140 TI - [Changes in the neural elements of lymphangiomas in children of various ages]. AB - The results of neurohistologic investigation of lymphangiomas, removed in 68 children, are presented. At the early age in children, the changes in neural fibers of lymphangiomas correspond to reaction of irritation. With increasing of the age, the pronouncement of the destructive processes in the neural fibers increases, leading to hypo- and anervia of the tissues of lymphangiomas. PMID- 2770141 TI - [Clinical manifestations, diagnosis and treatment of extraorgan neoplasms of the small pelvis in children]. AB - The results of examination and treatment of 100 children with the extraorganic neoplasms of the small pelvis were analysed. Benign tumours were revealed in 14, malignant--in 86 patients. Teratoblastoma was diagnosed in 40 children. The main symptoms of the impaired defecation and urination were noted in 70 patients. The conservative treatment was performed in 57 children. The results of chemoradiotherapy have proved to be unsatisfactory. The operations were performed in 43 patients, of them radical--in 37. The 3-year survival of the patients was 18.2%, 5-year--12.5%. PMID- 2770142 TI - [A linguistic approach to the differential diagnosis of acute appendicitis in children]. AB - The possibility of the use of the linguistic theory in differential diagnosis of acute appendicitis was studied. Analysed were 299 case records of the patients with intestinal dyskinesia, common and destructive appendicitis. Hypodiagnosis of appendicitis was noted in 8.6%, hyperdiagnosis--in 23.3% of cases. PMID- 2770143 TI - [The possibility of x-ray diagnosis of acute appendicitis in children]. AB - The plain roentgenograms of the abdominal cavity, performed in 87 children at the age of from 7 to 14 years, who were hospitalized for suspected, acute appendicitis, are analysed. The findings of roentgenometry of the stomach were processed statistically. The conclusion of a low diagnostic accuracy of the plain roentgenography was made. It is shown, that in acute appendicitis, the tonicity of the walls of a stomach increases, manifesting by the reduction in its size. PMID- 2770144 TI - [Drainage of the abdominal cavity in appendicular peritonitis in children]. AB - A comparative analysis of the effectiveness of different methods for drainage of the abdominal cavity in appendicular peritonitis in 138 children has shown, that the use of polyethylene drains permitted to achieve the minimal number of postoperative complications. In duration of the disease, which didn't exceed 24 hours, and in presence of less than 60 ml of exudate in the abdominal cavity, the microirrigators were used, in duration of the disease exceeding 48 hours and presence of more than 100 ml of exudate--the crimped films. PMID- 2770145 TI - [Secondary omentitis in children following appendectomy]. AB - The data on treatment of 18 children with secondary omentitis, which developed after appendectomy, are presented. A complication can manifest itself as an abscess of the omentum and as its infiltration, differing in clinical picture and the findings of electromyography. On the basis of the analysis of 463 appendectomies, at the time of which the changes in the omentum were revealed, the association of the form of appendicitis and secondary omentitis is shown. The necessity for resection of the omentum in periappendicular abscess and general peritonitis is noted. PMID- 2770146 TI - [Tactics of treating children with Meckel's diverticulum]. AB - The results of the treatment of 102 children at the age of from 25 days to 14 years with the Meckel's diverticulum (uncomplicated--in 37, complicated--in 65) were analysed. Tactics of treatment depended on the state and age of the children, history of the disease, findings of roentgenocontrast and radionuclide study of the stomach and intestine, laparoscopy, macro- and microscopic picture, state of the abdominal cavity at the moment of operation. In most patients, the favourable results of treatment were achieved. The lethality was 3%. PMID- 2770147 TI - [Diagnosis and treatment of cholelithiasis in children]. AB - At the period of from 1965 to 1988, the authors observed 20 children with cholelithiasis. Among the patients, the number of girls was predominant. Operated on were 13 patients. The indications for operative intervention, immediate and long-term results of the treatment are presented. PMID- 2770148 TI - [Characteristics of methods of profilometry of the anal canal in children]. AB - Profilometry by the perfusive method of the anal canal was performed in 23 children. In high speed of perfusion, the functional length of the anal canal decreases, and its tonicity is suppressed in patients with incontinence. The high speed of perfusion facilitates revelation of the maximum activity of the anal canal. In incontinence, it is necessary to perform profilometry with a low speed of perfusion, and in constipation--with a high speed. For revealing the functional length of the anal canal, the slow perfusion is necessary. In 28 patients, the comparison of the perfusive with balloon profilometry was made. The latter was more effective in sharp reduction of the anal canal function. PMID- 2770149 TI - [Experience with the use of methods of improving the healing of surgical wounds in children]. AB - To improve healing of the operative wounds in children, a complex of measures is suggested, which stipulates the reduction of patient's stay in the hospital before the operation, the use of transverse skin incision, atraumaticity of the operation, meticulous layer-by-layer suturing of the skin wound, free of dressings management of the operative wounds, early removal of skin sutures. As a result, the duration of hospitalization reduced, bed turnover increased, a high cost effectiveness was achieved. PMID- 2770150 TI - [Complex laser therapy of bacterial destruction of the lungs in children]. AB - The complex laser therapy with the use of a helium-neon laser was employed in 115 patients with bacterial destruction of the lungs at the age of from 3 mos to 14 years. The indications for endothoracic, external and intravascular laser therapy and their combination are substantiated. The calculations of the optimal parameters of laser influence, depending on the stage of the disease and optical characteristics of the damaged lung surface, are presented. PMID- 2770151 TI - [The choice of surgical tactics in the treatment of extensive scalp wounds in children]. AB - For evaluation of the viability of the skin flaps in treatment of the scalped wounds in 40 children, the oxygen tension, initial and after the 2-minute oxygen load, and as well the rate of oxygen consumption by the tissue of an autotransplant after its saturation under the conditions of hyperbaric oxygenation were defined. These indices permit to predict the survival of the skin flaps. PMID- 2770153 TI - [Complications of wound healing following appendectomy in children]. PMID- 2770152 TI - [Rectoanal manometry under anesthesia in patients with chronic constipation]. PMID- 2770154 TI - [Appendectomy following "appendectomy"]. PMID- 2770155 TI - [The differential diagnosis of acute appendicitis and pathology of the genital organs in girls]. PMID- 2770156 TI - [A rare complication of invagination of the intestines in a child]. PMID- 2770157 TI - [Idiopathic chronic intestinal pseudo-obstruction]. PMID- 2770158 TI - [A case of an accessory spleen in the greater omentum mimicking a tumor of the abdominal cavity in a child]. PMID- 2770159 TI - [A complication of intestinal yersiniosis]. PMID- 2770160 TI - [Vaginometra mimicking torsion of an ovarian cyst]. PMID- 2770161 TI - [Difficulties in the diagnosis and treatment of injuries of the abdominal organs in a child with combined trauma]. PMID- 2770162 TI - [Inveterate and wrongly united fractures in children as a result of inadequate treatment tactics]. PMID- 2770163 TI - [Acute inflammation of a vermiform appendix situated under the liver in a mother and son]. PMID- 2770164 TI - [The immune system in children with acute appendicitis]. AB - Cellular and humoral immunity was studied in 300 patients with acute appendicitis at the age of from 1 to 14 years. In all the patients, the secondary immunodeficient state was documented, which was the most pronounced at day 3 after the operation. In children after appendectomy, the inclusion into the complex of measures of the preparations increasing the immunologic reactivity of an organism is indicated. PMID- 2770165 TI - [A Meckel's diverticulum in a strangulated inguinal hernia]. PMID- 2770166 TI - [Intestinal invagination caused by a Meckel's diverticulum containing heterotopic tissue]. PMID- 2770167 TI - [Treatment of intestinal invagination in children]. PMID- 2770168 TI - [The Peutz-Touraine-Jeghers syndrome complicated by multiple invaginations of the small intestine]. PMID- 2770169 TI - [A total phlegmonous-necrotic lesion of the small intestine against a background of angiomatosis]. PMID- 2770170 TI - [Surgical treatment of recurrent hemorrhage in a child with a duodenal ulcer]. PMID- 2770171 TI - [Gastric torsion in a 6-month-old child]. PMID- 2770172 TI - [Phlegmonous-gangrenous cholecystitis in a 5-year-old child]. PMID- 2770173 TI - [2 cases of acute pancreatitis in young children]. PMID- 2770174 TI - [Torsion of the greater omentum in a child]. PMID- 2770175 TI - [A rare developmental defect of the urogenital system in a newborn infant]. PMID- 2770176 TI - [Hirudotherapy of postoperative infiltrates in children]. PMID- 2770177 TI - [Bilateral chylothorax in a child]. PMID- 2770178 TI - [Treatment of dynamic intestinal obstruction in children]. AB - The experience with the treatment of dynamic ileus (DI) in 305 children with acute appendicitis after the operation is presented. Among the other measures, in the treatment of DI, the two-lumen transnasal probe for unloading the initial portion of the stomach and intestine, created by the authors, was used. There were no relaparotomies for acute paralytic ileus and lethal outcomes. PMID- 2770180 TI - A new uricosuric substance 5-[(1H-imidazol-1-yl)phenylmethyl]-2-methyl-1H benzimidazole (C18H16N4). PMID- 2770179 TI - Influence of peripheral arterial occlusive disease on muscular metabolism. Part 2: Changes in pyruvate, alanine, and urea concentration in femoral blood. AB - The metabolites pyruvate, alanine and urea were determined under resting conditions in blood from the femoral artery, femoral vein and cubital vein of 23 patients with stage II, 10 patients and 20 diabetics with stage IV PAOD as well as 19 healthy volunteers. Measurements were also carried out immediately and 20 min after ergometric calf exercise in the patients with stage II PAOD and the controls. In both patient groups with stage IV PAOD, there were lower arterial and venous alanine levels and higher urea concentrations at rest than in patients with adequate resting circulation, which is evidence for increased hepatic alanine extraction. After exercise, a significantly higher increase in the arteriovenous difference of pyruvate concentration was to be found in the patient group with stage II PAOD than in the control group. Moreover, there was a significant increase in femoral venous concentration and a rise in the arteriovenous difference of alanine, indicating muscular release, only in the PAOD patients and not in the volunteers in spite of a three times higher exercise load. The exercise-induced rise in femoral venous alanine correlated closely with those of pyruvate and ammonia. Alanine formation fulfills the function of a non toxic carrier of muscularly produced amino groups and represents in PAOD a compensating mechanism that delays the limitation of muscular contractility. Alanine determination, especially in association with an exercise test, appears to be suitable for assessing the extent of anaerobic energy production in muscles of limbs affected by PAOD. PMID- 2770181 TI - The pyramidal lobe--a helpful criterion in the differential diagnosis of thyroid diseases. PMID- 2770182 TI - Theophylline: a new concept of nephroprotection in acute cyclosporin A nephrotoxicity? PMID- 2770183 TI - Inhibition of human adrenal androgen secretion by ketoconazole. AB - The effect of ketoconazole on adrenal androgen secretion was examined in 15 patients with elevated serum androgens. In a dose of 600 mg per day orally ketoconazole inhibited the biosynthesis of all measured androgens. The mean reduction in serum levels of dehydroepiandrosterone sulfate was 32%, of dehydroepiandrosterone 54%, of androstenedione 52%, and of testosterone 43%; mean serum levels of cortisol only fell by 19%. The reduction in serum androgen levels was first significant 24 h after beginning of treatment and persisted as long as the drug was administered. We conclude that ketoconazole inhibits adrenal androgen biosynthesis more pronouncedly than cortisol biosynthesis more pronouncedly than cortisol biosynthesis. This might be of clinical benefit in the treatment of hirsutism and other states of androgen hypersecretion. PMID- 2770184 TI - [Ambulatory indirect long-term blood pressure measurement in primary and secondary hypertension]. AB - Ambulatory 24 hour blood pressure measurements were performed in 21 patients with various forms of secondary hypertension and were compared with the blood pressure profile of a matched group of patients with primary hypertension. Patients with renovascular (n = 8) and renoparechymal hypertension (n = 8), and with primary hyperaldosteronism (n = 4) showed no significant fall in systolic blood pressure during the sleeping period (00-03 a.m.) and in systolic and diastolic blood pressure in the early morning (06 a.m.) as compared with essential hypertensives. However, in a single case of hypertension due to coarctation of the aorta the 24 hour blood pressure profile is not different from essential hypertension. Thus, ambulatory 24 hour blood pressure recording is a good method for screening secondary forms of hypertension. PMID- 2770185 TI - [Effectiveness and hemodynamic mechanism of action of blood pressure lowering by intravenous labetalol in patients with a critical increase in blood pressure]. AB - Labetalol (L) was intravenously given to ten patients with an acute elevation of arterial blood pressure above to 200 to 100 mmHg. Blood pressure was controlled in 9 of 10 patients (less than or equal to 170/100 mmHg) with 50 mg in 4, 100 mg in 4 and 200 mg L in 1 patient. In 9 responders, systolic pressure decreased from 207 +/- 20 to 161 +/- 9, diastolic pressure from 107 +/- 11 to 90 +/- 8, and mean pressure from 140 +/- 11 to 113 +/- 5 mmHg, and all pressures remained at these levels during a 25 min control period. Heart rate decreased significantly from 87 +/- 20 to 69 +/- 11 per min and cardiac index from 3.2 +/- 0.8 to 2.6 +/- 0.61/min x m2. Stroke volume index remained unchanged. Total peripheral resistance and pulmonary artery occlusion pressure were not significantly altered but tended to increase, resulting in a small shift to the right of the ventricular function curve. Pulmonary vascular resistance increased significantly from 236 +/- 108 to 314 +/- 132 dyn x sec x cm-5 and mixed venous oxygen saturation decreased from 70 +/- 5 to 65 +/- 8%. Peripheral resistance was considerably higher and cardiac index lower in patients with a heart rate below 70/min. We conclude that L effectively lowers the arterial blood pressure in hypertensive crisis, but the substance should not be used in patients with heart rates below 70/min, as in this case the beta-blocking effect may supervene resulting in a high-resistance low-output state. PMID- 2770186 TI - Inappropriate secretion of antidiuretic hormone, polydipsia and hypothalamic calcifications. AB - We studied a 41 year old patient who had pathologic fluid intake of 10 1/day together with syndrome of inappropriate antidiuretic hormone. Imaging studies revealed a lesion of the anterior wall of the third cerebral ventricle. A review of relevant literature indicated several different disturbances by which alterations of thirst, vasopressin-secretion and abnormalities of anterior third ventricle may be associated. The present case presents an unusual and potentially dangerous combination in this spectrum of changes. PMID- 2770187 TI - Renal infarction in adulthood due to a childhood trauma to the vertebral column. AB - A disproportional elongation and kinking of the suprarenal aorta caused by an early childhood trauma with vertebral growth retardation and deformation led to turbulent blood flow in the aorta, embolus formation and segmental renal infarction after 37 years. PMID- 2770188 TI - [The dilemma of the clinical trial: what does it prove?]. PMID- 2770189 TI - [Damage to blood cells caused by oxoferin?]. PMID- 2770190 TI - Leucocyte rheology in the early stages of ischaemic stroke. AB - Within 5 hours of the onset of ischaemic stroke the filterability patterns and the counts of the granulocyte, monocyte and lymphocyte subfractions were monitored. The results were compared to those of a healthy matched control group and to those of a matched group with cardiovascular risk factors. The granulocyte filterability rate was significantly impaired in the group at risk and even more so in the stroke group suggesting alterations in it may be a sign of latent ischaemia. PMID- 2770191 TI - [Diagnosis of disseminated intravascular coagulation: the value of soluble fibrin, D-dimers and fibrin(ogen) split products]. AB - The validity of the fibrin(ogen) derivatives 'soluble fibrin, D-dimers and fibrin(ogen) degradation products' was compared with other parameters in early and sensitive diagnosing of disseminated intravascular coagulation (DIC). In a clinical study 900 patients' samples from separate, defined groups were examined, including course observations of intensive care patients (n = 38) and patients with acute pancreatitis. The fibrin(ogen) derivatives correlated very well with the degree of blood coagulation disturbances: in particular, D-dimers and soluble fibrin proved to be more sensitive in early diagnosis of DIC than other parameters. The SF-PS-turbidimetry demonstrated a good validity and practicality in the quantitative determination of soluble fibrin, but a suitable analyzer is essential. Determination of D-dimers is preferable to that of fibrin(ogen) degradation products (both in the latex-agglutination test) because of the better sensitivity and practicality; even more sensitive results were provided by the D dimer-ELISA, which is, however, not practical in acute diagnostics. The decrease in protein C was at least equally sensitive as the antithrombin III-levels in indicating the consumption of the hemostatic potential. The decrease of thrombocyte counts and fibrinogen levels could first be detected in a later stage of DIC. In conclusion, D-dimers and soluble fibrin can improve the DIC diagnostics, making them more reliable; additionally, antithrombin III and possibly protein C deserve further consideration, although the fibrin(ogen) derivatives are apparently of greater importance. PMID- 2770192 TI - [Acid-base equilibrium of the blood during treatment using plasma UV-irradiation of chronic diseases of the liver and bile ducts with cholestasis]. AB - Donor plasma irradiated by ultraviolet rays was administered intravenously to patients with choledocholithiasis, chronic hepatitis and liver cirrhosis. Parameters of the acid-base balance of arterialized capillary blood shifted to alkalosis, were normalized, and tension of carbon dioxide and oxygen in the blood increased to physiological values. Dynamic changes of the biochemical parameters demonstrated alleviation of manifestations of the cholestasis syndrome. PMID- 2770193 TI - [Errors in the diagnosis and treatment of pancreatic cysts]. AB - Errors in the diagnosis and treatment of pancreatic cysts have been studied at various stages of rendering medical aid. In a polyclinic the diagnostic errors are due to inadequate skill of physicians, insufficient study of medical records, inadequate examination and ungrounded refusal to consult a surgeon. The most informative methods of examination are X-ray of the stomach, duodenography in the state of hypotonia, pneumoperitoneography in combination with retropneumoperitoneography and ultrasound examination. It is emphasized that the most common complication of cysts of the pancreas are suppuration of its contents and malignant transformation of its walls. The operation of choice in this condition is pancreatico-jejunostomy with an isolated jejunum according to the Roux-en-Y technique. External drainage of the cyst is indicated only in suppuration. Pancreatogastrostomy is considered an emergency operation. PMID- 2770194 TI - [Effect of intravascular laser irradiation of the blood on blood cells in pancreatitis]. AB - Inpatient examinations included 17 patients with necrosis of the pancreas (4 patients had hemorrhagic and 14 fat necrosis): synthetic lymphocyte activity was studied by the luminescent method and the erythrocyte content of adenyl nucleotides by thin-layer chromatography in the toxic phase of pancreatitis. Synthetic lymphocyte activity was found to be decreased and the ATP pool of erythrocytes exhausted in the toxic phase of pancreatitis. Intravascular laser irradiation of the blood caused recovery of lymphocyte activity and increase in the ATP content in erythrocytes. PMID- 2770195 TI - [Prevention and treatment of hemostatic disorders in patients with liver cirrhosis]. AB - Disorders of the different links of the hemostatic system in patients with liver cirrhosis can be corrected by simultaneous prescription of minimal doses of heparin, vicasol and curantyl. As a result, treatment of liver cirrhosis, including cases with initial manifestations of the hemorrhagic syndrome, produced significant improvement of the hemostatic parameters and abatement of this syndrome. It is expedient to include this method in the combined treatment of this category of patients. PMID- 2770196 TI - [Intestinal function in patients with peptic ulcer]. PMID- 2770197 TI - [Functional state of the distal part of the large intestine in Crohn disease]. AB - State of the locking apparatus has been studied in 22 patients with Crohn's disease free of the anorectal complications. Even prior to the development of these complications caused by metabolic abnormalities and inflammatory changes in the intestinal wall the locking apparatus undergoes certain functional changes. PMID- 2770198 TI - [Clinico-morphologic characteristics of 2 tumor forms of primary hyperaldosteronism]. AB - Unilateral adrenalectomy was performed in 32 patients with primary hyperaldosteronism due to tumour of the adrenal gland and with arterial hypertension (AH) of various degree of severity. Stable normalization of AH occurred in 14 patients and in 18 its course improved. The results of a retrospective analysis of a hypotensive effect, the morphological picture of the removed adrenal and the findings of clinico-biochemical and instrumental study made it possible to establish preoperatively the diagnostic criteria for the identification of two tumorous forms of primary hyperaldosteronism: aldosterone producing adenoma proper and the tumorous form of adrenocortical hyperplasia. They have different pathogenesis and postadrenalectomy hypotensive effect. PMID- 2770199 TI - [Endotoxemia and the criteria of its substantiation in patients with burns]. PMID- 2770200 TI - [A case of tracheal amyloidosis]. PMID- 2770201 TI - [Intestinal obstruction caused by fruit]. PMID- 2770202 TI - [Peutz-Jeghers syndrome]. PMID- 2770203 TI - [Aspiration pH-metry of the stomach by the Linar technic--an optimal method of studying gastric secretion]. AB - Discussion is devoted to the advantages of intragastric pH-metry and gastric probe study in aspiration pH-metry of the stomach. Data are given on the means of decoding the results of pH-metry. Aspects of the examination of gastric secretion that contribute both to research and clinical practice are discussed. PMID- 2770204 TI - [Teaching nephrology at postgraduate courses for the head and leading therapists]. PMID- 2770205 TI - [Internal pathology in trauma--an important branch of internal medicine and military medicine]. PMID- 2770206 TI - [Possibility of preventing myocardial infarction]. PMID- 2770207 TI - [Clinical value of studying fibrinogen degradation products in patients with ischemic heart disease]. AB - Study of fibrinogen degradation products in patients with angina pectoris and acute myocardial infarction proved to be of clinical importance. Their content in patients with acute myocardial infarction was increased more considerably than that in patients with angina pectoris. This parameter can be used for the differential diagnosis of angina pectoris and acute myocardial infarction. PMID- 2770208 TI - [Effect of a high-protein diet on the effectiveness of the treatment o patients with ischemic heart disease associated with diseases of the biliary tract]. PMID- 2770209 TI - [Status of capillary blood flow in the lungs in various outcomes of acute pneumonia]. AB - The method of perfusion scanning of the lungs with albumin microaggregate 131I was used for studying the state of pulmonary blood flow in patients with acute pneumonia (AP). The outcome of the disease was chronic non-specific lung disease (CNLD). The results of study demonstrated the improvement of microcirculation by the time of discharge from a hospital, but in 54.2 per cent of the patients blood flow was reduced. It was proved that reduced blood flow, by the time of discharge, together with impaired external respiration function, X-ray changes and biochemical blood shifts are the unfavourable factors with respect to prognosis which contribute to the transition of AP into CNLD. Combined therapy of AP should include measures directed to the improvement of pulmonary microcirculation. PMID- 2770210 TI - [Arterial hypertension syndrome in young persons]. AB - The prevalence and patterns of the hypertension syndrome (AH) in young subjects require further study. An examination of 879 young subjects revealed AH in 14.6 per cent; in 84 inpatients borderline AH was found in 20.2, essential hypertension in 17.9 and symptomatic AH in 61.9 per cent, in 22.6 per cent AH was attended by signs of connective-tissue dysplasia and minor developmental abnormalities (mitral valve prolapse, nephroptosis, pathology of cervical spine, structural disorders of the lid slit and floor of the auricle, etc.). Manifestations of connective-tissue dysplasia and minor developmental abnormalities have a bearing on the AH formation and course in this group of patients. Further detailed study of the AH course in young subjects with these manifestations is required. PMID- 2770211 TI - [Effect of the vertebral syndrome in cervical osteochondrosis on the course of I IIA stage hypertension and cerebral electrical activity and hemodynamics]. AB - Examination included two groups of patients with I-IIA stage essential hypertension combined with cervical osteochondrosis: with and without the vertebral syndrome. It revealed significant polymorphism of clinical symptoms, more severe course of vascular pathology, disorders of cerebral hemodynamics with decreased pulse blood filling, increased tone of arterioles, venules and veins, signs of disturbances of venous outflow and features of bioelectric brain activity indicating dysfunction of the middle structures in patients with the vertebral syndrome of cervical osteochondrosis. Since the pathogenic significance of cervical osteochondrosis is mostly realized in the presence of the vertebral syndrome, therapeutic policy should involve both antihypertensive agents and measures that control vertebrogenic pathology as well as medicamentous correction of hemodynamic cerebral disturbances. PMID- 2770213 TI - [Experience using videoendoscopes]. PMID- 2770212 TI - [Changes in the functional activity of the sympathetico-adrenal system after correction of electrolyte metabolism in patients with hypertension]. AB - Parameters of the sympathoadrenal system were studied in 81 patients with I-II stages essential hypertension. Their changes were analysed depending on the disease stage; study also included the interrelation between electrolyte metabolism, and sympathoadrenal and renin-aldosterone systems. Moderate consumption of common salt in "salt-sensitive" patients caused a significant decrease in the activity of the sympathoadrenal system, while in "salt nonsensitive", patients with paradoxical reaction this correction of salt regimen of nutrition activated the sympathoadrenal system. Thus, use of this non pharmacological method of treatment with limitation of common salt in essential hypertension patients requires a differential approach, depending on "salt sensitivity". PMID- 2770214 TI - [Hemodynamic studies during fibrogastroduodenoscopy]. PMID- 2770215 TI - [Study of genetic markers of duodenal ulcer]. AB - The results of determination of various hereditary predisposition markers in peptic ulcer are given: in the population, in patients with duodenal ulcer and in their siblings (risk group). Of importance for revealing subjects with hereditary predisposition to duodenal ulcer are the clinico-genealogical analysis, determination of the blood group, especially in simultaneous determination of a "secretory status" ("status of non-secretion" of the ABH blood system agglutinogen in the saliva), increase in the mass of parietal cells and, to some extent, of the distinguishing features of dermatoglyphics (in combination with the above markers). Determination of taste sensitivity to phenylthiocarbamide is non-informative. PMID- 2770216 TI - [Complex treatment of patients with non-healing stomach ulcers using hyperbaric oxygenation]. AB - The possibilities of local therapy used together with hyperbaric oxygenation were studied in patients with persistent gastric ulcers. The most effective in combined therapy of these patients was local administration of granulocyte concentrate and the use of hyperbaric oxygenation because of the action on the basic pathogenetic links such as impairment of the local and systemic microcirculation and pathological microflora. PMID- 2770217 TI - [Comparative evaluation of late results of the Hoffmeister-Finsterer gastrectomy and the method of valve anastomoses in peptic ulcer]. AB - Comparative assessment of the remote results of Hoffmeister-Finsterer gastrectomy with creation of valve anastomoses has demonstrated rare occurrence of postoperative complications owing to anastomoses. The operation is simple as concerns operative techniques and can be recommended as operation of choice in the treatment of peptic ulcer. PMID- 2770218 TI - [Diagnostic value of indicators of the kallikrein-kinin system of the blood and C 3 component of the complement in chronic viral hepatitis]. PMID- 2770219 TI - Immunohistochemical evidence for convergence of GABA-containing and glycine containing axon terminals on single spinal motoneurons of the rat. AB - GABA- and glycine-containing neuronal elements were visualized in the rat spinal cord by immunohistochemistry employing antisera raised against conjugated GABA and glycine. GABA- and glycine-like immunoreactivities were localized in axon terminals and neuronal perikarya. GABA- and glycine-like immunoreactive terminals were in synaptic contact with perikarya and dendrites of most spinal neurons. Single spinal motoneurons appeared to be in contact with GABA- or glycine-like immunoreactive terminals. These findings suggest that these neurons are regulated postsynaptically by both GABA and glycine. PMID- 2770220 TI - Cerebral embolism and hyperthyroidism. AB - Three different cases of cerebral embolism occurring in combination with hyperthyroidism are reported. Case 1; a healthy 37-year-old woman presented with sudden onset of left hemiparesis and left sided hypoesthesia of all modalities. Embolism in area of the right middle cerebral artery was confirmed by angiography and CT scan. Laboratory examination revealed hyperthyroidism and anemia. Antithyroid treatment brought about euthyroid function while slight hemiparesis remained present. Case 2; a 79-year-old woman who suffered from hypertension for one year had sudden onset of disorientation and left hemiparesis. Electrocardiogram showed atrial fibrillation. The CT scan indicated infarction in the right anterior and middle cerebral artery. The patient was diagnosed as having masked hyperthyroidism. Although antithyroid medication reduced it to euthyroid condition, the patient is now bedridden with hemiparesis. Case 3; a 45 year-old man who had partial thyroidectomy for Basedow's disease and had been treated with antithyroid and antiarrhythmic therapy for 10 years. Suddenly, he was in coma with dilated right pupil and left hemiplegia. Atrial fibrillation and hypothyroid function were observed. CT scan indicated hemorrhagic infarction in the territory of the middle cerebral artery with transtentorial herniation. He died on the 59th day of hospitalization following an episode of bronchopneumonia. On the basis of the cases presented here as well as on the basis of those described in the literature it appears that thyrotoxic patients with atrial fibrillation exhibit high incidence of cerebral embolism, and prophylactic anticoagulant therapy may be recommended. PMID- 2770221 TI - Effects of gastrin releasing peptide and its related peptides on the release of gastrin. AB - Gastrin release of porcine gastrin releasing peptide (pGRP) and its related peptides were evaluated. The concentration of serum gastrin after intravenous administration of the peptides was measured by a radio immunoassay. Among pGRP and its related peptides, pGRP was found to retain full bombesin potency with respect gastrin release. The carboxy-terminal fragments of pGRP, 14-27, 18-27, and 19-27 were equipotent for gastrin release, though the peak value of serum gastrin caused by each of these three fragments was significantly less than that evoked by pGRP. The pGRP fragment 20-27, despite showing considerably lesser potency, still evoked statistically significant levels of serum gastrin during its infusion. On the other hand, pGRP fragments 21-27 and 1-13 did not exhibit any appreciable activity. It was concluded that the carboxy-terminal octapeptide 20-27 constitutes the vital active core for gastrin releasing activity of the pGRP molecule. The amino-terminal tridecapeptide pGRP (1-13), while itself inactive, appeared to be important for the full active of pGRP. PMID- 2770222 TI - Transgastric vagotomy with selective proximal vagotomy for duodenal ulcer. AB - To improve surgical results of duodenal ulcer, transgastric myotomy (TGM) was added to the traditional selective proximal vagotomy (SPV) and its efficacy was evaluated clinically in 40 patients. 35 men and 5 women were involved, with a mean age of 33.07 +/- 14.25 years. Pyloroplasty was added in 12 operations for stenosis and perforation. 28 patients in this series underwent TGM with SPV without drainage. In the 36 patients, basal and maximal acid output (BAO and MAO) was compared preoperatively and at 6 months postoperatively. A satisfactory reduction of acid output was achieved, with a mean reduction rate of 71.4% in BAO and of 79.9% in MAO. All 40 patients were negative in Hollander's insulin stimulation test at 6 months postoperatively. The gastric mucosa was injured during myotomy in 2 of the patients (5.0%), and was simply sutured using 3-0 Dexon, without causing any problems. No other early or late postoperative complication was present. In addition, no peptic ulcer recurrence has been noted over a maximal follow-up of 8 years. The present results suggest the completeness of gastric denervation by TGM+SPV, and establish the efficacy of TGM with SPV, and therefore this method is recommended in the surgical treatment of duodenal ulcer. PMID- 2770223 TI - About reconstruction of the pharynx with colon in extensive corrosive strictures. AB - The author presents a series of 235 esophagocoloplasties, in 90 cases a pharyngeal reconstruction being performed. The colic graft was anastomosed to the hypopharynx in 43 cases, to the oropharynx in 14 cases, and in 33 cases a pharyngoplasty was done. A personal classification of the approach of the pharynx according to local innervation is attempted, and various original procedures of pharyngeal reconstruction are described (double pharyngoplasty "en Y", pharyngoplastia "vera"). A great effort was made in preservation of the larynx, which remains the main aim of the author. PMID- 2770224 TI - [School diagnosis: a new formula]. PMID- 2770225 TI - [At the disposal of the students]. PMID- 2770226 TI - Revision of rules--information conference of the Swiss Nursing Association. Only the future will tell.... PMID- 2770227 TI - [A visit at the University Medical Center at Kyung Hee, Seoul. Two kinds of medicine combined...]. PMID- 2770228 TI - [Joint education of nursing personnel and physicians. Diploma in tropical medicine]. PMID- 2770229 TI - [Living with AIDS patients]. PMID- 2770230 TI - [Part time: "to live better in order to work better"]. PMID- 2770231 TI - [Hospital without electricity]. PMID- 2770232 TI - [Let us dissassociate from a false servitude]. PMID- 2770233 TI - [More languages--better communication?]. PMID- 2770234 TI - [Psychiatric activity is always aggressive]. PMID- 2770235 TI - [Swiss Nursing Association information session for the revision of guidelines. Now to the negotiations]. PMID- 2770236 TI - ["Sister"--an untimely characterization]. PMID- 2770237 TI - [Behavior of the patient and attitude of the nurse]. PMID- 2770238 TI - [Under the banner of collaboration]. PMID- 2770239 TI - [Brain tumors]. PMID- 2770240 TI - [Approach to patients with brain tumors]. PMID- 2770241 TI - [Truth at the bedside. Physician and nursing between reality and humaneness]. PMID- 2770243 TI - [Revision of the guiding principles for the formation in the nursing occupations in Switzerland]. PMID- 2770242 TI - [Morphine]. PMID- 2770244 TI - [What are the possibilities offered by fiberbronchoscopy?]. PMID- 2770245 TI - A role for intracellular traffic of high-density lipoproteins in cholesterol metabolism. PMID- 2770246 TI - Effects of aging on expression of ischemic acute renal failure in rats. AB - Ischemic acute renal failure is principally a disease of the elderly, but the effect of aging on renal susceptibility to ischemic damage has not been defined. To address this issue, adolescent (3-4 months), mature (12-13 months), and aged (24-25 months) rats underwent base-line renal functional assessments, and then they were subjected to a standardized ischemic event (37-minute, bilateral renal artery occlusion). The loss of renal function [assessed by azotemia and creatinine clearance, (Ccr)] and the severity of tubular damage (necrosis, casts) were determined 24 hours later. Base-line functional assessments indicated no significant differences in Ccr/100 gm body weight between the groups, but urinary protein excretion increased with age (p less than 0.001). In response to renal artery occlusion, the adolescent, mature, and aged rats lost 59 +/- 4, 82 +/- 4, and 94 +/- 1% of their base-line Ccr (p less than 0.01), respectively. Among the proteinuric rats, no correlation was noted between percent loss Ccr and urinary protein excretion. Despite the large differences in postischemic renal function, the extent of tubular morphologic damage did not differ among the groups. The percent loss Ccr did not correlate with necrosis (r = -0.02) or casts (r = 0.07). Although focal glomerulosclerosis and mild tubular atrophy were noted in the aged kidneys these lesions were minimal to absent in the mature rats. We conclude that aging increases susceptibility to severe ischemic acute renal failure in the rat, an effect that is apparent even during a transition from the adolescent to the mature state. This finding cannot be simply ascribed to increasing proteinuria, a loss of renal functional reserve, or to increased tubular morphologic damage. The data are most consistent with the view that underlying age-related glomerular/hemodynamic changes lead to an exaggerated functional decline in response to ischemic renal injury. PMID- 2770247 TI - Atubular glomeruli in lithium-induced chronic nephropathy in rats. AB - Chronic renal failure was induced by administering lithium orally to 14 newborn rats. Seven rats were treated for 8 weeks followed by 8 weeks without lithium (group Li/C) and seven for 16 weeks (group Li/Li). Plasma urea and renal concentrating ability were measured, and one kidney fixed by vascular perfusion. Mean glomerular volume as well as volumes of individual glomeruli were estimated. In addition, the structural integrity between the glomerulus and the proximal tubule was investigated on serial sections. No sclerotic glomeruli were present. Only 37.6 and 27.9% of the glomeruli in the Li/C and Li/Li groups, respectively, were connected to a normal proximal tubule, and most remaining glomeruli were atubular. The mean glomerular volume was unchanged in the Li/C group and reduced by 40% in the Li/Li group. The intraindividual variation in glomerular volume was about 10-fold larger in the lithium-treated groups than in controls. The glomeruli connected to normal proximal tubules had the largest volumes, and hypertrophied glomeruli were encountered more frequently in the Li/C group than in the Li/Li group. There was a significant positive correlation between the plasma urea and the fraction of glomeruli that were not connected to normal proximal tubules. We previously demonstrated in this lithium model that there is a significant correlation between the tubulointerstitial lesion and the impairment of renal function. However, with the demonstration of atubular glomeruli we have a new explanation for the reduction in renal function in this model. PMID- 2770248 TI - Changes in size of motor axons in hereditary canine spinal muscular atrophy. AB - Hereditary canine spinal muscular atrophy (HCSMA), a dominantly inherited disorder of motor neurons, has three phenotypes: accelerated, intermediate, and chronic. In the accelerated and intermediate phenotypes, axonal sizes in ventral roots were smaller than in controls. Reductions in axonal size occurred primarily in large axons, and the frequency of small-caliber axons was increased. In HCSMA, nerve fiber shape, i.e., circularity, was reduced, and the relative thickness of the myelin sheath as a function of axonal caliber was decreased. The density of fibers in motor nerves was increased, making it unlikely that a selective loss of large-caliber axons explained the increased frequency of small-caliber axons. These observations suggest that, in HCSMA, changes in axonal size in motor nerves are associated with both growth arrest and axonal atrophy. PMID- 2770249 TI - Ethics, controversy, and the reader's right to know. PMID- 2770250 TI - School health services in the United States: a view from the United Kingdom. AB - Despite sharing both a common heritage and a common language, differences exist between life in the United States and the United Kingdom. During spring 1988, the author, who formerly served as editor for the Health Visitor, published by the Health Visitor's Association, completed a six-week study tour of school health services in the United States. In this article, she gives her impressions from the experience, including observations regarding salary, working conditions, professional preparation, and professional recognition. She concludes by identifying several poignant questions to clarify the school nurse's role and to set priorities for the optimal use of time and expertise. PMID- 2770251 TI - Differential effectiveness of an elementary school-based alcohol misuse prevention program. AB - An elementary school social skills/peer pressure resistance curriculum for the prevention of alcohol misuse was developed, implemented, and evaluated. Schools were randomly assigned to curriculum and control groups, with half of each group pretested prior to intervention and all students posttested two months, 14 months, and 26 months following intervention. Students in grade five at the beginning of the study were randomly assigned to treatment, treatment plus booster, and control conditions. Students in grade six were randomly assigned to treatment and control conditions. Three way repeated measures analyses of covariance (treatment condition by type of prior drinking experience by occasion) were conducted for each grade level on indices of "frequency/quantity of alcohol use" and "total alcohol misuse." Results indicated the intervention was effective in reducing the rate of increase of alcohol use and misuse among grade six students who entered the study with prior unsupervised as well as supervised alcohol use. After corrections for intraclass correlations on the dependent variables, the significant finding regarding the alcohol misuse variable was maintained. PMID- 2770252 TI - Weight cycling for profit: countering the claims of diet clinics. PMID- 2770253 TI - Constructing concept maps for health instruction. PMID- 2770254 TI - The school nurse's role in managing athletic injuries. PMID- 2770255 TI - Adolescents, AIDS, and HIV: the future starts now. PMID- 2770256 TI - Quality of the home environment of toddlers: a validation study of the home inventory. AB - The Home Observation for Measurement of the Environment (HOME) Inventory is introduced in this study to examine the home environments of children (three to four and a half years) in Singapore. The Inventory comprises eight subscales and a total of 54 items with a higher score indicating an environment which provides more possibilities for development and growth. Various statistical tests were carried out to determine the validity of the Inventory for use in the local context. These showed the Inventory to be internally consistent and to possess construct validity in particular the HOME Inventory had been validated in correlation tests with demographic variables such as social class index (F = 8.01, p less than 0.0001), people to room ratio (r = -0.37, p less than 0.0001) and a measure of IQ (r = 0.0003). Norms for local toddlers were also provided. It was concluded that the Inventory would play a useful role in detecting children who are physically and intellectually less advanced due to a poorer home environment. This finding could possibly be used in an intervention programme in ameliorating these conditions. PMID- 2770257 TI - Evaluation of lung function in Singapore obese children. AB - In this study, 65 obese children with a mean age of 12.1 years and mean relative weight (RW) of 156.1% had their lung function evaluated in comparison to predicted normal values. There were substantial changes in forced expiratory flow rates (FEF's) and maximum voluntary ventilation (MVV), with reductions to between 60% to 70% of predicted normal values. The more obese children (RVV greater than or equal to 150%) had significantly lower FEF's and MVV and a significantly greater proportion of the more obese children had FEF50 and MVV of less than 60% of predicted normal values. The results were suggestive of narrowing of small airways and increased respiratory inertance possibly due to excessive accumulation of fat in the chest wall and abdomen leading to respiratory limitation. PMID- 2770258 TI - Role of atopy in childhood asthma. PMID- 2770259 TI - Transient hyperinsulinemic hypoglycemia in large for date infants. AB - Two large for date infants with transient asymptomatic hyperinsulinemic hypoglycemia are presented. The importance of prompt recognition and treatment of this condition is emphasized. PMID- 2770260 TI - Chromosomal abnormalities in couples with recurrent abortions. AB - Out of 126 couples seeking genetic advice for abortions, 95 couples have experienced 2 or more spontaneous abortions. Of these, chromosome banding studies were carried out in one or both partners (92 women and 85 men). Abnormal karyotypes were found in 2 males. Both abnormalities were balanced translocations: 46 XY t(5q+ 11q-) and 45 XY t(13/14). This represents an overall frequency of 1.1% which is comparable to the reported incidence in the literature. PMID- 2770261 TI - A quicker simpler method of pre-determination of the length of umbilical artery catheter insertion in Asian babies. AB - A total of 50 neonates with birth weights varying from 919 gm to 5 kg with acute respiratory distress were studied for umbilical artery catheter placement in the thoracic aorta at T7 to T11 vertebral body level. The length of the catheter to be inserted was by a simple formula ie. for a 1000 gm baby, the length of insertion is 10 cm (delete the 00 from 1000 gm), and add 1 cm for each additional weight group of 250 gm till 2250 gm. Above 2250 gm, the length of insertion is 15 cm for all babies. Considering the 49 babies whose birth weights were more than a kg, 47 babies had catheter tips located at T7 and T11 vertebral body level. This method was thus accurate in 95.9% of babies studied. PMID- 2770262 TI - Institute of Sports Science, Rome. PMID- 2770263 TI - Psychiatric aspects of basketball. AB - This article presents a theory of the psychology of basketball from three perspectives: individual psychodynamics, family systems interactions and athlete community relationships. It focuses on the differences between functional and dysfunctional individual and team performance. Maximal individual performance usually requires relatively high levels of cognitive and physical skills, while team performance depends on having individuals with the interpersonal skills necessary to create the chemistry mandatory for the shared decision making called teamwork. PMID- 2770264 TI - Brain evoked responses reflect information processing changes with the menstrual cycle in young female athletes. AB - In sport activity, information processing plays a role crucial for sport performance. Neuropsychological and psychophysiological evidence based on behavioral and psychophysical tasks has been accumulated showing that the latter changes over the course of the menstrual cycle, but the available data are rather inconsistent. On the other hand, in sport literature, not much attention has been devoted to these topics by researchers who have mainly been asked to investigate changes in mood and well-being. Therefore, a study has been undertaken to investigate the relationships between the menstrual cycle and information processing in young female athletes, some of whom took oral contraceptives. The study was based on Auditory Evoked Responses that, unlike behavioral and psychophysical techniques, were revealed to be an exceptionally reliable tool for the study of neural activity during sensory information processing. The results showed the existence of clear fluctuations over the course of the menstrual cycle in time taken to handle information and in the amount of information processing that, with differences and similarities, could be observed both in spontaneously menstruating and on-pill athletes. In addition, neuroanatomical differences were evident in the response of different neural structures of the auditory pathways. In fact, the effects of the hormonal changes accompanying the menstrual cycle appear to be more effective and influential at higher central levels of the auditory pathway. PMID- 2770265 TI - Specificity of endurance, sprint and strength training on physical performance capacity in young athletes. AB - Three prebubescent athlete groups of endurance runners (E; n = 4), sprinters (S; n = 4) and weightlifters (WL; n = 4) and one control group (C; n = 6) as well as one junior but postpubescent weightlifter group (JWL; n = 6) volunteered as subjects in order to investigate specific effects of endurance, sprint and strength training on physical performance capacity during a 1 year follow-up period. The prepubescent E-group had higher (p less than 0.05) VO2 max (66.5 +/- 2.9 ml x kg1 x min-1) already at the beginning of the study than the other three groups. The prepubescent WL-group demonstrated greater (p less than 0.05) maximal muscular strength than the E-group and the WL-group increased its strength greatly by 21.4% (p less than 0.05) during the follow-up. No significant differences were observed in physical performance capacity between the prepubescent WL- and S-groups. Both groups demonstrated a slightly (ns.) better force-time curve recorded from the leg extensor muscles than the E-group and significant (p less than 0.05) increases occurred in these two groups in dynamic explosive performance during the follow-up. The postpubescent JWL-group demonstrated much greater (p less than 0.001) muscular mass and maximal strength than the prepubescent groups. No significant changes occurred in explosive types of performances in these athletes but significant (p less than 0.05) increase took place in the maximal neural activation and strength of the leg extensor muscles during the 1 year.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2770266 TI - Oxygen consumption and ventilation during constant-load exercise in runners and cyclists. AB - The effect of using specialized or no specialized muscle groups on ventilatory threshold (VT) and on maintenance of steady-state oxygen consumption during long term exercise on treadmill and on cycle ergometer was studied in ten endurance runners and nine cyclists. Initially, maximum oxygen consumption (VO2max) and VT were determined. Oxygen consumption (VO2) ventilation (VE) respiratory rate (f), and blood lactate (in the beginning and at the end of exercise) were measured during exercise at constant relative loads of 60, 70, and 80% of VO2max. In the runners, both VO2max and VT (expressed as % VO2max and VO2 l/min) were greater on treadmill than on cycle ergometer and in the cyclists, VO2max was higher on cycle ergometer than on treadmill, but no differences in VT were detected between the two tests. The VO2, VE, and f drifts correlated with blood lactate level as well as with the calculated VT. The results suggest that the effect of using specialized or no specialized muscle groups on the maintenance of VO2 steadiness is achieved through training-induced changes on the level of blood lactate and, in VT. PMID- 2770267 TI - Specific ergometry in the functional assessment of top class sportsmen. PMID- 2770268 TI - Flexibility characteristics of elite female and male volleyball players. AB - It is a common assumption that increased range of motion is related to high level performance, however it is difficult to provide conclusive evidence for this assumption due to the many variables contributing to skilled performance. The purpose of this study was to compare shoulder and hip flexibility to jumping height of members of the men's and women's United States Olympic Festival volleyball teams. Twenty-four men and 22 women were measured for standing vertical jump (SVJ) and approach vertical jump (AVJ), as well as range of shoulder extension (SHO) and hip flexion (HIP). A significant and positive correlation was revealed between AVJ and HIP for the men r = 0.42, p less than 0.03). For the women, significant and negative correlations resulted between SVJ and HIP (r = -0.54, p = 0.009) and between AVJ and HIP (r = -0.47, p = 0.03). Although a positive correlation between flexibility and AVJ observed for the men supported the assumption that greater flexibility is related to greater skilled performance, the opposite results occurred for the women. The negative correlations for the women indicate that the players with the greatest vertical jumps had the least hip flexibility. It was concluded that greater hip flexibility may benefit men more than women for jumping ability. PMID- 2770269 TI - Effects of arginine and ornithine on strength, lean body mass and urinary hydroxyproline in adult males. AB - Twenty-two adult males participated in a 5 week progressive strength training program. One half the subjects received the amino acids L-arginine and L ornithine and the other half, a placebo. The study used a double blind protocol so that subjects as well as investigators had no knowledge of which substances were being administered. Dosages amounted to 2 grams or 1 gram each of L-arginine and L-ornithine, and 600 mg of calcium and 1 gram of Vitamin C as placebos. These supplements were taken orally for a total of 25 administrations. Following the short term strength program using progressively high intensities, tests were taken for total strength (TS), lean body mass (LBM) and urinary hydroxyproline (UH). The results from ANOVA showed that subjects who were taking the arginine ornithine combination scored significantly higher in TS and LBM (p less than .05), and significantly lower in UH (p less than .05), than subjects on placebos. It was concluded that arginine and ornithine taken in prescribed doses can, in conjunction with a high intensity strength training program, increase TS and LBM in a relatively short period of time. Arginine and ornithine also aid in recovery from chronic stress by quelling tissue breakdown as evidenced by lower UH levels. PMID- 2770270 TI - Comparison of body composition, exercise and nutritional profiles of female and male body builders at competition. AB - Limited research information is available on the training programs and dietary practices of competitive male and female body builders. Information on body composition, training programs, and nutritional profiles of eleven competitive male and female body builders were obtained 48 hours prior to competition. Body composition was assessed by hydrostatic weighing. Skinfold data were obtained to assess the distribution of subcutaneous fat. Questionnaires concerning training programs and a three day food intake record were collected. The female body builders achieved a degree of leanness similar to the males. The relative training volumes for the women were greater than those of the men for all body regions. Gender differences were found in regional deposition of subcutaneous fat between males and females, with the males showing a more uniform distribution of subcutaneous fat. The nutritional profiles of male and female body builders were similar. The pre-competitive diets were low in kilocalories, and the relative energy intakes for men and women were 28.6 kcal/kg and 29.2 kcal/kg respectively. Both men and women consumed low fat and high protein foods. All of the vitamin/mineral intakes of the body builders exceeded the RDA's with the exceptions of calcium for men and women and iron for women only. PMID- 2770271 TI - Influence of exercise and cholesterol feeding on lipids and lipoproteins in rats. AB - The purpose of the study was to investigate the separate influence of exercise and dietary intervention and their interaction on body weight, heart weight, total cholesterol, and high density lipoprotein cholesterol (HDL-C) in rats. Thirty-two male rats were randomly placed into 4 groups: normal diet-inactive (NI), normal diet-exercise (NE), cholesterol diet-inactive (CI), and cholesterol diet-exercise (CE). The exercise protocol consisted of swimming to exhaustion with a 5% gram tail weight, 5 days x wk-1 for seven weeks. Both diet and exercise had a significant effect on heart weight/body weight ratios, primarily due to changes in body weight. Neither exercise nor diet intervention produced a significant change in heart weight. The high cholesterol diet produced greater total cholesterol levels (p less than 0.05), but significantly lower HDL-C levels (p less than 0.05) than the normal diet. Exercise exhibited no independent effect on cholesterol or HDL-C concentrations, although there was a trend in a favorable direction. The data suggest that exercise cannot offset the effects of a high cholesterol diet, and that dietary treatment may play a greater role than exercise on altering serum cholesterol and HDL-C. These data imply that aggressive diet therapy should accompany exercise in the treatment of high serum cholesterol. PMID- 2770272 TI - Metabolic responses associated with four modes of prolonged exercise. AB - The purpose of this study was to compare energy expenditure and substrate utilization during 60 min of steady state-exercise at similar heart rates (HR) using four exercise modes: stationary cycle (C), rower (R), ski simulator (S), and treadmill (walking) (T). Five subjects (means age = 23 +/- 4 yr) performed 60 min of continuous exercise at 65% HR max on each of the four modes in random order. Total energy (TE) and fat energy (FE) expenditure were determined from VO2 and respiratory exchange ratio (RER). VO2 during exercise averaged 2.427 for C, 2.167 for R, 2.242 for S, and 2.420 l min-1 for T and were not significantly different by repeated measures ANOVO (p greater than 0.05). RER, TE, and FE also were not statistically different among exercise modes. However, walking and skiing tended to use more fat; the average 60 min cumulative exercise values were 960 for C, 871 for R, 1088 for S, and 1188 kJ for T. The rate of fat expenditure generally increased after 20 min on all modes. These results indicate that the energy expended at comparable relative HR's is similar for four aerobic exercise modes. PMID- 2770273 TI - Pulmonary diffusing capacity as a predictor of performance in competitive swimming. AB - Pulmonary diffusing capacity has been noted by many investigators to be higher in championship swimmers than in average swimmers and in the non-swimming population. We measured pulmonary diffusing capacity (DLCO) and other parameters in 22 members of a collegiate swimming team and studied the relationship between pulmonary diffusing capacity and swimming performance. We also investigated change in lung function over a season of training and racing. Results suggested that while most good swimmers had above average diffusing capacities, there was no statistically significant difference in performance between those swimmers with high DLCO (greater than or equal to 110% predicted value) and those with a low DLCO (less than 100% predicted value). It was also determined that there was not a good correlation between performance (measured by either "best time" or "average time") and lung function (DLCO or VC). PMID- 2770274 TI - Career change: in quest of a controllable lifestyle. AB - Over the past decade, top medical students are selecting "controllable lifestyle" (CL) specialties at an increasing rate. CL specialties include anesthesiology, dermatology, emergency medicine, neurology, ophthalmology, pathology, psychiatry, and radiology. The choice of "noncontrollable lifestyle" (NCL) specialties such as family practice, internal medicine, obstetrics/gynecology, and pediatrics was negatively affected by this trend. The effect of CL on the selection of surgical training by top medical students was variable. The purpose of this study was to determine if CL is a factor in career change by young surgeons during and after residency. Graduates of the University of Kentucky College of Medicine from 1975 to 1983 (n = 796) were questioned regarding the specialty they entered after graduation and whether they remained in that specialty as of March, 1988. NCL and surgery specialties showed a net loss of practitioners during the study period (P less than 0.005) and CL showed a net gain (P less than 0.005). When physicians changed specialties, the direction of change occurred from NCL and surgery to CL (P less than 0.05). Change from CL to NCL and surgery occurred infrequently. PMID- 2770275 TI - Development and evaluation of a new polymeric material for small caliber vascular prostheses. AB - Polyethylene oxide (PEO), because of its low levels of protein and cellular adsorption, may provide a suitable coating for synthetic small caliber vascular prostheses. PEO/polysiloxane networks were synthesized via an acid-catalyzed epoxy/hydroxyl crosslinking reaction and used to produce conduits with a 4-mm internal diameter. Three networks with nominal PEO molecular weights of 2000, 8000, and 20,000 and all 65% PEO by weight were studied. Blood compatibility was assessed by measuring 111In-platelet and 125I-fibrinogen deposition in a baboon ex vivo shunt, over a 1-hr time period and at a flow rate of 50 ml/min. Differences in material performance were noted particularly after the initial 30 min blood contact period. Materials in the mid and high PEO molecular weight range (8000 and 20,000) had significantly lower levels of platelet adsorption than networks of low PEO molecular weight (2000) at 30 min (P less than 0.005) and 60 min (P less than 0.05). The lowest level of platelet deposition was noted on networks of high PEO molecular weight (20,000). During the observation period, platelet accumulation on this surface was less than one platelet per 1000 microns. Platelet deposition on Gore-Tex was two and three orders of magnitude greater than that on the high molecular weight PEO material at 30 and 60 min, respectively (P less than 0.001). Fibrinogen adsorption was also lower on materials of mid and high PEO molecular weights, when compared with low molecular weight networks (P less than 0.05) and Gore-Tex (P less than 0.05). Scanning electron micrographs confirmed these observations. Overall, platelet and fibrinogen depositions are low for PEO networks, particularly for materials of high PEO molecular weight. This latter observation may be related to increased surface molecular mobility and a relative enhancement of PEO content at the blood material interface. PMID- 2770276 TI - Fibronectin enhances early shear stress resistance of seeded adult human venous endothelial cells. AB - An in vitro parallel plate perfusion chamber was used to study the shear stress resistance of seeded adult human saphenous vein endothelial cells (AHSVECs) on glass surfaces coated with different substrates. Endothelial cells were seeded onto glass slides precoated with these substrates and then exposed to pulsatile flow with an average shear stress of 8 dyn/cm2 for 1 hr. After AHSVEC attachment periods of 15 min, 1 hr, and 2 hr, flow dislodged all but 1.4, 30.4, and 72.2%, respectively, of cells that had been seeded onto 1% gelatin. Control slides that were not exposed to flow retained 12.9% (P less than 0.03), 49.8% (NS), and 95.2% (NS) of seeded cells. Precoating the slides with 10 micrograms/ml fibronectin resulted in 69.4, 89.5, and 97.7% of cells remaining after flow, compared with 6.4% (P less than 0.03), 53.7% (NS), and 93.3% (NS), respectively, when using matched slides coated with 1% gelatin. Results with 20% fetal bovine serum as the substrate were not statistically different from those obtained with 1% gelatin. We conclude that fibronectin enhances the early attachment of AHSVECs to artificial surfaces and is, therefore, potentially useful for increasing attached cell yields on arterial prostheses prepared with immediate cell seeding techniques. PMID- 2770277 TI - Improved neonatal heart preservation with an intracellular cardioplegia and storage solution. AB - The optimal conditions for preservation of the neonatal heart for transplantation remain uncertain. An isolated, working neonatal piglet heart model was used to compare a standard extracellular-like cardioplegic solution followed by storage at 4 degrees C in normal saline for 12 hr (n = 8) to cardioplegia and storage at 4 degrees C for 24 hr in an intracellular-like solution (n = 7). Seven of eight hearts in the 12-hr Extracellular Group failed to regain function, with a maximum stroke work index (SWI), developed at a left ventricular end-diastolic pressure (LVEDP) of 9 mm Hg of 0.91 +/- 0.30 x 10(3) erg/g (mean +/- standard error of the mean), 7.1% of nonpreserved control hearts. In contrast, all hearts arrested and stored for 24 hr in the intracellular solution regained function with a maximum SWI, again at a LVEDP of 9 mm Hg of 9.51 +/- 1.98 X 10(3) erg/g, 73.7% of control (P less than 0.05). Ultrastructural changes seen by electron microscopy paralleled the functional results. We conclude that an intracellular arrest and storage solution may be superior to conventional solutions for extended preservation of the neonatal heart. PMID- 2770278 TI - Attenuation of ischemic renal injury with fructose 1,6-diphosphate. AB - Fructose 1,6-diphosphate (FDP) has been shown to attenuate tissue injury associated with ischemia and shock by enhancing the anaerobic carbohydrate utilization and by inhibiting oxygen-free-radical generation by the neutrophils. Previously, we have reported that FDP prevents ischemic renal failure if administered prior to the ischemic insult. The present study was designed to determine whether this agent could prevent renal damage when administered during the postischemic reperfusion period. Rats were subjected to 30 min of bilateral renal artery occlusion and infused with FDP (350 mg/kg body wt) beginning 10 min after release of the renal artery clamps. Control rats received an equal volume of glucose/saline solution. A third group of rats were sham operated. Twenty-four hours after injury, BUN, creatinine, and fractional sodium excretion values were less in FDP-treated rats than in control rats (P less than 0.001, P less than 0.005, and P less than 0.001, respectively) and not different from values observed in sham-operated rats. Inulin clearance was greater (P less than 0.001) in FDP-treated rats than in control rats (665 +/- 38 microliters/min/g kidney wt). Renal histology was also better preserved in the FDP-treated group. These data suggest that FDP infused after the initiation of an acute ischemic insult provides significant, but not complete, functional and histologic protection from renal damage. PMID- 2770279 TI - Localization by hand-held gamma probe of tumor labeled with antibody "cocktail". AB - Five groups (n = 4) of congenitally athymic female nude mice bearing subcutaneous implants of CX-1 and/or SW-1116 tumor in the hind limbs received iodine-125 radio labeled monoclonal antibodies (MoAbs) B72.3 (two groups), 17-1A (two groups), and cocktail (one group) (iodogen method, 50 microCi/10 micrograms/mouse). Daily probe counts were made in duplicate with a hand-held detector over each tumor site and the front leg (background) for 21 days. Animals were sacrificed and appropriate well counts were obtained. All the single MoAb preparations localized well in both tumor cell lines. Uptake of monoclonal antibody 17-1A was similar in the two tumor cell lines, with counts initially high and slowly decreasing over the 21-day period. Tumor/background ratios continued to increase over time, indicating that both tumor lines have similar antigenic expression for the monoclonal antibody 17-1A. This was not the case for monoclonal antibody B72.3, which showed a preferential uptake by the CX-1 tumor, with higher initial counts and prolonged binding of the antibody, giving rise to higher tumor/background ratios. The mixture of monoclonal antibodies B72.3 and 17-1A markedly improved the uptake by the CX-1 tumor cell line but not that by the SW-1116 cell line, where the effect was negative when compared to the uptake of the single MoAb preparations. The use of a monoclonal antibody mixture can enhance targeting of some tumor sites. Due to the heterogeneity of tumor cell lines, even within the same animal, different mixtures of monoclonal antibodies are needed to increase the targeting of tumor. PMID- 2770280 TI - Reduced intimal injury to canine arteries with controlled application of vessel loops. AB - Arterial intimal damage caused by elastic vessel loops was quantitated to determine (1) if they produce intimal injury, (2) if the injury is proportional to the force applied, and (3) if the injury is less than that produced by vascular clamps. Vessel loops were wrapped around 30 canine artery segments (5 mm in diameter) and a gram scale was connected to each to measure the force applied. The minimal occlusive force (MOF) and 150, 200, and 250 g force were applied for 30 min. For comparison, a Fogarty vascular clamp was applied at MOF for 30 min. Arteries were then reperfused for 30 min. Half was immediately harvested (group I); the remaining half was harvested at 2 weeks (group II). Scanning electron micrographs were made of each artery's intimal surface and graded from 0 (no injury) to 5 (severe intimal fracture). Mean injury grades were calculated. The MOF for vessel loops was 99 g. In group I, arteries subjected to less than 200 g force had a mean injury grade of 1.0 +/- 0.4; while those exposed to 200-250 g force had an injury grade of 3.5 +/- 0.7. The severity of injury was linearly correlated with the force applied (r = 0.72, P less than 0.009). In group II, the injury grade of 0.4 +/- 0.5 in arteries at MOF was significantly less than the injury grade of 2.8 +/- 0.5 in those at 200-250 g force, (P less than 0.0005). Injury grades of 3.7 and 3 were seen in groups I and II, respectively, when Fogarty clamps were applied. We conclude that vessel loops applied at MOF produce minimal injury. At greater occlusive forces, the injury is proportional to the force applied approaching that of a Fogarty clamp. Intimal injuries may be minimized when vessel loops are applied at MOF. PMID- 2770281 TI - Independent measurement of oxygen consumption and oxygen delivery. AB - This experiment investigated the relationship between oxygen consumption and oxygen delivery (cardiac output X arterial oxygen content) in an acute canine model. Previous studies investigating this relationship have largely utilized methods in which oxygen consumption and oxygen delivery were each calculated using the same measured variables resulting in mathematical coupling of variables. In this study, oxygen consumption was measured directly by closed circuit spirometry. Oxygen delivery was independently controlled using right atrial bypass. These techniques assured that the values for oxygen consumption and oxygen delivery were derived entirely independently. In our study using 11 dogs, we found that oxygen consumption was constant and independent of oxygen delivery at oxygen delivery levels greater than 8.0 cc/kg/min (normal canine oxygen delivery 20-25 cc/kg/min). Oxygen consumption was linearly related to oxygen delivery at oxygen delivery levels less than or equal to 8.0 cc/kg/min. Below this critical level of oxygen delivery, animals were more acidotic and hypotensive than at higher delivery levels. PMID- 2770282 TI - Monokine depression of bile flow in the isolated perfused rat liver. AB - Multiple system organ failure (MSOF) is a progressive dysfunction of vital organs that may develop in clinical settings such as sepsis or multiple trauma. One component of this syndrome is cholestasis and impaired liver function. The mechanism(s) for this liver failure (and the failure of other organs) remains obscure. Macrophages and Kupffer cells have been shown to secrete cytokines such as interleukin-1 and tumor necrosis factor. These cytokines mediate many aspects of the acute phase response, and they also can produce cellular injury. The purpose of this study was to evaluate the effects of a semipurified murine monokine preparation having interleukin-1 activity on bile flow in the rat isolated perfused liver (IPL). The monokine preparation produced a significant reduction of bile flow in the IPL system. The effect could not be explained by a venoocclusive phenomenon or residual endotoxin in the monokine preparation. We conclude that a semipurified monokine preparation having interleukin-1 but not tumor necrosis activity produced a significant depression of bile flow in the IPL, and we suggest that macrophage secretory product(s) may be responsible for the cholestasis in MSOF. PMID- 2770283 TI - A method for hepatic arterial perfusion studies in the rat. AB - The current model for selective hepatic arterial infusion therapy was evaluated for its suitability for short-term pharmacokinetic experiments. This preparation consists of selective cannulation of the common hepatic artery via the gastroduodenal artery of the rat. Radioactive microspheres were injected to determine hepatic or extrahepatic sites of perfusion. Radioactive microsphere determination of hepatic arterial flow and cardiac output were also performed. Our data indicate that at high flow rates (2 ml/min), significant loss of drug would occur due to retrograde flow. Modification of the model to include temporary proximal hepatic artery occlusion ensures hepatic delivery of greater than 95% of drug. Furthermore, temporary hepatic artery occlusion does not alter cardiac output or hepatic arterial blood flow. Selective hepatic arterial infusion in rats with synchronous temporary hepatic artery occlusion is an adequate model for short-term pharmacokinetic studies. PMID- 2770284 TI - CCK- and VIP-induced glycoprotein secretion from mouse gallbladder epithelium following vagotomy: a quantitative electron microscopic study. AB - The glycoprotein secretion from the mouse gallbladder epithelium induced by vasoactive intestinal peptide (VIP) and cholecystokinin (CCK) was investigated by electron microscopic morphometry. Both VIP and CCK caused a decrease in the volume density of the glycoprotein-containing granules of the principal cells. The effect on the gallbladder epithelium of a left-sided vagotomy was examined. Three and six weeks postvagotomy, slight decreases in cell and nuclear profile area and secretory granule volume density were noted. CCK induced a secretion of glycoprotein granules, whereas no such secretory effect due to VIP could be detected in animals 3 and 6 weeks after vagotomy. The results demonstrate that VIP, like CCK, is involved in glycoprotein secretion from the mouse gallbladder epithelium, but the secretory effect of VIP would appear to be dependent on an intact vagal innervation. The results are of interest in relation to the hypothesis that glycoprotein release may be a precipitating factor in the production of gallstones. PMID- 2770285 TI - A model of jejunoileal in vivo neural isolation of the entire jejunoileum: transplantation and the effects on intestinal motility. AB - The effects of intestinal transplantation on enteric physiology have not been well studied. Our aim was to determine the effect of jejunoileal transplantation on patterns of small intestinal motility. To avoid confounding effects of immune rejection or immunosuppression, we developed a model of autotransplantation in which all tissue connections to the entire jejunoileum were transected at the base of the mesentery except for the superior mesenteric artery and vein which were stripped meticulously of investing adventitia. After 3 weeks, motility was studied in eight dogs with intestinal electrodes during fasting, after meals of 50 and 500 g of liver, and during intravenous infusions of pentagastrin and cholecystokinin. During fasting, the characteristic inter-digestive migrating motor complex (MMC) was present in both the innervated duodenum and the "autotransplanted" jejunoileum; however, temporal coordination between the two regions was abolished. Feeding 50 g of liver abolished the MMC in the duodenum, but not in the jejunoileum; in contrast, 500 g of liver interrupted the MMC in both regions. Exogenous pentagastrin and cholecystokinin inhibited the MMC for the duration of the infusions. These findings suggest that extrinsic nerves and/or intrinsic (enteric) myoneural continuity do not initiate fasting motor patterns in the jejunoileum but do regulate the temporal coordination of motor patterns between segments of small intestine. Postprandial inhibition of the MMC is only in part mediated by neural factors. After transplantation, motility is abnormal; the overall effects on enteric physiology remain unknown. PMID- 2770286 TI - Sodium oxalate corrects calcium interference in Lowry protein assay. AB - We have previously noted that high levels (10 mM) of calcium interfere with protein determination in the Lowry assay. While there are numerous reports in the literature of substances interfering with the Lowry assay, none of these interfering substances are as ubiquitous as calcium. We hypothesized that physiologic levels of calcium may interfere with the protein determination as measured by the Lowry assay. To test this hypothesis, bovine serum albumin standards from 12.5 to 1600 micrograms/ml were tested in the Lowry assay in the presence of calcium chloride concentrations from 0 to 5 mM. In low protein concentrations (12.5-50 micrograms/ml) 1 to 2 mM calcium induced errors of up to 384%. In samples containing 100 to 400 micrograms/ml protein, 1 to 2 mM calcium induced errors of up to 40%. The addition of sodium oxalate to calcium-spiked protein samples significantly reduced the errors in protein determination at all calcium concentrations tested. This effect also is seen throughout the range of protein concentrations tested (50-1600 micrograms/ml). In most cases sodium oxalate pretreatment of samples used in the Lowry assay reduces errors by 70-95%. Physiologic levels of calcium induce significant errors in the estimation of protein concentration using the Lowry method. Routine pretreatment of Lowry samples with sodium oxalate will provide a more accurate estimation of the protein concentration in biological systems. PMID- 2770287 TI - Pneumococcal vaccine improves pulmonary clearance of live pneumococci after splenectomy. AB - The efficacy of pneumococcal capsular polysaccharide vaccines after splenectomy to decrease the incidence of postsplenectomy pneumococcal sepsis is controversial. We examined the effect of pneumococcal vaccine on clearance of live pneumococci from lungs of splenectomized and sham-operated mice following an aerosol challenge of pneumococci. Splenectomy impaired clearance of pneumococci from mouse lungs and allowed for increased translocation of pneumococci to tracheobronchial lymph nodes compared to shams (P less than 0.01). Pneumococcal vaccine improved lung clearance in both splenectomized and sham-operated mice compared to saline controls (P less than 0.01), but the number of live pneumococci recovered from lung pairs was greater in splenectomized mice compared to shams (P less than 0.01). Pneumococcal vaccination facilitated earlier translocation of pneumococci to tracheobronchial lymph nodes, and probably promoted bactericidal activity in these nodes, in both splenectomized and sham operated mice. Survival in splenectomized mice was improved by vaccination, but remained significantly less than that in saline-treated sham-operated mice (P less than 0.0009). The data show that pneumococcal vaccine can improve lung antipneumococcal defenses in splenectomized mice, but not to the same degree as in mice retaining their spleens. Pneumococcal vaccine should be given after splenectomy, but surgeons should caution patients that it may be less effective than when given to individuals with intact spleens or before elective surgery. PMID- 2770289 TI - Myocardial blood flow and oxygen consumption after aortic cross-clamping. AB - The effect of four repetitive periods of 10 min global ischemia, followed by 15 min of reperfusion on myocardial blood flow and oxygen consumption at 34 degrees C (group N) and 25 degrees C (group H) were studied in comparison with that of 60 min continuous ischemia combined with multidose St. Thomas Cardioplegia (group C) in dogs on cardiopulmonary bypass (CPB). Two groups, in which a protocol comparable to the groups N and H, respectively, but without repetitive periods of ischemia was followed, served as control. In all groups a hyperemic response was observed after release of aortic cross-clamping (AC). Myocardial blood flow was not diminished at the end of CPB as compared to the values at the start of CPB. We conclude that the no-reflow phenomenon did not occur after these procedures of intermittent or continuous AC. Immediately following release of AC the arterial coronary sinus difference of oxygen content reached a peak value in groups N and H indicating rapid replenishment of the low tissue oxygen content. These peak values appeared to be much smaller after cardioplegia. After 10 min of reperfusion a significant lower oxygen consumption was observed at 25 degrees C (0.2 mumole.g-1.min-1 O2) as compared to 34 degrees C (1.5 mumole.g-1.min-1 O2). This difference cannot be explained by temperature alone because oxygen consumption did not decrease below 0.5 mumole.g-1.min-1 in the control group of dogs put on CPB at 25 degrees C.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2770288 TI - Prothrombotic cytotoxicity of cyanoacrylate tissue adhesive. AB - Alkyl-2-cyanoacrylates exhibit properties suggestive of their use as surgical adhesives; however, their cytotoxic and proinflammatory properties have prevented their widespread application. The question of whether cyanoacrylate cytotoxicity may be due to eicosanoid production was investigated. Endothelial cells from rats were exposed to increased concentrations of isobutyl-2-cyanoacrylate. The products from this exposure promoted enhanced, concentration-dependent thromboxane biosynthesis as detected by platelet aggregation. When platelets were pretreated with 1-carboxyheptylimidazole (2.0 mM), an inhibitor of thromboxane biosynthesis, up to 80% less aggregation was observed. Such aggregation was inhibited using 1-carboxyheptylimidazole in a dose-dependent manner. Treatment of endothelial cells with isobutyl-2-cyanoacrylate and 1-carboxyheptylimidazole did not significantly alter the amount of platelet aggregation. A soluble metabolite of isobutyl-2-cyanoacrylate appeared to activate platelet aggregation. The cytotoxicity associated with the surgical use of alkyl-2-cyanoacrylates may be mediated by enhanced local thromboxane production. PMID- 2770290 TI - Gastrointestinal motor patterns: motilin as a coordinating factor. AB - Our aim was to further define the role of neural and hormonal control of upper gastrointestinal motility patterns. In five dogs, the stomach and duodenum were separated enterically by transecting and oversewing the proximal duodenum and by anastomosing a Roux-en-Y jejunal limb to the pylorus. Five intact dogs served as controls. After recovery, motility was recorded on four or more occasions during fasting and after feeding. Plasma was sampled for motilin radioimmunoassay. In three Roux-en-Y dogs, motilin (0.1 microgram/kg iv) was administered. We found in the Roux-en-Y group that the characteristic MMC occurred in the stomach, duodenum, and jejunal limb, but the jejunal MMC had a much shorter period (P less than 0.005). Gastric and duodenal MMCs were coordinated temporally and were associated with peaks in plasma motilin concentration. Jejunal MMCs had no apparent association with plasma motilin. Feeding disrupted the gastric and duodenal MMC and decreased plasma motilin, but inhibited the jejunal MMC in only 6 of 12 experiments. Exogenous motilin induced a "premature" MMC in the stomach, duodenum, and jejunum. This study suggests that (1) enteric neural continuity and/or luminal continuity are not necessary for coordination of gastric and duodenal motor patterns, and (2) post-prandial inhibition of the duodenal MMC may not depend on the presence of ingested nutrient in the duodenum. Hormonal factors, possibly motilin, may play a role in initiation and coordination of gastric and duodenal motor patterns. PMID- 2770292 TI - Effects of chronic alcohol intake and secretory stimulation on sodium taurocholate-induced pancreatic necrosis in the rat. AB - The effects of long-term alcohol intake and pancreatic secretory stimulation on pancreatic necrosis were studied in rats with acute pancreatitis induced by an intraductal injection of sodium taurocholate. Neither alcohol nor pancreozymin alone influenced the extent of pancreatic tissue damage in this experimental model. However, when animals were exposed to both alcohol and pancreozymin, the tissue lesions induced by the bile salt were wider than those in the presence of either alcohol or secretory stimulation alone. The results indicate that secretory stimulation with pancreozymin superimposed on chronic alcohol intake sensitizes the pancreas to the injury caused by intraductal bile salt administration. PMID- 2770291 TI - A demonstration of vascular proliferation in response to arteriovenous reversal in the ischemic canine hind limb. AB - Patients with diffuse peripheral vascular disease, resulting in inadequate arteriographic runoff, and/or multiple failed bypasses almost inevitably face amputation. We have previously used an arteriovenous reversal (AVR) procedure at the popliteal level to salvage severely ischemic canine hind limbs. This procedure is followed by the development of an intense network of new vessels in the proximity of the arteriovenous anastomosis. The present study was designed to define the nature of these vessels and their role in providing nutrient perfusion to the limb. Using an established model to create severe limb ischemia. AVR was performed in 24 dogs. Tissue perfusion and neovascularization were assessed by angiography, transcutaneous oximetry (TcpO2), tritiated thymidine uptake combined with autoradiography, and histologic capillary density measurements. Angiography revealed the intense vascular network in the region of the anastomosis by postoperative Day 22 in all dogs. TcpO2 on Day 1 was indicative of severe ischemia in the operated calf compared to controls (12 vs 80 mm Hg, P less than 0.01) but returned to normal by Day 22 (81 vs 76 mm Hg). A progressive, significant increase in tritiated thymidine uptake was seen by Day 22 (0.36 vs 0.27 microCi/g, P = 0.005); on autoradiography 95% of these labeled nuclei in the operated limbs were in endothelial cells compared to only 5% in the control limbs. Finally, capillary density studies of the calf muscles showed a substantial increase in the operated limbs (mean, 1011 vs 605 cap/mm2, P = 0.0004). These studies suggest that the dramatic increase in vascularity observed angiographically following AVR in a severely ischemic limb consists primarily of a rapidly expanding capillary network.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2770293 TI - Isometric contractile function recovery following tourniquet ischemia. AB - The purpose of this study was to document the recovery of isometric contractile function following tourniquet ischemia. Male Wistar rats (N = 27) were subjected to unilateral hindlimb tourniquet ischemia of 0 hr (control, N = 6), 1 hr (N = 5), 2 hr (N = 5), 3 hr (N = 5) and 4 hr (N = 3). Following a 2-week recovery period, isometric force measurements were made from both gastrocnemii of each rat with the contralateral limb acting as the control side. Each muscle was analyzed for maximal twitch (Pt, N/g), maximal rate of rise of twitch tension (DP/dt, N/sec), time to peak tension (TPT, msec), half relaxation time (RT 1/2, msec), maximal tetanus (P0, N/g, at 100 Hz), and fatigue (Burke Fatigue Protocol). Pt, P0, and DP/dt were significantly different from control values (P less than 0.05) for all hours of tourniquet ischemia. A strong negative correlation (P less than 0.001) was found for twitch (R = -0.84), tetanus (R = -0.78), and maximal rate of force development (R = -0.83) with respect to increasing hours of ischemia. The recovery of isometric twitch and tetanic function following tourniquet ischemia is inversely related to the ischemic interval. This study quantified the relationship between muscle ischemia and recovery of function following a 2-week interval and stresses the functional physiological changes which occur in skeletal muscle following tourniquet ischemia. PMID- 2770294 TI - Levels of the 90kd heat shock protein and resistance to glucocorticoid-mediated cell killing in a range of human and murine lymphocyte cell lines. AB - The 90kd heat shock protein is associated with the receptors for glucocorticoids and other steroids. The steroid is believed to function by releasing the receptor from hsp90 allowing the receptor to bind to DNA and activate transcription. The levels of hsp90 have been measured in a variety of lymphoid cell lines and compared with their sensitivity to steroid mediating killing. No correlation of high hsp90 levels with steroid resistance was observed. However, increased levels of hsp90 in response to steroid were observed in a number of cell lines. The significance of these findings is discussed in terms of the modulation of the cells response to steroid treatment and the mechanism of steroid resistance. PMID- 2770295 TI - A rapid, sensitive method for the simultaneous quantitation of estradiol and estradiol conjugates in a variety of tissues: assay development and evaluation of the distribution of a brain-enhanced estradiol-chemical delivery system. AB - A rapid and sensitive method that permits the simultaneous quantitation of estradiol (E2) and the E2 conjugate [estradiol 17-(1,4-dihydrotrigonellinate)] in biological tissues from rats is described. This method development was necessitated by the design of this E2-chemical delivery system (E2-CDS) which permits the predictable metabolism of the E2-CDS to a charged quaternary ion (E2 Q+) and its subsequent hydrolysis to slowly liberate E2. Based upon in vitro determinations of the rates of oxidation of E2-CDS to E2-Q+ and hydrolysis of E2 Q+ to E2, we anticipated that concentrations of E2-Q+ would be several orders of magnitude higher in tissues than E2. Three steps were used to extract and prepare samples for the radioimmunoassay (RIA) of estradiol. The first step is homogenization and extraction of the biological samples with an organic solvent; the second step is the base catalyzed hydrolysis of the E2 conjugate in 1 N NaOH; and the third step utilizes solid-phase extraction (SPE) with C18 reversed-phase columns which provide a means of achieving a rapid and precise extraction and separation of E2. The analysis of plasma samples does not require the initial solvent extraction. All purified E2 samples were then reconstituted in the assay buffer and assayed by RIA for E2. The application of this procedure to the determination of E2-Q+ and E2 in biological materials was assessed for specificity, reliability and recovery in vitro by using tissues and plasma from rats and in vivo evaluations of the distribution of E2 and E2-Q+ were done using rats treated with 1 mg E2-CDS/kg. Our in vitro analyses revealed that E2 and E2 Q+ could be differentially extracted with a high recovery and that both compounds could be specifically and reliably assayed in brain, plasma, anterior pituitary, liver, kidney, lung, heart and adipose tissue. In vivo analyses revealed that following a single i.v. injection of E2-CDS, brain levels of E2 exceeded serum levels by 30-, 41-, and 82-fold while brain levels of E2-Q+ exceeded serum levels by 33-, 70-, and 294-fold at 1, 7 and 14 days, respectively. Collectively, these data indicate that E2-Q+ and E2 can be reliably quantitated in a variety of tissues following the administration of an E2-chemical delivery system. PMID- 2770296 TI - Prolonged cultivation of rat uterine cells with preserved estrogen responsiveness. AB - A rat uterine cell culture was prepared as an experimental system for investigation of mechanisms of steroid hormone actions. Cells frequently supplemented with fresh medium were successfully cultured for 4 weeks through 2 successive passages. Studies of estrogen responsiveness in the primary culture as well as in it's first subculture were performed by a small scale uptake assay for determination of specific steroid binding. Scatchard analysis of specific ovarian hormone binding confirmed that cultured uterine cells preserve both estradiol and progesterone receptors. Characteristics of specific [3H]estradiol binding detected in cells of the first subculture were comparable to those obtained in the initial primary culture. The number of specific estradiol binding sites was diminished to one third of the initial values only in cells of the second subculture, 22 days after isolation of cells from tissue. In the primary culture and in it's first subculture the cells responded to estradiol with a 2-3-fold increase in progesterone receptor level. The subcellular distribution of steroid receptors was also studied; estradiol receptor complexes were detected predominantly in the nuclei whereas progesterone receptors were nearly equally distributed between nuclei and cytosol. PMID- 2770297 TI - Human placental 3 beta-hydroxy-5-ene-steroid dehydrogenase and steroid 5----4-ene isomerase: purification from mitochondria and kinetic profiles, biophysical characterization of the purified mitochondrial and microsomal enzymes. AB - In human placenta, 3 beta-hydroxy-5-ene-steroid dehydrogenase and steroid 5----4 ene-isomerase, an enzyme complex found in microsomes and mitochondria, synthesizes progesterone from pregnenolone and androstenedione from fetal dehydroepiandrosterone sulfate. The dehydrogenase and isomerase activities of the mitochondrial enzyme were copurified (733-fold) using sequential cholate solubilization, ion exchange chromatography (DEAE-Toyopearl 650S), and hydroxylapatite chromatography (Bio-Gel HT). Enzyme homogeneity was demonstrated by a single protein band in SDS-polyacrylamide gel electrophoresis (monomeric Mr = 41,000), gel filtration at constant specific enzyme activity (Mr = 77,000), and a single NH2-terminal sequence. Kinetic constants were determined for the oxidation of pregnenolone (Km = 1.6 microM, Vmax = 48.6 nmol/min/mg) and dehydroepiandrosterone (Km = 2.4 microM, Vmax = 48.5 nmol/min/mg) and for the isomerization of 5-pregnene-3,20-dione (Km = 9.3 microM, Vmax = 914.2 nmol/min/mg) and 5-androstene-3,17-dione (Km = 27.6 microM, Vmax = 888.4 nmol/min/mg. Mixed substrate studies showed that the dehydrogenase and isomerase activities utilize their respective pregnene and androstene substrates competitively. Dixon analysis demonstrated that the product steroids, progesterone and androstenedione, are competitive inhibitors of the C-21 and C-19 dehydrogenase activities. Enzyme purified from mitochondria and microsomes had similar kinetic profiles with respect to substrate utilization, product inhibition, and cofactor (NAD+) reduction (mean Km +/- SD using C-19 and C-21 dehydrogenase substrates = 26.4 +/- 0.8 microM, mean Vmax = 73.2 +/- 1.3 nmol/min/mg). Pure enzyme from both organelles exhibited identical biophysical properties in terms of molecular weight and subunit composition, pH optima (pH 9.8, dehydrogenase; pH 7.5, isomerase), temperature optimum (37 degrees C), stability in storage and solution, effects of divalent cations, and the single NH2-terminal sequence of 27 amino acids. These results suggest that the mitochondrial and microsomal enzymes are the same protein localized in different organelles. PMID- 2770298 TI - A simple method for the measurement of the steroid fraction bound to sex hormone binding globulin in serum. AB - The steroid-protein binding equilibrium in extra-cellular fluids is considered to have possible relevance to the development of endometrial and breast cancer. A method is described to measure the fraction of steroid bound to sex hormone binding globulin (SHBG) in serum, using binding of SHBG to Con-A-sepharose. To validate the assay, serum samples with different SHBG levels were studied at various dilutions and with various amounts of added ligands. Sera with high SHBG concentrations still showed considerable steroid binding after heating to 59 degrees C for 30 min. The intra-assay variation of the assay ranged from 2-4%, the inter-assay variation was approx. 5%. PMID- 2770299 TI - Formation of lipoidal steroids in follicular fluid. AB - The presence of high levels of lipoidal pregnenolone in follicular fluid has recently been established although no evidence has been presented concerning its possible origin. The following investigation focuses on the enzymatic conversion of non-conjugated steroids into their lipoidal derivatives in preovulatory follicular fluid obtained from women undergoing in vitro fertilization. Our observations indicated that pregnenolone, an important precursor steroid, was acylated at a similar rate as cholesterol in follicular fluid. Similar studies were subsequently conducted with serum obtained from a pool of normal women and women undergoing follicular stimulation which showed little difference to the results obtained in follicular fluid. Further studies using dehydroepiandrosterone, androst-5-ene-3 beta,17 beta-diol, estradiol and dihydrotestosterone were were also performed to monitor their respective lipoidal conversion percentages in follicular fluid which revealed a marked difference of conversion rates between steroids. The indirect identification of the lipoidal pregnenolone derivatives formed in follicular fluid was also conducted by incubating radiolabelled pregnenolone in follicular fluid. The fatty acid components of the resulting lipoidal pregnenolone derivatives showed a marked resemblance to those of cholesteryl esters formed in plasma by the enzymatic activity of lecithin:cholesterol acyltransferase. The pregnenolone derivatives were comprised predominantly of unsaturated fatty acids such as linoleate, palmitoleate, oleate, linolenate and arachidonate while saturated fatty acids, namely palmitate, constituted 20% of the total lipoidal pregnenolone. PMID- 2770300 TI - Microbial transformations of steroids--IV. 6,7-Dehydrogenation; a new class of fungal steroid transformation product. AB - Microbial steroid dehydrogenation is quite common. The reaction seems to occur mainly in bacteria and usually results in hydrogen abstraction from positions C(1)-C(2) and/or C(4)-C(5) with occasional aromatisation of ring A. We have screened large numbers of fungal cultures for their ability to monohydroxylate steroids at unusual sites and in the course of our investigations we have identified seven fungal strains capable of dehydrogenating ring B of progesterone and androstenedione at positions C(6)-C(7). Microbiological dehydrogenation at this site seems not to have been reported previously. The structures of the metabolites isolated from progesterone, and the producing fungi, are: 6 dehydroprogesterone (Botryodiplodia theobromae), 11 alpha-hydroxy-6 dehydroprogesterone (Botryosphaerica obtusa, Mucor racemosus and Nigrospora sphaerica), 12 alpha-, 15 beta- and 16 alpha-hydroxy-6-dehydroprogesterones (B. obtusa) and 14 alpha-hydroxy-6-dehydroprogesterone (Apiocrea chrysosperma) [1]. From androstenedione we isolated 6-dehydroandrostenedione (Absidia coerulea and Curvularia lunata) and 6-dehydrotestosterone (C. lunata). PMID- 2770301 TI - A convenient, unified scheme for the differential extraction of conjugated and unconjugated serum C19 steroids on Sep-Pak C18-cartridges. AB - In order to conveniently and rapidly isolate by group both conjugated and unconjugated serum androgens, a scheme has been devised for their differential extraction from commercially available, disposable octadecylsilane cartridges (Sep-Pak C18). Using added radioactive steroid standards and detection of endogenous serum steroids by group-specific enzymatic assays, the quantitative recovery of steroid glucuronides and sulfates in the 47% methanol fraction and of unconjugated steroids in the 100% methanol fraction was observed. Maximum recovery of serum protein-bound steroids (e.g. testosterone) was achieved with serum denatured by urea and heat. In order to separate glucuronides from sulfates, sequential hydrolysis of the conjugated fraction (47% methanol) by enzymatic hydrolysis and then organic solvolysis as well as an additional Sep-Pak cartridge extraction step was required. Groups of extracted steroids may be further separated and assayed by any appropriate method(s). An application is given which employs HPLC and an enzymatic assay for 17 beta-hydroxy- and 17-oxo steroids to provide separate profiles of unconjugated, glucuronidated, and sulfated androgens in human, male serum. PMID- 2770303 TI - Determination of estradiol 2- and 16-alpha-hydroxylase activities in MCF-7 human breast cancer cells in culture using radiometric analysis. AB - Using a radiometric assay the effects of estradiol upon the activity of estradiol 2- and 16 alpha-hydroxylases in MCF-7 human breast cancer cells in culture were studied. After 5 days of treatment and 36 h of withdrawal, incubation in the presence of either 2- or 16 alpha-tritiated substrate was carried out. Estradiol (10 nM) significantly increased 16 alpha-hydroxylase activity (21%, P less than 0.01), while no effects on 2-hydroxylase activity was observed. Treatment for 6 weeks caused a major increase in 16 alpha-hydroxylation (65%, P less than 0.001) and a significant reduction in 2-hydroxylation (21%, P less than 0.05). These effects were not observed in estrogen receptor-negative MDA-MB-231 human breast cancer cells. Our observations suggest that these two metabolic pathways in MCF-7 cells are independently regulated and that this regulation is affected via the estrogen receptor. PMID- 2770302 TI - Two progesterone receptors in the oviduct of the freshwater turtle Chrysemys picta: possible homology to mammalian and avian progesterone receptor systems. AB - Two progesterone receptors in the oviduct of the freshwater turtle Chrysemys picta: possible homology to mammalian and avian receptor systems. Here we report the characterization of two specific progesterone receptors in nuclear extracts of the turtle oviduct. The receptors differ in dissociation constants (2.8 nM vs 27 nM) which can be separated on DEAE-Sepharose, the former eluting at 0.08 M KCl and the latter at 0.20 M KCl. [3H]R5020 photoaffinity labeling SDS-PAGE revealed that the 2.8 nM moiety migrates with an apparent molecular weight of 80 +/- 5 kDa and the 27 nM moiety migrates with an apparent molecular weight of 120 +/- 5 kDa. These receptors are termed PR-A and PR-B due to their molecular mass and elution profiles. DNA-cellulose chromatographic studies show that both bind DNA-cellulose with the PR-A eluting at 0.09 M NaCl and PR-B eluting between 0.20-0.21 M NaCl. In reproductively inactive turtles (from the months of January and February) estradiol is undetectable, and PR-B is absent as determined by Scatchard analysis, [3H]R5020 photoaffinity labeling electrophoretic studies and DEAE Sepharose and DNA-cellulose chromatography. In these animals PR-B can be replenished by estrogen treatment, suggesting a physiological role for both PR-A and PR-B and dependence of PR-B on estradiol. PMID- 2770304 TI - Correlation of DNA ploidy and clinical outcome in Borrmann type 4 gastric carcinoma. AB - The correlation between DNA ploidy pattern and clinical outcome was studied in 76 patients with Borrmann type 4 gastric carcinomas. Twenty-six tumors were diploid, and 50 tumors were aneuploid. There was no correlation among DNA ploidy and histologic type, lymph-node status, wall invasion, or clinical stage. The incidence of vascular invasion in the aneuploid tumors was significantly higher than that in the diploid tumors. Five year survival was achieved in 28% of the patients with diploid tumors and 8% of those with aneuploid tumors, respectively. Among the patients undergoing curative resection, 5 year survival rate was 54% in the patients with diploid tumors compared to 28% with aneuploid tumors. There was a significant survival advantage in patients with diploid tumors. These results indicate that DNA ploidy might be an important prognostic factor in Borrmann type 4 gastric carcinomas. PMID- 2770305 TI - Metastatic tumors of the penis. AB - Six patients with metastases to the penis are described. The main characteristics of the primary tumors are described, along with the treatments, the features of the metastasis, and the response to treatment. Although in one patient a survival of 5 years was obtained, metastasis to the penis is generally associated with a dismal prognosis. A brief commentary is made concerning mechanisms of metastases formation. PMID- 2770306 TI - Accuracy of the subrenal capsule xenograft assay in predicting the clinical growth and chemosensitivity of human squamous head and neck carcinomas. AB - Thirty-seven of 54 human squamous head and neck carcinomas were successfully grown as first transplant generation xenografts under the kidney capsule of conventional mice immunosuppressed by daily treatment with 60 mg/kg of cyclosporine. Of the 18 different tumors evaluated for chemosensitivity, 39% responded to cis-platinum, 19% to 5-fluorouracil, 33% to methotrexate, and 40% to Cis-Pt/5Fu. In comparing the assay results in nine patients who received the same chemotherapeutic drugs, two of three patients responded to their drug with xenograft shrinkage noted, whereas four of six patients who did not respond had tumor growth in the mouse. It is hoped that this model will become useful for new drug testing and, in certain cases, for selection of chemotherapy for patients with refractory tumors. PMID- 2770307 TI - MTT assay with reference to the clinical effect of chemotherapy. AB - Tumor cells from 40 patients were tested by MTT assay. Five thousand to sixteen thousand tumor cells were plated into 96-well microplates with various concentrations of anticancer agents. After incubation for 48 h, the absorbance of each well was detected with an EIA reader and the effects of the agents were evaluated as positive when the inhibition rate was equal to or more than 50%. Normal cells were also processed under the same conditions, and the absorbance for normal cells was lower than that of tumor cells with statistical significance (P less than 0.05). The efficacy rates of MMC, 5-FU, ADM, and CDDP were 16.7, 8.3, 13.9, and 5.6%, respectively. The overall accuracy of this assay for clinical effects was 83.3%, with one false-positive and five true-negative cases. This MTT assay was also assumed to be useful for in vitro chemosensitivity testing of fresh surgical specimens. PMID- 2770308 TI - Management of nodal metastases from head and neck melanoma. AB - Ninety-three patients with nodal metastases from melanoma (stage II) located in the head and neck underwent surgery at the National Cancer Institute of Milan. Different surgical techniques were employed, ranging from radical to conservative treatment. Analysis of the data shows no significant difference from an oncological standpoint between radical and conservative surgery when a radical dissection is performed. Elective nodal dissections for malignant melanoma of the head and neck region, like those at other sites of lymphatic drainage such as the groin and axilla, did not prove beneficial. We do recommend parotidectomy in cases where the primary tumor arises in the superior area of the head. The number of nodes involved and the type of disease spread constitute the major prognostic factors, as in the case of melanomas located in other sites. Our data further indicate that the incidence of distant and local recurrence is not influenced by the type of dissection performed. PMID- 2770309 TI - Morphologic and morphometric studies on tumor necrosis produced by radiotherapy, and hyperthermia singly and in combination. AB - The purpose of the present study was to evaluate the therapeutic effects of hyperthermia associated with radiotherapy on neoplasia. Two transplanted experimental tumors (undifferentiated carcinoma of mouse breast and sarcoma 37) were used. A protocol was followed that included, for both models, four groups of animals: 1) control group; 2) radiotherapy group; 3) hyperthermia group; 4) radiotherapy associated with hyperthermia group. The animals were sacrificed after therapy according to a different schedule for each type of tumor. The morphology of the neoplasia in every group of treated tumors was compared with that of the control group. For quantitative evaluation of the necrosis, we studied the ratio of the tumor necrotic areas (N) to a tumor standard area (T). From the results obtained, the following conclusions were made: 1) Necrosis produced by combined treatment was significantly greater than that obtained by using one only; 2) necrosis appeared early after treatment and remained relatively unchanged; 3) The damaging effect of the hyperthermia occurred earlier than that produced by radiotherapy when these methods were used separately, thus suggesting distinct mechanisms of tumor necrosis. PMID- 2770310 TI - New intraoperative brachytherapy techniques for positive or close surgical margins. AB - Tumors attached or adjacent to critical structures can often not be completely resected or resected with adequate surgical margins. Sites involving major blood vessels, the paravertebral spaces, or critical abdominal structures often present technical difficulties for standard brachytherapy procedures using I-125 or Ir 192 implants. These techniques allow for a high-dose delivery to the tumor bed with minimal normal tissue toxicity. A relatively simple and accurate method is described using I-125 seeds in Vicryl suture threaded through Gelfoam. These permanent implant procedures with radioactive I-125 seeds effectively treat small residual tumors or suspicious margins where standard brachytherapy techniques may be unsatisfactory and technically difficult to perform. PMID- 2770311 TI - Metastatic sweat gland carcinoma: response to 5-fluorouracil infusion. AB - A 78-year-old white male presented with metastatic sweat gland carcinoma involving regional lymph nodes, pleura, pericardium, and chest wall. A complete response of three months duration was achieved by using a 96-hour infusion of 5 fluorouracil. This is the first report of a complete response to systemic chemotherapy in metastatic sweat gland carcinoma. PMID- 2770312 TI - Versatile perfusion chamber for high-magnification microscopy. AB - The large number of culture or perfusion chambers reflects the necessity of researchers to develop them from time to time because of specific biologic or optical requirements. The paper described a new versatile perfusion chamber, which can be machined at low cost and with a very rapid assembly procedure. An additional interesting feature is the lock system with an annular threaded screw that fits the angle of the objective, thus increasing the field of observation. PMID- 2770313 TI - High current pulser for transmural and field stimulation. AB - The determination of the requirements and the design of a constant current pulse generator with low internal resistance capable of providing the high currents required for transmural and field stimulation of biologic tissues are described. It is concluded that direct measurement of current flowing and voltage applied to electrodes is the best way of monitoring stimulus parameters. PMID- 2770314 TI - Device for quantitating tremor activity in mice: antitremor activity of atropine versus soman- and oxotremorine-induced tremors. AB - A tremor monitor was constructed and tested that quantitates soman- and oxotremorine-induced tremors. The device consisted of a force transducer, from which was suspended a plastic beaker containing a mouse. The signal from the force transducer was fed into a tremor monitor, which was essentially a low-pass filter, and quantitated using the Applecounter from Columbus Instruments (Columbus, Ohio) with the data stored on floppy diskette in a personal computer or on a magnetic tape cassette. The tremor monitor demonstrated a dose response relationship to both soman- and oxotremorine-induced tremors and the antagonism of these tremors by various doses of atropine. In addition, the duration of action of a dose of atropine (17.4 mg/kg, ip) normally used in the therapy of organophosphate poisoning was assessed using the atropine antagonism of oxotremorine-induced tremors as an indicator. This device permits the unbiased determination of the tremor activity of a drug and allows the use of statistical analysis on the data produced. PMID- 2770315 TI - New versatile restraining device for use with rats in pharmacokinetic or pharmacological studies involving chronically implanted cannulae or electrodes. AB - A new design for a rat restraining device is described. Features of the device include facilities to allow the accommodation of rats of a very wide weight range and to maximize its convenience in use in a variety of procedures including the collection of blood, feces, and urine. The restrainer is designed to minimize stress in the rat in the course of pharmacokinetic or pharmacological studies. The device is particularly useful for studies involving chronically cannulated animals. PMID- 2770316 TI - The effect of ischemic time and temperature on lung preservation in a simple ex vivo rabbit model used for functional assessment. AB - Despite 25 years of research in lung transplantation, little progress has been made in methods for improving lung preservation. To evaluate many factors that may affect lung function after preservation, we have developed a simple, reliable, and inexpensive animal model. This consists of an isolated rabbit lung preparation perfused with blood and ventilated with a closed-circuit system. Heart-lung blocks were harvested and the left lung was assessed after ligation of the right pulmonary artery and right main-stem bronchus. On completion of a storage period, the left lung was ventilated and perfused with fresh rabbit venous blood at a rate of 40 ml/min for 10 minutes. Assessment of lung function included gas analysis of infused and effluent blood, oxygen uptake, mean pulmonary artery perfusion pressure, and mean airway pressure. A control group and six preservation groups were evaluated, each with different storage temperatures (38 degrees C, 34 degrees C, 23 degrees C, 15 degrees C, 10 degrees C, and 4 degrees C). For each temperature, ischemic periods ranging from 1 to 30 hours were studied. In the control group, the lungs were assessed immediately after being harvested. In the preservation groups, the lungs were kept partially inflated, stored at a predetermined temperature by immersion, and later assessed after variable ischemic periods. Our studies demonstrated the following: (1) The degree of impaired lung function produced by ischemia is reflected by a decrease in oxygen uptake and in oxygen tension of the effluent pulmonary venous blood and an increase in pulmonary artery perfusion pressure; (2) hypothermia improves ischemic tolerance; (3) preservation of lung at 10 degrees C is superior to preservation at 15 degrees C and 4 degrees C. This screening model has allowed evaluation of independent multiple factors and methods pertinent to lung preservation and enables one to assess lung function reliably and rapidly. PMID- 2770317 TI - Aortic ruptures in seat belt wearers. AB - Several investigations have indicated that rupture of the thoracic aorta is one of the leading causes of immediate death in victims of road traffic accidents. In Finland in 1983, 92% of front-seat passengers were seat belt wearers on highways and 82% in build-up areas. The mechanisms of rupture of the aorta have been intensively investigated, but the relationship between seat belt wearing and injury mechanisms leading to aortic rupture is still largely unknown. This study comprises 4169 fatally injured victims investigated by the Boards of Traffic Accident Investigation of Insurance Companies during the period 1972 to 1985. Chest injuries were recorded as the main cause of death in 1121 (26.9%) victims, 207 (5.0%) of those victims having worn a seat belt. Aortic ruptures were found at autopsy in 98 victims and the exact information of the location of the aortic tears was available in 68. For a control group, we analyzed 72 randomly chosen unbelted victims who had a fatal aortic rupture in similar accidents. The location of the aortic rupture in unbelted victims was more often in the ascending aorta, especially in drivers, whereas in seat belt wearers the distal descending aorta was statistically more often ruptured, especially in right-front passengers (p less than 0.05). The steering wheel predominated statistically as the part of the car estimated to have caused the injury in unbelted victims (37/72), and some interior part of the car was the most common cause of fatal thoracic impacts in seat belt wearers (48/68) (p less than 0.001). The mechanism of rupture of the aorta in the classic site just distal to the subclavian artery seems to be rapid deceleration, although complex body movements are also responsible in side impact collisions. The main mechanism leading to rupture of the ascending aorta seems to be severe blow to the bony thorax. This also often causes associated thoracic injuries, such as heart rupture and sternal fracture. Injuries in the ascending aorta were mostly found in unbelted victims and were sustained in frontal impact collisions, the injury-causing part of the car being the steering wheel. Ruptures of the distal descending part of the aorta were frequently associated with fractures of the thoracic vertebra. PMID- 2770318 TI - The morphology of the normal aortic valve as compared with the aortic valve having two leaflets. AB - We studied 30 normal aortic valves and 64 aortic valves with only two leaflets to examine their morphologic components. The components of the aortic valve are the leaflets, the sinuses, and the interleaflet triangles. The first part of our study shows the relationship of these component parts of the normal aortic valve to the other cardiac structures. The second part shows a wide variation in the architecture of valves having two leaflets. Having produced criteria for the number of sinuses and the number of leaflets, we discovered that previous criteria used in the definition of valves with two leaflets are inadequate when the whole valvular complex is considered. Only seven valves in the study have two leaflets supported by two sinuses. The evidence points to the other valves having started with three leaflets but becoming bicuspid during either intrauterine or postnatal life. PMID- 2770320 TI - Cardiopulmonary bypass without systemic heparinization. Performance of heparin coated oxygenators in comparison with classic membrane and bubble oxygenators. AB - Performance characteristics of heparin-coated hollow-fiber membrane oxygenators (COATED HFMO, n = 5) were evaluated in an open-chest dog model without systemic heparinization. Four other oxygenators were evaluated with standard systemic heparinization (300 IU/kg, activated clotting time more than 400 seconds): a standard hollow-fiber membrane oxygenator (HFMO, n = 5), an inversed hollow-fiber membrane oxygenator (IHFMO, n = 5), a plate membrane oxygenator (PLATE MO, n = 5) and a bubble oxygenator (BUBBLE O, n = 5). The 25 dogs (36 +/- 12 kg) were perfused after cavo-aortic cannulation for 6 hours with a mean flow of 100 ml/kg body weight. At the end of perfusion without systemic heparin, heparin-coated equipment was replaced in three animals with standard uncoated equipment for control studies. Besides continuous hemodynamic evaluation with Mikro-Tip pressure transducers (Millar Instruments, Inc., Houston, Texas), a standard battery of analyses was performed before, after mixing, and every 30 minutes during bypass. All animals could be perfused in accordance with the protocol. Blood-gas values (pH, arterial oxygen tension, and arterial carbon dioxide tension) were maintained within physiologic ranges for all groups. After 6 hours of perfusion, plasma hemoglobin levels were as follows: 0.57 +/- 0.51 gm/L for COATED HFMO without systemic heparinization versus 2.65 +/- 1.02 gm/L for HFMO (p less than 0.05), 1.77 +/- 0.48 gm/L for IHFMO (p less than 0.05), 1.96 +/- 0.41 gm/L for PLATE O (p less than 0.05), and 1.5 +/- 0.40 gm/L for BUBBLE O (p less than 0.05) with systemic heparinization. Platelet levels were highest for COATED HFMO with 47% +/- 36% without systemic heparinization versus 33% +/- 9% for HFMO, 12% +/- 2% for IHFMO, 36% +/- 17% for PLATE O, and 19% +/- 12% for BUBBLE O with systemic heparinization. Activated clotting time for COATED HFMO without systemic heparinization was 135 +/- 75 seconds before bypass, 207 +/- 21 seconds after mixing, and 131 +/- 20 seconds after 4 hours of perfusion. There was no statistically significant increase of plasma heparin levels in the group perfused without systemic heparin. Determination of fibrin split products during perfusion without systemic heparinization did not show a significant increase. At the end of perfusion all devices were disconnected and gently rinsed with saline: There were no macroscopic clots in the COATED HFMO group perfused without systemic heparin. However, uncoated equipment introduced for control in animals perfused without systemic heparin showed major clotting.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2770319 TI - Studies on prolonged acute regional ischemia. III. Early natural history of simulated single and multivessel disease with emphasis on remote myocardium. AB - The early natural history of left anterior descending coronary artery occlusion was studied in 35 open-chest anesthetized dogs observed for 6 hours. Six control dogs underwent isolation of the left anterior descending without occlusion, 13 underwent isolated occlusion of the artery to simulate single-vessel disease, and 14 underwent occlusion of the left anterior descending and 50% stenosis of the circumflex coronary artery to simulate multivessel disease. Regional systolic shortening was measured by ultrasonic crystals. Control dogs had a mild fall in cardiac output (27%) and rise in aortic pressure (15 mm Hg). Ischemia produced immediate dyskinesia (-60% of control systolic shortening), and passive lengthening persisted for 6 hours. All dogs with only occlusion of the left anterior descending artery survived (0% mortality). They were less prone to ventricular fibrillation (46% versus 79%, p less than 0.05), developed compensatory hypercontractility of remote muscle (131% of control systolic shortening, p less than 0.05), mild energy and substrate depletion, and anaerobic metabolism (increased glucose-6-phosphate, p less than 0.05) despite maintenance of "normal" blood flow. In contrast, the early mortality rate was 57% (p less than 0.05) when 50% circumflex stenosis coexisted. Intractable ventricular fibrillation and/or cardiogenic shock caused the deaths. Remote muscle became progressively hypocontractile (61% of control systolic shortening, p less than 0.05), with progressive reduction in stroke work index (less than 0.5 gm-m/kg, p less than 0.05). Remote muscle showed moderate substrate and energy depletion (greater than 60% fall of adenosine triphosphate and creatine phosphate, 37% fall of glutamate) and more pronounced evidence of anaerobic metabolism (glucose-6 phosphate rose greater than 400%, p less than 0.05) despite normal blood flow. Mitochondrial ultrastructure and function remained intact in all hearts. These findings suggest that remote muscle is the principal determinant of mortality after an otherwise nonlethal ischemic event. Functional deterioration despite normal blood flow to remote muscle suggests either autoregulatory failure or substrate depletion as a cause of hypocontractility. The structural and functional integrity of mitochondria in ischemic and remote myocardium implies that salvage is possible despite hemodynamic deterioration and intractable ventricular fibrillation. PMID- 2770321 TI - Preservation of high-energy phosphates in human myocardium. A phosphorus 31 nuclear magnetic resonance study of the effect of temperature on atrial appendages. AB - After prolonged exposure to low temperatures (1 degree and 4 degrees C), human atrial trabeculae show poor recovery of contraction. At somewhat higher temperatures (12 degrees and 20 degrees C), recovery is much better (Keon and associates. Ann Thorac Surg 1988;46:337-41). Although better preservation of adenosine triphosphate and therefore improved contractile recovery might be expected after exposure to lower temperatures, it remained possible that, below a certain temperature, adenosine triphosphate-generating mechanisms could be slowed more than adenosine triphosphate utilization. To investigate this phenomenon further, we followed the time course of metabolic changes in human atrial appendages, harvested during cardiac bypass operations, at 1 degree, 4 degrees, 12 degrees, and 20 degrees C using high-resolution 31P and 1H nuclear magnetic resonance spectroscopy. The results are quantitated by correlation with data obtained from biochemical assays on quick-frozen tissues. Initial adenosine triphosphate levels in myocytes of human atrial appendages are 3.3 to 4.3 mumol.gm-1 tissue wet weight. At 20 degrees C, adenosine triphosphate disappears after 6 hours; at 12 degrees C, about half the initial adenosine triphosphate is still observable at this time; at 4 degrees C or 1 degree C, the decline is still slower. Only a small contribution toward adenosine triphosphate maintenance comes from creatine phosphate, since creatine phosphate, inorganic phosphate, and total creatine levels in the appendage are low (less than 2 mumol.gm-1 tissue wet weight). Glycolysis is active at all temperatures; the rate of glycolysis correlates positively with increasing temperature. Adenosine triphosphate generated by glycolysis falls just short of demand at all temperatures, but the difference is small at 1 degree and 4 degrees C. These studies lead us to conclude that the relatively poor recovery of contractile response of human atrial trabeculae, together with contracture reported previously at lower temperatures (1 degree and 4 degrees C), is not due to a failure to maintain adenosine triphosphate levels. PMID- 2770322 TI - Pedicled right atrial-pericardial tissue conduit for bypass of the obstructed superior vena cava in children. AB - Surgical relief of superior vena caval obstruction with flaps constructed from pedicled right atrium and pedicled pericardium has been performed successfully in 2 children aged 1 and 13 years. Long-term conduit patency 43 and 24 months after the operation has been achieved with this technique, despite continued growth of both patients. PMID- 2770323 TI - Correction of interrupted aortic arch. AB - Twelve consecutive infants with interrupted aortic arch, ventricular septal defect, and persistent ductus arteriosus have had the anomaly repaired without the use of synthetic grafts. In two infants (5 and 9 months) the ductus arteriosus was used for the arch repair. In three patients (mean age 14 days) the left carotid artery was turned down to form the new arch. In the remaining seven (mean age 12 days) a direct anastomosis was achieved, but one of these patients died at operation. Two others in this group also had persistent truncus arteriosus. Five patients have required another operation (two for stenosis of the anastomosis with one death). The 10 survivors (mean follow-up 5 years) are well and support our belief that complete repair without the use of synthetic grafts is the treatment of choice in this rare and difficult group. PMID- 2770324 TI - Myotomy for reflux-induced cricopharyngeal dysphagia. Five-year review. AB - This report describes 25 patients with reflux-induced cricopharyngeal dysphagia ultimately requiring surgical management. Eighteen patients underwent cricopharyngeal myotomy alone and seven patients required cricopharyngeal myotomy after an antireflux operation failed to correct this symptom. Cricopharyngeal incoordination was demonstrated at manometry in over 90% of patients. Treatment included cricopharyngeal myotomy, which was extended proximally to the pharynx and distally to the intrathoracic esophagus. Results were excellent to satisfactory in 24 of 25 patients. Pathologic examination of the cricopharyngeal muscle demonstrated a wide variety of myopathic degenerative changes. We stress that cricopharyngeal myotomy may be performed even in the presence of reflux without fear of subsequent aspiration. PMID- 2770325 TI - The role of neural and vasoactive mediators in the regulation of the pulmonary circulation during cardiopulmonary preservation. AB - The autoperfused working heart-lung preparation has been used for extended cardiopulmonary preservation for transplantation. However, acute lung injury and failure of the preparation can result from pulmonary hypertension, which previous investigators have linked to denervation. We studied the neural and vasoactive mediators of pulmonary vasoconstriction during normothermic autoperfusion of the heart and lungs from 13 calves. Pulmonary vascular resistance was quantitated by multipoint pulmonary artery pressure/flow plots generated by incremental reduction in venous return at three times: A, after sternotomy but before autoperfusion (control); B, during in situ autoperfusion (innervated heart-lung preparation); and C, after explanation (denervated heart-lung preparation). During hemodynamic measurements, left atrial blood samples were obtained for measurement of thromboxane B2, 6-keto-prostaglandin-F1 alpha, and complement activation products C3a and C5a. Results show that pulmonary hypertension in the autoperfused working heart-lung preparation begins during autoperfusion before denervation and may be related to complement activation and to increased levels of circulating thromboxane B2 and 6-keto-prostaglandin F1 alpha (both the absolute levels and the ratio of thromboxane B2 to 6-keto-prostaglandin F1 alpha). After denervation, both prostaglandin intermediates were markedly increased, but their ratio was not significantly affected. These data suggest that there is an initial stage of pulmonary vasoconstriction at the onset of autoperfusion that is accompanied by increased circulating levels of vasoactive mediators and that denervation further contributes to this response. PMID- 2770326 TI - Fifteen- to twenty-year results after the Hill antireflux operation. AB - Antireflux surgery, specifically the Hill procedure, has been shown to be effective management of refractory reflux when assessed in the relatively short term. This study follows 441 patients from the time of their initial operation and reports on assessments conducted after 5 to 10 years and 15 to 20 years. The late study group comprises 167 patients (mean age 71 years) with an average follow-up of 17.8 years; 15.6% of patients had undergone a previous antireflux operation. Overall subjective good and excellent results, as determined by the patients themselves, were seen to improve significantly (p less than 0.02) between the two follow-up periods, 82% and 88%, respectively. No serious late complications such as fistula, bleeding, or obstruction were observed in this series. The Hill antireflux operation, properly performed, provides durable long term results. PMID- 2770327 TI - Neuropsychologic alterations after cardiac operation. PMID- 2770328 TI - Delayed maturation of skin window macrophages in myelodysplastic syndromes. AB - Blood monocyte differentiation to macrophages was examined in nine patients with primary myelodysplastic syndromes using the skin window technique. Emigrated cells were stained cytochemically for acid phosphatase reaction after 1, 2, 4, 7, 9, 12 and 23 h. Compared to age-matched controls, seven patients showed a significant delay in lysosomal enzyme acquisition, which is associated with macrophage differentiation. Our results with this in-vivo assay demonstrate an involvement of the monocyte/macrophage system in primary myelodysplastic syndromes and show that patients often have a disturbance in macrophage differentiation. PMID- 2770329 TI - Whole blood assay for NK activity in splenectomized and non-splenectomized hairy cell leukemia patients during IFN-alpha-2b treatment. AB - Natural killer cell (NK) activity in peripheral blood (PB) was followed longitudinally for up to 2 yr after initiation of low-dose IFN-alpha-2b therapy in nine hairy cell leukemia (HCL) patients. A whole blood NK (WB-NK) assay was employed in order to measure the NK activity per unit blood. The pretreatment WB NK activity was consistently low, indicating that the patients' total NK activity in PB is decreased. Striking differences in WB-NK activity were observed between splenectomized and non-splenectomized patients, whereas no consistent patterns were found when using the conventional NK assay. Thus the WB-NK activity of splenectomized patients showed an immediate increase after initiation of treatment, while the activity in non-splenectomized patients decreased and remained low during the first 3-6 months. Subsequently, after reduction in spleen size, the WB-NK activity began to increase. In splenectomized patients, a second rise in WB-NK was observed after 3-6 months of therapy, coinciding with the normalisation of the peripheral blood counts. In both groups of patients incubation with IFN in vitro induced a rise in NK activity before start of treatment, which was abrogated promptly after initiation of therapy, indicating a maximal in vivo boosting of the NK cells. These differences observed indicate that the response of splenectomized and non-splenectomized HCL patients to IFN treatment should be evaluated separately. PMID- 2770330 TI - Leucocyte superoxide dismutase levels in acute and chronic leukemias. AB - Superoxide dismutase "SOD" enzyme levels in leucocytes of patients with acute and chronic leukemia, were measured by using Misra and Fridovich's epinephrine method. In all types of leukemia, the SOD levels were found to be significantly higher than normals. However, these levels decreased to normal in remission. No relationship was found between the SOD level and types of leukemia. The absence of relationship between the increase in SOD level and various clinical parameters suggests that this increase is the result of a disturbed gene expression in the stem cells. Hence it is of interest to ascertain the effect of the chemotherapy leading to the normalization of the SOD levels. PMID- 2770331 TI - The epidemiology of non-Hodgkin's lymphoma in the north-east of Italy: a hospital based case-control study. AB - We concluded a study on 208 cases of non-Hodgkin's lymphoma and 401 controls in the North-East of Italy in order to investigate the role of indicators of socio economic status, personal habits, past history of various disorders and medical treatments potentially affecting the immune system, and occupational exposures in the aetiology of such neoplasia. None of the several investigated characteristics appeared to be a strong determinant, i.e. relative risk, RR greater than 2.0, of non-Hodgkin's lymphoma. Cases and controls appeared to be very similar as regards education, main life-time occupation and alcohol consumption. Positive associations, however, emerged with chronic infectious diseases, mainly tuberculosis and malaria (RR = 1.8, 95% confidence interval, CI: 1.1-2.9). Non significantly increased risks were also found for smoking habit (RR ever vs never smokers = 1.5, 95% CI: 1.0-2.3), episodes of herpes zoster infection (RR = 1.4; 95% CI: 0.7-2.6) and occupation in chemical and petrochemical industries (RR = 1.6; 95% CI: 0.9-3.1, and 1.8; 95% CI: 0.9-3.8, respectively). Conversely, farming as well as specific exposure to herbicides and pesticides did not seem to affect the risk of non-Hodgkin's lymphoma in the present investigation. PMID- 2770332 TI - The significance of the ratio of blood to marrow hematopoietic progenitors (CFU GM and CFU-GEMM) in relation to disease state of patients with acute lymphoblastic leukemia. AB - We studied a total of 143 patients with 231 assays of CFU-GM, of these, 45 patients were studied with 58 simultaneous assays of CFU-GEMM in an attempt to correlate progenitor colony growth with disease state. Blood and marrow leukocytes were cultured in a standard methylcellulose culture system using normal human leukocyte colony stimulating activity. Results are expressed as natural logarithm of the ratio of blood colonies to marrow colonies. A high ratio of blood to marrow (greater than 1) was seen in active disease while a low ratio occurred during remission. Eighty-seven per cent of CFU-GM matched pair samples with active disease had high ratios while less than 1% of remission samples were high. In addition, patients with suspected relapse or relapse up to 14 months after this test often had high ratios indicating this test could be of prognostic value. It is not known if this effect of ALL is unique to ALL or if it occurs as a reaction to any hematopoietic stress. PMID- 2770333 TI - Comments on "Differences in DNA-fingerprints Between Remission and Relapse in Childhood Acute Lymphoblastic Leukemia". PMID- 2770334 TI - Microcomputer-controlled laboratory system for field potential experiments. AB - A microcomputer-controlled laboratory system for hippocampal field potential experiments was constituted. This system realized the quasi-simultaneous processing of execution of stimulation, data acquisition, data display and data analysis by means of a microcomputer for the first time. To attain this quasi simultaneous processing, a new algorithm for drawing a tangent on the wave-form of the potential was contrived, which enabled rapid analysis of an arbitrary population spike even in the case of generation of double spikes. The system has the following functions: (1) execution of the programmed stimulation paradigm, (2) analog/digital (A/D) conversion of the evoked field potential with a sampling interval of more than 50 microseconds per channel, (3) display of the A/D converted wave-form data on a CRT and storage of the data on a floppy disk, (4) on-line analysis of the population excitatory postsynaptic potential (EPSP) and population spike, (5) more detailed off-line analysis of the field potentials, and (6) output of the wave-form data and measured values through a printer and an X-Y plotter. PMID- 2770335 TI - A modified roller tube technique for organotypic cocultures of embryonic rat spinal cord, sensory ganglia and skeletal muscle. AB - The roller tube technique as initially described in the literature in 1981, was modified in several aspects for the coexplantation of embryonic rat spinal cord with attached dorsal root ganglia and skeletal muscle from newborn rats. The high metabolic activity of this coculture system required a particular culturing protocol to stabilize pH and osmotic pressure. The appropriate adjustment of the partial pressure of carbon dioxide gas in the incubator proved to be essential for the control of the pH within narrow limits (7.3 +/- 0.1). The adjustment of the osmotic pressure of the medium (290-300 mOsm) improved the growth of the cultures considerably. Roller drum speed was set to 120 revolutions per hour for enhanced flattening of the culture. A simple rating system was used to evaluate neuronal and non-neuronal outgrowth under different modifications of the culture system. Furthermore, morphological and electrophysiological criteria were defined for evaluating individual neurons. The technique described insures the growth of long-term organotypic cocultures of spinal cord, sensory ganglia and skeletal muscle. PMID- 2770336 TI - Electrochemical calibration of in vivo brain dialysis samplers. AB - Measurement of state-related changes in the concentration of an endogenous substance using the in vivo dialysis technique requires a definition of the factors which relate the concentration detected in the outflowing perfusate to the concentration actually occurring in the extracellular space in which the sampler is located. In determine these factors, a rapid and highly accurate detector system is required which measures the concentration recovery in the perfusate and the dead space of the entire sampling system. To reduce the limitations of the microdialysis technique, two electrochemical microcells were developed for calibration of dialysis probes by computerized voltammetry. The electrochemically calibrated samplers were implanted into freely moving cats to measure concentration changes of monoamine metabolites in synchrony with sleep stages identified by polygraphy in order to demonstrate the applicability of electrochemical calibration in dialysis methods used in behavioral investigations. PMID- 2770337 TI - The influence of the convulsant pentylenetetrazol on Ca2+-selective microelectrodes (neutral carrier ETH 1001). AB - Interference of the epileptogenic drug pentylenetetrazol (PTZ) on the Ca2+ selective microelectrode based on the neutral carrier ETH 1001 is described. It is suggested that tetraphenylborate, a component of the Ca2+-selective membrane, is responsible for this interference. Though the sensitivity of the Ca2+ selective microelectrode to PTZ is low, the error in measurements of the free Ca2+ concentration in biological preparations treated with PTZ has to be considered, since pathological changes in the extracellular Ca2+ concentration also produce relatively small changes in the relative electrode potential. PMID- 2770338 TI - Nerve fibre morphometry: a comparison of techniques. AB - This study compared different approaches to measuring nerve axon and fibre diameters and areas from transverse sections. A mock photomicrograph and mock tissue section, each with 100 identical, circular 'fibres' was constructed. Three measurement protocols were investigated: (A) circular approximation from minimum diameter; (B) circular approximation from the mean of orthogonal diameters; and (C) calculation of diameter and area from a digitized circumference. For each protocol, all 100 fibres on the photomicrograph were repeatedly measured using a digitizing tablet. Similarly, the fibres on the mock tissue section were measured using a digitizing tablet and microscope with camera lucida. The variance for these data was calculated. Protocols were compared on the basis of variability and the amount of digitizing time required. For diameter measurements, protocol B showed significantly lower variability than A or C (P less than 0.05), with only a modest increase in digitizing time over A. For area measurements, protocols B and C showed significantly lower variability than A (P less than 0.05), again with a modest increase in digitizing time. Measurements made using the microscope and camera lucida showed significantly lower variability than those made from the photomicrograph, but took more time. These data suggest that for diameter measurements, a mean of orthogonal diameters approach is best, and that for area measurements, a traced circumference approach is best as it is more flexible than the orthogonal diameter approach. While the microscope and camera lucida setup is more time-consuming to use, it eliminates the need for photomicrograph production. PMID- 2770339 TI - A versatile waveform generator for testing neuroelectric signal processors. AB - A multi-channel waveform generator was designed for testing neuroelectric signal processors. Smooth transient signals that resemble action potentials or evoked potentials are generated by a second order switched capacitor filter excited by brief rectangular pulses. The choice of an integrated circuit switched capacitor filter simplified the design by circumventing some of the disadvantages of conventional active filters. The waveform generator is versatile, with several signal parameters being independently adjustable from front panel controls: duration, waveshape, latency, amplitude and signal-to-noise ratio. The generator has been used for testing evoked potential acquisition and processing systems, for evaluating the effects of analog filters on evoked potentials and for testing systems designed to detect and classify trains of multi-unit action potentials. PMID- 2770340 TI - Long-term in vitro turtle preparation for the study of spinal organization. AB - A method by which muscles, nerves, and a section of spinal cord from a turtle can be stably maintained in vitro for many days has been developed. Tests of the viability of central and neuromuscular synapses, and the histochemical properties of muscle fibers have indicated that the preparation is viable and shows little decrement in function over a period of 3-5 days. The system allows continuous access to the muscles, nerves, and the spinal cord, as well as a controlled external environment. PMID- 2770341 TI - Prevention and torts: the role of litigation in injury control. PMID- 2770342 TI - Deterring death in the workplace: the prosecutor's perspective. PMID- 2770343 TI - Injury prevention. PMID- 2770344 TI - Intentional injury: are there no solutions? PMID- 2770345 TI - Injury, community and the republic. PMID- 2770346 TI - Injuries are not accidents. Introduction. PMID- 2770347 TI - Injury prevention as a public health responsibility: the New York State Department of Health Injury Control Program. PMID- 2770348 TI - Alcohol, injury, and legal controls: some complex interactions. PMID- 2770349 TI - Motor vehicle injuries: the law and the profits. PMID- 2770350 TI - Fires, cigarettes and advocacy. PMID- 2770351 TI - The chain saw and the regulator: inching toward safety. PMID- 2770352 TI - ATVs--the hidden danger. PMID- 2770353 TI - Lymphocyte emperipolesis in AIDS. AB - Excepting sperm, lymphocytes are the most motile cells within and outside of the body in mammals. In the body, lymphocytes are the primary victims of the Acquired Immune Deficiency Syndrome (AIDS). This photo-essay illustrates that migrant lymphocytes outside of the body are the primary vectors of AIDS spread. PMID- 2770354 TI - Effect of acute venous hypertension on erythrocyte, leukocyte, and plasma protein extravasation in the dog hindlimb. AB - The effect of acute venous hypertension on the extravasation of plasma proteins, erythrocytes, and leukocytes into regional lymph was studied in the dog hindlimb. Although the lymph protein transport sharply rose with hindlimb phlebohypertension, capillary permeability was unchanged with retention in draining lymph of a normal proportion of large to small molecular weight proteins. Leukocyte transport also increased initially but then progressively decreased despite persistent venous hypertension. Lymph transport of erythrocytes was also high during venous hypertension but in contrast to white cells, it remained at that level as long as venous pressure was elevated. These findings suggest that different pathways and mechanisms are involved in the capillary extravasation of plasma proteins and cells capable of intrinsic motility (i.e., leukocytes) and those without independent motion (i.e., erythrocytes). PMID- 2770355 TI - Contribution of the liver to thoracic duct lymph flow in a motionless subject. AB - To ascertain the contribution of the liver to thoracic duct lymph (TDL) flow in a resting subject, afferent hepatic blood flow was temporarily interrupted in dogs by placing an atraumatic clamp across the hepatoduodenal ligament containing the hepatic artery, portal vein and 80% of hepatic lymphatic drainage. To circumvent extrahepatic splanchnic venous sequestration, a side-to-side portacaval shunt (S S-PCS) was constructed prior to interrupting blood flow. Portal venous pressure, cervical TDL flow, and total protein content were serially monitored. TDL and total protein after S-S-PCS was comparable to that recorded in dogs without celiotomy (0.60 +/- 0.17 ml/min and 3.4 +/- 0.5g/dl, respectively). Interruption of hepatic blood flow was associated with a fall in TDL flow (0.38 +/- 0.8ml; p less than 0.001) and protein content (2.8 +/- 0.7g/dl; p less than 0.01) and TDL/plasma protein ratio (0.58 +/- 0.7 to 0.48 +/- 0.05; p less than 0.01). These data suggest that in the absence of supplemental fluid administration or other exogenous stimulation, hepatic lymph contributes one-third of resting TDL flow. PMID- 2770356 TI - Evaluation of leg edema using a multifrequency impedance meter in patients with lymphatic obstruction. AB - To evaluate quantitatively local edema, electrical tissue impedance in the leg was measured with a multifrequency impedance meter in 10 patients without edema and in 10 other patients with lymphedema after hysterectomy for uterine cervical cancer (Groups 1 and 2, respectively). Equivalent resistivity of extra- and intracellular fluid (RE, RI, respectively) and the ratio RI/RE were calculated. The difference in mean RE between Groups 1 and 2 was significant (p less than 0.05). In four patients in Group 1 and nine in Group 2, simultaneous measurements were carried out on both legs. The differences between mean RE and RI/RE in Group 2 were significant (p less than 0.05, p less than 0.025, respectively). In these 13 patients, correlation coefficients between the ratio of cross-sectional areas of both legs, and both RE and RI/RE were -0.614 (p less than 0.05) and 0.805 (p less than 0.001), respectively. The results suggest that RE and RI/RE could be used as sensitive indicators of local edema. PMID- 2770357 TI - 31P-MR spectroscopy of skeletal muscle in a lymphedematous arm. PMID- 2770358 TI - Effect of halothane anesthesia on mesenteric intralymphatic pressure in the rat. AB - The effect of halothane on mesenteric intralymphatic pressure was examined in 20 rats. Following administration of 1.5% halothane, lymph pressure decreased from a control value of 7.6 +/- 1.5cmH20 to 3.8 +/- 1.8cmH20. On the other hand, a lower concentration of halothane (1%) did not alter lymph pressure. In conjunction with earlier findings, these data suggest further that lymph propulsion is suppressed during halothane (greater than 1.5%) anesthesia. PMID- 2770359 TI - McIndoe procedure for vaginal agenesis: results and complications. AB - During the 10-year interval from 1976 through 1985, 50 patients with congenital absence of the vagina underwent McIndoe vaginoplasty at our institution. The medical records of these patients were retrospectively reviewed, and additional information was obtained through a survey of the patients. The mean duration of follow-up was 6.5 years. Two rectovaginal fistulas and one graft failure were among the complications that occurred. Five patients required additional reconstructive vaginal operations. Operative vaginoplasty was considered functionally successful by 40 of the 47 patients (85%) who responded to the survey, yet only 36 of these 40 (90%) had remained coitally active by the time of the survey. Recognizing the potential for complications, the need for long-term follow-up and care of the neovagina, and the less-than-perfect results achieved, we continue to consider the McIndoe operation as the procedure of choice for most patients with vaginal agenesis. PMID- 2770360 TI - Isolated Crohn's disease of the stomach. AB - Crohn's disease can involve any portion of the digestive tract, but isolated gastric Crohn's disease is a rare entity. In the few previously reported cases, the inflammatory disorder has involved only a portion of the stomach. Herein we describe a patient with diffuse involvement of the entire stomach and an associated gastrosplenic fistula but no evidence of involvement elsewhere in the gastrointestinal tract. Usually, a patient with isolated Crohn's disease of the stomach will have the clinical symptoms of nausea, vomiting, and epigastric pain and radiographic evidence of a small contracted stomach (or, occasionally, a huge dilated stomach). Because the condition may suggest the presence of a malignant lesion and biopsy specimens often reveal nonspecific inflammation, surgical resection is usually necessary for diagnosis of isolated Crohn's disease of the stomach. PMID- 2770361 TI - Rhytidectomy for treatment of the aging face. AB - Rhytidectomy or face-lift is an operation designed to remove facial wrinkles. Most often, it is performed in conjunction with other facial procedures, such as brow-lifts, blepharoplasty, and submental liposuction, for complete rejuvenation of the aging face. The recent surge of interest in cosmetic surgery has prompted more patients to inquire about and undergo a face-lift operation. Careful preoperative selection of patients is extremely important in achieving a successful outcome. At the Mayo Clinic, most facial cosmetic surgical procedures performed by the Department of Otorhinolaryngology are done on an outpatient basis. A combination of local anesthesia and intravenous sedation provides excellent patient tolerance and comfort both intraoperatively and postoperatively. Treatment involving the superficial musculoaponeurotic system is used for those patients who require additional underlying support and definition of the facial contour. Postoperative recovery is routinely uneventful. Complications of face-lift surgery are rarely encountered. Case reports are presented to illustrate the representative postoperative results. PMID- 2770362 TI - The language of medicine. PMID- 2770363 TI - Percutaneous balloon valvuloplasty for critical aortic stenosis: a bridge to safer noncardiac surgical procedures. PMID- 2770364 TI - Facts on Vietnam women veterans. PMID- 2770365 TI - A giant leap for lepers. PMID- 2770366 TI - Reflections on professional practice. PMID- 2770367 TI - Standards of practice for registered nurses. PMID- 2770368 TI - Tips for professionals: children and medication communication. PMID- 2770369 TI - Clustering and consistency of use of medicines among mid-aged women. AB - This paper describes the use of drugs among middle-aged Massachusetts women from 1982 to 1986. Data were obtained from follow-up interviews of women (n = 2565) who were premenopausal in a baseline survey of a representative sample of women with an age range of 45-55. In the first follow-up interview, 92% of women had used nonprescribed drugs ("current use"), but most only sporadically, while 47% had used prescribed drugs. The use of different types of drugs was concentrated in the same women, and women who had used prescribed drugs had also used nonprescribed drugs more often than the other women. In the first follow-up, women were classified as nonusers (includes sporadic nonprescribed drug use), nonprescribed medicine users, prescribed drug users, and mixed users; 43% of the women were in a different class three years later. Comparison of individual drug groups also showed changes in the user status between the two surveys. With the exception of poorer health, users of nonprescribed and prescribed drugs were similar to nonusers. Because use of drugs is common, further research on both its determinants and appropriateness is needed. PMID- 2770370 TI - The recognition, diagnosis, and treatment of mental disorders by primary care physicians. AB - A valid and reliable vignette-based measure of DSM-III psychiatric diagnostic knowledge was administered to practicing primary care physicians (PCPs; generally, internal and family practice medicine) and mental health professionals (MHPs, in psychiatry and psychology). Recognition, diagnosis, and treatment recommendations were measured for 14 different disorders. Contrary to other reports, PCPs consistently recognized the presence of mental disorder and did so virtually as well as MHPs, although both PCPs and MHPs showed more under recognition than over-recognition. Diagnostic accuracy, however, was substantially lower, with that of MHPs exceeding PCPs for the general classes of affective, anxiety, somatic, and personality disorders, but not for the organic disorders. In making specific diagnoses, significantly fewer PCPs than MHPs gave an accurate diagnosis for eight of the 14 disorders: dysthymic disorder, major depression with psychotic features, agoraphobia with panic attacks (marginally), generalized anxiety disorder, adjustment disorder with anxious mood (marginally), psychologic factors affecting physical condition, and two personality disorders. Overall, PCPs were most accurate in identifying organic disorders (81% correct), least accurate in identifying the personality disorders (14%), and intermediate in identifying the affective (47%), anxiety (49%), and somatic disorders (49%). In most cases, both PCPs and MHPs preferred referral to treatment in primary care, but more PCPs than MHPs recommended treatment in primary care for certain anxiety and somatic disorders. Some differences in the recommended use of antidepressants in primary care were also found. Implications for the provision of mental health care by primary care physicians are discussed. PMID- 2770371 TI - Rapid estimation of hospital charges in patients with leukemia. Validation of a multivariate prediction model. PMID- 2770372 TI - [Hodgkin's disease in patients with infection caused by the human immunodeficiency virus. Study of 9 cases]. AB - Nine young males with Hodgkin's disease (HD) and antibodies against the human immunodeficiency virus were evaluated. They had been diagnosed since 1984 in three Madrid hospitals: Hospital 12 de Octubre, Hospital Ramon y Cajal, and Clinica Puerta de Hierro. Eight patients were intravenous heroin abusers and one was homosexual. In 8 patients (88.8%) HD presented in advanced stages (III and IV), and in 5 cases (55.5%) the histology corresponded to mixed cell type. Four patients (44.4%) developed opportunistic infections. In the immunological study a reduction of CD4+ lymphocytes below 0.4 X 10(3)/l was found in 5 of 7 patients (71.4%), and an inversion of CD4+/CD8+ ratio in 6 of 7 patients (85.7%). The response to therapy was poor. Five patients died (55.5%). In 4, the direct cause of death was an opportunistic infection. The reasons why we think that HD in patients with HIV infections should be considered as indicating acquired immunodeficiency syndrome are discussed. PMID- 2770373 TI - [Myoclonic encephalopathy caused by bismuth salts. Efficacy of treatment with dimercaprol]. AB - Three patients with myoclonic encephalopathy caused by bismuth salts are reported, one with the severe and another with the mild form; dimercaprol was effective for the rapid improvement of the symptoms in both. In one of the patients in whom the clearance of bismuth was calculated it was found to be increased after dimercaprol therapy. We think that dimercaprol is an effective drug for the therapy of myoclonic encephalopathy caused by bismuth salts. PMID- 2770374 TI - [Systemic lupus erythematosus and non-Hodgkin's lymphoma]. PMID- 2770375 TI - [What is the aim of uncontrolled phase IV studies on efficacy?]. PMID- 2770376 TI - [A rotation in infectious diseases]. PMID- 2770377 TI - [Cluster headache and multiple sclerosis. Is it coincidence or a causal relation?]. PMID- 2770378 TI - Cutaneous manifestations of collagen vascular diseases and related disorders. PMID- 2770379 TI - Cutaneous vasculitis: its relationship to systemic disease. AB - Necrotizing vasculitis may be localized to the skin or may involve multiple organs. Although the etiology of cutaneous necrotizing vasculitis is unknown, evidence suggests that circulating immune complexes play an important role. The most common clinical lesion seen is palpable purpura, which histologically demonstrates leukocytoclastic vasculitis. The majority of patients affected with cutaneous necrotizing vasculitis have a benign course. PMID- 2770380 TI - Endoscopic sinus surgery for mucoceles: a viable alternative. AB - Functional endoscopic surgery affords the potential for dramatically reducing operative morbidity of surgery for paranasal sinus mucoceles by offering a minimally invasive approach under local anesthesia. Following surgery, direct endoscopic visualization of the area enables accurate follow-up. Unlike sinus obliteration, the ability to accurately image the sinus by CT is also preserved. This paper presents our preliminary experience with 18 mucoceles in which endoscopic sinus surgery was attempted. Five patients had preoperative proptosis and diplopia, three had Pott's puffy tumor and five had erosion of the posterior table of the frontal sinus. Fifteen patients were satisfactorily treated endoscopically, two lesions could not be satisfactorily approached and required external surgery, and one patient had persistent disease. No disease recurrence has been noted to date with endoscopic follow-up of up to 42 months. PMID- 2770381 TI - Radiographic diagnosis, surgical treatment, and long-term follow-up of cholesterol granulomas of the petrous apex. AB - Cholesterol granuloma is an unusual lesion of the petrous apex. Accurate preoperative differentiation of the various lesions of the petrous apex by computed tomography scanning only has been difficult. We reviewed the clinical findings, computed tomography and magnetic resonance imaging scans, surgical approaches, and long-term follow-up in 10 patients with cholesterol granuloma of the petrous apex who were seen between 1971 and 1988. Headache and deficits of the 5th, 6th, 7th, and 8th cranial nerves were common presenting symptoms. Magnetic resonance imaging with special imaging techniques was accurate in diagnosing cholesterol granuloma in four patients preoperatively and three patients prior to revision surgery. The optimal surgical approach was chosen on the basis of clinical and radiographic findings and included the transsphenoidal, infralabyrinthine, transcochlear, and suboccipital routes. Our review reveals that magnetic resonance imaging is more specific than computed tomography in establishing a preoperative diagnosis and is also the technique of choice in follow-up. The long-term results are discussed. PMID- 2770382 TI - Congenital aural atresia. AB - This report is based on 25 years' experience in the surgical management of 69 ears with congenital aural atresia. There were 7 ears with meatal atresia, 11 with partial atresia, 50 with total atresia, and 1 with hypopneumatic total atresia. Meatoplasty was performed in 7 ears, canaloplasty was performed in 22 ears, canaloplasties with strust in 8 ears, and mastoidectomy with stapediopexy was performed in 26 ears. Of the 62 ears that had partial or total atresia, five (8%) had hidden cholesteatomas that were destined to create future complications by expansion and erosion had they not been removed. In five of the 62 ears, temporary facial palsy resulted from exposing the facial nerve in the atresia plate, and in another five ears, attempts to improve hearing were abandoned intraoperatively because of surgically insurmountable anomalies. A reasonable criterion for success in an operation for bilateral atresia is that the need for a hearing aid is obviated; whereas, for unilateral atresia, a successful procedure should largely eliminate the disadvantages of unilateral hearing loss. These criteria seem to be satisfied if the threshold of hearing can be brought to a level of 20 dB or better. This criterion was met in 30% of the group that underwent canaloplasty and in 8% of the group that underwent mastoidectomy with stapediopexy. PMID- 2770383 TI - Osteocartilaginous necrosis of the sinonasal tract following cocaine abuse. AB - As cocaine abuse has become increasingly widespread, there has been a concomitant rise in associated medical complications. Nasal inhalation ("snorting") causes profound effects on the upper respiratory tract in addition to the well known nasal septal perforation. Septal necrosis can be accompanied by bleeding, granulation tissue, ulceration, and sinusitis. There are few reports of extensive sinonasal tract osteocartilaginous necrosis from cocaine abuse. We present five patients with this complication, which must be distinguished from other destructive midface lesions such as Wegener's granulomatosis and polymorphic reticulosis. PMID- 2770384 TI - A DNA linkage study of Usher's syndrome excluding much of chromosome 4. AB - By applying molecular genetic techniques to families in whom inherited forms of hearing impairment are segregating, it will be possible to identify and isolate genes that cause hearing impairment. This will increase our understanding of the biochemical and cytochemical processes associated with hearing, and ultimately could have therapeutic implications. To achieve this goal, DNA linkage studies must be done to localize defective genes to specific chromosome regions. Previous data had suggested that the gene causing Usher's syndrome was located on chromosome 4 in close proximity to the Vitamin D binding protein. A DNA linkage analysis of this chromosome does not confirm the linkage relationship and excludes much of chromosome 4 as the site of the Usher's syndrome gene. PMID- 2770385 TI - A method for ossicular reconstruction with tragal cartilage autografts. AB - Reconstruction of the ossicular mechanism using a tragal cartilage autograft frequently presents problems, including displacement of the cartilage graft, maintenance of firm and accurate contact between the graft and ossicular remnants, and loss of stiffness of the graft. To avoid these problems, we have used the cartilage graft and overlying perichondrium of appropriate size, with a tunnel made between the outer perichondrium and the cartilage to accommodate remnants of the incus or handle of the malleus. The graft has a small perichondrial flap on the other end for firm anchorage to the arch of the stapes or the footplate. This allows the cartilage graft to be firmly anchored with the adjacent ossicular remnants. The presence of perichondrium with the graft helps to maintain nutrition, stiffness, and the configuration of the cartilage. With minor modifications, we have used this technique in 115 patients to reconstruct different types of ossicular defects, with commendable hearing results. Of the 115 operated ears, an air-bone gap closure within 10 dB was found in 14.8%, within 15 dB in 34.8%, and within 20 dB in 24.4% of ears. In another 20.8% of cases, the air-bone gap closure remained in the range of 25 dB or less. The longest follow-up was 13 years 7 months. The presented technique is easy and effective and solves most of the problems of cartilage ossiculoplasty. PMID- 2770386 TI - Histopathologic consequences of surgical approaches to the singular nerve. AB - Selective sectioning of the singular nerve has proven successful in the relief of incapacitating benign positional vertigo (BPV), presumably on the histopathologic basis of posterior ampullary cupulolithiasis. Although the surgical techniques of transmeatal and the recently introduced retrosigmoid IAC approach have been well described, little has been written about the singular nerve's anatomical relationships determined histologically for each surgical approach. The anatomical relationships of the singular nerve in both the transmeatal and retrosigmoid IAC approaches are discussed. Histologic evidence presented suggests that other mechanisms may also be ultimately responsible for improvement in the symptoms of BPV following transmeatal surgery. Moreover, the high incidence of injury to the endolymphatic duct during retrosigmoid surgery raises questions about the exact role of the endolymphatic duct and sac in inner ear homeostasis. PMID- 2770387 TI - The effect of recurrent laryngeal nerve stimulation on phonation in an in vivo canine model. AB - The present investigation was designed to examine the effect of variation in recurrent laryngeal nerve stimulation (RLNS) on vocal fold vibration. Photoglottography (PGG), electroglottography (EGG), and subglottic pressure (Psub) were measured in seven mongrel dogs using an in vivo canine model of phonation. The PGG, EGG, and Psub signals were examined at three fundamental frequencies (F0) (100 Hz, 130 Hz, and 160 Hz) for RLNS, using a constant rate of air flow. Increasing RLNS, which caused activation of the intrinsic laryngeal muscles, produced a modest increase in F0, a marked increase in Psub, no change in the open quotient (OQ), and an increase in the closing quotient (CQ). Phase quotient (Qp), which describes the interval between opening of the lower and upper fold margins, decreased with increasing RLNS. PMID- 2770388 TI - Glottic reconstruction following conservation laryngeal surgery. PMID- 2770389 TI - Z-plasty modification of the Lynch incision. PMID- 2770390 TI - Ocular changes in reactions in leprosy. AB - A study of ocular changes in reactions in leprosy was undertaken to assign these changes, their proper place in the wide spectrum of ocular morbidity in leprosy. 76.1% of eyes of Type I reaction and 89.7% of eyes with Type II reaction showed some ocular involvement. Corneal hypoaesthesia, superficial punctate keratitis, a decrease of corneal film break up time (BUT), prominent corneal nerves, pigment on the endothelium of the cornea and a pigmented trabecular meshwork were the common ocular findings. The incidence of iridocyclitis in Type II reactions was low (8.1%). The significance of the ocular involvement in reactions in leprosy and the pathogenesis of iridocyclitis in Type II reactions is discussed. PMID- 2770391 TI - Slit-skin smears from the fingers in leprosy. PMID- 2770392 TI - Carcinoma in plantar ulcers of leprosy patients: a report of four cases from Turkey. PMID- 2770394 TI - Anxiety-induced ulnar paralysis--a case report. PMID- 2770393 TI - Dapsone and erythema nodosum leprosum. PMID- 2770395 TI - [A critical review of the drug field in Yugoslavia 1985-1988]. AB - Developments in the drug field are presented under the following headings: 1. Drug approval. About 220 new drugs have been discussed (including new formulations and dosages). The number of drugs belonging to the group A (important) and those which should not, according to the author's opinion, have been approved (group D) is similar 6.3/9.1%. About 64% are clinical or generic repetitions (i.e. "me too" drugs). Considerable difficulties with pricing, which is haphazard, and performed in an unsatisfactory way, is the reason why the industry tries to introduce "new drugs" which are often not new and do not present an advance to pharmacotherapy. 2. Drug regulation got (up till now with modest success) an important impetus through Conclusions of the Federal Council of the Parliament of Yugoslavia asking the Federal Committee for Health to elaborate the Yugoslav Essential Drugs List and revise the list of drugs approved in the country--the Federal Institute for Health Protection to prepare diagnostic and therapeutic standards. 3. Drug legislation was "enriched" by the Regulation of Adverse Drug Reaction Reporting (which dos not exist in other countries) and controversial Regulation on Auxiliary Therapeutic Substances, the latter being greatly insufficient. Finally, the List of Essential (unavoidable) Drugs comprising 1/3 (= 336) of drugs approved in Yugoslavia has been accepted. It is hoped that this will improve the availability of drugs, which availability is essential. The greatest problem in the Yugoslav drug field remains irrational prescribing, inadequate pricing (linear increases without observing the grade of necessity of various agents) and consecutive repetitive deficit even of most needed therapeutic agents.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2770396 TI - [Preoperative preparation and the quality of postoperative recovery in surgery patients: an experimental study]. AB - The authors describe the methods, content and main effects of an experimental program in education of surgical patients. The material used was obtained in a study of 32 patients who had been admitted for cholecystectomy at the Surgical Ward of Veterans Hospital, Split. The program has been organized according to basic principles of a communication approach in controlling surgical stress via informing and teaching patients in pain control and other active coping skills. Informed patients (n = 16), in contrast to the control group (n = 16), showed better psychophysiological condition and less situational anxiety while facing the episode, and later, in the course of 5-day follow-up, they showed shorter, and overall better quality of post-operational recovery. In discussion, the authors call attention to the need of further systematic investigations concerning the quality and effects of patient education programs at surgical wards in Yugoslavia as necessary basis for implementation and standardization of such programs in everyday clinical practice. PMID- 2770397 TI - [The effect of histamine and histamine H1 and H2 receptor blockers on the tone of the longitudinal muscles in the human appendix]. AB - The aims of this study were to determine whether the effect of histamine on a smooth musculature of the human appendix is mediated by histamine H1-receptors only or whether histamine H2-receptors are involved, as well. The obtained results indicate histamine increases tonus in musculature; however, histamine H1 receptor antagonist (promethazine) decreases tonus. Histamine H2-receptor antagonist (cimetidine) has caused a mild increase in tonus of musculature what indicates that it has a certain intrinsic activity. By blocking histamine receptors with H1 and H2 antagonists which were used either separately or together before cumulative histamine concentrations, it has been concluded that histamine actions are exerted not exclusively by H1-receptors but also histamine H2-receptor antagonists can significantly decrease the tonicizing effect of histamine. PMID- 2770398 TI - [The development and duration of immunity in children vaccinated against measles with the Edmonston-Zagreb vaccine]. AB - After routine measles-rubella-mumps (MRM) vaccine, seroconversion rate for measles heminhibiting (HI) antibodies in a group of 161 children was determined. Of the 154 children who had no HI antibodies in the first serum sample, 153 (99.3%) developed these antibodies in titres greater than or equal to 1:4 and 148 (96.1%) in titres greater than or equal to 1:8 at 6 weeks postvaccination. These results are in concord with the WHO standards. Another study was designed to evaluate persistence of HI antibodies to measles in a group of 123 children who were given MRM vaccine 1-6 years earlier. No significant decrease in HI antibody titers was recorded. It is concluded that immunity acquired through vaccination with the Edmonston-Zagreb measles virus strain in children aged 12 months to 3 years is satisfactory and that it does not decrease at least up to 6 years following vaccination. PMID- 2770399 TI - [Cardiorespiratory monitoring in the diagnosis and therapy of patients with adult respiratory distress syndrome]. AB - In thirty-six patients, meeting clinical criteria for the diagnosis of ARDS, findings of pulmonary functions and results of invasive hemodynamic monitoring have been separately evaluated and compared with normal values. The majority of patients presented with tachypnea having breathing frequency greater than 30/min, vital capacity less than 20 ml/kg body weight, effective pulmonary compliance less than 25 ml/cm H2O, VD/VT greater than 0.6 and D-L shunt greater than 20%. Pulmonary capillary pressure was normal in most patients and pulmonary artery mean pressure and pulmonary vasculary resistance increased. The authors believe that diagnosis of ARDS can be established with greater reliability by use of more complex pulmonary function testing and hemodynamic investigations. An invasive hemodynamic monitoring using a Swan-Ganz catheter gives irreplaceable data for diagnostic and therapeutic decisions in patients with ARDS. It enables an accurate hydration of patients, correct use of diuretics and vasoactive drugs and it is especially useful in controlled application of ventilators and PEEP. PMID- 2770401 TI - [Solitary extramedullary plasmacytoma of the larynx]. AB - Solitary extramedullary plasmacytoma (EMP) is histologically rare larynx tumor. Of the 620 treated larynx carcinomas, extramedullary plasmacytoma makes up 0.1% of larynx carcinomas recorded in our case reports. The symptoms of larynx EMP are like other tumor symptoms of the same site. Clinically, solitary extramedullary plasmacytoma is like a cyst. It is epithelialized and radiates grey light. Findings obtained by biopsy and extemporary histology did not confirm plasmacytoma. The diagnosis was made by histochemical procedure. PMID- 2770400 TI - [Cardiac insufficiency--a rare major symptom of hypothyroidism in an infant]. AB - A case of hypothyroidism in an infant who was born in an area where screening program was not accepted is presented. The diseases was recognized at the age of 5 months when the infant was admitted to hospital with pericarditis and heart failure - a rare complication in infant hypothyroidism. The possible mechanisms of the heart affection in hypothyroidism are reviewed. The necessity of hypothyroidism screening program is emphasized. PMID- 2770402 TI - [Determination of estrogen receptors in cytological smears of breast carcinoma biopsy samples using monoclonal antibodies (ER-ICA monoclonal)]. AB - The immunocytochemical method with monoclonal antibodies for estrogen receptors has been presented. This method has been adjusted for fine needle aspirates of the breast carcinoma tissue. The procedure of collecting, fixating, staining of aspirates and interpreting of our first results was described. Estrogen receptors were determined in 19 cytologic samples of the breast carcinoma. In more than a half of the investigated samples (11/19), the results were negative, whereas only a smaller number (8/19) provided positive results. The results were compared with those obtained using a quantitative biochemical method which was employed in investigating of tumor tissue. The value of this method compared with the sofar known methods has been discussed. PMID- 2770403 TI - [Comparison of single and double doses of hydrochlorothiazide in the treatment of arterial hypertension with special emphasis on changes in vascular reactivity]. AB - The hypotensive effects of 100 and 50 mg hydrochlorothiazide (HTZ) were evaluated in 30 mild-to-moderate hypertensives, divided into two groups, with diastolic pressure between 95 and 110 mmHg. In both groups, the average MAP reduction was 15% (P less than 0.05). There were no significant differences in antihypertensive effects between single (50 or 100 mg o.d.) and double (25 or 50 mg b.i.d.) doses of the same drug. Blood pressure control was better after two than after one month on each of the various dosing schedules. Side-effects were mild and well tolerated: observed was a significant increase in triglyceride level from 3.0 +/- 1.8 to 4.8 +/- 2.4 mmol/L under the treatment with 100 mg HTZ o.d. and a statistically significant decrease in potassium level from 4.4 +/- 0.3 mmol/L to 4.1 +/- 0.3 mmol/L after two months treatment with 50 mg HTZ o.d. Unexpectedly, these changes were not dose-related. The venous reflexes showed atenuated response to norepinephrine after HTZ treatment, while arterial inflow, venous capacity and venous outflow increased significantly (P less than 0.05). It is concluded that HTZ exhibits some direct vasodilator activity and that the pharmacokinetic features of this drug do not correlate with the pharmacodynamic ones. At least in the management of mild-to-moderate arterial hypertension single daily dosage is quite adequate. PMID- 2770404 TI - [The importance of the claudication test performed on a treadmill and its use in clinical practice]. AB - A group of 55 patients with lower limb occlusive arterial disease was submitted to a treadmill walking exercise test in order to estimate the walking exercise length. The treadmill speed was fixed at 3 km/h and the carpet incline was 0% and 12% respectively. Doppler method for blood pressure estimation was applied in 10 patients to art. brachialis and art. dorsalis pedis bilaterally prior to and 2.5 and 10 minutes after the test. The ankle pressure index was calculated prior and post exercise. Results showed 51 +/- 9% difference between patients walking (3 km/h/0%) and patients climbing (3 km/h/12%). Ischaemic pain and blood pressure fall over art. dorsalis pedis during exercise correlated significantly 2 and 5 minutes after the test. Arteria dorsalis pedis pressure at rest and 2 and 5 minutes post exercise was statistically significant. Blood pressure indices prior and post exercise were related in the same manner. There was no difference in art. dorsalis pedis pressure and ankle pressure indices in our control group. The walking treadmill exercise test showed to be a simple reliable method for estimation of the functional degree of lower limb arterial insufficiency and for assessment of their surgical or drug therapy. PMID- 2770405 TI - Neuropeptide Y and platelet aggregation by adrenaline. AB - The effect of neuropeptide Y on platelet-rich citrated human plasma has been studied both before and after addition of adrenaline. The peptide has no aggregatory properties of its own, but in the concentrations tested it does slow and inhibit the aggregatory responses of platelets to adrenaline. This effect is dose-dependent. The implications of this finding are discussed. PMID- 2770407 TI - Amino acid sequence homology between ligands and their receptors: potential identification of binding sites. AB - Mice were immunized with alpha-bungarotoxin (BGT), a nearly irreversible antagonist of the acetylcholine receptor (AChR), to produce monoclonal antibodies (Mabs). One of the Mabs (JMC2.7) bound not only to BGT, but to the AChR as well. To understand the molecular basis for this novel cross-reaction, the amino acid sequences of these proteins were searched for areas of similarity which might constitute the shared epitope. A number of short segments of sequence homology were found, one of them representing the BGT-binding site of the AChR. Because a portion of BGT resembles that part of the AChR that binds toxin, the self-binding of BGT was evaluated. As shown here, BGT binds specifically to itself to form dimers. In order to extend these observations, other ligand-receptor pairs were examined for sequence homology. The sodium channel and alpha-scorpion toxins were found to have distinct areas of similarity, as do interleukin 2 (IL-2) and the IL 2 receptor. As a general principle, we propose that peptide ligands and their receptors may often share amino acid sequence homology. In fact, the sites of interaction between two proteins may largely be determined by these regions of similarity. PMID- 2770406 TI - Abolition of clonidine's effects on ventricular refractoriness by naloxone in the conscious dog. AB - The interaction between opiate and adrenergic receptors on cardiac electrophysiologic function in the conscious dog was addressed in our study. We examined the effects of opiate receptor blockade with naloxone on clonidine induced changes in refractoriness of the cardiac ventricle. Nine dogs were chronically instrumented for recording mean arterial blood pressure, administration of drugs and for measurement of effective refractory period of the ventricle. Clonidine (10 micrograms/kg, i.v.) significantly (p less than 0.05) decreased heart rate to 72 +/- 5 beats/minute from 108 +/- 8 beats/minute; mean arterial pressure decreased significantly (p less than 0.05) to 83 +/- 3 mmHg from 91 +/- 4 mmHg. Ventricular refractoriness was increased significantly (p less than 0.05) at current levels of 7 and 10 mA and pacing rates 180 and 200 beats/minute. Naloxone (3-10 mg/kg, i.v.) abolished clonidine's effects on heart rate, mean arterial pressure and ventricular refractoriness. We conclude that ventricular refractoriness may be regulated in part by interactions between central adrenergic and opioidergic systems. PMID- 2770408 TI - Antinociceptive activity of salsolinol (racemate, R(+)-, S(-)-enantiomers): evidence of a peripheral mechanism. AB - The existence and the characteristics of the antinociceptive action of salsolinol (racemate) and its two R(+)- and S(-)-enantiomers were studied using different pain tests in mice. None of these drugs possessed a significant activity on the tests sensitive to central acting analgesics (hot-plate and tail-flick tests), either after systemic (i.p.) or central (i.c.v.) injections. However, injected i.p., they reduced the number of writhes induced by phenylbenzoquinone; the ED50 was 79 +/- 2, 73 +/- 2 and 61 +/- 2 mg/kg for racemate, R(+)- and S(-)-enantiomer respectively. This activity was not antagonized by naloxone. Moreover, racemate and S(-) reduced, only for the highest used active dose on the PBQ test (128 mg/kg, i.p.), the edema induced by an intraplantar injection of carrageenin. These results provide evidence of an analgesic activity independent of the endogenous opiate systems and involving a peripheral mechanism. PMID- 2770410 TI - The response to analgesia testing is affected by gonadal steroids in the rat. AB - The effect of gonadal steroids on the response to analgesia testing was determined in castrated male and female rats and castrated male and female rats treated with testosterone propionate (TP) and estradiol benzoate (EB), respectively. The time to respond to a noxious somatic stimulus in the form of heat was assessed using the tail withdrawal test (tail withdrawal from hot water) and hot plate test (the time to paw lick or jump). In male rats, castration resulted in a significant reduction of the reaction time for tail withdrawal. This effect was reversed by treatment with TP. The time to paw lick or jump in male rats was also diminished by castration. Treatment with TP resulted in a partial reversal of the effect of castration on this response. In castrated female rats, the time required for tail withdrawal was decreased by castration and increased by treatment with EB. The reaction time to the hot plate in female rats was diminished by castration and further reduced by EB administration. These data indicate that gonadal steroids influence the response to a noxious heat stimulus in male and female rats and that the effect may vary according to sex and the way in which the stimulus is applied. PMID- 2770409 TI - Metaphit antagonizes phencyclidine-induced hypothermia in the rat. AB - The acute administration of phencyclidine (PCP) causes hypothermia in the rat. Metaphit (1-[1-(3-isothiocyanatophenyl)cyclohexyl]-piperidine) is a derivative of PCP that has been shown to irreversibly acylate PCP receptors in vitro and in vivo and can antagonize the behavioral and electrophysiological effects of PCP in the rat. The purpose of the present study was to determine whether pretreatment with metaphit can block the hypothermic effects of PCP in the rat. Metaphit or PCP (1.0 mumol/rat) were injected into the lateral ventricles of rats, and 24 hr later the subjects were challenged with PCP (20.0 mg/kg s.c.). Pretreatment with metaphit blocked PCP-induced hypothermia; however, pretreatment with PCP did not affect the subsequent hypothermic response to PCP. These results indicate that the antagonism of PCP-induced hypothermia by metaphit was a specific effect and not due to PCP receptor desensitization. PMID- 2770411 TI - Effects of oleic acid and bile salts on canine villous motility. AB - The effects on canine villous motility of mucosal Tyrodes solution containing oleic acid (10 mM) and/or either taurocholic or cholic acid (15 mM) in the presence or absence of IV atropine (1 mg/kg) was used to assess the neural mediation of the effects of luminal nutrients. Villous motility was measured over 12 min periods by in vivo videomicroscopy of segments of jejunum. Neither bile salt had effects alone but villous motility increased after oleic acid was added to taurocholate and decreased after oleic acid was added to cholate. Villous motility increased when taurocholate and oleic acid were present initially and returned to control levels when removed. Villous motility was not affected by cholate and oleic acid but villous motility decreased when they were removed from the Tyrodes solution. Atropine blocked the increase in villous motility caused by taurocholate and oleic acid. Bile salts can modify the effect of oleic acid on villous motility and a cholinergic step is involved in the stimulation of motility. PMID- 2770412 TI - Acute effects of marijuana smoke on complex operant behavior in rhesus monkeys. AB - The acute behavioral effects of marijuana smoke were assessed in rhesus monkeys using a battery of food-reinforced complex operant tasks that included incremental repeated acquisition (IRA, n = 9), conditioned position responding (CPR, n = 8), progressive ratio (PR, n = 8), delayed matching to sample (DMTS, n = 6), and temporal response differentiation responding (TRD, n = 3). Marijuana or placebo smoke was delivered by a specialized face mask 15-min before sessions at exposure levels of 1, 5, 10, and 15 puffs (35cc/puff) or one cigarette smoked to a butt length of approximately 10 mm (approximately 20 puffs). Marijuana smoke caused significant disruptions of performance in all tests except PR after exposure to 10 or more puffs. Generally, response rates decreased or latencies to respond increased. Performance in the PR test was not consistently affected by marijuana exposure. Accuracy of responding was not altered by marijuana smoke at doses lower than those that decreased response rates in the IRA or CPR tests. In the three animals performing under all five schedules, the relative sensitivities for detecting marijuana behavioral effects were DMTS = TRD greater than IRA = CPR greater than PR. These results suggest that performance under operant schedules that are thought to represent some aspect of time perception, short-term memory, learning, motivation, and position discrimination show differential sensitivity to disruption by marijuana smoke, a finding similar to that noted previously for iv THC administration. PMID- 2770413 TI - Physiological characteristics of platelet serotonin in rats. AB - Physiological characteristics of platelet serotonin (5-HT) levels in rats of Wistar origin were investigated by use of a recently developed method. By comparison of populations of male and female rats (N = 281) similar unimodal frequency distributions, with a tendency to higher values in females (1.61 vs. 1.70 micrograms 5HT/mg platelet protein; p less than 0.01), were found. For a group of 55 animals, monitored twice for this parameter within a week interval, a remarkable intraindividual constancy in time, the mean difference between two determinations being 5.5%, was shown. No age-dependence could be demonstrated for platelet serotonin concentrations in 5- to 30-week-old rats, nor were there significant circadian or seasonal oscillations. PMID- 2770414 TI - AF-DX 116 discriminates heart from gland M2-cholinoceptors in man. AB - The M2-cholinoceptor subtype selective antagonist AF-DX 116 was compared with atropine with respect to effects on heart rate and salivary flow in healthy volunteers. These effects were related with in vitro occupancy of M-cholinoceptor subtypes in radioreceptor assays of plasma samples. Radioreceptor assays comprised M1-cholinoceptors in bovine cerebral cortex and M2-cholinoceptors in pig heart and rat salivary gland membranes. 3H-pirenzepine served as a label in the cerebral cortex 3H-N-methyl-scopolamine in the heart and gland preparations. Oral administration of 240 mg AF-DX 116 led to a time dependent increase in heart rate with a maximum effect comparable to atropine 40 micrograms/kg i.v. The effects of both drugs on heart rate were matched by a greater than 80% occupancy of heart M2-cholinoceptors in the radioreceptor assay of plasma samples. In contrast to the complete inhibition of salivary flow after atropine, AF-DX 116 induced an increase of salivation. The effects on salivary flow coincided with a greater than 80% occupancy of glandular M2-cholinoceptors after atropine but no detectable occupancy after AF-DX 116. Occupancy of the M1-subtype amounted to 61.7% after AF-DX 116 and a blockade of inhibitory, presynaptic M1-autoreceptors at missing postsynaptic blockade of glandular M2-cholinoceptors might explain the hypersalivation induced by AF-DX 116. PMID- 2770415 TI - Effect of NSAIDS on serum electrolytes and osmolality. AB - Rabbits and rats were injected two Nonsteroidal anti-inflammatory drugs (aspirin 300 mg/kg or indomethacin 3 mg/kg) intraperitoneally. One hour after injection blood was analyzed for serum electrolytes and osmolality. Administration of both aspirin and indomethacin in rabbits and rats caused increase in serum sodium, potassium, calcium, chloride, magnesium, phosphorus and osmolality. Results suggest the marked similarity in the action of aspirin and indomethacin on electrolytes and osmolality. It is concluded that the ingestion of aspirin and indomethacin can have a major effect on serum electrolytes and osmolality that may influence the interpretation of clinical data in patients taking these drugs. PMID- 2770416 TI - Enzyme-inducing and cytotoxic effects of wood-based materials used as bedding for laboratory animals. Comparison by a cell culture study. AB - Enzyme-inducing and cytotoxic effects of wood-based materials used as bedding for laboratory animals were studied in a cell culture system. Mouse hepatoma cell line, Hepa-1, was exposed to acetone extracts of hardwoods (alder and aspen), softwoods (pine and a mixture of pine and spruce) and cellulose materials. Cytotoxicity and induction of cytochrome P450IA1 (aryl hydrocarbon hydroxylase) and aldehyde dehydrogenase were measured. Both softwood and hardwood extracts were shown to contain inducers of these enzymes. Pine appeared to be the most potent inducer and softwoods more potent than hardwoods. The softwoods and alder were clearly more cytotoxic than aspen. The two bleached cellulose materials were found to contain inducers of aryl hydrocarbon hydroxylase. Unlike the wood beddings, the extracts of the cellulose materials were not found to be toxic to the cells. Hepa-1 cell culture system was found to be a rapid and sensitive method for screening and comparative purposes. PMID- 2770417 TI - Inorganic phosphate accelerates hemoglobin A1c synthesis. AB - The effects of inorganic phosphate (Pi), 2,3-diphosphoglycerate (2,3-DPG) and glucose-6-phosphate (G-6-P) on labile and stable hemoglobin A1c (HbA1c) synthesis were studied. After a 75 gram oral glucose administration, the rate of labile or stable HbA1c synthesis decreased in parallel to the decrease in plasma Pi concentrations. In in vitro incubations of red blood cell suspensions or hemoglobin preparations with glucose, Pi proportionally increased the rate of labile or stable HbA1c synthesis. The increase in 2,3-DPG caused by Pi explained only one fiftieth of the increased rate of labile HbA1c synthesis, and G-6-P did not affect HbA1c synthesis. The kinetic analysis of the effect of Pi showed the unchanged rate constant [K1], the decreased rate constant [K-1], and the increased rate constant [K2]. Based on these data it is concluded that Pi in its physiological range directly increases hemoglobin glycation by decreasing labile HbA1c dissociation and accelerating the Amadori rearrangement for stable HbA1c synthesis, and that Pi should be taken into account when using HbA1c to evaluate diabetic control. PMID- 2770418 TI - Phencyclidine-induced activation of ventral tegmental A10 dopamine neurons is differentially affected by lesions of the nucleus accumbens and medial prefrontal cortex. AB - The nucleus accumbens and medial prefrontal cortex contain high concentrations of phencyclidine (PCP) binding sites as well as supply inhibitory and excitatory inputs to the ventral tegmental area (VTA). Thus these two regions could be instrumental in mediating the unique bimodal response of A10 neurons to systemically administered PCP. Therefore we evaluated electrophysiologically the effects of lesions of these two areas on this pattern of response. In sham lesioned controls, i.v. injections of PCP elicited a typical dose-dependent bimodal effect which was characterized by an activation of A10 firing at low dose (reaching a maximum of +44% at 1 mg/kg) followed by a slowing of this response with larger doses. However, in animals with kainic acid or radiofrequency lesions of the nucleus accumbens, PCP produced only a unimodal response resulting in sustained and elevated (+88% in kainate and +55% in radiofrequency lesioned groups) firing rates. Notably, neither basal activity nor the degree of activation of the A10's at doses of PCP less than 1 mg/kg were affected by the lesions. In contrast, excitotoxic destruction of the medial prefrontal cortex had no effect on the response of A10 neurons to PCP even though basal activity was slightly elevated in this group. These results suggest that the inhibitory component of the bimodal response of VTA neurons to systemic PCP is mediated via feedback pathways from the nucleus accumbens, but that the mesocortical prefrontal cortex does not appear to modulate any portion of this bimodal response. PMID- 2770419 TI - The influence of moderate exercise in diabetic and normal pregnancy on maternal and fetal outcome in the rat. AB - The effect of treadmill exercise prior to and during pregnancy on maternal and fetal outcome was studied in nondiabetic and streptozotocin-induced diabetic rats. Animals were exercised daily on a motorized treadmill (16.1 m/min, 45 min/d) for three weeks prior to mating and throughout gestation. The catabolic state of diabetes was evidenced by changes in maternal body composition. Overall, fetuses of diabetic dams were smaller, lighter, had less calcified skeletons and had more malformations compared to control fetuses. Exercise in the nondiabetic dams resulted in a retardation of skeletal ossification compared to fetuses from sedentary controls. However, exercise improved fetal outcome in diabetic rats, resulting in increased fetal weight and a lower frequency of malformations compared to fetuses from sedentary diabetic dams. PMID- 2770420 TI - Intestinal transport of pyridoxine in experimental renal failure. AB - Renal failure (RF) has been shown to alter intestinal transport of a number of nutrients. We studied jejunal absorption of pyridoxine (B6) in rats rendered azotemic by subtotal nephrectomy (RF group) and compared the results with those obtained in normal rats subjected to sham operation (controls) and animals pair fed (PF) with their RF counterparts. In vivo recirculating perfusion and in vitro everted sac techniques were employed. The in vitro experiments were repeated using sera from uremic and normal individuals to assess the possible effect of uremic chemical environment. The results showed significant reduction in B6 absorption in vivo in the RF group as compared to the control and PF groups. Paradoxically, the rate of in vitro B6 absorption determined for a wide range of concentrations was increased in the RF and PF groups as compared to the control group. The observed increase in B6 absorption in vitro suggests enhanced permeability in the RF and PF groups due probably to reduced nutrient intake which was common to both groups. The disparity between the in vivo and in vitro results is indicative of some inhibitory factor(s) present in the RF animals. Sacs containing uremic serum showed significantly suppressed B6 absorption in vitro as compared to those containing normal serum. These observations suggest that the uremic chemical environment may be, in part, responsible for the observed impairment of B6 transport in RF animals despite in vitro evidence of hyperpermeability. PMID- 2770421 TI - Gamma 2-MSH immunoreactivity in the human heart. AB - In patients undergoing aorto-coronary by-pass surgery, we found a 26% arterial venous difference of immunoreactive gamma 2-melanocytostimulating hormone (MSH), a proopiomelanocortin (POMC) derived peptide known to possess profound hemodynamic effects. These results prompted an investigation of the presence of gamma 2-MSH in the human heart. Using a two-step extraction procedure, regions of human hearts were examined by sensitive and specific radioimmunoassays to determine their gamma 2-MSH content. Mean (+/- SEM) concentrations of 0.14 +/- 0.023 pmol/g and 0.12 +/- 0.017 were found in right atrium and right ventricle, respectively. High performance liquid chromatography indicated that 80-90% of the total immunoreactivity eluted in a single sharp peak in a position identical to that of synthetic gamma 2-MSH. PMID- 2770422 TI - Kainic acid-induced seizures: changes in brain extracellular ions as assessed by intracranial microdialysis. AB - The effect of kainic acid on extracellular [K+], [Ca2+], and [Na+] in the rat piriform cortex and hippocampus was studied by means of intracranial microdialysis. Either a dialysis fiber loop or horizontal Vita fiber were stereotaxically implanted within the piriform cortex or hippocampus, respectively. About 24 h later, fibers were perfused (1 ml/min) with Krebs-Ringer bicarbonate solution. Effluent samples were collected before (four at 30 min intervals), and after (six at 30 min intervals) administration of kainic acid (16 mg/kg, i.p.) or kainic acid vehicle. Kainic acid induced sequential signs of lethargy, staring, "wet-dog shakes," forepaw clonus, and tonic-clonic convulsions. In these awake free-moving rats, kainic acid induced a rapid and prolonged increase in extracellular [K+] and an apparent, but not statistically significant, decrease in extracellular [Ca2+] within the hippocampus. In the piriform cortex, kainic acid induced increases in extracellular [K+] and [Na+], which were associated with early pre-convulsive signs. In contrast to the pronounced ion changes commonly seen when the brain is activated by factors such as local application of excitatory substances or when the brain is made ischemic or hypoxic, extracellular ion concentrations are relatively well maintained during parenteral kainic acid-induced seizures. PMID- 2770423 TI - Effects of cocaine on conflict behavior in the rat. AB - The present studies examined the effects of acute cocaine administration, chronic cocaine administration and cocaine withdrawal on behavior in the Conditioned Suppression of Drinking (CSD) conflict paradigm, an animal model for the study of anxiety. In daily 10-minute sessions, water deprived rats were trained to drink from a tube that was occasionally electrified (0.25 mA), electrification being signalled by a tone. Within 3-4 weeks, control (i.e., non-drug) CSD behavior stabilized (30-50 shocks and 10-12 ml/session) and drug studies were initiated. Acute administration of cocaine (30-min pretreatment) produced a selective pro conflict effect only at a dose of 10 mg/kg cocaine, with lower doses (2.5, 5 mg/kg) exerting no effect on CSD behavior and a higher dose (20 mg/kg) depressing both punished and unpunished responding. In a second experiment, cocaine (10 mg/kg, IP, 2/day) or saline was administered to separate groups of subjects for 7 weeks. In this chronic treatment study, CSD testing was conducted 12 hours after each evening cocaine administration. Although it had no effect on CSD behavior during the first week of treatment, this chronic cocaine administration produced a significant and selective pro-conflict effect which was stable during the period from Weeks 2-7. In a final experiment, a high dose of cocaine (20 mg/kg, 3/day) or saline was given to separate groups of subjects for 2 weeks and the behavioral effects of these treatments and their subsequent termination were examined. In this study, CSD testing was conducted 8 hours after each evening cocaine treatment. During the first week of high dose cocaine treatment, a decrease in punished responding was observed; this parameter returned to baseline levels by Week 2. Discontinuation of this high dose chronic cocaine treatment resulted in a selective decrease in punished responding. This pro-conflict effect was greatest at 3 days, and lasted for 6 days after the last cocaine dose. These data are consistent with clinical findings demonstrating the anxiogenic effects of both acute and chronic cocaine treatment as well as cocaine withdrawal and suggest that conflict paradigms such as the CSD may be useful for the study of cocaine-induced anxiety states. PMID- 2770424 TI - Bacterial infection (Legionella pneumophila) stimulates fever, metabolic rate and brown adipose tissue activity in the guinea pig. AB - The objective of this study was to assess whether bacterial infection stimulates oxygen consumption and brown adipose tissue (BAT) activity. Guinea pigs infected with Legionella pneumophila showed marked fever and a significant (33%) increase in resting oxygen consumption (VO2), 24h after infection. At this time, food intake and body weight were normal and the in vitro thermogenic activity of BAT taken from infected animals was elevated by 64% above that of control guinea pigs. VO2 and BAT activity fell to control values by 48h as infected animals became moribund and over this period food intake was markedly reduced. PMID- 2770425 TI - On the enterohepatic cycle of triiodothyronine in rats; importance of the intestinal microflora. AB - Until 70 h after a single iv injection of 10 uCi [125I]triiodothyronine (T3), normal rats excreted 15.8 +/- 2.8% of the radioactivity with the feces and 17.5 +/- 2.7% with the urine, while in intestine-decontaminated rats fecal and urinary excretion over this period amounted to 25.1 +/- 7.2% and 23.6 +/- 4.0% of administered radioactivity, respectively (mean +/- SD, n = 4). In fecal extracts of decontaminated rats 11.5 +/- 6.8% of the excreted radioactivity consisted of T3 glucuronide (T3G) and 10.9 +/- 2.8% of T3 sulfate (T3S), whereas no conjugates were detected in feces from normal rats. Until 26 h after ig administration of 10 uCi [125I]T3, integrated radioactivity in blood of decontaminated rats was 1.5 times higher than that in normal rats. However, after ig administration of 10 uCi [125I]T3G or [125I]T3S, radioactivity in blood of decontaminated rats was 4.9- and 2.8-fold lower, respectively, than in normal rats. The radioactivity in the serum of control animals was composed of T3 and iodide in proportions independent of the tracer injected, while T3 conjugates represented less than 10% of serum radioactivity. These results suggest an important role of the intestinal microflora in the enterohepatic circulation of T3 in rats. PMID- 2770426 TI - Cholelithiasis in hamsters: effects of cholic acid and calcium on gallstone formation. AB - Dietary cholic acid (0.1%) and/or calcium (2.6% as calcium carbonate) were added to a semipurified diet containing cholesterol and ethynyl estradiol to determine whether the incidence of pigment and/or cholesterol gallstones would be changed. Male golden Syrian hamsters were fed the experimental diets for 96 days (Group 1, control; Group 3, cholic acid plus calcium) or only an average of 60 days (Group 2, 0.1% cholic acid). Animals in Group 2 became ill (weight loss, low food intake, diarrhea) possibly due to cholic acid (or deoxycholic acid) toxicity. Cholesterol gallstones and crystals were absent in all experimental groups. The incidence of pigment gallstones was: control, Group 1, 12/16; 0.1% cholic acid, Group 2, 3/13; and 0.1% cholic acid plus calcium, Group 3, 11/22. Cholic acid with or without calcium produced an elevation of both liver and plasma cholesterol: Group 2, 80.1 mg/g and 501 mg/dl; Group 3, 103.7 mg/g and 475 mg/dl vs Group 1, 65 mg/g and 209 mg/dl, respectively. The lithogenic indices of the bile were lower in Groups 2 and 3 compared to Group 1, controls, 0.45 and 0.58 vs 1.16, respectively. The extent of the portal tract pathology could not be correlated with the presence or absence of pigment gallstones or with the levels of lithocholic acid in the hamster bile. In summary, when semipurified diets were supplemented with ethynyl estradiol and cholic acid, with and without calcium supplementation, no cholesterol gallstones formed and the incidence of pigment gallstones was not altered. PMID- 2770427 TI - Influence of omega-3 and omega-6 fatty acid sources on prostaglandin levels in mice. AB - Studies from this laboratory, employing a hairless mouse model, have indicated that a polyunsaturated fatty acid source rich in omega-3 (n-3) fatty acid (FA) inhibits ultraviolet (UV)-carcinogenic expression, when compared to that of diets containing predominantly n-6 fatty acids. Omega-3 FA is a poor substrate for cyclooxygenase, the rate-limiting step in prostaglandin (PG) synthesis--the latter, particularly PGE2, are known to influence tumor biology. Based upon this rationale, plasma and cutaneous PGE2 levels were determined from hairless mice fed diets containing either 4% or 12% corn or menhaden oil. After two weeks on the respective diets, plasma PGE2 levels of corn oil-fed animals were approximately 6-fold greater than those of the menhaden oil-fed groups. A similar response was found in the dermis. Although the relationship to carcinogenic expression is unknown, dietary n-3 FA content can have a pronounced effect upon PGE2 levels and possesses the potential for influencing other immunomodulators. PMID- 2770428 TI - The combined effects of dietary proteins and fish oil on cholesterol metabolism in rats of different ages. AB - Male Sprague-Dawley rats at the ages of four weeks and nine months were fed purified diets containing 20% proteins either as casein (CAS), milk whey protein (WHY), or soybean protein (SOY) with 5% sardine oil for four weeks. The hypocholesterolemic effect of SOY was not statistically evident as compared to milk proteins at both ages, although serum cholesterol tended to be low in the SOY groups. A significant age-dependent increase in serum cholesterol was observed in all dietary groups. Liver cholesterol concentrations were comparable in young rats, whereas in adults they were significantly lower in the SOY than in the CAS or WHY groups. At both ages, the activity of liver 3-hydroxy-3 methylglutaryl coenzyme A reductase tended to be higher in the SOY than in the other groups. Fecal steroid excretion was significantly higher in rats fed SOY than those fed either CAS or WHY, especially in adult rats. Significant age- and dietary protein-effects were observed in fatty acid profiles of liver microsomal phospholipids. Thus, the effects of dietary proteins on various lipid parameters were essentially maintained even when fish oil served as the source of dietary fat. PMID- 2770429 TI - Fatty acid composition of umbilical arteries and veins: possible implications for the fetal EFA-status. AB - Fatty acid compositions were determined of phospholipids, isolated from umbilical arteries and veins, obtained from Dutch neonates after vaginal delivery, terminating normal pregnancy. The fatty acid profiles of the cord vessels were characterized by the absence of eicosapentaenoic (timnodonic) acid, a low (2-3%) content of linoleic acid and reasonable amounts of arachidonic acid (10-15%) and docosahexaenoic (cervonic) acid (3-5%). Significant amounts of Mead acid (1-4%) and its direct elongation product (0.5-2%) were also observed. In each cord, the efferent blood vessels contained significantly more Mead acid and other fatty acids of the oleic acid (n-9) family and less fatty acids of the linoleic (n-6) and linolenic (n-3) families than the afferent blood vessel. This indicates that the essential fatty acid (EFA) status of 'downstream' neonatal tissue may be marginal. No signs of EFA-deficiency were observed in endothelial and smooth muscle cells in culture, or in blood vessels from adults. In all cords 22:5(n-6) was significantly higher in the artery compared to the vein, whereas for all other (n-6) fatty acids this difference was negative. Since the synthesis of 22:5(n-6) is known to be stimulated when the required amount of cervonic acid, 22:6(n-3), is too low, our observations also suggest that the cervonic acid status of the neonates investigated was not optimal. Further studies are in progress to relate these findings to maternal EFA status and complications of pregnancy. PMID- 2770430 TI - A novel spectrophotometric assay for lipase activity utilizing cis-parinaric acid. AB - A new spectrophotometric assay for determining the activity of acylglycerol hydrolases (lipases, E.C. 3.1.1.3) was developed and optimized for yeast lipase (Candida cylindracea). Studies with porcine pancreatic lipase were also conducted and the influence of various detergents and divalent cations on the assay was evaluated. The assay uses cis-parinaric acid (PnA), a naturally occurring fatty acid that has unique spectroscopic properties, and takes advantage of the reversible binding of fatty acids to bovine serum albumin (BSA). Free PnA has an ultraviolet absorption peak at 321.2 nm. When PnA is bound to BSA, however, the peak shifts to 324.2 nm. The assay mixture contains 6 microM PnA, 1 microM BSA, 75 microM triolein, and 0.3 mM taurocholate in a 50 mM tris-HCl buffer with 1 microM EDTA. The release of oleic acid from triolein is monitored over time by measuring the ratio of optical densities (OD) at 319.0 and 329.0 nm. Initially, there is maximum binding of PnA to BSA, and the OD ratio is approximately 1.0. Upon addition of lipase, PnA is displaced from the BSA by oleic acid released from triolein, and the OD ratio increases to a maximum of about 1.8. However, when calcium is present in the reaction mixture an insoluble calcium-PnA complex forms, resulting in a progressive decrease in OD at both 319.0 and 329.0 nm. The kinetic assay described here is simple, rapid, sensitive, reproducible, inexpensive, and it can be adapted to measure the activity of a variety of calcium-independent lipases. Under similar assay conditions, activities for Candida cylindracea lipase obtained with this assay are similar to those obtained with 14C-labelled triolein. PMID- 2770431 TI - Isolation and purification of perfluorodecanoic and perfluorooctanoic acids from rat tissues. AB - A procedure for the extraction, separation, and isolation of perfluorodecanoic and perfluorooctanoic acids from biological samples is described. The use of conventional lipid extraction procedures leads to substantial loss of the perfluorinated fatty acids added to tissue. The presence of sulfuric acid in aqueous saline during phase partitioning is essential for the recovery of perfluorodecanoic and perfluorooctanoic acids in the organic phase following their extraction from tissue. The perfluorinated fatty acids are co-eluted with simple lipids from silica gel columns using diethyl ether/trifluoroacetic acid (100:1, v/v). Simple lipids are separated by thin layer chromatography. By substituting trifluoroacetic acid for acetic acid in the developing solvents, perfluorodecanoic and perfluorooctanoic acids migrate with other free fatty acids. PMID- 2770432 TI - Sialylation of lacto-N-neotetraosyl ceramide by a solubilized sialyltransferase(s) from chicken skeletal muscle: effect of phosphatidylcholine and sphingomyelin. AB - The sialytransferase(s) that transfers sialic acid to lacto-N neotetraosylceramide and other glycosphingolipids with a galactose nonreducing terminus has been successfully solubilized from embryonic chicken skeletal muscle. The enzyme can be stored in 50 mM HEPES (pH 6.8), 1% Triton CF-54, and 20% glycerol at -70 degrees C for as long as six months. Addition of phosphatidylcholine or sphingomyelin (0.167%) readily reactivates the stored inactive enzymes and such activity persists for about two weeks at 0 degrees-4 degrees C with the peak activity occurring at 1 to 2 days. Sphingomyelin from chicken muscle, which contains mainly C16:0 and C18:0, is 2.1-fold more effective than bovine brain sphingomyelin at the same concentration (0.4%). PMID- 2770433 TI - Copper overload in the developing guinea pig liver: a histological, histochemical and biochemical study. AB - The copper profile in Wilson's disease resembles that of human and guinea pig neonates. Microvesicular steatosis is characteristic of early histological damage in Wilson's disease. The aim of this study was to relate the histological, histochemical and ultrastructural changes seen in developing guinea pig liver to the developmental pattern of liver copper in these animals. Copper-stressed and control guinea pigs were studied. Liver biopsies were stained with haematoxylin and eosin, rhodanine (for copper), orcein (for copper-associated protein) and oil Red 0 (for fat). Selected specimens were examined by electron microscopy. Liver and serum copper levels and copper oxidase activity were also determined. Fetal liver copper increased during the last trimester of pregnancy, reaching five times the adult level in the perinatal period and falling rapidly in the 4 days after birth. Marked steatosis developed in both control and copper-stressed guinea pig liver. The fat score correlated strongly with liver copper concentration (r: 0.60; p less than 0.001). Orcein and rhodanine staining correlated with liver copper concentration (r: 0.52 and r: 0.40 respectively, p less than 0.01). Marked prenatal hepatic steatosis and its postnatal clearance correlates with changes in liver copper concentration. This experimental model provides an opportunity to study the pathogenesis of hepatic steatosis and the relationship between copper retention and steatosis. PMID- 2770434 TI - The source of serum alkaline phosphatases in liver-tumour-bearing rats. AB - Patients with hepatic tumours have increased serum activities of alkaline phosphatases. In order to clarify the origin of the increased enzyme activity, two experimental models of rat liver carcinogenesis were studied. In one model, the resistant hepatocyte model, the process was initiated by diethylnitrosamine (DEN, 200 mg/kg), and preneoplastic liver nodules were selected for by 2 weeks of 2-acetylaminofluorene (2-AAF, 0.02%) feeding and partial hepatectomy (PH). High activities of serum alkaline phosphatases were found in these rapidly growing nodules harvested at the peak time of nodular mass expansion. In the other model in which nodules were induced with long-term intermittent feeding of a diet containing 0.05% 2-AAF and harvested in a late stage with a low increase of nodular liver cell mass, no such increase in serum alkaline phosphatase activity was found. A similar difference was also noted when measuring the activities of the enzyme in the nodular tissue. Thus the first model showed high activities of the enzyme in the nodular tissue, while the second model had similar activities to those of the control animals. The serum levels reflected the nodular enzyme activity in both models. The tissue surrounding the nodules did not show increased enzyme activity. No difference was noted in the serum or tissue activity of transaminases. In both models the liver nodules occupied 30-50% of the liver volume. The experimental models were selected to emphasize the importance of the rate of intrahepatic mass expansion for the levels of serum alkaline phosphatase activities.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2770435 TI - Influence of HDV infection on clinical, biochemical and histological presentation of HBsAg positive chronic hepatitis. AB - In an attempt to identify some characteristics of HDV infection in the different forms of HBsAg positive chronic hepatitis (CH), we evaluated numerous clinical, biochemical and histological aspects in 203 consecutive HBsAg positive CH patients. The presence of hepatitis delta antigen (HD-Ag) in the liver tissue was the criterion used to identify HDV infection. HD-Ag was observed in none of the 7 patients with non-specific reactive hepatitis, in 14.6% of the 48 with chronic persistent hepatitis (CPH), in 36.4% of the 44 with chronic lobular hepatitis (CLH), in 36% of the 25 with mild chronic active hepatitis (CAH), in 52% of the 36 with severe CAH and in 30.2% of the 43 with inactive or moderately active cirrhosis. Compared with the 139 HD-Ag negative patients in this study, the 64 HD Ag positive patients more frequently had severe CAH (29.7 vs. 12.2%, p less than 0.01) and less frequently CPH (10.9 vs. 29.5%, p less than 0.01). Of the 139 HD Ag negative patients, 80 were anti-HD positive and 59 anti-HD negative. The 59 patients with no HD-Ag or anti-HD showed severe CAH less frequently than the 64 HD-Ag positive patients (6.8 vs. 29.7, p less than 0.01) and CPH more frequently (44.1 vs. 10.9, p less than 0.001). Both in CPH and CLH the presence of HD-Ag in the hepatocytes identified subgroups of patients who frequently showed high serum levels of aminotransferases and gammaglobulins and more extended areas of circumscribed lobular necrosis. HD-Ag positive CAH was characterized by a more frequent occurrence of eosinophilic degeneration of hepatocytes without peripolesis (p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2770436 TI - Natural course after the development of cirrhosis in patients with chronic type B hepatitis: a prospective study. AB - To examine the early stage of the natural course of liver cirrhosis, a prospective follow-up study was conducted in a series of 76 patients with recent development of cirrhosis during the course of chronic type B hepatitis. During a mean follow-up period of 34.4 months, 45 episodes of acute exacerbation were recorded; the majority of the episodes occurred within 2 years after entry. The calculated annual incidence of acute exacerbation was significantly higher in patients seropositive for hepatitis B e antigen (HBeAg) and/or hepatitis B virus (HBV)-DNA (25.9%) than in those without these markers (11.9%). Three-fourths of the acute exacerbations were attributable to the reactivation of HBV. Spontaneous HBeAg seroconversion to anti-HBe also occurred in the early phase, but less than 30% of the events were preceded by acute exacerbation. Late hepatitis B surface antigen clearance occurred in two patients. Hepatic decompensation, esophageal variceal bleeding and hepatocellular carcinoma developed relatively late in the course of the disease with a calculated annual incidence of 2.3%, 2.3% and 2.8%, respectively. Seven patients (9.2%) died of hepatic failure or variceal bleeding, usually more than 3 years after entry. The estimated 5-year survival rate was 80%. The results suggest that the natural events of chronic HBV infection, including exacerbation, seroconversion and its sequelae could occur after the development of cirrhosis. In addition, these events might be responsible for the clinicopathological changes and the outcomes of these cirrhotic patients. PMID- 2770437 TI - Guidelines to physicians on court subpoenas and testimony. PMID- 2770438 TI - Regional chemotherapy: pharmacokinetic basis and clinical applications. PMID- 2770439 TI - PRO update. Case example with a confirmed quality problem. PMID- 2770440 TI - [The place of radiotherapy in the treatment of pituitary adenomas]. AB - The paper is devoted to an analysis of the present-day role of radiotherapy of pituitary adenomas with relation to tumor spreading and the patient's neuroendocrine status. The authors made use of data obtained from the N. N. Burdenko Research Institute of Neurosurgery, USSR Academy of Medical Sciences. They analyzed the results of gamma-beam therapy, proton-beam therapy and radiosurgical implantation of 90Y granules used alone as well as in combination with surgical intervention. Based on the analysis of the clinical data on 320 patients, a conclusion is made on the indications for one or another method depending on the stage and course of the disease. PMID- 2770441 TI - [A multi-fractionated course of gamma teletherapy in the late stages of cancer of the maxillofacial area and neck]. AB - The results of gamma-beam therapy using a multifractional course in 373 patients with advanced stages of different parts of the maxillofacial area and neck were assessed. The 3-year survival rates among patients with stage IV (83.9%) were 18.8% for cancer of the organs of the oral cavity and 16.8% for cancer of the accessory nasal sinus and nose. Multifractional radiotherapy puts an end to painful symptoms in patients at advanced stages of cancer without causing any noticeable local reactions or deterioration in the patients' general status. PMID- 2770442 TI - [Evolution of radiotherapy of cancer of the breast]. AB - A many-year-old study of 3680 breast cancer patients receiving different types of radiation therapy as part of combined or multimodality treatment led to the following conclusions. Surgical intervention used alone or the first stage of combined treatment was found appropriate for stage I only. The most preferable modality in all cases was preoperative irradiation provided in large fractional regimens for operable tumors and, when possible, in combination with UHF-therapy; the use of common fractions with the incorporation of a primary focus and all zones of regional metastatic spreading in the zone of radiation exposure was found appropriate for inoperable tumors. PMID- 2770443 TI - [Strategy of the NCRP (National Commission on Radiation Protection) in establishing time limits on annual radiation dosages of the population following the accident at the Chernobyl AES. Concept of a lifetime dosage]. PMID- 2770444 TI - [Combined (poly-chemo-radio) therapy of non-Hodgkin's lymphomas]. PMID- 2770445 TI - [Renoscintigraphy in the differential diagnosis of arterial hypertension]. AB - Altogether 244 persons were examined. Of them 221 patients suffered from the syndrome of arterial hypertension, 23 were controls. Standard renoscintigraphy with 131I-hippuran was performed in all the patients. Routine indices: Tmax, T1/2 and T delta (RP retention mean time) were used as criteria for the assessment of renograms. The diagnostic accuracy of disorders of renal excretory function in patients with arterial hypertension by the results of assessment of renograms using routine indices was 65% only. The introduction of a new index T delta made it possible to raise the accuracy of examination by 35% as a result of the diagnosis of disorders of central hemodynamics. PMID- 2770446 TI - [Immunoscintigraphy of cancer of the ovaries and colon using labeled monoclonal antibodies]. AB - Immunoscintigraphy with labeled monoclonal antibodies for investigation of patients with ovarian and colon adenocarcinoma is a highly informative method which can be used for immunovisualization of primary tumor foci, their recurrences and metastases. A possibility to estimate specific tumor tissue activity was shown to be the advantage of immunoscintigraphy as compared to other special topical methods of investigation. High blood concentrations of tumor antigens did not deteriorate significantly the quality of visualization of tumor foci using labeled monoclonal antibodies. PMID- 2770447 TI - [Systematization of mistakes and errors of irradiation in radiotherapy]. AB - The paper is devoted to a search for and scientific substantiation of practical measures to enhance the quality of irradiation in radiotherapy of cancer patients aimed at the reduction of the frequency of tumor recurrences, radiation reactions and complications. Inaccuracies, errors and faults in irradiation of cancer patients were analyzed and classified with regard to topometric, dosimetric, technical, technological and other features. PMID- 2770448 TI - [Information support of an automated system for organizing a radiodiagnostic data archive]. PMID- 2770449 TI - [Re the article by B.Ia. Narkevich et al: "Choice of a method of determining the separate clearance of the kidneys"]. PMID- 2770450 TI - Isolation of a novel retina-specific clone (MEKA cDNA) encoding a photoreceptor soluble protein. AB - We have reported the isolation of clones which are candidates for retina-specific cDNAs. One of the cDNA clones, pCR-470, was further characterized. We found that mRNA corresponding to the pCR-470 was expressed only in the retina and encodes an unknown soluble protein whose molecular weight and pI are calculated to be 26,935 and 5.35, respectively. We designated it as a MEKA protein, because its amino acid sequence starts from M-E-K-A. It was found by in situ hybridization that MEKA mRNA was transcribed only in the photoreceptor cells and accumulated in the inner segments just like opsin mRNA. The MEKA cDNA was ligated with expression vector PEX 1, and a MEKA-fusion protein synthesized in E. coli was purified and used as an antigen. By the Western blot analysis anti-MEKA protein serum reacted with a soluble 32 kDa protein from bovine retina and 33 kDa for chick, but not with proteins from other tissues. Immunohistochemical study showed that anti-MEKA stained only the photoreceptor cells in bovine, chick, rat and mouse retinas. PMID- 2770451 TI - Single or repeated electroconvulsive shocks alter the levels of prodynorphin and proenkephalin mRNAs in rat brain. AB - The effects of single or repeated electroconvulsive shocks (ECS) on the abundance of mRNAs coding for prodynorphin (DYN mRNA) and proenkephalin (EK mRNA) in rat brain were investigated. Rats were given either a single ECS and sacrificed at 0.5, 2, 6, or 12 h post-shock (expt. I), or were subjected to ECS for 1, 3 or 6 days and killed 24 h after the last shock (expt. II). The amounts of DYN mRNA and EK mRNA were measured in several brain regions using RNA blot analysis. In expt. I, a biphasic change in the DYN mRNA level was found in the hippocampus, with an initial 49% decrease at 0.5 h followed by a 51% increase at 6 h after a single ECS. The EK mRNA content in the entorhinal cortex started to increase at 0.5 h, and continued to rise, reaching 260% of the control level at 12 h post-shock. A smaller increase in the EK mRNA level was found also in the hippocampus at 2 to 12 h post-shock. No significant increase in [Met5]-enkephalin or dynorphin A(1-8) immunoreactivity was detected by radioimmunoassay in either area. In expt. II, a dramatic reduction in the DYN mRNA level was observed in the hippocampus 24 h after a single or repeated ECS. In contrast, elevated DYN mRNA levels were seen in the striatum and hypothalamus. The EK mRNA level remained elevated in the entorhinal cortex after 6 daily ECS.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2770452 TI - Expression in heterologous cells of the unusual cytoplasmic domain of rat brain 5B4/NCAM-ld. AB - Monoclonal antibody 5B4 recognizes a carboxy-terminal epitope common to large (approximately 180 kDa) and short (approximately 140 kDa) forms of neural cell adhesion molecules (NCAM-ld and NCAM-sd, respectively). The deduced primary sequence of rat brain 5B4/NCAM-ld predicts a large cytoplasmic domain (390 amino acids, Mr 39,284) of striking amino acid composition (52% proline, alanine, serine and threonine) and little predicted alpha or beta secondary structure: its function is unknown. To directly test the deduced topology of the protein, and especially the solubility and stability of its unusual cytoplasmic domain, we have constructed a cDNA expression vector designed to express this domain independently as a soluble protein (designated 5B4cyt) in a heterologous cell system (simian Cos cells). 5B4cyt is indeed soluble, but migrates anomalously on SDS-PAGE under denaturing and reducing conditions as two species of approximately 77 and approximately 80 kDa. In pulse chase experiments, the approximately 77 kDa band chases into the approximately 80 kDa band with a t1/2 of approximately 1 h. The difference in mobility is apparently a consequence of the rapid phosphorylation of the approximately 77 kDa species. The approximately 88 kDa phospho-form is reasonably stable with a t1/2 of approximately 6 h. These results are consistent with the deduced topology of 5B4/NCAM-ld, and demonstrate the feasibility of this experimental approach for exploring the biochemistry and structure of its unusual cytoplasmic domain. PMID- 2770453 TI - TPA-induced neurite formation in a neuroblastoma cell line (SH-SY5Y) is associated with increased IGF-I receptor mRNA and binding. AB - The neuroblastoma cell line SH-SY5Y was cultured in the presence of TPA for three days. Increased neurite formation was noted as early as 24 hours after TPA was added. These changes were associated with an increase in IGF-I receptor binding as well as increased mRNA for the IGF-I receptor. PMID- 2770454 TI - Antidepressants regulate glucocorticoid receptor messenger RNA concentrations in primary neuronal cultures. AB - Increased cortisol secretion, caused by hyperactivity of the brain-pituitary adrenal axis, and non-suppression of cortisol secretion following dexamethasone administration are two characteristics frequently associated with major depression or the depressed phase of bipolar illness. Antidepressants, irrespective of their selective inhibitory actions on the re-uptake of serotonin or of norepinephrine, modify glucocorticoid receptor messenger RNA concentrations in primary cultures of rat hypothalamic or amygdaloid neurons in a biphasic manner, with predominant stimulatory effects. This suggests a mechanism whereby antidepressants, by restoring the sensitivity of the limbic-hypothalamic system to glucocorticoid feedback inhibition, reverse the hyperactivity of the brain pituitary-adrenal axis. PMID- 2770455 TI - Heat shock proteins as markers of neural injury. AB - Systemic or intracerebral injections of kainic acid induced immunoreactivity for the 72 kDa heat shock protein (HSP72) in individual neurons of the rat brain in patterns matching the known histopathology of the particular injury. HSP72 immunostaining was also induced in and around areas of infarction following experimental strokes. These results suggest that HSP72 immunocytochemistry may be used as a marker of cellular injury in the mammalian brain. PMID- 2770456 TI - Rural health efforts in the urban-dominated political economy: three Third World examples. PMID- 2770457 TI - Is socialism bad for your health? Cuba and the Philippines: a cross-national study of health systems. PMID- 2770459 TI - Minimizing health risks in Cuba. PMID- 2770458 TI - Capitalism, socialism and the physical quality of life. PMID- 2770460 TI - Towards a critical medical anthropology of health-related issues in socialist oriented societies. PMID- 2770461 TI - Radicalism, Marxism and medicine. PMID- 2770463 TI - Anthropological approaches to diabetes. PMID- 2770462 TI - Socialist health/capitalist health: is there a difference? PMID- 2770464 TI - Anthropological perspectives on diabetes mellitus type II. PMID- 2770465 TI - Beyond the thrifty gene: metabolic implications of prehistoric migration into the New World. AB - Several models have been proposed to explain the high prevalence of non-insulin dependent diabetes mellitus (NIDDM) and other diseases among New World populations. This paper examines the implications of a northern hunting adaptation (reliance on animal foods, seasonal shortages) in terms of energy digestion, absorption, metabolism and storage. Physiologic adaptations to a high protein, moderate fat, low carbohydrate diet are then examined in the context of agriculturally-based subsistence systems and in industrialized societies. Specific metabolic pathways, consistent with the work of both Neel and Weiss, are identified as fruitful areas for further research regarding genetic variants in New World populations. PMID- 2770466 TI - Adiposity or longevity: which factor accounts for the increase in type II diabetes mellitus when populations acculturate to an industrial technology? PMID- 2770467 TI - Cultural heterogeneity of Mexican-Americans and its implications for the treatment of diabetes mellitus type II. PMID- 2770468 TI - "Making sense" about diabetes: Dakota narratives of illness. AB - Diabetes, as it has increasingly affected Dakota (Sioux) in a North Dakota community, is deliberated upon by patients in commentaries that range beyond the more familiar biomedical "boundaries" of a given health condition. These commentaries--or "narrative reconstructions"--following Williams and Wood's (1986) considerations of patients "making sense" of illness and the disruption it may cause, touch upon larger concerns of Dakota regarding culture history and identity. While individuals' interpretations regarding etiology, illness experience, and efficacy of treatments vary, diabetes emerges as a symbol that conveys meaning at many levels. That diabetes treatment may impinge on customary foodways makes imagery of diabetes perhaps more salient. Health workers, trained within the "culture of biomedicine" (Hagey 1984), may learn to recognize key elements in such narratives for cooperative efforts in diabetes education and treatment. PMID- 2770469 TI - The coroner, the inquest and the verdict of suicide. PMID- 2770470 TI - Inner urban and national suicide rates, a simple comparative study. AB - The authors have calculated the suicide rate per million for individual causes of death in the Inner North London Coroner's jurisdiction and also a composite rate for all methods of self-destruction. These have been compared with the rates for England and Wales in the years 1979-1985 inclusive. Also calculated has been a total 'non-accidental' death rate comprising all deaths by self-destructive behaviour. For certain causes the two rates are similar but for the remainder there are wide differences. The effect of the law relating to suicide verdicts has been described and its effects discussed. PMID- 2770471 TI - Adverse effects of the use of unusual phenethylamine compounds sold as illicit amphetamine. AB - A 40-year-old man, who had regularly taken illicit amphetamine by intra-nasal inhalation for several years without ill effects, was admitted to hospital with signs of massive adrenergic overstimulation shortly after inhaling material which he had purchased in the belief that it was amphetamine. The administration of the beta-blocker practolol produced a paradoxical increase in blood pressure. After his discharge from hospital he suffered disabling feelings of anxiety for several weeks. Analysis of a sample of the material showed it to contain p-methyl amphetamine and N, p-dimethyl amphetamine. PMID- 2770473 TI - The effects of suspiciousness and anger on suggestibility. AB - In this paper three criminal cases are presented where a suspicious 'cognitive set' or anger during experimental interrogation appeared to have a dramatic effect on their general tendency towards suggestibility. The subjects were used as their own control, as their susceptibility to suggestions had been tested objectively on two separate occasions; on one occasion they proved very resistant to suggestions, this being clearly associated with temporary suspiciousness or anger; on the other occasion, when no obvious suspiciousness or anger was evident, they proved highly suggestible. The theoretical and forensic implications of the findings are discussed. PMID- 2770472 TI - The relationship between blood and urine alcohol concentrations at autopsy. AB - The relationship between the blood alcohol concentration and the urine alcohol concentration was studied in 109 routine coroner's autopsies. Although the average ratio for urine alcohol concentration to blood alcohol concentration lay close to the ratio of 4:3 quoted in the literature, the actual ratios determined were widely scattered around this value. Thus the use of this simple ratio to estimate the blood alcohol concentration from the urine alcohol concentration at post-mortem was unreliable. An equation determined by employing linear regression analysis was similarly unhelpful in enabling one to derive a precise value for the blood alcohol concentration from a given urine alcohol concentration. It was concluded that the main value in determining the urine alcohol concentration at autopsy was to exclude the possibility of the alcohol present in the blood sample having been generated during the post-mortem interval. PMID- 2770474 TI - Pharmaceutical production in space? The case of the USA. AB - Globally, over $100 billion are spent annually on space goods and services. These include space shuttles, space stations ('factories'), transportation into space and materials processing in space (MPS). Many countries are involved, such as the USA, USSR, Japan and China. A current, fascinating area of space commerce--albeit in its infancy--is the production in space of vital pharmaceuticals such as urokinase, interferon and Factor VIII. This article discusses space-based pharmaceutical production, marketing-related obstacles and other concerns in the USA. PMID- 2770475 TI - Rapid isolation with Sep-Pak C18 cartridges and wide-bore capillary gas chromatography of some barbiturates. AB - A simple and rapid method for isolation of nine barbiturates with Sep-Pak C18 cartridges from human urine, plasma and whole blood, is presented; the detection of drugs was made by wide-bore capillary gas chromatography (GC) with flame ionization. The drug-containing samples, after mixing with dilute acid solution, were directly applied to the cartridges and eluted with either chloroform/methanol (9:1) or acetonitrile. Separation of the nine drugs was satisfactory with use of an intermediately polar HP-17 capillary column. Recoveries of most compounds were excellent for both chloroform/methanol and acetonitrile as elution solvents. However, backgrounds were cleaner and evaporation time was much shorter for the chloroform/methanol system. The present isolation method with use of Sep-Pak C18 cartridges and wide-bore capillary GC seem very useful in the fields of forensic chemistry, clinical toxicology and clinical pharmacology. PMID- 2770476 TI - Identification of tandem bullets. AB - The possibility of identifying tandem bullets, causing separate entry holes on one or two victims, or found separately at the scene of a crime, is investigated. The phenomenon of tandem bullets has been studied to evaluate the physical evidence. The presence of deep indentations of propellant particles on the exposed lead base cavity, along with patches of striations on the inner periphery of the cavity, have been found to be useful physical evidence to conclude that the bullet had moved in tandem and was a lodged bullet. An outward protrusion of the base acts as corroborative physical evidence that the bullet was the striking bullet. PMID- 2770477 TI - Recording by the police of violent offences; an Accident and Emergency Department perspective. AB - The British Crime Surveys have demonstrated that police-derived crime statistics are an unreliable indicator of the true number of violent offences in society. We therefore investigated police recording of consecutive victims of violence who sought treatment in a large Accident and Emergency (A & E) Department. Of victims assaulted within the boundaries of the inner-city Police Division, only one quarter were recorded by the police, though half claimed police awareness of the incident. Proportionately fewer assaults which occurred in the street, in discoteques or on Saturdays were recorded, in comparison to assaults which occurred in other locations and on other days. Proportionately more female victims were recorded, compared to males. A & E data provide a useful insight into the efficiency and effectiveness of inner-city policing. Victims Support Schemes should liaise with A & E Departments as well as with the police. PMID- 2770478 TI - Police educational incentive programs. PMID- 2770479 TI - Colonic perforation following ingestion of plastic sheeting. AB - A case report of fatal faecal peritonitis, in a mentally retarded patient, resulting from perforation of the colon caused by ingested plastic sheeting is presented. Foreign body perforation of the intestines is discussed. PMID- 2770480 TI - Case report: co-ordinated motor movement of a lower limb after death. AB - This report concerns the observations of gross motor movement of the lower right limb of a corpse two hours after apparent death. PMID- 2770481 TI - [International chronicle]. PMID- 2770482 TI - [Nondrug treatment methods in pediatric practice]. PMID- 2770483 TI - [Disorders of sexual development and behavior in children]. PMID- 2770484 TI - [The detection and prevention of neuroses in children]. PMID- 2770485 TI - [The treatment of acute respiratory diseases in children]. PMID- 2770486 TI - [Filling materials used in dentistry]. PMID- 2770487 TI - [Dispensary observation of children with diseases of the digestive organs]. PMID- 2770489 TI - [The drug treatment of gout]. PMID- 2770488 TI - [Clinical tasks. Emergency care in pediatrics]. PMID- 2770490 TI - [Deontology: the nurse and the patient]. PMID- 2770491 TI - [The economics of public health: the key to better patient care?]. PMID- 2770492 TI - [Nursing personnel: the current problems]. PMID- 2770493 TI - [Programming requirements of x-ray computed tomography]. AB - The results of the technological support for the creation of the software for the first whole body USSR CPT-5000 Tomograph are being discussed. The questions for the consideration: creation of the means totality for the construction of operation pseudoenvironment and usage of the structural programming principles. PMID- 2770494 TI - [Microprocessor control of the equipment for extracorporeal extrarenal purification of the blood]. AB - Herein the decentralised microprocessor system is being considered. It allows one to perform automatic regulation in each module of the unit, to make measurements and control of the parameters, visualising the information on the linear display, digital quantitative estimation of the parameters, manual and automatic changing of the set and controlled means of the parameters, alarms, dialogue mode functioning. PMID- 2770495 TI - [An expert consulting system for the epidemiologic physician]. AB - The questions relating to the practical use of the automated expert system for diagnostics, the type of the epidemiological process and giving recommendations for carrying out single purpose prophylactic and antiepidemic measures has been considered herein. The peculiarities of use of the present system with micro computer has been described. PMID- 2770496 TI - [An automated system for evaluating the state of peripheral hemodynamics]. AB - A four-channel automated system based on the microelectronic computer "Elektronika-60M" for investigation of human peripheral hemodynamics is described. The block diagram of algorithm of the automated system operation is adduced, search algorithm of characteristic points is described in detail, the fundamental correlations are presented. PMID- 2770497 TI - [Microprocessors and microcomputers in the manufacture of medical instruments]. PMID- 2770498 TI - [A microprocessor monitoring system for control of the status of the fetus]. AB - To estimate the fetus condition according to its cardiotocogram it is very important to improve the accuracy of measurements of its parameters and objectifications of the estimate criteria. The described microprocessor system helps to meet these requirements. The described microprocessor system allows to measure immediate fetus contractions with the help of the autocorrelation method and automatic measurements of the cardiotocogram parameters. PMID- 2770499 TI - [A personal system of automated planning of microprocessor printing plates for radio-electronic medical equipment]. AB - Personal CAD/CAM for graphic projection and manufacture of microprocessor PCB masks, input information-carrying medium and numeric controlled lathes has been designed. CAD/CAM instrument-software could be interfaced to an APRICOT type PC and to the USSR-manufactured equipment. Personal CAD/CAM is considered as a person-machine system and works in the automatic and semi-automatic modes. The convertor program, which is included into the software allows one to use the present CAD/CAM system with the alternative USSR and foreign manufactured systems. PMID- 2770500 TI - [Computed tomography with variable levels of energy of x-ray radiation]. AB - Method of computer tomography with variable radiant energy is described. It permits to compensate the distortions in computer-tomographic sections in case of change in tube operating conditions and in visualization of information about tissue composition within the sectional limits. The developed method increases the efficacy of computer tomography. PMID- 2770501 TI - [An automated complex for the multiparametric analysis of galvanic skin response signals]. AB - The questions related to the design of the hardware and software means for the automation complex, which allows multiparameter analysis of the GSR signal based on IBM PC/XT microcomputer are being considered in the present article. The choice of the structure for the complex and working parameters of the separate modules is based on the experimental and printed data. Microcomputer GSR signal input and its further processing algorithms are presented. The possibility to simplify the soft- and hardware of the complex with the help of the rational choice of its structure and regarding the peculiarities of the GSR signal frequency-amplitude parameters is described. PMID- 2770502 TI - [A complex of microprocessor facilities for medical technology]. PMID- 2770503 TI - [A microcomputer complex of devices for routine diagnostic tests]. PMID- 2770504 TI - [A measurement and computing complex for control of the state of the operator]. AB - Herein is described the structure and technical parameters of the computer aided complex for the control of changes in operator's state. The design of the specialised operating system and software attached are considered. The article is quite interesting for the specialists engaged in the field of computer aided complex units, for the functional diagnostic specialists and specialists involved in automation of medical research work. PMID- 2770505 TI - Loss of virulence in Shigella strains preserved in culture collections due to molecular alteration of the invasion plasmid. AB - Fifty-two Shigella strains long preserved by three Japanese culture collections were examined for virulence. All of them were avirulent when judged by the focus plaque assay and the ability to bind Congo red. Fifteen strains had a plasmid comparable in size to that responsible for epithelial invasiveness and were positive in hybridization tests with a probe derived from a plasmid cistron, virG. Twenty-four strains had a similar plasmid but were negative in hybridization tests. The remaining 13 strains were negative in all the five criteria for virulence. Similar studies made on one hundred Shigella strains isolated from 1967 to 1985 clearly demonstrated loss of virulence with prolonged time of storage. PMID- 2770506 TI - Purification and characterization of Bordetella bronchiseptica dermonecrotic toxin. AB - Dermonecrotic toxin produced by Bordetella bronchiseptica was purified by chromatography on DEAE Toyopearl 650M and on Bio-Gel HTP, gel filtration on Sephadex G-200, and subsequent chromatography on Bio-Gel HTP and on SP Toyopearl 650M. The purified toxin was homogeneous by sodium dodecyl sulfate polyacrylamide gel electrophoresis and high performance liquid chromatography. There was a 90 fold increase in the dermonecrotic titer per mg protein in guinea pigs and the recovery of activity was 17.6% of that of the original cell extract. The purified toxin is a single-chain protein with a molecular weight of 145,000 and an isolelectric point of 6.3-6.7. Its minimal necrotizing dose is approximately 0.4 ng. It was completely inactivated by heating for 20 min at 56 degrees C. It contained no endotoxin, carbohydrates, nucleic acids, or hemagglutinins. PMID- 2770507 TI - Neutrophil-macrophage cooperation in the host defence against mycobacterial infections. AB - CD-1 mice inoculated intraperitoneally with Mycobacterium avium, M. bovis, M. microti or M. kansasii showed a persistent peritoneal granulocytosis (above 10(6) cells, i.e. more than 15% of total cells) throughout the 3 month period of infection studied. By contrast, in mice inoculated with the non-pathogenic M. aurum or with heat-killed M. avium the number of granulocytes decreased progressively after the first 15 days. No mycobacteria were found in granulocytes except in the first 2 days of infection. The mycobacteria-induced chronic granulocytosis was accompanied by phagocytosis of granulocytes by macrophages. Throughout the 3 months of infection, macrophages were found to contain intracellular lactoferrin. Macrophages with lactoferrin were also found in subcutaneous infection caused by M. marinum and in systemic infection caused by M. avium or M. kansasii. The in vitro activity of mouse peritoneal macrophages against M. avium and M. microti was increased after ingestion of granulocyte material by macrophages. These results lead us to propose that granulocytes participate in the host response to mycobacterial infections, not as phagocytes but rather through an indirect mechanism, as a source for the macrophages of molecules involved in antimicrobial mechanisms (e.g., lactoferrin and myeloperoxidase) lacking in the mature macrophage. PMID- 2770509 TI - Use of small-caliber polytetrafluoroethylene (Gore-Tex) grafts in microsurgical training. AB - We present the use of polytetrafluoroethylene (PTFE) graft material as a microsurgical training model that better simulates live vessel repairs. PTFE grafts have mechanical advantages over polyethylene or silicone tubing in that they better mimic the "feel" of an arterial vessel wall, thus allowing the student to perfect counterpressor maneuvers before attempting live vessel repairs. Saving the PTFE "repairs" for later comparison and study provides the student with positive feedback that is not possible with living models. This cost effective model has helped to shorten our directed teaching program and has reduced the use of laboratory animals. PMID- 2770508 TI - Sequential changes of noradrenaline content of vein grafts in rats: quantitative estimation by high-performance liquid chromatography using electrochemical detection. AB - Supradiaphragmatic inferior vena cava was transplanted end-to-end into the abdominal aorta of 11-week-old rats of the same inbred strain and same litter using microvascular technique. The grafts were removed 3 days, 4, 8, 16, and 35 weeks postoperatively, and their noradrenaline (NA) content was estimated by high performance liquid chromatography using electrochemical detection. The amount of NA was significantly lower (P less than .001) in all vein grafts as compared to nontransplanted vena cava. The substantial decrease of NA in the vein grafts throughout the observation period indicates a persistent denervation of the transplant. PMID- 2770510 TI - Regeneration of the rat sciatic nerve after different conditioning lesions: effects of the conditioning interval. AB - Regeneration of the rat sciatic nerve was studied after a crush lesion (test lesion) on nerves previously subjected to a conditioning lesion. The test lesion was made approximately 30 mm proximal to the conditioning lesion. The period between the conditioning lesion and the test lesion was varied. Regeneration was measured by the pinch test. The conditioning procedure increased the rate of axonal elongation and decreased the initial delay. Conditioning intervals between 14 hours and 4 days were sufficient to increase the regeneration distance significantly, but only until day 4. If the conditioning interval was prolonged to 7 or 14 days, the conditioning effect persisted until day 6. A conditioning effect also was produced by transection of the sciatic nerve and by local compression produced with a silicone tube. The results of this study demonstrate that the type of injury and the conditioning intervals are important determinants in producing the conditioning effect in the rat. PMID- 2770511 TI - Comparison of sciatic nerve regeneration through silicone tubes and nerve allografts. AB - Sciatic nerve regeneration through implanted silicone tubes was compared to allogenic nerve grafting in 30 adult female Sprague-Dawley rats. Regeneration was assessed at 10, 24, and 90 days post-transection. Axonal regrowth through the implanted neural prostheses was evaluated with electromyography and histologic examination. PMID- 2770512 TI - Complications from silicon-polymer intubulation of nerves. AB - Three cases are reported to illustrate the potential danger of silicon-polymer intubulation of nerve for either nerve repair or following neurolysis. Since silicon-polymer intubulation of nerve is now a proven model for producing chronic nerve compression, its use clinically may be contraindicated where neural regeneration is the desired goal. PMID- 2770513 TI - Comparison of two-point discrimination testing devices. AB - In order to provide hand therapists and physicians with information regarding instruments for testing two-point discrimination we evaluated 20 noninjured and 18 nerve-injured patients using the three-prong Aesthesiometer, a paper clip, and a Disk-Criminator. Two-point discrimination was tested by means of a randomized order for the two different discrimination tests and the three different testing devices. The measurement for either moving or static two-point discrimination, when obtained with the three-prong Aesthesiometer, was consistently less sensitive than with the Disk-Criminator, and the correlation coefficient was the least between these two testing devices. The Disk-Criminator measurement had the smallest standard deviation among the three testing devices. In terms of desirability of the testing device tip geometry, translation of interprong distance to numerical rating scale, and facility of alternating between one- and two-prong testing techniques, the paper clip was judged to be the least favorable and the Disk-Criminator to be the most favorable test device. PMID- 2770515 TI - Interpretation of cutaneous pressure threshold (Semmes-Weinstein monofilament measurement) following median nerve repair and sensory reeducation in the adult. AB - Semmes-Weinstein nylon monofilaments are used to evaluate recovery of cutaneous pressure threshold in adults recovering from median nerve repair at the wrist level. Of the 46 patients studied, 22 received a program of sensory reeducation. The nylon monofilament measurements accurately described the improvement in recovered sensation following nerve repair. There was a statistically significant better recovery (lower threshold) in patients receiving sensory reeducation, which was present in those less than 30 years old (P less than .003) as well as those greater than 30 years old (P less than .05). However, normal thresholds were not recovered in these patient populations. PMID- 2770514 TI - Relationship between sensibility and ability to read braille in diabetics. AB - Twenty-five vision-impaired diabetics received an evaluation of sensibility. Each subject had received 2 years of instruction in braille reading at the Konan Rehabilitation Center prior to the sensibility testing. Sensibility evaluation consisted of cutaneous pressure threshold measurements with the Semmes-Weinstein monofilament and evaluation of moving and static two-point discrimination with Disk-Criminator. The ability to read braille was graded by the braille-teaching instructors as good, fair, and unable. The results of the evaluation of sensibility demonstrated that the value of the cutaneous pressure threshold did not correlate with the ability to read braille. Moving and static two-point discrimination were found to correlate highly (P less than .001) with the ability to read braille at a level of fair or good. No patient in this study with a moving two-point discrimination value of 4 or more or a static two-point discrimination value of 5 or more was able to read braille even at the fair level of ability. PMID- 2770516 TI - Results of median nerve repair in children. AB - Seven children ranging in age from 1 to 13 years (mean 8 years) were evaluated at a range of 8 months to 15 years (mean 4.7 years) following group fascicular repair of the median nerve at the wrist following a sharp transection of the nerve. At the follow-up evaluation, they were measured with Semmes-Weinstein nylon monofilaments, moving and static two-point discrimination, and were judged for the presence or absence of paresthesias in their hands. The children did not receive sensory reeducation in the postoperative period. All children recovered to normal levels of moving and static two-point discrimination and were free from disabling paresthesias. These results are contrasted with a group of similar nerve injuries in adult patients treated in the same way and over the same period of time. It is concluded that the capacity for peripheral neural regeneration and cerebral plasticity in children is such that excellent recovery of functional sensation in the hand can occur without the need for sensory reeducation. PMID- 2770517 TI - Results of primary nerve repair in the upper extremity. AB - The results of primary repair of peripheral nerve injury in the upper extremity are reported for 143 nerves in 120 patients, with a mean follow-up of 24 months. Normal values for static and moving two-point discrimination were established and related to the person's age. Sensory reeducation was employed routinely in the postoperative rehabilitation program. Moving two-point discrimination recovered to a better level in 61%, the same level in 38%, and a worse level in 1% than static two-point discrimination after nerve repair. Results for digital, median, ulnar, and radial nerve repairs are reported. PMID- 2770519 TI - The optic nerve. Optic Nerve Study Group, second meeting. Padua, March 13-14, 1987. PMID- 2770520 TI - Anatomy of the optic nerve in elderly men. AB - The microscopic and ultrastructural modifications of glial and mesenchymal components of the optic nerve in the physiologic aging were studied in 182 human optic nerves. According to the age of subjects, a modification of topography of astrocytes was observed. In the 7th-8th decade, the axons of the optic nerve showed some phenomena of swelling and axonal degeneration. During the years, the central artery of retina showed an evident hyperplasia of intima and an increase of collagen of the media. While the connective tissue was good represented by the end of the 1st decade in the central vein of retina, the muscular tissue was almost absent. The interfascicular connective tissue increased considerably in the aging. PMID- 2770518 TI - Use of prolonged sympathetic blockade as an adjunct to surgery in the patient with sympathetic maintained pain. AB - Twenty patients with sympathetic maintained pain (SMP) underwent surgery to treat an associated nerve injury. In each patient, an axillary catheter technique was used to maintain anesthesia and sympatholysis for up to 4 days following surgery. In no instance was the SMP exacerbated by the operation. The use of prolonged sympathetic blockade as an adjunct increases the margin of safety in surgery for these patients when nonoperative measures cannot relieve the pain or restore function. PMID- 2770521 TI - The visual evoked potentials and the spatial vision in old people. AB - The latency of the visual evoked potentials elicited by pattern-reversal and onset-offset stimulation was measured in 75 healthy subjects aged 21 to 80 years. In 24 of these subjects the contrast sensitivity threshold was recorded by electrofunctional method. There is a close correlation between increasing latency of visual evoked potentials and age increase. This finding is of greater importance after 60 years. The delayed latencies are obtained with both pattern reversal and onset-offset stimulation, and are more striking using stimuli of small size. In the old people the contrast sensitivity shows a raised threshold, especially for small stimuli. These age-related changes of the visual evoked potentials and contrast sensitivity are due to optical factors--the most important is the reduction of the retinal illuminance caused by senile miosis- and to neural factors as degeneration and demyelination of the optic nerve axons and abnormalities of the neurotransmitters. PMID- 2770522 TI - Anterior ischemic optic neuropathy and aging. AB - The records of 293 patients admitted to Padua University Eye Clinic with diagnosis of optic neuropathy were reviewed. Age and sex distribution of different types of optic neuropathies were analyzed. 84 patients (28.7%) with a mean age of 61.9 years had anterior ischemic optic neuropathy (AION). The mean follow up of these patients was 3 years. In less than 30% of patients stabilized visual acuity of the first affected eye was better than 20/200; however, patients younger than 65 showed a significantly (p less than 0.01) better visual acuity than patients older than 64. Involvement of the second eye was found in 26 patients with AION (30.9%), of whom only five were considered idiopathic. The latency before controlateral eye involvement was significantly (p less than 0.05) shorter in patients over 64 years of age than in the younger group. Commonly known associated conditions such as giant cell arteritis (3.6%), arterial hypertension (34.5%), diabetes mellitus (10.7%), both arterial hypertension and diabetes (8.3%), migraine (7.2%) or intracapsular cataract extraction (1.2%) were considered. The frequency of a number of risk factors was found out in patients with arterial hypertension and/or diabetes and in patients with idiopathic AION. Symptoms or signs of ischemic cardiopathy and/or peripheral nonarteritic vascular disease, TIAs prior to AION onset, elevated plasma cholesterol or triglyceride levels, excessive smoking were considered. These risk factors were not found in 11.1% of diabetic patients with AION, in 37.9% of hypertensives, in 14.2% of both diabetic and hypertensive patients and in 31% of patients with idiopathic AION. Our data seem to indicate that the onset of AION may be influenced more strongly from these risk factors than aging. PMID- 2770523 TI - The pathology of optic nerve aging. AB - The pathology of the optic nerve in the advanced elderly has been investigated at autopsy in a sample of 50 subjects (43 males, 7 females), aged 95-103 years. Septal fibrous thickness and slendering of nerve fibers were the most frequently encountered lesions as well as degenerative processes involving the cribriform lamina. Other significant features included gliosis, demyelination, and corpora amylacea. Complete arteriosclerotic disease was rarely observed. The results of the present study suggest that optic nerve pathology in aged people is almost the consequence of an inadequate blood supply; nevertheless, the degree of these lesions does not seem to parallel that usually observed in other sites particularly injured by ischemic disease. PMID- 2770524 TI - The optic neuropathy of Alzheimer's disease. AB - Patients with Alzheimer's disease, or more often their families, frequently complain of problems with vision. Nonetheless, clinicians have tended to attribute these symptoms to impaired cognitive functions. Alzheimer patients have been ascribed to disease in the cerebral cortex. However, we have demonstrated that patients with Alzheimer's disease also have a primary optic neuropathy. Degeneration is noted in the retinal ganglion cell layer of the retina and among axons of the optic nerve. In particular, there appears to be a predilection in early Alzheimer's disease for injury to the largest retinal ganglion cell axons. Clinical assessments of patients with Alzheimer's disease demonstrated that patients with only mild dementia have excellent visual acuity. However, they demonstrate deficits in eye movements, visual evoked responses, and contrast sensitivity functions. Patients with more severe Alzheimer's disease are hard to evaluate but they demonstrate severe impairments of vision of many types including visual acuity. The differential involvement of various types of retinal ganglion cells and of different visual functions in early Alzheimer's disease further emphasizes the nature of parallel processing in human vision. PMID- 2770525 TI - Electrophysiological discrimination between retinal and optic nerve disorders. AB - In this study we show how the Pattern ERG (PERG) can be used to distinguish between optic nerve and retinal disease. Records from eyes with RBN and delayed visual evoked responses are compared with those recorded from the normal fellow eyes. In optic nerve disease there is a selective reduction of the later negative component of the response. PERG's were also recorded from patients with mild diabetic retinopathy. These were divided into three groups on the basis of the delay in their Visual Evoked Potential (VEP). The amplitude of both positive and negative components fall with increasing severity of the disease thus showing that the abnormally long delau in VEP found in some cases is due to retinal disease rather than optic nerve disease. PMID- 2770526 TI - Changes in spatial tuning of the pattern electroretinogram with age. AB - Experimental and clinical studies have demonstrated that the electroretinogram in response to periodical patterns alternating in contrast at constant mean luminance (pattern reversal ERG, P-ERG), is correlated with ganglion cell activity. Senile functional changes of these neurons might be therefore investigated by the P-ERG technique. Steady-state P-ERGs (8 Hz) in response to sinusoidal gratings of different spatial frequencies (0.6-6.8 c/d) were recorded in normal subjects ranging over 50 year age span. The P-ERG amplitude as a function of stimulus spatial frequency shows a maximum between 1.2-1.7 c/d and attenuation at higher and lower spatial frequencies (spatial tuning). The P-ERGs of the older subjects are reduced in amplitute, as compared to those of the younger ones, over the whole range of spatial frequency. This reduction is more marked at intermediate spatial frequencies resulting in a shallower tuning. PMID- 2770527 TI - Electrophysiological findings in anterior ischemic optic neuropathy. AB - Electroretinograms (ERG), oscillatory potentials (OP) and pattern reversal visual evoked potentials (VEP) were performed in nine patients (mean age 66 years) with unilateral long-standing anterior ischemic optic neuropathy (AION) and in an age matched control group. Normal ERGs but bilateral impaired OPs were observed in virtually all AION affected patients. Regardless of visual acuity, VEP amplitude reduction was found in all eyes with AION and in controlateral eyes of patients with associated systemic conditions such as diabetes mellitus, arterial hypertension and atherosclerosis. A normal latency of VEP was found bilaterally in AION affected patients; however no correlation between VEP latency and visual acuity or fields could be established. Our results seem to indicate moderate ischemic damage to the retina and to the axons of the optic pathways in patients with AION. PMID- 2770528 TI - The incidence of optic neuropathy in 84 patients treated with ethambutol. AB - The authors examined 84 patients with pulmonary TBC treated with ethambutol (25 mg/Kg/die). The patients were divided into two groups on the basis of zinc plasma levels: 53 patients with zinc plasma level greater than 1 mg/l and 31 with zinc plasma levels less than 0.7 mg/l. The two groups underwent periodical follow-up of visual acuity, fundus, color vision (Fransworth 100 HUE) and visual field. The checks were monthly on the first group and fortnightly in the second. Eight patients presented signs of optic neuropathy. Patients with lower zinc plasma levels showed a higher percentage of optic neuropathy. PMID- 2770529 TI - Optic nerve microangioarchitecture in the aging eye. AB - We investigated the various segments of optic nerve microangioarchitecture in the aging eye. Some clinical results were obtained. PMID- 2770530 TI - Neuroophthalmological implications of the radiological finding of the transverse sinus. AB - Visualization of transverse intracranial sinuses by means of standard radiograms of the skill is a rather unusual finding. In order to detect the radiological evidence of this important intracranial venous collector, the authors examined 5.638 radiograms, collected since January 1982 until December 1986 at the Neuroradiological Ophtalmic Centre of the University of Bologna. 87 cases (1.54%) resulted positive, with a prevalence of young (mean age 23 years) and female (88%) patients. Among these, an involvement of the optic nerve was the most consistent finding. In fact, it was observed in 47 cases (54%) suffering from: retrobulbar optic neuritis (25 cases), papillitis (13 cases), optic disk edema (6 cases), optic chiasma syndrome (2 cases) and stasis papilla (1 case). Moreover, the report of headache in 20 further cases may have significative implications with respect to the pathogenetic hypothesis about the accentuation of the transverse sinus. Our data suggest that a primitive inflammatory disorder, such as asymptomatic meningitis or meningoencephalitis--early developed in the life--, can induce a persistent local damage also with the radiological alteration. Thus, we presumed that this sign may represent a significant marker of a compromised anatomofunctional condition predisposing to relapsing inflammatory processes. A very interesting possible clinical correlation with demyelinating disorders is also discussed for its pathogenetic implications. PMID- 2770531 TI - Hexapropymate self-poisoning causes severe and long-lasting clinical symptoms. AB - Cases of hexapropymate poisoning requiring intensive care in an urban region of Sweden (420,000 inhabitants) were collected over 2.5 years (1985 to 1987). Only patients with serum hexapropymate concentrations above 5.5 mg/L (30 mumol/L) and with a negative history for intake of tricyclic antidepressants, phenothiazines, barbiturates, antihistaminic drugs and opiates were included. Clinical data about 8 intoxication events in 6 patients were evaluated retrospectively. Initial symptoms included coma, hypotension, hypothermia, and hypoventilation. Maximum coma depth (Glasgow coma score) was 3 to 5 in 5 out of 8 events. On 7 occasions assisted ventilation was required (for 12 hours or more in 5 events). There was no relationship between serum concentrations of hexapropymate and severity of clinical symptoms. All patients survived. Detailed analysis of the drug elimination in one patient showed a terminal elimination half-life of 21 hours, which is longer than previously reported (5 hours). The indications for use of this hypnotic drug may vary between doctors since an 8-fold variation was seen in drug prescription between Swedish counties in 1987. Poisoning with hexapropymate is a serious condition which may require symptomatic treatment in the intensive care unit. The clinical picture is similar to that seen in patients with burbiturate intoxication. There is no role for active forced elimination of the drug. It is questionable whether the clinical value of the drug is outweighted by its toxicity. PMID- 2770532 TI - Decreased 3 alpha-androstanediol glucuronide levels in plasma and random urines in male pseudohermaphroditism caused by 5 alpha-reductase deficiency. AB - Concentrations of 3 alpha-diol glucuronide (3 alpha-diol G) in plasma and/or random urine samples were determined in seven subjects with familial male pseudohermaphroditism (FMP) due to 5 alpha-reductase deficiency (5 alpha-RD). All subjects were natives of an isolated Turkish village with a high incidence of consanguineous marriage. A specific and sensitive antibody to 3 alpha-diol was used for radioimmunoassay of 3 alpha-diol G after hydrolysis and chromatographic purification. The mean plasma 3 alpha-diol G in three subjects (31 ng/dL) was much lower than the normal male concentration (516 +/- 50) (+/- SE) and was even lower than normal female values (119 +/- 10.9 ng/dL). In five subjects, mean urinary 3 alpha-diol G in random urine samples was 7.6 (range 2.1 to 12.7) ng/mg creatinine. This was considerably decreased compared with the mean adult male concentration of 65.4 +/- 9.4 and even lower than normal age-matched nonhirsute female values (19.6 +/- 2.1 ng/mg Cr). To validate the use of 3 alpha-diol G/creatinine ratios in random urine samples, correlations of three consecutive eight-hour samples with 24-hour values were determined in 8 male and 3 female age matched controls. There was an excellent correlation (r = .95) and the linear regression line (y = 0.51x + 2.58) indicates that the 24-hour excretion of 3 alpha-diol G in microgram/24 h is approximately twice the random urinary concentration in ng/mg Cr.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2770533 TI - Altered kinetics of an intravenous calcium load in idiopathic hypercalciuria. AB - Increased gut calcium absorption or reduced renal tubular calcium reabsorption have been alternatively reported in idiopathic hypercalciuria with kidney calculi. The present study aimed to investigate the handling of an exogenous calcium load in hypercalciuric stone formers to detect possible differences with regard to tissue calcium metabolism in vivo. A constant rate intravenous calcium infusion (0.2 mmol kg bodyweight per two hours) was carried out on six absorptives and six renals, defined according to the reported criteria, as well as on normal controls from clinical staff. Serum ionized calcium concentration were determined at regular intervals during the infusion and in the four hours after the end of calcium load. Over the same period, urinary calcium excretion was evaluated in timed urine collections. Absorptive and renal hypercalciurics had lower serum ionized calcium levels compared with normal controls at all experimental times, a finding that suggests a faster disappearance of calcium from the circulation. The total body calcium clearance calculated from the area under the curve of the serum calcium concentrations was enhanced in hypercalciuric patients (P less than .001). Although renal calcium excretion was higher in hypercalciurics, renal calcium clearance accounted for only a minor fraction of the total body clearance, suggesting that the reduced serum calcium levels found in the hypercalciurics could not be explained by the renal calcium leak. The enhanced total body calcium clearance found in hypercalciuric subjects is therefore due to an increased tissue calcium uptake. This finding provides indirect evidence of altered cell calcium handling in idiopathic hypercalciura with no difference between the so-called absorptives and renals in terms of the pathophysiologic mechanism. PMID- 2770535 TI - Nucleosomes. PMID- 2770534 TI - Hyperlipoproteinemia in spontaneously diabetic guinea pigs. AB - A colony of Hartley guinea pigs that exhibit hyperglycemia, glucosuria, and hypertriglyceridemia characteristic of human diabetes mellitus was developed. Initially, a group of guinea pigs that had normal serum glucose concentrations (less than or equal to 200 mg/dL of serum) at 3 to 4 weeks of age was obtained; however, in some of the animals progressively severe hyperglycemia (300 to 500 mg/dL of serum) and glucosuria (greater than 2 g of glucose/24 h) occurred as the animals matured. In addition, the animals exhibiting hyperglycemia and glucosuria had plasma insulin concentrations that were similar to those animals that were not hyperglycemic. The diabetic animals were found to be hypertriglyceridemic, with plasma triglyceride levels of 140 to 290 mg/dL at four months of age. Nondiabetic animals (plasma glucose concentration of less than or equal to 200 mg/dL and no glucosuria) had plasma triglyceride concentrations between 37 and 76 mg/dL. Lipoprotein analysis of plasma from nondiabetic and diabetic animals indicated that the diabetics had a fourfold increase in VLDL triglyceride and protein concentrations. The VLDL had an abnormal apolipoprotein composition and had reduced levels of apoprotein-E. The progeny from the mating of diabetic males and females also exhibited the diabetic trait, suggesting that the origin of the disease is genetic. This colony of guinea pigs is being further investigated as a suitable model for the study of the hyperlipoproteinemia of human noninsulin dependent diabetes mellitus. PMID- 2770536 TI - Electrophoretic analyses of nucleosomes and other protein-DNA complexes. PMID- 2770537 TI - Immunoelectron microscopy of nucleosomes. PMID- 2770538 TI - Use of fluorescent probes to study nucleosomes. PMID- 2770539 TI - Preparation and application of immunological probes for nucleosomes. PMID- 2770540 TI - Use of antihistone antibodies with nucleosomes. PMID- 2770541 TI - Digestion of nucleosomes with deoxyribonucleases I and II. PMID- 2770542 TI - Analysis of hypersensitive sites in chromatin. PMID- 2770543 TI - Preparation of nucleosomes and chromatin. PMID- 2770544 TI - Nuclease digestion of transcriptionally active chromatin. PMID- 2770545 TI - Analysis of RNA polymerase III transcription in vitro using chromatin and cloned gene templates. PMID- 2770546 TI - Mapping DNA-protein interactions by cross-linking. PMID- 2770548 TI - Purification and analysis of H1 histones. PMID- 2770547 TI - Crystallization of nucleosome core particles. PMID- 2770549 TI - Analysis of histone subtypes and their modified forms by polyacrylamide gel electrophoresis. PMID- 2770550 TI - Chemical cross-linking of histones. PMID- 2770551 TI - Sucrose gradient techniques and applications to nucleosome structure. PMID- 2770552 TI - Assembly of nucleosomes and chromatin in vitro. PMID- 2770553 TI - Reconstitution of chromatin from purified components. PMID- 2770554 TI - Analysis of nucleosome positioning by in vitro reconstitution. PMID- 2770555 TI - Influence of cefotaxime on Staphylococcus aureus with respect to their interaction with macrophages. AB - Many antibiotics in addition to their direct effect on bacteria can modulate host defence in different ways. The influence of cefotaxime on the phagocytic and bactericidal activity of mouse peritoneal macrophages was investigated. At concentrations of half the MIC the antibiotic caused macrophages to kill intracellular Staphylococcus aureus at a higher level than did macrophages without drug. Bacteria pretreated with cefotaxime became more sensitive to macrophage phagocytic and bactericidal activity. Macrophages taken from mice receiving intravenous cefotaxime showed greater phagocytic capacity than those from control mice. PMID- 2770556 TI - The effect of chlorhexidine on Streptococcus sanguis biofilms. AB - The bactericidal effect of chlorhexidine on Streptococcus sanguis biofilms was investigated and compared with its effect on suspensions of the organism. The biofilms were found to be more resistant to the bactericidal effects of chlorhexidine than the bacterial suspensions in terms of the number of surviving organisms. The minimum inhibitory concentration (MIC) being 25 and 50 micrograms/ml, respectively, for the suspension and the 24 h biofilm. The age of the biofilm had a marked effect on the number of bacteria surviving. Older (72 h) biofilms tended to be more resistant to chlorhexidine than younger (24 h) ones, with the MIC being 200 and 50 micrograms/ml, respectively. Addition of blood to the test system greatly reduced the bactericidal effect of the chlorhexidine, increasing the MIC for the 24 h biofilm from 50 to 200 micrograms/ml. PMID- 2770557 TI - Comparison of Karl Fischer titrimetric and gravimetric methods for determination of moisture content in BCG vaccine. AB - A model 447 Coulomatic K-F titrimeter was used to determine the water content of seventeen lots of freeze-dried Tice-substrain BCG vaccine. The results were compared with corresponding moisture contents determined by a standard gravimetric method at the time of manufacture. The advantages of the titrimetric method include simplicity, rapidity, convenience, sensitivity, reproducibility and specificity, whereas the gravimetric method is tedious and time-consuming. Although moisture content determined by the K-F titrimeter tended to be higher than that determined by the gravimetric method, the results correlated significantly (r = 0.882, P less than 10(-5]. Alteration of national and international regulations to permit use of the K-F titrimeter is recommended. PMID- 2770558 TI - Microbiological degradation of quinoline by Pseudomonas stutzeri: the coumarin pathway of quinoline catabolism. AB - A Gram-negative, oxidase positive, polar flagellated rod, characterised as Pseudomonas stutzeri, has been isolated from sewage by enrichment culture on quinoline. The organism utilizes quinoline as the sole source of carbon, nitrogen and energy, and liberates UV absorbing and phenolic metabolites during its growth on quinoline. 2-Hydroxyquinoline, 2,8-dihydroxyquinoline, 8-hydroxycoumarin and 2,3-dihydroxyphenylpropionic acid have been isolated as the transformation products of quinoline by this bacterium. Quinoline, 2-hydroxyquinoline, and 8 hydroxycoumarin were rapidly oxidised by quinoline-adapted cells; 2,3 dihydroxyphenylpropionic acid oxidation was also demonstrated by Warburg respirometry but 2,8-dihydroxyquinoline was not oxidised. A pathway for quinoline catabolism by P. stutzeri and the probable mechanisms for formation of 8 hydroxycoumarin are suggested. PMID- 2770559 TI - Induction of resistance with heat-killed unencapsulated strains of Staphylococcus epidermidis against challenge with encapsulated strains of Staphylococcus epidermidis. AB - Active immunization of mice with high doses of heat-killed unencapsulated strains of Staphylococcus epidermidis, which were grown in brain heart infusion media, protected mice against challenge with encapsulated strains of S. epidermidis. The unencapsulated strains were capable of absorbing the protective antibody in rabbit hyperimmune sera prepared with the encapsulated strains. Also, mice treated with rabbit hyperimmune sera prepared with the unencapsulated strains were protected against challenge with the encapsulated strains. The protective activities of these rabbit hyperimmune sera were assumed to be essentially identical to those of the protective antibody induced by the encapsulated strains. PMID- 2770560 TI - Characterization and reassembly of a regular array in the cell wall of Clostridium difficile GAI 4131. AB - The cell wall of Clostridium difficile GAI 4131 was revealed by electron microscopy to have an outer layer composed of a nearly square array and contained the two major proteins with molecular weights of 38 kDa and 42 kDa. The properties and reassembly of the two major proteins into the regular array were investigated. When the isolated cell walls were treated with hydrophobic bond disrupting agents or a chelating agent specific for Ca2+, the two major proteins were effectively removed and the regularly arranged outer layer disappeared. The amino acid composition of the two major proteins differed from each other. The two major proteins also gave different peptide maps from each other upon proteolysis with Staphylococcus aureus V8 protease. The major proteins solubilized from the isolated cell walls with 8 M urea or 4 M guanidine hydrochloride could be reassembled into open-ended cylinders possessing the native regular pattern by dialysis against neutral buffer containing 5 mM CaCl2. The reassembled cylinders purified by centrifugation on a Percoll density gradient were composed of almost equal amounts of the 38 kDa and 42 kDa proteins and freed from the other proteins. These results suggest that the regular array in the outer cell wall layer is constructed from the two major cell wall proteins and requires Ca2+ for its assembly. PMID- 2770561 TI - Carotenoid pigments of genus Rhodococcus. AB - A study of carotenoid pigments of the genus Rhodococcus was carried out. According to carotenes contained, Rhodococcus species were divided into three groups: the first group of Rhodococcus luteus, R. coprophilus, R. lentifragmentus, and R. maris, which formed beta-carotene; the second group of R. equi, R. rubropertinctus, R. aichiensis, R. sputi, R. chubuensis, R. obuensis, R. bronchialis, R. roseus, R. rhodochrous, R. rhodnii, and R. terrae, which formed gamma-carotene-like substance; and the third group of R. aurantiacus, which formed neither carotene. Other carotenoid pigments were different according to the species. PMID- 2770562 TI - Susceptibility of Mycobacterium avium and Mycobacterium intracellulare to various antibacterial drugs. AB - Mycobacterium avium and M. intracellulare of human and natural sources, identified by the Gen-Probe Rapid Diagnostic System for M. avium Complex (MAC) were studied for susceptibility to eight different drugs. In the case of human isolates of MAC, the following was noted. M. avium showed nearly the same susceptibility to streptomycin, kanamycin, ethambutol, and clofazimine as was seen with M. intracellulare. M. avium was much more resistant to rifampicin and rifabutin than was M. intracellulare, and M. avium was more susceptible to quinolones such as ofloxacin and ciprofloxacin. Conversely, in the case of MAC from natural sources, there was no difference between the susceptibility of M. avium and M. intracellulare to these antibacterial agents. PMID- 2770563 TI - Delayed-type hypersensitivity skin reaction to HBsAg and immunohistopathologic study of liver in patients with acute type B viral hepatitis. AB - In an attempt to clarify the role of cellular immunity in the pathogenesis of acute type B viral hepatitis (AHB, we studied delayed-type hypersensitivity (DTH) skin reaction to hepatitis B surface antigen (HBsAg) and immunohistopathology of livers in patients with AHB. DTH skin reaction to HBsAg developed early in the convalescent phase in all 14 patients with AHB. In contrast, the production of anti-HBs was significantly delayed in these patients, compared with healthy controls immunized with HB vaccine intradermally (P less than 0.001). These observations suggest that DTH to HBsAg but not anti-HBs may be associated with recovery from AHB. In the biopsied livers obtained from patients with AHB, the proliferation of Kupffer cells was extensive and immunohistopathologic studies revealed an accumulation of CD-4 positive lymphocytes in the portal area, a finding which suggested a DTH reaction in the liver with AHB. CD-8 positive cells had infiltrated the lobule and made contact with affected hepatocytes, thereby indicating that a cytotoxic T cell response is involved in damaging of the infected cells. All these observations taken together, we propose that not only a cytotoxic T cell response but also a DTH reaction may be involved in the pathogenesis of AHB. PMID- 2770564 TI - Electron microscopic studies of viruses labeled with magnetite. AB - We were able to develop a method with which to successfully and specifically detect virus particles under the electron microscope by using magnetite. This method was devised on the principle that magnetite-labeled antibody or magnetite coupled with protein A selectively bind virus or antibody-treated virus particles on the electron microscope grid by the action of an electromagnet. Another advantage characterizing the technique is the possibility of detection of a small number of virus particles. This is done through a process of concentration and purification of the reaction complexes trapped rigidly by magnetic force. PMID- 2770565 TI - Riverside midwife teams. PMID- 2770566 TI - A shortage of midwives? PMID- 2770568 TI - The midwife in private practice in Indonesia. PMID- 2770567 TI - Baby adoptions, midwives and health visitors. PMID- 2770569 TI - Crohn's disease and pregnancy. PMID- 2770570 TI - Looking out for emotional abuse. PMID- 2770571 TI - Science and art. PMID- 2770572 TI - Pre-registration posts in general practice: the chance of a lifetime? PMID- 2770573 TI - A house officer in general practice: a different experience. AB - This paper describes a single house officer's attachment in general practice, organized in a particular way and with specified aims. The attachment required careful planning and case-by-case supervision of the houseman. However, the extra clinical burden on the supervisor was not excessive. The attachment provided experience similar in some ways to hospital posts, but was broader in general clinical content and emphasized the continuity between primary and secondary care. Many of the important experiences could only be obtained in an attachment which involves responsibility inside and outside the hospital at the same time. We believe such attachments are a unique educational opportunity and should be strongly encouraged. PMID- 2770574 TI - Medical education: how is change to come about? AB - The challenge to medical education as we enter the last decade of the century and face the next millenium is how to utilize the new knowledge of human learning to train medical students in applying the fruits of rapidly advancing science and technology to the moral imperative of fulfilling social needs. To bring about the reforms defined in the Edinburgh Declaration, adopted as globally applicable by the World Conference on Medical Education, intrinsic and extrinsic elements must act in synergy. The intrinsic elements are teachers, students and institutional frameworks; the extrinsic elements political will, administrative commitment and societal pressure. In the developing world, while there is much that medical schools themselves can do through intrinsic changes, their dependence on government support is so pervasive that such government support becomes an essential prerequisite for change. The creation of a cohesive organizational framework involving health and education ministries, the academic sector and professional bodies for a systematic and continuing study of medical education and for inducing and sustaining change are essential to facilitate the change process. PMID- 2770575 TI - A collaboration between two innovative medical education programmes in Egypt and the United States. AB - In 1984, the Center for Educational Development at the University of Illinois at Chicago began to offer its Master of Health Professions Education leadership programme to 13 medical teachers on-site at Suez Canal University in Ismailia, Egypt. The central issue in this project was whether two institutions on different continents and representing different cultures could collaboratively develop and implement a relevant graduate programme. Of equal concern was whether the degree programme could be adapted to meet the needs of the teachers of a new innovative medical school in a developing country. The 13 doctors have now graduated. This paper describes the rationale for the enterprise, the planning phase of the project, the curriculum, problems that had to be overcome, and some indices of success. PMID- 2770576 TI - Permanent Working Group of European Junior Hospital Doctors. Policy statement on postgraduate medical education. Subcommittee on Postgraduate Training. AB - The Permanent Working Group of European Junior Hospital Doctors (PWG), representing junior doctors of 18 European countries, has amongst its foremost interests the quality of postgraduate medical training. Building upon the work of other groups, and notably that of the Advisory Committee on Medical Training (EC), it has developed its own policy statement on postgraduate training. The statement defines the aims of training and the needs of the trainee and proposes that these can only be met through a close relationship between the trainee and a clearly identified trainer. The duties of the trainer are set out, with emphasis on the need for both practical and theoretical teaching and on the importance of regular, unambiguous feedback regarding progress. Trainers themselves require remunerated time for carrying out these duties and training in educational methods. An appropriate balance between clinical and research experience may require an upper limit on the proportion of the training period which may be spent in research. Training programmes should be inspected and approved by appropriate professional bodies working to published criteria of sufficiency. The PWG believes that high levels of skill and knowledge amongst fully trained specialists can only be guaranteed when the training system identifies trainees' shortcomings at every stage and corrects them through unambiguous feedback. PMID- 2770577 TI - Postgraduate qualifications of British doctors. AB - Among British-qualified doctors of 1974 and 1977, about 80% held postgraduate qualifications of some kind. The commonest qualifications were DRCOG, MRCP and MRCOG. There were considerable differences between medical schools in the numbers of qualifiers taking various examinations. Apart from the MRC Psych, DRCOG and Family Planning Certificate, qualifications were more commonly held by men than women. Tables show the type of work being done 9-13 years after leaving medical school by holders of various postgraduate qualifications; e.g. 60% of MRCP holders were working in medicine or a medical specialty and 84% of FRCS holders in general surgery or a surgical specialty. Discussion deals with the plurality, specificity, variability, perceived necessity, sufficiency, international utility and career significance of British postgraduate qualifications. PMID- 2770578 TI - Lectures and skills workshops as teaching formats in a history-taking skills course for medical students. AB - The consulting skills acquired by medical students during their training are an important determinant of their ability to conduct adequate and efficient clinical interviews. These skills comprise: the acquisition of medical knowledge and the ability to apply this; and communication skills required to obtain full, accurate clinical histories from patients and to be able to give to patients the information they need to comply with prescribed regimens. Until recently, consulting skills training has certainly not had a high profile in medical curricula, despite evidence that students do not gain sufficient expertise during their medical training. A history-taking skills course within the Austin Hospital Clinical School, utilizing mass lecture and small-group skills workshops is described. Independent evaluation of students' videotaped interviews with patients, completed before training, after mass lectures and following small group workshops, showed that students trained in consulting skills demonstrated significant improvements in interview skills and techniques, compared with a similar group of students for whom training followed the more traditional model. Whilst there were some improvements after mass lectures, most significant gains in history-taking skills were obtained following skills workshops. Ongoing evaluation of these students will determine if these short-term improvements in consultation skills persist over their clinical training and internship. PMID- 2770579 TI - Scoring the objective structured clinical examination using a microcomputer. AB - The objective structured clinical examination (OSCE) is being used increasingly to assess students' clinical competence in a variety of controlled settings. The OSCE consists of multiple stations composed of a variety of clinically relevant problems (e.g. examining simulated patients, diagnosing X-rays, etc.) Generally, three types of performance data are collected: answers to multiple choice or true/false questions, written short answers, and performance check-lists completed by observers. In most OSCEs these student performance measures are scored by hand. This is time-consuming, increases the probability of mistakes and reduces the amount of data available for analysis. This paper describes a method of computer scoring OSCEs with over 100 students using statistical and test scoring software regularly used for multiple choice examinations. During the examination, students, markers and raters code answers and performance data directly on optical mark-sheets which are read into the computer using an optical mark reader. The resultant computer data can be efficiently scored and rescored, grouped into different types of subscales, weighted to reflect questions' relative importance, and easily printed in a variety of report formats. PMID- 2770580 TI - A test of medical problem-solving scored by nurses and doctors: the handicap of expertise. AB - There is evidence that nurses fulfil the requirements of objective judgement better than doctors. Simulation of Initial Medical Problem-Solving (SIMP), a paper-and-pencil test for the assessment of medical problem-solving, consists of case histories, followed by an open-ended question. The scoring of open-ended questions is time-consuming and adds subjective bias to measurement error. In order to reduce scoring error, answers on SIMP are scored by means of scoring models in the form of check-lists with descriptions of elements of a correct answer. The reliability of the scoring was analysed in a study, with six nurses rating 500 answers. The overall interrater reliability was high, expressed by an intra-class correlation of 0.83. Selection of raters, and improvement of the scoring models, could increase the interrater reliability even further. In addition to the scoring by the nurses part of the material was scored again by two experienced doctors. The reliability of the scoring method on the whole was confirmed. Nevertheless, some evidence was found of misinterpretation of the scoring models by the nurses. Analysis at the item level revealed several instances in which both doctors agreed on a score for an element in an answer and all the nurses agreed on the opposite score. On the other hand, however, the two doctors were less consistent between themselves than the nurses. The disagreement between the doctors seems to be a consequence of differences in their own medical judgement of the case in question. The impact of the mistakes that are made by the nurses is much smaller than the loss of reliability caused by the inconsistency among the doctors. PMID- 2770581 TI - Communication skills training for medical students: an integrated approach. AB - Skills of communication are not easily taught to medical students. Three main clinical departments (general practice, medicine and mental health) of the Medical Faculty of the Queen's University, Belfast, introduced an integrated course in January 1988 to teach the basic principles. The course is held at the beginning of clinical training and is an integral part of the introductory clinical course. It was introduced in response to the Report of a Working Party of the Education Committee of the General Medical Council (1987) which advocated the need for improved training in history-taking and communication. It is a 12 week course and every Monday and Friday afternoon from 1400 to 1700 hours 12 students are seconded from ward work, four to the Department of Medicine, four to the Department of General Practice and four to the Department of Mental Health. Hand-outs about information to be obtained and interview style are standardized and the principles to be followed are clearly defined in an aide-memoire. Staff from the Departments of General Practice and Mental Health experienced in teaching communication by videotape feedback and analysis of consultations prepared 12 tutors for their role and responsibilities. Procedures to be followed were carefully explained to all students beforehand. General practice and psychiatry traditionally have established teaching programmes in communication but the inclusion of the Department of Medicine has made a significant impact. Students have come to realize that the taking of a good history demands as much skill as the physical examination of the patient and is an important aspect of any clinical assessment. PMID- 2770583 TI - An assessment of the doctorate of medicine (internal medicine), University of the West Indies. AB - The outcome is described of 48 entrants to a postgraduate degree course (DM) in Internal Medicine established at the University of the West Indies in 1974. Contact by postal questionnaire was established in 96% of 26 graduates and 82% of 22 non-graduates. 22 of 25 DM graduate responders have remained in the Caribbean, working in six Caribbean territories. All graduate responders developed a subspecialty interest. The graduates' primary employers are the University (9) and the Government (12). However, failure to graduate did not necessarily preclude qualification as consultant physician (7 of 18 responders). Major difficulties with the DM programme included: (1) in practice, lack of recognition by contributing territories of individual DM (Internal Medicine) graduates; (2) incomplete regional coverage; (3) lack of adequate funding for the programme; (4) an inadequate research training input; and (5) difficulties with seniority for staff who trained in Jamaica to go to work in another territory. All these problems have solutions. Overall, the international recognition of the new degree programme has been satisfactory and the graduates' own assessment of the training was complimentary. At last a system has been devised that enables postgraduates to train as internal medicine specialists in the Caribbean to practise effectively within the Caribbean health system. PMID- 2770582 TI - Comparison of performance of students from different high school systems in medical sciences at Kuwait University. AB - Data, although limited, question the validity of the formula applied for admission to the medical school in which high school grades are the only preselection variable applied. Comparison between two groups of students from two different high school systems in Kuwait was carried out to determine if the admission criteria used currently for entry to the medical school are equally valid for both groups. The results are based on the students' performances in the first three-semester programme of medical sciences. Subjects covered were anatomy, physiology, biochemistry and behavioural sciences. The group derived from the High School National Diploma performed significantly better with a percentage pass rate of 82% while of those who were derived from the Course Credit System only 61% passed the final examination. In addition, only one of the latter group attained total marks of more than 80% compared to 12 students from the National Diploma group. The percentage failure according to subjects was consistently higher among the Course Credit graduates in all the subjects. All differences between the two groups are statistically significant (P less than 0.001). PMID- 2770584 TI - Volunteering for the care of patients with the acquired immunodeficiency syndrome. PMID- 2770585 TI - Evaluating interns' performance using simulated patients in a casualty department. AB - An observational study examined the care that was provided by 61 interns for three simulated (standardized) patients in a casualty department within a large teaching hospital. The consultations were recorded on videotape and were scored by reference to explicit criteria that were set by an expert panel. The criteria described standards of clinical competence, communication skills and preventive care for each of the three cases. An additional list of the general opportunities for preventive advice that were suggested by the patients' case histories also was compared with the interns' actual behaviour. Clinical competence was not demonstrated uniformly across the three cases. The problem of urinary-tract infection was managed best; 19% of the interns complied with all criteria, and 93% of the interns complied with 75% of the criteria. For tension headache, only 3% of the interns complied with all the criteria but 67% of interns complied with 75% of the criteria. In the case of bronchitis, only 3% of interns complied with all the criteria but 58% of interns met 75% of the criteria. The quality of preventive care also varied from case to case, being best for the patient with bronchitis and worst for the patient with tension headache. Over all, only three of the 13 criteria were met by more than half the interns. The communication skills criteria identified three behaviours which the interns were most likely to omit: the interns summarized the patients' problems in only 73 of the 173 consultations; they explained the aetiology of the problems in only 127 of the 173 consultations; and they ensured that the patients understood their plan of management in only 21 of the 173 consultations. PMID- 2770586 TI - Toxicology begins at home. PMID- 2770587 TI - Repeat myocardial revascularization surgery: an analysis of 169 cases. AB - One hundred and sixty-nine patients who underwent repeated myocardial revascularization surgery between 1982 and 1987 were studied. The mean interval between operations was 91.6 +/- 7.3 months. The indications for repeated surgery were graft failure in 37.2% of patients, progressive coronary atherosclerosis in 40.2% of patients and a combination of the two causes in 22.5% of patients. The mean number of grafts that were inserted was 2.74 +/- 0.61 grafts per patient at the second operation. Coronary endarterectomy as an adjunctive procedure was necessary in 17.1% of patients. The hospital mortality rate was 4.1%, with a 1.8% incidence of perioperative myocardial infarctions. Of the surviving patients, 96.3% were available for follow-up at a mean of 19 +/- 6.4 months. Of these patients, 68.5% were well and could be categorized into the New York Heart Association's functional class I. We conclude that both progression of coronary atherosclerosis in native vessels and obstruction of venous grafts cause recurrent angina and that repeated myocardial revascularization surgery is a feasible treatment option in these patients. PMID- 2770588 TI - The Ankali project: a model for the use of volunteers to provide emotional support in terminal illness. AB - The Ankali project has provided emotional support to about 250 persons with the acquired immunodeficiency syndrome, their partners, family members and friends. Volunteers act as a "supportive friend" and allow subjects the opportunity to express their feelings. The project's model easily could be adapted to meet the needs of persons with other terminal illnesses. One of the most important features of the model is the compulsory support-group structure for volunteers. PMID- 2770589 TI - A three-cornered solution. PMID- 2770590 TI - The hazards of automatic-dishwasher detergent. AB - Automatic-dishwasher detergent is a common household substance which is extremely corrosive and potentially fatal if ingested. In this report, we discuss the implications of the ingestion of automatic-dishwasher detergent in 18 children over a three-year period. Ten of the 18 children gained access to the automatic dishwasher detergent from the dishwasher on the completion of a washing-cycle, while the remainder ingested the detergent directly from the packet. There was a poor correlation between the presenting signs and symptoms and the subsequent endoscopic findings in the 14 children who underwent endoscopy. PMID- 2770591 TI - Knowledge of sexual abuse in children by general practitioners. PMID- 2770592 TI - Quality of imported herbal products. PMID- 2770593 TI - Management of postoperative pain. PMID- 2770594 TI - Survey of eosinophilic enteritis. PMID- 2770595 TI - Metered-dose aerosols. PMID- 2770596 TI - Greeks in Victoria: implications for mental-health services. PMID- 2770597 TI - Health-care interpreters and cancer. PMID- 2770599 TI - The role of the general practitioner in the 1990s. PMID- 2770598 TI - Birth defects in aborigines. PMID- 2770600 TI - To resuscitate or not, that is the question. PMID- 2770601 TI - Congenital malformations in aborigines and non-aborigines in Western Australia, 1980-1987. AB - A comparison of congenital malformations in Aboriginal and non-Aboriginal children in Western Australia has been made by means of data from the WA Congenital Malformations Registry, for births from 1980 to 1987 inclusive. Although the birth prevalence of all malformations was 3.5% for both Aboriginal and non-Aboriginal infants, significant differences were found in the birth prevalence of some individual malformations. Nervous-system and cardiovascular defects, and cleft lip and palate were significantly more prevalent in Aborigines, and pyloric stenosis and urogenital defects were significantly less prevalent. While some of the observed differences may have been a result of biases in ascertainment, others are likely to represent true differences. A discussion of Aboriginal beliefs concerning conception and birth is included, in order that the quantitative findings from the study might be considered in an appropriate cultural setting. PMID- 2770602 TI - General practitioners' recognition and management of psychiatric illness. AB - All 53 of the general practitioners from one community health area of the Hunter region of New South Wales were interviewed about patients with psychiatric illnesses who had presented to their practices. Four main themes were covered: personal data which included details of medical and psychiatric training and experience; attitudes to psychiatric illness; pharmacological management; and the effectiveness of existing services. Ninety-four per cent of the general practitioners felt that dealing with psychiatric problems was an integral part of their role as a general practitioner and 60% of the general practitioners believed that their management of these problems was adequate. Patients with personality problems and those with hypochondriasis were identified as their most difficult patient groups, while inability to refer quickly was cited as the major obstacle to successful psychiatric treatment. An increased awareness of the hazards of psychotropic drugs and of the proper uses of these agents existed. Finally, private psychiatrists and the mental hospitals were criticized for not providing an adequate back-up service for this group of general practitioners. PMID- 2770603 TI - Withholding cardiopulmonary resuscitation: one hospital's policy. AB - We investigated prospectively the current "do not resuscitate" policy at the Royal Adelaide Hospital, to assess the success of the policy in limiting cardiopulmonary resuscitation and to review how orders to withhold resuscitation were documented. We studied the medical records of 272 patients who died in hospital wards over a three-month period in 1987, and found that in 61% of patients a "do not resuscitate" order had been written, including in 75% of those patients who died with a malignant disease. "No resuscitation" was the most common wording, which occurred in 23% of the orders, whereas only 16% of orders used the terminology "for ordinary measures"--the wording that is recommended in the hospital policy. We conclude from this study of hospital deaths that "do not resuscitate" orders are used frequently and serve to limit the use of cardiopulmonary resuscitation in patients who die in hospital, but are documented without regard to official policy. PMID- 2770604 TI - Do general practitioners promote health? A needs assessment. AB - A random sample of 5% of NSW general practitioners was surveyed in December 1986 regarding their attitudes to health promotion in clinical practice. The results were compared with those of simultaneous surveys of trainee general practitioners and fourth-year medical students. Smoking, alcohol and weight reduction were the health behaviours that were considered by general practitioners to be the most difficult to change. More general practitioners than did students or general practitioner trainees reported finding less difficulty in changing health behaviours. More than three-quarters of the general practitioners were in favour of promoting health in their practices. A commonly reported barrier was the current Medicare financing arrangements for preventive practice. Other barriers included a lack of time for preventive practice. The complaint of a lack of training was expressed commonly; half the sample was willing to participate in advanced training in health promotion that would be organized by The Royal Australian College of General Practitioners. PMID- 2770605 TI - How well are endoscopes cleaned and disinfected between patients? AB - A questionnaire was sent to 276 hospitals throughout Australia to obtain details on the methods that are used in these institutions for the cleaning and disinfection of endoscopes. A broad range of hospitals was surveyed and 145 responses were received. Endoscopies were performed in 123 of the responding hospitals. Only 45% (55/123) of these hospitals both cleaned and disinfected their endoscopes satisfactorily. Generally, such hospitals were larger (300-600 beds) than were those which did not do so (100-300 beds) and also they were busier as more endoscopies were performed on a weekly basis (30.2 endoscopies compared with 19.3 endoscopies, respectively). Frequently (38% [47/123] of hospitals), the endoscopes were not disinfected between patients, or were disinfected for an insufficient time or were disinfected with an agent that did not have both antiviral and antibacterial activity. In a substantial proportion (40% [49/123]) of hospitals, endoscopes and their accessories appeared to be cleaned inadequately between patients. We conclude that in the majority of hospitals where endoscopies are performed that responded to our survey, there was considerable room for improvement in the cleaning and disinfection of endoscopes. PMID- 2770606 TI - Acute cardiac failure in multiple myeloma. PMID- 2770607 TI - Wastage among the tall poppies. PMID- 2770609 TI - Melioidosis and latent infection. PMID- 2770608 TI - Acute toxicity of inhaled gases and particulates. PMID- 2770610 TI - Management of hypercholesterolaemia in postmenopausal women. PMID- 2770611 TI - Adverse reactions to N-acetylcysteine. PMID- 2770612 TI - Calcium antagonist drugs in the management of cardiovascular disease. PMID- 2770613 TI - Migratory polyarthralgia and haemoptysis. PMID- 2770614 TI - Chinese ointment. PMID- 2770615 TI - [Mesotheliomas among mechanics of the railways in Italy: a current problem]. AB - Asbestos has been used on rolling stock of the Italian Railways since the 1940's. From the 1950's to the 1970's it was used on a massive scale for the insulation of passenger carriages (up to more than 800 kg per carriage). About 10 years ago, a programme was began to remove asbestos from rolling stock and replace it with glass fibre. We must consider as exposed to the carcinogenic effects of asbestos all mechanics who, during the past years, worked at the Major Repair Workshops (MRW), at the Locomotive Depots (LD) of the State Railways, or in other state or private factories where railway rolling stock insulated with asbestos was built, checked, repaired or demolished, or where asbestos removal operations took place. It has been estimated that the total number of mechanics potentially exposed to asbestos since 1950 in the MRWs alone amounts to more than 25,000. There are about 750 workers presently employed at the Bologna MRW and it has been estimated that the entire cohort of this MRW from the beginning of the 1950's includes about 3,000 people (in excess). In 1986 the Bologna Institute of Oncology reported 6 cases of pleural mesothelioma at the Bologna MRW and 1 at the Rimini MRW. This was the first report of pleural mesotheliomas among railway mechanics in Italy. From 1986 up to the present, other cases of pleural mesothelioma have been recorded among mechanics working on railway rolling stock in the MRW's and in the LD's of the State Railways and in other factories.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2770616 TI - [Carcinogenic risk for resin producers exposed to formaldehyde: extension of follow-up]. AB - A significant increase in lung cancer was observed in a previous study on the mortality experience of a cohort of 1332 male workers employed between 1959 and 1980 in a resin manufacturing plant. Due to the limited exposure and an inadequate follow-up, it was not possible to make a thorough analysis of the potential association of this elevated risk with exposure to formaldehyde. The study was therefore continued and extended for a further six years (1980-1986), in order to overcome the limitations. Despite these attempts, however, there were still 219 workers whose specific exposure could not be identified. Lung cancer risk in the whole cohort (27,202 person-years) was equal to that of the local population (observed = 24; expected = 23.9). Among those definitely exposed to formaldehyde, 6 lung cancer cases were observed and 8.7 were expected, while those with non-specified exposure exhibited an increase risk (observed = 9; SMR = 211); they were mainly short-term workers employed at the beginning of operations. The previously suggested increase in haematologic neoplasms was confirmed (observed = 7; SMR = 143); the risk was highest among formaldehyde exposed workers (observed = 3; SMR = 173). Five deaths due to primary liver cancer were observed, while 2.0 would have been expected from the local population rates (SMR = 244); the increased risk was fairly evenly distributed across the exposure categories (exposed to formaldehyde, SMR = 244; non-exposed to formaldehyde, SMR = 227; non-specified exposure = 287); however, all cases were first exposed at the age of 45 years or older. A noteworthy finding was a 50% increase in mortality from respiratory diseases. The increase was mainly apparent among those with longest and earliest exposure, employed in operations classified as involving exposures other than formaldehyde (observed = 9; SMR = 224). Overall, the results of this extended study do not provide sufficient grounds for associating work in formaldehyde resin production in this plant with increased carcinogenic risk; however, limitations in the individual exposure classification and suggestions of an increased risk for certain tumours preclude considering the study as negative. The numerous airborne irritative agents present in the plant environment appeared to have increased the risk of respiratory disease.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2770617 TI - [Risk of abnormal absorption of lead in glass decoration workers]. AB - Following the observation of an abnormal lead absorption (PbB 72 micrograms/100 ml) in a young female glass decorator on a routine laboratory test, blood lead levels were measured in glass decorators of the entire area of the Local Health Unit of Treviso (Northern Italy). Abnormal lead absorption was found in a large number of glass workers, the source of exposure being the high content of inorganic lead in the "low-melting" paints that were used (brush and spray painting). Most of the exposed workers were females of fertile age, for whom even a moderate exposure to inorganic lead may constitute a risk during pregnancy. Attempts to reduce lead exposure levels by means of a health education programme and environmental improvements at the workplace were unsuccessful. In conclusion, a reduction in lead absorption in female glass decoration workers can only be achieved by using "low-melting" paints with a lower lead content. PMID- 2770618 TI - [Mortality caused by pleural mesothelioma in the 1979-1983 lustre in Italy regarding provinces and single local health districts]. AB - The geographic distribution of deaths from pleural mesothelioma in Italian provinces was analysed over the five-year period 1979-1983. In the provinces where the mortality rates were markedly higher than the national average, a further analysis was made on the data referred to the local health districts (USSL) of each province. It was thus possible, in some cases, to identify small, high risk areas which corresponded, as expected, to the location of large factories or shipyards using asbestos. PMID- 2770619 TI - [Temporary myopia and subjective symptoms in video display terminal operators]. AB - The study covered a group of female VDT operators assigned to data entry and data acquisition. Subjective VDT-related symptoms of asthenopia were assessed by means of a questionnaire. All operators were examined by an ophthalmologist. Visual acuity was measured using vision tables with optotypes. In order to achieve an objective assessment of VDT-induced visual fatigue, refractive power was measured at the beginning and at the end of the shift, using an infra-red autorefractometer. Changes in refractive power were then related to VDT work and asthenopia symptoms. Visual acuity defects were observed in 63.5% of the operators; in 36% of the cases the subjects were either unaware of the defects or the defects were not adequately corrected. 62.5% of the operators complained of subjective asthenopia symptoms. Asthenopia was not related to the number of hours at the VDT. The results suggest that ametropic subjects are likely to be more susceptible to visual fatigue than emmetropic subjects, since there was a tendency for the prevalence of asthenopia to increase in the former group. A significant decrease in refractive power (temporary myopization) was observed in 20% of the operators at the end of the shift at the VDT: all these subjects also complained of asthenopia, compared to 50% of the workers without end-of-shift myopization. The difference between the groups was highly significant (p less than 0.01); contrarywise, none of the subjects without asthenopia developed myopization. On the basis of these results, it can be concluded that end-of-shift myopization, as measured by an automatic refractometer, may be used as a reliable objective measurement of VDT-related visual fatigue. PMID- 2770621 TI - The Crown Prosecution Service. PMID- 2770620 TI - Embryo arrest: the "no-man's-land" between contraception and abortion. PMID- 2770622 TI - The psychology of false confessions. PMID- 2770623 TI - Low osmolality contrast agents. PMID- 2770624 TI - Torture: diagnosis and rehabilitation. AB - This article describes psychological and physical methods of torture, the general stress-related sequelae that are unrelated to the method used, and some examples of clinical effects that are related to specific methods. The approach to the rehabilitation of victims of torture practised at RCT is outlined. Two illustrative case histories are given. PMID- 2770625 TI - In vivo measurement of cortical bone lead using polarized x rays. AB - An x-ray fluorescence system which utilizes polarized radiation to measure lead in vivo in human subjects is described. The minimum detection limit is approximately 6.4 ppm wet weight lead in the cortex of the tibia with 4 mm of overlying soft tissue. This appears to be adequate for assessing lead stores in lead-toxic preschool children. The measurement requires 16.5 min and is associated with an effective equivalent whole body dose to the subject of 2.5 muSv. The system, its calibration and its validation are described herein. PMID- 2770626 TI - Measurement of diagnostic x-ray spectra using a silicon photodiode. AB - Diagnostic x-ray spectra (66-103 kV, 1-2 mA) were measured without pinhole collimator or liquid nitrogen cooling by using a silicon p-i-n photodiode. An x ray count rate was low (approximately 400 photons/s) at distances of 2-3 m away from an x-ray target, because the i layer of the photodiode was very small (1.5 mm2 in area and 75 microns in thickness). The junction reverse current of the photodiode was 50-70 pA at room temperature and energy resolution for 59.5-keV gamma rays was 2.0 keV (full width at half-maximum), which was limited by the electric noise of a preamplifier. Measured spectra were corrected for detector distortion. The corrected spectra were similar to those determined with a Ge detector. The i-layer thickness of the photodiode was an important parameter for the correction. In particular, when the thickness was thin, the fraction of photoelectron escape became large; this fraction was estimated analytically for various i-layer thicknesses. The angular dependence of the full-energy peak efficiency was measured; for the photons whose energies were above 17.8 keV the angular dependence was isotropic except for angles greater than 60 degrees off the photodiode axis. This method is therefore applicable to the measurement of scattered x rays. PMID- 2770627 TI - Radionuclide synthetic Fourier images of cardiac wall motion abnormalities. AB - At present, the phase images together with amplitude images are used in nuclear medicine to aid the diagnosis of cardiac regional wall motion abnormalities (RWMA). The phase images represent the spatial distribution of the relative phase of the first harmonic fit of pixel time activity curves, and the amplitude images represent the distribution of the amplitude of the fit. These images contain only part of the information present in the original radionuclide images, and have to be mentally integrated with other known information to obtain a diagnosis. The proposed synthetic Fourier images overcome these deficiencies as their pixel intensity is a function of additional Fourier parameters of pixel time activity curves and of pixel location and are not limited to the first harmonic. But most importantly, their computation is based on "teaching" the computer by examples of previously diagnosed cases. The images offer direct and robust diagnosis which is superior to that derived from separate phase and amplitude images, especially for the detection of mild RWMA. PMID- 2770628 TI - The effect of breast composition on absorbed dose and image contrast. AB - We have studied the effect of breast composition on the average whole breast dose, average glandular dose, and image contrast in mammography, using both computational and experimental methods. Three glandular/adipose compositions were considered: 30/70, 50/50, and 70/30 by weight, for both 3- and 5-cm breast thickness. Absorbed dose was found to increase with greater glandular content and this increase is more pronounced for thick breasts and softer beams. For typical screen-film x-ray beams, the average dose to a highly glandular breast is nearly twice the dose to a highly adipose breast and the average glandular dose about 40% higher. Dose was reduced when higher energy beams were employed. The use of a grid increased the dose by a factor of 2.0 to 2.6. Finally, the measured image contrast decreases with increasing breast glandularity, to a greater extent in small breasts and when low energy beams were employed. PMID- 2770629 TI - System for digital acquisition of gastrointestinal images. AB - Previous theoretical work and clinical experience with digital acquisition of fluoroscopic images have identified several problems which needed to be solved. These are: image resolution; blurring due to patient motion, combined with long exposure times; and excessive x-ray quantum mottle levels. We will show that application of pulsed progressive readout (PPR) methods to the TV camera solves these problems. By permitting a high-intensity x-ray pulse to be delivered, all motion is stopped and quantum mottle is reduced to acceptable levels. It will be shown that 1024 x 1024 digital matrices provide adequate resolution and 8-bit digitization is sufficient to permit the same quality as is used in conventional 100-mm photofluorography. User acceptance can be made easier by incorporation of existing photofluorographic controls (with which the radiologist is already familiar) to acquire the digital images. It is possible to interface PPR video systems using existing 100-mm exposure circuits without much modification and the resulting system can be regarded as a digital 100-mm camera. PMID- 2770630 TI - Maximum likelihood analysis of free-response receiver operating characteristic (FROC) data. AB - Receiver operating characteristic (ROC) methodology is widely used in evaluating medical imaging modalities. While appropriate in some cases, it has several drawbacks when the detection task, e.g., nodule detection, involves localizing the abnormality. Free-response receiver operating characteristic (FROC) methodology offers a more natural framework to describe observer performance in such studies and has other advantages. Due to the lack of a statistical analysis procedure comparable to the maximum likelihood procedure (ROCFIT program) available for ROC studies, the FROC method has not gained widespread acceptance. This work presents and solves a two parameter model for the statistical analysis of FROC data. The model assumes that the probability density of the signal stimuli is normally distributed, as is the probability density for producing one or more false positives per image. A program (FROCFIT) is described for estimating the parameters and their uncertainties from experimental data. An index of performance is proposed to quantify observer performance in FROC experiments. Application of this methodology to several FROC data sets produced good to excellent fits. PMID- 2770631 TI - A study of motion in gastrointestinal x-ray fluoroscopy. AB - Studying motion in the gastrointestinal (G.I.) tract is the first step towards our goal of designing a digital algorithm for real-time noise and motion blurring reduction by temporal and spatial averaging in x-ray fluoroscopy. The present work concerns the types of motion relevant to G.I. fluoroscopy (e.g., motion of the walls of the oesophagus, the stomach, the small intestine, and the colon), and measurement of the range of velocities in different parts of the G.I. tract from tape recorded fluoroscopic sequences. The relationship between image contrast and velocity, the effects of motion on system response, and in particular the influence of these parameters on the evaluation of velocities will also be discussed. PMID- 2770632 TI - Collapsed cone convolution of radiant energy for photon dose calculation in heterogeneous media. AB - A method for photon beam dose calculations is described. The primary photon beam is raytraced through the patient, and the distribution of total radiant energy released into the patient is calculated. Polyenergetic energy deposition kernels are calculated from the spectrum of the beam, using a database of monoenergetic kernels. It is shown that the polyenergetic kernels can be analytically described with high precision by (A exp( -ar) + B exp( -br)/r2, where A, a, B, and b depend on the angle with respect to the impinging photons and the accelerating potential, and r is the radial distance. Numerical values of A, a, B, and b are derived and used to convolve energy deposition kernels with the total energy released per unit mass (TERMA) to yield dose distributions. The convolution is facilitated by the introduction of the collapsed cone approximation. In this approximation, all energy released into coaxial cones of equal solid angle, from volume elements on the cone axis, is rectilinearly transported, attenuated, and deposited in elements on the axis. Scaling of the kernels is implicitly done during the convolution procedure to fully account for inhomogeneities present in the irradiated volume. The number of computational operations needed to compute the dose with the method is proportional to the number of calculation points. The method is tested for five accelerating potentials; 4, 6, 10, 15, and 24 MV, and applied to two geometries; one is a stack of slabs of tissue media, and the other is a mediastinum-like phantom of cork and water. In these geometries, the EGS4 Monte Carlo system has been used to generate reference dose distributions with which the dose computed with the collapsed cone convolution method is compared. Generally, the agreement between the methods is excellent. Deviations are observed in situations of lateral charged particle disequilibrium in low density media, however, but the result is superior compared to that of the generalized Batho method. PMID- 2770633 TI - Optical dosimetry for interstitial photodynamic therapy. AB - An approach to photodynamic treatment of tumors is the interstitial implantation of fiber optic light sources. Dosimetry is critical in identifying regions of low light intensity in the tumor which may prevent tumor cure. We describe a numerical technique for calculating light distributions within tumors, from multiple fiber optic sources. The method was tested using four translucent plastic needles, which were placed in a 0.94 X 0.94 cm grid pattern within excised Dunning R3327-AT rat prostate tumors. A cylindrical diffusing fiber tip, illuminated by 630 nm dye laser light was placed within one needle and a miniature light detector was placed within another. The average penetration depth in the tumor region between the two needles was calculated from the optical power measured by the detector, using a modified diffusion theory. Repeating the procedure for each pair of needles revealed significant variations in penetration depth within individual tumors. Average values of penetration depth, absorption coefficient, scattering coefficient, and mean scattering cosine were 0.282 cm, 0.469 cm-1, 250 cm-1 and 0.964, respectively. Calculated light distributions from four cylindrical sources in tumors gave reasonable agreement with direct light measurements using fiber optic probes. PMID- 2770634 TI - The accuracy of single-seed dose superposition for I-125 implants. AB - The Monte Carlo method was used to study perturbations of single I-125 seed dose distributions created by the presence of one or three neighboring seeds for the case of seeds immersed in a water phantom. Perturbation factors were determined within the geometric shadow of neighboring seeds for two-seed designs, four-seed spacings, and several choices of dose point. The results were compared to dose estimates obtained by the simple superposition of single-seed data for one- and two-plane implants. Some significant differences were found. PMID- 2770635 TI - Dose anisotropy around an Au-198 seed source. AB - For interstitial implants with radioactive Au-198 seeds, the dosimetric calculations usually ignore the finite source size and employ a point source approximation, resulting in a computed isotropic dose distribution. However, the measured radiation fluence from Au-198 seeds is reported to be anisotropic, suggesting some amount of dose anisotropy in tissue. We have measured this dose anisotropy around Au-198 seeds (2.5 X 0.8 mm2) using Kodak X-OMAT XV-2 films placed in contact with individual seeds in a phantom. Autoradiographs obtained for various exposure times were digitized and studied with an image analysis computer network. The network's overall spatial resolution was about 0.01 cm. The optical isodensity contours around the seed were obtained. The useful range of optical density (OD) for the system was found to be 1 to 2 OD units. Within this range, the shape of an optical isodensity contour would be identical to an isodose contour. Proximal to the source, the contours were elliptical in shape, elongated along the seed axis. However, further away, the elongation was in the direction normal to the seed axis. This was in agreement with the reported data on the radiation fluence around Au-198 seeds. It was concluded that measurable dose anisotropy existed around Au-198 seeds. However, it was too small to be of any clinical significance. PMID- 2770636 TI - Dose parameters of 125I and 192Ir seed sources. AB - As mandated by an NCI brachytherapy contract, we measured dosimetric parameters for 192Ir seeds and two models of 125I seeds. Measurements were with LiF powder in a water-equivalent phantom. Data were corrected for background, sample mass, and finite detector volume. Selected parameters were also investigated through Monte Carlo calculations. Results are presented in terms of a dose parametrization that is described in detail, and are compared to published data. Our results agreed well with published data for relative quantities such as radial and angular dose dependence. Our measured value for the 192Ir dose factor was 4.55 cGy(H2O) cm2 mCi-1 h-1, also in good agreement with commonly used values. However, the measured dose factors for 125I seed models 6702 and 6711 were 1.18 and 1.06 cGy(H2O) cm2 mCi-1 h-1, values well below those in general use. PMID- 2770637 TI - Design of apparatus for precise x-ray dose chamber calibrations. AB - An apparatus for precision calibration of ion chambers in the x-ray region from 16 to 320 kV is described. The development of a fast-acting shutter with "opening" and "closing" times of less than 3-ms eliminates the requirement for operating time corrections. Controls from outside the radiation room permit changing x-ray filters and alternately positioning both test and standard ion chambers in the x-ray beam. Thus, the remote controls eliminate the need to enter the x-ray room in the course of a series of calibrations. The potential advantages resulting from the capabilities of this apparatus are described in this Technical Report. PMID- 2770638 TI - Effective atomic numbers of biological materials in the energy region 1 to 50 MeV for photons, electrons, and He ions. AB - A study of effective atomic numbers for biological materials such as bone, muscle, spleen, liver, mucin, and water has been carried out in the energy region 1 to 50 MeV for photons, electrons, and He ions. It is noticed that the effective atomic number for photons and electrons increases with energy, and remains, more or less the same, for He ions. PMID- 2770639 TI - Comments on: "Absorbed Dose Comparison Among Commercial Ionization Chambers in Polystyrene and Acrylic Phantoms". PMID- 2770640 TI - [Congenital hypothyroidism and development]. AB - The authors present the developmental outcome of 16 children with congenital hypothyroidism diagnosed by screening in the neonatal period, using the Brazelton and the Dubowitz scales in the newborn and the Griffiths scale subsequently. Results are compared with those of a control group assessed at 6 and 18 months using the Griffiths scale. PMID- 2770641 TI - [Glycosaminoglycans as a defense mechanism of the urothelium, in children]. AB - The quantity variations of glycosaminoglycans (GAGS) in urothelial samples from patients with malformations presenting infectious, obstructive or lithiasis signs have been investigated. They showed a highly significant deficiency in GAGS in patients with recurrent infections of the urinary ways, a more limited deficiency in sufferers from lithiasis and values within the normal range in patients with obstructive malformations. PMID- 2770642 TI - [Radio-chemotherapy in the treatment of non-operable brain tumors in children]. AB - Twenty-seven pediatric patients (less than 13 years of age) with inoperable primary brain tumors, treated with combined radiotherapy and chemotherapy or radiotherapy alone between January 1976 and December 1987 have been reviewed. Overall survival for all patients and for patients with brain-stem tumors was 49% and 43%, respectively. An increased risk of infection was associated with adjuvant chemotherapy. However, there were no toxicity that resulted in death. PMID- 2770643 TI - [The external left jugular vein as an access for placement of long-term permanent central venous catheters in children]. AB - We consider the approach through the left external jugular vein v/s right external jugular vein (Heinbach-Ivey technique) for the placement of central venous catheters (Broviac Hickman type and others) in pediatric patients. Between January '84 and February '87, 65 central venous catheters were inserted using the Heinbach Ivey technique. In 24.6% of the cases we failed and had to place the catheter through the right internal jugular vein. Between March '87 and November '88, 72 catheters were inserted through the left external jugular vein, only 5 through the left internal jugular vein, with a failure rate of 6%. Our data show that a more favourable anatomy makes easier and quicker the correct placement of a central venous catheter through a left external jugular vein approach. PMID- 2770644 TI - [Cutis laxa syndrome. Clinical, histologic and ultrastructural study of a new variant]. AB - Cutis laxa (generalized elastolysis) is a rare systemic disorder of connective tissue, whose elastic fibers appear fragmented and disorganized. The present study reports an undescribed form of cutis laxa in an infant male with loose and inelastic skin, osteoporosis, pulmonary emphysema and dislocation of the hip. The clinical features and the inheritance patterns of the various forms of cutis laxa are also discussed. PMID- 2770645 TI - [Congenital fructose 1,6 diphosphatase deficiency. Description of a case]. AB - In describing one case of congenital fructose 1,6-diphosphatase deficiency the Authors review the several clinical conditions giving problems of differential diagnosis. For certain diagnosis they underline the importance of liver biopsy, to dose the deficient enzyme directly in the liver tissue. PMID- 2770647 TI - The Mayo Clinic: where the system is king. Interview by Richard L. Reece. PMID- 2770646 TI - [Salivary IgA in a group of children with recurrent respiratory infections]. AB - Salivary IgA were examined in a group of children with recurring respiratory infections (RRI) in order to complete research into the immunological profile of such children. IgA assays were performed in 21 children suffering from RRI both in the remission period (Summer) and during infections (Winter). No children revealed any real disorder in basic salivary IgA. Salivary IgA levels were however about ten times higher in the Winter (the infection period). In a control group of 15 healthy children in the same age range, IgA levels were also high in the winter but still lower than those found in the RRI group. It is therefore concluded that children with RRI do not, as has often been suggested, present any basic disorder in salivary IgA, but that the response of secretory IgA is far more sensitive to infection than the system as a whole. PMID- 2770648 TI - A man who loves change. Interview by Richard L. Reece. PMID- 2770649 TI - A contradiction in diagnoses. PMID- 2770651 TI - A crisis in spirit. PMID- 2770652 TI - A fragile future for urban hospitals? PMID- 2770650 TI - Misleading statistics. PMID- 2770653 TI - The physician's role in adolescent health education. AB - This study was designed to identify topics of interest to the adolescent that can be addressed by the physician in the clinic or the classroom and to assess the extent to which such discussions currently take place. A confidential questionnaire was administered to 223 11th-graders and 186 7th-graders in the Duluth public schools between December 1987 and December 1988. Seven broad areas of adolescent life were addressed. Topics that more than 50% of the teens would most like to discuss with physicians include lifestyle, sexuality, family life, and psychological concerns. Reportedly, physicians often discuss lifestyle and sexuality topics with 7th-grade students; substantially fewer 11th-graders report these conversations. Students stated that they prefer to discuss all these issues (except individual body change) with a physician in the classroom setting. The results of the study encourage physicians to talk with teens about lifestyle, sexuality, family life, and psychological concerns, preferably in the classroom, even into late adolescence. PMID- 2770654 TI - Negotiating provider agreements. Challenging the 'form' agreement. PMID- 2770656 TI - [Cleidocranial dysostosis]. AB - Cleidocranial dysostosis is a syndrome defined by some workers as "osteodental" insofar as it presents with variously associated skeletal and dental anomalies. The aetiology, clinical picture and pathological anatomy are analysed, stress being laid on dental anomalies and on dentoskeletal irregularities. Finally, two clinical cases observed in recent years at the University of Bari Odontostomatological Clinic are reported. PMID- 2770655 TI - [Occlusal planning according to classical gnathology]. AB - The importance of perfect knowledge of the anatomy and physiology of the stomatognathic complex for any understanding of the aetiopathogenic mechanisms behind temporomandibular joint pain dysfunction syndrome is emphasised and the fundamental concepts underlying the use of the bite plane as a valuable aid in the diagnosis and initial treatment of articular dysfunction are described. PMID- 2770657 TI - [Odontomas. Description of a clinical case]. AB - After mentioning the etiopathogenetic, clinical and therapeutic characteristics of odontoma, the Authors describe a case of composite odontoma, particularly interesting both for its location in parasymphysial site and for the presence of all the dental elements in the arch corresponding to the hemimandible where the neoplasm is located. Differential diagnosis has been discussed, wishing a wider use of routine x-ray examination, in order to obtain an early detection of this particular neoplasm, which often goes undiscovered for a long time, because of its slow growth. PMID- 2770658 TI - [Calcium oxide therapy of periapical lesions. A clinical contribution]. AB - The use of calcium oxide as intermediate canal medication prior to definitive filling is described and followed by a report on the heating of periapical lesions in 6 particularly significant clinical cases. PMID- 2770660 TI - [Combined surgical orthodontic therapy in a patient with multiple agenesis]. AB - After a wide analysis of the problems concerning biology and integration of autogenic transplantation of tooth germs, the Authors present a clinical case of monolateral agenesis of two premolars, with the transfer of the second premolar germ from one side to an other, suggesting some technical details in flap scalloping. PMID- 2770659 TI - [Apparently solitary plasmacytoma with mandibular localization]. AB - A micromolecular, apparently isolated plasmocytoma on the mandible is reported. PMID- 2770662 TI - [Enlargement labial commissuroplasty using the Preaux-Texier-Real method. Our personal experience]. AB - The augmentation labial commissuroplasty technique, as described by Preaux, Texier and Real, after reduction of the buccal opening by lip-to-lip autoplasty is presented. The results achieved, the feasibility and the advantages of this procedure are compared with those of traditional techniques. PMID- 2770661 TI - [Periapical lesions treated with CaO. Histological controls]. AB - The results of histological examinations conducted on 2 granulomas found in teeth and treated with calcium oxide are reported. It is concluded that the treatment produces significant changes in the histological picture with the formation of scar tissue that precedes the growth of newborn in a relatively short time. PMID- 2770663 TI - [Standoli-Cecchi cheiloplasty in the treatment of cleft lip. Our personal experience]. AB - Labial repair by the "W-technique" in primary cleft lip surgery, as described by Standoli and Cecchi, is presented. The preliminary results achieved and the advantages of this procedure are compared with those of traditional techniques. PMID- 2770664 TI - [Odontoiatric pathology and bacterial endocarditis: risk factors and prevention]. AB - The risk of bacterial endocarditis in dentistry is examined and responsibilities for prevention clarified. A review of the principal chemotherapeutic protocols currently followed by International Cardiologist Associations is presented. PMID- 2770665 TI - [Dental caries and socioeconomic development of Sardinian population]. AB - A statistical survey has been carried out on the incidence of caries in the population of Sardinia. It is shown that the DMF index has grown steadily from 2.6 among the young (0-12 year old) to 13.07 in the group aged between 20.1 and 30. The socioeconomic changes of the past thirty years in Sardinia are looked at in an attempt to explain this phenomenon. PMID- 2770666 TI - [Bolton indices in Cl II/1, Cl II/2 and Cl I anomalies with frontal crowding]. AB - The Bolton indices in Kl II/1, Kl II/2 and Kl I anomalies with frontal crowding are examined. PMID- 2770667 TI - [Dermoid cysts of the floor of mouth]. AB - After brief mention of the embryogenesis of oral organs, a case of congenital dermoid cyst of the floor of the mouth treated surgically intraorally is reported. A short discussion on differential diagnosis follows. PMID- 2770668 TI - [Clinico-statistical considerations on a sample of school-age population in the Province of Trieste. I. Period of eruption of the lst molars and change in permanent incisors]. AB - The phenomenon relating to the period of change of the incisors and eruption of the first permanent molar were studied in a group of 343 Trieste school children. Both deciduous and permanent teeth were examined. The results were processed on a computer and are presented in graph form. PMID- 2770670 TI - Nutrition support of the critically ill obese patient. PMID- 2770669 TI - [Clinico-statistical considerations on a sample of school-age population in the Province of Trieste. II. Period of eruption of the second molars and change of the canines and 1st and 2d permanent premolars]. AB - The phenomena relating to the period of change of the canines and the first and second permanent premolars and of the eruption of the second permanent molar were studied in a group of 343 Trieste school children. Both deciduous and permanent teeth were examined. The results were processed on a computer, and are presented in graph form. PMID- 2770671 TI - Evaluation of energy expenditures in obese patients. PMID- 2770672 TI - Computed EEG topography in acute stroke. AB - The potential for clinical application of computed EEG topography (CET) has been known since 1978. However, studies relating to the focal brain lesions are few. We have studied 19 cases of acute stroke involving the cerebral hemispheres. CET and EEG were recorded as soon as possible, usually within 1-3 days of onset. Repeat maps were recorded at 1 wk. Symptoms, neurologic exam, routine EEG and CT scan were compared with the CET of power spectral and flash evoked potential data. Statistical criteria were also applied. Good correlation was noted between CET and EEG and CT. Occasionally, CET was noted to provide information beyond EEG or CT. These early studies suggest a potential utility for CET in the early diagnosis of stroke. PMID- 2770673 TI - [Contribution of ambulatory EEG recording (Medilog 9000) in a population of epileptics]. AB - Thirty-four epileptic patients, aged 9 to 36, were submitted to A/EEG between May 1987 and July 1988. All patients had a thorough clinical and EEG work-up including long-term conventional EEG, afternoon polygraphic sleep recording and, in some cases, full-night EEG and video monitoring. Patients were divided into 2 groups: group I included 19 patients (18 with symptomatic partial epilepsy (SPE) and 1 with idiopathic generalized epilepsy (IGE) in whom no seizure had ever been recorded in spite of EEG recordings averaging a total of 16 hrs 10 min, awake and asleep); group II included 15 subjects (6 with SPE, 5 with IGE, 3 with symptomatic GE and 1 with undetermined epilepsy) in whom one or several seizures had been recorded. A/EEG was performed in order to: 1) obtain better clinical and EEG characterization of seizures, 2) study the circadian distribution of seizures, 3) verify the efficacy of drug treatment and, 4) establish the epileptic or non-epileptic nature of some ictal events. The results of A/EEG were considered positive in 52.63% of group I patients and in 93.33% of group II patients. The authors discuss the specific advantages of A/EEG vs conventional EEG: recording of seizures with random occurrence, of seizures accompanied by falls, checking the remission of seizures. PMID- 2770674 TI - [Evolution of gross body movements during sleep in healthy infants aged from 1 to 4 months]. AB - To assess the evolution of body motility according to sleep states and age in young children, we performed day-sleep polygraphic recordings in 45 normal and full-term newborn infants, grouped according to age: 5 to 7 weeks, 9 to 11 weeks, 13 to 15 weeks of age. Generalized gross body movements were only studied. Our results showed that generalized movements varied according to sleep states and also according to age. The number of movements, in each age-group was significantly higher in active (AS) and indeterminate (IS) sleep than in quiet sleep (QS). This work also found that the distribution of the number of movements differed between sleep states. In AS, movements were equally distributed whereas in quiet sleep 40% of movements occurred during the last three minutes of a stage. Our results also showed that the mean number of movements per sleep hour, the mean duration of body movements and the percentage of time spent with movements significantly decreased with age. The distribution of the number of movements as a function of duration, showed that most of them lasted from 5 to 10 sec in each age-group of infants, whatever the sleep state; however, the number of the longest movements, lasting more than 10 sec, significantly decreased with age in IS and AS. These results were difficult to compare with those already published in the literature because of the different techniques for recording body movements; so it seemed impossible to use normal values established by other authors. PMID- 2770675 TI - [Quantified EEG and psychometric effects of 3 doses of dexfenfluramine in the young adult]. AB - In an acute, double-blind placebo-controlled study, three groups of nine healthy subjects were included. Each group received, in randomized and weekly intervals, a single oral dose of dexfenfluramine (15 mg, 30 mg or 60 mg) or placebo. Psychometric and EEG studies were carried out before as well as 1, 2, 3, 4, 5 and 6 h after drug administration. Changes from predrug to postdrug conditions for each time were determined by the ratio of absolute spectral power and compared to the evolution of power spectra under placebo conditions. Statistical evaluation was done with ANOVA. Dexfenfluramine induced a dose-dependent decrease of power spectra for theta and alpha 1 bands and an increase for the beta band. Topographic brain mapping of these significant changes displayed a central and posterior decrease for theta and alpha 1 bands, and a temporal localization for the beta-power. Maps of relative power-enhanced changes were seen in absolute power and provided false displays. Psychometric evaluation of dexfenfluramine effects only showed trends to extraversion and increased mood scores but no statistical significance was found. Arousal and performance tests were unchanged. These results suggest that qEEG variations are more sensitive to serotonergic drug effects than psychometric investigations. It appears that spontaneous EEG power spectra variations with time must be accounted for by drug evaluation. Absolute power variations are more reliable than relative power. Methodological implications are discussed. PMID- 2770676 TI - Neurologic manifestations of systemic disease. PMID- 2770677 TI - Surveillance for occupational lead exposure--United States, 1987. PMID- 2770678 TI - 1989 Sexually Transmitted Diseases Treatment Guidelines. PMID- 2770679 TI - [Cell kinetic study of human carcinomas using bromodeoxyuridine and immunohistochemistry]. AB - Cell kinetics of human carcinomas was studied in vivo using immunohistochemical technique with bromodeoxyuridine (BrdU). Relationship between tumor growth and DNA synthesis was analysed in 7 human tumor xenografts serially transplanted into nude mice by in vivo administration of BrdU. The specimens were processed in immunohistochemical staining of ABC method using anti-BrdU monoclonal Ab. The labeling index (LI) was determined as the ratio of stained cells to tumor cells. It was found that LI tended to increase transiently at the initial stage of exponential growth phase and remained stable thereafter. Correlation between tumor doubling time and LI was observed with statistical significance. In 29 cancer patients including 24 gastric and 5 colorectal cancers, LI was also determined in vivo. In advanced gastric cancers, LIs were higher at the site of invasion than the central area. LIs of gastric cancers in stage I were lower than those in stage II, III and IV. Considering the data of human tumor xenografts, it was suggested that the stage II, III and IV gastric cancers might be biologically different types of cancers compared to stage I gastric cancers. PMID- 2770680 TI - [Experimental and clinical study on the lymphatic pathway draining from the distal esophagus and gastric cardia]. AB - The intramural and extramural lymphatics draining from the distal esophagus and gastric cardia were studied in 140 mongrel dogs by dye injection technique. A clinical study was also performed on the lymphatic pathway in these regions by radio isotope uptake (RIU). The results were compared with that of lymph node metastases in 113 patients with carcinoma of the distal esophagus and 103 patients with carcinoma of the gastric cardia. The intramural lymphatics between the distal esophagus and gastric cardia were communicated at the central part of the muscularis mucosae. This finding coincided with the results of intramural RIU. The extramural lymphatics from the distal esophagus flowed both upward and downward. Those from the cardia entered the intraabdominal regional lymph nodes, but none was visualized either in the mediastinum or in the thoracic cavity. Similarly, few RIUs were detected in the mediastinal nodes. As the result of partial or total blockade at the cardiac portion of the stomach in dogs, ascending lymphatics reaching the thoracic cavity was observed in 6 of 27 cases. Clinically, the incidence of the mediastinal lymph node metastases were 17.0%. These results indicate that upward lymphatic spreads may occur in cases with cardiac cancer when the descending lymphatic pathway is blocked by the tumor invasion. PMID- 2770681 TI - [Changes in gastric mucosal blood flow after selective proximal vagotomy; an experimental study in rats]. AB - The effect of selective proximal vagotomy (SPV) on gastric mucosal blood flow (MBF) was studied in rats using hydrogen gas clearance technique. The following results were obtained. 1) Resting MBF of the corpus decreased significantly from 106.3 +/- 9.8 ml/min/100g to 74.5 +/- 15.5 ml/min/100g at 12 weeks after SPV (p less than 0.01). Resting MBF of the antrum did not decrease. 2) Tetragastrin, betazol-HCl and 2-deoxy-d-glucose (2DG)-stimulated acid outputs were reduced following SPV for more than 12 weeks after operation. 3) The increase of corporal MBF after tetragastrin, betazol-HCl and 2DG stimulation was less significant with accompanying reduction of acid output. 4) The increase of antral MBF after tetragastrin or betazol-HCl stimulation was less significant after SPV. But, the increase after 2DG stimulation was as much as after SPV. PMID- 2770682 TI - [Isolation and culture of bile duct epithelial cells as an useful tool for screening of biliary tract carcinogens]. AB - A method of isolation and culture of extrahepatic bile duct epithelial cells from Holstein cows has been established for detection of carcinogens in relation to bile duct cancer. Cells were isolated by digestion with Dispase followed by scraping of the mucosa. The integrity, the epithelial character and the purity of cells isolated were confirmed by electron microscopy. By the use of this culture induction of unscheduled DNA synthesis by chemicals which are capable of developing bile duct cancers in experimental animals, were assessed autoradiographically with or without addition of S-9 mixture. MNNG and ENNG induced UDS, which was not influenced by S-9 mixture. MCA elicited UDS only if S 9 mixture was added. Regardless of the presence of S-9 mixture, DMN failed to induce UDS but AFB1 induced UDS dose-dependently. The contact routes of the carcinogens with bile duct cells were established and this culture system way be an useful tool for the detection of biliary tract carcinogens. PMID- 2770683 TI - [Splenic vein occlusion due to pancreatic disease: regional portal hypertension from hemodynamic points of view]. AB - The purpose of this study is to clarify the clinicopathophysiology of splenic vein occlusion due to pancreatic disease from hemodynamic points of view. We reviewed the angiographic findings and medical records of 82 patients who had pancreatitis, pancreatic cyst or pancreatic cancer in the pancreatic body and tail. According to the site of occlusion in 16 patients with complete splenic vein occlusion, this entity may be divided into two categories: Type A, an occlusion close to the spleen in which short-gastric system seems to be major collateral, and Type B, an occlusion distant from splenic hilum in which gastroepiploic system becomes prominent as collateral. As compared to 7 patients with incomplete splenic vein occlusion, gastric varices and splenomegaly were frequently observed with the patients having complete occlusion. Among these 16 patients, splenic arterial occlusion was superimposed in 3 patients with pancreatic cancer in whom gastric varices were not detected. Thus, clinical features of this entity must be carefully assessed according to the nature of the underlying disease. Based on these observations, three consecutive phases: Phase 1 Insiduous or latent phase, Phase 2 Collateral developing phase, Phase 3 Vanishing phase may be distinguished for splenic vein occlusion secondary to pancreatic disease. PMID- 2770684 TI - [Clinical evaluation of surgical treatment of Graves' disease]. AB - Five hundred and thirteen surgical patients with Graves' disease from 1970 to 1983 were subjected to this study. They were divided into three groups by period in which operation was performed; 1st period from 1970 to 1974, 2nd from 1975 to 1979, and 3rd from 1980 to 1983. Postoperative thyroid function was evaluated. The weight of remnant thyroid was the greatest in the first period and the smallest in the third. There were no differences of frequency of postoperative complications among these periods in spite of remarkable decrease of weight of remnant thyroid tissue in the third period. Remission of thyroid function, was most frequently observed in the group of the remnant thyroid weight from 4 to 8 grams. Recurrence of hyperthyroidism was frequently observed in the group of the greatest weight of remnant thyroid and hypothyroid state was frequently observed in the group of the smallest remnant thyroid. These results indicate that the remnant thyroid weight may be one of the most crucial factors which influence on the postoperative functional state of patients with Graves' disease, and remnant thyroid tissue weighing from 4 to 8 grams may be the most appropriate in subtotal thyroidectomy. PMID- 2770685 TI - [Electrophysiological study on the atrophied pectoralis major muscle after modified radical mastectomy]. AB - In order to clarify the cause of the atrophy of the pectoral muscles after modified radical mastectomy, twenty patients who had had the operation at Nagasaki Chuo National Hospital 40 days to 2 years prior to this study, were investigated by electromyography. Of 20 subjects, 11 had the operation to preserve the pectoralis major muscle and 9 had the operation to preserve both the pectoralis major and minor muscles. The results were as follows: 1) Electromyography revealed some damages to the pectoral nerves in 16 cases of 20 (80%). In 12 cases, development of fibrillation potentials was observed at rest, while motor unit potentials disappeared during voluntary contraction. These findings suggest the damage to the nerves including neutrotomy. 2) The regions with macroscopic muscular atrophy remarkably coincided with those with neurogenic changes on electromyography. This suggests that the atrophy of the pectoralis major after modified radical mastectomy might be mainly caused by the damage to the pectoral nerves. 3) The mastectomy preserving only the pectoralis major tends to cause damage to nerves innervating the sternocostal part of the pectoralis major more frequently than the mastectomy preserving both the pectoralis major and minor muscles. The abdominal part was frequently damaged irrespective of the types of the operation. PMID- 2770686 TI - [Treatment of congenital tracheal stenosis. Retrospective study of thirteen cases]. AB - Thirteen cases of congenital tracheal stenosis (CTS) were retrospectively studied in terms of operative indication and treatment. The intratracheal transverse ratio of the stenotic/normal diameter (stenotic ratio, SR) was obtained by chest X-ray, tracheogram or autopsy, as one of the parameters of stenosis. SR ranged from 0.14 to 0.50 (mean 0.35 +/- 0.13 SD). Two cases (SR = 0.14) received tracheal resection and reanastomosis successfully. In three cases with pulmonary artery sling (PAS), PA translocation was performed to release tracheal compression. One (SR = 0.49) had good result but two (SR = 0.20, 0.30) died from respiratory failure (RF) and autopsy revealed PAS. Four cases underwent surgery for congenital heart disease (CHD), 3 (SR = 0.41, 0.46, 0.49) had good results but one (SR = 0.36) died from RF. In four cases medically treated, 3 (SR = 0.40, 0.44, 0.50) improved with growth but one (SR = 0.25) died before operation due to RF and autopsy revealed PAS. When SR greater than or equal to 0.40, cases without PAS improved with conservative treatment, those with PAS improved by PA translocation, and those with CHD tolerated open heart surgery. When SR less than 0.40, tracheal reconstruction is indicated. Cases with PAS would require primary or staged operation of PA translocation + tracheal reconstruction. The most appropriate therapy should be selected on the basis of symptoms, associated diseases and parameter of tracheal stenosis, for instance "SR". PMID- 2770687 TI - [Surgical consideration of ruptured abdominal aortic aneurysms]. AB - During the recent 18 and a half years, 30 cases of ruptured abdominal aortic aneurysm (including four cases of A-V fistula) were operated at Saiseikai Utsunomiya Hospital. In 26 cases, a conventional graft replacement was performed. In other four cases, axillo-bifemoral bypass (in the cases ruptured into the colon) or other methods were used. Overall operative mortality rate was 26.7%. However, during the last 9 years, operative results were improved (21.7%, 5 deaths out of 23 cases). Amount of intraoperative blood loss influenced the operative results greatly. Other operative risk factors included preoperative shock, preoperative severe cerebrovascular or cardiovascular complications, and postoperative thromboembolism. Factors of recent improvement in mortality included; establishment of emergency system which resulted in earlier operation after the patient's arrival at the hospital, use of occlusive balloon for bleeding control, heparin administration before the aortic clamp for preventing peripheral thromboembolism and introduction of autotransfusion system for reducing the amount of blood transfusion. PMID- 2770688 TI - [Open-heart surgery in a patient with chronic leukemia]. AB - A 66-year-old woman with severe congestive heart failure, leucocytosis and recent cerebral thrombosis, was admitted to our hospital. Examination of her heart revealed mitral steno-insufficiency, tricuspid regurgitation and left atrial thrombi. The hematological study confirmed the diagnosis of chronic neutrophilic leukemia (CNL). Administration of carbazilquinone (0.5-0.75mg/day) was quite effective to stabilize CNL. However, repeated episodes of cerebral thromboembolism, intractable heart failure and patient's desire pushed us to perform cardiac operation. Utilizing routine cardio-pulmonary bypass and moderate hypothermia, removal of left atrial thrombi, mitral valve replacement with a 27mm Bjork-Shiley prosthesis and tricuspid annuloplasty with a 32mm Carpentier-Edwards prosthetic ring were performed. We had no difficulty in hemostasis at the operation. Her recovery was, contrary to all expectations, satisfactory without hemorrhagic diathesis, infection nor blastic crisis. Six months after operation, she is doing well and it is unnecessary to reinstitute chemotherapy for CNL. To our knowledge, this is the first case report of open-heart surgery in a leukemic patient in Japan. PMID- 2770689 TI - [Flow-cytometric cell cycle analysis using a monoclonal antibody to bromodeoxyuridine on gastric cancer: preliminary report]. PMID- 2770690 TI - [Meaning in measurement of bone mineral content as preoperative evaluation of aged patients: preliminary report]. PMID- 2770691 TI - The linear mitochondrial plasmid pClK1 of the phytopathogenic fungus Claviceps purpurea may code for a DNA polymerase and an RNA polymerase. AB - Plasmid pClK1, a linear mitochondrial plasmid of Claviceps purpurea, was completely sequenced. The sequence contains two long open reading frames (ORF1, 3291 bp; ORF2, 2910 bp), and at least four smaller ORFs. The potential polypeptide derived from ORF1 shows homology to the family B type DNA polymerases. The product of ORF2 has significant homology to the mitochondrial RNA polymerase of yeast and RNA polymerases from bacteriophages. ORF1 and ORF2 show homology to URF3 and URF1 of the maize plasmids S1 and S2, respectively. No homology to any published protein sequence was found for the smaller ORFs. The origin of the terminal protein attached to the 5' ends of pClK1 remains open; several alternatives for its origin are discussed. The sequence data as a whole confirm the virus-like character of pClK1 already postulated from structural properties. Thus pClK1 together with S plasmids of maize and several other linear plasmids make up a distinct class of DNA species of plants and fungi probably derived from a common virus-like ancestor. PMID- 2770692 TI - The complete sequence of the rice (Oryza sativa) chloroplast genome: intermolecular recombination between distinct tRNA genes accounts for a major plastid DNA inversion during the evolution of the cereals. AB - The entire chloroplast genome of the monocot rice (Oryza sativa) has been sequenced and comprises 134525 bp. Predicted genes have been identified along with open reading frames (ORFs) conserved between rice and the previously sequenced chloroplast genomes, a dicot, tobacco (Nicotiana tabacum), and a liverwort (Marchantia polymorpha). The same complement of 30 tRNA and 4 rRNA genes has been conserved between rice and tobacco. Most ORFs extensively conserved between N. tabacum and M. polymorpha are also conserved intact in rice. However, several such ORFs are entirely absent in rice, or present only in severely truncated form. Structural changes are also apparent in the genome relative to tobacco. The inverted repeats, characteristic of chloroplast genome structure, have expanded outward to include several genes present only once per genome in tobacco and liverwort and the large single copy region has undergone a series of inversions which predate the divergence of the cereals. A chimeric tRNA pseudogene overlaps an apparent endpoint of the largest inversion, and a model invoking illegitimate recombination between tRNA genes is proposed which accounts simultaneously for the origin of this pseudogene, the large inversion and the creation of repeated sequences near the inversion endpoints. PMID- 2770693 TI - Nuclear proteins binding to a cauliflower mosaic virus 35S truncated promoter. AB - Proteins present in tobacco nuclear extracts bind to a truncated cauliflower mosaic virus (CaMV) 35S promoter fragment (from -90 to +2 relative to the transcription start site) in a sequence specific manner. Gel mobility shift assays show the presence of two protein-DNA complexes that are not competed by a 47/+2 promoter fragment. DNAse I protection and DNA methylation interference reveal two protected sites in the slower migrating complex; both include the pentamer TGACG, separated by a stretch of eight nucleotides where G methylation does not prevent the binding of the proteins. The faster complex is the prevalent form at low protein concentrations. As the protein concentration increases a non linear rise in the amount of the slower migrating complex relative to the faster one is seen suggesting that cooperative effects are involved in the binding to the second site. PMID- 2770694 TI - Isolation and expression of an anther-specific gene from tomato. AB - We have isolated and sequenced an anther-specific cDNA clone and a corresponding genomic clone from tomato. The gene (LAT52) encodes an 800-nucleotide-long transcript that is detectable in pollen, anthers and at 20- to 50-fold lower levels in petals. LAT52 mRNA is not detectable in pistils, sepals or non reproductive tissues. Steady-state levels of LAT52 mRNA are detectable in immature anthers containing pollen at the tetrad stage and increase progressively throughout microsporogenesis until anthesis (pollen shed). The LAT52 gene contains 5' and 3' untranslated regions of 110 and approximately 150 nucleotides, respectively, and a single intron with a highly repetitive sequence. A TATA box motif is located 28 nucleotides upstream of the transcription start site. The gene encodes a putative protein of 18 kDa that is cysteine rich and has an N terminal hydrophobic region with characteristics similar to eucaryotic secretory signal sequences. LAT52 is a single or low copy gene in tomato and shares homology with sequences in tobacco. PMID- 2770695 TI - The function of plant heat shock promoter elements in the regulated expression of chimaeric genes in transgenic tobacco. AB - A series of deletion mutants of a soybean heat shock (hs) gene promoter was generated and linked to the chloramphenicol acetyl transferase (CAT) coding sequence. These chimaeric promoter/reporter gene constructs were introduced into tobacco and thermoregulated expression of CAT activity was examined in leaf extracts. Three different types of gene fusions were tested using two different BIN19 vector constructions: (1) translational fusion between the N-terminus of the protein coding sequence of the heat shock gene Gmhsp17.3-B and CAT; (2) transcriptional fusions between the 5' nontranslated RNA regions of Gmhsp17.3-B and CAT; and (3) promoter fusions joining the hs promoter upstream sequences to the TATA box sequence of the delta CaMV 35S-CATter vector. Alternatively, multiple copies of a synthetic deoxyoligonucleotide with the soybean hs consensus element (HSE2) were used. Heat inducible CAT activities were detected except in plants containing a transcriptional fusion devoid of all but 18 nucleotides at the 5' terminus of the hs gene transcript. CAT activity was detectable in these plants only during the recovery at 25 degrees C after a hs (40 degrees C). Overlapping HSE-like promoter sequences seem to be necessary for the induction of heat inducible transcription of linked genes; synthetic HSE2 sequences have the capacity to reconstitute a hs promoter in combination with a TATA box sequence. Effective translation during hs seems to require sequences in the 5' non translated leader of the hs protein mRNA; these sequences can be functionally replaced by the 5' leader sequence of the delta CaMV 35S promoter. PMID- 2770696 TI - DNA transfer from Agrobacterium to Zea mays or Brassica by agroinfection is dependent on bacterial virulence functions. AB - DNA transfer from Agrobacterium tumefaciens, a soil bacterium, to the non-host graminaceous monocotyle-donous plant Zea mays, was analysed using the recently developed technique of agroinfection. Agroinfection of Z. mays with maize streak virus using strains of A. tumefaciens carrying mutations in the pTiC58 virulence region showed an almost absolute dependence on the products of the bacterial virC genes. In contrast, agroinfection of the control host Brassica rapa with cauliflower mosaic virus was less dependent on the virC gene products. In other respects, the basic mechanism of the plant-bacterium interaction was found to be similar. While intact virA, B, D and G functions were absolutely necessary, mutants in virE were attenuated. Agroinfection of maize was effective in the absence of an exogenously supplied vir gene inducer, and indeed wounded Z. mays tissues were found to produce substance(s) which induced the expression of A. tumefaciens vir genes. These findings are discussed in the light of current knowledge about the function of Agrobacterium vir genes. PMID- 2770697 TI - Identification and characterization of a locus inhibiting extrachromosomal maintenance of the Streptomyces plasmid SLP1. AB - We report here the existence and initial characterization of a genetic locus (imp) that inhibits maintenance of SLP1-derived plasmids as extrachromosomal replicons in a manner distinct from normal incompatibility between autonomous SLP1 replicons. The trans-acting imp function has been localized to a 1.8 kb Eco47III restriction fragment present on integrated SLP1 elements. At least part of this DNA segment is absent from SLP1-derived plasmids. DNA sequence analysis of the imp region indicates that it contains three overlapping open reading frames (ORFs) that may constitute a polycistronic operon. The effects of insertions within the imp region indicate that uninterrupted transcription through all three ORFs is necessary for imp activity. PMID- 2770699 TI - Extremely large chromosomal deletions are intimately involved in genetic instability and genomic rearrangements in Streptomyces glaucescens. AB - Genetic instability in Streptomyces glaucescens characteristically involves the occurrence of gross genomic rearrangements including high-level sequence amplification and extensive deletion. We investigated the relationship of the unstable melC and strS loci and a 100 kb region of the chromosome which frequently gives rise to intense heterogeneous DNA amplification. Standard chromosome walking using a cosmid bank in conjunction with a "reverse-blot" procedure enabled us to construct a contiguous genomic BamHI map of the unstable region exceeding 900 kb. The unstable genes and the amplifiable region (AUD locus) are physically linked within a 600 kb segment of the chromosome. The previously characterized deletions which affect these loci are merely components of much larger deletions ranging from 270 to over 800 kb which are polar in nature, effecting the sequential loss of the strS and melC loci. The more extensive deletions terminate either adjacent to, or in the vicinity of DNA reiterations at the AUD locus. Additionally, a deletion junction fragment and the corresponding deletion ends were cloned and analysed at the sequence level. PMID- 2770698 TI - Heterogeneous genomic amplification in Streptomyces glaucescens: structure, location and junction sequence analysis. AB - Certain chromosomal markers in Streptomyces glaucescens behave unstably, being lost at high frequency as a result of extensive genomic deletion. Additionally, mutant strains possessing such deletions frequently display intense DNA amplification. With the help of a wild-type cosmid library we investigated the structure of the amplified DNA sequences (ADS) and the corresponding wild-type amplifiable units of DNA (AUD). The reiterations were heterogeneous in location, copy number and sequences involved and originated predominantly from a single 100 kb region of the chromosome called the AUD locus. All strains bearing reiterations possessed associated deletions which terminated either close to or at the ADS. The termini of four AUDs were sequenced in order to gain more knowledge about these heterogeneous amplifications. In three of the four cases investigated small, interrupted homologies were found bordering the AUDs. With the help of orthogonal-field-alternation gel electrophoresis (OFAGE) we were able to visualize a tandem reiteration of more than 1,500 kb in length. PMID- 2770700 TI - Specificity of the interactions between the Rep proteins and the origins of replication of Staphylococcus aureus plasmids pT181 and pC221. AB - pT181 and pC221 are closely related Staphylococcus aureus plasmids with the same genome organization, which is characterized by the overlapping of the origin of replication with the sequence encoding a protein, Rep, essential for plasmid replication. Former results have shown the lack of in vivo cross-complementation between these two plasmids, while in vitro studies have revealed the ability of both Rep proteins to act on either origin. One possible explanation for this difference was based on a previous analysis of the incompatibility expressed by the origin of replication of these plasmids, showing that the origin embedded in the rep gene competes for Rep utilization with the origin of a test plasmid and that changes in the sequence of the origin reduce its ability to compete. To avoid this problem, in the present work special hybrids were constructed in which the origin of replication overlapping the rep gene was mutationally inactivated, without changing the amino acid sequence of the encoded protein. The level of Rep expression by these hybrids could be varied by taking advantage of what is presently known about the control of Rep synthesis in plasmid pT181.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2770701 TI - Enhanced DNA cross-link removal: the apparent mechanism of resistance in a clinically relevant melphalan-resistant human breast cancer cell line. AB - Resistance to the cytotoxic effects of alkylating agents is a major limitation to their clinical efficacy. Although a number of animal and human tumor cell models have been developed to study this problem, it has proven difficult to achieve very high levels of resistance to alkylating agents in vitro. This is consistent with the recent clinical evidence that alkylator resistance can be overcome by dose escalations of less than 10-fold. A number of mechanisms of alkylator resistance have been described, more than one of which may occur in the same model. This paper describes a human breast cancer cell subline selected for 3 fold resistance to melphalan and cross-resistant to other alkylators in which only one of the previously described mechanisms of resistance, enhanced removal of DNA interstrand cross-linking, is demonstrable. Northern blot analysis using the human incisional repair gene ERCC-1 cDNA demonstrated that this particular gene product is not the altered function in these cells, so the molecular characterization of the observed enhanced repair is pending. Because these cells are also cross-resistant to radiation and to adriamycin and epipodophyllotoxin, they may represent a clinically relevant model in which to examine the role of DNA repair of lesions resulting from alkylators and other cytotoxic agents. PMID- 2770702 TI - Characterization of 2,3,7,8-tetrachlorodibenzo-p-dioxin-mediated decreases in dexamethasone binding to rat hepatic cytosolic glucocorticoid receptor. AB - An investigation of the effects of 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) on the liver cytosolic glucocorticoid receptor (GRc) in intact and adrenalectomized (ADX) rats, using equilibrium binding analysis, sucrose gradient sedimentation, and affinity labeling experiments, clearly demonstrated that TCDD significantly reduced the binding capacity (Bmax) of the hepatic GRc but did not alter the apparent equilibrium dissociation constant (Kd). This effect was maximal after 24 hr and was still present 22 days after treatment. Western blot analysis revealed that TCDD treatment did not cause a comparable decrease in the levels of immunodetectable receptor protein, which suggests that the steroid-binding properties of the hepatic GRc are altered, rather than the absolute concentration of receptor protein. Studies of TCDD effects on the uptake of GRc by nuclei indicated that TCDD treatment did not alter the ability of the steroid-GRc complex to be taken up by nuclei; however, TCDD treatment did increase the total capacity of liver nuclei to bind steroid-GRc complexes. TCDD dose-response studies that compared the hepatic GRc steroid binding of ADX and intact rats indicated that adrenalectomy markedly enhanced the response to TCDD. Significant effects on the GRc binding in ADX animals were induced at TCDD doses that were 10,000 times lower than those required for a response in intact rats. Analysis of two other biochemical markers demonstrated that ADX rats were 10-fold more sensitive to the induction of microsomal benzo[a]pyrene hydroxylase but of similar sensitivity to reduction of epidermal growth factor receptor binding, when compared with the responses of intact animals. These data indicate that adrenal status may be important in modulating the responses of the animals to TCDD and that the alteration of the hepatic GRc pathway may have a role in some of the actions of TCDD. PMID- 2770703 TI - Analogues of taurine as stimulators and inhibitors of ATP-dependent calcium ion uptake in rat retina: combination kinetics. AB - Taurine is an amino acid that plays important roles in maintaining both the structural integrity and function of the retina. Thus, the effects of taurine, taurine analogues, and their combinations were studied in the ATP-dependent calcium ion uptake system at low calcium ion concentrations (10 microM) in a rat retinal membrane preparation. (+/-)-(trans)-2-Aminocyclopentanesulfonic acid (TAPS), a cyclic taurine analogue previously determined to inhibit ATP-dependent calcium ion uptake was demonstrated to be noncompetitive (Ki = 0.055 mM) with respect to taurine, that is, the values for the half-saturation concentrations calculated from varying concentrations of taurine compared with varying concentrations of taurine in the presence of a fixed concentration of TAPS (80 microM) did not change. However, the values for the maximal rates of change were significantly different. 1,2,3,4-Tetrahydroquinoline-8-sulfonic acid (THQS), a less potent inhibitor of ATP-dependent calcium ion uptake than TAPS, was also shown to be noncompetitive with taurine, with an inhibition constant (Ki) of 23.8 mM. Thus, it is presumed that both compounds (TAPS and THQS) are acting at receptor site(s) other than the taurine binding site. When TAPS and THQS were tested in a mixture that maintains a ratio (fixed ratio mixture) of 1 part TAPS and 25 parts THQS (by concentration, in mM), varied over a wide range of concentrations, and were then analyzed by median-effect plots and equation, the inhibitory effects are strongly synergistic, as shown by the combination index and the dose-reduction index. The parallel nature of the median-effect plots of TAPS and THQS indicates that the two inhibitors have a similar mode of action, that is, mutually exclusive. (+/-)-3-Aminotetrahydrothiophene-1,1-dioxide (ATS) and (+/-)-piperidine-3-sulfonic acid (PSA) are an agonist and partial agonist that demonstrated stimulatory effects on ATP-dependent calcium ion uptake. When tested in combination (1:1) with taurine, they were also determined to be mutually exclusive. It was demonstrated that ATS and taurine induced the same maximal rates of change of calcium ion uptake; however, PSA was less potent than taurine. The combination of taurine plus ATS was additive, whereas the combination of taurine plus PSA was synergistic. Structure-activity relationships of the taurine analogues and their topological relationships are discussed. PMID- 2770704 TI - Type-A cholecystokinin binding sites in cow brain: characterization using (-) [3H]L364718 membrane binding assays. AB - (-)-[3H]L364718 membrane binding assays were employed to localize and characterize cholecystokinin (CCK)-A binding sites in rat and cow brain. Specific binding was detected in all brain areas tested, but in all areas of rat brain and most areas of cow brain the level was too low to allow characterization of the ligand binding specificity of these sites. Membranes prepared from cow nucleus accumbens and striatum contained higher levels of (-)-[3H]L364718 specific binding which represented 55-70% of total binding. Characterization of the ligand binding properties of (-)-[3H]L364718 binding sites in cow nucleus accumbens revealed that these sites are similar to CCK-A sites found in pancreatic membranes. Binding of (-)-[3H]L364718 was saturable and had high affinity (Kd = 45 pm). Sites labeled by (-)-[3H]L364718 displayed stereospecificity for the stereoisomers of CR1409. The competition curve for CCK8 was shallow and was steepened and shifted to the right by the presence of the stable GTP analog guanosine 5'-(beta,delta-imido)triphosphate. The potency of CCK8, but not (-) L36478, was also affected by the buffer in which the assay was conducted. Future use of (-)-[3H]L364718 membrane binding assays using cow nucleus accumbens and/or striatum will help explore the possibility of differences in ligand recognition among CCK-A sites found in brain and peripheral tissues. PMID- 2770705 TI - Inhibition of monoamine oxidase by analogues of amiloride. AB - Amiloride analogues with nonaromatic substituents on the 5-amino group or different substituents on carbon-6 of the pyrazine ring were tested as inhibitors of monoamine oxidase A and B in rat brain homogenate. The inhibition was competitive and reversible. 5-(N,N-Tetramethylene)amiloride protected the A type in the homogenate against irreversible inhibition by clorgyline. A reciprocal relation was found to exist between inhibitory constants of 5-N-substituted amiloride analogues for monoamine oxidase A and the ratio of overflows of endogenous noradrenaline and 3,4-dihydroxyphenylethylene glycol from the isolated rat tail artery incubated in the presence of a 50 microM concentration of the analogue, when the tissue was exposed to 10 microM tyramine. The 5-amino group appeared to be essential for inhibition of the A but not of the B type. Bell shaped relations between inhibitory constants of 5-(N-alkyl)- and 5-(N,N-dialkyl) substituted analogues and lengths of alkyl chains were different for each type. The presence of a methyl group in the alpha-position of the chain increased substantially the inhibitory constant for the A type. Halogen atoms as substituents on carbon-6 increased inhibitory constants for both types of the enzyme in the sequence: I less than Br less than Cl less than F. These findings are consistent with the existence of hydrophobic binding sites of restricted dimensions in both types of the enzyme. PMID- 2770706 TI - Inhibition of acetylcholine storage by acetylcholine analogs in vitro. AB - Forty-five acetylcholine (AcCh) analogs were chemically synthesized and characterized. They and two commercially available analogs were tested for the ability to inhibit active transport of AcCh by synaptic vesicles purified from the electric organ of Torpedo californica. A range of potencies greater than 4 orders of magnitude was found. A quaternary nitrogen and the presence of the carbonyl group are important to potency. The addition of hydrophobic groups to both ends of isonipecotic acid yielded the most potent analogs, which exhibited a nearly 1000-fold increase in potency relative to AcCh. The probable conformation of AcCh bound by the transporter has been deduced and confirmed by the synthesis of a potent rigid analog based on 2-amino-9-fluorenone. A potent analog was shown to be a competitive inhibitor with respect to AcCh, thus confirming that its site of action is the transporter active site. The structure-activity data clearly distinguish the binding site for AcCh from the site for vesamicol [(--)-(trans)-2 (4-phenylpiperidino)cyclohexanol], which is a noncompetitive inhibitor. PMID- 2770707 TI - The activation of glucose dehydrogenase by p-chloromercuribenzoate. AB - p-Chloromercuribenzoate alters various reactions of rat liver glucose (hexose phosphate) dehydrogenase differently. The reagent has little effect on the glucose: NAD or the glucose: NADP oxidoreductases, doubles the rates of oxidations of galactose-6-phosphate and glucose-6-phosphate by NADP and greatly stimulates the oxidations of glucose-6-phosphate and galactose-6-phosphate by NAD. The reagent appears to react with a sulfhydryl group of the enzyme since activation is reversed and prevented by mercaptoethanol. The direct reaction of the reagent with the enzyme is indicated by its lower thermal stability in the presence of the p-chloromercuribenzoate. The size of the enzyme appears to be the same when determined by sucrose gradient centrifugation in the presence or absence of p-chloromercuribenzoate. In microsomes, the oxidation of NADH or NADPH hampers measurements of glucose dehydrogenase. Since p-chloromercuribenzoate inhibits microsomal oxidation of reduced nicontinamide nucleotides, it is possible to assay for glucose dehydrogenase accurately in the presence of the mercurial in microsomes and microsomal extracts and thus measure the effectiveness of a detergent in extracting the enzyme from microsomes. PMID- 2770708 TI - Inhibitors of adenosine catabolism improve recovery of dog myocardium after ischemia. AB - The effects of inhibitors of adenosine catabolism on contractile function and metabolites were assessed during 15 minutes of ischemia followed by 30 minutes of reperfusion in the open-chest dog heart. As compared to sham treatment, pretreatment with erythro-9-(2-hydroxy-3-nonyl)adenine (EHNA) and dipyridamole (DP) protected contractile function during ischemia, and improved recovery of high energy phosphate content and contractile function during reperfusion following ischemia. Testing EHNA and DP in a free-radical generating system indicated both compounds have some scavenging ability, suggesting the effect of EHNA + DP may not be on adenosine nucleotide metabolism alone. Comparison of end diastolic segment lengths to contractile function indicated the results were not affected by changes in preload resulting from peripheral vasodilation. PMID- 2770709 TI - The genes for beta-myosin heavy chain and glycogen phosphorylase are discoordinately regulated during compensatory growth of plantaris muscle in the adult rat. AB - It has been shown previously that compensatory hypertrophy of the plantaris muscle in adult rats can be induced by surgical removal of the synergistic gastrocnemius muscle. During hypertrophy, muscle transformation also occurs and there is a shift in the fiber type population of the muscle from fast to slow. Towards obtaining a better understanding of the molecular mechanisms controlling this process, we have carried out a kinetic analysis of the change in expression of two muscle-specific genes encoding the slow beta-heavy chain isoform of myosin and the muscle isoform of glycogen phosphorylase. This analysis indicated that significant increases (2-3 fold) in the steady-state levels of slow myosin heavy chain mRNA and protein did not occur until several weeks following ablation of the gatrocnemius muscle. Increases in slow fiber type paralleled the change in beta-myosin heavy chain expression. In contrast, the activity of phosphorylase, as well as the level of its corresponding mRNA, decreased approx. 1.5-2 fold shortly after (2-4 days) ablation of the gastrocnemius and levels remained low for at least several weeks. Significant changes in expression of these genes did not occur in plantaris muscle from sham operated contralateral legs. These studies indicated that changes in the expression of both genes was governed primarily by accumulation of their mRNAs. However, these genes were not coordinately regulated, indicating either that multiple control mechanisms regulate gene expression in this system or that the same controlling factor(s) regulates expression of these genes in temporally different ways. PMID- 2770710 TI - Comparison of the thermolability and hydrophobic properties of high- and low molecular-weight forms of rabbit liver arginyl-tRNA synthetase. AB - Two preparations with arginyl-tRNA synthetase activity have been obtained from rabbit liver post-microsomal fraction: a) a high-molecular-weight containing the multienzyme aminoacyl-tRNA synthetase complex and b) a low-molecular-weight preparation containing free enzymes. Thermal inactivation of arginyl-tRNA synthetase in both preparations has been compared in a solution which was successively supplemented with tRNA, reduced glutathione, L-ascorbic acid, ZnCl2 and Triton X 100. Moreover, hydrophobic properties of both enzyme preparations have been compared. It was found that the complexed arginyl-tRNA synthetase is more stable than the free enzyme. A role of hydrophobic interactions in the maintenance of the complexed enzyme stability is suggested. PMID- 2770711 TI - Ecto-enzyme activity of human erythrocyte adenosine deaminase. AB - Adenosine deaminase is found primarily in the cytoplasm of many cell types. In the human erythrocyte, about 30 per cent of the total adenosine deaminase activity is membrane associated, and about two-thirds of this is inactivated by treatment of intact erythrocytes with the nonpenetrating reagent diazotized sulfanilic acid, without affecting lactate dehydrogenase, a soluble cytoplasmic enzyme. This indicates that within the cell membranes, the catalytic site of about two-thirds of the adenosine deaminase faces the external medium, i.e., ecto adenosine deaminase. Localization of adenosine deaminase activity at the cell membrane is demonstrated directly by electron microscopy by use of the substrate 6-Chloropurine ribonucleoside, which is dechlorinated by adenosine deaminase to produce Cl-, which is precipitated at its locus of formation by added Ag+, and the precipitated AgCl converted into the electron dense Ag0 upon exposure to light. From the Hydropathic Profile of the amino acid sequence of adenosine deaminase it is evident that there are two hydrophobic domains of sufficient length to span a biological membrane, and it is proposed that these domains could function to anchor the enzyme to the membrane. The importance of adenosine deaminase is indicated by the fatal immuno-deficiency which results from untreated genetic adenosine deaminase deficiency. It may be important to determine whether the amount of ecto adenosine deaminase activity is better suited to assess the clinical status of adenosine deaminase deficient patients that the currently used total cellular enzyme activity. PMID- 2770712 TI - Binding of the transition metal ion [(H2O)(NH3)5Ru(II)]2+ to nucleosomal core and internucleosomal DNA. AB - The goal of this study is to establish the nature of pentammineruthenium(III) binding to DNA in intact mouse liver nuclei. Also, we wish to determine whether the nucleosomal organization of mouse chromatin has a substantial effect on the relative Ru(III) binding levels of internucleosomal and nucleosomal core DNA. These questions are important because ammineruthenium compounds share chemical and biological properties with the cis-dichlorodiammineplatinum(II) or cisplatin chemotherapeutic agent. Therefore, they represent a potential class of new chemotherapeutic agents. We find that in intact nuclei the predominant DNA binding site for pentammineruthenium(II), followed by air oxidation to pentammineruthenium(III), is N-7 guanine, as is the case with cisplatin. Also, the Ru(III) distribution between internucleosomal and nucleosomal core DNA was found to be nearly identical as probed with three non-specific deoxyribonucleases. PMID- 2770713 TI - The regulatory kinetic properties of porcine hepatic glucokinase. AB - Porcine hepatic glucokinase (ATP: D-hexose 6-phosphotransferase EC 2.7.1.1) has been purified by a modification of the procedure for its purification from rats. However, difficulties were encountered with endogenous proteases and the reliability of a source for porcine livers. The molecular weight has been determined to be 60,400 +/- 1,400 by sodium dodecyl sulfate, polyacrylamide gel electrophoresis. The enzyme has been characterized kinetically. The parameter values, S0.5 (glucose) and Hill coefficient (nH) are 2.4 mM and 1.9 respectively under sulfhydryl-reducing conditions. The enzyme undergoes the two sulfhydryl related decays of its activity previously observed in the enzyme isolated from rat (Tippett PS, Neet KE: Arch Biochem Biophys 222:285-298, 1983). The enzyme is inhibited by palmitoyl-CoA, Ki (apparent) = 1.0 microM, nH = 1.8; this concentration of inhibitor is significantly below its critical micelle concentration. Physically and kinetically glucokinase isolated from pig is similar to the enzyme isolated from rat. The porcine system provides a second source for isolation and further characterization of this important and unusual enzyme. PMID- 2770714 TI - Association of actin with DNA and nuclear matrix from Guerin ascites tumour cells. AB - The protein composition of nuclear matrices containing different amount of DNA was examined. It was found that, in matrices containing 2% to 80% of total DNA, the quantity of DNA-bound proteins remains relatively constant varying from 10% to 15% of total nuclear proteins. Electrophoretic patterns do not differ substantially, but autoradiograms with in vitro 125I labelled proteins show quantitative variations in the actin content. Application of radioimmunoassay (RIA) enabled to determine the exact content of actin in GAT nuclei and nuclear matrices - 5 micrograms/ml in nuclei, of which 50% are bound to DNA and 30% being a component of the protein part of the nuclear matrix. These results are supported by electron microscopic data, where immunogold technique was performed on thin sections and spread material. The applied methods suggest that part of the nuclear actin is tightly bound (resistant to 2 M NaCl) to DNA and represents a component of the internal nuclear matrix. PMID- 2770715 TI - Measurement of adrenolutin as an oxidation product of catecholamines in plasma. AB - Using the reverse phase high-performance liquid chromatography (HPLC) with mobile phases composed of simple acids, we have developed an assay technique for the measurement of adrenolutin, one of the oxidation products of catecholamines, in rat plasma. Ion-pairing chromatography permits the separation and quantitation of plasma adrenolutin (microM) in a linear manner. Sample preparation involved the precipitation of plasma proteins with perchloric acid and it is easier to handle a large number of samples at a time. However, we were unable to demonstrate the presence of adrenochrome, another oxidation product of catecholamines, in plasma since adrenochrome was rapidly destroyed in acid as well as in blood and was quickly changed into adrenolutin. Adrenolutin peak in HPLC was confirmed by 1) the retention time; 2) co-injection of adrenolutin and; 3) the appearance of 3H adrenolutin after injection of 3H-norepinephrine. Administration of different catecholamines as well as adrenochrome and adrenolutin in rats also increased the level of adrenolutin in plasma. Adrenolutin was found to be present in plasma in other species including dog, rabbit and pig. High level of adrenolutin, which may represent total concentration of aminolutin in plasma, suggests the presence of an efficient mechanism for the oxidation of catecholamines under in vivo conditions. PMID- 2770717 TI - Effects of warm and cold ischemia on mitochondrial functions in brain, liver and kidney. AB - The purpose of this work was to study the effects of warm (37 degrees C) and cold (4 degrees C) ischemia on different mitochondrial functions in rat brain, liver and kidney. After 10 to 60 minutes of ischemia at 37 degrees C the energy coupled respiration as well as the ADP-induced malate-aspartate shuttle activity in brain and liver mitochondria or the rate of mitochondrial ATP synthesis in kidney were significantly decreased. However, the respiratory rates and the shuttle activity in the absence of ADP remained unchanged. These data suggest that ischemia primarily affects electron transport in the respiratory chain rather than the hydrogen shuttle and the energy coupling system. When the temperature during the indicated ischemic periods was decreased to 4 degrees C, in brain and liver no significant alterations of these mitochondrial functions were found in comparison with the non-ischemic controls. When rat kidneys were stored for 36 hours at 4 degrees C according to Collins mimicking transplantation conditions, the mitochondrial respiration and ATP synthesis were only slightly decreased. It therefore appears that hypothermia can prevent effectively mitochondrial dysfunction due to ischemia. PMID- 2770716 TI - Regulation of gluconeogenesis in swine kidney proximal tubule cells. AB - Proximal tubule cells were isolated from swine kidney and cultured for periods of more than 30 days. The cells formed confluent monolayers after plating on a collagen surface and they were passaged more than 5 times on this matrix. The cells maintain several metabolic functions of proximal tubule cells, including gluconeogenesis and the ability to respond to epinephrine and parathyroid hormone. Gluconeogenesis, a principal metabolic pathway in proximal tubule cells, was examined as a function of days in culture. The isolated cells showed a nearly constant rate of gluconeogenesis from 14C-lactate, 14C-alanine and 14C-glycerol with no significant loss of activity for at least 30 days in culture. Likewise, the activities of several cytosolic and membrane associated enzymes including, alkaline phosphatase, delta-glutamyltransferase, fructose-1,6-bisphosphatase and phosphofructokinase were nearly constant over the same time period. The cells responded to treatment with epinephrine and parathyroid hormone, and the rate of gluconeogenesis from 14C-lactate doubled in the presence of these hormones. The morphological and biochemical evidence obtained in these studies show that the proximal tubule cells isolated from swine kidney provide an excellent well defined system for studying the hormonal regulation of carbohydrate metabolism in this tissue. PMID- 2770718 TI - The rate of degradation of liver glycogen phosphorylase is specifically decreased in the C57BL/KsJ-db/db mouse. AB - We have recently demonstrated that the activity of liver glycogen phosphorylase, the rate-limiting enzyme of glycogenolysis, is elevated in genetically diabetic (db/db) mouse and that it is primarily due to the presence of increased amounts of this enzyme. In the present study, we examined the turnover of glycogen phosphorylase in vivo in order to elucidate the mechanism for this specific increase. The rate of phosphorylase synthesis was slightly decreased in the diabetic mouse compared to controls. However, the relative rates of synthesis were similar in these two groups. The rate of degradation of this enzyme was decreased 20% (p less than 0.05) in the diabetic mouse compared to controls. More importantly, the relative rate of degradation of phosphorylase was found to be lower in the diabetic animals. This indicates that the elevated concentration of phosphorylase in the liver of the db/db mouse is likely due to a specific decrease in its rate of degradation. PMID- 2770719 TI - Heterogeneity of a crude synaptosomal preparation, studied by affinity partitioning using hexaethonium-poly(ethylene glycol). AB - The heterogeneity of a synaptosomal preparation was studied by the use of affinity partitioning in combination with centrifugal counter-current distribution. Hexaethonium-poly(ethyleneglycol) was used as the extracting agent. The fractions were analyzed for: light scattering, protein, choline acetyltransferase, L-glutamate decarboxylase, glutamine synthetase, 2',3' cyclicnucleotide-3'-phosphohydrolase, acetylcholinesterase and succinate dehydrogenase. The material was fractionated into three main fractions which differed in their content of marker-enzymes. PMID- 2770721 TI - [A factor from the venom of the Central Asiatic cobra Naja naja oxiana, which inactivates component C4 of human complement]. AB - An acid glycoprotein (mol. m. 60 kDa) containing 6 sialic acid residues and N terminal Thr was isolated from the venom of the central asian cobra Naja naja oxiana. The protein has an anticomplementary activity selectively inactivating of the C4 component of the human complement. This factor (CFA-Ib) binds C4 with Ki = 0.27 +/- 0.13 microM and then irreversible inactivates it with a rate constant k = 0.75 +/- 0.25 min-1. Membrane bound C4b restores its ability of CFA-Ib binding. This binding hinders component C2 sorption on C4b and C3 convertase formation. PMID- 2770722 TI - [Fluorescence characteristics of DNA complexes with dyes of the bis-benzimidazole series]. AB - Fluorescence characteristics of DNA-specific dyes of bis-benzimidazole type in a wide range of pH and r = C/P were investigated. Fluorescence spectra of DNA complexes with bis-benzimidazoles have elements of a structure, which may result from a superposition of the spectra of dye molecules in different protonization group states that form different types of complexes with DNA. Experimental data do not contradict the idea of bis-benzimidazole dye binding into the minor groove of DNA. Bis-benzimide molecules in the deprotonization state have a major affinity to DNA. PMID- 2770720 TI - Heterogeneity of lysosomes in human fibroblasts. AB - Lysosomes are defined traditionally with the marker enzyme acid phosphatase. We showed recently that lysosomes from human fibroblasts can be separated into a light and dense fraction as well as prelysosomal population. We now provide evidence that although acid phosphatase is enriched in all three fractions, the marker enzyme in the prelysosomal compartment is qualitatively distinct from that of the lysosomes. Ultrastructural analysis showed that the acid phosphatase in the prelysosomal vesicles deposited an extremely electron-dense reaction product, entirely obliterating the lumen of the vesicle, in contrast to that of the light and dense lysosomes which deposited a fine and diffuse product scattered throughout the luminal space. Biochemical analysis showed that only 51% of the acid phosphatase in the prelysosomes was inhibited by tartrate, while 80% of that in the lysosomes was tartrate-inhibitable. Immunoprecipitation with antibodies specific for various isozymes of acid phosphatase showed that 39% of the acid phosphatase in the prelysosomes was of the 'lysosomal' type whereas over 50% of the acid phosphatase in the lysosomes was of this type. These results showed that acid phosphatase in the prelysosomes of human cultured fibroblasts can be distinguished from that of the lysosomes cytochemically, biochemically, and immunologically and that lysosomes, as marked by acid phosphatase, are a heterogeneous organelle. PMID- 2770723 TI - [Purification and characterization of DNA-dependent DNA-polymerase alpha from human placenta]. AB - A preparation of human placenta DNA polymerase with specific activity 6000 unit/mg was obtained. The protocol of the enzyme purification includes the crude extract preparation, the subsequent chromatographies on phosphocellulose, red sepharose, DEAE sepharose and hydroxylapatite. The isolated DNA polymerase belongs to alpha-type according to the large molecular mass (greater than 150 kDa), high sensitivity to N-ethylmaleimide, the profound inhibition of DNA polymerization activity by 200 mM KCl and the ability to catalyze DNA synthesis, using the deoxyribonucleic template and ribonucleic primer. The DNA polymerase preparations contain a few forms with Stokes radii 50-60 A and sedimentation coefficients 7.3-9.0 S as found from data of gel-filtration and ultracentrifugation in glycerol density gradient, accordingly. The existence of four various forms of DNA polymerase activity: 150, 170, 220, 480 kDa were revealed by native electrophoresis. The four steps of purification result in DNA polymerase preparation that was shown by electrophoresis to contain 15-20% of protein possessing the polymerase activity. However the preparation obtained seems to be a "chromatographically pure substance", according to following ion exchange and affinity chromatographies. The other proteins without polymerase activity are suggested to be the components of the replicative complex of human placenta cells. PMID- 2770724 TI - [Influence of low-intensity laser radiation on the formation of liquid crystalline structures in a solution of glycoproteins]. AB - Liquid-crystalline structure formation in glycoprotein solutions irradiated by helium-neon laser in the presence of hydrogen peroxide was observed by both polarizing microscopy and spectrophotometry. High molecular weight (2.10(6) Da) and heavily glycosylated (about 80%) glycoprotein was isolated from the mucus layer of pig small intestine. Remarkable changes of both optic parameters of the solutions and the morphology of liquid-crystalline structures were detected in irradiated samples compared to the non-irradiated ones. PMID- 2770726 TI - [Nucleotide sequence of intergenic and external transcribed spacers of rDNA of diploid wheat Triticum urartu Thum. ex Candil]. AB - The primary structure of intergenic non-transcribed and external transcribed spacers of rDNA of diploid wheat Triticum urartu, cloned in pTu3 plasmid 2402 b.p. long was determined. The intergenic non-transcribed rDNA spacer of Tr. urartu was shown to consist of 8 subrepeats with an average of 133 b.p. long, heterogeneous in length and nucleotide sequence. A number of repeated sequences was revealed within each subrepeat. While comparing nucleotide sequences of rDNA subrepeats of Tr. urartu and Tr. aestivum a high homology was found (up to 82%). A high similarity between these plant species was also found in the promoter region and in the external transcribed rDNA spacer. Suppression of the nucleolar organizer of 1A chromosome in the presence of 1B and 6B chromosomes of Tr. aestivum is supposed to be connected with the existence of a great number of subrepeats in the intergenic non-transcribed rDNA spacer of B genome donors in polyploid wheat species of turgidum-aestivum row. PMID- 2770725 TI - [Nucleotide sequences of 5S rRNA genes of polyploid species of wheat and Aegilops species]. AB - Primary structures of 5S rRNA genes and of non-transcribed spacers between them were determined in families of 5S DNA repeats 420 and 500 b.p. long in 8 wheat and Aegilops species. The high conservatism of sequences coding for 5S rRNA, 3'- and 5'-ends of non-transcribed spacers was shown not to depend on the evolutional position, ploidy level and genomic composition of species. The activity of transcription of 5S rRNA cloned genes was determined in vitro. The functional heterogeneity was revealed in each family of repeats due to the existence of exchanges of separate nucleotides within the internal transcription control region. A greater deficiency of CpG dinucleotide was revealed in 5S rRNA genes than in non-transcribed spacers. PMID- 2770727 TI - [Nucleotide sequence of chum salmon preproinsulin gene]. AB - The nucleotide sequence of chum salmon preproinsulin gene isolated from the phage library of genomic sequences is presented. The transcription initiation site of the gene was experimentally determined. The resolved upstream region contains a TATA-promoter sequence and CAAT-like-box sequence. The salmon insulin gene is split and contains two introns. The first intron, 393 b.p. long, is situated in the 5'-untranslated region. The second intron, 287 b.p. long, interrupts triplet coding for the seventh amino acid residue of the C-peptide. Thus, the overall structure of the insulin gene appears to be closely related to other sequenced insulin genes, including those of birds and mammals. Both introns in the salmon insulin gene are flanked by GC...AG pairs in contrast to GT...AG, the rule common for the majority of genes. Analysis of the cloned salmon insulin gene and cDNAs reveals a high frequency of polymorphic differences, up to 6% in the translated region. The nucleotide sequence of the 3'-untranslated region of the gene is only 70% homologous to the corresponding region in the previously cloned salmon preproinsulin cDNAs. These differences may implicate for the presence of more than one insulin gene per haploid genome in salmon. PMID- 2770728 TI - [Molecular and cytologic analysis of clusters of moderate repeats of bird genomes]. AB - Pigeon genome long sequences containing clusters of moderately repeating elements have been cloned. Molecular analysis has shown a dispersed distribution of the repeats in both pigeon and chicken genomes. Within a single cluster, a scrambled distribution of elements belonging to different families of repeats has been shown. Similar repeated sequences have been revealed within clusters. The analysed clusters of repeats are characterized by a limited structural variability in the genomes. In situ hybridization revealed the localization of sequences complementary to the cloned clusters in pigeon and chicken macrochromosomes. Preferential localization has been demonstrated in telomeric and centromeric chromosome regions as well as in the region of R-bands. PMID- 2770729 TI - [Binding of polyamines by the double-helical DNA molecule in unfolded and compact forms]. AB - The influence of the natural polyamines [spermine (Sp) and spermidine (Spd)] on the conformation of thymus DNA molecule (M = 4 and 15 MDa) was studied by means of the viscometric method over the range of low supporting electrolyte concentrations (CNaCl = 0.6 divided by 8.4 mM). In was shown that at sufficiently low degrees of ligand binding (theta PA) which satisfy the condition ZPA theta PA less than 0.76 (where ZPA is the valence of PA), the PA addition results in a slight decrease of the volume effects in the DNA molecule due to the increase of the ionic strength (mu) of solution conditioned by the presence of polyvalent PA cations and also to the supplanting of "bound" Na+ cations. The further increase in CPA induces the corresponding increase in theta PA up to the value which provides ZPA theta PA greater than 0.76, and is accompanied by drastic decrease of macromolecule's dimensions and partial DNA condensation as well. At larger degrees of binding (ZPA theta PA approximately 0.90) a transition from the expanded to compact form of the DNA molecule is observed. The calculations of theta 1 = theta Na + theta PA and rcr = theta 1 + ZPA theta PA as a function of mu were carried out according to Manning's two-variables theory on the basis of the obtained dependences of the critical PA concentrations (Ccr PA), which correspond to the midpoint of the condensational transition, versus CNaCl. The increase of rcr and/or decrease of the effective site dimensions (ZPA) was shown to be necessary for the DNA molecule collapse over the range of low mu less than 0.01. The binding constants of the PA association to the compact DNA form were evaluated by the simplest model of McGhee and von Hippel. On the basis of the results obtained for Spd it was hypothesized that the non-electrostatic interactions are significant by the binding of the PA to the compact form of the DNA molecule. PMID- 2770730 TI - [Theoretical analysis of the DNA duplication mechanisms in the prokaryotic genomes on the basis of repeats]. AB - In the present work a theoretical analysis of the molecular mechanisms on duplications emergence in the genomes of prokaryotes on the basis of direct repeats has been carried out. The correlations obtained have shown, that the duplication rate depends on such parameters as the distance between repeated regions, repeats nucleotide composition and the number of homology damages in them. It has been revealed that the rate of duplications decreases more readily than the deletion rate upon the growth of the distance between the repeats. Such prevalence of deletions over duplications must lead to the elimination of various types of direct repeats from the prokaryotic genomes in the course of their evolution. PMID- 2770731 TI - [Complementary addressed modification of plasmid DNA]. AB - The possibility to accomplish the sequence-specific chemical modification of superhelical DNA with reactive oligonucleotide derivatives was demonstrated. Plasmids containing fragments of the immunoglobulin gene were modified with alkylating derivatives of oligonucleotides complementary to a nucleotide sequence in the immunoglobulin gene. In contrast to the relaxed plasmid DNAs, superhelical DNAs (sigma = -0.1) were found to be attacked by the derivatives at the target nucleotide sequence. The efficiency of the reaction increases with the increase of the plasmids negative superhelicity. It was found also that the denatured derivatives. The sequence-specific modification of plasmid DNAs with the reactive oligonucleotide derivatives can be used for the site-directed mutagenesis and the investigation of the repair processes. PMID- 2770732 TI - [Various properties of DNA from isolated fractions of the mouse synaptonemal complexes]. AB - A fraction of synaptonemal complexes (SC) isolated from mouse spermatocytes has been electrophoretically purified in agarose gel. The DNA from the SC fraction constitutes approximately 0.5% of total nuclear DNA, and its molecules have length heterogeneity from 1 k.b. to 20 k.b. The content of beta-globin gene is the same in DNA from the SC fraction and in total nuclear DNA. The specificity of DNA from the SC fraction is manifested by higher contents of the repeated alternative sequences GT/CA and B1-sequence that is probably due to the processes of genetic meiotic recombination. PMID- 2770733 TI - [Polymorphism of fibrin equilibrium oligomers in the presence of fragment D]. AB - The methods of viscosimetry, the Rayleigh light-scattering and analytical ultracentrifugation were applied to study the physicochemical mechanism of the effect of fragment D on the structure of fibrin equilibrium oligomers. Using the values of intrinsic viscosity, weight average molecular masses and mass/length ratio it was shown that when producing an antipolymerization effect the fragment D retains the three-dimensional organization of fibrin polymers, i.e. rigid rod like single- and double-stranded protofibrillas. The paper has proved that along with the traditional mechanism of inhibiting self-assembly of of the double stranded structure due to the competition of fragment D with fibrin monomer for central domain E there is an alternative attributed to its attachment to a peripheral region of the fibrin monomer. The second mechanism is the only one which occurs in the region of single-stranded pseudoprotofibrillas existence. The role of alpha C-domains in protein-protein interactions is also discussed. PMID- 2770734 TI - [Interaction of carminomycin with DNA according to data of laser polarized fluorescence]. AB - Anti-tumour antibiotic carminomycin interaction with chicken erythrocyte DNA is studied in aqueous-salt solutions by the laser polarized fluorescence method. Fluorescence quenches almost equally effectively during the antibiotic absorption on native (nDNA) and denatured (dDNA) DNAs, but the polarization degree of residual fluorescence differs about two times. Carminomycin binding to dDNA is characterized by one interaction type with a large density of occupancy sites - one antibiotic molecule per base pair. Carminomycin forms two types of complexes with nDNA, differing significantly with binding constants. Strong binding, intercalation, is saturated at one carminomycin molecule per 3 base pairs independently on the solution ionic strength. The weaker, external, interaction is characterized by the binding constant being by two orders of magnitude lower than that for intercalation, and the external interaction contribution is negligible. PMID- 2770735 TI - [An computer information system for genetic engineering]. AB - The article describes the vectors data base and the software for its use (the VECTOR-PC system). At present the prototype versions of data base and VECTOR-PC exist and are in test exploitation. The original data base entry format contains 17 main fields for specific genetic engineering information. The VECTOR-PC system includes programs for data base search and support, and also the "genetic engineering designer", which allows the user to design his own hypothetic structures from the objects of data base and to receive detailed information about them. The system is destined for IBM PC or compatible computers. PMID- 2770736 TI - [Determination of the upper limit of the value for rat genome expression]. AB - Nuclear RNA was isolated from the majority of adult rat tissues, and from the whole embryos at three different stages of gestation. 13 different mRNA preparations were mixed and the sequence complexity of this total RNA (sigma RNA) was measured by RNA-driven hybridization to [125I]DNA under conditions of maximal stringency. With unique DNA as a probe, the complexity of sigma RNA was equivalent (by assuming asymmetric transcription) to 55.4% of the single-copy genome, corresponding to enough information for 2.2 . 10(5) different 4.5 k.b. genes. With DNA probe containing both unique and middle-repetitive sequences (C0t greater than or equal to 0.02), the complexity of sigma RNA was equivalent to 67.6% of the genome. Nearly all middle-repetitive DNA is represented (by assuming asymmetric transcription) in embryos nuclear RNA. The value of genetic complexity of sigma RNA (55.4 and 67.6%) represents the highest published value of RNA complexity and approach the maximal theoretical capacity of the mammalian genome. We conclude that despite the dramatic increase of the genome size in higher animals, the relative values of their genetic information expression (at the level of nuclear RNA) is comparable with that in lower eukaryotes and bacteria. PMID- 2770737 TI - [Structuro-functional organization of delta sleep-inducing peptide]. AB - Theoretical conformational analysis was carried out for a nonapeptide hormone (delta sleep-inducing peptide). Possible structure of the neuropeptide under physiological conditions may be described by a set of low-energy conformations belonging to nine different forms of the backbone. A solution of the "reverse conformational problem" for delta sleep inducing peptide enables one to predict modified amino acid sequences (D-Ala3-, Pro4-, Pro6-, Pro7, and Tyr7-analogs), which may assume one of the low-energy states of the native hormone. The influence of the solute was not taken into account in our calculations. PMID- 2770738 TI - [Ca-inhibited binding of melittin with parvalbumin. A new role for parvalbumins?]. AB - It was found that pike parvalbumins pI 4.2 and 5.0 bind amphiphilic peptide melittin extracted from bee venom in an extraordinary Ca-dependent manner: in apo state the protein forms a tight equimolar complex with melittin (Ka = 10(6) M-1 at 18 degrees C); in Ca- (and Mg-) loaded state it does not take place. Heating of the protein up to temperatures above the denaturation temperature of apo parvalbumin does not change the stoichiometry of the complex but increases its association constant by an order of magnitude (Ka = 1.2.10(7) M-1 at 44 degrees C). Isolated Ca-binding domain of parvalbumin, 38-108, retains the ability for Ca inhibited binding of equimolar quantities of melittin. The possible function of parvalbumin in vivo is suggested: Ca-inhibited interactions with some intracellular components. PMID- 2770739 TI - [The effect of hydrogen ions on the B-A transition in DNA]. AB - The effects of hydrogen ions binding to DNA on its secondary structure and B to A transition were studied by methods of X-ray diffraction and infrared spectroscopy. Helical parameters of DNA molecules with different degrees of protonation were determined. It was shown that H+-ions binding stabilize the B form of DNA in fibers in the wide range of water and inorganic salt content. Only 0.03 H+-ions bound to each nucleotide are sufficient to prevent B to A transition caused by a relative humidity decrease in DNA fibers, containing 4% of NaCl. The effective stabilization of the DNA B form by H+-ions binding is explained by modifications in DNA - solvent molecules interactions, especially in the major groove of double helices. PMID- 2770740 TI - [Protein factors, interacting with the octamer sequence of immunoglobulin genes]. AB - Nuclei of different cell lines contain protein factors interacting with octamer ATTTGCAT. Fragment k53 of kappa-gene promoter region was used as DNA-probe. The factors from lymphoid cells yield a DNA/protein complex with mobility B0. The proteins are referred to as HF-B0. The nonspecific ubiquitous factor present in many non-lymphoid cells (for instance, HeLa cells) interacts with the probe to produce a complex whose mobility is much lower. The protein NF-B0 was isolated from the nuclear extract of myeloma MOPC21 cells. It was purified by chromatography on ion exchangers, hydroxylapatite, heparin-Sepharose and affinity sorbent containing a synthetic octamer sequence. At all the steps of purification, protein fractions were chosen for their ability to interact selectively with the octamer yielding a complex with the mobility B0. As a result, NF-B0 protein (60 +/- 2)kDa was purified 6.10(4) times to the electrophoretically homogeneous state. Purified factor NF-B0 selectively interacts with the octamer. PMID- 2770741 TI - [Identification of the segment for binding of transferrin using a cellular receptor]. AB - Methods of proteolysis, radio-immunoblotting and affinity chromatography were used for identifying the human transferrin molecular binding site with cellular receptor. Monoclonal antibody HTF-14 which inhibits binding of the transferrin molecule with the receptor was employed. We showed that this monoclonal antibody has an antigenic determinant of the conformational type which is localized on the COOH-sublobe of the NH2-lobe of the molecule of the transferrin. PMID- 2770742 TI - [Somatic hypermutagenesis in immunoglobulin genes. I. Connection of somatic mutations with repeats. A statistical weighting method]. AB - Based on the analysis of a number of immunoglobulin genes' nucleotide sequences, it has been suggested, that somatic mutations emerge by means of imperfect duplexes correction, formed by mispairing of complementary regions of direct and inverted repeats. In the present work provides new data, confirming this mechanism of somatic hypermutagenesis. It has been shown that the presented sample of V- and J-segments of immunoglobulin genes is abundant in nonrandom imperfect direct repeats and complementary palindromes. To prove the connection of somatic mutations with the correction of imperfect duplexes, made up by the regions of these repeats, we have developed the method of statistical weights, permitting us to analyse the samples of mutations and repeats and to reveal the reliability of the connection between them. Using this method we have investigated the collection of 203 nucleotide substitutions in V- and J-segments and have shown a statistically reliable (P less than 10(-4) connection of these mutation positions with imperfect repeats. PMID- 2770743 TI - [Collective dynamics of globular proteins and impulse methods of nuclear magnetic resonance]. AB - The theory of the NMR spin echo on globular proteins signals envelope is developed, based on the model description of collective excitations of macromolecules in terms of the continuous media mechanics. The influence of internal motions is taken into account with the suggestion of the local connection between the spin-spin relaxation and deformational rotations of separate parts of the molecule. The results of the calculations are compared with experimental data. PMID- 2770744 TI - [Phylogenetic analysis of partial nucleotide sequences of 18S rRNA for 14 plant species]. AB - The variable 260 base long region from the interior of 18S rRNA of 14 plant species was determined by chain termination method with the use of reverse transcriptase. The hairpin revealed in this region appeared to be conservative in all species compared. Thermodynamic stability of such hairpin is lower than of an alternative structure with different base pairing mode. From sequence data dendrograms were produced by clustering algorithms and by the compatibility method. In addition to the plant sequences these dendrograms included also the homologous regions from yeast and Xenopus 18S rRNAs. The compatibility method seems to be more reliable. Inferences were drawn on relations between gymnosperms and angiosperms, monocots and dicots on the bases of the analysis of this tree. PMID- 2770745 TI - [Comparative analysis of subdomain fragments of chromatin]. AB - Nuclei isolated from Djungarian hamster fibroblasts transformed by SV40 were treated with restriction endonuclease Bsp RI, fixed on Celite columns and underwent successive gradients of dissociating agents, such as NaCl, LiCl-urea, and temperature. This procedure leads to fractionation of DNA fragments in accordance with the tightness of DNA-protein bonds in situ. The fractions obtained were analysed by agarose gel electrophoresis and dot-hybridization technique with the use of various DNA probes. The results received are as follows: a) a DNA fragment size is not a factor determining the chromatographic position, the latter is probably stipulated by DNA-protein interactions; b) an analysis of cells synchronized at the G1/S border shows that the distribution of specific DNA sequences, such as actin, histone, hsp 70, and c-Ha-ras genes as well as reiterated DNA sequences, does not coincide with that of total genomic DNA; the nuclear matrix-attached fragments of those sequences are enriched to various extents. By nick-translation labeling in situ, DNase I-sensitive and hypersensitive regions were tentatively identified among subdomain chromatin fragments. PMID- 2770746 TI - [Structural changes in chromatin of heat shock protein 70 gene of Drosophila during transcription]. AB - Using "protein-image" hybridization technique combined with various crosslinking methods, for formaldehyde-prefixed nuclei we have analysed changes induced by activation in the chromatin structure of HSP-70 genes. From the crosslinking data it follows that chromatin of actively transcribed genes undergoes some structural rearrangements resulting in certain weakening of the contacts between DNA and the globular parts of histones so that the histones remain bound to DNA through their N-terminal regions. In addition, there have been found two specific regions with a reduced content of histones: the 5'-promoter of HSP-70 gene and a region distanced by approximately 1 k.b. from the 3'-end of the HSP-70 gene. PMID- 2770747 TI - Role of carbohydrate in binding of IgG to the Fc receptor of neonatal rat enterocytes. AB - Monoclonal IgG1, IgG2a, IgG2b and IgG2c were prepared from rat hybridoma cells treated with tunicamycin in order to inhibit N-linked glycosylation. The IgG produced by these cells was about 70% lower in carbohydrate content compared to IgG from equivalent untreated cells, but was similar to the corresponding normal IgG in terms of antigen binding. However, the ability of carbohydrate deficient (CHO-) IgG to bind in vitro to Fc receptor extracted from jejunum of neonatal rats was impaired in most cases and, in all but one case, the amount of CHO- IgG transported from gut lumen to blood in vivo was markedly reduced. No reduction in binding of normal IgG to extracted receptor was observed in the presence of various sugars. It is postulated that N-linked carbohydrate acts to stabilize the structure within the IgG molecule which is responsible for binding to this Fc receptor, possibly in the CH2 domain. PMID- 2770748 TI - Immunochemical studies of a murine polyreactive IgG2b autoantibody with rheumatoid factor activity. AB - The hybridoma, 62H3, which secretes a monoclonal IgG2b with anti-HLA-DR specificity, was expanded in pristane-primed BALB/c mice and the antibody was isolated from the ascitic fluid by affinity chromatography on Protein A Sepharose. The purified IgG2b antibody was tested by an enzyme immunoassay for antibody activity against a panel of 40 self and non-self antigens. It was found to react strongly with beta-galactosidase, actin, glutamate dehydrogenase, rabbit and human IgG and di- and trinitrophenyl groups; and moderately with tubulin, insulin and phosphorylcholine; but it did not react with various other self and non-self antigens, such as DNA, albumin, keyhole limpet hemocyanin, hen lysozyme and horseradish peroxidase. Fab and Fc fragments were prepared from this IgG2b by papain proteolysis. The Fab fragment possessed the same spectrum of polyreactivities as the native IgG2b, whereas no activity was detected with the Fc fraction. In order to investigate the properties of the antigen binding site, the actin, TNP and rabbit IgG antibody activities were studied in more detail by enzyme immunoassay, Western blot and immunocytochemistry. The monomolecular nature of this multireactivity was confirmed by immunoabsorption analysis. Furthermore, 62H3 monoclonality was also verified by comparative isoelectric focusing and sodium dodecyl sulfate-polyacrylamide gel electrophoresis analysis with other monospecific antibodies. The dissociation constants (Kd) of antigen antibody equilibria in solution were measured. The Kd for actin was 1.11 +/- 0.24 x 10(-5) M and the Kd for TNP-BSA was 8.7 +/- 0.51 x 10(-7) M. No interaction with rabbit IgG could be detected in solution. These findings raise the question of the possible implication in autoimmune pathology or in normal physiology of IgG class polyspecific antibodies with solid-phase restricted cross-reactive rheumatoid factor activity. PMID- 2770749 TI - The oligosaccharide chains of cobra venom factor are required for complement activation. AB - To examine the function of the carbohydrate chains of cobra venom factor (CVF), the molecule was enzymatically deglycosylated under non-denaturing conditions with N-glycanase (peptide-N4-(N-acetyl-beta-glucosaminyl) asparagine amidase). The deglycosylation of CVF chains seems to proceed independently of each other, leading to partially deglycosylated intermediates. Complete deglycosylation of CVF was found to abolish the activity of CVF. The deglycosylated molecule is unable to activate the alternative pathway of complement. Deglycosylated CVF no longer consumes the serum complement activity, it does not induce C3 activation in serum, nor does it induce complement-mediated hemolysis. These results indicate that the carbohydrate moieties of CVF are essential for its role in complement activation. PMID- 2770750 TI - Comparison of vasoactive intestinal peptide-mediated protein phosphorylation in human lymphoblasts and colonic epithelial cells. AB - Vasoactive intestinal peptide (VIP) induces phosphorylation of a basic 38,000 mol. wt protein in a human lymphoblastic cell line (Molt 4b) and a human colon carcinoma cell line (HT29). In both cell types, VIP interacts with specific high affinity receptors to activate adenylate cyclase and cAMP-dependent protein kinase. The two cell types appear to express homologous receptors with similar affinity and specificity for VIP, but the colonic epithelial cells express a greater number of receptors. HT29 colonic cells also exhibit a greater stimulation of adenylate cyclase and a higher phosphorylation index for the 38,000 mol. wt protein in response to VIP. This 38,000 mol. wt protein, which is phosphorylated in the presence of VIP, appears to be identical in both cell lines; it is phosphorylated in both lymphoblasts and colonic epithelial cells in the presence of forskolin, but not in the presence of phorbol 12-myristate 13 acetate. Phosphorylation of this 38,000 mol. wt protein may be an important step in VIP regulation of water and electrolyte secretion from colonic epithelial cells, and in VIP regulation of immunoglobulin and lymphokine secretion from lymphocytes. PMID- 2770751 TI - Molecular probes for general testicular and specific spermatogenic function. AB - Northern analysis of human testis poly(A+) RNA with a mixture of oligonucleotide primer extended cDNA probes revealed several similar RNAs. These RNAs were subsequently cloned into a VPCS (vector-primer-cloner-sequencer) plasmid. One of these clones, NDHu1, was represented within the library a number of times and hybridized strongly to a poly(A+) RNA of congruent to 1.2 kb. Sequence analysis identified this clone as the URF 1 subunit of the mitochondrial NADH dehydrogenase (NDHu1). Comparison of the relative levels of the NDHu1 and human protamine 1 (HP1) transcripts revealed that HP1 was less abundant than NDHu1. This was unexpected, since it is known that within differentiating mammalian spermatid cells, protamine (HP1) is an abundant transcript. This suggested that the ratio of the relative levels of these two very different mRNAs was indicative of the relationship between specific spermatogenic function (germ cell transcription, determined by the level of the HP1 transcript) and general testicular cell function (determined by the level of the mitochondrial mRNAs, i.e. NDHu1). This correlation was maintained when several individuals expressing various degrees of testicular dysfunction were examined. This study suggests that these probes may be useful markers for general testicular and specific spermatogenic function. PMID- 2770753 TI - Rapid identification of Campylobacter species using oligonucleotide probes to 16S ribosomal RNA. AB - A comparison of the 16S ribosomal RNA sequences from various Campylobacter species was used to identify unique sequences which distinguish pathogenically significant campylobacters from other members of the genus. Oligonucleotides complementary to these sequences were synthesized, and under stringent conditions hybridization reactions using these probes and total RNA as the target nucleic acid displayed the desired species specificity. A simple, rapid lysis procedure was developed that allowed the specific detection of C. jejuni or C. coli from as few as 10(6) bacterial cells in less than eight hours. This method provides immediate advantages for the unequivocal identification of Campylobacter species in the microbiology laboratory, and demonstrates the potential for the use of these probes in a rapid diagnostic test of clinical samples for Campylobacter infection. PMID- 2770752 TI - HBV and HIV expression in lymph nodes of HIV positive LAS patients: histology and in situ hybridization. AB - The presence of hepatitis B virus (HBV) and human immunodeficiency virus (HIV) was investigated using hybridization in 15 lymph nodes and one Kaposi's sarcoma skin lesion obtained from HIV-positive patients. Cryostat tissue sections were hybridized with chemically modified DNA probes for HBV and HIV. HIV genome was mainly observed in the cytoplasm of cells present in 7/15 lymph nodes and in the Kaposi's sarcoma skin lesion, thus indicating the expression of HIV replication. Control samples hybridized with an HTLV I probe were negative. HBV genome was found in the cytoplasm of lymphoid mononuclear cells in 2/7 lymph nodes, obtained from HIV+ patients without serum markers of ongoing HBV infection. Lymph node positivity for HBV DNA also confirms that lymphoid cells may be a target for HBV. Since HBV infection seems to precede HIV infection in nearly all patients, it is possible that it may represent a factor facilitating the development of the HIV related disease. PMID- 2770754 TI - Autoantibodies to immunoglobulins. PMID- 2770755 TI - The development of emotion expression during the first two years of life. AB - This study examines the course of emotion expression development over the first 2 years of life in a sample of full-term and preterm children. 58 mother/infant pairs were videotaped at infant ages of 2 1/2, 5, 7 1/2, and 22 months, recording face-to-face interaction involving play and separation/reunion sessions. The tapes were coded on a second-to-second basis using Izard's facial affect coding system. Data analysis focused on (1) differences in expressive behavior at 22 months as a function of risk status, gender, attachment status, and patterns of earlier maternal contingency behavior; (2) stability of specific emotional expressive patterns across assessment periods; and (3) the relation of expressive behavior and security of attachment at 2 years to qualities of earlier affective interchange. Mother's contingency behavior (both general level and specific contingency patterns) appeared to have a material effect on the course of emotional development, as did birth status and gender. Prematurity was associated with differential socioemotional development well into the second year, much in contrast to the "catch-up effect" observed in linguistic and cognitive functioning. Discrete emotions analysis of attachment groups yielded differentiation along a broad negative/positive dimension, but it also showed that insecurely attached children can be characterized as showing inhibited anger expression. The results of this study are discussed within the framework of organizational models of infant affective development; attachment theory and discrete emotions approaches were found to yield different yet equally informative data on the course of socioemotional development. PMID- 2770756 TI - Effects of active oxygen species on the genetic apparatus. PMID- 2770757 TI - Microsome-mediated clastogenicity of butylated hydroxyanisole (BHA) in cultured Chinese hamster ovary cells: the possible role of reactive oxygen species. AB - Butylated hydroxyanisole (BHA) was found to induce chromosome aberrations in Chinese hamster ovary (CHO) cells in the presence of Aroclor-induced rat-liver S9. The effects were more marked when washed microsomes were employed and chromosome damage was considerably reduced in the presence of catalase, suggesting that hydrogen peroxide was involved. Stimulation of H2O2 production by BHA in S9 or microsome incubation mixtures was demonstrated using the catalase mediated production of formaldehyde from methanol. One of the major microsomal metabolites of BHA, tert.-butyl hydroquinone (t-BHQ), which autoxidises in solution producing H2O2 also induced extensive catalase-sensitive chromosome damage in the absence of metabolic activation. These observations suggest that extracellular generation of reactive oxygen species may be implicated in the mechanism of BHA clastogenicity in vitro. However, chromosome damage was not completely abolished by catalase and the end product of t-BHQ oxidation, tert. butyl quinone, was also weakly clastogenic, suggesting that intracellular effects of quinone metabolites may also be involved in the clastogenicity of BHA. PMID- 2770758 TI - Is lipid peroxidation associated with DNA damage? AB - Specific binding to DNA of lipid peroxidation products was studied in rat hepatocytes labeled with [14C(U)]arachidonic acid after incubation at 37 degrees C either in the absence or in the presence of 200 microM FeSO4. The results obtained show that: (1) production of malondialdehyde-like thiobarbituric reactive substances occurred in the absence of FeSO4 and was increased, albeit quite variably, by exposure to this pro-oxidant; (2) a low but appreciable binding of radioactivity to DNA and protein was constantly detected in 5 independent experiments; (3) there was no quantitative correlation between malondialdehyde formation and the amount of DNA-bound and protein-bound radioactivity, and any meaningful evidence of a GSH-depletion effect was absent. Taking into account the possible biosynthetic incorporation of radioactivity into DNA, the results of this study must be interpreted with caution, and solely as indicating that in the intact cell the covalent binding to DNA of reactive species generated by lipid peroxidation, if it occurs, should be minimal, corresponding in our experimental conditions approximately to 0.01 mumole of radioactive arachidonic acid per mole nucleotides. PMID- 2770759 TI - The protective effects of L-ascorbic acid and DL-alpha-tocopherol on cultured rat embryos treated with xanthine/xanthine oxidase. AB - Abnormalities of the neural suture were observed in cultured rat embryos exposed to oxygen radicals generated by xanthine and xanthine oxidase. The distribution of the severity of these abnormalities was altered by the addition of L-ascorbic acid (AA) or DL-alpha-tocopherol (AT). The antioxidant effect of AA and AT were probably responsible for the protection of the embryos from the damaging effects of oxygen radicals. PMID- 2770760 TI - Studies on the ability of smoke from different types of cigarettes to induce DNA single-strand breaks in cultured human cells. AB - In this paper we report preliminary studies using alkaline elution to examine the incidence of DNA-strand breakage in human lung cells exposed to smoke/phosphate buffered saline generated from cigarettes of different tar contents and filter status. The majority of the DNA breaks induced were abolished by catalase indicating a role for active oxygen species. The incidence of breaks did not correlate with the tar content of the cigarettes. The presence of a filter in the cigarette reduced the TPM concentration of the mainstream smoke but did not reduce the number of single-strand breaks occurring in DNA after exposure to smoke/PBS. This last parameter was however reduced if the filter was ventilated. PMID- 2770761 TI - Effects of lethal exposure to hyperoxia and to hydrogen peroxide on NAD(H) and ATP pools in Chinese hamster ovary cells. AB - Cell death by oxidative stress has been proposed to be based on suicidal NAD depletion, typically followed by ATP depletion, caused by the NAD-consuming enzyme poly(ADP)ribose polymerase, which becomes activated by the presence of excessive DNA-strand breaks. In this study NAD+, NADH and ATP levels as well as DNA-strand breaks (assayed by alkaline elution) were determined in Chinese hamster ovary (CHO) cells treated with either H2O2 or hyperoxia to a level of more than 80% clonogenic cell killing. With H2O2 extensive DNA damage and NAD depletion were observed, while at a higher H2O2 dosage ATP also became depleted. In agreement with results of others, the poly(ADP)ribose polymerase inhibitor 3 aminobenzamide completely prevented NAD depletion. However, both H2O2-induced ATP depletion and cell killing were unaffected by the inhibitor, suggesting that ATP depletion may be a more critical factor than NAD depletion in H2O2-induced killing of CHO cells. With hyperoxia, only moderate DNA damage (2 X background) and no NAD depletion were observed, whereas ATP became largely (70%) depleted. We conclude that (1) there is no direct relation between ATP and NAD depletion in CHO cells subjected to toxic doses of H2O2 or hyperoxia; (2) H2O2-induced NAD depletion is not by itself sufficient to kill CHO cells; (3) killing of CHO cells by hyperoxia is not due to NAD depletion, but may be due to depletion of ATP. PMID- 2770762 TI - Mutagenic effects of TPA-induced clastogenic factor in Chinese hamster cells. AB - Previous work in our laboratory has shown that the clastogenic and SCE-inducing effects of 12-O-tetradecanoylphorbol 12-acetate (TPA) are mediated by secondary products formed by the cell in response to the tumor promoter. A low-molecular weight clastogenic factor (CF) was isolated from the medium of TPA-treated human leukocytes and caused chromosome aberrations and sister-chromatid exchanges (SCE) in fresh cultures not exposed to TPA itself. In the present study, we show that Chinese hamster fibroblasts (V79 cells) also produce CF when exposed to TPA. CF from V79 cells induced SCE not only in hamster cells, but also in human lymphocytes. Vice versa, CF from human leukocyte cultures induced SCE in hamster cells. It also increased the frequency of 6-thioguanine-resistant mutants in this cell system. All cyto- and geno-toxic effects of TPA-induced CF were prevented if the cells were treated with superoxide dismutase before exposure. The lipophilic CF seems to be derived from arachidonic acid of cell membranes released as a consequence of oxidative damage and subsequently degraded to genotoxic aldehydes in an autoxidative process. CF is formed only under culture conditions with low antioxidant content in culture media and sera. This may explain the discordant results obtained by different laboratories with regard to the genotoxic effects of TPA. PMID- 2770763 TI - Identification of 4 ataxia telangiectasia cell lines hypersensitive to gamma irradiation but not to hydrogen peroxide. AB - The effect of hydrogen peroxide on the rate of semi-conservative DNA synthesis in ataxia telangiectasia (AT) and normal human lymphoblastoid cells was investigated. The rate of DNA synthesis in AT cells was not depressed to a lesser extent than in normal cells, as might have been expected since H2O2 is a radiomimetic agent. On the contrary, 4 AT cell lines displayed a higher sensitivity to the inhibitory effect of H2O2 on DNA synthesis than 2 normal cell lines. Comparable levels of cytotoxicity were detected in cell viability studies. Furthermore, neither the level of DNA breakage produced by H2O2, nor the rate of repair of these lesions was significantly different in normal and AT cells. Together, these results indicate that the AT cell lines utilized in this study are not hypersensitive to the oxidant. It is suggested that H2O2 may not induce lethality via the direct action of the hydroxyl radical (OH.). PMID- 2770764 TI - Xeroderma pigmentosum complementation group XP-I withdrawn. PMID- 2770766 TI - Decreased stable transfection frequencies of six X-ray-sensitive CHO strains, all members of the xrs complementation group. AB - Six X-ray-sensitive strains (xrs) of the Chinese hamster ovary (CHO) cell line, all of which have a defect in double-strand break (dsb) rejoining, have been investigated for their proficiency in DNA transfection assays. All 6 strains and clonal isolates derived from them, show a decreased stable transfection frequency using the plasmids pSV2neo and pSV2gpt after transfection by either the CaPh method or the polybrene method. The magnitude of this effect is DNA concentration dependent and is more marked after transfection with higher DNA concentrations (5 20 micrograms DNA). A spontaneous X-ray-resistant reactivant (or revertant) of one xrs strain also acquired the elevated transfection frequency of the wild-type strain providing evidence for a causal relationship between the decreased transfection frequency and the xrs phenotype. In contrast, the strains show no defect when transfection is assayed using a transient transfection system. Since the transient transfection assay only depends on the uptake and transcriptional activity of foreign DNA, and does not necessitate DNA integration, this suggests that the xrs strains do not have a defect in the uptake of foreign DNA, but might have a defect in integration or the processing of DNA molecules prior to integration. PMID- 2770765 TI - Poly(ADP-ribose) catabolism in mammalian cells exposed to DNA-damaging agents. AB - DNA damage inflicted by the alkylating agent N-methyl-N'-nitro-N nitrosoguanidine, or by UV254nm, stimulated the catabolism of protein-bound poly(ADP-ribose) in the chromatin of cultured hepatocytes. The stimulation was highest at the largest doses of DNA-damaging treatment. As a consequence, the half-life of ADP-ribosyl polymers may drop to less than 41 s. This rapid turnover contrasts with the slow catabolism of a constitutive fraction of polymers exhibiting a half-life of 7.7 h. Our data suggest that post-incisional stimulation of poly(ADP-ribose) biosynthesis in DNA-excision repair is coupled with an adaptation of poly(ADP-ribose) catabolism in mammalian cells. PMID- 2770767 TI - Effects of UV light on DNA chain growth and replicon initiation in human cells. AB - Exposure of mammalian cells to 254 nm UV light produces lesions that block DNA polymerases at least on the leading strand. For rodent cells the extent and duration of this blockage is both cell line- and fluence-dependent. Using DNA fiber autoradiography we report here similar findings for human cells. Wild-type human cells did not exhibit significant blockage following exposure to 2.5 J/m2. After exposure to 5.0 J/m2, there was significant blockage immediately after exposure, but by 5 h segment lengths returned to control values. Excision deficient human cells, on the other hand, exhibited significant blockage both immediately and 5.0 h after exposure to 2.5 J/m2. Exposure of rodent cells to UV light is also known to activate alternative sites of replication. Such activation would enable cells to replicate areas of DNA which do not contain a 'normal' site of initiation, yet contain blocking lesions both upstream and downstream. We have previously shown (Griffiths and Ling, 1987) that this activation is more pronounced and long-lived in excision-deficient Chinese hamster ovary (CHO) cells than it is in wild-type CHO cells. We report here that excision-deficient human cells also exhibited a marked and prolonged activation of alternative sites of replicon initiation. Wild-type human cells, on the other hand, exhibited little if any activation. PMID- 2770768 TI - Clonal chromosome rearrangements in a fibroblast strain from a patient affected by xeroderma pigmentosum (complementation group C). AB - We report the results of DNA repair studies and cytogenetic investigations in a patient presenting acute phothosensitivity and cancerous skin lesions. In lymphocytes and fibroblasts a reduced level of unscheduled DNA synthesis after UV irradiation was found and the presence of xeroderma pigmentosum, complementation group C, mutation was demonstrated by complementation analysis. In lymphocyte and fibroblast cultures the frequency of spontaneous chromosome gaps and breaks was normal, whereas the frequency of chromosome rearrangements was higher than expected. In fibroblasts from the 4th to the 18th passage of the culture, 4 reciprocal translocations with a clonal distribution were identified. The rearranged chromosomes were Nos. 2, 13, 14 and 15, Nos. 2 and 13 being both involved in 3 different translocations with breakpoints at 2q21, 2q31, 2p23 and 13q31, 13q12 or 3. The biological significance of this finding is discussed in view of a possible correlation with the DNA repair defect and a possible relevance in tumor development of specific chromosome rearrangements. PMID- 2770769 TI - Heat shock mRNA in mouse epidermis after UV irradiation. AB - Total RNA from murine epidermis was extracted at different times after irradiation with erythemogenic doses of ultraviolet light (UVB or UVB/UVA) and hybridized to a DNA probe from the gene of a heat shock protein (hsp 70). An intense and transitory enrichment in RNA molecules hybridizing to the DNA probe was found between 15 and 120 min after irradiation, followed by a return to control levels over the next 70 h. Dose-response analysis indicates that 30 min after the irradiation, the relative amount of RNA hybridizing to the hsp 70 DNA probe increases with the dose (within the range explored: 0-180 mJ/cm2) up to values greater than 5 times the control. PMID- 2770770 TI - Chromosomal instability and progressive loss of chromosomes in HeLa cells during adaptation to hyperoxic growth conditions. AB - By sequential selection for resistance to stepwise increased levels of atmospheric O2, a genetic variant of HeLa cells was obtained capable of stable proliferation under an atmosphere containing 80% O2 (HeLa-80). This cell strain has previously been characterized in terms of growth characteristics, morphology and antioxidant status (Joenje et al., 1985). In an attempt to find cytogenetic clues possibly related to the O2-tolerant character, metaphases of HeLa-80 cells were analyzed and compared to the parental (HeLa-20) strain. Numerical analysis revealed a progressive decrease in the number of chromosomes per cell during selection for O2 resistance, from a modal number of 112 in HeLa-20 cells to 84 in HeLa-80 cells. Cytogenetic endpoints for genetic damage revealed increased frequencies in HeLa-80 cells of both chromosomal aberrations (29.7 versus 6.9% aberrant cells) and sister-chromatid exchanges (0.46 +/- 0.13 versus 0.31 +/- 0.10 SCE/chromosome). G-banded metaphases failed to reveal cytogenetic evidence of gene amplification (homogeneously staining regions, double minutes) in the karyotype of HeLa-80 cells. PMID- 2770771 TI - DNA damage and repair in female C57BL/10 mice of different ages injected with the carcinogen benzo[a]pyrene-trans-7,8-diol. AB - Female C57BL/10 mice 2 and 14 months of age were killed 3, 6, 9, 12, 18 and 24 h after injection with 0.4 mg of benzo[a]pyrene-trans-7,8-dihydrodiol. The amount of carcinogen bound to DNA isolated from liver and kidney of each mouse was determined as benzo[a]pyrene-7,8,9,10-tetrol liberated upon acid hydrolysis of the DNA and measured by synchronous scanning fluorometry. Considerable variability was observed and a subset of animals in the middle-aged group failed to sustain appreciable damage upon injection of the carcinogen. Nevertheless, repair of DNA-bound carcinogen from both the liver and kidney of 2-month-old animals was clearly evident. In the subset of 14-month-old animals who sustained damage, evidence for removal of DNA-bound carcinogen was marginal. PMID- 2770773 TI - In vivo cytogenetic effects of cooked food mutagens. AB - Using a variety of in vivo cytogenetic endpoints, we have investigated the effects of several compounds formed during the cooking of meat. C57Bl/6 mice were used to test for an increase in the frequency of sister-chromatid exchanges (SCEs), chromosomal aberrations, and micronucleated erythrocytes by 2-amino-3,8 dimethylimidazo[4,5-f]quinoxaline (MeIQx). 2-amino-3,4,8-trimethylimidazo[4,5 f]quinoxaline (DiMeIQx), and 2-amino-1-methyl-6-phenylimidazo[4,5-b]pyridine (PhIP). MeIQx and DiMeIQx did not induce SCEs in mouse bone marrow cells. PhIP induced sister-chromatid exchanges, but not chromosomal aberrations in bone marrow. In peripheral blood lymphocytes, PhIP did induce aberrations at 100 mg/kg, the highest dose tested. PhIP induced a low but significantly increased frequency of micronuclei in normochromatic but not polychromatic erythrocytes in bone marrow and peripheral blood. However, dose responses were not observed. With the exception of the SCEs induced by PhIP, these results contrast with observations made in vitro, where these compounds were found to have significant genotoxicity in mammalian cells and a very high mutation frequency in prokaryotic systems. PMID- 2770772 TI - Decreased DNA repair in familial Alzheimer's disease. AB - Alterations in the capacity of a cell to repair DNA lesions play an important role in a number of human diseases. We and others have demonstrated defective DNA repair of alkylation damage in cells from patients with Alzheimer's disease. It has been hypothesized that this defect is related to the cause of Alzheimer's disease and results in the accumulation of lesions in the central nervous system neurons. One prediction of this hypothesis is that in dominantly inherited Alzheimer's disease, the repair defect will be present in half of the offspring of affected patients long before they develop symptoms of the disease. In order to test the hypothesis that decreased DNA repair is responsible for familial Alzheimer's disease and their at-risk offspring we have studied DNA repair in these individuals after exposure of lymphoblasts to alkylating agents. Our results indicate that cell lines from affected patients repair significantly less damage in 3 h than cell lines from healthy controls. A small number of at-risk individuals were also studied and some of these had lower levels of repair, although more cell lines from individuals in this group must be studied. These findings provide further support for defective DNA repair playing a role in the pathogenesis of Alzheimer's disease. PMID- 2770774 TI - Effect of tetrandrine on micronucleus formation and sister-chromatid exchange in both in vitro and in vivo assays. AB - The genotoxicity of tetrandrine, a drug potentially useful for the treatment of silicosis, was studied using the micronucleus and the sister-chromatid exchange (SCE) assay systems. Cultured Chinese hamster lung (V79) cells were used for the in vitro micronucleus and sister-chromatid exchange studies. Mouse bone marrow was used for the in vivo micronucleus assay and mouse spleen cells for the in vivo/in vitro sister-chromatid exchange analysis. The results show that SCE levels in V79 and in spleen cells were significantly elevated by treatment with tetrandrine at doses above 0.08 mg/ml and 100 mg/kg bw, respectively. Increased tetradrine-induced SCE in vitro was metabolic activation dependent. Tetrandrine failed to induce micronuclei at any of the doses tested. A decrease of replicative index with an increase in the concentration of tetrandrine was found both in vitro and in vivo. These results indicate that tetrandrine is a weak indirect-acting genotoxicant. PMID- 2770775 TI - Lack of sister-chromatid exchange induction by polymethyl methacrylate bone cement in human lymphocytes cultured in vitro. AB - Human lymphocytes cultured in vitro were used to assess the ability of polymethyl methacrylate (PMMA), currently used in orthopedic surgery as bone cement, to induce sister-chromatid exchanges (SCE). Under the conditions used in this study, PMMA bone cement did not produce any significant increase in SCEs in phytohemagglutinin-stimulated human lymphocytes. However, a significant decline (p less than 0.05) in the proliferation rate index was observed, which might be an indicator of the cytotoxic effect of PMMA. PMID- 2770776 TI - Solar and UVC-induced mutation in human cells and inhibition by deoxynucleosides. AB - Optimum conditions were established for quantitating the induction of hypoxanthine guanine phosphoribosyl transferase-deficient (HGPRT-) mutants in HeLa cells and in a human amelanotic melanoma cell line (MM96L). Compared at a fluence of equal toxicity (D37, fluence required to decrease cell survival to 37% of unirradiated control), noon sunlight in summer was slightly more mutagenic in MM96L than in HeLa cells (17 and 12 HGPRT- mutants per 10(6) survivors respectively). UVC (predominantly 254 nm) exhibited similar mutagenicity as equitoxic sunlight in HeLa but was 8-fold more effective in MM96L than equitoxic sunlight. Addition of a mixture of deoxyguanosine (20 microM), deoxyadenosine (20 microM), deoxycytidine (100 microM) and thymidine (20 microM) to the culture medium during the 7-day expression period following irradiation gave a 3-fold reduction in the UVC-induced mutation frequency of MM96L but not HeLa cells. The results suggest that these melanocytic cells are highly susceptible to mutagenesis by short wavelength UV, in a mechanism sensitive to deoxynucleosides. PMID- 2770777 TI - Effect of processing time on the quality of mouse bone-marrow metaphase preparations. AB - To evaluate the effect of extended incubation in phosphate-buffered saline (PBS) on the quality of mouse bone-marrow metaphase preparations, bone-marrow samples were allowed to stand in PBS at room temperature for from 15 min to 3 h before hypotonic treatment and fixation. The frequencies of sister-chromatid exchanges, the rate of cellular proliferation and the mitotic indices in these mice were not significantly affected by prolonged storage in PBS. However, slide quality decreased significantly in bone-marrow samples stored in PBS for more than 2 h. These data demonstrate that the storage of bone-marrow samples in PBS at room temperature for at least 1 h does not adversely affect the quality of routine cytogenetic data, making it more feasible to conduct studies involving large numbers of animals. PMID- 2770779 TI - Muscle pain associated with tubular aggregates and structures resembling cylindrical spirals. AB - A 42-year-old man complained of muscle pain in the legs and episodes of left sided limb weakness. Light microscopy of his quadriceps muscle showed abundant subsarcolemmal accumulations with typical histochemical features for tubular aggregates. Electron microscopy showed areas filled with tubular aggregates and vesicular profiles. Scattered within some of the tubular aggregates circular profiles reminiscent of cylindrical spirals were seen. The presence of structures resembling cylindrical spirals within tubular aggregates suggest that they may arise from a component of the sarcoplasmic reticulum. There appears to be an intimate relationship between myalgia and these various types of abnormal membranous profiles; however, the pathophysiology remains to be elucidated. PMID- 2770778 TI - Sural nerve biopsy in chronic inflammatory demyelinating polyradiculoneuropathy. AB - We compared histologic features of sural nerve biopsies in 14 patients with chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) with those in other forms of neuropathy. In CIDP endoneurial pericapillary cellular infiltrates were found in 4 patients (29%), onion bulbs in 5 patients (36%), and predominant demyelination in 7 patients (50%). None of these abnormalities was specific, but cellular infiltrates and onion bulbs appear to be diagnostically useful when combined with clinical information. To detect macrophage infiltration of myelin, cell nuclei were counter-stained in 20 teased fiber preparations. Nine patients with CIDP had a significantly higher mean number of cells per centimeter of teased fiber than 11 patients with other neuropathies. Despite overlap, significant infiltration of myelin detected by this method suggests CIDP in an appropriate clinical setting. PMID- 2770780 TI - Proteins of muscle subcellular fractions in Duchenne progressive muscular dystrophy stained with "stains-all" cationic carbocyanine dye and with Coomassie Blue. AB - The protein compositions of subcellular fractions of muscle obtained from 17 Duchenne dystrophy patients, 15 disease controls (10 different primary myopathies, 5 spinal muscular atrophy patients), and 10 normals were examined by polyacrylamide gel electrophoresis. The gels were stained with Coomassie Brilliant Blue and with "Stains-all," which stains calcium-binding proteins, sialic acid-rich glycoproteins, and phosphoproteins. In muscle membrane fractions of Duchenne dystrophy patients there was a marked reduction in the concentrations of calsequestrin and a 39 kDa protein that stained blue with "Stains-all." There were changes in the proteins of all subcellular fractions of Duchenne's patients; some of these changes appear to be specific for Duchenne dystrophy (DD). There was no apparent correlation between the protein changes observed on acrylamide gels and the age of the patients, the duration of the disease, the degree of disability, or activity of creatine kinase. A decreased level of calsequestrin in DD sarcoplasmic reticulum may contribute to an increased level of free calcium seen in muscle from these patients. PMID- 2770781 TI - Principal component analysis of the features of concentric needle EMG motor unit action potentials. AB - Motor unit action potentials (MUAPs) were recorded from the biceps muscle of normal subjects and of patients with nerve or muscle diseases. Principal component analysis of the MUAP amplitude, area, area/amplitude ratio, duration, and the number of turns and phases produced three components that among them contained 90% of the variance of the data set. Thus the dimensionality of data was reduced from six to three. The first component reflected changes in the size of the MU, whereas the second reflected variations in the arrival time at the recording electrode of the action potentials of muscle fibers in the motor unit. The third factor reflected local loss of muscle fibers within the MU territory. Patterns of variations in the three components were different in patients with neuropathy and myopathy. PMID- 2770782 TI - Studies of water permeability and proteins of erythrocyte membranes in patients with Duchenne muscular dystrophy. AB - The characteristics of water permeability of erythrocytes from 54 Duchenne muscular dystrophy (DMD) patients and age-matched controls have been determined by a pulse nuclear magnetic resonance (NMR) technique. A decreased permeability of erythrocyte membrane in DMD was definitely found at all temperatures between 15 and 42 degrees C, with normal values for the activation energy of water diffusion. No differences between DMD and control subjects in the pattern of erythrocyte membrane polypeptides separated by two-dimensional electrophoresis could be detected. The findings are discussed in relation to the molecular mechanisms of water diffusion across erythrocyte membrane and the problem of erythrocyte membrane abnormalities in DMD. A new interpretation of erythrocyte membrane alterations is proposed based on the recent findings regarding the molecular pathology of DMD. PMID- 2770783 TI - The application of nerve conduction and clinical studies to genetic counseling in hereditary motor and sensory neuropathy type I. AB - One hundred and thirty two individuals at risk for hereditary motor and sensory neuropathy (HMSN) type I from 11 unrelated families were evaluated by physical examination. Motor conduction velocity (MCV) studies of median and/or peroneal nerves were performed on 99 of them. Seventy-three subjects were found to be affected. In all age categories including the first decade of life, the ratio of affected individuals at risk did not significantly differ from the expected 1:1 ratio; that is, penetrance of the gene was complete. The majority of affected members in the first decade had no clinical features considered diagnostic of peroneal muscular atrophy syndrome, and full clinical expression developed in the second decade. Marked slowing of MCV was already present in the early years of life, even as young as 6 months. Moreover serial MCV studies carried out throughout the first year of life in an affected girl showed no physiological increase in conduction velocity. For purposes of genetic counseling, our experience suggests that, starting from 6 months of age, a clinically and electrophysiologically normal subject has a zero risk of having inherited the HMSN type I gene. However given the limited numbers in this series, infants at risk with normal clinical evaluation and MCVs should be followed up yearly up to 5 years of age. PMID- 2770784 TI - Delayed-onset muscle damage and lipid peroxidation in man after a downhill run. AB - Lipid peroxidation initiated by free radical reactions is associated with tissue necrosis in a variety of conditions. We have measured serum lipid peroxide concentrations (as total thiobarbituric acid-reactive substances, TBARS) and creatine kinase (CK), lactate dehydrogenase (LDH), and aspartate aminotransferase (AST) activities and subjective muscle soreness in 16 men before and after a 45 minute downhill treadmill run. TBARS concentrations and enzyme activities were increased after exercise, with peak values observed at 6 hours (TBARS, LDH) or 24 hours (CK, AST) after exercise. Serum LDH activity returned to preexercise levels by 48 hours after exercise and TBARS by 72 hours after exercise: CK and AST activities remained elevated 72 hours after exercise. Leg muscle soreness also increased, with the greatest degree of soreness seen at 24 or 48 hours after exercise. Subjects with the greatest increase in CK, LDH, and AST also showed the highest serum TBARS concentration. This suggests a possible relationship between free radical generation and exercise-induced muscle damage. PMID- 2770785 TI - Nondystrophic myoblast transplantation into dystrophic muscle. PMID- 2770786 TI - Thiol proteases released in vitro by Fasciola hepatica. AB - Immature Fasciola hepatica release 11 distinct proteases when cultured in vitro for 16 h as revealed by gelatin-substrate sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE). Six of these proteases are active in the pH range 4.5 to 8.0. Five are acid proteases, being most active in the pH range 3.0 to 4.5. The majority of proteases released in vitro by immature flukes are also released by mature flukes; however, a 40-kDa protease released by immature flukes is a very minor protease released by mature flukes. The activity of all proteases is inhibited by leupeptin, L-trans-epoxysuccinyl-leucylamido(4-guanidino)butane, phenylmethylsulfonyl fluoride and iodoacetamide and enhanced or stabilized by the reducing agents cysteine and dithiothreitol. Therefore, all F. hepatica in vitro released proteases identified by gelatin-substrate SDS-PAGE are thiol proteases. PMID- 2770788 TI - Chromosome size and number polymorphisms in Leishmania infantum suggest amplification/deletion and possible genetic exchange. AB - We have studied the molecular karyotypes of 21 strains and 14 clones of Leishmania infantum using pulsed field gel electrophoresis (PFGE). We detected a high degree of polymorphism within this species, with 'strain-specific' patterns for most isolates, even within a restricted endemic area. Variations relate to both the size of chromosomes (270-2600 kb) and their number, which can vary from 24 to 31 between closely related isolates. This polymorphism does not correlate with isoenzyme analysis. Small size variations between homologous chromosomes of different strains are suggestive of DNA amplification/deletion events. Strains are also shown to be multiclonal, with slight differences between most clones, but with a predominant clone concealing the others in PFGE analysis. The analysis of these data leads to the hypothesis of occasional genetic exchange by nuclear fusion in Leishmania, as recently shown in the related protozoan Trypanosoma brucei. PMID- 2770787 TI - Major sperm protein genes from Onchocerca volvulus. AB - Nematode spermatozoa, unlike their mammalian counterparts, are nonflagellated crawling cells. The pseudopod of these cells contains the major sperm protein (MSP) which comprises more than 15% of the protein in the sperm. MSP is presumed to function as a cytoskeletal element involved in motility. An Ascaris MSP cDNA sequence was used as a probe to identify and isolate Onchocerca volvulus MSP clones from a lambda gt11 genomic library. Two clones, OVGS-1 (765 bp) and OVGS-2 (1765 bp), were characterized by restriction endonuclease mapping and sequence analysis. Both genomic clones contain MSP protein coding regions of 99 and 282 bp separated by an intervening sequence of 153 bp. The genes OVGS-1 and OVGS-2 are 95% similar in nucleotide sequence in the protein coding regions, but only 79% similar in their intron sequences. A number of potential regulatory sequences in the flanking regions and at the exon/intron junctions of the O. volvulus MSP genes are in good agreement with consensus sequences in other eukaryotic cells. The nucleotide sequence of the O. volvulus MSP genes were over 80% similar to the Ascaris MSP cDNA sequence and 79% similar to the Caenorhabditis MSP-3 cDNA. The predicted amino acid sequence of the O. volvulus MSPs were 96% similar to each other, 90-91% similar to Ascaris MSP and 81-82% similar to Caenorhabditis MSP-3. These results offer evidence that the MSP sequences have been highly conserved throughout nematode evolution but are variable in their genomic organization and the presence of introns. PMID- 2770789 TI - Purification of cytosolic glutathione transferases from Schistocephalus solidus (plerocercoid): interaction with anthelmintics and products of lipid peroxidation. AB - Glutathione (GSH) transferase isoenzymes have been partially resolved from the cytosol of Schistocephalus solidus (plerocercoid) by GSH affinity chromatography and chromatofocusing at pH 7-5. The presence of isomeric forms was also suggested by analytical isoelectric focusing and high-performance liquid chromatography (HPLC). Gel filtration and sodium dodecyl sulphate-polyacrylamide gel electrophoresis indicated that GSH transferase forms were dimers with a subunit size of approximately 24 kDa. The major GSH transferase form in S. solidus (plerocercoid) showed greater biochemical relationship to the Mu family of mammalian GSH transferase compared to the mammalian Alpha or Pi families. The major subunit purified by GSH affinity chromatography and reversed-phase HPLC also showed high N-terminal homology with the Mu family. A minor GSH transferase form appeared more biochemically related to the Alpha family with respect to substrate specificity and inhibitor sensitivity. The major GSH transferase was inhibited by haematin-related compounds, bile acids and a number of anthelmintics including members of the benzimidazole and phenol-based class of compounds. The major GSH transferase had conjugating activity with members of the trans, trans 2,4-alkadienal and trans-2-alkenal series, secondary products of lipid peroxidation. PMID- 2770790 TI - Sequence of a cDNA for the ND1 gene from Leishmania major: potential uridine addition in the polyadenosine tail. PMID- 2770791 TI - Renal disease in children with the acquired immunodeficiency syndrome. AB - Of 155 children with the acquired immunodeficiency syndrome (AIDS) whom we evaluated during a 6 1/2-year period, 12 were found to have proteinuria. Histologic studies of tissue from these 12 patients revealed a wide spectrum of renal disease: focal glomerulosclerosis in 5, mesangial hyperplasia in 5, segmental necrotizing glomerulonephritis in 1, and minimal change disease in 1. In addition, 6 had tubulointerstitial infiltrates, and 10 had glomerular dense deposits. All 10 renal specimens studied by electron microscopy contained endothelial tubuloreticular inclusions. The mean age (+/- SD) of the five patients with focal glomerulosclerosis when this condition was identified was 27 +/- 19 months. All five had severe renal failure within a year and died of other causes during the following year. The mean age of the five patients with mesangial hyperplasia was 38 +/- 31 months. Although none of them went on to have renal failure, four died within 8 +/- 7 months. Ten of the 12 patients with proteinuria died during the study period. Of the two surviving, one had mesangial hyperplasia and the other had minimal change disease. We conclude that children who acquire human immunodeficiency virus (HIV) infection during the perinatal period may have renal disease, most often focal glomerulosclerosis, as is the case in adults, or mesangial hyperplasia. Although 5 of the 12 children we studied had renal failure during the study period, none died of it. Further studies are needed to determine the correlations between clinical and pathological features and the pathophysiology of AIDS nephropathy in children. PMID- 2770792 TI - Demonstration of an adhering-junction molecule (plakoglobin) in the autoantigens of pemphigus foliaceus and pemphigus vulgaris. AB - Pemphigus foliaceus and pemphigus vulgaris are skin diseases in which antibodies against the cell surface of keratinocytes destroy the adhesion between epidermal cells, producing blisters. Patients with pemphigus foliaceus have antibodies to a complex of three polypeptides of 260, 160, and 85 kd (the foliaceus complex), whereas patients with pemphigus vulgaris have antibodies to a complex of 210-kd, 130-kd, and 85-kd polypeptides (the vulgaris complex). The 160-kd polypeptide of the foliaceus complex has been identified as desmoglein, a desmosomal glycoprotein. We suspected that the 85-kd component in both these antigenic complexes might be plakoglobin, another molecule in the adhering junctions of cells. To characterize these antigenic complexes, we used the serum of five patients with pemphigus foliaceus, that of four patients with pemphigus vulgaris, and monoclonal antiplakoglobin antibodies. We found that monoclonal antibodies to plakoglobin immunoprecipitated the 85-kd polypeptide from the dissociated foliaceus and vulgaris complexes and precipitated both complexes from epidermal extracts. Serum from patients with pemphigus foliaceus or pemphigus vulgaris (but not from four normal controls) bound desmoglein and the 130-kd polypeptide, respectively, showing that these peptides (and not plakoglobin) are the antigenic binding sites in these disorders. We conclude that plakoglobin, a protein of the adhering junctions of epidermal cells, is the 85-kd molecule in the antigenic complexes found in both pemphigus foliaceus and pemphigus vulgaris, although it is not the binding site in either disorder. PMID- 2770794 TI - Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 36-1989. A 34-year-old Jamaican man with fever, hepatic failure, diarrhea, and a progressive gait disorder. PMID- 2770793 TI - Genetic variants of chronic granulomatous disease: prevalence of deficiencies of two cytosolic components of the NADPH oxidase system. AB - Chronic granulomatous disease, a syndrome of recurrent infections and failure of oxidative microbicidal activity in phagocytes, results from defects in the gene for one of several components of an oxidase system that can undergo activation. To determine the relative prevalence of certain of the genetic variants of this disorder, we used immunoblotting to detect two specific neutrophil cytosolic proteins of 47 and 67 kd recently shown to be required for oxidase activation. Chronic granulomatous disease is usually an X-linked disorder associated with the absence of membrane cytochrome b558. Of our 94 patients with chronic granulomatous disease, however, 36 had a phenotype characterized by autosomal inheritance, normal membrane oxidase components (including cytochrome b558), and functionally defective cytosolic activity in a cell-free oxidase system. We studied 25 of these 36 patients and found that 22 lacked the 47-kd cytosolic protein, and the remaining 3 were missing the 67-kd component. Patients with chronic granulomatous disease whose functional defect was localized to the neutrophil membrane (classic X-linked cytochrome b-negative type and two other rare variants) had normal amounts of both cytosolic components. We estimate that approximately 33 percent of all patients with chronic granulomatous disease are missing the 47-kd cytosolic oxidase component and about 5 percent of patients are missing the 67-kd component. Chronic granulomatous disease caused by a defect in any cytosolic factors other than the 47-kd and 67-kd proteins, if it exists, is apparently rare. PMID- 2770795 TI - Management of hypercholesterolemia. Are preventive interventions advisable? PMID- 2770796 TI - HIV infection and child abuse. PMID- 2770797 TI - Lumpectomy or total mastectomy for breast cancer. PMID- 2770798 TI - Generic carbamazepine and erythema multiforme: generic-drug nonequivalency. PMID- 2770799 TI - The right to health care. PMID- 2770800 TI - When a house officer gets AIDS. PMID- 2770801 TI - Urinary tract disorders in patients with chronic granulomatous disease. AB - Twelve of the 25 patients with chronic granulomatous disease treated at our institution between 1957 and 1987 were found to have urinary tract disorders. All 12 patients were male and 22 years of age or younger when chronic granulomatous disease was diagnosed. Six patients had hydroureteronephrosis in association with recurrent episodes of pyelonephritis, retroperitoneal lymphadenitis, and granuloma formation. The other six patients had genital lesions or dysuria. Among the six patients with hydroureteronephrosis, a nephrectomy was performed in two, ureterolysis was used to relieve obstruction in one, and hydroureteronephrosis resolved after antibiotic therapy alone in three. We conclude that complications involving the genitourinary system occur frequently in patients with chronic granulomatous disease. Periodic imaging of the urinary tract may detect asymptomatic hydroureteronephrosis or other treatable genitourinary abnormalities in these patients. PMID- 2770802 TI - Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 37-1989. A 60-year-old man with granulomatous interstitial nephritis followed by neurologic disease. PMID- 2770803 TI - When a uniquely effective drug is teratogenic: the case of isotretinoin. PMID- 2770804 TI - Recurrence of thyroid nodules after surgical removal in patients irradiated in childhood. PMID- 2770805 TI - Glomerular lesions and microalbuminuria in diabetes. PMID- 2770806 TI - Increase with age in the prevalence of beta-thalassemia trait among Sicilians. PMID- 2770807 TI - Concurrence of multiple sclerosis and inflammatory bowel disease. PMID- 2770808 TI - Economic incentives in clinical investigation. PMID- 2770809 TI - The incidence of ulcerative keratitis among users of daily-wear and extended-wear soft contact lenses. AB - The wearing of contact lenses has increased dramatically in the past decade; over 4 million people in the United States now use extended-wear soft contact lenses, and 9 million use daily-wear soft contact lenses. Numerous reports have caused concern that the use of soft contact lenses, especially extended-wear lenses, may result in a substantial risk of ulcerative keratitis. To examine this issue, we conducted a prospective study in five New England states to estimate the incidence of ulcerative keratitis among those who use cosmetic extended-wear and daily-wear soft contact lenses. To obtain the numerator for each estimate of incidence, we surveyed all practicing ophthalmologists in the study area to identify all new cases diagnosed over a four-month period. To provide the denominator, we conducted a survey of 4178 households to estimate the number of persons who wore each type of soft contact lens. The annualized incidence of ulcerative keratitis was estimated to be 20.9 per 10,000 persons using extended wear soft contact lenses for cosmetic purposes and 4.1 per 10,000 persons using daily-wear soft contact lenses for cosmetic purposes (P less than 0.00001). PMID- 2770811 TI - Contact lenses--convenience and complications. PMID- 2770810 TI - Inhibin as a marker for granulosa-cell tumors. AB - Inhibin is a peptide hormone normally produced by ovarian granulosa cells. It reaches a peak of 772 +/- 38 U per liter in the follicular phase of the menstrual cycle and is undetectable in the serum of menopausal women. To determine whether measurements of serum inhibin levels would provide a biochemical marker of the presence or progression of ovarian granulosa-cell tumors and their metastases, we measured the serum immunoreactive inhibin concentrations in six women with such tumors. Three women had been treated by hysterectomy and bilateral salpingo oophorectomy. In the two women with residual or recurrent disease, the serum inhibin levels were abnormally elevated 5 and 20 months before the clinical manifestations of recurrence became evident. The maximal concentrations approached 3000 U per liter. The serum inhibin level remained undetectable in one patient who was disease-free for 11 years. Serum inhibin concentrations were also elevated in three women with amenorrhea and infertility that resulted from small granulosa-cell tumors. After the removal of the tumors, the serum inhibin levels in these women became normal, and fertility returned. There was a significant negative correlation between the serum concentrations of inhibin and follicle stimulating hormone, in a manner consistent with the autonomous production of inhibin by granulosa-cell tumors. We conclude that granulosa-cell tumors produce inhibin. Since serum inhibin levels reflect the size of the tumor, measurements of inhibin can be used as a marker for primary as well as recurrent disease. PMID- 2770812 TI - Inhibin: from hypothesis to clinical application. PMID- 2770813 TI - How good is peer review? PMID- 2770814 TI - Controlling AIDS in Cuba. PMID- 2770815 TI - HIV infection in Brazil. PMID- 2770816 TI - Seroprevalence of human immunodeficiency virus among male prostitutes. PMID- 2770817 TI - Seizures after jogging. PMID- 2770818 TI - Ranitidine to prevent recurrence of duodenal ulcer. PMID- 2770819 TI - Fluoride content of bottled water. PMID- 2770820 TI - Rubber anaphylaxis. PMID- 2770821 TI - The Journal's peer-review process. PMID- 2770822 TI - Infection with Mycobacterium avium complex in patients without predisposing conditions. AB - Pulmonary disease caused by Mycobacterium avium complex usually occurs in patients with chronic lung disease or deficient cellular immunity, and its prevalence is increasing. We describe 21 patients (mean age, 66 years) with such infection without the usual predisposing factors, representing 18 percent of the 119 patients surveyed. Seventeen women and 4 men were given a diagnosis of M. avium complex from 1978 to 1987, with a stable incidence over the decade, on the basis of pulmonary symptoms, abnormalities on chest films, positive cultures, and in 14, biopsy evidence of invasive disease. Most of the patients (86 percent) presented with persistent cough and purulent sputum, usually without fever or weight loss. The cough was present for a mean of 25 weeks before the correct diagnosis was made. Radiographic patterns of slowly progressive nodular opacities predominated (71 percent); only five patients had cavitary disease at presentation. All patients responded initially to antimycobacterial therapy, but eight eventually relapsed when it was stopped. Four patients died of progressive pulmonary infection caused by M. avium complex. The extent of the initial pulmonary involvement was greater in patients with progressive disease than in those whose condition improved. We conclude that pulmonary disease caused by the M. avium complex can affect persons without predisposing conditions, particularly elderly women, and that recognition of this disease is often delayed because of its indolent nature. PMID- 2770823 TI - Risk factors for human immunodeficiency virus infection in intravenous drug users. AB - To identify risk factors for human immunodeficiency virus (HIV) infection in intravenous drug users, we undertook a study of the seroprevalence of HIV antibody in 452 persons enrolled in a methadone-treatment program in the Bronx, New York. The seroprevalence of HIV was 39.4 percent overall, 49.1 percent in blacks, 41.8 percent in Hispanics, and 17.2 percent in non-Hispanic whites (P less than 0.001 for all comparisons). The presence of HIV antibody was associated with the number of injections per month (P less than 0.001), the percentage of injections with used needles (P less than 0.001), the average number of injections with cocaine per month (P less than 0.001), and the percentage of injections with needles that were shared with strangers or acquaintances (P less than 0.001), a practice that was more common among blacks and Hispanics than among whites. The number of heterosexual sex partners who used intravenous drugs was associated with HIV infection in women (P less than 0.004) and was the only risk factor found for users who had not injected drugs after 1982 (P less than 0.05). The presence of HIV antibody was independently associated with being black or Hispanic (adjusted odds ratio, 4.56; 95 percent confidence interval, 2.65 to 8.14), a more recent year of the last injection of drugs (adjusted odds ratio, 1.24; 95 percent confidence interval, 1.13 to 1.35), the percentage of injections of drugs that took place in "shooting galleries" (adjusted odds ratio, 1.49; 95 percent confidence interval, 1.19 to 1.88), having sex partners who used intravenous drugs (adjusted odds ratio 1.24; 95 percent confidence interval, 1.06 to 1.45), and low income (adjusted odds ratio, 1.55; 95 percent confidence interval, 1.10 to 2.17). We conclude that differences in both the social setting of drug use and behavior related to injection carry different risks for infection with HIV and may explain, in part, the higher seroprevalence of HIV among blacks and Hispanics. In addition, we found that heterosexual activity was an independent risk factor for drug users. PMID- 2770824 TI - Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 39-1989. A 63-year-old woman with a polypoid nasal mass and a recent grand-mal seizure. PMID- 2770825 TI - Cyclosporine treatment for inflammatory bowel disease: a step backward or a leap forward? PMID- 2770826 TI - Mycobacterium avium complex and the normal host: the other side of the coin. PMID- 2770827 TI - Safe sushi. PMID- 2770828 TI - Dye-laser treatment of children with port-wine stains. PMID- 2770829 TI - Genetic factors in diabetic nephropathy. PMID- 2770830 TI - Monosomy 22 in rhabdoid or atypical teratoid tumors of the brain. PMID- 2770831 TI - Case 18-1989: bacterial endocarditis. PMID- 2770832 TI - Iliac-vein thrombosis after extracorporeal shock-wave lithotripsy. PMID- 2770833 TI - Hazards of smokable methamphetamine. PMID- 2770834 TI - The arrhythmia consultation program. PMID- 2770835 TI - Health care issues in presidential campaigns. PMID- 2770836 TI - Effects of zinc on macromolecular synthesis and nuclear division during the yeast to mycelium transition in Sporothrix schenckii. AB - Zinc ions (10 mM) have been reported previously to inhibit the yeast to mycelium transition in Sporothrix schenckii. Yeast cells of this fungus were harvested, selected by filtration and allowed to form germ tubes in a basal medium with glucose in the presence of 10 mM zinc and the effects of this ion on protein, RNA and DNA synthesis and nuclear division recorded. All of these processes were affected by the addition of 10 mM zinc to the medium. Nevertheless, the inhibition of protein synthesis was observed earlier than that of RNA or DNA synthesis and was of a greater magnitude than that observed for both of these processes. Protein synthesis was inhibited within the first hour after inoculation, at which time this process begins in the control cells. RNA synthesis was inhibited during the 3 to 6 h interval after inoculation, that is, 3 h after the start of this process in the control cells. After 9 h of incubation, the inhibition of protein synthesis had reached its maximum at 70%, while that of RNA synthesis was only 52%. DNA synthesis was slightly inhibited, with maximum inhibition being observed 9 h after inoculation. Nuclear division in cells forming germ tubes in the presence of 10 mM zinc took place with a 3 h delay in relation to the control cells. These observations suggest that the inhibition of protein synthesis might be the most important mechanism by which zinc inhibits the yeast to mycelium transition in S. schenckii. PMID- 2770837 TI - A new Papulaspora species from the infected eye of a horse: Papulaspora equi sp. nov. AB - An unusual fungus, probably traumatically introduced into the eye of a horse while grazing, was studied on various mycological media. Upon examination of colonies the organism produced bulbils and clearly exhibited the characteristics of a new species of Papulaspora, P. equi Shadomy & Dixon. PMID- 2770838 TI - Keratinophilic fungi isolated from Antarctic soil. AB - In the present study, 10 soil samples were collected aseptically from an equal number of areas of the Antarctic in the zone occupied by the 1986-1987 Italian expedition for research on keratinophilic fungi. Of particular interest was the isolation of a pathogenic fungus, Microsporum gypseum, from two sites in the base camp occupied by men and by skuas. Trichophyton terrestre was isolated from a site in which people worked and through which penguins and skuas passed. The most widespread fungal species were members of the genus Chrysosporium. Some of these species were isolated but not identified and this part of the study was still be completed. Another significant finding was the absence of fungi in one sample, while in another the widespread and abundant growth in all the seeded dishes of a single species of Chrysosporium. Other species in genera of general diffusion in many environments were also isolated: Aspergillus spp., Malbranchea sp., Mycelia sterilia spp., Paecilomyces sp., Penicillium spp. and Scopulariopsis spp. PMID- 2770839 TI - Isolation of keratinophilic fungi from floor dust in Arab elementary and preparatory schools in the West Bank of Jordan. AB - Floor dust collected from classrooms of thirty three elementary schools (16 for girls, and 17 for boys) (children aged 6-11), and twenty four preparatory schools (13 for girls, and 11 for boys) (children aged 12-14) was studied for the occurrence of keratinophilic fungi with respect to human presence and age of children. Tichophyton mentagrophytes was present in 15.4% of the preparatory schools for girls, in 12.5% of elementary schools for girls, and in 11.8% of elementary schools for boys. It was not found in preparatory schools for boys. Microsporum gypseum was found in preparatory schools for girls only (7.7%). Trichophyton terrestre was also only isolated from elementary schools for boys (5.9%). Chrysosporium species were present in 30.3% of all elementary schools (10 schools/33), and in 20.8% of all preparatory schools (5 schools/24). Geotrichum candidum was the most frequent and predominant keratinophilic species in all schools. Pathogenic and potentially pathogenic keratinophilic fungi comprised a large proportion of all fungal isolates recovered from all schools; they comprised 87.2%-89.5% of all fungal isolates in the elementary schools, and 90.4% 93.5% of all fungal isolates in preparatory schools. PMID- 2770841 TI - The outcome of head injuries: the Saudi experience. AB - One analysis of the outcome of 159 cases of head injuries was based on patients' admission Glasgow Coma Scale (GCS), score, age, CT scan findings and uniform protocol of management. Fifty-three percent of the patients were children below the age of 10 years and 70% of all patients were Saudis. Eighty-point-five percent (80.5%) of the patients had a GCS score of 8 or more and their outcome was favorable. By contract, the 19.5% who had an initial GCS score of 7 or less tended to be older and had a worse prognosis (mortality 68%). A high initial GCS score, old age, associated multiple injuries and a shift of more than 4 mm of the midline structures on CT scan of the brain are useful prognostic indices in predicting the outcome of head injury. PMID- 2770840 TI - Digestion of killed Paracoccidioides brasiliensis by neutrophils. AB - We previously described an in vitro assay showing that neutrophils (PMNs) from patients with paracoccidioidomycosis (PARA) have a specific digestive deficiency against suspensions of live Paracoccidioides brasiliensis. We now report that this defect is equally detectable against autoclaved, but not Amphotericin B killed P. brasiliensis. The use of autoclaved suspensions facilitates the use of our in vitro assay. It might allow the development of an in vitro intradermal test for digestion of fungi. Differential digestive ability of phagocytes against live (or autoclaved) and Amphotericin-B killed fungi is of conceptual interest. It may be relevant in understanding therapeutic effect of Amphotericin B. PMID- 2770843 TI - The psychosocial aspects of arthritis. PMID- 2770842 TI - Fate of aflatoxins in soybeans during the preparation of "Soyogi". PMID- 2770844 TI - Epidemiology of arthritis. PMID- 2770845 TI - Future trends in rheumatology. PMID- 2770846 TI - Harmful hospital practices in breast-feeding. PMID- 2770847 TI - [Stress management in everyday life]. AB - Most of the stress in a person's life is self-initiated and self-propagated. Hans Selye has stated that it is not what happens to you that matters, but how you handle it. Stress is part and parcel of our daily living and it is important that we should be conscious of our healthy stress level and prevent the unhealthy effects of a too high level of stress. Different types of stress management techniques are discussed and it is important to remember that not only one technique must be utilized. Every person should identify stressors in his life that are not beneficial to him and choose techniques of stress management that will have the most positive effect. PMID- 2770848 TI - AIDS--a current overview of AIDS and its impact on society. PMID- 2770850 TI - Wounds caused by weapons of war. Part II. PMID- 2770849 TI - [Creating an optimal learning environment]. AB - The charge sister, or first-line nursing manager, is the king pin in clinical teaching of the student. The teaching function of the ward sister is discussed with emphasis on the principles of guidance, leadership and motivation, which is essential for establishing an optimal learning environment. PMID- 2770851 TI - How valuable are vitamins? PMID- 2770852 TI - About radiotherapy. PMID- 2770853 TI - Infection risks in the re-use of disposables. PMID- 2770854 TI - Plant researchers eager for genome programme. PMID- 2770856 TI - Cell motility. Myosin linkage strengthened. PMID- 2770855 TI - Embryo ethics. Science ahead of the law. PMID- 2770857 TI - Cell division. Photoactive microtubule flux. PMID- 2770858 TI - Heart disease risks. PMID- 2770859 TI - Defective viruses and AIDS. PMID- 2770860 TI - The glass gene encodes a zinc-finger protein required by Drosophila photoreceptor cells. AB - Null mutations of glass specifically remove photoreceptor cells, leaving other cell types intact. We have isolated the glass gene and have shown that its transcript encodes a putative protein of 604 amino acids with five zinc-fingers. The glass product may be a transcription factor required for the development of a single neuronal cell type. PMID- 2770861 TI - Binding of myosin I to membrane lipids. AB - The single-headed myosins called myosin-I were first isolated from the protozoan Acanthamoeba and subsequently identified in other cells. We previously reported evidence that myosin-I is responsible for the movement of membranes, extracted from Acanthamoeba, along actin filaments in vitro. Here we show for the first time that myosin-I can bind directly to NaOH-extracted membranes isolated from Acanthamoeba and to vesicles of pure lipids with an affinity sufficient for extensive binding in the cell. Membrane-bound myosin-I may provide a mechanism for many cellular movements previously thought to involve filamentous myosin-II. PMID- 2770862 TI - Exon shuffling by recombination between self-splicing introns of bacteriophage T4. AB - The organization of genes into exons separated by introns may permit rapid evolution of protein-coding sequences by exon shuffling. Introns could provide non-coding targets for recombination, which would then give rise to novel combinations of exons. Evidence to support this theory is indirect and consists of examples of homologous domains of protein structure encoded in different genes, with introns in conserved positions at the boundaries of these domains. Here, we report the first direct evidence for exon shuffling. Two spontaneous deletion mutations of phage T4 have been characterized by sequencing, and they are clearly the result of recombination between homologous regions of two self splicing group I introns. As a result of the recombination, exons of different genes are transcribed together, with a hybrid intron between them. One of these introns is proficient in self-splicing. PMID- 2770863 TI - DNA fingerprinting. Judge backs technique. PMID- 2770864 TI - Peer review (continued) PMID- 2770865 TI - Membrane proteins. Detergent ringing true as a model for membranes. PMID- 2770866 TI - Daedalus. Flying dust. PMID- 2770867 TI - The allosteric transition of glycogen phosphorylase. AB - The crystal structure of R-state glycogen phosphorylase b has been determined at 2.9 A resolution. A comparison of T-state and R-state structures of the enzyme explains its cooperative behaviour on ligand binding and the allosteric regulation of its activity. Communication between catalytic sites of the dimer is provided by a change in packing geometry of two helices linking each site with the subunit interface. Activation by AMP or by phosphorylation results in a quaternary conformational change that switches these two helices into the R-state conformation. PMID- 2770868 TI - A novel potassium channel with delayed rectifier properties isolated from rat brain by expression cloning. AB - Voltage-activated potassium channels play an important part in the control of excitability in nerve and muscle. Different K+ channels are involved in establishing the resting potential, determining the duration of action potentials, modulation of transmitter release, and in rhythmic firing patterns and delayed excitation. Using in vitro transcripts made from a directional complementary DNA library we have isolated, by expression cloning in Xenopus oocytes, a novel K+-channel gene (drk1). Functionally, drk1 encodes channels that are K+ selective and belong to the delayed rectifier class of channels, rather than the A-type class encoded by the Shaker gene of Drosophila. The channels show sigmoidal voltage-dependent activation and do not inactivate within 500 ms. Structurally, drk1 encodes an amino-acid sequence which is more closely related to the Drosophila Shab gene than to the Shaker gene. PMID- 2770869 TI - Embryonic MAP2 lacks the cross-linking sidearm sequences and dendritic targeting signal of adult MAP2. AB - The most prominent microtubule-associated protein of the neuronal cytoskeleton is MAP2. In the brain it exists as a pair of high-molecular weight proteins, MAP2a and MAP2b, and a smaller form, MAP2c, which is particularly abundant in the developing brain. High-molecular weight MAP2 is expressed in dendrites, where its messenger RNA is also located, but is not found in axons; it has been shown to be present in fine filaments that crosslink dendritic microtubules. This correlates with the primary structure of high-molecular weight MAP2, which consists of a short carboxy-terminal tubulin-binding domain and a long amino-terminal arm, which forms a filamentous sidearm on reconstituted microtubules. Here we report that the high- and low-molecular weight forms of MAP2 are generated by alternative splicing and share the entire C-terminal tubulin-binding domain as well as a short N-terminal sequence. In contrast to high molecular weight MAP2, embryonic brain MAP2c lacks 1,342 amino acids from the filamentous sidearm domain. Furthermore, the mRNA for low molecular weight MAP2c is not present in dendrites, indicating that the dendritic targeting signal is specific for the high-molecular weight form. PMID- 2770870 TI - AIDS now a tractable disease? PMID- 2770871 TI - Support for Japan's sequencers from MESC. PMID- 2770872 TI - US opposition to milk hormone. PMID- 2770873 TI - DNA fingerprinting. PMID- 2770874 TI - Ethical dilemmas. PMID- 2770875 TI - Space sickness on earth. PMID- 2770876 TI - Magnetic separation of DNA. PMID- 2770877 TI - Malaria. Binding of infected red cells. PMID- 2770879 TI - Hippocampal abnormalities in amnesic patients revealed by high-resolution magnetic resonance imaging. AB - The identification of brain structures and connections involved in memory functions has depended largely on clinico-pathological studies of memory-impaired patients, and more recently on studies of a primate model of human amnesia. But quantitative neurobehavioural data and detailed neuropathological information are rarely available for the same patients. One case has demonstrated that selective bilateral damage to the hippocampus causes a circumscribed memory impairment in the absence of other intellectual deficits. This finding, in conjunction with evidence from humans and monkeys, indicates that the hippocampus together with adjacent and anatomically related structures is essential for the formation of long-term memory, perhaps by virtue of the extensive reciprocal connections between the hippocampal formation and putative memory storage sites in the neocortex. Although cognitive studies of amnesia provide useful information about the functional organization of normal memory, it has not usually been possible to relate memory impairment to anatomy in living patients. We have developed a high resolution protocol for imaging the human hippocampus with magnetic resonance that permits visualization of the hippocampal formation in substantial cytoarchitectonic detail, revealing abnormalities in patients with severe and selective memory impairment. PMID- 2770878 TI - Neuronal correlates of a perceptual decision. AB - The relationship between neuronal activity and psychophysical judgement has long been of interest to students of sensory processing. Previous analyses of this problem have compared the performance of human or animal observers in detection or discrimination tasks with the signals carried by individual neurons, but have been hampered because neuronal and perceptual data were not obtained at the same time and under the same conditions. We have now measured the performance of monkeys and of visual cortical neurons while the animals performed a psychophysical task well matched to the properties of the neurons under study. Here we report that the reliability and sensitivity of most neurons on this task equalled or exceeded that of the monkeys. We therefore suggest that under our conditions, psychophysical judgements could be based on the activity of a relatively small number of neurons. PMID- 2770880 TI - Abortion issue destroys board. PMID- 2770881 TI - Animal welfare. About-turn on regulations. PMID- 2770882 TI - Genetic engineering. Dispute over monitoring. PMID- 2770883 TI - Characterization of the interaction constants for the binding of two unlabelled ligands to the sites of a receptor. An experimental strategy. AB - The model describing the binding of three ligands to the sites of a receptor is theoretically studied in order to characterize the binding interaction between two unlabelled ligands. For this, the binding of a third labelled ligand, the affinity of which is dependent on the presence of the unlabelled ligands, must be measured in different conditions. This paper describes an experimental strategy leading to an accurate determination of the equilibrium parameters of the model. This strategy, which assumes that the model is compatible with the data, rests on the determination of the optimal experimental conditions, i.e. the choice of the ligand concentrations which minimize the error of the parameter estimates. For this purpose, a computer program which runs on a microcomputer under the MS-DOS operating system has been elaborated on the basis of the D-optimization criterion. This work shows that such a computer analysis is essential to the determination of the optimal experimental design, even when very simple biochemical systems are considered. PMID- 2770884 TI - Effects of hypoxia on noradrenaline release and neuronal reuptake in isolated rabbit thoracic aortic strips. AB - To clarify the effects of hypoxia on stimulus-evoked noradrenaline release and on neuronal reuptake of the released noradrenaline, we examined the effects of hypoxia on contraction responses of rabbit thoracic aortic strips to transmural electrical stimulation and on the stimulation-evoked overflow of total [3H] and [3H]noradrenaline from the strips prelabelled with [3H]noradrenaline. This was done in the presence or absence of an inhibitor of neuronal uptake (cocaine). In a medium equilibrated with a gas mixture of 95% O2/5% CO2 (control), cocaine doubled the stimulation-evoked overflow of total [3H] and [3H]noradrenaline; there was a concomitant increase (130%) in contractions to electrical stimulation. At 0% O2 (95% N2/5% CO2, hypoxia), cocaine had no significant effects on either the stimulation-evoked overflow of total [3H] and [3H]noradrenaline or contractions. In the absence of the drug, hypoxia decreased the stimulation-evoked overflow of total [3H] and [3H]noradrenaline to 47% and 43%, respectively, of the control values, whereas these values were 31% and 28%, respectively, after exposure to cocaine. The inhibition by hypoxia of contraction responses to electrical stimulation was greater in the presence of cocaine than in its absence. These results show that hypoxia inhibits both noradrenaline release evoked by a given stimulus and neuronal uptake. PMID- 2770885 TI - Interaction between clonidine and physostigmine in normal rats and in rats after sinoaortic denervation. AB - Clonidine (3-30 micrograms.kg-1, i.v.) induced a fall in mean arterial pressure in rats after sinoaortic denervation but not in sham-operated animals. Moreover, sinoaortic denervation reduced the bradycardic action of this antihypertensive drug. Pressor and tachycardic response to physostigmine (60 micrograms.kg-1, i.v.) were greater in denervated than in sham-operated rats. The increase of mean arterial pressure was 26.2 +/- 2.2 mm Hg in sham-operated rats (n = 12) and 53.8 +/- 2.0 mm Hg in denervated rats (n = 12, P less than 0.005). Pretreatment with 3 micrograms.kg-1 (i.v.) of clonidine did not alter the pressor response to physostigmine (60 micrograms.kg-1) in either of the two groups; 10 and 30 micrograms.kg-1 of clonidine reduced the physostigmine-induced increase of mean arterial pressure in sham-operated rats but enhanced the pressor response in denervated animals. Furthermore, an ineffective dose of physostigmine (30 micrograms.kg-1, i.v.) induced a pressor response after pretreatment with clonidine (10 micrograms.kg-1) in denervated rats. Clonidine (10 micrograms.kg-1) did not affect the pressor effect of 1,1 dimethyl-4-phenylpiperazinium iodide (DMPP: 50 micrograms.kg-1, i.v.) or phenylephrine (4 micrograms.kg-1, i.v.) in either group. The anticholinergic effect of clonidine in sham-operated rats may be explained by an inhibitory action on the release of acetylcholine in several brain structures but the facilitatory effect of clonidine observed in denervated animals is not clear. The results did not suggest a peripheral involvement in this facilitatory effect. PMID- 2770886 TI - Nicotine antagonizes the effects of reserpine on the striatal metabolism of dopamine, 5-hydroxytryptamine and noradrenaline in hypothermic but not in normothermic mice. AB - Our previous studies indicate that repeated nicotine administration inhibits the release of striatal dopamine in hypothermic mice. To study if similar inhibition occurs in noradrenergic and serotoninergic neurons mice were given (-)-nicotine (3 mg/kg, s.c.) repeatedly at 110, 80, 50, and 20 min before sacrifice. The interactions of nicotine with reserpine were also investigated. Reserpine (5 mg/kg, i.p.) was administered after the second nicotine dose at 60 min before sacrifice. To prevent the effects of nicotine on autonomic ganglia all mice were given hexamethonium (10 mg/kg, i.p.). Experiments were carried out at 20-22 degrees C at which ambient temperature nicotine induced deep hypothermia or at 32 34 degrees C to prevent the drug-induced hypothermia. The changes in striatal metabolism of dopamine, noradrenaline and 5-hydroxytryptamine (5-HT) we Nicotine had temperature dependent effects on the dopamine metabolism which indicates a block of dopaminergic neurons as suggested in our earlier studies. Reserpine per se increased the homovanillic acid (HVA) and 3,4-dihydroxyphenylacetic acid (DOPAC) contents and decreased the 3-methoxytyramine (3-MT) and dopamine contents at both ambient temperatures. In hypothermic but not in "normothermic", nicotine treated mice reserpine's effect on dopamine metabolism was almost totally vanished. Nicotine and reserpine per se increased the 3-methoxy-4 hydroxyphenylethylglycol (MOPEG) content and decreased the noradrenaline content at both ambient temperatures. In hypothermic but not in "normothermic" mice nicotine antagonized the reserpine-induced decrease of noradrenaline content. Nicotine tended to decrease the 5-hydroxy-indoleacetic acid (5-HIAA) content in hypothermic mice but increased it in "normothermic" ones.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2770887 TI - On the origin of extracellular GABA collected by brain microdialysis and assayed by a simplified on-line method. AB - The present study describes a simplified on-line system for determination of GABA in brain dialysates. GABA was determined with an isocratic HPLC method after derivatization with o-phthaldialdehyde. One peristaltic pump was sufficient to transport both the perfusion fluid and the derivatizing reagent. The basal release of GABA was stimulated by infusion with either elevated K+ or the GABA uptake inhibitor (-)-nipecotic acid. Basal as well as stimulated GABA release were investigated for possible calcium-dependency by infusing submmolar amounts of the potent calcium antagonist cadmium. Infusion of cadmium did not modify the dialysate concentrations of GABA. In addition basal as well as nipecotic acid enhanced release of GABA dialysate concentrations were investigated for nerve impulse dependency by infusing mumolar amounts of tetrodotoxin. No change in the GABA output was observed during infusion of TTX. From these results it is concluded that the basal as well as the nipecotic acid induced release of GABA did not fulfill the criteria for classic exocytotic release. Possible explanations for these unexpected findings are discussed. PMID- 2770888 TI - Frequency-dependent effects of activation and inhibition of protein kinase C on neurohypophysial release of oxytocin and vasopressin. AB - Isolated rat neurohypophyses were superfused in vitro and the release of vasopressin and oxytocin into the medium was determined by specific radioimmunoassays. Hormone secretion was increased by electrical stimulation of the pituitary stalk at different frequencies. The effects of several phorbol esters, known to activate phorbol 12,13-dibutyrate, PDB) or not to affect (4 alpha-phorbol 12,13-dideconate and phorbol 12-monoacetate) protein kinase C, and of the direct protein kinase C inhibitor 1-(5-isoquinolinylsulfonyl)-2 methylpiperazine (H7) were tested. Electrical stimulation with 450 pulses caused the release of about 45 microU vasopressin and 55 microU oxytocin, when a frequency of 3 Hz was applied, and of about 500 microU vasopressin and oxytocin, when a frequency of 15 Hz was used. PDB (1 mumol/l) increased the release of vasopressin evoked by 15 Hz stimulation maximally by about 40-50% and that evoked by 3 Hz stimulation by about 150%. The release of oxytocin evoked by 15 Hz stimulation was increased by about 150% and that evoked by 3 Hz stimulation by about 400-500% in the presence of PDB. Both inactive phorbol esters had no effects on the evoked release of vasopressin or oxytocin. The effect of PDB on the release of vasopressin and oxytocin was blocked by H7 (10-30 mumol/l). H7 (30 mumol/l) alone reduced the release of vasopressin evoked by stimulation at 15 Hz by 50%. The release of oxytocin was not significantly affected by H7. In the presence of naloxone (1 mumol/l) the release of oxytocin evoked by 3 and 15 Hz stimulation was increased by about 175 and 105%, respectively.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2770889 TI - Interaction of arylpiperazines with 5-HT1A, 5-HT1B, 5-HT1C and 5-HT1D receptors: do discriminatory 5-HT1B receptor ligands exist? AB - The effects of several putative 5-HT1 receptor-subtype selective ligands were investigated in biochemical models for 5-HT1A, 5-HT1B, and 5-HT1D receptors (inhibition of forskolin-stimulated adenylate cyclase activity in calf hippocampus, rat and calf substantia nigra, respectively) and 5-HT1C receptors (stimulation of inositol phosphates production in pig choroid plexus). Following compounds were studied: 5-HT (5-hydroxytryptamine), TFMPP (1-(m trifluoromethylphenyl)piperazine), mCPP (1-(m-chlorophenyl)piperazine), CGS 12066 (7-trifluoromethyl-4-(4-methyl-1-piperazinyl)-pyrrolo[1,2-a] quinoxaline 1), isamoltane (CGP 361A, 1-(2-(1-pyrrolyl)-phenoxy)-3-isopropylamino-2-propranol), quipazine, 1-NP (1-(1-naphthyl)piperazine), and PAPP (LY165163, 1-[2-(4 aminophenyl)ethyl]-4-(3-trifluoromethylphenyl)- piperazine). Among reported 5 HT1B receptor selective drugs, TFMPP had similar potency at 5-HT1A, 5-HT1B and 5 HT1C receptors, mCPP did not separate between 5-HT1B and 5-HT1C receptors, CGS 12066 was equipotent at 5-HT1B and 5-HT1D receptors, and isamoltane was only slightly 5-HT1B versus 5-HT1A selective. Quipazine showed equal potency at 5-HT1B and 5-HT1C receptors and 1-NP did not discriminate between the four receptor subtypes. PAPP described as 5-HT1A receptor selective, was equally potent at 5 HT1A and 5-HT1D receptors. The potencies determined in second messenger studies were in good agreement with the affinity values determined in radioligand binding studies. Thus 5-HT1A, 5-HT1B, 5-HT1C and 5-HT1D receptors have different pharmacological profiles as predicted from radioligand binding studies. Despite claims to the contrary, none of the tested compounds had actual selectivity for a given 5-HT1 receptor subtype.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2770891 TI - Inhibition of cholera toxin-induced intestinal secretion by the 5-HT3 receptor antagonist ICS 205-930. AB - The secretory effect of cholera toxin on the gut has been ascribed to the activation of submucosal 5-hydroxytryptamine receptors by 5-hydroxytryptamine released from the enterochromaffin cells. The hypothesis that neuronally located 5-HT3 receptors are involved in cholera toxin-induced diarrhoea has now been tested. Intestinal secretion was stimulated in mice by oral administration of pure cholera toxin and the effects of ICS 205-930, a potent and selective antagonist at 5-HT3 receptors, and of ketanserin, a compound that blocks 5-HT2 receptors, were investigated. Oral administration of cholera toxin resulted in a significant accumulation of fluid in the intestine. Pretreatment of the animals with ICS 205-930 partly prevented this effect and a maximal reduction of about 50% was achieved with doses of 0.3 mg/kg i.p. and higher. Ketanserin had only minimal effects up to a high dose of 1 mg/kg i.p. when a 20% reduction of fluid accumulation was seen. The data support the view that activation of 5-HT3 receptors plays a major role in the secretory effect of cholera toxin in the gut. PMID- 2770890 TI - Release of 3H-5-hydroxytryptamine by amiflamine and related phenylalkylamines from rat occipital cortex slices. AB - In the present study amiflamine and other related reversible monoamine oxidase-A (MAO-A) inhibitory phenylalkylamines were examined in vitro for their ability to induce release of 3H-5-hydroxytryptamine (3H-5-HT) from rat occipital cortex slices. The slices were preincubated with 3H-5-HT 0.1 mumol/l in the presence of the irreversible MAO inhibitor pargyline 50 mumol/l and then continuously superfused. The effects were compared with those of the 5-HT releaser p chloroamphetamine (pCA), the reversible MAO-inhibitor alpha-ethyltryptamine and the 5-HT uptake inhibitor citalopram. Amiflamine, some related compounds and alpha-ethyltryptamine which in vivo after transport by the 5-HT uptake mechanism preferentially inhibit MAO within the serotonergic neurons caused a Ca2+ independent release of 3H-5-HT. Some transported compounds, particularly NBF 027 were, however, very weak releasers of 5-HT. This release and that induced by pCA was prevented by citalopram in the superfusion medium. FLA 365, FLA 417 and FLA 1088, which are not transported into the neurons, were poor releasers of 5-HT. It is concluded that compounds which were effective releasers of 5-HT in vitro were those that are transported into the serotonergic neurons by the 5-HT carrier in vivo and has in addition an ability to mobilise vesicular 5-HT. PMID- 2770893 TI - Reducing infant mortality in North Carolina. PMID- 2770894 TI - Survey of maternal transports to the North Carolina Memorial Hospital. PMID- 2770892 TI - Effects of cromakalim on acetylcholine release and smooth muscle contraction in guinea-pig small intestine. AB - The effects of the potassium channel opener cromakalim on smooth muscle contraction and 3H-acetyl-choline release were studied simultaneously in guinea pig longitudinal muscle myenteric plexus preparations which had been preincubated with 3H-choline. Cromakalim (10 mumol/l) inhibited more markedly the smooth muscle contractions caused by the release of endogenous acetylcholine (via electrical stimulation or via activation of nicotine- and 5-HT3-receptors) than contractions induced by pilocarpine. Cromakalim (10 mumol/l) did not affect the release of 3H-acetylcholine evoked by electrical stimulation or by stimulation of nicotine- and 5-HT3-receptors. In contrast, the release of 3H-acetylcholine caused by stimulation of M1-receptors was concentration-dependently reduced by cromakalim (1-100 mumol/l). The results suggest that the relaxant effect of cromakalim on smooth muscle contraction is not caused by a reduction of acetylcholine release from myenteric neurones. An opening of cromakalim-sensitive potassium channels may be involved in the inhibition of the M1-receptor mediated acetylcholine release. PMID- 2770895 TI - Sun protection. PMID- 2770896 TI - My first patient. PMID- 2770897 TI - Your mother is in the ICU--now what? PMID- 2770898 TI - The right to refuse medical treatment. PMID- 2770899 TI - Physicians' opinions and use of colorectal cancer screening procedures. PMID- 2770900 TI - The last of the untouchables. PMID- 2770901 TI - An interview with Claire M. Fagin: perspectives on nursing in today's health-care environment. PMID- 2770902 TI - A consortium approach to nursing staff development. AB - Within a consortium framework, four teaching hospitals have developed a curriculum for nursing staff development. Since 1980, the institutions have realized significant savings. The courses provide networking and integration of new research and facilitate technological transfer. Other institutions may also find a collaborative approach beneficial. PMID- 2770903 TI - Pitfalls and promises of diversification. AB - Diversification came upon the health-care scene with the promise of an expanded market base and financial solvency for all. Now with several diversification models advanced and successes and failures widely available for examination, what do we know about the potential pitfalls and promises of diversification? This article will present an overview of tried diversification models and analyze opportunities for success and warning signals of financial risk. PMID- 2770904 TI - Increasing resourcefulness: the key to declining resources. AB - Nurse executives face many daily issues related to balancing scarce resources with an ever-increasing demand for high quality services and programs. Never before have nursing organizations been faced with such relentless pressure to conserve resources and control costs in the process to meet organizational missions. PMID- 2770905 TI - A working plan to understand and control financial pressures. AB - As financial changes affect hospitals and nursing budgets, nurse executives must know how to anticipate financial results and make aggressive decisions based upon the financial ramifications. PMID- 2770906 TI - A rural hospital responds to the nursing shortage. PMID- 2770907 TI - The nursing care technologist: an interview with Linda Sims Matessino. AB - To better promote nursing, provide quality patient care, and address long-term problems posed by the nursing shortage, Ochsner Foundation Hospital of New Orleans developed and implemented the role of nursing care technician. In this interview, Linda Sims Matessino, Associate Hospital Director and Director of Nursing Services, details this position and how it has benefitted Ochsner Foundation Hospital. PMID- 2770908 TI - KAIZEN: innovations for nurse managers to improve productivity. PMID- 2770909 TI - Physician payment reform: implications for nurses. PMID- 2770910 TI - [Changes in neuronal excitability elicited by subthreshold depolarization as a possible mechanism of interval-selective interrelations in the central nervous system]. AB - The cellular process that may be considered as a mechanism of interval-selective functional interrelations between neurons in the mammalian brain identified in the previous studies has been studied in neurons of mollusc Lymnaea stagnalis. This process consists of regular excitability changes resulting in high probability (0.6-1) of the impulse reaction elicited by the subthreshold depolarization current shock applied in time intervals (specific, individual for each neuron) after identical subthreshold conditioned stimulus. It is shown that a cycle of the excitability changes after subthreshold depolarization is not a result of the time summation of electrotonic, local or postsynaptic potentials of a neuron, but may be represented by the endogenous (cytoplasmatic) process insensitive to the mediator application and reversibly changed when one of the modulator peptide (bombesin) is applied. PMID- 2770911 TI - [Ultrastructural organization of the chemosensitive ventrolateral region of the cat medulla oblongata]. AB - Some differences in the location of supposedly inhibitory synapses (F-type) have been revealed in the course of the study of the ultrastructural organization of the chemosensitive ventrolateral medulla in the cat at the level 2-6 mm caudally of trapezoid bodies. These synapses are formed by axon terminals filled with flattened synaptic vesicles whose long axis is 60-80 nm. Neurons of this area are supposed to play a different role in the cardiovascular regulation. PMID- 2770912 TI - [Dependence of the character of EPSP summation in mollusk neurons on the level of the membrane potential]. AB - The dependence of monosynaptic EPSP summation properties on the membrane potential level was studied in the experiments on identified neurons of mollusc Planorbis corneus. Summation functions were obtained by means of randomized paired stimuli technique. It was shown that the value of the interstimulus++ interval corresponding to the most marked EPSP interactions depended, mainly, on the postsynaptic mechanism. Really, selective changes in postsynaptic neuron parameters produced by changes in hyperpolarizing current led to a shift of the appropriate position of the summation function extremum. The results obtained made it possible to put forward the suggestion of selective (for every input or groups of inputs) "settlement" of neurons to specific intervals (frequencies); such "settlement" may be modulated by changes in the membrane potential in the corresponding part of a neuron. Possible functional role of this mechanism is discussed. PMID- 2770913 TI - [Influence of electric stimulation of the medulla oblongata on the smooth muscle tone of the airway in cats]. AB - Changes in the tracheal smooth muscle tone have been studied in 30 cats anaesthetized with a chloralose-urethane mixture and paralyzed with succinyl choline bromide during electrical stimulation of the medulla oblongata. Constrictor responses were evoked from the regions including the caudal portion of the dorsal motor nucleus of the vagus, nucleus ambiguous and neighbouring structures of the reticular formation. Dilatory responses of the tracheal smooth muscle were observed during stimulation of the reticular formation at the level from 1 mm caudally to 6 mm rostrally of the obex. It is supposed that structures responsible for contractile responses are vagal preganglionic neurons, located in the dorsal motor nucleus of the vagus, in the nucleus ambiguous and in neighbouring regions and axons of these cells, looping through the medial part of the medulla. It is also supposed that dilatory responses are associated with excitation of sympathotonic reticular neurons, inhibitory neurons activated by the input from pulmonary stretch receptors and, possibly, vagal efferent neurons belonging to the nonadrenergic nervous system of the bronchi. PMID- 2770914 TI - [Morphologic analysis of the origin of spinal locomotor strip fibers in the cat]. AB - The origin of spinal locomotor strip fibres was studied in cat by means of electrical stimulation combined with the horse-radish peroxidase transport technique. It was revealed that the cortico-spinal tract presumably formed the locomotor strip. Some reticulo-spinal and spinal trigeminal tracts fibres were also found. Descending catecholaminergic fibres did not pass through the investigated regions of the dorso-lateral funiculus; they were not, apparently, a part of the spinal locomotor strip. The specificity of locomotor regions of the brain stem and spinal cord is discussed. PMID- 2770915 TI - [Effect of serotonin on the background activity of neurons in the isolated spinal cord semisegment of the rat]. AB - The background activity of neurons in the isolated lumbar semisegment of 14-22 days old white rats was investigated before and after bath application of serotonin (5-HT, 1.10(-8)-1.10(-4) mol/l). 50% investigated neurons in dorsal horn and 70.6% interneurons in the ventral horn reacted on 5-HT. Excitation reactions prevailed. In the dorsal horn 5-HT evoked activation in 62.4% of responding interneurons, depression--in 8.4% and mixed reaction--in 29.2%. In the ventral horn 91.6% of all responses were activation reactions and only 8.4%- biphase ones. 5-HT induced discharges of motoneurons in the ventral root and ventral root depolarization. The data obtained have shown mainly the activation effect of 5-HT on the background activity of spinal neurons. PMID- 2770916 TI - [Immediate and remote postactivation effects in the human motor system]. AB - Postactivation effects (appearance of long-lasting non-voluntary contraction of muscles after 30-60 s of the sustained voluntary effort) were studied. It is shown that after contraction of distal muscles postactivation effects can appear in proximal muscles not involved in the previous voluntary activity. The testing of the motor system state by the muscle tendon vibration revealed that besides the well known immediate postactivation effects there were concealed changes lasting for 15-20 min. It is suggested that postactivation phenomena reflecting the functioning of certain central tonogenic structures activated by a voluntary effort or by an increased afferent inflow can be used as an efficient tool in the study of postural mechanisms. PMID- 2770918 TI - [Temperature dependence of neuronal activity in hypothalamic and hippocampal slices of the guinea-pig]. AB - Unit activity in slices of the hippocampus and medial preoptic area of the hypothalamus of guinea-pigs was extracellularly recorded under conditions of temperature changes. Seven out of nineteen hypothalamic neurons showed changes in the firing rate at threshold temperatures of 36-38 degrees C. In the suprathreshold range the activity of these neurons depended on the temperature level. It is suggested that such neurons may form a sensory part of the system controlling brain temperature within a narrow (1-2 degrees C) range. The pyramidal layer cells of the control structure (hippocampus) were insensitive to the temperature level within 32-40 degrees C. PMID- 2770917 TI - [Tryptamine as an endogenous modulator of neuronal sensitivity to serotonin]. AB - Tryptamine has been studied for its effect on the 5-hydroxytryptamine-induced responses of the dorsal root ganglion neurons in rat with intracellular registration of the membrane potential and conductance and application of drugs from micropipettes under pressure. It was found that tryptamine applied in high concentrations acted like 5-hydroxytryptamine; but in the concentration range when it has no effect on the membrane potential and membrane conductance it either enhanced (10(-7) mol/l) or diminished (10(-5) mol/l) 5-hydroxytryptamine responses mediated by 5-HT1A- but not by 5-HT2-receptors. Harmane acted like tryptamine, but its derivatives either only enhanced or only inhibited the 5 hydroxytryptamine effects. The allosterical nature of 5-hydroxytryptamine modulating action of tryptamine, harmane and its derivatives is discussed. PMID- 2770919 TI - [Various responses of neurons of the caudate nucleus in alert cats to visual stimulation]. AB - Activity of sixty two neurons of the caudate nucleus to the visual stimuli were recorded in awake cats. It was found that most (52%) of tested neurons gave visual responses of sensory type evoked by the appearance of light stimulus in the visual field and only 11% of them were of the motor type related to the guided eye movement to the target. About a quarter of neurons responded to biologically significant objects revealing nonspecific responses. Several types of visual responses could be recorded from the same neuron. The data obtained permit supposing the presence of several parallel pathways for afferent visual influences on the caudate nucleus. PMID- 2770920 TI - [Ultrastructure of neurosecretory cells of the hypothalamic supraoptic nuclei of albino rats during nociceptive stress and aging]. AB - Ultrastructural organization of neurosecretory cells from the hypothalamic supraoptic nuclei of aged and young rats was studied after painful stress of different duration (2 min, 20 min). Intact young rats formed the control group. An increase of the functional activity of neurosecretory cells was shown to follow the short-term stress (2 min) and a decrease of the activity--the long term stress (20 min). The prolonged stress in young rats was comparable with ultrastructural changes in the neurosecretory cells of aged animals. The prolonged painful stress is supposed to promote the aging of the neurosecretory cells. PMID- 2770921 TI - [Stereometric characteristics of the ultrastructure of presynaptic terminals in the dorsal horn of the cat spinal cord]. AB - Ultrastructure of 240 axo-dendritic presynaptic terminals (PT) in the dorsal horn of the spinal cord of cat was investigated using the morphometrical statistic method. Parameters describing shape and average spatial radius of the three dimensional PT (approximated by irregular ellipsoid) were estimated on the basis of the morphometry of random PT sections using ideas of the theory of probabilities. A lack of correlation between the synaptic operative zone localization and features of the terminals' shape was demonstrated. The distribution of the spatial PT radii was obtained. The obtained distribution elicited the relatively small variability of these parameters. PMID- 2770922 TI - [Effect of neurite-stimulating protein on the growth and proliferation of peripheral glia cells]. AB - Proliferative activity of peripheral glia was investigated in the organotypic culture of peripheral nerves of 9-10-day old chick embryos. The neurite stimulating protein, a stimulator of the neurite growth in the organotypic culture of spinal ganglia, being added to the culture media sharply increased the mitotic activity of glia: on the 3d day its level was 3.5 times higher as compared with the control one. PMID- 2770923 TI - [Effect of oxytocin on rat dorsal root ganglia in vitro]. AB - The influence of bath application of oxytocin (OT) was investigated on the isolated dorsal root ganglion (DRG) cells by means of intracellular recording. The results showed that OT evoked depolarization in most cells and affected predominantly the DRG neurons with biophysical+ characteristics inherent in small neurons. PMID- 2770924 TI - Comparative study on cancer incidence in neighboring regions of Hungary, Austria, Yugoslavia and Czechoslovakia in 1969-1980. Pannonian Tumor Epidemiology Study Group. AB - The present collaborative study was performed in four confined, neighboring regions of Austria, Hungary, Yugoslavia and Czechoslovakia with different demographic and occupational characteristics of their respective populations, various structures of medical facilities, and cancer registration systems. Crude and age-standardized incidence rates and trends of six major cancer sites (stomach, colorectum and lung in both sexes as well as breast, uterine cervix and uterine body in women) in three 4-year periods (1969-1972, 1973-1976, 1977-1980) were computed and mutually compared in the mentioned regions. Relatively high, different but more or less decreasing incidence rates of stomach, and varying but mainly increasing rates and trends of colorectal cancer were observed, while lung cancer incidence rates and tendencies showed great variations in both sexes. For women, besides continuous increase, the tendencies towards culmination and stabilization were found in regions with the highest incidence rates of breast and uterine body cancer in comparison with the more or less declining rates of uterine cervix cancer over the period studied. The observed different incidence rates and trends of these and obviously of other cancer sites require further investigations using more sophisticated epidemiological methods and approaches. PMID- 2770925 TI - Epidemiological aspects of childhood cancer incidence in Czech regions. AB - In this descriptive epidemiological report a total of 5100 childhood malignancies registered in Czech regions during the period of 1963-1985 was analyzed. The incidence of these tumors compared in years of this time period has been relatively constant, we did not find any significant changes in trends. That is why the average annual incidence rate, i.e., 10.8 in males and 8.7 in females per 100,000 sufficiently characterized the epidemiological situation in this respect. Those parameters allow, by knowledge of demographic prognosis, to estimate expected numbers of tumors in further years. The highest incidence occurred in boys and in the lower age groups of both sexes. All differences presented in this report were tested and were found to be significant. The percentage ratio of solid tumors, preferentially those of bone and skin of both sexes, and brain tumors in females in the period of 1976-1985, as compared to the period of 1961 1970, decreased, whereas there was a significant increase of systemic malignancies and soft-tissue sarcomas. Finally, the geographic differences of incidence are described, and the possible causes of the data presented are discussed. PMID- 2770926 TI - Age-dependent antileukemic action and suppression of immune response by 1,4 benzoquinone-guanylhydrazone-thiosemicarbazone (ambazone) in mice. AB - The antineoplastic activity of 1,4-benzoquinone-guanylhydrazone-thiosemicarbazone (ambazone) against murine leukemia P388 was found to be markedly reduced in 12- and 18-month-old mice as compared to young animals. The immune response against sheep red blood cells (SRBC), a T cell-dependent antigen, was also strongly diminished in tumor-free old mice and was further suppressed after ambazone treatment. Since the antileukemic effect of ambazone disappeared more or less in congenitally athymic nude mice, in neonatally thymectomized or silica-pretreated animals, it has been concluded that the action of the compound seems to be limited to young adult immunocompetent tumor-bearing hosts. Therefore immunosenescence, primarily of T cell functions of old tumor-bearers, may represent a decisive factor influencing the antileukemic, especially curative effect of ambazone in aged animals. A combined treatment with ambazone and immunomodulators (thymalin or a splenopentin derivative) failed to improve the antileukemic effect in young and old leukemia P388-bearing mice. PMID- 2770927 TI - Growth, flow cytometric, and karyological characterization of L1210 cell sublines resistant to various Pt derivatives. AB - Growth, flow cytometric, and karyological characteristics were analyzed with respect to differences between sensitive L1210 cells and eight sublines resistant to cisplatin (DDP), 1,2-diaminocyclohexane(DACH)-Pt(II) citrate, DACH-Pt(II) glucarate, cis-dichloro-bis-(isopropylamine)-trans-dihydroxyplatinum (IV) (CHIP, iproplatin), and methotrexate (MTX). No great differences were found in growth properties. The sensitive and a majority of resistant sublines displayed similar flow cytometric and karyological characteristics, major differences were found only in the sublines resistant to CHIP. The relationship between the mechanism(s) of resistance and different pharmacokinetics of the drugs is discussed with special reference to DNA content and chromosome structure. PMID- 2770928 TI - Effect of benfluron metabolites on ATP level in tumor cells. AB - Changes in ATP levels of both Ehrlich ascites carcinoma and P388 leukemia cells were evaluated after 2 h of incubation in the presence of different concentrations of benfluron (BF), 7-dihydrobenfluron (DBF) and N-oxide of benfluron (NOBF). Up to the concentration of 37.5 mumol/l, none of the substances significantly depressed the ATP levels. A more expressive decrease in ATP levels was noted only at concentrations of 75 mumol/l and higher. BF proved the most effective, less effective was DBF, while NOBF was practically without any effect. Of the remaining cytostatic drugs, Mitoxantrone, CCNU and Me-CCNU, in particular, proved efficient in depressing ATP level. The latter becomes depressed already after 15 min of incubation in the presence of the highest concentrations of benfluron and 7-dihydrobenfluron. PMID- 2770929 TI - Hydroxyurea-induced toxic side-effects in animals and an attempt at reducing them with vitamins E and C. AB - Using the changes in several blood parameters and in the histological picture of the liver as markers of toxicity, the effect of hydroxyurea (HU) in healthy rabbits or mice was examined during two weeks after a single administration of this drug. In rabbits a transient significant decrease in blood erythrocyte count with a gradual increase in their osmotic resistance, a suppression of granulocyte phagocytic capacity, and an elevation of acid phosphatase activity in the serum were found. An increase in the proportion of lymphocytes without detectable lysosomes as tested by supravital staining also appeared. No significant difference was observed in the white cell count and lipoperoxide levels after HU administration. Histological picture of the liver, excised from HU-treated mice, indicated a marked hepatotoxicity of the drug. Some of the toxic effects were reduced in animals supplemented with vitamins E and C. PMID- 2770930 TI - Flow cytometric analysis of primary cervical and vulvar carcinomas and their metastases. AB - In a series of 25 patients with cervical carcinoma and 35 patients with vulvar carcinoma, clinically classified (FIGO) as Stage I and Ib, respectively, DNA ploidy and S-phase cell fraction were estimated in paraffin-embedded samples of the primary tumors and their metastases by means of flow cytometry (FCM). The two groups of patients were selected cases in whom lymph nodes removed at radical operation were histopathologically verified as metastatic ones. Prevailing part of primary tumors of both anatomic sites had diploid DNA content and low S-phase fraction. Irrespective of the DNA content and low proliferative activity the early stage carcinomas behaved aggressively as indicated by the presence of metastases, the DNA content of which corresponded in most of the cases with that of primary tumor. It appears that prediction of the tumor growth based only on cytogenetic and cytokinetic parameters may be connected with difficulties. PMID- 2770931 TI - A multivariate analysis of prognostic factors in adult Hodgkin's disease. AB - A multivariate analysis of the prognostic factors was carried out with a Cox model on 167 patients with Stage I-IV Hodgkin's disease. The following indicators were prospectively registered: Sex, age, clinical stage, systemic symptoms, histological type, number of involved areas, nodal size, mediastinal thoracic ratio (MTR), localization of mediastinal involvement according to the aortic arcus, hilar involvement, extent of radiotherapy, and extent and mode of chemotherapy. A linear logistic analysis showed that most of the indicators were interrelated. This emphasizes the necessity of a multivariate analysis in order to assess the independent influence of each of them. The three main prognostic indicators for complete remission achievement were age, clinical stage and involvement of lung hili. The three main prognostic indicators for disease-free survival were sex, size of mediastinal involvement (MTR) and use of alternating chemotherapy COPP/ABVD in the initial treatment strategy. The most important prognostic factor for survival was clinical stage followed by hilar involvement, age, and nodal size. The coefficients estimated by Cox regression analysis can be used to combine the important prognostic factors into a single index for each patient at presentation. The prognostic index for each patient would allow the identification of cases with poor prognosis who might benefit from additional initial treatment. PMID- 2770932 TI - Peculiarities of hormonal regulation of adenylate cyclase and lipid composition in colonic and rectal tumors. AB - Peculiarities in hormonal regulation of adenylate cyclase (AC) were studied in large bowel tumors to establish criteria of their hormonal dependence. The investigation showed a diminished basal activity of AC matched by decreased response to sodium fluoride, glucagon, and vasoactive intestinal peptide (VIP) in tumors as compared with normal intestinal mucosa. Some cases revealed an increased response of AC to a nonspecific ("inappropriate") stimulator- calcitonin. This was rather typical of colonic tumors while a diminished response to specific ("appropriate") stimulation by VIP and glucagon was more frequent in rectal cancer. The results showed a relationship between hormonal regulation of AC activity and lipid composition of tumor tissue, thus suggesting the possibility of influencing the hormone dependence of intestinal tumors by drugs used to eliminate disturbance of fat-carbohydrate metabolism. PMID- 2770933 TI - A comparative study of mucin-like carcinoma-associated antigen (MCA), CA 125, CA 19-9 and CEA in patients with ovarian cancer. AB - A mucin-like carcinoma associated antigen (MCA), which is recognized by the monoclonal antibody b-12, was found to be elevated in sera of breast cancer patients. Since an immunohistochemical reaction of the monoclonal antibody b-12 was found in epithelial tumors of the ovary we investigated MCA serum levels in 50 patients with ovarian cancer (mean age 59 years, range 31-81 years). In addition, CA 125, CA 19-9 and CEA were determined to compare sensitivity, specificity and the predictive value of the positive test of each parameter used in this study. Blood samples were obtained in 20 patients with progressive disease and in 30 patients during disease free intervals. The MCA serum levels of patients with progressive ovarian cancer (mean +/- SD: 14.7 +/- 14.6 U/ml) did not differ significantly from those of patients in remission (mean +/- SD: 8.2 +/ 5.3 U/ml) or from values of a healthy control group (mean +/- SD: 7.7 +/- 3.8 U/ml, n = 70). Women with progressive disease displayed significantly higher CA 125 (p less than 0.0001) and CEA (p less than 0.0063) serum levels than patients in remission. No significant difference was found for CA 19-9 in patients with ovarian cancer, irrespective of the clinical status. Considering marker surge and tumor progression, the highest sensitivity was found for CA 125 (75%). Sensitivities of the other markers were significantly lower and reached only 25 35%. The predictive value of elevated marker levels as well as specificity of the marker substances were similar. Sensitivity could be extended to 90% if elevation of CA 125, CA 19-9, CEA and MCA were taken into consideration, however specificity was lowered by using this marker combination. PMID- 2770934 TI - High dose alpha-2-recombinant interferon in the treatment of malignant lymphoproliferative diseases. A pilot study. AB - In the presented clinical study, 10 patients with malignant lymphoproliferative diseases (2 with acute lymphoblastic leukemia, 3 with Hodgkin's disease, and 5 with non-Hodgkin's lymphoma), resistant to standard therapy, were administered alpha-2-recombinant interferon at a dosage of 120 x 10(6) IU as a continuous 48 h i.v. infusion. The second administration was performed after an interval of 1 month. A therapeutic response was seen in 50% of the patients, of them there were two complete remissions (in the two acute lymphoblastic leukemia patients) and 3 partial remissions (in 2 patients with Hodgkin's disease and in 1 patient with low malignant non-Hodgkin's lymphoma). In four patients with high malignant non Hodgkin's lymphomas the treatment did not evoke any response, and in 1 patient with the same diagnosis progression was noted after the treatment. The toxic effects of the drug were in accord with literature data, and although high doses of alpha-2-recombinant interferon were administered, it was not necessary to interrupt the treatment in any of the patients. Considering the therapeutic effect of this immunomodulator used in the treatment of malignant lymphoproliferative diseases, our results are promising, nevertheless further studies will be required. PMID- 2770935 TI - Bone alkaline phosphatase isoenzyme and urinary hydroxyproline in healthy subjects, patients with osteolytic metastases, and patients with primary hyperparathyroidism. AB - The values of urinary hydroxyproline excretion reflecting the bone remodelling by osteoclasts, and the bone isoenzyme of serum alkaline phosphatase reflecting the osteoblastic function, in 100 randomly selected healthy subjects, 100 patients with primary hyperparathyroidism, and 100 patients with osteolytic secondary tumorous deposits in the skeleton showed a bivariate lognormal distribution. Hotelling's test revealed highly significant differences in the biochemical values among these three conditions, even when Bonferroni's modification of the test was used. The individual biochemical values, however, displayed many mutual overlaps. Despite this, the discriminatory analysis based on bivariate biochemical data resulted in a correct diagnosis in all healthy subjects, in 82 patients with primary hyperparathyroidism, and in 93 patients with osteolytic metastases. The simultaneous determinations of urinary hydroxyproline excretion and the bone alkaline phosphatase insoenzyme improve the differential diagnosis between these conditions. The predominance of urinary hydroxyproline excretion relative to bone alkaline phosphatase isoenzyme suggests an osteolytic metastasis. Proportionately elevated both hydroxyproline and bone alkaline phosphatase isoenzyme indicate the presence of primary hyperparathyroidism. This shows the importance of a correct biometrical processing of data. Nevertheless, a complex clinical evaluation is always mandatory. PMID- 2770936 TI - Cardiovascular perspectives of reducing high blood pressure. PMID- 2770938 TI - Towards electronic manuscripts? PMID- 2770937 TI - Diabetes insipidus associated with leukaemia. AB - Three cases of leukaemia complicated by pituitary diabetes insipidus are presented. In one patient diabetes insipidus developed five months before acute myelomonocytic leukaemia became apparent. The two other patients suffered from acute myelomonocytic leukaemia and from a blastic transformation of chronic myeloid leukaemia. In one case a transient cure of diabetes insipidus was obtained after intrathecal chemotherapy and irradiation of the skull. PMID- 2770939 TI - Variability of albumin excretion in diabetes. AB - The variability of urinary albumin excretion was determined in 3 consecutive overnight urine collections from 152 adult type I diabetic patients (study A) and in two 1-h urine collections from 57 adult type I and type II diabetic patients, obtained at a 10-wk interval (= median, range = 2-30 wk) (study B). In both studies the coefficient of variation (CV) of urinary albumin excretion recorded as urinary albumin concentration (mg/l) was highest (study A: CV 51.1%; study B: CV 61.8%), whereas the CV of the urinary albumin/urinary creatinine ratio (mg/mmol) was lowest (study A: CV 41.9%; study B: CV 50.8%). In study A the CV of urinary albumin excretion rate (microgram/min) (CV 43.5%) did not differ from that of urinary albumin/urinary creatinine ratio. In study B, however, the CV of urinary albumin excretion rate (CV 57.2%) was higher than that of the urinary albumin/urinary creatinine ratio and of fractional albumin clearance (CV 51.0%). The variability of urinary albumin excretion was not related to its magnitude and could not be attributed to variations in plasma glucose, glycosylated haemoglobin or renal tubular glucose reabsorption. This high variability stresses the need to obtain several urine samples before the amount of albumin excreted can be reliably estimated. It is recommended that one does not use urinary albumin concentration but urinary albumin/urinary creatinine ratio or fractional albumin clearance in the assessment of urinary albumin excretion in diabetes management. PMID- 2770940 TI - Limits of reproducibility of left ventricular wall thickness and mass by M-mode echocardiography. AB - The present study describes the total intrinsic variability of both left ventricular wall thickness and left ventricular wall mass in a group of 11 normal volunteers with an echocardiographic follow-up of about 1 yr. Septal thickness, posterior wall thickness and left ventricular minor diameter were measured at end diastole. From the parameters under investigation the left ventricular minor diameter showed the best reproducibility with a coefficient of variation of 4%. The coefficients of variation for septal thickness, posterior wall thickness and left ventricular wall mass by both the Penn and the ASE method were 10, 10, 15 and 13%, respectively. The left ventricular wall mass was better reproducible by the ASE method than by the Penn method. PMID- 2770941 TI - Haemolytic anaemia due to cold agglutinins caused by psittacosis. AB - A 69-yr-old previously healthy woman, presenting with jaundice and the clinical symptoms of an atypical pneumonia, was hospitalized. Haemolytic anaemia due to cold agglutinins was diagnosed, and erythromycin therapy for a suspected Mycoplasma pneumoniae infection was instituted. Serological testing revealed, however, that the infection was attributable to Chlamydia psittaci. The literature on psittacosis and haematological complications is reviewed. Cold agglutinins are sometimes found in association with psittacosis, but a concomitant haemolytic anaemia is rare. PMID- 2770942 TI - "On-screen" writing and composing: two years experience with Manuscript Manager, Apple II and IBM-PC versions. AB - The problems of the direct composition of a biomedical manuscript on a personal computer are discussed. Most word processing software is unsuitable because literature references, once stored, cannot be rearranged if major changes are necessary. These obstacles have been overcome in Manuscript Manager, a combination of word processing and database software. As it follows Council of Biology Editors and Vancouver rules, the printouts should be technically acceptable to most leading biomedical journals. PMID- 2770943 TI - L-carnitine substitution in patients on chronic hemodialysis. AB - Patients on chronic hemodialysis with hyperlipidemia were found to respond either with decreased levels (responders) or with a further increase of the plasma triglyceride levels (nonresponders) to a carnitine substitution therapy. The aim of the present study was to find possible predictors to distinguish between responders and nonresponders prior to the initiation of therapy. Since it is suggested that erythrocytes are involved in carnitine transport to tissues, it was of interest to determine plasma and erythrocyte carnitine concentrations in the hemodialyzed patients before and during carnitine substitution therapy and to compare the results with those of healthy controls. Before therapy, comparatively lower plasma levels of both free and total carnitine, but higher portions of short-chain acylcarnitine on total carnitine were found in all patients. In erythrocytes, the nonresponders showed significantly higher total carnitine levels, compared to responders and controls. After the start of carnitine substitution, the increase of total plasma carnitine during the substitution period corresponded with the carnitine dose administered in responders, in nonresponders the highest carnitine values were found in the second week when the lower carnitine dose was administered. The changes of the plasma short-chain acylcarnitine levels with time were very similar to those of plasma triglycerides. All patients showed a time-delayed accumulation of carnitine in erythrocytes and, interestingly, markedly higher concentrations in the second week when the lower carnitine dose was administered. The results of the present study demonstrate that the erythrocyte carnitine content is a reliable predictor to distinguish between responders and nonresponders prior to the start of a carnitine substitution therapy. PMID- 2770944 TI - Protein selectivity: a prognostic index in IgA nephritis. AB - Among 98 patients with IgA nephritis who had protein selectivity studies performed, 54% had nonselective proteinuria and the remaining 46% had selective proteinuria. Patients with nonselective proteinuria had a higher incidence of glomerulosclerosis. At the end of a 4-year follow-up period, patients with nonselective proteinuria had lower creatinine clearance, higher incidence of hypertension and chronic renal failure when compared to patients with selective proteinuria. Six out of eleven patients (55%) in the study who had the nephrotic syndrome had selective proteinuria. Among these 6 patients, 1 had spontaneous remission and 5 responded to steroid or cyclophosphamide therapy. The remaining 5 patients with nonselective proteinuria did not respond to therapy. In the patients who had selectivity studies repeated, the data showed that the selectivity index (SI) can fluctuate depending on the clinical course of the patients. SI can therefore be used to monitor the progress of patients on long term follow-up. Protein selectivity appears to be a useful prognostic index in IgA nephritis. For patients with the nephrotic syndrome it may serve as a guide to therapy. PMID- 2770945 TI - Effect of ciclosporin on lymphocyte subpopulations and immunoglobulin production in IgA nephropathy. AB - The effect of ciclosporin on the cellular immunoregulation was examined in 19 patients with IgA nephropathy. The patients were randomly divided into two groups: 9 patients receiving oral ciclosporin (5 mg/kg/day) for 12 weeks and 10 patients receiving placebo and acting as controls. T lymphocyte subpopulations were determined using OKT monoclonal antibodies. The functional capability of lymphocytes was assessed by in vitro immunoglobulin synthesis of cultured peripheral mononuclear cells, thymidine uptake by cultured lymphocytes, and t lymphocyte activation with expression of interleukin-2 receptors. A fall of in vitro IgA production by cultured lymphocytes (p less than 0.05), a reduction of thymidine uptake by Staphylococcus aureus Cowan-stimulated cultured lymphocytes (p less than 0.05), and a reduction of activated lymphocytes expressing interleukin-2 receptor (p less than 0.05) were observed in patients after 12 weeks of ciclosporin therapy. The percentages of OKT4 and OKT8 lymphocytes and OKT4/8 ratios were not altered with therapy. A simultaneous reduction of proteinuria and a transient impairment of renal function were observed. Similar changes in cellular immune parameters and clinical response were not observed in the controls. Our study suggests ciclosporin could modulate the cellular immunity in IgA nephropathy. PMID- 2770946 TI - Presence of circulating immune complexes in the classic form of hemolytic uremic syndrome: a constant finding. AB - In an attempt to further study the possible contribution of circulating immune complexes (CIC) in the pathogenesis of the classic form of hemolytic uremic syndrome, 9 patients were studied during the acute phase of the diseases. C1q solid-phase ELISA and conglutinin solid-phase ELISA, were used to measure the levels of immune complexes. All 9 were positive in one or both assays. No correlation was found between the levels of CIC and the clinical severity of the disease. The constant finding of positive CIC in these patients might represent an epiphenomenon, point out the postinfectious nature of this disease but also suggest a possible pathogenic role. PMID- 2770947 TI - Neuropathy of uremia: evaluation by nerve conduction velocity versus neurospecific current perception threshold. AB - Normal peripheral nerve conduction is a marker of adequate dialytic therapy in the ESRD population. Decreasing nerve function detected by periodic testing indicates insufficient dialysis. The standard test for the quantitative evaluation of nerve integrity is the nerve conduction test (NCT). A study of 34 dialysis patients proves that the measurement of current perception threshold (CPT) is equally effective to NCT in defining peripheral nerve function (r = 0.81; p less than 0.001). The superiority of the CPT examination is discussed. PMID- 2770948 TI - Aluminum-binding protein in dialysis dementia. I. Characterization in plasma by gel chromatography and electrophoresis. AB - A low molecular weight (approx. 8,000 daltons) protein has been found to be the major aluminum-binding protein in plasma of patients with dialysis dementia. Following treatment with desferrioxamine, the concentration of the low molecular weight protein and its aluminum content rise in parallel. The results suggest that aluminum exposure in dialysis dementia may result in the de novo synthesis of an aluminum-binding protein and that desferrioxamine may release aluminum in conjunction with its binding protein from tissue stores. PMID- 2770949 TI - Aluminum-binding protein in dialysis dementia. II. Characterization in plasma by ultrafiltration. AB - Ultrafiltration experiments, using Amicon membranes with molecular weight exclusions of 1,000, 10,000 and 30,000 daltons, have revealed that Desferal, both in vitro and in vivo, markedly increases aluminum ultrafilterability in plasma from patients with dialysis dementia. Ultrafilterability was greater with the 10,000-dalton membrane (60%) as compared with the 1,000-dalton membrane (40%); the difference could be related to the presence of an 8,000-dalton aluminum binding protein in the 10,000-dalton filtrate. These observations are pertinent to in vivo dialysis studies which have demonstrated enhanced aluminum clearance with high-permeability polyacrylonitrile dialysis membranes. PMID- 2770950 TI - Impaired renal hemodynamic but conserved natriuretic response to dopamine in patients with renal disease. AB - Renal hemodynamics and sodium excretion were determined before and during infusion of dopamine in doses ranging from 0.25 to 8 micrograms/kg/min in healthy volunteers (n = 15) and in patients with renal disease and moderately impaired renal function (n = 21, baseline glomerular filtration rate 34-85 ml/min). While in normal volunteers dopamine resulted in marked renal vasodilation (maximal fall in filtration fraction 24%), in patients with moderately impaired renal function, the renal vasodilatory response to dopamine was impaired (maximal fall in FF 13%) and was found to depend on baseline glomerular filtration rate. Infusion of dopamine in doses of 2 micrograms/kg/min and higher resulted in an increase in urinary sodium excretion, which was comparable for healthy volunteers and patients with renal disease. We conclude that dopamine results in a predominantly efferent glomerular vasodilation and, therefore, may be salutary in lowering intraglomerular hypertension. However, in patients with renal disease the renal hemodynamic response to dopamine infusion is impaired compared to healthy volunteers, while the natriuretic response is maintained. PMID- 2770951 TI - Variations in the distribution of methylguanidine with the progression of renal failure after methylguanidine loading. AB - Methylguanidine (MG) was intraperitoneally administered to both normal rats and those given adenine, and MG levels in the serum, liver, kidney, muscle, brain and urine were compared. The accumulation of MG in the body increased with the progression of renal failure, whereas the rate of urinary excretion of MG in rats given adenine for 30 days was lower than the corresponding values in rats given adenine for 10 and 20 days. The velocity of MG elimination from serum and tissues became lower as the period of adenine administration lengthened. In particular, the rate of MG elimination from muscle was markedly low in comparison with that from the serum, liver, kidney or brain, and a high concentration of MG was still present 24 h after MG loading. In addition, the amount of MG obtained by subtracting the total amounts detected in the serum, liver, kidney, muscle, brain and urine from the dose decreased gradually as the period of adenine administration lengthened. The MG-scavenging effect is diminished according to the progress of renal failure. PMID- 2770952 TI - Effect of acute renal failure on free thyroid hormone levels in a thyrotoxic patient. AB - Acute renal failure in a previously undiagnosed case of thyrotoxicosis was accompanied by a rapid and spontaneous decline in thyroid hormone levels. Over a 2-week period, free triiodothyronine and thyroxine fell to the low levels seen in euthyroid patients with end-stage renal disease. Thyrotropin levels remained undetectable throughout, suggesting impairment of the pituitary-thyroid axis at the level of the thyroid gland. This may represent an important beneficial adaptation to severe illness and could explain the virtual absence of hyperthyroidism in renal failure patients. PMID- 2770953 TI - Abnormalities of skin in hereditary nephritis. PMID- 2770954 TI - Appendicitis in hemodialysis patients. PMID- 2770955 TI - Prognosis on dialysis of 31 patients after bilateral nephrectomy for bilateral renal cancer. PMID- 2770956 TI - Ulinastatin gives rise to an effectual diuresis in oliguric acute renal failure. PMID- 2770957 TI - Piracetam as a potent inhibitor of plasma thromboxane B2 during hemodialysis. PMID- 2770958 TI - Growing fractures: an unusual complication of head injuries in pediatric patients. AB - Authors analyze three cases of growing fractures they observed in infants under the age of one year. It is noticeable that in two cases, even if the lesion was already present when babies underwent the first procedure, no specific treatment was adopted, thus resulting in a progressive enlargement of the extracranial mass. Surgical treatment must be performed quickly after the diagnosis of growing fracture is done due to the necessity of an early repair of the bone defect to avoid the eventual onset of neurological deficits since they are not reversible. PMID- 2770959 TI - [Follow-up of computerized tomography findings in traumatic intracerebral hematomas]. AB - CT controls and follow-ups were conducted in 27 patients who had suffered traumatic intracerebral hemorrhage. Only such patients were included who did not die before the 14th day after the trauma and in whom operation did not become necessary during this period. In these patients the volume of the hematoma and perifocal edema was determined via CT and clinical parameters were measured or recorded such as state of consciousness at the time of admission and the neurological outcome. It was found that the hematoma had attained its maximum size on about the fourth posttraumatic day. However, even the size of the freshly CT-detected hematoma shows good correlation to the outcome of the patients. Examination of the edema size points to the existence of two groups: one with only slight edema formation in the early posttraumatic stage, and another with an immediate considerable edematic border. From approximately the 8th posttraumatic day the hematoma/edema ratio is approximately the same in both groups, namely, 0.3. Anisocoria, or inequality of the pupils, occurred early in patients with an average hematoma volume of 37.7 cm. Of these, none left the hospital without neurologic signs, so that anisocoria must be considered as a prognostically unfavorable sign. PMID- 2770960 TI - Spontaneous rupture of epidermoid cyst. AB - A case of suprasellar epidermoid cyst presenting by spontaneous rupture into subarachnoid space and ventricles, and diagnosed by CT scan is reported. PMID- 2770961 TI - [Xenon-enhanced CT CBF measurements in intracranial vascular malformations]. AB - In the management of intracranial vascular malformations, it is important to know the regional cerebral blood flow in its surrounding structure. However, CT scan with contrast medium and angiography have only a limited ability to estimate the rCBF. In this study, stable xenon-computerized tomography scanning by means of the end-tidal gas-sampling method was performed in eleven patients with intracranial vascular malformations. Seven of the patients had arteriovenous malformations, three had venous angiomas and one had aneurysm of the vein of Galen. In two patients with large arteriovenous malformations, in two with "larger" venous angioma and in one with aneurysm of the vein of Galen, rCBF values were significantly reduced, particularly adjacent to the malformations. In contrast, there were no areas showing reduced rCBF in cases where the malformations were small. This indicates development of ischemia correlates with the size of malformations. From the xenon-enhanced CT scan and angiographic findings, the presence of steal phenomenon with venous congestion might be a cause of rCBF reduction in those cases where ischemia exists. PMID- 2770962 TI - [A clinical and pathological study of diffuse axonal injury]. AB - There is increasing evidence from human and experimental studies that the most important factor governing the outcome in head injury is the severity of diffuse axonal injuries. The authors have experienced 18 cases of severe diffuse axonal injury which showed post-traumatic coma for more than 24 hours and CT findings resembling those of shearing injuries of the cerebral white matter such as have been presented by Zimmerman et al. (1978). The consciousness levels on admission were 6 or less on the Glasgow Coma Scale and all cases were shown clinically to have primary brain stem injury. The main type of head trauma resulted from road traffic accidents (83%). Skull fractures were found in only 5 cases (28%). These findings suggested that acceleration/deceleration injury produce in the patients severe diffuse axonal injury. Initial ICP was below 20 mmHg in 11 cases out of 13 (85%). Parenchymal small hemorrhagic lesions of initial CT were basal ganglia (7 cases), corpus callosum (4 cases), pons (4 cases), midbrain (3 cases) and thalamus (2 cases). Extraparenchymal hemorrhagic lesions included intraventricular hemorrhage (6 cases) and subarachnoid hemorrhage (6 cases). Two autopsied cases of severe diffuse axonal injury (acute case and chronic case) showed remarkable congestion and edema in the deep part of the frontal white matter. Microscopic examination revealed marked axonal degeneration including axonal retraction ball in the corpus callosum, in the internal capsule and in the white matter of the brain stem. Glasgow Outcome Scale of the 18 patients at 3 months after the trauma made us concerned that no patients indicated good recovery or even only moderate disability.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2770963 TI - [Operative correction of kinking and coiling at the origin of vertebral artery and stellate ganglionectomy in patients with severe vertigo and dizziness]. AB - Bilateral vertebral angiograms were taken in 125 cases with severe vertigo and dizziness during the period between April 1983 and March 1986. Various kinds of morphological abnormalities were found. Most impressive findings were kinking and coiling at the first portion of the vertebral artery, which was corrected by operation in 54 cases out of 100 cases. This method is accompanied with stellate ganglionectomy and completed by rolling the subclavian artery forwards and downwards with ligation. The follow-up results were evaluated one to four years after operation. Symptoms were cured in 50 cases out of 54. The postoperative course was satisfactory. It was emphasized in this paper that our operation was very useful for patients with severe and recurrent vertigo. PMID- 2770964 TI - [A case of recurrent internal carotid stenosis, after carotid endarterectomy, due to strangulation by scarring]. AB - A case of recurrent internal carotid stenosis, one year after carotid endarterectomy, due to strangulation by scarring composed of digastric muscle, hypoglossal nerve and a branch of external carotid artery (ECA) is reported in this paper. A 34-year-old male suddenly became nauseated and developed right hemiplegia and dysphasia. He was admitted to a hospital, and the symptoms and signs improved gradually during a period of several weeks. A left carotid angiography, performed in another hospital, revealed a stenosis and wall irregularity around the highly-situated carotid bifurcation. He was transferred to our clinic with a view to being operated on. On admission, neurological examination disclosed a mild right motor weakness and motor dysphasia. A right carotid angiography revealed good cross circulation to the opposite. An EEG monitoring under the Matas test showed no outbreaks. With diagnosis of an embolism arising from carotid atheromatous plaque, a carotid endarterectomy was performed successfully. A postoperative angiography revealed good patency without stenosis nor wall irregularity around the carotid bifurcation. The postoperative and out-clinic condition was uneventful. However, one year after the operation, a left carotid angiography revealed recurrent internal carotid stenosis in a high degree. A second operation was performed and the operative findings showed an internal carotid stenosis due to strangulation by scarring composed of digastric muscle, hypoglossal nerve, a branch of ECA and connective tissue. The scarring was decompressed and a postoperative angiography revealed an improvement of the stenosis.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2770965 TI - [Hypernatremia due to hypothalamic tumor: ADH response to changes in plasma osmolality]. AB - A case of a patient with the syndrome of chronic hypernatremia and hypodispia due to hypothalamic tumor was studied to evaluate the change of ADH response to plasma osmolality during the clinical course. A 23-year-old man was admitted for investigation of anorexia, hypodipsia and gait disturbance. Examination showed memory disturbance and generalized muscle weakness. Investigation showed marked hypernatremia (177 mEq/l) and hypopituitarism. Water loading test showed that ADH was not stimulated by hyperosmolality but continued to be secreted at a more or less constant level approximating normal basal state. CT scan revealed hypothalamic tumor. The tumor was suspected to be germinoma due to its radiosensitivity and high serum hCG level. After irradiation, the tumor lesion disappeared. ADH secretion came to be responsive to changes in osmolality but the response of the system was markedly reduced compared with the normal response, and hypodipsia and hypernatremia still remained. We conclude that the adipsia and complete destruction of the osmoreceptor in the patient caused marked hypernatremia and the destruction of ADH osmostat improved partially after irradiation. We believe it very useful for analyzing the disturbance of osmoregulatory system to evaluate the relationship of plasma ADH to plasma osmolality. PMID- 2770966 TI - [Trigeminal nerve dysfunction as a false localizing sign: a case of the choroid plexus papilloma in the IVth ventricle]. AB - Trigeminal nerve dysfunction as a false localizing sign, although rate, is known to occur. A case of choroid plexus papilloma in the 4th ventricle with hemifacial numbness is presented. A 24-year-old woman had been suffering from intermittent facial numbness on the left side for 3 months prior to admission. She noted no other symptoms. Neurological examination disclosed marked papilledema, horizontal nystagmus on both lateral gazes and mild truncal ataxia. CT scans showed a calcified mass lesion in the 4th ventricle on the midline extending into the left lateral recess. It was enhanced homogeneously with contrast material. The pathogenesis of such a false localizing sign and its clinical implications were discussed from the anatomical point of view. PMID- 2770967 TI - [A case of intracranial hypoglossal neurinoma]. AB - A case of intracranial hypoglossal neurinoma was reported and the literature was reviewed. A 56-year-old female with a three month history of urinary incontinence, headache and gait disturbance was admitted to our hospital in April, 1986. General physical examination revealed nothing remarkable. Cafe au lait spot was not found. Neurological examination revealed horizontal gaze nystagmus toward the right, paresthesia of the left upper extremity and mild muscle weakness of the left upper and lower extremities. Atrophy of the right side of the tongue with fasciculation was also noted. Computed tomography (plain, enhanced and metrizamide cisternography) demonstrated no obvious findings of a mass in the posterior fossa. Anterior-posterior view of skull tomography showed enlargement of the right hypoglossal canal. MRI in short spin echo demonstrated a low intensity mass at the foramen magnum on the right side, which compressed the medulla oblongata. Vertebral angiography demonstrated a hypovascular extra-axial mass with right posterior inferior cerebellar artery displacement. On May 1986, suboccipitocranioectomy was performed. The intracranial tumor which arose from the right hypoglossal nerve was removed, but the extracranial portion of the tumor was left unremoved. Histological diagnosis was neurinoma. Post-operative course was uneventful. Intracranial hypoglossal neurinoma are rare and our case marks the 38th reported case. Hypoglossal nerve palsy is the most important symptom and the enlargement of the hypoglossal canal shown by skull tomography or CT for bone images is the most frequent neuroradiological findings. Plain, enhanced CT and metrizamide CT have been discussed as very useful means to detect this lesion.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2770968 TI - [Atypical computed tomographic features of meningioma: a case report]. AB - Diagnosis of intracranial meningiomas with computed tomography (CT) is usually easy. However, some authors have reported cases preoperatively misdiagnosed because of atypical computed tomographic features. We report a case of non-cystic meningioma presenting a ring enhanced mass lesion, with CT scan. A 48-year-old male was admitted to our hospital on January 5, 1987, because of progressive monoparesis of his left lower limb. This had continued for 1 1/2 years. Neurological examination revealed monoparesis, hypesthesia and decreased deep sensation of the left lower limb. X-ray films of the skull appeared normal. A CT scan demonstrated a ring-like high density mass attached to the falx in the right frontoparietal area with perifocal low density. The ring-like high density was irregularly increased with contrast enhancement. Right carotid angiograms showed a doughnut like tumor stain without meningeal blood supply. Brain scintigrams revealed a dense round hot lesion in the frontoparietal area at 5 minutes, and the hot lesion was still visualized after 90 minutes. We diagnosed a cystic parasagittal meningioma. A right frontoparietal craniotomy was performed, and total removal of the parasagittal tumor was made. The center of the tumor was very soft but it could not be said that it was not cystic. Histologically the tumor was a meningotheliomatous meningioma. The center of the tumor, which was very soft, was necrotic with arteriolar hyalinization. The meningioma cells survived around the patent vessels. These intact meningioma cells were scattered like islands in extensive necrosis. This is so called "oasis phenomenon" indicating that the necrosis of the tumor was caused by intratumoral ischemia.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2770969 TI - [Perifocal abnormal signal intensity area in MRI in meningiomas]. AB - To investigate the perifocal abnormal signal intensity area in MRI in meningiomas, we have analysed MRI in 10 cases among 73 meningiomas which were diagnosed by X-ray CT and verified by operation and pathology. The MRI scanners used in this study were Siemens Magnetom and Toshiba MRT 15A. Ten meningiomas diagnosed by MRI were as follows; one free convexity, one pyramidal, three falx and parasagittal, one sphenoid ridge, one olfactory groove, one cerebellopontine angle, two ventricular meningiomas. Perifocal abnormal signal intensity area was diagnosed as vasogenic edema in 4 cases. This area was shown as high signal intensity in T2-weighted MRI and was confined to the white matter. In proton density-weighted MRI, it was shown as high signal intensity and usually clearly distinguished from rather iso- or hypointensity tumor area. In T1-weighted MRI, this area was shown as slightly low signal intensity, which could be readily differentiated from the remarkably low intensity ventricular CSF. In one case a thin semi-lunar abnormal intensity area bordering the tumor was verified in MRI, but no abnormal area was shown in CT. In the remaining 6 cases, namely one free convexity, one pyramidal and two ventricular meningiomas, one cerebello-pontine and one sphenoid ridge meningioma, in which CSF abutted the tumor, abnormal signal intensity area was diagnosed as entrapped CSF space. The perifocal abnormal signal intensity area in MRI should be regarded as vasogenic edema or entrapped CSF space, and these two should be differentiated by the signal intensity, the distribution of the area and CT-cisternography.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2770970 TI - [Enlarging of intracranial hemorrhagic lesions and coagulative-fibrinolytic abnormalities in multiple-injury patients]. AB - The clinical course of ten cases of head injury complicated with multiple systemic injuries were studied by comparing two groups divided according to the presence or absence of associated coagulative-fibrinolytic abnormality. All these cases had intracranial hemorrhagic lesions proven by the high density area in the initial CT scan. Five cases showed signs of disseminated intravascular coagulation (DIC) as evidenced by decreased counts of platelet, and/or elevated value of FDP at the time of admission. Four cases out of these five were in a state of hemorrhagic shock. All these five cases showed a subsequent enlargement of intracranial hematoma. Four cases died. Two of them, who had low initial Glasgow Coma Scale (G.C.S) died of uncontrollable increase of intracranial pressure. The other two, who had high initial G.C.S., died of acute renal failure and multiple organ failure. In contrast with these cases, five cases without signs of DIC intracranial hematomas did not enlarge in spite of the similar neurological conditions to the former group. In head injured patients with systemic injury, DIC frequently causes secondary hemorrhage in the intracranial lesions of minor severity. PMID- 2770971 TI - [Analysis of CSF flow through L-P shunt during changes in posture]. AB - Two methods for percutaneous study of lumboperitoneal shunt patency are described. The first is an LP shuntography in which patency of the shunt can be assessed by the intraperitoneal spread of contrast medium injected intrathecally via the lumbar route. This method was performed in 27 hydrocephalic patients. The other is a thermosensitive determination technique, in which patency of the shunt can be assessed by definite temperature changes. In a patient with an LP shunt, flow of CSF, and hence patency of the shunt, are indicated by a downward deflection of the recording trace. Twenty-three trials of the thermosensitive determination of CSF shunt patency in LP shunts of 19 hydrocephalic cases were performed. We got five different types of recording traces by the thermosensitive method. A flat-line recording (two recordings) and an upward deflection (two recordings) showed complete occlusion. Operative findings and LP shuntography showed that four cases with a nearly flat line recording had a partial occlusion of the shunt. Patency of the shunt was confirmed by LP shuntography in all cases (12 recordings) with a gradual downward deflection. A steep downward deflection showed an acute excessive CSF drainage. An experimental study was carried out to perform a quantitative analysis of CSF flow in an LP shunt. Derived data suggested that the flow velocity was 10 ml/hr in a case with a nearly flat-line recording, 30 ml/hr in a case with a gradual downward deflection and 60 ml/hr in a case with a steep downward deflection.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2770972 TI - [Three-dimensional display of structures and lesions in the brainstem using a personal computer]. AB - The method of three-dimensional reconstruction of structures and lesions in the brainstem was developed by using a personal computer to visualize the affected sites in some cranial nuclei and long tracts. Outlines of brainstem structures and lesions were digitalized manually by tracing the atlas of the human brainstem and CT or MR images. Four outlines of the brainstem, the medulla, lower pons, upper pons and midbrain, and the outlines of any parenchymal structures were taken at every point 2 mm in thickness. These were used as the standard visualization of the atlas. The CT and MRI, which show outlines of the lesions, were taken on the vertical planes to the floor of the fourth ventricle, one of which included the fastigium, at every point 3 to 5 mm in thickness. These two kinds of outlines, taken from the atlas and the CT/MRI, were reconstructed three dimensionally with commercial 3-D software. It took only 20 to 25 minutes for the digitalization and the 3-D reconstruction. Three-dimensional display of small structures, which were difficult to identify on CT or MRI, and lesions would enable the visualization of their anatomical relations and make possible the detection of the affected sites, not only in the axial but in the longitudinal direction. Correspondence between the affected sites on 3-D and the neurophysiological examinations (ABR, SSEP) confirms that our 3-D method is adequate for use in the anatomical diagnosis of affected sites in any small structure in the brainstem. PMID- 2770973 TI - [Thrombosed AVM presenting temporal lobe epilepsy]. AB - A rare case of thrombosed AVM presenting temporal lobe epilepsy is reported. A 27 year old man was admitted to our hospital because of a 7-year history of temporal lobe epilepsy. He had also suffered from generalized seizure since he was 6 years old. No neurological deficit was disclosed. CT scan demonstrated a small calcified mass lesion in the left temporal lobe which was not enhanced by contrast study. Skull X - P and cerebral angiography were normal. Low intensity area on T1-weighted MR image corresponded to the high density area on CT scan. T2 weighted MR image demonstrated that peripheral low intensity area was more prominent and extensive. Conventional EEG showed focal spike discharges from the left fronto-central lead, and subdural EEG recordings showed intermittent spike discharges from the medial side of the left temporal lobe. A 5 cm temporal lobectomy was performed and a thick fibrous mass adjacent to the hippocampoamygdala complex was removed. Histopathological examination demonstrated a thrombosed AVM surrounded by gliotic neural tissue. PMID- 2770974 TI - [Attempt of intracranial IC bypass for giant aneurysm in the cavernous portion of the carotid artery]. AB - We report here, a novel method for internal carotid (IC) bypass between C2 and C5, by using the autologous saphenous vein. The patient was a 58 year-old female, complaining of pain and motor disturbance in her right ocular region. She suddenly developed left-sided hemiparesis during her stay in our hospital. The following CT examination demonstrated a high density homogenous round mass, which occupied the right side of the parasellar region with no perifocal edema. The contrast enhancement CT, however, suggested there was still a certain degree of blood flow in the mass. On the other hand, carotid angiography showed an occlusion of blood flow at the C5 level (interosseous portion), which seemed to indicate either giant aneurysm or cavernous angioma. The mass was identified as a giant aneurysm during surgery, and the decompression procedure by removing the intra-aneurysmal blood clot was attempted first. However, this trial failed due to an accidental severe bleeding. Because of this, we then decided to perform the grafting of autologous saphenous for a length of 10 cm between C2 and C5. Intraoperative heavy bleeding mentioned above seemed to have occurred due to release of compression by the aneurysm against the internal carotid artery through which there was restricted blood flow. Postoperative angiography demonstrated that the graft remained patent enough to be approximately equal in size to the original artery. From our experiences in this case, two important points are, we suggest, to be kept in mind while applying this method; (1) to carefully expose the C5 segment, (2) to avoid damage of the surrounding structures such as the Eustachian tube, facial nerve and cochlear nerves, and so forth. In conclusion, we strongly recommend this IC bypass technique for other types of tumors in the cavernous portion as well. PMID- 2770975 TI - [Anterior inferior cerebellar artery aneurysm with a sudden onset of caudal cranial nerve symptoms]. AB - A case of the anterior inferior cerebellar artery aneurysm with a sudden onset of caudal cranial nerve symptoms was reported. A 20-year-old female suffered from sudden onset of dysphagia and throat pain. Three days later, she was admitted to our hospital, suffering from sudden onset of headache, nausea, vomiting and consciousness disturbance. On admission, consciousness disturbance, bilateral abducent nerve palsy, and left caudal cranial nerve palsy was observed. CT scan revealed a subarachnoid hemorrhage in the basal cisterns with the densest area in the left ambient cistern. Left vertebral angiogram revealed an aneurysm at the left anterior inferior cerebellar artery (AICA). On the third day after admission, operation was performed. The aneurysm was found near the jugular foramen, surrounded by thick clots. The dome was attached to the caudal cranial nerves, and the neck was located at the bending portion of AICA without branches. Neck ligation and clipping was performed. On the fortieth day after the operation, the patient was discharged from our hospital without neurological deficits. To our knowledge, aneurysm at the AICA is rare and only 33 cases have been reported. However, a case with a sudden onset of caudal cranial nerve symptoms, before evident symptoms due to subarachnoid hemorrhage, has never been reported previously. PMID- 2770976 TI - [Two cases of diastematomyelia: its evaluation with MR imaging]. AB - We experienced two cases of diastematomyelia. Magnetic Resonance Imaging (MRI) was very useful in definitive diagnosis and detection of associated abnormalities. Case 1 was a 5-year-old boy. He was admitted because of foot length discrepancy. He also presented scoliosis, hypertrichosis and pigmentation in his back skin, and foot deformity. Myelography and CT myelography revealed bony septum and split cord at midthoracic level, and two separated taut filum terminalis in the lumbosacral region. Sagittal MR image delineated the taut filum terminale adhering to the lipomatous tissue at the end of dural sac. Removal of the septum and division of the taut filum terminalis were performed. Case 2 was a newborn baby. She was admitted because of bulging of the back skin in the lumbosacral region and foot deformity. Plain CT revealed bony septum at lumbar level. Myelography was not performed. MR image demonstrated the split cord in its entirety, the bony septum and its structures in detail, and the associated lipoma. Removal of the septum and resection of the lipoma were performed. Diastematomyelia has been able to be definitely diagnosed only by myelography or CT myelography. In our case, MR image gave visualization of septum and split cord in its entirety, and also detected the associated anomalies such as lipoma, tight filum terminale. MRI has possibility of becoming a diagnostic technique in place of myelography and CT myelography. PMID- 2770977 TI - [An adult case of moyamoya disease associated with marked advance of occlusive lesion in the bilateral carotid system]. AB - We reported an adult case with moyamoya disease in which unilateral obstructive process proceeded to the bilateral lesion during a period of 45 months. A 30-year old female was admitted to our institute due to frequent ischemic episodes since she was 25 years old. At the time of admission, she was asymptomatic with slightly disturbed psychogenic reactions. At the time of the initial cerebral angiography when she was 25 years old, the right cerebral angiography demonstrated stenosis of the right ICA terminal portion with moyamoya vessels in the basal area and leptomeningeal anastomosis at the right parietal area. The left cerebral angiography revealed normal ICA system with a lightly narrowing Al portion, without Moyamoya vessels. The second cerebral angiography, taken 45 months after the initial angiography, demonstrated progression stenosis of the right ICA terminal portion, with decreasing moyamoya vessels at the basal area, obstruction of the left ICA terminal portion, stenosis at the Al portion with newly developed moyamoya vessels in the left basal area. We concluded at this time that this case was a definite case of moyamoya disease. The third cerebral angiography after right SDP (synangio-dural plasty), 49 months after the initial angiography, revealed, in the right angiography, newly formed anastomotic vessels perfusing the middle cerebral artery region via the extracerebral arteries and in the left cerebral angiography, and an increased obstruction of the ICA terminal portion, transdural anastomosis via the extracerebral arterial system, and a decrease of moyamoya vessels in the basal area. This rare case provided us a good picture of the pathogenic mechanism of moyamoya disease. PMID- 2770978 TI - Effects of passive immunization against vasoactive intestinal peptide on serum prolactin and LH levels. AB - Recent findings suggest that vasoactive intestinal peptide (VIP) may be a physiological regulator of prolactin secretion and may also be involved in the control of LH secretion. In the present work we have studied the effect of the blockade of endogenous VIP by means of the injection of a specific rabbit anti VIP serum, in male and female rats with hyperprolactinemia. The administration of 0.5 ml of the VIP antiserum in ovariectomized rats given an acute or chronic treatment with 17 beta-estradiol induced a significant decrease in serum prolactin and LH levels as compared with estrogenized-control rats injected with normal rabbit serum. Anti-VIP serum also reduced serum LH levels in ovariectomized rats not treated with estrogens. The administration of the same antiserum decreased serum prolactin levels in male rats implanted with 2 anterior pituitary glands under the kidney capsule. On the other hand, the injection of the anti-VIP serum in the morning in proestrus rats brought about an increase in serum prolactin and LH levels in the afternoon of the same day. These results confirm previous data showing that VIP is a stimulator of prolactin release, and may also participate in the control of LH secretion in ovariectomized rats acting as a facilitatory factor. During proestrus however, VIP may act in an opposite way, inhibiting, rather than stimulating, prolactin and LH release. PMID- 2770979 TI - GABAergic biochemical parameters of the tuberoinfundibular neurons following chronic hyperprolactinemia. AB - The effect of chronic hyperprolactinemia was studied on (a) GABA concentration in the pituitary anterior lobe; (b) GABA biosynthesis enzyme, glutamate decarboxylase (GAD) activity in the hypothalamic median eminence, and (c) GABA degradation enzyme GABA-transaminase (GABA-T) activity at both levels. In male rats bearing the prolactin-secreting tumor MtTF4 for 1 month or treated for 5 days with estradiol benzoate, the plasma prolactin concentration was markedly increased (between 4- and 10-fold basal values). In both cases, GABA concentration was significantly increased (40-60%) in the anterior pituitary lobe. A slight reduction (20-30%) in GABA-T activity was observed in the anterior lobe while no change in GAD or GABA-T activity was measured in the median eminence. These results are discussed in relationship to a possible feedback input of prolactin on the tuberoinfundibular GABAergic system. PMID- 2770980 TI - Autoradiographic identification of prolactin binding sites in rat median eminence. AB - Binding sites for prolactin were localized and quantified in the female rat brain by in vitro autoradiographic analysis with iodine-125-labeled ovine prolactin. Following incubation, labeled prolactin bound preferentially to the median eminence and choroid plexus of the lateral and third ventricles. The addition of excess unlabeled ovine prolactin blocked binding of the labeled hormone in the choroid plexus, and attenuated prolactin binding in the median eminence. These results provide evidence for median eminence. These results provide evidence for prolactin-specific recognition sites in the median eminence, a region intimately involved in the hypothalamic regulation of prolactin secretion. PMID- 2770981 TI - Central actions of adenosine on pituitary secretion of prolactin, luteinizing hormone and thyrotropin. AB - Pituitary hormones were measured in plasma in unanesthetized male and female rats prepared with venous and ventricular cannulae following ventricular infusions of adenosine and two adenosine receptor agonists. Adenosine (10, 100, and 200 nmol) injected intraventricularly caused dose-related rises in plasma prolactin (PRL) in males; in females, only the 100- and 200-nmol doses increased PRL. Similar doses of adenosine had little effect on plasma levels of luteinizing hormone (LH) and thyrotropin (TSH) in the same animals. The adenosine receptor agonists L-N6 phenylisopropyladenosine (L-PIA) and 5'-N-ethyl-carboxamideadenosine (NECA) potently stimulated prolactin secretion at doses of 10 and 50 nmol when administered into the lateral ventricle, and at a dose of 2.5 nmol when administered into the third ventricle. The secretion of PRL was antagonized by the adenosine receptor antagonist theophylline (25 nmol), when theophylline was coadministered with NECA and L-PIA. TSH levels were reduced slightly but significantly following the 10- and 50-nmol infusions of L-PIA into the lateral ventricle. The less potent D-isomer of PIA (D-PIA) did not significantly stimulate PRL release. Coupled with studies indicating the presence of adenosine in the basal hypothalamus, our observations indicate a potential neuroendocrine role for this purine in prolactin secretion. PMID- 2770982 TI - Daily trends in white blood cell count and temperature after subarachnoid hemorrhage from aneurysm. AB - A retrospective analysis of the cases of 173 patients operated on for aneurysms and admitted to a neurosurgical service early after subarachnoid hemorrhage was conducted with respect to white blood cell (WBC) count and highest daily temperature. Daily trends for the development of clinically significant vasospasm (VSP) as well as mortality during the hospitalization were analyzed. An admission WBC count greater than 15 x 10(9)/l was associated with 55% mortality as opposed to 25% mortality for those with a lower WBC count. The mortality of those with a temperature greater than 37.5 degrees C on Day 0 was 60%, compared with 35% for those with a lower temperature. A WBC count greater than 15 x 10(9)/l on Day 0 was associated with a VSP rate of 40%; a lower WBC count was associated with a VSP rate of 30% Day 0 temperatures greater than 37.5 degrees C were associated with a VSP rate of 40%, while patients with lower temperature had a VSP rate of 30%. By Day 6, the patients with temperatures greater than 37.5 degrees C had a VSP rate of 60%, double that of the VSP rate of those with temperatures less than 37.5 degrees C. WBC count was apparently more closely linked to the chance of dying than the chance of developing VSP. The development of fever after a few days is related to both increased mortality and increased chance of developing VSP. PMID- 2770983 TI - Cognitive deficits related to computed tomographic findings after surgery for a ruptured intracranial aneurysm. AB - A consecutive series of 118 patients operated on for ruptured intracranial arterial aneurysms was studied. Ninety-six of them could be adequately examined with a battery of psychological tests and computed tomographic scans 1 year after a subarachnoid hemorrhage. Seventeen orthopedic control patients with no history of brain damage were also tested. The pattern of cognitive deficits was strongly related to the findings on the computed tomographic scans. Patients with left lateral infarctions had deficits on performances requiring verbal efficiency, including memory and classification tasks, whereas patients who had right lateral infarctions were poor on a visuoconstructional task (the copying of Rey's Figure). These deficits were pronounced when lateral infarction was associated with diffuse brain damage. Patients with frontal medial infarctions had low scores on memory tests; the inefficiency in verbal fluency, categorical reasoning, and memory was related to diffuse brain damage. The patients who had no infarctions did not differ significantly from the control group. Cognitive impairments after left lateral and frontal medial infarctions, as well as diffuse brain damage, correlated with the Glasgow Outcome Scale. PMID- 2770984 TI - Cyst fluids of malignant human brain tumors contain substances that stimulate the growth of cultured human gliomas of various histological type. AB - The contents of 14 cysts that were located within human intracranial tumors were obtained at surgery by needle aspiration. These tumor cyst fluids (TCFs) were mostly derived from glial tumors (10 cases). TCFs from one metastasis from a mammary carcinoma, one cystic meningioma, one hemangioblastoma, and a cystic acoustic neurinoma were also included. These TCFs were added to primary cultures of human gliomas, established human glioma cell lines, and normal human arachnoid cells in culture. The presence of proliferation-promoting factors in all cyst fluids could be demonstrated. On the basis of the response patterns of the cultures, it was possible to distinguish different levels of growth autonomy and growth factor sensitivity among these cultures and to speculate about varying degrees of cellular autocrine activation. The TCFs appear to contain factors that are not normally present in fetal calf serum, which is a regular constituent of most cell culture media. Some primary cultured cells as well as cell lines react in an oversensitive manner to the addition of TCFs. PMID- 2770985 TI - Alumina ceramic as a biomaterial for use in afterloading radiation catheters for hyperthermia. AB - A major technical challenge to the use of interstitial hyperthermia in malignant brain tumors is the production of a well-defined, uniform hyperthermal field. In theory, A 915-MHz microwave antenna should allow fewer antennas to be used and cause less mechanical brain damage; however, standard radiation afterloading catheters require antennas to be 12 cm long; this is clearly impractical for intracranial use. Since alumina ceramic (Al2O3) catheters permit short microwave antennas (3-5 cm in length) to function properly in neural tissue, it is important to test the biocompatibility of alumina for use in combined interstitial microwave hyperthermia and brachytherapy. A 5-mm length of alumina catheter was implanted into the brains of 15 white rats. The animals were killed at 3, 7, 14, 28, and 56 days. Histological examination revealed only minor mechanical damage and no encapsulation until 1 month; even then, the glial wall was only a few cell layers thick. Five animals received implants and were killed at similar intervals for x-ray microanalysis with the scanning electron microscope. No migration of aluminum into the brain was detected when compared with two control animals that did not receive implants and an alumina blank. Although we measured 50% attenuation of the radiation from iridium-192 sources in alumina catheters as compared with conventional ones, alumina catheters can still be used for interstitial radiation by increasing either the activity of the seeds or the duration of treatment. PMID- 2770986 TI - Using a national health care data base to determine surgical complications in community hospitals: lumbar discectomy as an example. AB - To determine the incidence of acute complications of an operation in a large cross-section of U.S. community hospitals, we developed a method that combines the screening of discharge abstracts with the sampling of medical records. Our target patients were those who underwent discectomy for routine lumbar discogenic radiculopathy. We assembled 39,389 discharge abstracts of patients who underwent lumbar discectomy in the U.S. in 1980. This population contained some nontarget patients with a) errors in principal diagnosis or procedure, b) operations exceeding two levels, c) fusion, d) previous laminectomy, or e) problems of the lumbar spine in excess of routine disc disease. Screening of discharge abstracts allowed us to exclude some of these patients. Those remaining were then divided by the reported hospitalization into three groups: 1) death, 2) nonfatal complication, and 3) normal hospitalization. A sample of patients from each group was selected for detailed study, and questionnaires were mailed to hospital medical records departments to confirm the hospitalization and to obtain other medical information unavailable in the abstract. With this information, we 1) removed the remaining nontarget patients (a through e above); 2) categorized reported complications as erroneous, preexistent, trivial or major; 3) calculated the incidence of major complications; and 4) assessed the reliability of the discharge abstract data. Principal diagnosis and procedure were reliably coded in 96.5% of abstracts. No deaths were reported in error and none were excluded in error. Among patients who had complications, 4% of the abstracts incorrectly indicated complications, and 11% omitted one complication while correctly reporting others.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2770987 TI - Complications and demographic characteristics of patients undergoing lumbar discectomy in community hospitals. AB - We determined the incidence of acute, major complications in a population of 28,395 patients who underwent lumbar laminectomy for discogenic radiculopathy in the United States in 1980. This population was drawn from a broad cross-section of community hospitals and represented 31% of all patients who underwent laminectomy that year for this condition. Our cohort excluded patients with a) operations exceeding two disc levels, b) fusion, c) previous lumbar laminectomy, or d) coexistent discitis, spondylosis, spinal stenosis, myelopathy, or arachnoiditis. The incidence of death was 5.9 per 10,000. The causes of death were septicemia, myocardial infarction, and pulmonary emobolus. The incidence of at least one major complication was 157 per 10,000. The incidences of specific complications were as follows: infection requiring intravenously administered antibiotics, 30.7; major neurological deficit, 29.8; pulmonary embolus, 10.7; and myocardial infarction, 5.6. We studied four additional categories of complication. Patients were counted only when a second operation was required to treat the complication. The categories and incidence per 10,000 were as follows: incisional hematoma, 8.7; cerebrospinal fluid fistula, 10.5; ventral perforation, 1.6; and retention of a foreign body, 0.7. Among the patients whose hospitalizations were otherwise normal, 6.7% received a blood transfusion; of the patients whose hospitalizations were complicated, 24% required transfusion. The demographic characteristics of transfusion. The demographic characteristics of patients with a normal hospitalization were tabulated separately from those whose hospitalizations were complicated. Neurosurgeons performed 60% of the operations, and orthopedic surgeons performed 40%. The speciality of the surgeon was not a factor in determining the risk involved in surgery. Spinal anesthesia was used in 7% of the cases, and no pattern of complications emerged that was uniquely related to that technique. PMID- 2770988 TI - The symptomatic incompetent cervical intervertebral disc. AB - A series of 16 patients with symptoms such as pain in the neck, occiput, shoulder and arm; numbness in the hands; and/or difficulty in walking, is described. Neurological examination of the upper extremities disclosed signs of nerve roots dysfunction in 5 patients and long tract signs in 12, whereas examination of the lower extremities disclosed long tract signs in every patient. Positive contrast cervical myelograms suggested mild posterior bulging of one or two intervertebral discs in every patient, but computed tomographic myelograms invariably demonstrated a coincident narrow cervical spinal canal, thus revealing the true compressive potential of the aforementioned mild disc protrusion on the spinal cord. All patients underwent anterior cervical microdiscectomy of the offending disc or discs, which were found to be degenerated. No case of frank rupture of the anulus was identified. Response to treatment was graded as excellent in 12 patients, who had complete relief of symptoms, and good in 4 patients, who had mild residual complaints. This study suggests that incompetence (bulging) of a cervical intervertebral disc may acquire important clinical significance in the presence of a narrow spinal canal by compressing the spinal cord and the corresponding nerve roots. Surgical removal of the diseased disc may result in restoration of neurological function. PMID- 2770989 TI - Cerebral distribution of immunoconjugate after treatment for neoplastic meningitis using an intrathecal radiolabeled monoclonal antibody. AB - A detailed autopsy and autoradiographic study was performed after the death of a patient undergoing intrathecal, antibody-guided irradiation for carcinomatous meningitis. The results demonstrated tumor cells infiltrating the surface meninges and a severe astrocytic reaction associated with oedema in the periventricular and brain stem subpial white matter. This was not seen in cortical or other gray matter structures. Autoradiographic examination correlated well, demonstrating isotope within the oedematous areas of the white matter in addition to the expected concentration in the leptomeningeal layers. These findings are discussed in the context of antibody binding to tumor tissue and the possible benefits conferred in the treatment of infiltrating tumor cells. PMID- 2770990 TI - Cerebellar astrocytomas in elderly patients with very long preoperative histories: report of three cases. AB - Three patients, ages 69, 67, and 74 years, respectively, underwent surgical removal of cystic cerebellar astrocytomas. All three had past histories pointing to the existence of a cerebellar lesion for many decades prior to surgery: Patient 1 had had nystagmus on lateral gaze on the side of the tumor since early childhood; Patient 2 had had sensorineural hearing loss on the side of her neoplasm for 38 years preceding the operation; and Patient 3 was diagnosed as having a brain tumor 51 years before the operation. (He has been blind because of pressure hydrocephalus for half a century, but otherwise managed to live a productive farming and family life until he sustained a head injury in a car accident, which forced him to undergo removal of his cerebellar tumor.) The neoplasms in all three instances were found by histological examination to be low grade astrocytomas. These cases indicate that low-grade cerebellar astrocytomas, which are well known for their characteristically long postoperative courses, may at times manifest a slow growth potential with an exceptionally long preoperative course. PMID- 2770991 TI - Detection of brain death in barbiturate coma: the dilemma of an intracranial pulse. AB - Patients treated with barbiturate coma for elevated intracranial pressure after head injury may suffer brain death. Since such patients have an iatrogenically induced absence of neurological function, brain death cannot be diagnosed clinically. Furthermore, as demonstrated by two of our patients, monitoring of intracranial pressure, even in the face of brain death, may show a low intracranial pressure and an intracranial pulse, suggesting the presence of adequate cerebral perfusion pressure and, therefore, brain viability. Under these circumstances, however, significant intracranial blood flow may be absent. Therefore, we suggest that a patient in barbiturate coma should undergo serial blood flow studies, even when the intracranial pressure is low and an intracranial pulse is present, to determine whether brain death has occurred. PMID- 2770992 TI - Spinal subarachnoid hematoma complicating lumbar puncture: diagnosis and management. AB - Two patients with altered hemostatic mechanisms developed spinal subarachnoid hemorrhage after difficult lumbar punctures. One patient had received anticoagulation therapy soon after lumbar puncture and the other had a low platelet count (63,000/mm3) at the time of lumbar puncture. In both patients a hematoma evolved, producing blockage of cerebrospinal fluid flow. Clinical manifestations consisted of severe back and radicular pain with sphincteric disturbances followed by rapidly developing severe paraparesis. Of the methods of radiographic evaluation that were used, including computed tomography (CT) without contrast enhancement, myelography, CT with intrathecally administered contrast medium, and magnetic resonance imaging, we found the best study to be myelography via lateral cervical puncture followed by CT. Unfortunately, diagnosis was delayed, and surgical evacuation of the hematomas did not substantially improve the patients' conditions. The salient clinical and radiographic features of this disorder and its pathophysiology are reviewed. Prompt recognition of these lesions is necessary so that surgical intervention may maximize chances of recovery. PMID- 2770993 TI - Combination Jefferson fracture of C1 and type II odontoid fracture requiring surgery: report of two cases. AB - Two cases of simultaneous Jefferson fracture of C1 and Type II odontoid fracture requiring surgical stabilization are reported. One patient required early stabilization because alignment could not be maintained in a halo vest, and the second patient required late stabilization for nonunion after a 3-month period of immobilization in a two-poster cervical brace. Although this uncommon injury can often be managed conservatively, surgical fusion will need to be considered in the setting of early or late instability. PMID- 2770994 TI - Myeloradiculopathy secondary to pseudogout in the cervical ligamentum flavum: case report. AB - A case of cervical myeloradiculopathy secondary to deposits of calcium pyrophosphate dihydrate (Ca2P2O7 2H2O) (CPPD) crystals in the degenerating ligamentum flavum, with marked granulomatous inflammation, is presented. This uncommon clinical presentation of pseudogout (CPPD deposition disease) was confirmed after surgical removal of a compressive cervical ligamentum flavum. The diagnosis of CPPD crystal deposition was determined by polarized light microscopy and energy-dispersive x-ray microanalysis in frozen sections of the biopsy specimen. A review of seven previously reported cases along with the present case failed to reveal trauma as a causative factor. PMID- 2770995 TI - Neurosurgery in the Middle East: life under fire. PMID- 2770996 TI - Transcortical leak of cerebrospinal fluid as a cause of arachnoid cyst growth. PMID- 2770997 TI - Third ventriculostomy for slit ventricle syndrome. PMID- 2770998 TI - Management of the slit ventricle syndrome. PMID- 2770999 TI - MRI assessment of ventricular CSF dynamics in the presence of lesions of the foramen of Monro. PMID- 2771000 TI - Upward-gaze palsy. PMID- 2771001 TI - Redundancy of nerve roots of the cauda equina. PMID- 2771002 TI - Tumors of the choroid plexus in children. AB - Primary neoplasms of the choroid plexus in children are surgically treatable, and the encouraging results of surgical removal, even for carcinoma, justify an aggressive surgical approach. Forty cases operated on over a span of 45 years have been reviewed in detail, including a rereading of all microscopic slides. The prognosis for children with papilloma has been excellent. The 5-year survival rate for children with carcinoma of the choroid plexus was 50%, and all deaths occurred within 7 months of operation. The patients whose carcinomas were totally removed had a better prognosis than did those with subtotal removal. PMID- 2771003 TI - Magnetic resonance imaging of lipomyelomeningocele and tethered cord. AB - The operative and magnetic resonance image (MRI) findings of 25 patients with the diagnosis of lipomyelomeningocele and/or tethered cord were compared. Postoperative MRI scans of eight patients, five of whom were in stable condition, were also compared with the preoperative studies. In this review there was one false negative MRI scan and four MRI scans in which the relationship of the lipoma to the conus or filum was not demonstrated accurately. In six patients, incidental intramedullary cystic lesions at the conus were identified by MRI scan. All eight postoperative (1 month to 2 years) scans demonstrated no change in the level of the conus from the preoperative study. MRI is an accurate screening modality in the initial diagnosis of occult spinal dysraphism. MRI was not useful in the postoperative evaluation of lipomyelomeningocele and the tethered cord, since the caudal, posterior displacement of the conus was unchanged in all studies. PMID- 2771004 TI - Correlation between magnetic resonance imaging and surgical findings in the tethered spinal cord. AB - Between October 1982 and August 1987, 20 patients underwent magnetic resonance imaging (MRI) and subsequent surgical release of a tethered spinal cord. The tethering was caused by a thick filum terminale in 6 patients. On MRI scans, the conus medullaris was at L4 in 2 patients, at L2 in 3 patients, and the filum terminale appeared thick in 1 patient. The spinal cord was tethered to an intradural lipoma correctly demonstrated by MRI in 6 patients. Increased epidural fat was misdiagnosed as an intradural lipoma in one patient and a lipomatous stalk was not identified in 2 other patients. Scar tissue resulting from repair of a meningocele had tethered the cord in the remaining 8 patients. On MRI scans, the conus medullaris was located between L3 and S3; in 5 of the patients, scar tissue was apparent on the MRI scan. This correlative study supports the use of MRI as the initial, and possibly the only, imaging modality when a tethered spinal cord is suspected. Improved or more recent MRI techniques will help demonstrate these anomalies better. PMID- 2771005 TI - Mechanical aspiration of hematomas in an in vitro model. AB - A modified Nucleotome (Surgical Dynamics, San Leandro, California) was used to aspirate blood clot in an in vitro model of intracerebral hematoma. This machine was successful in removing the clot at a reasonably rapid rate. It aspirates normal rat brain far more slowly. It therefore shows promise for being effective and safe in removing intracerebral hematomas in humans. PMID- 2771006 TI - Titanium wire internal fixation for stabilization of injury of the cervical spine: clinical results and postoperative magnetic resonance imaging of the spinal cord. AB - Nine patients with dislocation of the cervical spinal with posterior ligamentous damage were treated with posterior internal fixation using a twisted pair of 22 gauge titanium wires and iliac crest bone fusion. Fixation using the titanium wire was compared with fixation using stainless steel wire for differences in surgical insertion, long term stability of bony fusion, and postoperative magnetic resonance imaging (MRI) artifacts near the implanted wire. MRI of the cervical spine is valuable for diagnosing the acute and chronic consequences of traumatic cervical spinal injury by providing anatomic evaluation of both the spinal cord and the supporting bony/ligamentous structures in the neck. Because MRI is an accurate and sensitive noninvasive test, it is especially useful for the long-term serial assessment of the region near the cervical dislocation site to detect the sequelae of spinal cord injury, including syrinx, arachnoid cyst, cord tethering, and persistent mechanical impingement on the spinal cord or spinal roots. Previous attempts at our institution to obtain useful MRI scans of the cervical region adjacent to stainless steel wires after posterior wire fixation have failed due to marked imaging artifacts from the ferromagnetic properties of these wires. Our substitution of biocompatible titanium wire (Titanium 6 A1-4V ELI alloy, Specialty Steel and Forge, Leonia, New Jersey) for stainless steel wire produced identical immediate stabilization and ultimate bony fusion of the fracture and yielded minimal MRI artifacts overlying the immediately adjacent spinal cord and neural canal; however, the installation was technically more difficult, because of the titanium wire's greater stiffness.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2771007 TI - The effect of the thermoplastic Minerva body jacket on cervical spine motion. AB - In order to determine the extent of cervical spine immobilization provided by the thermoplastic Minerva body jacket (TMBJ) 20 healthy male subjects underwent analysis of cervical spine motion before and after TMBJ placement. Maximal cervical flexion/extension and lateral bending were measured from lateral and anteroposterior roentgenograms, respectively. Maximal cervical rotation was measured from overhead photographs. The TMBJ significantly limited flexion/extension at each level of the cervical spine, as well as rotation and lateral bending (P less than 0.001). Flexion/extension at each cervical level was found to be equal to that allowed by the halo with body jacket at most levels and less at the occiput-C1, C3-C4, and C6-C7 (as reported in studies using similar methodology). The present study suggest that the thermoplastic Minerva body jacket is a valuable option for rigid external immobilization of the cervical spine. PMID- 2771008 TI - Factors influencing the development of gastrointestinal complications after neurosurgery: results of multivariate analysis. AB - A retrospective review of 526 patients who underwent neurosurgery for nontraumatic conditions over a 5-year period revealed 36 (6.8%) patients with endoscopically and or surgically documented postoperative gastrointestinal (GI) complications. Two patients had GI bleeding and perforation, and the remaining patients had bleeding only. Multivariate analysis indicated 5 factors that were of independent significance in predicting the development of postoperative GI complications. These factors included 1) inappropriate secretion of antidiuretic hormone, 2) preoperative coma (Glasgow Coma Score less than 9), 3) the presence of postoperative complications, 4) age greater than or equal to 60 years, and 5) pyogenic infection of the central nervous system. Further analysis of the 36 patients with GI complications revealed that they could be divided into three groups with different clinical courses. In Group I (n = 10), all patients died as a result of their neurological conditions; GI complications were just preterminal events and did not require treatment. In Groups II (n = 11) and III (n = 15), GI complications were symptomatic and life-threatening events, respectively. Eleven patients from Group III died as a direct result of the GI complications. Separate multivariate analyses based on the patients in Groups II and III revealed that preoperative coma was the only significant factor that predicted the occurrence of life-threatening complications. Patients who are at high risk of developing postoperative GI complications can thus be identified, and intensive prophylaxis may be instituted. PMID- 2771009 TI - Transcranial Doppler monitoring of cerebral flow velocities during surgical occlusion of the carotid artery. AB - Transcranial Doppler (TCD) was used to assess collateral flow and to quantitate perfusion velocity changes in a group of 18 patients requiring temporary or permanent surgical occlusion of the internal carotid artery for treatment of their cerebrovascular lesions. Velocity measurements were correlated with times of occlusion and neurological outcome in order to assess safe vessel occlusion times and the need for an intraoperative shunt. These data were used to calculate a perfusion velocity index (PVi), which indicated that values greater than 2 were well tolerated, and values of less than 1 were associated with ischemic signs. In addition, preoperative TCD examinations were combined with compressive maneuvers of the carotid artery in the neck to evaluate the feasibility of carotid clamp ligation for the treatment of giant intracranial aneurysms deemed unsuitable for direct clipping. When maintenance of neurological function and intracranial vessel flow velocities were found to be normal, with aneurysmal flow velocities of zero, ligation of the carotid artery could safely be undertaken. Finally, TCD allowed continuous surveillance of cerebral hemodynamics, which gave immediate assurance of postoperative ICA patency, as well as the ability to identify high velocity states associated with hyperperfusion syndromes, which occurred in two patients. PMID- 2771010 TI - Late magnetic resonance imaging related to neurobehavioral functioning after aneurysmal subarachnoid hemorrhage. AB - Twenty patients who underwent early aneurysm surgery--that is, surgery within 72 hours after rupture--underwent further follow-up examination including magnetic resonance imaging (MRI) of the brain and a comprehensive neuropsychological assessment. Significant statistical correlation between tissue loss as seen on a late MRI scan and neurobehavioral deficits could not be established. Among 9 patients with no tissue loss seen on MRI, 3 exhibited substantial cognitive dysfunction and 6 had mild impairment. Three patients showed minor but corresponding tissue loss and deficits. In 3 patients with pronounced pathological indications on MRI, evidence of cognitive dysfunction was absent in 2, and 1 patient showed substantial impairment. The remaining 5 individuals displayed moderate pathological indications on MRI, with no obvious correspondence to cognitive functioning. In 7 patients, small white matter lesions, probably silent infarcts not seen on computed tomographic scan, were discovered on MRI. There was a clear relationship between arterial hypertension prior to aneurysm rupture and the extent of tissue loss seen on MRI. Absence of pathological findings on MRI scan did not exclude cognitive malfunctioning, and vice-versa. PMID- 2771011 TI - Internal carotid artery occlusion for cavernous segment aneurysm. AB - We review our recent experience with occlusion of the cervical internal carotid artery (ICA) in 15 patients with symptomatic aneurysms of the cavernous segment. All the patients were women and ranged in age from 38 to 74 years. Ten patients sought treatment initially for ophthalmoplegia, 9 for retro-orbital pain, 8 for facial paresthesia, and 3 for loss of vision. Two patients had symptoms of transient ocular or brain ischemia. The diameter of the aneurysm was greater than 3 cm in 10 patients. Ten patients underwent gradual occlusion of the ICA by Selverstone clamp under anticoagulation and monitoring of neurological status. One patient underwent ligation of a severely stenotic ICA under general anesthesia and electroencephalographic monitoring. Four patients underwent trapping of the aneurysm (after attempts at direct obliteration) under electroencephalographic and cerebral blood flow monitoring. Two patients with incompetent circle of Willis collaterals underwent prophylactic superficial temporal artery to middle cerebral artery bypass surgery prior to ICA occlusion. There was no postoperative clinical change in 9 patients. Ophthalmoplegia improved in 2 patients, and facial pain improved in 3. Three patients developed new extraocular muscle palsies within hours of ICA occlusion; these resolved in all patients by 1 week postoperatively. No change in aneurysm size was documented by serial postoperative computed tomographic or magnetic resonance imaging scans. After a follow-up of 5 to 6 years (range, 6 months-9 years), 11 patients have remained neurologically stable. Two patients experienced delayed transient worsening of visual or facial symptoms.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2771012 TI - Anatomic evaluation of cisternal puncture. AB - Cisternal puncture, although less frequently used since the advent of computed tomography and magnetic resonance imaging, is an important tool in the neurodiagnostic armamentarium. An anatomic study of cisternal puncture was conducted on fresh cadavers by direct visualization and fluoroscopic guidance of cisternal puncture. Anatomic and radiographic analyses demonstrated a dramatic dynamic anatomy of the cisternal space during cisternal puncture and indicated that "tenting" of the dura mater over the needle occurs reliably during cisternal puncture. Lateral fluoroscopy may decrease the risk of cisternal puncture by allowing visualization of needle depth in the cisternal space. PMID- 2771013 TI - The case against staged operative resection of cerebral arteriovenous malformations. AB - Three cases of large cerebral arteriovenous fistulae are presented in which surgical ablation was complicated by brain swelling from hyperperfusion breakthrough believed to be caused by acute intraoperative hypoperfusion superimposed on chronic preoperative hypoperfusion. On the basis of these cases, experimental data, and theoretical considerations, we seriously question the wisdom of using staged surgical resection of cerebral arteriovenous malformation to prevent complications related to alterations in cerebral hemodynamics. The reasons for this concern are: the repeated occurrence of acute-on-chronic hypoperfusion during staged resection; a lack of understanding of the time course for the correction of a disordered autoregulation; risk of hemorrhage between the initial and final resection; difficulty in assessing and substantiating flow reduction after subtotal resection; the rapidity of collateralization; the divergence of flow from large, readily accessible feeding arteries to deep penetrating vessels; and attenuation of the wall thickness in collateral vessels as a consequence of increased flow. PMID- 2771014 TI - Partial section of the corpus callosum: focal signs and their recovery. AB - A 30-year-old woman underwent surgical partial callosotomy (posterior half) for removal of an arteriovenous malformation. The patient submitted to neuropsychological evaluation before and after surgery for a period of 8 months. There was transient dysfunction attributable to disconnection of parietal, temporal, and occipital connections. Because the symptoms disappeared over time, we conclude that the transcallosal surgical approach can, in the long term, be considered a relatively harmless method. PMID- 2771015 TI - Cerebral and two spinal meningiomas removed from the same patient: case report. AB - An exceptional combination of an intracranial convexity and two thoracic spinal meningiomas in a 17-year-old girl is reported. The small meningioma in the left central parasagittal region was removed. One year later, paraplegia rapidly developed. Two meningiomas (one of them ossified) about 2 cm in size were removed from the midthoracic level of the spinal cord. The distance between the two spinal tumors was about 2 cm. One and one-half years after surgery the patient is well. The problem of multicentricity of meningiomas is discussed. PMID- 2771016 TI - Spontaneous lateral pontine hemorrhage with associated trigeminal nerve root hematoma. AB - Spontaneous hemorrhage into the lateral part of the pons with sequelae compatible with survival has been documented previously. The author describes an unusual case with spontaneous hemorrhage into the lateral pons, with intraneural extension into the right trigeminal nerve root. Radiological features were of an expanding mass of the cerebellopontine angle. The patient was treated surgically with success. PMID- 2771017 TI - Primary intrasellar microgerminoma detected by magnetic resonance imaging: case report. AB - A case of primary intrasellar germinoma in a 24-year-old woman is presented. Her initial symptoms were diabetes insipidus and headaches. The neurological examination found no abnormalities, but the endocrinological examination disclosed a deficiency in growth hormone secretion. Her skull x-ray revealed a normal sella turcica, and a computed tomographic scan revealed no abnormal mass in the pituitary fossa, but a slightly enlarged stalk. Magnetic resonance imaging revealed a small tumor in the posterior lobe. Transsphenoidal exploration revealed a germinoma in the posterior pituitary lobe. Six cases of primary intrasellar germinoma, including our case, were reviewed. Our case is considered to be the smallest intrasellar germinoma yet reported. PMID- 2771018 TI - Anatomical evaluation of the caudal regression syndrome (lumbosacral agenesis) with magnetic resonance imaging. AB - Caudal regression syndrome involves absence of the sacrococcygeal vertebrae with or without lumbar vertebral defects. Since the neurological condition of infants with this syndrome deteriorates, radiographic studies are important to rule out any surgically correctable lesion. A paraplegic male neonate with a vertebral canal ending at T11 is presented. This is the first report of using magnetic resonance imaging to evaluate the spinal cord and surrounding soft tissues involved in this syndrome. Magnetic resonance imaging provides more anatomical details than myelogram with computed tomography, which greatly aids in determining whether surgery is necessary. PMID- 2771019 TI - Cerebral cavernous angiomas in the first year of life. AB - Two rare cases of cerebral cavernous angiomas in two infants, 9 and 6 months old, respectively, are reported and the other 11 cases in the literature concerning patients in the first year of life are reviewed. Cavernous angiomas of the brain occur rarely in the first year of life and present with seizures and head enlargement. On computed tomographic scan they typically appear as large, hyperdense, unenhanced masses, with large cysts and must be differentiated from tumors more common in infants, such as teratomas, ependymomas, and mixed tumors. Total removal is often possible, even with large lesions, because of the small amount of bleeding and the well-defined limits of the mass. PMID- 2771020 TI - Risks of radiosurgery. PMID- 2771021 TI - Aneurysm of the superficial temporal artery. PMID- 2771022 TI - Type I odontoid fractures. PMID- 2771023 TI - Transcranial Doppler evaluation of brain death. PMID- 2771024 TI - Angiographic abnormalities mimicking fibromuscular dysplasia in a patient with Ehlers-Danlos syndrome, type IV. PMID- 2771025 TI - Dichotic listening indices of right hemisphere semantic processing. AB - A new dichotic listening technique, based on a psychophysical threshold procedure and providing ordinal scale measurement of lateral asymmetry, was used to investigate variation in the size of right-ear advantage for verbal vs manual response modalities across three semantic categories of stimuli in 60 right handed males. For manual responders, abstract words elicited a significantly greater right-ear advantage than did concrete words, while emotional words elicited a non-significant left-ear advantage. Verbal responders showed no significant difference in the size of right-ear advantage across stimuli. The results suggest that both response modality and stimulus type are important variables for dichotic listening paradigms seeking evidence of right hemisphere contributions to semantic processing. PMID- 2771026 TI - Handedness not related to foetal position. PMID- 2771027 TI - The relationship between laterality and numerical and spatial ability. AB - Hypotheses derived from right shift theory concerning the relationship between laterality and mathematical ability were investigated. This was done by dividing a group of 129 subjects into subgroups with presumably different distributions of the rs+ +, rs+ - and rs- - genotypes on the basis of their manual skills and then assessing their numerical and spatial abilities. No relationship was found between laterality and ability when the group as a whole were considered, but some marginal effects were found for numerical ability when data for a subgroup of 96 young female subjects were analysed separately. The results did not, however, conform to the predictions of right shift theory. PMID- 2771028 TI - Negative evidence of difference between right- and left-handers in interhemispheric transfer of information. AB - The present study has been designed to investigate the relationship between handedness and callosal function. Based on the previous finding of a greater anatomical connection between the hemispheres in left-handers than in right handers and in order to test the possibility of greater functional communication, the efficiency of interhemispheric transfer of information has been measured using a finger localization task. Comparison of two groups of male right-handed and left-handed subjects shows no difference in the efficiency of interhemispheric transfer of information. PMID- 2771029 TI - Brain potentials reveal covert facial recognition in prosopagnosia. AB - Brain potentials were recorded in a prosopagnosic patient, in response to familiar and unfamiliar faces he was asked to recognize. The amplitude of the P300 component was found to be an inverse function of probability for each category of faces despite the patient's inability to consciously recognize the familiarity of these faces. In addition, P300 latency varied from 700 to 800 msec according to the familiarity of the faces, and P300 scalp location was different as a function of faces probability and overt recognition. The results imply that covert facial recognition may be evidenced in using event-related potentials of the brain. They also demonstrate that automatic and covert processing of face familiarity are preserved, but prolonged in this patient. PMID- 2771030 TI - Event-related potentials and the semantic matching of faces. AB - Event-related brain potentials (ERPs) were recorded while subjects determined whether two sequentially presented famous faces depicted individuals belonging to the same or to different occupational categories. During the 1.56 sec interval between the onset of the faces, ERPs recorded from right hemisphere electrodes were more negative-going than those from electrodes over the left hemisphere. The ERPs evoked by the second face on each trial differed as a consequence of whether or not the person depicted belonged to the occupational category specified by the first face. This difference took the form of a bilaterally-distributed negative going shift in the ERPs evoked by non-matching as opposed to matching faces. This negativity was maximal around 450 msec post-stimulus. The ERP asymmetries during the inter-stimulus interval are interpreted as evidence for the engagement of cognitive processes lateralized to the right hemisphere. The match/non-match differences are considered to reflect the modulation of an "N400" component similar to that evoked by words, and thus suggest that such components can be modulated by associative priming between non-linguistic stimuli. PMID- 2771031 TI - Inducing emotion by unilateral contraction of facial muscles: a new look at hemispheric specialization and the experience of emotion. AB - Subjects who maintained voluntary contractions of the left facial muscles experienced sadness. Right facial contractions resulted in a more positive but difficult to characterize experience. These contractions had similar effects on the affective tone of stories told about an ambiguous picture. These findings indicate that emotions can be aroused by unilateral muscle contractions without intervening cognitions. They provide a new methodology for studying the roles of the cerebral hemispheres in emotional experience. Finally, they support the conclusion that the right hemisphere is involved with negative emotional experiences and indicate that the left hemisphere is involved with experiences that are more positive but not readily characterized. PMID- 2771032 TI - Right hemisphere advantage for topographical orientation in the domestic chick. AB - When male chicks have to choose whether to orient by distant or proximal cues, chicks using the left eye (and so the right hemisphere) orient far better and make more use of distant cues than do right-eyed chicks. When both eyes are in use, left eye systems are mainly responsible for orientation, whereas right eye systems may concentrate on identifying food. Brief bias towards control of behaviour by the right eye system on day 8 allows it temporarily to be used successfully by the chick for orientation; apparently interference from the left eye system is reduced at this time. PMID- 2771033 TI - Hand dominance for signing: clues to brain lateralization of language. AB - Virtually all right-handed individuals are left hemisphere dominant for language. Sign languages of the deaf provide an unusual vehicle for exploring the link between handedness and hemispheric specialization for language since in sign language the hands themselves are the language articulators. Performance of the right and left hand was examined in deaf native users of American Sign Language (ASL) for speeded production of one-handed signs and for shadowing of signed discourse. Opposite patterns of asymmetries in hand performance were found in right- and left-handers. However, left-handers were more flexible than right handers in signing with their non-preferred hand. Furthermore, unusual patterns of hand use for sign were found in a deaf signer with a left hemisphere lesion, possibly indexing increased mediation of the intact hemisphere. Implications for brain organization of language in a visual-gestural mode are discussed. PMID- 2771034 TI - Hemispheric control of the initial and corrective components of aiming movements. AB - This study examined whether the left and right hemispheres play differential roles in controlling the initial and corrective components of aiming movements. A simple aiming task was administered to 31 normal control subjects and 29 unilateral stroke patients (14 with right hemisphere damage and 15 with left hemisphere damage). Movement amplitude was varied (25, 64 and 100 mm) and reaction time, movement time and accuracy were measured. Through a trajectory analysis, initial and corrective movements were separated. The stroke patients performed the task with their ipsilateral arm which was compared to the normal controls' right or left are performance. Regardless of the movement amplitude the left hemisphere group's reaction time was slower, and the execution of the initial movement component was less accurate than controls. No performance deficits were found on corrective movements. Performance was not impaired for the right hemisphere group on any measures. These results are discussed in terms of the hemispheres' possible roles in controlling movements which are largely open or closed loop. PMID- 2771035 TI - Deficient programming in spatial learning after frontal lobe damage. AB - Patients with anterior or posterior brain damage and control subjects performed a spatial sequence learning task in which the score obtained depended on the subject's ability to set sub-goals appropriate for his learning capacity. The anterior group obtained lower scores and more frequently set inadequate sub-goals than the posterior group. No anterior vs posterior difference was found on a similar learning task in which another sequence was learnt by predetermined sub goals. The result supported the hypothesis that frontal lobe lesions disturb programming or goal-based search for action structure on spatial learning. PMID- 2771036 TI - Evidence for subgroups of adextrals based on speech lateralization and cognitive patterns. AB - Some non-right-handers may prefer the left hand by virtue of well-organized or high levels of spatial ability, vested primarily in the right hemisphere, rather than as a result of anomalous speech representation. This study tested the hypothesis that adextral (left-handed or ambidextrous) individuals with high spatial ability might have cerebral speech lateralization patterns similar to dextrals. Paper-and-pencil tests of various cognitive abilities, a verbal dichotic listening task, and a handedness inventory were administered to two groups (science or non-science students) of adextral and dextral subjects. The science group had predictably higher spatial ability than the non-science group. Adextral science students were as lateralized on dichotic listening, and had equal spatial ability, compared to dextral science students. Adextral non-science males were less lateralized and had (unexpectedly) poorer spatial ability than dextral non-science males. Thus in adextrals, variations in ability patterns may be related to variations in speech lateralization. PMID- 2771037 TI - Unexpected sex-ratios in families of language/learning-impaired children. AB - There is a well-documented propensity of males affected with developmental language/learning impairment. Results from this study demonstrate, unexpectedly, that this sex-ratio difference of males to females with developmental language/learning disorders was found to occur significantly only in families with a language/learning-impaired mother. In addition, a remarkably aberrant offspring sex-ratio was found in families of language/learning-impaired children who had an affected mother, but not father. Mothers who were developmentally language/learning-impaired had three times as many sons as daughters, and five times as many language/learning-impaired sons as daughters. Genetic and hormonal influences that might affect both sex-ratio and neuroanatomical development and disorders are discussed. PMID- 2771038 TI - Dichotic listening in 126 left-handed children: ear advantages, familial sinistrality and sex differences. AB - In the present study we report data on dichotic listening (DL) performance in 126 left-handed children. Four specific questions were addressed: (1) What is the percentage of left-handers in a large sample of children in Sweden? (2) What is the distribution of children showing a right ear (REA), left ear (LEA), and no ear (NEA) advantage in DL? (3) What is the relationship between ear advantage and familial sinistrality in children? (4) Are there sex differences among left handed children, and if so, are these differences also reflected in DL performance? The results showed that the left-handers constituted 8.1% of the total sample of the screened subjects. The DL results showed 65.0% REA, 25.4% LEA, and 9.6% NEA. Of the subjects, 45.2% had left-handed relatives. Overall, there were more boys than girls in the sample (65.1% vs 34.9%). It is concluded that the present data match the sodium-Amytal data on left-handed adults with about 2/3 of a left-handed population with left hemisphere language dominance. PMID- 2771039 TI - Conduction velocity changes along the processes of rat primary sensory neurons. AB - Conduction velocities of rat L4, L5 and L6 dorsal root ganglion neurons were measured in vitro, from several points on the peripheral nerve and dorsal root. Conduction velocities calculated from a single stimulation point (12-26 mm from the ganglion) proved accurate for fibres conducting up to 17 m/s in the peripheral nerve and up to 14 m/s in the dorsal root, but tended to underestimate the value for faster fibres. C-fibre neurons of the L4 and L5 ganglia had a unimodal distribution of conduction velocities below 1.3 m/s. These were discontinuous with A-fibre conduction velocities, which also had a unimodal distribution and had no clear A delta peak. In contrast, conduction velocities of L6 ganglion neurons showed no discontinuity between C- and A-fibres, but had a clear A delta peak. In A-fibre neurons, dorsal root conduction velocities were on average about 14% slower than, and linearly related to, those in the peripheral nerve. However, in individual neurons the dorsal root conduction velocity could be slower or faster than that in the peripheral nerve. In C-fibre neurons dorsal root conduction velocities were almost always slower (average 28%) but not correlated with those of the peripheral nerve. Slowing of conduction velocity along the sciatic nerve was seen in most fibres conducting at less than 2 m/s, but not in faster fibres. The slowing was substantial (up to 60%), sometimes from the A delta to the C-fibre range, and sudden, occurring at a distance of between 15 and 29 mm from the ganglion. PMID- 2771040 TI - Calcium currents in rat cerebellar Purkinje cells maintained in culture. AB - Calcium permeabilities were examined in large cerebellar neurons maintained in culture, and morphologically identified as Purkinje cells. When cells were supplied with a Dulbecco Minimum Eagle's Medium with 10% horse serum added (5-10 days), somatic recordings revealed complex spikes and these were shown to be generated by Na and Ca components, the Na one being tetrodotoxin-sensitive. At the dendritic level, Ca currents were better resolved than at the soma. In dendrites, Ca entry was shown to occur through at least two distinct currents. The first was a low-threshold transient current (elicited above -60 mV from a holding potential of -80 mV) which was reduced by almost 30% by 50 microM cadmium. The second was a high-threshold current (above -20 mV) which gave rise to (1) a transient component exhibiting a steady-state inactivation and so requiring holding potentials at -80 mV, and (2) a sustained component. Both components were suppressed by 50 microns cadmium. We measured a total Ca current at the dendritic level reaching values of up to 1 nA. In another culture medium (Leibovitz medium) known to allow expression of three types of calcium currents in nodose cells we observed the development of the dendritic tree of Purkinje cells but with no simultaneous expression of the high-threshold Ca current. PMID- 2771041 TI - Electrophysiological properties of hypoglossal motoneurons of guinea-pigs studied in vitro. AB - Intracellular recordings were made from the hypoglossal nuclear complex in brain slices from guinea-pigs. Retrograde transport of horseradish peroxidase from the tongue confirmed the identity of the visually identified hypoglossal nucleus. Eighteen neurons were stained by intracellular electrophoresis of Lucifer Yellow through the recording pipette. Two types of neurons were encountered, motoneurons with maximal discharge rates of 90 Hz and another type with maximal discharge rates of 250 Hz. Motoneurons were prevalent in the hypoglossal nucleus and the other type prevailed in the adjoining nucleus prepositus hypoglossi. In both nuclei the two types were mixed. Antidromic spikes elicited from hypoglossal root fibres had initial segment and somatodendritic components. Electrical stimulation of the reticular matter dorsolateral to the hypoglossal nucleus elicited excitatory postsynaptic potentials and strychnine sensitive inhibitory postsynaptic potentials. Motoneurons responded to depolarizing current pulses with a train of spikes. The initial spike interval was much shorter than the rest and fast adaptation occurred over three to four intervals. Slow adaptation was most prominent when the neuron was depolarized and discharged at a high rate. High threshold calcium spikes were evoked by depolarizing pulses when sodium spikes were blocked by tetrodotoxin and the potassium conductance reduced by tetraethylammonium bromide. Motoneurons discharged in a single range, inflections on the frequency-current plot being absent. Spikes and spike trains evoked by depolarizing pulses were followed by afterhyperpolarizations with fast and slow parts. The fast phase was eliminated by tetraethylammonium bromide, possibly because the delayed rectifier was involved. A calcium dependent potassium conductance was probably involved in the slow phase, because it was sensitive to inorganic calcium blockers. The amplitude of the afterhyperpolarization following trains of spikes depended on the frequency of the preceding spikes. At constant frequency, the amplitude depended, in addition, on the strength of stimuli arising from different hyperpolarized potentials. Afterdepolarizing potentials were absent. Lissajous plots of double ramp current stimulation showed anomalous rectification between resting potential and spike threshold. The rectification was sensitive to inorganic calcium blockers. Subthreshold responses showed initial sags and rebound responses in all healthy cells and these were eliminated by caesium. Barium, substituted for calcium, unleashed a depolarizing plateau potential sensitive to tetrodotoxin, indicating the presence of a persistent sodium conductance.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2771042 TI - Intracellular study of oculomotor neurons in the rat. AB - The electrical and morphological properties of oculomotor neurons were investigated in the rat with intracellular recordings and intracellular horseradish peroxidase staining. Motoneurons were identified by their antidromic response to electrical stimulation of the ipsilateral medial rectus muscle. The antidromic action potential was followed by a delayed depolarization and an afterhyperpolarization of 20-50 ms in duration. The whole neuron input resistance calculated from intensity/voltage curves, was found between 4 and 15 M omega. Passive membrane properties showed the existence of anomalous rectifications. Motoneurons were studied on the basis of their responses to long-lasting depolarizing current pulses. The intensity/frequency curves suggest the existence of two ranges of discharges. The average intensity frequency slope during the steady state was 33 imp/s/nA. Ten oculomotor neurons were intracellularly labelled with horseradish peroxidase and fully reconstructed. The soma (23-33 microns in diameter) gave off five-eight primary dendrites which could extend over 600-800 microns from the soma. The oculomotor neurons were principally oriented in the sagittal plane. The soma size of oculomotor neurons was not related to the size of proximal tree. According to our observations, the morphological features of motoneurons did not allow us to predict the whole neuron input resistance. The comparison between in vivo and in vitro studies of oculomotor neurons revealed one major difference in the input resistance of the whole neuron which was three times higher in slices. PMID- 2771043 TI - Early and late components in cat Renshaw cell responses to random stimulation of motor axons: their differential sensitivity to preceding activation. AB - Lumbosacral Renshaw cells were activated by random stimulation of motor axons in muscle nerves or ventral roots. The stimulus patterns had mean rates of 9.5-13 or 20-23 pulses per second. The Renshaw cell responses were evaluated by two kinds of peristimulus-time histograms. "Conventional" peristimulus-time histograms were calculated by averaging the cell discharge with respect to all the stimuli in a train. "Conditional" peristimulus-time histograms were determined by averaging the cell discharge with respect to the second ("test") stimulus in pairs of stimuli which were separated by varied intervals. The effects of the conditioning stimuli were evaluated after correcting for the effect of linear superposition of the conditioning and test stimuli. The conventional peristimulus-time histograms showed an excitatory response which often consisted of two distinct components: a narrow and high "early" peak and a broad and low "late" elevation of firing probability. The early and late excitatory components were conditioned in different ways. Whereas the late component was virtually always depressed, the early component showed three patterns: (1) uniform depression; (2) uniform facilitation; (3) a mixture of depression and facilitation. Frequency responses (coherence and gain estimates) were also calculated separately for the cell discharges underlying either the early or the late components. The estimates for the "late spikes" showed a stronger decline with increasing frequency than those for the "early spikes". The origin of the different conditioning effects probably lies in a combination of pre and postsynaptic factors. They may play a role in tremor mechanisms. PMID- 2771044 TI - Selective depression of synaptic transmission by tetanus toxin: a comparative study on hippocampal and neostriatal slices. AB - Tetanus toxin reduces the release of neurotransmitters in several brain areas. We have studied the effects of this toxin on the intrinsic and synaptic activity of CA1 hippocampal neurons and of neostriatal cells in the rat by utilizing intracellular and extracellular recordings from slice preparations. Tetanus toxin (10 micrograms/ml) applied by bath produced an increase of the field potentials evoked by the orthodromic stimulation of the CA1 region coupled with the disappearance of the inhibitory period following the first conditioning stimulus. Orthodromically and antidromically activated postsynaptic hyperpolarizing potentials were also decreased and spontaneous bursting activity was observed following the application of tetanus toxin. At this concentration the toxin did not alter excitability in neostriatal cells and in these neurons even 30-50 micrograms/ml of the toxin produced only a slight increase of excitability. Higher concentrations (100 micrograms/ml) of tetanus toxin reduced the excitatory synaptic transmission in the hippocampus as well as in the neostriatum. The toxin (10-100 micrograms/ml) did not alter membrane potential, input resistance or directly evoked firing in both these structures. We conclude that, although the toxin's mechanisms of action in the neostriatum are similar to those operating in the hippocampus (i.e. decrease of inhibitory and/or excitatory inputs), the local synaptic circuits produce differential electrophysiological effects in these two structures. PMID- 2771045 TI - Morphology of identified entorhinal neurons projecting to the hippocampus. A light microscopical study combining retrograde tracing and intracellular injection. AB - Cells of origin of the entorhinohippocampal pathway were retrogradely labeled by injection of Fast Blue into the ipsilateral hippocampus. The cells, which were located in layers I, II and III of the lateral entorhinal cortex, were then intracellularly injected with Lucifer Yellow to reveal their complete morphology. We could thus establish that among the hippocampally projecting entorhinal cells there are pyramidal and pyramid-like cells, spiny stellate cells of various shapes, sparsely spinous horizontal and multipolar cells. The involvement of horizontal and multipolar neurons in projections has not previously been recognized although all of these cell types have already been described in Golgi studies. The results indicate that the organization of the perforant path is more complex than has been assumed. Finally, they are at variance with the classical concept which subdivides cortical neurons into projection neurons (pyramidal and spiny stellate) and interneurons (non-pyramidal, local circuit neurons). PMID- 2771046 TI - The organization of dorsal medullary projections to the central amygdaloid nucleus and parabrachial nuclei in the rabbit. AB - The amygdaloid central nucleus and the pontine parabrachial nucleus receive direct, ascending projections from autonomic regulatory nuclei of the dorsal medulla and are recognized as important components of a forebrain system which contributes to autonomic regulation. The present study was designed to provide more detailed information on the anatomical organization of this ascending system in the rabbit by determining (a) the extent to which separate populations of neurons within the solitary complex project to the central nucleus and parabrachial nucleus, (b) the topographical distribution of the projections of the solitary complex within the amygdaloid central nucleus and parabrachial nucleus and (c) the extent to which projections from the solitary complex to the parabrachial nucleus terminate in the region of origin of projections from the parabrachial nucleus to the amygdaloid central nucleus. A fluorescent dye, double retrograde-labeling technique demonstrated that separate populations of neurons in the solitary complex projected to the amygdaloid central nucleus and parabrachial nucleus. Neurons of both populations were more heavily concentrated within the caudal two thirds of nucleus of the solitary tract and were most numerous within the commissural, medial and dorsomedial subnuclei. Labeled neurons were also located within the dorsal motor nucleus of the vagus nerve. Autoradiographic experiments demonstrated that injections of amino acids into the solitary complex resulted in terminal labeling in the central nucleus. This labeling extended rostrally into the adjacent sublenticular substantia innominata and lateral component of the bed nucleus of the stria terminalis. Label was also observed within the lateral, medial, and Kolliker-Fuse regions of the parabrachial nucleus. A particularly dense field was observed overlying cells located within the ventrolateral region of the lateral parabrachial nucleus. This region contained the majority of labeled neurons within the parabrachial nucleus following fluorescent dye injections into the central nucleus. Furthermore, injections of amino acids into this region resulted in terminal labeling within the central nucleus, with a particularly dense area observed within the medial aspect of the nucleus. The results demonstrate that separate populations of neurons within the solitary complex of the rabbit project to the central amygdaloid and parabrachial nuclei and that the majority of these are located within the caudal two-thirds of the complex.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2771047 TI - Iso- and cross-oriented columns in cat striate cortex: a study with simultaneous single- and multi-unit recordings. AB - The constancy of orientation tuning in vertical columns of the visual cortex of the cat was examined with conventional and newly developed multi-electrode methods. Preferred orientation was measured with single- and multi-unit recordings in 68 penetrations approximately perpendicular to the cortical layers and with inter-recording steps of only 40-70 microns. The tuning curves obtained revealed three types of penetration sequences: no-shift penetrations (37%), one shift penetrations (41%) and double-shift penetrations (22%). Particular attention was paid to the orientation tuning at the transition zones below layer IV. The use of the multi-unit recording technique enabled the measurement of cross-oriented activity within a single electrode position mostly around the border between layers IV and V. Altering the type of anaesthesia (ventilation with room air or nitrous oxide-oxygen) produced only a quantitative change in the percentage of the encountered penetration types. The results suggest that upper and lower layers follow different principles of functional organization. As a consequence different types of columns, especially iso- and cross-oriented ones, are produced in a systematic way. PMID- 2771048 TI - Glutamate decarboxylase immunoreactivity in the rat interpeduncular nucleus: a light and electron microscope investigation. AB - The distribution of immunohistochemically demonstrable glutamate decarboxylase, the synthetic enzyme for GABA, was examined in the rat interpeduncular nucleus at the light and electron microscope levels. Immunoreactive perikarya were distributed in a characteristic pattern among the subnuclear divisions. The rostral, ventral and caudal portions of the nucleus possessed numerous immunoreactive perikarya, while few immunoreactive somata were observed in the subnuclei of the dorsal aspect. A dense field of immunostained axons and terminals was also present throughout. Ultrastructural examination of glutamate decarboxylase immunoreactivity revealed numerous labelled somata, dendritic processes, axons and boutons. Axodendritic and axosomatic synapses with immunoreactive postsynaptic profiles were numerous throughout those subnuclei with large numbers of immunoreactive somata. Immunostained terminals in contact with both immunoreactive and non-immunoreactive somatic and dendritic profiles were also present. An abundance of immunostained terminals was observed in the subnuclei that possessed a sparse population of immunoreactive somata. Immunoreactive myelinated axons of unknown origin were also present. This investigation demonstrates that the rat interpeduncular nucleus possesses a large population of glutamate decarboxylase-immunoreactive neurons coextensive with a plexus of immunostained axons and terminals. The results suggest that the immunoreactive neurons give rise to axons which contribute to an intrinsic circuit interconnecting the different subnuclear divisions. These immunoreactive neurons are in receipt of non-immunoreactive afferent inputs of variable morphology, as well as projections from intrinsic immunoreactive neurons. PMID- 2771049 TI - Compartmentation of alpha-tubulin in neurons: identification of a somatodendritic specific variant of alpha-tubulin. AB - The composition of alpha-tubulin in axons was compared with that in cell bodies and dendrites in the rat. Pure axons and highly enriched preparations of cell bodies and dendrites were obtained from explant cultures of sympathetic neurons, dissolved directly into sodium dodecyl sulfate, and analysed by isoelectric focusing gel electrophoresis. Immunoblots using two different monoclonal antibodies against alpha-tubulin and fluorographs of [35S]methionine- and [3H]tyrosine-labeled alpha-tubulin all show several variants common to both compartments, and an additional variant, more basic than the others, prominent in the somatodendritic compartment but absent from the axonal compartment. This variant, termed alpha s, partitions with both cytoskeletal and soluble tubulin pools, indicating that microtubules in the somatodendritic compartment differ from microtubules in the axonal compartment with respect to alpha-tubulin composition. Pulse-chase and immunoprecipitation analyses suggest that extensive post-translational modification of alpha-tubulin occurs in the neuron. Newly synthesized alpha-tubulin (10-min pulse-label) is relatively simple in profile, consisting of a major band with the mobility of alpha s, and a minor band slightly lower in isoelectric point. The profile is somewhat more complex after 5 h chase time, but is much more complex after 20 h. The generation of additional bands appears to be at the expense of the band co-migrating with alpha s, suggesting that alpha s is the unmodified form of a primary translation product that undergoes extensive post-translational modification. The unmodified form of the primary translation product is restricted to the somatodendritic compartment, while many of its derivatives are present throughout the neuron. PMID- 2771050 TI - Adenosine receptors linked to adenylate cyclase activity in human neuroblastoma cells: modulation during cell differentiation. AB - In IMR32 neuroblastoma cells, the two adenosine receptor agonists N6-R phenylisopropyladenosine and 5'-N-ethylcarboxamidoadenosine dose-dependently stimulated membrane adenylate cyclase activity with potencies consistent with the presence of adenosine receptors of the A2-subtype. The S enantiomer of N6-R phenylisopropyladenosine induced a significantly lower stimulation of adenylate cyclase, accordingly to its lower ability to activate adenosine receptors. These effects were selectively counteracted by the adenosine receptor antagonist theophylline and, conversely, were not affected by the A1-adenosine receptor selective blocker 8-cyclopentyl-1,3-dipropylxanthine. No adenosine receptors belonging to the A1-subtype seem, therefore, to be present in this cell line, as also shown by the lack of inhibitory activity of N6-R-phenylisopropyladenosine on both basal and forskolin-stimulated adenylate cyclase activity. Activation of A2 receptors did not modify intracellular basal calcium levels, did not influence calcium influx through voltage-dependent calcium channels and did not modify calcium influx and redistribution induced by muscarinic receptor activation. Prolonged exposure of cells to either N6-R-phenylisopropyladenosine or 5'-N ethylcarboxamidoadenosine was associated with a small but significant degree of morphological differentiation, comparable to that induced by dibutyryl cAMP, and therefore presumably related to the prolonged increase of intracellular cAMP levels elicited by the two adenosine agonists. After cellular differentiation induced with either dibutyryl cAMP or 5-bromodeoxyuridine, a selective desensitization of A2-receptor stimulated adenylate cyclase activity was found.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2771051 TI - The effects of brainstem peribrachial stimulation on perigeniculate neurons: the blockage of spindle waves. AB - The mode of action of afferents arising from the brainstem peribrachial region at the midbrain-pontine junction on neurons recorded from the reticular thalamic sector adjacent to the lateral geniculate nucleus (perigeniculate cells) was investigated at the intracellular level in the cat. Experiments were performed in cats under barbiturate or urethane anaesthesia and in non-anaesthetized deafferented animals. Most cats were pretreated with reserpine (1-2 mg/kg) and were also acutely deprived of their retinal and cortical visual inputs. It was found that peribrachial stimulation produced a short train of fast-rising depolarizations followed by a long-lasting period of hyperpolarization in all perigeniculate neurons. Although the latest part of the early depolarizations preceding the hyperpolarization resulted from a parallel activation of lateral geniculate relay neurons by peribrachial afferents, those occurring at shortest latencies appear to result from a direct excitation produced by peribrachial afferents. Furthermore, these early excitatory postsynaptic potentials persisted under deep barbiturate anaesthesia, a condition that prevents activation of thalamic relay neurons by peribrachial stimulation. The evoked hyperpolarization decreased with membrane hyperpolarization, was associated with a 40-50% increase in membrane conductance and was insensitive to Cl injections. It was no longer observed within one hour after i.v. injection of scopolamine. However, the depolarizing responses were not depressed by this muscarinic antagonist. Iontophoretic applications of scopolamine also removed peribrachial-evoked inhibition of synaptic responses triggered by optic chiasma stimulation. The peribrachial input exerted a powerful control on the oscillatory behavior of perigeniculate neurons. Spindle oscillations which are generated within the reticular thalamic complex were readily blocked by peribrachial stimulation. It is then concluded that the transition from an oscillatory to a relay mode of operation in the thalamus is controlled at least in part by a muscarinic inhibition of reticular thalamic neurons. The synaptic mechanism responsible for the early depolarization remains to be elucidated. PMID- 2771052 TI - Monoaminergic and GABAergic terminations in phrenic nucleus of rat identified by immunohistochemical labeling. AB - The termination patterns of axons in the phrenic nucleus immunoreactive to synthetic enzymes for catecholamines and for serotonin and GABA were studied in rats. Spinal cord tissue in which phrenic motoneurons were retrogradely labeled with horseradish peroxidase was incubated with antisera against dopamine beta hydroxylase, phenylethanolamine-N-methyltransferase, 5-hydroxytryptamine, and GABA to identify presumptive terminations of monoaminergic and GABAergic neurons onto identified phrenic motoneurons. In the C3 to C5 spinal cord, 5 hydroxytryptamine-, dopamine beta-hydroxylase- and GABA-like positive terminals with varicosities formed a dense network, with presumptive synaptic contacts on dendrites and somas of phrenic motoneurons. A similar pattern of terminations was also observed in adjacent (non-respiratory muscle) motoneuron pools. There were fewer phenylethanolamine-N-methyltransferase-positive terminal arborizations in the cervical spinal cord compared to thoracic spinal cord; phenylethanolamine-N methyltransferase terminals were not seen in the vicinity of phrenic motoneurons. These results suggest that phrenic motoneuronal activity is influenced by multiple supraspinal inputs utilizing different neurotransmitters. These transmitters also mediate inputs to other (nearby) spinal motoneurons and thus are not unique for signal transmission to phrenic motoneurons. PMID- 2771053 TI - Replacement of missing motoneurons by embryonic grafts in the rat spinal cord. AB - The ventral quadrant of embryonic spinal cord with its motoneurons prelabelled by 5-bromo-2'-deoxyuridine was grafted into the spinal cord of adult rats. The ventral horn of the host had been previously partially depleted of its own motoneurons by a neonatal nerve lesion. To enhance the chances of survival of the transplanted embryonic motoneurons a target muscle was provided for their axons. Two to three months after the grafts were inserted into the cord nuclei containing 5'-bromo-2'-deoxyuridine were found in the graft and in the host's spinal cord. Many of the stained nuclei were much larger than those of embryonic motoneurons, and their size distribution was similar to that of nuclei from control motoneurons. Retrograde labelling with horseradish peroxidase, injected into the target muscle provided for the embryonic motoneurons, showed that some motoneurons had reached the muscle and presumably made contact with it. Physiological and histological examination of the target muscle showed that it was innervated and that it contained at least three different types of muscle fibres. Thus embryonic motoneurons can survive and develop in the adult spinal cord. Moreover, they seem to be able to make functional connections with skeletal muscle fibres. The heterogeneity of the muscle indicates that the motoneurons that supply them are able to differentiate into various types of cells. PMID- 2771054 TI - The effects of brainstem peribrachial stimulation on neurons of the lateral geniculate nucleus. AB - The intracellular effects of brainstem peribrachial stimulation on lateral geniculate neurons were investigated in the cat. Experiments were performed in cats under barbiturate or urethane anaesthesia and in non-anaesthetized deafferented animals. Most animals were pretreated with reserpine and were acutely deprived of their retinal and visual cortical inputs. Short trains of stimuli triggered a transient depolarization in most relay neurons (latency: 20 30 ms; duration: 200-300 ms). This depolarization could be interrupted by a short duration unitary inhibitory postsynaptic potential. The depolarization increased with membrane hyperpolarization and was associated with an increase in membrane conductance. The inhibitory postsynaptic potential had an intrathalamic origin and likely resulted from parallel activation of intrageniculate interneurons. The above responses were largely enhanced in reserpinized cats and were completely abolished by small doses of barbiturates. Iontophoretic applications of the nicotinic blocker, hexamethonium, eliminated peribrachial-evoked discharges in these cells, while similar applications of the muscarinic antagonist, scopolamine, were devoid of any effect. The conclusion is reached that the depolarization of lateral geniculate relay neurons by peribrachial afferents represents a direct postsynaptic effect and does not result from a global disinhibitory mechanism involving inhibition of perigeniculate cells and intrageniculate interneurons. This peribrachial-evoked transient excitation of relay neurons results from a nicotinic mechanism. PMID- 2771055 TI - Distribution of insulin receptor-like immunoreactivity in the rat forebrain. AB - Previous studies have suggested that insulin may play a role in the hormonal regulation of neurotransmitter metabolisms within the central nervous system. In order to provide additional information to support this hypothesis, we examined the distribution of insulin receptors within the forebrain of adult male rats. Insulin receptors were localized by immunocytochemistry, using an antibody directed against the carboxy-terminus of the beta-subunit of the insulin receptor. The antibody specificity was tested by immunoprecipitation of brain insulin receptors with antiserum and the purity of the receptor-antibody preparation was determined using hormone binding-assays with radiolabeled insulin and insulin-like growth factor-l. Insulin receptor-like immunoreactivity was found in a widespread, but selective, distribution on neurons throughout the rat forebrain. Double-labeling with glial fibrillary acidic protein did not demonstrate any detectable insulin receptor-like immunoreactivity on glial cells. Areas with the highest density of insulin receptor-like immunoreactivity were found in the olfactory bulbs, hypothalamus and median eminence, medial habenula, subthalamic nucleus, subfornical organ, CA 1/2 pyramidal cell layer of the hippocampus and piriform cortex. Double-staining of hypothalamic sections with somatostatin and vasopressin antisera revealed insulin receptor-like immunoreactivity on a subpopulation of somatostatin neurons in the periventricular region and on vasopressin neurons in the supraoptic nucleus. A moderately dense insulin receptor-like immunoreactivity was observed in layers II IV of cerebral cortex, medial amygdala, reticular thalamic nucleus, zona incerta, and preoptic and septal regions, whereas a low density of insulin receptor-like immunoreactive neurons was found in basolateral amygdala and most thalamic regions. The basal ganglia and most parts of the thalamus were almost devoid of insulin receptor-like immunoreactivity. Our findings provide morphological support for a direct action of insulin on selected regions of the rat forebrain and suggest that the insulin receptor may modulate synaptic transmission or the release of neurotransmitters and peptide hormones in the CNS. PMID- 2771056 TI - Properties of neuronal type acetylcholine receptors in voltage clamped mouse neuroblastoma cells. AB - The pharmacological and physiological characteristics of nicotinic acetylcholine receptor-mediated ion current in mouse neuroblastoma N1E-115 cells have been investigated by superfusion of voltage clamped cells with known concentrations of agonists and antagonists for short periods. The acetylcholine-induced inward current is blocked by d-tubocurarine and by kappa-bungarotoxin with IC50 values of 0.5 microM and 30 nM, respectively. The inward current is resistant to alpha bungarotoxin up to a concentration of 0.5 microM. This allows classification of the acetylcholine receptors of N1E-115 cells as neuronal type nicotinic receptors. The amplitude of the inward current increases with increasing concentration of the agonists acetylcholine and carbamylcholine, resulting in concentration-effect curves with EC50 values of 53 and 240 microM and slope factors slightly below unity. Conversely, at the highest concentrations of the agonists the amplitude of the inward current is reduced and a transient increase of the current appears when the agonist is removed. The characteristics of this transient tail current indicate that the agonists cause rapid ion channel block by interacting with a low affinity site. In the continued presence of acetylcholine the peak inward current is reduced by desensitization. The IC50 value and the slope factor of the steady-state desensitization curve are 1.1 microM and 0.58, respectively. At a low concentration of acetylcholine both the onset of desensitization and the inward current decay are described by similar dual exponential kinetics, but the steady-state inward current is smaller than expected from the degree of desensitization. Neuronal nicotinic receptors in N1E 115 cells and end-plate nicotinic receptors have several characteristics in common. However, the present results indicate that these receptors are distinct, not only in their sensitivity to snake toxins, but also with respect to functional properties. PMID- 2771057 TI - An enkephalin-containing pathway from nucleus tractus solitarius to the pressor area of the rostral ventrolateral medulla of the rabbit. AB - A technique combining retrograde tracing of wheat germ-conjugated gold particles with immunocytochemical demonstration of enkephalin-containing neurons was used to study intramedullary enkephalin-containing pathways to the pressor area of the rostral ventrolateral medulla in rabbits. The rostral ventrolateral medulla represents a main source of bulbospinal sympathoexcitatory neurons, and is critical to the tonic and reflex control of blood pressure. Firstly, the distribution of enkephalin-positive neurons and terminal fibres in rabbit medulla were described, with special reference to a moderately dense terminal plexus in the rostral ventrolateral medulla. Then, retrograde tracing studies were conducted; the rostral ventrolateral medullary pressor region was first localized by injection of L-glutamate (25 nmol in 50 nl). Slow (30-min) injections of wheat germ-gold (1.00 microliter) were then made at the same coordinates, resulting in a restricted injection site corresponding to the C1 pressor area, verified by the presence of tyrosine hydroxylase- and neuropeptide Y-containing neurons. Transported gold was revealed by silver reduction, and enkephalin immunoreactive cells were revealed by immunocytochemistry. Enkephalin-positive gold-containing neurons were found primarily in the nucleus tractus solitarius, especially in the commissural and medial intermediate subnuclei. Cells in the nucleus tractus solitarius containing other transmitters (substance P. galanin, neuropeptide Y and catecholamines) did not show the same degree or pattern of double-labelling, suggesting that the transport was not due to non-specific silver reduction or spread from the pipette track. The potential importance of this endogenous intramedullary opiate system is discussed in terms of medullary control of the cardiovascular system. It is hypothesized that this opiate projection from the nucleus tractus solitarius to the rostral ventrolateral medulla could play an important modulatory function, influencing baroreceptor or other cardiopulmonary reflex pathways involved in the primary regulation of the cardiovascular system. Furthermore, this pathway could represent a central substrate underlying opiate effects on the cardiovascular system during such conditions as hemorrhagic shock, stress or opiate intoxication. PMID- 2771058 TI - Intrahippocampal colchicine injection results in spectrin proteolysis. AB - Neurons in the hippocampal formation vary markedly in their susceptibility to colchicine toxicity. The present study was directed at evaluating the effects of colchicine on the proteolytic breakdown of the cytoskeletal protein spectrin within the hippocampus in the rat. Quantified by immunoblot analysis of spectrin breakdown products, the extent of proteolysis was found to correlate with the relative vulnerability of different hippocampal subfields to colchicine toxicity. Levels of breakdown products increased dramatically between 1 and 2 days after colchicine injection, peaked between 2 and 4 days, and remained detectably elevated for at least 35 days. Two days after colchicine injection, the spectrin breakdown products were significantly more concentrated in the molecular layer than in the granule cell/hilar region of the dentate gyrus. The colchicine induced increase in spectrin breakdown products was significantly reduced by pretreatment with the protease inhibitor leupeptin and was significantly elevated by pretreatment with the lysosomal inhibitor chloroquine. Immunohistochemical analyses of the hippocampus at various times after colchicine injection revealed changes in the distribution of spectrin-like immunoreactivity that paralleled the changes observed by Western blot analysis. Thus increased staining was observed in the molecular layer of the dentate gyrus at 2 and 4 days after the injection, while staining in CA3 was only slightly increased. In addition, abnormal staining of reactive astrocytes was prominent at 2 days. The mechanism whereby colchicine results in neuronal death is as yet unknown. However, the results presented here demonstrate that extensive proteolysis of a cytoskeletal protein occurs in response to the drug, suggesting a plausible mechanism for its neurotoxicity. The protease responsible for the effect is likely to be calpain since the process is non-lysosomal, leupeptin-sensitive and produces spectrin breakdown products indistinguishable from those generated by calpain treatment in vitro. These data support the hypothesis that calpain-mediated degradation of cytoskeletal elements is a common and early response to neurodegenerative events and serves as a trigger in the development of various neuropathologies. PMID- 2771059 TI - Immunocytochemical localization of endopeptidase-24.11 in cultured neurons from pig striatum. AB - Endopeptidase-24.11 ("enkephalinase") appears to play a key role in the metabolism of a number of neuropeptides at cell surfaces. It has been previously mapped in the central nervous system, but some doubt has been expressed concerning the identity of the cell type expressing this peptidase. Primary cell cultures derived from striata of new-born piglets were set up and cells were characterized by immunocytochemistry using antibodies to neurofilament protein, a glial fibrillary acidic protein and a neuronal antigen recognized by a monoclonal antibody BM88 and by histochemistry for acetylcholinesterase. Some cultures were set up in which neurons were selectively enriched. Cells which were thus morphologically defined as neurons were recognized by an affinity-purified polyclonal antibody to endopeptidase-24.11. The staining for the peptidase, which was punctate in appearance, was shown to be at the cell surface and extended to the perikaryon and all neurites. Compared with the number of neurofilament protein-positive cells, relatively few cells were positive for endopeptidase 24.11. No glial cells, immunochemically defined by glial fibrillary acidic protein, were stained by the antibody to endopeptidase-24.11. We conclude that endopeptidase-24.11 is expressed on the surface of a set of neurons derived from the striatum in primary culture and not by any glial cells in these cultures. PMID- 2771060 TI - The cellular mechanism of thalamic ponto-geniculo-occipital waves. AB - The cellular mechanisms underlying the genesis of thalamic ponto-geniculo occipital waves were studied in reserpinized cats under urethane anaesthesia. Simultaneous field potential and intracellular recordings were performed in the lateral geniculate nucleus after acute lesions of retinal and visual cortical inputs. In most relay cells, reserpine-induced ponto-geniculo-occipital waves were associated with a transient depolarization that was often interrupted by a unitary inhibitory postsynaptic potential. The depolarization grew in size with membrane hyperpolarization and was accompanied by an increase in membrane conductance. The inhibitory postsynaptic potential is likely to have resulted from the activation of intrageniculate interneurons since perigeniculate cells were always inhibited during the occurrence of ponto-geniculo-occipital waves. Under reserpine, thalamic ponto-geniculo-occipital waves could also be triggered by peribrachial or auditory stimulation. These evoked ponto-geniculo-occipital waves were associated with intracellular events identical to those occurring spontaneously after reserpine administration. In addition, thalamic spindle oscillations were readily blocked by the occurrence of spontaneous or evoked ponto-geniculo-occipital waves. On the basis of the present results and those already published in the literature, the conclusion is reached that lateral geniculate ponto-geniculo-occipital waves result from a nicotinic activation of relay cells and from a parallel muscarinic inhibition of perigeniculate cells by peribrachial afferents. The functional significance of the ponto-geniculo occipital activity is discussed on the basis of the antagonistic action of these signals on thalamic oscillations. It is proposed that these signals are the central correlates of orienting reactions elicited by sensory stimuli during waking (the so-called eye movement potentials) and by internally generated drives during paradoxical sleep. PMID- 2771061 TI - Limited neocortical devascularizing lesions causing deficits in memory retention and choline acetyltransferase activity--effects of the monosialoganglioside GM1. AB - In mature rats with unilateral cortical lesions, choline acetyltransferase activity was found to decrease by 40% in the ipsilateral nucleus basalis magnocellularis, compared with control animals. Intraventricular administration of the monosialoganglioside GM1 (5 mg/kg per day), via minipumps, over a period of 14 days prevented this fall in choline acetyltransferase activity. The activity of this enzyme in the sham operated subjects was not significantly different from that in the unoperated group. This biochemical data is in full agreement with regards to the protective action of monosialoganglioside GM1 on forebrain cholinergic neurons. In this study the behavioral effects of these cortical lesions were investigated for the first time. Results show that these lesions, with their associated retrograde neuronal degenerative effects, altered a variety of sensorimotor and memory-based behaviors. In particular, the limited unilateral devascularization of the neocortex increased baseline locomotor activity above control; affected motor coordination; impaired passive avoidance retention and reacquisition; and decreased the retention of learnt Morris water maze information. Infusion of the monosialoganglioside into the ventricles, whilst having no effect on the increased motor activity or motor coordination deficit, did enhance the reacquisition of information in both memory-related tasks. PMID- 2771062 TI - Enigmatic action of ciclosporine A on the naloxone-precipitated morphine withdrawal syndrome in mice. AB - Various alterations of the immune system have recently been reported to attenuate the severity of morphine withdrawal. The effect of the immunosuppressive agent ciclosporine A on the naloxone-induced morphine withdrawal syndrome in the chronically dependent mouse was investigated. Ciclosporine A significantly suppressed stereotyped behaviour such as jumping and forepaw treading while wet shakes were potentiated. Withdrawal diarrhoea was diminished as a consequence of a promotive action of ciclosporine A on the intestine. A ciclosporine derivative, which is devoid of immunosuppressive activity, had no influence on withdrawal signs. The attenuating effect of ciclosporine A was observed at a dose of 20 mg/kg i.p., which is not regarded as immunosuppressive in the mouse. It was also effective in animals lacking an intact immune system as a result of a genetic T cell defect (nude mouse) or after selective ablation by whole body irradiation. Nude mice and irradiated normal mice developed dependence on morphine to the same extent as normal animals, as could be derived from the severity of their withdrawal signs. These results suggest that an intact immune system is not a necessary prerequisite for ciclosporine A to attenuate morphine withdrawal and that its action may be attributable to mechanisms other than immunosuppression. It is possibly a result of a direct effect of ciclosporine A on the central nervous system structures involved in the behavioural expression of the opiate withdrawal syndrome. PMID- 2771063 TI - Ocular pseudomyasthenia or ocular myasthenia 'plus': a warning to clinicians. AB - Myasthenia gravis (MG) commonly presents with weakness and fatigability of the lids and extraocular muscles, which respond to treatment with anticholinesterase medication. However, certain intracranial mass lesions may mimic these features of MG; alternatively, MG may mask the signs of a coexistent intracranial mass. We describe 8 patients originally diagnosed as having MG by knowledgeable clinicians, in whom an intracranial lesion instead of, or in addition to, MG was later identified. The lesions included parasellar tumors and aneurysms. In patients presenting with clinical features of ocular MG, it is therefore essential to establish a definite diagnosis of MG, to exclude other possible causes of "pseudomyasthenia," and to exclude other diseases that might be masked by coexisting myasthenic weakness. We recommend that patients with clinical features of MG limited to the ocular or cranial musculature be thoroughly evaluated for intracranial mass lesions, using CT or MRI if warranted. PMID- 2771064 TI - The Consortium to Establish a Registry for Alzheimer's Disease (CERAD). Part I. Clinical and neuropsychological assessment of Alzheimer's disease. AB - The Consortium to Establish a Registry for Alzheimer's Disease (CERAD) has developed brief, comprehensive, and reliable batteries of clinical and neuropsychological tests for assessment of patients with the clinical diagnosis of Alzheimer's disease (AD). We administered these batteries in a standardized manner to more than 350 subjects with a diagnosis of AD and 275 control subjects who were enrolled in a nationwide registry by a consortium of 16 university medical centers. The tests selected for this study measured the primary cognitive manifestations of AD across a range of severity of the disorder, and discriminated between normal subjects and those with mild and moderate dementia. The batteries also detected deterioration of language, memory, praxis, and general intellectual status in subjects returning for reassessment 1 year later. Interrater and test-retest reliabilities were substantial. Long-term observations of this cohort are in progress in an effort to validate the clinical and neuropsychological assessments and to confirm the diagnosis by postmortem examinations. Although information on validation is limited thus far, the CERAD batteries appear to fill a need for a standardized, easily administered, and reliable instrument for evaluating persons with AD in multicenter research studies as well as in clinical practice. PMID- 2771065 TI - Stroke in the Lehigh Valley: racial/ethnic differences. AB - We investigated black/white differences in stroke rate (standardized morbidity), severity, and subtype, and the relative frequencies of 5 primary risk factors (hypertension, diabetes, myocardial infarction, other heart diseases, and transient ischemic attack [TIA]) using the Lehigh Valley Stroke Register. Blacks had a statistically significant higher, age-adjusted rate of stroke than whites. We found no differences in stroke severity using our measures but blacks had a statistically higher proportion of lacunar stroke, while whites had a higher proportion of embolic stroke. There were no differences in proportions of thrombotic stroke or intracerebral hemorrhage. The relative frequencies of hypertension, myocardial infarction, other heart diseases, and diabetes were higher for blacks, while the relative frequency of TIA was higher for whites. These observations are consistent with other reports that blacks have a higher frequency of stroke and tend to have more small-vessel cerebrovascular pathology than whites. PMID- 2771066 TI - Anterior operculum syndrome. AB - The anterior operculum syndrome (AOS) is a well-defined clinical entity that has received little attention in the English literature. We report the clinical and CT findings in 3 cases of AOS; 2 were caused by bilateral cerebral infarctions secondary to bilateral internal carotid occlusion and 1 by the residual effects of viral encephalitis. Although there was variability in the range of deficits found in our cases, each of these patients presented with characteristic facio pharyngo-glosso-masticatory diplegia with a dramatic automatic-voluntary movement dissociation. This syndrome deserves attention for its characteristic anatomic and prognostic implications. PMID- 2771067 TI - Compression syndromes due to hypertrophic nerve roots in hereditary motor sensory neuropathy type I. AB - Three patients with hereditary motor sensory neuropathy type I developed neurologic deficits attributable to hypertrophic nerve roots. Compression of the cervical spinal cord by enlarged nerve roots occurred in our index patient. Multilevel decompressive laminectomies relieved the myelopathy. An unrelated patient who had syncope precipitated by neck rotation had hypertrophied nerve roots that eroded into the transverse foramina in juxtaposition to the vertebral arteries. In a 3rd patient, compression of hypertrophied nerve roots within the thecal sac and neural foramina was associated with spinal claudication and radiculopathy, respectively. PMID- 2771068 TI - Gadolinium-DTPA-enhanced magnetic resonance imaging in childhood brain tumors. AB - Gadolinium DTPA (Gd-DTPA) is a paramagnetic blood-brain barrier contrast agent for MRI that has been used primarily in adults. During May through October 1987, 17 children between the ages of 3 and 18 years with brain tumors underwent MRI examinations, before and after Gd-DTPA (11 gliomas, 4 medulloblastomas, 1 craniopharyngioma, and 1 child with neurofibromatosis and no pathologic diagnosis). We compared T1 and T2 Gd-DTPA-enhanced MRI with concurrent unenhanced MRI and enhanced CT, and then correlated this with the clinical and pathologic findings. Gd-DTPA enhanced tumors in all 7 patients with newly diagnosed tumors and enhanced tumors in 7 of 10 patients without clinical evidence of progressive disease at the time of the study. In the 7 new patients, Gd-DTPA defined tumor margins in all, and demonstrated internal tumor architecture (vessels, necrosis, and cysts) in 5. Areas believed to represent surgical scars showed varying degrees of enhancement. Leptomeningeal tumor spread, including spinal, not seen on pre-Gd-DTPA MRI or on contrast CT, was evident in 2 patients. Gd-DTPA enhancement obscured hemorrhage within the tumor (methemoglobin) in 2 patients. There were no significant side effects. These results suggest that Gd-DTPA enhanced MRI (1) is safe in children, (2) demonstrates the extent and character of tumors better than unenhanced MRI and enhanced CT, and (3) may allow for noninvasive imaging of leptomeningeal disease, including the spine, not previously demonstrated by any other noninvasive neuroimaging technique. PMID- 2771069 TI - Attentional mechanisms during the intracarotid amobarbital test. AB - We investigated the integrity of attentional mechanisms following unilateral intracarotid amobarbital injection in 23 patients undergoing preoperative evaluation for epilepsy surgery. Performance for ipsilateral hand-button response to a quasi-random strobe flash was markedly altered following unilateral amobarbital injection as evidenced by decreased correct responses and increased perseverative errors. The increase in perseverations was inversely correlated with subsequent memory performance. The results indicate that unilateral amobarbital injection commonly produces a marked reduction in attention as well as disturbances in strategic control mechanisms. PMID- 2771070 TI - Effect of age at onset on progression and mortality in Parkinson's disease. AB - We examined longitudinal disability scores in 54 patients with Parkinson's disease followed for 6 years at UCLA. We sorted data into 3 groups based on age at onset of symptoms: group A, onset under 50 years; group B, 50 to 59 years; group C, 60 years or older. There were no significant differences between groups initially. All 3 groups improved dramatically when levodopa was given, but group A showed significantly less disability in years 4, 5, and 6 than did group C. The groups did not differ with respect to side effects. To determine if age at onset affected mortality, we sorted records from 4 geographically diverse centers into the same 3 groups. Results on 359 patients followed for 3,314 person-years, covering a period of 17 years after onset of symptoms, showed that group A had the most favorable observed-to-expected mortality ratio, 1.82, compared with 2.17 and 2.20 for groups B and C respectively, but the difference was not statistically significant. Results from the disability analyses indicate that patients with onset of Parkinson's disease under 50 years of age may have a more favorable prognosis than those whose symptoms begin in later years. PMID- 2771071 TI - High-field proton magnetic resonance spectroscopy of human cerebrum obtained during surgery for epilepsy. AB - We analyzed specimens of histologically normal human cerebrum obtained at surgery for medically refractory epilepsy using proton magnetic resonance spectroscopy. Perchloric acid extracts of anterolateral temporal lobe cortex contained greater concentrations of creatine, N-acetylaspartate, gamma-aminobutyric acid, alanine, and glutamate than the under lying white matter, which contained more acetate. Frontal and temporal lobe specimens composed of both gray and white matter failed to show statistically significant differences in the concentrations of creatine, N-acetylaspartate, alanine, aspartate gamma-aminobutyric acid, glutamate, glycine, taurine, threonine, valine, acetate, choline, beta-hydroxybutyric acid, inositols, lactate pyruvate, or succinate. PMID- 2771073 TI - Clozapine in the treatment of psychosis in Parkinson's disease. AB - Clozapine is an antipsychotic medication that is virtually free of extrapyramidal side effects. We report our successful treatment of 6 patients with idiopathic Parkinson's disease and various psychoses using clozapine on a chronic basis along with carbidopa/L-dopa. PMID- 2771072 TI - Differential effects of isoflurane on SEP recorded over parietal and frontal scalp. AB - We evaluated the effects of different concentrations of isoflurane on short latency somatosensory evoked potentials recorded over the parietal and frontal scalp in 14 patients during general anesthesia at stable end-tidal concentrations between 0% and 2.5%. At concentrations between 0% and 1%, there was a marked discrepancy between the amplitude of the parietal N20, which remained stable, and the striking increase of the frontal P22. At concentrations above 1.5%, the parietal N20 disappeared in 6 patients whereas the P22 was clearly identified in 12. The central conduction time increased significantly whereas the spinal conduction was not delayed by increasing levels of isoflurane. These results show that isoflurane anesthesia is a useful pharmacologic model to demonstrate the independence of the N20 recorded over the parietal scalp and the P22 recorded over the frontal scalp. PMID- 2771075 TI - Patterns of neurologic involvement in multiple sclerosis. AB - Specific patterns of neurologic involvement within the 8 Functional Systems (Pyramidal, Cerebellar, Brain Stem, Sensory, Bowel & Bladder, Visual, Cerebral, Other) in a well-documented series of early MS patients have been presented in rank order of expected frequency. The first 35 and the first 86 of the 256 possible patterns comprised respectively 71% and 90% of all cases expected or observed. Patterns with increasingly higher rank orders provided increasingly greater likelihood for the diagnosis of MS. For 1 of the 4 most common patterns, the likelihood of MS was 17 times that without consideration of any pattern. In this series, the occurrence of any of the first 35 patterns was well above expectations, while patterns ranked beyond 86 were highly unlikely. PMID- 2771074 TI - Nonmetabolic fatigue in exercising human muscle. AB - Human muscle fatigue, assessed by declining maximum voluntary contraction (MVC), may be caused by impairment of excitation-contraction coupling as well as by metabolic alterations within the muscle. To distinguish between these 2 possibilities, we assessed changes in excitation-contraction coupling by measuring twitch tension (TT) and twitch potentiation (P-TT) of the human adductor pollicis and tibialis anterior, while we analyzed metabolic changes using 31P magnetic resonance spectroscopy. Low-intensity exercise produced a much greater fall of TT and P-TT than MVC, high energy phosphates, or intracellular pH (pHi). In addition, the recovery of TT and P-TT was much slower than recovery of MVC, high energy phosphates, or pHi. These results suggest that the greater fall of TT and the delayed recovery following low-intensity exercise are caused by impaired excitation-contraction coupling. PMID- 2771076 TI - Behcet's disease with slowly enlarging midbrain mass on MRI: resolution following steroid therapy. AB - We describe a case of Behcet's disease with a slowly enlarging midbrain mass on magnetic resonance imaging, which resolved after 4 months of oral steroids. PMID- 2771078 TI - Bruxism following cerebellar hemorrhage. PMID- 2771077 TI - Initial bolus of conventional versus high-dose dexamethasone in metastatic spinal cord compression. AB - We randomly assigned dexamethasone in an initial bolus of 10 mg IV or 100 mg IV followed by 16 mg daily orally to 37 patients with metastatic spinal cord compression. The average pain score before the start of treatment was 5.2 (SD = 2.8) and decreased significantly (p less than 0.001) to 3.8 at 3 hrs, 2.8 at 24 hrs, and 1.4 after 1 week. There were no differences between the conventional and high-dose group on pain, ambulation, or bladder function. PMID- 2771079 TI - Oculomotor palsy with cyclic spasms. PMID- 2771080 TI - Cervical spine and headaches. PMID- 2771081 TI - Chronic demyelinating neuropathy. PMID- 2771082 TI - Neuroleptic malignans. PMID- 2771083 TI - [Arterial pressure and heart rate: postural variations in the elderly]. AB - The behaviour of arterial blood pressure and heart rate after an active change from the supine to the upright posture was studied in the aged. A significant decrease in the average values for systolic and diastolic blood pressure and a significant increase in the average values for heart rate in the first minute of the upright posture were observed. The systolic and diastolic pressures are reduced in a higher percentage of the cases in the 80-94 year age class. In the same class the PAS is more frequently reduced in the male and the PAD in the female. The heart rate, in the upright posture, is higher in 80-94 year-old males without a significant difference between the sexes. PMID- 2771084 TI - [Type A behavior and cardiovascular reactivity. Preliminary findings]. AB - In view of reports of a connection between ischaemic cardiopathies and "A" type behaviour, the response of certain cardiocirculatory parameters to given physical stimuli was investigated in a group of people doing high stress work. The data did in fact reveal a tendency to more pronounced cardiovascular reactivity in the A group, a difference that was statistically significant in the cold pressor and cold tests. The possible links between enhanced vasomotor response and increased risk of coronary heart disease are pointed out with emphasis on recent hypotheses about the possible pathogenic role of enhanced 5-OH-tryptamine release and particular alterations in the alpha/beta adrenergic receptor balance. PMID- 2771085 TI - [The lipid hypothesis in the etiopathogenesis of ischemic heart disease: confirmations and doubts resulting from primary prevention trials]. AB - Sufficient evidence exists today pointing to the relationship between high levels of plasma cholesterol and coronary atherosclerosis. Up to now, however, the last criterion for validating the aetiopathogenetic relationship between dyslipidemia and CHD, i.e., the demonstration that reduction of plasma cholesterol reduced the formation or progression of the plaque and the incidence of its fatal or non fatal cardiac and vascular complications, has been lacking. For more than two decades, numerous trials have had this aim in mind but until very recently results have not been substantiated owing to various deficiencies in the method. Before publication of the NHLBI Task Force of Atherosclerosis, eleven major randomised clinical studies based on hypolipidemia interventions were completed. The three studies involving dietetic interventions were considered non-conclusive overall because of the lack of a double-blind factor and of other important epidemiological criteria. Of three pharmacological trials only two involved studies of primary prevention carried out on a population of hypercholesterolaemics. These produced partial results on certain cardiac end points but not on total deaths and at times not even on deaths from CHD. Multifactorial studies, finally, were even less demonstrative. Taken together, however, the trials based on hypolipidemia interventions point to interesting though not definitive evidence of a reduction in blood cholesterol levels to reduce the incidence and mortality from CHD. According to the NHLBI, many of these studies lacked important features that were codified and suggested for later studies.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2771086 TI - [Dynamic phonocardiography in the study of mitral valve prolapse. Our experience]. AB - The purpose of this paper is to check the usefulness of dynamic phonocardiography for mitral valve prolapse (MVP) diagnosis, especially in apparently silent cases, or with late-systolic click. In fact, possible MVP or mitral valve regurgitation can be shown. 148 patients (58 males, 90 females) have been examined by basal and dynamic phonocardiography and M-echocardiography. Patients were recruited for routine medical examination or during investigations for other causes or to explain evocative MVP troubles. Provocative tests by amyl nitrite, isoproterenol and methoxamine registered a late-systolic click in 17 normal cases and a late systolic murmur in 22. M-echo demonstrated MVP in 142 cases (96%), with a slight prevalence of late-systolic MVP; tricuspid valve prolapse coexisted in 8 cases and aortic regurgitation in 12. Today echocardiography is the most important examination, but all our data point to the usefulness of dynamic phonocardiography for MVP diagnosis: in our opinion, the integration of both techniques represents the most correct approach. PMID- 2771087 TI - [Electrocardiographic, clinical and prognostic evaluation of sustained ventricular tachycardia in acute and chronic ischemic heart disease]. AB - We retrospectively evaluated 48 patients with sustained ventricular tachycardia (STV), in whom a 12 lead ECG had been recorded during arrhythmia, considering two groups: pts. with acute or subacute myocardial infarction (MI group = 15 pts.) and pts. with chronic post infarction ischemic heart disease (CPIIHD group = 33 pts.). The electrocardiographic patterns in the basal ECG and during SVT (16 SVT in the MI group, 40 in the CPIIHD group) as well as the in-hospital and long-term prognosis were evaluated. The two groups were comparable as far as mean age, site of acute or previous infarction, and baseline ECG parameters are concerned. QTc values greater than 440 msec were present in 64.5% of the cases. The ECG recording during SVT showed longer duration of QRS in CPIIHD group (171 +/- 39 msec) versus MI group (140 +/- 25 msec) (p less than 0.005). In comparison to basal ECG, Q waves in the SVT recording were in the same site (47.2%) or in a wider site (38.1%), rarely (10.9% of the cases) there was a discordance between the two tracings. In-hospital mortality was 40% (6/15 pts.) in MI group, related to severe hemodynamic impairment, 15.1% (5/33 pts.) in CPIIHD group. During the follow-up (mean 38.4 months) survival in CPIIHD group was 89.3% at 12 months, in MI group 88.9% at 12 months. In CPIIHD patients SVT was recurrent in 60.6% of the cases.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2771088 TI - [Persistence of the right venous sinus valve simulating a right atrial myxoma in a case of total anomalous pulmonary venous return. Echocardiographic, anatomo clinical and surgical aspects]. AB - A case of persistence of the right venous sinus valve that on echocardiographic examination simulated right atrial myxoma is reported in a patient with total abnormal pulmonary venous return in the coronary sinus. Echocardiography showed a mobile, pedunculated mass present in systole in the right atrium that shifted to diastole in the right ventricle, highly suggestive of right atrial myxoma. The right ventricle also showed a volume overload and a space without echoes behind the left atrium. A membrane was encountered in the right atrium at surgery. This was removed and the venous return corrected. PMID- 2771089 TI - [Cardiac echinococcosis. Description of a case with cysts localized in the free wall of the left ventricle]. AB - A case of isolated cardiac echinococcosis is reported. A 19-year-old man was hospitalized for chest pain with electrocardiographic pathological Q waves in D1, aVL, V5, V6. Two-dimensional echocardiography and chest computed tomography documented pericardial effusion and an intramyocardial cyst. Casoni's reaction and immunological tests completed the diagnosis of cardiac hydatidosis. The localization and the etiology of the cyst were confirmed during cardiac surgery. PMID- 2771090 TI - [Multiple choice questions in educational assessment: proposal of a computerized program]. AB - After a description of the basic criteria for the correct formulation of Multiple Choice Questions (MCQ) for use in the assessment of different levels in the intellectual process (memorising, data interpretation, problem solving) a package of computer programs for the use of MCQ in the assessment of what has been learned in a General Surgery course in the Faculty of Medicine and Surgery are presented. The MCQ is a valuable didactic tool that can well supplement though not replace oral examination for assessment at all stages of a course. PMID- 2771091 TI - [A new therapeutic approach to retained biliary calculi. Results in 6 patients]. AB - A new three-phase therapeutical approach to retained biliary stones (RBS) is designed to shorten the long treatment times with Monooctanoin (Mo). In the first phase, the litholytic agent is infused to soften the stones. In the second one the calculi are crushed, and in the last complete elimination of the fragmentary stones into the duodenum is obtained after 1-2 flushings with ceruletide. In 6 patients a complete clearance of the stones was obtained (success 100%) together with a reduction in the litholytic agent dose (52%) and the infusion time (62%), in comparison with the results of using Mo. alone. PMID- 2771092 TI - [Synchronous hepatectomy and exeresis of primary tumor of the colorectum]. AB - Personal experience of 6 hepatectomies at the some time as primary colorectal tumour excision is reported. Like most Italian and foreign Authors, the paper stresses the negligible mortality and morbidity after this double surgery. Moreover, in these particular patients, it was never necessary to postpone hepatectomy. Finally, emphasis is placed on the importance of intraoperative echography for the identification of micrometastasis in one or two lobes, for the correct staging of the primary tumour and for oncologically appropriate hepatectomy. PMID- 2771093 TI - [Biliary ileus. Our experience]. AB - Personal surgical experience of 7 cases of typical gallstone ileus and 2 cases of Bouveret's syndrome secondary to spontaneous bilio-digestive fistula of lithiasic aetiology are reported. After analysing the problems inherent in the clinical picture and the diagnostic protocol, stress is laid on the therapeutic strategies employable in the event of typical gallstone ileus. It is concluded that single stage correction of the bilio-digestive occlusion and fistula is always preferable except in patients whose general condition is very poor. Patients should initially be submitted to treatment of intestinal occlusion alone. PMID- 2771094 TI - [Treatment of perforated duodenal ulcer. Our experience]. AB - Personal experience in the treatment of perforated duodenal ulcers is reported. The 78 patients concerned were divided into two groups (operated on before or after the introduction of anti-HZ antihistamines) and were encountered between 1 1-1972 and 30-12-1986. The results were generally satisfactory: mortality (operative and postoperative) 5.1%; postoperative complications 6.4%; recurring ulceration 1-5 years after surgery 6.4%. The most successful operations (lowest death and complication rates, shortest hospital stay) were simple suturing and suturing combined with superselective vagotomy. Analysis of the results show that the success of the operation was significantly influenced by the following factors: patient's age and general condition, associated diseases, time of onset of the ulceration prior to perforation and above all the length of time between the perforation and the operation i.e. the presence or absence of peritonitis. Simple suturing should always be used where possible, particularly now we have the anti-H2 drugs. Superselective vagotomy combined with suturing is the definitive surgical treatment of choice and produced no deaths or complications in the 13 patients given this treatment. PMID- 2771095 TI - [Gastric polyps: endoscopic and surgical treatment]. AB - A personal series of gastric polyps is reported. The therapeutic approach is described together with the results obtained. Comparison are made with literature. PMID- 2771096 TI - [Cancer of the colorectum in the aged. Clinical considerations with reference to our case series of 65 operated cases during the triennial, 1984-1986]. AB - Starting from the note that in industrialised countries colorectal tumours are an increasingly serious problem, especially in the elderly, and after some epidemiological remarks, a personal series of 65 consecutive operations on over- 70s in a three-year period is considered. Personal statistics are analysed following careful assessment of risk factors and the immediate and long-term surgical results, also examined on the basis of reported data. It is noted, first, that age is never an absolute contraindication to surgery; second that early diagnosis is basic for the achievement of an improved prognosis: proof of this lies in the excessive number of emergency operations for occlusion or perforation. On the other hand, while it is true that extreme radicalism at an advanced stage does not imply any substantial modification to prognosis, it should also be recognised that the shortening of surgical times (after the introduction of mechanical staplers and the improvement in anaesthesiological assistance techniques) offer greater scope for manoeuvre. PMID- 2771097 TI - [Hartmann's operation in complicated lesions of the sigmoid and rectum]. AB - A personal series of 49 Hartmann's operations carried out in the period 1975-1986 for complicated rectal-sigmoid lesions, 43 for cancer and 6 for diverticular sigmoiditis, are reported. Fully 45 of these patients (92%) were operated on in emergency conditions and the choice of the operation was imposed by the gravity of the lesions observed. In the light of this series and a review of the literature, it is maintained that the operation still has a place in complicated rectal-sigmoid lesions, especially under emergency conditions and in patients at risk for age and general conditions, it being very well tolerated and consenting recanalisation if necessary. PMID- 2771098 TI - [Cholecystectomy and adenomatous polyps of the colorectum]. AB - The possible correlation between cholecystectomy and adenomatous polyps of the colorectum is evaluated by means of a retrospective study of 2 groups of patients: 90 patients subjected to endoscopic removal of one or more adenomatous polyps of the colon-rectum (histological diagnosis) and 90 control patients paired by sex and age, hospitalised for benign pathology and selected from among those submitted to totally negative colonoscopy. Ten patients (11.1%) were submitted to cholecystectomy among those with adenomatous polyps, 5 (5.5%) in the control group. Subdividing patients by sex women evidenced a relative risk of 5 (O.R. = 5/1, degree of confidence 95% = 0.7-33.4) but the figure was not statistically significant. For males, on the other hand, the relative risk was 1 (O.R. = 5/4). It is concluded that cholecystectomy may be considered a risk factor for the development of adenomas of the colon-rectum in females. PMID- 2771099 TI - [Complications of septorhinoplasty]. AB - A review of the literature on complications in septorhinoplasty is presented. Though rare, complications may arise in the surgical treatment of such a delicate anatomical area as the nasal septum and both theoretical and practical knowledge of the problem is necessary in order to prevent and/or handle such unexpected events. Complications are grouped according to aetiopathogenesis into infectious, haemorrhagic, traumatic, systemic and miscellaneous. PMID- 2771100 TI - [Fibrinolytic treatment in acute ischemia caused by thrombosed popliteal aneurysm. Apropos of 2 cases]. AB - Two personally observed cases of ischaemia of the lower extremities due to thrombosis caused by a popliteal aneurysm are presented. While surgery is known to be treatment of choice, in these cases locoregional fibrinolysis was preferred. It seems useful to detail the advantages of this approach that has never appeared in the literature as a treatment for aneurysmatic pathologies. PMID- 2771101 TI - [Retrospective analysis of 1354 autopsies in cases of death caused by trauma]. AB - 1,354 deaths due to traumatic causes arising in 1976-1985 among patients admitted to the Molinette Hospital, Turin were analysed. The causes were divided into 5 major groups with to monitoring the course of the pathologies concerned over time. The results confirm an increase in deaths from septic shock that reflects increased recourse to surgery and the application of resuscitation manoeuvres and equipment, but a decrease in death due to haemorrhagic shock. These two pathologies represent the major lines for future research aimed at improving the prognosis in traumatic lesions. PMID- 2771102 TI - [Spontaneous rupture of the spleen caused by primary amyloidosis. Description of a clinical case]. AB - Spontaneous rupture of the spleen in primary amyloidosis is an uncommon event. After a review of the pertinent literature (10 case-reports between 1948 and 1987) a case of spontaneous splenic rupture with hemoperitoneum is presented. The diagnosis depends on the demonstration of amyloid deposit in splenic and hepatic tissues. PMID- 2771103 TI - [Benign Castleman's lymphoma. Remarks on 2 cases]. AB - Two personally observed cases of Castleman's benign lymphoma of the hyaline vascular type located in the mediastinum are described. The stages in the development of our knowledge of this tumour are traced and the various aetiopathogenic theories discussed. The difficulty of preoperative diagnosis is emphasised while the potential predictive value of calcifications combined with hypervascularization in an asymptomatic mass usually in the mediastinum and revealed by CT is pointed out. PMID- 2771104 TI - [Roux-en-y hepatojejunostomy in benign pathology of the common duct]. AB - Personal experience is reported of 59 hepaticojejunostomies performed on an excluded Roux loop in the treatment of benign pathologies of the main bile duct. The advantages and disadvantages of this approach are discussed. Several particular cases are described as is the surgical technique adopted. Complications arising in 5 patients included 3 duodenal ulcers, one of them bleeding and 2 cases of anastomotic stenosis. In all other cases the operation was satisfactory. Follow-up involved echographic and cholescintigraphic examinations. It is concluded that Roux en Y hepaticojejunostomy is the treatment of choice in benign pathologies of the main bile duct when transduodenal papillostomy is contraindicated. PMID- 2771105 TI - [Hepato-cholescintigraphy using technetium Tc 99m diethyl IDA in the follow-up of biliodigestive anastomoses]. AB - The results of a study conducted on 24 patients given biliodigestive shunts are reported. Follow-up involved cholescintigraphy using 99m-IDA technetium. This examination provided valuable information about the morphodynamics of biliary flow and when the biliary peak and intestinal appearance times were lengthened, it was also able to identify significant obstructions. The technique is considered highly significant. PMID- 2771106 TI - [Distal pancreatectomy with conservation of the spleen. Apropos of 3 consecutive cases]. AB - Three distal pancreatectomies with preservation of the spleen are described. The indications were infiltration of the pancreatic tail by a gastric adenocarcinoma in the first patient; acute and chronic inflammation of the pancreas in the second and third. This type of operation takes very little longer than classic distal pancreatectomy with splenectomy, does not increase the incidence of postoperative complications and above all prevents the onset of sometimes lethal sepsis especially in young patients. PMID- 2771107 TI - [Surgical therapy of the kinking of the internal carotid artery. Indications and limitations]. AB - Surgical treatment of a case of symptomatic kinking of the internal carotid suggested a review of the problem on the basis of the national and international literature. Opinions are not only extremely distant but not infrequently antithetical. In such a heterogeneous subjects that is often difficult to interpret, the most interesting approaches are examined in the light of new experimental and clinical findings. PMID- 2771108 TI - [Heterotopic autotransplant of the spleen after splenectomy in traumatic rupture. Personal experience and scintigraphic follow-up]. AB - Certain aspects of OPSI (Overwhelming Post-Splenectomy Infection) are examined, mainly its considerable gravity, its relatively high incidence, especially in children; its difficult prophylaxis with a report on personal experience of ectopic autotransplant of spleen tissue in two young patients after splenectomy for traumatic rupture. The technique was found to be simple and quickly performed. Scintigraphic follow-up for over 4 years after the operation showed satisfactory growth in the transplanted spleen tissue. PMID- 2771109 TI - [Sessile tubulo-villous polyps in the rectum: problems of diagnosis and treatment. Personal experience]. AB - A retrospective analysis was performed on 22 patients (mean age 65) in whom preoperative rectosigmoidoscopy had diagnosed tubulovillous rectal polyp. In 12 cases the polyps were removed transanally and the remaining 10 were subjected to laparotomy. The incidence of error in the preoperative histological diagnosis was 18.2% (9% for the nature and 10% for degree of dysplasia of the polyp). There were 25% recurrences after transanal exeresis, 10% after laparotomy. Total survival at 42 months was 86.3%. The study confirms the validity of transanal exeresis of tubulovillous polyps of the rectum assuming careful preoperative patient selection. PMID- 2771110 TI - [The role of the blood viscosity and hematocrit value in acute stroke. Experimental considerations]. AB - The link between blood viscosity, Ht and the onset of stroke is highlighted and reports in the literature are examined. On this basic, the paper proposes an experimental model of cerebral ischaemia in the rabbit as providing a better insight into this aspect which may be highly significant, particularly in the prevention of strokes. PMID- 2771111 TI - [CEA (carcinoembryonic antigen): its value as an early indicator of recurrence of neoplastic disease in carcinoma of the colon and rectum]. AB - A personal series is examined in order to assess the reliability of CEA in the diagnosis of returning colorectal cancer and to compare the data accumulated with reports in the literature with a view to establishing reliable criteria for the use and assessment of this test. PMID- 2771112 TI - [Treatment of tissue loss in surgery of the scalp. An analysis of 89 patients brought to our attention]. AB - The recent computerisation of operating theatre and forensic files facilitated a retrospective study of 136 plastic surgery operations performed on 89 patients presenting traumatic or surgical scalp tissue loss in the San Camillo Hospital, Rome between 1/1/1980 and 31/12/1987. The study provided some useful data for the planning of the surgical approach to this delicate anatomical area. Where the dimensions of the defect and the trophic condition of the local tissues permitted, the best functional and cosmetic results were obtained by using flaps of contiguous skin. In this field, new prospects are offered by the introduction of skin expanders whose gradual and controlled distension of the skin permit excellent functional and cosmetic results. PMID- 2771113 TI - [Our subcostal retractor]. AB - A new self-restraining table-fixed abdominal retractor, thought up and built by Dr. Bonini, is described. This retractor is easy to construct and use and is recommended whenever very good exposure of the diaphragmatic vault and the supramesocolic area is required. PMID- 2771114 TI - [Value of rectosigmoidoscopy in the secondary prevention of carcinoma of the colon and rectum. Results of a study of ours carried out in elderly patients]. AB - Secondary prevention is undoubtedly a vital consideration in the early diagnosis of cancer of the large bowel. The examination of asymptomatic subjects considered to be at high risk of colorectal carcinomas will improve the prognosis for this tumour by identifying lesions at an early stage or, even better, pathologies considered precancerous. Rectosigmoidoscopy was therefore employed on a sample of asymptomatic geriatrics, at high risk because of their age. The examination of 245 elderly people revealed various asymptomatic conditions (haemorrhoids, rhagades, polyps, etc.) and, more importantly, 4 cases (1.6%) of rectosigmoid tumours, 2 of them Dukes stage A and 2 polyps in the initial phase of degeneration into malignancy. The paper concludes by emphasising the value of mass screening of the elderly and indeed of other high risk groups using a flexible rectosigmoidoscope, in the hope of identifying early-stage tumours or precancerous lesions with a view to reducing the incidence of colorectal carcinoma and therefore significantly improving the prognosis for that condition. PMID- 2771116 TI - [Our experience on the surgery of liver tumors]. AB - Personal experience of liver surgery for benign and malignant pathology is reported. The type of operation and results obtained in relation to mortality and possible intra- and postoperative complications are considered. The extraparenchymal and transparenchymal techniques are both considered valid but in approaching the vascular structures the former is preferred because it permits preliminary vascular monitoring. The results obtained are similar to those of other series reported in the literature. PMID- 2771115 TI - [Treatment of septic complications in diverticular disease of the colon]. AB - Eight years' experience in the treatment of the septic complications of diverticular disease of the colon is examined and 44 cases treated in the period 1980-1988 are considered. The Hartman procedure gave good results in the majority of cases; other procedures such as drainage with colostomy, or anastomosis resection during a single intervention are reserved for particular cases. In addition, on examining the case histories and the current literature it seems that it is correct to treat DD (diverticular disease) surgically whenever the typical manifestations of the overt disease appear; waiting often represents nothing more than a postponement of the surgical treatment until an emergency arises. PMID- 2771117 TI - [Cancer of the breast. I. Epidemiology and risk factors (our experience)]. AB - Data concerning different risk factors for breast cancer based upon the results obtained in a study of 461 women are reported. Comparing this experience with other Italian and international series, it is concluded that the most reliable risk-index for breast cancer is the age of the woman, while less incisive, though prominent, are family history, immunodeficiency, hormonal metabolism and other environmental factors. PMID- 2771118 TI - [Cancer of the breast. II. Prognostic factors (our experience)]. AB - Data concerning different prognostic factors based upon results observed in a group of 212 women operated fro breast carcinoma and submitted to follow-up for 5 consecutive years from diagnosis are reported. Comparing this experience with other Italian and international series, it is concluded that the most reliable prognostic factors are the tumour's size and lymph-node status, while less incisive, though relevant, are the site of the tumour, invasiveness, the grade, the labeling index, hormonal receptor status, the levels of Ca 15.3 and of CEA and the age of the woman at diagnosis. PMID- 2771119 TI - [Reconstruction of the breast after radical mastectomy in cancer. Reconstruction of the areola-nipple complex and the symmetry of the 2 breasts]. AB - After pointing out the need for reconstruction of the nipple-areola complex and the restoration of symmetry between the two breasts after radical mastectomy for cancer, the paper briefly examines the techniques currently available for the achievement of these "finishing touches" that usually take longer then the primary and fundamental breast reconstruction. PMID- 2771120 TI - [Use of blood and its derivatives by the emergency surgeon]. AB - In spite of the fact that the initial injury has to be treated as quickly as possible, in many emergency pathologies, the priority in early resuscitation periods is to provide an adequate blood flow, tissue perfusion and oxygenation. In multiple injuries, treatment starts before diagnosis because diagnostic examinations cannot begin until the patient's condition has become more stable. PMID- 2771121 TI - [Leg ulcers in chronic venous insufficiency]. AB - The incidence of the various types of ulcer is assessed in 180 subjects suffering from chronic ulcer of the legs and various syndrome. It emerges that about 10% of ulcers are not due to chronic venous insufficiency but to other pathologies. PMID- 2771122 TI - [Treatment of fractures of the mandible: a new type of external fixator]. AB - The use of external fixators in the treatment of complex mandibular fractures is described, as are the advantages offered by the technique which permits accurate, controlled reduction of the bone fragment without immobilising the temporomandibular joint. PMID- 2771123 TI - [Use of buprenorphine as a cornerstone in narcosis and as analgesic in the postoperative period in gynecologic surgery]. AB - In a clinical trial buprenorphine (0.3 mg i.v.) was administered, 20-45 minutes before the surgical operation, to 220 women undergoing gynecological surgery. If necessary buprenorphine (0.2-0.3 mg i.m.) was administered also in the post operative period. By the pre-operatory administration of buprenorphine, a great stability of life parameters was observed during the surgical operation. In the post-operative period most of the patients showed absence of pain or mild pain. PMID- 2771124 TI - [Perforations in free peritoneum in Crohn disease]. AB - Among Crohn's disease complications, perforation in free peritoneum is extremely rare, this being due to the disease's anatomopathological characteristics. Three cases of free perforation are described: one of the colon and two of the intestine. On the basis of the results of surgical treatment, straightforward suture of the perforation is contraindicated. The most rational treatment, when possible, is resection with immediate or deferred reconstruction. PMID- 2771125 TI - [Neoplasm on cholecysto-jejunal anastomosis: an endoscopic diagnosis]. AB - Bilio-digestive anastomoses represent a tried and tested surgical procedure in lithiasic or neoplastic type obstructions of the main biliary way. Among long term postoperative complications the case of neoplasia in the stomy is rare. A clinical case of neoplasia on cholecystojejunal anastomosis diagnosed endoscopically is reported. The physiopathological aspects are discussed. PMID- 2771126 TI - [Primary duodenal lymphoma. Communication of a case]. AB - Primary malignant lymphoma of the duodenum is a rarity. A case of primary non Hodgkin lymphoma of the duodenum is reported. Symptoms, signs, radiographic and endoscopic findings are discussed. C.T. with C.V.P. were performed in addition to subtotal pancreatico-duodenectomy Follow-up, after one year, did not show any signs of recurrence. PMID- 2771127 TI - Empathy and related emotional responses. PMID- 2771128 TI - Maternal emotional signals, social referencing, and infants' reactions to strangers. PMID- 2771129 TI - Individual differences in empathy among preschoolers: relation to attachment history. PMID- 2771130 TI - Mothers' emotional arousal as a moderator in the socialization of children's empathy. AB - Overall, our findings suggest that the moderating effects of maternal affective arousal in the socialization of children's empathic responding are complex. On the one hand, at low levels of mothers' affective intensity, positive relations were found between children's sad facial reactions and mothers' prosocial suggestions. At the highest levels of affective responding, however, mothers' altruistic responding was significantly and positively related to children's sad facial responses, and mothers' altruism and inductive reasoning was negatively related to children's distressed facial reactions (Table 2). The negative relation of mothers' inductions and altruistic responding to children's facial distress reactions at high levels of mothers' affective responding could be interpreted to mean that these practices are associated with decreases in children's personal distress reactions to distressed peers (that is, with decreases in one's focus on one's own negative feelings). However, the positive relations between mothers' inductions and altruistic responding and children's facial distress reactions at low levels of mothers' emotional responding could support the interpretation of facial distress reactions as vicarious emotional responses. The affective response depicted by the children in the empathy films involved physical distress, so a purely vicarious affective (that is, empathic) response might be expected to be expressed facially as a distressed reaction. Thus, the variability in the results regarding children's facial distress reactions suggests that to interpret them as an index of either empathy or personal distress requires considering the nature of the empathy stimulus and may ultimately require assessing additional criterion variables (for example, examining the relation of facial distress reactions to actual prosocial behavior). Results not found in previous research were that high-intensity parental affect combined with negative control practices was associated with a lessening of children's sympathetic orientations, whereas situational definitions were positively associated with children's facial distress reactions to peer distress. The variability in these findings may be explained, in part, by the interpretation that parental affect may potentiate the impact of the semantic content of parental messages to the child. That is, if the content of the message is inductive, the mother's intense affect may heighten the meaningfulness of the relation between the child's behavior and its consequences for the peer's situation or feelings (unless, of course, the parent overwhelms the child with information). PMID- 2771131 TI - Children's helping strategies: influences of emotion, empathy, and age. PMID- 2771132 TI - [Correlation of positivity for serum anti-chlamydia antibodies and tubal damage as a cause of infertility. Preliminary study]. AB - Chlamydia Trachomatis is one of the most frequently bound aetiological agents in acute salpingitis. Chlamydia infection often runs asymptomatically or with slight symptomatology, so patients do not call in their doctor. This hypothesis is backed by the observation that serum antibody positivity for Chlamydia and tubal infertility are often found together. The purpose of the present study was to determine the positivity of serum antibodies for Chlamydia in infertile women observed at this Centre and compare it with a control group of non-sterile patients. Further, in those patients in whom antibody positivity exists, it was also proposed to seek tubal lesions at hysterosalpingography or coelioscopy. The antibody titre in infertile women is compared with that of the control group. The study was carried out in 30 sterile women and in 30 patients in the definitely fertile control group. The "Ipazyme" (Sorin) immunoperoxidase test was used to seek IgG and IgA anti-Chlamydia antibodies. The geometric mean of the antibody titre was calculated in those women with a titre equal to or greater than 64 for IgG antibodies and equal to or greater than 16 for IgA antibodies. It is now intended to study whether the titre is higher in infertile women compared to the control group and if positivity is more significant in these patients. PMID- 2771133 TI - [Danazol in the therapy of dysfunctional uterine hemorrhage in women of fertility age]. AB - The effectiveness of Danazol in a dose of 200 mg/day for 3 consecutive months has been assessed in 30 women complaining of dysfunctional uterine haemorrhages. The patients were selected by excluding any associated genital pathology (myomas, ovarian neoformations, endometrial cancer, etc.) and any clotting pathology. Danazol proved effective in all cases treated. Side-effects were inconsequential save for 2 women who had to suspend treatment following increase in transaminases in one case and defluvium capitis in the other. The treatment remained effective for at least 2 months after termination. In 26% of the women, the haemorrhagic pathology reappeared within 6 months but, apart from one case, repetition of the cycle using the same modalities as before, mastered and normalised the menstrual picture. PMID- 2771134 TI - [Prevention of deep venous thrombosis in obstetrico-gynecologic surgery. Our experience with defibrotide]. AB - Defibrotide, a new anti-thrombotic and profibrinolytic agent, has been experimented in the prophylaxis of thromboembolic disease in 99 women subjected to obstetrico-gynaecological operations. The drug's effectiveness, lack of changes in the clotting set-up and good tolerance were demonstrated. In conclusion, it is hoped that the good results obtained will promote more regular use of this drug in the prophylaxis of deep venous thrombosis in obstetrico gynaecological surgery. PMID- 2771135 TI - [Anatomical knowledge in relation to the female genitalia in adolescent girls]. AB - The purpose of the research was to analyse drawings of the inside of the body and the female genital apparatus produced by 275 female adolescents aged 11 to 18, with particular interest in the quality and structural properties of the drawings and in the female genital elements best known to the subjects. The results reveal the presence of a progressive process of integration of the genital parts into the representation of the inside of the body and show how knowledge of the female genitals evolves in the age group considered. PMID- 2771136 TI - [Stromal tumors of the endometrium]. AB - The clinicopathological and immunohistochemical features of three types of endometrial stromal neoplasms are analyzed. The tumors are divided into three groups on the basis of two observations: 1) the presence or absence of invasion; 2) the frequency of mitotic figures. PMID- 2771137 TI - [Embryonal carcinoma of the ovary. Anatomo-clinical aspects and presentation of a case]. AB - A case of ovarian embryonic carcinoma in a 25 year old patient hospitalized in the Gynecological Department of the National Cancer Institute, Naples, is described. After a general introduction the clinical condition of the patient is discussed with emphasis on the histological aspects of the neoplasm. PMID- 2771138 TI - [Ovarian pregnancy after intraperitoneal insemination (I.P.I.)]. AB - An observed case of ovarian pregnancy after intraperitoneal insemination (IPI) triggers a description of this new technique and a suggestion as to the possible dynamics of the ensuing ectopic pregnancy. PMID- 2771139 TI - [Determination of fetal pulmonary maturity using gas chromatographic analysis of fatty acids in the amniotic fluid. Statistic reliability of the method]. AB - Assessment of foetal lung maturity by gas chromatographic analysis of the fatty acids in the amniotic fluid. Statistical reliability of the technique. Gas chromatographic analysis of the fatty acids (Palmitis acid/Steric acid ratio: P/S ratio) was carried out in 432 samples of amniotic fluid obtained between the 28th and 42th weeks of gestational age. The present results from a series of normal (257) and various pathological (175) cases support the conclusions of other investigations that an amniotic fluid P/S ratio equal to or greater than 5 is a reliable indicator of attained fetal lung maturity. When correlated with gestational age the P/S ratios show regression lines that define the range of lung maturity in normal pregnancies between 32 and 33 weeks and in pathological cases around and over 36 weeks. Statistical studies stress that centrifugation in standard sample conditions before its gas chromatographic analysis is an essential step in order to avoid the serious consequences of an erroneous prediction. Finally Lecithin/Sphingomyelin (L/S) and P/S ratios were assessed in the same 100 samples of amniotic fluid: statistical analysis shows a very good correlation between the two methods and their reliability in the prediction of fetal lung maturity. PMID- 2771140 TI - [Cervical conization in the diagnosis and treatment of cervical epithelial neoplasms]. AB - Thirty-seven patients who underwent cone biopsy for cervical intraepithelial neoplasia (CIN) of varying gravity have been considered. The follow-up points to the therapeutic as well as diagnostic value of this intervention (92% success). Analysis of the responses provided by colpocytology in comparison with those provided by biopsy, evidences the poor diagnostic reliability of the pap-test with respect to intraepithelial lesions of the uterine cervix (under-estimated in 51% of cases compared to biopsy). Operation did not substantially modify patients' reproductive capability (5 pregnancies of which 3 developing, during the control period) an extremely important factor in view of the young age of patients (average 31 years). PMID- 2771141 TI - [Ciclopiroxolamine in the topical treatment of vaginal mycoses]. AB - We have verified the local activity and tolerance of the antimycotic drug ciclopiroxolamine in an open trial. The study included 34 women suffering from clinically and mycologically diagnosed vulvovaginitis caused by Candida. The therapy consisted of inserting a 100 mg ovule of ciclopiroxolamine once a day for 3 days. The cultural examination was negative in 76.5% of cases at the 1st control after the treatment and in 82.3% of cases at the 2nd control after the treatment. All the considered subjective and objective symptoms showed a highly significant decrease of frequency and intensity. No chemical parameter was modified; only in one patient a very mild side effect was verified. PMID- 2771143 TI - [Changes in the psychophysical experience of orgasm in pregnancy]. AB - A semistructured questionnaire was used as the basis for an examination of qualitative and quantitative changes in orgasm among 200 pregnant women brought to term. The frequency of orgasm gradually diminished over the 9 months in most women, only occasionally increasing. A total of 149 women (79.5%) said they had felt no pain during orgasm, 20.5% reported increased pleasure or incomplete post orgasmic resolution. It should be pointed out that none of the women had experienced painful orgasm prior to their pregnancy. PMID- 2771142 TI - [Danazol in the treatment of menometrorrhagia in patients with mitral prosthesis treated with warfarin]. AB - The difficulty in the treatment of patients undergoing Warfarin therapy for mitral stenosis, is underlined and cases treated with Danazol in sideropenic anaemia caused by menometrorrhagia are reported. PMID- 2771144 TI - [Uterine fibroleiomyoma: a case of abdominal mass of extraordinary dimensions]. AB - A case of abdominal mass strongly suspected at examination of being a primary ovarian tumour with abnormal echographic features is reported. At laparotomy, it proved to be a uterine fibroleiomyoma of extraordinary dimensions. PMID- 2771145 TI - [Acute pancreatitis in pregnancy. Description of a case]. AB - A case of acute pancreatitis arising in the third trimester of pregnancy is described. After analysing the currently accepted aetiopathogenic hypothesis, the paper described the multidisciplinary clinical approach adopted with a report on the delivery and the conditions of mother and foetus. PMID- 2771147 TI - Sodium-dependent and sodium-independent nicotine-evoked catecholamine release from cat adrenals. AB - Cat adrenal glands were stimulated with nicotine under Na-free conditions; subsequently, Na was gradually introduced as a continuously increasing gradient from 0 to 134 mM. With this experimental approach two catecholamine secretory peak responses were obtained: one was Na-independent and the second was dependent of this cation. This second response was greater in magnitude than the first and selectively blocked by (+)PN200-110, a potent dihydropiridine Ca channel blocker. The results suggest that Na, although not essential to evoke some degree of secretion, plays, however, a prominent role in amplifying the nicotine-secretory response by causing cell depolarization and opening of voltage-dependent Ca channels. PMID- 2771146 TI - Location of motoneurons innervating the musculus sphincter cloacae in the domestic fowl. AB - Horseradish peroxidase was injected into the musculus (m.) sphincter cloacae through the mucosa from the lumen side of the cloaca in the domestic fowl. Labeled neurons were found in the ventrolateral area of the ventral horn from the lumbosacral segments 7-9. The craniocaudal distribution of labeled neurons overlapped with that of hindlimb motoneurons. The m. sphincter cloacae is innervated by motoneurons sending axons to the sphincter cloacae either through the connexus caudalis branching from the caudal coxal nerve of the sacral plexus or through the lateral caudal nerve arising from the pudendal plexus. PMID- 2771148 TI - Existence of inward potassium currents in adult human oligodendrocytes. AB - We report the first measurements of single channel currents in cultured adult human oligodendrocytes, obtained postmortem. The channels selectively pass potassium inwardly and possess properties which would be suitable for a physiological role for oligodendrocytes in the human brain as part of a regulatory mechanism for maintenance of extracellular potassium concentration near active neurons. These properties include a long mean open time near normal resting potential and a marked dependence of membrane depolarization to increase the channel open time which could be an important factor when the driving force for inward potassium movement was small. Furthermore, the properties of these potassium channels are remarkably similar to those of channels previously observed in adult bovine oligodendrocytes, which supports the use of animal data to describe function in the human brain. PMID- 2771149 TI - Oculomotor nucleus afferents from the interstitial nucleus of Cajal and the region surrounding the fasciculus retroflexus in the rabbit. AB - After injecting horseradish peroxidase (HRP) or Fast blue in the oculomotor nucleus of the rabbit, two groups of labelled neurons were observed among the fibres of the rostral medial longitudinal fasciculus (MLF). The first group of neurons was located in the interstitial nucleus of Cajal (INC), mainly in the contralateral side to the injected oculomotor nucleus. The second group of labelled cells was located rostrally to the INC ipsilateral to the injection in the vicinity of the fasciculus retroflexus. These neurons might be homologous to those labelled in the INC and in the rostral interstitial nucleus of the MLF in frontal-eyed mammals, and involved in the control of vertical eye movements. PMID- 2771151 TI - Transient increase in the number of cholinergic neurons in the developing rat dentate gyrus. AB - Using a monoclonal antibody against choline acetyltransferase (ChAT), we have examined the distribution of cholinergic neurons in the rat dentate gyrus during development. ChAT-positive neurons were occasionally detected in the hilus on postnatal day 2 (P2). There was a transient abrupt increase in the number and density of ChAT-positive neurons between P15 and P20 and then a decline to the adult level with few ChAT-immunoreactive neurons. A few ChAT-positive varicose fibers and punctae were first seen at P5. They increased in number and density until P20 when they reached the adult level and distribution. These observations suggest the occurrence of a transient expression of cholinergic markers in the hippocampus. PMID- 2771150 TI - Recovery of hippocampal cholinergic activity by transplantation of septal neurons in AF64A treated rats. AB - Embryonic septal neurons were transplanted into the hippocampus of adult rats which had received lateral-ventricular administration of AF64A, a cholinergic neurotoxin, and the effects on hippocampal cholinergic activity were studied. One week after AF64A administration, we injected dissociated septal cell suspension into the dorsal hippocampus, unilaterally. About 3 months after the transplantation, acetylcholine (ACh)-rich septal grafts formed extensive acetylcholinesterase (AChE)-positive fibers into the host hippocampus, recovering choline acetyltransferase (ChAT) level only in the grafted side. These results indicate that septal implants can produce a partial recovery of the cholinergic activity in the chemically damaged hippocampus. PMID- 2771152 TI - The morphology of cat spinal neurons projecting to both the lateral cervical nucleus and the dorsal column nuclei. AB - Morphological features of physiologically characterized doubly projecting spinocervical tract-dorsal column postsynaptic (SCT-DCPS) neurons were examined following intracellular injections of horseradish peroxidase. Their cell bodies and majority of dendrites were located in laminae III-IV. The SCT-DCPS neurons have rostrocaudally elongated dendritic trees with spiny fine caliber dendrites, and issue local axon collaterals that are studded with varicosities. The results show that the doubly projecting SCT-DCPS neurons do not represent a morphologically distinct subset of the spinocervical tract (SCT) or dorsal column postsynaptic (DCPS) cells. PMID- 2771153 TI - Does magnetic resonance imaging compromise integrity of the blood-brain barrier? AB - It has been reported that a standard clinical procedure of magnetic resonance imaging (MRI) carried out experimentally in the rat caused temporary opening of the blood-brain barrier. Electron micrography indicated blood-to-brain movement of horseradish peroxidase, a protein tracer that does not normally permeate the barrier. In the present study, permeability-area products (PA), describing the limited permeation of blood-borne [14C]sucrose into brain parenchyma, were measured in anesthetized rats subjected either to 23 min of MRI, to osmotic barrier opening by intracarotid infusion of hypertonic arabinose, or to control conditions. Osmotic opening caused manyfold increases in PA whereas MRI produced no change. The proposal that MRI can compromise integrity of the blood-brain barrier is not supported by these findings. PMID- 2771154 TI - Separation of different types of afterpotentials following penicillin-induced paroxysmal depolarization shifts of neurons in the motor cortex of the rat. AB - Afterpotentials of penicillin-induced paroxysmal depolarization shifts (PDS) of neurones in the motor cortex of the rat in vivo were investigated with intracellular recordings. Following the PDS, 4 different types of afterpotentials were observed: fast afterhyperpolarizations with an average duration of 600 ms, fast afterdepolarizations with an average duration of 700 ms, slow afterhyperpolarizations with an average duration of 1.9 s and slow afterdepolarizations with an average duration of 1.8 s. The fast and slow afterpotentials could occur in various combinations with the exception of a fast afterhyperpolarization followed by a slow afterdepolarization. Neurones displaying afterdepolarizations had higher resting membrane potentials than those displaying afterhyperolarizations, i.e. the polarity of the afterpotential depended on membrane potential. Experiments with intracellular Cl- injection indicated that the fast but not the slow afterpotentials are associated with an increase in membrane Cl- conductance. The slow afterhyperpolarizations are suggested to result from a calcium-dependent or a synaptically generated potassium current. PMID- 2771155 TI - Rhythmic discharges in the perfused isolated brainstem preparation of adult guinea pig. AB - An isolated brainstem preparation of adult guinea pig was used for an in vitro electrophysiological study of rhythmic neuronal discharge patterns. More than half of the spontaneously active neurons (40/71) exhibited a rhythmic discharge. Rhythmic discharges were recorded dorsally in the nucleus tractus solitarius and ventrally in the ambiguus and paragigantocellular reticular nuclei. Three types of rhythmic patterns of discharge were identified in these areas: repetitive single discharge, repetitive bursting discharge and spontaneous periodic discharge. No rhythmic patterns were recorded in other explored parts of the brainstem. Comparison of these data with those from brainstem slices shows that spontaneous periodic discharges may require extended networks within the brainstem. PMID- 2771156 TI - The rat nucleus paragigantocellularis as a relay station to mediate peripherally induced central effects of nicotine. AB - Previous electrophysiological studies have shown that intravenously administered nicotine in low doses indirectly excites noradrenergic locus coeruleus (LC) neurons. In the present study this effect of nicotine was attenuated (to about 25% of control response) by injection of lidocaine into the nucleus paragigantocellularis (PGi) whereas injection into the nucleus prepositus hypoglossi (PrH) had no effect in this regard. Whereas the basal firing rate of LC neurons was not affected by lidocaine injection into the PGi, more than 50% of the LC neurons displayed increased firing rate following lidocaine injection into the PrH. It is suggested that the peripherally induced effect of nicotine on LC neurons is indirectly mediated via activation of the PGi. PMID- 2771157 TI - Facilitation of retention performance in mice by pretest microinjection of AVP into dorsal or ventral hippocampus: differential influence of the peptide on appetitive task. AB - Pre-test local microinjection of arginine-vasopressin (AVP) into dorsal or ventral hippocampus resulted in an improvement of retention performance in an appetitively motivated task. Nevertheless, a better improvement appeared when AVP treatment was performed into ventral hippocampus suggesting a higher sensitivity of this part of hippocampus to the action of AVP. To examine a non-specific behavioral action of the peptide, the effect of AVP treatment on locomotor activity was assessed. When the treatment was given into ventral hippocampus, a reduction of locomotor activity was recorded, whereas after AVP injection into dorsal hippocampus, the peptide failed to alter locomotor activity. PMID- 2771158 TI - B-vitamins potentiate the antinociceptive effect of diclofenac in carrageenin induced hyperalgesia in the rat tail pressure test. AB - B-vitamins possess antinociceptive and antiinflammatory activity. The rat tail pressure test was used to examine whether a mixture of the vitamins B1, B6, and B12, clinically used as Neurobion, has antinociceptive activity itself or potentiates the effect of the non-steroidal antiinflammatory drug (NSAID) diclofenac on carrageenin-induced hyperalgesia. Only the highest dose of the vitamin mixture (667 mg/kg B1 and B6, 6.7 mg/kg B12 p.o.) exhibited antinociceptive activity. Nevertheless, lower doses which alone were lacking in activity (100-250 mg/kg B1 and B6, 1-2.5 mg/kg B12 p.o.) dose-dependently potentiated the antinociceptive of diclofenac. This result supports the clinical experience of a reduced need for diclofenac when B-vitamins are administered concomitantly. PMID- 2771159 TI - Long-term survival of decentralized axons and incorporation of satellite cells in motor neurons of rock lobsters. AB - Previous electrophysiological experiments have shown that in the abdominal extensor muscles of rock lobsters, axons which were cut in surviving animals do not degenerate peripherally for several months, but conduct action potentials and release transmitter quanta on stimulation closely distal to the scar. Electron micrographs from the axon distal to the scar (in a reliably conducting region) show invasion of the axoplasmic space by nucleated cells, probably glia. After several months, the cell membranes of the invaders have vanished and apparently functional multiple nuclei remain. We suggest that decentralized axons may survive for months with the help of 'donated' nuclei. PMID- 2771160 TI - Identification of astrocyte- and oligodendrocyte-like cells of goldfish optic nerves in culture. AB - Fish glial cells were obtained from cultivated segments of the optic nerve and raised in vitro. Two types of cells were identified as astrocyte- and oligodendrocyte-like glia by the monoclonal antibody Mab O1 (specific for oligodendrocytes) and the rabbit serum anti-goldfish glial fibrillary acidic protein (anti-G-GFAP). Cells of compact morphology were rare, and anti-G-GFAP positive and O1 negative. Multipolar cells in 5-day-old cultures were anti-G-GFAP but rarely O1 positive. In 5-week-old cultures, however, roughly 75% of the multipolar cells were double-labeled with both anti-G-GFAP and O1; 10% were single labeled with Mab O1 and 15% with anti-G-GFAP, respectively. PMID- 2771161 TI - Retrotrapezoid nucleus in the rat. AB - The retrotrapezoid nucleus (RTN), recently described in the cat, is an anatomically identified cell group of the ventral medulla. It is of interest because of its possible role in the generation or control of breathing. The present investigation confirms the existence in the rat of an analogous cell group, as identified by retrograde transport of rhodamine microbeads from an injection site in the ventral respiratory group of the ventral medulla. Electrophysiological recordings from the region of RTN reveal individual units with respiratory related activity. These results support a possible role for the RTN in the control of breathing. PMID- 2771162 TI - Electrophysiological analysis of the neural circuitry underlying opiate effects in the nucleus accumbens septi. AB - Systemically administered opiates inhibit or excite spontaneously active single units of the nucleus accumbens septi (NAS) but do not affect fimbria-evoked NAS responses. However, microinjections of morphine to the dopamine cell bodies of the ventral tegmental area (VTA-M) do inhibit these evoked responses. Since systemic heroin can reverse the inhibitory effect of VTA-M on the fimbria-evoked NAS responses, systemic opiates might exert actions on other brain regions that oppose the inhibitory effect of VTA-M on the NAS. Evidence is provided indicating that this opposing action can arise from opiate actions at the ventral subiculum of the hippocampus. PMID- 2771163 TI - Age-related decline of acetylcholine release evoked by depolarizing stimulation. AB - Release of endogenous acetylcholine (ACh) from the dorsal hippocampus in response to depolarizing stimulation with high-K+ infusion was examined in young and aged rats using the method of in vivo dialysis. ACh content in the dialysate was determined by high-performance liquid chromatography-electrochemical detection (HPCC-ECD). During the high-K+ stimulation, the concentration of ACh in the dialysate only slightly increased in aged rats in contrast with young rats where the ACh content during stimulation increased about 2-fold of the basal level. These results showed that ACh release evoked by depolarizing stimulation declined through aging in the hippocampus. PMID- 2771164 TI - Low glutathione levels in brain regions of aged rats. AB - Glutathione (GSH) was measured in 6 regions of brain and liver of young adult, middle-aged and aged rats. GSH levels were significantly lower in cortex, cerebellum, striatum, thalamus and hippocampus of aged rats, while no changes were observed in liver as compared to young adult rats. On the other hand, lipid peroxidation as measured by thiobarbituric acid-reactive products increased significantly in all the regions of brain examined and in the liver of aged rats. Since GSH plays an important role as a cellular protectant against oxygen radical mediated injury, decreased levels of GSH in aged rat brain are indicative of the vulnerability of the aged cerebral tissue to oxidative injury. PMID- 2771165 TI - Quinolinic acid neurotoxicity: protection by intracerebral phenylisopropyladenosine (PIA) and potentiation by hypotension. AB - In the present study we have used the purine agonist R-phenylisopropyladenosine (PIA) which suppresses excitatory amino acid release to assess its effect on quinolinate toxicity. Quinolinic acid was injected into the rat hippocampus alone or with PIA and the animals allowed to recover. After 4 days the brain was removed for histological examination. The extent of neuronal degeneration was assessed blind by an independent observer on a scale of 0 (no damage) to 10 (complete degeneration). Co-administration of PIA protected against the toxicity, and this protective action of PIA was blocked by a xanthine adenosine receptor antagonist. However, systemic injections of PIA or the non-purine ganglion blocking drug trimetaphan, both of which caused significant depression of blood pressure, potentiated quinolinate toxicity. The results may indicate an interaction between endogenous excitotoxins and episodes of hypotension which may be critical in determining cell death in the CNS. PMID- 2771166 TI - Effects of basic fibroblast growth factor (bFGF) on choline acetyltransferase activity and astroglial reaction in adult rats after partial fimbria transection. AB - Adult rats received a partial and unilateral transection of the fimbria. They received then intracerebroventricular (i.c.v.) injections of 5 microliters of Tris, half of them containing 2.5 ng of basic fibroblast growth factor (bFGF). They were injected twice a week for 4 weeks. At the end of this period, choline acetyltransferase (ChAT) activity was measured in the hippocampus. ChAT activity, which was decreased by the fimbria transection, was higher (by about 20%) in medial hippocampus of the bFGF group compared with the Tris group. In addition, bFGF enhanced the lesion-induced astroglial reaction by changing the morphology of the astrocytes and increasing the apparent number of these reactive astrocytes. PMID- 2771167 TI - Quantitative [14C]2-deoxyglucose study of a functional dissociation between anterior and posterior cingulate cortices in mice. AB - We have previously shown that lesion of the posterior cingulate cortex (CCP) but not of the anterior cingulate cortex (CCA), produced learning and memory deficits. As a first evaluation of the functional anatomical basis of this dissociation, we used the quantitative [14C]2-deoxyglucose method and electrical brain stimulation to determine the functional connections of the CCA and CCP in mice. CCP stimulation (but not CCA stimulation) produced significant metabolic increases in the hippocampal formation and in the subicular complex. This result is consistent with the hypothesis that learning and memory deficits following CCP lesion may be due to the disruption of functional neural pathways between the CCP and hippocampal structures. PMID- 2771168 TI - Phosphatidylserine administration during postnatal development improves memory in adult mice. AB - Postnatal administration of an aqueous suspension of phosphatidylserine (BC-PS) to C57BL/6 mice resulted in improvement of memory processes in adulthood, as assessed in a passive avoidance task. These findings are discussed in terms of the effects of BC-PS on cholinergic mechanisms and of cholinergic patterns of this inbred strain. PMID- 2771170 TI - Quantitative autoradiography of nicotinic receptors in large cryosections of human brain hemispheres. AB - In vitro quantitative autoradiography was used to visualize nicotinic receptors in large cryosections of human brain hemispheres. Sections 80 microns thick of human brain hemispheres were incubated with (-)-[3H]nicotine and the distribution of nicotinic receptors in human brain was studied. Increasing numbers of nicotinic binding sites were observed in the: hippocampus less than cortex less than cerebellum less than substantia nigra less than putamen less than periaqueductal gray. The cartography of nicotinic receptors in the normal human brain will hopefully be of use in the study of the alteration of these receptors in diseased brain. PMID- 2771172 TI - Potential related to no-go reaction of go/no-go hand movement task with color discrimination in human. AB - Twenty-three human subjects were asked to perform a go/no-go reaction-time hand movement task with discrimination between different color light signals, and potentials related to the discrimination task were recorded with plate electrodes placed on the scalp and analyzed by averaging procedures. A negative potential was found to be recorded specifically to no-go trials in the frontal-parietal part of 21 subjects out of 23 tested. In referring to our recent experiments with monkeys, it is suggested that the potential is related to the judgement not to move and/or the suppression of motor execution. PMID- 2771169 TI - In vivo labelling of the mouse dopamine uptake complex with the phencyclidine derivative [3H]BTCP. AB - [3H]BTCP ([3H]N-[1-(2-benzo(b)thiophenyl)cyclohexyl]piperidine), a phencyclidine (PCP) derivative which binds with a high affinity to the dopamine (DA) uptake complex in vitro, has been tested for in vivo binding to mouse brain. Using [3H]BTCP as a tracer (5 microCi, i.v.) we found the striatum as the region which accumulated the largest amount of radioactivity (58 dpm/mg tissue). In other brain regions the radioactive level (about 20 dpm/mg tissue) was close to the non specific binding determined by an injection of unlabeled BTCP (40 mg/kg, s.c.) 2 h prior to the [3H]BTCP injection. In the striatum [3H]BTCP binding was inhibited in a dose-dependent manner by unlabeled BTCP (ID50 = 6.34 mg/kg) and nomifensine (ID50 = 11.06 mg/kg). It was unaffected by the DA receptor antagonist haloperidol and by PCP or its analog TCP at doses of 10 mg/kg. These results suggest that [3H]BTCP binds to the dopamine uptake complex in the mouse brain in vivo. Thus, although PCP has no effect on [3H]BTCP binding in these experimental conditions, this in vivo binding model will be useful for the determination of the precise interaction of PCP and its derivatives with the striatal dopamine uptake complex in vivo independently of their interaction with the N-methyl-D-aspartate receptor channel complex. PMID- 2771171 TI - The effects of long-term lead intoxication on the nervous system of the chicken. AB - In order to study the possible etiologic role of lead in human motor neuron disease we produced chronic lead intoxication in the chicken by daily administration of lead acetate. Control animals received sodium acetate. During life, periodic measurements were made of motor function, motor nerve conduction velocity and response amplitude. After sacrifice, histologic analysis was performed on spinal cord, peripheral nerve and muscle. A syndrome was produced characterized by a fall in motor response amplitude, spinal motor neuron degeneration, motor axonal loss and atrophy of muscle, similar to that seen in human motor neuron diseases. PMID- 2771173 TI - Aging but not estrogen alters regional [3H]5-HT binding in the CNS of female Fischer 344 rats. AB - Age-related changes in serotonergic regulation of neuroendocrine function were investigated in female Fischer 344 rats; serotonin ([3H]5-HT) binding sites were characterized in several brain regions. Neither the number (Bmax) nor the affinity (Kd) of [3H]5-HT sites were altered in the frontal cortex of reproductively young and senescent groups. However, a significant decline in receptor affinity was observed in the hypothalamus and midbrain dorsal raphe nucleus. An increase in the density of binding sites was also observed in the hypothalamus with advancing age. Acute 48 h exposure to estrogen failed to influence [3H]5-HT binding site characteristics in these brain regions. In summary, these results suggest that age-related changes in [3H]5-HT binding are regionally specific. Moreover, the observed changes in hypothalamic 5-HT function may underlie neuroendocrine aging events. PMID- 2771174 TI - Postischemic moderate hypothermia inhibits CA1 hippocampal ischemic neuronal injury. AB - We have determined whether lowering brain temperature during the acute recirculation period following transient cerebral ischemia would influence the extent of ischemic neuronal injury. Anesthetized rats underwent 10 min of bilateral carotid artery occlusion combined with systemic hypotension (50 mmHg). Four animal subgroups were investigated, including non-ischemic controls; rats whose postischemic brain temperature was maintained at 36 or 30 degrees C starting 5 min into the recirculation period; and rats in which postischemic hypothermia was begun 30 min into the recirculation period. In all cases, intra ischemic brain temperature was 36 degrees C and body temperature was held at 36 37 degrees C throughout. Three days following the ischemic insult, the CA1 sector of the hippocampus was severely damaged in normothermic rats (36 degrees C). In contrast, when postischemic brain temperature was decreased to 30 degrees C starting 5 min into the recirculation period, normal-appearing pyramidal neurons were present throughout the CA1 hippocampus. A beneficial effect of postischemic hypothermia was not demonstrated when brain cooling was initiated 30 min into the recirculation period. These results demonstrate that postischemic hypothermia can markedly protect CA1 pyramidal neurons from injury following transient ischemia. The 'therapeutic window' for postischemic hypothermia was found to be narrow under the present experimental conditions. PMID- 2771176 TI - Temporal relationship between A1 adenosine receptor upregulation and alterations in bicuculline seizure susceptibility in rats. AB - The temporal requirements for theophylline-induced upregulation of A1 adenosine receptors and elevation of seizure threshold were examined. Chronic theophylline exposure (75 mg/kg twice daily) elicited a significant upregulation of [3H]cyclohexyladenosine ([3H]CHA) binding sites following 7 and 14 days of treatment. Alterations in seizure threshold followed a similar temporal pattern of development. The reversibility of theophylline-induced upregulation of high affinity [3H]CHA binding sites was complete at 10 days following cessation of theophylline administration, while the alteration of seizure threshold required 21 days to return to control values. PMID- 2771175 TI - Changes of transcranially evoked motor responses in man by midazolam, a short acting benzodiazepine. AB - The present study investigated the effects of midazolam, a short acting benzodiazepine, on muscle responses elicited by magnetic brain stimulation. During continuous midazolam infusion (0.3 mg/kg/h for up to 30 min) amplitudes and durations of transcranially elicited compound muscle action potentials decreased progressively while latencies remained unchanged. The results can be accounted for by midazolam enhancement of the inhibitory action of GABAergic cortical interneurons, which decreases the excitability of pyramidal cells and reduces the number of neurons available for generation of descending pyramidal tract activity. PMID- 2771177 TI - Residual control of isometric finger forces in hemiparetic patients. Evidence for dissociation of performance deficits. AB - Dissociation of performance in the control of isometric finger forces was observed in 6 patients with left-sided unilateral lesions involving sensorimotor areas. In a precision task subjects had to maintain, under visual feedback, a low constant force (2.5 N) while holding a force transducer between thumb and index finger. Performance was compared with that in a speed task, where changes had to be produced, as rapidly as possible, between two prescribed forces (6.25 and 18.75 N). While there were severe deficits in fast force changes corresponding to the functional impairment of the right hand in all patients, right hand maintenance of low isometric force remained intact in the same patients. PMID- 2771178 TI - A study of non-isotopic in situ hybridization histochemistry on postmortem changes in vasopressin mRNA in rat brain. AB - Rat models which stimulated various postmortem conditions were used to determine postmortem changes in the vasopressin mRNA content of the brain. In situ hybridization histochemistry experiments using biotinylated oligonucleotide probes revealed that vasopressin mRNA could be detected in the rat hypothalamic nuclei, even though the rats had been killed and left for 8 h postmortem at room temperature and the brains were then fixed by immersion in 4% paraformaldehyde instead of by transcardial perfusion. However, these signals were greatly reduced in the nuclei if the brains were removed after a 24-h delay. These results suggest that gene expression study of neuropeptides at the cellular level can be performed on postmortem human brains after a short postmortem delay. PMID- 2771179 TI - Monosynaptic nigral inputs to the pedunculopontine tegmental nucleus neurons which send their axons to the medial reticular formation in the medulla oblongata. An electron microscopic study in the cat. AB - An electron microscopic study in the cat has suggested that neurons in the substantia nigra pars reticulata (SNr) project to the medial reticular formation of the medulla oblongata (MRF) via the pedunculopontine tegmental nucleus (PPN): PPN neurons, which were labeled with a retrograde tracer (WGA-HRP; horseradish peroxidase conjugated to wheat germ agglutinin) injected into the MRF, were found to be in synaptic contact with axon terminals which were degenerated with neurotoxic agents applied into the SNr. PMID- 2771180 TI - Relation between electromyogram and torque of isometric reflex contractions in man. AB - Human subjects maintained isometric plantar or dorsal flexions of the ankle in a matching task. H-reflexes of different sizes were superimposed on the steady activity. The peak-to-peak amplitude of the reflexes was measured on the electromyogram (EMG) of the soleus muscle. The size of the corresponding muscle contractions was determined on the isometric torque signal in relation to the maintained flexion force. The EMG-torque relation which was defined as the reflex muscle contraction as a function of the EMG reflex signal approximated a square root function for a given steady contraction level. It was not modulated by steady dorsal flexions, but it decreased continuously with stronger plantar steady torques. This dependence was caused by the silent period following the reflex discharge. Since the reflex discharge and the silent period were near in time to the duration of the contraction, the silent period had a direct effect on the reflex contraction amplitude. PMID- 2771181 TI - The increase in [3H]glutamate release associated with long-term potentiation in the dentate gyrus is blocked by commissural stimulation. AB - Previous findings have indicated that long-term potentiation (LTP) in the perforant path-granule cell synapses is accompanied by an increase in K+ stimulated, calcium-dependent release of [3H]glutamate 45 min after the induction of LTP. Here we report that release of [3H]glutamate is increased at 3 time intervals following induction of LTP, 2.5 min, 45 min and 3 h. Stimulation of the commissural input to the granule cells blocks the induction of LTP and the increase in [3H]glutamate release. PMID- 2771182 TI - Imipramine prevents stress gastric glandular lesions in rats. AB - Intraperitoneal (i.p.) administration of imipramine dose-dependently inhibited gastric lesions induced by 3 h of cold restraint stress. The high dose of imipramine (5 mg/kg) almost completely abolished gastric lesion formation, and also suppressed acid secretion in rats with pyloric ligation. Intracisternal imipramine (1 microgram) was also protective. These findings suggest that tricyclic antidepressants may play an important role in preventing the deleterious effects of stress on the gut. PMID- 2771183 TI - Microinjection of a glutamate antagonist into the nucleus accumbens reduces psychostimulant locomotion in rats. AB - In order to study a possible modulatory effect of glutamatergic afferents to the nucleus accumbens (NAC) on psychostimulant-induced locomotion, L-glutamic acid diethyl ester (GDEE), a glutamate antagonist, was injected in the NAC of rats acutely treated with cocaine, amphetamine or caffeine. GDEE at the doses of 5, 10, and 20 micrograms/side significantly reduced locomotion induced by cocaine (20 mg/kg, i.p.). Amphetamine-induced hyperactivity was also reduced by GDEE, whereas caffeine-induced hyperactivity was not significantly decreased by GDEE. This suggests that glutamatergic afferents to the NAC modulate the effects of psychostimulants and also dopamine function in the mesolimbic system. PMID- 2771184 TI - Favourable effect of flunarizine on the recovery from hemiparesis in rats with intracerebral hematomas. AB - In 25 rats, an intracerebral hematoma was created in the foreleg area of the motor cortex by injection of 50 microliters blood. After the lesion, 13 were treated with flunarizine and 12 with the solvent. Neurological testing was performed by measuring the running time on a rotating platform. In animals with hemiparesis, the flunarizine group (n = 7) showed a significantly (P less than 0.05) better recovery than the control group (n = 8). No significant differences occurred in animals without neurological deficits (flunarizine: n = 6, control: n = 4). So the effect of the drug is not due to a non-specific activation; it may partially cure neurological deficits caused by intracerebral hematoma. PMID- 2771186 TI - Nurses' participation in their own governance. PMID- 2771185 TI - Local perfusion of the thalamus with GABA increases sleep and induces long lasting inhibition of somatosensory event-related potentials in cats. AB - The extracellular concentration of gamma-aminobutyric acid (GABA) was increased in the ventroposterolateral nucleus of the thalamus in cats using in vivo microdialysis probes. In freely moving cats, the permanent injection of 8 x 10( 9) M/mm2 x min GABA induced a significant increase in sleep proportion. The duration of paradoxical sleep was particularly increased resembling the effects of benzodiazepines. In chloralose anesthesia, a similar increase in GABA concentration in the thalamus induced a tonic decrease in the peak-to-peak amplitude of cortical event-related potentials evoked by stimulation of the radial nerve. Following 10-15 min of inhibition during which the responses were as small as 20% of the original ones, the potentials started to recover. Finally, the responses were stabilized at a reduced amplitude. The present data suggests the important role of the thalamic GABAergic neurons in the regulation of sleep. PMID- 2771187 TI - Nursing staff bylaws and practice privileges. PMID- 2771188 TI - Professional nursing staff: a model of self-governance for nursing. PMID- 2771189 TI - Increasing nursing autonomy and recognition through shared governance. PMID- 2771190 TI - Shared governance at Saint Joseph's Hospital of Atlanta: a mature professional practice model. AB - Quality in work comes from people who care about what they do, are consistent, and have a desire to make a difference. This is not something that can be taught, but it can be nurtured. Patient care is the perfect place to start. Nurses participating in a shared practice situation can extend their working system to others. The rewards of quality care are felt by the patient, by the staff, and ultimately by the hospital. The desire to make a difference grows as more people become involved in a system. Developing systems that are positive, goal oriented, and rewarding is the first step toward shared practice. Shared governance then becomes a natural progression in determining the framework in which a nurse functions. PMID- 2771191 TI - Shared governance: the challenge of change in the early phases of implementation. PMID- 2771192 TI - St. Michael Hospital: A shared governance model. AB - The list grows longer as exploration continues. This model of measuring climate and job satisfaction in the transformation to shared governance is providing a deeper understanding than traditional modes of inquiry. The authors are eager to continue this exploration and look forward to sharing their results. They also look forward to reviewing the results of other nursing leaders who are engaged in creating new models within their divisions of nursing, and who are creatively attempting to explore and understand the paradigm shifts within nursing in the new age. PMID- 2771193 TI - Staff perceptions of shared governance. AB - Future research must consider a number of potential influencing variables, focus on before and after comparisons and comparisons among types of shared governance models, and include replications and longitudinal studies. In addition, qualitative, descriptive data regarding the life of the organization will be beneficial in interpreting the more quantitative findings. The ideal of controlling all variables is simply not possible when one is studying a complex organization. With ingenuity, creativity, and a blend of methodologies, however, researchers may come considerably closer to understanding more about how and why shared governance can work effectively. PMID- 2771194 TI - Nurse practitioner liability and authority. AB - Nurse practitioners are being held to a higher professional standard. No longer can nurses assume that their practice is protected by physicians and hospitals. Current trends indicate that nurse practitioners are accountable for their actions and are liable for malpractice. Legislation regulating the practice of nurse practitioners varies from state to state; differing opinions among nurses, physicians, and legislators account for some of these variances. The ultimate goal of the health care professions is the delivery of safe, effective, cost efficient health care. Nurse practitioners are helping to achieve this goal. PMID- 2771195 TI - Legal forum: the employee contract. AB - Nurse executives face increasing demands on their abilities to assist the health care institution to meet its corporate objectives. These demands are no different from those faced by many other corporate executives. In this changing environment, nurse executives should consider the need for a written employment contract. Fairly drawn employment contracts can serve a useful purpose for both the institution and the nurse executive. By setting forth in a comprehensive fashion the respective rights and obligations of each party, these agreements can protect the institution's and the employee's interests. The terms on which the nurse executive is retained by the institution should not be left to chance or oral agreement. PMID- 2771196 TI - Different histochemical findings in the brain produced by mercuric chloride and methyl mercury chloride in rats. AB - The chemical form of mercury reactive by the histochemical technique was studied by using rats and mice treated with mercuric chloride (HgCl2) and methyl mercury chloride (MeHgCl). Mercury granules were demonstrated histochemically in the brain of HgCl2-treated rats with higher levels of inorganic mercury. However, mercury granules were not demonstrated in the brain of MeHgCl-treated rats in spite of a considerably high organic mercury level. In rats and mice with significant biotransformation of injected MeHg to inorganic mercury, the appearance of the peak inorganic mercury level and mercury granules in the brain seemed to occur on the same day. These results suggested that mercury granules in the brain represent inorganic mercury, but not organic mercury. In the brains showing mercury granules, the lowest level of inorganic mercury was 0.12 micrograms/g in HgCl2-treated rats, 0.14 micrograms/g in MeHgCl-treated rats, and 0.12 micrograms/g in MeHgCl-treated mice. These values were similar to the level of inorganic mercury in the brain from human autopsy cases. Mercury granules were demonstrated histochemically in nerve cells, choroid plexus and phagocytes in the brain of both HgCl2-and MeHgCl-treated rats, and in ependyma of MeHgCl-treated rats. The level of inorganic mercury of the brains showing mercury granules in phagocytes was lower in MeHgCl-treated rats than in HgCl2-treated rats. The numbers of mercury granules in nerve cells increased with the rising level of inorganic mercury in the brain of MeHgCl-treated rats. PMID- 2771197 TI - Thermoregulatory responses of the rabbit to central neural injections of sulfolane. AB - Systemic exposure of the rabbit to sulfolane results in hypothermia; however, the mechanism of this thermoregulatory effect is unknown. This study was designed to determine the thermoregulatory effects of sulfolane on the central nervous system (CNS) of the rabbit. Male rabbits were stereotaxically implanted with an injection cannula over the preoptic/anterior hypothalamic area (POAH) or into the lateral cerebral ventricle. POAH temperature (TPOAH), ear temperature (Te), and metabolic rate (MR) were recorded at an ambient temperature (Ta) of 15 degrees C. No changes were observed in any of the thermoregulatory indices following injections of saline or sulfolane in dosages of 100, 300, and 1000 micrograms directly into the POAH. Intracere-broventricular (ICV) injection of saline also had no effect on thermoregulation. However, ICV sulfolane in dosages of 300, 1000, and 3000 micrograms caused TPOAH to rise 0.23, 0.47, and 0.56 degrees C, respectively. This hyperthermia was significant at a dosage of 3000 micrograms. There was no change in Te or MR at these three dose levels. Microinjection of 10,000 micrograms sulfolane ICV caused a slight decrease in TPOACH for 30 min which was accompanied by an increase in Te. Following the slight decrease, TPOAH increased to + 0.54 degrees C at 120 min after injection as Te returned to baseline values. The data suggest that the previously observed thermoregulatory effects of sulfolane following systemic exposure cannot be attributed to a direct action of the parent compound on the CNS. PMID- 2771198 TI - Effects of lead acetate on cerebral glutathione peroxidase and catalase in the suckling rat. AB - Exposure of immature rats to lead acetate results in hemorrhagic encephalopathy of variable evolution. As the maintenance of adequate protection against peroxides may be critical in this condition, the activities of selenium glutathione peroxidase and catalase in cerebrum and cerebellum of suckling rats poisoned with lead acetate were studied from day six to day sixteen post exposure. Age-related decreases of glutathione peroxidase and catalase activities in both controls and lead poisoned animals were observed. An increase in catalase activity was observed in cerebrum and cerebellum of lead-treated rats compared to controls. Glutathione peroxidase activity did not change significantly in cerebrum over the period studied. By contrast, glutathione peroxidase activity in cerebellum of lead-treated rats remained at about twice the control level over most of the study period. This apparent increase in glutathione peroxidase activity may be due either to a slower ontogenic decrease of its specific activity or to enzyme induction in response to oxidant stress in cerebellum. PMID- 2771199 TI - EMG activities of neck muscles underlying lateral flexion of the neck during head turning induced by electrical stimulation of the caudate nucleus in cats. AB - Patterns of EMG activities of neck muscles underlying the initiation of head turning, induced by stimulation of the caudate nucleus, were analyzed with special reference to temporal relations between the onset of head-turning and that of changes in EMG activities. These patterns were compared with those associated with the initiation of lateral flexion of the neck which occurred without electrical stimulation of the caudate nucleus in order to examine whether the caudate-induced head-turning was initiated via the same muscular system as that used in non-caudate-induced head movements. Experiments were carried out using 5 awake, unrestrained cats which were trained to stand still with one limb on each of 4 footplates. Trains of stimulating current pulses were applied to several stimulation points in the caudate nucleus while the animal maintained a stable standing posture with its neck extended. Head movements in the horizontal plane and EMGs of 6 neck muscles (splenius, longissimus cervicis, obliquus capitis caudalis, biventer cervicis, complexus and cervical multifidus) were recorded. Patterns of EMG activities of neck muscles around the onset of the caudate-induced head-turning were characterized by an increase in activity of the splenius, the longissimus cervicis and the obliquus capitis caudalis muscles, and by a decrease in activity of the complexus, the biventer cervicis and the cervical multifidus on the side of flexion. It is suggested that an increase in activity of the splenius, the longissimus cervicis and the obliques capitis caudalis muscles was responsible for the initiation of this evoked response. In non-caudate-induced lateral flexion of the neck, patterns of activities of neck muscles were similar to those in caudate-induced head-turning. It is therefore concluded that the caudate-induced head-turning as an evoked behavioral response was initiated through a muscular system similar to that utilized for similar head movements occurring without electrical stimulation of the caudate nucleus, although the pathways involved are thought to be different. PMID- 2771200 TI - Regional and laminar distribution of choline acetyltransferase immunoreactivity in the cat superior colliculus. AB - The pattern of distribution of cholinergic fibers was examined immunohistochemically in the cat superior colliculus by using a monoclonal antibody against choline acetyltransferase (ChAT). In the superficial layers, an obvious immunoreactive zone was found in the rostral two-thirds of the outer portion of the superficial gray layer (SGS), with increasing immunoreactive intensity at the rostral pole of the colliculus. A mesh-like distribution of the immunoreactive fibers was found throughout the deeper portion of this layer with a higher concentration in the caudal levels. In the deeper collicular layers, a number of ChAT-immunoreactive fibers were seen in the outer portion of the intermediate gray layer (SGI) in a patch-like fashion. A few fibers were also immunoreactive in the deeper portion of the SGI and in the medial aspect of the deep gray layer. The density of the immunoreactivity in the deeper layers increased in the caudal levels. After unilateral destruction of the parabigeminal nucleus, the ChAT immunoreactivity was markedly reduced in the rostral aspect of the contralateral SGS, and moderately in the caudal aspect of the ipsilateral SGS. PMID- 2771201 TI - A mapping study of hypothalamic defensive attack and related responses in cats. AB - Effective stimulation sites for the hypothalamic defensive attach and its related responses were mapped in 65 tame adult cats (107 sites). The hypothalamic defensive attack was classified into two types according to its locomotion component: one with only directed attack and the other with retreat. The retreat appeared accompanied by back arching and intermingled with the directed attack. Otherwise, the directed attack and the retreat were accompanied by the same kinds of threat responses, including piloerection, ear retraction, growling and hissing. Stimulation sites for the directed attack with thresholds under 100 microA were located at the dorsal half of the ventromedial hypothalamic nucleus (VM) and areas just rostral to it. Directed attack with thresholds above 100 microA was elicited by stimulation of the marginal portion of the VM and adjacent areas, especially those rostral to it. Stimulation sites for the directed attack, which was replaced by stereotyped circling at higher intensities, were located at the part of the above-mentioned areas most distant from the VM. The retreat was elicited from the ventral half of the VM. Stimulation sites which evoked stereotyped circling with threat responses were distributed in a wider area of the medial hypothalamic area outside the VM. PMID- 2771202 TI - Effect of GABA (gamma-aminobutyric acid) on neurotransmission in inferior colliculus slices from the guinea pig. AB - Inferior colliculus (IC) slices from guinea pigs were prepared by cutting the IC parasagittally and incubating the obtained slices in the standard medium. Postsynaptic field potentials (PSFP) were recorded in the superficial layer of the pericentral nucleus (PN) by stimulating the deep layer of the PN. GABA (gamma aminobutyric acid) and its agonists (muscimol and baclofen) and antagonist (bicuculline) were applied in the perfusion medium. GABA (1-12.5 mM), muscimol (1 200 microM) and (-)-baclofen (0.1-20 microM) reduced the amplitude of the PSFP in a dose-dependent manner. Bicuculline (1-10 microM) enhanced the amplitude of the PSFP and evoked the epileptiform burst discharge (EBD). The incubation of IC slices with methoxypyridoxin (100 microM) and 3-mercaptopropionic acid (100 microM) for 2 h reduced the GABA level of the slice to about 50% of the initial value, at which point a distinct EBD appeared. The application of GABA (5 mM) to the medium in this condition blocked the EBD completely. The removal of chloride from the medium as well as the application of furosemide (100 microM) enhanced the amplitude of the PSFP and also elicited the EBD; GABA application in this case did not block the EBD. These results indicate that GABA plays an inhibitory role in the IC, and that the reduction of GABA and the blockade of GABA function cause the appearance of EBD in the IC. PMID- 2771203 TI - Altered lipofuscin pigmentation in the basal nucleus (Meynert) in Parkinson's disease. AB - The basal nucleus (Meynert) and the horizontal limb nucleus of the diagonal band are composed of 3 types of neurons that can be differentiated with the use of Nissl preparations counterstained for the demonstration of lipofuscin pigment. The pattern of pigmentation of these neurons has been investigated in parkinsonian cases and compared with controls. In the parkinsonian cases the number of large multipolar neurons showing pigment granules in a dendritic stem is significantly higher than in controls. Moreover, the degree of pigment penetration is more pronounced in parkinsonian cases. The results show that staining of lipofuscin granules offers an approach to detecting further details of the changes in the basal nucleus in Parkinson's disease. PMID- 2771204 TI - Effect of aminophylline upon the protective activity of common antiepileptic drugs and their plasma levels in mice. AB - Aminophylline (50 mg/kg) decreased the protective efficacy of carbamazepine (20 mg/kg), diphenylhydantoin (8-12 mg/kg), phenobarbital (20 and 25 mg/kg), and valproate (250 and 300 mg/kg) against electroconvulsions in mice. On the other hand, aminophylline (5 mg/kg) was devoid of such activity. Plasma levels of antiepileptic drugs were measured with the help of the Abbott TDx analyzer and after administration of carbamazepine (20 mg/kg), diphenylhydantoin (10 mg/kg), phenobarbital (25 mg/kg), and valproate (250 mg/kg) were as follows: 8.61, 6.48, 24.3 and 329 micrograms/ml, respectively. Aminophylline (50 mg/kg) remained without any significant influence upon these plasma levels. This may lead to the conclusion that aminophylline-induced reversal of antiepileptic drug activity is not dependent upon a pharmacokinetic mechanism and probably occurs at the neuronal level. PMID- 2771205 TI - Caudato-nigral transmission in the substantia nigra pars reticulata neurons changes with recovery from circling movements induced by microinfusion of ibotenic acid. I. Behavioral study. AB - Following creation of a unilateral circumscribed lesion in a portion of a cat substantia nigra pars reticulata by microinfusion of ibotenic acid, circling movements toward the contralateral side of the lesion appeared within 2 days and disappeared a few days later. After recovery, the circling movements reappeared when the cats were decerebrated at the premammillary and precollicular level, suggesting that brain centers rostral to the decerebration participate in compensating the circling movements. PMID- 2771206 TI - Caudato-nigral transmission in the substantia nigra pars reticulata neurons changes with recovery from circling movements induced by microinfusion of ibotenic acid. II. Electrophysiological study on synaptic transmission. AB - Caudato-nigral synaptic transmission was examined by stimulation of the caudate nucleus while recording from nigral neurons in cats recovering from circling movements induced by a unilateral circumscribed lesion in the substantia nigra pars reticulata after microinfusion of ibotenic acid. Extra- and intracellular recording from neurons in lesion-spared areas of the substantia nigra pars reticulata indicated that the caudato-nigral synaptic action on the side ipsilateral to the lesion exhibited a shorter duration of inhibition and a larger amplitude of excitation as a means of compensating for the circling movements. PMID- 2771207 TI - Experimentally induced postinhibitory rebound in rat nucleus ambiguus is dependent on hyperpolarization parameters and membrane potential. AB - Postinhibitory rebound (PIR), a transient depolarization subsequent to release from experimental hyperpolarization, was identified and characterized in 81% of the cells studied in the nucleus ambiguus in slices from medulla of rat. Hyperpolarizing current pulses were administered via the recording microelectrode in the bridge-balanced mode to test for PIR. The voltage trajectory was characterized by a depolarizing sag during the pulse, rebound depolarization (PIR) after the pulse and increased input resistance during rebound. The amplitude and time course of PIR were dependent on prepulse membrane potential, pulse amplitude and pulse duration. These results suggest a potential role of PIR in respiratory rhythmogenesis. PMID- 2771208 TI - 'Chalasia' terminology and treatment questioned. PMID- 2771209 TI - Factors affecting prescribed medication compliance of the urban homeless adult. AB - Compliance with medical treatment may constitute an impenetrable barrier to homeless persons experiencing significant physiological and psychosocial limitations. The purpose of this study was to describe the perceived factors that enhance or diminish prescribed medication compliance of homeless adults. A retrospective descriptive study of 61 urban homeless adults sheltered at the Union Rescue Mission in downtown Los Angeles were interviewed with a compliance questionnaire. Findings revealed that more than two-thirds of the sample reported their health status to be fair to poor. Nearly one-third reported compliance rates ranging from none of the time to half of the time. Deterrents to compliance included structural variables such as availability of drugs and lack of privacy and storage space. Factors enhancing compliance included carrying the medications, being close to the health clinic and understanding the need for the medication. Many of the factors reported to enhance or diminish compliance are within the realm of professional practice. PMID- 2771210 TI - Sleep disorders: suggested conformation, cause. PMID- 2771212 TI - Night watch. From the heart. PMID- 2771211 TI - Clarification, supplemental information for 'Condylomata acuminata' article. PMID- 2771213 TI - Investigating dysuria. PMID- 2771214 TI - A case of patient abandonment? Court case. PMID- 2771215 TI - Think twice ... about confusion. PMID- 2771216 TI - Meeting the nurse retention challenge. Interview by Anthony A DeCrosta. PMID- 2771217 TI - Nursing technical assistants--one solution to the nursing shortage. PMID- 2771218 TI - Seeing Mabel through Frank's eyes. PMID- 2771219 TI - A.I.D.S. update--a roundup of news and trends. PMID- 2771220 TI - A kick in the head. PMID- 2771222 TI - Thank you, nurses. PMID- 2771221 TI - Action stat! Self-extubation. PMID- 2771223 TI - Mastering the ins and outs of chest drainage. Part 1 (continuing education credit). PMID- 2771224 TI - New drugs update 89. PMID- 2771225 TI - IV therapy that clicks. PMID- 2771226 TI - Tanya was 11 years old--and pregnant. Nursing grand rounds. PMID- 2771227 TI - Rescuing an SCI victim from a pool. PMID- 2771228 TI - Ellen's going home. Can she manage without you? PMID- 2771229 TI - Strategies for handling manipulative patients. PMID- 2771230 TI - Mrs. Murphy's strange behavior. Insights on death & dying. PMID- 2771232 TI - Insights on death and dying. PMID- 2771233 TI - Cardiac emergency drugs. PMID- 2771231 TI - Clinical and human issues dominate A.I.D.S. conference. PMID- 2771234 TI - Returning nurses--easing the transition. PMID- 2771235 TI - Better communication--learning how to assert yourself. PMID- 2771236 TI - New strategies for avoiding medication errors. PMID- 2771237 TI - 10 rules for taking verbal orders. PMID- 2771239 TI - Making Carolyn a believer one step at a time. PMID- 2771238 TI - Treating wounds on the scene. Part 2. PMID- 2771240 TI - When patients with genital herpes turn to you for answers. PMID- 2771242 TI - Why two professionals should interpret orders. PMID- 2771241 TI - If I'd known who Helen was.... PMID- 2771243 TI - Take the gamble out of changing jobs. PMID- 2771244 TI - 6 steps to building your confidence. PMID- 2771245 TI - Helping Jack help himself. PMID- 2771246 TI - Insights on death & dying. PMID- 2771247 TI - Action stat! Acute alcohol intoxication. PMID- 2771249 TI - My most unforgettable patient: Angel. PMID- 2771248 TI - Recognizing and reversing insulin shock. PMID- 2771250 TI - L.E.A.D drugs for cardiac emergencies. Clinical close-up on lidocaine. PMID- 2771251 TI - Safe suctioning. PMID- 2771252 TI - One precious moment: what you can offer when a newborn infant dies. PMID- 2771253 TI - Giving emergency care for burns. PMID- 2771254 TI - A nurse's guide to fail--safe delegating. PMID- 2771255 TI - Avoiding restraints. Why it can mean good practice. PMID- 2771256 TI - About pressure ulcers. PMID- 2771257 TI - Continuing controversy: more from the A.I.D.S. Conference. PMID- 2771258 TI - Tracking the nursing shortage. PMID- 2771259 TI - Administering eye medications. PMID- 2771260 TI - Feeding tubes: reducing the risk of aspiration. PMID- 2771261 TI - Chemotherapy: relieving nausea and vomiting. PMID- 2771263 TI - Renovascular hypertension: obstructed renal blood flow. PMID- 2771262 TI - Children with R.S.V.: developing a protocol. PMID- 2771264 TI - Stress test: dipyridamole-thallium testing. PMID- 2771266 TI - A small gesture brings great rewards. PMID- 2771265 TI - An older patient's return home challenges some stereotypes about which patients "deserve" treatment. PMID- 2771267 TI - Versed--a powerful sedative/hypnotic. PMID- 2771269 TI - Filling the vacuum. PMID- 2771268 TI - Discovering a post-T.U.R.P. complication. PMID- 2771270 TI - Elastomeric separation to aid the diagnosis and treatment of anterior proximal caries lesions. AB - Elastomeric separation of anterior teeth for the diagnosis and treatment of small proximal lesions has been described. A case report illustrates the technique. PMID- 2771271 TI - Severe localised periodontitis in an adult: initiation by orthodontic rubber bands. AB - An adult patient presented with advanced periodontitis around teeth 11 and 21. This was found to have been caused by the patient placing orthodontic bands 1 year previously around these teeth to close a mid-line diastema. PMID- 2771272 TI - Fluoride and dental caries. PMID- 2771273 TI - The new era. PMID- 2771274 TI - Deaths from lung cancer and ischaemic heart disease due to passive smoking in New Zealand. AB - Passive smoking is increasingly recognised as a public health hazard. Among New Zealanders who have never smoked, the prevalence of exposure to spousal smoking has been estimated to be 12.7% for men and 16.1% for women. The prevalence of exposure to passive smoking in the workplace has been estimated to be 33.6% and 23.4% for never smoking men and women respectively. The pooled risk estimates from epidemiological studies of the health effects of passive smoking were used to estimate the numbers of deaths from lung cancer and ischaemic heart disease attributable to passive smoking in New Zealand in 1985. The pooled relative risk estimates for lung cancer mortality were 1.3 (95% confidence interval (CI): 1.1 1.5) in both men and women exposed to passive smoking at home, and 2.2 (CI 1.4 3.0) in both men and women exposed to passive smoking at work. Using these relative risk estimates, it was calculated that 30 lung cancer deaths (range: 11 41) were attributable to involuntary smoking in New Zealand in 1985. From pooled relative risk estimates of ischaemic heart disease death of 1.3 (CI 1.1-1.6) and 1.2 (CI 1.1-1.4) for exposure to spousal smoking in men and women respectively, it was estimated that a further 91 ischaemic heart disease deaths (range: 39-177) were due to passive smoking at home. The number of ischaemic heart disease deaths due to passive smoking in the workplace was even higher, at 152 (range: 62-224), assuming relative risks of 2.3 (CI 1.4-3.4) and 1.9 (CI 1.4-2.5) for men and women respectively.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2771275 TI - Congenital long QT syndrome in adults. AB - A family with the Romano-Ward syndrome is presented. This family showed typical features of this syndrome with QT prolongation, torsades de pointes ventricular tachycardia, sudden death and an autosomal dominant inheritance pattern. The index case presented with an exacerbation of torsades de pointes ventricular tachycardia from diuretic induced hypokalaemia, and responded to diuretic withdrawal and beta blocker therapy. PMID- 2771276 TI - Catheter ablation of the atrioventricular junction in patients with refractory atrial arrhythmias. AB - Twelve patients with refractory symptomatic atrial arrhythmias were evaluated for closed chest ablation and permanent pacemaker implantation. This was successful in nine of the 11 patients in whom ablation was attempted. Two of these nine patients required two separate ablative procedures. Three patients underwent open surgical ablation. Electrical ablation had failed in two of these patients and had not been undertaken in the remaining patient (inadequate His recording). The mean His amplitude and delivered energy levels were not significantly different between the two groups. Complications occurred in three patients and were minor. Because ventricular arrhythmias and late sudden death are recognised complications in a minority of patients undergoing closed chest ablation of the A V junction it should be restricted to patients with symptomatic atrial arrhythmias who have failed maximal medical treatment. PMID- 2771278 TI - The assessment of operating theatre requirements for emergency surgery. AB - Acute surgical operations were analysed over a period of two months. Recordings were made of the times of admission, the start and finish of surgery, and the surgical specialty. Fifteen emergency operations per day used 23.5 hours operating theatre time. The delay from admission to surgery averaged eight hours but varied from a few minutes to over 24 hours. The acute work is increasing by 5% per annum and now comprises over 50% of the 10,500 operations done each year at Middlemore. Two thousand of the remaining operations form a separate group consisting of repeat operations, operations for complications, and transfers from other disciplines and hospitals. Waiting list operations have fallen from nearly 5000 in 1981 to 3000 in 1988 as more theatre time and hospital beds are used for emergency cases. The trends justify the building of three extra theatres to meet the community needs of the next decade. PMID- 2771277 TI - Asthma: a provincial study. AB - To identify factors contributing to increased mortality and morbidity we prospectively evaluated 200 consecutive adult (greater than 17 years) asthmatic presentations (105 patients) referred to Gisborne Hospital over a 28 month period between 1985 and 1987 using a modified protocol adapted from previous national studies. In the moderate asthmatic group (113 presentations, 56%), 6% failed to use beta agonists prior to admission and 43% were not on regular steroid inhaler therapy. No patient had a crisis plan although 45 (22.5%) had received oral steroid therapy before admission. Poor drug compliance was twice as common in the Maori. Fifty-eight percent of patients were on regular long term oral theophylline whereas 48 (43%) patients with moderate and severe asthma were not on corticosteroid inhalers. We conclude that patient education and more liberal use of steroid inhalers have the greatest potential for improving morbidity and mortality. PMID- 2771279 TI - Doing research in the real world--a case history and some implications for medical research. PMID- 2771280 TI - Ecstasy abuse. PMID- 2771281 TI - Paediatric fees. PMID- 2771282 TI - Cytochemical characterisation of extramedullary blast crisis in chronic myelogenous leukaemia using fine needle aspiration biopsy. PMID- 2771283 TI - A cot death prevention trial: King v La Leche. PMID- 2771284 TI - International AIDS conference. PMID- 2771285 TI - Parathyroid imaging with thallium-201. PMID- 2771286 TI - Measuring the workload. PMID- 2771287 TI - A huge adjustment: the reality of spinal injury after rehabilitation. PMID- 2771288 TI - Quality circles: how nursing staff can have their say in management decisions. PMID- 2771289 TI - Wanted: local role models. PMID- 2771291 TI - The protocols. PMID- 2771290 TI - Who assesses assessment? PMID- 2771292 TI - Does the law discriminate against women dentists? PMID- 2771293 TI - The committee on chemical dependency. A report. PMID- 2771294 TI - The female identity in dentistry. PMID- 2771295 TI - The fulfilling journey from hygienist to G.P. PMID- 2771296 TI - The changing role of women in dentistry. PMID- 2771297 TI - The odyssey of a woman dentist. PMID- 2771300 TI - Dentistry's distaff side. PMID- 2771299 TI - Vive la difference. PMID- 2771298 TI - A female dentist in a rural practice. PMID- 2771301 TI - Equal legal protection for dentists. PMID- 2771302 TI - The implant blitz. PMID- 2771303 TI - Confidence intervals. PMID- 2771305 TI - Anti-M antibody in pregnancy. AB - Our three cases represent the spectrum of findings when maternal anti-M is present. In the first case, the father's genetic makeup (NN) indicated no disease would occur. In the second case, despite antibody capable of crossing the placenta, the infant did not become sick. In the third case, hemolytic anemia required transfusion of the newborn, despite a negative direct Coombs' (DAT). In summary, anti-M antibody is an uncommon cause of hemolytic disease of the newborn. When anti-M, IgG optimally reactive at 37 degrees C, is identified in the maternal blood, the paternal blood must be checked for the presence of M antigen. If the father has M antigen the fetus may be at risk. Since there is no documented body of experience that titers of anti-M predict severity of disease, our recommendation is that amniotic fluid bilirubin studies be done, in spite of the fact that only one prior case of hemolytic disease due to anti-M was found reported from the United States. Anti-M is an unpredictable antibody and serial antibody titers are not reliable. After delivery the infant's MN antigen status should be determined, because a negative direct Coombs' test may be found even when M antigen is present in the infant and hemolysis is occurring. Further studies are needed to determine the clinical impact of anti-M antibody on unrecognized hemolytic disease of the newborn. PMID- 2771304 TI - DISIDA kinetics measure liver function in dogs. AB - We have investigated the ability of 99Tcm-disofenin (DISIDA) kinetics to measure liver function. Two approaches have been used: first, quantitative analysis of serial liver images, and second, clearance estimation from whole blood concentration-time data. Graded liver dysfunction was produced in 11 dogs over three months by common bile duct ligation and surgical relief of biliary obstruction one month later. The kinetic analysis of serial liver images showed clear abnormalities during biliary obstruction, with calculated rates of liver uptake falling in stages from 11.09 to 5.15 cts s-1 (p less than 0.001), and rates of elimination from the liver from 8.8 to 1.6 x 10(-4) cts s-1 (p less than 0.0001). These parameters paralleled the deterioration and recovery of liver function through the experimental period, and had not fully recovered 7 weeks after relief of biliary obstruction (10.5 and 6.2 x 10(-4) cts s-1 respectively). Serial blood sampling after injection of DISIDA permitted calculation of whole blood disposition rates (for hepatic clearance). Mean values fell from 256 to 67 ml min-1 with chronic biliary obstruction (p less than 0.001), and returned to almost normal (206 ml min-1) 10 days after surgical relief of biliary obstruction. It is clear that the gradual nature of recovering liver function was more sensitively identified by image analysis than serial blood data. Serial liver biopsies showed marked changes following biliary obstruction. These improved over a period of 7 weeks following its relief, when there was still considerable residual abnormality. This work supports the view that hepatic abnormalities caused by biliary obstruction do not recover quickly following its relief. DISIDA kinetics can quantitate both major and minor degrees of hepatic dysfunction, and may prove to be a valuable method to quantitative liver function. PMID- 2771306 TI - Experts respond to proposal. PMID- 2771307 TI - Businesses should share strategies for health-care cost management. PMID- 2771308 TI - Endangered species. PMID- 2771309 TI - Employers must consider legal aspects of reproductive hazards. PMID- 2771310 TI - Multiple factors affect speech communication in the work place. PMID- 2771311 TI - Realistic manikins simulate patients and help teach healthcare safely. PMID- 2771312 TI - Age a factor in spread of AIDS. PMID- 2771313 TI - Drastic rise in AIDS predicted. PMID- 2771314 TI - New drugs for head injuries. PMID- 2771315 TI - Logging standard under review. PMID- 2771316 TI - [Cholinesterase in the amnion of chick embryos]. AB - Cholinesterase (ChE) activity in amnion was studied in developing chick embryos and the enzyme's substrate-inhibitory characteristics were established. The enzyme activity increased until the 8th day of incubation and then gradually decreased; on day 12-15 the activity is 40% only of the maximal one. On the basis of substrate-inhibitory analysis the enzyme was referred to propionyl cholinesterases. Relations between age changes in ChE activity and morphological structure of smooth-muscle amnion tissue, its differentiation during development and functional activity of amnion are discussed. PMID- 2771317 TI - [Study of gene expression of yolk proteins in Drosophila using a method of in situ hybridization]. PMID- 2771318 TI - [Injection of gene p53 into the pronuclei of mouse zygotes]. AB - Attempts to transfer gene p53 via pAT153 vector to the mouse genome are described. Transgenic mice were obtained that carried sequences homologous to the pAT153 only. No transmission of foreign nucleotide sequences to progeny was observed. PMID- 2771319 TI - [Effect of neonatal androgenization on the septal neurons of the brain in female rats in early postnatal ontogeny]. AB - Newborn female rats were androgenized, and the reaction of neurons of brain septum on excessive quantity of exogenous androgens, introduced during so-called "crucial" period of formation of centers of gonadotropic regulation of sexual cycles, has been studied in 3, 5, 7, 10, 20, 30, and 60 days old animals. Morphometry of brain septum cell nuclei revealed that most neuron nuclei shrink after androgenization. Monoamine content was significantly increased in septum nuclei of experimental animals. Neonatal androgenization led to the increased capacity of septal complex neurons to bind 3H-estradiol and to the decreased 3H testosterone binding. The data obtained suggest that the brain septum neurons of female rats depend on sex steroids, particularly during "crucial" period of development. PMID- 2771320 TI - Stereoscopic depth perception by static stereo-deficient observers in dynamic displays with constant and changing disparity. AB - The performance of 11 static stereo-deficient subjects and 11 static stereo normal subjects was compared on two types of dynamic stereo displays--one where disparities were constant during motion and one where disparities changed continuously. Computer-generated displays simulating horizontal motion of figures at different depths or rotation of figures about a vertical axis were viewed through a Brewster stereoscope. About one-half of the subjects in our static stereo-deficient sample were able to make depth judgments on the basis of disparity in both types of dynamic displays. The clinical feature which appeared to distinguish those static stereo-deficient subjects who could use disparity information in dynamic displays from those who could not was early onset constant strabismus. These results indicate that a complete evaluation of stereo ability should include tests with dynamic displays, possibly including both constant and changing disparities. PMID- 2771321 TI - Comparison of four methods of assessing visual acuity in young children. AB - The purpose of this study was to determine which of four tests, the Acuity Cards, the Dot Visual Acuity test, the Broken Wheel test, or the American Optical (AO) pictures, might be most useful for clinical assessment of visual acuity in 2- and 3-year-olds. Data related to clinical utility including success rates, required test times, reliability, and acuity norms were collected. High success rates and short test times support use of the Acuity Cards for 2-year-olds. For testing 3 year-olds a measure of recognition acuity, the Broken Wheel test, may be most useful. PMID- 2771322 TI - Peripheral visual acuity with monovision and other contact lens corrections for presbyopia. AB - We have conducted two experiments to investigate the effect of monovision and other contact lens corrections for presbyopia upon peripheral visual acuity. In the first study, we measured binocular peripheral visual acuity using Landolt rings with seven subjects wearing a monovision correction. The Landolt rings were presented at eccentricities of 10, 20, 40, and 70 degrees on each side of the subject, with near additions of +1.50 D, +2.50 D, and no addition. We found no significant effect of monovision correction on peripheral visual acuity. In the second experiment we measured the peripheral visual acuity of 11 presbyopic subjects wearing distance contact lenses with lookover spectacles, soft progressive bifocal contact lenses, soft concentric bifocal contact lenses, monovision contact lenses, modified monovision contact lenses, and hard bifocal contact lenses using Koenig bar targets. There were no significant differences in peripheral visual acuity between any of the contact lens corrections for presbyopia. PMID- 2771323 TI - Comparison of fusional ranges measured by Risley prisms, vectograms, and computer orthopter. AB - Maximum base-in (BI) and base-out (BO) fusion vergence ranges were measured in 38 normal subjects using 3 different clinical procedures. These procedures used different instruments, instructions, and vergence stimuli (Risley prisms, vectograms, and video-displayed contour and random dot stereograms) presented at 50.8 cm. Test-retest measures, which were taken on each test for each subject, indicated high positive correlations between test and retest measures for most vergence tests. Paired inter-test correlations among five different tests varied as a function of the pairing as well as type of measure taken (BI, BO, break, recovery). It was concluded that different methods of measuring vergence provide different kinds of information and such tests may not be used interchangeably. PMID- 2771324 TI - An instrument for in vivo tear film interferometry. AB - An instrument has been designed and constructed that facilitates the measurement of in vivo tear film topology, thickness, and wetting, using the principles of thin film interferometry. The use of this tear film interferometer (TFI) allows objective evaluation of the breakup characteristics of the tear film on contact lens surfaces and provides a means for examining the dynamic changes in thickness, thickness distribution, and wetting properties during sequential interblink periods. The effects of contact lens material, wetting solutions, and cleaning regimens can be compared objectively. The instrument is easy to use, no additives to the natural tear fluid are required. PMID- 2771325 TI - Alport's syndrome: review and case report. AB - Alport's syndrome is a rare disorder characterized by neurosensory hearing impairment and progressive kidney dysfunction. The syndrome affects both males and females but males manifest more serious kidney problems and have a higher mortality rate. Ocular manifestations occur in approximately 15% of these patients with anterior lenticonus being the most common. It is believed that this is the first reported case of a patient with Alport's syndrome and anterior lenticonus who underwent lensectomy and lens implant to improve visual function. PMID- 2771326 TI - Contact lenses and acute exposure to ultraviolet radiation. AB - The eyes of twenty-three pigmented rabbits (weight approximately 2kg) were irradiated with a single dose of UVB (285 to 315 nm total bandpass at approximately 450 muW.cm-2 irradiance) for exposure times of 22s to 1680s. One group wore UV-transmitting soft contact lenses during exposure of one eye with the fellow eye serving as a control while another group wore a UV-absorbing lens on each eye with only one eye irradiated. UV-transmitting contact lenses did not affect the clinical response to UV exposure whereas the UV-absorbing contact lenses protected the corneas as could have been predicted by consideration of the absorption characteristics of the lenses at the experimental waveband. In no case was there any evidence of adhesion between the contact lens and the corneal epithelium. PMID- 2771327 TI - Clinical characteristics of anomalous correspondence. AB - The correspondence status of 68 constant, early-age onset strabismics was evaluated with three common clinical tests to determine the prevalence of anomalous retinal correspondence (ARC) and which clinical features of the strabismus were most highly associated with the ARC. Ninety-six per cent, 71%, and 51% of the patients manifested ARC with the striated lens test, the synoptophore, and the afterimage test, respectively. The clinical features of the strabismus that were correlated, although weakly, with the diagnosis of ARC were: (1) the magnitude of the deviation at near for the striated lens test; (2) the age of the patient at the time of testing and the laterality of the deviation on the synoptophore; and (3) the age of the patient at the time of testing, the change in the deviation from distance to near, and the spherical equivalent refractive error for the afterimage test. A low correlation also existed between the age of the patient and the depth of ARC (superficial or deep-rooted). We conclude that the clinical features of strabismus cannot be utilized effectively to predict the status of retinal correspondence. PMID- 2771328 TI - Temporal summation in age-related maculopathy. AB - We measured temporal summation in subjects with atrophic age-related maculopathy (ARM) and age-matched control subjects at photopic and scotopic luminance levels. Although the ARM subjects did show longer critical durations in each case these differences were not statistically significant. This result, in conjunction with our earlier work on temporal discrimination, indicates that the processes which are responsible for temporal summation of the eye (presumably located at the receptors) are more resistant to the degenerative processes of ARM than are those responsible for temporal discrimination. This may be because the simple threshold procedure used here does not sufficiently stress the temporal response system to show a deficit. PMID- 2771329 TI - Effect of defocus on visual acuity as measured by source and observer methods. AB - The relation between refractive error and visual acuity has been measured by two very different methods. In one called "source methods," emmetropes or corrected ametropes view defocused stimuli presented on projection screens or photographs. In the type called "observer methods," focused stimuli are presented to the observers who are either uncorrected ametropes or emmetropes defocused by lenses placed (usually), in the spectacle plane. The study reported in this paper demonstrates for the first time that these two methods of defocusing retinal images and their effects on visual acuity can be correlated. Results show that the source method of producing defocus could be used interchangeably with the observer method in investigating the rates of change of visual acuity with defocus for young normal observers. The angular diameter of the defocused image of a point, the blur disc diameter in object space, allows the two methods to be compared. Although the results show that the two methods are highly correlated, they show that the source method gives a statistically but not clinically significant lower acuity. The results of both methods are used to derive an equation linking refractive error, visual acuity, and pupil diameter. PMID- 2771330 TI - Relation between clinically measured tonic accommodation and refractive status in 6- to 14-year-old children. AB - Previous studies have shown a relation between refractive status and tonic accommodation (TA), with corrected hyperopes displaying a significantly higher TA than corrected myopes. TA measurements in those studies were made on adult subjects, under laboratory conditions with an infrared or laser optometer. The study reported here used a different measurement method and younger subjects. The TA of 113 (19 hyperopic, 61 emmetropic, 33 myopic) children, ages 6 to 14 years, was measured by a clinical method described earlier. Analysis of variance indicated significant (p less than 0.25) between-group mean differences similar to the adult-subject data cited above. Clinical implications of the data and the measurement method are discussed. PMID- 2771331 TI - Central and peripheral sensitivity to temporally modulated stimuli presented to the sighting and nonsighting eyes. AB - Thirty-two visually normal observers showed reduced sensitivity to uniform field flicker in the fovea of the nonsighting eye relative to the sighting eye. The two eyes showed equal sensitivity to flicker in the peripheral retina. This result with visually normal observers is analogous to that found in observers with functional amblyopia. It is also consistent with the hypothesis that amblyopic and normal suppressive processes share a common mechanism. PMID- 2771332 TI - Accommodation to size and blur changing in counterphase. AB - We explored the influence of changing size and blur on accommodation by presenting the two stimuli sinusoidally in counterphase. The frequency response of the accommodative system (0.05 to 1 Hz) was determined using a high-speed infrared optometer while the subject viewed the target in a Badal optometer. Blur was provided by moving the target dioptrically toward and away from the subject, and size of the target was altered by a variable aperture. Both stimuli were varied sinusoidally at the same frequency, but in counterphase. We find that both size and blur can have an influence on accommodation: blur is particularly powerful at low temporal frequencies, whereas size becomes effective at moderate and high temporal frequencies. PMID- 2771333 TI - Effects of short-term VDT usage on visual functions. AB - An on-site comparative study was carried out on the effects of video display terminal (VDT) and non-VDT work on visual functions in two working populations in the same office environment. Both continuous VDT usage in a training situation over a few days and intermittent VDT usage in a normal working situation were assessed and particular attention paid to their effects on the refractive error of different refractive groups and for different age populations. Other visual functions measured were visual acuity (VA), accommodation, and convergence. Results show that VDT work does not have a significantly greater effect on visual function than non-VDT work. PMID- 2771334 TI - High and low contrast acuity and clinical contrast sensitivity tested in a normal population. AB - Visual acuities obtained with a high contrast Bailey-Lovie chart (HCBL) and a low contrast Bailey-Lovie chart (LCBL) were compared with clinical contrast sensitivity function (CSF) measurements in a group of normal subjects with a wide range of refractive errors. We found high and significant correlations for the measurements obtained with the visual acuity tests, and between measurements obtained with the acuity tests and the CSF chart. These results indicate that the CSF test provides little additional information as a screening test in routine practice, and could probably be restricted in its use to patients in whom ocular disease is suspected. PMID- 2771335 TI - Photographic method for Bruckner and Hirschberg testing. AB - An apparatus for strabismus detection was designed to allow photographing fundus and corneal reflexes for Bruckner and Hirschberg testing, respectively. Photographs of adult subjects with simulated strabismic deviations were viewed by two groups of observers, optometry students and optometry faculty. In general there was no significant difference in testing results between the two groups. Subject error produced unreliable Bruckner results. However, Hirschberg testing was effective approximately 80% of the time in detecting a deviating eye in strabismus of magnitudes of about 5 delta. Anisometropia in Bruckner testing was also investigated. Magnitudes of 2.00 D or greater significantly affected results. Clinical application of the photographic Hirschberg test may have potential value as a screening method. The photographic Bruckner test is not recommended for adults; its reliability in children requires investigation. PMID- 2771336 TI - Declared vs. true age of patients. AB - The mean declared age of 137 male and 56 female optometry clinic patients was 2.4 years (SD = 3.8) lower than the birth certified or true age. Approximately 57% of the males and about 52% of the females had discrepancies between their declared and true ages. A more penetrating re-evaluation of prior claims concerning Nigerian (or other tropical countries) age-related health issues may be advisable in view of the present findings of age errors. PMID- 2771337 TI - Sagitta and lens thickness: generalized equations for arbitrary surfaces. PMID- 2771338 TI - Changes in refractive error for exotropes treated with overminus lenses. AB - The refractive changes of pediatric patients who were prescribed overminus lenses for exotropia were evaluated. Overminus lenses means additional minus power over the lenses required to correct the refractive error at distance. Forty exotropic patients, ages 1 to 15 years, were prescribed overminus lenses (-0.50 D to -3.75 D) for a period of 9 to 86 months. A small but significant correlation was found between the initial refractive error and the mean annual change toward myopia. Other factors such as age when treatment was given, duration of therapy, amount of overminus, and the amount of the exodeviation had little effect on the rate of myopic change. The mean annual changes in refractive error for hyperopes (-0.13 +/- 0.44 D, N = 15), emmetropes (-0.26 +/- 0.37 D, N = 17), and myopes (-0.75 +/- 0.77 D, N = 18) were similar to values reported in the literature for nonexotropic children. PMID- 2771339 TI - Optical design of intraocular lenses. I. On-axis performance. AB - The theoretical effect of intraocular lens shape on on-axis performance of model pseudophakic eyes was investigated. Image quality criteria included the magnitude of spherical aberration (both wave and longitudinal), spot diagrams, and the modulation transfer function. For eyes with corneal asphericities encompassing most of the population (Q greater than or equal to -0.5), the optimum lens form is close to being plano-convex, with the more curved surface facing the cornea. PMID- 2771340 TI - Retinal adaptation effects on the patterned VEP and ERG. AB - The patterned visually evoked potential (pVEP) and patterned electroretinogram (pERG) after light and dark adaptation were investigated in 10 visually normal human observers. The influence of retinal preadaptation on the pVEP appeared to be dependent on the stimulus field size. With a 6 degree field size retinal adaptation effects were not apparent, but with a 12 degree field size the amplitudes of the dark-adapted steady-state pVEP (ssVEP) and transient pVEP (tVEP) were significantly larger than the light-adapted amplitudes. Similarly pERG's elicited by a 12 degree field size produced larger amplitude dark-adapted results. The implications of these findings are discussed. Monitoring the temporal changes in the pVEP subsequent to different retinal preadaptation levels proved to be inconclusive for the conditions studied. PMID- 2771341 TI - Cornea-soft contact lens interaction: a nuclear magnetic resonance study. AB - Because 31P NMR (phosphorus-31 nuclear magnetic resonance) spectroscopy can detect phosphorus metabolites and more than 90% of them reside in corneal epithelium, we applied this technique to the examination of the metabolic response of the cornea (epithelium) to soft contact lens (CL) wear. Our results showed that 4 h of soft CL (59% water) wear caused a 50% loss of ATP, and both ATP and phosphocreatine (PCr) decreased drastically if the eyes were closed. Topical application of 5.5 mM glucose to CL-fitted eyes restored the 31P profile to nearly normal. Possible approaches for maintaining corneal health are discussed. PMID- 2771342 TI - Correction of presbyopia with contact lenses: comparative success rates with three systems. AB - In a study designed to compare subjective success rates of three presbyopic contact lens systems, 200 presbyopes were fitted with monovision (MV), a pair of concentric center-near lenses (CN pair), or a combination of center-near/center distance concentric lenses (CNCD). Overall, 112 subjects (56% of those fitted) successfully wore at least one lens system for a minimum of 3 months. MV was the most successful system (67% success); disrupted stereopsis was not a significant reason for failure with this system. The lower success rates with the two concentric bifocal systems (CN pair 42%, CNCD 37%) could be attributed to the greater visual compromise required with these lenses. PMID- 2771343 TI - Relation between tonic accommodation and visual perceptual skills development in 6- to 12-year-old children. AB - Refractive status has been shown to be related to both tonic accommodation (TA) and visual perceptual skills (VPS) development in children. The purpose of this study was to investigate possible direct links between TA and VPS development, independent of refractive status. The TA and VPS of 162 children (29 hyperopic, 81 emmetropic, 52 myopic) were assessed clinically. Analysis of the data corroborated the aforementioned relation between refractive status and TA, and between refractive status and VPS, but also revealed substantial within refractive-group variability in TA and a highly significant relation between TA and VPS. The evidence indicates that children with high TA are much more likely to have delays in VPS development than are children with low TA, regardless of their refractive status. PMID- 2771344 TI - Potential visual acuity measured with and without pupil dilation. AB - Potential visual acuities were measured with the Randwal IRAS portable interferometer, with and without pupil dilation, on a sample of predominately elderly patients with mild to moderate cataract. No clinically significant difference was found between interferometer potential acuities before and after pupil dilation. PMID- 2771345 TI - A comparison study of dynamic retinoscopy techniques. AB - The dynamic retinoscopy technique that has undergone the most quantitative study is the Monocular estimate method (MEM). For reasons of examiner preference, patient cooperation, or equipment availability it may be useful for the practitioner to have alternative methods available to assess accommodative status. The purpose of this study was to compare data obtained by two experienced examiners using Bell, Cross, and Nott retinoscopies, MEM and Binocular cross cylinder (BCC) to evaluate accommodative lags of 10 young adult subjects. Statistical analysis revealed no significant differences between the results of the two examiners (p less than 0.2672). Results obtained by the MEM, Cross, and Nott techniques were not significantly different, but those obtained by Bell and BCC were significantly different from the other three techniques. The results of this study suggest that an examiner may use MEM, Cross retinoscopy, or Nott retinoscopy interchangeably to evaluate accommodative lag of the young adult subject. PMID- 2771346 TI - Effect of defocus on blur thresholds and on thresholds of perceived change in blur: comparison of source and observer methods. AB - The defocus levels required for normal observers to notice the first perceptible blur of a clear test target (blur threshold) and the least perceptible change in the degree of blurriness of an already blurry target (threshold of perceived change in blur) were measured using both the source and observer methods. In the source method observers viewed defocused stimuli presented on a projection screen, whereas in the observer method focused stimuli were presented to observers who were defocused using lenses placed in the spectacle plane. Blur thresholds were found to be dependent on target size and when the Landolt ring targets were near threshold acuity size blur thresholds were as small as 0.10 D. For larger target sizes (0.6 log min arc or more above threshold acuity size) the blur thresholds remained relatively unchanged and were about 0.18 D. Thresholds of perceived change in blur were found to be independent of the initial defocus level. Measurements of the threshold of perceived change in blur were found to be 0.05 to 0.07 D, which is much smaller than the blur threshold values. Comparison of results from the two methods of producing defocus indicate that the source and observer methods can be used interchangeably. However, for the same angular blur disc diameter, the blur thresholds found with the source method were significantly lower than those found with the observer method. PMID- 2771347 TI - Viewing distance affects stereoscopic tilt created with spatial frequency disparity. AB - A controversy exists as to whether stereoscopic tilt created with interocular differences in spatial frequency is based on perception of spatial frequency disparity or positional disparity. To determine which hypothesis is correct, we investigated the influence of viewing distance on perceived tilt. Tilt was induced by having observers view, at three viewing distances, dichoptic spatial frequency grating patterns differing in frequency by 25%. By appropriate physical scaling of the size of the patterns, their spatial frequency and angular width remained unchanged as distance varied. Under such conditions, the spatial frequency disparity hypothesis predicts no effect of distance, whereas the positional disparity hypothesis predicts a significant effect of distance (due to stereoscopic depth constancy) on the magnitude of tilt. The results showed that perceived tilt does covary with distance, a result consistent with only the positional disparity hypothesis. PMID- 2771348 TI - Influence of extraocular muscle imbalance on binocular performance. AB - In assessing binocular performance, it is possible that extraocular coordination is more significantly involved than presently recognized. Dynamic phorometry or phorometric testing in the nine cardinal directions of gaze is advised for evaluating the extraocular muscular system. These case reports used interrelation of phorias to evaluate binocular problems. The interpretation of these data helps determine the amount of horizontal prism necessary to reduce compensating vergences. Although a control group was not used, the elimination of associated vertical fixation disparity in these cases seemed to ameliorate binocular stress. PMID- 2771349 TI - Transconjunctival lower eyelid blepharoplasty. Technique and complications. AB - The transconjunctival lower eyelid blepharoplasty is extremely effective at reducing lower lid fullness due to prominent orbital fat. The authors performed 122 consecutive transconjunctival blepharoplasties over a 24-month period. Four patients had skin excision via the pinch technique in conjunction with the transconjunctival fat excision. The main complication was under excision of fat which occurred in nine patients (7.4%). Moderate postoperative wound hemorrhage without hematoma formation occurred in one patient (0.8%). There were no cases of lid retraction, ectropion, entropion, inferior oblique palsy, or over excision of fat. The main advantage of this technique is that it avoids the most common complication of transcutaneous lower eyelid blepharoplasty, namely lower eyelid retraction. PMID- 2771350 TI - Levator aponeurosis surgery. A retrospective review. AB - A review of all cases of aponeurotic repair done since 1980 by the author identified 140 patients and 174 eyelids. An acceptable result at 6 weeks was defined as a lid level within 1 mm of the desired level achieved in 74% of lids with acquired ptosis. The amount of ptosis present preoperatively was the major factor in our study; levator function and type of anesthesia did not affect the success rate. The most significant finding was a lower long-term success rate due to a drop in lid level clustered at the 2- to 4-month period postoperatively. The authors speculate on the cause for this finding. PMID- 2771351 TI - Computed tomographic features of nonthyroid extraocular muscle enlargement. AB - While Graves' disease is the most common cause of enlarged extraocular muscles, other disorders may masquerade as dysthyroid orbitopathy. The authors conducted a retrospective analysis of the computed tomographic (CT) scans of 60 patients with nonthyroid enlarged extraocular muscles to establish the differential radiographic features of these disorders. The diseases were classified as primary or local invasion of neoplasm (26%), inflammatory (25%), metastatic tumor (20%), vascular (13%), infection (12%), and acromegaly (3%). The inflammatory cases demonstrated more bilateral involvement (40%) and less involvement of the tendons (47%) than previously appreciated. The relatively high incidence of these features in the inflammatory group is important because both features have been considered pathognomonic for Graves' disease. Primary and metastatic tumors produced a nodular muscle enlargement with sharp borders and frequent bone changes. Certain tumors showed a predilection for certain muscle groups. Vascular cases involved multiple unilateral muscles and usually enlarged the superior ophthalmic vein. Infectious cases usually demonstrated fusiform muscle enlargement with blurred margins, whereas acromegaly caused moderate enlargement of all recti. Although certain diagnosis-specific radiographic patterns are described, no feature is pathognomonic for any disorder. PMID- 2771352 TI - Methylprednisolone pulse therapy in severe dysthyroid optic neuropathy. AB - Five patients with severe dysthyroid optic neuropathy were treated with intravenous methylprednisolone (1 g daily for 3 consecutive days). Before administration, visual acuity of the more severely affected eyes of each patient was counting fingers at 5 feet, 8/200, 20/400, 20/200, and 20/80. Immediately after completion of pulse therapy, visual acuity improved to 20/25 in four patients and 20/30 in one. Remissions were maintained with oral prednisone and external beam irradiation of the orbit. Pulse methylprednisolone therapy appears to be beneficial in the initial management of severe dysthyroid optic neuropathy. PMID- 2771353 TI - Optic tract injury after anterior temporal lobectomy. AB - Three patients had complete homonymous hemianopia with clinical and neuroimaging characteristics of ipsilateral optic tract infarction after anterior temporal lobectomy for seizure control. This injury presumably resulted from irritative vasospasm of the anterior choroidal artery. The features of this pure optic tract syndrome should be distinguished from the more common compressive optic tract syndrome which generally also impairs ipsilateral optic nerve function. PMID- 2771354 TI - Intracranial aneurysms with superior division paresis of the oculomotor nerve. AB - Five patients with intracranial aneurysms had unilateral ptosis, limitation of supraduction, and normal pupillary reactivity. The most common aneurysm location for superior division paresis of the oculomotor nerve was the superior cerebellar posterior cerebral artery junction, where aneurysms (3) of the basilar artery compressed and flattened the interpeduncular oculomotor nerve from below. A superior cerebellar artery aneurysm and brain stem infarction affected the intra axial course of the oculomotor nerve producing superior division paresis. Only an aneurysm of the intracavernous carotid artery resulted in superior division paresis at the expected anatomic site of bifurcation of the oculomotor nerve into its superior and inferior divisions. Because the superior division supplies innervation exclusively to the superior rectus muscle and levator palpebrae, an aneurysm involving this branch does not affect the pupillo-constrictor fibers. Consequently, cerebral angiography should be considered in the initial evaluation of this ocular motor deficit. PMID- 2771355 TI - Ocular manifestations of endemic syphilis (bejel). AB - Bejel or nonvenereal syphilis is a treponemal infection that is still endemic in many parts of the world including Saudi Arabia. The authors have examined 17 patients with clinical findings consistent with bejel. All patients had positive serologic tests for bejel. There were 11 male and six female patients, with a mean age of 54 years (range, 37-73 years). Results of clinical examination showed uveitis in nine patients, optic atrophy in six, and chorioretinitis scars in six. In four patients who needed intraocular surgery, two aqueous specimens showed positive antibodies for Treponema pallidum. PMID- 2771356 TI - Anterior chamber depth after trabeculectomy. PMID- 2771357 TI - The Diabetic Retinopathy Vitrectomy Study. PMID- 2771358 TI - Scrutinizing peer review. PMID- 2771359 TI - Chemodenervation of strabismic children. A 2- to 5-year follow-up study compared with shorter follow-up. AB - To determine longer-term efficacy of botulinum treatment, the author examined 85 children younger than 14 years of age who had been treated from November 1982 to February 1984, comparing shorter follow-up (range, 6-24 months) with longer follow-up (range, 2-5.5 years) as of last examination before March 1988. Fifty esotropes meeting the 2-year criteria for follow-up had an average of 35 prism diopters (PD) before and 5 PD after treatment. Twelve exotropes averaged 30 and 5 PD. No long-term complications were discovered. The results are similar to the shorter follow-up and suggest that botulinum is effective in creating a 2- to 5 year stable improvement for strabismic children. PMID- 2771360 TI - Management of strabismus with botulinum A toxin. AB - Three hundred eight patients with strabismus were treated with botulinum A toxin (Oculinum) chemodenervation; 153 were followed by the authors for at least 6 months. In this study group, 97 received botulinum A toxin injections as the primary method of treatment of their ocular deviation. Fifty-six received injections after traditional extraocular muscle surgery. Botulinum A toxin was useful for management of patients with recent surgical overcorrections and for management of some patients with sixth cranial nerve palsy. Chemodenervation of an extraocular muscle was not as successful as traditional strabismus surgery for treatment of infantile esotropia and other comitant deviations. Botulinum A toxin injection was ineffective in patients who had restrictive strabismus. This drug has limited application in the management of patients with strabismus. PMID- 2771361 TI - Calibration of Hirschberg test photographs under clinical conditions. AB - The feasibility of determining the angle of ocular deviation from clinical photographs was assessed. Corneal reflex photographs were obtained from 30 strabismic patients and 5 orthophoric control subjects, using a centered electronic flash, with a millimeter ruler placed across the forehead for calibration. Measurements of corneal reflex displacement were obtained from the photographs and compared with standard prism-cover results. The value of 20.89 prism diopters (PD) per millimeter of corneal reflex displacement was obtained for the factor of conversion from reflex displacement to strabismic angle. This value of the Hirschberg coefficient is valid only for measurements of reflex displacement along a true frontal plane, as provided in a photograph. Detailed algorithms for the calculation of strabismic angle from photographic data are provided in an appendix. PMID- 2771362 TI - Primary inferior oblique overaction in congenital esotropia, accommodative esotropia, and intermittent exotropia. AB - A statistical analysis of the onset and natural history of primary inferior oblique eye muscle overaction (IOOA) was conducted using the records of 456 strabismus patients. With 5 years or more of follow-up, IOOA developed in 72% of congenital esotropes (CETs), 34% of accommodative esotropes (AETs), and 32% of intermittent exotropes (X[T]s) at an average age of 3.6, 5.2, and 5.2 years, respectively. Incidence of IOOA was positively related to the number of horizontal surgeries in CETs but not in AETs or X(T)s. Incidence was not related to age of onset of strabismus, time from onset of strabismus to surgery, age at first surgery, or decompensation of ocular alignment. Mild IOOA did revert to normal in 12 patients after only horizontal surgery. The association of IOOA with dissociated vertical deviation, as well as symmetry, range of age of detection, and recurrence after surgery are also explored. PMID- 2771363 TI - Magnetic resonance imaging versus computed tomography of leukocoric eyes and use of in vitro proton magnetic resonance spectroscopy of retinoblastoma. AB - To evaluate the usefulness of magnetic resonance imaging (MRI) in the evaluation of leukocoric eyes, the authors studied 28 patients with either leukocoria or intraocular mass with a 1.5-tesla (T) MRI imager. Retinoblastomas were reliably distinguished from Coats' disease, toxocariasis, and persistent hyperplastic primary vitreous on the basis of MRI findings. Calcification cannot be reliably detected on MRI scans. Lesions elevated less than 4 mm may not be detected reliably by MRI at this time. Computed tomography (CT) can detect calcification with a high degree of accuracy. Retinoblastomas appeared as moderately hyperintense masses on T1- and proton-weighted MRIs. They became hypointense in T2-weighted MRIs. This MRI characteristic is similar to that of uveal melanoma. Intraocular calcification in children especially younger than 3 years of age is highly suggestive of retinoblastoma. In the diagnosis of retinoblastoma, MRI is not as specific as CT because of its lack of sensitivity in detecting calcification. However, MRI, because of its superior contrast resolution, offers more information in the differentiation of pathologic intraocular conditions responsible for leukocoria. The authors also describe their preliminary work of in vitro proton magnetic resonance spectroscopy of eyes with retinoblastoma and an eye with uveal melanoma in an 18-year-old black woman. PMID- 2771364 TI - Conjunctival melanocytic lesions in children. AB - Seventy-one conjunctival melanocytic proliferations in patients 20 years of age or younger were examined. Sixty-five (91.5%) were nevi; there were three cases (4.2%) of racial or acquired melanosis, and three patients were identified who had malignant melanoma of the conjunctiva. The melanoma patients are presented in detail, and additional cases of conjunctival melanoma in children and adolescents reported in the literature are reviewed to determine factors that might influence prognosis. The number of cases is so small, however, that factors cannot be identified with confidence. Follow-up data are presented. Conjunctival nevi are relatively common in children, and appear to carry no risk for the development of melanoma during childhood. However, -conjunctival melanomas do occur rarely in children and have a variable prognosis. PMID- 2771365 TI - Peripunctal melanocytic nevi. Distinctive clinical findings and differential diagnosis. AB - A peripunctal nevus is a rare lesion of the eyelid margin, six examples of which are included in this report. The lesions all involved the lower punctum and had been present for many years without producing epiphora. In addition to their variable clinical pigmentation and translucent appearance on biomicroscopy, all shared several other diagnostically useful clinical features: an overall dome shape with a fine micronodularity; a prominent ramifying vascularity; and, most importantly, circumferentially swollen punctal lips that created a slit-like punctal orifice. Histopathologically, the lesions were predominantly or exclusively subepithelial melanocytic nevi and were demonstrated not to compress the punctum or canaliculus. Infiltration of the nevus cells within the orbicularis striated muscle fibers was a common finding owing to the latter's superficial location in the eyelids. If patients request excision for cosmetic reasons, these lesions are best managed by a horizontal circular shave excision with the temporary placement of a silicon punctual plug. The differential diagnosis includes cyst, papilloma, melanoma, and basal cell carcinoma. PMID- 2771366 TI - Metastatic melanoma within and to the conjunctiva. AB - Two patients with epibulbar juxtalimbal primary conjunctival melanomas experienced local intralymphatic metastases to the inferior cul-de-sac, and a hematogenous metastasis to the conjunctiva developed in five other patients with cutaneous melanomas. Whether reflective of a local or distant metastasis, all of the lesions histopathologically were located in the substantia propria, and were separated from the overlying epithelium by a thin mantle of collagen. There was no evidence of atypical intraepithelial melanocytic proliferation, as would be expected in association with a primary conjunctival melanoma. Two of the cutaneous metastases exhibited a binodular or multinodular appearance that correlated histopathologically with variably confluent micronodules suggestive of the origin of the clinical lesion from a shower of tumor cell emboli. Patients with local intralymphatic spread from a primary conjunctival melanoma may experience additional lesions in the conjunctival sac or eyelid skin and are at risk for regional or distant metastases. They should be examined closely several times a year. The patients with the distant metastases all had their previously diagnosed primary cutaneous tumors on the truncal skin (a similar tendency emerges from a review of previous ocular cases), typically had myriad other cutaneous lesions, and two of them had a neoplastic iridocyclitis and vitreitis. These patients tended to die of the disseminated tumors within 1 year after conjunctival metastases developed. PMID- 2771367 TI - Cryosectional observations of functional anatomy of the temporomandibular joint. AB - The anatomy and function of the temporomandibular joint are complex, and our understanding about how the retrocondylar tissues change when the condyle translates anteriorly has been incomplete. We therefore examined the sectional anatomy of 24 fresh human temporomandibular joints at different gradations of jaw opening, protrusion, and laterotrusion. We found that the tissues of the posterior disk attachment expanded in volume and occupied the space behind the condyle when the mouth was opened, protruded, or laterotruded to the contralateral side. Volumetric expansion of the tissue seemed to be due mainly to distension of the venous structures in the retrodiskal area. In the lateral region of the joint, tissue from the superior aspect of the parotid gland also seemed to contribute to the filling of the space posterior to the condyle. Thus, the retrodiskal tissue appears to have a substantial capacity to expand and fill the mandibular fossa when the condyle translates anteriorly. The possibility of a dynamic vascular physiology is suggested. PMID- 2771368 TI - Talisman in the orofacial region. AB - Among the various traditional beliefs and practices of the peoples of the Southeast Asia region is the practice of inserting talismans under the skin in various parts of the human body. In the orofacial region, these talismans (also called charm needles or charm pins) are also seen, usually as incidental radiographic findings. These talismans are believed to enhance the beauty of the wearers, as well as to provide protection to the wearers against harm. It is also believed that they could help the wearer obtain favorable business deals inasmuch as they are believed to have a "spell-like" influence on the business counterparts. In the present series, 67% of the patients are female and 66% of them are Muslim. Very little is known about the possible ill effects of these talismans because there is no report of these radiographic findings in major dental journals. In the present series of 12 cases representing a total of 65 talismans, only one talisman was surgically removed. We believe that generally no definitive treatment is required. However, we believe that the existence of these talismans should be made known so that they will not be misdiagnosed and mismanaged. PMID- 2771369 TI - Trends in temporomandibular joint surgery: economic implications and complications. AB - A 5-year retrospective study of 103 patient records was undertaken. It analyzed the trend toward outpatient surgical management of patients requiring temporomandibular joint arthroplasties and determined the relative economic value and complication rate associated with this trend. Complication rates were not significantly different during the 5-year study interval, and comparative costs to the patient showed a 26% reduction for the 5-year interval. PMID- 2771370 TI - The psychological and behavioral considerations of orthognathic surgery on identical (monozygotic) twins. AB - The psychologic and behavioral changes that may occur with the impact of orthognathic surgery on the physical appearance of an identical twin set have been addressed. This unique situation has not been discussed in the literature with respect to reconstructive or cosmetic facial surgery. A report on elective orthognathic surgery performed on identical twins and the subsequent impact on the twin relationship due to alterations of "self-image phenomenon" is given. Such an impact was a consideration in this case. Further collective study in this area is needed but is difficult to obtain because of the rarity of occurrence of this type of case. PMID- 2771371 TI - Clinical implications of factor XII deficiency. AB - A patient with known factor XII deficiency underwent extraction of four impacted third molars. Significant preoperative laboratory values included a partial thromboplastin time (PTT) of greater than 100 seconds and a factor XII level of less than 1%. The third molars were removed without any significant intraoperative or postoperative bleeding. Factor XII not only has an important function in the initiation of the intrinsic pathway of the coagulation cascade, but it also plays a significant role in complement activation, kinin generation, and fibrinolysis. It would seem that a deficiency in this factor would have widespread clinical implications. In fact, the only clinical significance seems to be a predisposition to thromboembolism in factor XII deficient patients. PMID- 2771372 TI - Persistent foramen of Huschke: possible risk factor for otologic complications after arthroscopy of the temporomandibular joint. AB - Several cases of otologic injury after arthroscopy of the TMJ have been reported. This study describes the persistent foramen of Huschke, an area of incomplete ossification of the tympanic plate of the temporal bone present in some persons. The presence of this foramen may render middle and inner ear structures vulnerable to injury during arthroscopy of the TMJ. PMID- 2771373 TI - The soft laser: therapeutic tool or popular placebo? PMID- 2771374 TI - Effects of chlorhexidine mouthrinse on oral health in patients with acute leukemia. AB - The effects of chlorhexidine mouthrinses, used as a supplement to mechanical oral hygiene measures, were studied in patients receiving treatment for acute leukemia. Twenty-eight patients were randomly divided into two groups. During two periods, when the patients were taking medication for the leukemia, one group rinsed with a 0.2% chlorhexidine solution twice daily and the other group did not. Chlorhexidine had no effects of any clinical significance on parameters such as number of days with fever, number of oral lesions, plaque score, gingival bleeding score, or occurrence of candidiasis. There was, however, an increased number of patients who had a burning sensation in the mouth, and a tendency toward increased numbers of salivary enterococci, enterobacteria, and/or Pseudomonas in patients who rinsed with chlorhexidine. The results of the present study do not support the use of chlorhexidine mouthrinses in patients who are able to maintain good oral hygiene by mechanical means during their illness. PMID- 2771375 TI - Simultaneous occurrence of a congenital lateral upper lip sinus and congenital gingival cyst: a case report and discussion of pathogenesis. AB - The simultaneous occurrence of a congenital lateral sinus of the upper lip and of a congenital gingival cyst in a newborn boy is reported. The sinus extended to a depth of 10 mm and was lined by a parakeratinized squamous epithelium. The gingival cyst appeared as a 1 cm palatal enlargement lingual to the maxillary alveolar ridge and demonstrated a thin epithelial lining with localized plaquelike thickenings and occasional clear cells with vacuolated cytoplasm. There was no familial history of congenital deformities, and no additional abnormalities were noted. These two epithelium-lined structures show a clear topographic and morphologic relationship, and they may share a common embryologic origin. It is suggested that they derive from epithelium remaining subsequent to the union of the maxillary process and medial nasal process mesoderms. PMID- 2771376 TI - Apicoectomy with retrograde gutta-percha root filling. AB - Sixty-four teeth were treated by means of apicoectomy with retrograde gutta percha filling with the use of new instruments that we devised. The new instruments consisted of a biangle explorer, angle reamers, and angle files. Operations with this technique showed a success rate of 95.3% (61/64 teeth). We conclude that our technique for apicoectomy with retrograde gutta-percha filling is not only simple in procedure, but also shows excellent results. PMID- 2771377 TI - Endomethasone root canal filling material in the mandibular canal. A case report. PMID- 2771378 TI - Electronic thermography of normal facial structures: a pilot study. AB - New electronic thermographic instruments capable of routine clinical examination need to be evaluated for their potential as a diagnostic aid in dentistry. This study assessed thermal symmetry of the face and neck in 20 normal subjects with the use of frontal and lateral views, at 1.0 degree C and 0.5 degree C sensitivity, under controlled conditions. Electronic thermographic images were analyzed for thermal symmetry, by means of a grid matching technique, in 12 anatomic regions and the overall face. Results indicated that thermal symmetry for the entire face was high (70.2%). The 12 specific facial areas demonstrated varying levels of thermal symmetry. Regions of high symmetry on frontal projections included the anterior portion of the neck (82.0%), the TMJ (80.0%), the lower lip (78.6%), and the upper lip (77.3%). The temporal region (46.7%) was found to be of relatively low thermal symmetry. Regions of high symmetry on lateral projections included the nasal region (69.5%) and the inframandibular region (67.0%). The posterior neck region (44.2%) was found to be of relatively low thermal symmetry. In general, normal subjects demonstrated high levels of thermal symmetry over most regions of the face. This pilot investigation is an early step in the evaluation of electronic thermography for future use in dentistry. PMID- 2771379 TI - Temporomandibular joint comparative imaging: diagnostic efficacy of arthroscopy compared to tomography and arthrography. AB - This comparative imaging study of the TMJ was conducted to examine the diagnostic data obtained from arthroscopy as compared to data from tomography and arthrography. Six joints from cadaver material were imaged by each technique and subsequently dissected. Each technique had value, but none was comprehensive. Tomography was the technique of choice for imaging osseous changes. Double joint space arthrotomography was useful for examining articular disk position and morphology. Diagnostic arthroscopy, through direct visualization of surface morphology, showed localized surface pathosis, such as synovitis; provided data on the location and size of disk perforations; and contributed reliably to a diagnosis of disk displacement on the basis of associated pathosis such as stretching of the posterior attachment. PMID- 2771380 TI - The appearance of mental foramina on panoramic radiographs. I. Evaluation of patients. AB - The appearance of the mental foramen on panoramic radiographs can be classified as a continuous, separated, diffuse, or unidentified type. In a sample of 297 patients, the most frequent appearance was separated (43%), followed by diffuse (24%), continuous (21%), and unidentified (12%). There were no significant differences in foramen diameter or relative vertical position within foramen types or developmental stages of the dentition. It is strongly suspected that sometimes the radiographic landmark presumed to be the mental foramen may actually be the reappearance of the mental canal. PMID- 2771381 TI - Signs without symptoms. PMID- 2771382 TI - Stereoscopic dental radiography: a practical dental office procedure (technique tip). PMID- 2771383 TI - Evaluating the appropriateness of care: a study of cesarean section rates. AB - The Maryland Hospital Associations Quality Indicator Project was initiated in 1987 to evaluate ten inpatient care outcome indicators. One of these indicators, cesarean sections, has been a primary focus of the project's efforts thus far. Data on 270 C-sections performed in six Maryland hospitals were gathered and analyzed by a committee that included expert clinicians and representatives from medical societies. A protocol for C-sections was then developed listing the elements that required documentation in the records of patients having C sections. For monitoring purposes, the protocol was converted into a data collection and evaluation form that was subsequently tested for its validity and practical value. The pilot test showed that the form was a viable tool for collecting information and that the direction and magnitude of association between data elements was as expected. PMID- 2771384 TI - [The role of alkaline secretion of the duodenal mucosa in protecting the mucosa from hydrochloric acid]. AB - In animal experiments, an in vivo comparison was made of the alkaline secretion (AS) of the duodenal mucosa and of its ability to defend against hydrochloric acid. An i.v. infusion of NaHCO3 and glucagon was applied to stimulate AS, and one of NH4Cl, vasopressin and furosemide to depress it. In the stage of AS influenced via various mechanisms and to different extents, the luminal surface of the duodenum was exposed with HCl. The extent of mucosal damage was determined by quantitative morphometry. The mucosa-damaging effect of standardized HCl exposure was significantly lower in the stage of enhanced AS than in the control experiments. In contrast, during inhibition of AS hydrochloric acid caused more extensive and deeper mucosal damage. A linear correlation was observed between the degree of AS of the duodenum and the proportion of damaged intestinal villi. In the opinion of the authors, inhibition of the As of the duodenum is accompanied by a decreased acid tolerance of the mucosa, while its stimulation enhances the ability of the mucosa to defend against hydrochloric acid. PMID- 2771385 TI - [A letter to my clinician colleagues]. PMID- 2771386 TI - [Serum lipids and lipoproteins as cardiovascular risk factors in infants and children]. PMID- 2771387 TI - [The measles virus is not teratogenic]. PMID- 2771388 TI - [Progressive cardiomyopathic lentiginosis (Leopard syndrome, Moynahan syndrome)]. AB - In connection of a sporadic and three familary cases a syndrome involving the skin, heart, eyes, bone-system, hearing organs and genitales is presented. As leading sign of the syndrome, profuse lentigiosis is held to be. Based on this finding, involvement of the other organs may occur too. Specialty of our cases is Marfan-syndrome associated with Leopard syndrome, and blood-vessel anomaly as a new alteration. PMID- 2771390 TI - [Insertion of a gliding prosthesis of Hungarian manufacture, without the use of adhesives]. AB - The author report on the first implantations of gliding prosthesis performed without sticking in Hungary. Gliding prostheses of Hungarian product were used. Thirty operations have been carried out so far. The technique and results will be discussed in a later publication on the basis of higher number of cases. PMID- 2771389 TI - [Continuous respiratory therapy of newborn and premature infants with respiratory disorders]. AB - 2216 newborns and prematures with respiratory distress of different underlying diseases were treated with long term respiratory therapy from 1. Jan. 1975 to 31. Dec. 1985. One part of the patients were born in our hospital, the other part of them were transported from outside. The rate of prematures was 81.2%. The respiratory therapy was applied in 1813 cases because of pulmonary diseases (group 1.), while in 403 cases the respiratory troubles were extrapulmonary in origin (group 2.). The diseases in the first group were as follows: hyaline membrane disease in 482 cases (27.30%), intrauterine pneumonia in 634 cases (34.64%), postnatal pneumonia in 291 cases (15.90%), meconium aspiration syndrome in 110 cases (6.01%), severe RDS-II in 158 cases (8.63%), pulmonary immaturity in 116 cases (6.35%), persistent fetal circulation in 21 cases (1.15%) and pulmonary aplasia on the left in 1 case (0.021%). In the second group the greatest part of the cases were treated for neurological disturbances. We discuss the indications of different types of respiratory therapy and the complications as well. The survival rate was in the first group 59.3%, while in the second only 16.9%. Therefore the respiratory therapy seems to be more effective in the pulmonary diseases of the newborns. The mortality rate and the rate of severe complications were lower among inborn babies because of the early application of the respiratory therapy. PMID- 2771391 TI - [Endocrine loading tests in familial testicular feminization]. AB - The case of 2 children in a family suffering from testicular feminisation of X linked recessive inheritance, with 46 XY karyotypes, feminine constitution and external genital organs, rudimentary vaginal stump as well as the absence of uterus and tube is described. The histology of the testicles in the labium majus, hormone examinations and the results of choriogonin and testosterone loading are presented. The cases displayed total androgenic insensitiveness. PMID- 2771392 TI - [Value of Doppler echocardiography in the indications for correction of tricuspid valve insufficiency in the course of mitral valve implantation]. AB - To assess the postoperative reversibility of functional tricuspid regurgitation (FTR) and its relation to preoperative pulmonary artery systolic pressure (PASP) 103 patients were studied by Doppler echocardiography (DE) in whom at the time of mitral valve replacement the correction of the FTR was not considered to be necessary by the surgeon. Moderate or severe FTR was found in 36% of patients preoperatively, and it diminished or disappeared early after operation if the preoperative PASP was more than 60 mmHg, while the improvement of FTR was found only in the half of patients with PASP less than 60 mmHg. Persistent FTR was still unchanged in 7 of 10 patients at 1 year follow-up. It is concluded that DE should be performed prior to mitral valve replacement and severe FTR found by DE should be surgically treated even in case of negative surgical findings if the PASP is less than 60 mmHg. PMID- 2771393 TI - [Increased androgen-binding capacity and decreased free androgen index in male alcoholics with liver disease]. AB - Androgen binding capacity in the serum of 30 male patients under 51 years of age suffering from chronic alcoholic liver disease was investigated with tritiated 5 alpha-dihydrotestosterone. The result received by saturation analysis is regarded as an indicator of the SHBG (sex hormone binding globulin) content of the blood. Testosterone was measured simultaneously and the free androgen index (FAI) was calculated. The diagnosis of liver disease was based on case histories, physical symptoms and laboratory abnormalities, in some cases on liver biopsy too. Age matched control group consisted of 18 healthy males. The results showed markedly elevated androgen binding capacities (SHBG contents), testosterone values in the normal range and significantly decreased FAI, indicating insufficient amounts of biologically active testosterone. PMID- 2771394 TI - [Fatal septum pellucidum cyst]. AB - Case history of a patient with cysta septi pellucidi is described. Pathomechanism of the symptoms and that of the fatal outcome is curtly analysed. It is stated that communicating cysta may become non-communicating one and vice versa, so in case of a known cysta when neurologic symptoms appear, causal role of it has to be considered. PMID- 2771395 TI - [Malignant degeneration of partial hydatidiform mole pregnancy]. PMID- 2771396 TI - [Neurologic tests in children having recovered from leukemia]. AB - 56 long-term survivors of childhood ALL have been investigated with CT and neuro psychological methods. At the CT examination we found that 45.4% of the cured patients had alterations. Short-term memory, attention, visual-motor coordination and IQ were found to be slightly impaired in this group. Nevertheless they didn't influence the social integration and educational achievement of long-term survivors of ALL. PMID- 2771397 TI - [Deformities, caused by premature ossification of the cranial sutures, and their treatment]. AB - The establishment of the Hungarian cranio-facial surgical team is reported on and the activity sphere of this special field is described. The consequences of early ossification of the cranial sutures as well as the therapeutical possibilities are dealt with. Brief review is given on the development of cranio-facial surgery. The age, diagnosis and interventions performed with the patients in 1987 are summarized in a table. PMID- 2771398 TI - [Follow-up of cases of diabetes mellitus existing over 25 years]. AB - The life prospects of patients grew parallel with the improving possibilities of the treatment of diabetes mellitus. In 36 insulin-treated patients with diabetes existing longer than 25 years, obesity, smoking and alcohol consumption were infrequent, microangiopathic complications were moderate and displayed protracted course. Lability of carbon hydrate metabolism does not characterize the long lasting diabetes. Higher insulin requirement was found only with patients whose sulphonylurea resistance made later necessary the insulin therapy. Organic manifestations of macroangiopathy, hypertension and hypercholesterinemia were often observed. Two patients remained free of complications even after 28- and 31 years long diabetes. Long-term insulin dependent or after oral administration insulin treated diabetes mellitus continuing even in old age is a relatively benign slowly progressing disease. PMID- 2771399 TI - [A new method for treating ectopic pregnancy with methotrexate]. AB - Due to diagnostic methods of the last decades, such as laparoscopy, ultrasonography and radioimmunoassays, early diagnosis of pregnancy and also of ectopic pregnancy became available. Management of ectopic pregnancy has been conservative tubal surgery so far. Local Methotrexate treatment of ectopic pregnancy was reported only recently. The authors treated successfully two cases of ectopic tubal pregnancy with locally administered 50 mg Methotrexate. One of the tubal pregnancies occurred after IVF, and the other one following GIFT. After local Methotrexate treatment both patients are without any complaints or symptoms. This new method in the treatment of early diagnosed ectopic pregnancy is emphasized and prosed. PMID- 2771400 TI - [Limitations and possibilities of detecting lung cancer by fluoroscopic screening of the population]. AB - In 10th district of Budapest a longitudinal, epidemiological examination was started in 1975 with the aim of analysis of the objective factors influencing the population screening and determination of possibilities of screening effectiveness. It was found that effectiveness of lung cancer detection with screening depends on the tumour cell-type, as well as on the localization being in connection with same. By computer method based on mathematical modelling the population can be divided into the following groups: risk-free, moderate-risk, high-risk and superhigh risk groups. The screening was said to be absolutely unnecessary in risk free groups and in case of persons over the age of 70 irrespective of their risk factor status. The material savings resulting from the reduction of screenings can be assigned to introduction of complex methods. The switch-over from quantitative screening to the qualitative one can increase the effectiveness of lung cancer detection. PMID- 2771401 TI - [How often and for what symptoms would parents consult child heath services?]. AB - Author prepared and processed 1500 computerised questionnaires in which primary school children' parents were asked about their knowledge of symptoms of children diseases and habits: "how to consult with physicians". The questionnaire was divided 3 parts: in the first one general questions and some problem in connection with high temperature, in the second one about symptoms, and in the third group pains were mentioned located in organs and different body-parts of children. The majority of parents accepted these questions and gave good answers and prepared some additional suggestions. Other group of parents having very bad habits relation to symptoms, and "how to consult with doctors and call duty system". Author emphasized the very important role of data processing system for the further health organisation and health education. PMID- 2771402 TI - [Transcranial Doppler sonography, a new non-invasive method for the study of cerebrovascular circulation]. AB - Transcranial Doppler Sonography. Authors publish the experiences gained by 2300 examinations with Transcranial Doppler Sonography (TDS) which is a new, noninvasive ultrasound method to examine cerebral blood flow velocity in the basal arteries. The theoretical ground and the technique of the investigation is detailed. Mean values of blood flow velocity in the middle cerebral artery of 88 healthy volunteers in different age groups are reported. Authors stress on the numerous advantages of the utilization of this technique. Different pathological alterations of blood flow velocity and characteristic types of velocity-pulse figure are accounted. At last illustrative case reports proving the importance of TDS in different pathological states are presented. PMID- 2771403 TI - [Treatment of cervical cancer using the Wertheim-Latzko radical operation at the Gynecology Clinic of Pecs]. AB - The authors performed 119 Wertheim--Latzko operations from July 1, 1975 to December 31, 1988. 108 patients are still alive. The 5 years survival rate of patients operated on before 1984 was 89.8%. Radical hysterectomy involving careful removal of regional lymphnodes was carried out after lymphography and preoperative irradiation. Postoperative irradiation was made on radiologist's indication. Significance of combined surgical and radiotherapy is emphasised in the management of cervical cancer in stages IB and IIA. Surgery is especially important in adenocarcinomas that are less sensitive to irradiation, in cases of large and necrotic tumors with the barrel formation of endocervical cavity and in cases not showing appropriate regression after radiotherapy. Surgical tumor removal appears to be of much value in young patients, in cases of anaplastic tumors in suspicious lymphographic findings, and in those patients, whose recovery may be expected only from operation and supplementary radiotherapy. Very important condition for obtaining good recovery results and low rate of surgical complications are the team of experienced surgeons and organized regional centres for radical hysterectomies. PMID- 2771404 TI - [Surgical management of post-traumatic strictures of the membranous portion of the urethra]. AB - On the basis of the results of invaginational urethroplasty performed in 22 cases because of the stricture of traumatic origin of the pars membranacea urethrae the authors define the field of indication for operation. Certain elements of the operative technique which play a role in achieving good and permanent results are emphasized. PMID- 2771405 TI - [The role of risk factors in the development of lung cancer of various cell types]. AB - Between 1975 and 1978 in 10th district of Budapest a basis examination was carried out with the aim of determination of lung cancer risk factors. Out of the 30,566 inhabitants 403 persons got ill with lung cancer during the above mentioned period. In case of 321 patients the cell type was determined in detail. As to the connection between the main risk factors and the various cell types it was found that planocellular lung cancer can be regarded as the cell type of men, but exclusively of smokers, while the microcellular type lung cancer can be considered as cancer of not only the younger age-groups, but that of expressly women, especially heavy smokers. With elimination of the two main risk factors (smoking, pulmonal lesions) not only the number of patients with lung cancer could be decreased to one third, but the ratio of adenocarcinomic diseases would also increase. These diseases are more favourable in respect of operability and survival. PMID- 2771406 TI - [The world after Lainz--pathways to a better future]. PMID- 2771407 TI - [Not to kill the severely ill but to attend them]. PMID- 2771408 TI - [Attractive hospitals]. PMID- 2771409 TI - Regulation of bcl-2 gene expression in lymphoid cell lines containing normal #18 or t(14;18) chromosomes. AB - The bcl-2 (B cell lymphoma/leukemia-2) gene at band 18q21 is involved in t(14;18) chromosomal translocations in most follicular lymphomas and occasional other human B cell malignancies, where it becomes juxtaposed to the transcriptionally active immunoglobulin (Ig) locus at 14q32. Regulation of bcl-2 gene expression was investigated in neoplastic lymphoid cell lines containing normal #18 chromosomes or a t(14;18) translocation with regard to steady-state mRNA levels, RNA stability, transcription rates, and DNA methylation. High steady-state levels of bcl-2 mRNA, and proportionally high rates of bcl-2 transcription (measured in isolated nuclei), were found in B cell lines containing t(14;18) translocations. The half-life of bcl-2 mRNA (approximately 2-3 hr) was similar in all cell lines examined, including a t(14;18)-containing follicular lymphoma cell line, which has a translocated and rearranged bcl-2 gene that produces bcl-2/Ig fusion transcripts. However, in the presence of cycloheximide (inhibitor of protein synthesis), the half-life of some of the bcl-2/Ig mRNAs produced by these cells was prolonged, indicating that in some circumstances mRNA stability may contribute to deregulated bcl-2 expression. Despite stabilizing some bcl-2 mRNAs, the overall effect of treating cell lines with cycloheximide was a reduction in the levels of accumulated bcl-2 mRNAs through inhibition of bcl-2 gene transcription. These latter data provide indirect evidence that short-lived transacting factor(s) regulate transcription of the human bcl-2 gene in lymphoid cells with or without a t(14;18) translocation. No clear correlation was discovered between bcl-2 gene methylation and transcription. PMID- 2771410 TI - Anatomy for endoscopic sinus surgery. AB - An understanding of the anatomy of the paranasal sinuses is essential for successful endoscopic sinus surgery. The anatomy of the sinuses is carefully described and illustrated. PMID- 2771411 TI - Endoscopic sinus surgery. PMID- 2771412 TI - Office endoscopy--when, why, what, and how. AB - Comprehensive diagnostic nasal endoscopy is a relatively recent advance in the office practice of rhinology. The examination is performed most commonly with 4.0 mm telescopes (0 and 30 degrees) and 2.7-mm telescopes (30 and 70 degrees). Nasal endoscopy provides the rhinologist with unparalleled visualization with brilliant illumination of the nasal cavity which permits more accurate diagnosis of nasal conditions. It also serves as an excellent teaching tool and source of photodocumentation. PMID- 2771413 TI - Radiologic assessment preoperative to endoscopic sinus surgery. AB - At our institution, the screening coronal section CT scan has largely replaced the use of the sinus series for the initial evaluation of patients suspected to have sinus pathology. However, in those patients with obvious mucosal disease on endoscopic examination, the screening coronal section CT scan is bypassed and a complete coronal section CT scan obtained. Axial section CT scans are not routinely obtained and bone windows are consistently selected for viewing. PMID- 2771414 TI - Instruments and equipment for endoscopic sinus surgery. AB - It is the fiberoptic endoscope and its related hardware that distinguish endoscopic sinus surgery from previous techniques. Lens angles of 0, 25, and 70 degrees, comprising a representative telescope set, accommodate virtually any endoscopic sinus procedure, diagnostic or therapeutic, with unsurpassed visualization. Each telescope may be fitted with an optional suction-irrigation adaptor, a highly controversial accessory among endoscopic surgeons. The clinical situation often dictates the optimal combination of equipment, anesthesia, and technique; surgeon's preference is equally influential. Mastery of conventional operative techniques combined with thorough endoscopic skills is essential for consistent, effective, and safe surgical performance. PMID- 2771415 TI - Basic surgical techniques and variations of endoscopic sinus surgery. AB - This article gives complete information on the care of the endoscopic sinus surgery patient. Indications and preoperative evaluations necessary for endoscopic sinus surgery are described. The technique of functional endoscopic sinus surgery is covered in detail. Postoperative care and complications are also described. Various procedures for patients with extensive or unusual disease are discussed. PMID- 2771416 TI - Endoscopic total sphenoethmoidectomy. AB - Endoscopic total sphenoethmoidectomy is a procedure reserved for the patient with extensive paranasal sinus disease. Candidates for this operation should have radiographic evidence of pansinusitis and be refractory to medical and lesser surgical management. Given these criteria, total sphenoethmoidectomy with frontal sinusotomy and antrostomy offers an excellent treatment for this patient population. PMID- 2771417 TI - Pediatric functional endonasal sinus surgery. AB - Functional endoscopic sinus surgery has been used to treat children in whom medical and traditional surgical therapy have failed. Special approaches are necessary in children because of the small size of the paranasal sinuses. Modifications of the techniques used in adults that are appropriate for use in children are fully explained. PMID- 2771418 TI - Lasers and endoscopic rhinologic surgery. AB - Lasers are playing a more important role in rhinologic surgery. A new laser, the KTP/532, provides flexible fibers that can be combined with nasal endoscopes to reach the recesses and spaces of the nasal cavity. It can deal effectively with turbinate dysfunction, bleeding disorders, polyps, and scarring. The author's experience with the use of this laser is described. PMID- 2771419 TI - Complications of endoscopic sinus surgery. AB - Complication rates of intranasal sinus surgery range from 2 per cent to 17 per cent. This range identifies the difference between experienced and inexperienced sinus surgeons. Endoscopic sinus surgeons encounter the same risks as traditional intranasal or external sinus surgeons. New technology demands added training and increased vigilance so that complication rates remain as low as possible. Synechia formation, orbital hematoma, and antrostomy closure are the most common complications. CSF leak with meningitis, double vision, and blindness are the most devastating. Reduction of complication rates begin with prevention, which is achieved through diligent preparation. Careful surgical technique based on both old and new principles combined with compulsive postoperative care are the necessary ingredients needed for safe sinus surgery. PMID- 2771420 TI - The role of standard technique in modern sinus surgery. AB - This article reviews the most commonly performed intranasal and extranasal sinus operations. The indications, complications, and functional results of each are presented. Endoscopic approaches should be used in conjunction with standard techniques in order to supplement and improve the efficiency of standard techniques of sinus surgery. PMID- 2771421 TI - Difficult decisions in endoscopic sinus surgery. AB - Sinus disease, like many other problems in otolaryngology, may run the gamut of being either easily correctable with a clear-cut treatment or completely resistant to any form of treatment. Fortunately, many patients have problems somewhere between these two extremes. Clearly there is no one correct approach for treatment of many problems. Two, three, or even four approaches may be equally effective in some cases. In other cases, one approach may be successful in the hands of one surgeon whereas another approach is more appropriate for a different surgeon. This article presents nine cases that do not have clear-cut solutions. In some, the consultants clearly disagreed, whereas in others there was some uniformity in treatment plans. This flexibility in surgery in general and specifically with a technique that is relatively new is what makes it so exciting and so promising for continued success in treating sinus disease. PMID- 2771422 TI - Revision endoscopic ethmoidectomy for chronic rhinosinusitis. AB - In summary, revision endoscopic surgery for chronic rhinosinusitis can be performed safely by using the middle turbinate (or portion thereof) or the anterior wall of the sphenoid as a landmark. These cases are more difficult and may be more prone to bleeding and scarring. The surgeon should be thoroughly familiar with and not hesitate to switch to conventional techniques in the event of excessive bleeding, proptosis, or a loss of landmarks. Aggressive postoperative care and follow-up, including office endoscopic "touch-up" procedures, may be necessary to maintain control of aggressive disease, along with continued medical management and any indicated immunotherapy. PMID- 2771423 TI - Nonsurgical treatment of sinusitis. AB - Acute infections of the paranasal sinuses is an infrequent complication of viral upper respiratory infections. Prolonged or repeated episodes of acute sinusitis may lead to irreversible changes in the mucosa, resulting in chronic sinusitis. In hospitalized and immunocompromised patients sinusitis may be caused by unusual and resistant bacteria or fungi. Although sinusitis is often considered as merely an annoyance, complications can be associated with significant morbidity and mortality. Therapy of acute sinusitis is often empiric and directed against the most common pathogens. Fungal infections of the sinuses often require surgery as well as amphotericin-B therapy. In hospitalized or immunocompromised patients therapy should be directed at suspected nosocomial pathogens or be based on appropriate culture material. PMID- 2771424 TI - The effect of a temporary nasoantral window on mucociliary clearance. An experimental study. AB - Although many studies have clearly shown that nasoantral windows do not help ciliary clearance of sinus disease, studies have not addressed the possible adverse effects of nasoantral windows. This study was performed to determine if an inferior antrostomy can actually improve ciliary clearance. Even with the advent of endoscopic sinus surgery we need to have a better understanding of inferior antrostomies. PMID- 2771425 TI - The role of endoscopic sinus surgery for the treatment of nasal polyposis. AB - Nasal polyposis remains a significant challenge to the treating physician. The functional endoscopic surgery technique provides a tool by which the clinician can accurately diagnose, meticulously and atraumatically perform surgery, and precisely provide postoperative care and follow-up for patients with nasal polyp disease. PMID- 2771426 TI - Development of metacyclic Leishmania promastigotes is associated with the increasing expression of GP65, the major surface antigen. AB - Using immunofluorescence techniques and flow microfluorometry analysis, we have demonstrated that the binding of a monoclonal antibody (VD5/25) produced against GP65, the major surface antigen of Leishmania braziliensis, increased on the surface of stationary-phase promastigotes from all the New World Leishmania species causing mucocutaneous or cutaneous disease as compared with the log-phase parasites. In addition, a sequential development of Leishmania amazonensis promastigotes from a non-infective to an infective stage was demonstrated. Indeed, promastigotes in the stationary phase (days 6-7) were found to be far more infective than those in the logarithmic phase of growth (day 3) both in vitro for mouse peritoneal macrophages and in vivo for BALB/c mice. The intracellular survival and multiplication of L. amazonensis were significantly inhibited when infective promastigotes were treated with the VD5/25 monoclonal antibody. The increasing expression of GP65 on the promastigote surface may thus contribute to Leishmania infectivity. This seems to represent a characteristic mechanism applicable to all New World Leishmania species studied. PMID- 2771427 TI - In-vitro exoerythrocytic development of Plasmodium cynomolgi bastianellii: inhibitory activity of monoclonal antibodies against sporozoites of different P. cynomolgi strains and of P. knowlesi. AB - The inhibitory effect of anti-sporozoite monoclonal antibodies (MoAb) on the in vitro development of liver stages of Plasmodium cynomolgi bastianellii (NIH strain) was evaluated using primary cultures of rhesus monkey hepatocytes. MoAbs against the circumsporozoite proteins of five strains of P. cynomolgi (NIH, London, Gombak, Ceylon, Berok), and of P. knowlesi (H strain) were used. Incubation of sporozoites of P. cynomolgi bastianellii with the anti-NIH strain MoAbs entirely prevented liver-stage development; MoAbs produced against the other four strains had no apparent activity. The anti-P. knowlesi MoAbs had a partially inhibitory effect on parasite development. These functional studies complement previous immunological studies on P. cynomolgi strain specificity, and confirm the cross-reactivity observed previously between sporozoites of P. cynomolgi bastianellii and P. knowlesi (H strain). PMID- 2771428 TI - Identification of protein components of Echinococcus granulosus protoscolex antigens for specific serodiagnosis of E. granulosus infection in dogs. AB - Proteins of Echinococcus granulosus protoscolex excretory/secretory or deoxycholate solubilized somatic antigens were radiolabelled with 125I and immunoprecipitated with sera from dogs naturally or experimentally infected with E. granulosus and various control dog sera. Analysis of immunoprecipitates was performed using one- and two-dimensional gel electrophoresis to identify antigenic protein components specific for E. granulosus. Using both electrophoretic techniques, a basic component of Mr 27,000 and an acidic component of Mr 94,000 were defined in both excretory/secretory and somatic protoscolex antigens, and were specifically identified by 95% and 62% of 21 sera from E. granulosus-infected dogs, respectively. An abundant component of Mr 35,000 was identified by 100% of these dogs, parts of which were E. granulosus specific. Results of this study should allow identification of specific recombinant antigens for routine serodiagnosis of E. granulosus infection in dogs. PMID- 2771429 TI - [Carbohydrate transport in the cestode Triaenophorus nodulosus]. AB - The data demonstrating the presence of the glucose active transport system in the cestode T. nodulosus are obtained. Kinetic characteristics of the transport are estimated and their dependence on the incubation temperature are shown. Heterogeneity of the worm body in respect to transport processes and their dependence on the physiological state of cestodes are discovered. The absorption of different forms of glucose is studied and the similarity of digestion processes in parasites and their hosts is shown. PMID- 2771430 TI - [The biology of the trematode Echinochasmus milvi under the southern conditions of the Far East]. AB - The biology of the trematode Echinochasmus milvi Yamaguti, 1939 under the conditions of the southern Far East of the USSR is studied. The development of the trematode proceeds with the participation of intermediate hosts, molluscs of the genus Juga, additional hosts, freshwater fishes, and definitive hosts, fish eating birds and mammals, and is completed at a temperature of 17 to 23 degrees within 21 weeks. PMID- 2771432 TI - [Pellucidhaptor fidus n. sp. (Monogenea, Dactylogyridae) from the lake minnow Phoxinus percnurus from the Anadyr River basin]. PMID- 2771431 TI - [The unique nature of the formation of parasitic fish fauna in the reservoirs of the Daugava River]. AB - The formation of parasite fauna of fishes from water reservoirs of the Daugava differs from that of plain type water reservoirs of the moderate zone. Instead of expected flourishing of limnophilic elements an intense, increasing with years impoverishment of the specific composition of nearly all systematic groups of fish parasites is observed in the studied reservoirs. The impoverishment of the parasite fauna in the water reservoirs is associated first of all with their relatively small sizes, frequent and strong fluctuations of the water level and repeated dryings of large bottom areas. The investigations show that such a picture of fish parasite fauna genesis is observed in all relatively small water reservoirs with frequent and strong fluctuations of water level. PMID- 2771433 TI - [Cestode lysosomes]. AB - By differential centrifugation method a lysosomal fraction was obtained from five species of cestodes, which possesses the highest specific activity of acidic phosphatases as compared to other subcellular fractions. By isopyknic centrifugation in the density gradient of saccharose the lysosomal fraction is divided into primary and secondary lysosomes. Lysosomes of cestodes are similar to those of vertebrate animals in the character of fractional distribution of acidic phosphatase, sedimentation abilities and sensitivity of membranes to triton X-100. PMID- 2771434 TI - [Correlation of the relative population count of ixodid ticks with various recording methods]. AB - Data are given on the relative abundance ratio of 3 species of ixodid ticks obtained by different counting methods. PMID- 2771435 TI - [Parasitism of the louse fly Lipoptena fortisetosa on cattle]. AB - Parasitism of Lipoptena fortisetosa Maa on cattle was first established. Data on the distribution of this species in the USSR and its abundance on cows in Moldavia are given. PMID- 2771436 TI - Displaced dorsal coronal fracture of the hamate. AB - A displaced dorsal coronal fracture of the hamate occurred in a 29-year-old man. A case report of this extremely rare entity and a review of the literature are presented. PMID- 2771437 TI - Irreducible fracture of the proximal tibial physis in an adolescent. AB - Fracture of the proximal tibial physis is a rare injury. This paper reports an unusual case of a 13-year-old boy who sustained a displaced Salter II proximal tibial fracture. Closed reduction could not be achieved. An open reduction revealed interposed periosteum in the fracture site. PMID- 2771438 TI - The use of epidural bupivacaine following total knee arthroplasty. AB - Pain relief and maximization of knee joint range of motion (ROM) are the two major goals in the postoperative management of the total knee arthroplasty (TKA) patient. Epidural bupivacaine infusions have been reported to be safe and effective for pain control in obstetric anesthesia, chronic pain management, and postoperative pain relief. The purpose of this study was to evaluate the effect of continuous epidural bupivacaine on postoperative pain and progressive knee ROM as well as to record the incidence of urinary retention and other side effects or complications. Continuous epidural bupivacaine infusion was found to provide safe, effective analgesia for TKA patients in the immediate postoperative period. Excellent pain relief with reduced narcotic requirements was observed in the patients as compared to intramuscular narcotic analgesia. No complications occurred and serum bupivacaine levels remained well below toxic levels. Short term clinical orthopaedic outcome was improved, and patient, surgeon, and nurse acceptance of the technique was excellent. PMID- 2771439 TI - Pediatric update #9. Revision surgery in congenital dislocation of the hip. AB - Of 759 dislocated hips operated on in our department, 667 received their primary treatment in our hands, while 92 were revised by us after failure of primary surgery. In 71 hips, reconstructive operations were possible, whereas in 21, the joint was destroyed beyond any possibility of repair and a total hip replacement was performed. The reconstructive operations included 16 reopen reductions, five Colonna arthroplasties, six varization derotations, four open reductions and derotations, two valgization osteotomies, and 38 combined procedures. The latter included a shortening varization derotation osteotomy with an open reduction and a Chiari osteotomy of the pelvis. All the revised cases were improved in comparison with their functional status prior to revision. Of the 71 reconstructed joints, the result was good in 59. In the remaining 12, function was improved as compared with the preoperative status, but a total hip replacement will most probably be required in the future. Revision surgery after failure of previous operations for congenital dislocation of the hip can always improve function, but can rarely result in a normal joint. Primary operations should be performed with maximum caution, and it is certainly better to leave limping pain-free children alone than to transform them into limping children in pain. PMID- 2771440 TI - Imaging rounds #100. Congenital dislocation of the radial head. PMID- 2771441 TI - Tips of the trade #15. Removal of hardware prior to total hip replacement. AB - Since the introduction of metals into orthopaedic surgery over a hundred years ago, patients often present with a wide variety of hardware in their bones. Normally this is of little significance, but if the hardware is in the proximal femur and the hip is arthritic, then the metal must be removed before hip replacement can commence. This paper presents a series of guidelines to be used in such cases. PMID- 2771442 TI - Waste management. PMID- 2771443 TI - Carpal tunnel syndrome. PMID- 2771444 TI - Human host selection by anophelines: no evidence for preferential selection of malaria or microfilariae-infected individuals in a hyperendemic area. AB - Host selection among humans by Anopheles punctulatus was studied in an area of Papua New Guinea endemic for malaria and filariasis. Blood films were made from the stomach contents of freshly engorged mosquitoes found resting on the walls of houses in which the parasite status of the occupants was known. Engorgement rates on humans were non-random but could not be consistently related to the parasite status of individuals in the houses for either malaria or filaria. In some households, anophelines preferentially fed on parasitaemic individuals while in other households aparasitaemic individuals were significantly more often selected. This finding is believed to reflect the fact that malaria and filarial infections in this endemic area are predominantly asymptomatic. There were no significant differences in axillary temperatures between malaria or microfilariae positive or negative individuals. PMID- 2771445 TI - The sex ratio of Plasmodium gametocytes. AB - Sex ratio theory usually predicts an equilibrium sex ratio and equal proportions of males and females in a population, including the progenitors of the reproductive cells of protozoans. This proposal was tested with three species of malarial parasites of lizards, Plasmodium mexicanum of the western fence lizard, and P. agamae and P. giganteum of the African rainbow lizard, using single samples from naturally infected lizards, repeated samples from free-ranging lizards (P. mexicanum only), and repeated samples from laboratory maintained animals. Macrogametocytes were usually more abundant than microgametocytes, and were slightly larger, revealing a typically greater investment of resources by the progenitors of female reproductive cells. However, the proportion of microgametocytes varied among the three species and among infections within each species of Plasmodium. The sex ratio of gametocytes often remained constant within infections followed over time even if the absolute number of gametocytes was changing. However, the equilibrium sex ratio of gametocytes varied among those infections that had an unchanging microgametocyte proportion. Thus, although an equilibrium sex ratio apparently occurs for most infections, there appears to be no characteristic proportion of microgametocytes for any of the species. Potential explanations for this conflict with theory are presented. PMID- 2771446 TI - Transport processes of 2-deoxy-D-glucose in erythrocytes infected with Plasmodium yoelii, a rodent malaria parasite. AB - The transport processes of D-glucose in Plasmodium yoelii-infected mouse erythrocytes were investigated using 2-deoxy-D-glucose (2DOG), a non metabolizable analogue of D-glucose. Infected cells showed an increase in the uptake of 2DOG compared to uninfected controls, and an effect which was more prominent in cells with mature-stage parasites. Kinetic studies measuring the initial rates of 2DOG uptake revealed two components in infected cells with late trophozoite and schizont-stage parasites: a simple diffusion system and a carrier (transporter)-mediated system. The transporter was common for D-glucose and 2DOG and had a kinetic constant indicating a high affinity for 2DOG (the Km = 0.18 mM and the Vmax = 0.61 mmol/10(10) cells/min), as compared to the constant of the mouse erythrocyte carrier (the Km = 10 mM and the Vmax = 1.8 mmol/10(10) cells/min). Determination of the distribution of [3H]2DOG in infected cells and experiments with metabolic inhibitors indicated that the simple diffusion system localizes in the membrane of host cells and the transporter in the parasite plasma membrane. The parasite glucose transporter was much less sensitive to cytochalasin B than that of the host cells and the uptake of 2DOG via the transporter was dependent on energy. Based on these findings, the following features emerge: D-glucose first gains access to the cytosol of infected erythrocytes via the simple diffusion system, which appears after infection by the parasite, and an active uptake against the concentration gradient takes place at the parasite plasma membrane via the parasite glucose transporter in an energy dependent manner.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2771447 TI - Aerobic to anaerobic transition in the carbohydrate metabolism of Schistosoma mansoni cercariae during transformation in vitro. AB - Schistosoma mansoni cercariae in water were shown to possess a largely aerobic energy metabolism, the Krebs cycle being the main terminal of carbohydrate breakdown. A metabolic transition towards a more anaerobic breakdown of carbohydrate could be achieved by incubation conditions which also stimulated biological transformation. Incubation of cercariae in a simple salt medium containing 5 mM glucose induced such a metabolic transition: beside carbon dioxide large amounts of lactate and pyruvate were excreted. The results indicate that the production of pyruvate was coupled to electron transfer in the respiratory chain. Some aspects of this unusual pyruvate production are discussed. The observed change in the end-product pattern of carbohydrate breakdown is very rapid: most of the switch occurred within 2 h. Our results show that the metabolic transition was triggered by the biological transformation itself, or by the same event that induces the biological transformation. The metabolic and the biological changes proceeded synchronously. PMID- 2771448 TI - Models to assess the potential of Capillaria hepatica to control population outbreaks of house mice. AB - Population outbreaks of house mice (Mus domesticus) occur periodically in the wheatlands of southeastern Australia. This paper uses mathematical models to assist in the evaluation of the potential of a nematode, Capillaria hepatica, as a biological control agent to reduce the severity of these 'plagues'. C. hepatica is unique amongst helminths of mammals in that its eggs are released only upon the death of an infected host. The major goal of the modelling in this paper is to determine the impact of this feature on the population dynamics of the host parasite interaction. Simple differential equation models are used to examine the general properties of the system and determine which population parameters are most crucial to the outcome of the interaction. These models are supplemented by age-structured models which investigate the initial behaviour of the system after introduction of the parasite. The necessity of host death for transmission is a strongly destabilizing factor, suggesting that C. hepatica cannot regulate most populations stably in the absence of strong resource limitation, although it has the potential to depress mouse populations below infection-free levels. Although C. hepatica influences mouse fecundity at lower burdens than it affects mortality, the age-structured models show that parasite-induced host death cannot be neglected. Because transmission requires host death, the parasite life-cycle operates on a time-scale similar to that of the hosts, and introduction of the parasite as early as possible in the development period of an outbreak will therefore be necessary to achieve substantial reductions in plague intensity. PMID- 2771449 TI - Diversity patterns in helminth communities in common gulls, Larus canus. AB - The parameters of species richness, abundance and diversity of the intestinal helminth infracommunities of a sample of 269 Common gulls, Larus canus, were examined over one season at Agdenes, Norway. The communities developed rapidly in unfledged gulls and the diversity parameters were of similar magnitude in immature and adult birds. All parameters were low in the early part of the season, reached maxima in June or July and fluctuated erratically or declined thereafter. Comparison of summary parameters with those from other species of gulls indicated that helminth community diversity in Common gulls is fairly typical of gulls in general. in gulls as a group, helminth communities show common features of high species richness, low abundance, few or no core species and a number of species that occur rarely and in low numbers. Expectations of particularly high parasite community diversity were not fully realised because species lists and diversity of the component community are not a very good basis for predicting diversity at the infracommunity level. PMID- 2771450 TI - Availability of caecal habitat as a density-dependent limit on survivorship of Leptorhynchoides thecatus in green sunfish, Lepomis cyanellus. AB - Distribution of Leptorhynchoides thecatus (Acanthocephala: Rhadinorhynchidae) among the pyloric caeca and the relationship between site and rate of maturation were studied in laboratory infections of 10, 25 and 40 cystacanths fed to green sunfish, Lepomis cyanellus. After 1 week fish fed at each intensity had significantly different numbers of worms. By the 3rd week post-infection, parasites disappeared from the anterior portion of the intestine. At this time the mean numbers of worms recovered from 25 and 40-cystacanth infections were not significantly different. At the end of the 1st week, the area where caeca join the alimentary tract (between caecal area) and caeca numbered 6 and 7 contained significantly more worms than the other sites. By the 3rd week post-infection only caecum 7 contained significantly more worms, and at 5 weeks there was no significant difference between the number of worms present in any caecum or the between caecal area. Initially worms in the more intense infections matured more slowly, but by the 3rd week post-infection there was no significant difference in the states of maturity. The rate of maturation was not related to the site occupied. PMID- 2771451 TI - Density dependence in establishment, growth and worm fecundity in intestinal helminthiasis: the population biology of Trichuris muris (Nematoda) infection in CBA/Ca mice. AB - The results are presented of an experimental study of the population biology of chronic Trichuris muris (Nematoda) infection in cortisone-treated CBA/Ca mice. Attention is focused upon both the validity of the common use of faecal egg counts to demonstrate density dependence in helminth fecundity, and the identification of other possible density-dependent mechanisms that may regulate worm numbers in chronic trichuriasis. The results show that faecal egg counts, although demonstrating high daily variation, are not an artefact of host faecal output but a significant density-dependent function of worm burden. This finding contrasts with the observations on Heligmosomoides polygyrus infection in outbred MFI mice, but accords with similar studies in a wide variety of host - helminth systems. Worm establishment in the murine host is found to be a density related function of infection dose. This is attributed to the probable existence of a physical gut-carrying capacity in the murine host for T. muris. Worm distribution in the gut is also shown to the density dependent, with worms being displaced from the caecum to the colon at increasing intensities of infection. The sex ratio of the adult parasites, however, is found to be both unitary and independent of worm burden. Evidence for a significant density-dependent decline in female T. muris growth or size is presented. The results also show a significant positive association between female T. muris weight and per capita fecundity. These findings indicate that the stunted growth of individual worms at high parasite densities may be a potential mechanism underlying density dependence in helminth fecundity. PMID- 2771452 TI - Immunological relationships during primary infection with Heligmosomoides polygyrus (Nematospiroides dubius): expulsion of adult worms from fast responder syngeneic and hybrid strains of mice. AB - The time-course of low and high intensity primary infections with Heligmosomoides polygyrus was monitored in SJL and SWR mice, both of which usually expel worms within 7 weeks of larval administration. Worm expulsion in these strains was not dependent on the intensity of infection, with low and high intensity worm burdens being lost within the same period of time. The ability to expel worms rapidly was inherited in a dominant manner in F1 offspring of SJL or SWR mice mated with C57Bl10 mice; the latter being a strain in which no loss of worms was evident within 10 weeks of infection. However, neither (SJL x C57Bl10)F1 nor (SWR x C57Bl10)F1 mice expelled worms as rapidly as the parental SJL and SWR strains. (SWR x B10G)F1 [H-2q] mice eliminated worms faster than (SWR x C57Bl10)F1 [H 2bq], suggesting that the b haplotype had a moderating influence on the expulsion process. In fact (SWR x B10G)F1 mice showed a significant reduction in worm burdens by week 4 but by weeks 6-8 the rate of worm loss had slowed considerably. In contrast, SJL and SWR mice, whilst initiating rejection slightly later, (after week 4) expelled all worms within the following 2 weeks. Thus two distinct patterns of response were observed among the fast responder strains as exemplified by SWR and SJL mice on the one hand and (SWR x B10G)F1 on the other. Our results support the hypothesis that the course of a primary infection with H. polygyrus is influenced by multiple host gene loci, some of which are encoded within the MHC. SJL and SWR mice probably have similar if not identical gene combinations at loci which determine a fast responder phenotype, distinguishing them from the other mouse strains which have been studied. PMID- 2771453 TI - Serous surface carcinoma of the ovary and peritoneum. A flow cytometric study. PMID- 2771454 TI - Lesions of the breast in children exclusive of typical fibroadenoma and gynecomastia. A clinicopathologic study of 113 cases. AB - This large series of cases demonstrates that the breast of the child or adolescent is the potential site for a number of interesting lesions exclusive of fibroadenoma and gynecomastia. Adenoma of the nipple, juvenile papillomatosis, and juvenile or cellular fibroadenoma should be correctly diagnosed to insure conservative surgical management and appropriate clinical follow-up. The results of the Juvenile Papillomatosis Registry suggest that this lesion is a morphological marker of potentially more serious breast disease in the future. Recognition of a cellular fibroepithelial neoplasm, especially in young black females, as a cellular fibroadenoma will hopefully eliminate the need for the diagnosis of "benign" cytosarcoma phyllodes. On occasion, the equivocal case may be labeled a "phyllodes tumor fo indeterminate biologic behavior." Those neoplasms with stromal atypia and mitotic activity, overgrowth of stroma with epithelial dissociation, and sarcomatous elements are appropriately designated as cytosarcoma phyllodes. In contrast to vascular tumors of the breast in adults, the majority of vascular lesions in the child's breast are bening and represent either a capillary or a histiocytoid hemangioma. Our experience and reports in the literature support the conclusion that most malignancies of the breast in children are metastatic. Rhabdomyosarcoma was the most common example in our study, but secondary involvement by acute leukemia or malignant lymphoma also occurs. PMID- 2771456 TI - Fourier analysis of broad spectral EEG from a fluctuation point of view. AB - It is believed that the EEG is the most reliable method of evaluating brain function, but neither quantitative nor qualitative studies of the EEG have been carried out over the entire range of frequencies. Analysis of limited frequency bands of the EEG has not disclosed the whole of neuronal activity. The aim of this study is to clarify the upper limit of EEG frequency. Our EEG analytic system is composed of a high fiedlity preamplifier and signal processor with a frequency response within -3 dB below 20 kHz. Thirty adult cats were used for these experiments. The upper limit of the frequency varied in different structures: 6.9 +/- 0.8 kHz (+/- SEM) in motor cortex, 4.1 +/- 0.3 kHz in the hippocampus, 2.9 +/- 0.5 kHz in the amygdala, 9.3 +/- 0.6 kHz in the ventrolateral nucleus of the thalamus, and 9.9 +/- 0.5 kHz in the midbrain reticular formation. Three different types of amplitude spectra were characterized in bilogarithmic graphs. These types are named types f, f + L, and L corresponding to 1/f or Lorentzian fluctuation. In conclusion, the upper limit of frequency and the spectral types correspond to the neuronal specificity of different brain regions. Their physioanatomic significance is discussed. PMID- 2771455 TI - Manipulating the QT interval of the ECG by cognitive effort. AB - Abnormal prolongation of the QT interval of the ECG has been reported to indicate a hazard of sudden arrhythmic death. Therefore, with the aid of biofeedback from a newly devised instrument capable of measuring and recording the QT interval of the ECG in real time, ten healthy subjects, aided by biofeedback, attempted to shorten and also to lengthen QT. Although the changes achieved were relatively small, the ten subjects as a group were successful in both shortening and lengthening QT at the 0.01 level of significance. The degree of success varied, however, from person to person and from time to time in the same individual. If the findings reported here can be applied more generally to patients at risk for sudden death, and if biofeedback effects can be made to persist without reinforcement, it or other cognitive techniques may prove clinically useful for shortening QT. PMID- 2771457 TI - Effects of auditory frequency-shifts on zero and below-zero SCR habituation. AB - The purpose of the present experiment was to test a procedure for the measurement of effects of zero- and below-zero habituation (BZH) on responding to frequency shifts in auditory stimuli. The present procedure avoided some of the drawbacks of other procedures, that is, long duration, ambiguity in the definition of BZH, and inadequate control procedures. Two groups received 18 stimulus presentations each; group 1 received first a tone of 1000 Hz 12 times, then 1400 Hz (test stimulus 1) 3 times, and 1850 Hz (test stimulus 2) 3 times. Group 2 received the same stimuli, but 3, 12, and 3 times, respectively. The procedure had the advantages of short duration of the experiment, zero habituation and BZH were operationally defined (as 3 and 12 stimulus presentations, respectively), and there were adequate control conditions since a control group that did not receive stimulus change on the relevant trial was employed. The results showed no effects of stimulus shifts on responding to the test stimuli. Group 2 responded significantly less than group 1 across trials, though, and this may be explained by an inhibitory process elicited by changes in weak stimulation during the habituation process. PMID- 2771458 TI - Artery wall calcification: correlation of atherosclerosis with mineralization. AB - Popliteal arteries from 14 individuals (17-85 y old) were investigated. The concentrations and localizations of P, S, Cl, K, Ca, Fe, Cu, Zn and Br were measured by means of PIXE and micro-PIXE methods. The presence of PO4(3-) and CO3(2-) groups was assessed using the IR technique. The amount of P and Ca increased with age approaching at places 9% and 20% and mineral deposits were detected in tunica media. At the same time an increase in the Ca/P ratio and in the crystallinity of deposits was observed. The samples from old individuals also contained more CO3(2-) groups. The concentrations and localization of Zn and Br showed artery wall layer-dependent changes. In some places of the artery wall, minerals were also found in young persons. They were not correlated with places of blood vessel branching. PMID- 2771459 TI - Carotid body paraganglioma (chemodectoma): cytologic remarks. AB - The fine needle aspiration findings of a carotid body paraganglioma observed in a female patient aged 18 showed a pattern similar to that of previously described cases, but also some other morphological features to be noticed: a continuous spectrum of nuclear volumetric variations, rosette-like structures, cell embracing phenomenon and characteristics nuclear clear areas. We believe that these findings may help in the cytological distinction of carotid body paraganglioma from other laterocervical neoplasms. PMID- 2771460 TI - [Primary neuroendocrine carcinoma of the skin: histologic, immunohistochemical and ultrastructural study of a case with highly aggressive biological behavior]. AB - We report a histological, immunohistochemical and ultrastructural study of a case of neuroendocrine carcinoma of the skin, which occurred in a 52 years old woman in the dermal, subcutis and soft tissues of the left buttock. Clinically this neoplasm, which was related to intramuscular injections and a to a following abscess, had rapidly reached unusual dimension compared with other cases of neuroendocrine carcinoma of the skin reported in the literature. The patient died three months after presentation with distant metastases. A variable percentage of the neoplastic cells was positive for low molecular weight cytokeratins (CK), neurofilaments (NF), neuron specific enolase (NSE) and occasionally for vaso intestinal polypeptide (VIP). Ultrastructural investigations showed two types of neoplastic cells, identified for some features of the nucleus and of the cytoplasm; these two groups of cells are, in our opinion, related to different stages of cellular development. Our results, in agreement with some observations reported in the literature, give evidence of a possible origin of neuroendocrine carcinoma of the skin from an undifferentiated cell which is capable of neuroendocrine or ectodermal differentiation. PMID- 2771461 TI - [A case of tuberous sclerosis: anatomo-pathologic description]. AB - The authors describe the simultaneous presence of renal and pulmonary hamartomas occurring in a young man affected by tuberous sclerosis. The clinical diagnosis was based on the characteristic symptoms of epilepsy, adenoma sebaceum and mental retardation. These symptoms began at the age of four and were mostly characterized by epilepsy and adenoma sebaceum. The mental retardation was slight. The anatomopathological findings at death refer the presence of encephalic, renal and pulmonary lesions; the later are very rare. PMID- 2771462 TI - [Metastatic location in the temporal bone of a primary bladder carcinoma]. AB - The authors on basis of literature point out, the relative shortage in human beings of metastatic locations to the temporal bone from primitive tumours to another seat. After an examination of the anatomopathological report they describe a case, occurred to their observation, of massive metastases to the temporal bone of bladder carcinoma painting out its exceptionality. PMID- 2771463 TI - The psychologically battered child: toward a definition. PMID- 2771464 TI - Commentary on criminal prosecution in cases of child abuse. PMID- 2771465 TI - Third annual North American Cystic Fibrosis Conference. Tarpon Springs, Florida, October 11-14, 1989. Abstracts. PMID- 2771466 TI - Periodic breathing parameter values depend on specific pneumogram scoring criteria. AB - Periodic breathing (PB) has been related to both normal and pathologic respiratory system control in infants. However, comparison of the results of separate studies has been limited by the variability in procedures used by different investigators to quantify PB. In this study we scored 15 24-hr impedance pneumograms using the criteria of Parmelee et al. (Neuropediatrie 3:294 304, 1972), Christova-Gueorguieva (Biology of the Neonate 44:325-332, 1983), and Curzi-Dascalova, Kelly and Shannon (Pediatrics 63:355-360, 1979) and analyzed the resulting differences in several commonly used PB parameters. Scoring criteria consistently and significantly influenced three PB parameters: the %PB, number of episodes of PB/100 min recording time, and mean duration of PB episode length showed average changes of 74%, 179%, and 36%, respectively, when the methods with the most extreme differences were compared. In contrast, the duration of the longest episode of PB showed no significant change as a function of scoring criteria. Awareness of the particular method of PB scoring is therefore essential in interpreting PB parameter values. PMID- 2771467 TI - Inspiratory-to-expiratory ratio during ventilation for idiopathic respiratory distress syndrome. AB - We have studied the effects of changes in inspiratory-to-expiratory ratios (I/E ratios) on transcutaneous blood gases in a group of 30 infants receiving respiratory support for the idiopathic respiratory distress syndrome (IRDS). Following the use of a reversed I/E ratio (inspiration exceeding expiration), changes in oxygenation were very variable but improvements were seen most consistently in babies weighing greater than 1,750 g and less than 850 g. The use of reversed I/E ratios seemed less efficient than positive end-expiratory pressure in raising TcPO2 for the same increase in mean airway pressure. Changes from a 1:1 ratio to a normal I/E ratio, in which expiratory time exceeded inspiratory time by 50-100%, led to more marked and consistent falls in TcPO2. We conclude that a flexible attitude toward the use of I/E ratios should be adopted to avoid raising mean airway pressure needlessly. PMID- 2771468 TI - Home measurement of oxygen saturation during sleep in patients with cystic fibrosis. AB - Feasibility and reproducibility of home measurement of arterial oxygen saturation (SaO2) were evaluated in 14 clinically stable patients with cystic fibrosis (CF). Changes in SaO2 during sleep were compared to the clinical status and pulmonary function while awake to identify predictors of nocturnal oxyhemoglobin desaturation. Each patient was assessed by clinical score, spirometry, and arterial blood gas analysis within 72 hours of the overnight study. Eight patients were studied on more than one occasion to assess dependence of SaO2 on position and reproducibility of overnight studies. A pulse oximeter stored up to 8 hours of nocturnal SaO2 measurements in its memory. Off-line analysis of trend data provided the proportion of sleep with SaO2 less than 90% and less than 85%. We found that patients with daytime PaO2 less than 60 mm Hg spent greater than 80% of their sleep with SaO2 less than 90%, while those with PaO2 greater than 70 mm Hg spent less than 20% of the night with SaO2 less than 90%. Patients with daytime PaO2 of 67-70 mm Hg were desaturated to less than 90%, from 0 to 98% of the night. No consistent body position dependence of daytime SaO2 was found. Home measurement of SaO2 during sleep was reproducible, with a difference on two repeat occasions of 4% +/- 2 (mean +/- SEM) for %time with SaO2 less than 90% and 3% +/- 2 for %time with SaO2 less than 85%. The severity of hemoglobin desaturation during sleep could not be reliably predicted from clinical scores or awake pulmonary function.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2771469 TI - Comparison of high-frequency oscillatory ventilation and high-frequency jet ventilation in cats with normal lungs. AB - Four adult cats received alternating high-frequency oscillatory ventilation (HFOV) and high-frequency jet ventilation (HFJV) at equivalent proximal airway pressures. Physiologic measurements were made before and after each ventilator change. Proximal airway pressures were then adjusted as necessary to reestablish normal pH and PaCO2 values. Aortic, pulmonary artery, and central venous pressures were monitored. Cardiac outputs were measured. Pulmonary and systemic vascular resistance, intrapulmonary shunt, and alveolar-arterial oxygen gradient were determined. Following the change from HFOV to HFJV at similar proximal airway pressures, HFJV always produced higher pH values (P less than 0.0001), higher PaO2 values (P less than 0.05), lower PaCO2 values (P less than 0.0001), as well as higher cardiac outputs (P less than 0.01), lower pulmonary artery pressures (P less than 0.001), and lower pulmonary vascular resistances (P less than 0.001). Following the reciprocal crossover, from HFJV to HFOV, HFJV pH values were again higher (P less than 0.001), and PaCO2 values were again lower (P less than 0.001). A comparison of HFOV and HFJV at similar pH and PaCO2 values showed that HFOV consistently required higher peak inspiratory pressures (P less than 0.001), higher mean airway pressure (P less than 0.001), and higher pressure wave amplitudes (P less than 0.001). Under the circumstances of this study, HFJV produced better gas exchange at lower proximal airway pressures. PMID- 2771470 TI - Tracheal compression caused by achalasia. PMID- 2771471 TI - Pulmonary association in a case of chronic recurrent multifocal osteomyelitis. PMID- 2771472 TI - Changes in functional residual capacity in response to bronchodilator therapy among young asthmatic children. AB - Measurements of functional residual capacity (FRC) by helium gas dilution and peak expiration flow rate (PEFR) were made in 63 young asthmatic children aged 2 and 7 years before and after bronchodilator therapy. All 63 children tolerated two measurements of FRC, but only 33 children were able to perform the peak flow maneuver. Bronchodilator therapy was associated with significant change in FRC in the majority (80%) of children; in some, however, this change was an increase rather than a decrease. The change in FRC was significantly correlated with both prebronchodilator FRC and the change in PEFR. An increase in FRC following bronchodilator therapy was more common in children with severe and symptomatic asthma. We suggest that changes in FRC may be used in asthmatic children to demonstrate bronchodilator responsiveness, particularly in those too young to perform other respiratory function tests. PMID- 2771473 TI - Esophageal edema as a predictor of unsuccessful balloon extraction of esophageal foreign body. PMID- 2771474 TI - Catheter removal of blunt esophageal foreign bodies in children. Survey of the Society for Pediatric Radiology. AB - The membership of the Society for Pediatric Radiology was surveyed to determine the safety and efficacy of the Foley catheter technique. Completed questionnaires were returned from 148 institutions. Sixty-four institutions reported that they were currently removing blunt esophageal foreign bodies utilizing the balloon catheter. Over 2500 patients were reported as having been treated utilizing this technique. Only one potentially serious but reversible complication was observed. PMID- 2771475 TI - Quantitative density-time measurements in the lungs of children with suspected airway obstruction using ultrafast CT. AB - Fourteen children under 3 years of age with possible airway obstruction were evaluated with an ultrafast CT scanner, Imatron C-100. Serial 0.05-second multilevel scans were obtained through the chest at rates of 17 images per second. No patient sedation or contrast medium was used. Time-density curves generated over each lung and specific pulmonary zones were compared to characterize the normal variation of density during inspiration and expiration and to determine abnormal patterns associated with airway obstruction. There was a high, positive correlation value (r greater than 0.79) between time/density curves over those pulmonary regions in which there was no focal bronchial obstruction and a low, negative correlation value (r = less than -0.58) with bronchial obstruction. Three studies with reconstruction artifacts were excluded. Furthermore, the results indicate that young children generally have denser lungs, particularly in expiration, than older children or adults. This preliminary study suggests that ultrafast CT offers a promising, unique, rapid and noninvasive approach for diagnosing airway obstruction in childhood. PMID- 2771476 TI - CT of anorectal malformation--a postoperative evaluation. AB - In spite of the progress in the field of surgical treatment of anorectal malformations, faecal incontinence is, in variable degrees, still an unpleasant and frequent postoperative sequela. Postoperative CT demonstrate the location of the pulled-through intestine, including whether it had been correctly placed through the levator ani and in the spincteric muscular complex. In our nine patients we discovered a correlation between the CT findings and the clinical picture. The cases of incontinence whether associated with sacral anomalies or not were characterized either by marked hypoplasia of musculature or by the pull through having missed the sphincteric musculature. CT scans could be of use in planning further surgery. PMID- 2771477 TI - Ovarian torsion and amputation resulting in partially calcified, pedunculated cystic mass. AB - Three children with torsion and amputation of the right ovary are presented. The detached ovary resulted in a cystic mass containing necrotic material and a solid, partially calcified mural node. The cysts were attached to the omentum, to the mesentery of the transverse colon, or to the lower edge of the liver by a long twisted pedicle containing thin-walled vascular spaces. The radiographic and sonographic findings were quite similar and clearly reflected the operative and pathologic changes. PMID- 2771478 TI - Metabolic and anatomic development of the chick embryo as studied by phosphorus 31 magnetic resonance spectroscopy and proton MRI. AB - Thirty fertilized chick eggs were studied sequentially over the 22-day maturation period of the egg by phosphorous-31 (P-31) magnetic resonance spectroscopy (MRS) and proton (H-1) magnetic resonance imaging (MRI) at 2.0 Tesla. The total MR observable P-31 volume in the egg decreased by nearly 80% from day 4 through day 22, suggesting P-31 uptake into tissues in which the P-31 signal is not visible by MR, such as phospholipid bilayers, membranes, cellular structures, and bone mineral phosphates. Of the remaining visible phosphates, the relative phospholipid peak area decreased and the relative peak areas of the phosphocreatine and nucleoside di- and triphosphate metabolites increased. Inorganic phosphate also showed an increase in peak area during maturation. The metabolic development correlated with the anatomic development of visible structures such as brain, eyes, spine and organs in the chick as seen by MRI. In vivo MR techniques offers the potential to follow changes in prenatal development and maturation. PMID- 2771479 TI - Mucolipidosis II: correlation between radiological features and histopathology of the bones. AB - Twelve cases of Mucolipidosis II (I-cell disease) with a wide range of severity of skeletal involvement were studied. Pathological findings in two cases provided helpful information in understanding the radiographic features of dysostosis multiplex. Inhibition of the growth plate cartilage calcification and rickets like lesions were observed in the metaphyses. Enhanced subperiosteal remodelling and paratrabecular fibrosis were also evident in the diaphyses. High levels of parathormone were found in one case. This finding supports the hypothesis that bone lesions may be secondary, at least in part, to damage in such viscera as the kidney and/or the liver and that they are mediated by vitamin D and parathormone. PMID- 2771480 TI - Computerized tomography appearances of pelvic haemangioma involving the large bowel in childhood. AB - The Computed Tomography (CT) appearance of a pelvic haemangioma involving the rectum in two children, one with the Vater association and one with Klippel Trenaunay syndrome, is described. Both cases complained of painless rectal bleeding and the diagnosis was suggested by the presence of pelvic phleboliths on the plain abdominal radiograph. CT provides a simple, non-invasive method of diagnosing such lesions and assessing their extent. PMID- 2771481 TI - Sponastrime dysplasia. A radiologic-pathologic correlation. AB - The 2nd family with Sponastrime Dysplasia is described. The clinical, radiologic and chondro-osseous morphology of boy and girl siblings are presented. The facial appearance is an "oriental look" with midface hypoplasia and a saddle nose. The radiological findings include the spinal changes of lordosis, osteoporosis and pear-shaped vertebrae, as well as striated metaphyses (osteopathia striata). The morphological findings suggest a disturbance in the formation of cartilage, with a defect in collagen and proteoglycans synthesis in this rare autosomal recessive skeletal dysplasia. PMID- 2771482 TI - A spectrum of skeletal anomalies associated with pulmonary agenesis: possible neural crest injuries. AB - Six cases of unilateral pulmonary agenesis with skeletal and other deformities have been diagnosed in our hospitals. The various pulmonary, spinal, rib and limb anomalies with their possible inter-relationships were examined and described in detail and comparison with previously reported cases was made. It became apparent that the limb abnormalities which most constantly involved hypoplasia of the phalanges of a thumb with varying metacarpal and radial anomalies, were ipsilateral to the pulmonary agenesis in all cases. The spinal deformities involved degrees of failure of segementation of T1-T3 with other vertebrae randomly involved. Rib abnormalities also varied and did not necessarily correspond to the same side as the pulmonary agenesis. The concept of the anomalies all being part of a group of neural crest injuries was then explored. PMID- 2771483 TI - Computed tomography of the "near miss syndrome" with basal ganglion calcification. PMID- 2771484 TI - Cerebral candidiasis. Computed tomography appearance. AB - A three year old child who had been suffering from oral candidiasis since the age of 1 year presented with osteitis of the clavicle, 2 cerebral frontal abscesses and an occipital abscess which extended across the calvaria and was associated with osteolysis. Histological and microbiological studies following surgery confirmed the diagnosis of candidiasis in this girl who was found to have IgA immunodeficiency. The authors report the computed tomographic appearance of the cerebral lesions and review the literature. PMID- 2771485 TI - MRI in the evaluation of spina bifida patients in the remote period after meningomyelocele repair. AB - MRI was performed on 22 patients ranging in age from 3 months to 16 years who had closure of their meningomyelocele shortly after birth. These patients had developed new clinical findings suggestive of spinal cord dysfunction. MRI showed low placement of the spinal cord in all 22. Six patients had lipomas, five had diastematomyelia and six had hydromyelia. Four patients had an obviously dysplastic terminal cord. PMID- 2771486 TI - Patchy cerebral white matter edema in chronic renal failure. AB - Bilateral patchy cerebral white matter edema was observed in two children with chronic renal failure. Uremia in one case and hypertension or hyponatremia in the other appeared to be the cause of the neurological and radiological findings. PMID- 2771487 TI - Congenital pulmonary steal associated with Tetralogy of Fallot, right aortic arch and an isolated left carotid artery. PMID- 2771488 TI - Sequential development of multiple aortic aneurysms in a neonate post umbilical arterial catheter insertion. AB - A neonate in whom multiple aortic aneurysms developed as a result of umbilical arterial catheterization is presented. Initially a single aneurysm was diagnosed by ultrasound. Serial sonographic examinations showed enlargement of the first as well as formation and subsequent enlargement of additional aneurysms. PMID- 2771489 TI - Esophageal vascular impression in total anomalous pulmonary venous return below the diaphragm. AB - This paper discusses a new oblique posterior to anterior extrinsic vascular impression on the distal esophagus in total anomalous pulmonary venous return (TAPVR) below the diaphragm caused by a right common pulmonary vein. PMID- 2771490 TI - Death associated with bronchography. Question role of heating the contrast agent. AB - A young woman died following bronchography. The bilateral bronchogram done under general anesthesia without fluoroscopic control was associated with extensive small airway filling or "alveolarization" of the contrast medium. The oily Dionosil used had been heated in an autoclave. Experiments showed that the viscosity of oily Dionosil decreases with heating. The lowered viscosity could have contributed to the increased "alveolarization" of the contrast agent and death of the patient. PMID- 2771491 TI - Magnetic resonance imaging of a lingual thyroid gland. AB - A lingual thyroid gland was discovered by chance via MRI and was subsequently verified by a nuclear medicine scan. PMID- 2771492 TI - A case of bilateral gastric bronchopulmonary-foregut malformation. PMID- 2771493 TI - Chronic torsion of the wandering spleen. AB - Torsion of a wandering spleen can occasionally produce chronic disabling clinical findings that are mistaken for a variety of digestive disturbances. Since the clinical complaints are misleading, a correct and timely radiographic analysis can prevent an extensive but unnecessary pursuit of other more common conditions. Images of an ectopic, enlarged, disoriented spleen with a devitalized parenchyma and adherent pseudocapsule can quickly establish the diagnosis of chronic splenic torsion. PMID- 2771494 TI - Umbilical and portal vein calcification following umbilical vein catheterization. AB - Calcifications of the umbilical vein and intrahepatic branches of the portal vein developed in a newborn who had an umbilical vein catheter inserted for 11 days postnatally. The calcified intrahepatic portal veins can still be demonstrated sonographically at the age of three years, but these calcifications were no longer detectable radiologically. PMID- 2771495 TI - Intrahepatic biliary cysts after hepatic portoenterostomy in four children with biliary atresia. AB - We report our experience with 4 cases of cystic dilatation of intrahepatic bile ducts following hepatic portoenterostomy for biliary atresia. Two of the cases did not achieve satisfactory bile excretion and all four cases developed recurrent cholangitis after hepatic portoenterostomy. The attacks of cholangitis seemed to be associated with the presence of intrahepatic cysts. Although one case resulted in death from hepatic failure, three other cases are now outpatients. Patients who develop recurrent cholangitis following hepatic portoenterostomy, should be examined to exclude the presence of intrahepatic biliary cysts. Ultrasonography, computed tomography and percutaneous transhepatic cholangiography were all effective in detecting cysts and provided valuable information for planning treatment. Percutaneous transhepatic or surgical drainage of the bile ducts was effective in reducing jaundice, and recurrent cholangitis. PMID- 2771496 TI - Primary malignant lymphoma of the rectum. AB - A rare case of a primary malignant lymphoma of the rectum in a 7 year old girl is presented. Although rectal polyps in children are usually benign juvenile polyps, a rare possibility of malignancy should be kept in mind. An adequate histological examination is essential. PMID- 2771497 TI - Intestinal obstruction in a neonate with adrenal hemorrhage and renal vein thrombosis. AB - Adrenal hemorrhage and renal vein thrombosis are two distinct vascular entities encountered in the newborn period. Occasionally, both entities may co-exist in the same patient. A premature infant of a diabetic mother presented with intestinal obstruction secondary to extrinsic compression by the mass effect of the enlarged hemorrhagic adrenal and thrombosed kidney on the left hemicolon, a phenomenon which to our knowledge has not previously been described. PMID- 2771498 TI - Eosinophilic cystitis and coexistent eosinophilic gastroenteritis in an infant. AB - This report describes the first documented case of eosinophilic cystitis and eosinophilic gastroenteritis occurring in a child. PMID- 2771499 TI - Florid radiological appearance of megakaryoblastic leukaemia--an aid to earlier diagnosis. AB - Accurate diagnosis of leukaemia is essential to enable appropriate treatment. The diagnosis is made by cytological and cytochemical techniques but radiology may, however, serve a very useful role in first suggesting a diagnosis. We present here four cases of megakaryoblastic leukaemia (AML FAB classification M7), three of which have strikingly similar unusual radiological changes. A review of the literature suggests this condition has previously been diagnosed as acute or malignant myelofibrosis, and the megakaryoblastic nature of the disease was not recognised. The presence of these radiological features may therefore prompt specific immunocytochemical testing, in a disease that is otherwise difficult to diagnose early. PMID- 2771500 TI - Osteomesopycnosis. A new case. AB - A 10-year old, mentally and physically normally developed girl complained of back pain following an accident. Radiological findings revealed an inhomogeneous, coarse osteosclerosis along the endplates and posterior parts of the ovoid shaped vertebral bodies, in the proximal and distal femora-, proximal humeri and tibia epiphyses, and along the lateral aspects of the femoral necks. The pelvis presented a mottled appearance of the trabecular pattern at the symphysis pubis and the lateral parts of ischii and sclerosis in the acetabular region. The only laboratory abnormality was a high serum parathormone level. The family history revealed an autosomal dominant inheritance. The name proposed by Maroteaux for this skeletal disorder is osteomesopycnosis, as the lesions were localized to the spine, pelvis and sometimes proximal femur. The skull, ribs, long bones, hands and feet were not involved in the reported 12 cases. Radiographs of this patient showed in addition changes in the hand. This disease must be distinguished from atypical axial osteomalacia. PMID- 2771501 TI - Polytopic dystelephalangy of the fingers. AB - An 11-year-old girl with dystelephalangy (Kirner deformity) of the right middle, ring, and little, and the left index through little fingers is reported. To the author's best knowledge, such polytopic affection with dystelephalangy has not yet been reported. The parents, one of the siblings and maternal grandfather showed dystelephalangy of the little finger. So, the patient was considered to be a homozygous state of dystelephalangy gene. PMID- 2771502 TI - Persistent femoral neck cysts in healed Legg-Perthes' disease: a clue to the etiology of simple bone cyst? AB - Persistent femoral neck cysts in an adult with healed Legg-Perthes disease had the radiological features of which are rather like those of simple bone cyst. To the author's knowledge such persistent cysts have not been reported previously. Existence of such cysts in healed Legg-Perthes' disease may provide a clue to the etiology of simple bone cyst. PMID- 2771503 TI - Electrocardiographic QT prolongation after ablation of the nodose placode in the chick embryo: a developmental model of the idiopathic long QT syndrome. AB - Electrocardiographic abnormalities characteristic of the idiopathic long QT syndrome are thought to be caused by an imbalance of sympathetic activity in the heart. Recent evidence indicates that autonomic and sensory innervation density in the end-organ is modulated by reciprocal interactions. Ablation of one neuronal population allows reciprocal increases in growth of the remaining nerves. To test whether QT prolongation could be produced in chick embryos by altering sensory innervation to the heart, microcautery was used to ablate premigratory areas of the right nodose placode, a coalescence of cells in the embryonic ectoderm that generates neurons providing sensory innervation to the heart via the inferior ganglion of the vagus (nodose ganglion). After functional autonomic innervation was established, three-lead ECG were obtained in embryos with the right nodose placode ablated (experimental) and in sham-operated controls (sham) at incubation days 17-20 in a controlled temperature environment. Electrocardiograms were analyzed for RR and QT intervals. The QT interval was corrected for heart rate using the formula QTc = QT/(RR)1/2 using an average of ten complexes. Compared with shams (n = 8), experimental embryos (n = 7) had significantly longer QTc (0.339 +/- 0.005 versus 0.318 +/- 0.004), and slower heart rates (RR = 0.29 +/- 0.005 versus 0.27 +/- 0.007). These findings mimic those in children with the idiopathic long QT syndrome. Experimental manipulation of the sensory innervation to the heart in the chick embryo via the nodose placode may provide an animal model to improve understanding of the pathogenesis of the idiopathic long QT syndrome. PMID- 2771504 TI - Lack of sex differences in antioxidant enzyme development in the fetal rabbit lung. AB - A sex difference characterized by a female advantage in the maturation of the fetal pulmonary surfactant system is well documented. Because the surfactant system and the antioxidant enzyme system of the fetal lung have chronologically similar developmental patterns and share some of the same hormonal regulators, such as glucocorticoids, we questioned whether a sex difference would be present in antioxidant enzyme maturation as it is in surfactant system maturation. We studied fetal rabbits at days 26 and 28 of a 31-day gestational period. Fetal sex was identified histologically. Fetal lung lavage was performed and lavage fluid assayed for phosphatidylcholine, disaturated phosphatidylcholine, and sphingomyelin. Lung tissue from separate fetuses was assayed for disaturated phosphatidylcholine content and total phospholipid content and for the activities of three antioxidant enzymes--superoxide dismutase, catalase, and glutathione peroxidase. No differences were present in antioxidant enzyme maturation between male and female fetal rabbits at the gestational days studied. A female advantage was observed in the lung lavage disaturated phosphatidylcholine/sphingomyelin ratio (at 26 days: female 1.38 +/- 0.42, male 0.99 +/- 0.26; and at 28 days: female 3.29 +/- 0.53; male 2.26 +/- 0.35, p less than 0.05). A female advantage in surfactant development was not reflected in lung tissue disaturated phosphatidylcholine or total phospholipid. We conclude that, unlike the development of the surfactant system, the development of the antioxidant enzyme system in the fetal rabbit lung does not demonstrate a sex difference. PMID- 2771505 TI - The total free radical trapping ability of cord blood plasma in preterm and term babies. AB - The interaction between various antioxidants may be important in protecting the newborn baby against oxygen toxicity. We studied the total radical trapping capacity of the antioxidants in plasma (TRAP) and compared the TRAP level in the preterm and term baby (cord blood) with that in adults. In addition, the concentrations of various known antioxidants were measured and the theoretical contribution of these antioxidants to the TRAP calculated. The measured and calculated TRAP were higher in the newborn babies than the adults. The uric acid concentration was similar in the three groups but the vitamin C concentration was higher and the vitamin E and sulfhydryl concentrations were lower in the newborn babies. In contrast to the adult group, the measured TRAP in the newborn babies did not correlate with the calculated TRAP. This may be due to differences in inhibition or recycling of antioxidants in the newborn and adult groups. Theoretical considerations showed that there may be a large unidentified group of antioxidants that contribute to measured TRAP in plasma. Bilirubin and beta carotene were measured (higher and lower concentrations, respectively, in the newborn) in an attempt to identify these antioxidants. The efficient plasma radical trapping capacity in the cord blood may partly compensate for deficiencies in other components of the antioxidant defenses, e.g. cellular enzymes, at the time of birth. PMID- 2771506 TI - Changes in upper intestinal epithelial morphology and kinetics in the growing guinea pig. AB - Weaning, the process of intestinal adaptation from milk to solid diet, demands changes in gastrointestinal function. We aimed to measure upper intestinal mucosal morphology and cytokinetics during early life, to determine whether the marked changes seen at weaning in altricial species, such as rat and mouse also occur in the precocial guinea pig. A total of 79 animals was studied. Jejunal morphology was measured by microdissection and crypt cell production rate by a metaphase arrest technique in animals at 1, 7, 14, 21, and 28 days after birth. There was a 40% decline in villus height from 986 to 576 microns during the first 2 wk (p less than 0.001). Crypt depth increased by 25% from 148 to 199 microns (p less than 0.01). After an initial decline there was a significant increase in crypt:villus ratio from 6.7 to 8.2 (p less than 0.001), in crypt cell production rate from 3.9 to 5.6 cells/crypt/h (p less than 0.001), and net villus influx from 26.1 to 45.9 cells/villus/h (p less than 0.001) from 14 days onward. These proliferative changes were accounted for by an increase in the depth and number of crypts, and in crypt cell production rate, leading to an increase in net villus influx. In contrast with the rat and mouse they were gradual, occurred largely during the 3rd wk, and appeared to follow the cessation of breast feeding and commencement of solid food. It is suggested that the functional changes in the small intestine that occur during weaning in the guinea pig are neither due to rapid proliferation of a new epithelial cell population, nor precipitated by change in diet. PMID- 2771507 TI - Plasma beta-casomorphin-7 immunoreactive peptide increases after milk intake in newborn but not in adult dogs. AB - To determine the relation between milk intake and plasma levels of beta casomorphins as a function of age, we studied the levels of beta-casomorphin-7 immunoreactive material (BCMIR) in 2- and 4-wk-old beagle neonates and adult dogs following milk intake. We used three kinds of milk: 1) bovine casein-based milk formula; 2) canine bitch's milk, and 3) soy protein-based (noncasein) formula. Using a new extraction technique, BCMIR was isolated from plasma and assayed by radioimmunoassay at 0, 2, 4, and 6 h after feeding. We found that BCMIR increased significantly in both 2- and 4-wk-old puppies post bovine and canine milk feeding, but not after soy protein formula. Base-line values were about 80-120 fmol/ml and increased to 100-120% 2 h after bovine casein intake in the older puppies and by 4 h in the younger group. BCMIR levels were undetectable in adult dogs before or after bovine milk feeding. Beta-casomorphin-7 added to plasma was rapidly degraded whereas BCMIR was stable. Chromatographic profiles demonstrated that the BCMIR moiety is larger than beta-casomorphin-7. Our data suggest that the appearance of BCMIR in the plasma of neonatal dogs is a result of beta-casein degradation along a permeable gastrointestinal mucosa. We speculate that morphiceptin and beta-casomorphins can be cleaved from BCMIR and may have important physiologic effects. PMID- 2771508 TI - Restoration of a phosphaturic response to parathyroid hormone in the immature rat. AB - Recent studies have shown that immature rats display a diminished sensitivity to the phosphaturic effects of parathyroid hormone (PTH), and that the responsiveness to PTH increases with age. The attenuated phosphaturia may reflect an inability of the neonate to respond to the hormone because of functional immaturity of the developing kidney. Alternatively, PTH may actually inhibit tubular phosphate reabsorption in the neonate but, due to other phosphate conservation mechanisms, no phosphaturia occurs. Our objective was to determine whether a phosphaturic response to PTH would be elicited in immature rats during infusion of moderate amounts of phosphate (Pi). Clearance experiments were performed on 26 acutely thyroparathyroidectomized immature Wistar rats (3-5 wk of age) fed a normal Pi diet (0.63%). In response to infusion of either Pi (1 mumol/min.100 g) (group I) or PTH (8.3 ng/min.100 g) (group II) alone, the fractional excretion of phosphate rose minimally (from 0.01 +/- 0.01% to 4.9 +/- 1.9% and from 0.12 +/- 0.12% to 2.9 +/- 1.4% for groups I and II, respectively). However, when Pi and PTH were combined either Pi first followed by PTH (group III) or PTH first followed by Pi (group IV), the fractional excretion of Pi rose dramatically (from 0.01 +/- 0.01 to 21.8 +/- 3.5% and from 0.04 +/- 0.04 to 27.7 +/- 3.3% for groups III and IV, respectively). A significant increase in urinary cAMP excretion occurred during infusion of PTH even when Pi excretion was minimal, but there was no further increase in urinary cAMP during the combined infusion of Pi and PTH.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2771509 TI - Vitamin D-regulated, ATP-dependent calcium transport by intestinal Golgi vesicles during maturation in the rat. AB - The developmental aspects of calcium uptake by intestinal Golgi vesicles was determined using highly purified Golgi vesicles from enterocytes of suckling (2 wk old), weanling (3 wk old), and adolescent (6 wk old) rats. Calcium uptake by Golgi vesicles at all age groups represented transport into the intravesicular space as evident by temperature dependency and by calcium ionophore A23187 induced calcium efflux studies. Calcium uptake was driven by ATP at all age groups, however, maximal uptake at 15 min was significantly greater in Golgi vesicles of adolescent rats compared to mean values in Golgi vesicles of suckling rats (p less than 0.01). Calcium uptake in the absence of ATP was minimal. The requirement for the adenine base and the hydrolysis of the beta-gamma phosphodiester was tested by replacement of ATP in the incubation media by CTP and the nonhydrolyzable ATP analogue, adenylyl-(beta-gamma methylendiphosphonate). Both agents had no stimulatory effect on calcium uptake. Calcium uptake was linear up to 40 s. Kinetic parameters of calcium uptake at free calcium concentrations of 0.04 to 1.0 microM showed a maximal transport capacity of 0.99 +/- 0.05, 0.55 +/- 0.04, and 0.29 +/- 0.03 nmol/mg protein/15 s for adolescent, weanling, and suckling rats, respectively. Km values were 0.16 +/ 0.02, 0.12 +/- 0.03, and 0.07 +/- 0.02 microM for adolescent, weanling and suckling rats, respectively. Km and Vmax values were significantly different between adolescent and suckling rats (p less than 0.01). The calcium regulatory protein calmodulin has no effect on calcium uptake by Golgi vesicles. Vitamin D deficiency in all age groups decreased ATP-dependent calcium uptake. Administration of 1,25-(OH)2 vitamin D3 8 h before death enhanced ATP-dependent calcium uptake in all age groups studied. This enhancement was the result of increase in maximal transport capacity of ATP-dependent calcium uptake. This study demonstrates a vitamin D-regulated ATP-driven calcium uptake by intestinal Golgi vesicles at all age groups including the suckling period. This transport system shows developmental patterns in regard to its kinetic parameters. PMID- 2771510 TI - Gestational changes in renal responsiveness to cortisol in the ovine fetus. AB - The ontogenetic renal responsiveness to exogenous cortisol was examined in the chronically cannulated ovine fetus. The contribution of effects at proximal and distal tubule of the kidney were studied also. Cortisol (81.5 micrograms/h) was infused into immature ovine fetuses (mean gestational age -113.9 days) on five occasions and increased blood cortisol from 0.8 +/- 0.5 to 21.3 +/- 6.2 nmol/liter. This dose of cortisol produced a highly significant diuresis and natriuresis, in part due to an increase in GFR and in part due to a significant decrease in proximal tubular reabsorption of sodium. Cortisol (107.2 +/- 4.7 micrograms/h) was infused into mature fetuses (mean gestational age 133.4 days) and produced an increase in blood cortisol concentration from 11.4 +/- 5.6 to 33.7 +/- 6.8 nmol/liter. No natriuresis or diuresis was seen in the mature fetuses. Cortisol caused a significant depression of proximal tubular sodium reabsorption in mature fetuses, but this extra load was reabsorbed in the distal tubule in these fetuses. The inability of the premature or very low birth wt baby to maintain normal sodium balance on a standard salt intake may be due, at least in part, to a "fetal" renal response to the high plasma cortisol concentrations found in such babies. As the kidney matures it becomes capable of increasing distal tubular sodium reabsorption to compensate for any increased distal tubular fluid delivery. PMID- 2771511 TI - Metabolic studies of carnitine in a child with propionic acidemia. AB - Carnitine metabolism was studied in a 7-y-old boy with propionic acidemia due to an almost total deficiency of propionyl-CoA carboxylase. The initial diagnosis was made at 3 wk of age followed by numerous episodes of metabolic acidosis despite a low-content branch-chain amino acid diet containing supplemental biotin. Although clinically stable and in a nonacidotic state, the plasma concentration of total carnitine was normal (38.9 microM; normal = 46 +/- 10, mean +/- SD, n = 30) whereas free carnitine was decreased (5.7 microM; normal = 37 +/- 8) and short-chain acylcarnitines were increased (28.6 microM; normal = 5.7 +/- 3.5). Skeletal muscle and liver specimens obtained at open biopsy had low total and free carnitine contents and increased ratio of short-chain acylcarnitines to free carnitine. Short-chain acylcarnitine content was low in liver but increased in skeletal muscle. The liver contained fatty vacuoles, enlarged mitochondria with paracrystalline inclusions, and numerous peroxisomes whereas the skeletal muscle also had lipid vacuoles and an increase in number and size of mitochondria. A carnitine challenge test (100 mg L-carnitine/kg body wt via a gastrostomy tube) resulted in a peak plasma carnitine concentration at 120 min. With maintenance therapy of 100 mg L-carnitine/kg/day the plasma free carnitine remained relatively low, the plasma glycine concentration decreased, and urinary acylcarnitine excretion increased. This study demonstrates that the alterations in carnitine and its derivatives observed in plasma and urine reflect the same type of altered distribution in tissue and provides further data on the effects of L-carnitine therapy. PMID- 2771512 TI - Utilization of mercaptoethylgluconamide for depleting human cystinotic fibroblasts of their accumulated lysosomal cystine. AB - Human cystinotic fibroblasts were completely depleted of their accumulated intracellular free cystine within a 2-h time interval when exposed to culture medium containing between 1 and 5 mM mercaptoethylgluconamide. This cystine depleting action of mercaptoethylgluconamide was observed with three different human cystinotic fibroblast cell lines and with all three cell lines, 2 mM mercaptoethylgluconamide was as effective as 1 mM cysteamine in depleting cells of their intracellular free cystine. Cell viability was excellent for cystinotic fibroblasts exposed to 2 mM mercaptoethylgluconamide for up to 6 days in duration. Mercaptoethylgluconamide (2 mM) was sufficiently stable under cell culture conditions such that a single addition of mercaptoethylgluconamide maintained cystine depletion in human cystinotic fibroblasts for at least a 4-day period. In contrast to cysteamine, 2 mM mercaptoethylgluconamide was not capable of depleting the cystine content of isolated cystinotic lysosomes, implying that cellular integrity is necessary to achieve cystine depletion by mercaptoethylgluconamide. The efficient cystine-depleting action of mercaptoethylgluconamide coupled with its lack of offensive odor encourage further investigation of this agent to possibly complement or supplant the use of cysteamine in the treatment of nephropathic cystinosis. PMID- 2771513 TI - Carbamyl phosphate synthetase and ornithine transcarbamylase activities in enzyme deficient human liver measured by radiochromatography and correlated with outcome. AB - Sensitive and specific radiochromatographic methods to measure enzymatic activities of carbamyl phosphate synthetase I (CPS I) and ornithine transcarbamylase (OTC) were developed. The activities of these enzymes were assayed in frozen liver tissue obtained from 23 individuals with hyperammonemia caused by CPS I (five patients) and OTC deficiency (18 patients). In addition, livers of one aborted fetus with OTC deficiency and four normal individuals were studied. The assays use radioactive ornithine as a substrate followed by separation of citrulline formed in the reactions by HPLC and quantitation of the radioactivity in both amino acids by a radioactivity flow monitor or by a scintillation counter. Both CPS I and OTC assays were linear with respect to length of incubation time and concentration of tissue homogenate. The sensitivity of the methods allowed measurements of CPS I and OTC activities as low as 0.1 mumol/g/min on 5 mg of liver tissue and the diagnosis of CPS I or OTC deficiency could be established on as low as 0.5 and 0.05 mg of tissue, respectively. CPS I activity in different sections of four normal livers was 3.01 +/- 0.16 mumol/g/min (mean +/- SEM, n = 19) and OTC activity was 93.4 +/- 6.3 (mean +/- SEM, n = 19). Residual enzymatic activity could be detected and measured in the liver tissues of one of the five subjects with CPS I deficiency and in 14 of 19 subjects with OTC deficiency. OTC/CPS I activity ratio in normal liver tissue was 31.2 +/- 1.3 (mean +/- SEM, n = 19), whereas this ratio ranged from 343 to greater than 5000 in CPS I deficient livers and from less than 0.02 to 1.55 in OTC deficient livers.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2771514 TI - Intestinal blood flow and oxygen consumption: responses to hemorrhage in the developing piglet. AB - Age-related differences in the intestinal hemodynamic and oxygenation responses to arterial hemorrhage were studied in anesthetized and ventilated 1-d, 3-d, 1 wk, and 2-wk-old piglets. Steady-state values of superior mesenteric blood flow, venous pressure, and arteriovenous oxygen difference were obtained before and after 5 and 10 mL/kg arterial hemorrhage. With 5 mL/kg hemorrhage, intestinal blood flow fell significantly below baseline values, but oxygen extraction increased to maintain oxygen uptake at control levels in all age groups. In contrast to 2-wk-old piglets, the intestine of 1-d, 3-d, and 1-wk-old animals could not compensate for the greater reduction in blood flow produced by 10 mL/kg hemorrhage, resulting in a significant reduction in oxygen uptake. Thus, the intestine of developing piglets up to 1 wk of age appears to be at greater risk for tissue hypoxia induced by arterial hemorrhage than that of older animals. PMID- 2771515 TI - Adenosine concentration in umbilical cord blood of newborn infants after vaginal delivery and cesarean section. AB - Umbilical blood was collected immediately at birth (less than 30 s) in full-term infants after vaginal deliveries (n = 33) and elective cesarean sections (n = 11). Blood gases, plasma adenosine, hypoxanthine, and catecholamine concentrations were determined. In vaginally born infants the median arterial adenosine concentration was found to be 0.46 microM (range 0.13-2.06) and the venous 0.48 microM (0.09-1.62). These levels were significantly higher (p less than 0.01) than in infants delivered by elective cesarean section; 0.16 microM (0.04-0.42) in the artery and 0.17 microM (0.02-0.56) in the vein. Vaginally born infants showed about a 4-fold higher level of umbilical arterial catecholamines than infants born by elective cesarean section. There was a strong inverse correlation between arterial hypoxanthine concentration and pH (r = -0.81, p less than 0.01). It is suggested that increased adenosine release at vaginal delivery modulates the stress response elicited by the strong catecholamine surge and may furthermore exert protective effects in perinatal asphyxia. PMID- 2771517 TI - Biochemical abnormalities of the third component of complement in neonates. AB - The third component of complement, C3, is of central importance as an opsonin in the nonimmune host. Although gestational deficiencies in C3 levels are well recognized in neonates, defects in complement-mediated functions have not in every case correlated with low levels of complement proteins. Because opsonic functions of C3 are mediated through a reactive thiolester bond, we hypothesized that a biochemical dysfunction at this active site could explain the newborn's predisposition to infection, even with relatively normal C3 levels. We therefore examined the biochemical integrity of the C3 thiolester in an assay independent of all other complement proteins. As measured by ELISA, mean C3 levels from 44 neonates (24-43 wk) were significantly lower in infants less than 30 wk gestational age (0.79 +/- 0.13 mg/mL) than in full-term newborns (1.19 +/- 0.27 mg/ml, p less than 0.05). Furthermore, biochemical reactivity of the thiolester bond, as measured by incorporation of the radiolabeled nucleophile, methylamine, correlated significantly with gestational age (r = 0.45, p less than 0.01). Functional C3 was defined as the product of thiolester reactivity and C3 level; 9/11 premature and 2/17 full-term infants had levels of functional C3 which were less than 50% of the adult norm. Structural analysis of neonatal C3 revealed the two-chain structure in all neonates; four neonates had an additional band at 205 kD which may represent an impairment in posttranslational processing of a precursor molecule. We conclude that defects in thiolester reactivity may constitute a newly identified mechanism for the newborn's susceptibility to infection. PMID- 2771516 TI - Fetal control of calcium transport across the rat placenta. AB - Control of maternofetal calcium transfer across the in situ perfused rat placenta at day 21 of gestation (term 23 d) was investigated in both intact fetuses and those parathyroidectomized by decapitation on day 19. Decapitation resulted in significant fetal hypocalcemia. Injection of fetuses subcutaneously through the uterine wall with 0.43 micrograms bovine (b) PTH(1-84), 20 ng 1,25(OH)2D3 or 10 microL of the appropriate diluent resulted 2 h later in a raised fetal blood ionized Ca concentration only with bPTH(1-84) in both normal and decapitated fetuses. Fetal decapitation caused a significant (p less than 0.001) fall in the clearance of 45Ca across the placenta (Kmf45Ca), which was significantly (p less than 0.05) reversed after fetal bPTH(1-84) and 1,25 dihydroxy vitamin D3 (1,25(OH)2D3) injection, but not back to normal levels. There was no effect of either hormone on Kmf45Ca in placentas from intact fetuses, or on Kmf51Cr-EDTA (used as an extracellular marker) in either group. When 4 ng/mL r[Nle8,21, Tyr34] PTH(1-34), 50 pg/mL 1,25(OH)2D3 or the appropriate diluent was perfused through placentas the only response observed was a significant (p less than 0.05) increase in Kmf45Ca with 1,25(OH)2D3 perfusion in placentas from decapitated fetuses, Kmf51Cr-EDTA being unchanged. Finally, perfusion with 10(-5) M forskolin (an activator of adenylate cyclase) stimulated Kmf45Ca in placentas from both normal and decapitated fetuses. Although there was also some effect on Kmf51Cr EDTA in the latter, there was none in the placentas from normal fetuses, and here the effect on Kmf45Ca was dose dependent with an initial response at 10(-6) M.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2771518 TI - Effects of furosemide on body water compartments in infants with bronchopulmonary dysplasia. AB - We studied the effects of a single dose of intravenous furosemide on the body water compartments of nine infants with bronchopulmonary dysplasia. We measured total body water, extracellular water, and plasma volume using deuterium oxide, sodium bromide, and Evans blue dye, respectively. From the results of these measurements, we calculated cell water, interstitial water, red cell volume, and total blood volume. We performed these measurements on the first day of the study and again 28 h later, 4 h after an intravenous dose of furosemide (1 mg/kg). All infants had a brisk diuresis in the first hour after the dose, but urine output was no greater during the 24-h period after the dose than during the preceding 24 h period. Total body water, extracellular water, and interstitial water were significantly decreased 4 h after furosemide. There was no change in plasma volume, red cell volume, or total blood volume. PMID- 2771519 TI - Effects of protein deprivation from the neonatal period on lung collagen and elastin in the rat. AB - We have previously reported mechanical lung alterations in rats fed a protein deficient diet from neonatal period to postnatal day 49 (12 and 8% protein versus a control 15% protein diet). From saline vol-pressure analysis, lungs from protein-deficient rats showed lower recoil pressure and needed higher pressure to rupture. In our study we have measured the collagen and elastin contents of homogenates of the lungs previously used for air-filling experiments. Results show that protein-deficient rats had lesser amounts of collagen and elastin per lung. Nevertheless tissue concentration of collagen remained constant, whereas elastin concentration was severely decreased. The decrease in lung recoil pressure is thought to be related to the lowered elastin concentration. Thus elastin accumulation, which mainly occurs between postnatal d 12 and 20, is predominantly affected by early protein deficiency with a consequent lack of increase in lung elasticity. The increased rupture pressure in protein-deficient rat lungs occurs despite the maintenance of the tissue concentration of collagen and suggests a role for other factors in this process. PMID- 2771520 TI - Effects of ascorbic acid in alkaptonuria: alterations in benzoquinone acetic acid and an ontogenic effect in infancy. AB - The effects of ascorbic acid on the excretion of homogentisic acid and its derivative benzoquinone acetic acid were studied in two adults and three infants. The administration of relatively large amounts of ascorbic acid to the adults was followed by a disappearance of benzoquinone acetic acid from the urine, whereas the level of excretion of homogentisic acid did not change. This could have relevance to the pathogenesis of ochronotic arthritis. In the 4-mo-old infant and the 5-mo-old infant ascorbic acid in the urine may have doubled the amount of homogentisic acid, presumably through an effect on the immature p hydroxyphenylpyruvic acid oxidase. Dietary reduction of the intake of tyrosine and phenylalanine substantially reduced the excretion of homogentisic acid. PMID- 2771521 TI - Major peroxisomal membrane polypeptides are synthesized in cultured skin fibroblasts from patients with Zellweger syndrome. AB - Biosynthesis of three major peroxisomal membrane polypeptides (70, 26, and 22 kD) were investigated in an attempt to account for the absence of peroxisomes in patients with Zellweger syndrome. Immunoblot analysis using membrane fractions of autopsied livers revealed that 70- and 22-kD polypeptides were deficient in three Japanese patients with this syndrome. However, pulse-labeling and chase experiments using cultured skin fibroblasts demonstrated that 70-, 26, and 22-kD polypeptides were synthesized in these patients at levels similar to those in the controls. No significant difference in the degradation rates of these polypeptides was noted between the patients and the controls. Subcellular fractionation after pulse-chase experiments revealed 70-kD polypeptides present in a membrane fraction of the cells. These observations indicate that at least 70 , 26-, and 22-kD peroxisomal membrane polypeptides are normally synthesized and considered to be transported into the disorganized peroxisomal membrane in patients with Zellweger syndrome. Molecular and functional analyses of these polypeptides are underway to clarify whether they contribute to membrane integrity or to the transport of peroxisomal matrix enzymes. PMID- 2771522 TI - Energy metabolism in children with newly diagnosed acute lymphoblastic leukemia. AB - The effect of tumor burden in acute lymphoblastic leukemia on resting energy expenditure, thermic effect of food, and substrate utilization was investigated with open-circuit indirect calorimetry after an overnight fast. Nine patients (six females, three males) ages 6.5 to 15.8 y were studied. Patients were divided into two groups according to their tumor burden at diagnosis (i.e. white cell count, presence or absence of mediastinal mass, or massive organomegaly). The patients with a greater tumor burden had increased energy expenditure. Their resting energy expenditure returned to normal in response to chemotherapy. These results must be interpreted with caution due to the small patients numbers (high tumor burden n = 3; low tumor burden n = 6). Substrate utilization was altered by chemotherapy with an increase in carbohydrate utilization and a decrease in fat oxidation (p less than 0.009). The magnitude of the thermic effect of food tended to increase on treatment (p less than 0.016). Inasmuch as most chemotherapy programs for children last up to 3 y, we believe it is important that the effects of chemotherapy on intermediary metabolism be studied, particularly in relationship to any possible permanent effects on growth and development. PMID- 2771523 TI - Latin-American Society for Pediatric Research. Abstracts for the 26th annual meeting. November 3-6, 1988, Mar del Plata, Argentina. PMID- 2771524 TI - Structural maturation of the human fetal lung: a morphometric study of the development of air-blood barriers. AB - To quantitatively follow the progressive capillarization of the fetal airway epithelium, we examined human lung tissue from nine fetuses ranging in gestational age from 18-26 wk. Our goals were to 1) determine the initial time of appearance of the air blood barrier (ABB) in the fetus; 2) follow the increase in the number of ABB per total epithelial airway surface (capillary load) with gestational age; and 3) measure the thickness of the ABB. Our results, obtained by using light and electron microscopy and an interactive computerized morphometry system, show that ABB first appear at 19 wk. Increasing gestation is accompanied by an exponential increase in the number of ABB (r = 0.96) and the total surface area that the ABB contribute to the total surface area of airway epithelium (r = 0.93). ABB thickness is comparable to the dimensions of minimal barrier thickness of the adult ABB. The structural development that we describe may be one of the factors determining preterm viability. PMID- 2771525 TI - Effects of an aorticopulmonary shunt on lung fluid balance in the young lamb. AB - We studied the effects of increased pulmonary blood flow on lung fluid balance in seven chronically instrumented lambs (18 +/- 1 d) with surgically created aorticopulmonary shunts. We measured mean pulmonary arterial and left atrial pressure (LAP), pulmonary blood flow, lung lymph flow, and lymph (CL) and plasma (CP) protein concentration with the shunt closed and opened. With the shunt partially open, a 35% increase in pulmonary blood flow resulted in an increase in pulmonary arterial pressure (15.5 +/- 1 to 19.5 +/- 1 torr) and LAP (2.0 +/- 0.5 to 3.5 +/- 0.5 torr). Lung lymph flow nearly doubled (1.53 +/- 0.28 to 2.83 +/- 0.52 mL/h) whereas the CL decreased (4.1 +/- 0.1 to 3.4 +/- 0.1 g/dL) resulting in a decrease in the CL/CP ratio (0.67 +/- 0.01 to 0.58 +/- 0.01). With the shunt fully open, pulmonary blood flow increased 65% over baseline, pulmonary arterial pressure increased from 16.5 +/- 2.0 to 26.5 +/- 5 torr, and LAP increased from 1.5 +/- 0.5 to 6.5 +/- 2.0 torr. Lung lymph flow increased (1.1 +/- 0.2 to 3.1 +/ 0.2 mL/h) whereas CL (4.1 +/- 0.1 to 3.1 +/- 0.3 g/dL) and CL/CP (0.66 +/- 0.02 to 0.51 +/- 0.05) decreased. All changes were statistically significant (p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2771526 TI - A diminished role for the sarcoplasmic reticulum in newborn myocardial contraction: effects of ryanodine. AB - Ryanodine, known to reduce Ca2+ release from the sarcoplasmic reticulum (SR), was used in conjunction with the single sucrose gap voltage clamp technique to study excitation-contraction coupling in papillary muscles isolated from newborn and adult rabbits. Ryanodine altered the components of voltage clamp-induced tension in the adult producing a pattern that closely resembled the normal newborn. The phasic component of tension in mature myocardium was markedly and significantly reduced by ryanodine. In addition, ryanodine significantly altered the voltage dependence of this component of tension, suggesting a change in its mechanism of generation. The appearance of a prominent phasic component of tension, absent normally, but produced in the newborn by Ca2+ loading, was also abolished by ryanodine. These results support previous proposals that the phasic component of voltage clamp-induced tension in mammalian myocardium is produced by the release of Ca2+ from the SR. In the newborn, ryanodine caused a significantly smaller decrease in the ratio of phasic to tonic tension than in the adult, suggesting a much less significant role for the SR in excitation-contraction coupling in the younger age group. Although ryanodine had a significant effect on phasic tension, no alteration in the amplitude or voltage dependence of tonic tension, generated by transmembrane Ca2+ influx, could be demonstrated in either newborn or adult heart. This investigation suggests that in newborn myocardium, Ca2+ release from the SR plays a negligible role in excitation-contraction coupling, which depends, rather, on the influx of Ca2+ from the extracellular space. PMID- 2771527 TI - Transmission of genital mycoplasmas from mother to neonate in women with prolonged membrane rupture. AB - Colonization of the neonate with genital mycoplasmas occurs during passage through a colonized birth canal or in utero via contamination of the amniotic fluid. To define further the route of transmission we obtained cultures from the maternal vagina, the amniotic fluid and the neonatal pharynx in 131 mother-baby pairs. Sixty-six percent (33 of 50) of the corresponding amniotic fluids were colonized when the vagina was colonized with Mycoplasma hominis. When the amniotic fluid contained M. hominis, 26% (9 of 34) of the neonates were colonized. Sixty percent (66 of 110) of the corresponding amniotic fluids were colonized when the vagina was colonized with Ureaplasma urealyticum. When the amniotic fluid contained U. urealyticum, 32% (22 of 69) of the neonates were colonized. No neonates were colonized with M. hominis without prior colonization of both the vagina and the amniotic fluid. We conclude that colonization of the amniotic fluid is an important intermediate step in colonization of the neonate with genital mycoplasmas. PMID- 2771528 TI - Neonatal serologic response at term to the genital mycoplasmas. AB - Genital mycoplasmas are frequently found in the amniotic fluid (AF) of women with ruptured membranes but are infrequent pathogens in the neonates born to these women. The serologic response to the genital mycoplasmas, Mycoplasma hominis and Ureaplasma urealyticum, was studied in 35 mother-baby pairs following term deliveries. Amniotic fluid and neonatal surface cultures were obtained in all cases, as were maternal and neonatal acute and convalescent sera. Despite significant maternal serologic response, there was essentially no neonatal response. Mothers with M. hominis in the AF were significantly more likely than those with negative cultures for M. hominis to exhibit IgG seroconversion and had significantly greater changes in IgG concentrations. Their infants, however, did not exhibit a significant seroresponse regardless of the AF and neonatal culture results. There was also a significant maternal seroresponse to U. urealyticum. However, this did not correlate with the presence of U. urealyticum in the AF. Significantly fewer neonates exhibited a seroresponse to U. urealyticum, again with no relation to culture results. PMID- 2771529 TI - Failure of erythromycin ointment for postnatal ocular prophylaxis of chlamydial conjunctivitis. AB - Chlamydia trachomatis is the most common pathogen associated with conjunctivitis during early infancy in the United States. During a 13-month interval at our medical center 4834 infants were born, 311 of whom (6.4%) had conjunctival specimens tested for chlamydial antigen before the age of 12 weeks. In 44 (14% of all tested infants, 0.9% of live births) chlamydial antigen was present. Because the rate of asymptomatic maternal chlamydial endocervical colonization is estimated to be 26% at our institution (previous prospective study), we calculated a minimal failure rate for erythromycin ocular prophylaxis of from 7 to 19.5%. A subsequent case-control study revealed that mothers of infants with chlamydial conjunctivitis were more likely to be primiparous (P = 0.03) and experience longer duration of rupture of membranes before delivery (P = 0.046). We conclude that a substantial percentage of infants exposed to Chlamydia develop chlamydial conjunctivitis despite receiving erythromycin ocular prophylaxis. PMID- 2771530 TI - Analyses of adverse reactions to diphtheria and tetanus toxoids and pertussis vaccine by vaccine lot, endotoxin content, pertussis vaccine potency and percentage of mouse weight gain. AB - We investigated the rates of local and systemic reactions following 9920 diphtheria-tetanus toxoids-pertussis immunizations from 25 lots of commercially available, United States-licensed diphtheria-tetanus toxoids-pertussis adsorbed vaccines from four manufacturers as a function of vaccine lot, endotoxin content, pertussis vaccine potency and percent of mouse weight gain. There were significant differences between the rates of reactions by lot for all local and systemic reactions except convulsions and hypotonic hyporesponsive episodes. For these latter reactions there were insufficient cases for analyses. P was less than 0.0001 for local reactions, fever, drowsiness, fretfulness, anorexia and screaming and 0.017 for vomiting. No single lot was associated with the highest or lowest rate of reactions for more than 3 of the 11 reactions. There was a significant positive association of endotoxin unit (EU) content and the percent of vaccine recipients who developed fever (P = 0.004). Fever increased in frequency from 20.6% of children immunized with vaccine lots that contained 2500 EU to 55.1% of children immunized with vaccine lots containing 40,000 EU. There were significant positive associations of all local reactions and pertussis vaccine potency (P = 0.0004), and percent of mouse weight gain (P less than 0.0001). There was also a positive association of percent mouse weight gain and persistent screaming (P = 0.001). However, for the majority of reactions there was no clinically meaningful associations between reaction rates and the biological properties of the vaccine studied. PMID- 2771531 TI - Omphalitis in the newborn infant. PMID- 2771533 TI - Pneumococcal antibody concentrations in young Papua New Guinean Highland children with pneumonia. PMID- 2771532 TI - Lack of toxicity in two cases of neonatal acyclovir overdose. PMID- 2771534 TI - Yersinia enterocolitica septicemia after accidental oral iron overdose. PMID- 2771535 TI - Susceptibility testing of anaerobes. PMID- 2771536 TI - Perinatal transmission of human immunodeficiency virus. PMID- 2771537 TI - Steroids for meningitis: tuberculous and bacterial. PMID- 2771539 TI - Symposium on Genitourinary and Gastrointestinal Infections. 9th annual National Pediatric Infectious Disease Seminar. Washington, DC, March 30 to April 1, 1989. PMID- 2771538 TI - Hazards of air travel for a child with otitis. PMID- 2771540 TI - Options in antimicrobial management of urinary tract infections in infants and children. PMID- 2771541 TI - Management of urinary tract infections. PMID- 2771542 TI - Management of diarrheal illness. PMID- 2771543 TI - Early detection of delayed myelination in preterm infants. AB - Myelination of the central nervous system can be demonstrated with magnetic resonance imaging. The influence of periventricular-intraventricular hemorrhage and periventricular leukomalacia on cerebral myelination was studied using magnetic resonance imaging. The subjects were 33 preterm infants of less than 30 weeks' gestation studied at 44 weeks' postmenstrual age: 11 infants with periventricular-intraventricular hemorrhage, 7 with periventricular leukomalacia, and 15 without periventricular-intraventricular hemorrhage or periventricular leukomalacia. There were no differences in mean gestational age and birth weight between the three groups. However, infants without periventricular intraventricular hemorrhage or periventricular leukomalacia had significantly less respiratory distress syndrome. At 44 weeks postmenstrual age, infants with periventricular leukomalacia had a significantly delayed myelination pattern (stage M2) in comparison with infants without periventricular-intraventricular hemorrhage or periventricular leukomalacia and infants with periventricular intraventricular hemorrhage (stages M3 and M4). The latter two groups had myelination stages that were similar to those of healthy term infants at 44 weeks' postmenstrual age. The results demonstrate that periventricular leukomalacia causes delayed myelination of the cerebrum, whereas periventricular intraventricular hemorrhage does not. PMID- 2771544 TI - Assessing the need for transfusion of premature infants and role of hematocrit, clinical signs, and erythropoietin level. AB - There are no clear criteria for administration of blood to premature infants. In the past, indications for transfusion have included tachypnea, tachycardia, poor weight gain, apnea, bradycardia, pallor, lethargy, decreased activity, or poor feeding. Some have suggested that erythropoietin levels may also be useful in determining the need for transfusion. Data were studied from 11 premature infants with birth weights less than 1500 g collected throughout 469 hospital days. During that period the infants received a total of 37 blood transfusions. No overall relationship was found between hematocrit of 19% to 64% and heart rate, respiratory rate, or the occurrence of bradycardia; ie, these variables proved to be clinically unreliable as indicators of hematocrit. Furthermore, no predictable effect of transfusion could be identified on heart rate, respiratory rate, or on the incidence of apnea or bradycardia. It was anticipated that frequent episodes of apnea or bradycardia might increase serum erythropoietin concentration. To the contrary, more frequent bradycardia was associated with the low erythropoietin levels because those infants tended to receive transfusions for "symptomatic" anemia. The data are consistent with the concept that "anemia of prematurity" is not predictably associated with symptoms classically attributed to anemia. Possible reasons for this are that the premature infant has a different inherent response to anemia; that it is inappropriate to extrapolate symptoms of severe acute anemia to persons with mild or moderate chronic anemia; or, most likely, that other determinants of heart rate, respiratory rate, and apnea/bradycardia are of more importance than mild or moderate anemia. PMID- 2771546 TI - Eye injuries in childhood: demography, etiology, and prevention. AB - A 1-year survey was conducted of all children with eye injuries seen in the Wills Eye Hospital emergency room to determine demographic, etiologic, and prophylactic factors. There were 810 children with ocular trauma. Childhood ocular injuries are frequent, often resulting in serious visual impairment. Many of these injuries are preventable. PMID- 2771545 TI - Brain death in the newborn. AB - The clinical courses of 18 preterm and term infants less than 1 month of age in whom brain death was diagnosed were retrospectively reviewed. Clinical diagnosis was determined neurologically and included (1) coma, (2) apnea, manifested by inability to sustain respiration, and (3) absent brainstem reflexes. Electroencephalograms were performed in all patients; 17 patients had adequate cerebral blood flow as estimated by radionuclide imaging. The results indicate that (1) neurodiagnostic tests such as electroencephalograms and radionuclide scanning reconfirmed clinically determined brain death in only one half to two thirds of patients; (2) electrocerebral silence in the absence of barbiturates, hypothermia, or cerebral malformations during 24 hours was confirmatory of brain death if the clinical findings remained unchanged; (3) absence of radionuclide uptake associated with initial electrocerebral silence was associated with brain death; (4) term infants clinically brain dead for 2 days and preterm infants brain dead for 3 days did not survive despite electroencephalogram or cerebral blood flow status; and (5) phenobarbital levels greater than 25 micrograms/mL may suppress electroencephalographic activity in this age group. The findings suggest that determination of brain death in the newborn can be made solely by using clinical criteria. Confirmatory neurodiagnostic studies are of value because they can potentially shorten the period of observation. PMID- 2771547 TI - Sports injuries in a high school. AB - A 1-year study was undertaken investigating all sports injuries at a large high school. A total of 1283 student athletes participated in sports and suffered 280 injuries for an overall injury rate of 22%. The largest injury rate was in football (61%) followed by girls and boys gymnastics, wrestling, and boys basketball. Five sports had no injuries--boys' tennis, golf, boys' and girls' swimming, and girls' water polo. Severity of injury was measured by number of days lost per injury. Girls' track had the greatest number of days lost per injury (320) followed by girls' basketball, girls' cross country, boys' track, and boys' wrestling. Sprains and strains accounted for 57% of all injuries. Of the injured athletes, 87 were seen by a physician and only 5 athletes required surgery. The small number of serious injuries requiring surgery suggests that a motivated and competent pediatrician can play an integral role as a team physician. PMID- 2771548 TI - Passive smoking by asthmatics: its greater effect on boys than on girls and on older than on younger children. AB - In 415 nonsmoking asthmatic children who were seen consecutively, asthma symptoms were more severe if the mother was a smoker than if she was a nonsmoker. This applied to both sexes but was more marked in boys than in girls. There were also other indications that sons were the more severely affected: the forced expiratory volume at 1 second, the forced expiratory flow rate during the middle half of the forced vital capacity, and the provocation concentration of histamine needed to result in a 20% decrease in the forced expiratory volume at 1 second were significantly decreased only in the sons, and lung function test results were significantly less in sons than in daughters of mothers who smoked. When the 415 children were stratified according to age, lung function improved significantly with increasing age in the children of nonsmokers; in children of smokers, by contrast, symptoms and lung function test results became progressively worse. As well, there was a correlation between these indications of asthma severity and the number of years the child had been exposed to the mother's smoke. It appeared that, compared with girls, boys were more sensitive to passive smoking, and that its adverse effect increased with age and with duration of exposure. PMID- 2771550 TI - Community physician's role in case management of children with chronic illnesses. AB - There is general agreement that case management should be provided to children with chronic illnesses, yet it is not clear who should provide this service. A survey of physicians and parents of children with chronic illnesses was conducted to evaluate the practice and views of pediatricians and compare their assessments with those of parents. Surveys were mailed to 360 physicians and 519 families with response rates of 39% and 63%, respectively. The majority of physicians (74%) thought that the primary care physician should provide case management. When compared with parents, physicians underestimated the parental need for information about the child's diagnosis (8% vs 52%, P less than .001), treatments (3% vs 54%, P less than .01), and prognosis (30% vs 78%, P less than .01). They also overestimated parental needs for information regarding financial aid (70% vs 58%, P less than .01), vocations (78% vs 54%, P less than .01), and insurance (62% vs 51%, P less than .05). Four services ranked by need by parents in the top 10 were not ranked in the top 10 by physicians. Rural physicians noted that services were more difficult to obtain than did those in nonrural areas. The physicians surveyed made several recommendations for steps that could be implemented to facilitate their role as case managers. If primary care physicians are to be effective case managers, alterations in the current system of care will be required including continuing education related to chronic illness, information about community resources, reimbursement for the time required to perform case management, and better communication between physician and parents. PMID- 2771549 TI - Cardiovascular fitness in children with asthma correlates with psychologic functioning of the child. AB - Abnormalities in fitness in asthmatic children are assumed to derive from illness severity. We studied 90 children with moderately severe to severe but stable asthma for (1) fitness levels using bicycle ergometry, (2) measures of asthma severity, (3) clinician's impression of child (Child Global Assessment Scale), and (4) mother's rating of child's behavior (Child Behavior Checklist). Fitness values ranged from 15% to 120% of normal values for age, sex, and body surface area: 48% were abnormal (less than 2 SD below mean) and 5% were borderline (1 to 2 SD below mean). Associations between levels of fitness and medical and psychologic criteria were tested using regression analyses. Of the 11 medical variables used to define the severity of asthma, recent exacerbation of disease, forced expiratory volume in 1 second, and specific airway conductance together accounted for 8.1% of the variability in the workload ratios (ie, R2 = 0.081). The importance of the psychologic factors in determining the variability in the workload ratios was tested after the importance of the medical variables had been considered: Child Global Assessment Scale accounted for a significant amount of variability, improving the R2 to 0.180 (an increase to 0.100, P = .003). These data suggest that, within the spectrum of disease presented by the patients in this study, adjustment to the disease is at least as important as severity of disease in determining fitness. PMID- 2771551 TI - Growth of vegetarian children: The Farm Study. AB - To examine the effects of a vegetarian diet on child growth, height and weight data of 404 vegetarian children aged 4 months to 10 years who lived in a collective community in Tennessee were studied. Height for age, weight for age, and weight for height were compared with the US growth reference. Birth weights, infant feeding patterns, and parental heights were also evaluated in relation to growth. Most of the height for age, weight for age, and weight for height (n = 833) were within the 25th and 75th percentiles of the US growth reference. The mean height for age and weight for age, however, were slightly less than the median of the reference population. For different age groups, the mean height ranged from 0.2 to 2.1 cm and the mean weight ranged from 0.1 to 1.1 kg less than the reference median. The largest height difference was observed at 1 to 3 years of age and may be partly the result of intrinsic irregularities in the US growth reference at those ages. By 10 years of age, children from The Farm averaged 0.7 cm and 1.1 kg less than the reference median, representing only 0.1 and 0.3 SD from the reference. Thus, these children have adequate attained growth, even though it was modestly less than that of the reference population. PMID- 2771552 TI - Superwarfarin poisoning in children: a prospective study. AB - This prospective study was undertaken to determine the incidence, severity, time of onset, and duration of coagulopathy in children following accidental ingestion of long-acting anticoagulant rodenticides, often called "superwarfarins." Of 110 children, who ingested superwarfarins and in whom one or more prothrombin time values were obtained, 8 had a prothrombin time ratio (patient to control) of greater than or equal to 1.2, indicative of anticoagulation. Prothrombin time values obtained 48 hours after ingestion were more likely to be prolonged (6/34, 17.6%) than values obtained 24 hours after ingestion (2/104, 1.9%) (P less than .005). The occurrence of an abnormal prothrombin time could not be predicted based on the history of amount ingested or on the presence of the characteristic green-blue product dye in or around the child's mouth. Acute toxicity was evidenced by transient abdominal pain, vomiting, and heme positive stools in 2 patients. The duration of prothrombin time prolongation could not be determined because of the few values obtained after 48 hours. To detect all possible abnormal prothrombin time values, 24- and 48-hour determinations are recommended after a child has ingested a superwarfarin. PMID- 2771553 TI - Linear growth of children with nephrotic syndrome: effect of alkylating agents. AB - Growth velocity measurements were assessed in 12 children with steroid responsive but frequent relapsing or dependent nephrotic syndrome prior to and following treatment with either cyclophosphamide or chlorambucil and alternate day prednisone. Patients averaged 6 +/- 3 years (mean +/- SD) of age at the time of treatment. All of the patients underwent renal biopsy prior to treatment; 5 of the 12 showed mesangial proliferation; and in 10 of the 12, IgM deposits were seen within the mesangium of the glomerulus. Growth rates before treatment with the alkylating agent were 4.3 +/- 1.3 cm/y increasing to 8.7 +/- 2.5 cm/y (P less than .001) after therapy despite the relapses that occurred in 5 of the patients in the year following treatment. Short-term side effects of the treatment were minimal. The significant increase in growth associated with diminished use of steroids makes the use of alkylating agents reasonable for children with nephrosis who show signs of decreased growth velocity. PMID- 2771554 TI - Feeding and temperament as determinants of early infant crying/fussing behavior. AB - In the first 3 months of life, crying and fussing in normal infants tend to increase until 6 weeks of age and decrease progressively thereafter. To determine whether feeding choice and early infant temperament are predictors of early crying, 374 healthy, full-term infants were observed prospectively from birth to 6 weeks of age. Feeding choice and sociodemographic characteristics were ascertained in the first few days postpartum. Parents completed a 17-item early infant temperament questionnaire at 2 weeks of age and a 24-hour behavior diary for 8 days at 6 weeks of age. Initially breast-fed infants cried and fussed more frequently throughout 24 hours compared with those who were formula fed, and increased frequency and duration of crying and fussing were predicted by "more difficult" temperament. Furthermore, a different pattern of crying and fussing within the day was found for infants who were changed from breast- to formula feeding. However, according to stepwise multiple regression models, daily duration of crying/fussing was significantly predicted only by the temperament score (but not initial feeding choice), which accounted for 7% of the variance. Frequency of crying/fussing were predicted only by socioeconomic status, temperament, and feeding frequency, which accounted for 12% of the variance. Breast- or formula feeding at 6 weeks of age was independently associated with crying/fussing only during the evening. It was concluded that early infant temperament predisposes to early crying and fussing but is of limited use as a clinical predictor. Later crying/fussing behavior is not predicted by initial feeding.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2771555 TI - Victimization of mothers of abused children: a controlled study. AB - To search for indicators of violence against mothers of child abuse victims by husbands or boyfriends, the women's medical records were reviewed and compared to records of mothers of a nontraumatized child comparison group. Of the 32 children ascertained in a 6-month interval, the records of mothers of 19 (59.4%) were diagnostic or highly suggestive of current or previous victimization. Although the prevalence of documented violence against the mothers of children in the comparison group was an unexpectedly high 16%, the case-control difference was highly significant (P less than .001). Although differences were found in the (younger) ages and (higher) parity of mothers of abused children, these differences did not predict risk of mothers' exposures to violence in a multivariate analysis. The rate of violence against single mothers of child abuse victims, however, was four times the rate against mothers who were married (P = .022). These findings suggest a need to broaden the diagnostic conceptualization of child abuse to include maternal victimization and argue for including data concerning maternal risk in formulating diagnoses and disposition plans for abused children. PMID- 2771556 TI - Prenatal exposure to alcohol: effect on infant growth and morphologic characteristics. AB - In this prospective study of alcohol and other substance use during pregnancy, a cohort of 650 women was interviewed at each trimester of pregnancy. Data are presented concerning the status of 595 live singleton births. A relationship was demonstrated between prenatal maternal alcohol use and growth and morphologic abnormalities in the offspring. Low birth weight, decreased head circumference and length, and an increased rate of fetal alcohol effects were all found to be significantly correlated with exposure to alcohol during the first 2 months of the first trimester. PMID- 2771557 TI - Pediatric rheumatology manpower and training: planning for the 1990s. PMID- 2771558 TI - Colic: exasperating but fascinating and gratifying. PMID- 2771560 TI - Acute splenic sequestration in a 2-month-old infant with sickle cell anemia. PMID- 2771561 TI - Ehrlichia canis infection in a child. PMID- 2771559 TI - Moebius sequence and prenatal brainstem ischemia. PMID- 2771562 TI - Chest pain in an adolescent: think of cocaine! PMID- 2771563 TI - American Academy of Pediatrics. Committee on Sports Medicine and Committee on School Health: Organized athletics for preadolescent children. PMID- 2771564 TI - Resurgence of acute rheumatic fever. PMID- 2771565 TI - Early language milestone scale and language screening. PMID- 2771566 TI - Growth of children with cerebral palsy. PMID- 2771567 TI - Expert testimony. PMID- 2771568 TI - [Status of the pulmonary surfactant system of the lungs and their morphofunctional maturity in full-term newborn infants with a history of chronic intrauterine fetal anoxia]. PMID- 2771569 TI - [Indicators of blood coagulation and fibrinolytic activity of the urine in children with calculous pyelonephritis]. AB - Parameters of hemocoagulation and fibrinolysis in the blood and urine were studied in 108 children with calculous pyelonephritis. Fibrinolytic inhibition and signs of hypercoagulation were noted. Changes in coagulation were found to be corresponding to the activity of the disease. The changes were mostly pronounced in the urinary fibrinolytic activity, with almost zero levels in those with bilateral nephrolithiasis accompanied by renal dysfunction. Fibrinolytic and anticoagulatory medication was found to be mandatory for the aforementioned patients. PMID- 2771570 TI - [Preliminary results of studying the effectiveness of hemosorption in the complex treatment of children with lupus nephritis]. AB - Hemosorption was employed in multi-modality treatment of 12 children aged 10-15 years with lupus nephritis. Of these, 5 patients suffered from nephritis associated with the nephrotic syndrome (NS), 4 patients had active pronounced nephritis without the NS, and 3 patients presented with latent nephritis. One case was characterized by transitory renal failure in the acute phase while 3 cases by chronic renal failure. Hemosorption produced a beneficial effect on the renal process and on electrolyte balance. The long-term observation over the patients evidences a short-term effect of hemosorption. After the attainment of that effect the further disease course depended on the adequacy of the conservative therapy administered to the patients with lupus nephritis. PMID- 2771572 TI - [Vitamin B6 metabolism in children with allergic dermatoses]. PMID- 2771571 TI - [Differential diagnosis of allergic and pseudoallergic variants of urticaria, Quincke's edema and neurodermatitis in children]. PMID- 2771573 TI - [Pulmonary and pleural changes in children with systemic lupus erythematosus]. PMID- 2771574 TI - [Intestinal lymphangiectasis in children]. PMID- 2771575 TI - [Disorders of microcirculation and problems of their correction in children with severe surgical pathology]. PMID- 2771576 TI - [Physical factors in the complex treatment of bronchial asthma in children]. PMID- 2771577 TI - [Neurologic disorders in young children with thymomegaly]. PMID- 2771578 TI - [Joint work of the AMS USSR Institute of Pediatrics with practical institutions of child health in Moscow]. PMID- 2771579 TI - [A case of Wissler-Fanconi allergic sepsis in a 6-month-old child]. PMID- 2771580 TI - [Wolman disease in children in the same family]. PMID- 2771581 TI - Myasthenia gravis: familial occurrence. A study of 1100 myasthenia gravis patients. AB - Eleven-hundred myasthenia gravis cases observed by the author in a period of 37 years are reviewed. The ratio of familial incidence was 4.23%. Transitory (neonatal) myasthenia in new-born babies should be separated from the familial cases. In familial myasthenia gravis both maternal and paternal line can occur. The majority of the cases are similar to the generalized, acquired myasthenia gravis, still there are some myasthenic familial congenital patients, too. Some rare instances are reported, among them a unique family with six sisters suffering from myasthenia gravis. Genetic line and HLA antigens' role are dealt with. Observation of familial myasthenia cases may contribute to the knowledge of the immunologic and clinicopathologic background of the disease. PMID- 2771582 TI - Effect of lithium on chemiluminescence of polymorphonuclear granulocytes and mononuclear cells of peripheral blood. AB - Influence of lithium on luminol amplified chemiluminescence activity of leucocytes of human peripheral blood was studied by a continuously recorded system. Lithium had a biphasic effect on mitogen-induced early activation of mononuclear cells, i.e. at concentration of 1.0 mM an increase, at higher concentrations a significant inhibition in photon emission was observed. Activating the mononuclear cells by opsonized Zymosan in the presence of lithium a dose-dependent decrease of chemiluminescence was registered. The respiratory burst of polymorphonuclear granulocytes induced by either mitogen or opsonized Zymosan was significantly inhibited at 2.0 and 5.0 mM of lithium, respectively. Chemiluminescence activity of peroxidase-dependent and independent cell-free system was not influenced by lithium. It was concluded that lithium by accumulating into target organs might have an immunosuppressive and antiphlogistic effect by mean of inhibition of antigen-presenting cells and polymorphonuclear granulocytes. PMID- 2771583 TI - Variations in prolactin secretion in hyper- and normoprolactinaemia with or without galactorrhoea. AB - The circadian variations and secretory rhythms in prolactin secretion were examined in 10 hyperprolactinaemic and 10 normoprolactinaemic women with or without galactorrhoea in order to establish a clearer picture of this secretion and to find, if exists, correlation between the prolactin level and galactorrhoea. In the normoprolactinaemic women a rhythmical rise and fall were observed within 20 min, with higher values during nocturnal sleeping; these changes were more marked in the galactorrhoeic group. In the hyperprolactinaemic group the diurnal and pulsation changes were less pronounced, galatorrhoea usually being accompanied by a higher degree of hyperprolactinaemia. In galactorrhoeic patients with a normal basal prolactin level, a relative prolactin excess may be reckoned with at certain times. A proportion of these women can in fact then be regarded as hyperprolactinaemic. In the hyperprolactinaemic cases without galactorrhoea, a decreased prolactin sensitivity and milk-forming ability of the breasts may be assumed. PMID- 2771584 TI - Drug use during pregnancy in Hungary. AB - The data-set of the Hungarian Case-Control Surveillance of Congenital Abnormalities, 1980-1985, demonstrates the occurrence and distribution of drug intakes during pregnancy in the so-called negative control pregnant women delivering unmalformed babies. Of 13.882, only 1260 (9.1%) did not mention drug intakes during pregnancy studied. When vitamins, iron and calcium supplements are excluded, this proportion increases to 29.1%. The most frequently used categories of drugs were sex hormones (41.8%) mainly as hormonal support therapy sedatives, hypnotics and other drugs acting on the central nervous system (38.8%), and drugs acting on the cardiovascular system (33.9%). PMID- 2771585 TI - The characteristics of the peripheral-limb-circulation in congestive heart failure. AB - The regulation of the peripheral-limb circulation was investigated in 21 patients suffering from chronic cardiac failure (NYHA stage II and III). In 11 patients the extremital circulation was intact, while 10 patients suffered from peripheral obliterative arterial disease, too (intermittent claudication or rest pain). The control group consisted of 75 subjects with normal cardiac condition. In 35 of the control subjects the peripheral circulation was intact, the remaining 40 suffered from extremital venous isotope dilution technique. In congestive heart failure the limb blood flow and the limb oxygen consumption slightly diminished, but remained in the normal range. The limb vascular resistance significantly increased. In patients suffering from intermittent claudication or rest pain, the marked diminution of the limb blood flow and elevation of the vascular resistance was more pronounced in congestive heart failure than in healthy subjects. The pathologically elevated limb vascular resistance decreased and the limb blood flow significantly increased in congestive heart failure on administration of vasodilator drugs. A pathological and mostly reversible increase in extremital vascular resistance is the most characteristic sign of the peripheral circulation in congestive heart failure. PMID- 2771586 TI - Changes with aging in the bone mineral content of the lumbar spine and femoral neck in healthy women in Hungary. AB - The bone mineral content (BMC) of the lumbar spine and femoral neck was studied in relation to aging in healthy Hungarian women by duel photon-absorptiometric method. The data were compared with North-American and West-European values. The Hungarian values are lower than these for reported from North-America or France, but similar to the BMC values for Sweden. The observed vertebral and femoral bone loss could be well represented by cubic equations. The acceleration of bone loss seems to begin around 40 years. The rate of bone loss was similar to the published values but the decrease in bone loss in the 6th and 7th decades was more suggestive. With regard to the fracture-threshold below which the risk for non-traumatic fractures of vertebrae increases, about 60% of Hungarian women at age 50-59 and about 84% at age 60-69 are considered to be at risk. It is concluded that geographical and habitual differences might be important factors in the development and change of BMC for different populations. PMID- 2771587 TI - Comparative studies of the elastin content of normal and emphysematous human lungs with special regard to antitrypsin deficiency. AB - The elastin content and the amino acid composition of elastin in emphysematous and healthy control lung tissues were comparatively studied. Decreased lung elastin content was found in the emphysematous patients of both normal and reduced trypsin inhibitor activity compared to normal control subjects. In the emphysematous patients with reduced inhibitor level a more significantly decreased elastin level was found than in those emphysematous patients with normal inhibitor level. There was no difference between the two groups in either the amino acid composition of elastin or the ratio of nonpolar to polar amino acid components. There was no significant correlation demonstrable between the age and the elastin content of the lung. This applied to the control group as well as to the emphysematous patients with normal trypsin inhibitor activity. The results indicate that no genetically abnormal pulmonary elastin structure is a predisposing risk factor but the reduced elastin content induced by elastase enzymes leading to changed mechanical properties is responsible for the development of pulmonary emphysema. PMID- 2771588 TI - Studies on semen of male rabbits in stilbestrol-induced hyperprolactinaemia. AB - Seminal volume, motility and sperm cell concentrations and seminal plasma levels of fructose, lactate, pyruvate, citrate and non-esterified fatty acids were determined in the semen of male rabbits treated with a daily dose of 1 mg stilbestrol for 15 successive days, and were assessed in their relation to the reproductive state. The results revealed reduction in the seminal volume, motility and sperm cell concentration in the treated animals as compared with the findings in untreated rabbits. The fructose level increased while the lactate level followed by pyruvate, citrate and non-esterified fatty acids levels decreased after stilbestrol injection. Thus, frequent administration of stilbestrol results in changes in both physical and biochemical constituents of semen. The physical characters and chemical constituents measured were discussed on the basis of their vital importance in the reproductive processes. PMID- 2771589 TI - Questions of quanta and qualia: does sensation make sense of matter--or does matter make sense of sensation? Part 2. PMID- 2771590 TI - Necessary considerations for a theory of form perception: a theoretical and empirical reply to Boselie and Leeuwenberg (1986) AB - Boselie and Leeuwenberg (1986) recently defended their version of the minimum principle, called structural information theory or SIT, against a varied set of criticisms. Two of the most notable of these criticisms are (i) that perceptual organization can proceed as a piecemeal, rather than as a global, process (as demonstrated by partially-biased Necker cubes and 'impossible' figures), and (ii) that perceptual organization is influenced by subjective variables as well as by stimulus variables (Peterson and Hochberg 1983). The second criticism was acknowledged by Boselie and Leeuwenberg but not addressed. The first criticism was addressed by the introduction of two new variables into SIT in order to argue that the perceived organization of partially-biased Necker cubes and impossible figures can be predicted by a global coding scheme, thereby supporting rather than refuting global minimum principles. It is argued here that the criticisms cannot be dismissed by this rebuttal, which is focused narrowly on single examples rather than on the general principles embodied by the demonstrations. The implications of piecemeal perception and subjective mediation are spelled out, and both old and new data showing that the applicability of global minimum principles must be reexamined, not merely defended, are discussed. Finally, the argument for a richer, more interacting, theory of form perception is presented. PMID- 2771591 TI - Tactile memory in sighted and blind observers: the influence of orientation and rate of presentation. AB - Sighted, early blind, and late blind subjects attempted to identify numerals or number sequences printed on their palms. The numerals were either upright, or inverted, or rotated perpendicular to the arm axis. Stimulus rotation degraded recognition in the early blind subjects, suggesting the influence of experience with visual frames of reference. Slower rates of presentation with upright number sequences improved recall in both sighted and blind observers. An experiment on tactual-visual braille recognition in the sighted observers showed that tilt degraded pattern identification, but visual guidance of the fingertip and ballpoint minimized this loss. A further experiment was performed to distinguish between visual imagery and visual frame of reference explanations of the visual guidance effect on recognition of rotated braille. Subjects explored upright or tilted braille characters while viewing only a light emitting diode on the exploratory fingertip. Sight of scanning movements did not aid pattern recognition with tilt. The results indicate that the benefits of visual guidance on recognition of tilted patterns were probably due to frame of reference information. It is concluded that spatial reference information may aid tactile memory in the sighted and late blind, since the early blind performed at a lower level in the retention task. It is proposed that visual imagery may only explain the superiority of the sighted and late blind when familiar stimuli are studied. PMID- 2771592 TI - Two-dimensional tilt illusions induced by orthogonal plaid patterns: effects of plaid motion, orientation, spatial separation, and spatial frequency. AB - Tilt illusions occur when a drifting vertical test grating is surrounded by a drifting plaid pattern composed of orthogonal moving gratings. The angular function of this illusion was measured as the plaid orientation (and therefore its drift direction) varied over a 180 degrees range. This was done when the test and inducing stimuli abutted and had the same spatial frequency, and when the test and inducing stimuli either differed in frequency by an octave, or were spatially separated by a 2 deg blank annulus, or both differed in frequency and were also separated by the annulus (experiments 1-4). The obtained angular function was virtually identical to that obtained previously with the rod and frame effect and other cases involving orthogonal inducing components, with evidence for illusions induced both by real-line components and by virtual axes of symmetry. Although the magnitude of the illusion was very similar in all four experiments, there was evidence to suggest that largest real-line effects occurred in the abutting same-frequency condition, with a pattern of results similar to that obtained previously with the simple one-dimensional tilt illusion. On the other hand, virtual-axis effects were more prominent with gaps between test and inducing stimuli. A fifth, repeated-measures, experiment confirmed this pattern of results. It is suggested that this pattern-induced tilt effect reflects both striate and extrastriate mechanisms and that the apparent influence of spatially distal virtual axes of symmetry upon perceived orientation implies the existence of AND-gate mechanisms, or conjunction detectors, in the orientation domain. PMID- 2771593 TI - Depth interpolation with sparse disparity cues. AB - The interpolation of stereoscopic depth given only sparse disparity information was investigated. The basic stimulus was a rectangle with zero disparity at one edge, and 20 or 30 min visual angle disparity at the other. The depth assigned to the ambiguous intervening locations was measured by means of a small briefly flashed binocular comparison spot. For a stimulus consisting of a uniform rectangle presented on a background of random dots with zero disparity, interpolated depth was greater for a high mean contrast between rectangle and background than for a low mean contrast. Relative to a linear interpolation between the edges, a larger difference in edge disparity resulted in poorer depth interpolation. Depth interpolation based on rivalrous information was examined by filling the stimulus rectangle with narrow-band filtered noise which was uncorrelated between the two eyes. Four different passbands which were matched in apparent contrast were investigated. The results demonstrate that the rivalrous low-spatial-frequency content was resistant to interpolation; rivalrous high spatial frequencies did not interfere with depth interpolation. High-spatial frequency stimuli yielded a percept similar to the uniform-field condition, whereas low-spatial-frequency stimuli lay in a depth plane near or even behind the background. In the latter case a transparent plane was perceived which was linearly interpolated between the two edges, and which floated above the rivalrous noise. PMID- 2771594 TI - Spatial and orientation specific integration in the tilt illusion. AB - Lateral inhibition across a population of cells in visual cortex which are tuned to local orientation has been proposed and widely accepted as a basic process in the analysis of contour in the visual field. The tilt illusion is usually explained in terms of this inhibition. Experiments are reported which cast new light on the analysis of visual orientation. It is shown that tilt illusions may be obtained with very thin inducing annuli which are spatially remote from the test figure. In experiments in which remote crossed-grating plaids were used, an illusion which was pattern (global) rather than component (local) selective was seen. It is difficult to account for these observations in terms of local inhibitory mechanisms. Rather, the results support the existence of a secondary mechanism which is involved in basic orientation analytic processes. The relevance of these observations to models of visual contour analysis is discussed. PMID- 2771595 TI - Stereoscopic depth: its relation to image segmentation, grouping, and the recognition of occluded objects. AB - Image regions corresponding to partially hidden objects are enclosed by two types of bounding contour: those inherent to the object itself (intrinsic) and those defined by occlusion (extrinsic). Intrinsic contours provide useful information regarding object shape, whereas extrinsic contours vary arbitrarily depending on accidental spatial relationships in scenes. Because extrinsic contours can only degrade the process of surface description and object recognition, it is argued that they must be removed prior to a stage of template matching. This implies that the two types of contour must be distinguished relatively early in visual processing and we hypothesize that the encoding of depth is critical for this task. The common border is attached to and regarded as intrinsic to the closer region, and detached from and regarded as extrinsic to the farther region. We also suggest that intrinsic borders aid in the segmentation of image regions and thus prevent grouping, whereas extrinsic borders provide a linkage to other extrinsic borders and facilitate grouping. Support for these views is found in a series of demonstrations, and also in an experiment where the expected superiority of recognition was found when partially sampled faces were seen in a back rather than a front stereoscopic depth plane. PMID- 2771596 TI - Development of infant reaching in the dark to luminous objects and 'invisible sounds'. AB - Two studies were conducted to investigate the existence of an unusual U-shaped developmental function described by Wishart et al (1978) for human infants reaching towards invisible sounds. In study 1, 2-7 month olds were presented with four conditions: (i) an invisible auditory stimulus alone, (ii) a glowing visual stimulus alone, (iii) auditory and visual stimuli on the same side (ie combined), and (iv) auditory and visual stimuli on opposite sides (ie in conflict). Study 2 was designed to examine the effects of practice and possible associations made when using the 'combined conflict' paradigm. Infants of 5 and 7 months of age were given five trials with the auditory stimulus, with or without prior visual experience, and five trials with the visual stimulus, with the position of the stimulus varied on each trial. Stimuli were presented individually at the midline, and +/- 30 and +/- 60 degrees from the midline. In both studies testing was conducted in complete darkness. Results indicated that the auditory-alone condition was slower to elicit a reach from the infants, relative to the visual alone one, and reaches were least frequent to the auditory target. No U-shaped function was obtained, and reaching for auditory targets occurred later in age than for visual targets, but even at 7 months of age did not occur as often and was achieved by fewer infants. In both studies the quality of the reach was significantly poorer to auditory than to visual targets, but there were some accurate reaches. This research adds to our understanding of the development of auditory-manual coordination in sighted infants and is relevant to theories of auditory localization, visually guided reaching, and programming for the blind. PMID- 2771597 TI - Partial color constancy of isolated surface colors examined by a color-naming method. AB - Color samples selected from the OSA Uniform Color Scales set were viewed without any surround. Separate light sources were used to illuminate the samples and to control the state of adaptation of the subject, thereby separating two factors that are normally confounded. A color-naming procedure was used to assess shifts in color appearance produced by altering the spectral distributions of one or both light sources. The results confirm that chromatic adaptation, when it is the only factor operating, can mediate partial color constancy. PMID- 2771598 TI - The role of the adjacency between background cues and objects in visual localization during ocular pursuit. AB - Subjects used eye movements to pursue a light target that moved from left to right with a velocity of 15 deg s-1. The stimulus was a sudden five-fold decrease in target intensity during the movement. The subject's task was to localize the stimulus relative to either a single stationary background point or the midpoint between two points (28 deg apart) placed 0.5 deg above the target path. The stimulus was usually mislocated in the direction of eye movement; the mislocation was affected by the spatial adjacency between background and stimulus. When an auditory, rather than a visual, stimulus was presented during tracking, target position at the time of stimulus presentation was visually mislocated in the direction opposite to that of eye movement. The effect of adjacency between background and target remained the same. The involvement of processes of subject relative and object-relative visual perception is discussed. PMID- 2771599 TI - Hands-on to handle-turning man. PMID- 2771600 TI - Angular induction as a function of contact and target orientation. AB - The Poggendorff effect is seen as misalignment of two obliques, or misprojection of one, when the obliques are placed outside a set of parallel lines. To understand better the mechanisms behind this effect, the orientation of the lines which are normally parallel was systematically manipulated. The results indicate that projection bias is affected by the orientation of either line, is at a minimum where the line is orthogonal to the oblique, and is maximal at small angles. This is in line with classic theories which attribute the illusion to misperception of angular size. However, such explanations presuppose that in order to be effective the induction line must be proximal to the oblique so that an angle can be formed. Results are reported which show that the angle formed by the oblique and a line placed at a distance from the oblique, serving as the target of the projection, follows an angular rule of effectiveness similar to what is seen when the line is placed directly in contact with the oblique. The underlying process is described as 'angular induction'. PMID- 2771601 TI - Globally perceived directional flow in static images. AB - Visual sensitivity to spatial direction has classically been associated with motion perception. Yet humans are adept at deriving directional information in the absence of motion, as when they read maps, or follow arrows or animal tracks. Experiments are reported on the perception of parallel arrow-like forms in which a specific visual sensitivity to static direction is demonstrated. Global processing is operationally defined in terms of the relative discriminability of sets and subsets of stimulus elements; a set of parallel elements and a set in which one element is antiparallel to the rest are shown to be processed globally. The result of this global processing is a static analog of unidirectional optic flow. Global spatial direction differs fundamentally from other perceptions derived from static image processing. It involves long-range interactions in texture arrays, it does not carry information about stimulus location, and it is not reducible to the perception of component stimulus elements. Its likely function is in the construction of the layout of visual space. PMID- 2771602 TI - Rotating trapezia which appear luminous and transparent during reversals. AB - If a rotating trapezium is lit by a visible source at one side, it sometimes reflects light to the observer and sometimes appears dark. This provides information about its orientation which is relevant to the suppression of apparent reversals. Marked suppression does occur if the light is between the observer and the object, but in other cases novel phenomena arise. The onset of light may precipitate corrections, ie discontinuous shifts from an illusory percept to a veridical one. At certain stages the object may also appear to be transparent and luminous, particularly if a bar has been passed through it: the bar then appears to be visible through the object. The effects illustrate the limited use vision makes of seemingly excellent sources of information, but they also indicate that the problem may lie in misplaced sophistication rather than crudity. PMID- 2771603 TI - 'Where' and 'what' in visual search. AB - A line segment target can be detected among distractors of a different orientation by a fast 'preattentive' process. One view is that this depends on detection of a 'feature gradient', which enables subjects to locate where the target is without necessarily identifying what it is. An alternative view is that a target can be identified as distinctive in a particular 'feature map' without subjects knowing where it is in that map. Experiments are reported in which briefly exposed arrays of line segments were followed by a pattern mask, and the threshold stimulus-mask interval determined for three tasks: 'what'--subjects reported whether the target was vertical or horizontal among oblique distractors; 'coarse where'--subjects reported whether the target was in the upper or lower half of the array; 'fine where'--subjects reported whether or not the target was in a set of four particular array positions. The threshold interval was significantly lower for the 'coarse where' than for the 'what' task, indicating that, even though localization in this task depends on the target's orientation difference, this localization is possible without absolute identification of target orientation. However, for the 'fine where' task, intervals as long as or longer than those for the 'what' task were required. It appears either that different localization processes work at different levels of resolution, or that a single localization process, independent of identification, can increase its resolution at the expense of processing speed. These possibilities are discussed in terms of distinct neural representations of the visual field and fixed or variable localization processes acting upon them. PMID- 2771604 TI - How serial is serial processing in vision? AB - Visual search for an element defined by the conjunction of its colour and orientation has previously been shown to be a serial processing task since reaction times increase linearly with the number of distractor elements used in the display. Evidence is presented that there are parallel processing constituents to this serial search. Processing time depended on the ratio of the number of the two distractor types used, suggesting that only one type was scanned. Which type was scanned also depended on the distractor ratio, indicating that this decision was made after stimulus presentation and was based on a parallel figure-ground separation of the stimulus elements. Furthermore, in accordance with this serial scanning model, there was an increase in processing speed (elements scanned per second) with increase in number of elements to be scanned. This increased efficiency suggests that clumps of elements were processed synchronously. Under the stimulation conditions used, clumps contained six to sixteen elements and each clump was processed in 50-150 ms. PMID- 2771605 TI - Privileged directions for subjective contours: horizontal and vertical versus tilted. AB - Subjective contours and brightness enhancement in Ehrenstein-like situations are affected by pattern orientation. If a classic Ehrenstein pattern (with four inducing elements for every gap at intersection points) is observed, a number of anomalous illusory patches usually appear in these gaps, but if the same pattern is observed tilted by 45 degrees the patches disappear and it is possible to see an illusory grid of horizontal and vertical 'streets'. These two perceptual results are mutually exclusive. In a Koffka-cross variant of this pattern, the illusory patches, which are usually square, appear more rounded in the tilted pattern. All these results were confirmed in two experiments by means of a magnitude estimation procedure. It is suggested that the formation of a subjective contour is easier along horizontal and vertical directions and more difficult in an oblique direction, and that this phenomenon, as well as other visual acuity oblique effects, depends in part on the basic functioning of the visual system at the level of sensation. PMID- 2771606 TI - Misaligned maps lead to predictable errors. AB - Three experiments were conducted to investigate the ability of subjects to make judgments of direction when using misaligned maps. Two hypotheses were proposed (i) errors would fall into two lawful categories--mirror-image errors and alignment errors; (ii) the effect of map orientation would generalize to a different mode of responding than has been used in previous studies. Support for both hypotheses was obtained. The results are discussed in terms of the mental processes used to align maps to spaces, and the task demands required by different response modes. PMID- 2771607 TI - Making Mayhew and Frisby effortlessly discriminable. AB - Mayhew and Frisby (1978) demonstrated that patterns which differ markedly in their spatial-frequency content may be very hard to discriminate. This they took as evidence against any model which proposes that the processes underlying texture discrimination have direct access to some local piecewise Fourier analysis of the patterns performed by spatial-frequency channels. It is shown that Mayhew and Frisby's patterns can be discriminated easily if their components have been incorporated into a pattern-contingent colour aftereffect. This demonstration suggests that the location in the visual pathway for contingent aftereffect adaptation must lie before the construction of the raw primal sketch, to which, according to Marr, we have conscious access. This location must also allow the orientation specificity seen in the aftereffect. This points to a locus in the striate cortex. PMID- 2771608 TI - Errors in estimating the orientation of dot patterns. AB - The error in estimating the orientation of a dot pattern was measured as the difference between the orientation of the least-squared-distances line (LS-line) of the pattern and the orientation of a line adjusted by the subject to match the perceived orientation of the pattern. Analysis of the mean errors (averaged over ten subjects) obtained for one hundred patterns confirmed that the orientation of the LS-line represents the orientation of elongated dot-patterns. It is shown that estimated orientation was systematically biased towards the nearest 45 degrees oblique meridian. This bias points to the importance of the +/-45 degrees directions as natural norms for left- and right-side tilt in the frontoparallel plane. PMID- 2771609 TI - Anatomy of a flash. 1. Two-peak masking and a temporal filling-in. AB - A modified paradigm of Crawford masking was used to link masking to brightness fluctuation, as distinct from flash brightness. Thresholds were measured for a 10 ms incremental pulse (the 'probe') presented before, during, or after a 500 ms pulse (the 'flash'). Both pulses were spatially coextensive with the background field, thus the criterion for probe detection was purely temporal. The flash occurred either in the tested eye, the opposite eye, or in both eyes. In all conditions, masking was strongly bimodal: thresholds peaked near flash onset and flash offset. The flash was perceived as a unitary event. Bimodal masking is attributed to cortical on-and off-effects, as (i) dichoptic masking was strong and (ii) the same incremental probe was masked by either incremental or decremental flashes. Strikingly, monocular probe thresholds were about equally elevated by binocular as by monocular flashes, although the binocular flashes were brighter. Therefore, some monocular features can be preserved in the larger net binocular response. A general conclusion is that masking depends on the same transient neural responses that bring about a brightness fluctuation, whereas the appearance of the flash as a single event, a unitary change of brightness, depends on a different mechanism, perhaps a sustained response that performs a temporal filling-in. PMID- 2771610 TI - Effects of phosphor persistence on perception and the control of eye movements. AB - When a rapid eye movement (saccade) is made across material displayed on cathode ray tube monitors with short-persistence phosphors, various perceptual phenomena occur. The phenomena do not occur when the monitor has a long-persistence phosphor. These phenomena were observed for certain spatial arrays, their possible physiological basis noted, and their effect on the control of eye movements examined. When the display consisted simply of two dots, and a saccade was made from one to the other, a transient ghost image was seen just beyond the destination target. When the display consisted of vertical lines, tilting and displacement of the lines occurred. The phenomena were more intrusive for the latter display and there was a significant increase in the number of corrective saccades. These results are interpreted in terms of the effects of fluctuating illumination (and hence phosphor persistence) on saccadic suppression. PMID- 2771611 TI - Olfactory adaptation and recovery in old age. AB - Four experiments are reported in which it is shown that elderly adults are more prone than young adults to olfactory adaptation and are slower to recover threshold sensitivity. The first three experiments differed in detail, but had in common an initial threshold determination for 1-butanol, a 30 s exposure to a concentration twenty-seven times threshold, followed by repeated presentation of the initial threshold level at various intervals after adaptation. In three experiments accuracy of forced-choice discrimination was poor immediately after adaptation but tended to improve with time, and considerably faster in the young than in the elderly. In the fourth experiment, groups of twenty-three elderly and twenty-five young subjects threshold-matched for pyridine were compared. The subjects participated in three sessions in which pyridine was infused into a test chamber at either 2.5, 1.25, or 0 L min-1 (sham session). At 2.5 L min-1 both groups were able to track the buildup of odor intensity during infusion and its decline after infusion. In contrast, at 1.25 L min-1 only the young were able to track odor intensity, even though the concentration rose above initial threshold levels. PMID- 2771612 TI - Partial masking in electrocutaneous sensation: a model for sensation matching, with applications to loudness recruitment. AB - A model for partial masking and other threshold-elevation effects is presented in the context of a sensation-matching paradigm. The model is applied to an electrocutaneous experiment in which the subjects adjusted stimulus intensity on the right-hand fingertip to match sensation levels of standard stimuli presented to the left fingertip. Concurrent mechanical stimulation on the right fingertip masked sensation magnitude in a way consistent with the model. Similarities between this tactile masking effect and analogous auditory phenomena are explored. When applied to loudness matching, the model describes the general shape of loudness contours and it shows that the steep slopes observed in auditory masking and "recruitment" can be a consequence of a threshold shift alone, without a supranormal growth in loudness. The model also shows that a small response bias can distort plots of sensation matching, leading to the suggestion that some varieties of loudness recruitment may not have a sensory basis. PMID- 2771613 TI - The psychophysics of the pursuit oculomotor system. AB - When a fixation point moves under a row of identical targets at a speed of one target for each flash of a strobe, smooth apparent movement of the targets is seen (the "picket-fence illusion"). When the fixation point is removed, the eye continues to pursue the apparent target movement. Pursuit continues through small changes in target configuration, but is interrupted by a change to a very dissimilar target (such as 1 vs. x) in the middle of a row. This new method, the "pursuit-interruption method," showed that large differences in the number of pixels in a line did not interrupt tracking if the end points of the line were preserved. Pursuit interruption by changes in line orientation (such as /vs./) corresponded to the orientation bandwidth of orientation-sensitive cortical neurons. The maximum number of consecutive missing targets that does not interrupt pursuit depends on frequency of target presentation as well as on parameters of the pursuit system. PMID- 2771614 TI - Visual orientation estimation. AB - A systematic error is reported in orientation estimation, in that on average, estimates are closer to the vertical axis than are the stimuli by up to 6 degrees. This systematic error results from a specific mechanism that may be related to depth perception, and that is avoided in certain circumstances or when other mechanisms take over. For example, the estimates of one observer who was a well-trained professional draughtsman did not show this systematic error. Furthermore, for all observers tested, estimation of clock time is not subject to the regular orientation estimation error. Rather, observers tend to estimate times as slightly further from the quarter hour than they really are. Orientation judgement channel capacity was also studied under various conditions. The number of discriminable orientations is far above the magic number "7" limit, reaching over 20 in optimal circumstances. The distribution of discriminable orientations is nonlinear, in that these are more closely packed about the horizontal and vertical axis than at the oblique. PMID- 2771615 TI - Identification and discrimination of sweep formants. AB - Earlier identification experiments with sweep tones are repeated with rising and falling single formant (band) sweeps, with durations ranging from 15 to 40 msec and sweep rates from 0 to 40 oct/sec. Steady-state portions of 100-msec duration are then added to the sweeps. The general conclusions are that the tendency to perceive level and slightly rising tones as falling, which was such a prominent feature of the earlier results, disappears as the stimuli become more complex, and that sweep discrimination seems to be a function of the difference between the initial and the final frequency of a sweep. PMID- 2771616 TI - Eye movement control during reading: II. Frequency of refixating a word. AB - An analysis of over 40,000 eye fixations made by college students during reading indicates that the frequency of immediately refixating a word following an initial eye fixation on it varies with the location of that fixation. The refixation frequency is lowest near the center of the word, positively accelerating with distance from the center. The data are well fit by a parabolic function. Assuming that refixation frequency is related to the frequency of successful word identification, the observed curvilinear relation results naturally from models that postulate a linear decrease in visual information with retinal eccentricity. A single letter difference in fixation location in a word can make a sizeable difference in the likelihood of refixating that word. The effects of word length and cultural frequency on the frequency of refixating are also examined. PMID- 2771617 TI - Do response time advantage and interference reflect the order of processing of global- and local-level information? AB - Navon's (1977) global precedence hypothesis was based primarily on the joint occurrence of two effects: a response time (RT) advantage for identifying global targets, and interference by global distractors on responding to local targets. Although the hypothesis has been questioned on the basis of experiments in which it has been shown that a local RT advantage and local interference can occur, it is still frequently assumed that these two effects are a valid measure of the order in which local and global levels of structure are processed. In the present experiment, this assumption was examined. Subjects identified target letters that occurred randomly at the global or local level in a divided-attention task. The visual angle subtended by the stimulus pattern was varied, a manipulation known to affect the relative speed of response to local- or global-level information. Local targets were identified faster than global targets at the larger visual angles, but there was no difference in RT at the smallest visual angle. Despite this change in RT advantage, the interference effect did not change as a function of the visual angle of the stimulus pattern. Moreover, global distractors interfered with responding to local targets but local targets had no effect on responding to global targets, which is exactly the opposite of the finding one would expect if RT advantage and interference reflected order of processing. These findings are not consistent with the assumption that RT advantage and interference reflect order of processing in a simple way. PMID- 2771618 TI - The temporal distribution of stimulus information in the visual evoked potential. AB - Research in psychophysics (Bloch's law) and perceptual experiments concerned with the integration of successively presented stimuli suggest that the perception of form is a process that occurs over a period of as much as 200-300 msec. Such results prompted the question of whether the visual evoked potential (VEP) might contain information about the distribution over time of perceptual processing. Subjects viewed lines formed from combinations of three lengths and four angles while the EEG was recorded. Analysis of the VEPs indicated that the length and angle of the lines produced temporal distributions of information in the VEP and that the distributions for length and angle were somewhat different. The major difference was that the processing of angle begins earlier and is completed sooner than the processing of length. A conclusion of the experiment was that an alternative or supplement to analyzing VEPs for specific waveform features is to consider the encoding of stimulus information in the VEP as a density or concentration over time. PMID- 2771619 TI - The effect of movement velocity on form perception: geometric illusions in dynamic displays. AB - We investigated the effects of movement velocity on the perception of simple geometric trajectories. We show that when an ellipse is traced by the continuous displacement of a spot against an empty background, the subjective aspect ratio (R = vertical axis/horizontal axis) of the figure depends on the law of motion of the spot. If the tangential velocity of the spot is constant, very large and subject-specific biases emerge in the perception of the aspect ratio. If the tangential velocity of the spot is made equal to that of an elliptic motion with aspect ratio R less than 1, and resulting from the vectorial composition of two harmonic functions (Lissajous motion) there is a general trend to perceive the ellipse as being flatter than in reality. The effect, however, is not symmetric: when the velocity follows a Lissajous modulation with R greater than 1, highly significant biases are still present in most subjects, but no common trend emerges from the experimental population. The results are discussed in the context of recent findings on the relationship between form and kinematics in spontaneous human movements. PMID- 2771620 TI - Lingual vibrotactile threshold shift during magnitude-estimation scaling: effects on magnitude-estimation responses and scaling behavior. AB - The purpose of the present study was to determine if lingual vibrotactile threshold shifts occurred during magnitude-estimation scaling of suprathreshold stimuli presented to the dorsal surface of the tongue. Possible relationships of the lingual vibrotactile threshold shifts to suprathreshold stimulus intensity, magnitude-estimation responses, and overall scaling behavior were explored. A single group of 24 subjects with an age range of 18 to 22 years participated in this study. Each subject performed two magnitude-estimation tasks. In one of the tasks, threshold of sensitivity was determined after every suprathreshold numerical response of the subject. If a threshold shift was recorded, threshold was allowed to return to the pretest baseline level before continuing to the next suprathreshold stimulus presentation. The results showed that threshold shift did occur during lingual vibrotactile magnitude-estimation scaling, and that it was related to suprathreshold stimulus intensity. The results also showed that the numerical magnitude-estimation responses of the subjects were different for the two scaling tasks. Overall scaling behavior of the subjects in the form of power function exponents was not different for the two tasks. PMID- 2771621 TI - Is visual illusion decrement based on selective adaptation? AB - Illusion decrement is the reduction in the magnitude of visual geometric illusions with continued exposure, and it has been explained in two ways. The first explanation is the selective adaptation, or fatigue, of neural channels carrying orientation and/or spatial frequency information; the second explanation involves perceptual learning, in which the observer changes viewing strategy after continued exposure to a stimulus. Either mechanism could cause changes in the perception of a stimulus over time. One hundred twenty observers were tested in an illusion-decrement paradigm under exposure conditions that altered the amount of selective adaptation of specific neural channels. Observers were also measured on the magnitude of the transfer-of-decrement effect. Both decrement and transfer of decrement occurred, but there was no significant difference across exposure conditions. In addition, the pattern of transfer differed from that observed in selective adaptation paradigms. These results argue against a neural adaptation interpretation of illusion decrement. PMID- 2771622 TI - Vowel and consonant judgments are not independent when cued by the same information. AB - Despite many attempts to define the major unit of speech perception, none has been generally accepted. In a unique study, Mermelstein (1978) claimed that consonants and vowels are the appropriate units because a single piece of information (duration, in this case) can be used for one distinction without affecting the other. In a replication, this apparent independence was found, instead, to reflect a lack of statistical power: The vowel and consonant judgments did interact. In another experiment, interdependence of two phonetic judgments was found in responses based on the fricative noise and the vocalic formants of a fricative-vowel syllable. These results show that each judgment made on speech signals must take into account other judgments that compete for information in the same signal. An account is proposed that takes segments as the primary units, with syllables imposing constraints on the shape they may take. PMID- 2771624 TI - Data-reduction problems in biopharmaceutics and pharmacokinetics. AB - The importance of the use of appropriate biostatistical methods is stressed. In this article some problems and common errors in the data-reduction methods applied in biopharmaceutical and pharmacokinetic research are discussed. A commonly used representation of a set of concentration-time curves is the so called 'mean curve', a curve through the arithmetic means of concentrations at discrete time points. If individual curves are compared with the 'mean curve' it appears that important characteristics have disappeared while other, incorrect, characteristics have been created. Unreliable conclusions may result from this procedure. Rather every single concentration-time curve should be fitted by appropriate regression methods and the resulting parameters be considered as multiple characteristics of individual pharmacokinetic behaviour. In a second data-analysis step these parameters may be clustered into more or less homogeneous subgroups, which subsequently may be represented by a representative curve. Standard errors of the mean and confidence intervals based on standard errors of the mean instead of the standard deviation are often misused as dispersion measures to characterize the sample or population distribution. Standard errors of the mean and confidence intervals measure the precision of the mean of a sample and are sensitive to the sample size. Vertical bars (in curves) representing standard deviation, standard errors of the mean or confidence intervals suggest symmetrical distributions, but this is sometimes not justified. Deviations from normality appear to occur often. A simple graphical method to indicate the dispersion of non-normal sets is presented. Methods for the determination of confidence intervals for normal and non-normal distributions are discussed.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2771623 TI - Resolution in one dimension with random variations in background dimensions. PMID- 2771625 TI - Comparative study on the production and accumulation of unusual phenylpropanoids in plants and in vitro cultures of Coreopsis tinctoria and C. lanceolata. PMID- 2771626 TI - Effect of albumin distribution. A simulation analysis of the effect of altered albumin distribution on the apparent volume of distribution and apparent elimination rate constant of drugs. AB - The effects of altered albumin distribution on the apparent volume of distribution (V) and the apparent elimination rate constant (kappa) of drugs were investigated by a simulation analysis. The Equations derived by Oie et al. were modified for this purpose. Within the range observed in normal healthy subjects and patients, the change in albumin distribution significantly affected V of drugs but, in general, not kappa. For drugs with more than 90% plasma-protein binding, V changed by more than 100%. The change in plasma-protein binding caused by an altered albumin distribution produced a greater effect on V than that caused by an altered albumin amount. These results suggest that albumin distribution is an important factor in controlling the kinetics of drugs which are highly bound to plasma protein. This is illustrated using midazolam as an example. PMID- 2771627 TI - Cytogenetics acquisitions in malignant lymphomas. PMID- 2771628 TI - Prognostic factors in malignant lymphomas. PMID- 2771629 TI - The usefulness of phenotypic and genotypic studies in malignant lymphoma and related disorders. PMID- 2771630 TI - MHC related genetic susceptibility to Hodgkin's disease. AB - The present report describes 4 Caucasoid families, HLA genotyped, with at least 2 affected siblings suffering from Hodgkin's disease. The affected sibling pairs were identical (2 shared haplotypes) in 2 families and haploidentical (1 shared haplotype) in the 2 others. These results together with the data already published provide evidence for a distortion of the segregation of HLA haplotypes: from a total of 43 pairs of siblings reported, the observed repartition is 22, 15, 6 (2, 1, 0 shared haplotypes respectively) instead of 10.75, 21.5, 10.75 (mendelian repartition). The excess of identical siblings pairs (51% instead of 25%) (p less than 10(-5) confirms the existence of a genetic linkage between the chromosomal HLA region and the susceptibility to the disease. PMID- 2771631 TI - Cytogenetics of acute nonlymphocytic leukemia in relapse. AB - Cytogenetic studies were performed at diagnosis and in relapse in 45 patients with acute nonlymphocytic leukemia. While 23 patients did not exhibit clonal chromosome changes, the other half had changes of different types: apparent acquisition of clonal abnormalities in 4 cases normal at diagnosis; appearance of additional chromosome changes either in the same clone or as mosaic in 9 cases; selection of a minor subclone previously observed at diagnosis in 7 cases; disappearance of the abnormal clone replaced by a cytogenetically unrelated karyotype in 2 cases. Some non clonal anomalies similar to those observed in secondary leukemias were also detected. PMID- 2771632 TI - Serotonin and human immunodeficiency viruses. AB - This preliminary study shows, for the first time to our knowledge, decreased whole blood serotonin levels in AIDS patients as compared to healthy controls and cancer patients. The lowest serotonin levels were found in AIDS patients with neuropsychiatric symptoms. Finally the present data suggest an inverse relationship between serotonin level and AIDS severity. PMID- 2771634 TI - Metaanalysis: methodology, biostatistic rules, application in onco-hematology. AB - Metaanalysis are proposed in order to increase statistical power and draw better conclusion about the efficacy of a treatment. After inclusion of trials corresponding to an objective, a statistical procedure is performed permitting to obtain an estimate of the common effect with the confidence interval after model validation. The main problem is posed by the selection of trials in order to avoid positive bias linked to the greater number of positive published studies. Application of metaanalysis in oncohematology should be proposed in case of weakness size of population in the individual trials. PMID- 2771633 TI - Combined therapy interferon and chemotherapy in chronic myelogenous leukemia. AB - In view of the results achieved by others with interferons and also with low doses of Cytosine-arabinoside, we have treated 24 patients with IFN alpha 2a and Hydroxyurea for induction, with addition of low dose Ara-C during IFN maintenance therapy when the cytogenetic results were deemed insufficient. Complete hematological responses were obtained in 75% of the cases. Cytogenetic responses were noted in 83% of 12 previously untreated (complete or almost complete response in 3) and in 50% of previously treated patients (complete or almost complete response in 3 patients). PMID- 2771635 TI - Erythropoietin and chronic renal failure. PMID- 2771636 TI - Overview of the LiMB database. AB - The rapidly increasing number of databases relevant to molecular biology has given rise to a need for a coordinated effort to identify, characterize, and link them. The LiMB database, which contains information about molecular biology and related databases, is a step in that direction. It serves molecular biologists seeking data sets containing information relevant to their research, and is also intended to anticipate the needs of database designers and managers building software links for related data sets. We present an abbreviated version of the database here; the full database is available free of charge as described below. PMID- 2771637 TI - Synthesis and selective cleavage of oligodeoxyribonucleotides containing non chiral internucleotide phosphoramidate linkages. AB - Oligodeoxynucleotides containing phosphoramidate internucleotide links 3'-OP(O)NH 5' have been prepared using standard solid phase phosphoramidite techniques. For the incorporation of the phosphoramidate linkages we have used monomer as well as dimer building blocks. With the monomer 3'-phosphoramidite building blocks, which are derived from 5'-amino-2',5'-dideoxynucleosides, it is possible to incorporate phosphoramidate links into specific positions within an oligodeoxynucleotide. Furthermore the synthesis of several dinucleoside phosphate derivatives which are linked by phosphoramidate bonds are described. The internucleotide phosphoramidate linkage was performed using the Staudinger reaction followed by a Michaelis-Arbuzov type transformation. After 3'-phosphitylation these dinucleosides are compatible with the current phosphoramidite methodology of oligodeoxynucleotide synthesis. PMID- 2771638 TI - Analysis of the collagen alpha 1(I) promoter. AB - The collagen alpha 1(I) gene is regulated at a developmental and tissue specific level. We have previously demonstrated that only 220bp of the promoter region of the collagen alpha 1(I) gene are required for efficient expression in NIH 3T3 cells. DNAse I protection assays demonstrated 4 footprinted segments in the promoter region. Deletional analysis revealed that the 3 most proximal footprints were required for maximal expression. The most proximal footprint contains a CCAAT sequence and a 12bp segment that forms a direct repeat with the preceding footprint. Ligation of the proximal footprint sequence to a heterologous promoter enhanced transcription of the reporter gene. These studies, therefore, identify and characterize elements in the promoter region of the collagen alpha 1(I) gene that interact with DNA binding proteins and are required for efficient expression. PMID- 2771639 TI - Synthesis and biological evaluation of some phosphate triester derivatives of the anti-viral drug AraA. AB - A number of novel phosphate triester derivatives of the anti-viral nucleoside analogue araA have been prepared by a rapid 2-step procedure, not necessitating prior sugar protection. Spectroscopic and lipophilicity data have been collected on these compounds, and they have been assayed with a range of hydrolytic enzymes. The compounds have been found to be highly resistant to hydrolysis at physiological pH, enzymatic or otherwise. An in vitro assay indicated inhibition of DNA synthesis by mammalian cells, by each of these compounds, in the range 3 300 microM. Moreover, the degree of inhibition showed a close correlation to chemical structure; in particular, there was a direct relationship between inhibition of thymidine incorporation and lipophilicity. These results suggest cellular penetration by the phosphate triesters and intracellular hydrolysis, by an unspecified mechanism, to the free nucleotide or nucleoside. PMID- 2771640 TI - Specific-primer-directed DNA sequencing using automated fluorescence detection. AB - Automated fluorescence-based DNA sequence analysis offers the possibility to undertake very large scale sequencing projects. Directed strategies, such as the specific-primer-directed sequencing approach ('gene walking'), should prove useful in such projects. Described herein is a study involving the use of this approach in conjunction with automated fluorescence detection on a commercial instrument (ABI 370A DNA sequencer). This includes procedures for the rapid chemical synthesis and purification of labeled primers, the design of primer sequences that are compatible with the commercial analysis software, and automated DNA sequence analysis using such primers. A set of four fluorophore labeled primers can be reliably synthesized in a twenty-four hour period, and greater than 300 nucleotides of analyzed new sequence obtained using this set in an additional twenty-four hours. Scale-up of these procedures to take advantage of the full capabilities of the sequencer is, at present, too slow and costly to be suitable for routine sequencing, and therefore the use of specific-primers is best suited to the closure of gaps in extended sequence produced using random cloning and sequencing strategies. PMID- 2771641 TI - Chromosomal localization of nucleic acid-binding proteins by affinity mapping: assignment of the IRE-binding protein gene to human chromosome 9. AB - Three human mRNAs are regulated post-transcriptionally by iron via iron responsive elements (IREs) contained in each mRNA. A cytoplasmic protein (IRE-BP) binds to these cis-acting elements and mediates the translational regulation of ferritin H- and L-chain mRNA and the iron-dependent stability of transferrin receptor (TfR) mRNA. We have taken advantage of the different mobilities of the human and rodent IRE/IRE-BP complexes on non-denaturing polyacrylamide gels to determine the chromosomal localization of the gene encoding the IRE-BP. Utilizing a panel of 34 different human/rodent hybrid cell lines we have assigned the IRE BP gene to human chromosome 9. This new technique based on nucleic acid/protein interaction may allow determination of the chromosomal localization of other RNA- or DNA-binding proteins. PMID- 2771642 TI - Uncharged stereoregular nucleic acid analogs: 2. Morpholino nucleoside oligomers with carbamate internucleoside linkages. AB - A novel oligonucleotide analog has been prepared from ribonucleoside derived morpholine subunits linked by carbamate groups. Oxidative cleavage of the 2',3' vicinal diol of cytidine followed by reductive amination of the resulting dialdehyde afforded the morpholine subunit. Coupling of the subunits are through carbamate moieties and the oligomers were characterized by 1H NMR and FAB MS. Evidence for interaction of the hexamer 19 with p(dG6) was found, but an atypical interaction of 19 with a RNA target was observed. PMID- 2771643 TI - Expression and DNA sequence analysis of a human embryonic skeletal muscle myosin heavy chain gene. AB - Vertebrate myosin heavy chains (MHC) are represented by multiple genes that are expressed in a spatially and temporally distinct pattern during development. In order to obtain molecular probes for developmentally regulated human MHC isoforms, we used monoclonal antibodies to screen an expression cDNA library constructed from primary human myotube cultures. A 3.4 kb cDNA was isolated that encodes one of the first MHCs to be transcribed in human skeletal muscle development. A portion of the corresponding gene encoding this isoform has also been isolated. Expression of this embryonic MHC is a hallmark of muscle regeneration after birth and is a characteristic marker of human muscular dystrophies. During normal human development, expression is restricted to the embryonic period of development prior to birth. In primary human muscle cell cultures, devoid of other cell types, mRNA accumulation begins as myotubes form, reaches a peak 2 days later and declines to undetectable levels within 10 days. The expression of the protein encoded by the embryonic skeletal MHC gene follows a similar time course, lagging behind the mRNA by approximately two days. Thus, expression of the human embryonic gene is efficiently induced and then repressed in cultured muscle cells, as it is in muscle tissue. The study of the regulation of a human MHC isoform with a central role in muscle development and in muscle regeneration in disease states is therefore amendable to analysis at a molecular level. PMID- 2771646 TI - The nucleotide sequence of cymbidium ringspot virus RNA. PMID- 2771644 TI - Subfamily of submaxillary gland-specific Mup genes: chromosomal linkage and sequence comparison with liver-specific Mup genes. AB - Mouse major urinary proteins (MUPs) are encoded by a family of ca. 35 genes that are expressed in a tissue-specific manner in several secretory organs; in the liver, in the submaxillary, sublingual, parotid and lachrymal glands, and in the skin sebaceous glands. In this paper we describe the isolation of a Mup gene, Mup 1.5a, which is expressed predominantly in the submaxillary gland of BALB/c mice. We show that Mup-1.5a is a member of a subfamily consisting of two closely related genes, both of which are closely linked to the Mup-1 locus on mouse chromosome 4. Mup-1 is the locus of a class of Mup genes (Group 1) expressed in the liver. The complete nucleotide sequence of Mup-1.5a has been determined, and was compared to a previously sequenced Group 1 Mup gene. The comparison shows that the differentially expressed Mup genes are uniformly divergent in exons, introns and in their flanking sequences. The regions of homology extend at least 5 kb into the 5' flanking region of Mup genes. PMID- 2771645 TI - Purification of DNA-binding transcription factors by their selective adsorption on the affinity latex particles. AB - A simple method with the use of affinity latex particles has been developed for the fast and efficient purification of sequence-specific DNA-binding proteins on the basis of their ability to selectively bind to their target sequences. Complementary oligodeoxynucleotides that contained a recognition site for a sequence-specific DNA-binding protein were chemically synthesized, annealed and ligated to give oligomers. The oligomers were coupled to latex particles, composed of polyglycidyl methacrylate, using cyanogen bromide to yield affinity latex particles. The concentration of covalently bound DNA on the affinity latex particles was 6 times as much DNA per ml as that in the Sepharose resin conventionally used. By sequential batch-wise procedures with the affinity particles, one of the sequence-specific DNA binding transcription factors, ATF or E4TF3, was quickly and efficiently purified to homogeneity from either a protein fraction in which the factor was enriched or a crude cell extract. PMID- 2771647 TI - The nucleotide sequence of transthyretin cDNA isolated from a sheep choroid plexus cDNA library. PMID- 2771648 TI - Complete nucleotide sequence of the human creatine kinase B gene. PMID- 2771649 TI - The nucleotide sequence of cDNA for a mouse liver-type glucose transporter protein. PMID- 2771650 TI - A human cDNA sequence for a novel glutathione peroxidase-related selenopeptide, GPRP. PMID- 2771651 TI - Nucleotide and deduced amino acid sequence of a gamma subunit of bovine fibrinogen. PMID- 2771652 TI - The nucleotide sequence of 5.8S rRNA from the fern Marsilia quadrifolia L. PMID- 2771653 TI - Nucleotide sequence of a gene for indole-3-acetamide hydrolase from Bradyrhizobium japonicum. PMID- 2771654 TI - The primary structure of rat beta 2-glycoprotein I. PMID- 2771655 TI - Nucleotide sequence of cDNA for rat apolipoprotein C-I. PMID- 2771656 TI - Cytochrome P450CMF cDNA: nucleotide sequence of P450CMF1b. PMID- 2771657 TI - The mouse homologue of the human acidic ribosomal phosphoprotein PO: a highly conserved polypeptide that is under translational control. PMID- 2771658 TI - Pre-plastocyanin from Lycopersicon esculentum. PMID- 2771659 TI - Rapid detection of octamer binding proteins with 'mini-extracts', prepared from a small number of cells. PMID- 2771660 TI - Rapid test for in vivo stability and DNA binding of mutated octamer binding proteins with 'mini-extracts' prepared from transfected cells. PMID- 2771661 TI - A fast detection protocol for screening large numbers of transgenic animals. PMID- 2771662 TI - Cell lyophilization for safe conservation and transportation in view of DNA analysis. PMID- 2771664 TI - Positivism vs. negativism: the choice is yours. PMID- 2771663 TI - Human antithrombin II (AT3) gene length polymorphism revealed by the polymerase chain reaction. PMID- 2771665 TI - Back to the art of bandaging. PMID- 2771666 TI - Bandaging. Strong support: strength and stability. PMID- 2771667 TI - Bandaging. Back to basics. PMID- 2771668 TI - Bandaging. Retention: keeping things in place. PMID- 2771669 TI - Bandaging. Light support: the light touch. PMID- 2771670 TI - Driven to desperation. PMID- 2771672 TI - A step forward. PMID- 2771671 TI - Ominous silence? PMID- 2771673 TI - Adolescence. Teenage trauma. PMID- 2771674 TI - Adolescence. Ewing's Sarcoma of the pelvis. PMID- 2771675 TI - Let's stick together! PMID- 2771676 TI - Enrolled nurses: stuck on the career ladder. PMID- 2771677 TI - Making sense of wound drainage. PMID- 2771678 TI - The interview. 3. Trial by sherry party. PMID- 2771679 TI - A sweet smelling success. PMID- 2771680 TI - Do you remember? PMID- 2771682 TI - Fit for nursing. Let's get physical. PMID- 2771683 TI - Fit for nursing. Not-so-big John. PMID- 2771681 TI - Going the way of the dinosaur? PMID- 2771684 TI - Quest. NT's educational supplement. PMID- 2771685 TI - Quest. Into the unknown. PMID- 2771687 TI - Quest. The challenge of joint validation. PMID- 2771686 TI - Quest. Vital links. PMID- 2771688 TI - Quest. Who needs a degree? PMID- 2771689 TI - 'Loony lefties' and 'mad mullahs'. PMID- 2771690 TI - Fighting for the NHS. PMID- 2771691 TI - Stand up for nursing. PMID- 2771692 TI - Jabs for everyone. PMID- 2771693 TI - The great divide. PMID- 2771694 TI - A harlequin baby survives. PMID- 2771695 TI - Child abuse. PMID- 2771696 TI - Coping with cancer. PMID- 2771697 TI - Near death experiences. PMID- 2771698 TI - Jargon is bad for you. PMID- 2771699 TI - Attracting the right candidates. PMID- 2771700 TI - Systems of life No. 173. Senior systems-38. Cerebrovascular disease-1. PMID- 2771701 TI - The experiences of women hospitalised in pregnancy. PMID- 2771703 TI - Modern approaches to qualitative research in nursing. PMID- 2771702 TI - Occupational health nursing: curricular issues. PMID- 2771704 TI - RCM supplement. Teenage mums--focus on a new initiative. PMID- 2771705 TI - RCM supplement. Young mums' club. PMID- 2771706 TI - RCM supplement. NHS review. The problems. PMID- 2771707 TI - RCM supplement. NHS review. The challenge. PMID- 2771708 TI - RCM supplement. In the bosom of the family. PMID- 2771709 TI - RCM supplement. Friend and counsellor. PMID- 2771711 TI - Slum sweet slum. PMID- 2771710 TI - Community care. The new mix. PMID- 2771712 TI - A sane decision? PMID- 2771713 TI - Anti-ageists unite. PMID- 2771714 TI - Responsibility for organizing community care. PMID- 2771715 TI - Enrolled nurses: mass conversion. PMID- 2771716 TI - Waiting. PMID- 2771719 TI - Fit for nursing. Entering the gym jungle. PMID- 2771717 TI - Cervicography. The nurse's role. PMID- 2771718 TI - Selection: equal opportunities. PMID- 2771720 TI - Health care overseas: Chinese revolutions. PMID- 2771722 TI - A cultural approach to change in nurse education. PMID- 2771721 TI - Junior monitor: measuring standards of child care. PMID- 2771724 TI - Advance to mayfair. PMID- 2771723 TI - The management of elderly patients with painful conditions. PMID- 2771725 TI - The union makes us strong. PMID- 2771726 TI - Computers in nursing news (CINNEWS). Computers--friends or foes? PMID- 2771727 TI - Cinnews: computer ethics. PMID- 2771728 TI - Cinnews: nursing computers back to health. PMID- 2771729 TI - The shape of things to come? PMID- 2771730 TI - Two steps forward, one step back. PMID- 2771731 TI - A new lease of life. PMID- 2771732 TI - I only have ears for you. PMID- 2771733 TI - Continuous pain relief. PMID- 2771734 TI - Enrolled nurses--fair and efficient. PMID- 2771735 TI - Botulism: the basics. PMID- 2771736 TI - Selection--advertising by design. PMID- 2771737 TI - Diogenes syndrome. PMID- 2771739 TI - Code of conduct: when the crunch comes. PMID- 2771738 TI - Anxiety management groups in clinical practice. AB - Anxiety symptoms are commonly reported both in patients and in the general population. There is also increasing concern being expressed over the widespread use of prescribed anxiolytics. This has encouraged the development of psychological interventions for both specific and generalised anxiety. In this paper, 29 patients, most of whom suffered from generalised or free-floating anxiety, were treated in small groups as part of a staff training programme. Their treatment was standardised, and consisted of progressive muscular relaxation, cognitive therapy and an educational input as to the nature of anxiety. Two measures, the Spielberger Trait Scale and an individualised problem rating scale were completed before and after the group and at three months follow up. All but one of the results was statistically significant. The implications of these results are discussed. PMID- 2771740 TI - Fit for nursing--down on the farm. PMID- 2771742 TI - Let relatives help elderly mentally ill. PMID- 2771741 TI - Pulmonary artery pressure measurement. PMID- 2771743 TI - Povidone-iodine and thrombophlebitis. PMID- 2771744 TI - Travelling boy. PMID- 2771745 TI - Dermatomyositis. PMID- 2771746 TI - Legal aspects of paediatric nursing. PMID- 2771747 TI - Community care--up in the air? PMID- 2771748 TI - Community care. Partners in care: how will they work together? PMID- 2771749 TI - Community care. A sinister scenario? PMID- 2771750 TI - Community care. Carers' concern. PMID- 2771751 TI - 'No people are uninteresting'. PMID- 2771752 TI - Enrolled nurses--follow that dream. PMID- 2771753 TI - Old: almost a four-letter word? PMID- 2771754 TI - Interviewing. Preparing for the response. PMID- 2771755 TI - A need to know. PMID- 2771756 TI - On the receiving end. PMID- 2771757 TI - Talking pictures. PMID- 2771759 TI - Birth and after birth--what choices are available to mothers? PMID- 2771758 TI - Documentation--a novel approach. PMID- 2771761 TI - Midwives'--touching base. PMID- 2771760 TI - Birth and after birth. PMID- 2771762 TI - Chilean midwifery: under the jackboot. PMID- 2771763 TI - User friendly. PMID- 2771765 TI - Life in the fast lane. PMID- 2771764 TI - Quo vadis? PMID- 2771767 TI - Nursing recruitment campaign. PMID- 2771766 TI - How healthy are you? PMID- 2771768 TI - Fit for nursing: feedback. PMID- 2771769 TI - Creating the right atmosphere. PMID- 2771770 TI - Under pressure. PMID- 2771771 TI - Enrolled nurses: fast, flexible ... and fallible? PMID- 2771772 TI - Key skills for the interviewer. PMID- 2771773 TI - Systems of life. No. 174. Senior systems--39, cerebrovascular disease-2. PMID- 2771774 TI - Too many processes spoil the care. PMID- 2771775 TI - Nursing practice and breast self-examination. PMID- 2771777 TI - Sensory stimulation in head-injured patients. PMID- 2771776 TI - Self-care in cancer. PMID- 2771778 TI - Mental handicap nursing. "I've lost a good friend". PMID- 2771779 TI - Mental handicap nursing. Doubly disadvantaged. PMID- 2771781 TI - Patient teaching. PMID- 2771780 TI - Mental handicap nursing. Common ground? PMID- 2771782 TI - Overview of patient education. Opportunities and challenges for the twenty-first century. AB - Nurses, on a day-to-day basis, and the profession as a whole, will continue to be challenged by the economic climate and nursing shortage. Nursing must march forward, demonstrating the ability to delivery cost-effective patient education based on research. Issues in patient education must be addressed by the profession as a whole. Benefits of education, resulting from nursing care, for patients, families, and communities, as outlined in this overview, must be brought to the public's attention. In this way the opportunities for the twenty first century will be achieved and the challenges met. PMID- 2771783 TI - Adult education. The cornerstone of patient teaching. AB - Patient teaching is necessary for good nursing care. Nurses cannot learn for patients, but they can facilitate learning by incorporating concepts of adult education into their teaching. Both the educational and nursing processes are based on the steps in the problem-solving approach: assessing, planning, implementing, and evaluating. Special attention to assessment and evaluation are necessary to achieve the desired change in behavior. PMID- 2771784 TI - Compliance, low literacy, and locus of control. AB - Compliance remains a critical, complex issue in health care today. As outlined, many interrelated factors affect levels of compliance and noncompliance. Assessing literacy and locus of control may assist the health care professional in identifying persons less likely to comply with medical treatments. Although compliance remains difficult to predict, these components should be considered carefully in patient-professional relationships and patient education. PMID- 2771785 TI - Cross-cultural perspectives on patient teaching. AB - Patient education for individuals of different cultures provides the professional nurse an opportunity to make a difference in the increasingly complex and changing problems in our bureaucratic society. Use of therapeutic relationships, indeed, can blend two worlds. Although we never can fully predict a patient's response to health teaching, we are likely to be much more effective if we understand and draw from the cultural context in which the patient is enmeshed. PMID- 2771786 TI - Perspectives on research in patient teaching. AB - Selection of outcome measures needs to go beyond assessment of knowledge gains to include indicators of adherence to the self-care regimen and health outcomes. Because standard didactic approaches are relatively ineffective in fostering participation in self-care, program content should be individualized and may need considerable reinforcement. In studies of program effectiveness, both the experimental and the comparison conditions should be monitored. Although a wide variety of patient, educator, and situational characteristics may mediate program efficacy, a lack of theoretically based studies and insufficient replication precludes generalizable conclusions about these or other aspects of patient teaching. PMID- 2771787 TI - Teaching patients with life-threatening illnesses. Cardiovascular disease, transplantation, and organ donation. AB - Providing teaching for open heart and transplant patients and their families is an important and rewarding role for the professional nurse. Through patient teaching, the nurse provides the patient with information that facilitates informed consent, prepares the patient for pre- and postoperative experiences, hastens postoperative recovery, and eases the transition from hospital to home. PMID- 2771788 TI - Patient teaching in the ambulatory setting. AB - Tremendous growth in the ambulatory setting has made patient education an integral part of health care in that setting. Numerous factors can hinder the implementation of patient education. Institutional variables include time, environment, and money. Acuity, psychosocial issues, and available resources are patient-centered variables. In order to promote effective patient education in an ambulatory setting, nurses need to be involved actively in planning and presenting material and in evaluating patient learning. In addition, nurses should be knowledgeable about the content being presented. The type of environment in which the teaching occurs and the strategies utilized in patient education facilitate the information exchange. The nurse and client must develop trusting relationships built on effective communication skills by both client and nurse. The trend toward fostering the patient as an active partner in health care can be accomplished through the teaching of communication skills as well as prevention, management, and self-care skills. PMID- 2771789 TI - Homeward bound. Discharge teaching for parents of newborns with special needs. AB - This article presents the complex work that professionals and parents must accomplish together prior to the discharge of a very ill or premature infant. Nurses play a critical role in this work by coordinating and directing the discharge teaching process. This process begins with the establishment of trusting relationships with parents and includes an assessment of the family's feelings, readiness to learn, and resources. A written teaching plan flows from this assessment and includes specific teaching topics germane to the individual child. A case manager coordinates the implementation of the plan and the evaluation of the learner's ability to care for the child independently in the home. Although time consuming and challenging, adequate discharge teaching in the NICU is critical to the successful integration of these special children into the family unit. PMID- 2771790 TI - Education as the key to rehabilitation. AB - Rehabilitation education is the key for successful transference to the home setting for the client and family. Can you picture a family at the rehabilitation facility on the day of discharge taking home a 19-year-old son with a severe head injury or a high spinal cord injury without this preparation? The client and family must be evaluated by the rehabilitation team to plan the individualized educational program. Education must start at admission and involve every member of the rehabilitation team in order to offer a complete educational program. The criteria for discharge of the client are based on an educational program successfully addressing self-care, self-direction, and self-responsibility. PMID- 2771791 TI - Patient teaching for elders. AB - There are many myths regarding elders' abilities to learn, which may affect the nurse's approach to the older person during patient teaching. Physiological changes of aging have an effect on learning and must be considered by the nurse when a teaching plan is developed. The older person has the capability to learn and probably will do so when the time is right, when the plan is right, and when motivated to learn. Learning is facilitated by a one-to-one encounter, but also may occur in a group or community setting. PMID- 2771792 TI - Gerontology. PMID- 2771794 TI - The consultative role of the gerontological nurse specialist in hospitals. AB - The role of the GNS in an acute care hospital is a many faceted one. The consultative role is difficult to separate from the practitioner, educator, and researcher roles that the GNS also fills. Examining how the GNS functions as both an informal and a formal consultant gives us only a glimpse into the many ways she may be used as a resource to assist clinical nurses in the care of acutely ill, frail, hospitalized elders. PMID- 2771793 TI - Community support. Promoting health and self-care. AB - Nursing has become more aware of the importance of community-based health care for elders. Community supports assist older adults to maintain or improve their health, care for themselves, and continue living at home as long as possible. A variety of community services are needed by older people to achieve these purposes. Many of the services provide support for health promotion and self-care activities. These are activities in which people engage to enhance their well being and increase their personal fulfillment and self-actualization. Health promotion program topics include exercise, nutrition, stress reduction, and physical and mental health. Self-care is the method by which people implement the lifestyle changes necessary to promote their health. As the move toward health promotion and self-care activities grows, nurses need to be alert to the issues that impact the development of community-based programs. These issues include the utilization of community health services by older adults, the allocation of health care resources to wellness-oriented as well as illness-oriented services, and reimbursement for both health promotion and nursing services. Future directions in community care for elders will include a continuing concern for cost containment. Research therefore will be needed to demonstrate the potential for cost effectiveness of health promotion and self-care activities. Interdisciplinary health care teams working with elders in the community may be the most effective means to support the quality of life that we all desire for our later years. PMID- 2771796 TI - Elder-family caregiver relationships. Determining appropriate nursing interventions. AB - Providing excellent care to elders involves more than the nurse's ability to minister to them; it is dependent on nurses' focusing assessment and intervention on the elder-caregiver dyad. Only by planning nursing care within the context of the dyad and considering the needs of the elder, the caregiver, and the unit, is it possible for nursing to realize its potential for improving the care of all elderly clients. PMID- 2771795 TI - Continence issues in acute care. AB - Urinary incontinence affects up to 43 per cent of acute care patients. Toileting is a function of intact bladder, sphincters, and nervous system. Five types of incontinence are stress, urge, reflex, total, and functional. Problems affecting patients in acute care are: 1. Diagnostic studies 2. Treatments--for example, intravenous fluids, hyperalimentation, medications, catheters 3. Bedrest 4. Restraints 5. Pain 6. Iatrogenic conditions 7. Environment Assessment includes a specific history and physical examination, focused on previous episodes of incontinence, functional ability, and cognitive status. Management includes scheduled fluid intake and toileting, manipulation of the environment, and attention to orientation and psychological factors. The treatment of fecal incontinence in the hospital elderly includes: 1. Assessment of incontinence and contributing factors; 2. Bowel regimen and environmental assists for persons with periodic incontinence; 3. Treatment of diarrhea or constipation; and 4. Protection of perineal skin from stool exposure. PMID- 2771797 TI - The geriatric nurse practitioner in home care. Challenges, stressors, and rewards. AB - The geriatric nurse practitioner is an appropriate provider of care for homebound elders. Her scope of practice includes managing acute and chronic illnesses and providing preventive care. It incorporates collaboration as an essential part of practice. The focus on issues of aging assists the geriatric nurse practitioner to differentiate presentation and complications of illness from a younger population and to understand the interrelationship of emotional, physiological, functional, and social factors on outcomes. The challenge to provide home care to homebound elders has intensified as a result of recent changes in the health care system. The expertise of the geriatric nurse practitioner is well suited to address these needs and future issues as the percentage of the elderly population increases. PMID- 2771798 TI - Does salt protect against breast cancer? PMID- 2771799 TI - Development of a food frequency instrument: ethnic differences in food sources. AB - Dietary intake was assessed among 431 black, white, and Mexican American men and women in southeast Texas using 24-hour dietary recall interviews. These data were collected to provide information on ethnic-specific food sources of selected nutrients; this information was used to construct a food frequency questionnaire for a study of nutrient intake and cancer. Nutrient content of total fat, total vitamin A, and vitamin C was determined for all foods consumed and was aggregated across unique food codes. These aggregated food codes were then ranked according to the contribution of each food to the total population intake of each nutrient. Ethnic differences existed in food sources of nutrients that would not be identified if data from only the analysis of the combined data set were used. Generally, however, the food sources identified from analyses of the combined data set included those foods that were important nutrient sources for each of the ethnic groups as well. PMID- 2771800 TI - Latitudinal variation of digestive tract cancers in the US and China. AB - Latitude influences the availability of fresh fruits and vegetables (which are associated with cancer protection) and the use of food preservation methods (which are associated with increased cancer). Such dietary differences might be reflected in the frequency of death from cancer of the digestive tract. Female mortality rates for states and provinces of the US and China, both of which cover a wide latitude range, were chosen to investigate latitude- and time-related changes. Mortality for cancer of the stomach, liver, and rectum did increase with latitude in both nations, which is consistent with the hypothesis. Exceptions were cancer of the colon and esophagus; these cancers had a variable association with latitude and did not decline markedly in the US by 1970-1979 as did mortality rates from cancer of the other digestive tract sites. Increased refrigeration and improved transportation, both of which result in increased consumption of fresh fruits and vegetables, and decreased use of older food preservation methods may be responsible for the US decline in mortality rates from stomach, liver, and rectal cancers. PMID- 2771801 TI - Dietary and alcohol intake, smoking pattern, occupational risk, and family history in lung cancer patients: results of a case-control study in males. AB - In a case-control study of 71 consecutive new male cases of lung cancer and 71 male hospital control patients, previous dietary and alcohol intake, smoking pattern, occupation, dust exposure, and family history of lung cancer were investigated. The cases and controls were similar in age, country of origin, area of residence, and marital status. Using a frequency-based assessment of previous dietary intake, broad food groups were similar for cases and controls. Cases had a significantly lower intake of fish than controls did (odds ratio = 0.5, confidence interval = 0.2-1.0, p = 0.05). A protective effect for fish consumption in lung cancer has not been previously reported. The dietary intake of foods containing retinol and beta-carotene and the intake of alcohol were not significantly different between cases and controls. For cases, smoking duration was longer and the time since cessation for exsmokers was shorter, cigarette pack years were longer, and the number of cigarettes smoked per day was greater. The factors of occupation, dust exposure, and family history of cancer (including lung cancer) were similarly distributed between cases and controls. PMID- 2771802 TI - A semipurified diet that suppresses phenobarbital promotion of hepatocarcinogenesis in the rat. AB - Six groups of F344/N female rats were fed either a modified AIN-76 diet (20% casein, 5% corn oil, 65% cornstarch, 5% cellulose) (AIN) or a diet formulated by Dr. M. Pariza (PD) (30% casein, 10% partially hydrogenated corn oil, 40% sucrose, 15% cornstarch) beginning four days before 70% partial hepatectomy. One day after the surgery, one group fed each diet was intubated with 10 mg/kg diethylnitrosamine (DEN). One week later, these groups plus one control group fed each diet were given 0.05% phenobarbital in the diet for 6 or 14 months. After the rats were killed, blocks of liver tissue were frozen on dry ice and stored at -70 degrees C. Three frozen serial sections were stained for gamma glutamyltransferase, ATPase, and glucose-6-phosphatase. Numbers and volume of altered hepatic foci (AHF) were analyzed by stereological techniques. After 14 months of feeding these regimens, rats initiated with DEN and fed the AIN + PB had significantly greater numbers and a higher percent volume of the liver of most phenotypes of AHF than all other groups, including those fed PD + PB following initiation with DEN. The numbers of AHF exhibiting more complex phenotypes (i.e., scored by more than one marker) remained unaltered between 6 and 14 months. These findings indicate that the effectiveness of PB as a promoting agent in multistage hepatocarcinogenesis is significantly altered when fed with two different diets of known composition. Therefore, dietary composition can be a significant factor in studies of the stage of promotion in hepatocarcinogenesis. PMID- 2771803 TI - Natural killer cells, vitamins, and other blood components of vegetarian and omnivorous men. AB - The study population consisted of male vegetarians (aged 28-50 years), who were recruited from the vegetarian cohort being followed by the Department of Epidemiology (German Cancer Research Center, Heidelberg, FRG), and the same number of age- and sex-matched controls from the personnel of the same center. Among the vitamins tested, only the level of carotene was significantly higher in vegetarians; the levels of vitamin A, K, and E were not elevated. Among the other blood parameters tested, only creatinine and glutamine-transferase levels were significantly lower in vegetarians. The natural cytotoxicity of peripheral blood lymphocytes was measured using a chromium-release test. Cytotoxic activity, which is expressed as lytic units, was significantly higher in vegetarians than in their omnivorous controls by a factor of 2. The total number of white blood cells, lymphocytes, and other subpopulations did not differ between vegetarians and nonvegetarians. The enhanced natural cytotoxicity may be one of the factors contributing to the lower cancer risk shown by vegetarians. PMID- 2771804 TI - Role of dietary magnesium and/or manganese variables on Ehrlich ascites tumor bearing mice. AB - Female Swiss albino mice were placed on seven dietary regimens for five weeks. These regimens differed only in magnesium and/or manganese contents. At the end of the feeding period, the animals were inoculated with Ehrlich ascites tumor. Ten days after transplantation, Ehrlich ascites carcinoma (EAC) cells were harvested, and all animals were killed. EAC cells and plasma samples were subjected to several biochemical tests. The results suggest several conclusions. 1. Dietary supplements of magnesium and/or manganese have no effect on retarding tumor growth in vivo. 2. Dietary restriction of manganese and combined magnesium and manganese gave promising effects on retarding tumor growth in vivo. 3. Dietary magnesium deficiency, per se, had no significant effect on tumor regression in vivo. 4. In contrast to in vitro studies, manganese supplementation appeared to exert no effect on tumor progression in vivo. 5. Magnesium supplementation seemed to have no effect on tumor progression in vivo, which is in agreement with in vitro studies. PMID- 2771805 TI - A comparison of wax matrix and microencapsulated potassium chloride in relation to upper gastrointestinal illness requiring hospitalization. AB - The frequency of hospitalization for documented upper gastrointestinal illness among recipients of either wax matrix or microencapsulated potassium chloride was similar in a study in which clinics were randomly assigned to dispense one or the other preparation. The results indicate that there is no material difference between the two preparations in relation to serious upper gastrointestinal illness. PMID- 2771806 TI - Evaluation of factors associated with stability of anticoagulation therapy. AB - Eighty-two patients receiving long-term warfarin therapy provided 199.34 patient years of data that were evaluated to determine if certain variables could identify those who might be monitored safely at less frequent intervals. Most patient demographics, social habits, medical histories, indications for anticoagulation, and concurrent therapy were not useful in discriminating between patients with stable (n = 67) and unstable (n = 15) anticoagulation. A few trends were noted, but they failed to achieve statistical significance. Patients who never achieved stability (the unstable group) tended to be younger than those who did (p 0.13). Among the stable patients, those with a diagnosis of deep vein thrombosis or pulmonary embolus, or with elevated alanine aminotransferase values, were significantly more likely to require a dosage change. The probability of requiring a dosage change at monthly visits did not correlate with the time required to become stable, but it did correlate inversely with the duration of stable anticoagulation. This probability declined from almost 16% when monitoring frequency was first extended to monthly intervals to less than 8% at 2 months of stable anticoagulation, and tended to decline further with longer periods of stable therapy. Of the 67 patients who became stable, 23 did not require a dosage change during an average of 526 days of follow-up. Among the 44 stable patients who required a dosage change, the mean time to the change was 250 days after becoming stable. Few complications occurred, almost all of them early in therapy.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2771807 TI - Comparison of disposition values obtained by two assay methods for quinidine gluconate in patients with ventricular tachycardia. AB - Eight patients with previously untreated ventricular tachycardia, age 48.54 +/- 28.02 years (mean +/- SD), were enrolled in a protocol evaluating the disposition of quinidine gluconate as determined by two assay methods. Patients received two infusions of 5 mg/kg over 30 minutes separated by 20-30 (24.9 +/- 4.0) minutes of electrophysiologic testing. Blood samples were obtained at 0.17 hours and just prior to the second infusion, and then at 0.17, 0.25, 0.33, 1.0, 6.0, 12.0, and 24.0 hours after the second infusion. Paired serum samples were assayed for quinidine concentrations by fluorescence polarization immunoassay and high performance liquid chromatography. The two assays compared well, with a linear regression equation of Y = 0.927X + 0.247 with a correlation coefficient of 0.985. With the exception of the beta elimination rate constant and beta distribution volume, t test comparison of disposition values demonstrated no significant difference. Differences in the estimates of the beta elimination rate constant reflected differences in the two methods and indicated that even though both assays were comparable, subtle differences in specificity could be reflected in significant differences in this variable. PMID- 2771808 TI - Effect of metoclopramide, bethanechol, and loperamide on gastric residence time, gastric emptying, and mouth-to-cecum transit time. AB - The effects of metoclopramide, bethanechol, and loperamide on the gastric residence time (GRT), gastric emptying (GE), and mouth-to-cecum transit time (MCTT) of a solution were investigated in three separate studies of five healthy male volunteers each. Metoclopramide in doses of 5, 10, and 15 mg prolonged GRT by 33, 88, and 162%, respectively, almost reaching statistical significance (p 0.058). A relationship was observed between GRT prolongation, and metoclopramide area under the plasma-time curve (p 0.01) and metoclopramide observed time to maximum concentration (p 0.01). Metoclopramide had an inconsistent effect on MCTT. Bethanechol 50 mg prolonged GRT by 64% (p 0.031) and had no effect on MCTT. Loperamide at doses of 2 and 8 mg prolonged GRT by 18 and 115% (p 0.043) and MCTT by 30 and 130% (p 0.0001), respectively. None of these motility-altering agents affected GE. PMID- 2771809 TI - The efficacy of inhaled beclomethasone in chronic obstructive airway disease. AB - The objective of this study was to examine the effectiveness of inhaled beclomethasone in the treatment of stable chronic obstructive airway disease (COAD). Eight patients completed a randomized, double-blind, placebo-controlled, crossover trial of inhaled beclomethasone and oral prednisone. Each patient received 3 treatment regimens given for 14 days: inhaled beclomethasone, prednisone, and placebo. There were no statistically significant differences in pulmonary function tests, oxygen cost diagram, or 12-minute walking distance test among the regimens. The only improvement in arterial blood gasses was partial pressure of oxygen, which was negligibly increased during prednisone treatment compared with beclomethasone and with placebo (p less than 0.05). Evaluation of 95% confidence intervals indicated that clinically significant mean differences were unlikely with either beclomethasone or prednisone. Larger studies are required to determine if a responsive subgroup exists, and to determine if this form of therapy has a role in treatment of COAD. PMID- 2771810 TI - Diagnosis and therapy of acute adrenal insufficiency. PMID- 2771811 TI - What matters in developmental assessment? AB - Many feel the urge to calculate a score or figure for a child's development by submitting him to some objective test of readily scorable items, without regard to the child as a whole. I suggest that instead of merely determining a score for a child's development we should try to understand development, and particularly the purpose of developmental tests, their limitations and the reasons for those limitations. We should continue to learn about development by following up all those many children in which for a variety of reasons the assessment was unusual or difficult. PMID- 2771812 TI - Fumes from the spleen. PMID- 2771814 TI - XIIth European Congress of Pathology. Porto, Portugal, September 3-9, 1989. Abstracts. PMID- 2771813 TI - So what? Listening and learning. PMID- 2771815 TI - Management of developmental coxa vara in cleidocranial dysostosis. PMID- 2771816 TI - Radiologic case study. Diffuse pigmented villonodular synovitis. PMID- 2771817 TI - Answer Please. Transcaphoid perilunate dislocation. PMID- 2771818 TI - The biomechanics and biology of internal fixation using plates and nails. PMID- 2771819 TI - Pedicle screw fixation--limitations. PMID- 2771820 TI - Measurement of effective pedicle diameter in the human spine. AB - Effective pedicle diameter (EPD), the maximal cancellous diameter of the spinal pedicle, demonstrates the maximal diameter available for transpedicular screw placement. The pedicles of 16 spines from T6 to L5 were measured directly with a graduated mean increase in the EPD ranging from 4.8 mm at T6 to 5.9 mm at L5. This direct pedicle measurement was significantly smaller than that of previously reported studies, which directly and radiographically measured pedicle outside width rather than inner diameter. Three specimens had little, if any, pedicular medullary cavity on direct measurement, although radiographic appearance of a medullary cavity existed. If EPD is significantly smaller than radiographic pedicle width measurements, safe transpedicular screw fixation may not be achieved. Preoperative planning must account for this so that transpedicular screws of correct diameter may be used and the complications of pedicular blowout fracture and neurologic impairment may be avoided. PMID- 2771821 TI - Quantitative computed tomography reflects vertebral fracture morbidity in osteopenic patients. AB - We studied the relationship between spontaneous vertebral compression fractures and lumbar vertebral trabecular bone density in 69 consecutive patients with suspected osteopenia. Seven had biopsy-confirmed osteomalacia. The remaining 62 were divided into three groups: group 1--asymptomatic patients suspected of having osteopenia on plain films, but with no vertebral compression fractures (N = 24); group II--those with one to five vertebral compression fractures (N = 16); and group III--those with six or more vertebral compression fractures (N = 22). A quantitative computed tomographic (QCT) scan of the lumbar spine was performed on all patients. Patients in group I had QCT values of 94 +/- 23 mg/cm3 (mean +/- SE); those in group II had QCT values of 66 +/- 28 mg/cm3; and those in group III had values of 34 +/- 28 mg/cm3. There were significant differences among all groups (P less than .001), although there was considerable overlap of individuals among the groups. There was no significant difference between the mean QCT value of patients with one compression fracture and the value of those with between two and five compression fractures. Patients with biopsy-proven osteomalacia had higher vertebral trabecular bone density than patients with osteoporosis and compression fractures. Our study provides evidence suggesting a strong inverse relationship between QCT-measured vertebral bone density and the presence of vertebral compression fractures in a group of osteopenic patients. PMID- 2771822 TI - Single-vessel forearm arterial repairs. Patency rates using nuclear angiography. AB - Nuclear angiograms were used to determine early and delayed patency rates following primary microvascular repair of 12 radial and 24 ulnar arteries in 36 patients. All patients had nuclear angiograms within 1 week after repair, demonstrating an early patency rate of 86.1%. Nineteen patients had additional nuclear angiograms at various intervals from 30 days to 2 years, showing a delayed patency rate of 68.4% at an average of 5.4 months follow up. Survival analysis showed that patency fell steadily during the first 90 days postoperatively, after which no further arterial occlusions occurred. Patency rates were not significantly affected by age or sex of the patient, level of forearm injury, total tourniquet time, treatment delay, or the diameter of nylon suture used for arterial repair. At follow up, there were statistically insignificant trends for higher patency rates in patients with partial vessel lacerations and in nonsmokers. PMID- 2771823 TI - Sporotrichosis. AB - Forty-nine patients with culture-proven sporotrichosis were treated between 1957 and 1986. Infections were lymphocutaneous in 36 patients, pulmonary in two, intraarticular in four, and involved multiple deep tissues in seven. Thirty-six infections involved an upper extremity. Five patients with deep infection had some evidence of being immunocompromised. Delay in diagnosis after presentation averaged 4 months overall and 25 months for those with deep infection. Ten of 12 joint infections resulted in significant functional impairment. Treatment with saturated potassium iodide solution was effective for lymphocutaneous infection. Four patients with infection of deeper tissues remain infected despite multiple operations and systemic courses of antifungal medication. PMID- 2771824 TI - Frozen shoulder. Part II: Treatment by manipulation under anesthesia. PMID- 2771825 TI - Trimalleolar fractures: late results after fixation of the posterior fragment. AB - From 1969 to August 1981 60 trimalleolar fractures were operated on with fixation of the posterior fragment. A late follow up (average 8 years) including radiographs was possible in 45 patients. In 36 patients, there are no complaints and full function has been obtained. Films of the articulation are normal in 17 cases and show isolated osteophytes in 19. Five patients show some benign arthrosis but only occasional pain and slightly reduced function; four patients show severe arthrosis caused by clearly visible operative technical faults. Depressed areas in the articular surface were present in ten patients. Their prognosis is doubtful. Thus, a correctly reduced and fixed posterolateral fragment helps avoid or reduce postoperative arthrosis in trimalleolar injuries. PMID- 2771826 TI - Fracture of the femur after total hip arthroplasty. AB - The classification and treatment of ipsilateral femur fractures after total hip arthroplasty are described on the basis of the predicted stability of the implant after the fracture. Conservative treatment was successful in most cases. PMID- 2771827 TI - Diagnosis and treatment of obscure ulnar-sided wrist pain. AB - Thirty-seven patients were followed for symptoms of chronic ulnar-sided wrist pain in which specific physical examination and standard radiographs were unrevealing. Initial conservative treatment did not relieve the pain. The patients underwent further diagnostic studies including dynamic cineroentgenographic evaluation and radiocarpal arthrography. Nineteen of the 37 patients were demonstrated to have a triangular fibrocartilage complex (TFCC) tear on arthrography; 18 had a normal examination. The average follow up was 23 months. Seven of the 19 patients with TFCC tears have undergone operative treatment, and 5 (71%) remain symptomatic. Of the remaining 12 patients with TFCC tears treated nonoperatively, eight (67%) have persistent symptoms. Of the 18 patients whose arthrograms were normal, five eventually underwent surgical exploration, four of which remain symptomatic. Of the 13 patients without TFCC tears treated nonoperatively, seven (54%) continue to have symptoms. In our experience, both surgical exploration and nonoperative treatment have been less than satisfying. In addition, treatment results could not be correlated with arthrographic findings. PMID- 2771828 TI - Urinary tract catheterization protocols following total joint arthroplasty. AB - Six hundred one consecutive total joint arthroplasty patients were divided into three groups using three different catheterization protocols. Each group was evaluated for preoperative and postoperative urinary tract infections, number of catheterizations, and number of subsequent urinary tract manipulations. Group 1 (165 patients) was treated with "as needed" intermittent catheterization. One hundred six of these patients (64%) required a minimum of one catheterization with a total of 265 (mean 2.4 per patient) catheterizations. One post-operative urinary tract infection was recorded. Group 2 (295 patients) was treated with in and-out catheterization on one occasion followed by anchoring of a closed drainage system if needed. One hundred eighty-one patients (61%) required catheterization, 124 (69%) of these patients required anchoring of a closed system. Two (0.69%) of these patients developed postoperative urinary tract infections. Group 3 (140 patients) were treated with intraoperative sterile anchoring of a closed drainage system which was maintained for 48 hours or less. Ten patients required in-and-out catheterizations (maximum one per patient) after system discontinuance. No urinary tract infections developed. Using Fisher's Exact test, no statistical difference in infection rates was found between the three groups. The group 3 protocol was felt to offer several patient conveniences. PMID- 2771829 TI - Completely displaced distal radius fractures with intact ulnas in children. AB - Completely displaced distal radius fractures with intact ulnas are uncommon, difficult-to-reduce fractures in children. Ten of these fractures were retrospectively reviewed from a series of more than 600 forearm fractures. Eight of ten patients were available for follow up clinically and radiologically at an average of 21 months. Considerable remodeling was noted including two fractures that were left in an overriding position of 10 mm. If angulation does not exceed 16 degrees of radial deviation and 20 degrees of dorsal angulation, repeat manipulations need not be performed. Stimulation of growth by the fracture restored radial length. Thus, reduction of the overriding is unnecessary. PMID- 2771830 TI - Non-Hodgkin's lymphoma of bone. PMID- 2771831 TI - Quantitative urine testing. A new tool for diagnosing and treating cocaine use. AB - The new quantitative urine tests for cocaine are an easy and inexpensive method of diagnosing and monitoring use of this drug and thus are practical for the primary care physician's office. They may help differentiate between occasional and addicted users, thus establishing the severity of the problem for the patient and family, employer, or school officials. Although the tests cannot be used for legal applications, they have great clinical value. The receptivity of patients and third parties to urine testing has been gratifying. Physicians are encouraged to consider use of these tests in office assessment. PMID- 2771832 TI - Hyphema. PMID- 2771833 TI - Arthritis of the foot. Pinpointing the disease process involved. AB - Arthritides of the foot present with inflammatory signs. The age of the patient, location of the pain, findings on foot examination, and radiographic signs can help determine which of the arthritides is present. Accurate diagnosis can help establish the appropriate course of therapy. Rest and the use of nonsteroidal antiinflammatory agents and shoes fitted with appropriate orthoses can be beneficial in most cases. Surgery is rarely indicated but may be useful to correct severe deformities or to relieve debilitating pain. PMID- 2771834 TI - Sports Illustrated gets an 'F' on NFL drug testing article! PMID- 2771835 TI - Common forefoot deformities. How to treat, when to refer. AB - Initial assessment of common forefoot deformities by the primary care physician is quite feasible. A thorough history, examination of the foot with the patient standing and seated, assessment of the patient's footwear, and radiographic evaluation can often lead to gratifying relief with use of simple office measures. Even in cases that require referral to an orthopedic surgeon, interim relief of symptoms and the patient's increased awareness of the problem and its cause enhance the patient's understanding and the final outcome as well. PMID- 2771836 TI - Frontal lobe trauma in the elderly. Personality changes aren't always dementia. AB - Changes in personality and behavior are fairly specific when they are caused by damage to the frontal lobe of the cerebral cortex. They are characterized by changes in affect and in emotional response and may be pseudopsychopathic, pseudodepressive, or a combination of both. Cognitive ability (eg, verbal fluency, maintaining attention, achieving goals) may also be diminished. Neurologic signs may include abnormal reflexes, increased or decreased motor behavior, and loss of ability to complete purposeful movement. If the damage is caused by trauma, treatment begins with care of the acute injury. Any resulting seizures should be treated with an anticonvulsant and the patient observed carefully for side effects. Another agent (eg, a stimulant, antipsychotic, tricyclic antidepressant) may be needed as well, depending on the individual patient, to restore as much psychological function as possible. Counseling of both the patient and the family is important to help them avoid some difficulties and frustrations that may accompany the change in personality. PMID- 2771837 TI - Genital warts. Newly discovered consequences of an ancient disease. AB - Venereal warts are an ancient disease, but the relationship between certain human papillomavirus serotypes and genital neoplasia is just being recognized. Women are at higher risk for development of neoplasia from the infection and are more likely to be reinfected, because a male partner's lesions may be invisible without application of acetic acid or examination of a urethral smear. Other factors that favor progression to cancer are young age at first exposure, multiplicity of exposures, and immunosuppression. Colposcopy with cytology and biopsy allows definitive microscopic identification of the virus and serotyping. Aggressive management of both male and female partners will reduce the spread of the virus and reinfection. Successful treatment methods have included cryosurgery; electrocautery; carbon dioxide laser therapy; and use of a keratolytic, cauterizing agent, topical fluorouracil (Efudex), and interferon. PMID- 2771838 TI - Stolen prescription blanks. PMID- 2771840 TI - A new surgical approach to Parkinson's disease. PMID- 2771839 TI - Treating acute mandibular dislocation. PMID- 2771841 TI - A new TSH assay. Just another technique or a useful test? AB - The immunoradiometric assay is a sensitive test for diagnosing thyroid dysfunction. It permits greater accuracy by measuring response of thyrotropin producing cells of the pituitary to thyroxine (T4) as opposed to comparing circulating T4 to a range of values from healthy controls. The assay allows improved precision in establishing replacement and suppressive doses of hormone for thyroid disease. PMID- 2771842 TI - Effects of CGA-72662 (Larvadex) in turkeys during rearing and reproduction. AB - Turkeys were fed CGA-72662 (Larvadex) at treatment levels of 0, 500, 1,000, and 2,000 mg/kg diet from hatch to 16 wk of age, when the 500 mg/kg level was reduced to 250 mg/kg because of a significant reduction in feed intake. All diets continued through 40 wk of age. Body weight, feed consumption, livability, egg production, fertility, hatchability, and progeny performance were examined. Turkeys fed a treatment level of 2,000 mg CGA-72662/kg diet exhibited reduced growth rate and feed consumption prior to sexual maturity and decreased fertility and poult weight after sexual maturity. Necropsies suggested that the kidney was the primary site of lesions at the 1,000 and 2,000 mg/kg diet treatment levels. The kidneys were characterized as enlarged, nodular, and cystic, containing urate deposits and areas of necrosis. These data indicate that dosage levels of CGA 72662 at 250 mg/kg diet produced no deleterious effects on growth, feed consumption, egg production, fertility, hatchability, livability, or progeny performance. PMID- 2771843 TI - Transmission of residues to eggs following long-term administration of 14C labelled deoxynivalenol to laying hens. AB - The transmission of radioactive residues of 14C-labelled deoxynivalenol (DON; vomitoxin) to eggs was investigated during prolonged administration of low levels of DON-contaminated feed to White Leghorn chickens. Laying hens were provided with a 5.5 ppm 14C-DON-spiked diet (.55 mg DON; .8.25 microCi bird/day) for a 65 day period, after which they received a clean, unadulterated diet for 21 days. Total residues (based on specific radioactivity) increased daily until the 8th day of 14C-DON exposure, when levels reached a plateau for several days, then decreased slowly thereafter. Maximum radioactivity measured was equivalent to 1.7 micrograms DON or metabolites per 60-g egg; the yolk, albumen, and shell membrane contributed 70, 29, and 1% of the total amount, respectively. By Day 30, levels had declined to 25% of peak levels (.40-micrograms DON equivalents/egg) and remained relatively constant until the spiked feed was removed at Day 65, at which time residues quickly declined to negligible values. These findings indicate that although very low concentrations of DON can be found in eggs under these feeding conditions, levels are so low that a potential health hazard to humans would likely be minimal. PMID- 2771844 TI - Effect of dietary acetic acid levels on protein and energy utilization in chicks. AB - Chicks were given diets containing varying amounts of dietary acetic acid (0, 12.7, 25.4, 38.1, 50.8, and 63.5 g/kg diet) under ad libitum feeding in Experiment 1 and under equalized feeding (average feed intake of Experiment 1) conditions in Experiment 2. In Experiment 1, values for body weight gain (g/10 days), feed intake (g/10 days), fat retention (g/10 days), and energy retention (kJ/10 days) were linearly lower as dietary acetic acid was increased. In Experiment 2, values for body weight gain, protein retention, and fat retention (grams/10 days), and for energy retention (kiloJoules/10 days) were changed curvilinearly. These values tended to increase until diets contained 25.4 g acetic acid/kg diet and then decreased significantly when diets contained 50.8 g acetic acid/kg diet. All chicks given the 63.5-g acetic acid/kg diet died during Experiment 2. Dietary acetic acid had a detrimental rather than a beneficial effect on chick performance, particularly at the high level. PMID- 2771845 TI - Replacement of soybean meal by cottonseed meal and peanut meal or both in low energy diets for broilers. AB - In a feeding trial, 936 1-day-old male (Hybro) broilers were allocated equally to 72 cages to evaluate cottonseed meal (CSM) and peanut meal (PNM) as substitutes for soybean meal (SBM). The 12 treatments were completely randomized among the cages. All diets were balanced to maintain equal levels of sulfur amino acids and lysine and were kept isocaloric (2,850 kcal ME/kg) and isonitrogenous (CP 21%). Feeding diets containing increasing amounts of CSM (0, 8, 16, and 24%) had a negative linear effect (P less than .05) on body weight gain and a positive linear effect (P less than .05) on feed:gain ratio of broilers to 3 wk of age. Diets with 8, 16, and 24% CSM contained 0, 196, and 310 ppm free gossypol, respectively, after chelation with iron from the feedstuffs and premix used in the diets. The improved growth and feed intake (P less than .05) resulting from the addition of 600 ppm Fe to the diet containing 24% CSM suggested that the negative effect of CSM was due to the high content of free gossypol. Increasing PNM from 5 to 10 and 15% had a negative linear effect (P less than .05) on body weight gain at 3 wk of age, due to the elevated levels of total iron in the 10 and 15% PNM diets (390 and 520 ppm, respectively). Addition of CSM at 8% with PNM at 5 or 10% had a negative linear effect (P less than .01) on body weight gain at 3 and 6 wk of age and a positive linear effect (P less than .05) at 3 wk of age on feed:gain, due to the high iron contents of 330 and 460 ppm, respectively. PMID- 2771846 TI - Sex differences in body weight of chicken embryos. AB - Experiments were conducted to determine if sex differences in body weight of chickens exist prior to hatching and to determine if growth of twin embryos is affected by the sex of their siblings. The mean wet BW of male embryos was significantly greater than that of females at 11, 13, and 18 days of incubation, whether expressed on an absolute basis or as a percentage of egg weight. The mean dry weight of male embryos was not different from that of females at 11 days of incubation. Male dry weights were not different from female weights at 13 days of incubation in one experiment (P = .540) but approached significance (P = .078) at this age in another experiment. The mean dry weight of males was significantly greater than that of females at 18 days of incubation. Vascular anastomoses between twin embryos in double yolk eggs were demonstrated by the exchange of 125I between the twins. Fifteen-day-old twin embryos in double-yolked eggs were significantly lighter than single embryos developing in double-yolked eggs. Female embryos twinned with females were slightly but not significantly lighter than males twinned with males. Mixed sex twins tended to be lighter than unisex twins. Females twinned with males were significantly lighter than males twinned with males. The data do not support the concept that a male humoral factor is responsible for more rapid growth of male embryos. PMID- 2771847 TI - Comparison of the amino acid composition of the intracellular and extracellular matrix protein fractions isolated from avian skeletal muscles. AB - Intracellular and extracellular skeletal muscle protein fractions were isolated from the legs and breasts of young and adult White Leghorn chickens and quantified by detailed amino acid analysis. This involved repeated homogenization in the presence of 50 mM CaCl2, neutral phosphate-buffered saline (pH 7.4), solubilization by 2% sodium dodecyl sulfate (SDS), and centrifugation to separate all intracellular muscle proteins from the extracellular matrix. The total SDS soluble intracellular muscle proteins in the adult and young birds ranged respectively from 93.2 to 94.5% in the leg and from 93.5 to 94.1% in the breast muscles. Collagen and collagen-like proteins in the extracellular matrix protein fractions were calculated from the amounts of 5-hydroxylysine found in their 96-h acid hydrolysates and elastin content from the amounts of desmosine present. Total collagen ranged from 3.42 to 5.18% in legs and from 2.91 to 3.89% in breasts. The elastin content of leg muscles represents only .061% of the total muscle protein. The calculated protein efficiency ratios for intracellular avian muscle proteins averaged 3.2 compared with a mean value of 1.4 for the extracellular matrix. PMID- 2771848 TI - Performance of Leghorn type hens fed two levels of energy and a synthetic estrogen during the growing period. AB - Feeding of an estrogen, dienestrol diacetate, at 352 mg/kg of diet to December hatched White Leghorn type pullets, from 16 to 20 wk of age, caused onset of production to be delayed approximately 3 wk. The dietary dienestrol diacetate also resulted in increased body weights at 30 and 46 wk in one experiment. Hens receiving the estrogen laid significantly (P less than .05) heavier but fewer eggs during most of the production year than did those fed diets without the estrogenic compound. The addition of 2.2% fat to diets of pullets from 0 to 20 wk of age failed to influence their performance in the layer house. PMID- 2771850 TI - A quick and simple quantitative method to monitor house fly populations in caged layer houses. AB - A simple quantitative method (moving sticky tape) to monitor house fly populations in commercial caged layer houses was described and compared with a standard monitoring (spot card) method routinely used in egg houses. Numbers of flies counted by the sticky tape method were highly correlated (.78, P = .005) with those obtained with the spot card method. The moving sticky tape method is quicker and easier to use than the spot card method. The moving sticky tape method has been used satisfactorily since 1985 by the authors and cooperating service managers of commercial caged layer houses to monitor house flies in integrated pest management programs. A fixed sticky tape method was also compared with the spot card method; there was no significant correlation between the numbers of flies counted by these two methods. PMID- 2771849 TI - Water consumption and fecal moisture of laying hens fed wheat middlings and corn soybean-alfalfa meal diets. AB - Hens, housed on the floor and fed a diet containing 89% wheat middlings (WM) either as mash or pellets, consumed more feed and water than hens fed corn soybean meal-alfalfa meal (CSA) diets with either .15, .50, or .75%. NaCl. Moisture content of the hens' feces was not affected by mash or pellet processing of the WM diet. Feeding the .75% NaCl-CSA diet, however, significantly increased fecal moisture beyond that observed with the other treatments. Caged layers fed the WM diet voided more feces (2.6 fold) than did caged layers fed the .50% NaCl CSA diet, suggesting that wet litter problems observed in the floor pens of birds fed WM were the result of a greater fecal volume voided rather than a higher moisture content per unit of feces. PMID- 2771851 TI - Growth of broiler breeder pullets with skip-a-day versus daily feeding. AB - One hundred and sixty-eight broiler breeder pullets were fed skip-a-day or half the same feed allotment on a daily basis from 5 to 20 wk of age. When weighed on the same day, daily fed birds were significantly larger than skip-a-day-fed birds, but this difference appears to be partly due to feed retained in the digestive tract. Body composition and uniformity were unaffected by feeding regimen. PMID- 2771852 TI - Determination of the sex of chickens by a biotin-labeled deoxyribonucleic acid probe. AB - Repeating units of the W chromosome-specific, XhoI-family repetitive DNA of chickens have been cloned and sequenced. The recombinant plasmid carrying the .7 kilobase (kb) W chromosome-specific repeating unit was labeled by biotinylated deoxyuridine 5'-triphosphate and used to determine the sex of White Leghorn chicken by two DNA hybridization techniques. Hybrids formed were detected by the streptavidin-alkaline phosphatase method. By Southern blot hybridization, XhoI-.7 kb, XhoI-1.1 kb, and EcoRI-1.3 kb fragments were detected in the genomic DNA from the female White Leghorn but not in the DNA from the male. By dot-blot hybridization, which is the most convenient way to detect a specific nucleotide sequence, the difference between male and female could be clearly detected not only using purified DNA samples but also using blood cells or even blood itself as samples. PMID- 2771853 TI - Influence of degree of acetylation of scirpenol mycotoxins on feed refusal by chickens. AB - The refusal by young chickens of feed containing graded levels (0, 1.25, 2.5, 5.0, 10.0, 20.0, and 40.0 micrograms/g of diet) of the Fusarium mycotoxins scirpentriol (STO), monoacetoxyscirpenol (MAS), diacetoxyscirpenol (DAS), and triacetoxyscirpenol (TAS) was tested in a defined experimental model. The order of activity as measured by minimum effective dose was DAS greater than MAS = STO greater than TAS whereas the order measured by percentage refusal at 10, 20, and 40 micrograms/g was MAS greater than DAS greater than STO greater than TAS. These results imply that feed refusal associated with corn and feed infested with Fusarium sps. might be a multiple toxicosis because the scirpenols, which are not tested for routinely, can occur together naturally. PMID- 2771854 TI - Morphine treatment and intravenous glucose tolerance tests in mice. AB - The effect of acute and chronic morphine treatment on i.v. glucose tolerance tests in mice was investigated. It was found that neither acute nor chronic morphine treatment affected the serum glucose disappearance with time after i.v. glucose loading, indicating that morphine has no significant effect on glucose tolerance. Analysis of hepatic glycogen and glucose levels in these mice revealed that morphine treatment might have some effects on glucose metabolism, but at the analgesic dose employed, did not impair the animal's physiological response to i.v. glucose loading. PMID- 2771855 TI - Radioimmunoassay of pyridostigmine in plasma and tissues. AB - A sensitive and specific radioimmunoassay is reported for the cholinergic agent, pyridostigmine. Antibodies were raised in rabbits against a conjugate of pyridostigmine and bovine serum albumin. The assay can detect as little as 2.5 ng/ml of drug directly in plasma and tissue homogenates. Structurally similar compounds and major metabolites are not recognized by the antibody. The specificity of the antibody has been confirmed by utilizing high pressure liquid chromatography. Plasma concentration-time profiles and tissue distribution of the drug were determined by this method in rat after intramuscular administration of pyridostigmine. PMID- 2771856 TI - Pharmacological studies on zymosan inflammation in rats and mice. 1: Zymosan induced paw oedema in rats and mice. AB - Injections of zymosan in mouse and rat paws provoke inflammatory reactions, the kinetics of which are different. In both models, inflammation occurs at an early stage but oedema is maximal at 30 min in rat paw and 6 h in mouse paw. In this study the two reactions have been studied up to 6 h. The reduction of oedema by anti-H1 compounds, as well as by disodium cromoglycate, proves the active role played by histamine in rat paw oedema. In mouse its role appears to be minor or non-existent. Serotonin seems to be clearly implicated in the early stages of the oedema in mouse, somewhat less in rat. In the two species, non-steroidal anti inflammatory compounds only reduce the 4-6 h phase. BW755C and phenidone reduce the early and late phase of paw oedema in both species, with the exception of phenidone which is inactive on the 4-6 h phase in the mouse. We can hypothesize that in the two species some leukotrienes seem to be implicated principally in the early phases, while derivatives of cyclooxygenase play a more important role in the late phases. Theophylline reduces inflammation in the two models, hydrocortisone acetate, however, is only active on the late phases. These results indicate that there are important differences in the participation of the various mediators studied in the two models. PMID- 2771857 TI - Pharmacological studies on zymosan inflammation in rats and mice. 2: Zymosan induced pleurisy in rats. AB - Injection of zymosan in rat pleural cavity provokes an exudate which is already detectable at 15 min and which is maximum at 24 h. The leucocyte count (mostly neutrophils) increases at 2-4 h and is maximum at 48 h. In this paper the reaction has been studied up to 6 h. Evidence of histamine release, of mast cell degranulation and of reduction of the exudate by anti-H1 compounds, as well as by sodium cromoglycate, proves the active role played by histamine in the early stage of pleurisy. Serotonin (whose role was studied exclusively using antagonists) seems to have only a minor part in the early phase of the reaction. Some metabolites of arachidonic acid were determined in the pleural exudate at 1 h and 6 h. The concentration of leukotriene B4 was high at 1 h and decreased at 6 h. The thromboxane B2 level was already high at 1 h and was neatly augmented at 6 h while the amount of prostaglandin F1 alpha was high at both times. The non steroidal anti-inflammatory substances studied all reduced the pleural exudate at 1 h but their activity then varied from each other at 6 h. Cyclooxygenase and lipoxygenase inhibitors (phenidone, BW755C) induced a reduction of the exudate at both times. Zymosan-induced pleurisy seemed thus to be an excellent model for the investigation of antiallergic and anti-inflammatory compounds active on histamine and cyclooxygenase and lipoxygenase pathways. PMID- 2771858 TI - Evidence that ATP and noradrenaline are released during electrical field stimulation of the rat isolated seminal vesicle. AB - The effects of electrical field stimulation (at 1-100 Hz with 20-25 V, supramaximal, and 0.2 ms pulse duration, for 10-20 s), on tone and contractility of rat isolated seminal vesicle was studied, in the absence and presence of specific antagonists (phentolamine, 1 microM, alpha, beta-Me-ATP, 10 microM, and verapamil, 1 microM). The aim was to provide pharmacological evidence of the release of ATP, alongside NA, during electrical stimulation of the rat seminal vesicle. Electrical field stimulation of the rat seminal vesicle produced frequency-dependent contractions. At low rates of stimulation (1-20 Hz), only small tonic contractions were observed (0.3 g tension), whereas at high rates of stimulation (80-100 Hz), only phasic contractions (2-3 g) were seen. However, at intermediate rates of stimulation (e.g. 50 Hz), a biphasic response was produced: an initial fast, twitch-like response (phasic), followed by a slow tonic contraction. The phasic contraction was blocked by the stable analogue of ATP (alpha, beta-Me-ATP), which desensitizes P2-purinoceptors. The tonic contraction is adrenergic and was blocked by phentolamine. Verapamil reduced both types of contractions in this preparation and the block was unselective on tonic versus phasic contraction. It was concluded that electrical field stimulation produced frequency-dependent contractions tonic and phasic in the rat seminal vesicle. These responses were blocked by specific antagonists, suggesting the presence of different types of neurotransmitters released during electrical stimulation of the rat seminal vesicle. PMID- 2771859 TI - Effect of various aminoglycoside antibiotics on glucose formation in isolated rabbit kidney-cortex tubules. AB - The effect of six aminoglycoside antibiotics on the rate of gluconeogenesis was studied in isolated rabbit kidney-cortex tubules incubated with various substrates. All antibiotics studied did not affect glucose formation from both malate and 2-oxoglutarate. The rank order of the drug-induced inhibition of glucose formation from lactate, pyruvate and propionate was the following: neomycin = gentamicin greater than tobramycin greater than kanamycin = amikacin greater than streptomycin. This in principle corresponds to their ability to diminish pyruvate carboxylation in isolated kidney-cortex mitochondria, as well as to their known nephrotoxic potential observed in vivo. Aminoglycoside antibiotics decreased the respiration of tubule suspension incubated with various substrates. However, the rank order of the inhibition by antibiotics of oxygen uptake was different from that observed for gluconeogenesis, suggesting that the rate of energy generation does not limit glucose formation under conditions studied. PMID- 2771860 TI - Antimalarial efficacy of arteether against multiple drug resistant strain of Plasmodium yoelii nigeriensis. AB - New quick-acting blood schizontocides are needed to contain the spread of multiple drug resistant strains of P. falciparum and for the treatment of the cerebral malaria cases. A multiple drug resistant strain of P. yoelii nigeriensis resistant to mefloquine (128 mg/kg x 6 days), quinine (300 mg/kg x 7 days) and chloroquine (64 mg/kg x 8 days) was found to be completely susceptible to arteether (a 30:70 mixture of alpha and beta enantiomers) and a dose of 5 mg/kg x 3 days by i.m. route was curative in Swiss mice. Artemisinin at 50 mg/kg x 7 days had only suppressive action against this strain. PMID- 2771861 TI - Effects of Ginkgo biloba extract on glucose transport and glycogen synthesis of cultured smooth muscle cells from pig aorta. AB - We have examined the effect of an extract of Ginkgo biloba (Gbe) on glucose uptake and on glycogen synthesis in cultured smooth muscle cells (SMC) from pig aorta. Initial rates of glucose transport were determined by measurements of 2 deoxy-D-glucose (2-DG) uptake. From kinetic analyses apparent KM and Vmax values of facilitated glucose transport in cultured SMC were evaluated at 2.2 mM and 9.1 nmol/min/10(6) cells respectively. Gbe stimulated glucose transport in a dose dependent manner; the maximum effect was reached at a Gbe concentration of 0.25 micrograms/ml and represented an increase of 35 +/- 4% above basal activity. This stimulation mainly occurred on facilitated glucose transport. The passive diffusion measured when cells were treated with cytochalasin B represented 15 +/- 3% of glucose total transport activity either in the absence or the presence of Gbe. The effect of Gbe on glycogen synthesis in cultured SMC was then tested by the incorporation of U14C-glucose into cellular glycogen. This process was enhanced by Gbe, the maximal effect was observed at a Gbe concentration of 0.25 micrograms/ml, and represented a 41 +r4% increase above basal activity. These data argue for a direct effect of Gbe upon glucose transport and glucose utilization in cultured SMC thus allowing a better nutriment disposal in the vascular wall. PMID- 2771863 TI - Italian Pharmacological Society, 2nd inter-regional meeting. Modena, December 15, 1988. Abstracts. PMID- 2771862 TI - A succinylcholine-like action of an Ipomoea carnea Jacq subsp. fistulosa (Mart. ex choisy) extract. AB - An aqueous alcoholic extract of Ipomoea carnea subsp. fistulosa was tested in vitro on isolated preparations of the frog rectus abdominis muscle and the rabbit perfused heart as well as in vivo in the chicken. The extract and succinylcholine (suxamethonium) contracted the frog rectus abdominis muscle and this action was blocked by tubocurarine, 1.5 micrograms/ml. Both extract and succinylcholine produced bradycardia of the rabbit heart which was antagonized by atropine, 20 micrograms/ml. Like succinylcholine, the extract produced spastic paralysis in chickens. It is suggested that the extract possesses a depolarizing action similar to that of succinylcholine. PMID- 2771864 TI - Effect of antibiotics on colony formation from mouse granulocyte-macrophage progenitors (CFU-GM), megakaryocyte progenitors (CFU-M) and erythrocyte progenitors (CFU-E, BFU-E) in vitro. AB - Mouse bone marrow cells were cultured in vitro in semisolid medium containing various concentrations of beta-lactam antibiotics, moxalactam (LMOX), cefotetan (CTT), flomoxef (FMOX), ceftizoxime (CTZ), cefmenoxime (CMX), cefotasime (CTX), cefamandole (CMD), cefotiam (CTM), carbenicillin (CBPC) or sulbenicillin (SBPC). All of these antibiotics dose-dependently suppressed colony formation from granulocyte or macrophage progenitors (CFU-GM) and from megakaryocyte progenitors (CFU-M). The suppressive potencies of these antibiotics for both progenitors, as evaluated from the drug concentrations that induced 50% suppression of colony formation (IC50), were ranked as the weakest for CBPC and SBPC, moderate for LMOX, CTT, CMX, FMOX and CTZ, and strongest for CMD, CTX and CTM. LMOX, FMOX, CTX, CBPC and SBPC also showed dose-dependent inhibition of colony formation from erythroid progenitors (CFU-E and BFU-E). In the ranking of suppression of colony formation from CFU-E, CMD and CTX showed comparatively strong inhibition but others showed a weak effect, and in that from BFU-E, the effect was weakest for CBPC and SBPC, moderate for LMOX and FMOX, and strongest for CMD and CTX. The suppressive effect of LMOX and CMD on colony formation from each progenitor could almost be prevented by washing the cells after incubation with these antibiotics for 24 hr. PMID- 2771865 TI - Neurochemical studies on quinolone antibiotics: effects on glutamate, GABA and adenosine systems in mammalian CNS. AB - Quinolone antibiotics, which can be proconvulsant in susceptible patients, were found to inhibit the specific binding of the adenosine receptor ligands L-3H-N6 phenylisopropyladenosine (L-3H-PIA) and 3H-N-ethylcarboxamidoadenosine (3H-NECA) to rat brain synaptic membranes. The inhibitions were concentration dependent, and for both ligands the order of potency was rosoxacin greater than nalidixic acid greater than oxolinic acid greater than or equal to ciprofloxacin greater than norfloxacin greater than enoxacin: IC20 values (concentrations causing a 20% inhibition of specific binding) ranged from 30-35 microM to 1-3 mM. Hill coefficients were approximately 0.5, suggesting that the compounds are probably antagonists at these sites. Most of the compounds did not alter 3H-diazepam binding directly, although rosoxacin showed relatively strong, and enoxacin weak, concentration-dependent inhibition. At 50 microM the compounds enhanced the maximal gamma-aminobutyric acid (GABA) activation of 3H-diazepam binding to varying degrees, without altering the EC50 of activation, whereas at 200 microM they tended to reduce GABA activation. Most noteworthy was the large increase in GABA-stimulated 3H-diazepam binding caused by 50 microM nalidixic acid. The compounds did not alter the Ca2+/Cl- -dependent binding of 3H-glutamate, nor of the binding of the glutamate site-selective ligands 3H-kainate and alpha-3H-amino 3-hydroxy-5-methylisoxazole-4-propionic acid (3H-AMPA); the uptake of the non metabolized glutamate analogue D-3H-aspartate by cortical homogenates was also unaffected. The CNS side effects of these antibiotics may result, in part, from interaction with sites which mediate the inhibitory neurotransmission of adenosine and, possibly, GABA. PMID- 2771866 TI - Disposition kinetics of disopyramide in human healthy volunteers described by an open three compartment model. AB - Disposition kinetics of disopyramide was examined in an open randomised cross over study in 8 healthy volunteers. Disopyramide was randomly administered as a single bolus injection (150 mg) over a period of 5 min. and as an infusion (28.2) mg/h to steady state. Disposition kinetics of disopyramide were most precisely described by an open three compartment model according to Akaike's information criteria. Significant positive correlations (0.909 +/- 0.04, P less than 0.05 (injection study); 0.787 +/- 0.11, P less than 0.05 (infusion study] were observed between total serum concentrations of disopyramide and renal clearance while no significant correlation could be demonstrated between free serum concentrations and renal clearance. This implies a constant value of unbound renal clearance. The results are consistent with non linear kinetics (mainly caused by the variable free fraction of the drug), when based on total serum concentrations. The disposition of unbound disopyramide, however seems to be linear (i.e. the kinetic parameters are independent of dose) in the bolus injection study. Total elimination clearance (free and total), volume of distribution and elimination half-life were significantly higher in the steady state experiment than in the bolus injection study. PMID- 2771867 TI - Effects of flunitrazepam and triazolam in man: are they influenced by the time of ingestion? AB - Five healthy young volunteers were given flunitrazepam 1 mg, triazolam 0.25 mg or placebo at 2 a.m. or 9 a.m. in a double blind, cross-over study. The aim was to investigate the cyclic variations mainly in residual effects of the drugs, but also in sleep onset latency and pharmacokinetics. The study suggested cyclic variations in mood, psychometric tests and in sleep onset latency. PMID- 2771868 TI - Mercuric chloride activates latent, anion-dependent cation transport systems in the plasma membrane of Ehrlich ascites tumour cells. AB - Electronic cell sizing of Ehrlich ascites tumour cells is presented as a biological test system for assessment of membrane associated effects of toxic compounds. Ehrlich ascites tumour cells readjust their cell volume after osmotic swelling in hypotonic media. This regulatory process (Regulatory Volume Decrease, RVD) involves a net loss of KCl from the cells. Addition of HgCl2 (1 microM) results in a Cl- -dependent acceleration of RVD in hypotonic medium. Cells in isotonic Cl- -containing medium shrink upon addition of HgCl2 due to a Cl- dependent net loss of K+. In addition, a Cl- -dependent net uptake of Na+ was also seen in the presence of HgCl2. It is concluded that HgCl2 activates a latent K+, Cl- cotransport as well as Na+, Cl- cotransport in Ehrlich cells. PMID- 2771869 TI - Fluoride-induced cytoplasmic acidification: possible role of protein kinase C in BCECF-loaded L929 cells. AB - The effect of fluoride on cytoplasmic pH (pHi) in L929 cells was investigated by using a fluorescent pH indicator, BCECF. Fluoride decreased pHi in a dose dependent manner. This cytoplasmic acidification was composed of two phases: 1) a rapid decrease in pHi occurring within seconds, and 2) a slow decrease in pHi occurring 1-2 min. after stimulation with fluoride. The phase one decrease in pHi at external pH (pHe) 7.7 was more rapid than that at pHe 6.8, whereas the phase two decrease at pHe 7.7 was slower than that at pHe 6.8. In addition, both in the protein kinase C-inhibited and depleted cells, the fluoride-acidified pHi gradually returned to the resting pHi level in phase two, though the initial cytoplasmic acidification (i.e. phase one) was not affected. These results suggest that the fluoride-induced cytoplasmic acidification is dependent upon pHe and is sustained by the protein kinase C-dependent Na+/H+ exchange. PMID- 2771870 TI - Effect of growth hormone dosing on ultimate weight and length of XO mice. AB - Mice with the karyotype 39, XO and XX mice with the same genetic background were injected for a six month period with daily subcutaneous doses of 0.5 IU biosynthetic human growth hormone (hGH) or with placebo. The XO mice dosed with hGH obtained a significantly higher body weight and greater final length than the XO mice dosed with placebo (39.2 g versus 29.0 g and 21.1 cm versus 19.2 cm respectively). The body weight remained constant after cessation of dosing. The XX mice became significantly longer but not heavier as a result of hGH dosing. The placebo dosed XO mice became significantly longer than the placebo XX mice but their body weights were comparable. Dosing with hGH caused a significant increase in growth rate in both XO and XX mice, and the ultimate body weight was reached within a significantly shorter time period. In the XO mice the hGH injections increased significantly the length and thickness of the femoral bones and the length of the tibia bones. Stimulated endogenous plasma growth hormone levels were significantly higher in XX mice compared to XO mice. Plasma IGF-I levels were significantly higher in XO compared to XX mice, but the levels were not affected by hGH dosing. XO mice may be useful in future metabolic and hormonal studies. PMID- 2771871 TI - Inhibition of hepatic microsomal drug metabolism in rats by five calcium antagonists. AB - The effects of five calcium antagonists, verapamil, diltiazem, nifedipine, darodipine and isradipine, on rat liver microsomal drug metabolism in vitro and in vivo were studied. All compounds prolonged hexobarbital-induced sleeping time in a dose-dependent manner (doses 3.0 and 30.0 mg/kg, except nifedipine 0.3 and 3.0 mg/kg) and inhibited cytochrome P450-dependent N-demethylation of aminopyrine in vitro in rat liver microsomes. The incubation of all compounds with microsomes resulted in the apparent formation of formaldehyde, suggesting either N- or O demethylation. Diltiazem, isradipine and darodipine gave rise to a type I spectral change. Nifedipine seemed to produce a type II spectral change. A spectrum of verapamil changed from a type I to a type II as concentration increased. These results indicate that all calcium antagonists studied interact with P450 and are in vitro inhibitors of microsomal drug metabolism in the rat and the inhibition brings out pharmacokinetic drug-drug interactions in vivo. PMID- 2771872 TI - Chlorpromazine, administered in vivo and in vitro, inhibits the efflux of bile acids in freshly isolated rat hepatocytes. AB - Although it has been speculated that chlorpromazine may alter the transhepatic movement of bile acids from plasma to bile, the effect of chlorpromazine on various determinants of bile acid transport in isolated rat hepatocytes remains incompletely defined. In particular, there is little information about the effect of chlorpromazine on the release of bile acids from freshly isolated hepatocytes. Therefore, we examined the effect of chlorpromazine, administered in vivo and in vitro, on the efflux rate of radiolabeled bile acids in freshly isolated rat hepatocytes. In an isolated haptocyte system, it is not possible to distinguish the sinusoidal plasma membrane function of efflux (back diffusion) from the canalicular plasma membrane function of excretion. Therefore, efflux, as used in this manuscript, reflects both back diffusion and excretion. In vitro, chlorpromazine produced a rapid dose dependent significant (P less than 0.05) decrease of the bile acid efflux rate in freshly isolated hepatocytes. This decrease in bile acid efflux was observed at chlorpromazine concentrations which did not alter hepatocyte plasma membrane permeability (viability), as measured by intracellular potassium content, release of lactate dehydrogenase, and trypan blue exclusion. Moreover, in freshly isolated hepatocytes from chlorpromazine pretreated rats, a significant (P less than 0.05) decrease in the bile acid efflux rate was also observed, and this decrease in efflux was similar in magnitude to the decrease in bile acid efflux observed following exposure of freshly isolated hepatocytes to chlorpromazine in vitro.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2771873 TI - The effects of inorganic lead on the spontaneous and potassium-evoked release of 3H-5-HT from rat cortical synaptosome interaction with calcium. AB - Interaction of lead with the serotonergic system has been studied in vitro in rat brain synaptosomal fraction prepared from cortical tissue. Synaptosomes were loaded with 3H-5-HT and spontaneous and K+-evoked release of the amine was examined in the presence and the absence of calcium. It was shown that lead itself induced the release of 3H-5-HT (EC50 = 27 microM). This effect decreased (40%) in the presence of calcium without modification of the EC50. Moreover, lead markedly inhibited the K+-evoked release of 3H-5-HT observed in the presence of calcium. This effect was obtained either in the presence of lead or using synaptosomes pretreated with lead and washed. These results indicate that lead interferes with neuronal 5-HT release by mechanism(s) involving calcium. PMID- 2771874 TI - Molecular cloning of cDNA for rat brain metallothionein-II and regulation of its gene expression. AB - A rat brain metallothionein-II (MT-II) complementary DNA (cDNA) clone was isolated from a cDNA plasmid library, which was prepared from non-treated rat brain mRNA, by a colony screening procedure using 32P-labeled synthetic oligonucleotide probes. It is deduced that the clone encodes for a protein of 61 amino acids comprising 20 cysteines, which is highly homologous to MT-IIs in other species. Northern blot analysis demonstrated major mRNA species in the brain, liver and kidneys (approximately 350 b in size), which is induced in response to dexamethasone, zinc, cadmium and mercury but not to methyl mercury. These findings confirm that MT-II genes are expressed and regulated both by steroid and heavy metals in the brain as well as in peripheral organs. PMID- 2771875 TI - Diethylthiocarbamic acid methyl ester: a suicide inhibitor of liver aldehyde dehydrogenases? PMID- 2771876 TI - Differential radiosensitivity in cultured B-16 melanoma cells following interrupted melanogenesis induced by glucosamine. AB - The relationship between cell pigmentation and radiosensitivity was investigated in a cell model in which melanogenesis was suppressed by a glycosylation inhibitor. It was found that X-irradiation of melanotic B-16 melanoma cells and their amelanotic counterparts, obtained by glucosamine treatment, showed an inverse correlation between radiosensitivity and melanin contents. Since melanogenesis interruption by glucosamine does not affect the DNA repair capacity of nonpigmented cells, it is likely that intracellular melanins play a role in the relative resistance of pigmented cells to X-irradiation. PMID- 2771877 TI - Drug-induced and genetic hypermelanism: effects on pigment cell differentiation. AB - Allopurinol, a drug that inhibits the enzyme xanthine dehydrogenase (XDH), is known to cause hypermelanism in the axolotl. The hypermelanistic condition that results from allopurinol treatment is similar in most respects to the phenotype that results from the action of the melanoid (m) gene in axolotls. On the basis of structural and biochemical studies, it now seems clear that genetic and drug induced hypermelanism are the same in the following ways. 1) Both types of melanism result in the production of more than normal amounts of melanin and more melanin-containing cells (melanophores). 2) In both cases the amount of pteridine associated yellow pigment declines during development, and this is associated directly with fine structural changes that occur within the pigment organelles (pterinosomes) of yellow pigment cells (xanthophores). 3) In both cases the hypermelanistic condition results in the suppression of reflecting pigment cell (iridophore) differentiation. 4) Both conditions have now been linked directly to depressed levels of XDH activity. Thus both genetic and drug-induced hypermelanism result in alterations in the normal differentiation of all three pigment cell types and the subsequent disruption of normal pigment pattern formation. The possible significance of these findings with regard to factors known or suspected to direct the migration and/or differentiation of neural crest derived pigment cells is discussed. PMID- 2771878 TI - Ionic requirements for melanin concentrating hormone (MCH) actions on teleost Poecilia reticulata melanophores. AB - Melanin concentrating hormone (MCH) is a cyclic heptadecapeptide, Asp-Thr-Met-Arg Cys-Met-Val-Gly-Arg-Val-Tyr-Arg-Pro-Cys-Trp-Glu-Val, synthesized in the hypothalamus and released by the neurohypophysis of teleost fish. This hormone is a potent lightening agent of fish skin. This lightening results from the stimulation of a centripetal melanosome (melanin granule) migration to a perinuclear position within integumental melanophores. MCH and related fragment analogues, MCH5-17 and MCH1-14 were used to investigate the ionic requirements for receptor activation by MCH on dermal melanophores of the fish Poecilia reticulata. In calcium-free saline, the sensitivity of the melanophores to MCH and MCH1-14 increased, whereas the sensitivity of the cells to MCH5-17 decreased. Verapamil diminished the sensitivity to MCH5-17, but did not affect melanophore responses to MCH or MCH1-14. The melanosome aggregating response to MCH was not affected in the presence of tetrodotoxin or in sodium- or potassium-free (choline substituted) saline. These results suggest that neither TTX-sensitive sodium channels nor extracellular sodium or potassium ions play a role in MCH-induced melanosome aggregation. It is known that MCH and MCH1-14 also exhibit MSH-like melanosome dispersion within melanophores, skin darkening activity on fish melanophores whereas MCH5-17 lacks this characteristic. Since the darkening activity of MCH and MCH1-14 requires calcium, these analogues exhibited a diminished lightening (MCH-like) activity in the presence of the divalent cation. In the absence of the N-terminal tetrapeptide sequence (necessary for the expression of MSH-like activity), a role for calcium on melanosome aggregation became evident. These results demonstrate a bifunctional role of calcium on melanosome movements. PMID- 2771879 TI - Immunobiology of bacterial and protozoan infection of man. Colloquium. PMID- 2771880 TI - [Foster care placement and self determination]. AB - Tension exists between the reality of outside placement and the tendency toward self-determination. The importance of this tension is examined by way of the history of outside placement, the current practice of outside placement, and the experience of the children involved; the relationship to protective conditions is also examined. PMID- 2771881 TI - [Psychologically conspicuous children in kindergarten: on the consultation and education of teachers]. AB - Children's conspicuous behaviour in the kindergarten can be caused by many factors. To initiate necessary help or to protect the child from stigmatization, the following range of possible influences should be examined: circumstances of the kindergarten, relationship between kindergarten-teacher and the child, way of life and habits of the entire family, and organic functioning of the child. Kindergarten-teachers need competent counseling to improve the curative and compensatory possibilities of the kindergarten. PMID- 2771882 TI - [Evaluation of inpatient adolescent psychiatric therapy--a comparison of the attitudes of adolescents and parents]. AB - This paper reports methods and findings of a retrospective study on this subject. Remarkable contrasts regarding central aspects of adolescent psychiatric inpatient treatment offer an interesting variety of hypotheses and desire quantitative and qualitative amplifications of the study. PMID- 2771883 TI - [Organization of ambulatory psychoanalytic supervision in child and adolescent psychiatry]. AB - In this study the effect of supervision on the team and treatment of clinical patients with a "basic-fault" was investigated. Over a period of 2 years 381 questionnaires were evaluated. According to a scheme proposed by M. Balint a questionnaire was developed to provide subjective value-estimation of supervision by the members of the therapeutic team. Each individual session of supervision was documented. In the subsequent study the predominating issues of these supervisions were divided into "problem-groups" to give better estimation of the general function of supervision. The problem-group of therapeutic team-patient relationship was further differentiated to evaluate the main difficulties of individual team members concerning the emotional approach to the patient. As a marker of an intensified therapeutic intervention with severe "basic-fault" patients arouse such as "never before experienced emotions" or "problems of symbolizing" of psychodynamic structures. The study concludes in assuming a positive effect of supervision on the therapeutic approach and attitude as well as on the internal structure of the team. This was most noticeable in the specialized treatment of patients with a predominating "basic-fault". PMID- 2771884 TI - [Common structures of psychotherapy and movement therapy]. AB - The text deals with the anthropological analogies of psychotherapy and movement therapy, especially in view of cooperation between therapists of both directions. Points in common are: coordination of psychic and somatic processes, the unity of perception and movement, the significance of imagination, the connection of the imaginary with the real consciousness as well as promotion of partial functions with central integration and of activity with relaxation. Important analogies further concern the experience of space, time and the formation of identity. Finally the two therapeutic approaches are connected with the different functional centres of both brain hemispheres. PMID- 2771885 TI - Resorbed co-twin as an explanation for discrepant chorionic villus results: non mosaic 47,XX,+16 in villi (direct and culture) with normal (46,XX) amniotic fluid and neonatal blood. AB - Non-mosaic trisomy 16 was observed in chorionic villus cytotrophoblasts (direct) as well as cultured mesenchymal core cells derived from the pregnancy of a 38 year-old woman. Chromosome preparations from amniotic fluid and neonatal cultures (cord blood) were 46,XX. Normal fetal growth as determined by serial ultrasound examinations occurred throughout the pregnancy, which resulted in a healthy 2724 g female. Multiple biopsies taken from the umbilical cord, placental cotyledons, and fetal membranes were 46,XX. However, a placental nodule and three of six cultures initiated from membranes (amnion and chorion) showed 46,XX/47,XX,+16 mosaicism. We propose that the trisomy 16 cells arose from residual villi derived from a trisomic co-twin that never developed. This case further demonstrates that normal fetal growth may presage normal outcome irrespective of cytogenetic findings in cytotrophoblasts (direct) and cultured mesenchymal core cells. PMID- 2771886 TI - Prenatal diagnosis and psychological distress: amniocentesis or chorionic villus biopsy? AB - The psychological reactions of 211 women undergoing prenatal diagnosis (PND) with amniocentesis (group A, n = 122) or chorionic villus biopsy (group V, n = 90) were examined by questionnaires and interviews. The distress experienced while waiting for the test, during the test procedure, and while waiting for the result was reported by the women, both in questionnaires and in interviews. In the questionnaires, no difference between the two diagnostic methods was observed. In the interviews, however, the women undergoing amniocentesis appeared significantly more distressed by the procedure. In group A 97 per cent and in group V 100 per cent wished a method which, like chorionic villus biopsy, could be used in the first weeks of pregnancy. The risk of miscarriage was, as described in other studies, regarded as a serious threat by the pregnant women. PMID- 2771888 TI - Trisomy 20 mosaicism confirmed in a phenotypically normal liveborn. AB - Prenatal diagnosis of trisomy 20 mosaicism in this case was based on cytogenetic analysis of cultured amniotic fluid cells (23/252 cells were trisomy 20 representing cells from each of four primary cultures). The pregnancy continued to term and the mosaicism was confirmed in the phenotypically normal male neonate by analysis of cultured foreskin fibroblasts (7/49 cells + 20) and placental cells 20/20 cells + 20) whereas the peripheral lymphocytes were cytogenetically normal (20/20 cells were 46,XY). This represents the first confirmation of trisomy 20 mosaicism in a phenotypically normal full-term neonate. PMID- 2771887 TI - Rapid sexing of human embryos by non-radioactive in situ hybridization: potential for preimplantation diagnosis of X-linked disorders. AB - Sixty spare human embryos at various stages of preimplantation development were prepared for cytogenetic analysis. Fluorescent staining of those with metaphases allowed scoring for the presence of a Y chromosome. In situ hybridization was then performed using a biotinylated Y-specific sequence, and the probe was detected by a standard streptavidin-linked alkaline phosphatase system. This enabled comparison of the chromosomal sex with that obtained after in situ hybridization in 28 embryos, and the sexing result obtained by the two methods was concordant in all cases. A further 21 embryos in which no metaphase chromosomes were obtained were sexed by biotinylated in situ hybridization only. Overall, 66 per cent of male interphase nuclei demonstrated a Y-specific hybridization signal. Results were obtained in under 24 h, which may permit the sexing of an embryo biopsied during cleavage and the transfer of sexed embryos at the blastocyst stage to the mother's uterus in the same cycle as oocytes are collected for in vitro fertilization. PMID- 2771889 TI - Confirmation of a balanced chromosomal translocation using molecular techniques. AB - Investigation of a couple, who had produced three babies with cri du chat syndrome, showed initially that the mother had an apparent deletion of chromosome 5. It seemed likely that she had a balanced chromosomal translocation but it proved impossible to detect the second chromosome involved using routine cytogenetic methods. Molecular techniques using quantitative hybridization dosage studies were performed and these showed that the mother had a double dose of DNA in the suspected deleted area of chromosome 5. Further studies, using in situ hybridization techniques, revealed that the missing segment of chromosome 5 had translocated onto the short arms of a C group chromosome and further analysis of prometaphase chromosomes showed the presence of a balanced translocation, 46,XY,t(5;9)(5qter----5p14.1::9p22----9pter;9 qter----9p22::5p14.1----5pter). As a result of these findings, it was possible to offer prenatal diagnosis to the patient in future pregnancies, by detecting the presence of a balanced or unbalanced translocation in the fetus using molecular and cytogenetic techniques. PMID- 2771890 TI - [Experimental heart hypertrophy caused by thyroxine administration]. PMID- 2771891 TI - [Idiopathic arterial calcinosis in children. A case with arterial hypertension, heart infarct and cerebral massive hemorrhage]. PMID- 2771892 TI - [Histologic and clinical markers of inflammatory infrarenal aneurysm of the abdominal aorta]. PMID- 2771893 TI - [Dysplasia in chronic inflammatory bowel diseases. On the standardized classification of the Inflammatory Bowel Disease-Dysplasia Morphology Study Group]. PMID- 2771894 TI - Proteins associated with activity of Fc receptors on isolated human placental syncytiotrophoblast microvillous plasma membranes. AB - To identify Fc receptors from human placental microvilli, proteins that were liberated by detergents from human placental synctiotrophoblast microvillous membranes (StMPM) were characterized by their abilities to bind human IgG in immune complexes with sheep or goat anti-human IgG and to monomeric rabbit anti dinitrophenol (DNP) IgG bound to DNP-lysine Sepharose. Three placental IgG binding proteins coprecipitated with immune complexes (Mr = 68,000, 52,000 56,000, 40,000) and were designated pIBP68, pIBP56 and pIBP40, respectively. Of the three proteins only pIBP56 bound to immobilized monomeric rabbit IgG. It was isolated from detergent lysates of StMPM and LDS/phenol glycoprotein extracts of placental plasma membranes suggesting that pIBP56 was a glycoprotein FcR previously reported (Mikulska et al, 1982). The binding specificities of pIBP56 and pIBP40 appeared to be detergent dependent. Photoaffinity crosslinking of StMPM surface proteins in situ to monomeric rabbit derivatized with N succinimidyl(4-azidophenyl)-I, 3-dithiopropionate identified IgG-binding proteins identical in size to pIBP56 and pIBP40. Crosslinking further suggested that monomeric IgG covalently bound to a complex of StMPM proteins with a total size of 110,000-120,000 Mr. The findings suggest that pIBP68, pIBP56 and pIBP68 are responsible for IgG binding activity of placental StMPM. PMID- 2771895 TI - Electron microscopic study on early decidualization of the endometrium of pregnant mice, with special reference to gap junctions. AB - Cytological changes in mouse decidual cells during the early stages from 4.5th to 11th day of pregnancy were examined by electron microscopy with special reference to gap junctions. The most noticeable feature of decidual cells was that there was an abundance of various-shaped gap junctions such as flat, undulated, omega shaped, and annular-shaped gap junctions. Serial sectioning revealed that annular shaped gap junctions were separated from the decidual cell plasma membrane. Intramembranous particles (IMPs) of the gap junctions as seen by freeze-fracture displayed a well-packed arrangement and a homogeneous size. Degenerative changes first appeared in decidual cells directly contiguous with trophoblasts on the 7th day, and spread to the deeper area as clearly seen on the 8th day. Along with degeneration of decidual cells, annular-shaped gap junctions were enfolded and gradually degraded by lysosomes. IMPs of such degenerative gap junctions were irregularly arranged and heterogenous in size. The decidual tissue became thin with elongated decidual cells as the placental disc grew on the 10th day. Extremely long undulated gap junctions were present in decidual cells, and a small number of annular-shaped gap junctions were also found in the cytoplasm. The presence of abundant gap junctions as demonstrated in the present study suggests that decidual cells will be able to develop as well as to function synchronously. In addition, it is suggested that redundant gap junctions become annular-shaped to be finally degraded by lysosomes. PMID- 2771896 TI - Stereological re-examination of the effects of varying oxygen tensions on human placental villi maintained in organ culture for up to 12 h. AB - The effects of exposure to various oxygen tensions on villi in organ culture are re-examined. Villi from ten normal mature placentae were cultured under hypoxic (6 per cent oxygen) and hyperoxic (40 per cent oxygen) conditions for 6 or 12 h. Control tissue (zero time in culture) was also taken. Pieces of tissue were fixed by immersion and embedded in resin for semithin sectioning. Systematically sampled microscopical fields were analysed stereologically to estimate harmonic and arithmetic mean thicknesses for the trophoblast and for the villous membrane and to assess the volumetric composition and mean diameter of villi. Trophoblast thicknesses were influenced significantly by oxygen tension, being smaller in hypoxic and greater in hyperoxic media. No significant interaction terms or effects of time in culture were detected. Villous membrane thicknesses altered in a similar fashion to trophoblast thicknesses. No significant differences in the composition of villi were detected but villi tended to be greater in diameter during hyperoxia. Findings are discussed in the context of previously reported adaptations in vivo, in different regions of the placental lobule and during chronic maternal hypoxic stress at high altitude. We conclude that there is insufficient evidence to support the claim that villi can adapt in vitro to varying ambient oxygen tensions. PMID- 2771897 TI - Placental weight in diabetic pregnancies. AB - The placenta from 30 women with diabetes mellitus were examined and weighed at delivery. Nineteen of these were from women with overt and eleven from women with gestational diabetes. Eleven placentae from normal pregnancies served as controls. There was no difference between the mean +/- s.d. placental weight for the diabetic group and the control group (609 +/- 148 versus 591 +/- 93 g, NS). The mean placental weight ratios for the diabetic group and the control group were also similar (0.98 +/- 0.23 versus 0.89 +/- 0.15, NS). Moreover, there was no difference between the weights and weight ratios of placentae from women with overt (622 +/- 173 g, 1.02 +/- 0.27) and those with gestational diabetes (586 +/- 90 g, versus 0.90 +/- 0.13). Placental weights correlated with birthweights (r = 0.70, P less than 0.01) and with skinfold thickness measurements fo the infants (r = 0.40, P less than 0.05), but neither with gestational ages (r = 0.15, NS) nor with maternal glycosylated haemoglobin levels in the third trimester (r = 0.24, NS). Among the women with overt diabetes, placental weights were greater in those in White's class B and C than those in class D and R (689 +/- 143 versus 530 +/- 177 g; P less than 0.05). In general, placentae from well controlled diabetic patients were not heavier than those from normal pregnant women, although there was an increase in placental weight in White's class B and C, as compared with those in class D and R. PMID- 2771899 TI - Morphometric analysis of the histology of spontaneous fetal resorption in a murine pregnancy. AB - Immunopathology of the spontaneous resorption phenomenon in the CBA x DBA/J murine model was explored using morphometric analysis. Accompanying the previously reported presence of natural killer (NK) cells in resorptive feto placental units we find major changes in tissue morphology indicating that early infiltration of the feto-placental unit by maternal leukocytes plays a direct role with NK cells in fetal demise. Total number of cell nuclei per field and total nuclear area per field were significantly elevated in feto-placental units containing abnormally increased NK cell presence before detectable resorption as early as day 7 of gestation. This difference persisted throughout all stages of early gestation up to and including the final resorption event at day 10 to 12. Increases in cell density were also detected in areas of the embryonic unit not associated with NK infiltration. These results demonstrate that the spontaneous resorption phenomenon in this model involves: (i) Early (day 7-8) cellular infiltration of the decidual-ectoplacental cone junction associated with the presence in this area of NK cells. (ii) Late (day 8-9) cellular infiltration of the ectoplacental cone. PMID- 2771898 TI - Villous oedema of the placenta: a clinicopathological study. AB - Villous oedema was observed in 259 placentae among 1925 consecutive singleton pregnancies of greater than 19 weeks gestation. It was present in 11 per cent of term placentae in which significant associations with fetal and neonatal death (P less than 0.03), and absence of maternal cigarette smoking (P less than 0.002) were found. In preterm placentae, the oedema was usually more severe, and its prevalence increased from 20 per cent for 33-37 weeks to 40 per cent for less than 33 weeks. Our analysis showed that for a given gestational age, villous oedema was not significantly related to chorioamnionistis, Apgar scores of less than 7 at 1 and 5 min, or neonatal death, an exception was for 33-37 weeks gestation, in the absence of chorioamnionitis, villous oedema was associated with low 1 min Apgar score. Immature intermediate villi are present in premature placentae as a normal developmental stage and in dysmature placentae as a result of villous maldevelopment. Since villous oedema closely resembles the 'stromal channels' in this villous type and shows significant association with prematurity and villous dysmaturity, we postulate that villous oedema is a lesion primarily of the immature intermediate villi. Both fetal and maternal factors are involved in its pathogenesis. PMID- 2771900 TI - [The German Central Committee for Control of Tuberculosis. Recommendations for preventing infection in tuberculosis]. PMID- 2771901 TI - [Mycobacterial zooanthroponoses]. PMID- 2771903 TI - [Effect of standardized hay exposure of healthy probands and patients with farmer's lung with special reference to bronchoalveolar lavage]. AB - Ten farmers with farmer's lung disease, and 15 healthy subjects who had not previously been exposed to hay, were exposed to hay for one hour. Over a period of twenty-four hours, the symptoms, number of leukocytes, temperature and pulmonary functional-analytical parameters were recorded. In all the cases with farmer's lung, and in seven of the healthy test subjects, broncho-alveolar lavages (BAL) were carried out prior to and 48 hours after the exposure to hay. In the patients with farmer's lung, a systemic, statistically significant reaction associated with an increase in the number of leukocytes to about 7,400/cmm, together with an increase in temperature of about 1.6 degrees C, occurred 8 hours after the initiation of the provocative test. In addition, a primary reaction developed, with a statistically significant decrease in vital capacity (VC) by 700 ml, of the total lung capacity (TLC) of 500 ml, and of the oxygen partial pressure of 14 mmHg. Four hours after the start of the provocation, the resistance increased, on average, by 0.5 cm H2O/l/s (p less than 0.05). In the case of the farmers with farmer's lung disease, a comparison of the cell composition of the BAL fluid prior to and after the provocative test revealed a decrease in the percentage of macrophages from 84.6 +/- 9.1% to 46.8 +/- 15.7% (p less than 0.003), an increase in the percentage of lymphocytes from 10.8 +/- 6.6% to 26.4 +/- 23.4% (p less than 0.04), and an increase in the percentage of polymorphs from 4.3 +/- 5.7% to 26.4 +/- 20.0% (p less than 0.004).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2771902 TI - [Oxygen radical production of alveolar inflammatory cells in sarcoidosis and idiopathic lung fibrosis]. AB - Interstitial lung diseases are characterised by chronic inflammatory processes in the lower respiratory tract, parenchymal cell injury and progressive fibrosis of the alveolar structure. Oxygen radicals are claimed to be a major cause of the tissue damage in the lung. We evaluated the spontaneous and stimulated oxygen radical release of bronchoalveolar lavage (BAL) cells in 35 patients with sarcoidosis and 17 patients with IPF. In comparison with the control in both diseases the spontaneous as well as the stimulated oxygen radical release of the BAL cells is markedly increased. In IPF alveolar macrophages produce the buk part of radicals (84%). Due to their low percentage and in spite of a higher activity on a per cell basis the contribution of neutrophils to the total radical burden is only marginal. In sarcoidosis there is a positive correlation between the oxygen radical release of AM and the CD4/CD8 ratio of BAL lymphocytes. Our results demonstrate that the clinical activity of sarcoidosis and IPF is reflected by the oxygen radical release of BAL cells. PMID- 2771904 TI - [Pulmonary alveolar microlithiasis (disease in 2 siblings--case report)]. AB - This article presents case reports on brother and sister suffering from microlithiasis alveolaris pulmonum. Diagnosis was established by means of the course of the disease, the relatively typical x-ray film and the findings on performing scintigraphy of the skeleton and also by computed tomography. Findings confirmed that the course of the disease is symptom-free for a long time; that it occurs in both sexes; and that it becomes manifest with considerable incidence in some families. Pulmonary alveolar microlithiasis is not a generalised metabolic disease, since it affects the lungs only. If the aetiology remains unclear, no causal treatment can be effected. PMID- 2771905 TI - [Clinico-immunologic characteristics of patients with pulmonary tuberculosis, psychic diseases and a congenital glucose-6-phosphate dehydrogenase deficiency]. AB - Clinical and immunological characteristics of the tuberculosis process in patients with mental diseases and congenital deficiency of glucose-6-phosphate dehydrogenase were investigated. Enzymopathy was detected in 34 (8.9 per cent) out of 382 patients subjected to the investigation. It was shown that among the carriers of the anomalous gene, the proportion of patients with chronic destructive tuberculosis was high. The patients (91.2%) showed more frequent bacterial isolation. Despite immunotherapy, no positive changes in the immunological indices were observed in the carriers, which was attributable to decreased activity of the enzyme in the immunocompetent cells. PMID- 2771906 TI - [Organization of a tuberculosis surgical service for patients in Western Siberia]. AB - The conditions of the surgical care for patients with pulmonary tuberculosis and in particular patients with chronic cavernous tuberculosis were investigated in some regions of West Siberia. In the last 5 years the activity of the surgical care and the proportion of the operated persons among the contingents of the patients with active tuberculosis increased by 63 and up to 10.5%, respectively. Surgical treatment was mainly applied to new cases of pulmonary tuberculosis since many persons with chronic tuberculosis had contraindications to such treatment due to the disease severity and asocial behaviour. PMID- 2771907 TI - [Diagnosis of cancer of the lung in patients with tuberculosis and subjects with post-tuberculosis changes of the lungs]. AB - Recently, the number of cases of primary lung carcinoma associated with tuberculosis and posttuberculous lesions has become more frequent. In this connection the problem of early diagnosis of cancer in such patients is gaining clinical importance and becomes urgent. The presence of tumor in such patients is mainly stated by phthisiologists as a result of time course x-ray observations with a delay, in half of the patients at stages III-IV. The time for verification of the diagnosis of lung cancer appears to be especially long when it is associated with active tuberculosis and the processes are located in the same area. The time required for diagnosis of cancer in association with inactive tuberculosis when the processes are anatomically located in different areas is somewhat shorter. However, it takes on an average 2-fold time to verify the diagnosis in patients with associated abnormalities as compared to those with cancer not aggravated by concomitant tuberculosis or posttuberculous lesions in the respiratory organs. Persons with tuberculosis or posttuberculous lesions in the lung require more intent attention as for oncological diseases and the above factors should be considered as additional indications to risk of lung cancer. PMID- 2771908 TI - [Efficacy of treating patients with disseminated forms of destructive pulmonary tuberculosis using chemical preparations and T-activin]. AB - The use of T-activin in combination with chemical drugs allowed to markedly increase efficacy of the treatment. As a result of the treatment significant improvement was found in 17 (41.5 per cent) out of 41 patients with marked disorders in cellular immunity and severe tuberculosis. At the same time in the patients treated with the chemotherapeutics alone the improvement was stated only in 18.5 per cent of the patients. T-Activin improved the indices of cellular immunity and eliminated imbalance in regulatory subpopulations of T-helper and T suppressor cells. PMID- 2771909 TI - [Clinico-roentgenologic characteristics of patients with pulmonary tuberculosis and damage to segment VI and results of their treatment]. AB - The clinicoroentgenological pictures of pulmonary tuberculosis located in segment VI in 90 patients and the results of their treatment were analyzed. Among the clinical forms, only infiltrative tuberculosis (88.9 per cent) and tuberculoma (11.1 per cent) were diagnosed. In 92.7 per cent of the patients the destruction phase was stated. Pneumonia was detected in almost half of the patients with acute and subacute processes of the disease. Tuberculosis in them was confirmed within the periods from 1 to 6 months. This is indicative of late diagnosis in some of them. Diagnostic mistakes were mainly associated with the features of the process localization and defective bacteriological and roentgenological examinations since the clinical signs and histories were typical of tuberculosis. The treatment results were estimated in 79 patients who stayed in hospital for at least 2 months. Closure of destructive cavities was observed in 73.7 per cent of the patients against 81.1 per cent in the control group. Abacillation was recorded in 96.5 per cent of the patients. PMID- 2771910 TI - [Tuberculosis of the lungs complicated by opisthorchiasis under conditions of the extreme north]. AB - Two hundred and sixty patients with pulmonary tuberculosis, residents of the North were subjected to multidisciplinary clinico-laboratory examination. The main group included 173 patients with tuberculosis complicated by opisthorchiasis. It was shown that the patients with the mixed pathology were characterized by more pronounced clinical signs of tuberculosis, more frequent disorders in the functions of the liver and pancreas and lower immunologic reactivity as compared to the patients not affected by opisthorchiasis. In the patients of the major group, activity of the alpha 1-proteinase inhibitor (alpha 1-PI) was more frequently higher and, among them, carriers of two markers i.e. Hp 2-2 and Gc 1-1 were more frequent. Factor analysis by the main components revealed that influence of helminthic invasion on biochemical and immunological reactivity of the patients with pulmonary tuberculosis was first of all brought about through the level of the serum alpha 1-PI and antiphosphatide hemagglutinins. PMID- 2771911 TI - [Dynamics of interstitial silicosis in relation to the state of the intrathoracic lymphatic system]. AB - The time course of interstitial silicosis in 150 patients was investigated retrospectively by the roentgenograms for a follow-up varying from 2 to 20 years. It was shown that silicosis progress followed the affection of the intrathoracic lymph nodes. The latter was mainly predetermined by tuberculous infection in person working under silicosis-hazardous and unfavourable sanitary and hygienic conditions. The picture of pulmonary lesions developing after adenopathy in patients with silicosis was roentgenologically completely identical to that of polymorphous tuberculosis. In this connection it was recommended that thorough clinical and bronchological examinations for silicotuberculosis of adenogenic genesis be performed in all the cases with progressing silicosis. PMID- 2771912 TI - [Correction of breathing in a program of medical (physical) rehabilitation of patients with asthmatic bronchitis and bronchial asthma]. AB - A method for training respiration is described. It includes an instruction on volition control of respiration and the use of a simple device for biological feedback. During the first and second examinations 90 and 86.7 per cent of the patients, respectively, thought that the rehabilitation program was more efficient than the previous treatment. PMID- 2771914 TI - [Changes in the content and composition of phospholipids in various portions of the spinal cord in patients with tuberculosis of the spine]. AB - Content and composition of phospholipids in various sections of the spinal marrow were investigated in patients with spinal tuberculosis. In the patients with tuberculous spondylitis, changes in the content of phospholipids in the spinal marrow were observed which were especially pronounced in the injured areas. The changes varied in different patients: in some patients, the content of the lipids was changed insignificantly while in the others it was markedly lowered (5-6 fold). Investigation of the phospholipid composition revealed in some patients decreased relative contents of the phosphatidyl ethanolamine plasmogenic form characteristic of myelin. It was suggested that the spinal marrow cells had undergone destruction in the injured areas. PMID- 2771913 TI - [Biochemical bases of adverse reactions to antibacterial preparations used in renal tuberculosis and means of their prevention]. AB - Factors leading to development of adverse reactions to antituberculous drugs in patients with nephrophthisis were studied and complex treatment regimens to prevent the reactions were developed. The use of such regimens along with chemotherapy allowed the frequency of adverse reactions to be lowered almost 2 fold in patients with limited nephrophthises and to postpone the development of adverse reactions in patients with extended tuberculosis for 1-1.5 months. PMID- 2771915 TI - [Changes in the human epiphysis in fibrocavernous tuberculosis of the lungs]. AB - Histologically detected lesions of the epiphysis in patients who died of fibrocavernous tuberculosis of the lung are described. The lesions were of nonspecific nature and appeared as pinealocyte dystrophy, decreased secretory parenchyma and developed replacement gliosis and were accompanied by pronounced calcification. Quantitative mathematical techniques such as stereometry or informative entropy indicated the adaptive nature of the described lesions in the epiphysis and its role in pathogenesis of the clinicomorphological type of tuberculosis. PMID- 2771916 TI - [Determination of indices of the functional state of the pneumocardial system in patients with tuberculosis of the lungs]. PMID- 2771917 TI - [Differential diagnosis of acute nonspecific diseases of the lungs and tuberculosis under the conditions at a rural tuberculosis hospital]. PMID- 2771918 TI - [Non-free osteochondrous autoplasty in surgery of tuberculosis of the knee joint]. AB - A new procedure for arthroplasty in tuberculous gonitis was developed by the author. The principal peculiarity of the procedure is the use of a nonfree osteocartilaginous autotransplant which is the best biological plastic material for replacing defects in the knee joint edge. The transplant is dissected from the patella joint surface and its feeding pedicle is formed of the soft tissues fixed to the outer kneecap border. Blood is supplied for the transplant by the anterior tibial recurrent artery located in the transplant pedicle. The procedure was applied to 10 patients with tuberculosis of the knee joint. The results of the treatment were good. PMID- 2771919 TI - [Tuberculosis of the breast]. PMID- 2771920 TI - [Ocular complications during treatment with ethambutol]. PMID- 2771922 TI - Partial characterization of the adsorbed protein layer on Dirofilaria immitis (Nematoda) cuticle. AB - Electron microscopy coupled with ferritin-conjugated indirect immunolabeling was used to locate sites of adsorbed host protein on cuticular surfaces of the adult canine heartworm, Dirofilaria immitis. The epicuticle appeared as a trilaminated structure. At high magnifications, the outermost layer of this structure was resolved into a trilaminar layer, which might correspond to the plasma membrane of animal cells. A ruthenium red-positive layer was external to the epicuticle. Ferritin-antibody conjugates showed evidence of adsorbed dog albumin, dog immunoglobulin class G (IgG), and dog complement fraction 3 (C3) on the surface. Ferritin adsorption to control surfaces was minimal. Possible causes and effects of interfacial host-protein adsorption are discussed in an attempt to bring insight to the hemocompatible nature of the parasitic cuticle. PMID- 2771921 TI - Echinococcus granulosus of camel origin: development in dogs and parasite morphology. AB - The developmental characteristics of Echinococcus granulosus of camel origin were studied in four dogs artificially infected with protoscolices originating from hydatid cysts isolated from the lung of a camel (Camelus dromedarius). Two dogs each were necropsied 34/35 and 41 days post-infection (p.i.); one dog had a low worm burden and the others were heavily infected (27,625-41,150 worms). At day 35 p.i., 20% of the parasites had developed three segments and the uterus of the vast majority of the total population was full of developing eggs in the terminal segment. At day 41, up to 58% of the parasites contained mature eggs (embryonated eggs with fully developed, "thick-shelled" embryophores). Morphological studies revealed the following major characteristics for 35 day-old worms: the mean length of the terminal segment accounted for 54% of the total worm length; the position of the sexually mature segment was always terminal; the female reproductive system possessed an elongated ovary with compact lobules; the female ducts were also compact; the Mehlis' gland was covered by the vitelline gland and the testes were distributed throughout the segment, with 1 row posterior to the vitelline gland. The camel isolate can readily be distinguished from the horse and sheep strains, but it is similar to the cattle strain in some respects, particularly in its precocious development. However, the camel isolate differs from the cattle strain in the position of the sexually mature segment, arrangement of the testes and structure of the female reproductive system. As in the cattle strain, the metacestodes in the principal intermediate host are mostly localised in the lung and have a high fertility rate.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2771923 TI - Experimental chemotherapy of Schistosoma curassoni in mice. AB - Mice experimentally infected with Schistosoma curassoni were treated with different dose regimens of praziquantel, metrifonate, oxamniquine and hycanthone. Praziquantel was the most effective drug; a dose of 100 mg/kg given orally for 5 days resulted in a 95% reduction in worm burdens. The drug produced oogram changes in all animals. Metrifonate did not result in a reduced worm burden but caused oogram changes even on a low-dose (150 mg/kg during 2 consecutive days) schedule. Oxamniquine proved to be ineffective; no reduction in worm burdens or alterations in oograms were observed. Hycanthone (80 mg/kg for 1 day) resulted in a significant reduction in worm burdens. PMID- 2771924 TI - Protection against Trichinella spiralis induced by purified stage-specific surface antigens of infective larvae. AB - The stage-specific surface antigens of the infective larvae of Trichinella spiralis, isolated using an affinity column of monoclonal antibody (Mab) NIM-M1, consisted of four components with molecular weights of 72, 65, 52, and 47 kDa, respectively. These four components may have unique as well as shared structural features and appear to be products of the stichosome. When injected i.p. as an emulsion in complete Freund's adjuvant, the purified antigens induced protection against infection of BALB/c mice with T. spiralis, as assessed by reductions in both the muscle larvae load and the number of adult intestinal worms. PMID- 2771925 TI - The heterogeneity of Leishmania cell-surface antigens. AB - A comparative study of the radioiodinated promastigote cell-surface antigens of Leishmania mexicana and L. major was carried out under reduced and nonreduced conditions by means of sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) followed by autoradiography. Under reduced conditions, the cell surface of L. mexicana promastigotes showed three iodinated polypeptides with molecular weights of 65,000, 50,000 and 27,000 daltons, whereas L. major promastigotes displayed a single polypeptide of 63,000 daltons. Under nonreduced conditions, the radioiodinated cell-surface component of L. major shifted to a mol.wt. of 51,000 daltons, whereas only one of the three components of L. mexicana (mol.wt., 65,000 daltons) underwent a large shift (to 59,000 daltons). The different immunochemical nature of the L. mexicana cell-surface antigens was demonstrated by using different anti-Leishmania sera. The rabbit anti promastigote serum immunoprecipitated mainly the 50,000- and 27,000-dalton L. mexicana cell-surface polypeptides, whereas the rabbit anti-amastigote serum as well as a serum from a patient with cutaneous leishmaniasis immunoprecipitated almost exclusively the 65,000-dalton polypeptide. Immunoblot studies using a rabbit antibody against the L. major deglycosylated major surface antigen gp63 confirmed the differences in nature of the 65,000- and 50,000-dalton cell-surface antigens of L. mexicana. The results obtained are discussed in the light of the differences in antigenic cell-surface expression among Leishmania isolates and their consequences in the development of a differential diagnosis of leishmaniasis. PMID- 2771926 TI - Adherence and surface properties of Tritrichomonas mobilensis, an intestinal parasite of the squirrel monkey. AB - Adherence properties of the potentially enteropathogenic Tritrichomonas mobilensis were studied in vitro. Axenically cultivated trichomonads readily attached to isolated intestinal epithelial cells and mucus of the squirrel monkey. The kinetics and nature of T. mobilensis cytadherence were microscopically evaluated in cell-suspension assay using Chinese hamster ovary (CHO) cells and in microplate hemagglutination assay with human erythrocytes. Adherence of the parasites to target cells was concentration- and time-dependent; it was inhibited by sialic acid (N-acetylneuraminic or N-glycolylneuraminic acid) and sialyllactose. Neither trypsinization of the flagellates nor their exposure to low temperature (4 degrees C) affected their cytadherence capacities. The data indicate the presence of adhesin(s) with lectin properties on T. mobilensis. Agglutination of live protozoa by animal and plant lectins with various carbohydrate-binding specificities as well as the occurrence of an electron-dense cell coat on plasma membrane suggest marked glycosylation of the parasite surface. PMID- 2771927 TI - Application of isoenzymatic typing to the identification of nonaxenic strains of Naegleria (Protozoa, Rhizopoda). AB - Isoenzymatic typing of the different species of Naegleria was studied by comparing isoelectric focusing on axenic and nonaxenic strains using the most discriminating enzymes: lactate dehydrogenase (LDH), malic enzyme (ME), beta hydroxybutyrate dehydrogenase (beta-HBDH), superoxide dismutase (SOD), and acid phosphatase (AP). The results show that bacteria in nonaxenic cultures have no influence on the interpretation of zymograms. The specificity of the enzymatic patterns of each strain is maintained in all of these enzymatic systems except LDH. With SOD, the existence of a supplementary isoenzyme among all of the nonaxenic strains is probably linked to an enzymatic induction phenomenon. PMID- 2771928 TI - Tissue cyst rupture in mice chronically infected with Toxoplasma gondii. An immunocytochemical and ultrastructural study. AB - The incidence and effect of tissue cyst rupture in the brains of mice chronically infected with Toxoplasma gondii was studied by immunocytochemistry and electron microscopy. Cyst rupture was extremely rare (2 of 750 tissue cysts) irrespective of the interval post-infection. The event was associated with a rapid cell mediated immune response, giving rise to microglial or inflammatory nodules. Macrophages were observed to engulf and degrade the cystozoites and cyst debris. Initially, the nodules contained large amounts of immunologically reactive material, but this was degraded with the majority (94%) of lesions containing no recognizable parasites or Toxoplasma antigens. There was little evidence of parasite multiplication or new cyst formation associated with cyst rupture. This study shows that although intermittent cyst rupture occurs, in immunocompetent individuals the immune response limits the potential damage from the release of large numbers of infective organisms to small microglial/inflammatory nodules. PMID- 2771929 TI - Ultrastructural evaluation of the effects of diclazuril on the endogenous stages of Eimeria maxima and E. brunetti in experimentally inoculated chickens. AB - The ultrastructural morphology of the different endogenous stages of Eimeria maxima and E. brunetti was evaluated after oral treatment of inoculated chickens with a single dose of 5 mg/kg diclazuril. The drug induced no ultrastructural change in the growth or differentiation of the various schizont stages of both Eimeria spp. In E. maxima, the micromorphological appearance of micro- and macrogamonts developing from the blast from to maturation also remained unaffected by drug treatment. However, in all fertilized macrogamonts the normal pattern of oocyst wall establishment was completely disturbed, resulting in the formation of an abnormally thickened, incomplete oocyst wall and the necrosis of the zygote. In E. brunetti, the growth and nuclear division during microgametogenesis were not affected but differentiation was clearly abnormal. In comparison with the controls, this abnormal differentiation was characterized by a less extensive enlargement of the parasite surface area, aberrant morphological configurations of condensed heterochromatin, intracytoplasmic flagella formation, and glycogen accumulation. Finally, the complete degeneration of all microgamonts ensued. The growth and differentiation leading to mature macrogamonts was not disturbed; however, subsequent oocyst wall formation was largely precluded and the macrogamonts proceeded to degenerate completely. We conclude that diclazuril treatment primarily affected particular stages in the sexual development of both Eimeria spp., resulting in the complete eradication of these coccidian species. PMID- 2771930 TI - Variations in egg size of Trichuris trichiura. AB - In patients infected with Trichuris trichiura, large eggs as well as more typical eggs were frequently found in the feces; these large eggs have been attributed to human infection by T. vulpis. To clarify whether the female worms laying the large eggs were T. trichiura or T. vulpis, we examined the morphology of adult worms and the size of whipworm eggs obtained from a patient and from several domestic dogs. Adult female T. trichiura worms were easily and quickly distinguished from those of T. vulpis by their convoluted vaginal tracts and uteri. Eggs obtained from the uteri of T. trichiura were of two sizes, with approximately 80% being of the smaller variety (57 X 26 microns) and 20%, the larger (78 X 30 microns). These percentages were about equal to those found the feces of the patient. T. vulpis uterine eggs were slightly larger (82 X 39 microns) than the large eggs of T. trichiura. The distribution of the 2 populations of eggs in 30 adult female T. trichiura was as follows: 1 worm had only large eggs, 14 had only the typical smaller eggs, and 15 had both varieties in their uteri. PMID- 2771931 TI - Anthelmintic activity of praziquantel on Raillietina tetragona in chickens. AB - Praziquantel was tested against mature (17-day-old) and immature (7-day-old) Raillietina tetragona in experimentally infected chickens using single oral doses of 10, 7.5, 5, or 2.5 mg/kg body wt. The compound showed potent anticestodal activity, with 100% efficacy at 10, 7.5, and 5 mg/kg against immature worms and an efficacy of 100% 97.1%, and 95% against mature worms when given at 10, 5, and 2.5 mg/kg, respectively. Residual worms surviving drug treatment had less biomass than the controls. Praziquantel appears to be well tolerated by chickens, and treated birds showed no clinical reactions at any of the doses tested. PMID- 2771932 TI - Effects of cyclosporin A on humoral immunity to ticks and on cutaneous immediate and delayed hypersensitivity reactions to Ixodes ricinus L. salivary-gland antigens in re-infested rabbits. AB - When rabbits are repeatedly infested with Ixodes ricinus L. adults, they acquire resistance to these ticks. A humoral response occurs and the skin of the host becomes progressively sensitized to the saliva of the ectoparasites. The present study examined the effects of cyclosporin A on these two aspects of immunity in re-infested rabbits. Using the enzyme-linked immunosorbent assay (ELISA), moderate suppression of the secondary IgG response to bites of these ticks was observed in animals given this immunosuppressive drug. The agent blocked the immediate cutaneous (type I) reaction normally developed in response to the intradermal injection of I. ricinus salivary gland antigens, as detected by measuring the skinfold thickness. The same method revealed a decreased delayed (type IV) hypersensitivity to these antigens. The present experiments demonstrate the major role of cyclosporin A-sensitive cells (mostly T-lymphocytes, mast cells and basophils) involved in the complex phenomenon of resistance to ticks. PMID- 2771934 TI - A cross-reference table between the Protein Data Bank of macromolecular structures and the National Biomedical Research Foundation-Protein Identification Resource amino acid sequence data bank. AB - The National Biomedical Research Foundation-Protein Identification Resource (NBRF PIR) and the Protein Data Bank at Brookhaven National Laboratory (PDB) both contain protein sequences. We have prepared a cross-reference index of the sequences in these data banks, and compared the data. Of the 270 cases of sequences of the same protein appearing in both data bases, for only 31% are the sequences identical. This is often the result of a difference in the state of maturation of the proteins rather than experimental error. Nevertheless is useful to be aware that the sequence information in these two data archives should not be regarded as redundant. PMID- 2771933 TI - Amino acid sequences of ferredoxins from rice cultivars, japonica and indica. AB - Ferredoxins were isolated from the leaves of two rice cultivars, japonica and indica. The purified protein preparations each contained two components, the major (I) and the minor (II) ferredoxin. Ferredoxin I from each cultivars was sequenced. The amino acid sequences of the ferredoxin I from the two strains were found to be identical to each other. The sequence similarity with wheat ferredoxin is about 90%. Most of the amino acid alterations are located at the ends of the protein, with the sequences surrounding the iron-sulfur coordinating cysteine residues being well conserved. PMID- 2771935 TI - The following protein sequences were reprinted from the protein sequence database of the Protein Identification Resource (PIR). PMID- 2771937 TI - Direct transfer of NADH between alpha-glycerol phosphate dehydrogenase and lactate dehydrogenase: fact or misinterpretation? AB - Following the criticism by Chock and Gutfreund [Chock, P.B. & Gutfreund, H. (1988) Proc. Natl. Acad. Sci. USA 85, 8870-8874], that our proposal of direct transfer of NADH between glycerol-3-phosphate dehydrogenase (alpha-glycerol phosphate dehydrogenase, alpha-GDH; EC 1.1.1.8) and L-lactate dehydrogenase (LDH; EC 1.1.1.27) was based on a misinterpretation of the kinetic data, we have reinvestigated the transfer mechanism between this enzyme pair. By using the "enzyme buffering" steady-state kinetic technique [Srivastava, D.K. & Bernhard, S.A. (1984) Biochemistry 23, 4538-4545], we examined the mechanism (random diffusion vs. direct transfer) of transfer of NADH between rabbit muscle alpha GDH and pig heart LDH. The steady-state data reveal that the LDH-NADH complex and the alpha-GDH-NADH complex can serve as substrate for the alpha-GDH-catalyzed reaction and the LDH-catalyzed reaction, respectively. This is consistent with the direct-transfer mechanism and inconsistent with a mechanism in which free NADH is the only competent substrate for either enzyme-catalyzed reaction. The discrepancy between this conclusion and that of Chock and Gutfreund comes from (i) their incorrect measurement of the Km for NADH in the alpha-GDH-catalyzed reaction, (ii) inadequate design and range of the steady-state kinetic experiments, and (iii) their qualitative assessment of the prediction of the direct-transfer mechanism. Our transient kinetic measurements for the transfer of NADH from alpha-GDH to LDH and from LDH to alpha-GDH show that both are slower than predicted on the basis of free equilibration of NADH through the aqueous environment. The decrease in the rate of equilibration of NADH between alpha-GDH and LDH provides no support for the random-diffusion mechanism; rather, it suggests a direct interaction between enzymes that modulates the transfer rate of NADH. Thus, contrary to Chock and Gutfreund's conclusion, all our experimental data compel us to propose, once again, that NADH is transferred directly between the sites of alpha-GDH and LDH. PMID- 2771936 TI - Multistep pathway for replication-dependent nucleosome assembly. AB - We have used cell-free DNA replication to study the relationship between DNA replication and chromatin assembly. As others have reported, we find that DNA replication facilitates nucleosome assembly. We show here that replication dependent nucleosome assembly occurs in at least two steps. The first step requires replicating DNA; the second step occurs after replication has been completed and is promoted by a nuclear extract. Consistent with this multistep model, we observe that the replicated simian virus 40 minichromosome is organized into a repeating array of DNA-protein particles that are structurally distinct from mature nucleosomes. These particles may be precursors in a pathway of nucleosome assembly since in the second, replication-independent step the nuclear extract converts this nascent chromatin into nucleosomes. PMID- 2771938 TI - Lambda repressor recognizes the approximately 2-fold symmetric half-operator sequences asymmetrically. AB - Results of systematic base-substitution experiments suggest that the lambda repressor dimer, made of identical subunits, recognizes the "pseudo(2 fold)symmetric" operator sequence asymmetrically. Base substitutions within the consensus half of the operator affect binding more than base substitutions within the nonconsensus half of the operator. Furthermore, changing the nonconsensus base pairs to the consensus base pairs does not increase, but decreases, binding. Evidently, the two subunits of the lambda repressor dimer bind to the two halves of the operator differently. This is consistent with the recently determined crystal structure of the complex, which shows that the relative positioning of the amino acids to the DNA bases are slightly different in the two halves of the operator. The sequence-specific interactions indicated by the systematic base substitution experiments correlate well with the locations of the specific contacts found in the complex. Thus, the amino acids of lambda repressor, mainly of alpha 3-helix and the N-terminus arm, seem to directly read-out the DNA sequence by forming specific hydrogen bonds and hydrophobic contacts to the DNA bases. The observed asymmetric recognition suggests that no recognition code governs amino acids and DNA bases in protein-DNA interactions. PMID- 2771939 TI - U3 small nuclear RNA can be psoralen-cross-linked in vivo to the 5' external transcribed spacer of pre-ribosomal-RNA. AB - U3 small nuclear RNA is hydrogen-bonded to high molecular weight nucleolar RNA and can be isolated from greater than 60S pre-ribosomal ribonucleoprotein particles, suggesting that it is involved in processing of ribosomal RNA precursors (pre-rRNA) or in ribosome biogenesis. Here we have used in vivo psoralen cross-linking to identify the region of pre-rRNA interacting with U3 RNA. Quantitative hybridization selection/depletion experiments with clones of rRNA-encoding DNA (rDNA) and cross-linked nuclear RNA showed that all of the cross-linked U3 RNA was associated with a region that includes the external transcribed spacer (ETS) at the 5' end of the human rRNA precursor. To further identify the site of interaction within the approximately 3.7-kilobase ETS, Southern blots of rDNA clones were sandwich-hybridized with cross-linked RNA and then probed for cross-linked U3 RNA. These experiments showed that U3 RNA was cross-linked to a 258-base sequence between nucleotides +438 and +695, just downstream of the ETS early cleavage site (+414). The localization of U3 to this region of the rRNA precursor was not expected from previous models for a base paired U3-rRNA interaction and suggests that U3 plays a role in the initial pre rRNA processing event. PMID- 2771940 TI - Crystallographic structure of a photoreceptor protein at 2.4 A resolution. AB - The first essential step in protein photoreception is the capture and storage of energy from a photon. We have recently identified and isolated, from the purple photoautotrophic bacterium, Ectothiorhodospira halophila, a 13,000-dalton photoactive yellow protein (PYP) that has a photocycle with kinetics similar to sensory rhodopsin and a very high quantum efficiency. To study the structural chemistry of protein photoreception, we determined, refined, and analyzed the crystallographic structure of PYP at 2.4 A resolution and report here that it is composed of two perpendicular antiparallel beta-sheets that enclose the chromophore. Each of the 10 beta-strands of PYP is connected directly to its nearest neighbor with +1 topology. Globally, an asymmetric distribution of side chains places aromatic and acidic side chains in an ellipsoidal band around the chromophore with a cluster of basic side chains on one side. Locally, the electron density maps place an internal lysine and the chromophore in an apparent Schiff base linkage stabilized by a buried glutamate and a tyrosine side chain. To our knowledge, the atomic resolution structure of a protein with a reversible photoisomerization has not been reported previously. Furthermore, PYP may also represent a class of proteins that bind conjugated molecules and interact with a secondary receptor system. PMID- 2771941 TI - Cis- and trans-acting elements involved in the regulation of the erythroid promoter of the human porphobilinogen deaminase gene. AB - Two cis-acting sequences, recognized by two erythroid-specific trans-acting factors, are involved in the regulation of the erythroid promoter of the human gene coding for porphobilinogen deaminase (PBGD). The first region, located at 70, binds the erythroid factor NF-E1, and point mutations within this region abolish the induction of transcription of this promoter during murine erythroleukemia (MEL) cell differentiation. The second region, located at -160, binds the erythroid-specific factor NF-E2 and the ubiquitous factor AP1. Using UV cross-linking, we show that NF-E2 has a higher molecular weight than AP1, demonstrating that NF-E2 is not an erythroid-specific degradation product of AP1. By point mutagenesis of the NF-E2/AP1 binding site, we define mutations that abolish binding of either NF-E2 alone or AP1 and NF-E2 together. Regulation of transcription of the PBGD erythroid promoter is abolished by those mutations, suggesting that NF-E2 but not AP1 is necessary for correct regulation of this promoter in erythroid cells. PMID- 2771942 TI - Cholesteryl-conjugated oligonucleotides: synthesis, properties, and activity as inhibitors of replication of human immunodeficiency virus in cell culture. AB - A family of oligonucleotides and phosphorothioate oligonucleotide analogues was synthesized with a cholesteryl group tethered at the 3'-terminal internucleoside link. This modification, introduced to enhance interaction of the polyanions with cell membranes, significantly increases the antiviral activity of the oligomers, as judged by inhibition of syncytia formation and expression of viral proteins p17, p24, and reverse transcriptase for human immunodeficiency virus 1 in Molt-3 cells. In the most favorable case, with a 20-mer cholesteryl-phosphorothioate derivative, complete inhibition by all assays was obtained with an oligomer concentration of 0.2 microM. Even decamers were active, and some antiviral activity was observed for a heptanucleotide cholesteryl-phosphorothioate derivative, which binds very poorly to complementary oligonucleotides. These facts, and the finding that the activity of the phosphorothioate decamers does not correlate with a specific sequence, suggests that a mechanism other than "antisense inhibition" may be operative in these systems. PMID- 2771943 TI - Cloning and expression of cDNA for the luciferase from the marine ostracod Vargula hilgendorfii. AB - The marine ostracod Vargula hilgendorfii ejects luciferin and luciferase into seawater to produce a bright luminous cloud. The light is due to the oxidation of luciferin, an imidazopyrazine compound, by molecular oxygen, catalyzed by luciferase. The mechanism of the reaction has been studied extensively and the 60 kcal/mol required for the blue emission have been shown to be derived from the oxidation of luciferin via a dioxetanone intermediate, in which the excited state oxyluciferin bound to luciferase is the emitter. However, only limited information is available regarding the properties of the enzyme. This paper reports the cloning and sequence analysis of the cDNA for Vargula luciferase and the expression of the cDNA in a mammalian cell system. The primary structure, deduced from the nucleotide sequence, consists of 555 amino acid residues in a single polypeptide chain with a molecular weight of 62,171. Two regions of the enzyme show significant amino acid sequence homology with an N-terminal segment of the photoprotein aequorin. The Vargula luciferase gene, which contains a signal sequence for secretion, should be well suited as a reporter in studies of gene expression. PMID- 2771944 TI - Identification of the A2 adenosine receptor binding subunit by photoaffinity crosslinking. AB - A high-affinity iodinated agonist radioligand for the A2 adenosine receptor has been synthesized to facilitate studies of the A2 adenosine receptor binding subunit. The radioligand 125I-labeled PAPA-APEC (125I-labeled 2-[4-(2-[2-[(4- aminophenyl)methylcarbonylamino]ethylaminocarbonyl]- ethyl)phenyl]ethylamino-5'-N ethylcarboxamidoadenosine) was synthesized and found to bind to the A2 adenosine receptor in bovine striatal membranes with high affinity (Kd = 1.5 nM) and A2 receptor selectivity. Competitive binding studies reveal the appropriate A2 receptor pharmacologic potency order with 5'-N-ethylcarboxamidoadenosine (NECA) greater than (-)-N6-[(R)-1-methyl- 2-phenylethyl]adenosine (R-PIA) greater than (+)-N6-[(S)-1-methyl-2- phenylethyl]adenosine (S-PIA). Adenylate cyclase assays, in human platelet membranes, demonstrate a dose-dependent stimulation of cAMP production. PAPA-APEC (1 microM) produces a 43% increase in cAMP production, which is essentially the same degree of increase produced by 5'-N- ethylcarboxamidoadenosine (the prototypic A2 receptor agonist). These findings combined with the observed guanine nucleotide-mediated decrease in binding suggest that PAPA-APEC is a full A2 agonist. The A2 receptor binding subunit was identified by photoaffinity-crosslinking studies using 125I-labeled PAPA-APEC and the heterobifunctional crosslinking agent N-succinimidyl 6-(4'-azido-2' nitrophenylamino)hexanoate (SANPAH). After covalent incorporation, a single specifically radiolabeled protein with an apparent molecular mass of 45 kDa was observed on NaDodSO4/PAGE/autoradiography. Incorporation of 125I-labeled PAPA APEC into this polypeptide is blocked by agonists and antagonists with the expected potency for A2 receptors (see above) and is decreased in the presence of 10(-4) M guanosine 5'-[beta, gamma-imido]triphosphate. Photoaffinity crosslinking of the A1 adenosine receptor binding subunit with 125I-labeled 8-[4-[2-(4- aminophenylacetylamino)ethyl]carbonylmethyloxyphenyl]-1,3-di propylxanthine (PAPAXAC) (an A1 selective photoaffinity probe) in the same tissue reveals a 38 kDa peptide that exhibits the appropriate A1 receptor pharmacology. 125I-labeled PAPA-APEC, therefore, has identified the A2 receptor binding subunit as a 45-kDa protein that is unique and distinct from the A1 binding subunit. PMID- 2771945 TI - Crystal structure analysis of auromomycin apoprotein (macromomycin) shows importance of protein side chains to chromophore binding selectivity. AB - The crystal structure of macromomycin, the apoprotein of the antitumor antibiotic auromomycin, has been determined and refined at 1.6-A resolution. The overall structure is composed of a flattened seven-stranded antiparallel beta-barrel and two antiparallel beta-sheet ribbons. The barrel and the ribbons define a deep cleft that is the chromophore binding site. The cleft is very accessible and in this structure is occupied by two 2-methyl-2,4-pentanediol and two water molecules. The overall shape of the binding site is similar to that of the analogue actinoxanthin. Highly specific side chains that are not conserved between different analogues extend into the binding site and may be important to the chromophore binding specificity. PMID- 2771946 TI - Topological distribution of four-alpha-helix bundles. AB - The four-alpha-helix bundle, a common structural motif in globular proteins, provides an excellent forum for the examination of predictive constraints for protein backbone topology. An exhaustive examination of the Brookhaven Crystallographic Protein Data Bank and other literature sources has lead to the discovery of 20 putative four-alpha-helix bundles. Application of an analytical method that examines the difference between solvent-accessible surface areas in packed and partially unpacked bundles reduced the number of structures to 16. Angular requirements further reduced the list of bundles to 13. In 12 of these bundles, all pairs of neighboring helices were oriented in an anti-parallel fashion. This distribution is in accordance with structure types expected if the helix macro dipole effect makes a substantial contribution to the stability of the native structure. The characterizations and classifications made in this study prompt a reevaluation of constraints used in structure prediction efforts. PMID- 2771947 TI - K+/H+-antiporter nigericin arrests DNA synthesis in Ehrlich ascites carcinoma cells. AB - Acidification of the cytoplasm of Ehrlich ascites carcinoma cells to pH 6.3 arrests DNA synthesis in these cells. Such an effect can be achieved by incubating the cells at pH 6.2 or by adding low concentrations of the K+/H+ antiporter, the antibiotic nigericin, at neutral pH. Glucose and anaerobiosis potentiate the nigericin effect. The inhibition of DNA synthesis by nigericin occurs without any significant decrease in the ATP concentration and in the mitochondrial membrane potential. The DNA synthesis inhibition is caused neither by a decrease in the intracellular [K+] nor by an increase in the intracellular [Na+] accompanying the nigericin effect (at least at low concentrations of the antibiotic). Nigericin should thus be regarded as a type of a cytostatic primarily affecting intracellular pH. PMID- 2771948 TI - Structure, oligosaccharide structures, and posttranslationally modified sites of the nicotinic acetylcholine receptor. AB - Using mass spectrometry, we have examined the transmembrane topography of the nicotinic acetylcholine receptor, a five-subunit glycosylated protein complex that forms a gated ion channel in the neuromuscular junction. The primary sequences of the four polypeptide chains making up the acetylcholine receptor from Torpedo californica contain many possible sites for glycosylation or phosphorylation. We have used liquid secondary ion mass spectrometry to identify posttranslationally modified residues and to determine the intact oligosaccharide structures of the carbohydrate present on the acetylcholine receptor. Asparagine 143 of the alpha subunit (in consensus numbering) is shown to be glycosylated with high-mannose oligosaccharide. Asparagine-453 of the gamma subunit is not glycosylated, a fact that bears on the question of the orientations of putative transmembranous helices M3, MA, and M4. The structures of the six major acetylcholine receptor oligosaccharides are determined: the major components (70%) are of the high-mannose type, with bi-, tri-, and tetraantennary complex oligosaccharides making up approximately equal to 22 mol% of the total carbohydrate. This application of a multichannel array detector mass spectrometer provided a breakthrough in sensitivity that allowed us to identify the site of attachment of, and the sequence of, oligosaccharides on a 300-kDa membrane protein from only 5 pmol of the isolated oligosaccharide. PMID- 2771949 TI - Genetic switching in the flagellar gene hierarchy of Caulobacter requires negative as well as positive regulation of transcription. AB - Caulobacter crescentus flagellar (fla, flb, or flg) genes are periodically expressed in the cell cycle and they are organized in a regulatory hierarchy. We have analyzed the genetic interactions required for fla gene expression by determining the effect of mutations in 30 known fla genes on transcription from four operons in the hook gene cluster. These results show that the flaO (transcription unit III) and flbF (transcription unit IV) operons are located at or near the top of the hierarchy. They also reveal an extensive network of negative transcriptional controls that are superimposed on the positive regulatory cascade described previously. The strong negative autoregulation observed for the flaN (transcription unit I), flbG (transcription unit II), and flaO (transcription unit III) promoters provides one possible mechanism for turning off fla gene expression at the end of the respective synthetic periods. We suggest that these positive and negative transcriptional interactions are components of genetic switches that determine the sequence in which fla genes are turned on and off in the C. crescentus cell cycle. PMID- 2771950 TI - Negative transcriptional regulation in the Caulobacter flagellar hierarchy. AB - The Caulobacter crescentus flagellum is formed at a specific time in the cell cycle and its assembly requires the ordered expression of a large number of genes. These genes are controlled in a positive trans-acting hierarchy that reflects the order of assembly of the flagellum. Using plasmids carrying transcriptional fusions of either a neo or a lux reporter gene to the promoters of three flagellar genes representing different ranks in the hierarchy (the hook operon, a basal body gene flbN, and the flaO gene), we have measured the level of chimeric gene expression in 13 flagellar mutant backgrounds. Mutants in the hook operon or in basal body genes caused overproduction of both hook operon and basal body gene chimeric mRNAs, suggesting that negative regulation is superimposed on the positive trans-acting control for these early events in the flagellar hierarchy. Mutants in the structural genes and in genes involved in flagellar assembly had no effect on flaO expression, placing the flaO gene near the top of the hierarchy. However, flaO expression appears to be under negative control by two regulatory genes flaS and flaW. Negative control, as a response to the completion of specific steps in the assembly process, may be an important mechanism used by the cell to turn off flagellar gene expression once the gene product is no longer needed. PMID- 2771951 TI - Exceptional chromosomal mutations in a rodent population are not strongly underdominant. AB - The observation of karyotypic uniformity in most species has led to the widespread belief that selection limits chromosomal change. We report an unprecedented amount of chromosomal variation in a natural population of the South American marsh rat Holochilus brasiliensis. This variation consists of four distinct classes of chromosomal rearrangements: whole-arm translocations, pericentric inversions, variation in the amount of euchromatin, and variation in number and kind of supernumerary (B) chromosomes. Twenty-six karyotypes are present among 42 animals. Observations of the natural population over a 7-year period and breeding experiments with captive animals indicate that heterozygous individuals suffer no detectable reduction in fitness. This is at odds with a central assumption in current models of chromosomal speciation and provides a firm rejection of the view that selection necessarily restricts chromosomal change. PMID- 2771952 TI - Alu polymerase chain reaction: a method for rapid isolation of human-specific sequences from complex DNA sources. AB - Current efforts to map the human genome are focused on individual chromosomes or smaller regions and frequently rely on the use of somatic cell hybrids. We report the application of the polymerase chain reaction to direct amplification of human DNA from hybrid cells containing regions of the human genome in rodent cell backgrounds using primers directed to the human Alu repeat element. We demonstrate Alu-directed amplification of a fragment of the human HPRT gene from both hybrid cell and cloned DNA and identify through sequence analysis the Alu repeats involved in this amplification. We also demonstrate the application of this technique to identify the chromosomal locations of large fragments of the human X chromosome cloned in a yeast artificial chromosome and the general applicability of the method to the preparation of DNA probes from cloned human sequences. The technique allows rapid gene mapping and provides a simple method for the isolation and analysis of specific chromosomal regions. PMID- 2771953 TI - A strategy to detect and isolate an intron-containing gene in the presence of multiple processed pseudogenes. AB - We have devised a strategy that utilizes the polymerase chain reaction (PCR) for the detection and isolation of intron-containing genes in the presence of an abundance of processed pseudogenes. The method depends on the genomic DNA sequence between the PCR primers spanning at least one intron in the gene of interest, resulting in the generation of a larger intron-containing PCR product in addition to the smaller PCR product amplified from the intronless pseudogenes. A unique intron probe isolated from the larger PCR product is used for the detection of intron-containing clones from recombinant DNA libraries that also contain pseudogene clones. This method has been used successfully for the selective isolation of an intron-containing rat L19 ribosomal protein gene in the presence of multiple pseudogenes. Analysis of a number of mammalian ribosomal protein multigene families by PCR indicates that they all contain only a single gene with introns. PMID- 2771954 TI - Principal neutralizing domain of the human immunodeficiency virus type 1 envelope protein. AB - The principal neutralizing determinant of human immunodeficiency virus type 1 (HIV-1) is located in the external envelope protein, gp120, and has previously been mapped to a 24-amino acid-long sequence (denoted RP135). We show here that deletion of this sequence renders the envelope unable to elicit neutralizing antibodies. In addition, using synthetic peptide fragments of RP135, we have mapped the neutralizing determinant to 8 amino acids and found that a peptide of this size elicits neutralizing antibodies. This sequence contains a central Gly Pro-Gly that is generally conserved between different HIV-1 isolates and is flanked by amino acids that differ from isolate to isolate. Antibodies elicited by peptides from one isolate do not neutralize two different isolates, and a hybrid peptide, consisting of amino acid sequences from two isolates, elicits neutralizing antibodies to both isolates. By using a mixture of peptides of this domain or a mixture of such hybrid peptides the type-specificity of the neutralizing antibody response to this determinant can perhaps be overcome. PMID- 2771955 TI - Human platelet glycoprotein IX: an adhesive prototype of leucine-rich glycoproteins with flank-center-flank structures. AB - The glycoprotein (GP) Ib-IX complex on the surface of human platelets functions as the von Willebrand factor receptor and mediates von Willebrand factor dependent platelet adhesion to blood vessels. GPIX is a relatively small (Mr, 17,000) protein that may provide for membrane insertion and orientation of the larger component of the complex, GPIb (Mr, 165,000). Using antibody screening, we cloned a cDNA encoding GPIX from a human erythroleukemia cell cDNA library constructed in phage lambda gt11. Lacking a 5' untranslated region and start codon, the cDNA sequence includes 604 nucleotides, beginning with 495 bases at the 5' end coding for 165 amino acids, followed by a stop codon and 106 noncoding bases at the 3' end. By Northern blot analysis, the GPIX cDNA hybridizes with a single 1.0-kilobase species of platelet poly(A)+ RNA. Translation of the cDNA sequence gives a predicted protein sequence beginning with a truncated putative signal sequence of 5 amino acid followed by a sequence of 17 amino acids matching that determined directly by Edman degradation of intact GPIX. The predicted amino acid sequence of mature GPIX includes an NH2-terminal extracytoplasmic domain of 134 residues, a transmembrane domain of 20 residues, 6 intracytoplasmic residues, and 1 N-linked glycosylation site. GPIX contains a leucine-rich glycoprotein (LRG) sequence of 24 amino acids similar to conserved LRG sequences in GPIb and other proteins from humans, Drosophila, and yeast. "Flanking" sequences of approximately 22 amino acids are present at the NH2 and/or COOH sides of the "central" LRG sequence(s) in GPIX, GPIb, and the other human and Drosophila members of the LRG family. The role of the flank-LRG center-flank structure in the evolution and function of the LRG proteins remains to be defined. PMID- 2771956 TI - Significance of abnormal serum binding of insulin-like growth factor II in the development of hypoglycemia in patients with non-islet-cell tumors. AB - We reported that serum and tumor from a hypoglycemic patient with a fibrosarcoma contained insulin-like growth factor II (IGF-II), mostly in a large molecular form designated "big IGF-II." We now describe two additional patients with non islet-cell tumor with hypoglycemia (NICTH) whose sera contained big IGF-II. Removal of the tumor eliminated most of the big IGF-II from the sera of two patients. Because specific IGF-binding proteins modify the bioactivity of IGFs, the sizes of the endogenous IGF-binding protein complexes were determined after neutral gel filtration through Saphadex G-200. Normally about 75% of IGFs are carried as a ternary complex of 150 kDa consisting of IGF, a growth hormone (GH) dependent IGF-binding protein, and an acid-labile complexing component. The three patients with NICTH completely lacked the 150-kDa complex. IGF-II was present as a 60-kDa complex with variable contributions of smaller complexes. In the immediate postoperative period, a 110-kDa complex appeared rather than the expected 150-kDa complex. Abnormal IGF-II binding may be important in NICTH because the 150-kDa complexes cross the capillary membrane poorly. The smaller complexes present in our patients' sera would be expected to enter interstitial fluid readily, and a 4- to 5-fold increase in the fraction of IGFs reaching the target cells would result. PMID- 2771957 TI - Alterations in the p53 gene and the clonal evolution of the blast crisis of chronic myelocytic leukemia. AB - Molecular mechanisms responsible for the clinical progression of chronic myelocytic leukemia to its accelerated phase or to blast crisis have not been defined. We found alterations of the p53 gene (p53 is a 53-kDa nuclear protein) including deletions and rearrangements in 8 of 34 patients in blast crisis and 1 of 4 patients in the accelerated phase, but in only 1 of 38 patients in the chronic phase of chronic myelocytic leukemia. Only two other examples of p53 gene alterations were found among 203 patients with hematologic malignancies and solid tumors. Transcripts of the p53 gene were uniformly found in chronic-phase cells, but gene expression was variable in blast crisis, and transcripts were reduced or undetectable in 10 of 16 patients. Heterogeneous alterations in the structure and expression of the p53 gene appear to be relatively frequent in blast crisis and may be involved in the evolution of disease. PMID- 2771958 TI - 5-HT1c receptor is a prominent serotonin receptor subtype in the central nervous system. AB - Neurons in rat central nervous system (CNS) that express 5-HT1c receptor mRNA have been localized by in situ hybridization histochemistry. The 5-HT1c receptor is expressed in a wide variety of cortical and subcortical neurons including hippocampal pyramidal neurons, neurons within most of the central monoaminergic cell groups, neurons in thalamic sensory relay nuclei, and neurons involved in the central processing and regulation of nociceptive transmission. Therefore, the 5-HT1c receptor is a prominent but poorly characterized central subclass of serotonin (5-HT) receptor. The distribution of the 5-HT1c receptor within the CNS is considerably more widespread than that of the structurally and functionally related 5-HT2 receptor. PMID- 2771959 TI - Effects of phenotype, sex, and diet on plasma lipids in LA/N-cp rats. AB - The LA/N-corpulent (cp) rat is a recently developed congenic strain which exhibits obesity. The effects of phenotype and sex on serum and lipoprotein lipid content were examined in LA/N-cp rats fed either a control or an atherogenic diet high in saturated fat and protein. Obese rats were pair-fed to equivalent lean animals. Results from this study indicate that sex, phenotype, and diet exert significant effects on plasma and lipoprotein cholesterol content. Plasma cholesterol levels were higher in obese compared with lean rats, females than in males, and rats consuming the atherogenic diet compared with the control diet. Plasma and lipoprotein triglyceride levels were significantly increased only in obese compared with lean animals. The increased plasma cholesterol and triglyceride was observed primarily in the chylomicron and very low density lipoprotein fractions. Increased levels of plasma cholesterol were not a result of increased dietary cholesterol absorption or increased liver cholesterol biosynthesis. These data suggest that LA/N-cp rats can serve as a unique rodent model for the study of the interrelationships between hyperlipidemia, obesity, and coronary heart disease. PMID- 2771960 TI - Intestinal absorption of L-ascorbic acid in rats with renal failure. AB - We studied L-ascorbic acid absorption in rats subjected to subtotal nephrectomy (renal failure (RF) group) and compared the results with those obtained in sham operated normal animals and those pair-fed with their azotemic counterparts (PF group). In vivo recirculating perfusion and in vitro everted sac techniques were employed. The in vitro experiments were repeated substituting buffer within the serosal compartment with pooled sera from uremic and normal individuals. L Ascorbic acid absorption in vivo in the RF group was significantly lower than those found in normal control and PF groups. In contrast, the in vitro mucosal to serosal transport was increased in the RF and PF groups when compared with the normal control group, suggesting increased permeability to L-ascorbic acid in the former groups. The disparity between in vivo and in vitro results in the RF animals is indicative of some inhibitory influence present in the intact uremic animals. However, experiments comparing the effect of uremic with normal sera on in vitro transport failed to reveal any suppressive effect of uremic chemical environment. In addition, serum ascorbic acid was reduced in PF and RF groups when compared with the normal control animals, thereby excluding elevated blood level as a cause of impaired absorption in intact animals with RF. In conclusion, in vivo jejunal absorption of L-ascorbic acid is impaired in rats with RF despite evidence of increased in vitro permeability. The latter appears to be mediated by reduced nutrient intake and weight loss. The inhibitory influence present in vivo could not be reproduced by incubation with uremic sera in vitro. PMID- 2771961 TI - Chemopreventive effect of N-homocysteine thiolactonyl retinamido cobalamin on carcinogenesis by ethyl carbamate in mice. AB - Because of abnormalities of metabolism of homocysteine thiolactone and methionine in malignant cells, and because of the chemopreventive activity of N-homocysteine thiolactonyl retinamide against chemical carcinogenesis by ethyl carbamate in mice, the cobalamin derivative of this retinamide was prepared and tested for chemopreventive activity. The substance, N-homocysteine thiolactonyl retinamido cobalamin, was found to have a different UV-visible absorption spectrum from that of 5'-deoxyadenosyl cobalamin or N-homocysteine thiolactonyl retinamide. Spectral analysis suggests a ratio of 2 mol of retinamide/mol of cobalamin within the molecule. To demonstrate chemopreventive activity, ethyl carbamate was given in a dose of 2 mg/animal to A/J mice (15-18 g) weekly over a period of 10 weeks to induce pulmonary tumors. A total dose of N-homocysteine thiolactonyl retinamido cobalamin of 60 mg/kg, given for a total of 16 weeks, decreased by one fourth (P less than 0.05) the number of pulmonary tumors induced by ethyl carbamate. An equimolar dose of 5'-deoxyadenosyl cobalamin (40 mg/kg) increased the number of tumors by one third (P less than 0.001), and an equimolar dose of N-homocysteine thiolactonyl retinamide (20 mg/kg) had no effect on the number of pulmonary tumors. No mortality was observed in the experiment. When the ethyl carbamate was given in a single dose of 20 mg/animal, all three substances produced significant mortality in doses of 0.75-30 mg/kg. In the survivors of this experiment, doses of 0.75-30 mg/kg of N-homocysteine thiolactonyl retinamido cobalamin decreased the number of pulmonary tumors induced by ethyl carbamate to 52-82% of controls (P less than 0.01). The results show that N-homocysteine thiolactonyl retinamido cobalamin has chemopreventive activity against chemical carcinogenesis by ethyl carbamate in mice. PMID- 2771962 TI - In vivo apoprotein catabolism of high density lipoproteins in copper-deficient, hypercholesterolemic rats. AB - High density lipoprotein (HDL) apoprotein catabolism was examined in male Sprague Dawley rats deficient in dietary copper. Twenty-four rats were randomly divided into two groups: copper-adequate (control, 5 mg of copper/kg diet) and copper deficient (0.6 mg of copper/kg diet). After 5 weeks, animals were administered a tracer dose of iodinated HDL protein previously isolated from donor rats that were subjected to the same dietary treatments as the test animals. Copper deficient rats exhibited a 54% increase in plasma volume and a 26% increase in HDL protein concentration above controls. Consequently, the intravascular pool of total HDL protein was increased 2-fold. The fractional catabolic rate of total HDL protein was similar between groups. However, because of the increased intravascular HDL pool in copper-deficient animals, the absolute catabolic rate was greater (640 +/- 49 micrograms/hr vs 316 +/- 12 micrograms/hr in controls). Tissue uptake of total HDL protein in copper-deficient rats tended to be greater in the kidneys, spleen, and testes compared with controls; the heart exhibited a significant 2.3-fold increase. In contrast, the catabolic rate of HDL protein in the liver and adrenal gland were not different between treatment groups. That an obligatory increase in HDL protein uptake was not observed in the liver and adrenal gland (organs which are sensitive to and can further metabolize cholesterol) suggests that these organs may be regulated, possibly contributing to the observed hypercholesterolemia in this model. These data imply that total HDL apoprotein catabolism is increased in response to the increased intravascular pool of HDL in copper-deficient rats. PMID- 2771964 TI - Effect of maternal alcohol consumption on the fetal thyroid in the rat. AB - To investigate the effect of maternal alcohol consumption on the development of the fetal thyroid gland, Sprague-Dawley rats were given 20% ethanol for 4 weeks prior to mating and 30% ethanol throughout gestation. Pair-fed controls received an isocaloric amount of corn starch and chow, with water ad libitum, and ad libitum controls received rat chow and water. On Days 17, 18, 19, and 20 of gestation, the fetuses were weighed and the fetal thyroids were removed for histometric observation. On Days 19 and 20, the fetal thyroids of alcohol-exposed fetuses weighed significantly less than those of the two control groups, but more than the control thyroids 1 day earlier. Maternal alcohol consumption caused a significant decrease in both the follicular cell height and the follicle diameter of the fetal thyroid on all days examined. In the alcohol group on Days 19 and 20 of gestation, the cell height was less than, and the follicle diameter was approximately equal to those in the two controls 2 days earlier. These results indicate that, as a consequence of maternal alcohol consumption, growth of the fetal thyroid gland is retarded, and there are indications of fetal hypothyroidism, as seen from the histometric data. This latter is suggestive of a retarded thyrotropic activity of the fetal pituitary gland. PMID- 2771963 TI - Poly-beta-hydroxybutyrate/calcium polyphosphate complexes in eukaryotic membranes. AB - Poly-beta-hydroxybutyrate/calcium polyphosphate (PHB-CaPolyPi) complexes exist as labile quasi-crystalline structures in bacterial plasma membranes. The composition, structure, and distribution of the complex suggest it may play a role in the regulation of intracellular calcium and in calcium signaling. The importance of these functions led to this investigation of the occurrence of PHB CaPolyPi complexes in eukaryotes. A variety of plant and animal systems were analyzed and all were found to contain PHB associated with CaPolyPi. The intracellular location of the complex in bovine liver was primarily the mitochondria and microsomes, with smaller amounts in the plasma membranes. Eukaryotic PHB had the same narrow range of chain lengths (120-200 subunits) as PHB in bacterial membranes, and was associated with PolyPi of somewhat greater length (170-220) than the bacterial counterpart (130-170). PMID- 2771965 TI - Isolation of a natural cytotoxic IgM "antibody" in human serum sensitizing L cells to complement. AB - An IgM fraction of human serum was isolated and purified. A portion of this fraction firmly attaches to L cells' surfaces, which sensitizes these cells to the lytic action of low concentrations of serum C. It contains the natural cytotoxic "antibody" to L cells. PMID- 2771966 TI - Production of a factor (CIF) from normal fibroblast cells inhibiting tumor necrosis factor/cachectin production. AB - Murine embryonic fibroblast cells produce a factor designated cytotoxin inhibiting factor (CIF) which inhibits tumor necrosis factor (TNF) and interleukin 1 production as well as tumoricidal activity by lipopolysaccharide activated macrophages. This study determines the physiologic conditions of CIF production in serum-free medium. CIF production was largely dependent upon the presence of lipopolysaccharide. A quantitative correlation between fibroblast cell number, lipopolysaccharide concentration, and incubation time was established. Evidence is presented that CIF inhibited the production or release of TNF. CIF did not destroy TNF after production and release nor did it sequester secreted TNF. The supernatant fluids which inhibited TNF production did not suppress the capability of resting macrophages to phagocytize opsonized sheep erythrocytes, suggesting that only functions expressed in the activated state are inhibited. PMID- 2771967 TI - Regional hemodynamic responses to nicotine in conscious and anesthetized dogs: comparative effects of pentobarbital and chloralose. AB - This study was conducted in 12 dogs to evaluate regional hemodynamic responses during intravenous infusion of nicotine (36 micrograms/kg/min) in the conscious state and compare them with those in the same dogs following either pentobarbital (n = 6) or chloralose anesthesia (n = 6). Values for regional blood flow were obtained with 15-microns radioactive microspheres and used to calculate regional vascular conductance. In the conscious state, nicotine increased aortic pressure (+70%) and caused hyperventilation that reduced arterial PCO2 (-44%). These systemic effects were associated with decreases in vascular conductance in the renal cortex (-48%), pancreas (-81%), duodenum (-58%), and cerebral cortex ( 55%), whereas no significant change in vascular conductance was evident in spleen, liver, or myocardium. Pentobarbital anesthesia blunted the increases in aortic pressure and respiratory activity and the reductions in vascular conductance in the renal cortex, pancreas, duodenum, and cerebral cortex during nicotine infusion. In contrast, chloralose anesthesia accentuated the increase in aortic pressure and the decrease in vascular conductance in the renal cortex during nicotine infusion, while it converted no change in vascular conductance in the spleen into a decrease and no change in vascular conductance in the myocardium into an increase. Chloralose anesthesia blunted nicotine-induced hyperventilation. These findings demonstrate that general anesthetic agents may have markedly different effects on cardiovascular reflex pathways. They emphasize the importance of considering the particular characteristics of the anesthetic agent used in interpreting results from studies of cardiovascular pharmacology and physiology in anesthetized animals. PMID- 2771968 TI - Inhibition of nocturnal prolactin surges in the pregnant rat by incubation medium containing placental lactogen. AB - Rats hysterectomized on Day 7 or 8 of pregnancy continued to have nocturnal prolactin surges 1 day later. Conditioned medium obtained from incubation of Day 11 placentas infused via the jugular vein completely blocked this nocturnal surge, indicating a negative feedback of placental secretions on prolactin. Infusion of an ultrafiltrate of the conditioned medium which only contained molecules with Mr above 10,000 also blocked the prolactin surge. Next, it was determined whether this feedback of placental secretions on prolactin may work by way of hypothalamic dopamine. Levels of dopamine in hypophysial stalk blood from pregnant rats on Day 12, a time when secretion of placental lactogen is high, were not different from those in rats in which placental lactogen was absent. It is concluded that termination of prolactin surges at midpregnancy may be due to feedback of placental secretions, possibly placental lactogen, on the hypothalamus and/or pituitary. However, these experiments do not support the hypothesis that this inhibition is mediated by alteration in hypothalamic dopamine secretion. PMID- 2771969 TI - Twenty-four-hour variations in ornithine decarboxylase and acid phosphatase in mice. AB - Polyamines are essential for cell growth and differentiation. Ornithine decarboxylase (ODC) is the rate-limiting enzyme in polyamine biosynthesis. Acid phosphatases (AP) are lysosomal enzymes that are important in normal intracellular metabolism. Twenty-four-hour variations in these enzymes may be important in understanding the temporal responses of different tissues to various stimuli. The purpose of this study was to examine a variety of tissues for fluctuations in the levels of ODC and AP over a 24-hr period. Significant circadian variations in the amount of ODC activity were observed in all tissues examined. Activity of AP varied with time of day in the liver, kidney, and heart. The highest and lowest measurements of ODC activity were as follows: liver, 81.5 +/- 7.0, 47.9 +/- 4.4; colon, 11.7 +/- 1.2, 3.1 +/- 0.7; stomach 3.1 +/- 0.4, 0.9 +/- 0.1; kidney, 420.9 +/- 0.9, 67.5 +/- 0.8; and heart, 4.7 +/- 1.0, 2.5 +/- 0.2. The highest and lowest measurements of AP activity were as follows: liver 3.8 +/- 0.1, 2.8 +/- 0.1; kidney, 3.4 +/- 0.1, 1.9 +/- 0.1; and heart, 2.6 +/- 0.1, 2.0 +/- 0.1. These findings suggest that rhythmic fluctuations in polyamine biosynthesis and lysosomal enzymes may influence other metabolic pathways differentially throughout 24 hr. PMID- 2771971 TI - Get wise to drugwise! PMID- 2771970 TI - Abstracts: 1989 annual meeting of the Beijing, China Section of the Society for Experimental Biology and Medicine. Beijing, China, February 25, 1989. PMID- 2771972 TI - Postoperative pain: the alternatives to analgesia. PMID- 2771973 TI - Position in labour-does mother know best? PMID- 2771974 TI - Caring in Great Britain today. PMID- 2771975 TI - What is resource management? PMID- 2771976 TI - Out in the mid-day sun? Nurses' perceptions of the dangers of sun exposure. PMID- 2771977 TI - The adder and its bite. PMID- 2771978 TI - Encopresis is not a problem in travelling families. PMID- 2771979 TI - How antibiotics work: the cell membrane. PMID- 2771980 TI - Nursing in London--a capital experience? PMID- 2771982 TI - Pressure sores: assessing the wound. PMID- 2771981 TI - Building confidence: a development programme for newly qualified staff nurses. PMID- 2771983 TI - The threat of rabies. PMID- 2771984 TI - Can continuing education ease the nursing shortage? PMID- 2771985 TI - Which compression stocking? PMID- 2771986 TI - What are febrile convulsions? PMID- 2771988 TI - Elderly care now offers dynamic career opportunities. PMID- 2771987 TI - Oxfordshire and the surrounding counties excel in many specialties. PMID- 2771989 TI - BCG in superficial bladder cancer. EORTC Genitourinary Group Monograph 6. Proceedings of a meeting. Kerkrade, The Netherlands, September 7-8, 1988. PMID- 2771990 TI - Intravesical BCG therapy in patients with superficial bladder tumors. PMID- 2771991 TI - Bladder tumors invading the lamina propria (stage T1): influence of endovesical BCG therapy on recurrence and progression. AB - We treated 47 patients with transitional cell bladder carcinoma invading the lamina propria (stage T1) from 1984 to 1986 with complete transurethral resection followed by one to three courses of endovesical BCG instillation and followed them for 14-64 months with cystoscopic and endoscopic tests and bladder biopsy. Complete response was achieved in 64%, and 36% had recurrences (recurrence rate per 100 month/patient, 2.2); 21% progressed to muscle invasion. Duration of treatment, tumor size or type (solid versus papillary), and presence of carcinoma in situ bore no relation to the final result. A history of previous T1 bladder tumor appeared associated with a higher risk of progression, although not statistically significantly. The results were compared with those obtained by transurethral resection alone in a similar group of 50 patients treated from 1982 to 1984 and followed for 12 to 100 months. Of these 90%, had recurrence, and 34% progressed to muscle invasion, with a recurrence rate per 100 month/patient of, 9.2. In light of the limits of a non-randomized historical comparison, it appears that endovesical BCG therapy favorably alters the recurrence pattern of T1 bladder cancer. PMID- 2771992 TI - Intravesical instillation of BCG in carcinoma in situ of the urinary bladder. EORTC protocol 30861. EORTC-GU Group. AB - This is a report of an ongoing phase II study which should elucidate some of the open questions which still remain in the most effective treatment of CIS by BCG. As indicated by the preliminary results on side effects the number of instillations or reducing the dosage (as toxic reaction to BCG could be possibly reduced by changing already shown by Dr. Pagano in this meeting), as far as there is equal efficacy. Prognostic factors in patients with intravesical BCG have yet to be defined. A recent publication by Torrence demonstrated that granulomatous cystitis or PPD skin test are of no or borderline significance (Torrence et al., 1988). They are not considered as a prognostic indicator for the individual patient. Although the number of patients (14) evaluated by immunohistological techniques is small, we do hope that the information about the local immune response will give more insight in the mode of action of BCG as well as indicate possibly a good prognostic factor. PMID- 2771994 TI - Percutaneous BCG perfusion of the upper urinary tract for carcinoma in situ. PMID- 2771993 TI - The influence of Tice strain BCG treatment in patients with transitional cell carcinoma in situ. PMID- 2771995 TI - Future clinical research on the use of BCG for bladder cancer. PMID- 2771997 TI - Tissue specific trisomy--the significance of confined placental mosaicism. AB - Confined placental mosaicism is tissue specific chromosomal mosaicism arising in both chromosomally normal and abnormal zygotes. Studied by first trimester chorionic villus sampling it has been reported in about 1-2% of human gestations. It is more common in the cytotrophoblast than in placental connective tissue. While intrauterine survival of some chromosomally abnormal embryos and fetuses appears to be significantly enhanced by its presence, the effect of confined placental mosaicism on chromosomally normal fetuses is variable and at present time still unpredictable. PMID- 2771996 TI - Pathologic and structural changes in the bladder after BCG intravesical therapy in men. PMID- 2771998 TI - An investigation of factors influencing the survival of trisomic fetuses in the mouse. AB - The prevalence of trisomy at a given time of gestation depends on two factors: its incidence at conception and the probability that the trisomic embryo or fetus survives up to the time of observation. In mammals, little is known about the factors controlling either of these two events. A mouse model is particularly useful for these types of studies, as it allows us to examine each event, under strictly controlled experimental conditions. Using this mouse model, a systematic analysis of the influence of various factors including maternal age, diet, as well as fetal and maternal genes, on the survival of trisomic fetuses, at different times of gestation, has been performed. Our studies show that high post implantation survival of trisomic fetuses is associated with a specific diet or a specific maternal gene, but not increasing maternal age. Future studies are aimed at identifying the specific genetic and environmental factors involved, and understanding their pathogenesis. PMID- 2771999 TI - Gene-centromere mapping and the study of non-disjunction in autosomal trisomies and ovarian teratomas. PMID- 2772000 TI - Synthesis and pharmacological evaluation of triazolo derivatives of 8-amino-10,11 dihydro-dibenzo[b,e]1,4-thiazepine-11-one. AB - In the present communication, the syntheses, characterization and pharmacological evaluation of 8-amino-(1,2,4)-triazolo[4,3-d][b,e]1,4-dibenzothiazepine (4) and its various substituted analogs (6-9) are reported. PMID- 2772001 TI - Studies of neutralizing properties of antacid preparations. Part 5: Dissolution kinetics of dihydroxyaluminum aminoacetate. AB - The acid dissolution process of dihydroxyaluminum aminoacetate (1) has been studied by pH-stat method. The neutralization reaction was examined by monitoring the appearance of aluminum ion and aminoacetic acid in the reaction medium. The Weibull distribution function was applied to the quantitative interpretation of neutralization rate data. The mechanism of acid neutralization of 1 is discussed. PMID- 2772002 TI - [Preparation of peroral sustained release drug forms on a base of biodegradable polymers. 1. Preparation and characterization of polylactic acid]. AB - Biodegradable polymers get more interest for the preparation of drug formulations. Their main advantage is their physiological safety. Polylactic acid is one of the biodegradable polymers. It was prepared by the direct polyesterification of lactic acid and by polymerisation of the cyclic oligomers. Both the polymers were identified by elementary analysis, by IR spectroscopy, by X-ray-test and by the molecular mass. They differ in their molecular mass and in the degree of the crystalline state. The determination of the grain size, moisture content, flowability and of the parameters for the direct compression were carried out with regard to the use of polylactic acid as auxiliary substance for the direct compression. The results show, that polylactic acid which was prepared on the basis of polyesterification, is a very suitable auxiliary substance for the direct compression. PMID- 2772003 TI - Bioavailability of isosorbide dinitrate from an oral therapeutic system and from tablet Sorbonit Prolongatum 20,0 in human volunteers. AB - The bioavailability of isosorbide dinitrate from an oral therapeutic system (OTS) and from tablet Sorbonit Prolongatum 20,0 mg in 6 volunteers employing a crossover method was studied. Concentrations of isosorbide dinitrate (1),2 mononitrate (2) and 5-mononitrate (3) are plotted as mean concentrations for all volunteers. As evident, the concentration-time curves are similar after administration of both OTS and tablet Sorbonit Prolongatum. Concentration of the nitrates in the serum is close to the maximum level starting 2 h after the drugs were administered. Such concentration is nearly constant for 7 h in the case of nonmetabolized 1 and for 9 h for its metabolites. 24 h after administration metabolites 2 and 3 were found in the serum of 5 subjects. Based on the experimental data, we calculated the areas under curves (AUC). The observed differences in AUC appeared statistically insignificant at the 95% confidence level for the two preparations studied in the case both 1 and its metabolites. PMID- 2772004 TI - Pharmacological characterization of a new structural variant of 4 amidinophenylalanine amide-type synthetic thrombin inhibitor. AB - The synthetic thrombin inhibitor N alpha-(2-naphthylsulfonylglycyl)-4 amidinophenylalanyl-proline (1) was synthesized in order to evaluate the importance of the carboxyl group in its amine portion for fundamental pharmacodynamic and pharmacokinetic properties of these benzamidine derivatives. The compound is better tolerated in mice and rats than are similar compounds lacking this carboxyl group. It has a significantly longer plasma half-life in rabbits compared to the corresponding compound bearing piperidine instead of proline in the amide moiety. The main excretory route of 1 is via the bile. Hepatic uptake and/or biliary excretion show, however, another time course than that seen for the piperidide. Lower toxicity and more suitable pharmacokinetics may compensate for the loss of thrombin inhibitory potency of this new synthetic thrombin inhibitor. PMID- 2772005 TI - Comparative study of different essential oils of Bupleurum gibraltaricum Lamarck. AB - A comparative study was performed of the essential oil extracted from the fruiting apex of Bupleurum gibraltaricum Lamarck (Umbelliferae) collected in different areas within the province of Granada, including the Cazulas mountains, the Balcon de Canales and the Quentar Reservoir. All three essential oils were very similar in chemical composition, consisting mainly of monoterpenic hydrocarbons (delta 3-carene and alpha-pinene). When anti-inflammatory activity against both acute (carrageenin-induced plantar edema) and subchronic inflammation (granuloma technique) was assayed, quantitative differences came to light: the essential oil of the Cazulas Mountains population was most active against acute inflammation owing to its high delta 3-carene content, whereas the Quentar Reservoir essential oil of B. gibraltaricum was most effective against granuloma induced inflammation. PMID- 2772007 TI - Densitometric determination of ketoprofen in synovial fluid. PMID- 2772006 TI - [Optimizing electrode contact with adhesive agents]. AB - An evaluation of three hydrogel-forming substances carboxylmethylamylopectine sodium, carboxymethylcellulose sodium, hydroxyethylcellulose used in the G.D.R. is presented in respect of their quality to form a electrodes-fixing gel. Useful compositions were tested on their fixation-power, physiological compatibility, decreasing of skin-resistance, oppression of interferences and preparation consistence during six month. A gel consisting on 15% hydroxyethylcellulose, 20% glycerol, 0.9% sodium chloride and 64.1% preserved water has been accepted as useful for storage and for an interferenceless conduction of biopotentials for several hours. PMID- 2772008 TI - [The effect of propranolol and structurally related compounds on the in vitro lipid peroxidation of rat brain homogenates]. PMID- 2772009 TI - Antimicrobial activity screening of 32 common constituents of essential oils. PMID- 2772010 TI - Synthesis and reactions of some biologically active 2-(2'-thienyl)benzoxazinone and quinazolinone derivatives. AB - Different amines were found to attack the hitherto unknown 6,8-dibromo-2-(2' thienyl)-3,1-benzoxazin-4(H)-one (2) entirely at position-4, producing the corresponding benzamide derivatives 3a-i. Compound 2 reacted with hydrazoic acid affording the tetrazole 5, beside the benzimidazole derivative 6. Similarly carbon nucleophiles, such as ethyl acetoacetate attack 2 to give 7. 6,8-Dibromo 2(2'-thienyl)-4(3H)-quinazoline and its 3-substituted derivatives 8 a-g were also synthesized. Theoretical calculations for the benzoxazinone 2 and others, based on the simple HMO-method were performed. Close accordance between the theoretically predicted reactivities and the experimental findings was obtained. Biological activities of some of the compounds obtained were also tested. PMID- 2772011 TI - [The reaction of imidates with isocyanates]. AB - Derivatives of isocyanates were prepared by reaction with imidates. Fragmentation reactions and behaviour in a simple biological test were examined. PMID- 2772012 TI - [Preparation of oral sustained-action preparations with a base of biologically degradable polymers. 2. Preparation of matrix tablets with a base of polylactic acid]. AB - It is reported on the preparation and investigation of matrix tablets on the basis of the polylactic acid. Caffeine and phenazone served as model drugs. The release values obtained were analyzed by the equations of Noyes-Whitney and of Higuchi. It was demonstrated, that the solubility and the grain size of the drugs, their content in the tablets and an addition of Heweten 12 have an influence of the release of the drugs. In in vitro-investigations can be shown a hydrolytic degradation of the polymer, but not an enzymatic degradation. PMID- 2772013 TI - [Skin permeation of liposomal incorporated hydrocortisone]. AB - With the liposomal incorporated hydrocortisone a very much improved concentration time profile was obtained in the different layers of human skin after topical application when compared with conventional hydrocortisone in the ointment. The increased hydrocortisone penetration into human skin correspond with the degree of blanching results by vasoconstriction test. Under in vivo conditions the influence of liposomal hydrocortisone on percutaneous resorption was investigated. In guinea pigs a decreased serum concentration and urinary excretion of hydrocortisone could be demonstrated. Thus, hydrocortisone-loaded liposomes, when applied topically, act as a selective drug delivery system, it can be provide increased therapeutic efficacy and, simultaneously, decreased unwanted systemic effects. The significance of liposomal incorporated attenuative and higher potent glucocorticoids in external therapy is discussed. PMID- 2772014 TI - Bioavailability of nifedipine from different oral dosage forms in healthy volunteers. AB - The absolute and relative bioavailability of nifedipine (1) from different formulations administered as single oral doses in healthy volunteers was determined. Serum concentrations of 1 were measured by GC. The absolute bioavailability of 1 was 53% because of presystemic metabolism. The bioavailability of Adalat (Bayer) tablets, Nifedipina (Terapia) and Corinfar (VEB Arzneimittelwerk Dresden) sugar-coated tablets was 93%, 92% and 86% (respectively) as compared with Adalat capsules. The AUC were not significantly different. The Cmax and tmax values were different, indicating that the absorption of 1 showed differences in first-order rate constants of dissolution in the above mentioned order. Despite the differences among the formulations studied, each preparation may have its merits. In a multiple dose regimen of 20 mg 1 (Nifedipina, Terapia) t.i.d., minimal therapeutic drug levels were achieved and maintained during steady state, from the 1st d of treatment. PMID- 2772015 TI - Fate of 14C-terpolymer (methylmethacrylate-14C, 2-hydroxyethylmethacrylate, butylacrylate) nanoparticles after peroral administration to rats. AB - The fate of 14C-terpolymer (methylmethacrylate-14C, 2-hydroxyethylmethacrylate, butylacrylate) nanoparticles was studied in male Wistar rats after peroral administration. These nanoparticles may reach systemic circulation as evidenced by the plasma 14C level, excretion of the label in the urine, as well as organ label deposition. It was found that at least 2% of the dose of 14C was absorbed from the gastrointestinal tract. As expected, the radioactive nanoparticles were excreted predominantly via the feces. The amount of the label in the gastrointestinal tract, liver, and carcasses fell below the limit of detection on day seven after administration. However in the spleen and lung some slight radioactivity persisted after 7 d of experiment. PMID- 2772016 TI - 2-(2-arylvinyl)thieno[2,3-d]pyrimidines. Part 1: Synthesis and structure of 2-(2 arylvinyl)thieno[2,3-d]pyrimidin-6-yl-ketones with potential biological activity. PMID- 2772017 TI - Synthesis of some thiazole derivatives with prospective local anaesthetic activity. PMID- 2772018 TI - [Antimicrobial effects of quarternary ammonium compounds]. PMID- 2772019 TI - [17th meeting of the Pharmaceutical Society of East Germany. 23-25 January 1989, Leipzig. Proceedings]. PMID- 2772020 TI - Health care tradeoffs based on age: ethically confronting the "R" word. PMID- 2772021 TI - Counseling the individual: genetic concerns. PMID- 2772022 TI - The case for a total ban on smoking in hospitals. PMID- 2772023 TI - Pre- and post-persons. PMID- 2772025 TI - Attendings who never attend. PMID- 2772024 TI - Should physicians always offer hope? PMID- 2772026 TI - Fee splitting. PMID- 2772027 TI - Past and present. Ethics versus the law. PMID- 2772028 TI - Where is the woman in obstetrics and gynecology? PMID- 2772029 TI - On the effects on source localisation of volume currents in neuroelectric and neuromagnetic signals. AB - By assuming the surfaces of discontinuity in the electrical conductivity of brain tissues and fluids to be many and of complicated geometry, the influence of volume-current effects (due to the surfaces of discontinuity) on evoked electro- and magnetoencephalographic signals is assessed. The supposition that in such complicated geometry volume-current effects tend to modify the electrostatic potential significantly is supported by the properties of the solution of the partial differential equation for the electrostatic potential when the electric conductivity has a short-scaled stochastic component. The potential of volume current effects to dominate the EEG signal is thereby reaffirmed. Moreover, it is shown that even in the case of the strongest possible volume-current effects they only contribute a term of the order of unity to the neuromagnetic signal, allowing for the possibility to determine the primary source location from the position of the peaks in the neuromagnetic signal. In the same limit any information on source location carried by the neuroelectric signal is obliterated. A set of one-dimensional model equations is used to exemplify the expected differences in the behaviour of the neuroelectric and neuromagnetic signals. PMID- 2772030 TI - Examination of errors caused by random summing in in vivo prompt gamma ray analysis. AB - A technique is described for examining the mode of operation of radiation detectors and estimating the losses and gains caused by random summing effects in spectra acquired at high counting rates. The technique is applied to estimating the errors caused by random summing when measuring the amounts of carbon and nitrogen in the human body by the prompt gamma ray neutron activation analysis system installed in Leeds, UK. Our examination shows that the counting rate would have to increase to more than twice the value used at the method's calibration, before an error of greater than 10% is caused in the estimation of carbon by random summing effects, whilst for nitrogen a change of only 18% in the counting rate will cause a 10% error in its estimation. PMID- 2772031 TI - Model calculations of oxygen supply to tissue slice preparations. AB - Excised tissue slice preparations are widely used in experimental medicine, pharmacology and physiology. Since slices are separated from the vascular system they have to be supplied with oxygen from the bath solution in which the slices are fixed. Otto Warburg designed a simple model of oxygen diffusion in such a tissue preparation. His model does not utilise some important parameters which may influence the oxygen distribution in the tissue: Unstirred bathing, non-vital superficial layers of tissue slices, damage by the cutting procedure and the influence of volume fraction and tortuosity over the oxygen supply. A compartment model has been designed to test how these parameters affect the oxygen distribution in tissue slices. The calculations have shown that all parameters may considerably affect the oxygen supply to tissue slices. Therefore, they have to be considered in the analysis of oxygen distribution and consumption in tissue slice preparations. PMID- 2772032 TI - Construction of a calorimeter prototype with a high sensitivity pulsed signal detection circuit. AB - A calorimeter based on a Wheatstone bridge detector is considered to be an ideal absolute absorbed dose measuring device. One drawback of the calorimeter is that its output signals are extremely small. The signal size can be increased by increasing the bridge excitation voltage, which, however, may lead to excess self heating of a temperature-sensing thermistor in the calorimeter detector and may require corrections. The use of pulsed excitation was investigated in this study in place of a conventional DC excitation to induce higher bridge output voltage while keeping the average self-heating of a thermistor to a reasonably low value. Performance evaluations of our prototype pulsed calorimeter are presented. PMID- 2772033 TI - Abstracts of proceedings: 3D-treatment planning and conformation therapy. 12 April 1989, London. PMID- 2772034 TI - Impact of role stress on physical therapists' emotional and physical well-being. AB - This study examined the relationship between role stress and the physical and emotional well-being of 187 physical therapists practicing in the state of Missouri. Data collected via survey research established a significant relationship between role conflict (conflict between organizational demands and personal and professional values) and emotional exhaustion (r = .50) and between role conflict and somatic and job-induced tension (r = .43 and r = .44, respectively). Role ambiguity created by an uncertain organizational climate was related significantly to emotional exhaustion (r = .26) and to somatic and job induced tension (r = .21 and r = .29, respectively). Perceived improper allocation of time, inadequate staff or resources, and receipt of incompatible demands were identified as significant role stressors and predictors of diminished emotional and physical well-being. Physical therapy directors and individual therapists should work within their organizations to reduce role stress and its detrimental effects, to align professional and organizational values, and to maintain personal and professional standards. PMID- 2772035 TI - Comparison of motor copy and targeted biofeedback training techniques for restitution of upper extremity function among patients with neurologic disorders. AB - A total of 30 targeted training electromyographic biofeedback treatments were administered to the hemiplegic upper extremities of 12 chronic stroke and head injured patients (TT Group). The 30 treatments were divided into three series of 10 treatments each directed to the shoulders; the elbow; and the wrist, fingers, and thumb, respectively. Evaluations for function, active range of motion, and integrated EMG activity were undertaken five times before treatment (baseline measurements), after each series of 10 treatments, and at follow-up intervals for one year. Data from these evaluations were compared with those obtained over an identical time course from 14 chronic stroke and head-injured patients undergoing a motor copy procedure (MC Group) in which the patients matched EMG output viewed on a screen from homologous upper extremity muscles. Both groups showed appropriate significant changes among many independent variables. Changes within the TT Group, however, appeared more treatment-related, whereas changes among the MC Group were latent, occurring more frequently at follow-up evaluations. There were no substantial correlations between EMG activity, active ROM, or function, thus highlighting the continuing difficulty of identifying a causative relationship between physiologic change and enhanced motor capabilities among patients with neurologic disorders. Nonetheless, the results do suggest that both techniques are of clinical benefit, with the motor copy technique offering potential cost-effectiveness because patients can self-train. PMID- 2772036 TI - Mobility methods selected for use in home and community environments. AB - Efficient mobility methods are a necessity for maximum participation in home and community environments. Individuals who require the use of assistive devices for mobility are at risk for limited environmental access. Few investigations have compared the effectiveness of various mobility methods as a function of the environments in which mobility is required. Sixty-eight adults with physical disabilities who used assistive devices for independent mobility were surveyed to determine mobility methods selected for use in specific home and community environments and to determine how far they would travel outdoors before resorting to use of a motor vehicle. Results indicated that frequently individuals used more than one mobility method at home but only one method in outdoor and community environments. Individuals who used wheeled mobility methods traveled greater distances outdoors than those who walked. Implications for practice and research are discussed. PMID- 2772038 TI - Effect of breathing instruction on blood pressure responses during isometric exercise. AB - Twenty-seven normotensive, college-aged, female subjects were studied to assess the effects of training in breathing techniques on blood pressure during isometric contractions. Subjects were randomly and equally assigned to one of three training groups: 1) a group that was taught to perform a Valsalva maneuver during isometric efforts (VAL Group), 2) a group that was instructed to avoid performing the Valsalva maneuver (NO-VAL Group), and 3) a control group that was given no instructions (CONT Group). Prior to and following three breathing technique training sessions, two blood pressure measurements were made by amplified auscultation during 10 isometric contractions of the quadriceps femoris muscle with the leg positioned at 65 degrees of knee flexion. Breathing patterns were recorded on an impedance pneumograph. Data were submitted to a 2 X 2 X 3 (time X trial X group) multivariate analysis of covariance using resting systolic and diastolic blood pressures as covariates. A significant (p less than .05) time x-group interaction revealed posttraining blood pressure response to isometric exercise had significantly decreased in the NO-VAL Group (163/120 vs 148/112 mm Hg), and had not significantly changed in the CONT Group (157/117 vs 153/117 mm Hg). These data illustrate that training to avoid the Valsalva maneuver may help attenuate the pressor response observed during isometric contractions and provide a means for safer patient exercise. PMID- 2772037 TI - Balance performance among noninstitutionalized elderly women. AB - Descriptive data were collected regarding static standing balance of 71 noninstitutionalized elderly women as they performed two timed balance tests. All subjects performed the sharpened Romberg test and the one-legged stance test on each foot in four test conditions: 1) eyes open, 2) eyes closed, 3) shoes on, and 4) shoes off. Subjects were grouped and analyzed according to the following age ranges: 1) 60 to 64 years, 2) 65 to 69 years, 3) 70 to 74 years, 4) 75 to 79 years, and 5) 80 to 86 years. The best time of three trials was used for data analysis. The maximum balance time for the sharpened Romberg test was 60 seconds. For the one-legged stance test, a maximum balance time was 30 seconds. No significant difference was found between right and left or dominant and nondominant limbs while performing the one-legged stance test. No significant difference was found in mean balance time between subjects who had fallen versus those who had not fallen, nor between shoes-on and shoes-off test performance. Subjects' performance on the eyes-open test was consistently superior to their eyes-closed test performance (p less than .0001). The one-legged stance test mean balance time decreased significantly as age increased. More subjects reached the maximum balance time on the sharpened Romberg test than on the one-legged stance test. The results of this study indicate that additional research is needed in the area of balance maintenance among the elderly population. PMID- 2772039 TI - Reliability of a new device used to measure shoulder subluxation. AB - The purposes of the study were to determine the reliability of a new device used to quantify shoulder subluxation and to estimate its standard error of measurement. The device is an L-shaped thermoplastic jig with a metric tape measure embedded in it. A sliding beak-like marker, which can be anchored with a thumbscrew, is used to identify landmarks and to measure the amount of subluxation. Eight male and two female hemiplegic subjects, 40 to 80 years old, consented to be measured for subluxation. Three standardized subluxation measurements were taken by one investigator to determine the reliability with a single rater. One measurement was taken by a second investigator and compared with the first measurement obtained by the first investigator to determine the reliability using more than one rater. Both investigators were experienced physical therapists. Each measurement was read by the other investigator, who disassembled the jig and cleaned the marks from the patient between measurements. For both analyses, an analysis of variance for repeated measurements reflected no differences between measurements attributable to raters. The unbiased intraclass correlation coefficient for a single measurement by a single rater was .89 (p less than .01) and for more than one rater was .74 (p less than .01). The standard error of measurement was +/- 0.77 mm for a single rater and +/- 1.20 mm for more than one rater. We recommend the jig as a tool to measure shoulder subluxation in patients. PMID- 2772040 TI - Decreased shoulder range of motion on paretic side after stroke. AB - The purposes of this investigation of patients with stroke were to 1) determine and compare shoulder lateral rotation range of motion (SLRROM) measured at the threshold of pain on the paretic and nonparetic sides; 2) establish the intrarater and interrater reliability of the measurements; and 3) determine the relationship between SLRROM measurements and the independent variables of age, sex, and time since onset of stroke. Subjects were 25 rehabilitation inpatients. The two investigators each measured the patients' SLRROM twice on both the paretic and nonparetic sides using a gravity goniometer. An analysis of variance (ANOVA) demonstrated that SLRROM was significantly less on the paretic side than on the nonparetic side (F = 28.98, p less than .001). The ANOVA demonstrated no difference in the two raters' measurements of SLRROM. The intraclass correlation coefficients (ICC[3,1]) and interrater reliability coefficients were all good to high (.874-.989). The SLRROM on the paretic side correlated significantly with time since onset of stroke (r = -.538, p less than .01). As a consequence of this study, we concluded that 1) patients with stroke tend to lose SLRROM on the paretic side, 2) SLRROM tends to decrease with time, and 3) measurements of SLRROM obtained with a gravity goniometer are reliable and sensitive. PMID- 2772041 TI - Roth technique--a new approach for measuring sensory neural conduction in the median and ulnar nerves: suggestion from the field. PMID- 2772042 TI - Modified Motor Assessment Scale. PMID- 2772043 TI - [French Society of Phlebology. 16 December 1988, Paris. Proceedings]. PMID- 2772044 TI - [Ultrasonic analysis of the influence of position on dimensions of the bend of the external saphenous veins]. PMID- 2772045 TI - [Edema of the hand during secondary swelling of the arms: primary etiopathogenic hypotheses]. AB - Iatrogenic swollen arms following surgery and radiation therapy after breast cancer, may be -or not- associated with a swollen hand: the percentage is approximately 50%. This study attempts to formulate a few hypotheses regarding the pathogenesis of this distal edema. Clinical examination, lympho-phlebography, isotopic scintigraphy and exploration of the microcirculation (periungual capillaroscopy, distal plethysmography and distal Doppler) were performed in ten patients with hand edema. If the dual nature of the stasis seems to be confirmed the most remarkable result is that in 8 out of 10 patients the anomalies are bilateral. These first hypotheses should be confirmed by a more in-depth quantitative study, and perhaps by more direct paraclinical investigations. PMID- 2772046 TI - [Preliminary study of the lymphology unit at the hospital of La Ferte-Mace (Orne)]. AB - The presence of people with lymphedema taking the waters at the thermal spa at Bagnoles-de-l'Orne led to the creation of a Lymphology Unit at the Hopital de La Ferte-Mace, situated 5 km from the spa. A course of treatment at a spa is a considerable aid in treating lymphedema because of its filtering, resolving, keratolytic and sedative action and because of hydraulic pressure therapy. The Lymphology Unit finishes off the result using intensive care consisting of postural drainage, manual massage of lymphatic drainage, bandages, pneumatic pressure therapy and physiotherapy followed by final immobilization. Moreover, it can also carry out an intensive basic treatment or booster treatment for a short stay without spa treatment. The author sets out the first encouraging results from combining the two techniques. PMID- 2772047 TI - [Patients' rights, being the fourth third of phlebology therapy. Tribute to Glauco Bassi]. AB - Current social, cultural and ethnic patterns all have an influence on phlebology therapy. At the present time, the desire to improve the appearance of their legs is much stronger than before in subjects who have uncomplicated varicose veins. This must be taken into consideration. However, it should also be noted that "capillary phobias" are met with, and these are nothing more than neuroses due to lack of adaptation to present-day life and are certainly not curable by phlebology therapy. On the contrary, care should be taken not to practice "Utopian medicine" in chronic venous insufficiency by prescribing treatment that the patient cannot or does not want to carry out. For this reason, it is not sufficient to prescribe the most logical treatment; a careful examination should be undertaken of the patient's character, requirements, family circle and work, as well as the influence exerted upon him by current social behaviour. Above all, three observations should be made. Some patients undertake cures that are completely different from those prescribed by their phlebologist, since they still have faith in certain outmoded rules. Others put into practice fragments of medical knowledge that have been passed on by popular wisdom. Very often the case is met of post-phlebitis patients who are unable to put on and take off their support stockings and who are the victims of current social conditions which no longer oblige families to help their close relations.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2772048 TI - [Vascular Pathology Society of Normandy. Opening comments]. PMID- 2772049 TI - [Vascular Pathology Society of Normandy. Deauville, 19 November 1988. Proceedings]. PMID- 2772051 TI - [Occupational angioneurotic disorders provoked by vinyl monochloride and vibration]. AB - Microcirculatory disorders of the extremities may have an occupational origin, which it is desirable to specify. Exposure to vinyl monochloride results in a chemical nuisance which also proved to be carcinogenic in man. Strict preventive measures are therefore enforced in the industry and angioneurotic disorders should no longer be observed. Use of vibrating tools results in a microvascular response to a physical nuisance which is difficult to prevent completely. In both cases the physiopathology is not well-known, but compensation is possible as occupational diseases. Repeated trauma of the ulnar artery, and/or its superficial palmar branch are, on the contrary, the main explanation for hypothenar hammer syndrome, which is easily prevented by mere adjustment of the work position and occupational movements: the conditions for medico-legal compensation for this particular syndrome, which is still not listed among occupational diseases, will be in effect in the very near future. PMID- 2772052 TI - [The role of vascular microsurgery in trauma of the hand]. AB - The author presents the current scope of microvascular techniques in hand surgery. In a first stage, basic techniques are presented: sutures under microscope. Then, the indications are made, stressing emergency procedures, with emphasis on: limb (or segments) reimplantation, revascularization. Indications for reimplantation, operative technique and additional treatments are presented, emphasizing the failure rates (40%) and the contraindications. We are insisting on the fact that the indications for revascularization in simple or complicated wounds of the hand are the most frequent and the most positive for these patient's future. Finally, secondary reconstruction techniques are presented, always compared with classical techniques (free 2nd toe transfer versus pollicization). PMID- 2772050 TI - [Effect of noise on circulatory disorders]. AB - The author reports a dramatic case of severe functional and trophic disorders of the lower limbs which proved to be entirely caused by noise. This case led him to study noise and its repercussions on the vascular system: physical characteristics, methods of measurement, epidemiology of this environmental nuisance, general and vascular diseases produced by the traumatic-vibration syndrome, and study of its mechanism of action. He concludes by calling for interdisciplinary action to combine fundamental research, screening and prevention of the disorders caused by noise. PMID- 2772053 TI - [Acute trauma to the popliteal artery]. AB - In spite of the advances in reconstructive vascular surgery, acute trauma of the popliteal artery still results in a high percentage of amputations, around 30%. In a series of 33 traumas of the popliteal artery, at la Salpetriere Hospital, a marked predominance of contusions (28 cases) was recorded, with osteoarticular lesions representing the most frequent cause of these contusions. Two injured patients died at an early stage and 9 underwent an amputation. 22 injured patients were reconstructed and the immediate result was satisfactory. The need for early treatment, rapid transfer of the injured, admission to a specialized vascular surgery department and short but effective investigations, should be emphasized. From a therapeutic standpoint, venous repair is advisable and orthopaedic reconstruction must precede arterial repair. A venous graft is most often used for that purpose in cases of contusion, or resection-anastomosis in clean side-arm wounds. PMID- 2772054 TI - [The compartment syndrome]. AB - The compartment syndrome is in fact secondary to intracompartmental hypertension which creates ischemia of the muscles, nerves, vessels, and anterior tibial and peroneal arteries in the leg. Described in the 19th century, the clinical picture is better known when progressing either in the acute form or in the chronic form. Diagnosis depends basically on the measurement of intramuscular pressure; treatment, at least initially, apart from subcutaneous aponeurotic decompression, also calls for hyperbaric oxygen therapy. The latter is particularly indicated in those cases bordering on surgical and medical treatment, for preventing deterioration and improving muscular possibilities in the post-surgical period. At the present time, the physiopathology of the condition is still poorly understood. The whiplash syndrome was well described by Martorelli and is due to rupture of the muscular veins of the calf. The clinical picture is often ambiguous and can suggest underlying phlebitis. The triad of symptoms --pain, disability and ecchymosis-- generally enables a diagnosis to be made, with treatment consisting primarily of immobilization. As for Bywaters' syndrome (crush syndrome), it is still very topical. The original description of the clinical picture by Bywaters during the bombardment of London in 1942 has been replaced by the picture resulting from large scale accidents that are part of modern society. The picture is still highly dramatic and if untreated progresses to acute renal insufficiency. Treatment has certainly changed and hyperbaric therapy (administered at two or three atmospheres) is a valid adjuvant to basic treatment and modifies the progress of the phenomenon with entirely satisfactory results. PMID- 2772055 TI - [Problems caused by safety shoes, diabetes, standing upright]. PMID- 2772056 TI - [Bone infarcts and vibration]. PMID- 2772057 TI - [Venous trauma of the limbs]. AB - Traumatic lesions of veins in the limbs must be considered in 3 types of circumstances: (1) Extensive injuries, open or closed, affecting the principal vascular axis and usually damaging both the vein and artery at the same time; these wounds or ruptures in the principal venous supply pose the problem of repair using autogenous venous material, since it is now known that the result of arterial reconstruction (which is so essential for the limb) may be compromised by the lack of a satisfactory return circulation. Because of this, amputation may be resorted to, as is still too often seen in the case of the popliteal fossa. (2) Lesions of the collateral veins: these remain the most frequently encountered in civil practice; they result in either deep hematomas in the muscles (sub aponeurotic), or superficial hematomas between aponeurosis and integument. The former may be a factor in compartment syndromes with the risk of irreversible ischemia in a muscular compartment if aponeurotomy is not carried out very rapidly, while the latter can give rise to skin necrosis if they are not drained in time. (3) Limited wounds affecting vein and artery, which are in contact, with formation of an arteriovenous fistula which may only be recognized after a certain delay if it is not systematically borne in mind. The question of assessing the sequelae over the medium and long term is raised in all cases; in the vast majority of cases, these correspond to a picture of post-traumatic thrombophlebitis. Correct preventive and curative treatment can lessen the disabling nature of the sequelae and especially their professional repercussions. PMID- 2772058 TI - [Stress phlebitis of the upper extremity. Medico-legal aspect]. AB - Stress phlebitis of the upper extremity is in fact due to compression of the subclavian vein in the costo-clavicular space during certain movements, the effort being only a fortuitous component. Clinically, it evolves in two stages: at the stage of intermittent compression, the functional symptoms are related to certain positions of the upper extremity; the compression is identified clinically and with additional tests. Treatment includes physical therapy; however, persistence of the symptoms may result in having to consider the resection of the first rib. At the stage of organized phlebitis, the diagnosis is obvious although sometimes unrecognized, and the current consensus is to use anticoagulants: heparin followed by anti-vitamin K. From a medico-legal standpoint, stress phlebitis of the upper extremity is not considered a professional disease, but if it is possible to attribute it to a type of work requiring frequent upward positioning of the arms, there is an obligation for these patients to be rehabilitated professionally. PMID- 2772059 TI - [Venous sequelae after trauma to the lower limbs]. PMID- 2772060 TI - [Vascular trauma--sequelae]. PMID- 2772061 TI - [Preventive role of the occupational physician faced with cardiovascular risk factors]. AB - The preventive role of the occupational practitioner and occupational medicine no longer has to be demonstrated. As far as cardiovascular risk factors are concerned, on the one hand there are a certain number of cardiovascular diseases which have their origin in certain occupational fields (this concerns 10 pictures of occupational diseases which are entitled to compensation) and, on the other hand, occupational medicine has an important role to play when faced with the usual cardiovascular risks such as sedentary life style, obesity or excess weight, alcohol, tobacco, diabetes, fatigue and stress. Apart from giving advice to employees (health education) and instantly replying to the risk by individual or collective prevention and by medical and technical prevention, there is epidemiological observation and the investigation of quantitative or quantifiable "indicators". All these roles imply interdisciplinary dialogue and community participation so as to be able to counteract environmental hazards, rehabilitate vulnerable subjects, and develop health. PMID- 2772062 TI - [Functional rehabilitation of arteriopathies]. AB - In spite of an intricate predisposition, the rehabilitation of arteriopathies proves its efficacy by bringing into play complex biological and physiological mechanisms which decrease oxygen consumption. The management of rehabilitation depends on clinical, angiological (Doppler, digital pulsed plethysmography, transcutaneous partial oxygen pressure) and energy (maximum oxygen consumption, walking test) assessments. Based essentially on exercise re-training, specific segmental work and respiratory exercises, reeducation takes place at every stage, with amputation requiring more specialized techniques for the production of optimum equipment. The objective is successful rehabilitation with suppression of risk factors. PMID- 2772063 TI - [Vascular Pathology Society of Normandy. Summary and conclusions]. PMID- 2772064 TI - [Surgical treatment of acute deep venous thrombosis of the lower limbs. Description of an original thrombectomy technic]. PMID- 2772065 TI - Transverse location of new fluorene based depth dependent fluorescent probes in membranes--quenching studies with 9,10-dibromostearic acid. AB - Fluorescence quenching technique has been used to determine the transverse location of the fluorescent fluorenyl fatty acids in single bilayer vesicles prepared from phosphatidylcholine. The fluorenyl fatty acids used here are 2 fluorenyl acetic, butyric, hexanoic and octanoic acid. In addition a new type of fluorescent probe, 7-n-butyl-fluorene-2-butyric acid, wherein a hydrophobic tail is attached to 2-fluorenyl-butyric acid has also been used to study its effect on alignment of these probes in the membrane. The association properties of the quencher 9,10-dibromostearic acid have been analysed. It is observed that the quencher association involves partitioning into the vesicles and does not involve any binding to the vesicles. The absolute partition coefficient of the 9,10 dibromostearic acid which partitions between the aqueous and the lipid phases of the phospholipid dispersion has been evaluated. Using this information the corrected Stern-Volmer plots were drawn and the bimolecular quenching constant evaluated. PMID- 2772066 TI - [On classification and symptomatology of hypochondriasis]. PMID- 2772067 TI - [Psychophysiological study of laughing expression in schizophrenic patients]. PMID- 2772068 TI - [Criticism of the Mental Health Act, 1987]. PMID- 2772069 TI - [Cerebrospinal fluid parameters in Guillain-Barre polyradiculitis. Importance of barrier disorder and intrathecal immunoglobulin synthesis]. AB - With routine CSF determination of 21 patients with GBS the BBB and the intrathecal IgG synthesis was investigated when calculated CSF/serum albumin ratio and CSF IgG-index respectively. Only in 2 of 21 patients (9.5%) an intrathecal IgG synthesis and in 14 of 21 patients (67%) a BBB damage was found. The BBB was considered as an important pathogenetic factor in GBS. A hypothesis for the development of the albumino-cytological dissociation is presented. PMID- 2772070 TI - [An arsonist with a sexual motivation]. AB - In the period 1963-1983 expert opinion was given 147 times on the criminal accountability of premeditated arsonists. In 12% of the cases the crime was sexually motivated. We exemplify the transition of the motive from heightened SELBSTWERTERLEBEN through FREUDE UND ALLGEMEINE LUST in fire to (pre)sexual motivation. The individual features of these 18 cases are noted and distinguished, and the conclusions reached in the expert testimony set out. PMID- 2772071 TI - [Cognitive training in schizophrenic diseases]. AB - The comparison of an experimental group of schizophrenic patients undergoing cognitive training with a control group was tested for significance over a total of 23 psychometric features, using the test known as t-distribution or "Students distribution". Cognitive training results in varying degrees of improvement in the various parameters. Uncharacteristic schizophrenic basic disorders remitted significantly, and there was improvement in activity of intention, BP/RS sum score, and the BP/RS factors of anxiety/depression, anergy, and activation. The NOSIE factors of manifest psychosis, irritability, and depression remitted, and social interest improved. From the psychological data it can be concluded that cognitive training can help improve, in particular, cognitive adjustment and adaptability, and the organisation of complex societal conditions. PMID- 2772072 TI - [Occupational therapy in neurology--results of 7 years' experience]. AB - Indications, mode of referral, therapeutic methods, and documentation of the functional occupational therapy practised in the field of neurology are presented and experiences hitherto existing discussed. For many of neurological diseases, the occupational therapy may be regarded as an equivalent method to the medication and to the physiotherapeutic treatment. When carrying-out as group therapy, it is an economical way of treatment, and most of the patients take this kind of therapy in a positive manner. In addition to this, the occupational therapy renders possible that the state of the rehabilitation can be sized up. PMID- 2772073 TI - [Foreign citizens as patients at a psychiatric clinic]. AB - On 98 hospitalizations of foreign patients admitted to psychopathic wards of the mental hospital of Karl-Marx-Stadt from 1983 to 1987 is reported. Basing upon whose course of the disease and under consideration of special literature of medicine, selected questions concerning boundary-exceeding psychiatry are discussed. The proceeding practical importance of questions regarding intercultural psychiatric problems is mentioned. PMID- 2772074 TI - [Anticonvulsive therapy and complications of pregnancy in epileptic patients]. AB - During observation of 92 pregnancies, epileptic seizures, pregnancy complications and complications regarding the newborns were noticed with 67 women having epilepsy and correlated by means of following therapeutic aspects: without anticonvulsive therapy, monotherapy, combined therapy. Most of the attacks suffered women that were treated by combined therapy. Pregnancy and birth complications appeared nearly to the same extent more with patients under mono- and combined therapy than with patients without therapeutic treatment. Most frequently we saw complications and malformations with regard to the children in that group of mothers that had been treated by an anticonvulsive combined therapy. PMID- 2772075 TI - [Anorexia nervosa masculina--concordance in monozygotic twins]. AB - The case report presents the courses of the disease of an infantile-juvenile masculine monozygotic pair of twins suffering from anorexia nervosa. Beginning, therapy and result turned out differently in spite of a commonly suffered disease. Already the importance of smaller differences in their personality development as well as the merit of the intrageminate dynamic of parts are worked out. PMID- 2772076 TI - [Initial experiences with the Reiber 1979 determination of autochthonous IgG production within the scope of clinical and immunologic follow-up studies in multiple sclerosis treated with immunosuppressive therapy]. AB - We carried out clinical and immunological follows-up to 21 patients suffering from multiple sclerosis, 16 of whom had been immunosuppressively treated. A remission in clinical way was possible to point out with 8 of 12 patients (66%) average remission by 1 score acc. to the Bronx-Scale- and with these patients a local formation of immunoglobulin acc. to Reiber (1979) could be proven. With 40 to 60% of the patients pathological changes were found out by determining of routine parameters by means of liquor examinations (total number of cells, sediment, total protein, electrophoresis) in which the humoral values responded not so sensitively to immunosuppressive therapy than the cellular values. For the present, liquor- and immunodiagnostic is being considered as a solid part of diagnostic programm and therapy control with regard to patients suffering from multiple sclerosis. PMID- 2772077 TI - [Systems theory reflections on the treatment of the acute and post-acute stage of schizophrenic psychoses]. AB - Biological, psychical and social phenomena of acute and postacute phase of schizophrenic psychoses are differentiated according to systems theory. During the acute phase the therapeutical interventions aim to stabilize mainly the biological and psychical sphere, whereas for the post-acute phase the emphasis lays on the psychical and social phenomena. This phase-oriented coupling between the therapist, the patient and his/her social network promotes a successive restructuring by generating consensual spheres, which help the patient and his/her social net to find new ways for autonomous development. PMID- 2772078 TI - [Coping and psychological compensation in patients with endogenous psychoses of schizophrenic origin]. AB - For a long period of time, the coping and compensatory mechanisms that arise from the patients with schizophrenic psychoses themselves have been considered only to a small extent by the psychiatric research. On the basis of Huber's concept of basic symptoms, we extended the six categories of coping mechanisms which are described in the Bonn Scale for the Assessment of Basic Symptoms (BSABS) by three further categories. With ten schizophrenic patients - mostly in-patients - semistructured interviews concerning these categories were done. All patients were found to have coping and compensatory mechanisms, and as a contribution to recognize and describe these mechanisms, parts of the patients' remarks are quoted. This is a prerequisite for an operationalized recording on larger patient populations that will possibly also allow correlation-statistical conclusions. PMID- 2772079 TI - [Homesick reactions in inpatient treatment and rehabilitation of psychoses]. AB - The paper refers to primary not obvious, but severe nostalgic reactions in the inpatient treatment and rehabilitation of schizophrenics which frequently lead to discontinuity of treatment. After a brief historical survey some clinical cases will illustrate that nostalgia is both expression of strong regressive tendencies and preventive mechanism to protect from psychosis and/or suicide. Finally the management of nostalgic reactions is discussed. PMID- 2772080 TI - [Suicide in schizophrenic patients]. AB - Based on retrospective investigation using hospital records of 44 schizophrenic patients of a rehabilitation department, who committed suicide between 1966 and 1986, the paper discusses demographic and psychological features of schizophrenic suicide in comparison with international literature. Subjects who committed suicide were found to be accumulated within age-range 25 to 30 years and between one or two years of duration of illness. 20% of subjects died in an acute psychotic state, 58% had been found within a depressive episode and 66% had confronted themselves with their social situation and/or future in the light of their illness. PMID- 2772081 TI - [Psychopathology-oriented ergotherapy. An example of the treatment of negative schizophrenic symptoms using the batik technic]. AB - Ergotherapy or occupational therapy is an indispensable part of psychiatric treatment, and which has an exceptionally long history of use ergotherapy focuses on psychopathology. Treatment of schizophrenic patients with batic-work exemplifies how product oriented creative work, with concrete materials, can be used to regain capabilities which have been lost during an illness and/or to foster healthy coping strategies in a compensatory manner. Ergotherapy can be viewed as a "mediator therapy" and as such, is always part of a complex, general treatment plan. Physicians referring patients for ergotherapy have a responsibility to clarify indications as well as to specify treatment demands. PMID- 2772082 TI - [Comments on electroconvulsive treatment from the viewpoint of the psychotherapy oriented psychiatrist]. AB - The use of electroconvulsive treatment is discussed from the viewpoint of the psychotherapist. It is explained that such treatment is incompatible with genuine psychotherapy. PMID- 2772083 TI - [Problems of electroconvulsive treatment in advanced age--its possible applications and necessities, indications criteria, method and effectiveness]. AB - After a critical discussion with antiquated and actual problems to the electroconvulsive therapy the problem-important peculiarities of progress and treatment of the psychosis in the higher age are exhibited. In search of satisfactoring solutions we used Dexamethazon as a supplemental premedication in the electroconvulsive therapy and by this way we found out a remarkable minimize of complications which allowed to put in more frequently the electroconvulsive therapy during the psychosis in the higher age. This leads to a general optimation of prognosis of the late psychical diseases. Beside the method itself the urgency of indications and exclusion of standards are described in the same way, also there are shown the few complications in comparison with the successes of therapy of 2010 electricalconvulsive therapies from 433 patients. PMID- 2772084 TI - Scientific progress in psychodynamic formulation. AB - This issue of psychiatry contains five papers describing or comparing five different methods for making a psychodynamic formulation (Luborsky and Crits Christoph; Horowitz; Johnson et al.; Perry, Augusto, et al.; Perry, Luborsky, et al.). As Luborsky and Crits-Christoph make clear in their introduction, while the idea of the psychodynamic formulation originated with Freud, successful efforts to develop scientific methods for making a formulation are largely a phenomenon of the past decade. Indeed, since the introduction of the Core Conflictual Relationship Theme method (Luborsky 1977), around a dozen methods have been developed with the same overall aim. Let us consider why this is important. PMID- 2772085 TI - A relationship pattern measure: the core conflictual relationship theme. AB - Relationship pattern measures are recently developed systems for measuring the main relationship patterns expressed in psychotherapy sessions or in other interviews. They are precise measures of the kind of pattern that dynamic psychotherapists have estimated clinically ever since the start of such therapies. Leading off the comparisons of such measures that are presented in this issue, this paper will (a) describe a relationship pattern measure, (b) illustrate it, and then (c) compare it with one or more other relationship pattern measures. Beyond these purposes our aim is to indicate the values of these new methods for personality and psychotherapy research. PMID- 2772086 TI - Relationship schema formulation: role-relationship models and intrapsychic conflict. AB - Recurrent maladaptive interpersonal relationship patterns are a central characteristic of the personality disorders and the main focus in dynamic, cognitive, and family psychotherapies. In dynamic formulations the emphasis is on examining conflict in terms of opposing wishes, fears, and defenses. Such formulations can take place at various levels of information, involving ideas, emotions, self and objects. This paper presents a system for formulating intrapsychic conflicts at the level of person schemas (Horowitz 1988a). It uses units called Role-Relationship Models (RRM). PMID- 2772087 TI - Converging evidence for identification of recurrent relationship themes: comparison of two methods. AB - The therapeutic process is complex, and researchers and clinicians alike search for organizing principles or underlying structures that will reduce this complexity and thereby augment the efficacy of their respective endeavors. As other papers in this issue indicate, one such organizing principle is the concept of a recurring relationship theme that can be identified in the patient's descriptions of current and past relationships, as well as observed in the patient's interaction with the therapist. This concept has its origins in Freud's discovery of the transference phenomenon (1912), wherein the patient reenacts early relationships with significant others in the relationship with the analyst, and in Sullivan's interpersonal theory of psychiatry, with its central tenet that "personality is the relatively enduring pattern of recurrent interpersonal situations which characterize a human life" (1953, pp. 110-11). In the psychoanalytic and interpersonal therapies, these recurrent interpersonal themes, associated with the patient's difficulty in living and characterized as self defeating and self-perpetuating, can potentially serve three main purposes: diagnosing and describing patients' difficulties, focusing therapeutic interventions, and measuring change on an individual basis. However, until recently, research on transference and rigidity of interpersonal style has been hampered by the lack of objective and clinically relevant measures for quantifying this clinical phenomenon (Kiesler 1986; Luborsky and Spence 1978). Luborsky (1977) developed the first reliable method for operationalizing the transference concept. Since then, as the companion papers in this issue point out, several different methods have been developed (e.g., Gill and Hoffman 1982; Horowitz 1979; Schacht et al. 1984). Although these methods differ in the postulated structural composition or components of the transference theme or recurrent relationship theme, they operate from similar methods of assessment. This paper presents the results of an initial investigation into convergent validity (Cronbach and Meehl 1955) of two of the major relationship theme methods -the Core Conflictual Relationship Theme (CCRT) of Luborsky and colleagues (Luborsky 1977), and the Cyclical Maladaptive Pattern (CMP: formerly called the "dynamic focus") of the Vanderbilt group (Schacht et al. 1984; Schacht and Henry, in press). In our investigation, developers of the approaches independently applied their methods to the same interview with a depressed patient. It was hypothesized that aside from differences due to the structural composition, the two methods would identify a similar relationship theme. PMID- 2772088 TI - Assessing psychodynamic conflicts: I. Reliability of the idiographic conflict formulation method. AB - Recent years have seen increasing interest in devising methods of studying psychodynamic phenomena. These efforts have had confront difficulties, first, in specifying the data, the observation language, and rules of inference for psychodynamic propositions, and second, in determining the reliability and validity of the measures used. Given how "fuzzy" traditional psychodynamic concepts are, it is no wonder that psychodynamic clinicians from Freud onward have achieved more success in generating new hypotheses than in testing their validity. As Reichenbach (1938) has observed, science requires that discovery be followed by systematic validation of all new propositions, regardless of their degree of popular acceptance. At the core of efforts to study psychodynamics have been methods to study ego functioning (Bellak and Goldsmith 1984), defense mechanisms (Perry and Copper 1988), and psychodynamic conflicts. This paper reports on the reliability of the Idiographic Conflict Formulation (ICF), a guided method for formulating an individual's psychodynamic conflicts. PMID- 2772089 TI - An examination of three methods of psychodynamic formulation based on the same videotaped interview. AB - While psychodynamic theory and therapy are approaching their centennial, the science of psychodynamics is still in an earlier developmental stage. Any scientific field generates the most controversy and excitement when it is still developing. For psychodynamic psychology this means that its basic units of observation as well as its rules for justifying clinical inference in formulating and testing dynamic hypotheses require more development. In short, we are still evaluating different methods for both discovering and validating psychodynamic propositions. This is especially true for central features of dynamic psychology, including intrapsychic conflict, relationships, and transference patterns. This report compares three different methods for making a dynamic case formulation: 1) the Core Conflictual Relationship Theme (CCRT) of Luborsky (Crits-Christoph and Luborsky 1985a,b; Luborsky 1976, 1977, 1984, and companion paper in this issue; Levine and Luborsky 1981), 2) the Plan Diagnosis (PD) method of Silberschatz, Curtis and colleagues of the Mount Zion group (Caston 1986; Curtis and Silberschatz 1986; Rosenberg et al. 1986; Curtis et al. 1988) and, 3) the Idiographic Conflict Formulation (ICF) of Perry and Cooper (1985, 1986, and companion paper in this issue). Each has a slightly different focus. The CCRT focuses on relationship patterns as the central feature of individual dynamics and transference in or out of the treatment situation. The Plan Diagnosis focuses on dynamic features related to transference, resistance and insight in therapy. The Idiographic Conflict Formulation focuses on stress and internal conflict, and the individual's adaptation to them in or out of treatment. PMID- 2772090 TI - A theory of mental illness: integrating social and emotional aspects. AB - The theory developed here locates mental illness in a biosocial context involving social bonds. Because of the inclusion of both social and emotional elements, light may be shed on how mental illness originates, the part played by family, agents of social control, and society. Labeling and stigma may rest on strong unacknowledged emotions, particularly shame and anger. The shame construct is used to provide a model of mental illness at the intra/interpersonal and societal levels, which involves a bilateral relationship between the labeled and the labelers. I use excerpts from a psychiatric interview to illustrate my model. Although preliminary, the findings point to the role of shame in mental illness; it may figure in both the formation of symptoms and their maintenance. PMID- 2772091 TI - Commentary on Retzinger. AB - Suzanne Retzinger's article, "A Theory of Mental Illness," provides further untangling of the complex links between social relationships and psychopathology. Those links have been demonstrated in such diverse areas as the impact of family relationships on relapse (e.g., Brown et al. 1972), the predictive importance of social relations to outcome (e.g., Strauss and Carpenter 1977), and the genetic connections between social relationship traits and vulnerability to psychopathology (Kendler et al. 1982). The research presented here focuses on social relationships with special emphasis on stigma in those relationships and its impact on disorder. It also has the valuable role of forging connections between the more abstract labeling theory and the actual behaviors of people as viewed in their interaction. PMID- 2772092 TI - Cohesion, alliance and outcome in group psychotherapy. AB - Cohesiveness has been viewed as the group psychotherapy equivalent of the therapeutic alliance in individual treatment. Although researchers have attempted to study the concept of cohesion in group treatment, understanding of this so called "curative" group factor remains quite primitive. In this study of 12 time limited psychotherapy groups, with a total of 90 nonpsychotic outpatients, we explore the relationships between cohesion, alliance and treatment outcome. Our cohesion measure is a new instrument, the Harvard Community Health Plan Group Cohesiveness Scale, developed for use with group therapy videotapes. To measure alliance we have modified the Penn Helping Alliance Scale (Group Alliance Scale) to be scored from videotapes of group sessions. Both of these instruments use trained observers to make ratings for the group-as-a-whole. The outcome battery for patients in these groups included a widely varied set of measures, enabling us to view change from a number of perspectives. Our findings indicate that cohesion and alliance as measured here are related concepts. We also find that both cohesion and alliance appear to have strong relationships with improved self esteem and reduced symptomatology for patients in these groups. In addition, it appears that outcome is most related to cohesion in the first 30 minutes of a group session. Implications of these and other findings are discussed. PMID- 2772093 TI - The catalytic function in psychotherapy. AB - Managed mental health care requires that psychotherapists translate their theories to fit consumer-driven systems. Core concepts such as motivation, resistance, and psychopathology can be understood operationally, as they relate to the relative flexibility and adaptability of the patient challenged by ordinary life events. When psychotherapy is viewed as inherently a change facilitating process, subjugated to and oriented toward such events, the therapist's function is catalytic rather than analytic. The objective of therapy is to reinforce motives and mitigate obstacles to necessary change, through timely, focused interventions. A model is presented and case examples are used to illustrate how such an objective may be reached. PMID- 2772094 TI - Suicide and parasuicide in multiple personality disorder. AB - Multiple personality disorder (MPD) has been diagnosed with increasing frequency in the 1980s: according to one estimate 6,000 cases have now been diagnosed in North America (Coons 1986). The diagnosis of MPD can be difficult because patients usually present in a polysymptomatic fashion, and the specific features of their dissociative disorder may be difficult to elicit (Kluft 1985a, 1987). One of the most common presenting features consists of suicidal ideation and suicide attempts. Putnam et al. (1986), for instance, noted suicidality as a presenting symptom in nearly 70% of 100 cases of MPD reported to them by 92 clinicians throughout North America. We have collected a series of 236 cases of MPD reported to us by 203 clinicians throughout North America. Our results show that 72% of the patients attempted suicide. The purpose of this report is to compare 48 cases of MPD from this series with no previous suicide attempts to 167 cases that have attempted suicide to determine features that differentiate the patients who attempt suicide from those who do not. PMID- 2772095 TI - Evidence for a decline with age in behavioral responsivity to the serotonin agonist, m-chlorophenylpiperazine, in healthy human subjects. AB - The functional significance of alterations in brain serotonin (5HT) associated with normal aging in both animals and humans is largely unknown. Using the effects of the 5HT agonist, m-chlorophenylpiperazine (m-CPP), as a measure of central serotonergic responsivity, we compared the behavioral and neuroendocrine responses of older normal volunteers (mean age +/- SD = 62.4 +/- 4.12) to those of younger normal volunteers (mean age +/- SD = 31.6 +/- 5.52). When m-CPP was administered intravenously, older subjects showed decreased behavioral responses but similar neuroendocrine responses, compared to younger subjects. The decreased behavioral responsivity was unrelated to pharmaco-kinetic differences between the groups, since m-CPP plasma levels were similar in both groups. This report is the first in vivo study in humans to demonstrate decreased behavioral responsivity with age following serotonergic stimulation, and may indicate a functionally less responsive 5HT subsystem in older subjects. PMID- 2772096 TI - Relationship of bone density to estradiol and cortisol in anorexia nervosa and bulimia. AB - Dual photon absorptiometry was used to assess the risk of developing osteoporosis in patients with anorexia nervosa and patients of normal weight with bulimia nervosa. Anorectic patients had significantly lower vertebral bone mineral densities compared with healthy controls. Bulimic patients had values similar to those of controls, and the differences between bulimics and anorectics narrowly missed significance. No significant difference was found between patient groups in measurements of serum estradiol, but anorectics, compared with bulimics, had significantly higher values of 24-hour urinary free cortisol. Hypercortisolemia, by diminishing bone formation and increasing bone resorption, is likely to contribute to the development of osteoporosis in patients with eating disorders. PMID- 2772097 TI - Persistent tardive dyskinesia and neuroleptic effects on glucose tolerance. AB - The relations of persistent tardive dyskinesia (TD) to glucose tolerance and family history of type 2 diabetes mellitus (FH-NIDDM) were examined in 22 schizophrenic patients. All patients underwent a standard oral glucose tolerance test (GTT) while receiving haloperidol, and 15 patients also underwent a GTT when drug free. Fasting blood glucose (FBS) was significantly higher in the TD group than in the non-TD group in the medicated condition, but not in the drug-free state. TD and non-TD groups did not differ significantly in postload glucose levels either in the drug-free or in the medicated condition. However, relative to the drug-free state, haloperidol-treated TD patients showed decreased glucose tolerance while non-TD patients showed increased glucose tolerance. Seven (32%) of the 22 patients had an FH-NIDDM. A positive FH-NIDDM was significantly associated with the presence of TD and with higher drug-free FBS. A possible role of melatonin in mediating the TD-augmenting effects of FH-NIDDM and the neuroleptic-induced decrease in glucose tolerance has been proposed. PMID- 2772098 TI - Fluctuating dermatoglyphic asymmetry in psychotic twins. AB - Fluctuating asymmetry of bilateral morphological traits is the result of prenatal developmental instability and has been shown to be greater in organisms having more homozygous genotypes (aabb vs. AaBb, for example). This expected increase in fluctuating asymmetry has been found among individuals having a high degree of liability for schizophrenia, as this disorder appears to have a polygenic basis. We tested the additional prediction that the greater genetic liability for schizophrenia necessary for concordance between twins should be associated with greater fluctuating asymmetry in twin pairs in which both twins are mentally ill compared to twin pairs in which one individual is normal. Our analysis of asymmetry for finger ridge counts from fingerprints of concordant and discordant pairs of twins supports this prediction and provides additional indirect support for the roles of polygenic transmission and prenatal epigenetic vulnerability in schizophrenia. PMID- 2772099 TI - The continuous performance test, identical pairs version: II. Contrasting attentional profiles in schizophrenic and depressed patients. AB - The Continuous Performance Test-Identical Pairs version was administered to 14 schizophrenic patients, 17 depressed patients, and 28 normal controls. The task was divided into verbal and spatial stimuli, as well as no-distraction and distraction (verbal and auditory) conditions. Both patient groups displayed attentional impairments compared to normal subjects, but they differed from each other in specific profiles. Schizophrenic patients were characterized by a global impairment and a particular inability to focus on the critical stimuli, whether verbal or spatial. They also made an excess of random responses throughout the task but showed no evidence that attention declined from its initial level over time. Depressed patients did not display a global attentional deficit but did show a specific inability to attend to spatial as compared to verbal stimuli and, in particular, a confusion when the spatial stimuli were only slightly different. Performance on a secondary task in response to a change in expectation improved dramatically for depressed but not schizophrenic patients, suggesting a more efficient allocation strategy, a greater reserve of processing capacity, or more dependence on motivational factors in depressed patients. Schizophrenic and depressed patients were alike in extent of distractibility. Whereas normal controls improved with the onset of external distraction, schizophrenic and depressed patients deteriorated to an equal extent. Distractibility was thus concluded to be a correlate of acute psychiatric illness and not specific for schizophrenia. PMID- 2772100 TI - The future of psychoanalysis. AB - We have tried, in a necessarily kaleidoscopic and highly condensed manner, to highlight our perspectives on the foreseeable future of psychoanalysis, along a number of interrelated but clearly distinct dimensions. Our discussion has dealt with the nature of our field as a science and also as a discipline, the nature of the training for it, the nature of its research, and the nature and scope of its professional practice. In all of these areas, matters seem both more complex and less clear-cut than they were in the immediate post-World War II period when we entered the field, which is now forty years ago in the approximately one-hundred year-old history of psychoanalysis. We did not discuss in any detail the International Psychoanalytical Association or the American, its component through which we have our international membership. We have, however, via the IPA Newsletter, given voice to the organizational struggles of the International: the April 1989 issue of the Newsletter carries our account of the organizational changes within the IPA during the last four years and what we think they mean in relation to some of the issues discussed in this article. The fuller story of how our changing psychoanalytic life and identities are reflected in our institutional structures, as well as a more detailed specification of the future directions we have tried to chart in our inquiry, all deserve separate extended treatment and more complete justification. PMID- 2772101 TI - On the analysis of defenses in dreams. AB - This paper deals with a particular analytic approach to the clinical use of dreams: the analysis of defenses in dreams. Clinical vignettes are used to demonstrate various ways that defenses can be depicted in dreams and the manner in which the patient's attention may be drawn to those defenses. Dreams can offer an especially vivid view of defenses and hence can heighten patients' emotional conviction about the nature of their conflicts. PMID- 2772102 TI - Society for Psychophysiological Research, twenty-ninth annual meeting. October 18 22, 1989, New Orleans, Louisiana, USA. Program abstracts. PMID- 2772103 TI - Persistent cardiovascular effects with repeated caffeine administration. AB - Although habitual caffeine users ingest the drug repeatedly throughout each day, the persistence of caffeine's known cardiovascular effects with such repeated use has not been investigated. Blood pressure and heart rate were measured under resting conditions in 10 healthy, male coffee or tea drinkers for 2 hours following a pretreatment dose of caffeine (125 mg) on two separate days after overnight abstinence. Either a second caffeine dose or placebo was administered and measurements continued for 1.5 hours. Compared to placebo, the second dose of caffeine produced significant increases in heart rate and diastolic and mean arterial, but not systolic, blood pressures. The results suggest that the cardiovascular effects of caffeine may persist throughout the day with repeated administration of moderate amounts of caffeine. Habitual caffeine use does not necessarily lead to complete tolerance, which suggests that caffeine's cardiovascular effects could contribute to an increased risk of cardiovascular disease. PMID- 2772104 TI - Cardiovascular reactivity, emotional factors, and home blood pressures in black males with and without a parental history of hypertension. AB - Differences in cardiovascular responses to mental stress, psychological factors, and self-determined home blood pressure between black individuals with and without a family history of essential hypertension (EH) may suggest mechanisms responsible for the high incidence of EH in blacks. In this study, 12 black male students with a parental history of EH and 12 without a parental history of EH participated in a laboratory session during which two mental challenge tasks (anagrams and mental arithmetic) were presented. Following the laboratory session all subjects made daily recordings of their morning and evening blood pressure for four weeks (28 days) after the laboratory session. The results showed that sons of hypertensive parents had higher systolic (SBP) and diastolic (DBP) than sons of normotensive parents at rest and during mental challenge; no reliable differences in heart rate were observed. Sons of hypertensive parents had higher self-determined home blood pressure (SBP and DBP) and scored significantly higher on psychological measures of Trait-Anger/Temperament, Anger-Out, and Submissiveness. Apparently there was no significant change in SBP or DBP over the four weeks prior to final examinations in either of the groups. Although the resting blood pressure level, weight, and family history predicted a large proportion of the variance in home SBP and DBP, the amount of explained variance, particularly for DBP, was significantly increased by the inclusion of psychological variables and the level of cardiovascular responses (and not the delta change) to mental challenge in the regression equation. These findings indicate that the degree to which self-determined home blood pressures can be predicted is enhanced significantly by considering both the level of cardiovascular responses to stress and psychological measures of the experience and expression of anger. The implications of these results are discussed in light of current research demonstrating that average home blood pressures are a better predictor of cardiac complications than casual (office) blood pressures. PMID- 2772105 TI - Situational determinants of cardiovascular and emotional reactivity in high and low hostile men. AB - Various epidemiologic studies have found that high scores on the Cook and Medley Hostility (Ho) scale are associated with increased risk of coronary heart disease (CHD), severity of atherosclerosis, and all-cause mortality. One plausible biological mechanism suspected of contributing to increased risk of CHD is sympathetic nervous system-mediated hyperresponsivity to environmental stressors. The present study evaluated cardiovascular reactivity among young men with high versus low Ho scores during performance of an anagram task with or without harassment. Compared to performing the task alone, harassment led to increased cardiovascular arousal that was more pronounced for the high Ho subjects than the low Ho subjects. Moreover, harassment produced increases in self-rated anger, irritation, and tension, but it was only among those subjects with high Ho scores that increased anger and irritation were associated with enhanced cardiovascular arousal. While suggesting a role for anger- and irritation-induced cardiovascular arousal in pathogenesis of CHD, these findings indicate that situation characteristics mediate the relationship between Ho scores and cardiovascular reactivity, and that there may be a differential biological link between anger/irritation and cardiovascular responses in men with high and low Ho scores. PMID- 2772106 TI - Responses of the QT interval of the electrocardiogram during emotional stress. AB - The relationship of emotional stress to the duration of the QT interval of the electrocardiogram (which contains the period of repolarization of the myocardium) was explored because QT prolongation has been shown under some circumstances to carry a risk of potentially fatal cardiac arrhythmia. A thoroughly studied case of repeated serious and ultimately fatal arrhythmia which occurred in a setting of overwhelming family and personal stress and which was preceded by marked prolongation of the QT interval prompted an experimental study of the behavior of the QT interval during stressful interviews. The subjects were 17 men and women ranging in age from 26 to 74. The experimental sessions included: 1) a period of inactivity with the subject sitting alone, 2) a period of "neutral" discussion, 3) a period of dwelling on a presumed stressful topic, followed by 4) a period of reassurance. Heart rate, respiration, arterial pressure, and the electrocardiogram were recorded throughout the four intervals together with a real time tracing of the QT interval of the electrocardiogram made by a computerized instrument recently devised by one of us (J.E.). Most of the subjects reacted to the stressful discussion with anger and resentment that was associated with shortening of QT. Two of them, however, who reacted with dejection and a feeling of being overwhelmed, displayed lengthening of QT. The QT changes were generally not linked to changes in heart rate. PMID- 2772108 TI - Annual NCDEU meeting 1988. Abridged proceedings. 28th annual meeting of the New Clinical Drug Evaluation Unit. May 31-June 3, 1988, Key Biscayne, Florida. PMID- 2772107 TI - Genetic and environmental influences for type A-like measures and related traits: a study of twins reared apart and twins reared together. AB - The relative influences of genetic and environmental factors for Type A-like behaviors and related traits were examined in the Swedish Adoption/Twin Study of Aging. The sample consisted of 99 pairs of monozygotic twins separated at an early age and reared apart, 229 pairs of dizygotic twins reared apart, 160 monozygotic pairs reared together, and 212 dizygotic pairs reared together. The average age of the Swedish Adoption/Twin Study of Aging twins at the time of data collection in 1984 was 58.6 (SD 13.6); 72% of the pairs were over 50 years of age and 60% were female. The Framingham Type A Scale, three descriptors of the Type A behavior pattern (pressure, hard-driving, and ambitious), and measures of hostility and lack of assertiveness were assessed in a mailout questionnaire. Heritability (the proportion of total variance due to genetic effects) was 27%, 28%, 43%, 37%, 20%, and 12%, respectively, for the six measures. The most conservative test of significance indicated significant genetic influence for all but the hostility and assertiveness scales. Sharing the same rearing environment was generally unimportant for twin similarity in the Type A behaviors later in life; however, 20% of the variation in the hostility and assertiveness measures could be attributed to shared family environment. Evidence for the effects of correlated post-rearing environments was found for hostility. Approximately 60% of the variation in each of the measures can be attributed to non-shared environmental experiences unique to the individual. PMID- 2772110 TI - Intravenous pulse loading of clomipramine in adolescents with depression. PMID- 2772109 TI - Comparative effects of methylphenidate on attention-deficit hyperactivity disorder with and without aggressive/noncompliant features. PMID- 2772111 TI - Open-trial maintenance nortriptyline in geriatric depression: survival analysis and preliminary data on the use of REM latency as a predictor of recurrence. PMID- 2772112 TI - Differential effects of antihypertensive medications on cognitive functioning. PMID- 2772113 TI - An evaluation of three strategies for interim analysis in an ongoing study. PMID- 2772114 TI - Effects of diazepam on recall memory: relationship to aging, dose, and duration of treatment. PMID- 2772115 TI - Fenfluramine treatment of negative symptoms in older schizophrenic inpatients. PMID- 2772117 TI - The review of clinical safety data in a new drug application. PMID- 2772116 TI - The plasma phenylalanine/large neutral amino acid ratio: a risk factor for tardive dyskinesia. PMID- 2772118 TI - Prospective study of tardive dyskinesia in the elderly. PMID- 2772119 TI - Clozapine effects on tardive dyskinesia. PMID- 2772120 TI - Vasopressin for ECT-induced memory impairment: a placebo-controlled comparison. PMID- 2772121 TI - Plasma homovanillic acid as a predictor of response to fluphenazine treatment. PMID- 2772122 TI - Treatment outcome of first episode schizophrenia. PMID- 2772123 TI - Been to America. PMID- 2772124 TI - Death certification in fractured neck of femur. AB - Fracture of the neck of the femur is a major public health problem within the elderly population of most industrialised countries whose health services are increasingly being taken up with its management. Moreover, within Britain, there is evidence of a real increase in its incidence even allowing for the ageing of the population. A condition whose aetiology is still far from clear (and where no strategy for prevention can therefore be formulated), and which is of such importance to the planning and provision of services demands detailed investigation and careful monitoring. Mortality data are an important part of epidemiological studies of disease problems and, in Britain, in resource allocation through the Resource Allocation Working Party (RAWP) formula. In this study, a cohort of 2,631 elderly patients, resident in the largest health district in the country, and admitted to hospitals over a seven year period with the diagnosis of fractured neck of femur, was assembled. Hospital records were linked to national mortality data to determine whether patients had died and, where this was so, to record underlying cause of death. A total of 930 deaths occurred within the study cohort but only 52 were certified as dying from fractured neck of femur; even amongst those who died in the hospital to which they were admitted with the fracture, less than a fifth of deaths were attributed to the fracture as underlying cause. Diseases of the circulatory system accounted for almost half of all underlying causes of death and bronchopneumonia a further 20%. These findings suggest a gross undercertification of fractured neck of femur as a cause of death in the elderly and are consistent with other studies. They may be explained by a failure of junior hospital doctors to understand the importance of accurate certification of cause of death and a misguided attempt to reduce the burden to coroners of having to consider each death from this cause.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2772125 TI - A comparative study between the use of analgesia/anaesthesia and of episiotomy in women delivered under consultant supervision or general practitioner care. AB - A retrospective cohort study based on obstetric records was performed, to compare the use of analgesia/anaesthesia during labour by consultants and general practitioners. The episiotomy rates for the two groups were also compared. 111 general practitioner patients were identified and these were matched with 111 consultant patients. No difference was found between the two groups for duration of stages I or II. The rates for episiotomy, 1 degree or 2 degrees tear or intact perineum were the same in each group. Women delivered under consultant supervision used more entonox than women delivered under general practitioner care, but this was counterbalanced by an increased use of pethidine in the latter group. No difference was found between the two groups with regard to the use of epidurals. There was an increased use of local anaesthetic by general practitioners. This was due to general practitioners preferring to use local anaesthetic for suturing after an epidural had worn off, whereas hospital doctors preferred to top-up the epidural to provide anaesthesia for suturing. This study supports the view that women delivered under the care of their own general practitioner in a hospital obstetric unit fare no worse than similar women delivered under consultant supervision. The former group have the advantage of continuity of care from their general practitioner. PMID- 2772126 TI - Schoolchildren's knowledge of cervical cancer and smears. AB - A survey of 264 schoolchildren aged 15 and 16 in four Aberdeen schools revealed that 17% had never heard of cervical cancer or smears; proportionately more of the 244 were boys and were 15 years old. Of the other respondents, when asked to locate the cervix on an anatomical drawing, nearly three-quarters placed the cervix accurately or within the cervical canal. The same proportion knew that a cervical smear involved an internal examination. Not surprisingly, more girls than boys gave correct answers. The survey was carried out to assess the need for health education before the introduction of call-up for cervical cytology at the age of 20. It is recommended that further surveys of knowledge in older teenagers would be useful before effective health education programmes can be devised to ensure a high uptake of the new screening programme. PMID- 2772127 TI - Testing the water: a GP vocational training scheme rotation in community medicine. PMID- 2772128 TI - Politics and the public health. The 1987 Duncan lecture. PMID- 2772129 TI - Risk management, public policy and informed consent: a case study. AB - The present guidelines on the use of hepatitis B vaccine in mental handicap hospitals dictate the need for an a priori identification of occupational risk, but fail to clarify how this risk should be defined. The ethical requirement of a respect for autonomy however demands that in offering vaccine as a means of protection, the choice of options must be "informed'. The determinants of institutional transmission have not been clearly defined and it is therefore difficult to inform client groups as to the degree or nature of their occupational risk. It is questionable whether the literature can support the recommendations in their present form, and supposedly "cost-effective' solutions to the problem, pay scant regard to the fact that in risk management, the relative desirability of options is conditional on the alternatives considered, how they are framed, what evidence is consulted and how consequences are weighed. In informing the policy making process, it is imperative that the values of those whose voice is seldom heard, are considered. PMID- 2772130 TI - Measles immunisation non-acceptance: validation of computer-held records and raising the vaccine uptake at early school age; the Maidstone experience. AB - The parents of all 977 resident children born in 1981 and 1982 recorded as not having received measles vaccine were contacted by letter. They were strongly advised to seek immunisation for their children and asked to complete and return a reply-paid questionnaire. Details of their children's immunisation status, reasons for non-immunisation and history of measles infection were sought, and whether they then intended to have their children immunised. The response rate was 53.3%. Of responders, 27% claimed to have written evidence that their children had already been immunised, the majority of them having been done outside the District. There was a high degree of mobility, mainly into the District, emphasising the need to record immunisation status when registering newly arrived children. The main reasons for non-immunisation were: a history of measles infection, personal or family history of fits or allergy, and mistrust of the vaccine. Many parents had been inappropriately advised by health professionals. 78 children from these cohorts are now known to have been vaccinated in the three months following the mailing and these together with the validation exercise have raised vaccination cover for 1981-born children from 74.7% to 78.9% and for 1982-born children from 77.0% to 81.4%. PMID- 2772131 TI - Studies on schistosomiasis in the Niger Delta: Schistosoma intercalatum in the urban city of Port Harcourt, Nigeria. AB - Ova of S. intercalatum have been found in the urban city of Port Harcourt in the Niger Delta area of Nigeria, following examination of stool and urine samples from 1,709 persons (5-15 years of age) resident in various parts of the city. The ova occurred only in urine, with prevalence ranging from 1.0% to 9.8% with an overall prevalence of 5.7%. The intensity of the infection was low. Most infected individuals had counts of less than 500 ova in total bladder content. There was no significant difference in either the prevalence or intensity of the infection among the sexes (Male; prevalence 6.1%, intensity 527.3 vs Female; prevalence 5.4%, intensity 500.9). No case of infection with either S. haematobium or S. mansoni was encountered in the study. Malacological surveys in the gutters, creeks, streams and stagnant waterbodies within the city showed the presence of Lymnaea natalensis, Bulinus forskalii, Pila ovata, Melanoides tuberculata, Physa sp., Lanistes ovum and Segmentorbis sp. B. forskalii is indicated as the probable vector of S. intercalatum in the city. The growing problem of urban schistosomiasis in tropical Africa is discussed. Further studies on urban transmission and epidemiology of schistosomiasis in the Niger Delta area of Nigeria is also indicated. PMID- 2772132 TI - Reproductive health of Asian women: a comparative study with hospital and community perspectives. AB - A comparative study of Asian and non-Asian women's reproductive health was performed. The hospital case notes of 48 Asian and 51 non-Asian women, matched for age, were examined. Asian women had shorter stature, bigger families, booked later for antenatal care, and were less likely to have a cervical smear taken. Of the above, 30 Asian and 24 non-Asian women were interviewed in their homes. Many Asian women had difficulties with the English language and a low literacy rate which gave rise to communication barriers during health care. Their knowledge of procedures and tests such as amniocentesis, self examination of the breast etc. was comparatively low. Fewer Asians attended parent-craft classes or did post natal exercises. Many disliked, and some refused, vaginal examination by male doctors. Despite equal access, Asian women were less well informed and made lesser use of services. Lack of knowledge and difficulties of communication, rather than negative attitudes, may explain Asian women's lesser use of services and to some extent the poor outcome of pregnancy observed in many studies. PMID- 2772133 TI - Investigating gastroenteritis: the Merseyside experience. PMID- 2772134 TI - Ionization yields in hydrocarbons under electron irradiation. AB - Ionization yields and W-values in several hydrocarbon gases under electron irradiation have been calculated using Inokuti's solution of the Fowler equation, i.e., incorporating a linear dependence of ionization yield on source electron energy. Collision stopping powers of hydrocarbons were evaluated using the Bethe formula with mean excitation energies determined using the additivity rule with modification based on molecular bond strengths. Contributions to the collision stopping powers from discrete level excitations were estimated by multiplying collision stopping powers by the excitation fractions constructed from atomic calculations. Average energy transfers for ionizing collisions producing subionization electrons were calculated using differential ionization cross sections proposed by Khare and co-workers. The calculated W-values are in good agreement with those recommended by ICRU. PMID- 2772135 TI - An isoeffect approach to the study of combined effects of mixed radiations--the nonparametric analysis of in vivo data. AB - The combined effects of mixed radiations can be examined using a system of simple isoeffect relations which are derived from a recent analysis of in vitro results obtained for a variety of radiation mixtures. Similar isoeffect analysis methods have been used for over two decades in studies of the combined action of toxic agents such as drugs and antibiotics. Because of the isoeffect approach, the method is particularly useful for the analysis of ordinal data for which conventional models that are based on parametric dose-effect relations may not be suitable. This is illustrated by applying the method to the analysis of a set of recently published in vivo data using the mouse foot skin reaction system for mixtures of neutrons and X rays. The good agreement between this method and the ordinal data also helps to provide further experimental support for the existence of a class of radiobiological data for which the simple isoeffect relations are valid. PMID- 2772136 TI - Fission fragment RBE for bone sarcoma induction. AB - Thirty beagles and 277 mice were injected with 249Cf, and 30 beagles and 274 mice were injected with 252Cf. The skeletal dose (in Gy) from 252Cf was about half from fission fragments and half from alpha particles, whereas 249Cf emits alpha particles in 100% of its transformations. Bone sarcomas (mostly osteosarcomas) were the main radiation-induced cancer. The relative biological effectiveness (RBE) of fission fragment dose relative to alpha-particle dose for bone sarcoma induction was calculated from the ratio of 249Cf/252Cf doses at equal times to bone sarcoma in (a) beagles and (b) mice, and (c) from the ratio 252Cf/249Cf risk coefficients in mice. The average RBE +/- standard deviation of the three evaluations was 0.1 +/- 0.1. The very low RBE for bone sarcomas is supported by the data of A. L. Batchelor, T. J. Jenner, and L. M. Cobb [Phys. Med. Biol. 28, 475-483 (1983)] for lung cancer induction in rats and by that of A. L. Brooks, J. A. Mewhinney, and R. O. McClellan [Health Phys. 22, 701-706 (1972)] for producing chromosome aberrations in the liver cells of Chinese hamsters. The low effectiveness of fission fragments relative to alpha particles, per gray of absorbed dose, is ascribed primarily to the much larger number of cells traversed by the alpha particles. Consideration might be given to decreasing the quality factor of fission fragments by an order of magnitude below that for alpha particles. PMID- 2772137 TI - Dose-response studies on the spermatogonial stem cells of the rhesus monkey (Macaca mulatta) after X irradiation. AB - Studies of the dose response of the spermatogonial stem cells in the rhesus monkey were performed at intervals of 130 and 160 days after graded doses of X irradiation. The D0 of the spermatogonial stem cells was established using the total numbers of the type A spermatogonia that were present at 130 and 160 days after irradiation and was found to be 1.07 Gy; the 95% confidence interval was 0.90-1.34 Gy. PMID- 2772138 TI - Evidence from nondenaturing filter elution that induction of double-strand breaks in the DNA of Chinese hamster V79 cells by gamma radiation is proportional to the square of dose. AB - We have used nondenaturing filter elution performed at both pH 7.2 and pH 9.6 to measure the induction of double-strand breaks (DSBs) in the DNA of Chinese hamster V79 cells by 60Co gamma-radiation doses between 10 and 120 Gy. The absolute DSB yields as measured by this assay were determined by using our recent calibration of the assay based upon disintegrations of 125I incorporated into the DNA. An analysis of the dose-response relationship for the induction of DSBs by 60Co gamma rays showed that the number of DSBs induced per dalton of DNA was proportional to the square of the applied dose throughout the dose range used. The contribution made by the dose to the first power was small at pH 9.6 and negligible at pH 7.2. These results suggest that DSB induction in cells by gamma rays may be entirely a two-hit event. PMID- 2772139 TI - Relative biological effectiveness of 241Am relative to 192Ir for continuous low dose-rate irradiation of BA1112 rat sarcomas. AB - Sealed sources of 241Am have been developed for intracavitary irradiation of gynecological cancers. Relative to conventional isotopes (that is, 226Ra, 137Cs, 192Ir), 241Am allows for better shielding of dose-limiting normal tissues in the patient. In addition, the long half-life of 241Am (432 years) makes it an attractive isotope both for clinical use and for long-term radiobiology studies. Using a previously developed in vivo applicator system, BA1112 sarcomas on WAG/Rij Y rats were irradiated using 241Am or 192Ir at three different dose rates. Following in vivo treatment of the sarcomas with graded doses of radiation, cell survival curves were determined using an in vitro colony formation assay. The slopes of the resulting cell survival curves were observed to increase significantly as the dose rate increased from 0.30 to 0.60 Gy/h, then to decrease slightly as the dose rate increased from 0.60 to 0.95 Gy/h. The relative biological effectiveness (RBE) of 241Am relative to 192Ir was observed to increase linearly with increasing dose rate; the RBEs were 0.96 +/- 0.009, 1.09 +/- 0.12, and 1.17 +/- 0.11 at dose rates of 0.30, 0.60, and 0.95 Gy/h, respectively. PMID- 2772140 TI - Morphological and functional changes in the rat heart after X irradiation: strain differences. AB - The hearts of mature male rats of the Wistar and Sprague-Dawley strains were locally irradiated with single doses of 17.5 and 20.0 Gy of X rays, respectively. These two dose levels had previously been shown to result in a comparable latent period between irradiation and the death of rats of these two strains from cardiac failure. Morphological changes in the myocardium and modifications in cardiac function were assessed in the animals at 28, 70, and 100 days after irradiation. The first radiation-induced change which was observed in the myocardium was a rapid decline in capillary density and a loss of alkaline phosphatase activity by the capillary endothelial cells. The capillary density was reduced to approximately 50% of that of unirradiated control values at 28 days and to approximately 40% of the control values between 70 and 100 days after irradiation. The loss of enzyme activity was also detected at 28 days. Examination of histological sections showed an increase by 70 days in the areas with negative enzyme activity up to approximately 70% of the myocardium. The reduction in capillary density and the loss of enzyme activity occurred before any marked pathological changes were seen in the myocardium. The pathological lesions seen in the myocardium at 100 days after irradiation were qualitatively and quantitatively the same in the two strains of rat. Measurements of cardiac output in Sprague-Dawley rats showed a gradual decline in output after irradiation; however, measurements in Wistar rats showed a progressive increase in cardiac output over the same period of time. It was shown by rubidium extraction that there was an increase in the percentage of the total cardiac output distributed to the ventricular muscle of Sprague-Dawley rats, while similar measurements in Wistar rats showed no significant change. In spite of the marked strain differences observed in cardiac output and rubidium extraction, blood perfusion per gram of ventricular muscle was apparently not modified in both strains of rat after irradiation. These findings indicated that the correlation between morphological effects after irradiation and the functional expression of damage is highly complex. PMID- 2772141 TI - Changes in the nuclear protein kinase activities in the regenerating liver of partially irradiated rat. AB - X rays (4.8 Gy) inhibit both DNA synthesis and phosphorylation of histone H1 in the regenerating liver of the rat. To determine the cause of the inhibition of histone H1 phosphorylation, changes in the nuclear protein kinase activities during the prereplicative phase of regeneration were measured. The cAMP-dependent protein kinase activity was low during regeneration, and the changes in the activity were not statistically significant. The cAMP-independent protein kinase activity increased at 15 h, decreased at 18 h, and increased again at 24 h after partial hepatectomy. X irradiation prior to partial hepatectomy did not inhibit the increase at 15 h, but it did inhibit the increase at 24 h. The activity was not inhibited by isoquinolinesulfonamide inhibitors such as H-7, and it was activated by a commercial preparation of an inhibitor protein of the cAMP dependent kinase. It was also inhibited by quercetin. The possibility that the radiation-sensitive nuclear protein kinase is a nuclear cAMP-independent protein kinase specific for histone H1 is considered. PMID- 2772142 TI - Radiobiology of ultrasoft X rays. III. Normal human fibroblasts and the significance of terminal track structure in cell inactivation. AB - Ultrasoft characteristic X rays from carbon (0.28 keV) are severely attenuated as they pass through biological material, causing a nonuniform distribution of dose to cell nuclei. Complications of studying ultrasoft X rays can be minimized in this context by using cells with very thin cytoplasm and nuclei (e.g., less than the attenuation length of the X rays), and which exhibit a more nearly exponential dose response to cell killing, such as normal human fibroblasts compared with V79 cells. Using this cell system, we report the relative biological effectiveness (RBE) of A1-K and C-K X rays to be near unity. Previous studies of cell inactivation by characteristic carbon X rays gave RBEs of 3 to 4, supporting the idea that localized energy depositions from secondary electrons and primary track ends represent the principal mode of biological action for other low-LET radiations. In part, the reported high RBEs result from the use of mean dose to describe energy deposited within the cell nuclei by these poorly penetrating radiations. Implicit in the use of mean dose is that cellular damage varies linearly with dose within a critical target(s), an assumption that is of questionable validity for cells that exhibit pronounced curvilinear dose responses. The simplest interpretation of the present findings is that most energy depositions caused by track-end effects are not necessarily more damaging than the sparsely ionizing component. PMID- 2772143 TI - Radiobiology of ultrasoft X rays. IV. Flat and round-shaped hamster cells (CHO 10B, HS-23). AB - The results reported earlier in this series indicated that the relative biological effectiveness (RBE) of ultrasoft X rays decreases with decreasing cell thickness, approaching unity for the thinnest cells used, plateau-phase human skin fibroblasts (HSF). The possible dependence of RBE on the configuration of the cell nucleus is investigated further in this paper using two CHO cell lines that attach well and have similar intrinsic radiosensitivities to 60Co gamma rays. One of the lines forms monolayers similar to V79 cells, while the other remains more spherical during growth. We find an increasing RBE with decreasing X ray energy for both of these cell lines, consistent with our results using V79 cells. Also consistent with our results obtained with 10T1/2 and HSF cells, we find an increasing RBE with increasing cell thickness. The possible dependence of RBE on radiosensitivity and the use of the concept of mean dose for ultrasoft X rays is discussed. PMID- 2772144 TI - A comparison of the effects of photodynamic therapy on normal and tumor blood vessels in the rat microcirculation. AB - The effects of light activation of the tumor photosensitizer dihematoporphyrin ether (DHE) were studied in the microcirculation of the rat cremaster muscle. Arterioles and venules in an implanted chondrosarcoma were studied by in vivo television microscopy and were compared to normal vessels of the same size elsewhere in the preparation and in control preparations. Activation with green light (530-560 nm, 200 mW/cm2, 120 J/cm2) 48 h after intraperitoneal injection of DHE (10 mg/kg body wt) resulted in significant narrowing of diameters of red blood cell columns in tumor arterioles and venules. The response in normal and control arterioles and venules was not significantly different from that seen in the tumor vessels except that the control arterioles did not remain significantly constricted during the treatment period. Treatment resulted in stasis of blood flow in 90% of tumor and normal arterioles at the completion of light activation. In venules, stasis of blood flow was observed in 75% of tumor and 70% of normal vessels. Vasoconstriction was the primary response in arterioles, while thrombosis predominated in venules. Morphologic assessment of light-activated vessels in the cremaster preparation by transmission electron microscopy revealed platelet aggregation with damage to endothelial cells and smooth muscle cells. Perivascular effects observed included interstitial edema and damage to skeletal muscle cells. In the tumor-bearing preparation, no direct cytotoxic effect on the tumor cells was shown. The surrounding vessels exhibited similar vascular stasis, but the lining cells appeared minimally affected. Photoactivation of DHE results in significant changes in the microcirculation which lead to stasis of blood flow. In this model, the response was similar for the normal microvasculature and for the microcirculation of an implanted chondrosarcoma. These effects may account, in part, for the mechanism of action of photodynamic therapy. PMID- 2772145 TI - The dose-response relationships for myeloid leukemia and malignant lymphoma in BC3F1 mice. AB - The present analysis of data on the induction of lymphoma and myeloid leukemia in BC3F1 mice has indicated some new and interesting aspects regarding the shapes of the dose-effect curves. The incidence data can be interpreted by radiobiological models of the induction process coupled with cell inactivation. In particular, for malignant lymphoma the dose-response curve after X rays can be described assuming a quadratic model corrected for cell inactivation, while the incidence data after fission neutrons are best fitted by a linear model which also allows for cell inactivation. Myeloid leukemia has also been induced in BC3F1 mice. The bell-shaped dose-response curves observed after irradiation with either X rays or neutrons are explained by assuming simultaneous initial transforming events and cell inactivation with the data for cell inactivation at higher doses being in agreement with data reported for other strains of mice. A value for relative biological effectiveness of 4 is obtained at the lowest neutron dose used. The value of the inactivation parameters can be compared with those of the cell inactivation probability per unit dose for the bone marrow hematopoietic stem cells, which are believed to be the target cells for these tumors. PMID- 2772146 TI - An in vitro micronucleus assay for determining the radiosensitivity of hepatocytes. AB - An in vitro micronucleus assay was developed for primary cultures of rat hepatocytes and utilized to determine the oxygen enhancement ratio (OER). Freshly isolated Fischer 344 female rat hepatocytes were irradiated in suspension either in air or in anoxia, cultured for 60 h to allow for the maximum expression of micronuclei, fixed with methanol-glacial acetic acid, stained with the fluorescent dye 4',6-diamidino-2-phenylindole (DAPI), and scored with a fluorescent microscope for the presence of micronuclei. The percentage of cells with micronuclei increased linearly with dose, and the slopes of the relationships were 0.044 +/- 0.001 Gy-1 and 0.015 +/- 0.001 Gy-1 in air and anoxia, respectively. The calculated OER of 2.9 +/- 0.5 is similar to that previously obtained for hepatocyte cell survival. Our data demonstrate that this in vitro hepatocyte micronucleus assay is a rapid and sensitive method to further investigate those factors which influence the radiosensitivity of hepatocytes. PMID- 2772147 TI - DNA supercoiling changes in nucleoids from irradiated L5178Y-S and -R cells. AB - DNA supercoiling ability was assayed following irradiation in two cell lines of differing radiosensitivity, L5178Y-S (LY-S) and L5178Y-R (LY-R). Cells treated with NaCl and Triton X-100 were exposed to increasing concentrations of the fluorescent, DNA-intercalating dye, propidium iodide (PI), and the diameter of the resulting fluorescent halo of DNA was measured. As the PI concentration was increased from 0.5 to 5 micrograms/ml, halo diameter increased from 20-25 to 45 55 microns due to the unwinding of the DNA supercoils. This process was similar for both cell lines under all conditions studied. As the PI concentration was increased to 50 micrograms/ml, the halo rewound to a diameter of 25-30 microns in unirradiated cells from both lines. However, following exposure to 3-12 Gy of 137Cs gamma rays, the ability of the DNA to be rewound was inhibited in a dose dependent manner. Rewinding inhibition was greater in LY-S cells than in LY-R cells. Since the induction of DNA damage (e.g., single-strand DNA breaks) appears to be the same for both cell lines, this result implies that a similar extent of damage results in a greater loss of topological constraints on the DNA loops in LY-S. Such a change might be related to the protein composition of the nucleoid cores. One-dimensional sodium dodecyl sulfate-polyacrylamide gel electrophoresis demonstrated that nucleoids from LY-S cells were missing a 55-kDa protein present in LY-R. PMID- 2772148 TI - The threshold question and the search for answers. PMID- 2772149 TI - Comments on "It is Time to Reopen the Question of Thresholds in Radiation Exposure Responses" by J. R. Totter. PMID- 2772151 TI - [Results of combined operative-radiologic therapy of bladder cancer from the viewpoint of optimizing the physical-technical irradiation planning]. AB - In 294 patients with bladder carcinoma, in which after transurethral or transvesical operation a high-voltage irradiation with daily 1.5 Gy and a total target dose of 60 Gy (four fields cross firing technique) was done, the influence of quality of physical-technical irradiation planning is studied on survival rates, portion of recurrences, side-, and late effects. The group of patients with individually computer-based optimizing of irradiation parameters based on a patient's cross-section, ascertained on therapy simulator, significantly shows better results with regard to above-mentioned criteria than the groups of patients with standard irradiation technique without and with definition of bladder topography. PMID- 2772150 TI - [Therapy of carcinoma of the oral cavity and the mesopharynx]. AB - From the period 1969-1984 the progresses of 93 patients could be analysed, which were treated because of a squamous cell carcinoma of the mouth-cavity and the mesopharynx. Different therapeutic modalities and the prognostic relevance of locoregional tumor starting situation were analysed at criterion of survival. 44.8% of tumors of category T1, 23.3% of T2, 22.2% of T3 and 0% of T4 lived 5 years later. Only 18 months later T4-tumors turned prognostically worse. Only in fixed lymph-node of the neck (N3-category) the prognosis grew worse in our patients. The global 5-years-survival was 25.8% only. Sole operation and combination of short-time preirradiation, operation and postoperative dose saturation gave the same 5-years-survivals (40% or 43%), in prognostically more auspicious patients in starting situation for the sole operation. From the groups of combined radiologically-surgically treated patients these ones were observed separately, whose tumors could not be removed within the healthy tissue. In these patients a pre- and postoperatively irradiation shows a little better results than postoperative radiotherapy alone, both concerning the mean survival and the 5-years-survival too. For carcinomas of the mouth-cavity (T1N0) the sole operation is the adequate treatment. For all the other cases the medium-high short-time preirradiation with operation and, depending on findings, postoperative dose-saturation should be considered. Plastic reconstructive measures can be planned 24 months later, because after this period the survival rates stay constant. PMID- 2772152 TI - [A catalog of computer programs for dosimetric irradiation planning]. AB - A catalogue of computer-based programmes for dosimetric irradiation planning is described, that was elaborated according to the programme of the joint research of the CMEA-countries on field of radiotherapy of malignant tumors in the years 1983-1985. The catalogue includes 55 programmes from 11 research-centres in Hungary, the GDR, Poland, the USSR, and the CSSR: 23 programmes are determined for dosimetric planning of distant irradiation, 13 for intracavitary, 7 for interstitial, 6 for combined irradiation, and 6 for radiobiological planning. 26 programmes are used to optimize the dose fields by selection of adequate irradiation conditions. The catalogue includes 42 tables, which in details inform on possibilities of the programmes, on radiotherapeutic equipments, which were these programmes elaborated for, and on their clinical use. The problem is discussed to procure the catalogue. PMID- 2772153 TI - [A procedure for determining the dose distribution behind block shields. I. A computational method of determining the scatter distribution of a 60Co pencil beam]. AB - The energy dose distribution of a photon pencil beam ray for photons with the primary energy of 1.25 MeV is determined using the Monte-Carlo-method. The found energy dose distribution underlies the calculation of spreading additive-air ratio for extended 60Co-irradiation fields. The spreading additive-air-ratios, found by the model, show good correspondence with known values from literature. PMID- 2772154 TI - [A procedure for determining the dose distribution behind block shields. II. Calculation of the dose distribution of 60Co radiation fields using a pencil beam model]. AB - A model to calculate dose distribution behind block shielding is represented in a water equivalent medium for 60Co-radiation. The model is based on integration of spread dose distribution of a pencil beam over the total irradiation area. It is suitable to estimate dose distribution for an irregularly shaped irradiation field. PMID- 2772155 TI - [Functional interactions of the adrenal cortex and liver in rats following x-ray irradiation]. AB - In rats the roentgen irradiation with lethal doses results in an essential decrease of liver capacity to metabolise corticosteroids with increasing secretion activity of adrenal cortex. That is a sign for increasing waste of reciprocal control of adrenal gland and liver, that is indispensable to maintenance of corticosteroid hemostasis. PMID- 2772156 TI - [X-ray irradiation of the human epidermis in vitro. II. Comparison of a single 44 kV and 200 kV x-ray irradiation]. AB - On example of the reduction of epidermal binding of FITC-wheat germ agglutinin (WGA) the direct membrane effect of a single roentgen irradiation (44 kV and 220 kV) was analysed in vitro. Human normal skin and psoriasis centre were compared. Normal skin showed no alteration of light-microscopically visible FITC-WGA binding on epidermal cells over the whole doses range. Psoriatic lesions responded to doses of greater than or equal to 5 Gy (44 and 220 kV) with a drastic reduction of epidermal lectin adhesion to lower and middle cell layers. The maximum of efficacy was with 5 Gy (44 kV) or 10 Gy (220 kV). A dose elevation up to 20 Gy did not result in an increase of efficacy. Topographically the radiosensitive FITC-WGA-binding could be seen in the rete ridges above all. The findings support the impression of an increased radiosensitivity of the lesional psoriasis epidermis compared with normal skin. The causes for this are seen in an abnormal differentiation of keratinocytes in psoriasis. PMID- 2772157 TI - Testing a combined radiation protection modality: chemical protector and local shielding. AB - The impact of combined radiation protection upon damage to critical organs spleen, small intestine, and bone marrow was studied in adult rat males 3 days after whole-body exposure to 9.5 Gy gamma-ray dose. Adeturone, the chemical radioprotector used, was administered intraperitoneally at 1/17 of its LD50 dose. Local shielding of the abdomino-lumbal region was accomplished using a lead ring providing on average 28-30% attenuation of radiation exposure. This degree of physical abdomino-lumbal protection combined with adeturone (50 mg/kg) pretreatment resulted in mutual enhancement of the components' action, expansion of the chemical agent's therapeutic range, providing a combination with improved overall antiradiation properties. PMID- 2772158 TI - Diagnostic imaging of pediatric skeletal trauma. AB - Because many injuries to the pediatric skeleton are unique and can present with only subtle radiographic abnormalities, familiarity with their appearance can aid in accurate diagnosis. These include physeal injuries, incomplete fractures, and avulsion injuries. Recognition of characteristic fractures also allows correct identification of a battered child. As illustrated in examples of injury to the elbow, an organized search for clues to abnormal alignment is particularly helpful in the evaluation of pediatric skeletal trauma. PMID- 2772159 TI - Diagnostic imaging of fracture complications. AB - Fracture complications as discussed in this article are those abnormalities occurring as a direct result of or in association with a fracture or dislocation. Complications with radiographic findings are stressed, although those without definite radiographic manifestations are mentioned for the sake of completeness. PMID- 2772160 TI - Musculoskeletal trauma. PMID- 2772161 TI - Diagnostic imaging of craniofacial fractures. AB - This article reviews common fractures involving the facial skeleton and describes their typical radiographic appearance. The roles of conventional radiography, supplemental projections, conventional tomography, and computed tomography are discussed. Nasofrontal, orbital, zygomatic, maxillary, and mandibular fractures are described and illustrated. PMID- 2772162 TI - Diagnostic imaging of spinal trauma. AB - The radiologist has a pivotal role in evaluation of spinal trauma patients because proper treatment cannot begin before the abnormality is diagnosed. Plain films remain the screening modality of choice, and by understanding the radiographic signs of injury, patterns produced by various traumatic mechanisms can be recognized. As radiologists we can then provide insight to our clinical colleagues into the optimal methods of further investigation. The objective is to eliminate the possibility of further damage and to identify lesions amenable to correction. PMID- 2772163 TI - Diagnostic imaging of pelvic and chest wall trauma. AB - Imaging of patients with pelvic trauma begins with a logical approach to plain radiographs. These films reveal the probable mechanism of injury and suggest a rationale for emergent reduction. Radiographs, along with the clinical impression, suggest the likelihood of associated soft tissue injury, possibly requiring further specific radiographic studies. Significant vascular injury most often accompanies disruption of the posterior pelvic ring. Bladder and urethral trauma may be suspected in any displaced type III pelvic fracture with suggestive clinical signs. Ideally, urethrography precedes bladder catheterization. Acetabular fractures must be recognized because of their implications for future hip joint function. CT is very helpful in definitive treatment planning of pelvic (especially acetabular) fractures but may be delayed until other life-threatening injuries have been addressed. Plain radiography is also well suited to evaluation of chest wall trauma. When multiple ribs are fractured in two places, the radiologist should suggest the possibility of flail chest. Sternal fractures and multiple rib fractures, including the first three ribs, may herald life threatening vascular or cardiac damage. To summarize, the radiologist contributes most to the care of the trauma patient by recognizing roentgen patterns of injury, knowing which are commonly accompanied by damage to critical soft tissues, and performing the indicated radiographic studies efficiently. PMID- 2772164 TI - Conventional tomography in musculoskeletal trauma. AB - Conventional tomography utilizes controlled blurring of overlying structures, in effect, to remove these possible obscuring overlying structures and permit improved evaluation of anatomic detail within the specific layer or focal plane of interest. Although it has largely been replaced by true sectional imaging modalities such as CT and MR imaging, it remains a valuable tool in specific settings as in musculoskeletal trauma. It is particularly useful when the orientation of the pathology requires coronal or sagittal planes for optimal evaluation. PMID- 2772165 TI - Spontaneous subcapsular and perirenal hematomas. PMID- 2772166 TI - Radiology department organization and radiology education. Reply: The organization of a modern radiology department. PMID- 2772167 TI - Radiology department organization and radiology education. Reply: How should radiology residencies be structured? How should radiology departments be organized? Proposals for the 1990s. PMID- 2772168 TI - Coronary angiographic abnormalities in mucocutaneous lymph node syndrome: acute findings and long-term follow-up. AB - Coronary arterial changes in mucocutaneous lymph node syndrome were evaluated by retrospectively analyzing 62 coronary angiograms of 42 patients with abnormal coronary arteries. A total of 108 aneurysms on the initial studies were classified as follows: eight diffuse, 18 saccular, and 50 fusiform aneurysms and 32 localized areas of dilatation. These were also classified as large, medium, or small aneurysms. Approximately one-third of the aneurysms were in the right coronary artery and two-thirds in the left. Seventy percent of the aneurysms were located in the proximal portion of the coronary artery, 16% in the middle portion, and 14% in the distal portion. Sixteen patients were followed up with angiography for periods ranging from 4 months to 8 years 11 months. At follow-up, 48% of the 62 aneurysms had regressed to normal, 37% were diminished in size, and 10% were unchanged. Small and medium-sized aneurysms frequently showed complete regression. In contrast, large aneurysms tended to persist, and stenotic lesions formed at or adjacent to the aneurysm in 41%. Aneurysms larger than 9 mm in diameter, especially those that were diffuse in shape, carried a high risk of subsequent total occlusion. PMID- 2772169 TI - Subtalar joint coalition in children: new observations. AB - Eleven children with clinical and radiographic findings suggestive of nonosseous subtalar coalition were found to have fibrous bridges at the time of surgery. A second group of 14 children with similar clinical and radiographic findings is being conservatively treated at present. This series of children suggests that a common site of nonosseous subtalar coalition is found posterior to the sustentaculum tali. Diagnosis of nonosseous coalition requires careful examination with computed tomography, with attention to subtle changes in the hindfoot, particularly posterior to the sustentaculum tali. PMID- 2772170 TI - Comparison of scanning equalization and conventional chest radiography. AB - A clinical comparison study of scanning equalization radiography (SER) and conventional chest radiography was performed with the latest prototype SER system. Conventional chest radiography was performed at 120 kVp with Lanex regular screens (Eastman Kodak, Rochester, NY) and Kodak Ortho-G or Ortho-C film (Eastman Kodak). The 253 volunteer patients were examined with both techniques. The chest radiographs were interpreted by four radiologists. The study group was composed of 58 normal and 195 abnormal posteroanterior and lateral chest radiographs. In 31 cases there were two major radiologic diagnoses. The number of correct interpretations increased when the SER images were examined, compared with the conventional Ortho-G (chi 2 = 4.17, P less than .05) and conventional Ortho-C (chi 2 = 16.9, P less than .001) radiographs. The overall accuracy of disease detection improved for all radiologists with the SER system. There was no disease category in which the accuracy of interpretation decreased when the SER system was used. The SER system is a clinically reliable method of improving image quality and increasing diagnostic accuracy. PMID- 2772171 TI - Tumors of the bronchi: role of evaluation with CT. AB - Computed tomography (CT) was performed in 142 patients thought to have an endobronchial tumor based on clinical or radiologic grounds. In 121 patients an endobronchial mass was confirmed at bronchoscopy with biopsy or at surgery. The CT scans were evaluated independently by two experienced observers (A and B). For statistical purposes the result in each single bronchus from the level of the trachea to the segmental bronchi was considered separately. A total of 361 abnormal and 1,413 normal bronchi were confirmed with bronchoscopy or surgery. Observers A and B identified 100% and 99%, respectively, of the abnormal bronchi and 97% and 96%, respectively, of the normal bronchi on CT scans. For the standard CT examination (8-mm-thick sections) a sensitivity of 94% (observer A) or 91% (observer B) and a specificity of 99% (observers A and B) were found in the diagnosis of a normal or narrowed bronchial lumen. CT proved to be a reliable method for demonstrating tumor lesions of the bronchi. PMID- 2772172 TI - Right upper lobe versus right middle lobe: differentiation with thin-section, high-resolution CT. AB - A new method was developed to differentiate the upper lobe from the middle lobe of the right lung with thin-section, high-resolution computed tomography. In the upper lobe, a medial subsegmental bronchus of an anterior segmental bronchus is always located lateral to the corresponding artery. In the middle lobe, a medial subsegmental bronchus of a lateral segmental bronchus and a superior and inferior subsegmental bronchus of a medial segmental bronchus are always located medial to the corresponding artery. In other words, the anatomic relationship between the subsegmental bronchi and the corresponding pulmonary arteries in the upper lobe is opposite to that in the middle lobe. One hundred seventeen cases, including 54 cases of lobar volume loss, were reviewed with this method, and in each case it was possible to differentiate the upper lobe from the middle lobe without the contiguous section analysis. PMID- 2772173 TI - Mediastinal histoplasmosis granuloma: evaluation with CT. AB - Mediastinal granuloma secondary to histoplasmosis was described in three patients. Computed tomographic scans in each patient demonstrated a large, low attenuation mediastinal mass crossed by enhancing septae. Other granulomatous diseases may produce similar abnormalities. The differential diagnosis of such lesions was discussed. PMID- 2772174 TI - Disappearing breast calcifications. AB - Seventeen patients aged 47-67 years had 20 foci of disappearing breast calcifications. Firm compression was used to obtain craniocaudal and oblique mediolateral views of each patient. The authors categorized calcifications according to shape, size, number, position, and likelihood of benignity or malignancy. The right breast was the site of disappearing calcifications more often than the left. The most common configuration of disappearing calcifications was round or oval. All calcifications but one were found in dense glandular areas of the breast. Dense glandular tissue within 1 cm of the border with the stroma was the most common location. Only one of 20 foci suggested malignancy. The disappearance of breast calcifications is uncommon but probably not rare. PMID- 2772175 TI - Carcinoid tumors: iodine-131 MIBG scintigraphy. AB - Eighty-two patients with pathologically proved carcinoid tumors were examined with iodine-131 metaio-dobenzylguanidine (MIBG) scintigraphy. Localization scores of I-131 MIBG accumulation in the primary tumor or metastatic site ranged from 0 to 3+ on the basis of comparison with normal liver. I-131 MIBG uptake varied greatly in different patients with carcinoid tumors. The localization scores in known tumor sites were related to the location of the primary tumor in the stomach (1-3+ in two of five patients), pancreas (1-3+ in four of five patients), cecum (3+ in two of two patients), appendix (0 in one of one patient), jejunum (0 in one of one patient), Meckel diverticulum (3+ in one of one patient), terminal ileum (2-3+ in 19 of 28 patients), bronchus (3+ in one of nine patients), thymus (1+ in one of two patients), and unknown (2-3+ in 18 of 28 patients). Tumors of midgut origin concentrated I-131 MIBG more frequently than those of foregut origin. Uptake of I-131 MIBG was more likely if neurohumor levels, particularly serum serotonin, were elevated. There was no relationship of I-131 MIBG uptake to carcinoid syndrome. I-131 MIBG is useful in the determination of the location and extent of some carcinoid tumors, particularly those of midgut origin. PMID- 2772176 TI - Small bowel phytobezoars: detection with radiography. AB - The authors reviewed the radiographic findings in 19 patients with phytobezoars of the small bowel. The most common predisposing causes were previous gastric outlet surgery and persimmon ingestion. Twelve patients underwent contrast material-enhanced studies of the upper gastrointestinal tract, and one patient underwent a barium enema study. These examinations revealed four gastric, two duodenal, and eight small bowel phytobezoars in 10 patients. The obstruction caused by small bowel phytobezoars frequently occurred in the jejunum or proximal ileum, more proximally than has been reported in previous series. Barium studies are useful in differentiating obstruction due to postoperative adhesions from obstruction caused by bezoars. In addition, barium studies enable the detection of residual gastric bezoars. This information has important implications in patient treatment because bezoar obstruction is unlikely to respond to conservative treatment, and concurrent gastric bezoars must be removed to prevent recurrent bowel obstruction. PMID- 2772177 TI - Colonic perforation: complication of automatic implantable cardioverter defibrillator placement. AB - Massive pneumoperitoneum developed 3 days after placement of an automatic implantable cardioverter defibrillator in a 75-year-old man. A subsequent computed tomographic examination revealed generator wires passing through the subxiphoid colon. Partial colectomy was performed, the generator was removed, and the wires were moved. The postoperative course was uneventful. PMID- 2772178 TI - Coronary artery calcifications: significance of incidental detection on CT scans. AB - A scoring system was devised for the assessment of coronary artery calcifications apparent on computed tomographic (CT) scans, with width and length used to assess severity. The degree of calcification was compared with the presence of stenoses of 70% or greater at cardiac catheterization in 46 patients who underwent both studies. Although many significantly stenosed vessels showed no calcification, heavy calcifications had a high positive predictive value for significant disease. In a separate branch of the study, the perioperative cardiac morbidity and mortality were compared in 30 age- and sex-matched pairs of patients undergoing thoracotomy who did and did not have coronary calcifications on CT scans obtained before surgery. Patients with calcifications had a higher frequency of cardiac complications, including arrhythmias, ischemia, hypotension, myocardial infarction, and death. PMID- 2772179 TI - Reperfused and nonreperfused myocardial infarction: diagnostic potential of Gd DTPA--enhanced MR imaging. AB - Forty-five patients with suspected acute myocardial infarction were examined with magnetic resonance (MR) imaging before and serially up to 30 minutes after intravenous injection of gadolinium diethylenetriaminepentaacetic acid (DTPA), 0.1 mmol/kg of body weight. Coronary angiography after thrombolytic therapy was performed in all patients to assess reperfusion. Intensity ratios between both reperfused and nonreperfused infarcted areas and normal myocardium increased significantly up to 15-20 minutes after administration of Gd-DTPA and were still elevated 30 minutes after injection (P less than .0001). In accordance with the findings in experimental studies, four distribution patterns of infarct enhancement were observed. The overlap in enhancement patterns and similar maximal intensity ratios after Gd-DTPA administration for both reperfused and nonreperfused infarcts preclude a reliable differentiation on the basis of these factors alone. Significant enhancement of both reperfused and nonreperfused infarcts allows adequate infarct imaging up to at least 30 minutes after administration of Gd-DTPA. PMID- 2772180 TI - Perforation of the inferior vena cava with aortic and vertebral penetration by a suprarenal Greenfield filter. AB - Various complications have been reported after insertion of the Greenfield filter. This report describes an unusual complication after suprarenal placement of this filter: spreading of the filter struts, with perforation of the inferior vena cava, and penetration of the aorta and a vertebral body, followed by fracture of one of the struts. PMID- 2772181 TI - Urinary bladder neoplasms: evaluation with contrast-enhanced MR imaging. AB - Forty-eight patients with urinary bladder neoplasms were examined with magnetic resonance imaging before and after intravenous administration of gadolinium diethylene-triaminepentaacetic acid (DTPA). Spin-echo sequences with short repetition and echo times were used in all patients; in 20 a gradient-echo technique was used to perform sequential imaging. In 31 patients ratios of tumor signal intensity to that of fat, muscle, and bone marrow were calculated before and after Gd-DTPA enhancement on T1-weighted spin-echo images. Increases in tumor signal intensity on T1-weighted spin-echo images were statistically significant after contrast enhancement (alpha = 1%, P less than .0001). The average rise in relative signal intensity after contrast enhancement was 120% for the tumor-fat ratio (tumor-marrow ratio, 105%; tumor-muscle ratio, 85%). Tumor signal intensity peaked within 120 seconds and remained on a plateau for up to 45 minutes. Necrotic tissue within the tumor, seen in three cases, was detectable only on contrast-enhanced images. PMID- 2772182 TI - Hysterosalpingography with a balloon catheter versus a cannula: evaluation of patient pain. AB - The amount of procedural and post-procedural pain due to hysterosalpingography performed with a standard cannula (28 patients) versus a balloon catheter (23 patients) was compared. Patients completed questionnaires in which they rated the pain they experienced during insertion of the instrument, during injection of contrast material, immediately after the examination, several hours after the examination, and over the next 6 days. The balloon catheter produced less discomfort during the procedure but significantly more discomfort after the procedure than did the standard cannula. These results indicate that hysterosalpingography with the balloon catheter is not as painless as has been claimed. PMID- 2772183 TI - P-31 MR spectroscopy in assessing testicular torsion: rat model. AB - To develop phosphorus-31 magnetic resonance (MR) spectroscopy as an indicator of testicular viability, unilateral 720 degrees torsion of the spermatic cord was performed in 11 Copenhagen rats. In six of 11 rats, detorsion was done 1 hour later. The authors used special surface coils to obtain P-31 MR spectra (at 2 T) from both tests, then correlated MR findings with those from gross morphologic and histologic examination. In the normal testis, P-31 MR spectra had prominent phosphomonoester (PME) and adenosinetriphosphate (ATP) peaks. Testicular torsion dramatically reduced ATP to almost undetectable levels and significantly decreased the PME/Pi at 1 hour (1.18 +/- 0.22) in nine rats. In two rats, however, no spectral changes were present. Of the six rats in which detorsion was performed, three showed immediate regeneration of ATP and a normal PME/Pi (2.87 +/- 0.06) 3 hours later; testicles in the other three rats did not recover (PME/Pi = 0.72 +/- 0.01). Because gross morphologic observations and histologic findings prior to detorsion were unable to differentiate viable from nonviable tests, these preliminary data suggest P-31 MR spectroscopy may help clinicians diagnose testicular torsion and assess testicular viability. PMID- 2772184 TI - Graves ophthalmopathy: MR imaging of the orbits. AB - Thirty-nine patients with Graves ophthalmopathy were examined with magnetic resonance (MR) imaging at 0.5 T with use of a surface coil. T1- and T2-weighted spin-echo images were obtained, and T2 relaxation times of eye muscles and retrobulbar fat were calculated from a multiecho sequence. Normal values for T2 relaxation times of eye muscle were obtained by examining nine control subjects. MR imaging demonstrated eye muscle enlargement in 23 patients. Visual examination of T2-weighted and calculated T2 images showed areas of high signal intensity in enlarged eye muscles of 12 of 23 patients. Calculated T2 relaxation times of eye muscles differed significantly between control subjects and patients with stage III and IV disease. Signal intensity characteristics of these changes, as well as their correlation with well-known histologic findings, suggested their interpretation as edema caused by acute inflammation. Since computed tomography is not able to depict eye muscle edema, the MR findings of structural changes within enlarged eye muscles might have an impact on therapeutic decisions concerning the application of anti-inflammatory drugs. PMID- 2772185 TI - Benign and malignant sinonasal lesions with intracranial extension: differentiation with MR imaging. AB - Most sinonasal lesions that extend into the anterior cranial fossa are malignant tumors. However, benign inflammatory polypoid disease can also rarely be manifested in this manner. Fourteen surgically proved cases of such benign and malignant disease were studied with magnetic resonance (MR) imaging. The appearances of the benign and the malignant lesions were quite different and allowed the seven chronic polypoid lesions to be distinguished from the tumors. The benign lesions had nonhomogeneous appearances on MR images due primarily to varying degrees of free-water resorption and protein concentration. The tumors had primarily homogeneous low-to-intermediate signal intensities due to their highly cellular composition. PMID- 2772186 TI - Trigeminal neuralgia: MR imaging features. AB - Magnetic resonance (MR) imaging was used to evaluate the relationship of the cisternal portion of the fifth cranial nerve to surrounding vascular structures in six patients with documented trigeminal neuralgia and in 85 asymptomatic patients. MR imaging clearly demonstrated the course of the fifth nerve from its root entry zone (REZ) to the Meckel cave and its relationship to the surrounding vertebrobasilar system. In the six patients with trigeminal neuralgia, the presence of a vascular structure at the REZ of the fifth nerve was identified. In the 85 asymptomatic patients, examination of 170 trigeminal nerves revealed that 30% had contact between a vascular structure and the fifth nerve at the REZ, but only 2% had actual deformity. These results indicate that although neurovascular contact may be asymptomatic, MR demonstration of a vascular structure at the REZ of the fifth cranial nerve in a patient with trigeminal neuralgia may implicate this as the cause of symptoms, which may influence the treatment of choice. Because of the inherent limitations of computed tomography in the visualization of posterior fossa structures, MR imaging should be considered the initial screening procedure in the assessment of patients with trigeminal neuralgia. PMID- 2772187 TI - Reduced-bandwidth MR imaging of the head at 1.5 T1. AB - A decrease in the magnetic resonance (MR) imaging bandwidth can be used to increase the signal-to-noise ratio (S/N) at constant imaging time or to maintain the S/N for reduction of imaging time. The effect of bandwidth reduction from the default value of 16 kHz to 8 kHz was evaluated prospectively in 50 patients referred for MR imaging of the head. On intermediate (2,000/30 [repetition time msec/echo time msec]) and more T2-weighted (2,000/90) studies, there were no definite missed diagnoses and no diagnostically important changes in lesion characteristics when the reduced-bandwidth technique was used to obtain half- or quarter-time studies, excluding differences attributable to unintentional changes in patient position between image acquisitions. Chemical shift misregistration artifacts associated with reduced bandwidth are easily recognized with experience and do not interfere with diagnosis, as the artifacts occur in characteristic locations and diminish in most anatomic locations with increasing echo time. This study suggests the feasibility of reduced-bandwidth techniques in clinical MR imaging of the head at high field strength to achieve an increased S/N, to decrease imaging time, or to obtain images in additional projections. PMID- 2772188 TI - Improved MR images of the brain with use of a gated, flow-compensated, variable bandwidth pulse sequence. AB - Peripheral gating and first-order flow compensation were compared for their ability to improve the quality of second-echo (echo time = 80 msec) brain images obtained with a T2-weighted spin-echo sequence. The contrast-to-noise ratios (C/Ns) for interfaces between brain and cerebrospinal fluid, gray and white matter, and lesion and white matter were measured; the C/N was highest for the combination of gating and flow compensation. This combination of motion compensation also reduced motion artifacts more than did either technique alone. Further improvement in C/N was sought by using a variable-bandwidth pulse sequence, which was compared to a conventional spin-echo sequence. The variable bandwidth technique increased the C/N of the second-echo image by 27%. The combined use of gating, flow compensation, and the variable-bandwidth option produced high-resolution brain images with a single excitation and retained flexibility in number of sections, number of echoes, and echo times. PMID- 2772189 TI - Cerebral Erdheim-Chester disease: persistent enhancement with Gd-DTPA on MR images. AB - A case of Erdheim-Chester disease with intracerebral masses containing characteristic lipid-laden histiocytes is presented. These unusual lesions remained enhanced on magnetic resonance images obtained 8 days after injection of gadolinium diethylenetriaminepentaacetic acid (DTPA) dimeglumine. Chemical analysis of a biopsy specimen revealed a high concentration of gadolinium. Findings suggest that the Gd-DTPA complex or possibly a gadolinium-containing metabolite may be retained for extended periods in this unusual type of histiocytic lesion. PMID- 2772190 TI - Sports-related muscle injuries: evaluation with MR imaging. AB - Sports-related muscle pain is frequent in both trained and untrained persons; however, its severity and significance may be difficult to assess clinically. The authors used magnetic resonance (MR) imaging to evaluate acute strains and delayed-onset muscle soreness in sedentary subjects and postmarathon myalgia in trained runners. MR imaging documented the distribution of affected muscles and the absence of focal hematoma, fascial herniation, subsequent fibrosis, and fatty infiltration. Pain associated with strain and that occurring several days after exercise were both associated with prolongation of muscle T1 and T2. In a prospective evaluation of delayed-onset muscle soreness, abnormalities depicted at MR imaging persisted longer than symptoms by up to 3 weeks, indicating that MR imaging is sensitive to tissue alteration that is not apparent clinically. Highly trained marathon runners tended to have relatively mild abnormalities involving the myotendinous junctions. PMID- 2772191 TI - Patellar tracking abnormalities: clinical experience with kinematic MR imaging in 130 patients. AB - A kinematic magnetic resonance (MR) imaging technique for assessment of malalignment of the patella, involving the acquisition of multiple sequential axial images of the patellofemoral joint during the early increments of passive knee flexion, was used to evaluate 130 patients (235 symptomatic patellofemoral joints) showing clinical evidence of having patellar tracking abnormalities. Twenty-three of the patellofemoral joints had undergone previous surgical procedures for patellar realignment. In addition, 14 (28 patellofemoral joints) asymptomatic control subjects were studied. Normal patellar tracking was observed in all of the asymptomatic subjects and in 43 (17%) of the 260 patellofemoral joints in the patient population, 18 (7%) of which were symptomatic. Sixty-nine (26%) of the patellofemoral joints had lateral subluxation of the patella, 106 (41%) had medial subluxation of the patella, 21 (8%) had excessive lateral pressure syndrome, 19 (7%) had lateral-to-medial subluxation of the patella, and two (1%) had dislocation of the patella. Of the 235 patellofemoral joints with suspected abnormalities, 217 (93%) had patellar malalignment. Of the 23 patellofemoral joints that had undergone prior surgery, 20 (87%) had abnormal patellar tracking. Thirteen of 14 (93%) patellofemoral joints that had undergone a prior arthroscopic lateral retinacular release had a medially displaced patella. PMID- 2772192 TI - Bone marrow disorders: characterization with quantitative MR imaging. AB - Thirty patients with various hematologic disorders and 15 healthy control subjects underwent quantitative magnetic resonance (MR) imaging of the lumbar spine with spin-echo techniques. Images of patients with infiltrative bone marrow disorders showed significantly more prolonged T1 times than those of control subjects (P less than .001). It was not possible to distinguish different diffuse infiltrative bone marrow disorders on the basis of T1 values. Aplastic anemia could be distinguished from normality because of significantly shortened T1 (P less than .001). A significant correlation was seen between T1 and bone marrow cellularity (r = .74, P less than .001). T2 was of no value in the characterization of bone marrow disorders. Quantitative MR imaging dose not improve the diagnostic potential of bone marrow imaging in the detection of diffuse marrow infiltrates. PMID- 2772193 TI - Osteosarcoma: use of MR imaging and MR spectroscopy in clinical decision making. AB - Magnetic resonance (MR) imaging was performed on 14 patients with histologically proved osteosarcoma (mean age, 14.4 years). There was excellent correlation of intramedullary tumor extent as determined with MR imaging and pathologic examination (r = 99%). This was facilitated by the presence of a chemical shift artifact at the tumor-marrow interface on the T1-weighted images. The correlation between CT and pathologic findings was not as good (r = 84%). In a single patient, however, a 10-cm length of sclerotic bone was incorrectly interpreted as being tumor. If this case is excluded, the correlation between CT and pathologic findings improves significantly (r = 96%). T2-weighted images were optimal in demonstrating soft-tissue bulk and breach of the epiphysis or cortex. Vascular involvement was also readily defined. The T2 value of the tumor soft-tissue component decreased in patients who were deemed to have responded well to therapy. Two patients with very high T2 values after chemotherapy developed wide spread metastatic disease and died. Phosphorus-31 MR spectroscopy of five patients with osteosarcoma showed elevated levels of phosphomonoesters (PMEs), inorganic phosphate (Pi), and phosphodiesters (PDEs). PME and PDE peak areas decreased in three patients after chemotherapy, while Pi peak areas increased. PMID- 2772194 TI - Temporomandibular joint: morphology and signal intensity characteristics of the disk at MR imaging. AB - Magnetic resonance (MR) imaging has been used in the temporomandibular joint (TMJ) primarily to define the disk position. This report examines altered morphology and signal intensity characteristics of the TMJ disk as they relate to the severity of internal derangement. Two hundred sixteen joints in 133 patients with a history of such derangement. were imaged with MR. Disk position, signal intensity, morphology, and the presence of osteoarthritis were determined for each joint. The normal disk was not anteriorly displaced and had a normal "bow tie" shape. A grade 1 disk was anteriorly displaced and had a normal shape; a grade 2 disk was anteriorly displaced and had an abnormal shape. Forty (19%) joints were considered normal; none of these exhibited osteoarthritis. One hundred thirty-nine (64%) joints were grade 1; osteoarthritis was found in 17%. Thirty-seven (17%) were grade 2; osteoarthritis was found in 95%. All forty normal joints had high or intermediate signal intensity in the disk. Osteoarthritic joints had a higher percentage of disks with diminished intensity (P less than .0001). Severe or untreated osteoarthritis is known to be a complication of TMJ internal derangements; hence this grading system seems to correlate with the severity of internal derangement. PMID- 2772195 TI - Temporomandibular joint motion: efficacy of fast low-angle shot MR imaging. AB - One hundred temporomandibular joints (TMJs) in 62 symptomatic patients and two healthy volunteers were prospectively examined with T1-weighted spin-echo and fast low-angle shot (FLASH) gradient-echo sequences. FLASH sequences were performed during opening of the mouth and provided a pseudodynamic depiction of TMJ motion. In 49 joints, FLASH sequences provided information that potentially influenced the therapeutic approach to the patient. This information was not available from standard T1-weighted images. The additional information fell into four general categories: (a) determination of the exact time of disk recapture, (b) distinction of normal variants from pathologically displaced disks, (c) clarification of discrepancies found between clinical examination results and T1 weighted images, and (d) elimination of motion degradation of images. PMID- 2772196 TI - Desmoplastic fibroma of bone: radiographic analysis. AB - Desmoplastic fibroma (DF) of bone is a rare, nonmetastasizing but locally aggressive tumor that has been discussed infrequently in the radiology literature. The radiographs from 107 previously published cases of DF and seven cases from the authors' institution were analyzed to better understand and define its radiographic characteristics. DF was most common in the mandible, pelvis, and femur. A geographic pattern of bone destruction, with a narrow zone of transition and nonsclerotic margins, was seen in 80 (96%) patients with intraosseous DF for whom radiographs were available (83 patients). Internal pseudotrabeculation was seen in 76 (91%). Although widening of the host bone due to gradual apposition of periosteal new bone was common, occurring in 74 (89%) patients, distinct periosteal new bone occurred in only two (2%) patients with DF of intraosseous origin. The cortex was breached in 23 (28%) patients. Three cases of DF arising in the periosteum were identified and were differentiated radiographically from desmoid tumors of intraosseous or soft-tissue origin. PMID- 2772197 TI - Isolated avulsion fracture of the lesser tuberosity of the humerus: report of two cases. AB - Isolated avulsion fractures of the lesser tuberosity of the humerus are exceptionally rare. Two cases are reported here, each involving a 12-year-old boy. The mechanism of injury appears to be a strong external rotatory force applied while the arm is at maximum external rotation and approximately 60 degrees of abduction. In children and adolescents the fracture most likely occurs through the apophyseal plate of the lesser tuberosity (traction epiphysis). In adults, clinical differentiation from the far more common calcific peritendinitis of the rotator cuff can be difficult. Whereas large, displaced fractures can be easily demonstrated on anteroposterior radiographs with internal and external rotation of the humerus, the axillary view is often necessary to detect smaller fragments with little displacement. PMID- 2772198 TI - Osteosclerosis of the phalanges in Werner syndrome. AB - Werner syndrome is an autosomal-recessive disease characterized by premature aging, shortness of stature, scleroderma-like skin changes, endocrine abnormalities, and cataracts. Although radiographic findings have been well documented, the presence of distinctive osteosclerotic changes in the phalanges of the hands and feet has not been emphasized in previous publications. The authors' review of radiographs of both hands in nine patients and of both feet in six patients with Werner syndrome documented the frequent occurrence of phalangeal sclerosis related predominantly to endosteal thickening. In the hand, sclerosis was present in every patient, was generally symmetric in distribution, predominated in the distal phalanges, and demonstrated an ulnar predilection. Similar changes in the phalanges of the feet were demonstrated in only two patients. The presence of osteosclerosis in the phalanges of the hand alone or both the hand and foot, when combined with osteoporosis and periarticular calcification, suggests the diagnosis of Werner syndrome. PMID- 2772200 TI - Coil holder and marker system for MR imaging of the total spine. AB - To improve the efficiency of magnetic resonance imaging of the total spine, the authors developed a coil holder and marker system to accurately localize the level of the spine imaged. The patient's external auditory canal and the alignment light on the imager are lined up with marks on the coil holder. The spine is then imaged in three segments by using a 24-cm field of view. The device has been successful in 20 of the 23 patients in whom it was used. The three failures were due to technical problems. PMID- 2772199 TI - Recurrent tumors of the head and neck, pelvis, and chest wall: treatment with hyperthermia and brachytherapy. AB - Cancer that recurs after surgery and radiation therapy remains a major problem. The claimed effectiveness of thermobrachytherapy in patients with this problem prompted the present study. Forty-six lesions (20 head and neck, 18 pelvic, seven chest wall, and one limb sarcoma) in 38 patients were treated with interstitial hyperthermia that sandwiched the use of Ir-192 with the aim of delivering 2,000 6,000 cGy, depending on prior dose and tissue tolerance. Complete regression occurred in 19 (54%) of 35 evaluable cases. More than 58,000 measured temperature points were analyzed to develop a representative quantitative measure, the "modal thermal dose," that represented the temperature reported most often during heating sessions. The pattern was plotted in each case. No significant relation was found between heating patterns and tumor response. Of all the prognostic factors studied, the radiation dose was the most significant, with a complete response rate being 78% when the total radiation dose exceeded 6,000 cGy, compared with 8% when the dose was lower than 5,000 cGy (P less than .005). The tumor volume also was important, with smaller lesions responding much better than larger ones (P = .1). PMID- 2772201 TI - Ultralong, reverse-curve angiographic catheter. AB - An ultralong, reverse-curve angiographic catheter has been developed to facilitate selective internal pudendal arteriography for evaluation of vasculogenic impotence. The catheter has enabled successful selective catheterization of the internal pudendal arteries in 95% of more than 200 attempts. The catheters have also been used in approximately 100 vascular procedures other than pudendal arteriography. PMID- 2772202 TI - Returning to academic radiology: why am I doing this? PMID- 2772203 TI - What is a radiologist? A "day of imaging" can provide much needed public information. PMID- 2772204 TI - Inferior vena cava: translumbar catheterization for central venous access. AB - In six patients who required long-term central venous access, translumbar catheterization of the inferior vena cava was performed seven times after the usual sites of access had become thrombosed. Four of the patients were male and two were female, and they ranged in age from 2 to 76 years. Placement of a 12-F Silastic catheter in one procedure, a 10-F catheter in three, a 9-F catheter in one, and a 7-F catheter in two was successful and uncomplicated. Of the three surviving patients, two had a functioning catheter at 1 week and 32 months, respectively; in the third patient the catheter was removed after 3 weeks, a few days after successful bowel surgery. Two patients with functioning catheters died, one of metastatic breast cancer after 12 months and the other of acquired immunodeficiency syndrome after 5 weeks. One patient twice required removal of a functioning catheter due to sepsis, the first after 3 weeks and the second after 6 weeks. These results show this technique to be safe and successful for selected patients. PMID- 2772205 TI - Percutaneous transjejunal approaches to the biliary system. AB - The authors report 10 cases in which various retrograde manipulations in the biliary tract were performed via percutaneous access from the jejunum in patients who had previously undergone Roux-Y biliary surgery. The first cases involved attempted retrograde cholangiography through the jejunal limb in children who had undergone Roux-Y portoenterostomies, followed by cases of percutaneous placement of U tubes and an attempt at percutaneous creation of an hepaticojejunostomy. When a limb from the Roux-Y has been brought to the skin and marked with clips, jejunal puncture is easily performed, is well tolerated by patients, and may be repeated frequently. It also appears that after Roux-Y choledochojejunostomy, the Roux-Y limb is fixed and may be punctured with relative safety. Since access from below is more favorable for intrabiliary manipulations, the transjejunal approach expands the armamentarium of the interventional radiologist in the combined radiologic and surgical management of complex biliary disease. PMID- 2772206 TI - Obstructions of the hepatic duct confluence: internal drainage of bilateral lesions with a single catheter. AB - Strictures at the confluence of the right and left hepatic ducts are difficult to treat surgically, endoscopically, or percutaneously. Percutaneous decompression techniques previously described involved separate transhepatic catheterizations of the isolated right and left ducts. In the present study, modifications of existing self-retaining loop drainage catheters allowed bilateral internal biliary drainage of isolated right and left hepatic ductal systems with a single catheter in three patients. The technique can be used for primary palliation and for recurrent strictures after hepaticojejunostomy. PMID- 2772207 TI - Regional anesthesia for hepatic arterial embolization. AB - Hepatic arterial embolization (HAE) has been utilized for treatment of unresectable primary and metastatic hepatic malignancies. While palliation results from this procedure, one of the major drawbacks to its use is the immediate short-term side effects, especially the right upper quadrant and epigastric pain experienced by all patients. High doses of intravenous narcotics have been used for pain control. The data on 18 patients who received a celiac plexus block immediately prior to 31 HAE procedures were compared with those on 19 control patients who underwent 42 HAE procedures without celiac plexus block. All patients who received a celiac plexus block had relief of pain without requiring intravenous analgesic both during the procedure and for the first 8 hours after HAE. These patients also subsequently received substantially lower dosages of analgesics than the control subjects. Two patients had transient hypotension due to the celiac plexus block, but no other complications occurred. It is recommended that patients undergoing HAE first receive a celiac plexus block for pain control. PMID- 2772208 TI - Antibiotics and nephrostomy tube care: preliminary observations. Part II. Bacteremia. AB - Bacteriuria occurs after long-term drainage of the kidney. This study was designed to determine if the risk of bacteremia increases at the time of tube or stent change, whether bacteremia correlates with clinical infection, and if prophylactic antibiotics are effective in the prevention of bacteremia. One hundred four tube changes in 74 patients with percutaneous nephrostomy tubes and documented positive urine cultures were studied. Patients were arbitrarily divided into groups receiving and not receiving antibiotics before nephrostomy tube change. Asymptomatic bacteremia was documented in 11 of 104 tube changes (11%). Results of five blood cultures were positive in the group receiving antibiotics, and six cases of bacteremia occurred in the group not receiving antibiotics (P = .96). Routine nephrostomy/stent change can cause frequent, asymptomatic bacteremia in patients with colonization of bacteria in the urinary tract. Antibiotic prophylaxis was unsuccessful in preventing transient bacteremia, a factor that may have implications in patients with underlying valvular heart disease and other patients at risk for bacteremia. PMID- 2772209 TI - Transrenal ureteral occlusion with Gianturco coils and gelatin sponge. AB - The authors report the use of Gianturco coils and gelatin sponge plugs to achieve complete occlusion of nine ureters in five patients with advanced pelvic malignancies and lower urinary tract fistulas. The method is simple to apply, is readily available, and to date has been associated with no significant complications. These results suggest that, before more elaborate methods of ureteral occlusion are applied, the use of coils and gelatin sponge should be considered as the primary method of ureteral occlusion. Further work is needed to elaborate the exact mechanism by which these materials cause occlusion. PMID- 2772210 TI - The decline of diagnostic radiology: call to action. 1989 Dotter lecture. AB - Major socioeconomic changes in the practice of medicine in the past 2 decades have had a great impact on diagnostic radiology and have encouraged other physicians and entrepreneurs to enter many areas of this specialty. Major alterations in the practice of diagnostic radiology will be required if the specialty is to survive. Diagnostic radiologists must move from a position of dependency to self-sufficiency by encouraging patients to access their services and talents directly. PMID- 2772211 TI - The route to subspecialty accreditation. AB - Subspecialty training accreditation is a way in which the adequacy of postresidency training can be controlled. The development of subspecialty training accreditation is the purview of the Residency Review Committees (RRCs) of the Accreditation Council for Graduate Medical Education (ACGME). An RRC develops the Special Requirements and the Justification/Impact statement for the subspecialty. These documents are reviewed by all other RRCs, the parent organizations of the sponsoring RRC, and the ACGME and other interested groups. When all suggestions from these groups are answered by the RRC, the Committee for Review of Special Requirements of the ACGME must approve the program. The final step is ACGME approval. The program will then go into effect on the date specified in the Justification/Impact statement. The procedure is complex and time-consuming. However, in the final analysis, a subspecialty program accredited in this fashion will be a solid educational experience for the trainee and should have a well-defined role in the parent institution. PMID- 2772212 TI - Treatment of femoropopliteal stenoses by means of self-expandable endoprostheses: midterm results. AB - An endovascular mechanical support that can be introduced percutaneously could be an attractive approach to preventing acute occlusion and restenosis following angioplasty. The self-expandable metallic endoprosthesis is characterized by its flexibility and elasticity. The authors report the results of 40 femoropopliteal implantations in 36 patients; the follow-up period was greater than 6 months in all patients. Lesion length exceeded 7 cm in 25% of cases and was 3-7 cm in 75%. Thirty percent of lesions were total occlusions. At hemodynamic and angiographic study, two types of complications were noted. In patients not receiving orally administered anticoagulants, six thromboses occurred early; no early thromboses were noted in the nine patients treated with acenocoumarol. Restenosis occurred in 10% of cases (maximum follow-up, 2 years) and was noted even in long lesions (greater than 7 cm). The authors believe that placement of this type of prosthesis is an attractive approach to preventing postangioplasty restenosis, provided that the conditions of anticoagulation are well controlled. PMID- 2772213 TI - Thrombus-trapping efficiency of the Greenfield filter in vivo. AB - A total of 100 radiopaque blood clots were injected into seven adult sheep under fluoroscopic observation to assess the clot-trapping efficiency of the Greenfield vena caval filter. Eleven percent of the clots passed through the filter, with all failures limited to the two smallest clot sizes: 4 x 10 mm (five of 25) and 4 x 30 mm (six of 25). The Greenfield filter was 100% efficient in trapping larger clots (8 x 10 mm and 8 x 30 mm). There was a tendency toward poorer clot-trapping performance when the Greenfield filter was tilted within the vena cava, but this was not significant. There were no significant differences in hemodynamic measurements obtained immediately before and after injection of each clot, and no significant changes were noted in the animal's hemodynamic status or in blood gas measurements in those cases in which the clots passed through the filter. Since the caval diameter in sheep approximates that in humans, the authors conclude that the Greenfield filter in the clinical setting is capable of stopping large, likely fatal, emboli and a large number of smaller, possibly less clinically significant, emboli. PMID- 2772214 TI - Shear stress in the performance of esophageal dilation: comparison of balloon dilation and bougienage. AB - While both the balloon catheter and the bougie are effective for esophageal dilation, each has its proponents. From a biomechanical point of view, the two methods should differ significantly, since bougienage depends on advancing a tapered dilator to generate radial force and balloon catheter dilation depends solely on balloon inflation to generate its radial dilating force. In a series of equivalent esophageal stenoses made by suture plication in swine esophageal segments, the authors measured shear force and radial force generated by dilation with a Maloney bougie, a Savary-Gilliard bougie, and an esophageal balloon. The mean radial forces generated were 6.42, 4.46, and 4.04 N, respectively, which did not differ significantly. However, the mean shear forces measured were 16.92, 6.92, and 1.44 N, respectively. The shear force with the Maloney bougie differed significantly from that with the Savary-Gilliard and the balloon and was on the same order of magnitude as the tensile strength of the esophagus (25-27 N). The shear force with the balloon was significantly lower than that with either bougie. In theory, the reduced shear force associated with balloon dilation might reduce the risk of esophageal perforation, but safety will have to be determined in clinical trials. PMID- 2772215 TI - Chemical dissolution of gallstones: in vitro studies. AB - Groups of human cholesterol gallstones were subjected to monooctanoin with and without agitation, methyl-tert-butyl ether (MTBE) with and without agitation, and monooctanoin and MTBE used in succession with agitation. In this in vitro study, agitation greatly expedited the rate of dissolution with MTBE, by far the more potent of the two solvents. An additive effect was suggested when the solvents were used sequentially, monooctanoin followed by MTBE. Cholesterol-calcium stones were also dissolved by MTBE but at a slower rate, depending on the amount and distribution of calcium. Computed tomographic (CT) scans and mammographic images clearly delineated the amount and distribution of calcification, but plain radiographs did not. On the basis of these findings, the authors instituted two changes in their clinical protocol: All patients with gallstones are now examined by means of CT before chemical dissolution begins, and monooctanoin is instilled overnight before the MTBE procedure. PMID- 2772216 TI - Nurse blows whistle: freedom of speech. PMID- 2772217 TI - Anesthesia death: "fraudulent concealment" issue. Case in point: Bourassa v. LaFortune (711 E. Supp. 43--MA (1989)). PMID- 2772218 TI - Legal case briefs for nurses. TX.: "claims made" & "occurrence" policies; MO.: hospital sues on "educational loan". PMID- 2772219 TI - Nurse contracts hepatitis-B: "dual capacity" issue. Case in point: Gatlin v. Truman Medical Center (770 S.W. 2d 510--MO (1989)). PMID- 2772220 TI - Increased activity of the platelet-activating factor acetylhydrolase in plasma low density lipoprotein from patients with essential hypertension. AB - We have measured activity of platelet-activating factor (PAF) acetylhydrolase, an enzyme that specifically inactivates PAF, in plasma from patients with essential hypertension and healthy controls. The average activities in 34 patients and 22 controls were 113 +/- 60 and 79 +/- 32 nmol/ml/min, respectively, and the difference was significant (p less than 0.05). Approximately three fourths of the total plasma activity was recovered in LDL, with the remainder in HDL; and there was a significant difference in the activity associated with the LDL between patients and controls. The relative distribution of the activity among lipoproteins was almost equal in the two groups, and there was no difference in plasma lipids or apoproteins between them. In patients there was a tendency for plasma PAF acetylhydrolase activity to increase with the length of the history of hypertension. Further studies are needed to distinguish between a number of reasons for increased levels of plasma PAF acetylhydrolase in essential hypertension. PMID- 2772221 TI - A new method using simple solid phase extraction for the rapid gas chromatographic mass-spectrometric determination of 11-dehydro-thromboxane B2 in urine. AB - A new gas-chromatographic mass-spectrometric method for the rapid determination of 11-dehydro-thromboxane B2 in urine, the major metabolite of systemic thromboxane formation, has been developed. Excellent sample clean-up was obtained in a single step by adsorption of 11-dehydro-TXB2 on phenylboronate cartridges, vigorous polar and organic washing and elution with an acidic methanol mixture. Then the pentafluorobenzylester trimethylsilylether derivative of 11-dehydro-TXB2 was formed and quantified in isotope dilution technique by negative chemical ionisation gas-chromatography tandem mass-spectrometry. The daughter fragments m/z 243/247 of the parent ion m/z 511/515 were monitored. Recovery was linear and quantitative over a wide range, accuracy was 95 + 7% and precision was 11% down to the very low pg range in biologic samples. Independent validation of this very fast extraction method with a reference method applying extensive sample purification with consecutive reversed and straight phase extraction, precolumn derivatisation, reversed phase high pressure liquid chromatography and tandem gas chromatography mass-spectrometry gave excellent agreement of values. Values for 11-dehydro-TXB2 excretion in 8 healthy controls were 501 + 298 (range 231 to 1141) ng/g creatinin. Excretion was suppressed by aspirin, moderately elevated in heavy smokers (range 680 to 1540) and increased in patients with venous thrombosis or pulmonary embolism (2370 to 13350 ng/g creatinin). This rapid extraction method is useful for the highly specific and sensitive determination of 11-dehydro-TXB2 in large sample numbers. PMID- 2772222 TI - The influence of xanthines on the contractile responses of PGF2 alpha and PGD2 in human parenchymal strips. AB - Prostaglandins (PGs) F2 alpha and D2 are bronchoconstrictor agents which are released under allergic conditions such as asthma. The efficacy and potency of PGF2 alpha and PGD2 differ in some tissues. We compared the effects of these two PGs in sensitized human parenchymal strips. In six experiments, PGF2 alpha 0.1 and 0.3 microM produced greater contractions than PGD2 at the same concentrations. There were no significant differences between the contractions from the two PGs at concentrations of 0.01, 0.03, 1.0-10 microM and the two PGs appeared to be equipotent. We studied the effects of the anti-asthmatic drug theophylline, and its analogue enprofylline, on the contraction caused by these PGs. Theophylline 100 microM caused no change to the cumulative concentration response curves. However, enprofylline 100 microM reduced the PGF2 alpha-induced contractions. PMID- 2772223 TI - [Ischemic heart disease. Its incidence and association with risk factors]. AB - Cardiovascular diseases are the first cause of death in all developed countries and in many underdeveloped countries (1). In Cuba they have constituted the first cause of death in the last 20 years, with a tendency to increase, with the characteristic that this tendency is due to ischemic heart disease (IHD) (2). The frequency of IHD increases with age, but it has increased in the population under 50 years of age lately (3, 4, 5). Although the cause of atherosclerosis is unknown, in the last years an epidemiologic association has been demonstrated between the atherosclerotic disease (mainly IHD) and a series of pathologies, habits of the population, genetical, biochemical, physiological and environmental factors, which influence directly and indirectly the early development, frequency, severity evolution and prognosis of IHD and have been called coronary risk factors (CRF); at present, the disease is considered to be multifactorial and its magnitude and severity are influenced by the exposure time and the combination of CRF; it has also been demonstrated that it is decreased by the application of measures for the pressure measurements with Hg sphygmomanometer, in the population (1, 5, 6, 7, 8, 9, 10, 11). In our country, a series of studies have been made to ascertain the magnitude and characteristics of cardiovascular diseases (12-14); through these works we will know the incidence of IHD, some of its characteristics and its relation with some coronary risk factors hypercholesterolemia, arterial hypertension, (AH), diabetes mellitus, smoking habit and obesity).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2772224 TI - [Symposium on Problems of the Epidemiology and Prevention of Arterial Hypertension and Ischemic Heart Disease. 10-14 November 1986, Budapest. Proceedings]. PMID- 2772226 TI - [Initial results of studies on changes in arterial blood pressure in a longitudinal international program of blood pressure control of the general population (Warsaw)]. PMID- 2772225 TI - [Analysis of blood pressure patterns and their changes during a 6-year prevention program for patients with hypertension referred to the Hypertension Unit]. PMID- 2772227 TI - [Arterial hypertension in a population of working men--6 years' observation]. PMID- 2772228 TI - [Arterial blood pressure and hypertension among the Polish population in an agricultural region]. PMID- 2772229 TI - [Active detection, long-term observation and treatment of patients with arterial hypertension in one of the administrative regions of Moscow (a cooperative program with the COMECON countries)]. PMID- 2772230 TI - [Up-to-date results and concepts of further studies toward improving the effectiveness of detecting arterial hypertension and the ambulatory care of patients with hypertension]. PMID- 2772231 TI - [Social factors and arterial hypertension]. AB - Hypertension in Hungary is classed as a potentially prevalent disease both because of its incidence and social consequences. Its origins can be traced back to environmental, economic and social changes. The aim of our analysis is: -to show the connections between hypertension development and the characteristics of social structure, life style and awareness. -to define social determination of hypertension and to evaluate it in view of applicability in prevention and treatment. Screening examination and sociological data collection was conducted in the 17th district of Budapest in 1982-83 in a random sample of patients between 20-64 years of age. While screening besides blood pressure measurement weight and height were measured, blood sugar content and serum lipid were determined and anamnestic particulars were recorded. Groups of topics of the sociological interview: -characteristics of social stratification and mobility nutritional habits -smoking habits -leisure time physical activity characteristics of work performed -social connections -critical personality traits -health care culture The 20-64 population of the 17th district is 39,456. Our analysis concerns 1,600 persons selected on a statistical basis. In the present lecture we analyse the connection between social stratification and life style and hypertension. Systolic and diastolic blood pressures are analysed separately as their biological characteristics are different. In our analysis blood pressure was treated as a continuous variable or was classified as normal marginal or high based on WHO criteria.2+ Systolic blood pressure of the surveyed population shown in Table I. Multiple regression or multivariable discriminant analyses were used to examine factors affecting classification into each group.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2772232 TI - [Surgical treatment of unstable trochanteric fractures of the femur. I. Evaluation of the surgical treatment of trochanteric fractures of the femur using angular nails]. AB - One hundred and two patients with trochanteric fractures of the femur were treated with angular nail-plates during a four-year period between 1984 and 1987. It is proved that this method is efficient for stable fracture patients, particularly used 24 hours after trauma. Whereas concerning unstable fractures III-th and IV-th degree most results are unsatisfactory. Disadvantage of the method is that patients can not be weight bearing operated leg soon after operation, what has negative influence for healing results. PMID- 2772233 TI - [Nifedipine level in the blood and its immediate hypotensive effect after its sublingual administration to aged patients]. AB - In 28 aged patients (means = 73.1 years) with arterial hypertension nifedipine has been administered sublingually in a single dose of 20 mg and the hypotensive effect of that drug under the control of its concentration in the blood serum was evaluated. The nifedipine concentration was determined by the use of gas chromatography with electron capture detector. The mean drug concentration increased from 38.1 ng/ml to 82.3 ng/l during the 2nd hour of observation. After 3 hours the lowering of the nifedipine concentration and the decrease of its hypotensive effect was observed. After 15 min from the drug application the systolic pressure lowered by the average 22.1 mmHg whereas the diastolic pressure was 7.0 mmHg lower. The most significant pressure decrease (mean of systolic pressure 52.7 mmHg) 7.03 kPa and that of diastolic pressure 23.2 mmHg (3.1 kPa) occurred after 2 and 1.5 hours. The decrease of pressures after nifedipine correlated with the start-point value of systolic pressure. The frequency of the heart action in the whole group did not altered significantly, however, in individual cases both the acceleration of that action (34 per min) or acceleration (42 systoles per min) was noted. Slight typical side-effects were noted in 5 treated patients. A single-dose sublingual 20 mg nifedipine (Cordafen- Polfa) administration enabled in all the subjects the obtaining of therapeutic drug level in the blood and in the aged patients with hypertension may be regarded as efficacious antihypertensive treatment. PMID- 2772234 TI - [Bilateral tubal pregnancy]. PMID- 2772235 TI - [Coexistence of mitral valve prolapse and pericentric inversion of chromosome 9]. PMID- 2772236 TI - [Surgical treatment of unstable trochanteric fractures of the femur. II. Elastooptic and tensometric studies of the isolated femur and fixed bones in trochanteric fractures using angular or intramedullary Y nails]. AB - Here are presented the results of investigations on the isolated femur and after osteotomy the re-enacting of experimental 2nd degree trochanteric fractures. The connection of fractured bone fragments has been performed with the use of the angular or intramedullar Y nail. It has been stated that pressures (overload 2000 N) on the fracture surface in the bone connected by the use of the intramedullar Y nail are lower than the bone tension prior to fracture in the same place. So far as the angular nail is concerned the connections made by the use of that nail is characterized by lower pressures than tensions prior to fracture (overload 1000 N) and is 20% higher than tensions in the site of hypothetic fracture (overload 2000 N). Moreover, the intramedullar Y nail transfers the pressure below the site of the trochanteric fracture cross-section, relieving the pressure of the fracture site. The length of the intramedullar part of the Y nail is equal to 3/4's of the femur length and is sufficient for stabilization of post-fracture bone fragments. PMID- 2772237 TI - [Clinical and control studies of cancer of the lungs. Smoking and employment in metallurgy]. AB - Deaths due to the lung cancer has been investigated among the Cracow inhabitants in years 1980-1985. The control group consisted of men died to other causes than diseases and neoplasms of the respiratory tract. Data on smoking habits and habitation place of the investigated and the control group were received from family members of subjects studied. It has been stated that relative risk of death due to the lung cancer in subjects working in metallurgical industry increases parallely to the time of work and the class of workers employed more than 30 years and in these groups the relative risk of death to above cancer was equal to 2.66 (95% PU 1.37-5.42). The relative risk associated with occupational exposure has also been significant in subject working more than 20 years in other industry branches. The cigarette smoking has been determined as most significant etiologic factor of the lung cancer. PMID- 2772238 TI - [Defense reactions and coping with stress in patients with cancer]. AB - The paper presents the psychological analysis of 56 cancer patients' reactions to stress connected with illness and treatment and their efforts to cope with stress. The main emotional reactions of cancer patients were anxiety, emotional tension and lowering of self-esteem. The defense mechanisms of suppression and denial could also be found. The most frequent effective coping strategy was forming the positive attitude towards the treatment, formulating more distant goals, not connected with illness, confidence in doctors. Much more seldom were the strategies of seeking social support among close relatives. PMID- 2772239 TI - [Serum immunoglobulins and various components of complement in patients with insulin-dependent diabetes mellitus]. AB - Serum concentrations of immunoglobulin (Ig) A, M, G and complement components C3, C4, Bf were investigated in 50 patients with insulin--dependent, non--insulin dependent diabetes of 60 patient and control healthy subjects. The mean level of IgA was lower and IgM and IgG higher in both types of diabetic patients. But the low level of IgG was observed in 11% patients with insulin dependent diabetes. It was not significant difference in concentrations of complement components proteins in both diabetic groups and control subjects. Insulin dependent diabetic patients with microangiopathic complications had lower level of serum C4, but this difference was not statistically significant. PMID- 2772241 TI - [Surgical treatment of unstable trochanteric fractures of the femur. III. Comparative studies of the tensile strength of osteosynthesis in trochanteric fractures of the femur using angular and intramedullary Y nails]. AB - Here is shown a comparison of endurance in different types of connected trochanteric fractures by the use of angular and intramedullary Y nails. Studies were made on 24 isolated femora, upon which an osteotomy was performed so as to experimentally reconstruct trochanteric fractures of the II, III and IV degree. Bone fragments were connected by the use of angular or intramedullary Y nails. Such connected bones underwent the gradual increase of weight in order to test the endurance of the connections applied. It was established that the angular nail stabilizes fragments in fractures of the II degree, but in fractures of the III degree it can only serve as a bone suture. On the other hand it is of no use in connected fractures of the IV degree. The intramedullary Y nail stabilizes bone fragments well in fractures of the II and III degree, as well as in fractures of the IV degree. The connection of trochanteric fractures of the II degree by use of the intramedullary Y nail is more beneficial than connection by use of the angular nail due an approximately doubled endurance in connections of this kind. PMID- 2772240 TI - [Studies of the effect of ischemia of the legs on the degree of osteoporosis of the femur and tibia using the cortex-shaft index]. AB - On the basis of arteriographs in 98 patients with chronic arterial ischemia of lower limbs, degree of osteoporosis was determined in symmetrical femoral and tibial bones using cortical index and statistical calculations. The study demonstrates similar level of mineralization of the examined bones in limbs with similar degree of ischemia. In patients with more pronounced unilateral osteoporotic changes more severe obliterations of the arteries was observed in the respective limb as compared with the opposite limb. The observed differences in cortical index values are statistically significant. Moreover chronic ischemia diminishes the correlation between cortical index and age. The study indicates, that chronic bone ischemia could play a role in the pathomechanism of local osteoporosis. PMID- 2772243 TI - [Surgical treatment of unstable trochanteric fractures of the femur. IV. Evaluation of the surgical treatment of trochanteric fractures of the femur using intramedullary Y nails]. AB - Here is shown a method of operating a trochanteric fractures of the femur by use of a modified intramedullary Y nail. During a period of 18 months this method was performed on 36 patients with unstable trochanteric fractures. It was established that this operating procedure is simple, from a technical point of view. It ensures excellent stabilization of bone fragments in all types of trochanteric fractures, including fractures of the IV degree, as well as enabling the patient to be completely weight bearing immediately after operation on the injured extremity. Stabilization of bone fragments in trochanteric fractures can be achieved due to the fact that part of the intramedullary nail is 3/4 the length of the femur. The possibility of early weight bearing on the operated extremity caused that 70% of operated patients regained efficiency of movement similar to efficiency prior to fracture of the extremity, 6 weeks after being operated on. PMID- 2772242 TI - [Blood lipid and lipoprotein profile in patients in the first week of myocardial infarction]. AB - The serial enzymatic and lipid determinations have been performed in 30 patients with myocardial infarction during the first 6 to 7 days of the disease. During the phase of myocardial infarction development paralel to increasing creatine kinase (CK) activity the increase in the cholesterol (CH) and phospholipid (PL) as well as the increase of HDL and LDL serum fraction (p less than 0.0005) has been observed. At the end of the second day the CK activity normalization has been accompanied by the gradual decrease in the HDL and LDL fraction concentration up to values lower than that at the start of observation (p less than 0.0005). The HDL-PL/HDL-CH coefficient enables the evaluation of changes in the subfraction HDL during the first days of myocardial infarction consisting of HDL2 concentration decrease. Above changes indicate the progressive arteriosclerosis of coronary arteries despite lowering the total CH and the LDL CH concentration in the serum of patients with acute myocardial infarction. PMID- 2772244 TI - [Comparison of various pharmacologic and conventional methods of increasing the effectiveness of peritoneal dialysis. V. Usefulness of selected parameters of peritoneal transfer for evaluating the effectiveness of intermittent peritoneal dialysis]. AB - On the basis of analysis of peritoneal transfer parameters in intermittent++ peritoneal dialysis it was shown that 1) dialysate/plasma ratio is a good parameter for comparison of efficiency of peritoneal dialyses performed using different schedule only when dialysis fluid flow rate is unchanged; 2) dialysis induced ultrafiltration markedly influences peritoneal transfer parameters of sodium; 3) when the influence of residual dialysis fluid on peritoneal transfer parameters is excluded, peritoneal clearance is very useful in comparison of efficiency of peritoneal dialyses performed using different dialysis schedule, but if dialysis schedule is changed during the course of dialysis, the determination of clearance value in each exchange is advisable because dialysis schedule used in one dialysis period can influence clearance value in following exchanges performed in different manner; 4) concentration of low-molecular-weight substances in dialysate after intraperitoneal administration of pharmacological agent if does not decrease in the course of dialysis may indicate on enhancing effect of this agent on peritoneal transfer. PMID- 2772245 TI - [Primary malignant lymphomas of the digestive tract. Morphologic and clinical analysis of 100 cases]. AB - The morphologic and clinical evaluation of malignant lymphomas having the primary localization in the digestive tract has been presented. The analysis of particular cases involved the localization of tumors, the histological types, age, sex and clinical symptoms. It has been stated that malignant lymphomas are rare primary malignancies of the digestive tract which develop most frequently in the stomach and their clinical course may be masked by other diseases of digestive tract. PMID- 2772246 TI - [Arrhythmia during endoscopy of the upper gastrointestinal tract]. AB - Continuous++ electrocardiographic monitoring was performed before, during and after endoscopy on 203 patients undergoing upper gastrointestinal endoscopy. Significant increase of cardiac arrhythmias during fiberoscopy (on 49,83% of the examined patients) was noted. The most common were: tachycardia over 120 beats per minute, ventricular and supraventricular premature beats and ischemic changes in the heart. These changes were increasing in the majority of the examined patients. However, much more of them were observed in patients with coexisting cardiovascular diseases. The research showed that the premedication influences the increase of cardiac arrhythmias and ischemic changes during panendoscopy, mainly with patients with coexisting cardiovascular diseases. The largert number of cardiac arrhythmias appeared during the introduction of the endoscope into the throut and the esophagus. PMID- 2772247 TI - [Results of internal-medical examinations of the population from the region of a rural health center in Wielka Wies-BiaLy KoscioL]. AB - Among 250 adults (120 male farmers-workers and 130 female farmers) belonging to the population of a village near Krakow, 153 (61%) were recognized sick (67 men- 56% and 86 women--66%). Most frequent diseases concerned: the circulation (30% arterial hypertension), digestion (18%, peptic ulcer 14%), respiration (14% mainly bronchial chronic inflammations and asthma), locomotion (11% degenerative joint changes), neuroses (10%) and urogenital system (8.4%). Some cases of neoplasms (3.2%), parasitism (2.8%) and bone fractures caused by professional traumas (2.8%) were registered. The diseases of digestion and respiration were more frequent in men, arterial hypertension, neuroses, urogenital and locomotion diseases more common in women. Arterial hypertension and peptic ulcer afflicted persons over 30, the degenerative joint changes the individuals over 45 years of age. PMID- 2772248 TI - [Registration of myocardial infarction in the Augustow region from January 1, 1983 to December 31, 1984]. AB - The purpose of report was in presentation of data on the myocardial infarction occurrence in the Augustow region. The analysis involved the confirmed cases of myocardial infarctions and the sudden death that is the probable myocardial infarctions. The analysis included the site of habitation (city, country), age, sex, the time of the disease, the diurnal occurrence of the disease, day of a given week of month. The risk factors such as arterial hypertension, smoking and diabetes mellitus have also been analysed. It has been stated that the morbidity index for myocardial infarction in the Augustow region was significantly lower than that in the highly industrialised regions or great urban agglomeration regions. The morbidity ratio men:women was 3.1:1. The most frequent myocardial infarct incidence was during the hours. Among country people the myocardial infarction cases occurred more frequently during first days of the week whereas urban population was characterized by more frequent disease occurrence during last days of the week. Arterial hypertension and smoking occurred more frequently in the city inhabitant than in patients living in the country. PMID- 2772249 TI - [Idiopathic nephrotic syndrome. I. Pathophysiology and treatment of nephrotic edema]. PMID- 2772250 TI - The progression rate of late radiation effects in normal tissue and its impact on dose-response relationships. AB - The progression of late skin telangiectasia after radiotherapy has been studied prospectively in patients for 1, 2 and 5 fractions per week and various dose levels. The degree of telangiectasia was scored on an arbitrary scale. Skin telangiectasia was found to be a continuously progressing endpoint both in the individual patient and in terms of the number of patients who achieved a certain degree of damage. The rate of progression was dose-dependent. Dose-response analysis were performed at 3, 5 and 9 years follow-up for various endpoints: telangiectasia score greater than or equal to 1, score greater than or equal to 2 and score greater than or equal to 3. Iso-effective doses (ED50S) for score greater than or equal to 1 at 3 years, score greater than or equal to 2 at 5 years and score greater than or equal to 3 at 9 years were very similar. In an iso-effect analysis it is therefore worthwhile and time-saving to include the minimal detectable damage in the endpoint (e.g. using score greater than or equal to 1), even if this mild damage is of no clinical significance, and the dose in the endpoint (e.g. using score greater than or equal to 1), even if this mild damage is of no clinical significance, and the dose response become somewhat less steep than for more severe damage. The fact that the progression rate is dose dependent has impact on dose-response analysis. Dose-response analysis for score greater than or equal to 3 at various follow-up times showed a very flat curve at 3 years compared to 5 and 9 years. The steepness of the dose-response curves was similar at 5 and 9 years. A minimum follow-up of 5 years is therefore necessary for reliable estimation of the late complication rates in a comparison of two dosage schedules using this endpoint. The implication of the continuous progression of telangiectasia is that the dose-response curves are shifted to the left with follow-up. The ED50 is dramatically reduced between 3 and 5 years. The ED50 is also significantly reduced between 5 and 9 years' follow-up, in spite of no change in the steepness of the dose-response curve during this period. Consequently, the time of response is the most fundamental parameter in any iso effect analysis with progressive endpoints and the late complication rates always have to be specified at a fixed time of follow-up. PMID- 2772251 TI - Role of radiotherapy in metastatic spinal cord compression: preliminary results from a prospective trial. AB - A non-randomized prospective trial in which radiotherapy (RT) alone played the major role in the treatment of metastatic spinal cord compression (MSCC) is reported. Diagnosis was formulated on myelography and/or myelography plus computed thomography (CT). Of 51 cases treated, 48 are evaluable. The therapy consisted of radiation alone (42 cases) or decompressive laminectomy followed by radiotherapy (6 cases). Surgery was performed when the site of the primary tumor was unknown. The group of patients who received radiotherapy alone (42 of 48 evaluable cases) are analysed in this report. Medium to high doses of steroids were administered to all patients depending on the gravity of the case. Patients with chemo- or hormone-responsive primary tumors also received chemotherapy and/or hormone therapy. Pain relief, assessed by comparing use of narcotics and minor analgesics before and after treatment, was achieved in 54% cases (confidence limits, CL = 38-69%). In 36% (CL = 22-51%) of patients back pain diminished to the point when only milder analgesics were necessary (partial remission). Motor performance, based on patients' ability to walk, improved in 48% cases (CL = 31-65%). The 19 patients who were ambulatory before RT, did not deteriorate after treatment. Sphincter function, evaluated by patient's need for indwelling catheter, improved in 3 of 7 automatic dysfunction cases. It was found that early diagnosis was more important than primary tumor type for predicting a good was found that early diagnosis was more important than primary tumor type for predicting a good prognosis. In fact, all ambulating patients responded to treatment independent of the radiosensitivity of the tumor histology.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2772252 TI - Lactation after breast conserving therapy, including radiation therapy, for early breast cancer. AB - Two patients who underwent breast conservation including radiotherapy for early breast carcinoma are described and who subsequently delivered healthy newborn infants. One of the two patients lactated from both the irradiated and the non irradiated breast; whereas the other patient did not lactate from the irradiated side. The treatment and implications are discussed. PMID- 2772253 TI - An intercomparison of the accuracy of computer planning systems for brachytherapy. AB - The accuracy of brachytherapy computer planning systems has been investigated by means of an intercomparison of the dose distributions as calculated by these systems for five specific test cases. In this intercomparison, 13 radiotherapy institutions in The Netherlands participated. The planning systems evaluated comprise all commercial systems in clinical use in The Netherlands (different versions of in total four manufacturers) as well as in-house developed systems. The five test cases were designed in order to quantify the errors introduced by: (a) the calculation algorithm including the method of source specification used; (b) the localisation procedure via orthogonal radiographs; and (c) the clinical dose specification system in the case of a geometrically irregular implantation for which no established, rigid dose specification method is available. The results of this comparison can be summarized as follows: The accuracy of most calculation algorithms appears to be satisfactory except for the region close to the longitudinal axis of linear sources. Source strength specification in terms of activity or milligram radium equivalent can result in dosimetric errors which may be clinically relevant and therefore specification of the source strength in terms of "output", i.e. air-kerma rate at a specified distance, is to be preferred. This concurs with recent national and international recommendations regarding source strength specification. Localisation via orthogonal radiographs, as commonly used, appears to cause noticeable errors. This aspect could be improved in a quality assurance program. In case of "irregular" implantations, the uncertainty in clinical dose specification clearly dominates the overall accuracy. This illustrates the need for a consistent dose specification system, which is capable of including interstitial implants with a source geometry deviating from the rules given by the existing specification systems. It can be concluded that in brachytherapy, whenever possible, a well-defined, rigid clinical dose specification system should be applied, but that even in such cases the delivered dose may be in error by more than 5% (1 S.D.). PMID- 2772254 TI - Latent-time estimation for late cutaneous and subcutaneous radiation reactions in a single-follow-up clinical study. AB - In this paper, an analysis of the fractionation sensitivity and latency of subcutaneous fibrosis and telangiectasia in a clinical series is presented. The series comprised 163 breast cancer patients who, from 1978 to 1980, received postmastectomy irradiation delivered in 12 fractions, with 2 fractions per week over a period of 37 to 46 days. The total dose was specified either as a maximum absorbed dose of 51.36 Gy, or as a minimum target dose of 36.6 Gy specified at the level of the mid-axilla. From 1981 to 1982, 66 patients received a minimum target dose of 40.92 Gy in 22 fractions administered as 5 fractions per week over 29 to 35 days. Late complications were evaluated prospectively at a single follow up after a minimum observation time of 16 months. The clinical endpoints analyzed were subcutaneous fibrosis and telangiectasia. The data were analyzed using a mixture model that incorporates both dose fractionation and latency effects. The length of time to expression of 90% of the ultimate frequency of moderate or severe complications was 3.2 years (95% confidence limits (c.l.) [2.3,3.9] years) and 4.7 years (95% c.l. [4.0,4.8] years) for fibrosis and telangiectasia respectively, while the alpha/beta ratios were 1.9 Gy (95% c.l. [0.8,3.0] Gy) and 3.7 Gy (95% c.l. [0.2,47] Gy), respectively. For subcutaneous fibrosis the time to reach a specific grade of reaction increases with the grade, thus being consistent with the clinical impression that fibrosis progresses in severity over time. If latency and censoring effects are unaccounted for, serious underestimates of the ultimate frequency of radiation complications in groups with incomplete follow-up may result. PMID- 2772255 TI - A functional assessment of the relative cardiotoxicity of adriamycin and epirubicin in the rat. AB - The cardiotoxicity of the two anthracyclines, adriamycin and epirubicin, were studied in 14-week-old Sprague-Dawley rats after the intravenous administration of single doses of 1-4 mg/kg of adriamycin and 2-6 mg/kg of epirubicin. These doses of the two drugs were well tolerated with little acute toxicity. Acute toxicity was characterised by a transient reduction in body weight with recovery within 14 days. The cardiac output of the rats was measured at 4-weekly intervals, for up to 20 weeks, using an external counting technique with the radioactive tracer, 99mTc. The time-related changes in cardiac function in the rat after adriamycin and epirubicin were similar. The time course of the changes in cardiac output were biphasic. There was an initial phase of rapid decline in cardiac output in the first 12 weeks (phase I) and a second phase of persistent depression in cardiac function (phase II) after 12 weeks. The late progression of anthracycline-induced cardiotoxicity could be predicted from the measurements of cardiac output at 12 weeks. The relative cardiotoxicity of adriamycin and epirubicin was evaluated from the reductions in cardiac output and from the incidence of deaths related to cardiotoxicity. Both methods of evaluation showed that adriamycin was approximately twice as cardiotoxic as epirubicin. This relationship was independent both of the dose level of drugs used and of the damage level used for the evaluation. Dose-response curves were steeper for adriamycin than for epirubicin. The present findings agree with the somewhat limited clinical data suggesting that the present rat model is highly predictive and clinically relevant. PMID- 2772256 TI - Radiosensitivity of human prostate cancer and malignant melanoma cell lines. AB - The relative radioresponsiveness of human prostate cancer compared to malignant melanoma is well known. The effects of beta-estradiol or testosterone on the X irradiation survival of several human cell lines were studied, including: human prostate carcinoma cell lines PC3 and DU145 and human malignant melanoma cell lines A375 and A875. Lines PC3 and DU145 demonstrated 55-61 fmol per 10(6) cells of androgen receptor with no detectable estrogen or progesterone receptor. Cells were irradiated at 120 cGy/min dose rate. There was no detectable toxicity of up to 10(-4) M testosterone or beta-estradiol on PC3 or DU145 cells in the absence of X-irradiation. At plating efficiencies from 11-13%, and plating densities of 1 x 10(4) cells per 60 cm2 flask, cell lines PC3 and DU145 demonstrated a Do of 108.5 +/- 6.5, n 2.1 +/- 0.7 cGy, and Do of 143.5 +/- 1.5 cGy, n 2.4 +/- 0.5, respectively. The addition of testosterone or beta-estradiol at 10(-4) to 10(-10) M prior to or after, X-irradiation did not alter radiosensitivity. At the same dose rate of 120 cGy/min, malignant melanoma cell lines A375 and A875 had a Do of 125 +/- 2.5 cGy, n 1.56 +/- 0.8 SF2 0.65 +/- 0.03 and line A875 demonstrated a Do of 129 +/- 4.5 cGy, n 1.58 +/- 0.4 SF2 0.55 +/- 0.04, respectively. The radiosensitivity of melanoma cell lines did not decrease at low dose rate 5 cGy/min. Thus, the in vitro radiosensitivity of androgen receptor positive prostate cancer cell lines is not necessarily altered by the presence of androgen before or after irradiation. The data support the concept that all malignant melanoma cell lines do not show a broad-shouldered cell survival curve in vitro and intrinsic cellular radioresistance. PMID- 2772258 TI - Nursing and minority research. PMID- 2772257 TI - Evaluation of L6, an anti-carcinoma murine monoclonal antibody, in tumor-bearing nude mice. AB - L6 is a murine monoclonal antibody (MAb) binding to cells of most human carcinomas, mediating antibody-dependent cellular cytotoxicity and complement dependent cytotoxicity, and inhibiting tumor growth in nude mice [10]. Fab and F(ab')2 fragments of L6, as well as intact MAb, have been evaluated for immunospecific localization in nude mice xenografted with a human lung carcinoma. They were compared with preparations of an isotype-matched control immunoglobulin, P1.17, after labelling with 125I or 131I. L6 Fab fragments prepared from MAb L6 and labelled with 67Ga via desferrioxamine were also tested. The data suggest that MAb L6 may be useful for in vivo detection of human carcinomas. PMID- 2772259 TI - Developing and testing the beliefs about caregiving scale. AB - Four studies were conducted to refine and test a newly developed instrument designed to identify caregivers who are at high risk for providing poor-quality care to a dependent elder in the home: the Beliefs About Caregiving Scale (BACS). The BACS was tested for internal consistency, stability, and construct validity. Results suggest strong evidence for internal consistency and for construct validity using the multitrait method as well as moderate evidence for construct validity using predictive modeling. Although further refinements are required, initial tests suggest that the BACS is potentially useful for both research and clinical applications. PMID- 2772260 TI - Measurement of the chronic pain experience: development of an instrument. AB - Development and testing of the Chronic Pain Experience Instrument (CPEI) were initiated to address the need for a valid and reliable instrument for the accurate clinical assessment of, as well as for the empirical investigation of, the chronic pain experience, that is, the personal response to living with nonmalignant persistent pain. When tested with persons with rheumatic disease (N = 160), the 16-item CPEI demonstrated high internal consistency, adequate stability, and moderate construct validity. Analysis included coefficient alpha, interitem correlations, item-scale correlations, Pearson r, factor analysis, and predictive modeling. Additional testing of the CPEI is suggested prior to its clinical application. PMID- 2772261 TI - Maternal presence, childrearing practices, and children's response to an injection. AB - The purpose of the study was to investigate the effects of maternal presence or absence and childrearing practices on young children's response to an injection. One hundred thirty-eight mothers and their children, who were attending health screening clinic, were assigned to one of four groups in which mothers were either present or absent during an interview and an immunization. Mothers were asked to fill out a questionnaire about their childrearing practices. Child behavior was observed during both the interview and the immunization. Results indicated that while maternal presence was associated with the children behaving more distressed during the interview, maternal presence had no effect on child behavior during the immunization. Children whose mothers reported high levels of both control and warmth in their relationship (authoritative parents) were found to be significantly less distressed during the immunization than children of either the low-control, high-warmth (permissive), high-control, low-warmth (authoritarian) or low-control, low-warmth (nonresponsive) parent groups. PMID- 2772262 TI - Explaining the pain of active labor: the importance of maternal confidence. AB - This study was designed to investigate the relationships between the perception of pain during active labor and nine predictor variables: age, parity, childbirth preparation, state anxiety, confidence in ability to handle labor, concern regarding the outcome of labor, fear of pain, cervical dilatation and frequency of uterine contractions. The sample included 134 low-risk women at term with a normal singleton pregnancy. Standard and stepwise regression was used to examine the ability of the selected variables to explain the variance in the sensory, affective, and evaluative components of pain as measured by the subscales of the Pain Rating Index of the McGill Pain Questionnaire. Although significant proportions of variance were explained for each component of pain, the study variables were most powerful in their ability to explain the variance in the affective component of active labor pain. The stepwise analysis suggested that of the nine variables, confidence in ability to handle labor was the most significant predictor of all components of pain during active labor. PMID- 2772264 TI - Stress and coping in a NICU. AB - The stress and coping of NICU nurses were examined in this study. Questionnaires were designed to measure the coping strategies used by the nurses (N = 30); the perceived helpfulness of the coping strategies; the frequency, controllability, and stressfulness of eight common NICU situations; and overall stress and satisfaction. The results suggested that nurses used a variety of problem oriented and emotion-oriented coping strategies, which they found helpful. Common coping strategies were identified regardless of the NICU situation. Overall satisfaction was inversely related to experience and education, but unrelated to stress. The implications of these findings for managing stress and reducing burnout were discussed. PMID- 2772263 TI - Beliefs about aging and illness in a community sample. AB - Findings from recent studies have demonstrated age group differences in coping with illness. One explanation for these age group differences has received little attention: perceptions of illness may differ with age and these differences in perception may account for the observed differences in coping. The purpose of this study was to examine the effects of age on illness perceptions along dimensions that influence coping. Specifically, we explored perceptions about aging as a cause of illness and perceptions about the effect of age on seriousness, curability and controllability of illness. Four hundred fifty-one community-dwelling adults (age range 20 to 90 years) participated in the study. The pattern of results showed respondents of all ages expressing the belief that aging is associated with increased susceptibility to disease and lowered potential for control or cure. Implications of these beliefs for health monitoring and coping with illness are discussed. PMID- 2772265 TI - Nursing turnover: an integrated model. AB - An integrated model of turnover incorporating personal, organizational, and job experience variables as well as job attitudes and behavioral intentions as predictors of voluntary turnover among staff nurses was tested. Results confirmed the hypothesis that intention to leave would be the most immediate determinant of actual turnover. Personal, organizational, and job experience variables were found to influence voluntary turnover only indirectly through their effects on three attitudinal variables: felt stress, job satisfaction and organizational commitment, and intention to leave. As hypothesized, the strength of the intention-turnover relationship decreased as the time interval between expressed intentions and turnover behavior increased. PMID- 2772266 TI - Analysis of structure-function relationships of neuropeptide Y using molecular dynamics simulations and pharmacological activity and binding measurements. AB - Studies on the structure-function relationship of neuropeptide Y (NPY) were undertaken using a combination of in vacuo molecular dynamics (MD) simulations and pharmacological receptor binding and biological activity measurements. Following a conformational search of NPY from which a theoretical structure was determined, a study of the structural and dynamic changes in the region of amino acids 25-36 was performed in a variety of NPY fragments and in the NPY free acid. Results revealed an increased structural change as the fragment size was decreased. Also, the mobility appears to be lowest in the full NPY vs the NPY fragments. Pharmacological measurements showed a decreased receptor binding and biological activity as fragment size decreased. Combination of the two approaches suggests a model where conformational maintenance and low configurational entropy of the 25-36 region of NPY favors both receptor binding and biological activity. Furthermore, the possibility of two receptor interaction modes is suggested. Analysis of the NPY structure suggests the direct importance of the amidated C terminus, Gln34 and His26, an indirect importance of the Tyr1 sidechain as well as the potential importance of an apparent electric 'dipole' in NPY for receptor binding and biological activity. PMID- 2772268 TI - Effect of pancreatic enzyme supplementation on postprandial plasma cholecystokinin secretion in patients with pancreatic insufficiency. AB - To test the hypothesis, based on studies in healthy man and dog, that patients with impaired digestion due to severe pancreatic insufficiency have impaired postprandial cholecystokinin (CCK) secretion that can be improved by the addition of pancreatic enzymes, we have studied plasma CCK responses to a test meal with and without addition of pancreatic enzymes in 10 patients with pancreatic insufficiency and steatorrhea, in 8 patients with chronic pancreatitis without steatorrhea, and in 6 healthy subjects. The patients with steatorrhea had a significantly (P less than 0.001) lower integrated plasma CCK response to the meal (177 +/- 23 pM.150 min) than the healthy subjects (468 +/- 41 pM.150 min), while patients with chronic pancreatitis without steatorrhea had an intermediate integrated postprandial CCK secretion (327 +/- 101 pM.150 min). Addition of pancreatic enzymes to the meal significantly augmented the integrated CCK response in both the patients with steatorrhea to 483 +/- 72 pM.150 min (P less than 0.01) and in those without steatorrhea to 480 +/- 85 pM.150 min (P less than 0.05). These values were not significantly different from those in the healthy subjects (521 +/- 86 pM.150 min). Integrated CCK secretion in the three groups during bombesin infusion was similar (patients with steatorrhea 134 +/- 23 pM.20 min, patients without steatorrhea 131 +/- 33 pM.20 min, and healthy subjects 146 +/- 28 pM.20 min), indicating a normal capacity to secrete CCK in response to a humoral stimulus. These data are in agreement with the suggestions from previous studies that digestion of nutrients by pancreatic enzymes plays an important role in the regulation of plasma CCK secretion after feeding. PMID- 2772267 TI - Peptide histidine isoleucine (PHI) immunoreactivity in the rat retina: identification and characterisation by radioimmunoassay, immunohistochemistry and high-performance liquid chromatography. AB - The presence of peptide histidine isoleucine immunoreactivity (PHI-IR) in the retinae of male Wistar rats has been demonstrated using a specific radioimmunoassay (RIA), immunohistochemistry (IHC) and high performance liquid chromatography (HPLC). PHI levels (mean +/- S.E.M.) of 16.68 +/- 1.61 ng/g wet weight of normal retinal tissue were measured by RIA. IHC showed PHI-IR to be localized to a population of amacrine cells distributed along the proximal aspect of the inner nuclear layer and to processes in laminae I and IV of the inner plexiform layer. PHI-IR in retinal extracts was shown to coelute with a synthetic porcine PHI standard on a reverse phase HPLC system. Additionally levels of PHI IR were significantly increased (P less than 0.001) with light adaptation. PMID- 2772269 TI - Statistical analysis of data on airborne asbestos levels collected in an EPA survey of public buildings. AB - Data from a recent EPA study of airborne asbestos levels in 49 buildings occupied by the General Services Administration (GSA) are statistically analyzed. The study focuses on differences between indoor and outdoor levels, and on differences among buildings with no asbestos-containing material (ACM) (6 buildings), buildings with ACM generally in good condition (6 buildings), and buildings containing damaged ACM (37 buildings). Seven indoor samples and a single outdoor sample were collected from most buildings and analyzed by TEM (transmission electron microscopy) using a direct preparation method. No statistically significant differences were detected in asbestos levels between indoors and outdoors or among the three categories of buildings. The average indoor concentration of asbestos was 0.00073 fibers/cc (f/cc) for all fibers and 0.00007 f/cc for fibers 5 microns or longer. The current OSHA occupational standard is 0.2 f/cc for fibers 5 microns or longer as measured by phase-contrast microscopy. PMID- 2772270 TI - Ecosystem health. IV. The National Animal Poison Information Network database as a tool for ecological risk assessment. AB - Toxicology is a unique discipline in human and veterinary medicine because there are orders of magnitude more toxicants available to man and animals than all known pathogenic microorganisms and parasites. The study of toxicologic responses of ecosystems to contaminants, ecoepidemiology, and the specific study of animal populations in this context, epizootiologic ecotoxicology, are concerned with identifying chemically induced causes and determining effects on and links among populations, communities, and ecosystems. Necessary activities implied by the term "epizootiologic ecotoxicology" are the systematic compilation and analysis of "health" data for ecosystem components. This concept paper describes the value and limitations of adapting methods used by the National Animal Poison Information Network (NAPINet) for epizootiologic ecotoxicology studies. It is concluded that NAPINet methodology, as part of an innovative use of population statistics and clinical measurements, could eventually be adapted into a valuable component of a standardized approach to epizootiologic ecotoxicology. PMID- 2772271 TI - [The relief of postspinal headache using the Whitacre cannula. Experimental studies]. AB - The structure of the spinal dura mater and the consequences of puncturing the dural tissue with different types of spinal needles were examined. There is no uniformly longitudinal parallel arrangement of dural fibers in human lumbar dura mater from the segments L3-5, but as shown in both scanning electron microscope imaging and polarized light microscopy the small collagenous fibrils are connected by cross-linked bridges. After perforation with Whitacre's pencil-point needle a kind of double layer membrane surrounds the puncture hole and might be responsible for the rearrangement of dural fibers and sealing of the hole after removal of the needle, like wings closing over each other (curtain-effect). This double layer membrane was not seen after dural puncture with sharp Quincke bevelled needles. PMID- 2772273 TI - [Does the development of methemoglobin in the newborn infant affect the suitability of prilocaine for pudendal anesthesia? A clinical study in the peripartum phase]. AB - Pudendal block is a well established method of achieving analgesia during the second stage of labor. Whenever a large amount of a local anesthetic has to be injected in well vascularized tissue, local anesthetic drugs with low systemic toxicity should be used, to minimize side effects. This means that prilocaine is the drug of choice. It is well known that the metabolites of prilocaine induce methemoglobinemia, and thus the question arises as to whether the methemoglobinemia affects the fetus. PATIENTS AND METHODS. Pudendal block was achieved with 2 x 10 ml prilocaine 1% in each of 17 mothers. Plasma concentrations of the local anesthetic in the second stage of labor were determined by gas chromatography in blood samples drawn from the mother and the newborn at the moment of childbirth. In addition, the time course of methemoglobinemia was determined by capillary blood samples from the neonate up to 6 h. To evaluate methemoglobinemia in the newborn, 125 microliters heparinized capillary blood was diluted with 200 microliters 0.9% sodium chloride; methemoglobin was detected by absorbance spectrometry. RESULTS. Before the pudendal block maternal methemoglobin concentrations were about 0.2% of the total hemoglobin concentration and within the physiological range. At the moment of delivery it was increased only to a small extent, without statistical significance. In the neonates mean methemoglobin concentrations were about 1% of total hemoglobin immediately after delivery, increasing up to 1.8% in the next 2 h and then decreasing continuously in all. At the moment of childbirth maternal mean prilocaine concentrations were 0.57 micrograms/ml on an average and 0.29 micrograms/ml in the newborn. DISCUSSION. With respect to systemic toxicity, prilocaine is the drug of choice in local anesthetic procedures when a long duration of anesthesia is not required; it guarantees short latency and adequate relief of pain. Methemoglobinemia induced by its metabolites is not a contraindication for its use in humans. Formerly prilocaine was judged to be contraindicated in pregnant women during delivery because of the small redox capacity of fetal erythrocytes. Our study, however, demonstrates that 200 mg prilocaine for pudendal block does not induce methemoglobinemia in newborns to any significant extent. One explanation for this may be the increased renal elimination of local anesthetics in newborns and the low fetomaternal ratio. PMID- 2772272 TI - [The relief of postspinal headache using the Whitacre cannula. A clinical study]. AB - In a prospective study spinal anesthesia was performed in 500 patients (338 male and 162 female patients between 16 and 91 years of age: mean 46 years), with a total number of 603 spinal anesthetics. In all cases a 22G Whitacre needle was used. All patients were mobilized from the day of the operation onward and visited 4 days later by the interviewer and asked about any symptoms, especially headache. Mild postspinal headache occurred in 11 cases (1.8% of total), all in patients younger than 50 years of age and more in women. There were 6 patients among the 11 who did not need specific therapy their headache; for the others antipyretic analgesics, adequate hydration and/or bedrest were satisfactory. The study shows that the incidence of postspinal headache was significantly reduced by the use of Whitacre's pencil-point needle in comparison with findings reported in the literature. PMID- 2772275 TI - [Endotracheal intubation in thoracic catheter peridural anesthesia]. AB - After standard preparation, the catheter is preferably inserted in a sitting position. A test dose of 4 ml etidocaine 1% is injected, initially followed by 1 ml per segment of the total calculated analgesic dose. Analgesic spread, blood pressure, and pulse are checked every 2 min. If a sufficient effect is not reached within 20 min, a further 2 ml per segment is injected. The patient is sedated in the operating room with diazepam, droperidol, or chlorpromazine and receives 6-8 l O2 during spontaneous respiration via a Hudson mask. The epidural catheter is left in place for postoperative analgesia. Intubation is used only as required. Of a total of 52 patients, 31 (60%) did not require intubation, 24 (46%) were age 70 or older, and 31 (60%) were classified as ASA risk group III IV. Thirty-three of all the procedures (63%) involved upper abdominal surgery (liver, gallbladder) and the majority of these received thoracic (Th 9-10) punctures, with the catheter inserted 5 cm in the epidural space; 88% were punctured medially and 12% laterally. The most frequent complications were bradycardia and hypotension. Respiratory arrest and aspiration were not seen. Thoracic epidural catheter anesthesia can be carried out with or without intubation and with a minimum of complications in selected procedures. Postoperative analgesia is an important advantage. PMID- 2772274 TI - [The quantitative analysis of amide local anesthetics using high pressure liquid chromatography and ultraviolet detection (HPLC/UV)]. AB - This study was undertaken to develop a time- and cost-effective method for the detection of lidocaine, mepivacaine, prilocaine, bupivacaine, and etidocaine by HPLC/UV. The chromatographic system consisted of a C18-column (300 x 3.9 mm) for reversed-phase chromatography and a mobile phase of 30% acetonitrile and 70% 0.05 M sodium phosphate buffer. For the analysis of lidocaine, mepivacaine, and prilocaine, the buffer was adjusted to pH 5.8. The buffer for the analysis of bupivacaine and etidocaine was adjusted to pH 3.5. The flow rate was 1 ml/min. UV detection took place at a wavelength of 210 nm. All blood samples were taken from a central venous line. After plasma separation, 1 microgram (100 microliters) of internal standard was added to 1 ml plasma. The samples were alkalized and extracted with ether, followed by the extraction of the organic phase in 250 microliters 0.05 N sulphuric acid; 50 microliters of this solution was injected into the system. The chromatographic system allowed the separation of bupivacaine and etidocaine (pH 3.5) as well as lidocaine and mepivacaine or prilocaine (pH 5.8). Separation of prilocaine and mepivacaine in one run was not satisfactory. Recovery rates for all local anesthetic substances were about 90%, standard variations below 3%, and coefficients of variation below 2%. The detection limit was about 30 ng/ml. The method is suitable for clinical practice. Only minor methodological modifications are necessary for the detection of the amide local anesthetics in current clinical use. PMID- 2772276 TI - [The local anesthetic effect of tetrodotoxin on the natural spike activity of the depressor nerve in rabbits]. AB - Tetrodotoxin (TTX) has been presented as an ultra-long-acting local anesthetic. Because its duration of action on myelinated nerve fibers of warm-blooded animals is unknown the effect of TTX on natural spike activity (A-delta fibers) of rabbit aortic nerve in vivo was studied. In 13 animals, a segment of the aortic nerve was placed in a perfusion chamber and exposed to increasing concentrations of TTX (n = 8) and, for comparison, of procaine (n = 8), which like TTX has a high pka. Total nerve activity and its change as related to drug concentrations was recorded continuously (concentration effect curves). The half-lives (t1/2) of onset time after drug administration and recovery following drug washout were also determined. TTX blocked nerve activity in a concentration-related manner, as did procaine; however, the potency of TTX (EC50 = 3.3 +/- 0.8.10(-9), cm = 1.3 +/ 0.4.10(-8) mol/l) was about 50,000 times higher than that of procaine (EC50 = 1.6 +/- 0.2.10(-4), cm = 2.5 4/- 0.3.10(-4) mol/l). Onset time did not differ statistically (p = 0.08) between TTX (t1/2 = 3.5 +/- 0.4 min) and procaine (t1/2 = 2.2 +/- 0.5 min). Most importantly, TTX block could not be reversed within 1-5 h of drug washout (n = 5) or was reversed incompletely (13%, 66%, and 90% of control activity) with t1/2 16 to 21 min. In contrast, all the procaine-blocked nerves recovered completely (t1/2 = 3.0 +/- 0.4 min). TTX blocks myelinated A delta fibers of warm-blooded animals with lower concentrations and for a longer time than nonmyelinated fibers.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2772278 TI - [Initial experiences with a novel nerve stimulator for use in axillary plexus anesthesia]. AB - The advantages of an electrical nerve stimulator for detection of the axillary neurovascular sheath have been frequently described in the literature and are now well known. In most of these techniques, stimulation is achieved by a fixed electrical voltage and variable amplification. The new nerve stimulator presented here offers the possibility of measuring the current at the site of stimulation ("test" position). PATIENTS AND METHODS. Axillary block was performed in 23 patients undergoing orthopedic surgery. Identification of the neurovascular sheath was first achieved by the "loss of resistance" technique, after which the injection cannula was connected to the new device. Stimulation was started at 1.0 mA. In case of a negative response to stimulation the actual electric current was checked by means of the test position in order to exclude an error in the circuit system. In these cases, the position of the cannula was altered so as to maintain a response at the lowest possible current (less than 0.5 mA). After removal of the inner solid steel stylet of the cannula, the local anesthetic was injected while compressing the distal part of the neurovascular sheath in order to avoid downstream diffusion. RESULTS. All 23 patients were operated upon under axillary block after nerve stimulator control without any additional drugs. Table 2 indicates the lowest stimulation current that still evoked a response. Disturbances in the circuit system were found twice, one caused by a short circuit, the other by a desiccated gel pad on the adhesive electrode. After elimination of the defect, stimulation produced a response. DISCUSSION. Since it is now well known that induction of paresthesias in locating peripheral nerves can cause irreversible lesions, the use of electrical nerve stimulators is preferred to locate the cannula as near as possible to the nerve without direct contact. The mode of operation of the stimulator presented here, which defines the chosen technical starting impulse as well as the actual current, allows much better localization of nerves during local anesthesia. Thus, disturbances in the circuit between nerve stimulator and patient, as shown in the two cases, can be detected. According to our experience, the intensity of stimulation for successful nerve blockade should be approximately 0.5 mA or lower. Consequently, universally applicable stimulating instruments with constant electrical tension should allow fine tuning of the current in 0.1-mA aliquots. PMID- 2772277 TI - [Epidural anesthesia and local administration of high-dose prostaglandin in obstetrics. A dangerous combination]. AB - The use of high epidural anesthesia for cesarean section has generally been accepted as a safe and comfortable means of intra- and post-operative pain relief in recent years. However, the accompanying vasomotor blockade of the lower body and the sometimes impaired cardiac reflex activity restrict the use of concomitant--even local--medication. Described are the deleterious side effects on hemodynamic stability and patient comfort of an intramyometrically administered synthetic prostaglandin E (PGE2)-compound (dinoprostone) given to three female patients under high epidural anesthesia during cesarean section. Differentiation of the various symptoms is made in relation to their epidural or PGE origin or to a combination of the two. A striking therapeutic resistance of the hypotension of a sufficiently volume-expanded patient to even large doses of ephedrine is discussed as representing possible PGE-mediated suppression of peripheral norepinephrine release. PMID- 2772279 TI - [Tachyphylaxis to local anesthetics]. PMID- 2772280 TI - [Use of continuous block of the lumbar plexus ("3-in-1 block") for pain management in children]. PMID- 2772281 TI - Fluid overload in acute renal failure. PMID- 2772282 TI - Effect of 1,25-dihydroxyvitamin D3 on intestinal glucose absorption in uremic rats. AB - The effect of 1,25-dihydroxyvitamin D3 (1,25-D) on the absorption of glucose in the small intestine was studied in five-sixths nephrectomized uremic rats and sham-operated rats. Four weeks after the nephrectomy, the uremic animals were divided into two groups: One group was given 1,25-D (300 pmol/kg body weight/day, three times per week) intraperitoneally, and the other was left untreated. One week after the 1,25-D treatment, an in vivo glucose absorption test was performed at 00.00 h in consideration of the circadian rhythm of glucose absorption. In untreated uremic rats, the glucose absorption rate was lower than in sham operated rats. In 1,25-D treated uremic rats, the glucose absorption rate was higher than in untreated uremic rats and not lower than in sham-operated rats. These results suggest that the absorption rate of glucose of the small intestine is reduced in uremic rats and that it is recovered on treatment with 1,25-D. PMID- 2772283 TI - Acute renal failure due to McArdle's disease. AB - A 37-year-old previously fit man developed acute renal failure associated with rhabdomyolysis following a brief period of strenuous exercise. Subsequent muscle biopsy and ischaemic arm exercise confirmed the diagnosis of McArdle's disease. This case illustrates that McArdle's disease can present with acute renal failure in the absence of a past history of exercise-induced muscle pain and stiffness. PMID- 2772284 TI - Effect of prostaglandin E2 (PGE2) in the prevention of acute renal failure in anesthetized dogs. In situ renal preservation. AB - Six healthy dogs, after control measurements, were subjected to renal artery occlusion for 90 min, under general anesthesia. 5 mg of PGE2 (Prostin E2, Upjohn) diluted in 100 mL of normal saline was infused directly into the left renal artery for 90 min (PG group), while only normal saline was infused into the right renal artery (control group). After removal of the clamps blood and urine samples were collected every hour for the first 3 h of revascularization and both kidneys were then removed for histological study by light microscopy. PG kidneys regained urine flow above the oliguric levels within 3 hr of revascularization (0.30 +/- 0.04 mL/min vs 0.14 +/- 0.03 mL/min in controls (p less than 0.001). Creatinine, urea, and osmolar clearances were also significantly higher in PG group (p less than 0.01 or p less than 0.001 for 2 and 3 hr of follow-up after revascularization). Urine sodium concentration and fractional sodium excretion (FENa) (%) were not significantly lower in the PG group compared to the controls. Histology showed focal brushborder loss, hyaline and granular casts, focal tubular dilation, and focal necrotic lesions on the tubular cells in both groups of kidneys. A direct cytoprotective effect of the PGE2 was not found. It is suggested that PGE2 is effective in the protection of renal function when it is administered during the mechanical occlusion model of acute renal failure in anesthetized dogs. PMID- 2772285 TI - Influence of the rate of infusion on cyclosporine nephrotoxicity in the rat. AB - The effect of the rate of infusion of single and multiple doses of cyclosporine (CsA) on renal function was evaluated in Sprague-Dawley rats. CsA was dissolved in cremophore (Crem) or Tween 80 (Tween) and infused over consecutive 10-min periods at doses of 10, 20, 30 and 40 mg/kg. CsA-Crem and CsA-Tween produced similar and progressive changes in MAP, RBF, and RVR. By the end of the infusion, the mean values (% of control) of MAP (122 +/- 16% and 131 +/- 22%), RBF (56 +/- 11% and 66 +/- 20%), and RVR (222 +/- 38% and 232 +/- 134%) were significantly different from their respective preinfusion values. Infusion of Crem alone resulted in renal vasodilation at low doses and renal vasoconstriction at high doses. Vasoconstriction was not produced by infusion of Tween alone. In addition, animals were treated with vehicle alone (Gp 1), CsA 10 mg/kg/day by injection (Gp 2), or CsA 20 mg/kg/day by i.v. infusion over 4 hr (Gp 3), and were studied at 1 week. Systemic toxicity was greater with the 4-hr infusion as judged by an increase in MAP. The mean values of MAP were 107 +/- 8 (Gp 1), 101 +/- 13 (Gp 2), and 135 +/- 5 mm Hg (Gp 3; p less than 0.05). However, renal function was less severely affected with the 4-hr infusion. The mean values of CIn were 434 +/- 99 (Gp 1), 298 +/- 101 (Gp 2; p less than 0.05), and 425 +/- 114 microL/min/100 g BW (Gp 3); and the mean values for RBF were 2.72 +/- 0.74 (Gp 1), 2.08 +/- 0.17 (Gp 2; p less than 0.05), and 3.35 +/- 0.61 mL/min/100 g BW (Gp 3), respectively. Microangiograms showed marked abnormalities in the intrarenal perfusion pattern in the rats injected with CsA, 10 mg/kg BW. In rats infused over 4 hr with CsA, 20 mg/kg BW, the microangiographic pattern was normal. These studies demonstrate that the acute hemodynamic effects of CsA are directly related to the rate of infusion. Furthermore, the renal toxicity which follows repetitive injection of CsA can be minimized or avoided by administering CsA as a slow infusion. In addition to the total dose administered, the rate of infusion is an important determinant of nephrotoxicity. PMID- 2772287 TI - Abstracts: International Symposium on Prevention, Treatment and Diagnosis of Acute Renal Failure: From the Laboratory to the Clinic. September 17-20, 1988, Edmonton, Alberta, Canada. PMID- 2772286 TI - Acute renal failure due to viperine snake bite as seen in tropical western India. AB - A wide spectrum of clinicopathological changes have been described in 50 cases of ARF following viperine snake bite studied prospectively over a 15-year period. Disseminated intravascular coagulation (DIC) was seen in 24/50 cases (Russel's viper bite in 62% and Ecchis carinatus bite in 42% of subjects). Histological examination of renal tissue obtained 1.5 days to 8 weeks after the bite revealed proliferative glomerular changes in 17 cases. These were characterized by ballooning of the capillaries, thickening and splitting of glomerular basement membrane (GMB), fibrin thrombi in the capillaries, and mesangial cell proliferation most prominently seen in Ecchis carinatus bites resulting in ARF. PMID- 2772288 TI - Mental health aspects of mental retardation: results of an NIMH-UIC conference. PMID- 2772289 TI - Movement of developmentally disabled individuals among out-of-home residential facilities. AB - This paper reported on the movement of a large (N = 2271) probability sample of the nation's residents of public (PRF) and community (CRF) residential facilities for developmentally disabled children and adults. Estimates placed the national population at 217,410 in all facilities--73,709 in CRFs and 143,701 in PRFs--in the fall of 1978, when the sample was selected, although extrapolation from subsequent surveys suggest that the CRF numbers should be about 100,000. In the winter of 1979 direct care staff and administrators completed detailed information about each resident sampled, about themselves, and about their facilities. In 1980 they were asked if their residents had moved exactly one year later. Most residents (91%) had not moved; 1.3% had died; and about 8.5% had moved. Most moves featured greater integration into the community. Multivariate analyses indicated very little difference between moved and unmoved residents. Among moved subjects, three dimensions accounted for 62% of the common variance in placement status: (a) ability, (b) age, and (c) autonomy. PMID- 2772291 TI - [Antioncogenes]. PMID- 2772290 TI - Behavior disorders and mental retardation: the family system perspective. AB - The aim of this study was to investigate feelings of stress among parents of mentally retarded children who demonstrate behavior disorders. The interrelations of the children's pathology and family climate variables with the levels of parental stress were studied. The sample consisted of 39 families with moderately mentally retarded children divided into two groups: Children demonstrating disruptive behavior (n = 17), and children who did not demonstrate behavior disorders (n = 22). The instruments included the Child Behavior Checklist, the Classroom Behavior Inventory, the Family Environment Scale, and the Questionnaire on Resources and Stress. Significant differences between the children's levels of pathology validated the two groups' division. The children with disruptive behavior were described by their parents as more hyperactive and aggressive, and were described by their teachers as more distractable and dependent on adults. No significant differences were found between the profiles of family climate among the two groups of parents. However, levels of children's pathology and aspects of family climate predicted the parental stress, pinpointing different patterns of variables for fathers and mothers. Further studies should be addressed to the interrelations between children's pathology, family climate, and parental feelings of stress. PMID- 2772292 TI - [Complications in diabetic patients on dialysis: experiences in 10 years of treatment using 3 technics]. AB - In treated diabetic patients with terminal renal failure we have examined the complications arising from the dialysis technique used. 55 patients were followed up for 1.279 months. Out of the latter, 24 were on hemodialysis (HD) 33 on continuous ambulatory peritoneal dialysis (CAPD) and 9 on intermittent peritoneal dialysis (IPD). Intraperitoneal insulin in patients on CAPD best controlled glycemia. Antihypertensive therapy was not necessary in 86%, 66%, and 46% of the patients on CAPD, IPD and HD respectively (CAPD vs HD, p less than 0.001). Acute myocardial infarction was more common in patients on HD (33%) (p less than 0.05). 22% of the patients on IPD had limb amputation (IPD vs CAPD-HD, p less than 0.05). The type of dialysis method used does not seem to influence the course of the retinopathy. The neuropathy behaved in a similar manner in those on CAPD and on HD when followed up for two years. Vascular complications were frequent in those on HD with one thrombotic event every 9.7 months/patient and a new vascular access every 7.4 months/patient. Peritonitis was the main complication of CAPD and IPD which was found more frequent in the former and longer hospitalization in the latter. The election of the dialysis technique in diabetic patients can directly influence the glycemia levels and blood pressure reading, as well as heart complications and those due to the method used. However they seem to influence less the neuropathy, retinopathy and peripheral vasculopathy. PMID- 2772293 TI - [Legionellosis at intensive care units: study of 30 cases]. AB - A prospective study during 44 months has been carried out in order to establish the incidence of pneumonia due to Legionella sp. in our hospital's intensive care unit (ICU). Thirty cases of legionellosis were diagnosed (22.2% of the studied pneumonias) two of them were acquired in the ICU and 76.6% were caused by L. pneumophila serotype. The most evident symptomatology was intense dyspnea, neurological disorders, acute respiratory and renal failure. The biochemical alterations, most commonly encountered were increased liver enzymes, hypoxemia, hypoalbuminemia, increased urea, creatinine and hematuria. As a consequence of this severe disease, the mortality rate was high (13 out of 30 cases). PMID- 2772294 TI - [Infection in systemic lupus erythematosus]. AB - The possible infections of 43 hospitalized patients with systemic lupus erythematosus (SLE) has been assessed. Out of the 43 patients 17 had some type of infection (41%). The diagnosis was proven by positive cultures in 84% of the cases. Urinary infections due to E. coli were the infections most commonly found. Four infections due to staphylococcus, 2 to S. typhi and 2 to invasive Aspergillosis were also found. Tuberculosis was observed only in 2 patients. In twelve out of the 17 patients with infections, SLE was active and 10 of the latter had renal failure. In addition to the 18 urinary infections diagnosed, sepsis was encountered in 5 patients and pneumonias in 4. Only two infected patients died (those with invasive aspergillosis). Thus, infections are frequent in patients with SLE and precise diagnosis often requires positive culture test. PMID- 2772295 TI - [Second neoplasms in Hodgkin's disease]. AB - Today, excellent therapeutic results are obtained in Hodgkin's disease however, they may be obscured by the development of long term complications due to the treatment given including second neoplasias. Out of the total of 250 cases of Hodgkin's disease reviewed during 19 years we found 13 secondary neoplasias. All the patients received alkylating drugs and in 10, both chemo and radiotherapy were associated. The average interval of time was 48 months. Bronchopulmonary carcinomas and acute leukemias were the malignancies most often encountered. PMID- 2772296 TI - [A 73-year-old patient with discrete changes in hepatic biochemistry]. PMID- 2772297 TI - [Tumor of the bone in a young man]. PMID- 2772298 TI - [Role of ibopamine in cardiac insufficiency in auricular fibrillation. Presentation of a case]. PMID- 2772299 TI - [Atrioventricular block associated with left spontaneous pneumothorax]. PMID- 2772300 TI - [Sepsis and multiple hepatic abscesses caused by Yersinia enterocolitica]. PMID- 2772301 TI - [Visceral leishmaniasis and HIV infection: 3 new cases]. PMID- 2772302 TI - [Meningoradiculitis caused by Borrelia burgdorferi]. PMID- 2772303 TI - [Statistical study of evaluation in pharmacology at the Valladolid University Medical School (1979-86)]. PMID- 2772304 TI - [Tuberculosis, HIV and hepatitis medicamentosa]. PMID- 2772305 TI - [Paralysis of the pathetic nerve associated with dolichobasilar artery]. PMID- 2772306 TI - [Intravenous diclofenac sodium in the treatment of nephritic colic]. PMID- 2772307 TI - [Smoking in health professionals at a general hospital]. PMID- 2772308 TI - [Vasculitis-AIDS. A fortuitous association?]. PMID- 2772309 TI - [Biochemical plasma changes in essential hypertension patients treated for a year]. AB - The possibility that certain antihypertensive drugs produce metabolic alterations in patients with hypertension treated during one year, has been prospectively assessed in 40 patients with essential hypertension with matched age and blood pressure readings. Four groups (Gr) of 10 patients each were studied. Group 1 received 100 mg/day of atenolol (AT), group 2 received 5 mg of amiloride and 50 mg of hydrochlorothiazide (4 tablets per week), group 3 received 40 mg/day of nifedipine retard (NF) and group 4 received 50 mg/day of captopril (CP). The parameters studied prior and after one month of treatment were the following: urea, creatinine, uric acid, Na+, K+, Ca+, total cholesterol, HDL-cholesterol, triglycerides, glycemia, blood pressure (BP), pulse rate (PR) and body weight. Both group 1 and 2 showed significantly increased total cholesterol (p less than 0.001 and p less than 0.01 respectively) as well as decreased HDL levels. In addition, group 2 had significantly increased levels of uric acid, glycemia and triglycerides (p less than 0.01). In the latter groups no significant changes were found within body weight, lipid levels, glycemia, uric acid ruling-out weight gain as a possible cause for these adverse metabolic effects. Pulse rate decreased in group 1. Group 3 pulse rate significantly increased (p less than 0.001) However, no other changes were significant. No significant biochemical or pulse rate readings were found in group 4. BP was best controlled in groups 1, 3 and 4. PMID- 2772310 TI - [Clinical study of tuberculosis in immunocompromised patients]. AB - We have reviewed the clinical histories of 1,815 immunocompromised patients seen in "La Paz Hospital" over a period of 6 years, in order to study the incidence and clinical forms of tuberculosis (TB) in this group of patients. We have distributed the patients into three groups: Group A: 1,372 patients with neoplasia, Group B: 173 patients under immunosuppressor treatment, and Group C: 270 intravenous drug abusers (IVDA). 53 patients developed TB (2.9%): Of these, 31 belonged to group A (2.25%), 14 to group B (5.78%) and 8 to group C (2.96%), resulting in an incidence 50 to 100 times greater than the calculated for the Spanish general population (0.05%). There is a greater incidence of extrapulmonary and atypical forms in IVDA and patients under immunosuppressor treatment. Patients with neoplasia do not present differences in these aspects with regard to immunocompetent patients. If the TB is diagnosed and treated on time it is a potentially curable disease and the immunosuppressed state does not condition a worse response to treatment. PMID- 2772311 TI - [Acute hepatitis in heroin addicts: etiologic and follow-up study of 110 cases]. AB - In order to know the etiology and natural history of acute viral hepatitis in intravenous drugs abusers, a panel of 110 heroin addicts, suffering acute hepatitis, is studied. The B virus, by itself or in conjunction with the delta virus was responsible for 63 cases. 35 patients suffered of NANB hepatitis and only two patients were diagnosed of hepatitis A. Delta infection was detected in 38 of the 77 cases of HBsAg-positive acute hepatitis. All the hepatitis B patients had serum conversion within the first 6 months of the acute episode. All the patients suffering acute delta hepatitis and 75% of those suffering non-A, non-B hepatitis, developed chronic hepatic disease. We conclude that in our environment, the B virus is the main responsible for acute hepatitis in heroin addicts. Delta infection is detected in almost half of the heroin addicts with HBsAg-positive acute hepatitis. The acute hepatitis caused by B virus, or by B and delta viruses simultaneously, have a satisfactory evolution, thus, almost all the cases are cured within 6 months. On the contrary, hepatitis caused by NANB or delta viruses usually progresses to chronic hepatic disease. PMID- 2772312 TI - [Chylothorax and osteolytic lesion]. PMID- 2772313 TI - [Pachydermoperiostosis]. PMID- 2772314 TI - [Design, evaluation and application of a model for evaluating the cognitive abilities related to scientific aptitude in medical students]. AB - A model for evaluating the cognitive ability related to scientific aptitude consisting of 10 different problems is presented. The design conditions, validity and the application of the model to selected second year Medical students as well as randomly chosen first, third and sixth year students are described. The authors record and analyze global results as well as the results of individual or group of problems, concluding on the validity and fiability of the model as well as on the detection of failures in student's performances inspite of the effort made. Future action is proposed. PMID- 2772315 TI - [Remission of a case of intraparenchymal neurocysticercosis following treatment with praziquantel]. PMID- 2772316 TI - [Bronchiolitis obliterans with organizing pneumonia in an 81-year-old man]. PMID- 2772317 TI - [Glomerulosclerosis in reflux nephropathy. Apropos of 2 cases. Theory of hyperfiltration]. PMID- 2772318 TI - [Platelet activity, platelet size and asthma]. PMID- 2772319 TI - [Risk of contagion with respect to human immunodeficiency virus (HIV) and hepatitis B (HB) due to accidents on the beaches in the city of Barcelona and occupational accidents in non-health personnel]. PMID- 2772320 TI - [Disulfiram-like reaction caused by mushroom ingestion]. PMID- 2772321 TI - [Prolonged fever of unknown origin secondary to a pericolonic abscess due to acute diverticulitis]. PMID- 2772322 TI - [Complications in Mediterranean boutonneuse fever: prospective study of 78 patients]. AB - A prospective study of the clinical evolution of 78 patients diagnosed of mediterranean botonous fever has been performed. Hospital admissions because of complications were necessary in 5 (6,4%) patients. 13 patients (16,6%) had a devious evolution with signs of severe involvement of organs and systems. The evolution was favorable in the remaining 60 cases (79,9%) on home treatment with doxycycline. The unfavorable evolution was associated with advanced age, underlaying chronic disease, and the delay in the initiation of the appropriate treatment. Previous thrombopenia was the major predictive biological factor of unfavourable evolution in our patients. PMID- 2772323 TI - [Possibilities of remission of acute lymphoblastic leukemia in adults: retrospective study of 51 patients subjected to a "total therapy" protocol in the period 1969-1983]. AB - Between 1969 and 1983, 51 (35 men and 16 women) new cases of acute lymphoblastic leukemia (ALL) were diagnosed in patients aged 15 to 85 years (mean 21 yrs.). All patients received a "total therapy" which included: 1st induction (PRD, VCR, DBR, and/or L-ASN); 2nd, Central Nervous System profilaxis (craneal TCT and/or intrathecal MTx); 3rd, maintenance (6MP and MTx) and 4th, reinductions every 3 months (PRD, VCR, and DRB). This treatment lasted for at least 3 years. Complete Remission (CR) was achieved in 45 patients (88.2%): 3 of these patients were referred to other centers to continue treatment, 1 patient developed an early "metamorphosis" to hemophagocytic hystiocytosis and another patient developed a late chronic granulocytic leukemia (Ph +) dying a few months later after an acute myeloblastic worsening. During treatment 16 patients relapsed (9 in bone marrow and 7 in Central Nervous System). Treatment was discontinued in 24 patients with complete remission of which 5 relapsed in bone marrow 17 to 61 months after treatment). In one of the latter (ALL Ph +) an allogenic bone marrow transplant was performed and CR was achieved and maintained 46 months later. The post diagnosis acutarial curve of the 51 patients gave a mean survival of 6 years with a plateau at 43% of the patients after 11 years. The duration of the first uninterrupted CR was of 6.5 years and a plateau was reached at 46% of the patients after 10.5 years. At the present time, 20 patients are in CR (46 to 129 months) without treatment.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2772324 TI - [Levels of blood theophylline in patients with acute bronchospasm]. AB - Plasma theophylline levels (mcg/ml) of 93 patients with a bronchopulmonary disease (asthma and chronic obstructive lung disease) who were on theophylline (normal or retarded) treatment, were determined on admission at the emergency ward because of acute bronchospasm. Our results show that theophylline blood levels were subtherapeutical in patients treated either with normal (2.1 +/- 0.8 mcg/ml) or retarded theophylline (9.6 +/- 1.3 mcg/ml). This was probably due to insufficient dosing and/or poor patient compliance. The necessity of monitoring this type of treatment is once again evident. PMID- 2772325 TI - [Open lung biopsy in immunocompromised patients with diffuse pulmonary infiltrates]. AB - In order to evaluate the diagnostic usefulness of open lung biopsy and to determine how could it influence the treatment and the evolution of the disease, the clinical histories of 19 immunocompromised patients with diffuse lung infiltrates were reviewed. One or more specific diagnosis were obtained in 14 patients (73%) by open lung biopsy. However, the initial treatment was modified, in view of the results of the biopsy only in 3 cases (15%). Only 5 patients survived and were discharged. There were no differences in the survival rate of patients with a specific or a nonspecific diagnosis (11 out of 14 deaths and 3 out of 5 respectively). 5 patients suffered severe complications from the surgical procedure. Open lung biopsy should not be used routinarily in the study of diffuse lung infiltrates in immunocompromised patients. PMID- 2772326 TI - [Priapism as the first manifestation of chronic granulocytic leukemia]. AB - We report a case of priapism in a patient with philadelphia positive chronic granulocytic leukemia. Combined medical and surgical therapy, including chemotherapy with hydroxyurea and multiple punctures of the corpora cavernosa respectively, effected a rapid detumescence and resolution of the priapism and control of the primary disease, although subsequent ability of erection was not fully restored. PMID- 2772327 TI - [Analysis of metastasis in a series of 210 oncology patients admitted to a general internal medicine service]. PMID- 2772328 TI - [Cardiac disease caused by non-Hodgkin's lymphoma in a heroin addict with AIDS]. PMID- 2772329 TI - [Aortic valvulopathy in patients with angiodysplasia of the colon. Apropos of 5 new cases]. PMID- 2772330 TI - [Bronchoalveolar lavage in the diagnosis of pulmonary tuberculosis]. PMID- 2772331 TI - [Alcoholic ketoacidosis or accidental hypothermia?]. PMID- 2772333 TI - [Massive pleural effusion secondary to hydronephrosis]. AB - The most frequent causes of pleural effusion are congestive heart failure, advanced cirrhosis and nephrotic syndrome. In some rare cases urine can be found accumulated in the pleural compartment, being this entity denominated urinotorax. This phenomenon is generally considered secondary to an urinary obstruction or to an urinoma on the same side as the effusion through mechanisms not yet clarified. Given that it is a benign condition, easily resolved by clearing the obstruction of the urinary tract and that there is little information about it in the literature, we report a case of a massive pleural effusion secondary to hydronephrosis. PMID- 2772332 TI - [Lyme disease with a 12-year course and serologic diagnosis]. PMID- 2772334 TI - [Glipizide in the treatment of non-insulin-dependent diabetes mellitus]. AB - We present the results of a large study (1.282 patients) carried out in non insulin dependent diabetic patients recruited in the frame of primary care, and treated with Glipizide during 1985 and 1986. We have basically evaluated the overall efficacy of the treatment during 6 1/2 months, with a variable dose of Glipizide established in accordance with the patient's needs, starting with a minimum dose of 2.5 mg (10-30 min. before meals), according to the glycemic control reached. Tolerance was evaluated by laboratory tests and adverse events recorded. In most (83%) of the non insulin dependent diabetic cases previously controlled only with diet, the treatment with Glipizide affords a satisfactory glycemic control, as well as in most of the cases previously treated with other oral hypoglycemias (63%). The median decrease of hyperglycemia has been very significant, with plasma levels under 140 mg/dl (fasting plasma glycemic values), and under 175 mg/dl (postprandial plasma glycemic values), with normal HbA1 levels (less than 8%). This decrease is higher in initial fasting glycemia greater than or equal to 200 mg/dl. Side-effects were scarce (4.2%), mostly gastro-intestinal in previously treated patients (2.7%), with only 2.1% hypoglycemia, usually mild and transient. Treatment with Glipizide went on in 95% of previously untreated patients and in 90% of patients with previous oral hypoglycemias, with a mean daily dose of 10 mg (2 tablets). PMID- 2772336 TI - [Severe dysphagia in a woman with chronic symptomatic gastroesophageal reflux]. PMID- 2772335 TI - [Liver lipids in patients with cholelithiasis]. AB - The different hepatic lipid fractions of patients suffering choledocholithiasis of cholesterol stones exclusively, have been studied by thin layer chromatography. None of the patients studied had metabolic disorders, were alcohol abusers or obese, or were on any treatment that could alter lipid metabolism. The liver concentration of cholesterol and triglycerides in these patients was greater than in control subjects without choledocholithiasis. The liver concentration of esterified cholesterol and triglycerides was greater in female patients with choledocholithiasis than in males, while some other phospholipid fractions were lower. PMID- 2772337 TI - [Incidence of B virus in the prostitute population of Vigo]. PMID- 2772338 TI - [Diabetic amyotrophy]. PMID- 2772340 TI - [An outbreak of food poisoning caused by Salmonella enteritidis]. PMID- 2772339 TI - [Pleural calcifications in pneumoconiosis caused by mica]. PMID- 2772341 TI - [Clindamycin in the treatment of cerebral toxoplasmosis in a patient with AIDS]. PMID- 2772342 TI - [Proximal interruption of the right pulmonary artery. Presentation of a case]. PMID- 2772343 TI - [Pellagroid encephalopathy in chronic alcoholism: diagnostic difficulties]. PMID- 2772344 TI - [Abdominal pain associated with deficiency of factor XII]. PMID- 2772345 TI - [Subacute lupus erythematosus?]. PMID- 2772346 TI - [Fibrositis as the presenting form of non-secreting myeloma]. PMID- 2772347 TI - [Epidemiologic and clinical study of infection caused by hepatitis delta virus in the health service area of La Coruna]. AB - A prospective study on 175 hepatitis HBsAg positive patients was carried out between March 1986 and June 1987 in order to study the epidemiological and clinical aspects of the HVD infection. The global prevalence of this infection was 19.42%, with a statistically relevant predominance amongst intravenous drug addicts (IVDA). Moreover, in most cases it was associated with liver disease (91.17%). Chronic liver disease had a greater incidence amongst HVD positive infected patients and presented more severe clinical and biochemical aspects than other chronic liver diseases without HVD infection. The HVD infection was confirmed in 39.4% of the HBs Ag positive acute hepatitis, being in the majority of the cases delta coinfections with a clinical and biochemical evolution similar to the hepatitis caused by the B virus only. The overinfections evolved to cronicity in all cases. No delta infection occurred amongst immunodepressed patients, and there was an incidence amongst hemophiliacs of 40%. In view of our results, we may conclude that in our community the parenteral route is the main mechanism for the transmission of HVD. PMID- 2772348 TI - [Epidemiology of brucellosis. Retrospective study of 246 hospital cases]. AB - 246 cases of brucellosis registered by the Medicine Preventive Service of Miguel Servet Hospital for the period 1981-87 are retrospectively studied. It emphasizes the consumption of non controlled dairy products as the most frequent (54.5%) risk factor. A greater prevalence of professional and contact with cattle risk factors are observed in the male patients coming from rural areas. PMID- 2772350 TI - [Clinical characteristics of arterial hypertension in the elderly]. AB - The clinical characteristics of systolic and diastolic hypertension in 75 and of systolic hypertension in 50 elderly patients have been studied and the results have been compared to those obtained in 23 normotense elderly controls and 500 young patients with essential hypertension. A greater incidence in cardiovascular and neurologic morbility was observed in the hypertense elderly, existing also a greater incidence of electrocardiographic abnormalities and impairment in renal function. The changes in blood pressure with postural changes and isometric and physical exercise were evaluated in a subgroup of these patients, finding that the elderly with hypertension, specially those with systolic hypertension, showed orthostatic hypotension, and an increase in blood pressure with exercise, reaching levels that could potentially cause the clinical complications. PMID- 2772351 TI - [Weber Christian disease with immunoblastic lymphoma. Apropos of a case]. AB - The clinical case of a female patient suffering Weber Christian disease of long evolution with cutaneous and systemic manifestations, involvement of the mesenteric and epicardic fat and that later involved to immunoblastic lymphoma is presented. The different etiopathogenic factors are discussed. PMID- 2772349 TI - [Characteristics of the incidence of bronchogenic carcinoma in extreme age groups]. AB - The protocols of 852 patients with bronchogenic carcinoma (BC) were reviewed in order to establish its characteristics in the most extreme age groups in which it appears: group I, patients aged 40 years or younger (18 cases), and group II, patients aged 80 or older (19 cases). No differences were found in the relation men/women, time elapsed from the beginning of symptoms to diagnosis, staging and survival. The differentiating characters included the greater incidence of thoracic pain, microcytic carcinoma, surgery possibilities and therapeutic attitude in group I, and the predominance of squamous cell carcinoma in group II. The continuous and intense exposure to tobacco smoke is common to both groups. PMID- 2772353 TI - [A young man with pneumonia with a torpid course]. PMID- 2772352 TI - [Diabetologic education at a general hospital in Cataluna: methodology and short term indicators of effectiveness]. AB - In order to carry out an initial evaluation of an intrahospital diabetes education programme after its first year, the methods used are described and some previously established short term effectiveness indicators are analyzed: 1) knowledge of the theory, 2) insulinization, 3) blood glucose self testing at home, 4) metabolic control, 5) readmission in hospital, and 6) detection of chronic complications. An analysis of the previous situation was carried out resulting in a mean hospital stay of 10.8 days/patient/year during 1985, being the mean hospital stay for the general population of 8.1 days. 222 diabetic patients (63 type I and 159 type II) were included in the programme during the first year, and their cultural background, diabetes education, place of origin and participation were evaluated. 358 written tests were examined. The scores obtained after the educational sessions (75.6 +/- 17.5) were significantly higher than the initial scores (47.4 +/- 23.1; p less than 0.001). Prior the programme, 93 patients (41.9%) were on insulin. At the time of the evaluation 156 (70.2%) were on insulin treatment, of which 86 (38.7%) were on rapid insulin. Furthermore, 141 patients (66.1%) were carrying out periodic (over 10 tests/week) blood glucose determinations at home. In a 96 patient follow up group (36 type I and 60 type II) a significant improvement in baseline glucose levels (8.6 +/- 2.7 vs 12.6 +/- 4.2 mmol/l; p less than 0.001) as well as glycosylated hemoglobin levels (9.3 + 1.2% vs 11.0 + 2.0%; p greater than 0.001) was confirmed; this improvement was maintained throughout the time period considered.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2772354 TI - [Hilar mass with atelectasis of the upper left lobe]. PMID- 2772355 TI - [Epidemiologic aspects of leprosy in the province of Jaen]. AB - Jaen is the province with the greatest number of patients with lepra. This study analyzes the prevalence of the disease in Jaen during 1984 and 1985. At that time, all the patients known to the health and consume provincial delegation of Jaen were studied. The 305 patients included received a protocol aimed to study the different risk factors (age, clinical form, the people living together, socioeconomic standing, ethnic, etc ...). The disease shows to have a highly significant and special predilection in gypsies and it is located in a significant geographical area in the province. Lepra did not show a rural distribution, however it prevails in middle size urban nuclei. Although all patients belonged to a low social class, the disease did not show to exhibit any association among the ecology and the income per inhabitant. PMID- 2772356 TI - [Contribution to the definition of high-risk groups of low birth weight infants]. AB - Follow-up studies of low birth weight infants concern usually infants selected on the basis of either the birthweight--inferior or equal to 1500 g--or the gestational age: the upper limit is 31 or 32 weeks. To determine the most pertinent criterium, mortality and neurodevelopmental outcome at two years were compared in 3 groups, selected on the above criteria from a cohort of 369 infants with a birthweight below 2,000 grams admitted in 1983 in the neonatal unit of the University hospital of Lille. Under 1501 grams the rate of small for gestational age infants is high: it could be a part of the explanation for the high rate of minor sequelae. When cohorts are selected on the basis of gestational age, it appears that mortality is low at 32 weeks but the rate of major and moderate sequelae is still high: that fact must be considered when premature induced delivery comes in discussion. Because these criteria select different high risk populations, mortality and neurodevelopmental follow-up studies should include all infants with gestational age inferior or equal to 32 weeks and/or birthweight inferior or equal to 1,500 grams. PMID- 2772357 TI - [Injuries and poisoning caused by various types of activities. Epidemiologic survey on death and hospitalization in Aquitaine]. AB - From the data of a survey conducted in 1986 within the French area of Aquitaine and based on a representative sample of injuries having led to immediate death or hospitalization, different types of injuries were compared. Domestic and recreational accidents constituted the leading cause (41%) of injuries, followed by traffic accidents (28%) and suicides (13%). The overall ratio of immediate deaths to hospitalizations was 1 to 30 (1 to 10 for suicides, 1 to 20 for traffic accidents and 1 to 80 for domestic accidents). The overall annual incidence was 131 per 10,000 (respectively 20, 34 and 53 for suicides, traffic accidents and domestic accidents). The incidence by sex, age and type of accident was assessed. Among hospitalizations, about 3/4 of domestic and school accidents were falls; 45% of work accidents were cutting-piercing or being struck by an object, and 40% were falls; 90% of attempted suicides were poisonings. Using the Injury Severity Score (ISS), severity of injuries was the highest in traffic accidents. Traffic accidents also led to the highest hospital mortality within eight days (1.6%). PMID- 2772358 TI - Smoking, prevalence of disease and health service utilization among the Swiss population. AB - The data of the 1981-83 Swiss National Health Survey "SOMIPOPS", based on a randomly selected sample of 4,235 individuals aged 20 or over representative of the whole Swiss population, were used to investigate the relation between smoking, prevalence of disease and frequency of health care utilization. The risks of several conditions, including hypertension, myocardial infarction and other heart diseases, asthma, tuberculosis and kidney disease were elevated among ex-smokers. The diseases showing elevated risks among current smokers and significantly positive dose-risk trends included acute bronchitis (relative risk, RR = 3.2 for heavy cigarette smokers vs never smokers), chronic bronchitis or lung emphysema (RR = 2.0), gastro-duodenal ulcer (RR = 1.8) and bone fractures (RR = 1.6). For respiratory conditions, the risk of pipe or cigar smokers was comparable to that of moderate cigarette smokers, whereas for ulcer (RR = 4.1) or fractures (RR = 2.0) the point estimates were even higher than for heavy cigarette smokers. Smokers tended to consult more frequently general practitioners, used more other outpatients services, and were more frequently admitted to hospital during the year preceding the interview. These effects were consistent across strata of age, socio-economic indicators, and persisted after allowance for major identified potential distorting factors. Thus, the results of this survey confirm that smoking is an important cause of morbidity and a major contributory factor to the use of health services. PMID- 2772359 TI - [Epidemiology of smoking in the Wilaya population of Algeria]. AB - A questionnaire survey was done in 1985 to determine the smoking habits of a representative sample of men and women in the Wilaya of Algiers. Among the men 77.1% used tobacco: 48.7% smoked cigarettes, 15.0% chewed tobacco, and 13.4% used both. There was no relationship between socioeconomic category and tobaccos consumption. Tobacco use among women was much lower (13.6%) and limited to cigarette smoking. The authors also examined relationships between smoking habits and functioned respiratory signs, and the reasons why former smokers stopped smoking. PMID- 2772360 TI - [Nutrition behavior in adolescent students (15-19 years of age) in the Nancy metropolitan area. A comparison with the recommended nutritional intake of the French population]. AB - This paper describes the food behavior of 495 adolescents (15-19 years old) sample living in Nancy (France). The results are compared with the Recommended Dietary Allowances (RDA) for French adolescent population. The RDA are not satisfied for important percentages of girls for the daily energy intake (26.3% of girls have allowances less than 30% RDA), for the calcium intake (28.7% of girls have allowances less than 40% RDA), and for the protein intake (17.6% of girls have allowances less than 20% RDA). Lipids consumption is excessive (19.9% of boys and 23.4% of girls have allowances greater than 20% RDA) and energy intake from breakfast are low (25% of adolescents provide less 10% of daily energy intake by breakfast) for all these teen-agers. These results confirm the data observed in two others studies concerning the food behavior of French adolescents. PMID- 2772361 TI - [Study of general mortality and of mortality related to malaria in the mountains of Kivu, Zaire]. AB - A longitudinal study in the "health region" of Katana (Kivu, Zaire) has permitted to determine age and disease specific mortality rates. The infant mortality rate is 172 per 1000/year, the child mortality rate 45 p.1000/year and the crude rate 24 p.1000/year. Two thirds of this mortality are related to infectious and parasitic diseases: measles, diarrhoea, respiratory diseases and malaria. In the mountainous Katana region (4500 feet), malaria is responsible for 12%, of the decrease and the specific mortality rates are 3 p.1000/year in the general population and 18 and 6 p.1000/year in, respectively, the 0 to 11 month and 1 to 4 year age groups. We discuss the potential of PHC to improve, in the framework of an integrated development approach, this unfavorable health situation. PMID- 2772363 TI - [Study of the prevalence of prescribing HIV serology in the Loire Atlantic region]. PMID- 2772362 TI - [Value of public opinion polls for evaluating the acceptability of epidemiologic surveys in urban areas]. AB - A prevalence study on non communicable diseases related to nutrition, alcoholism and tabagism is planned in French Polynesia. The methodology used, although complicated, has been successful in insular states of the South Pacific with either traditional or transitional ways of life. Acceptability level of the study in the urban area of Papeete (Tahiti) has been tested by a public opinion poll using the quota method in order to obtain valuable information on feasibility of the project. The public opinion poll showed that 75% of people would participate, 19.5% would be reluctant and 5.5% would hesitate. The good results must be carefully interpreted with regards to the multi-ethnic structure of French Polynesian population, and to the limits of the quota method. PMID- 2772364 TI - [Cardiovascular risk factors in children and adolescents in Fuenlabrada: objectives, features of the population, design, participation, equipment, laboratory technics, and quality control]. AB - Fuenlabrada is at the present time the most industrialized town placed at the south are of Madrid. This population has some peculiar attractive characteristics from the epidemiologic point of view. Perhaps the most important is that the majority of its inhabitants are immigrant from other depressed rural areas of the country, with a low socio-economic and cultural level. The new conditions of life could have changed the life expectation and the causes of morbidity and mortality of this population. Between 1981 and 1984 we have studied the prevalence of cardiovascular risk factors in children and adolescents of its population, the relationships with cardiovascular risk factors and cardiovascular disease of the family and type of lactancy of the newborn. The variables studied were: height, weight, skin fold, blood pressure, lipids, lipoproteins, glycemia, uric acid and tobacco habit. The laboratory technics were standardized with serums of reference. The index of participation in the study of the required population was approximately of 80%. PMID- 2772365 TI - [Coronarography using high-flow 5F catheters. Percutaneous technic using the femoral and brachial routes]. AB - In order to validate 5F catheters for assessing ischemic heart disease either by the femoral and the right brachial approaches, we prospectively studied with these catheters 125 patients by means of left ventriculogram and coronary artery angiograms. Twenty-five patients were studied with pigtail and Amplatz catheters using the right brachial approach (group I) and 100 patients were studied by the femoral route with pigtail and Judkins catheters (group II). Results were compared to those obtained in a control group of 100 patients prospectively studied by the femoral route with 8F catheters (group III). The following parameters were analyzed: need to change the initially elected catheter diameter or/and artery approach; technical difficulty for obtaining left ventriculogram, left coronary artery, and right coronary artery angiograms; total time of X-ray exposure; quality image of left ventriculograms; incidence of arterial puncture related hematomas or total arterial occlusion; and duration of local compression after sheath removal. There were no differences between groups I and II except for the arterial compression time (p less than 0.0001), and the X-ray exposure time (p = 0.02); both were longer in patients studied by the brachial approach (group I). Whatever the route used, 5F showed a mild increased difficulty (brachial p = 0.001; femoral p = 0.01), and a mild decreased quality image for left coronary artery (brachial p = 0.006; femoral p less than 0.05). Among patients studied by the femoral route a reduction in mild hematomas (p less than 0.05) and in the arterial compression time (p less than 0.0001) were observed in those studied with 5F catheters.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2772366 TI - [Hemodynamic effects of hydrochlorothiazide, propranolol and a combination of pindolol and clopamide in patients with essential hypertension]. AB - To characterize the haemodynamic effects of diuretics, betablockers and the association of both, 24 hypertensive patients, stages I-II WHO criteria, were studied. Two haemodynamic studies were performed, before under placebo and after two month of active drug therapy. Seven patients received propranolol (PPL) (160 240 mg/day); 7 patients, hydrochlorothiazide (HCT) (150-100 mg/day), and 10 a combined fixed dose of pindolol (PDL) and clopamide (CLP): PDL 10 mg, CLP 5 mg per tablet, each patient receiving one to three tablets according blood pressure response. The haemodynamic study was performed with percutaneous intravenous flow directed. Swan-Ganz catheter, associated with direct puncture of femoral artery and measuring cardiac output by thermodilution. Arterial pressure was significantly reduced on PPL (p less than 0.05) and PDL-CLP (p less than 0.01) groups, but not in the HCT group. The cardiac index was reduced by PPL (p less than 0.05) but not by HCT and PDL-CLP. The systemic vascular resistance was only reduced in the PDL-CLP group (p less than 0.05). The use of a betablocker with intrinsic sympathetic activity (ISA) (pindolol) in association with a thiazide diuretic (clopamide) seems to induce a favourable change in systemic resistance without a deleterious change in cardiac output as occurred with propranolol. PMID- 2772367 TI - [Cardiovascular pathology in Marfan syndrome. Study of 11 children using two dimensional echocardiography]. AB - From 1983 to 1987 we have studied by two-dimensional echocardiography 11 pediatric patients with Marfan's syndrome. All of them presented cardiovascular lesions localized mainly in the aortic and mitral valves and in the ascending aorta. Nine patients had a dilated aortic ring in both transversal and longitudinal diameters 2.03 and 2.29 cm/m2 of body surface (bs), respectively. The average value of the aortic valvular area was 4.71 cm2/m2 bs. The 9 patients presented also dilatation of the ascending aorta (2.01 cm/cm2 bs). There was thickening of the mitral valve in 5 cases and a prolapse was present in 8 (73%). In 4 cases the prolapse was localized in anterior leaflet valve in 2 in the posterior and in 2 in both. The maximal mitral valve diastolic area was 3.25 cm2/m2 bs. None of them has needed during follow up valvular replacement. Considering the importance of this cardiovascular disease and knowing its unpredictable evolution we recommend, in the absence of valvular insufficiency, and annual echocardiographic reevaluation, and more often if valvular insufficiency is already present. IN CONCLUSION: two-dimensional echocardiographic is useful and necessary for the diagnosis and follow up of patients with Marfan's syndrome. PMID- 2772368 TI - [Scimitar syndrome in the newborn child and infant]. AB - We present 10 symptomatic patients with scimitar syndrome. Their age was below 1 year and four were newborn babies. In 5 patients there was secundum atrial septal defect and in one there was a patent ductus arteriosus. Sixty per cent of the patients had pulmonary sequestration. The right lung was moderately or severely hypoplasic in 8 cases and seven had frequent respiratory infections. The anomalous venous drainage produced a left-to right shunt at atrium level which in our series had a value of 2.87 +/- 0.5. Five patients had pulmonary hypertension either moderate or severe. The severity of this disease in early infancy is related to the pulmonary hypertension (40%), requiring a prompt surgical correction. Eight patients were operated upon, the drainage being connected to the left atrium. The six surviving patients are asymptomatic at 12 years of follow-up. Our series is the biggest published in our country and the second in the world literature in infancy. PMID- 2772369 TI - [Experimental study of the effects of ATP on sinus automatism and atrioventricular node conduction]. AB - A study was made of 14 thoracotomized dogs under i.v. sodium thiopental anesthesia; the effects of 1.5 mg/kg intravenous ATP on sinus node automatism and atrio-ventricular conduction were investigated. In 7 dogs (group A) ATP was administered under control conditions and following successive intravenous administrations of atropine (1 mg/kg), aminophylline (5 mg/kg) and propranolol (0.6 mg/kg). The remaining 7 dogs (group B) received ATP following atropine (1 mg/kg), isoproterenol (0.4 microgram/kg/min.), and aminophylline (5 mg/kg). An analysis was made of the percentage variations in cardiac cycle length during spontaneous rhythm and of the AH interval during atrial pacing at a fixed rate. In group A the negative dromotropic and chronotropic effects of ATP under control conditions decreased in 5 cases following atropine, although the average decrease was not statistically significant. On adding aminophylline, a statistically significant decrease was observed in the effects of ATP, and following propranolol the drop in negative chronotropic effect of ATP provoked by aminophylline was maintained. In group B, and following prior atropinization, the negative chronotropic and dromotropic effects of ATP were maintained in the presence of isoproterenol. As in group A, aminophylline significantly reduced the effects of ATP. To conclude: in the thoracotomized dog under sodium thiopental anesthesia, 1) atropine does not prevent the negative chronotropic and dromotropic actions of ATP, although the effect of the latter is decreased in a large percentage of cases; 2) sympathetic beta stimulation following prior atropinization does not prevent ATP action; 3) aminophylline in the atropinized dog noticeably reduces the effects of ATP, and 4) this action of aminophylline is effective in the presence of sympathetic beta stimulation. PMID- 2772370 TI - [Recurrent pericarditis with effusion caused by Q fever. Presentation of a case]. AB - We present a case report of recurrent pericarditis with pericardial effusion and high levels of Coxiella burnetti antibodies (phase II), excluding other possible etiologies. The rarity of this disorder is commented and the necessity of be considered this etiological possibility in a second time, particularly in patients who are susceptible to suffer Q-Fever disease. PMID- 2772371 TI - [Ambulatory cardiology]. AB - In order to assess the reality of the ambulatory cardiology care in our region, we have studied prospectively the number and type of patients assisted daily in five outpatient clinics of Virgen del Rosell, Cartagena. 26.3% of the 9,312 studied patients were first visit. 51.1% were cardiologic patients, 35.7% pneumonic and 13.2% non cardiologic neither pneumonic patients. Coronary heart disease was the main pathology. An average of 21.4 +/- 4.7 patients were assisted daily, and time per patient was 7 minutes and 30 seconds. In January and February the affluence of patients to the outpatient clinics increased, and in three of this clinics, the time per patient was less than 6 minutes. We stress the need for Heart and Lung medical specialties separation, the need for number of patients limitation, and the need for technics material dotation for ambulatory cardiology. PMID- 2772372 TI - [Usefulness of dobutamine in producing myocardial ischemia. Comparison with ergometry]. AB - Fifty six patients were studied while in the Coronary Care Unit: 17 with unstable angina and 39 with acute myocardial infarction. All patients underwent dobutamine stress testing (doses of 5, 10, 15 and 20 micrograms/kg/min every 5 min) and exercise testing (modified protocol to finish at an energy expenditure of approximately 5 METS): 4-5 days after the last crisis of angina or 6-8 days after the onset of noncomplicated acute myocardial infarction. The heart rate increased from 72 +/- 10 to 104 +/- 12 beat/min with dobutamine (p = 0.00001) and from 84 +/- 11 to 118 +/- 15 beat/min with exercise testing (p = 0.00001). The systolic blood pressure increased from 116 +/- 9 to 138 +/- 11 mmHg with dobutamine (p = 0.00001) and from 117 +/- 8 to 156 +/- 7 mmHg with exercise testing (p = 0.00001). Due to different reasons 33 patients did not finish the exercise protocol, while only 8 patients did not finish the dobutamine testing. The ST segment wast elevated in 22 cases with dobutamine and in 9 cases with exercise, eight of them coinciding in both tests. The ST segment was depressed in 36 cases with dobutamine and in 21 cases with exercise, 20 of them coinciding in both tests. Angina was present in 11 cases with dobutamine and in four exercise, three of them coinciding. If the unfinished tests or those with angina or ST segment depression are considered abnormal, there were 40 abnormal tests with dobutamine and 38 with exercise, 32 of them coinciding.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2772373 TI - [Prolapse of the mitral valve. Study using bidimensional echocardiography]. AB - Mitral valve prolapse is frequent in childhood. The use of two-dimensional echocardiography may enable more accurate diagnosis and assessment of the degree of valve involvement. Twenty five (1.9%) of all children studied by two dimensional echocardiography fulfilled the diagnostic criteria for mitral valve prolapse. In 48% it was associated to a different congenital heart as normality. The apical four chamber and parasternal long and short axis views were used, and cases were graded according to the severity of the prolapse. Diagnosis was made in 44% of cases by the apical four chamber view, which was the best projection to detect the abnormality. Cases of moderate and severe prolapse were also detected in the parasternal long axis view. All patients were asymptomatic but they were all controlled detect progression to mitral insufficiency of the appearance of other complications. PMID- 2772374 TI - [Cardiac fulguration. A healing treatment for intranodal re-entry tachycardias refractory to medication]. AB - Six patients underwent fulguration of the AV junction for typical paroxysmal intranodal reentry tachycardias, refractory to medical treatment. Unipolar cathodic discharges at distal electrode were administered against an external plate. Bipolar His and atrial deflections showed mean values of 0.16 and 0.54 mv, respectively. Mean energy used was 233 J (range 50-750), with a mean number of 1.6 (range 1-3) discharges per patient. Complete AV block was achieved, but conduction reappeared in all, within a mean of 30 minutes. Electrophysiologic evaluation was assessed 3-8 days after ablation. Intranodal reentry tachycardias could not be initiated in any patient. Retrograde conduction was abolished in 3 patients, and in three it was slow and decremental. First degree AV block, with intranodal delay was diagnosed in 4 with a mean AH interval of 237 msec (range 190-300). Mean rate for appearance of Wenckebach AV block was 154 b/m. None of the patients required permanent pacing. Mean follow-up of the patients was 6.8 months. One of the patients required a new ablation for reappearance of intranodal tachycardia and CAVB was achieved in the second ablation. The other five remain asymptomatic. Intranodal reentry tachycardias can be cured by fulguration. Less energy and less discharges should be administered to abolish functional dissociation of the AV node, without complete interruption of anterograde conduction. PMID- 2772375 TI - [Changes in the aortic arch in chick embryos resulting from modified hemodynamic factors]. AB - Hemodynamic factors acting as modelator agents in the outflow region of great vessels and aortic arches have been studied by many authors. In our study, we have tried to analyse the influence which a modification of some of these factors, as it is an increased blood volume, could cause on truncus and aortic arches, by means of the perfusion of blood from chick embryos of 12-15 days of incubation to receptor embryos between stages 22-29 of HH. We have obtained a malformation percentage smaller than expected, on the basis of bibliographic data, so we now believe that hemodynamic factors, by themselves, don't play a role in the definitive morphogenesis and septation of great vessels and its main branches as important as believed until present time. PMID- 2772376 TI - [Anomalous origin of the left coronary artery at the pulmonary trunk and its relationship with other primary coronary anomalies: experimental study]. AB - The origin and course of the coronary arteries were studied in 1,436 Syrian hamsters belonging to 10 breeding colonies subjected to high endogamous pressure by mating either animals of the same litter or first cousins. The study was carried out using a corrosion casting technique. A left coronary artery originating from the pulmonary trunk was found in 48 specimens of the series. In all cases anastomoses had developed between the right and left coronary systems. Moreover, five types of minor primary anomalies of the coronary arteries occurred in 144 hamsters. These findings agree with the morphogenetic hypothesis that each of the aortic and pulmonary sinuses has the potential to develop coronary arteries. Familial recurrence risks for coronary arterial anomalies were estimated taking into account the sex and the inbreeding coefficient of the probands carrying a left coronary artery from the pulmonary trunk. The recurrence risks increase as the inbreeding level increases, this suggesting that the whole primary coronary anomalies are a phenotypic set subordinated to a complex mode of inheritance. Therefore, an echocardiographic study of the first degree relatives of patients with coronary arterial anomalies is advisable to diagnose clinically silent coronary malformations. PMID- 2772377 TI - [Induction of a double nodal pathway in dogs by transcatheter ablation with high frequency currents]. AB - A dog weighing 15 kg and anesthetized with intravenous sodium thiopental was subjected to transcatheter ablation of the AV junction with high-frequency currents, in order to induce a partial alteration in AV conduction (first degree AV block). Two conventional bipolar electrode-catheters were introduced through the right femoral vein and used one for atrial pacing and the other for His bundle recording and current delivering. The catheter used for ablation was situated in the AV junction where the distal monopolar recording of the His bundle electrogram showed an A/V ratio close to one in the presence of His bundle deflection. Three discharges were delivered under continuous electrocardiographic monitoring. The output power used was 15 watts and current application time was up to five seconds after attaining complete AV block; 1:1 AV conduction was quickly restored on concluding discharge. After the second discharge, a discontinuous nodal function curve of the dual AV nodal pathway type was obtained (absent in control and after first discharge studies). Following the third discharge the conduction through the slow pathway was abolished. The study was repeated after four weeks, an a dual AV nodal pathway type curve similar to that found during the acute phase was obtained. The histologic findings showed a collagen scar partially replacing nodal tissue and creating a partial septation of the AV node. To conclude: The structural alterations of the AV node may induce a dual AV nodal pathway response. PMID- 2772378 TI - [Doppler echocardiography in cor triatriatum: apropos of 2 cases]. AB - In this communication we present a Doppler-echocardiographic investigation on two cases of cor triatriatum. The echocardiographic features and the pulsed Doppler findings, which have not been published previously, are also discussed. When the Doppler sample volume is positioned in the distal camera of the left atrium from apical projections, a positive systolic flow is obtained. This finding has not been described, to our knowledge, in the cor triatriatum nor in any other cardiac abnormality. It is our thought that flow studies in the left atrium in cases of cor triatriatum can be a useful aid to the echocardiographic diagnosis of the anomaly. Doppler studies are also helpful in the differential diagnosis with other intracavitary images, and it is probably also useful in the assessment of the degree of obstruction at the membrane level. PMID- 2772379 TI - [Successful fibrinolytic treatment in a patient with acute mitral prosthetic thrombosis]. AB - A case is described of a 50 year-old man with an acute prosthetic dysfunction due to valve thrombosis and cardiogenic shock, on a prosthesis in the mitral position (Bjork-Shiley). The patient was promptly treated with a streptokinase in two infusions 1.5 x 10(6) UI over 180 and 90 minutes, respectively. Early clinical, fluoroscopy and echocardiography improvement was observed. The authors comment the present role of the thrombolytic therapy in front of surgery of prosthetic valve thrombosis. PMID- 2772380 TI - [Decrease in postoperative mortality caused by bleeding peptic ulcer]. AB - Hemorrhage continues to be a serious complication of peptic ulcer, especially in patients over 65 years. Gastric location, delay in the surgical intervention, the amount and characteristics of hemorrhage and the use of laborious resection techniques are factors that worsen the prognosis and contribute to increased mortality. In the authors' experience, the comparison of two series separated in time led them to conclude that restriction of the use of resection techniques for gastric ulcers and improved medical-surgical collaboration, facilitated by use of a special protocol for bleeding peptic ulcers, has reduced mortality from 12.5% to 4.08% in 49 patients operated in the last 3 years. PMID- 2772381 TI - [Preneoplastic lesions associated with carcinoma of the stomach: retrospective study of 125 gastrectomy pieces]. AB - A study was made of 125 gastrectomy pieces with gastric carcinoma in which metaplastic and dysplastic changes on the intact gastric mucosa adjacent to the tumor were analyzed. Both incomplete intestinal metaplasia and different types of dysplasia were more frequently and significantly associated with carcinomas of intestinal pattern than with diffuse ones (p less than 0.001). Jass type I dysplasia was more frequent in well-differentiated carcinomas, while Jass type II was more common in relatively undifferentiated tumors, the difference being highly significant (p less than 0.001). Our results and those of other studies in the literature suggest a pathogenic relationship only between preneoplastic lesions and gastric carcinoma of intestinal pattern, which probably includes entities that can be differentiated by pathogenesis to judge from the variations in the dysplastic changes observed. PMID- 2772382 TI - [Nephrotic syndrome associated with ampulloma]. AB - A patient is reported who presented simultaneously classic nephrotic syndrome and adenocarcinoma of the Vater ampulla. Morphological study of the renal biopsy revealed changes characteristic of membranous glomerulonephritis and subepithelial deposits. These deposits stained specifically for IgG and C'3 with a granular pattern, but deposits of CEA-antiCEA immune complexes were not found in glomerular capillaries. The association of nephrotic syndrome with lymphoproliferative diseases and a large variety of solid tumors, like carcinoma of the breast, bronchogenic, colon and stomach has been communicated, but the present case constitutes the first known association with adenocarcinoma of the Vater ampulla. PMID- 2772383 TI - [Computerized tomography findings in annular pancreas in an adult]. AB - We present a case of annular pancreas in an adult female studied by computerized tomography. CT demonstrated an enlarged pancreatic head in the center of which was visualized the contrast-filled duodenal lumen. We consider these findings to be sufficiently characteristic of annular pancreas to permit differential diagnosis with neoplastic processes of the pancreatic head without having to resort to more invasive diagnostic methods like endoscopic retrograde cholangiography. PMID- 2772384 TI - [Gastric pseudotumor caused by varices]. AB - A case is presented of a variceal gastric pseudotumor demonstrated by angiography. The literature is reviewed and the authors underline the importance of including varices in the differential diagnosis of submucosal gastric tumor. PMID- 2772385 TI - [Colorectal tuberculosis]. AB - Intestinal tuberculosis has been a clinical rarity in the western world since the tuberculostatic agents were discovered. The most common location of these lesions is usually the ileocecal region, lesions of the transverse colon being much less frequent and perforation of this viscus being exceptional. The etiological diagnosis is usually difficult because there are no specific radiological signs and false negatives are often found in biopsy material obtained by colonoscopy since the process is mainly submucous. This disease is often diagnosed during operation so treatment is usually resection. Should a preoperative diagnosis be made, the picture generally responds to tuberculostatics. PMID- 2772386 TI - [Morphologic findings in systemic amebiasis. Apropos of 1 case]. AB - Amebiasis is an uncommon infectious disease in our region. We describe the anatomopathologic findings of the autopsy of a patient who died of systemic amebiasis, briefly commenting the anatomo-clinical characteristics of this disease and its diagnosis. PMID- 2772387 TI - [Hepatic polycystosis in adults]. PMID- 2772388 TI - [Tuberculous peritonitis with acute onset caused by lymph node rupture following abdominal trauma]. PMID- 2772389 TI - [Evaluation of transcutaneous oxygen pressure in adults with respiratory pathology]. AB - The usefulness of the transcutaneous oxygen tension (tcPO2) in adults is under controversy. In a varied group of respiratory patients, results of the application of this method were compared with those from the arterial blood sampling method. Thirty-eight arterial oxygen tension (PaO2) and tcPO2 simultaneous determinations were made in a group of 22 patients, while in a sitting position; the tcPO2 measurements obtained (68 +/- 12.36 Torr) were significantly lower (p less than 0.05) than the PaO2 values (74 +/- 13.07 Torr). The correlation coefficient was 0.51 (p less than 0.01) with a regression line, tcPO2 = 31.58 + 0.48 PaO2. It is concluded that tcPO2 measurement does not correlate well with PaO2 and that this method cannot be always be safely applied and used in adults with respiratory diseases. PMID- 2772390 TI - Onthogenic changes in the orientation of the ventricular activation and recovery mean vector in pig. AB - The effect of physical maturation on the ventricular activation and recuperation mean vectors has been analyzed in pigs during a period of time between 1 day and 6 months of age. The results showed that whilst the vectorial magnitude of AQRS on the horizontal plane was not affected by physical maturation, that of the spatial vector (SAQRS) underwent an increase during the period of study. Likewise, it was determined that the ventricular activation front showed an inclination to change its orientation from caudal, sinistral or dextral, to dextrocranial, maintaining the dorsal orientation in all individuals. For the ventricular recuperation mean vector the results showed that its vectorial magnitudes both on the horizontal plane and in space underwent an increase during the 6 months analyzed. As regards the direction of the recuperation front, it was established that, at any age, the preferential orientation is caudal, with a deviation to the left in a high percentage of the 20 day to 3 month old pigs, and ventral in all individuals. PMID- 2772391 TI - Effect of age on the orientation of the auricular activation vector in pig. AB - The effects of cardiac maturation on the orientation of the auricular activation mean vectors (AP and SAP) in Landrace X White Belgian pigs has been analyzed. The magnitudes of AP and SAP vectors undergo a significant increase between 5 and 20 days of age. On the contrary, physical maturation does not appear to have any effect on the sequence of auricular activation in pigs, since in all the age groups analyzed, the same orientation for P vectors on the horizontal plane and in space was maintained. Both vectors indicated that the auricular activation front was predominantly directed towards the left, caudally and ventrally. It should be noted that in a high percentage of individuals of 1 to 5 days of age, the auricular activation vector goes towards the left and cranially. PMID- 2772392 TI - Iron mobilization in three animal models of inflammation. AB - The effect of acute, subchronic, and chronic experimental models of inflammation upon hematocrit, hemoglobin, serum iron and ferritin iron and nonheme iron concentration in the liver and spleen has been studied in the rat. In the acute model (carrageenan oedema) no iron mobilization took place, whereas in the chronic models differences in iron mobilization were observed, related to their different chronicity and to the time elapsed from induction. The carrageenan induced granuloma (from 12 h to 8 days) (subchronic model) was accompanied by a decrease of plasma iron (12 and 24 h), a later decrease of the hematocrit values (2 and 4 days) and high ferritin and nonheme iron concentrations in the liver and spleen for 4 days, followed by a tendency to return to the control values. The anemia in the adjuvant arthritis (from 1 to 4 weeks after induction) (chronic model) was observed at 7 days and is related to increased iron stores in the liver and spleen. However, the iron store levels in liver decreased and fell later below control values. The increase of ferritin and nonheme iron concentrations may be responsible for the reduced availability of iron release from tissue. PMID- 2772393 TI - [Activity of premotor vestibular neurons in the alert cat]. AB - The activity of medial vestibular nucleus neurons projecting to the contralateral abducens nucleus (premotor vestibular neurons) has been recorded during spontaneous and vestibular induced eye movements in the alert cat. Recorded neurons were identified by their antidromic activation from the abducens nucleus and by the post-synaptic field potential induced in this nucleus. The activity of identified medial vestibular neurons increased significantly with horizontal eye position and velocity toward the contralateral side, and decreased abruptly during ipsilateral saccades. The activity of these neurons was also related to head velocity toward the ipsilateral side. The functional role and origin of eye position and velocity signals present in these vestibular neurons are discussed. PMID- 2772395 TI - [Activity of the coagulation and fibrinolysis in non-insulin-dependent diabetes mellitus. In vivo study]. AB - In vivo study of blood coagulation and fibrinolysis activities in non insulin dependent diabetes mellitus. The aim of the study was to investigate in vivo blood coagulation and fibrinolysis activities in a group of diabetic patients NIDDM with and without vascular complications. For this purpose we determined two sensitive indicators in vivo of blood coagulation and fibrinolytic activities such as fibrinopeptide A and B beta 15-42 respectively. Moreover, we computed the ratio between B beta 15-42 and fibrinopeptide A in order to investigate a possible imbalance in vivo between blood coagulation and fibrinolysis. Control groups were 15 healthy subjects and 28 non diabetic patients affected by atherosclerotic disease. Fibrinopeptide A and B beta values were significantly higher in the diabetic patients than controls but there was no difference between the former group and the atherosclerotic patients. Also, no correlation was found for FPA, B beta, B beta/FPAr and HbAlc, fructosamine and blood glucose levels. There was no difference in B beta, FPA and B beta/FPAr values for patients treated with insulin and for those treated with either hypoglycemic agents or diet. Our data indicate that in diabetic patients fibrinolysis activity is increased, but it cannot counterbalance thrombin activity which appears much more enhanced. Finally, the lack of correlation for FPA, B beta, B beta/FPAr and HbAlc, fructosamine and blood glucose suggests that blood coagulation and fibronolysis abnormalities are not related to the degree of blood glucose control. PMID- 2772394 TI - Phospholipids and their fatty acid composition in the muscle of trout fed on diets supplemented with olive oil bagasse or technical rendered fat. AB - A study to determine the effects of two by-products from the food industry (olive oil bagasse or technical rendered fat) on the phospholipid content and the fatty acid composition of the muscle of rainbow trout (Salmo gairdneri) has been made. Three batches of 150 trout were given for 100 days a commercial diet alone or supplemented either with 11% olive oil bagasse or technical rendered fat. The phospholipid content in the muscle of the three batches of trout ranged from 0.70 to 0.93% (wet weight). In this fraction, six different phospholipid classes were detected, phosphatidylcholine and phosphatidylethanolamine achieving average values of 55 and 25% of total phospholipids. Although differences in the fatty acid composition of the diet were observed, the only clear influence of diet was on the fatty acid C-22:6 of muscular phosphatidylethanolamine. PMID- 2772396 TI - [Angioimmunoblastic lymphadenopathy with dysproteinemia. Personal case reports]. AB - Angioimmunoblastic lymphadenopathy with dysproteinemia. Case report. We report nine cases of angioimmunoblastic lymphadenopathy with dysproteinemia. Initial symptoms were not specific in any case nor was a specific drug involved as a possible cause. In every case we observed a diffuse enlargement of the lymph nodes and severe dysproteinemia (with hyper or hypo-gammaglobulinemia). Death during the first year was observed for four patients. PMID- 2772397 TI - Blood and muscle metabolic responses to draught work of varying intensity and duration in horses. AB - Three standardbred trotters performed treadmill exercise at a velocity of 2 m s-1 with a draught load of both 34 kiloponds (kp) (test 1) and 80 kp (test 2), and also at 7 m s-1 with 34 kp (test 3). The heart rate increased to average values of 111 (+/- 5), 157 (+/- 10) and 197 (+/- 7) beats min-1 in tests 1, 2, and 3, respectively. Plasma free fatty acids increased only during tests 1 and 2. Blood lactate and muscle glucose-6-phosphate and lactate concentrations were low after tests 1 and 2, but high after test 3, where also muscle glycogen utilisation was greatest. Muscle creatine phosphate and adenosine triphosphate concentrations decreased after test 3 only. The study indicates that oxidative metabolism is most important for energy supply in muscles when exercise is performed with draught loads of both 34 and 80 kp at a low velocity. Glycogenolysis with lactate accumulation and phosphagen breakdown becomes much more important when, with a draught load of 34 kp, the velocity of exercise increases. PMID- 2772398 TI - Comparative study of the effect of the effect of carbadox, olaquindox and cyadox on aldosterone, sodium and potassium plasma levels in weaned pigs. AB - To study the effects of olaquindox and cyadox on aldosterone, sodium and potassium in the blood in comparison with the effects of carbadox, weaned pigs were fed these compounds in different doses. Pigs treated with 100 and 200 ppm carbadox showed a significant decline of aldosterone after five and three weeks, respectively, compared with control values. In the 200 ppm group treatment was interrupted at week 4. With olaquindox a continuous, significant decline was found from 50 ppm and above after five weeks, and from 25 ppm and above (but excluding the 100 ppm group), after six weeks. In the cyadox groups a significant decline was measured after six weeks in the 50, 200 and 400 ppm groups. Only the 200 ppm group had an earlier response at three and five weeks. A decrease of sodium to hyponatraemic levels in the carbadox groups was seen after three weeks in the 200, and after five weeks in the 100 ppm group. In the olaquindox groups only the 200 ppm dosage showed a consistent decrease to hyponatraemic levels from four weeks treatment. In the cyadox groups the 200 ppm dosage reached a hyponatraemic level after six weeks. An increase of potassium to hyperkalaemic levels occurred at 100 and 200 ppm carbadox dosage after four and three weeks, respectively, and at 200 ppm olaquindox dosage after four weeks. No hyperkalaemic levels were seen in the cyadox groups. It is concluded that the toxic effect of olaquindox, despite minor differences, is comparable with that of carbadox but that cyadox is less toxic. PMID- 2772399 TI - 'Simultaneous' urethral pressure profilometry in the bitch: methodology and reproducibility of the technique. AB - The technique of 'simultaneous' urethral pressure profilometry in the bitch is described. Four consecutive recordings were made from each of 100 bitches. From each recording, the maximum urethral closure pressure and functional profile length were measured and assessed for reproducibility. Analyses of variance revealed no significant differences (P greater than 0.2) between the measurements of functional profile length (means: 3.84, 3.84, 3.83, 3.80 cm; standard error of the differences: 0.037) but there were significant variations (P less than 0.001) in maximum urethral closure pressure (means of square roots: 2.26, 2.18, 2.12, 2.08 cm water; standard error of the differences: 0.042). Overall, there was a significant dependence of maximum urethral closure pressure on the measurement order (P less than 0.001). Thus, while functional profile length is a highly reproducible parameter, maximum urethral closure pressure is subject to significant variation. PMID- 2772400 TI - 'Simultaneous' urethral pressure profilometry: variations in intravesical pressure with respiration. AB - Pressure changes in the urinary bladder due to respiration were measured in 75 bitches. The changes fell within a narrow range (0.5 to 2.5 cm water) and were unaffected by size or whether the bitches were entire or spayed. Significant differences were found, however, between continent (mean +/- SD, 1.1 +/- 0.4 cm water) and incontinent (mean +/- SD, 1.4 +/- 0.5 cm water) animals (P less than 0.01). PMID- 2772401 TI - Detection of leptospires in pig kidney using DNA hybridisation. AB - DNA hybridisation detected leptospiral organisms in homogenised kidneys from experimentally infected pigs, and in homogenates of pig kidneys collected at abattoirs. The technique is easy to perform and had some advantages over cultural and histological methods, in permitting the rapid survey of many kidneys simultaneously. Leptospires added to a homogenate of uninfected kidney could be detected at 10(2) organisms ml-1 by DNA hybridisation, but the technique appeared to be less sensitive than culture. PMID- 2772402 TI - Erythrophagocytosis in phenylhydrazine induced acute anaemia in chickens. AB - Acute anaemia was experimentally induced in chickens with a single subcutaneous injection of phenylhydrazine-hydrochloride. The birds were necropsied at fixed intervals. Liver, spleen and red bone marrow (from middle of tibia) were promptly dissected out. Impression smears were stained and examined under dry high power. Erythrophagocytosis was massive in the liver, moderate in the spleen and less conspicuous in bone marrow. Extensive erythrophagocytosis by the mononuclear cells might be associated with extravascular haemolysis. This appeared to be a major factor in the induction of anaemia. PMID- 2772403 TI - Intracellular electrolytes and water analysis in dystrophic canine muscles. AB - Skeletal muscles from normal dogs and labrador retrievers with a hereditary muscular dystrophy were examined morphologically and histochemically and were analysed for sodium (Na+), potassium (K+) and chloride (Cl-) ions and total muscle water. The partition of total muscle water and electrolytes between intracellular and extracellular phases was calculated on the basis of the chloride space method as the estimate of extracellular fluid volume. Muscle samples from dystrophic dogs contained significantly increased concentrations of Na+, Cl-, total muscle water, and a significant reduction in the level of K+ compared with normal values. There was a significant increase in the intracellular water and Na+ levels with a concomitant reduction of intracellular K+ content. Most dystrophic muscle samples had a pronounced type 2 fibre deficiency and a marked increase in numbers of fibres with internalised nuclei. PMID- 2772404 TI - An electron microscopic study of Cytoecetes phagocytophila infection in Ixodes ricinus. AB - Tick-borne fever, caused by a rickettsia-like organism, Cytoecetes phagocytophila, is transmitted by the sheep tick Ixodes ricinus. An electron microscopic technique was developed to examine I ricinus for C phagocytophila infection. Infected and uninfected ticks were obtained from a laboratory maintained tick culture. All stages of I ricinus collected from one field site were examined; 44 per cent of nymphae and 32 per cent of adults were infected with C phagocytophila, but larvae were uninfected. This supports the previously held theory of transtadial, but not transovarial transmission of tick-borne fever. PMID- 2772405 TI - Retinal vascular patterns in domestic animals. AB - In this paper a morphological study of the retinal vascular patterns in various species of domestic animals is reported. A classification of these patterns into four well-defined groups is described. In the domestic ruminants, pigs and carnivores the retina contains a compact plexus of blood vessels located in the major part of the light-sensitive portion of the retina (euangiotic or holangiotic pattern). In other domestic animals blood vessels are present only in a smaller part of the retina. In the rabbit, vessels are confined to a broad horizontal band coincident with the area of dispersion of the myelinated nerve fibres. The larger of these vessels are readily visible macroscopically (merangiotic pattern). In the horse and the guinea pig the retinal blood vessels are minute and restricted to the direct neighbourhood of the optic disc (paurangiotic pattern). The avian retina is completely avascular (anangiotic pattern), but a densely vascularised pecten oculi is attached to the linear optic nerve head and protrudes far into the inferior part of the vitreous body. PMID- 2772406 TI - Interactions between Bordetella bronchiseptica and toxigenic Pasteurella multocida in atrophic rhinitis of pigs. AB - Three strains of Bordetella bronchiseptica were compared for their ability to assist colonisation of the nasal cavity of gnotobiotic pigs by toxigenic Pasteurella multocida. Toxigenic P multocida (counted in nasal washings) colonised the cavity in large numbers in pigs previously infected with a cytotoxic phase I strain of B bronchiseptica (B58), whereas it colonised only in small numbers in those previously infected with B65, a phenotypic phase III variant of B58. Toxigenic P multocida colonised pigs infected with a non cytotoxic phase I strain of B bronchiseptica (PV6) in fewer numbers than were seen in pigs infected with the cytotoxic phase I strain but in greater numbers than in pigs infected with the phase III strain. The turbinates of pigs infected with the cytotoxic phase I strain of B bronchiseptica and toxigenic P multocida were most severely affected and those in pigs infected with the non-cytotoxic phase I strain and toxigenic P multocida were moderately reduced in size. The turbinates of pigs infected with the phase III strain and toxigenic P multocida were slightly reduced in size except for one piglet whose turbinates were severely affected. Pigs infected with the non-cytotoxic phase I strain of B bronchiseptica alone showed no signs of atrophy and their turbinates were used to calculate reductions (per cent) in those infected with P multocida. The reduction (per cent) in size of turbinates and total numbers of P multocida isolated from the nasal washings of each pig were linearly related.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2772407 TI - Rate of development of oesophagogastric parakeratosis in the growing pig: some effects of finely ground barley diets, genotype and previous husbandry. AB - The rate of development of parakeratotic lesions in the gastric pars oesophagea was investigated in three experiments using 360 pigs, initially aged 10 to 11 weeks and weighing about 30 kg, of differing genotype and with some differences in previous rearing method, given a diet based on finely ground barley which was known to predispose to lesion formation. Lesions were found in some pigs at 10 to 11 weeks old but the incidence and severity increased progressively indicating development as quickly as one month after first giving the finely ground diet. There were indications that different genotypes and different diets given previously in rearing may have influenced the results obtained. The possible influence of other environmental factors is discussed. PMID- 2772408 TI - Interference between drug-resistant and drug-sensitive stocks of Trypanosoma congolense in goats. AB - A study was undertaken in goats to investigate the ability of two unrelated stocks of Trypanosoma congolense, one of which is highly sensitive to isometamidium chloride and one which is drug-resistant, to become established in the presence of an existing infection with the other stock. The goats, which were initially infected with the sensitive strain and were then challenged with the resistant strain, were cured by treatment at 0.1 mg kg-1 isometamidium, indicating that the resistant stock did not establish an infection. Goats initially infected with the resistant stock, which were then challenged with the sensitive stock, experienced temporary remission of infection followed by relapse after treatment at 0.1 mg kg-1 isometamidium. In contrast, the goat infected only with the resistant stock remained parasitaemic following treatment at 0.1 mg kg 1. This suggests that superinfection with the sensitive stock resulted in the establishment of infection, which suppressed the resistant stock to below the limit of detection of the method used. These observations suggest that isometamidium-resistant stocks may be less viable than sensitive strains, and could explain the relative scarcity of isometamidium resistant in the field. PMID- 2772411 TI - Isolation and characterisation of lymphoblastoid cells from cattle and deer affected with 'sheep-associated' malignant catarrhal fever. AB - Cells with the histological and ultrastructural characteristics of large granular lymphocytes (LGL) have been obtained in culture from both cattle and red deer (Cervus elaphus) reacting with 'sheep-associated' malignant catarrhal fever (MCF). Such cells have been derived from thymus, lymph node and spleen suspensions as well as from cerebrospinal fluid cells and cultured cornea. On most occasions their presence was observed only transitorily but by providing the cells with feeder monolayers and, or, interleukin-2, several lines were maintained indefinitely, and some became independent of these factors after prolonged culture. A similar cell line was also derived from a Pere David's deer affected with MCF at Whipsnade zoological park. Functionally, cultured LGL were cytotoxic to both primary cell cultures and cell lines and their cytotoxicity was not restricted to histocompatible target cells. These findings suggest that the cultured cells have natural killer cell-like activity and that they are important targets for the agent of MCF in cattle and deer. One cell line derived from a red deer transmitted the disease but none of the cells generated from cattle did. PMID- 2772409 TI - Physiological effects of etorphine, acepromazine and xylazine in the scimitar horned oryx (Oryx dammah). AB - Scimitar horned oryx (Oryx dammah), kept under confined and unconfined conditions were immobilised with etorphine in combination with acepromazine or xylazine or both, and with xylazine alone. Both groups of animals were successfully sedated with etorphine and xylzine, with or without acepromazine, although hypothermia and mild hypoxaemia and a fall in packed cell volume were frequently noted. Xylazine alone produced a dose dependent degree of sedation in semitame subadult animals kept in confinement, but only slight depression in their wild, unconfined counterparts. If xylazine was not included in the immobilising mixture induction was traumatic and full sedation not achieved. Heart rates and arterial pressures (systemic and pulmonary) were also monitored but no remarkable changes were noted. The only abnormalities in blood biochemistry were raised aspartate transminase and creatine kinase. Ruminal regurgitation could be a major problem if endotracheal intubation was not achieved early in the procedure. PMID- 2772410 TI - Effect of a new macrolide antibiotic (tilmicosin) on pneumonia experimentally induced in calves by Mycoplasma bovis and Pasteurella haemolytica. AB - Two gnotobiotic calves were treated once with tilmicosin (20 mg kg-1) six hours before they were infected by the intratracheal route with Mycoplasma bovis and Pasteurella haemolytica serotype 1. This treatment prevented colonisation of the lungs by P haemolytica and considerably reduced colonisation by M bovis, and the clinical scores and the extent of pneumonic consolidation, compared with two untreated gnotobiotic calves, both of which had to be killed in extremis for humanitarian reasons within 24 hours of infection. In a second experiment, 10 conventionally reared calves were similarly exposed to infection and, at the onset of clinical disease, five were treated once with tilmicosin (20 mg kg-1). Colonisation by P haemolytica and M bovis, the clinical scores and extent of pneumonic consolidation were suppressed or greatly reduced in the treated compared with the untreated calves, one of which had to be killed in extremis two days after infection. It was concluded that tilmicosin had a beneficial effect. PMID- 2772412 TI - Bromsulphthalein and indocyanine green elimination from plasma, and urinary bromsulphthalein excretion, in normal cats. AB - The elimination of bromsulphthalein (BSP) and indocyanine green (ICG) from plasma and urinary excretion of BSP were investigated in healthy cats. At 5 mg kg-1, BSP elimination fitted a two-compartment open model, with mean t1/2 beta of 7.1 (SD 2.5) minutes. A tendency for slower elimination of BSP at 10 mg kg-1 suggested saturation of excretory mechanisms, while at 2 mg kg-1 accurate dosing and assay of low BSP concentrations were difficult. Urinary recovery of BSP at 5 mg kg-1 was 0.01 to 0.13 per cent of the total dose. Plasma ICG (0.5 mg kg-1) data fitted a one-compartment open model, with mean t1/2 2.7 (SD 1.0) minutes. In cats, retention tests are more attractive than clearance tests because fewer blood collections are necessary. Proposed reference values are under 3.6 per cent retention of BSP (5 mg kg-1) at 30 minutes and under 17.5 per cent retention of ICG (0.5 mg kg-1) at 15 minutes. At present economic and technical factors favour BSP over ICG. PMID- 2772413 TI - Comparison of a quantitative standardized HBV-DNA assay and a classical spot hybridization test in chronic active hepatitis B patients undergoing antiviral therapy. AB - A quantitative solution hybridization assay (Genostics Tm hepatitis B viral DNA, Abbott Laboratories) for hepatitis B viral DNA (HBV DNA) in serum was compared with the classic spot hybridization test in chronic hepatitis B carriers undergoing antiviral therapy. Twenty-eight patients with HBsAg- and HBeAg positive chronic liver disease were studied and 128 sera were analysed during treatment. Ninety-nine (86%) sera were found to be positive with the two assays. Fourteen sera were negative in both assays. Fifteen samples were positive by Genostics and negative by spot test. Therefore, the sensitivity of the Genostics assay was equivalent to or slightly greater than that of the spot test. Changes in HBV-DNA levels measured by the two assays showed a high correlation during therapy, but changes in the viral replication level seemed to be better resolved by Genostics. The Genostics assay represents a standardized, easy-to-use, quantitative method for the detection of HBV DNA in serum. It will be useful for monitoring antiviral therapy and should now be evaluated on a large scale. PMID- 2772415 TI - Dugbe virus replication in nymph and adult Amblyomma variegatum. PMID- 2772414 TI - Characterization of a non-structural 147-kDa precursor polypeptide of echovirus 33 and its immunogenicity in man. AB - Zinc chloride (0.9 mM)--an inhibitor of the processing of the initial polypeptides of Picornaviridae--was used to accumulate large precursors of echovirus 33 (EV33) and notably two proteins of 147- and 97-kDa. Polyclonal hyperimmune sera were raised in mice against these polypeptides and assayed by immunoblotting against EV33-infected cells blocked or not with ZnCl2, showing that protein 147--2ABC3ABCD according to the L434 convention--can be considered to be the precursor of the two non-structural proteins P2 and P3. Sixty-three serum specimens from subjects exhibiting varying antibody status against EV33 by seroneutralization were investigated by immunoblotting against an EV33 ZnCl2 blocked antigen. Some subjects infected with EV33 were shown to elicit antibodies which recognize the non-structural precursor polypeptides, a fact whose clinical significance needs further evaluation. PMID- 2772416 TI - Recovery of virus from the liver of children with fatal dengue: reflections on the pathogenesis of the disease and its possible analogy with that of yellow fever. AB - Dengue viruses types 2 or 3 were recovered from the liver of 5 out of 17 children who were suspected to have died of dengue. Among the 5 children with liver isolates, virus was also recovered from the heart blood, spleen and midbrain of one and from the spleen of another. Attention is drawn to the many similarities in the clinical manifestations of yellow fever and severe dengue, their indistinguishable liver lesions and the close relationship of the viruses themselves. In view of the liver isolates reported here and those described by others, it is suggested that the pathogenesis of the two diseases may be analogous. PMID- 2772417 TI - Antibody-dependent cellular cytotoxicity mediated by lung macrophages: a comparison of two target cells. AB - Mononuclear cell-mediated cytotoxicity may be an important cellular immune function in host lung defense. Prior investigators have shown that lung macrophages participate in cell cytotoxicity which is antibody-dependent (ADCC). We tested the hypothesis that alveolar macrophages share some cell surface receptors for the Fc portion of IgG, i.e., Fc receptors, similar to those found on circulating monocytes in order to function in ADCC. Hence, ADCC mediated by autologous human blood monocytes and lung macrophages was studied by measuring the release of chromium-51 from prelabeled target erythrocytes coated with IgG. Alveolar macrophages were obtained from healthy adult subjects by bronchoalveolar lavage and tested against two different erythrocyte target cells to measure ADCC activity. Our results show significant activity by alveolar macrophages demonstrated against chicken erythrocytes at a target to effector cell ratio of 2:1 or 10:1 and with an antibody concentration of 1:100 or 1:400 (volume per volume, p less than 0.05, Student's test). However, when a peripheral blood monocyte specific target cell (human type B erythrocyte) was utilized, alveolar macrophages were not as capable of significant ADCC activity against these monocyte-specific target cells. The inability of lung macrophages to function in ADCC against other target cells (i.e., human type B erythrocytes) unlike the peripheral blood monocytes suggests that some Fc receptors are not shared. In other words, these different cell types share IgG receptors but differences in activity may be due to some changes in the Fc portions of IgG due to cellular differentiation. The use of these target cells may potentially be useful in functionally discriminating between two types of adherent autologous mononuclear cells (lung macrophages vs. blood monocytes). PMID- 2772419 TI - Sympathetic uveitis after giant tear repair. AB - A 33-year-old Hispanic man developed sympathetic ophthalmia 4.5 months after vitrectomy and repeat scleral buckling for a giant retinal tear in an aphakic previously traumatized eye. The patient had gray-white, subretinal nodules with characteristic changes of sympathetic uveitis detected by fluorescein angiography. The fluorescein angiographic and clinical findings revealed a dramatic response to steroid treatment: visual acuity returned to the previous 20/20 level within 5 weeks of therapy. PMID- 2772418 TI - Acute leukemia presenting as a unilateral exudative retinal detachment. AB - The leukemias commonly involve the eyes and adnexae. It is unusual, however, for leukemia to present with visual complaints. Furthermore, there are only rare case reports of leukemic patients presenting with bilateral exudative retinal detachments. We report a unique case of a boy who presented with visual loss due to a unilateral exudative retinal detachment. A systemic evaluation discovered acute lymphocytic leukemia (ALL). There was rapid settling of the exudative detachment and improvement in vision while the patient received chemotherapy and radiotherapy for the ALL. PMID- 2772420 TI - Transscleral and transconjunctival diathermy. AB - The authors developed a new diathermy electrode that can be used with simultaneous indirect ophthalmoscopic control. The electrode uses the same source and handle as the conventional diathermy but can be used transconjunctivally or transsclerally through full thickness sclera. Chorioretinal scars were successfully induced in 30 rabbit eyes (with or without retinal detachment). Long term follow-up revealed normal maturation of the scars, with firm adhesion of the retina to the choroid but no gross or histopathologic evidence of permanent scleral damage. PMID- 2772421 TI - Epiretinal membranes and cystoid macular edema in gyrate atrophy of the choroid and retina. AB - A 26-year-old woman with gyrate atrophy of the choroid and retina and hyperornithinemia lost central visual acuity because of cystoid macular edema associated with epiretinal membrane formation. Dietary manipulation over a 5 month interval reduced the plasma ornithine levels 37% but did not halt the progression of the gyrate atrophy nor influence the cystoid edema or visual acuity. PMID- 2772422 TI - Clinicopathologic correlation of an eye after surgical removal of an epiretinal membrane. AB - An epiretinal membrane causing macular pucker was surgically removed from an eye that had previously undergone a scleral buckling procedure for retinal detachment. The eye was obtained postmortem and studies by light and electron microscopy disclosed a large area of retina that was void of internal limiting membrane (ILM). The presence of extremely thin ILM, and rare segments of basement membrane with an increased number of attachment plaques of Mueller cells near the margin of the area of ILM loss, suggested a limited capacity for regeneration of the ILM. Minor recurrence of fibrous astrocyte proliferation along the inner surface of the area devoid of ILM was observed. Recurrence of epiretinal membrane, without contraction changes, occurred at the margins of the area from which ILM had been removed. PMID- 2772423 TI - Neuron-specific enolase and retinoblastoma. Clinicopathologic correlations. AB - Neuron-specific enolase (a glycolytic, ubiquitous, intracellular enzyme) has recently been reported to be detectable in the aqueous humor of eyes containing retinoblastoma. Aqueous humor from 17 patients with histologically proven retinoblastoma was assayed for the presence of neuron-specific enolase (NSE). NSE was detectable in 17 out of 17 patients with levels between 619 and 60,000 ng/ml. A multitude of clinocopathological parameters were examined for statistically significant correlations with levels of aqueous humor NSE. This investigation demonstrated that only two parameters, the presence of tumor invasion into the anterior chamber, and inflammation significantly correlated with aqueous NSE levels. Histological parameters which did not correlate with aqueous NSE levels included tumor necrosis, calcification, Flexner-Wintersteiner rosettes, exophytic/endophytic tumor type, tumor extent relative to the equator, and optic nerve/choroidal invasion. Clinical parameters which showed no correlation included patient sex (M/F), enucleation age, presentation age, family history, laterality, prior treatment, and presence of metastatic disease. Neuron-specific enolase is present in the anterior chamber of eyes enucleated for retinoblastoma, but additional testing is necessary to determine the normal levels of neuron specific enolase in children's eyes and the levels in eyes with lesions simulating retinoblastoma. PMID- 2772424 TI - Idiopathic central serous choroidopathy (ICSC) PMID- 2772425 TI - Repetitive, selective angiography of individual vessels of the retina. AB - Recent experiments have shown the feasibility of using laser or microwave energy for the externally controlled release of both dyes and drugs from temperature sensitive liposomes (lipid vesicles). In the present study, calcein, a fluorescent dye, was used to improve the in vivo capabilities of this controlled release system. In vitro studies showed that the encapsulation efficiency was improved when compared to carboxyfluorescein, the fluorescent dye used previously. The improved liposome and dye system was used to obtain repetitive, "selective angiograms" in isolated segments of the retina in rabbits and in a nonhuman primate (Macaca mulatta) over a period of up to 2 hours after a single liposome injection. Conventional fluorescein angiography of the primate retina one week after the end of the experiments showed no visible damage, even after more than 400 individual laser exposures. PMID- 2772426 TI - Comparative study of clinical factors predisposing patients to proliferative vitreoretinopathy. AB - Clinical features of 57 eyes with proliferative vitreoretinopathy (primary PVR) that developed preoperatively were statistically analyzed and compared with a control group of 1353 eyes with non-PVR rhegmatogenous retinal detachment. The statistically significant (P less than 0.05) factors predisposing to PVR were as follows: retinal detachment for more than 1 month; aphakia (47.4% in the PVR group versus 11.1% in the control group); vitreous hemorrhage (26.3% versus 11.0%); giant tear (15.8% versus 0.8%); breaks larger than 3 disc diameters (62.1% versus 27.3%); and horseshoe tear (65.5% versus 44.9%). PMID- 2772428 TI - Immobilized adriamycin: toxic potential in vivo and in vitro. AB - We report experiments which test the toxicity of a new potential therapeutic agent, agarose-bound adriamycin (ImA). In C57Bl/6N mice this preparation is almost completely devoid of untoward effects when administered intraperitoneally; ImA lacks all the usual toxic repercussions of free adriamycin including abdominal adhesions, inflammatory peritonitis, weight loss and cardiotoxicity. The immobilized adriamycin is also inactive in a fetal mouse heart model of cardiac toxicity. This lack of toxicity is not due to an intrinsic inactivity of the drug, however, since previous studies have shown that polymer-bound adriamycin can kill actively dividing cells. We also show here that the immobilized drug can undergo redox reactions and interact with enzymes from isolated respiratory chain preparations, so the lack of cardiac toxicity in vivo is most likely due to inaccessibility of the target. These results suggest that polymer immobilized adriamycin lacks the toxicity of the parent compound and may present a useful approach to regional chemotherapy. PMID- 2772429 TI - Arrest and retention of multilamellar liposomes in the brain of normal mice or mice bearing experimental brain metastases. AB - The blood-brain barrier presents a major obstacle to the systemic treatment of malignant brain tumors and brain metastases. We investigated whether the direct injection of liposomes into the internal carotid artery of normal mice or mice with experimental brain-melanoma metastases could allow delivery of anticancer drugs across this barrier. Liposomes of different sizes (greater than 5 microns, less than 1 micron, 40-80 nm) and lipid compositions were injected i.v. or into the internal carotid artery. The retention of liposomes in the brain of normal C3H/HeN mice was similar to that observed in mice with experimental brain cancer metastasis. The highest accumulation of liposomes in the brain occurred with large multilamellar vesicles, which also produced severe toxicity presumably due to embolism. Smaller liposomes were not toxic but did not accumulate in the brain. Liposomes injected i.v. did not accumulate in the brain, either. Thus, neither i.v. nor intracarotid administration of liposomes produce results suitable for therapy of brain tumors/metastases. PMID- 2772427 TI - Biocompatibility of a biodegradable, controlled-release polymer in the rabbit brain. AB - The biodegradable polyanhydrides are a new class of controlled release polymers developed for the interstitial delivery of drugs to their target site in the brain or other organs over periods ranging from days to years. These polymers can release molecules of any size in a predictable fashion. Their degradation products are non-cytotoxic and biocompatible. The biocompatibility of a biodegradable polyanhydride, the copolymer of poly[bis(p-carboxyphenoxy)propane] anhydride and sebacic acid (PCPP-SA) in a 50:50 formulation, was studied in the rabbit brain. Twenty adult New Zealand White male rabbits underwent implantation of PCPP-SA in a frontal lobe and absorbable gelatin sponge (Gelfoam) in the other frontal lobe. The animals were evaluated daily until the time of sacrifice. Groups of four animals were sacrificed sequentially on post-operative days 1, 3, 7, 21, and 60, and the brains processed for histological evaluation. None of the animals showed behavioral changes or neurological deficits suggestive of toxicity and all that received implants survived to their date of sacrifice. The histological examination showed no significant differences between the tissue reaction from PCPP-SA compared to Gelfoam. The polymers were also tested in the rabbit cornea bioassay and did not induce an inflammatory response. We conclude that PCPP-SA (50:50), a new biodegradable polymeric matrix that can be surgically implanted for the interstitial delivery of drugs in the brain, is biocompatible in the rabbit brain. PMID- 2772431 TI - Genetic diseases of the kidney. PMID- 2772432 TI - Does chloride play an independent role in the pathogenesis of metabolic alkalosis? PMID- 2772430 TI - Combination chemo-radiation therapy for jaundice due to focal malignant obstruction of the major bile ducts. AB - Twenty patients with focal malignant obstruction of the major bile ducts (6 cholangiocarcinoma, 8 colorectal, 3 hepatoma, 2 unknown primary, and 1 gastric cancer) were treated on a protocol examining the toxicity and efficacy in relieving jaundice of external beam radiation therapy (4500 cGy in 300 cGy fractions) combined with continuous hepatic arterial (15 patients) or peripheral venous (5 patients) fluorouracil infusion. Toxicity of this regimen consisted of anorexia with mild nausea and vomiting in 55% of patients and gastric ulceration (responsive to medical management) in 15% of patients. One patient exhibited transient grade 2 hepatic toxicity and one had asymptomatic grade 4 leukopenia. Of 14 patients treated without prior biliary drainage, 8 exhibited a decrease in bilirubin levels from a mean of 14.5 mg/dl to 1.5 mg/dl. Four of six patients with biliary drainage catheters at the start of treatment were able to have them removed without reobstruction. For the 8 responding patients among those who did not have cholangiocarcinomas, the median response duration was 5 months with a median survival from treatment of 6.5 months. For the 4 responding patients with cholangiocarcinoma, the median response duration was 16 months with a median survival from treatment of 20 months. All responders did not have a return of jaundice due to reobstruction of the major ducts (until death or to the present). All responders who have died did so due to tumor progression outside of the treated field except for one who died of unrelated causes. The mean number of proven or presumed episodes of cholangitis per patient was virtually identical in those without (1.8) and those with stents/tubes (1.4, p = 0.561). This regionally focused combined modality cytotoxic therapy was able to relieve obstruction in the majority of patients without excess morbidity (including a lack of any detectable increase in sepsis). Thus, it appears feasible to consider randomized studies of this cytotoxic approach versus standard mechanical drainage procedures to define the relative risks and benefits of each. PMID- 2772433 TI - Changes in limb volume during head-out water immersion in humans. AB - In order to investigate the contribution of fluid shift from the legs to immersion-induced diuresis, 7 normal and 2 legless (both legs disarticulated at the hip) individuals were tested to measure changes in leg volume (normal subjects) and urinary excretion of solutes and water during a 3-h head-out water immersion (HOI) in thermoneutral water (34.5 +/- 0.5 degrees C) with a 1-h control period before and after immersion. On a separate day, a 5-h time control (TC) experiment on the same subjects was carried out by having them sit in thermoneutral air (29 +/- 0.1 degrees C, relative humidity 60%). The leg volume decreased by 192 +/- 20 ml during the 3-h HOI, which accounted for 3.5% of the average leg volume of the preimmersion period. During TC, however, the leg volume increased by 110 ml in the same time course. An increase in urine volume and sodium excretion was observed during HOI in both normal (P less than 0.05) and legless subjects. Net urine volume induced by HOI (urine volume during HOI minus urine volume during corresponding TC) in normal subjects was 494 +/- 89 ml in 3 h, which was close to a calculated volume reduction of the lower extremities during HOI (508 +/- 53 ml). The average net urine volume during HOI in the legless subject was 183 +/- 48 ml/min. The above results may suggest that the increase in renal water output is largely accounted for by a fluid shift from the lower extremities during HOI, however, the fluid other than that from the extremities should be accounted for as the urine source.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2772434 TI - [Mass screening for endometrial cancer according to the Law of Health for the Elderly]. AB - Due to the gradual increase of endometrial cancer, mass screening for this type of cancer began from 1987 in Japan in accordance with the Law of Health for the Elderly. However, a screening system for endometrial cancer has many controversial problems when compared with that for cervix cancer. Criteria for screening, methods of screening, management after screening, and executive systems are all controversial points in the performance of mass screening. The actual condition in the detection of endometrial cancer in Fukuoka Prefecture based on a questionnaire is discussed in this paper. PMID- 2772435 TI - [Effects of inhalation of ethylene oxide on female rats]. AB - The effects of systemic toxicity including reproductive toxicity of ethylene oxide on female rats were studied. When Wistar female rats were exposed to 250 ppm of ethylene oxide for six hours a day, five days a week for ten weeks, they showed inhibition of body weight gain and paralysis of the hindlegs. Hematological examination revealed macrocytic and normochromic anemia with high reticulocyte counts. The estrus cycle of the exposed group was prolonged and the percentage of the diestrus stage increased. There was no atrophy in the ovary or the uterus. However, the activity of glutathione reductase in the ovary decreased by 18% and that of glutathione-S-transferase increased by 30%. These results indicate that ethylene oxide has a similar effect on both female and male rats and that the female reproductive system is also affected. PMID- 2772436 TI - [Semi-malignant pitch-acanthoma on the hand of a coke oven worker]. AB - We experienced a case of pitch-acanthoma which had developed on the hand of a coke worker after 15 years from his retirement. The patient was a 75-year-old male, who had worked mainly as a coke-oven worker for 24 years. In the spring of 1988, after 15 years from his retirement, he noticed a small nodule on the dorsal aspect of his right hand. He visited our clinic on June 1988 because the nodule was rapidly growing larger. The diagnosis of pitch-acanthoma was obvious from his occupational history and the characteristic poikilodermatous outlook of his skin. The tumor was removed surgically. Histological examination showed hyperkeratosis and acanthosis with horn-pearl formation. Moreover, a pack of atypical cells was observed within the lesion, suggesting an early malignant change. The patient was heavily exposed to a tar-gas-containing atmosphere in his workplace for quite a long period. As tar or pitch remains within the skin in spite of careful cleansing, workers in this atmosphere have a relatively high risk of developing skin cancer. Our present case shows that such malignant change can occur after long years and we would emphasize the necessity of a long term follow-up, perhaps throughout the lifetime of these workers. PMID- 2772437 TI - [Opinion survey on the bioethical views of Catholic physicians in Japan. I. Contraception and induced abortion]. AB - This opinion survey on sex and bioethics was carried out in March and April of 1988 by the special committee for family planning and sex related problems which the JMCA (President Dr. Yasuro Anno) had drawn up. This study deals with the analysis of 229 responses to the 3 questions concerning contraception, natural family planning and induced abortion respectively. The background factors of the respondents, sex, age, baptismal age, region (by archdiocese), specialty (clinical, fundamental and social medicine), and payment of the membership fees during the past 3 years were investigated by means of the multiple regression analysis. In addition to the age factor which clearly influenced the responses of each question, the regional factor showed significant influences on the responses to the contraception as well as natural family planning questions. The author proposes five operational hypotheses (A-E) to explain these phenomena, and concludes that it is important to undertake interdisciplinary research as well as to conduct continuous education programs concerning biomedical ethics among the catholic physicians in Japan. PMID- 2772438 TI - Regression with an ordered categorical response. AB - A survey on Mseleni joint disease in South Africa involved the scoring of pelvic X-rays of women to measure osteoporosis. The scores were ordinal by construction and ranged from 0 to 12. It is standard practice to use ordinary regression techniques with an ordinal response that has that many categories. We give evidence for these data that the constraints on the response result in a misleading regression analysis. McCullagh's proportional-odds model is designed specifically for the regression analysis of ordinal data. We demonstrate the technique on these data, and show how it fills the gap between ordinary regression and logistic regression (for discrete data with two categories). In addition, we demonstrate non-parametric versions of these models that do not make any linearity assumptions about the regression function. PMID- 2772439 TI - Sample size tables for logistic regression. AB - Sample size tables are presented for epidemiologic studies which extend the use of Whittemore's formula. The tables are easy to use for both simple and multiple logistic regressions. Monte Carlo simulations are performed which show three important results. Firstly, the sample size tables are suitable for studies with either high or low event proportions. Secondly, although the tables can be inaccurate for risk factors having double exponential distributions, they are reasonably adequate for normal distributions and exponential distributions. Finally, the power of a study varies both with the number of events and the number of individuals at risk. PMID- 2772440 TI - Sample sizes for constructing confidence intervals and testing hypotheses. AB - Although estimation and confidence intervals have become popular alternatives to hypothesis testing and p-values, statisticians usually determine sample sizes for randomized clinical trials by controlling the power of a statistical test at an appropriate alternative, even those statisticians who recommend the use of confidence intervals for inference. There is merit in achieving consistency in the techniques for data analysis and sample size determination. To that end, this paper compares sample size determination with use of the length of the confidence interval with that obtained by control of power. PMID- 2772441 TI - A method for the evaluation of dose-toxicity relationships in clinical trials. AB - This paper considers a proportional hazards model that describes the relationship between time-dependent cumulative dose of drug and development of toxicity. We estimate probabilities of developing toxicity in both the presence and the absence of competing risks and provide variances for the latter case. Mitoxantrone data collected in Southwest Oncology Group studies illustrate the methods. PMID- 2772442 TI - On correcting for misclassification in twin studies and other matched-pair studies. AB - In twin studies (and other matched-pair studies) of the effect of a K-level risk factor on disease risk, one must estimate the proportion of pairs in each of K2 possible pair categories, of which K(K-1) categories represent discordant pairs. In particular, for a binary factor, one must estimate proportions within two discordant-pair categories and the variances of functions of these estimates. This paper shows how to do so when misclassification is present and stable estimates of the classification rates are available. Unlike methods that estimate only the discordance ratio, one can use the methods presented here to improve estimates of epidemiologic effects. PMID- 2772443 TI - Statistical analysis of the stages of HIV infection using a Markov model. AB - We use a staged Markov model to estimate the distribution and mean length of the incubation period for acquired immunodeficiency syndrome (AIDS) from a cohort of 603 human immunodeficiency virus (HIV) infected individuals who have been followed through various stages of infection. The model partitions the infected period into four progressive stages: (1) infected but antibody-negative; (2) antibody-positive but asymptomatic; (3) pre-AIDS symptoms and/or abnormal haematologic indicator; and (4) clinical AIDS. We also model a fifth stage: death due to AIDS. The estimated mean (median) waiting times in each stage of infection are stage 1, 2.2 (1.5) months; stage 2, 52.6 (36.5) months; stage 3, 62.9 (43.6) months; and stage 4, 23.6(16.3) months. We estimate the mean AIDS incubation period (from infection to development of clinical AIDS) as 9.8 years with a 95 per cent confidence interval of [8.4, 11.2] years. The paper also considers the estimated density function of the AIDS incubation period and the estimated survival functions for individuals in each stage of infection. This work represents one of the most complete statistical descriptions to date of the natural history of HIV infection. PMID- 2772444 TI - Estimability and estimation of excess and etiologic fractions. AB - This paper describes conditions under which epidemiologic data can provide estimates of the excess fraction (proportionate increase in caseload due to an exposure) and the etiologic fraction (fraction of cases caused by exposure). The excess fraction can be estimated under essentially the same conditions often cited for general study validity. In contrast, estimation of the etiologic fraction will usually require very specific non-identifiable assumptions about exposure action and interactions, although one can derive simple lower and upper bounds for the fraction from survival comparisons. Since the etiologic fraction is equivalent to the probability of causation, our results have implications for injury compensation in lawsuits involving the probability of causation. PMID- 2772445 TI - Comparison of the information in two lung function experiments. AB - The amount of ventilation relative to perfusion (the ventilation-perfusion ratio) received by the lung is a useful indicator of the efficiency of lung function. Two alternative techniques for recovering the ventilation-perfusion ratio are outlined. While both techniques rely on the use of inert gases, one is well established and the other is only in a developmental stage. This paper focuses on a comparison of the amount of statistical information provided by these two techniques about the ventilation-perfusion ratio. The criterion applied here for measuring amount of information has roots in communication theory and uses ideas inherent to Bayesian inference. PMID- 2772447 TI - Some analysis strategies for three period changeover designs with two treatments. PMID- 2772446 TI - Test for batch-to-batch variation in stability analysis. AB - We propose several statistical tests for batch-to-batch variation in the stability analysis of a drug product and present applications with data from new drug application stability and marketing stability analyses. PMID- 2772448 TI - Response to "Life-span development: a review of theory and practice for families with chronically ill members". PMID- 2772450 TI - Response to "Empathy, diversity, and telepathy in mother-daughter dyads: an empirical investigation utilizing Rogers' conceptual framework". PMID- 2772449 TI - Empathy, diversity, and telepathy in mother-daughter dyads: an empirical investigation utilizing Rogers' conceptual framework. AB - The purpose of this study was to examine empathy, diversity, and telepathy in natural mother-daughter dyads. The investigation was conceptualized and conducted according to the concepts and principles of the Rogerian Science of Unitary Human Beings. The sample for this descriptive study consisted of 180 volunteer mother daughter dyads; the mother served as the receiver and the child as sender of telepathic messages. Empathy and diversity were expected to be related to telepathy levels. Results indicated that one form of empathy (personal distress) and diversity were significantly (p less than .05) related to telepathy. When the components of the diversity score were further examined, only those subjects who were moderately differentiated and mobile demonstrated significant telepathy scores. Multiple regression analysis showed that 6% of the variance in telepathy was accounted for by diversity and empathy. Findings added to what is known about living systems that manifest negentrophy and evolve toward increasing diversity. PMID- 2772451 TI - Environmental lighting, behavioral state, and hormonal response in the newborn. AB - This experimental study was designed to investigate the effects of constant and intermittent light on newborn infants. Changes in levels of salivary cortisol were utilized as indications of increased pituitary-adrenal activity. The sample consisted of 99 babies who were classified as state predominance sleep (Group A) babies or state predominance awake (Group B) babies following a 3-hour observation period for each infant. The experimental group was subjected to intermittent light and the control group to constant overhead lighting on two consecutive nights. A 2 X 2 ANOVA utilizing absolute change salivary cortisol scores revealed a statistically significant interaction between light and state. The findings suggest that the effects of different light conditions are related to individual response differences. In intermittent light, the absolute change salivary cortisol scores may reflect a previously assumed unobservable cortisol rhythmicity in Group B babies and a diminution of stress in Group A babies. PMID- 2772452 TI - Response to "Environmental lighting, behavioral state, and hormonal response in the newborn". PMID- 2772453 TI - Response to "An interpretive study describing the clinical judgment of nurse practitioners". PMID- 2772454 TI - Rural nursing: developing the theory base. AB - Many health care needs of rural dwellers cannot be adequately met through the use of existing nursing models alone but require unique approaches emphasizing the special needs of this population. The development of an integrated theory base for rural nursing is necessary. A retroductive approach, building upon both qualitative and quantitative research data, is being used to develop a theory of rural nursing. Key concepts identified are: work beliefs and health beliefs; isolation and distance; self-reliance; lack of anonymity; outsider/insider; and old-timer/newcomer. Implications for practice include the importance of relating health care to work practices and the need to intervene indirectly through established informal systems. PMID- 2772455 TI - Response to "Rural nursing: developing the theory base". PMID- 2772456 TI - Response to "The relationship among background characteristics, purpose in life, and caregiving demands on perceived health of spouse caregivers". PMID- 2772457 TI - An interpretive study describing the clinical judgment of nurse practitioners. AB - Devaluation of nursing practice by both practicing nurses and nurse educators is giving way to keen interest in clinical scholarship. A naturalistic study was conducted to provide a contextual account of the actual practice of experienced nurse practitioners. Data collection procedures consisted of clinical situation interviews with nurse practitioner pairs, participant observation of patient visits to nurse practitioners in four hospital-based ambulatory settings, individual interviews with nurse practitioners, and administration of a brief demographic questionnaire. The 199 clinical situations that constituted the resulting text were analyzed using phenomenological and existential perspectives. The clinical judgment of experienced nurse practitioners is described through interpretive analysis of the text according to the dictates of hermeneutical phenomenology. This methodology provides a way of describing and communicating the knowledge that develops among experienced practitioners and their patients. Text interpretation also produced an adaptation of Benner's (1984a) domains and competencies specifically for nurse practitioner practice, which may be useful as a conceptual framework for nurse practitioner practice, education, and research. PMID- 2772458 TI - [Self measurement of arterial pressure. The World League against Hypertension]. PMID- 2772459 TI - [Technical aspects of guided biopsy following placement of a "harpoon" for infra clinical, radiologically suspect breast lesions]. AB - The importance of systematic mammography in cancer screening had been well demonstrated. "Harpooning" under radiological control improves the precision of the surgical technique of excisional biopsy of infra-clinical mammary lesions. Among the 20 patients subjected to this technique at the Bordet Institute, 6 cases were malignant tumors (30%). Only once did this technique not allow the excision of the mammographically visualized lesion. No surgical complications have been noted. The neoplastic lesions had been essentially represented radiologically as grouped, dense and irregular microcalcifications. PMID- 2772460 TI - [The effect of cigarette smoking on the cicatrization of duodenal ulcers in patients treated with cimetidine. The role of acid hypersecretion]. AB - In 92 patients with duodenal ulcer, male cigarette smokers treated with cimetidine 1 g/day, 66.3% healed after four weeks. No differences were observed between healed and non-healed patients for age, symptom period before treatment, early onset (less than 30 years), multiple ulcers. In non-healed patients, more had a greater ulcer diameter (p = 0.0026) and more were heavy smokers (p = 0.0002). In non-healed patients, pentagastrin-induced maximal acid output, corrected for age, was higher than in healed patients (p less than 0.05). We confirmed the linear relationship between acid output and the number of cigarettes smoked per day (p less than 0.05). These observations suggest that cigarette smoking over a long period could stimulate the vagus. This would increase the functional parietal cell mass and explain the observed increase in pentagastrin-induced acid output. PMID- 2772461 TI - [Comparison of 24-hour gastric pH in control subjects, in patients with duodenal ulcer and in patients with atrophic gastritis]. AB - Twenty four hour intragastric acidity was measured by continuous recording using intragastric glass electrodes in 16 controls, 18 inactive duodenal ulcer patients and 7 patients suffering from atrophic gastritis. Medians pH for the 24h period, for the 8 AM-8 PM period, for the 8 AM-8 PM period were significantly lower in duodenal ulcer patients than in controls (1.19 vs 1.78; 1.17 vs 2.05; 1.27 vs 1.64). Median pH for these three periods were significantly higher in patients suffering from atrophic gastritis than in controls (3.90; 3.72; 3.81). In duodenal ulcer patients, 33 p 100 had medians for the 24h period higher than the lower quartile value of the control group. During the night (24h-3h) duodenal ulcer patients had median pH (1.03) significantly lower than controls (1.51). Antisecretory treatment should be directed to decrease this period of unbuffered acidity. PMID- 2772462 TI - [Addiction--a contribution from the viewpoint of adolescent psychiatry]. AB - While a single patient's addiction arises from a pattern of individual factors there appears to be a general cultural climate fostering its genesis in many variants. In the present contribution the metamorphosis of the metaparadigm from the dialectic to the dialogue is characterized as cultural transition-time demanding from the individual to cope and live with permanent contradictions and conflicts. On the background of this anthropologic situation addiction is understood as internalized foreign determination sustaining a common though antiquated scheme of psychic and social conflict conditioned by outdated patterns of education and socialisation. Addiction is appreciated as an inadequate attempt of the individual and of society toward adaptation, based on historic evolution of culture. PMID- 2772463 TI - The value of regional lymph node dissection in genitourinary cancer. AB - Regional lymph node dissection in the management of genitourinary (GU) neoplasms is controversial but is based on a 17 year clinical experience and the achievement of survival figures as good or better than those achieved by any other modality of therapy. Lymphadenectomy has proved to be effective in curing patients with metastatic testicular cancer, renal cell carcinoma and transitional cell carcinoma. Its efficacy in prostate cancer is much less certain and remains largely a staging procedure. PMID- 2772464 TI - Infected false aneurysms of the femoral artery in intravenous drug addicts. AB - The evaluation and treatment of 60 intravenous drug addicts with infected false aneurysms of the femoral artery seen at Henry Ford Hospital (Detroit) from 1977 to 1988 were retrospectively reviewed. The most common presenting signs and symptoms were groin swelling and/or mass in 56 (93%) of the patients and pain and/or tenderness in 48 (80%) of the patients. Digital subtraction angiography and standard arteriography showed sensitivities of 92% and 96%, respectively, in the detection of aneurysms. Twenty-three (39%) of the 60 patients had polymicrobial infections. Staphylococcus aureus was isolated in 50 (83%) of 60 cases; 21 (42%) of the isolates were beta-lactam-resistant strains. Anaerobes and aerobic gram-negative bacilli were observed in 12 (20%) and seven (12%) of 60 patients, respectively. Thirty-six (60%) of the patients were bacteremic. All patients received parenteral antibiotics and had surgical resection of their false aneurysm(s). Bacteriologic treatment failures occurred in five of 13 patients who received less than or equal to 15 days of parenteral antibiotics following surgical ligation, as compared with one of 47 who received longer courses (P = .002). Six of 12 grafting procedures were successful, and six of the 60 patients required amputations. There were no deaths. Previously reported cases from the United States medical and surgical literature are reviewed. PMID- 2772465 TI - Community-acquired pneumonia requiring hospitalization: 5-year prospective study. AB - We studied all patients with community-acquired pneumonia who were admitted to our 800-bed adult acute care hospital from 1 November 1981 to 15 March 1987. The 719 patients had a mean age of 63.2 years; 18% were admitted from nursing homes, and 18% required ventilatory assistance as part of the therapy for pneumonia. Patients with nursing home-acquired pneumonia were significantly older; had a higher mortality (40% vs. 17%); were more likely to be admitted in January; were less likely to complain of cough, fever, anorexia, chills, headache, nausea, sore throat, myalgia, or arthralgia; and were more likely to be confused than those admitted from the community. Pneumonia of unknown etiology and aspiration pneumonia were more common and Mycoplasma pneumoniae infection less common among those with nursing home-acquired pneumonia. Streptococcus pneumoniae accounted for 58% of the 48 cases of bacteremia. None of the bacteremic patients received antibiotics before admission, compared with 34% of the nonbacteremic patients. Aerobic gram-negative rod bacteremia was not more frequent among nursing home patients than among those from the community. The overall mortality was 21% (8.5% for those less than 60 years of age and 28.6% for those greater than 60 years old). By multivariate analysis the following variables were significant predictors of mortality: number of lobes involved by the pneumonic process, number of antibiotics used to treat the pneumonia, age, admission from a nursing home, ventilatory support, and the number of complications that occurred while the patient was in the hospital. PMID- 2772466 TI - Pseudomonas cepacia typing systems: collaborative study to assess their potential in epidemiologic investigations. AB - To determine the utility of available Pseudomonas cepacia typing systems for confirming the relatedness of isolates, we applied these methods to isolates associated with previously investigated nosocomial outbreaks. We compared chromosome analysis, serologic reactions, biochemical tests, bacteriocin production and susceptibility, and antimicrobial susceptibility in their ability to determine outbreak relatedness. Chromosome analysis, serologic reactions, and biochemical tests were each demonstrated to be epidemiologically useful methods for typing isolates. Determination of the sensitivity and specificity of these typing techniques will facilitate their application in the epidemiologic study of this increasingly important nosocomial pathogen. PMID- 2772467 TI - Effect of hospitalwide change in clindamycin dosing schedule on clinical outcome. AB - We compared clinical outcomes of 65 hospitalized patients receiving clindamycin before and 59 after a sudden hospitalwide shift in dosing schedules for this drug from 600 mg every 6 hours to 600 mg every 8 hours. Outcomes studied included the efficacy of antibiotic treatment, length of febrile period, and frequency of adverse effects. We also compared and controlled for patient characteristics such as age, sex, presence of multiple diagnoses, length of therapy, and concurrent use of other antibiotics. There were no differences in measured clinical outcomes between the two groups. Treatment was successful in 87% of both groups. The average number of febrile days was 5.1 in the first group and 3.9 in the second (P less than .05). Patients on 6-hourly therapy experienced a 12% rate of antibiotic-related adverse effects vs. 5% for the 8-hourly group (P greater than .05). These data support the clinical rationale and safety of a hospitalwide reduction in the frequency of clindamycin dosing. In addition to considerable pharmacy and nursing time saved, this change also saved greater than $40,000 annually in antibiotic costs. PMID- 2772468 TI - Mycobacterium avium-Mycobacterium intracellulare infection limited to the skin and lymph nodes in patients with AIDS. AB - Three patients with AIDS who were taking 3'-azido-3'-deoxythymidine (AZT) developed cutaneous abscesses from which Mycobacterium avium-Mycobacterium intracellulare was isolated. Culture of multiple blood samples and bone marrow aspirate from all three patients revealed that the infection was not disseminated. This is a rare form of presentation for this infection in AIDS patients. We speculate that the antiviral drug AZT was responsible for the localization of disease. PMID- 2772469 TI - Fever and headache in a splenectomized woman. PMID- 2772470 TI - Blastocystis hominis as a human pathogen. PMID- 2772471 TI - Heterosexual spread of HIV infection. PMID- 2772472 TI - Prosthetic valve endocarditis and paravalvular abscess caused by Actinobacillus actinomycetemcomitans. PMID- 2772473 TI - Beta-hemolytic group C streptococci and pharyngitis. PMID- 2772474 TI - Disseminated fusarial infection. PMID- 2772475 TI - Second International Symposium on New Quinolones. Geneva, Switzerland, 25-27 August 1988. PMID- 2772476 TI - [Selective occlusion of the hepatic artery and portal vein in hepatic rupture due to severe pre-eclampsia]. AB - A case of hepatic rupture in 32 years old woman with severe preeclampsia is presented. She was definitively treated by right hepatic arterial occlusion and right porta branch occlusion. There were no postoperative complications, and the patient is still alive. This is the first case report of right hepatic arterial occlusion and right porta branch in severe preeclampsia. PMID- 2772477 TI - [Rapid detection of Campylobacter pylori]. PMID- 2772478 TI - [The importance of physiopathology in the management of peptic ulcer]. PMID- 2772479 TI - [Drainage using an extraperitoneal route: a better alternative in the treatment of patients with pancreatic abscess?]. PMID- 2772480 TI - [Preparation of the colon for elective surgery]. AB - Mechanical bowel preparation and antibiotic therapy have been conclusive to decrease morbi-mortality in elective colon surgery. Two methods were compared: the traditional laxative and three days solution enemas method, and the 3-6 hours total intestinal irrigation method. We evaluated the patient's acceptance, intraoperative bowel preparation, and postoperative. We included 31 patients distributed in both groups and with similar procedures. Our results showed up 80% effectiveness in colon cleaning on both methods; 100% patients accepted the irrigation method which had 6.6% postoperative mobility, the enemas method had 18.7%. Therefore, we concluded that total intestinal irrigation method is quick, safe and effective in elective colon surgery. PMID- 2772481 TI - [Distribution of the antigen of hepatitis B virus in liver tissue in healthy carriers and in patients with chronic active and acute hepatitis]. AB - We have studied 120 cases of B hepatitis. Sixty were healthy carriers of B virus, 40 had chronic active hepatitis (CAH) and 20 acute hepatitis (AH). The AgsHBV distribution was made in liver tissue by immunoperoxidase technic. In 73% of patients with CAH the AgsHBV was found around portal tracts. In contrast in patients with AH the AgsHBV was seen around central vein. Healthy carriers showed an disseminated pattern. All healthy carrier had AgSHBV in liver, in contrast only 65% of patients with CAH and 20% with AH exhibited AgSHBV in liver biopsy. PMID- 2772482 TI - [Rapeseed in experimental cirrhosis in the rat]. AB - It has been reported that rapeseed in hens has been able to induce liver reticulum lysis and in rats it was possible to prevent the development of liver cirrhosis induced by carbon tetrachloride (CCl 4). The objective of these experiments is 1st. to confirm by a more extensive study the prevention of cirrhosis; 2nd. to determine the ratio of rapeseed necessary to inhibit the development of cirrhosis and 3rd. to learn if the active part can be found in the whole seed, in the oil or in the meal. Wistar white male rats were used, to which CCl 4 was administered to induce liver cirrhosis and simultaneously rapeseed was administered mixed in the food at different concentrations, rapeseed oil and meal were also administered. The results of this study confirmed, first that rapeseed was able to prevent the cirrhosis development, second that this prevention can be obtained at 10% concentration, but not less, and third that rapeseed oil affords only partial protection and the meal affords none. PMID- 2772483 TI - Possible role of free radical altered IgG in the etiopathogenesis of rheumatoid arthritis. AB - Alteration of IgG by oxygen-derived free radicals has been implicated in an in vivo process which renders IgG autoantigenic and leads to the production of rheumatoid factor (RF) and the perpetuation of inflammation, as in rheumatoid arthritis (RA). In this study the impact of UV irradiation on IgG was investigated as well as the ability of RF to bind to UV-altered gamma globulin. Inhibition studies of the binding of 125I aggregated human gamma globulin (AHG) to RF-coated sepharose beads show that UV-irradiated IgG is able to bind RF to the same extent as AHG. Binding studies to 125I-C1q proved that UV-irradiated IgG could bind the first complement component, but also that the complement system could be activated as illustrated by the C3a generation. These results support the hypothesis that free radical damage to gamma globulins plays a role in the chronicity of the inflammatory reaction in RA. PMID- 2772484 TI - Histopathology of femoral head osteonecrosis in rheumatoid arthritis: the relationship between steroid therapy and lipid degeneration in the osteocyte. AB - To investigate the pathology of osteonecrosis of the femoral head (ON) in patients with rheumatoid arthritis (RA), we examined 26 hips clinically and histologically. In this study, we diagnosed ON by both the radiological evidence of femoral head collapse, with or without narrowing of the joint space, and by histological evidence of extensive areas of bone necrosis with surrounding reparative new bone. Thus 14 hips were diagnosed as ON, and 12 hips were not. All of the patients with ON had a history of steroid medication. The frequency of lipid-containing osteocytes observed in the subchondral area of the femoral head significantly correlated with the occurrence of ON (P less than 0.05). In electron micrographs, these osteocytes showed degenerative features, with their nuclei pressed towards one side of the cell by plump fatty droplets (fatty degeneration). In patients with RA, there was a significant correlation between the appearance of lipid-containing osteocytes and steroid medication (P less than 0.05). No relationship existed between the severity of RA synovitis and the occurrence of ON. These data suggest that ON in rheumatoid hips may relate to the administration of a steroid and the fatty degeneration of osteocytes. PMID- 2772485 TI - Thoracic and lower cervical spine involvement in a case of rheumatoid arthritis. AB - The authors report a case of spine involvement in a severe case of rheumatoid arthritis treated with corticosteroids. First, the patient developed acute back pain, related to costovertebral joints arthritis at levels T9-T10. Then, neck pain and cord involvement yielded to diagnosis of cervical interapophyseal joints arthritis; there was a C5-C6 subluxation which necessitated surgical treatment. The conjunction of these two rheumatoid localizations is an uncommon feature. Study by the CT scan is valuable when rheumatoid arthritis of the spine is suspected. Lower cervical spine subluxation, even severe, may be well tolerated. Surgery is necessary when there is medullary involvement. PMID- 2772486 TI - IGM-containing immune complexes and antiphospholipid antibodies in patients with Sneddon's syndrome. AB - We report three patients with a Sneddon syndrome in whom predominantly small (500 900 kD) IgM-containing serum immune complexes were detectable. Furthermore, antiphospholipid antibodies and increased von Willebrand factor antigen were found in the sera of two cases. Especially the data demonstrating small circulating immune complex as suggest that Sneddon's syndrome, a rare vasculitis disorder, might immunologically be characterized by circulating IgM-containing immune complexes which, in addition, could play a role in the pathogenesis of this disease entity. The elevated antiphospholipid antibodies as well as the increased von Willebrand factor antigen in the sera of the investigated patients have to be considered as nonspecific vasculitis-associated phenomena. PMID- 2772487 TI - Clinical arthritis associated with positive radiological and serological findings in Finnish adults. AB - The Mini-Finland Health Survey was designed to analyse the epidemiology of major public health problems. The study covered a representative sample of the Finnish population aged 30 years or over, and initially comprised 8,000 people. Serum rheumatoid factor was determined in 7,124 cases (89%). There were 138 cases of clinical arthritis in the series, corresponding to a prevalence of 1.9% (1.0% in males and 2.7% in females). Fifty-nine of the cases (0.8% of the population) were seropositive, and 50 cases (0.7%) had in their hand radiographs changes characteristic of rheumatoid arthritis. Twelve of the X-ray positive cases were seronegative. One-half of these proved to be seroconversion cases or rheumatoid variants typically seronegative, such as early-onset juvenile rheumatoid arthritis. PMID- 2772489 TI - Cholesterol distribution between HDL subfractions. A study of 498 subjects. AB - In 498 subjects (205 normolipidemics and 293 hyperlipidemics) of both sexes, the cholesterol content of high density lipoprotein (HDL) subfractions has been determined. The serum concentration of total HDL-cholesterol appears to be more strictly related to the cholesterol content of HDL2 than to that of HDL3. This latter one, however, gives a contribution to the variability of HDL-cholesterol so that the value of HDL-cholesterol cannot be assumed as a reliable estimate of the serum level of the more anti-atherogenic HDL2 subfraction. The cholesterol content of HDL and its subfractions is higher in women than in men and decreases with increasing serum VLDL-cholesterol level and body weight. Both HDL2- and HDL3 cholesterol appear to largely depend from the metabolism of triglyceride-rich lipoproteins in accordance with the data of experimental studies. PMID- 2772490 TI - Recurrent polyposis nasi. Plenary session, held during the 12th Congress of the European Rhinologic Society, including the VIIth I.S.I.A.N. Amsterdam (The Netherlands), June 1988. PMID- 2772488 TI - Membrane fatty acids and erythrocyte Li-Na countertransport in nephrotic syndrome and their relationship. AB - Cholesterol/phospholipids molar ratio and fatty acid composition have been estimated in erythrocyte membrane of 12 patients suffering from nephrotic syndrome and compared to values obtained in 23 normal subjects matched for sex and age. The membrane lipid composition has been correlated with the activity of erythrocyte Li-Na countertransport of the same subjects. The results show a significant increase in cholesterol/phospholipids ratio and total saturated fatty acids when erythrocytes of nephrotic patients are compared to normal erythrocytes, whereas total unsaturated fatty acids were lower in nephrotics (p less than 0.002). Li-Na countertransport was higher in nephrotics (p less than 0.001) and it was positively correlated with the total amount of saturated fatty acids of the erythrocyte membrane (r = +0.451; p less than 0.01). On the contrary, Li-Na countertransport was negatively correlated with the total amount of unsaturated fatty acids (r = -0.468; p less than 0.01). PMID- 2772491 TI - Microsurgical treatment of recurrent nasal polyposis. AB - Nasal polyposis has to be considered as an advanced form of chronic ethmoiditis requiring surgery. Its proliferation starts in the osteo-meatal complex of the lateral nasal wall, and follows typical routes. Depending on its extension endoscopical partial resections of the ethmoid may be carried out. For diffuse polyposis of all sinuses a complete endonasal ethmoidectomy together with the fenestration of the frontal, sphenoidal and maxillary sinuses (pansinus operation) is indicated. The importance of preoperative imaging by CT or polytomography, and of flanking measures, is stressed. Fair results concerning subjective relief and objective proof of lasting mucosal recovery are reported against the background of a low incidence of surgical complications. PMID- 2772492 TI - Laser polypectomy. AB - The contact Nd:YAG laser technique in endonasal surgery is presented as a new therapeutic tool. The clinical experience in cases with recurrent polyposis is presented. The therapeutic results are evaluated. Although patients with nasal polyposis remain to be treated on an individual basis, due to the multifactorial etiopathogenesis of this disorder, the initial results with this new surgical procedure are promising. PMID- 2772493 TI - Treatment of nasal polyps--medication or surgery and which technique. PMID- 2772494 TI - Recurrent polyposis nasi. Documentation. AB - After a short historical review a proposal is made for the definition of nasal polyposis. The authors studied 350 CT-scans of patients with nasal complaints. In a high percentage anatomical anomalies were observed. In 57.5% of the CT-scans sinus mucosal disease was visible. In all patients with maxillary sinus disease polyps (rounded structures) could be found; in 31% these polyps were mainly of grade 2. From a retrospective study of 111 biopsies of nasal polyposis (65 patients) it became clear that different polyps from the same patient showed substantial difference in cellular content, i.e. presence of eosinophils, neutrophils, plasma cells, glands, ducti and thickening of the basal membrane. As oral acetylsalicylic acid provocation may be hazardous in ASA-sensitive patients, the authors developed a nasal aspirin provocation test. This nasal ASA test was carried out in 10 normal test subjects, 10 patients with aspecific hyperreactivity, 10 atopic patients and 16 patients with polyposis nasi. The reproducibility of the test, however, was so poor that the nasal ASA challenge test in its present form does not appear to be of any great clinical value. Finally, the authors discuss the physiopathology of nasal polyposis. PMID- 2772495 TI - Recurrence of nasal polyps after surgical treatment. AB - Recurrence of nasal polyposis after polypectomy or ethmoidectomy was studied in 85 patients four years after surgery. The patients were classified into one of three groups according to clinical findings: an atopy group (history confirmed by skin test or nasal provocation), an acetylsalicylic acid intolerance (ASA) group (confirmed by provocation), or an "intrinsic" group (no specific diagnosis). The risk of recurrence was significantly greater in patients with ASA intolerance than in the other two patient groups; the frequency of reoperations during the follow-up period was significantly higher in the ASA group and the need for topical corticosteroid treatment had also been more frequent. Bronchial asthma was diagnosed in 40% of all patients. Asthma was significantly more often associated with ASA group (91%) vs 46% at AT and in only 16% at INTR group. PMID- 2772496 TI - [Immunotherapy using the nasal route in bronchial asthma]. AB - A study of 1124 asthmatic patients was performed. Patients belonged to different health centers and outpatients services, as well as to the Hospital Clinico Quirurgico 10 de Octubre. Besides asthma patients had other allergic associated conditions, such as dermatitis, conjunctivitis, urticaria and rhinitis. Laboratory studies included the following obligatory tests: hemogram, erithro sedimentation, serology urine, stool examination and glucose. Eosinophilia nasal and pharynx exudate. The immunoallergologic study consisted of standard allergic tests using different respiratory inhalant and bacterial extracts, including controls with buffer and histamine. Immunotherapy was initiated using nasal drops during four years including four summers and four winters. Good evolution was observed in 1032 cases (91%), fair in 67 (6%) and no modification without improvement in 25 (2.2%). Conclusions and recommendations are given. PMID- 2772497 TI - [Lymphocyte transformation in allergy to penicillin]. AB - Thirty patients both sexes with ages between 1-52 years old, thinking that they are allergic to penicillin, were studied because they were found to have some clinic symptoms immediately after the administration of penicillin procain I.M. (intramuscle) such as urticaria, angioedema, anaphylactic shock and Stevens Johnson syndrome. In order to confirm or to discard this asseveration an in-vitro lymphocyte transformation test was realized, with the venous peripherical blood of each patient, using the greater determinative of penicillin: the peniciloil. The results obtained were twelve negatives, twelve on doubt and six positives. These results show that the in-vitro lymphocyte transformation test may be useful to decide, when a patient could be considered allergic or not to penicillin. PMID- 2772498 TI - [The diagnosis of asthma in children]. PMID- 2772499 TI - [Effect of cigarette smoke on the airway of asthmatic children]. AB - A study was carried out on 62 asthmatic children for observed the acute effects of one hour of passive cigarette smoking on pulmonary function test before and after 1-hour exposure. Three parameters were measured: Forced vital capacity (FVC), Forced expiratory volume in one second (FEV 1), and Mid-Maximum expiratory flow rate (MMEF). Of those measurement MMEF showed the most important changed in 23% of patients. Passive smoking produced changed on 32.2% on asthmatic patients in any of pulmonary function test. Finally, correlation were made between parental cigarette smoking habits and skin test sensitivity at tobacco antigen, we didn't found correlation between this parameters. PMID- 2772500 TI - [Hereditary angioedema. Effect of danazol on C4 and functional C1INH]. AB - Hereditary angioedema (HAE) is an inherited deficiency of the inhibitor of C1 esterase (C1 inh). Two types of genetic C1 inh deficiency have been described, type I: quantitative, and type II: functional. For the purpose of the present study, 4 out of 51 HAE patients were selected. None of them had received any previous androgenic therapy. The group was integrated by two type I and one type II cases. All patients that entered in the protocol received 400 mg/day of danazol over 14 days. The complement system was evaluated by monitoring C4, Hemolytic complement 50% (CH50), Circulating Immune Complexes (CIC), and antigenic and functional C1 INH during the study. The level of the complement factors at the beginning and the end of this period demonstrated a statistically significant increase of C4 and CH50 and the disappearance of CIC, while C1INH remained unmodified. These results suggest that the therapeutic effect of Danazol may have two mechanisms of action: i. promotion of C4 synthesis by anabolic effect resulting in an improvement of the complement system with the disappearance of CIC, and ii, a minor increase of C1 inh level primarily due to the lack of its consumption. PMID- 2772501 TI - [Pragmatism in primary care]. PMID- 2772502 TI - [The postcesarean care plan]. PMID- 2772503 TI - [Digitalis glycosides: their pharmacology and administration]. PMID- 2772504 TI - [Continent colostomies and the quality of life]. PMID- 2772505 TI - [Reintegration of the elderly patient into society]. PMID- 2772506 TI - [Oxygen therapy at home]. PMID- 2772508 TI - [Nursing and health system management]. PMID- 2772507 TI - [Continuing education. 39. Subject: health administration. Topic: reflections on the Spanish health system]. PMID- 2772509 TI - [Aneurysmal cysts of the fronto-parietal bone]. AB - The authors describe the case of a patient affected by an aneurysmal bone cyst of the fronto-parietal bone. A short review of the literature follows. PMID- 2772510 TI - Epidermoid and dermoid tumors. AB - The authors report their experience in the surgical treatment of intracranial dermoid and epidermoid tumors. These lesions are rare but may, in most of the occasions, be completely resected allowing a complete cure of the patient. The usefulness of the most recent diagnostic tools is discussed and the surgical indications, complications and results are reviewed in comparison to the most significant literature reports. PMID- 2772512 TI - [Neurophysiologic study of the influence of the habenula on the hippocampus: electroencephalographic aspects]. AB - The habenula, an epithalamic structure considered as a part of the limbic system, is able to control interictal activity of the hippocampus. Its influence seems to be facilitatory and to have the raphe as a relay station. Habenular action might putatively be ascribed to activation of the serotonergic system. PMID- 2772511 TI - Intracerebral hemorrhage following intravenous administration of epinephrine. AB - We report a case of intracerebral hemorrhage (ICH) in a young man following intravenous self-administration of epinephrine. Arteriography evidenced normal intracranial vessels, and namely excluded the presence of vascular malformations which could have been implicated in the pathogenesis of ICH. We believe that the main pathogenetic agent in this case was the sudden rise in arterial blood pressure. This report aims at underlying the severe implications of non-medical use of sympathomimetic drugs. PMID- 2772513 TI - Clinical evaluation of Mansonella ozzardi in Haiti. AB - The clinical evaluation of 150 individuals in Bayeux, Haiti, revealed no significant morbidity that could be attributed to infection with Mansonella ozzardi. However, the distribution of patent infections and their microfilaria density were significantly affected by the age and sex of the individuals. Also, the eosinophilic response was associated with the intensity of the microfilaremia when age was considered as a co-variable. The microfilaria rate was significantly higher in certain occupations, but this was discounted as a risk factor for reasons that are explained. PMID- 2772514 TI - Efficacy of bites from Asiatic and African tarantulas. AB - The results of 3 accidents with Poecilotheria fasciata and 1 with Pterinochilus sp. are reported. In one case the symptomatology following the bite of Poecilotheria was more marked than after the bites of different large American tarantulas on the same person. In the other three cases no essential effectiveness of the venoms could be observed. PMID- 2772515 TI - In vitro differentiation between Trypanosoma brucei brucei and T.b. evansi. AB - Transformation experiments of bloodstream form trypanosomes into procyclics are described to differentiate the pleomorphic Trypanosoma brucei brucei and the monomorphic T.b. evansi. Stocks previously identified as T.b. brucei transformed into procyclics in vitro, whereas T.b. evansi did not. PMID- 2772516 TI - Mollusc-killing agents from Khaya grandifoliola. PMID- 2772517 TI - Molluscicidal activity of Solanum aculeatum (family: Solanaceae) berries against Biomphalaria pfeifferi, Bulinus globosus and Lymnaea natalensis. AB - Aqueous suspensions of powder of sun- or freeze-dried berries of the plant Solanum aculeatum (Family Solanaceae), indigenous in Kenya, were tested for molluscicidal activity against Biomphalaria pfeifferi, Bulinus globosus and Lymnaea natalensis under laboratory conditions. One hundred or 50 mg powder L-1 of sun- or freeze-dried berries killed over 60% of the test B. pfeifferi, Bul. globosus and L. natalensis. Whereas 25 mg L-1 of the sun dried material killed less than 60% of the test snails, similar concentrations of the freeze dried molluscicide produced 60-80% mortality in the snails, under similar conditions. Using L. natalensis as the target snail, it was shown that the freeze dried material was more potent than the freeze-dried berries of S. incanum, S. nigrum or leaves of Polygonum senegalensis (Family Polygonaceae), all present in Kenya, and known to possess molluscicidal properties. The powdered material retained molluscicidal activity even after several months storage at room temperature. These findings suggest that S. aculeatum is a potent plant molluscicide, and has the potential for the control of vectors of schistosomiasis and fascioliasis in Kenya. PMID- 2772518 TI - Proceedings of the GTZ/WHO/AFRO Seminar. Maintenance of schistosomiasis control. Douala, Cameroon, 7-11 November 1988. PMID- 2772520 TI - Quality control in schistosomiasis programmes. AB - The evaluation of a schistosomiasis control programme requires regular monitoring of the performance of technicians responsible for measuring prevalence rates and intensities of infection; simple quality control measures are the most effective form of monitoring. Quality control of microscopy has usually been carried out immediately after primary examination of fresh microscope specimens or by transport of preserved urine or stool samples to a central laboratory; the first method was impossible in Madagascar, and the second involved severe loss and breakage of specimen containers. A new method involving the transport of dried filters fixed on plastic sheets with adhesive tape was therefore used. Essential requirements of the quality control methods were simplicity, effectiveness, acceptability to field technicians, and the production of results valuable to the control programme. Acceptable limits of error (ALE) were determined by a combination of trial-and-error assessment of technicians' capabilities, and the application of a rule-of-thumb derived from quality control studies in clinical chemistry. Results were prepared in the form of simple 2 x 2 tables and easily understood charts for visual assessment of results. Technicians' work varied from excellent to poor; false negative rates (FNR) were usually higher than false positive rates (FPR) and technicians' field counts of eggs were most often lower than control counts. Control proved very useful in motivating technicians, in maintaining high work standards, and in identifying technicians needing further training. PMID- 2772519 TI - African trypanosomiasis and S. intercalatum infection in Equatorial Guinea: comparative epidemiology and feasibility of integrated control. AB - The integration of schistosomiasis control with the activities of different endemic disease control or health programmes has been endorsed by a WHO Expert Committee on the Control of Schistosomiasis (WHO 1985). Endemic countries face increasing economic and manpower constraints which limit the coverage and effectiveness of control activities. Integration would be expected to optimize available resources for control. The feasibility of integration can be assessed by a comparative evaluation of: the epidemiology and distribution of the health problems; the techniques and methodology of control; and the requirements for maintenance and their relative health importance. This report presents a preliminary assessment of trypanosomiasis and schistosomiasis in Equatorial Guinea. The background and implementation of the operational national trypanosomiasis control programme are summarized. Population-based epidemiological investigations undertaken by the staff of the trypanosomiasis control programme are reported from a rural village and an urban suburb of Bata, Equatorial Guinea. The distribution and morbidity of S. intercalatum are compared, the public health importance of S. intercalatum is reviewed and the feasibility of integration of control of trypanosomiasis and schistosomiasis are assessed. PMID- 2772521 TI - Training elements at different levels in the strategies for control of schistosomiasis. AB - Recently acquired comprehensive knowledge concerning the epidemiology of schistosomiasis has provided the background for the establishment of schistosomiasis control strategies. However, the planning, implementation, and maintenance of such control programmes requires sufficient numbers of well trained personnel at the local, district and central levels. Training of health personnel as well as motivation of the community are fundamental and essential elements in any schistosomiasis control programme. The training elements and approaches are discussed. PMID- 2772522 TI - Schistosomiasis control: an estimation of costs. AB - Costs are estimated for different types of schistosomiasis control programmes. From the point of view of feasibility and financing, schistosomiasis has been classified into four levels, representing different rates of prevalence, intensity of infection and the rate of reinfection. The different possibilities of approach and their financial aspects are discussed. Costs are estimated for a period of five years. Costs for sanitation and snail control programmes are not included, as they may vary greatly according to local conditions and circumstances and valid generalizations cannot be made. PMID- 2772523 TI - Leishmaniasis in Kenya: description of leishmaniasis of a domestic goat from Transmara, Narok District, Kenya. AB - Extensive research has been carried out in Eastern Africa for animal reservoirs of both visceral and cutaneous leishmaniasis. The domestic dog has been the only domestic animal so far implicated as a possible reservoir for visceral leishmaniasis. For cutaneous leishmaniasis caused by Leishmania aethiopica, the hyrax and the giant rat are the proven reservoirs of the disease while several species of rodents have been demonstrated to harbor L. major. Recent studies conducted in domestic animals in West Pokot led to the first isolation of leishmanial parasites from a domestic goat, a close associate of man in the vast endemic leishmaniasis foci. Consequent encounter of a clinical case of the disease is the basis for this paper. It is the first autochthonous case in Eastern Africa. The goat originated from the Western escarpments of the Rift Valley which are known to harbor L. aethiopica. Clinical signs included lesions, indurations, and enlargement of lymph nodes. Parasitological and pathological investigations revealed amastigotes in various tissues. Cultures of the affected tissues produced promastigotes. PMID- 2772524 TI - Magnitude, presentation, management and outcome of acute respiratory infections in children under the age of five in hospitals and rural health centres in Tanzania. AB - In preparation for a national control programme acute respiratory infections (ARI) were studied in children under five years of age in 14 health centres, one referral and four district hospitals in five regions of Tanzania. 10.5% of all under-fives attending these health institutions presented with symptoms of ARI. 50% of all ARI patients were less than one year old. Cough, fever and difficult breathing were the main complaints motivating consultation. On examination nearly half of ARI patients had signs of difficult breathing, which corresponded to high prevalence of pneumonia (36.8% of all diagnoses). An excessive use of antibiotics for the treatment of all kinds of ARI was observed. This may explain the low case fatality rate of 2.6% for pneumonia. Those children who died from ARI came later to the health facility, had poorer nutritional status and more severe signs on examination than those children who survived. To reduce ARI mortality further, intervention should concentrate on early diagnosis and treatment at lower, i.e. dispensary and community levels. PMID- 2772525 TI - Taking charge: we wanted a smoke-free workplace and we got it. PMID- 2772526 TI - Let's stop fighting in front of the kids. PMID- 2772528 TI - When exercise can kill: how to spot IHSS. AB - For the patient who has idiopathic hypertrophic subaortic stenosis vigorous activity can be deadly. Identifying this condition and teaching the patient how to compensate may keep him alive. PMID- 2772527 TI - Patient's advocate: children with cancer still deserve a childhood. PMID- 2772529 TI - A quality-assurance tool that works overtime. PMID- 2772530 TI - Coping with chronic complications. AB - It's the chronic complications of diabetes--not the disease itself--that kill most patients. Helping them cope with nephropathy, retinopathy, and disorders of the nerves and blood vessels requires all the nursing expertise you can muster. PMID- 2772531 TI - Rx: Elvis! AB - Many people find music relaxing and therapeutic. Hospital patients are no exception, especially when they get to choose their own. PMID- 2772532 TI - "What I didn't know really hurt me". PMID- 2772533 TI - Patient teaching for X-ray and other diagnostics. AB - Many patients scheduled for diagnostic tests want to know in detail what they will experience. Here are the first in a new series of patient guides to X-ray exams. PMID- 2772534 TI - A better way to deliver long-term oxygen therapy. PMID- 2772535 TI - Legally speaking: off-the-job conduct can jeopardize your career. PMID- 2772536 TI - When your patient tells you he can't sleep. PMID- 2772537 TI - [Meningeal metastasis of malignant melanoma]. AB - Two woman patients with malignant melanoma of the skin known from their case history and with acutely emerging neurological symptoms were examined both by CT and by MR tomography (both plain and with intravenous contrast medium). The radiologically derived suspicion of meningioma could not be confirmed by intraoperatively performed histological examination. In both cases the patients had meningeal melanoma metastases with low melanin content and without noticeable bleeding into the metastases. MR diagnosis is rendered difficult by the absence of paramagnetic substances typical of melanoma metastases. Hence, if the case history is known, it should be considered whether there is meningeal metastasising with atypical histology. PMID- 2772538 TI - [Computed tomographic follow-up of cranio-cerebral injuries in children]. AB - 38 children with moderate and severe head injuries had CT follow-ups. On initial scans combined lesions dominated over diffuse (diffuse swelling, subarachnoid haemorrhage) and focal lesions (focal swelling, contusions). Contusion showed up until the 6th day after the accident. Two cases of focal lesions could be demonstrated only after intravenous contrast. Up to 40% of the children developed hypodense extracerebral accumulations. Long-term CT follow-ups showed ventricular (84%) and sulcal enlargement (63%) as well as hypodense parenchymal lesions (50%). Combined and diffuse lesions showed a correlation of initial scans and long-term follow-up which could not be demonstrated in case of focal lesions. PMID- 2772540 TI - Plain radiography and tomography of the internal auditory canal for the diagnosis of acoustic neuroma. AB - In the series of 50 acoustic neurinomas (AN) the internal auditory canal (IAC) diameter and the diameter difference between the tumor and non-tumor side are compared with the sizes of the AN. No correlation is found. About 50% of the AN cases had normal ipsilateral IAC in plain and tomographic radiographies. A pathological IAC finding strongly favours AN, but the border between a normal and pathological finding is not an exact one. A normal plain and tomographic radiography does not exclude AN and further investigations cannot be avoided. Our conclusion is that plain radiograms and tomograms have no place in the modern diagnosis of AN. PMID- 2772539 TI - [Heterotopia of the cerebral cortex: a comparison of CT and MRT]. AB - Heterotopic grey matter is a rare cause of seizures. While lesions appear suspicious on CT because of equidensity to cortex, MR imaging can establish the diagnosis by demonstrating same signal intensity of heterotopia and grey matter on T1- and T2-weighted as well as inversion-recovery sequences. PMID- 2772541 TI - [Clinical and computed tomographic follow-up of conservatively treated disk prolapse]. AB - Of a total of 238 patients suffering from root compression syndrome, 41 successfully conservatively treated patients were followed up both clinically and via CT. At follow-up time they were all largely free from complaints. 71% showed unchanged prolapse on CT examination. 29% had a moderate or marked regression of disk prolapse. All unchanged cases of prolapse were medial prolapses. The reason for regression of the sequestered disk tissue is discussed controversially and has not been satisfactorily clarified to date. Improvement of findings in unchanged prolapse is mainly explained by the adaptability of the root if there is enough space for shifting. PMID- 2772542 TI - [The effect of acute and chronic hypoxia on ascorbic acid levels in various areas of the brain, liver, adrenal glands and in biological fluids in 18-day-old rats]. AB - The influence of acute and chronic hypoxia on the ascorbic acid content in liver, adrenal, plasma, cerebrospinal fluid and brain in 18-day-old rats was studied. Due to acute hypoxia a significant decrease in ascorbic acid concentration in the adrenal occurred. Its levels in plasma and cerebrospinal fluid increased significantly compared with controls. Chronic hypoxia caused a significant ascorbic acid concentration increase in all samples studied with the exception of olfactory lobe and vermis cerebelli. PMID- 2772543 TI - [Knee joint replacement with the Motorlet endoprosthesis in patients with rheumatoid arthritis and osteoarthritis]. AB - 60 type MOTORLET knee joint endoprostheses are evaluated in this paper. Endoprostheses were implanted in the years 1984-1986 to 51 patients with rheumatoid arthritis and osteoarthrosis of the knee joint. EULAR knee project questionnaire was used to evaluate the results. In 72% of patients the pain completely disappeared both at rest and in movement. The average range of movement, ability to walk and knee joint stability were significantly improved, with highly favourable evaluation in 90% of operated patients. All parameters were compared with the results of 1569 knee joint operations evaluated within the range of EULAR knee project. At the same follow-up period the endoprosthesis type MOTORLET has been comparable to other widely used knee joint replacements. PMID- 2772544 TI - [The use of lasers in medicine]. AB - The paper provides information concerning basic types of lasers used in medicine. Their most frequent indications are summarized and advantages of single types of apparatus are described. PMID- 2772545 TI - [Treatment of benign laryngeal diseases using a CO2 laser]. AB - CO2 laser surgery is becoming a part of larynx surgery. The authors inform about their experience in benign larynx tumours treatment. They present analysis of concrete therapeutic procedures in individual larynx affections. They conclude that laser surgery is an advantegous method for benign larynx tumours treatment. PMID- 2772546 TI - [Intranasal meningoceles]. AB - The authors present a case of intranasal meningocele in 38-year-old patient. Clinical picture, diagnostics, treatment and postoperative course are described. PMID- 2772547 TI - [Excretion of phenoltetrachlorophthalein in the bile in rats]. AB - Phenoltetrachlorphthalein secretion into bile was followed in Wistar strain rats intoxicated per os by tetrachlormethane (0.25, 0.50, 2.00, and 3.00 ml/kg) after 1, 2, 4 and 8 days after intoxication. Biotransformation processes resulting in the formation of phenoltetrachlorphthalein metabolites are altered during the intoxication unequally. So far mutual relation of secreted metabolites has not been proved to serve generally as a simple criterion for absolute activity assessment of hepatic glucuroniltransferase or other hepatic enzymes. PMID- 2772548 TI - [Inverted papillomas]. AB - Inverted papilloma is a relatively rare benign tumour of nasal mucosa and paranasal sinuses which approx. in 15% is connected with malignancy. The morphology, occurrence, etiology and biological behaviour of this tumour are dealt with. A group of 8 patients is presented. The significance of nasal polyps routine histologic investigation for early detection of these tumours is stressed. Various treatment possibilities are discussed and a therapeutic procedure based on radical surgery is suggested. PMID- 2772549 TI - Human intrinsic factor. Its primary structure compared to the primary structure of rat intrinsic factor. AB - Human intrinsic factor was digested by trypsin and the resulting peptides purified by gelfiltration. Two peptides were sequenced to a total of 61 amino acid residues. Including the sequence for the N-terminal peptide and four cyanogen bromide peptides previously reported, we have now determined a total of 163 amino acid residues, that is a fraction of about 0.40 of the primary structure of human intrinsic factor. The 110 of the 163 residues known of human intrinsic factor are identical to the sequence of rat intrinsic factor. PMID- 2772550 TI - Cobalamin binding proteins in the human fetus. AB - Cobalamin binding proteins are synthesized by the fetus from at least 16-19 gestational weeks. Cerebrospinal fluid contained transcobalamin with size and isoelectric points identical to adult transcobalamin. The unsaturated cobalamin binding capacity in the fetal cerebrospinal fluid was comparable to adult levels, that is 0.01-0.04 nmol/l, median 0.03 nmol/l, n = 4. The unsaturated cobalamin binding capacity in serum was low compared to adult values (0.02-0.04 nmol/l, median 0.03 nmol/l, n = 4). The unsaturated cobalamin-binding capacity in at term umbilical cord serum was alike for arterial and venous blood. The values obtained was 0.14-1.03 nmol/l, median 0.66 nmol/l, n = 22, which was two thirds of the corresponding values in maternal serum: In the amniotic fluid haptocorrin, intrinsic factor and transcobalamin were identical with the adult binders regarding the size and the isoelectric point. PMID- 2772551 TI - Construction and use of a RIA-gram. AB - All equilibrium protein binding assays, as exemplified by radioimmunoassays (RIA) are governed by the law of mass action. If the reactants are homogenous, then the reaction is characterized by a simple apparent dissociation constant (Kd). We have calculated a set of binding curves, a RIA-gram, in which all concentrations are expressed with Kd as unit. This RIA-gram can be generally employed to optimise equilibrium protein binding assays. Using the RIA-gram we illustrate three points. First, the sensitivity of a given assay is related to either the Kd or the concentration of the labeled ligand, whichever is the larger. Second, if Kd determines the sensitivity of the assay, one can not improve the sensitivity by decreasing the concentration of the labeled ligand below 0.1Kd. Finally, in order to obtain an optimal assay the fraction of ligand bound when only labeled ligand is present depends on the concentration of labeled ligand and on the concentration for which one wants the highest sensitivity of the assay. PMID- 2772552 TI - Preparation of calibration standards for quantitation of cobalamins in plasma, a NORDKEM project. PMID- 2772553 TI - Cobalamin analogues in plasma. An in vitro phenomenon? AB - In the course of investigations on the source of cobalamin analogues in human plasma six kits for measuring serum cobalamins were studies to determine if analogues can arise in vitro. High pressure liquid chromatography (HPLC) were used to estimate tracer stability during extraction procedures. Results showed that up to 60 percent of the radioactive cyanocobalamin was degraded. Alkaline pH increases the degradation; this effect is further intensified by addition of dithiothreitol. Implications for the cobalamin assay is discussed. Determination of cobalamin analogues by the difference of concentrations determined from assays using haptocorrin ("total corrinoids") and instrinsic factor ("true cobalamins") as binders may be misleading because the affinity of possible analogues for the assay binder is unknown. Thus quantification of the analogues could be erroneous. The need for definitive assay methods for cobalamin and its analogues is stressed. PMID- 2772554 TI - Hemoglobinopathies in Danish families. AB - Based on cases referred for investigation, as well as a questionnaire sent to all medical and pediatric departments in Denmark, 48 cases of hemoglobinopathy in 15 families of Danish ancestry are reviewed. 18 Danes in six families have been identified as having beta-thalassemia, and remarkably one - a homozygote - has beta-thalassemia intermedia requiring treatment with iron-chelation therapy. A further 36 Danes in 9 families have a hemoglobin variant: five unstable hemoglobins (Volga, Niteroi, and three unidentified), one hereditary methemoglobinemia (M-Arhus), one polycythemia (Ty Gard) and 2 asymptomatic (Athens-Georgia and Hafnia). Although rare in Danish families, a hemoglobinopathy should be considered in families with an unexplained chronic hemolytic anemia, cyanosis or polycythemia. PMID- 2772555 TI - Characterization of hemoglobin variants. Prenatal diagnosis on a fetus at risk of having the hemoglobin variants S and/or C in combination with beta-thalassemia. AB - The determination of hemoglobin types in a fetus whose father and mother were heterozygous for Hb S and Hb C, respectively, is used as an example for demonstrating different techniques. The parents were furthermore suspected of being heterozygous for beta-thalassemia. Several of the possible combinations give rise to such serious conditions that abortus provocatus would be considered. The conclusion from the analyses was that the fetus was normal, having no variants nor thalassemia. PMID- 2772556 TI - LABKA. A real-time computer system for the clinical laboratory. AB - This paper provides an introduction to the real-time clinical laboratory information system (LABKA), which is implemented on a Hewlett-Packard 1000 system. The system is optimized for fast data handling combined with easy control of on-line results, data flow, and linking of related information. The design of LABKA is based on the principle of having a short reporting time together with simplified working procedures. The system can be adjusted to small as well as very large laboratories. Data control is achieved by status information being returned to the operator in real-time, thus avoiding having to use matching lists. This information is presented immediately in response to the procedure which has caused the error. This method of early error detection simplifies working procedures, inhibits accumulation of errors, and increases the flexibility and speed of data reporting. As a result, the number of requested stat analyses has been reduced by 50 percent. Working lists are not generally used. Instead, requisition information is transferred on-line to the instruments on request. A fourth-generation program system for entry, calculation, and test of manually entered data, called RUCAT (1), has been developed. This system enables the user to define forms on vdu-terminals, specify calculations, and test all manually entered data. The LABKA system can also produce cumulative reporting as standard reporting, in real time, fast and in a very high print quality. The real-time demands have strongly influenced the design and layout of the lab files and system design. PMID- 2772557 TI - Reference methods--with special reference to cholesterol. AB - Through the work of the committee for reference methods in NORDKEM and the Scandinavian Society for Clinical Chemistry, a hierarchy of methods was established in Denmark in 1982 for accuracy assurance of determination of total cholesterol in serum. The hierarchy makes it possible for any laboratory to relate their results of measurements on fresh samples from humans, to the results obtained on the same samples by reference methods, which have been adjusted to definitive methodology. Proficiency studies in 1985 and 1988 gave consensus values (mean of all participants data) for total cholesterol in frozen human serum almost identical to values obtained by reference methods. Interlaboratory coefficients of variations were 4-5%. It is essential for the clinical chemist as well as for the clinician to be aware of the relative quantitative importance of preanalytical, analytical and biological variation and to realize to what extent replicate measurements on the same sample and on several samples from the same person reduce the total intraperson variation of serum cholesterol concentrations. PMID- 2772558 TI - Measurement, value, and scale. AB - The terms 'qualitative', 'semiquantitative', and 'quantitative' are used ambiguously. Based on international recommendations by IEC, IFCC, ISO, IUPAC, and OIML, and the work on scales by Stevens, a systematic terminology is presented. Measurement is considered to be the set of operations by which a value (consisting of a relational operator, and symbols, figures, or letters) is assigned to a quantity. The possible values constitute a scale that may be subdivided into classes. A hierarchy of four types of scale is characterized: nominal (values are independent of magnitude), ordinal (ranked according to magnitude), interval (equality of differences, arbitrary zero), and ratio scale (equality of ratios, absolute zero); each type allows a different set of statistical calculations. The type of scale is independent of its number of values or classes, or the uncertainty of measurement. The number of values on a scale is indicated by the terms two-value, three-value,..., multivalue and the number of classes analogously by two-class, etc. Examples of transformation of quantities are given. PMID- 2772559 TI - Annual reports from departments of clinical chemistry: a NORDKEM project. AB - The purpose of this report is to describe briefly the structure and purpose of NORDKEM, to illustrate how projects are developed within NORDKEM, and to discuss the results obtained in the project chosen for this presentation. PMID- 2772561 TI - The calcaneus in ankylosing spondylitis. A radiographic study of 43 patients. AB - A prospective study analysing the radiological findings of calcaneus bone in ankylosing spondylitis is presented. It includes 43 patients with a relatively low mean age (33.5 years). The morphology of their lesions correlated with disease duration. Abnormal radiological findings were observed in 63% of the patients and in 58% of the radiographs, but in only 3 of 20 normal subjects. Erosive lesions were more frequently found in early stages, whereas sclerotic and proliferative lesions were typical of advanced stages of the disease. Only one patient suffered relevant local pain. No clinico-radiological correlation could be established. PMID- 2772560 TI - Immunohistochemical demonstration of insulin-like growth factor I in inflammatory lesions in Wegener's granulomatosis and idiopathic midline destructive disease. AB - The immunoreactivity of the trophic peptide insulin-like growth factor I (IGF-I; somatomedin C) was mapped in nasal mucosa biopsies from three patients with Wegener's granulomatosis (WG) and one with idiopathic midline destructive disease (IMDD; idiopathic midline granuloma). Strongly increased IGF-I immuno-reactivity restricted to cells bordering and in vessel walls and in granulomas (WG) was demonstrated, while necrotic and noninflammatory areas were negative. Treatment with steroids and cyclophosphamide reduced the IGF-I immunoreactivity. The abnormally increased IGF-I immunoreactivities in WG and IMDD probably reflects the reactive growth processes in diseased tissue and is not thought to be the primary cause of either disease. IGF-I may be formed locally by cells in and close to the vascular walls in areas with active disease resulting in e.g. vascular growth, granuloma formation, and finally vessel obliteration and necrosis. IGF-I is likely to form, possibly in concert with other trophic factors, a link in the chain of events resulting in the tissue abnormalities in WG and IMDD. PMID- 2772562 TI - The progress of oesophageal involvement in progressive systemic sclerosis during D-penicillamine treatment. AB - In 21 patients with initial signs of progressive systemic sclerosis, oesophageal motility was monitored manometrically from the start of D-penicillamine treatment and over a period of up to 5 years. Urinary excretion of the collagen-specific amino acids hydroxyproline and hydroxylysine, and of proline was used as a guideline for monitoring the bioavailability of D-penicillamine. D-penicillamine therapy was found to be unable to arrest the progress of oesophageal involvement. A downward trend over time--statistically significant at p = 0.03, p = 0.02, and p less than 0.005--was found for lower oesophageal sphincter pressure, peristaltic wave pressure in the distal third, and peristaltic wave pressure in the middle third of the oesophagus, respectively. PMID- 2772563 TI - Juvenile-onset mixed connective tissue disease: clinical, serological and follow up data. PMID- 2772564 TI - Amyloidosis in mixed connective tissue disease. PMID- 2772565 TI - Chronic metastatic arthritis as the first symptom of lung adenocarcinoma. PMID- 2772566 TI - Eosinophilic granuloma and necrotizing vasculitis (Churg-Strauss syndrome?) involving a parotid gland, lymph nodes, liver and spleen. PMID- 2772567 TI - The role of rheumatoid factor in rheumatoid arthritis. PMID- 2772568 TI - Stability and change in feelings of loneliness: a two-year prospective longitudinal study of advanced alcohol abuse. AB - In order to study the changing nature of loneliness in a prospective design, 78 alcoholics were examined twice with an interval of two years. Change scores in loneliness were correlated with change scores in social network, psychological well-being, life-satisfaction, activities, adaptation to one's work and non-work situation, psychiatric symptoms and alcohol consumption. In addition, a step-wise multiple regression analysis with loneliness change as the dependent variable was performed. Change in loneliness was accompanied by changes in well-being (especially indolence, self-esteem and perceived treatment from others), mood related psychiatric variables and satisfaction with autonomy and life as a whole. However, other variables, like satisfaction with one's social network and a number of non-cyclic psychiatric disorders, did not change along with loneliness, despite stable cross-sectional links. The discrepancy between the cross-sectional and the longitudinal correlation patterns may be indicative of different forms of loneliness in regard to temporal stability. PMID- 2772569 TI - Parents' heuristics for judging children's accident risk. AB - Heuristics parents use for judging the risk or likelihood of accidents to children were investigated. It was first hypothesized that the risk is judged on the basis of the number of personally experienced previous accidents or near accidents which are recalled. Mothers, sampled from a general population, female undergraduates who had theoretical knowledge but little experience with children, and female students with both little theoretical knowledge and experience judged the risk that a child at the age of 2-4, 5-6, 7-9, and 10-12 years have an accident where the subjects lived. In Experiment 1 no further specification of accident was given, in Experiment 2 a number of types of accidents were specified. A positive relationship between judged risk and the number of recalled accidents was found but the latter referred to generic classes rather than to personal experiences, and the mothers did not judge the risk as higher and did not recall more accidents than the other subjects. In Experiment 3 where the risk of accidents to children was judged from specific descriptions, the importance of causal conceptions of accidents was verified by the fact that subjects predominantly mentioned the presence of a number of causes (e.g., the child's lack of skill) as reasons why they judged the accidents as likely as they did. The results furthermore were similar when subjects gave reasons for their judgements as when they were asked to explain why the accidents occurred. PMID- 2772570 TI - Psychometric features related to the acute phase and final outcome of anorexia nervosa. AB - The MMPI responses of a poor and good final outcome group from a follow-up study of anorexia nervosa were compared with responses of a group of anorexic patients in the acute phase. The poor outcome group produced elevated scores in the psychopathological range except on scales 4, 5 and 9. No elevations occurred in the good outcome group and the MMPI thus discriminated significantly between different kinds of final outcome of anorexia nervosa. The profile of the patients in the acute phase at time of testing was not significantly different from the poor outcome group profile. In order to improve the predictive validity of the MMPI related to anorexia nervosa, the paper points to possible directions for further research. PMID- 2772571 TI - Neonatal imitation of tongue protrusion and mouth opening: methodological aspects and evidence of early individual differences. AB - The present work examines imitation of mouth opening and tongue protrusion in 32 full-term infants at three different occasions: When the infants are two to three days, three weeks, and three months old. The analysis focuses (1) on individual differences in imitative behaviour and (2) on how to operationalize the infants' responses. The overall group analysis revealed that imitation of tongue protrusion was statistically significant for both two- to three-day-old and three week-old infants but not when the children had become three months old. No statistically significant effect was observed for imitation of mouth opening. Two different imitation indexes were constructed in order to assess individual differences in early imitative behaviour. Results show that short-term stability in imitative tendencies exists between the first and second observation. The results further reveal that methodological factors must be seriously considered when studying neonatal imitation: the overall imitation found for tongue protrusion is demonstrated to be dependent on how the infants' responses are coded. PMID- 2772572 TI - Cancer incidence in an occupational cohort exposed to bitumen fumes. AB - This study was conducted to investigate whether bitumen fumes should be considered carcinogenic to human beings. A historical cohort of heavily exposed mastic asphalt workers was followed from 1959 through 1984 (inclusive) with regard to cancer incidence. A total of 679 Danish men were included in the study cohort. Among these, 75 new cases of cancer were observed within the period studied. The cancer incidence observed among the group significantly exceeded that of the total Danish male population, the standardized morbidity ratio (SMR) being 195 (95% confidence interval (95% CI) 153-244). Significant increases were seen for cancer of the mouth (SMR 1111, 95% CI 135-4014), the esophagus (SMR 698, 95% CI 144-2039), the rectum (SMR 318, 95% CI 128-656), and the lung (SMR 344, 95% CI 227-501). It is suggested that exposure to cracking products in the fumes of heated bitumen has contributed to the elevated cancer incidence observed. PMID- 2772573 TI - Noise exposure during pregnancy and selected structural malformations in infants. AB - The study tested the hypothesis of exposure to noise during pregnancy being teratogenic. It included 1,475 Finnish mothers who had given birth to a malformed child (orofacial cleft or structural defect of the central nervous system, skeleton, or heart and great vessels) and 1,475 reference mothers. A special interview soon after delivery yielded the primary information on exposure. Of the 783 mothers who reported noise exposure in the first trimester, 370 were case mothers and 413 were referents. Hygienic assessment indicated that 102 case mothers and 103 referents had been exposed in the first trimester to a sound level of around 80 dB LAeq(8 h) or higher, the overall odds ratio being 1.0 (95% confidence interval 0.7-1.3). Adjustment for potential confounders by logistic regression methods gave similar results. There was no obvious trend suggesting a hazard when different exposure categories were considered. PMID- 2772574 TI - Occupational noise exposure and course of pregnancy. AB - The study examined the possible relation of occupational noise exposure to adverse pregnancy outcomes. The experience of 1,190 reference mothers from a case referent study based on the Finnish Register of Congenital Malformations was scrutinized. Exposure to noise was blindly assessed from a description of the mother's workday by two industrial hygienists. Women with an estimated level of noise of around 80 dB LAeq(8 h) or higher were considered exposed. Threatened abortion was not associated with noise exposure alone, but, when it was combined with shift work, the adjusted risk was over twofold. The adjusted risk of pregnancy-induced hypertension was twice as high among the mothers exposed to noise in shift work, and the duration of their pregnancy was shorter. The analyses produced indications of a relation between noise and growth retardation which was not connected with shift work. There were significantly ascending trends in the proportions of these outcomes according to increasing exposure intensity. PMID- 2772575 TI - Regional cerebral blood flow at the time of diagnosis of chronic toxic encephalopathy induced by organic-solvent exposure and after the cessation of exposure. AB - Regional cerebral blood flow was measured in patients with the diagnosis of chronic toxic encephalopathy induced by exposure to organic solvents. Measurements were made at the time of diagnosis and 24-84 months after the cessation of exposure. During the follow-up the patients were carefully examined for other possible causes of brain dysfunction. Comparisons were made to unexposed and solvent-exposed referents. At the first examination the patients had a 7% lower mean flow level than the unexposed referents and a 5% lower level than the exposed workers. The largest flow differences were seen in the frontotemporal areas. At the follow-up, the difference in the mean flow level between the patients and referents was no longer significant. Regionally, the flow had increased, especially in areas which initially showed the most pronounced decreases. There was a significant negative correlation between the initial cerebral blood flow level and the degree of normalization of the flow level at follow-up. PMID- 2772576 TI - Cytogenetic and hematological effects in plastics workers exposed to styrene. AB - For 20 glass-reinforced plastics workers exposed to styrene and 22 unexposed referents, the frequency and size distribution of micronuclei were determined for lymphocytes stimulated with phytohemagglutinin or pokeweed mitogen, and white blood cell counts were made. Furthermore, chromosome aberrations were scored for 11 of the exposed subjects and 15 of the referents. The mean level of styrene in the breathing zone of the workers was 56 mg/m3. Workers exposed to styrene did not show an increase in any of the cytogenetic end points studied when the effect of age and smoking was allowed for in a multiple regression analysis. A significant 30% increase in the number of peripheral monocytes was observed for the exposed workers. No correlations between the cytogenetic and hematological tests on one hand and the length of exposure time on the other could be detected. PMID- 2772577 TI - Cell response in bronchoalveolar lavage fluid after sulfur dioxide exposure. AB - Environmental chamber exposure and bronchoalveolar lavage (BAL) were used to study the dose-response relationship between short-term exposure to sulfur dioxide (SO2) and inflammatory reactions in the human lung as reflected in BAL fluid. Healthy subjects were exposed to 10, 13, 20, or 30 mg/m3 for 20 min. BAL was performed several weeks preexposure and 24 h postexposure. Mast cells, lymphocytes, lysozyme positive macrophages, and the total number of macrophages were significantly increased after SO2 exposure. A dose-dependent increase in the cell response in BAL fluid was observed after exposure to 10-20 mg/m3, but no further increase was detected after 30 mg/m3. Inflammatory cell response was found in BAL fluid at SO2 levels that occur in industrial indoor environments worldwide, and cell response to SO2 was also seen below the short-term exposure limit of Sweden and many other countries (13 mg/m3). PMID- 2772578 TI - Allergic airway disease caused by methyl tetrahydrophthalic anhydride in epoxy resin. AB - Work-associated rhinitis and asthma occurred in a subject exposed to methyl tetrahydrophthalic anhydride (MTHPA) used as a curing agent in an epoxy resin system. He displayed bronchial hyperreactivity in provocation with methacholine, as well as skin prick test positivity and specific immunoglobulin E (IgE) serum antibodies, against a conjugate of MTHPA and human serum albumin. Thus, it seems likely that the disease was caused by an IgE-mediated allergy. PMID- 2772579 TI - Re: "Office Employment, Work with Video Display Terminals, and Course of Pregnancy: Reference Mothers' Experience from a Finnish Case-Referent Study of Birth Defects" by T Nurminen, K Kurppa. PMID- 2772580 TI - Industrial disasters and epidemiology. A review of recent experiences. AB - Disasters of industrial origin are usually overt, but sometimes their source is silent and their occurrence diluted in time. Thus, the ascertainment of the health impact is not the sole epidemiologic task; epidemiology is often needed to identify the disaster source; in addition, a postdisaster scenario may represent an unfortunate, unplanned experimental setting from which scientific knowledge and public health achievements can be drawn. In the aftermath of a disaster, three sets of illness determinants ought to be considered: the relevant exposure; the stressful experience of the population; the response measures. Ecological, geographic, and personal indicators might be used to ascertain individuals' exposure. Relevant health outcomes (early and long-term) are either exposure related or stress-related (mental and physical). A cohort approach should be sought to avoid major selection/information biases and facilitate later studies. Early planning is of paramount importance to identify study goals, problems, and resource requirements. PMID- 2772581 TI - Cancer incidence among Danish stone workers. AB - The lung cancer incidence of 2071 Danish stone workers was followed for a 42-year period. The expected numbers of cancer cases were based on the incidence rates for all Danish men after adjustment for region, and the data were analyzed separately for skilled and unskilled stone workers. The standardized incidence ratio (SIR) for lung cancer was 200 (44 observed, 22.0 expected) for all skilled stone workers, 808 (7 observed, 0.9 expected) for skilled sandstone cutters in Copenhagen, 119 (8 observed, 6.5 expected) for skilled granite cutters in Bornholm, 181 (24 observed, 13.2 expected) for all unskilled stone workers, 246 (17 observed, 6.9 expected) for unskilled workers in the road and building material industry, and 111 (7 observed, 6.3 expected) for unskilled workers in the stonecutting industry. Smoking was unlikely alone to explain the excess risk, and the available data on levels of exposure in the Danish stone industry point to a possible dose-response relationship between exposure to respirable silica dust and the incidence of lung cancer. PMID- 2772583 TI - Influence of personal characteristics, job-related factors and psychosocial factors on the sick building syndrome. Danish Indoor Climate Study Group. AB - The influence of personal characteristics, life-style, job-related factors, and psychosocial work factors on symptoms of the sick building syndrome was investigated in Greater Copenhagen, Denmark. The buildings were not characterized beforehand as "sick" or "healthy." Of the 4369 employees sent a questionnaire, 3507 returned them. Multivariate logistic regression analyses of the multifactorial effects on the prevalence of work-related mucosal irritation and work-related general symptoms among the office workers showed that sex, job category, work functions (handling of carbonless paper, photocopying, work at video display terminals), psychosocial factors of work (dissatisfaction with superiors or colleagues and quantity of work inhibiting job satisfaction) were associated with work-related mucosal irritation and work-related general symptoms, but these factors could not account for the differences between the buildings as to the prevalence of the symptoms. The building factor (i.e., the indoor climate) was strongly associated with the prevalence of the symptoms. PMID- 2772582 TI - Combined effects of job strain and social isolation on cardiovascular disease morbidity and mortality in a random sample of the Swedish male working population. AB - This study examined the impact of psychosocial work organization on cardiovascular disease (CVD) morbidity and the nine-year cumulative mortality incidence for a random sample of the male Swedish working population (N = 7219). A multiplicative measure was constructed to model the combined effects of psychological job demands, work-related social support and work control. Highly strained and isolated workers had a higher age-adjusted prevalence ratio for CVD morbidity and a higher age-adjusted risk ratio for CVD mortality when compared with those working under less strained and more collective conditions. Blue collar workers showed the greatest risk for both morbidity and mortality when groups with highly isolated and strained conditions were compared to those in more collective and less strained conditions. Strained and isolated workers also had a substantially higher probability of developing and dying of CVD at a younger age than did those in less adverse environments. PMID- 2772584 TI - Lung function and bronchial reactivity in aluminum potroom workers. AB - Lung function and bronchial reactivity were measured in 38 aluminum potroom workers with no airway symptoms and in 20 healthy referents (office workers). All of the participants were non-smokers. The magnitude of exposure to airborne dust (alumina) and fluorides was determined. The aluminum potroom workers had obstructive lung function impairment with a significant decrease in expiratory flow and an increase in residual volume. Diffusing capacity was found to be lower than in the referents. No bronchial hyperreactivity was found in the aluminum potroom workers. The exposure to inhaled alumina and particulate and gaseous fluorides in the plant was low, 15-20% of the Swedish exposure limits. The finding of only modest lung function alterations with no bronchial hyperreactivity in the aluminum potroom workers is not consistent with the results of other authors. This discrepancy can probably be explained by the fact that the exposure to inhaled contaminants in the investigated aluminum plant was low. PMID- 2772585 TI - A possible case of mercury-related toxicity resulting from the grinding of old amalgam restorations. AB - The potential hazards of metallic mercury in dentistry are well recognized. The present report concerns a patient who experienced an uncommonly high mercury exposure and, possibly, mercury-related toxicity from vapor released during extensive grinding of old amalgam fillings. PMID- 2772587 TI - [The lateral capsule sign in the traumatized knee joint]. AB - The lateral capsular sign is a simple radiographic finding visible on routine anteroposterior knee x-ray near the tibial articular surface at the lateral point of the lateral tibial plateau. The lateral capsular sign is a flake of bone superior and posterior to the insertion of the iliotibial tract, and represents an avulsion of the meniscotibial portion of the lateral capsular ligament. A positive lateral capsular sign implies disruption of the lateral capsule and a tear of the anterior cruciate ligament. These findings are illustrated by clinical examples. PMID- 2772586 TI - [Acute kidney insufficiency in the treatment of psoriasis using fumaric esters]. AB - We describe two patients who developed acute renal failure during therapy with fumaric acid-esters. Histologic findings after renal biopsy in one patient were compatible with the diagnosis of acute tubular necrosis (ATN), and renal function was restored after cessation of the medication. The histologic diagnosis in the other patient was tubulo-interstitial nephritis (TIN), possibly reactive to ATN. The recovery of renal function was incomplete after 9 months. Two other patients had deterioration of renal function and proteinuria during therapy with fumaric acid-esters. The symptoms were completely reversible in one patient after discontinuation of the medication, and incompletely reversible in the other. The literature is reviewed and a comparison is drawn with the maleic acid model in the rat. PMID- 2772588 TI - [Osseous integration]. PMID- 2772589 TI - [The role of mechanical factors in the development of cervical wedge-shaped erosions]. AB - The surface of single or multiple cervical wedge-shaped defects was studied with a scanning electron microscope. After an initial stage during which the root surface became smooth and polished, the developed lesions had an angular shape with the presence of one or several grooves of 0.2 to 0.3 mm in width at the angle vertex. The presence of these grooves forming horizontal gutters strongly suggested the existence of a horizontal brushing movement. Beside these large grooves, a more or less parallel network of fine striae was observed. The lesion surfaces consisted of dentin with obliquely oriented tubules which were not completely sclerosed. Relatively thin bacterial layers were present on these surfaces. The presence of horizontal wear gutters seemed to confirm the traumatic origin of the wedge-shaped defects connected with toothbrushing. PMID- 2772590 TI - [Tensile strength of short-fiber-reinforced temporary plastics]. AB - Glass fibers added to temporary crown and bridge material (Proviso-Blend, Blendax) by 5% to the weight increased the tensile strength of the acrylic resin by 38%. The increase was even greater when carbon fibers were added (50%), but the resin discoloured to a greyish shade. The results were less spectacular with Dentalon Plus (Kulzer), and the experiment did not work with Protemp (Espe). The amount of improvement in tensile strength depended on the type and geometry of the fiber and of the fiber concentration. Neither the properties of the polished surface of a fiber-reinforced acrylic nor adverse effects of such fibers possibly swallowed by the patient are investigated as yet. PMID- 2772591 TI - [Implants--preprosthetic surgery. Endosseous implants and simultaneous preprosthetic operations on the mandible: the technic and results]. PMID- 2772592 TI - [Synoptic treatment planning (I)]. PMID- 2772593 TI - [How much is prophylaxis really worth?]. PMID- 2772594 TI - [Recall or the exigencies of the system]. PMID- 2772595 TI - [Construction and testing of a strain gauge for measuring masticatory force]. AB - The main objective of this study was to establish and test a measuring system for monitoring occlusal forces and force cycles during mastication. A measuring module using strain gauge transducers was incorporated in the bridge-pontic of a three part test bridgework. A load cell was used intraorally for loading and calibration. The test bridges were incorporated in the patient's mouth and calibrated in vivo using variable loads. The recording system was a special intensifying and processing system (Alpha 3000, Hottinger-Baldwin Messtechnik, Darmstadt, West Germany). The percentage errors registered for every test bridge in various in-vitro tests were below 2%. Clinically, occlusal forces resulting during chewing of 4 types of food of different consistency were measured in 5 subjects. The results were shown as continuous force cycles which reflect cybernetic guidance patterns of the masticatory system. PMID- 2772596 TI - [Recall systems and intervals]. PMID- 2772597 TI - [Resection prosthetics. Experiences and problems of the prosthodontic treatment of patients with maxillary resection]. PMID- 2772598 TI - [Synoptic treatment planning (II)]. PMID- 2772599 TI - [The goals of a continuing education course at Les Diablerets. Interview by K. Venner]. PMID- 2772600 TI - [The Federation Dentaire Internationale FDI]. PMID- 2772601 TI - [Electromyography and spinal evoked potentials in cauda equina syndrome of dogs]. AB - In order to investigate usefulness of electrodiagnostic methods in Cauda Equina Compression, 26 dogs with this disease were subjected to electromyography and spinal evoked potentials. 16 normal dogs served as controls. It was found that- after stimulation of the Nn.tibialis, peronaeus, pudendus and coccygeales and recording at the lumbosacral junction--latencies and nerve-conduction velocities were largely normal. However the amplitudes were decreased and--depending on the severity of the compression--the morphology of the potentials was altered although considerable standard deviations were obtained. Electromyographically, increased spontaneous activity with fibrillations and positive sharp waves were found in the myotomes of the lumbosacral nerves. Their number increased according to the severity of the cauda equina compression and they had a centrifugal distribution pattern. Based on these results it appears indicated to perform an electromyographic exam before applying myelography. The technique of spinal evoked potentials will need more refinement and standardisation before being useful in a clinical situation. PMID- 2772602 TI - [The cervical vertebral column of horses--a clinico-radiological study]. AB - For various anamnestic reasons the cervical vertebral column of 78 horses was examined radiologically. Statistical comparisons showed that male "warmbloods" were more frequently affected than was expected. Our horses were older than comparable animals in the international literature. Independently of their history the radiologic diagnosis of "cervical spondylarthrosis" was established in 56 horses. Arthrosis and other conditions were clinically manifested by spinal ataxia (44 horses) or mechanical impairment of the neck's mobility (21 horses). 10 of the arthrotic patients had synovial cysts causing compression of the spinal cord. 79 percent of all dorsal intervertebral arthrotic joints were found in the caudal column (C6/7 to C7/Th1). With 38 percent, C6/7 was the most frequently affected joint. Clinical and radiological findings could be compared with patho anatomic results in 29 horses. The correlation was satisfactory. PMID- 2772603 TI - [Diagnostic aspects of neurological diseases of cattle. A retrospective study]. AB - 188 bovines with neurological disease were analysed in a retrospective study. We found that only few diseases can be diagnosed on the basis of neurologic signs only. However, with a few additional clinical data such as signalment, history, extraneural findings, hematological findings and cerebrospinal fluid analysis, a diagnosis can be made in many cases. A history of neurologic signs occurring since birth, is highly suggestive of a congenital malformation. High fever and mucosal changes are typical for malignant catarrhal fever. Lesions of peripheral nerves and spinal cord compression can be diagnosed based on the neurologic signs. Cranial nerve dysfunction and central vestibular signs in combination with other findings as age, season and cerebrospinal fluid, are indicative of listeriosis. Tetanus is characterized by pronounced extensor rigidity. Systemic muscle diseases were also included, because motor neurons and muscle cells are a functional unit. A suspicion of white muscle disease can be confirmed by increased creatine phosphokinase activity in serum. Suppurative bacterial meningoencephalitis can be diagnosed by the presence of a polymorphonuclear pleocytosis in the cerebrospinal fluid. The clinical differentiation between sporadic non suppurative meningoencephalitis and metabolic diseases of the central nervous system remains difficult. PMID- 2772604 TI - [Transcranial magnetic stimulation of the motor cortex and percutaneous magnetic stimulation of the peripheral nervous structures in the dog]. AB - The motor cortex was transcranially and peripheral nervous structures (motor roots, plexus, peripheral nerves) were percutaneously stimulated by magnetic pulses in awake dogs and in dogs awaking from general anesthesia. The compound muscle action potentials were recorded by surface or needle electrodes. The central motor conduction time as an information about central motor tracts was obtained by subtracting the peripheral latency from the corticomuscular latency. The peripheral latency was assessed by high voltage electrical and magnetic stimulation of motor roots and by the F-wave technique. The motor conduction velocity of the tibial nerve was measured by percutaneous magnetic and by electrical stimulation and the resulting values were compared. PMID- 2772606 TI - Arachidonic acid metabolism in the nervous system. Physiological and pathological significance. PMID- 2772605 TI - [Neurotoxic syndrome of sheep due to the ingestion of plants of the Mediterranean scrub: clinical, histopathological, histochemical and ultrastructural observations]. AB - A severe neurological disorder was observed during a very dry season, in sheep pasturing on land with mediterranean vegetation. During the crisis, lasting 5 20", ataxia and convulsions were the main clinical signs. Brain congestion, spongy appearance of the liver, interstitial nephritis and hyperpigmentation of visceral lymph nodes were the most important macroscopic lesions. Histopathological, histochemical and ultrastructural findings confirmed liver and kidney lesions and showed considerable neurovisceral storage of lipofuscin. Although further toxicological and experimental studies are needed to elucidate the origin of the disease, the Authors attribute the outbreak of the neurological syndrome to the ingestion of a neurotoxin containing plant. PMID- 2772607 TI - The growing human population. PMID- 2772608 TI - Short-answer question. A defective receptor may cause pygmies to be short. PMID- 2772609 TI - Different strokes... Premature infants gain from being handled. PMID- 2772610 TI - Too much pressure? Are deep-water divers risking their bones and brains? PMID- 2772611 TI - Natural levels of lead, cadmium and mercury in tissues and hair of newborn calves from different areas of Czechoslovakia. AB - Liver, kidney, muscle and hair samples from newborn, born-dead or found-dead calves were collected within 10 days after parturition, for the determination of Pb, Cd and Hg levels. Differential pulse anodic stripping voltammetry at the static mercury dropping electrode was used for Pb and Cd determination after dry ashing of the samples. Cold-vapour atomic absorption spectrometry was used for direct Hg determination. The aim of the study was to monitor background Pb, Cd and Hg levels in vital and important tissues of newborn calves in which nutritional influence was negligible. Three geographic areas in Czechoslovakia were monitored (A, B and C). The following ranges of mean values for all animals were obtained (mg kg-1, wet wt): Pb--muscle (0.04-0.25), liver (0.10-0.29), kidney (0.05-0.43), hair (0.11-0.55); Cd--muscle (0.007-0.038), liver (0.008 0.073), kidney (0.007-0.062), hair (0.009-0.074); Hg--muscle (0.002-0.071), liver (0.005-0.18), kidney (0.004-0.50), hair (0.07-0.77). The value obtained for heavy metal levels (Pb, Cd, Hg) indicated that there is a significant difference between the groups of found-dead and slaughtered calves from the Nymburk region (muscle--Pb, Cd; liver--Pb; kidney--Pb, Cd). Unexplained high Hg levels in hair samples were measured in the Hradec Kralove region. PMID- 2772612 TI - Heavy metal pollution induced by a ferro-nickel smelting plant in Greece. AB - Seven heavy metals, Co, Cr, Cu, Fe, Mn, Ni and Zn, were measured in marine sediments, plants and invertebrates in the vicinity of a ferro-nickel smelting plant in Greece. The concentrations of metals in the sediment were higher than those found in the average unpolluted Greek coastal sediment. High levels of metals were observed in the gastropod molluscs, particularly Cerithium vulgatum, which concentrated metals more than other invertebrates. PMID- 2772613 TI - Cadmium in hair of children living near a lead smelter in Brazil. AB - In a cross-sectional study, concentrations of cadmium in hair (CdH) were determined for 263 children aged 1-9 years, living less than 900 m from a lead smelter in Santo Amaro, Brazil. The mean CdH level was significantly higher when individuals with the following characteristics were considered: female, racial group "dark" or "medium", and children of lead workers. The mean CdH value did not vary significantly according to nutritional status or iron status or hair type. Hair Cd levels increased significantly in relation to an increase in cadmium concentration in soil. An increase of 0.024 ppm in mean CdH level was estimated for each 1 ppm increase in the cadmium concentration in soil. However, children with the habit of pica had only a slight increase in CdH levels, when compared with those without the habit. The marked variations observed in CdH levels suggest the possibility of using them as an epidemiological index in situations of intense environmental pollution. PMID- 2772614 TI - Mercury levels in total suspended matter and in plankton of the Mediterranean basin. AB - Mercury levels in total suspended matter (TSM) and in plankton of sea water from some Mediterranean areas have been determined. The mercury concentration in TSM collected with a filter of 0.45 micron pore size ranges from 0.1 to 2.4 ng l-1 and from 0.1 to 4.7 ng mg-1, dry wt. These levels are 3-10 times higher than those observed in plankton (0.08-0.29 ng mg-1 dry wt.) collected with a 200 microns net mesh size. The larger amounts of mercury in TSM than in the matter collected by the plankton nets are probably due to the high abundance of smaller sized particles selected by the filter. PMID- 2772615 TI - Salts as a source of metals in dialysis fluids: an assessment study by means of neutron activation analysis. AB - Thirty-nine trace metals were determined by neutron activation analysis (NAA) in nine salts (glucose, NaCl, KCl, CaCl2, MgCl2, Na-lactate, Na-acetate, NaHCO3 and NaOH), from different European producers, used in the preparation of dialysis fluids. Metal concentrations vary widely from less than 1 ng g-1 to several micrograms per gram. The data are used to assess the potential metal contribution of the salts to a hypothetical dialysis fluid. A comparison of these calculations with NAA of commercial haemodialysis solutions, and water used for their preparation, suggests that salts are the main source of metal contamination of the dialysate. Despite this, the chemical purity of the salts analyzed is considered to be good and it would be unrealistic to expect a clearly better chemical quality on a commercial scale. In order to protect the health of dialysis patients against abnormal metal exposure, toxicological research directed towards the estimation of the effective daily metal exposure and the determination of possible metal overloads in dialysis patients is necessary. A standardization of the dialysis systems actually used is also an important aspect if uncontrolled metal contamination of the dialysis fluid is to be avoided. PMID- 2772616 TI - Characteristics of air pollution in Birmingham, England. II. On the significance of sampling height. AB - Air quality data for "standard smoke" and for sulphur dioxide in central Birmingham are examined for the influence of sampling height. Data from two sites at the same location but separated vertically by about 30 m indicate that the effect of sampling height can change over a period of several years. For standard smoke the effect of height appears to be diminishing, whereas for sulphur dioxide the effect of sampling height appears to be increasing. PMID- 2772617 TI - Radionuclides in shoreline waters of the northeast Irish Sea. AB - The shoreline waters of the Irish Sea along the Cumbrian coast near the British Nuclear Fuels plc works at Sellafield have been sampled at three locations over a 31/2 year period from December 1980. The particulate content was analysed for 238Pu, 239 + 240Pu, 241Am, 137Cs and stable Al. In some cases the radionuclide concentrations in filtered seawater were also determined. The results showed that the suspended particulate loads were high (typically about 100 mg l-1) and variable, and that they contained about 65 mg g-1 of aluminium. The isotopic ratio 238Pu/239 + 240Pu, which can indicate the chronology of the discharge, was about 0.26, which suggested that the Sellafield discharges over at least 5 years contributed to the observed concentrations. The 239 + 240Pu and 241Am annual average concentrations in the particulate material were in the ranges 3.0-5.1 and 3.3-5.2 Bq g-1, respectively. The individual values were very variable in time, but highly correlated with each other. No significant downward trends in the concentrations could be identified over this period. This is consistent with the behaviour of a reservoir (the northeast Irish Sea) where Pu and Am, which are available for suspension in particulate material, are fed by the Sellafield discharges and are subject to a mean removal time of several years. Thus the effects of the large reduction in the Sellafield discharges which occurred over this period should only be observable over a longer time interval. The concentrations in the dissolved fractions in seawater were negligible compared with the particulate fraction concentrations, in sharp contrast with the situation in offshore seawater.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2772618 TI - Background concentrations of lead and cadmium in the lichen Hypogymnia physodes at different altitudes. AB - The background concentrations of lead and cadmium in the epiphytic lichen Hypogymnia physodes were determined and found to depend on altitude. The lead content increases linearly with increasing altitude, whereas the cadmium content increases up to altitudes of 900-1100 m, and then decreases above this height. PMID- 2772619 TI - The regional distribution of selenium in Greek cereals. AB - The selenium content of hard and soft wheat, barley, oats, rye and corn grown in approximately 100 different locations of Greece has been determined fluorimetrically. The mean values +/- SD for these cereal types were 0.29 +/- 0.19, 0.21 +/- 0.12, 0.16 +/- 0.10, 0.14 +/- 0.10, 0.19 +/- 0.10 and 0.12 +/- 0.08 ppm Se (dry weight basis), respectively. Based on data for selenium in corn from 96 different locations, a geobotanic map of Greece for the selenium in soil available for uptake by plants was prepared. Macedonia, West Epirus, south-east Thessaly, north-east Sterea Hellas and the Aegean Islands produce corn deficient or low in selenium, but only sporadic selenium-deficiency diseases in animals have been observed in many of these areas, probably because the farm animals are given mixed food or they are free to graze. No areas with toxic levels of selenium in soil were found. PMID- 2772620 TI - Speciation of ionic alkyllead in potable water and soil. AB - Various potable water and soil samples have been analyzed for tri- and dialkyllead compounds using a sensitive speciation procedure based on diethyldithiocarbamate extraction, Grignard derivatization and gas chromatography atomic absorption spectrometry. The species are generally present as ultra-trace contaminants, and their abundance is critically discussed. In addition, a degradation study of ionic alkyllead in ambient matrices is presented. PMID- 2772621 TI - Trace elements intake in the Faroe Islands. III. Element concentrations in human organs in populations from Bergen (Norway) and the Faroe Islands. AB - Flameless as well as flame atomic absorption spectrophotometry were used for the analysis of six elements (calcium, iron, zinc, selenium, cadmium and mercury) in human organs (liver, kidney cortex and medulla, heart, pancreas and spleen) from 13 bodies from Bergen and 10 from the Faroe Islands. Samples were taken at autopsy and the organs selected were without pathological signs. All patients were born between 1899 and 1923. Element concentrations in the organs studied were comparable to previous studies, except for high mercury and selenium values in the liver, the kidney cortex and medulla of subjects from the Faroe Islands. The high mercury and selenium values may be explained by the high consumption of pilot whales by the Faroe Islands population. PMID- 2772622 TI - Time-dependent radioactive concentrations of fallout following the Chernobyl reactor accident. AB - The levels of Chernobyl-derived 137Cs, 134Cs, 106Ru and 103Ru were measured at Thessaloniki, Greece, in air, rain, soil, grass and milk samples for more than 2 years after the accident. The data were analysed in conjunction with 7Be (produced in the atmosphere by cosmic rays) measurements and show that significant variations were observed, particularly in the spring and in the autumn measurements. In interpreting these variations we took into consideration the tropospheric, or possibly stratospheric, fallout injections into the atmosphere due to the Chernobyl accident, nuclear weapons testing or other releases from nuclear reactors operating world-wide. Useful information can be derived for determining the periodicity of global circulation of the fallout radionuclides. PMID- 2772623 TI - Seasonal variations in hair zinc concentrations in Canadian and African children. AB - Proximal occipital scalp hair samples were collected during three survey periods from 30 omniverous Canadian boys aged 75.6 +/- 10.4 months (mean +/- SD) and 66 rural Malawian children (37 M; 29 F) aged 62 +/- 10 months (mean +/- SD) consuming predominantly plant-based diets. Hair samples were washed and then analyzed for zinc and copper using instrumental neutron activation analysis. Selected anthropometric measurements were also taken and dietary intakes calculated from weighed dietary records. A marked seasonal variation in hair zinc concentrations occurred in both groups; levels were highest in the season with shortest daylight hours (i.e. December/January in Canada vs July/August in Malawi). A similar trend was not observed for hair copper concentrations. Changes in hair zinc were not associated with changes in growth indices, age, socio economic group, method of infant feeding, in either group, but were related to intakes of protein (per 1000 kcal) (p = 0.02, r = -0.36), zinc (mg day-1) (p = 0.01, r = -0.39), and dietary fiber (g day-1) (p = 0.04, r = 0.28), in the Malawian children during the second survey period. The seasonal effect on hair zinc concentrations must always be considered when interpreting hair zinc concentrations in children; its etiology remains unclear. PMID- 2772624 TI - Geotoxicology of multiple sclerosis: the Henribourg, Saskatchewan, Cluster Focus. I. The water. AB - Some childhood-related, geographically-linked factor predisposes towards (or protects against) multiple sclerosis (MS). It is quite plausible that this factor could be one or more chemicals in the environment, and that chemical study of the environment or "focus" of an MS cluster might maximize the chances of detecting such an etiological link. The water chemistry of such a focus (Henribourg, Saskatchewan) was compared with North American norms, and with the chemistry of water from a nearby control area with a near-zero incidence of MS and of childhood homes of MS cases. Overall, the results suggest that an environment predisposing to MS may have a number of water chemistry characteristics such as: relative deficiency of selenium and sulfate, but relative abundance of barium, calcium, chloride, chromium, magnesium, manganese, molybdenum, nitrate plus nitrite, strontium and zinc. Possible explanations for the apparent link between the excess rate of MS and the water geochemistry findings at Henribourg are discussed. PMID- 2772625 TI - Exposure to lead and cadmium of children living near a lead smelter at Lavrion, Greece. AB - Exposure of children of the Greek town of Lavrion to lead and cadmium has been evaluated by determination of the levels of lead (PbB) and cadmium (CdB) in the blood of 514 children living in the town. The Lavrion area is heavily polluted by lead owing to the presence of a large lead-zinc mining and smelting industrial complex. The industrial PbB level (geometric mean) was 21.7 micrograms dl-1 (range 7.4-79.8 micrograms dl-1). The CdB levels were, on average, 0.36 micrograms l-1 (range 0.1-3.1 micrograms l-1). The results were evaluated with respect to a number of constitutional, social and environmental variables, such as age, gender, distance of the school from the lead-zinc mining and smelting complex, and occupation and education of the father. PMID- 2772626 TI - pH- and protein-dependent buffer capacity and viscosity of respiratory mucus. Their interrelationships and influence on health. AB - The macromolecular proteins (greater than 100,000 daltons) have proved mainly responsible for the protective power of mucus against penetration of the H+ ion into the surrounding tissues. This fraction is also mainly responsible for the buffer capacity and, owing to its content of glycoproteins, for the pH-dependent viscosity of mucus. Viscosity determinations, both on native sputum and on reconstituted human alpha-acid glycoprotein, indicate that either raising or reducing the pH from neutral results in an increase in viscosity. The results suggest that individuals with low pH and/or a low protein concentration (less than 6 mg ml-1) or low buffer capacity (less than 3 mumols H+/pH unit) in their mucus, i.e. a low protective power of their mucus, will risk effects released from the underlying tissues when exposed to acidic pollutants. Alternatively, persons with higher concentrations of mucus proteins will risk effects caused by increased mucus viscosity. Sputum was tested from six smokers without any symptoms other than the ability to clear their throats easily. PMID- 2772627 TI - Effects of lime on nickel uptake and toxicity in celery grown on muck soil contaminated by a nickel refinery. AB - A study was conducted to investigate the effects of soil lime application as a means of conteracting nickel phytotoxicity in muck soil. Metal-contaminated muck soil (5700 micrograms g-1 Ni, 650 micrograms g-1 Cu and 90 micrograms g-1 Co) was obtained from a farm adjacent to a nickel refinery in southern Ontario and was placed on a field test plot at Brampton, Ontario, during the summer of 1984. The treatments were: (a) control soil (uncontaminated), (b) unlimed metal soil and (c) limed metal soil. Calcium hydroxide was used at the rate of 10 t ha-1 to raise the pH of the metal-rich soil from approximately 5.7 to 6.9. The amount of Ni extracted by ammonium acetate was reduced by 36% in the limed metal soil compared with the unlimed metal soil. Distinct Ni-toxicity foliar symptoms appeared only on celery grown on the unlimed metal soil. The unlimed metal treatment resulted in an average celery shoot weight 28% less than the control (significant at P = 0.05). Liming the metal soil increased average celery shoot height by 36.5% (significant at P = 0.05), but slight increases in shoot and root weight of 13 and 8%, respectively, were not significant. PMID- 2772629 TI - Biotechnology: society's role. PMID- 2772630 TI - Rabies vaccine trials. PMID- 2772628 TI - A rational approach to the assessment of aluminium solubility controls in freshwaters. AB - The problem of assessing aluminium equilibrium solubility controls in freshwaters using thermodynamic techniques is placed in a statistical hypothesis testing framework. As an aid in interpreting field information, artificial data are generated which correspond to ideal equilibrium conditions, but which incorporate realistic analytical and temperature related uncertainties. These artificial data are then subjected to thermodynamic interpretations. The technique is useful in answering "what if" questions by showing the scatter to be expected in real data under true equilibrium conditions. Aluminium hydroxide is used as the example in this report. Reasons for discarding the conventional dependent axis plot (pAl3+ vs pH) in favour of a plot with independent or nearly independent axes are emphasized. An improved method is suggested allowing for temperature variations in the equilibrium constants when constructing stability diagrams. Also, the need for caution when regressing variables which both contain errors is noted. PMID- 2772632 TI - Strasbourg home for frontiers. PMID- 2772631 TI - Wanted: $25 million for mouse house. PMID- 2772633 TI - Caution urged on DNA fingerprinting. PMID- 2772634 TI - Light adaptation in cat retinal rods. AB - It has long been an open question whether individual rod receptors in the mammalian retina show any light adaptation. The prevailing evidence so far has suggested that these cells, unlike those in lower vertebrates, adapt little if at all. The experiments on cat rods reported here, however, indicate that this is not really true. Since the cone system in the cat retina has a fairly high light threshold, the rods also need to adapt so that they do not saturate with light before the cones fully take over vision at higher light intensities. In similar experiments, adaptation was found in rods of other mammalian species, including primates. PMID- 2772635 TI - Neuronal correlates of subjective visual perception. AB - Neuronal activity in the superior temporal sulcus of monkeys, a cortical region that plays an important role in analyzing visual motion, was related to the subjective perception of movement during a visual task. Single neurons were recorded while monkeys (Macaca mulatta) discriminated the direction of motion of stimuli that could be seen moving in either of two directions during binocular rivalry. The activity of many neurons was dictated by the retinal stimulus. Other neurons, however, reflected the monkeys' reported perception of motion direction, indicating that these neurons in the superior temporal sulcus may mediate the perceptual experience of a moving object. PMID- 2772636 TI - NIMH assigns blame for tainted studies. PMID- 2772637 TI - Buprenorphine suppresses cocaine self-administration by rhesus monkeys. AB - Cocaine abuse has reached epidemic proportions in the United States, and the search for an effective pharmacotherapy continues. Because primates self administer most of the drugs abused by humans, they can be used to predict the abuse liability of new drugs and for preclinical evaluation of new pharmacotherapies for drug abuse treatment. Daily administration of buprenorphine (an opioid mixed agonist-antagonist) significantly suppressed cocaine self administration by rhesus monkeys for 30 consecutive days. The effects of buprenorphine were dose-dependent. The suppression of cocaine self-administration by buprenorphine did not reflect a generalized suppression of behavior. These data suggest that buprenorphine would be a useful pharmacotherapy for treatment of cocaine abuse. Because buprenorphine is a safe and effective pharmacotherapy for heroin dependence, buprenorphine treatment may also attenuate dual abuse of cocaine and heroin. PMID- 2772638 TI - Imaging of memory-specific changes in the distribution of protein kinase C in the hippocampus. AB - Activation of protein kinase C (PKC) can mimic the biophysical effects of associative learning on neurons. Furthermore, classical conditioning of the rabbit nictitating membrane (a form of associative learning) produces translocation of PKC activity from the cytosolic to the membrane compartments of the CA1 region of the hippocampus. Evidence is provided here for a significant change in the amount and distribution of PKC within the CA1 cell field of the rabbit hippocampus that is specific to learning. This change is seen at 1 day after learning as focal increments of [3H]phorbol-12,13-dibutyrate binding to PKC in computer-generated images produced from coronal autoradiographs of rabbit brain. In addition, 3 days after learning, the autoradiographs suggest a redistribution of PKC within CA1 from the cell soma to the dendrites. PMID- 2772640 TI - AAAS presidents. PMID- 2772639 TI - Angiotensin II: does it have a direct obligate role in ovulation? PMID- 2772641 TI - Monitoring the U.S. AIDS epidemic. PMID- 2772642 TI - NRDC on alar. PMID- 2772643 TI - Science education in the United States: what the scientific community can do. AB - It is argued that the need to improve science education should be a national priority. Ways are suggested by which the federal government and the scientific community, working together, can address this issue. It is recommended that scientists, engineers, and educators make a significant personal and institutional commitment to participate in science education activities, and that the President of the United States provide the personal leadership to generate a national commitment to the improvement of education at all levels. PMID- 2772644 TI - The cystic fibrosis gene is found. PMID- 2772645 TI - The CF gene hits the news. PMID- 2772646 TI - NSF's summer of discontent. PMID- 2772647 TI - Drug prohibition in the United States: costs, consequences, and alternatives. AB - "Drug legalization" increasingly merits serious consideration as both an analytical model and a policy option for addressing the "drug problem." Criminal justice approaches to the drug problem have proven limited in their capacity to curtail drug abuse. They also have proven increasingly costly and counterproductive. Drug legalization policies that are wisely implemented can minimize the risks of legalization, dramatically reduce the costs of current policies, and directly address the problems of drug abuse. PMID- 2772648 TI - A protein that binds to a cis-acting element of wheat histone genes has a leucine zipper motif. AB - The structure and function of transcription factors of higher plants was studied by isolating cDNA clones encoding a wheat sequence-specific DNA binding protein. A hexameric nucleotide motif, ACGTCA, is located upstream from the TATA box of several plant histone genes. It has been suggested that this motif is essential for efficient transcription of the wheat histone H3 gene. A wheat nuclear protein, HBP-1 (histone DNA binding protein-1), which specifically binds to the hexameric motif, has previously been identified as a putative transcription factor. A cDNA clone encoding HBP-1 has been isolated on the basis of specific binding of HBP-1 to the hexameric motif. The deduced amino acid sequence indicates that HBP-1 contains the leucine zipper motif, which represents a characteristic property of several eukaryotic transcription factors. PMID- 2772649 TI - Synthesis of functional human hemoglobin in transgenic mice. AB - Human alpha- and beta-globin genes were separately fused downstream of two erythroid-specific deoxyribonuclease (DNase) I super-hypersensitive sites that are normally located 50 kilobases upstream of the human beta-globin gene. These two constructs were coinjected into fertilized mouse eggs, and expression was analyzed in transgenic animals that developed. Mice that had intact copies of the transgenes expressed high levels of correctly initiated human alpha- and beta globin messenger RNA specifically in erythroid tissue. An authentic human hemoglobin was formed in adult erythrocytes that when purified had an oxygen equilibrium curve identical to the curve of native human hemoglobin A (Hb A). Thus, functional human hemoglobin can be synthesized in transgenic mice. This provides a foundation for production of mouse models of human hemoglobinopathies such as sickle cell disease. PMID- 2772650 TI - Fitness differences among remnant populations of the endangered sonoran topminnow. AB - Four correlates of fitness were measured in three stocks of the endangered Sonoran topminnow, Poeciliopsis occidentalis, from Arizona. Survival, growth, early fecundity, and developmental stability were greatest in laboratory-reared fish from the most heterozygous natural population studied. Conversely, all four traits were poorest in fish from a population with no electrophoretically detectable genetic variation. These results emphasize the need for genetic as well as demographic information for the development of comprehensive species recovery programs. PMID- 2772651 TI - Transient pioneer neurons are essential for formation of an embryonic peripheral nerve. AB - In developing nervous systems, many peripheral and central pathways are established by early arising populations of pioneer neurons. The growth cones of these pioneer neurons can migrate while embryonic distances are short and while intervening tissue is relatively uncomplicated. Are these pioneers necessary? In grasshopper embryos, a pair of pioneer neurons arise at the tips of limb buds and extend axons through the limb to the central nervous system. Growth cones of later arising sensory neurons migrate along the pioneer axons. After ingrowth of sensory axons, the pioneer neurons die. If the pioneer neurons are prevented from differentiating by heat shock, then the sensory growth cones that would have migrated along them are blocked and fail to reach the central nervous system. Thus, the pioneer axons are necessary for successful migration of these sensory growth cones. By crossing a segment boundary early in embryogenesis, the pioneers circumvent an incompatibility between differentiated segment boundary cells and growth cone migration. Pioneer neurons may resolve similar problems in many systems. PMID- 2772652 TI - Agent Orange studies. PMID- 2772653 TI - "Radiation-induced" cancer. PMID- 2772654 TI - NIH, Inc.: the CRADA boom. PMID- 2772655 TI - Biomagnetism attracts diverse crowd. PMID- 2772656 TI - The (liquid) breath of life. PMID- 2772657 TI - Identification of the cystic fibrosis gene: chromosome walking and jumping. AB - An understanding of the basic defect in the inherited disorder cystic fibrosis requires cloning of the cystic fibrosis gene and definition of its protein product. In the absence of direct functional information, chromosomal map position is a guide for locating the gene. Chromosome walking and jumping and complementary DNA hybridization were used to isolate DNA sequences, encompassing more than 500,000 base pairs, from the cystic fibrosis region on the long arm of human chromosome 7. Several transcribed sequences and conserved segments were identified in this cloned region. One of these corresponds to the cystic fibrosis gene and spans approximately 250,000 base pairs of genomic DNA. PMID- 2772658 TI - Prospective analysis of liver biopsies before and after methotrexate therapy in rheumatoid patients. AB - The significance of hepatic changes in methotrexate-treated RA patients is unclear at this time. In our group of RA patients, there was a slight increase in the incidence of triaditis and fat during methotrexate therapy. Disease duration greater than or equal to 10 years was associated with increased hepatic triaditis before treatment. Age greater than 50 years was associated with increased hepatic fat before and after treatment. It appears that patients' ages and duration of underlying RA account for some changes, independent of methotrexate therapy. Several of our patients changed from higher to lower histologic grade or had an apparent decrease in fibrosis, fat, or triaditis on the pathologists' reports and the blind readings of the repeat biopsies. This may be explained by sampling error. More importantly, some of these changes may not be of clinical significance. One report of methotrexate-induced cirrhosis in patients with psoriasis demonstrated that in all but one of 14 patients who continued receiving methotrexate the cirrhosis decrease or did not progress. This may also be true of the hepatic fibrosis seen in RA after methotrexate treatment. In this study, there did not appear to be changes seen on pretreatment liver biopsy that were predictive of subsequent fibrosis or cirrhosis. Our data indicate that pretreatment biopsy is unwarranted in a population similar to ours. However, our practice has been to try to avoid methotrexate in patients with diabetes, prior liver disease, alcoholism, or obesity because of previous reports suggesting that these patients are at increased risk for the development of cirrhosis. Only the above-mentioned patient, eventually diagnosed as having cirrhosis, might have been handled differently. Including the study, none of the approximately 700 RA patients in the literature having liver biopsies after methotrexate therapy have developed cirrhosis consequent to its use. Most of these had received a total dose of approximately 1,500 mg in small weekly doses, and alcohol was prohibited. Below this cumulative dose the risk of clinically significant liver damage in carefully selected patients is very low. In view of this experience, the recommendation that RA patients have liver biopsies after 1,500 mg of methotrexate (a holdover from the psoriasis literature) may be too conservative in low-risk RA patients, provided methotrexate is administered weekly and alcohol is prohibited. Recognizing that the absolute need for biopsy is unproven, a more realistic milestone for those choosing biopsy might be after each 2,000 to 2,500 mg.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2772659 TI - Fetal disease. PMID- 2772660 TI - Reflections on future directions of perinatal medicine. AB - Up to the immediate past, and perhaps even to the present, a major difference between care of the fetus and of the neonate was the ability to examine directly the physical and biochemical traits of the unborn patient. In a span of time as short as perhaps 10 years it has become progressively possible to institute almost all neonatal investigative maneuvers to the fetus. In the last 5 years, the concept of treating the decreased fetus in utero has developed from a multitude of sources. The psychological, physical, and therapeutic barriers between the fetus and newborn are sharply eroded now, and may soon disappear. The impact on the advances discussed is likely to be very significant, since the near elimination of all late gestation (greater than 20 weeks) perinatal death is not unrealistic, and a major thrust in either preventing or ameliorating disease of genetic origin is at least worthy of serious contemplation. With each advance, either concrete or speculative, comes a need to reassign training priorities, professional self-definition, societal resources, and societal priorities. The distinct possibility of achieving near excellence in perinatal care exists. The possibility that society and its physicians would wish to ensure that such events are entirely desirable despite the cost is less certain. It is likely that the definitive confrontation will occur on this field. PMID- 2772661 TI - Osteogenic sarcoma: an update. PMID- 2772662 TI - Osteosarcoma: pathology and classification. AB - Osteosarcoma encompasses many different clinical, roentgenographic, and pathologic entities. Some of the tumors, but not all, have prognostic implications that have to be considered during the evaluation of the results of new treatment regimens. PMID- 2772663 TI - Cross-sectional imaging in the evaluation of osteogenic sarcoma: MRI and CT. PMID- 2772664 TI - The long-run cost characteristics of dental practices in the U.S.A. AB - The long-run cost structure of U.S. dental practices is analyzed using data collected in 1977 from a representative sample of U.S. dental practices. The practices were stratified by the number of dentists on staff before sampling. Participation rates by the sampled practices of different sizes were approx. 80% and the response rates for the data collection instruments ranged from 84 to 93%. Empirical results show that linear total and L-shaped average long-run cost curves best explain the cost structure of dental practices, indicating that dental technology exhibits constant returns to scale. Indivisibilities in production may cause firms with extremely small output to experience higher average costs than their larger counterparts. Any economies due to indivisibilities are exhausted at a rather small practice size. There is no evidence that large group practices have a substantial technical advantage over efficient one, two, and three dentist practices. PMID- 2772666 TI - Premature mortality and chronic alcoholism: medical examiner cases, New Jersey. AB - To obtain estimates of premature mortality from nonviolent causes associated with chronic alcoholism, median ages at death were calculated for 994 Essex County, New Jersey Medical Examiner cases aged 25 or older classified as (1) 'nonabusers' or (2) alcoholics whose underlying cause of death was natural disease and (3) those who died of chronic alcoholism. Alcohol-associated mortality accounts for considerable years of potential life lost. Differences in its life-shortening effects according to sex, race, and natural disease versus chronic alcoholism as underlying and/or contributing cause(s) of death are analyzed. Criteria for classifying cases as alcoholics were: (1) autopsy findings attributable to alcoholism; (2) case information that the decedent was a 'known alcoholic', or ever had any health or other related problems because of drinking; or, (3) alcohol-specific disease or condition attributable to alcoholism as underlying or contributing cause of death. Nonabusers were cases not classified as alcoholics and/or other drug abusers. Nonabusers had the oldest median age at death, followed by alcoholics who died of (1) natural disease and (2) chronic alcoholism. Female nonabusers were older than their male counterparts, whereas female alcoholics whose underlying cause of death was natural diseases or chronic alcoholism were younger than male alcoholics with the same underlying cause. Median age at death was considerably lower for blacks than whites in all subgroups, with consistently greater race than sex differences. Evidence is presented which supports the accelerated development of alcoholism symptoms and associated illness among women. Aspects of increased mortality risk among alcoholics with natural disease and/or chronic alcoholism as underlying or contributing cause(s) of death are discussed. PMID- 2772665 TI - Sentinel health events as indicators of unmet needs. AB - It is vitally important to be able to assess the impact of the health care system on the populations it serves. This paper explores whether sentinel health events- negative health states, such as death, disability, and disease, that might have been avoided given current medical and public health knowledge and technology- can be used as sociomedical indicators to assess levels of unmet needs and to evaluate health system performance. Using hospital discharge data, the occurrence of sentinel health events in New York State and differences among population subgroups are examined. Among hospitalized residents of New York State in 1983, more than 17,000 deaths occurred that were possibly avoidable. More than 336,000 instances of disease were found that were potentially preventable. Significantly higher rates and ratios for many sentinel events were found among blacks, Medicaid recipients, and users of public hospitals than were found for comparison groups. The sentinel events approach proved to be useful and practical. However, refinements and adaptations of the sentinel events method are needed, including the development of one or more smaller sets of indicators--tracer sentinel events -that can be used to profile aspects of health status and the health system. PMID- 2772667 TI - The impact of the physical environment on the psychological well-being of office workers. AB - This paper examines the relationship between the physical office environment and the psychological well-being of office workers. The results indicate that adverse environmental conditions, especially poor air quality, noise, ergonomic conditions, and lack of privacy, may effect worker satisfaction and mental health. The data also provide substantial evidence that worker assessments of the physical environment are distinct from their assessments of general working conditions, such as work load, decision-making latitude and relationships with other people at work. Stated another way, people who reported problems with the physical environment could not simply be characterized as dissatisfied workers exhibiting a tendency to 'complain' about every aspect of their working conditions. Taken together, these findings lend support to the position that the stress people experience at work may be due to a combination of factors, including the physical conditions under which they labor. Both theoretical and practical considerations arise from these data, including the need for work site based health promotion and stress reduction programs to consider both the physical and psychological design of jobs. PMID- 2772668 TI - Life events, meaning and narrative: the case of infidelity and divorce. AB - This article examines how three interviewees construct the meaning of the 'same' life events--marital infidelity and divorce--in radically different ways. All three narrate their experience, using narrative structures to reconstruct and interpret events and yet, because they have different points to make about the spouses' affairs and their divorces, they combine story elements in contrasting ways. Using narrative analysis, I show that what on the surface appear to be the same life events are, in fact, quite different events. I argue that stress research needs to attend more closely to the personal meanings of life events, and show how narrative methods can enrich studies of stress by illuminating how individuals make sense of difficult experiences. PMID- 2772669 TI - Professional life cycle changes and their effect on knowledge level of dental practitioners. AB - Utilizing a national data set (U.S.A.), the effect of age and age-related professional characteristics on dentists' knowledge with regard to prevention of infective endocarditis was examined. The following research questions were addressed: (1) Do age-related characteristics produce different effects on knowledge level at various stages of professional careers?; (2) What are the key changes in these age-related characteristics and what processes are suggested by these changes? Multiple regression analysis assessed the influence of potential predictors of variation in knowledge level with regard to prevention of infective endocarditis for the entire sample. Using these findings as a guide, variation in the effect of significant predictor variables was then analyzed for three time segments of approximately equal duration: early professional life less than 40, mid-professional life 40-54, and older professional life 55 or greater than. Age had a profoundly negative effect on knowledge level, i.e. the level progressively declines as clinicians grow older. The impact of the age-related characteristics on knowledge level of infective endocarditis prevention also varied according to the stage of the professional life cycle. Indices measuring the size or extent of theoretical understanding, in-office networks, institutional affiliations, and consulting networks were significant predictors of endocarditis prevention knowledge for younger clinicians. For those 40-54, only practice organization (office business and staff size and diversity) was a significant predictor, while for older clinicians theoretical understanding was the only significant predictor. Differences in the mean levels of these predictor (independent) variables across age groups were also examined via ANOVA.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2772670 TI - An empirical analysis of the dimensions of health status measures. AB - The objective of this study is to verify empirically the existence of separate dimensions in the overall concept of health status by analyzing 10 variables included in a questionnaire that was applied to all adults in a simple random sample of households in St John's, Newfoundland. The response rate was 85% for a total of 3300 subjects. These data were analyzed by frequencies and by associations with sex, age and education. Nonparametric correlation, factor and cluster analyses on variables were used to verify if health status had identifiable dimensions. All these methods produced similar results showing five distinct factors. The first factor is composed of variables related to disease (disability/chronic conditions/worry about health); the second, to happiness (happiness/emotional); the third, to subjective appraisal of health (physical condition/comparative level of energy/self-rated health status). Finally, the fourth and fifth factors were single variables; restriction of normal activities and social contacts. An interesting finding was that self-rated health status was distributed with almost equal weight in both the first and third factors. A validation of the 10 variables and the 5 factors was undertaken by studying their association with health care utilization. Two measures of utilization were used; number of physicians' visits in a year and number of hospital days in a 4-year period. Number of chronic conditions, disability and self-rated health status were associated with both measures of utilization; factor 1 was the only summary construct showing association with utilization. This paper demonstrates that self rated health status is valid as a single measure of overall health status in this sample, being associated with both disease and subjective assessment components. PMID- 2772671 TI - What diagnosis does not tell: the case for a noncategorical approach to chronic illness in childhood. AB - Medical training, practice and research are traditionally organized around body systems and disease categories. There is, however, a disciplinary split over the question of whether the clinical diagnosis is the central issue in describing an individual with an illness. Data from two studies, one institutional and one population based (The Pediatric Ambulatory Care Treatment Study and the National Health Examination Survey--Cycles II and III), are used to test the usefulness of diagnostic groupings in examining correlates of illness. A series of analyses of variance with the diagnostic groupings as the independent variable and a range of psychological, social and educational measures as the dependent variables reveal only the number of significant differences expected by chance. The only area in which a pattern of significant differences is found in the family's interaction with the health care delivery system. These results indicate that there is more variability within diagnostic groupings than between them and suggest that diagnosis is not a helpful categorization in the examination of psychological and social variables. While not surprising to social scientists, these data suggest the need for a major reorientation of the research paradigm when examining the psychological, social, rehabilitative and preventive issues raised by chronic illness in children and families. PMID- 2772672 TI - Drug use among Puerto Rican youth: an exploration of generational status differences. AB - An analysis of the relationship between generational status, or a migrational experience, and adolescent drug use takes advantage of a natural experiment--the migration of Puerto Ricans to the continental United States and their immigration back to the island. Although researchers have studied different sources of variation in adolescent drug use behavior, few have examined the drug use experience of the same ethnic group in varying sociocultural settings. The present study focused on the drug use involvement of four generational status groups of Puerto Rican adolescents in two different settings--New York City and San Juan, Puerto Rico. The groups surveyed in New York City were: New York Ricans (New York City-born Puerto Ricans) and New York migrants (island-born Puerto Rican adolescents). The two groups identified in Puerto Rico were: Puerto Rican islanders (adolescents who had never lived outside of Puerto Rico) and Puerto Rican immigrants (New York City-born youngsters of Puerto Rican parentage whose families had returned to live on the island). In this study, it was hypothesized that the more the perceived environment dimensions of the different generational status groups have characteristics conducive to drug use, the greater the drug use involvement of the groups will be. The analysis confirmed that the drug use involvement of the four groups of Puerto Rican adolescents paralleled the exposure of the groups to a host society, New York City, which has a higher prevalence of adolescent drug use than the culture of origin, Puerto Rico. In addition, it was found that the longer New York migrants lived in New York City, the greater was their drug use involvement. The roles of various other sociodemographic factors (i.e. gender, grade level, family structure and socioeconomic status) in relation to adolescent drug use were also investigated. Two important conditional relationships were documented. First, the impact of length of time living in New York City varied with the adolescent's gender, with higher risk of drug involvement observed for female migrants. Second, socioeconomic status was associated with Puerto Rican adolescents' drug use involvement in the New York City subgroups, but not among the students in Puerto Rico. PMID- 2772673 TI - [Detection of group characteristics and contamination with microorganisms]. AB - Evidence of group properties in traces and residues of human origin may be very difficult; very frequently in the same individual controversial results are obtained in different tissues but also in the same samples during repeated examinations. This was revealed by examinations of reliets from prehistorical findings as well as in remains of Czech historical personalities and contemporary important forensic cases, using different methods of detection, incl. the absorption elution test. The author discusses the condition of investigated residues and traces, the degree of decomposition of tissues due to the possible action of microorganisms with regard to assessment of group properties. The investigation revealed that in addition to the anticipated action of some microorganisms contaminating examined tissues, different transformation of group properties of the sample, and panaglutinability or disintegration of the entire ABO system, a possible effect of the organism's own serological activity of microorganisms on results must be also taken into account. Examination of different tissues of the individual, and if the results are controversial, examination of group properties of cultivated microorganisms makes it possible to eliminate to a certain extent the artificial component of results and makes the conclusions more accurate and helps to explain the interpretation of results. PMID- 2772674 TI - HIV infection from casual contact. PMID- 2772675 TI - Are missionaries at risk for AIDS? Evaluation for HIV antibodies in 3,207 protestant missionaries. AB - Serum specimens (n = 6,045) obtained from 3,207 Protestant missionaries serving in 57 countries, including 28 African nations, between 1967 and 1984 were assayed for antibodies to the human immunodeficiency virus (HIV) by enzyme-linked immunosorbent assay (ELISA) screening and Western blot confirmatory testing. Seventy sera (1.2%) from 51 missionaries (1.6%) were ELISA positive; however, on Western blot confirmatory testing none was diagnostic of HIV infection. Twenty two (43%) of the Western blot tests were read as indeterminate, with band p17 occurring with the greatest frequency (57%), followed by p24 (23%), either alone or in combination. The significance of these equivocal results is unclear, but they do not appear to be a consequence of exposure to either HIV or the related retrovirus HTLV-I. Based on this seroprevalence survey, we conclude that missionary staff and their families were not at high risk of HIV infection between 1967 and 1984, even when serving in regions of high HIV endemicity. PMID- 2772676 TI - Human immunodeficiency virus: risk of exposure among health care workers at a southern urban hospital. AB - To assess the risk of exposure to the human immunodeficiency virus (HIV) among health care workers in a southern urban setting, random screening for antibodies to HIV was undertaken. Patients who were admitted for major trauma, for medical emergencies, or in labor were screened. Of 534 sera screened, 11 (2%) were seropositive. All but two of the seropositive patients were men. Rates were similar among black and white patients. Seven patients could be placed into an established risk group, but only one patient was known to have AIDS upon presentation to the emergency room. The mean age of seropositive individuals was 30.9 years; there were similar seroprevalence rates in each of four age groups among men. We conclude that there is a substantial risk of exposure to HIV in trauma and medical emergency centers; therefore all health care workers should practice universal barrier precautions whenever exposure to a patient's blood or body fluids is likely. PMID- 2772677 TI - Seizure disorders and trauma. AB - The prevalence of seizure disorder diagnosis in the general population is between 0.5% and 2.0%. Seizures may be manifested by abnormal motor activity, loss of muscle tone, and changes in mental status. Seizure may increase an individual's risk for traumatic injury by adversely influencing performance in a particular situation. We identified 30 patients admitted to our trauma service over a three year period with injury related to seizure; 16 were male and 14 were female, with a mean age of 34.8 years. Twenty-eight patients (93%) had a history of seizure activity, with the mean duration of seizure activity of 16.5 years (range, three to 40 years). Both seizure diagnosis and etiology were multifactorial. Multiple drug therapy predominated, phenytoin (Dilantin) being the most frequently used medication. Overall compliance was poor (53%). Only blunt injury occurred in these patients, 50% suffering injury from falls. Injuries from motor vehicle accidents (40%) were the next most frequent (auto crash in seven cases, motorcycle crash in four, and bicycle crash in one case). The remainder of the injuries were burns (10%). Nine patients (30%) required operation. Skeletal injuries predominated (67%). Patients with a history of seizure will be frequently encountered by physicians of all specialties. The patients likely to be at increased risk for injury are noncompliant, have breakthrough seizures (ie, despite therapy), or have the metabolism of their seizure medication altered by alcohol or other drugs. To prevent potentially serious injury, these patients should be identified and counseled. PMID- 2772678 TI - Necrotizing enterocolitis: improving survival within a single facility. AB - Necrotizing enterocolitis (NEC), a disease associated with prematurity, carries a significant morbidity and mortality. This study was designed to evaluate our progress in dealing with NEC both medically and surgically in a single large neonatal intensive care unit (NICU). We also sought to confirm the relation of birth weight and particular indications for operation to outcome. Over 6 1/2 years, there were 7,807 admissions to a large NICU. Though there has been a steady increase in total admissions, especially of infants weighing less than 1,000 gm, survival has improved significantly in all groups (mean 89.1%). NEC occurred in 358 infants (4.6%), and 115 (32%) required surgical intervention. Infants weighing between 751 and 1,000 gm had the highest incidence of NEC. There has been a significant decrease in the mortality of both medically and surgically treated infants with NEC; in both cases, this decrease is weight-dependent. We found that using erythema and edema of the abdominal wall and a fixed-loop roentgenographic pattern as early indicators of necrotic bowel significantly improves survival in surgically treated infants. PMID- 2772679 TI - Hematologic complications of gastric bypass for morbid obesity. AB - Of 530 patients who have had a gastric bypass operation for morbid obesity at Allegheny General Hospital, 41 had decreases in serum iron, vitamin B12, and/or folate levels. These abnormalities were detected eight months to eight years (median, two years) after the operation. The hemoglobin level ranged from 7.4 to 14.1 gm/dl at the time of detection, and mean corpuscular volume (MCV) ranged from 58 to 119 cu microns. The most common problem was combined iron and vitamin B12 deficiencies. Physicians should be aware that folate, vitamin B12, and iron deficiencies occur after gastric bypass, though the time to development is variable. Hemoglobin level and MCV are not predictive of these deficiencies. PMID- 2772680 TI - Pulmonary thromboembolism after head and neck surgery. AB - In a retrospective study of all patients who had pulmonary embolism during a 37 year span at M. D. Anderson Hospital, we identified 502 patients, 30 of whom had a primary malignancy in the head and neck region. Only five of these patients had a clinically significant pulmonary embolus during the immediate postoperative period; these patients are the subject of a more detailed review with a case study as an example. Three of these patients died. Heart disease was identified as the most common predisposing factor. We review the results of this clinical study of pulmonary thromboembolism in patients having head and neck surgery as well as the natural history, diagnosis, and current treatment of pulmonary embolism. PMID- 2772681 TI - Hypomagnesemia and hypertension in primary hyperparathyroidism. AB - A retrospective study of 89 patients with surgically proven primary hyperparathyroidism was done to gain insight into the pathogenesis of hypertension associated with this condition. The 43 patients (48%) who were hypertensive did not differ significantly from the normotensive patients with regard to age, sex, serum calcium and phosphate levels, and creatinine clearance. However, the mean serum magnesium level was significantly lower in hypertensive hyperparathyroid patients (1.52 +/- 0.24 mEq/L) than in normotensive hyperparathyroid patients (1.76 +/- 0.18 mEq/L; P less than .001), irrespective of use of diuretics in the former group. Although some studies implicate hypomagnesemia in the pathogenesis of essential hypertension, we are unaware of any previous human study reporting a link between hypomagnesemia and hypertension associated with primary hyperparathyroidism. This study suggests that a low level of serum magnesium may play a role in the pathogenesis of hypertension associated with primary hyperparathyroidism, a finding that needs further evaluation. PMID- 2772682 TI - Group C beta-hemolytic streptococci causing pharyngitis and scarlet fever. AB - After a young woman had scarlet fever associated with group C beta-hemolytic streptococcal pharyngitis, we reviewed all cases of pharyngitis treated at a student health clinic during that semester. From 541 cases of pharyngitis, 34 cultures yielded group C Streptococcus. The patients who harbored group C organisms were similar to the patients with group A streptococcal pharyngitis in the presence of fever, exudate, and cervical adenopathy. The severity of symptoms and the demonstration of scarlet fever developing from infection with this organism supports antibiotic treatment of patients with group C streptococcal pharyngitis. PMID- 2772684 TI - Fatal injuries in Oklahoma: descriptive epidemiology using Medical Examiner data. AB - To characterize mortality associated with injuries and other health problems in Oklahoma, we examined data from the Office of the Chief Medical Examiner of the State of Oklahoma for the years 1978 through 1984. Each year, approximately 1,500 and 800 deaths resulted from unintentional injury (UI) and intentional injury (ie, suicide and homicide), respectively. The medical examiner (ME) data differed substantially from the state's vital statistics (VS); over the seven years, the ME records showed 2,021 (16%) fewer UI deaths than did the VS, as well as 24 (1%) more cases of suicide and 499 (23%) more cases of homicide. Rates for UI and suicide were highest for young adults and for the elderly; in contrast, rates for homicide were highest for young adults, and then decreased with age. For each of the three categories of injury-related deaths, rates for male subjects were approximately three times those for female subjects; rates also varied by race ethnic group. Deaths due to UI and homicide occurred more often in the summer and on weekends, though suicides did not vary by month and were slightly more common on weekdays. This study indicates that ME data represent an important source of epidemiologic information for the surveillance and study of injury-related mortality. PMID- 2772683 TI - Cerebrospinal fluid cell counts and chemistries in bacterial meningitis. AB - We evaluated the records of 428 patients with bacterial meningitis to document initial cerebrospinal fluid (CSF) findings and detail their changes during therapy. Compared to patients with an initial polymorphonuclear cell predominance in the CSF, patients with initial CSF lymphocytosis had lower CSF leukocyte counts, milder CSF chemical abnormalities, and a lower frequency of positive CSF Gram stains and cultures. These findings suggest that CSF lymphocytosis may represent an early phase of infection. A low CSF leukocyte count was associated with a poor outcome, presumably reflecting an inadequate host response to infection. The CSF white cell count increased during the first 24 hours of therapy in 45% of cases. Morbidity and case fatality rates were not significantly increased in this group, suggesting that an initial rise in the CSF leukocyte count does not reflect a poor response to therapy. PMID- 2772685 TI - Amputation of the distal portion of the foot. AB - For 101 patients, initial amputation of 124 extremities involved some distal portion of the foot. Amputations done for atherosclerosis healed in eight of 21 cases (38%), compared with 40 of 77 extremities (52%) in diabetic patients. Presence of cellulitis (44 cases) and absence of a popliteal pulse (44 cases) had no significant effect on success of amputation, but a palpable foot pulse was significantly associated with a successful outcome (29/35 cases, or 83%) (P less than .005). Serial amputations to preserve the foot were successful for 18 of 31 extremities (58%), a success rate equal to that of the entire series, 72 of 124 (58%). Attempts to preserve viability in the distal portion of the foot were not associated with mortality. Cellulitis and absence of a distal pulse are not contraindications to attempting preservation of the extremity, although the best results occur when distal extremity pulses are palpable. In nearly six of every ten cases, amputation of the distal portion of the foot resulted in a successful outcome. PMID- 2772686 TI - Diagnosis. AB - The emotional significance of diagnosis to patients must not be overlooked in medical therapeutics. Many cases require successful interaction with the patient about what is wrong before treatment can succeed. Treatment failure is often based upon a misunderstanding between patient and doctor about the nature of the problem to be treated. PMID- 2772687 TI - Squamous cell carcinoma infiltrating a pancreatic pseudocyst. AB - We have described a case of primary squamous cell carcinoma infiltrating a pancreatic pseudocyst, and have discussed pancreatic neoplasms arising in association with pseudocysts. PMID- 2772688 TI - Acute coronary artery thrombosis in paroxysmal nocturnal hemoglobinuria. AB - We have reported a case of coronary artery thrombosis in a 36-year-old man with paroxysmal nocturnal hemoglobinuria (PNH), a potentially lethal thrombotic complication not previously documented in this unique patient population. Although the etiology of PNH remains unknown, the pathogenesis appears to be related to the deficiency of a specific membrane complement-regulatory protein, decay accelerating factor. Coronary artery thrombosis must now be added to the list of potential life-threatening thrombotic complications. PMID- 2772689 TI - Granulomatous myocarditis with unusual histologic features. AB - A 61-year-old white man was found to have granulomatous myocarditis associated with a carcinoid tumor in the ileum with local lymphatic metastasis, a mixed papillary and follicular carcinoma of the thyroid with regional lymph node metastasis, benign tubular cell adenomas of the kidneys, and chronic pancreatitis. PMID- 2772690 TI - Focal glomerulosclerosis in Hodgkin's disease necessitating peritoneal dialysis. AB - A 16-year-old white boy had nephrotic syndrome due to focal segmental glomerulosclerosis six months before the diagnosis of Hodgkin's disease was established. Peritoneal dialysis was necessary for volume control after one month of unsuccessful therapy with high doses of corticosteroids. Nephrosis remitted after two courses of chemotherapy. PMID- 2772691 TI - Adrenal insufficiency in AIDS. PMID- 2772692 TI - Cocaine-associated acute myoglobinuric renal failure. PMID- 2772693 TI - Ibuprofen-induced lithium toxicity. PMID- 2772694 TI - Dengue fever in American military personnel in the Philippines: clinical observations on hospitalized patients during a 1984 epidemic. AB - From June - August, 1984, 24 American military personnel were hospitalized with dengue (DEN) at Clark Air Base in the Philippines. Their infections were confirmed by serology using the hemagglutination-inhibition test and/or by virus isolation in Aedes pseudoscutellaris cell cultures. Most of the patients had a secondary type of antibody response probably reflecting prior vaccination against yellow fever. Three serotypes of DEN virus were isolated; 7 isolates of DEN 1, 4 isolates of DEN 3 and 3 isolates of DEN 2. All of the patients were Caucasian males between the ages of 20-43 years. All of the cases were clinically diagnosed as classical dengue fever. A platelet count of less than or equal to 100,000/microliters was a common finding (83.3%); however, hemoconcentration was not documented. Other major findings were the occurrence of mild hypotension (62.5%) and petechiae (37.5%). One patient presented with shock and upper gastrointestinal bleeding, but his diagnosis was complicated by a history of epigastric pain and use of aspirin. Although all of the patients fully recovered, the severity of illness was clearly documented by the average-length of hospitalization (5.9 days) and average time absent from work (8.7 days). PMID- 2772695 TI - A new intestinal fluke, Plagiorchis harinasutai n.sp. AB - Dilution-sedimentation examination of stool specimens from four opisthorchiasis patients treated with praziquantel led to the discovery of six Plagiorchis worms. This is the first known report of plagiorchis infection in man in Thailand. The morphological features differed from those of previously described Plagiorchis species indicating that these worms belong to a new species, which we designated as Plagiorchis harinasutai n.sp. in honour of Professor Chamlong Harinasuta, former Dean of the Faculty of Tropical Medicine, Mahidol University, Bangkok. The holotype is held at the Museum and Reference Centre. Paratypes are held in the Bangkok School of Tropical Medicine, Faculty of Tropical Medicine, Mahidol University. PMID- 2772696 TI - In vivo efficacy of levamisole against larval stages of Angiostrongylus cantonensis and A. costaricensis. AB - Anti-larval effects of levamisole were examined on A. cantonensis in rats and A. costaricensis in mice. 1) In rats inoculated with 40 infective larvae of A. cantonensis: Compared with a non-treated control group, a significant reduction in number of worms recovered was seen in the group receiving a single dose of 1.0 mg/kg or more. A significant decrease in host lung-body weight ratio was seen in the group receiving drug of 3.0 mg/kg or more. 2) In mice inoculated with 20 infective larvae of A. costaricensis. In the non-treated control group, a severe loss in body weight and death of host animals were observed. A single dose of 30 mg/kg on 3, 4 or 5 days post-infection remarkably inhibited these changes. At 30 mg/kg for 3 or 7 days levamisole was more effective than a single dose of the drug. These results suggest that levamisole has conspicuous in vivo effects against larval stages of A. costaricensis as well as A. cantonensis. PMID- 2772697 TI - Preparation of monoclonal antibody against Angiostrongylus cantonensis antigen. AB - Monoclonal antibodies (MAb) against A cantonensis were produced through fusion of immunised spleen cells from BALB/c mice with NS-1 myeloma cells at a ratio of 10:1. The successful fusion rate on the 3rd day of fusion was 90.1%. Ten MAb were characterised, six of which were IgG1 and the remaining four were IgG2a, IgG2b, IgM and IgA respectively. Among 6 IgG1 MAb, four were A. cantonensis-specific, of which three reacted to adult worm antigen only and one reacted to both adult worm and juvenile worm antigens. Two other IgG1 MAb showed cross-reaction with other helminthic antigens of Toxocara canis. Ascaris suum. Paragonimus westermani, Dirofilaria immitis, Anisakis Spp, Gnatostoma Spinigerum and Clonorchis sinensis. PMID- 2772698 TI - Foodborne disease outbreaks of chemical etiology in Thailand, 1981-1987. AB - A study was conducted to determine the current situation of chemical foodborne outbreaks in Thailand for the period 1981-1987. Seventy-three outbreaks of chemical poisoning involving 1236 persons of whom 54 died were reported. Twenty outbreaks affecting 722 cases were caused by insecticide poisoning and methomyl was the most commonly recognized insecticide involved. Poisonous plants were responsible for 43 outbreaks with 420 cases. Mushroom poisoning was the most common entity (21 outbreaks, 211 cases), with plant seed poisoning next (9 outbreaks, 179 cases). There were 8 outbreaks following consumption of poisonous seafoods. Mussels were identified to be the vector in the outbreak of PSP. Horseshoe crabs which served as the vehicles for 4 outbreaks were also suspected to be associated with PSP. Puffer fish accounted for the remaining 3 outbreaks involving 6 cases of tetradotoxin poisoning. More complete reporting and more effort in outbreak investigations are needed for appropriate preventive and control measures. PMID- 2772699 TI - Alteration in Aedes togoi susceptibility to Brugia pahangi microfilariae induced by Aedes albopictus thoracic homogenate. AB - Refractoriness to Brugia pahangi microfilarial infection could be induced in the normally susceptible Aedes togoi mosquitoes by intrathoracic injection with crude thoracic homogenate of the refractory Aedes albopictus mosquitoes. The crude thoracic homogenate contained three Sephadex G-200 protein profiles of which the first profile showed strongest inhibition to the parasite development. PMID- 2772700 TI - A comparison of methods for the isolation of Campylobacter species from stool specimens. AB - Eight methods used for isolation of Campylobacter species were compared. Using a combination of methods Campylobacter species were isolated from 30 (11%) of 270 children with diarrhea seen at Bamrasnaradura Infectious Disease Hospital, Nonthaburi, Thailand. The membrane filter method using a gas generating envelope at 37 degrees C identified 73% of the total positive specimens and was found to be the best isolation method for Campylobacter species from stool specimens. This method identified two strains that failed to grow on antibiotic containing media, and also gave a higher isolation rate of C. jejuni than could be isolated with conventional methods. The combination of the membrane filter method and a selective antibiotic method identified 90% of all isolates. At present the cost of the membrane filter method is higher than other methods. Therefore, the selective antibiotic method (Campy-BAP) with sheep blood under gas mixture at 42 degrees C is recommended for laboratories with limited supplies. Diagnosis by direct smear with 1% basic fuchsin revealed high degree of sensitivity and specificity. This rapid, inexpensive, and simple method could be used to make a presumptive diagnosis of Campylobacter enteritis when isolation methods are unavailable. PMID- 2772701 TI - A field survey on the role of low-density microfilaraemia cases in the transmission of filariasis. AB - In former filariasis endemic areas, where the disease has been basically controlled, a few cases of low-density microfilaraemia remain. A survey was carried out in Deqing County, Zhejiang Province, from September 1981 to 1986 in order to determine whether such cases play a role in the continuation of transmission. The results of parasitological and entomological investigations for two consecutive years revealed that after the implementation of intervention measures, the mean microfilaraemia rate in the population fell to about 0.5% and the mean microfilaria density to about 4.2 mf/60 microliter of blood in previously endemic areas of malayan filariasis. Although there were considerable numbers of An. sinensis biting humans, infective larvae could be found in only two positive mosquitoes out of 5,484 dissected, and no new microfilaraemic cases were detected in the 1983 and 1986 follow-up blood examinations, indicating that transmission had already been interrupted. Two volunteers with a microfilaraemia of 3-5 mf/60 microliter of blood were exposed to two batches of An. sinesis in August 1981. The engorged mosquitoes were dissected eight days later. Even though the infection rate of An. sinensis having fed on low-density microfilaraemic cases was as high as 16.8%, the intensity of infection was extremely low, being 1.1 mf/mosquito. From the transmission dynamics point of view, infected mosquitoes carrying very few infective larvae have no practical significance in the transmission of filariasis. It is suggested that the treatment of persons with low-density microfilaraemia (with 5 mf/60 microliters of blood) in areas with low microfilaria rates (less than 1%) need not to be considered as essential. PMID- 2772702 TI - Platelet function during the acute phase of dengue hemorrhagic fever. AB - Platelet aggregation, plasma betathromboglobulin (BTG) and platelet factor 4 (PF4) were studied in 35 children with dengue hemorrhagic fever. The suppression of platelet aggregation was demonstrated during acute phase of DHF in both shock and non-shock patients. Simultaneous with abnormal platelet aggregation, there was increased release of BTG and PF4 from platelets into plasma during the acute phase which lasted only 3-4 days after shock or subsidence of fever. Acute phase plasma during DHF infection was also shown to have a stimulatory effect on the aggregation of autologous platelets. In this study we showed that there was an increase in platelet secretory activity of BTG and PF4 along with an impairment of the platelet aggregation during acute phase of DHF. PMID- 2772703 TI - Dose finding studies of procholeragenoid in Thai volunteers. PMID- 2772704 TI - Malaria prophylaxis with doxycycline in soldiers deployed to the Thai-Kampuchean border. AB - A battalion of Royal Thai Marine militia was assigned to take either 50 mg or 100 mg of doxycycline daily or pyrimethamine/dapsone weekly for malaria prophylaxis on the Thai-Kampuchean border for a 17 week period. Attack rates for the groups expressed as cases/100 men were 34 for 50 mg doxycycline, 18 for 100 mg doxycycline, and 52 for pyrimethamine/dapsone. The relative efficacy of the two doxycycline regimens compared to Maloprim were 1.6 and 1.4. Compliance with the daily drug nearly equalled that of the weekly regimen. This suggests that 100 mg of doxycycline daily can be effectively used for malaria prophylaxis by soldiers under operational conditions on the Thai-Kampuchean border. PMID- 2772705 TI - Determination of quinine and quinidine in biological fluids by high performance liquid chromatography. AB - A simple, specific, rapid and sensitive High Performance Liquid Chromatography (HPLC) method has been developed to measure plasma level of quinine and quinidine. The drugs were extracted successively from plasma at basic pH with chloroform and quantified on a revers-phase Z-module C18 HPLC column with fluorescence detector (excitation 340 nm, emission 425 nm). The isocratic mobile phase used was the mixture of 0.05 M ammonium formate and acetonitrile (93.5:6.5, v/v), adjusted pH to 2.0 with ortho-phosphoric acid. The limits of quantitation for these compounds were as low as 4 ng/ml of plasma, using a 0.25 ml specimen. Calibration curves were linear (R squared = 0.9994) in the range 0-7,000 ng/ml. An interassay reproducibility was 6.8%, 0.3% and 1.2% at the concentrations of 250 ng, 4,000 ng and 8,000 ng of quinine, respectively. Inter-assay coefficient of variation of quinidine was 1.8%, 2.7% and 3.7% at the concentrations of 250 ng, 1,500 ng and 3,000 ng, respectively. Recovery of quinine and quinidine were 76% and 81%, respectively. The method has been used in the analysis of quinine and quinidine in healthy volunteers receiving quinine or quinidine intravenously. The method is now being used to assay samples from field studies with satisfactory results. PMID- 2772706 TI - The determination of anti-Toxoplasma gondii antibodies in different IgG subclasses of human sera by the enzyme-linked immunosorbent assay (ELISA). AB - The level of activity of the 4 IgG subclasses in toxoplasmosis were determined in an ELISA employing commercially available monoclonal antibodies to the 4 subclasses. Forty-four sera positive by IgG-ELISA and 73 negative sera were tested for IgG subclass activity. IgG1 was found to be the predominant subclass while IgG3 and IgG4 were probably produced at low but significant levels in sera which were positive for IgG antibodies. The significance of the results were discussed. PMID- 2772708 TI - Characterization of antigens of Paragonimus miyazakii by ELISA. AB - The characterization of adult worm and excretory-secretory (ES) antigens of P. miyazakii was performed with a sandwich enzyme-linked immunosorbent assay (ELISA) IgG and Fab' fragments were prepared from P. miyazakii-infected rat sera. The former was purified by affinity column chromatography. The latter was prepared from IgG2c by passage through a Protein A affinity column, then conjugated to horseradish peroxidase. Cross-reactivity of the ELISA with Fasciola hepatica. Fischoederius elongatus. Taenia saginata. Schistosoma mansoni and S. Japonicum was negligible. With Paragonimus westermani, the same genus as P. miyazakii, cross-reactivity was below 30%. The molecular weight of both antigens was comparable (36,000) as determined by Sephadox G-100 gel filtration. Isoelectric points in both antigens had many peaks in a pH range of 3.9-4.7. In adult worm, pI of the major peaks were 4.6 and 4.7 and minor part of peaks had the common isoelectric points with four ES peaks in a pH range of 4.1-4.6. Antigenicity per protein concentration of both antigens was examined by the ELISA. The ES antigen was about five times as active antigenically as adult worm antigen. These results suggest that ES is one of the major antigens inducing antibody synthesis in rats infected with P. miyazakii, and that other antigens may be present within the adult worm. PMID- 2772707 TI - Circumoval and larval microprecipitation reactions in experimental and human gnathostomiasis. AB - Mice, rats and cats were infected either orally or percutaneously with a number of early or advanced third-stage larvae (EL3 or AL3, respectively) of G. spinigerum. Sera obtained from these infected animals and 10 human gnathostomiasis cases were tested against various developmental stages of the parasite which were prepared and used while being alive (fresh) or dead (air dried) for the circumoval and larval microprecipitation (COP and LMP) reactions. No precipitin reactions were observed in all sera tested against unembryonated eggs, embryonated eggs and first stage larvae neither air-dried nor fresh preparations. Sera were merely reactive giving various degrees of membranous or filamentous precipitates against the air-dried preparation of AL3. PMID- 2772709 TI - Human pathology of Opisthorchis viverrini infection: a comparison of adults and children. AB - The pathology of human opisthorchiasis in 22 adults (20 to 68 years) and 7 children (7 to 15 years) at autopsy is described. The changes of the liver in adults and children are similar and are summarized as follows: Enlargement of the liver was a common finding. Pericholangitis was observed in most cases. The pathology was confined to the large and medium-sized bile ducts where the flukes inhabited. The small interlobular bile ducts had minimal or unremarkable changes. Dilatation of the bile ducts with hyperplasia, desquamation and proliferation of the bile duct epithelial cells, glandular formation and fibrous connective tissue infiltration of the walls were the most common features. The pathological changes were well established within 7 to 15 years. Dilatation of the gallbladder, chronic cholecystitis and carcinoma were found only in adults. Eight of ten cases were cholangiocarcinoma and two were hepatocellular carcinoma. PMID- 2772710 TI - Scoliosis Research Society, 23rd annual meeting. Baltimore, Maryland, September 29-October 2, 1988. PMID- 2772711 TI - The current status of scoliosis screening in North America, 1986. Results of a survey by mailed questionnaire. AB - In May, 1986, 374 questionnaires on the multiple aspects of school screening for scoliosis were mailed to health care professionals throughout North America. An overall response rate of 73% provided objective information about screening efforts. Results showed that although there is great variability among the programs, at least some screening is done in each of the 50 United States and the District of Columbia. Previously widespread in Canada, only two Provinces currently are officially engaged in screening, Alberta (research projects only) and Prince Edward Island. The most common target population seems to be grades five through nine for both boys and girls. Lack of funding appears to be the largest factor hampering data collection. Although many varied comments and suggestions were received, most called for: 1) new recommendations for screening boys and girls at different grade levels; 2) quantitative referral criteria; 3) improved data gathering: 4) statewide uniformity within programs; and 5) improved understanding within the medical community about indications for referral and the principles of scoliosis treatment. PMID- 2772712 TI - The contribution of the three columns of the spine to rotational stability. A biomechanical model. AB - A function of the spine as a structural column is its ability to resist torsion. The goal of this study was to evaluate the contribution of the columns of the spine to torsional rigidity. Ten human cadaver spines were harvested and frozen. The specimens, consisting of segments from T11 to S1, were subjected to torsional loads of up to 20 N-m. Rotation was recorded throughout the loading cycle. The columns of the spine were destroyed at the L2-3 interspace in a predetermined fashion and loading was repeated. The data were plotted as torsion versus rotation in degrees. The curves of each loading cycle were compared and the ratios of the intact and compromised specimens were calculated. The contribution of each column of the spine to torsional rigidity was determined. In an intact lumbar spine, the anulus was the most effective structure in resisting torsion. Experience gained in this study supports the following conclusion: Flexion distraction injuries of the thoracolumbar and lumbar spine involving soft tissue destruction of the anterior column and anulus result in rotational instability. PMID- 2772713 TI - The effect of magnetic resonance imaging on metal spine implants. AB - In Part 1 of this study, the forces and torques exerted on metallic spine implants by a 0.3-T magnetic field were evaluated using a cantilever system sensitive to forces as low as 250 mg and torques as low as 4 g/cm. Results indicated that the 0.3-T magnification field did not cause forces or torques that could be measured within this range. It is concluded that patients with spine implants may safely undergo magnetic resonance scanning. In Part 2, the magnetic resonance scans from 33 patients (61 studies) then were reviewed to determine which, if any, parameters could be adjusted to minimize artifact. Magnetic power, slice thickness, plane of scan, and pulse sequence were considered. Plane of scan was found to be the most significant parameter in achieving useful studies, with the sagittal plane being the preferred orientation. Scans of patients who had posterior wiring were more likely to be useful, while scans of patients with spinal rods usually showed a large amount of artifact. PMID- 2772714 TI - Effects of spinal cord lesioning on somatosensory and neurogenic-motor evoked potentials. AB - Somatosensory (SEPs) and neurogenic-motor evoked potentials (NMEPs) were elicited from 16 hogs and two humans before, during, and after spinal cordotomy, dorsal, or ventral root rhizotomy. Results indicated that SEPs appear to be insensitive to the effects of motor tract lesioning in hogs and humans. In every case of motor paraplegia, SEPs remained unchanged in the presence of abnormal ischiatic/sciatic NMEPs. These results suggest that SEPs are not adequately sensitive to the functional status of the motor system in hogs and humans. Ischiatic/sciatic NMEPs remained unchanged after sensory tract lesioning, suggesting that these NMEPs are insensitive to the functional status of the sensory system. These results suggest that SEPs and NMEPs should be used in combination when monitoring spinal cord function during surgeries that place that structure at risk. PMID- 2772715 TI - Transcranial magnetic motor evoked potentials (tcMMEP) for functional monitoring of motor pathways during scoliosis surgery. AB - Transcranial magnetic motor evoked potentials (tcMMEP) were used to assess the functional integrity of the descending motor pathways. The tcMMEP, recorded bilaterally from anterior tibialis muscles, were evoked by an electric current induced in the motor cortex by a high-intensity transient magnetic field applied to the scalp surface. Potentials were recorded from ten of 12 volunteer subjects and preoperatively in 11 of 11 scoliotic patients. Group mean latency in the volunteers (32.0 +/- 2.1 msec) did not differ from that of the scoliotics (28.6 +/- 5.0 msec), but values in the latter group were more variable. During nitrous oxide-narcotic anesthesia, tcMMEP with reproducible latencies were obtained in 9 of 11 (82%) cases. A small, but statistically significant, increase in latency occurred during anesthesia. Compared with preoperative values (523 +/- 490 microV), individual tcMMEP amplitudes were significantly decreased intraoperatively (163 +/- 153 microV). Although the absolute amplitudes varied widely, the minimum recorded value was over 20 microV. Thus, intraoperative tcMMEP waveforms were readily discriminable from background electrical noise. These results demonstrate the technical feasibility of intraoperative tcMMEP monitoring. Combined somatosensory evoked potential and tcMMEP monitoring may provide a more complete picture of spinal cord function, intraoperatively. PMID- 2772716 TI - Compound muscle action potentials and spinal evoked potentials in experimental spine maneuver. AB - In this study, the authors evaluated the effects of spine manipulations, similar to those used in scoliosis surgery, on the compound muscle action potential (CMAP) and spinal evoked potential (SEP) in 25 cats: a distraction maneuver was performed in ten, a rotation in five, and a combined (distraction and rotation) procedure in ten cats. Compound muscle action potential was only minimally changed by the rotation maneuver alone in all five cats. Distraction resulted in earlier deterioration of CMAP than SEP; when CMAP was no longer elicitable in ten cats, seven still showed measurable SEP. All ten cats became paraplegic. With the combined procedure, both CMAP and SEP were abolished earlier than with distraction alone. This was observed in all ten cats becoming paraplegic. The authors further extended the study to ten rabbits having experimentally induced scoliosis. Following corrective surgery with distraction and derotation, eight rabbits lost both CMAP and SEP. Two lost CMAP with still recordable SEP. All ten rabbits became paraplegic. These findings suggest that monitoring CMAP is a more sensitive measure than SEP, and that the spinal cord is more vulnerable to a combined distraction and derotation maneuver than to either one alone. PMID- 2772717 TI - Scoliosis induced by anterior and posterior rhizotomy. AB - This paper presents the result and statistical analysis of an experiment in which selective anterior or posterior rhizotomy was carried out under microscopic surgery. The animals used for the experiment were 48 young rabbits, and they were divided into four groups. Group 1, which was used as control, was subjected to lower dorsal bilateral laminectomies with dural incision; Group II to laminectomies with three right posterior rhizotomies; Group III to laminectomies with three right anterior rhizotomies, and Group IV to laminectomies with three right anterior and posterior rhizotomies. Scoliosis was induced in Groups II, III, and IV. There was no significant statistical difference in the degree of curvatures among these three groups. The convexity of the curvature faced to the side of the divided roots. In Groups III and IV, scoliotic curvatures were obvious within 2 weeks, but there were no considerable changes thereafter. In Group II, the curves progressed slowly up to the 12th week. They were statistically significant at the fourth week and increased continuously thereafter. The histologic findings in Groups III and IV showed denervation atrophy of the paravertebral muscles at the apex of the curvature, but there was little or no muscle atrophy in Groups I and II. The experimental results indicate that scoliosis may be induced not only by anterior root paralysis but also by selective posterior root paralysis. PMID- 2772718 TI - An experimental study on spinal cord traction effect. AB - An experimental study was carried out on the pathophysiology of spinal cord traction injury. In 50 dogs, spinal cord traction impairment was created by gradual lumbosacral cord traction. Physiologic integrity of the spinal cord was monitored and recorded by the spinal evoked potentials. With greater traction force, the potentials gradually lessened in amplitude. The vulnerability of the spinal cord to compression force was increased by spinal cord traction. Under 200 g traction, the vulnerability of the lower thoracic cord was most increased. The authors conclude that tethered cord syndrome is caused by the impairment of the spinal cord and lumbosacral roots due to traction, and that spinal cord traction not only causes spinal cord impairment but increases the spinal cord vulnerability to compression. PMID- 2772719 TI - Peak skeletal mass assessment in young adults with idiopathic scoliosis. AB - In 52 adult women with ages ranging from 20 to 35 years (mean age, 26.5 +/- 4.9 years) with scoliosis of the idiopathic type (mean, 44.7 +/- 17.4 Cobb degrees), bone density was assessed by conventional grading of the relative vertebral density (RVD) and the Singh trabecular index (STI). In vivo determinations of the bone mineral content (BMC) were performed in the radius, femur, and lumbar vertebrae by new noninvasive techniques of single (SPA)- and dual (DPA)-photon absorptiometry. Frequency distributions of scoliosis vs. control subjects with respect to RVD and STI grades showed interdependence to the P less than 0.01 level of significance. The mean BMC determinations of the radius (0.685 +/- 0.061 gm/sq cm) of the femur (0.947 +/- 0.110 gm/BA/sq cm) and of the vertebrae (1.091 +/- 0.105 gm/BA/sq cm) were markedly reduced compared with published control values (P less than 0.001). In comparison with the authors' institutional controls, mean BMC measurements were significantly lower for the radius (P less than 0.05) and for the femur (P less than 0.001). These results conclusively demonstrated that assessment of peak skeletal mass in a population of adult premenopausal women with idiopathic scoliosis showed significant decrease in average BMC measurements compared with control values. Maximal bone accretion was best evaluated at locations unaffected by deformity such as the radial diaphysis and the femoral neck. PMID- 2772720 TI - Anterior extension of the thoracic vertebral bodies in Scheuermann's kyphosis. An anatomic study. AB - Changes consistent with Scheuermann's kyphosis were noted in 103 specimens (7.4%) of a sample of 1,384 thoracic spines in the Hamann-Todd collection of human skeletons. In 94% of the affected vertebrae, a distinct anterior elongation of the vertebral centrum was present. This anterior extension was composed of mature cancellous bone and was morphologically and roentgenographically different from marginal osteophyte formation. It was not present in any vertebrae of a control group of 50 unaffected spines. Associated findings included vertebral wedging and Schmorl's nodes. PMID- 2772721 TI - Segmental analysis of the sagittal plane alignment of the normal thoracic and lumbar spines and thoracolumbar junction. AB - Recent advances in spinal instrumentation have brought about a new emphasis on the three-dimensional spinal deformity of scoliosis and especially on the restoration of normal sagittal plane contours. Normal alignment in the coronal and transverse planes is easily defined; however, normal sagittal plane alignment is not so simple. This retrospective study was undertaken to increase the understanding of the normal alignment of the spine in the sagittal plane, with a special emphasis on the thoracolumbar junction. Measurements were made from the lateral radiographs of 102 subjects with clinically and radiographically normal spines. Cobb measurements of the thoracic kyphosis (T3-T12), the thoracolumbar junction (T10-T12 and T12-L2), and the lumbar lordosis (L1-L5) were determined. The spices of the thoracic kyphosis and lumbar lordosis also were determined. Using a computerized digitalizing table, the segmental angulation was determined at each level from T1-2 to L5-S1. In conclusion, there is a wide range of normal sagittal alignment of the thoracic and lumbar spines. When using composite measurements of the combined frontal and sagittal plane deformity of scoliosis, this wide range of sagittal variance should be taken into consideration. Using norms established here for segmental alignment, areas of hypokyphosis and hypolordosis commonly seen in scoliosis can be more objectively evaluated. The thoracolumbar junction is for all practical purposes straight; lumbar lordosis usually starts at L1-2 and gradually increases at each level caudally to the sacrum. PMID- 2772722 TI - The syndrome of inappropriate antidiuretic hormone secretion and its effect on blood indices following spinal fusion. AB - Red blood cell indices in four adolescent and preadolescent patients with documented inappropriate antidiuretic hormone secretion (SIADH) following spinal fusion were examined for evidence of dilution. The blood indices in these preoperative patients demonstrated evidence of dilution on both the intracellular and extracellular levels. The major factors causing these dilutional effects were elevated ADH, intravenous fluid overloading, and mobilization of "third space" fluids. It appears that extracellular dilution secondary to these factors results in spuriously low blood indices (namely, hemoglobin, hematocrit, and red blood cells) during the postoperative period. These findings suggest that an awareness of SIADH and avoiding intravenous fluid overloads by accurately managing intraoperative and postoperative fluids will decrease the dilutional effects observed on blood indices and perhaps save patients from unwarranted transfusions. PMID- 2772723 TI - Temporal analysis of vascularized and nonvascularized rib grafts in canine spine surgery. AB - The authors have previously reported work demonstrating the superiority of vascularized vs. nonvascularized rib grafts, which were inlaid to bridge three vertebral bodies studied at 3 months postoperatively. They questioned whether the mechanical and biologic properties of the nonvascular grafts would improve over time to approach the performance of the vascularized grafts by 6 months. They found that, with increased time, the vascularized grafts continued to improve, showing hypertrophy, maintenance of cortical integrity, and bonding to the recipient vertebral bodies. The nonvascularized grafts, however, showed porosity, fragmentation, and replacement by spongiosa. Mechanical properties showed increased performance in the vascularized vs. nonvascularized grafts, and no improvement was seen between the nonvascularized grafts from 3 to 6 months. PMID- 2772724 TI - Frontal plane and sagittal plane balance following Cotrel-Dubousset instrumentation for idiopathic scoliosis. AB - Postoperative decompensation has been reported following Cotrel-Dubousset instrumentation for right thoracic idiopathic scoliosis. The authors examined balance in the frontal and sagittal planes in 53 patients to determine optimal levels for fusion. King et al Type II curves, particularly larger ones, shifted to the left when the thoracic curve was fused to the stable vertebra or just below. Most Type III curves balanced well regardless of the levels fused. One third of all patients developed mild radiographic junctional kyphosis at the lower level instrumented, more commonly when instrumentation ended at or above T12. The authors recommend fusing one segment short of the stable vertebra in most Type II curves. Large Type II curves need both curves fused for optimal balance. Type III curves can be fused short of the stable vertebra. PMID- 2772725 TI - Analysis of the primary and compensatory curvatures following Zielke instrumentation for idiopathic scoliosis. AB - The behavior of the primary and compensatory curvatures of 34 patients (follow up, 24-48 months) with solid fusions following Zielke instrumentation were evaluated. All patients showed correction of their primary curvatures (range, 40 112%; average, 70%) postoperatively. Thirty-one showed loss of correction (range, 2.8-78.5%; mean, 25%). There was a higher tendency to lose correction if the curve was fused short of the Cobb measurement (35% vs. 17%). The majority of both the thoracic and the lumbosacral compensatory curves improved postoperatively (average of 38.6 and 66%, respectively). However, when the instrumentation was carried cephalad to the primary curve, there was a high probability that the upper compensatory curve would be worse after the surgery. Trunk list tended to improve during the course of follow-up. PMID- 2772726 TI - Long-term results of spinal instrumentation surgery for scoliosis five years or more after surgery, in patients over twenty-three years of age. AB - From 1967 to 1981, 311 scoliotic patients treated at Chiba University, with a minimum follow-up of 5 years and aged more than 23 years, were selected for this study. Seventy-two were males and 239 were females, whose age at operation ranged from 9 to 44 years, with an average of 16.5 years. The operative procedures were one-stage Harrington procedure in 179 cases, staged procedure in 108 cases, anterior procedure in 20 cases, and combined anteroposterior fusion in four cases. Including 198 patients examined physically, a total of 263 patients (54 males and 209 females) have responded to a questionnaire or were interviewed by telephone. In general, 85% of the patients were satisfied with the result of the operation for the control of spinal deformity, improvement of the cosmesis, and increase in physical and social activity. PMID- 2772727 TI - Spine fusion in cerebral palsy with L-rod segmental spinal instrumentation. A comparison of single and two-stage combined approach with Zielke instrumentation. AB - The benefits of achieving rigid internal fixation and eliminating the need for postoperative external orthotic support with L-rod spinal instrumentation made it desirable for use in the surgical treatment of neuromuscular scoliosis. From May 1981 to May 1985, 31 severely involved cerebral palsy patients with progressive spinal deformity underwent posterior fusion and L-rod instrumentation. All patients except one were nonambulatory. Surgical indications included prevention of curve progression, correction of pelvic obliquity, and achievement of balanced spinal alignment in order to improve sitting balance and tolerance without external spinal orthotic support. Ten patients (Group I), with an average age of 15.2 years, with double major or flexible paralytic C-curves or scoliosis measuring less than 70 degrees, underwent posterior fusion and L-rod instrumentation only. Twenty-one patients (Group II), with an average age of 22.1 years, with thoracolumbar, lumbar, or rigid paralytic C-curves or scoliosis measuring greater than 70 degrees, underwent initial anterior release, bone grafting, and Zielke instrumentation followed by second-stage L-rod instrumentation. In Group I, scoliosis averaged 57 degrees and postoperatively 27 degrees (53% correction). In Group II, scoliosis averaged 88 degrees and postoperatively 36 degrees (63% correction). Fifteen Group II patients had posterior fusion extend into the sacrum using the Galveston technique. Six Group II patients were not fused into the sacrum. Scoliosis and pelvic obliquity were corrected in both groups. Torso decompensation improved to 2.7 cm in the Galveston group, but increased to 5.6 cm at follow-up in the patients not fused into the sacrum.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2772728 TI - Spinal muscular atrophy: natural history and orthopaedic treatment of scoliosis. AB - To study the natural history of scoliosis in spinal muscular atrophy (SMA), 63 spinal radiographs of affected patients who attended the Muscle Clinic of Rizzoli Orthopaedic Institute between 1974 and 1988 were reviewed. All but one of the intermediate SMA patients, and all of the mild SMA patients who stopped walking had a scoliosis that ranged from 10 degrees to 165 degrees. Out of the 19 mild SMA patients still able to walk, 12 had a scoliosis ranging from 10 degrees to 45 degrees. Mean age at the onset of scoliosis was 4 years 4 months in intermediate SMA, and 9 years 10 months in mild SMA. Data on characteristics of the scoliotic curve are reported. The effectiveness of orthopaedic treatment in the prevention of scoliosis is discussed. PMID- 2772729 TI - Surgical and functional results of spine fusion in spinal muscular atrophy. AB - From 1965 to 1987, 84 spinal muscular atrophy patients were followed at Rancho Los Amigos Medical Center (RLAMC). Twenty-seven patients were excluded from this study due to insufficient medical documentation (16), lack of follow-up (5), and death (6); leaving 57 patients in the general study group. Group I (34 patients) had posterior spinal fusion (PSF) with Harrington rod instrumentation (HRI); mean age at surgery was 12 years, average preoperative curve was 57 degrees, average postoperative correction was 42%, with a loss of correction of 9 degrees. The complication rate in this group was 35%. The average follow-up interval was 9 years (range, 4-19 years). Group II (six patients) underwent PSF with Luque segmental spinal instrumentation (SSI); mean age at surgery was 11 years, preoperative curves averaged 37 degrees, average postoperative correction was 42% with a loss of correction of 3 degrees. The complication rate in this group was 16%. Follow-up was 3.5 years. Physical therapy and occupational therapy evaluations were done preoperatively and postoperatively at 2- and 5-year intervals. Information was gathered in three categories: 1) ambulation, 2) equipment use, and 3) functional activities. After fusion, sitting tolerance was maintained but additional use of mobile arm supports, lapboards, and reaching aides was necessary for all patients. The ability to perform activities such as drinking, self-feeding, and self-hygiene declined during the 2 years immediately following surgery but improved by 5 years. Surgical patients never approached their preoperative skill levels. Therapy evaluations further demonstrated that there were no difference in function between either operative group. PMID- 2772730 TI - Functional activities in spinal muscular atrophy patients after spinal fusion. AB - Spinal muscular atrophy patients present with weakness, greater in the proximal muscles, leading to scoliosis and limited upper extremity function. The purpose of this study is to identify unique aspects of these patients and to understand how spinal fusion affects their function. Forty patients underwent Harrington or Luque rod instrumentation with functional evaluations preoperatively and 2 and 5 years postoperatively. Biomechanical assessment of function is important. Flexibility of the spine is functionally advantageous because distal strength is used to align weaker proximal segments. Postoperatively, lack of spinal flexibility resulted in a decline in gross motor function and increased use of UE aids due to a change in the trunk position in the weaker patients. The stronger patients' activities were maintained. Earlier mobilization in patients with Luque procedures did not improve postoperative function. PMID- 2772731 TI - Intrinsic disc pressure as a measure of integrity of the lumbar spine. PMID- 2772732 TI - [Drinking water and garbage: customs and beliefs among schoolchildren of a marginal population]. AB - A study of 80 children from 6th and 7th grades was conducted to determine their beliefs and behaviours about drinking-water and garbage management. The children come, in their totality, from a poor suburban population of the north of Buenos Aires. The survey showed that most of the children kept some drinking-water provision at home. Therefore, they had to collect, treat, and store the water. The pupils had correct knowledge about the process of contamination and some adequate behaviours concerning the hygiene of collection containers, but also showed inadequate conceptions about the protection of such containers and water treatment. The children reported inadequate behaviours and incorrect beliefs about the elimination of garbage. These results establish the need for teaching learning experiences designed to reinforce correct knowledge and behaviours and modify the incorrect ones. PMID- 2772733 TI - [Removal of arsenic from water for human consumption in homes in rural communities in the Comarca Lagunera, Mexico]. AB - This paper presents the results of an intradomiciliary procedure for arsenic removal from water, by means of flocculation with ferric sulphate. The reaction was carried out in a specifically designed tank with a manual agitator (reactor) installed in a vertical support. The salts to flocculate were handed in two small envelopes, whose contents were added independently, agitating the water and letting it settle for two to three hours. Water is decanted by opening a faucet connected to the inferior part of the recipient. Ten families of the states of Durango and Coahuila (the Comarca Lagunera) were selected. Samples of water were taken before and after the treatment. In 70 percent of these samples the arsenic removal was total, and in the remaining 30 percent the removal was superior to 93 percent. The arsenic removal of water in the domicile was very effective, for which it is suggested as a palliative method for those groups with higher levels of exposition. PMID- 2772734 TI - [Prevalence of Vibrio parahaemolyticus in seafood from restaurants in the city of Merida, Yucatan]. AB - We report the prevalence of the Vibrio parahaemolyticus in raw (11.54%), insufficiently cooked (0.00%) and partially cooked with heat (4.55%) sea foods, from restaurants of the city of Merida, Yucatan, Mexico. We studied 190 samples from March to August 1987. We isolated 12 strains (6.32%) from an equal number of samples, whose biochemical characteristics corresponded with Vibrio parahaemolyticus. We didn't find significant statistically differences when we compared the prevalences of the samples of raw and insufficiently cooked sea foods (chi 2 = 0.03, p greater than 0.05), of raw and partially cooked with boiled sea foods (chi 2 = 1.96, p greater than 0.05), and of insufficiently heated and partially cooked with heat sea foods (chi 2 = 0.24, p greater than 0.05). When we compared the prevalences of the samples of crustaceans and mollusks, of crustaceans and fishes, and of mollusks and fishes, we didn't find significant statistically differences: chi 2 = 0.022, p greater than 0.05; chi 2 = 0.52, p greater than 0.05 and chi 2 = 1.78, p greater than 0.05, respectively. PMID- 2772735 TI - [Sanitary quality of ham eaten in Mexico City]. AB - Microbiological results of 2,539 hams were analyzed (counts of mesophilic aerobes, Salmonella sp. and S. aureus) at the National Public health Laboratory from 1979 to 1987. In 58.7 percent of the cases the hams were not acceptable for human consumption, due to any of the above mentioned microbiological determinations. The main cause was the finding of high levels of mesophilic aerobes (57.5%), followed by Salmonella sp (4.4%) and S. aureus (0.43%). Raw, cooked and smoked hams presented the highest counts of mesophilic aerobes. Virginia, american style and blade hams presented the most elevated frequencies of Salmonella sp. Baked ham was the one in better sanitary conditions. The conclusion is that the quality of hams in Mexico City is bad. PMID- 2772736 TI - [Mortality from tetanus in children less than 1 year of age, Mexico, 1970-1982]. AB - The results of a study about mortality by tetanus in Mexican children under one year of age, during the 1970-1982 period, are reported. This age-group was subdivided in three, as follows: perinatal (less than 7 days), neonatal (less than 29 days) and postneonatal (29 to 364 days). Mortality by tetanus in children under one year of age showed a decreasing trend during the mentioned period, and this was most pronounced from 1979, because of changes in the codification of mortality by tetanus in this group of age. On the other hand, it was found that the greatest proportion of deaths by tetanus happened in the under one year of age group, and particularly in the neonatal group (less than 29 days). The geographic distribution of tetanus in Mexico was studied later, and showed a predominant incidence of the disease in coastal states of the country; an additional finding in this investigation was the displacement of the disease from the Pacific strip to the Gulf of Mexico. Finally, the mortality differentials by sex were studied, and showed that males were the most affected in the three age groups. We cannot explain this finding at the time. PMID- 2772737 TI - [Second-level hospitals in the health care model for the population without coverage]. AB - Hospital health care may be a complement of ambulatory care and promotes the integration of a real National Health System. The measures adopted in the last years in Mexico to create a net of second level hospitals under a new model of health care are described; decentralization, the creation of high quality regional health care centers, administrative modernization, new financial formulas and community participation are some of the analyzed topics. PMID- 2772738 TI - [Induced abortion in figures: analysis of the dissemination of statistics in the press]. AB - The use of secondary sources of information such as the newspaper is necessary in order to do research on the degree of diffusion of public health issues. The problem of abortion in Mexico has been scarcely studied due to several factors mentioned in this paper. Content analysis of articles published in the newspapers is a strategy that allows the study of the role of public opinion on this socio political and health problem. A research based on content analysis was carried out in 771 newspaper articles on abortion found in seven national newspapers from 1974 to 1982. The results show a great inconsistency in the statistics on the numbers of abortions and the number of maternal deaths due to this cause. On the other hand, the information published on the characteristics of the women that have had an abortion in Mexico was found to be congruent. These elements point to the fact that the health sector has to produce and publish reliable statistics on abortion. PMID- 2772739 TI - [Evaluation of epidemiological articles published in 2 journals in the area of public health]. AB - The main aim of this study was to assess the quality and quantity of the Mexican epidemiologic production published in two journals: Salud Publica de Mexico (SPM) and Boletin de la Oficina Sanitaria Panamericana (BOSP). A previously accepted criterion was used to qualify a paper as an epidemiologic work. The period of study was eleven years (1975-1985) with 89 classified paper as "epidemiologic reports" (36 of BOSP and 53 of SPM). The variables included: original or revision's report; epidemiologic design; measures employed (frequency, association or potential impact); condition (contagious diseases, chronic degenerative diseases or physiologic status); use of prevalent cases, incident cases or deaths; internal and external validity; bias' recognition; and number of references. Among the results that stand out are the proportion of cross sectional designs (51.75), the weight for communicable diseases (36%), the detection of potential bias (65.7%) and the reports without references (30%). The discussion is centered in the main implications of these results when they are used to make decisions in the planning, operation and assessment of health services and in the generation of new epidemiologic knowledge. PMID- 2772740 TI - [Doctrinal bases of health activities]. AB - During his administration as Minister of Health, doctor Guillermo Soberon led one of the most important structural changes in health of this century in Mexico. All along the process, an ideological and doctrinal corpus was created. In this paper the main streams of this corpus are presented. PMID- 2772741 TI - [Curriculum revision for a master's program in public health]. AB - The Master's degree program of the Escuela de Salud Publica de Mexico (ESPM) has undergone a continuous process of evaluation and re-design since January 1988. An analysis of the program for 1985 showed problems of organization, sequence and integration of the curricular contents, as well as lack coherence with the stated objectives of the program and with the desired profile of the public health professional. Attention to environmental and population problems was almost absent. The Division of Academic Programs was created, and with the active participation of the academic staff a new design was developed, which resulted in the program to be applied in 1989. The next phase in this continuous process of evaluation and updating consists of the project Prospective Planning for Public Health Education in the Year 2005. PMID- 2772742 TI - [Diagnostic imaging of thalamic infarcts]. PMID- 2772743 TI - [Pseudotumor of the kidney: the value of angiography]. PMID- 2772744 TI - [Atrial septal defects: the importance of peroperative morphometric evaluation of defects]. AB - The authors analyze the results of preoperative morphometry of atrial septal defects. They compare the area of the defect and the septal area in different types of defects. Based on the thus obtained relative value, they select either suture of the defect or its correction by means of a patch. They emphasize that during correction defects deformations and reduction of the septal area must be avoided. They do not admit the possibility that the suture of the defect is exposed to traction. Ostium secundum defects the area of which is greater than 40% of the septal area are suited for correction by means of a patch. An important indicator is the transverse dimension of the defect and of the septum. This relation determines the grade of deformity during an inadequately selected suture and the presence of traction mechanisms in the area of the suture and cardiac skeleton. The authors recommend more frequent use of patches also in ostium secundum defects in the cranial lateral and distal part of the atrial defect. PMID- 2772745 TI - [Endarterectomy of the coronary arteries]. AB - The authors present an account, based on their clinical material, of 15 endarterectomies of the coronary arteries, which from the chronological aspect are divided into two groups. The first six were performed in 1972-1974 without the use of cardioplegia, total cardias arrest, only with ventricular fibrillation, with a 50% rate of success. The series of the remaining nine patients was operated during the period between October 1987 and the end of 1988 under far more favourable conditions, using cold cardioplegia, hypothermia and total cardias arrest. Only one patient died 24 hours after operation, the remaining eight patients are being followed up for one to 14 months after operation. In six patients endarterectomy of the right coronary artery was performed and in three instances in the area of the r. interventricularis of the left coronary artery. There was no case of perioperative myocardial infarction. The immediate postoperative development of the patients is promising and encourages us to proceed with this surgery (endarterectomy of the coronary artery) which is the only alternative method in the group of patients with diffuse distal arteriosclerosis of the coronary arteries. PMID- 2772747 TI - [Reconstructive surgery in post-operative strictures of the extrahepatic bile ducts]. AB - The authors made in 1982-1988 in 24 patients with iatrogenically conditioned strictures of the extrahepatic biliary pathways reconstruction operations, most frequently hepaticojejunostomy Roux-Y. Within four weeks after operation three patients died (12.5%): two were repeatedly re-operated previously, one 71-year old female patient died as a result of hepatic coma and renal failure. The authors discuss conditions for successful reconstruction operations in iatrogenic strictures of extrahepatic biliary pathways, in particular the importance of the localization and duration of stricture, mucosobiliary anastomosis, internal drainage, solution of the stricture already during the first operation. PMID- 2772746 TI - [Long-term results of surgical treatment of portal hypertension]. AB - Large number of contradictory operative surgeries refer best to embarrasments, existed on this section of surgery. Today, from the amount of operative surgeries prevail the endoscopic sclerotization of the gastroesophageal varices. On basis of retrospective study of 48 portosystemic shunts was showed, that 28 operated patients survive average 8.1 year, till now 4 patients of them are alive, within 8-14 years. In 7 cases of azygoportal deconexion by Torres-Dengi, average time of survive was 2.5 year. There experiences led the authors to elaborate an algorithm of treatment of portal hypertension, where the postosystemic shunts are the portosystemic shunts are the effective palliative operative surgery in indicated cases. PMID- 2772748 TI - [Experience with selective proximal vagotomy in the surgical department of a type I polyclinic hospital]. AB - The authors describe experience with selective proximal vagotomy in 1982-1986 in 192 patients, they evaluate postoperative results in 120 patients by means of questionnaires. According to the authors' experience the operation is a useful extension of surgical possibilities in duodenal ulceration. PMID- 2772749 TI - [Prophylactic administration of antimicrobial drugs in surgery]. PMID- 2772750 TI - [The compartment syndrome after fractures of the calf]. AB - In the submitted paper the authors summarize views regarding the definition, causes of compartment syndrome, its classification, the diagnostic and therapeutic procedure. In a group of 165 fractures of the leg treated in 1984 1987 in the Traumatological Research Institute in Brno the compartment syndrome was found in 26 patients. The author supplements the problem by case-histories of two patients with compartment syndrome. He discusses the need of early and correct diagnosis, differential diagnosis, therapy, involving in the manifest form of the syndrome decompression by fascitotomy. PMID- 2772751 TI - [Function of the affected cervical spine in head injuries]. AB - The authors followed up 100 patients hospitalized on account of a head injury. Of these 100 patients 48 suffered concussion, in 52 no affection of the CNS was recorded. On admissions 85 of the casualties reported headache (in 79%), vertigo (in 13%) and vomiting (in 30%). In 83.53% with subjective complaints a block of the upper cervical spine and of the cervicothoracic area was proved. In these patients immediately manipulation or mobilization treatment was provided. On discharge all patients were free from complaints. After an interval of one week to three months four patients were re-examined on account of headache, inc. one girl who suffered from mild vertigo. After repeated treatment the complaints receded. In two subjects the association with the original injury was doubtful. Adequate rehabilitation treatment thus practically eliminated the complaints described incorrectly as "postcommotion syndrome". The authors emphasize the necessity of close collaboration of the traumatologist with the rehabilitation physician. PMID- 2772752 TI - [Treatment of unusually resistant prostato-urethritis]. AB - From a total number of 1410 patients only 67, i. e. less than 5% were very torpid cases, i. e. cases which called for treatment longer than two years. The main factors of chronicity of the disease and its refractory character are chronic congestion and oedema, fibrous tissue changes, allergy, the last frequent cause being chronic bacterial infection (only six patients). The author discusses therapeutic methods he found most useful in the treatment of the four mentioned aetiopathogenetic components. Among others he draws attention to a new experience, the very favourable action of Reparil therapy in surgical congestive prostatitis. PMID- 2772753 TI - [The results of a questionnaire on the status of vascular surgery in Czechoslovakia]. AB - In 1985 an enquiry by means of questionnaires was made at all surgical departments of the CSR. Its aim was to assess the state of vascular surgery, conditions under which it is performed and to compare quantitative and qualitative data with the actual needs. In 1984 in the CSR a total of 2564 vascular operations were performed, incl. 751 urgent ones and 1813 planned operations. With regard to the estimated need of cca 500 operations per 1 million population (comparable data from Scandinavian countries), the 248 operations per 1 million population are quite inadequate. In contrast to this, 82 surgeons claim to be concerned with active vascular surgery which is almost twice the number needed to ensure an adequate number of vascular surgical operations. The authors analyze the causes of the inadequate development of vascular surgery which ensued from the enquiry and indicate possibilities of future development. PMID- 2772755 TI - [Arthroscopic findings of cartilage changes in knees with rheumatoid arthritis]. AB - We evaluated 28 cases (45 knee joints) with rheumatoid arthritis as our subjects using simple X-rays of the knee joints according to their Larsen grade and also measured the femoro-tibial angle (FTA). Moreover, using an arthroscope we observed 6 regions, namely, the medial femoral condyle, medial tibial plateau, medial meniscus, lateral femoral condyle, lateral tibial plateau, and lateral meniscus, and evaluated the degree of cartilage degeneration according to a 5 point grade classification of our own devising. We studied the relationship between the simple X-ray findings and the arthroscopic findings of cartilage degeneration and reached the following conclusions. Even when simple X-ray findings are slight as in Larsen grade I, various degrees of cartilage degeneration are observed and moreover, as the stage of the disease progresses, cartilage degeneration becomes more severe. The progression of cartilage degeneration up to Larsen grade III is not uniform but degenerative changes in the lateral meniscus progress. Also, a correlation was observed between the nature of the cartilage destruction and the FTA. PMID- 2772754 TI - [Evaluation of disease activity by hand X-ray findings in rheumatoid arthritis]. AB - It would appear to us that the patients with rheumatoid arthritis (RA), in whom articular bone lesions were confined to the wrist and/or carpal joints in X-ray films, may follow a milder disease activity than do the patients with the hand and finger joint lesions. To clarify it, the present study was performed retrospectively. RA patients showing stage II or more lesions in the wrists and/or carpal joints but no lesions over stage II in any hand and finger joint (MCP, IP and PIP) radiologically after 5 years or more duration were regarded as the carpal type (C type). The clinical and laboratory data were compared between 44 patients of the C type RA and 44 patients of other type RA, matched in the sex, age and disease duration. Significant differences were observed in the following parameters between the 2 groups; the functional class, Lansbury's activity index, number of the affected joints, ESR, CRP and hemoglobin values, and ADL scores. That is, Hb values and ADL scores were higher, but the others were lower, in the C type RA group than in other type RA group. The positive percentage and titer of rheumatoid factor were not significantly different between the 2 groups. It was concluded that C type RA patients are milder in the activity and fewer in the number of affected joints than other type RA patients. Furthermore it was suggested that C type RA patients may have milder clinical course and better prognosis than other type RA patients. PMID- 2772756 TI - [A case of systemic lupus erythematosus associated with meningitis, myelitis, and bilateral optic neuritis]. AB - A 16-year-old girl was admitted to our hospital in August 23, 1986, for headache, nausea and low grade fever. Marked increases in immunoglobulin indices were found in the cerebrospinal fluid. When she was 13, she was diagnosed as having SLE and lupus nephritis. On September 9, 1986, she complained of urinary retention, and pathological reflexes were elicited bilaterally. On September 13, she complained of a sudden loss of vision (count fingers) in the right eye which worsened to a visual acuity of light perception over the next 48 hours. A visual evoked response potentials (VEP) to flash stimulation gave a loss of amplitude and an increase in latency. On September 16, she complained of a similar loss of vision in the left eye. Leakage of dye around the left optic disc was found by a fluorescein angiogram on September 26. These results indicated a diagnosis of bilateral optic neuritis. Both visual acuity returned rapidly over the following month following oral prednisolone treatment. Optic neuritis is an exceedingly rare complication in SLE. Although the visual prognosis have been fairly good in the reported cases, some have resulted in various states of blindness. As for etiology of optic neuritis in our patient, ischemic change of optic nerves due to microvasculopathy as well as slight demyelinating process were speculated by the VEP pattern. PMID- 2772757 TI - [Analysis of systemic lupus erythematosus (SLE) involving the central nervous system by magnetic resonance imaging (MRI)]. AB - Involvement of the central nervous system (CNS) commonly occurs in systemic lupus erythematosus (SLE). But definitive diagnosis remains difficult even with computed tomography (CT). In this study, we used the recently developed technique, magnetic resonance imaging (MRI) for CNS lupus and compared it with CT scans. CT was performed with a General Electric 8800 CT/T scanner. MRI was performed using a Mitsubishi Electric MMI-150 S. Ten patients with CNS lupus were divided into 3 groups. Group I included 4 cases with neurological manifestations alone. All lesions seen on CT were also detected by MRI, with greater clarity and extent. Furthermore, MRI depicted several microinfarcts in white matter without symptoms. Group II included 5 cases with psychiatric features alone. MRI detected a thalamic microinfarct in only one case while CT showed no abnormality in all cases. Group III included 1 case with both neurological and psychiatric symptoms. MRI demonstrated a small infarct of midbrain corresponding with neurological symptoms, more clearly than CT. Therefore MRI demonstrates the degree of brain involvement in SLE more accurately than CT. PMID- 2772759 TI - Dystonia. PMID- 2772758 TI - [Evaluation of the 1987 revised ARA criteria for rheumatoid arthritis in Japan]. AB - Three hundred and sixty two Japanese patients with rheumatoid arthritis (RA) and 455 patients with other rheumatic diseases (SLE 233, PSS 63, MCTD 51, PM-DM 41 Behcet's disease 33 and OA 33) were examined for the evaluation of the 1987 revised ARA criteria for RA. In our cases sensitivity was slightly decreased and specificity was markedly increased 5 out of 7 criterions compared with the results reported by ARA. In the investigation how many number of criterions at least which the patients with RA should satisfy, 4 out of 7 criterions in the 1987 criteria turned out the highest figure in the accuracy (the mean of sensitivity and specificity values). So the patients who satisfied at least 4 criterions were classified to have RA. Sensitivity of the 1987 criteria decreased to 90% although that of the 1958 ARA criteria was 93%. Specificity were markedly increased from 88% to 95% (the 1958 and 1987 criteria, respectively). These results might be based on the revision of the duration of "morning stiffness" (lasting at least 1 hour) and on the deletion of "joint pain or tenderness" which was relatively less specific for RA. PMID- 2772760 TI - A question of race. PMID- 2772761 TI - Nomenclature in a pigmentocracy--a scientist's dilemma. PMID- 2772762 TI - Population groups, politics and medical science. PMID- 2772764 TI - The load independence of the end-systolic pressure-length relationship of the heart. AB - The end-systolic pressure-volume relationship is the state of the art in the measurement of myocardial contractility. This index is load-independent and relatively independent of heart rate. In this study the load-independent character of the end-systolic pressure-length (ESPL) relationship was evaluated in dogs under general anaesthesia. The results indicated that the ESPL is pre- and afterload-independent, since the comparative values of ESPL from afterloaded and reduced preload contractions did not differ significantly (N = 75; P = 0.5993). The application of the ESPL relationship as a means of describing the function of the heart as a muscle as well as a pump is discussed. PMID- 2772763 TI - Association of rheumatoid arthritis with HLA in three South African populations- whites, blacks and a population of mixed ancestry. AB - The association between rheumatoid arthritis and HLA was studied in three South African populations: whites (N = 66), blacks (N = 33) and patients of mixed ancestry (Cape Coloureds) (N = 183). The antigens of the HLA-A, B, C, DR and DQ loci were detected by microlymphocytotoxicity assay and their frequencies in the three patient groups were compared with the corresponding frequencies in normal individuals of the same population group. HLA-DR4 was significantly associated with rheumatoid arthritis in whites (P less than 0.0001), blacks (P less than 0.001) and patients of mixed ancestry (P less than 10(-6]. The relative risk for HLA-DR4 was 3,2 in whites, 3,9 in blacks and 3,7 in patients of mixed ancestry. Other significant associations detected were with HLA-A2 in whites and HLA-B8 and DQw3 in patients of mixed ancestry. The constant association with HLA-DR4 seen in the different populations provides support for the suggestion that the HLA genes themselves are responsible for the genetic susceptibility to rheumatoid arthritis. PMID- 2772765 TI - Psychogenic pain disorder in children. AB - The concept of psychogenic pain in children is by no means new; it has been researched for at least 3 decades. There is increasing recognition of the relationship between emotional factors and complaints of pain in the absence of organic disease. By their very nature these conditions warrant a team approach, incorporating both medical and psychological perspectives, to treatment. A study was undertaken that focused on identifying the incidence and related features of this problem at a general hospital. Over a 2-year period 46 children showed psychogenic pain disorder according to the criteria of Diagnostic and Statistical Manual of Mental Disorders. Physical examinations and basic investigations revealed no organic disease. The majority of the children (34, 73.9%) complained of abdominal pain, although limb and chest pains also featured. Marital problems between parents constituted the most common stressor, affecting 31 of the children (67.4%). Psychotherapeutic management was initiated with all the children and their families. Thirty-five (76.1%) had remission of symptoms after psychotherapy. PMID- 2772766 TI - Parasitic infestation in Cape Town children. A random study of 101 patients. AB - Over a 12-month period random stool specimens were collected from 101 children admitted to the trauma unit of the Red Cross War Memorial Children's Hospital, Cape Town. The majority of the children were resident on the Cape Flats or in Mitchell's Plain. Examination of the stools showed evidence of parasitic infestation in 46 of the children, of whom 39 harboured Ascaris lumbricoides (8), Trichuris trichiura (11) or both (20). Cysts of Giardia lamblia were identified in 8 patients. These findings suggest that at least half the children living in a well-defined area of Cape Town may be at risk of complications from intestinal parasitic infestation. PMID- 2772767 TI - Chorio-amnionitis in relation to mode of delivery at term. AB - The incidence of inflammatory changes on histological examination in the placenta, membranes and umbilical cord of 50 infants born by spontaneous vaginal delivery were compared with those of 50 infants born by elective caesarean section before the onset of labour at term. Inflammation was significantly more frequent after vaginal delivery (28%) than after caesarean section (6%). This suggests that intra-uterine bacterial colonisation is uncommon before the onset of labour and it is argued that chorio-amnionitis in the vaginally delivered placentas occurred during labour. PMID- 2772768 TI - Improving compliance in Xhosa psychiatric patients. AB - Compliance with psychotropic medication is particularly poor in Xhosa psychiatric patients. A study demonstrated that explicit and repeated verbal and written instructions did not increase compliance with oral medication, but that a single home visit, limited to giving instructions about medication, almost doubled the compliance rate (to 65%). Similar increases also occurred in relation to intramuscular medication and clinic attendance. The most common reason for noncompliance was found to be resistance to, or plain ignoring of, what was actually known (64%). Several possible reasons for this are proposed, the most significant being the patients' cultural and social attitudes and belief system. Recommendations for increasing compliance are given. PMID- 2772769 TI - A methodology for resource allocation in health care for South Africa. Part I. Rationale and prerequisites. AB - A strategy for the equitable allocation of health care resources is needed in South Africa. The existing health administrative structures are obstacles to achieving this goal. An attempt is made to describe a framework in which the prerequisites for the equitable allocation of resources are a major restructuring of health services into a number of regional health authorities in a unified health service, and to establish a formula which is adapted from the RAWP (Resource Allocation Working Party) model used in the UK. PMID- 2772770 TI - Detection of bacterial antigens in cerebrospinal fluid by a latex agglutination test in 'septic unknown' meningitis and serogroup B meningococcal meningitis. AB - The latex agglutination test (Wellcogen) was evaluated specifically in cases of 'septic unknown' meningitis, with CSF findings characteristic of bacterial meningitis but with no bacterial organisms grown on CSF culture or seen on microscopy after Gram staining. In only 4 (12%) of 33 cases of 'septic unknown' meningitis were antigens identified in the CSF. This kit contains for the first time reagents for the detection of serogroup B Neisseria meningitidis antigens and was also evaluated for this bacteria. Only 6 (27%) of 22 serogroup B N. meningitidis cases were identified. PMID- 2772771 TI - Haemoperitoneum--a complication of acute cholecystitis in a patient on anticoagulant therapy. A case report. AB - A case of haemoperitoneum in a patient taking warfarin sodium, originating in the wall of a perforated, inflamed gallbladder, is presented. To the best of our knowledge such a case has not been reported previously. Diagnostic and therapeutic aspects are briefly discussed. PMID- 2772773 TI - Adverse reactions to immunisation. PMID- 2772772 TI - Sudden cardiac death during ambulatory ECG monitoring. A report of 2 cases. AB - Two cases of sudden cardiac death during ambulatory ECG monitoring, each with an episode of torsade de pointes as part of the terminal dysrhythmia, are reported. In the first case, pause-dependent changes of the TU waves favour early after depolarisations and triggered activity as the initiating mechanism of torsade. Quinidine therapy was probably an aggravating factor. Torsade was not initiated in a pause-dependent fashion in the second patient, who had ECG evidence of an episode of ischaemia as trigger for the terminal dysrhythmia. Both patients had impaired left ventricular function and underlying coronary artery disease. PMID- 2772774 TI - Blood lead levels in young newspaper vendors. PMID- 2772775 TI - Intratubal synechiae as a cause of infertility. PMID- 2772776 TI - [Monodose aztreonam in the prevention of infection after extracorporeal shockwave lithotripsy. Theoretical premises]. AB - A series of 905 patients suffering from renal calculosis and treated with ESWL is considered and the indications for antibiotic treatment with prophylactic or prolonged aztreonam reviewed: 1) for calculi with sterile urine or occasionally infected with I.S.T. less than 200, monodose prophylaxis is certainly advantageous; 2) for calculi with sterile urine or occasionally infected with I.S.T. between 200 and 500, prolonged antibiotic cover is useful; 3) for calculi with chronic infection or with I.S.T. greater than 500, prolonged target antibiotic therapy is necessary; 4) aztreonam is an effective drug for both monodose prophylaxis and for cover treatment. In more complex cases, an antibiogram indication is necessary. PMID- 2772778 TI - [International Conference on Informatics in Nephrology. Turin, 3 June 1987. II. Proceedings]. PMID- 2772777 TI - [Antibiotic prevention with aztreonam in urologic surgery in children]. AB - In a group of 51 children aged 3 days-17 years old, 40 were given operative 8 endoscopic and 3 percutaneous surgery, while all received antibiotic prophylaxis with Aztreonam (Squibb Azactam) for the prevention of surgical infections. Preoperative uroculture revealed sterile urine in all 51 but 49 needed excretory catheters at various levels: urethral, pyelic. Drug treatment was started preoperatively at the time of narcosis and continued until catheter removal. Aztreonam was chosen for its anti-Gram negative action and absence of toxicity as reported in the literature. Urine cultures at the end of treatment and 7 days later revealed sterile urine in 49 (96%) of the children, while 2 presented asymptomatic infection by Gram positive bacteria. No significant side effects definitely attributable to the drug were encountered. PMID- 2772779 TI - [Hematologic repercussions of physical exercise in the mountains]. AB - Marked decrease of serum ferritin was found in 28 cadets of the General Military Academy after a 15-day high-mountain drill period during which they practised ski 5 hours a day. No significant changes were found in serum iron, total iron binding capacity, vitamin B 12 and folates. Slight differences found in haemoglobin, white blood cell count and serum albumin were attributed to haemodilution. These findings were thought to be due to decreased iron stores leading neither to anaemia nor to diminished transferrin saturation. PMID- 2772780 TI - [Bone marrow biopsy in non-Hodgkin's lymphoma: experience with 259 samples]. AB - A study performed on 259 cases of bone-marrow biopsy specimens from 121 patients with non-Hodgkin's lymphoma (NHL) is presented after an introduction dealing with several well-known facts. Specific involvement of the initial samples was present in 53.45% of the cases. Such involvement was more frequent in stages III and IV, although no difference was found between the clinical forms, A or B. Stage progression due to positive bone-marrow biopsy occurred in 26% of the patients, and in 25% of these it was from stages 0 to II onto stage IV. Low-grade lymphomas showed higher bone-marrow involvement than high-grade ones (p = 0.025); specific involvement significantly influenced survival in only high-grade lymphomas, not in the low-grade ones, when the series was considered as a whole. Absolute compatibility between lymph-node and bone-marrow cellularity was found in 71% of the cases, and in 85% was taken into account. Six possible histological lesions are described herein, while for practical purposes, the use of 5 patterns of involvement is recommended, namely, interstitial, nodular, patchy, mixed nodular patchy, and diffuse. Patchy pattern associated to low-grade and skin-involvement lymphomas. Although those patterns had non-significant influence on survival, this last was found when comparing diffuse pattern with the remainders; similarly, the diffuse pattern correlated with significantly lower haemoglobin rates. Finally, fibrosis was present in 58% of the positive biopsies and in 94% of the lesions, it being thus considered as a marker of bone-marrow involvement. PMID- 2772781 TI - [Cytogenetic results in 9 cases of non-Hodgkin's lymphoma with a high grade of malignancy]. AB - Cytogenetic studies were performed in nine patients with non-Hodgkin's lymphoma; four were lymphoblastic lymphoma, three Burkitt's-type and two diffuse lymphomas with mixed small and large cell. All cases showed pseudodiploid or hyperdiploid mode and, moreover, four cases had metaphases with a normal karyotype. All patients showed clonal chromosomal abnormalities, except one (lymphoblastic T lymphoma). The translocations t (8;14) (q24;q32) and t (8;22) (q24;q11) were the abnormalities found in Burkitt's lymphoma. The translocation t (14;18) (q32;q21) was found in one case, of lymphoblastic type. In the other tumours, the chromosomes involved in the different aberrations were: #1, #3, #7, #8, #9, #14 and #17. We attempted to correlate the cytogenetic findings with histology and prognosis. PMID- 2772782 TI - [Multicentric abdominal angiofollicular hyperplasia: a clinical variant with exclusive involvement of the liver and abdominal lymph nodes]. AB - Three patients with a non-malignant lymphoproliferative disease involving liver and abdominal lymph nodes, without peripheral lymphadenopathy, are presented. They had systemic symptoms, fever and/or arthralgia, a biochemical pattern of liver obstruction and signs of B-cell immune hyperactivity (hypergammaglobulinaemia and different autoantibodies). Abdominal lymph node enlargement was found on laparotomy; the lymph node histologic pattern was that of angiofollicular hyperplasia (AFH), malignant lymphoma being discarded. Several stages of involvement were present in all cases, made up of small lymphocytes, plasma cells, and centrofollicular cells forming portal nodules with cholangiole infiltrates in one case which gave rise to a lymphoepithelial lesion. Steroid therapy was effective in all cases, but the symptoms and the liver obstruction relapsed in two patients after steroid suppression. Persistent functional anomalies of B and T lymphocytes were present in all cases. No evidence of viral disease was seen. These patients form a clinicopathological variant of multicentric AFH on whom malignant lymphoma could be excluded only by the histological study of abdominal lymph nodes. The persistence of lymphocytosis (although polyclonal and lacking cytogenetic alterations) may suggest the possible evolution into true and malignant lymphoma in any case. PMID- 2772783 TI - [Measurement of phospholipids in erythrocytes, plasma and platelets in a patient with hereditary spherocytosis]. AB - The amount and distribution of phospholipids (PLs) were studied in erythrocytes, plasma and platelets of one patient with hereditary spherocytosis (HS). Phosphatidylethanolamine (PE) was always decreased. Total PLs amount was remarkably reduced in erythrocytes but normal in platelets. Since platelets do not contain those proteins which have been implicated in the red cell abnormalities of patients with HS, our findings reinforce the theory that a defective protein-lipid interaction causes the abnormal lipid loss in the erythrocytes of these patients. PMID- 2772784 TI - [Erythroblastopenia associated with chronic myelomonocytic leukemia]. AB - A patient is presented in whom the diagnoses of chronic myelomonocytic leukaemia (CMML) and erythroblastopenia were simultaneously established. Besides the conventional criteria for both haemopathies, the culture of bone-marrow precursor cells showed lack of growth of the erythroid stem cells. 6-Mercaptopurine given as therapy for CMML failed to induce any favourable changes in erythroblastopenia, which in turn improved with prednisone. Nevertheless, the patients died five months after diagnosis due to acute transformation of the CMML. PMID- 2772785 TI - [Use of FMC macromolecular medium for determination of the erythrocyte ABO group using microtiter plates]. AB - Several blood group determination techniques have been developed in recent years which provide easy handling, fine reproducibility and similar or even higher sensitivity than the procedures commonly employed, aimed to be used in the automation of blood bank work. A microtitration plate technique for ABO determination on red cells is presented in this report. A macromolecular medium, comprised of a mixture of the polymers Ficoll 400 and carboxymethyl cellulose (FMC) is used ad coadjuvant for the reaction. This medium increases by 15- the score units and by 4-fold (or more) the intensity of haemagglutination (titration) in typing the ABO antigenicity of red cell A, B, O and AB groups. PMID- 2772786 TI - [Granulocytic sarcoma of the base of the skull in chronic myeloid leukemia]. AB - A 54 years old patient with Ph' negative chronic granulocytic leukaemia is reported, who presented rapidly progressive multiple cranial nerve palsies. A cerebral CT scan showed an invasive tumoral disease on the base of skull. Histologic examination of this mass was diagnostic for granulocytic sarcoma, which was the presentation form of an extramedullary blastic crisis. The general characteristics of granulocytic sarcoma are commented, special attention being paid to its appearance in the course of chronic granulocytic leukaemia. PMID- 2772787 TI - [Cell types in multiple myeloma: analysis of the correlation of bone marrow aspirates and biopsies according to 2 classifications]. PMID- 2772788 TI - [Bone marrow with dysmyelopoietic changes in a chronic alcoholic patient]. PMID- 2772789 TI - Percutaneous insertion of subclavian venous catheters in infants and children. AB - All attempts at subclavian venous catheterization by the Pediatric Surgery Service done during a one and one-half year period at the Children's Hospital of Los Angeles were prospectively studied. Catheterization was attempted in 107 patients with a mean age of 9.8 years. Cannulation of the vein was successful 89 times (71 per cent) with the major complications being arterial puncture (8.0 per cent), pneumothorax (2.4 per cent) and abnormal position (12.8 per cent). Fluoroscopy was a valuable adjunct when used, resulting in an 86 per cent success rate. The serious complication rate was similar between left and right-sided attempts, but more catheters were abnormally positioned during right-sided attempts (15.7 versus 5.2 per cent). Percutaneous insertion of subclavian venous catheters can be accomplished in infants and children with low morbidity. Cannulation of the left subclavian vein can be accomplished with a similar success rate and a lower malposition rate than the right side. Fluoroscopy is a useful tool to assist in the correct placement of the catheter. PMID- 2772790 TI - Hypotension and bleeding with various anatomic patterns of blunt splenic injury in adults. AB - A retrospective study of 112 consecutive adult patients with blunt splenic lacerations was performed. All of the patients had operative grading of the splenic injuries according to a prospective protocol. Data on preoperative hypotension (systolic blood pressure of less than 100) and intraoperative splenic bleeding were collected from hospital records. Patients with subcapsular hematomas were excluded. Over-all, 55.4 per cent of the patients with splenic lacerations were hypotensive preoperatively and 76.6 per cent were noted to be bleeding from the spleen at operation. For injuries not involving the hilum, seven of 22 of the patients with Grade I injuries were hypotensive preoperatively versus 19 of 29 of the patients with Grade IV injuries (p = 0.025). Fourteen of 21 patients with Grade I injuries were noted to be bleeding at operation. Seventeen of 23 with Grade IV injuries were noted to be bleeding. This difference was not significant. Of the patients with injuries involving the hilum, 25 of 38 were hypotensive preoperatively and 25 of 29 were noted to be bleeding at operation. No difference in the incidence of hypotension or bleeding was found between superficial and deep hilar injuries. No significant difference was found between the active bleeding with hilar and nonhilar injuries (p = 0.19). For isolated splenic injuries (N = 36), the incidence of hypotension was 39 per cent. However, 79 per cent of the patients with isolated splenic injuries were noted to be bleeding at operation. Of 49 patients with nonisolated splenic injuries who had been hypotensive preoperatively, 72.9 per cent were found to be bleeding at operation. Of the 27 patients never hypotensive preoperatively, 78 per cent were noted to be bleeding at operation (NS). For isolated splenic injury also, no relationship was found between preoperative hypotension and the presence of operative bleeding. No significant correlation was found between preoperative hypotension or the anatomic grade of splenic injury and the incidence of bleeding found at operation. Even if computed tomographic scans can reliably grade splenic injuries, anatomic grade may not be a predictor of clinical behavior. Hypotension also failed to predict the occurrence of continued splenic bleeding. PMID- 2772791 TI - Prospective trial of the six hour rule in stab wounds of the chest. AB - Stab wounds of the chest may be associated with a spectrum of injuries ranging from the lethal to the insignificant. The management of asymptomatic patients with stab wounds of the chest is controversial. The results of previous reports have asserted that asymptomatic patients with stab wounds of the chest do not have delayed complications develop if roentgenograms of the chest taken six hours after the injury are normal. This "rule" has not been validated. A three year, prospective study of patients with stab wounds of the chest was done. Patients were excluded from the study if they had symptoms on arrival, evidence of physiologic derangement caused by intrathoracic injury, wounds near the subclavian vessels or precordial wounds. Patients with lower thoracic stab wounds were evaluated by diagnostic peritoneal lavage. If findings from lavage were negative, the patients were included in the study. One hundred and five patients met the criteria for inclusion in the study group. All of the patients were hospitalized and examined serially. All had roentgenograms of the chest performed at admission, at six hours and at 24 hours. Four patients had a pneumothorax or hemothorax develop between the time of admission and six hours of hospitalization. In the remaining 101 patients, none had a pneumothorax or hemothorax between six and 24 hours. No patient asymptomatic on admission had a tension pneumothorax develop later. No patient had delayed evidence of abdominal injury. An asymptomatic patient with a stab wound of the chest that is not precordial, not in proximity to the subclavian artery and not suspected of diaphragmatic penetration should be serially examined and have a follow-up roentgenogram of the chest at six hours. If the patient remains asymptomatic and the six hour film is normal, delayed complications are rarely, if ever, encountered and the patient does not require further studies or hospitalization. The six hour rule for stab wounds of the chest is valid. PMID- 2772793 TI - Hypospadias hidden by a complete prepuce. AB - Nine boys were found to have hypospadias despite the presence of a complete prepuce. The urethral meatus was in the subcoronal position in six boys, the distal shaft position in one boy and on the corona glandis in two boys. Although it is generally thought that boys with hypospadias have a dorsal hooded prepuce resulting from incomplete development of the ventral phallus, we have found hypospadias in boys with complete preputial development. Thus, physicians who perform circumcision should fully retract the prepuce to detect occult hypospadias before completing the procedure. Parents of newborns with hypospadias and a complete prepuce should be told, before circumcision, that preputial tissues may be needed to repair the hypospadias. PMID- 2772794 TI - Splenectomy for massive splenomegaly. AB - Several groups of authors have recently reported that removal of the massively enlarged spleen (1,500 grams or greater) is associated with a greater morbidity than that encountered in patients with spleens of smaller sizes. In our experience, 46 of 51 patients with massively enlarged spleens had a myeloproliferative disorder (leukemia, lymphoma or agnogenic myeloid metaplasia) and usually had a limited life expectancy. When morbidity in these patients was compared with that in patients with the same diagnosis but spleens of smaller size, no increase in complications or death was found other than a greater operative blood loss in patients with non-Hodgkin's lymphoma. Limitation of operative morbidity in patients with very large spleens depends on careful selection and appropriate operative and perioperative management. PMID- 2772792 TI - Surgical staging of carcinoma of the ovaries. AB - One hundred and eighty-seven patients with stages I, II and III optimal (metastatic lesions of less than 3 centimeters) epithelial carcinoma of the ovaries were evaluated preoperatively and had standardized exploration and biopsy. The protocol called for examination and biopsy of the peritoneum, diaphragm, omentum, pelvic and para-aortic lymph nodes and aspiration of ascites or peritoneal washings for cytologic examination. Of those patients with metastases to the omentum, the clinical impression did not correlate with pathologic findings in 45 per cent. The findings were similar for diaphragmatic lymph nodes (50 per cent), pelvic lymph nodes (71 per cent) and para-aortic lymph nodes (96 per cent). Nine of 97 patients clinically thought to have stage I disease had the stage elevated to II and III based on pathologic findings. Similarly, 15 patients thought to have stage II were found to have stage III based on histopathologic findings. There were 74 complications in 54 patients, with 29 having at least one complication. Surgical exploration for early stage carcinoma of the ovary should include biopsy of the retroperitoneal pelvic and para-aortic lymph nodes, excision of the infracolic omentum, biopsies of pelvic and abdominal peritoneum, including the right diaphragm, and peritoneal cytologic studies. PMID- 2772795 TI - Pelvic abscesses in postmenopausal women. AB - Seventeen postmenopausal women with pelvic abscesses were cared for at the Los Angeles County-University of Southern California Women's Hospital during the past eight years. Nine had experienced either postmenopausal bleeding or uterine instrumentation, or both, within the prior six months. Findings from physical examination and various laboratory and roentgenologic studies did not significantly help in improving the accuracy of preoperative diagnosis. In four, the abscess was associated with intra-abdominal pathologic conditions, and six had poorly controlled adult onset diabetes mellitus. Transfusion was required in eight patients. Two patients had a prolonged hospital stay because of pulmonary and septic complications. One patient had carcinoma of the ovary while another had carcinoma of the cervix uteri that was undiagnosed preoperatively. Our conclusion is that about one-half of postmenopausal patients with pelvic and tubo ovarian abscesses have postmenopausal bleeding. The remainder may have associated intra-abdominal infective pathologic findings or a malignant condition of the genital tract. Expeditious surgical treatment should be undertaken. PMID- 2772796 TI - Hemodynamic consequences of Foley catheter control in experiment penetrating cardiac wounds. AB - Insertion of the Foley catheter has been recommended to control bleeding from penetrating cardiac wounds. Potential complications from this maneuver include enlargement of the tear in the myocardium or further impediment to cardiac function by the balloon. This study was done to evaluate the hemodynamic consequences of the balloon catheter when it was used to control bleeding in cardiac stab wounds created in pigs. A significant decrease in cardiac function occurred with control of the bleeding by the balloon catheter. This effect was dependent on the size of the balloon and cardiac location. PMID- 2772797 TI - The overlooked technique of ampullary excision. AB - Local excision of ampullary tumors with reimplantation of the ducts is a relatively easy procedure, compared with pancreaticoduodenectomy. For properly selected patients, it will offer a longevity similar to that of the more radical procedure, at lower morbidity and mortality rates. It is the procedure of choice for benign ampullary lesions and deserves serious consideration for the high risk patient with a malignant lesion that is localized to the ampulla and adjacent duodenal wall. PMID- 2772798 TI - Technique using the fiberoptic valvulotome for the in situ vein graft. PMID- 2772799 TI - Maintaining decompression of sigmoid volvulus. PMID- 2772800 TI - Follow-up results of 3,500 arthroscopic operations on the knee joint. AB - In a clinical study the postoperative results of 3,500 arthroscopic operations on the knee joint were analyzed with a follow-up period of 1 year. At the time of examination 55.3% of patients were symptom-free, 33.8% had definite relief of symptoms and in 10.9% the symptoms were unchanged or progressive. The results of the different procedures performed varied widely, with the best results being obtained after meniscectomy. The average postoperative hospitalization was 3.5 days. Arthroscopy is a procedure with a low morbidity. Rehabilitation in the immediate postoperative period is accelerated due to reduced pain and functional impairment. PMID- 2772801 TI - Malignant duodenocolic fistula diagnosed by endoscopy. AB - A case of duodenocolic fistula secondary to carcinoma of the hepatic flexure is reported that was diagnosed by gastroduodenoscopy. The clinical, endoscopic, and radiographic features of this entity are discussed. Treatment options are reviewed. PMID- 2772802 TI - Electronic imaging with choledochoscopy. PMID- 2772803 TI - Endoscopy in the immediate postoperative period. PMID- 2772804 TI - Endoscopic microsurgical dissection of the esophagus. Results in an animal model. AB - Blunt dissection of the esophagus is considered the least invasive technique in the treatment of either benign or malignant diseases of the esophagus. Its disadvantage is that it has to be carried out blindly. The results may be uncontrollable hemorrhage, unrecognized injuries to the trachea, and damage to the recurrent laryngeal nerve. In order to reduce the degree of invasiveness a new endoscopic microsurgical technique for the dissection of the esophagus has been developed and tried out in animals. This paper presents the operative technique. Our new endoscopic microsurgical technique obviates a thoracotomy, while direct endoscopic vision results in improved dissection. The magnified endoscopic view permits selective exposure of blood vessels and prevents injury to the adjacent organs. PMID- 2772805 TI - The clinical spectrum of anomalous pancreatobiliary junction. AB - Anomalous junction of pancreatobiliary ducts (AJPB) is known to be associated with choledochal cyst and gallbladder cancer. This report describes our experience with eight patients with AJPB, six of whom were diagnosed at endoscopic retrograde cholangiography and two at transhepatic cholangiography. Four of the patients with AJPB had an associated congenital choledochal cyst, two had a normal biliary tree and one each had inspissated bile syndrome and cholangiocarcinoma. The last two associations have not been previously described. It is felt that the clinical spectrum of AJPB may unfold further with the widespread use of the cholangiographic techniques. PMID- 2772806 TI - Follow-up after polypectomy of colorectal adenomas. The importance of total colonoscopy. AB - Five hundred eighty-two patients with colorectal adenomas or early cancers were polypectomized from 1974 to 1985. In 100 patients, total colonoscopy was performed more than twice after the initial polypectomies. These patients were divided into three groups: group A patients underwent total colonoscopy at 1-year intervals; group B patients underwent total colonoscopy at 2-year intervals, group C patients underwent total colonoscopy at 3-year or more than 3-year intervals. The frequency and location of newly developed adenomas were investigated. The detection rate for new adenomas was 13% in group A and 50% in group B; thus, there was a significant difference between group A and group B (P less than 0.01). The transverse colon is the only segment where the topological proportion of newly developed adenomas increased in comparison with that of index adenomas (P less than 0.05). The detection rate for new adenomas was significantly higher in patients who had carcinoma in situ at the time of initial polypectomy (P less than 0.05). Questionnaires about colonoscopy and colonic adenomas were therefore mailed to the patients who were lost to follow-up after the polypectomy. PMID- 2772807 TI - Traumatic intracerebral hematoma--which patients should undergo surgical evacuation? CT scan features and ICP monitoring as a basis for decision making. AB - When a patient presents to the neurosurgeon with a traumatic intracerebral hematoma and has not deteriorated or developed new neurological deficit since the injury, the decision to remove the hematoma may be difficult. Of 244 patients with traumatic intracerebral hematomas, 85 were selected for intracranial pressure monitoring to assist in deciding whether surgical evacuation was indicated. None had deteriorated in conscious level or developed new neurological deficit since injury. Fifty-five patients (65%) demonstrated high intracranial pressure and underwent craniotomy. In 30 patients, intracranial pressure remained under 30 mm Hg, and their hematomas were not initially removed. Five of these 30 patients suddenly deteriorated or died 6 to 11 days after injury, with features of high intracranial pressure clinically or at postmortem. Intracranial pressure monitoring therefore failed to predict a late rise in intracranial pressure in 16.6% of those with low intracranial pressure initially. An analysis of computed tomography scanning and clinical features was therefore carried out to search for better predictors of the need for surgery. Our data suggest that basal cistern status, coma score, and the severity of edema surrounding the intracerebral hematoma should be used, in addition to intracranial pressure monitoring, to improve management of patients with traumatic intracerebral hematoma. PMID- 2772808 TI - The distribution of intravenous nicardipine in rat brain after subarachnoid hemorrhage. AB - The distribution of intravenously injected nicardipine in rat brain was investigated, as well as the influence of subarachnoid hemorrhage on its distribution. Autoradiographic studies demonstrated the accumulation of 3H nicardipine only in the ventricles and subarachnoid spaces around pial vessels in normal brains. Thirty minutes after subarachnoid hemorrhage, the concentration of 3H-nicardipine was higher in the ventricles and in the subarachnoid space than that found in normal brains. It is concluded that nicardipine penetrates into the subarachnoid spaces and ventricles from pial vessels and/or choroid plexus, and that subarachnoid hemorrhage increases the penetration of nicardipine from vessels into the subarachnoid space. PMID- 2772809 TI - Interface between the meningioma and the brain. AB - Though meningiomas are usually well demarcated from the brain, their interfaces with the brain take various forms. Based on 27 nonoperated supratentorial meningiomas from autopsies, the interfaces were classified into four types, that is, smooth, lobular, finger-like expansion, and invasive. Relationships between the types of interfaces and the so-called capsule of the tumor and subarachnoid vessels are discussed. Additionally, three surgical cases which showed more or less the invasive form are presented with neuroradiological findings. PMID- 2772810 TI - Malignant intraventricular meningioma with spinal metastasis through the cerebrospinal fluid. AB - A 67-year-old man developed a malignant meningioma of the right lateral ventricle at the trigone, for which he underwent total removal of the tumor and local irradiation. Six months after the operation, a spinal tumor developed and subtotal removal of the tumor was made. The spinal tumor was considered to be a metastasis via the cerebrospinal fluid in view of its histologic identity with the primary tumor, histologic findings of malignancy, absence of von Recklinghausen's disease, and lack of tumor attachment to the dura. PMID- 2772811 TI - Papillary meningioma arising from the confluens sinuum with multidirectional extension through venous sinuses. AB - Successful removal of a meningioma arising from the confluens sinuum is described. This tumor extended multidirectionally through the venous sinuses (superior sagittal sinus, bilateral transverse sinuses, straight sinus, and occipital sinus) and protruded like a club in nodular pattern from the left inner surface of the confluens sinuum into the left occipital lobe. The tumor was completely removed via a bilateral large parieto-occipito-suboccipital craniotomy. Angiographically, unusual venous drainage from the vein of Galen into the superior sagittal sinus was demonstrated. Histologically, this tumor was a papillary meningioma characterized by two types of papillary structure in many areas. PMID- 2772812 TI - Magnetic resonance imaging of embolism from intracranial aneurysms. AB - Two patients with embolism from unruptured intracranial aneurysms are reported. These patients experienced cerebral ischemic attacks at the ages of 10 and 64 years, respectively. Angiography revealed normal extracranial vessels and middle cerebral artery aneurysms. Preoperative magnetic resonance imaging showed intraaneurysmal clots and cerebral infarcts distal to the aneurysms. Aneurysmal neck clipping was carried out on the young patient. In the other case, the aneurysmal sac was excised, the intraluminal clot was removed, and the neck was closed with nylon sutures. These are the first cases of embolism from unruptured aneurysms in which magnetic resonance imaging revealed intraaneurysmal clots and cerebral infarcts distal to the aneurysms. PMID- 2772813 TI - Bioethics' middle-aged spread. PMID- 2772814 TI - Results of radiotherapy in stage I to II extranodal non-Hodgkin's lymphoma of the head and neck. AB - 29 patients with previously untreated clinical stage I and II extranodal non Hodgkin's lymphoma of the head and neck received involved or extended field radiotherapy at the Northern Israel Oncology Center during the years 1968 to 1979. Complete initial locoregional control was achieved in all patients; however, 18 patients (62%) relapsed. Two of the relapsing patients (11%) had "in field" failure, and one (6%) had "marginal" failure, with no evidence of disease elsewhere. 13 of the relapsing patients (72%) failed at distant sites, and two of these (11%) both locally and systemically. 13 of 15 patients (87%) with lymphoma of Waldeyer's ring relapsed, most commonly in the abdominal cavity. Only one of seven patients (14%) with lymphoma of the paranasal sinuses recurred. The five- and ten-year actuarial survival of all patients was 50% and 46%, respectively. While patients with lymphoma of the paranasal sinuses had a survival probability of 86% at ten years, patients with disease originating in Waldeyer's ring had an actuarial ten-year survival of 18% only. The prognosis of younger patients was better than the prognosis of patients older than 65. Although this series is too small and heterogeneous to derive definite treatment recommendations, it is suggested that radiotherapy to doses of 4000 to 6000 cGy can control most local disease. The overall results of radiation therapy alone have been unsatisfactory in our patients with lymphoma of Waldeyer's ring and the parotid gland due to failure outside the locally treated area, frequently in the abdominal cavity. Precise staging procedures are needed to detect sites of occult disease which require the use of systemic chemotherapy. It is felt that adequately staged, localized, small size non-Hodgkin's lymphoma of the paranasal sinuses can be treated by radiotherapy alone without loss of curability. PMID- 2772815 TI - [Demonstration of independent cellular prognostic factors in squamous cell carcinoma of the lung]. AB - The aim of this investigation was to find out whether a histopathologically homogeneous group of patients (similar in histology, grade, operation, and therapy) could be divided with respect to survival by determining cellular tumor factors. Therefore out a group of 100 patients 46 patients with previously untreated epidermoid lung carcinomas were selected. From these patients fresh surgical specimens of tumors were investigated by means of flow cytometry and the obtained data were correlated with five years survival. Patients with aneuploid tumors had significantly shorter survival times than did those with diploid tumors (p = 0.02). Seven of eleven patients with diploid tumors survived five years or more, whereas 25 of 35 patients with aneuploid tumors died within this period. Patients having tumors with a high proportion of G0/G1-phase cells survived significantly longer (p = 0.04) than patients having tumors with a lower proportion of G0/G1-phase cells. Within five years half of the patients with a high proportion of G0/G1-phase cells survived in contrast to 10% of patients in the other group. These data demonstrate that in addition to the well known clinical and histological factors independent cytometric prognostic factors in epidermoid carcinoma of the lung exist. PMID- 2772816 TI - Radiosensitivity test for cancer of the uterine cervix. AB - In selecting the method of treating uterine cervical cancer, radiosensitivity is one of the most important factors. To know this factor before treatment, we are trying to estimate radiosensitivity with changes of primary tumors before and after the irradiation. Tumors must be irradiated uniformly with small doses, and based on these considerations, we are attempting external test irradiation for estimation of radiosensitivity. Radiosensitivity was determined histopathologically by comparing the results of histological specimens taken before and seven days after test irradiation. Radiosensitivity is closely related to prognosis: of 183 cases with good sensitivity, 146 cases (79.8%) were surviving at five years after radiotherapy. On the other hand, the five-year survival rate of cases with poor sensitivity was only 37.2%. Comparing radiation with operation in operable cases of stage I and II, the five-year survival rate in cases with good sensitivity was about the same (90%). On the contrary, in cases with poor sensitivity, there was a substantial difference: that is, 66.0% of operated cases had a five-year survival compared with 39.7% of radiated cases. PMID- 2772817 TI - [Three-dimensional irradiation planing]. AB - A software for three-dimensional display of dose distributions in irradiation planning was developed which is based on the computed tomography (CT) data and dose matrices of the commercial irradiation planning system Mevaplan (Siemens). Isodoses with CT background can be reproduced in all planes lying in a normal position with respect to the CT plane and displayed perspectively in any combination. In order to achieve a better quantitative assessment of the dose distribution, an algorithm was introduced into Mevaplan allowing the calculation and display of dose-volume histograms and of the dose gradient. PMID- 2772818 TI - [Control measurements with TLD-100 sticks for selected radiation fields]. AB - The influence exerted on dose distribution by the specific mass of the material is investigated for irradiation planning on the basis of CT matrices. It is shown that the specific masses of the Alderson phantom actually differ from those calculated by conversion of CT figures. In some planning systems, the conversion of CT figures into specific masses is the only parameter which can be verified by the user. Furthermore, the results of control measurements on the irradiation planning with the system Sidos-U (Siemens Company) are presented. PMID- 2772819 TI - [Radioactivity of air in the vicinity of medical linear accelerators]. AB - Some mathematical expressions are given for the calculation of the activity concentration (13N,15O) in the surroundings of medical electron accelerators with a maximum photon energy up to 25 MeV. The author differentiates between prolonged irradiations typical of physical operation or maintenance work and shorter irradiations separated into fractions which are typical of the treatment of patients. In most cases the calculated concentrations are considerably lower than the limit values valid e.g. for persons of category B professionally exposed to radiation, so that the margin of error assumed for this calculation method is of no significance. A measure of the activity concentration which is always time- and cost-consuming would be unnecessary in that case. PMID- 2772820 TI - [Morphological changes in the bladder of female mice after x-ray and peak-pion irradiation (the piotron)]. AB - Early and late effects of irradiation of the urinary bladder in female NMRI mice were studied histologically. The animals were exposed either to X-rays or to negative pions in the peak (by single or fractionated local irradiation). With doses above 12.5 Gy the X-rays produced more severe late effects than the pions with the same dose. PMID- 2772821 TI - Effect of indomethacin, diclofenac sodium and sodium salicylate on peripheral blood cell counts in sublethally gamma-irradiated mice. AB - Treatment with indomethacin and diclofenac sodium was found to increase granulocyte counts in the blood of sublethally gamma-irradiated mice. Treatment with sodium salicylate was ineffective in this respect, administration of sodium salicylate together with indomethacin even decreased the indomethacin-induced effects. The results suggest that the hemopoiesis-stimulating effects of non steroidal anti-inflammatory drugs cannot be correlated with the anti-inflammatory activity but rather with the side effects of these compounds, including the action on gastro-intestinal prostanoid production. This conclusion doubts on the possibility of the usefulness of non-steroidal anti-inflammatory drugs in conditions of the radiation syndrome. PMID- 2772822 TI - Aggressive surgery for carcinoma of the gallbladder. AB - Forty patients with gallbladder cancer were admitted to our institution in a 9 year period. For two patients with Nevin's stage I carcinoma who had undergone cholecystectomy, resection of the lower portion of the fourth and fifth segments of the liver and extrahepatic bile duct with dissection of lymph nodes was carried out as a second-stage operation. Thirteen patients with stage V carcinoma underwent extensive aggressive operations. Operative procedures comprised various types of liver resection with cholecystectomy and extrahepatic bile duct resection and wide lymph node dissection in all cases, portal vein reconstruction in 3, pancreatoduodenectomy in 3, partial colectomy in 3, and right nephrectomy in 1. The operative and in-hospital mortality rates were 0%. Two patients with stage I carcinoma are both doing well. Two patients with stage V carcinoma who underwent an extended operation are working without recurrence 7 years 8 months and 8 years 5 months after surgery. From our experiences we believe that long term survival may be achieved by aggressive surgery if it is suitably indicated. PMID- 2772823 TI - Conversion surgery for morbid obesity: complications and long-term weight control. AB - Some operations for morbid obesity fail--for a variety of reasons. To better understand the risk and efficacy of converting, during a single operation, a failed procedure to a second type of operation for morbid obesity, a review was made of all 120 patients who underwent this type of conversion surgery at one university hospital during a 10-year period. The initial operations of 62 patients were converted to a gastric bypass with a Roux-en-Y gastrojejunostomy, 11 to an unbanded gastrogastrostomy, and 47 to a vertical banded gastroplasty. Four patients are dead (three of unrelated causes), 11 have undergone a third operation for morbid obesity, and five (4.2%) are lost to follow-up. For 69 of 86 patients, 3- to 5-year follow-up data are available. Serious early complications occurred in 5.8% of the patients. Almost 80% of the patients who received an unbanded gastrogastroplasty did not control their weight, whereas most of those who received a Roux-en-Y gastrojejunostomy or a vertical banded gastroplasty had satisfactory long-term weight control 3 to 5 years later, maintaining an average weight loss of 30% of their original weight or 55% of their excess weight. Conversion surgery is safe and effective. PMID- 2772824 TI - The role of contrast radiography in presumed bowel obstruction. AB - A retrospective review of 229 patients with a final diagnosis of small-bowel obstruction was undertaken to evaluate the role of contrast radiography in the management of their conditions. In 84 patients (37%) the clinical findings and plain abdominal roentgenograms were sufficient for diagnosis and subsequent management. Of the remaining 145 patients with equivocal findings, 27% had an upper gastrointestinal series, 29% a barium enema, and 44% had both. Useful information (complete obstruction, unobstructed passage of contrast, or diagnosis other than adhesional obstruction) was obtained from 86% of the radiographic studies. Three patients had negative contrast studies yet eventually underwent adhesiolysis (enterolysis) and were classified as false-negative. Two patients had evidence of high-grade obstruction yet had nonoperative resolution and were classified as false-positive. The mortality in the contrast group (7%) was not statistically different than that in the no-contrast group (7%). Contrast radiography is a safe and effective means of increasing diagnostic accuracy in patients with presumed small-bowel obstruction. PMID- 2772825 TI - Delayed plasma cholecystokinin and gallbladder responses to intestinal fat in patients with Billroth I and II gastrectomy. AB - This study was undertaken to examine the intestinal phase of cholecystokinin (CCK) secretion and gallbladder contraction in patients who had undergone partial gastrectomy. Plasma CCK concentrations, measured by radioimmunoassay, and gallbladder contraction, measured by cholescintigraphy, were studied after intestinal administration of fat. Fasting plasma CCK concentrations were in the same range in nine patients who had undergone Billroth I gastrectomy (1.0 +/- 0.2 pmol/L), in nine patients who had undergone Billroth II gastrectomy (1.4 +/- 0.2 pmol/L), and in nine normal subjects (1.5 +/- 0.4 pmol/L). The peak increments in plasma CCK after intestinal fat were significantly (p less than 0.05) lower in patients with partial gastrectomy (5.4 +/- 0.6 pmol/L) compared with normal subjects (7.9 +/- 0.8 pmol/L). The integrated plasma CCK secretion was significantly (p less than 0.01 to p less than 0.05) reduced during the first 30 minutes in patients after Billroth I (74 +/- 11 pmol/1.30 min) and Billroth II gastrectomy (51 +/- 11 pmol/1.30 min) compared with normal subjects (122 +/- 18 pmol/1.30 min). Similarly, the start of gallbladder emptying was significantly (p less than 0.05) delayed in patients after partial gastrectomy. After 1 hour, however, the integrated plasma CCK response and gallbladder emptying were in the same range in Billroth I patients (186 +/- 34 pmol/1.60 min, 60% +/- 7%), Billroth II patients (175 +/- 17 pmol/1.60 min, 63% +/- 7%) and normal subjects (190 +/- 18 pmol/1.60 min, 55% +/- 6%). It is concluded that in patients who have undergone partial gastrectomy plasma CCK and gallbladder responses to intestinal fat are significantly delayed but reach normal levels beyond 30 minutes. PMID- 2772826 TI - Role of neutrophils in generalized reperfusion injury associated with resuscitation from shock. AB - Recent studies suggest that neutrophils are an important factor in the organ injury associated with ischemia and shock. Increased neutrophil-endothelial adhesiveness is essential for neutrophil-mediated vascular injury. To examine the role of neutrophils and neutrophil adhesiveness in the development of injury after hypovolemic shock, and to determine whether this injury is a consequence of reperfusion, we used the monoclonal antibody (MAb) 60.3 (directed to the primary human neutrophil adherence glycoprotein, CD18) to block neutrophil adherence functions at the time of resuscitation in a rabbit model of hemorrhagic shock. None of the unanesthetized control animals subjected to 2 hours of shock (cardiac output, 30% of baseline) followed by resuscitation survived 5 days. All had gross and histologic evidence of injury to lungs, liver, and gastrointestinal mucosa. In contrast, 71% of the animals that received MAb 60.3 immediately before resuscitation survived 5 days (p less than 0.005), and visceral organ injury was absent or markedly attenuated. We conclude that a significant proportion of injury resulting from shock and resuscitation occurs after the ischemic insult and that increased neutrophil adhesiveness plays an important role in the development of multiple organ injury and death following shock and resuscitation (in this model). This injury may be significantly reduced by blocking neutrophil adherence functions with the MAb 60.3--even if administration is delayed until resuscitation. PMID- 2772828 TI - The influence of the surgical wound on local tumor recurrence. AB - Failure of a primary surgical treatment for cancer is often caused by recurrence of the tumor at the surgical site. The KHT mouse tumor system recapitulates this experience and provides a useful model to test strategies for reducing the incidence of local recurrence after surgical excision. There was an 82% local recurrence of the KHT tumor after surgery. A cell dilution assay indicated that it would require only 39 tumor cells injected into the wound site to result in the same (82%) incidence of tumors. This figure is in contrast to 340 cells required when the cells were injected into an unwounded flank. With the B16 melanoma in C57B1 mice and the Meth A sarcoma in BALB/c mice, the number of cells necessary to induce a tumor (TD/50) was also significantly reduced when the cells were injected into a surgical wound rather than into nonwounded tissue. The difference in cell number was interpreted as the result of the presence of growth factors derived from the traumatized tissue and the inflammatory cells at the wound site. Neither a 5 nor a 15 Gy dose of x-radiation delivered to the wound site immediately after surgical excision of the KHT tumor resulted in a significant reduction in the incidence of local recurrences. When the same doses of x-radiation were given immediately after injecting 36 KHT cells into a wound, no tumors developed. This difference was believed to have resulted from the hypoxic condition in the wound site and the presence of residual clonogenic tumor cells in a nonproliferating (radioresistant) state. PMID- 2772827 TI - Microfluorometric measurements of cytoplasmic calcium in chief and oxyphil parathyroid cells of adenomatous and hyperplastic glands and of normal-sized glands associated with adenomas. AB - The effects of extracellular calcium on the cytoplasmic Ca2+ concentration (Ca2+i) were studied by dual-wavelength microfluorometry in individual human parathyroid cells obtained from adenomatous glands and normal-sized glands associated with adenomas in hypercalcemic hyperparathyroidism (HPT), as well as from enlarged glands of patients with uremia with HPT. In comparison with the normal parathyroid tissue, chief cells of the adenomatous and hyperplastic glands showed significantly lower Ca2+, and also right-shifted responses of Ca2+i to increases in the extracellular calcium concentration within the 0.5 to 3.0 mmol/L range. This pathophysiologic disturbance apparently was independent of the cell size. Oxyphil cells of nodules from the hyperplastic glands had lower Ca2+i and responded less to increments in extracellular Ca2+ than the chief cells from the surrounding parts of the same glands. Also the chief cells from the normal-sized glands associated with single adenomas exhibited a disturbance of the regulation of Ca2+i, which was less pronounced than that in the cells of the adenomas. These findings support the presence of relative calcium insensitivity of Ca2+i in chief and oxyphil parathyroid cells from adenomatous and hyperplastic glands. This derangement may also be found in all parathyroid glands of individuals with adenomatous HPT. PMID- 2772830 TI - Horseshoe anomaly of the appendix: a previously undescribed entity. AB - Anomalies of the appendix are extremely rare. The case presented here has not been previously described and is that of a "horseshoe" appendix in a 33-year-old man with sigmoid diverticulitis. This appendiceal variant cannot be classified into any of the existing categories of appendiceal anomalies. PMID- 2772829 TI - Esophageal blood flow in the rabbit: response to calcium channel blockers. AB - Calcium channel blockers have recently been added to the therapeutic regimen for patients who have chest pain of esophageal origin. Although relief of symptoms has been reported, this has not always been associated with changes in esophageal contraction pressures or luminal pH. Myoischemia has been proposed as one possible mechanism for esophageal chest pain. We have investigated the effect of the calcium channel blockers verapamil, nifedipine, and diltiazem on esophageal blood flow in the rabbit model. Esophageal blood flow was measured three times in each rabbit with use of the radiolabeled microsphere technique after a 30-minute continuous infusion of (1) saline solution (baseline), (2) a low dose, and (3) a high dose of each agent. Esophageal mucosal blood flow significantly decreased with nifedipine but was unchanged with verapamil and diltiazem. Esophageal muscle blood flow significantly increased--approximately 100% after administration of each of the calcium channel blockers. Thus esophageal muscle blood flow is enhanced after administration of calcium channel blockers, and this may be one therapeutic mechanism of the calcium channel blockers in the relief of esophageal chest pain in some esophageal diseases. PMID- 2772831 TI - Operative strategies in the management of mediastinal pancreatic pseudocyst. AB - Thirty-four cases of mediastinal pancreatic pseudocyst have been previously reported. Among the 32 previous reports with operative or autopsy analysis, communication has been identified in 30. Even when this communication has been quite small between the mediastinal fluid collection and the pancreas, the recommended operative strategy has been enteric drainage directly to this communicating tract. We report the case of a patient with a mediastinal pancreatic pseudocyst in whom the communication between the pancreas and the pseudocyst was not located. The condition was managed by drainage of the mediastinal pseudocyst with decompression of the main pancreatic duct by means of a longitudinal pancreaticojejunostomy in a patient with chronic pancreatitis. PMID- 2772832 TI - Giant colonic mucocele after diversion colostomy for ulcerative colitis. AB - We report an unusual complication occurring after diversion transverse loop colostomy in a patient with long-standing ulcerative colitis. The formation of a giant colonic mucocele resulted from distal stomal and rectal stenosis, with subsequent accumulation of mucus in the obstructed segment over many years. The pathophysiologic features of this case, which are similar to mucocele of the appendix, are discussed. To our knowledge, this is the first report in the literature of a giant colonic mucocele after diversion colostomy. PMID- 2772833 TI - Hemangiopericytoma of the spleen. AB - Hemangiopericytomas are rare vascular tumors, most frequently found in the muscles of the lower extremities. A parenchymatous origin is extremely uncommon. We present here what we believe is the first case ever reported of an hemangiopericytoma of the spleen. PMID- 2772834 TI - Giant cyst of the breast. PMID- 2772835 TI - Recurrence or persistence. PMID- 2772836 TI - Persistence and not recurrence when a tumor appears at the site of resection. PMID- 2772837 TI - Sorbitol and dental plaque. Aspects of caries-related microbiological and biochemical factors. PMID- 2772838 TI - Cholinergic modulation of frequency receptive fields in auditory cortex: II. Frequency-specific effects of anticholinesterases provide evidence for a modulatory action of endogenous ACh. AB - Exogenously applied muscarinic agonists--for example, acetylcholine (ACh) and acetyl-beta-methacholine (MCh)--modify frequency receptive fields in auditory cortex of unanesthetized animals in a frequency-specific rather than global manner. The present study sought to relate these findings to endogenous actions of ACh by using the anticholinesterase agents eserine sulphate and soman (0-1,2,2 trimethylpropylmethylphosphonofluoridate) to facilitate the effects of endogenous ACh. Frequency receptive fields (FRF) were determined by presenting sequences of different isointensity tones before, during, and after application of ACh, MCh, eserine, or soman; also the cholinesterase blockers were applied between applications of ACh or MCh. The major effects produced by the inhibitors were similar to those of the agonists. Predominant effects were frequency-specific changes in FRF. Further, eserine and soman, similar to ACh and MCh, produced shifts in the best frequency (BF) of FRF due mainly to coordinated depression of responses to the BF and increased responses to adjacent, non-BF. The results indicate that exogenous and endogenous ACh, acting via muscarinic receptors, can significantly influence the physiological functioning of cortical neurons and consequently their processing of sensory information. PMID- 2772839 TI - Colocalization of taurine- and cysteine sulfinic acid decarboxylase-like immunoreactivity in the hippocampus of the rat. AB - It is proposed that taurine is an inhibitory neurotransmitter/neuromodulator in the CNS. The present study localized taurine-containing neurons within the rat hippocampus with the use of a monoclonal antibody against conjugated taurine (Tau2) in conjunction with an antiserum against cysteine sulfinic acid decarboxylase (CSADC), a synthesizing enzyme for taurine. Taurine-like immunoreactivity Tau-LI) and CSADC-LI were colocalized in neurons of the dentate gyrus, CA1(/CA2), CA3, and CA4. Of all the cells examined, pyramidal basket cells within the granule cell layer of the dentate gyrus were most intensely stained with both Tau2 and CSADC. Granule cells were also double-labeled with Tau-LI and CSADC-LI. Cell nuclei and dendrites in the CA1 region stained more intensely with Tau2 than somata. CSADC-LI was colocalized with Tau-LI within these neurons. Light staining with both Tau2 and the CSADC antiserum was inconsistently present in CA3 and CA4 neurons and was found to be highly dependent on the type of fixation and delay to fixation. Tau-LI was more consistently present in increased numbers of neurons in CA3 when glutaraldehyde was added to the paraformaldehyde fixative solution. Hippocampi which were immersion-fixed in paraformaldehyde following a 0-, 6-, or 24-hour postmortem delay exhibited a lack of Tau2 staining in the CA3 region in the majority of animals studied, similar to some paraformaldehyde perfusion-fixed rats. These studies suggest that taurine was present in the majority of neurons within the major cell layers of the rat hippocampus, but Tau-LI was more easily lost from neurons in the CA3 region following delay to fixation. The localization of Tau-LI in excitatory neurons such as granule cells and pyramidal cells is not consistent with its proposed inhibitory transmitter role. However, the prominent Tau2 staining in dendrites of the CA1 region provides anatomical support for the hypothesis that taurine may be released from dendrites in the CA1 region and may function as a neuromodulator of calcium flux in these pyramidal neurons. PMID- 2772840 TI - Ultrastructural description of taurine-like immunoreactive cells and processes in the rat hippocampus. AB - A monoclonal antibody against taurine conjugated to KLH was used to identify and describe taurine-like immunoreactive processes in the rat hippocampus. Tissue from perfused rats was processed for immunohistochemical visualization of taurine and embedded for electron microscopy. Representative tissue samples from three regions, the dentate gyrus, CA3, and CA1, were sectioned, examined, and photographed. In the dentate gyrus, both granule cells and pyramidal basket cells were taurine-like immunoreactive. Some axon terminals in the dentate gyrus molecular layer as well as some mossy fiber boutons in the hilus were also taurine-like immunoreactive. In the CA3 region both pyramidal neurons and glial cells were taurine-like immunoreactive A few small-diameter axon terminals in stratum radiatum and some mossy fiber boutons in stratum lucidum were taurine like immunoreactive. In CA1, pyramidal neurons and some glia were intensely taurine-like immunoreactive. A few immunoreactive axon terminals were seen in stratum radiatum and stratum oriens. In all regions, dendritic staining predominated. Our results support the hypothesis that while taurine may act as a neurotransmitter in a small portion of hippocampal terminals, its main function is probably as a neuromodulator or ionic regulator. PMID- 2772841 TI - Effects of dinocap on otolith development: evaluation of mouse and hamster fetuses at term. AB - The morphology of otoliths in CD-1 mouse and Syrian hamster fetuses exposed to the fungicide dinocap were evaluated at the end of gestation. Pregnant mice were dosed by gavage with 0, 10, 15, 30, or 60 mg/kg/day dinocap in corn oil on days 7 16 of gestation. Pregnant hamsters were dosed by the same route with 0, 50, 100, or 200 mg/kg/day on days 7-14 of gestation. At the end of gestation (day 18 in mice, day 15 in hamsters) dams were killed and all fetuses were removed and fixed overnight in 70% ethanol. Fetal heads were then removed, left in 70% ethanol for at least 3 days, and then dehydrated in a graded ethanol series and cleared with methyl salicylate. Otoliths were examined by darkfield microscopy, and each otolith was scored for morphological completeness on a scale of 0 to 3. Otolith development was complete by day 18 of gestation in control mouse fetuses. Otolith development was complete in many, but not all, of the hamster fetuses by day 15 of gestation. In the mouse, dinocap exposure inhibited fetal otolith formation in a dose-related manner, with a significant effect on total otolith score occurring at 10 mg/kg/day and above. Dinocap affected otolith formation in the hamster only at 100 mg/kg/day (200 mg/kg/day was embryolethal), concomitant with severe maternotoxicity and fetotoxicity.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2772842 TI - Hemodynamic effects of acetylcholine in the chick embryo and differences from those in the rat embryo. AB - It has been reported that acetylcholine induces cardiac anomalies in the chick embryo. Thus, we studied hemodynamic effects of this drug in the chick embryo and also compared them with those in the rat embryo since we found that the effect of caffeine was different between the chick and rat embryos. Acetylcholine was given at doses of 5, 0.5, and 0.05 micrograms into the vitelline vein in chick embryos at Hamburger-Hamilton stage 21 and at a dose of 0.5 micrograms into the placenta in rat embryos at gestational day 12. In the chick embryo, heart rate was reduced to 91, 88, and 87% of control at the end of injection of 0.05, 0.5, and 5 micrograms, respectively, then returned to the baseline level. Vitelline arterial blood pressure was 110% of control with 0.05 micrograms, 134% with 0.5 micrograms, and 142% with 5 micrograms at 1 min after injection. The dorsal aortic blood flow decreased with time after injection, but it was increased only by a 5 micrograms dose at the end of injection. The vascular resistance increased in a dose-dependent manner. In the rat embryo, the change of heart rate was qualitatively similar to that of the chick embryo. The blood pressure did not change significantly. The blood flow velocity at the outflow tract decreased at the end of injection, which indicated the decrease in cardiac output, along with slowing of heart rate, then returned to the control level thereafter.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2772843 TI - Protective effect of ouabain on adriamycin-induced cardiovascular anomalies in chick embryos. AB - Adriamycin (2.5-10.0 micrograms) was administered to 4 1/2 and 5 day embryonic chicks (Hamburger-Hamilton developmental stages 24-26) to investigate the effect of the drug on cardiovascular morphogenesis. The drug produced dose-related increases in both mortality rate and malformation frequency with a maximum incidence of 82% cardiovascular anomalies following a dose of 10.0 micrograms/egg (P less than .001 relative to saline controls). Frequencies of embryos with ventricular septal defect (P less than .005), dextroposition of the aorta (P less than .005), or aortic arch anomalies (P less than .05) were significantly higher than among controls. In a second study, embryos were pretreated with ouabain (12.2 micrograms), verapamil (0.5 micrograms), coenzyme Q10 (100 micrograms, 200 micrograms), or vitamin E (1.0 mg, 5.0 mg)--agents previously shown to protect against adriamycin-induced cardiotoxicity. Pretreatment of embryos with ouabain significantly reduced the incidence of cardiovascular malformations induced by adriamycin from 55 to 21% (P less than .05). A major protective effect was observed relative to the induction of ventricular septal defect, the frequency of which was reduced from 45 to 14% (P less than .05). However, administration of verapamil, coenzyme Q10, or vitamin E did not have an appreciable effect on adriamycin-induced frequencies of cardiovascular malformations. Negative inotropism is suggested as a mechanism for adriamycin-induced cardiac anomalies but warrants further study. PMID- 2772844 TI - Test of six chemicals for embryotoxicity using fetal mouse salivary glands in culture. AB - Many new chemicals come into use each year, and the need for rapid and cost effective methods for testing developmental toxicity is apparent. Establishing reliable in vitro techniques is important to a tier approach to testing for developmental toxicity. The fetal mouse salivary gland was selected as a possible test system because several interacting developmental processes occur in gland growth, and development is quantifiable by counting lobes. For each chemical tested, 20 glands from 13-day embryos were treated in a control media and in three concentrations of the test chemicals. The number of lobes present after 48 hours is dependent on the number of lobes at explantation. Glands with different numbers of lobes at explantation were compared by dividing the number of lobes present after 48 hours by the number present at explantation to determine a growth ratio. Mean growth ratios were used to construct dose-response curves, and from these curves the concentration that reduced growth by 50% (TP50) was determined. Comparisons with in vivo data were made by calculating three ratios; the TP50 was divided into the lowest teratogenic dose, the lowest maternal toxic dose, and the dose that was lethal to 50%. Four in vivo teratogens, 6 aminonicotinamide, cytochalasin B, hydroxyurea, and 3-acetylpyridine, all had ratios much higher than 1, indicating a very sensitive response by the glands. One in vivo teratogen, dexamethasone, had much lower ratios, indicating less sensitivity. Acetaminophen, a nonteratogen in vivo, actually stimulated growth of the glands at 10(-5) M and had very low ratios indicating a minimal response by the glands. PMID- 2772845 TI - Cortisone cure of the eyelid closure defect in lidgap-Stein fetal mice: a dose response and time-response study as a test of the hypomorph hypothesis for the lidgap alleles. AB - The lidgap-Stein mutation is one of a series of alleles that cause the birth defect open eyes in mice. Previously it was known that cortisone administered during pregnancy prevents the defect in some lidgap-Stein fetuses. In this study, the hypothesis that lidgap-Stein is a hypomorph of effect intermediate between that of its alleles lidgap-Miller (least abnormal) and lidgap-Gates (most abnormal) was tested in a dose-response, time-response, and scanning electron microscopic study. Cortisone produced a response at doses of 20-80 mg/kg, with maximum cure of 30% in right eyes, 24% in left eyes, and 13% bilaterally. There was significantly more response in right than in left eyes. The response was slight at doses of less than 20 mg/kg and dropped to zero at the highest dose of 120 mg/kg. Treatment on days 13 or 14 gave the maximum response, with little or no response to treatment on days 10, 11, 12, 15, or 16. Severity of defect, measured as the size of gap in open eyes on day 18, was not reduced as the frequency of open eyes was reduced; most unclosed eyes remained wide open. The much lower level of maximum bilateral response to cortisone in lidgap-Stein (13%) than in lidgap-Miller (94%) is entirely compatible with the hypomorph hypothesis. PMID- 2772846 TI - Retinoic acid vs. excess vitamin A. PMID- 2772847 TI - Differential neuronal loss following early postnatal alcohol exposure. AB - Neonatal rats were exposed to 6.6 g/kg of alcohol each day between postnatal days 4 and 10 while artificial-rearing procedures were used, in a manner which produced high peak and low trough blood alcohol concentrations each day. Gastrostomy controls were reared artificially with maltose/dextrin isocalorically substituted for alcohol in the milk formula, and suckle controls were reared normally by dams. The pups were sacrificed on day 10 and tissue sections (2 microns thick) were obtained in the sagittal plane through the cerebellum and in the horizontal plane through the hippocampal formation. Overall area measures were obtained for the hippocampus proper, area dentata, and cerebellum, along with areas of the cell layers of these regions. In the hippocampal formation, cell counts were made of the pyramidal cells of the hippocampus proper, the multiple cell types of the hilus, and the granule cells of the area dentata. In the cerebellum, cell counts of Purkinje cells, granule cells of the granular layer, granule cells of the external granular layer, and mitotic cells of the external granular layer were obtained from lobules I, V, VII, VIII, and IX. Alcohol selectively reduced areas and neuronal numbers in the cerebellum but had no significant effects on neuronal numbers in the hippocampal formation. Purkinje cells exhibited the greatest percent reductions, and cerebellar granule cells were significantly reduced in the granular layer but not in the external granular layer. All lobules showed these effects, but lobule I was significantly more affected than the other four lobules that were analyzed. The results demonstrate the differential vulnerability of selected neuronal populations to the developmental toxicity of alcohol exposure during the brain growth spurt. PMID- 2772848 TI - Enhancement of murine phenytoin teratogenicity by the gamma-glutamylcysteine synthetase inhibitor L-buthionine-(S,R)-sulfoximine and by the glutathione depletor diethyl maleate. AB - The teratogenicity of phenytoin may result from its enzymatic bioactivation to a reactive intermediate, which, if not detoxified, can interact with embryonic tissues and alter development. Glutathione (GSH) is an important cofactor/substrate for many physiological processes and for the detoxification of xenobiotic reactive intermediates. This study examined the effects of the GSH depletor diethyl maleate (DEM) and the GSH synthesis inhibitor L-buthionine-(S,R) sulfoximine (BSO) on phenytoin embryopathy. Phenytoin, 55 mg/kg, was administered intraperitoneally (ip) to pregnant CD-1 mice at 0900 hr on gestational days 12 and 13. Pretreatment with DEM, 150 or 300 mg/kg ip, enhanced the incidence of phenytoin-induced cleft palates by 3.3-fold and 2.3-fold, respectively (P less than 0.05), without affecting the incidence of resorptions, postpartum death, or mean fetal weight. BSO, 1,800 mg/kg ip, given 0.5 hr prior to phenytoin, resulted in a 2.4-fold increase in postpartum lethality and a 5-fold increase in fetal weight loss (P less than 0.05), without altering the incidence of resorptions or cleft palates. In two subsequent studies, BSO, 680-1,018 mg/kg/day, was given in the drinking water on gestational days 9 to 13 in the first study and on days 10 to 14 in the second study. Phenytoin, 55 mg/kg ip, was given on days 11 and 12 and on days 11 to 13 in the respective studies. In the first drinking water study, BSO enhanced the incidence of phenytoin-induced fetal resorptions 3.8-fold and cleft palates 3.3-fold (P less than 0.05) but did not affect postpartum death. In the second study, BSO enhanced the incidence of resorptions, cleft palates, and postpartum death by 2-fold, 2.6-fold, and 1.7-fold, respectively (P less than 0.05). In both of the latter two studies, phenytoin-induced fetal weight loss was altered by BSO treatment (P less than 0.05). BSO alone had no embryopathic effects. These results suggest that GSH may be involved in the detoxification of a reactive intermediate of phenytoin and/or in fetal cytoprotection. PMID- 2772849 TI - Comparative developmental toxicity of cationic and neutral rhodamines in mice. AB - Rhodamines 123 and 6G (Rh 123 and Rh 6G) are cationic fluorescent dyes that inhibit oxidative phosphorylation following their selective accumulation within mitochondria. Neutral rhodamines (e.g., Rh 116 and Rh B) do not share these properties. To determine if cationic and neutral rhodamines differ in their effect on mammalian development, pregnant CD-1 mice were injected i.p. with Rh 123, Rh B, or Rh 116 at doses of 15 mg/kg/day. The rhodamines were given alone or in combination with 500 mg/kg/day 2-deoxy-D-glucose (2-DOG), an inhibitor of glycolysis, daily on gestation days 7-10 (copulation plug = day 1). Additional pregnant mice were similarly treated with Rh 6G at a dose of 0.5 mg/kg/day. Controls were given saline equimolar to the dose of 2-DOG. Treatment with Rh 6G, alone or in combination with 2-DOG, significantly increased the incidences of prenatal mortality (17% and 35%, respectively) when compared with the control incidence (6%). Treatment with Rh 123 or Rh 6G, alone or with 2-DOG, inhibited fetal growth. Treatment with the neutral rhodamines had little effect on prenatal survival or growth. Exposure to Rh 6G, with or without 2-DOG, was associated with high incidences of gross malformations (41% and 61%, respectively). Rh 116 or Rh B, with or without 2-DOG, and Rh 123 alone were not associated with statistically significant teratogenic effects, but results of the latter treatment were suggestive of such an effect (9.1% grossly malformed fetuses vs. 0% for controls). The incidences of skeletal malformations were significantly increased in the test groups given Rh 6G + 2-DOG, Rh 123 + 2-DOG, or Rh 6G alone.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2772850 TI - Bendectin and human congenital malformations. AB - The relationship between Bendectin exposure during the first trimester of pregnancy and the occurrence of congenital malformations was prospectively studied in 31,564 newborns registered in the Northern California Kaiser Permanente Birth Defects Study. The odds ratio for any major malformation and Bendectin use was 1.0 (95% confidence interval 0.8-1.4). There were 58 categories of congenital malformations; three of them were statistically associated with Bendectin exposure (microcephaly--odds ratio = 5.3, 95% confidence interval = 1.8 15.6; congenital cataract--odds ratio = 5.3, 95% confidence interval = 1.2-24.3; lung malformations (ICD-8 codes 484.4-484.8)--odds ratio = 4.6, 95% confidence interval = 1.9-10.9). This is exactly the number of associations that would be expected by chance. An independent study (the Collaborative Perinatal Project) was used to determine whether vomiting during pregnancy in the absence of Bendectin use was associated with these three malformations. Two of the three (microcephaly and cataract) had strong positive associations with vomiting in the absence of Bendectin use. We conclude that there is no increase in the overall rate of major malformations after exposure to Bendectin and that the three associations found between Bendectin and individual malformations are unlikely to be causal. PMID- 2772851 TI - Retinoic-acid-induced limb-reduction defects: perturbation of zones of programmed cell death as a pathogenetic mechanism. AB - Pregnant C57Bl/6J mice were treated with 100 mg/kg body weight of all-trans retinoic acid in sesame oil on day 11.0 of gestation. Among the live fetuses harvested on day 18 of gestation, 100% had mesomelic defects of the limbs as determined by gross examination and skeletal staining. Control fetuses treated with sesame oil had no observable limb malformations. Some treated and control embryos were harvested 12 hr after treatment and examined for patterns of cell death by using the supravital stain Nile blue sulphate and methylene-blue- and acid-fuchsin-stained histological sections. Retinoic-acid-induced cell death in the core of the limb was always associated with the zones of programmed cell death as seen in control embryos of comparable stages. This, in concert with previous studies demonstrating excessive cell death in regions of programmed cell death that correlated with subsequent malformations, leads us to conclude that the pathogenesis of mesomelic malformations has a primary association with the phenomenon of programmed cell death. PMID- 2772853 TI - Trends in mortality from chronic obstructive airways disease in the United Kingdom. PMID- 2772852 TI - Growth of the secondary palate in the hamster following hydrocortisone treatment: shelf area, cell number, and DNA synthesis. AB - The contribution made by mesenchymal cells during the later stages of palatal development was examined in control and hydrocortisone-treated hamster embryos. Cross-sectional area of the palatal shelf was measured, and the numbers of both epithelial and mesenchymal cells were counted. DNA synthesis was measured by 3H thymidine incorporation and was used as an index of growth by cell proliferation. The observations in controls indicated that, unlike development during the initial 24 hr, the later period of vertical palate development, followed by reorientation of shelves and their closure, was characterized by a steady level of mesenchymal cell number and palatal shelf area. An absence of corresponding growth in the epithelial cell number suggests that the cells may accommodate the growth either by increasing their size and/or by stretching along the basal lamina. Hydrocortisone treatment did not alter the growth pattern of cell numbers or shelf area. However, it prevented the fusion between the opposing shelves, perhaps by affecting the cytodifferentiation of the palatal tissues. Although a continuous increase in the number of mesenchymal cells during the latter half of vertical shelf development, i.e., between days 11:00 and 12:00 of gestation, is not required for reorientation and fusion of the shelves, it is not clear from the data from the present study whether a critical number of cells and/or cell density is essential for reorientation and fusion of the palate. It was suggested that, for normal palatal development, information on cell cycle and positioning of mesenchymal cells within the shelf during the vertical development may be crucial for further understanding of subsequent events of palatogenesis. PMID- 2772854 TI - Laser light scattering spectroscopy: a new method to measure tracheobronchial mucociliary activity. AB - Laser light scattering spectroscopy is based on the evaluation of the frequency shift of coherent light scattered by moving particles. This makes it particularly suitable for use in light guiding systems. In this study laser light scattering spectroscopy was assessed for its ability to provide information on the motility of respiratory cilia. In vitro and in vivo measurements were undertaken with animal tracheal mucosa. The intensity fluctuations of laser light scattered from moving cilia were analysed in terms of their autocorrelation functions to provide information on the frequency and synchrony of beating cilia. In vitro measurements were performed on fresh bovine trachea to estimate a safe laser power level for mucosal exposure and to test the method by defining the temperature dependence of the ciliary beat frequency. Power densities not exceeding 0.3 kW/cm2 were found to be the upper limit for long term exposure of the mucosa in vitro. Ciliary beat frequency showed a pronounced temperature dependence, ranging from 5.8 to 28.3 Hz over the temperature range 20-43.5 degrees C. A maximum frequency was found at 41.5 degrees C. In vivo measurements of ciliary activity were performed in six pigs by means of optical fibres for light transmission combined with fibreoptic bronchoscopy. A ciliary beat frequency of 5 Hz was obtained; heart and breathing frequencies could be separated and identified. These results suggest that laser light scattering spectroscopy might provide a convenient method of studying the mucociliary system of the lower airways. PMID- 2772855 TI - Effect of bracing on respiratory mechanics in mild idiopathic scoliosis. AB - The use of a corrective orthopaedic brace is an established form of management for patients with progressive idiopathic scoliosis. Thirteen patients with mild idiopathic scoliosis were studied with and without the corrective brace applied. Lung volumes and the pattern of chest wall and abdominal movement were measured during quiet breathing. Transdiaphragmatic pressures were measured in six of the patients and upper ribcage movement in seven patients. Application of the brace resulted in a significant reduction in vital capacity (14%), functional residual capacity (22%), and total lung capacity (12%). There was no effect on respiratory rate or minute volume. In the erect position the pattern of chest wall movement was altered with a reduction in lower ribcage movement of 46% and abdominal wall of 39% and an increase in upper ribcage movement of 43%. These changes were greater in the supine position. There was at least a twofold increase in end inspiratory and end expiratory gastric pressures during tidal breathing, but oesophageal pressures were not affected by the brace. Transdiaphragmatic pressures showed a similar twofold increase, which implies a substantial increase in the work of breathing. In view of the doubts concerning the influence of bracing on the natural history of idiopathic scoliosis and the substantial functional effect of bracing on the respiratory system, it is suggested that the current practice of bracing in this condition needs to be reviewed. PMID- 2772856 TI - Prescription of oxygen concentrators: adherence to published guidelines. AB - The indications for the prescription of oxygen concentrators have been assessed in 82 patients against the Department of Health guidelines, except that only one set of blood gas and spirometry measurements was required if the patient's condition was stable. Of the 49 patients recommended for this treatment by a chest physician, 41 (82%) fulfilled the requirements, compared with only 11 of 33 patients where the concentrator was recommended by a general practitioner or non specialist physician. Eleven patients died within one month of prescription. The results show that many patients are being prescribed oxygen concentrators without assessment and underline the importance of full assessment and attention to prognosis before prescription. PMID- 2772857 TI - Posture and nocturnal asthma. AB - To investigate whether the supine posture caused sustained bronchoconstriction and could thus contribute to the development of nocturnal asthma, nine patients with nocturnal asthma were studied on two consecutive days, lying supine for four hours on one day and sitting upright for four hours on the other, the order of the two postures being randomised. Peak expiratory flow (PEF), forced expiratory volume in one second (FEV1), and forced vital capacity (FVC) were measured immediately before and after the four hours and over the subsequent hour. There was no significant difference between the erect and supine posture for PEF (248 v 248 l/min), FEV1 (1.31 v 1.22 l), or FVC (2.34 v 2.28 l) at the end of the four hours, nor did any significant change develop subsequently. Thus the supine posture is not associated with prolonged bronchoconstriction. As each patient had previously shown an average overnight fall in PEF of more than 20%, this study strongly suggests that the supine posture is not an important cause of overnight bronchoconstriction. PMID- 2772859 TI - Bronchial asthma at high altitude: a clinical and laboratory study in Addis Ababa. AB - In a study designed to throw light on the natural history of asthma in Ethiopia, 91 patients living at 2500 metres and attending asthma clinics in Addis Ababa underwent spirometric and skinprick testing. Only eight had had symptoms of asthma before the age of 16. Sixty two had a history of allergic rhinitis and 16 had a family history of allergic rhinitis; 33 had a family history of asthma. In 30 cases asthma was worse from August to October. All patients had tried traditional remedies, usually without success; and all took modern drugs, oral combination bronchodilators being the most frequently used. PMID- 2772858 TI - Diurnal variation in serum cortisol concentrations in asthmatic subjects after allergen inhalation. AB - To assess whether differences in the adrenal response to allergen are important in determining the magnitude of the allergen induced late responses in asthmatic subjects, we measured serum cortisol concentrations after inhalation challenge with allergen or control solution (phosphate buffered saline). The two challenges were performed in random order with an interval of 14 days. A normal diurnal decrease in serum cortisol concentrations was observed on both days. Mean blood cortisol concentrations three hours after inhalation of allergen (before the late response), nine hours afterwards (at the time of the late response), and 24 hours afterwards were virtually identical to those observed after inhalation of phosphate buffered saline. Serum cortisol concentrations before challenge and three, nine, and 24 hours after challenge were not related to the diurnal increase in blood eosinophils on the control day, or to the size of the late asthmatic response or accompanying changes in blood eosinophils after allergen challenge. It is concluded that serum cortisol concentrations show normal diurnal variation after allergen challenge and are unrelated to the size of the late response or associated changes in blood eosinophil counts. PMID- 2772860 TI - Metastatic uterine leiomyosarcoma in association with recurrent lung abscess. AB - A case of metastatic uterine leiomyosarcoma complicated by recurrent lung abscesses is described. PMID- 2772861 TI - Tuberculous retropharyngeal abscess producing respiratory obstruction. AB - Oropharyngeal tuberculosis is a rare presentation of the disease even in the presence of extensive pulmonary tuberculosis. A case is described in which a retropharyngeal abscess, causing stridor and threatening respiratory obstruction, was the only manifestation of Mycobacterium tuberculosis infection. PMID- 2772862 TI - Effect of hyperthyroidism on bronchial reactivity in non-asthmatic patients. AB - Thyrotoxicosis may be associated with deterioration in asthma. To determine whether bronchial reactivity to histamine is increased in hyperthyroidism 10 thyrotoxic non-asthmatic patients were assessed before and after treatment of their thyrotoxicosis. No significant change in bronchial reactivity was found after treatment. PMID- 2772863 TI - Changes in serum potassium concentration in asthmatic and normal subjects during exercise. AB - Serum potassium concentrations were measured before, during, and after exercise in 32 patients with asthma (12 with exercise induced asthma), and in seven normal subjects. The changes in serum potassium in response to exercise did not differ significantly in the two groups or between those with and without exercise induced asthma. The potassium response to exercise is unlikely to be relevant to the mechanism underlying exercise induced bronchoconstriction. PMID- 2772864 TI - Studies on antithrombotic effects of recombinant hirudin. AB - Recombinant desulfato hirudin (rH) was studied with regard to its effects on various models of thrombosis, its pharmacokinetic behaviour as well as its influence on primary haemostasis in rats. The pharmacological behaviour of rH proved to be similar to that of native hirudin. Depending on the different models of experimental thrombosis different dosages of rH were required to prevent thrombus formation. This corresponds to rH plasma concentrations of 0.5-1.5 micrograms/ml. Primary haemostasis is influenced only after excess dosages and plasma concentrations of 4 micrograms/ml and above. PMID- 2772866 TI - Imaging of human thrombi in the rabbit jugular vein: I: Comparison of two fibrin specific monoclonal antibodies. AB - The development of monoclonal antibodies with a specificity for cross-linked fibrin may have a potential role in the detection and of thrombi and thrombolytic therapy. In this study, two monoclonal antibodies with a specificity for fibrin have been examined. In vitro studies have shown NIBn 123 (which has a high affinity for X-oligomer) and DD-3B6 to bind to immobilised fibrin on PVC plates as well as plasma clots which were incubated in the presence of plasma. The Km values for NIBn 123 and DD-3B6 wre 1.0 x 10(10)/7.7 x 10(8) M and 2.6 x 10(8) M respectively. No significant binding to fibrinogen either immobilised or in solution was found. The binding of these antibodies to a human thrombus in the jugular vein of the rabbit was monitored over a 24 hour period. Preferential binding of each antibody reached a ratio of approximately 1.0 (jugular/heart) at 24 hours and an image was detected. PMID- 2772865 TI - Inhibition of cancer procoagulant by peptidyl diazomethyl ketones and peptidyl sulfonium salts. AB - Cancer procoagulant (CP) is a cysteine proteinase from cancer cells that initiates blood coagulation. Members of two classes of unique and highly specific cysteine proteinase inhibitors, peptidyl diazomethyl ketones (PDK) and peptidyl sulfonium salts (PSS), were studied to determine whether or not they inhibited CP. The inhibitors did not impair the activity of the coagulation system. There was a differential inhibitory effect of the 6 PDK and 2 PSS inhibitors, influenced by the amino acid composition or sequence of the peptide moiety, that suggests differences in structural features of the active site of CP and papain. CP was inhibited by both classes of inhibitors. PMID- 2772867 TI - Antithrombotic activity of recombinant hirudin in the rat: a comparative study with heparin. AB - Hirudin, a potent inhibitor of blood coagulation, differs in its antithrombotic activity according to the source of isolation. It was therefore of interest to study recombinant hirudin. Hirudin was obtained by a genetic process from E. coli. Its antithrombotic action was investigated in an experimental (rat) model of venous thrombosis and was compared to heparin whose results are known. Heparin (400 micrograms/kg) and hirudin (12.5, 25 and 50 micrograms/kg) present an antithrombotic effect and limit the extension of an existing thrombus (p less than 0.05). Higher heparin dosages increase the bleeding time mean value (p less than 0.05) whereas hirudin does not. So, recombinant hirudin presents the same antithrombotic action as heparin but with very inferior dosage. This activity seems not dose-dependent and is associated to weak hemorrhagic effects. PMID- 2772869 TI - Shortened method for the determination of euglobulin lysis time employing Malayan pit viper venom. PMID- 2772868 TI - Evidence for regulation of endothelial plasminogen-activating system by polymorphonuclear leukocyte elastase. AB - Incubation of unstimulated polymorphonuclear leukocytes with cultured bovine pulmonary artery endothelial cells increased the activity of endothelial plasminogen activator. On the other hand, polymorphonuclear leukocytes stimulated by serum-opsonized zymosan decreased the plasminogen activator activity. A specific elastase inhibitor increased the enhancing effect of the unstimulated polymorphonuclear leukocytes and reversed the suppressing effect of the stimulated polymorphonuclear leukocytes. Catalytically active elastase suppressed the plasminogen activator activity and increased the activity of plasminogen activator inhibitor. In contrast, inactivated elastase enhanced the activity of plasminogen activator. Both, active and inactive forms of elastase bound to the endothelial cells. These findings suggest that elastase modulates the endothelial plasminogen-activating system, apparently by binding to the endothelial cells. PMID- 2772870 TI - [Collegiality has its limits]. PMID- 2772871 TI - [Injuries in nursing homes]. PMID- 2772872 TI - [Children, morbidity and drugs]. PMID- 2772873 TI - [Abdominal injuries]. PMID- 2772874 TI - [Abdominal injuries. Occurrence and outcome]. AB - A retrospective study of intra-abdominal injuries treated during the ten-year period 1977 to 1986, show that road traffic accidents were responsible for the injury in 38% of 221 patients. Accidents from sports and recreation were the cause in 23% of the cases. The median age was 19 years. Renal injuries were most common, followed by splenic injuries. 119 patients (54%) were operated for abdominal injury. 90 patients (41%) needed blood transfusions and 29 (13%) were treated by respirator. 95 patients had concommitant extraabdominal injuries. The overall lethality was 9%. PMID- 2772875 TI - [Grading and prognosis of abdominal injuries]. AB - The present study was carried out in order to find out the relationship between injury grading and the use of different resources and the result of the treatment in patients with intra-abdominal injuries. The injuries were graded according to two trauma scores: The Injury Severity Score and the Norwegian Injury Score. In 221 patients with intra-abdominal injuries there were good correlations between these two scores and the time of hospitalization, units of blood transfusions, need for respirator treatment and lethality. PMID- 2772876 TI - [Drugs for the mother and infant in the maternity ward. A study of 5 Norwegian university hospitals]. AB - Hospital records were used to record, all drugs prescribed in the maternity ward, delivery characteristics and complications in both mother and infant at five university hospitals. The retrospective survey comprised 970 women and represented 10% of all vaginal deliveries in these hospitals in 1980, and 2% of all annual births in Norway. In total 90% of the women received drugs, excluding laxatives, oxytocics and long-term medication, vitamins and iron. Large variations were found between hospitals in respect of hypnotics (41-86%) and analgesics (65-95%). Of newborns 4-23% were treated with a drug. The large variation was largely due to frequent administration of naloxone at one of the hospitals. Drug utilization post partum was significantly higher in primipareas and in mothers who underwent interventions such as epidural anaesthesia, oxytocin drip, forceps delivery and tears. 98% of the babies were breast-fed on discharge and thus received milk potentially containing drugs. The frequent use of hypnotics indicates that breast-feeding mothers were treated like hospital patients in general. For the majority of the drugs used as a routine in the maternity wards there was no data or insufficient data on excretion in breast milk. The large discrepancy between hospitals as regards prescription of hypnotics and oxytocics to the mother and naloxone to the newborn was considered not to reflect rational prescription criteria and should therefore be reassessed. PMID- 2772877 TI - [Disorders and drug consumption among infants. Does breast feeding have an impact?]. AB - Disorders and drug use were analysed in 885 infants whose mothers responded to a questionnaire approximately four months after birth in Oslo, Norway in 1985. Breast-feeding had no influence on drug use in infants, though a lower incidence of some disorders (diarrhea, constipation, vomiting) was found in infants who were breast-fed for average four months than in infants who were weaned earlier. Use of drugs in infants was positively associated with use of drugs by the mother and with the length of her education. About 75% of the babies had at least one disorder and 60% had received at least one drug during the four month registration period. It was claimed that 85% of the drugs were recommended by a physician or a nurse. Anticolic agents, respiratory agents and dermatologicals were given frequently. The single most used drug was dimethicone. 98% of the 261 infants with colic syndrome were treated with this surface active drug, which has an efficacy similar to placebo. During a two week period preceding registration 12% of all infants and concomitantly 25% of the breast-fed infants were exposed to drugs at least once. The drug intake through breast milk was calculated to be 1/7 of the total drug use (117 infant Defined Daily Doses/1,000 infants/day) in breast-fed babies. Validation of the answers to the written questionnaire by subsequent interview of 96 mothers revealed considerable underreporting in the former; 33% for disorders, 22% for drugs and 18% for infant doses. It is concluded that medication for minor disorders in infancy is quite extensive and often unnecessary. Further informative efforts should be directed at parents, as well as the health workers involved. PMID- 2772878 TI - [Distal esophageal banding. A modified method of surgical treatment of obesity]. AB - 64 patients were treated with distal oesophageal banding for morbid obesity from 30/4-1984 to 1/6-1988. By this method a Dacron vascular prosthesis is passed around the oesophagus from incisura cardiaca to pars cardiaca. There will be no upper ventricular pouch. The method was introduced in order to avoid the problems seen after operation with gastric banding, such as valve mechanism secondary to pouch distension and band penetration. Such problems have not been encountered following our operative modification. 18 patients were observed for more than two years. The mean weight loss one year after operation was 28 kg, which was equivalent to 26% of preoperative weight. The main problem is excessive tightening of the band. Therefore, in three patients, the band had to be removed later. PMID- 2772880 TI - [Physicians and the National Insurance System]. AB - The National Insurance Scheme will spend more than the half of its budget for 1989 for purposes linked to activities performed by (medical) doctors. The scheme transfers NOK 25 billion to cover health services. Additionally, an amount of more than NOK 30 billion is spent on cash benefits related to sickness, rehabilitation and permanent disability. This article focuses on the importance the Norwegian doctor attaches to the assignment of benefits under the National Insurance Scheme. The purpose is not to promote a campaign in order to save money on behalf of the National Insurance Scheme, but to promote a more common attitude among doctors concerning their relation to social insurance and the information they provide. The article presents points of view expressing the possibility of too low consumption as well as too high consumption of benefits. Some of this may be compensated by doctors being more aware of the consequences of their activities for the National Insurance Scheme, and for the patient. PMID- 2772879 TI - [The Christiansen endoprosthesis. 10 years' data]. AB - 44 hips operated for insertion of the Christiansen hemiprosthesis at the County hospital of Nordland from 1968 to 1976 were evaluated in 1986. Seven hips had been reoperated because of loosening or mechanical failure of the prosthesis. Another four prostheses were found to have loosened at the time of follow-up, bringing the total loosening frequency up to 25 percent, 26 patients reported no pain from the hip, 20 of these were still in normal activity with no restriction in walking as a consequence of the defect hip. All the prostheses had been inserted in a varus position. Acetabular protrusion was found in 14 cases, indicating that there are frictional forces working at the hip joint, also with the trunnion bearing system. The average time from operation to verified loosening was nine years. The trunnion bearing may thus have spared the hip joint from stress during the first years of use. PMID- 2772881 TI - [Omeprazole. A new inhibitor of gastric secretion]. PMID- 2772882 TI - [Sucralfate. What place does this drug have in the treatment of patients with digestive diseases?]. PMID- 2772883 TI - [Cosmetic surgery. Is it dangerous?]. AB - Postoperative complications from 7,552 cosmetic surgical procedures were studied retrospectively. 22 general and 60 local complications occurred. Five of the most serious were three complications from anaesthesia, one peripheral nerve damage and one prolonged psychiatric situation. Two patients required hospitalization. Correction of protruding ears gave the relatively largest incidence of local complications, and Suction lipectomy the largest incidence of general complications. The most common complications were hematoma, skin slough and problems related to anaesthesia. The most common cosmetic surgical procedures such as mammaplasty, face lift, blefaroplasty, liposuction, rhinoplasty and hair transplantation, were rarely associated with complications. PMID- 2772884 TI - [Injuries in nursing homes. Hospital-based registration of injuries of patients in nursing homes]. AB - 109 patients were registered in a prospective study of accidents occurring in geriatric nursing homes and treated in Harstad Hospital. In more than 50% the seriousness of the injury was so high that in-patient treatment was necessary. More than 90% of the patients had fallen and 50 patients had suffered fracture of the proximal femur. The incidence of injury is higher than the estimated 13% average, and the seriousness of the injury is substantially higher than the average for all age groups. PMID- 2772885 TI - [The cheapest synonymous preparation--a suggestion with unwanted consequences. Is it the cheapest drugs?]. PMID- 2772886 TI - [It won't be a duty to prescribe the cheapest synonymous agent]. PMID- 2772887 TI - [Guidelines for diagnosis and treatment of meningococcal diseases at hospitals]. PMID- 2772888 TI - [Atrial fibrillation: an indication to prevent stroke]. PMID- 2772889 TI - [Biliary tract occlusion with laboratory diagnosis of liver cell injury]. PMID- 2772890 TI - [Risk of transmission of HIV/AIDS and narcotic dependence]. PMID- 2772891 TI - [Waiting lists and priorities]. PMID- 2772892 TI - [Aspiration cytology of the breast]. PMID- 2772893 TI - [Modern morphologic diagnosis of lymphoma]. PMID- 2772894 TI - [Fine needle aspiration cytology of the breast. A simple method?]. AB - During the period 1981-85, 3,743 fine-needle aspiration cytologies of breast tissue from 3,188 patients were reported by the Gade Institute, Department of pathology. Subsequent histologic examination was performed in the case of 798 patients. Among 421 histologically proven carcinomas after previous fine-needle aspiration, there were no false positive and 13 false negative cytological diagnoses. The specificity was 100% and, depending on the criteria used, the sensitivity 77.9 or 96.4%. Altogether 223 doctors performed the aspirations. This high number was probably the main reason for an unacceptably high proportion of inadequate smears. In experienced hands the proportion of inadequate smears was less than 4-7% in patients with carcinomas. PMID- 2772895 TI - [Aspiration cytology in palpable breast changes of the breast. Too many specimens without cell material to examine]. AB - During the first half of 1988, 927 fine needle aspiration cytology samples from palpable non-cystic breast lesions were examined in our laboratory. Among 582 aspirations performed by members of the laboratory medical staff the frequency of technically non-diagnostic specimens was 4.3 per cent, as against 34.2 per cent among 345 referred specimens. In the latter group there was a clear relationship between the frequency of inadequate specimens and experience in aspiration technique as judged from the number of referred specimens from the individual clinician. It is concluded that education and training in aspiration technique is needed to improve the quality of this diagnostic method. PMID- 2772896 TI - [Giant cell anaplastic anemia]. AB - The Ki-1-antibody was raised against a cell-line of Hodgkin-cells, and reacts with most Hodgkin- and Reed-Sternberg-cells. By use of this antibody a new entity of non-Hodgkin's lymphomas has been identified; the anaplastic large cell lymphoma. We report our experience from studying 16 such tumours diagnosed during the period October 1986 to February 1988. In three cases the anaplastic large cell lymphoma appeared in patients who presented Hodgkin's disease as well. Of 15 cases studied using frozen section immunohistochemistry, ten showed T-, one B-, and one monocyte/macrophagephenotype, whereas three cases presented a mixed T-, B and monocyte/macrophagephenotype. All cases showed a high proliferative activity as evaluated by presence of activation antigens. In paraffin sections six of 16 cases expressed epithelial membrane antigen (EMA). In 13 cases EMA, leucocyte common antigen (LCA) and Ber-H2 (a Ki-1-antibody) reactivity was compared in paraffin and frozen sections. The EMA reactivity was of nearly equal intensity in paraffin and frozen sections, while the reactivity of LCA and Ber-H2 was significantly reduced in paraffin sections, implying only partial preservation of the antigens. Clinically, most cases were in an advanced (III and IV) stage by the time of diagnosis. Of 14 actively treated patients, nine went into complete and two into partial remission, while three patients did not respond. Six patients are dead, five after less than one year. The coexistence of anaplastic large cell lymphoma and Hodgkin's disease and the common Ki-1 (CD30) antigen expression in these tumours suggest a possible histogenetic relationship. PMID- 2772897 TI - [HIV and the central nervous system]. AB - It is well documented that human immunodeficiency virus (HIV) can infect the central nervous system. Neurological dysfunction occurs frequently in acquired immunodeficiency syndrome (AIDS) and most commonly in the form of a subacute HIV encephalitis. The pathological abnormalities in patients with subacute HIV encephalitis are most prominent in subcortical structures, notably in the cerebral white and deep gray matter. The patients frequently develop abnormalities in cognitive, motor and behavioral functions. The infected cells are predominant lymphocytes and macrophages. The production of cytokines by these cells appears to be a central factor in the pathogenesis of subacute HIV encephalitis. The central nervous system can function as a reservoir of HIV infection. Neuropsychological assessment is a sensitive method for documentation of early brain involvement by HIV infection. The HIV-associated neurological abnormalities may be partially ameliorated by administration of zidovudine (AZT). PMID- 2772898 TI - [Urinary incontinence. A study of occurrence in the municipality of Sund]. AB - The study describes the prevalence and severity of urinary incontinence, factors associated with incontinence, use of remedies and social consequences of incontinence among groups of the population in a small municipality in Western Norway. We sent a 35-item questionnaire by post to all men and women in Sund aged 44-45 and 74-75, total 145 persons. The answers were anonymous, and information was received from 88 persons (61%). 21% of the young males and 50% of the old males were incontinent. The corresponding figures for females were 31% for young and 27% for old females respectively. PMID- 2772899 TI - [A long waiting time for radiotherapy. Not acceptable for patients with neoplasms]. AB - Radiotherapeutical resources in Norway are inadequate, which was further verified in this retrospective study of 73 patients with cancer of head and neck. The average duration of symptoms before the first ear-nose-throat examination was 153 days, and it took about 10 days after the examination to get the diagnosis. An unacceptably long time (mean 30 days) elapsed between the decision on therapy until the radiotherapy was initiated. There is no doubt that radiotherapy departments in Norway need better resources. PMID- 2772900 TI - [The British Health Services System--major changes once again. The White Paper and commercialization of the National Health Service]. AB - In February 1989 Prime Minister Margaret Thatcher presented her Proposals in a White Paper. These proposals imply essential changes in the National Health Service (NHS) in Great Britain. The changes will result in a more commercial way of managing both the hospitals and the offices of general practitioners. Among other things, they will imply buying and selling health services. Important objectives in the proposals are cost control, quality assurance and a greater choice for patients. During a visit to London this winter, the author studied the main topics of the proposals. This article discusses the content and aims of the White Paper, also with relevance to Norwegian health policy. Some aspects of the British health system today are also considered, with special reference to the development of the NHS during last 10 to 15 years. PMID- 2772901 TI - [Suggestions for reorganization of the British Health Service System. Some health economic aspects]. PMID- 2772902 TI - [Health care for patients with mental retardation. Special care--consequences of institutionalization]. PMID- 2772903 TI - [Personality and cancer]. PMID- 2772904 TI - [Clinical experiences with triazolam (Halcion)]. PMID- 2772905 TI - [Trental Hoechst (pentoxyfylline) and withdrawal]. PMID- 2772906 TI - The intracellular pathway and kinetics of digestive enzyme secretion in an insect midgut cell. AB - The opaque zone cells of the midgut of the stablefly, Stomoxys calcitrans display a cyclical series of ultrastructural events in response to feeding, which it has been suggested are related to the synthesis and secretion of digestive enzymes. These cells have been studied in vivo using a combination of biochemical, morphometric and electron microscopical autoradiographic techniques. The cyclical nature, timing and relationship of the ultrastructural events to enzyme secretion has been confirmed. The autoradiographic data presented is in good agreement with the classical synthetic pathway for exported proteins. The kinetics of the cellular process have been described: transfer of newly synthesized product from the rough endoplasmic reticulum to Golgi apparatus begins ca. 13-14 min after labelling of the fly and from the Golgi apparatus to secretory granules after ca. 24-26 min. Secretion of this newly synthesized material begins before 60 min and possibly as early as 30 min after labelling of the fly. The data are discussed in relation to the comparable studies in other tissues. PMID- 2772907 TI - Pituitary intracisternal granule formation during the estrus cycle of the rat. AB - An ultrastructural study of the anterior pituitaries of cycling rats reveals changes in the ultrastructure of the gonadotrophs during the afternoon of proestrus when the release of follicle stimulating hormone (FSH) and luteinizing hormone (LH) is high. The rough endoplasmic reticulum cisternae become greatly dilated, forming extensive channels which are continuous with the perivascular space and provide an increased surface for the release of hormones. Granules and cytoplasmic islands of granules are seen in these spaces. Such changes are not observed during diestrus and early proestrus when the release of FSH/LH is low. The data indicate that intracisternal granule formation is an important mechanism by which anterior pituitary cells respond to increased hormonal requirements. PMID- 2772908 TI - Wax lipid secretion and ultrastructural development in the egg-waxing (Gene's) organ in ixodid ticks. AB - Gene's organ, the egg-waxing organ of ticks, performs an essential function in females by coating the eggs with a waterproofing layer during oviposition, which prevents desiccation of the embryo, ensuring its viability. The organ is a target for control agents and a potential site of virus replication involving trans-oval transmission of arboviruses. The organ is a complex dermal gland, developed to an elaborate degree. The external appendage, the horns, is an evertable balloon-like cuticular sac which manipulates the eggs and coats them in wax. Wax passes through pores in the cuticle from the internal, sub-cuticular lumen. Gene's organ develops in synchrony with oogenesis and oviposition. This paper describes the development of the gland cells and formation of the intra-cuticular lumen and its ultrastructure during engorgement and oviposition in ixodid ticks. The structural basis for wax secretion in Gene's organ is also described. PMID- 2772909 TI - Macrophages and epithelial cells of the thymus gland. An ultrastructural study in the natterjack, Bufo calamita. AB - In the present study, the ultrastructure of the stromal components, basically epithelial elements and macrophages, of the thymus of adult natterjacks, Bufo calamita has been analyzed. A network of stellate epithelial-reticular cells joined together by desmosomes, constitutes the main component of the thymic parenchyma in both cortex and medulla. In the medulla pale, electron-lucent epithelial cells, sometimes showing surface interdigitations, are striking elements. Moreover, uni- and multicellular epithelial cysts appear in the thymic medulla as well as granulated cells of possible endocrine significance. Remarkably, isolated or grouped gland cells whose morphology and cytoplasmic content resemble that of the skin glands, were occasionally found. Finally, macrophages, multinucleated giant cells and dendritic-like cells, the latter intimately associated to lymphocytes, occur in the thymus of Bufo calamita. The most remarkable morphologic characteristics of all those non-lymphoid cell types, as well as their possible functional significance are comparatively discussed with available information on the amphibian and higher vertebrate thymic cytoarchitecture. PMID- 2772910 TI - Avian epidermal differentiation. II. Adaptive response of permeability barrier to water deprivation and replenishment. AB - Zebra Finches are the epitome of desert-adapted avian species; i.e. they are able to survive without drinking water for over a year. Whereas transepidermal water loss (TEWL) in naked Zebra Finch nestlings is lower than in adults, and desert adaptation is accompanied by intercellular deposition of epidermal multigranular body (MGB) contents, MGB secretion is reduced as nestlings mature into feathered adults, indicative of less stringent barrier requirements. Here, removal of drinking water resulted in increased intercellular deposition of MGB contents, and TEWL progressively decreased. In contrast, MGB intercellular deposition decreased when birds were rehydrated, with TEWL returning towards normal within 5 days of rehydration. Finally, water-deprivation caused significant changes in epidermal lipid composition that returned toward control levels with rehydration. These studies show that adult Zebra Finches adapt to xeric stress by increased secretion of multigranular bodies resulting in reduced TEWL. PMID- 2772911 TI - Endothelial cell junctional integrity modulation by serotonin: an ultrastructural analysis. AB - We have reported previously that exogenous serotonin (5-hydroxytryptamine, 5-HT) alters cultured bovine aortic endothelial cell (BAEC) structural integrity by modulating the assembly of stress fibers. In the present study a 5-HT stimulus coupled change in BAEC junctional integrity was quantitated by determining the width and percentage of intercellular openings in a monolayer. BAEC treated with 5-HT at concentrations of 10(-9) M to 10(-3) M caused a significant dose dependent decrease in interendothelial cell junctional openings compared to controls, with the greatest reduction induced at 10(-6) M (92% from control). Treatment of BAEC with histamine (10(-4) M) increased the junctional openings by 82% when compared to controls. This change could be prevented by either pretreatment of the monolayers with 5-HT or by adding 5-HT in conjunction with the histamine. To assess a direct interaction of 5-HT with actin filaments, cultured BAEC monolayers were extracted, treated with 5-HT, and processed for immunocytochemical localization of 5-HT using the Avidin-Biotin method. Electron microscopy revealed 5-HT antibody bound to actin filaments and dense in areas of filament intersection, which implies a role for internalized 5-HT in stimulating the assembly of an actin filament network. Collectively, these results suggest that 5-HT helps to regulate the endothelial junctional barrier by promoting actin filament formation and stability, which may in turn increase the junctional apposition between endothelial cells. PMID- 2772912 TI - Dual-phase response of bovine pulmonary artery endothelial cells to agonists which increase free cytoplasmic calcium concentration. AB - The regulation of free cytoplasmic calcium concentration ([Ca2+]i) was studied in bovine pulmonary artery endothelial cells (BPAEC). The cells were seeded on the inner surface of glass cuvettes, grown to confluency and loaded with INDO-1. Using a multiwavelength method for estimation of [Ca2+]i it was shown that in Ca2+ containing medium a rapid rise of [Ca2+]i occurs in response to bradykinin, ATP or thrombin followed by a much slower decrease in free cytoplasmic calcium. Binding of extracellular Ca2+ by EGTA lowered basal [Ca2+]i but had no effect on the rate of agonist-induced [Ca2+]i increase or its absolute amount. In contrast, the kinetics of [Ca2+]i decrease were entirely different. A rapid (less than 0.5 min) decrease in [Ca2+]i to the basal level was observed immediately after the maximum had been achieved. If excess Ca2+ was added to the medium after EGTA, a second [Ca2+]i rise in response to the agonists occurred. The decrease in [Ca2+]i after the second peak was several times slower than the decrease in Ca2+ free medium. It is concluded that Ca2+ entry from the external medium had no effect on the maximal increase in [Ca2+]i but provides a severalfold increase in the duration the endothelial cell responses to the agonists. PMID- 2772913 TI - The development of ciliated and mucus cells from basal cells in hamster tracheal epithelial cell cultures. AB - Hamster tracheal epithelia consist of three cell types: ciliated, mucus and basal cells. Autoradiographic data from several studies suggest that either basal or non-ciliated columnar cells may serve as stem cells for regeneration of lost or damaged ciliated and mucus cells. The objective of the present study was to examine the role of basal cells in the formation of ciliated and mucus cells in hamster tracheal epithelial (HTE) cell cultures via tritiated thymidine ([3H] TdR) autoradiography. When 3 day cultures were pulsed with [3H]-TdR for 6 hr and incubated for 2 additional days in non-radioactive media (5 day total) label was present in the nuclei of basal and columnar epithelial cells suggesting that the labeled columnar cells may be derived from basal cells. However, the morphological reorganization occurring during this 2 day interval may create difficulties in this interpretation. Since these morphological changes are minimal during the 6 day to 8 day in vitro period, 6 day HTE cultures were pulsed with [3H]-TdR for 6 hr and incubated for 2 additional days in non-radioactive media (8 day total), and examined to further study the fate of labeled basal cells during this period. Analysis of these 8 day cultures revealed that labeled nuclei were present in both basal cells and adjacent ciliated and mucus cells. These results do not exclude the possibility of non-basal cell origin of ciliated and mucus cells in other systems but suggest that, at least in HTE cultures, undifferentiated basal cells have the ability to develop into ciliated and mucus cells. PMID- 2772914 TI - Sarcolemma blebs and cell damage in mammalian skeletal muscle. AB - Plasma membrane blebs are an early sign of cellular damage in isolated cells. Phenazine methosulphate (PMS) triggers the production of conspicuous and characteristic sarcolemma blebs in mouse diaphragm skeletal muscle incubated in vitro and also causes severe myofilament damage. It is suggested that PMS activates transmembrane NAD(P)H dehydrogenases and, in turn, a modification of sulphydryl groups of the cytoskeleton, thereby permitting bleb formation in contracting cells. PMID- 2772915 TI - Morphogenesis of silkmoth chorion: sequential modification of an early helicoidal framework through expansion and densification. AB - The silkmoth chorion is a helicoidally layered, fibrous structure which is constructed in four sequential morphogenetic modes, beginning with the assembly of a thin, low density lamellar framework. Subsequently, the framework expands in height by the insertion of additional fiber sheets into the preexisting lamellae. This expansion mode begins farthest from the follicular secretory cells and progresses in reverse. Individual fibers then grow in thickness, presumably through accretion of newly synthesized proteins, and eventually fuse. This third mode, which also begins in the most distant lamellae and proceeds in reverse, is called densification, as it results in an approximately two fold increase in overall chorion density without further lamellar expansion. Finally, lamellogenesis is recapitulated in miniature in a region of the chorion's surface, where very-late-forming lamellae are molded into prominent surface structures, the aeropyle crowns. The densification and especially the expansion modes suggest considerable fluidity in the developing chorion, consistent with its proposed cholesteric liquid crystalline structure. Such a structure is also consistent with numerous deviations from the ideal helicoidal array. These distortions and defects are described and discussed in terms of their possible origin and function. PMID- 2772916 TI - Establishment of the specific radioimmunoassay for serum thymic factor (STF). AB - Serum thymic factor is a humoral factor involved in the differentiation of T cells. In the present study, a radioimmunoassay system for STF was established using a specific antiserum and an iodinated synthetic STF as a tracer. Serum levels of STF-like immunoreactivities were around 30 pg/ml in human, but in contrast to previous reports serum STF levels did not show age-dependent decreases. STF-like immunoreactivities of the thymic gland were lower than those of the liver and kidney in rats. The livers of human and pig contained high STF like immunoreactivities. The rat thymic gland extract showed three peaks of STF like immunoreactivity by gel filtration of Sephadex G-25 which corresponded to the eluted position of authentic STF, a larger molecular size, and a smaller molecular size of STF, respectively, while the rat liver extract showed two peaks corresponding to the void volume fraction and to the position of authentic STF, respectively. When this void volume fraction was digested by trypsin, three peaks which corresponded to authentic STF, a larger molecular size, and a smaller molecular size of STF were observed. Present studies suggest that serum thymic factor is produced as a larger STF molecule in the liver and kidney. PMID- 2772917 TI - Normal values for quantitative parameters for evaluation of mucociliary clearance in lungs. AB - Twenty-eight normal male subjects (13 nonsmokers and 15 smokers, 25 to 76 years of age) inhaled ultrasonically generated 99mTc-tagged human serum albumin aerosol (mass median diameter: 1.93 microns with geometric standard deviation of 1.52) and radioactivity from the thorax was measured continuously from anteriorly in 10 sec frame mode for 90 to 120 min to evaluate mucociliary clearance function in the lungs. Normal values for lung retention ratio (LRR), airway deposition ratio (ADR), airway retention ratio (ARR), airway clearance efficiency (ACE), alveolar deposition ratio (ALDR), and disappearance rate of radioactivity from the ciliated airways (DR) were presented. ALDR was significantly larger in nonsmokers than in smokers. LRR and ARR were significantly smaller and ACE, significantly larger in smokers at any time intervals than in nonsmokers, while ADR and DR were larger in smokers only in the initial 30 min following radioaerosol inhalation was completed. Thereafter there was little difference in ADR and DR between normal smokers and nonsmokers. PMID- 2772918 TI - Gastric emptying in patients with gastric and duodenal ulcer. AB - Gastric emptying was measured in patients with proximal gastric, distal gastric and duodenal ulcers using a radioisotopic method. Gastric emptying was rapid in patients with proximal gastric ulcer, and was considered to be due to accelerated proximal evacuation. However, emptying was delayed in patients with distal gastric ulcer, and was considered to be due to reduced emptying in the antrum. On the other hand, rapid emptying seen in duodenal ulcer patients was considered to be due to accelerated emptying in both the proximal stomach and the antrum. Gastric emptying in the healing stage was closer to that in healthy subjects than in patients with active-stage ulcer. PMID- 2772919 TI - Similarity in amplitude of the nocturnal fall in blood pressure in old and young patients with essential hypertension. AB - The influence of age on the nocturnal fall in blood pressure (BP) was examined in essential hypertensive patients as well as normal subjects. BP was monitored every 5 min for 24 hr by means of a finger volume oscillometric device. Average daytime BP was similar in the 3 age groups [young: less than 40 (years), n = 49, average daytime systolic BP (ASBP) = 132 +/- 20 mmHg, average daytime diastolic BP (ADBP) = 82 +/- 17 mmHg; adult: 40 less than or equal to less than 60, n = 110, ASBP = 127 +/- 19 mmHg, ADBP = 86 +/- 13 mmHg; old: 60 less than or equal to, n = 33, ASBP = 131 +/- 17 mmHg. ADBP = 83 +/- 11, mean +/- S.D.]. The nocturnal fall in BP was observed in all age groups and its amplitude (delta BP = average daytime BP - average nighttime BP) in the old patients (delta SBP = 13 +/ 11 mmHg, delta DBP = 10 + 8 mmHg) was similar to that in the young patients (delta SBP = 11 +/- 8 mmHg, delta DBP = 10 +/- 8 mmHg). The results suggests that information on the nocturnal behavior of BP is valuable in treating aged essential hypertensives to prevent cerebral and/or myocardial ischemia during sleep. PMID- 2772920 TI - Plasma amino acid abnormalities in liver disease: comparative analysis of idiopathic portal hypertension, extrahepatic portal occlusion and liver cirrhosis. AB - To clarify the clinical significance of specific plasma amino acid abnormalities occurring in liver disorders with portal-systemic shunting, plasma amino acids and insulin levels were measured in idiopathic portal hypertension (IPH), extrahepatic portal occulusion (EHPO), and liver cirrhosis (LC). Three branched chain amino acids (BCAA: valine + leucine + isoleucine) were decreased in all three diseases in comparison with controls. Since plasma insulin measured during oral glucose tolerance tests did not specifically rise in LC, reduction of BCAA is not merely ascribed to hyperinsulinemia. Either portal-systemic shunting or some extent of liver damage may contribute to a fall in BCAA. Two aromatic amino acids (AAA: phenylalanine + tyrosine), which were within the normal range in EHPO and IPH, showed a marked increase in LC. Thus, changes of AAA probably mainly reflect the severity of the liver disease. The molar ratio of BCAA/AAA (MR) significantly correlated with ICG k, ICG R15, PT and the sum of blood ammonia in an oral ammonia tolerance test which may reflect the degree of hepatic disorder. MR diminished in the following decreasing order: controls, EHPO, IPH and LC. PMID- 2772921 TI - A rapid and sensitive micro-assay to determine the capacity of quinones to undergo redox cycling. AB - Using a series of aziridinyl-benzoquinones it is shown that the conversion of oxyhemoglobin to methemoglobin in sheep erythrocytes is correlated with the capacity of each quinone to undergo redox cycling. Based on these findings a semiquantitative assay is developed for the rapid screening of redox cycling quinones. PMID- 2772922 TI - Mercury-selenium interaction: distribution and excretion of 203Hg2+ in rats after simultaneous administration of selenite or selenate. AB - In female rats intravenously injected with 203HgCl2 (0.6 mg Hg2+ per kg body wt.) the effect of intraperitoneal administration of selenite or selenate (0.525 mg Se per kg body wt.) on distribution and excretion of 203Hg was studied. The content of 203Hg was lower in kidney and higher in liver and blood in the groups treated with selenate or selenite when compared with rats which received only mercury. The brain content of 203Hg was significantly increased in rats injected with selenite. Both selenium compounds injected immediately after mercury significantly decreased urinary as well as biliary excretion of 203Hg. A transient increase in the rate of biliary excretion of 203Hg during the first 2 h after administration was observed in rats treated with selenate. This finding seems to support the idea that the reduction of selenate to selenite in the body is not rapid but takes at least several hours. PMID- 2772923 TI - Transplacental pharmacokinetics and teratogenicity of a single dose of retinol (vitamin A) during organogenesis in the mouse. AB - Pregnant mice received 10 or 100 mg retinol/kg body wt. by gavage on day 11 of gestation (plug day = day 0). One group of animals was used for a pharmacokinetic study. At various times after dosing, plasma and tissue samples were collected and analyzed by HPLC for retinyl esters, retinol, 13-cis- and all-trans-retinoic acid and 13-cis-4-oxo and all-trans-4-oxoretinoic acid. In the other group the fetuses were removed on day 18 and examined for malformations. After 10 mg/kg retinol, no teratogenic effect was observed. The pharmacokinetic investigation revealed a moderate increase of retinyl esters, retinol and all-trans-retinoic acid in plasma, embryonic tissue, placenta, yolk sac membranes and extraembryonic fluid. A high incidence of severe fetal malformations occurred after 100 mg/kg retinol. These malformations included limb defects (81% of fetuses) and cleft palate (55% of fetuses) which are characteristically found after administration of a single teratogenic dose of an active retinoid on day 11 of gestation. The concentration-time profile of retinoids after 100 mg/kg on day 11 showed a pronounced increase of retinyl esters and retinol in all compartments including the embryo and a massive generation of the polar metabolites all-trans-retinoic acid and all-trans-4-oxoretinoic acid. These polar metabolites were found in the embryo with peak concentrations of 327 +/- 115 and 143 +/- 20.7 ng/g (mean +/- SE) wet tissue, respectively. It is likely that all-trans-retinoic acid and all trans-4-oxoretinoic acid, both well-known teratogens, largely contributed to the teratogenic outcome. The in-vivo oxidation of retinol may be an important factor in the teratogenic activity of high doses of vitamin A. PMID- 2772924 TI - The influence of di(2-ethylhexyl)phthalate on protein turnover in rat liver. AB - Treatment of rats with the plasticizer di(2-ethylhexyl)phthalate increases liver weight and leads to proliferation of mitochondria and peroxisomes. Using in vivo labelling with [3H]leucine, an increased rate of incorporation into the total protein of mitochondria and microsomes was observed. The half-lives of proteins in subcellular fractions were determined using [35S]methionine labelling. The half-lives for the total protein of mitochondria, microsomes, and supernatant were increased from 6 to 25 days, from 3.5 to 5.5 days and from 2.5 to 5 days upon treatment with phthalate esters. Experiments with [14C]guanidino-L-arginine indicated that some reutilization of [35S]methionine occurred, but this did not influence the results substantially. It appears that phthalate esters increase protein synthesis and decrease protein breakdown, the former effect being of greater importance. PMID- 2772925 TI - Cisplatin-induced changes in cytochrome P-450, lipid peroxidation and drug metabolizing enzyme activities in rat kidney cortex. AB - This study investigates the effects of 3 successive cisplatin administrations on rat kidney cytochrome P-450 and drug-metabolizing enzyme activities. Furthermore, because glutathione (GSH) and its related enzymatic system are involved in cellular detoxification processes, we examined the effects of cisplatin on lipid peroxidation, GSH levels, and GSH reductase and peroxidase activities. Cisplatin induced a decrease in cytochrome P-450, GSH, GSH S-transferase, GSH reductase and GSH peroxidase activities, and an increase in N-glucuronyl transferase, lipid peroxidation and oxidized glutathione (GSSG) in kidney cortical microsomes and cytosolic fractions. It is suggested that cisplatin nephrotoxicity could be explained by its affinity for SH-groups of several enzymes and SH-containing compounds. Among these, GSH and its related enzymatic system play a primary role. Moreover, cisplatin increases lipid peroxidation, which might participate in cisplatin nephrotoxicity. PMID- 2772926 TI - Copper status and adriamycin treatment: effects on antioxidant status in mice. AB - The biochemical response of Cu-sufficient and Cu-deficient mice to adriamycin (ADR) treatment was evaluated. Mice were injected intraperitoneally with ADR (17 mg/kg body wt.) or saline (0.9% w/v) and killed 4 d after injection. There was no effect of ADR on cardiac superoxide dismutase (SOD) activity in Cu-sufficient of Cu-deficient mice. ADR injection resulted in higher cardiac glutathione (GSH) concentrations in Cu-sufficient mice while it resulted in lower GSH concentrations in Cu-deficient mice relative to their saline-injected controls. The effects of ADR in Cu-deficient mice were tissue-specific as its administration resulted in lower hepatic SOD activity and higher hepatic GSH concentrations relative to saline-injected controls. PMID- 2772927 TI - [Characteristics of the cellular cooperation in the connective tissue base of the gingiva in periodontitis]. AB - The features of clinical course of chronic generalized periodontitis were studied from the viewpoint of analysis of cellular cooperative connective tissue basis. This allowed to single out 2 groups of patients. In the 1st group, a potent lymphoid (seldom lymphoplasmocytic) infiltration was detected within the gingival connective tissue basis, and sIgA preserved or even increased in the mixed saliva. In the 2nd group, the oral cavity physiological neutralization of antigenic substances was impaired and neutrophilic leucocytes were dominating in the gingival connective tissue framework with considerably increased levels of serum IgG. The gingival tissue basophils population was investigated in these groups of patients and their variants given the histochemical characterization. Prognostic criteria of treatment effectiveness are derived from studies of biopsied gingival tissues. PMID- 2772928 TI - [Lipid peroxidation in persons with chronic odontogenic foci of infection]. AB - In 86 patients with chronic granulomatous and granulating periodontitis in the absence of other pathology the lipid peroxidation products levels were increased as indicated by accumulation of malonic dialdehyde and diene conjugates in the whole blood. The relative content of disulphide groups in the red blood cells was increased and that of sulfhydryl groups decreased. The findings correlate with those detected in granulomas. PMID- 2772929 TI - [Experimental use of a pulsed CO2 laser in bone and osteoplastic operations on the maxillofacial area]. AB - Weak efficiency of laser incisors in bone surgery is primarily connected to a lack in the optimization of laser beam parameters in the above conditions. Experimental data are presented in which bone specimens were sectioned using a beam of a pulsed of continuous CO2 laser. Pulsed irradiation had some advantages over the continuous one in that the marginal necrotic zone of the incision was substantially reduced. The perspectives of the pulsed CO2 laser in maxillofacial surgery are outlined as related to bone and osteoplastic interventions. PMID- 2772930 TI - [Validation of the choice of antibacterial agents for treating periodontitis]. AB - Sensitivity of microflora sampled from the dental root channels of periodontitis patients to chlorhexidine, dioxidine, quinosol, Metrodgile was investigated. Chlorhexidine and dioxidine were shown to act predominantly on gram-positive and gram-negative bacteria, Metrodgile most active against anaerobic flora. High antibacterial activity of quinosol and chlorhexidine was combined with their pronounced cytotoxic effects. Metrodgile could be successfully used for preventing purulent odontogenic inflammations caused by anaerobic flora. PMID- 2772931 TI - [Indices of microorganism sensitivity to antiseptics in apical periodontitis]. AB - High incidence of detection of staphylococci aur. and epiderm.; streptococci hemolyt. and virid., and gram-negative microorganisms in dental root channels in periodontic patients was established. Among antiseptic drugs, most toward major periodontal++ initiators were pervomur, iodopyrone, chlorhexidine, ethonium. PMID- 2772932 TI - [Rheographic and photoplethysmographic research on the periodontium in adults with an orthognathic bite, healthy periodontium and an intact dental arch]. AB - The periodontal hemodynamics was investigated in 27 individuals aged 18 to 23. Qualitative evaluation of the curves recorded from marginal gingival sites revealed the identity of the data to those obtained using rheographic and photoplethysmographic techniques. Quantitative parameters of photoplethysmography were somewhat different from rheographic ones, though their course was similar. Pronounced reduction of variability characteristics in the plethysmography substantially increased the informative value of the technique. PMID- 2772933 TI - [An analysis of the psychoemotional tension in patients before oral surgery in relation to their psychological personality traits]. AB - Psychoemotional strain caused by the anticipation of surgical intervention with premedication exhibited greater anxiety levels (detected by means of Spielberger test) in extraverts as compared to introverts. This coincided with an elevated RR interval variability and, in extraverts, more pronounced alterations in ECG T wave amplitude. PMID- 2772934 TI - [Immunological aspects of the effect of inflammatory diseases of the maxillofacial area on the brain]. AB - Indirect hemagglutination was used to detect the blood serum antibrain antibodies in 472 patients with inflammatory maxillofacial diseases. Long-term follow-up was performed in 109 of the patients. High titres of antibrain antibodies were found. These were most pronounced in patients with concomitant odontogenic phlegmons. The disease severity correlated with the antibrain antibodies titers. The bodily disorders in severe odontogenic infection are accounted for by an "overload syndrome" due to the inflammatory focus influence on the brain and, subsequently, vicious circle formation involving facial inflammation and the brain as the organ of central homeostatic regulation. PMID- 2772936 TI - [X-ray changes in persons with facial skeleton deformities of the "long face" type]. AB - The analysis of X-ray data suggested that the syndrome of "long face" could be caused by three types of changes: (1), preferential lengthening of lower jaw bone; (2), combination of lower micrognathia with increased vertical dimensions of middle facial zone; (3), prevailing anterior extension of the middle facial zone. In all the three groups the vertical dimensions of the chin region of mandible were frequently enlarged. PMID- 2772935 TI - [Function of the respiratory and circulatory systems in patients with mandibular fractures]. AB - In 178 patients treated for the lower jaw fractures the respiration and gas exchange were studied. Respiratory insufficiency was caused by obstructive events due to bone fragments and maxillofacial soft tissues dislocation with arterial blood levels of oxygen decreased and hemoglobin oxygen saturation lowered. Traumatic stress resulted in hyperdynamic circulatory response correlating with the severity of lesion. PMID- 2772937 TI - [The planning of local plastic operations after the radiation therapy of malignant tumors of the head taking into account the blood microcirculation of the skin]. AB - The microcirculation changes were detected in tissues within and beyond the irradiated area. The changes were marked to a different degree depending on the ionizing irradiation dose and the time since its termination. The microcirculatory changes were less pronounced in the major cerebral vessels' body. The data suggest that microcirculation could provide an objective test in planning the local plastic surgery in the zones of irradiated skin malignant tumors in maxillofacial and haired regions of the head. PMID- 2772938 TI - [De- and remineralization processes of the surface layer of the enamel in intact and pulp-extirpated teeth]. AB - Clinico-laboratory investigation of 61 intact teeth and 61 teeth after pulp extraction was performed, including in vivo acid enamel biopsy and intravital staining with 2% methylene blue solution. The regularities were established governing Ca and P efflux from superficial enamel layer of intact and pulp extracted teeth into the acid solution with respect to age, group of the tooth and pulp extraction terms. The pulp extraction factor was investigated with special reference to the tooth acid resistance and its remineralization rate. PMID- 2772939 TI - [Effect of titanium on the osteogenic and proliferative potentials of bone marrow cells in vitro]. AB - The impact of titanium (BT-1.0) on proliferative and osteogenic potential of in vitro bone marrow was studied in rabbits. Titanium showed no influence on proliferation and differentiation of osteogenic determined cells precursors in the bone marrow. These cells' growth showed a titanium-tropicity. The authors came to a conclusion that the use of titanium in combination with automyeloplasty can be successfully used to accelerate the bone integration in implanted dental patients. PMID- 2772940 TI - [The immune status of patients with trigeminal neuralgia and its correction]. AB - Immune status (IS) was investigated in 82 patients with trigeminal neuralgia. In 89.1% of the patients IS was disturbed in the acute phase of the disease. IS showed major dependence on the etiology, period, severity and duration of the disease. Most substantial changes in IS were detected in patients with allergic neuralgia. In suppressive and stimulated with deficit IS types the use of levamisole accelerated the positive changes in IS. PMID- 2772941 TI - [The use of composite materials for the orthodontic treatment of patients with the vertical form of pathological tooth abrasiveness]. AB - The author summarizes his experience with 34 patients with localized vertical pathological teeth abrasion. The coronal defects of 189 anterior teeth were corrected using individually fitted polymeric caps and composition materials: carbodent and epacryl (USSR), evicrol (CSSR), microrest (Japan). The technique is described in detail with its advantages, indications and contraindications. PMID- 2772942 TI - [Patient assessment of the personality and professional qualities of the orthodontist]. AB - A total of 119 patients filled a questionnaire. Its analysis revealed that women are more open to the dentist, though all the patients felt strained while seeing the doctor. Most patients highly appreciated personal qualities of their orthopedic dentists and showed high respect for them. Patients were generally well oriented in semantic features of the questionnaire. PMID- 2772944 TI - [Hemisection of the mandibular molars and their use for orthodontic purposes]. AB - The results of a combined treatment of 41 patients with chronic periodontitis of lower molars are described. The four-stage technique of hemisection is presented in detail: (1), endodontic treatment of a preserved root; (2), crown reconstruction beneath the root in the form of the premolar; (3), separation of the afflicted root from intact ones using an improved set of minute instruments; (4), diseased root extraction. The recommendations are given to improve the orthopedic treatment. PMID- 2772943 TI - [Experimental research on the Dacryl-4B material for denture bases]. AB - Comparative investigations of 2 acrylic compounds: Ethacryl and Dacryl-4b are reported. In 240 white rats blood serum lysozyme was studied during 3 days to 6 months. Comparative data evaluation showed that Dacryl-4b had substantially less adverse action on the organism than did Ethacryl. As soon as after 3 months the serum lysozyme levels in experimental group was close to that of sham-operated rats. Encouraging results suggest further investigation into the properties of Dacryl-4b. PMID- 2772945 TI - [A treatment-prevention combination in the therapy of chronic parenchymatous parotitis in children]. AB - A combined treatment-and-prevention complex includes infusion of ol. semeni fructus Rosae into the diseased gland via its duct, peroral administration of retinol acetate and gland electrophoresis with 1% ascorbic acid solution. Up to 10 years follow-up of 118 children confirmed high efficiency of the procedure in 84,75% of the cases. Treatment duration in cases of exacerbations of chronic parotitis was reduced by 7.9 days per year per 1 patient. PMID- 2772946 TI - [The immune status of children with differing intensities of caries]. AB - The present paper reports on the results of the studies of the quantity, functional activity of immunocytes and interrelation between their parameters in healthy children (12-14) with healthy periodontium which were ascribed either to caries-resistant or caries-prone group. In all the subjects venous blood and mixed saliva were investigated. Immune state was described through its parameters interrelations. This yields better detection of differences in immune states of both groups. PMID- 2772947 TI - [Characteristics of the enamel mineralization of the intact permanent teeth in children 6 to 14 years old]. AB - The composition of enamel from the first permanent lower molars was studied intravitally in 140 somatically asymptomatic children with intact teeth. The contents of Ca, P and molar Ca/P ratio were determined. At the age of 10, 13 and 14 years Ca levels were higher as related to 10, 13 and 14 for cuspid and to 13 and 14 years for paracervical specimen. After 10 years, cuspid Ca content was higher than cervical. At the age of 10 to 14 cuspid P content was reduced. Age related increase in molar Ca/P ratio was also found. The values attained those characteristic of adult intact enamel at cuspid by the age of 9, and at cervix by 12 years. The data suggest that cuspid enamel matures earlier than pericervical one. PMID- 2772948 TI - [The hemodynamics of the parotid glands in children consuming carbohydrates]. AB - The rate of sweets consumption was shown to determine, to a large extent, the salivary glands function. In children rarely consuming sweets the parotid blood flow and salivation increased after intake of a 10% sucrose solution. In children abusing sweets even crystal sugar failed to change the parotid glands blood filling with salivation virtually unaltered. PMID- 2772949 TI - [The use of computers for the interpretation and analysis of teleroentgenograms of the skull]. AB - Software was designed suitable for detection of facial soft tissues contours and reading the anthropometric reference points with their plotting and calculation of angular, linear and indexed teleroentgenographic parameters. These were compared to normal data to determine their percent deviation. PMID- 2772950 TI - [The incidence of acute herpetic stomatitis in children in the Carpathian area]. AB - In the city of Chernovtsy the incidence of acute herpetic stomatitis (AHS) was 8.7%, in Ternopol 9.8% and in Lvov 5.7% of a total of children patients primarily referring to dentists. An age group of 1 to 3 years was most numerous. The increasing incidence of AHS requires preventive measures among which information of population is of a principal value. PMID- 2772951 TI - [Clinico-experimental research on the use of collagen in periodontal disease]. AB - Clinico-experimental studies of a new collagen derivative are presented. Experimental investigation in 30 rats showed the substance to promote wound healing. It also proved efficient in the five-years clinical follow-up of 254 patients after 441 surgical interventions (generalized periodontitis). PMID- 2772952 TI - [The development of a system of accounting for the work of dentists]. PMID- 2772953 TI - [The results of an experiment in the perestroika of dental care]. PMID- 2772954 TI - [A statistical analysis of the population incidence of dental caries]. PMID- 2772955 TI - [Treatment of chronic periodontitis by using tissue trepanation in the area of the periapical focus of destruction]. PMID- 2772957 TI - [Effect of physical exercises on the blood flow in a pedicled skin flap]. PMID- 2772956 TI - [A rare case of the clinical manifestation of chronic granulating periodontitis]. PMID- 2772958 TI - [The pairing and symmetry of jaw bone involvement in a central osteoblastoclastoma]. PMID- 2772959 TI - [A case of hereditary soft leukoplakia]. PMID- 2772960 TI - [Treatment of patients with mandibular fractures and a nonfixed height of the lower face]. PMID- 2772961 TI - [Necrosis of the tissues of the retromandibular and retroauricular areas and the lateral surface of the neck as a consequence of the self-treatment of lymphadenitis]. PMID- 2772962 TI - [The choice of the functional test in electromyographic study of the masticatory muscles]. PMID- 2772963 TI - [Experience in developing tasks for an algorithm-based test check in dentistry]. PMID- 2772964 TI - The antiprogesterone RU486 stabilizes the heterooligomeric, non-DNA-binding, 8S form of the rabbit uterus cytosol progesterone receptor. AB - The salt-induced (0.3 M KCl) transformation of the non-transformed, heterooligomeric 8S-form of the rabbit uterus cytosol progesterone receptor (PR) was analyzed by density gradient ultracentrifugation (8S----4S conversion) and DNA-cellulose chromatography (non-binding----binding forms). After 1 h treatment at 2 C, greater than 90% of agonist (R5020 or Org2058)-PR complexes were transformed, contrary to antagonist (RU486)-PR complexes, which did not undergo any transformation. Thus, there is stabilization of the non-transformed receptor form by RU486 as compared to the effect of agonist binding. The hydrodynamic parameters of both agonist- and antagonist-bound non-transformed receptors were similar and the calculated Mr were approximately 283,000 and approximately 293,000, respectively. In both cases, purification indicated the presence of a 90 kD non-hormone-binding protein associated with the hormone binding unit(s). Transformation of RU486-PR complexes occurred after exposure to high salt at increased temperature and was correlated to the dissociation of the 90-kD protein from the receptor. Both agonist- and antagonist-bound transformed forms of PR had apparent similar affinities for DNA-cellulose. Molybdate-stabilized and KCl treated RU486-PR complexes were more stable, as assessed by steroid binding, than the corresponding R5020-PR complexes, arguing in favor of a stabilizing effect of both the 90-kD protein and RU486 against inactivation. These cell-free experiments support the concept that RU486 in the rabbit uterus system stabilizes the 8S non-DNA binding, non-transformed form of the receptor at low temperature. The possibility that impaired dissociation of the heterooligomeric receptor form is involved in the antiprogesterone activity of RU486 is discussed. PMID- 2772965 TI - Reaction of trimethylsilylimidazole with 5,10 beta-epoxy-3-ketosteroids: enolization and aromatization of the A-ring. AB - The reaction of trimethylsilylimidazole (TSIM) and 3-keto-5,10-epoxy-nor-19 methylandrostanone 3 and its 17-acetate analog 4 was examined at two different temperatures. In both compounds, reaction at 90 degrees C gave predominantly a delta 3-silyl-enol ether plus a minor product as a result of the epoxide ring opening. Under reflux conditions, besides the aforementioned products, aromatization of the A-ring was observed as a major process. The results suggest the potential use of silylation reactions with epoxyketones towards the synthesis of aromatic compounds. PMID- 2772966 TI - Synthesis and gas chromatographic-mass spectrometric analysis of reduced compounds derived from 6 alpha- and 6 beta-hydroxy-11-deoxycorticosterone. AB - A series of thirty two 6-hydroxylated steroids were synthesized by selective reduction of the 4-5 double bond, the 3-oxo group, and/or the 20-oxo group of 6 alpha- and 6 beta-hydroxyDOC. The different reactions leading to the production of specific isomers are discussed. The gas chromatographic and spectrometric characteristics of the methoxime-trimethylsilyl (MO-TMS) or trimethylsilyl (TMS) derivatives of the isomers obtained are given. The gas chromatographic separation of the syn- and anti-isomers of the methoxime in position 3 was found to be characteristic of the configuration of the hydroxyl in position 6. The difference between methylene unit values of syn- and anti- isomers is much larger for the 6 alpha-series than for the 6 beta-series. The mass spectral analysis showed that many ions are specific of the MO-TMS derivatives of steroids with 3,6-dihydroxy-4 ene or 3-oxo-6-hydroxy-4-ene structure. In the case of steroids with a saturated ring A no significant ions characteristic of the presence of a 6 trimethylsilyloxy substituent were found. This work provides previously unavailable reference data on 6-hydroxylated steroids which should facilitate the study of corticosteroid metabolism. PMID- 2772967 TI - Modulation of steroid affinity for the androgen receptor by sucrose. AB - The effects of sucrose on androgen binding to its receptor were investigated. Sucrose decreased the rate of thermal inactivation of unoccupied and occupied androgen receptor (AR) and the rates of [3H]5 alpha-dihydrotestosterone [( 3H]DHT) dissociation from both activated and nonactivated AR complexes. Binding of [3H]DHT to AR in vivo, or in intact cells at 37 degrees C, caused reduction of [3H]DHT dissociation from cytosolic and nuclear complexes, as compared to in vitro labeled receptor complexes. Further, exposure of these complexes to sucrose at 0 degrees C caused an additional reduction of dissociation rates. Thus, the decrease of [3H]DHT dissociation induced by sucrose is independent of the reaction that reduces DHT dissociation from activated and transformed AR. Sucrose also reduced the ability of mersalyl acid to inactivate AR complexes. This effect of sucrose was markedly diminished in the presence of 2M urea. Sucrose did not significantly affect the association rate, sedimentation properties, or nuclear binding ability of AR complexes, but it did decrease the equilibrium dissociation constant. Other monosaccharides and disaccharides also stabilized AR. These data suggest that sucrose induces conformational changes in the steroid binding domain of androgen receptor, thereby reducing the rates of inactivation, steroid dissociation, and the accessibility of sulfhydryl groups to mersalyl. PMID- 2772968 TI - The effects of infusions of ring-A-reduced derivatives of aldosterone on the antinatriuretic and kaliuretic actions of aldosterone. AB - Infusion of Ring-A-reduced metabolites of aldosterone in adrenalectomized male rats for 4 days revealed that 5 alpha-Ring-A-reduced derivatives, 5 alpha dihydroaldosterone (5 alpha-DHAldo; 2.5-5.0 micrograms/day), 3 alpha,5 alpha tetrahydroaldosterone (3 alpha,5 alpha-THAldo; 5-25 micrograms/day), and 3 beta,5 alpha-THAldo (50-175 micrograms/day) possessed intrinsic Na+-retaining activity. The same infusions of 5 alpha-DHAldo, 3 alpha,5 alpha-THAldo, and 3 beta,5 alpha THAldo, also lowered the urinary excretion of potassium. The 5 beta-Ring-A reduced derivative 3 alpha,5 beta-THAldo did not demonstrate either of these biological properties. In another set of experiments, on the fourth day of infusion, aldosterone (0.1 microgram/rat) was administered acutely subcutaneously; none of the Ring-A-reduced derivatives altered the Na+-retaining activity of aldosterone. However, in a dose-dependent manner, both 3 alpha,5 alpha-THAldo and 3 beta,5 alpha-THAldo blunted the urinary K+-secretory effect of aldosterone; low dosages of 5 alpha-DHAldo and larger dosages of 3 alpha,5 beta THAldo did not. Thus, the 5 alpha-reduced derivatives of aldosterone not only lowered urinary Na+ and K+ excretion in their own right, but two of them blunted the kaliuretic response of the parent mineralocorticoid, aldosterone. Further experiments will be required to determine whether these aldosterone metabolites are further metabolized or interconverted during the expression of the regulatory properties described here and whether these properties are physiologically relevant. PMID- 2772969 TI - Norethandrolone produces temporary loss of the ability to escape from salt retaining steroids. AB - Patients with diseases characterized by salt retention manifest a loss of the normal ability of healthy persons to escape from repeat injections of aldosterone or other salt-retaining steroids. This phenomenon may be a clue to the pathophysiological mechanisms of salt retention. Administration of norethandrolone to a subject who had demonstrated the ability to escape from the salt-retaining effect of corticosteroid administration temporarily and reversibly deleted his ability to escape. Thus norethandrolone administration provides the basis for a model system for exploring the mechanisms of escape (and therefore of salt retention). PMID- 2772970 TI - Radioimmunoassay of 16 alpha-hydroxyestrone in human urine. AB - A radioimmunoassay for the quantitation of the sum of free, glucuronidated and urine is described. The method is reliable and accurate. Using this method, urinary excretion of 16 alpha-hydroxyestrone was determined in normal men, premenopausal women, and postmenopausal women. The values were compared to the urinary excretion of estrone and estradiol. In two women, the urinary excretion of the three estrogens was measured in daily samples throughout a normal menstrual cycle. We conclude that 16 alpha-hydroxyestrone is a quantitatively important urinary estrogen. Inclusion of the measurement of 16 alpha hydroxyestrone should yield a more accurate assessment of estrogen metabolism. PMID- 2772971 TI - Daily metabolism and hepatic balance studies of plasma cortisol and aldosterone in the preruminant calf. AB - Intestinal and hepatic catabolism of cortisol and aldosterone were studied in the calf using blood samples from the mesenteric artery and portal and hepatic veins collected over 24 h, the hepatic blood flow being continuously recorded during this period. The total hepatic blood flow remained broadly constant over the 24 h, although meals were followed by decreasing flow in the portal vein and by increasing flow in the hepatic artery. The intestinal tract catabolizes cortisol as intensively as the liver (both 13% of cortisol reaching the organ). The part played by the gut and the liver in the catabolism of aldosterone were also equivalent (both 30% of aldosterone reaching the organ). This 24-h study demonstrated that a constant ratio existed between secretion and catabolism of cortisol while the hepatic balance of aldosterone seemed to be modified during the night. PMID- 2772972 TI - Preparation of 14,15-secoestra-1,3,5(10)-trien-15-ynes, inhibitors of estradiol dehydrogenase. AB - The conversion of estrone to 14,15-secoestratrien-15-ynes, inactivators of estradiol dehydrogenase from human term placenta, is described. The optically pure precursor 7-acetoxy-octahydro-2-phenanthrenecarboxylic acid methyl ester is prepared from estrone in five steps and 40% yield. The unsubstituted propargylic secoestratriene diol, a mechanism-based inactivator of estradiol dehydrogenase, and the corresponding acetylenic ketone, an affinity label inactivator of the same enzyme, arise from the phenanthrene ester in three and four steps. The propargylic secoestratriene diol also competes with [3H]estradiol for binding to calf uterus estrogen receptor and possesses weak uterotrophic activity. PMID- 2772973 TI - Synthesis of bile acid analogs: 7-alkylated chenodeoxycholic acids. AB - This paper describes a method for the preparation of 7-alkylated chenodeoxycholic acids from 3 alpha-hydroxy-7-oxo-5 beta-cholanoic acid. The synthetic procedure is based upon a Grignard reaction between the keto bile acid and an alkyl magnesium halide. Under the conditions employed, the introduction of alkyl groups is highly stereoselective. Only 7 beta-alkylated epimers are obtained. The overall yield is several-fold higher than that obtained by the previous method, which involved the preparation of an oxazoline intermediate. PMID- 2772974 TI - Immediate and long-term results of carotid endarterectomy. AB - We review the long-term results of carotid endarterectomy in 200 consecutive patients operated on from 1980 to 1987. The patients were part of an ongoing study using duplex scanning to assess the status of the carotid bifurcation before and after endarterectomy. The average follow-up for the patients was 31 months. The indications for surgery were transient ischemic attacks in 87 (43.5%) and stroke in 36 (18%) patients; 77 patients (38.5%) were asymptomatic. In 176 sides (88%), the degree of stenosis exceeded 50% in terms of diameter reduction. The perioperative stroke rate was 2.3% in patients with transient ischemic attacks, 2.8% in patients with strokes, and 1.3% in asymptomatic patients. There was one perioperative death (0.5%). There were five occlusions of the internal carotid artery, one during the perioperative period and four after discharge; in three patients the occlusion was associated with the development of a stroke. There was a restenosis rate of 19.7% secondary to myointimal hyperplasia; such lesions did not appear to contribute to new ischemic events during or after their development. The mean stroke incidence after the decision was made for carotid endarterectomy was 2.8%/yr in the patients with transient ischemic attacks, 6.2%/yr in the patients with stroke, and 0.65%/yr in the asymptomatic patients. The annual death rate was 6% for the entire group, 5.5%/yr in the patients with transient ischemic attacks, 9.2%/yr in the patients with stroke, and 4.6%/yr in the asymptomatic patients. PMID- 2772975 TI - Incidence and prognosis of subarachnoid hemorrhage in a Japanese rural community. AB - Twenty-six first episodes of subarachnoid hemorrhage occurred among 1,621 Hisayama residents aged greater than or equal to 40 years during the 22-year follow-up of a prospective study. Subarachnoid hemorrhage was confirmed by both clinical and autopsy findings. The average annual incidence (96.1/100,000 population) was 3-13 times higher than any previously reported and steeply increased with age in both sexes, being 2.3 times higher for women than for men after adjusting for age. Nine patients (35%) died less than or equal to 8 hours after the onset of subarachnoid hemorrhage. None was correctly diagnosed on the death certificates, and four of the nine (44%) were misdiagnosed as intracerebral hemorrhage. We found the survival rate of patients suffering subarachnoid hemorrhage to be much lower than previously reported because we detected a large number of sudden deaths due to subarachnoid hemorrhage through the high rate of autopsy in our cohort (81.4%). PMID- 2772976 TI - Serial electrocardiographic recording in aneurysmal subarachnoid hemorrhage. AB - We prospectively studied serial electrocardiograms in 61 patients with aneurysmal subarachnoid hemorrhage. Electrocardiographic changes were related to the initial level of consciousness, to subsequent events, and to outcome after 3 months. All 61 patients had at least one abnormal electrocardiogram, but cardiac disease did not contribute directly to morbidity or mortality. Fast rhythm disturbances, ischemic changes, or both on the electrocardiograms were significantly correlated with poor outcome but not with specific outcome events, particularly not with rebleeding or cerebral ischemia. The Glasgow Coma Scale score on admission and the amount of cisternal and (to a lesser extent) intraventricular blood on the initial computed tomogram were also significantly correlated with poor outcome, but these factors only partially confounded the relation between electrocardiographic abnormalities and poor outcome. We conclude that in patients with aneurysmal subarachnoid hemorrhage, electrocardiographic abnormalities do not herald impending cardiac disease but indirectly reflect adverse intracranial factors. Electrocardiographic abnormalities may therefore have some independent value in predicting poor outcome. PMID- 2772977 TI - Atheromatous pseudo-occlusion of the internal carotid artery. AB - Between 1978 and 1988, the diagnosis of atheromatous pseudo-occlusion of the internal carotid artery was made in 34 patients by angiography. Results of noninvasive tests were abnormal in 33 of the 34 patients examined. Twenty-five patients had carotid endarterectomy, and the other nine were treated medically. Four of the 34 patients (12%) had significant complications, two related to angiography and two to surgery. Twenty-three of the 25 operated patients were seen in long-term follow-up; 19 (83%) were found to have a patent operated vessel by noninvasive testing. None of the 23 operated patients followed up suffered recurrent neurologic deficits following surgery; two had distant contralateral strokes. Three of the nine patients treated medically (33%) experienced delayed ipsilateral stroke. This study shows that the risks associated with angiography and surgery for atheromatous pseudo-occlusion are significant and are higher than previously reported. PMID- 2772978 TI - Regional cerebral blood flow measurement with intravenous [15O]water bolus and [18F]fluoromethane inhalation. AB - In 20 patients with ischemic cerebrovascular disease, classic migraine, or angiomas, we compared paired dynamic positron emission tomographic measurements of regional cerebral blood flow using both [15O]water and [18F]fluoromethane as tracers. Cerebral blood flow was also determined according to the autoradiographic technique with a bolus injection of [15O]water. There were reasonable overall correlations between dynamic [15O]water and [18F]fluoromethane values for cerebral blood flow (r = 0.82) and between dynamic and autoradiographic [15O]water values for cerebral blood flow (r = 0.83). We found a close correspondence between abnormal pathologic findings and visually evaluated cerebral blood flow tomograms obtained with the two tracers. On average, dynamic [15O]water cerebral blood flow was 6% lower than that measured with [18F]fluoromethane. There also was a general trend toward a greater underestimation with [15O]water in high-flow areas, particularly in hyperemic areas, probably due to incomplete first-pass extraction of [15O]water. Underestimation was not detected in low-flow areas or in the cerebellum. Absolute cerebral blood flow values were less closely correlated between tracers and techniques than cerebral blood flow patterns. The variability of the relation between absolute flow values was probably caused by confounding effects of the variation in the circulatory delay time. The autoradiographic technique was most sensitive to this type error. PMID- 2772979 TI - Evaluation of cerebral blood flow data in stroke patients using a mapping system. AB - We retrospectively examined regional cerebral blood flow values in 78 patients in the stabilized phase of stroke to evaluate the consistency of lateralization compared with computed tomographic imaging. Examinations were performed using the xenon-133 inhalation technique, and the data were processed and displayed by a computer-assisted system of our own design that allows statistical analysis in real time and is suitable for clinical use. The consistency of lateralization correlated with computed tomographic findings was tested for absolute values, percent distribution, and asymmetries. The latter yielded the highest degree of sensitivity (in 83.3% of the patients the affected hemisphere was correctly identified). Absolute values showed at least one hypoperfused area in the affected hemisphere in 48.7% of the patients, and percent distribution did so in 57.7%. Furthermore, the combination of the three methods of data analysis yielded a sensitivity of 91%; the remaining 9% of the patients, however, exhibited some abnormalities of regional cerebral blood flow (bilateral or contralateral hypoperfusion). Although good agreement was found for lateralization by computed tomography and by the combined use of the three methods of analysis, a complete overlap between functional and structural examinations should not be expected. Problems concerning the sensitivity of the xenon-133 inhalation technique under conditions of low blood flow and the statistical analysis of regional cerebral blood flow data are discussed. PMID- 2772981 TI - The TOPOSCOUT expert system for stroke localization. AB - Clinically, strokes are localized by the findings on neurologic examination. TOPOSCOUT is an expert system designed to diagnose the anatomic location and the corresponding vascular territory of strokes based on the clinical signs and symptoms. The inference engine of TOPOSCOUT uses a backtracking algorithm and a rule-based data base that includes associations of neurologic signs with vascular and anatomic areas. TOPOSCOUT is capable of detecting typical stroke patterns, for example, "top-of-the-basilar" or Wallenberg's syndromes. The accuracy of TOPOSCOUT's diagnoses has been tested for conformity with the final diagnoses of 129 patients in the Hamburg Stroke Data Bank, and a high level of agreement was found for hemispheric lesions. The program runs on microcomputers with MS-DOS and is intended as a practical aid for physicians not fully familiar with topologic stroke diagnosis and as an interactive teaching device. PMID- 2772980 TI - Comparison of six depression rating scales in geriatric stroke patients. AB - We compared three self-rating scales (the Geriatric Depression Scale, the Zung Scale, and the Center for Epidemiologic Studies Depression Scale) with three examiner-rating scales (the Hamilton Rating Scale, the Comprehensive Psychopathological Rating Scale-Depression, and the Cornell Scale), to see which was best for 40 elderly (mean age 80 years) stroke patients, 17 of whom were depressed according to clinical examination. External validity and concurrent validity were good for all except the Cornell Scale. Reliability (internal consistency) showed that some items were not significantly correlated, which might be explained by our selection of the patients. The Geriatric Depression Scale, the Zung Scale, and the Comprehensive Psychopathological Rating Scale Depression had the highest sensitivity, and the Zung Scale had the highest positive predictive value (93%). With regard to internal consistency, sensitivity, and predictive value, the best self-rating scales were the Geriatric Depression and the Zung scales and the best examiner-rating scale was the Comprehensive Psychopathological Rating Scale-Depression. PMID- 2772982 TI - Hemorrhagic stroke development in spontaneously hypertensive rats fed a North American, Japanese-style diet. AB - The purpose of my study was to assess a North American, Japanese-style diet commercially available from Zeigler Brothers (Gardners, Pennsylvania) with respect to the initiation of stroke development in 34 stroke-prone spontaneously hypertensive rats (spSHR) and in 14 stroke-resistant spontaneously hypertensive rats (srSHR). Nineteen spSHR fed the diet containing 4% NaCl and 0.75% K+ (low-K+ diet) from weaning had an accelerated rate of stroke development (mean +/- SEM age at death 15.3 +/- 0.5 weeks). The same diet containing 2.11% K+ (high-K+ diet) increased the mean lifespan of 15 spSHR by 39% but did not prevent stroke. The locations of hemorrhagic lesions were similar in the groups of spSHR fed high and low-K+ diets, being nearly equally divided between the territories of the anterior, posterior, and middle cerebral arteries. The 14 srSHR fed the low-K+ diet exhibited 50% mortality at 66 weeks of age. However, in the srSHR fed the low-K+ diet, death did not result from hemorrhagic stroke. The differing incidence of stroke between the spSHR fed high- and low-K+ diets and between spSHR and srSHR fed the low-K+ diet could not be explained on the basis of differing blood pressures. Compared with spSHR fed the low-K+ diet, both srSHR fed the low-K+ diet and spSHR fed the high-K+ diet exhibited higher drinking and urine excretion rates and elevated plasma K+ levels. My study indicates the availability of a commercial North American diet that produces a predictable high incidence of stroke within a compressed time period in spSHR but not in srSHR. This diet would be useful in studies attempting to determine the events preceding and leading to the development of stroke and in determining the genetic factors responsible for stroke resistance. PMID- 2772983 TI - Hypoxia-induced increases in hypoxic tolerance augmented by beta-hydroxybutyrate in mice. AB - A standard murine model was used to determine whether acute pretreatment exposures to hypoxia could alter ultimate hypoxic survival time. Adult male albino mice (Mus musculus) weighing 25-30 g were subjected to three pretreatment hypoxic exposures (4.5% O2, balance N2) of increasing duration (90, 120, and 150 seconds) with 300 seconds of normoxia between each pretreatment exposure and before testing of hypoxic survival time. Acute pretreatment exposures to hypoxia significantly increased mean +/- SEM hypoxic survival time from 108 +/- 4 to 403 +/- 42 seconds. Mean +/- SEM blood glucose concentrations increased significantly from 201 +/- 19 to 397 +/- 10 mg/dl immediately after hypoxic pretreatment. A significant increase in mean +/- SEM blood ketone concentrations, from 0.15 +/- 0.01 to 0.40 +/- 0.08 mM, was detected in the blood 1,800 seconds but not 300 seconds after hypoxic pretreatment. However, pretreatment with exogenous glucose or ketones alone, to mimic the blood levels seen after hypoxic pretreatment, failed to increase hypoxic survival time. In contrast, mice pretreated with hypoxic exposures plus the exogenous substrate beta-hydroxybutyrate had an increased mean +/- SEM hypoxic survival time of 749 +/- 48 seconds and a decreased body temperature. Stepwise Cox regression analyses with body temperature as a fixed covariate suggest that this decrease in body temperature has a partial role in, but can not fully account for, the increased hypoxic survival time. These data suggest that sequential exposures to hypoxia induce metabolic changes that protect against the lethal effects of hypoxia, perhaps by altering substrate mobilization and utilization and/or by inducing a hypometabolic hypothermia. PMID- 2772984 TI - Modification of acute focal ischemia in rabbits by poloxamer 188. AB - We studied the effect of a synthetic copolymer surfactant, poloxamer 188, on cerebral blood flow in a rabbit model of focal cerebral ischemia. Following retro orbital craniectomy, the parietal branch of the middle cerebral artery was occluded with bipolar current. Cerebral blood flow was measured by the hydrogen clearance technique using platinum-iridium electrodes placed within the parietal cortex. Ten rabbits were infused with 50 mg/kg poloxamer 188 in saline beginning 30 minutes after occlusion; 12 control rabbits received an equal volume of saline. Poloxamer 188 increased blood flow significantly in areas of severe or moderate ischemia but had little effect in areas with mild or no ischemia. The improvement in blood flow could not be accounted for by hemodilution, and the copolymer did not affect blood viscosity at any shear rate from 1 to 100 sec-1. We hypothesize that poloxamer 188 increases circulation in ischemic tissue by inhibiting adhesive interactions among proteins (fibrin and fibrinogen) and cells in the microcirculation. PMID- 2772985 TI - Blood-brain barrier sodium transport limits development of brain edema during partial ischemia in gerbils. AB - Sodium derived from the blood is known to accumulate in brain tissue during the early stages of incomplete ischemia. Our present studies were undertaken to determine the relation between blood-brain barrier sodium transport and the development of ischemic brain edema. Incomplete cerebral ischemia was produced in gerbils by ligation of the left common carotid artery under ether anesthesia. Following recovery from the anesthetic, the gerbis were evaluated for the presence of neurologic symptoms and were divided into symptomatic (n = 77) and asymptomatic (n = 94) groups. Tissue water, sodium, and potassium contents, tissue plasma volume, and brain uptake of 22Na were measured in both groups 1.5, 3, 6, 12, and 24 hours after carotid ligation. There was a progressive accumulation of sodium and water in the ipsilateral cerebral cortex of the symptomatic group compared with either the corresponding contralateral cortex of the same gerbils or with the asymptomatic group. Net changes in brain sodium and potassium concentrations appeared to be the main determinants of fluid accumulation. Brain edema was not due to opening of the blood-brain barrier because the unidirectional transport of 22Na remained low and was even reduced by 35-55% in the ischemic cortex. Nevertheless, this sodium transport activity appeared to be rate-limiting in the development of brain edema during the first 3 hours of ischemia because the rate of sodium accumulation in the tissue was the same as the rate of 22Na transport from the blood to the brain. We conclude that blood-brain barrier sodium transport is an important factor in the formation of ischemic brain edema. PMID- 2772986 TI - Volume therapy in orthostatic transient ischemic attacks. AB - We report the case of an 83-year-old man with recurrent orthostatic transient ischemic attacks despite anticoagulation and crystalloid therapy. An initial cerebral angiogram revealed a nearly occluded right carotid artery with a string sign. Following aggressive volume expansion with albumin, the patient became asymptomatic. A second angiogram demonstrated the resolution of the carotid string sign and unmasked a high-grade, very tight, surgically approachable stenosis. The role of a high intravascular volume status is discussed. PMID- 2772987 TI - Slowly progressive ischemic stroke as first manifestation of essential thrombocythemia. AB - We report a case of essential thrombocythemia, the only clinical manifestation of which consisted of neurologic symptoms, including anomic aphasia, tactile and painful hypesthesia in the right hand, headache, and Gerstmann syndrome, with a relatively benign and slowly progressive clinical course. Neuroradiologic examination disclosed a large ischemic area in the left temporoparietal region. Cerebral angiography revealed an occlusion of the cortical branches of the left middle cerebral artery with total sparing of the carotid vessel. These findings are discussed in relation to the possible pathogenetic mechanisms of the vascular occlusion due to abnormal platelet function in essential thrombocythemia. PMID- 2772988 TI - Heparin in acute stroke. PMID- 2772989 TI - Stroke, hemodilution, and mortality. PMID- 2772990 TI - Relationship of treatment for hypertension and stroke mortality. PMID- 2772991 TI - Pure motor hemiplegia due to pontine hemorrhage. PMID- 2772992 TI - Facial spasm from lacunar infarction of the thalamic ventrolateral nucleus. PMID- 2772994 TI - The effect of a breastfeeding education program on lactational amenorrhea in the Philippines. AB - A study was conducted in two communities in the rural Philippines to determine whether breastfeeding mothers could intensify their nursing enough to increase the period of lactational amenorrhea. Women in one community were exposed to a breastfeeding education program before the birth and during lactation, while women in the other community served as a comparison group. Increased breastfeeding was observed in the group that received breastfeeding education, beginning in the sixth month postpartum. Bottle use began earlier and was more common in the comparison group, but the introduction of solid foods at five to six months was similar. No difference in the duration of postpartum amenorrhea (a proxy for the duration of infertility) was observed between the groups. PMID- 2772993 TI - Organizing community participation in family planning projects in South Asia. AB - "Community participation" is a popular phrase with policymakers but the operational implications of putting the idea into practice are not clearly understood. This paper presents the findings from a comparative analysis of seven case studies of community participation projects implemented by the nongovernmental Family Planning Associations (FPAs) of India, Bangladesh, Pakistan, Sri Lanka, and Nepal. The analysis focuses on the interactions between staff and communities and assesses the extent to which the organization of the FPAs encourages and enables participation in project implementation. The results suggest that, despite the policy rhetoric seeking greater community involvement and self-reliance in program implementation, FPAs most commonly use participation as a means to generate new demand for services by presenting family planning in a manner that is acceptable and appropriate to the communities involved. PMID- 2772995 TI - Knowledge of reproductive physiology and modern contraceptives in rural Peru. AB - This report is based on fieldwork conducted in a Peruvian community in 1986, which investigated Quechua-speaking Indians' knowledge of the female reproductive organs, perceptions of the way contraceptives work in the body, folk beliefs about conception and menstruation, and opinions about modern contraceptives. The findings reveal that the men have a more accurate knowledge of the female reproductive organs than the women do. However, the women are more knowledgeable about the action of modern contraceptives in the body. Most respondents perceived modern contraceptive methods as the best methods available, but the majority reported using the calendar rhythm method. This preference for rhythm is based on its economic advantage and on its adaptability to folk beliefs about physiology. The men's dominant role in reproductive behavior is related to cultural norms that emphasize traditional gender roles and that prohibit communication about sexual matters between men and women. Educational material, based on the respondents' knowledge of reproduction and taking into account their folk beliefs, might help to decrease the fear of contraceptive side effects and increase understanding of the function of contraceptives. PMID- 2772996 TI - Helping managers to manage: work schedules of field-workers in rural Bangladesh. AB - The Maternal-Child Health/Family Planning (MCH/FP) Extension Project in Bangladesh identifies and examines barriers to implementation of the national MCH/FP program, and determines strategies to overcome them. This study analyzes field-workers' ability to carry out more tasks than they do presently, and how their performance might be improved when additional field-workers are hired. In two experimental subdistricts, researchers observed the work of family welfare assistants (FWAs), the female family planning field-workers, to determine the duration and frequency of their home visits with village women and the content of their exchanges. While many factors influence the FWA's work, researchers found that the preplanned monthly work schedules could be manipulated relatively easily to improve duration and frequency of program contact with village women. With more time available to spend with women, the potential to improve the quality of services is enhanced. PMID- 2772998 TI - [Morphology of fractures of long tubular bones in children upon trauma due to solid blunt objects]. AB - Morphologic features of diaphyseal fractures of lond tubular bones in different age groups in childhood were studied experimentally on biodummy using direct stereomicroscopy (MBC-9). Blow effect was induced by solid blunt objects at the middle diaphyseal parts at a right angle. A series of specific morphologic features which help to diagnose the specific bone tissue lesions in different fracture zones as well as in different age periods was obtained. Experimental data were confirmed by expert observations which proves the possibility of using these specific morphologic features of diaphyseal fractures of long tubular bones in childhood for medicolegal purposes. PMID- 2772997 TI - Trinidad and Tobago 1987: results from the demographic and health survey. PMID- 2772999 TI - [Mechanism of formation of spinal injuries]. AB - It was stipulated that in medicolegal examination of deaths due to mechanical trauma accompanied by vertebral column separation it is necessary to investigate the surface of separation, which as a rule passes along the verge of the osseous and cartilagnous locking laminae. At the initial stage of avulsion a fragment of osseous lamina of the adjacent vertebral corpus remains fixed to cartilaginous lamina. Taking into account the localization of this fragment one may judge upon the direction of spine flexure. PMID- 2773000 TI - [Forensic-medical aspects of dermatoglyphics of the hands and feet]. AB - Issues on possibility of using capillary patterns of hands and feet in medicolegal examination of unidentified dead bodies and unknown persons, in cases of disputed paternity and maternity and child substitution are considered. Up-to date theories on inheritance of dermatoglyphics features, their racial, sexual, age and occupational variability as well as interrelationship with some genetic diseases are analysed. Ways of researches in the field of dermatoglyphics of hands and feet for expert practice are outlined. PMID- 2773002 TI - [The use of anti-A and anti-B monoclonal antibodies in forensic medicine]. AB - Anti-A and anti-B monoclonal antibodies (MCA) may be used in the analysis of liquid blood, blood and saliva traces in order to detect ABO blood group antigens A and B using common methods of evidence investigation. Use of MCA and isohaemagglutinins anti-A and anti-B in absorbtion-elution reaction during the analysis of minute saliva traces enhances the possibility of establishing the origin of the saliva at the expense of nonsecretor. PMID- 2773001 TI - [The use of a method of mathematical analysis in establishing the species affiliation of animal hair]. AB - Quantitative content of 10 trace elements in hair of 9 species of animals was determined by atomic-absorbtion spectroscopy. Analysis of the resulting digital data using discriminant algorithm makes it possible to determine species and sex of an animal by trace element content of hair. PMID- 2773003 TI - [The principle of an occupational approach in expert evaluation of carbon monoxide poisoning during the investigation of aviation accidents]. AB - In case of expert evaluation of poisonings (CO in particular) violation of occupational duties under the influence of toxic substances should be considered as these violations in some cases may result in erroneous actions of a man operator, which may cause the development or aggravation of accident situation and in the end, death of aircrew and passengers of an aircraft. PMID- 2773004 TI - [Determination of toxic nitriles in the blood of victims perishing at a fire site]. AB - Technique of quantitative Gas--chromatographic determination of acrylic acid nitrile and acetonitrile in the blood was developed. Range of detectable concentrations was 1-600 mg/l. Postmortal blood samples obtained from 48 victims of fire were analysed. Toxic nitriles were detected in 85.4% of cases and the relation between nitrile contents and carboxyhaemoglobin concentration was stated. PMID- 2773005 TI - [Thanatology (origin and interpretation of the word)]. AB - History of origination of a term "thanatology' its interpretation nowadays by pathologists and medicolegal examiners are considered in this work. PMID- 2773006 TI - [Comparative study of methods of isolating ergometrine from cadaveric material]. AB - The results of comparative study using three methods of ergometrine isolation from cadaveric material with respect to Vasiljeva, Kramarenko, Stas-Otto are presented. Vasileva's method appeared to be more effective. PMID- 2773008 TI - [Methods of detecting furosemide]. AB - The following methods for furosemide identification were recommended: microcrystalline reactions with Dragendorf and Zonnenstein reagents, with cuprous iodide and ferric iodide complexes, rhodanide cadmium complex, plumbous iodide solution in iodized potassium, and thin-layer sorbent chromatography. PMID- 2773007 TI - [A rapid method of identification and quantitative determination of zinc phosphide in cadaveric material]. PMID- 2773009 TI - [Determination of trasodone in cadaveric material]. AB - Methods of trasodone isolation from cadaveric material by water and acetonitrile at pH-2.0, which may be used in expert practice, were developed. Acetonitrile method is recommended for everyday practice as it allows one to isolate about 60% of trasodone and to obtain extracts with lower content of extractive substances. Detection limit in case of trasodone isolation by acidified water is 50 micrograms in 25 g of the liver and by acetonitrile--25 micrograms in 25 g of the liver and kidney. PMID- 2773011 TI - [Realization of an adaptive method of simulating the process of temperature change of a cadaver on a microcomputer]. AB - Programme based on mathematical model of the process of dead body temperature changing was developed for estimation of postmortem interval. Automatic retrieval of problem solution was performed on programmable microcalculators of "Electronica MK-61" type using adaptive approach. Diagnostical accuracy in case of dead body being preserved in permanent cooling conditions is +/- 3%. PMID- 2773010 TI - [Clinical and social characteristics of persons accused of committing sexual offenses]. AB - The results of clinical statistical examination of 1.405 men responsible for sexual offences are presented. On the basis of the results obtained some data are given (which were unknown before) concerning unlawful sexual behaviour of subjects with psychic pathology, frequency and character of sexual offences in the given population; then the effect of alcoholisation and general recidivation of crimes is specified and stressed; most criminogenic social and clinical groups are singled out; and knowledge on distribution and representation of sexual pathology (perversion) in nosologic groups and in practical work of forensic psychiatrists is outlined and supplemented. PMID- 2773012 TI - [Information on upcoming 1989 continuing education courses for forensic medicine specialists at institutes for advanced medical training]. PMID- 2773013 TI - [A method of obtaining conditionally-transverse sections of a traumatizing area of a solid blunt object]. PMID- 2773014 TI - [A method of determining impact force and simulating injuries caused by stabbing cutting objects]. PMID- 2773015 TI - [A method of joining tubular bone fragments]. PMID- 2773016 TI - [Ability for active actions in the case of multiple cuts and stab wounds to the body]. PMID- 2773017 TI - [Differential diagnosis of marginal fractures of the vertebrae]. PMID- 2773018 TI - [An unusual cause of death in self-hanging]. PMID- 2773019 TI - [Suicide with a noose]. PMID- 2773020 TI - [Fatal poisoning of a child with clofeline]. PMID- 2773021 TI - [Detection of euphylline in cadaveric material]. PMID- 2773023 TI - [Establishing the cause of death in pneumopathies]. AB - The article deals with determination and differential diagnosis of the cause of death in different forms of pneumopathy and mechanical asphyxia on the basis of developed morphometric method for separate evaluation of the volume of lung tissue per se, the air and pathologic contents of airways. PMID- 2773022 TI - [A method of detecting aminazine in cadaveric material]. PMID- 2773024 TI - [Comparative characteristics of chest cavity injuries in children and adults as a result of a blow from a solid blunt object]. AB - Deformity character and mechanism of thoracic injury occurrence in children regarding different variants of striking effect of solid blunt objects were studied. It was found that the bone frame of a middle part of rear and lateral surfaces of thorax is most often damaged and isolated incomplete fractures of 2 to 9 ribs occur (in adults - multiple, complete fractures). In case of wide striking surface 3 to 10 ribs are injured both in children and in adults, and construction flexion fractures are noted while in case of blows with limited surface local extension fractures with injuries of up to 3 adjacent ribs are seen. PMID- 2773025 TI - Survival of Borrelia burgdorferi in blood products. AB - The incidence of Lyme disease is rapidly increasing in the United States. To assess the potential of transmission of the disease through blood transfusion, we studied the survival of Borrelia burgdorferi in blood products under blood bank storage conditions. Two units of whole blood, separated into red cells (RBCs), fresh-frozen plasma (FFP), and platelet concentrates (PCs), were inoculated with B. burgdorferi (strain B31) in concentrations of approximately 3000 organisms per mL of RBCs and FFP and 200 organisms per mL of PCs. Products were then stored under blood banking conditions and sampled at several storage times. The viability of the spirochete in blood components was determined by darkfield microscopic examination of cultures in modified Kelly's medium. The organism was shown to survive in RBCs (4 degrees C) and FFP (below -18 degrees C) for 45 days and in PCs (20-24 degrees C) for 6 days. The results of this study do not exclude the possibility of transmission of Lyme disease through blood transfusion. PMID- 2773026 TI - Evaluation of technical and behavioral issues in predonation alanine aminotransferase testing. AB - To evaluate the technical and behavioral impact of predonation alanine aminotransferase (ALT) testing, one group of 2914 donors (Reflotron group) were tested with the Boehringer Mannheim Reflotron instrument; 3042 control group donors had no predonation test. Mobile blood collection sites in three regional blood centers were studied. More Reflotron group donors than control group donors thought that predonation testing did not add time and was a good idea. Both groups were equally satisfied with the donation process and indicated they would donate again even if testing added time. Comparison of the Reflotron and standard laboratory tests showed excellent correlation with low variability. The mean r value was 0.934, with a mean sensitivity of 94.4 percent and a specificity of 99.8 percent. The staff working with the Reflotron group found predonation testing easy to incorporate into donor screening. They observed that donors were pleased with testing and accepting of deferral counseling for elevated ALT. The control group staff was concerned that predonation testing would require more time and would have a negative effect on the donor return rate. This did not appear to be the case as judged by donor response and the 6-month return rates of 50 percent for Reflotron group and 54 percent for control group donors. PMID- 2773027 TI - Evaluation of platelet concentrates prepared from buffy coats and stored in a glucose-free crystalloid medium. AB - Comparison was made between platelet concentrates prepared from pools of buffy coats removed from standard blood donations and stored in a glucose-free, commercially available crystalloid solution (BC-PCs) and standard platelet concentrates prepared from platelet-rich plasma (PRP-PCs). Platelet yield in BC PCs and PRP-PCs was 59 and 75 percent of donated platelets, respectively. The number of total white cells in 1 BC-PC unit, prepared from a pool of 7 buffy coats, was 21 x 10(6), i.e., 50 times lower than that of 7 units of PRP-PCs. The in vitro values of adequate platelet quality were maintained for 10 days in BC PCs stored in 1000-mL polyolefin bags. Prolonged bleeding times were reduced or corrected in three of three thrombocytopenic leukemic patients evaluated before and after transfusion of stored BC-PCs. Pretransfusion and 1- and 24-hour posttransfusion median platelet counts in 57 leukemic recipients during 4 months of routine transfusion of BC-PCs (n = 93) were 14, 35, and 27 x 10(9) per L, while those of PRP-PCs (n = 246) were 13, 37, and 31 x 10(9) per L, respectively. No reactions to BC-PCs were reported, but a 1.3 percent rate of reaction to PRP PC transfusions was reported. This study indicates that BC-PCs are a good alternative to PRP-PCs for platelet support of thrombocytopenic patients. PMID- 2773029 TI - 5-day storage of platelets collected on a blood cell separator. AB - One of the earliest devices available for plateletpheresis is the Haemonetics system; this machine has been updated recently to permit the use of software in a closed system and thus storage of the collected platelets beyond 24 hours. The authors examined the in vitro and in vivo function of platelets collected on the Haemonetics AutoSurge machine and stored for 5 days in two separate 1000-mL CLX bags. The average count per bag was 1.8 +/- 0.4 x 10(11) in approximately 200 mL of plasma. Immediately following collection, the platelet response to ADP and epinephrine represented 78 and 35 percent, respectively, of the preapheresis values. Aggregation to single stimuli subsequently decreased to 29 and 0 percent, respectively by Day 5. This response is equal to or better than the response reported with the Fenwal CS-3000, the only other plateletpheresis device routinely used for long-term storage. The pH of the preparations was well maintained throughout storage, and there was little alteration in hypotonic shock response or serotonin uptake. Serotonin release decreased consistently. The morphology scores indicated good maintenance of shape immediately following collection; this subsequently decreased after 5 days of storage. Bacterial cultures were negative in all instances. The 51Cr in vivo survival and recovery was good with 65.5 +/- 7.1 percent recovery and an average survival of 7.3 +/- 1.3 days (multiple hit; n = 5). The data indicate that storage of the Haemonetics plateletpheresis product is feasible and that the product is as good as others currently available. PMID- 2773028 TI - Risk of hemolytic disease of the newborn as a result of directed donations from relatives. AB - Women of childbearing age are more and more often requesting directed blood donations from their husbands or other relatives. With a mathematical model, the risk was derived of such transfusions causing hemolytic disease of the newborn (HDN) in subsequent pregnancies. Calculations were performed for six classes of relatives of the recipient and her husband and for four racial groups. In general, the risk of HDN increases with the donor's degree of relatedness to the husband and decreases with the donor's degree of relatedness to the recipient in a fairly continuous manner. The relative risk for subsequent HDN was as high as 4.1 if the husband donated. The risk varied with the recipient's race as well as Rh(D) status. Although small, the risk involved in transfusing a woman of childbearing age with blood from her husband or his relatives should be considered when using directed donors. PMID- 2773030 TI - Th activation of maternal and cord blood. AB - Th activation of red cells is characterized by agglutination with the peanut lectin from Arachis hypogaea and is diminished by treatment with proteolytic enzymes. The first cases of Th activation were associated with bacterial infections. More recently, a high incidence of Th activation in congenital hypoplastic anemia has been reported, along with the finding that 13.5 percent of cord bloods are Th activated. The incidence of Th reactivity in newborn infants was confirmed by studying 200 paired samples of maternal and cord blood. Twenty two (11%) of the cord samples and 13 (6.5%) of the maternal samples were Th activated. In 6 paired samples (6/22), both the mother and child had Th activation, a finding that demonstrates a high degree of concordance. Additionally, 3 (6%) of 50 pregnant women were Th positive. These findings indicate that Th activation is another of the red cell antigen alterations related to pregnancy. PMID- 2773031 TI - Immune hemolytic anemia associated with tolmetin and suprofen. AB - This article reports the first case of immune hemolytic anemia possibly associated with the ingestion of suprofen. The patient suffered from massive hemoglobinuria and acute renal failure. Serologic studies of the patient's serum revealed suprofen-dependent red cell antibodies. However, tolmetin-dependent antibodies were also found in the serum, showing the same properties as the suprofen antibodies and an even higher titer. The patient not only had drug dependent antibodies in the serum, but also had developed autoantibodies, a phenomenon that has been described for several other drugs. The working mechanism by which suprofen and tolmetin caused immune hemolysis had properties of both the immune complex model and the induction of autoimmunity. Although it was unclear whether the immune hemolytic anemia was the result of suprofen, tolmetin, or cross-reacting antibodies, we feel that suprofen should be added to the list of nonsteroidal anti-inflammatory drugs associated with a positive direct antiglobulin test. PMID- 2773033 TI - A flow cytometric technique to accurately measure post-filtration white blood cell counts. AB - Leukocyte-depleted blood products are being used with increasing frequency in hopes of preventing or delaying platelet alloimmunization. However, accurately monitoring the efficiency of leukocyte (WBC) removal is a difficult problem because electronic cell counters are not accurate at very low WBC numbers and hemocytometer counts are tedious and time consuming. A simple flow cytometric technique was developed which accurately and rapidly measures extremely low WBC counts. Using a propidium iodide solution which causes DNA to fluoresce, the residual WBC count was measured in 42 units of blood products after leukocyte depletion using a commercial filter. There was a significant correlation with simultaneous hemocytometer counts, r = 0.672, but residual WBC could be identified in every unit using the flow cytometer, whereas in 19% of the units no WBC were seen using the hemocytometer. Extremely low counts, as low as a single WBC/4 microliters could be reproducibly obtained. In addition, serial dilution studies yielded a correlation coefficient of 0.997. Because most clinical laboratories now have access to flow cytometers, this technique can be widely used. PMID- 2773032 TI - The Kmod blood group phenotype in a healthy individual. AB - This report describes a healthy blood donor whose red cells have weakened expression of Kell blood group antigens. Kell antigen activity could not be detected by flow cytometric analysis and was demonstrable only by sensitive serologic techniques. As with normal-strength Kell antigens, reactivity could be abolished by treatment with 2-aminoethylisothiouronium bromide (AET). The donor's red cells have Kx antigen activity. Other commonly tested blood group antigens (MNSs, Rh, P1, Lewis, Duffy, and Kidd systems) appear normal. Clinical and serologic examination showed that this case is different from previously described examples of modified Kell expression. The propositus's phenotype has remained unchanged for 19 months, which suggests that it is not a transient condition. However, family studies provide no evidence that it is inherited. A 93 kD protein, which reacted weakly by Western blot with rabbit antibody to Kell protein, was isolated from the propositus's red cells by immunoprecipitation. This finding was not reproduced in subsequent studies, which suggests that the quantity of Kell protein recovered was at the threshold level detectable by the technique used. The red cell phenotype is categorized as Kmod, of which this is the first example reported in a healthy individual. PMID- 2773034 TI - Neutrophil-specific antigens and gene frequencies in Japanese. PMID- 2773036 TI - Abstracts of papers: American Association of Blood Banks, 42nd annual meeting. October 21-26, 1989, New Orleans, Louisiana. PMID- 2773035 TI - More on the pros and cons of directed blood donations. PMID- 2773037 TI - Structure and regulation of ribulose-1,5-bisphosphate carboxylase/oxygenase. PMID- 2773038 TI - How 'hidden' reading frames are expressed. AB - Secondary reading frames, 'hidden' under other reading frames, are used for coordinated expression of proteins in several eukaryotic viruses. In some genes, ribosomal frameshifting and initiation or reinitiation of protein synthesis on internal AUG codons are translational mechanisms allowing access to such 'hidden' reading frames. In others, secondary reading frames are translated from alternatively spliced or edited mRNAs. PMID- 2773039 TI - Characterization of oligosaccharides by lectin affinity high-performance liquid chromatography. AB - Alterations of the oligosaccharide structures of glycoproteins are associated with differentiation, malignant transformation, and expression of the same protein in different cell types. The potential biological importance of oligosaccharides has resulted in a growing need for detailed structural information. When glycoproteins are available in limited quantities and/or bear highly heterogeneous oligosaccharides, characterization of their oligosaccharides is difficult. We have developed an efficient approach for obtaining detailed information about oligosaccharides by determining structural 'fingerprints' using lectin affinity high-performance liquid chromatography. PMID- 2773040 TI - A flavor of protein chemistry. PMID- 2773041 TI - Similar amino acid sequences revisited. AB - The rapid accumulation of protein sequences, many bearing unexpected resemblances to each other, is providing a new perspective on evolution. PMID- 2773042 TI - The teaching of clinical pharmacology in Europe and North America. AB - A recent survey conducted under the auspices of the WHO shows that on average in European medical schools only 28 hours of teaching are devoted to clinical pharmacology, whereas over 100 hours are devoted to pharmacology. In many schools no clinical pharmacology is taught, and there is a lack of trained individuals and posts in clinical pharmacology. In North America there is a similar lack of clinical pharmacology teaching. PMID- 2773044 TI - Brain microdialysis fails to detect a dopamine-acetylcholine interaction in the basal ganglia. PMID- 2773043 TI - Calculating receptor number from binding experiments using same compound as radioligand and competitor. AB - Saturation experiments using increasing concentrations of radioligand are commonly used to determine receptor number and affinity, but this protocol is not feasible in all situations. Alternatively, competitive binding experiments are often performed in which binding of a single concentration of radioligand is completed for by multiple concentrations of the same unlabelled ligand, but the analysis of such data has been difficult. Antonio DeBlasi and colleagues present here a simple method for calculating receptor number and affinity from competitive binding data. This experimental protocol is useful when a single class of binding site is present, but is often not able to detect the presence of two classes of site. PMID- 2773045 TI - H3 receptors in airways. PMID- 2773046 TI - Neonatology in the developing world. Part 1. PMID- 2773047 TI - Simplified surgical treatment of large hydatid cysts of the liver. PMID- 2773048 TI - Reasons for non-use of family planning methods at Ilorin, Nigeria: male opposition and fear of methods. AB - This study reports the main reasons given for non-use of contraception by non pregnant women aged 15-44 years, who are at risk of unplanned pregnancy and living in the Ilorin Local Government Area of Kwara State, Nigeria. Six hundred and forty-six women were derived from a stratified cluster sample and interviewed using a questionnaire. Almost one-third (31.4%) of respondents gave male opposition to family planning as the reason for current non-use. Another 13.3% expressed fear of methods, 6.3% did not want to use contraception until the first child was born, and 13.6% until the desired number of children were born. Sociodemographic variables including age, educational level, religion, and residence as reasons for non-use were reported. Other important findings included a high awareness of, low availability of, or poor accessibility to contraceptive methods. Short and long term intervention strategies using information, education and communication materials are proposed to combat low levels of contraceptive use in this area. PMID- 2773049 TI - Effects of the institutionalization of primary health care. PMID- 2773050 TI - With free health services, why does the Brazilian working class delay in seeing the doctor? AB - The length of delay in seeing a physician was related to perceived difficulty in access to services and to scepticism and doubt about the effectiveness of medical care. Attention is called to the importance of the doctor-patient relationship in fostering prompt patient action. PMID- 2773051 TI - Hazards of injectable therapy. PMID- 2773052 TI - Standard treatment regimens--a personal account of Papua New Guinea experience. PMID- 2773054 TI - Gastrointestinal malignancies in a young tropical African population. AB - The records of 695 patients with confirmed gastroenterological malignancies over a 10 year period (January 1976-December 1985) were analysed. Of these, 264 patients (37.98%) were below the age of 40 years. Primary liver cell carcinoma was the commonest malignancy while gallbladder and oropharyngeal cancers were the least common. Most of the patients (66.3%) were in their fourth decade. The prognosis was poor as most of the patients presented late. PMID- 2773053 TI - Precautions against HIV transmission in hospitals. PMID- 2773055 TI - Deliberate burns in Nigerians. AB - Eleven cases of deliberate burns in Nigerians were studied. Three major reasons for burning were recognized. Ignorance was identified as a factor in the aetiology of some of these avoidable burns. Primary prevention of the burns and the secondary prevention of their complications are outlined. The management of the patients is discussed. PMID- 2773056 TI - Self-made instruments for eye examination. PMID- 2773057 TI - Injections and health. PMID- 2773058 TI - Medical standards in the developing world. PMID- 2773059 TI - [Ultrastructural changes of platelets during ADP- stimulated aggregation (in the presence of fibrinogen)]. AB - The ultrastructure of resting and stimulated human blood platelets (P) was studied by the transmission electron microscopy. The cells were chemically fixed (using tannic acid and OsFeCN mixture) 1, 3, 5 and 15 min after the addition of ADP and fibrinogen (F). Early changes in P ultrastructure consist in drastic reduction of the electron-dense layer of glycocalyx and in an increase of the plasma membrane permeability. At the early stages of P aggregation the cells contact with each other due to rapidly arising pseudopodia. Later, the extracellular network containing an exogenous F participates in the aggregation process. PMID- 2773060 TI - [Role of genetic and environmental factors in the realization of the hereditary potential of record-holding cows' longevity]. AB - A positive correlation is found between the level of record productivity of record-holding cows and duration of their farm use. A positive correlation is found to exist between the value of the record milk-yield and repetition of milk yields similar to the record. It is stated that the overwhelming majority of record-holding cows are well developed, have solid sound constitution, better adaptability to living conditions, higher viability. PMID- 2773062 TI - [Ultrastructural changes in the interneuronal contacts of the upper layers of the cerebral cortex in cats when aminazine is applied]. AB - The fine structure of upper layer of axodendritic synapses of the cat cerebral cortex was studied during 10, 45 and 90 minute applications of aminazine, and also 2.5 and 5 hours after the cessation of the 90 minute application. During the 10 and 45 minute applications no clear-cut changes are observed in the ultrastructure of the synapses. 90 minutes after the onset of application osmophilic changes are enhanced in the pre- and postsynaptic areas. During the drug application, the number of synaptic vesicles and the area of the axonal terminals decrease. The above morphological changes are reversible: restoration of the number of synaptic vesicles commences, but the area of the terminal is still shrunken. PMID- 2773061 TI - [Cytogenetic activity of the butylcaptax defoliant transformation product]. AB - Cytogenetical activity of the product of metabolitic butylcaptax transformations in cells of cotton plants G. barbadense has been studied. It is shown that butylcaptax, with a significant mutagenicity, looses its mutagenic activity, metabolizing in low mutagenic 2-oxyamylthiobenzthiazole. Low water solubility prevents its concentration to exceed 0.005% in tissue liquids and to exert a mutagenic action on cotton plants. PMID- 2773063 TI - [Effect of natural human leukocyte interferon on cell cycle kinetics, the frequency of sister chromatid exchanges and chromosome aberrations in fopurin treated human lymphocytes]. AB - Natural human leukocyte interferon (50 IU/ml), added to human lymphocytes for 24 hour incubation time, increased the background sister chromatid exchange (SCE) frequency and shortened the average generation time (AGT). Interferon pretreatment decreased the levels of the SCE induced by antineoplastic alkylating drug fopurin (2-dimethylamino-6-diethylene iminophosphamido-7-methylpurine; treatment conditions: the 20-24 hour incubation time, 25 and 50 microM), but no statistically significant changes were noticed in AGTs, in the number of aberrant metaphases, and in the total number of induced chromosome aberrations (CA). The increased number of the exchange-type CA induced by fopurin (50 microM) was observed in interferon pretreated cells. The results obtained indicate different formation mechanisms for SCE and CA, as well as different modification ways of SCE and CA formation by interferon. PMID- 2773064 TI - ["Spontaneous" oscillations of the cell surface in the frequency interval of 0.2 30 Hz]. AB - The local transverse displacements of the cell surface within the frequency range of 0.2-30 Hz occur on animal cells attached to cover glass: fibroblasts 3T6, primary culture of rat cardiomyocytes, mouse lymphocytes, human macrophages and erythrocytes, frog erythrocytes. The area of the cell rim, moving transversely, is no more than 0.5 X 0.5 microns. The maximum amplitude of the local transverse surface displacement is different in various cell types, being maximum (350-400 nm) in human erythrocytes and minimum in fibroblasts 3T6, mouse lymphocytes and human macrophages (20-30 nm). High-amplitude oscillations of human erythrocytes and low-amplitude oscillations of frog erythrocytes correlate with differences in the size of elastic shear modulus. PMID- 2773065 TI - [Rapid local oscillations of the surface of the human erythrocyte]. AB - The transverse displacements of the human erythrocyte surface with amplitude 300 400 nm in the frequency range 0.2-30 Hz are recorded on the minimal area erythrocyte rim (approximately 0.5 X 0.5 microns). These local oscillations of the surface are diminished at hypoosmotic erythrocyte swelling, on addition of substances which increase the membrane rigidity (0.01% glutaraldehyde, 0.5 mM 4 hydroxymercuribenzoate, cell membrane stain--0.002% Heliogen Blue) and on discocyte--echinocyte transformation due to addition of 1-2 mM 2,4-dinitrophenol. The amplitude of transverse displacements is reduced by 1.7-2 times on erythrocytes of patients with inherent microspherocytosis. These erythrocytes have inherent defects in spectrin. It is suggested that spectrin is important for rapid local oscillations of the human erythrocyte surface. PMID- 2773066 TI - [Contact stimulation of the proliferation of cultured chick embryo cells]. AB - It was reported elsewhere (Gasparian, Grigorian, 1989a) that in the secondary chick embryo cell culture, after its superinoculation with additional homologous cells, the cell population density increased and the cell proliferation was activated. It has been shown in the present paper that the cell proliferation rate increase after inoculation of fixed cells, as well. The results obtained are discussed as a direct evidence for growth-stimulating effect of contacts between homologous cells. PMID- 2773067 TI - [The harmful action of ethanol on the liver: the role of alcohol dehydrogenase and aldehyde dehydrogenase]. AB - White rats were divided into water-preferring (WP) and ethanol-preferring (EP) groups, on the basis of their preferable drink: either water or 15% solution of ethanol. Each of these groups was then subdivided into groups which were given to drink for 1 year 15% solution of ethanol (ethanol-treated) or water (controls). Alcohol dehydrogenase/aldehyde dehydrogenase activity ratios (ADH/AlDH) in livers of WP controls were considerably higher than those in EP controls. The difference in ADH/AlDH has somewhat decreased after ethanol treatment. However, this ratio remained the highest in the WP alcohol-treated group. The signs of proteinic and lipid dystrophy of the liver in alcohol-treated WP rats were expressed much more clearly than in all other groups. It is concluded that in the liver of animals with a high ADH/AlDH ratio there are favourable conditions for accumulation of a toxic hepatocyte-damaging acetaldehyde. PMID- 2773068 TI - [Functional characteristics of rat hepatocytes isolated by a nonenzymatic method and incubated in vitro]. AB - A study was made of the effect of normothermic incubation on the metabolic state of parenchymal liver cells, isolated by the nonenzymatic method. In the process of a 2 hour incubation in the nutritious sodium-containing medium, a high level of the energy supply system is maintained, determined by the contents of adenine nucleotides, the rate of endogenous respiration and by its stimulation by succinate. PMID- 2773069 TI - Time dependency in human cancer. AB - The concept of latency period has developed in chronic disease epidemiology by analogy with the incubation period associated with infectious diseases. We discuss the use of the concept of mean latency period to describe the temporal development of cancer and the underlying conceptual and methodologic problems. The respective roles of age at diagnosis, age at start of exposure, duration of exposure, and years since exposure in modifying cancer risks are considered. Multistep models for the development of cancer are illustrated, and their use and limitations for interpreting temporal associations in cancer development are discussed. Rather than trying to define exposure-disease relationships as being characterized by a long or a short latency period, it seems more promising to study the temporal sequence of disease development as a multistep process. PMID- 2773070 TI - Cancer mortality in Italy, 1983. PMID- 2773071 TI - Purification to homogeneity of the major "4S" PAH binding protein from "non responsive" DBA/2N mouse liver by affinity chromatography. AB - DBA/2N is a genetically non responsive inbred strain of mice in which administration of polycyclic aromatic hydrocarbons (PAHs) does not induce microsomal monooxygenase activity. DBA/2N mouse liver cytosol contains a polycyclic aromatic hydrocarbon-binding protein that sediments, in a sucrose gradient, at 4S ("4S" PAH-BP). Its binding kinetic and physicochemical properties indicate that this protein is practically indistinguishable from the "4S" PAH-BP identified and characterized in liver cytosol of rats and other PAH responsive rodents including C57 B1/6J mice. "4S" PAH-BP was purified to homogeneity from DBA/2N mouse liver by ammonium sulfate fractionation of the cytosol, followed by Sephadex G-200 chromatography and, finally, affinity chromatography using 1 aminopyrene-Sepharose 6B. This procedure yielded about 50 micrograms of protein from 50-60 g of mouse liver, with a recovery of 18%. "4S" PAH-BP as a complex with 3H-(benzo-a-pyrene) was more than 99% pure. A single band was seen on polyacrylamide gel electrophoresis under non denaturing conditions. H-BaP comigrated with the protein band. 3H-BaP bound to the protein was displaced by PAHs with a specificity identical to that obtained using crude cytosol. On electrophoresis in SDS gels, the purified protein migrated as a single protein band with an apparent molecular weight of 40,000. PMID- 2773072 TI - "4S" polycyclic aromatic hydrocarbon binding protein. Its role as a benzo(a) pyrene cytosolic carrier to the microsomes of DBA/2N mouse liver. AB - Rodent liver cytosol and other biological systems contain two proteins that bind polycyclic aromatic hydrocarbons (PAH) in a non covalent manner and that sediment at a different rate when centrifuged on sucrose gradient. The role of the smaller protein ("4S" PAH-BP) was studied. When DBA/2N mouse liver homogenate was incubated with 3H-BaP, most of the radioactivity was found in the microsomal subcellular fraction. The cytosol binding activity apparently decreased but reincubation of the cytosol with the radioactive ligand completely restored "4S" PAH-BP activity. The microsomal uptake of 3H-BaP can be studied in a reconstituted system in which microsomes are incubated with radioactive benzo(a)pyrene in the presence of crude cytosol. In these conditions the microsomal uptake rate of 3H-BaP increased with the temperature and at 37 degrees C ten minutes were required to reach the plateau. When cytosol was substituted by HEDG buffer, the amount of radioactivity found in the microsomes decreased drastically. 0.2 microM was the benzo(a)pyrene concentration required to saturate the microsomes. When microsomes were incubated with ammonium sulfate cytosolic fractions or with homogeneously purified "4S" PAH-BP, the 3H-BaP uptake was restored and reached the maximum with 3 micrograms/ml of purified protein. The radioactive benzo(a)pyrene bound to microsomes was oxidated in the presence of NADPH regenerating system. The oxidated products were discharged from microsomes only when "4S" PAH-BP was either present during the incubation or added at its end. Thus, this protein is able to transfer benzo(a)pyrene to the microsomal metabolization sites and to facilitate the release of oxidized products and, presumably, bind them. PMID- 2773073 TI - Cycloheximide increases endogenous retroviral RNA levels in murine liver and lung. AB - The expression of moloney murine leukemia virus (Mo-MuLV), intracisternal A particle (IAP), virus-like 30S sequence (VL30), early transposon (ET) endogenous retroviral sequences was analysed in the liver of untreated C3Hf, C57BL/6J and AKR mice, and in the lungs of untreated A/J, BALB/c, C3Hf and C57BL/6J mice. C3Hf mice are genetically susceptible to hepatocarcinogenesis, whereas the other strains are resistant. A/J and BALB/c mice are genetically susceptible to lung carcinogenesis, whereas the other strains are resistant. Both in liver and lung tissues we found differences between murine strains in the pattern of basal retrovirus expression. The effect of inhibition of protein synthesis on the levels of retroviral mRNAs was studied in the same tissues and strains 3 h following in vivo cycloheximide treatment. Cycloheximide treatment increased the liver and lung levels of virus Mo-MuLV, IAP, ET related transcripts in a strain dependent way, whereas VL30 mRNA levels increased in both tissues of all strains examined. These results suggested the existence of labile proteins that regulate the abundance of specific retroviral mRNAs in murine liver and lung in a strain specific fashion. No clear relationships between pattern of retrovirus expression and genetical susceptibility to hepatocarcinogenesis was found. The strains genetically resistant to lung carcinogenesis (C3Hf, C57BL/6J) showed higher lung basal levels and higher cycloheximide inducibility of mRNAs homologous to Mo-MuLV than the susceptible strains (A/J, BALB/c). PMID- 2773074 TI - Persistent generalized lymphadenopathy syndrome vs "AIDS"--unrelated malignant lymphoma: comparison of presenting clinical and laboratory findings in 88 patients. AIDS and Related Syndromes Study Group. AB - The purpose of this report is to document and compare the presenting clinical and laboratory findings of 38 patients, all intravenous drug abusers, with pathologically documented persistent generalized lymphadenopathy (PGL), and of 50 patients with AIDS-unrelated malignant lymphoma (30 with Hodgkin's disease and 20 with non-Hodgkin's lymphoma). All patients, aged 40 years or less, consecutively seen since May 1984 in a single institution in Italy, have prospectively undergone a similar clinico-pathologic approach. In addition to a history of intravenous drug abuse and HIV serology, the results indicate that a history of infection in the previous year, night sweats, weight loss, generalized lymphadenopathy, beta 2 microglobuline, transaminase, T4/T8 ratio less than 1, and polyclonal hypergamma-globulinemia significantly increased among PGL patients compared with patients with AIDS-unrelated malignant lymphoma. In contrast, patients with malignant lymphoma had a significant increase in mediastinal lymph nodes, sedimentation rate, LDH, fibrinogen and anemia. Therefore, at this time of an AIDS epidemic, after histologic diagnosis of reactive lymphadenopathy has been performed in young patients presenting with generalized lymphadenopathy, a request for a second biopsy and other invasive procedures may be avoided if clinical and laboratory data suggest a PGL syndrome. If not already performed, HIV antibody detection should be carried out in this setting. PMID- 2773075 TI - A radiologic study by CT scan of pineal size in cancer patients: correlation to melatonin blood levels. AB - Alterations in size of the pineal body and melatonin secretion have been observed in cancer patients. The present study was carried out to evaluate pineal dimensions in a group of cancer patients and their relation to melatonin blood levels. The study included 70 oncologic patients. As controls, 41 patients with acute or chronic disease other than cancer entered the study. Melatonin serum levels were measured by radioimmunoassay on venous blood samples collected at 9:00 a.m. Pineal size was determined by brain CT scan, by considering the product of the two longest perpendicular diameters, multiplied by the thickness of the stratum. The volume of the pineal body was found to be enlarged in 12/70 (17%) cancer patients, and its mean value was significantly higher than that observed in controls. Melatonin levels were also significantly higher in oncologic patients than in controls. However, there was no correlation between melatonin levels and pineal size in cancer patients. Finally, cancer patients did not show a higher degree of pineal calcifications than controls. The clinical significance of pineal enlargement in cancer patients remains to be understood. PMID- 2773076 TI - 4'epidoxorubicin plus verapamil in anthracycline--refractory cancer patients. AB - Four patients refractory to doxorubicin (DX) and 9 patients refractory to 4'epidoxorubicin (4'EpiDX) were treated with verapamil (VRP) (120 mg every 6 h for 3 days) plus 4'EpiDX (80 mg/m2 i.v. bolus, together with the 6th VRP administration). Three patients had partial remissions lasting 3, 3.5 and 7 months, respectively. Toxicity grading did not exceed usual levels. The study demonstrates that VRP, when added at conventional doses to 4'EpiDX, can induce objective responses in some patients refractory to anthracyclines. PMID- 2773077 TI - Phase II study of divided-dose vinblastine in advanced cancer patients. AB - A better therapeutic index has been obtained in breast cancer patients when vinblastine is given by a 5-day continuous infusion program than by i.v. bolus; the continuous infusion pharmacokinetics has been reproduced by an iv divided bolus at 0 and 48 h, which may be more easily applied to outpatients. We performed a broad phase II study in 97 advanced cancer patients in which vinblastine was administered by i.v. divided bolus at 0 and 48 h at the starting dose of 3.5-4 mg/m2, every 3 weeks. Our aim was to confirm the results achieved by continuous infusion and to investigate the toxicity pattern of this novel administration schedule. Neurotoxicity and myelosuppression were the main side effects: constipation and peripheral neurotoxicity respectively developed in 28% and 38% of patients and were severe in 5% and 1%. Leukopenia and thrombocytopenia respectively occurred in 70% and 40% of patients and were severe in 11% and 4%. Four partial responses, 38 no changes and 42 progression were obtained out of 84 evaluable patients. Responses were seen in tumors of breast, lung, and head and neck. Our results do not support the use of vinblastine in divided doses in advanced cancer patients. PMID- 2773078 TI - A preliminary clinical study of cyclophosphamide with reduced glutathione as uroprotector. AB - Reduced glutathione (GSH) has been reported to be an effective protector against cyclophosphamide-induced urotoxicity in experimental models, providing protection comparable to that of mesna. This paper describes our preliminary results of the clinical use of GSH in combination with cyclophosphamide. GSH was administered i.v. in two divided doses of 2.5 g, 15 min before and 30 min after escalating doses of cyclophosphamide ranging from 1.2 up to 1.6 g/m2 (1-h infusion). GSH was well tolerated and did not produce unexpected toxicity. The lack of bladder damage, including microscopic hematuria, supports the protective role of this thiol compound. PMID- 2773079 TI - Outpatient surgical treatment of lip carcinomas: immediate and long-term results. AB - From 1977 to 1987, outpatient surgery was performed under local anesthesia on 131 patients with squamous cell carcinoma of the lip without regional lymph nodes at the Day Hospital of the Istituto Nazionale Tumori (INT) Milan. Radical surgery was achieved in 117 cases (89.3%), independently of the size of the neoplasm. Of the 7 patients in whom radical surgery was not achieved at first operation, 3 were reoperated on as outpatients, 2 were hospitalized and reoperated, and 2 underwent X-ray treatment. Finally, in the remaining 7 patients radical surgery was not obtained or was near the borderline of the neoplasm. Complications (diastasis and/or suppuration) arose in 4.6% of the cases. During the follow-up (mean duration, 30 months) 7 patients developed a relapse and 2 manifested regional metastasis. Twenty-three patients developed a second tumor (13 on the lip, 3 in the lung, and 7 in other areas). These results prove that day hospital surgery of T1-T2 lip squamous carcinoma is feasible. It is appreciated by the patient, requires very little postoperative care, is less expensive than hospitalization, and involves less psychologic stress for the patient. PMID- 2773080 TI - Fine needle aspiration cytology and breast cancer diagnosis. AB - The authors report on 315 histologically confirmed consecutive breast cancer (BC) cases undergoing fine needle aspiration cytology (FNAC). Inadequate smears were infrequent (7%), particularly when reaspiration of inadequate cases was employed (1-2%). FNAC suspected BC in 81% of the total or 88% of adequate smears. Univariate and multivariate (Cox's model) analyses showed no correlation between inadequacy or suspect/positive FNAC rate and patient age, T category or histologic type. Differences in the inadequacy and suspect/positive rate were recorded among 30 operators (surgeons, oncologists, radiologists) performing the sampling, but the average results were consistent with literature reports. FNAC was found to be a useful diagnostic tool for BC diagnosis, and proper training of the highest number of operators is recommended to allow the widest diffusion of this diagnostic technique. PMID- 2773082 TI - [Bronchial carcinoid tumor]. AB - The present knowledge concerning bronchial carcinoid tumour (BCT) of the lung is described on the basis of two case histories. BCT belongs to the group of APUD tumours which are better known in the intestine. Patients with BCT are younger than patients with malignant pulmonary tumours. The incidence is less than 6% of all pulmonary tumours. The symptoms are similar to those of malignant pulmonary tumours but the duration is longer. The carcinoid syndrome is rare. It is frequently difficult to differentiate between BCT and small cell carcinoma. Radical surgery is indicated on account of the potential malignancy of BCT. The relapse frequency is less than 5% over a period of five years. PMID- 2773083 TI - [Fatal gunshot injuries in East Denmark]. AB - All of the fatal gunshot lesions in East Denmark during the period 1984-1987 were investigated. A total of 276 cases were found corresponding to an annual frequency of approximately 3.0 per 100,000 live population. The majority were cases of suicide (86%) and the majority of these were men. Only four accidents were found. Two of these were due to "Russian roulette"). No hunting accidents were encountered. In the middle of the period investigated, new and more restrictive legislation concerning firearms was introduced in Denmark. No specific effect in the form of reduction in the number of cases with smooth barrelled shot guns resulting from this could be demonstrated but there was, possibly, a general prophylactic effect. As compared with previous Danish investigations, the absolute number of cases of suicide with firearms has increased during the period investigated here while not only the absolute but also the relative number of homicides have increased. Increased information and further attempts to limit the number of firearms in the population are recommended. PMID- 2773081 TI - Results of hyperthermia, alone or combined with irradiation, in chest wall recurrences of breast cancer. AB - In the period between September 1983 and July 1987, 28 locoregional recurrences (about 86% in the chest wall) of breast cancer in 19 patients were treated with external microwave hyperthermia. Of these, 11 lesions were treated with hyperthermia alone and 17 with the combination of heat and external irradiation. Hyperthermia was induced in most cases with 915 MHz microwave (at least 42 degrees C for 30-45 min, for 6-10 sessions). Radiation was administered using photon or electron beams with total doses varying from 2000 to 5000 cGy. Complete and partial response rates on the whole series of patients were 53.6% and 42.9%, respectively. Of 17 lesions treated with combined treatment, 10 had a complete (58.8%) and 7 a partial response; of 11 lesions treated with hyperthermia alone, 5 had a complete (45.5%), 5 a partial (45.5%), and 1 no response. Complete responses were long lasting in all but 3 cases, which recurred after 4 months (2 cases) and 1 year, respectively. PMID- 2773085 TI - [Cervix cancer during pregnancy]. AB - A retrospective review of case records for the years 1967-1987 revealed 41 patients with invasive cancer of the uterine cervix associated with pregnancy. The prevalence of pregnancy in patients referred on account of invasive cancer of the uterine cervix savings between 0.7% and 3.5%, but despite the extensive cytological screening of fertile women, no decrease has been observed. The average patient is 31.5 years, 3.7 gravida and 3.0 para. The five-year survival for the disease in stage I b is found to be 70% and thus now appears to be poorer than in non-pregnant women. On this background and as 39% were asymptomatic, routine smear examination is recommended at the first antenatal examination. If deviations in the cell pattern are found, meticulous follow-up must be performed with colposcopy and biopsy specimens so that the question of invasive growth can be elucidated as early as possible during pregnancy and, when this is present, adequate treatment must be instituted. PMID- 2773084 TI - [Injury patterns on the first icy day of winter--a survey in Copenhagen County]. AB - The injuries on the first icy day of the winter 1986-1987 in Copenhagen County were compared to the injuries on the preceding day. There were 368 and 276 injuries (both days 95 non-surgical) respectively. The significant increment of fractures and emergency hospitalization was mostly due to fractures of the wrist, humerus and femur. Only a few sprains of the ankle were registered. The majority of patients were middle aged and elderly women. The economical and personal consequences are considerable, but impossible to evaluate, as reliable statistics are needed. Intensive snow clearing and recurrent propaganda are recommended. PMID- 2773086 TI - [Laparoscopic sterilization in women using Filshie clips]. AB - A material of 194 women sterilized laparoscopically using Filshie clips was followed for 16-51 months. The method is economical (short stay in hospital) and with little damage to the tube. Only few complaints and no complications were recorded. One woman became pregnant in the observation period, a failure rate of 0.5%. According to the literature the potential for reversal seems very good. The method seems to have some advantages over other methods in common use for female sterilization. PMID- 2773087 TI - [Perinatal growth. A practical perinatal growth curve]. AB - A linear perinatal growth curve, covering the period from 28 weeks gestation to 18 weeks after term birth is presented. The curve was first presented 15 years ago, and is now supported by Danish data, both cross-sectional and longitudinal. It may be used for classification of birth weight in relation to gestational age and at the same time for monitoring of postnatal growth, regardless of gestational age at birth. Limitations of empirical curves are pointed out. The postnatal growth potential of preterm infants is stressed. PMID- 2773088 TI - [Contact between preschool children with chronic diseases and the authorized health services and forms of alternative therapy]. AB - A questionnaire investigation was undertaken to study the circumstances of life of 115 families with children aged 0-7 years suffering from asthma, diabetes and epilepsy. Their contacts with the authorized and alternative therapeutic systems were investigated. In addition, 317 families with healthy children matched for age and sex were also investigated. 89.8% of the families with sick children and 86.4% of the families with healthy children replied. The average percentage of replies was 87.2. The frequency of change of doctor was similar in the case and the control group. Among families with sick children, no association was found between change of doctor and the degree of satisfaction with medical treatment. One third of the sick children had received alternative treatment. The majority had consulted chiropractors. 73% of the parents reported that the treatment had been of benefit to their child. Among parents of asthmatic children who had received chiropractic treatment, 92% considered this treatment beneficial. Alternative treatment was more frequent among children from the higher social classes. A tendency was observed towards less satisfaction with medical treatment, information and general guidance concerning the illness among families who sought alternative treatment. The differences were not statistically significant, possibly because of the limited size of the study population investigated. PMID- 2773090 TI - [Toxic effects of waste gases and intravenous anesthesia]. PMID- 2773089 TI - [A hamburger may be included in the diabetic diet. A questionnaire study of glycemic response and dietary treatment in connection with a hamburger meal in teenage diabetics]. AB - By means of a glycaemic response study the effect on postprandial blood glucose of a standard hamburger was compared with an ordinary, isocaloric cheese sandwich. Twenty five teenage insulin dependent diabetic patients participated; patients with preprandial blood glucose above 12 mmol/l were excluded. On different days at 3.30 p.m. they consumed a standard hamburger (McDonald's) and an isocaloric cheese sandwich. Blood glucose was measured every half hour during the 3 1/2 hour observation period. The glycaemic response and peak postprandial blood glucose were calculated, and no significant differences in either indices were observed (p greater than 0.05). It is concluded that hamburgers of this specific composition can substitute snack meals in the diabetic diet without risk to the metabolic control. PMID- 2773092 TI - [First aid in amputation injuries]. PMID- 2773091 TI - [Toxic effects of waste gases in anesthesia]. PMID- 2773094 TI - [Prehospital treatment]. PMID- 2773093 TI - [Omeprazole. An effective antisecretory agent in ulcerative disease and reflux esophagitis]. PMID- 2773095 TI - [An mobile intensive care unit manned with medical personnel. Experience from a 16-year period]. AB - An attempt is made to assess the value of a medically-staffed mobile intensive care unit which has functioned for 16 years at Holstebro Central Hospital. The medically-staffed ambulance responded to emergency calls concerning 2,048 patients. The average age was 56 years, 1,225 patients were men, 461 were women and in 362 cases the sex was not recorded. Of these 753 were non-cardiac cases, 883 were cardiac cases and in 412 cases, the diagnosis was not recorded. Resuscitation was commenced in 649 cases and this proved successful primarily in 175 cases (27%). Sixty-seven of these patients (38%) were discharged from hospital. In nine cases only defibrillation was performed while supplementary drugs were administered in 434 cases. Treatment consisted mainly of cardiovascular drugs, divretics, analgesics, intravenous fluid and in 518 cases intubation. The drug treatment required the presence of a doctor. The cost was modest, particularly as this arrangement has, hitherto, not required extra staffing. Improvements in the existing prehospital emergency treatment are proposed. In particular, the alarm system should be changed. A medically-staffed mobile intensive care arrangement will render commencement of thrombolytic treatment possible in cases of acute myocardial infarction as early as possible. PMID- 2773096 TI - [The time interval before hospitalization in acute myocardial infarction]. AB - The prehospital time interval in 103 patients with acute myocardial infarction was investigated. Twenty patients were admitted with cardiac arrest. In the remaining patients the average total delay was found to be 3.3 hours and the patient delay 1.5 hours. The total delay was significantly prolonged in patients who were admitted during working hours, patients who were unaffected on admission, patients transported for long distances, patients who had been visited by their doctors prior to admission and patients who contacted their own doctors. The authors find that attempts should be made to reduce these delays by means of information both to the public and to doctors. PMID- 2773097 TI - [Cardiac arrest outside of hospital. A retrospective study in Odense]. AB - During the period 1.10.1986-30.9.1987, all patients with cardiac arrest outside hospital brought to the casualty department in Odense Hospital were registered. Out of 160 patients, 133 (83%) could be primarily resuscitated, 19 (12%) were resuscitated but died later in hospital and eight patients (5%) were resuscitated and could be discharged alive from hospital. Out of the eight patients who were discharged alive, only two (1%) had retained reasonable cerebral function as assessed by dementia testing. Treatment of the cardiac arrest prior to the arrival of the ambulance, duration of the cardiac arrest for less than six minutes and staffing of the ambulance with three first-aid men were factors of decisive importance for survival of the patients. The results of this investigation demonstrate that treatment of cardiac arrest outside hospital is unsatisfactory. Proposals for improvement of treatment include: 1. Information to the population. 2. Training of first-aid staff in treatment of cardiac arrest. 3. Quicker arrival of ambulances and 4. Better staffing and training of ambulance staff in the use of a defibrillator possibly with participation of a doctor. PMID- 2773098 TI - [A non-immobilizing regimen following meniscal suturing]. AB - Vertical lesions in the peripheral third of the meniscus were sutured in 13 patients. The patients were treated with restricted activity postoperatively instead of immobilization. The patients were kept in bed until they could lift the leg with extended knee, which they were allowed up with careful support (and support with crutches) until the sutures were removed on the loth day. After removal of the sutures, patients were permitted to bear weight with the knee extended until limited by pain and were permitted unlimited flexion of the knee. From the 21st day, rehabilitation with weight-bearing with the flexed knee was permitted until they could be discharged with normal mobility and quadriceps power after an average of 6.4 weeks. Re-rupture was demonstrated in one patient. At the time of examination after a period of observation of 25.5 months, the patients had an average score of 78 points on Lysholm's functional scale from 0 100. These results are apparently similar to the results obtained following immobilizating regimens. The authors therefore conclude that it is ethically justifiable to carry out an extensive comparative investigation of the results after immobilizing and nonimmobilizating regimens, respectively, following suture of menisci. An investigation of this type appears to be necessary. PMID- 2773099 TI - [An alcoholic clientele and causes of death]. AB - The object of this investigation was to describe the deaths in the Nordic groups and among Greenlanders from section 105 institution in Copenhagen. The investigation included 206 known patients. The median ages for Danes, Finns, Norwegians, Swedes and Greenlanders were 52 years, 45 years, 45 years, 56 years and 33 years, respectively. Nineteen deaths in women were included in the investigation. Socially, the majority of these were lonely and many of these had no fixed abode. The previously recognized somatic diseases in this group were dominated by alcohol misuse, malnutrition, poor housing conditions and sequelae of head injuries. Half of the previous conditions in the group were psychiatric. The deaths in the group were frequently violent and sudden. In 43% of the cases, deaths were not from natural causes, 35% of the deaths were from natural causes and in 22% the causes were unknown. In the group of Greenlanders, which differed considerably from the other groups with Nordic nationalities, 2/3 of the deaths were from violence. PMID- 2773101 TI - [Erective dysfunction. Therapeutic consequences of a basal program of investigation]. AB - During a period of nine months, 50 men aged 21-75 years were investigated on account of erective dysfunction by means of a simple outpatient programme of investigation. Five patients could be discharged after the primary contact with history-taking and information about further investigation and treatment. Forty five patients were submitted to the programme of investigation which consisted of measurement of penile blood pressure, Doppler investigation of the penile arteries and the papaverine test. After this, ten patients (20%) could be referred for sexological advice while five were discharged as they did not desire further treatment. Sixteen patients (32%) were taught self injection. Out of the six patients (12%) in whom arterial insufficiency was demonstrated, penile prostheses were introduced operatively in four. Venous leakage from the corpus cavernosum was demonstrated in seven patients (14%) by means of cavernosometry and cavernosography. Venous ligature was performed in five with good effect in two. Thus, specific treatment could be offered to 35 men (70%) with satisfactory therapeutic results in 22 (44%). PMID- 2773100 TI - [Clostridium septicum and colonic cancer]. AB - During the period 1980-1987, Clostridium septicum was identified at Statens Seruminstitut, from anaerobic blood cultures in six patients. Five of the patients had cancer of the colon or rectum (c. coli) and one had cancer of the ovary. Correspondingly great incidence of solid tumours, particularly c. coli with C. septicum infection without preceding trauma or compromizing of immunity has been reported in the literature. Meticulous bacteriological identification should be undertaken on anaerobic culture as the finding of C. septicum in the blood should instigate investigation for c. coli or another form of solid tumour if no other explanation for the infection is available. PMID- 2773102 TI - [Use of the APACHE II scoring method for registering patients receiving intensive care at a central hospital]. AB - The APACHE II scoring method was employed prospectively for registration of patients in intensive care in a central hospital. Scoring was performed in a total of 390 patients. Seventy-three patients (20.2%) of the patients died in hospital. A significant difference in the APACHE II score was found in the surviving patients (9 points) as compared with those who died (19 points). A significant linear connection was found between the frequency of death observed and the estimated risk of death in hospital. The APACHE II score could not be correlated to the number of bed-days in the intensive care unit but to the resources employed measured as the number of therapeutic procedures carried out. The APACHE II scoring method was found to be employable in the prognosis for survival as a control of quality, as a tool for description of the degree of severity of illness and as an indirect measurement of the resources required. PMID- 2773104 TI - [Metastasizing squamous cell carcinoma in patients with psoriasis treated with immunosuppressive agents]. AB - Immunosuppressive agents are imployed increasingly frequently in treatment of nonfatal disorders. We report two cases of metastasizing squamous cell carcinoma after treatment for psoriasis with methotrexate. Additional cases must be reported, but we consider that: 1) methotrexate medication, when possible, should be withdrawn when a localized squamous cell carcinoma is diagnosed and 2) when this diagnosis is confirmed the patient should be referred for radical treatment. PMID- 2773103 TI - [Anterior gastropexy using the Boerma method in gastroesophageal reflux]. AB - The results obtained in 38 patients with gastro-oesophageal reflux who had been submitted to operation by Boerema's method are presented. Twenty-nine (76%) became entirely symptomfree and eight (21%) experienced reduction of symptoms. Postoperative oesophageal stenosis was demonstrated in five patients. PMID- 2773105 TI - [Ibuprofen triggered asthma attack in a patient with known aspirin hypersensitivity]. PMID- 2773106 TI - [Remission with antineoplastic agents?]. PMID- 2773108 TI - [The forgotten disease (whooping cough)]. PMID- 2773107 TI - [Treatment of pinworm]. PMID- 2773109 TI - [Medically staffed ambulances for trauma victims]. AB - During a period of 16 years, prehospital advanced life support was provided for a total of 123 trauma patients. The average age was 32 years. Fifty-five patients were dead on the arrival of the mobile intensive care unit. In 83% of the cases, the Causes of the injuries were traffic accidents. The median injury severity score was 23. Out of the 63 treated patients, 27 suffered from respiratory failure, 23 were in shock and 35 were unconscious. Potential life-saving treatment in the form of intubation and/or massive intravenous infusion was provided for 24 patients, six of whom survived. On the basis of these results it is recommended that advanced prehospital life support should be extended also to include trauma patients. PMID- 2773111 TI - [Early retirement among the 1914 population in Glostrup. Significance of social and health problems in choosing early retirement]. AB - In the population investigation in Glostrup, the 1914 population was examined at the ages of 50, 60 and 67 years. A total of 141 participants at the 67 years examination (106 men and 35 women) stated that they had chosen early retirement prior to transition to old age pensions. The social and health circumstances of these early retirees at the ages of 50 and 60 years are compared with the circumstances in the 243 persons in the cohort (154 men and 89 women) who remained occupationally active until the age for old age pensioning. In the group of early retirees, unskilled men predominated. Out of those who found the occupational environment stressful at the ages of 50 or 60 years, a majority subsequently chose early retirement. Significantly more of the men with abnormal findings in the heart and lungs at the health examinations subsequently chose early retirement. Where the remaining health variables were concerned, no connection could be found with subsequent choice of early retirement. Where the health conditions at the age of 60 years were concerned, a tendency for more frequent choice of early retirement was observed in men with a series of abnormal conditions in the lungs and intestinal tract but no distinct tendency was observed in women. Where both sexes were concerned, an increasing tendency to subsequent choice of early retirement was observed with increasing incidense of cardiovascular risk factors at the age of 60 years. Data concerning low back pain at the age of 60 years did not reveal any connection with subsequent choice of early retirement but may suggest early elimination of persons with low back pain. PMID- 2773110 TI - [Roller skating accidents. 393 roller skating accidents treated at the casualty department of Odense Hospital during the period 1 January 1980 to 30 September 1988]. AB - During recent years, the import of roller skates has increased markedly and, during the period 1.1.1980-30.9.1988, an increase has been observed in the number of roller skate accidents treated in the Casualty Department of Odense Hospital. These accidents are particularly frequent in early spring and involve children under the age of 15 years, in particular, with slight preponderance of girls. The typical mechanism of injury is a fall which the victim tries to mitigate with the hands and arms. Nearly 90% of all injuries were localized to the locomotor system and just under half of the patients sustained fractures, typically of the wrist. Over 8% of the injuries necessitated hospitalization. The great majority of accidents occurred in unorganized groups and not in clubs, in ordinary traffic and without the use of protective equipment. In a selected group of roller skaters, as in this investigation, no connection could be found between the type of roller skates, employment of protective equipment and the frequency of fractures. The actual risk in roller skating is not known but possible prophylactic measures are discussed and simple safety rules are recommended. PMID- 2773112 TI - [Somatic disease at a department for acute psychiatric disease]. AB - All of the patients admitted to the psychiatric inpatient department of the Municipal Hospital in Copenhagen during a period of three months were, on discharge, registered as regards somatic disease. 70% (95% confidence limits 66 75%) had somatic disease (38% of these were newly diagnosed). Treatment of these was carried out by the medical staff of the department and in 46% of the cases this was carried out in cooperation with the medical staffs of somatic departments. The close geographic contact with the departments for somatic diseases facilitated this cooperation. The staff in departments for emergency inpatient treatment of psychiatric disease should be able to observe and treat somatic disease on account of the high incidence of this. A psychiatric/medical special department could probably provide optimal treatment in cases of combined psychiatric and somatic disease. PMID- 2773113 TI - [Right ventricular myocardial infarction. Prognostic significance of ST elevation in right chest leads V3R-V7R in patients with acute inferior/posterior myocardial infarction]. AB - The prognostic significance of ST-elevation greater than or equal to 1 mm in right chest leads V3R-V7R during inferior/posterior acute myocardial infarction (AMI) was evaluated in 86 consecutive patients with their first inferior/posterior AMI, and compared with the prognosis for 72 patients with first anterior AMI. At follow-up, the maximum observation time was 3.0 years (mean 1.8 years). A total of 49 patients died. Using Cox multivariate analysis, ST-elevation in right chest leads during inferior/posterior AMI was found to be an independent predictor of the prognosis in patients surviving the initial ten days after infarction (n = 129). For these patients, the cumulative survival was better after inferior/posterior AMI with ST-elevation in V3R-V7R (n = 25) compared with; (1) all other infarcts (n- 104, p = 0.05), (2) inferior/posterior AMI without ST-elevation in these leads (n = 45, p = 0.09), and (3) anterior AMI (n = 59, p = 0.08). PMID- 2773114 TI - [A comparative study of contact media for defibrillation]. AB - In DC-conversion, the transthoracic resistance is of significance for the amount of energy which influences the myocardium with the object of convertering ventricular fibrillation to sinus rhythm. It is therefore of significance that contact between the thorax and the electrodes of the defibrillator is optimal. Investigation of the contact media (Litmann and Nikman) compared with electrode gel did not reveal any difference in total impedance (thoracic impedance + 2 x transition impedance) (p = 0.001). On employing defibrillation out of hospital, it was definitely advantageous that the contact medium could be stuck to the patient's thorax, not only on alternation between cardiac massage and DC-shock but also during transport. PMID- 2773115 TI - [Aorto-esophageal fistula originating from a peptic ulcer in Barrett's esophagus]. AB - A case of an aorto-esophageal fistula originating from a peptic ulcer in a Barrett's esophagus and which ran a fatal course is presented. PMID- 2773116 TI - [Cauda equina syndrome developing during anticoagulant therapy]. AB - A woman aged 70 years with rheumatic heart disease developed the cauda equina syndrome (CES) seven days after commencement of anticoagulation therapy. Investigation suggested an intraspinal haematoma with subarachnoid haemorrhage. The patient was considered to be inoperable. The untreated CES resulted in permanent neurological deficits. PMID- 2773117 TI - [Subcutaneous emphysema caused by anastomotic leakage]. AB - A case of subcutaneous emphysema with pneumoperitoneum/mediastinum caused by anastomic leakage is reported. PMID- 2773118 TI - [Serum cholesterol measurements in a rural practice]. PMID- 2773119 TI - [Malnutrition in hospitals--action possibilities]. PMID- 2773120 TI - [Treatment of neuromuscular dysfunction of the lower urinary tract in patients with acute lesions of the spinal cord]. PMID- 2773121 TI - [Urologic examination and treatment of patients with acute injuries of the spinal medulla]. AB - During a period of one year, nine patients with traumatic lesions of the spinal medulla were examined and treated urologically. The patients were followed-up for 24-36 months and follow-up will continue. All of the patients were treated primarily with sterile intermittent catheterization by the nursing staff. Exceptions from this were patients in whom indwelling catheters were necessary on account of complicating conditions. During the acute phase, the patients were examined by a urologist and bladder function investigations with cystometry + electromyographic registration from the pelvic floor were undertaken. When patients had recovered from the spinal shock phase, emptying of the bladder supplemented by alpha-adrenergic blocking preparations and clean intermittent catheterization were instituted in the patients with supra-sacral lesions. Patients with infra-sacral bladder paresis were trained in miction on abdominal pressure supplemented by clean intermittent catheterization. No complications from this treatment have occurred and renal function has remained stable. Only one patient has an indwelling catheter and it has not proved possible to persuade the patient to accept removal. PMID- 2773122 TI - [A study of percutaneous absorption of estradiol and progesterone in absolute alcohol in postmenopausal women]. AB - Absorption of solutions containing 17-beta-oestradiol (E2) in absolute alcohol and progesterone (P) in absolute alcohol was investigated in six postmenopausal women. These preparations were applied to the skin of the forearm and the abdomen. 1 mg E2 was applied twice daily to the left forearm (RAS) for 28 days. After an interval of one week, the treatment was continued with 1 mg E2 twice daily for 28 days in the epigastric region (RE). From the 14th to the 28th day, this treatment was supplemented by 10 mg P twice daily partly on the right forearm and partly on the epigastrium. The 24-hour absorptions of E2 and P were investigated: E2 on the first and fourteenth days and P on the fourteenth day in both periods. On days 1, 7, 14, 21 and 28, plasma E2, oestrone (E1) and oestrone sulphate (E1SO4) were investigated for hormone application. Statistically significant absorption of E2 was found after 24 hours (p less than 0.05) and significantly greater absorption from RAS than RE (p less than 0.005). No systematic variation in plasma E2 was found during the period of investigation on RAS or RE. P was not absorbed. No local side effects were registered. It is concluded that E2 dissolved in absolute alcohol is clinically employable for treatment of postmenopausal women but that P is of no value in the dosage employed here. Further investigations of transcutaneous absorption of P are desirable. PMID- 2773123 TI - [Rupture of the spleen in a patient with infectious mononucleosis]. AB - A case of rupture of the spleen in connection with infectious mononucleosis is described. Simultaneously the frequency and findings of this serious complication are mentioned. PMID- 2773124 TI - [Familial hemophagocytic histiocytosis in 2 siblings]. AB - Two siblings presented with fever, hepatosplenomegaly and pancytopenia at the age of six weeks. Subsequent investigations showed hypofibrinogenaemia, hypertriglyceridaemia, cellular-mediated immunodeficiency and hepatic and splenic lymphohistiocytic infiltrates showing haemophagocytosis. These findings are consistent with the diagnosis of familial haemophagocytic histiocytosis. Splenectomy in one infant was followed by brief improvement in the haematological parameters. Both infants died by the age of five months. PMID- 2773125 TI - [Epididymitis caused by amiodarone]. AB - A case of epididymitis developed in a 33 year old man after treatment with the anti-arrhythmic agent, amiodarone, for approximately 18 months. No signs of bacterial infection or anatomical abnormalities were found. Amiodarone as the cause of epididymitis has only previously been described on a few occasions. We stress the importance of considering this adverse effect of amiodarone therapy as a differential diagnosis in the etiology of epididymitis. PMID- 2773126 TI - [Bladder neoplasms in Denmark during the period 1943-1985. Cancer statistics no. 25]. PMID- 2773127 TI - [Pre-operative psychological test in lumbal disk prolapse operations]. PMID- 2773128 TI - [Savings achieved by cooperation with physicians]. PMID- 2773129 TI - [Levomepromazine (Nozinan) and pain therapy in acute myocardial infarction]. PMID- 2773130 TI - [Treatment of addicts]. PMID- 2773131 TI - [The effect of physical training on physical, mental and social conditions in drug and/or alcohol addicts]. AB - The physical, mental and social conditions of eight drug and alcohol addicts were examined prior to and after a period of three months with systemical physical training. The condition improved significantly during training. The circulatory reaction to stress remained unchanged before and after training but the resting levels for pulse and blood pressure were lower after training. Prior to training, a significant correlation was observed between the excretion of adrenalin in the urine and the anxiety level and this was not observed after training. The anxiety level measured by a STAI test decreased during the period of training whereas the excretion of adrenalin in the urine was not altered significantly and remained within the normal range. The patients were followed-up for approximately 18 months after discharge from hospital. During this period, the result of the physical stress and a hiking holiday which was included in the treatment were discussed before discharge. None of the patients continued the physical training after discharge from hospital despite encouragement to do so. The group gradually disintegrated and two years after the conclusion of the training, five patients had resumed the addiction. This investigation suggests that physical training may be of significance in the treatment of addicts but continued contact with the therapist is of decisive significance. PMID- 2773132 TI - [Ergotism in migraine. Peripheral vascular complications in 14 patients with migraine]. AB - The general occurrence of subclinical ergotism with reduced peripheral systolic blood pressures in patients taking ergotaminepreparations regularly for migraine and the frequent occurrence of milder symptoms indicates that severe ischaemia of the extremities is not as rare a complication as would appear from the few case reports published. The 14 cases reported here constitute the largest series published of migraine patients with acute ergotism. The patients, all women, were admitted to a vascular department over a period of 14 years. They suffered from severe ischaemia of one or more extremities after consumption of varying doses of ergotamine tartrate. Ten patients had previously exhibited symptoms of acute or chronic ergotism, but only eight were admitted with this diagnosis. Liver enzyme tests were abnormal in five out of six patients examined, while three patients had ECG signs of myocardial ischaemia, regressing during treatment. At the beginning of the period, hyperbaric oxygen at 3 ATAB was the standard treatment. Since 1980, the treatment of choice has been continous i.v. nitroglycerine infusion for 24 hours. Nine patients experienced prolonged postischaemic symptoms; one patient required a forefoot amputation and four patients had permanent ischaemic muscular damage. Increased bioavailability of ergotamine due to hepatic vasospasm is suggested as a cause of sudden reduced tolerance to ergotamine. Peripheral systolic pressures and liver function tests should be controlled in patients taking ergotamine regularly. Subclinical ergotism over a prolonged period may facilitate development of occlusive peripheral vascular disease. PMID- 2773133 TI - [Medial stress syndrome in military conscripts]. AB - Thirty-two Danish recruits had signs and symptoms compatible with shin splints. 65% of the cases noticed symptoms during the first four weeks of conscription. 78% were free from symptoms after 30 days exemption from physical exercise. The patients were examined together with a group without shin splints. The passive subtalar joint mobility was identical in the two groups. When examining the subtalar joint position in the standing position, increased eversion was found in the group with shin splints. PMID- 2773134 TI - [Fractionated P-bilirubins]. AB - A diazo-based dry film technique for the estimation of different bilirubins in plasma is now available. This procedure separates bilirubins from icteric sera into three separate fractions: bilirubin (unconjugated), bilirubin-glucuronides (mono + diglucuronide) and bilirubin-albumin. In newborns with prolonged jaundice classification of hyperbilirubinemia is of importance for choice of treatment. While binding of bilirubin and bilirubin-glucuronides to albumin is non covalent, reversible, bilirubin-albumin appears to be firmly associated with albumin by covalent bonds. This causes delayed clearance of this bilirubin fraction from plasma as the half-life of albumin is approximately 18 days. Hence the substance concentration of bilirubin-albumin will decrease at a slower rate than will bilirubin and bilirubin-glucuronide, despite hepatobiliary recovery. Bilirubin albumin may therefore prove of value in the differentiation between different clinical entities with hyperbilirubinemia. PMID- 2773135 TI - [Fractionated P-bilirubins. Clinical use]. AB - Development of new assays for accurate quantification of bile pigments in plasma have facilitated their clinical application. Hyperbilirubinemia and jaundice occur frequently in the neonatal period. The purpose of the present study was to determine reference intervals for bilirubins in 60 fullterm healthy infants during the first four days of life. For comparison the bilirubin fractions were analyzed in an infant with biliary atresia and six adults with hepatobiliary disorders. PMID- 2773136 TI - [An apparatus for intravesical chemotherapy]. AB - To prevent spillage of cytostatic drugs when administering intravesical chemotherapy, a closed apparatus for preparation, instilling and disposal of the cytostatic drugs has been developed. After use, the apparatus is disposed of intact. PMID- 2773137 TI - [Can measurement of oral or axillary temperature replace rectal temperature measurements?]. AB - The Craftemp thermometer is an electrical device for measurement of oral and axillary temperatures. The applicability of this thermometer in clinical practice was investigated by comparison with rectal temperatures measured with a mercury thermometer. Ninety-five patients hospitalized in a medical department participated in the study. The median differences between rectal/oral and rectal/axillary temperatures were 0.8 degrees C and 1.2 degrees C, respectively. The range of the extrarectal measurements was unacceptably wide. In previous studies of the Craftemp thermometer, few investigators performed the temperature measurements on hospitalized patients and found the electrical thermometer usable. In the present investigation the measurements were performed by the permanent staff during their daily routine. It was concluded, that the oral and axillary temperatures measured with an electrical thermometer were unsuitable for determination of body temperature in patients hospitalized in a medical department. PMID- 2773138 TI - [Hemangioendothelial sarcoma of the thyroid]. AB - Haemangioendothelial sarcoma in the thyroid gland is a very rare disease in regions where goitre is not endemic. The case history of a man aged 65 years who had previously enjoyed good health who developed this disease is reviewed as regards diagnosis, treatment and course of the condition and this emphasizes the poor prognosis in this condition. PMID- 2773139 TI - [In vitro fertilization--fertilization in a reagent tube]. PMID- 2773140 TI - [An agent against nocturnal enuresis]. PMID- 2773141 TI - [Drug consumption and expenses in Denmark]. PMID- 2773142 TI - [Aviation medicine]. PMID- 2773143 TI - [Psychopharmaceuticals in general practice]. PMID- 2773144 TI - [Prescription of tranquilizers and hypnotics in the municipality of Holbaek]. AB - On the basis of an investigation of prescriptions of tranquillizers and hypnotics for individuals resident in the Municipality of Holbaek, a description was made of which tranquillizers and which hypnotics were prescribed and the quantities provided. 96% of the prescriptions were written by the general practitioners in the town. Only 2% of the patients had obtained medicine from various doctors. Benzodiazepine derivatives constituted 93% of all tranquilizers and 96% of the hypnotics prescribed. Diazepam, nitrazepam and triazolam were the preparations most frequently prescribed. Diazepam, flunitrazepam and the older hypnotics were prescribed in quantities which suggested that these preparations were preferred by chronic users with massive drug intake. The smallest portions available were employed for 17% of the prescriptions for tranquillizers and in 2% of the prescriptions for hypnotics. The favourite amount prescribed was 100 tablets. Where triazolam was concerned, strikingly high defined daily dosages were prescribed. As only brief or episodic use is rational, half of all the tranquilizers and four out of five prescriptions for hypnotics are considered unsuitable. PMID- 2773146 TI - [An analysis of massive prescription of tranquilizers and hypnotics]. AB - Investigation of the prescriptions for tranquilizers and hypnotics issued in a provincial Danish town with approximately 30,000 inhabitants, revealed that 12% of all users over 40 years had received massive quantities of tranquilizers and hypnotics within one month, viz more than 100 defined daily doses/user. Only four recipients of massive prescriptions were found in the age group 16-39 years. In the group of recipients of massive prescriptions over the age of 60 years, it was found that persons entitled to medicine free-of-charge comprised every third or forth user. Recipients of massive prescriptions over the age of 40 years did not differ as regards age and sex from recipients of ordinary quantities, viz less than or equal to 100 defined daily doses/user/month. Differences in the frequencies of prescription of massive quantities could be demonstrated between the various general practices. These differences could not be correlated with differences in the ages of the general practitioners, types of practice or sizes of practice. A series of prescribing habits on the part of the practitioner appear to be of particular significance for prescription of massive quantities of tranquillizers and hypnotics. These include; the decision to prescribe hypnotics, choice of hypnotic and prescription of several tranquillizers and/or hypnotics simultaneously. PMID- 2773145 TI - [Deregistration of barbiturates. A follow-up study after 1 year]. AB - On January 1st 1986, all hypnotics and sedatives containing barbiturates were removed from the Danish Drug Register. After one year, a follow-up investigation of previous barbiturate users was undertaken with the object of investigating the significance of various factors for cessation or continuation of use of psychotropic drugs in connection with the removal of barbiturates from the Danish Drug Register. The investigation was carried out of a questionnaire investigation in general practice with participation of 82 practices. Information was obtained concerning 141 previous barbiturate users. Twenty-four of these had stopped (17%, 95% confidence limits 11-23) having psychotropic drugs prescribed during the course of the year in question. In particular, patients without or with slight mental conditions ceased using drugs (p = 0.02). An age and sex stratified analysis revealed that more patients who had obtained the preparation by direct doctor-patient contact stopped the habit (odds ratio 3.00, 95% confidence limits 1.04-8.61). Other factors were without significant significance for continued use or cessation, respectively. In 75% of the patients, adjustment was, in the opinion of the general practitioner, easy. Out of 105 patients who continued to have psychotropic drugs prescribed and where the preparation employed was known, 90 (86%) were prescribed benzodiazepines. PMID- 2773147 TI - [Goodpasture's syndrome. Antiglomerular basal membrane antibody-mediated glomerulonephritis]. AB - A review is presented of antiglomerular basal membrane antibody-mediated glomerulonephritis (anti-GBM-Ab-nephritis) which constitutes 2-5% of all cases of acute glomerulonephritis. The disease frequently commences in the age group 20-30 years but may be encountered in all age groups, in women particularly at 60 years of age. The disease is due to autoantibodies (IgG) to the basal membranes in the glomeruli and alveoli. Deposition of IgG with C3 precipitates an inflammatory reaction which causes renal and possibly also pulmonary damage. It is possible to demonstrate anti-GMB-antibodies in the blood and, by means of immunofluorescence microscopy, these and C3 may be demonstrated in the basal membranes in the glomeruli and alveoli. The disease is still serious but introduction of immune suppressive treatment and plasmapheresis has improved the prognosis considerably. PMID- 2773148 TI - [Allergy presumed by parents of children in nursery schools and day care in relation to conditions of care]. AB - By means of an interview investigation with the staffs of the 11 nursery schools in the Municipality of Odense and 344 day care homes, information was collected about the number of children who received special diets on account of allergy postulated by the parents or predisposition to allergy. 8% of the children in day care and 10% of the children i nursery schools received special diets on account of presumed allergy. Special diets are often instituted without medically documented indications. In institutions with many children on special diets, this frequently results in dietary changes for all of the children. Nursery schools have only very few possibilities for dietary advice. The dietary efforts are not combined with corresponding efforts in other fields such as tobacco smoking, exposure to carpeting and animals. Placing of children with postulated allergy occurs independently of the presence of carpets, animals and smoke in the day care situation. 40-50% of the children in day care homes are passive smokers. PMID- 2773149 TI - [Morbidity among children attending nursery schools]. AB - The object of this investigation was to assess the extent to which absence on account of illness in children attending day-nurseries expressed the total morbidity. In four day-nurseries with a total capacity for 164 children, absence on account of illness and symptoms in the children present were registered over a period of 101 weekdays. Children were absent on 5.8% of the days on account of illness. The commonest causes were epidemic children's diseases, colds, sore throats and pyrexia. More than one third of the children present in the day nurseries presented sign of illness. The most frequent of these were colds. Children were present in the day-nurseries five times as frequently with at least one symptom than they were absent on account of illness. Absence on account of illness provides an incomplete indication of illness among children attending day nurseries as absence due to illness only represents a lesser quantitative fraction of the total morbidity among these children. PMID- 2773151 TI - [A new campaign on help in cardiac arrest]. PMID- 2773150 TI - [Chemotherapy in basal cell carcinoma. Complete remission of locally advanced basal cell carcinoma following treatment with chemotherapy containing cis platinum]. AB - A case of locally advanced basal cell carcinoma of the head treated with systemic chemotherapy consisting of cis-platinum, fluorouracil and bleomycin is reported. The treatment resulted in complete remission lasting for 13 months. PMID- 2773152 TI - [Naloxone and AMI]. PMID- 2773153 TI - [Ganciclovir [9-(1,3-dihydroxy-2-propoxymethyl)] guanine. A new antiviral agent against Cytomegalovirus]. PMID- 2773154 TI - Parameters for bioeffects experiment. Overview. PMID- 2773156 TI - EFSUMB position. PMID- 2773155 TI - AIUM's position on reporting parameters of bioeffects experiments. PMID- 2773157 TI - Alcohol and bends. PMID- 2773158 TI - Ethanol treatment for acute decompression sickness in rabbits. AB - Rabbits developed acute decompression sickness after staying at 6 ATA for 30 min followed by decompression to 1 ATA in 20 min or less. If the rabbits received an i.v. injection of 25% ethanol upon surfacing, all survived, whereas half the untreated control group died within 15-35 min after decompressing. In ethanol treated animals, no bubbles were seen in blood vessels of visceral organs, muscles, and subcutaneous tissues at autopsy 60 min after treatment. Decompression reduced platelet counts markedly in all rabbits, but in the control group the count stayed low, whereas with ethanol treatment the counts had reached the precompression level after 1 h and 24 h. PMID- 2773159 TI - Effects of intravenous perfluorocarbon and oxygen breathing on acute decompression sickness in the hamster. AB - Anesthetized female hamsters (Mesocricetus auratus) were divided into 3 experimental groups with 16 animals in each group. After control arterial blood pressure and ECG recordings, the animals were placed in a hyperbaric chamber for 30 min at 7 ATA and then decompressed directly to the surface at a rate of 60 fsw/min. After their removal from the chamber, animals were either not treated (group 1); given i.v. saline while breathing 100% oxygen (group 2), or given i.v. oxypherolperfluorochemical (Fluosol-43) perfusion emulsion while breathing 100% oxygen (group 3). Thirty minutes after decompression, all but one of group 1 had died (a 6% survival rate). Group 2 had a 62% survival rate and group 3 had a 94% survival rate. Perfluorochemicals were observed to reduce the number of bubbles formed, enhance bubble disappearance, and reduce dysrhythmias. PMID- 2773160 TI - Analysis of some individual risk factors for decompression sickness in Hong Kong. AB - Individual risk factors for decompression sickness (DCS) were studied in 932 men who had worked for 12 shifts or more at maximum working pressure (MWP) of 1 bar or above in a compressed air tunneling project in Hong Kong. Two dependent variables were used: presence or absence of bends and number of bends experienced by a man. Three hundred and fifty-six men (38.2%) had one or more bends. Univariate analysis showed that many variables were associated with presence or absence of bends. Logistic regression showed that the best equation included five independent variables: MWP, number of exposures, past number of bends, job (being a miner), and Quetelet Index (or Body Mass Index). The number of bends was also associated with many variables. Stepwise multiple regression revealed five important independent variables: ethnicity, MWP, Quetelet Index, number of exposures, and past number of bends. Obesity and past number of bends were therefore important risk factors for DCS after taking into account MWP and number of exposures. The age effect observed in univariate analysis could be due to obesity. Miners and Japanese had higher risks of DCS, probably due to their strenuous labor. PMID- 2773161 TI - Hyperbaric He but not N2 augments Ca2+-dependent dopamine release from rat striatum. AB - Endogenous dopamine (DA) and 3,4-dihydroxyphenylacetic acid (DOPAC) were measured by high performance liquid chromatography with electrochemical detection in perfusate from continuously superfused rat brain striatal slices, and the effects of various pressures of He and N2 were determined. He at 24 and 100 atmospheres absolute (ATA) significantly (P less than 0.01 and less than 0.05) increased the release of DA evoked by a 6-min exposure to 35 mM K+, whereas He at 48 ATA did not. Experiments conducted in a Ca2+-free medium showed that only the extracellular Ca2+-dependent component of release was affected by pressure. Similar increases in DA release were observed when DA reuptake and metabolism were blocked with cocaine and pargyline, although statistical significance was not achieved. N2 did not significantly affect DA release at 12, 24, 48, or 100 ATA. The results indicate that He (= hydrostatic pressure) augments Ca2+ dependent DA release and that substitution of N2 negates this effect. The relevance of these observations to the phenomena of high pressure neurologic syndrome in divers and the anesthetic reversal of pressure effects is discussed. PMID- 2773162 TI - Inspiratory flow limitation in divers. AB - Inspiratory dyspnea becomes an important factor in reducing a diver's ability to carry out physical work at depths in excess of 300 m. It is possible that dynamic compression of the trachea occurs when the intratracheal pressure drops below environmental pressure, thereby causing transient reduction in inspiratory flow. Vocal cords form an orifice of variable diameter, and orifice flow is predicted to occur at flow rates as low as 22 liter/min when gas density is 5 kg/m3 or more. Pressure drop across the vocal cords is calculated to range from 70 N/m2 at flow rate 1 liter/sec to 2.8 kN/m2 flow rate 4 liter/sec, aperture of the vocal cords 1.2 X 10(-2) m, gas density range 5-10 kg/m3. A smaller aperture, 0.6 X 10( 2) m, results in a pressure drop range 1.29-41.15 kN/m2 for the same flow rates and density range. Thus the transmural pressures that can occur are high enough to cause tracheal compression. At 300 m, gas density 5.9 kg/m3, 3 of 4 divers showed evidence of sudden inspiratory flow limitation. PMID- 2773163 TI - Changes in insulation of wetsuits during repetitive exposure to pressure. AB - This investigation was intended to a) establish a relationship between pressure and thickness (and hence insulation) of wetsuits during acute changes in pressure from 0.5 to 5 atmospheres absolute (ATA); b) determine the effect of repetitive compression-decompression (C-D) procedures on the insulation properties of wetsuits; and c) assess the possible recovery of insulation after cessation of repetitive C-D. Various wetsuits with different thicknesses and types of linings were selected. In all wetsuits, insulation and thickness were both reduced as similar, curvilinear functions of acutely increasing pressure in the range of 0.5 5.0 ATA. Effects of repetitive C-D (3 ATA) were studied in 5-mm-thick suit samples with various linings. The insulation of suits (0.100-0.120 degrees C.W 1.m-2) rapidly decreased after the first 5000 C-D. In suits without linings (skin suits), the insulation was reduced to 0.080 degrees C.W-1.m-2 at 5000 C-D and revealed no further reduction during the continuation of C-D cycles up to 30,000. Suits lined with single- or double-sided jersey showed a continuous decrease in the insulation and thickness as the number of cycles increased up to 12,000 and remained at a lowered value (0.060 degrees C.W-1.m-2) until the termination of C D (30,000 times). A nearly complete recovery of thickness was seen 10 days after cessation of C-D treatment in the skin suit when C-D cycles were less than 3500; however, no recovery was observed in suits with linings (either single- or double sided) in 25 days.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2773164 TI - Cylindrical tissue models. PMID- 2773166 TI - Acute gastric volvulus and strangulation of colon mimicking chest infection. PMID- 2773165 TI - Compulsive jogging: exercise dependence and associated disorder of eating. PMID- 2773167 TI - Tetany in association with gentamicin therapy. PMID- 2773168 TI - Primary medical care in a paediatric accident and emergency department. AB - The characteristics of a random sample of 853 children who attended the accident and emergency department of the Royal Belfast Hospital for Sick Children were studied prospectively to determine the extent to which the department was being used to provide primary medical care. Direct parent referrals accounted for 69% of all attendances with a further 21% referred by the family doctor. Parental preference and accessibility were the main reasons given for choosing to attend the department with the latter significantly higher among out-of-hours attendances. However, only 37 of the 585 parent referrals had made an attempt to contact the family doctor. Overall, 33.9% of children were felt to be inappropriate attenders, i.e. were neither accident nor emergency cases, and the proportion was highest among the parent-referred groups. The present financial restraints facing the National Health Service make it uneconomical to provide primary medical care at both hospital and community level. However, the level of demand for the accident and emergency department, together with the attitudes of those who attend, make it unlikely that a more rational use of resources will be achieved in the foreseeable future. PMID- 2773169 TI - An outbreak of salmonellosis amongst holidaymakers in Madeira, July 1988. AB - In July 1988, 20 of 49 tourists from Northern Ireland became ill with gastrointestinal symptoms while on holiday in Madeira and four were admitted to hospital. Salmonella enteritidis was subsequently isolated from eight members of the party. Epidemiological investigations implicated fried and/or scrambled eggs as the vehicle of infection. PMID- 2773170 TI - Perinatal mortality in Northern Ireland: where are we now? AB - Perinatal mortality in Northern Ireland has been declining over the last 30 years, but the factors which may account for this fall have not been clearly delineated. Crude perinatal mortality figures yield very little insight into the problem, and meaningful management statistics are urgently required if service performance is to be reasonably assessed. This paper sets out the case for birth weight standardisation and explores the utility of a broad diagnostic taxonomy of causes of death. PMID- 2773171 TI - Motivation in deliberate self-harm. AB - Fifty adult patients presenting with deliberate self-harm at the Royal Victoria Hospital were given a choice of nine reasons for their actions. Most chose more than one reason and all but two of the 24 who said that they wished to die chose at least one other motive. There were no trends with respect to sex, past history, or method of deliberate self-harm. These results illustrate the complexity of this condition and show the importance of investigating motives beyond simply the intent to die. PMID- 2773172 TI - Treatment of pilonidal sinus by phenol injection. AB - This report reviews the treatment of pilonidal sinus by phenol injection in 54 patients. Forty-four patients were treated initially by phenol injection and this was successful in 70%. The median number of injections per patient was one (range 1-5) with a median hospital stay per injection of two days (range 1-17 days). The median time to complete healing for patients treated by injection alone was two months (range 1-32 months). These results compare very favourably with more radical methods of treatment. PMID- 2773173 TI - Ice rink injuries: a new epidemic in Northern Ireland. PMID- 2773174 TI - Extreme lateral lumbar disc herniation. PMID- 2773176 TI - [Choice of the treatment method in patients with acute inflammatory diseases of the scrotal organs]. AB - The results of treatment for acute scrotal inflammations are reported. Conventional methods of conservative treatment are of little effect, while the duration of hospital stay is 24 days, and 25% of the patients are eventually readmitted to hospital for various complications. The choice of treatment strategy is made with reference to the clinical severity of acute epididymo orchitis (mild, moderate and severe forms). Ninety-nine patients with mild and moderate acute epididymo-orchitis received combined conservative treatment. In the past two years, combined treatment has made use of a helium-neon optic quantum-mechanical oscillator, OKG-LG-12, producing beams with a wavelength of 632.8 nM and an output power of 18-20 mV. No side effects were identified during or after the laser treatment. Patients with severe conditions are subject to surgical treatment. Early surgical intervention includes the opening of testicular membranes, inspection of the epididymis and drainage. Postoperative patients were treated with broad-spectrum antibiotics and 3 or 4 sessions of laser therapy. The use of combined conservative treatment, incorporating laser therapy, for mild and moderate conditions, and surgical treatment for severe ones has shortened hospital stay two-fold, while the results have been good. PMID- 2773175 TI - [A diagnostic method in acute pyelonephritis in pregnant women]. AB - A radiothermometer has made it possible to take deep temperature directly from the kidney. Comparison of temperatures, obtained from normal nonpregnant women, normal pregnant women and pregnant patients with acute pyelonephritis has demonstrated a significant drop in renal temperature during pregnancy. In acute pyelonephritis, renal temperature drops still further, with the temperature difference between the affected kidney and the contralateral one ranging from 0.5 degrees to 1.5 degrees. Deep temperature measurements of each kidney are taken from several sites, selected at ultrasonic scanning, which makes it possible to calculate temperature variance for the kidney. Variance increases significantly (more than two-fold) in the inflamed kidney, as compared to the intact one. Therefore, the diagnosis of acute pyelonephritis can be made where deep temperature difference is between 0.5 degrees and 1.5 degrees and temperature variance is increased twofold or more in one kidney, as compared to the other, in a pregnant patient. The side of affection is also determined in this way. The proposed diagnostic method is perfectly safe for the mother and the fetus, and can be used for the diagnosis of acute pyelonephritis during pregnancy, along with other procedures. PMID- 2773177 TI - [Descending urethrography in men with low urine flow]. AB - The paper describes a method of shuttering mixed cystourethrography in patients with low volumetric rate of urination that permits one to stop urination for the period of time necessary to fill the urethra but avoiding its overload and the development of venous refluxes. The aforementioned method was tested in 29 patients with stenosis of urethra and urocyst neck and proved the possibility to obtain the clear picture of urethra below its stricture, to measure its length and diameter. PMID- 2773178 TI - [Medical encyclopedias at the service of public health]. PMID- 2773180 TI - [Hazards and complications of endoscopic transurethral ureterolithotripsy and lithoextraction and means of prevention]. AB - Complications related to ureterolithotomy and ultrasonic ureterolithotripsy performed under the control of visual endoscope were analyzed in 86 ureterolithiasis patients, methods of their prevention discussed. All the aforementioned complications were distributed into three groups: inapplicability of surgery due to anatomic and functional defects of lower and upper urinary tracts, intraoperative, and postoperative complications. The commonest ones were ureteral abruption and perforation, acute pyelonephritis, temporary vesicoureteral reflux. Their control measures were considered as relative methods of treatment: immediate surgical intervention in case of ureteral abruption, renal catheterization in patients with insignificant ureteral perforation or acute pyelonephritis. Adequate ureteroscopy, careful consideration of pro- and contraindications, catheterization of renal pelvis and urinary bladder performed within 2-3 days after the surgery and adequate antibacterial therapy are the most decisive steps in the control of aforementioned complications. PMID- 2773181 TI - [The development of calcium metabolic disorders in patients in the terminal stage of chronic kidney failure receiving hemodialysis treatment]. AB - To follow calcium metabolism in patients with a terminal stage of chronic renal failure who are on hemodialysis treatment is necessary for the assessment of phosphorus/calcium metabolism in a whole, efficiency of conservative treatment, indications to surgical intervention (parathyroidectomy, renal allotransplantation). The investigation included the assessment of total and ionized calcium blood plasma levels with regard to hemodialysis duration; the correlation of clinical and roentgenological picture of secondary hyperparathyroidism. A total of 222 patients were observed, and with regard to hemodialysis duration allocated into 5 groups: in the first hemodialysis lasted for not more than 3 mos; in the second--from 3 mos to 1 yr; third group with its duration from 1 to 2 yrs; fourth, when it lasted from 2 to 3 yrs; and the fifth group--hemodialysis lasted for more than 3 yrs. It was documented that disorders in calcium metabolism were increasing in parallel with the duration of hemodialysis. Clinical and roentgenological picture of hyperparathyroidism was accompanied by an evident increment of blood plasma ionized calcium while the levels of total blood calcium were but slightly changed. As a part of combined diagnosis ionized calcium assessment is helpful in early prevention and management of calcium metabolism disorders. PMID- 2773182 TI - [The early stages of chronic kidney failure in children with congenital obstructive uropathies and results of surgical treatment]. AB - Ninety-six children, aged 4 to 14, with congenital obstructive uropathies were subjected to 131I-hippuran renography, followed by mathematical processing of renographic curves, the measurement of blood mean molecular levels, and blood and urinary immunochemical tests before, and 1 month as well as 1 year after surgery. Intraoperative renal biopsy was taken from 20 patients with unilateral hydronephrosis. Latent chronic renal failure (CRF) was identified where a deficiency of total renal clearance of 131I-hippuran (20 to 56%) was combined with a rise in blood mean molecules from 0.3 to 0.41 conventional units at 254 nm. Latent CRF was detected in 40 of 64 children with unilateral uropathy and in all 32 patients with bilateral uropathy. In patients with unilateral hydronephrosis, the presence of CRF was unrelated to the morphological pattern of pyelonephritis in the affected kidney. Children with latent CRF showed high levels of urinary IgG and albumin and blood mean molecules. One year after the operation, renal function improved in patients whose contralateral kidney had no secretory deficiency. One year after surgery, renal reabsorption mechanisms tended to recover in CRF-free patients only. The clinical pattern of latent CRF and its elimination following surgery were unrelated to roentgenologic markedness of hydronephrosis and VUR, but were dependent on the recovery of compensatory mechanisms in the contralateral kidney. By the end of the first postoperative year, latent CRF was diagnosed in 31% of children with unilateral hydronephrosis (as compared to the preoperative 68%), 43% (vs. the preoperative 60%) of children with unilateral VUR, and in 44% (vs. the preoperative 50%) of patients with unilateral neuromuscular ureteral dysplasia.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2773179 TI - [Acid-base balance of the blood and possible renal mechanisms of its imbalance in children with oxalate-phosphate stones of the urinary tract]. AB - A total of 191 children with oxalate-phosphate urinary concrements and 28 virtually healthy ones were studied for the main parameters of acid-base blood status with the use of Astrup's microtest. Besides, the urine circadian levels of acid and ammonium were followed up too. The proportion of the main and H+ secreting insertion cells of collecting tubes were calculated in 46 operative biopsy specimens, cells studied with electron microscopy. Advanced metabolic acidosis associated with a decrease in acid and ammonium titration was diagnosed in all patients with bilateral and in 81.6 per cent with unilateral nephrolithiasis. Regardless of acid-base blood status biopsy examination revealed a decrease in the number of insertion cells in renal collecting tubes of the patients mostly pronounced in those with bilateral concrement localization. Ultrastructure of insertion cells in children with oxalate-phosphate urolithiasis featured by a sharp decrease in mitochondria number, absence of smooth-walled vesicles, frequency of myelinoid lysosomes pointed to the failed competence of these cells to efficient H+ secretion. The data obtained evidence of the relationship between the metabolic acidosis and primary disability of the children's kidney to excrete H+. PMID- 2773183 TI - [Prevention of postoperative phlebothrombosis of the legs using low-dose heparin in urologic patients]. AB - Deep vein thrombosis of low extremities is the commonest complication in postsurgical urology. Difficult for diagnosis it induces thromboembolism of pulmonary artery contributing from 11.1 to 66 per cent to the rate of total postsurgical mortality. Possibility of solving the problem depends strongly on the development of efficient technique of phlebothrombosis prevention. The paper deals with the corresponding research conducted in 202 urologic patients aged from 40 to 90 years. The control group (108 persons) was subjected to routine nonspecific methods of thromboembolism prevention. The research group (94 patients) was additionally prone to the treatment with low dosages of heparin. The effect of the treatment was assessed with 125I-fibrinogen radionuclide test. Low-dosage heparin treatment resulted in a 3.3-fold decrease in the number of patients who developed postsurgery phlebothrombosis of low extremities. Incidence of thrombosis in them was 4.2-fold lower. Besides, there was a reduction in bilateral and macrofocal thrombosis incidence (11 and 11.5 times as less, respectively). The effect of the chemotherapy closely correlated with the pattern of surgical intervention and the dosage of the drug used. Low dosages of heparin (10,000 U per 24 hrs) administered to the patients with adenectomized prostate resulted in a 2.1-fold decrease in the number of those who developed deep venous thromboses of low extremities and a 3.4-fold decrease in the number of thrombosed extremities as low-dosage heparin treatment significantly influenced the incidence of bilateral thrombosis. When used as 15,000 U per 24 hrs in those patients who were exposed to lithotomy or nephrectomy the drug led to a 5-fold decrease in the incidence of phlebothrombosis.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2773184 TI - [Causes of varicocele recurrence after Ivanissevich's operation]. AB - The relapse of varicocele occurring after the most radical operative intervention performed with the use of Ivanissevich's technique and its possible cause were studied. For this 22 patients developing a relapse of left-sided varicocele were examined and operated on. Vascular investigation was found to be of great aid in identifying the types and variants of testicular vein structure and the case of operation failure. Intact medial and sometimes lateral trunks of crumble structure testicular vein or erroneous cut of vein in fat tissue of sigmoid colon performed instead of testicular vein cutting was stated as the main cause of varicocele relapses and disease progression. Thus it is stated that the cutting of all the trunks of testicular vein is necessary for relapse prevention and the method of treatment by Ivanissevich be regarded as pathogenetically substantiated one. PMID- 2773185 TI - [Induction of an erection using papaverine]. AB - In 61 patients erectile impotency was treated with papaverine injections into penile spongy body: initially 20-30 mg/day, then followed several days of intermittence, and then the dosages were built up with regard to the optimum time of erection for each person. Dosages higher than 80-100 mg were not advisable because of the evidence of prolonged erections. Recorded in 6 patients (7 times) prolonged erections lasted from 5 to 16 hrs (in 5 cases it was stopped by intracavernous injection of dopamine but in 2 patients cavernotomy was performed). A total of 300 sessions of papaverine intracavernous injections were made in 61 patients before the copulation (out of them 16 patients injected the drug themselves). During the treatment the patients were warned against prolonged erections: when it lasted for more than 4 hrs emergency clinical treatment be required for priapism prevention. It was proved that an adequate dosage of papaverine autoinjections into a spongy body was a simple, safe and effective method to cure erectile impotency, especially in patients with nonadvanced psychoneurological or vasculogenic disorders. PMID- 2773186 TI - [Candidal cystitis and leukoplakia of the bladder]. PMID- 2773188 TI - A new method of investigating the efficacy of regional thermotherapy in subcutaneous xenografts of nude mice. AB - A new method of investigating the efficacy of regional thermotherapy in subcutaneous xenografts of nude mice is reported. The use of high frequency hyperthermia was well tolerated by the sensitive animals and allowed an exact continuous temperature measurement in different tumor regions. The interstitial procedure in this model could be the best approach for later clinical use in urology, e.g. for prostate treatment and is an alternative to the transrectal hyperthermia application. PMID- 2773187 TI - [Treatment of short urethral strictures in children using magnets]. AB - In 20-35 per cent of short (up to 05 cm) urethral stenosis or cicatricial obliterations of urethra it was found advisable to start the treatment with nonoperative technique. Before 1982 bouginage or tunneling of urethra were commonly used. In 5 out of 6 children the strictures relapsed. Since 1983 when permanent magnets were employed, in 4 out of 5 patients normal urination recovered. 1 child was exposed to preventive 5-months bouginage to ensure constant patency of urethra. Long-term results in all the children satisfied the investigators. But out of 3 magnet-treated children with longer strictures (more than 1 cm) the disease relapsed in 2. It was concluded that in patients with longer stenosis the method was a failure, but in those with short ones the technique was more effective than routine methods. Besides, technical availability, safety and shorter terms of the treatment could also be regarded as the benefits of the aforementioned therapy. PMID- 2773189 TI - Morphological changes of urothelial and intestinal mucosa after ureterosigmoidostomy during experimental urogenic carcinogenesis. AB - To analyze the effect of chemical carcinogens on urothelial and intestinal mucosa on 214 female Wistar rats an ureterosigmoidostomy was performed. After 10-14 days 123 surviving rats were randomly divided into 4 groups: Group I-III received 0.05 per cent N-Butyl-N-(4-hydroxybutyl)-nitrosamine (BBN) in drinking water over a period of 15 weeks. Group IV received normal drinking water over the same period. The defunctionalized bladders were instilled each second day: Group I: physiologic saline solution, Group II: urine of normal rats, Group III and IV: urine of BBN-treated rats. 30 rats without diversion but BBN treatment served as a control. The evaluation of the histological data gave the following results: In the control group urothelial tumors were found in the bladder exclusively. Dependent on the grade of obstruction in the BBN-treated groups, with diversion urothelial tumors in the renal pelvis and ureter could be documented, whereas in the bladder no tumor growth could be shown. In the intestinal mucosa of BBN treated animals a high incidence of adenocarcinoma was found. The chemical tumor induction by BBN is related to the urine and takes place by direct contact to the mucosa when the metabolites excreted by the kidneys are activated in the urine. BBN or other urogenic carcinogens seem to have no urothelial specificity. The incidence of bowel carcinoma after diversion must lead to intensive long-term follow up. PMID- 2773191 TI - In-vitro contractility of human seminiferous tubules in response to testosterone, dihydrotestosterone and estradiol. AB - The effects of steroids (testosterone, dihydrotestosterone and estradiol) on human seminiferous tubules in vitro were ascertained by recording the intratubular pressure with a servonull micropressure measuring device. We describe here the first response of the human seminiferous tubule to steroids. Testosterone and dihydrotestosterone had a biphasic effect on tubular contractility. Higher doses of both testosterone and dihydrotestosterone induced contractions of the seminiferous tubules whereas lower doses of these compounds induced relaxation. Estradiol (10(-9) M to 10(-6) M) induced relaxation of the seminiferous tubules in a dose-dependent manner. The results from these experiments suggested that steroids may be involved in the control of contraction of the human seminiferous tubule and may regulate the movement of spermatozoa from the testes. PMID- 2773190 TI - Morphological changes following ESWL in the rat kidney. AB - Fifty four Wistar rats were treated with 500, 1,000 or 2,000 shock waves, using the modified DORNIER HM 3 system with the new SG40 shock wave generator. The animals were sacrificed after a period of 24 hours, 7 days or 35 days. Histological examination, scanning electron microscopy (SEM) and magnetic resonance imaging (MRI) were used to evaluate acute and long term effects after extracorporeal shock-wave lithotripsy (ESWL). Acute morphological changes such as glomerular bleeding, tubular dilatation, atrophy and partial necrosis occurred immediately after ESWL throughout the kidney. SEM revealed a tubular loss of microvilli and cilia. There was restitutio ad integrum of these diffuse lesions. The extent of the long term lesions was determined by the following mechanism: venous rupture occurred during ESWL, especially in thin arcuatae veins which are, tortuous their and run between two different tissue densities. This resulted in interstitial haematoma, demonstrable by MRI; in the long term groups, the haematomas progressed to interstitial fibrosis with segmental retraction of renal convexity. The blood supply in these areas was reduced and secondary changes such as glomerular-tubular atrophy and sclerosis followed. The degree to which long term renal lesions resulted was determined by the extent of these changes, which were shock-wave dose dependent up to a dose of 2,000 shock waves. PMID- 2773192 TI - Buying and selling a partnership. PMID- 2773193 TI - How gullible are the media? PMID- 2773194 TI - Long incomplete longitudinal fractures of the third metacarpal and metatarsal bone in horses. AB - Five horses with long incomplete longitudinal fractures of the third metacarpal bone and three horses with similar fractures of the third metatarsal bone were examined. In three of the metacarpal fractures a long incomplete fissure extended proximomedially, in association with the more common lateral condylar fracture of the third metacarpal bone, and in the other two cases the fracture originated from the medial aspect of the distal articular surface. In the three horses with fractures of the third metatarsal bone the fractures had a consistent spiral configuration. PMID- 2773195 TI - Delayed-type hypersensitivity test for assessing tick-immune status of cattle in Zambia. AB - Delayed-type hypersensitivity skin reactions were used to assess the tick resistance status of Tonga calves in Zambia. The antigen used in the tests was a homogenate of unfed nymphal Rhipicephalus appendiculatus which had been shown to give protective immunity in guinea pigs to adult female R appendiculatus. There was a significant negative correlation between the intensity of the reactions and the total number of ticks (Amblyomma variegatum, R appendiculatus, Hyalomma truncatum, Boophilus decoloratus and Rhipicephalus species) on the animals. PMID- 2773196 TI - Plasma alpha-tocopherol, total lipids and total cholesterol in wild rockhopper, magellanic and gentoo penguins before and after moulting. AB - Post moult rockhopper penguins (Eudyptes crestatus) had significantly higher plasma alpha-tocopherol (vitamin E), total lipid and total cholesterol concentrations than their pre-moult counterparts. In the magellanic penguins (Spheniscus magellanicus) there were post moult increases in total lipid, cholesterol and alpha-tocopherol concentrations, but only the increase in alpha tocopherol was significant. Plasma alpha-tocopherol, total lipid and total cholesterol concentrations in post moult gentoo (Pygoscelis papua) chicks were similar to those in non-moulting adult gentoos. Species differences in the levels of these nutrients in plasma may be due to differences in their dietary habits. PMID- 2773197 TI - Dinoprost 14-day oestrus synchronisation schedule for dairy cows. AB - Oestrus and ovulation were synchronised in 82 lactating Friesian dairy cows with two injections of dinoprost, and the cows were inseminated 72 and 96 hours after the second injection. Twenty-one of the 41 cows (51 per cent) which had a 14-day interval between the dinoprost injections conceived to the inseminations, compared with 18 of the 41 cows (44 per cent) which had an 11-day interval between the injections. PMID- 2773199 TI - Duration of maternal immunity to peste des petits ruminants. PMID- 2773198 TI - Efficacy of diclazuril against robenidine resistant Eimeria magna in rabbits. PMID- 2773200 TI - Benzoic acid hazard in cat preparations. PMID- 2773201 TI - Ectopic pregnancy in a cat. PMID- 2773202 TI - Prostaglandins and clostridial vaccination. PMID- 2773203 TI - Severe disease in a dairy herd associated with acute infection with bovine virus diarrhoea virus, Leptospira harjo and Coxiella burnetii. AB - Between November 1984 and February 1985, a serious outbreak of pyrexia, diarrhoea, agalactia, metritis and severe weight loss affected most of the recently calved cows in a 183-cow dairy herd in Norfolk. Fifteen cows died and 20 were culled. Forty cows aborted during or after the outbreak, and many of them produced mummified fetuses; 18 calves were stillborn and three others died soon after birth. Necropsy of three affected cows revealed ulceration of the gastrointestinal tract similar to that seen in cases of mucosal disease. Bovine virus diarrhoea virus was isolated from the intestines of one cow that died soon after the onset of illness. The virus was also isolated from the blood of four acutely ill cows and seroconversion was demonstrated in three of those that survived. The virus was isolated from three aborted fetuses, a stillborn calf and a live neonatal calf. Body fluids from two aborted fetuses were seropositive for the virus as were sera from all the aborting cows tested. In addition to widespread seroconversion to bovine virus diarrhoea virus during the outbreak, there was serological evidence of recent infection with Leptospira interrogans serovar hardjo and Coxiella burnetii in a high proportion of cows. It was concluded that this was primarily an acute outbreak of bovine virus diarrhoea but its unprecedented clinical severity was probably associated with the concurrent introduction of L hardjo and C burnetii into an immunologically naive herd during the main calving period. Epidemiological analysis suggested that the source of the virus and L hardjo was down-calving heifers returning from communal marsh grazing. PMID- 2773204 TI - Suspected ehrlichiosis in a gelding in Wales. PMID- 2773205 TI - Extrathoracic thymus tissue in lambs in Zimbabwe ('goitre'). PMID- 2773206 TI - Presence of Cytoecetes phagocytophila in an atypical disease of cattle in Spain. PMID- 2773207 TI - A tax on income. PMID- 2773208 TI - Vetsure and the profession. PMID- 2773209 TI - A case of canine otitis due to screwworm, Cochliomyia hominivorax, in France. PMID- 2773210 TI - Virus-like particles associated with a 'wet litter' problem in chickens. PMID- 2773211 TI - Leech infestation of livestock. PMID- 2773212 TI - Juvenile cellulitis in Gordon setters. PMID- 2773214 TI - Allergic response to proligestone. PMID- 2773213 TI - Food hygiene in the 1990s. PMID- 2773215 TI - Discontinuation of redwater treatments. PMID- 2773216 TI - Metaldehyde poisoning. PMID- 2773218 TI - Dog registration. PMID- 2773217 TI - BVA Review Working Party recommendations. PMID- 2773219 TI - Too highly qualified? PMID- 2773220 TI - Primary hyperoxaluria (L-glyceric aciduria) in the cat: a newly recognised inherited disease. AB - The clinical features of a newly recognised inherited disease, primary hyperoxaluria in the cat, are reported. Affected cats developed acute renal failure between five and nine months old owing to the deposition of oxalate crystals in the tubules of the kidney. In addition to the signs attributable to kidney failure the affected animals became profoundly weak; there was evidence of denervation atrophy in skeletal muscle, and accumulations of neurofilaments were found in the proximal axons of the ventral horn cells and dorsal root ganglion cells of the spinal cord. Examination of urine from affected cats revealed L glyceric aciduria and intermittent hyperoxaluria suggesting that the disease is a feline analogue of the human disorder, primary hyperoxaluria type 2. This supposition was confirmed by liver enzyme studies. PMID- 2773221 TI - Three cases of non-displaced radial fracture in horses. AB - Three horses with non-displaced fractures of the radius were examined. The affected animals showed a sudden onset of severe forelimb lameness with swelling of the antebrachium. Two cases had associated wounds on the medial aspect of the distal radius. The diagnoses were confirmed on radiographic examination. All three cases were treated conservatively by box rest. In one case slight further displacement of the fracture occurred three weeks after the initial injury but all the fractures went on to heal. The three horses returned to work but two were limited to light ridden exercise. PMID- 2773222 TI - Birth of piglets from frozen embryos. PMID- 2773223 TI - Interview technique. PMID- 2773224 TI - Diabetes mellitus. PMID- 2773225 TI - Scouring syndrome in young cattle. PMID- 2773226 TI - Tuberculin testing deer. PMID- 2773227 TI - Equine sinkers. PMID- 2773228 TI - How gullible are the media? PMID- 2773229 TI - 1992: challenge and opportunity. PMID- 2773230 TI - Concurrent use of the oxfendazole pulse release bolus and the monensin rumen delivery device in young grazing cattle. AB - When they were turned out to grass in May 1987 for their first season, 10 calves were dosed with a 5 x 750 mg oxfendazole pulse release bolus (OPRB) and a monensin sodium rumen delivery device (RDD); eight calves received one OPRB; 10 calves received one RDD and eight calves received neither bolus. Each group was set-stocked on individual paddocks which had been grazed during the previous season by cattle which developed clinical parasitic gastroenteritis and bronchitis (husk). In July, before they were due to be moved to new pastures in mid-summer, and before they were dosed strategically with levamisole HCl, some of the calves not dosed with an OPRB succumbed to clinical parasitic gastroenteritis and husk and received emergency anthelmintic treatment, after which no further clinical episodes occurred. The 'dose and move' strategy was implemented in early August after which both groups not dosed with an OPRB were set-stocked together until the trial ended on October 14, 147 days after turn out. The two groups of calves which had received the OPRB were also moved to new pasture and set-stocked together until the end of the trial. No evidence of clinical helminthiases developed in either of the two groups of calves dosed with OPRBs and their faecal worm egg and larval counts, and plasma pepsinogen activities remained low. They gained significantly more weight than the two groups of calves not dosed with OPRBs (P less than 0.001). The bolus types were compatible and induced no untoward side-effects when used together. PMID- 2773231 TI - Into the 21st century. PMID- 2773232 TI - Europe--matters of concern. PMID- 2773233 TI - Continuing professional development. PMID- 2773234 TI - BSE safety precautions. PMID- 2773235 TI - Immaculate conception? PMID- 2773236 TI - Rain and windchill as factors in the occurrence of pneumonia in sheep. AB - A computerised information retrieval system of abattoir pathology and meteorological data has been used to investigate the effect of prevailing weather conditions on the occurrence of pleurisy and pneumonia in the sheep population of Northern Ireland. Significant correlation coefficients were found between the percentage condemnations due to pleurisy and pneumonia in sheep and rainfall, windspeed, temperature and humidity. The most significant correlation was found with windspeed. The paper describes the calculation of a new meteorological variable, the rain/windchill factor. Very highly significant correlation coefficients were found between the percentage lung condemnations in sheep and the rain/windchill factor prevailing during the same month and both one and two months previously. The paper discusses the practical implications of these findings for sheep production and highlights the desirability of protecting sheep from adverse climatic conditions during the winter months. PMID- 2773237 TI - Epidemiology of Potomac horse fever: an investigation into the possible role of non-equine mammals. AB - A serological study of antibodies to Ehrlichia risticii was carried out on 10 species of wild and domestic mammals found on or near 21 horse farms in an area of the USA in which Potomac horse fever is endemic. No antibodies were found in 133 peridomestic rodents (Norway rats and house mice), nor in 108 wild rodents (white-footed mice and meadow voles) captured on farms. Three of the six domestic animal species examined, cats, pigs and a goat, showed serological evidence of exposure to E risticii. Seropositive animals were detected on three of the 21 premises. The eight seropositive cats (of 48 cats tested) were on two farms, and the three seropositive pigs (of 14 tested) were all on one farm which lay some 3 km from where the one seropositive goat (of three tested) was found. None of the 79 dogs, 75 cattle and seven sheep tested had antibodies to E risticii. The significance of these findings is discussed in the light of current understanding of the transmission of Potomac horse fever and of the epidemiology of other related ehrlichial diseases. PMID- 2773238 TI - Variations in the virulence of strains of Chlamydia psittaci for pregnant ewes. AB - Invasive and non-invasive strains of Chlamydia psittaci isolated from faeces of clinically healthy ewes and from vaginal swabs of ewes which had aborted were injected intravenously or intradermally into pregnant ewes. The results were studied by recording the ewes' thermal and serological responses, lambing performance and the excretion of chlamydia from the vagina. The differences between the effects of different invasive strains were greater after intradermal inoculation than after intravenous inoculation. After intradermal inoculation non invasive strains did not disturb pregnancy (11 of 13 ewes lambed normally) whereas invasive strains induced abortion in 23 of 25 ewes, 24 of which excreted chlamydia in vaginal secretions. PMID- 2773239 TI - Rapid chromosomal sexing of birds by direct and short term culture techniques. PMID- 2773240 TI - Canine blood coagulation. PMID- 2773241 TI - Interpretation. PMID- 2773242 TI - Associations between types of lameness and fertility. AB - Four hundred and twenty-seven cases of first-reported foot lameness were recorded in 17 dairy herds in Somerset during the winter housing period. Lameness was classified into three categories: sole ulceration, digital disease (white line abscess, foreign bodies in the sole and pricked or punctured sole), and interdigital disease (lesions of the skin between claws and heel including foul in the foot, interdigital fibroma and dermatitis). In addition, a 'clinical effect score' was calculated to take account of the severity of lameness, the structures involved and the time for which the cows were clinically affected. The fertility records of lame cows were compared with those of the healthy cows nearest in parity and stage of lactation. In the lame cows the interval from calving to first service was four days longer, and the interval from calving to conception was 14 days longer than in the control cows, the pregnancy rate to first service was 46 per cent (controls 56 per cent), 2.14 services were required per conception (controls 1.72) and 16 per cent of lame cows were culled (controls 5 per cent). Lameness, first reported in the period 36 to 70 days after calving, was associated with a significant (P less than 0.01) increase in the interval from calving to first service of eight days; and sole ulceration, in the period 71 to 120 days after calving, was associated with an increase of 11 days (P less than 0.05). Lameness in all periods up to 120 days after calving was associated with significantly increased intervals from calving to conception (P less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2773243 TI - A comparison of radioimmunoassay with quantitative and qualitative enzyme-linked immunoassay for plasma progestogen detection in bitches. AB - Plasma samples were obtained from seven bitches during 10 oestrous periods. Progestogen concentrations were determined in 182 samples by radioimmunoassay and by both quantitative and qualitative enzyme-linked immunoassay (ELISA) commercial kits. The concentrations determined by the quantitative ELISA were consistently higher than those measured by radioimmunoassay although the values were highly and significantly correlated. The qualitative ELISA readily distinguished between low and high progestogen concentrations, ie, less than 1.0 ng/ml and greater than 2.6 ng/ml measured by radioimmunoassay. Sequential evaluation with either kit, especially when combined with vaginal cytology, should be useful in determining the optimum time for mating. PMID- 2773244 TI - Effect of clenbuterol on the incidence of abomasal ulcers in veal calves. AB - The effect of clenbuterol on the incidence of abomasal lesions in veal calves was studied in two fattening units. Some of the calves in each unit were treated with 1.6 micrograms clenbuterol/kg bodyweight/day from the seventh until the 23rd week of the fattening period. In one unit the calves were fed milk replacer only and 176 of the 236 calves were treated with clenbuterol. In the other unit the calves were fed roughage pellets in addition to milk replacer and 92 of the 194 calves were treated with clenbuterol. Only in the second unit did the calves treated with clenbuterol have significantly fewer abomasal lesions. PMID- 2773245 TI - Monensin and toxoplasmosis in sheep. PMID- 2773246 TI - Withdrawal of product licences. PMID- 2773247 TI - The medicines (medicated animal feeding stuffs) regulations 1988. PMID- 2773248 TI - Superovulatory response in pashmina goats. PMID- 2773249 TI - Tetanus in the dog. PMID- 2773250 TI - Veterinary surgeons and leeches. PMID- 2773251 TI - Dangerous dogs. PMID- 2773252 TI - Geographical titles. PMID- 2773253 TI - Effect of oral L-carnitine on its concentration in the plasma of yearling Thoroughbred horses. AB - After an oral dose of 10 g of L-carnitine the plasma concentrations of free and total carnitine increased in five yearling thoroughbred horses, reaching a peak two to four hours after administration, but in two horses there was no increase. In the five which responded, the mean (+/- sd) peak increase in total carnitine concentration was 15.1 +/- 6.9 mumol/litre from a predose mean of 18.8 +/- 3.4 mumol/litre, and the mean peak increase in free carnitine concentration was 13.5 +/- 3.1 mumol/litre from a pre-dose mean concentration of 12.5 +/- 2.2 mumol/litre. These changes were similar to those observed previously in a group of adult thoroughbred horses given 10 g of L-carnitine. There was no consistent pattern of change in the concentration of acetylcarnitine in the seven yearling horses. PMID- 2773254 TI - Efficacy of a multivalent Bacteroides nodosus vaccine against foot rot in sheep in Britain. AB - A multivalent Bacteroides nodosus foot rot vaccine was tested by comparing the prevalence of foot rot in 317 vaccinated ewes and lambs with the prevalence in 422 unvaccinated control sheep. The vaccine conferred statistically significant protection against foot rot. The vaccine also demonstrated a therapeutic effect in animals with foot rot, after one injection. PMID- 2773255 TI - Rate of claw horn growth and wear in biotin-supplemented and non-supplemented pigs. AB - The growth and wear rate of claw horn was measured in 42 commercial hybrid pigs. Half received a ration supplemented with 1 mg d-biotin/kg food daily, while the others acted as controls. The start weights of three replicates of 10 pigs averaged 25 kg and their mean finishing weight was 85 kg. Twelve pigs averaged 18 kg at the start and 118 kg at the end of the experiment. No differences in horn growth and wear rates were found between the biotin-supplemented pigs and the controls, or between the front and hind claws, although horn growth and wear both decreased with age. Claw horn grew at an average of 10 mm/28 days in the pigs taken from 25 to 85 kg bodyweight and at 11 mm/28 days in the pigs taken from 18 to 118 kg. The mean rate of wear of claw horn was 6 mm/28 days. PMID- 2773256 TI - Head swelling of traumatic aetiology in broiler breeding fowl. PMID- 2773257 TI - Anthrax vaccination. PMID- 2773258 TI - Veterinary manpower, past and future. PMID- 2773259 TI - Case histories. PMID- 2773260 TI - Chlamydia in ovine milk. PMID- 2773261 TI - CPD. PMID- 2773262 TI - Adverse reaction to potentiated sulphonamides in horses? PMID- 2773263 TI - Unusual bovine cases. PMID- 2773264 TI - Efficacy of diclazuril in the prevention and cure of intestinal and hepatic coccidiosis in rabbits. AB - The efficacy of diclazuril against intestinal and hepatic coccidiosis was studied in artificially infected rabbits. Prophylaxis against intestinal coccidiosis was evaluated using a mixed infection of Eimeria intestinalis, Eimeria magna and Eimeria perforans. Continuous medication in the feed at 1 p.p.m. was 100% effective in reducing oocyst output and faecal scores, and weight gain and feed efficiency were normal. Hepatic coccidiosis induced by Eimeria stiedai was prevented at 0.5 and 1 p.p.m. as shown by negative oocyst counts, normal liver weight, absence of liver lesions, and normal body-weight gain and feed efficiency. Medication at 1 p.p.m. for 7 consecutive days during the prepatent phase of hepatic coccidiosis resulted in large reductions in oocyst counts and lesion scores with a normal liver weight and growth performance. Diclazuril at 1 p.p.m. in the feed prevented both intestinal and hepatic coccidiosis in rabbits and can be advocated for safe mass medication. PMID- 2773265 TI - Role of the spleen and rosette-formation response in experimental Eperythrozoon ovis infection. AB - The role of the spleen and rosette-formation responses was investigated in sheep experimentally infected with Eperythrozoon ovis. Phagocytic activity was observed in the spleen 19 days after primary infection. Phagocytosis of E. ovis parasitised and non-parasitised erythrocytes by cordal reticular cells occurred. E. ovis organisms seemed to be detached from the erythrocytes by pseudopodia extending from macrophages and cordal reticular cells without causing damage to the plasmalemma of the erythrocyte. No phagocytic activity was observed in spleens removed 74 and 146 days after infection. Antigen-specific lymphoid cell responsiveness, assessed by rosette formation, indicated that 2.8, 15.4, 8.0 and 6.0% of lymphoid cells in the spleens of the four E. ovis-infected sheep, respectively, formed antigen-specific rosettes. Rosette formation did not occur when splenic lymphocytes from E. ovis-infected sheep were mixed with non-infected erythrocytes or when splenic lymphocytes from an uninfected sheep were used. PMID- 2773266 TI - Lesions in goats fed Toxoplasma gondii oocysts. AB - Tissues of 20 2-3-month-old kids and 17 2-4-year old does fed Toxoplasma gondii oocysts were examined histologically. Kids were necropsied between 3 and 50 days post-inoculation (DPI) and does were necropsied between 10 and 422 DPI. Lesions were seen in tissues of all young goats fed 1000-100,000 oocysts and consisted of acute enteritis, necrosis of mesenteric lymph nodes and encephalomyelitis. Lesions were not seen in does fed 10-10,000 oocysts. PMID- 2773268 TI - A field evaluation of anthelmintics in horses in Sweden. AB - A field evaluation of anthelmintics in 336 horses on 37 farms was conducted between February and May 1986 in Sweden. The herds, each comprising at least eight horses, had histories of grazing on permanent pastures and receiving regular treatments against parasites at least three times a year. Small strongyles were refractory to (pro)-benzimidazole drugs in all but one of 23 herds examined. There was an average reduction in egg output of approximately 60%, and approximately 30% of 205 horses examined were shedding less than 100 eggs g-1 7 days after treatment. There was great between-herd variation of both the faecal egg-count depression (6.4-90.4%) and drug efficacy (0.0-80.0%). The non-benzimidazole drugs under investigation were fully effective against mature small strongyles. PMID- 2773269 TI - Strongylus vulgaris in donkeys (Equus asinus) from the highveld of Zimbabwe. AB - Strongylus vulgaris populations in the cranial mesenteric arteries, caecum and colon were studied in 14 donkeys obtained from a communal area of the Zimbabwean highveld during July and November, 1986, and January and April 1987. Adult parasites were present in all animals and larvae in the cranial mesenteric arteries of 12 animals. Aged animals had high worm burdens. The number of adult parasites varied from 63 to 1255 (mean 382) and of larvae in the arteries from 0 to 181 (mean 69). The mean adult worm burdens were highest in July (400) and November (488), and lowest in April (107). The mean arterial larval burden was highest in July (130) and lowest in November (21). These observations indicate that infection with S. vulgaris takes place during the rainy season resulting in the heavy arterial larval population from January onwards and the heavy adult population during the dry season. PMID- 2773267 TI - Levels of serum IgE in response to gastrointestinal nematodes in cattle. AB - Serum IgE concentration has been considered a valuable measurement in parasitic infections, yet little has been reported regarding cattle. This study examines the association of IgE levels of nematode-naive Holstein steer calves and the level of gastrointestinal parasitism acquired by grazing irrigated pasture for 30 days. Total IgE levels were determined by enzyme-linked immunosorbent assay (ELISA) specific for bovine IgE on serum collected both before and after exposure to parasite-infected pastures. Following necropsy, parasite loads were determined by direct count from the contents of the abomasum, small intestine, cecum and large intestine; species of Ostertagia and Cooperia being the most common helminths found. Significant increases of IgE in the serum of calves with light infestations were seen, whereas calves with moderate to heavy infestations showed only mild IgE increases. With increased parasite burden, the frequency of increased IgE levels was reduced. Additionally, there appeared to be a seasonal correlation relating the level of serum IgE detected to the number of worms counted and to the course of parasite development. PMID- 2773270 TI - Effect of temperature on development of the free-living stages of Ostertagia circumcincta. AB - Hatching of the eggs of Ostertagia circumcincta was studied by recovering them from faeces and incubating them in distilled water at temperatures of 4, 16, 25 and 35 degrees C. Hatching occurred at all the temperatures. The rate of hatching increased with the rise in temperature. Development of larvae to the infective third stage (L3) was studied in faecal cultures incubated at 4, 16, 25, 30, 35, 40 and 45 degrees C. Except at 4 degrees C, L3 developed at all temperatures, the optimum temperature being 16 degrees C. The rate of development of L3 increased with the rise in temperature. This resulted in a corresponding decrease in the percentage recovery of larvae. PMID- 2773271 TI - Outbreaks of early-season trichostrongylosis in calves in Denmark. AB - This paper describes clinically manifest infections occurring as early as June and early July in first-season grazing calves in Denmark during the period 1972 1987. Two severe outbreaks in 1976, included in our experiments, were studied in detail. Herbage infectivity was particularly high in grass tufts surrounding cow pats that were present in high numbers around the time of turnout. It is hypothesized that the preceding extremely dry summer followed by a hard winter had indirectly retarded degradation of dung pats and thereby favoured the overwintering of the larval populations in the dung reservoirs. In a third experiment, conducted in the same year, the epidemiological pattern was more normal; presumably due to artificial irrigation of the pasture during the drought. Early-season cases that were recorded in 1980 and 1987 could possibly be related to cold winters and/or very early turnout. The findings are discussed in the light of ecological factors responsible for the breakdown of cow pats. The clinical implications are seen in relation to current control methods. PMID- 2773272 TI - The effects on merino lambs of chronic infection with Trichostrongylus rugatus. AB - Four groups of six 5-month-old merino lambs were exposed to infection with 12,000 larvae of Trichostrongylus rugatus per week and one group was killed at each of 3, 6, 9 and 12 weeks. Numbers of adult worms increased in an approximately linear manner throughout the experiment; the percentage of larvae developing to adults remained between 35 and 25% throughout the course of the experiment. Sub-total villus atrophy was evident in the anterior small intestine of each group of infected sheep and significant reductions occurred in the plasma concentrations of albumin and phosphate. Serum globulin and calcium concentrations rose in infected animals. No clinical signs were observed in infected sheep, no alteration in bone histology was detected and no decrease in growth rate occurred. PMID- 2773273 TI - Comparison of the effects of infection with Trichostrongylus colubriformis, T. vitrinus and T. rugatus in merino lambs. AB - Groups of six worm-free merino lambs were infected with 100,000 larvae of T. colubriformis, T. vitrinus, T. rugatus or a mixture of the three species and were slaughtered 21 days later. Nematodes were distributed predominantly in the first 3 m of the small intestine where they caused subtotal villus atrophy. T. vitrinus caused severe erosion of the epithelium; erosion was less severe with T. colubriformis infections and mild with T. rugatus infections. Plasma concentrations of albumin declined during the experiment and were most marked in sheep infected with T. vitrinus. Plasma phosphate concentrations declined during infection with all three species, while plasma concentrations of globulin and calcium declined only in sheep infected with T. vitrinus. Food intake was reduced in all groups, but was most marked with sheep infected with T. vitrinus. T. vitrinus appeared to be more pathogenic than the other species. PMID- 2773274 TI - Characterization of Trypanosoma (Trypanozoon) evansi from dromedary camels in Kuwait by isoenzyme electrophoresis. AB - Blood from 115 camels in Kuwait was examined for blood parasites. Two camels of a local herd (1.7%) were found to be infected with Trypanosoma (Trypanozoon) evansi and three camels (2.6%) with microfilarial nematodes. The Trypanosoma stocks isolated from these two camels were screened for isoenzyme patterns of 10 enzymes using thin-layer starch-gel electrophoresis. The results revealed that these two stocks were identical to camel stocks of T. evansi from certain countries in Africa, as well as to two stocks isolated from dogs in Kuwait. This is the first record of Trypanosoma (Trypanozoon) evansi isolates and microfilariae from camels in Kuwait. PMID- 2773275 TI - Encephalomyelitis and myositis in a boxer puppy due to a Neospora-like infection. AB - A 10-week-old Boxer dog from Uppsala, Sweden, was killed because of hind limb paralysis. The hind limb muscles were grossly atrophied and encephalomyelitis and myositis were the predominant microscopic lesions. Neospora caninum-like tachyzoites were found in the brain and skeletal muscles, and tissue cysts were found in the brain. The organism was not Toxoplasma gondii, as T. gondii antibody was not found in the indirect fluorescent antibody test in serum samples from the puppy and the dam, and the organism in the dog's brain did not react with T. gondii antibody in the immunoperoxidase test. PMID- 2773276 TI - Congenital toxoplasmosis in Abyssinian cats. AB - Two of three litter-mate kittens born to an Abyssinian cat died of acute toxoplasmosis. Toxoplasma gondii was found in histologic sections of both kittens and this was confirmed by immunoperoxidase staining. PMID- 2773277 TI - Chemical composition of lipopolysaccharide from Moraxella bovis. AB - Lipopolysaccharide from Moraxella bovis was isolated and its components characterized by paper and gas-liquid chromatography and mass spectrometry. The endotoxin showed a small amount of protein and contained 2-keto-3-deoxyoctonic acid glucose, mannose, glucosamine, heptose and phosphate. Six fatty acids (palmitic, palmitoleic, margaric, stearic, oleic and arachidic acids) were also identified. Margaric acid was the most prevalent fatty acid present in the lipid fraction. PMID- 2773278 TI - The effects of vaccination with tissue culture-derived viral vaccines on detection of antibodies to equine arteritis virus by enzyme-linked immunosorbent assay (ELISA). AB - An enzyme-linked immunosorbent assay (ELISA) was developed for the detection of serum antibodies to equine arteritis virus (EAV). Results from this assay produced a good correlation with results from virus neutralisation tests in horses which had not been regularly vaccinated with commercially available mammalian tissue culture-derived viral vaccines. Vaccination of some horses with tissue culture-derived vaccines induced the formation of antibodies to bovine serum. These antibodies reacted with the bovine protein contaminants in the EAV ELISA antigen, producing false-positive results. Non-viral protein contaminants were found to be closely associated with EAV in that they co-purified with the virus during gradient centrifugation. PMID- 2773279 TI - Arthroscopic treatment of osteochondritis dissecans in the canine shoulder. AB - Twenty-three shoulders of 21 dogs were treated arthroscopically for osteochondritis dissecans (OCD). Thirteen dogs had bilateral lesions detectable radiographically; however, only two dogs had arthroscopic surgery on both shoulders. Arthroscopic procedures included removal of the osteochondral flap, curettage of the subchondral defect, and partial synovectomy. Fourteen dogs were using the treated limb within 1 day and eight dogs within 2 days, although some lameness may have persisted for several weeks. Force plate evaluation was effective for comparison of preoperative and postoperative mean peak force/body weight (PF/BW) values. Improvement was detected objectively in 9 of the 10 dogs returned for postoperative force plate analysis. All owners were satisfied with the cosmetic results and the rapid return to function. PMID- 2773280 TI - Healing of mandibular body osteotomies after plate and intramedullary pin fixation. AB - Osteotomies were created in the left body of the mandible of nine dogs and immediately stabilized with either a six hole dynamic compression bone plate or an intramedullary pin. Cortical bone healing and vascular supply were evaluated at weeks 2, 5, and 10 by microradiography, microangiography, and correlated histology of selected mandibular slices. Perforating arterioles from the buccal mucosa maintained vascular supply to rostral mandibular segments. The mandibular body rostral to the osteotomy site and caudal to the canine tooth suffered an interruption of vascular supply that was replaced by a temporary extraosseous supply during healing of the osteotomy. Intramedullary pin placement resulted in destruction of rostral teeth. There was an inflammatory response around the rostral portion of all intramedullary pins. Osteotomy sites involving tooth roots resulted in no disruption of the normal vascular or neural structures of the tooth pulp. PMID- 2773281 TI - Clinical evaluation of three surgical methods for treatment of caudal cervical spondylomyelopathy of dogs. AB - Sixty-four dogs with caudal cervical spondylomyelopathy (CCSM) caused by chronic degenerative disc disease were treated with ventral decompression (n = 20), linear traction and interbody screw stabilization (n = 7), or linear traction and plastic plate stabilization (n = 37). Interbody screw stabilization was ineffective in treating CCSM because of an unacceptably high rate of implant failures. Ventral decompression or linear traction and plastic plate stabilization were effective in the treatment of most patients with mild to moderate neurologic deficits (neck pain, paraparesis, or ambulatory tetraparesis). Although these techniques were also used successfully in some patients with severe neurologic deficits (weakly ambulatory tetraparesis or nonambulatory tetraparesis), variable success rates and prolonged postoperative recovery periods were noted. PMID- 2773282 TI - Total colectomy with ileorectal anastomosis in the cat. AB - Total colectomy with end-to-end ileorectal anastomosis was performed in eight healthy adult cats. Hydration status, body weight, attitude, appetite, and stool consistency were monitored for 24 weeks. Ileal water absorption was determined at weeks 1, 6, 12, 18, and 24 using the double-lumen catheter intestinal perfusion technique with polyethylene glycol as the indicator substance. Bowel adaptation was evaluated by histologic morphometric analysis of full-thickness ileal biopsies taken at the time of total colectomy and at weeks 6, 12, 18, and 24. The anastomoses were examined at necropsy for evidence of leakage and development of strictures. All cats resumed normal activity in 48 hours and maintained or gained weight during the study. Small volumes of watery diarrhea were present immediately after surgery, but by week 1 all cats had a semi-solid nonformed stool. At month 2, three cats developed semi-solid formed stools. One cat had occasional perineal soiling and five cats had at least one episode of hematochezia. There was improvement in ileal water absorption in two cats, and there were significant increases in villus height, enterocyte height, and enterocyte density in all cats. Results of postmortem examination of the anastomosis showed no evidence of stricture in any cat. PMID- 2773283 TI - Comparison of adhesive polyurethane membrane and polypropylene sutures for closure of skin incisions in cats. AB - Paired skin incisions were made on each side of four cats and closed with either interrupted polypropylene sutures or adhesive polyurethane membrane. The healing of these wounds was compared by gross appearance, break strength determination, and histologic examination. The adhesive polyurethane membranes were quicker and easier to apply, producing a more uniform closure than sutures both clinically and histologically. They adhered strongly to the skin, supporting more wound length than sutures for the first 7 days. There were no differences in break strength between closure techniques. Histologically, the wounds closed with adhesive polyurethane membrane were characterized by a milder inflammatory reaction and greater vascular infiltration than sutured wounds, especially early in the healing period. PMID- 2773284 TI - Reactivity of equine palmar digital arteries and veins to vasodilating agents. AB - Palmar digital arteries and veins removed surgically from healthy horses under general anesthesia were cut into 4 mm vascular rings, suspended in tissue baths, and attached to force displacement transducers for continuous measurement of vascular tension. In vitro vascular responses were determined for acetylcholine, acepromazine, isoxsuprine hydrochloride (isoxsuprine), prostaglandin E2 (PGE2), and prostaglandin I2 (prostacyclin). After preconstriction with norepinephrine hydrochloride (norepinephrine), or prostaglandin F2 alpha (PGF2 alpha), the concentrations needed to produce 50% maximum relaxation (EC50) and the maximum percentage of relaxation were determined for each drug. Acetylcholine was the most potent arterial vasodilator (smallest EC50 value) and PGE2 was the least potent. Prostacyclin was the least potent venodilator (highest EC50 value); there were no differences between acetylcholine, acepromazine, isoxsuprine, and PGE2. Isoxsuprine produced greater arterial relaxation than all other agents. Isoxsuprine and acepromazine produced significantly greater venous relaxation than did acetylcholine and PGE2. Prostacyclin produced minimal vasodilation of arteries or veins. Acepromazine and isoxsuprine relaxed the veins significantly more than the arteries. When PGF2 alpha was used instead of norepinephrine to preconstrict the arteries and veins, the potency and effectiveness of acepromazine and isoxsuprine to produce vasodilation were significantly decreased. Results indicate that acepromazine and isoxsuprine can relax the equine digital vasculature but their effectiveness varies depending on the origin of the constriction. PMID- 2773285 TI - Use of the cobra head bone plate for distal long bone fractures in large animals. A report of four cases. AB - Four long bone fractures with a short distal fragment were repaired with a cobra head bone plate alone (2 cattle) or in combination with a straight, broad dynamic compression plate (2 horses). Three fractures were of the distal femur (1 horse, 2 cattle) and one was of the distal radius (1 horse). The long-term outcome of the three femoral fractures was soundness in one case and mild lameness in two. Although satisfactory bone healing progressed in the horse with the radial fracture, laminitis in the contralateral forelimb necessitated euthanasia at week 6. PMID- 2773286 TI - Evaluation of pentobarbital as a drug for standing sedation in cattle. AB - Pentobarbital (1.0, 1.5, and 2.0 mg/kg intravenously [IV]) was administered to four adult cows to determine a dose suitable for producing standing sedation in adult cattle, and to evaluate its effects on cardiopulmonary function and rumen motility. The response was assessed after 15, 30, 60, and 90 minutes. The 1.0 and 1.5 mg/kg doses induced mild sedation at 15 and 30 minutes, and no sedation at 60 and 90 minutes. The 2.0 mg/kg dose produced moderate sedation at 15 and 30 minutes, and mild sedation at 60 minutes. The 2.0 mg/kg dose was judged to be the most suitable. The effects of pentobarbital (2.0 mg/kg IV) on heart rate, blood pressure, respiratory rate, blood gases, and rumen motility were measured in five cows during a 90 minute period. Respiratory rate was significantly depressed at 15, 30, and 60 minutes, but there were no significant changes in the other variables. Pentobarbital (2.0 mg/kg IV) is reliable in adult cattle for standing sedation of short duration. PMID- 2773287 TI - An unusual cause of increasing airway pressure during anesthesia. AB - A mare with a thoracic laceration was anesthetized with halothane-O2 for surgical repair. Shortly after initiation of controlled ventilation, inspiratory plateau pressure began to increase. The increase in pressure continued despite decreasing the tidal volume. Tension pneumothorax was suspected, but because arterial PCO2 and PO2 were normal, the anesthetic apparatus was examined. Excess gas continued to exit through the bellows pop-off valve even when the fresh gas flow was turned off. It was determined that driving gas from the ventilator was entering the breathing circuit through a hole in the bellows. Testing the integrity of the bellows before use is suggested to avoid this potentially harmful complication. PMID- 2773288 TI - Thermal burns in four dogs during anesthesia. AB - Thermal burns occurred in four anesthetized dogs as a result of using latex surgical gloves filled with warm water to treat hypothermia. The burns were on relatively hairless skin that had been in contact with the gloves. Small containers full of warm water are a relatively inefficient source of heat, but if the temperature of the water exceeds 45 degrees C and the container contacts the animal's skin, thermal injury can result. PMID- 2773289 TI - Cardiovascular function and serum catecholamine concentrations after anesthesia and surgery in the dog. AB - Peripheral vasoconstriction and plasma catecholamine concentrations were studied in 37 dogs after cervical disc fenestration and salivary gland excision, laparotomy for intestinal anastomoses and cystotomy, or laparotomy for repair of diaphragmatic rupture, gastrotomy, and pyloromyotomy. Meperidine (4.4 mg/kg) was administered before extubation of 12 dogs undergoing laparotomy. Heart rate, respiratory frequency, indirect blood pressure, rectal temperature, toe web temperature, and plasma concentrations of epinephrine and norepinephrine were determined before induction of anesthesia, after intubation, after extubation, at sternal recumbency, and at standing. All dogs were hypothermic during surgery. After surgery, peripheral hypothermia (large rectal-toe web temperature gradients) increased from a mean of 4.6 degrees C after intubation to a mean of 10.4 degrees C when the dogs initially stood. Heart and respiratory rates and blood pressures during recovery were similar to those before anesthesia. Mean plasma catecholamine concentrations were neither significantly higher during recovery than before surgery nor were they increased in any surgical group, including the dogs not treated with meperidine. After anesthesia, 15% of the epinephrine and 12% of the norepinephrine samples were more than two standard deviations above the mean of the preanesthetic concentrations of all dogs. The ratio of all dogs with an epinephrine concentration more than two standard deviations above the mean of baseline epinephrine concentrations was greater at sternal recumbency than before anesthesia and the ratio of dogs with an increased epinephrine concentration at sternal recumbency was greater in the laparotomy dogs (9 of 24) than in the cervical surgery dogs (0 of 12).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2773291 TI - Transcatheter thoracic duct embolization in the dog. An experimental study. AB - Thoracic duct embolization was created by injecting an isobutyl 2 cyanoacrylate/iophendylate (IBCA) mixture through a cannulated mesenteric lymphatic vessel in eight normal dogs. Aqueous contrast lymphangiography was repeated at minute 10 and week 6. Six dogs were euthanatized at week 6 and two dogs at month 6. Embolization with 1.5 to 3.9 ml of the mixture resulted in complete obstruction of the thoracic duct in all eight dogs. Results of lymphangiography in six dogs at week 6 showed a persistent, complete obstruction of the thoracic duct in six dogs and alternate lymphaticovenous anastomoses in four dogs. Histologically, there were a sclerosing granulomatous response surrounding the lymphatic embolus, mild congestive changes in the mesenteric lymph nodes, and mild lacteal dilatation in the jejunum. The procedure was well tolerated with only a few complications. One dog suffered partial thrombosis of the cranial vena cava by the injected material with later dislodgement and embolization of a pulmonary artery branch. Modifications have been made in the injection procedure to avoid this complication. This technique for occlusion of the thoracic duct shows potential for clinical use in the management of canine chylothorax. The obstruction appears to be complete and permanent, and surgical/anesthetic time is decreased greatly from previously described procedures. PMID- 2773290 TI - Intraperitoneal circulation and drainage in the dog. AB - The patterns of dispersion and drainage of a low viscosity, oil-based contrast medium within the peritoneal cavity were examined in 12 normal dogs. Intraperitoneal injection of contrast medium was cranial or caudal and drainage was by the sump-Penrose or open peritoneal method. Radiographs were made over a 96 hour period, before and after peritoneal drainage was established. Each dog was euthanatized and necropsied. The contrast medium was dispersed throughout the peritoneal cavity 15 to 30 minutes after cranial injection and 1 to 2 hours after caudal injection. Most of the contrast medium drained within 6 hours after open peritoneal drainage and within 24 to 48 hours after sump-Penrose drainage. At necropsy, there was complete encasement of all sump-Penrose drains and partial occlusion of all open peritoneal incisions by omentum adhered to the abdominal wound edges. Peritonitis was not grossly evident, but all dogs showed histologic evidence of an acute inflammatory reaction associated with the drain or wound edge. PMID- 2773292 TI - Transfer of deep circumflex iliac flaps to the tarsus by microvascular anastomosis in the horse. AB - Eighteen deep circumflex iliac flaps were elevated in healthy adult horses. Four flaps survived well when elevated as islands, but five orthotopic flaps and nine heterotopic flaps transferred to the tarsus and face failed. Technical reasons could explain the failure of the orthotopic flaps, but not the heterotopic flaps. Failure of the heterotopic flaps was apparently caused by the no-reflow phenomenon. PMID- 2773293 TI - Carpal joint arthrodesis as a treatment for chronic septic carpitis in calves and cattle. AB - Chronic septic carpitis in 72 calves and adult cattle was treated by arthrodesis of the carpus (n = 24), proximal or distal carpal row resection with arthrodesis (n = 31), or resection of both the proximal and distal carpal bones and radio metacarpal arthrodesis (n = 17). Painfree arthrodesis permitting full weight bearing was obtained in 69% of the cases. Arthrodesis without resection of carpal bones was successful in 87% of the cases. With resection of one carpal row, 72% of the cases were treated successfully. Radio-metacarpal arthrodesis with removal of both carpal rows resulted in fusion in 35% of the animals. PMID- 2773294 TI - The effect of exercise on the healing of articular cartilage defects in the equine carpus. AB - Arthroscopic surgery was performed on 12 horses (2-4 years of age) to create a 7 x 14 mm full-thickness cartilage defect in one radial carpal bone and in the contralateral third carpal bone. Six horses remained confined to a small paddock and six horses underwent a program of increasing exercise consisting of walking, trotting, and cantering for 13 weeks. All lesions showed evidence of healing at week 6 that progressed to more complete healing at week 13. There was no difference in the amount of repair tissue covering the defect. Histologically, the lesions healed with a combination of fibrous tissue and fibrocartilage. The repair tissue was significantly thicker in the exercised horses but there was no difference in repair quality. It was concluded that radial carpal and third carpal lesions have an equal ability to heal and that early postoperative exercise is not detrimental to the repair tissue within these carpal cartilage defects. PMID- 2773295 TI - The hemodynamic response of calves to tiletamine-zolazepam anesthesia. AB - Six isoflurane-anesthetized calves were instrumented for hemodynamic studies and allowed to recover from anesthesia. When the mean arterial blood pressure rose to 100 mmHg or when vigorous movement occurred, a 1:1 tiletamine-zolazepam mixture (4 mg/kg) was administered intravenously (IV). Values for cardiac output, cardiac index, stroke index, central venous pressure, and right ventricular stroke work index did not change significantly. Systolic, mean, and diastolic arterial blood pressures and systemic vascular resistance were significantly decreased below baseline at 5 minutes; they were significantly increased above baseline at 20 minutes and remained so throughout the 60 minute study. Changes in left ventricular stroke work index and rate pressure product were similar to those of arterial blood pressure and systemic vascular resistance, although they were not significant. Heart rate and pulmonary capillary wedge pressure decreased significantly but gradually returned to baseline at 40 minutes and then increased significantly above baseline by the end of the study. Minor venous-arterial shunting or perhaps mismatching of ventilation and perfusion appeared to have developed in the later stages of the study. This was reflected in a minor increase in the arterial partial pressure of carbon dioxide (PaCO2) and a decrease in the arterial partial pressure of oxygen (PaO2) and arterial pH. At the dose administered, the hemodynamic changes induced by tiletamine-zolazepam were minimal and were compatible with safe anesthesia in calves. PMID- 2773296 TI - The influence of the swine major histocompatibility genes (SLA) on variation in serum immunoglobulin (Ig) concentration. AB - Variation in serum IgG and IgM concentration was determined in three homozygous SLA-defined strains of miniature swine (SLAa, SLAc and SLAd) and one recombinant strain SLAg (ABcDd) as part of a study of SLA and other genetic effects on immune response. Data were obtained from 119 8-week-old piglets from 29 litters by 12 sires and analyzed using a SAS linear model for the effects of SLA haplotype, sire, dam, litter, sex, season of birth and sow parity. SLA haplotype (P less than 0.10) and other genetic effects due to sire (P less than or equal to 0.001) and dam (P less than or equal to 0.002) contributed to the variation in serum IgG concentrations. Season of birth and sow parity also affected IgG concentration as did litter effects. Least squares mean comparisons indicated that pigs of the dd, dg and gg haplotypes had significantly higher serum IgG than did pigs of the other haplotypes. Heritability estimates for IgG, calculated by paternal half-sib correlation, ranged from 0.31 to 0.27, indicating that selection for increased serum IgG concentrations would be possible. For serum IgM concentrations, only the effect of litter was significant at P less than or equal to 0.001 and P less than or equal to 0.009 by the radial immunodiffusion test read at 24 or 48 h. Since sire variance components estimates were negative, heritabilities were not calculated for IgM and are assumed to be zero. PMID- 2773298 TI - Specific antibody response in porcine respiratory tract secretion following intraperitoneal immunization. AB - Experiments were conducted to determine whether intraperitoneal (IP) immunization and subsequent intratracheal (IT) challenge were able to augment the specific antibody response in secretions of the porcine respiratory tract. Following IP immunization and two IT challenges within a period of 18 days the specific IgG and IgA antibody response was elevated in respiratory tract secretions and serum. While a portion of the anti-ovalbumin (OVA) IgG in respiratory tract secretions was generated locally, it would appear that the bulk of anti-OVA IgA was derived from serum. PMID- 2773297 TI - Incidence and characterization of canine rheumatoid factor. AB - Rheumatoid factor (RF) was found in titers greater than 1:8 in 72.2% of cases of classical or definite canine rheumatoid arthritis (RA) and in 5.9% or normal sera. Serum fractionation and immunoabsorbant studies that much of the RF present was IgG, although activity was demonstrated in all 3 major immunoglobulin classes. Evidence of involvement of both IgG and IgM to form complexes of varying sizes was obtained. PMID- 2773299 TI - Identification of the antigenic components of the virulent Mycoplasma gallisepticum (R) in chickens: their role in differentiation from the vaccine strain (F). AB - The antibody response to different proteins of Mycoplasma gallisepticum (MG) was studied in chickens experimentally infected with virulent MG R strain. The chickens were challenged at 8 weeks of age by the intranasal route. Each cockerel received 1.3 X 10(6) colony-forming units (CFU). MG strains (R and F) were banded by Sodium Dodecyl Sulfate-Polyacrylamide Gel Electrophoresis (SDS-PAGE). The banding pattern was distinctively different between the two strains in the range of 92.5 to 200 kilodaltons (kD). Chicken sera collected at different times following challenge were analyzed by Western blot to determine the patterns of antibodies raised to specific MG proteins (R versus F strains). Early in infection (2 weeks postchallenge), antibodies to 60-kD and 75-kD polypeptides of MG R strain were produced. Subsequently (greater than or equal to 4 weeks postchallenge), antibodies recognized a larger number of MG antigens in both strains. The immunoblot patterns remained the same in the period 8-11 weeks postinfection in each of the two strains; however, the patterns were different when the two strains were compared. The early response recognized the 75-kD protein in the R strain while it recognized the 80-kD protein in the F strain. The late response recognized the 130-kD protein and the protein slightly heavier than 200 kD in the R strain. These two bands did not appear in the immunoblot performed against the F strain of MG. Electroeluted protein of MG R strain, namely adhesin (75 kD), showed a hemagglutination activity (HA) on chicken red blood cells. With the appearance of antibodies specific to the 60-kD and 75-kD polypeptides, there was a significant rise in hemagglutination-inhibition geometric mean titer of chicken sera. PMID- 2773300 TI - Evaluation of a delayed-type hypersensitivity test for the diagnosis of Brucella abortus infection in cattle. AB - The delayed-type hypersensitivity (DTH) test was used to diagnose brucellosis in two cows experimentally induced with brucellosis, and 176 dairy cows from a farm suspected of brucellosis. DTH test results were compared with results of the milk ring test, the serum agglutination test, the complement fixation test and the Coombs test. Cows positive in the DTH test and in one of the other tests were examined bacteriologically. In experimentally infected animals the DTH test was positive 10 days after infection, 1-4 weeks before serologic tests indicated brucellosis. Although the DTH test was positive during the whole experiment, on the one occasion when serologic titres were high, it was negative. Of the 176 dairy cows, 45 were positive in one or more serologic tests. In twelve cows (29%) the diagnosis was inconclusive because they were positive in only one of the serologic tests. In these cases the DTH test confirmed the infection. Three cows with high serologic response tested negative in the DTH test. B. abortus was isolated from 13 of 15 cows examined. We conclude that when serologic results are ambiguous, the DTH test is a useful additional technique for diagnosing brucellosis. PMID- 2773302 TI - The effects of butyrate and glucagon on the proliferation of ruminal epithelial cells in culture. AB - When the rate of ruminal epithelial cell proliferation was measured on the basis of 3H-thymidine incorporation into the cellular DNA, butyrate dose-dependently reduced 3H-thymidine incorporation. In contrast, glucagon at 10 and 100 pg/ml had a slight stimulatory effect on the incorporation, but only in the absence of butyrate. PMID- 2773301 TI - Pharmacokinetic data on doxycycline and its distribution in different biological fluids in female goats. AB - A pharmacokinetic study of doxycycline after intravenous administration at 5 mg/kg body weight in goats revealed that a concentration of greater than or equal to 0.5 microgram/ml was maintained for 5 min-2 h, 4-12 h, 2-12 h and 5 min greater than 48 h in plasma, interstitial fluid, milk and urine respectively. The low t1/2 alpha of 0.73 +/- 0.11 h and high t1/2 beta of 16.63 +/- 1.58 h show that the drug is rapidly distributed but slowly eliminated from the body. The tissue:plasma concentration of 4.86 +/- 1.06 during the elimination phase [K12/(K21-beta)] indicates a high expected tissue concentration, which is supported by similarly increased drug concentration in interstitial fluid and milk. The high Vdarea of 9.78 +/- 0.86 L/kg observed denotes that, apart from its wide distribution, the drug may be stored in fat depots as it is known to be highly lipophilic. As the drug maintained a therapeutic concentration for a shorter time in plasma, and the calculated dose rate for maintaining a minimal plasma concentration of 0.5-1.5 micrograms/ml is relatively high, it may not be of much use in treating septicaemia in this species. Since the observed tissue:plasma concentration was higher and a therapeutic concentration was maintained in interstitial fluid and milk for longer, the drug can be used for other systemic infections at a lower dose rate than that required for treating septicaemia. As the drug maintained a very high concentration in urine, it may be of particular value in treating urinary tract infections caused by sensitive micro-organisms. PMID- 2773303 TI - Estimation of body weight in Indian elephants (Elephas maximus indicus). AB - Thirty-nine adult Indian elephants (Elephas maximus indicus) of both sexes and various ages and weights, belonging to the Forest Department of the Government of Kerala (India), Temple Devaswoms, Gemini Circus and other private agencies, were used to derive formulae to predict body weight and height from body measurements. Several models were fitted separately for males and females and also for adults irrespective of sex. The best prediction of body weight (W) in kg was obtained for adults irrespective of sex by using two parameters, the body length (L) in cm from the base of the forehead to the base of the tail, and the chest girth (G) in the formula W = -1010 + 0.036 (L x G). No single parameter gave as accurate a prediction of the body weight, and the inclusion of height as a third parameter did not improve the prediction. No significant improvement in the accuracy of prediction resulted from the use of different formulae for males and females. An equation to predict the height at the shoulders (H) in cm from the right forefoot circumference (C) in cm in adult elephants irrespective of sex was also derived. This was H = -1.60 + 1.99 C. PMID- 2773305 TI - The influence of watering practices on the transmission of Fasciola among sheep in the Ethiopian highlands. AB - As many ewes and lambs watered at concrete ponds in well-drained sites acquired fluke infection as those watered at natural ponds in areas suitable for the snail intermediate hosts of Fasciola hepatica. Fasciola transmission, as evidenced by the increasing number of seropositive hosts in an enzyme-linked immunosorbent assay (ELISA), occurred during the heavy rainy period of July-September and declined with the onset of the dry season, being succeeded by the emergence of faecal positive hosts. This indicates the superiority of ELISA over coprological techniques in the early diagnosis and seroepidemiology of this parasitic infection. Host productivity, as reflected in weight gains and haematological parameters, was not significantly affected by the fluke infections. PMID- 2773304 TI - Antithrombin III activity (residual thrombin activity) in plasma from non medicated or heparinized horses. AB - Two synthetic substrate assays (fluorometric and chromogenic) were used to measure antithrombin-III (AT-III) activity (residual thrombin activity) in non medicated and heparin (sodium) treated horses. In 18 non-medicated horses the fluorometric substrate assay (FSA) values were similar to previous reports but they reflected inconsistent trends and larger deviations in the heparin-treated groups (Group 2: 40 and 100 U/kg IV, n = 6; Group 3: 240 U/kg IV, n = 5; Group 4: 80 U/kg IV followed by 160 U/kg SC, n = 8) when compared to the chromogenic substrate assay (CSA) values. The CSA values for the 18 non-medicated horses indicated a higher AT-III activity (lower residual thrombin activity) than the FSA. AT-III activity was quantified in 18 non-medicated horses (29 mg/dl) and compared well with values for humans (30 mg/dl) and dogs (40 mg/dl). Plasma heparin concentrations, determined by the FSA, correlated well with the 'therapeutic range' (1.5 fold to 2.5 fold prolongation of the activated partial thromboplastin time (APTT) normal value) and values reported for humans. The effect of heparin therapy on AT-III activity in four treatment regimens was evaluated. AT-III activity was not significantly affected (with one exception) by a single dose of intravenous (IV) heparin (40 and 100 U/kg) nor by repeated subcutaneous (SC) injections of heparin (240 U/kg). A transient increase in residual thrombin activity was measured 12 h after an intravenous (80 U/kg) injection of heparin. Large doses of heparin (80 U/kg IV followed by 160 U/kg SC) given every 12 h produced a progressive prolongation of the APTT. In this group the APTT remained prolonged 48 h after the last treatment. PMID- 2773306 TI - The effect of handling methods on subsequent plasma progesterone levels in sheep. AB - The mean progesterone concentration in the plasma of 10 adult Ethiopian Highland sheep obtained immediately after slaughter was 10.56 +/- 3.98 ng/ml. Samples were subsequently incubated at 4 degrees C, room temperature (19-22 degrees C) or 26 degrees C as either plasma or intact but citrated blood. Failure to separate plasma affected the progesterone content at 2-72 h at room temperature or 26 degrees C (p less than 0.01 - p less than 0.0001). Incubation temperature affected the plasma concentration at 18 h (p less than 0.05) and 24 h (p less than 0.001). Although progesterone values were generally higher in separated plasma, disparity with the values from plasma separated from incubated citrated blood was small (r = 0.76-0.98). Progesterone concentration declined haphazardly after collection but sometimes exceeded the initial readings. This kept the average concentration of progesterone in plasma separated immediately after collection fairly constant and within 15% of zero time samples during the first 48 h. PMID- 2773307 TI - Development and survival of free-living stages of gastrointestinal nematodes of sheep and goats on pasture in the Nigerian derived savanna. AB - Four grass plots were sequentially contaminated with goat faeces containing known numbers of unembryonated eggs of predominantly Haemonchus contortus and Trichostrongylus spp. between October 1982 and April 1983. Four other plots were similarly contaminated with sheep faeces between February and May 1987. An additional plot was repeatedly contaminated with sheep faeces from February to April 1987. Populations of free-living stages in faeces and of infective larvae (L3) in the herbage were subsequently monitored until the end of April and June of 1983 and 1987 respectively. During February and May 1987 two control cultures of sheep faeces were incubated in the laboratory at 25 degrees C-30 degrees C and at a constant temperature of 50 degrees C and the free-living development was also monitored. L3 developed very readily in the faeces cultured at 25 degrees C 30 degrees C and in those spread on a grass plot in October, at the end of the wet season, but developed less on the plot contaminated in May at the start of the wet season. Worm eggs in faeces deposited on plots during the hot dry season (December to April) or incubated at 50 degrees C died and disintegrated after 24 48 h exposure to the high environmental temperatures. The results indicate that it is unlikely that gastrointestinal nematodes of sheep and goats can develop or survive on open pasture during the dry season in the Nigerian derived savanna zone. PMID- 2773308 TI - Comparative studies on the effect of fenbendazole on the liver and liver microsomal enzymes in goats, quail and rats. AB - To compare the effect of fenbendazole on the liver and liver microsomal mono oxygenases of goats, quail and rats, an oral dose of 25 mg/kg was administered to the animals daily for 9 consecutive days. On the tenth day, blood samples and livers were collected from both the control and the treated animals for preparation of serum and microsomes respectively. Determination of the activities of sorbitol dehydrogenase (SDH, alanine aminotransferase (ALT) and aspartate aminotransferase (AST) in the serum samples showed that there was no significant increase in the activities of these enzymes in the treated animals as compared to their corresponding controls, suggesting no liver damage. Similarly, no significant difference in the amount of microsomal cytochrome P-450 was found between the control and the treated animals of the same species. Compared to their respective controls, the activities of microsomal benzphetamine N demethylase and aniline hydroxylase were almost unchanged in the treated goats and rats. However, fenbendazole treatment appeared to enhance the activity of these two microsomal enzymes in quail. The results indicate that fenbendazole is not liver toxic to goats, quail or rats at a dose rate of 25 mg/kg. PMID- 2773309 TI - Serological evidence for influenza virus activity in Nigeria (1985-1987). AB - A study to determine the activity of influenza virus among the children population was undertaken between 1985 and 1987 in Nigeria. Paired sera were obtained from children presenting with respiratory diseases at the children emergency and outpatient clinics of the University College Hospital, Ibadan. Forty-two paired sera were examined by haemagglutination-inhibition test to determine HI antibody level of the patients to different serotypes of influenza virus. Ninety percent of the children showed serological evidence of previous contact with influenza A virus subtypes while only 24% were positive when tested against influenza B virus. Twenty-two of the 42 children tested seroconverted to influenza A virus strains while only 2 seroconverted to influenza B virus strain used. Out of the 22 children that seroconverted to influenza A virus, 14 were due to H3N2 A/Mississippi 1/85, 4 to H3N2 A/Leningrad 360/86 and 2 each seroconverted to H1N1 A/Chile 1/83 and H1N1 A/Taiwan 1/180. Two other individuals showed serological conversion to either H3N2 A/Mississippi 1/85 and H1N1 A/Chile 1/83 or H3N2 A/Mississippi 1/85 and H1N1 A/Taiwan 1/86. While cases were seen throughout the year during the period under review, more cases occurred during early (April May) to peak raining season (September) and during harmattan period (November) in Ibadan area where the study was conducted. It is evident from this study that continuous and synchronous circulation of influenza viruses occur in this environment. There is therefore danger of influenza epidemic under depressed immunity and if the virus is introduced into population with low level of immunity in other parts of the country. PMID- 2773310 TI - Molecular hybridization with DNA probes as a laboratory diagnosis test for influenza viruses: further investigations on the possibilities of the method. AB - The possibilities of the molecular hybridization test, i.e. test, i.e. using neuraminidase probes of different subtypes for subtype specific detection of influenza, as well as different probes (PA, M, NP) for type A specific detection of influenza viruses in infected cells were shown. The results of molecular hybridization in washings' analyses from patients during the outbreaks give us an opportunity to make some conclusions about the usefulness of the method in epidemic control of influenza morbidity. PMID- 2773312 TI - Studies on Tanapox virus. AB - Virus characterization studies were performed to meliorate the taxonomic status of three currently unclassified, serologically related viruses: Tanapox virus (causes vesicular skin lesions in humans), Yaba-like disease (YLD) virus (causes vesicular skin lesions in monkeys), and Yaba monkey tumor virus (YMTV, causes epidermal histiocytoma). These studies included (1) microscopic observations of Tanapox virus cytopathic effect and morphogenesis during its 6-day cytolytic-type growth at 35 degrees in CV-1 monkey kidney cells; (2) resolution of Tanapox virion proteins by sodium dodecyl sulfate-polyacrylamide gel electrophoresis of nonenveloped and double-enveloped virus particles purified by velocity sedimentation in sucrose and CsCl density gradients; and (3) restriction endonuclease DNA comparison of the three viruses. DNA analysis showed that six recent Tanapox virus isolates from patients in Zaire, Africa, were identical to Tanapox virus, Kenya strain, from 1957 from a patient in the Tana River Valley. In addition, BamHI, MluI, and PstI cleavage sites mapped on the DNA of Kenya Tanapox virus, and PstI sites mapped on DNA of YLD virus differentiated YLD and Tanapox viruses as separate strains. On the other hand, YMTV shared few restriction endonuclease sites with Tanapox and YLD viruses, although all three cross-hybridized extensively. These studies along with published viral characteristics, support the formation of a new poxvirus genus: the suggested name is Yatapoxvirus, and the genus currently comprises two species, Tanapox virus and YMTV. PMID- 2773311 TI - Investigations on the role of some viral, chlamydian, rickettsian and mycoplasmic agents in several gynecological diseases. AB - This work presents the results of a study on some viral, chlamydial, rickettsial and mycoplasmal agents incidence and their role on several gynecological ailments: vulvovaginitis, cervicitis, cervicovaginitis. The presence of some viral, chlamydial, rickettsial and mycoplasmal antigens in the vaginal secretion was investigated by immunofluorescence technique, isolation on selective media for Mycoplasma, and MGG staining in a group of 60 women with gynecopathies (group A) and in a control group (also 60 clinically healthy women) (group B). This study pointed out to higher incidence of chlamydial and mycoplasma antigens as well as of parainfluenza virus types I and III, adenovirus and herpes virus type II in group A. The serological screening revealed significant differences between the specific antibodies to antigens found in vaginal secretions to prove the presence of an immunological response on the same category of subjects. PMID- 2773313 TI - Antigenic and genetic characterization of three influenza C strains isolated in the Kinki district of Japan in 1982-1983. AB - Three strains of influenza C virus (C/Kyoto/41/82, C/Nara/82, C/Hyogo/1/83) have been isolated from humans in the Kinki district of Japan between February 1982 and December 1983. Oligonucleotide mapping of total vRNA and antigenic analysis with anti-HE monoclonal antibodies have shown previously that they are closely similar to one another but dissimilar to any of the strains isolated in Japan before 1982. In the present study, the nucleotide sequences of the hemagglutinin esterase (HE) genes of these three strains were determined and compared with those of the previously published strains. The results revealed that the Kinki isolates had a high nucleotide sequence homology (98.4-98.5%) with the virus isolated in 1980 in the United States (C/Mississippi/1/80). Similarity of the Kinki strains to C/Mississippi/1/80 was also confirmed by oligonucleotide mapping of total vRNA and antigenic comparison using a panel of 11 anti-HE monoclonal antibodies. The isolates from Kinki and Mississippi could be distinguished from the previously isolated strains in serological tests with heterogeneous sera, suggesting that they may have possessed epidemiological advantage in Japan around 1982-1983. These observations raise the possibility that the rapid spread of influenza C variant closely related to C/Mississippi/1/80 has occurred in Kinki in 1982-1983 presumably because this imported virus was largely different in antigenicity from the previously prevalent ones. PMID- 2773314 TI - Sequence characterization of the adenovirus 40 fiber gene. AB - The fiber gene of human adenovirus type 40 has been characterized. The 6.1-kbp EcoRI fragment C of the Ad40 genome, from map units 74 through 92, was cloned and the right-most 2.8 kbp from 84 map units was sequenced. By analogy with Ad2, this region would be expected to contain the gene specifying the Ad40 fiber polypeptide. Sequencing revealed an open reading frame of 1641 bases on the r strand, the first 53 bases of which had marked homology with the corresponding L5 (fiber) regions of Ad2 (77.2%), Ad5 (75.0%), and Ad3 (64.3%). In addition, base positions 1114 to 1146 of this open reading frame had 85% homology with base positions 1198 to 1230 of the Ad2 fiber gene. The predicted polypeptide sequence of 547 amino acids showed marked homology with the Ad2, Ad5, and Ad3 fiber polypeptides in two regions, in the first 55 amino acids from the N-terminus and from amino acids 372 through 382. Analysis of hydrophobic amino acid positions revealed a repeating pattern of approximately 15 residues between positions 42 and 374, with 21 repeats. The sequence of the Ad40 polypeptide thus fits the model of Green et al. [1983), EMBO J. 2, 1357-1365) for the structure of the adenovirus fiber, but is 35 amino acids shorter than the Ad2 fiber polypeptide, with one less 15-residue repeat in the shaft region. According to this model, the regions of highest homology between the Ad40 fiber polypeptide and those of Ad2, Ad5, and Ad3 correspond to the tail of the shaft and the base of the knob. The results of this analysis are in agreement with previously published EM data on the fiber length of subgroup F adenoviruses. PMID- 2773315 TI - Antigenic and molecular characterization of subtype H13 hemagglutinin of influenza virus. AB - Influenza A viruses with subtype H13 hemagglutinin display an unusual host range. Although common in shorebirds, they are very rare or absent in wild ducks; additionally, H13 viruses have been isolated from a whale. To study the molecular basis for this host range, we have determined the complete nucleotide sequences of the hemagglutinin genes of three H13 influenza viruses from different species or geographical areas: A/gull/Maryland/77, A/gull/Astrachan (USSR)/84, and A/pilot whale/Maine/84. Based on the deduced amino acid sequences, H13 hemagglutinin shares the basic structure of other type A hemagglutinin subtypes such as H3, but has clearly diverged from other completely sequenced subtypes. Unique features of H13 hemagglutinin include the occurrence, near the receptor binding pocket, of residues Arg/Lys-227 and Trp-229 (H3 numbering); the significance of these are unknown. The sequence of the HA1-HA2 cleavage site resembles those of avirulent avian influenza viruses. The whale H13 hemagglutinin is similar to those from gulls, supporting the hypothesis that influenza viruses from avian sources can enter marine mammal populations but are probably not permanently maintained there. Antigenic analysis using a panel of monoclonal antibodies suggests that, like other subtypes, H13 viruses are heterogeneous, with different antigenic variants predominating in the eastern versus the western hemispheres. PMID- 2773316 TI - The expression, localization, and effect of a human interferon in plants. AB - The ORF II of Cauliflower mosaic virus (CaMV) DNA was replaced with the human IFN alpha D coding sequence to yield a stable CaMV strain designated Ca524i. Inoculation of turnip (Brassica rapa cv "Just Right") with strain Ca524i DNA excised from plasmid pCa524i resulted in the production of biologically active IFN alpha D in infected plants. This was also true for its mutant (Ca562i) where one of the CYS codons was deleted. IFN alpha D produced in planta did not hamper superinfection with a single-stranded (+) sense RNA plant virus, turnip yellow mosaic virus (TYMV). Antibody gold labeling techniques and electron microscopy of infected plants showed that IFN was localized in the CaMV inclusion bodies. PMID- 2773317 TI - Inhibition of proteolytic activation of influenza virus hemagglutinin by specific peptidyl chloroalkyl ketones. AB - Lysates of cultured cells have been analyzed for arginine-specific endoproteases using peptidyl-p-nitroanilides as chromogenic substrates. The enzymes present in MDBK, MDCK, VERO, BHK, and chick embryo cells required lysine-arginine or arginine-arginine pairs as cleavage sites, whereas chorioallantoic membrane cells contained, in addition, an activity that could cleave at a single arginine. The effect of peptidyl chloroalkyl ketones on the activation of the fowl plague virus hemagglutinin by the proteases specific for paired basic residues has been investigated. When virions containing uncleaved hemagglutinin were incubated with lysates of uninfected cells, cleavage was completely inhibited by peptidyl chloroalkyl ketones containing paired basic residues at a concentration of 1 mM. In contrast a compound containing a single arginine had no inhibitory activity. When dibasic peptidyl chloroalkyl ketones were added to infected cell cultures, cleavage of hemagglutinin and multiple cycles of virus replication were inhibited at 10 mM. However, a 100- to 200-fold increase of the inhibitory activity in intact cells could be achieved by N-terminal acylation. These studies suggest a potential role of peptidyl chloroalkyl ketones as antiviral agents. PMID- 2773318 TI - Inhibition of an inflammatory response is mediated by a 38-kDa protein of cowpox virus. AB - The Brighton Red (BR) strain of cowpox virus induces a flat, bright red pock on the chorioallantoic membrane (CAM) of the 12-day-old chick embryo. In contrast, mutants with a deleted 38K gene (which is located 31 to 32 kb from the right-hand end of the virus genome) induced a raised, white, and opaque pock. During the first 24-hr p.i., both CPV-BR and the 38K deletion mutants replicated similarly in the CAM of the chick embryo, as indicated by immunocytochemical detection of similar amounts of virus antigen. By 48 hr p.i., the pocks induced by the mutant and CPV-BR are strikingly different. The pocks induced by the 38K deletion mutants were infiltrated by large numbers of heterophils and macrophages, which correlated with a reduction in the levels of virus antigen and virus infectivity. The CPV-BR pock had an absence of inflammatory cells and increased levels of virus antigen and infectivity. By 72 hr p.i., many of the pocks induced by the mutant were undergoing resolution of the virus infection, as indicated by further decrease of virus antigen and visible signs of healing, whereas CPV-BR pocks continued to be a site of active viral replication. These data are consistent with a model where this 38-kDa protein directly or indirectly inhibits the generation of chemotactic molecules which are elicited during virus replication in the CAM or, alternatively, blocks the interaction of these molecules with cells of the host inflammatory response. PMID- 2773320 TI - In vitro synthesis of biologically active beet necrotic yellow vein virus RNA. AB - Beet necrotic yellow vein virus (BNYVV) has a quadripartite plus-strand RNA genome in which the two smallest genome components, RNA 3 and 4, are not necessary for virus multiplication in leaves. Infectious transcripts of BNYVV RNA 3 and 4 have already been described (V. Ziegler-Graff, S. Bouzoubaa, I. Jupin, H. Guilley, G. Jonard, and K. Richards (1988) J. Gen. Virol. 69, 2347-2357). In this paper we describe synthesis of a full-length RNA-1 transcript by bacteriophage T7 RNA polymerase-directed run-off transcription of cloned viral cDNA. A recombinant plasmid containing a full-length cDNA insert of RNA 2 could not be maintained in Escherichia coli. Therefore full-length transcript of RNA 2 was produced by transcription of cDNA ligation products without amplification in bacteria. When inoculated together to leaves of Chenopodium quinoa or Tetragonia expansa the RNA 1 and 2 transcripts were infectious; they also supported multiplication of the BNYVV RNA 3 and 4 transcripts, providing a totally synthetic inoculum of the virus. In one recombinant clone of RNA 2 a point mutation causing an arginine to serine substitution at position 119 of the viral coat protein was discovered. The mutation was detected because the resulting coat protein had altered electrophoretic mobility. RNA 2 transcripts containing this mutation were infectious but viral RNA was not encapsidated. The mutation also interfered with long distance movement of the virus in spinach, presumably as a consequence of the packaging deficiency. PMID- 2773319 TI - A tobacco mosaic virus-hybrid expresses and loses an added gene. AB - An additional open reading frame from the chloramphenicol acetyltransferase (CAT) gene was fused behind a tobacco mosaic virus (TMV) subgenomic RNA promoter and inserted into different positions in the complete TMV genome to examine how much this viral genome can be altered with continued replication. One hybrid virus, CAT-CP, with the insertion between the 30K and coat protein genes, replicated efficiently, produced an additional subgenomic RNA and CAT activity, and assembled into 350-nm virions, compared to 300-nm virions of wild-type TMV. However, during systemic infection of plants, the inserted sequences were deleted. This deletion was exact, resulting in progeny wild-type TMV. Another hybrid virus examined was CP-CAT, which had the insertion between the coat protein gene and the nontranslated 3' region. This virus replicated poorly, produced only minimal levels of CAT activity, and did not systemically invade infected plants. These data show that some extensive modifications of the TMV genome still allow efficient virus replication. PMID- 2773321 TI - Identification of the initiation codons for translation of cowpea mosaic virus middle component RNA using site-directed mutagenesis of an infectious cDNA clone. AB - A full-length cDNA copy of CPMV M RNA has been cloned downstream of a phage lambda promoter in the plasmid pPMI. Transcripts obtained from this clone can be translated in vitro and replicated in cowpea mesophyll protoplasts in the presence of viral B RNA. We have constructed a series of site-directed mutants of this clone to investigate the mechanism of translation of CPMV M RNA. The results obtained confirm that the AUG at position 161 is used to direct the synthesis of a 105K protein in vitro and the detection of a 58K protein in infected cowpea protoplasts suggests that it is also used in vivo. The synthesis of the 95K protein can be initiated from either of the AUGs at positions 512 and 524, though synthesis of this protein does not appear to be essential for CPMV replication in protoplasts. PMID- 2773322 TI - Characterization of the repetitive DNA elements in the genome of fish lymphocystis disease viruses. AB - The complete DNA nucleotide sequence of the repetitive DNA elements in the genome of fish lymphocystis disease virus (FLDV) isolated from two different species (flounder and dab) was determined. The size of these repetitive DNA elements was found to be 1413 bp which corresponds to the DNA sequences of the 5' terminus of the EcoRI DNA fragment B (0.034 to 0.052 m.u.) and to the EcoRI DNA fragment M (0.718 to 0.736 m.u.) of the FLDV genome causing lymphocystis disease in flounder and plaice. The degree of DNA nucleotide homology between both regions was found to be 99%. The repetitive DNA element in the genome of FLDV isolated from other fish species (dab) was identified and is located within the EcoRI DNA fragment B and J of the viral genome. The DNA nucleotide sequence of one duplicate of this repetition (EcoRI DNA fragment J) was determined (1410 bp) and compared to the DNA nucleotide sequences of the repetitive DNA elements of the genome of FLDV isolated from flounder. It was found that the repetitive DNA elements of the genome of FLDV derived from two different fish species are highly conserved and possess a degree of DNA sequence homology of 94%. The DNA sequences of each strand of the individual repetitive element possess one open reading frame. PMID- 2773323 TI - Sequence of cowpea chlorotic mottle virus RNAs 2 and 3 and evidence of a recombination event during bromovirus evolution. AB - The genomic sequence of cowpea chlorotic mottle virus (CCMV) was completed by sequencing biologically active cDNA clones of CCMV RNA2 (2774 bases) and RNA3 (2173 bases). While only the central core of the encoded 94-kDa CCMV 2a protein contains features conserved among known and putative RNA replication proteins from many viruses, both flanking regions of CCMV 2a show substantial similarity to the corresponding protein of the related brome mosaic virus (BMV). The 3a proteins of CCMV and BMV, implicated as contributors to the distinct host specificities of the two viruses, show lower levels of conservation but are still discernibly related throughout. Major differences occur in the organization of noncoding sequences in CCMV and BMV RNA3. With respect to an otherwise similar region preceding the BMV 3a gene, the CCMV RNA3 5' noncoding sequence contains a clearly bounded 111-base insertion that must reflect a sequence rearrangement in evolution of at least one of the two viruses. The presence of a subgenomic promoter-like sequence near the end of the novel CCMV sequence makes the organization of genes in CCMV RNA3 reminiscent of the 3' end of tobacco mosaic virus RNA, suggesting that CCMV or its 3a gene might have been derived from an ancestor with fewer genomic RNAs. Sequence similarities between the CCMV and BMV RNA3 intercistronic regions include the subgenomic mRNA promoter and an oligo(A), but not an intercistronic segment required for BMV RNA3 amplification, implying that replication signals on the two RNA3s may be organized quite differently. PMID- 2773325 TI - Evidence that nucleocapsid disassembly and a later step in virus replication are inhibited in transgenic tobacco protoplasts expressing TMV coat protein. AB - Tobacco mosaic virus (TMV)-like pseudovirus particles containing mRNA for Escherichia coli beta-glucuronidase (GUS) were electroporated into mesophyll protoplasts from control or TMV coat protein (CP)-transgenic tobacco (Nicotiana tabacum cv. Xanthi). GUS-particles were expressed 100-fold less efficiently in CP transformed than in control protoplasts whereas unencapsidated GUS mRNA was expressed only 2.8-fold less efficiently. Lower transient expression of packaged GUS mRNA is probably due to inhibited disassembly of nucleocapsids in CP transgenic protoplasts. Control and U1 CP-transformed protoplasts are equally susceptible to infection by cowpea strain TMV (Cc), as well as unencapsidated Cc or U1 RNA. In contrast, native or in vitro reconstituted U1 TMV particles result in 5- to 6-fold fewer infected CP-transgenic than control protoplasts. When Cc RNA was transcapsidated in U1 CP in vitro, the hybrid virions were equally infectious in both classes of protoplasts. We conclude that although compatible U1 protein-protein interactions significantly inhibit (GUS) nucleocapsid disassembly in CP-transgenic protoplasts, the endogenous CP must also interfere with a later stage of infection involving the homologous viral RNA. PMID- 2773324 TI - A capripoxvirus pseudogene whose only intact homologs are in other poxvirus genomes. AB - Equivalent regions from within the inverted terminal repeats (ITRs) of the genomes of two capripoxviruses, KS-1 and InS-1, were sequenced. The sequence from KS-1 DNA covers the major part of three contiguous open reading frames (ORFs), which match three contiguous ORFs from within the genomic ITRs of the leporipoxvirus Shope Fibroma Virus (SFV). The sequenced region of InS-1 DNA contains only two of the three ORFs. The region homologous to the third ORF has no coding potential due to the presence of several stop codons, resulting from small frameshifting deletions and insertions. The significance of a degenerate poxvirus gene, intact homologs of which are only found in other poxvirus genomes, is discussed. PMID- 2773326 TI - Sequence variation of the P gene among mumps virus strains. AB - We have determined nucleotide sequences of a 183-nucleotide long region of the P gene of 10 mumps virus strains after gene amplification mediated by DNA polymerase catalyzed chain reaction (PCR) and have compared them with those of two strains which had been reported earlier (K. Takeuchi et al., J. Gen. Virol., 69, 2043-2049 (1988]. It was shown that mutation is generally noncumulative, i.e., most nucleotide substitutions in earlier strains do not appear in later strains. Viruses of different lineages appeared to cocirculate, but the comparison of American and Japanese strains suggested that those isolated in one country are more closely related to each other than to those isolated in the other country. PMID- 2773327 TI - The alpha-anomeric form of sialic acid is the minimal receptor determinant recognized by reovirus. AB - A series of synthetic sialosides were evaluated for their ability to interact with reovirus serotype 3. It was found that sialosides with terminal N acetylneuraminic acid (NeuNAc) linked in either an alpha 2,3 or alpha 2,6 configuration effectively blocked the binding of reovirus to mouse L fibroblasts, in contrast to a monosaccharide mixture containing the oligosaccharide constituents. Direct binding of reovirus to the sialosides was also demonstrable using sialosides conjugated to bovine serum albumin as ligands in a solid phase binding system. Of particular significance was the finding that the conjugate containing alpha-sialic acid alone (linked to bovine serum albumin) was capable of being recognized by reovirus at a level comparable to that of the other sialoside conjugates. Virus binding was abrogated by pretreating such conjugates with neuraminidase. These results suggest that the alpha-anomeric form of sialic acid is the minimal receptor determinant for reovirus recognition. PMID- 2773328 TI - Psychophysically derived visual mechanisms in turtle. II--Spatial properties. AB - Visual mechanisms isolated in Pseudemys by the two-color threshold technique of Stiles show peak wavelength sensitivities at 650 nm (red light) and 540 nm (green light). Ricco critical areas were measured for the two test wavelengths under three conditions: dark, moderate and intense backgrounds. As expected, critical spatial areas decreased with light adaptation. Under dark adaptation only rods and red-sensitive cones were operative, and one photon per 12 rods was sufficient for green-light threshold, as was one photon per four red-sensitive cones for red light threshold. Rods apparently pool their information among the several receptors within the threshold area. Under light adaptation, rods were not functional and thresholds were determined by red-sensitive and green-sensitive cones alone. Cones did not share information over many receptors, requiring close to one photon per receptor to function at threshold. PMID- 2773329 TI - The relative numbers of long-wavelength-sensitive to middle-wavelength-sensitive cones in the human fovea centralis. AB - The determination of the relative numbers of different cone types in the human retina is fundamental to our understanding of visual sensitivity and color vision; yet direct measurement which provide this basic information have not previously been made for all cone types. Here we present a model which links the detection of a test light of small dimension to the number of cones contributing to detection of the light. We selectively isolated either the long-wavelength sensitive (L) or the middle-wavelength-sensitive (M) cones, by choosing combinations of wavelengths of adapting backgrounds and tests to favor detection by the cone class of interest. Our model was applied to the detection functions measured for six color normal observers to obtain estimates of the relative numbers of L to M cones. Our estimates ranged between 1.46 and 2.36 for our observers with a mean value near two L cones for every M cone in human fovea centralis. PMID- 2773330 TI - Contrast, spatial frequency and test duration effects on the tilt aftereffect: implications for underlying mechanisms. AB - The tilt aftereffect (TAE) was measured with a forced-choice technique for gratings of different spatial frequencies, contrasts and adapting and test durations. At short test durations, a 2 c/deg grating gave a larger TAE than a 10 c/deg, while at long test durations the opposite occurred. Low contrast gratings tended to give smaller TAEs at short test durations, and larger TAEs at long durations, than high contrast. A longer adapting duration tended to produce larger TAEs at low contrast for any test duration, but larger TAEs at high contrast only at long test durations. We suggest that the spatial frequency effect reflects differential excitation by the test stimuli of transient and sustained channels, and that the contrast effects reflect both a non-linearity in the relationship between excitation and inhibition, and the adapting effects of the test grating. PMID- 2773331 TI - Contrast modulated maskers: test of a late nonlinearity hypothesis. AB - The contrast threshold for detecting a low frequency test grating in the presence of a contrast-modulated high frequency masker is heavily dependent upon the phase relations between the gratings: test stimuli in + or - cosine phase are much more detectable than those in + or -sine phase. The present study tests a new hypothesis of these and related phenomena. It is based on the report by Derrington (1987) that recordings from cat geniculate on-center and off-center X cells exhibit significant point nonlinearities. The major empirical finding of this study is that for highly practiced observers, sine-phase test stimuli and cosine-phase test stimuli are similar in two important respects: (1) there exist phase uncertainty effects; that is, detection thresholds for test stimuli differing in phase by 180 degrees are elevated when they are intermixed within the same block of trials, rather than being presented in separate blocks; (2) phase identification thresholds for test stimuli differing in phase by 180 degrees are the same as their detection thresholds. The new nonlinearity hypothesis cannot account for the results obtained with sine-phase test stimuli, though it gives a better account of the results with cosine-phase stimuli than does the early nonlinearity hypothesis which was tested and rejected by Nachmias and Rogowitz (1983). PMID- 2773332 TI - The role of subjective contours in capture of stereopsis. PMID- 2773333 TI - Motion components of VEPs to the waggon wheel effect. AB - Visual evoked potentials (VEPs) from eight subjects are presented from scalp sites O1, O2, T5, T6, P3 and P4. A spoked wheel was illuminated by a constantly flashing strobe. By adjusting the real angular speed of the wheel the subjective impression was given of; a stationary wheel, a wheel spinning slowly or spinning rapidly clockwise. Two visually identified components, a negativity and a positivity, were found to be of larger amplitude in response to motion. The results were interpreted as consistent with a model of AM proposing motion information to be processed within the visual system. PMID- 2773334 TI - Binocular beats: psychophysical studies of binocular interaction in normal and stereoblind humans. AB - We describe a psychophysical method for assessing binocular integration using dichoptically-presented uniform fields. By temporally modulating uniform field luminances at different frequencies between the eyes, a rhythmic beat is produced -a visual percept characterized by undulations in luminance at a frequency equal to the arithmetic difference between the two monocular stimulus frequencies. Using a signal detection paradigm, we studied the beat as a function of modulation depth in normal and binocularly deficient subjects. Normal subjects easily detected the beat, even at low modulation depths, while stereoblind subjects (with stereoacuity worse than 2000 sec arc) failed to detect beats at any modulation depth or with any combination of stimulus frequencies tested. The beat provides evidence for the confluence of monocular signals into binocular integrating mechanisms. Our results therefore suggest that the status of functioning binocular mechanisms is related to the detectability of the beat. This uniform-field stimulus does not require accurate accommodation, fixation, vergence or high spatial resolution, thus making this technique particularly attractive for the study of binocular interaction in developing infants and in binocularly deficient adults. PMID- 2773335 TI - Chromatic opponency in 3-month-old human infants. AB - A test spectral sensitivity curve was measured on 3-month-old human infants using a steady 8 degrees test light on a 580 nm adapting field. The data show a "Sloan" notch near 580 nm and a peak near 610 nm. The results are compared to standard nonopponent and opponent models of color vision, and it is concluded that 3-month old infants have a chromatically opponent detection channel. PMID- 2773336 TI - Direction perception in complex dynamic displays: the integration of direction information. AB - We created random-dot cinematograms in which each dot's successive movements were independently drawn from a Gaussian distribution of directions of some characteristic bandwidth. Such a display, comprising many different, spatially intermingled local motion vectors, can produce a percept of global coherent motion in a single direction. Using pairs of cinematograms, direction discrimination of global motion was measured under various conditions of direction distribution bandwidth, exposure duration, and constancy of each dot's path. A line-element model gave an excellent account of the results: (i) over a considerable range, discrimination was unaffected by the cinematogram's direction distribution bandwidth; (ii) only for the briefest presentations did changes in duration have an effect; (iii) so long as the overall directional content of the cinematogram remained unchanged, the constancy or randomness of individual dots' paths did not affect discrimination. Finally, the line-element model continued to give a good account of the results when we made additional measurements with uniform rather than Gaussian distributions of directions. PMID- 2773337 TI - Foveal cone thresholds. AB - The method of constant stimuli was used to estimate the psychometric functions for detection of one or two flashes when two light pulses were presented. The test stimulus consisted of two simultaneous 0.5 msec, 1' pulses separated by 17'. Observers reported seeing 0, 1 or 2 flashes. A computer-controlled direct-view apparatus allowed sampling of slightly different foveal locations on each trial. The data were analyzed assuming a binomial probability for sampling of L and M cones and Poisson distributed quantal fluctuation. Under these assumptions, the measurements imply that detection requires a minimum of 5-7 quanta absorbed per cone, and that the effective number of cones illuminated by the 1', 0.5 msec pulse is two. The estimated L/M cone ratio was 1.6 for one observer and 4.0 for the other; each observer's ratio was in general agreement with the value estimated independently by heterochromatic flicker photometry. PMID- 2773338 TI - Psychophysically derived visual mechanisms in turtle. I--Spectral properties. AB - Two-color increment thresholds were measured in turtle using a behavioral avoidance paradigm. Four visual mechanisms were isolated, and their spectral sensitivities were compared to action spectra of photoreceptors known to occur in this animal. One visual mechanism appears to be mediated by rods and red sensitive cones at low background intensities, a second mechanism by coupled red- and green-sensitive cones at intermediate levels, a third and fourth mechanism by red-sensitive, and green-sensitive single cones, respectively, acting alone at high background intensities. PMID- 2773339 TI - A model for spatiotemporal frequency responses in the X cell pathway of the cat's retina. AB - A linear model is described for the cat eye's signal-processing pathway, from the visual stimulus at the cornea, to cones, to X-type ganglion cells. The model contains elements representing the eye's optics, phototransduction, gain control, spatiotemporal processing by cell layers, and pure delay. Centre-surround antagonism in the model arises through the presence of a centre element producing a small spatial spread of signals, and an antagonistic element producing a larger spread. Two arrangements were tried, feedforward and feedback, in which the antagonistic element's output was subtracted from the centre element's output, and input, respectively. The model was fitted to empirical spatial and temporal frequency responses collected by Frishman et al. (1987), and accounted qualitatively for these data in the feedback, but not the feedforward, arrangement. The model's centre pathway comprises a cascade of low-pass spatial filters, as does the surround pathway. As a consequence, the spatial frequency responses for these two pathways closely approximate Gaussian functions of spatial frequency, and the spatial frequency response of the complete model at low temporal frequency closely matches that of the difference of Gaussians model. PMID- 2773340 TI - Consensual pupillary light reflex in the pigmented rat. AB - We measured the pupillary light reflex (PLR) in 5 pigmented, Long Evans rats (under urethan sedation) in three conditions: direct stimulation, consensual stimulation, and a control condition designed to measure the effects of stray light. The average constriction (maximal amplitude) produced by a ganzfeld stimulus delivering 1.6 log quanta absorbed per rod per sec for a duration of 3 sec was measured to be 0.78 +/- 0.07 mm for the direct PLR, 0.67 +/- 0.06 mm for the consensual PLR, and 0.07 +/- 0.029 mm for the control condition. We corrected the consensual measurement for each rat by subtracting the value of the control (stray-light induced) constriction. A comparison of the corrected consensual constriction to the direct constriction showed that, on average, the consensual constriction attained an amplitude of 78% of the direct constriction. Our findings contradict claims that the consensual pupillary light reflex is absent in rodents. Although our results are in agreement with findings showing bilateral projections of the retina to the pretectum (which subserves the pupillary light reflex) in the rat, the consensual-to-direct ratio we report is higher than might be expected from anatomical estimates of the overall proportion of uncrossed to crossed optic fibers in the rat. PMID- 2773341 TI - The effect of stimulus contrast on the latency and amplitude of the pattern electroretinogram. AB - Our studies have verified that a linear relationship exists between the amplitude of the pattern onset ERG and retinal contrast, but indicate that there is no systematic variation in peak latency with contrast. The optical degradation of high spatial frequency patterns cannot therefore provide an explanation for the variation in peak latency with spatial frequency. PMID- 2773342 TI - Visually perceived eye level and perceived elevation of objects: linearly additive influences from visual field pitch and from gravity. AB - Observing a pitched visual field (i.e. tilted around a horizontal axis in the observer's frontal plane) results in large changes in the elevation visually perceived to correspond to eye level (VPEL) and in the perceived elevation and size of stationary objects viewed against the field. With topforward pitch (top toward observer) VPEL lies above true eye level and objects appear smaller and lower; with topbackward pitch VPEL lies below true eye level and objects appear larger and higher. Oscillation of the pitched field induces synchronous perceived oscillation of elevation of a stationary target viewed against the field. Typical VPEL settings deviated from true eye level by 20 degrees with the field pitched at 40 degrees, although some individuals mislocalized by as much as 40 degrees. VPEL varied linearly with visual field pitch with individual slopes for the relation between VPEL and visual field pitch ranging from +0.42 to +0.78 (avg = +0.56). The linear correlation (r) between VPEL in darkness and against an erect visual field was +0.91. The two relations--VPEL vs visual field pitch, VPEL in darkness vs VPEL in the erect illuminated visual field (slope approximately equal to 0.5)--are both accurately predicted by the linear model: VPEL = kvV + kbB; in which V is the influence of visual field structure and B is the influence of the body-referenced mechanism which combines information regarding the orientation of the head relative to gravity, the position of the eye in the orbit, and the vertical location of the image on the retina; kv and kb are the relative weights of V and B with kv + kb = 1. In an illuminated field kv = kb approximately equal to 0.5; in the dark kv = 0, kb = 1. PMID- 2773343 TI - Response pooling between chromatic and luminance systems. AB - Two experiments were designed to examine interactions of the responses of the chromatic and luminance systems to suprathreshold stimuli. We measured simple reaction times (RT) to eight photometrically matched (1 cd/m2) wavelengths between 448 and 658 nm. These chromatic test stimuli were incrementally presented on either a spatially coextensive 1.2 or a larger 2 degrees steady white background. Sectors of the outer annulus region (between 1.2 and 2 degrees) could be removed to allow systematic variation of the extent of the spatial contour between test and background fields. When the white background was spatially coincident with the test field, RTs showed trichromatic saturation-like wavelength dependence, with a maximum RT at 572 nm. As white sectors were added to the annulus (introducing spatial transients between test and background fields), RTs became less and less wavelength-dependent, and were nearly wavelength-independent when a full annulus was used. The data were analysed in terms of a two-system RT model for processing chromaticity and luminance. PMID- 2773344 TI - The less you see it, the faster it moves: shortening the "on-time" speeds up apparent motion. AB - The apparent motion (AM) created by two spots illuminated in alteration looks faster when there is dark temporal interval (ISI) between the offset of one spot and the onset of the other than when the spots are presented immediately after one another (no ISI), even though the temporal frequency and the spatial separation between spots are held constant. AMISI looks 18.6% faster than AMnoISI at temporal frequencies between 1.5 and 4.5 Hz. Reducing the duty cycle from 0.5 to 0.05 increases the apparent speedup to 30%. This difference in subjective speed is not due to differential saturation of velocity detectors, nor to the apparent spatial separation between spots, nor to differences in the time averaged luminance of the stimuli. It is the "on-time", the time for which the spot is visible in one position, that determines the subjective speed. The longer the on-time, the slower the spot appears to move. PMID- 2773345 TI - The interactions between chromatic aberration, defocus and stimulus chromaticity: implications for visual physiology and colorimetry. AB - It has long been recognised that chromatic aberration can introduce luminance artifacts into nominally isoluminant colour stimuli. In this study the effects of chromatic aberration (along with those of defocus and stimulus spatial frequency) on the chromaticity of the retinal image are considered. Such optical effects have important methodological and functional implications for visual physiology. The "Silent Substitution" principle is a fundamental feature of modern colorimetry, being employed in both psychophysical and electrophysiological approaches to the visual system. The theoretical colour spaces introduced by MacLeod and Boynton (1979) and Derrington et al. (1984) are also ultimately based on this principle. All such applications of the silent substitution principle are sensitive to the optical effects of chromatic aberration, defocus, spatial frequency and stimulus chromaticity. The spatial acuity of the mechanisms of colour vision are appreciably lower than those of the luminance system (Mullen, 1985). In addition chromatic aberration has been shown to be a cue to ocular accommodation (Fincham, 1951). The analysis presented in this study suggests a possible explanation for these findings in terms of the ecological and computational constraints placed on the visual system by chromatic aberration. PMID- 2773346 TI - Binocular fields with lateral-eyed vision. AB - A simple geometrical model is constructed of the binocular field in animals with laterally directed eyes (such as the pigeon). Height and width are derived as a function of elevation, for eye-centred and for cyclopean co-ordinates. Stereoscopic vision in the frontal field is considered, and it is pointed out that convergence movements can facilitate stereopsis even in an afoveate periphery. PMID- 2773347 TI - Retinal densitometer with the size of a fundus camera. AB - This paper describes a small, user-friendly fundus reflection densitometer. All optics and part of the electronics are contained in a box with the size of a fundus camera. A personal computer is used for control and on-line display of output. A single 30 W halogen lamp provides bleaching and measuring light. A chopper wheel generates 24 light pulses in 100 msec time frames: 16 pulses of measuring light at different wavelengths covering the spectrum, four pulses of bleaching light (optionally), and four dark pulses for assessing the dark current of the photomultiplier. The fundus can be viewed when the bleaching light is on. The measuring field has four widths ranging from 1.6 to 5.4 deg; the bleaching light is fixed at 25 deg. A fixation aid may be positioned anywhere in the bleaching field. A microprocessor sorts the quanta, detected by the photomultiplier after reflection from the fundus, in 16 channels labeled with wavelength information. Real-time changes in spectral reflection can be viewed on a monitor. Due to optimal design of entrance and exit pupils foveal density differences of up to 0.5 were recorded in human subjects. This is higher than ever reported before with retinal densitometry. PMID- 2773348 TI - [The structure of automated expert systems for assessing the operation of military health care facilities]. PMID- 2773349 TI - [Optimizing the analysis of results of functional tests with the use of automated work stations]. PMID- 2773350 TI - [Automated work stations in managing a multiprofile medical facility]. PMID- 2773351 TI - [The experience of creative cooperation of the official military- physician commission and scientists]. PMID- 2773352 TI - [The use of microcomputers for processing medical accounts]. PMID- 2773353 TI - [Diagnosis and treatment of acute respiratory insufficiency in cases of multiple trauma]. PMID- 2773354 TI - [Study of blood flow through the renal arteries by an ultrasonic Dopplerography device]. PMID- 2773355 TI - [Dislocation and fracture-dislocation of the wrist joint]. PMID- 2773356 TI - [Mycoses of the foot in student pilots]. PMID- 2773357 TI - [Diagnosis of early forms of cancer and pre-cancerous diseases of the stomach and colon at a specialized sanitorium]. PMID- 2773358 TI - [Disseminated intravascular blood coagulation syndrome in acute disorders of cerebral blood circulation]. PMID- 2773359 TI - [The effect of physical loads and temperature-humidity conditions on the functional status of the serviceman]. PMID- 2773360 TI - [Possibilities of psychophysiological prediction of success in professional activities]. PMID- 2773361 TI - [Diagnostic possibilities of a method of EKG-monitoring of pilots under flight conditions]. PMID- 2773362 TI - [The effect of motion sickness on the diurnal rhythm of the sinus node of the heart conduction system]. PMID- 2773363 TI - [At the center of attention--care for man]. PMID- 2773364 TI - [The orthostatic stability of athletes of various specializations and its change under the effect of decreased gravity]. PMID- 2773365 TI - [The outcome of neck wounds from being shot with a flare gun]. PMID- 2773366 TI - [On the treatment of complete dislocation of the acromial end of the clavicle]. PMID- 2773367 TI - [Acute appendicitis and pathology of the female sex organs]. PMID- 2773369 TI - [The use of mineral water type "Naftusia-Shklo" in the treatment of chronic cholecystitis]. PMID- 2773368 TI - [The use of a CO2-laser for radical excision of an infected cyst of the coccyx]. PMID- 2773370 TI - [A case of diagnosing an unreduced artery of the vitreous body]. PMID- 2773371 TI - [Effectiveness of treating patients with chronic pyoderma with antibiotics combined with zinc oxide]. PMID- 2773372 TI - [Sensitivity of the passive hemagglutination reaction in the diagnosis of hepatitis B]. PMID- 2773373 TI - [Boundaries of restructuring national health care (numbers and facts)]. PMID- 2773375 TI - [The effect of nerve growth factor, guanethidine and their combined use on nuclease activity in animal tissues]. AB - Activity of ribo- and deoxyribonucleases RNAases I and II, DNAases I and II was studied in brain hemispheres, liver, kidney and heart tissues of one-month-old rats, which were administered daily, beginning from birth either with nerve growth factor 15 micrograms/kg, guanethidine 30 micrograms/kg or with these compounds simultaneously at the doses mentioned above. Activity of the nucleases studied was altered in nervous tissue and in vegeto-dependent tissues after separate treatment with both nerve growth factor and guanethidine, while their simultaneous administration caused slight normalization but not to complete recovery of the patterns studied. PMID- 2773374 TI - [Modification of micrococcal histidine decarboxylase with tetranitromethane]. AB - Tetranitromethane inhibited distinctly the histidine decarboxylase activity at pH above 7.0. Spectral and fluorescence properties as well as amino acid composition of the transformed enzyme were studied. Nitration of tyrosine residues occurred simultaneously with oxidation of cysteine in a molecule of histidine decarboxylase treated with tetranitromethane, while the other amino acids such as tryptophane, histidine and methionine were not altered. The histidine decarboxylase pretreated with dithiothreitol, became insensitive to the tetranitromethane effect but complete inactivation of the enzyme was observed under these conditions. Possible mechanisms of the histidine decarboxylase inactivation are discussed. PMID- 2773377 TI - [Peroxidation and features of fatty acid composition of cell membrane lipids in patients with hypertension]. PMID- 2773376 TI - [Features of purine compound metabolism in hepatoma 22, mouse liver and erythrocytes during tumor development]. AB - During development of transmitted solid hepatoma 22 pools of purine metabolites were studied as well as the rate of 3H-hypoxanthine and inosine incorporation was measured in acid soluble fraction of liver tissue and erythrocytes of mice C3HA as well as of the tumor tissue. Specific alterations in metabolism of adenine and guanine nucleotides and of their derivatives were detected at various steps of the hepatoma development in the tissues studied. Specific interaction of the hepatoma cells with host tissues appears to be realized via the pool of purine nucleotides. PMID- 2773378 TI - [An analysis of blood serum proteins in chronic alcoholism patients by a cross immunoelectrophoresis method]. AB - Prealbumin, albumin, alpha 1-antitrypsin, alpha 1-antichymotrypsin, ceruloplasmin, haptoglobin, transferrin, IgG, IgM and IgA were studied in blood serum of healthy donors and of patients with chronic alcoholism by means of cross immuno-electrophoresis and immunodiffusion. Only content of alpha 1-antitrypsin was distinctly altered in blood serum of the patients with alcoholism as compared with normal state, while individual variations in content of the proteins studied were considerably higher in blood serum of the patients. At the same time, distinct dissimilarity of the patterns studied was found between healthy donors and patients with chronic alcoholism when concentration ratios of some positively and negatively charged acute phase proteins were calculated (alpha 1 antitrypsin/albumin, haptoglobin/albumin, haptoglobin/transferrin). PMID- 2773379 TI - [Preparation of a staphylococcal immunosorbent sensitized by antibodies to the M subunit of LDH]. AB - A simple and rapid immunochemical procedure is developed for estimation of the LDH1 activity which involved separation of LDH1 from other LDH isoenzymes using immunosorbent. The immunosorbent consisted of killed Staphylococcus aureus cells, membrane of which contained protein A with absorbed antibodies towards M-subunits of porcine LDH. PMID- 2773380 TI - [The effect of radiotherapy on the antioxidative activity of tissues and blood erythrocytes]. AB - Dynamics of antioxidative activity (AOA) of lipids was studied in tumors, in the tissues surrounding tumor and in blood plasma and erythrocytes of patients with mammary gland carcinoma after surgical and combined treatments. Intensity of lipid peroxidation was increased in blood plasma and erythrocytes of the treated patients within the later periods of the disease. AOA of the tumor lipids was elevated after the radiation treatment; at the same time, similar reaction to radiotherapy was detected in erythrocytes and the tissues surrounding tumor: a decrease in the AOA within the initial steps and elevation--during the later periods of the disease as compared with the activity in erythrocytes and tissues of treated patients. Qualitatively altered conditions of body functioning and its relationship with the tumor occurred apparently during the later periods of the disease. PMID- 2773381 TI - [Activity of the pentosephosphate pathway of glucose metabolism in ischemized skeletal muscles in humans and animals]. AB - Activation of both glucose-6-phosphate dehydrogenase and transketolase was found in skeletal muscles of patients with occlusion impairments of main arteries as well as of animals with acute arterial ischemia. PMID- 2773383 TI - [Erythrocyte lipids in diabetes mellitus with vascular involvement]. AB - Alterations in content of neutral lipids, phospholipids and of their lysoforms were studied in erythrocyte membranes of patients with various severity of vascular impairments considering clinical manifestation of diabetes mellitus. Impairments of lipid composition in erythrocyte membranes observed correlated with the steps of diabetic angiopathies, thus considering an importance of these alterations in pathogenesis of vascular diseases of patients with diabetes mellitus. PMID- 2773382 TI - [Low density lipoprotein distribution by flotation characteristics in normal conditions and in dyslipoproteinemias]. AB - Distribution of low density (LDL; density range of 1.006-1.063), using the LDL flotation velocity in ultracentrifugation as a criterion, was studied in 4 groups of patients with coronary atherosclerosis (31 patients was examined, 24 of which were with angiographically confirmed coronary atherosclerosis): control group, patients with ischemic heart disease-with normal level of blood plasma lipids, with increased content of triglycerides and with decreased content of LDL cholesterol. The ratio of LDL particles with high hydration density was elevated in the LDL spectrum of all the patients examined. At the same time, each group of patients examined exhibited specific alterations in the LDL distribution spectra. PMID- 2773384 TI - [The effect of cholesterol esterase on low density lipoproteins. The effect of modified lipoproteins on the accumulation of cholesterol in cultured cells]. AB - Up to 5% of cholesterol esters were hydrolyzed after incubation of blood serum low density lipoproteins (LDL) with pancreatic cholesterol esterase free of proteinases and phospholipase activity in absence of detergents. The surface layer of the lipoprotein particles appears to contain about 5% of cholesterol esters. More active intracellular accumulation of cholesterol esters was found in fibroblasts cultivated in a medium containing modified LDL as compared with cultivation in presence of native LDL. Deterioration of normal interrelations between free cholesterol and its esters appears to be responsible for alterations in the LDL structure and contributed to more active transport of cholesterol into cells. PMID- 2773385 TI - [Intensity of gluconeogenesis in the rat liver in the recovery period after long term hypokinesis]. AB - Gluconeogenesis was studied in liver tissue of 60 rats within the period of readaptation after 60 days of hypokinesia. Biosynthesis of glucose from alanine, aspartic-, glutamic-, alpha-ketoglutaric and pyruvic acids as well as from glycerol was distinctly inhibited as a result of long-term hypokinesia. Stimulation of gluconeogenesis was noted during the beginning of the readaptation period within 1-7 days, which caused the "superrestoration" of glycogen content in liver tissue. The rate of glucose synthesis was decreased within the later period (15 days) of readaptation. The specific properties of the restoration period should be considered in working out of the rehabilitation courses. PMID- 2773386 TI - [The effect of bacterial endotoxin on the activity of liver mitochondria monoamine oxidase]. AB - An increase of lipid peroxidation and a decrease of the monoamine oxidase (EC 1.4.3.4) activity were found in mice liver mitochondria within 9 hrs of intoxication developed after administration of bacterial endotoxin at a dose corresponding to its LD50. The decrease in the monoamine oxidase activity appears to occur due to some alteration of the enzyme substrate specificity as well as to its partial liberation from mitochondrial membrane. PMID- 2773387 TI - [Isolation and immunochemical properties of LDG-5 from swine muscle]. AB - Homogeneous crystalline isoenzyme LDH5 was isolated from pig muscles with a yield of 33%. Antiserum, developed to the purified LDH5 preparation from pig muscles, reacted with human and pig LDH isoenzymes containing M subunits and did not interact with LDH1 isoenzyme. The heterologous antiserum might be used for estimation of LDH1 content in human blood serum. PMID- 2773388 TI - [Mechanism of activating the lymphocyte glucocorticoid receptor in acute myocardial infarct]. AB - Dose-dependent increase in content of highly specific binding sites for glucocorticoids (receptors), but without alteration in their affinity to the hormone, was observed after incubation during 2 hrs of healthy donor lymphocytes with blood serum of patients with acute myocardial infarction. The similar effects exhibited protein extracts of necrotized and normal parts of human myocardium (heart antigens) as well as the autologous blood serum and human blood serum albumin treated with UV-irradiation. Number of receptors was not altered in human skin fibroblasts incubated both with the patients blood serum and with the UV-treated blood serum. Antigenic effects of protein components, developed in blood serum after acute myocardial infarction, on cells of the lymphoid system appear to be responsible for the increase in number of binding sites for glucocorticoids in lymphocytes of patients with acute myocardial infarction or in lymphocytes of healthy donors incubated with the patients blood serum. PMID- 2773389 TI - [Determination of the amino acid composition of cartilage and creatine phosphokinase isoenzymes with the use of phenylthiocarbamyl amino acid derivatives]. AB - A method for estimation of amino acid composition and collagen-specific amino acids was developed. The assay was based on the precolumn reaction of amino acids with phenylisothiocyanate. The phenylthiocarbamyl derivatives were analyzed by means of reverse-phase chromatography on octadecyl sorbents, which involved gradient elution with ethanol and sodium or ammonium acetate. The method was used for effective separation of collagen-specific and main amino acids in cartilage hydrolysate from healthy persons and of patients with funnel chest and Ehlers Danlos syndrome and also for determination of amino acid composition in creatine phosphokinase B- and M-subunits. PMID- 2773390 TI - [Hypoglycemic effect of thymosine in an animal experiment]. AB - Short-term hypoglycemic effect of thymosin was found in intact mice and in animals with alloxan diabetes: single intramuscular administration of 5 mg/kg of thymosin was accompanied by a decrease in glucose content in blood within 15-30 min. Increase in content of immunoreactive insulin in blood was responsible for the hypoglycemia, while the direct insulinotropic effect of thymosin was not observed in isolated pancreas. PMID- 2773391 TI - [Heparin and its antagonist--a quaternary ammonium salt of oligomer-25-conidine: distribution in subcellular organelles, effect on DNA synthesis in the regenerating rat liver]. AB - Dynamics of distribution in subcellular organelles as well as effects on DNA synthesis of heparin, polycanidine (ChAS oligomer of 25 canidine) and their complexes were studied in regenerating rat liver tissue after partial hepatectomy. Polycanidine and heparin penetrated from circulation into hepatocyte cells, nuclei and mitochondria. After consecutive administration of polyelectrolytes polycanidine increased 2-2.5-fold the amount of heparin entering into cells. Polycanidine formed stable complexes with DNP in nuclei. Heparin and its complexes with polycanidine decreased the DNA synthesis within first day. Heparin appears to be responsible for the inhibitory effect, whereas administration of polycanidine only into animals caused a slight increase in 3H thymidine incorporation into DNA as compared with controls. PMID- 2773392 TI - [The effect of hepatotoxins on the activity of organelle-specific enzymes and metabolism of liver lipids]. AB - Release of lysosomal hydrolases (including phospholipase A), increase in content of lysophosphatidyl choline and cardiolipin and decrease in content of phosphatidyl choline and phosphatidyl ethanolamine, activation of lipid peroxidation, inhibition of the cell antioxidant system, inhibition of tricarboxylic acid cycle enzymes and of beta-hydroxybutyrate dehydrogenase in mitochondria were detected in hepatocytes of rats after acute poisoning with necrosogenic toxins D-galactosamine, allyl alcohol and apamide. Hydrazine and ethanol caused an extensive steatosis of liver tissue parenchyma, decreased moderately the activity of mitochondrial enzymes, stimulated lipid peroxidation without impairment of antiradical activity of the lipids, contributed to accumulation of cardiolipin and to a decrease in phosphatidyl choline content. PMID- 2773393 TI - [Amino acid composition and properties of fibrin self-assembly inhibitors]. AB - Three peptides, inhibitors of fibrin self-assembly, were shown to be responsible for stable antipolymerization activity of blood plasma. Similarity of amino acid composition of these inhibitors might be considered as an indication of their origin from a common precursor by means of limited proteolysis. Inhibition of the self-assembly occurred due to interaction of the peptides with monomeric fibrin in the region of domain D, which was accompanied by loosening of electrostatic interactions between molecules of fibrin. PMID- 2773394 TI - [Relations between antioxidant activity and lipid state of blood as an indicator of the effect of tumor on the body]. AB - Studies on antioxidant activity and lipid profile of erythrocytes and blood plasma in patients with fibroadenoma, fibrous-cystic mastopathy and neoplasia at different stages of progression showed each pathology to be associated with certain changes in the said parameters. Identification of signs of systemic effect of cancer growth was attempted. Malignant tumor was shown to involve at certain stage pronounced quantitative changes in lipid metabolism and erythrocyte membrane properties. These included changes in cholesterol/phospholipids molar ratio, presence of phosphatidylinositides and dissociation of regulatory links between antioxidant activity and cellular lipid profile in erythrocytes. PMID- 2773395 TI - [Blood lipase activity in cancer patients]. AB - Blood plasma lipoprotein lipase level was measured in lung and stomach cancer patients before surgery and during postoperative period. A drop in the enzyme level was observed, particularly, in patients at stage IV. Postoperative infusion and drug therapy was followed by increase in the enzyme activity in stage III disease whereas at stage IV, only a tendency of lipoprotein lipase to rise was observed. Deterioration in patient condition led to a sharp decrease in the enzyme activity. PMID- 2773396 TI - [Evaluation of diagnosis and treatment of various clinico-anatomical forms of lung cancer]. AB - Among 3898 cases of primary lung cancer registered in Leningrad within 1985-1986, central cancer clearly predominated (61.9%). Central/peripheral cancer ratio was 1.6:1. The most common procedure used for treatment of central lung cancer was pneumonectomy (74.6% of cases) and lobectomy--for peripheral cancer management (85.7%). Significant differences in approach to diagnosis and surgical treatment of these pathologies were established. It seems unfeasible to increase resectability of central lung carcinoma by extending surgery. Such tumors should be diagnosed at the stage of segment involvement. However, prophylactic photo roentgenography does not assure early detection of central lung cancer. Organization of lung cancer detection in Leningrad needs to be improved. PMID- 2773397 TI - [Body weight, blood lipids, blood cortisol and prognosis of patients with cancer of the large intestine and breast]. AB - Survival was evaluated in 121 patients with breast cancer and 114 with colorectal tumors versus overweight, body surface, preoperative blood-cholesterol level, cholesterol fraction profile and blood-triglyceride and -11-hydroxycorticosteroid levels. Survival was assessed by actuarial method. In breast cancer patients, prognosis inversely correlated with overweight and preoperative blood-cholesterol level whereas in colorectal cancer--with preoperative blood-triglyceride level, and--in males--with those of 11-hydroxycorticosteroids. The prognostic significance of cancrophilia factors in cancer as well as differences in said significance for colorectal and breast tumors are discussed. PMID- 2773398 TI - [Influence of the pathogenetic variant of uterine cancer on the dynamics of prolactin secretion in the early and late postoperative periods]. AB - In early postoperative period, patients with uterine carcinoma of pathogenetic types I and II developed hyperprolactinemia with similar frequency. However, elevation of prolactin concentration was found to vary with pathogenetic type. For type I endometrial carcinoma, prolactin level on postoperative days 1-5 was twice those registered in type II tumor. Later, prolactin levels returned to normal. PMID- 2773399 TI - [Morphohistochemical and electron microscopic characteristics of malignant tumors of the upper respiratory tract after combined local hyperthermia and radiotherapy]. AB - The paper discusses morphohistochemical and electron microscopic characteristics of 15 primary tumors of the upper respiratory tract removed following preoperative irradiation in combination with local hyperthermia as a radio modifying factor. Eighteen tumors removed after irradiation alone served as controls. Application of local microwave hyperthermia resulted in a higher degree of irreversible tumor cell dystrophia and damage. Hyperthermia--induced damage included disorders in ultrastructure of intracellular membranes and cell organelles mainly due to derangement of membrane--binding proteins, protein- lipid and nucleotide complexes. Thermoradiotherapy stimulated protective reaction of surrounding tissue which took the form of increase in fraction of leukocytes and macrophages with high acid phosphatase level in areas of tumor cell damage. PMID- 2773400 TI - [Identification of trihalomethanes in drinking water and assessment of their toxicity, mutagenicity and carcinogenicity]. AB - Dichlorobromomethane (DCMB) and dibromochloromethane (DBCM) isolated from chlorinated drinking water were tested for toxicity, mutagenicity and carcinogenicity. Both agents proved mutagenic in a "dessicator" modification of the Ames test using Salmonella typhimurium TA98 and TA100 in the presence of exogenous metabolic activation. In aquarium Danio rerio fish tests, LD50/30 was 250 mg/l for both compounds. Both agents induced hepatocellular carcinoma in fish: DCMB--in 11 out of 29 animals (at 16.5 weeks) and DBCM--in 3 out of 16 (at 26.5 weeks). These data merit further investigation of the agents' carcinogenicity in chronic experiments in rodents. PMID- 2773401 TI - [Assessment of the degree of carcinogenicity of small doses of nitrites]. AB - Chronic experiments on CBA and C57B1 mice and acute experiments on CBA mice established: (a) carcinogenic effect of sodium nitrite given continuously with drinking water (0.1; 1.0 and 10.0 maximum allowable concentration) in combination with morpholine fed with bread, and (b) endogenous synthesis of nitrosomorpholine as a result of simultaneous intragastric administration of same doses of sodium nitrite and morpholine. Also, nitrosomorpholine and N-nitrosodimethylamine synthesis was observed in vitro following addition of low-dose sodium nitrite, morpholine and amidopyrine to human gastric juice. Carcinogenic hazard associated with low-dose nitrite consumption in humans is discussed. PMID- 2773402 TI - [Effects of thermal burns of the esophagus on carcinogenesis induced by ethyl ethers of N-nitrososarcosine in rats]. AB - The study was concerned with the effect of electro-thermocoagulation burn of the rat gullet on carcinogenesis induced by esophagotropic carcinogen--ethyl ester of N-nitrososarcosine (50 mg/kg, five times a week, four months). Treatment was started on day 15 postburn, and at 8 months tumors of the esophagus occurred in 71.8% including tumors in the burn area (46.8%). Forestomach neoplasms were observed in 15.6%. Animals treated with the carcinogen alone showed a significant decrease in both overall frequency of esophageal tumors (42.4%) and that for the burn area (18.1%) while frequency of forestomach neoplasia remained nearly the same (21.2%). Most tumors were benign papillomas. It was concluded that burn- induced cicatricial changes in the esophageal mucosa predispose to development and growth of tumors of this site. PMID- 2773403 TI - [Plastic surgery of postoperative defects in patients with tumors of the maxillofacial area]. AB - Defects resulting from surgical treatment for maxillo-facial tumors of various origin were studied. Procedures for reconstruction versus site are discussed and immediate results are presented. Reconstruction should be performed in early postoperative period to assure normal food passage. PMID- 2773405 TI - [Conservative surgery in extensive forms of lung cancer]. AB - The paper discusses a 15-year experience gained in using surgical treatment for lung cancer. Lobe- or bilobectomy, extended lobectomy and combined lobectomy were carried out for advanced tumor in 97 patients (11.5% of radically--operated cases). Postoperative lethality was 5.2%. The end results in cases of tumor dissemination to regional lymph nodes was half that in metastasis--free patients. Organ--saving surgery is indicated in patients with well-differentiated advanced cancer of the lung without metastasis to lymph nodes. PMID- 2773404 TI - [Electroroentgenography in the diagnosis of soft tissue tumors]. AB - Clinical, electroroentgenographic and X-ray studies of soft tissues were carried out in 425 patients with malignant (75), benign (246) soft tissue tumors and in cases of such soft tissue pathologies of the extremities and body (104) as bursitis, hematoma, cyst and ganglia which may clinically simulate tumors. The paper discusses the technicalities of electroroentgenography which produces on one roentgenogram separate images of all components of soft tissues and bones in a given segment. A comparison of image quality assured by electroroentgeno- and roentgenography did not establish any significant difference in soft tissue tumor semiotics. Electroroentgenography of soft tissues is relatively less sophisticated, time-consuming and cheaper; it does not require special medical facilities for examining patients bearing soft tissue tumor or suspect lesions. PMID- 2773407 TI - [Treatment of patients with marginal tumors of the ovary]. AB - The clinico-morphological data on the results of five- and ten-year follow-up of 228 patients suffering "borderline" epithelial (serous, mucinous and endometrioid) ovarian tumors were studied. Considerations of choice of optimal treatment procedure versus degree of clinical and morphological malignancy, tumor histotype and age are discussed. PMID- 2773406 TI - [Cancer of the breast at a remote time after segmental resection]. AB - An analysis of 72 case histories of breast cancer treated by surgery for nodular dyshormonal hyperplasia established that all cases of lumpectomy should be followed up. Particular care should be exercised in monitoring cases of multi factor risk for breast cancer and preceding proliferation. PMID- 2773408 TI - [Characteristics of the clinical course of cancer of different parts of the tongue]. PMID- 2773410 TI - [Problems of training family practitioners]. PMID- 2773409 TI - [Yolk sac tumor of the ovary]. PMID- 2773411 TI - [Pneumothorax developing as a result of acupuncture in the treatment of bronchial asthma]. PMID- 2773412 TI - [The role of hemodialysis and hemosorption in the complex therapy of acute poisoning]. AB - The method of henosorption and hemodialysis was used in 50 patients with acute intoxication. A total of 44 hemosorption and 40 hemodialysis procedures were carried out in the toxicogenous and somatogenous stage of acute intoxication. Results indicate high efficacy of using extracorporal detoxication in the toxicogenous stage of acute poisoning. The method of treatment of acute chemical intoxications is described. PMID- 2773413 TI - [Clinical symptoms of chronic hyperthermia in miners of deep coal mines]. AB - Results are discussed of investigations with the purpose of analysing the clinical manifestations of long-term effects of the thermal factor on the body of miners of deep coal-mines aimed at the diagnosis of chronic hyperthermia. It shown that miners working in hyperthermia conditions showed prevalence of vegetovascular and astheno-neurotic syndrome. PMID- 2773414 TI - [The effect of surface active substances on the barrier properties of the skin]. AB - It was established in experiments conducted on white rats that application to the skin of sulphonol and cintamide--5 for a period of three months result in morphological disorders of the ultrastructural organization of the epidermis, especially of the structure of intercellular contacts. A mixture of these substances produces a more severe noxious effect on the structures. These substances produced also a local effect on the skin microcirculation. The authors propose a scheme for explanation of the mechanism of structural-functional changes of the skin in local applications of surface-active substances. PMID- 2773416 TI - [Physiologo-hygienic characteristics of the work of hot glass cutters]. PMID- 2773415 TI - [Professional diseases caused by the action of antibiotics]. AB - A follow-up study is presented of the clinical aspects and pathogenesis of professional diseases due to the effect of antibiotics. A progressing, stable and regressing course of the disease was singled out. It is shown that in the long term period the main pathogenetic mechanism was allergic vasculitis caused by penicillin, streptomycin and Candida fungi. PMID- 2773417 TI - [Activity of alanine aminotransferase in women of child-bearing age, ill with viral hepatitis]. AB - A study is presented of 150 patients with viral hepatitis B. They are women of the child-bearing age with different severity of the disease. A dependence was established of the increase of alanine aminotransferase activity on the level of estradiol in the blood serum under normal conditions and different forms of viral hepatitis B. The estradiol and alanine aminotransferase values wer in the more severe cases, particularly, in the ovulatory and luteinic peaks of the menstrual cycle. Results of the study allow to reconsider the norm rates of alanine aminotransferase activity in women of childbearing age as adding new data to existing ideas on the mechanisms of development of hyperenzymemia in this kind of pathology. PMID- 2773418 TI - [Immunity against tetanus in patients with chronic diseases]. AB - A study of the blood serum in indirect hemagglutination reaction in 435 patients with ulcer and neoplastic diseases of the gastrointestinal tract and, in particular, of the liver and biliary tract revealed lower concentrations of tetanus antitoxin than in healthy persons of corresponding age. The proportion of protected against tetanus in individual types of pathology decreased to 58.0 +/- 7%-48.0 +/- 7.1% indicating the necessity of correcting immunity in this category of patients. PMID- 2773419 TI - [An increase in the professional level of physicians--supervisors of interns]. PMID- 2773420 TI - [The use of clofelin in the acute period of myocardial infarct]. AB - Data are reported on the action of intravenous clophelin in 30 patients administered within the first 24 hours of myocardial infarction. The agent exhibited a significant analgetic effect, sedative action and normalized the main hemodynamic values. The effect of clophelin on the hemodynamics depended on its initial state. The possibility is shown to predict the pain-killing and hemodynamic effects of the drug by the initial response. PMID- 2773421 TI - [Prognostic value of cardiac rhythm in acute myocardial infarction]. AB - A computer-assisted special calculating complex to analyze a dynamic series of 128 successive R-R ECG intervals in 42 patients with acute myocardial infarction is described. It was established that statistical indices of the rhythm allow to evaluate the degree of severity of the disease, the reserve of adaptation possibilities of the body and predict the course of the disease. PMID- 2773422 TI - [The use of anti-inflammatory agents and stimulators of reparative processes in myocardial infarction]. AB - Agents effecting healing of the infarction zone were used in treatment of 326 patients with macrofocal myocardial infarction. In hyporeactive myocardial infarction stimulators of reparative processes, namely, methyluracil, sodium nucleinate, riboxin, retabolil, phenabolil). In hypereactive myocardial infarction antiinflammatory agents (amidopyrin, butadion, ibuprophen, indomethacin and oth.) were used beginning with the first days while stimulators of reparative processes were used beginning with the 3-4 days. Inclusion into treatment of agents optimizing healing of the myocardial infarction improved the clinical course of the disease, reduced manifestations of cardiac insufficiency and disorders of the cardiac rhythm. PMID- 2773423 TI - [Prediction of the course of post-infarction cardiosclerosis]. AB - On the basis of veloergometric testing and discriminant analysis carried out in 178 patients with a history of myocardial infarction a formula was designed for preventive evaluation of the course of the disease for a two-year period. This method allows to single out patients with an unfavourable course of the disease even in case of satisfactory tolerance of physical loads during initial examination. The prognosis efficacy was 75%. PMID- 2773424 TI - [Cardiac glycosides and calcium antagonists in the treatment of blood circulation insufficiency]. AB - A study is presented of the main microcirculation values in comparison with systemic hemodynamics in patients with chronic circulatory insufficiency under the effect of complex therapy with dilanacin + corinfar and clift + corinfar. It was established that calcium antagonists reduce postloads and, thus, facilitate the cardiac work in overcoming general peripheral resistance of blood vessels supplementing the effect of cardiac glycosides in the direction of improvement of myocardial inotropism and increase of its propulsive force. PMID- 2773425 TI - [Intraventricular septal defect in conjunction with mitral valve prolapse in twins]. PMID- 2773426 TI - [The effect of hemosorption on clinical symptoms of ischemia of the lower extremities, heart and brain]. AB - Sixty-eight hemosorptions were carried out in 55 patients with atherosclerotic lesions of the lower extremity vessels. Hemosorption efficacy was evaluated by biochemical methods, clinical manifestations of ischemia of the legs, heart and brain. It was established that hemosorption proved highly efficient in the complex treatment of obliterative lesions of the lower extremity vessels, particularly, in the II-III stages of the disease. PMID- 2773428 TI - [Functional status of the myocardium and rheologic properties of the blood in patients with iron-deficient anemia]. AB - A study is presented of 38 patients with severe iron-deficiency anemia and 70 patients with non-severe iron-deficiency anemia. All patients showed hypotension with a mean arterial pressure from 70.0 to 76.6 mm Hg. With progression of the severity of iron- deficiency anemia the patients exhibited a reduction of the contractile function of the left ventricular myocardium accompanied by a simultaneous dilatation of its cavity. The hyperkinetic type of hemodynamics is considered as a compensatory reaction of the circulation in response to hypoxia while the state of peripheral hemodynamics evidences venous dilatation furthering high minute blood volume utilization of oxygen at the level of hemotissue barrier is disturbed. Correction of the cardiohemodynamic disorders in combination with ferrotherapy improved the contractile function of the myocardium. PMID- 2773427 TI - [Pathogenetic mechanisms of atherogenesis in patients with rheumatoid arthritis]. AB - Blood lipids, peroxidation of lipids, inflammation mediators were examined in patients with rheumatoid arthritis. It was found that corticosteroids cause changes in blood lipids of the atherogenic type that in association with increased levels of malonic dialdehyde, serotonin, histamine and reduced blood heparin level is the main pathogenetic mechanism of atherogenesis in rheumatoid arthritis. PMID- 2773430 TI - [Long-term results of treating acute erosion and ulcer of the digestive tract]. AB - The authors studied results of treatment of acute erosions and ulcers of the digestive organs that developed in 43 patients after different operative interventions. Twenty-one patients developed uncomplicated erosions and ulcers, 20--complicated hemorrhages and 2--perforations. Follow-up terms--from 1 to 7 years. Approximately 50% of patients complained of stomach pain, some--of dyspeptic phenomena. Endoscopic findings indicate that these patients suffered of chronic diseases of the digestive organs (gastritis, gastroduodenitis). This evidences the necessity of prophylactic medical treatment of patients with a history of acute erosion and ulcers of the digestive organs. PMID- 2773429 TI - [Abscess of the spleen as a complication of cardiomyopathy]. PMID- 2773431 TI - [The functional status of natural killer cells in patients with cancer of the digestive organs]. AB - The author investigated the state of functional activity of the system of natural resistance in patients suffering of cancer of the gastrointestinal tract organs. It was established that in the course of development of the disease natural resistance reduced. The obtained data may be used for immunomonitoring in oncological clinical practice. PMID- 2773432 TI - [Morphologic data on the immune reaction of malignant tumors of the stomach]. AB - The authors present a morphological investigation of the status of local immunoreactivity in gastric cancer. It was established that the character and degree of severity of the local immune response in cancerous neoplasms of the stomach depends on the histological structure of the tumour and stage of the pathological process and does not depend on the age of the patient. PMID- 2773433 TI - [Cholate-forming and cholesterol-secreting function of the liver in patients with ulcers after vagotomy]. AB - The cholate-forming and cholesterol-excretory function of the liver was studied in patients with ulcer disease of the duodenum after different types of vagotomy- selective proximal vagotomy and selective proximal vagotomy with pyloroplasty. The patients revealed different degrees of disorders in the content of bile acids, their fractions, bile cholesterol as well as a dependence of these changes of the type of operation. The changes were more pronounced in patients undergoing selective proximal vagotomy as compared with those undergoing selective proximal vagotomy with pyloroplasty. PMID- 2773434 TI - [Results and prospects of studying thrombosis formation in ischemic heart disease]. AB - On the basis of own investigations and literary data of recent years the author discusses problems of frequency and location of thromboembolic complications in ischemic heart disease, their pathogenesis, effect on the course of acute myocardial infarction, clinico-laboratory criteria of diagnostics of the intravascular coagulation syndrome, current methods of diagnosis, treatment and prophylaxis. PMID- 2773435 TI - [Subdiaphragmatic vagotomy in acute experimental pancreatitis]. AB - Subdiaphragmatic vagotomy influences on the course and outcome of acute pancreatitis were studied experimentally in 26 mongrel dogs. Truncal and selective vagotomy was performed in the animals with experimentally induced pancreatitis. Histological and histochemical methods showed that truncal vagotomy produced a positive effect on the course and outcome of experimental pancreatitis. PMID- 2773436 TI - [The value of radioimmunologic analysis of tumor-associated antigens in the differential diagnosis of pancreatic tumors]. PMID- 2773437 TI - [Monitoring in hepatology]. AB - A program has been worked out of dynamic observation on patients with chronic diffuse liver diseases (CDLD) and 4 kinds of monitoring--metabolic, immunological, regulatory and structural were singled out. Monitor tests were determined by means of mathematic analysis of the results of examination of 167 patients with CDLD. The possibility has been shown of using dispensarization schemes for creation of a therapy program and evaluation of its efficacy. PMID- 2773438 TI - [Lipid levels in peripheral blood neutrophilic leukocytes in diseases of the hepatobiliary system]. PMID- 2773439 TI - [Disruption of the electrolyte and microelement composition of gastric juice and bile in patients with chronic diseases of the hepatobiliary system]. AB - A study is presented of 403 patients with chronic diseases of the stomach and biliary tract. It was established that these patients showed disorders of the electrolytic and micro-element composition of the gastric juice and bile depending on the functional state of the stomach and liver. PMID- 2773440 TI - [Changes of the liver and bile ducts in patients with acute intestinal diseases]. AB - Patients with acute intestinal infections, in particular, salmonellosis showed in 1/3 during the acute period an insignificant increase of bilirubin and alaninaminotransferase. During early reconvalescence the majority of patients revealed functional changes of the biliary tract, mainly, in the form of hypotensive-hypokinetic type of dyskinesia. PMID- 2773441 TI - [The use of bilimin in the radiologic study of the gallbladder]. PMID- 2773442 TI - [Clinico-morphologic comparisons in primary diffuse mesangio- proliferative glomerulonephritis]. AB - Data are reported of a clinical and morphological including electron microscopical study of 132 patients with primary diffuse mesangioproliferative glomerulonephritis (DMPGN). A comparison of morphological signs using methods of non-parametric statistics revealed a complex dependence between glomerulosclerosis and sclerosis of the stroma, tubular atrophy and dystrophy; sclerosis of stroma and its cellular infiltration. Comparison of morphological aspects and clinical manifestations of DMPGN allowed to establish that development of disorders of partial functions of the kidneys has a complex genesis as evidenced by dependence of disorders on the presence and severity of glomerulosclerosis, stroma sclerosis, tubular atrophy and frequency of crescents/microcrescents. PMID- 2773443 TI - [Effectiveness of sanitorium treatment of patients with chronic glomerulonephritis depending on their permanent residence]. AB - The authors analyze the immediate and long-term results of 48-day health resort treatment at the Southern Coast of the Crimea of three groups of patients with chronic glomerulonephritis (150 patients in each) depending on the place of their permanent residency: "north", "middle" and "south" climatic zones. Treatment efficacy was higher in the group of patient inhabiting the "middle zone" (latitude 57.5 degrees-42.5 degrees North). These findings make it possible to improve the organization of selection of this contingent of patients for climatotherapy as well as to study the processes of their adaptation to new climatic conditions. PMID- 2773444 TI - [The effect of enterosorption on the status of central and peripheral hemodynamics in patients with diabetes mellitus]. AB - A study is presented of the effect of carbon-containing sorbents on the state of the central and peripheral hemodynamics in patients with diabetes mellitus. It was established that a 10-day's course of enterosorption improved the peripheral and central hemodynamics that was manifested by an increase of the stroke and minute blood volume while the peripheral resistance reduced. Simultaneously the volume of work at the veloergometer increased. PMID- 2773445 TI - [The significance of studying phospholipids in the diagnosis of hypothyroidism]. AB - Phospholipids and their fractions were examined in 85 patients with hypothyroidism of various severity grades in the state of decompensation. It was established that hypothyroidism is characterized by essential disorders of the phospholipid metabolism which occurs already at the initial stages of the disease advances with progression of its severity and is manifested in an increase of phosphatidylserine, lysophosphatidylcholine, sphingomyelin, phosphatidylethanolamine and reduction of phosphatidylcholine. Examination of phospholipids and their fractions is one of the important supplementary objective methods of diagnosis of hypothyroidism, especially, in young persons, a criterion of metabolic decompensation of the disease. PMID- 2773446 TI - [The effect of prednisolone on the functional status of phagocytic cells in the peripheral blood of patients with pulmonary sarcoidosis]. AB - An immunological study was carried out of 51 patients with pulmonary sarcoidosis. Two groups of patients were singled out: receiving and not receiving glucocorticoid treatment (prednisolone: 0.3 mg/kg of body weight). It was found that patients with pulmonary sarcoidosis revealed changes of the functional state of neutrophils and monocytes of the peripheral blood manifested in a reduction of their absorptive capacity, number of rosette-forming cells, adhesiveness of neutrophils, increase of oxygen-dependent metabolism, production of lysozyme by neutrophils. Prednisolone treatment effected the state of neutrophils manifested in a reduced acid phosphatase activity; the production of lysozyme increased, the absorptive capacity normalized. PMID- 2773448 TI - [Features of erythrocyte aggregation in various forms of bronchial asthma]. AB - A model of aggregation of erythrocytes was used to study the characteristic features of membrane disorders in different forms of bronchial asthma. It was found that erythrocytic aggregations depended on the form of bronchial asthma, primarily due to the characteristic features of the erythrocytic cellular membrane. In infectious-dependent bronchial asthma and chronic obstructive bronchitis erythrocytic aggregation was increased while in atopic bronchitis it tended to decrease. PMID- 2773447 TI - [Treatment of chronic bronchitis in tobacco smokers under sanitorium conditions]. AB - The efficacy of health resort treatment was studied in 227 tobacco smokers suffering from chronic bronchitis. It was found that by the end of the treatment course patients that gave up smoking as compared with those continuing smoking revealed an increased tolerance to physical loads, an improvement several external respiration indices. Biochemical findings and analysis of the mucus revealed a reduction of the inflammatory process in the bronchopulmonary system. Health resort rehabilitation treatment of chronic bronchitis was effective when the patients ceased smoking. The authors present a scheme of staged treatment of nicotinism in health resort conditions allowing to achieve success in 70.1% of patients. PMID- 2773450 TI - [Morphofunctional characteristics of autonomic disorders in patients with chronic alcohol intoxication]. AB - Clinico-physiological and biochemical methods were used in 136 patients with chronic alcoholism and morphological investigations of the cingulum and hypothalamic region in 40 alcoholized rabbits with the purpose of evaluating vegetative disorders. The severity of anatomo-clinical changes depended on the stage of the neurotoxis process and duration of alcohol abuse. As alcohol intoxication advanced functional disorders were followed by organic. PMID- 2773449 TI - [Kyphoscoliosis in intramedullary cysts and tumors of the spinal cord]. PMID- 2773451 TI - [The limits of the reference range of serum enzymes]. AB - The reference ranges of some of the most frequently used in the clinical laboratory practice serum enzymes and isoenzymes are determined: aspartate aminotransferase (ASAT), alanine aminotransferase (ALAT), creatine kinase (CK) and its isoenzyme (CK-MB), lactate dehydrogenase (LDH) and its isoenzyme--HBDH, and alkaline phosphatase (APh). The reference ranges of the enzymes and isoenzymes studied are calculated from the results obtained in 182 clinically healthy persons, 20-50 years of age, by the "single test" method. All analyses are made with the flexible discrete analyzer "Technicon PA 1000". The influence of several factors is studied. The age of the patients does not exert any influence on the enzymes and isoenzymes studied. Statistically significant sex dependent differences are established for CK, ASAT, ALAT and APh. The statistical processing of the results for the determination of the reference ranges of the enzymes and isoenzymes studied is accomplished with a computer "Hewlett Packard 85". PMID- 2773452 TI - [Diagnosis and treatment of idiopathic hypogonadotropic hypogonadism in men based on a clinical case]. AB - A patient with tertiary hypogonadotropic hypogonadism was followed up for many years. On the basis of this observation the possibilities for a correct diagnosis with the gonadoliberin test are pointed out. A positive effect of the treatment with gonadotropic hormones, especially on the spermatogenesis, is established. Several other new therapeutic means which can be applied in these patients are discussed. PMID- 2773453 TI - [Diffuse cavernous hemangioma of the rectum]. AB - A case of a 59 years old woman with a diffuse rectal cavernous hemangioma is reported. The rectoscopic diagnosis was that of rectal cancer. PMID- 2773454 TI - [Endocrine localization of Hodgkin's disease]. AB - Among 130 patients with Hodgkin's disease hospitalized for a 13 year period were established two cases of primary extranodular localization in the thyroid gland and an extremely rare case of affection of the neurohypophysis as a manifestation of hematogenous dissemination. The clinical manifestations, therapeutic approach and the effect of the endocrine localization on the survival of the patients are presented. The prognosis was comparatively good in the patients with thyroid localization but in the patients with hypophyseal localization it was unfavourable. The diagnostic and therapeutic possibilities in Hodgkin's disease with endocrine localization are discussed. PMID- 2773455 TI - [Chronopharmacokinetics of the preparation biomet400 in patients with duodenal ulcer]. AB - Biomet400 is a selective H2-blocker produced by the firm "Pharmacia" of the Bulgarian Medical Academy. 11 patients were treated with the drug in a dose of 400 mg taken orally in the morning or in the evening. The pharmacokinetic analysis revealed a slower resorption of cimetidine in the patients who had taken the drug in the evening (Tmax = 2 h, resp. 1.67 h) and a lowered Cmax (1.96 micrograms/ml, resp. 2.79 micrograms/ml) in comparison with the patients who had taken the drug in the morning. In the patients who had taken the drug in the evening the apparent volume of distribution is statistically significantly higher (242 l, resp. 124 l by the morning administration) and a tendency toward a slower elimination than by the morning administration is found (t1/2 = 4.41 h, resp. 3.89 h). In the patients who had taken the drug in the morning the elimination is mainly by renal excretion (Clr = 405 ml/min, resp. 3.29 ml/min for the evening administration) while in the patients with evening administration the nonrenal clearance prevails (Clnr = 534 ml/min, resp. 339 ml/min). The results indicate the presence of chronopharmacokinetic differences in the cimetidine action and they can explain the better chronotherapeutic results of the treatment with biomet400 administered in the evening. PMID- 2773456 TI - [Biotidin treatment of duodenal ulcer]. AB - The results of the treatment with the Bulgarian drug biotidin of 30 patients with endoscopically proved duodenal peptic ulcer are presented. The drug was given in a dose of 150 mg twice daily in the course of 20 days. The pain ceased up to the third day in 93.3% of the patients treated and the dyspeptic complaints vanished up to the second day of treatment in 96.6% of the patients. Following the treatment a statistically significant lowering of the indices of gastric secretion (V abd V1) and acid production (BAO, MAO, PAO) was found compared to those before the treatment. Endoscopically full epithelialization was found in 63.3% of the patient, in 33.3% of the patients the size of the ulcer diminished and in only 3.4% of the patients there was no change of the ulcer size. The ulcer epithelialization was related to the initial ulcer size. The results achieved do not differ substantially from those achieved with the English drug Zantac. In the course of treatment with biotidin no side effects were observed and no changes of the basic biochemical indices were found. PMID- 2773457 TI - [Effect of age and the duration of the peptic ulcer on reflux changes of the esophageal mucosa]. AB - 446 patients with an active peptic ulcer were examined. In 81.2% of them gastroesophageal reflux was found. In 220 patients the changes in the esophageal mucosa were studied morphologically. The patients were classified into groups according to their age and the duration of the disease. In 70.3% of the patients with a history of peptic ulcer over 15 years a reflux esophagitis was found and in 34.5% of the patients it was well expressed while in only 39% of the patients with a 5 year history of the disease a reflux esophagitis was found histologically and it was well expressed in 8.1% of them. Gastroesophageal reflux and reflux esophagitis are more frequent in patients over 40 years of age and in these patients the more severe forms prevail. The longer is the duration of the disease the greater is the number of cases with well expressed destructive changes. PMID- 2773458 TI - [Transendoscopic mechanical lithotripsy in choledocholithiasis]. AB - When there are large stones in the common bile duct or constrictions of the bile ducts the stones very often cannot pas spontaneously or after an endoscopically performed sphincterotomy. In 54 patients after an unsuccessful attempt to extract the stone with the Dormia-basket endoscopic mechanical lithotripsy was performed followed by balloon extraction of the fragments, balloon dilatation of the constricted sectors of the bile duct and securing a bilionasal drainage for prophylaxis of cholangitis. The mechanical lithotripsy was successful in 50 of the patients (92.4%). The jaundice and the cholestasis decreased up to the 10-th day and the cytolytic enzymes became normal. Complications occurred in 2 patients (4%)--hemorrhage up to the 12-th hour after the manipulation. The author recommends, in cases of unsuccessful stone extraction by endoscopic sphincterotomy, the mechanical lithotripsy in combination with balloon extraction of the fragments, balloon dilatation of the constricted sectors of the bile duct and nasobiliary drainage for washing the bile ducts, prevention of bile duct occlusion and treatment of cholangitis in cases of unsuccessful extraction by endoscopic sphincterotomy. PMID- 2773459 TI - [Complex assessment of the electrophysiologic changes in patients with left ventricular cardiac overload]. AB - 130 healthy persons and 146 cardiac patients with left ventricular cardiac overload were examined by 4 electrophysiologic methods: corrected orthogonal electrocardiogram according to Frank, corrected orthogonal vectorcardiogram, space electrocardiogram, high-speed space electrocardiogram. 76 indices were examined. The cardiac patients were classified into two basic groups: patients with systolic overload and patients with diastolic overload. By variational analysis, performed in all patients, statistically significant differences were found between the cardiac patients and the healthy persons. On the basis of the criteria sensitivity, specificity and assessment of realization the best indices for every method were determined. In order to improve the sensitivity "sets" with sensitivity of 91-96% are established by mathematical calculations. The "sets" are made up of 4 indices from different methods and are suitable for inclusion in computer programs. PMID- 2773460 TI - [Epidemiologic studies of the prevalence of arterial hypertension among industrial workers in Stara Zagora]. AB - An epidemiologic study was carried out in June 1986 among 1702 industrial workers from the machine-building and metal-manufacturing industry--956 men and 746 women. 57.9% of the workers were in the 30-39 and 40-49 age groups. Arterial hypertension was found in 16.6% of the examined and borderline hypertension was found in 12.9%. With advancing age the hypertension frequency increases. Men suffer more frequently (18.4%) than women (14.2%). In younger age this difference is statistically significant. A relation was established between hypertension and obesity in both sexes. The characteristics of the hypertension structure and the relation of borderline hypertension with age, sex and body mass are discussed. PMID- 2773461 TI - [Long-term (beyond 5 years) prognosis of successfully resuscitated patients with ventricular fibrillation]. AB - An investigation was carried out of 58 patients who had survived ventricular fibrillation during the period 1975-1982 and had been successfully resuscitated in the Cardiologic Clinic of the High Medical Institute in Varna. 12 of the patients were women and 46 were men, mean age 60.8 years (from 43 up to 85 years). 3 of the patients were dropped out of the investigation because of lack of information. 35 patients (63.6%) had died and 20 patients (36.4%) were alive. 4 of the alive patients (20%) had resumed their previous occupation. 3 of the patients (15%) were on old age pension but were engaged in some kind of work. 12 patients (60%) were old age pensioners or on a disablement pension but in good functional class. Only one patient (5%) was in a bad physical condition confined to bed. Ventricular fibrillation has a poor prognosis but if timely and properly treated it could be overcome and the life of the patients could be prolonged. Some of the patients could live a wholesome life for a long period of time (more than 5 years). PMID- 2773462 TI - [Bicycle ergometry--an objective criterion for determining the work capacity of patients with a history of myocardial infarct]. AB - The importance of bicycle ergometry for the objective assessment of the working capacity of patients with past myocardial infarction is great. Of 283 followed up patients with myocardial infarction III patients were examined by bicycle ergometry (39.2%). 66 patients of the latter group had restored their working capacity (59.4%) and 45 patients (40.6%) were disabled. The mean threshold power in all patients was 87.07 W, in the patients with restored working capacity the threshold power was 100.37 W, in the patients with group II disability it was 51.6 W and in the patients with group III disability it was 88.33 W. The dynamics of the threshold power was followed up by control bicycle ergometric examinations in 2-4 year intervals. In the patients with restored working capacity the threshold power was 107.69 W and in the disabled patients it changed from 70 to 80.83 W. The positive dynamics of the bicycle ergometric indices corresponds to the positive dynamics of the working capacity and the stabilization of the health condition of the patients with past myocardial infarction. PMID- 2773463 TI - [Mortality of patients with a history of acute myocardial infarct 3 months after the disease]. AB - The lethality rate of patients with past myocardial infarction after the third month of the infarction is discussed. Two groups of patients with past myocardial infarction were followed up for 4 years after the third month of the infarction. The basic group included patients who carried out a rehabilitation program while the patients in the control group were not included in any kind of rehabilitation. At the of the first year the lethality rate of the basic group of patients was 5.71%% while of the control group it was 8.82%. In the second year the lethality rate fell in the basic group to 4.55% and in the control group to 6.45%. In the third year the lethality rate was 3.17% for the basic group and 3.45% for the control group, and in the fourth year it was 1.63% for the basic group and 3.57% for the control group. The rehabilitation program carried out with the patients of the basic group had exerted a favorable influence on the survival of the patients and had led to a lower total lethality rate of 15.06% compared to that of 22.29% of the control group for the whole four year period of observation. The physical rehabilitation reduces the known until now factors of increased risk as well as the possibility for a new infarction. PMID- 2773464 TI - [Changes in the level of urinary secretory immunoglobulin A in patients with recurrent pyelonephritis]. AB - The urine concentration of secretory immunoglobulin A was studied in 58 healthy persons (26 women and 32 men) and in 55 patients (44 women and 11 men) with chronic recurrent pyelonephritis before the beginning of the antibacterial treatment. An immunoenzyme method on a solid phase was used (ELISA). In 21 patients a lowered urine secretory immunoglobulin A level (IgA) was found, in 19 patients it was elevated and in 15 patients it was in normal ranges. In the group of patients with an elevated secretory IgA level the antibacterial treatment was successful in 89.5% of the patients while in the group of patients with a lowered secretory IgA level the treatment was successful only in 61.9% of the patients. In 12 patients the secretory IgA level was examined after the treatment and in 72.7% of them it was changed--in 38.2% of the patients the level was lowered and in 34.5% of the patients it was elevated. The local immune response of the organism against infections is discussed. PMID- 2773465 TI - [Chronic pyelonephritis in polycystic kidney]. AB - The characteristics of chronic pyelonephritis are studied in 37 patients out of a total of 53 patients with proved renal polycystosis. A group of 71 patients with chronic pyelonephritis selected at random are used as a control group. The frequency of chronic pyelonephritis among the patients with renal polycystosis is 69.8%. The difference between the mean age of the patients with renal polycystosis and chronic pyelonephritis and the patients with renal polycystosis without chronic pyelonephritis is 8.6 years. A significant difference is established between these two groups of patients concerning the frequency of symptomatic hypertension--89.2% for the patients with renal polycystosis and chronic pyelonephritis and 45% for the patients with uncomplicated renal polycystosis. A similar difference is established also for the renal failure- respectively 64.9% and 37.5%. The frequency of hypertension and chronic renal failure is lower in the control group of patients. 59% of the patients with renal polycystosis and chronic pyelonephritis have significant bacteriuria, E. coli and Proteus being the most frequently isolated bacteria but Pseudomonas shows the highest drug resistance. The isolated bacteria are most sensitive to nitroxoline and aminoglycoside antibiotics. PMID- 2773466 TI - [Effect of autonomic pathology in uremia on the blood pressure during hemodialysis]. AB - The state of the vegetative nervous system was studied by the deep respiration test, Valsalva test and the orthostatic test in 12 patients with terminal chronic renal failure and hypotension in the course of hemodialysis, 12 patients with stable hemodynamics in the course of hemodialysis and 12 healthy controls. By the deep respiration test the mean change of the cardiac rate in the patients with hypotension is significantly lower than that in the healthy controls (p less than 0.001) and that of the normotonic patients on hemodialysis (p less than 0.01). In the dialyzed normotonic patients the change of the cardiac rate is significantly lower than that in the healthy controls (p less than 0.02). Similar results are achieved with the Valsalva test. The impairment of the vegetative nervous system is considerably better expressed in the hypotensive patients. The proposed tests are noninvasive, easy to perform and give reliable information for the affection of the vegetative nervous system. PMID- 2773467 TI - [The side effects of drugs]. AB - The study is based on the statistical data of 3317 hospitalized patients 310 of whom (9.34%) were hospitalized because of a drug untoward reaction. The drug side effects are more frequent in women (60.64%) than in men (39.35%). The most affected age groups are those of 20-29 and 30-39 years. 74.21% of the untoward reactions are of immune character and the remaining are pharmacologic. The greater part of the untoward reactions are due to the following drugs: noramidopyrine (10.4%), co-trimoxazole (9.07%), acetylsal (8.21%) and amoxycillin (6.23%). Most frequently affected are: the skin (44.41%), the central and peripheral nervous system (17.41%) and the cardiovascular system (11.06%). PMID- 2773468 TI - [15 patients with myelodysplastic syndrome]. AB - 15 patients (10 men and 5 women) with myelodysplastic syndrome, treated in a Hematologic Clinic during the last three years, are studied. The patients are classified in the following groups: with a refractory anemia (4 patients), with an acquired idiopathic sideroblast anemia (3 patients), with a refractory anemia with an excess of blast cells (8 patients). The diagnosis is proved by morphologic examinations, in some of the patients by isotopic examinations and in 5 patients a cytogenetic analysis is made. 7 patients died and in 5 of them the post mortem examination confirms the clinical diagnosis of myelodysplastic syndrome passed in acute leukosis. 4 patients are still alive and are under active observation. For the remaining 4 patients there are no data. The shortest survival is 6 months and the longest one is 9 years. The prognostic importance of the number of blast cells in the bone marrow is pointed out. The patients with refractory anemia with an excess of blast cells are treated with mercaptopurine or small doses of cytosine arabinoside in addition to the conventional blood stimulating therapy applied in the other forms of myelodysplastic syndrome. PMID- 2773469 TI - Recent increase in incidence of acute rheumatic fever in southern West Virginia. AB - Rheumatic fever appeared to decline in the United States in the 1970s and early 1980s. In the last two years, however, there have been multiple reports of the resurgence of rheumatic fever. Two of these reports originated in states that border West Virginia. This study demonstrates that there has been a similar outbreak in the southern part of West Virginia in 1988. In addition, it appears that the incidence of first-attack heart damage is high, and that physicians should maintain their vigilance in diagnosing and treating acute rheumatic fever. PMID- 2773470 TI - No place to hide. PMID- 2773471 TI - Medical education for today's practice. PMID- 2773472 TI - A view from Canada. PMID- 2773473 TI - The role of echocardiography in managing cardiac emboli. PMID- 2773474 TI - The increased rate of fractures of the hip and spine in Alzheimer's patients. PMID- 2773475 TI - Lyme disease in northern California. PMID- 2773476 TI - Managing hypercholesterolemia. PMID- 2773477 TI - Snake oil. PMID- 2773478 TI - More on dismemberment. PMID- 2773479 TI - Familial thyrotoxic periodic paralysis. PMID- 2773480 TI - Misleading articles. PMID- 2773481 TI - Lessons from the frozen North. AB - Presented in part as the Kaiser Foundation Distinguished Lecture at the annual meeting of the Western Association of Physicians, February 7, 1989. PMID- 2773482 TI - Clove cigarettes. The basis for concern regarding health effects. AB - The smoking of clove cigarettes has been associated with 13 cases of serious illness in the United States, including hemorrhagic pulmonary edema, pneumonia, bronchitis, and hemoptysis. We describe a patient in whom, after she smoked a clove cigarette, pneumonia complicated by lung abscess developed. Her lung disease may have been caused by aspiration pneumonia as a consequence of pharyngolaryngeal anesthesia from clove cigarette smoke. Clove cigarettes appeal to adolescents experimenting with smoking practices and may influence the development of later smoking habits. PMID- 2773483 TI - A matter of trust. PMID- 2773484 TI - [Tumor markers in endocrinology (without gynecology and urology)]. AB - In tumours of the endocrine system there are very few real "tumour markers" (e.g. CEA); all other relevant tests measure by radioassay several endocrine materials which are produced in similar ways by tumours and normal glands. Therefore, tumour marker assays in endocrinology are usually performed in follow-up studies after more or less radical therapy of tumours of the pituitary gland, thyroid gland, parathyroid glands, endocrine pancreas and the adrenal glands. On the basis of approximately 3000 assays of HGH, prolactin, thyroglobulin, calcitonin, CEA, insulin, gastrin, cortisol and aldosterone (in part with suppression and/or stimulation techniques), it is shown that these mostly indirect tumour marker assays are very important in follow-up programmes after therapy of neoplasms of the endocrine system. Their sensitivity amounts to 80%, their specificity is of the same degree. PMID- 2773485 TI - [Tumor markers in the upper intestinal tract--stomach and pancreas]. AB - Expectations of early diagnosis of carcinoma of the stomach and pancreas by using the tumour markers CEA and CA 19-9 have been disappointed. Although the sensitivity of CA 19-9 for pancreatic cancer is high, its field of application for screening is not efficient due to poor specificity of the marker. CEA and CA 19-9 are of great importance in the follow-up of pancreatic cancer. Results of tests of CEA and CA 19-9 in 100 patients with gastric cancer and 50 patients suffering from pancreatic cancer are reported. PMID- 2773486 TI - [The high autopsy rate in Vienna]. AB - In 1983 34% of all persons who died in the Republic of Austria were autopsied. We examined the frequency of postmortem examinations in the capital city, Vienna, between 1983 and 1987 in view of this high overall autopsy rate. The annual autopsy rate in all 9 pathology institutes and the department of legal medicine of the University of Vienna was on average 51 to 53%. There was a slight statistically verifiable decline in 1987. The reason for this high necropsy rate is that Austrian law permits the autopsies without the consent of next of kin if it appears indicated for medical, scientific or educational reasons; further more the fact, that the chairman of the department is at the same time the coroner for the hospital. A high autopsy rate is necessary to maintain a high standard of diagnostic accuracy even in modern medicine. The diagnoses were inaccurate or incomplete in 15% of all cases. The high autopsy rate is the basis for extremely accurate mortality and morbidity statistics and provides the basis for long range public health planning. Medical students develop an insight in disease patterns, which cannot be gained in any other way. The pathology departments of Vienna introduce a new city-wide computer-supported diagnostic file system, which will provide a baseline for comparative scientific studies. PMID- 2773488 TI - [Prognostic factors for long-term mortality and risk of stroke in patients with transitory ischemic attacks]. PMID- 2773487 TI - [The activity spectrum of psoralen photochemotherapy. Comparative treatment of psoriasis with 335 nm and 365 nm]. PMID- 2773489 TI - [Management of acute intrathoracic aortic dissection]. AB - At the intensive care station of the Internal Medicine Department, University Clinic Graz, all patients admitted were promptly and carefully examined in case of suspected acute intrathoracic aortic dissection and immediately treated. In 1987 a total of 4446 patients were referred to this CCU, 893 suffered from acute thoracic pain. In 21 patients of the latter a clinical suspicion of aortic dissection was observed. In 9 patients of these, diagnosis could be established within 5 hours by echocardiography, CT and angiography. 11 patients had no dissection while one positive finding could only be determined by postmortem exam. Retrospectively, these figures for 1982 were 3908 admitted patients, 790 suffering from acute thoracic pain of which only 5 showed suspected dissection. In 3 cases dissection could be confirmed using the same diagnostic procedures, but 2 were without finding. Further 3 patients out of the total series were affected with dissection which could only be determined postmortem. Out of the 9 patients with positive diagnosis, 6 showed Typ I, 1 Typ II and 2 Typ III dissection according to DeBakey (8m, 1f, range 46-78 years). 2 patients underwent surgery immediately after diagnosis, 1 after 12 hours, while 4 cases were conservatively treated. These 7 patients have survived by controlled hypotension up to now (10 to 22 months). Two patients died 2 and 10 hours, respectively, after admission with positive diagnosis. In spite of the severity of this disease prompt and efficient diagnosis and rapid therapeutic management are the key to survival. PMID- 2773490 TI - [Results of rubella prevention in Austria (1988 status)]. AB - The aim of any rubella eradication programme is the prevention of rubella embryopathy. In Austria, every girl aged 13 years is vaccinated without prior antibody testing. In addition, all pregnant women are tested for antibodies and vaccinated post partum, if necessary. As in other European countries, this policy has not (yet) led to the elimination of rubella embryopathies. In 1987 and 1988, 3 embryopathies as well as 16 and 17, respectively, rubella infections in pregnant women were diagnosed. In order to monitor the effectiveness of the vaccination in 13 years old girls, we tested 325 sera from student nurses (mean age 15.6 years) as well as 895 sera from pregnant women (mean age 23.1 years). In the 1st group, only 2.2% had a titer of less than or equal to 16 in hemagglutination inhibition test and therefore were not unequivocally protected. In the pregnant women, this ratio was 6.1%. We therefore draw the conclusion that in some cases the protection afforded by the vaccination begins to decrease after 10 years. At the same time, we also tested the sera of 4186 pregnant women who claimed they never had been vaccinated. Their mean age was higher (26 years) and 11.1% were not unequivocally protected. In addition, we tested 28 women who had been vaccinated 3 to 6 months previously due to negative serology. Of these, 6 (21.4%) did not produce antibodies with a titer of at least 32. Many European countries had the same experience and therefore began vaccinations of all children in the 2nd year, using the trivalent vaccine (mumps, measles, rubella) instead of the bivalent one (without rubella).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2773492 TI - Progress symposium--Progress in craniofacial surgery. PMID- 2773491 TI - [ExacTech--a new measuring system for personal control of blood glucose]. AB - ExacTech is a pen-sized glucose meter that uses an amperometric principle for blood glucose determination. Accuracy was assessed in 94 capillary blood samples by comparing the ExacTech values to the hexokinase method. Correlation between the methods was 0.983. 76% of ExacTech measurements were within +/- 10% of the reference method. Coefficients of variation for within run precision determined in two different blood glucose levels were 3.2% (81 mg/dl) and 4.2% (222 mg/dl) resp. 12 diabetic patients compared ExacTech to their reflectance meters. The ExacTech readings when correlated with the hexokinase method gave slightly better results than those obtained with common glucose meters. Patients acceptability of this novel measuring system was excellent. PMID- 2773493 TI - Recent advances in medical imaging: surgery planning and simulation. AB - Three-dimensional display of medical image data has under gone rapid development since its introduction. This article explores the current state-of-the-art of 3 dimensional imaging applied to surgery planning and discusses the various image acquisition sources: computed tomography (CT), cine CT, magnetic resonance imaging, and ultrasound. Since increased physician involvement is the goal of the surgery planning software described, the future directions discussed emphasize the inclusion of "expert" knowledge and ways to facilitate realistic interaction for surgery simulation. PMID- 2773494 TI - Cephaloceles: classification, pathology, and management. AB - A cephalocele is defined as a herniation of cranial contents through a defect in the skull. Cephaloceles are classified according to their contents and location. We have reviewed a total of 112 patients with cephaloceles, 51 of whom had sincipital meningoencephaloceles (fronto-ethmoidal meningoencephaloceles). This group is distinctive in its demographic distribution, in the effect on growth of other facial structures, and in the combined craniofacial approach needed to treat them. This review is based on the sincipital encephaloceles with the other cephaloceles included for completeness. Despite many theories, the cause of congenital cephalocele is not known. Preoperative work-up includes 3-dimensional computed tomography scan of the facial skeleton, and surgical management is multidisciplinary in nature. The aim is to remove the lesion before the deformity has time to greatly distort facial growth, which appears to realign itself after surgery. The 50 patients who underwent surgery for fronto-ethmoidal encephalocele all survived with minimal complications. PMID- 2773495 TI - Craniosynostosis. AB - Craniosynostosis affects approximately one infant out of one thousand. Increase of intracranial pressure and risks of functional problems are more frequent than previously thought, especially in single-suture synostosis. Frontocranial remodeling will correct both functional and esthetic consequences of craniosynostosis. The best time for surgery is the first year of life, 2-3 months of age for the brachycephalies, and 6-9 months of age for the other craniosynostoses. Not only does growth not deteriorate after forehead remodeling, but the adjacent orbitonasal areas improve with time. In Crouzon's disease and Apert's syndrome, early frontal advancement does not prevent the midface retrusion, and a radical frontofacial advancement may be occasionally indicated in very severe cases. Frontocranial remodeling is also indicated in children presenting with sequelae of classical neurosurgical treatment or those who have had no treatment. PMID- 2773496 TI - Early operation in craniofacial dysostosis. AB - Craniofacial dysostosis is encountered in different congenital malformations such as Kleeblattschadel deformity, Crouzon's disease, and Apert's, Chotzen's, Pfeiffer's, and Carpenter's syndromes. Premature closure of cranial and facial sutures leads to characteristic disfigurement of the skull with orbital and maxillary hypoplasia. Operative treatment should be performed as early in life as possible to prevent further functional and esthetic deficiencies, and psychosocial problems. Correction is done by an intracranial approach with mobilization, remodeling, and advancement of the deformed skull. Thirty-two children have been operated during the first year of life with a maximum follow up of 8 years. Most favorable results were obtained in 28 cases. The rate of complications were lower than in a series of children operated on later in life. We advocate that complex 1-stage corrections of craniofacial syndromes may be safely carried out during infancy utilizing modern techniques, expert pediatric anesthesia, and postoperative intensive care. PMID- 2773497 TI - Facial clefts. AB - Facial clefts, including those of the lip and palate, are extremely rare. Some arise at the junction of facial processes preventing fusion, others have their origin in or between ossification centers. Virtually all are associated with osseous deficiencies. This article reviews the pathogenesis and morphology of these clefts. The principles of skeletal and soft tissue reconstruction are discussed and the experience of the authors with various new techniques is reported. PMID- 2773499 TI - Hemifacial microsomia. AB - Hemifacial microsomia is variable with respect to the degree of the deformity it presents, thus, treatment varies. Mild degrees of the condition are usually treated adequately by waiting until adolescence, when definitive surgical correction of any skeletal or soft tissue asymmetry can be dealt with. Some mild and moderate cases may benefit from orthodontic functional appliance therapy during growth, but orthodontic opinion is divided on the value of such therapy. Children with severe forms of hemifacial microsomia are improved in appearance during their school years by early surgery performed in the preschool period. A number of surgical approaches have been used at this stage. The technique currently being used by the author involves composite transfer of vascularized soft tissue for contouring, together with a vascularized costochondral strut to lengthen the affected side of the mandible. Early results using this method are satisfactory, but further work is required to assess the advantages of this over other techniques. PMID- 2773498 TI - Correction of orbital hypertelorism in Asian patients. AB - In this article, correction of orbital hypertelorism in Oriental patients is summarized. An orbital osteotomy is currently used to correct an abnormally wide interorbital distance. At present, associated deformities such as a short nose and a depression deformity in the temporal region following orbital osteotomy can be partially corrected. In Oriental patients, the Mongolian fold can be enhanced after correction of orbital hypertelorism. This fold can be easily corrected by epicantoplasty. PMID- 2773501 TI - Midface retrusion. AB - Experience with 162 patients for whom a midface advancement was performed over the last 10 years is reported. The series includes cases of primary maxillary hypoplasia, post-cleft deformities, and major craniofacial anomalies. The indications and techniques applicable to each particular deformity are discussed and final results are analyzed. The overall facial esthetic concept is emphasized to ensure achievement of not only a good functional result, but also a pleasant appearance. PMID- 2773502 TI - Advances in craniofacial tumor surgery. AB - The use of craniofacial surgical techniques has stimulated the development of new approaches to the excision of skull base tumors. Experience gained from operating on 200 skull base tumors (45 nonmalignant and 155 malignant) is presented. The cranial base area is subdivided into specific areas, and surgical approaches have been devised. In addition, the use of vascularized tissue such as the galea, temporalis fascia, temporalis muscle, or free vascularized tissue transfer has prevented the complication of infection so frequently seen as a cause for morbidity and mortality in the past. In this series, there were no major infections. The variety of pathology seen in this area is considerable. Therefore, in a series such as this operated on by a single surgeon, only trends can be observed. We suggest that with experience, surgery in this area is safe, and the long-term survival of this mixture of tumors (primary, recurrent, carcinomas, and sarcomas) is between 40% and 50%, and, therefore, makes excisional procedures worthwhile. PMID- 2773500 TI - Treacher Collins syndrome: present concepts of the disorder and their surgical correction. AB - Treacher Collins Syndrome is a rare bilateral congenital deformity occurring in 1 in 10,000 births. It is also known, in the European literature, as Franceschetti Syndrome, and is additionally known as mandibulofacial dysostosis. It is a syndrome with a very wide spectrum of manifestations characterized by distortions of the orbit secondary to hypoplasia of the maxilla, mandible, and, most markedly, of the zygoma. Soft tissue deformities include lower lid colobomas, laxity and dystopia of the lateral canthus, microtia, and a paucity of the muscular aponeurosis of the midface. The syndrome is frequently accompanied by significant hearing loss, early failure to thrive, chronic respiratory insufficiency, and sleep apnea. Intelligence is usually within normal limits although learning disabilities are common in early life. These major anatomical and physiological abnormalities, as well as the psychological and social stigma associated with severe facial deformity, make this syndrome one of the most challenging reconstructive problems presented to the craniofacial surgeon. PMID- 2773503 TI - Anastomotic leakage after resection and bypass for esophageal cancer: lessons learned from the past. AB - A retrospective study of anastomotic leakage has been undertaken in 730 patients who had resection or bypass for carcinoma of the esophagus during the period 1964 1982 at the Department of Surgery, University of Hong Kong, Queen Mary Hospital, Hong Kong. Partial or complete gangrene of the substitute loop also resulting in anastomotic disruptions were excluded from this series. Anastomotic leakage due to suture line failure occurred in 182 patients (24.9%). Two factors were found by multivariate analysis to influence leakage: the type of operation and the choice of organ used as substitute. Leakage occurred more than twice as often in bypass (42.7%) than in resection (18.3%). When the substitute used for reconstruction was viable, jejunum was associated with the lowest incidence of leakage followed by whole stomach, distal stomach, and colon in that order. The risk of leakage for any combination of the type of operation (resection or bypass) and substitute loop used was calculated. The probability of leakage was lowest when a resection was performed and jejunum was used as substitute. In view of the simplicity and relative safety of using the whole stomach, esophagectomy followed by gastric reconstruction is still the procedure of choice for the majority of patients. A bypass procedure using colon as substitute has the highest leakage rate. A low leakage rate should now be obtained, otherwise nonoperative therapy has a legitimate claim as the preferred alternative treatment modality. PMID- 2773504 TI - Modulation of inflammatory reactions by surgical trauma: lack of relationship with corticosteroid secretion. AB - The effect of surgery on inflammation was studied in male Wistar R/A rats using the carrageenin-induced edema model. Swelling of the paw was measured in standardized arbitrary units 2, 4, and 6 hr after a subcutaneous injection of carrageenin iota in the subplantar region of the right hind limb. It was significantly depressed in rats submitted to laparotomy (5.0 +/- 0.4, 8.0 +/- 1.0, 13.7 +/- 1.9) when compared with controls simply anesthetized with ether (6.2 +/- 0.5, 15.5 +/- 1.2, 23.7 +/- 0.6) (p less than 0.001 at 4 and 6 hr). This inhibition lasted for at least 24 hr and was also observed after amputation, although in these experiments, the difference between operated animals and controls was not significant. Alterations of the inflammatory cellular infiltrate were studied using polyurethane sponges soaked with carrageenin lambda implanted subcutaneously in control animals and rats undergoing laparotomy or amputation. The total number of cells recovered from these sponges 5 hr after implantation was smaller in operated rats (2.9 +/- 0.4 x 10(6) cells after laparotomy, 3.1 +/- 1.0 x 10(6) cells after amputation) when compared with controls (11.1 +/- 1.9 x 10(6) cells and 10.3 +/- 1.3 x 10(6) cells) (p less than 0.001 for laparotomy and p less than 0.005 for amputation). The inhibitory effect of operative trauma was not abolished by bilateral adrenalectomy performed 12 days before laparotomy. In rats, surgical trauma induces a depression of remote inflammatory reactions. This phenomenon is not related to increased corticosterone levels. PMID- 2773505 TI - Prognosis of patients over 75 years of age with a ruptured abdominal aortic aneurysm. AB - Forty-seven patients (34 males and 13 females) over 75 years of age (mean: 79.7 +/- 3.8 SD) suffering from a ruptured abdominal aortic aneurysm were operated on between 1977 and 1986. In 16 patients (34%), the aneurysm had been diagnosed previously. Seventeen patients (36%) had a delay of 6 hours or more in the beginning of the treatment and 26 (55%) were in shock preoperatively. The mean diameter of the aneurysms was 8.9 +/- 2.6 cm (SD) and the mean operative bleeding was 8.5 +/- 7.8 (SD) liters. The mean operating time was 220 +/- 96 (SD) minutes. The 1-month mortality was 60% (28 patients) and 63% (12 patients) of survivors had postoperative complications, mostly pneumonia. The 5-year survival rate was 26%. In the analysis of risk factors associated with death, preoperative shock, old age, and a previously diagnosed but untreated abdominal aortic aneurysm were associated with a significantly worse prognosis. PMID- 2773506 TI - Uptake and biotransformation of 6,7-dimethylquinoline and 6,8-dimethylquinoline by rainbow trout (Salmo gairdneri). AB - 1. 6,7-Dimethylquinoline (6,7-DMQ) is readily taken up by rainbow trout and bioconcentrated in tissue after exposure to ca 1 mg/l for 7.5 h. Mean bioconcentration factors (from water) were 21, 18, 6 and 14 for bile, liver, muscle and carcass respectively. Mean tissue concentrations after 69-96 h depuration were ND, ND, 0.54 and 0.48 micrograms/g for bile, liver, muscle and carcass respectively. 2. Major metabolites, following exposure to 6,7-DMQ, were conjugates (glucuronide or sulphate) of 7-hydroxymethyl-6-methylquinoline and 6 hydroxymethyl-7-methylquinoline. Mean concentration of metabolites in the bile were 500 micrograms/g after 7.5 h exposure to ca 1 mg/l and 1367 micrograms/g after 9.5 h exposure to ca 1 mg/l and 69 h depuration. 3. 6,8-Dimethylquinoline (6,8-DMQ) is also readily bioconcentrated in fish tissue after exposure to ca 1 mg/l. Mean bioconcentration factors (from water) were 23, 20, 13 and 25 for bile, liver, muscle and carcass respectively. Mean tissue concentrations after 7 h exposure to ca 1 mg/l and 63 h depuration were 4.0, 0.67, 0.49, and 3.2 micrograms/g respectively for bile, liver, muscle and carcass. 4. Major metabolites, following exposure to 6,8-DMQ were conjugates (glucuronide or sulphate) of 6,8-dimethyl-5-hydroxyquinoline, 6,8-dimethyl-7-hydroxyquinoline, 6,8-dimethyl-3-hydroxyquinoline and 6-hydroxymethyl-8-methylquinoline. Mean concentration of metabolites in the bile were 1278 micrograms/g after exposure to ca 1 mg/l for 8 h and 1031 micrograms/g after exposure to ca 1 mg/l for 7 h and 63 h depuration. PMID- 2773507 TI - The suitability of carbamazepine as a single-sample probe of human mixed function oxidase activity. AB - 1. Carbamazepine concentrations measured in plasma and plasma ultrafiltrates by fluorescence polarization immunoassay (f.p.i.a.) from 0 to 48 h post-dose were used to calculate CL, V, clearance of plasma unbound drug (CLunb), Vunb; mean (+/ SD) values for these were: 0.017 l/kg/h (+/- 0.004), 1.05 l/kg (+/- 0.14), 0.058 l/h/kg (+/- 0.012), and 4.28 l/kg (+/- 0.41), respectively. 2. A single-dose, single-sample procedure for estimating carbamazepine oral clearance was evaluated with a view to using carbamazepine as a probe in screening for host factor influences on human drug metabolism. Single sample estimates of carbamazepine clearance (CL) were closest to multiple sample values for carbamazepine clearance (CL) when blood samples were collected 48 h after carbamazepine ingestion. This was the case for plasma total carbamazepine and plasma unbound carbamazepine. 3. A value of 1.1 l/kg was used for V in calculating all single sample estimates of clearance (CL), and a value of 4.3 l/kg was used to calculate single sample estimates of clearance of plasma unbound drug (CLunb). The mean prediction error (MPE) was negatively biased for CL and CLunb values calculated from single carbamazepine concentrations in samples collected at 24, 36, and 48 h post-dose. MPE was less than 5% errant for CL and less than 1% errant for CLunb when those parameters were calculated from 48 h concentrations of plasma total carbamazepine or plasma unbound carbamazepine, respectively. Root mean squared error (r.m.s.e.) was lost lowest when 48 h post-dose samples were used for single-sample clearance estimates. PMID- 2773508 TI - Effects of methyl ethyl ketone pretreatment on hepatic mixed-function oxidase activity and on in vivo metabolism of n-hexane. AB - 1. Male Fischer-344 rats were given methyl ethyl ketone (MEK; 1.87 ml/kg), a potentiator of the neurotoxicity of n-hexane, by gavage for 4 days prior to a single inhalation exposure to n-hexane (1000 ppm). 2. Samples of blood, liver, testis and sciatic nerve were obtained and analysed for n-hexane, MEK and their metabolites by g.l.c.-mass spectrometry. 3. Pretreatment with MEK increased the concentrations of 2,5-hexanedione (2,5-HD; the proximal neurotoxin) in blood, sciatic nerve and testis relative to concentrations in the tissues in sham treated controls. 4. Concentrations of 2,5-dimethylfuran, a metabolite of 2,5-HD, were increased in all four tissues tested. 5. After 1-7 days treatment with MEK, the activity of 7-ethoxycoumarin O-deethylase was increased (up to 500%), but benzphetamine N-demethylase activity was virtually unaffected. 6. Hence, the potentiating effects of MEK on the neurotoxicity of n-hexane appear to arise, at least in part, from the activating effects of MEK on selected microsomal enzymes responsible for n-hexane activation. PMID- 2773509 TI - Metabolism of 2,6-dinitrotoluene in male Wistar rat. AB - 1. Unchanged 2,6-dinitrotoluene (2,6-DNT), 2-amino-6-nitrotoluene, 2,6 dinitrobenzyl alcohol, 2-amino-6-nitrobenzyl alcohol, conjugated 2,6 dinitrobenzyl alcohol and conjugated 2-amino-6-nitrobenzyl alcohol were detected in urine of male Wistar rats dosed with 2,6-DNT. The major metabolite was conjugated 2,6-dinitrobenzyl alcohol, which accounted for about 1.5% of the dose. 2. Unchanged 2,6-DNT, 2-amino-6-nitrotoluene, 2,6-dinitrobenzyl alcohol, and conjugates of 2,6-dinitrobenzyl alcohol, 2-amino-6-nitrotoluene and 2,6 dinitrobenzaldehyde were detected in the bile of rats dosed with 2,6-DNT. The major metabolite was conjugated 2,6-dinitrobenzyl alcohol, which accounted for 30% of the dose. Conjugates of 2,6-dinitrobenzyl alcohol (major) and 2,6 dinitrobenzaldehyde (minor) were common biliary metabolites in rats dosed with 2,6-dinitrobenzyl alcohol or 2,6-dinitrobenzaldehyde. 3. 2,6-Dinitrobenzyl alcohol and 2,6-dinitrobenzaldehyde were detected by incubating bile from rats given 2,6-DNT with rat intestinal contents under N2. 4. Incubation of 2,6-DNT with hepatic microsomal preparations gave 2,6-dinitrobenzyl alcohol. Incubation of 2,6-dinitrobenzyl alcohol with microsomal plus cytosol preparations gave 2,6 dinitrobenzaldehyde. Incubation of 2,6-dinitrobenzaldehyde with cytosol preparations gave 2,6-dinitrobenzyl alcohol and 2,6-dinitrobenzoic acid. The activities of 2,6-DNT oxidation to 2,6-dinitrobenzyl alcohol, 2,6-dinitrobenzyl alcohol oxidation to 2,6-dinitrobenzaldehyde, 2,6-dinitrobenzaldehyde oxidation to 2,6-dinitrobenzoic acid, and 2,6-dinitrobenzaldehyde reduction to 2,6 dinitrobenzyl alcohol were 22.0, 4.7, 1.3, and 23.3 nmol formed/g liver per min, respectively. 5. These results indicate that 2,6-dinitrobenzaldehyde, an intermediary metabolite of 2,6-DNT in male Wistar rats, is produced either by oxidation of 2,6-DNT in the liver, or by oxidation of 2,6-dinitrobenzyl alcohol formed by hydrolysis of 2,6-dinitrobenzyl alcohol conjugates excreted in the bile, and further indicate that enterohepatic circulation of 2,6-dinitrobenzyl alcohol and 2,6-dinitrobenzaldehyde occurs. This result, together with previous findings, shows that there are metabolic differences, including the biliary excretion of a diol glucuronide of 2,6-dinitrobenzaldehyde and the lack of urinary excretion of 2,6-dinitrobenzoic acid, between 2,4-DNT and 2,6-DNT in male Wistar rat. PMID- 2773511 TI - Ethacizin metabolism in humans. AB - 1. The major metabolites of ethacizin (ethyl 10-[3 diethylaminopropionyl]phenothiazine-2-carbamate) have been isolated from human urine by h.p.l.c. and identified by determination of u.v., i.r., n.m.r. and mass spectra and comparison with spectra of synthetic standard compounds. 2. The pathways of metabolism of ethacizin include N-de-ethylation, sulphoxidation, N-10 amide hydrolysis, aromatic hydroxylation and conjugation. PMID- 2773510 TI - Disposition of cefotaxime and its metabolite, desacetylcefotaxime, in rat: application of a pharmacokinetic-protein binding model. AB - 1. The pharmacokinetics and protein binding of cefotaxime and desacetylcefotaxime were studied in rat. 2. After i.v. dosing of cefotaxime (100 mg/kg) the concentration-time profiles of cefotaxime and its metabolite desacetylcefotaxime followed biphasic decays, giving the kinetic parameters for cefotaxime: VTss and AUC of 127 ml/kg and 8.2 mg/min per ml, respectively. The beta-elimination half life was 17 min with Cls of 13.1 ml/min per kg. The average association constant (K x 10(3) M-1) and total protein binding site concentration (Pt x 10(-3) M) for cefotaxime were 3.87 and 0.68, respectively, with saturation of plasma protein binding occurring at about 30 micrograms/ml. The average free fraction of cefotaxime in plasma (Fp) was 0.48. 3. The metabolite desacetylcefotaxime had a plasma Cmax of 74.4 micrograms/ml (35 min). The respective elimination half-life and AUC were 53 min and 7.2 mg/min per ml. The binding profile, unlike that of cefotaxime, was non-saturable with a K value of 13.90M-1. The Fp of desacetylcefotaxime was 0.89. 4. The concentration-time behaviour of total and free desacetylcefotaxime (i.v. bolus, 50 mg/kg) declined biexponentially with respective VTss and AUC of 125 ml/kg and 19.4 mg/min per ml (total drug), and 192 ml/kg and 13.9 mg/min per ml (free drug). The beta-phase half-life of total and free drug was about 36 min, whereas CLs (ml/min per kg) were 2.7 (total) and 3.7 (free). The binding characteristics were in good agreement with those of the metabolite produced in vivo, with a K value of 8.58 M-1. The Fp value of desacetylcefotaxime in plasma was 0.73. PMID- 2773512 TI - Use of antisera in the isolation of human specific conjugates of haloperidol. AB - 1. Three conjugated metabolites of haloperidol were isolated from urine of patients on haloperidol and purified by h.p.l.c. with immunological detection, using three types of anti-haloperidol antisera. 2. Structures of the metabolites were: a sulphate conjugate of the 2-hydroxylated 4-fluorophenyl ring of reduced haloperidol (MH-1), a glucuronide conjugate at the same position as MH-1 (MH-2), and a glucuronide conjugate of the hydroxy group of haloperidol (MH-3). 3. MH-3 was the main urinary metabolite in volunteers receiving haloperidol, who excreted 18% of the dose in the 24 h urine as MH-3, while other conjugates were less than 1%. MH-3 could not be hydrolysed with beta-glucuronidase, due to steric hindrance. 4. Immunological detection of conjugated metabolites is very useful in metabolic studies in humans because of its sensitivity and specificity. PMID- 2773513 TI - Selective destruction of cytochrome P-450d and associated monooxygenase activity by carbon tetrachloride in the rat. AB - 1. The effects of acute treatment of 3-methylcholanthrene (MC)-induced rats with carbon tetrachloride (CCl4) on the content and activity of the polycyclic aromatic hydrocarbon-inducible forms of cytochrome P-450 (P-450c and P-450d) in liver and kidney have been determined. 2. Post-treatment of MC-induced rats with CCl4 in vivo decreased the specific content of total, spectrally determined, P 450 in both hepatic and renal microsomes, by 60% and 40%, respectively. CCl4 treatment destroyed almost all of the hepatic P-450d (specific content after 6 h, less than 2% of control), but had no effect on P-450c, which increased slightly over the 6 h, to 30% above control values. 3. Immunocytochemical measurements demonstrated greater loss of P-450d from the centrilobular and midzonal than from periportal regions of the liver. 4. Hepatic phenacetin O-deethylase, an activity catalysed specifically by P-450d in this tissue, was dramatically decreased following administration of CCl4 to MC-induced rats. Loss of monooxygenase activity was highly correlated with the decrease in P-450d content (r = 0.947, P less 0.001). Aryl hydrocarbon hydroxylase activity of liver, catalysed almost entirely by P-450c, was unchanged and neither activity was affected in kidney. 5. Treatment of MC-induced rats with CCl4 causes a selective loss of hepatic P-450d and associated monooxygenase activities. Phenacetin O-deethylation is catalysed specifically by P-450d in liver, but not in kidney. The mechanism for this destruction of P-450d may be suicide activation of CCl4, but the rate of such activation appears to be much lower than with P-450b. Alternatively, P-450d may be particularly sensitive, and P-450c particularly resistant, to the active metabolite of CCl4 diffusing from a distant site of formation. PMID- 2773514 TI - Anatomic viral detection is automated: the application of a robotic molecular pathology system for the detection of DNA viruses in anatomic pathology substrates, using immunocytochemical and nucleic acid hybridization techniques. AB - This paper presents the first automated system for simultaneously detecting human papilloma, herpes simplex, adenovirus, or cytomegalovirus viral antigens and gene sequences in standard formalin-fixed, paraffin-embedded tissue substrates and tissue culture. These viruses can be detected by colorimetric in situ nucleic acid hybridization, using biotinylated DNA probes, or by indirect immunoperoxidase techniques, using polyclonal or monoclonal antibodies, in a 2.0 hour assay performed at a single automated robotic workstation. PMID- 2773517 TI - [Results of a gerontologic longitudinal study--consequences]. PMID- 2773515 TI - Herpes simplex latent infection: quantitation of latency-associated transcript positive neurons and reactivable neurons. AB - Dorsal root ganglion neurons, which express herpes simplex virus (HSV) latency associated transcript (LAT) during experimental latent infection, were investigated by in situ hybridization. The number of LAT-positive neurons was determined by examination of ganglion serial sections. In other latently infected mice, the number of ganglion neurons that reactivated HSV antigen after explant culture was determined in serial sections. LAT was detected in 100 percent of ganglia, with an average of 19.5 LAT-positive neurons per ganglion. After explant culture of latently infected ganglia (in the presence of colchicine to decrease spread of reactivated virus), HSV antigen was detected in 94 percent of ganglia, with an average of 13.1 positive neurons in the antigen-positive ganglia. The similar quantities of LAT- and antigen-positive neurons within ganglia support the hypothesis that LAT-positive neurons were the neurons from which HSV was reactivated. PMID- 2773518 TI - [Eligibility determination for indications-related disability evaluation]. PMID- 2773519 TI - [Which form of anesthesia can be recommended in repositioning of distal radius fractures?]. PMID- 2773516 TI - Approaches to antiviral drug development. AB - At present, only a few drugs have been approved by the FDA for therapy of viral infections in humans. There is a great need for antiviral drugs with increased potency and decreased toxicity, as well as drugs to treat viral diseases for which no drug or vaccine is currently available. Two approaches for development of antiviral drugs are described--an empirical strategy and a rational strategy- with several examples of each. Although many compounds have potent antiviral activity in cell culture, only a small fraction of these will go on to become antiviral drugs for use in humans. At this time, only seven synthetic compounds and alpha interferon have been approved by the FDA for therapy of viral infections in humans. None of these approved drugs are without toxicities, however, and hence there is a great need for antiviral drugs with increased potency and decreased toxicity, as well as for drugs to treat viral diseases for which no drug or vaccine is currently available. Two approaches for the development of antiviral drugs--the empirical and the rational strategies--and their applications and future directions are discussed. PMID- 2773520 TI - [Preventable errors in filling out death certificates]. PMID- 2773521 TI - [Use of cooking salt in the northern part of East Germany]. PMID- 2773522 TI - [The educational curriculum of the Society of General Medicine and Academy of Medical Education. An analysis of educational presentations and teaching methods for group instruction]. PMID- 2773523 TI - [Pediatric management from the legal viewpoint. 1]. PMID- 2773524 TI - [The effect of temporal distribution in relation to constant frequency of stimuli on habituation of the orienting reaction]. AB - The lack of empirical evidence for faster habituation with the regular presentation of stimuli suggests that it is not the constancy of presentation of stimuli, but rather the rate of stimulation--defined as the reciprocal of the harmonic mean of the interstimulus intervals--that determines the speed of habituation. Using alternation of 10-70 and 30-50 sec and a constant sequence of 40 sec, three different rates of stimulation were realized. The hypothesis of faster habituation of skin conductance reactions with higher rates of stimulation was not confirmed. However, a consistent pattern of skin conductance reactions, with an increase in reaction after long intervals and a decrease after short intervals, was found, especially in the group with alternating intervals of 10 and 70 sec. The analysis of an additional group with a random sequence of intervals showed that the response pattern did not result simply from the expired time since last stimulus, i.e., a simple mechanical effect. The possibility of anticipating the stimuli and differing information content of the stimuli are discussed as possible determining factors. PMID- 2773525 TI - [Differentiation of existential guilt and compassion in relation to responsibility induction: a film experiment]. AB - Feelings of existential guilt are assumed to depend on the perception of a causal relationship between one's own behavior or (privileged) situation and the disadvantages of others. By contrast, pity should not depend on such perceptions. This hypothesis, which has been supported so far only by correlational studies, was tested experimentally. Eighty students were shown a film about a developing country. The film was provided with four different comments, each representing one experimental condition (between-subjects design). Experimental factors were "amount of misery of the people shown" and "subject's responsibility for these peoples' conditions of life". As expected, subjects in the condition "misery and responsibility" reported higher feelings of guilt, though no more pity than subjects in the remaining three treatment conditions (experiment 1, n = 40). This mean difference, however, was statistically significant for men only. Contrary to our theoretical expectations--and to finding from other experiments on vicarious reparation--the induction of guilt had no effect on willingness to help a third party (experiment 2, n = 40). Possible reasons for this unexpected finding are suggested. PMID- 2773526 TI - [Effect of divided attention on explicit and implicit aspects of recall]. AB - If subjects have to form word images before spelling a word from the image, results of a repetition of the spelling test reveal a reliable priming effect: Old words can be spelled faster than comparable control words, reflecting a form of implicit memory. We investigated whether this kind of repetition priming remains stable under conditions of divided attention in the study phase. The subjects had to spell meaningful words, meaningless non-words, and non-words that were meaningful with a backward spelling direction (troper, for example). In the testing stage, recognition judgments as a form of explicit memory were required, too. Divided attention in the study phase had a negative effect on explicit memory, as revealed by performance on the recognition task, but had little effect on implicit memory, as revealed by performance on the repetition of the spelling test. A further dissociation between implicit and explicit memory showed up as meaningful words were recognized much better than non-words, whereas implicit memory was uninfluenced by the meaningfulness variable. The disadvantage of backward spellings was not reduced with non-words (like troper) spelled backwards. Finally, we analyzed the relations between spelling times and recognition judgments and found a pattern of dependency for non-words only. Generally, the results are discussed within processing-oriented approaches to implicit memory with a special emphasis on controversial findings concerning the role of attention in different expressions of memory. PMID- 2773527 TI - [Surgical therapy of acute cholecystitis]. AB - The active surgical approach obtains more and more importance in the therapy of acute cholecystitis. On the basis of an own retrospective examination over 10 years (1978 to 1987) with 342 cases of treatment and of the literature the various possibilities of the surgical therapy are described and assessed. On account of the possibilities of complication the treatment of the acute cholecystitis should on principle be performed at a hospital. According to the treatment of acute cholecystitis is differed between the immediate and early operation in the acute phase and the interval operation 2-3 months after the beginning of the disease. The early operation can further be subdivided into the principal early operation and the early operation for necessity in which the indication for the operation is made dependent on the development of the findings. The advantages of the early operation in contrast to the interval operation do not result from a smaller lethality, but among others from the avoidance of further complications, shorter times of complaint and treatment and lower costs. The interval operation and the only conservative therapy are still justified only in motivated exceptional cases. PMID- 2773528 TI - [Risk factors for the development of fistulas in Crohn disease]. AB - The pathophysiology of fistula formation in Crohn's disease is as yet poorly known. We, therefore, studied in 111 patients with Crohn's disease factors which may be associated with the development of fistulas. Male patients, patients with exclusively involved colon or extended disease of the colon and ileum as well as patients treated with prednisone demonstrated an increased relative risk to develop fistulas. In patients with ileitis alone and after laparatomy in combination with resection of the bowel the relative risk was less than 1. Furthermore, in 71% of the patients fistulas developed during active disease. In 65% the patients had underweight at the time of fistula formation. We conclude, that the localization of the disease, a factor which can not be influenced, as well as active disease and malnutrition, both factors which can be influenced, may be involved in the formation of fistulas in Crohn's disease. PMID- 2773530 TI - Intestinal zinc absorption in cirrhotic patients. AB - We studied intestinal zinc absorption and daily urinary zinc excretion in 13 healthy controls and 27 cirrhotic patients (14 alcoholics, 13 non-alcoholics) with normal serum creatinine levels. Intestinal zinc absorption was determined by the oral zinc tolerance test. Serum levels were significantly lower in cirrhotics, whether alcoholic or non-alcoholic, than in healthy controls (6.2 +/- 2.1 mumol/L vs. 11.6 +/- 2.1 mumol/L; p less than 0.001). Daily urinary zinc excretion was significantly higher in alcoholic cirrhotics (17.6 +/- 9.4 mumol/d vs. 11.4 +/- 4.1 mumol/d; p less than 0.05). Intestinal zinc absorption was significantly reduced in cirrhotics and correlated with the degree of liver dysfunction. During the oral tolerance test, urinary zinc excretion was not significantly higher in cirrhotics than in controls. We conclude that the low serum zinc levels in cirrhotics are of multifactorial origin. Impaired intestinal absorption seems to play a role, particularly in patients with more severe liver dysfunction, but increased urinary excretion may contribute to zinc deficiency in alcoholics. PMID- 2773529 TI - [The effect of acetylsalicylic acid on gastric transmural potential difference in healthy children and in children with inflammatory diseases]. AB - The transmural potential difference (tpd) of the gastric mucosa was investigated in relation to age and sex of the patients. The administration of acetylsalicylic acid in healthy children causes no significant decrease in gastric potential difference. In children with acute of chronic inflammatory diseases (elevated blood sedimentation velocity) the tpd was found to be increased compared with normal controls. After local ASA application a temporary, significant decrease of the tpd to normal values could be observed. PMID- 2773532 TI - [Bile acid binding by antacids in a "quasi-natural" reflux milieu]. AB - In a "quasi-physiological" reflux mixture obtained from non-stimulated gastric juice and hepatic bile the bile acid adsorption of 7 antacids is investigated with an newly developed HPLC method. The antacids produce pH values varying from 3.7 to 7.6. With increasing pH and increasing polarity of bile acids the bile acid binding to antacids decreases. The theoretically desirable combination of high pH and good bile acid binding is difficult to achieve. The relatively good total bile acid binding (over 60%) by Trigastril at a high pH (7.53) contrast with better bile acid adsorption by Maaloxan and Aludrox (about 90%) at a lower pH (4.5-4.9). Interestingly, toxic nonpolar bile acids are particularly well adsorbed by antacids. PMID- 2773531 TI - [Clinical symptoms, psychopathology and intestinal motility in patients with "irritable bowel"]. AB - Recent investigations of pathogenesis of the irritable bowel syndrome (IBS) either suggested psychopathology as the cause of bowel symptoms or proposed abnormalities in colonic motor and myoelectrical activity. Therefore, we prospectively compared clinical symptoms, personality traits, subjective stress reports, and motor and myoelectrical activity of the sigmoid colon and rectum in patients with IBS, patients with lactose malabsorption (LMA) who had not consulted a doctor for bowel complaints, and normal subjects. It could be shown that neither colonic activity nor stress distinguished patients with IBS from those with LMA. Patients with IBS exhibited significantly more clinical symptoms and psychopathology than patients with LMA and normal subjects. These findings suggest that psychopathology does not cause the symptoms or results from bowel dysfunctions but determines who will consult a doctor for bowel complaints. PMID- 2773533 TI - [Hyperestrogenemia following various shunt operations: on the role of estrogens in the development of focal nodular hyperplasia of the liver]. AB - Hormones especially estrogens have been suspected to induce liver cell tumours or hepatic focal nodular hyperplasia (FNH). In rats 6 months after portocaval anastomosis (PCA) the occurrence of FNH has been observed. Modified portocaval anastomosis (mPCA) does not lead to FNH. To test the concept of estrogen induced tumour formation we measured in both groups as well as in a shamoperated control group (SOP) the levels of estradiol (E2), estrone (E1) and of testosterone (T). In a further experiment the hormone levels were measured in rats with portocaval transposition (PCT), an operation which leads to high gonadal hormone production. In groups of 6 male rats each (280-300 g) either SOP, PCA, mPCA or PCT were performed. 30 days later the blood levels of E2, E1, and of T were measured by radioimmunoassay. In PCT-rats hormone levels were measured in the blood synchronously taken from the inferior vena cava (prehepatic) and from the heart (posthepatic), to get an information of the hepatic hormone degradation. After PCA the median level of E2 (77 pg/ml) and E1 (63 pg/ml) are significantly elevated when compared with SOP-rats (41 and 43 pg/ml). Equally after mPCA the E2 and E1 levels are significantly higher (61 and 70 pg/ml) than in controls rats. In contrast the concentrations of T are significantly reduced (PCA 0.03, mPCA 0, 10, SOP 1.0 ng/ml). PCA as well as mPCA result in a hyperestrogenic and hypoandrogenic status. When PCA and mPCA are compared, only the testosterone blood levels are significantly different.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2773534 TI - [Late initial manifestations of Crohn disease with atypical symptoms]. AB - The case of a 55-year-old patient with Crohn's disease and chronic intermittent diarrhea as well as progressive weight loss of 20 percent of his body weight is reported. The establishment of the diagnosis was difficult at the beginning, since characteristic symptoms were missing and radiological and endoscopical findings were normal. Loam-coloured glossy stools, repeated registration of a reduced chymotrypsin concentration of the stool and the response of the symptoms to a substitution of pancreatic enzymes were initially regarded as signs of an exocrine pancreas insufficiency. Not before multiple biopsies were taken from the macroscopically largely normal small and large intestine during persisting complaints, an extensive infiltration with Crohn's disease could be shown. This case report emphasizes the importance of taking multiple biopsies in etiologically unexplained chronic diarrhea even from macroscopic inconspicuous intestinal mucosa. Because of the rising incidence of Crohn's disease late onset is gaining increasing significance in the differential diagnosis of chronic diarrhea in the elderly patients. PMID- 2773536 TI - [Immune mechanisms in primary sclerosing cholangitis]. PMID- 2773535 TI - [Clozapine-induced cholestatic jaundice: a case report]. AB - We report on a patient who became jaundiced during treatment with clozapine (Leponex). Histologically, cholestatic hepatitis with single-cell necroses of hepatocytes and infiltration of the portal zones with eosinophilic granulocytes were found. The patient recovered after discontinuation of clozapine, and liver function tests returned to normal within 4 weeks. This adverse effect of clozapine suggests that this "atypical" tricyclic neuroleptic resembles the phenothiazines both with regard to therapeutic spectrum and side effects. PMID- 2773538 TI - [Congenital pseudomelanoma]. AB - Benign congenital melanocytic nevi, removed shortly after birth, may histologically be misinterpreted as malignant melanomas. We present the criteria for the differential diagnosis. As a name for these unusual melanocytic tumors, which belong to the large group of pseudomalignancies of the skin, we suggest the term 'congenital pseudomelanoma'. PMID- 2773537 TI - [Metastatic malignant melanoma]. PMID- 2773539 TI - [The prognosis of patients with level V melanomas of the extremities]. AB - Patients with level V melanoma have a very bad prognosis on account of their high rate of lymph node and distant metastases. From Jan. 1979 to Dec. 1987, a total of 251 patients suffering from malignant melanoma of the extremities (including 28 patients with level V melanoma = 11.2%) underwent excision of the primary tumor, lymph node dissection, as well as regional hyperthermic perfusion with cytostatics. The prognosis of our patients with level V melanoma could be improved considerably by therapy. PMID- 2773540 TI - [Digital thermo-coronary angiography--development and validation of the method in comparison with conventional cine-coronary angiography]. AB - We describe the technique-thermal coronary angiography (TCA)-for real-time assessment of coronary anatomy and flow. The goal of this study was to compare thermal coronary angiography to cine coronary angiography and to validate its value for detecting stenoses. We studied the exposed LAD both in beating and arrested hearts in 11 open-chest pigs by TCA and cine angiography. We used an AGA 782 Thermovision system combined with a TIC 8000 digital image processor providing coronary images with 0.1-0.2 mm spatial and 0.1 degrees C thermal resolution, and a CFR x-ray system. The coronary arteries were catheterized via the right carotid artery, using standard 5F catheters. The thermal camera was focused at a 1m-distance to the heart surface and the x-ray was angled to LAO position. We performed simultaneous thermal and cine angiography using Angiovist 370 at different temperatures (10-40 degrees C) and injection rates (1-2.5 ml/s). Different grades of stenoses were created by snares. Thermistor probe readings of the epimyocardium and the left atrial blood were performed to reference the thermal camera measurements. We obtained high resolution TCA images of both the coronaries and of the myocardial perfusion beds whenever there was greater than 4 degrees C difference between injectate and epicardial temperature. The TCA detection of stenoses as compared to cine angiography was 29/30 (96.6%) in arrested and 36/42 (85.7%) in beating hearts. Coronary occlusion produced immediate and dramatic perfusion defects as detected by TCA. TCAs were highly reproducible. Injection rate of 2 ml/s provided optimal thermal coronary images. Thermal angiograms of the LAD were sometimes affected by large crossing coronary veins, myocardial bridges, and excess of fat pretending nonexistent coronary stenosis. TCA is a highly sensitive and reproducible method as compared to standard coronary angiography and allows for detection of coronary stenoses. The image quality was best in arrested hearts. PMID- 2773541 TI - [The cito-laboratory information system CILIS]. AB - The cito-laboratory of a big hospital must be able to work a higher number of cito-analyzes economically and with a high degree of security and to send back the results as fast as possible to the demander. For that reason the simple employment of efficient analytical methods or tools is not sufficient. The cito laboratory-information-system CILIS is able to support all the steps of work, which are necessary to workout cyto-results and to send them back to the demander. It is also able to relieve the nurses as well as the MTLA from writing and recording. CILIS is based on the computer A 5120. It is usable in other comparable institutions and with certain restrictions to further development or enlargement. In our hospital the system has been working since november 1986 during the regular shift and the shift from 2 pm till 10 pm and partly on working days from 10 pm to 7 am and respectively at the weekend. Since that time it has been approved excellently. PMID- 2773542 TI - [A method for understanding halothane-induced changes of cytosolic calcium concentrations in blood platelets]. AB - A method will be presented for monitoring the halothane-induced changes of the cytosolic calcium concentration in blood platelets. Using the fluorescent indicator quin2 it was demonstrated for the first time that halothane causes a temporary increase of the cytosolic free calcium in platelets. The parameter Mean Cytosolic Calcium Concentration describes the halothane-induced changes quantitatively. PMID- 2773544 TI - [The determination of acetylcholinesterase activity in amniotic fluid as a further possibility for the prenatal diagnosis of open neural tube defects]. AB - A method for the determination of the activity of acetylcholinesterase (AChE) in amniotic fluid is developed. In connection with other AChE-determination methods for blood quinidine sulphate in a concentration of 2.10(-5) mol/l is used as an inhibitor for the serum-cholinesterase (ChE). With amniotic fluid samples of 162 gravidities are established preliminary limits of reference ranges. The hitherto existing experiences showed that values below the 90. percentile can be classified as normally, above the 99. percentile as pathological findings. This method is to consider among the ultrasonographical examination and the measurement of alpha-fetoprotein in serum and amniotic fluid as a further diagnosis confirming part on the suspicion of the presence of open neural tube defects. PMID- 2773543 TI - [The determination of trypsin activity in duodenal fluid with N alpha-(p toluenesulfonyl)-L-arginine-p-nitranilide (L-TAPA)]. AB - The conditions are optimized for the determination of trypsin activity in duodenal juice at 37 degrees C using L-TAPA as a substrate ("Bio-La-Test Trypsin", Lachema, CSSR). Most of the directions of the kit could be accepted, but optimal pH was 0.4 units below that described there. This method allows a highly specific, sensitive, and sufficiently precise determination of trypsin activity in duodenal juice. PMID- 2773545 TI - [The adaptation of four protein determination methods to flow injection analysis (FIA)]. AB - The adaptation of 4 manual methods to the flow-injection analysis is described for the determination of proteins (Biuret- and Exton-method, albumin and hemoglobin determination). The comparison of analytical results of FIA with the manual methods shows a very good agreement of values. Flow-injection-analysis appears not only as an excellent possibility to automate these 4 investigated methods but it also shows unlike the manual methods a considerable better precision and accuracy of the analytical results and a reduction of time and materials. PMID- 2773546 TI - [Experiences with the use of a lyophilized reference plasma for calibrating the determination of thromboplastin time values]. AB - Experiences are notified about production and employment of a lyophilised standard plasma for designation of thromboplastin time-value in the district Magdeburg. In addition to testing the homogeneity and the methodology for declaration the 100% - value results of ring tests are exhibited, which underline the necessity of a unitary standard plasma pool, secured to various criterions. PMID- 2773547 TI - [Simple self-production of flow cuvettes]. PMID- 2773548 TI - [The practicality of an NBT test]. PMID- 2773549 TI - Scanning electron microscopic studies on the embryonic development of the surface structures of the paraventricular organ in the Brown Leghorn chicken. AB - The development of the surface specialization of the paraventricular organ (PVO) was studied in the domestic chicken from the 10th embryonic day to the day of hatching by scanning electron microscopy. On the 10th embryonic day, the ventricular surface of the PVO was found to be covered with many oval-shaped processes. On the 12th embryonic day, an additional kind of elongated processes appeared in the dorsal area of the ventricular surface of the organ. From the 16th to 18th embryonic day, such elongated processes were present on the entire ventricular surface of the PVO. At the same stage, the elongated processes in the dorsal portion of the PVO began to form small, meshed networks over the surface of the ependyma. Both the oval-shaped processes and the elongated processes are thought to be dendritic terminals of the PVO neurons. PMID- 2773550 TI - Computerized morphometric analysis of the chick embryo duodenum organogenesis. AB - A computerized morphometric analysis was performed on histological sections of the proximal and distal limbs of the chick embryo duodenum, from the 8th to the 15th day of incubation, with the aim of evaluating the quantitative aspects of organogenesis. A semiautomatic digital system was used. The areas of total section, of the lumen, of the wall and of its components (subserous stratum, muscle layer, lamina propria, epithelium) and the thickness of the epithelium and muscle layer were measured; the mean +/- S.E.M. of the values obtained was calculated. The percentage of shrinkage, due to the histological procedures, was calculated for each day. The values obtained were added to the measurements of each area and thickness thus giving the true value of each parameter measured. The differences between the mean values of the areas of the proximal and the distal tract were statistically evaluated. Exponential curves and r coefficient were determined to evaluate the general growing pattern of the mean area of the components of the duodenal wall, as a function of age. The main results are the following: the areas of the wall components of the proximal limb are always greater than the corresponding areas of the distal limb of the duodenum. There are some differences between the proximal and the distal limbs of the duodenum in the growing pattern of the intestinal wall components. The anlage of the duodenum also has a different developmental pattern compared with that of the chick embryo ileum. PMID- 2773551 TI - The ultrastructural picture of cerebral cortex of rat after hypoxia. I. Findings after inhalation of 5% O2 and 95% N2. AB - The ultrastructure of some elements in the motor region of the cerebral cortex of the rat were studied after hypoxia. The experimental animals, after receiving intraperitoneal chloral hydrate anaesthesia, were placed in a chamber with a controlled supply of a mixture of 95% N2 and 5% O2. After 2- and 3-hour exposure to hypoxic conditions the animals were processed for electron optic study. Edematous mitochondria pith partial or total destruction of the mitochondrial matrix were observed. Some mitochondria were changed into large vacuolar formations. The granular endoplasmic reticulum of neurocytes was dilated and in the broad dilatation structures of lamellar shape were sporadically found. The Golgi complex contained vacuoles of different sizes and long cisterns. Hydrated astrocytes were visualized in the neuropil and perivascular astrocyte processes displayed edematous changes. In the group of animals exposed to hypoxia for 3 hours but processed only 24 hours after termination of hypoxia the same changes were observed yet their extent was considerably diminished. This finding indicates that changes induced by hypoxia tend to return to normal conditions. PMID- 2773552 TI - A morphometrical study of human fetal thymus. AB - A morphometrical study was made of the thymus lobules in the cortical and medullary layers of male and female fetuses, 16 to 31 weeks old, divided into the age groups 16 to 19, 20 to 23, 24 to 27 and 28 to 31 weeks of intrauterine life. Results were correlated with body and thymus weights; the lobular, cortical and medullary volumes, as obtained using a histometrical method, were proportional to thymus, but not body weight increase. No differences were noted in the volumes and weights investigated as a function of fetal sex. PMID- 2773553 TI - "Light" and "dark" pinealocytes of the porcine pineal gland. AB - Both qualitative and quantitative comparative studies of "dark" and "light" pinealocytes of the porcine pineal gland have been carried out. These cells differ from each other in their electronic density of cytoplasm, shape of nucleus, the structure of membrane bound dense bodies and the number of microtubules and smooth endoplasmic reticulum. The membrane bound dense bodies- characteristic structures of pig pinealocytes as well dense core vesicles occur in both types of cells. The relative volume of the majority of the cells' organellae apart from the Golgi apparatus, also do not show any significant difference. The results obtained support a functional basis for pinealocyte differentiation in the porcine pineal gland. PMID- 2773554 TI - Morphometric changes between one-day-old and adult chicken neurons of the nucleus isthmi. AB - The most important parameters of the neuronal soma of neurons of the chicken nucleus isthmi have been analyzed, with photo and morphometric techniques, in order to quantify the morphological variations present during the first months of the life to determine if the developmental changes of both neuronal populations of the nucleus are similar or different. The study was carried out on neurons of the parvicellular part and magnocellular part of the Nucleus Isthmi in one day and four month-old chickens. The soma shape did not change during this time interval in parvicellular neurons. The magnocellular neurons became more fusiform. In-one-day old chickens, the section shapes of the neuronal soma and optical density, are similar in both the magnocellular and parvicellular parts of the nucleus. The area and the maximum and minimum diameters do not present significant differences between magnocellular and parvicellular neurons. In adults, the maximum diameter, neuronal area and optical density are higher in magnocellular neurons than in parvicellular neurons. In summary, magnocellular neurons of the nucleus Isthmi of adults are bigger, darker and more elongated than the ones that constitute the parvicellular territory. PMID- 2773555 TI - Ultrastructure of the camel monocyte. AB - The fine structure of the camel monocytes was studied in order to record its constituents because these informations were missed from the literature. The observations revealed the presence of a few short cisternae of rough endoplasmic reticulum and various forms of vesicles associated with the Golgi complex which were seen near the mitochondria. The distribution of the cytoplasmic organelles seemed to be located adjacent to the main indentation in the nuclei. Camel monocytes were found to possess microvilli of varying length and number. The functional morphology of the above mentioned structures was discussed. PMID- 2773556 TI - [The vasa vasorum of peripheral lymph vessels in the human]. AB - Using the anterior inner prefascial bundle as an example the structure of the vasa vasorum of lymphatic vessels can be demonstrated. They have a one dimensional capillary network of their own in the outer layers of the vascular wall. In humans this network is already differential in the second half of the fetal period. PMID- 2773557 TI - [Pathogenesis, diagnosis and therapy of nerve lesions following combined (surgical-radiotherapy) cancer therapy]. AB - Classical cancer therapy (surgical and/or radiotherapeutic measures) is not uncommonly subject to late complications which frequently confront the patient and therapist with problems which are difficult to resolve. Typical examples of such late complications are damage to the nerve plexuses which are usually associated with pain, functional deficits and pareses which can hardly be influenced. The topography of these two nerve plexuses as well as the pathogenesis, clinical symptoms and therapy of plexus lesions is reported with reference to two cases: plexus lesion after combined therapy a) of a malignant testicular tumor and b) of a breast cancer. PMID- 2773558 TI - [Lymph scintigraphy in edema of the extremities]. AB - The method presented here for scintigraphic measurement of lymphatic drainage can be carried out easily and entails little stress for the patient. It is very suitable for routine use in many patients. Since consistency with clinical findings is very good this is an inexpensive method for clarification of lymph drainage disturbances. PMID- 2773559 TI - [Resolution of the 58th session of the General Assembly of the USSR Academy of Medical Sciences]. PMID- 2773560 TI - [The secretory and systemic humoral immune response to polysaccharide A in patients with rheumatism]. AB - The level of sIgA saliva antibodies and Ig(M + G + A) serum antibodies to group polysaccharide A of streptococcus was studied in healthy donors and patients with streptococcal angina and rheumatic fever. It was shown that an elevated level of secretory and serum antibodies to polysaccharide A was registered in patients with angina and rheumatic fever reliably more frequently than in healthy donors. Independence of local and systemic humoral immune response to polysaccharide A was established. PMID- 2773561 TI - [The development of fundamental studies in the field of medicine in the light of the decisions of the 19th All-Union C.P.S.U. conference and the July (1988) plenary session of the Central Committee of the C.P.S.U]. PMID- 2773562 TI - [Circulation of intestinal infection in the families of patients with rheumatic diseases and the state of humoral immunity to enterobacterial antigens]. AB - ELISA quantitation of antibodies to Klebsiella pneumonia, Proteus mirabilis, and Yersinia enterocolitica was conducted in 75 ankylosing spondylitis (AS), rheumatoid arthritis (RA), and systemic lupus erythematosus (SLE) probands and in 262 of their first-degree relatives. The control group comprised 28 healthy donors. Sixteen (64 per cent) AS probands (12 with B27+) and 26 (30.2 per cent) their relatives (14 with B27+) were found to have high titres of antibodies to Klebsiella pneumonia. In 18 (60 per cent) active RA probands and 27 (23.7 per cent) relatives, antibodies to Proteus mirabilis were found. The obtained results suggest the presence of genetic determinants of the increased immune response to various infectious agents, at least in the AS cases. The possibility of Enterobacteriaceae acting as polyclonal stimulators is not excluded. PMID- 2773564 TI - [Diagnostic possibilities of a test of blood neutrophil damage in various forms of yersiniosis in man]. PMID- 2773563 TI - [Clinico-immunologic characteristics of complicated and uncomplicated yersiniosis]. AB - Asymmetric affection of the major lower limb joints is a characteristic feature of the joint syndrome in yersiniosis-associated arthritis. The sacroiliac articulations are frequently (47% cases) involved. In addition, yersiniosis associated arthritis concurs with the signs and symptoms of systemic disease- gastroenterocolitis, myocardiopathy and myocarditis, erythema nodosum, hepatitis, urethritis, conjunctivitis, myositis and myalgia, enteropathy; changes in the CNS typical for the astheno-neurotic syndrome are frequently present. Comparison of the immunological assay data in complicated and uncomplicated yersiniosis shows equally high levels of IgG and CIC. High anti-DNA antibody titres are more frequently found in the serum of uncomplicated yersiniosis patients. ELISA quantitation of specific IgA, IgM, and IgG class antibodies in yersiniosis associated arthritis patients demonstrated persistence of all the three antibody classes or of IgA-IgG combination in cases with most severe of the joint syndrome. In the presence of cardiac disease, patients were found to have high titres of antibodies reactive with the cardiac interstitial tissue, while in authentically diagnosed myocarditis cases with the sarcolemma. The investigation findings strongly suggest a high degree of involvement of immune and autoimmune processes in the pathogenesis of arthritides secondary to Yersinia infection. PMID- 2773565 TI - [The state of humoral immunity to enterobacterial antigens in juvenile rheumatoid arthritis and reactive arthritis in children]. AB - Investigation findings are generalized based on quantitation of antibodies against the antigens of intestinal microorganisms of Enterobacteriaceae family conducted in 66 children with various joint disease using the enzyme-linked immunoassay (ELISA) methodology. High antibody titres were revealed in 77.1% juvenile rheumatoid arthritis cases and in 80% cases with chronic juvenile arthritis which was not defined nosologically. All the patients with reactive arthritis associated with intestinal infection showed high tension of immunity to all tested enterobacteriaceae antigens with cross reactions to them. Patients with reactive arthritis associated with oral infection, with Reiter's disease and other disorders exhibited high antibody titres at the same rate as in the control. PMID- 2773566 TI - [Yersinia arthritis in children]. AB - Clinical and laboratory evaluation of arthritis in 36 children with diagnosed enteric yersiniosis is presented on seven-years' follow-up data. Twenty-eight patients were found to have an active course of the disease developing in cycles with a favourable outcome and no residual effects. In eight cases arthritis took a protracted (up to 8-10 months) or chronic (over 12 months) course which ended in clinical and laboratory remission; in three of the eight cases the clinical picture was similar to that of rheumatoid arthritis, in two of which the diagnosis was not excluded by the morphological study of the synovial biopsy sample. PMID- 2773567 TI - [Characteristics of the clinical course of Reiter's disease in relation to the causative agent]. AB - Reiter's disease patients (RD, 83 per cent) were divided into five groups according to the causative agent. The clinical variants were compared. For the clinical picture of Chlamydia-associated RD follicular lesions of the cervical, rectal, and conjunctival mucosa are characteristic; latent forms prevail with initial joint syndrome and enteropathy. RD of Chlamydia-ureaplasma aetiology is characterised by extensive clinical manifestation with obligatory involvement of the sacro-iliac joint. Enterocolitis RD is epidemic, highly active, with pronounced fever syndrome and a more favourable prognosis. PMID- 2773568 TI - [The work of expert committees of the USSR Academy of Medical Sciences]. PMID- 2773569 TI - [Mycoplasma and rheumatoid arthritis in children]. AB - A microbiological and serologic investigation was carried out in 80 children with rheumatoid arthritis (RA) in order to detect Mycoplasma and Ureaplasma as possible causative agents of RA. The antigen of Mycoplasma in question is shown to be detectable in 42.6% of cases more commonly as part of an association of 2 or more species. M. arthritidis and U. urealyticum are the more common findings. Anti-mycoplasma antibodies were detected in 25.7% of the examined children. The role of these Mycoplasma species in RA is discussed, as is the need for etiotropic treatment of mycoplasma rheumatoid arthritis. PMID- 2773570 TI - [Mycoplasma arthritis in man and mechanisms of its pathogenesis]. AB - Possible etiologic contribution of mycoplasma to human rheumatoid arthritis (RA) is supported by their recovery from synovial fluid of RA patients, as well as Mycoplasma antigens and antibodies detection in the bloodstream. The detectability of free antigens of M. arthritidis (Ma) and M. fermentans (Mf) in the sera of patients was 22.4%, and that of antibodies against those, 52.7%. Considerable difference between the detectability of Mycoplasma antigens and antibodies can be attributed to the fact that the bulk of the antigens form part of immune complexes and cannot be detected by serologic tests. Mitogenic effect of arthritogenic Mycoplasma and their ability to produce a cytotoxic effect on various cells, including lymphocytes, appears to be a mechanism of immune process developing in association with human RA. A study of immunobiological properties of individual Ma and Mf cell components has shown that a protein factor translocated into the culture medium is responsible for mitogenic action. Ma cytotoxicity in respect of target cells is related to its cytoplasmatic membrane. Mf produces a factor, acting directly on rat lymphocytes; its synthesis is apparently taking place on the cell membrane. PMID- 2773571 TI - [The state of the gastrointestinal tract in reactive arthritis]. AB - The gastrointestinal tract status (GIT) was evaluated in 23 reactive arthritis (RA) patients: in 17 after intestinal infection, in 2 after urogenital infection, and in 4 after mixed infection. All the examined were found to have signs of diffuse variously pronounced chronic inflammation of the small and large intestine, impaired barrier function of the stomach, liver disorders, and moderate-severe intestinal dysbacteriosis with developing transitory bacteraemia in most severe cases. The GIT changes were correlated with the severity of the RA course. In 20 control-group patients not afflicted with joint disease and operated on for cicatricial stricture of the oesophagus, no signs of chronic inflammation of the mucosa were revealed in the biopsy samples of the large and small intestine. The obtained results may be indicative of the role played by the GIT in the development of pathogenic processes in RA. PMID- 2773572 TI - [The histamine-serotonin-monoamine oxidase system in patients with foot mycosis during treatment]. AB - Examinations of 18 patients with mycoses of the foot complicated by allergic processes, have revealed elevated blood serum concentrations of histamine, serotonin, cathepsin D, and acid phosphatase, and a lowered activity of monoamine oxidase, as compared to 22 patients with mycoses not complicated with allergic manifestations. This fact reflects one of the aspects of a pathogenetic difference between these patients and necessitates combined therapy to correct the detected abnormalities. PMID- 2773574 TI - [A specific stimulation test of the peripheral blood lymphocytes in the diagnosis of syphilis]. AB - The authors analyze the results of laboratory studies on the diagnosis of syphilis with the use of this test. T. pallidum has been used as an antigen. The study has involved 234 patients with active and latent forms of syphilis, as well as donors and subjects with nonspecific positive serologic reactions. The test has yielded negative results in 27 (12%) patients; of these, in only 1 of the 170 patients with active syphilis. PMID- 2773573 TI - [Electron microscopic analysis of the effect of Trichophyton rubrum on the reproduction of the human immunodeficiency virus]. AB - The authors have examined the effect of a Tr. rubrum infection on HIV reproduction in H9 cell culture. A statistically significant activation on HIV multiplication has been observed 24 hrs after cell culture infection with the fungus: the infected cells produced more viral particles than the reference cells. The number of HIV virions has been increased mainly at the sites of Tr. rubrum localization and near H9 cell sites containing phagocytized elements of the fungus. In case of a mixed infection abnormal HIV forms (minimal and giant ones) have been detected along with the common virions. The ability of HIV virions to adsorption on Tr. rubrum surface has been revealed. PMID- 2773575 TI - [An improvement in the terminology of atopic dermatitis-diffuse neurodermatitis]. AB - The problem of dermatologic terminology at large is discussed as exemplified by the synonymous terms concerned with diffuse neurodermatitis. PMID- 2773576 TI - [Atopic dermatitis as a term and a disease]. AB - Basing on the literature data and their own clinical experience, the authors consider atopic dermatitis as skin manifestations of hereditary atopic constitution. They distinguish 5 clinical forms of the condition, emphasizing the age succession (phase pattern) of the clinical and morphologic picture of the dermatosis. Attention is called to the fact that atopic dermatitis may be a part of the clinical picture of many syndromes. The authors hope that the present discussion will minimize the confusion in the terminology of this disease. PMID- 2773577 TI - [Determination of the required volume of a sampling population in scientific and practical research]. AB - Three stages in the determination of the sampling population volume are described. The significance of a correct definition of the confidence interval is stressed, as well as the adjustment of the calculated values of the sampling population volume during the investigation. PMID- 2773578 TI - [Skin changes in diabetes mellitus]. AB - Basing on analysis of case histories of 264 diabetics, the authors have developed an original classification of the dermatoses occurring in diabetes mellitus. Clinical and laboratory findings evidence the identity of changes in the peripheral blood levels of calcium and immunoreactive insulin in the patients with psoriasis, neurodermatitis, and diabetes mellitus. PMID- 2773579 TI - [Comparative effectiveness of current pathogenetic methods of treating neurodermatitis]. AB - The authors compare various present-day pathogenetic methods used in the treatment of 258 patients with disseminated neurodermatitis (81 cases with the atopic form and 177 ones with the nonatopic form). Clinical and laboratory studies have demonstrated the efficacy of adrenoblockers, pyrroxan and butyroxan, included in multiple-modality therapy for patients with manifest disorders of the autonomic nervous system. Combinations of glycyrrham and voltaren and decimetric wave exposure of the adrenal area have been also effective, as well as parmidine, an antibradykinin drug, in a daily dose of 2.0 g. In the most severe and stubborn cases corticosteroids may be administered; the schemes of therapy should be sparing and physiological, with the drugs given every other day, this helping reduce the total dose of the drug. PMID- 2773580 TI - [The psychological characteristics of patients with vitiligo]. AB - Psychologic examinations, using the MMPI (a Multifactorial Method for Personality Investigations), of 74 patients with common vitiligo, have revealed impeded social adaptation in 63.5% and accentuation of the characterological personality traits in 29.7% of the examinees. The detected psychologic disorders of a borderline type are explained by both the presence of a manifest cosmetic defect- vitiligo, and by the individual characteristics of the patients--sex, age, type of psychologic reaction. Depigmentation and psychoemotional disorders are closely related, one stimulating the other. PMID- 2773581 TI - [The treatment of psoriatic arthropathy with a combination of mefenamic and aminocaproic acids]. AB - Studies of the connective tissue status, lysosomal enzymes and kallikrein-kinin system activities in 30 patients with psoriatic arthropathy have revealed an increased level of the connective tissue matrix and collagen metabolites, elevated activities of proteoglycan-destroying hydrolases and of kallikrein and its precursor. The detected shifts correlated with the severity of the skin and articular processes. Besides the traditional local and fortifying therapy, the patients have been administered mefenamic acid (connective tissue stabilizer) and aminocaproate (tissue protease and kinin system inhibitor). Such treatment has been effective in 76% of the patients. The mean length of treatment has made up 42.3 days. The drugs have had a positive effect on both the skin and articular processes. A tendency to normalization of the biochemical characteristics has been observed. The suggested scheme of therapy is recommended for practice. PMID- 2773582 TI - [The antifungal activity of fibrous materials containing chemically bound antimicrobial substances]. AB - Studies of the antifungal characteristics of modified cellulose and polycaproamide materials containing chemically bound antibacterial agents, hexachlorophene or catamine AB, have shown antifungal activity of these materials towards the major fungi inducing mycoses of the feet. PMID- 2773584 TI - [Clinico-biochemical parallels in patients with early forms of syphilis and pathology of the cerebrospinal fluid]. AB - Altogether 160 patients with early syphilis have been examined (49 ones with primary seropositive, 36 with secondary new, 75 with secondary relapsing condition). Abnormalities in the cerebrospinal fluid have been detected in 49 (30.6%) patients, of these Stage I-II abnormalities in 9, Stage II-III in 26, and Stage III-IV in 14 cases. Clinically the patients with abnormal liquor have developed multiple erosive and ulcerous chancres, papular eruptions on the palms and soles, copious papular rash, wide condylomas, alopecia, leukoderma; analyses have revealed marked dysproteinemia, impaired protein production, absorption excretory and enzymic functions of the liver. The changes have been the most severe in the patients with the liquor abnormalities who abused alcohol. PMID- 2773583 TI - [Clinico-immunologic characteristics of patients with seroresistant syphilis]. AB - Clinical and immunological analysis of patients with seroresistant syphilis has revealed a number of immunological shifts. The authors emphasize that only immunologically based therapy may be prescribed to patients with seroresistant syphilis. PMID- 2773585 TI - [2 cases of error in the diagnosis of syphilis]. AB - Two patients with syphilis are described. Unrecognized disease in one of them has become the reason of the other's infection. Only after a comprehensive examination the disease has been diagnosed and the treatment started. PMID- 2773586 TI - [Ethacizine in the treatment of psoriasis]. AB - Ethacizine (2-carbethoxyamino-10 (3-diethylaminopropionyl) phenothiazine hydrochloride) has been administered in a daily dose of 150-200 mg for 8-10 weeks to 46 patients with diffuse psoriasis. The treatment has been effective in 84.8% of the patients. Late results, followed up over a year in 40 patients, are fine. PMID- 2773587 TI - [Effectiveness of the new Soviet immunomodulator mielopid in the combined treatment of patients with chronic pyoderma]. AB - Thirty-four patients with chronic pyoderma have been examined. Fifteen of these have been treated with mielopid (18 mg per course). Immunologic and clinical examinations carried out in 3-10 months after therapy have demonstrated a wide spectrum immunostimulating action of the new drug. PMID- 2773588 TI - [Algimaf treatment of trophic ulcers]. AB - A new biologically active preparation, algimaf, developed at the All-Union Research Institute for Medical Polymers, stimulates the regenerative processes, is characterized by analgesic, antiedematous, manifest antibacterial and hemostatic effects, promotes the formation of hardly visible cicatrices, and is a highly effective means for the management of trophic ulcers of the skin. PMID- 2773589 TI - [Immunocorrective properties of new antileprotic preparations]. AB - Antimycobacterial and immunotropic characteristics of new antileprosy drugs, made in this country, have been studied and compared with those of dapsone. Animal experiments have demonstrated a high immunostimulating activity of the new drugs; this calls for clinical trials of these agents, for they may improve the therapy efficacy, help prevent the disease recurrences, and cut down the length of treatment for leprosy. PMID- 2773590 TI - [Mondor's disease]. AB - A 29-year-old patient suffering from Mondor's disease is described. This case is remarkable for the presence of two fragments of subcutaneous cords in the thoracic and abdominal area. Administration of indomethacin for 2 weeks has been fairly effective. PMID- 2773591 TI - [Klaforan in the treatment of newly diagnosed gonorrhea in men]. AB - Two injections of klaforan, 1 g per injection, with a 12 hrs interval is an effective method for the therapy of male patients with fresh gonorrheal urethritis. PMID- 2773592 TI - Monoclonal antibodies that cross-react with the E1 glycoprotein of different alphavirus serogroups: characterization including passive protection in vivo. AB - A panel of four monoclonal antibodies (mAb) were produced that cross-react with representatives of two different togavirus serogroups, namely sindbis (SIN) and Semliki Forest (SF) viruses, by ELISA and ADCMC assays. Three of these mAb, IgG2a and IgG2b isotypes, passively protected C3H/Hej mice against 10 and 100 LD50 of SF challenge and one, IgM, did not protect against either challenge dose, or even at 1 LD50. All these mAb were cross-reactive with the E1 glycoprotein of the viruses by immunoblotting in which three different patterns of reactivity were evident, suggesting that three epitopes were involved. The patterns depended upon whether the mAb recognized E1 extracted from purified virions or infected cells and whether SDS-PAGE and immunoblotting were done in the presence or absence of beta-mercaptoethanol. One mAb (IgM) reacted with nonreduced or reduced E1 from either virions or cells suggesting recognition of a linear epitope. The other three mAb reacted with nonreduced but not reduced E1 from virions suggesting that recognition depends upon conformational epitopes. These three mAb reacted also with nonreduced E1 extracted from SF-infected cells whereas only one reacted with nonreduced E1 extracted from SIN-infected cells. PMID- 2773593 TI - Arrangement and expression of integrated adenovirus type 12 DNA in the transformed hamster cell line HA12/7: amplification of Ad12 and c-myc DNAs and evidence for hybrid viral-cellular transcripts. AB - In the genome of the adenovirus type 12 (Ad12)-transformed hamster cell line HA12/7 about three copies of the viral DNA are fixed by integration. The results of blot-hybridization, molecular cloning, and nucleotide sequencing experiments suggest a model for the arrangement of Ad12 DNA molecules in which the left hand terminus of one of the Ad12 DNA copies is linked to unique hamster DNA. The right hand end of this DNA molecule is fused to an inverted copy of a left terminal approximately 4.3 kb fragment of Ad12 DNA. This ensemble is followed by the second Ad12 DNA copy whose right terminus is again joined to an inverted, supernumerary left terminal approximately 4.3 kb Ad12 DNA fragment. There is a third Ad12 DNA copy whose right terminus is linked to cellular DNA. In this sequence arrangement, the left terminus of Ad12 DNA is overrepresented, as had been shown earlier (S. Stabel, W. Doerfler and R.R. Friis (1980) J. Virol. 36, 22 40). In the presented model, cellular DNA sequences are interspersed in between the three copies of Ad12 DNA. In the left terminus of the integrated Ad12 DNA, transcription of RNA is initiated which extends out into cellular DNA. The interviral DNA junctions are also transcribed. The c-myc gene in cell line HA12/7 is amplified about 10-fold and considerably more c-myc RNA has been identified in the Ad12-transformed cells than in BHK21 or in LSH hamster cells. It has been shown previously that the E1 region of Ad12 DNA is transcribed into mRNA in HA12/7 cells (Ortin et al. (1976) J. Virol. 20, 355-372). It remains to be investigated whether c-myc amplification and expression are related to the transformed phenotype of HA12/7 cells. PMID- 2773594 TI - Molecular cloning and sequencing of influenza virus A/Victoria/3/75 polymerase genes: sequence evolution and prediction of possible functional domains. AB - The influenza virus A/Victoria/3/75 (H3N2) polymerase genes encoding PB1, PB2 and PA have been cloned by cDNA synthesis and insertion into bacterial vectors. The complete sequence for each polymerase gene has been obtained from random M13 subclones and compared to other influenza virus polymerase genes. A total of 45, 74 and 78 nucleotide changes were fixed in the period 1968-1975, corresponding to 10, 12 and 9 amino acid changes, for PB1, PB2 and PA genes, respectively. The amino acid sequence of PB1 polypeptide contains motifs found in a series of positive- and negative-RNA virus polymerase genes and that of PA polypeptide share invariant residues common to DNA and presumptive RNA helicases. PMID- 2773595 TI - The complete nucleotide sequence of plum pox potyvirus RNA. AB - The complete nucleotide sequence of the plum pox virus (PPV) RNA genome has been determined. The RNA sequence is 9786 nucleotides in length, excluding the 3' terminal poly(A) tail. An AUG triplet at position 147-149 was assigned as the initiation codon for the translation of the genome size viral polyprotein which would consist of 3140 amino acid residues. The nucleotide sequence of the non coding regions and the predicted amino acid sequence of the polyprotein of PPV were compared with those previously reported for two other potyviruses (tobacco etch virus, TEV, and tobacco vein mottling virus, TVMV), with nucleotide and amino acid sequences of other viruses, as well as with sequences from data banks. The potyvirus genomic expression is discussed in relation to the homologies observed, in particular the predicted protease recognition sequences in related viruses. PMID- 2773596 TI - Virion and nonstructural polypeptides of human herpesvirus-6. AB - Human herpesvirus-6 (HHV-6) was purified from HHV-6-infected mononuclear cells from cord blood or infected culture medium. Virion was found to have at least 29 polypeptides ranging from 280 to 30 kDa. Six polypeptides were identified in the envelope fraction. Twenty-five viral polypeptides were also identified in HHV-6 infected cells by immunoprecipitation with immune serum. PMID- 2773597 TI - The glycoprotein of infectious hematopoietic necrosis virus elicits neutralizing antibody and protective responses. PMID- 2773598 TI - Rubella virus: mechanism of attenuation in the vaccine strain (HPV77). AB - The vaccine type (HPV77 strain) of rubella virus replicates slower and manifests a delayed appearance of cytopathic effect in Vero-76 cells as compared to wild type virus (M33). The change in cytopathic effect coincides with the delayed appearance of both genomic and subgenomic RNA as well as viral structural proteins in the cell. The delay in the appearance of the viral proteins in the cells was also evident when the cells infected with the vaccine-type virus were treated with the lysosomotropic agent such as chloroquine. Binding studies using [35S]methionine-labeled virus showed that the vaccine-type virus bound to the cells poorly and the binding was not completely competed out with the cold virus. PMID- 2773599 TI - [Laser-assisted transurethral resection of ureteral occlusions]. AB - After transurethral resection across the ureteral ostium a scared stenosis or complete occlusion is possible and its transurethral recanalization is dangerous. Therefore, a new concept with utilisation of laser light is presented. After percutaneous renal punction the laser light fiber is placed antegrade into the ureter near the stenotic ostium and the stenosis is resected transurethrally under fluoroscopy onto the laser light spot. Thereafter a splint is placed transrenal into the bladder for 3 weeks. The presented technique could minimize the operative expense. PMID- 2773600 TI - [Treatment of distal ureteral calculi with extracorporeal shockwave lithotripsy: experiences with 310 cases]. AB - Distal ureteral calculi are approached by ureterorenoscopy by most authors. With increasing experience ESWL of distal ureteral calculi gained in importance. The success rate of 96.2% in a large series of 310 consecutive patients treated in this manner, confirmed the results of other authors. Excluding women of child bearing age and very large calculi (greater than 2 cm) the ESWL is a suitable treatment modality of distal ureteral calculi. PMID- 2773601 TI - [Successful surgical treatment of masculine pseudohermaphroditism]. AB - It is reported on the successful surgical therapy of a male pseudohermaphrodit. The transformation to a woman was made in two stages. In the first session castration and penile amputation were performed and in the second operation a vaginal reconstruction using a small bowel segment has been done. PMID- 2773602 TI - [Primary tumors of the choroid plexus. Frequency, localization and age]. AB - In 30 years, from 1956 through 1985, 155 primary tumours of the choroid plexus were first reported for entry into the National Cancer Registry of the GDR, with 125 of them having been identified as plexus papillomas and 30 as plexus carcinomas. A total of 30.4 per cent of all plexus papillomas was diagnosed in patients in the first decade of life, half of them during the first year of life. A lateral ventricle was the site from which 78.9 per cent of the plexus papillomas in the first decade were recorded. Among all plexus tumours 39.4 per cent were detected only on postmortem investigation. The number of plexus tumours reported for entry into the National Cancer Registry had continuously grown in the period under review, which, however, did not necessarily suggest increasing incidence of such tumours in the general population. Possible factors of influence are discussed in some detail, for example, completeness of recording. The number of plexus tumours reported in children up to three years of age rose with significance, between 1981 and 1985. This is assumed to have possibly been the consequence of an aetiological factor. The average annual incidence (crude rate) of plexus tumours at GDR level was found to be 0.3 to one million (0.36 among males and 0.25 among females). Reasons are given that might support the assumption that real incidence has been above these values. PMID- 2773603 TI - [Chronic cor pulmonale due to granulomatous and obliterating pulmonary arteritis caused by schistosomiasis]. AB - Among 3,125 autopsies undertaken at the Department of Pathology of the "Americo Boavida" Hospital in Luanda, from January 1976 to March 1987, we recorded four cases of children with schistosomiasis. Macroscopically, we observed Symmers type periportal fibrosis and chronic cor pulmonale secondary to schistosomiasis of liver and spleen. Histological examination of the lungs revealed granulomatous arteritis, obliterating segmental endarteritis and multiple schistosoma granulomas in the parenchyma. Pulmonary hypertension had caused secondary changes to arteries, such as subendothelial fibrosis and hypertrophy of the media. PMID- 2773604 TI - [Cytogenetic relationship between portal fibroblasts and Ito cells of the liver]. AB - Portal fibroblasts of normal human and rat liver were morphologically investigated to estimate their capability of storing vitamin A. Vitamin A levels were semiquantitatively estimated by evaluation of the number and size of intracellular lipid droplets. Vitamin A storage was found to be low in more than 10% of normal portal fibroblasts in man and rat. Lipidstoring fibroblasts of portal tracts exhibited remarkable morphological similarities to "activated" Ito cells and were accordingly designated as portal transitional cells. PMID- 2773605 TI - [Abstracts from the 4th Neuropathology Symposium. Munich (FRG), 25 June 1988]. PMID- 2773606 TI - [Abstracts of the annual meeting of the Austrian Society of Neuropathology. 14 April 1988, Bad Ischl (Austria)]. PMID- 2773607 TI - [Seasonal rhythms in the functioning of the hypophyseo-thyroid system of the suslik Citellus parryi]. AB - In experiments on the Arctic ground squirrel Citellus parryi, radioimmune assay of the content of thyrotropin of the hypophysis and thyroxine and triiodothyronine of the thyroid in the peripheral blood has been made at monthly intervals from July until May. It was found that during hibernation period, thyroxine and triiodothyronine concentrations in the blood of sleeping animals are high as compared with those during pre-hibernation period in autumn and active period in May. Thyrotropin content of the blood increases from October to May, being the lowest however during the season of the deepest hibernation from December to February. It is suggested that activation of the hypophysial--thyroid system after resting period in summer and autumn begins in October. During deep sleeping, it is depressed, being recovered in March. High levels of the thyroid hormones during hibernation period may be explained by metabolic strategy of the organism in hibernating animals which is directed to optimization of energy supply of hibernation. PMID- 2773608 TI - [Hypothermic effect on mice of a 1-10 kD fraction of the small intestine of the hibernating suslik Citellus undulatus during hypoxia and hypercapnia]. AB - Studies have been made on a possibility of inducing a prolonged hypothermia by injections to albino mice of a fraction with a molecular mass 1-10 KD isolated from the small intestine of hibernating ground squirrels. Specific conditions for the onset of hibernation (hypoxia, hypercapnia, temperature) were simulated. Exposure of mice to hypoxia and hypercapnia for 2 hours in combination with injection of the mentioned fraction extended hypothermic condition in animals up to 24-36 hours as compared to 2-3 hours after sole injection of the fraction. After the injection of 5-OT under the same conditions, the prolonged hypothermia was less stable. PMID- 2773609 TI - [Comparative determination of the potential for activating lipid peroxidation of the adrenal cortex, liver and heart in various animals]. AB - Studies have been made on the rate of spontaneous, ascorbate- and NADP.H dependent lipid peroxidation in the adrenal cortex, liver heart of rats, rabbits and cattle. It was shown that in spite of some species differences in predisposition of tissues to lipid peroxidation. The highest rate of this process is characteristic of the liver of all the animals investigated. PMID- 2773610 TI - [Factors affecting the cholinomimetic activity of alkyltrimethylammonium compounds in experiments on isolated neurons of the mollusk Planorbarius corneus]. AB - It has been shown that the elementary current is independent whereas the duration of channel opening is slightly dependent on the number of methylene groups (from 1 to 9) in the molecule of alkyltrimethylammonium compounds. However, substances with more than 4 methylene groups exhibit lower cholinomimetic activity (i.e. the ability to increase the membrane current) and higher values of Q10 for the reaction with cholinoreceptor. It is suggested that lower activity of these compounds is due to a low rate of formation of a complex with cholinoreceptor because of the higher potential energy barrier. PMID- 2773611 TI - [Ontogenetic aspects of individual characteristics of functional brain asymmetry in the perception of emotions]. AB - Studies have been made on individual variations in perception of speech emotional information by 7-16-year children. Significant differences between subjects from various age groups were found concerning the correct recognition of emotions, the degree of brain asymmetry and domination type. The exactness of emotional recognition increases with age, while the degree of asymmetry becomes lower, the right hemisphere domination becoming more stable in processing of speech emotional information. With age, individual type of asymmetry turns to the specific one, reflecting asymmetry formation during evolution. PMID- 2773612 TI - [Functional characteristics of the skin receptor structures in animals and man]. AB - Threshold electrical reactions of single fibers from the ischiadic nerve of rats to mechanical stimulation and rectangle impulses of focused ultrasound have been compared with respect to the parameters of stimulation to the effect of focused ultrasound on the skin of human fingers evoking different sensations. It was concluded that low-threshold fibers may be associated with tactile reception, mean-threshold ones--with tactile and thermal, whereas high-threshold fibers may be referred to reception of specific skin pain. PMID- 2773613 TI - Azelaic acid: a new therapeutic agent. Proceedings of the CMD-satellite-symposium on azelaic acid. 17th World Congress of Dermatology. Berlin, May 1987. PMID- 2773614 TI - Ten years' experience of treating lentigo maligna with topical azelaic acid. AB - Topically applied azelaic acid led to complete clinical and histological resolution of lentigo maligna in more than 50 patients. The therapeutic results are highly durable, in fact 27 out of the 50 are still disease-free, 5-10 years after treatment. There was a recurrence in 11 cases, but all resolved on renewing treatment. The effect of azelaic acid is illustrated in a patient with lentigo maligna monitored clinically, histologically and ultrastructurally over the past 5 years. PMID- 2773615 TI - Topographical analysis of proliferation ([3H]thymidine labelling index and mitotic index) as compared with tumour growth and tumour weight in xenotransplanted melanoma. Changes due to local and systemic application of azelaic acid. AB - Xenotransplanted human melanoma was investigated by measuring the increase in tumour volume and in final tumour weight (macroscopical parameters) and histomorphological parameters of cell proliferation: Mitotic index (MI) and autoradiographic [3H]thymidine labelling index (LI). A total of 87 tumours, derived from a human melanoma metastasis and a primary nodular melanoma respectively, were analysed by these methods in two series. Topical treatment of the tumours with azelaic acid cream resulted in a statistically significant reduction in the increase in tumour volume and, in the first series, in a clear decrease in final tumour weight and in the MI, as compared with controls. The LI was decreased only in the superficial region of the tumours, i.e. at the site of treatment. Subtumoral injection of azelaic acid (disodium salt solution) was the second route of local therapy. It was followed by a significant reduction in the increase in tumour volume, of final tumour weight (first series) and in the MI. The average LI was clearly smaller than in the controls, especially at the tumour base, which was the site of injection (local effect). Systemic (intravenous) injection of azelaic acid (same concentration of the disodium salt solution) had no negative effect on the increase in tumour volume or final tumour weight, but was followed by a clear reduction of the MI. The average LI of this group was significantly smaller than in the controls as well. This effect was most impressive in the perivascular regions of large and small vessels, which fact can be interpreted as a sort of local effect via the blood stream after systemic application of azelaic acid.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2773616 TI - Uremic pruritus. Clinical and experimental studies. AB - The aim of the study was to investigate clinical aspects of pruritus in maintenance hemodialysis patients and to evaluate factors of putative pathogenic importance. 60-65% of the patients in a maintenance hemodialysis program during a two-year period suffered from itching. Patients with pruritus tended to have been on dialysis treatment longer than those without pruritus (p = 0.05), otherwise there was no difference in clinical data or routine laboratory tests. Measurement of itch intensity continuously over one week in 28 patients using a computerized method showed that itching peaked at night after two days without dialysis, was relatively high during treatment and lowest during the day following dialysis. Our results suggest that the accumulation of pruritogens between dialysis sessions influences the intensity of itching. Most patients had "dry" skin. Recording of the stratum corneum water content by measurement of electrical capacitance, in 31 patients (19 with pruritus) and 12 controls, disclosed no significant difference between dialysis patients and controls, but a tendency that pruritic patients had a lower water content than the other subjects. In different body areas, there was a positive correlation in all groups between the clinical estimation of xerosis and hydration. Serum concentrations of parathyroid hormone (PTH) were significantly higher in dialysis patients with pruritus than in those without, but there was no correlation between the degree of symptoms and the PTH level. Indirect immunohistochemistry revealed no immunoreactivity for different parts of the PTH molecule in skin biopsies from uremic patients. Intradermal injections of PTH fragments did not evoke itching or other cutaneous reactions in patients or controls. Our results do not support PTH as a peripheral mediator of uremic itching. Flare reactions induced by intradermal histamine injections were significantly smaller in 26 dialysis patients (18 with pruritus) than in 9 healthy subjects. However, the itch responses were greater in patients with pruritus than in the other subjects, indicating an augmented sensitivity to pruritogens. Repeated histamine injections induced tachyphylaxis in both uremic patients and controls. Indirect immunohistochemistry revealed neuron-specific enolase (NSE) immunoreactive nerve fibers sprouting throughout the layers of the epidermis in 12 dialysis patients (9 with pruritus) but in none of 15 controls. This finding suggests that hemodialysis patients develop an abnormal pattern of cutaneous innervation. PMID- 2773617 TI - Serum thyroglobulin during the menstrual cycle, during pregnancy, and post partum. AB - Serum thyroglobulin, TSH, thyroid hormones and thyroid volume were investigated during the menstrual cycle in 10 healthy females (day 2, 9, 16, 23 and day 2 of next cycle), during pregnancy (week 18, 24, 30 and 36) and post partum (1, 2, 3, 6 and 12 months) in 20 healthy females. During the menstrual cycle median serum thyroglobulin increased from 27 (day 2) to 32 micrograms/l (day 23, p less than 0.01). Serum TSH and thyroid volume demonstrated a similar increase with a positive correlation between serum thyroglobulin and thyroid volume (r = 0.65, p less than 0.02). Median serum thyroglobulin was significantly increased during the whole pregnancy (week 36, 73 micrograms/l) compared with post partum (1 month post partum, 22 micrograms/l, p less than 0.01), as was thyroid volume. Serum TSH was unaltered and free thyroid hormone indices decreased during pregnancy compared with post partum. No relation between changes in serum thyroglobulin and thyroid volume, TSH or thyroid hormones could be demonstrated. Serum thyroglobulin alterations thus were related to alterations in TSH and thyroid volume during the menstrual cycle. However, the increase in serum thyroglobulin and thyroid volume during pregnancy were unrelated to changes in serum TSH, indicating other mechanisms of regulation than TSH. When interpreting serum thyroglobulin levels in women, the co-existence of pregnancy and time of menstrual cycle should be taken into account in order to avoid misinterpretation of results. PMID- 2773618 TI - A sensitive and practical bioassay for thyrotropin using cultured FRTL-5 cells: assessment of bioactivity for serum TSH in patients with chronic renal failure. AB - A sensitive bioassay for TSH employing a practical extraction method was developed, and the bioactivities in patients with chronic renal failure receiving hemodialysis were compared with those in normal subjects. Serum samples were obtained from 12 normal subjects and 12 patients with chronic renal failure receiving hemodialysis. TSH was extracted from the serum using anti-human TSH monoclonal antibody coated tubes, followed by elution with 2.0 mol/l guanidine HC1 solution (pH 3.2). After the eluate had been dialyzed against phosphate buffered saline (pH 7.4) and again against TRIS-HC1 solution (pH 7.4) and then lyophilized, it was reconstituted with hypotonic Hanks' solution. Bioassay for TSH was performed by measuring the levels of cAMP released into the medium from cultured FRTL-5 cells incubated with the extract. The mean immunoreactive recovery rates of TSH from the serum in normal subjects and patients with chronic renal failure were about 42% (+/- 6) and 40% (+/- 2), respectively. The present bioassay was sufficiently sensitive to detect a serum TSH level of 1.0 mU/l when 3.0 ml of serum was used. Extracts from standard sera at concentrations ranging from 1.0 to 10 mU/l added to the culture medium caused significant linear increases in cAMP production. Based on analysis of covariance the regression line between the immunoreactivities and bioactivities of serum TSH in patients with chronic renal failure (y = 0.90x + 0.3, r = 0.92) was not significantly different from that in normal subjects (y = 1.04x + 0.1, r = 0.93).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2773619 TI - High frequency of cancer in cold thyroid nodules occurring at young age. AB - In order to evaluate the risk of malignancy of cold thyroid nodules occurring in young as compared with adult patients, we studied a consecutive series of 2327 patients with a solitary cold thyroid nodule over a 6-year period. None of these patients had been previously irradiated in the neck or head. Fine needle aspiration of the nodule and cytologic examination were carried out in all patients and, on the basis of this evaluation and clinical examination 391 patients were selected for surgery; 109 patients were 4-20 years old and 2218 patients were older than 20 years. Malignancy was found in 11 (10.1%) and in 112 (5.0%) of cold thyroid nodules occurring in young and adult patients, respectively. The annual incidence of cold thyroid nodules in the population of the area studied was 5.2 vs 55.9 (per 10(5) inhabitants) in the young and in the adult group, respectively, and the annual incidence of thyroid cancer was 0.53 vs 2.82 (per 10(5) inhabitants) in the young and in the adult patients, respectively. The present study indicates, therefore, that in the absence of head or neck irradiation, cold thyroid nodules are much less frequent in young age, but that the malignancy rate of cold nodules occurring in young patients is 2 fold higher than in adults patients. PMID- 2773620 TI - Antithyroid antibodies during amiodarone treatment. AB - In 44 euthyroid and goitre-free patients, 23 treated with amiodarone (group A) and 21 treated with other antiarrhythmic drugs (group B), antimicrosomal antibodies and antithyroglobulin antibodies were determined before the beginning of treatment and after 7, 15, 30, 60, and 180 days. In group A, none of the patients had antithyroid antibodies before treatment. 1 of 15 patients (6.7%) had antimicrosomal antibodies (titre 1:100) on day 7 only, and 1 of 18 (5.5%) had antithyroglobulin antibodies (titre 1:80) on day 180. In group B. 1 of 21 patients (4.8%) had antimicrosomal antibodies (IgG class) at titre 1:400 before the beginning of treatment, which was negative on day 180, and 2 of 17 (11.8%) had antimicrosomal antibodies (titre 1:100) on day 60 only. None of these patients showed clinical and/or laboratory signs of hyper- or hypothyroidism. These data indicated that antithyroid antibodies rarely appear in amiodarone treated patients and do not differ significantly from patients treated with other antiarrhythmic drugs. The role of autoimmunity and the meaning of antithyroid antibodies in the pathogenesis of amiodarone-induced thyroid dysfunction (mainly of hypothyroidism) in patients without pre-existent thyroid diseases is still unclear. PMID- 2773621 TI - Thyroid hormone and not growth hormone is the principle regulator of mammalian mitochondrial biogenesis. AB - T3 and GH have been implicated in the regulation of mitochondrial biogenesis. Since thyroid hormone promotes the synthesis of growth hormone, its control of human mitochondrial biogenesis could arise through a permissive action on GH biosynthesis. This was studied in hypophysectomized rats treated with T3 and/or human GH by the continuous infusion of hormone for 6 days from mini-infusion pumps implanted sc. Increases in mitochondrial respiration, enzyme activities, and protein synthesis were found in isolated liver mitochondria from rats receiving T3. In contrast, GH alone had no effect, nor did it increase the response to T3. Since it has been argued that mitochondrial biogenesis results from a direct interaction (binding) of GH with mitochondria, GH-specific binding sites were measured with 125I-bGH, a specific somatogenic receptor ligand, in isolated mitochondrial membranes in vitro. In addition, the intracellular endocytic uptake of 125I-bGH injected in vivo was compared in purified subcellular membrane fractions and mitochondria. No evidence in favour of specific GH interaction on mitochondrial membranes was found by either test. It is concluded that T3 exerts a direct, rather than permissive, effect on mitochondrial biogenesis, and that high affinity binding sites for GH are not present in rat liver mitochondria. PMID- 2773622 TI - Use of ketoconazole in the treatment of a virilizing adrenocortical carcinoma. AB - Ketoconazole, an oral antimycotic agent, is known to have a potent inhibitory effect on adrenal steroid production. It was given at a dose of 1200 mg/day to a 52-year-old female patient with a virilizing adrenocortical carcinoma in order to achieve better metabolic control pre-operatively. Together with a rapid normalisation of hypertension and hyperglycemia, a dramatic fall was noticed in serum and urinary adrenal steroids after a few days. Levels of total testosterone (20 nmol/l), androstenedione (greater than 35 nmol/l) and DHEA-sulphate (greater than 28 nmol/l) fell to normal levels in 6 days. By contrast, levels of 17-OH progesterone (30 nmol/l) and progesterone (2.45 nmol/l) increased slightly, indicating inhibition of adrenal 17,20-lyase. Cortisol (620 nmol/l at 08.00 h) fell to very low levels (50 nmol/l) on day 6 of the trial. We conclude that ketoconazole is very effective in suppression of adrenal tumoural steroidogenesis and merits consideration in pre-operative use. We warn against dangerous hypoadrenalism which seems to occur earlier in tumoural than in normal adrenal metabolism. PMID- 2773623 TI - Renal iodide clearance in rabbits. AB - The purpose of the study was to compare indirect clearance methods based on plasma values and external detection of activity using small skin attached radioactivity detectors with a direct clearance method based on constant infusion and urine collection. The experiments were performed in anesthetized rabbits. The plasma iodide concentration was increased 100 times to prevent thyroid organification of radioactive iodide. [131I]iodide was infused at a constant rate and [125I]iodide was administered iv as a bolus for indirect clearance determination. The ratio between plasma values and external values 125I-activity was constant in all experiments from 15 min after administration of [125I]iodide and throughout the experiment. The results of 7 experiments in 3 rabbits showed a highly significant correlation (r = 0.98) between direct and indirect values within the range of direct clearance values obtained (0.002-0.6 ml.min-1.kg-1. The direct and indirect clearances were measured simultaneously during a 2-h period of steady state. The 95% confidence interval of the mean ratio between direct and indirect clearances was +/- 20% for plasma activity and +/- 26% for externally measured activity. It is concluded that both methods of indirect clearance determination can be applied to rabbits to estimate absolute values of the renal iodide clearance. PMID- 2773625 TI - Wrongful termination. PMID- 2773624 TI - Familial acromegaly. AB - Five family members over 3 generations had isolated functional pituitary adenomas diagnosed. In four cases acromegaly was diagnosed, and in the fifth galactorrhoea from prolactin excess was the presenting feature. A prominent feature of the affected members tumours were histological finding of either atypical mixed cell or undifferentiated cell type. Given the low incidence of acromegaly and the demonstration of vertical transmission over 3 generations it is suggested this family represents an inherited pituitary syndrome, distinct from Multiple Endocrine Neoplasia (MEN) type 1. PMID- 2773626 TI - A simple pediatric anesthetic screen. PMID- 2773627 TI - Whole brain thinking: a potential link to successful learning. PMID- 2773628 TI - Single-dose intravenous H2 blocker prophylaxis against aspiration pneumonitis: assessment of drug concentration in gastric aspirate. AB - This placebo-controlled trial compared the effects of preoperative, intravenous cimetidine (300 mg) or ranitidine (50 mg) on gastric pH and gastric volume in 31 adult patients requiring general anesthesia. The elapsed time from drug administration to initial gastric sampling did not differ significantly between ranitidine (45 minutes), cimetidine (48 minutes), or placebo (52 minutes) treated patients. Ranitidine, but not cimetidine, significantly (P = 0.02) increased gastric pH when compared with placebo. Gastric pH correlated (r = 0.7, P = 0.01) with cimetidine concentration in gastric fluid at induction. Gastric pH was directly proportional to ranitidine concentration in gastric fluid at induction, but the correlation was weak (r = 0.54, P = 0.1). The H2 blockers did not significantly alter gastric volume when compared with placebo. The number of patients with gastric pH less than = 2.5 and gastric volume = greater than 25 ml did not differ significantly between cimetidine (8%), ranitidine (10%), and placebo (22%). No clinical evidence of aspiration pneumonitis was found in our study patients. PMID- 2773630 TI - Training for wartime anesthesia in Sweden. AB - Sweden has been spared from wars and similar disasters for almost two centuries, and over the years the population and politicians have been lulled into the belief that "it'll never happen". This has affected the ability of the medical system to respond adequately to the enormous demands that a war would make upon us. The geographical and political situation and the basic facts about Swedish health care are briefly sketched. After a review of the history of anesthesia in war, current medical planning for war or similar disaster situations in Sweden is outlined and its weaknesses mentioned. A program is presented that aims at improving the situation in anesthesia manpower, postgraduate training and equipment. The expanded role of the already highly skilled and independent Swedish corps of nurse anesthetists (RNA's) is outlined, especially in the field of regional anesthesia. Standardized methods for anesthesia in war also are presented. The aim is to make optimal use of existing resources and enable patients to be transferred immediately postoperatively to understaffed wards. PMID- 2773629 TI - Arterial oxygen desaturation following intravenous injection of midazolam. AB - The water soluble benzodiazepine derivative, midazolam, is used almost exclusively at our institution to produce sedation for numerous surgical procedures. Mild arterial oxygen desaturation has been reported in patients who have received as little as .04 mg/kg. A time series design study was undertaken to determine if there was any correlation between the decline in arterial oxygen percent saturation (SaO2) and the time at which sedation occurred and to establish the presence of any statistical significance in this decline. Thirty one ASA I and II patients consisting of 8 females and 23 males requiring various minor orthopedic and general surgical procedures were studied. The total mean age of the population was 32.29 +/- 12.43 years (mean +/- SD). Fourteen patients had a smoking history, while 15 patients did not (2 patients were eliminated from the study for failure to demonstrate sedation, as characterized by either Verrill's sign or thickened speech following intravenous administration of midazolam). All patients arrived in the operating room unpremedicated and were administered .04 mg/kg midazolam intravenously. Arterial oxygen saturation was measured over a 10 minute period using pulse oximetry. Results were analyzed using regression analysis, a t-test for independent groups, and a one-way analysis of variance. There was no statistically significant difference in the decline in SaO2 between smokers and nonsmokers. Our study has shown that the mean onset of sedation using a dose of .04 mg/kg occurred between 3 and 4 minutes, with the peak fall in SaO2 occurring at the 3-minute interval irrespective of smoking history. The greatest mean drop in SaO2 was 95.84%. Midazolam, like its parent drug, diazepam, alters ventilatory mechanics.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2773631 TI - [Fine structure of the epithelial cells of the lingual dorsal mucosa in the guinea pig]. AB - The fine structure of the lingual dorsal epithelium of the guinea pig was examined in detail by transmission electron microscopy. In the epithelium of the posterior side of filiform papillae, the surface layer was strongly stained by toluidine blue. This staining pattern is a characteristic feature of hard keratinization. By contrast, in the epithelium on the anterior side of filiform papillae, the surface layer was stained with moderate efficiency by toluidine blue, a characteristic feature of "soft keratinization." The surface area of the interpapillary epithelium was not stained as effectively as these other areas by toluidine blue (Fig. 1). When examined by transmission electron microscopy, cells in the germinal layer of the epithelium on the anterior and posterior sides off iliform papillae and those of the interpapillary epithelium appeared to have an almost identical oval shape. The nuclei of these cells were located in their central areas. In the cytoplasm of these cells, many mitochondria, many free ribosomes, and a few of tonofibrils were seen. Cellular processes were seen to be distributed almost all around each cell. A basal lamina was intercalated between the basal cells of the epithelium and the underlying connective tissue (Fig. 2). In the intermediate layers between the germinal layer and the surface layer of the epithelium, a large number of ketatohyaline granules was observed on the anterior side of filiform papillae. In the deep intermediate layer, mitochondria, kertohyaline granules and free ribosomes were abundant, although the keratohyaline granules were fewer in number and smaller than those in the shallow intermediate layer. Each cell had a rugged surface with spines. The spines of neighbouring cells were linked together by desmosomes (Figs. 3, 4). Both the number and size of the keratohyaline granules tended to increase in the cells of the shallow intermediate layer. Abundant free ribosomes were observed, as was the case in the deep intermediate layer, although the mitochondria were fewer in number than in the deep layers. Relatively flat nuclei were scattered in cells of both the deep and the shallow intermediate layers (Fig. 5). The cells of the surface layer showed a continuous gradation in their composition from that of the cells of the intermediate layer, the major part of their cytoplasm was filled with electron-dense, fibrous structures, and amorphous, moderately electron-dense materials were dispersed between these fibrous structures. A marginal band was located in the contact zone just beneath the cytoplasmic membrane.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2773632 TI - Pneumatic retinopexy in 50 patients. AB - Pneumatic retinopexy was introduced in our clinic in 1986. This paper reports the results from the first 50 cases. Detachments with multiple breaks within 3 clock hours and proliferative vitreoretinopathy up to grade C1 were included. This technique compares favorably to buckling procedures in selected cases. The primary success rate was 83%, and the overall success rate was 90% (pneumatic retinopexy +/- scleral buckling +/- vitrectomy). PMID- 2773633 TI - Acute retinal necrosis syndrome treated with vitrectomy and intravenous acyclovir. AB - Acute retinal necrosis syndrome in a healthy 32-year-old man was treated successfully with systemic acyclovir and corticosteroids in combination with vitrectomy, 360 degrees encircling band and transscleral cryocoagulation. Herpes simplex virus antibodies were detected in the vitrectomy aspirate supporting the current view that acute retinal necrosis is caused by viruses of the herpes group. PMID- 2773634 TI - Orbital inflammation as presenting sign for myelodysplastic syndrome. PMID- 2773635 TI - Regional sensitivity to hypoglycemia within the rabbit lens epithelium. AB - Paired rabbit lenses were kept in organ culture; one of the lenses was subjected to hypoglycemia, and the other served as control. The lens changes were followed and examined by photomacrography, light microscopy of the intact lens, and light and electron microscopy at different time intervals. The possibility of reversing the morphological changes was evaluated at different times by replacing the hypoglycemic medium with a normal glycemic one. The central zone of the lens epithelium was affected first through the formation of large extracellular vacuoles. These changes were reversible. Subsequently, the central lens epithelial cells showed severe swelling and breakdown of the lens membranes. These changes were not reversible. With time the epithelial changes spread from the central zone towards the equator. Lens fiber swelling followed the severe epithelial damage. These findings show that there is a regional sensitivity to hypoglycemia within the lens epithelium. The results are discussed in relation to hexokinase activity. PMID- 2773636 TI - Long-term visual results of vitreous surgery in diabetic eye disease. AB - Long-term visual results in the first 124 consecutively vitrectomized eyes of 105 diabetic patients in our department were evaluated. The indications for vitrectomy were unresorbable vitreous haemorrhage (77 eyes, 62%) (group A), central traction retinal detachment (21 eyes, 17%) (group B), and a combination of both (26 eyes, 21%) (group C). Initially visual acuity (VA) improved at least by one category in 83 eyes (67%). The latest postoperative VA after the mean follow-up of 3.7 +/- 0.2 years was greater than = 0.3 in 36 eyes (29%), 0.1-0.25 in 15 eyes (12%), 0.05-0.08 in 9 eyes (7%), counting fingers (CF) 1-less than 3 m in 13 eyes (11%), and less than CF 1 m in 51 eyes (41%). The latest VA of 0.3 or better was significantly more common in group A (40%) than in group B (10%) or group C (12%) (P = 0.0087 and 0.0076, respectively). The most common causes of visual failure (VA less than C F 1m) were neovascular glaucoma and/or retinal detachment. At the latest follow-up visit 50% of the patients had VA of 0.3 or better, 16% were in the low-vision category, and 34% were blind (VA less than 0.05). PMID- 2773637 TI - Silicone oil in retinal detachment surgery. Results and complications. AB - Results and complications with the use of intraocular silicone oil in 25 eyes operated on for complicated retinal detachment are reported. Most eyes had undergone several operations for detachment before silicone injection. The follow up time after silicone injection was 12-48 months. In perforating injuries the outcome was quite poor, 27% received anatomic success (attached retina) compared to primary rhegmatogenous detachments with 57% success rate. Visual acuity was counting fingers 1 m or better in 56% in the whole group examined. Silicone oil was removed in 5 eyes. Of the late complications, keratopathy occurred in 3 eyes (12%), increased intraocular pressure in 4 eyes (16%), and cataract in 2 of 3 phakic eyes. Angiographic signs of iris neovascularization were obvious or suspected in 3 of 9 eyes examined. PMID- 2773638 TI - Changes in corneal endothelium after treatment of retinal detachment with intraocular silicone oil. AB - Keratopathy represents one of the most frequent late complications in eyes with complicated retinal detachment treated with intraocular silicone oil. Corneal examinations including endothelial specular photography were done on 18 silicone treated eyes, 16 of which were aphakic. In addition to widespread silicone oil endothelial contact in 2 eyes, a bubble or droplets of silicone oil were observed in the anterior chamber in 8 eyes. The mean endothelial cell density was lower in the silicone eyes (2076 +/- 196 cells/mm2) as compared to the control fellow eyes (2738 +/- 86 cells/mm2) (P = 0.004). In eyes with silicone oil in the anterior chamber the endothelial cell density was significantly decreased (1857 +/- 232 cells/mm2) (P = 0.005). Obvious endothelial degeneration was noticed when silicone oil had been in the eye for more than a year. Also small droplets of oil with transient contact contributed to its development. PMID- 2773639 TI - Antiviral activity of a D-glucosamine derivative against herpetic ulcers (HSV type 2) in rabbit cornea. AB - Although most herpetic ocular infections in adults are caused by herpesvirus hominis type 1, several cases of culture proved HSV-2 ocular infection in adults have been described, with more severe and prolonged disease. In a screening for new antiherpetic compounds, we investigated the efficacy in vivo of a new compound, nitroderivative of D-glucosaminhydrochloride (GN-11) in comparison with D-glucosaminhydrochloride (GN), Acyclovir (ACV) and placebo against herpetic keratitis of herpes simplex type 2 in 4 x 4 eyes from 4 x 4 rabbits, respectively. ACV and GN-11 showed similar results. The treatment with GN-11 retarded the appearance of herpetic lesions, which were small and diffuse in comparison with the placebo group. A total recovery was obtained on the 12th day of the treatment. In the ACV treated group, a minimal number of small lesions appeared, but the eyes recovered normality on the 7th day of treatment. The appearance of acute herpetic keratitis was prevented by GN-11. Placebo and GN treated groups showed similar evolution, with lost vision and neurological involvement on the 7th day of infection. PMID- 2773640 TI - Foam at inner eye canthus in office workers, compared with an average Danish population as control group. AB - Foam formation in the eye canthus is well-known. The presence of foam was observed in 169 office workers in 4 town halls in Copenhagen County compared with 112 control persons from the general population in the same area. The presence of foam depends on age and gender. A significant increase with age was observed in the control population (P = 0.0078). In both groups, females had a significantly lower occurrence of foam than males (P = 0.0043, P = 0.010). This difference was mainly caused by the use of eye make-up. After correction for age, gender and use of eye make-up, the prevalence of foam was significantly lower in the office population than in the control population (P less than 0.0001). Furthermore, low foam formation was significantly correlated to reported subjective eye irritation in the office population (P = 0.0074), but not in the control population (P = 0.40). Also, significant positive correlation between absence of foam and different degrees of dry eyes (expressed as a combination of premature break-up of the precorneal tearfilm and lissamine green stained epithelial damage of the bulbar conjunctiva) was found both in the office population and in the control population (P = 0.0090, P = 0.0034). However, after correction for the more frequent appearance of dry eyes in the office population, foam was still observed significantly less frequently in the office population than in the control population (P = 0.0001). It is concluded that the decreased foam formation in the office worker constitutes a key symptom in the development of 'office eye syndrome'. In what way the office environment influences the foam formation is unknown. Possible mechanisms are discussed. PMID- 2773641 TI - Intraocular lens power calculation. A retrospective analysis of its practical value. AB - Two hundred and two consecutive intraocular lens (IOL) implantations, the lens power being predicted with the SRK-method, are retrospectively analyzed, and the factors possibly influencing the error in IOL power prediction are evaluated. The actual post-operative refraction is compared to the expected refraction for each IOL and to a hypothetical refraction that would have been obtained by a standard power IOL implant. Axial length measurement and a high pre- and post-operative astigmatic error, along with low- and high power IOL predictions, are the factors that most influence the post-operative refractive error. A similar distribution of post-operative refraction could have been obtained by using a standard-power IOL instead of pre-operative calculation. PMID- 2773642 TI - Migration of cells in the rat corneal epithelium. AB - The migration of cells in the rat corneal epithelium was studied using continuous labelling with tritiated thymidine [3H]TdR, during a 24 h period. Most mitoses resulted in 2 new basal cells. Cells leaving the basal cell layer moved vertically to the surface in all areas of the corneal epithelium. The first labelled cells reached the surface 3 days after the first injection of [3H]TdR. No stream of cells from the conjunctiva to the cornea in the limbal areas was observed, and no centripetal migration of epithelial cells in the cornea could be observed. After a cell has lost its attachment to the basement membrane, it is committed to be exfoliated in a few days without undergoing mitosis. Thus the slow centripetal migration of epithelial cells and the exchange of centrally located cells, as indicated by clinical findings and experimental studies, can only be explained by migration of basal cells. PMID- 2773643 TI - Ocular findings in polycystic lipomembranous osteodysplasia with sclerosing leukoencephalopathy. AB - A routine ophthalmologic examination supplemented by color fundus photography and, in 2 cases, by fluorescein angiography was performed in 8 patients with PLO SL (= polycystic lipomembranous dysplasia with sclerosing leukoencephalopathy). Five patients showed some degree of retinal nerve fiber defect. The relation of the changes in ocular fundi to the pathological findings of PLO-SL are discussed. PMID- 2773644 TI - [Composition of essential oils from native Hungarian camomile]. PMID- 2773645 TI - Formulation of Polyethylene Glycol ointment bases suitable for tropical and subtropical climates. II. AB - Attention has been focused on the suitability of PEG ointment bases in tropical and subtropical regions. Penetrometer studies were carried out at 33, 37 and 50 degrees C respectively. Penetrometer experiments indicate that the type and amount of PEG will greatly affect the penentration time, and a large number of selected PEGs showed softening in the second month. Rotovisco experiments were conducted at 35 and 45 degrees C. Experiments conducted by Rotovisco at 35 degrees C indicate that PEG bases exhibit plastic flow and rheopexy, and there is an increase in yield values during the twelve months. Experiments worked out by Rotovisco at 45 degrees C reflected that an increase in temperature resulted in a decrease in rheopexy, viscosity, area of histeresis loop and yield values. Results obtained by the two methods demonstrate that PEG 4000 in the presence of equal amounts of PEG 400 has a good texture and might be a suitable ointment base for tropical and subtropical areas. PMID- 2773646 TI - Potentiation of the diuretic and natriuretic effect of furosemide by the calcium antagonist nifedipine. AB - The renal excretory function was studied in rats under control conditions, after treatment with nifedipine, with furosemide and combined treatment with nifedipine and furosemide. The experimental animals were investigated in metabolic cages. Spontaneously excreted urine was collected for 6 h (under control conditions and when nifedipine was applied) and for two hours in the experiments with furosemide treatment. The diuresis, the excretion of sodium, potassium, chlorine, creatinine and the total amount of osmotically active substances were studied. Blood samples were taken from the heart under nembutal anaesthesia. The clearances and the excretory fractions of the substances tested were determined. The glomerular filtration was determined by the clearance of the endogenous creatinine. The blood pressure in the tail artery was measured in control experiments. Increased diuresis was observed after treatment with nifedipine, without substantial changes in the sodium, chlorine, potassium and total osmotic excretion. When furosemide was applied after pretreatment with nifedipine, the diuresis was by 33 per cent higher than when only furosemide was applied (p less than 0.01), sodium excretion was by 40% higher (p less than 0.01) and that of chlorine--by 16.9% (p less than 0.01). Potassium excretion remained unchanged. The results of the excretory fractions and of the clearances of the substances studied support the evidence about potentiation of the natriuretic and chlorouretic effect of furosemide under the effect of nifedipine. The concentrating function of the kidney, determined through the clearance parameter Cosm/TcH2O manifested an additional limitation under the effect of nifedipine. PMID- 2773648 TI - The role of the pelvic nerves in the realization of the reservoir function of the colon. AB - In situ experiments were made on a group of dogs and in vivo experiments on another group of dogs with implanted electrodes for recording the electrical activity of the colonic muscle wall. A bipolar platinum electrode implanted in the pelvic nerve entering into the distal area of descending colon was used for electrical stimulation of the nerve (1 ms impulse duration, frequency of 2, 8, 10 and 15 Hz and amplitude of 10, 15 or 20 V). Electrical stimulation of the pelvic nerve with a frequency of 2 Hz resulted in inhibition of the spike activity. However, groups of spike potential burst in the distal part of the descending colon in response to electrical stimulation with frequencies of 8, 10 or 15 Hz. Repeated stimulation caused spreading of the spike activity of the descending colon in oral direction until the transverse colon. These antiperistaltic waves probably prevented the propulsion of the content of the descending colon. Thus, in addition to the inhibitory effect exercised by the sympathetic and noncholinergic nonadrenergic inhibitory part of the intrinsic nervous system, the reservoir function of the colon is influenced by these orally spreading waves of spike activity (antiperistaltic waves), which are caused by impulses along the pelvic nerves. PMID- 2773647 TI - Biological tests for opiate activity of newly-synthesized compounds--opioid peptides and cyclic beta-diketones. AB - A group of newly-synthesized (Leu5) enkephalinamides and their derivatives, with incorporated D-amino acids, as well as a group of cyclic beta-diketones from the group of 1, 3-indandiones, were partially pharmacologically characterized in experiments in vivo and in vitro. The substances studied, applied subcutaneously in doses of 50 to 1250 micrograms/kg bogy mass in mice, did not induce symptoms of acute and late toxicity. According to the parameters of the neuropharmacological screening tests performed, no significant differences were observed between the mice treated with the agents tested and the control mice. All five agents investigated significantly shortened the duration of hexobaribital-induced sleep. In the experiments using the conflict test after Vogel et al. (1971), (D-Ala2, D-Leu5) enkephalinamide induced a behavioural effect which can be qualified as anxiolytic. The same analogue also manifested a marked analgesic effect with the two tests used: hot plate test and the peritoneal test with glacial acetic acid. The cyclic beta-diketones (methindiones) tested also manifested good analgesic effect with both test. (D Ala2, D-Leu5), enkephalinamide strongly reduced the electrically induced contractile responses of the ileum. This effect was completely prevented by naloxone. The fact that (D-Ala2, D-Leu5) enkephalinamaide, known as a selective agonist of the delta-opiate receptors, proved to be particularly active suggests that both mu- and delta-type opiate receptors exist in the guinea-pig ileum. The pronounced analgesic effect of the leucine-enkephalinamide analogue with two substituted D-amino acids and of the two cyclic beta-diketone methindiones opens up new possibilities for synthesizing efficient analgesic agents. PMID- 2773649 TI - Allylglycine and brain excitability. Electrophysiological investigation in cats. AB - The effect of DL-allylglycine (DL-AG) in two doses (40 and 60 mg/kg i.v.) was studied on cats under acute conditions. DL-AG provoked the appearance of epileptiform EEG patterns either spontaneous or in response to intermittent light stimulation with a frequency of 5-25 Hz. The effect was dose-dependent. The paroxysmal EEG was restricted to or began in the cortex and later it appeared in the thalamus and mesencephalic reticular formation. This finding together with the observation that after DL-AG the visual evoked potentials increased in the primary visual cortex and decreased in the centre median nucleus and in the reticular formation support the view about the role of the cortex in the increased brain excitability and in the increased photosensitivity after allylglycine. The photosensitive of spontaneous epileptiform EEG activity in cats pretreated with DL-allylglycine could be an useful experimental model of epilepsy for assessing the efficacy of anticonvulsant drugs. PMID- 2773650 TI - Hemispheric asymmetry of the harmonic components ot the visual potentials evoked by the onset-offset of spatially periodic stimuli. AB - The distribution on the scalp of the first (H1) and second (H2) harmonic components of the steady-state visual evoked potential was studied. The stimulus was the onset-offset of a sinusoidal grating with spatial frequency of 4 c/deg, temporal frequency of 7.1 or 16.7 Hz and contrast of 0.2. The visual evoked potentials were recorded monopolarly from symmetric points at distances of 3, 6 and 9 cm laterally from Oz. It was found that while in the averaged data for all investigated subjects there were no differences in the distributions of H1 and H2 to the right and to the left of Oz, the different individuals had a characteristic asymmetry in the amplitude of the response. The statistical processing of the data revealed a significant prevalence of the second harmonic in the left hemisphere upon stimulation at 16.7 Hz for right-handed subjects. The hypothesis about the dominating role of the left cerebral hemisphere in the processing of signals with high temporal frequency was supported for this group of subjects. PMID- 2773651 TI - Interactions of angiotensin II with piracetam in exploratory behavior and convulsive-seizure threshold. AB - The interactions between angiotensin II (AT II) and piracetam in exploratory behavior of rats in open field and in pentylenetetrazol (PTZ) convulsive-seizure threshold in mice were studied. AT II at a dose of 0.5 microgram injected intracerebroventricularly (i.c.v.) increased exploratory behavior. Piracetam at a dose of 600 mg.kg-1 administered orally twice daily for 7 days increased the frequency of the exploratory behavior components. AT II decreased this effect of piracetam. AT II (0.5 microgram i.c.v.) tended to increase the PTZ convulsive seizure threshold. On single administration piracetam had no effect on the convulsive-seizure threshold but on multiple administration it increased the threshold. The two drugs applied together increased the PTZ convulsive-seizure threshold to a larger extent as compared to the effect they exerted when administered alone. The changes in exploratory behavior and in convulsive-seizure threshold, increased by the combination of AT II and piracetam, are explained by the interactions between the two drugs at the level of AT II and GABA binding sites in brain. PMID- 2773652 TI - Antihypoxic effect of the hydroxylamine derivative HB-7. AB - The antihypoxic effect of the newly-synthesized hydroxylamine barbiturate HB-7, compared with the effects of phenobarbital and pentobarbital, was studied in experiments on albino mice, using the following models of hypoxia: hypobaric, anoxic, asphyctic and haemic. A dose-effect dependence was established when the survival of the mice was prolonged under the effects of the barbiturates tested, applying the asphyctic and haemic hypoxy tests. The latter two tests were also used to determine the average effective doses (ED60) of the barbiturates. HB-7 was superior in its action to phenobarbital and pentobarbital, manifesting higher protective indices (PI-LD50: ED50): for HB-7 PI is 4.2, for phenobarbital--3.2 and for pentobarbital--2.5, using the haemic hypoxy test. It is concluded that HB 7, i.e. 2-hydroxylamine-5-ethyl-5-sec, pentylbarbituric acid, manifests a marked protective effect in the hypoxy tests used, exceeding in some cases the effects of phenobarbital and pentobarbital. PMID- 2773654 TI - Orienting reactions to light tactile stimuli after single and repeated partial spinal cord lesions in the cat. AB - Cats which had been trained to remain quietly standing were tested for orienting responses to light tactile stimulation (ORLT) of either hindlimb before and after different single, and subsequently increased, low thoracic spinal cord lesions. The individual lesions covered one dorsal column, and/or the dorsal part of one lateral funiculus, and/or the ventral part of the lateral funiculus, and/or one entire lateral funiculus and/or one or both ventral quadrants. Normal ORLTs were produced from the first post-operative test after each of the above lesions alone, or in combination with one of the others. Acute and chronic disappearances and/or disturbances of the ORLTs were observed for one hindlimb only after lesions involving at least the dorsal column and the dorsal part of the lateral funiculus of the ipsilateral side, as well as the contralateral lateral funiculus. The amount of disturbance varied with the technique in such a way that the number of operations which had been carried out to cause the actual lesion was inversely correlated to the degree of post-operative defect. The findings showed that the severity of the tactile symptoms after spinal cord lesions may depend on the speed with which they had developed. The types of lesions causing defects indicated that cats, under normal conditions, may utilize one of the three ascending spinal pathways for orienting reactions to light tactile stimulation. In relation to the peripheral receptive fields, these pathways are the ipsilateral dorsal column and spinocervical pathways, and a pathway of the contralateral lateral funiculus. The possible spinothalamic character of the crossed pathway has yet to be established. PMID- 2773653 TI - Very rapid net transcapillary fluid absorption from skeletal muscle and skin in man during pronounced hypovolaemic circulatory stress. AB - High levels (110-120 cmH2O) of lower body negative pressure (LBNP) were used in male volunteers (n = 7) to produce pronounced hypovolaemic circulatory stress in an attempt to reveal the potential in man for compensatory absorption of extravascular fluid from skeletal muscle and skin as studied in the upper arm by plethysmographic technique. LBNP evoked clear-cut hypovolaemic symptoms or even accidental syncope as well as a marked tachycardiac response and a significant fall in systolic blood pressure. In the studied arm there was concomitantly a very rapid net transcapillary absorption of extravascular fluid into the circulation at an average rate of 0.35 ml min-1 100 ml-1 soft tissue during 5 min of LBNP exposure. These data demonstrate an amazingly great potential to increase plasma volume by 'autotransfusion' of fluid from tissue to blood, as may be visualized by extrapolation of the data from the arm to apply to the whole mass of skeletal muscle and skin in the body. The observed absorption rate would then correspond to a total fluid gain of no less than 700 ml within a period no longer than 5 min. At present, however, there is no evidence to indicate that such impressive fluid volumes can be rapidly transferred from the extra-to the intravascular space after actual blood loss. PMID- 2773655 TI - Local cooling of pre-frontal cortex induces pacemaker-like firing of dopamine neurons in rat ventral tegmental area in vivo. PMID- 2773657 TI - Failure of the venous pressure decline in hypovolaemia to be transmitted to the capillary level and cause compensatory absorption of extravascular fluid into the circulation. PMID- 2773656 TI - Does clonidine- or neuropeptide Y-mediated inhibition of ATP secretion from sympathetic nerves operate primarily by increasing a potassium conductance? PMID- 2773658 TI - Vagally induced hexamethonium-resistant jejunal contractions in the cat. PMID- 2773659 TI - Marked regional heterogeneity in blood flow within a single skeletal muscle at rest and during exercise hyperaemia in the rabbit. AB - In 1985 both Pendergast et al. and Piiper et al. described a major regional heterogeneity in blood flow within single skeletal muscles both at rest and during exercise. Based on the microsphere method they described large variations in blood flow between muscle samples as large as 1 g each. The aims of the present study were: (1) To test this notion of regional heterogeneity in microsphere deposition within single skeletal muscles both at rest and during exercise. (2) To compare the distribution of microspheres with other blood flow tracers. (3) To test whether or not any heterogeneity was due to vasomotion in small arteries or arterioles. Microspheres were infused into anaesthetized rabbits over either 10, 30 or 120 s, or 10 min. Exercise was mimicked by tetanic contractions obtained by electrical stimulation of the motor nerves. Three hindleg muscles were divided into samples of 0.25 g each. Regional heterogeneity was expressed as the coefficient of variation corrected for statistical distribution of microspheres (CVc). The CVc at rest was about 0.34. The CVc was unaffected by the various infusion periods and did not change during exercise. Simultaneous infusions of microspheres and 86Rb+ or antipyrine gave high correlations between the two blood flow tracers, with all r values exceeding 0.83 (n = 18). We conclude that the microsphere method provides reliable estimates for regional blood flow within single skeletal muscles. The distribution of blood flow was markedly heterogeneous both at rest and during exercise. The heterogeneity in blood flow was apparently not a result of vasomotion. PMID- 2773660 TI - Enzyme activities in type I and II muscle fibres of human skeletal muscle in relation to age and torque development. AB - The quadriceps muscles from 20- 30- and 70-year-old clinically healthy men and women were studied regarding maximal isometric and isokinetic muscle torque in Newton metres (Nm), morphology and enzyme activity. Biopsy specimens were taken from the vastus lateralis muscle and freeze-dried, and individual fibres were dissected out and identified as type I or type II. The activities of citrate synthase (CS), 3-OHacyl-coA dehydrogenase (HAD), lactate dehydrogenase (LDH), myokinase (MK) and creatine phosphokinase (CPK) were determined in pools of type I and type II fibres. In both age groups a higher oxidative (CS, HAD, 1.3-1.5 x) and a lower glycolytic (LDH, 0.7 x) capacity was found in type I than in type II fibres. The myokinase activity was higher in type II (2 x) than in type I, whereas CPK activity was similar. The young men showed higher CS activity in both type I and type II fibres (1.5 x) and higher CPK activity in type I fibres (1.4 x) than the young women. There were only minor changes in oxidative or glycolytic capacities in relation to age. Myokinase was the only enzyme that decreased markedly with age in both pools of fibre types. Type II fibre area and mean fibre area correlated significantly to muscle torque in both sexes. In men, myokinase activity in type II fibres was significantly correlated to type II fibre area and to maximal muscle torque. PMID- 2773661 TI - Effects of amrinone on twitch, tetanus and shortening kinetics in mammalian skeletal muscle. AB - The contractile effects of amrinone were studied on twitch and tetanus responses of mouse lumbrical muscles. Amrinone (1.1 mM) increased the maximum force level during the tetanus, reduced the rate of rise of force during the onset of tetanus and prolonged the time from the last stimulus to half-relaxation. The rate of redevelopment of force after a release during the tetanus plateau was likewise reduced. Amrinone (greater than or equal to 0.5 mM) increased the time to peak twitch force and the time to half-relaxation during the twitch. The peak twitch force was not significantly changed. The force-velocity relation was markedly affected by amrinone: there was a decrease in maximum velocity of shortening, an increase in maximum isometric force and a decrease in curvature of the force velocity relation. The results suggest that amrinone modulates the kinetic properties of the myosin cross-bridges by exerting a specific effect upon the myofilament system. The latter effects are mainly responsible for the contractile changes produced by amrinone in mouse skeletal muscle. Amrinone appears to have little effect on the metabolism of activator calcium in this particular preparation. PMID- 2773662 TI - Motor patterns of a fast voluntary postural task in man: trunk extension in standing. AB - The co-ordination between muscles controlling the primary movement and associated postural adjustments during fast trunk extension movements was studied in six male subjects. Myoelectrical activity (EMG) was recorded from antagonistic muscle pairs at the trunk, hip, knee and ankle. Horizontal displacements of the upper trunk, hip and knee were recorded with an opto-electronic system (Selspot). A backward displacement of the trunk was accompanied by a forward displacement of the hip and knee. In general, the trunk started to move 30 ms before the hip and knee. Muscle activity first appeared in the ankle extensors (soleus/gastrocnemius) up to 150 ms prior to onset of prime mover muscles (trunk extensor, erector spinae; and hip extensors/knee flexors, hamstrings). This pre activation was seldom followed by any detectable ankle joint movement. Prime mover muscles were activated simultaneously followed by the hip extensor gluteus maximus. Time to activation of muscles braking the movement (rectus abdominis, rectus femoris and vastus lateralis) was correlated with the amplitude of the primary movement (r = 0.63 0.75, P less than 0.01). Onset of activity in vastus lateralis was highly correlated with the amplitude of the forward displacement of the knee (r = 0.93, P less than 0.01). An associated postural adjustment appeared as an ankle flexion accompanied by activity in the ankle flexor tibialis anterior, and often also in the ankle extensors. This co-activation of antagonistic ankle muscles can under certain conditions have interesting functional implications for the control of posture. PMID- 2773663 TI - Glucose polymer syrup attenuates prolonged endurance exercise-induced vasopressin release. AB - We investigated the effect of glucose and glucose polymer ingestion on plasma arginine vasopressin (pAVP) levels, on plasma osmolality (p-osm), and on performance during two prolonged endurance events. The study subjects were 37 Finnish elite endurance athletes, of whom 18 were orienteers and 19 cross-country skiers. Plasma AVP increased in both combined glucose and glucose polymer groups, but the increase in the glucose polymer group was significantly smaller (P less than 0.001) than that in the glucose group. A significant change in p-osm caused a significant change in pAVP and vice versa. Both the orienteers and the skiers on glucose polymer tended to have more success in the competition; the orienteers on glucose polymer ran the last third of the competition significantly faster than those on glucose (P less than 0.05). It is suggested, in the light of the smaller pAVP response, that after glucose polymer ingestion the physical stress in prolonged endurance exercise is smaller than after ingestion of glucose. PMID- 2773664 TI - Much larger transcapillary hydrodynamic conductivity in skeletal muscle and skin of man than previously believed. AB - The capillary filtration coefficient (CFC) in the human forearm, determined with the 'venous occlusion' method, was found to be about 0.005 ml min-1 100 ml-1 soft tissue mmHg-1 when capillary pressure (Pc) was raised by about 30 mmHg, a finding in accordance with previous literature. With gradually smaller increments of Pc, however, the calculated CFC became gradually larger to reach maximal values of about 0.05 ml min-1 100 ml-1 mmHg-1 at increases in venous pressure that raised Pc by only 1.5-2 mmHg. It is suggested that these high CFC values, obtained at increases of intravascular pressure so low as to ensure minimal interference with the normal circulation, reflect the true prevailing transcapillary hydrodynamic conductivity in the tissue. The low CFC values during high increases in capillary (microvascular) pressure, on the other hand, seem to represent serious underestimations of the true CFC as a result of experimentally induced undesired active smooth muscle constrictor responses and/or passive deterioration of capillary exchange function. The conclusion is therefore reached that CFC in skeletal muscle and skin in man might be about 10 times higher than previously believed. PMID- 2773665 TI - Application of a new technique--blood pressure clamping--for analysis of prostaglandin interference with sympathetic neurotransmission in man. AB - To circumvent baroreceptor reflexes following drug-induced interference sympathetic neurotransmission, a new technique - blood pressure clamping--has developed. This implies that the sympathetic activity in an awake human is 'clamped' at a supranormal level by infusion of a vasodilator. In 11 healthy volunteers nitroprusside or saline was randomly infused in two consecutive 2-h periods. Plasma and urinary catecholamine levels were analysed by liquid chromatography. The experiments were repeated after random administration of the prostaglandin synthesis inhibitor, ibuprofen, or placebo. In the basal state (no ibuprofen, saline infusion) the mean arterial blood pressure was 81.4 +/- 2.3 mmHg, the heart rate was 60.9 +/- 0.3 beats min-1 and the plasma level of noradrenaline was 1.12 +/- 0.15 nM. Infusion of nitroprusside at a dose lowering the mean blood pressure by 11.6 +/- 1.6 mmHg and increasing the heart rate to 74.6 +/- 2.9 beats min-1 elevated plasma noradrenaline to 2.86 +/- 0.39 nM. After pretreatment with ibuprofen (saline infusion), the systemic blood pressure, the heart rate, and the plasma and urinary levels of noradrenaline were unaffected in comparison to before drug (80.1 +/- 2.3 mmHg, 58.4 +/- 0.3 beats min-1 and 1.13 +/- 0.12 nM respectively). Infusion of nitroprusside at a rate lowering the blood pressure by 11.2 +/- 2.4 mmHg and increasing the heart rate to 74.4 +/- 0.5 beats min-1, elevated the plasma level of noradrenaline to 2.46 +/- 0.38 ng ml-1, which is not different from before ibuprofen. The amount of nitroprusside required to lower the blood pressure was not different in the presence and absence of ibuprofen.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2773666 TI - Effects of nerve compression or ischaemia on conduction properties of myelinated and non-myelinated nerve fibres. An experimental study in the rabbit common peroneal nerve. AB - Compound action potentials of both myelinated (A) and non-myelinated (C) fibres in the common peroneal nerve of rabbits were studied during and after acute, graded compression of the nerve at 200 or 400 mmHg applied for 2 h or during ischaemia created by nitrogen inhalation or aortic occlusion. Compression of the nerve at 200 mmHg blocked the AI component (large myelinated fibres) after about 23 min, while compression at 400 mmHg shortened this time to 11 min. The A2 component (thinner myelinated fibres) had a lower conduction velocity and a higher resistance to compression. There was just a slight decrease in conduction velocity of the non-myelinated fibres when the nerves were compressed at 200 mmHg for 2 h. However, compression at 400 mmHg for 2 h induced a marked deterioration of amplitude and conduction velocity of the C-fibres. There was an incomplete restitution of function of A- and C-fibres during 2 h of recovery. The thinner myelinated fibres were more susceptible to deprivation of oxygen than the thicker ones, while non-myelinated fibres differed in response according to method of ischaemia induction. It is concluded that non-myelinated fibres are very resistant to compression and a very high pressure (greater than 400 mmHg) is needed to affect these fibres. PMID- 2773667 TI - Developing rat cerebellum--I. Effects of abnormal thyroid states and undernutrition on sulfated glycosaminoglycans. AB - Sulfated glycosaminoglycans deposition during rat postnatal cerebellar developmental is affected by altered thyroid states and undernutrition. These ontogenetic alterations seem not to be specific but to be one aspect of the general acceleration, slowing down and reduction of the cerebellar development occurring in thyroid-deficient, hyperthyroid and undernourished rats, respectively. PMID- 2773668 TI - Developing rat cerebellum--II. Effects of abnormal thyroid states and undernutrition on hyaluronic acid. AB - The early postnatal pattern of hyaluronic acid (HA) deposition in rat cerebellum is affected by thyroid deficiency, thyroxine treatment and undernutrition. The modification of HA ontogenesis apparently reflects the smaller number of cells formed in undernourished rats, or alterations of cell maturation (accelerated in thyroxine-treated and slowed down in thyroid-deficient rats). The developmentally regulated loss of tissue water is also affected in the three conditions; this can be correlated with the roughly simultaneous disappearance of extracellular, but not of total, HA. PMID- 2773669 TI - Developing rat cerebellum--III. Effects of abnormal thyroid states and undernutrition on gangliosides. AB - Alteration of rat postnatal cerebellar development produced by undernutrition, thyroxine treatment and thyroid deficiency also involves ganglioside deposition. The distribution of the different ganglioside types is apparently unaffected but quantitative alterations are present that reflect the reduction of cell number and cell process surface in the adult, and either acceleration or slowing down or reduction of cell formation and maturation occurring during cerebellar development in the three experimental situations. PMID- 2773670 TI - Vimentin-GFAP transition in primary dissociated cultures of rat embryo spinal cord. AB - Primary dissociated cultures derived from 15-day-old rat embryo spinal cord with or without dorsal root ganglia (DRG) were grown on polylysine, Primaria and laminin substrates. On polylysine and Primaria substrates, spinal cord neurons formed aggregates connected by bundles of neurites in a distinctive pattern similar to that observed in cultures derived from embryonal rat brain and neonatal rat cerebellum. After 2 days in culture, the number of cells stained with GFAP antibodies progressively increased within the vimentin-positive monolayer surrounding the neuronal aggregates. These astrocytes had the typical appearance of astrocytes in primary dissociated cultures derived from late fetal or early neonatal murine brain, i.e. large flat or stellate cells with thick processes staining equally well with GFAP and vimentin antibodies. Astrocytes found within the neuronal aggregates in 4-5 day cultures were markedly different, i.e. small stellate cells with slender processes forming a delicate mesh throughout the aggregate. These GFAP-positive cells stained only weakly with vimentin antibodies. Spinal cord neurons formed aggregates on laminin substrates but failed to extend neurites and rapidly degenerated. The large flat cells in the surrounding monolayer gradually invaded the aggregates. These cells stained with both GFAP and vimentin antibodies. DRG neurons developed equally well on Primaria and laminin substrates, extending their neurites on the vimentin positive flat cells forming the monolayer regardless of their reactivity with GFAP antibodies. PMID- 2773672 TI - The interaction of substrate and taurine modulates the outgrowth from regenerating goldfish retinal explants. AB - Retinal growth from explants attached to different substrates was evaluated in the absence and the presence of various concentrations of taurine. Fiber thickness was higher in poly-L-lysine, collagen and laminin than in the other substrates tested. Explants on wheatgerm, soybean, and red kidney bean lectins did not show emission of neurites at 5 days in culture; growth on laminin was very poor at this period of time. By day 10 nerve growth index was possible to evaluate on soybean and laminin. Outgrowth from retinal explants on wheatgerm lectin was only observed in the presence of taurine. The percentage of growing explants on laminin was increased by the amino acid. Emission of neurites from explants on concanavalin A and lentil lectin was constant from 5 to 10 days in culture and was not accelerated or increased by taurine. Growth on poly-L-lysine and collagen was stimulated by the addition of taurine in a concentration dependent manner. The amino acid stimulates outgrowth from explants attached to peanut lectin in a bell-shaped concentration dependency similar to that observed on poly-L-lysine. The effect of taurine on retinal explants is substrate dependent, as an indication of the interaction of soluble molecular components plus charge and structure of the extracellular matrix in order to modulate the outgrowth from regenerating tissue. PMID- 2773673 TI - Effects of acidic and basic fibroblast growth factors on proliferation and maturation of cultured rat oligodendrocytes. AB - A pure culture of oligodendrocytes has been developed starting from brain hemispheres of newborn rats. Various effects of acidic and basic fibroblast growth factors (FGFs) on the development of oligodendrocytes have been examined and compared. Both factors elicited similar effects, i.e. stimulation of the proliferation, inhibition of the specific activity of the marker enzyme 2',3' cyclic nucleotide 3'-phosphodiesterase and decrease of the ratio of myelin basic protein positive cells. These results indicate that FGFs are very potent mitogens for oligodendrocytes, even in the absence of other cell types, but that they elicit a negative effect on the cell maturation, possibly related to their strong effect on proliferation. PMID- 2773671 TI - Development of the neuronal system containing neuropeptide Y in the rat hypothalamus. AB - In the rat hypothalamus, neuropeptide Y-containing neurons first appeared on day 14.5 of gestation in the arcuate nucleus and in the dorsolateral hypothalamic area. Until birth neuropeptide Y-containing cell bodies increased in number in the arcuate, dorsomedial-lateral and paraventricular nuclei, but disappeared thereafter, but some cells remaining in the arcuate nucleus. In animals treated neonatally with monosodium L-glutamate to destroy the arcuate nucleus, neuropeptide Y-immunoreactivity became evident in many cells scattered in the magnocellular paraventricular and dorsomedial-lateral hypothalamic nuclei on day 16 but not on days 60 and 12. These neuropeptide Y-immunoreactive neurons which appeared in the paraventricular nucleus were also vasopressin-positive. Neuropeptide Y fibers, on the contrary, remarkably diminished in number on day 16, particularly in the paraventricular and dorsomedial-lateral nuclei, and the medial preoptic area, but made a considerable recovery on days 60 and 120. Hence it is probable that, in normal ontogenetic progress, the development of the neuropeptide Y fibers in these areas is inhibitorily affected by that of arcuate neuropeptide Y neurons. PMID- 2773674 TI - [Phenylketonuria--physical and mental development of phenylketonuric children subjected to early treatment]. AB - The Authors present the first clinical and laboratory assessment of 6 children with PKU, diagnosed and treated early, as a result of the application of the Early Diagnosis Programme in the southern part of the country, from April 1984 to November 1986. The main protein source used in the feeding of these patients was a phenylalanine-free mixture of amino-acids, with an excellent tolerance. PMID- 2773675 TI - [Acute lithiasic pancreatitis. Usefulness of a multiple quantitative index]. AB - The authors present a prospective study of early diagnosis of biliary etiology in Acute Pancreatitis, using a Multiple Quantitative Index. A positive diagnosis was achieved in more than a 80% of cases if female, age over or equal 55 years, and serum alanine-aminotransferase over or equal twice normal. Some questions concerning usefulness and therapeutical implications of an early diagnosis of Biliary Pancreatitis is already present in discussion. PMID- 2773677 TI - [Surgical therapy of reflux esophagitis in patients with normal lower esophageal sphincter pressure]. AB - In a group of 12 patients with reflux esophagitis resistant to the medical treatment and normal LES pressure, gastric emptying and bile-gastric (B.G.) reflux (HIDA-CCK test) were determined. All of the patients had delayed gastric emptying associated in seven with high levels of B.G. reflux. Two of the patients had an unsuccessful fundoplication two years ago and five have been cured of duodenal 3 or gastric 2 ulcer with antacids. Although there was an evolution to an ulcer scar in all of these patients the abdominal post-prandial pain persisted and some of them maintained occasional bilious vomiting. Deep gastritis with dysplasia and metaplasia of the gastric mucosa was demonstrated in all of these five patients. The esophagitis was an isolated phenomenon in 3 patients, one had a peptic esophageal stricture above de cardia, and another one a Barrett esophagus. A proximal gastric vagotomy (PGV) and pyloroplasty was performed in patients with delayed gastric emptying without BG reflux. The other 7 patients with concomitant high BG reflux were treated by a duodenal diversion to a Roux-en Y loop and P.G.V. Esophageal and gastric symptoms disappeared soon after surgery. Esophageal biopsies were normal six months after surgery and the intense gastritis changed to a less serious form of superficial gastritis. It is concluded that delayed gastric emptying associated or not with high values of BG reflux can be the most important pathogenic factor that cause reflux esophagitis in this group of patients. The improvement of gastric emptying and elimination of BG reflux can be the proper method to treat these situations. PMID- 2773676 TI - [Value of ascitic lipids and sero-ascitic gradient of albumin in the differential diagnosis of ascites]. AB - In order to compare its diagnostic value in the differentiation between malignant and hepatic ascites, we analysed the ascitic fluid concentrations of cholesterol (Ct) and triglycerides (Tg) and the serum-ascites albumin gradient (S-A alb grad) in 58 patients--forty one with chronic liver disease (CLD) and 17 with malignancy. In CLD group the mean values +/- SD for Ct (27.1 +/- 20.1 mg/dl), Tg (34.2 +/- 33.8 mg/dl) and S-A alb grad (1.9 +/- 0.6 g/dl) were significantly different from those obtained in malignant ascites (Ct 103.1 +/- 45.1 mg/dl; Tg 62.1 +/- 43.0 mg/dl; S-A alb grad 0.5 +/- 0.4 g/dl) (p less than 0.001 for all parameters). Application of the cutoff concentrations given in the literature revealed the following results: Ct-Sensitivity (Se) 82.4%, Specificity (Sp) 85.4%, Efficiency (E) 84.5%; Tg-Se 29.4%, Sp 95.1%, E 75.9%; S-A alb grad- Se 88.2%, Sp 97.6%, E 94.8%. The exclusion of the 4 patients with massive hepatic metastasis from malignant group by ultrasound or computer tomography gave an efficiency of 87.0% for Ct, 88.9% for Tg and 98.1% for S-A alb grad. We conclude that: 1) S-A alb grad is the best analysed parameter in the discrimination between malignant and hepatic ascites, 2) the combination with non-invasive imaging methods increases its diagnostic value. PMID- 2773679 TI - [Depression and anxiety in general practice and family medicine consultation]. AB - The aim of this work was to study depression and anxiety in outpatients of Family Practice, namely: definition of cases, caseness, point-prevalence, clinical features, correlations with social demographic factors and identification of risk groups for those psychological disorders. Therapeutic attitudes displayed by family practitioners were also evaluated. The results of the study reveal a high prevalence of depression in family medicine settings and a relative tendency of family doctors to underdiagnose case of depression. Such an evidence allows the authors to conclude that steps should be taken in order to provide training programs for family practitioners and to plan appropriate treatment programmes at public Health Centres. PMID- 2773678 TI - [Renal insufficiency with primary hyperaldosteronism]. AB - We describe a case of advanced chronic renal failure with persisting hypokalemia. The clinical study revealed the simultaneous presence of a salt and potassium loosing nephropathy associated with aldosterone-producing adenoma. This late pathology was revealed as electrolytic changes characteristic of primary hyperaldosteronism became evident as the renal function progressively deteriorated. PMID- 2773680 TI - The incidence and management of the slit ventricle syndrome. AB - The incidence of slit ventricles of shunt treated hydrocephalic children was evaluated in a follow up study of 141 patients. Slit like ventricles on computer tomography was seen in 75 patients (53%). 52 patients (37%) suffered from clinical symptoms corresponding with overdrainage of cerebrospinal fluid. Those 52 patients with the "Slit Ventricle Syndrome" (SLVS) were treated by changing the valve to one with a higher opening pressure and/or adding an antisiphon device (ASD) to the shunt. 22 patients, initially treated by changing the opening pressure of the valve, needed the ASD later. Altogether 74 episodes of the SLVS were treated. The ASD proved reliable for the management of the SLVS. Normalization of ventricular size occurred in 54% of patients. whereas only in 15% treated without the ASD. Reduction of paroxysmal activity on EEG was seen in 70% of patients treated with the ASD, whereas only in 23% of patients treated without the ASD. Clinical relief of symptoms occurred in every patient, and ventricular catheter obstructions could be avoided, even if the ventricular size remained slit-like on CT. PMID- 2773681 TI - Preoperative angiographical prediction of the necessity to removal of the anterior clinoid process in internal carotid-posterior communicating artery aneurysm surgery. AB - During the last 10 years, we had to resect the anterior clinoid process (ACP) before applying the clip in three of the 70 patients with internal carotid posterior communicating artery (ICPCom) aneurysms. To reveal the angiographic characteristics in these three patients, we measured the following parameters on carotid angiograms in all 70 patients: 1) the angle between the midline of the skull and the axis of the C1 segment of the internal carotid artery (ICA) on A-P view (angle A). 2) the angle between the axes of the C1 and C2 segments of the ICA on A-P view (angle B). and 3) the distance between the posterior wall of the carotid "knee" and the proximal aneurysmal neck on lateral view (distance d). The common angiographic features of these three patients were as follows: 1) angle A was larger than 60 degrees. 2) angle B was less than 90 degrees. 3) distance d was less than 10 mm. and 4) the posterior communicating artery was of the foetal type. The present results suggest that preoperative angiogram can predict whether or not the ACP should be removed during ICPCom aneurysm surgery. PMID- 2773683 TI - Cerebral and carotid haemodynamic changes following cervical spinal cord stimulation. An experimental study. AB - Since it is accepted that spinal cord stimulation may produce segmentary vasodilation, it is presumable that when applied in the high cervical segments some carotid and cerebral blood flow changes can be expected. Following this assumption, 25 dogs and 25 goats were used. Under routine experimental conditions a C 7 laminectomy was performed in these animals and a bipolar lead introduced and manipulated in the epidural space till the right C 2 segment. Right common and internal carotid arteries of the dogs were isolated and electromagnetics probes placed for continuous monitoring of blood flow changes. Right internal maxillary artery was isolated and its branches ligated for flowmetry of hemispheric blood flow in the goat. 131I antipyrine also studied to control regional cerebral blood flow changes. Arterial pressure and blood gasometry were periodically determined to avoid masking results. Pulse width of 0.1 to 0.2 msec, 80 to 120 cps and amplitude to muscle contraction threshold at low rate were used as electrical parameters. After stimulation common and internal carotid blood flow increased with a mean of 60% and hemispheric blood flow with a mean of 55% according to flowmetry findings. Iodoantipyrine studies showed an average increase of 35%. These changes were not modified by atropine, morphine and naloxone and partially blocked by indomethacin, cimetidine and propanolol. PMID- 2773682 TI - Time course of CSF lactate level in subarachnoid haemorrhage. Correlation with clinical grading and prognosis. AB - Cisternal and/or ventricular cerebrospinal fluid (CSF) and arterial blood lactate and acid-base balance were measured serially in 38 patients with aneurysmal subarachnoid haemorrhage (SAH). Based on daily clinical assessment, the patients and accordingly the samples were divided into two groups according to the grading of the World Federation of Neurosurgical Societies (W.F.N.S.). In cisternal CSF, samples of Grade III-V showed significantly higher lactic acidosis than those of Grade I-II. The time course of lactate and pH in poor prognosis groups had a significant tendency of lactic acidosis, especially on the 5th, 6th, 7th day after SAH. Ventricular CSF lactate increased even without CSF acidosis in Groups III-V. Measurement of CSF lactate, especially from the cisterna magna is useful as an indicator of prognosis and changes of intracranial environment following SAH. PMID- 2773684 TI - Some basic features of the pathological and normal motor system studied by chronic deep electrodes. AB - Our stereotactic experiences in agreement with the literature showed, that different target points could influence the same motor disturbance. To choose the best target point or target point combinations we generally implant the electrodes into VL, Vim, CM, P, dentate nucleus and motor cortex. To ensure the correct sequence of therapeutic lesions we developed an investigation system, taking into consideration the resting and the working state of the motor system. We elicited events centrally (stimulation of the different target points) and peripherally (reflexes) and recorded the evoked potentials at the non-stimulated sites along with the motor and motor modulation effects in the appropriate muscles. The elicited events depend on the site of stimulation and registration and on the state of muscle activity. The centrally and peripherally elicited events influence each other. With our technique the elicited events and their functional dependency is most explicit within the motor system. The results help to explain some basic motor functions and help to answer some of our therapeutic questions. PMID- 2773685 TI - Behavioural responses to cerebellar stimulation in cerebral palsy. AB - Stereotactic placement of stimulating electrodes (TESLA) into deep regions of the cerebellum (Fischer instruments) was analyzed in respect to its organization into sagittaly oriented zones. This was done after imaging of the trajectory and target area and verification of the position of electrodes by CT (Siemens). A correlation was observed between the position of the stimulating electrode from the midline laterally and localization of induced responses on the body--from bilateral to ipsilateral. The combination of deep cerebellar stimulation and destructive method in the supratentorial region could be the optimal approach to relieve spasticity and to improve motor function in some cases of cerebral palsy. PMID- 2773686 TI - Use of intrathecal baclofen administered by programmable infusion pumps in resistent spasticity. AB - On the basis of previous experimental and clinical studies patients with severe spasticity due to spinal cord damage from multiple sclerosis in 8 cases and postraumatic paraplegia in 6 and resistent to all conservative treatments were selected for a trial with morphine and baclofen administered intrathecally through a catheter placed in the spinal subarachnoid space rostral to the affected segments and attached to a subcutaneous reservoir. Whereas morphine single injection did not show any benefit, baclofen bolus injection 30 to 60 micrograms, revealed a marked decrease of spasticity and associated symptoms in 8 cases. After checking the clinical effect during 3 weeks and changes in electroneurophysiological studies and bladder manometry the catheter was attached to a subcutaneous programmable pump able to be refilled percutaneously and administered baclofen continuously or more often following a multistep complex programme in total doses of 90 to 150 micrograms per day. After a mean follow-up of 5 months all cases showed an absence of spasms and pain, a notable improvement for bettering of sphincter functions and a marked muscle relaxation that improves motor capacity, leading to increased ambulation or mobility. Neither complications nor side-effects were observed. PMID- 2773687 TI - Intra-operative spinal cord evoked potentials during cervical and lumbo-sacral microsurgical DREZ-tomy (MDT) for chronic pain and spasticity (preliminary data). AB - We have undertaken the intra-operative study of spinal cord surface evoked potentials in patients operated upon for pain and/or spasticity using the microsurgical DREZ-tomy (MDT) procedure. The goals of this work were 1) to collect data on spinal cord evoked potential components and 2) to analyze the effects of MDT on spinal cord physiology. The MDT consists of a therapeutic lesion in the ventro-lateral aspect of the dorsal root entry zone, directed to the activatory circuitry, and aiming at returning the dorsal horn physiology towards inhibition. Averaged evoked potentials to peripheral nerve electrical stimulations were obtained from various loci on the surface of the dorsal columns of the cervical and lumbo-sacral spinal cord in 19 patients, using a small uninsulated silver ball electrode. An initial far-field positivity was found, corresponding to a compound action potential in the proximal part of the brachial (or lumbo-sacral) plexus. Pre-synaptic compound action potentials were identified, most often composed of multiple successive sharp peaks. A post synaptic field potential generated in the dorsal horn was recognized. The MDT caused an immediate and irreversible decrease of amplitude down to a disappearance of the dorsal horn potential. This decrement was proportional to the amount of operated cord segments. In contrast, there has been a relative post MDT sparing of the pre-synaptic action potentials originating from the operated cord segments, and the scalp contralateral parietal N 20 has been only reversibly affected by the therapeutic lesion. We thus argue for a specific involvement of dorsal horn physiology by the MDT, with a relative sparing of the dorsal column system. PMID- 2773688 TI - Is vasodilatation following dorsal column stimulation mediated by antidromic activation of small diameter afferents? AB - It is well-known that high intensity electrical stimulation of peripheral nerves and dorsal root fibres causes vasodilatation. However, the mechanisms underlying the vasodilatory effect of stimulation applied to the dorsal columns (DCS), with an intensity insufficient to recruit small diameter, high threshold fibres are virtually unknown. The present project was planned to elucidate underlying neural mechanisms. Albino rats, anaesthetized, paralyzed and artificially ventilated were used. Electrical stimulation with different parameters was applied to various sites of the exposed spinal cord, root fibres and peripheral nerves. In some experiments the spinal cord, root fibres or peripheral nerves were transected. Peripheral blood flow was recorded using laser Doppler technique. With stimulation of the lower thoracic region at low intensity substantially increased blood flow in the ipsilateral hind paw. The compound action potentials from the gural nerve displayed only components from low threshold, rapidly conducting fibres without detectable late components. Transection of the spinal cord above the stimulation site did not affect the blood flow changes. Also low intensity stimulation of the proximal part of a sectioned dorsal root resulted in a substantial rise in peripheral blood flow, whereas the same intensity proved ineffective when applied to the distal stump. High intensity stimulation of the distal stump not unexpectedly, caused a major increase in blood flow. The findings in the present study implicate the importance of a central circuit for the effect, whereas antidromic activation of primary afferents seems to be a less likely explanation. Possibly, stimulation induces a transitory inhibition of sympathetic vasoconstrictor tone, though activation of sympathetic vasodilatory efferents cannot be excluded. PMID- 2773689 TI - [Aggressiveness and the teaching function]. AB - The authors study aggression with the "Instrument I to measure aggression of Ledesma Jimeno, Rodrigues Isidoro and Izquierdo de la Torre" in a sample of teachers (N = 48) made up of 15 university professors and 33 non-university professors (primary school, secondary school and professional training). The teacher sample is compared with a control sample of 479 men. The group of non university professors showed more self-aggression and less aggression toward others than the control sample and university sample did. Both groups of teachers showed high levels of "technical intelligence". The aggression of the university professors was very similar to the control group and showed special peculiarities giving high values of intrapsychic incoherence that made their conduct more unforeseeable, with higher creative dispositions and a higher risk to their mental health than the other two groups studied. PMID- 2773691 TI - [Psychosomatics and cancer]. AB - The cancerous patient who suffers a coinciding psychiatric illness shows, according to the M.M.P.I., signs of a depressive personality with marked introversion and dependence. The aggressivity test shows that self-aggressiveness coincides with inhibition and lethargy tone. An accumulation of stress factors and events stand out in patients with depression (72%), which do not appear in those patients diagnosed as having neuroses and schizophrenia. There is a need for psychiatric attention which contributes to treating the patient interdepartmentally; thus relieving both the moral and physical pain which these patients suffer. PMID- 2773690 TI - [Psychopathologic traits of patients addicted to heroin]. AB - The aim of our work is the search for some differential psychopathologic features in the heroin addict personality, through the 16 PF of Cattell (A form), which we try to contrast with other contributions from studies carried out up to the present. Moreover, other parameters of demographic and socioeconomic interest have been evaluated. Through the results we have gotten, it seems that there is a larger number of psychopathologic elements in the personality of the heroin addict, such as greater introversion, frustration, culpability, radicalism, self sufficiency, anxiety, over-excitement, actions influenced by their feelings, and a minor acceptance of the rules of the group, though these features do not constitute a standard structure of personality. PMID- 2773693 TI - [Psychiatry and psychoanalysis. Ethical considerations. A propos of a case]. AB - The ethical propositions underlying the psychoanalytic and medical models are analyzed, emphasizing their practical implications. It is concluded that both models are two sides of the same coin. PMID- 2773692 TI - [Emotional disorders in the mothers of children treated at a mental health center]. AB - The aim of this research has been the detection of possible psychiatric disorders in the mothers of referred children. Also, we investigated the family history and its dynamic aspects. It was carried out from February to June of 1988. The sample is made up of 43 children (3-16 years old). Each of the mothers filled out the GHQ-28. Other variables studied were the epidemiologic ones, parental age, the DSM-III diagnostics and the severity of the pathology found in the children through the CGAS. We found that the mothers tended to be pathologic in the GHQ values; 17 children (40%) had familial antecedents and abnormal family dynamics; 11 children (26%) had a mother with a pathologic GHQ and abnormal family dynamics and psychiatric antecedents. It was suggested that these 3 factors may have a predictive value for the DSM-III-specific diagnosis different from the Code V diagnosis, that is, predictive of more severe psychopathology. PMID- 2773694 TI - [Epidemiologic study of alcoholism by a university section and a department of psychiatry from 1969 to 1985]. AB - The author reviews the census of outpatients in a Psychiatric Department of a General Hospital between 1969 and 1985, finding 12,241 cases. Following the first selection, 644 patients were found to be diagnosed with alcoholic disorder, at least, typified in the ICD-8 or ICD-9 of the O.M.S. Later, 31 cases were rejected due to insufficient information. A protocol of investigation was elaborated to apply retrospectively and establish a descriptive study. The epidemiological and clinical profile of the patients showed a 5% frequency of alcoholic disorder, a male patient (93.96%), an average age of 40, primary studies (65.74%), unskilled laborer (69.65%), starting to drink between the age of 15-19 (41.59%), wine drinker (65.74%), with an average intake of 244 g, without a diagnosis related to alcoholic psychoses (83%), discontinues the consultation after the first interview (38%), and continues drinking in the last consultation carried out, in 57.91% of the cases. PMID- 2773695 TI - [Expectations of the patient and attitudes toward treatment as predictive factors in the clinical course of affective disorders]. AB - The effect of antidepressant treatment was evaluated in a group of outpatients with symptoms of depressive illness ("dysthymic disorder" and "major depression", according to DSM-III criteria) with regard to the expectations they had for the results of the therapy. Therefore, patient ideas about the efficacy of the treatment, psychiatrist capability, duration of illness and other factors were analyzed. The clinical status of the patients was studied at the 1st visit, 2nd visit (a week later), and 3rd visit (3 weeks later). The patients were included in one of the followings three groups: "good responders", "moderate responders", and "bad responders". Data were analyzed statistically to show the correlation between patients expectations and attitudes toward the treatment, and clinical outcome. PMID- 2773696 TI - [Variation of intraocular pressure by non-contact tonometry and cardiac pulse wave]. AB - We performed successive IOP measurements with a noncontact tonometer (NCT) in twelve eyes of six normal volunteers to analyze the relationship between the variation of IOP and the cardiac cycle. For this study, we devised a special apparatus composed of an photoelectric plethysmograph, an electric cardiograph and a NCT. With this apparatus, non-contact tonometry was permitted only at the peak or trough of the cardiac pulse wave. At the peak or trough of the cardiac pulse wave, IOP showed a variation of 0.8 +/- 0.4 mmHg (mean +/- s.d.) which was thought to be caused mainly by respiration. Between the peak and trough of the cardiac pulse wave, we found a maximum difference in IOP of 3.8 +/- 1.0 mmHg and a mean difference of 1.9 +/- 0.8 mmHg, which seemed to be attributable to the cardiac cycle. PMID- 2773697 TI - [Evaluation of diabetic retinopathy by automated static perimetry]. AB - Decibel values of threshold sensitivity depression of the retina were evaluated in 69 eyes with NIDDM using the Humphrey automated static perimeter. The eyes were classified into three groups: group I (GI) consisting of 32 eyes with no retinopathy or with stages 1 and 2 of simple diabetic retinopathy, group II (GII) consisting of 21 eyes with stage 3 of simple retinopathy or pre-proliferative retinopathy and group III (GIII) consisting of 16 eyes treated by panretinal photocoagulation using an argon laser. The average age in each group was 60 years and all eyes had a visual acuity of over 0.6. As controls, 16 normal eyes were examined. In comparison with the values of the control, the mean of the sum of decibel threshold sensitivity in the macular retina significantly decreased by 5% in GI, 7.8% in GII, and 24.3% in GIII. It was found that the mean of the sum of decibels in the central retina decreased by 8.2% in GI and 15.5% in GII. The sum of decibels in the mid-peripheral retina showed a decrease of 11.4% in GI and 27.5% in GII. In addition, the decibel values of threshold sensitivity of the lower half of the retina tended to decrease more easily than those of the upper half of the retina in the parafoveal and the macular areas. It was also suggested that decibel values of threshold sensitivity of the retina may decrease shortly after PRP in the paramacular area (located about 10 degrees from the fovea) but not in the foveal area. PMID- 2773698 TI - [Inhibition of acetylcholinesterase at pupil-related central nuclei by organophosphorus pesticide (fenthion)--an experimental study]. AB - An organophosphorus pesticide (OP) inhibits acetylcholinesterase (AChE) of various organs, especially in cholinergically innervated organs. Pupil constriction is a major sign of an ocular symptom in the patient with acute OP intoxication, but the etiology is unknown. The present experiments were intended to elucidate a central mechanism of pupil size in which AChE and OP are involved. Fenthion (dimethyl 4-methylthion-m-tolyl phosphorothionate) of 5mg/day body weight) was subcutaneously administered dorsally in Wistar rats for 14 days consecutively in the longest group. Histochemical staining and microspectrophotometry were used to analyze the intensity of the AChE activity in the iris, the pretectal nucleus and Edinger-Westphal (EW) nucleus on the 2nd, 4th, 6th, 10th and 14th day of administration. The pupil was measured after 20 minutes of dark adaptation. The pupil constricted on the 6th day and most remarkably on the 10th day. The AChE activity in the iris decreased remarkably on the 4th day. Miosis was not seen on the 4th day. The AChE activity in the pretectal nucleus decreased remarkably on the 6th day. The AChE activity in the EW nucleus reduced gradually from the 6th day and 62% reduction of initial value was seen on the 14th day. Intense miosis was seen on the 10th day. In conclusion inhibition of AChE activity was detected first in the iris, thereafter in the pretectal nucleus and the EW nucleus in close correlation with the miotic pupil. Therefore, miosis associated with OP intoxicated patients may parallel the central inhibition of AChE in pupil-related centers. PMID- 2773699 TI - [Contributory factors for glaucomatous disc cupping. 4. Generalized expansion type and localized type]. AB - It is widely recognized that there are two types progressive disc cupping in glaucoma. One of them is the localized type (L type) in which the cupping extends to a certain direction and the other is the generalized expansion type (G type) in which the cupping expands generally. We evaluated the optic disc in 86 eyes with primary open angle glaucoma (G type 44 eyes L type 42 eyes) to evaluate correlations of age and visual field defects between the 2 groups. Our study revealed that G type patients were significantly younger than those with L type when matched according to visual field defects. We also found that G type was revealed as the nasal step alone but not in L type. These results suggest that in G type, the optic nerve head is diffusely damaged by elevated intraocular pressure and the total nerve fibers are destroyed uniformly. On the other hand, in L type, the vulnerable portion of the optic nerve head is selectively damaged and nerve fibers constituting the optic rim area are destroyed. As a result, L type is likely to form cupping notch and reveal Bjerrum scotoma. These facts correspond to the anatomical structures of nerve fiber layers. PMID- 2773700 TI - [The threshold of pupil-blocking force]. AB - The purpose of this study was to quantitate the dynamic changes which take place in the anterior eye segment during the prone position test. The pupil-blocking force was measured before and after the prone position test (PTT) by a method of image analysis using a computer. The changes in the magnitude of pupillary block were evaluated. The mechanics of this provocation seems to be both pupillary block and direct lens block angle-closure. Pupil-blocking force standardizes the assessment of the eyes with relative pupil-block. The present results provide valuable information in the analysis of the mechanism of primary angle-closure glaucoma and also contribute to the determination of a real value for the threshold of the pupil-blocking force (approximately 0.1 or greater), followed by a clinically significant elevation of intraocular pressure. PMID- 2773701 TI - [Distribution of cone pedicle and superficial capillary. A morphological study on the macular region of normal human retina]. AB - The distribution and arrangement of cone pedicle (CP) and peri-foveolar superficial capillary net works (SC) in the macular region was studied in two eyes obtained from a 24-year-old male and a 34-year-old female, light and electron microscopically. CP and SC were not seen in the central area of the macular region. Both the CP-free zone and SC-free area were ellipsoid in form and the horizontal dimensions were larger than 140 microns and 425 microns in one case and 360 microns and 630 microns in the other. The dimensions of the SC-free area measured 200 microns and 500 microns in the first case and 520 microns and 650 microns in the second. The para-foveolar circle formed by CP- and SC-free zones were concentric and the SC circle was about 50 microns larger in radius than that of CP. PMID- 2773702 TI - [The blood flow in post-laminar optic nerve in monkeys was dependent on intraocular pressure level]. AB - The effects of artificial elevation of intraocular pressure on the blood flow in the 1mm post-laminar portion of the optic nerve was evaluated in 9 monkeys (Macaca fuscata). The intraocular pressure of one eye was elevated while the fellow eye served as control. The intraocular pressure of the control was maintained at 15 mmHg. We used the hydrogen clearance method in quantitating the blood flow. Anesthesia was maintained with injection of pentobarbital sodium into the femoral vein. In each experiment, the intraocular pressure was raised from 15 mmHg to 30, 50 or 70 mmHg in a stepwise fashion. At the intraocular pressure level of 15 mmHg, the blood flow measured 120.0 +/- 19.4 ml/min/100g (mean +/- standard deviation). The blood flow decreased linearly along with the rise of intraocular pressure up to 70 mmHg. The blood flow at 70 mmHg was 37% of the initial value. At each level of raised intraocular pressure, the blood flow remained constant for at least 60 minutes. The decreased blood flow promptly returned to the initial level when the raised intraocular pressure was restored to the initial value of 15 mmHg. We concluded from the above findings that the blood flow in the immediate post-laminar portion of the optic nerve is dependent on the level of intraocular pressure up to 70 mmHg. PMID- 2773703 TI - [Studies on HLA system of family members with Behcet's disease]. AB - In order to investigate the immunogenetic mechanism of Behcet's disease, frequencies of HLA antigens were studied in family members of patients with this disease. The subjects consisted of 37 patients, 74 family members and 49 normal controls. It was shown that the frequencies of HLA-B51 were equally higher in the patients, fathers, mothers and siblings of the patients than in the normal controls. On the other contrary, the frequency of HLA-DQw1 was significantly decreased only in the patients with this disease. These results may suggest that family members of the patients have resistant genetic factors, unlike the patients. PMID- 2773704 TI - [Analysis of motor response with respect to the time course in cyclofusion]. AB - Torsional eye movements during cyclofusional responses are recorded objectively and analyzed with respect to the time course of the eye movement until the subject perceives a fused image. Eight subjects whose age ranged from 24 to 35 years old were studied. Torsional disparity was presented stepwise by a synoptiscope. The Number of subjects whose motor response was stepped was less than that of the subjects whose motor response was not stepped. The time course of responses varied in individual. Moreover, the number of the subjects whose motor response showed cyclovergence was less than that of subjects whose motor response showed cycloversion. Fusional cyclovergence is reasonable to bring the disparate images within Panum's area efficiently. However our analysis shows that stepped response and cyclovergence is less in number and the motor response is variable in each individual. Therefore, we do not accept the explanation that the cyclofusional motor response simply brings the disparate images within Panum's area. We speculate that cyclofusional motor response is carried out by a feed back loop through the cyclofusional sensory input to fuse the disparate images. PMID- 2773705 TI - [Heterogeneity of human cataractous lens low molecular weight crystallins--study of concanavalin A binding proteins by two-dimensional electrophoresis]. AB - Low molecular weight proteins (beta s, gamma H and gamma L crystallins) were fractionated from human cataractous lens using gel filtration of Sephadex G-75 column chromatography. Each crystallin was separated by two-dimensional electrophoresis and identified by Coommassie blue staining and Concanavalin A binding. Several components of beta s, gamma H and gamma L-crystallins stained with Coomassie blue did not bind with Concanavalin A. Two-dimensional electrophoresis revealed heterogeneities of all three low molecular weight crystallins. This phenomenon may be due to differences in the amount of bound glucose and mannose. PMID- 2773707 TI - [Studies on the mechanism of closure of the embryonic fissure (II). A morphological study of a transmission electron microscope]. AB - The object of this study was to elucidate the mechanism of closure of the embryonic fissure with a transmission electron microscope in mouse embryos. Every specimen was cut at right angle to the embryonic fissure. Desmosome-like junctions and gap junctions were found between the cells of the inner wall and those of the outer wall of the optic cup. The lip facing the embryonic fissure of the optic cup was covered with the basal lamina. In the section immediately before closure, the cells composing the lip were flattened and had processes on their margins. In addition, collagen fibrils appeared in some portions on the basal lamina. The more posterior section of the same specimen showed immature cell junctions and fusing parts between the cells of both sides. It was deduced that the cells which composed the lip produced the collagen fibrils on the basal lamina when both lips drew closer together. After the adhesion of both basal laminae, immature cell junctions appeared transiently between the cells on either side. The fusion of these cells resulted from disappearance of the cell junctions. PMID- 2773706 TI - [Magnetic field on the deranged accommodation of visual detector terminal operators]. AB - The effects of magnetic fields on the accommodation of operators engaged in visual display terminals (VDT) who complained of asthenopia and proved to have some abnormalities in the semistastic properties of accommodation were examined. Before and after loading a magnetic field of 400 Gauss or 2,000 Gauss on the eye, the quasistatic properties of accommodation were measured and compared. The quasistastic properties analyzed in this experiment were the maximum amplitude of accommodation and the gradient of accommodation that means a ratio of accommodative response to accommodative stimulus. Both factors were statistically improved in a dose dependent manner after loading the magnetic field, i.e. 2,000 Gauss was more effective than 400 Gauss concerning the improvement of accommodation. To exclude a psychogenic effects, simulated loading by a placebo which was an imitation magnet which did not produce a magnetic field was also applied to the patients, but no improvement was detected. Normal persons who were examined as controls showed no statistical change in the semistastic properties of accommodation after loading of the magnetic field. After examination of the semistatic properties of accommodation, refraction was also estimated by an autorefractometer, but no change was detected in either patients or controls. The magnetic field seemed definitely to have effects on the functionally involved accommodative system. PMID- 2773708 TI - [Effect of short-time exposure of 5-fluorouracil on cultured conjunctival cells]. AB - 5-fluorouracil (5-FU) has recently been injected subconjunctivally after glaucoma filtering surgery to prevent scar formation at filtration sites. We studied the effect of short time exposure to 5-FU on cultured human conjunctival cells. Thirty-second exposure to more than 100 microns/ml 5-FU caused significant inhibition of cell growth and morphological changes such as decrease of mitotic cells, and scanning electron microscopy showed reduction of filopodia and microvilli. Although cell growth 24 hr after the cell passage exposed to 100 microns/ml 5-FU was restored, morphological changes remained. PMID- 2773709 TI - [Human flash visually evoked cortical potentials under different levels of halothane anesthesia]. AB - Flash visually evoked cortical potentials (FVECPs) were recorded in 13 surgical patients under different levels of halothane anesthesia, altering the rate of stimulus frequency from 0.5 Hz to 10 Hz. VECPs were obtained in the awake state under premedication with atropine sulphate, and at end-tidal halothane concentrations of 0.38%, 0.75%, 1.13% and 1.5%. The peak latency of P1 (the major positive component with a latency of about 100 msec) progressively increased from 116.7 +/- 3.3 msec (mean +/- SE) in the awake state to 124.3 +/- 6.3 msec, 136.5 +/- 5.2 msec, 151.5 +/- 5.2 msec and 166.3 +/- 8.7 msec with increasing halothane concentration. Significant reductions in P1 amplitude were observed to 2 Hz, 5 Hz and 10 Hz stimuli, whereas there were no significant changes in amplitude to 0.5 Hz and 1 Hz stimuli. P1 amplitude plotted against stimulus frequency had a maximum at 10 Hz in the awake state. This curve gradually and preferentially attenuated at higher frequencies as halothane concentration increased. PMID- 2773711 TI - [Vitreous fluorophotometry after vortex vein occlusion in rabbit eyes]. AB - Vitreous fluorophotometry (VFP) was performed to study the disappearance of fluorescein injected into the vitreous cavity in rabbit eyes after experimental occlusion of the vortex vein. Two vortex veins of the left eye in each rabbit were ligated with 6-0 silk suture and the right eye was saved as control. The rate of disappearance of fluorescein was measured with VFP at 24 hours, 1,2 and 4 weeks after vortex vein occlusion. The rate of fluorescein disappearance at the posterior vitreous was significantly lower in the eyes at 24 hours and 1 week after the ligature than that in the control eyes (p less than 0.01). This result suggests that the active transport systems of the retinal pigment epithelium were disturbed for 1 week after vortex vein occlusion. PMID- 2773710 TI - [Results of vitrectomy for diabetic traction retinal detachment involving the macula; a comparison of six-month and three-year postoperative findings]. AB - Three-year follow-up examinations were performed on 45 cases that underwent pars plana vitrectomies for diabetic retinopathy complications from 1982 to 1983. All of these cases had traction retinal detachment involving the macula. Visual improvement was noted in 27 eyes (60%) and 11 eyes (24%) had worse visual acuity at 6 months after surgery. Final visual improvement was noted in 21 eyes (47%) at the there-year follow-up examinations. Five (11%) of the 45 cases had better visual acuity at the three-year examination than at six months, 18 (40%) had the same visual acuity, but 22 (49%) had poorer vision at the three-year examination. Out of those cases, 28 eyes (62%) had totally attached retina 6 months after operation and the results in those eyes were quite stable at three years. Of these, 19 (68%) had the same or better visual acuity at three years compared with six months. But if retinal detachment was present at 6 months, the prognosis was very poor at the three-year examination with a visual acuity of less than hand motions. Reattachment of the retina is most important to maintain good prognosis for surgical treatment for diabetic retinopathy with traction retinal detachment. PMID- 2773712 TI - [Magnetic resonance imaging (MRI) in the diagnosis of optic neuritis and neuropathy]. AB - Magnetic resonance imaging (MRI) was performed in thirty patients who had been suffering from optic neuritis (ON). Twenty-one cases were caused by multiple sclerosis (MS) and in 9 cases the causes been defined. In MRI, abnormalities were found in 17 out of 21 MS cases in several places such as near the ventricles, mid brain, spinal cord etc. Increased signals from the optic chiasm to optic radiation were found in 5 cases. However, abnormal MRI findings did not always correspond to Goldmann visual field defects. In 3 out of 9 cases of ON with unknown causes, high signals in the white matter of the brain were found, and it was suggested that those may develop to MS. MRI was, thus, proved to be very useful for the diagnosis of MS. PMID- 2773714 TI - [Experimental study on the effects of a replacement of the vitreous body with perfluorotributylamine on the rabbit eye]. AB - The effects of replacement of the vitreous body with perfluorotributylamine on albino rabbit eyes were studied. Twenty eight eyes were divided into three groups. In the first group (n = 14), which was used as a control, only vitrectomy was performed. In the second group (n = 6), the vitreous was temporarily substituted with perfluorotributylamine after the vitrectomy. One hour after the operation, the injected perfluorotributylamine was again replaced with a balanced salt solution (SM-A2). In the third group (n = 8), the injected perfluorotributylamine was left in the eye until the time of enucleation. The eyes were evaluated both electrophysiologically and histopathologically, at predetermined time intervals ranging from one to form one to four weeks after operation. All the eyes in the second group did not show any histopathological changes until four weeks after the operation. The ERGs obtained from these eyes exhibited dominant a- and b-waves similar to those of the control group at all intervals after operation. However, the eyes in the third group showed progressive deterioration with elapsed of time. At the two weeks after operation, b-wave amplitudes moderately decreased in two eyes. These eyes showed an initial slight degeneration in the outer segment layer. At four weeks after the operation, the a- and b-waves further decreased in amplitude with a significantly prolonged peak latency. The outer segments were severely damaged, and the histopathological changes extended to the inner segment layer as well as the RPE layer.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2773713 TI - [Kinetic study of cell proliferation in a new wound healing model using tissue cultured corneal endothelial cells]. AB - We studied cell kinetics in the wound healing process using cultured bovine corneal endothelium. We cultured bovine endothelial cells on coverslips coated by hydroxyethyl methacrylate (HEMA) which had on 8 mm HEMA-free zone in diameter, and produced wounds at the center of the monolayer cell sheets using a rotating silicone tip. At various time periods after injury, we added bromodeoxyuridine (BrdU) to the medium and incubated for 12 hours. Then, the specimens with fixed 10% phosphate-buffered formalin and were incubated with a monoclonal antibody against BrdU. The cells incorporating BrdU into DNA were stained by the Avidin Biotin Peroxidase Complex (ABC) method. At 12 hours, no labeled cells were observed. At 24 hours, 14.6 +/- 4.0 cells were stained. The maximum labeling occurred during 48-60 hours after the wound. Seventy two hours after the wound, labeled cells decreased rapidly. Labeled cells were localized within 0.6mm from the wound edge throughout the wound healing process. It can be thought that the wound healing process comprised four phases, i.e., latent, migration, migration plus mitosis, and contact inhibition phases. The first is the latent phase observed during the first six hours after wound infliction. The cells respond to external expansion. The second phase in the migration phase which is last until 24 hours after wound infliction, and occurs mainly through cellular migration, while proliferation has only a minor contribution in this phase. The third is the migration plus mitosis phase. The cell proliferation shows a rapid increase after 72 hours after wound infliction.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2773715 TI - [Effect of acetazolamide on aqueous flare in normal human eyes]. AB - A newly developed instrument for the quantitative measurement of aqueous flare, the laser flare-cell meter, is now being introduced clinically. The present experiment was designed to assess the effect of a commonly administered drug, acetazolamide, on measurements obtained in normal, healthy subjects. Control measurements were taken over a 24 hr period, from 0900 hrs to 0900 hrs of the next day in 12 drug-free, normal, healthy subjects. A second, similar time-course measurement was conducted in the same subjects on another day after oral administration of 500 mg acetazolamide. Results revealed that acetazolamide increased aqueous flare from 2 hrs to 10 hrs post-administration. The peak effect was observed approximately 6 hrs after acetazolamide administration, reaching a level 41% greater than that on the control day. Anterior chamber volume and serum protein concentration were not affected by the drug treatment. The use of the laser flare-cell meter in the clinic and possible mechanisms contributing to the effect of the drug are discussed. PMID- 2773716 TI - [Lectin binding pattern of the normal rat lens]. AB - Paraffin sections of normal rat lenses were stained with seven lectins, using an avidin-biotin-complex (ABC) procedure to study the presence and distribution of specific glycoconjugate in the lens. Epithelial cells were stained with concanavalin A (Con A) and wheat germ agglutinin (WGA). Lens fibers with nuclei were stained with six lectins: peanut agglutinin (PNA), ricinus communis agglutinin (RCA), soybean agglutinin (SBA), dolichos biflorus agglutinin (DBA), ConA and WGA. The equatorial cortex stained heavily, while lens fibers without nuclei stained only slightly. Ulex europeus agglutinin (UEA-I) caused no staining at all. Con A stained the nuclear membrane of lens fibers. These results suggest that glycoconjugate changes during lens cell differentiation, and that high levels of N-acetyl-glucosamine and mannose are distributed in both lens epithelium and lens fibers, but that N-acetyl-galactosamine distribution level is low in the lens epithelium. PMID- 2773717 TI - [Effects of vancomycin and ofloxacin on rabbit ERG in vivo]. AB - The retinal toxicity of vancomycin and ofloxacin was studied by electroretinogram (ERG) before and after intravitreal injection in rabbits. Vancomycin is known to be effective on methicillin-resistant Staphylococcus aureus. A dose of 1mg vancomycin caused no ERG change for at least eight weeks after injection. The feature that ERG became non-recordable during one to four weeks after an intravitreal injection of 10mg vancomycin, with recovery of only the c-wave was conspicuous. A dose of 200 micrograms ofloxacin did not cause deterioration of the b-wave, the c-wave or the oscillatory potentials throughout the follow-up period up to eight weeks. Judging from the susceptibility of each ERG component to antimicrobials and taking into account the difference of vitreous volume between rabbits and humans, clinical doses of intravitreal single-shot injection should be less than 1mg for vancomycin and 200 micrograms for ofloxacin. PMID- 2773718 TI - [Studies of ocular fundus and visual functions in Kearns-Sayre syndrome--with special reference to the new stage classification]. AB - This paper describes the fundus appearance, visual function and electrophysiological findings in five cases of Kearns-Sayre syndrome. In three of them, retinopathy was not seen before the onset of this syndrome. The characteristic "salt and pepper retinopathy" progressed to peripapillary loss of the RPE and choriocapillaris over a period of some years. The ERG, normal in the beginning, became extinct in these cases. They were also at first subnormal for the scotopic as well as for the photopic activity. We distinguished five stages of ocular manifestations in Kearns-Sayre syndrome. Stage 0: The fundus appearance and the visual function are normal. Stage I: "Salt and pepper retinopathy" occurs in the entire retina but the visual function and the ERG are still normal. Stage II: Abnormal visual function and ERG occur with retinopathy. Stage III: A chorioretinal atrophy progresses around the disc and nasal retina and the ERG becomes extinct. Stage IV: The retinopathy demonstrates the appearance of choroidal sclerosis. PMID- 2773719 TI - [New quantitative parameters for CT evaluation of orbitopathy in dysthyroid ophthalmopathy]. AB - The new index (c/o ratio) is defined as the content of the orbit divided by the capacity of the bony orbit on the mid-orbital axial CT slice showing the medial and the lateral rectus muscles and optic nerve. Other quantitative parameters such as for exophthalmos and the capacity of bony orbit were also obtained on CT films. These parameters were measured in 474 eyes of patients with dysthyroid ophthalmopathy. The capacity of bony orbit showed large variations among all patients. The average for males was 17.8cm3 and that for females was 16.1cm3. Exophthalmos measurement on CT is more reliable than that by the Hertel exophthalmometer. The new index (c/o ratio) is a very reliable parameter for evaluating orbitopathy in dysthyroid ophthalmopathy. A large c/o ratio (greater than 1.6) was of clinical significance, because approximately 70% of the enlargement of the extraocular muscle observed in older patients (greater than 40 yrs old) was associated with a large c/o ratio (greater than 1.6). PMID- 2773720 TI - [Increasing of aqueous flare intensity with aging in normal human eyes]. AB - An attempt was made to evaluate the influence of aging on aqueous flare intensity by measuring 203 normal human eyes. Subjects were divided into six age groups from twenty years to seventy nine years old, and the values for aqueous flare intensity were then determined by a flare-cell meter. Flare values were higher in the older age groups and correlated well with age (linear correlation coefficient r = 0.506, Spearman r = 0.510, p = 0.000). Subjects in their fifties, sixties and seventies showed statistically significant differences to those in their twenties (p less than 0.01). A preliminary in vitro experiment was performed to convert the flare-cell meter reading (photon count/msec) into bovine albumin concentration (mg/dl), which is necessary to compare measurements of different flare-cell meters. The three flare-cell meters employed in this study all showed good linear relationships between photon count and albumin concentration (r = 0.99-1.00), giving converting equations of Y = -0.72 + 0.969 X, Y = -0.68 + 0.958 X, Y = -0.84 + 1.017 X less than Y = log (photon count), X = log (albumin concentration) greater than, respectively. In this report, flare values are expressed in albumin concentrations for each age group, which will then serve as control values in future studies. PMID- 2773721 TI - [Subjective measurement of apparent accommodation in pseudophakic eyes with pattern VECPs]. AB - Apparent accommodation was measured subjectively with pattern reversal visually evoked cortical potentials (PVECPs) in 22 pseudophakic eyes (20 patients, 47-83 years of age) after implantation of posterior chamber intraocular lenses. No significant difference was found in the obtained amplitude of accommodation measured with PVECPs between pseudophakic eyes and normal phakic eyes. Moreover this amplitude was independent from the age of patients, corrected visual acuity, or refractive errors. In one case, however, the amplitude of apparent accommodation was reduced with artificial dilating of the pupil diameter and contribution of the depth of focus to the apparent accommodation was indicated. PMID- 2773722 TI - [The local cooling effect of anterior chamber irrigation on the blood-aqueous barrier]. AB - Local cooling effect on the breakdown of the blood-aqueous barrier (BAB) following anterior chamber irrigation, including additional direct irritation of the iris, was evaluated fluorophotometrically. The rabbit anterior chamber was irrigated with simulated aqueous humor (S-MA 2) the temperature of which was maintained at 35 degrees C or 10 degrees C. The fluorophotometry was performed before and 4, 24, 48 hours and 7 days after irrigation for 30 or 60 minutes. The temperature changes in the anterior chamber, retrolental vitreous body and posterior retina were also measured with a thermocouple during irrigation at 10 degrees C. The temperature of the anterior chamber and the retrolental vitreous fell to 15.0 degrees C and 28.2 degrees C, respectively, within 30 minutes after starting irrigation, whereas the temperature drop in the posterior retina was only 2.0 degrees C after 60 min. At 4 hours after 60-minute irrigation, the breakdown of the BAB was greater than following 30-minute irrigation. There was no significant difference in the BAB breakdown between eyes irrigated at 10 degrees C and 35 degrees C. PMID- 2773723 TI - [Cytochemical localization of actin filaments in endothelial cells of rabbit trabecular meshwork]. AB - Localization of actin filaments in the endothelial cells of rabbit trabecular meshwork was studied by the nitrobenzoxadiazole-phallacidin (NBD-ph) staining method for fluorescence microscopy and modified heavy meromyosin (HMM) decoration method for electron microscopy. Endothelial cells stained with NBD-ph exhibited intense fluorescence which was apparently associated with the basal plasma membrane area. By the modified HMM decoration method, labeled actin filaments were readily detected in the prefixed endothelial cells, because of the distinctive arrowhead-like appearance, observed beneath the basal plasma membrane facing the trabecular collagen sheet. The actin filaments were arranged with dual directionality within the bundle. In contrast, intermediate (10nm) filaments in the deeper region of endothelial cells were always unlabeled with HMM. The function of the actin filament bundles in endothelial cells may be to maintain the cell shape and provide contractility of the trabecular meshwork resulting in an alteration of the outflow resistance of aqueous humor drainage. PMID- 2773724 TI - 1989 ARRS Executive Council Award. Exercise-enhanced MR imaging of variations in forearm muscle anatomy and use: importance in MR spectroscopy. AB - 31P MR spectroscopic studies of forearm exercise frequently assume that the volume sampled is appropriate for the muscle of interest and that individual variations in muscle anatomy and use are not important. Postexercise MR imaging was used to assess variations in the size, location, and use of forearm flexors and the accuracy of palpation as a method for locating the muscle of interest. By using the information obtained with MR, the effects of errors in surface-coil position relative to the muscle of interest on 31P MR spectroscopy were examined. In the midforearm of seven men, the greatest diameter of the flexor carpi ulnaris was 29 +/- 4 mm, and that of the flexor digitorum superficialis was 28 +/- 6 mm. However, in the proximal forearm, 58 +/- 10% of the diameter was covered by the palmaris longus, when present (79% of subjects). An unexpected finding was that a focal portion of the superficial finger flexor was used primarily as a wrist flexor in 26% of subjects. Palpation incorrectly identified flexor muscle margins by more than 15 mm in 50% of attempts. When a surface coil was positioned over wrist flexors during handgrip, attenuation of exercise-induced changes in 31P spectra resulted. Exercise-enhanced MR imaging reveals variations in forearm muscle anatomy and use that are common and difficult to appreciate by palpation. It therefore allows improved localization of the sensitive volume for MR spectroscopic studies of muscle physiology. PMID- 2773726 TI - Diagnosis of a myocardial lipoma by using CT. PMID- 2773725 TI - Serial assessment of myocardial infarction by using gated MR imaging and Gd-DTPA. AB - In order to assess the usefulness of Gd-DTPA in the evaluation of myocardial infarction, 17 patients were examined with gated MR imaging. Scans were made by using a spin-echo pulse sequence before and after IV administration of 0.15 mmol/kg of Gd-DTPA. The images were made at four intervals (average of 5, 12, 30, and 90 days) after the onset of the infarction. Gd-DTPA uptake at the infarcted area was graded as marked, moderate, or no increase in signal intensity by visual inspection. At these four time intervals, an area of increased signal intensity in the infarcted myocardium was detected on T1-weighted images after administration of Gd-DTPA in 14 (82%) of 17 cases, 16 (94%) of 17 cases, six (38%) of 16 cases, and three (21%) of 14 cases, respectively. Markedly increased signal intensity in infarcted areas was shown on T1-weighted images with Gd-DTPA at 5 and 12 days. The ratio of gadolinium uptake in the infarcted area to that in normal myocardium also was evaluated. At 5 and 12 days, the mean increase in signal intensity in the infarcted area was significantly higher than that in a normal area, but not at 30 and 90 days. Increased signal intensity also was apparent on T2-weighted images without Gd-DTPA at 5 and 12 days; however, the use of late echo reduced the signal-to-noise ratio, leading to image degradation. Uptake of Gd-DTPA was a positive marker in acute myocardial infarction, but no significant uptake of Gd-DTPA occurred in chronic myocardial infarction. PMID- 2773727 TI - Chronic eosinophilic pneumonia: CT findings in six cases. AB - We reviewed the chest radiographs and CT scans in six patients with proved chronic eosinophilic pneumonia. In all patients, the chest radiographs showed patchy air-space consolidation, and in five of six cases, the consolidation was most marked in the middle and upper lung zones. In only one patient was the classic pattern of air-space consolidation that is confined to the outer third of the lungs readily apparent. In three patients, the consolidation appeared to be diffuse, although a slight peripheral predominance was present. In two patients, a peripheral predominance was difficult to appreciate, even in retrospect. The CT scans in all cases showed peripheral air-space consolidation. In addition, mediastinal adenopathy was identified on CT scans in three cases. This has not been described before in association with chronic eosinophilic pneumonia. A follow-up CT scan in one patient showed resolution of the adenopathy and marked improvement in the peripheral air-space disease within 2 weeks. We conclude that patients with chronic eosinophilic pneumonia show predominantly peripheral air space consolidation on CT scans, even when this distribution is not readily apparent on the radiograph. CT may be helpful in the diagnosis when the clinical findings are suggestive, but the radiographic pattern is nonspecific. PMID- 2773728 TI - Positive predictive value and posttest probability of diagnosis of colonic polyp on single- and double-contrast barium enema. AB - The positive predictive value for a radiographic diagnosis of colonic polyp, the prevalence of polypoid disease, and posttest probability relative to patient age were studied. The positive predictive value for colonic polyp on single- and double-contrast barium enema was determined for 191 polyps found radiographically in 136 patients who also underwent colonoscopy for confirmation. Of 72 polyps seen in 54 patients on single-contrast examination, 59 were confirmed endoscopically; 110 of 119 polyps seen in 82 patients on double-contrast examination were confirmed similarly, giving positive predictive values of 82% and 92%, respectively. Positive predictive values per patient, disregarding the number of polyps present, were 87% (47/54) and 90% (74/82) for the single- and double-contrast examinations, respectively. False-positive errors were due to stool, air bubbles, haustration, and misinterpretation of an appendiceal stump. By using specificities derived from our prevalence of polypoid disease and previously reported sensitivities, we drew posttest probability curves showing that predictive values depend both on the chance of disease before the test is done and on the efficacy of the test used. PMID- 2773729 TI - Localized clotted blood as evidence of visceral trauma on CT: the sentinel clot sign. AB - We retrospectively reviewed the CT scans of 116 patients with abdominal trauma who had visceral injuries to determine if identification on CT of focal high density clotted blood (a "sentinel clot") was an accurate sign of injury to an adjacent organ. The sentinel clot sign was sensitive, present in 101 (84%) of 120 visceral injuries with only three false-positive cases. Whereas CT visualized the visceral injury itself in 86% of cases, the sentinel clot was the only clue as to the source of hemorrhage in 14% of the cases. Splenic and bowel/mesenteric injuries were frequently subtle, and the focal clot helped to focus attention on the traumatic lesion. In 9% of splenic trauma cases and 32% of bowel/mesenteric injuries, the sentinel clot was the only positive finding. Localized clot is a frequent and accurate sign of injury to an adjacent organ. By facilitating diagnosis of trauma to a specific organ, it may influence the management decision of surgical vs conservative therapy. PMID- 2773730 TI - MR angiography and dynamic flow evaluation of the portal venous system. AB - We studied the value of MR angiographic techniques in imaging the portal venous system. Projection angiograms were created by postprocessing a series of two dimensional, flow-compensated gradient-echo images. Flow velocity was determined by a bolus-tracking method with radiofrequency tagging and multiple data readout periods. Each image was acquired during a breath-hold. MR angiography was applied to six normal subjects and four patients with abnormal hemodynamics in the portal venous system. Flow velocity determined by MR was correlated with the results of duplex sonography. The main portal vein and intrahepatic branches were shown in all cases. Portosystemic collaterals were identified in all patients with portal hypertension. In normal subjects, peak flow velocities (17.9 +/- 2.8 cm/sec) on MR correlated well with values determined by duplex sonography (17.5 +/- 2.2 cm/sec) (r = .846, p less than .04). Reversed portal blood flow was shown in two patients. One patient with portal vein thrombosis had no evidence of flow by MR angiography. Our results indicate that MR angiography can provide a three dimensional display of normal and abnormal vascular anatomy as well as functional information in the portal venous system. PMID- 2773731 TI - Idiopathic cecal ulcer: CT findings. PMID- 2773732 TI - In vivo MR spectroscopic imaging of the adrenal glands: distinction between adenomas and carcinomas larger than 15 mm based on lipid content. AB - The usefulness of MR spectroscopic imaging for discriminating between lipid and water was applied to the in vivo differentiation of adrenal adenomas from carcinomas. By using the Dixon sequence in 20 patients, the lipid content of 22 adrenal tumors larger than 15 mm was determined. The mean percentage of lipid in 15 adenomas was 13.4% (standard deviation, 8%), compared with 3.5% lipid (standard deviation, 2%) in seven carcinomas. Only one lesion would have been misclassified on the basis of in vivo measurements of lipid content. After surgery, in vitro MR spectroscopy was used to determine the percentage of lipid in excised samples of nine of the 22 tumors. These in vitro measurements confirmed the in vivo results on lesions larger than 20 mm in diameter. Respiratory artifacts appeared to decrease the accuracy of in vivo measurements in smaller lesions. In vivo MR spectroscopic imaging of adrenal tumors appears to be useful for differentiating between adrenal carcinomas and adenomas. PMID- 2773733 TI - Biocompatible copolymer ureteral stent: maintenance of patency beyond 6 months. PMID- 2773734 TI - Radiation-induced sarcoma of bone: CT findings in 19 cases. AB - We reviewed the CT findings in 19 cases of radiation-induced sarcoma of bone. The latent period before development of the sarcoma ranged from 5 to 50 years (mean, 17 years). In all 19 lesions, a soft-tissue extraosseous component was seen on CT, and 18 of them had associated bone destruction. Expansion of the affected bone and tumor-matrix mineralization each were present in 10 patients, but occurred together in only five patients. Periosteal reaction was seen in five patients, one of whom had an associated fracture. Radiation osteitis could not be identified on CT scans in the affected bone of any of the patients when tumor was present, but it was present in contiguous bone in two patients and had been shown 6 years before tumor became apparent in the affected bone in one other patient. Radiation-induced sarcoma of bone should be considered when bone destruction and an associated soft-tissue mass are shown on CT, or when changes occur in the appearance of previously stable irradiated bone. PMID- 2773736 TI - Findings on chest radiographs after prophylactic pulmonary surfactant treatment of premature infants. AB - Clinical trials are underway that use pulmonary surfactant replacement therapy in an attempt to prevent respiratory distress syndrome (RDS) in premature infants. This study was undertaken to determine the relationship between the clinical course of infants receiving prophylactic "first-breath" endotracheal surfactant and their initial posttreatment radiographs. The study population consisted of 80 premature infants of 24-32 weeks gestational age. All received 3 ml of calf-lung surfactant extract via endotracheal tube at birth. Anteroposterior chest radiographs taken within 1 hr of treatment were reviewed and correlated with gestational age, birth weight, days of endotracheal intubation, mean airway pressure, and days of oxygen requirement greater than 30%. Three distinct patterns of radiographic abnormality were encountered: typical RDS with hypoinflation, diffuse granularity, and air bronchograms (30%); central clearing of RDS (14%); and disproportionate clearing of RDS in the right lung (8%). No significant differences in ventilator requirements or clinical course were seen among these three groups. A fourth group (49%), whose posttreatment radiographs showed no evidence of RDS, required significantly less ventilatory support. Prophylactic first-breath surfactant treatment of premature infants occasionally results in radiographic patterns that are atypical for RDS. Familiarity with these patterns and their clinical significance will be important if surfactant augmentation becomes prevalent. PMID- 2773737 TI - CT evaluation of blunt abdominal trauma in children: comparison of ultrafast and conventional CT. AB - Previous reports describing the use of ultrafast CT have emphasized its value in evaluating the heart, chest, and airway. We describe our experience using this technology on children with blunt abdominal trauma. We retrospectively reviewed 54 consecutive ultrafast CT studies and 30 consecutive conventional dynamic CT studies performed on children after blunt abdominal trauma. Thirty percent of the scans showed abnormalities. CT or pathologic follow-up was available for all abnormal cases. We compared scans made with these two techniques for diagnostic accuracy, amount of visible motion on each slice, and contrast enhancement seen on each study. A protocol of 0.4-sec images and 2 ml/kg IV contrast material administered before scanning was used for the ultrafast CT scans. A standard protocol of 2-sec scanning and 3 ml/kg IV contrast material was used for conventional CT studies. There was no difference in diagnostic accuracy between the two techniques. There was significantly less visible motion (p less than .0001) and significantly better contrast enhancement (p less than .0001) seen on the ultrafast CT studies. Two of 54 ultrafast scans had images with sufficient motion to require repeated scanning, compared with 13 of 30 conventional CT studies. In addition, ultrafast scans required less sedation, decreased radiation dose, and improved accessibility of the patient to support personnel. Ultrafast CT is a valuable technique for abdominal imaging, offering equal diagnostic accuracy with improved image quality and important benefits to the patient. PMID- 2773738 TI - Reliability of voiding cystourethrography to detect reflux. AB - To our knowledge, the reliability of the voiding cystourethrogram for showing vesicoureteral reflux has not been established. Therefore, we evaluated the procedure in 207 children, each of whom underwent voiding cystourethrography with two or more bladder fillings and voidings. The results showed a discrepancy of presence and/or grade of vesicoureteric reflux from one filling to the other in 22 (12%) of 177 patients with two cycles and in six (20%) of 30 patients with three cycles. No changes were observed with cyclic voiding in cases of grade IV reflux (large, tortuous ureters with pelvic dilatation and caliceal clubbing). The grading of reflux was upgraded from 0 to grade I (into ureter only), II (ureter and collecting system), III (distension of pelvis and calices) by a second voiding cycle in only 3% of patients and by a second and third cycle in 4%. Reflux was downgraded by the second or third filling in a similar percentage. Most changes occurred between minor grades of vesicoureteric reflux. With two fillings, the percentage of agreement of the test (including all grades of reflux) for patients with abnormal findings during the first voiding study was 64%; the percentage of agreement for patients with normal results on the first voiding cystourethrogram was 96%. Voiding cystourethrography is a less reliable test for grading reflux than for documenting the absence of vesicoureteric reflux. Although voiding cystourethrography is a good test to rule out reflux, its diagnostic reliability can be enhanced by a second voiding cycle. PMID- 2773735 TI - Optimal plain film imaging of the shoulder impingement syndrome. PMID- 2773739 TI - Radiographic evaluation of velopharyngeal incompetence in childhood. PMID- 2773740 TI - The cerebellum in sagittal plane--anatomic-MR correlation: 1. The vermis. AB - Correlation of thin (5-mm) sagittal high-field (1.5-T) MR images of three brain specimens and 11 normal volunteers with microtome sections of the human cerebellar vermis and hemispheres demonstrates that proton-density-weighted (long TR/short TE) and T2-weighted (long TR/long TE) spin-echo pulse sequences provide the greatest contrast between gray and white matter. These images also can display (1) the corpus medullare and primary white-matter branches to the vermian lobules, including the lingula, centralis, culmen, declive, folium, tuber, pyramis, uvula, and nodulus; and (2) several finer secondary branches to individual folia within the lobules. Surface features of the vermis including the deeper fissures (e.g., preculminate, primary, horizontal, and prepyramidal) and shallower sulci are best delineated by T1-weighted (short TR/short TE) and T2 weighted images, which provide greatest contrast between CSF and parenchyma. Given that the width of the normal vermis varied from 6 to 12 mm in our volunteers, the acquisition of thin slices (less than or equal to 5 mm) was required to minimize volume averaging of the cerebellar hemispheres with the vermis on a midline sagittal MR section. Knowledge of the detailed normal anatomy of the cerebellar vermis on sagittal MR images can assist in the identification of various pathologic alterations. PMID- 2773741 TI - The cerebellum in sagittal plane--anatomic-MR correlation: 2. The cerebellar hemispheres. AB - Thin (5-mm) sagittal high-field (1.5-T) MR images of the cerebellar hemispheres display (1) the superior, middle, and inferior cerebellar peduncles; (2) the primary white-matter branches to the hemispheric lobules including the central, anterior, and posterior quadrangular, superior and inferior semilunar, gracile, biventer, tonsil, and flocculus; and (3) several finer secondary white-matter branches to individual folia within the lobules. Surface features of the hemispheres including the deeper fissures (e.g., horizontal, posterolateral, inferior posterior, and inferior anterior) and shallower sulci are best delineated on T1-weighted (short TR/short TE) and T2-weighted (long TR/long TE) sequences, which provide greatest contrast between CSF and parenchyma. Correlations of MR studies of three brain specimens and 11 normal volunteers with microtone sections of the anatomic specimens provides criteria for identifying confidently these structures on routine clinical MR. MR should be useful in identifying, localizing, and quantifying cerebellar disease in patients with clinical deficits. PMID- 2773742 TI - MR imaging of muscles of mastication. AB - High-field MR imaging was used to study structural and physiologic alterations involving the muscles of mastication in 46 patients. Muscular abnormalities were often detected incidentally in conjunction with lesions of the CNS, cranial nerves, facial bones, and/or temporomandibular joint (TMJ). Specific pathologic alterations observed included anomalies of musculoskeletal development, muscle hypertrophy, atrophy (disuse and denervation), inflammatory disorders, injuries (including contusions, tears, and muscle rupture), posttraumatic musculoskeletal deformities, and reflex sympathetic dystrophy. Atrophy, fatty replacement, fibrosis, and contracture of selected muscles of mastication may accompany internal derangement of the TMJ in the absence of traumatic deformity. We conclude that MR is a highly accurate imaging method for detecting masticatory muscle disease. Nontraumatic anatomic and physiologic abnormalities of the muscles of mastication are uncommon disorders. Demonstrable muscle alterations frequently accompany fracture dislocations of the mandibular condyle neck and related facial bones onto which masticatory muscles attach. PMID- 2773744 TI - CT of nasopharyngeal carcinoma: significance of widening of the preoccipital soft tissue on axial scans. AB - Axial CT scans of 60 patients with biopsy-proved nasopharyngeal carcinoma were reviewed with particular reference to sites of origin and routes of spread of disease. In all patients there was involvement of the pharyngeal space with blunting of the fossa of Rosenmuller and usually associated thickening of the adjacent levator veli palatini muscle. Tumor infiltration through the pharyngobasilar fascia manifested by obliteration or displacement of the parapharyngeal fat space was seen in 65% of the patients. T-staging by CT showed T1 (28%), T2 (20%), T3 (5%), and T4 (47%) involvement. In three patients there was bilateral symmetric blunting of the fossa of Rosenmuller with no evidence of tumor infiltration into the parapharyngeal space. The scans were initially interpreted as normal except for widening of the preoccipital soft-tissue area in the midline of more than 1.5 cm and up to 2.0 cm in the anteroposterior plane. Biopsy of the postnasal space was positive for tumor in these patients. With symmetric, early stage nasopharyngeal carcinoma, a confident radiologic diagnosis on CT can be difficult. If there is asymmetry of pharyngeal mucosal space or evidence of deep infiltration this should not be a problem. Although lymphoid adenoid tissue can sometimes result in widening of the preoccipital area, it is proposed that widening of this area of greater than 1.5 cm is an additional CT sign of nasopharyngeal carcinoma not previously emphasized. It is the result of early submucosal infiltration of the disease, and a patient with clinically suspected nasopharyngeal carcinoma should have aggressive deep biopsies of the fossa of Rosenmuller. PMID- 2773743 TI - MR imaging of neurocysticercosis. AB - Twenty-six patients with neurocysticercosis were studied with MR imaging to correlate their clinical presentation with the location and appearance of their neurocysticercosis lesions. Intraventricular cysts were present in 14 patients (54%), parenchymal cysts were present in 18 (69%), and intraventricular together with parenchymal cysts were present in six (23%). Intraventricular cysts were detected by mass effect, ventricular obstruction, detection of a cyst rim, and/or CSF flow void adjacent to the cyst. The intensity of most intraventricular and parenchymal cysts presumed to be viable was similar to that of CSF on both T1- and T2-weighted sequences. Cysts presumed to be degenerated had increased signal intensity on T1-weighted images, probably resulting from increased protein content. Pericystic high signal intensity surrounding lesions of various ages was seen on both proton-density- and T2-weighted images and represents gliosis, edema, and inflammation. Patients with parenchymal cysts had symptoms of seizures, while those with intraventricular cysts generally had symptoms related to obstructive hydrocephalus. Aqueductal stenosis, seen in 10 patients (38%), was possibly due to ependymal inflammation or adhesions caused by prior ventricular infection by neurocysticercosis. One patient with the racemose form of neurocysticercosis demonstrated abundant cyst wall proliferation resulting in obstructive hydrocephalus. In six patients scanned 1-6 months after oral praziquantel therapy, there was no change in the MR appearance of intraventricular cysts, while some parenchymal cysts showed evidence of degeneration. We found MR to be useful in detecting the cysts of neurocysticercosis and the accompanying signs of cyst degeneration and pericystic inflammation. MR was inferior to CT in the detection of parenchymal calcifications. PMID- 2773745 TI - MR signal intensity of parathyroid adenomas: correlation with histopathology. AB - Recent experience has shown that parathyroid adenomas vary in their MR signal intensity, which raises the question of whether the signal intensity is related to different histologic characteristics. In order to address this question, 10 patients who had MR imaging studies (four at 0.35 T, six at 1.5 T) showing large- to medium-sized parathyroid adenomas and who subsequently underwent surgery with histologic proof of the lesion were evaluated. The MR appearance was compared with histologic characteristics. The adenomas were classified into three groups according to the MR appearance: group I, low signal intensity on short TR/TE images, high signal intensity on long TR/TE images (n = 5); group II, low signal intensity on short and long TR/TE images (n = 3); group III, high signal intensity on short and long TR/TE images (n = 2). Histologic analysis revealed that the major features of each group were different. High cellularity without degeneration or fibrosis was observed for all five adenomas from group I. In group II, all three adenomas showed cellular degenerative changes, old hemorrhage with hemosiderin-loaded macrophages, and/or fibrosis. In group III, both adenomas showed evidence of acute hemorrhage without significant degenerative or fibrotic changes. These data suggest that the signal intensity of parathyroid adenomas on T1- and T2-weighted images corresponds at least in part to differences in histologic composition. PMID- 2773746 TI - Error in meeting news report. PMID- 2773747 TI - Partial flip-angle spin-echo imaging: clinical applications. PMID- 2773748 TI - Focal nodular hyperplasia of the liver: features on Gd-DTPA-enhanced MR. PMID- 2773749 TI - Focal nodular hyperplasia of the liver on delayed enhanced CT. PMID- 2773750 TI - Direct sagittal CT of the foot. PMID- 2773751 TI - The lateral ankle index. PMID- 2773752 TI - Spinal cord compression by unusual epidural air accumulation after continuous epidural analgesia. PMID- 2773753 TI - Normal location of conus medullaris in childhood. PMID- 2773754 TI - IgA1, IgA2 or secretory piece containing antigliadin antibodies in the sera of coeliac patients. AB - A study was made of the gliadin antibodies containing secretory piece (SP) found in 73 sera samples obtained from 38 children with coeliac disease (CD); simultaneously an intestinal biopsy was carried out. In 32 cases the mucosa was flat and the remaining 41, following a gluten-free diet, had a normal intestinal histology. Thirty chronic non-coeliac gastrointestinal patients and 22 normal children were used for a control. An enzymoimmunoassay technique with monoclonal IgA1 and IgA2, and SP polyclonal antibodies was used. The antigliadin antibodies containing SP in serum were above normal limits in 24/32 (75%) active CD patients, but also in 22/41 (54%) patients with normal biopsy and in 20/30 (66%) chronic non-coeliac gastrointestinal patients. There was a multivariant correlation (p less than 0.002) among antigliadin, ovoalbumin and lactoglobulin antibodies containing SP. These results are probably due to non-specific intestinal damage. Nevertheless, antigliadin antibodies containing SP in the sera of gluten-free CD cases lasted longer than antiovoalbumin and antilactoglobulin antibodies. The IgA1 antigliadin antibodies were increased in 19/30 (64%) of active CD patients and 0/8 of inactive CD patients (p less than 0.0005). Nevertheless IgA2 antibodies were increased in only 2/30 (7%) of active CD patients (p less than 0.05). According to this study the IgA antigliadin antibodies in serum are the result of a systemic response, although another interpretation could be that gliadin mainly stimulates IgA1 subclass antibodies in the gut. PMID- 2773756 TI - [HLA compatibility and susceptibility to habitual abortion. Results of histocompatibility testing of couples with frequent miscarriages]. AB - We have performed class I HLA antigen testing in 42 women with recurrent habitual abortions and in their husbands. The main criterion for inclusion in this group was a frequency of more than two abortions without the known reasons for abortion and without a living child. 29 couples with a least two healthy children and no abortion in the clinical history served as a control group. The data were evaluated in respect to the association of HLA and disease as well as to the level of histocompatibility within the couples. In our results we did not find any significant association between HLA-A, B, C phenotypes and the habitual abortion. On the other hand, we observed a significantly higher level of histocompatibility in the couples with habitual abortions in comparison to the control couples. The frequency of identity in one and more histocompatibility antigens was in the patient group significantly higher than in the control group and as it could be expected by chance, calculated on the basis of antigen distribution within the loci A, B, C in the population in the southern part of the GDR. In no case we have revealed lymphocytotoxic antibodies as a possible cause for miscarriage. Our results are in favour of the hypothesis that a higher level of histocompatibility could be an immunological explanation for the habitual abortions. In addition, this hypothesis was supported by the successful immunotherapy with leukocytes derived from the husband or nonrelative donors. PMID- 2773757 TI - Fulminant idiopathic pseudomembranous colitis. AB - Pseudomembranous colitis is characterized by inflammatory plaques and pseudomembranes on the colonic mucosa. The disorder most commonly occurs after the use of antibiotics, which allow overgrowth of Clostridium difficile, a spore forming, gram-positive rod that produces a toxin. Overgrowth of Staphylococcus aureus can also produce pseudomembranous colitis. In rare cases, pseudomembranous colitis is not associated with antibiotic use. When C. difficile is present, vancomycin or metronidazole usually produces a prompt response. In idiopathic cases, surgery may be required. PMID- 2773755 TI - A one year survey of airborne pollen and spores in the neotropical city of Bogota (Colombia). AB - A one-year study of potentially allergenic airborne biological particles was carried out in Bogota, the capital city of Colombia. Bogota is a populous city of approximately 6 million inhabitants. Located at 4 degrees Lat N and 2,600 m on the sea level, it has a mild tropical climate. The mean annual temperature of the city is 14 degrees C, the annual rainfall 1,013 mm and the relative humidity 72%. During the year June '86-May '87 the pollen count was 7,626 contributed by 72 grain types. Among these, 24 taxa have been identified. The majority of the grains came from imported trees; Cupressus spp was the main contributor. Weed pollen counts, which include the Compositae (ragweed), were notoriously low (4% of the total). The spore count was 13,264, almost twice as large as that of pollen. Fourty-four spore taxa were identified out of 72 types recorded. More than two-thirds (72%) of the spore count was contributed by the deuteromycetes. Cladosporium was the more frequently recorded genus, Penicillium/Aspergillus second next. Miscellaneous particles recorded were 609 Algae and 142 fern spores. Because of its location in the tropics, Bogota has neither true seasons nor the large variations in atmospheric particle counting which are typical of temperate zones. However, distinct periodical increments in the counts of various species (peaks) may be the cause of seasonal allergic symptoms. PMID- 2773758 TI - Biologic theories of aging. AB - Many theories have been proposed to explain aging. Currently, the most important theories include genetic control, deterioration of the immune system, somatic mutation, accumulated damage by free radicals, cross-linkage of macromolecules, and metabolic causes. While no single theory accounts for all of the observations about aging, recent research suggests that the primary process is under genetic control, with contributions from environmental factors. PMID- 2773759 TI - Methionine-enkephalin shows promise in reducing HIV in blood. PMID- 2773760 TI - Pesticides and food safety. PMID- 2773761 TI - Erythropoietin for severe anemia in AIDS patients. PMID- 2773763 TI - Obstetric training in family practice. PMID- 2773762 TI - Assembly-line physicals. PMID- 2773764 TI - Preoperative mental status evaluation in the elderly. PMID- 2773765 TI - The family physician's role in the HIV epidemic. PMID- 2773766 TI - The politics of pain relief. PMID- 2773767 TI - AAFP-PT: proficiency testing for office labs. PMID- 2773768 TI - Clinical experience in seventy-seven patients with the automatic implantable cardioverter defibrillator. AB - Seventy-seven patients with drug-refractory sustained ventricular tachycardia (VT) (28 patients) or ventricular fibrillation (VF) (49 patients) underwent implantation of an automatic cardioverter defibrillator (AICD). The 67 men and 10 women, with a mean age of 60 +/- 12 years (range 18 to 79), had coronary artery disease (60 patients), idiopathic cardiomyopathy (eight patients), mitral valve prolapse (four patients), hypertensive heart disease (one patient), Ebstein's anomaly (one patient), long QT syndrome (one patient), and primary electrical disease (two patients). The mean left ventricular ejection fraction was 35 +/- 16% (range 10% to 75%). Sustained VT/VF was induced in 64 patients (83%) at baseline electrophysiologic testing. A mean of 4.1 +/- 1.3 antiarrhythmic drugs failed to control the arrhythmia. Associated surgery at AICD implantation included coronary artery bypass in 19 patients, coronary bypass with aneurysmectomy in six patients, and aneurysmectomy alone in one patient. Five patients had only prophylactic patches implanted during aneurysmectomy or coronary bypass and the AICD device was subsequently implanted under local anesthesia to prevent arrhythmia recurrence or to control persistently inducible VT. Operative mortality was 2.6% with two deaths from intractable VF. Fifty-two patients (69%) continued receiving antiarrhythmic drugs to suppress spontaneous VT. During a mean follow-up of 15 +/- 13 months (range 1 to 63), six patients died: two suddenly due to probable pulse generator failure (greater than 2 years old), one of acute myocardial infarction, two of heart failure, and one of respiratory failure.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2773769 TI - Success rate versus defibrillation energy: temporal profile and the most efficient defibrillation threshold. AB - To determine the temporal profile of the energy requirement for defibrillation, shocks were delivered to canine hearts after 5, 10, or 20 seconds from the onset of fibrillation with a combination of patch and catheter electrodes. A total of 956 fibrillation-defibrillation sequences were performed at one of four energy levels appropriately selected for each period of fibrillation in 10 anesthetized dogs. The energy values related to 50% (E50) and 80% (E80) of the predicted success were calculated from a logistic regression curve. The E50 and E80 values at 10 seconds after the onset of fibrillation were less than those at 20 seconds after the onset by 7.1% +/- 18.3% and 9.7% +/- 21.4%, respectively; differences were not significant. At 5 seconds after the onset, the differences were 15.3% +/ 14.2% (p less than 0.02) and 16.4% +/- 12.7% (p less than 0.01), respectively. The defibrillation energy efficiency was assessed by dividing the success rate (SR) of fibrillation by the applied energy (E). The maximal SR/E at 5, 10, and 20 seconds of fibrillation was achieved at the energy corresponding to the SRs of 88.8% +/- 4.5%, 90.4% +/- 3.9%, and 88.1% +/- 4.6%, respectively. We conclude that the energy requirement for defibrillation increases with the duration of fibrillation, even shortly after the onset of fibrillation, and the maximal energy efficiency is attained at the energy associated with the SR of approximately 90%. PMID- 2773770 TI - Further observations on entrainment of atrial flutter in the dog. AB - To determine whether the first postpacing interval after entrainment was affected by recording and pacing sites, overdrive atrial pacing was undertaken in 13 episodes of atrial flutter with a mean flutter cycle length (FCL) of 140 +/- 8 msec induced in seven dogs. Atrial flutter was induced by means of an anatomic obstacle. Seven recording sites, four in the right atrium and three in the left atrium, and three pacing sites, two in the right atrium and one in the left atrium, were selected. After entrainment from the right atrium at pacing cycle lengths that were 94% of the FCL, the first postpacing interval was not significantly different from the intrinsic FCL at each recording site, but it tended to be shorter than the FCL at the recording sites near pacing sites. For entrainment from the left atrium, the first postpacing interval was longer than the FCL at recording sites in the left atrium (p less than 0.001), but it was not different from the FCL at recording sites in the right atrium. These results are due to differences in placement of recording and pacing electrodes relative to the reentrant circuit. Also we observed that activation sequences involving three appropriately selected recording sites were always identical when paced from two different pacing sites at a single constant pacing cycle length. This new phenomenon may best be explained by postulating reentry as the mechanism for atrial flutter. PMID- 2773771 TI - Effect of the second-generation calcium channel blocking drug nisoldipine on diastolic left ventricular dysfunction in heart failure. AB - The effect of intravenous nisoldipine (0.12 microgram/kg/min) on diastolic left ventricular (LV) dysfunction was studied from simultaneous hemodynamic and radionuclide measurements in 12 patients with New York Heart Association class II to IV cardiac failure. The initial LV filling fraction was low, the peak LV filling rate normalized for end-diastolic volume was decreased, and the pulmonary capillary wedge pressure (PCWP) was high and associated with clinical shortness of breath. Nisoldipine produced an increase in LV filling fraction from 36 +/- 17% to 43 +/- 20% (p = 0.003). The increase in filling took place in both early and late diastole: peak early filling rate (PFR) increased in 11 of the 12 patients (p = 0.02) and late diastolic filling rate (atrial [A] wave in eight of them (NS). When the determinants of these changes, were examined further, it was found that in the control state PFR was inversely related to LV end-systolic volume (r = 0.77), whereas the A wave was related in exponential fashion to PCWP (preload) (r = 0.79). Nisoldipine did not change the slope of these relationships, and it did not alter the end-diastolic pressure-volume relationship, implying that inherent myocardial relaxation and distensibility were unaltered by the drug. In summary, nisoldipine improved measurements of diastolic LV dysfunction in patients with cardiac failure. This study illustrates the importance of considering ventricular loading conditions when analyzing and interpreting measurements of diastolic ventricular dysfunction. The measured changes in diastolic LV function during infusion of nisoldipine appear to be due to alterations in ventricular loading conditions rather than to a direct myocardial effect of the drug. PMID- 2773773 TI - Long-term function of the morphologic right ventricle in adult patients with corrected transposition of the great arteries. AB - Because of the concern about the ability of the morphologic right ventricle (MRV) to function over a long term as a systemic ventricle, adult patients with congenitally corrected transposition of the great arteries (CCTGA) were evaluated to determine the long-term function of the MRV. Morphologic right ventricular function was assessed by functional clinical classification and angiographic ejection fraction in 18 adult patients with congenitally corrected transposition of the great arteries. These patients had a mean age of 30.2 +/- 14.5 years (range 10 to 67 years). All but one had hemodynamically significant lesions, the most common being left atrioventricular valve regurgitation (11 patients), ventricular septal defect (seven patients), atrial septal defect (four patients), and pulmonic stenosis (three patients). The mean MRV ejection fraction at presentation was 55% +/- 11.5% (range 24% to 74%). Twelve of the 18 patients (67%) were followed clinically, with a mean follow-up time of 9.9 +/- 7.1 years (range 1 to 22 years). Eight were reassessed angiographically, with a mean MRV ejection fraction of 51.3% +/- 10.7% (range 30% to 67%). The other four were followed up clinically and evaluated by two-dimensional echocardiography, with normal MRV function in two patients. Eight of 12 patients (67%) were in functional class I at follow-up, one was in functional class II, one was in functional class III, and two had died. Our data suggest that the morphologic right ventricle can function appropriately over a long term in adult patients with congenitally corrected transposition of the great arteries.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2773772 TI - Influence of UDCG-115 on hemodynamics and myocardial energetics in patients with idiopathic dilated cardiomyopathy. AB - The influence of the new inotropic and vasodilating agent UDCG-115 on hemodynamics and myocardial oxygen metabolism was investigated in 11 patients with idiopathic dilated cardiomyopathy (New York Heart Association class II to III). After intravenous administration of UDCG-115, cardiac index increased from 3.03 +/- 0.68 to 3.76 +/- 1.07 L/min/m2 (p less than 0.01), left ventricular ejection fraction increased from 31 +/- 13 to 39 +/- 16% (p less than 0.01), and maximum rate of left ventricular pressure rise increased from 935 +/- 248 to 1056 +/- 284 mm Hg/sec (p less than 0.05). Left ventricular end-diastolic wall stress (index of preload) and left ventricular end-systolic wall stress (index of afterload) decreased by 41% (p less than 0.01) and 34% (p less than 0.001), respectively. Heart rate did not change significantly. With UDCG-115 myocardial oxygen consumption decreased from 14.3 +/- 5.1 to 10.6 +/- 3.8 ml/min/100 gm (p less than 0.05), and the ratio of myocardial oxygen supply to myocardial oxygen demand increased from 1.40 +/- 0.08 to 1.53 +/- 0.17 (p less than 0.05). Thus intravenous UDCG-115 improves left ventricular function by increasing inotropism and reducing preload and afterload in patients with idiopathic dilated cardiomyopathy and moderate congestive heart failure. The systemic hemodynamic actions are associated with favorable effects on myocardial energetics. PMID- 2773775 TI - Efficacy of treatment of patients with echocardiographically detected right-sided heart thrombi: a meta-analysis. AB - Although echocardiography detected right-sided heart thrombi are frequently associated with massive pulmonary embolism and death, there are conflicting recommendations in the literature about the optimal treatment of this condition. Our objective was to resolve this uncertainty by pooling all existing English language case reports in order to examine the relationship of treatment with survival. There were 71 published reports involving 119 subjects, of which 93% presented with abnormal cardiac signs and symptoms and 7% were asymptomatic but had risk factors for pulmonary embolism. The only factors that were significantly related to survival were whether pulmonary emboli were present, and the type of treatment actually received. Variables not significantly related to survival included cardiac symptoms and the echocardiographic appearance of the thrombus. The estimated probability of survival in patients with pulmonary emboli receiving heparin, thrombolytic agents, surgical embolectomy, or none of the above, was 0.70, 0.62, 0.62, and 0.19, respectively, while the estimated probability of survival in patients without pulmonary emboli for the same four treatment groups, was 0.92, 0.89, 0.89, and 0.53, respectively. We conclude that the efficacy of all three treatments are similar, and that they enhance the probability of survival. Because of the similar efficacy of drug therapy and surgery and the convenience of the former, drug therapy should probably be chosen. In addition, considering the small advantage of heparin with respect to the probability of survival, heparin may be the best choice if the illness is not characterized by a rapid downhill course. PMID- 2773774 TI - Influence of left ventricular diastolic function on vascular and humoral responses to head-up posture in hypertension. AB - The left ventricular (LV) diastolic filling rate has been reported to be reduced in hypertensive patients. To investigate the possible influence of altered LV diastolic function in hypertension on peripheral vascular regulation, hemodynamic measurements were obtained in 16 hypertensive patients in the resting supine position and during head-up tilt. The study population included seven men and nine women with an age range of 30 to 62 years (mean, 49.5 years +/- 10.6). Measurements included LV peak filling rate (+dv/dt), LV peak ejection rate ( dv/dt), LV ejection fraction, heart rate, total peripheral resistance, stroke volume, and cardiac index. Moreover, we calculated the ratio relating left ventricular filling rate to left ventricular ejection rate (+dv/dt/-dv/dt) because a complex interaction between ventricular contraction and relaxation is well recognized. We observed that in patients with slow diastolic filling rate (ratio +dv/dt/-dv/dt less than 0.9), the increase in total peripheral resistance in response to head-up tilt was less marked than in those with normal LV filling rate (+dv/dt/-dv/dt greater than or equal to 0.9), whereas changes in stroke volume during tilt were not statistically different between the two groups. Conversely, supine resting cardiac index and total peripheral resistance was not significantly different among groups. We conclude that abnormal diastolic filling is associated with abnormal cardiovascular adjustment to changes in body posture. We suggest that the altered response to head-up posture is related to decreased sensitivity of low pressure receptors in the cardiopulmonary area as a result of impaired LV diastolic function.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2773776 TI - Deleterious hemodynamic effects of lidocaine in severe congestive heart failure. PMID- 2773777 TI - Pseudoakinesis: a radionuclide ventriculography sign for subacute heart rupture and tamponade early after acute myocardial infarction. PMID- 2773778 TI - Dipyridamole-induced negative U waves: scintigraphic evidence of severe anterior myocardial ischemia. PMID- 2773779 TI - Myocardial damage associated with electrical injury. PMID- 2773780 TI - Tricuspid valve endocarditis in children with normal hearts. PMID- 2773781 TI - Two-dimensional echocardiographic visualization of turbulent intracardiac blood flow across the stenotic mitral valve. PMID- 2773782 TI - Facilitation of localized conduction block with procainamide during entrainment of sustained ventricular tachycardia. PMID- 2773783 TI - Cerebral embolization in two young patients with fascioscapulohumeral muscular dystrophy and atrial dysrhythmias. PMID- 2773784 TI - Unmasking of ventricular preexcitation by adenosine triphosphate: its usefulness in the assessment of ajmaline test. PMID- 2773785 TI - Type A behavior and survival: a follow-up study of 1,467 patients with coronary artery disease. AB - Patients with documented coronary artery disease, admitted to Duke Medical Center between 1974 and 1980, were assessed for type A behavior pattern and were followed until 1984. The relation of type A behavior to survival was tested using data from coronary angiography to control for disease severity. Cox model regression analyses demonstrated an interaction (p less than 0.01) between type A behavior and an index of disease severity in the prediction of cardiovascular death. Among those with relatively poor left ventricular function, type A patients had better survival than type B. This difference was not present among patients with better prognoses. Type A behavior did not predict the subsequent incidence of nonfatal myocardial infarctions. Differential risk modification and differential selection into postinfarction status are possible explanations for the findings. These results need not conflict with the proposition that type A behavior plays a role in the pathogenesis of coronary artery disease. PMID- 2773786 TI - Comparison of nifedipine, propranolol and isosorbide dinitrate on angiographic progression and regression of coronary arterial narrowings in angina pectoris. AB - Calcium antagonists and beta blockers may retard or inhibit atherogenesis. This study investigated whether nifedipine or propranolol influences coronary atherosclerosis in humans. In selected patients with effort angina and proven coronary artery disease, the cineangiographic pattern after 2-year therapy with nifedipine (group 1, 39 patients), propranolol (group 2, 36 patients) or isosorbide dinitrate (group 3, 38 patients) was compared to that before treatment. The disease evolved to a different extent in the 3 groups. Patients with evidence of progression of old narrowings and appearance of new narrowings were significantly fewer in group 1 (31% and 10%) than in group 2 (53% and 34%) and group 3 (47% and 29%). The number of stenoses with evidence of progression was significantly smaller after nifedipine (14), and larger after propranolol (39) compared with group 3 (24). Thus, nifedipine seemed more protective than the other 2 drugs against coronary atherosclerosis. The coronary risk factors were normal in the nifedipine group and remained so with treatment, suggesting that they were dissociated from influences on atherosclerosis. The evolution, as judged by the number of narrowings with progression, appeared significantly (p less than 0.01) worse with propranolol than with isosorbide dinitrate. Propranolol caused unfavorable modifications of serum lipids; there was a 28% increase in total triglycerides and a 25% decrease in high density lipoprotein cholesterol at 12 months in group 2. PMID- 2773788 TI - A new epidemiologic classification system for interim myocardial infarction from serial electrocardiographic changes. AB - Many clinical trials or population studies have used change in Minnesota Q code, ST-segment depression code or T-wave inversion code as evidence of new myocardial infarction or new coronary heart disease event. Direct electrocardiogram (ECG) waveform comparison is a new standardized procedure for diagnosing interim myocardial infarction from ECGs classified according to the Minnesota code (serial Q-wave pattern change). This procedure was investigated for its application in epidemiologic studies. Use of this procedure in the Multiple Risk Factor Intervention Trial resulted in a 50% increase in the positive predictive accuracy, improved agreement with clinically defined myocardial infarction and a strong independent prognostic association with total and coronary heart disease mortality. Among those with major Minnesota Q-code findings, there was substantial variation in mortality. The 5-year coronary heart disease death rates estimated by life table analysis were 8.5% for those with major serial Q-wave pattern change, 5.1% for those with minor serial Q-wave pattern change and 1.5 to 2.6% for those with major or minor Minnesota Q-code change not substantiated by direct waveform comparison, compared with 2.4% for those with no Minnesota Q-code findings. The coronary heart disease death rate for those with major serial Q wave pattern change was greater than that for the other ECG groups (p less than 0.01). Adjustment for age and other risk factors did not qualitatively alter these findings. This new approach is eminently suitable for export to other investigators, for incorporation into computer analysis programs and for statistical analysis. PMID- 2773787 TI - Left ventricular dysfunction in acute myocardial infarction due to isolated left circumflex coronary artery stenosis. AB - The characteristics of regional and global left ventricular dysfunction due to isolated left circumflex (LC) artery stenosis were determined from the contrast ventriculograms of 52 patients studied during acute myocardial infarction. In patients with a left dominant coronary circulation (35%), the severity, circumferential extent and location of hypokinesia resembled those of right coronary artery stenosis. However, in patients with a right dominant or balanced circulation (65%), the location of LC artery-related hypokinesia varied over the entire left ventricular contour, overlapping with the territories of the left anterior descending and right coronary arteries. The method for measuring the severity of hypokinesia was adjusted to take into account the wide territory of the LC artery. This enhanced the sensitivity of the method, particularly in the right anterior oblique view, as indicated by the greater severity of hypokinesia measured (-2.5 +/- 0.9 vs -1.8 +/- 1.1 standard deviations by our previously published method, p less than 0.001). However, the overlap of the artery territories may make it difficult to selectively measure the dysfunction due to stenosis of an artery of interest in patients with multiple infarctions. The circumferential extent of hypokinesia due to LC artery thrombosis was greater in the left than the right anterior oblique view. When averaged over both views, the size of the dysfunctional segment approached that due to left anterior descending coronary artery thrombosis, exceeding the size previously reported. These results suggest that current eligibility criteria for thrombolytic therapy select patients with extensive LC artery beds. PMID- 2773789 TI - A simplified approach for evaluating multiple test outcomes and multiple disease states in relation to the exercise thallium-201 stress test in suspected coronary artery disease. AB - This study describes a simplified approach for the interpretation of electrocardiographic and thallium-201 imaging data derived from the same patient during exercise. The 383 patients in this study had also undergone selective coronary arteriography within 3 months of the exercise test. This matrix approach allows for multiple test outcomes (both tests positive, both negative, 1 test positive and 1 negative) and multiple disease states (no coronary artery disease vs 1-vessel vs multivessel coronary artery disease). Because this approach analyzes the results of 2 test outcomes simultaneously rather than serially, it also negates the lack of test independence, if such an effect is present. It is also demonstrated that ST-segment depression on the electrocardiogram and defects on initial thallium-201 images provide conditionally independent information regarding the presence of coronary artery disease in patients without prior myocardial infarction. In contrast, ST-segment depression on the electrocardiogram and redistribution on the delayed thallium-201 images may not provide totally independent information regarding the presence of exercise induced ischemia in patients with or without myocardial infarction. PMID- 2773791 TI - Effect of selective intracoronary antiarrhythmic drug administration in sustained ventricular tachycardia. AB - The effect of selective intracoronary antiarrhythmic drug infusion on inducibility of cardiac arrhythmias was studied in 3 patients with recurrent sustained monomorphic ventricular tachycardia referred for comprehensive electrophysiologic studies. Each patient had evidence of prior myocardial infarction, 1 or more occluded coronary arteries and a readily identifiable collateral vessel that provided collateral flow to the infarct-related artery. In each patient, the clinical arrhythmia was reproducibly inducible by programmed stimulation in the control state. After positioning a small infusion catheter in the collateral vessel, selective intracoronary lidocaine 0.3 to 0.6 mg/min (patients 1 and 2) or procainamide 0.1 to 1.4 mg/min (patient 3) was infused for a 10-minute period. In each patient the clinical arrhythmia was rendered noninducible during selective intracoronary drug infusion. The arrhythmia was again inducible after a 10-minute drug-washout period and also after standard intravenous doses of antiarrhythmic drug. Selective intracoronary antiarrhythmic drug infusion may help to localize the site of origin of some cardiac arrhythmias, may provide a means of testing the effects of several drugs during a single study and may be a new method for studying mechanisms of action of antiarrhythmic drugs. PMID- 2773790 TI - Clinical course and long-term prognosis of spontaneous coronary artery dissection. AB - Spontaneous coronary artery dissection is rare. In comparison with the usual myocardial infarction population, it occurs in relatively young people with a striking predilection for women. Of 83 cases that have been described, 62 were diagnosed at autopsy and 21 were found antemortem. A series of 11 patients with the antemortem diagnosis of spontaneous coronary artery dissection is reported and follow-up is provided for 16 of the 21 previously reported cases. Of the 62 autopsy cases, 10 (16%) were men (mean age 47) and 52 (84%) were women (mean age 40). Dissection of the left anterior descending coronary artery predominated in this group of patients, occurring in 80% of men and 65% of women. Of the 32 cases diagnosed antemortem, 15 (47%) were men (mean age 46) and 17 (53%) were women (mean age 38). Men were found to have dissection predominantly of the right coronary artery (73%). Women were found to have dissection predominantly of the left coronary artery system (88%). The etiology of spontaneous coronary artery dissection remains unclear. The 3 groups that can be identified are those associated with atherosclerotic coronary artery disease, those in the postpartum period and those found to be idiopathic. Of the 94 known cases, 69 (73%) occurred in women; 21 (31%) of these were associated with the postpartum state. The prognosis of patients surviving the initial event is good, with an 82% survival rate (follow-up: range 1.5 to 144 months, mean 38). The indications for medical or surgical treatment are presented. Spontaneous coronary artery dissection should be considered in the differential diagnosis of any young person sustaining an acute myocardial infarction, especially women in the postpartum state. PMID- 2773792 TI - Stress and pharmacologic tests as methods to identify patients with Wolff Parkinson-White syndrome at risk of sudden death. AB - Noninvasive stress and pharmacologic tests with procainamide and propafenone were studied as methods to identify patients with Wolff-Parkinson-White syndrome (WPW) who would otherwise be judged at risk of sudden death on the basis of electrophysiologic criteria: the shortest RR interval during induced atrial fibrillation less than or equal to 250 ms or accessory pathway anterograde effective refractory period less than or equal to 250 ms. Sixty-five patients were studied. Twenty-four patients fulfilled the electrophysiologic risk criteria (group A) and 41 patients fulfilled none of these criteria (group B). Persistence of preexcitation during stress test showed a sensitivity of 96% and a specificity of 17% to identify group A patients; its positive predictive value was 40% and negative predictive value 88%. With both procainamide and propafenone tests persistence of preexcitation identified group A patients with a sensitivity of 96% and a specificity of 51%; their positive and negative predictive value were, respectively, 53 and 95%. Stress and pharmacologic tests have good sensitivity and negative predictive value, but low specificity and positive predictive value. PMID- 2773793 TI - Significance of positive or negative thallium-201 scintigraphy in hypertrophic cardiomyopathy. AB - Myocardial ischemia, fibrosis and infarction may occur in patients with hypertrophic cardiomyopathy (HC) in the absence of epicardial coronary artery disease. To determine their prevalence and relation with common characteristics, stress thallium-201 scintigraphy was performed in 28 patients. Eleven (39%) had positive scans despite normal epicardial coronary arteries (7 patients) or a pretest risk of coronary disease less than or equal to 5% (4 patients). There was no relation between thallium defects and age, sex, chest pain or outflow tract gradients at rest. However, the mean left ventricular ejection fraction was significantly lower in those with perfusion abnormalities compared with those without (64 +/- 15 vs 75 +/- 11%, respectively, p less than 0.05). Also, the mean ventricular septal thickness was greater in patients with positive scans (27 +/- 7 vs 21 +/- 6 mm, p less than 0.05), and there was a nonparametric relation between increasing septal thickness and the frequency of positive scans (p less than 0.025). Seven of 11 patients with positive scans had ventricular tachycardia compared with none among those who had negative scans (p less than 0.001), and 5 of these 11 patients had conduction system disease requiring permanent pacemaker insertion compared with 1 of 17 with negative scans (p less than 0.025). It is concluded that thallium perfusion abnormalities are common in patients with HC in the absence of epicardial coronary disease, and are strongly associated with potentially lethal arrhythmias. Thallium scintigraphy appears to identify a subset of patients with HC at increased risk for sudden death, who therefore require closer follow-up. PMID- 2773794 TI - Correlation between histomorphometric findings on endomyocardial biopsy and clinical findings in idiopathic dilated cardiomyopathy. AB - Multivariate analysis was used to analyze the morphometric data of endomyocardial biopsies (area, perimeter and minor diameter) of myocardial cells obtained at light microscopy by a computerized approach with 16 clinical parameters and prognosis in 52 patients with idiopathic dilated cardiomyopathy. The best morphometric parameter was "area" (R2 = 0.47). A positive correlation was found with age (p less than 0.02), interval between first symptoms and diagnosis (p less than 0.02), left ventricular end-diastolic volume (p less than 0.02), cardiac index (p less than 0.05) and echocardiographic end-diastolic diameter (p less than 0.1). A negative correlation was found with prognosis (p less than 0.02), ejection fraction (p less than 0.02), shortening fraction (p less than 0.05), echocardiographic end-systolic diameter (p less than 0.06) and mitral regurgitation presence (p less than 0.1). The parameters that provided no correlation were New York Heart Association class, left ventricular end-diastolic pressure, right atrial pressure, cardiothoracic ratio, presence or absence of heart failure, fever or alcohol intake. These findings suggest that endomyocardial biopsy may provide prognostic information and confirm clinical diagnosis. PMID- 2773795 TI - Two-dimensional echocardiographic aortic root dimensions in normal children and adults. AB - Two-dimensional echocardiography is increasingly used to measure aortic root dimensions, which provide prognostic information in aortic regurgitation and the Marfan syndrome. Aortic root dilatation is currently detected by nomograms based on M-mode echocardiographic data. Aortic root diameters measured by 2-dimensional echocardiography at the anulus, sinuses of Valsalva, supra-aortic ridge and proximal ascending aorta in 135 normal adults and 52 normal children were compared with age, gender, body habitus, blood pressure and stroke volume, and with M-mode findings and normal limits. Two-dimensional measurements at the sinuses of Valsalva were larger than M-mode aortic root values (p less than 0.001), and use of 2-dimensional values with M-mode nomograms falsely diagnosed aortic dilatation in 40% of normal children and 19% of normal adults. Two dimensional measurements at the sinuses closely correlated with body surface area in children (r = 0.93, p less than 0.0005), moderately in adults younger than 40 years of age (r = 0.71, p less than 0.0005) and weakly in older adults (r = 0.40, p less than 0.0005). In adults, gender influenced aortic root size at all levels (p less than 0.001), but dimensions were similar when indexed for body surface area. Age strongly influenced supraaortic ridge and ascending aortic diameters; blood pressure and stroke volume had no independent effect on aortic size. In conclusion, (1) 2-dimensional echocardiographic aortic root dimensions are influenced by age and body size but not by blood pressure; (2) aortic root dilatation is overdiagnosed when aortic diameter at the sinuses of Valsalva is compared with M-mode nomograms; (3) nomograms comparing aortic diameter with body surface area should be used in children; and (4) although use of nomograms based on body size in adults should maximize sensitivity for aortic dilatation, 98% specificity is attained by use of an upper normal limit of 2.1 cm/m2 for aortic diameter at the sinuses of Valsalva in both men and women. PMID- 2773796 TI - Effect of weight loss on coagulation factors VII and X. AB - Coagulation plays an important role in the pathogenesis of coronary artery disease. Therefore, reversing a tendency to thrombosis may be an avenue for its prevention. Because of an association between obesity and high levels of several coagulation factors, the effect of weight loss on coagulation factors VII and X was investigated among subjects taking part in a 3-month weight loss study. At baseline, both coagulation factors were correlated with age, Quetelet's index, total cholesterol and triglycerides. During the diet period, the subjects lost an average of 3.5 kg at 1 month and 4.2 kg at 3 months, whereas lipoproteins changed in only minor ways. In the group as a whole, factor VII and X both decreased at 1 month but returned to or exceeded the baseline levels despite continued weight loss at 3 months. Although changes in weight, serum total cholesterol and triglycerides were correlated with the changes in the factors during the first month, during months 2 and 3 these correlations remained substantial only for triglycerides. Multiple regression analysis indicated that changes in weight, cholesterol and triglycerides could not explain the decreasing and increasing pattern in factors VII and X. These data suggest that weight itself does not explain the association between obesity and factors VII and X, and that weight loss does not effectively decrease the levels of these factors. PMID- 2773798 TI - Transcoronary techniques and cardiac arrhythmias. PMID- 2773797 TI - Doppler echocardiography and ultrafast cine computed tomography during dynamic exercise in chronic parenchymal pulmonary disease. AB - In an effort to better understand the cardiac contribution to exercise limitation in chronic lung disease, 21 patients with advanced chronic pulmonary parenchymal disease and 10 normal control subjects were evaluated for changes in right ventricular (RV) pressure, volume and function during incremental, symptom limited supine bicycle exercise. Patients underwent sequential exercise tests with Doppler echocardiography and ultrafast cine computed tomography (CT). RV systolic pressure during exercise was determined by saline-enhanced Doppler of tricuspid regurgitation. RV ejection fraction, end-diastolic volume, stroke volume and cardiac index were obtained by CT at rest and peak exercise. Sixteen of the 21 study patients also exercised on high-flow oxygen. In the control subjects RV systolic pressure increased from 21 +/- 6 mm Hg (mean +/- standard deviation) at rest to 32 +/- 8 mm Hg at peak exercise, whereas in patients with lung disease, RV systolic pressure increased from 42 +/- 17 to 81 +/- 26 mm Hg (both p less than 0.01). Compared with the control subjects, the patients with lung disease had significantly lower mean values for RV ejection fraction at rest (47 +/- 7 vs 55 +/- 7%) and at peak exercise (47 +/- 9 vs 57 +/- 3%, respectively, both p less than 0.05). The patients who demonstrated oxyhemoglobin desaturation during exercise showed the most abnormal cardiac responses, with marked increases in mean RV systolic pressure, decreases in mean RV ejection fraction and blunted increases in cardiac index and RV stroke volume. Although acute oxygen supplementation was associated with a slight decrease in RV systolic pressure at peak exercise and a longer duration of exercise, there was no significant improvement in RV function. Doppler echocardiography and CT provide complementary and potentially useful information about right-sided heart pressures and RV ejection fraction during exercise in patients with advanced chronic lung disease. Oxyhemoglobin desaturation during exercise is a marker for the most abnormal pulmonary vascular reserve, as indicated by RV contractile dysfunction and limited ability to increase cardiac index. PMID- 2773800 TI - Safety of percutaneous coronary atherectomy with deep arterial resection. PMID- 2773799 TI - Comparison of time- and frequency domain-based measures of cardiac parasympathetic activity in Holter recordings after myocardial infarction. PMID- 2773801 TI - Prognosis in peripartum cardiomyopathy. PMID- 2773802 TI - Hemodynamic effects of high dose naloxone in congestive heart failure. PMID- 2773803 TI - Myxoma attached solely to the tricuspid valve. PMID- 2773804 TI - Primary aortic sarcoma mimicking aortic dissection. PMID- 2773805 TI - Atherosclerotic risk factors--are there ten or is there only one? PMID- 2773806 TI - A symposium: Cardiovascular diagnosis--implications for imaging in the 1990s. February 9-13, 1989, Laguna Niguel, California. Proceedings. PMID- 2773807 TI - Magnetic resonance imaging and the future of cardiac imaging. AB - Within the last 5 years, technology for cardiac imaging has improved spectacularly. The choices now include ultrasound with Doppler, single-photon emission computed tomography and positron emission tomography, cine computed tomography, biplane and digital subtraction angiography and magnetic resonance imaging (MRI). MRI is the most expensive noninvasive option, but also provides the best information on chamber size, wall motion, valvular function and great vessel blood flow. It is multiplanar and multiparametric; thus, nearly any clinical problem except detailed coronary anatomy can be addressed, but the very plethora of technical details is daunting. With contrast agents as indicators, relative tissue perfusion of any organ appears achievable, including regional perfusion of the myocardial wall. As patient acceptance is high, MRI may become a major cardiac imaging tool and occupy the central position between office ultrasound and invasive angiography. PMID- 2773808 TI - Mapping gold-labeled receptors on cell surfaces by backscattered electron imaging and digital image analysis: studies of the IgE receptor on mast cells. AB - The response of cells to signaling molecules such as hormones, growth factors, and immune mediators that bind to cell-surface receptors depends in part on the density and distribution of the relevant receptors. We have developed methods to map the distribution of IgE receptors on RBL-2H3 mast cells at high resolution in the scanning electron microscope (SEM). The key elements of our procedure are a new fixative that preserves receptor binding activity; a family of colloidal gold conjugated probes that bind directly or indirectly to the IgE-receptor complex; an SEM with detectors for both secondary and backscattered electrons (to observe surface topography and gold particles, respectively); and an image processor that can average, digitize, and store these images. Topographical maps are generated by processing and superimposing the digitized images. The methods we describe can be applied to study the density and distribution of any membrane receptor that can be labeled with colloidal gold particles. PMID- 2773809 TI - Immunogold-surface replica study of ADP-induced ligand binding and fibrinogen receptor clustering in human platelets. AB - Platelet cohesion requires the binding of fibrinogen to its receptor, a heterodimer consisting of the plasma-membrane glycoproteins GPIIb and GPIIIa. Although the GPIIb-IIIa complex is present on the surface of unstimulated platelets, it binds fibrinogen only after platelet activation. We have used an immunogold-surface replica technique to study the distribution of GPIIb-IIIa and bound fibrinogen over broad expanses of surface membranes in unstimulated and ADP activated human platelets. We found that the gold prove was monodispersed over the surface of unstimulated platelets, although the cell surface lacked immunoreactive fibrinogen. To ascertain whether the receptors clustered prior to ligand binding or as a consequence thereof, we studied the surface distribution of GPIIb-IIIa after stimulation with ADP, which causes activation of the fibrinogen receptor function of GPIIb-IIIa without inducing the secretion of fibrinogen. In the absence of added fibrinogen, the unoccupied, yet binding competent receptors on ADP-stimulated platelets were monodispersed. The addition of fibrinogen caused the GPIIb-IIIa molecules to cluster on the cell surface. Clustering was also induced by the addition of the GPIIb-IIIa binding domains of fibrinogen--namely, the tetrapeptide Arg-Gly-Asp-Ser on the alpha-chain or the gamma-chain decapeptide gamma 402-411. These results show that receptor occupancy causes clustering of GPIIb-IIIa in activated platelets. PMID- 2773811 TI - Immunogold detection of glycoprotein antigens in sea urchin embryos. AB - Four developmental stages of sea urchin embryos were labeled with colloidal gold in an attempt to elucidate the intracellular trafficking patterns within the cells that produce the glycoprotein matrix of the embryonic spicule. The primary mesenchyme cells (PMCs) form a syncytium and secrete an organic matrix on which calcium carbonate is laid down to form an endoskeletal spicule. The organic matrix has been isolated and characterized as glycoprotein consisting of four major bands. Polyclonal antibodies to these glycoproteins were used to label embryos from the mesenchyme blastula, early gastrula, late gastrula, and plutei stages of development. The label is concentrated in the Golgi complex and associated vesicles, in secretory vesicles, and in the organic matrix. The density of the labeling increases as development proceeds. PMID- 2773810 TI - Distribution and movement of membrane-associated platelet glycoproteins: use of colloidal gold with correlative video-enhanced light microscopy, low-voltage high resolution scanning electron microscopy, and high-voltage transmission electron microscopy. AB - Scanning electron microscopy (SEM), especially low-voltage (1 KeV) high resolution SEM, can be used in conjunction with stereo pair high-voltage (1 MeV) transmission electron microscopy (HVEM) of whole spread cells or thick sections effectively to correlate surface structure with internal structure. Surface features such as microvilli, pits, pseudopodia, ruffles, attached virus, and other surface-related morphologic characteristics can be identified using SEM, while underlying cytoskeletal structure and organelle organization can be viewed by HVEM of the same preparation. However, the need to "prepare" cells for electron microscopy precludes observation in the living state. The use of several types of video-enhanced light microscopy (VLM) permits observation of living cells such that certain surface and internal features can be observed at a relatively high level of resolution or detection. Thus, changes in living cells can be followed, and at appropriate times the cells may be chemically fixed or rapidly frozen and prepared for ultrastructural examination by electron microscopy. We have utilized VLM in conjunction with SEM and HVEM to correlate changes in shape and surface structure with changes in the internal structure of platelets. In addition, we have found it advantageous to use colloidal gold labeling procedures, because these markers are detectable by all three forms of microscopy. Using this approach we have labeled platelet membrane GPIIb/IIIa, a receptor for RGD-containing adhesive proteins, with gold-fibrinogen or gold-anti IIb/IIIa. The initial binding and subsequent movement of gold-fibrinogen-IIb/IIIa complexes in living platelets was followed by VLM. The movement of individual labels could be mapped. Subsequent observation by low-voltage (1 KeV) high resolution SEM and HVEM permits visualization of the same individual receptors tracked by LM. The final position on the membrane or the position-in-transit when fixative was added was determined relative to surface ultrastructure (SEM) and internal, particularly cytoskeletal, ultrastructure (HVEM). PMID- 2773813 TI - Double-labeling immunogold electron-microscopic study of hormonal colocalization in nontumorous and adenomatous rat pituitaries. AB - According to the one cell, one hormone theory, the pituitary gland is composed of 5 cell types which secrete 6 hormones. Recent investigations indicate that this theory must be modified, as there are some bihormonal cells containing 2 hormones, i.e., mammosomatotrophs prolactin-growth hormone (PRL-GH). This study was undertaken in order to elucidate whether other adenohypophysial cells are capable of producing 2 hormones and to demonstrate the presence of cells coexpressing PRL-GH, PRL-thyrotropin (TSH), or TSH-GH. Sixteen nontumorous and 16 adenomatous male and female Sprague-Dawley and Long Evans rat pituitaries were removed immediately after the animals were killed and processed for transmission electron microscopy and the immunogold double-labeling technique. Coexpression of PRL-GH, PRL-TSH, and TSH-GH was found in both nontumorous and adenomatous pituitaries. Double labeling was present not only in the same cell cytoplasm but also in the same secretory granules. The question of whether these double-labeled cells represent different cell populations, transitional cell types, or precursor cells requires further investigation. PMID- 2773812 TI - Localization of cellular regulatory proteins using postembedding immunogold labeling. AB - Cyclic AMP-dependent protein kinase (cAPK) mediates the effects of catecholamines and hormones that cause elevation of intracellular cyclic AMP levels. The holoenzyme is a tetramer consisting of catalytic (C) and cyclic AMP-binding regulatory (R) subunits. The type I and type II cAPK isoenzymes are defined by R subunits (RI and RII) of differing molecular weight, primary structure, and cyclic AMP-binding properties. Postembedding immunogold labeling procedures and specific polyclonal and monoclonal antibodies to RI, RII, and C were used to study the subcellular distribution of cAPK subunits in several tissues. In the rat parotid gland, both RI and RII were present in the cytoplasm, nuclei, and secretory granules of the acinar cells, whereas secretory granules of intercalated and striated duct cells were poorly labeled. These results confirmed that the acinar secretory granules are the source of R subunits previously identified in saliva by specific photoaffinity labeling techniques. Zymogen granules of pancreatic acinar cells and secretory granules of seminal vesicle cells were labeled with antibody to RII. Pancreatic and seminal fluids were shown to contain cyclic AMP-binding proteins. The granules of several endocrine cells (pituitary, pancreatic islet, intestinal) also labeled with RII antibody. Double labeling of ovarian granulosa cells showed that both RI and C were present in the nuclei and cytoplasm. The localization of cAPK subunits revealed by postembedding immunogold labeling is consistent with the postulated regulatory functions of these proteins in gene expression, cell proliferation, exocytosis, and various metabolic events The widespread occurrence of cAPK subunits in secretory granules and their release to the extracellular environment suggests that they play an important role in secretory cell function. PMID- 2773814 TI - Use of colloidal gold in diagnostic surgical pathology. AB - Colloidal gold immuno-electron microscopy is a powerful tool for defining antigenicity at the subcellular level. Such studies permit correlation with cell fractionation studies. They also allow one to assess the specificity of a particular antibody. The most useful reagent for immuno-electron microscopy is colloidal gold stabilized by a binding protein, either staphylococcal protein A or immunoglobulin. This method permits highly discrete labeling, and the system is useful for most antibodies used in diagnostic pathology. PMID- 2773815 TI - Immunogold-labeled microtubule crossbridges in platinum-carbon replicas of the marginal band of erythrocyte cytoskeletons. AB - Cytoskeletons of erythrocytes from the toad Bufo marinus are composed of a surface-associated cytoskeleton that encapsulates the annular bundle of microtubules known as the marginal band (MB) and the centrally located nucleus. As seen by phase-contrast microscopy, the microtubules (MTs) of the MB remain tightly bundled after cell lysis without the need for added stabilizing factors. The integrity of this structure suggested that in addition to MTs other components were present in the MB and were responsible for its stability. Thin (less than 18 nm) platinum-carbon (Pt-C) replicas of freeze-dried cytoskeletons prepared by using a modified Balzers 300 system provided a novel method of sample preparation for a high-resolution study of the ultrastructure of the MB. Electron micrographs of replicas revealed that, the MTs of the MB displayed numerous filamentous projections which, when viewed in stereo, appear as side-arm connections between adjacent MTs. Immunofluorescence data show that monospecific antibodies to tubulin and to MT-associated protein 2 (MAP2) from brain each detect cross-reactive material in the MB. The combination of immunogold cytochemistry with Pt-C replication provided the increased resolution required to identify the individual structures recognized by antibodies to tubulin and MAP2. As expected, antitubulin labeled the MTs of the MB. However, anti-MAP2 antibodies were localized specifically to the cross-bridging filaments between adjacent MTs. Thus, a MAP2-like protein was identified in situ as the crossbridging filament that bundles MTs to form a stable MB. PMID- 2773817 TI - Hypnotizability testing and clinical hypnosis. PMID- 2773816 TI - A validation study of a short-form hypnotic-experience questionnaire and its relationship to hypnotizability. AB - This study investigated the validity of a 16-item scale inquiring about hypnotic experience, drawn from the Hypnotic Experience Questionnaire developed by Kelly (1985) to measure components of hypnotic experience. We administered the HEQ-S and the Harvard Group Scale of Hypnotic Susceptibility: Form A (HGSHS:A) to 198 students. Factor analysis of the scale produced three stable principal components accounting for 70% of the data variance: Dissociation/Altered State (DAS), Rapport (RAP), and Relaxation (REL). Subscales representing these three factors and a composite measure, "General Depth," were constructed. Subscale correlations with HGSHS:A scores were highest for the DAS subscale (.69) and lowest for REL (.41). Applications of the HEQ-S in clinical and research use are considered. PMID- 2773818 TI - Suggested posthypnotic amnesia in four diagnostic groups of hospitalized psychiatric patients. AB - We studied the parameters of suggested posthypnotic amnesia (initial deficit in recall, reversibility, and temporal disorganization of the initial material partially recalled during amnesia) in 132 psychiatric inpatients with DSM-III diagnoses of schizophrenia (N = 25), eating disorders (N = 77), alcoholism (N = 12), and major affective disorder (depression) (N = 18). We compared the findings on these patients with normal student control groups on the Stanford Hypnotic Susceptibility Scale (SHSS:C) posthypnotic suggestion item. In general, the small patient subgroups showed posthypnotic amnesia on each of these criteria in similar fashion to normal student populations. Highly hypnotizable patients were more likely to recall their hypnotic experiences in a more random order than the temporally more accurate sequence shown by low-hypnotizable subjects. Schizophrenic patients initially recalled fewer of their hypnotic experiences (indicating some cognitive deficit), and eating disorder patients initially recalled more of their experiences than other patient groups or normal subjects. Nevertheless, all patient subgroups showed significant additional recall after the reversibility cue. The results support the robustness of posthypnotic amnesia in psychiatric patients. PMID- 2773819 TI - Hypnotic treatment of Sleep Terror Disorder: a case report. AB - This case report describes the hypnotic treatment of Sleep Terror Disorder in a 16-year-old male who was resistant to other forms of treatment. In this patient, night terrors seemed to be precipitated by nocturnal noises wakening him from deep sleep. Posthypnotic suggestions reducing awareness of nocturnal sensory stimulation successfully eliminated his night terrors. PMID- 2773820 TI - Clinical uses of measures of hypnotizability. AB - At a teaching workshop, 45 experienced hypnotherapists were queried regarding their use of tests of hypnotizability; of these, 82% completed the questionnaire. Of those who completed the questionnaire, 30% currently use these tests, and 24% have abandoned their use. Eight percent of the total currently routinely perform a standardized test with their patients. Most respondents considered tests to be clinically inappropriate for a variety of reasons. Implications of these findings are discussed. PMID- 2773821 TI - An indirect method of discovering primary traumatic experiences: two case examples. AB - Our primitive brain has the capacity to recall visual, auditory, olfactory, tactual, and postural memories. Consciously we all set limitations on our abilities to recall. The technique described here suggests that all of us can recall meaningful sensory experiences with the help of multiple subconscious reviews of an event. We are aware of moods unconsciously and can assign colors to these moods. The unconscious mind can localize the true site of pain even when the patient is consciously sure the pain is localized elsewhere. The methods of exploration are described, and possible values of the methods are pointed out. PMID- 2773822 TI - Fat-free mass in children and young adults predicted from bioelectric impedance and anthropometric variables. AB - Fat-free mass (FFM) values calculated from densitometry by using a multicomponent model were significantly (p less than 0.05) larger than those from the Siri two component model (465 males, 441 females), especially in children and females. The multicomponent model assumes the density of FFM varies by age and sex because of differences in its constituents. With FFM values from the multicomponent model as the dependent variable and impedance and anthropometry as the independent variables, prediction equations were derived by all possible subsets of regression (140 males, 110 females). These equations had RMSEs of 2.2-2.3 kg and CVs of 5.0-5.8%. Cross-validation results were excellent for young adults but less satisfactory for children for whom a different calf skinfold had been measured. The selected equations are applicable to healthy white individuals aged 7-25 y. PMID- 2773824 TI - Sources of variation in energy intake by men and women as determined from one year's daily dietary records. AB - Data from a year-long study conducted by the US Department of Agriculture's Beltsville Human Nutrition Research Center were used to identify sources of variation in daily energy intakes. A specific hypothesis was that an inverse relationship exists between past body weight and future energy intake whereas a direct relationship exists between past energy intake and future weight. Daily energy intakes of 29 male (n = 13) and female (n = 16) adult subjects were related through linear-regression analysis to sex (+ for males), age (-), height (+), weight (- for past and present measurements, + for future measurement), data collection method (- for duplicate plate), day of week (+ for Friday and Saturday), and month (+ for May, July, August, December, and January). These relationships were statistically significant (p less than 0.05). The results confirmed the hypothesis and were in general agreement with previously published studies that used larger samples but fewer days of data. PMID- 2773823 TI - Magnitude of body-cell-mass depletion and the timing of death from wasting in AIDS. AB - The impact of malnutrition on survival in AIDS was evaluated by examining the magnitude of body-cell-mass depletion as a function of time from death. Body cell mass was estimated as total body-potassium content and determined by whole-body counting. There was progressive depletion of body cell mass as patients neared death. The extrapolated and observed values for body cell mass at death were 54% of normal. Body weight had a similar relationship to death, with a projected body weight at death of 66% of ideal. We conclude that death from wasting in AIDS is related to the magnitude of tissue depletion and is independent of the underlying cause of wasting. The degree of wasting seen in this study is similar to historical reports of semistarvation, with or without associated infections. This observation suggests that successful attempts to maintain body mass could prolong survival in patients with AIDS. PMID- 2773825 TI - Nutrient intake and nitrogen metabolism in cancer patients during oncological chemotherapy. AB - Aggressive oncological chemotherapy often impairs the nutritional status of tumor patients. To evaluate the pathogenetic mechanisms, food intake in 13 cancer patients was investigated in correlation with nitrogen losses, N balances, muscle wasting, and weight course, during cytostatic therapy. Median daily N and energy intakes were reduced only in patients with weight loss [0.55 g protein, 16.5 kcal/kg ideal body wt (IBW)]. Patients with constant weight had the same intake as control subjects (1.27 g protein, 37.2 kcal IBW). N balances and creatinine height index (CHI) correlated with daily nutrient intake. Fecal N excretions did not correlate with urinary losses; there was no excess of fecal N loss because of cytostatic treatment. The impairment of cancer patients' nutritional status seems to depend primarily on the decrease of spontaneous oral intake as a consequence of the side effects of tumor therapy. Changes in CHI, compared before and after chemotherapy, indicated muscle wasting of weight-losing patients. PMID- 2773826 TI - Estimation of body fat in healthy Swedish women during pregnancy and lactation. AB - Reliable estimates of changes in body fat are important in studies of energy requirements during human reproduction. It is not known if current methods for the estimation of total body fat (TBF) are adequate for this purpose. In this paper earlier reported data from 29 women are used to show how methodology affects estimates of changes in TBF during reproduction. Skinfold thicknesses are also reported and equations relating these measurements to TBF were developed and used to demonstrate how well the skinfold technique could estimate such changes. No correlation was found between changes in body weight and body fat during early pregnancy or between the maternal changes in body weight and body fat over the complete pregnancy. These findings are tentatively explained by changes in the degree of hydration of the body. PMID- 2773827 TI - Biotin nutritional status of vegans, lactoovovegetarians, and nonvegetarians. AB - Urinary excretion of biotin (total avidin-binding substances) was measured in adults and children who were adhering to one of the following self-selected diets: strict vegetarian (vegan), lactoovovegetarian, or mixed (containing meat and dairy products as well as plant-derived foods). In a subset of subjects, plasma biotin concentrations were also measured. In adults the biotin excretion rate was significantly greater in the vegan group than in either the lactoovovegetarian or the mixed-diet groups; the latter were not significantly different from one another. In children the biotin excretion rates in both the vegan group and the lactoovovegetarin group were significantly greater than in the mixed-diet group. A similar trend (vegan greater than lactoovovegetarian greater than mixed) was detected in the plasma concentrations of biotin of adults and children but differences were not generally statistically significant. These observations provide evidence that the biotin nutritional status of vegans is not impaired. PMID- 2773829 TI - Normal vitamin E status in sickle hemoglobinopathies in Colorado. AB - Because previous studies of serum or plasma vitamin E (E) levels reported a high prevalence of E deficiency in patients with sickle cell anemia (SCA), we studied the E status in 101 patients with SCA in Colorado using both levels of serum E and ratios of serum E to total lipid (E:L). Compared with age-, sex-, and race matched controls, 1 of 70 patients with homozygous SCA (SS), 1 of 7 with sickle beta+-thalassemia, and 0 of 24 with hemoglobin SC disease had E deficiency according to E:L and all were E-sufficient based on serum E levels. Serum cholesterol levels, lower in SS patients than in control subjects, correlated more strongly with serum E levels than did total serum lipid levels in control subjects and SS patients; hence, the ratio of serum E to cholesterol may be a useful indicator of E status in these patients. We conclude that vitamin E deficiency rarely occurs in SCA patients in Colorado. PMID- 2773828 TI - Serum alpha-tocopherol levels of Mexican Americans, Cubans, and Puerto Ricans aged 4-74 y. AB - Data from the Hispanic Health and Nutrition Examination Survey were used to examine serum alpha-tocopherol levels (in subjects aged 4-74 y) and ratios of alpha-tocopherol to cholesterol plus triglyceride and to cholesterol (in subjects aged 20-74 y) of Mexican Americans (MA), Cubans, and Puerto Ricans (PR). Neither alpha-tocopherol nor the alpha-tocopherol-lipid ratios differed between sexes. PR had lower mean alpha-tocopherol and alpha-tocopherol-lipid ratios and higher prevalences of alpha-tocopherol less than 11.6 mumol/L than did MA or Cubans in several age groups. MA and Cuban adolescents had lower alpha-tocopherol levels than children had. Mean alpha-tocopherol levels and alpha-tocopherol-lipid ratios increased and prevalences of alpha-tocopherol less than 11.6 mumol/L decreased during adulthood in all three ethnic groups. PMID- 2773830 TI - Folate intake and food sources in the US population. AB - Dietary data from 24-h recalls collected in the Second National Health and Nutrition Examination Survey (NHANES II) were analyzed to determine intake and food sources of folate in US adults between ages 19 and 74 y. Mean daily folate intake was 242 +/- 2.8 micrograms (means +/- SEM) for all adults, 281 +/- 3.6 micrograms for males, and 207 +/- 2.9 micrograms for females. Daily intake per 1000 kcal was 130 +/- 1.3 micrograms for all adults 122 +/- 1.3 micrograms for males, and 137 +/- 1.7 micrograms for females. Based on the Recommended Dietary Allowance of 400 micrograms/d, our results suggest that folate intake in the United States is low, particularly among women and blacks. Intake by age, education, and poverty index is discussed. Orange juice, white breads, dried beans, green salad, and ready-to-eat breakfast cereals are the major food sources of folate on a given day, contributing 37% of total folate intake. PMID- 2773831 TI - Bone mineral content in postmenopausal women: comparison of omnivores and vegetarians. AB - This cross-sectional study of bone mineral content (BMC)/bone width (BW) (BMC/BW, cortical radius) was conducted in elderly, free-living Methodist omnivores (n = 146) and Seventh-day Adventist vegetarians (n = 144) in southern California. The purpose was to investigate relationships between BMC/BW and dietary factors (primarily vegetarianism and intakes of protein and calcium) and use of prescribed drugs. BMC was measured by single-photon absorptiometry. Dietary intakes during current and early periods of life were assessed by 24-h dietary recall and frequency methods. Information about drug use was obtained by interview. BMC/BW was not different in omnivores vs vegetarians. There were no significant relationships or trends between current or early dietary intakes and BMC/BW in either group. In multiple-regression analysis, age, weight, and use of estrogen and thiazide diuretics were predictive of 31% of the variability in BMC/BW in the total group. PMID- 2773832 TI - Effect of dietary cholesterol in normolipidemic subjects is not modified by nature and amount of dietary fat. AB - A double-blind, cross-over study of the effects of adding cholesterol to the diet, equal to about two egg yolks daily, was carried out in 25 men with an average plasma cholesterol of 5.3 mmol/L. There were no significant elevations in the mean plasma concentrations of cholesterol, low-density-lipoprotein cholesterol, or apolipoprotein B. The absence of an effect was seen against two background diets, one high in saturated fatty acids and the other modified in fat content and in fatty acid composition. Although the mean high-density-lipoprotein (HDL) cholesterol concentration did not change, the proportion of HDL2 particles (radius greater than 4.4 nm) increased significantly, especially in subjects who did not show a rise in plasma cholesterol; this may represent a means of clearing dietary cholesterol. The results suggest that reducing dietary cholesterol might be emphasized for hypercholesterolemic subjects rather than for the population generally. PMID- 2773833 TI - Acute effects of nicotine on resting metabolic rate in cigarette smokers. AB - The acute effects of nicotine on resting metabolic rate (RMR) were examined to identify a mechanism that may help explain the inverse association between smoking and body weight. Multiple administrations of two nicotine doses (moderate [15 micrograms/kg body wt] and low [7.5 micrograms/kg body wt]) and a placebo (0 micrograms) were presented to 18 male smokers via nasal-spray solution on three separate occasions while RMR was assessed by computerized open-circuit indirect calorimetry. Plasma nicotine levels confirmed the reliability of dosing. RMR increases of 6% above base line after both moderate and low doses were significantly greater than the 3% increase after the placebo. Subsequent examination of the effects of smoking a nonnicotine cigarette suggested that the small placebo effect was due to acute metabolic consequences of inhalation. These results confirm that intake of nicotine, isolated from tobacco smoke, significantly increases RMR in humans. However, the results also indicate that non-pharmacological, behavioral aspects of smoking may also contribute to acutely increasing RMR in smokers. PMID- 2773834 TI - Nutritional factors associated with benign breast disease etiology: a case control study. AB - Between 1977 and 1980, 854 biopsied cases of benign breast disease (BBD) and 755 matched surgical and 723 matched neighborhood controls subjects were interviewed in Israel by using a detailed food frequency questionnaire. Cases were classified according to degree of ductal atypia (Black-Chablon grading system). Women with atypic lesions (grades greater than or equal to 3) reported a higher intake of all types of foods compared with both control series. Further analyses indicated that the increased consumption was due primarily to foods containing greater than or equal to 10% fat. Odds ratios associated with the highest fat consumption quartile were close to 3.0. There was a trend for increasing saturated fatty acid consumption with increasing ductal atypica. After adjusting for hormonal and demographic confounders, the association with fat intake was strengthened. Because atypic BBD has been reported to be a precursor of breast cancer, our findings lend support to the hypothesis that dietary fat is a risk factor for breast cancer. PMID- 2773835 TI - Use of animal studies in predicting human bioavailability. PMID- 2773836 TI - Training in clinical nutrition programs. PMID- 2773837 TI - International Conference on Iron deficiency and Behavioral Development. Proceedings. Geneva, October 10-12, 1988. PMID- 2773838 TI - Iron deficiency and behavior: criteria for testing causality. AB - The association between iron deficiency and poor behavioral-test performance is well established. The question of causality, however, remains unanswered. This paper presents the essential criteria for a valid test of causality. Internal validity is examined in terms of positive and negative findings. Plausibility of the findings requires analyzing the congruency of the results; for example, those who respond to the iron treatment are also those who respond behaviorally. External validity describes the extent to which inferences may be made about other populations or circumstances. PMID- 2773839 TI - Search for nutritional confounding factors in the relationship between iron deficiency and brain function. AB - This paper on confounding factors in the relationship between iron deficiency and brain function is mainly limited to nutritional factors, primarily factors that can contribute to the development of iron deficiency and that may have an independent direct action on brain function. Three theoretically possible confounders were found in a systematic search for dietary factors: 1) low intake of ascorbic acid, 2) excess of phytates, and 3) increased absorption of lead. Ascorbic acid has a marked effect on the bioavailability of dietary iron and is also known to directly influence various metabolic processes in the brain. Phytates inhibit the absorption not only of iron but also of zinc. An iron deficiency may thus be accompanied by a zinc deficiency which may affect mental performance. A state of iron deficiency may increase the absorption of lead from the diet, which in turn may affect brain function. PMID- 2773840 TI - Putative biological mechanisms of the effect of iron deficiency on brain biochemistry and behavior. AB - An animal model of nutritional iron deficiency (ID) is described that demonstrates a reduction of brain nonheme iron. The most prominent feature of ID is the significant and selective diminution of central dopamine neurotransmission resulting from the decreased number of dopamine D2 receptors in the caudate nucleus, nucleus accumbens, pituitary, and in all probability the frontal cortex. The consequences of diminished dopaminergic neurotransmission is a modification of dopamine-dependent behaviors and biochemical reactions, the most important of which is the reduction in learning processes. The role of iron in maintaining the homeostasis of normally functioning dopamine neurons and their involvement in cognitive processes cannot be excluded. An interference with iron metabolism at an early age can result in irreversible damage to developing dopamine neurons, with consequences that may manifest themselves in adult life. PMID- 2773842 TI - Methodologic issues in studying behavioral effects of infant iron-deficiency anemia. AB - Methodologic challenges proving that iron-deficiency anemia (IDA) adversely affects infant behavior and development are examined. This community-based study in Costa Rica included 191 infants aged 12-23 mo with varying degrees of iron deficiency. The Bayley Scales of Infant Development were administered before and both 1 wk and 3 mo after intramuscular or oral administration of iron. Appropriate placebo-treatment control infants were also tested. Infants with IDA showed significantly lower mental and motor test scores, even after factors relating to birth, nutrition, family background, parental IQ, and the home environment were considered. The methodologic issues raised by the study point to the need to assess behavioral effects in a prospective, randomized trial of measures to prevent iron-deficiency anemia in infancy. PMID- 2773843 TI - Infancy: mental and motor development. AB - In a prospective cohort study of 196 infants from birth to age 15 mo, the relationship of iron status to psychomotor development, the effect of a short term trial of oral iron or placebo, and the effect of longer-term oral iron therapy was assessed. Development was assessed with the Bayley Scale of Infant Development in anemic, nonanemic, iron-deficient, and control children. Anemic infants had significantly lower indices than did control or nonanemic, iron deficient infants. Control infants and nonanemic, iron-deficient infants performed comparably. No difference between the effect of oral administration of iron or placebo was noted after 10 d or 3 mo of iron therapy. A hemoglobin concentration of less than 105 g/L and anemia duration greater than 3 mo were correlated with significantly lower motor and mental scores, suggesting that when iron deficiency progresses to anemia, adverse influences in the performance of developmental tests appear and persist, despite iron therapy. PMID- 2773841 TI - Behavioral effects of iron supplementation in infants in Madang, Papua New Guinea. AB - The effect of iron supplementation on attending behavior of 96 1-y-old infants was assessed in a double-blind, randomized, controlled trial of iron dextran in Papua New Guinea. The treatment group received an injection of iron dextran at 2 mo; the controls received a placebo injection. Because many children had malarial parasitemia at testing, presence of malaria was used in the analysis. A significant interaction was found between iron and malaria infection on total fixation time: iron-supplemented groups and placebo-treated parasitemic children showed significantly higher total fixation scores than did placebo-treated aparasitemic children. Blood analysis of iron status showed similar results, with lowest iron status evident in the placebo-treated aparasitemic group. There was no effect of treatment on rate of habituation or dishabituation. Supplemental iron treatment has a significant effect on attention but the direction of the effect depends on the presence of malaria infection. PMID- 2773844 TI - Effects of iron deficiency on attention and learning processes in preschool children: Bandung, Indonesia. AB - A double-blind clinical trial was conducted in Indonesia to assess effects of iron supplementation on performance of iron-depleted and iron-deficient anemic children in discrimination and oddity learning tasks. Half these children received elemental Fe for 8 wk; the others received a placebo. There were significant changes from pre- to postintervention evaluations in ferritin, transferrin saturation, free erythrocyte protoporphyrin, and hemoglobin among the anemic and iron-depleted children; no changes were observed among the placebos or any of the iron-replete children. The magnitude of hematological changes in anemic children treated with iron was small; yet, after treatment the children's mean ferritin, transferrin saturation, and hemoglobin values were above the cutoff points used for the definition of iron-deficiency anemia (IDA). Pre- and posttreatment psychological test data show that IDA produces alterations in cognitive processes related to visual attention and concept acquisition, alterations reversed with iron treatment. PMID- 2773845 TI - Impact of iron supplementation on cognitive functions in preschool and school aged children: the Indian experience. AB - Four studies examined impacts of iron supplementation on school children of various ages and both sexes. The first study investigated impact of iron-folic acid supplements for 60 d on cognition in 94 boys and girls aged 5-8 y. Improvement in total scores of the anemics was significantly higher than the nonanemics in 7-8-y-old children only. The second study assessed impacts of supplementation on cognition in 14 pairs of 5-6-y-old anemic boys, with clear beneficial effects on cognitive function. The third study investigated effects of varying dosages of elemental iron on cognitive function in 48 boys aged 8-15 y, with different levels of improvement. The fourth study investigated impacts of iron supplementation on 163 anemic girls aged 8-15 y with treatment and evaluations at 4 and 8 mo, with significantly improved scores in cognitive function after the eighth month. PMID- 2773846 TI - Iron deficiency and educational achievement in Thailand. AB - This double-blind clinical trial was conducted in Thailand to assess the impact of iron treatment on the IQ and educational attainment of 1358 9-11-y-old children. The children were classified into one of three groups: iron replete, iron depleted, and iron-deficient anemic. The Raven Progressive Matrices was used to measure IQ. A Thai language and a math test were administered to assess school attainment. A 50-mg/d tablet of ferrous sulphate was given for 2 wk and a 100 mg/d tablet, for 14 wk. An anthelminthic drug was given on the day of the blood test before treatment and 3 mo after the intervention started. There is evidence of a positive association between iron status and IQ and a language school achievement test but there is no support for the internal validity of the hypothesis that this association is causal. PMID- 2773847 TI - Preliminary findings on iron supplementation and learning achievement of rural Indonesian children. AB - The effects of oral iron supplementation on blood iron levels and learning achievement in 130 rural Indonesian school children were assessed in this double blind study. The children were classified into anemic and nonanemic groups according to their initial hemoglobin and transferrin saturation levels and were randomly assigned to either iron or placebo treatment for 3 mo. Hematological, anthropometric, and learning-achievement data were collected before (T1) and after (T2) the treatment period and 3 mo later. The means and standard deviations suggest that supplementation with 10 mg ferrous sulfate per kilogram body weight per day for 3 mo resulted in an apparent improvement in anemic subjects' hematological status and learning-achievement scores. No tests of statistical comparisons are reported. PMID- 2773848 TI - DNA ploidy profiles as prognostic indicators in CIN lesions. AB - The prognostic significance of DNA ploidy measurements in cervical tissues was examined. Microphotometric measurements of 302 Feulgen-stained tissue sections (91 normal squamous epithelia, 14 condylomata, 29 cervical intraepithelial neoplasia (CIN) I, 78 CIN II, and 90 CIN III) were performed with a personal computer (PC)-based video microphotometry system. Analysis of these data shows that the DNA profile provides significant prognostic information: CINs with a polyploid DNA profile are more likely to return to normal than are those exhibiting an aneuploid pattern. Of 211 abnormal cases, 38% had polyploid DNA profiles and 62% were aneuploid. Eight-six percent of the cases that regressed were polyploid and 14% were aneuploid. Of the 130 aneuploid DNA cases, 95% remained static or progressed and only 5% regressed. Of these nonregressing aneuploid lesions, 90 remained static and 34 progressed, whereas within the nonregressing polyploid group 37 remained static and only 6 progressed. This result holds across diagnostic categories. Several other ploidy-related descriptors also showed prognostic significance (including mean ploidy, the 5N exceeding rate and 2N deviation index, and discriminant functions derived from order statistic analysis of the cumulative DNA histograms), but not to the degree or with the consistency of expression as the DNA profile categorization. These results indicate that important information about the prognosis of CIN lesions may be obtained by the DNA profile on Feulgen-stained tissue specimens. The data were acquired by a cytophotometry system of relatively modest cost consisting of readily available hardware components. PMID- 2773849 TI - Evaluation of 24-second cyanide-containing and cyanide-free methods for whole blood hemoglobin on the Technicon H*1TM analyzer with normal and abnormal blood samples. AB - Automated methods, with and without cyanide (+CN and -CN), for whole blood hemoglobin (Hb) determination were evaluated on the Technicon H*1TM System. Both automated Hb methods were linear over the range 0-250 g/L (0-25 g/dL) and correlated well with the International Committee for Standardization of Hematology (ICSH) reference method and with the Coulter S+II. Both methods quantitatively converted whole blood containing up to 100% carboxyhemoglobin in less than 24 seconds to their respective end products. With respect to abnormal samples (sickle cell anemia, multiple myeloma, and hyperlipemia), both H*1 methods gave Hb results that were equivalent to the (postfiltration) ICSH method. For samples with white blood cell (WBC) counts less than 36 X 10(9)/L, the +CN method was equivalent to the (postfiltration) ICSH method, whereas for WBC counts greater than 20 X 10(9)/L, the -CN method showed acceptable recovery of the mean but unacceptable imprecision. For WBC counts of 36-164 X 10(9)/L, the +CN method yielded acceptable Hb recovery with unacceptable imprecision. Hyperlipemia, resulting from addition of Intralipid directly to the blood samples, caused large errors in both H*1 methods. PMID- 2773850 TI - Analytic inaccuracy resulting from hematology specimen characteristics. Three cases of clinically misleading artifacts affecting white blood cell and platelet counts. AB - Sporadically, hematology analyzers generate grossly erroneous results for one or several parameters of the complete blood count (CBC) because of a characteristic or peculiarity of an individual patient specimen. This article presents three cases of relatively less well-known analytic errors of this sort, falsely elevating white blood cell count and platelet count and decreasing total white blood cell count, as determined on a Coulter Aperture Impedence Analyzer. The type of alteration in the CBC parameters and the instrument histogram abnormalities seen in each of these different types of analytic inaccuracy are discussed. PMID- 2773852 TI - Prenatal diagnosis of sickle cell anemia. Hemoglobin electrophoresis versus DNA analysis. AB - The prenatal diagnosis of sickle cell anemia (hemoglobin SS) can be established by DNA analysis using two highly sensitive techniques (Southern blot and polymerase chain reaction [PCR]). Hemoglobin electrophoresis provides a third, simpler and more rapid, technique to analyze blood from a fetus at risk for sickle cell anemia. The authors present examples of prenatal diagnostic studies using both DNA analysis techniques and hemoglobin electrophoresis. Hemoglobin electrophoresis of fetal hemolysate can provide a simple and rapid alternative method to PCR analysis for the prenatal exclusion of sickle cell anemia, and it is especially useful in cases in which rapid results are needed because of advanced gestational age. PMID- 2773851 TI - Comparison of two automated coagulometers and the manual tilt-tube method for the determination of prothrombin time. AB - Two automatic coagulometers--ACL 810 (Instrumentation Laboratory), a laser nephelometric centrifugal analyzer, and KoaguLab 40 A (Ortho Diagnostics), an optical automatic coagulometer--were compared with the manual tilt-tube method for the performance of prothrombin time (PT). Seven ISI- (International Sensitivity Index) calibrated commercial thromboplastin reagents were used for duplicate determinations in 30 normal subjects, 30 patients with liver disease, and 30 patients receiving stabilized oral anticoagulation. Clotting times were longer with the manual method than with ACL 810 and, to a lesser extent, with KoaguLab 40 A. Average imprecision of duplicate determinations (CV) was less than 1% with ACL 810; KoaguLab 40 A and the manual method had similarly higher imprecisions (2.8% and 2.7%). Differences in origin and slope of the regression curves of clotting times obtained with the coagulometers over the tilt-tube method were observed with all the reagents tested. Transformation of clotting times to PT ratios did not eliminate the bias resulting from the different clot detection methods. A higher percentage of patients with liver disease had abnormal PT ratios when their plasma was tested with the coagulometers than with the manual method. Transformation of PT ratios to International Normalized Ratios effectively eliminated the bias resulting from the different thromboplastin reagents but had no effect on the bias resulting from the different clot detection methods. A significant proportion of patients appeared excessively anticoagulated (INR greater than 4.5) with the coagulometers but not with the manual method. These results highlight the need for standardization of both instrumentations and reagents to improve monitoring of oral anticoagulant treatment. PMID- 2773853 TI - Hepatic vein thrombosis (Budd-Chiari syndrome) in the microgranular variant of acute promyelocytic leukemia. AB - The microgranular form of acute promyelocytic leukemia (APL) was described in the late 1970s and adopted by the French, American, and British classification system in the early 1980s. Morphologically, this form shows distinct differences from the classic form of APL, but clinically it shares many of the same traits. Among these is the predilection for coagulopathies, including disseminated intravascular coagulation (DIC). This DIC has been associated with one previously reported case of fatal hepatic vein thrombosis (Budd-Chiari syndrome), in association with an untreated case of APL. The authors present a case of the microgranular variant of acute promyelocytic leukemia (FAB-M3V), with autopsy and electron microscopic evidence in support. It is important to recognize this variant form of APL and its association with hepatic vein thrombosis, because any successful attempt at therapy must be instituted early in the course of the disease. PMID- 2773854 TI - Placental teratoma. AB - Teratomas of the placenta are rare tumors. A case arising in a term placenta is reported, past cases are reviewed, and possible mechanisms of pathogenesis are reviewed. PMID- 2773855 TI - The clinical relevance of plasminogen activator assays. PMID- 2773856 TI - Eliminating some possible errors in phenylketonuria screening. PMID- 2773857 TI - Avoiding sources of error in PKU screening. PMID- 2773858 TI - Campylobacter pylori and other urease positive bacteria in gastric biopsies. PMID- 2773859 TI - Turnaround times. PMID- 2773860 TI - The timing of major life events: effects of departing from the social clock. AB - It is widely believed that social norms govern the timing of major life events, such that events experienced off time are considerably more stressful than events experienced on time. Experiencing life events either earlier or later than one's peers presumably reduces opportunities for social support and may also invite social disapproval. Relatively few empirical studies have investigated these ideas, however, and those that have suffer from several limitations. The present study made use of a general population survey to investigate the effects of normative versus nonnormative timing of major life events on psychological functioning, interpersonal resources, and interpersonal tensions. Desirable and undesirable events were examined separately, as were the effects of departures from perceived versus statistical age norms. The results of the study offered only limited support for social clock theory. Implications for further research and for the relevance of the theory in a less age-differentiated society are discussed. PMID- 2773861 TI - Orthopedic and orthodontic effects resulting from the use of a functional appliance with different amounts of protrusive activation. AB - A functional appliance worn full-time was given to 50 consecutively treated girls aged 8 1/2 to 14 years. These patients were divided into three groups: in 14 patients, protrusive activation was maintained at 1 mm; in another 14 patients, it was maintained at 3 mm; and in 22 patients, there was an initial, large single advancement averaging 5 to 6 mm. These amounts of protrusion were checked and maintained every 2 months. Analysis of the data, using control patients matched for age and sex, indicated that there was no difference in either orthopedic or orthodontic variables between the 3 mm continuous-advancement group and the single large-advancement group. The 1 mm continuous-advancement group showed a diminished but still statistically significant response. Assuming linearity, it was calculated that, had the 1 mm activation group been treated long enough to have obtained the mandibular orthopedic effects of the other two groups, the orthodontic changes also would have been comparable. PMID- 2773862 TI - Periodontal implications of orthodontic treatment in adults with reduced or normal periodontal tissues versus those of adolescents. AB - This longitudinal study monitored periodontal status in 20 adults and 20 adolescents undergoing fixed orthodontic treatment. Ten adults had generalized periodontitis and received periodontal treatment, including periodontal surgery, before orthodontic treatment. They also received periodontal maintenance at 3 month intervals during orthodontic treatment. The other 10 adults had normal periodontal tissues. Neither these latter adults nor the adolescents received periodontal maintenance during orthodontic treatment. Periodontal status was determined (1) at six standard sites before fixed appliances were placed (baseline), (2) at 1, 3, 6, 9, 12, and 18 months after appliances had been placed, and (3) 1, 3, 6, and 12 months after appliances had been removed. At each of these visits, these sites were assessed for plaque index, gingival index, bleeding tendency, and pocket depth. Loss of attachment between baseline and 3 months after appliances were removed and tooth loss were also determined. Complete data were obtained for 15 adolescents and 14 adults. During orthodontic treatment the adolescent group showed significantly more (p less than 0.05) periodontal inflammation and supragingival plaque than the adults; after appliances were removed, this pattern was no longer statistically significant. For loss of attachment, there were no significant differences among adolescents, adults with normal periodontal tissues, or adults with reduced but healthy periodontal tissues who had undergone treatment for periodontal disease. For tooth loss, three nonstudy site teeth with pockets deeper than 6 mm and/or furcation involvements were lost because of periodontal abscesses in the adult group treated for periodontal disease. PMID- 2773863 TI - Orthodontic fusion. PMID- 2773864 TI - Quo vadis? PMID- 2773865 TI - Oral hygiene program for orthodontic patients. AB - The gingival and periodontal health of 62 adolescent orthodontic patients was assessed before and again after orthodontic treatment in a controlled clinical study. Before the commencement of orthodontic treatment, the experimental group received an oral hygiene program consisting of 4 weekly sessions of oral health education, instruction on plaque-control techniques and reviews in plaque removal performance. The control group did not receive this program. It was found that there was a general trend in the study population for improved gingival health as measured by the bleeding index, gingival index, plaque index and gingival crevicular fluid volume. Furthermore, the oral hygiene program induced in the experimental group significantly lower scores in the measured clinical indices compared to the control group. However, no significant difference was noted in the measured probing depths in all subjects before or after the study period. PMID- 2773866 TI - Veristic reporting. PMID- 2773867 TI - Orthognathic surgery. PMID- 2773868 TI - Tooth extrusion effects on microvessel volumes, endothelial areas, and fenestrae in molar apical periodontal ligament. AB - Extrusive tooth loads, simulating short-term orthodontic movements, have not previously been used for transmission electron microscopic quantification of their effects on the periodontal ligament vessels. In this study, a continuous extrusive load of 1.0 N, applied to the rat maxillary first molar for 30 minutes, produced statistically significant changes in the microvascular bed of the tensioned apical periodontal ligament. The mean vascular volume, as a percentage of apical periodontal ligament volume, increased (p less than 0.01) in postcapillary-sized venules, venous capillaries, arterial capillaries, and terminal arterioles from 16.6% to 22.3%, 2.0% to 2.7%, 0.4% to 1.0%, and 1.0% to 2.5%, respectively. Mean endothelial surface area per cubic millimeter of apical periodontal ligament tissue increased (p less than 0.01) in postcapillary-sized venules from 16.8 to 25.7 x 10(6) microns 2/mm3, in venous capillaries from 3.0 to 4.8 x 10(6) microns 2/mm3, and in arterial capillaries from 0.7 to 1.5 x 10(6) microns 2/mm3. The number of fenestrae per square micron of endothelium in postcapillary-sized venules, venous capillaries, and arterial capillaries showed a mean increase from 0.02 to 0.07, 0.11 to 0.31, and 0.02 to 0.21 fenestrae/microns 2, respectively (p less than 0.01). Fenestrae per cubic millimeter of periodontal ligament tissue also demonstrated a statistically significant increase with extrusion (p less than 0.01) in postcapillary-sized venules from 0.37 to 1.55 x 10(6) fenestrae/mm3, in venous capillaries from 0.27 to 1.34 x 10(6) fenestrae/mm3, and in arterial capillaries from 0.02 to 0.22 x 10(6) fenestrae/mm3. Fenestrae in control vessels had a mean diameter of 54.2 +/- 0.56 nm (SE) compared with 61.1 +/- 0.7 nm in tensioned vessels (p less than 0.01). This investigation demonstrates multiple ultrastructural changes in the periodontal ligament microvascular bed after tooth extrusion. PMID- 2773869 TI - Intrusion of incisors in adult patients with marginal bone loss. AB - Elongated and spaced incisors are common problems in patients suffering from severe periodontal disease. Thirty patients characterized by marginal bone loss and deep overbite were treated by intrusion of incisors. Three different methods for intrusion were applied: (1) J hooks and extraoral high-pull headgear, (2) utility arches, (3) intrusion bent into a loop in a 0.17 x 0.25-inch wire, and (4) base arch as described by Burstone. The intrusion was evaluated from the displacement of the apex, incision, and the center of resistance of the most prominent or elongated central incisor. Change in the marginal bone level and the amount of root resorption were evaluated on standardized intraoral radiographs. The pockets were assessed by standardized probing and the clinical crown length was measured on study casts. The results showed that the true intrusion of the center of resistance varied from 0 to 3.5 mm and was most pronounced when intrusion was performed with a base arch. The clinical crown length was generally reduced by 0.5 to 1.0 mm. The marginal bone level approached the cementoenamel junction in all but six cases. All cases demonstrated root resorption varying from 1 to 3 mm. The total amount of alveolar support--that is, the calculated area of the alveolar wall--was unaltered or increased in 19 of the 30 cases. The dependency of the results on the oral hygiene, the force distribution, and the perioral function was evaluated in relation to the individual cases. It was obvious that intrusion was best performed when (1) forces were low (5 to 15 gm per tooth) with the line of action of the force passing through or close to the center of resistance, (2) the gingiva status was healthy, and (3) no interference with perioral function was present. PMID- 2773870 TI - Integumental profile changes after surgical orthodontic correction of bimaxillary dentoalveolar protrusion in black patients. AB - An investigation was undertaken to evaluate the soft-tissue changes of the lips as a result of dentoalveolar setback procedures performed to reduce bimaxillary dentoalveolar protrusion in black patients. Lateral head films of 14 adult patients taken preoperatively and postoperatively were compared to evaluate soft- and hard-tissue changes. A stepwise regression analysis with hard-tissue changes, initial interlabial gap, lip thickness, and lip area as predictor variables was performed to assess their influence on the change in an associated soft-tissue point. Upper lip thickness and horizontal change in PR accounted for 60% of the horizontal variance in the upper lip at SLS, and horizontal change in PR accounted for 80% of the horizontal variance in LS. Lower lip area accounted only for 28% of the horizontal variance in the lower lip at LI. Vertical changes of the upper lip were small and could not be predicted. Vertical changes of the lower lip were small but predictable: IL and lip thickness accounted for 75% of the vertical variance in the lower lip at ILS, and ID accounted for 58% of the vertical variance in LI. PMID- 2773871 TI - Frictional forces in fixed appliances. AB - The aim of this investigation was to measure the frictional resistance to bodily tooth movement along, a continuous arch wire. A fixed appliance was constructed in vitro to simulate tooth movement in a previously aligned arch. The effect of load, bracket width, slot size, arch wire size, and material were studied. It was found that friction was proportional to applied load and inversely proportional to bracket width. Arch wire dimension and slot size had little effect. Nitinol and TMA (beta-titanium) arch wires produced frictional forces two and five times greater than those of stainless steel. PMID- 2773873 TI - The future of orthodontic education: a personal perspective. PMID- 2773872 TI - The occurrence of craniomandibular symptoms in healthy young adults with and without prior orthodontic treatment. PMID- 2773874 TI - Legal aspects of orthodontic practice: risk management concepts. The impacted canine. PMID- 2773875 TI - Computed tomography in the diagnosis of osteoid osteoma in infancy. PMID- 2773876 TI - Clear heads and bayesian tales: predictive value and the coin toss? PMID- 2773877 TI - Priapism following testosterone therapy for delayed puberty. PMID- 2773878 TI - Computers in medicine. Augmenting medical care in pediatric patients with chronic illnesses. AB - The use of computers to aid care for chronically ill pediatric patients is a relatively new concept. We are currently using Filemaker II software and a Macintosh Plus computer to augment overall patient care in children with chronic diseases, such as spina bifida, cerebral palsy, neuromuscular diseases, head injury, and spinal cord injury. This is a computerized medical record with a clinical database for dissemination of information to multidisciplinary team members, generating letters to private health care providers, displaying telephone messages, and assisting inpatient care. Advances in computer technology will provide future applications to aid health care providers in caring for patients with chronic illnesses. PMID- 2773879 TI - Cast bronchitis in infants and children. AB - Seventy-two children (age range, 3 months to 5.5 years) with a clinical diagnosis of obstructive bronchitis (asthmatoid or spastic bronchitis or bronchiolitis) were found to have bronchial casts in the gastric fluid, and in 2 additional cases casts were spontaneously expectorated in the bronchial exudate. Cast bronchitis had a long-term course of 10 to 24 months in 65 of the 74 patients. Common radiologic findings included bronchi presumably filled with secretions, areas of atelectasis, and lung emphysema of varying degrees. Cast bronchitis did not appear to be associated with eosinophilia and elevated serum IgE levels. Therefore, an extrinsic allergic mechanism is not likely involved in the pathogenesis of the condition. Bronchial casts had varying consistencies; although they were usually soft, they were sometimes rather hard. They were hollow, often ramified, and white and measured from 0.5 to 2 cm in length. Histologically, they consisted of metaplastic squamous epithelium with a varying degree of inflammatory cells and noncellular material. Some differences in biochemical composition were observed between bronchial casts and bronchial exudate of acute catarrhal bronchitis. No viruses could be isolated in 11 cast specimens. Our results suggest that cast formation is mainly related to the metaplastic transformation of the bronchial epithelium and that this metaplasia may play an important pathophysiologic role in certain infants and children with obstructive bronchitis. PMID- 2773881 TI - Emergence of isolates resistant to ampicillin. AB - Clinical isolates of Streptococcus faecium demonstrating ampicillin resistance were recovered from eight pediatric patients. Sites of isolation included blood, surgical wound, bile drainage, urine, burns, and peritoneal fluid. Seven patients had prolonged hospitalization, and all had been treated with broad-spectrum antibiotics prior to isolation of the resistant enterococcus. One isolate was from an ill, bacteremic patient; the others were in mixed culture and were not considered causes of disease. The isolates were not epidemiologically related. Minimal inhibitory concentrations for various antibiotics included ampicillin (16 to 32 mg/L), penicillin (128 mg/L), gentamicin (16 mg/L), and vancomycin (2 mg/L). Three isolates demonstrated high-level resistance (greater than 2000 mg/L) to streptomycin; none did so to gentamicin. In vitro synergy testing performed on seven available isolates for ampicillin and gentamicin demonstrated no synergy to this combination. None produced beta-lactamase. Combined antibiogram and plasmid data showed at least five distinct patterns. These strains present a new clinical problem in their high level of resistance to ampicillin and to the combination of ampicillin and gentamicin. PMID- 2773880 TI - Purpuric rashes in cystic fibrosis. AB - Sixteen patients with cystic fibrosis experienced vasculitic rashes of the lower extremities that resembled hypergammaglobulinemic purpura. The rashes were associated with increased serum gammaglobulin G levels and rather severe lung disease. The rashes are probably the expression of chronic lung infection and high antigenic load in these patients. Their appearance was associated, in most cases, with poor long-term survival. PMID- 2773882 TI - Anti-Staphylococcus aureus IgE antibodies for diagnosis of hyperimmunoglobulinemia E-recurrent infection syndrome in infancy. AB - Four infants with hyperimmunoglobulinemia E presented with a persistent papulovesicular rash and eosinophilia. Serum IgE levels and specific anti Staphylococcus aureus IgE antibodies were studied during the first year of life. Increased anti-S aureus IgE antibodies were an early indicator of the disease; they appeared as soon as 7 weeks of age in patient 1 and before 1 year of age for the other patients. These antibodies were detected before the development of deeper staphylococcal infections. Prompt diagnosis and treatment are important, as they may prevent long-term infectious complications. PMID- 2773883 TI - Corticosteroids as adjunctive therapy in bacterial meningitis. A meta-analysis of clinical trials. AB - A meta-analysis of all nine available controlled trials of corticosteroids for adjunctive therapy for bacterial meningitis was performed. Risks of various outcomes were assessed for control and treatment groups from each study, and risk differences were determined. For each outcome a weighted average of the individual risk differences was calculated. The results show that corticosteroid administration did not reduce the risk of death or neurologic abnormality at hospital discharge or follow-up examination. Based on statistically combined results of the three most recent trials, there is evidence that dexamethasone reduces the risk of bilateral moderate or more severe hearing loss (risk difference, -9%; 95% confidence limits, -15% and -3%). However, this may be true only for children with meningitis caused by Haemophilus influenzae type b. There are inadequate data in adults or in children with meningitis due to other organisms to demonstrate the benefit of dexamethasone administration. Further study is necessary to fully assess the benefits and risks of corticosteroids for adjunctive therapy for bacterial meningitis. PMID- 2773885 TI - A sexually transmitted diseases curriculum in adolescent medicine. AB - We conducted a needs assessment and developed and evaluated a model curriculum on sexually transmitted diseases (STDs) for house officers on an adolescent medicine rotation. Residents thought it important for physicians to acquire skill in treating STDs during residency (mean rating, 4.4 on a five-point scale) and were willing to provide medical care for adolescents likely to have an STD (mean rating, 4.4). Knowledge was measured before and after presentation of both of the two curriculum levels. There were significant increases in knowledge after each level, with a mean increase of 4.4 (of 50 possible) points for level 1 and a mean increase of 1.8 (of 38 possible) points for level 2. This improved knowledge about STDs should reflect increased competence and enhanced willingness to treat STDs in adolescents. PMID- 2773884 TI - Fiberoptic bronchoscopy in the treatment of intubated neonates. AB - A study of the role of fiberoptic bronchoscopy in intubated neonates was conducted. The study aimed to ascertain the applicability of fiberoptic bronchoscopy for assessment of endotracheal tube tip position, and to assess the incidence and clinical significance of airway disease in unselected patients. Seventy examinations on 65 neonates were performed without interruption of mechanical ventilation. The procedure was well tolerated in all cases. The accuracy of bronchoscopic measurement of endotracheal tube tip position improved markedly with user experience and reached a correlation of .96 with a chest roentgenogram. Although the technique was safe and accurate, the need for available and skilled personnel may limit the applicability of this method for endotracheal tube tip position assessment. Significant airway disease requiring a change in treatment was found in 13 patients (19%). This high incidence of significant but clinically unsuspected airway disease suggests that there should be more frequent consideration of diagnostic bronchoscopy in all sick intubated neonates who are at risk for airway disease. PMID- 2773886 TI - Attitudes toward mental illness prevention in routine pediatric practice. AB - Attitudes toward preventive mental health activities with high-risk children in clinical practice were surveyed in 316 pediatricians. Although generally positive attitudes were expressed regarding appropriateness and efficacy of such activities, uncertainty was expressed regarding the ethical issues and knowledge on which such activities rest. Pediatricians perceived serious barriers to preventive activities related to financial, educational, and time factors. Pediatricians whose personal health beliefs favored an internal locus of control were more positively inclined toward preventive activities. Studies relating reported attitudes and beliefs to actual practice patterns are necessary. Pediatricians also require additional training in mental health-related preventive activities. PMID- 2773887 TI - Advising parents to stop smoking. Opportunities and barriers in pediatric practice. AB - All pediatricians in Maine were surveyed by mail to assess their beliefs and attitudes about parental smoking and their current activities concerning advice on smoking cessation. The response rate to three mailings was 86%. Most pediatricians (91%) reported advising parents who smoke to quit and estimated spending an average of almost 5 minutes giving advice on how to quit smoking. Almost all pediatricians (94%) felt moderately or very confident in addressing passive smoking issues. However, only 46% felt moderately or very confident in advising parents how to stop smoking. Important barriers to providing advice on smoking cessation to parents included negative parental expectations and not having enough time. Only 6% of the pediatricians noted lack of reimbursement as a barrier. The majority of respondents (84%) were moderately or very willing to learn brief methods of giving advice on how to stop smoking to parents. PMID- 2773888 TI - Radiological case of the month. Pylephlebitis secondary to unsuspected appendiceal rupture. PMID- 2773890 TI - Hypophosphatemia in the nutritional recovery syndrome. AB - We studied the incidence of hypophosphatemia in patients during the nutritional recovery syndrome. The charts of 150 patients receiving a complete nutritional assessment for 18 months were reviewed; 45 met established nutritional risk criteria. Only 9 of these 45 had serial phosphorus values measured during nutritional repletion, and 5 of these 9 patients had hypophosphatemia (phosphorus levels less than 0.97 mmol/L). Anthropometric measurements of arm circumference and arm muscle circumference were less than the fifth percentile in all patients developing hypophosphatemia. We concluded that hypophosphatemia is an underrecognized complication of nutritional repletion and that anthropometric measurements may be predictive of patients at risk. All patients with significant malnutrition should be evaluated for this complication of refeeding. PMID- 2773889 TI - Postdelivery head bleeding in hemophilic neonates. Causes and management. AB - During a 12-month period, four of the five infants with hemophilia known to have been born in Arkansas were examined for head bleeding. Three of the infants had had traumatic delivery, with use of low forceps in two and vacuum extraction in one. In the fourth patient, hemophilia was prenatally diagnosed, and vaginal delivery resulted in cephalohematoma. Diagnosis was delayed in three patients, including one with a family history of hemophilia. Central nervous system bleeding may be more common in hemophilic neonates than has been presumed. Pregnancy management should include consideration of family history of bleeding disorders and carrier testing in appropriate cases. In confirmed carriers, prenatal diagnosis is justified to allow choice of the least traumatic delivery method. Any term neonate with intracranial hemorrhage should be treated as being possibly hemophilic until proved otherwise. PMID- 2773891 TI - Falls from pickup trucks during childhood. PMID- 2773892 TI - Acute suppurative adenoiditis. PMID- 2773893 TI - Collagenous colitis in a child. PMID- 2773894 TI - It's a small world. PMID- 2773895 TI - Effect of rectal infusion of short chain fatty acids in human subjects. AB - Solutions containing 90 mmol sodium acetate plus 30 mmol sodium propionate (90 mM; isotonic), 180 mmol acetate plus 60 mmol propionate (180 mM; hypertonic) or an equivalent volume of isotonic saline were given over a 30-min period in random order by rectal infusion to six healthy subjects. Peripheral venous blood samples were obtained at 30-min intervals over the next 2 h. After the 90 mM infusion, the serum acetate response reached a peak at 60 min and had fallen to baseline by 120 min. The incremental area under the serum acetate response curve after 180 mM was twice that after 90 mM. Propionate was undetectable in serum at any time. Blood glucose fell after all of the infusions, but there was no significant difference between the saline- and short chain fatty acid (SCFA)-containing infusions. SCFA had no significant effect on serum insulin or c-peptide concentrations. However, compared with the saline control, the 180 mM solution resulted in a significant fall in serum free-fatty acids (FFA) and a significant rise in serum total cholesterol and triglyceride, with no change in beta hydroxybutyrate levels. The data provide strong evidence that colonic SCFA are absorbed and metabolized in the human subject. The fall in FFA suggests that colonic SCFA have an effect on carbohydrate metabolism. In addition, the data provide indirect evidence for utilization of SCFA for lipid synthesis. PMID- 2773896 TI - The true cost of protective loop colostomy. AB - Transverse loop colostomies are commonly used to "protect" low colorectal anastomoses after anterior resection for rectal carcinoma. However, anastomotic leaks occur despite proximal decompression. We studied 61 consecutive patients who underwent anterior resection to evaluate the cost of loop colostomy as reflected by morbidity, mortality, and length of post-operative hospital stay. Colostomy patients had significantly greater blood loss (736 vs. 500 ml, p = 0.004), more blood transfusions (1.55 units vs. 0.41 units, p less than 0.001), and longer operations (238 vs. 193 min, p = 0.005). They were also older (68 vs. 65, p = 0.13), had lesions closer to the anal verge (10.2 vs. 11.4 cm, p = 0.07), and had more infectious complications (13.6% vs. 2.6%, 0.05 less than p less than 0.1) than patients without colostomies. Colostomy was not related to sex or stage. There were no anastomotic leaks among those with colostomies and only one among those without colostomies; there were no associated mortalities. Patients with colostomies stayed an additional 10 days, on average, when readmitted for colostomy closure. The 22 patients who received loop colostomies had postoperative stays averaging one-third longer than patients without colostomies (16 vs. 12 days, p = 0.004). In both groups, the 8th postoperative day was the mean for resumption of a regular diet; all patients were eating a regular diet by the 12th postoperative day. The delay in discharging colostomy patients was due to the additional time necessary for patients to learn to change their appliance and irrigate their stoma. Proximal diverting colostomies may more than double the total dollar cost of anterior resection, although DRG reimbursement is the same with or without a colostomy. This additional cost could be reduced by initiating ostomy teaching in the preoperative period and by reducing the use of unnecessary colostomies. PMID- 2773897 TI - Ultrastructural abnormalities in endoscopically and histologically normal and involved colon in ulcerative colitis. AB - Twenty colonoscopies (eight complete or almost complete; 12 short) were carried out on 15 patients with ulcerative colitis with the aim of comparing the endoscopic aspects with the light and electron microscopic features in biopsies taken from multiple sites. Patients with severe attacks were examined without prior preparation (two examinations). When the attack was mild to moderate (11 examinations), or the patient was in remission (seven examinations), two saline enemas were given up to 1 h before examination. There was a favorable correlation between the endoscopic and light microscopic features in 94.7% of the biopsies (total number of biopsies, 76). The electron microscope findings greatly exceeded those observed by light microscope and indicated that the major abnormality resides within the colonic epithelial cells. Distinctive ultrastructural changes were present both in apparently uninvolved (endoscopically and histologically) parts of colon and in inactive stages of ulcerative colitis. These findings suggest that colonic mucosal involvement may be universal, persist during clinical remission, and precede the light microscopic findings. They also support the importance of maintenance therapy. PMID- 2773898 TI - Multiple strictures in Crohn's disease of the small bowel: a benign variant. AB - Involvement of both jejunum and ileum is uncommon in Crohn's disease of the small bowel. We report five patients with multiple strictures of the small bowel associated with one or more intervening segments of dilated bowel. A diagnosis of Crohn's disease was delayed because none of the patients experienced diarrhea. Despite the early radiologic appearance of extensive small bowel disease, only three patients have required surgery, a limited surgical resection of 65-75 cm was possible, and long-term prognosis has been favorable. PMID- 2773899 TI - The effect of bismuth subsalicylate on the histologic gastritis seen with Campylobacter pylori: a placebo-controlled, randomized study. AB - In order to assess whether bismuth subsalicylate (BSS) clears Campylobacter pylori and whether this clearance is associated with improvement in histologic gastritis, 20 patients with antral biopsies colonized by C. pylori were randomized to treatment with 30 ml of BSS (525 mg) or placebo q.i.d. for 21 days. After both 2 and 3 wk of treatment, C. pylori was cleared in 70% (7/10) of BSS treated patients, compared with 10% (1/10) of patients on placebo (p less than 0.05) at 2 wk and 0% (0/10) of patients on placebo at 3 wk (p less than 0.01). A significant improvement in histologic gastritis (p less than 0.05) was noted after 2 and 3 wk of treatment in the group receiving BSS. Gastritis improvement was a result of both reduced polymorphonuclear and mononuclear cell infiltration. Clearance of C. pylori was highly correlated with improvement of histologic gastritis (p less than 0.001). In addition, mucus depletion scores were significantly improved in the BSS-treated group. These data indicate that treatment with BSS provides short-term clearance of C. pylori in antral mucosa, and this clearance is associated with an improvement in histologic gastritis. These findings support the pathogenic role of C. pylori in histologic antral gastritis. PMID- 2773900 TI - Implications of flow cytometry in malignant conditions of the stomach. AB - Aneuploidy, abnormal nuclear DNA content, has been demonstrated in most malignant processes, including gastric malignancies. Utilizing flow cytometry on endoscopic biopsies, we have attempted to characterize the prevalence of aneuploidy and to investigate the prognostic implications of gastric biopsy DNA content with regard to survival. DNA aneuploidy was detected in 71% of specimens revealing malignancy by histologic evaluation. When aneuploidy was demonstrated, 63% of the specimens proved to be positive for malignancy (positive predictive value). However, the absence of aneuploidy had a negative predictive value for malignancy of 93%. Patients with diploid adenocarcinomas had a median survival of 32 months, compared to a median survival of 4 months in the group with DNA aneuploidy. CONCLUSIONS: 1) The prevalence of aneuploidy in endoscopically obtained specimens compares favorably with other previously reported series. 2) The presence of aneuploidy in gastric malignancies appears to correlate with decreased survival and may be helpful in making therapeutic decisions. PMID- 2773901 TI - Gastric emptying and gastric myoelectrical activity in patients with diabetic gastroparesis: effect of long-term domperidone treatment. AB - We measured gastric emptying and gastric myoelectrical activity with solid-phase gastric-emptying tests and cutaneously recorded electrogastrograms (EGGs), respectively, in six insulin-dependent diabetic patients with nausea and vomiting who did not respond to standard treatments. Baseline solid phase gastric emptying was markedly delayed (78 +/- 8% retained at 120 min) and EGG recordings revealed gastric dysrhythmias; tachygastria (4-9 cpm signals) in one patient, 1- to 2-cpm waves in two patients, and flatline patterns in three patients. No patient had a normal 3-cpm EGG pattern. After 6 months of domperidone treatment, mean upper gastrointestinal symptoms scores decreased from 17.8 to 3.7 (p less than 0.01), and normal 3-cpm EGG frequencies were recorded from each of the six patients. The mean percentage of meal retained at 120 min decreased but did not improve significantly. Thus, establishment of normal 3-cpm gastric myoelectric activity and resolution of dysrhythmias, not normalization of emptying rates, was associated with improvement in upper gastrointestinal symptoms in these diabetic patients. PMID- 2773902 TI - The immediate effects of cessation of cigarette smoking on gastroesophageal reflux. AB - Cigarette smoking is thought to adversely affect gastroesophageal reflux. Eight male patients with endoscopic evidence of gastroesophageal reflux had 24-h esophageal pH monitoring while smoking at least 20 cigarettes. This was repeated while abstaining from smoking the following day. In the initial study period, 28.3% of the reflux time occurred within 20 min of smoking a cigarette. There were fewer reflux episodes in the nonsmoking period (95.7 episodes vs 70.0). The patients had significant improvement while in the upright position (57 reflux episodes vs 28.5). Yet, total reflux time was not significantly changed (pH less than 4.0 11.2% of total time smoking vs 10.1% total time nonsmoking). Immediate cessation of smoking decreases the number of daily reflux episodes, but does not significantly affect total esophageal acid exposure in symptomatic patients with endoscopic evidence of gastro-esophageal reflux disease. PMID- 2773903 TI - Atenolol-associated cholestasis. AB - Atenolol, a beta 1-selective beta-adrenergic receptor-blocking agent, is frequently used for the treatment of hypertension and angina pectoris. We report our experience with a patient who developed cholestatic hepatitis related to the initiation of therapy with atenolol with prompt resolution of symptoms and biochemical abnormalities upon discontinuation of this medication. A review of the literature failed to demonstrate any prior report of atenolol-associated hepatic injury. Although rare, because of the common use of atenolol, clinicians should be aware of this potential adverse effect. PMID- 2773904 TI - Chronic intermittent gastric volvulus within the foramen of Morgagni. AB - Hernia through the foramen of Morgagni is uncommon in adults. Chronic gastric volvulus within the foramen of Morgagni is very rare. In this report, we describe a patient who presented with symptoms of gastric outlet obstruction due to chronic intermittent gastric volvulus in the foramen of Morgagni. PMID- 2773905 TI - Good's syndrome complicated by opportunistic intestinal infestation. PMID- 2773907 TI - Listeria septicemia after colonoscopy in an ulcerative colitis patient receiving ACTH. PMID- 2773906 TI - Lack of antibiotic compliance in patients treated for Campylobacter pylori associated gastritis. PMID- 2773908 TI - Response to Mogadam on cancer and nutrition. PMID- 2773909 TI - Lower-third esophageal cancer penetrating the aorta: sudden death after emergency admission in a nontreated patient. PMID- 2773910 TI - Response to Simko. PMID- 2773911 TI - Wartime determinants of arteriographically confirmed coronary artery disease in Beirut. AB - This study investigates the association of wartime stress variables and coronary artery disease as determined by coronary angiography in Lebanon in 1986, a country with an ongoing civil war for over a decade. A total of 127 patients who underwent coronary angiography at the American University of Beirut Medical Center were individually matched on age and sex with visitor controls free from any evidence of clinical coronary artery disease. Arteriographic cases (greater than or equal to 70% maximal stenosis) were compared with two control groups: arteriographic controls (entirely normal coronaries) and visitor controls. Findings suggest that there is a relation between exposure to both acute and chronic war events and coronary artery disease in this patient population. The reporting of exposure to acute war events was significantly higher in cases compared with both visitor controls (odds ratio (OR) = 2.4, 95% confidence interval (Cl) 1.17-4.90) and arteriographic controls (OR = 2.8, 95% Cl 0.93 8.47). Crossing the "green-lines" that separate two belligerent sides, considered as an attribute of war-related chronic stress, was more frequent in cases compared with visitor controls (OR = 3.25, 95% Cl 1.54-6.89) and arteriographic controls (OR = 5.38, 95% Cl 1.65-17.6). The relation observed between wartime stress and coronary artery disease could not be explained by possible overreporting of stressful events in patients with suspected coronary artery disease or by an increase in clinical awareness for the disease for those under continuous stress. Adjusting for the effect of the well-established coronary artery disease risk factors did not alter the above findings. PMID- 2773912 TI - Serum lipids, lipoproteins, and apolipoproteins and the excessive occurrence of coronary heart disease in non-insulin-dependent diabetic patients. AB - Serum lipids, lipoproteins, and major apolipoproteins and their association with previous myocardial infarction were studied in patients with non-insulin dependent diabetes mellitus (NIDDM) and nondiabetic subjects in East and West Finland in 1982-1984. NIDDM patients had higher age-adjusted serum triglyceride and apolipoprotein B levels and a higher apolipoprotein B/apolipoprotein A-I ratio, lower serum high density lipoprotein (HDL) cholesterol and apolipoprotein A-1 levels, and a lower HDL cholesterol/apolipoprotein A-1 ratio than nondiabetic subjects. With a few exceptions, these differences persisted after adjustment for body mass index, alcohol intake, physical activity, smoking, and hypertension, which suggests that the atherogenic serum lipoprotein pattern in NIDDM is an inherent feature of the disease. In general, the association of serum lipids, lipoproteins, and apolipoproteins with myocardial infarction was similar in nondiabetic subjects and NIDDM patients, although it was somewhat stronger in the diabetic subjects. A low serum HDL cholesterol/apolipoprotein A-1 ratio, which was closely linked to high serum triglyceride level, seemed to be more consistently related to myocardial infarction in NIDDM patients than in nondiabetic subjects. Serum lipids, lipoproteins, and apolipoproteins, either separately or in various combinations, could only to a small extent explain the higher prevalence of myocardial infarction in diabetic subjects compared with nondiabetic subjects when tested in multivariate analysis with other cardiovascular risk factors as background variables. The association between serum lipoproteins and myocardial infarction was largely similar in East and West Finland, two areas that differ markedly with respect to the occurrence of coronary heart disease. PMID- 2773913 TI - A prospective study of high blood pressure and cardiovascular disease in women. AB - The relation of self-reported high blood pressure to the subsequent development of coronary heart disease and stroke was examined in a cohort of 119,963 women, aged 30-55 years, who were initially free from cardiovascular disease. Participants in the Nurses' Health Study reported high blood pressure and other cardiovascular risk factors on baseline questionnaires mailed in 1976. During six years of follow-up, there were 308 incident cases of coronary heart disease (66 fatal and 242 nonfatal myocardial infarctions) and 175 strokes (50 fatal and 125 nonfatal). Fatal as well as nonfatal coronary heart disease and stroke were all significantly more frequent among the women who had reported high blood pressure. After adjusting simultaneously for age and other risk factors, the relative risks were 3.5 (95% confidence interval (Cl) 2.8-4.5) for total coronary heart disease and 2.6 (95% Cl 1.8-3.5) for total stroke. This association was evident at all levels of relative weight. The results emphasize the importance of high blood pressure as an independent predictor of coronary heart disease and stroke in middle-aged women and suggest that the increased risk occurs in both lean and obese women. PMID- 2773914 TI - Familial cancer history and chronic lymphocytic leukemia. A case-control study. AB - In a population-based case-control study carried out in the Baltimore, Maryland metropolitan area, family cancer history for 342 chronic lymphocytic leukemia cases diagnosed in 1969-1982 revealed significantly higher risks of leukemia as well as other hematolymphoproliferative neoplasms and breast cancer among their first-degree relatives compared with reported occurrence of these neoplasms in first-degree relatives of 342 matched cancer controls and 342 matched controls without cancer. Siblings of case subjects also had a significant elevation of kidney cancer compared with siblings of controls. Only one of the affected case families (and no control family) included more than one additional member with leukemia. The results suggest a genetic component for leukemia occurrence in several case families, although the majority of cases of chronic lymphocytic leukemia appeared to be sporadic. The similarity of findings between the two comparisons (cases vs. cancer controls and cases vs. controls without cancer) diminishes the likelihood of recall bias as an explanation for the observed excess risks. PMID- 2773916 TI - Occupational risk of colon cancer. An analysis by anatomic subsite. AB - A case-control study was conducted to investigate occupational risks for colon cancer. The Missouri Cancer Registry was used to identify a total of 1,993 white male cases and 9,965 age-matched cancer controls diagnosed between 1984 and 1987. Effect estimates were calculated for specific occupations and industries and for three levels of occupational physical activity. Odds ratios (ORs) and 95% confidence intervals (Cls) were also calculated according to anatomic subsite of colon cancer. Elevated risks were identified for workers in several occupations and industries including printing machine operators (OR = 1.9, 95% Cl 1.0-3.3), workers in food manufacturing (OR = 1.6, 95% Cl 1.2-2.2), communications workers (OR = 1.8, 95% Cl 1.0-3.3), and workers employed in the petroleum product trade (OR = 2.7, 95% Cl 1.0-7.2). Previous findings of excess risk among selected occupations of higher socioeconomic status were confirmed. Analyses by anatomic subsite showed that excess risk for an occupational group was usually confined to a single subsite, which suggests some specificity of effect. For example, elevated risk among males employed in manufacturing-related industries was shown primarily for cancer of the cecum. The findings by level of occupational physical activity corroborated recent reports of increased colon cancer risk associated with employment in sedentary occupations. Excess risk (OR = 1.4, 95% Cl 1.0-1.9) was shown among males employed in sedentary jobs and an inverse linear trend in risk was shown according to level of occupational physical activity. Risk associated with sedentary occupations was highest for cancer of the cecum (OR = 2.1, 95% Cl 1.1-4.0). Despite the limitations of the cancer registry-collected data, some associations were observed that deserve further study. PMID- 2773915 TI - A case-control study of soft-tissue sarcoma. AB - The roles of nonagricultural occupations, tobacco use, beverage consumption, medical history, and other factors in the development of soft-tissue sarcoma were examined in a population-based case-control study in Kansas. Based on 133 cases diagnosed between 1976-1982 and 948 controls, there were significant excesses associated with use of the drug chloramphenicol (odds ratio (OR) = 5.4, 95% confidence interval (Cl) 1.2-23.9) and chewing tobacco or snuff (OR = 1.8, 95% Cl 1.1-2.9). The risk associated with smokeless tobacco varied with the location of the tumors; greater risks were observed for tumors of the upper gastrointestinal tract (OR = 3.3), the lung, pleura, and thorax (OR = 3.1), and the head, neck, and face region (OR = 2.4) than other regions of the body (OR = 1.4). A nonsignificant excess was seen with the use of cholesterol-lowering drugs, such as clofibrate (OR = 1.7). Four cases reported histories of prior radiation treatment to the same area of their bodies as their tumors. Soft-tissue sarcoma was also associated with employment in woodworking occupations (OR = 1.7, 95% Cl 0.9-3.2) and risk increased with increasing duration of employment. Persons with first-degree blood relatives with a history of Hodgkin's disease, lymphoma, or cancers of the pancreas, prostate, brain, or skin were at increased risk. Many of the associations observed in this study, notably the risk of soft-tissue sarcoma with smokeless tobacco and medications such as chloramphenicol, deserve further evaluation. PMID- 2773917 TI - Development of epidemiologic tools for measuring environmental tobacco smoke exposure. AB - In this study, current weekly environmental tobacco smoke exposure was measured in 53 nonsmoking volunteers. Three exposure assessment tools were used: a passive nicotine monitor; a baseline questionnaire; and a seven-day diary. Exposure episodes were recorded according to location, space ventilation characteristics, number of smokers, number of hours, proximity of smokers, and intensity of environmental tobacco smoke. In Phase 1, various formulas for an environmental tobacco smoke exposure index based on the questionnaires and diaries of 19 volunteers were tested against the nicotine (microgram) collected by the monitor to determine the index providing the best fit. The formula referred to as the hsp (hours x smokers x proximity) index provided the best correlation with log nicotine levels for the questionnaire (r2 = 0.829) and the diary (r2 = 0.900). All episodes of environmental tobacco smoke exposure in all locations were summed over seven days. Each exposure received a weighting according to number of hours (h), number of smokers (s) and proximity of smokers (p). In Phase 2, the hsp index was refined to adjust for social situations with many smokers. In Phase 3, the refined hsp index (hsp*) was used to predict cumulative weekly nicotine collected on monitors worn by 33 new volunteers. All 33 nicotine measurements in the validation set were closely predicted by a simple linear regression model using log nicotine and the hsp* index (r2 = 0.98). The results of this study indicate that relatively simple questionnaires and diaries can be developed to assess current environmental tobacco smoke exposure for epidemiologic studies. PMID- 2773918 TI - Retrospective versus original information on cigarette smoking. Implications for epidemiologic studies. AB - This study was conducted to evaluate the agreement between retrospective information on cigarette smoking and original information obtained six years previously. A questionnaire on smoking habits was answered by 94% of a random sample of the adult Swedish population in 1963 (original information). Of the 10,356 subjects aged 40-59 years who reported that they had ever smoked regularly, 9,394 answered a second questionnaire in 1969. Information was obtained on present smoking habits as well as on smoking habits in 1963 (retrospective information). Cigarette consumption was divided into four categories: 0, 1-7, 8-15, and 16+ cigarettes per day. In relation to the original information on smoking, retrospective information showed a strong tendency to overestimate previous cigarette consumption among subjects who had increased their cigarette smoking (69%), and to underestimate previous cigarette consumption among subjects who had decreased their cigarette smoking (49%). Subjects with unchanged cigarette consumption showed a high level of agreement between original and retrospective information (89%). Age, sex, income, and occupational status also had some impact on the agreement between retrospective and original information on cigarette consumption. Consequences for epidemiologic studies based on retrospective smoking information are discussed. The use of retrospective information may introduce considerable differential misclassification when cases and noncases differ with regard to changes in smoking habits. PMID- 2773919 TI - The Tecumseh Study. XVI: Family and community sources of rotavirus infection. AB - The effect of age on transmission of rotavirus infection within households and on the risk of infection from outside of the household was investigated through analyses of serum pairs. These paired specimens had been collected from individuals of all ages in families of diverse age composition in Tecumseh, Michigan. Serologic observations on 1,508 individuals divided into 0-1, 2-4, 5-9, 10-17, and 18+ year age groups provided infection determinations on 3,311 person seasons during the 1977 through 1981 rotavirus seasons. Infection occurring in an individual in each age group was generally associated with infection in all other age groups in the household. Despite these associations by household, two different means of estimating the proportion of all infections acquired in the household yielded estimates of only 17 and 20%, indicating the importance of community acquisition of infection. Very young children had a very small percentage of their infections acquired in the household, while progressively older ages had an increasing percentage of infections acquired there. These results indicate that a strategy of indirectly protecting infants from infection by preventing infection in their household contacts would be inefficient. PMID- 2773920 TI - Estimating intervention effects in longitudinal studies. AB - Longitudinal studies aimed at assessing the impact of interventions on disease risk factors often confront several statistical problems. These problems include 1) dependent variables measured by ordered categories, 2) numerous potentially relevant patterns of transition between outcome levels, 3) mixed units of analysis (e.g., assignment by social unit while theorizing in terms of individuals), 4) incomplete randomization, and 5) correlated estimates for successive occasions of longitudinal measurement. Longitudinal data on use of cigarettes, alcohol, and marijuana among adolescents (n = 1,244, complete data) from the Midwestern Prevention Project are used to demonstrate solutions to each of these problems: 1) a proportional odds regression model, 2) conditional logistic models of transitions with interactions between baseline level and intervention effect, 3) a logistic model estimated with linear regression methods on measures aggregated by social unit, 4) conditional and unconditional models of effect magnitude, and 5) a repeated measures logistic regression technique. Panel data fit to the various models yielded the following conclusions concerning intervention effects in the Midwestern Prevention Project: reduction in the prevalence of cigarette users in treatment schools compared with control schools (8% vs. 18% smoked in the last week at one year follow-up), mixed evidence of an effect on marijuana use, and no evidence of an effect on alcohol use. PMID- 2773921 TI - Response of chronic renal failure mice to peritoneal Staphylococcus epidermidis challenge: impact of repeated peritoneal instillation of dialysis solution. AB - The effect of repeated instillation of peritoneal dialysis (PD) solution on the peritoneal clearance of a Staphylococcus epidermidis challenge was investigated in a mouse model of surgically induced chronic renal failure. For periods of up to 2 weeks, mice bearing peritoneal catheter implants underwent daily (3 mL) or twice daily (1.5 mL) peritoneal instillation of PD solution (4.25% dextrose) by transcutaneous injection into the catheter lumen. Peritoneal instillation of PD solution did not have a significant influence on the microbiological status of peritoneal structures of renal failure or sham-operated mice following experimental intracatheter S epidermidis inoculation with 10(6) colony-forming units (CFU) (assessment 48 hours after inoculation) or 10(8) CFU (assessment 1 week after inoculation). Microbiological and scanning electron microscopy (SEM) assessments of recovered peritoneal catheters demonstrated that S epidermidis remained associated with the catheter site after other peritoneal structures had become culture negative. SEM of the parietal peritoneum revealed striking morphologic alterations of the mesothelial surface as a consequence of daily PD solution infusion. In the absence of S epidermidis inoculation, repeated instillation of PD solution caused a marked acute peritoneal inflammation without evidence of a concomitant systemic inflammatory response. Furthermore, peritoneal inflammatory response to S epidermidis challenge was augmented by the infusion procedure. Concurrent assessments of inflammatory response and microbiological status revealed that, in spite of heightened peritoneal inflammatory response with peritoneal infusion, bacterial clearance from the catheter site was not improved. Although the animal preparation was limited to peritoneal infusion without drainage, the influence of repeated peritoneal instillation of hyperosmolar, acidic PD solution on the response of mice to S epidermidis challenge was successfully addressed. PMID- 2773922 TI - Hyponatremia in the very young chronic peritoneal dialysis patient. AB - Two anuric infants had recurrent hyponatremia during chronic peritoneal dialysis (PD). This occurred because at normal serum sodium concentrations ([Na]), Na losses from ultrafiltration (UF) were greater than the Na ingested from infant formula. Hyponatremia was corrected with increased oral Na intake or with increased dialysis solution [Na]. Anuric infants undergoing PD have hyponatremia because of their high UF requirements/body weight and the low Na content of proprietary infant formulas. PMID- 2773923 TI - Lead increases red cell sodium-lithium countertransport. AB - The effect of 1, 3, 5, and 20 mumol/L lead on normal red cell sodium-lithium countertransport was studied in vitro. Red cell suspensions incubated with lead had increased sodium-lithium countertransport at all concentration levels compared with paired, unleaded controls when all groups were evaluated by analysis of covariance (F = 19.2, P less than 0.001). The effect of lead was concentration dependent (r = 0.998, P less than 0.001). These observations suggest that abnormalities in sodium transport are involved in the pathogenesis of lead-induced hypertension. Because increased red cell sodium-lithium countertransport is characteristic of essential hypertension, these observations further suggest that lead-induced and essential hypertension may share common pathophysiological mechanisms. PMID- 2773924 TI - Nephrogenic diabetes insipidus and tubulointerstitial nephritis during continuous therapy with rifampin. AB - While receiving continuous daily rifampin therapy, a 57-year-old man developed acute renal failure and nephrogenic diabetes insipidus due to acute tubulointerstitial nephritis which was reversible by discontinuing the rifampin. Tubulointerstitial nephritis rarely develops during continuous rifampin therapy, and associated nephrogenic diabetes insipidus has not previously been reported. The majority of cases of tubulointerstitial nephritis due to rifampin have occurred following reintroduction of rifampin after an interruption in therapy. The clinical differences between patients developing tubulointerstitial nephritis during interrupted and continuous therapy are discussed. PMID- 2773925 TI - Acrorenal syndrome in an adult--presentation with proteinuria, hypertension, and glomerular lesions. AB - Acrorenal syndrome is characterized by central longitudinal axis defects of the limbs, ie, split hand and/or foot. Associated renal lesions described so far comprise agenesis, bilateral hypoplasia (originally diagnosed as oligomeganephronia), and duplication abnormalities. The case of a 29-year-old patient with split hand resulting from bilateral aplasia of the third phalanges associated with dysplasia of the third and fourth metacarpals is reported. In addition, the following lesions were noted: hypoplasia of the middle phalanx of the fifth toe, arched palate, pectus excavatum, hypoplastic mammilae, scoliosis, and congenital hip dislocation. The patient presented with hypertension, modest reduction of glomerular filtration, proteinuria, microhematuria, cylindruria, and moderate harmonic hypoplasia of the right kidney on angiography. Glomeruli had no immune deposits on immunohistology. Light microscopy showed widening of the mesangial axis, focal segmental glomerular sclerosis, and renal interstitial fibrosis with occasional foam cells. This case shows that the spectrum of renal abnormalities in the acrorenal syndrome is wider than previously noted. PMID- 2773926 TI - Survival after severe iatrogenic hypernatremia. AB - The case of a 24-year-old woman who survived without subsequent neurological damage after severe iatrogenic hypernatremia is presented. This previously healthy woman who had given birth with an uncomplicated delivery developed hypernatremia (serum sodium, 178 mmol/L) after erroneous infusion of hypertonic sodium solution. PMID- 2773927 TI - Seizures during correction of hypernatremic dehydration in an infant. PMID- 2773928 TI - Scleroderma renal crisis prior to scleroderma. PMID- 2773929 TI - Fools and their money ... but Congress is no fool. PMID- 2773930 TI - The solitary kidney: a model of chronic hyperfiltration in humans. PMID- 2773931 TI - Mapping the cleft-lip genes: the first fix? PMID- 2773934 TI - Strategies and sample-size considerations for mapping a two-locus autosomal recessive disorder. AB - The problem of detecting linkage, by using the LOD-score method, of polymorphic marker loci to a disorder that is determined by recessive alleles at two independent autosomal diallelic loci has been considered. The expected LOD score and the distribution of the LOD score have been worked out for various scenarios. It is found that the expected numbers of families to be sampled for detection of linkage are within feasible limits if the recombination fractions between the marker loci and the disorder loci are less than or equal to .1. The strategy of studying affected offspring only is shown to be more efficient than the strategy of studying both affected and normal offspring. The efficiency of the "affecteds only" strategy (1) increases with increase in sibship size, (2) decreases with increase in population prevalence of the disorder, and (3) increases with increase in recombination distances between the marker and the disorder loci. From various considerations, it is found that sampling families of sibship size three with at least one affected, and adopting the affecteds-only strategy for analysis, may be an optimal strategy. PMID- 2773932 TI - A high proportion of ADA point mutations associated with a specific alanine-to valine substitution. AB - In 15%-20% of children with severe combined immunodeficiency (SCID), the underlying defect is adenosine deaminase (ADA) deficiency. The overall goal of our research has been to identify the precise molecular defects in patients with ADA-deficient SCID. In this study, we focused on a patient whom we found to have normal sized ADA mRNA by Northern analysis and an intact ADA structural gene by Southern analysis. By cloning and sequencing this patient's ADA cDNA, we found a C-to-T point mutation in exon 11. This resulted in the amino acid substitution of a valine for an alanine at position 329 of the ADA protein. Sequence analysis revealed that this mutation created a new BalI restriction site. Using Southern analyses, we were able to directly screen individuals to determine the frequency of this mutation. By combining data on eight families followed at our institution with data on five other families reported in the literature, we established that five of 13 patients (seven of 22 alleles) with known or suspected point mutations have this defect. This mutation was found to be associated with three different ADA haplotypes. This argues against a founder effect and suggests that the mutation is very old. In summary, a conservative amino acid substitution is found in a high proportion of patients with ADA deficiency; this can easily be detected by Southern analysis. PMID- 2773933 TI - Localization of the genes for histatins to human chromosome 4q13 and tissue distribution of the mRNAs. AB - A cDNA coding for histatin 1 was isolated from a human submandibular-gland library and sequenced. This cDNA was used to probe RNAs isolated from a variety of tissues to investigate tissue-specific regulation and to determine whether histatins might play a role other than in the oral cavity. The same probe was also used for Southern blot analysis of human genomic DNA restricted with various enzymes, and it showed that the genes coding for histatins are on the same chromosome. In situ hybridization of the cDNA probe to metaphase chromosome spreads was performed to determine chromosomal location of the genes for histatins. A genomic fragment isolated using the cDNA probe was also hybridized to chromosome spreads, and the same chromosome was identified. The genes for histatins are located on chromosome 4, band q13. We have shown that three histatin mRNAs are expressed in human parotid and submandibular glands but in none of the other tissues studied. These results suggest that histatins are specific to salivary secretions. PMID- 2773936 TI - Pelizaeus-Merzbacher disease: an X-linked neurologic disorder of myelin metabolism with a novel mutation in the gene encoding proteolipid protein. AB - The nosology of the inborn errors of myelin metabolism has been stymied by the lack of molecular genetic analysis. Historically, Pelizaeus-Merzbacher disease has encompassed a host of neurologic disorders that present with a deficit of myelin, the membrane elaborated by glial cells that encircles and successively enwraps axons. We describe here a Pelizaeus-Merzbacher pedigree of the classical type, with X-linked inheritance, a typical clinical progression, and a pathologic loss of myelinating cells and myelin in the central nervous system. To discriminate variants of Pelizaeus-Merzbacher disease, a set of oligonucleotide primers was constructed to polymerase-chain-reaction (PCR) amplify and sequence the gene encoding proteolipid protein (PLP), a structural protein that comprises half of the protein of the myelin sheath. The PLP gene in one of two affected males and the carrier mother of this family exhibited a single base difference in the more than 2 kb of the PLP gene sequenced, a C----T transition that would create a serine substitution for proline at the carboxy end of the protein. Our results delineate the clinical features of Pelizaeus-Merzbacher disease, define the possible molecular pathology of this dysmyelinating disorder, and address the molecular classification of inborn errors of myelin metabolism. Patients with the classical form (type I) and the more severely affected, connatal variant of Pelizaeus-Merzbacher disease (type II) would be predicted to display mutation at the PLP locus. The other variants (types III-VI), which have sometimes been categorized as Pelizaeus-Merzbacher disease, may represent mutations in genes encoding other structural myelin proteins or proteins critical to myelination. PMID- 2773935 TI - Norrie disease gene is distinct from the monoamine oxidase genes. AB - The genes for MAO-A and MAO-B appear to be very close to the Norrie disease gene, on the basis of loss and/or disruption of the MAO genes and activities in atypical Norrie disease patients deleted for the DXS7 locus; linkage among the MAO genes, the Norrie disease gene, and the DXS7 locus; and mapping of all these loci to the chromosomal region Xp11. The present study provides evidence that the MAO genes are not disrupted in "classic" Norrie disease patients. Genomic DNA from these "nondeletion" Norrie disease patients did not show rearrangements at the MAOA or DXS7 loci. Normal levels of MAO-A activities, as well as normal amounts and size of the MAO-A mRNA, were observed in cultured skin fibroblasts from these patients, and MAO-B activity in their platelets was normal. Catecholamine metabolites evaluated in plasma and urine were in the control range. Thus, although some atypical Norrie disease patients lack both MAO-A and MAO-B activities, MAO does not appear to be an etiologic factor in classic Norrie disease. PMID- 2773937 TI - Functionally important regions of the factor IX gene have a low rate of polymorphism and a high rate of mutation in the dinucleotide CpG. AB - We have recently described genomic amplification with transcript sequencing (GAWTS), a three-step procedure that allows direct genomic sequencing. By GAWTS more than 100,000 bp of sequence have been generated from eight regions of the factor IX gene, which include the putative promoter region, the coding region, and the splice junctions. All eight regions were examined in 20 unrelated normal individuals of defined ethnicity and subsequently in 22 hemophiliacs in different families. The following three major conclusions emerge: (1) The rate of polymorphism in these eight regions of functional significance has been measured in an X-linked gene, and it is about one-third of the average rate observed for intronic and intergenic sequences on the X chromosome. The rate is low enough that the causative mutation should be the only sequence change seen in the overwhelming majority of hemophiliacs. (2) Transitions of CpG account for 31% (5/16) of the distinct mutations and for 38% (5/13) of the single-base changes. The rate of transitions at CpG is elevated by an estimated 77-fold, presumably owing to lack of repair of thymidine generated by the spontaneous deamination of 5-methylcytidine. (3) High-quality, reproducible sequence data can be obtained on a time scale that makes direct carrier testing and prenatal diagnosis feasible. PMID- 2773938 TI - High-resolution analysis of a hypervariable region in the human apolipoprotein B gene. AB - A hypervariable region occurs immediately 3' of the human apolipoprotein B gene. Several allelic variants of this tandemly repeated sequence can be resolved by genomic blotting. Higher resolution among size variants may be obtained by polymerase-chain-reaction amplification of this region followed by electrophoresis in a denaturing acrylamide gel. Fourteen different alleles containing 25-52 repeats of the basic 15-bp unit were distinguished in a population study of 318 unrelated individuals. This approach should be applicable to pedigree and linkage analysis with the apolipoprotein B gene or other tandemly repeated sequence elements. PMID- 2773940 TI - Maternal age-specific rates of chromosome abnormalities at chorionic villus study: a revision. PMID- 2773941 TI - Re: Pellestor et al. on sperm chromosomes. PMID- 2773939 TI - Segregation of genetic hemochromatosis indexed by latent capacity of transferrin. AB - A genetic analysis of the segregation of hereditary hemochromatosis, indexed by the measurement of latent capacity of transferrin (LCAP), was undertaken in an ascertained sample of 147 pedigrees from Brittany, France. There were no mean differences by sex in the distribution of LCAP in the control sample, although in the family data there was a higher representation of males with low values than of females with low values, consistent with the higher proportion of affected males. The results of bivariate segregation analysis revealed no systematic evidence for heterozygous expression either in the biochemical domain of LCAP abnormalities or in increased liability to overt symptomatic disease. Joint consideration of the quantitative variable with hemochromatosis affection status allowed clear resolution of a recessive single-gene inheritance pattern in these families. PMID- 2773942 TI - High-resolution CT in the diagnosis of asbestos-related pleuroparenchymal disease. PMID- 2773943 TI - Follow-up of subjects who developed chloracne following TCDD exposure at Seveso. AB - Three follow-up surveys from 1976 to 1985 were carried out on 193 subjects who developed chloracne following the Seveso accident (1976). A comparison group, age and sex matched, was selected randomly from the list of residents of the town of Varedo (in the same health district but out of the dioxin-contaminated zone). At each follow-up a questionnaire was administered and biochemical tests, skin examination, and electrophysiologic measurements were performed. Biochemical indicators of hepatic function and nerve conduction studies did not show significant differences either between groups or for temporal trends. Chloracne was shown to be clinically reversible: all the chloracne cases (except for one subject) clinically recovered by 1983. The discrepancy between our results and those from other previous experiences can be related to a different type of exposure, the young age of the target population, and the interval since exposure. PMID- 2773944 TI - Cancer mortality among a cohort of chromium pigment workers. AB - A study of mortality among 1,879 male workers employed in a New Jersey chromium pigment factory was carried out, with follow-up from 1940 to 1982. Vital status of 1,737 (92%) of the eligible cohort members was determined. For all malignant neoplasms, 101 deaths were observed while 108.8 were expected, SMR = 93 (standardized mortality ratio; n.s.). For the entire study group, no significant excess was observed for respiratory cancer or cancer at other sites. However, the total number of years of employment in the factory and the total number of years of exposure to chromate dusts were both statistically significantly (p less than .05, for trend) associated with an increased risk for lung cancer. The excess risk for lung cancer associated with duration of exposure to chromate dusts was, however, only clearly apparent for subjects followed for 30 years or more after initial employment. For this group, the SMRs were 81, 139, 201, and 321 for the subjects with 0 years, less than 1 year, 1-9 years, and 10+ years of exposure to chromate dusts (p less than .01, for trend), respectively. The risk for digestive cancer was only weakly associated with exposure to chromate dusts. PMID- 2773945 TI - Levels of polychlorinated dibenzo-p-dioxins and dibenzofurans in workers exposed to 2,3,7,8-tetrachlorodibenzo-p-dioxin. AB - Review of employment and chemical production records at a Missouri chemical plant and of questionnaires with self-reported occupational exposure to 2,3,7,8 tetrachloro-dibenzo-p-dioxin (2,3,7,8-TCDD) for 16 Missouri workers has explained the wide diversity of 2,3,7,8-TCDD levels previously reported in the workers' adipose tissue (3.5-750 ppt on whole-weight basis). We show that the highest exposures reported to date in the United States occurred in a group of nine production workers who made products contaminated with 2,3,7,8-TCDD. The nine workers had adipose tissue levels with a mean of 246 ppt and a range of 42 to 750 ppt. Seven persons who worked at the same chemical company, but not in the 2,3,7,8-TCDD-contaminated process, had a mean of 8.7 ppt and a range of 3.5 to 25.8 ppt. We also report serum levels of 2,3,7,8-TCDD in these individuals. The adipose tissue from a subset of four production workers with elevated levels of 2,3,7,8-TCDD and seven Missouri residents with normal 2,3,7,8-TCDD levels was also analyzed for other isomers of the PCDDs and PCDFs. The mean adipose tissue level of 2,3,7,8-TCDD in the subset of production workers was 45 times higher than the mean level in the unexposed Missouri residents, but similar levels of the other PCDDs and PCDFs were found in both groups. PMID- 2773946 TI - Lead exposure among lead-acid battery workers in Jamaica. AB - To assess lead exposure in the Jamaican lead-acid battery industry, we surveyed three battery manufacturers (including 46 production workers) and 10 battery repair shops (including 23 battery repair workers). Engineering controls and respiratory protection were judged to be inadequate at battery manufacturers and battery repair shops. At manufacturers, 38 of 42 air samples for lead exceeded a work-shift time-weighted average concentration of 0.050 mg/m3 (range 0.030-5.3 mg/m3), and nine samples exceeded 0.50 mg/m3. Only one of seven air samples at repair shops exceeded 0.050 mg/m3 (range 0.003-0.066 mg/m3). Repair shop workers, however, had higher blood lead levels than manufacturing workers (65% vs. 28% with blood lead levels above 60 micrograms/dl, respectively). Manufacturing workers had a higher prevalence of safe hygienic practices and a recent interval of minimal production had occurred at one of the battery manufacturers. Workers with blood lead levels above 60 micrograms/dl tended to have higher prevalences of most symptoms of lead toxicity than did workers with lower blood lead levels, but this finding was not consistent or statistically significant. The relationship between zinc protoporphyrin concentrations and increasing blood lead concentrations was consistent with that described among workers in developed countries. The high risk of lead toxicity among Jamaican battery workers is consistent with studies of battery workers in other developing countries. PMID- 2773947 TI - Effects of respirator dead space, inspiratory resistance, and expiratory resistance ventilatory loads. AB - The effects of respiratorlike inspiratory resistance (IR), expiratory resistance (ER), and dead space (DS) were assessed in a group of 11 normal volunteers during moderate steady-state (SS) and rapidly incremented (RI) exercise. The physiologic effects of IR were predominant, increasing inspiratory time, duty cycle, and several measures of ventilatory work. Effects of DS appear related to increased minute ventilation and include increasing flow rates and duty cycle and requiring greater ventilatory work; during RI exercise, the DS effect became relatively smaller at higher exercise levels. ER compressed expiratory time. These results characterize the response to IR, ER, and DS loads and suggest that DS may be relatively less physiologically significant than IR. PMID- 2773948 TI - Predisposing factors in laboratory animal allergy: a study of atopy and environmental factors. AB - A population of 101 laboratory technicians handling laboratory animals was studied with regard to predisposing factors for allergy. Twenty-seven had symptoms indicating laboratory animal allergy (LAA); of these, nine had asthma and were skin prick test positive for animal allergens. The LAA asthmatics had an increased frequency of a family history of allergy (relative risk, RR = 3.8); the predictive value was 0.27. There was also an increase of skin prick positivity against common nonanimal allergens (RR = 15); the predictive value was 0.60. All persons with marked positive skin prick tests (greater than or equal to +2) to environmental allergens had developed animal-test-positive LAA asthma. In 56% of the LAA asthma cases the serum IgE levels were elevated (greater than 100kU/L). In preemployment screening of susceptible individuals two important selection criteria emerged, viz., family history of allergy and positive skin prick reactions against environmental allergens. PMID- 2773949 TI - Industry-related urothelial carcinogens: application of a job-exposure matrix to census data. AB - A job-exposure matrix has been developed linking the work tasks in the Swedish National Census of population 1960 to exposure to 50 single agents or groups of substances. All 1,905,660 men, aged 20-64 years in 1960, reporting themselves as gainfully employed in the Census, were observed for the occurrence of urothelial cancer 1961-1979 by linkage to the National Swedish Cancer Registry. Subjects classified as exposed to creosote had a relative risk (with 95% confidence interval) of 2.6 (1.2-5.9) for renal pelvis cancer and 1.3 (1.0-1.8) for urinary bladder cancer; subjects exposed to polychlorinated biphenyls (PCB) had a relative risk of 1.3 (1.0-1.8) for urinary bladder cancer. Adjustment was made for age, socioeconomic group, and degree of urbanization. Exposure to combustion gases from coal gave a relative risk of 1.2 (1.0-1.4) for bladder cancer. The study carries several sources of nondifferential misclassification diluting the estimates of the relative risks toward 1.0. The limitations of exposure classification by job-exposure matrices are discussed. PMID- 2773950 TI - Can the birth certificate yield clues to parental occupational exposures? AB - An analysis of reported birth record variables by parental occupation suggests that certain birth outcomes may identify toxic or carcinogenic occupational exposures of the parents. Fathers coded to an asbestos and insulation worker rubric sired fewer plural births, and more stillbirths than expected. A number of other fathers' occupations with putative exposure to asbestos and increased lung cancer mortality also showed a deficit of plural births. PMID- 2773951 TI - Bladder cancer and occupation among Swedish women. PMID- 2773952 TI - State regulations for home i.v. therapy. PMID- 2773953 TI - Drug information monographs for AIDS patients. PMID- 2773954 TI - Reguisition forms for serum aminoglycoside or vancomycin concentration determinations. PMID- 2773955 TI - Dual-chambered vials should carry warnings on label. PMID- 2773956 TI - Facilitating drug-use evaluation with database and other software. PMID- 2773958 TI - Error in facts and comparisons. PMID- 2773957 TI - Fax fiction. PMID- 2773959 TI - Harvey A.K. Whitney lecture. Taking charge of the profession. AB - The relationship between pharmacists' attitudes toward the profession and their career opportunities is described. Pharmacists must be committed to the idea that pharmacy is an essential component of health care. Pharmacy education needs to instill an attitude of service and excellence and an expectation of success. Social, political, economic, and professional change has challenged fundamental assumptions and values that made life predictable in the past. Pharmacists have permitted others to establish the scope and limits of professional pharmacy practice; it is time for pharmacists themselves to determine the future of their profession by focusing on providing services to fulfill unmet health-care needs. The profession as a whole will suffer if pharmacists view certain practice roles or settings as inferior. When all pharmacists accept "drug-use control" as the primary ethic that drives pharmaceutical decisions, the public, the government, and other health-care providers will respect that role for pharmacists. Studying the pharmacy literature can enhance pharmacists' positive feelings about their contributions. Pharmacists alone are responsible for the status of the profession and for changing what needs to be changed. By changing their thinking about the profession, pharmacists can broaden their career opportunities. PMID- 2773960 TI - Evaluation of prescription charges in a health maintenance organization. AB - Differing patterns in drug use and charge variances among three pharmacy sites were determined for a university-based health maintenance organization (HMO). Computerized prescription claim data for the HMO inhouse pharmacy and those chain and independent pharmacies contracting with the HMO were analyzed on a personal computer using database management and statistical software. Chain and independent pharmacies were under contract to charge the average wholesale price plus a $2.00 fee per prescription. Drug-claim data were separated by pharmacy site (inhouse, chain, and independent), and the data for each site were sorted by national drug code number. High-charge and high-use drugs were identified for evaluation on a unit-charge basis. During the six-month study period, 22,393 prescriptions were filled, representing total charges of $347,063.79. The mean per-prescription charges submitted to the HMO by the chain, independent, and inhouse sites were $14.99, $16.08, and $16.41, respectively. The inhouse pharmacy had many charges in high dollar ranges. Of 10 high-charge drugs analyzed, isotretinoin 40 mg, flunisolide nasal solution, naproxen 250 mg, cyclosporine oral solution, and atenolol 50 mg were dispensed in significantly different proportions at each site. There were significant differences in unit prices of nine high-use drugs among pharmacy sites. This study indicates the importance of evaluating adverse selection among pharmacy sites and the value of auditing claims submitted. PMID- 2773961 TI - Analysis of drug-drug interactions among nursing home residents. AB - The extent of clinically important drug-drug interactions in the patient population of a nursing home was studied. The administration of medications to all 138 residents of two wards of the hospital-affiliated facility was monitored for 15 days through a review of nurses' medication-administration records and patients' charts. Information on the nature and timing of administered drug combinations was compared with published information to identify potential drug interactions. If a serious drug interaction was suspected, the recorded information was verified through the nurse in charge of that patient. Few of the drug interactions commonly reported to occur in nursing homes were observed at the facility, where drug therapy is monitored by a team of geriatric practitioners that includes two pharmacists. Of the 24 suspected interactions that were identified, 11 had potential clinical importance, and all 11 involved drug combinations that could alter the metabolism or action of one of the drugs. However, only two patients were exposed to any substantial degree of risk, and dosages of the drugs involved were adjusted. An additional 13 patients were taking a combination of drugs that could have altered the intestinal absorption of one of the drugs. Careful timing of drug administration avoided this potential problem. With proper education of the nursing staff, immediate clarification of medication orders, and optimal timing of drug administration, many clinically important drug-drug and drug-food interactions can be avoided in nursing home patients. PMID- 2773962 TI - Use of concurrent monitoring and a preprinted note to modify prescribing of i.v. cimetidine and ranitidine in a teaching hospital. AB - The use of concurrent monitoring and an informational note to modify physician prescribing of i.v. cimetidine and ranitidine is described. The study population consisted of all patients for whom i.v. cimetidine and ranitidine therapy was prescribed by house-staff physicians at an 850-bed, tertiary-care, university affiliated hospital during February, March, and April 1987. Phase 1 of the trial consisted of an initial drug-use review of all eligible patients receiving therapy. In phase 2, the study population was divided into an intervention group and a control group. When therapy could be changed from the i.v. to the oral or nasogastric (NG) route of administration, an informational note was placed in the chart of the patients in the intervention group. Patients in the control group were also assessed daily for the appropriateness of conversion to oral or NG therapy. The following outcome measures were used to test the effectiveness of the intervention in modifying physician prescribing: mean number of i.v. doses and days of i.v. therapy per patient and mean number of inappropriate i.v. doses and days of i.v. therapy per patient. The drug acquisition costs for both groups were also analyzed. A total of 233 patients were monitored during the study period. The percentage of patients who did not receive oral therapy as soon as possible was not significantly different between the intervention (55%) and control (58%) groups. Patients in the intervention group received three to six fewer i.v. doses than patients in the control group and three to six additional oral doses.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2773963 TI - Antimicrobial misuse in patients with positive blood cultures. AB - PURPOSE: Inappropriate antimicrobial use was examined among a randomly and prospectively selected cohort of patients with at least one positive result of blood cultures. This misuse was then analyzed with respect to hospital charges and length of stay (LOS). PATIENTS AND METHODS: The study consisted of 70 patients (average age, 58.5 years) who had not undergone bone marrow transplantation. Patient charts were reviewed daily for the following information: clinical signs and symptoms of infection, pertinent laboratory data, culture results, detailed data on each antimicrobial in every antimicrobial regimen and their appropriateness, hospital charges, LOS, diagnostic and procedure codes, and discharge status. Three severity of illness variables were generated. Inappropriate antimicrobial use was described according to one of 12 categories. RESULTS: The percent of antimicrobial misuse, defined as the proportion of days of administration of antimicrobials on which one or more antimicrobials were judged inappropriate, was found to be 22.3%. After adjustment for severity of illness and diagnosis, this average inappropriateness correlated with 4.2 additional hospitalization days and $5,368 additional hospital charges. CONCLUSION: Our results cannot distinguish among several possible reasons for these associations, including direct causality (e.g., toxicity and prolonged hospitalization for antimicrobial use) and indirect links such as inappropriate utilization of other resources and influences of severity of illness on antimicrobial use not accounted for in our equations. Nevertheless, the magnitude of the association gives import to the desirability of further studies. PMID- 2773964 TI - Nephrotoxicity and hyperkalemia in patients with acquired immunodeficiency syndrome treated with pentamidine. AB - INTRODUCTION: Recently, the use of pentamidine has risen because of its efficacy in managing patients with acquired immunodeficiency syndrome (AIDS) and Pneumocystis carinii infection. We undertook a retrospective analysis of the charts of 22 patients with AIDS given pentamidine when they were hospitalized over a two-year period. PATIENTS AND METHODS: Collectively, these 22 patients were admitted 28 times during this period and received a total of 23 courses of pentamidine. During five of these admissions, pentamidine was not given. The duration of therapy ranged from five to 33 days (mean: 13.4 days). Three admissions were excluded because of insufficient laboratory data or concomitant use of therapies that could affect the parameters being studied. RESULTS: In 19 of the remaining 20 admissions, the patients treated with pentamidine were observed to have elevations of potassium (5.1 to 8.7 mEq/L), creatinine (1.5 to 11.8 mg/dL), and blood urea nitrogen (27 to 183 mg/dL), and a decrease in serum bicarbonate (14 to 21 mEq/L). Of the 19 patients exhibiting these abnormalities, most required sodium polystyrene sulfonate and two required dialysis. During the admissions when pentamidine was not given, hyperkalemia was not observed. After discontinuation of pentamidine therapy, these metabolic derangements normalized in all patients except for one who died while still in acute renal failure. Four patients received more than one course of therapy and upon reinstitution of pentamidine treatment, the same metabolic abnormalities recurred. CONCLUSION: In conclusion, pentamidine is more nephrotoxic in patients with AIDS than previously reported in other subjects and can cause life-threatening hyperkalemia. PMID- 2773965 TI - Prevalence of acanthosis nigricans in an unselected population. AB - PURPOSE: The intent of this study was to determine, in an unselected population, the prevalence of the hyperinsulinemia-associated skin lesion, acanthosis nigricans. SUBJECTS AND METHODS: The posterior neck of every child in the sixth and eighth grades of the public schools of Galveston, Texas, was personally examined by the investigators during a state-mandated school health survey. A total of 1,412 children were examined. RESULTS: The data for each child examined included the absence or presence of acanthosis nigricans, height, weight, age, sex, and ethnic background. A subset of the children with the skin lesion also had fasting plasma insulin levels measured. Acanthosis nigricans was present in 7.1% of the 1,412 children examined. The skin lesion was equally distributed between boys and girls and was most common among children with severe obesity. The condition was present in two of 440 white non-Hispanics, 19 of 343 Hispanics, and 80 of 601 blacks examined. The fasting plasma insulin concentrations measured in some of these children and in previously evaluated subjects strongly correlate with the presence and severity of the acanthosis nigricans skin lesion. CONCLUSIONS: This skin lesion is much more common than previously believed and has a dramatic ethnic predisposition. We conclude that the high prevalence of this skin lesion further suggests that insulin resistance and hyperinsulinemia, with all of their serious medical implications, are also highly prevalent. PMID- 2773966 TI - Cimetidine and adverse reactions: a meta-analysis of randomized clinical trials of short-term therapy. AB - PURPOSE: We pooled data from randomized, double-blind, placebo-controlled trials to determine the frequency of adverse reactions among patients treated with cimetidine for acute acid-peptic disorders. METHODS: Meta-analysis was used to analyze data obtained from a search of English language reports of trials of cimetidine in the ambulatory treatment of acute acid-peptic disorders that were published between January 1982 and April 1987. RESULTS: Of 161 trials of cimetidine that we identified, 84 provided complete reporting of data on adverse reactions and, of these, 24 employed a randomized, double-blind, placebo controlled design. Across these 24 trials, the overall rate of reported adverse reactions among 622 patients randomly assigned to receive cimetidine was 10.9%; the corresponding rate among 516 patients randomly assigned to receive placebo was 10.1%. This difference was not statistically significant (p greater than 0.10), nor were any significant differences noted in the frequencies of reported central nervous system or gastrointestinal adverse reactions (p greater than 0.10). Rates of adverse reactions also did not differ by dosage or trial duration. The overall rate of adverse reactions reported in the 60 trials that did not utilize a randomized, double-blind, placebo-controlled design was similar to the rate reported in those that did. CONCLUSIONS: Our findings suggest that the frequency of adverse reactions among patients receiving cimetidine for acute acid-peptic disorders is not significantly different from that of patients receiving placebo. PMID- 2773967 TI - Intra-articular orgotein in osteoarthritis of the knee: a placebo-controlled efficacy, safety, and dosage comparison. AB - PURPOSE: Superoxide dismutase (orgotein for injection) has been used in managing osteoarthritis for more than seven years in Europe; however, well-controlled studies to establish an optimum dosage regimen have not been conducted. In this study, three orgotein dose/regimens were compared with placebo in terms of efficacy, safety, and duration of effect in patients with active osteoarthritis of the knee. PATIENTS AND METHODS: A total of 139 patients with osteoarthritis of the knee were enrolled in the study. Nonsteroidal anti-inflammatory agents were withdrawn to induce a flare of disease activity. Patients were then randomly assigned to receive one intra-articular injection of either placebo or orgotein (8 mg to 32 mg) each week for three weeks. Both investigators and patients evaluated disease activity and adverse experiences at a series of follow-up visits for three months. RESULTS: Orgotein was effective in reducing symptoms of osteoarthritis for up to three months after treatment; 16 mg given twice was the most effective and most best-tolerated regimen. Discomfort at the injection site was drug related, although this effect also occurred occasionally after injection of placebo. CONCLUSION: The long-lasting effects of intra-articular superoxide dismutase contribute to a favorable risk-benefit ratio and support the importance of the free-radical anion, superoxide (O2-), in the biochemical pathology of osteoarthritis. PMID- 2773968 TI - Lyme disease concurrent with human immunodeficiency virus infection. PMID- 2773969 TI - Granulocytic sarcoma: three unusual patients. AB - This report describes three unusual patients with lesions due to myeloblasts. In one instance, the patient presented with massive adenopathy. The second patient had bone lesions and a pathologic fracture. The third patient, with myelodysplasia, had diffuse skin lesions infiltrated with myeloblasts. These cases fit the diagnostic category of granulocytic sarcoma. Granulocytic sarcoma is a tumor of immature myeloid cells that may involve any site in the body but that most commonly affects the skin, soft tissues, lymph nodes, bone, and periosteum. Lesions can predate leukemia or occur late in an established chronic granulocytic leukemia or acute granulocytic leukemia. The most common presentation occurs late in the course of acute granulocytic leukemia or in chronic granulocytic leukemia as a herald to blastic transformation. Therapy for localized lesions is radiotherapy, which produces prompt shrinkage of the lesions but relapse occurs subsequently. Systemic chemotherapy also produces satisfactory clinical results. In all instances, therapy can only be considered palliative since virtually all patients have a short survival following the appearance of an extramedullary myeloblastic lesion. Recognition of this pathologic entity at an early stage may give us information on the best management for these patients. PMID- 2773970 TI - Successful management of Mycoplasma hominis septic arthritis involving a cementless prosthesis. PMID- 2773971 TI - Prostatitis in chronic granulomatous disease. PMID- 2773972 TI - Recurrence and specificity of nephrotic syndrome due to tolmetin. PMID- 2773973 TI - Myxedema coma associated with lithium therapy. PMID- 2773974 TI - Streptokinase therapy and cholesterol embolization. PMID- 2773975 TI - Acute renal failure precipitated by elevated colloid osmotic pressure. PMID- 2773976 TI - Factor V inhibitor in celiac disease. PMID- 2773977 TI - Labetalol hepatotoxicity. PMID- 2773979 TI - Hepatitis B: the disease and its prevention. Proceedings of a symposium. October 17, 1988, San Francisco, California, and October 21, 1988, Washington, D.C. PMID- 2773978 TI - Fatal colchicine toxicity. PMID- 2773980 TI - Hepatitis B infection in the United States. Recent trends and future strategies for control. AB - Viral hepatitis is the second most common reportable infectious disease in the United States, with hepatitis B accounting for about 45 percent of cases. Although approximately 25,000 cases of hepatitis B are reported to the Centers for Disease Control each year, it is estimated that there are actually about 300,000 annual infections (up from 200,000 in the early 1980s). This increase has occurred despite the availability of a safe and effective hepatitis B vaccine since 1982. Hepatitis B occurs primarily in young adults because of lifestyle or occupationally related exposure. Reported cases in homosexual men have decreased, probably because of changes in behavior related to the acquired immunodeficiency syndrome epidemic. Cases due to heterosexual transmission and intravenous drug use are increasing. The proportion of cases in health care workers has decreased, possibly because 30 to 40 percent of high-risk health care workers have been vaccinated. Because of the increase in hepatitis B infection, the strategy of controlling this disease by vaccinating high-risk groups must be reconsidered. Alternative strategies include selective or universal immunization of infants or adolescents. Although integrating hepatitis B vaccine into infant immunization programs takes advantage of the existing system, it would not lead to measurable disease reduction for two decades. Immunizing adolescents would more rapidly reduce the incidence of hepatitis B, but currently no structured health care setting reaches them. PMID- 2773981 TI - Feasibility of controlling or eradicating the hepatitis B virus. AB - A hepatitis B vaccine, prepared from the hepatitis B surface antigen in human blood has been available since the early 1980s. A recombinant vaccine, which can be supplied in unlimited amounts, was recently introduced. Based on current data, these vaccines are highly effective and safe. The most effective procedures for controlling hepatitis B virus is the vaccination of newborn infants. After universal vaccination of newborns has been ensured, vaccination of susceptible persons in older age groups could be instituted. Any attempt at eradicating hepatitis B virus will require international cooperation, and ideally the hepatitis B virus vaccine should be integrated into other childhood vaccination programs. PMID- 2773982 TI - Seroepidemiology of hepatitis B virus infection in the United States. 1976 to 1980. AB - The prevalence of hepatitis B virus (HBV) infection was determined using sera from persons participating in the second National Health and Nutrition Examination Survey, conducted from 1976 to 1980. Of 14,488 scientifically selected participants aged 12 to 74, 821 had evidence of past or present infection with HBV. In the white population, the weighted estimate of hepatitis B infection was 3.2 percent (95 percent confidence interval, 3.1 to 4.2). A steady increase with age was seen; by ages 65 to 74, the prevalence was 6.9 percent (95 percent confidence interval, 5.2 to 8.5). In the black population, the overall weighted estimate of prevalence was 13.7 percent (95 percent confidence interval, 11.6 to 15.8). In this racial group, there was a dramatic increase with age, with the oldest age groups having a prevalence of 39.6 percent (95 percent confidence interval, 29.1 to 50.0). In both racial groups, there was a low prevalence of infection in young children that began to rise between ages 12 and 18. In a multivariate analysis of factors associated with infection, there was an interaction of race with age; therefore, the odds ratio for race is presented for four ages. This ratio ranged from 3.0 (95 percent confidence interval, 1.8 to 4.2) for a 15-year-old to 8.2 (95 percent confidence interval, 6.5 to 10.3) for a 70-year-old. These relative odds estimates were not substantially affected by adjustment for the available information on risk factors for HBV infection. The results of this study in a representative sample of the United States population show that adult black Americans are at high risk for hepatitis B infection. Other independent predictors of HBV positivity include male sex; residing in the South, Northeast, or West; residing in a city of 250,000 or more people; serving in the armed forces; living below the poverty level; and having a positive treponemal test for syphilis. These data suggest that the immunization practices for controlling this disease should be re-examined. PMID- 2773983 TI - Microscopic study of holoprosencephalic facial anomalies in trisomy 13 fetuses. AB - The cerebral and facial anatomy of four trisomy 13 fetuses was studied in order to delineate the varying degrees of expression of severity of holoprosencephaly. Fetal heads were serially sectioned and analyzed microscopically in the horizontal plane. Examples of cyclopia, cebocephaly, and a proposed new category, premaxillary dysgenesis, were studied. The last category represents the least severe end of the facial spectrum of holoprosencephaly in this series. In this condition, there are deficiencies or clefts within the premaxilla, in contrast to the usual site of clefting between the maxilla and the premaxilla. There is asymmetry of the defects in the anterior midface of all four cases. PMID- 2773984 TI - Lethal form of fibuloulnar A/hypoplasia with renal abnormalities. AB - The present report describes two sibs with lethal acrorenal developmental complex who were products of a nonconsanguinous marriage. Clinical and roentgenologic characteristics did not match any of the known types of fibuloulnar dysostosis. Distinct abnormalities included lethality at birth, facial anomalies, ear anomalies, symmetrical mesomelic shortness of long bones, fibular agenesis, normal vertebrae, oligosyndactyly of phalanges, congenital heart defect, and cystic or hypoplastic kidney. These cases suggest a new lethal form of recessively inherited fibuloulnar dysostosis with renal anomalies. PMID- 2773985 TI - Polyasplenia complex with mesocardia and renal agenesis in an infant of a diabetic mother. AB - Despite improved prenatal care, infants of diabetic mothers (IDM) have an increased risk of congenital malformations. We report on an IDM with multiple congenital anomalies consistent with the polyasplenia complex with associated mesocardia and renal agenesis. The morphologic characteristics of these malformations are discussed. Special emphasis is given to the polyasplenia complex as an example of midline developmental field defect. The importance of maternal levels of hemoglobin A1c in relation to congenital malformations is addressed. PMID- 2773986 TI - Clinical, cytogenetic, and pedigree findings in 18 cases of Aicardi syndrome. AB - Eighteen girls with Aicardi syndrome were identified through a survey of neurologists, geneticists, and ophthalmologists. All had infantile seizures, developmental delay, agenesis of the corpus callosum (complete: 72%, partial: 28%), and characteristic chorioretinal lacunar lesions. Costovertebral defects including hemivertebrae, scoliosis, and absent or malformed ribs were present in 39%, cortical heterotopias were present in 50%, and microphthalmia was identified in a third. Cytogenetic investigation was carried out in all families. An unbalanced X;3 translocation, 46,X,der(X)t(X;3)(p22.3;p23)mat, was discovered in a girl with chorioretinal lacunar lesions characteristic of Aicardi syndrome, developmental delay, and infantile seizures. However, this child had a normal appearing corpus callosum on CT and magnetic resonance imaging scans and therefore did not meet the criteria for inclusion in the study. Chromosomes of all other patients and parents were normal. Findings at birth, age of seizure onset, treatment, and prognosis are discussed. The pedigree data from these 18 families demonstrated an unaffected male:female sib ratio of 1:1.7 and a 14% spontaneous abortion rate. The findings of this study support the contention that Aicardi syndrome is an X-linked dominant disorder with early embryonic lethality in hemizygous males and that all cases represent new mutations. PMID- 2773987 TI - Skeletal dysplasia syndrome with progeroid appearance, characteristic facial and limb anomalies, multiple synostoses, and distinct skeletal changes: a variant example of the Lenz-Majewski syndrome. AB - Here we report a 10 year-old mentally retarded, deaf boy with a unique pattern of anomalies: progeroid appearance, characteristic facial and limb anomalies, multiple synostoses, and distinct skeletal changes. He represents a variant example of "hyperostotic dwarfism" as delineated by Lenz and Majewski. PMID- 2773988 TI - Gaucher disease type I and pregnancy. AB - We surveyed 47 pregnancies of 17 women affected with Gaucher disease (GD) type I. In two women affected with the severe form of GD type I, no change was observed in the course of the disease during pregnancy. In one patient with the moderate form of the disease there was an exacerbation of the disease during and after pregnancy, and thereafter two subsequent pregnancies of this woman ended by early spontaneous abortion. Four women were diagnosed during their pregnancy or soon after delivery suggesting in these women an exacerbation related to pregnancy. In the other ten women there was no change in the course of the disease. In general, the pregnancies of women affected with GD were normal; however, six women needed blood transfusion during pregnancy or at delivery. From these data it is suggested that there is some risk to pregnant women affected with GD type I, and accordingly, appropriate follow-up should be planned at the beginning of pregnancy in these patients. PMID- 2773989 TI - Hypertrichosis cubiti. AB - Hypertrichosis is an unusual but well-recognized genetic condition. Hypertrichosis may be generalized or limited to specific body areas, in which case it is usually not associated with other anomalies. Five previous cases of hypertrichosis cubiti have been reported, with short stature in 2 sibs being the only other associated abnormalities. We report on a child with hairy elbows, developmental delay, facial asymmetry, and delayed speech with normal parents. Our patient may represent severe expression of the hairy elbow syndrome or constitute a previously unrecognized syndrome. PMID- 2773990 TI - Tricho-rhino-phalangeal and branchio-oto syndromes in a family with an inherited rearrangement of chromosome 8q. AB - Here we report on a family with an inherited rearrangement of chromosome 8q, dir ins(8)(q24.11q13.3q21.13). Individuals with the chromosome abnormality, which does not appear to be associated with deletion of chromosome material, have manifestations of both tricho-rhino-phalangeal syndrome (TRPS) and branchio-oto syndrome (BOS). TRPS has been linked previously to deletions involving 8q24.11--- q24.13, but none of the described patients with deletions in this part of 8q have had characteristics of the BOS. The presence of a breakpoint in 8q24.11 without apparent chromosome deletion in the family described suggests that TRPS maps to this band of 8q. Further, it is suggested that BOS maps to either 8q13.3 or 8q21.13. PMID- 2773991 TI - Confirmation of prenatal diagnosis of sex chromosome mosaicism. AB - Prenatal diagnosis of mosaicism causes problems in interpretation and in genetic counselling. Part of the difficulty with any prenatal diagnosis of mosaicism is interpretation of results without knowing the exact origin, embryonic or extraembryonic, of the abnormal cell line. To confuse the issue in cases of prenatal diagnosis of 45,X/46,XY mosaicism is the recent demonstration that a diagnosis of 45,X/46,XY made prenatally is not necessarily associated with the same phenotype as when diagnosed postnatally. We present two cases of prenatal diagnosis of sex chromosome mosaicism (45,X/46,XY and 45,X/47,XYY). Posttermination examination of the phenotypically normal male fetuses and their placentas established that the placenta was the most likely source of the 45,X cell line. An approach to confirming the prenatal diagnosis of sex chromosome mosaicism and establishing its origin utilizing detailed cytogenetic examination of both fetus and placenta is suggested. PMID- 2773992 TI - Prenatal diagnosis of a large heteromorphic region in a chromosome 5: implications for genetic counseling. AB - We performed an amniotic fluid chromosome study at 16 weeks of gestation because of advanced maternal age. G-band chromosome analysis demonstrated that one 5q was significantly longer than its homologue. The region subjacent to the centromere appeared similar to a 9qh region. Subsequent Giemsa-11 and C-band staining results of this area were positive. Cytogenetic studies in this family demonstrated several other individuals who have the same chromosome 5qh+ as the proposita. All are asymptomatic. The clinical insignificance of the chromosome heteromorphism in this family readily demonstrates the need for special cytogenetic and family chromosome studies before performing genetic counseling. PMID- 2773993 TI - Cataracts, alopecia, and sclerodactyly: a previously apparently undescribed ectodermal dysplasia syndrome on the island of Rodrigues. AB - An unique autosomal recessive ectodermal dysplasia is present in 5 sibs from the Indian Ocean island of Rodrigues. The main manifestations are total congenital alopecia, bilateral congenital cataracts, and skin changes of the hands and feet including sclerodactyly, hyperkeratosis, contractures, and pseudoainhum formation. The phenotype differs from that of other genetic ectodermal dysplasias and independent syndromic status is probable. PMID- 2773994 TI - Nonketotic hyperglycinemia in a patient with the 9p- syndrome. AB - We describe a newborn infant with 9p- syndrome and nonketotic hyperglycinemia. This unusual occurrence may not have been coincidental and suggests that there may be a gene for nonketotic hyperglycinemia located on the short arm of chromosome 9. PMID- 2773995 TI - Chromosome mosaicism in 6,000 amniocenteses. AB - Multiple cell-multiple flask mosaicism was found in 0.20% of 6,000 amniocenteses, and multiple cell-single flask mosaicism was found in 0.92%. Multiple cell multiple flask mosaicism usually was found in fetal or infant tissues at delivery or elective abortion. Most multiple cell-multiple flask mosaicism involved sex chromosomes and was either 45, X/46, XY or 45, X/46, XX. Except for one fetus with 45, X/46, XX and an aortic coarctation, phenotypic abnormalities associated with sex chromosome mosaicism were not found in these patients. One normal boy has continued to show 45,X mosaicism during the first 4 years of life. Autosome abnormalities found in multiple cell-multiple flask mosaicism included del(18q) associated with fetal anomalies. Apparently normal phenotypes were associated with prenatal trisomy 17, two de novo supernumerary marker chromosomes, and monosomy 21. Since an aberrant cell line present in only one primary amniotic fluid cell culture was occasionally identified from another amniocentesis or at birth, multiple cell-single flask mosaicism involving a sex chromosome or a viable autosome abnormality cannot be assumed to be an in vitro event. Maternal cell contamination, which was found in 0.49% of amniocenteses, could have resulted in an erroneous diagnosis of fetal sex in two cases if cells from independent culture vessels were not examined. PMID- 2773996 TI - Interstitial deletion of the proximal long arm of chromosome 4 associated with father-child incompatibility within the Gc-system: probable reduced gene dosage effect and partial piebald trait. AB - Gc-system typing by isoelectric focusing polyacrylamide gel electrophoresis and quantitative assays were carried out on a patient with a karyotype of 46,XY,del(4)(q12q21.1) and on his parents with normal chromosomes. Although a father-child incompatibility within the Gc-system suggested that its locus is on segment 4q12-13, the serum concentration of vitamin D binding protein in the patient and his father were only about half of that of his mother and control individuals. The possibility of interference of a silent allele in the child could not be excluded. Associated congenital partial leukodermia appeared to be an expression of a partial piebald trait. PMID- 2773997 TI - Prometaphase chromosomes in the tricho-rhino-phalangeal syndrome type I. AB - Prometaphase chromosome analysis was undertaken in a patient with familial tricho rhino-phalangeal syndrome type I (TRPS-I). The patient had apparently normal chromosomes and produced counterevidence to part of Buhler's hypothesis. Thus, although some cases of typical TRPS-I may be derived from a deletion of 8q24.12, others might be caused by gene mutation or submicroscopic deletion involving the corresponding locus within the band 8q24.11----24.13. PMID- 2773998 TI - Growth of the foramen magnum in achondroplasia. AB - Foramen magnum growth curves in achondroplasia and in the general population are presented. The achondroplastic foramen magnum is small at birth, and during the first year it has a severely impaired rate of growth especially in the transverse dimension. This markedly diminished growth results not only from abnormal endochondral bone growth but also because of abnormal placement and premature fusion of the synchondroses. Evaluation of the foramen magnum in achondroplasia should address absolute size of the transverse and sagittal dimensions, shape, and growth centers to determine growth potential of this area. PMID- 2773999 TI - Somatic and intellectual development in a patient with 47,XX,psu dic(X)(p11.2) chromosome constitution. AB - An unusual form of X chromosome aneuploidy, 47,XX,psu dic(X)(p11.2), was found during an evaluation for short stature of a prepubertal girl. Unlike 45,X, 47,XXX, 48,XXXX, and 49,XXXXX females, this patient is phenotypically normal except for her short stature, which appears to be unrelated to her chromosome abnormality. X chromosome inactivation studies disclosed inactivation (late replication) of one normal X and the abnormal X chromosome in all cells examined from this patient. Therefore, she is disomic for early-replicating distal Xp loci, found in inactivated X chromosomes, and thought to remain active after lyonization. These data suggest that the presence of three or more copies of the early-replicating, active Xp loci may be responsible for the cognitive deficits and other phenotypic abnormalities seen in and other phenotypic abnormalities seen in polysomy X females. PMID- 2774000 TI - Echinogenic action of L-alpha-lysophosphatidylcholine in Duchenne muscular dystrophy: a study on carrier detection. AB - The percentage of echinocytes induced after red cell treatment with L-alpha lysophosphatidylcholine in the blood of 16 patients affected by Duchenne muscular dystropy (DMD) has been evaluated. Moreover, 15 mothers, 10 sisters, and 15 fathers were also included in the study. We found an increased level of echinocytes in dystrophic patients and in known and possible carriers. Correlations were also evaluated between echinocytes and serum enzymes used in DMD diagnosis, showing an increase of echinocytes also in DMD carriers with normal levels of serum creatine kinase, lactate dehydrogenase, and aldolase. Our results suggest that the sensitivity of erythrocytes to L-alpha lysophosphatidylcholine in DMD could be used as a diagnostic test for carrier detection. PMID- 2774001 TI - Detection of a 15q deletion in a child with Angelman syndrome by cytogenetic analysis and flow cytometry. AB - A proximal 15q deletion, del(15) (q11:q13), was detected in a child with Angelman syndrome by cytogenetic analysis of peripheral lymphocytes. The chromosomes of both parents appeared normal. Flow karyotype analysis carried out on lymphoblastoid cell lines derived from the child and her parents confirmed the presence of a de novo 15 deletion. The estimated size of the deleted segment ranged from 6.1-9.5% of chromosome 15 (approximately 6-9.3 million base pairs). The parental origin of the deleted chromosome could not be resolved by flow cytometry, but cytogenetic evidence suggested that it was derived from the smaller chromosome 15 homologue in the mother. PMID- 2774002 TI - Aspartoacylase deficiency and N-acetylaspartic aciduria in patients with Canavan disease. PMID- 2774004 TI - Urinary tract abnormalities in hand-foot-genital syndrome. PMID- 2774003 TI - Height and clinical course of Duchenne muscular dystrophy. PMID- 2774005 TI - Idiopathic multicentric osteolysis: report of two new cases and a review of the literature. PMID- 2774006 TI - Apert syndrome with polysyndactyly of the feet. PMID- 2774007 TI - Another case of ring chromosome 9 associated with gastroesophageal reflux. PMID- 2774009 TI - Complex chromosomal rearrangements. PMID- 2774008 TI - Inheritance of Rubinstein-Taybi syndrome. PMID- 2774011 TI - A turnaround toward caring? PMID- 2774010 TI - Sex vesicle "entrapment": translocation or nonhomologous recombination of misaligned Yp and Xp as alternative mechanisms for abnormal inheritance of the sex-determining region. AB - Abnormal inheritance of the sex determining region, normally located on Yp, results in about 1 in 20,000 phenotypic males with a 46,XX genotype. Studies to date indicate that many 46,XX males apparently arise due to a balanced, yet abnormal, nonhomologous interchange of Xp and Yp termini. However, 2 of the 5 XX males we report here have 3 copies of the pseudoautosomal locus, MIC2. Thus, they appear to have inherited the sex determining region as a result of Yp sequences being added onto the X pseudoautosomal region. Such an unequal, extremely nonhomologous interchange could alternatively be considered to arise from an unbalanced translocation of Yp to Xp. Our results suggest that very unequal interchange or translocation of Yp sequences onto the X pseudoautosomal region is not as rare a mechanism for XX males as originally thought. We also suggest that sex vesicle "entrapment" favors the association of a Yp fragment to the X pseudoautosomal region over a translocation to either Xq or an autosome. PMID- 2774013 TI - AIDS. PMID- 2774012 TI - The sad state of children's health includes a rise in abuse. PMID- 2774014 TI - Comfort versus cure. PMID- 2774015 TI - Pressuring for the use of HBO. PMID- 2774016 TI - Sexual healing after heart attack. PMID- 2774017 TI - Drug overdose. PMID- 2774018 TI - Quicker and sicker. PMID- 2774020 TI - Digital replantation in children. PMID- 2774019 TI - The birth-weight/battering connection. PMID- 2774021 TI - Healing we cannot explain. PMID- 2774022 TI - Coauthorship: collaboration without conflict. PMID- 2774023 TI - Northeast jobfocus. A Northeast primer. PMID- 2774024 TI - Expert practice: trading examples over pizza. PMID- 2774025 TI - How do you give continuous epidural fentanyl? PMID- 2774026 TI - Boston jobfocus. Boston basics. PMID- 2774027 TI - Pennsylvania jobfocus. Pennsylvania profile. PMID- 2774028 TI - AIDS-infected RN wins "confidentiality" fight. PMID- 2774029 TI - Do you want everything done? PMID- 2774030 TI - Risk factors for the development and severity of glaucoma in the pigment dispersion syndrome. AB - The medical records of 93 patients with pigmentary glaucoma and 18 patients with pigment dispersion syndrome were studied with regard to factors associated with the presence and severity of secondary glaucoma within this population. Male gender, black race, severe myopia, and Krukenberg spindles were identified as possible risk factors. Men were predominant in this population 75 (67.6%); the diagnosis was made in men at an earlier age; they had a higher proportion in the glaucoma group; and they required more aggressive glaucoma therapy. There were only four black patients, but all required surgery. Patients in the glaucoma group had significantly more severe myopia and a higher incidence of Krukenberg spindles. These risk factors may help to identify which patients with the pigment dispersion syndrome require closer follow-up or the possible initiation of prophylactic therapy. PMID- 2774032 TI - Familial cavernous angiomas manifesting with an acute chiasmal syndrome. AB - We studied a family in which the proband had an acute chiasmal syndrome secondary to a cavernous angioma of the optic nerve and chiasm. A brain magnetic resonance imaging scan indicated additional asymptomatic intracerebral cavernous angioma, and several of the patient's relatives were found to have various central nervous system vascular malformations. Magnetic resonance imaging may distinguish, noninvasively, symptomatic and asymptomatic carriers of cavernous angiomas and further delineate their inheritance patterns. Asymptomatic cavernous angiomas of the central nervous system are best followed without intervention, whereas symptomatic patients should be treated on an individual basis, depending on the location of lesion and the risk of surgical removal. PMID- 2774031 TI - An autosomal dominant form of low-tension glaucoma. AB - A condition causing glaucomatous optic atrophy and visual field loss at normal or borderline intraocular pressure affected eight members of a family of consecutive generations. The disease was detectable in early adulthood and progressed slowly throughout life. The pattern of inheritance is autosomal dominant. One affected individual died of a myocardial infarction, and his eyes were obtained post mortem. Light and electron microscopic examination demonstrated glaucomatous optic atrophy with loss of ganglion cells. The trabecular meshwork, choroidal and optic nerve vasculature, retinal pigment epithelium, and photoreceptors were normal in appearance. We believe this family has an autosomal dominant genetic condition that is a distinct type of low-tension glaucoma. PMID- 2774033 TI - Diphtheroids as ocular pathogens. AB - Unlike Corynebacterium diphtheriae and Propionibacterium acnes, the pleomorphic gram-positive rods known as diphtheroids are generally regarded as nonpathogenic contaminants of the human external eye. We reviewed five years of microbiology records at Wills Eye Hospital and studied a series of eight cases of apparently infectious keratitis associated with heavy growth of diphtheroids on cultures of ulcer scrapings. All of these cases included indolent ulcers that occurred almost exclusively in elderly patients (mean age, 72 years; range, 11 to 92 years). All patients had preexisting ocular conditions that compromised the corneal surface such as exposed corneal sutures, eyelid surgery, aphakic extended wear contact lenses, viral keratitis, and diabetes mellitus. No other pathogens were isolated. All infections responded well to antibiotic therapy with all organisms sensitive to cefazolin and all but one sensitive to gentamicin. PMID- 2774034 TI - Central pigmentary sheen dystrophy. AB - Three members from two successive generations demonstrated a bilateral, symmetric pigmentary maculopathy consisting of a diffuse yellowish sheen of the posterior pole. The visual acuity was variable (20/25 to 10/400) and visual function tests indicated a localized disorder. Historic information suggests the disorder is slowly progressive. On the basis of mode of inheritance, fundus and angiographic appearance, and visual function testing this appears to be a newly described disorder. PMID- 2774035 TI - The role of cryotherapy in the management of retinoblastoma. AB - Between February 1974 and August 1987, we treated 67 retinoblastomas in 47 eyes of 45 patients with cryotherapy (triple freeze-thaw technique). Overall, cryotherapy eradicated 53 (79%) of the tumors, whereas additional treatment with episcleral plaque radiotherapy, external beam radiotherapy, or enucleation was necessary in 14 (21%) of the tumors. Tumor destruction was achieved with one or more cryotherapy treatments in all cases in which the tumor was no greater than 2.5 mm in diameter and 1.0 mm in thickness, and in which the tumor was confined to the sensory retina without seeding into the adjacent vitreous humor. We therefore recommend cryotherapy in such cases. Cryotherapy alone failed in 14 larger tumors, ten of which had clinical evidence of vitreous seeding by tumor cells. Cryotherapy is therefore contraindicated in cases of vitreous seeding or if the tumor exceeds 3.5 mm in diameter and 2.0 mm in thickness. Cryotherapy can be successful for tumors up to 3.5 mm in diameter and 2.0 mm in thickness, but more than one treatment may be necessary. PMID- 2774036 TI - Flurbiprofen sodium to prevent intraoperative miosis during vitreoretinal surgery. AB - To assess the efficacy of flurbiprofen sodium 0.03% at maintaining pupillary dilation during vitreoretinal surgery, we performed a randomized, double-masked, controlled trial of 139 consecutive patients. The mean decrease in pupil size during surgery in patients who received flurbiprofen was 0.9 mm; for patients who did not receive the drug it was 0.8 mm. The type of surgery performed (vitrectomy or scleral buckle), gender, age, lens status, and a history of diabetes or previous intraocular surgery were assessed and the addition of flurbiprofen to routine preoperative dilation did not significantly affect the mean change in pupil size for any of these subgroups. Of the nine patients who developed at least 3 mm of miosis, five received flurbiprofen and four did not. Use of flurbiprofen did not appear to reduce intraoperative miosis during vitreoretinal surgery in a clinically meaningful manner. PMID- 2774037 TI - Hereditary macular dystrophy without visible fundus abnormality. AB - We found an unusual form of macular dystrophy in three patients from two generations of the same family. The fundi of these patients appeared normal by ophthalmoscopy and fluorescein angiography, even in an older patient and in patients with poor visual acuity. Results of full-field electroretinograms were also normal in both cone and rod components. Focal macular electroretinograms were severely affected, however, indicating retinal impairment in the macular region. Results of Tubingen perimetry were consistent with electroretinographic findings. Since the condition was progressive, this disease is thought to be a hereditary macular dystrophy without visible fundus abnormality. PMID- 2774038 TI - Extracapsular cataract extraction in Fuchs' heterochromic iridocyclitis. AB - We studied 15 patients with Fuchs' heterochromic iridocyclitis who underwent extracapsular cataract extraction. Ten patients also had capsular-fixated posterior chamber intraocular lens implantation. The patients were followed up for a mean of 23 months (range, six to 48 months). The clinical course and visual outcome were favorable. All patients had a postoperative best-corrected visual acuity of 20/40 or better. There were no major surgical, intraoperative, or postoperative complications. PMID- 2774039 TI - A comparison of two methods of punctal occlusion. AB - We performed punctal occlusion by thermal cautery on 23 patients (45 sides, 90 puncta). One punctum on the right side was randomly assigned to deep cauterization of the punctum and vertical canaliculus, and the other punctum assigned to cauterization of the punctum only. The two treatments were assigned to the opposite puncta on the left side. One month after cauterization, the puncta that received deep cauterization were significantly more likely to have remained closed than those that received superficial cauterization (P less than .01). Survival analysis over a period of follow-up that exceeded one year after surgery, using time to examination because of a reopened punctum as the endpoint, indicated a long-term advantageous effect of deep over superficial cauterization. PMID- 2774040 TI - The future of computerized image analysis in the management of glaucoma. PMID- 2774041 TI - Photographic simulation of image quality through bifocal intraocular lenses. PMID- 2774042 TI - A retrospective study on the selection criteria for ophthalmology residents. PMID- 2774043 TI - Examination of hydrophilic contact lenses with light microscopy to aid in the diagnosis of Acanthamoeba keratitis. PMID- 2774044 TI - Keratoconus in Alagille's syndrome. PMID- 2774045 TI - Vitreous hemorrhage associated with pilocarpine. PMID- 2774046 TI - Tube migration after glaucoma shunt procedure. PMID- 2774048 TI - Indomethacin for the treatment of idiopathic orbital myositis. PMID- 2774050 TI - Louisiana's criteria of eligibility for occupational therapy services in the public school system. AB - Since the enactment of the Education for All Handicapped Children Act of 1975 (Public Law 94-142), occupational therapists in the public schools have been responsible for determining the occupational therapy needs of special education students. In Louisiana, therapists and special educators, in cooperation with the Louisiana Department of Education, have developed the criteria of eligibility for occupational therapy. These criteria do not alter the descriptive standards established in Public Law 94-142; instead, they provide an objective method for the selection of students in need of occupational therapy. The criteria, which have been revised and refined since 1981, were adopted recently by the Louisiana Board of Elementary and Secondary Education. This paper presents these criteria and examples of their implementation. PMID- 2774047 TI - Kearns-Sayre syndrome and primary open-angle glaucoma. PMID- 2774049 TI - Home health care revisited: challenges for the future. PMID- 2774051 TI - The effect of positioning on the hand function of boys with cerebral palsy. AB - The effect of positioning (sitting and prone standing) on the hand function of 10 boys (mean age = 12.5 years, SD = 1.2 years) with spastic diplegic cerebral palsy was studied. Two groups of subjects were tested twice (Tests 1 and 2) with the Jebsen-Taylor Hand Function Test (Jebsen, Taylor, Treischmann, Trotter, & Howard, 1969; Taylor, Sand, & Jebsen, 1973) to measure rate of manipulation. In addition, a scale modified from Hohlstein (1982) was used to measure quality of grasp on each subtest of the Jebsen-Taylor test. No significant differences between the mean scores of the two groups were found on the total scores of the Jebsen-Taylor test, either between Tests 1 and 2 or between sitting and prone standing. When the data from Tests 1 and 2 were combined, it was found that on one subtest- simulated feeding--the subjects performed significantly faster while in a prone standing position. On another subtest--picking up small objects--the subjects performed significantly faster while in a sitting position. Except during the simulated feeding subtest, the quality of the subjects' grasp was observed to be mature and tailored to the objects manipulated. This paper presents considerations for analyzing positioning in relation to upper extremity tasks. PMID- 2774053 TI - Competence, duration, and heart rate--factors that affect exercise. PMID- 2774052 TI - The effects of a maternal preparation program on mother-infant pairs: a pilot study. AB - This quasi-experimental pilot study examined the association of a maternal preparation program with womens' competence in maternal care behaviors, self perceived adaptation to the maternal role, and satisfaction with the maternal preparation received in conjunction with obstetric and delivery care. Sixteen subjects participated in the program. A cost-benefit questionnaire was completed by the program participants to examine whether the availability of such a maternal preparation program would influence future selections of a hospital for delivery. Our Occupational Therapy Maternal Role Preparation Program was provided to the subjects in four sessions. The program included material on physiological changes in the new mother, orchestration of activities of daily living, infant development and individual differences, and the mother-infant relationship. Results were statistically significant only for the factor of the mothers' satisfaction with their obstetric care and preparation for the maternal role, in favor of the treatment group. In addition, all 8 members of the treatment group reported that they thought the program was helpful and would recommend it to other mothers. PMID- 2774054 TI - Immunohistochemical localization of HTLV-I p19- and p24-related antigens in synovial joints of patients with rheumatoid arthritis. AB - In formalin-fixed, paraffin-embedded synovial tissues from patients with early proliferative rheumatoid arthritis (RA), immunoreactivity could be demonstrated utilizing monoclonal IgG antibodies reactive with the p19 and p24 protein of human T cell leukemia virus (HTLV-I). Additionally, surgical specimens of fresh unfixed synovial tissues from patients with RA also demonstrated immunoreactivity. At the light microscopic level, both HTLV-I antigens were detected in approximately 45% of the rheumatoid synovial tissues by the immunocolloidal gold method with silver enhancement (IGSS) and the avidin-biotin complex technique (ABC), whereas six of eight of the frozen RA specimens stained positive by immunofluorescence. Patients whose synovial tissues were immunoreactive by immunofluorescence were seronegative to HTLV-I antigens as determined by ELISA and immunoblotting. Conversely, cases with osteoarthritis, juvenile rheumatoid arthritis, psoriatic arthritis, Dupuytren's contracture, and gangrene were shown to be nonreactive by immunohistochemistry. The results indicate that expression of antigens is related to or crossreactive with HTLV-I in synovial tissues from patients with rheumatoid arthritis. PMID- 2774055 TI - Expression of the cell-cell adhesion glycoprotein cell-CAM 120/80 in normal human tissues and tumors. AB - Polyclonal and monoclonal antibodies raised to the 80 kd glycoprotein component of the cell to cell adhesion molecule cell-CAM 120/80 were used to map its distribution immunohistochemically in normal human tissues and in benign and malignant tumors. Cell-CAM 120/80 was found in all normal epithelial tissues, but was not expressed on neural, lymphoid, smooth, striated and cardiac muscle, connective tissue, or the germ cells in either sex. The expression of this adhesion molecule was polarized in ductal and glandular epithelia and evenly circumferential in squamous and transitional epithelia. Some organs, such as the kidney, liver and endocrine glands, showed unique organ to tissue specific patterns. Maturation-dependent loss of cell-CAM 120/80 was noticed in superficial layers of squamous epithelium and the placenta. Benign epithelial tumors expressed cell-CAM 120/80 in a manner comparable with their tissue of origin. Malignant tumors expressed cell-CAM 120/80 either in a manner similar to the tissue of their origin or assumed a less polarized phenotype. Overall, the immunoreactivity in many malignant tumors appeared weaker and the polarization was less pronounced. Thus, cell-CAM 120/80 is a universal marker of human epithelial cells, but its mode of expression differs in various anatomic sites, and may be influenced by maturation or malignant transformation of cells. PMID- 2774057 TI - Characterization of a dermal derived malignant mesenchymal tumor arising in ultraviolet irradiated mice. AB - Skh/hr-1 hairless albino mice were irradiated with photocarcinogenic dosages of ultraviolet light for periods of 30 weeks or longer. A high proportion of mice developed pleomorphic spindle cell tumors and epidermal neoplasms of various types. These spindle cell tumors were studied by immunofluorescence and immunoperoxidase techniques and by electron microscopy. Freshly isolated tumor cells were grown in tissue culture. Immunocytochemical analysis showed varying expression of markers of mesenchymal differentiation: vimentin, procollagens I and III, type I collagen, and lysozyme. Electron microscopy showed spindled and cuboidal cells with abundant endoplasmic reticulum, filopodia, and lysosomes, but no intercellular connections. The cells grown in vitro were cuboidal and stellate and also showed mesenchymal differentiation by electron microscopy. These results are perhaps similar to those described for a human actinically produced fibrohistiocytic neoplasm, atypical fibroxanthoma, and this system may provide a useful model of ultraviolet-induced dermal neoplasia. PMID- 2774056 TI - Clonal rearrangements of immunoglobulin genes and progression to B cell lymphoma in cutaneous lymphoid hyperplasia. AB - Cutaneous lymphoid hyperplasia (CLH) is a disorder characterized by the development of one or more skin lesions containing dense lymphoid infiltrates that exhibit the histopathologic features of a benign, reactive process. Nevertheless, some cases have been associated with the subsequent development of clinically overt lymphomas. This suggests that monoclonal populations may exist in some cases of CLH and that these cases may represent a subset more likely to evolve into lymphoma. To determine if such a subset of CLH can be distinguished, Southern blot analysis of DNA was used to study the immunogenotypic features of lesions from 14 patients with clinical, histopathologic, and immunopathologic findings characteristic of CLH. Five cases exhibited detectable clonal rearrangements of immunoglobulin genes. Furthermore, one of these five cases evolved into overt diffuse large cell lymphoma of B cell lineage during a 2-year follow-up of recurrent disease at the original cutaneous site. The immunoglobulin gene rearrangements of this lymphoma were identical to those of the prior CLH lesion. There was no evidence of detectable t(14;18) chromosomal translocations or clonal rearrangements of the beta gene of the T cell receptor in any case. It was concluded that CLH can be divided into two subsets based on the presence or absence of a clonal B cell population, and that overt lymphoma can arise from the former subset and contain the same B cell clone identified in the pre-existent CLH lesion. PMID- 2774058 TI - Formalin-resistant leukocyte surface antigens in the diagnosis of cutaneous malignant lymphomas. AB - Immunophenotyping of routinely embedded lymphoma biopsies, increasingly used in nodal lymphomas, has not been systematically performed in cutaneous lymphomas. Eight monoclonal antibodies were tested directed against formalin resistant antigens (T cell biased: UCHL1, MT1; B cell biased: 4KB5, L26, Ki-B3; HLA-class II: CBL 120; activation antigens: Ber-H2; myeloid biased: Mac 387, M1) in cutaneous T (N = 29) and B (N = 10) cell lymphomas and pseudolymphomas (N = 9). UCHL1 and MT1 showed a high specificity and sensitivity. B cell-restricted antibodies L26 and 4KB5 showed the best sensitivity and specificity among the B cell-associated antibodies; Ki-B3 showed aberrant expression on T cells in some cases. Ber-H2 (CD30) was demonstrated in most cases of large cell anaplastic lymphoma and single cases of other lymphomas and lymphomatoid papulosis. Class II antigen expression, as determined by CBL 120, showed good specificity but low sensitivity, and antibodies directed against myeloid antigens did not react with tumor cells. PMID- 2774059 TI - Emergence of neoplastic transformants spontaneously or after exposure to N-methyl N'-nitro-N-nitrosoguanidine in populations of rat liver epithelial cells cultured under selective and nonselective conditions. AB - Many studies have shown that cultured rat liver epithelial cells can be neoplastically transformed by repeated or long-continued exposure to chemical carcinogens. These cells also may transform spontaneously in the absence of carcinogen treatment after long-term, continuous passage in culture or after chronic maintenance in a confluent state in vitro. In this study, we have compared the times of emergence and rates of accumulation of transformed cells in populations of rat hepatic epithelial cells exposed either to a single dose of N methyl-N'-nitro-N-nitrosoguanidine (MNNG, 3 micrograms/ml culture medium for 30 minutes) or to acetone vehicle alone (3 microliters/ml culture medium for 30 minutes). Transformation was compared in cell populations that were passaged continuously once a week as they attained a confluent density (nonselective growth conditions), or that were maintained at a confluent density for 3 weeks between passages once a month (selective growth conditions). Emergence of both spontaneous transformants and transformants induced by MNNG was facilitated by selective growth conditions, as compared with non-selective growth conditions. Transformants were detected both in cultures exposed to MNNG and in cultures exposed only to acetone (solvent controls), but they always emerged earlier in cultures exposed to MNNG (nine population doublings earlier when grown under selective growth conditions and 22 population doublings earlier when grown under nonselective growth conditions). Once transformants were detected, they replaced the nontransformed population more quickly under selective than under nonselective conditions of culture. Cells possessing the ability to grow in soft agar and to produce tumors in syngeneic rats were detected (at about 12 population doublings after treatment) under selective conditions much earlier than under nonselective growth conditions (at about 90 population doublings after treatment). Among MNNG-treated cultures, the fraction of aneuploid cells in the population was correlated significantly with tumorigenicity. In contrast, among acetone-treated control populations, aneuploidy and tumorigenicity were not correlated; populations of aneuploid acetone-treated cells often were not tumorigenic. These observations suggest that MNNG treatment produced a specific type of aneuploidy that was associated with tumorigenicity. PMID- 2774060 TI - Cocaine-induced small vessel spasm in isolated rat hearts. AB - Cocaine abuse has been associated with pathologic cardiovascular events including acute myocardial infarction (AMI) and sudden death. Although coronary vasospasm has been proposed as a possible mechanism, the ability of cocaine to induce coronary spasm has not been conclusively demonstrated. In these studies, isolated rat hearts were perfused with cocaine (100 micrograms to 500 micrograms/ml) for 1 minute, perfusion-fixed with glutaraldehyde, and histologically assessed for evidence of coronary spasm through light and electron microscopy. Light micrographs revealed that cocaine induced spasm in coronary arterioles up to 65 microns in diameter, whereas larger caliber vessels did not constrict. Ultrastructurally, vacuolation was observed in the endothelial and smooth muscle cells of constricted arterioles. Endothelial integrity was maintained and interendothelial junctions remained intact. Morphologic evidence of constriction was supported by data obtained from Langendorff-heart preparations in which cocaine reduced myocardial flow rate under constant pressure conditions and increased aortic perfusion pressure under constant flow conditions. Spasm induced by cocaine was prevented by the calcium entry blocker nitrendipine, but not by phentolamine, an alpha-adrenergic antagonist. The finding of small vessel spasm in this study may explain the significant number of clinical cases of cocaine associated AMI in which the main coronary arteries appear angiographically normal. PMID- 2774061 TI - Genetic differences among language families in Europe. AB - We investigated whether 59 allele frequencies and 10 cranial variables differed among speakers of the 12 modern language families in Europe. Although this is a classical analysis of variance design, special techniques had to be developed for the analysis because of spatial autocorrelation of both biological and language data. The method examines pooled sums of squares within language families. These are compared with the same quantities obtained by randomly partitioning the available data points in Europe into internally cohesive subsets representing the same sample sizes for each language family as in the originally observed data. Our results suggest that for numerous genetic systems, population samples differ more among language families than they do within families. These findings are considered in relation to two contrasting models: a model of random spatial differentiation of gene frequencies unrelated to language and a model of aboriginal genetic differences among speakers of different language groups. Our observed findings suggest partial validity of both models. PMID- 2774063 TI - Ecology of a semi-isolated population of adult Anopheles freeborni: abundance, trophic status, parity, survivorship, gonotrophic cycle length, and host selection. AB - A population of adult Anopheles freeborni near Sheridan, CA was sampled daily during 13 August-7 September 1984. Data on abundance, trophic status, and gonotrophic age were recorded. Abundance and gonotrophic age data were analyzed to estimate daily survivorship and gonotrophic cycle length. Daily survivorship for unfed mosquitoes was estimated to be 0.72 with a gonotrophic cycle of 6 days duration. Daily survivorship for bloodfed mosquitoes was estimated to be 0.74 with a gonotrophic cycle of 4 days. The 2 day difference in gonotrophic cycles between unfed and bloodfed mosquitoes was the result of the period required for maturation and mating of teneral females. In 1986, an incage release of field collected females estimated survivorship at 0.75 per day. Precipitin tests of 1,338 blood-engorged mosquito abdomens indicated that bovids, horses, rabbits, and canids comprised 92% of bloodmeals; no bloodmeals of human origin were detected. PMID- 2774062 TI - Mechanisms of splenic control of murine malaria: tissue culture studies of the erythropoietic interplay of spleen, bone marrow, and blood in lethal (strain 17XL) Plasmodium yoelii malaria in BALB/c mice. AB - This work characterizes the erythropoietic interplay of the spleen, blood, and bone marrow in a lethal murine malaria, strain 17XL P. yoelii. This malaria runs a fulminant 7 day course in BALB/c/ByJ mice, marked by high levels of parasitized reticulocytes with death likely due to anemia. We have quantitated the levels of burst forming units-erythroid (BFU-E), the early, niche-seeking, largely erythropoietin-unresponsive erythropoietic precursors, and of colony forming units-erythroid (CFU-E), the more differentiated sessile erythropoietin responsive precursors, in bone marrow, blood, and spleen, through the course of this malaria. A decline in marrow BFU-E began on day 2, but recovered, relatively, after day 3. Marrow cellularity declined, being but 75% normal on day 6. Spleen weight increased about 5-fold within 6 days with enlargement of erythroid, lymphoid, macrophage, and stromal compartments. Splenic BFU-E increased in the first 24 hr and 5-fold by day 6. Splenic CFU-E increased in the first 24 hr and into day 4. They then declined and showed a secondary, large scale, sustained rise interrupted by death. Because the spleen was enlarging, a greater than 60-fold increase in the absolute number of splenic CFU-E occurred at the time of death. Marrow CFU-E followed the same pattern as splenic CFU-E, but the terminal increase represented but a 4-fold absolute increase because of declining marrow cellularity. High levels of erythropoietin occurred only late in the course of disease, likely in response to profound anemia.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2774064 TI - Eosinophil hyporesponse of jirds induced by microfilariae of Brugia pahangi. AB - Male jirds (Meriones unguiculatus) were inoculated sc with 100 infective larvae of Brugia pahangi. After 16 weeks, the animals were reinoculated with a comparable number of organisms. Blood eosinophil responses during the 5 weeks subsequent to this attempt to reinfect were much lower than those of comparable naive animals, while the response to a heterologous infection (Toxocara canis) was comparable to that of controls. Mebendazole was given to infected animals for 2 weeks beginning 5 weeks (prepatent) or 16 weeks (patent) after infection. At comparable intervals after drug administration, the animals were reinoculated with infective larvae and the blood eosinophil response was measured over a 5 week period. The response in the animals treated during the prepatent period was higher than the untreated infected controls. Treatment during the patent period had no demonstrable effect. Jirds made artificially microfilaremic by intravenous inoculation of viable filaria before and after the standard infecting dose had a low eosinophil response to infective larvae. A primary experience of jirds with the microfilariae of B. pahangi evokes an eosinophil response. Subsequent inoculation of larvae did not produce a comparable response. PMID- 2774066 TI - SSAT symposium. Shock-wave lithotripsy and other new methods for the treatment of biliary stone disease. Papers presented as part of a postgraduate course during the 30th annual meeting of the Society for Surgery of the Alimentary Tract. Washington, DC, May 14, 1989. PMID- 2774067 TI - Extracorporeal shock-wave lithotripsy of gallstones: Boston experience with the Dornier MPL 9000 lithotripter. AB - After the success of shock-wave therapy for fragmentation of renal stones, machines for shock-wave therapy of gallbladder stones were quick to follow. In Munich, gallstones were successfully treated in 174 of 175 patients who were also taking ursodiol to help solubilize the calculous rubble left after treatment. In Boston, of the initial 87 patients accepted, 58 were treated for a single stone (mean diameter 15.7 mm), 16 were treated for 2 stones, and 13 for 3 stones. Although reporting of exact results is not possible before the Food and Drug Administration issues a clearance, it is fair to say that both patients and physicians are generally pleased with the results. PMID- 2774065 TI - Characterization of the mesenteronal infection with Western equine encephalomyelitis virus in an incompetent strain of Culex tarsalis. AB - Interactions of western equine encephalomyelitis (WEE) virus are compared with mesenterons of 2 genetically selected susceptible (WS) and refractory (WR) lines of Culex tarsalis. Both WS and WR females had similar susceptibility when parenterally inoculated with virus, thus it was initially thought that resistance in WR Cx. tarsalis was associated with a mesenteronal infection barrier. Present data on viral growth in mesenterons dissected from females fed on virus-soaked pledgets suggest that virus infected and multiplied in some WR mesenterons, but to significantly lower titers than in WS mesenterons. The proportion of WR females with infected mesenterons varied depending on the time after feeding, incubation temperature, and whether mesenterons were incubated with WEE viral antibody before viral assay. The percentage of WR mesenterons infected did not increase significantly when diethylaminoethyl dextran was added to the infectious bloodmeal, the pH of the infectious bloodmeal was altered, or virus was introduced by intrathoracic inoculation into the hemocoel. It was concluded that the low titers of virus detected in both WR mesenterons and whole mosquitoes were influenced by the genetic ability of WR Cx. tarsalis to modulate WEE viral titers to low or undetectable levels after peroral or parenteral infection. These findings make it difficult to determine what proportion of the WR mesenterons are resistant to infection with WEE virus. WS and WR Cx. tarsalis were equally susceptible to peroral infection with the flavivirus St. Louis encephalitis and the bunyavirus Turlock. PMID- 2774068 TI - Panel discussion: cholecystitis. PMID- 2774069 TI - Panel discussion: cholangitis. PMID- 2774070 TI - Endoscopy versus double-contrast barium enema in the evaluation of patients with symptoms suggestive of colorectal carcinoma. PMID- 2774071 TI - [Prognosis and prevention of obstetric and perinatal pathology in threatened miscarriage]. AB - To reveal risk factors for pregnancy miscarriage 1104 pregnant females (including 620 patients from the risk-group and 484 controls) were studied. 226 factors allocated to 16 groups were found to affect the outcome of pregnancy. The computer-assisted system for individual prognosis and stepwise dispensary observation with regard to fetoplacental function was developed. With its help, programme stages have been distinguished as follows: the formation of risk-groups and development of the pathogenetic prevention policy; prognosis for reasonabless of therapeutic maintenance of pregnancy in case of a developed risk for pregnancy miscarriage, prognosis for maternal and fetal outcomes in the initial stages of the delivery. PMID- 2774072 TI - [Multifactorial evaluation of miscarriage risk]. AB - Presented in the paper are the results of epidemiological survey of pregnancy miscarriage in the Moscow population. Computer-assisted prognosis for pregnancy outcomes is discussed. PMID- 2774073 TI - [Urogenital chlamydia infection in women with habitual abortion]. AB - The Chlamydozoan population was identified in 43.6 per cent of 110 females with a history of habitual abortion. It was found that the infection was more frequent in females aged under 30 years, in those who was born preterm, in patients with early (premarital) sexual contacts or those with spontaneously stopped pregnancy during the first trimester, as well as in those females who suffered from cervicitis, yeast colpitis, pyelonephritis or had post-inflammatory changes of placental tissue. Higher incidence of cervicitis, cervical erosion, yeast colpitis, salpingo--oophoritis and pyelonephritis was documented in females infected with Chlamydozoa. PMID- 2774074 TI - [Morphological appearance of cellular immune reaction in the endometrium in spontaneous miscarriage]. AB - Morphometric analysis of lymphocyte, macrophage and polymorphonuclear leukocyte levels in the endometrial stroma was performed in 67 spontaneous and 30 induced abortions during 5-12 weeks of gestation. The results were correlated with the degree of structural maturity of decidual tissue and terminal chorionic villi and showed activation of lymphocyte macrophage reaction mostly pronounced in case of incomplete decidual transformation of endometrial stroma and hypoplastic alterations of chorionic villi. It was concluded that the aforementioned changes were secondary to a decreased function the gravid yellow body and subsequent activation of cell-mediated immune response in the endometrium during spontaneous abortion. PMID- 2774075 TI - [Use of acetomepregenol in the treatment of threatened habitual miscarriage]. AB - Monitoring for pregnancy development and treatment efficacy in 104 females treated with acetomepregenol for threatened recurrent abortion at 8 to 16 week of gestation was performed with the use of ultrasonic variations. Ultrasonic criteria characteristic of the aforementioned condition were established. The technique suggested was distinguished by high levels of sensitivity, simplicity, availability and safety for mother and fetus. PMID- 2774076 TI - [Role of disorders of pentosephosphate pathway of glucose oxidation in the pathogenesis of the arrest of fetal development in miscarriage]. AB - Activity of glucose-6-phosphate dehydrogenase and 6-phosphogluconate dehydrogenase, the enzymes participating in the pentose phosphate pathway of glucose oxidation was studied in the blood of 15 normal fetuses and 25 abortuses as well as in 80 females (20 with normally advancing pregnancy, 40 with the signs of discontinuation and 20 patients with spontaneous abortion developed during 24 26 weeks of gestation). The impact of abnormal pentose phosphate pathway of glucose oxidation on the pathogenesis of fetal development arrest in females with incompetent pregnancy was established. PMID- 2774077 TI - [State of the reproductive function in women with hyperandrogenism and miscarriage in the immediate period and long-term follow-up]. AB - A study was made of 180 females aged 22-58 years with a history of premature labor secondary to high levels of androgen. The ovarian pattern of the disease was stated in 21 per cent (group I), mixed in 49 per cent (group II) and adrenal, in 30 per cent of examinee s (group III). In 69.4 per cent, the pregnancy ended in the delivery of a viable fetus. Recovery of reproductive function was a failure in 30.6 per cent of the patients (group II mainly). Longitudinal study revealed the dependence of menstrual and generative functions both on the disease pattern and outcome of the previous pregnancy. The most unfavourable prognosis for the further progression of reproductive dysfunction was made for females with ovarian or mixed patterns of the disease therefore they might be considered as a risk-group. PMID- 2774078 TI - [Acetomepregenol in the treatment of threatened late miscarriages (clinico experimental study)]. AB - A new Soviet synthetic gestagen, acetomepregenol, was used to control threatened abortion in 46 patients, aged 20 to 40 years. The use of acetomepregenol was shown to be justified as part of combined treatment in cases where the cause of threatened abortion is depressed ovarian activity. PMID- 2774079 TI - [Preventive use of intermittent normobaric hypoxic hypoxia in pregnant women at high risk of developing late toxicosis]. AB - The authors studied the efficiency of preventive usage of intermittent normobaric hypoxic hypoxia (INHH) in 44 pregnant females at high risk for late gestosis in presence of essential hypertension, stages I-II, and hypertensive type of neurocirculatory asthenia. The authors paid attention to a decrease in the incidence of late gestosis, its severe patterns especially, and perinatal mortality. PMID- 2774080 TI - [Dynamics of the development of disseminated intravascular coagulation syndrome in dystocia]. AB - A comprehensive investigation of the hemostasis system permitted to follow the dynamics of disseminated intravascular hemocoagulation syndrome in patients with dystocia. In patients with spastic contractility and myometrial hypertonicity hypercoagulation stage of the aforementioned syndrome was preserved, in those with uterine inertia a transitory stage persisted, those with hypotonicity demonstrated hypocoagulation stage of the syndrome development. It was concluded that the prevention of acute syndrome stages depended on the rapid recovery of coordinated uterine contractility. PMID- 2774082 TI - [Correlated parameters of immune reactivity, hormonal balance and lipid metabolism during pregnancy in healthy women]. PMID- 2774081 TI - [Clinical significance of mean molecules in the prognosis of pyo-septic complications in patients with genital fistulas]. AB - Fifty-four patients with a variety of inflammatory diseases were investigated. Thirty-four of those were admitted for elective surgical treatment of genital fistulas, and 20 patients underwent a conservative anti-inflammatory treatment. Three degrees of intoxication were identified on the basis of the mean molecular level. The data obtained are an evidence of the predictive value of mean molecular level for the prognosis of pyo-septic complications. PMID- 2774083 TI - [Interrelations of central and organ hemodynamics in pregnant women the day before normal labor and labor complicated by incoordination of uterine contraction]. PMID- 2774084 TI - [Several biochemical indicators of the kidney tubular function in patients with diabetes mellitus during the 3d trimester of pregnancy]. PMID- 2774085 TI - [Features of pregnancy course and labor in women after artificial insemination]. PMID- 2774086 TI - [Biochemical analysis of blood as a method complementing cardiotocography]. PMID- 2774087 TI - [Tactics of pregnancy and labor management in cases of low position of the placenta]. PMID- 2774088 TI - [Role of qualifying characteristics of the obstetrician-gynecologist in the evaluation of the level of professional competence during certification proceedings]. PMID- 2774089 TI - Maturation of peripheral nerves in preterm infants: proprioceptive and motor nerve conductions of tibial nerve. AB - Premature birth induces a profound change in the environmental factors affecting nerve maturation. The proprioceptive sensory and motor nerve conduction velocities (NCV) of the posterior tibial nerve, which reflect peripheral nerve maturation, have been measured in 3 groups of newborns. Two groups of premature (PT) babies, studied when they reached the expected date of birth (group I, gestational age (GA) at birth, 28-31 weeks, n = 8; group II, GA at birth, 32-35 weeks, n = 6) were compared to 9 normal full-term (FT) newborns. As previously shown, the motor NCV of PT babies at a post-conceptional age close to term is similar to that of FT newborns: group I, 22.70 +/- 2.95 m/s (mean +/- SD); group II, 25.90 +/- 4.61 m/s; FT, 25.48 +/- 4.09 m/s. The proprioceptive sensory NCV was significantly lower in group I (21.59 +/- 4.39 m/s) than in group II (31.89 +/- 4.15 m/s) and FT newborns (32.22 +/- 6.56 m/s) (p less than 0.01). Such a delay in maturation could be responsible for the subtle clinical dysfunctions often observed in PT babies. PMID- 2774090 TI - Peripheral nerve involvement in Werdnig-Hoffmann disease. AB - The number of large myelinated axons was markedly decreased in almost all the intramuscular nerve bundles included in 32 muscle biopsies from patients with Werdnig-Hoffmann disease compared to that in normals. The morphometric analysis of peripheral nerves in 5 epon-embedded sections also showed a selective loss of larger myelinated fibers. The ultrastructural findings of the nerves were similar to those seen in Wallerian degeneration including axonal degeneration, myelin breakdown with phagocytosis, Schwann cell proliferation forming Schwann cell columns, axonal sprouting and probable remyelination. The earlier and more striking peripheral nerve involvement than that previously believed was not different from that seen in amyotrophic lateral sclerosis (ALS). The earlier damage to the peripheral nerves probably resulted from a degeneration of the anterior horn cells or anterior spinal roots as in ALS rather than from a dying back process. PMID- 2774092 TI - Computed tomographic findings in children with spastic diplegia: correlation with the severity of their motor abnormality. AB - Computed tomographic findings of 46 children with spastic diplegia examined at nine months to three years of age corrected for preterm births were analyzed. Both the size of the lateral ventricles measured by the width of the anterior horns, and the volume of the extracerebral low-density areas were enlarged in some patients. Both enlargements did not, however, correlate to the severity of the motor abnormality in the patients. The low-density areas of the periventricular white matter, especially adjacent to the trigone, were reduced in many children, probably due to the atrophy of the cerebral white matter having periventricular leukomalacia. The anterior expansion of the white matter reduction from the trigone corresponded to the severe motor abnormality in the children with spastic diplegia. PMID- 2774091 TI - Normal sonographic findings of the infant temporal lobe in coronal sections. AB - Coronal sonograms of the temporal lobe of the infant brain were obtained using a real time sector scanner with a 5.0 MHz transducer probe. The precise normal anatomy in the coronal sections was determined by correlating with corresponding brain specimens. It was revealed that the spatial arrangement of structures in the medial part of the temporal lobe, i.e. the hippocampal formation and the inferior horn, varied in the three different planes. In the plane through the anterior part of the temporal lobe, these structures were seen as a horizontal lamellar configuration, whereas in the plane through the middle part these structures were depicted as a typical interfolded arrangement. However, the hippocampal formation was barely visible in the plane through the posterior part. PMID- 2774093 TI - Hyperpolarization and short-circuiting as mechanisms of seizure prevention following febrile convulsions. AB - Though children with febrile convulsions only have seizures in the early stage of a febrile illness and not later, these seizures have been attributed to the fever. We studied the serum electrolyte and metabolite profiles in the later stage to see if there were fuel responses resulting in electrophysiological changes which prevented further seizure activity. On admission there was intracellular glucose starvation, as evidenced by increased ketones and lactate, and the possibility of the failure of some electrolyte pumps, as suggested by hyperuricaemia (energy crisis) and decreased serum Na+, Cl- and Ca2+. However, there was adaptive hyperglycemia and decreased serum K+. It seems likely that the hyperglycemia, induced the uptake of K+ by neurones, enabling their repolarization and hyperpolarization, which prevented further seizure activity, while Cl- influx short-circuited depolarizing currents produced by Na+ influx. Studies during recovery showed a gradual return of the metabolic and electrolyte aberrations to normality, suggesting that the provision of energy through adaptation to the stress, enabled recovery of the aforementioned pumps. PMID- 2774094 TI - Autonomic function and the sinus tachycardia of Duchenne muscular dystrophy. AB - The cardiovascular autonomic function of 13 boys with Duchenne muscular dystrophy was examined in order to test the hypothesis that the labile sinus tachycardia of that disorder is due to autonomic dysfunction. Five non-invasive procedures evaluated the responses of heart rate and blood pressure to postural change, the Valsalva maneuver, sustained hand grip and deep breathing. No individual had sufficient evidence of autonomic dysfunction. Most tests were normal (76%), 16% were borderline, and 8% were abnormal. None had more than one abnormal test. Although most had some difficulty with the Valsalva maneuver, the study demonstrated that simple clinical non-invasive testing of autonomic function can be carried out on a young severely handicapped population. PMID- 2774095 TI - Polymicrogyria: a case detected by MRI. AB - We report a 3-year-old child affected by severe encephalopathy, partial seizures with early onset and microgyria whom polymicrogyria was detected by means of magnetic resonance imaging (MRI). We believe that MRI first allow an early and confident in vivo diagnosis of this severe and probably not so rare condition. PMID- 2774096 TI - The abnormal bridging vein: light and electron microscopic observations. AB - We observed a patient with an abnormal bridging vein having a thickened vessel wall and newly formed vessels within it. It was suggested that the former is a phenomenon accompanying capsule formation around hygroma and the latter, indicating recanalization, originates in cells along the luminal side. Our morphological observations provided the reactive pattern of bridging veins against brain damage. PMID- 2774098 TI - Abstracts from the 11th Conference on Febrile Convulsions. Tokyo, December 17, 1988. PMID- 2774097 TI - Type II fiber myolysis in a patient with hypocarnitinemia. AB - The repeated muscle biopsy findings in a female affected by hypocarnitinemia were reported. Electron microscopic (EM) examination revealed degeneration of Type II fibers as well as lipid accumulation in Type I fibers during an episode mimicking the Reye syndrome (mRS), and no morphological abnormality in the subclinical stage. There was no previous information on myolysis of Type II fibers in patients with carnitine deficiency (CD). However, this study showed that Type II fibers were more severely affected than Type I fibers during exacerbation in patient with CD. PMID- 2774099 TI - Proliferative activity of cutaneous melanocytic tumors defined by Ki-67 monoclonal antibody. A quantitative immunohistochemical study. AB - In various tumors, proliferative activity has been demonstrated to be closely related to the degree of malignancy. In the present study, we examined the proliferative pool in a total of 25 melanocytic (nevocytic) skin tumors by immunohistochemical staining with Ki 67 monoclonal antibody (labeling the G1, S, G2-phase of the cell cycle) and quantitative morphological evaluation. There were highly significant differences in the numerical density of Ki 67-positive cells between nevocellular nevi (number of positive cells: 2.2 +/- 0.7 X 10(3)/mm3), primary malignant melanoma (6.3 +/- 1.9 X 10(3)/mm3), and metastatic malignant melanoma (47.0 +/- 9.2 X 10(3)/mm3). Within the malignant melanoma group, there was a significant correlation between proliferative activity and maximum tumor thickness (r = 0.85; p less than 0.05). Comparison with previous studies using tritiated thymidine labeling and colony-forming efficiency shows that the stereological evaluation of Ki 67 staining in melanocytic skin tumors provides a reliable estimate of proliferative activity, which might be of prognostic value. PMID- 2774100 TI - Nuclear indices and survival in cutaneous melanoma. AB - Computerized video image analysis of Feulgen-stained paraffin sections was used to assess the relationships of nuclear DNA content and other nuclear morphological characteristics with survival from cutaneous melanoma. The results indicate that nuclear area and deviation from diploidy have effects on survival independent of tumor thickness and the age of the patient. Tumor thickness, however, remained the most important predictor of survival. Video image analysis of tissue sections, by virtue of its speed, simplicity, and accuracy, appears to be a potentially valuable prognostic method. PMID- 2774101 TI - Chronologic aging in black skin. AB - Histologic studies examining chronologic aging in skin have been confined to white skin. In the present study, we examined the features of sun-protected black skin from individuals 6 weeks to 75 years of age with light and electron microscopy. With age, the dermoepidermal junction became flattened with multiple zones of basal lamina and anchoring fibril reduplication. Microfibrils in the papillary dermis became somewhat more irregularly oriented. Compact elastic fibers showed cystic changes and separation of skeleton fibers with age. The area occupied by the superficial vascular plexus in specimens of equal epidermal surface length decreased from the infant to young adult (21-29 years old) to adult (39-52 years old) age groups, then increased in the aged adult (73-75 years old) age group. With the exception of the vascularity in the aged adult group, the above features are similar to those seen in aging white skin, and suggest that chronologic aging in white and black skin is similar. In addition, there was a decrease in the number of melanocytes with age. Basal keratinocyte melanin granule density increased with age to age 52 and remained dense in the aged adult group, even as the number of melanocytes decreased. PMID- 2774102 TI - Histopathologic pattern analysis of human intracutaneous tuberculin reaction. AB - The involvement of cellular immune reactions in the pathogenesis of many inflammatory dermatoses can be postulated from their histopathologic features, e.g., those dermatoses that show a perivascular lymphohistiocytic infiltration in the dermis in addition to their own characteristic epidermal changes. Several granulomatous dermatoses further show an additional infiltration of epithelioid cells. However, experimental production of similar changes is usually not feasible in animals. A human model is needed of delayed-hypersensitivity skin reaction induced by a definite antigen. After closely observing the histopathologic changes of the skin reactions to the purified protein derivative (PPD) of tuberculin, we noted that all patients did not show uniform histologic patterns at intradermal PPD injection sites. Therefore, we have tentatively analyzed histopathologically the pattern of tuberculin skin reactions at injection sites 48 h to 1 year after injection in eight healthy volunteers and 63 patients with various dermatoses. We classified the reactions at 48 h into three types, based on the extent of the tissue damage (i.e., their resemblance to features noted in corresponding inflammatory dermatoses): (a) the perivascular dermatitis type, (b) the basal spongiotic dermatitis type, and (c) the erythema multiforme type. There was a clear correlation between the magnitude of macroscopic skin reactions and these histopathologic patterns. Even those with clinically negative reactions showed a reaction pattern of perivascular dermatitis, whereas those who clinically developed prominent inflammatory reactions with blister formation always showed a erythema multiforme-like histologic pattern. Interestingly, in more than half of the cases, the dermal cellular infiltrate had a mixture of various numbers of neutrophils in addition to mononuclear cells.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2774103 TI - Malignant epithelioid schwannoma of the skin. A low-grade neurotropic malignant melanoma? AB - We studied a polypoid cutaneous neoplasm excised from the left arm of a 23-year old man by light microscopy, immunohistochemistry, and electron microscopy. Histologically, the tumor was composed of a proliferation of round to oval epithelioid cells that were arranged in fascicles and showed a prominent perineural distribution. Immunohistochemistry revealed the presence of S-100 protein and vimentin within tumor cells. Electron microscopy demonstrated reduplication of basal lamina and abundant long-spacing collagen in intercellular spaces. The findings are consistent with a primary malignant epithelioid schwannoma of the skin. We discuss the relationship of this lesion with other neoplasms in the spectrum of tumors showing schwannian and melanocytic lines of differentiation. PMID- 2774104 TI - Two pyogenic granulomas arising in an epidermoid cyst. AB - Two pyogenic granulomas arising from the wall of an epidermoid cyst on the midback of a 62-year-old white man are reported. Histologically, each pyogenic granuloma was a polypoid sessile nodule that showed well-vascularized granulation tissue; edema; a mixed inflammatory infiltrate; an epidermal collarette; and a thinned, variably ulcerated epidermis. Although pyogenic granulomas may develop anywhere on the skin, this appears to be the first report of pyogenic granulomas in an epidermoid cyst. PMID- 2774105 TI - Eruptive vellus hair cysts. A follicular cyst of the sebaceous duct (sometimes) AB - The eruptive vellus hair cyst is an uncommon, yet distinct, clinical and pathological entity that may be acquired in a sporadic or hereditary form. This descriptive term gives no indication of the type of epithelium lining this cyst. A case report of eruptive vellus hair cyst is reported herein in which the epithelial lining differentiated toward the sebaceous duct. We propose that eruptive vellus hair cysts should be more accurately diagnosed by characterizing the type of epithelial lining. PMID- 2774106 TI - Malignant melanoma in light of the multistep theory of neoplasia. PMID- 2774107 TI - Some remarks on dysplasia. PMID- 2774108 TI - French and German words in medical English. PMID- 2774109 TI - [Oculomotor disorders in Parinaud's syndrome]. AB - In a patient suffering from Parinaud's syndrome due to a dorsal mesencephalic spontaneous hematoma the electro-oculographic study show the paralysis of the vertical gaze and retraction-convergence nystagmus. The paper emphasizes the importance of the electro-oculometry in those cases showing troubles of the oculomotricity. PMID- 2774110 TI - [Occupational exposure in cancer of the mouth, pharynx and larynx]. AB - The AA. have scheduled a case-control study in order to assess the ambient hazards factors in these cancers, through the evaluation of its occupational risk. The program cover 242 cases of the epidermoid type of carcinoma (positive biopsy), and the group was parallelled with another group of 322 (after the age) admitted at the same Hospital, but affected with several processes. Were excluded the cancer of the lung, bladder, pancreas and kidney because of the causal link with tobacco smokers. In oral and pharyngeal cancer the AA. found out that the workers of high risk were butchers, blacksmiths, masons, drivers, electricians and railwaymen. Regarding the cancer of the larynx mechanics, plumbers, farmers, textile workers and drivers showed the greatest linkage. These findings are in accordance with those published in previous papers. PMID- 2774111 TI - [Jugular phlebectasia]. AB - The seldom seen ectasia of the veins of the neck are known as venous congenital cyst, venous aneurysm, jugular phlebectasia, venous ectasia of the neck or essential venous dilatation. The latter nomination meaning the augmentation of the vessel without either typical histopathologic feature or etiopathogenic explaining its development. All veins of the neck can be affected, especially in this sequence: interna, externa jugular, anterior jugular and the superficial communicans. PMID- 2774112 TI - [Measurement of pulmonary function in laryngectomized patients]. AB - Comparative study upon clinic, radiological and spirometric parameters in 30 laryngectomees, which were spirometric tested by means of a device either simple, cheap, speed and efficient, designed by the AA. These are the conclusions drown out: 1st. There is a poor correlation clinic-functional in patients with obstructive pathology (which command, in the AA's opinion an exploration of the respiratory function in all laryngectomees). 2nd. On the contrary, there are a good radiological and functional correlation in patients suffering for restrictive disease (here the assessment functional means the quantification of the restrictive process). And 3rd. The laryngectomees show a higher functional affectation and can be expected if related to the age and sex. The explanation is to be found in the intercurrent diseases and also in the infections following the larynx removal. PMID- 2774115 TI - [Therapy in the pathology of love]. PMID- 2774113 TI - [Exploration of the eustachian tube with the Toynbee maneuver in combination with the impedancemeter]. AB - The classic Toynbee experiment produce changes in the patency of the Eustachian tube. With the finality of knowing the practicality of this ease maneuver the AA. measure the tympanogram variations during 10 swallowing sequences. The tracings are then confronted with the opening moments. The conclusion drawn out is that it does exist a correlation between the kind of register and the forced aperture of the ostium tubae. PMID- 2774114 TI - [Bone metastasis as the first manifestation of follicular carcinoma of the thyroid gland. Apropos of 1 case]. AB - The first symptom in this case was an spastic paraplegia following a compressive metastasis of the spine sitting in the D8-9 after a follicular Carcinoma of the thyroid gland. PMID- 2774116 TI - [The carbon-14 test and the Holy Shroud]. PMID- 2774117 TI - [Congenital cysts and fistulas of the neck]. PMID- 2774118 TI - Neurophysiological monitoring. PMID- 2774119 TI - Anaphylaxis to latex during surgery. AB - Five young women, all of whom had anaphylactic responses in operating units, are described. Three of them worked in a hospital three showed immediate hypersensitivity to fruit and all had known urticaria to latex. Anaphylaxis appeared progressively 15 to 30 minutes after injection of anaesthetic drugs. Skin tests with these drugs were negative. Skin prick tests through gloves and with four different allergen preparations (saline which had been incubated with gloves and three kinds of latex) were positive. Human basophil degranulation tests with all four allergens were positive and radio allergo sorbent tests to latex were also positive. IgE-dependent allergy to latex may be investigated by questionnaire and if necessary by prick tests before each operation to prevent anaphylaxis due to surgical gloves. PMID- 2774120 TI - Effect of single-dose omeprazole on intragastric acidity and volume during obstetric anaesthesia. AB - Various antacid or antisecretory agents are used to reduce the risk to patients of aspiration of gastric contents during general anaesthesia and a trial of the gastric proton pump inhibitor, omeprazole, is reported here. Twenty women admitted for elective Caesarean section under general anaesthesia received a single 80-mg oral omeprazole dose at 2000 hours on the evening before surgery. Intragastric pH and volume were measured immediately after induction of anaesthesia and on completion of surgery. Eighty-five percent of pH measurements at induction and extubation and 80% and 95% of volume measurements at induction and extubation respectively met the defined success criteria (pH greater than or equal to 2.5, volume less than 25 ml). Omeprazole treatment was well tolerated by the women and Apgar scores and subsequent progress of the babies were acceptable. These results indicate that gastric acidity and volume were acceptable in the majority of women after omeprazole treatment, but the interval from drug administration to induction of anaesthesia may have been too long in some cases and resulted in unacceptably low pHs. PMID- 2774121 TI - Gastric emptying after head injury. AB - Gastric emptying was measured in patients after head injury and compared with that of healthy volunteers using the rate of paracetamol absorption as an indicator of gastric emptying rate. There was a trend towards slower gastric emptying in the head injured patients, but the differences were not statistically significant. PMID- 2774122 TI - Migration of thoracic epidural catheters. Three methods for evaluation of catheter position in the thoracic epidural space. AB - Migration of thoracic epidural catheters was evaluated in 25 patients by three methods either after placement of the catheter or immediately after surgery. The first method was the determination of the depth of the catheter from the skin, the second the determination of the level of sensory blockade which resulted from a test dose of a local anesthetic agent, while the third consisted of radiological visualisation of the catheter tip in the epidural space with radiopaque dye. The evaluations were repeated on the third or fourth day after operation. We observed an inward movement of the catheter in 56% of the patients instead of the expected outward movement. This inward movement was accompanied by a higher level of sensory blockade. No relationship with radiological visualisation was found. PMID- 2774124 TI - The requirement for intensive care support for the pregnant population. AB - Pregnancy-associated admissions to the Intensive Care Unit during the first 5 years of a newly established teaching hospital obstetric unit are reviewed. There were 23 such admissions; in the same period, 21,983 deliveries occurred. The most frequent cause for Intensive Care admission was hypertensive disease of pregnancy. Most patients required admission for less than 48 hours. Two patients died during the period of study. PMID- 2774123 TI - A comparison between open-end (single hole) and closed-end (three lateral holes) epidural catheters. Complications and quality of sensory blockade. AB - A randomised, single-blind study was conducted on 802 parturient women who required epidural analgesia, to compare open-end (single hole) with closed-end (three lateral holes) epidural catheters. The complication rate after catheter insertion was not statistically different between the two groups, but the number of unsatisfactory blocks was significantly higher in the open-end group (p less than 0.001). The closed-end catheters were easier and less painful to place, but gave a higher incidence of bloody taps. The open-end catheters caused sensory blockade to be more frequently unilateral and more frequently missed sensory segments. This resulted in a significantly higher number of open-end catheters that required replacement (p less than 0.001). Open-end catheters despite their theoretical advantages in the detection of intravenous and subarachnoid placement caused an unacceptably high incidence of unsatisfactory sensory blockade. PMID- 2774125 TI - Recurrent anaphylactoid reaction during caesarean section. AB - A 28-year-old woman presented for emergency Caesarean section at 31 weeks' gestation with deranged liver function and a history of recurrent anaphylactoid reactions during previous pregnancy-related anaesthetics. The anaesthetic management and outcome of this case is presented. PMID- 2774126 TI - Giant false aneurysm of the subclavian artery. An unusual complication of internal jugular venous cannulation. AB - A false aneurysm with a diameter of 15 cm developed in the wall of the subclavian artery after attempted internal jugular cannulation. This potentially lethal complication, its diagnosis and treatment are described. PMID- 2774128 TI - Anaesthesia and the law. Monitoring. PMID- 2774127 TI - Volatile agent use: perception and practice. A survey of agent use over a 3-year period. AB - We calculated the quantity, as MAC hours and MAC hours anaesthetic, of halothane, enflurane and isoflurane, used in this Health District over a 3-year period. Halothane accounted for 77% of anaesthesia in the first year and for 57% in the final year. Overall usage of volatile agents decreased. Fifteen consultants and 19 senior registrars perceived, in a survey of practice, only a change in relative use of volatile anaesthetic agents with a large swing from halothane to both enflurane and isoflurane. Half the anaesthetists stated that the medicolegal consideration was the prime reason for their change. The perceived total demise of halothane does not appear to have been realised, despite individual anaesthetist's perceptions. PMID- 2774129 TI - Vegetative survival. PMID- 2774130 TI - Inadvertent epidural midazolam and fentanyl. PMID- 2774131 TI - IgA nephropathy and the anaesthetist. PMID- 2774132 TI - Ischaemic lesions related to pressure from the bindings of a wrist splint and cardiopulmonary bypass. PMID- 2774133 TI - Respiratory arrest and retrobulbar block. PMID- 2774134 TI - Postoperative mediastinal emphysema: blame the anaesthetist? PMID- 2774135 TI - Unusual complication of nasopharyngeal intubation. PMID- 2774136 TI - Controlled ventilation and the laryngeal mask. PMID- 2774137 TI - A stand for a defibrillator. PMID- 2774138 TI - Apparent resistance to thiopentone. PMID- 2774139 TI - Not necessarily a finger on the pulse. PMID- 2774140 TI - [Cardiovascular and pulmonary changes in patients with an isolated cerebral lesion. II. Extravascular lung water and pulmonary gas exchange ("neurogenic lung edema")]. AB - While in animal experiments neurogenically initiated pulmonary edema is a well known event and is supposed to be due to centrally initiated hemodynamic disturbances ("neurohemodynamics") in patients with severe cerebral lesions fulminant alveolar edema is reported to occur very rarely. The questions addressed by this study are: 1. whether and to what extent changes in extravascular lung water (EVTVL) can be demonstrated in patients with a severe isolated cerebral lesion; 2. whether a relationship between the severity of the cerebral lesion and accompanying EVTVL changes can be proven; and 3. whether or not EVTVL changes are associated with corresponding changes in intravascular hydrostatic and oncotic Starling parameters; i.e. cardiogenic or noncardiogenic pulmonary edema accompanying the cerebral lesion. This study included 44 patients presenting with a severe isolated cerebral lesion and decerebrate posturing on admission. EVTVL (by thermo-dye double-indicator technique), pulmonary gas exchange (AaDO2/pAO2), colloid oncotic pressure (COP) and mean systemic arterial (SAP), mean pulmonary arterial (PAP), and pulmonary capillary wedge pressures (PCWP) were measured from the day of admission to the 6th day after the acute cerebral lesion maximally; in addition the microvascular pressure in the pulmonary bed and intravascular filtration pressure were calculated from the above mentioned parameters. The neurological status on admission and throughout the observation period was scored using the Innsbruck Coma Scale (ICS) and the neurological outcome by the Glasgow Outcome Scale (GOS). Statistical analysis was performed using the distribution independent Kruskal Wallis test, the correlation coefficient r (Pearsan and Bravais), and the Spearman rank correlation (RSp); values are given as means +/- SEM; the significance has been set at P less than 0.05. Our results reveal an overall increase in EVTVL from 8.8 +/- 0.8 ml/kg on the day of admission up to 11.3 +/- 1.6 ml/kg on the 4th day. While survivors (n = 13) remained within the normal range of EVTVL (less than 9 ml/kg), non survivors (n = 31) started at an already elevated level (10.05 +/- 1.04 ml/kg) and reached their maximum values (15.4 +/- 2.3 ml/kg) on day 3 to 4. In 3 non survivors these increased initial EVTVL values were accompanied by pathologically increased intravascular pressures, indicating that hydrostatic mechanisms were involved in the EVTVL rises. While the hydrostatic pressures normalized spontaneously, EVTVL values stayed within the pathological range throughout the remaining observation period.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2774141 TI - [Fulminant sepsis following posttraumatic splenectomy--OPSI (overwhelming postsplenectomy infection) syndrome]. AB - We report a case of fulminant sepsis 10 years after posttraumatic splenectomy. The low-cardiac-output stage of the septic shock with disseminated intravascular coagulation (DIC), which was already marked on admission to the intensive care unit, could not be overcome despite appropriate shock treatment. The pathogenetic spectrum includes more than 70% pneumococci, but any pathogen can trigger an overwhelming postsplenectomy infection (OPSI) syndrome. Pathogenetically, the OPSI syndrome is primarily due to distinctly reduced bacterial clearance from loss of the reticuloendothelial tissue in the spleen. Appropriate treatment of the septic shock is of prime therapeutic importance. In summary, the following recommendations can be made: 1. Nonspecific symptoms of infection in splenectomized patients, such as fever, call for immediate clarification with respect to the onset of a septic process. Immediate admission to a hospital, close monitoring, including blood cultures, and immediate antibiotic therapy are unavoidable. 2. The aim of treatment is to prevent DIC by aggressive therapy of the septic shock with prevention of the low-output stage. 3. Splenectomized patients must be informed of the possibility of a serious, potentially fatal infection and its premonitory symptoms. An emergency passport is appropriate. 4. In view of the few side effects of the vaccine, all splenectomized patients should be immunized against pneumococci. Children under 2 years of age should furthermore receive prophylactic oral penicillin up to the age of 5. PMID- 2774142 TI - On AIDS and some happier matters. PMID- 2774143 TI - A thing about AIDS. PMID- 2774144 TI - Patient-controlled analgesia in children. AB - The use of patient-controlled analgesia is described for forty children who had undergone major orthopaedic or general surgery. Ages ranged from 6 to 18 years (mean 11.4 years) and PCA was used for an average of 46.2 hours postoperatively. Morphine requirements overall averaged 40.5 micrograms/kg/hr (SD 22.6). Requirements for the first six hours were not significantly different to a similar period 24 hours later. There was a large individual variation for patients undergoing similar procedures. Patients undergoing scoliosis surgery required significantly more morphine than any other group of patients. Problems with patient-controlled analgesia have been of a minor nature. We conclude that patient-controlled analgesia is a suitable and safe method of pain relief for paediatric patients and that the lower age limit is that at which a child can understand the concept after suitable explanation. In this study children as young as six years were able to successfully use the method. PMID- 2774145 TI - Interpleural administration of bupivacaine after cholecystectomy: a comparison with intercostal nerve block. AB - Pethidine requirements and verbal pain scores were recorded in 36 patients after cholecystectomy via subcostal incision. All patients also received 20 ml 0.5% bupivacaine with adrenaline 1/200,000. Group 1 (12 patients) received unilateral intercostal nerve blocks. Interpleural catheters were inserted through the 8th intercostal space in the remaining patients; 12 received local anaesthetic via the catheter immediately after surgery (Group 2) and 12 were given local anaesthetic at three hours (Group 3). Small asymptomatic pneumothoraces were noted on chest X-ray in six of the 24 patients with interpleural catheters. Both types of local anaesthesia produced lower pain scores than pethidine alone (P less than 0.05) with 25% of intercostal nerve blocks and 63% of interpleural catheters requiring no pethidine in the following three hours. The provision of catheter 'top-ups' between six and 18 hours after surgery also resulted in lower pain scores and a reduction in pethidine requirements (P less than 0.05). PMID- 2774146 TI - Clinical experience with atracurium during prolonged anaesthesia. AB - The pharmacodynamic properties of repeated injections of atracurium were studied in twenty-two patients. A control group received narcotic-based anaesthesia while another group received the same narcotic-based anaesthesia subsequently modified by the addition of 0.5% isoflurane. The twitch response of the adductor pollicis muscle was recorded after train-of-four (TOF) stimulation of the ulnar nerve at the wrist. Duration of effect and recovery time were measured. A bolus dose of atracurium (0.5 mg/kg b.w.) was given for tracheal intubation and maintenance doses of 0.2 mg/kg b.w. were given during anaesthesia at a TOF ratio of 0.25. Mean duration of anaesthesia was 7.5 hours (range 3-19). In the control group mean duration of effect and mean recovery time remained unchanged (six doses studied). A noteworthy inter-individual variation was found. In the isoflurane group mean duration of effect increased from 36.1 (SD 6.3) minutes to 42.2 (SD 8.1) minutes (P less than 0.05) following the addition of isoflurane. Corresponding recovery times remained unchanged. We conclude that during repeated administration of atracurium during narcotic-based anaesthesia, each patient shows a constant interval between requirements for maintenance doses of atracurium of 0.2 mg/kg b.w. Addition of 0.5% isoflurane causes a moderate prolongation of the duration of effect, but recovery time remains unchanged. PMID- 2774147 TI - Preoperative transdermal hyoscine for the prevention of postoperative nausea and vomiting. AB - In a randomised, double-blind study, a transdermal patch containing either hyoscine or placebo was applied post-auricularly in 190 adult patients under 65 year old, seven to twelve hours prior to their undergoing minor orthopaedic or plastic surgery under thiopentone/nitrous oxide/halothane general anaesthesia. In the first 24 hours after surgery 34% of patients vomited. The incidence of nausea (31% vs 54%; P less than 0.01) and the number of episodes of vomiting (66 vs 125; P less than 0.05) during the first 24 hours were significantly less with hyoscine than with placebo. The hyoscine group required fewer doses of antiemetic than the placebo group (12 vs 27; P less than 0.05). Side-effects were mild, the only difference between the two groups being the frequency of dry mouth immediately preoperatively. No differences were seen in the second 24 hours after surgery. We conclude that transdermal hyoscine is moderately effective in reducing the occurrence of postoperative nausea and vomiting following minor surgery. PMID- 2774148 TI - Comparison of the processed electroencephalogram and awake neurological assessment during carotid endarterectomy. AB - A processed electroencephalogram (EEG) produced by the Lifescan monitor (Neurometrics), was compared to awake neurological assessment for detecting cerebral ischaemia in seventy patients undergoing carotid endarterectomy under cervical plexus block. Of the six patients demonstrating neurological signs on cross-clamping the carotid, five displayed simultaneous EEG changes, four being detected during surgery, and one being detected after reviewing the EEG postoperatively. Another four patients displayed EEG changes indicative of ischaemia but unassociated with neurological signs. A further patient displayed contralateral intraoperative EEG changes. Hypotension resulted in one EEG change and two cases were associated with technical difficulties with the monitor. The presence of false negatives, possible false positives, technical errors and subjective interpretation associated with the processed EEG make it less reliable than awake neurological assessment for the detection of cerebral ischaemia. PMID- 2774149 TI - A comparison of brachial, femoral, and aortic intra-arterial pressures before and after cardiopulmonary bypass. AB - Following recent evidence that brachial and femoral artery pressures are more reliable than radial artery pressures after cardiopulmonary bypass, thirty-one adults had simultaneous pre- and post-bypass measurements of brachial, femoral, and ascending aortic pressures. Two minutes after cardiopulmonary bypass, brachial artery systolic pressure and mean arterial pressure fell significantly below corresponding pressures in the femoral artery and aorta. Five minutes after cardiopulmonary bypass, only brachial artery systolic pressure was still less than femoral and aortic systolic pressures. By ten minutes after bypass, all significant pressure differences had resolved except between brachial and femoral artery systolic pressures. Clinically significant (greater than or equal to 5 mmHg) aortic-to-brachial reductions in mean arterial pressures occurred in six (19%) patients at two minutes and in three (10%) patients at five and ten minutes after bypass. Equivalent aortic-to-femoral mean pressure diminution occurred in two (6%) patients at two minutes and one (3%) patient at five and ten minutes after bypass. Neither systemic vascular resistance nor body temperatures contributed significantly to post-bypass central-to-peripheral pressure reductions. Immediately following bypass, femoral artery pressures reproduce central aortic pressures more reliably than do radial or brachial artery pressures. PMID- 2774150 TI - Postoperative epidural morphine analgesia in Papua New Guinea. AB - In order to introduce the technique of epidural narcotics for pain relief in Papua New Guinea, fifty patients were given low doses of epidural morphine and thereupon the quality of analgesia and morbidity evaluated. The lowest effective epidural morphine dose was determined by considering the patient's characteristics and height of surgical incision. Pain relief was provided for three postoperative days in the surgical or gynaecological wards. The quality of analgesia thus provided was excellent in all the patients with no incidence of clinically significant respiratory depression or hypotension. Minor complications such as nausea, vomiting, pruritus and retention of urine were also relatively uncommon. PMID- 2774151 TI - Foot surgery in Vanuatu: results of combined tibial, common peroneal and saphenous nerve blocks in fifty-six adults. AB - Combined tibial and common peroneal nerve anaesthesia was used for foot and ankle surgery in fifty-six adults. Where necessary, the saphenous nerve was also blocked. A calibrated constant current nerve stimulator was used to localise the nerves in the popliteal fossa. Using lignocaine 1%, an opioid premedication, but no other sedation or top-up injection, 60% of the blocks were successful. If a patient felt pain at incision or during surgery, the block was recorded as a failure. PMID- 2774152 TI - Fibreoptically guided endotracheal intubation in a child. PMID- 2774153 TI - Tracheal occlusion following oesophageal foreign body removal. PMID- 2774154 TI - Anaphylaxis to thiopentone: an unusual outbreak in a single hospital. PMID- 2774155 TI - Looping of a pulmonary artery flotation catheter around a papillary muscle. PMID- 2774156 TI - Carcinoid syndrome: the combined use of ketanserin and octreotide in the management of an acute crisis during anaesthesia. PMID- 2774157 TI - A fatal case of pulmonary oedema in a healthy young male following naloxone administration. PMID- 2774158 TI - Spinal anaesthesia for caesarean section in a patient with spina bifida cystica. PMID- 2774160 TI - Training in the Pacific Island. PMID- 2774159 TI - Reconstitution of dantrolene. PMID- 2774161 TI - Hypoglycaemia and cardiac anaesthesia. PMID- 2774162 TI - Partial hepatectomy in children. PMID- 2774163 TI - Avoiding needle-stick injuries. PMID- 2774164 TI - 'Conchapak failure'. PMID- 2774165 TI - Postoperative hypoxaemia in children. PMID- 2774166 TI - Hypernatraemia and hyperglycaemia with massive blood transfusions. PMID- 2774167 TI - N.S.W. Medical Retrieval Services. PMID- 2774168 TI - Anaesthetic training in Papua New Guinea. PMID- 2774169 TI - 'Foetus or fetus'. PMID- 2774170 TI - A rapid procedure for cell colony hybridization using DNA probes. AB - A rapid, direct method for screening single cell-derived colonies or foci is described. The method allows the screening of a large number of colonies or foci by nitrocellulose filter hybridization using DNA probes. This technique simplifies current screening procedures and is a reliable, rapid, and sensitive method for the selection of cell clones containing a desired transfected gene. PMID- 2774171 TI - Dual-enzyme cascade--an amplified method for the detection of alkaline phosphatase. AB - A method in which a two-enzyme cascade is used for rapid and sensitive detection of alkaline phosphatase is described. A masked inhibitor, 4-(3-oxo-4,4,4 trifluorobutyl)phenyl phosphate, is dephosphorylated by the action of alkaline phosphatase. The resulting compound, 1,1,1-trifluoro-4-(4-hydroxyphenyl)-butan-2 one, acts as a potent inhibitor of the second enzyme, a liver carboxylesterase. A determination of the residual esterase activity provides a highly sensitive indication of the original phosphatase concentration. The sensitivity of this dual-enzyme cascade is approximately 125-fold greater than that observed for the direct detection of phosphatase activity with p-nitrophenyl phosphate. PMID- 2774172 TI - Glutathione measurement by high-performance liquid chromatography separation and fluorometric detection of the glutathione-orthophthalaldehyde adduct. AB - Glutathione reacts with orthophthalaldehyde to form a stable, highly fluorescent tricyclic derivative which is easily separated and quantitated by high performance liquid chromatography. Separation of the glutathione adduct is achieved by isocratic elution over a reverse-phase column with 7.5% methanol/92.5% 0.15 M sodium acetate, pH 7.00. The adduct is detected fluorometrically and quantitated by integration of peak area. Detection of 0.1 to 200 pmol glutathione produces a linear response and the recovery of reduced and oxidized glutathione from rat liver homogenate, bile, and plasma is quantitative. The chemical identity of the adduct was confirmed by mass spectrometry. PMID- 2774173 TI - Simple and inexpensive preparation of dried polyacrylamide gels for densitometry and/or storage. AB - Polyacrylamide gels soaked in glycerol, dried at room temperature, and sealed with a clear sheet of inexpensive polypropylene are clear, flat, flexible, and stable. The technique is simpler and less expensive than others that have been described and does not involve the use of protein glues. PMID- 2774174 TI - Spectrophotometric assay for the condensing enzyme activity of the microsomal fatty acid chain elongation system. AB - A rapid and simple spectrophotometric method was developed to measure the activity of the condensing enzyme component of the microsomal fatty acid chain elongation system. The intermediate product of the condensation reaction is the beta-ketoacyl CoA which exists in two tautomeric forms, i.e., keto and enol. The addition of bovine serum albumin (BSA) to a cuvette cell containing a beta ketoacyl CoA derivative resulted in the formation of a 303-nm absorbance peak, characteristic of enolate formation. The beta-ketoacyl CoAs with carbon chain length of 6 to 18 interacted with BSA to produce the 303-nm peak; acetoacetyl CoA was the only beta-keto compound tested which did not interact with BSA to produce the peak. Other compounds which were unaffected by BSA included CoA, free beta keto acid, beta-hydroxyacyl CoA, acyl CoA, trans-2-enoyl CoA, and malonyl CoA. BSA could not be replaced by ovalbumin; furthermore, denatured (boiling) BSA could not induce the 303-nm peak. The specific activity of the condensing enzyme measured by the spectrophotometric method compares favorably with the activity obtained by the radioactive method. The apparent extinction coefficient (epsilon) for the absorbance peak generated by the beta-keto thioester varied from 5 to 30 mM-1 cm-1 depending on the beta-keto derivative. The spectrophotometric procedure can be used in the determination of the condensing enzyme activity in not only hepatic microsomes but also in kidney and brain microsomes both of which have significantly lower activity. The advantages of the novel method over the radioactive method are that (i) it does not involve the use of radioactive compounds, (ii) it is much less cumbersome and significantly less costly, and (iii) it is rapid and easy to perform. PMID- 2774175 TI - Inhibition of carnitine acetyltransferase by bile acids: implications for carnitine analysis. AB - Carnitine acetyltransferase is used in a radioenzymatic assay to measure the concentration of carnitine. While determining the concentration of carnitine in rat bile, we found that the apparent concentration increased as bile was diluted (6.7 +/- 1.0 and 66.6 +/- 9.4 nmol/ml in undiluted and 20-fold diluted bile, respectively). The present study was designed to investigate whether a component of bile inhibited carnitine acetyltransferase. Inhibition was evaluated by measuring carnitine concentration in bile or by determining the recovery of a known amount of carnitine in the presence of bile. Inhibitory activity was extractable in organic solvents, stable to heat and base treatments, resistant to trypsin and lipase digestions, and removable by cholestyramine, a bile acid binding resin. These results suggested that the inhibitory activity was associated with bile acids. Direct evidence was obtained by showing a reduced detectability of carnitine in the presence of individual bile acids. Chenodeoxycholic acid was the most potent inhibitor. Inhibition was unrelated to the detergent properties of bile acids. Kinetic studies revealed that carnitine acetyltransferase was inhibited competitively by chenodeoxycholic acid with a Ki of 520 microM. Bile acids also interfered in the quantitation of carnitine in cholestatic plasma. Carnitine concentration in such plasma was underestimated (17.5 +/- 2.1 mmol/ml). Reduction of bile acid concentration by a 20-fold dilution of cholestatic plasma resulted in a 3-fold higher carnitine concentration (54.6 +/- 9.0 nmol/ml). Results demonstrate that, because of the inhibition of carnitine acetyltransferase by bile acids, the radioenzymatic assay will underestimate carnitine concentration in bile or in cholestatic plasma. Accurate measurement requires either the removal of bile acids or a marked reduction in their concentration. PMID- 2774176 TI - Simultaneous measurements of rates of protein de novo synthesis and its steady state levels by immunoblotting. AB - Immunoblotting was used for simultaneous measurements of rates of de novo synthesis and steady-state levels of a model protein-cytochrome P450r. This is the major phenobarbital-inducible P450 form in cultured chick-embryo hepatocytes (L. Oron, and S. Bar-Nun, 1984) Biochem. Biophys. Res. Commun. 125, 1096-1102). Cultured hepatocytes were metabolically labeled with [35S]methionine, and cellular proteins were resolved by gel electrophoresis and then quantitatively electroblotted onto nitrocellulose. The blot was directly exposed to autoradiography and the rates of de novo synthesis were estimated from the 35S label of P450r. The same blot was then incubated with specific anti-P450r antibodies, followed by 125I-labeled secondary antibodies, and the blot was reexposed to autoradiography through white paper. The paper masked the 35S labeled proteins and the steady-state levels were estimated from the 125I immunodecorated P450r. By this simple method, "true" inducers of cytochrome P450r, such as phenobarbital, can be defined, whereas "false" inducers, which primarily affect the degradation of P450r, can be detected. PMID- 2774177 TI - South western blot mapping: a procedure for simultaneous characterization of DNA binding proteins and their specific genomic DNA target sites. AB - A method called "South Western blot mapping" for rapid characterization of both DNA binding proteins and their specific sites on genomic DNA is described. Proteins are separated on a sodium dodecyl sulfate (SDS) polyacrylamide gel, renatured by removing SDS in the presence of urea, and blotted onto nitrocellulose by diffusion. The genomic DNA region of interest is digested by restriction enzymes selected to produce fragments of appropriate but different sizes, which are subsequently end-labeled and allowed to bind to the separated proteins. The specifically bound DNA is eluted from each individual protein-DNA complex and analyzed by acrylamide gel electrophoresis. Evidence that tissue specific DNA binding proteins may be detected by this technique is presented. Moreover, their sequence-specific binding allows the purification of the corresponding selectively bound DNA fragments and may improve protein-mediated cloning of DNA regulatory sequences. PMID- 2774178 TI - Purification of lysosomal membrane-bound glucocerebrosidase from human cultured fibroblasts using high-performance liquid chromatography. AB - Glucocerebrosidase from human skin fibroblasts was purified more than 2300-fold to apparent homogeneity with an overall yield of 39% using taurocholate extraction, ammonium sulfate fractionation, and high-performance hydrophobic interaction and gel permeation column chromatography. This relatively high yield is attributed to two modifications from previously published procedures: (i) the elimination of a butanol delipidation step that resulted in substantial loss of enzyme activity; and (ii) the use of 2% (w/v) sodium taurocholate instead of 1-2% sodium cholate that resulted in more than 90% solubilization of total membrane bound enzyme activity. Confluent monolayers of human cultured skin fibroblasts (approximately 3.6 x 10(8) cells) were harvested from 10 roller bottles. Glucocerebrosidase in the cell pellet was solubilized with 2% (w/v) sodium taurocholate, fractionated in 14% ammonium sulfate, and applied to a high performance hydrophobic interaction phenyl-5PW column. After an ammonium sulfate descending linear gradient step, glucocerebrosidase was eluted from the column at 4% cholate concentration using a 0-5% linear cholate gradient. There was a 36 fold purification and 80% recovery. In the subsequent step, concentrated glucocerebrosidase fractions from the phenyl column were injected into two Bio Sil TSK-250 gel permeation columns joined in series. Glucocerebrosidase peak activity was eluted at 263 ml corresponding to Mr 76,000. There was an 18-fold purification and 78% recovery. The enzyme preparation was then recycled through the phenyl-5PW column in order to remove a remaining contaminant.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2774179 TI - Isoelectric points of proteins: theoretical determination. AB - Three methods for calculating the isoelectric points (pI) of proteins, provided that their amino acid compositions are known, are described. The comprehensive and abridged procedures involve solutions of polynomial equations of different degrees depending on whether pK values of the specific acid-base residues or the means of some of those values, respectively, are adopted. In the simplified procedure, approximate pI values of proteins can be determined easily with the help of calculated values, included in this paper, related to the amino acid composition of proteins. PMID- 2774180 TI - Quantitation of methylated hemoglobin via hydrolysis of methyl esters to yield methanol. AB - Methyl esters formed by methylation of carboxylic acid groups on hemoglobin can be quantitated via GC/MS negative-ion chemical ionization analysis of the pentafluorobenzoate derivative of the methanol released from the hemoglobin upon base hydrolysis. Although the method requires extensive cleanup of extracting solvents because of the ubiquitous presence of trace levels of methanol, it is possible to quantitate adducted hemoglobin at levels as low as 4 ng per gram of hemoglobin using [13C, 2H3]methyl alcohol as the internal standard. In principle this method can be used in humans as a dosimeter for exposure to environmental methylating or alkylating agents. PMID- 2774181 TI - Determination of cyclodextrins and branched cyclodextrins by reversed-phase chromatography with pulsed amperometric detection and a membrane reactor. AB - A high-performance liquid chromatographic method has been developed for the determination of cyclodextrins (CDs) and branched CDs. The method involves their separation on a reversed-phase column using a mixture of water and acetonitrile as an eluant, eluant pH modification with a cation-exchange membrane reactor surrounded by 1.5 M sodium hydroxide solutions, and pulsed amperometric detection with a gold working electrode. The calibration graphs constructed by peak height versus injected amount were linear over the ranges 50-1000 pmol. The detection limits for CDs and branched CDs were about 1-5 pmol at a signal-to-noise ratio of 3. The method was successfully applied to the assay of beta-CD in serum samples. PMID- 2774182 TI - A method of removing gels from narrow-diameter glass tubes as part of a mini-two dimensional electrophoresis procedure. AB - A glass chamber that facilitates the removal of polyacrylamide gels from narrow glass tubes after the completion of isoelectric focusing is described. The tube is firmly held at one end of the glass chamber and a syringe is connected to the other end. By slowly forcing water from the syringe into the glass chamber, sufficient pressure can be generated to cause the rod gel to move slowly out of the glass tube. The rod gel is then used for the second stage of a mini-two dimensional electrophoresis technique. Rod gels of 1.7-mm diameter have been used most extensively and can be removed from the glass tubes with almost 100% success. PMID- 2774183 TI - Identification of the clathrin assembly protein AP180 in crude calf brain extracts by two-dimensional sodium dodecyl sulfate-polyacrylamide gel electrophoresis. AB - We present a two-dimensional gel electrophoretic method which affords a diagnostic means for the identification of the neuron-specific clathrin assembly protein AP180 in crude cytosolic and microsomal fractions of bovine brain. The method is based on the finding that in the presence of sodium dodecyl sulfate (SDS) in a newly developed continuous high salt Tris-acetate-EDTA buffer system protein AP180 migrates at a rate corresponding to its molecular weight of approximately 120,000, while in other more commonly used SDS-polyacrylamide gel electrophoresis methods it behaves anomalously as a 170- to 180-kDa polypeptide. By combining electrophoresis in the Tris-acetate-EDTA system in the first dimension with either the electrophoretic system of Laemmli [Laemmli, U.K. (1970) Nature (London) 227, 680-685] or that of Neville [Neville, D.M. (1971) J. Biol. Chem. 246, 6328-6334] in the second dimension, it is possible to identify AP180 in complex protein mixtures, because it is the only major protein that fell significantly off a diagonal defined by other proteins. A comparison of the microsomal and soluble fractions examined in this manner reveals that most of the AP180 is present in the soluble fraction. PMID- 2774184 TI - The quantitation of biotinidase activity in dried blood spots using microtiter transfer plates: identification of biotinidase-deficient and heterozygous individuals. AB - A simple and rapid method for the quantitation of biotinidase activity in blood soaked filter paper spots was developed. The assay measures the release of p aminobenzoate from N-biotinyl-p-aminobenzoate. A microtiter transfer plate is used to rapidly separate the reaction solution from the filter paper spots. Color is developed and the absorbance is determined using a microplate reader. The biotinidase activity in frozen filter spots correlates well with the activity in serum (r = 0.94). The enzyme activities of obligate heterozygotes for biotinidase deficiency were significantly different from those with normal activity (P = 0.03). This rapid screening procedure can be used to quantitate biotinidase activity in newborn screening samples, identify heterozygotes, and estimate the gene frequency and incidence of biotinidase deficiency in large populations. In addition, the use of microtiter transfer plates can be applied to other assays in which the separation of the incubation solution from a filter paper spot is required. PMID- 2774186 TI - Enzymatic amplification for spectrophotometric and electrochemical assays of NAD+ and NADH. AB - Five different procedures are presented for the enzymatic assay of the sum of NAD+ and NADH concentrations. They are based on the principle of amplification by cycling. The reactions involve oxidation of the formate ion, ethanol, glucose, or carnitine catalyzed by the corresponding dehydrogenases. The detection reactions are based on the 2-(4-iodophenyl)-3-(4-nitrophenyl)-5-phenyltetrazolium chloride (INT)/INT-formazan and ferricyanide/ferrocyanide couples and use a diaphorase. Two of the systems presented--with formate ion and ethanol--were coupled with spectrophotometric detection. The absorbance measurement values were multiplied by 3 in the first case and by 20 in the second, with respect to the values that would have been obtained in the same conditions without the amplification system. The accessible concentration ranges were between 0.05 and 100 microM approximately. Three systems--with formate ion, carnitine, and glucose--used an electrochemical detection based on oxidation of the ferrocyanide ion. The response times were of the order of 10 min and the precision of about 5%. The first brought to light some difficulties concerning the design of such devices. For the second, the proportionality constant had a value of the order of 0.25 microA.microM-1 and an accessible concentration range between 0.2 and 40 microM. The third allowed more precise assays for lower concentration values: between 0.02 and 1.5 microM, with a proportionality constant of 0.49 microA.microM-1. Emphasis was placed on the adaptation possibilities of these systems as a function of the assay requirements. PMID- 2774185 TI - A chromogenic assay for catecholoxidases based on the addition of L-proline to quinones. AB - The coupling reaction between L-proline and the quinone products of the oxidation of various catechols serves as a sensitive assay for catecholoxidases. The chromogenic products, 4-N-prolyl-o-quinones, were unique and stable over the course of the reaction. The spectra of these adducts typically had two absorbance maxima, in the ranges 309-340 and 526-540 nm. Assay conditions in which the oxidation of catechols was rate limiting were developed, and initial rates of reaction, monitored spectrophotometrically at the lambda max of the adducts, showed improved initial linearity when compared with the direct spectrophotometric determination of quinone formation. The molar extinction coefficients (epsilon) of a number of adducts ranged between 5310 and 9630 M-1 cm 1, about five- to sevenfold greater than those of the corresponding quinones. Since 2 mol catechol must be oxidized to their quinones to generate 1 mol of adduct, this assay improves catecholoxidase detection sensitivity by approximately three- to fourfold compared with direct estimation of quinone formation. PMID- 2774187 TI - Synthesis and analysis of selenomethionine metabolites. AB - This paper describes the enzymatic synthesis of selenomethionine metabolites of the transmethylation and polyamine synthesis pathways: adenosylselenomethionine, adenosylselenohomocysteine, decarboxylated adenosylselenomethionine, and methylselenoadenosine. These compounds and the corresponding methionine metabolites were simultaneously separated by a single HPLC run. The sensitivity of the HPLC method is about 20 pmol per compound. The method may be used for direct analysis of the metabolite levels in tissues or cells treated with selenomethionine and it provides an assay method for the pulse-chase type of analysis of relative flows for both selenium- and sulfur-containing compounds in transmethylation and polyamine pathways. PMID- 2774188 TI - Spectrofluorometry of dyes with DNAs of different base composition and conformation. AB - The increase in fluorescence, upon interaction with several fluorescent dyes was found to depend on the base composition of DNA. 4',6-Diamidino-2-phenylindole-2 HCl and Hoechst 33258 which bind to AT base pairs show a logarithmic relation. This relation is linear when DNAs interact with mithramycin, chromomycin A3, and olivomycin, which bind to GC base pairs. Deviations from these relationships were observed for T2 DNA, containing hydroxymethylcytosine, and for 2C DNA, containing hydroxymethyluracil. On the basis of these data, a simple technique is proposed for determination of base composition. The presence of abnormal bases can be monitored by the use of given fluorophores. Fluorescence intensities were not modified upon linearization of covalently closed circular plasmid pBR322. Denaturation of lambda DNA was accompanied by a decrease of fluorescence, when complexed with the five dyes tested. PMID- 2774189 TI - Peptide and protein analysis by electrospray ionization-mass spectrometry and capillary electrophoresis-mass spectrometry. AB - The extension of mass spectrometry to high molecular weight biopolymers based upon electrospray ionization and the on-line combination with capillary electrophoresis is described. Electrospray ionization produces gas-phase intact multiply charged molecular ions of biomolecules from highly charged liquid droplets by a high electric field. For high molecular weight substances electrospray ionization results in a characteristic bell-shaped distribution of multiply charged ions, with each adjacent major peak in the spectrum differing by one charge. Multiply charged molecular ions of proteins with molecular weights greater than 130,000 have been observed with a quadrupole mass spectrometer of limited mass-to-charge range (m/z 1700). Molecular weights can be readily determined for large proteins with accuracies in the range of +/- 0.01 to 0.05%; at least an order of magnitude further improvement appears feasible with improved techniques and instrumentation. The electrospray ionization method is sensitive, presently requiring samples in the 100 fmol to 10 pmol range for proteins. Initial results combining rapid separations by capillary zone electrophoresis with on-line mass spectrometric detection via the electrospray ionization source are demonstrated for myoglobin and other proteins and polypeptides. The potential for extension of these methods to molecular weights on the order of 10(6) is discussed. PMID- 2774190 TI - A sensitive, inexpensive method for determining minute quantities of lipase activity. AB - We describe a sensitive and reproducible lipase assay based on the binding of 63Ni to fatty acid. This method can detect down to 1 nmol of fatty acid per milliliter of solution. It has been adapted for measuring low concentrations of lipoprotein lipase and hepatic triacylglycerol lipase. Furthermore, in the presence of tritiated triolein, the method is insensitive to radiolabel interference, even when the fatty acid is labeled. PMID- 2774191 TI - Analytical potential of protein A for affinity chromatography of polyclonal and monoclonal antibodies. AB - Protein A based rapid affinity chromatography for quantitation of various immunoglobulins of class G (IgG) is described. Three-minute analysis using either citrate or phosphate buffers and detection with 220- or 280-nm ultraviolet absorption was found to be optimum for quantitation of IgG from 0.25 to 250 micrograms of IgG on-column with a percent relative standard deviation (% RSD) of 2-3% RSD. The method has a detection limit estimated to be 100 ng of IgG on column. It has been used to analyze a variety of IgG-containing samples from such diverse sources as hybridoma selection, media cultivation, and purification studies. Gradient elution studies and the relationship of IgG elution to IgG isoelectric point (pI) are also described. PMID- 2774192 TI - Permselectivity and ion-exchange properties of Eastman-AQ polymers on glassy carbon electrodes. AB - Eastman-AQ55D is a new poly(ester sulfonic acid) cation exchanger available in a commercial dissolved form. Films of this polymer were coated onto glassy carbon surfaces, and the resulting electrodes exhibit attractive permselectivity, ion exchange, and antifouling properties. Substantial improvement in the selectivity is observed as a result of excluding anionic species from the surface. The charge selective behavior is demonstrated in the presence of a variety of compounds of neurological significance. A rapid response to dynamic changes in the concentration of cationic and neutral species is observed. The polymer strongly binds multiply charged counterions. Cyclic voltammetry is used to determine the quantity of incorporated ions as a function of time, concentration, and other variables. The oxidation of hydrogen peroxide is catalyzed when Ru(bpy)3(2+) is incorporated in the coating. The film can also protect the substrate electrode from foulants present in the contacting solution. These features, as well as the low cost, simple coating procedure, strong adherence to surfaces, and versatility, make the Eastman-AQ55D polymer well-suited for a variety of electro analytical applications. PMID- 2774193 TI - Sequence analysis of highly sulfated, heparin-derived oligosaccharides using fast atom bombardment mass spectrometry. AB - Heparin, a polydisperse, sulfated copolymer of 1----4 linked glucosamine and uronic acid residues, has been used clinically as an anticoagulant for half a century. Despite a yearly use of over 50 million doses in the U.S. alone, heparin's exact chemical structure remains unclear. The negative ion fast atom bombardment mass spectrometry (FAB-MS) analysis is presented for a series of enzymatically prepared, homogeneous, structurally characterized, highly sulfated, heparin-derived oligosaccharides using triethanolamine as the FAB matrix. In addition to the clear presence of monoanionic sodiated molecular ions, structurally significant (sequence) fragment ions are observed and characterized with respect to the known structure for five of the heparin-derived oligosaccharides. The structure of a sixth oligosaccharide is predicted by using negative ion FAB-MS and subsequently confirmed by chemical, enzymatic, and NMR spectroscopic methods. PMID- 2774194 TI - Carbon fiber electrode cell for square wave voltammetric detection of biogenic amines in high-performance liquid chromatography. PMID- 2774195 TI - Continuum source atomic absorption spectrometry in a graphite furnace with photodiode array detection. AB - A graphite furnace continuum source atomic absorption spectrometer using a photodiode array detector is described that provides high-resolution wavelength versus absorbance spectra over a 2.5-nm range for a single atomization step. The multiwavelength detection power allows the simultaneous determination of several elements, reduces problems caused by spectral interferences, and automatically corrects for nonzero background absorbance. Each spectrum is acquired in 0.33 s, and several successive spectra can be obtained during a single run. Three dimensional wavelength-absorbance-furnace temperature spectra can be obtained by using ramped heating steps to provide a rough separation of elements in a mixture. Limits of detection calculated for 19 elements range from 0.1 pg for magnesium to 700 pg for arsenic. The sampling precision was found to be better than 10% relative standard deviation in all cases, with the precision for a single atomization being greatly increased when multiple absorption lines for a single element are observed in the spectrum. The error found for the measurement of the iron concentration in an NBS standard bronze was 8.5%, with the calculated concentration agreeing with the certified concentration within 95% confidence limits. PMID- 2774196 TI - Picogram level quantitation of 2,3,7,8-tetrachlorodibenzo-p-dioxin in fish extracts by capillary gas chromatography/matrix isolation/Fourier transform infrared spectrometry. AB - For the first time, gas chromatography/matrix isolation/Fourier transform infrared spectrometry (GC/MI/FTIR) has been reported to confirm the identity of 2,3,7,8-tetrachlorodibenzo-p-dioxin (2378-TCDD) and to quantify its level in fish extracts in the 170-220 pg range "on disk". When expressed on a fish tissue basis, analyte levels ranged from 15 to 45 pg/g. Spectroscopic identification was based on the position and relative intensity of seven absorption bands. Optical alignment as well as performance evaluation and optimization of the GC/MI/FTIR system are described. The use of [13C12]2378-TCDD as an internal standard was essential for quantitation, and quality assurance controls were used to verify system performance. GC/MI/FTIR quantitation of 2378-TCDD was compared with that independently found by GC with electron capture detection. Recovery of 2378-TCDD averaged 52% (n = 8, 30% relative standard deviation) for fish extracts. PMID- 2774197 TI - Fourier transform atomic absorption flame spectrometry with continuum source excitation. AB - The design and performance of a Fourier transform atomic absorption flame spectrometer (FT-AAS) is presented. A 300-W xenon arc continuum source and a Michelson interferometer are used. A signal to noise disadvantage arising from the multiplex feature of FT-AAS is demonstrated by varying the photon flux at the detector without changing the exciting radiation. A grating is used for dispersion of the radiation before the interferometer to reduce the spectral window at the photomultiplier tube. Detection limits for several elements are generally an order of magnitude poorer than those obtained by continuum atomic absorption methods using echelle-grating spectrometers. Line profiles and absorption spectra, within the region of the spectral window selected by the grating, can be obtained with this method. Standard curves for sodium were constructed to extend the linear calibration range, by using absorbances measured at the absorption maximum and 0.022 nm off-line. PMID- 2774198 TI - Mixture analysis and quantitative determination of nitrogen-containing organic molecules by surface-enhanced Raman spectrometry. AB - Surface-enhanced Raman spectrometry (SERS) on a silver-coated filter paper substrate of nitrogen-containing organic molecules is reported. A correction procedure for standardization of measurements is proposed and evaluated to solve the difficult problem of quantitation of adsorbate in SERS. The relative standard deviation obtained through this procedure is around 15%. Linearity (r = 0.999) was achieved up to 50 micrograms/mL aminoacridine. A limited dynamic range is observed, however, due to the limited number of SERS active sites in the substrate. Spectral fingerprinting of three-component mixtures by concentration dependent selective molecular adsorption on the substrate is also reported. PMID- 2774199 TI - On-line electrochemistry/thermospray/tandem mass spectrometry as a new approach to the study of redox reactions: the oxidation of uric acid. AB - The electrochemical oxidation pathway of uric acid was determined by on-line electrochemistry/thermospray/tandem mass spectrometry. Intermediates and products formed as a result of electrooxidation were monitored as the electrode potential was varied. Several reaction intermediates have been identified and characterized by tandem mass spectrometry. The tandem mass spectrometric results provide convincing evidence that the primary intermediate produced during the electrooxidation of uric acid has a quinonoid diimine structure. The results indicate that once formed via electrooxidation, the primary intermediate can follow three distinct reaction pathways to produce the identified final products. The final electrochemical oxidation products observed in these studies were urea, CO2, alloxan, alloxan monohydrate, allantoin, 5-hydroxyhydantoin-5-carboxamide, and parabanic acid. The solution reactions that follow the initial electron transfer at the electrode are affected by the vaporizer tip temperature of the thermospray probe. In particular, it was found that at different tip temperatures either hydrolysis or ammonolysis reactions of the initial electrochemical oxidation products can occur. Most importantly, the results show that the on-line combination of electrochemistry with thermospray/tandem mass spectrometry provides otherwise difficult to obtain information about redox and associated chemical reactions of biological molecules such as the structure of reaction intermediates and products, as well as providing insight into reaction pathways. PMID- 2774200 TI - Desorption chemical ionization, thermospray, and fast atom bombardment mass spectrometry of dihydropyridine in equilibrium with pyridinium salt-type redox systems. AB - Trigonellyl-substituted (pyridinium salt type) compounds decompose during sample introduction using desorption chemical ionization (DCI) and thermospray (TSP) ionization. Thermal dequaternization is the main degradation process in DCI, while hydrolytically sensitive bonds are subject to cleavage in the TSP source, and dequaternization and reduction to the dihydropyridine analogues are also observed. Fast atom bombardment (FAB) is the suggested method of ionization because of its ability to provide an intense intact cation. The neutral dihydropyridine analogues can be effectively ionized by DCI and TSP. These methods are recommended, because bombardment-induced oxidation produces artifacts and shows a matrix effect in positive FAB. PMID- 2774201 TI - Potentiometric homogeneous enzyme-linked competitive binding assays using adenosine deaminase as the label. AB - Homogeneous enzyme-linked competitive binding assays for biotin are described that are based on the competition between an enzyme-biotin conjugate and free biotin for a fixed number of binding sites of avidin. Unlike conventional homogeneous enzyme immunoassays, in this system the analyte (biotin) is labeled with adenosine deaminase (ADA), an ammonia-producing enzyme. Consequently, potentiometric rather than photometric methods can be used as means of detection. Several ADA-biotin conjugates were prepared and showed as high as 97% inhibition of the enzymatic activity in the presence of avidin. Addition of free biotin reverses this inhibition in an amount proportional to the concentration of analyte. Relatively steep dose-response curves were observed, leading to a precise and accurate assay for biotin. The detection limits of these curves were as low as 1 x 10(-8) M. Varying the concentration of the reagents in the assay allowed the detection limit and working range to be altered to a desired value. The proposed method was applied in the determination of biotin in a horse-feed supplement. PMID- 2774202 TI - Conductometric transducers for enzyme-based biosensors. AB - The use of alternating current conductometric transducers in biosensing devices has been investigated for urea and D-amino acid sensors using the enzyme systems urease and D-amino acid oxidase/catalase. Transducers with copper and platinum electrodes were constructed and characterized, and two enzyme immobilization methods were tested. Detection limits of 1 x 10(-6)M and linear ranges of 2 orders of magnitude were routinely achieved for these model sensors with enzymes covalently immobilized on collagen films. PMID- 2774203 TI - Center for automated systems. PMID- 2774204 TI - Symposium on Matrix Proteins as Templates for Mineralization. Satellite symposium of the 66th general session of the International Association for Dental Research and the 12th annual meeting of the Canadian Association for Dental Research. Proceedings. PMID- 2774205 TI - Critical comments on the article entitled "Organization of Crystals in Enamel" by H. Warshawsky. PMID- 2774206 TI - Response to the critical comments on the article entitled "Organization of Crystals in Enamel". PMID- 2774207 TI - Biosynthesis and secretion of enamel proteins in the rat incisor. AB - The synthesis and secretion of enamel proteins (EPs) in rat incisors was examined using cytochemical and biochemical methods. Radioautography after injection of 3H methionine showed that ameloblasts in the presecretory, secretory, and maturation stages of amelogenesis actively synthesized and secreted proteins. Immunocytochemistry with an antibody to mouse amelogenins revealed the presence of EPs in the protein synthetic and secretory organelles of these cells at all three stages. Labeling was also found in elements of the endosomal/lysosomal compartment. Sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE) and silver staining of proteins extracted from enamel and enamel organ showed several protein bands. However, transfer to nitrocellulose paper and immunoblotting revealed that most of the proteins recognized by the antibody were situated between approximately 14 and 32 kDa. EPs were further characterized by using lectins to examine their carbohydrate content. Lectin-gold cytochemistry on sections showed the binding of wheat germ agglutinin and Helix pomatia lectin to secretory stage enamel. Lectin blotting indicated that the amelogenins were heterogeneously glycosylated and contained the sugars N-acetyl-glucosamine/N acetyl-neuraminic acid and N-acetyl-D-galactosamine. Fluorography at 6 and 10 min and 1 h after injection of 35S-methionine revealed four labeled bands in the main amelogenin group near 22, 28, 30, and 32 kDa. A short-lived protein of approximately 58 kDa was also observed primarily in cells. The appearance of labeled proteins in enamel was paralleled by their disappearance from cells and the intensity of the radiolabeled protein bands, both, in enamel and in cells, decreased towards the maturation stage. These data are consistent with the concept that ameloblasts produce multiple amelogenins throughout amelogenesis. PMID- 2774209 TI - The morphology of release of vitamin A-containing lipid droplets by hepatocytes in rat liver. AB - Vitamin A-containing lipid droplets in the hepatocytes of rat liver were found to be exocytotically released from the cells in the form of a "lipid droplet- retinol-binding protein (RBP)--immunoreactive complex" following intraportal injection of retinol (17, 33, 67, or 100 micrograms). Evidence that the lipid droplets contain vitamin A was obtained by fluorescence microscopy of vitamin A. Intraportal injection of retinol produced varied numbers and sizes of vacuoles in the hepatocytes. The substance within the vacuoles exhibited a meshwork-like configuration in sections from slices incubated in a medium for revealing acid phosphatase activity or the corresponding control medium and was RBP immunoreactive and proteinaceous in nature. The occurrence and number of the vacuoles depended on the dosage of injected retinol, being greatest at a dosage of 100 micrograms of retinol and becoming progressively less at dosages of 67, 33, and 17 micrograms. The vacuoles were formed by vacuolization of cisternae of the rough endoplasmic reticulum. The formation of vacuoles reached a maximum 30 min after intraportal injection of 100 micrograms retinol, and the vacuoles and lipid droplets had almost disappeared from the hepatocytes after 90 min. Little or no esterase activity was found in lipid droplets in the hepatocytes before intraportal injection of retinol, but after the injection, lipid droplets that had fused with the vacuoles become strongly positive for this enzyme activity. This suggests that hydrolysis of retinyl esters may occur in the process of complex formation in rat hepatocytes. PMID- 2774208 TI - Degradation and loss of matrix proteins from developing enamel. AB - The pattern and timing of the breakdown and loss of matrix proteins were studied in developing rat incisor enamel using sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE), fluorography, radioautography, and in vitro incubations of proteins isolated from freshly dissected, crushed pieces of enamel. For biochemical studies, the technique of Robinson et al. (1974, 1977, 1983) was used to transect the enamel organ and enamel into a series of strips at 1 mm intervals along the length of the tooth. The proteins in each strip were extracted and either quantified by Lowry analysis or applied to 12% slab (enamel) or 5-15% continuous gradient (enamel organ) SDS-polyacrylamide gels and separated by electrophoresis. The biochemical studies indicated that the amount of protein contained within an enamel strip increased gradually by volume across the secretory stage, reached a peak early during the maturation stage, and then declined rapidly thereafter. The distribution of enamel proteins on SDS polyacrylamide gels changed markedly throughout this period. These changes included increases and decreases in the intensity of staining of proteins at certain molecular weights (e.g., 18 kDa) and the appearance and disappearance of some proteins not seen clearly near the start of the secretory stage of amelogenesis (e.g., 32 and 10 kDa). Labeling studies with 35S-methionine suggested that the "stacked" arrangement of proteins typical of forming enamel (secretory stage) actually represented a very dynamic association of proteins, with new ones being added at the top of the stack and then breaking down with time to become those seen at lower molecular weights. Across the secretory stage, new proteins were always added to the top of the stack, but during early maturation this activity slowed dramatically, allowing the breakdown of aging proteins to be visualized more clearly. Radioautographic studies with 3H methionine indicated that the breakdown of newly secreted proteins also was correlated with a movement of label from the site of secretion into deeper, previously unlabeled, areas of forming enamel. In vitro studies revealed that the rate and degree of breakdown of enamel proteins varied markedly, depending on the stage of amelogenesis from which the proteins were extracted. Secretory stage enamel proteins showed slow in vitro degradation with accumulation of proteins near 18 kDa. Early maturation stage enamel proteins showed more rapid breakdown with little accumulation of proteins near 18 kDa, whereas late maturation stage enamel proteins showed complete degradation by 2 days of incubation in vitro.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2774210 TI - In vitro reconstruction of a cartilage matrix granule network. AB - The cartilage extracellular matrix contains electron-dense granules and fine filaments when studied electron microscopically after staining with ruthenium red. The matrix granules contain proteoglycans, while the filaments are thought to represent hyaluronic acid. In the present study partial extraction of proteoglycans from the cartilage prior to staining reduced the density of matrix components to allow visualization of a well-developed network involving the matrix granules and hyaluronic acid filaments. The matrix granules frequently had multiple filamentous attachments and the network appeared to be formed by intersecting filaments with the matrix granules at points of intersection. A similar network was created in Sepharose CL-2B beads when proteoglycans, link proteins, and hyaluronic acid were concentrated in the beads. Elimination of any one of these components resulted in failure to form a complete network. Purified proteoglycan monomers alone were sufficient to create matrix granules in the beads. Filaments were seen only when hyaluronic acid was added to the beads. The nature of the network suggests that some type of association between separate aggregates is occurring both within cartilage and within the Sepharose CL-2B beads. PMID- 2774211 TI - Musculotopic innervation of the primary flight muscles, the pectoralis (Pars thoracicus) and supracoracoideus, of the pigeon (Columba livia): a WGA-HRP Study. AB - The distribution of motoneurons innervating the primary depressor and elevator muscles of the wing of the domestic pigeon (Columba livia) was studied by using the retrograde axonal tracer lectin-conjugated horseradish peroxidase (WGA-HRP). Injection of WGA-HRP into the pectoralis (pars thoracicus) labeled neurons in the ventromedial corner of the lateral motor column of the spinal cord. These neurons were arranged in a column extending from spinal segment X or XI to spinal segment XII or XIII. The pectoralis, the primary depressor muscle of the wing, consists of two parts which are anatomically and functionally distinct, the sternobrachialis (SB) and thoracobrachialis (TB). Injection into the SB labeled neurons in the rostral and middle regions of the pectoralis motoneuron column. In contrast, injection into the TB labeled neurons in the middle and caudal regions of the pectoralis motoneuron column. Injection into the primary elevator muscle of the wing, the supracoracoideus, labeled neurons in the lateral motor column in spinal segments X and XI. These motoneurons were located dorsolateral to motoneurons labeled following pectoralis injection. These data demonstrate musculotopic segregation of the motoneurons innervating the primary flight muscles in the pigeon and, further, illustrate that the SB and TB subregions of the pectoralis are innervated by discrete aggregations of motoneurons. PMID- 2774212 TI - Skeletal muscle in the diabetic mouse: histochemical and morphometric analysis. AB - Despite the extensive literature concerning the neuropathy associated with diabetes, only limited information describes changes in the associated muscle. The objective of this study was to evaluate the histochemical and morphometric characteristics of diabetic muscle in the C57BL/KsJ db-m strain of mouse. The histochemical analysis of myofiber type for the diabetic mouse revealed that the extensor digitorum longus muscle consisted of 53.1% type 2a, 46.0% type 2b, and 0.9% type 1 myofibers, a significant shift from the percentages found in the nondiabetic litter mates (44.4% type 2a, 55.6% type 2b, no type 1). Computer assisted morphometric analysis of myofiber size by fiber type indicated a significant difference in myofiber size for the type 2b fibers in muscles from diabetic mice. Similarly, there was a shift in the fiber size distribution to include a greater number of small type 2b myofibers when compared to controls. Skeletal muscle from diabetic mice exhibited a significant change in the percentage of fiber types, with an increase in the number of type 2a fibers, a fiber type grouping that implies possible denervation and reinnervation, and a decrease in myofiber size. These findings may explain why some diabetic patients complain of muscle weakness. PMID- 2774213 TI - Influence of epithelial-mesenchymal interaction on the viability of facial mesenchyme in vitro. AB - Separation and recombination experiments, employing a variety of tissue configurations in organ culture, were performed to determine the extent to which the epithelium of the maxillary process influences the viability of the underlying mesenchyme during organogenesis. The results of these studies indicated that the viability of mesenchyme of the maxillary process of early stage embryos was severely impaired when separated from the overlying epithelium. The influence of epithelium on the viability of mesenchyme was stage dependent; that is, the requirement for the presence of epithelium for the maintenance of the viability of mesenchyme became progressively less pronounced at older developmental stages. The response of mesenchyme to the presence of recombined epithelium resulted in the appearance of a delimited zone of influence extending, within specific boundaries, from the epithelial-mesenchymal interface. Preliminary data from homotypic (maxillary epithelium-maxillary mesenchyme), heterotypic (limb apical ectodermal ridge-maxillary mesenchyme) and heterochronic (stage 28 epithelium-stage 22 mesenchyme) recombination experiments indicated that viability of mesenchyme could be achieved only through direct epithelial mesenchymal contact which allowed restoration of normal morphological relationships at the interface of the two tissues. PMID- 2774214 TI - Structural assessment of rat sciatic nerve following tourniquet compression and vascular manipulation. AB - In a recent study (Nitz et al., Exp Neurol 94:264-279, 1986) the validity of a rat animal model to examine effects of tourniquet compression and vascular occlusion on limb motor function, leg girth, and electrophysiologic changes was established. Here we report observations on sciatic nerve morphologic and morphometric alterations of these same animals. The hindlimbs of 90 rats were compressed by a pneumatic tourniquet at clinically relevant pressures (200 to 400 mm Hg) for 1 to 3 hours, and the sciatic nerve was assessed by light and electron microscopy at 1, 3, and 6 weeks post compression. The nerves were also examined from five additional animals at each of these time intervals following arterial ligation and sciatic nerve epineurectomy (30 rats). Percentage of degenerating myelinated nerve fibers and volume fraction of mast cells and fibroblasts were quantified morphometrically. The percentage of degenerating myelinated nerve fibers after moderate to severe tourniquet compression and vascular manipulation was similar and ranged from 15% to 45%. Tourniquet compression, but not vascular occlusion, resulted in an increase of mast cells and fibroblasts and disruption of endothelial cells of endoneurial vessels. The results suggest that clinically relevant tourniquet compression causes a secondary increase in vascular permeability, intraneural edema, and subsequent prolonged tissue ischemia, resulting in nerve degeneration. PMID- 2774215 TI - [Dermatological diseases in andrological patients]. AB - The paper emphasizes on the importance of a complete clinical skin inspection by all andrological patients. In a three year period (1985-1987) 4779 patients were newly seen in the department of andrology. 575 (12,03%) out of the above mentioned group showed clinical skin. Taking the clinic, localisation and age into consideration we make a detailed presentation of the various skin diseases caused by mycotic infections. The results strengthen the necessity of a complete inspection of the skin in all andrological cases. It should be not allowed exclusively to investigate the area of the external genitals. PMID- 2774216 TI - [Species specific motility patterns of hyperactivated mammalian spermatozoa and quantitative analysis of the hyperactivation of bull spermatozoa]. AB - Movement tracks of spermatozoa of human, lion, tiger, cow, pig and sheep are recorded by dark field photography (fluid layer thickness 16.7 microns, exposure time 1 s). Comparison before and after capacitation by an incubation of 2 h in modified tissue culture medium TCM 199 with 10% fetal calf serum resulted in two quite different patterns of hyperactivated spermatozoa: 1) Tracks are broadened due to enlarged lateral head displacement or radius of rotating head movements respectively (tiger, lion) and show beside that a markedly increase in erratic motility (human). 2) In the studied species of artiodactyla, cow, pig and sheep, a qualitative new, panicle-like pattern arised as a result of superposition of spermatozoa head pendular movements around the axis of forward motility and the other one around the head axis. This new type of tracks allows a simple quantitative analysis of hyperactivation of bull spermatozoa, first described in this report. The method is applied to investigations on efficacy of capacitation media and provides evidence for high individual differences of semen donors in capacitation success. PMID- 2774217 TI - Ultrastructure of testicular cells in rats treated with dibromochloropropane (DBCP). AB - Three days after a single injection of rats with dibromochloropropane (DBCP) the testicular seminiferous tubules displayed focal damage, which became more pronounced six days after the treatment. Severely damaged tubules exhibited an almost complete exfoliation of the germ cells, while the Sertoli cells' lining remained mostly intact. The most affected germ cells were the spermatids. The mitochondrial sheath of the midpiece was often incomplete, vacuolated and/or broken into several pieces. In many cases the mitochondrial sheath protruded towards the interior, thus partially separating dense fibers 1, 2 and 9 from 3 to 8. In addition, cross sections revealed several midpieces of different flagellae surrounded by a single plasmalemma. In young spermatids, an atypical acrosome formation was noted concomitantly with a progressive emptying of the central nuclear region. This resulted in nuclei with electron lucent center surrounded by a chromatin belt. Sertoli cells displayed intense phagocytotic activity, their cytoplasm containing increased numbers of lysosomes, cellular debris and axonemal fragments. PMID- 2774219 TI - Lectin-binding sites in testis of men with acrosomeless round-headed spermatozoa. AB - We report herein about lectin histochemistry of seminiferous epithelia in two infertile men with exlusely acrosomeless round-headed spermatozoa. FITC conjugated lectins (ConA, PNA, RCA II, WGA) have been employed on tissue sections of Bouin fixed testicular biopsies. RCA II gave a dot-like fluorescence of the acrosomal region and WGA gave a cap-like acrosomal fluorescence of spermatids. PNA-a marker of acrosomal differentiation-failed to stain spermatids. The binding of ConA to germ cells was not influenced by this syndrome. In conclusion, the syndrome of acrosomeless round-headed spermatozoa is associated with selective perturbations of testicular lectin-binding sites. They might contribute of the inability of sperm cells to adhere to and penetrate into ova. PMID- 2774218 TI - Evaluation of HLA expression on gametogenic cells isolated from human testis. AB - Human germinal cells were isolated using a combined mechanical method and enzymatic digestion of testicular tissue. The attempt to fractionate the testicular cells by centrifugation in the continuous and discontinuous Percoll gradient was undertaken. The homogeneous (100%) fraction of late spermatids and enriched fractions of spermatocytes (up to 60%) and round spermatids (approx. 66%) were obtained. Cell-binding radioimmunoassay (CB-RIA) was used to evaluate the HLA expression both on heterogeneous suspensions and enriched fractions of testicular, germ cells using mouse monoclonal antibodies directed to Class I (HLA, -A, -B, -C) and Class II (HLA, -DR) determinants of MHC (main histocompatibility complex). Consistently negative results were obtained as well for heterogenous populations of germinal cells as their fractions in respect to both Class I and Class II antigenic determinants of HLA system. PMID- 2774220 TI - Toxic environmental chemicals in human semen: analytical method and case studies. AB - In 1982, 89 men from all over the FRG participated in an investigation of sperm density and the presence of selected persistent environmental chemicals in their semen. Semen concentrations for the following chemicals were measured: lead, cadmium, hexachlorobenzene (HCBC), a-hexachlorocyclohexane (a-BHC), DDT and metabolites, dieldrin and polychlorobiphenyls (PBC). Heavy metal analyses were performed by Zeeman-AAS with direct sample measurement. A method for the quantitative determination of chlorinated hydrocarbons in semen by liquid-liquid extraction, clean-up and quantitation by gas chromatography with an electron capture detector. Recovery rates ranged from 72 to 120%. Compound identification in samples was confirmed by negative chemical ionization mass spectrometry. Heavy metals and organochlorine compounds in semen were present in the same concentration range as in blood or other biofluids. Occupational exposure as well as extraordinary environmental exposure appeared to influence semen concentrations. Students in chemistry showed elevated levels of organochlorine compounds. Men who lived in the vicinity of an atmospheric source of heavy metals showed strikingly the vicinity of an atmospheric source of heavy metals showed strikingly elevated levels of semen lead and cadmium. We were unable to find a statistically significant correlation between sperm density and any of the variables examined in this study including: orgonochlorine compounds summed or individually; lead and/or cadmium; and tobacco consumption. Significant correlations were found between the simultaneous occurrence of lead and cadmium and between the simultaneous occurrence of HCB, DDT and DDE. PMID- 2774221 TI - [The effect of forskolin on sperm motility. In vitro experiments with bull sperm]. AB - We have investigated the effect of Forskolin, a substance that stimulates c-AMP, on the motility of freshly thawed bull-sperm. Forskolin was added in amounts of 25.78 and 2.57 micrograms. In control samples we employed saline. An amount of 25.78 micrograms Forskolin increased significantly the procentage of motile spermatozoa compared with 2.57 micrograms Forskolin or saline. The mean velocity of the motile sperm is decreased slightly, but constantly, over a period of 130 minutes by Forskolin (25.78 micrograms), but not by 2.57 micrograms Forskolin or saline. With respect to progressive motile sperm and their mean velocity, there were no significant differences detectable. The usefulness of Forskolin in reproductive medicine needs further evaluation. PMID- 2774222 TI - [The effect of relaxin on sperm motility. In vitro experiments with bull sperm]. AB - We investigated the effect of relaxin (1990 pmol, 199 pmol, 19.9 pmol) on bull sperm-motility by means of Laser-Doppler (Lazymot). We evaluated 4 parameters, i.e. percentage of motile spermatozoa and percentage of spermatozoa with good progression, mean velocity of the sperm sample and characteristic velocity of the sperm subpopulation with good progression. Amounts of 199 and 19.9 pmol relaxin did not provoke a significant change with respect to sperm motility compared with "relaxin-free" medium. The highest amount of relaxin (1990 pmol) inhibited sperm motility with respect to all 4 parameters that had been investigated. The action of relaxin on sperm-motility depends on the amount of relaxin in the medium, e.g. activation at physiologic and inhibition at very high amounts of that substance. PMID- 2774223 TI - Myocardial and cerebral drug concentrations and the mechanisms of death after fatal intravenous doses of lidocaine, bupivacaine, and ropivacaine in the sheep. AB - This paper reports the cardiovascular effects of intentionally toxic intravenous doses of lidocaine, bupivacaine, and ropivacaine and the mechanisms of death. Fatal doses of lidocaine, bupivacaine, and ropivacaine were established in sheep treated with successive daily dose increments of each drug. The mean fatal dose of lidocaine (+/- SD) was 1450 +/- 191 mg (30.8 +/- 5.8 mg/kg), that of bupivacaine was 156 +/- 31 mg (3.7 +/- 1.1 mg/kg), and that of ropivacaine was 325 +/- 108 mg (7.3 +/- 1.0 mg/kg); thus the ratio of fatal doses was approximately 9:1:2. In four out of four lidocaine-treated animals, respiratory depression with bradycardia and hypotension without arrhythmias were the causes of death. Three out of four bupivacaine-treated animals died after the sudden onset of ventricular tachycardia/fibrillation without hypoxia or acidosis; the fourth died in a similar manner to the lidocaine-treated animals. Three out of five animals given ropivacaine died in a manner resembling the fatal effects of lidocaine-treated animals, but unlike the lidocaine-treated animals, in all three sheep there were also periods of ventricular arrhythmias. The remaining two ropivacaine-treated sheep died as a result of the sudden onset of ventricular tachycardia/fibrillation. The mean percentages of the fatal dose found in the myocardium was 2.8 +/- 0.7 for lidocaine-treated animals, 3.3 +/- 0.9 for bupivacaine-treated animals, and 2.2 +/- 1.4 for ropivacaine-treated animals; the corresponding percentages in whole brain were, respectively, 0.71 +/- 0.01, 0.71 +/- 0.21, and 0.89 +/- 0.27. PMID- 2774224 TI - Hemodynamic and central nervous system effects of intravenous bolus doses of lidocaine, bupivacaine, and ropivacaine in sheep. AB - Lidocaine hydrochloride (HCl) (80-320 mg), bupivacaine HCl (20-80 mg), and ropivacaine HCl (30-120 mg) were administered as intravenous bolus doses to conscious sheep (n = 18; average body weight 45 kg) that had previously placed intravascular cannulae for hemodynamic monitoring and for obtaining blood samples. The mean convulsive doses and arterial blood concentrations were approximately 110 mg and 40 mg/L, respectively, for lidocaine HCl, 45 mg and 14 mg/L for bupivacaine HCl, and 60 mg and 20 mg/L for ropivacaine HCl. After subconvulsive doses of each agent, there were minimal cardiovascular effects. After convulsive doses, there were marked increases in heart rate, mean arterial pressure, pulmonary artery pressure, cardiac output, systemic vascular resistance, left ventricular end diastolic pressure, and myocardial contractility. Ventricular fibrillation caused death in two sheep after bupivacaine (80 mg) and in two sheep after ropivacaine (90 and 120 mg) administration. With sublethal doses, the hemodynamic responses to these agents were qualitatively and quantitatively similar when compared with their local anesthetic potencies. PMID- 2774225 TI - Lack of effect of spinal anesthesia on drug metabolism. AB - The effect of spinal anesthesia on drug disposition was determined in six dogs with chronically implanted vascular catheters using propranolol as a model compound. On the first study day, 40 mg of unlabeled propranolol and 200 microCi of [3H]propranolol were injected into the portal and femoral veins respectively. Arterial blood samples were taken for 4 hr for measurement of plasma concentrations of labeled and unlabeled propranolol by high-pressure liquid chromatography (HPLC) and of [3H]propranolol by liquid scintillation counting of the HPLC eluant corresponding to each propranolol peak. Twenty-four hr later, spinal anesthesia was induced with tetracaine (mean dose 20.7 +/- 0.6 mg) with low sacral to midthoracic levels and the propranolol infusions and sampling were then repeated. Spinal anesthesia had no significant effect on either the intrinsic clearance of propranolol (2.01 +/- 0.75 L/min before and 1.9 +/- 0.7 L/min during spinal anesthesia), or on mean hepatic plasma flow (2.01 +/- 0.5 L/min before and 1.93 +/- 0.5 L/min during spinal anesthesia). The systemic clearance and elimination half-life of propranolol were also unchanged by spinal anesthesia (0.9 +/- 0.23 L/min on the first day, 0.7 +/- 0.1 L/min during spinal anesthesia; and 101 +/- 21 min on the first day, 115 +/- 16 min during spinal anesthesia, respectively). The volume of distribution (Vd) of propranolol was similarly unaffected by spinal anesthesia.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2774226 TI - Effect of N2O on segmental left ventricular function and effective arterial elastance in pigs when added to a halothane-fentanyl-pancuronium anesthetic technique. AB - The interaction of various concentrations of N2O and a stable halothane-fentanyl pancuronium anesthetic technique was examined in nine pigs. Segmental myocardial contractility was measured with the end-systolic pressure-length relationship (Ees), and the effective arterial elastance (Ea) was quantified based on the Windkessel model. The addition of 30, 50, and 70% N2O did not change myocardial contractility or the effective arterial elastance. During the 30 and 70% N2O challenge, however, arterial capacitance decreased significantly from a mean (+/- SEM) 0.86 +/- 0.15 to 0.71 +/- 0.0.11 mL/mm Hg with 30% N2O (P less than 0.05) and from 0.90 +/- 0.09 to 0.71 +/- 0.07 mL/mm Hg (P less than 0.05) with 70% N2O. A dose-response relationship for the effect on the arterial capacitance could not be demonstrated. We concluded that in the presence of halothane, fentanyl, and pancuronium, N2O does not depress the normal myocardium or change left ventricular afterload. The decrease in arterial capacitance that occurred when 30 and 70% N2O were given was not sufficient to change the effective afterload and appears to be of no importance to normal left ventricular function. PMID- 2774227 TI - Spinal cord distribution of 3H-morphine after intrathecal administration: relationship to analgesia. AB - The distribution of intrathecally administered 3H-morphine was examined by light microscopic autoradiography in rat spinal cord and temporal changes in silver grain localization were compared with results obtained from simultaneous measurements of analgesia. After tissue processing, radio-activity was found to have penetrated in superficial as well as in deeper layers (Rexed lamina V, VII, and X) of rat spinal cord within minutes after application. Silver grain density reached maximal values at 30 min in every region of cord studied. Radioactivity decreased rapidly between 30 min and 2 hr and then more slowly over the next 24 hr. In rats tested for responses to a thermal stimulus (tail flick test), intrathecal administration of morphine (5 and 15 micrograms) resulted in significant dose dependent analgesia that peaked at 30 min and lasted up to 5 hr (P less than 0.5). There was a close relationship between analgesia and spinal cord silver grain density during the first 4 hr of the study. It is postulated that the onset of spinal morphine analgesia depends on appearance of molecules at sites of action followed by the activation of anti-nociceptive mechanisms. PMID- 2774228 TI - The effects of oral transmucosal fentanyl citrate premedication on preoperative behavioral responses and gastric volume and acidity in children. AB - The authors compared the safety, efficacy, and effects on gastric volume and pH of oral transmucosal fentanyl citrate (OTFC) premedication and of placebo lollipop and no premedication in 55 children undergoing elective operations. The patients were randomly assigned to receive no premedication (group A, N = 18); OTFC containing 15-20 micrograms/kg of fentanyl citrate (group B, N = 18); or a placebo lollipop (group C, N = 19). Activity (sedation) and anxiety scores, vital signs (including systolic and diastolic arterial blood pressures, heart and respiratory rates), and pulse oximetry determined oxygen saturation were measured before and at 10-min intervals after premedication until the patients were taken to the operating room. Gastric contents were aspirated via an orogastric tube and analyzed for volume and pH after induction of anesthesia. Quality of induction and recovery were evaluated using scoring schedules; recovery times were measured and side effects recorded. OTFC was readily accepted and provided levels of sedation and anxiolysis significantly greater after 10 min than after no premedication or the placebo lollipop. Arterial blood pressures, heart rate, and oxygen saturations were not different among the three groups. In patients given OTFC, respiratory rates were significantly lower after 10 min than they were in patients having no premedication.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2774229 TI - Time-courses of zones of differential sensory blockade during spinal anesthesia with hyperbaric tetracaine or bupivacaine. AB - The purposes of this study were twofold: to compare bupivacaine and tetracaine spinal anesthesia with regard to the zones of differential sensory blockade and to evaluate the time-courses of the widths of the zones of differential sensory blockade during spinal anesthesia. In 51 patients, the most rostral levels of sensory denervation to light touch, pinprick, and temperature discrimination were measured. There was no statistically significant difference in the height of sensory blockade in the 29 patients given bupivacaine and in the 22 patients given equipotent doses of tetracaine. The widths of the zones of differential blockade were also not statistically different between the two groups during onset, maintenance, and regression of anesthesia, except that the light touch-to pinprick and light touch-to-temperature zones of differential blockade were greater with bupivacaine than with tetracaine 30 min after subarachnoid injection. The width of the zones of differential blockade also remained unchanged within each group during onset, maintenance, and regression of anesthesia. Changes in, and absolute levels of, blood pressure and heart rate were similar with both bupivacaine and tetracaine throughout. We conclude that zones of differential sensory blockade are essentially the same with tetracaine and bupivacaine, that the widths of the zones of differential sensory blockade remain constant during onset, maintenance, and offset of spinal anesthesia, and that bupivacaine and tetracaine are associated with similar changes in heart rate and blood pressure during spinal anesthesia. PMID- 2774230 TI - Urodynamic studies after intrathecal fentanyl and buprenorphine in the dog. AB - Cystometrograms (CMG) and urethral pressure profiles (UPP) were used in six anesthetized dogs to study the urodynamic effects of intrathecal (IT) injections of fentanyl and buprenorphine. The CMG and UPP were examined for each of the two drugs in all dogs (four experiments per animal). The measurements were performed before and 15, 30, 60, 90, and 120 min after IT injection of either 1.5 micrograms/kg fentanyl or 2 micrograms/kg buprenorphine. Fifteen minutes after IT injection of fentanyl, reduction in bladder tone was already noted, followed by decreases in mean peak vesical pressure of 48.3% +/- 6.0 (SE) (P less than 0.05) and mean peak urethral pressure of 38% +/- 3.0 (P less than 0.05) between 30 and 60 min after injection. These decreases, occurring in each experiment, gradually lessened at 90 and 120 min. The effects of IT buprenorphine, a partial opioid agonist, on bladder and urethral dynamics were inconsistent and non-significant in all studies. Disturbances of micturition observed clinically after spinal opioid administration may be related to the decrease in intravesical pressure and the resulting highly compliant bladder. Relaxation of the urethral musculature seen 15 min after IT fentanyl may prevent overdistension of the bladder and its associated complications. PMID- 2774231 TI - Nitrogen-sparing effect of epidural administration of local anesthetics in colon surgery. AB - A nitrogen-sparing effect of epidural anesthesia has been clearly demonstrated in gynecological and lower abdominal surgery. To determine if epidural anesthesia also has a protein-sparing effect during major upper or mid-abdominal surgery, postoperative nitrogen balance and 3-methylhistidine urinary excretion (an index of skeletal muscle protein catabolism) were measured for 6 days in 28 patients who had undergone colon resection for cancer with general anesthesia (N2O-O2-1% enflurane) either supplemented with low dose fentanyl plus intermittent systemic pentazocine for postoperative pain (n = 13), or the same general anesthetic plus epidural injection of either etidocaine 1% intraoperatively and bupivacaine 0.25% postoperatively (n = 8) or meperidine (n = 7) for 48 hr after skin incision. The cumulative 6-day nitrogen balance and the cumulative 3-methylhistidine urinary excretion were significantly less after epidural injection of etidocaine intraoperatively and bupivacaine postoperatively than in the two other groups. There was a significant correlation between the daily urinary excretion of 3 methylhistidine and the daily nitrogen balance in the three groups. This study suggests that in colon surgery, epidural analgesia with local anesthetics in the postoperative period improves nitrogen balance and this effect takes place partly in the muscle. PMID- 2774232 TI - Effects of thoracic epidural anesthesia on systemic hemodynamic function and systemic oxygen supply-demand relationship. AB - The effects of thoracic epidural anesthesia (TEA) on total body oxygen supply demand ratio are complex due to potential influences on both O2 delivery (QO2) and consumption (VO2). One hundred and five patients undergoing abdominal aortic surgery were randomly assigned to one of three groups to compare the cardiovascular and metabolic responses associated with (1) thoracic epidural anesthesia plus light general anesthesia (group TEA); (2) general anesthesia with halothane (group H); and (3) neuroleptanalgesia (group NLA). Values of cardiac index (CI) and QO2 were less intraoperatively in the TEA group than in the H or NLA groups, while VO2 values were similar. VO2 during recovery was greater in both the TEA and NLA groups than in the H group. Consequently the oxygen supply demand ratio (QO2/VO2) was less in the TEA group throughout the perioperative period and about 30% below baseline values during early recovery. At comparable VO2, CI and mixed venous O2 saturation were always less in the TEA group than in the NLA group. Heart rate was slowest intraoperatively during TEA, and stroke work was less with TEA than with NLA. As cardiac filling pressure and systemic vascular resistance did not differ among the three groups, reduced adaptation of CI to tissue O2 needs during TEA was attributed to negative inotropic and chronotropic effects of the sympathetic blockade. We conclude that in patients undergoing abdominal aortic surgery, TEA has no apparent advantage over general anesthesia. PMID- 2774233 TI - Solubility of I-653, sevoflurane, isoflurane, and halothane in human tissues. AB - Tissue/blood partition coefficients of anesthetics are important indicators of the rate of tissue wash-in and wash-out, and wash-in and wash-out are determinants of the rates of induction of and recovery from anesthesia. In the present study of human tissues, we found that the tissue/blood partition coefficients (for brain, heart, liver, kidney, muscle, and fat) for the new anesthetic I-653 were smaller than those for isoflurane, sevoflurane, and halothane (anesthetics listed in order of increasing tissue/blood partition coefficients). For example, the respective brain/blood partition coefficients were 1.29 +/- 0.05 (mean +/- SD); 1.57 +/- 0.10; 1.70 +/- 0.09; and 1.94 +/- 0.17. This indicates that induction of and recovery from anesthesia with I-653 should be more rapid than with the other agents. The finding of a lower tissue/blood partition coefficient for I-653 parallels the previous finding of a lower blood/gas partition coefficient. PMID- 2774234 TI - The effects of airway impedance on work of breathing during halothane anesthesia. AB - Humidifiers and small diameter endotracheal tubes placed in the airway circuit increase the impedance to breathing. The effect of such impedances on the work of breathing and respiratory patterns was studied in eight healthy adult patients (60-80 kg) anesthetized with 1 and 2 MAC halothane in oxygen. A Cascade Humidifier and Portex Humid-Vent (dry and water saturated) were evaluated while patients breathed through an 8.0-mm endotracheal tube. A 6.0-mm endotracheal tube was also assessed without the humidifiers. At 1 MAC the Cascade Humidifier and the wet Humid-Vent when used with the 8.0-mm tube increased the work of breathing to 86.8 ml and 76.8 ml, 77% and 70% above baseline levels of 48.1 ml, whereas the 6.0-mm tube without the humidifiers increased work 89% to 78.9 ml. Tidal volume and respiratory frequency were unchanged throughout the study, although inspiratory time was prolonged. Lightly to moderately anesthetized healthy adult patients are able to maintain minute ventilation despite the impedance associated with commonly used humidifiers by significantly increasing work of breathing. PMID- 2774235 TI - Isoflurane-induced hypotension in orthognathic surgery. AB - The effect of isoflurane-induced hypotension on reduction of blood loss, improvement of surgical field, and postoperative edema was investigated in 52 patients undergoing combined maxillary and mandibular osteotomies. Anesthesia was maintained with fentanyl, N2O, O2, and isoflurane. Deliberate hypotension was induced by increasing isoflurane inspired concentration. Blood loss in the hypotensive group (MAP 55-65 mm Hg) was significantly less than that in the control group (MAP 75-85 mm Hg); 454.0 +/- 211.3 mL versus 755.3 +/- 334.6 mL (P less than 0.001). Fewer patients had to be transfused in the hypotensive group, 12.0% versus 44.4% (P less than 0.02). The surgical field was significantly improved by the hypotensive technique, but operative time was not shortened. Subjective and objective measurements of postoperative edema failed to show any effect of deliberate hypotension. Our data suggest that isoflurane-induced hypotension effectively reduces blood loss and the number of transfusions in orthognathic surgery. PMID- 2774236 TI - Ocular lubricants and corneal injury during anesthesia. AB - Seventy-six patients undergoing general endotracheal anesthesia were studied prospectively to determine whether simply taping the eyelids closed during the surgical procedure as opposed to taping the lids after instilling a bland lubricating ointment had any different effect on corneal or conjunctival epithelium. No significant difference was found. PMID- 2774237 TI - Incidental discovery of persistent left superior vena cava during cardiac surgery. PMID- 2774238 TI - Celiac plexus block for hepatic arterial embolization: a comparison with intravenous morphine. PMID- 2774239 TI - Interpleural bupivacaine for postoperative pain during lactation. PMID- 2774241 TI - AIDS infection protection--reinforced gloves. PMID- 2774240 TI - Successful resuscitation of bupivacaine-induced cardiac arrest using cardiopulmonary bypass. PMID- 2774242 TI - Thiamine for prevention of Wernicke's encephalopathy: a reminder. PMID- 2774243 TI - Epidural narcotic use for outpatient pain treatment. PMID- 2774244 TI - On hot mice, cold facts, and would-be replication. PMID- 2774246 TI - Disposal of epidural catheter stylets: taming the snake. PMID- 2774245 TI - Tourniquet pain during bupivacaine and tetracaine spinal anesthesia. PMID- 2774247 TI - Diffusion of felt-tip marker pen ink into intravenous bags. PMID- 2774248 TI - What is MIR? PMID- 2774249 TI - Acute left bundle branch block precipitated by trimethaphan. PMID- 2774250 TI - A simple, inexpensive device to prevent airway disconnection when using remote capnometry. PMID- 2774251 TI - Clinical use of subarachnoid neuropeptides: an experimental contribution. PMID- 2774252 TI - Hazards of henna. PMID- 2774253 TI - Cut-off values and aspiration risk. PMID- 2774254 TI - A buccal sensor for measuring arterial oxygen saturation. PMID- 2774255 TI - Monitoring effective chest compression during cardiopulmonary resuscitation. PMID- 2774256 TI - Difficult intubation in severe diabetics. PMID- 2774257 TI - Time-dependent changes in bupivacaine pharmacokinetics. PMID- 2774258 TI - Epidural clonidine in lower limb deafferentation pain. PMID- 2774259 TI - Effect of oral liquids and ranitidine on gastric fluid volume and pH in children undergoing outpatient surgery. AB - Eighty-eight children (mean age 5.6 yr, range 1-14 yr) about to undergo elective outpatient surgery were randomly assigned to four groups. All children were given phenolsulfonphthalein (PSP) orally 2-3 h before the scheduled time of surgery as a marker dye to assess gastric emptying. Immediately after receiving PSP they were given: group A--liquids, up to 5 ml/kg + placebo (glucose water 0.2 ml/kg); group B--liquids, up to 5 ml/kg + ranitidine 2 mg/kg in glucose water 0.2 ml/kg; group C--placebo only; group D--ranitidine only. Gastric contents were aspirated after induction of anesthesia. Mean volume (range) in ml/kg of aspirated gastric fluid in each group was: group A--0.34 (0-1.0); group B--0.17 (0.07); group C- 0.25 (0-1.1); group D--0.16 (0-0.6). The pH mean (range) value was: group A--1.83 (0.9-3.6); group B--4.76 (2.0-7.7); group C--2.10 (1.2-4.1); group D--3.97 (1.3 7.3). PSP could not be detected in the gastric samples from children in whom the ingestion-sampling interval was more than 2.25 h. In comparison with prolonged starvation, administration of oral liquids without ranitidine 2-3 h preoperatively did not produce a significant increase in mean volume of gastric aspirate, and there was no increase in the number of patients with gastric aspirate greater than 0.4 ml/kg. Administration of ranitidine with or without fluids resulted in a decrease in both volume and acidity of gastric contents. PMID- 2774260 TI - Thiopental requirements for induction of anesthesia in neonates and in infants one to six months of age. AB - The authors determined the thiopental dose needed for satisfactory induction in ten neonates, 0-14 days of age, and 20 infants, 1-6 months of age. A single iv bolus of thiopental was given. Thirty seconds after injection the anesthesia mask was applied and the response was observed during the following 30 s while the patient breathed oxygen. Induction was considered satisfactory if there were no gross movements or coughing. The dose required for satisfactory induction in 50% of patients, ED50 (+/- SE), was 3.4 +/- 0.2 mg/kg in neonates and 6.3 +/- 0.7 mg/kg in infants (P less than 0.001). It is concluded that the thiopental dose needed for satisfactory induction is less in neonates than in infants. PMID- 2774261 TI - Passive and active inspired gas humidification in infants and children. AB - The hypothesis that both active and passive airway humidification prevents hypothermia in infants and children, but that neither decreases the duration of postoperative recovery was tested. Twenty-seven ASA physical status 1 or 2 patients were studied who weighed between 5 and 30 kg, underwent superficial operations, were anesthetized with halothane and 70% N2O, and whose lungs were ventilated via a Rees modification of an Ayre's t-piece. The children were randomly assigned to receive active airway humidification and warming using an MR450 Servo airway heater and humidifier set at 37 degrees C (n = 10), passive airway humidification using the Humid-Vent 1 heat and moisture exchanger placed between the Ayre's t-piece and the endotracheal tube (n = 8), or no airway humidification and heating (control, n = 9). Distal tracheal and tympanic membrane temperatures and airway humidity were recorded during the first 90 min of surgery. Rectal temperature was measured during the postanesthetic recovery period. Relative humidity of inspired respiratory gases was approximately 30% in the control group and approximately 90% in the group given active airway humidification. Initial inspired humidity in the passive humidification group (50%) increased to approximately 80%, a level not significantly different from that in the active group after 80 min of anesthesia. Central body temperature increased 0.25 degrees C during active active airway humidification and heating, whereas temperature decreased 0.25 degrees C during passive humidification and 0.75 degrees C without airway humidification. Distal tracheal temperature was significantly higher in the groups given passive and active humidification than in the control group.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2774262 TI - Intraoperative glucose infusion and blood lactate: endocrine and metabolic relationships during abdominal aortic surgery. AB - The hypothesis that increased intraoperative blood lactate depends both on intraoperative glucose supply and inadequate tissue oxygenation occurring during surgery was tested in anesthetized patients undergoing infrarenal abdominal aortic surgery. Twenty surgical patients received either Ringer's solution or 5% glucose solution for intraoperative volume loading. Arterial blood lactate, arterial glucose, hemodynamic variables, insulin, glucagon, cortisol, epinephrine, and norepinephrine were determined preoperatively and intraoperatively. There were no significant changes in hemodynamic values, glucagon, norepinephrine, and epinephrine compared with control values in both groups. Oxygen consumption decreased only during aortic clamping. Cortisol and lactate increased significantly 10 min after aortic clamping until the end in both groups. Glucose 5% solution infusion resulted in significantly greater blood lactate accumulation and significantly greater blood glucose and insulin levels, whereas there were no changes in the patients receiving Ringer's solution. From control until aortic clamping, lactate and glucose were significantly correlated with each other in both groups; after aortic clamping until the end of the procedure, the correlation remained constant in patients in the Ringer's group, whereas no relationship could be demonstrated in those in the glucose group. The authors conclude that intraoperative glucose administration increases intraoperative blood lactate and that blood lactate accumulation depends both on glucose supply and tissue oxygen deficit. Furthermore, none of the hemodynamic metabolic and endocrine factors were reliable for assessing tissue perfusion and metabolic demands during surgery. PMID- 2774264 TI - Where antecubital catheters go: a study under fluoroscopic control. AB - Fifty attempted central venous cannulations via the antecubital route were studied with fluoroscopy to determine catheter tip location. Only "catheter through needle" devices were employed. Successful central placement occurred on the first attempt in 27 cases. The major impediment to central location of the catheter tip (ten cases) was the tendency of the catheter tip to lodge at the subclavian-internal jugular vein junction. The second most common cause of noncentral location was migration of the catheter tip into the internal jugular vein (nine cases). One catheter tip was located in the contralateral subclavian vein and one ended in the external jugular vein. All of these problems were avoided by two maneuvers: 1) turning the patient's head toward the side of cannulation and applying digital pressure to the ipsilateral supraclavicular fossa, and 2) withdrawing the catheter stylet and injecting 5-10 ml of physiologic saline solution while the catheter was advanced. The only cause of unsuccessful central placement in this study was inability to pass the catheter tip past the axillary venous plexus (two patients). It is concluded that the head turn-supraclavicular fossa pressure maneuver in combination with the stylet withdrawal-saline injection maneuver can result in greater than a 90% rate of successful central venous catheter placement. PMID- 2774263 TI - Short trachea, a hazard in tracheal intubation of neonates and infants: syndromal associations. AB - Short trachea results from reduction in number of tracheal cartilage rings to 15 or fewer from normal mean of 17 rings in infants. In a review of radiologic and pathologic data, the thoracic vertebral level of tracheal bifurcation as seen in anteroposterior chest radiographs of infants with congenital malformations, cardiovascular anomalies, and skeletal dysplasias, was compared with numbers of tracheal cartilage rings demonstrated in postmortem specimens. Increased frequency of short trachea was seen in patients with DiGeorge anomaly (77%), skeletal dysplasias (55%), brevicollis (57%), diaplacental rubella (40%), and patients with congenital heart disease who did not have DiGeorge anomaly (36%, with range 25-83% for different types, the highest, 83%, being interrupted aortic arch). Preintubation high kilovoltage chest radiographs to establish the level of tracheal bifurcation in patients with increased risk of short trachea can be helpful in avoiding bronchial intubation and its complications. Postintubation chest films to assure the level of the endotracheal tube tip should be considered for such patients. Growth in length of the trachea with age is accomplished both by increase in size of tracheal cartilage rings and interring membranes, and by increase in ring number. PMID- 2774265 TI - The relationship between adductor pollicis twitch tension and core, skin, and muscle temperature during nitrous oxide-isoflurane anesthesia in humans. AB - Temperature and volatile anesthetic agents influence neuromuscular transmission. Because mild hypothermia is common during general anesthesia, the authors sought to determine the relationship between the core temperature, adductor pollicis muscle temperature, and the twitch response of the adductor pollicis muscle, during isoflurane anesthesia in 15 patients undergoing elective surgery in which muscle relaxants were not required. Five patients were allowed to cool spontaneously, five were cooled actively, and normothermia was maintained actively in the remaining five. In the normothermic patients (core greater than 36.5 degrees C, muscle greater than 35.7 degrees C), the twitch response of the muscle remained unchanged from control values. In the patients who were cooled passively or actively, a muscle temperature threshold was observed (35.2 degrees C), below which twitch response of the muscle diminished by 10-15%/degrees C decrease in muscle temperature. To ensure that the adductor pollicis muscle temperature remained above 35.2 degrees C, the core temperature had to be maintained above 36 degrees C. A significant linear relationship (P less than 0.05) was found between the adductor pollicis muscle temperature and twitch tension below the threshold for each individual patient in the cooled groups (correlation coefficient range, 0.80-0.99). Thus, there is a temperature-related decrease in adductor pollicis twitch response during isoflurane anesthesia, and the temperature of this muscle should be maintained above 35-35.5 degrees C during studies of neuromuscular transmission. This can be achieved by maintaining core temperature above 36 degrees C. PMID- 2774266 TI - Differences between handwritten and automatic blood pressure records. AB - Comparison of 46 handwritten and electromechanically generated blood pressure records revealed substantial differences between the recordings. The highest automated record pressures exceeded the highest pressures found in corresponding handwritten records. Similarly, the lowest pressures from automated records were lower than those from handwritten records. Seventeen records (37%) had at least three automatic blood pressure determinations with values substantially in excess of the most extreme values recorded by hand. No handwritten record contained a diastolic pressure above 110 mmHg. Discrepancies between handwritten and automatic records may arise from one or more causes. Among these are readings captured automatically but not observed by the anesthesiologist, faulty reconstruction of handwritten records from memory, and bias in favor of less controversial values. PMID- 2774267 TI - Perioperative pulmonary function in acute respiratory failure: effect of ventilator type and gas mixture. AB - Whether maintaining pulmonary nitrogenation and/or a stable ventilatory pattern during surgery would minimize changes in perioperative pulmonary function in two groups of patients with acute respiratory failure (ARF) whose lungs were being mechanically ventilated was examined. Group 1 (n = 39 cases) (inspired oxygen fraction [FIO2] less than or equal to 0.5, minute ventilation less than or equal to 15 l/min, peak inspiratory pressure less than or equal to 50 cmH2O, positive end-expiratory pressure [PEEP] less than or equal to 10 cmH2O) were assigned randomly to one of four intraoperative ventilator-gas mixture (FIO2 approximately 0.5) combinations: 1) Siemens 900C ventilator, N2/O2; 2) Siemens 900C ventilator, N2O/O2; 3) Ohio anesthesia ventilator, N2/O2; or 4) Ohio anesthesia ventilator, N2O/O2. Group 2 (n = 15 cases) (ventilatory requirements exceeding any of those in Group 1) had their lungs ventilated intraoperatively with the Siemens 900C ventilator and a gas mixture determined by their anesthesiologist (FIO2 approximately 0.6-1.0). In patients whose lungs were ventilated with the Ohio N2O/O2 combination, PaO2/FIO2 decreased significantly (P less than 0.05) from 358 +/- 93 mmHg (mean +/- SD) preoperatively to 282 +/- 77 mmHg intraoperatively. The level of PEEP increased significantly from 5 +/- 3 cmH2O preoperatively to 9 +/- 4 cmH2O intraoperatively (P less than 0.05). In patients whose lungs were ventilated with the Ohio N2/O2 combination, PaO2/FIO2 decreased significantly from 270 +/- 86 mmHg preoperatively to 174 +/- 74 mmHg intraoperatively. These variables did not change significantly in patients ventilated with the Siemens ventilator (groups 1 and 2). Pulmonary oxygen gas exchange returned to preoperative values by the first hour postoperatively.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2774269 TI - Pharmacokinetics and dynamics of intravenous, intrathecal, and epidural clonidine in sheep. AB - Epidural clonidine administration produces analgesia by a spinal action but may produce hemodynamic depression by activating other central or peripheral alpha 2 adrenoceptors. To determine clonidine's distribution and cardiorespiratory effects 300 micrograms clonidine was injected epidurally, intrathecally, and intravenously in six chronically prepared sheep, and cerebrospinal fluid (CSF) and arterial plasma clonidine were measured. Dural transfer of epidurally administered clonidine was rapid and extensive: time to maximal concentration (Tmax) in CSF was 32 +/- 8 min, bioavailability in CSF was 14 +/- 4% of the administered dose, and maximal CSF concentrations following epidural administration (820 +/- 30 ng/ml) were three orders of magnitude greater than those following iv injection (0.71 +/- 0.06 ng/ml). Systemic absorption of epidurally administered clonidine occurred rapidly: Tmax in plasma was 34 +/- 6 min and plasma concentrations were similar to those following iv injection at all time points beyond 20 min. Elimination half-lives from plasma were similar for all three routes of administration (81-95 min). Clonidine's effect on blood pressure differed with route of administration. Blood pressure increased and heart rate decreased following iv injection when plasma clonidine concentrations were high (greater than 2 ng/ml). Clonidine, following all routes of administration, numerically decreased blood pressure, but this decrease was significant only following epidural (mean arterial pressure = 97 +/- 6 mmHg before, 86 +/- 6 mmHg after; P less than 0.05) and intrathecal (93 +/- 9 mmHg before, 79 +/- 10 mmHg after; P less than 0.05) injection. Blood pressure decreased earlier following intrathecal than following epidural injection, corresponding with higher CSF clonidine concentrations.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2774268 TI - Intracellular mechanisms of halothane's effect on isolated aortic strips of the rabbit. AB - The intracellular mechanisms of halothane action were examined in vascular smooth muscle from the aorta. Medial layers of the aorta from rabbits were mounted on photodiode tension transducers, stretched to 20 mg resting tension, and "skinned" with saponin. The skinned fiber preparations were then immersed in bathing solutions to study the effects of halothane (0.5-2%) on Ca2+ activation of the contractile proteins, and Ca2+ uptake and release from the sarcoplasmic reticulum (SR) using caffeine-induced tension transients. For comparison, isolated intact aortic rings were mounted on Blinks' dual tissue bath and attached to force transducers. The preparations were contracted with either 40 mM KCl, or norepinephrine (NE) followed by acetylcholine (ACh)- or sodium nitroprusside (SNP)-induced relaxation. At steady state contraction or relaxation, the effects of halothane (1-3%) were studied. The steady state tension during halothane was expressed as a percentage of the steady state tension before administration of halothane. In the isolated intact aortic rings, halothane (1-3%) produced biphasic effects on KCl-induced tension, i.e., an initially slight increase followed by decreases, independent of endothelium. Halothane markedly increased tension in the ACh- or SNP-relaxed state. The effects were dose-dependent. In the skinned aortic strips, halothane slightly decreased maximum Ca2+-activated tension development of the contractile proteins. Halothane decreased Ca2+ accumulation in the SR and increased Ca2+ release from the SR in a dose-dependent manner. The halothane-induced increases in Ca2+ release from the SR were blocked by ryanodine, an SR Ca2+ release channel blocker. It is concluded that halothane directly causes vascular contraction or relaxation, depending on the condition, and that halothane's effects on the SR may play a role. PMID- 2774270 TI - The effect of fentanyl anesthesia and intrathecal naloxone on neurologic outcome following spinal cord injury in the rat. AB - Whereas opiate receptor agonists have resulted in spinal cord damage; opiate receptor antagonists have demonstrated protection against spinal cord injury. Because opioids are used in clinical anesthesia, the effect of an opiate antagonist was evaluated on neurologic outcome in a rat model of spinal cord injury occurring during opioid anesthesia. One day prior to spinal cord injury, a catheter was inserted into the spinal subarachnoid space with the tip at T8. On the day of spinal cord injury a balloon tipped catheter was inserted in the epidural space with the tip at the thoracolumbar junction. Spinal cord injury was produced by balloon inflation during one of the following states: 1) group 1 (A/S), injury was produced in awake rats and saline was administered in the subarachnoid space immediately following injury; 2) group 2 (F/S), injury was produced during a fentanyl/nitrous oxide (N2O) anesthetic, and subarachnoid saline administered; and 3) group 3 (F/Nx), injury was produced during a fentanyl/N2O anesthetic, and subarachnoid naloxone (1 mg/kg) was administered immediately following injury. Dose-response curves describing the relationship between the duration of balloon inflation and the percentage of animals with a persistent neurologic deficit were constructed and compared for differences by use of a group t test. The duration of balloon inflation required to produce a neurologic deficit was greater in both the F/S and F/Nx groups than in the A/S group (P less than 0.05). There was no difference between the F/S and F/Nx groups. In summary, in rats receiving a fentanyl/N2O anesthetic, neurologic outcome was improved compared with the awake state.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2774271 TI - Metabolism of halothane in obese Fischer 344 rats. AB - Halothane is metabolized by an oxidative pathway to stable, nonvolatile end products, trifluoroacetic acid (TFAA) and bromide (Br-), and by reductive pathways to Br-and inorganic fluoride (F-). There is evidence that both oxidatively and reductively formed intermediates may produce hepatotoxicity, although the exact etiology of the fulminant hepatic necrosis seen in humans is unproven. Obese patients receiving volatile anesthetics exhibit higher serum anesthetic metabolite concentrations than do normal-weight patients, and thus might be at greater risk of hepatotoxicity because of higher concentrations of reactive intermediates from halothane metabolism. To eliminate the variables inherent in human clinical studies leading to confounding interpretation of data, this study determined the contributions of oxidative and reductive pathways to halothane metabolism in an animal model of human hypertrophic obesity, the most common form of human obesity. Eight pairs of obese (high-fat diet) and normal weight (standard chow), male Fischer 344 rats were anesthetized with halothane for 4 h at an inspired concentration of 0.78%. Serum and urinary concentrations of TFAA, Br-, and F-were measured. Thirty-six hours following halothane anesthesia, mean serum TFAA concentrations peaked at 7.3 +/- 1.1 mM in obese rats and 4.7 +/- 0.7 mM in nonobese rats. TFAA urinary excretions during the 180-h period postanesthesia were 519 +/- 69 and 336 +/- 22 mumol, respectively. Peak serum Br- concentrations were 9.1 +/- 1.0 and 6.9 +/- 0.6 mM for obese and nonobese rats, respectively, and Br-urinary excretions were 127 +/- 30 and 79 +/- 14 mumol, respectively.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2774272 TI - The effect of etomidate pretreatment on cerebral high energy metabolites, lactate, and glucose during severe hypoxia in the rat. AB - Etomidate was compared with thiopental with respect to preventing loss of brain high energy metabolites and accumulation of lactate during 20 min of hypoxemia (Pa2 of 16-19 mmHg) in rats with unilateral carotid artery ligation. Male Sprague Dawley rats, anesthetized with halothane and nitrous oxide (N2O) in oxygen were randomly assigned to one of six groups. A normoxic control group which received 70% N2O in oxygen, a hypoxia group received no iv drug treatment (hypoxia-N2O), and four iv drug treatment groups (N2O was replaced by 70% nitrogen at the start of drug administration). The iv drug groups were treated as follows: hypoxia etomidate low dose (1 mg.kg-1 iv followed by an infusion at 0.35 mg.kg-1.min-1); hypoxia-etomidate high dose (1 mg.kg-1 then 1.3 mg.kg-1.min-1); hypoxia thiopental low dose (15 mg.kg-1, then 1.5 mg.kg-1.min-1); and hypoxia-thiopental high dose (15 mg.kg-1, then 5 mg.kg-1.min-1). After hypoxia or a corresponding period in the normoxic group, the brains were frozen in situ for later biochemical analysis. Blood was obtained prior to and at the end of hypoxia and analyzed for glucose. Brain metabolite concentrations on the side ipsilateral to the ligated carotid artery in the normoxia-N2O group were adenosine triphosphate (ATP), 2.76 +/- 0.1, phosphocreatione (PCr) 3.88 +/- 0.12, lactate 2.34 +/- 0.16, and glucose 3.56 +/- 0.28 (mumole.g-1 wet weight, mean +/- SE). There was no significant decrease in ATP in any of the hypoxia groups. PCr decreased by 45% (compared to normoxia-N2O) in the hypoxia-N2O group.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2774273 TI - Dilutional hyponatremia associated with intrauterine endoscopic laser surgery. PMID- 2774274 TI - Cardiorespiratory arrest following initiation of cranial irradiation for treatment of a brain stem tumor. PMID- 2774275 TI - Lingual and buccal nerve neuropathy in a patient in the prone position: a case report. PMID- 2774276 TI - Pulse oximetry and patient positioning: a report of eight cases. PMID- 2774277 TI - Bronchial rupture associated with the use of a double-lumen tube in a small adult. PMID- 2774278 TI - Inadvertent development of subatmospheric airway pressure during cardiopulmonary bypass. PMID- 2774279 TI - Meningococcal purpura fulminans: treatment of vascular insufficiency in a 2-yr old child with lumbar epidural sympathetic blockade. PMID- 2774280 TI - Phenylephrine and myocardial ischemia in patients undergoing carotid endarterectomy. PMID- 2774281 TI - Bloodless turbinectomy following blind nasal intubation. PMID- 2774282 TI - A maneuver to facilitate flexible fiberoptic intubation. PMID- 2774283 TI - Practice standards--the emperor's old clothes. PMID- 2774284 TI - More on standards, monitoring, and outcome. PMID- 2774285 TI - A method for subcutaneous tunneling of epidural catheters using readily available equipment. PMID- 2774286 TI - Airway fires during surgery with the carbon dioxide laser. PMID- 2774287 TI - Cerebral venous thrombosis versus postlumbar puncture headache. PMID- 2774288 TI - Visual analogue pain scale with convenient digitizer. PMID- 2774289 TI - Abstracts of scientific papers. 1989 annual meeting, American Society of Anesthesiologists. PMID- 2774290 TI - Blood exposure and protection in funeral homes. PMID- 2774291 TI - Permeability of latex and vinyl gloves to water and blood. AB - Two thousand four hundred medical gloves were evaluated for leakage. Types of gloves examined (number of brands) included sterile latex (seven) sterile vinyl (four), nonsterile latex (six), and nonsterile vinyl (seven). Sampling was done from one box of each brand. Fifty gloves from each box were filled with 300 ml of water (the standard test used by the American Society for Testing and Materials). An additional 25 cm pressure was applied to water-filled gloves. Another 50 gloves of each box were donned and dipped into a basin that contained heparinized human blood. Only four brands of sterile latex surgeon's gloves proved nonpermeable to water and blood. Other brands showed leakage that ranged from 1% to 52%. Analysis of proportions of pairs of gloves permeable to water or blood indicated a strong statistical association of nonsterile packaging or packaging in suction kits with increased leakage rates. These findings affirm that gloves can be regarded only as a means of reducing the risk of gross soilage from blood or body fluids. Quality control standards to ensure more uniform glove quality are needed. PMID- 2774292 TI - Barriers to influenza vaccine acceptance. A survey of physicians and nurses. AB - The Immunization Practices Advisory Committee (ACIP) recommends that health care providers who contact high-risk patients receive influenza immunization annually. There are few available data on hospital employees' acceptance of these recommendations or their attitudes about influenza immunization. In a hospital where no formal influenza immunization program was in place, a survey of 193 nursing personnel and physicians showed that only 2.1% received the 1986-1987 trivalent influenza vaccine and 3.2% the monovalent A/Taiwan/1/86 vaccine before the 1986-1987 influenza season. An influenza-like illness developed in a total of 35.3% of hospital employees during the influenza season, and 76.6% of them cared for patients while ill. Fear of adverse reactions, avoidance of medications, and the inconvenience of vaccine administration were frequently cited reasons for declining immunization. Hospital employees would be more inclined to receive future influenza immunization if vaccine administration were more accessible and if they were informed that immunization were a national health care policy. During the influenza season, nurses and physicians should be considered a uniformly susceptible reservoir of infection capable of transmitting influenza to patients. Moreover, ACIP guidelines alone probably will not lead to acceptable immunization rates among health care providers; organized institutional efforts to promote immunization of health care providers may be required. PMID- 2774293 TI - Professional response to scientific betrayal. PMID- 2774294 TI - Occlusal contacts following orthodontic treatment: a follow-up study. AB - Occlusal contacts in maximum intercuspation were examined in a sample of 40 patients at the end of active orthodontic treatment and again an average of 21 months later. An increase in the total number of contacts was due to more actual and near contacts on all posterior teeth and more near contacts on anterior teeth. When the results were compared to a previous short term study, continued settling of the occlusion occurred beyond an initial three months of retention. Few contacts changed their location between the occlusal inclined planes and central grooves, suggesting minimal settling of the occlusion in a buccolingual direction. PMID- 2774295 TI - Mandibular condyle morphology in relation to malocclusions in children. AB - Recent studies show that forces applied to the mandible during treatment with functional appliances and other orthodontic therapies produce changes in the TMJ. Specific malocclusions might also apply forces that can produce changes in the morphology of the TMJ. This study examined 104 orthodontic patients (44 males and 60 females) prior to treatment. The size and location of the condyle was determined on submento-vertex and tomographic films which was related to clinical findings including age, sex, malocclusion type, facial type, TMJ symptoms, tooth eruption sequence, crossbites and midline discrepancies. The medio-lateral width of the condylar head correlated positively with the patients age (p less than 0.001) and sex (p less than 0.001). Also the antero-posterior widths of the condyle were correlated with age (p less than 0.05). The condylar size in males was found to be greater than in females. Midline discrepancy significantly altered the increase in condylar size during growth. Transversel anomalies had a markedly greater influence on condylar growth compared to other characteristics of occlusion. The major change in condylar size during growth occurred in medio lateral dimension as compared to the antero-posterior. In addition, the medio lateral width was affected by midline discrepancy but not the antero-posterior width. PMID- 2774297 TI - A comparison of the accuracy of cephalometric landmark location between two screen/film combinations. AB - The introduction of faster screen/film combinations allows a reduction in radiation dose but at the expense of film quality. This study investigated the accuracy of landmark location on cephalometric radiographs made using two screen/film combinations. No significant differences in reproducibility of landmark location were found. There was a 20 percent difference in the radiation dose between the two film types studied. PMID- 2774296 TI - Space closure in adult patients using the segmented arch technique. AB - Periodontally compromised adult patients may benefit from modified appliance designs for space closure. TMA T-loops of .016" x .022" and .017" x .025" cross sections, with angulations incorporated via concentrated bends and gradual curvature bends are presented. The force systems these appliances produce are measured, and their clinical performances discussed. Templates for these T-loops are presented. By producing lower forces and higher moment to force ratios, this type of T-loop may benefit patients with bony loss. PMID- 2774298 TI - An evaluation of the relationship between rest position of the mandible and malocclusion. AB - Rest position of the mandible and integumental change in a control group of Class I occlusions is compared and contrasted with a study group of Class II malocclusion and a study group of Class III malocclusion. Change from centric occlusion to rest position of the mandible was suggestive of simulated correction of the malocclusion and improved facial esthetics. PMID- 2774299 TI - Juvenile rheumatoid arthritis: a 14-year posttreatment evaluation. PMID- 2774300 TI - The role of physicians in smoking cessation. PMID- 2774301 TI - Fever, hemorrhagic bullae and gastritis in a 20-month-old male. PMID- 2774302 TI - Inhibition of dermographia, histamine, and dextromethorphan skin tests by ketotifen. A possible effect on cutaneous vascular response to mediators. AB - Forty-one subjects with dermographia were studied for a 4-week period. Twenty subjects received ketotifen therapy, the other 21 received chlorpheniramine (H1) for 2 weeks, and then chlorpheniramine plus cimetidine (H1 + H2). Both groups had significant suppression of dermographia and skin wheals caused by dextromethorphan and histamine after 2 weeks. The inhibition by ketotifen of dermographia, histamine wheal, and the dextromethorphan wheal increased from week 2 to week 4. During the first 2 weeks, ketotifen's activity was comparable to chlorpheniramine. Ketotifen's activity increased during the second 2 study weeks to match the additional chlorpheniramine. These results suggest that ketotifen may have additional pharmacologic activities besides H1 antagonism, including possible inhibition of mast cell mediator release. As a consequence, cutaneous vascular hyperresponsiveness may decrease. Ketotifen appears promising as treatment for allergic skin disorders. PMID- 2774303 TI - Neutrophil function and humoral immunity in children with recurrent infections of the lower respiratory tract and chronic bronchial suppuration. AB - Neutrophil motility and superoxide anion production and serum immunoglobulin levels were assessed in 51 children with recurrent infections of the lower respiratory tract and chronic bronchial suppuration, not due to anatomic or functional cause. In 26 children (50.9%), a significant defect of the immunologic defenses, likely to be responsible for the disease, was observed. A precocious diagnosis and an adequate therapy could result, at least in some patients, in the prevention of progressive lung damage. PMID- 2774304 TI - Evaluation of multi-allergen dipstick screening test. AB - In order to determine the diagnostic performance of the Quidel Allergen Screen (QAS), 43 patients characterized by standard skin prick test and intradermal testing for atopic sensitivity were evaluated, in parallel, using Phadebas RAST and QAS to detect the presence of serum IgE. The Quidel Allergen Screen and RAST were compared with the investigator's clinical assessment. The differences between QAS and RAST are not statistically significant. The QAS appears to be equal to the Phadebas RAST in sensitivity and specificity and thus offers a rapid, easily interpreted in vitro method for the detection of specific serum IgE. PMID- 2774305 TI - Persistent severe asthma in an adult from transient dog exposure: a brief communication. AB - While atopy is commonly found without signs of asthma, it has been proposed that in some settings, allergen exposure itself can lead to the development of the asthmatic diathesis. To date, this theory has been primarily supported by cases of occupational asthma, where prolonged symptoms have persisted following termination of exposure to the suspect allergen. This model is complicated by associated medicolegal implications, as well as by the generally long-term nature of the exposure, raising questions about the concurrent natural history of a given patient's illness. We report a case of non-occupational dog dander-induced asthma. Exposure was on an intermittent basis over a 15-month period, with the patient exhibiting a classic late phase response. Following discontinuation of exposure to dog dander, he continued to have symptoms, considerably in excess of his findings prior to dog dander exposure. PMID- 2774306 TI - Cimetidine in the treatment of refractory anaphylaxis. AB - After preoperative intubation and administration of intravenous cefuroxime, a 48 year-old white female developed anaphylactic shock that was refractory to the usual therapeutic measures but was responsive to treatment with intravenous cimetidine. Beta-lactam sensitivity was subsequently confirmed by skin testing. Cimetidine, which antagonizes arterial H2 receptors, may be useful in the treatment of anaphylaxis refractory to the usual resuscitative measures. PMID- 2774307 TI - Studies on the allergenicity of the developing spores of Pteris vittata L. AB - Ninety patients were investigated with intradermal testing of developing stages of Pteris vittata L., whole spores, and their fractions. Allergenic principles were found to be present in both protoplasm and spore wall of the fertile tissue. PMID- 2774308 TI - Seasonal asthma in Hong Kong and its management implications. AB - Quarterly analysis of 48,003 hospitalization episodes of asthma in Hong Kong from 1976 to 1985 reveals a consistent bimodal seasonal variation of hospitalization rates most noticeable in younger age groups. Statistical analysis shows that with a drop of relative humidity and an increase in wind speed, more episodes of asthma hospitalization are expected. During seasons of increased susceptibility, aggressive prophylaxis and vigilant monitoring should reduce hospitalization for those with seasonal predisposition. PMID- 2774309 TI - Inverse correlation of expiratory lung flows and sputum eosinophils in status asthmaticus. AB - Seventy-six consecutive patients admitted to Los Angeles County General Hospital with acute asthma were studied. Blood and sputum smears for cell counts were obtained on all patients within 12 hours of admission. Fifty-one (67%) patients were able or willing to perform spirometry and flow/volume curves in the first 24 hours of hospitalization. The severity of airway obstruction as assessed by forced expiratory volume in one second (FEV1), maximum mid-expiratory flow rate (MMFR), and forced vital capacity (FVC) was compared with blood and sputum eosinophil counts. Although there was no relation between the blood eosinophilia and airway obstruction, an inverse relationship between the number of eosinophils in the sputum and airway flow rates was observed. Higher percentages of sputum eosinophils were associated with diminished flow rates. We believe that sputum eosinophils may be helpful in the initial assessment of severe bronchial asthma. PMID- 2774310 TI - Analysis of the longitudinal and radial resistivity measurements of the nerve trunk. AB - Of the many models of peripheral nerve in the literature, essentially all have relied on experimentally derived values for the anisotropic resistivity of the nerve bundle interstitial space. This paper is a comprehensive mathematical analysis of the most referenced experiment for the longitudinal and radial resistivity measurements of the nerve trunk, namely that of Tasaki. For the analysis of the longitudinal measurements we introduce intracellular as well as interstitial current pathways (not considered by Tasaki). For the radial measurement the resistivity is expected to depend on the geometric packing of fibers within the trunk. Since Tasaki's paper did not include a histological examination of the nerve trunk these measurements are difficult to evaluate. However, our analysis indicates the importance of including the above factors, in addition to the epineurial (and perineurial) sheath as a resistive pathway. Our mathematical analysis supports the experimental measurements and confirms an assumed nerve trunk composition with theoretically derived values for the interstitial resistivities. It is therefore concluded that, at present, an appropriate procedure in determining resistivity values for use in modeling is to derive these values for an idealized nerve bundle based on the microscopic (electrolytic) resistivity of the interstitial medium. PMID- 2774311 TI - The Korotkoff sound. AB - As the auscultatory method of blood pressure measurement relies fundamentally on the generation of the Korotkoff sound, identification of the responsible mechanisms has been of interest ever since the introduction of the method, around the turn of the century. In this article, a theory is proposed that identifies the cause of sound generation with the nonlinear properties of the pressure-flow relationship in, and of the volume compliance of the collapsible segment of brachial artery under the cuff. The rising portion of a normal incoming brachial pressure pulse is distorted due to these characteristics, and energy contained in the normal pulse is shifted to the audible range. The pressure transient produced is transmitted to the skin surface and stethoscope through deflection of the arterial wall. A mathematical model is formulated to represent the structures involved and to compute the Korotkoff sound. The model is able to predict quantitatively a range of features of the Korotkoff sound reported in the literature. Several earlier theories are summarized and evaluated. PMID- 2774312 TI - Resonance mode analysis for volume estimation of asymmetric branching structures. AB - The resonance conditions associated with the propagation of a harmonic wave within a rigid, lossless branching structure can be explicitly derived. In this study, exact resonance conditions are derived for multi-order, rigid, asymmetric branching structures. These are compared with resonance conditions for rigid, multi-order, symmetric branching structures which we reported previously. The effect of asymmetry on the form of the higher-order resonance condition is discussed. In the low-frequency range, the resonance condition can be modified into simpler forms which facilitate volume estimation of the branching structure. Two such volume approximation techniques are presented: (a) a fundamental frequency method, in which the lowest resonance frequency is inversely proportional to the structure volume, and (b) an effective-length method, in which an effective length is calculated for all branches distal to the first bifurcation. Equivalence of the two methods is demonstrated. An experimental study was performed to measure the resonance modes of several second-order glass models with asymmetric branching structures similar to those of mammalian lungs. The resulting volume estimates were in close agreement with the true volumes. PMID- 2774313 TI - Factors affecting respiratory system stability. AB - Periodic breathing (recurrent central apneas) occurs frequently during sleep. Periodic breathing can arise as a result of unstable behavior of the respiratory control system. A mathematical model of the respiratory control system was used to investigate, systematically, the effect of severity of disturbances to respiration and certain system parameters on periodic breathing occurring during sleep. The model consisted of multi-compartment representation of O2 and CO2 stores, a peripheral controller sensitive to O2 and CO2, and a central controller sensitive to CO2. The effects of hypoxia and hypercapnia on the upper airway muscles were not considered in the model. Episodes of hyperventilation or asphyxia were used to disturb the control system and explore the boundaries of stable breathing. Circulation time and metabolic rate were also varied. Simulations with the model produced the following findings: The number of central apneas associated with periodic breathing were greater as circulation time increased; controller gain increases also made the number of apneas greater, although periodic breathing occurs with lower controller gains as circulation time increases. At each level of circulation time there was a range of controller gain changes which caused little change in the number of apneas. There were more apneas with hypoxia; also the number of apneas increased with sleep-associated reductions in metabolic rate. The more rapidly resting PCO2 rose at sleep onset, the greater the likelihood of recurrent apneas. Finally, the more intense the disturbance, the more apneas there were. PMID- 2774314 TI - An intrafascicular electrode for recording of action potentials in peripheral nerves. AB - We are developing a new type of bipolar recording electrode intended for implantation within individual fascicles of mammalian peripheral nerves. In the experiments reported here we used electrodes fabricated from 25 microns diameter Pt wire, 50 microns 90% Pt-10% Ir wire and 7 microns carbon fibers. The electrodes were implanted in the sciatic nerves of rats and in the ulnar nerves of cats. The signal-to-noise ratio of recorded activity induced by nonnoxious mechanical stimulation of the skin and joints was studied as a function of the type of electrode material used, the amount of insulation removed from the recording zone, and the longitudinal separation of the recording zones of bipolar electrode pairs. Both acute and short term (two day) chronic experiments were performed. The results indicate that a bipolar electrode made from Teflon insulated, 25 microns diameter, 90% Pt-10% Ir wire, having a 1-2 mm long recording zone, can be used for recording of peripheral nerve activity when implanted with one wire inside the fascicle and the other lead level with the first lead, but outside the fascicle. No insulating cuff needs to be placed around the nerve trunk. PMID- 2774315 TI - A parametric axisymmetric model study on the interface motions in porous-surfaced tibial implants. AB - The effects of a number of variables on the interface relative motions in porous surfaced tibial implants are investigated using a simplified axisymmetric finite element model. The parameters considered are contact or link spacing, height of the central metal stem, presence of a circumferential metal flange, presence of a UHMWP articular plate resting freely on or fixed to the metal base, resting of the prosthesis edge on the cortical shell, and type of the metal alloy. In order to represent the immediate post-surgical situation with no bone ingrowth, the interface between the bone and porous-surfaced metal is modelled by frictionless rigid links oriented normal to the interface. Cases are also studied in which the horizontal interface is assumed to be fixed while the vertical interface remains frictionless. The magnitudes of the interface motion are negligibly affected by the variation in the link spacing from 0.3 mm to about 3.0 mm. The interface relative motion is predicted to decrease in cases with a shorter central metal stem, with the addition of a circumferential metal flange, with the use of more rigid prosthesis, and with the addition of a UHMWP articular plate. PMID- 2774316 TI - Effect of tactile stimulation pulse characteristics on sensation threshold and power consumption. AB - The psychophysical responses of human subjects to vibratory tactile stimulation of the skin were investigated experimentally. The parameters of the waveform important to the minimization of power consumed by the tactile array of electromechanical vibrators and the maximization of the skin sensitivity to the stimulus were explored to develop optimum stimulation. Parameters investigated included the amplitude, frequency, and duty cycle of the current waveform used to drive the vibrators as well as the number of pulses per stimulating burst and the recovery time between bursts. Graphical techniques were used to determine the optimal combination of the parameters which gave a stimulus that excited the skin to above tactile threshold while maintaining at a relative minimum the power required for the stimulus. The optimal stimulation waveform contains a burst of 10 rectangular pulses of 4% duty cycle separated by a period of nonstimulation of 2 s. Such a waveform can elicit a sensitivity of 29.4 mA-1 consuming only 55 microW of power. PMID- 2774318 TI - Culture-positive persistence and serum agglutinating antibody response after intrauterine inoculation of Haemophilus somnus in virgin heifers. AB - Viable Haemophilus somnus of reproductive tract origin (OSU-1167) was inoculated transcervically into the uterus of 6 virgin heifers. Five heifers were sham inoculated (intrauterine) with sterile mycoplasmal medium and served as controls. After inoculation and observation, all heifers had nasal and vaginal vestibular swab specimens and serum obtained periodically for 44 days. Signs of systemic illness were not detected. On the day after inoculation, all inoculated heifers had signs of vulvovaginitis, whereas none of the control heifers had similar signs (P less than 0.002). Haemophilus somnus was not isolated from any nasal or vaginal vestibular swab specimens obtained before inoculation or from any nasal swab specimens obtained after inoculation. During the 44 days after inoculation, H somnus was isolated from 25 of 54 vestibular specimens obtained from inoculated heifers and from 3 of 45 specimens obtained from controls (P less than 0.02). Vulvovaginal lesions were associated with vestibular isolation of H somnus in 23 of 25 (92%) such isolations from inoculated heifers; lesions were never associated with concurrent isolation of H somnus in controls. All heifers had H somnus microagglutination test (MAT) titer less than or equal to 256 against a commercially prepared H somnus antigen at the beginning of the study. Considered as groups, neither inoculated nor control heifers achieved fourfold increases in MAT titer during the 44 days after inoculation. When compared by day of sample collection, inoculated heifers did have significantly (P less than 0.04) lower geometric mean titer at 7 days after inoculation than did control heifers when tested by use of a commercially prepared antigen.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2774317 TI - Dipole moment of in vivo and isolated perfused rabbit hearts. AB - We have measured magnitude and location of heart dipole moment during QRS in 46 New Zealand white rabbits. The spatial magnitude curve had one to three peaks. Mean values were M1 = 80 +/- 10 microA-cm (N = 5) pointing to right anterior and caudal, M2 = 260 +/- 15 microA-cm (N = 42) directed slightly to left of due anterior and caudal, and M3 = 236 +/- 9 microA-cm (N = 43) pointing towards left posterior and cephalad. The mean thorax resistivity was 250 ohm-cm. For 23 rabbits, M2/M3 greater than 1 and for 16 rabbits, M2/M3 less than 1. Mean times of occurrence of the three peaks were 5.8, 11.2, and 19.6 ms, respectively. Spatial magnitude curves for hearts perfused at the center of a sphere showed usually one major peak at about 19 ms. Locuscardiograms of in vivo hearts were also measured. By comparing M values for in vivo and isolated hearts, we found that M1 values agreed closely but mean M2 measured from the hearts in vivo was 2.5 times that for the isolated hearts, and M3 for in vivo hearts was about two thirds that for isolated hearts. We relate these differences to the effects of intracardiac blood and lungs on the measured dipole moment. PMID- 2774319 TI - In vitro antimicrobial activity of sulfonamides against some porcine pathogens. AB - The minimal inhibitory concentrations (MIC) of sulfonamides were determined against Bordetella bronchiseptica (n = 10), Pasteurella multocida (n = 10), Haemophilus pleuropneumoniae (n = 20), and Streptococcus suis (n = 10) strains isolated from pigs with atrophic rhinitis, pneumonia, or meningitis. Sulfonamides tested in an agar dilution method were sulfachloropyridazine, sulfadiazine, sulfadimethoxine, sulfamethazine, sulfadoxine, sulfisoxazole, sulfamerazine, sulfamethoxazole, sulfamethoxypyridazine, sulfanilamide, sulfatroxazole, and sulfisomidine. Results indicated that monotherapy of S suis infections with sulfonamides should not be encouraged because the MIC50 of all sulfonamides investigated was greater than 32 micrograms/ml. The MIC50 of the sulfonamides against B bronchiseptica ranged from 0.5 to 8 micrograms/ml, against P multocida from 2 to 32 micrograms/ml, and against H pleuropneumoniae from 8 to 64 micrograms/ml. The MIC50 of sulfachloropyridazine, sulfadiazine, sulfadimethoxine, sulfamerazine, and sulfamethoxazole for the gram-negative bacteria did not exceed 16 micrograms/ml. Among these compounds, sulfamethoxazole had the highest activity. The frequently prescribed sulfamethazine had an overall low antimicrobial activity. PMID- 2774320 TI - Differences in virulence between two strains of Streptococcus suis type II after experimentally induced infection of newborn germ-free pigs. AB - Fifteen newborn germ-free pigs were inoculated with 2 strains, D-282 and T-15, of Streptococcus suis type II. Some pigs also were preinoculated with Bordetella bronchiseptica, which successfully predisposed them to S suis infection. The 2 streptococcal strains were differentiated by muramidase treatment, which released certain high molecular-weight proteins, termed muramidase-released proteins (MRP), from the cell wall of strain D-282, but not from the cell wall of strain T 15. Only strain D-282 (MRP-positive) induced clinical signs of disease and markedly increased neutrophil numbers in pigs. Streptococci were more frequently isolated from fecal swab specimens obtained from pigs inoculated with strain D 282 (MRP-positive) than from specimens obtained from pigs inoculated with strain T-15 (MRP-negative). Both strains were isolated from nasal swab specimens obtained from all infected pigs. Postmortem examination revealed fibrinopurulent meningitis, polyserositis, and polyarthritis in pigs inoculated with strain D 282; this strain was isolated from the CNS, serosae, visceral organs, heart, and joints. Whereas strains D-282 caused several pathologic changes, strain T-15, isolated from the lungs, caused only pneumonia. Both strains were isolated from the tonsils of all pigs. Virulence differed distinctly between the MRP-positive and the MRP-negative strains. PMID- 2774321 TI - Effect of vaccination with a bacterin containing Leptospira interrogans serovar bratislava on the breeding performance of swine herds. AB - Swine herds suspected to be infected with Leptospira interrogans serovar bratislava were vaccinated with bacterins containing 5 or 6 leptospiral serovars in which serovar bratislava was the unique component. The principal diagnostic feature indicating an infection by this organism was demonstration of antibody against serovar bratislava in sera from stillborn pigs. For 1 breeding cycle after vaccination of herds on 3 farms, 255 of 266 (95.9%) sows and gilts given the 6-serovar bacterin farrowed. In contrast, 233 of 311 (74.9%) sows and gilts given the 5-serovar bacterin farrowed. These results, as evaluated by analysis of variance techniques, showed a significant improvement (P less than 0.01) in reproductive performance for groups vaccinated against serovar bratislava. PMID- 2774322 TI - Hemagglutination and hemagglutination inhibition of turkey red blood cells with Mycoplasma hyopneumoniae. AB - The ability of Mycoplasma hyopneumoniae to agglutinate RBC was evaluated to develop an in vitro cytadsorption assay. Using swine RBC in a microtitration hemagglutination test, no agglutination or partial agglutination was detected. Comparison of RBC from various other species indicated that improved hemagglutination was obtained with RBC from turkeys. This hemagglutination was detected only when mycoplasma cells used in the assay had been frozen and thawed, heated at 50 C for 30 minutes, or treated with trypsin. Treatment of RBC with trypsin or neuraminidase enhanced hemagglutination. Possible surface lectin activity in M hyopneumoniae was evaluated by use of carbohydrates in a blocking assay; hemagglutination was not inhibited by any of 13 carbohydrates evaluated. Mycoplasma hyopneumoniae convalescent porcine serum and monoclonal antibodies against 2 M hyopneumoniae immunogens of molecular weights of 64,000 and 41,000 inhibited hemagglutination. PMID- 2774323 TI - Effects of inoculations with Eimeria zuernii on young calves treated with decoquinate or narasin with or without dexamethasone. AB - Sixteen 7-week-old Holstein male calves were inoculated with sporulated oocysts of Eimeria zuernii. Four calves (controls) were euthanatized and necropsied at 14 and 20 days after inoculation (DAI). Two calves were treated with 20 mg of dexamethasone (IM) on 13, 14, and 15 DAI and euthanatized and necropsied 17 DAI and 2 calves were given similar treatments and necropsied 20 DAI. The 8 other calves were euthanatized and necropsied 20 DAI. Two were started on the anticoccidial drug decoquinate in feed 13 DAI; 2 others were given decoquinate on the same schedule plus dexamethasone on 13,14, and 15 DAI. Two calves were given the antibiotic narasin in feed beginning 13 DAI and 2 calves were given parasin on the same schedule plus dexamethasone on 13,14, and 15 DAI. All calves, except 2 controls necropsied 14 DAI and 4 calves given decoquinate, discharged moderate to-large numbers of oocysts in feces and had moderate-to-serve changes in fecal consistency. Histologic examinations revealed large numbers of endogenous stages in tissues of calves treated or not treated with dexamethasone. Few endogenous stages were observed in tissues from calves that were given decoquinate or decoquinate plus dexamethasone. Calves given narasin or narasin plus dexamethasone had moderate-to-large numbers of endogenous stages in the tissues. PMID- 2774324 TI - Evaluation of lasalocid and decoquinate against coccidiosis resulting from natural exposure in weaned dairy calves. AB - Eighteen female Holstein calves, raised as natural herd additions under conditions typical of a well-managed midwestern United States dairy farm, were used in a natural-exposure study to determine the anticoccidial efficacies of lasalocid and decoquinate. Calves were allotted to 6 treatment blocks of 3 calves each as they were weaned. Within each block, calves were randomly assigned to be given either lasalocid or decoquinate or to remain as a nonmedicated control. Calves were given medication for 90 days and remained separated from other calves for 120 days. Adjusted weight gains were consistently greater in calves that were given medication; however, differences were not statistically significant. Fecal specimens were obtained from calves at weekly intervals during the study. Overall, oocyst shedding was low. During the medication period, quantitative mean fecal shedding of oocysts was reduced eightfold in calves given decoquinate and four-fold in calves given lasalocid, as compared with nonmedicated control calves. During the period following the medication period, calves that had been controls shed fewer oocysts than did calves that had previously been given medication. A pairwise comparison of the proportion of specimens that were oocyst positive was made to assess qualitative oocyst shedding among treatment groups. During the medication period, qualitative oocyst shedding (all species, Eimeria bovis, E zuernii, species other than E bovis and E zuernii) was greater in controls than in either lasalocid-or decoquinate-treated groups. Like-wise, lasalocid-medicated calves shed oocysts more frequently than did the decoquinate medicated group. After medication, qualitative findings were reversed. Little diarrhea was noticed in treatment or control calves during the study.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2774326 TI - Prevalence of Cryptosporidium infection in dairy calves in western Washington. AB - The prevalence and intensity of Cryptosporidium infection were examined in 445 Holstein calves at 10 dairy farms in western Washington, near Seattle. Fifty-one percent (176) of calves in the 7- to 21-day-old age group (n = 342) were positive for oocysts in the feces by carbolfuchsin staining. Prevalence and intensity of infection were highest in calves 8 to 14 days old; prevalence was 60% in this group, and 48% of the Cryptosporidium-positive calves had oocyst shedding at a 4+ level. A seasonal pattern in prevalence was not evident. PMID- 2774325 TI - Antigenic relationship among field isolates of Tritrichomonas foetus from cattle. AB - Analysis of protein and antigen profiles of Tritrichomonas foetus isolates from cattle from 5 western states was accomplished by sodium dodecyl sulfate polyacrylamide-gel electrophoresis, immunoblot, immunoprecipitation, and fluorography techniques. Total protein profiles of all isolates were compared by Coomassie brilliant blue staining of T foetus protein samples prepared by 4 protein-extraction methods. Antigenic tritrichomonas proteins were identified by immunoblot assay with polyclonal bovine or rabbit anti-T foetus serum. Additionally, [14C]glucosamine-labeled T foetus was used for total and antigenic glycoprotein analyses. Detectable differences in the composition of total proteins or antigenic tritrichomonal proteins were not observed among all isolates. However, intensity differences in some antigenic protein bands were apparent. Bovine and rabbit sera from immunized animals possessed antibodies to the same antigenic tritrichomonal proteins. Each T foetus isolate contained 4 to 7 molecular weight size classes of glycoprotein, which were labeled by [14C]glucosamine; however, only 3 to 4 glycoproteins were identified as antigens by bovine or rabbit antiserum. PMID- 2774327 TI - Efficacy of ivermectin in oral drench and paste formulation against migrating larvae of experimentally inoculated Parascaris equorum. AB - Twenty-one mixed-breed pony foals, reared and maintained under parasite-free conditions, were used to test the efficacy of ivermectin in oral drench and paste formulations (200 micrograms/kg) against 11-day-old migrating larvae of Parascaris equorum. Three replicates of 4 foals and 3 replicates of 3 foals were formed on the basis of age. Foals in replicates of 4 were randomly allocated to be indicators, or to receive vehicle (control) or ivermectin paste or ivermectin liquid. Foals in replicates of 3 were randomly allocated to receive vehicle or ivermectin paste or ivermectin liquid. The recovery of larvae from the lungs, liver, and small intestines of the indicator foals showed that 99.9% of the larvae were in the lungs 11 days after inoculation (day 0 of treatment). The recoveries of larvae from lungs and small intestines of controls at 25 days after inoculation indicated that all larvae had migrated to the small intestine by this time. The mean length of larvae recovered from the lungs (11 days after inoculation) was 0.87 mm the mean length of those recovered from the small intestine (25 days after inoculation) was 3.65 mm. Using larvae recovered from small intestinal contents for calculations, ivermectin in both formulations was 100% effective against 11-day P equorum (P less than 0.01, compared with control group geometric mean of 1498.4). PMID- 2774328 TI - Efficacy of levamisole against immature and mature nematodes in goats with induced infections. AB - Anthelmintic efficacy of levamisole against induced infections with 7- and 21-day old Haemonchus contortus, Ostertagia circumcincta, Trichostrongylus axei, and T colubriformis was evaluated as an oral drench in goats. Group 1 (n = 8) was not treated, group 2 (n = 8) was given 3.96 mg of levamisole/kg of body weight, group 3 (n = 8) was given 7.92 mg of levamisole/kg, and group 3 (n = 7) was given 11.88 mg of levamisole/kg. Efficacy against all worms was low in goats given 3.96 mg of levamisole/kg, but was high against adult H contortus (99%) and adult T colubriformis (99.7%) in goats given 7.92 mg of levamisole/kg. Although efficacy against adults of all species was high in goats given 11.88 mg of levamisole/kg, some immature worms of all species remained in the abomasa of goats. PMID- 2774329 TI - Dose titration and confirmation tests for determination of cesticidal efficacy of epsiprantel in dogs. AB - Fifty-five dogs, naturally infected with Taenia sp or Dipylidium caninum or both, were assigned to the following treatment groups for dose titration studies with epsiprantel: nonmedicated control dogs (n = 14), medicated dogs given a dosage of 2.75 mg/kg of body weight (n = 15), medicated dogs given a dosage of 5.5 mg/kg (n = 16), and medicated dogs given a dosage of 8.25 mg/kg (n = 10). Medication was given orally in a tablet formulation. Feces were examined for cestodes passed and the gastrointestinal tract was examined at necropsy for retained cestodes. Efficacy of epsiprantel was 92.9% against Taenia and 44.8% against Dipylidium for a dosage of 2.75 mg/kg, 100% against Taenia and 99.8% against Dipylidium for a dosage of 5.5 mg/kg, and 94.6% against Taenia and 100% against Dipylidium for a dosage of 8.25 mg/kg. For dose confirmation, 36 dogs naturally infected with Taenia sp or D caninum or both were allotted to 2 treatment groups: nonmedicated control dogs (n = 16) and dogs medicated with epsiprantel at a dosage of 5.5 mg/kg (n = 20). Efficacy was 100% for both Taenia sp and D caninum. PMID- 2774330 TI - Effect of prostaglandin F2 alpha on adrenal-produced steroid hormones in cows. AB - Ovariectomized, nonlactating cows were treated with IM injections of either physiologic saline solution or prostaglandin F2 alpha. Plasma concentrations of cortisol increased significantly by 30 to 60 minutes after injection of prostaglandin F2 alpha, but there were no significant increases in plasma concentrations of estradiol, progesterone, or testosterone. After saline solution treatment, there were no increases in any of the hormones measured. PMID- 2774331 TI - Endogenous prostaglandin F2 alpha release induced by physiologic saline solution infusion in utero in the mare: effect of temperature, osmolarity, and pH. AB - Thirty mares with normal estrous cycles were allotted equally to 5 groups and infused with 250 ml of saline (NaCl) solution in utero on the seventh day after ovulation to test the effects of temperature, osmolarity, or pH of the saline solution on prostaglandin F2 alpha (PGF2 alpha) release and luteolysis. Intrauterine infusion of phosphate-buffered saline solution failed to alter the duration of the luteal phase, compared with the control group. Similarly, increasing the temperature of phosphate-buffered saline solution to 42 C or increasing (600 mosm) or decreasing osmolarity (less than 10 mosm) did not change the duration of the luteal phase. Decreasing the pH of saline solution to 3 caused significant (P less than 0.0001) releases of PGF2 alpha from the uterus within the first hour after infusion, and the luteal phase was shortened to 8.8 +/- 1.0 days (mean +/- SEM; control, 15 +/- 1.2 days). The results of this study showed that pH is the main factor in eliciting PGF2 alpha release by intrauterine infusion of a saline solution, whereas increased temperature and osmolarity have no effect on the release of PGF2 alpha. The intrauterine infusion of sterile water or physiologic saline (NaCl) solution has been used to induce estrus in mares for the past 50 years. Many investigators have reported that intrauterine infusion of physiologic saline solution or water at body temperature (37 C) or warmer up to 45 C) causes most "anestrous" mares to return to estrus in 1 to 8 days.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2774332 TI - Effects of dopamine administration on cecal mechanical activity and cecal blood flow in conscious healthy horses. AB - Lateral cecal arterial blood flow, carotid arterial pressure, heart rate, and mechanical activity of the circular and longitudinal muscle layers of the cecal body were measured in 7 conscious healthy horses during IV infusion of physiologic saline solution for 60 minutes (control), during a 60-minute IV infusion of dopamine (at dosages of 1, 2.5, and 5 micrograms/kg/min), and for 60 minutes after IV infusion of dopamine. The mean values for lateral cecal arterial blood flow during IV infusion of dopamine at a dosage of either 1 or 2.5 micrograms/kg/min were not significantly different from the mean values for lateral cecal arterial blood flow during IV infusion of saline solution. The mean values for lateral cecal arterial blood flow, however, were significantly greater during IV infusion of dopamine at a dosage of 5 micrograms/kg/min than the mean values for lateral cecal arterial blood flow during IV infusion of saline solution. Intravenous infusion of dopamine at 1 and 2.5 micrograms/kg/min did not significantly change the mean values for carotid arterial pressure. In contrast, the mean values for carotid arterial pressure were significantly less during IV infusion of dopamine at dosages of 2.5 and 5 micrograms/kg/min than during infusion of saline solution. The mean values for heart rate were not significantly altered by infusion of dopamine at a dosage of either 1 or 2.5 micrograms/kg/min, but infusion of dopamine at a dosage of 5 micrograms/kg/min significantly increased heart rate.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2774333 TI - Application of a Hall-effect transducer for measurement of tendon strains in horses. AB - Custom-designed Hall-effect strain sensors (HES) were implanted surgically onto the superficial digital flexor tendons of the forelimbs of 4 adult Thoroughbreds. Strains were recorded at various gaits, using a portable amplifer and FM cassette recorder. Strain calculations used the original length (L) as the HES position with the forelimb in the relaxed neutral position during anesthesia. A characteristic deflection in the strain cycle recording was confirmed to correspond to initial hoof contact with the ground (heel strike) by simultaneous recording of weight bearing via a footswitch. Heel strike was used as the reference point to determine the magnitude of strain change during weight bearing and nonweight bearing under various conditions. The weight-bearing strains (heel strike to maximal strain) recorded in 2 horses (with a rider) were 3.1% and 7.6% at the walk, 6.5% and 10.1% at the trot, and 11.5% and 16.6% at the gallop. Strain rate during tendon loading at the gallop was approximately 200%/s. The magnitude of strain change during nonweight bearing (minimal strain to heel strike) was smaller than during weight bearing, but also increased with faster gaits. In 3 horses led at the walk and trot, modest increases in hoof angle (baseline 52 degrees) resulted in small increases in the magnitude of strain change during weight bearing at the trot, but the magnitude of strain change at the walk was not affected. Results of the study indicated that the HES can be successfully adapted to provide continuous strain measurement without subjective signs of discomfort or lameness in horses during or after instrumentation. PMID- 2774334 TI - Effects of xylazine and/or butorphanol or neostigmine on myoelectric activity of the cecum and right ventral colon in female ponies. AB - Effects of xylazine HCl (0.5 mg/kg of body weight, IV) and/or butorphanol tartrate (0.04 mg/kg, IV) or neostigmine methylsulfate (0.022 mg/kg, IV) on myoelectric activity of the cecum and right ventral colon were studied in 4 conscious female ponies. Eight bipolar Ag/AgCl electrodes were sequentially placed on the seromuscular layer of the cecum (6 electrodes) and right ventral colon (2 electrodes). Recordings began 30 minutes before and continued for 90 minutes after drug administration. Each drug or drug combination was studied on 2 occasions in each pony. Two major patterns of coordinated spike bursts were identified. A series of coordinated spike bursts began at the cecal base and was conducted to the cecal apex (pattern I). A series of coordinated spike bursts began at the cecal apex, traversed the cecum, cecocolic orifice, and right ventral colon and was termed a progressive pattern (pattern II). Xylazine administration caused a significant decrease in patterns I and II for 20 minutes (P less than 0.05). Butorphanol tartrate administration caused a significant decrease in the progressive pattern for 10 minutes (P less than 0.05) without affecting the orally directed pattern. Administration of the combination of xylazine/butorphanol significantly decreased the frequency of pattern I for 40 minutes (P less than 0.05) and pattern II for 30 minutes (P less than 0.05). Neostigmine administration caused a significant increase in the frequency of pattern II for 30 minutes (P less than 0.05) without affecting pattern I (P greater than 0.05). Changes in conduction velocity of pattern I or II or the duration of spiking activity were not significantly different because of any treatment. PMID- 2774335 TI - Tropism of canine neutrophils to xanthine oxidase. AB - Quantitative evaluation of neutrophil chemotaxis was performed on cells obtained by hypotonic-lysis techniques from heparinized blood samples from clinically normal dogs. The techniques resulted in neutrophil recovery rates between 60 and 80%. Chemotaxis comparisons were based on cellular migration in microchambers equipped with polycarbonate membranes with 5-micron pores. Chemo-attractant comparisons were based on neutrophil migration to medium, normal canine plasma, zymosan-activated plasma, and xanthine oxidase. Cellular migration to zymosan activated plasma in buffer (1:100 dilution) was significantly (P less than 0.001) enhanced over random baseline medium migration. Neutrophil migrations to normal canine plasma and xanthine oxidase were quantitatively less than to zymosan activated plasma, but were equivalent to each other and significantly greater than for random migration. Migration to xanthine oxidase was maximal at concentrations near 1 U/ml within 30 minutes. PMID- 2774336 TI - Serum chemical profile of feeder pigs, as influenced by market stress and feeding regimen. AB - Two hundred eighty-eight crossbred feeder pigs were used in 2 trials to determine the effects of feed and/or water deprivation at an auction market, and the effects of restricting the intake of the receiving diet on their serum chemical profile. The study also was designed to assess the value of the serum chemical profile as a diagnostic data base for stress disorders in feeder pigs. Performance data indicated that feeder pigs provided water only at the auction facilities lost significantly more weight than did those provided feed and water. Feeder pigs deprived of both feed and water were not significantly different in body weight from either group. Several serum chemical values (creatinine, triglycerides, cholesterol, blood urea nitrogen, and lactate dehydrogenase) were significantly influenced by feed deprivation, but not by feed and water deprivation. However, only the serum creatinine values were significantly different after the 24-hour posttransport period. There were no significant differences in pig weight or serum chemical values 84 days after pigs had arrived at the finishing unit. The serum chemical profile, widely used in human medicine, appears not to provide a reliable marker for identification of short-term nutritional deprivation, nor for transport stress in feeder pigs. PMID- 2774337 TI - Spectrophotometric method for differentiation of cardiac and hepatic lactate dehydrogenase activities in dogs. AB - To differentiate the origin of high total lactate dehydrogenase (LD) activity in canine sera, a spectrophotometric method based on the preferential inhibition of cardiac LD isoenzymes by pyruvate was performed. Comparison with the electrophoretic separation of LD isoenzyme activities and determination of the hydroxybutyrate dehydrogenase-to-LD ratio indicated that the method proposed gave a better discrimination between cardiac and hepatic LD activities than did the other tests. PMID- 2774338 TI - Production and characterization of monoclonal antibodies to Ehrlichia risticii. AB - Hybridomas producing monoclonal antibodies to Ehrlichia risticii were developed to provide a means of molecular investigation of the biochemical and immunopathologic characteristics of the organism. All of 6 stable monoclonal antibodies obtained were IgG isotypes. The ascitic fluid titers induced by the hybridomas ranged from 10(2) to 10(7). Competitive binding experiments conducted by ELISA and binding of labeled protein A to antigen-antibody complexes indicated competition among monoclonal antibodies. Two monoclonal antibodies (HybI and 14D4) were reactive in an indirect fluorescent antibody test; these antibodies also bound a maximum of labeled protein A, indicating recognition of epitopes on the surface of the ehrlichia. Protein specificity of monoclonal antibodies could not be demonstrated with western blot procedure. HybI monoclonal antibody, however, did precipitate the 28 kD protein from 125I-surface-labeled ehrlichiae and was shown to be specific to E risticii on the basis of nonreactivity with E sennetsu, using the indirect fluorescent antibody test. By use of the different monoclonal antibodies as probes, more definitive molecular studies now will be feasible. PMID- 2774339 TI - Serum and tissue concentrations of erythromycin in calves with induced pneumonic pasteurellosis. AB - The effects of pneumonia on the pharmacokinetics of erythromycin administered IM and the tissue concentration changes with time were evaluated in 2-month-old calves. Pneumonia was induced by injection of Pasteurella haemolytica cultures through the thoracic wall into each lung. Six days prior to induction of pneumonia, erythromycin (15 mg/kg) was administered in a single IM dose. Erythromycin was administered again 48, 72, and 96 hours after injection of P haemolytica. On the third day of erythromycin administration (96 hours), the calves were serially euthanatized in groups of 4 calves each at 2, 5, 8, 12, 18, and 24 hours after the final dose was given. Tissue concentrations of erythromycin in kidney, liver, lung, muscle, CSF, and serum were determined. Neither the serum concentrations nor the overall pharmacokinetic values were significantly (P less than or equal to 0.05) changed by pneumonia. The concentrations of erythromycin were maximal at 5 hours for liver, muscle, and serum and at 8 hours for CSF, kidney, and lung. Serum and muscle concentrations were similar, whereas concentrations in CSF were lower than in serum and higher in kidney, liver, and lung. The lung/serum ratios were approximately 2.5 to 3 at 8 through 24 hours after IM administration. The peak concentration in lung was approximately 6 micrograms/g at 8 hours. PMID- 2774340 TI - Effectiveness of two benzathine cloxacillin formulations for treatment of naturally occurring infectious bovine keratoconjunctivitis. AB - A field study was performed to determine the effectiveness of benzathine cloxacillin for the treatment of infectious bovine keratoconjunctivitis in cattle from 2 farms located in northern California. The study was performed between June and September of 1987. Affected calves ranging from 2 to 9 months of age were selected from the main herd when signs of corneal ulceration were observed. The study was conducted in 2 phases. For phase I, the affected calves of herd 1 (n = 21; Holsteins) and herd 2 (n = 43 Angus crossbred), were randomly assigned to 1 of 3 groups, and were either treated with 250 (n = 23) or 375 mg (n = 21) of benzathine cloxacillin, or mineral oil (n = 20) on days 1 and 4. For phase II, affected calves (n = 16; Angus crossbred, 3 to 9 months of age) from herd 2 were treated with benzathine cloxacillin (250 mg). Eight of these calves were retreated on day 4. After treatment, all calves were examined every 72 hours for 16 days. For examinations, a clinical score was assigned to each eye, and the surface areas of photographed corneal ulcers were measured. The ocular secretions were collected and examined culturally for Moraxella bovis. On days 7, 10, and 13, the calves treated with benzathine cloxacillin had significantly (P less than 0.05) lower lesion scores, compared with the controls.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2774341 TI - Furazolidone-induced injury in the isolated perfused chicken heart. AB - The Langendorff isolated heart preparation was adapted to determine the effect of furazolidone (0.5 and 2 micrograms/ml of perfusate) on hearts of 3-week-old broiler chickens. Following 115 minutes of perfusion, both concentrations of furazolidone caused approximately a two-fold increase in myocardial vascular resistance and a six-fold increase in lactate dehydrogenase release into the effluent fluid, compared with a control perfused group of isolated hearts (P less than 0.01). Ultrastructural alteration differences were not found between the drug-treated and control groups. It was concluded that: (i) furazolidone, at concentrations only moderately above therapeutic plasma concentrations, caused detrimental changes in myocardial vascular resistance and lactate dehydrogenase release and (ii) the isolated chicken heart preparation is an example of a cost effective, reliable laboratory tool for screening potential cardiotoxins. PMID- 2774342 TI - Lack of virus transmission to offspring from a gorilla positive for HTLV-I related antibodies and provirus. PMID- 2774343 TI - Nurses see new horizons for organized nursing. PMID- 2774344 TI - Hundreds of RNs respond to plane crash in Sioux City. PMID- 2774345 TI - Programs to develop health care data bases. PMID- 2774346 TI - Royal College executive seeks new gains. Interview by Patricia McCarty. PMID- 2774347 TI - Funding bill falls short of recommendations. PMID- 2774348 TI - ANA certification enrollment up 21 percent. PMID- 2774349 TI - AMA set to implement RCT project in Kentucky. PMID- 2774350 TI - As I see it: ANA now designed to achieve goals. PMID- 2774352 TI - We chose what we could live with. PMID- 2774351 TI - Shared vision will take us to new horizons. PMID- 2774353 TI - Clues can alert SNAs to impending union raid. PMID- 2774354 TI - Nursing supply and demand. PMID- 2774355 TI - Public and private responsibility for mental health services. A report on the Tennessee Task Force. AB - The "privatization" of mental health services during the last decade has literally reshaped the way state and county departments of mental health go about fulfilling their statutory responsibilities. In Tennessee, a conference and later a task force examined the implications of this trend for the future. Two issues came to the forefront: Is it appropriate or possible for the private sector to take over the delivery of all mental health services, and if so, who will ensure that the poor receive adequate care? The Tennessee task force concluded that the privatization trend is appropriate and should be encouraged by government. It further concluded that government is ultimately responsible for ensuring access to care for the poor and uninsured although private facilities should provide some free care. Government best serves the poor by providing them the financial means to purchase care from private providers. PMID- 2774356 TI - A model for representing gender differences in the pattern of cognitive abilities. PMID- 2774357 TI - Empirical support for credibility and giving in cross-cultural psychotherapy. PMID- 2774358 TI - Use of the bladder as an abdominopelvic partition. AB - In patients required to undergo abdominoperineal resection, optimal results are obtained only when small bowel loops are prevented from entering the pelvis postoperatively. If small intestine is lodged within the pelvic cavity, fistulization or small-bowel obstruction from fixed twisted bowel loops may occur. Also, postoperative radiation therapy is likely to permanently damage the small bowel. In order to prevent these long and short term complications, the bladder may be used as an abdominopelvic partition to exclude abdominal contents from the pelvis. When the pelvic defect is large, the space beneath the bladder is filled with a pedicle flap of greater omentum. The results of this technical approach is reported in 2 patients; uniformly good results have been seen in 10 patients. These patients had normal urinary tract function after bladder suspension as an abdominopelvic partition. Also, a benign, postoperative course and long-term, normal small-bowel function without fistulization or obstruction resulted. PMID- 2774359 TI - Sulindac-induced acute pancreatitis mimicking gallstone pancreatitis. AB - Two patients with sulindac-induced acute pancreatitis presented clinically with abdominal pain, right upper-quadrant tenderness, markedly increased serum amylase values, and hyperbilirubinemia, findings initially suggestive of gallstone pancreatitis. Ultrasound examinations were negative for gallstones. One patient was inadvertently treated two years later with sulindac with recurrence of abdominal pain, marked hyperamylasemia, and jaundice. Clinical resolution was rapid with each episode following discontinuation of sulindac. PMID- 2774360 TI - Primary adenocarcinoma of the jejunum. AB - Experience with primary adenocarcinoma of the jejunum at the Union Memorial Hospital is reviewed. Six patients treated from 1968 to 1986 with this interesting but rare tumor were identified. Although symptoms appeared to be of long duration, all patients were diagnosed with advanced disease, with only one patient surviving long-term. Data on primary jejunal adenocarcinoma reported in the medical literature were reviewed. The survival figures appear to correlate with stage at presentation, and therefore early and aggressive diagnostic and therapeutic intervention seems indicated to improve the outlook in these patients with historically poor survival rates. PMID- 2774361 TI - The positive effect of accurate noninvasive studies in decreasing the number of normal radiographic studies. AB - We examined the charts of all patients who had aortograms, venograms, and carotid arteriograms for a five-year period, beginning two years prior to the opening of our vascular lab, to determine the effect on these studies. The indications for radiologic studies, the results, and the therapeutic regimen instituted, if any, were analyzed for each patient. We found a negligible effect on the number of aortograms and hypothesize that this is due to the fact that segmental pressures rarely pick up asymptomatic patients. The total number of cerebral arteriograms was not affected; however, the percentage of positive studies for transient ischemic attacks showing severe extracranial carotid disease increased significantly (41% to 74%). We hypothesize that the minimal effect seen on the number of carotid arteriograms was due to a trade off, i.e., the number of patients not having an arteriogram due to a normal noninvasive exam was offset by those minimally symptomatic patients picked up by noninvasive exams to have high grade disease. The total number of venograms decreased significantly and there was a significant increase in the percentage of studies that tested positive for deep venous thrombosis (33% to 46%). The proper use of the vascular lab can significantly reduce the number of normal studies performed in radiology. PMID- 2774362 TI - Delirium in the surgical patient. AB - Delirium is a common and often unrecognized syndrome in hospitalized surgical patients. It can be caused by many different physical abnormalities, which are potentially correctable. Frequently, several etiologies coexist. It is associated with high morbidity and mortality rates. Delirium might be recognized (and its associated serious physical disorders corrected) earlier and more frequently if the diagnosis is considered whenever a patient has mental or behavioral abnormalities. PMID- 2774363 TI - Papillary cystic neoplasm of the pancreas. A report of a case presenting with carcinomatosis. AB - Papillary cystic neoplasm of the pancreas is a rare entity. We report on two patients, one of them having carcinomatosis, and review the literature. This neoplasm is usually found in young women. The most common presentation is a painless abdominal mass. Abdominal ultrasound and CAT scan are helpful in defining the origin of the mass. Due to its benign behavior, the neoplasm is amenable to surgical resection with cure. Immunohistochemistry and electron microscopy should be performed for classification and definition of this curable pancreatic neoplasm. PMID- 2774364 TI - A new, rapid safe method for local radiation of intrathoracic sites. AB - A technique for intraoperative, intrathoracic placement of afterloading catheters for post-thoracotomy radiation therapy is described. This technique offers speed and simplicity and requires no advance planning of radiation therapy. It uses materials that are readily available in operative theaters and radiation oncology units. No radiation exposure of operating room personnel is involved. It also avoids the mechanical problems of crimping and dislodgment associated with the traditional method of individual placement of small afterloading catheters for local radiation therapy. Isodose curves derived from radiographs showing postsurgical source positions demonstrated that it was possible to achieve a uniform therapeutic radiation dose distribution to the chest wall at the site of desired radiotherapy. PMID- 2774365 TI - Reduction of fresh frozen plasma use with a simple education program. AB - Fifty-six charts of patients who received 307 units of fresh frozen plasma (FFP) were audited to determine the transfusion practice of this component at our 550 bed regional referral hospital. Forty-six patients (82%) were on the surgical service. Indications for FFP transfusion were poorly documented. Forty-nine patients (87%) lacked evidence of a coagulopathy. An educational program addressing appropriate use of FFP was initiated. Over the course of two years, FFP usage dropped by over 1,000 units annually (46%). PMID- 2774366 TI - Brown-bowel syndrome. AB - Extensive brownish discoloration of the small bowel is rare and has been described mainly in association with malabsorption disorders. It is related to deficiency of the fat soluble vitamin E. Vitamin E is an antioxidant substance that prevents peroxidation of unsaturated fatty acids. Vitamin E deficiency may result in oxidized lipids, which when polymerized with polysaccharides form the brown, PAS-positive pigment termed ceroid or lipofuscin. The deposition of pigmented granules in the effected tissues accounts for the brownish discoloration. We present three patients ultimately found to have "brown bowel syndrome (BBS)," in which the symptoms, preoperative findings, and respective diagnoses were different. In all three patients, serum Vitamin E levels were found to be extremely low. PMID- 2774367 TI - Retained common bile duct stones. Endoscopic papillotomy is the preferred approach. AB - In six patients who had undergone cholecystectomy and common bile duct exploration, the postoperative T-tube cholangiogram demonstrated stones. Endoscopic cholangiography demonstrated a normal common bile duct in 2 patients and stones in 4 patients. In the latter group, endoscopic papillotomy and stone extraction were successful. PMID- 2774368 TI - Management of pediatric patients who have swallowed foreign objects. AB - The clinical management of children who have swallowed foreign bodies presents a great challenge for both pediatricians and pediatric surgeons. Our 7-year experience of treating 141 patients with a history of foreign body ingestion is reported. In 114 patients, there were 122 foreign bodies present in areas from the esophagus to the rectum, as located by plain chest and abdominal x-ray examination. In two patients, a plastic toy and the plastic cap of a razor were passed with stool a few days later. In the remaining 25 patients, nothing was found. In babies under one year of age, button batteries were the most commonly swallowed foreign bodies, while coins were the most frequently swallowed objects in children over the age of three years. Seventeen foreign bodies in the esophagus were removed: seven by balloon catheter, four endoscopically, and one by a magnet tube. Four were dislodged into the stomach. Twenty nine of the 78 items present in the stomach were button batteries and 23 of the items were removed using a magnet tube. One was removed endoscopically and 5 batteries that had moved beyond the pylorus were excreted within 48 hours. Twenty four coins in the stomach were managed conservatively. Surgical intervention was required in two patients; one patient had a previous history of pyloromyotomy, and a magnet tag measuring 1.5 cm in diameter did not pass through the pylorus for 7 weeks. The other patient had swallowed a sewing needle that moved into the descending colon and abdominal pain ensued. PMID- 2774369 TI - Treatment of asymptomatic gunshot injuries to the spine. AB - Gunshot wounds to the spine and spinal canal are usually associated with significant neurologic loss. When this occurs, treatment is usually supportive, the predominant indication for surgical intervention being progression of the deficit. If the deficit does not progress, but a spinal block can be demonstrated to persist beyond the acute injury period, surgical decompression may also be indicated. When no neurologic deficit is present, the optimum approach is less clear. Complications such as infection or persistent cerebrospinal fluid (CSF) leak may necessitate surgical repair in asymptomatic patients, as well as those with neurologic loss. The presence of copper in the spinal canal is also considered by some to be an indication for surgical intervention in both groups. PMID- 2774370 TI - Is percutaneous better than open gastrostomy? A clinical study in one surgical department. AB - Percutaneous endoscopic gastrostomy (PEG) has become an acceptable alternative to open gastrostomy since its inception in 1981. The PEG procedure has been assumed by most to have lesser associated morbidity and mortality and to be more cost effective. Only a few studies have compared the two procedures, and even fewer cost comparisons have been performed. A review of the literature and a retrospective study was performed over a three-year period examining eighty-eight consecutive patients who underwent either PEG (48) or gastrostomy (4) for feeding purposes only by the same group of surgeons. Patients undergoing PEG or gastrostomy tube placement in association with other procedures were excluded from the study. The results of our experiences with PEG versus open gastrostomy revealed no difference in age or gender. Intraoperative morbidity was higher (50%) for PEG than for gastrostomy (2.5%). Six-month follow-up mortality was 30 per cent and 32 per cent for PEG and gastrostomy. The cost for PEG ($1360) was approximately half the cost for gastrostomy ($2448). This study demonstrates that PEG has a significantly higher intraoperative morbidity rate relative to open gastrostomy, whereas both carry a substantial percentage of late complications. Problems often encountered with PEG included suture breakage, inadvertent colon puncture, local peritonitis, and inability to keep the stomach inflated. Late complications seen with open gastrostomy were wound infection, wound dehiscence, and respiratory complications. No deaths were a direct result of either procedure, and long-term mortality rates were comparable. PEG was clearly more cost effective.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2774371 TI - Prevalence of regurgitant murmurs in patients with valvular regurgitation detected by Doppler echocardiography. AB - STUDY OBJECTIVE: To determine the relation between heart valve regurgitation detected by Doppler echocardiography and audible regurgitant murmurs. DESIGN: Consecutive sample. SETTING: Adult echocardiography laboratory in a tertiary care university hospital. PATIENTS: Sequential sample of 408 patients presenting for clinical echocardiographic studies who had technically satisfactory studies and were available for auscultation. MEASUREMENT AND MAIN RESULTS: Valvular regurgitation occurred in 43% of patients at the mitral valve, 39% of patients at the tricuspid valve, 33% of patients at the aortic valve, and 15% of patients at the pulmonic valve. Corresponding regurgitant murmurs were frequently absent. A murmur corresponding to Doppler-detected regurgitation was detected in 56% of patients with mitral regurgitation, 61% of patients with aortic regurgitation, 28% of patients with tricuspid regurgitation, and 15% of patients with pulmonic regurgitation. There was a highly significant positive correlation of audibility with severity of valve regurgitation for the aortic, tricuspid, and mitral valves. Audibility ranged from 10% to 40% for mild regurgitation to 86% to 100% for severe regurgitation. Murmur audibility was not related to the type of valvular disease present. CONCLUSIONS: Doppler echocardiography is a sensitive method for detecting valve regurgitation. Corresponding regurgitant murmurs are frequently not present. The audibility of regurgitant murmur is highly dependent on the severity of valve regurgitant and has little relation to the type of valve disease present. PMID- 2774373 TI - Glomerulonephritis caused by chronic hepatitis B virus infection: treatment with recombinant human alpha-interferon. AB - STUDY OBJECTIVES: To assess the efficacy of alpha-interferon therapy in patients with hepatitis B virus (HBV)-related glomerulonephritis. DESIGN: Prospective, nonrandomized study. PATIENTS: Five patients with persistence of hepatitis B surface antigen, hepatitis B e antigen (HBeAg) and HBV DNA in serum for at least 6 months and histologic changes of chronic hepatitis on liver biopsy as well as persistent proteinuria of greater than 2 g/d and histologic changes of glomerulonephritis on renal biopsy. INTERVENTIONS: Patients received a 4-month course of recombinant human alpha-interferon (alfa-2b) beginning at a dose of 5 million units administered subcutaneously each day. RESULTS: Serum levels of HBV DNA decreased in all patients and fell to undetectable levels during treatment in four of five patients. In the four responding patients, serum HBeAg disappeared, aminotransferases fell into the normal range, and a follow-up liver biopsy showed an improvement in the hepatocyte necrosis and inflammation. Urine protein excretion also decreased during treatment. In the four responding patients, urine protein excretion gradually fell to less than 1 g/d and serum albumin levels rose into the normal range. Resolution of the biochemical and serologic evidence of chronic hepatitis and glomerulonephritis was accompanied by disappearance of signs and symptoms of liver and kidney disease. CONCLUSIONS: A high proportion of patients with HBV-related glomerulonephritis will respond to a 4-month course of alpha-interferon with a clinical, biochemical, and serologic remission. PMID- 2774374 TI - Hepatic toxicity after acebutolol therapy. PMID- 2774372 TI - Is liver biopsy useful in the evaluation of patients with chronically elevated liver enzymes? AB - STUDY OBJECTIVE: To determine the diagnostic usefulness of percutaneous liver biopsy in evaluating patients with chronically elevated liver-associated enzymes. DESIGN: Comparison of diagnosis made before biopsy by one physician on the basis of a noninvasive work-up (history, physical examination, laboratory values, and imaging studies) and final diagnosis made after biopsy by a second physician formulated after review of all available noninvasive information and study of the biopsy specimen. SETTING: Referral-based gastroenterology clinic at a U.S. Navy medical center. PATIENTS: Sequential sample of 107 patients with elevated liver associated enzymes for a minimum of 3 months. Ninety patients were eligible for study. INTERVENTIONS: The final diagnosis made by the second physician blinded to the first clinician's diagnosis served as the criterion standard. MEASUREMENTS AND MAIN RESULTS: Four diagnostic groups were selected for analysis: Alcoholic liver disease, fatty liver, chronic necroinflammatory diseases, and miscellaneous. The positive predictive value of the prebiopsy diagnosis ranged from 88% (CI, 75% to 100%) for alcoholic liver disease to 56% (CI, 37% to 75%) for fatty liver. Higher elevations of transaminase values (greater than three times the upper limit of normal) correlated positively with increased prebiopsy diagnostic accuracy. Fatty liver was present in 19% of the cohort. Liver diseases requiring specific therapy other than alcohol abstinence were overlooked and diagnosed only after review of the biopsy in five cases. Conversely, four cases of liver disease, thought to require specific therapy on the basis of noninvasive work-up, were ruled out by biopsy. CONCLUSION: The cause of chronic liver disease is best elucidated when the noninvasive work-up is complemented by review of a biopsy specimen. PMID- 2774376 TI - Interstitial cystitis and Borrelia burgdorferi. PMID- 2774375 TI - Antithrombin III concentrate for treatment of chronic leg ulcers in sickle cell beta thalassemia: a pilot study. PMID- 2774377 TI - Chlamydial pharyngitis. PMID- 2774378 TI - Methotrexate therapy in cutaneous sarcoidosis. PMID- 2774379 TI - Reply to a letter on carotid endarterectomy. PMID- 2774380 TI - Intravenous pyelography before hysterectomy. PMID- 2774381 TI - Care of adolescent patients. PMID- 2774382 TI - Care for "environmental illness". PMID- 2774383 TI - Correction: Cancer Chemotherapy Protocols and dose of chlorambucil. PMID- 2774384 TI - High-dose busulfan and seizures. PMID- 2774385 TI - Reimbursement and declines in internal medicine training. PMID- 2774386 TI - Style notes: bacterial vaginosis or vaginal bacteriosis? PMID- 2774389 TI - National Study of Internal Medicine Manpower: XVI. Subspecialty fellowship programs, 1988 update. AB - Much of the debate about medical manpower during the 1980s has focused on the growing number of medical subspecialists. We examined the number of subspecialty fellows since 1976, paying particular attention to data collected in the 1987 1988 academic year. The number of fellows in subspecialty training at a given time has increased by 27% since 1976; however, much of this increase is due to the increased length of the training programs. The number of first-year fellows has increased only 7% since 1976. Growth in the number of fellowships has varied by subspecialty. The number of fellowships in geriatrics, critical care, and general internal medicine has increased dramatically. Additionally, the traditional subspecialties-cardiology, pulmonary disease, gastroenterology, infectious diseases, rheumatology, and allergy-immunology-have all grown to some extent. Program directors in all subspecialties anticipate continued growth in the coming years. PMID- 2774388 TI - Amiodarone in patients with previous drug-mediated torsade de pointes. Long-term safety and efficacy. AB - The safety and efficacy of long-term amiodarone therapy were examined in 12 patients who had previously developed torsade de pointes as a complication of previous antiarrhythmic therapy. The QTc intervals were determined at the time of torsade de pointes (570 +/- 40 ms), after 7 days of amiodarone loading (490 +/- 70 ms), and after 3 months of chronic amiodarone administration (580 +/- 80 ms). Compared to a drug-free control period, QTc was significantly prolonged (P less than 0.05) at the time of torsade de pointes, after amiodarone loading, and after 3 months of amiodarone therapy. The QTc intervals at the time of torsade de pointes and after chronic amiodarone treatment were not significantly different. At 16 +/- 7 months of follow-up, all patients remained free of subsequent torsade de pointes, syncope, or sudden death. In addition, 5 of 6 patients with a history of sustained ventricular tachycardia remained free from arrhythmic recurrence despite persistence of inducible ventricular tachycardia during programmed stimulation studies done before discharge. We conclude that amiodarone can often be used safely and effectively in patients who have previously had an episode of drug-mediated torsade de pointes. Amiodarone-induced QTc prolongation, even when marked, does not predict recurrent torsade de pointes. These observations also suggest that the propensity for a drug to produce this arrhythmia is dependent on other electrophysiologic effects in addition to its ability to simply lengthen repolarization. PMID- 2774387 TI - Spinal and peripheral bone mineral densities in acromegaly: the effects of excess growth hormone and hypogonadism. AB - STUDY OBJECTIVE: To measure spinal and peripheral bone mineral densities in patients with acromegaly. DESIGN: Retrospective study. SETTING: Tertiary care center. SUBJECTS: Twenty-four patients with acromegaly and 24 case controls. Seventeen patients (12 eugonadal and 5 hypogonadal) had "active" disease as indicated by elevated plasma concentrations of growth hormone or somatomedin C or both at the time of the study. Seven patients (all hypogonadal) had inactive disease by these criteria. MEASUREMENTS AND MAIN RESULTS: Bone mineral was measured by single photon absorptiometry of the forearm and dual photon absorptiometry of the spine. The forearm bone mineral content of patients with active disease, regardless of gonadal status, was significantly higher than that of normal subjects (P less than 0.001) or of patients with inactive disease (P less than 0.001). The disease "activity" (17.2 +/- 3.7; CI, 9.5 to 24.9) and the sex of the patient (female, -16.6 +/- 3.4; CI, -23.7 to -9.5) were the only independent predictors of forearm measurements. Vertebral bone densities were lower in acromegalic patients than in normal subjects (P less than 0.001). Vertebral values were correlated with the gonadal status of the patients (hypogonadism, -0.126 +/- 0.056; CI, -0.244 to -0.009) and with serum calcium concentrations (0.592 +/- 0.274; CI, 0.032 to 1.153) but not with acromegalic activity. In 13 patients, forearm bone was measured before and after treatment (mean duration of follow-up, 3.4 years). Patients with persistently elevated, plasma somatomedin C concentrations at the end of the study period showed a mean annual increase of 1.5% in forearm measurements during the period of observation, whereas patients with normal concentrations showed a mean annual decrease of 1.0% (P less than 0.01 for the difference between the groups). The percent change in forearm bone mineral content per year (y) was highly correlated with residual somatomedin C activity (x): y = 2.023x - 2.75; r = 0.665. CONCLUSIONS: Forearm and vertebral bone mineral measurements change in opposite directions in acromegaly. The high forearm values are attributable to the growth-promoting action of growth hormone and somatomedin C, whereas low vertebral values are associated with hypogonadism. PMID- 2774390 TI - Phencyclidine pharmacokinetics after a massive overdose. PMID- 2774392 TI - Cardiopulmonary resuscitation of elderly persons. PMID- 2774391 TI - Recognition of cardiac tamponade in the presence of severe pulmonary hypertension. PMID- 2774393 TI - Asthma in respiratory therapists. PMID- 2774395 TI - Node-negative breast cancer and the clinical alert. PMID- 2774394 TI - Screening for lung cancer. PMID- 2774396 TI - [Semiology of obesity]. AB - Obesity is a syndrome defined simply as an excess of body fat. It is becoming increasingly clear that the condition is multifactorial and has a wide range of causes. Detailed analysis of the clinical presentation is the basis of the diagnosis of the pathophysiological mechanism at work in each individual case and a prerequisite for the determination of the therapeutic strategy. Although there is no ideal system of classification, an attentive medical, dietary and psychological examination often provides relevant information to decide what is useful, possible or even harmful for the patient. PMID- 2774398 TI - 12-keto-eicosatetraenoic acid. A biologically active eicosanoid in the nervous system of Aplysia. AB - The lipoxygenase product 12-hydroperoxy-5,8,10,14-eicosatetraenoic acid (12 HPETE), stimulates the synaptic response produced by the modulatory transmitter histamine and the neuroactive peptide Phe-Met-Arg-Phe-amide (FMRFamide) in identified neurons of the marine mollusk Aplysia californica. The 12-lipoxygenase pathway has not yet been fully characterized, but 12-HPETE is known to be metabolized further. Therefore, we began to search for other metabolites in order to investigate whether the actions of 12-HPETE might require its conversion to other active products. We have identified 12-keto-5,8,10,14-eicosatetraenoic acid (12-KETE) as a metabolite of 12-HPETE formed by Aplysia nervous tissue. 12-KETE was identified in incubations of the tissue with arachidonic acid using HPLC, UV spectrometry, and gas-chromatography/mass spectrometry. [3H]12-KETE is formed from endogenous lipid stores in nervous tissue, labeled with [3H]arachidonic acid upon stimulation by application of histamine. In L14 and L10 cells, identified neurons in the abdominal ganglion, applications of 12-KETE elicit changes in membrane potential similar to those evoked by histamine. Another metabolite of 12 HPETE, 12(s)-hydroxy-5,8,10,14-eicosatetraenoic acid [12(S)-HETE], is inactive. These results support the hypothesis that 12-HPETE and its metabolite, 12-KETE, participate in transduction of histamine responses in Aplysia neurons. PMID- 2774397 TI - Mechanisms involved in the action of prostaglandins as modulators of neurotransmission. PMID- 2774399 TI - Ischemia stress and arachidonic acid metabolites in the fetal brain. AB - Hypoxic-ischemic insults caused by placental insufficiency in perinatal life are today considered a major cause for neuronal injury and impaired postnatal development. A major consequence of placental insufficiency and ischemia is the change in metabolism of arachidonic acid and its oxidation products. A burst of postischemic production of prostaglandins, unequivocally shown in many systems, is documented in the fetal rabbit brain as well as in placenta tissue soon after vascular restriction. PGE2, a most abundant prostaglandin of the fetal brain, is particularly elevated. Similarly, thromboxane B2 and 6-keto PGF1 alpha, the stable metabolites of thromboxane A2 and prostacyclin, are both increased over the control values. However, after 48 h of restriction, the levels of these eicosanoids are restored to near-normal values. The metabolic machinery responsible for the conversion of arachidonic acid into eicosanoids in brain and placenta tissues appears to be impaired following a period of placental insufficiency. This inhibition can be accounted for by excessive production of eicosanoids and also by formation of an endogenous inhibitor or free radicals. Studies are in progress to test these possibilities. PMID- 2774400 TI - Isolation, characterization, and regulation of diacylglycerol lipases from the bovine brain. PMID- 2774401 TI - Arachidonic acid metabolism in ischemic neuronal damage. PMID- 2774403 TI - Eicosanoids in deteriorating stroke. Review of studies on the rabbit spinal cord ischemia and reperfusion model. PMID- 2774402 TI - Arachidonic acid and its metabolites in cerebral ischemia. PMID- 2774404 TI - Arachidonic acid metabolism and cerebral blood flow in the normal, ischemic, and reperfused gerbil brain. Inhibition of ischemia-reperfusion-induced cerebral injury by a platelet-activating factor antagonist (BN 52021). AB - Cerebral ischemia and ischemia-reperfusion induced cerebral injury results in the accumulation of free fatty acids and diacylglycerols as a result of increased activity of phospholipases A and C. We have evaluated the incorporation of 14C arachidonic acid into the whole brain and synaptoneurosomes, the effect of cerebral ischemia on 14C incorporation, and the effect of a PAF antagonist (BN 52021) on cerebral blood flow, free fatty acids, diacylglycerols, and polyphosphoinositides. Peak incorporation of 14C arachidonic acid into the whole brain and synaptoneurosomal fractions occurred 30 minutes following intraventricular injection. Peak incorporation into cerebellar synaptoneurosomal fractions was at 60 minutes following intraventricular injection. Turnover in phospholipid pools was similar in the whole brain and synaptoneurosomes (PI greater than PC greater than PE). Considering phosphatidylinositol content in the gerbil brain, the specific activity of 14C arachidonic acid was 22 times greater in PI than PC. Five minutes of bilateral carotid artery ligation resulted in decreased phosphatidylinositol and polyphosphoinositols. Bilateral carotid artery ligation resulted in systemic arterial hypertension, complete forebrain ischemia (CBF less than 7 ml/100 gm/min) and a 20% to 50% reduction in midbrain CBF. Reperfusion resulted in cerebral reactive hyperemia and systemic hypotension. BN 52021 inhibited the maturation of ischemia-reperfusion induced cerebral injury. Cerebral blood flow was improved. Free fatty acids were decreased, suggesting inhibition of phospholipase A activity. Decreased DAG pools with increased PIP2 pools suggest a possible coinhibition of phospholipase C. PMID- 2774406 TI - The aging brain. A normal phenomenon with not-so-normal arachidonic acid metabolism. PMID- 2774405 TI - Arachidonic acid and its metabolites during cerebral ischemia and recirculation. Pharmacological interventions. PMID- 2774407 TI - Prostaglandin D2 and sleep. PMID- 2774408 TI - The role of arachidonic acid metabolites in mediating ethanol self-administration and intoxication. AB - Prostaglandin synthesis inhibitors antagonize the effects of alcohols, indicating that some aspect of cyclooxygenase activity and arachidonic acid metabolism is involved in the mechanism of action of alcohols. In addition, ethanol increases in vivo brain PGE and PGF levels in a manner correlated across dose and time with the absorption phase of ethanol. These results have provided systematic evidence in support of the hypothesis that ethanol produces its intoxicating effects to a significant degree through a prostaglandin-mediated mechanism. This report has presented an overview of this work, as well as additional results from a series of recent studies that examined the effects of pretreatment with INDO, a potent PGSI, on ethanol self-administration. The results of these self-administration studies indicate that INDO can decrease responding for ethanol in a dose-related manner. The pattern of changes suggests that INDO decreases ethanol self administration by decreasing the reinforcing effects of ethanol and not by producing a conditioned aversion to ethanol. In a subsequent study, INDO did not affect saccharin self-administration. These results suggest that there exists a common prostaglandin-related mechanism that is important in the mediation of both acute sensitivity to ethanol and the reinforcing properties of this drug. These findings may provide for the development of novel pharmaceutical treatments for acute alcohol overdose as well as for chronic alcohol abuse. PMID- 2774409 TI - Modulation of defined vertebrate neural circuits. PMID- 2774410 TI - Construction of an auditory space map. AB - The computation of ITD begins with preservation of the phase angle of spectral components by eighth-nerve fibers and by cells of the nucleus magnocellularis. At the level of the nucleus laminaris, the difference in phase angle of corresponding spectral components in the left and right ears is extracted. At the next level, the central nucleus, neurons are consolidated into tonotopic ensembles in which preferred delta phi and frequency covary, so that only a single ITD coactivates all constituent neurons. Neurons of such ensembles project convergently on space-specific neurons, endowing the space-specific neuron with a selectivity for ITD and, therefore, a selectivity for azimuth. Ensembles representing ITDs corresponding to ipsilateral and contralateral auditory hemi fields are found in the core and lateral shell of the central nucleus, respectively. The lateral shell receives its representation of the contralateral hemi-field from the opposite central nucleus core. The central nucleus core is innervated by the contralateral nucleus laminaris, which contains a representation of contralateral space. The projection from the lateral shell to the ipsilateral external nucleus forms a map of contralateral space in the external nucleus. PMID- 2774411 TI - Electromechanical analogs of human reflexes. AB - The conclusion to be drawn from our modeling is that the combined stretch and tendon reflexes alone can endow artificial muscle with a springlike feel as well as give it a baseline tone. In response to questions that motor physiologists often ask as to what variables the system controls, the answer here is clear: the stretch and tendon reflexes act together to maintain both a tension set-point and a length set-point, but in so doing they also give the system a springlike feel because of the existence of a servo error. The main goal of our studies is to understand the integration of reflexes, and thus far we have only begun to explore the two lowest-level spinal reflexes. We are in the process of expanding this work by developing a much more refined arm explicitly modeled after the human arm. This new arm is to be activated by a minimum of 10 muscles, each of which is reflexively driven, and it will allow us to explore the integration of higher-level reflex action such as automatic inhibition of antagonists and facilitation of synergists. PMID- 2774412 TI - Neural control of the jaw and ingestive behavior. Anatomical and behavioral studies of a trigeminal sensorimotor circuit. PMID- 2774413 TI - Adaptive gain modification of the blink reflex. A model system for investigating the physiologic bases of motor learning. PMID- 2774414 TI - Regulation of testicular function. Signaling molecules and cell-cell communication. PMID- 2774415 TI - Germ cell-Sertoli cell interactions. Studies of cyclic protein-2 in the seminiferous tubule. AB - This review briefly describes the discovery and isolation of a novel Sertoli cell product, cyclic protein-2, (CP-2) and the generation of an antiserum against this protein. Using this antiserum, we demonstrated a stage-specific change in the synthesis of CP-2 by Sertoli cells within intact seminiferous tubules; synthesis is maximal at stages VI and VIIa,b of the cycle and minimal at stage XII. That CP 2 is a product of Sertoli cells was confirmed by immunohistochemical analysis. Comparison of CP-2 and transferrin synthesis by immature (17-day) and mature (75 day) Sertoli cells within intact seminiferous tubules has documented a significant increase in the synthesis of both proteins during testicular maturation. It was noteworthy, however, that the increase in CP-2 synthesis was much greater than the increase in transferrin synthesis. These data in conjunction with previous comparisons of the stage-specific changes in CP-2 and transferrin synthesis and secretion led to the hypothesis that the synthesis of these two proteins is regulated by different cellular interactions. Examination of cultured Sertoli cells obtained from mature rats demonstrated that transferrin synthesis and secretion were stimulated by hormones and vitamins, whereas CP-2 synthesis and secretion were not significantly affected by the same factors. Therefore, these data demonstrate that hormonal regulation of transferrin synthesis by Sertoli cells differs from hormonal regulation of CP-2 synthesis. Indeed, our data suggest that CP-2 synthesis is not directly regulated by hormones and vitamins. Finally, we demonstrated that when Sertoli cells are separated from germ cells and the Sertoli cells placed in culture, the age dependent increase in CP-2 synthesis, noted with cultured tubules, is lost. In contrast, significantly more transferrin is synthesized by primary cultures of Sertoli cells obtained from old animals than from young animals. Taken together, all of these data indicate that the regulation of CP-2 synthesis and secretion by the Sertoli cell is unique and is primarily stimulated by paracrine signals or direct cell contact with the germ cells. Which of these mechanisms of cell-cell communication in the testis is important to regulation of CP-2 synthesis by Sertoli cells is unknown. Neither do we know which spermatogenic cell type provides this stimulus. These issues can now be addressed, however, because we have developed the protocols for isolating and culturing Sertoli cells from mature rat testes. PMID- 2774416 TI - Expression of mouse protamine 1 genes in transgenic mice. AB - Mouse protamine genes are expressed exclusively in spermatids. Mouse protamine 1 (mP1) transcriptional regulatory elements can target the expression of either marked mP1 transgenes or mP1 chimeric genes to spermatids in transgenic mice. Sequences between -40 and -465 bp relative to the transcription start site are required for expression in spermatids, whereas sequences 3' of the point of translation initiation are dispensable. mP1 transcriptional regulatory sequences were used to direct the expression of a toxic gene product to spermatids. The phenotypic consequences of toxin expression in spermatids are described. PMID- 2774417 TI - The microcirculation of the testis. PMID- 2774418 TI - Structural analysis of the human and rat androgen receptors and expression in male reproductive tract tissues. PMID- 2774419 TI - Application of the disector method to enumerate cells in the testis. PMID- 2774420 TI - Sickle cell disease. PMID- 2774421 TI - Delayed growth and sexual maturation in sickle cell disease. PMID- 2774422 TI - Do pregnant women benefit from hemoglobinopathy carrier detection? AB - A 45% sample of all pregnancies in Rochester, N.Y. over a five-year period showed that 4.2% of pregnant women had a hemoglobinopathy. Sixty-six percent of these women did not know they had such an abnormality, and 80% did not understand its reproductive significance. Sixty-eight percent of women informed they were positive came for counseling. Fifty-seven percent of counseled women had the baby's father tested. Forty-seven percent of couples at risk offered amniocentesis wanted it. (table; see text) A woman was more likely to want her partner tested if she had a more thorough knowledge of the disease or viewed having an affected child as more burdensome. The partner was more likely to come for testing if the couple were living together than if living apart. Prenatal hemoglobinopathy screening is accepted by providers and pregnant women, at least when expert services are provided at no charge to either. Women and couples use the information provided to pursue their reproductive goals. PMID- 2774423 TI - Adjustment and coping in adolescents with sickle cell disease. PMID- 2774425 TI - Design and testing of antisickling therapy. PMID- 2774424 TI - The possible role of genetic modifiers in the clinical severity of sickle cell syndromes. PMID- 2774426 TI - Covalent chemical modifiers of sickle cell hemoglobin. PMID- 2774427 TI - The rheology of sickle cell hemoglobin. PMID- 2774428 TI - Prenatal diagnosis of sickle cell anemia--1988. PMID- 2774429 TI - Prenatal diagnosis for sickle cell disease. A survey of the United States and Canada. AB - Prenatal diagnoses for sickle cell disease in the United States and Canada numbered at least 1065 through the end of 1987. The 272 prenatal diagnoses in the United States in 1987 constituted only about 4.1% of the estimated pregnancies at risk. The termination rate for diagnosed fetuses was 39% for sickle cell anemia and 23% for hemoglobin SC disease. Prenatal hemoglobinopathy screening programs should not be judged solely on the number of terminations for affected fetuses. Other benefits are reassurance for couples shown to have an unaffected fetus and, for couples shown to have an affected fetus, preparation for the birth of a child requiring special care and information relevant to future childbearing. PMID- 2774430 TI - The trigeminal (V), an oft-neglected nerve. AB - Corneal denervation is one of the most serious insults that can occur to an eye; disease symptoms can be suppressed, and epithelial breakdown is likely to occur. In the cases presented, failure to test corneal sensation delayed diagnosis and endangered the cornea. Conditions affecting the trigeminal sensory pathway, including those causing a pain-anesthesia paradox, are described. Corneal sensation must be tested in all instances of suspicious head pain or paresthesia, head trauma, cranial nerve defect, cranial autonomic dysfunction, or unexplained corneal epithelial defect. The trigeminal nerve is often neglected, but corneal anesthesia aids in the diagnosis of intracranial disease and dictates the need for corneal observation and protection. PMID- 2774431 TI - Temporal branch retinal vein obstruction masquerading as a retinal arterial macroaneurysm: the Bonet sign. AB - We present the case report of a patient with a hemorrhage at an arteriovenous crossing which was erroneously interpreted as being an arterial macroaneurysm. Shortly thereafter, the typical appearance of a temporal branch retinal vein obstruction was evident indicating that the hemorrhage was an early sign of the venous obstruction. This sign (the Bonet sign) should alert the clinician to this disorder so that the correct diagnosis and recommendations for patient care can be undertaken. PMID- 2774432 TI - Acquired toxoplasmic retinochoroiditis after platelet transfusions. AB - We present a rare well-documented case of acquired toxoplasmic retinochoroiditis transmitted by platelet transfusion. A 52-year-old woman developed severe thrombocytopenia shortly after receiving a sulfamethoxazole-containing antibiotic. This episode was treated with platelet transfusions and a three-day course of corticosteroids. Thirteen days later, she developed an acute febrile illness typical of the typhus-like form of toxoplasmosis. Fifty-six days later, while still taking corticosteroids for recurrent immune thrombocytopenia, she developed an acute macular retinochoroiditis OD. Serology showed recently acquired toxoplasmosis. Epidemiologic investigation revealed no possible source for the toxoplasmosis other than the platelet transfusion. PMID- 2774433 TI - Ocular self-mutilation. AB - A 32-year-old paranoid schizophrenic man repeatedly stabbed both his eyes with a sharpened wire coat hanger. The patient underwent vitrectomy on each eye approximately 2 1/2 weeks after injury, with multiple retinal defects noted OU. None of the posterior wounds involved the macula or optic disc, and final vision was 20/70 OD and 20/50 OS. Ocular self-mutilation, deliberate and severe self injury which threatens visual function, is a rare occurrence most often described in acutely psychotic patients. Psychosis may be due to schizophrenia, drug abuse, manic phases of bipolar mood disorders, and depression. A striking number of these patients have delusions with religious and sexual content. They are prone to repeated attempts during the acute psychotic phase and must be monitored closely at this time. PMID- 2774434 TI - Serous choroidal detachment after spontaneous expulsion of episcleral exoplant. AB - A 70-year-old man was treated with scleral buckling surgery and photocoagulation for rhegmatogenous retinal detachment. One year later, serous choroidal detachment occurred after spontaneous expulsion of the episcleral exoplant. To our knowledge, this is an uncommon cause of choroidal detachment. PMID- 2774435 TI - A review of extracapsular cataract extraction and intraocular lens implantation combined with trabeculectomy. AB - Six eyes underwent combined extracapsular cataract extraction with or without intraocular lens implantation and trabeculectomy in 1985 and 1986. Postoperatively, the intraocular pressure was acceptable without medication in all cases. Visual acuity also improved in every case. There was no greater incidence of postoperative complications than that expected when either procedure is done alone. PMID- 2774436 TI - Radiation retinopathy treated with the krypton red laser. AB - We present two cases of radiation retinopathy treated with the krypton red laser (647 nm). The macular edema and exudates resolved completely after treatment, but visual acuity improved only partially due to the development of a lamellar macular hole. The rationale for laser therapy and the selection of the red wavelength are discussed. PMID- 2774437 TI - [Results of mammographic screening and organizational aspects]. PMID- 2774438 TI - Eye socket reconstruction with free radial forearm flap. AB - Deformity of the orbital region and contraction of the eye socket were encountered in 3 patients who in their infancy underwent exenteration of the orbit and postoperative irradiation for the treatment of retinoblastoma. These major problems were attributed to the less-vascularized cicatricial conjunctiva left in place. To solve these disadvantages, a microvascular technique using a free radial forearm flap was adopted. A large permanent eye socket was achieved and depression deformity of the orbital region was corrected in a one-stage operation. This is, to our knowledge, the first report on the use of a free vascularized skin flap for "malignant contracture" of an anophthalmic eye socket. The excellent cosmetic results of this method are demonstrated. PMID- 2774439 TI - Arteriovenous shunts in free vascularized tissue transfer for extremity reconstruction. AB - Local vessels are occasionally unsatisfactory donor choices for vascularized tissue transfer in extremity reconstruction. Construction of a temporary arteriovenous loop facilitates not only tension-free anastomoses outside the zone of injury but also affords vascular distention at physiological pressures, an opportunity to verify vein graft patency before tissue transfer, and presumably a decrease in the ischemia time of the vein graft itself. We reviewed the cases of 25 consecutive patients who underwent upper and lower extremity reconstruction facilitated by temporary arteriovenous shunts. In single-stage procedures, greater or lesser saphenous veins were used; the venous end was left in situ in its bed in 17 patients and the entire vein harvested freely in 8. The most common destination was the leg (11), followed by the thigh (7), foot (2), sacrum (2), knee (1), arm (1), and forearm (1). There were three (12%) failures. We conclude that construction of temporary arteriovenous shunts using vein grafts is a productive adjunctive technique in vascularized tissue transfer where additional pedicle length is needed. PMID- 2774440 TI - The sensory potential of free flap donor sites. AB - Microneurovascular techniques make transfer of innervated soft tissue a reality. The present study investigated the sensory potential of four such donor sites: volar wrist, dorsal hand, dorsal foot, and great toe. Normal moving and static two-point discrimination values for these areas are reported. A sensory reeducation protocol demonstrated that even these normal values may be improved with training. This suggests that the full potential of transferred innervated soft tissue may best be achieved by incorporating sensory reeducation routinely in the postoperative rehabilitation program. PMID- 2774441 TI - Correlation of postoperative bone scintigraphy with healing of vascularized fibula transfer: a clinical study. AB - This study examines the usefulness and reliability of bone scintigraphy in correlation with radiological and clinical evidence of bone healing in 15 patients who underwent microvascular transfer of the fibula. All patients were followed for a minimum of 18 months postoperatively. Technetium-99 methylene diphosphonate bone scans and the most recent radiographs were blindly rereviewed. Bone scintigraphic results were characterized as (1) clearly positive (i.e., excellent visualization of the fibula), (2) clearly negative (i.e., no evidence of tracer uptake in the fibula), or (3) indeterminate (i.e., artifact present as a result of metallic or soft tissue interference). Bone radiographs were classified into three typical patterns: (1) complete bony union and graft hypertrophy, (2) incomplete union (either distal or proximal) requiring a second procedure), and (3) nonunion, with increased proximal and distal lucency (with or without pathological fracture) and loss of graft definition. Eleven patients had positive scintigraphic scans postoperatively. In 8 no subsequent procedure was necessary; 2 patients required additional bone grafts to augment the osseous reconstruction; viable fibulas were seen at reoperation. One patient with a positive scan showed decreased graft definition at four months followed by autograft fracture. Three patients had indeterminate scans, 2 of whom evidenced uncomplicated clinical and radiological union. One patient had a clearly negative scan and ultimately tibia-fibula synostosis was required to attain stability. Bone scintigraphy appears to correlate with survival, but not necessarily union, of a vascularized fibula autograft. Additional monitoring techniques should be used in combination with a one-time bone scan to both monitor the patency of the microanastomoses and to prioritize the orthopedic management of the patient. PMID- 2774442 TI - Inhibitory effect of mature cartilage on perichondrial neochondrogenesis. AB - The perichondrium adhering to mature cartilage is not active, but that separated from cartilage is highly chondrogenic. Cartilage formation from isolated perichondrium does not last forever, and perichondrium soon becomes inactive. What activates or inactivates the perichondrium. The authors investigated the effect of mature cartilage on the cartilage formation from perichondrial graft material. The results showed that mature cartilage attached to the perichondrium inhibited neochondrogenesis. The phenomenon that cartilage--a product of chondrogenesis--inhibits neochondrogenesis of perichondrium can be called negative feedback. PMID- 2774443 TI - Chemical peel: a change in the routine. AB - The use of occlusive taping following phenol chemical peel has become a standard technique. Many studies have demonstrated the effectiveness of tape occlusion in producing a deeper, more profound chemical peel. For the last 18 months, we have abandoned tape occlusion following phenol peel and have substituted an occlusive dressing using a thick layer of petroleum jelly (Vaseline). The occlusiveness provided by the petroleum jelly has proved to be almost as effective as the standard tape mask, and the results using this technique parallel those with a tape mask. The advantages of Vaseline occlusive dressing include greater patient comfort, the ability to evaluate the wound beneath the petroleum jelly, and the prevention of streaking, which can occur from uneven tape application. Eschar formation and crust separation are avoided after the peel by the constant use of facial lubricants, our preference being A & D ointment. PMID- 2774444 TI - Lymphedema of the face. AB - Lymphedema of the extremities is well documented in the literature. We present a case of lymphedema involving the face of a 27-year-old man and discuss the clinical presentation, microscopic findings, and surgical treatment. To our knowledge, this is the first such case report in the literature. PMID- 2774445 TI - Thyroidectomy under local analgesia: the anatomical basis of cervical blocks. AB - This paper describes the anatomical compartments of the neck and their innervation, followed by details of superficial, deep and modified cervical blocks which can be performed during thyroidectomy. Advantages and disadvantages of each technique are discussed. Superficial and deep cervical blocks leave some structures unaffected. A modified cervical block is described which can be used to overcome these difficulties. PMID- 2774446 TI - A new technique of caecostomy using endotracheal tubes. PMID- 2774447 TI - Shoulder arthroscopy. AB - The results of 50 shoulder arthroscopies are presented. A great variety of different lesions were seen. In 27 of the 50 cases the diagnosis was changed or refined. In particular, unexpected rotator cuff tears and radiolucent loose bodies were found. The presence of Bankart and Hill-Sachs lesions confirmed the diagnosis of recurrent dislocation in clinically subluxing patients with no radiological evidence of dislocation. Shoulder arthroscopy promises to increase diagnostic precision in patients with shoulder pain and may have therapeutic potential with minimal morbidity. PMID- 2774448 TI - Fasting in children for day case surgery. AB - Thirty-four children admitted for day case surgery were studied to determine the period of preoperative fasting and blood sugar concentrations at the time of induction of anaesthesia. Of these, 88% fasted for 12 h or more, 20% fasted for 16 h or more. Three were found to be hypoglycaemic. The introduction of routine 'mid-day' operating lists for paediatric day case surgery is suggested as a method of reducing the period of fasting and risk of hypoglycaemia. PMID- 2774449 TI - Prolene plug repair for femoral hernia. AB - We present the technique and our results in using a plug of Prolene mesh to repair femoral hernias. By filling the femoral canal with a Prolene plug we achieved a sound hernia repair. Our results allow us to recommend the technique to others. PMID- 2774450 TI - Surgical treatment of grade III gynaecomastia. AB - Gross enlargement of the male breast with skin redundancy and ptosis cannot be effectively managed by subcutaneous mastectomy alone. A technique is described in which the excess breast tissue and skin are excised along a design which allows the nipple-areolar complex, mounted on a vertical deepithelialised pedicle, to lie in a natural position. A horizontal scar is an unavoidable exchange for this particular operation. PMID- 2774451 TI - Risk factors in selected patients undergoing femoral embolectomy. AB - Mortality rates after femoral embolectomy (FE) in patients with an acutely ischaemic leg vary from 20-40%. In the last 3 years we have adopted a policy of proceeding directly to femoral embolectomy in those patients with a strong clinical suspicion of an embolus. Where doubt exists about the diagnosis, arteriography is performed in combination with local streptokinase, balloon dilatation and/or reconstruction. In a prospective study between September 1984 and March 1987, 43 patients underwent femoral embolectomy with a limb salvage rate of 87%. The early mortality (within 30 days) was 16%, the late mortality was 26%, with a mean follow-up of 22 months. Of the seven patients who died within 30 days, one had a successful embolectomy but died from a cerebrovascular accident. The remaining six failed to improve clinically, all had poor backbleeding and no return of the peripheral pulses. None of these patients had an amputation. We recommend that femoral embolectomy be performed in those patients with a short history of ischaemia (less than 72 h), a risk factor suggesting an embolic source and no past history of intermittent claudication. If all three criteria are not met, arteriography should be performed with a view to fibrinolytic therapy or vascular reconstruction. In those patients who have had a failed embolectomy or where the circulation cannot be restored promptly, despite fibrinolytic therapy and/or distal reconstruction, early major amputation may be life-saving. PMID- 2774452 TI - Autotransplantation for renovascular hypertension with complete renal artery occlusion. AB - We report a personal series of 13 autotransplantation procedures in 12 patients who suffered from severe renovascular hypertension. In all of these cases preoperative investigation demonstrated a viable kidney, despite complete occlusion of the affected renal artery. One-half the patients had stenosis of a milder degree affecting the contralateral kidney. In eight of these patients the operation was considered successful. One patient died due to postoperative superior mesenteric artery thrombosis and two had infarction of the transplanted kidney. A fourth patient lost the autotransplant because of postoperative haemorrhage. It is suggested that if medical treatment fails then autotransplantation should be considered in place of nephrectomy for cases of renovascular hypertension with complete occlusion of the renal artery. PMID- 2774453 TI - Prospective and retrospective data compared in patients with PTFE femoropopliteal bypass grafts. AB - Twenty-four patients with PTFE, femoropopliteal grafts were studied using two different methods. A prospective study was carried out as part of a clinical trial and later the same patients were identified as part of a retrospective study. Comparison of the details obtained independently showed marked differences in patients' ages, indications for surgery, angiographic runoff, operative detail, risk factors and subgroup patency. PMID- 2774455 TI - The pathophysiological effects of brain death on potential donor organs, with particular reference to the heart. AB - Major electrocardiographic, haemodynamic, and histopathological changes take place during the development of brain death; myocardial and pulmonary injury may result. Significant depletion of certain circulating hormones occurs, resulting in an inhibition of mitochondrial function, leading to reduced aerobic metabolic oxidative processes, affecting the body as a whole. Major organ energy stores are therefore diminished, leading to deterioration of function. Replacement of the depleted hormones, in particular triiodothyronine (T3), cortisol, and insulin, leads to rapid replacement of organ energy stores, associated with a return to normal function. T3 alone leads to reactivation of the mitochondria, stimulating aerobic metabolism. Hormonal therapy to brain-dead potential organ donors has been shown to lead to metabolic and haemodynamic stability, resulting in no wastage of organs, and in improved function after transplantation. PMID- 2774454 TI - Surgery for gastro-oesophageal reflux: the Angelchik prosthesis compared to the floppy Nissen fundoplication. Two-year follow-up study and a five-year evaluation of the Angelchik prosthesis. AB - Twenty-two patients were followed for 5 years after insertion of an Angelchik prosthesis for gastro-oesophageal reflux (GOR) and the 2-year results compared with a subsequent group of 28 patients treated by floppy Nissen fundoplication. The overall clinical results of the two procedures were equivalent at 2 years (Angelchik Visick 1 and 2, 80%; Nissen Visick 1 and 2, 78%) but the reasons for failure were different. In the Angelchik group failures were due to mechanical problems associated with the device, whereas the Nissen failures were mainly due to recurrent GOR. There were no patients in the Angelchik group with recurrent reflux at 5 years, but between 4 and 5 years postoperatively four patients developed mild dysphagia. The Angelchik prosthesis appears to be as effective as the floppy Nissen fundoplication, but further long-term studies are required before its widespread use can be recommended. PMID- 2774457 TI - Cholecystectomy and the development of colorectal neoplasia: a prospective study. PMID- 2774456 TI - Distal femoropopliteal bypass using a composite graft of PTFE and non-reversed saphenous vein. PMID- 2774458 TI - Viable intraluminal tumour cells and local/regional tumour growth in experimental colon cancer. PMID- 2774459 TI - Subcutaneous ketamine analgesia: postoperative analgesia using subcutaneous infusions of ketamine and morphine. PMID- 2774460 TI - Minitracheostomy--a report of a proposed further development. PMID- 2774461 TI - Anterior spinal tuberculosis: paraplegia following laminectomy. PMID- 2774462 TI - Commission on the Provision of Surgical Services. The management of patients with major injuries. PMID- 2774463 TI - Patients who have undergone amputation. PMID- 2774465 TI - Trends towards increasing specialisation of the consultant surgeon in the United Kingdom. PMID- 2774464 TI - Structure of examinations of trainees in surgery. PMID- 2774467 TI - The place of research in surgical training. PMID- 2774466 TI - Helicopter Emergency Medical Services--HEMS One. PMID- 2774468 TI - Overseas Doctors Training Scheme in Surgery. PMID- 2774469 TI - Selected papers from the Conference on Disease Prevention and Health Enhancement. PMID- 2774470 TI - Ischaemic heart disease and its risk factors in Singapore in comparison with other countries. AB - Mortality from ischaemic heart disease in Singapore is now reaching comparability with the West. For the early 1980s, rates for Indians and Malays were higher than in U.S.A. and England and Wales and while those for Chinese were lower they were considerably higher than in Japan. In keeping with this the levels of the major risk factors in Singapore are now comparable to the West. Cigarette smoking in males is virtually the same as in Britain, while the proportion of hypertensives on medication is higher than in the West. The main cause for concern is the current high levels of serum cholesterol in Singapore and strenuous health education efforts are needed to bring about dietary changes. PMID- 2774471 TI - The role of fine needle aspiration for breast cancer in the climacteric--a preliminary report. AB - Fine needle biopsy has been used with great accuracy in the diagnosis of breast tumours. There have been few reports on its efficacy as an adjunct to other breast screening techniques like x-ray mammography. Abnormal mammograms in the absence of a palpable breast lump are sometimes detected in the climacteric and these pose a problem of tissue sampling for pathologic diagnosis. We have tried to evaluate the technique of radiologically guided fine needle aspiration in such patients. Our report is of an initial series of 13 cases of non-palpable, mammographically abnormal breast lesions. Eight cases were fibroadenoma, 4 cases mammary dysplasia and 1 a benign breast lesion. Representative cytologic samples were obtained in 11 of our 13 cases. Cytologic diagnosis should be correlated with mammographic findings. PMID- 2774472 TI - A pilot study on intensive lipid lowering--a new approach to cardiac rehabilitation. AB - The deleterious effects of raised plasma lipids on the progression of coronary artery disease has been well established. Recent research data suggests that intensive lipid lowering represents a new approach to Cardiac Rehabilitation. There was a total of twenty-four participants with twenty-one (87.5%) males and three (12.5%) females. There were seventeen Chinese (70.8%), six Indians (25%) and one Malay (4.2%). Their ages ranged from group forty to forty-nine, five participants (20%); fifty to fifty-nine, twelve participants (50%); sixty to sixty-nine, six participants (25%) and seventy to seventy-nine, one participant (5%). In this study, twelve individuals were treated with Cholestyramine, seven by Gemfibrozil, four by Clofibrate and three by Bezafibrate. The duration of antilipid treatment ranged from two to eighteen months (mean eight months). Side effects were reported in twelve patients (50%) on Cholestyramine who complained of constipation while one (4%) on Bezafibrate had abnormal liver function tests (raised SGOT and SGPT). All patients had been on an exercise and diet control program for one year which they were enrolled in an intensive lipid-lowering protocol. The pre and post treatment lipid profiles with lipid-lowering agents showed 18% reduction for Triglycerides, 15% reduction for Total Cholesterol, 5% increase for HDL-Cholesterol, 19% decrease in LDL Cholesterol, 19% decrease in Total Cholesterol: HDL ratios. The initial results suggest that an intensive lipid-lowering strategy in a Cardiac Rehabilitation Program appears to have a beneficial effect on lipid profiles and represents an expanded approach to lipid management involving exercise, nutrition and pharmacological intervention. PMID- 2774473 TI - International networking: coordinating health promotion strategies with multiple interventions. AB - Although practice variations in medical care is gaining wide attention, practicing physicians in the U.S. who were surveyed found time commitments and inadequate reimbursement were major barriers to recommending preventive procedures and advice to their patients. Those internists in the Pulmonary Disease Clinical specialty area are reported to have included patient counseling during thirty percent of all patient encounters during the study period. The comprehensive effects of health promotion interventions are recognised only as those practiced by populations independent of physicians' intervention. The health and population status reports for Singapore and the U.S.A. are presented. Green's health promotion evaluation model provides a process for inquiry, efficacy, and evaluation outcomes for health promotion strategies and programs. Resources and international networking are presented representing those within the University of North Carolina at Chapel Hill, U.S.A. PMID- 2774474 TI - Informed consumerism--education of the cardiac patient in the twenty-first century. AB - Education of cardiac patients in the 21st Century is likely to use newer technologies to help support the transfer of needed information, attitudes and behaviours, and skills. Appropriately used, technology may enable cost-effective, high quality instruction. PMID- 2774475 TI - Bone mineral content in women. AB - Osteoporosis is characterised by a reduction in bone mass that may result in fracture, particularly of the vertebrae, proximal femur and lower forearm. Dual photon absorptiometry is a reliable method of assessing Bone Mineral Content and thus predicting osteoporosis. Osteoporosis especially in women is preventable. For effective prevention we need to have a better understanding of the factors that control the bone mineral content. Further research in this area should be undertaken in our local population. PMID- 2774476 TI - Cholecysto-duodeno-colic fistula--a case report. AB - A rare case of cholecysto-duodenal-colic fistula presenting with non-faeculent vomiting, diarrhoea and loss of weight and appetite is reported. This fistula was demonstrated both by barium and endoscopic studies. She was treated with a simple closure of the fistulous tract and a cholecystectomy with good results. The surgical management of this condition is simple and rewarding. PMID- 2774477 TI - Radiological investigation of recurrent dislocation of the shoulder. AB - Various methods of radiological investigation of recurrent dislocation or subluxation of the shoulder are described and their merits compared. Magnetic resonance imaging is expensive and its role not yet well established in the evaluation of shoulder instability. Double contrast arthrography still provides an adequate examination of the shoulder joint. If the glenoid labrum needs to be better defined, this procedure should be followed by computerised tomography. PMID- 2774478 TI - Multiple splenic abscesses following Pseudomonas sepsis. AB - Splenic abscess is an unusual clinical entity, which in most cases is secondary to metastatic spread of bacteria from a primary site of infection. Before the antibiotic era, Salmonella typhi was a common offending organism but now staphylococci and streptococci are predominant organisms. We report two rare cases of multiple splenic abscesses caused by Pseudomonas infection. One case followed Pseudomonas septicaemia and the other was secondary to Pseudomonas pseudomallei osteomyletis of the femur. Both cases underwent splenectomy and promptly recovered. PMID- 2774479 TI - Intramedullary spinal cord metastasis. AB - Intramedullary spinal cord metastasis (ISM) is uncommon. It is one of the causes of a noncompressive myelopathy in a patient with systemic cancer. It is very difficult to diagnose clinically and on myelogram. We found the Magnetic Resonance Imaging appearance very useful in its diagnosis. We report one proven case of ISM to illustrate the diagnostic and therapeutic problem. PMID- 2774480 TI - Effect of altered eating pattern on serum fructosamine: total protein ratio and plasma glucose level. AB - The effect of alteration of eating pattern during Ramadan on body mass index (BMI), serum fructosamine: total protein ratio (F/TP), and glucose level in 18 healthy male Asiatic Moslems were studied. The results showed a significant decrease (p less than 0.025) in F/TP at the second week of Ramadan in 11 subjects who experienced continuous decrease in BMI throughout Ramadan. The remaining 7 subjects showed no significant changes in BMI and F/TP. No evidence of hypoglycaemia was observed in the subjects during the study. Serum fructosamine: total protein ratio in subjects with altered eating pattern preferably should be interpreted along with the change in body mass index. PMID- 2774481 TI - [Endoscopic percutaneous gastrostomy. Several precise details]. PMID- 2774482 TI - [Treatment of digestive cancers: 7 protocols proposed by the French Foundation of Digestive Cancerology]. PMID- 2774483 TI - [Does Q fever hepatitis mimic acute alcoholic hepatitis?]. AB - The authors report the case of a chronic alcoholic woman, hospitalized for chest pain accompanied with fever. The laboratory test mimic an acute alcoholic hepatitis; the presence of a clinical and radiological pulmonary affection led to the discovery of Q fever, the diagnosis of which was confirmed by serology and the discovery of a granuloma on histological examination of the liver. PMID- 2774484 TI - Results of surgical treatment in patients with bitemporal epileptiform abnormalities. AB - Fifty-three of 57 patients who had evidence of bitemporal epileptiform abnormalities and who required investigation with stereotactic depth electroencephalography (SDEEG) recordings to determine the site of origin of seizures underwent surgical resection for the treatment of their epilepsy. A minimum of 2 years' follow-up was available in 48 patients who underwent a temporal lobe resection. In this group, 19 patients (40%) were greatly improved, and of these 14 (29%) became seizure free and 5 (10%) had no more than 3 seizures each year. Another 22 patients (46%) showed a worthwhile reduction in seizure frequency of at least 50%. Seven patients (15%) were not significantly improved. An etiological factor of early convulsions before age 3 (usually febrile) was associated with a better outcome. Both the lack of a strong predominance for SDEEG-recorded seizures to arise in the resected temporal lobe and the presence of residual epileptiform abnormalities in the postexcision electrocorticogram were correlated with poorer results. PMID- 2774485 TI - Quantitation of cerebral atrophy in preclinical and end-stage Alzheimer's disease. AB - Morphometric analysis of standardized gross cerebral slices from 16 patients with end-stage Alzheimer's disease (AD), 14 controls without neuropathological lesions or neurological disease, and 4 neurologically intact nondemented patients with histopathological lesions of AD was used to measure cross-sectional areas of cerebral cortex, white matter, subcortical nuclei, and the ventricular system. In AD, there was global cerebral atrophy of both cortex and white matter, selective atrophy of the amygdala and hippocampus, and ex vacuo hydrocephalus. In addition, in half the cases of AD, white matter atrophy was associated with overt histopathological evidence of patchy rarefaction of fibers and gliosis. Patients with preclinical AD had prominent and selective shrinkage of white matter comparable to that observed in AD, yet their cortical areas were normal. These observations suggest that white matter degeneration is an intrinsic component of AD. Moreover, its presence in preclinical AD where cortical atrophy is not evident indicates that cytoskeletal abnormalities associated with axonal degeneration may precede and perhaps cause the cortical atrophy observed in clinically manifested AD. PMID- 2774486 TI - Simple and choice reaction time in patients with human immunodeficiency virus infection. AB - The performance of 56 homosexual men infected with human immunodeficiency virus (HIV) was compared to that of 23 HIV antibody-seronegative controls on simple (SRT) and choice (CRT) reaction time tasks. Patients were classified into 3 groups according to Centers for Disease Control clinical criteria. There were 18 patients who had acquired immunodeficiency syndrome (AIDS), 18 who had AIDS related complex (ARC), and 20 who were HIV antibody-seropositive but otherwise asymptomatic (HIV-Ab+). The SRT task consisted of 5 trials, each containing 10 target stimuli. The CRT task consisted of 10 trials, each containing 5 target stimuli randomly interspersed with 5 nontarget stimuli. The mean response latency of each of the patient groups on the SRT task was not significantly different from that of controls. However, the performance of patients with AIDS or ARC on the CRT task was significantly lower than that of controls, whereas that of HIV Ab+ patients was not. Analysis of the quality of RT task performance also indicated that the impairment of processing efficiency at higher levels of task difficulty reflected a disruption of processing prior to the response selection stage. PMID- 2774487 TI - Amyotrophic lateral sclerosis: abnormalities of the tongue on magnetic resonance imaging. AB - We compared the magnetic resonance images of the tongues of 16 amyotrophic lateral sclerosis (ALS) patients with those of 20 control patients and found the tongue in ALS patients is more frequently and more severely involved than suspected clinically, with major abnormalities of size, shape, position, and internal structure. The tongue size in ALS, as measured in the sagittal plane, can be reduced by as much as two-thirds of normal. The shape of the tongue in ALS tends to be rectangular or square rather than curved as is normal. As severity of the disease increases, the position of the tongue changes so that the bulk of the muscle falls away from the incisors and no longer is in contact with the hard or soft palate. The normal radial bands from the anterior floor of the mouth to the mucosal surface are often missing in ALS as are the two curvilinear bands that run parallel to the mucosal surface and intersect the radial bands. Also, there is a mottled disorganization of the internal structure of the tongue with areas of increased and decreased signal intensity. PMID- 2774488 TI - Continuous and intermittent levodopa differentially affect basal ganglia function. AB - The effects of continuous and intermittent levodopa treatment on behavioral and biochemical indexes of basal ganglia function were compared in rats with unilateral 6-hydroxydopamine lesions of the nigrostriatal dopamine pathway. Animals treated for 30 days with intermittent levodopa exhibited behavioral sensitization manifested by an enhanced rotational response to apomorphine; the rotational response of rats treated with an equivalent dose of levodopa by continuous infusion did not differ from that of saline-treated controls. Dopamine receptor up-regulation in the denervated striatum relative to the intact striatum was statistically significant for D1 but not D2 receptors: This asymmetry in dopamine receptor levels was diminished following intermittent levodopa treatment. Glutamic acid decarboxylase activity, modestly elevated in all groups in the denervated striatum relative to the intact striatum, increased substantially over control values bilaterally as a result of intermittent, but not continuous, levodopa treatment. These findings suggest a relation between the schedule of chronic levodopa administration and the development of behavioral sensitization, possibly as a consequence of alterations in neuronal systems located downstream from striatal dopamine receptors. The behavioral sensitization induced by chronic, intermittent dopaminomimetic treatment may serve as a model for motor fluctuations in Parkinson's disease. PMID- 2774489 TI - Normalization of short-chain acylcoenzyme A dehydrogenase after riboflavin treatment in a girl with multiple acylcoenzyme A dehydrogenase-deficient myopathy. AB - A 12-year-old girl was shown to have carnitine-deficient lipid storage myopathy and organic aciduria compatible with multiple acylcoenzyme A (acyl-CoA) dehydrogenase deficiency. In muscle mitochondria, activities of both short-chain acyl-CoA dehydrogenase (SCAD) and medium-chain acyl-CoA dehydrogenase (MCAD) were 35% of normal. Antibodies against purified SCAD, MCAD, and electron-transfer flavoprotein were used for detection of cross-reacting material (CRM) in the patient's mitochondria. Western blot analysis showed absence of SCAD-CRM, reduced amounts of MCAD-CRM, and normal amounts of electron-transfer flavoprotein-CRM. The patient, who was unresponsive to treatment with oral carnitine, improved dramatically with daily administration of 100 mg oral riboflavin. Increase in muscle bulk and strength and resolution of the organic aciduria were associated with normalization of SCAD activity and "reappearance" of SCAD-CRM. In contrast, both MCAD activity and MCAD-CRM remained lower than normal. These results suggest that in some patients with multiple acyl-CoA dehydrogenase deficiency riboflavin supplementation may be effective in restoring the activity of SCAD, and possibly of other mitochondrial flavin-dependent enzymes. PMID- 2774490 TI - Assessment of genetic risk for Alzheimer's disease among first-degree relatives. AB - Life table methods were used to determine the relative risk of Alzheimer's disease (AD) in relatives of index cases with AD. Risk of AD was assessed in 967 first-degree relatives of 128 probands with clinically diagnosed AD and 572 first degree relatives of a control group consisting of 84 subjects with Parkinson's disease (PD). Using a method that weights likelihood of correct diagnosis of AD, cumulative risk among AD relatives by age 93 was 24%, whereas relatives of the PD probands had a weighted risk of 16% by age 90. Overall, the total lifetime risk of developing dementia was similar among first-degree relatives of patients with AD and those of patients with PD. The age-specific risks were much different, however; from the age of 65 years to the age of 80 years, relatives of patients with AD had a twofold to fourfold increased risk of dementia. Equal risks were found for parents and siblings and for male and female relatives after adjustment for sex-specific patterns of survivorship. Relatives of probands with early-onset (less than or equal to 67 years) and late-onset (greater than 67 years) AD had equivalent risks of developing illness. Because onset age was found to cluster in families, the apparent increase in cumulative incidence for dementia in relatives of early-onset cases was likely due to relatives of the late-onset cases dying before developing illness.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2774491 TI - The lymphocyte saga continues. PMID- 2774492 TI - Epilepsy surgery: is it an effective treatment? PMID- 2774493 TI - Hereditary long Q-T syndrome presenting as epilepsy: electroencephalography laboratory diagnosis. AB - Patients with hereditary Q-T interval prolongation can present with seizures, syncope, and sudden death. In 2 siblings with autosomal dominant familial long Q T syndrome, electroencephalographic examinations performed 6 and 2 years before diagnosis included electrocardiographic tracings documenting the cardiac abnormality. A timely diagnosis of this condition may have prevented the death of 1 of these patients. Measurement of the corrected Q-T interval on electrocardiographic tracings obtained in the electroencephalography laboratory should be considered in selected patients. PMID- 2774494 TI - The effect of carbamazepine on cerebral glucose metabolism. AB - We used positron emission tomography with 18F-2-deoxy-D-glucose to study the effect of carbamazepine on local cerebral metabolic rate for glucose (lCMRGlc) in 9 patients with complex partial seizures. Twenty regions of interest were evaluated. Seven control patients had serial scans without a drug change. Metabolic rates were significantly (p less than 0.05) lower in patients on carbamazepine in 6 of 20 regions of interest (3 left cerebral hemisphere, 3 right). Mean lCMRGlc was 7.4 +/- 2.0 mg/min/100 in patients on carbamazepine and 8.8 +/- 2.5 in patients off carbamazepine (p less than 0.00005; cutoff level for 180 comparisons: 0.00027). The mean (+/- SEM) difference in lCMRGlc between scans was 12 +/- 2%. No significant changes in lCMRGlc on serial scans were detected in any of the 20 regions for the control group. The mean (+/- SEM) variation for control regions of interest was 1 +/- 1%. This study showed that carbamazepine depresses cerebral glucose metabolism as much as phenytoin does, but much less than phenobarbital does. The difference in effect on lCMRGlc may be related to drug mechanisms of action, as well as to effects on memory, learning, mood, and behavior. PMID- 2774495 TI - Swellings of proximal axons in a case of motor neuron disease. AB - Serial semithin sections of lumbar anterior horn cells from a patient with rapidly progressive sporadic motor neuron disease were searched for direct connections between swellings of neuronal processes and perikarya. Focal swellings of the proximal axons were not uncommonly seen to be connected directly to perikarya. These swellings varied in shape and size and some were identified as spheroids. Most of the cell bodies connected with swellings showed otherwise normal architecture. These observations suggest that the focal swellings of proximal axons, particularly the distal portion of the initial segment and the first internode of the myelinated axon, indicate an early pathological change, and may represent functionally and morphologically vulnerable sites. PMID- 2774496 TI - Pathogenesis of dyskinesias in Parkinson's disease. AB - Abnormal involuntary movements complicate the management of a majority of patients with advanced Parkinson's disease. The ability of levodopa to induce dyskinesias and alleviate parkinsonism has generally been considered a continuous dose-dependent pharmacological spectrum. In this study, the acute dose-response profile of intravenously administered levodopa for both inducing dyskinesia and alleviating parkinsonism, and its duration of action on these motor manifestations were evaluated in 52 parkinsonian patients. The minimum dose of levodopa required to produce mild dyskinetic movements was significantly lower in patients with fluctuations in motor response compared with those who had a stable response to standard oral therapy; the minimum dose for antiparkinsonian benefit, however, failed to show significant differences. The rate of disappearance of dyskinetic movements was faster than the rate of reappearance of parkinsonian signs following withdrawal of a steady-state infusion of levodopa. The dissociation of the pharmacodynamic profile of the two major motor effects of levodopa suggests their mediation through two different central pharmacological mechanisms, perhaps involving the two classes of dopamine receptors or other transmitter systems, and could have important implications for the design of future antiparkinsonian agents. PMID- 2774497 TI - Contamination of trigeminal evoked potentials by muscular artifacts. PMID- 2774498 TI - Magnetic resonance imaging morphology of the corpus callosum in monozygotic twins. AB - Recent reports describe wide variations in the size and shape of the human corpus callosum. To investigate genetic influences on this variability, magnetic resonance images from 5 pairs of monozygotic twins and 10 unrelated control subjects were analyzed. Measurements of size and shape revealed greater similarity in twin pairs than in randomly paired controls. The results are consistent with the view that the anatomy of the corpus callosum, while clearly influenced by nongenetic factors, is under considerable genetic control. PMID- 2774499 TI - Stiff-man syndrome, dysimmune disorder, and cancer. PMID- 2774500 TI - Predictors of outcome after intracerebral hemorrhage. PMID- 2774501 TI - Benign childhood epilepsy with occipital paroxysms: a 15-year prospective study. AB - Eighteen of 418 children who had onset of epilepsy before the age of 13 years showed clinical and electroencephalographic evidence of benign childhood epilepsy with occipital paroxysms. They represented one-fifth of all benign age- and localization-related idiopathic epilepsies seen. Some patients were followed as long as 15 years. There was a preponderance in females and peak age at onset of epilepsy was 5 years. In 16 children, the seizures were infrequent and sometimes prolonged and consisted mainly of tonic deviation of the eyes and vomiting, often with evolution to unilateral or generalized convulsions. Seizures were only nocturnal in 11 and nocturnal and diurnal in another 5 children. Prognosis was excellent; 5 children had only one fit. Remission usually occurred 1 to 2 years after onset and no seizures occurred after the age of 12 years. The remaining 2 children had frequent diurnal episodes consisting of visual hallucinations, postictal headache, and occasional nocturnal hemiconvulsions. Their prognosis was less favorable. Electroencephalographic abnormalities in all 18 patients consisted of repetitive spike and slow-wave discharges confined to the occipital regions and attenuated when the eyes were open. These outlasted clinical remission for many years, sometimes up to the age of 16. Fixation-off sensitivity was demonstrated frequently. Based on these findings, a unifying definition for benign childhood epilepsy with occipital paroxysms is proposed. PMID- 2774502 TI - Residual ethylene oxide in hollow fiber hemodialysis units is neurotoxic in vitro. AB - Ethylene oxide gas is used to sterilize plastic medical equipment including capillary flow dialysis membranes. To test whether ethylene oxide retained in the dialyzers might be neurotoxic, tissue culture medium was incubated in the blood compartment of dialyzers. Embryonic rat dorsal root ganglion neurons were then incubated in this medium for up to 5 days. During the first 24 hours axonal growth was normal. During the next 24-hour period varicosities appeared on axons, and after 4 days neuron cell bodies died. The pattern of degeneration was identical to that observed when cultures were exposed to an atmosphere containing 1 ppm ethylene oxide gas. Culture medium introduced into dialyzers after routine prerinsing still caused degeneration, which was not completely abolished even by a 10-liter rinse. When medium was exposed to identical dialyzers sterilized by gamma irradiation, no changes were seen in culture. Identical morphological changes were produced by using dialysis patient serum in the culture medium in place of the usual calf bovine serum. Such changes were never seen with control human serum. Since ethylene oxide is toxic to the human peripheral nervous system, it is proposed that ethylene oxide in dialyzers may contribute to the progressive neuropathy observed in patients on long-term hemodialysis. PMID- 2774503 TI - Amaurosis fugax and ocular infarction in adolescents and young adults. AB - Because the cause and natural history of amaurosis fugax and ocular infarction are unknown in most younger patients, we reviewed the records of 83 patients who had become symptomatic before the age of 45. Cerebral transient ischemic attacks had occurred in 9 of these patients but no case of stroke was found. A striking feature of these patients was that 41% had headache or orbital pain accompanying their amaurotic spells and an additional 25.3% had severe headaches independent of the visual loss. Results of laboratory studies were rarely abnormal and echocardiography disclosed that only 1 patient had previously unknown heart disease. Mitral valve prolapse was detected in 6.5%, a figure similar to that expected for the general population. Of the original 83 patients, 42 were reexamined after a mean period of 5.8 years. None of the patients in this group had had a stroke, and the clinical status at follow-up was not found to correlate with the duration of the visual loss (amaurosis fugax versus ocular infarction), frequency (single versus recurrent episodes), sex, presence of headache or heart disease, cigarette smoking, use of oral contraceptives, or abnormal findings on echocardiograms or laboratory studies. We conclude that amaurosis fugax and ocular infarction occurring in the younger patient are probably associated with a more benign clinical course than that seen in older persons and that migraine is a likely cause for the episodes of visual loss in a majority of this group. Because of this, we believe that a conservative approach to the evaluation of such patients seems warranted. PMID- 2774504 TI - Altered glucose metabolism in microvessels from patients with Alzheimer's disease. AB - Microvessels isolated from temporal cortex of patients with Alzheimer's disease showed decreased uptake of glucose when compared with vessels from age-matched or young control subjects. This was due to decreased hexokinase activity in the Alzheimer samples, as determined by ion exchange chromatography. This finding was confirmed independently by determination of the phosphorylation constant for hexokinase, K3, using positron emission tomography. The results suggest that Alzheimer's disease may result from a global defect in brain energy metabolism. PMID- 2774505 TI - Do oligodendrocytes mediate iron regulation in the human brain? AB - We used immunohistochemical studies to demonstrate that transferrin (the iron mobilization protein) and ferritin (the iron storage protein) are specifically localized in oligodendrocytes in gray and white matter of the human central nervous system. In addition, iron is also localized predominantly in oligodendrocytes. Oligodendrocytes have been well established as the cells responsible for myelin production in the central nervous system. The results of this study suggest that oligodendrocytes (or a subpopulation of oligodendrocytes) might have the additional function of mediating iron mobilization and storage in the central nervous system. PMID- 2774506 TI - A prospective study on sudden unexpected death in epilepsy. AB - Sudden unexpected death accounts for a substantial portion of deaths among epileptics. The incidence of this phenomenon is probably 1 in 370 to 1 in 1,110 in the general epileptic population but may be even higher in the 20- to 40-year age group, and still higher if epileptics with symptomatic epilepsy are selected. Sudden unexpected death in epileptics has been observed at least once weekly by the Office of the Medical Examiner of Cook County (Chicago), Illinois, for many years. A year-long prospective study revealed that victims of this complication of epilepsy are most commonly black males averaging 35 years of age who have infrequent generalized seizures and usually have some structural lesion in the brain responsible for their seizures. They tend to abuse alcohol and have poor compliance with anticonvulsant medication. The electroencephalograms display considerable variability from record to record. At autopsy the heart, lung, and liver weights were heavier and the brain weights were lighter than expected. The mechanisms involved in sudden unexpected death in epileptics may include autonomically mediated cardiac arrhythmia alone or in combination with sudden "neurogenic" pulmonary edema and "backward" cardiac failure. PMID- 2774507 TI - Aberrant guanosine triphosphate-beta-tubulin interaction in Alzheimer's disease. AB - Guanosine triphosphate (GTP) is an absolute requirement for tubulin polymerization in situ. The nucleotide photoaffinity probe 8-azidoguanosine 5' triphosphate (8N3GTP) has been shown to be a biological mimic of GTP in this system and, also, an effective active site probe of the exchangeable GTP binding site. Using [32P]8N3GTP we demonstrate that the exchangeable GTP site of the beta subunit of tubulin is available to added guanine nucleotide in normal aged brain homogenates, whereas it is variably unavailable in Alzheimer's diseased brain. Inability of 8N3GTP to photolabel beta tubulin appears to be associated with neurofibrillary tangle density. These results support the hypothesis that microtubule formation is abnormal in brains affected by Alzheimer's disease. PMID- 2774508 TI - Perceptual-motor and attentional correlates of developmental dyscalculia. AB - From the patient population of a learning disorders clinic, a group of 72 "relative math underachievers" was selected for achievement test performance below grade level on mathematics but at or above grade level on reading, with a difference of at least 1.5 standard deviation between the two. A comparison group of 30 "relative reading underachievers" met the converse criteria. Neurological examination showed mixed laterality preference (right hand and foot but left eye) to be more prevalent among the math underachievers. The two groups were closely comparable on Wechsler intelligence quotient scores, although the "freedom from distractibility quotient" tended to be lower for the match group. The latter group also showed a lower mean achievement quotient on the Bender Visuomotor Gestalt Test. On a standard questionnaire derived from DSM-III criteria for attention deficit disorder, the math group showed higher scores for inattention, but not for hyperactivity, impulsivity, or poor peer relations. Both perceptual motor and attentional deficits appear to characterize children who are specifically learning disabled for math. PMID- 2774510 TI - Abnormal pattern electroretinograms in patients with senile dementia of the Alzheimer type. AB - Patients with senile dementia of the Alzheimer type frequently have difficulty performing visual tasks. These difficulties may be due, at least partially, to degenerative changes in both the primary visual pathway and the visual association areas. To determine whether retinal ganglion cell dysfunction contributes to visual loss in senile dementia of the Alzheimer type, we tested a group of patients with this disease (n = 13) using the pattern-reversal electroretinogram to both low (4.0 reversals per second) and high (16.0 reversals per second) temporal frequency checkerboard patterns (1.0 degree checks). Significant amplitude reductions were noted for the patients relative to age matched control subjects (n = 30). In addition, the observed amplitude reductions were most pronounced for the high temporal frequency condition. Therefore, the results are consistent with retinal ganglion cell dysfunction and support the notion that optic nerve damage induced by senile dementia of the Alzheimer type preferentially affects the larger, faster-conducting retinal ganglion cells along with their retinocortical projections. PMID- 2774509 TI - Abnormal pattern electroretinogram in Alzheimer's disease: evidence for retinal ganglion cell degeneration? AB - We recorded pattern-reversal electroretinograms, flash electroretinograms, pattern-reversal visual evoked potentials, and flash visual evoked potentials in 6 patients with clinically diagnosed Alzheimer's disease and 6 age- and sex matched control subjects. The mean amplitude of the pattern-reversal electroretinogram in the Alzheimer patients was significantly less than that of the control group (p = 0.004). This anomaly of the pattern-reversal electroretinogram may be a reflection of documented axonal depletion within the optic nerve and the degeneration of retinal ganglion cells seen in Alzheimer's disease. We found Alzheimer patients to have normal pattern-reversal visual evoked potentials and flash electroretinograms, but a delayed second positive component of the flash visual evoked potential. This combination of findings may be of diagnostic import in Alzheimer's disease. PMID- 2774511 TI - Peripheral pharmacokinetics of apomorphine in humans. AB - Apomorphine, a potent dopamine agonist, has been used in acute and chronic studies of parkinsonism and other neurological disorders. To define its peripheral pharmacokinetics, we administered apomorphine by subcutaneous injection, by subcutaneous infusion, and by intravenous infusion to 15 patients with parkinsonism and measured plasma apomorphine levels by high-performance liquid chromatography with electrochemical detection. The peak drug levels and area under the curve were closely correlated with the dose administered; time to peak was brief and was independent of dose. The variation in absorption was high between subjects but low within individual subjects. In 11 of 15 subjects, the disappearance of drug could be described by a two-compartment model, with a distribution half-life of 5 minutes and an elimination half-life of 33 minutes. The drug absorption, volume of distribution, plasma clearance, and half-lives were similar for subcutaneous injection, subcutaneous infusion, and intravenous infusion. We conclude that apomorphine is rapidly and completely absorbed from subcutaneous tissue, correlating with the rapid onset of clinical effects, and that the brief duration of clinical action of the drug is explained by its rapid clearance. PMID- 2774512 TI - Chronic progressive multiple sclerosis: serial magnetic resonance brain imaging over six months. AB - Eight patients in the chronic progressive stage of multiple sclerosis were studied prospectively with magnetic resonance imaging of the head and neurological examination every 2 weeks for 6 months. There were no clinical relapses and disability ratings did not change between the start and completion of the study. Despite the clinical inactivity, a total of 86 active events (new, reappearing, or enlarging lesions) were identified by magnetic resonance imaging over the 6 months, with 50 (51%) of 98 follow-up scans showing evidence of one or more active lesions. New and changing lesions were indistinguishable in appearance, distribution, and temporal pattern from those previously seen in patients who had relapsing and remitting multiple sclerosis. However, as noted previously, the patients in the chronic progressive stage had many more confluent lesions than did the group in relapse. These results strongly suggest that the frequently observed clinical evolution of multiple sclerosis into a chronic progressive course is not accompanied by a fundamental change in the disease process. In fact the chronic progressive stage seems associated with more active changes demonstrated by scans than does relapsing and remitting multiple sclerosis. This study also confirms our previous experience that serial magnetic resonance imaging is much more sensitive than clinical examination in detecting disease activity in multiple sclerosis. PMID- 2774513 TI - Postmortem detection of measles virus in non-neural tissues in subacute sclerosing panencephalitis. AB - Subacute sclerosing panencephalitis, a rare, progressive, fatal central nervous system disease of children, is caused by measles virus. Clinical signs occur months to several years after recovery from acute measles infection. It is not known where the virus persists while the disease is inapparent. Involvement of organs outside the central nervous system has rarely been documented. To search for possible peripheral reservoirs of measles virus we used in situ hybridization to probe for measles virus RNA and immunocytochemical studies to localize measles virus antigens ina variety of organs taken at autopsy from confirmed cases of subacute sclerosing panencephalitis. Seven of 9 cadavers were found to contain measles virus RNA or antigens, or both, in at least one location outside the central nervous system. These sites included lymphoid organs such as thymus, spleen, lymph nodes, and tonsil, suggesting a role for lymphocytes in disease pathogenesis. Virus was also detected in kidney, lung, and glandular tissues such as pancreas, adrenal, and pituitary. These reservoirs may provide the antigenic stimulus leading to the elevated response characteristic for subacute sclerosing panencephalitis. PMID- 2774514 TI - Localization of immunoreactive thymosin alpha 1 in astrocytes of normal human brain. AB - We employed an immunocytochemical method to examine human brain for the presence of immunoreactive thymosin alpha 1 (T alpha 1), a peptide derivative of thymic tissue, using a well-characterized antiserum. For cell identification, serial sections were stained with antisera to thymosin beta 4(T beta 4), another thymic peptide that identifies oligodendrocytes, and with anti-glial fibrillary acidic protein (GFAP) antiserum that stains astrocytes in a double-staining technique using avidin-biotinylated horseradish peroxidase or avidin-biotinylated alkaline phosphatase complex. Antiserum to T alpha 1 stained the cell body, but not the processes, of GFAP-positive astrocytes, suggesting that T alpha 1 is a common antigen shared between thymus and astrocytes. Because T alpha 1 and its precursor molecule play a role in cell proliferation and immunomodulation, our findings could explain the role of astrocytes in certain central nervous system diseases. PMID- 2774515 TI - Direct evidence for calcium-induced ischemic and reperfusion injury. AB - Changes in cytosolic free calcium [( Ca2+]i) in the cat cortex were measured in vivo by indo-1 fluorometry during cerebral ischemia and reperfusion and were correlated to the histopathological ischemic changes. These changes were most pronounced in stroke cases with an increase in [Ca2+]i throughout the ischemic and reperfusion periods. Cases without a [Ca2+]i increase showed no histopathological change in the cortical gyrus in which [Ca2+]i was measured. The data support the hypothesis that an increase in [Ca2+]i during cerebral ischemia and reperfusion leads to neuronal damage. PMID- 2774516 TI - Acetaminophen metabolism by cytochrome P450 monooxygenases in Parkinson's disease. AB - It has been suggested that alterations in the activity of cytochrome P450 monooxygenases may play a role in the pathogenesis of Parkinson's disease, particularly in patients who had onset before the age of 40. We studied the P450 mediated metabolism of acetaminophen to 3-hydroxy-acetaminophen in 26 patients with Parkinson's disease and in 18 control subjects. After subjects ingested 1,000 mg acetaminophen, urine was collected under controlled conditions. Acetaminophen and 3-hydroxy-acetaminophen were measured in the urine using newly developed high-pressure liquid chromatography methods. The ratio of 3-hydroxy acetaminophen to acetaminophen was calculated for each patient and no significant differences were observed in patients compared with control subjects. Abnormal metabolism was not observed in patients who had onset of Parkinson's disease at or before the age of 40. In addition, no difference in metabolic activity was observed between the patients who were treated with levodopa/carbidopa and those who were not treated. These findings suggest that there are no alterations of P450-mediated metabolism of acetaminophen in patients with Parkinson's disease. PMID- 2774517 TI - Driving and Alzheimer's disease. PMID- 2774518 TI - Right-hemisphere speech, callosal size, perinatal brain insult, and schizophrenia. PMID- 2774519 TI - Anthropological studies in Assam, India. 7. Socio-biological observations on Assamese populations. AB - Three population groups of Assam, viz., the Hindus, Muslims and Mongoloids have been investigated for certain bio-social variables, e.g., size and composition of family, sex distribution, menarcheal age, age at marriage, marriage distance, conception, pregnancy wastage and fertility. The results are discussed on comparative basis, and attempts are made to offer possible reasons for differences. PMID- 2774520 TI - Genetic studies in a Hungarian isolate: Ivad. AB - A total of 675 individuals from the Hungarian isolate Ivad has been typed for 25 genetic polymorphisms. This sample was devided into three subgroups: 1. Full Ivadys (both spouses and their ancestors are members of the Ivad family; n = 330), 2. Half Ivadys (= either husband or wife and his or her, respectively, ancestors are from the Ivady family, the other partner from the outside population; n = 267), and 3. Non-Ivadys (married couples not belonging to the Ivady family; n = 78). The main concern of this paper is 1. to show to intra-Ivad variability of the distribution of various genetic parameters (allele frequencies, heterozygosity, gene diversity etc.) among these three groups, and 2. to analyze the impact of the different mating patterns of these groups on the genetic structure of the Ivad population. From the comparison of the Ivad gene frequencies with that of neighbouring populations (Petervasara and Erdokovesd) it is seen that drift or founder effects played some role. Within the Ivad population only few gene frequencies show a marked heterogeneity. As expected the average heterozygosity in Full Ivadys is somewhat lower than in Half Ivadys and Non-Ivadys, respectively. The pattern of genetic relationships of the various Ivad groups is in conformity with the demographic and historical facts of this village. PMID- 2774521 TI - Sexual dimorphism of the weight of internal organs in fetal ontogenesis. AB - The paper contains results of the investigation on the sexual differentiation of the weight of brain, heart, lungs, liver, spleen, kidneys, adrenal glands and thymus. The studies were carried out on a total of 632 fetuses (349 males and 283 females) and 1276 newborns (795 males and 481 females) in the age from 17 to 43 weeks of life. The study of sexual dimorphism of internal organs concludes that in the period of fetal development of man this dimorphism is weakly developed. PMID- 2774522 TI - Haem-containing protein complexes of Acinetobacter calcoaceticus as secondary electron acceptors for quinoprotein glucose dehydrogenase. PMID- 2774523 TI - First assistant article clarification. PMID- 2774524 TI - Latex gloves supplement. PMID- 2774525 TI - How much is an injury worth? PMID- 2774526 TI - Caregiving--learning to cope, learning the options. AB - Preplanning and education are the best ways caregivers can help themselves. This recommends learning about options before the need arises to alleviate some of the stress. Belonging to support groups is one way that caregivers can help each other. In addition to sharing their problems and concerns, group members recommend that keeping journals help to relieve stress. Reynolds, who took care of her father in her home, says that hindsight is invaluable. "If I had known about a company that ensured he would eat meals and take medication, I would have had some relief," she says. "I hope my experience can help other caregivers." PMID- 2774527 TI - Multichannel cochlear implants. Help for the profoundly deaf. PMID- 2774528 TI - Operative stretchers. Use in ophthalmologic procedures. AB - Operative stretchers have been used at Holy Spirit Hospital for more than 500 ophthalmologic procedures. Most of those procedures have been extracapsular cataract extraction with intraocular lens implants performed as ambulatory surgery procedures. We also have used these stretchers for the inpatient procedures such as scleral buckling. Because the stretchers eliminate the need to clean and remake a stationary OR bed between each procedure, we have decreased the downtime between cases. We have recently started using the operative stretchers in selected plastic and otolaryngology procedures. We have six operative stretchers in use and, at times, need more. PMID- 2774529 TI - Undergraduate OR experience. Are we meeting students' needs? PMID- 2774530 TI - Personal safety. It is a matter of awareness. AB - The safety and security points discussed in this article are only a few of the awareness tips that can add to your personal safety. When reporting to work, especially during odd hours, be suspicious of all activities. Ask yourself, "What if?" Becoming a victim or not becoming a victim is easy. PMID- 2774531 TI - Delegating intraoperative activities. A pilot study. AB - The purpose of phase one of this descriptive study was to obtain information about the research process. We identified problems associated with the pilot and examined the feasibility of completing phase two of the study at the national level. The pilot provided insight into the weaknesses and strengths of the tool design. It also identified interesting trends and data regarding delivery of intraoperative nursing care. The pilot study supported the ultimate goals of the research project, and we plan to continue with phase two of the study. Further research is needed to substantiate the findings and solidify the implications for perioperative nursing. PMID- 2774532 TI - Subclavian-external carotid artery bypass graft. Restoring blood flow to the brain. AB - This article describes an unusual surgery for a type of carotid artery disease. The perioperative nurse has an important role on the vascular team when performing this procedure. For this reason, a thorough knowledge of the events and possible complications are important in the care of these patients. Careful preoperative nursing assessment and postoperative follow-up will help prevent any complications and promote a successful outcome in these patients. PMID- 2774533 TI - Perioperative clinical simulations. Development and use in nursing education. PMID- 2774534 TI - Proposed recommended practices. Safe care through identification of potential hazards in the surgical environment. AORN Technical Practices Coordinating Committee. PMID- 2774536 TI - Nationwide mandatory seat belt, motorcycle helmet legislation proposed. PMID- 2774535 TI - Proposed recommended practices. Surgical attire. PMID- 2774537 TI - Perioperative nurses must prepare themselves to monitor patients receiving local anesthesia. PMID- 2774538 TI - No daughter of mine. PMID- 2774539 TI - Use of pulse oximeter with nail polish. PMID- 2774540 TI - Tetralogy of Fallot. Using pulmonary allograft conduits to reconstruct the right ventricular outflow tract. PMID- 2774541 TI - Aortoiliac occlusive disease. Treatment for the obese patient. PMID- 2774543 TI - Opening an outpatient facility. Conducting a mock run. AB - It was amazing how involved the nurses became in playing the roles. Throughout the entire mock run, they were cooperative, followed the rules of the game, and worked together as a team. The nurses were glad to have a chance to run through the various problems because it enabled them to become more comfortable with their new unit. The benefits of the mock run were realized by all involved. At the discussion group meetings, problems were identified and proposed solutions discussed. Also, a list of duties for opening the unit was developed. Some problems identified were not considered routine, such as: Where is the crash cart? Who takes the ECG (electrocardiogram)? Where are the narcotics kept? How does the new autoclave work? How and where is the patient discharged? Based on the discussion, educational needs were identified such as instructions on operating the autoclave and the new OR beds. Even in the final group discussion, many routine operational questions came up. PMID- 2774542 TI - Endoscopic retrograde cholangiopancreatography. A diagnostic outpatient procedure. AB - Increased numbers of diagnostic ERCPs will be performed in ambulatory surgery units because the patient's needs can be accommodated safely and efficiently in outpatient care centers, and insurance carriers and Medicare providers currently have guidelines for reimbursement purposes only if the patient has the procedure as an outpatient. PMID- 2774544 TI - Faculty practice. Issues and applications for perioperative nurses. PMID- 2774545 TI - Perioperative documentation. Incorporating nursing diagnoses into the intraoperative record. PMID- 2774546 TI - Preoperative patient teaching. Producing a video account. PMID- 2774547 TI - Accepting criticism. A positive process. AB - Criticism often has negative connotations, even when it is a planned supervisory technique and is part of a comprehensive approach aimed at improving employee behavior without damaging employee morale. The nurse may be the target of criticism from a variety of other people that he or she encounters in the health care setting. The nurse's response to criticism is important to optimal conflict resolution and to maintaining relationships with integrity. The nurse's actions and attitudes in response to criticism should be planned deliberately and directed at resolving the conflict. PMID- 2774548 TI - Recommended practices. Monitoring the patient receiving local anesthesia. AORN Technical Practices Coordinating Committee. PMID- 2774549 TI - Good Samaritan laws--who they protect and how. PMID- 2774550 TI - Interrelationships between water, food and digestible energy intake in desert and temperate goats. AB - Intra- and interspecific relationships between energy intake and digestible energy intake (DEI) and water turnover (WTO) in Black Bedouin and temperate (Swiss Saanen) goats were analyzed. Available data from other species of mammals were also evaluated. A highly significant linear relationship between WTO and DEI holds within breeds of goats under different levels of DEI and between breeds which vary considerably in their body weight and metabolic expenditure (WTO ml/kg per day = -5.4 + 0.911 DEI kcal/kg per day, n = 34, r2 = 0.99, Sb = 0.057). In lactating goats the relation between WTO rate (minus water secreted in milk) and DEI is the same as that measured in non-lactating ones. Mammals with quite a different body weight have the same WTO per unit of metabolism--about 1 mol of water per 5 mol of oxygen--although their absolute turnover is very different. Furthermore, the above relationship is similar to the relationship between WTO:DEI found in goats here. (WTO ml/kg per day = 5.8 + 0.849 x kcal/kg per day, n = 8, r2 = 0.99, Sb = 0.030, where x is the caloric equivalent of oxygen consumption. PMID- 2774551 TI - Changing children's food preferences: parent opinions. AB - This study is the first systematic survey directed at discovering the beliefs and practices of parents with respect to the creation of likes or dislikes for food by their young children. Seventy-six American parents completed a questionnaire that asked for their spontaneous suggestions about ways to create food likes and dislikes, and probed their opinions of the effectiveness, and frequency of use, of 11 possible methods for creating food likes and six for creating dislikes. Favored methods for creation of likes most commonly invoked a positive social affective context, such as indication to the child that parents like the food in question, or involving the child in preparation of the food. Coercive methods were thought to be ineffective. Contrary to the overjustification literature, parents thought that rewarding ingestion of a target food would be at least as likely to produce an increased liking for the food as using the target food as a reward. Parents were more forthcoming with suggestions for creating likes than for creating dislikes. While parents believe that mixing a target food with a highly desirable or undesirable food can change the preference for the target food, they rarely use this technique. Parents of children who were problem eaters showed no characteristic differences in training practices or attitudes. PMID- 2774552 TI - Xth International Conference on the Physiology of Food and Fluid Intake. Paris (France), 4-8 July 1989. Abstracts. PMID- 2774553 TI - Glutathione-S-transferases are major cytosolic thyroid hormone binding proteins. AB - Thyroid hormone binding proteins of rat liver cytosol were characterized. Glutathione-S-transferases were identified among major cytosolic proteins adsorbed by thyroxine affinity matrices. The Ya and Yb subunits of the glutathione-S-transferases were also principal proteins of cytosol covalently labeled with 3,3',5-triiodo-L-thyronine (T3) or 3,3',5,5'-tetraiodo-L-thyronine (T4) by photoaffinity methods. T3 and T4, but not L-thyronine or iodinated tyrosines, were bound with high affinity to purified glutathione-S-transferases and were potent inhibitors of their enzymatic activities. These results suggest that glutathione-S-transferases have the potential to function in the intracellular binding and transport of thyroid hormones. The proteins provide a means for regulating the action and metabolism of thyroid hormones by acting as high capacity binding components. PMID- 2774554 TI - Interaction of ferric complexes with rat liver nuclei to catalyze NADH-and NADPH Dependent production of oxygen radicals. AB - The production of potent oxygen radicals by microsomal reaction systems has been well characterized. Relatively little attention has been paid to generation of oxygen radicals by liver nuclei, or to the interaction of nuclei with different ferric complexes to catalyze NADH- or NADPH-dependent production of reactive oxygen intermediates. Intact rat liver nuclei were capable of catalyzing an iron dependent production of .OH as reflected by the oxidation of .OH scavenging agents such as 2-keto-4-thiomethylbutyrate, dimethyl sulfoxide, and t-butyl alcohol. Inhibition of .OH production by catalase implicates H2O2 as the precursor of .OH generated by the nuclei, whereas superoxide dismutase had only a partially inhibitory effect. The production of .OH with either cofactor was striking increased by addition of ferric-EDTA or ferric-diethylenetriamine pentaacetic acid (DTPA) whereas ferric-ATP and ferric-citrate were not effective catalysts. All these ferric complexes were reduced by the nuclei in the presence of either NADPH or NADH. The pattern of iron chelate effectiveness in catalyzing lipid peroxidation by nuclei was opposite to that of .OH production; with either NADH or NADPH, nuclear lipid peroxidation was increased by the addition of ferric ammonium sulfate, ferric-ATP, or ferric-citrate, but not by ferric-EDTA or ferric DTPA. NADPH-dependent nuclear lipid peroxidation was insensitive to catalase, superoxide dismutase, or .OH scavengers; the NADH-dependent reaction showed a partial sensitivity (30 to 40%) to these additions. The overall patterns of .OH production and lipid peroxidation by the nuclei are similar to those shown by microsomes, e.g., effect of ferric complexes, sensitivity to antioxidants; however, rates with the nuclei are less than 20% those of microsomes, which reflect the lower activities of NADPH- and NADH-cytochrome c reductase in the nuclei. The potential for nuclei to reduce ferric complexes and catalyze production of .OH-like species may play a role in the susceptibility of the genetic material to oxidative damage under certain conditions since such radicals would be produced site-directed and not exposed to cellular antioxidants. PMID- 2774556 TI - Hemolysis by aliphatic alcohols and saponin measured by the coil planet centrifugation method. AB - Using the coil planet centrifugation method, the mechanism of hemolysis by alcohols and saponin was investigated. With this technique, erythrocytes are introduced into a gradient of hemolytic agents in saline, which is prepared in a long coiled polyethylene tube. The tube is centrifuged so that the cells move from a low to a high concentration of hemolytic agent. When the cells lyse, they release hemoglobin which remains stationary, and therefore hemolytic potency can be determined spectrophotometrically by the distance the cells move before lysing. We found that alcohols caused hemolysis at a particular concentration, whereas saponin-induced hemolysis was dependent on the amount of saponin accumulated in the environment of the cell. In addition, alcohols with longer carbon chains were more potent hemolytic agents than those with shorter chains, but each additional carbon group produced less of an increase in hemolysis per mole of alcohol. This chain-length dependency is consistent with a previous study on in vivo alcohol-induced hemolysis. The coil planet centrifugation method is also adaptable to comparative studies on the mechanism of other types of hemolysis, such as immune or drug-induced lysis, and to toxicological studies. PMID- 2774555 TI - Partial purification and properties of geranyl pyrophosphate synthase from Lithospermum erythrorhizon cell cultures. AB - A prenyltransferase (EC 2.5.1.1) was isolated from cell cultures of Lithospermum erythrorhizon. The enzyme was purified 92-fold by subsequent chromatography on DEAE-Sephacel, phenyl-Sepharose, and Sephadex G-150. Geranyl pyrophosphate (GPP) was the sole product of the enzymatic reaction with dimethylallyl pyrophosphate and isopentenyl pyrophosphate as the substrates. The enzyme showed a molecular weight of 73,000, estimated by gel chromatography on Sephadex G-150, and an isoelectric point at pH 4.95, determined by analytical isoelectric focusing. It had an absolute requirement for a divalent cation with Mg2+ and Mn2+ being most effective. The enzyme was soluble rather than membrane-bound. The physiological role of this prenyltransferase probably is to supply GPP for the biosynthesis of shikonin. It is the first chain-length specific geranyl pyrophosphate synthase reported from eukaryotic cells. PMID- 2774557 TI - Isolation of human blood coagulation alpha-factor Xa by soybean trypsin inhibitor sepharose chromatography and its active-site titration with fluorescein mono-p guanidinobenzoate. AB - A method based on active-site affinity chromatography on soybean trypsin inhibitor (SBTI)-Sepharose was developed for isolation of human factor Xa in primarily the undergraded alpha-form. The chromatography procedure separated factor Xa from factor X, the Russel's viper venom proteinase used to activate factor X, and traces of contaminating thrombin. alpha-Factor Xa was unstable at pH 7.6 and 25 degrees C, undergoing slow proteolytic degradation to functionally heterogeneous products as evidenced by the greater loss of coagulation assay activity compared to activity measured with a chromogenic substrate. The results of monitoring factor Xa degradation by sodium dodecyl sulfate-polyacrylamide gel electrophoresis were consistent with proteolysis of the light chain as a major component reaction occurring in parallel with slower proteolysis of the heavy chain. The decreased rates of these reactions at pH 6.0 enabled isolation and storage of factor Xa in greater than or equal to 88% alpha-form and minimized the heterogeneity due to proteolytic degradation. Characterization of the reaction of fluorescein mono-p-guanidinobenzoate (FMGB) with human and bovine factor Xa isolated by SBTI-Sepharose chromatography demonstrated its utility as a sensitive reagent for continuous fluorometric active-site titration. Analysis of the reaction kinetics as a function of FMGB and human factor Xa concentrations in G/2 0.3, pH 7.4, buffer at 25 degrees C indicated that the ratio of acylation to deacylation rate constants was greater than 200 and that the Km for FMGB was 0.06 0.11 microM, predicting pre-steady-state burst amplitudes of greater than or equal to 96-98% of the active-site concentration at FMGB concentrations greater than or equal to 5 microM. Human factor Xa active-site concentrations were consistent with 82-99% active preparations when compared with the protein concentrations determined from the 280-nm absorbance. Concentrations of human alpha-factor Xa as low as 20 nM could be measured with FMGB, indicating a sensitivity approximately 50 times greater than that measured by spectrophotometric active-site titration with p-nitophenyl p'-guanidinobenzoate. PMID- 2774558 TI - Isolation and characterization of thymosin beta 9 Met from pork spleen. AB - We have identified a new thymosin beta 4-like peptide in pork spleen. The new peptide (12 mg) and thymosin beta 4 (33 mg) were isolated from 230 g of spleen by solid phase extraction, preparative isoelectric focusing, and HPLC. The new peptide was termed thymosin beta 9 Met to indicate its close relationship to thymosin beta 9 from calf. The only difference from thymosin beta 9 is the substitution of leucine by methionine at position 6. This peptide replaces thymosin beta 10 which is the minor thymosin beta 4-like peptide in most mammals, e.g., in man, rat, mouse, cat, and rabbit. The structure was determined by amino acid analysis, tryptic digestion, and carboxypeptidase digestion. Pork spleen contains 192 micrograms of thymosin beta 4 and 117 micrograms of thymosin beta 9 Met per gram of tissue. PMID- 2774559 TI - Purification and properties of novel molluscan metallothioneins. AB - Two low-molecular-mass cadmium-induced, cadmium-, zinc-binding proteins were purified from the oyster Crassostrea virginica using procedures that included acetone precipitation, Sephadex gel chromatography, and anion-exchange and reverse-phase high-performance liquid chromatography. Although they could be cleanly separated from each other, they exhibited similar molecular weights, metal and amino acid compositions, and electrophoretic behavior. These proteins were glycine-rich, in addition to being cysteine-rich, and lacked methionine, histidine, arginine, and the aromatic amino acids phenylalanine and tyrosine. Determination of the NH2-terminal amino acid sequence of these molecules showed that they were identical in primary structure in this region and differed only in that one had a blocked NH2-terminal. This provided an explanation for the isolation of two proteins with otherwise identical characteristics. Serine was the NH2-terminal amino acid. The sequence was most similar to that of vertebrate metallothioneins when compared with other proteins, which included metallothioneins from other invertebrate phyla. All cysteines in the first 27 residues of the oyster metallothionein aligned with those in the mammalian forms. On this basis, these proteins were classified as class I metallothioneins. PMID- 2774560 TI - Mechanistic studies of the dioxygenase and leukotriene synthase activities of the porcine leukocyte 12S-lipoxygenase. AB - Lipoxygenases react with hydroperoxy fatty acids and catalyze dioxygenase or dehydrase (leukotriene A4 (LTA4) synthase) types of reactions. In the present investigation we studied the mechanism of reaction of the purified porcine leukocyte 12S-lipoxygenase with 15S-hydroperoxyeicosatetraenoic acid (15S-HPETE). Oxygen-18 labeling experiments with GC-MS analysis were used to distinguish dioxygenase and leukotriene synthase activities of the enzyme; 8S,15S-DiHPETE and 14R,15S-DiHPETE were formed by oxygenation, and a series of 8,15- and 14,15-diols were formed via enzymatic synthesis of 14,15-LTA4 and nonenzymatic hydrolysis of the epoxide. 10D-3H- and 10L-3H-labeled substrates were used to study the stereospecificity of the C-10 hydrogen abstraction in the synthesis of these products. Formation of 14,15-DiHPETE and 14,15-LTA4 was associated with stereoselective abstraction of hydrogen from the 10L position of 15S-HPETE. The same type of measurements on the 8S,15S-DiHPETE product indicated a variable (50 250%) retention of the 10L-3H label, and a consistent 90% retention of the 10D 3H. In contrast, the synthesis of 8S,15S-DiHPETE by the soybean lipoxygenase was associated with the expected stereoselective abstraction of the 10D hydrogen. It appears that the porcine leukocyte 12S-lipoxygenase synthesizes 8S,15S-DiHPETE by a different mechanism. PMID- 2774561 TI - In vitro effects of acetaminophen metabolites and analogs on the respiration of mouse liver mitochondria. AB - Acetaminophen, an analgesic and antipyretic, is toxic in overdose to liver and kidney. The effects on mitochondrial respiration of acetaminophen, its less toxic analog, 3-hydroxyacetanilide, and metabolites which arise from these compounds have been investigated. The parent compounds inhibited NADH-linked respiration reversibly, whereas the metabolites inhibit all mitochondrial respiration, apparently in the Complex III region of the respiratory chain. The quinone derivatives, 4-acetamido-o-benzoquinone and 2-acetamido-p-benzoquinone, are the best inhibitors, with the onset of inhibition dependent on active respiration, suggesting interaction of these compounds with oxidized components of the electron transport chain. PMID- 2774562 TI - Ah receptor for 2,3,7,8-tetrachlorodibenzo-p-dioxin in rat liver: lack of sensitivity to alkaline phosphatase when compared with that of glucocorticoid receptor. AB - Rat hepatic cytosol was treated with alkaline phosphatase in order to determine if dephosphorylation altered the ability of Ah receptor to bind 2,3,7,8 [3H]tetrachlorodibenzo-p-dioxin (TCDD). Glucocorticoid receptor was studied for comparison. As previously had been shown in other laboratories, treatment of cytosol with purified alkaline phosphatase dramatically reduced the subsequent ability of glucocorticoid receptor to bind hormone. However, alkaline phosphatase had no effect on the ability of Ah receptor to bind [3H]TCDD. If either glucocorticoid receptor or Ah receptor was occupied by its ligand prior to exposure to alkaline phosphatase there was no loss in ligand binding capacity. Crude alkaline phosphatase (containing some protease activity) substantially reduced the ability of glucocorticoid receptor to bind hormone and shifted the sedimentation position of the glucocorticoid receptor from approximately 8 S to approximately 2 S. Crude alkaline phosphatase did not reduce the ability of Ah receptor to bind [3H]TCDD and did not alter sedimentation of the 9 S [3H]TCDD. Ah receptor complex. Although the Ah receptor appears to be a member of the steroid receptor superfamily, the lack of effect of alkaline phosphatase on Ah receptor (compared to the sensitivity of glucocorticoid receptor) highlights another significant difference in molecular characteristics between the Ah receptor and the receptors for steroid hormones. PMID- 2774564 TI - Redox cycling of myoglobin and ascorbate: a potential protective mechanism against oxidative reperfusion injury in muscle. AB - Metmyoglobin catalyzes the decomposition of H2O2 as well as other hydroperoxides by using ascorbic acid as a substrate. The ratio of H2O2 reduced to ascorbate oxidized is close to one, whereas the rate of oxidation is directly proportional to both H2O2 and metmyoglobin concentrations. Ascorbate also prevents the protein modifications and the O2 evolution that accompany the reaction of metmyoglobin with hydroperoxides. In the absence of ascorbate, myoglobin and H2O2 promote the peroxidation of unsaturated fatty acids and, thus, may cause damage to cellular constituents. However, lipid peroxidation is inhibited in the presence of ascorbate and, for this reason, it is suggested that this heme protein functions in the opposite manner. The redox cycling of myoglobin by ascorbate may act as an important electron "sink" and defense mechanism against peroxides during oxidative challenge to muscle. PMID- 2774563 TI - Relationships between the NAD(P) redox state, fatty acid oxidation, and inner membrane permeability in rat liver mitochondria. AB - Dysfunction of mitochondria after oxidation of endogenous NAD(P)H, especially after calcium accumulation, has been abundantly reported, but the causes of membrane perturbations did not receive a full explanation. In light of several additional observations reported in this study, we propose a general scheme which shows the sequential processes that are likely involved in the appearance of calcium-induced membrane leakiness. Addition of acetoacetate, oxaloacetate, or ketomalonate to rotenone-treated mitochondria led to a massive oxidation of both NADH and NADPH. Under these conditions, stimulation of fatty acid oxidation could be observed. This process was shown to be accompanied by a reduction of intramitochondrial NADP+. The reduction of NADP+ was inhibited by uncouplers, electron transfer inhibitors and N,N'-dicyclohexylcarbodiimide. It was thus probably catalyzed by the mitochondrial transhydrogenase. Oxidation of pyridine nucleotides in the presence of acetoacetate induced (i) a slight decrease in the number of sulfhydryl groups reactive with N-ethylmaleimide (but no change in the amount of intramitochondrial reduced glutathione) and (ii) modifications of the kinetics and the orientation of the ADP/ATP carrier. In the presence of calcium ions, acetoacetate-stimulated fatty acid oxidation promoted an extensive swelling of mitochondria. Uptake of calcium ions into the matrix was a critical factor for triggering the swelling. Thiols, if they were added at a sufficiently high concentration, suppressed the swelling. Also ligands of the ADP/ATP carrier which stabilized the m-state conformation of the protein, exerted an efficient protective action. Three essential interacting factors emerge from this study: (i) The crucial role of the ADP/ATP carrier orientation in promoting the calcium induced membrane destabilization. More precisely, it has been shown that the ADP/ATP carrier adopts the c-state conformation (i.e., nucleotide binding site facing the cytoplasm) during fatty acid oxidation. (ii) The modification of a very small number of sulfhydryl groups of mitochondrial protein. These groups are probably in an oxidized state when the level of reduced pyridine nucleotides is low. (iii) The prevailing role of the transhydrogenase, the function of which is also intimately associated with fatty acid oxidation. After energization, transhydrogenase can hinder thiol oxidation and therefore partially protect the membrane structure. PMID- 2774565 TI - Characteristics of the sulfation of N-linked oligosaccharides in vesicles from Dictyostelium discoideum: in vitro sulfation of lysosomal enzymes. AB - Lysosomal enzymes from Dictyostelium discoideum contain unusual sulfated N-linked oligosaccharides, whose synthesis has been well studied in vivo. However, little is known about the properties of the pertinent sulfotransferases. To study these transferases, we have prepared a cell-free system which transfers 35SO4 from 3' phosphoadenosine 5'-phosphosulfate to either endogenous or exogenous acceptors. We found that the 35SO4 was released from macromolecules by protein N-glycanase F to yield a mixture of anionic oligosaccharides with 1-6 negative charges. Some of the labeled molecules contained acid-stable methyl phosphodiesters but none contained phosphomoesters or acid-labile diesters. The sulfate was found in molecules with the acid stability characteristic of esters of primary alcohols. In all these ways, the products resembled those generated in vivo. We also demonstrated that a membrane-associated form of beta-hexosaminidase and the precursor of alpha-mannosidase were among the products. In addition, glycoproteins prepared from a sulfation-deficient mutant strain could act as exogenous acceptors in permeabilized vesicles. PMID- 2774566 TI - An immunologically related family of apolipoproteins associated with triacylglycerol storage in the Cruciferae. AB - The major apolipoproteins associated with oil-storage bodies have been isolated from the mature seeds of six different species of the family Cruciferae. The apolipoproteins were all of molecular mass 19-20 kDa. They were highly abundant in mature seed tissue, accounting for up to 20% total seed proteins, and were localized exclusively on the membranes of oil-storage bodies. Antibodies were raised in rabbits and mice against the six purified apolipoproteins. In each case, the antibodies specifically recognized 19-20 kDa polypeptides on immunoblots of total seed proteins from 15 different species of the Cruciferae. The extent of the immunological cross-reactivity among the six purified seed apolipoproteins of the Cruciferae was investigated quantitatively using enzyme linked immunosorbent assay. Very high levels of cross-reactivity were obtained, in contrast to a complete lack of cross-reactivity observed when the major seed apolipoprotein of a non-crucifer, Glycine max, was assayed. Peptide mapping studies showed that the different crucifer seed apolipoproteins gave rise to similar proteolytic cleavage products following treatment with Staphylococcus aureus V8 protease, Lysobacter enzymogenes Lys-C endoprotease, and trypsin. The patterns of immunogenic proteolytic cleavage products of the different apolipoproteins were also similar. We propose that there is a family of abundant 19-20 kDa apolipoproteins in mature seeds of oil-bearing Cruciferae. These apolipoproteins are all major components of the membranes of oil-storage bodies. The apolipoproteins are therefore very closely related with respect to their structure, function, and immunological properties. PMID- 2774567 TI - Bioactivation mechanism of L-thiomorpholine-3-carboxylic acid. AB - L-Thiomorpholine-3-carboxylic acid (L-TMC) is a cyclized analog of S-(2 chloroethyl)-L-cysteine, which is cytotoxic in vitro and nephrotoxic in vivo. To determine whether L-TMC may play a role in S-(2-chloroethyl)-L-cysteine-induced toxicity, the cytotoxicity of L-TMC was studied in isolated rat kidney cells. L TMC produced time- and concentration-dependent cytotoxicity. Probenecid, an inhibitor of the renal anion transport system, and L-alpha-hydroxyisocaproic acid, a substrate for L-amino acid oxidase, inhibited L-TMC-induced cytotoxicity. Rat kidney cytosol catalyzed the metabolism of L-TMC to a product absorbing at 300 nm. The increase in absorbance at 300 nm was accompanied by an increase in oxygen consumption and was inhibited by L-alpha-hydroxyisocaproic acid; moreover, the absorbance of the metabolite was quenched by addition of potassium cyanide or sodium borohydride, which indicated the formation of an imine. When L-TMC was incubated with rat kidney cytosol and sodium borodeuteride was added at the end of the incubation period, analysis by gas chromatography/mass spectrometry of the tert-butyldimethylsilyl ester of L-TMC showed the formation of [2H]TMC, indicating the intermediate formation of the imine 5,6-dihydro-2H-1,4-thiazine-3 carboxylic acid; chemically synthesized TMC imine showed similar behavior. The enzyme responsible for the metabolism of L-TMC was purified from rat kidney and was identified as L-amino acid oxidase. These observations indicate a role for L amino acid oxidase in the bioactivation and cytotoxicity of L-TMC. PMID- 2774568 TI - Binding of copper to albumin and participation of cysteine in vivo and in vitro. AB - Albumin, the major copper-binding protein in blood serum, was shown to form different albumin-copper complexes in in vivo and in vitro. Cupric ions added in vitro to control rat serum bound preferentially to mercaptalbumin and the mercaptalbumin-copper complex remained unchanged with time. Cupric ions injected intravenously into the rat first formed the mercaptalbumin-copper complex; this binary complex changed gradually with time to form an albumin-copper-cysteine complex. The participation of cysteine in the formation of this complex was demonstrated in vitro and further suggested that its conversion was an oxidative reaction. Glutathione also participated in forming the complex, but it was not as effective as cysteine. Albumin-copper complexes were separated on a gel filtration column and detected simultaneously by high-performance liquid chromatography-inductively coupled argon plasma-atomic emission spectrometry. PMID- 2774569 TI - Penetration and fusion of phospholipid vesicles by lysozyme. AB - The lysozyme-induced fusion of phosphatidylserine/phosphatidylethanolamine vesicles as studied at a wide range of pH is found to correlate well with the binding of this protein to the vesicles. An identical 6000 molecular weight segment of lysozyme at the N-terminal region is found to be protected from tryptic digestion when initially incubated with vesicles at several pH values. Only this segment is labeled by dansyl chloride, which is partitioned into the bilayer. These results suggest the penetration of one segment of lysozyme into the bilayer. Photoactivated labeling of the membrane-penetrating segment of lysozyme with 3-(trifluoromethyl)-3-([125I]iodophenyl)diazirine ([125I]TID) and subsequent identification of the labeled residues by Edman degradation and gamma ray counting indicate that four amino acids from the N-terminal are located outside the hydrophobic core of the bilayer. Although treatment of the membrane embedded segment with aminopeptidase failed to cleave any amino acids from the N terminal, it appears that a loop of lysozyme segment near the N-terminal penetrates into the bilayer at acidic pH. A helical wheel diagram shows that the labeling is done mainly on one surface of the alpha-helix. The penetration kinetics as studied by time-dependent [125I]TID labeling coincide with the fusion kinetics, strongly suggesting that the penetration of the lysozyme segment into the vesicles is the cause of the fusion. PMID- 2774570 TI - Phosphorylase a formation in protein-glycogen particles isolated from fast-twitch muscle of euthyroid and hypothyroid rats. AB - A fraction containing a protein-glycogen complex was isolated from rat skeletal muscle in order to study the effect of hypothyroidism on phosphorylase activation in this structural and functional unit of the glycogenolytic process. The total activities of phosphorylase and phosphorylase phosphatase in euthyroids and hypothyroids were the same in the fraction containing the protein-glycogen complex (P2 suspension). Hypothyroidism selectively lowered the maximal phosphorylase kinase activity in glycogen particles in the P2 suspension by 40%. Addition of Mg2+ (10 mM), ATP (2 mM), and Ca2+ (5 mM) rapidly stimulated phosphorylase b to a conversion resulting from phosphorylase kinase activation. Hypothyroidism reduced the rate of phosphorylase a formation by 50-70% in the P2 suspension. Glucose 6-phosphate (0.4-1.4 mM) inhibited the rate of phosphorylase a formation and this inhibition was similar for eu- and hypothyroids. There was a shift from 5.2 to 5.8 in the free Ca2+ concentration (pCaF) for half-maximal activation of phosphorylase in the P2 suspension of hypothyroids. A sixfold higher steady-state level of phosphorylase in euthyroids compared to hypothyroids was observed at a pCaF of 5.5. The Ca2+ sensitivity of the phosphorylase kinase, however, was not changed by hypothyroidism. These results provide further insight into the different time course of the phosphorylase activation in skeletal muscle during tetanic stimulation observed in euthyroidism and hypothyroidism (W. J. Leijendekker et al. (1985) Metabolism 34, 437-441). PMID- 2774571 TI - Retinoic acid synthesis by cytosol from the alcohol dehydrogenase negative deermouse. AB - Cytosolic alcohol dehydrogenase in the deermouse is coded by a single genetic locus and a strain of the deermouse which is alcohol dehydrogenase negative exists. These two strains of the deermouse were used to extend insight into the role of cytosolic alcohol dehydrogenases in the conversion of retinol into retinoic acid. Retinoic acid synthesis from physiological concentrations of retinol (7.5 microM) with cytosol from the alcohol dehydrogenase negative deermouse was 13% (liver), 14% (kidney), 60% (testes), 78% (lung), and 100% (small intestinal mucosa) of that observed with cytosol from the positive deermouse. The rates in the negative strain ranged from 0.3 to 0.7 nmol/h/mg protein: sufficient to fulfill cellular needs for retinoic acid. Ten millimolar 4 methylpyrazole inhibited retinoic acid synthesis 92, 94, 26, and 30% in kidney, liver, lung, and testes of the positive deermouse, respectively, but only 50, 30, 0, and 0% in the same tissues from the negative deermouse. Ethanol (300 mM) did not inhibit retinoic acid synthesis in kidney cytosol from the negative strain. Therefore multiple cytosolic dehydrogenases, including alcohol dehydrogenases, contribute to retinol metabolism in vitro. The only enzyme(s) likely to be physiologically significant to retinoic acid synthesis in vivo, however, is the class of dehydrogenase, distinct from ethanol dehydrogenase, that is common to both the positive and the negative deermouse. This conclusion is supported by the data described above, the kinetics of retinoic acid synthesis and retinal reduction in kidney cytosol from the negative deermouse, and the very existence of the alcohol dehydrogenase negative deermouse. This work also shows that microsomes inhibit the cytosolic conversion of retinol into retinoic acid and that the synthesis of retinal, a retinoid that has no known function outside of the eye, does not reflect the ability or capacity of a sample to synthesize retinoic acid. PMID- 2774572 TI - Macromolecular components of tomato fruit pectin. AB - Chelate and alkaline-soluble pectin extracted from cell walls of pericarp tissue from mature green, turning, and red ripe (Lycopersicon esculentum Mill.) fruit (cv. Rutgers), were studied by high-performance size-exclusion chromatography. Computer-aided curve fitting of the chromatograms to a series of Gaussian-shaped components revealed that pectin from all fractions was composed of a linear combination of five macromolecular-sized species. The relative sizes of these macromolecules as obtained from their radii of gyration were 1:2:4:8:16. Dialysis against 0.05 M NaCl induced partial dissociation of the biopolymers. Apparently, the weight fraction of smaller sized species increased at the expense of larger ones. Also, the dissociation produced low-molecular-weight fragments. Behavior in the presence of 0.05 M NaCl led to the conclusion that cell wall pectin acted as if it were an aggregated mosaic, held together at least partially through noncovalent interactions. PMID- 2774573 TI - Cholate effects on all-trans-retinyl palmitate hydrolysis in tissue homogenates: solubilization of multiple kidney membrane hydrolases. AB - Retinyl ester hydrolysis was observed in the absence of cholate in homogenates of rat lung, liver, kidney, intestine, and testes. Eighty-four percent of the activity in kidney was membrane-associated. The kidney microsomal fraction contained 19% of the total activity and was the only subcellular fraction that had increased specific activity relative to the homogenate (about 1.5-fold). In contrast, the cytosol was the only fraction that was decreased in specific activity (about 3-fold). Cholate (18 mM), reportedly required to observe hydrolysis of all-trans-retinyl esters by rat liver preparations, was not obligatory for activity in kidney homogenates or microsomes. The microsomal activity was solubilized efficiently and with a twofold increase in specific activity by the synthetic detergent 1-S-octyl-beta-D-thioglucopyranoside. Gel permeation chromatography of the solubilizate suggested that at least two pools of activity existed, with molecular weights in the ranges 70-95 and 30-40 kDa. Neither hydrolyzed cholesteryl oleate. Both were more active in hydrolyzing retinyl palmitate than trioleoylglycerol. The higher mass pool had decreased trioleoylglycerol hydrolase activity relative to the solubilizate. Anion-exchange chromatography separated the lower mass pool into two major peaks. A major peak, distinct from the two peaks observed with the lower mass pool, was observed upon anion-exchange chromatography of the higher mass pool. These data demonstrate that multiple retinyl ester hydrolases, more efficient at hydrolyzing retinyl esters than cholesteryl esters and triacylglycerol, occur in a retinoid target tissue. PMID- 2774574 TI - Bromine derivatives of amino acids as intermediates in the peroxidase-catalyzed formation of singlet oxygen. AB - Recently, J. R. Kanofsky et al. (1988, J. Biol. Chem. 263, 9692-9696) reported that human eosinophils generated modest amounts of singlet oxygen. In the mechanism proposed, hypobromous acid (made from the peroxidase-catalyzed oxidation of bromide ion) reacted with hydrogen peroxide to form singlet oxygen. In contrast, human neutrophils, which generate both hypochlorous acid and hydrogen peroxide, do not make singlet oxygen. The failure of human neutrophils to generate singlet oxygen is due in part to the trapping of hypochlorous acid by endogenous amines. In this paper, I show that amino acids are much more effective traps for hypochlorous acid than for hypobromous acid. Glycine totally inhibits singlet oxygen generation from a model enzyme system composed of chloroperoxidase, hydrogen peroxide, and chloride ion, but causes only a 35% reduction in singlet oxygen generation from an analogous enzyme system containing bromide ion instead of chloride ion. The products of the reaction of hypobromous and glycine (presumably an equilibrium mixture of N-bromoglycine, N,N dibromoglycine, and hypobromous acid) retain the ability to react with hydrogen peroxide to form singlet oxygen. In contrast, the products of the reaction of hypochlorous acid and glycine do not react with hydrogen peroxide to produce singlet oxygen. Similar results were obtained for L-alanine, L-arginine, L asparagine, L-aspartic acid, L-cystine, L-glutamic acid, L-glutamine, L histidine, L-lysine, L-phenylalanine, L-proline, L-serine, and L-tyrosine. Thus, bromine derivatives of amino acids may act as intermediates in the peroxidase catalyzed generation of singlet oxygen. PMID- 2774575 TI - Botulinum neurotoxin type A radiolabeled at either the light or the heavy chain. AB - Botulinum neurotoxin (NT) has two distinct structural regions called L and H chains (approximately 50 and approximately 100 kDa, respectively). Although the H chain is responsible for binding of the NT to neuronal cells, it is not known which of the subunits is internalized and therefore responsible for causing the blockage of acetylcholine release in susceptible neuronal cells. In this report we describe for the first time the preparation of type A NT which is selectively radiolabeled at either the L or the H chain subunit. Such NT preparations will be useful as tools for determining the distribution of L and H chains in poisoned neuronal cells and the role that each subunit plays in inducing toxicity. The L and H chains of the NT (approximately 150 kDa) were separated, purified, and then individually radiolabeled by reductive methylation of the lysine residues using [3H]- or [14C]formaldehyde. The labeled L and H chains were reconjugated with the complementary unlabeled L and H chains. Formation of -S-S- and noncovalent bonds between the L and H chains regenerated the approximately 150 kDa NT. Autoradiographs of sodium dodecyl sulfate polyacrylamide gels confirmed that each reconstituted NT preparation was labeled at only one subunit chain. NT selectively labeled at either the L or the H chain had specific radioactivities of ca. 25-30 and 45-55 microCi/mumol, respectively, and toxicity (mouse LD50/mg protein) values of 2.2 +/- 1.1 X 10(7) and 3.0 +/- 1.0 X 10(7), respectively. A linear increase in the specific radioactivity of L and H chain subunits was observed with increasing concentrations of 3H- or 14C-labeled formaldehyde in the reaction mixture and with increasing concentrations of L or H chain in the reaction mixture. PMID- 2774576 TI - Lyophyllum cinerascens aminopeptidase: purification and enzymatic properties. AB - An aminopeptidase (EC 3.4.11.1) was purified from the extract of Lyophyllum cinerascens by ammonium sulfate fractionation and sequential chromatographies on DEAE-Sephadex, Sephadex G-150, HPLC-phenyl-5PW, and HPLC-DEAE-5PW columns, with an activity recovery of 4.6% using Leu-beta-naphthylamide as a substrate. The enzyme was a tetrameric protein of molecular weight 150,000 and was found to be rich in histidine. It exhibited a pH optimum of 7.2 and stability between pH 5.7 and 7.7. The isoelectric point of the enzyme was 4.6. The enzyme catalyzed the hydrolysis of amino acid beta-naphthylamides, Phe greater than Leu greater than Met greater than Tyr greater than Ala greater than Glu, and the differences of the measured kcat's ranged over 2-3 orders of magnitude while many of the amino acid beta-naphthylamides were not hydrolyzed at all. Other interesting comparisons include two aliphatics, Ala vs Leu, and the aromatics, Tyr vs Phe, which show a 30-fold difference in the kcat/Km values. The enzyme also hydrolyzed Leu-Gly-Gly and the B chain of oxidized insulin to release N-terminal leucine and phenylalanine, respectively. The release of N-terminal Phe from the oxidized B chain is interesting in view of the fact that the penultimate residue is Val, an unfavorable amino acid in the beta-naphthylamide series. The enzyme seems to be a true aminopeptidase, requiring the free amino groups and hydrolyzing dipeptide and oligopeptide from the N-terminal end. The enzyme was resistant to the action of amastatin. Neither sulfhydryl reagents nor serine protease inhibitors affected the enzyme activity; however, the enzyme was inhibited weakly by EDTA and bestatin and strongly by diethyl pyrocarbonate. PMID- 2774577 TI - Chloroplast glucose-6-phosphate dehydrogenase: Km shift upon light modulation and reduction. AB - Illumination of intact chloroplasts and treatment of chloroplast stroma with dithiothreitol (DTT) both inactivate glucose-6-phosphate dehydrogenase (G6PDH; EC 1.1.1.49) to less than 10% apparent activity when assayed under standard conditions. Illumination of intact protoplasts and incubation of leaf extract with DTT inactivate about 25-35% of the total G6PDH activity. In the leaf extract, however, further loss of activity is observed if NADP is absent. Light- and DTT-inactivated chloroplast G6PDH can be reactivated by oxidation with sodium tetrathionate or the thiol oxidant diamide. Chloroplast G6PDH is as sensitive toward reductive enzyme modulation in a stromal extract as are other light/dark modulated enzymes, e.g., NADP-malate dehydrogenase. Also, glutathione, provided it is kept reduced, is sufficient to cause inactivation. Light- and DTT-induced inactivation are shown to be due to a Km shift with respect to glucose-6 phosphate (G6P) from 1 to 35 and 43 mM, respectively, and with respect to NADP from 10 to 50 microM without any significant change of the Vmax. NADPH competitively (NADP) inhibits the enzyme (Ki = 8 microM). Reactivation by oxidation can be explained by an enhanced affinity of the oxidized enzyme toward G6P and NADP. The pH optimum of the reduced enzyme is more in the alkaline region (pH 9-9.5) as compared to that of the oxidized form (pH 8.0). The presence of 30 mM phosphate causes a shift of 0.5 to 1.0 pH unit into the alkaline region for both forms. PMID- 2774578 TI - Copper activation of superoxide dismutase in rat erythrocytes. AB - Several lines of evidence suggested that copper can activate a preexisting pool of superoxide dismutase (SOD) apoprotein in erythrocytes from copper-deficient rats. First, feeding adequate copper to copper-deficient rats raised initially low erythrocyte SOD activities to normal values in under one-third the time needed to replace the entire red cell population. Moreover, copper injection (1 mg Cu/kg, sc) doubled erythrocyte SOD activity levels in 16 h. Since protein synthesis is restricted in mature erythrocytes, these results imply that copper activated apoSOD in vivo. Furthermore, injected copper raised SOD activity contents of both young and old erythrocytes. Neither dietary copper status nor copper injection influenced red cell SOD immunoreactive protein levels. In contrast, copper injection increased the amount of copper associated with the SOD activity peak region resulting from gel filtration of hemoglobin-free erythrocyte proteins on Sephadex G-75. Copper ions (3 microM) elevated SOD activity levels in vitro by 63% in 4 h in intact red cells from copper-deficient rats. No activation took place in lysed red cells from the same rats or in intact cells from copper adequate rats. These results all suggest that copper can activate SOD apoprotein in erythrocytes by a specific, saturable process. PMID- 2774579 TI - Structural changes in myosin subfragment 1 by mild denaturation and proteolysis probed by antibodies. AB - The perturbations in the structure of myosin subfragment 1 (S1) by mild denaturation or proteolysis were investigated by measuring the inhibition of the binding of antibodies to immobilized S1 by treated S1 in a solution-phase competitive immunochemical assay. The structural changes in S1 were probed by using anti-50-kDa segment, anti-N-terminus, anti-27-kDa segment, and anti-A1 light chain monoclonal antibodies (MAbs). Methanol and heat denaturation increased MAb binding to the 50-kDa segment. MAb binding to regions in the 27-kDa segment was also promoted, slightly by methanol and more drastically by heat. Proteolysis also induced structural alterations in 50- and 27-kDa segments as shown by increased MAb binding to these regions in cleaved S1. These results indicate that mild denaturation and proteolysis induce structural perturbations which alter the epitope accessibility in 50- and 27-kDa segments of S1 and that antibody binding studies afford a sensitive probe to such perturbations. PMID- 2774580 TI - Vibrational spectroscopy in the ultraviolet via Gd3+ fluorescence: application to biological systems. AB - Coupling of the narrow 311-nm Gd3+ fluorescence transition with the vibrational transitions of its inner-sphere ligands gives rise to the emission of vibronic photons between 320 and 350 nm. The energy difference between the fluorescence and vibronic transitions is equal to that of the vibrational transitions of the molecular group coordinated to Gd3+; thus the ir spectrum of the ligand can be measured in the uv spectral region the presence of other molecules absorbing in the ir. The vibronic spectra of several biological, organic, and inorganic molecules are shown to accurately report the vibrational spectrum of the ligand. PMID- 2774581 TI - Biochemical characterization of mitochondrial and lysosomal particles in old rat liver. AB - Sedimentation rates, equilibrium densities, and membrane fragility of liver mitochondrial and lysosomal particles were estimated in adult and 36-month-old rats. The sedimentation coefficient and the size of particles were also calculated. The fractionation experiments indicated a similar enzymatic distribution for mitochondrial and lysosomal tracer enzymes in both types of animals. The liver mitochondria of senescent and mature rats were identical in sedimentation rate, sedimentation constants, equilibrium densities, fragility under isotonic conditions, and oxidative phosphorylation. Only in hypotonic media was there a decreased cohesiveness of the external mitochondrial membrane in older animals. In old rats several lysosomal tracer enzymes had lower sedimentation rates and sedimentation coefficients. The equilibrium densities were higher in these animals too. The lysosomal latency in old and mature rats was identical. It can be concluded that in very old age liver lysosomes are smaller in size than those in mature animals. PMID- 2774582 TI - Effects of thermodynamic nonideality on the kinetics of ester hydrolysis by alpha chymotrypsin: a model system with preexistence of the isomerization equilibrium. AB - The effects of a small inert solute, sucrose, on the kinetics of hydrolysis of N acetyl-tryptophan ethyl ester by bovine alpha-chymotrypsin have been investigated. In studies at pH 7 and 20 degrees C the presence of 0.5 M sucrose in assay mixtures caused no discernible change in kinetic parameters, a result consistent with existence of the enzyme in a single conformational state under those conditions. However, at pH 3.5 and 50 degrees C, conditions under which the enzyme comprises an equilibrium mixture of compact and expanded isomeric states, inclusion of the inert solute led to a considerable decrease in Michaelis constant (0.84 to 0.61 mM) but no significant change in maximal velocity. These results were shown to be amenable to quantitative interpretation in terms of thermodynamic nonideality effects on catalysis by an enzyme undergoing reversible isomerization in the absence of substrate. For that analysis, which required experimental estimates of the equilibrium constant for preexisting isomerization of enzyme and the activity coefficient of substrate, the magnitude of the former (0.3) was obtained by difference spectroscopy: liquid-liquid partition studies with bromobenzene as organic phase were used to determine the effect of sucrose on the activity coefficient of N-acetyltryptophan ethyl ester. Such agreement between experimental kinetic findings and theoretical predictions based on considerations of excluded volume points to the possible use of the space-filling effects of small solutes for delineating the gross extent of conformational changes associated with reversible isomerization of proteins, and hence to the potential of thermodynamic nonideality as a probe for studying protein denaturation mechanisms as well as substrate-mediated changes associated with enzyme reaction mechanisms. PMID- 2774583 TI - Existence of acetyl-CoA-dependent chain elongation system in hepatic peroxisomes of rat: effects of clofibrate and di-(2-ethylhexyl)phthalate on the activity. AB - The acetyl-CoA-dependent elongation of medium-chain acyl-CoA in the presence of pyridine nucleotide was studied in rat liver. The activity was increased by the administration of peroxisome proliferators, clofibrate and di-(2 ethylhexyl)phthalate, and the change was more remarkable in peroxisomes than in mitochondria. Addition of 0.01% Triton X-100 to the incubation mixture caused an increase in the mitochondrial activity, whereas the peroxisomal activity did not increase significantly. The pH optimum for the peroxisomal activity was in the range of pH 6.5-7.0 and that for the mitochondrial activity was pH 7.5-8.0. The specificities of primer chain length in both organelles were almost the same, and octanoyl-CoA was the preferred substrate. Peroxisomal activity was completely inhibited by the addition of 1 mM N-ethylmaleimide or 1 mM p hydroxymercuribenzoic acid, while the activity did not change on the addition of 1 mM KCN or an antibody to acyl-CoA oxidase, the first enzyme of the peroxisomal beta-oxidation system. The activity of enoyl-CoA reductase, which catalyzes the last step of the elongation system, was also detected in peroxisomes, although the main activity was localized in microsomes. When the liver peroxisomal fraction of clofibrate-treated rats was incubated with a mixture of octanoyl-CoA, acetyl-CoA, NADH, NADPH, and Triton X-100 in a buffer system, dodecanoyl-CoA was detected as the main product by radio-gas chromatography. On the other hand, the elongation activity was decreased greatly by the addition of NAD+ into the mixture. These results indicate that (i) peroxisomes have activity to elongate medium chain acyl-CoA; (ii) the peroxisomal elongation system may consist of the reverse reaction of the beta-oxidation system except for the last step, which is catalyzed by enoyl-CoA reductase; and (iii) the peroxisomal elongation system is less active than the beta-oxidation system under physiological conditions. PMID- 2774584 TI - Role of extrahepatic alcohol dehydrogenase in rat ethanol metabolism. AB - Rat alcohol dehydrogenase exhibits three isoenzymes with very different capacities of ethanol oxidation and with characteristic distribution in tissues. ADH-1 (class II isoenzyme, Km = 5 M) is especially concentrated in the most external organs: auditive, bucal, and nasal mucoses, cornea, esophagus, stomach, rectum, penis, and vagina. ADH-2 (class III isoenzyme) is present in all organs but has a poor activity with ethanol. ADH-3 (class I isoenzyme, Km = 1.4 mM) is the main liver isoenzyme, also present in lung, intestine, kidney, and sexual organs. At 33 mM ethanol and pH 7.5, total hepatic activity (3.5 +/- 0.6 units) represents 90% of the whole activity in the male rat, while the remaining 10% is distributed in many organs. The skin is the extrahepatic organ with the highest total activity (88 +/- 15 mU) followed by testis and small intestine. ADH-3 accounts for 96% of total activity (90% hepatic and 6% extrahepatic) and ADH-1 contributes with 4% (extrahepatic). However, in conditions that may be found in the digestive tract mucose after ethanol ingestion (pH 7.5, 1 M ethanol), stomach and small intestine activities represent 10% of the liver activity at 33 mM ethanol. Therefore, oral administration of ethanol will result in a higher contribution of the extrahepatic activity than will intravenous or intraperitoneal administration, because of the great ADH-1 content of the digestive tract. On the other hand, pyrazole inhibition constants at pH 7.5 for ADH-1 (33 mM) and ADH-3 (4.2 microM) are much higher than those at pH 10.0 (0.56 mM and 0.4 microM) and indicate that at the usual concentration of inhibitor only ADH-3 activity will be effectively suppressed. ADH-1 will be, therefore, responsible in part for the residual ethanol oxidation activity in pyrazole treated rats. PMID- 2774585 TI - Microsomal glutathione-dependent protection against lipid peroxidation acts through a factor other than glutathione peroxidase and glutathione S-transferase in rat liver. AB - Ascorbate-Fe3+-induced and NADPH-induced lipid peroxidation of rat liver microsomes were inhibited by glutathione (GSH). This inhibition was due to microsomal GSH-dependent factor. This factor was heat labile, and storage of microsomes at 4 degrees C for 1 week diminished the activity. GSH could not be substituted by other sulfhydryl compounds tested. Deoxycholate (1 mM) and bromosulfophthalein (0.1 mM) inhibited GSH-dependent protection but did not inhibit microsomal GSH peroxidase activity. Iodoacetate (10 mM) inhibited GSH dependent protection but did not inhibit microsomal GSH S-transferase. N Ethylmaleimide (0.1 mM) and oxidized glutathione (10 mM) inhibited GSH-dependent protection but activated microsomal GSH S-transferase activity. These results indicate the existence of a heat-labile, microsomal GSH-dependent protective factor against lipid peroxidation that acts through a factor other than GSH peroxidase and GSH S-transferase. PMID- 2774586 TI - Role of variant prealbumin in the pathogenesis of familial amyloidotic polyneuropathy: fate of normal and variant prealbumin in the circulation. AB - According to recent studies on protein chemistry and genetic engineering, replacement of the Val30 residue of prealbumin by methionine is believed to play a critical role in the formation of amyloid deposit and the pathogenesis of familial amyloidotic polyneuropathy (FAP). However, only limited information is available concerning the behavior of prealbumin in the circulation. To obtain the molecular insight into the mechanism of amyloid deposition, it is indispensable to know the fates of normal and variant prealbumin in vivo. Thus, the fates of prealbumin samples from normal and FAP patients were studied in normal rats as well as in animals that were challenged with acute inflammation induced by turpentine. The effect of in vitro photooxidation of prealbumin samples on their behavior was also examined in vivo. Kinetic analysis revealed no appreciable difference between prealbumin samples from normal and FAP patients. These results suggest that factors other than the rate of transfer of the variant form prealbumin from plasma to an extravascular compartment may play a critical role in the pathogenesis of amyloid deposition in FAP patients. PMID- 2774587 TI - Synthesis and targeting of hexokinase to mitochondria in hepatoma cells. AB - The synthesis and turnover of hexokinase has been measured in Zajdela hepatoma ascites cells labeled for short periods with [35S]methionine. Digitonin fractionation of the labeled cells into a soluble and a membrane fraction showed that only a small part of the newly labeled hexokinase is transferred to mitochondrial binding sites. The soluble enzyme disappears, however, with a half life of less than 2 h. Glucose had no effect on the stability of the soluble enzyme in intact cells. Our experiments suggest that Zajdela cell hexokinase is synthesized in excess of binding sites and that the excess enzyme is not stable. PMID- 2774588 TI - [Effects of massive administration of cepharanthin on chemotherapy-induced leukopenia]. AB - The effects of Cepharanthine on chemotherapy-induced leukopenia was investigated in our university hospital. Thirty-four patients with gynecological malignant tumors were divided into two groups: One group (20 patients) was administered 50 mg of Cepharanthine intravenously every day during postoperative chemotherapy (CAP or FAMT therapy) period and the other (14 patients) was without administration during the same period. Out of 20 patients treated with Cepharanthine, 14 patients (70%) showed a slight decrease in the number of leukocytes (less than 20% decrease as compared to that before chemotherapy) five weeks after administration of anticancer drugs. Only two patients (14%) demonstrated a slight decrease of the number of leukocytes in the control group. No side effects were observed in the patients who were treated with Cepharanthine. These data suggest that the large dose of Cepharanthine contribute to the prevention of leukopenia in patients who are treated with a sufficient amount of anticancer drugs. PMID- 2774589 TI - [High-dose cytosine arabinoside treatment of leukemia with special reference to the optimal number of doses]. AB - A high dose of cytosine arabinoside (ara-C) was given to 51 patients during consolidation therapy or with refractory or relapsed acute leukemia. Ara-C was administered as a 3-hour infusion at a dose ranging from 2 to 3 g/m2 every 12 hours, diluted in 500 ml of 5% dextrose in water for 2 to 6 days. Complete remission was attained in 3 (25%) of 12 evaluable patients. Two with blast crisis of chronic myelogenous leukemia of these did not obtain complete remission. Death due to marrow aplasia occurred in five patients, and two of these had relatively good performance status and were given a dose of 3.0 g/m2 x 8 or 12 of ara-C. At a dose of 3.0 g/m2 x 6, the mean duration of granulocytes of less than 100/mm3 was 6.7 days. This duration seemed to be manageable myelosuppression. Therefore, 3.0 g/m2 x 6 was thought to be an adequate dose. Seizure occurred in one patient, and conjunctivitis was seen in another. In conclusion, from the manageable myelosuppression observed, administration of 3.0 g/m2 x 6 of ara-C seemed to be an adequate dose. PMID- 2774590 TI - [Measurement of creatinine clearance and urinary NAG for the evaluation of cis platinum induced nephrotoxicity]. AB - Creatinine clearance and beta-D-acetyl-glucosaminidase (NAG) were useful markers for the evaluation of the renal function of 57 cases of head and neck cancer treated with 60 mg/m2 cis-platinum (CDDP). There was a significant correlation between creatinine clearance and NAG values for (r = -0.4820, p less than 0.01). The nadir of creatinine clearance and NAG values were observed between 2 and 3 weeks after administration of CDDP. After 2 courses of chemotherapy with CDDP, more nephrotoxicity was observed in the cases received prior CDDP therapy, than cases without chemotherapy statistically. Combined chemotherapy with CDDP and 5 FU (CF therapy) caused more renal damage, comparing with other combined chemotherapy such as COP therapy (CDDP, vincristine and peplomycin), and CAP therapy (CDDP, aclacinomycin and cyclophosphamide). Early recovery from the renal damage following CDDP therapy was detected in the cases given Fosfomycin (FOM). This results suggest that FOM would be effective for decreasing the nephrotoxicity by CDDP. PMID- 2774591 TI - [An experimental study on subrenal capsule assay (SRCA)--problems for the use of immunosuppressive agents]. AB - We studied whether or not cyclosporin A (CSA) has a usefulness in subrenal capsule assay (SRCA) with normal immunocompetent mice. Sixty mg/kg of CSA was given to BDF1 mice daily subcutaneously, and various dosages of adriamycin (ADR) was given intravenously on day 2. The body weight of BDF1 mice decreased over 20% within ten days when ADR was given at more than 5 mg/kg. MX-1, a human breast carcinoma line is known to be sensitive to ADR. This tumor was implanted subcutaneously in the back of BALB/c nu/nu mice and chemosensitivity was tested against ADR. ADR resulted to be positive at the dose of 8 mg/kg. On the contrary, the dose of 5 mg/kg proved to be negative, and hence the result of SRCA would be false negative, if the dose of ADR is reduced to avoid the toxicity of CSA. The tumor grew slowly when only 60 mg/kg of CSA was given daily for three weeks, and the inhibition rate was 56.2%. The toxicity of CSA was neglected because of the body weight loss was approximately 13%. CSA may have the antitumor effect by itself, and we therefore suggest that the CSA is not useful for SRCA. PMID- 2774592 TI - [Histological take rates of fresh human tumors in the subrenal capsular space of cyclosporin A treated mice]. AB - To elucidate the reliability of subrenal capsule assay, histological take rates of fresh human tumors from 75 clinical cases were studied. (1) Take rates of the clinical materials in immune suppressed ddY mice treated by cyclosporin A (60 mg/kg sc, qd) at 6 day were 71% in colon cancer, 50% in stomach cancer, 43% in breast cancer and 0% in lymphoma. (2) Regarding to the histological type, take rates were better in more differentiated type being around 80%, and worse in poorly differentiated type, around 20%. (3) Factors affecting on the poor take rates, other than organ type and histological type, were such as strong heterogeneity of fragments, paucity of cancer cells and abundant stroma. Good tumor take among poorly differentiated type was observed in medullary type. (4) By the daily observation of the growing pattern of the implants (mainly assessed by the amounts of viable tumor cells) the group with good tumor shows similar number of cells through the experimental days and, on the other hand, group with poor tumor shows an early disappearance of tumor cells at day 1 or 2. (5) By lowering pH of the medium harboring fragments down to pH 6.8-7.0 take rates were improved as well as the quality of viability. PMID- 2774593 TI - [Binding of K-18 on the surface of tumor cells--flowcytometrical analysis in vitro]. AB - After K-18 was contacted with various kinds of tumor cell lines in vitro, the binding pattern was examined. K-18 bound on the surface of K-562 cells showed the maximum levels 1 hr later and maintained the binding activity for 24 hrs in the analysis by flowcytometry. K-18 also bound to HeLa S3, KB, RPMI8226, P815, YAC-1 and L1210 cells. Fluorescent intensity on K-562 cells was stronger with whole molecules of K-18 than with F(ab')2 conjugated with melphalan. Normal human IgG could bind more on the surface of K-562 cells than F(ab')2 of IgG. These results suggest that K-18 might bind on tumor cells via IgG Fc receptors on their surface. PMID- 2774594 TI - [Change of blood lentinan level in patients with advanced cancers]. AB - A conventional limulus test can detect not only endotoxin but also beta(1----3) glucan. Therefore, with a quantitative limulus test, the limulus colorimetric test, we studied the pharmacokinetics of lentinan, an antitumor beta(1----3) glucan preparation, in the blood of 10 healthy volunteers and 20 patients with advanced cancers. The calibration curve of lentinan in the human plasma was linear in the range of 0 to 100 ng/ml. Two mg of lentinan was administered once a week and blood samplings for the measurement were done immediately before the next lentinan administration to document trough-levels serially at a week interval. Trough-levels tended to rise gradually and showed a rapid elevation between 4 and 8 weeks after beginning of administration. This phenomenon may correlate closely with the antitumor effect of lentinan and, therefore, deserves further investigations. PMID- 2774595 TI - [Concentration of ACNU in a branch of middle cerebral artery, femoral vein and brain tissue by intracarotid or intravenous administration in a patient with recurrent glioblastoma]. PMID- 2774597 TI - The role of liver biopsies in psoriatic patients receiving long-term methotrexate treatment. Improvement in liver abnormalities after cessation of treatment. AB - Liver biopsy specimens from 168 patients who underwent a total of 364 biopsies were examined. Of 83 patients receiving biopsies before methotrexate treatment, 14 had one or more risk factors predictive of liver abnormality but they had normal pretreatment biopsy specimens. Among 17 patients with abnormal biopsy specimens before methotrexate treatment, only 1 had an identifiable risk factor and 5 had abnormal results of liver function tests. The probability of a normal biopsy specimen after methotrexate treatment dropped below 50% at a cumulative methotrexate dose of 3115 mg for the 31 patients with biopsy specimens from before and after methotrexate treatment and 5776 mg for those who had biopsies only after methotrexate treatment; this difference was statistically significant and is thought to be related to the fact that the patients who had biopsies before and after methotrexate treatment had received most of their medication by the parenteral rather than the oral route. A significant association existed between biopsy grade after methotrexate treatment and obesity. Other risk factors were not correlated with biopsy grade. Blood chemistry tests were not predictive of histopathologic findings. Eight of 11 patients with fibrosis or cirrhosis showed meaningful improvement in liver histologic findings after methotrexate treatment had been withdrawn for 6 months or more; none had progression of abnormalities. PMID- 2774596 TI - Detection of hepatotoxicity associated with methotrexate therapy for psoriasis. AB - To determine whether liver function tests and clinical and demographic information would predict methotrexate-associated hepatotoxicity, we identified 78 patients who had undergone 147 liver biopsies associated with methotrexate therapy for psoriasis. The joint sensitivity of aspartate aminotransferase, alkaline phosphatase, and total bilirubin values in detecting abnormal results from a biopsy specimen obtained after treatment was .86; the predictive value of negative test results was .93. A logistic regression model significantly predicted the presence of abnormal (grade III or higher) liver biopsy specimen results. The concordance index was .92 (perfect, 1.0). Regression coefficients may be used along with information from a specific patient to calculate the predicted probability of an abnormal result from a liver biopsy specimen after treatment. We conclude that this multivariate risk estimation model significantly predicts the likelihood of positive findings from liver biopsy specimens in this patient population. The clinical use of this model awaits further validation. PMID- 2774598 TI - Pyoderma gangrenosum with pulmonary involvement. AB - A 60-year-old woman had a typical pyoderma gangrenosum with monoclonal IgA gammopathy and atrophic gastritis. Two years after the onset of her skin disease, she had evidence of pulmonary abscesslike involvement. Corticosteroid therapy led to healing of skin and lung diseases. This case stresses the multisystemic manifestations of neutrophilic dermatoses with special attention to pulmonary involvement. PMID- 2774599 TI - Papular protothecosis of the chest. Immunologic evaluation and treatment with a combination of oral tetracycline and topical amphotericin B. AB - A 65-year-old woman presented with cutaneous, pruritic papules of the upper part of her chest. Histologic findings and culture of a biopsy specimen confirmed that these papules were caused by an infection with Prototheca wickerhamii, an achloric alga that rarely infects humans. Natural killer cell activity in this patient was significantly depressed before initiation of therapy. Reevaluation following successful treatment with oral tetracycline hydrochloride and topical amphotericin B cream revealed an improvement in natural killer cell activity. This patient is presented to demonstrate a rare clinical presentation of protothecosis; to document that cutaneous protothecosis can be successfully treated without the risk of toxic side effects associated with systemic antifungal agents; and to illustrate that although most patients with cutaneous protothecosis are immunosuppressed, infection with this alga appears to be at least partially responsible for the immunosuppression. PMID- 2774600 TI - Heterotropic brain tissue presenting as bald cysts with a collar of hypertrophic hair. The 'hair collar' sign. AB - We report the cases of two children who were each noted at birth to have a single bald compressible nodule on the scalp that was surrounded by a collar of hypertrophic hair. One of the mothers had taken doxylamine succinate during pregnancy. Extensive investigations and, finally, surgery revealed that the lesions were heterotropic brain tissue without connection to the brain. Encephaloceles may also have a "hair collar." The presence of a hair collar around any cutaneous lesion should alert the clinician to the possibility of a neuroectodermal defect. All procedures on these lesions should be delayed until appropriate investigations have excluded any connection with the underlying nervous system. PMID- 2774601 TI - The cutting edge. PMID- 2774602 TI - To tan or not to tan. A burning question. PMID- 2774603 TI - Validation of a diagnostic test. Epidemiologic principles in dermatology. PMID- 2774604 TI - Progressive erythematous and atrophic eruption in a patient with chronic myelogenous leukemia. Poikilodermal vasculare atrophicans (PVA). PMID- 2774605 TI - Dyslipoproteinemia in patients with xanthelasma. PMID- 2774606 TI - The size of lesions, or point counting as a step toward the solution of the PASI problem. PMID- 2774607 TI - Leg ulcers following subcutaneous injection of a liquid silicone preparation. PMID- 2774608 TI - Oligosymptomatic form of Klippel-Trenaunay-Weber syndrome associated with giant nevus spilus. PMID- 2774609 TI - Azidothymidine-induced hyperpigmentation of skin and nails. PMID- 2774610 TI - Erythropoietic protoporphyria presenting in adulthood. PMID- 2774611 TI - Diminished cutaneous hair density in dysplastic nevus syndrome. PMID- 2774612 TI - Acute duodenal ulcer. AB - A series of 31 infants and children with acute duodenal ulcer verified by endoscopy was studied over an eight year period. Eighteen (58%) of them were under 2 years of age. The most common symptom was upper gastrointestinal bleeding (n = 27, 87%). Twenty nine patients (94%) had a preceding illness characterised by diarrhoea, upper respiratory tract infection, or fever, which was not necessarily treated with antipyretic drugs. Initial endoscopy showed that ulcer lesions were solitary in 14 patients and present on the anterior wall (n = 11), posterior wall (n = 2), or both (n = 1). Multiple ulcers were found in 17 patients, and present in the bulb with (n = 6) or without (n = 11) extension into the second part of duodenum. The most conspicuous finding was the irregularly shaped ulcers seen in eight young children with similar clinical and endoscopic features. Sixteen patients were re-endoscoped one to two weeks after the initial examination; the ulcers had entirely disappeared in 13, and there were only small residual ulcers in three. Thirty patients were treated medically and only one (with uncontrollable haemorrhage) required operation. Most patients were symptom free two to six years after the initial diagnosis. Our results suggest that young children may develop acute duodenal ulcers after viral illnesses whether or not they are treated with drugs, mainly antipyretics. This kind of acute duodenal ulcer usually heals quickly irrespective of the morphology, site, and number of ulcers. PMID- 2774613 TI - Gastro-oesophageal reflux in preterm infants. AB - Gastro-oesophageal reflux in very low birthweight infants was studied using a new 1 mm monocrystalline antimony oesophageal pH electrode. Gastro-oesophageal reflux was detected in 30 (85%) subjects. The mean (SEM) number of episodes of reflux in 24 hours was 12.1 (2.1), and 3.2 (0.6) lasted over five minutes. The mean reflux index was 4.5 (1.0)%, and the longest episode 17.1 (4.6) 17.1. Reflux was unrelated to postconceptional age or to resting lower oesophageal sphincter pressure. The mean reflux index was low at rest before feeds, being 1.8 (0.6)%, and increased slightly after feeds (3.8 (1.0)%), but was significantly increased after nursing care to 16.4 (3.0)%, and while xanthines were being given (5.9 (1.6)%. A subgroup of seven infants with xanthine resistant apnoea had severe gastro-oesophageal reflux that was not clinically apparent (reflux index 27.4 (3.6)%). Successful treatment of the reflux (reflux index: 3.6 (1.2)%) was associated with cessation of the apnoea. We conclude that gastro-oesophageal reflux is common, and is usually not clinically apparent, even when severe. It is important to consider gastro-oesophageal reflux in the differential diagnosis of xanthine resistant apnoea in preterm infants. PMID- 2774614 TI - Long term survival and cure after childhood cancer. AB - Investigations of long term survival and evidence concerning cure among children surviving at least three years after most of the more common childhood cancers treated in Britain between 1960 and 1981 are reported. The results indicate striking improvements in survival beyond three years for many childhood tumours over this period. For most childhood tumours considered over 80% of those who had survived at least three years were alive 10 years later. Comparison of mortality observed among survivors with that expected for the general population showed evidence of cure among those who had survived at least three years after non Hodgkin lymphomas and non-genetic retinoblastoma. Survivors of other tumours, with sufficient cases surviving beyond 10 years to examine excess mortality, rarely experienced an excess that exceeded one extra death per 100 survivors per year. Children who had survived at least 10 years after other embryonal tumours, soft tissue sarcomas, or osteosarcoma never experienced an excess mortality exceeding one extra death per 200 survivors per year. PMID- 2774615 TI - Intermittent catheterisation for neuropathic urinary incontinence. AB - Eighty six children with neuropathic urinary incontinence who had been treated by clean intermittent catheterisation for more than five years were reviewed. Eighty five had congenital lesions, and one traumatic paraplegia. During the day, 72 (84%) patients were dry or had minor stress incontinence only, 11 were damp but controlled with pads, and only three were continuously wet. Eleven abandoned clean intermittent catheterisation, five because of poor control, four by choice despite good control, and only two because of deterioration of upper urinary tract disease. Most of them usually had bacteriuria, but only 32 developed occasional symptomatic infections. Urinary calculi occurred in six, epididymitis in three, and urethral problems in four. Upper urinary tract dilatation did not arise in a previously normal renal system in any patient during clean intermittent catheterisation. Clean intermittent catheterisation was successful in controlling wetting with few serious complications, and was well tolerated. It remains the method of choice for the management of neuropathic urinary incontinence in such children. PMID- 2774616 TI - Referral patterns after school medical examinations. AB - The incidence of sensory or language abnormalities and the factors influencing the clinical medical officers' decisions to refer children who failed developmental tests were studied. There were 1259 children examined and referrals for vision, hearing, and language assessment were made for 39(3.1%), 75(6.0%), and 27(2.1%), respectively. About 80% of these problems, however, were not known to the child health services when the children were 3.5 years old, mainly because children had moved to the district after the age of 3.5, and did not attend the 3.5 year screening clinics. Referrals formed only a small percentage of children who failed a test (11.0% failed vision, 19.5% hearing, and 24.6% language assessments). For vision and hearing the most important reason for the discrepancy was the clinical medical officers' wish to reassess children who failed the test before referring them. For the language test the clinical medical officer's often believed that the screening did not reflect the child's skills, which suggests that language screening as currently used in the district is not effective. Evaluation of the examination has highlighted the need to review the tests being used. PMID- 2774617 TI - Cerebral palsy in two national cohort studies. AB - The prevalence of cerebral palsy in the 1958 British Perinatal Mortality Survey and the 1970 British Births Survey remained constant at 2.5/1000 births (40 and 41 cases, respectively). The prevalence at 10 years was higher in the 1970 cohort in which all children with cerebral palsy survived, whereas 22% of the cases in the 1958 cohort died during the first 10 years of life. A case-control study matched three controls for social class, maternal age, parity and marital state, and a further three controls for the infant's sex, gestation, and birth weight. Comparison of cases and controls showed no consistent differences in social and environmental factors, history of pregnancy, labour, or delivery. Important differences were found in the incidence of respiratory and neurological symptoms in the neonatal period. These prospective data derived form two whole populations of births support the hypothesis that most cases of cerebral palsy are not associated with adverse obstetric factors, and confirm that neonatal neurological symptoms are associated with subsequent cerebral palsy. PMID- 2774618 TI - Focal glomerulosclerosis treated with heparin. AB - A boy with focal glomerulosclerosis as a result of nephrotic syndrome became unresponsive to corticosteroids and cyclophosphamide. He was given prolonged subcutaneous heparin with reduction in proteinuria, return of corticosteroid sensitivity, and no further deterioration (possibly improvement) in histological appearance. He remained completely well after five years. PMID- 2774619 TI - Phycomycotic abscesses in a preterm infant. AB - We report a case of neonatal infection with rhizopus, one of the Mucoraceae family. Human infection is rare but the mortality is high without prompt, correct treatment. The infant had a simultaneous candida septicaemia secondary to colonisation of a central venous line. Serial C reactive protein estimations are valuable in monitoring treatment. PMID- 2774620 TI - Diarrhoea caused by collagenous colitis. AB - The first case of collagenous colitis in a child with protracted watery diarrhoea and abdominal pain is reported. Small bowel investigations and the macroscopic appearances were normal, but histological examination of the colon showed collagenous colitis. Steroids temporarily relieved the diarrhoea and induced transient dissolution of the subepithelial collagen band. PMID- 2774621 TI - Effect of fever on recurrence rate of febrile convulsions. AB - We studied 154 children admitted consecutively with their first febrile convulsion to assess the influence of the temperature on the recurrence rate of convulsions. Those with temperatures of 40 degrees C or more were nine times less likely to have subsequent convulsions than those with temperatures of 38-38.9 degrees C. PMID- 2774622 TI - Meningitis in the newborn--a 14 year review. AB - A 14 year review of meningitis in babies showed that overall mortality and survival without handicap has not improved. The failure to improve the prognosis of these babies during a period when overall perinatal mortality fell rapidly is because smaller babies are being affected and different organisms are being cultured. PMID- 2774623 TI - Organ donation. PMID- 2774624 TI - The other end of the telephone. PMID- 2774625 TI - Deliberate self poisoning in adolescents. PMID- 2774626 TI - Hyperventilation in the awake state in children with autistic traits. PMID- 2774627 TI - Treatment of renal failure in neonates. PMID- 2774629 TI - Bradycardia associated with chlorhexidine spray. PMID- 2774628 TI - Impact of AIDS on neonatal care. PMID- 2774630 TI - Cerebral blood flow velocity variability after cardiovascular support in premature babies. AB - The variability of cerebral blood flow velocity was measured in 20 very low birthweight infants. The area under the curve of the Doppler frequency spectrum was used and was obtained from the anterior cerebral artery in the infants before and after infusions of plasma or dopamine. Both interventions significantly reduced the variability without a demonstrable effect on cardiac output, heart rate, or cerebral blood flow velocity. The reduction was from a median of 13% to 5% after plasma and from 13% to 4% after dopamine. The effect was probably due to an increase in circulating blood volume. It is proposed that appreciable variations in systolic blood pressure occurring in phase with respiration indicate a low central venous pressure in infants, as in adults and animals. The variations could be transmitted to the cerebral circulation in the absence of autoregulation, and their detection in either the aorta or a cerebral artery may prove a useful index of hypovolaemia. PMID- 2774631 TI - High alkaline phosphatase activity and growth in preterm neonates. AB - In a study on 857 infants born preterm, high peak plasma alkaline phosphatase activity was independently related to slower growth rate in the neonatal period, and to a highly significant reduction in attained length at 9 months and 18 months post term. At 18 months the deficit in body length associated with peak neonatal plasma alkaline phosphase activity of 1200 IU/l or more was 1.6 cm (95% confidence interval 0.9 to 2.3 cm) after adjusting for confounding factors. The strength and magnitude of this association between high plasma alkaline phosphase activity and body length was greater than that for any other factor identified, including the infant's sex and the presence of fetal growth retardation. Data are presented that support the view that the high plasma alkaline phosphatase activity reflected early bone mineral substrate deficiency resulting in metabolic bone disease. We speculate that even silent early bone disease may interfere with the control of subsequent linear growth and emphasise the potential importance of providing preterm infants, especially those fed human milk, with adequate substrate for bone mineralisation. PMID- 2774632 TI - Bone mineral accretion rate and calcium intake in preterm infants. AB - Thirty six preterm infants (20 boys) of 25 to 32 weeks' gestation were observed from birth to around 40 weeks' postconception. When oral feeding became possible, nine received mother's own breast milk (group B), 15 formula feed (group F), and 12 formula feed supplemented with calcium (5 ml 10% calcium gluconate/100 ml feed) and phosphorus (0.5 ml 17% potassium phosphate similarly) (group S). All received a daily supplement of 400 IU vitamin D. Intakes of calcium, phosphorus, vitamin D, energy, and fluid volume were recorded. When oral feeding started, and near 40 weeks' postconception, bone mineral content of the forearm was measured by photon absorptiometry; weight and crown-heel length were also measured. After logarithmic transformation of the measurements, there were no significant intergroup differences between the mean rate constants for weight or crown-heel length describing growth during the observation period. The mean rate constant for mineral accretion (M) was significantly higher in group S than in both the others. Pooling all data, M was significantly correlated with calcium intake but not with any other variable. Mineral supplementation of feed can reduce but not cure osteopenia of prematurity. PMID- 2774633 TI - Bone mineralisation in preterm infants measured by dual energy radiographic densitometry. AB - Dual energy radiographic densitometry was used to follow postnatal changes in the bone mineral content of the radii of 15 infants of less than 30 weeks' gestation. The system permitted bone mineral content to be measured with minimal disturbance to the infants in their incubators. Mean bone mineral content at birth was 2.4 mg/mm shaft length, decreasing to 1.9 mg/mm at 6 weeks of age, before starting to rise. Mineralisation was poor compared with that of a fetus at an equivalent postconceptual age. Mean intakes of calcium and phosphate were considerably less than the intrauterine accumulation of these minerals and it is postulated that this was the main cause of the poor mineralisation. Radiographic densitometry is both accurate and precise and has advantages over photon absorptiometry in that it can be used to measure bone mineral in infants who are not only preterm, but also ill enough to require intensive care. PMID- 2774635 TI - Effect of prenatal lignocaine on auditory brain stem evoked response. AB - To test the hypothesis that there would be a positive correlation between the interpeak wave (I-V) interval as measured by auditory brain stem evoked response and the ratio of umbilical cord blood arterial to venous lignocaine concentrations in infants born after maternal epidural anaesthesia, 10 normal infants born at full term by elective caesarean section were studied. Umbilical cord arterial and venous plasma samples were assayed for lignocaine, and auditory brain stem evoked responses were elicited at 35 and 70 dB at less than 4 (test 1) and greater than or equal to 48 hours (test 2). Mean wave I-V intervals were prolonged in test 1 when compared with test 2. Linear regression showed the arterial:venous ratio accounted for 66% (left ear) and 43% (right ear) of the variance in test 1 intervals. No association was found in test 2. In newborn infants, changes in serial auditory brain stem evoked response tests occur after maternal lignocaine epidural anaesthesia and these changes correlate with blood lignocaine concentrations. PMID- 2774634 TI - In vivo distribution of human milk leucocytes after ingestion by newborn baboons. AB - The in vivo distribution of enterally administered human milk leucocytes labelled with indium hydroxyquinoline (111In) was studied in premature baboons. The animals were killed at 72 hours of age and tissue samples examined for radioactivity. Maximum activity was found in the luminal contents, and activity in the liver and spleen was higher than in bone marrow, the site where free isotope is normally deposited. These findings suggest that some intact milk leucocytes may cross from the gastrointestinal tract into the neonatal circulation. Also the high activity in gastrointestinal tissue that had been washed several times indicates that leucocytes adhere to mucosa or lie intramurally. We speculate that the presence of leucocytes in the gastrointestinal tract 60 hours after a single breast feed can provide an important defence mechanism against infection. PMID- 2774636 TI - Eyelid opening in preterm neonates. AB - The frequency and patterns of eyelid opening were examined in a group of neonates (gestational age 24-35 weeks). Observations were spread over the 24 hour period to obtain a complete pattern of events. Mean eyelid closure was 74%. When babies were grouped by gestational age, however, differences became apparent, babies of less than 26 weeks having their eyes shut for only 55% of observations compared with 93% at 28 weeks. Trend analysis confirmed that eyelid closure reached a peak at 28 weeks. Neonates exposed to a day/night regimen, opened their eyes significantly more than those exposed to continuous illumination. We suggest that frequency of eyelid opening may be related both to the infant's developmental state (postmenstrual age) and the illumination of the neonatal unit. Frequency of eyelid opening should therefore be considered when calculating the ocular light exposure of preterm neonates. PMID- 2774637 TI - Recognition and management of fetal abnormalities. Members of the Joint Study Group on Fetal Abnormalities. PMID- 2774638 TI - Biochemical and biological profile of a new enzyme preparation from Antarctic krill (E. superba) suitable for debridement of ulcerative lesions. AB - A protease extract from Antarctic krill (E. superba) intended as a new enzymatic debrider for necrotic ulcers has been characterized by sodium dodecyl sulphate polyacrylamide gradient gel electrophoresis and fast protein liquid chromatography. The predominant enzymes in the preparation represent trypsin-like activity associated with three serine proteinases. In addition two carboxypeptidases A and B are present as cooperative enzymes for a more complete breakdown of complex proteinaceous substrates. Biological studies on a well defined substrate (fibrin) originating from leg ulcers, demonstrated more effective degradation by krill enzymes than bovine trypsin, a common component in marketed enzymatic debriders. These findings support previously in vitro/in vivo studies in an animal model (rat) using excised rat skin as "necrotic" tissue. PMID- 2774639 TI - Influence of grenz rays and psychological factors on experimental pruritus induced by histamine and compound 48/80. AB - The interaction between grenz rays and experimentally induced pruritus was evaluated in 14 healthy subjects. Grenz rays were administered once weekly for 4 weeks on restricted areas of the upper arms. Pruritus was evoked by intradermal injection of histamine and the histamine liberator compound 48/80. The results were compared with unconditioned values and with those obtained following a placebo treatment procedure. The influence of psychosocial and psychosomatic factors was also evaluated. Grenz-ray therapy reduced itch but not flare responses. The influence of grenz rays was, however, not statistically different from that observed after placebo treatment. Psychosocial and psychosomatic factors were good predictors of individual skin responsiveness. The results indicate that grenz rays do not interfere with experimental histamine-induced pruritus more than placebo and emphasize the importance of knowing individual characteristics and coping strategies. PMID- 2774640 TI - Effects of isotretinoin on lipid metabolism in the rat. PMID- 2774641 TI - Higher incidences of anti-SS-A/Ro and anti-SS-B/La autoantibodies in Japanese patients with autoimmune disorders--studies of antigens and antibodies using the immunoblotting method. AB - A specific and sensitive assay was performed to detect both anti-SS-A/Ro and anti SS-B/La antibodies in sera of patients with autoimmune diseases, including systemic lupus erythematosus (SLE), progressive systemic sclerosis (PSS), Sjogren's syndrome (SS), discoid lupus erythematosus (DLE), mixed connective tissue disease (MCTD), generalized morphea (GM), and dermatomyositis (DM). The SS A/Ro and SS-B/La antigens were prepared from human spleen (HSE) and cultured human cell line (KB cells, KBE), white rabbit thymus extract (RTE) was used as the SS-B/La antigen marker. The antigens were partially purified by DEAE cellulose column chromatography. Immunoblotting showed that the SS-A/Ro antibody reacts mainly with the 58-kDa peptide of the partially purified antigen. Sera containing both the SS-A/Ro and SS-B/La antibodies reacted with the 40-kDa peptide of RTE, and the 58-kDa, 42-kDa, and 40-kDa peptides of HSE and KBE. We found that some of the SS-A/Ro antisera could further react with the 64-kDa peptide of HSE and KBE. The 58-kDa peptide is rich in its cytoplasmic fraction of KB cells, and the 4-kDa peptide in nucleoplasmic fraction. The KB cell line is a better source of the antigens than human spleen extract. The immunoblotting method clearly showed that the positivity rates of SS-A/Ro and/or SS-B/La autoantibodies were higher in sera from Japanese patients with SLE compared with titers reported for Caucasians but not in sera from healthy volunteers. PMID- 2774642 TI - Cutaneous responses to topical methyl nicotinate in black, oriental, and caucasian subjects. AB - The response of human skin to topical methyl nicotinate (MN) has been monitored in black, oriental, and caucasian subjects. The study aimed to address the question: "Do racial differences in percutaneous absorption and microcirculatory sensitivity exist?" MN-induced vasodilatation was assessed visually and by laser Doppler velocimetry (LDV). At three dose levels, in the three subject populations, four parameters were compared: (a) the diameter of the maximum visually perceptible erythematous area (Emx); (b) the area under the erythematous diameter versus time curve (AUE); (c) the maximum LDV response (Lmax); and (d) the area under the LDV response versus time curve (AUL). At p less than 0.05, AUL (black) greater than AUL (caucasian) for all MN concentrations; AUL (oriental) greater than AUL (caucasian) for the higher dose levels. Emx, AUE and Lmx showed no significant differences between races within concentrations. For all subjects, Emx, AUE, and AUL were significantly dependent on MN dose whereas Lmx was not. The results suggest that some racial differences in response to topical MN exist and that perception of these distinctions may depend upon the method of measurement. PMID- 2774643 TI - Alpha-fluoromethylhistidine in the treatment of idiopathic cold urticaria. AB - Alpha-fluoromethylhistidine (alpha-FMH), a new irreversible inhibitor of mammalian histidine decarboxylase, was tested in the treatment of idiopathic cold urticaria in 11 patients. In the initial trial with 50 mg b.i.d., a significant decrease (about 30%) in the total blood histamine level was found after 3 weeks of treatment but clinically there was no improvement in the symptoms of ten cold urticaria patients nor in the responses to the ice-cube test. In the second trial with three patients suffering from severe idiopathic cold urticaria, a higher dose of up to 500 mg b.i.d. of alpha-FMH for 3 weeks resulted in a marked decrease in the total blood histamine level as well as in an apparent inhibition of histamine synthesis in the skin previously exposed several times to cold water. The symptoms of cold urticaria and the responses in the ice-cube tests also decreased simultaneously. No clinical side effects nor changes in laboratory analysis were seen during the treatment with alpha-FMH. These results suggest that alpha-FMH may be useful in the treatment of severe cold urticaria especially in combination with histamine exhaustion of mast cells using cold water. PMID- 2774644 TI - The Ki-67 antigen in primary human melanomas--its relationship to mitotic rate and tumor thickness and its stability. AB - We investigated whether two parameters of proliferative activity - mitotic rate and Ki-67 positive cells - are interchangeable. The mitotic rate was assessed on paraffin-embedded sections, Ki-67 positive cells were immunohistologically determined in frozen tissue. A poor correlation (correlation coefficient r = 0.57) was found between both parameters. The proliferative activity was often not homogeneously distributed in the tested tumors. However, this is a major reason for the observed difference only in thin melanomas (less than 1.5 mm) as seen by comparison of tumors with homogeneous and inhomogeneous proliferative activity. We assume that arrest of cells in different stages of the cell cycle - variable from melanoma to melanoma - is the major reason for the observed discrepancy between mitotic rate and Ki-67 positive cells in tumors of 1.5 mm and thicker. The mean number of Ki-67 positive cells increased with tumor thickness. The stability of the Ki-67 antigen towards freezing, thawing, and formalin was studied. PMID- 2774645 TI - Growth defects of melanocytes in culture from vitiligo subjects are spontaneously corrected in vivo in repigmenting subjects and can be partially corrected by the addition of fibroblast-derived growth factors in vitro. AB - Melanocytes cultured from uninvolved skin of untreated vitiligo subjects have decreased initial seeding capacities, manifest a lag period for the onset of the growth phase, and cannot be passaged. In contrast, melanocytes obtained from uninvolved and perilesional skin of vitiligo subjects actively repigmenting under 8-methoxy psoralen plus sunlight (PUVA) therapy have higher initial seeding capacities, grow faster without a lag period, and can be passaged to more than 12 passages. Extracts of a fetal lung fibroblast cell line (PMR-GF) that promote the growth rates and passage capacities of melanocytes from normal adult donors have been found also to promote the growth rates and passage capacities of melanocytes from the uninvolved skin of vitiligo subjects. Extracts of a fetal lung fibroblast cell line (PMR-GF), however, did not have any further stimulatory effect on the growth of melanocytes obtained from repigmenting vitiligo subjects. Melanocytes cultured from normal and untreated vitiligo subjects grew individually dispersed in the absence of PMR-GF, but tended to grow in clusters in its presence. Melanocytes from the repigmenting vitiligo subjects, however, tended to grow in clusters even in the absence of PMR-GF. These results indicate that the defective in vitro growth characteristics of melanocytes from vitiligo subjects may be related to the pathogenesis of this disease. It is possible that growth factors may be involved in the process of repigmentation in vitiligo subjects. PMID- 2774646 TI - Effects of plucking on the anatomy of the anagen hair bulb. A light microscopic study. AB - The effects of mechanical plucking on the anatomy of human anagen hair bulbs were studied histologically in biopsy specimens taken from scalp areas of ten volunteers immediately after plucking. Anagen hair bulbs were shown to tear off not arbitrarily but in reproducible patterns which include, apart from the "typical" break conically surrounding the dermal papilla, three additional break forms: (1) rupture of the hair around the upper third of the papilla resulting in so-called dysplastic anagen hairs of the trichogram, (2) rupture of the hair well above the dermal papilla resulting in "broken" anagen hairs, (3) total removal of the proximal follicle epithelium with removal of the dermal papilla resulting in so-called papilla hairs of the trichogram. Plucking also gives rise to alterations of the mesenchymal sheath of the hair follicle mainly leading to hemorrhages and a distinct edema entailing an increase in the volume of both the dermal papilla and the underlying "papilla cushion" of Pinkus. The different break types can be due to inappropriate plucking techniques or may depend on different subphases of the anagen stage. PMID- 2774647 TI - Influence of drug solubility in the vehicle on clinical efficacy of ointments. AB - In a bilateral paired comparison (randomized double-blind study) 31 dermatitis patients (atopic and contact dermatitis) were tested with two ointments containing 0.0056% betamethasone-17-benzoate. One ointment was applied on each side of the body. The topical formulations differed in their solution capacities for the drug by a factor of about 50 (solution-type: high mutual affinity between drug and vehicle; suspension-type: low affinity). The different antiinflammatory effects were studied visually by assessing five symptoms: erythema, scaling, infiltration, lichenification, and excoriation. On the 5th day, 73% of the patients showed significant differences between the sides in favor of the suspension-type ointment (Wilcoxon test). Blanching tests on 30 volunteers confirmed the result. The in vitro drug release, however, was faster with the solution-type ointment. The efficacy of an ointment can be increased greatly, if the solution capacity for the drug is low, and thus the partition coefficient between the stratum corneum (barrier of the skin) and the vehicle is high. As long as the barrier is not damaged completely, the difference in drug release is not the determining factor for the effect. PMID- 2774649 TI - Intracellular contents of cyclic nucleotides in neutrophils and lymphocytes from patients with systemic lupus erythematosus. PMID- 2774648 TI - Effect of topical application of clotrimazole to rats on epidermal and hepatic monooxygenase activities and cytochrome P-450. AB - Clotrimazole, an N-substituted imidazole, is a widely used topical agent for the treatment of superficial fungal infections. In this study, the effect of application of clotrimazole to the skin of neonatal rats on the induction response of the cytochrome P-450-dependent monooxygenase system in epidermis and liver has been examined. A single topical application of clotrimazole (10 mg/100 g) to rats resulted in a 53% increase in hepatic cytochrome P-450 content. Clotrimazole treatment also resulted in significant induction of epidermal 7 ethoxycoumarin-O-deethylase activity. Hepatic p-nitrophenol hydroxylase, an enzyme, catalyzed principally by the ethanol inducible cytochrome P-450 isozyme, was also significantly induced (58%) by topically applied clotrimazole. This enzyme activity was undetectable in epidermal microsomes. Further characterization of the cytochrome P-450 isozymes induced in liver by clotrimazole treatment was based on monoclonal antibodies (MAbs) raised against purified rat liver cytochrome P-450 isozymes induced by phenobarbital (MAb 2-66 3) and ethanol (MAb 1-98-1). Hepatic microsomes prepared from clotrimazole treated rats showed significant immunoreactivity on Western blot with both the MAbs whereas no reactivity occurred in epidermal microsomes. Our data indicate that topical application of clotrimazole to rats results in the induction of selected cytochrome P-450 isozyme(s) in liver and epidermis which may have implications for the therapeutic use of this compound. PMID- 2774650 TI - A report on the efficacy of regional intravenous sympathetic blocks (RIS-blocks) with guanethidine (Ismelin) in long-standing and complicated leg ulcers. PMID- 2774651 TI - Immunocytochemical detection of in vitro incorporated 5-bromodeoxyuridine in paraffin sections of human skin. PMID- 2774652 TI - Attempts to find retroviral sequences in psoriatic cells. PMID- 2774654 TI - Allergic contact dermatitis to Ginkgo biloba L.: relationship with urushiol. AB - A Ginkgo biloba L. fruit extract was prepared and purified. Three groups of guinea pigs were sensitized to the crude extract, anacardic acids 1, and cardanols 2 respectively, using the FCAT method, and the fourth group to urushiol using the epicutaneous route. Each group was tested for reaction to the primary sensitizer and to the different main aromatic compounds isolated from Ginkgo fruits. Anacardic acids were found to be good sensitizers, while cardanols failed to induce allergic contact dermatitis (ACD). No cross-reactions were observed among the compounds tested. Ginkgolic acids 1 seem to be the main allergens of Ginkgo biloba L. and the hypothesis of a biotransformation of 1 into catechol 4 is not supported by experiment. PMID- 2774653 TI - Nevoid basal cell carcinoma syndrome. PMID- 2774655 TI - Fungus invasion of human hair tissue in tinea capitis caused by Microsporum canis: light and electron microscopic study. AB - Previously, we reported a morphological change of Trichophyton violaceum in hair tissue in black dot ringworm. To investigate the morphology of Microsporum canis in human hais tissue, three cases of tinea capitis by M. canis were examined by both light and electron microscopy. The fungal elements, which were located deeplyin the keratogenous zone, showed nonseptate hyphae in the outer part of the hair cortex. With the upward development of hair tissues, some hyphae invaded the keratinized inner root sheath and were there transformed into arthrospores, which then occupied the large volume of the inner root sheath; each spore was surrounded by an electron-lucent halo. In some affected hair follicles, at the follicular isthmus level, a microabscess composed of polymorphonuclear leukocytes was often formed in the outer root sheath adjacent to the arthrospores in the keratinized inner root sheath. On the other hand, the remaining hyphae in the cortex became degenerated. Fungi did not invade the hair-germinative cells. There is a distinct relationship between the morphological change of fungi and the differentiation of hair cells in tinea capitis by M. canis as well as in that by T. violaceum, although the direction of invasion and pathological roles of fungal elements within hair tissue are significantly different between the two species of fungi. PMID- 2774657 TI - Biologic roles of the innermost cell layer of the outer root sheath in human anagen hair follicle: further electron microscopic study. AB - To elucidate the biologic roles and further cytologic characteristics of the innermost cell (IMC) layer of the outer root sheath (ORS), human anagen hair follicles were ultrastructurally examined. In the lower follicle, the transeversely running tonofilaments in the inner side of the cytoplasm of the IMCs showed a massive accumulation, facing the keratinized part of a Huxley's cell protruding through a Henle's pore. In a rare instance, a spindle-shaped cell was seen between the IMC layer and the keratinized Henle's layer. At the lower isthmus portion, some of the IMCs containing a large number of tonofilaments showed a partial degeneration of the inner side of the cytoplasm. More distally, intercellular spaces between the keratinized IMCs and keratinized Henle's cells were partly dilated and contained amorphous substances. It is suggested that the IMCs in the lower follicle may play a role to support and cover the inner hair structures, tightly as hoops of a barrel. In the isthmus portion, the IMCs may loosely support and guide the keratinized Henle's cells undergoing degeneration. PMID- 2774656 TI - Animal models of androgen-dependent disorders of the pilosebaceous apparatus. 1. The androchronogenetic alopecia (AGA) mouse as a model for male-pattern baldness. AB - The androchronogenetic alopecia (AGA) mouse if a mutant strain which expresses androgen-dependent baldness. Daily s.c. injection of testosterone (T) induced thinning of the hair coat along the upper dorsum after 4 weeks of treatment. After 12 to 14 weeks this diffuse alopecia eventually eveloped into a bald area which extended to the middorsum. Dihydrotestosterone was more effective than T in stimulating the onset of AGA. In this model, T produced the alopecia by decreasing the rate of hair growth, decreasing the duration of anagen, and markedly prolonging the duration of telogen. When applied topically at a concentration of 5%, cyproterone acetate delayed the progression of the T mediated hair loss. However, this inhibitory effect occurred through systemic means as evidenced by decrease in the size of the submaxillary gland. Chronic feeding of androgen-treated female AGA mice with a diet containing 0.01% minoxidil also inhibited the development of alopecia. Skin and core temperatures were found to be higher in minoxidil-treated animals than in the placebo-treated controls. Minoxidil at a topical dose of 1% did not produce any effect. Increasing the dose to 2% caused a slight retardation of the development of alopecia. However, a 60% inhibition was observed at a topical dose of 5% minoxidil after 12 weeks of treatment (p less than 0.03). The data demonstrate that hair loss in the AGA mouse is androgen dependent and that this mutant strain can serve as a suitable model for the screening of compounds, such as antiandrogens and vasodilators, which may influence the balding process. PMID- 2774658 TI - Study of basement membrane formation in dermal-epidermal recombinants in vitro. AB - Two different dermal-epidermal recombinants were prepared in vitro and used to study the synthesis and formation of basement membrane. The first was obtained by culturing keratinocytes on the surface of a collagen lattice populated by fibroblasts. The second was prepared by coculture of both keratinocytes and fibroblasts in a collagen lattice. After 6 weeks of culture, the basal lamina was observed with electron microscopy only if keratinocytes were cultivated on top of the collagen lattice populated by fibroblasts. In the second model, however, type IV collagen, laminin, and pemphigoid bullosa antigen could be detected by immunofluorescence as well as synthesis of type IV collagen in the culture, but no basement membrane was observed by electron microscopy. These data demonstrate that, in vitro, basement membrane formation depends not only on the presence of the macromolecular components but also on the culture conditions. PMID- 2774659 TI - Epidermal proliferation and the neutrophilic infiltrates of experimental cutaneous candidiasis in mice. AB - A mouse model of cutaneous candidiasis was used to determine if the prominent neutrophilic infiltrates in the infected skin of nonimmune animals were responsible for inducing the early phase of epidermal proliferation seen in these infections. Both the organisms and resulting neutrophilic microabscesses were found in the cellular layers of the epidermis at 12 h after inoculation, and were then extruded together to a more superficial site in the stratum corneum over the next 1-2 days. The degree of epidermal proliferation elicited at the site of the Candida foci, as determined from the thickness of the cellular layers of the epidermis, was the same for foci with neutrophils as for those without, even when the latter came from severely leukopenic animals. The location of neutrophils within the infected skin or the numbers of organisms present did not seem to make a difference with respect to the degree of epidermal proliferation produced at the site of Candida foci. These data suggest that in acute experimental cutaneous Candida infections the organisms can elicit a vigorous epidermal proliferative response in the absence of the neutrophilic infiltrates usually seen in these infections. PMID- 2774660 TI - Ultrastructure of cultured mouse S91 melanoma cells with special emphasis on viral particles. AB - Mouse S91 melanoma cells which grow as a monolayer in culture were studied by transmission and scanning electron microscopy after fixation in situ. The cells were spindle-shaped and tended to grow in dense colonies. Melanosomes at all stages of melanization (stages I-IV) were observed. Other cell organelles reflected high cellular activity. Both A-type and C-type viral particles were abundantly observed. A-type particles were 60-90 nm in diameter. They had an electron-lucent center surrounded by a double shell. They were abundantly observed in the cisternae of the endoplasmic reticulum but never extracellularly. C-type retrovirus particles were larger, 80-110 nm in diameter. They had an electron-dense core surrounded by an electron-lucent area and a limiting membrane. They were seen to bud from the plasma membrane into intracellular vacuoles or into the intercellular space. PMID- 2774661 TI - Increased number of mast cells accompany enhanced collagen synthesis in linear localized scleroderma. PMID- 2774662 TI - Does an association exist between PCT and SLE? Results of a study on autoantibodies in 158 patients affected with PCT. PMID- 2774663 TI - Quantification of sodium lauryl sulfate irritant dermatitis in man: comparison of four techniques: skin color reflectance, transepidermal water loss, laser Doppler flow measurement and visual scores. PMID- 2774664 TI - Residues of chlorinated phenols and phenoxy acid herbicides in the urine of Arkansas children. AB - Urine samples from 197 Arkansas children were analyzed for eight chlorinated phenols and four chlorinated phenoxy herbicides by using a new procedure that combined gas chromatography with tandem mass spectrometry. With the detection limit of 1 part per billion (ppb), six of these pesticides were detected in more than 10% of the samples. 2,5-Dichlorophenol (a metabolite of p-dichlorobenzene), and pentachlorophenol were detected in 96% and 100%, respectively, of the children's urine at median concentrations of 9 ppb and 14 ppb, respectively. 2,4,5-Trichlorophenol was detected in 54% of the children's urine at a median concentration of 1 ppb. One trichlorophenol and three other dichlorophenols were found in 3% to 27% of the samples. The herbicide 2,4-dichlorophenoxyacetic acid was observed in 20% of all samples. The concentrations of all analytes are reported as background or reference levels for use in future studies. The finding of 2,5-dichlorophenol as a ubiquitous contaminant merits further study. PMID- 2774665 TI - Pentachlorophenol measurements in body fluids of people in log homes and workplaces. AB - Human exposure to pentachlorophenol (PCP) was evaluated in the normal population (controls), residents of PCP-treated log homes, and persons exposed primarily in the workplace. Blood and urine samples were analyzed by gas chromatography after extraction and acetylation. For 34 controls, serum PCP values ranged from 15-75 ppb with a mean of 40 ppb. For 123 residents of log homes, serum levels ranged from 69-1,340 ppb with a mean of 420 ppb. In such homes, serum levels for children were significantly higher than those for parents, averaging 1.8 times greater. Serum and urine values for workers varied widely, depending on the workplace, with serum levels ranging from 26 to 84,900 ppb of PCP. Urinary concentrations when corrected for creatinine values correlated well (r = 0.92) with serum concentrations. Coating PCP-treated logs of home interiors with a sealant reduced serum PCP levels in the residents. PMID- 2774666 TI - Organochlorine chemicals in human breast milk in Hong Kong. AB - The results of a small-scale survey of organochlorine contaminants in human breast milk are presented and compared to previous data from 1976 for Hong Kong, and to reported data from elsewhere. Concentrations of p,p DDT, dieldrin and hexachlorobenzene (HCB) in recent breast milk samples were slightly but significantly lower than those in samples taken a decade previously in Hong Kong. However, levels of gamma-HCH (hexachlorocyclohexane) were higher in the more recent samples. The concentrations of DDT, DDE and beta-HCH in Hong Kong breast milk remain among the highest reported in the literature. Probable routes of uptake of such contaminants include the ingestion of seafood, as these same compounds have previously been found at high concentrations in mussels from Hong Kong waters. Data for organochlorine levels in breast milk from other parts of Asia are not available, but trends in global pesticide usage suggest that significant contamination elsewhere in the continent is likely. PMID- 2774668 TI - Propagation of error and bias in half-life estimates based on two measurements. AB - Limited data on toxic compounds in humans often necessitate that biological half life estimates be based on only two measurements over a time interval, both of which are subject to analytical error. Propagation of error calculations and computer simulations were performed which showed that as the time interval gets shorter and/or the analytical error increases, the variability of the half-life estimate increases. Negative and large positive values create problems in computing the mean half-life and can lead to biases in that estimator. However, when negative values are considered equivalent to large positive half-lives, the median half-life has negligible bias even at large analytical coefficients of variation and measurement intervals much shorter than one half-life. PMID- 2774667 TI - Observations on the progress of chlordane contamination in humans by blood and sebum analysis. AB - Chlordane residues were determined in human blood and sebum samples. The residue levels in both types of samples were remarkably increased in pest control operators and in the general population living in an area heavily contaminated with chlordane. The compound with the highest level among the residues in the blood of control subjects was oxychlordane followed by trans-nonachlor and trans chlordane, while in the sebum, the highest levels found was that of trans chlordane followed by cis-chlordane and trans-nonachlor. The sebum residue was similar to technical chlordane in its component pattern, but it largely originated from sources other than simple exogenous contamination. Thus, sebum might be a unique and available sample source for evaluating direct exposure to technical chlordane. A progressive state of contamination was observed in residents whose homes had been treated with chlordane. PMID- 2774669 TI - Pesticide exposure to greenhouse handgunners. AB - The exposure of pesticide applicators in a commercial greenhouse facility was assessed. Data were collected from four handgunners who applied fluvalinate (insecticide), chlorpyrifos (insecticide), ethazol (fungicide), and dicofol (miticide). Potential exposure was measured with exposure pads placed outside all clothing of the applicator. Handwashes and air samples were also collected, as were pre- and post-exposure tank mixture samples. Pesticide penetration was measured with exposure pads placed inside protective clothing. When all exposure assessments were normalized for spray rate, it was determined that applicators were at significantly greater potential dermal risk (excluding hands) from fluvalinate. The normalized air samples showed significantly more exposure to the applicator from ethazol. Exposure to outside pads was primarily (84%) to the legs of the applicators. Ethazol penetrated Tyvek coveralls more readily than the other compounds. Tank mixture analyses suggested that the wettable powder formulations were not well-mixed. PMID- 2774671 TI - Bridging the gap between the nurse researcher and clinician. PMID- 2774672 TI - The effects of pet therapy on the social behavior of institutionalized Alzheimer's clients. AB - Twelve (N = 12) Alzheimer's (AD) residents of a Special Care Unit in a large midwest Veterans' Home were observed for the effects of the presence of a pet dog on eight social behaviors: smiles, laughs, looks, leans, touches, verbalizations, name-calling, and others. Observations took place on three separate occasions (absence of dog, temporary presence of the dog, and permanent placement of the dog) in both group and individual settings. The results showed that the presence of the dog increased the number of total social behaviors of the AD clients, but no differences were found in behaviors between the temporary and permanent placement of the dog. PMID- 2774673 TI - Ethnic differences in intrinsic/extrinsic religious orientation and depression in the elderly. AB - Religion is thought by many to assume an increasingly important role in the lives of elderly people. This phenomenon is true for both black and white elderly. Comparative analysis of religious participation of black and white elderly individuals indicates that while religion is important for both groups, they differ in specific religious behaviors and the role that religion plays in providing a resource for coping with the adversities of aging. Data were collected from 68 noninstitutionalized elderly individuals to determine if black and white elderly differed in intrinsic and extrinsic religious behaviors. Chi square analysis indicated differences between black and white elderly in intrinsic religious orientation chi 2 = 30.32; df = 18, p = 0.03). Black elderly individuals were more intrinsically oriented to religion than were white. There were no differences between black and white elderly in extrinsic orientation, but both groups differed in depression (F = 2.23, p = 0.03). Black elderly group members were more depressed than were whites members. Pearson correlation analysis showed a significant negative relationship between intrinsic religious orientation and depression (r = -.23, p = .026). The findings suggest that nurses should encourage the elderly client to participate in religious practices and activities. PMID- 2774670 TI - Effect of zinc deficiency on the accumulation of metallothionein and cadmium in the rat liver and kidney. AB - The effects of zinc (Zn) deficiency and repeated exposure to cadmium (Cd) on the accumulation and distribution of metallothionein (MT), Cd and Zn in the liver and kidney were studied. Male Sprague-Dawley rats were fed either a Zn-deficient (1 ppm) or a Zn-adequate (40 ppm) diet during the experiment, and the rats were injected subcutaneously with a cadmium chloride solution (1.0 mg Cd/kg of body weight, 5 days a week) for 4 weeks. Cadmium, Zn, and Cd-induced MT concentrations in the liver and kidney were lower in the Zn-deficient rats (-Zn + Cd) than in the Zn-adequate rats (+Zn + Cd), while the content of Cd bound to high molecular weight proteins (HMWP) was greater in the Zn-deficient rats (-Zn + Cd). The Zn bound to Cd-induced MT was reduced to 30% in the liver and to 60% in the kidney of the Zn-deficient rats (-Zn + Cd) as compared with that of the Zn-adequate rats (+Zn + Cd). In the kidney of Zn-deficient rats, exposure to Cd caused a decrease in essential Zn associated with HMWP as compared with that of Zn-adequate rats (+Zn + Cd). Thus, Zn-deficiency affected the distribution of Cd in tissues, MT and HMWP and accelerated substantially Cd-induced Zn-deficiency in the kidney.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2774675 TI - Nurses' networks: obstacles and challenge. AB - Occupational cohesiveness and network formation among nurses are widely advocated as logical solutions to practical problems and as sources of emotional support. However, actual nurses' networks have not been studied. As part of a larger study, this report analyzes the social support networks of 35 psychiatric nurses. The nurses, who were employed in a large public hospital, were studied as individuals who had private as well as occupational roles. Properties, significance, and articulation of private and public portions of networks were examined for patterns that correlated with characteristics of the nurses. Evidence of significant barriers to practice-level relationships among nurses is presented. Realistic expectations for development of effective networks require management of those obstacles. PMID- 2774674 TI - Parents' illness models of schizophrenia. AB - The aim of this study is to describe the lived experience of schizophrenia, as understood by parents who care for adult schizophrenic offspring in the community. Parents' illness models--their personal understandings of the causes, nature, course, and appropriate treatment of schizophrenia--were explored in open ended interviews with 21 parents from 14 families. Parents described four distinct models of the everyday lived reality of schizophrenia. Parental care patterns were substantially shaped by these illness models. Nurses can support families' efforts to care for the ill member by broadening their focus to the meaning and experience of the illness for schizophrenics and their families. PMID- 2774676 TI - Cross-cultural relationships between self-concept and body image in high school age boys. AB - The relationship between self-concept and body image was investigated through a secondary analysis of data from a sample of 1,200 high school male students from 30 language/culture communities (Osgood, May, & Myron, 1975). Subjects rated adjectives pertaining to self-concept and body image using 7-step semantic differential bipolar scales. Adjectives were related to the dimensions of Evaluation, Potency, and Activity. Correlation, factor analysis, and multiple regression were utilized to examine multivariate relationships among self-concept dimensions and body-image dimensions. Significant positive correlations were found between self-concept and body image. In addition, significant positive relationships were found when self-concept factors were regressed on the body image factor (R2 = .49 to .57, p less than or equal to .001) for Activity and Potency. Results support the existence of a strong positive relationship between self-concept and body image across the 30 cultures involved. Findings have important implications for nursing in assessment and interventions with clients who have deficits in either self-concept or body image. PMID- 2774677 TI - Could it be Ganser's syndrome? AB - The term, "Ganser's syndrome," was identified by Sigbert J. Ganser, a German psychiatrist, near the turn of the century. Ganser's syndrome, defined as an hysterical reaction, was often used to describe prisoners who appeared to be trying to escape prosecution. Today, Ganser's syndrome is debated by both psychiatric and judicial systems. This paper addresses these issues by identifying guidelines for assessment and recognition of common malingering behaviors displayed by Ganser's syndrome patients. Psychiatric nurses who practice in both psychiatric and legal systems need an understanding of Ganser's syndrome to adequately assess the patient, plan effective treatment, and complete an evaluation of care. This understanding will enable the nurse to answer the important question, "Could it be Ganser's syndrome?" With the increase of crime and the prison population, the use of "Insufficient Comprehension to Stand Trial" may be a legal option for defendants. If they are exhibiting inappropriate behavior and are a danger to themselves or others, a psychiatric evaluation may be ordered by the court. It is then the responsibility of a psychiatric facility to assess, treat, and evaluate Ganser's syndrome patients in an attempt to return them to competency. The patients may return to court following the psychiatric evaluation if they are found competent to stand trial. PMID- 2774678 TI - Placental protein 12 (PP 12), a decidual protein, in pregnancy complicated by diabetes with retinopathy. AB - Placental protein 12 (IGF-bp/PP 12) is a soluble tissue antigen produced in the decidua. PP 12 was measured in the 3rd trimester of diabetic pregnancy complicated by retinopathy. The mean values of the healthy control group between 28 and 34 and between 35 and 39 weeks gestation were 108 +/- 39 micrograms/l and 124 +/- 47 micrograms/l, respectively. The equivalent values in diabetic pregnancies complicated by retinopathy were 200 +/- 80 micrograms/l and 204 +/- 81 micrograms/l, respectively; both these PP 12 values were significantly (P less than 0.05) above the values in the control group. There was no significant difference between benign and proliferative retinopathy. The increased PP 12 levels in the presence of diabetic retinopathy are probably caused by decidual degeneration. PMID- 2774680 TI - Why does subclavian vein thrombosis happen and can it be prevented or treated? PMID- 2774679 TI - Placental characteristics in twin transfusion syndrome. AB - The authors describe the histological features of the placenta in a typical case of twin-to-twin transfusion, with particular attention focused on the stereologic aspects. Villi from the anemic placental portion were slightly edematous, with small and inconspicuous vessels. The stereologic characteristics of this portion were nearer values of normal placentas. The plethoric region appears as a postmature organ, with a very thin trophoblast layer and numerous vasculo syncytial membranes. The most dramatic alterations of this region were mainly related to the foetal capillary. According to the stereologic results, the consecutive circulatory alterations would facilitate the maternal-fetal exchanges in the plethoric placental territory, thus justifying the greater development of this twin. PMID- 2774682 TI - Do we belong? PMID- 2774681 TI - Managing a diabetic for aortic valve replacement with CCPD. PMID- 2774683 TI - School and the in-center pediatric hemodialysis patient. AB - Life "on the machine" can significantly disrupt the social and academic school experience of preadolescent and adolescent renal failure patients because of their frequent absences. When hemodialysis patients were offered treatments after school and on Saturday mornings, patients, families, and staff reported significant improvement in the patients' social integration and academic performance. PMID- 2774685 TI - Physical growth and behavioral adaptations of children with renal insufficiency. AB - The purpose of this study was to explore the relationship between physical growth and behavioral adaptations of children in the early stages of renal insufficiency. Twenty children between the ages of two and ten years were evaluated along with their parents. The results showed that there was a relationship between growth velocity and the balance of stresses to supports. PMID- 2774684 TI - A tool for assessing inadequate dialysis. AB - Blood urea nitrogen (BUN) is thought to be a useful marker of the concentration of other solutes that underly the manifestation of uremia. By monitoring quality assurance parameters, 8 out of 57 dialysis patients were found during monthly blood work exams to have BUN greater than 100 mg/dl. An "Inadequate Dialysis Checklist" was designed for hemodialysis and peritoneal dialysis and used to assess all eight patients' treatments. The dialysis was corrected or integrally modified. As a result, the number of patients with BUN greater than 100 mg/dl decreased. These checklists can be useful for case managers to assess and evaluate dialysis variables. PMID- 2774686 TI - The image of nursing: a personal responsibility. PMID- 2774687 TI - Acute care nurses' perceptions of hemodialysis patients. AB - The purpose of the study was to determine how medical-surgical nurses in an urban community hospital view end stage renal disease patients on hemodialysis and to identify factors that influence these perceptions. Data were collected by a single, semistructured interview. Nurses described the care of dialysis patients as being difficult and identified special problems they encountered when caring for these patients. These findings have major implications for nephrology nursing practice. PMID- 2774688 TI - Pathophysiology of anemia and ESRD. AB - Patients with end-stage renal disease often develop anemia. Laboratory tests show that inadequate erythropoietin quantities are the major mechanism causing this anemia. Traditional therapies for correcting blood parameters include androgens and blood transfusions, but both of these modalities produce a wide range of side effects. PMID- 2774689 TI - Epoetin alfa: patient management. AB - Nurses play an integral role in managing the patient receiving Epoetin alfa. Patient parameters, such as blood pressure and hematocrit, must be continually monitored to assure the effectiveness of the medication. PMID- 2774690 TI - Nursing care plan/patient teaching plan. AB - Nurses will play a vital role in monitoring and educating the patient receiving Epoetin alfa. Nursing understanding of the patient management aspects of Epoetin alfa therapy will assist in the ultimate goal of maintaining the hematocrit at an acceptable level. PMID- 2774691 TI - Effectiveness of a phosphorous educational program for dialysis patients. AB - Fifty-four percent of all dialysis patients followed by a single center had elevated serum phosphorus levels on more than 25% of all measurements. A phosphorus patient education program was developed and implemented and knowledge was measured with a pretest and posttest. The continuous ambulatory peritoneal dialysis group had a significant increase in knowledge and a minor, but statistically significant, decrease in serum phosphorus after participating in the education program. In contrast, center hemodialysis patients did not demonstrate a significant increase in knowledge or decrease in serum phosphorus. These different outcomes could not be attributed to specific differences between the two groups. Serum phosphorus control is a complex process, and this education program did not result in a clinically significant improvement in serum phosphorus levels. PMID- 2774692 TI - International exchange: nephrology nursing in the United Kingdom. PMID- 2774693 TI - Nephrology nursing consult: acute renal failure secondary to chemotherapy/sepsis. PMID- 2774694 TI - Death with dignity. PMID- 2774695 TI - Effects of low dose corticosteroids on bone mass in rheumatoid arthritis: a longitudinal study. AB - Low dose corticosteroids are effective in suppressing synovitis in rheumatoid arthritis (RA), but there remains concern about their side effects, particularly osteoporosis. To examine the effects of low dose corticosteroids on bone loss in RA bone mineral density (BMD) was measured in the lumbar spine and hip for up to two years in 15 patients treated with these agents (mean dose prednis(ol)one 6.6 mg/day). 15 patients not receiving them, and 15 age matched controls. The initial BMD at both skeletal sites was significantly reduced in both patient groups compared with controls. The mean change in bone density was 0.2, 0.1, and -0.1% a year in the spine and -2.0, -1.9, and -1.0% a year in the hip respectively for the three groups. These rates of bone loss were not significantly different between groups at either site. These findings suggest that low dose corticosteroid treatment in RA is not associated with an increased risk of osteoporosis. PMID- 2774697 TI - Determination of synovial fluid hyaluronate concentration and polymerisation by high performance liquid chromatography. AB - High performance liquid chromatography (HPLC) with a size exclusion column and ultraviolet monitoring was used to study the effect of synovial fluid hyaluronate concentration and degree of polymerisation on viscosity and mucin clot formation. Rotational viscometry measurements showed an exponential relation between the synovial fluid hyaluronate concentration and relative viscosity, the viscosity increasing particularly steeply with hyaluronate concentrations exceeding 2-2.5 mg/ml. The scattering of individual values observed around the expected curve was eliminated when both the hyaluronate concentration and its degree of polymerisation were taken into account. Hyaluronate concentration and degree of polymerisation also correlated with the quality of mucin clot, though only HPLC provided more detailed quantitative information about this association. Because HPLC allows reproducible and rapid simultaneous analysis of the synovial fluid hyaluronate concentration and the degree of polymerisation in small volumes of unprocessed samples it can be used in well equipped rheumatological units to replace other methods used previously. PMID- 2774696 TI - Characterisation of soluble and cell associated phospholipase A2 from rheumatoid synovial fluid. AB - The hydrolysis of radiolabelled Escherichia coli phospholipids, and micellar dispersions of phosphatidylethanolamine and phosphatidylcholine, were used to characterise the phospholipase A2 activity in synovial fluid from patients with rheumatoid arthritis. Cell free fractions of synovial fluid contain a phospholipase A2 enzyme that preferentially releases [14C]oleic acid from E coli biomembranes (specific activity 291.3 (SEM 27.6) pmol/min/mg). This enzyme requires calcium and is optimally active at neutral pH. Purified dispersions of phosphatidylethanolamine are also readily degraded by the soluble enzyme, but it is not active against phosphatidylcholine. The substitution of [14C]oleic acid by [3H]arachidonic acid for the labelling of E coli allowed differentiation between the soluble phospholipase A2 and the cell associated phospholipase A2 present in sonicates of mononuclear cells and neutrophils from peripheral blood and synovial fluid. The cell associated phospholipase A2 preferentially releases [3H]arachidonic acid from E coli cardiolipin. In this paper the phospholipid substrate specificity of phospholipase A2 from rheumatoid synovial fluid, the optimal assay conditions for its detection, and a standardised expression of activity in terms of pmol per minute per mg of protein are established. PMID- 2774698 TI - Immunoblot analysis of IgM, IgG, and IgA responses to plasmid encoded released proteins of Yersinia enterocolitica in patients with or without yersinia triggered reactive arthritis. AB - The IgM, IgG, and IgA antibody responses of patients with Yersinia enterocolitica O:3 infection were studied by immunoblotting with plasmid encoded released proteins of Y enterocolitica as the antigens. The results indicate that antibodies of all three classes are most consistently directed against the proteins of molecular weights 25,000 and 36,000. Less than two months after the onset of infection 18 of the 19 patients with yersinia triggered reactive arthritis had IgA class antibodies against the released protein of mol. wt 36,000, whereas only eight of the 17 patients with non-arthritic yersiniosis had these antibodies. The same difference between the arthritic and non-arthritic patients was observed also 8-12 months after the onset of infection. PMID- 2774699 TI - Variation of serum IgG subclass concentrations with disease activity in juvenile chronic arthritis. AB - Nineteen patients with juvenile chronic arthritis were followed up and serum IgG subclass concentrations measured at different stages of disease activity. Patients were divided into three groups according to clinical activity of the disease: active disease, partial remission, and remission. The results were compared with normal values obtained in 448 healthy children aged 6 months to 18 years with a homogeneous distribution for each year of age. Serum IgG subclass concentrations of each child were first log transformed and then age corrected, taking the deviation of the log transformed value from that expected for a child of the same age. It was found that patients with partial remission had increased concentrations of IgG2 and decreased concentrations of IgG1 compared with patients with active disease. This suggests that the remission inducing process, at least in juvenile chronic arthritis, is accompanied by a switch of IgG subclass production. PMID- 2774700 TI - Platelet serotonin in systemic sclerosis. AB - Platelet serotonin concentrations were measured in 43 patients with systemic sclerosis, in 11 patients with primary Raynaud's phenomenon, and in 38 normal controls. Patients with the CREST variant (calcinosis, Raynaud's phenomenon, oesophageal dysmotility, sclerodactyly, telangiectasia) had significantly lower platelet serotonin concentrations than normal controls. Patients with diffuse systemic sclerosis had normal platelet serotonin concentrations. In patients with CREST treatment with ketanserin, a specific serotonin antagonist, normalised platelet serotonin concentrations. These data provide further evidence suggesting that in systemic sclerosis, particularly the CREST variant, there is widespread platelet activation. PMID- 2774701 TI - C4 concentrations and C4 deficiency alleles in systemic lupus erythematosus. AB - In a study of 66 patients with systemic lupus erythematosus (SLE) and 80 controls it was found that the presence of two deficiency (null) alleles of C4 had a significant effect on mean C4 concentrations in serum. In six controls who each had two C4 null alleles the mean C4 concentration in serum was 56% lower than in 43 controls without C4 null alleles; the nadir of the C4 concentration in four patients with SLE with two null alleles was also lower by a mean of 55% than in 32 patients who did not have null alleles. Reduced production of C4 allotypes in subjects with two null alleles may be an important determinant of total C4 concentration in patients with SLE. For optimal interpretation of C4 concentrations in SLE, C4 allotyping appears to be indicated, particularly to identify patients who have two null alleles of C4. PMID- 2774702 TI - Allergic granulomatosis and angiitis (Churg-Strauss syndrome): response to 'pulse' intravenous cyclophosphamide. AB - A 51 year old Chinese woman suffering from classical Churg-Strauss syndrome is presented. She deteriorated with acute pulmonary infiltrates resulting in hypoxaemic respiratory failure but responded dramatically with 'pulse' intravenous cyclophosphamide. PMID- 2774703 TI - Fatal aplastic anaemia and liver toxicity caused by D-penicillamine treatment of rheumatoid arthritis. AB - A 65 year old woman with rheumatoid arthritis developed marrow aplasia and jaundice owing to D-penicillamine treatment. Recovery of bone marrow was ineffective, and the patient finally died despite intensive therapeutic measures. The rare coexistence of myelotoxicity and hepatotoxicity is presented and discussed. PMID- 2774704 TI - Heberden's nodes and osteoarthrosis of the hip. PMID- 2774705 TI - Osteomalacia and coeliac disease presenting as isolated dactylitis. PMID- 2774706 TI - The skill, science, and soul of the surgeon. PMID- 2774707 TI - Long-term follow-up of surgically managed carotid bifurcation atherosclerosis. Justification for an aggressive approach. AB - To document the efficacy of our aggressive surgical approach to stroke prevention, we compiled follow-up data on 619 patients undergoing 993 carotid endarterectomies at our institution since 1970. Following carotid endarterectomy, crude annual stroke incidence, including perioperative strokes (2.2%), was 1.9%. In our symptomatic patients crude annual stroke incidence, including perioperative strokes (2.7%), was 2.1%. This is superior to the annual stroke incidence seen in patients on "optimal" medical therapy as defined by the Canadian Cooperative Study (4.6% in men), the AICLA Study (2.9%), the American Multicenter Trial (8%), and the Canadian- American Cooperative Trial (approximately 5%). In our asymptomatic patients, crude annual stroke incidence, including perioperative strokes (1.1%), was 1.4%. This is superior to nonsurgical therapy for asymptomatic patients with hemodynamically significant or more than 75% stenoses as reported by the Mayo Clinic (3.4%) or Chambers and Norris (2.7%). An aggressive surgical approach to carotid bifurcation atherosclerosis is superior to nonsurgical therapy in symptomatic and selected asymptomatic patients if low perioperative mortality/stroke morbidity rates are achieved. PMID- 2774708 TI - Does the bacteremia observed in hemorrhagic shock have clinical significance? A study in germ-free animals. AB - We have recently reported the rapid appearance of bacteria and endotoxin in the blood of rats and of trauma patients in the course of 30 minutes to 2 hours of hemorrhagic shock. The current study was designed to determine the effect of this bacteremia and endotoxemia on survival. Thirty-three conventional (C:group 1) and 36 germ-free (GF:group 2) Sprague Dawley rats were subjected to our previously described model of treated hemorrhagic shock. Survival in the GF group was significantly better than the C group at 24, 48, and 72 hours after shock. Endotoxin levels were elevated in 88% of C group during shock and in 28% of GF group. The gut of the GF animal contains endotoxin (26 ng/gm of stool) as does the sterile food supply (393 ng/gm of rat chow). PMID- 2774709 TI - Vena caval involvement by renal cell carcinoma. Surgical resection provides meaningful long-term survival. AB - In 1972 we first reported that vena caval extension by tumor thrombus was a potentially curable lesion provided that complete removal could be achieved. We have developed a technique for safe removal of extensive vena caval thrombi extending up to the right atrium without the need for cardiopulmonary bypass or hypothermic cardioplegia. Cardiopulmonary bypass, however, is advocated for some type III thrombi, but the addition of the pump and heparinization compounds the magnitude of the procedure. We use a right thoracoabdominal approach for tumors arising from either kidney with vascular isolation of the vena cava from its insertion into the right atrium to the iliac bifurcation. From 1972 to 1988, 56 patients ranging in age from 31 to 76 years were evaluated and 53 underwent radical nephrectomy with en bloc vena caval tumor thrombectomy. Of these patients, 21 had subhepatic caval thrombus extension (level 1); 24 had extension into the intrahepatic vena cava (level 2), and 8 had thrombi extending into the heart (level 3). Overall 1-, 3-, and 5-year survival was 56%, 34%, and 25%, respectively. Crucial to survival was complete surgical excision. Successful extirpation of all apparent tumor was possible in 75% of the patients in this series. With an expected 5-year survival rate of 57% for those without metastatic disease to other organs, we continue to advocate an aggressive optimistic approach for patients if there is no preoperative evidence of metastatic disease. PMID- 2774710 TI - Post-traumatic changes in, and effect of colloid osmotic pressure on the distribution of body water. AB - The aim of this study was to define the post-traumatic changes in body fluid compartments and to evaluate the effect of plasma colloid osmotic pressure (COP) on the partitioning of body fluid between these compartments. Forty-two measurements of plasma volume (green dye), extracellular volume (bromine), and total body water (deuterium) were done in ten traumatized patients (mean Injury Severity Score, ISS, = 34) and 23 similar control studies were done in eight healthy volunteers who were in stable fluid balance. Interstitial volume, intracellular volume, and blood volume were calculated from measured fluid spaces and hematocrit; COP was directly measured. Studies in volunteers on consecutive days indicated good reproducibility, with coefficients of variation equal to 3.5% for COP, 6.3% for plasma volume, 4.5% for extracellular volume, and 4.9% for total body water. COP values extended over the entire range seen clinically, from 10 to 30 mmHg. Interstitial volume was increased by 55% in patients, but intracellular volume was decreased by 10%. We conclude (1) that posttraumatic peripheral edema resulting from hemodilution is located in the interstitial compartment, with no intracellular space expansion; and (2) that interstitial volume, but not intracellular volume, is closely related to plasma COP. PMID- 2774711 TI - The effects of lithogenic bile on gallbladder epithelium. AB - Prairie dogs were fed a 1.2% cholesterol diet for up to 24 weeks to evaluate the effects of lithogenic bile on the mucosa of the gallbladder. There was a progressive increase in the lithogenic index of the gallbladder bile (1.44 +/- 0.15 at 4 weeks, p less than 0.05). Fifty-five of 70 animals developed gallstones between the second and fourth week. Increasing stone burden was associated with a 27% (p less than 0.05) decrease in the electrical resistance of the epithelium and a 60% (p less than 0.05) decrease in net sodium transport when measured isotopically in an Ussing chamber (3 weeks). After 4 months, seven of ten animals developed inflammatory mucosal polyps characterized by a heavy infiltration of plasma cells into an expanded matrix. Cellular infiltration began as early as 2 weeks. These changes occurred without alterations in the ultrastructural appearance of the epithelium. PMID- 2774712 TI - The expected lifetime of porcine valves. PMID- 2774713 TI - Surgical recanalization for treatment of evolving myocardial infarction. PMID- 2774714 TI - Evolving techniques in the management of benign esophageal stricture. PMID- 2774715 TI - The porcine bioprosthetic heart valve: experience at 15 years. AB - The porcine bioprosthetic valve has been in use at Henry Ford Hospital since 1971. In this review, 980 patients with 1,081 porcine bioprosthetic valves were examined from 1 month to 16.4 years after implantation with a 99% complete follow up. Patient survival was 59% +/- 2.2% (+/- standard error of the mean) at 10 years and 38% +/- 4.0% at 15 years. Factors associated with decreased survival after hospital discharge were age greater than 35 years and New York Heart Association functional class IV. Freedom from thromboembolism was 92% +/- 1.2% at 10 years and 89% +/- 3.2% at 15 years. Freedom from endocarditis was 93% +/- 1.2% at 10 years and 92% +/- 1.3% at 15 years. Freedom from structural valve degeneration for all valves was 71% +/- 2.6% at 10 years and 31% +/- 5.6% at 15 years. Factors associated with increased risk of structural valve degeneration were age younger than 35 years, female sex, and preoperative cardiac index greater than 2 L/min/m2. Among a total of 172 patients undergoing removal of a degenerated valve, mortality was 12.5%, and significant risk factors for death at reoperation were emergency operation and functional class IV. Experience with the porcine bioprosthetic valve after 15 years suggests that its use be confined to older patients or patients with a contraindication of anticoagulation. PMID- 2774716 TI - Reperfusion of infarcting myocardium: benefit of surgical reperfusion in a chronic model. AB - Surgical reperfusion of experimental infarction leads to improved recovery of regional function compared with medical reperfusion, but sustained myocardial salvage has not been demonstrated. Twenty-two dogs were subjected to two hours of anterior descending occlusion and divided into three groups: group P (n = 7), no reperfusion; group M (n = 8), medical reperfusion; and group S (n = 7), controlled surgical reperfusion. Ischemia caused systolic bulging (-36% of control systolic shortening, p less than 0.01) and decreased regional work (9% of control pressure-length loop area, p less than 0.05). Thirty minutes after reperfusion group M had persistent systolic bulging (-9% of control systolic shortening) and decreased regional work (9% of control pressure-length loop area), whereas group S had +17% of control systolic shortening and 33% of control pressure-length loop area. After 1 week, regional function improved in all three groups (percent of control systolic shortening: group P, 26%; group M, 19%; group S, 52%), but systolic shortening was significantly better in group S (p less than 0.05 versus group M). Surgical reperfusion also resulted in one half of the eventual myocardial necrosis found in the other groups (group P, 45% of area at risk; group M, 38%; group S, 19%; p less than 0.05, group S versus group P or M). In this model, medical reperfusion offered no demonstrable benefit, whereas controlled surgical reperfusion led to a sustained (1 week) improvement in regional function and significant myocardial salvage. PMID- 2774717 TI - Aortic valve and left ventricular outflow tract replacement using allograft and autograft valves: a preliminary report. AB - A comparison of allograft and autograft (pulmonary) replacement of the aortic valve has, to our knowledge, not been done in America. Fifty-seven patients (age range, 2 to 70 years; mean age, 30 years) underwent 59 operations for replacement of the aortic valve (20) or entire left ventricular outflow tract (39) using autograft (35) or allograft (24) valves. Many had undergone a previous operation (25) or had concomitant procedures (13). Postoperative mortality was 8.5% (5/59). Two deaths occurred in the allograft group and three in the more complex pulmonary autograft group. One late death occurred. One autograft was replaced with an allograft 7 months postoperatively for severe aortic regurgitation. There have been no episodes of either endocarditis or thromboembolism. Forty-nine of 51 survivors are in New York Heart Association class I. Preliminary results suggest that congenital or acquired disease of the left ventricular outflow tract and aortic valve can be safely and effectively treated with either allograft or autograft valve transplantation. PMID- 2774718 TI - Gastric vascular pedicle patch esophagoplasty for stricture. AB - Three patients with Barrett's esophagus and strictures between the middle and distal thirds of the esophagus, of 5 to 26 years duration at the time of the plasty, were treated with an infradiaphragmatic Nissen fundoplication and gastric vascular pedicle patch esophagoplasty, based on the right gastroepiploic vessels. Follow-up for 2 patients has been 6 and 7 years; both patients are asymptomatic except for periodic mild dysphagia in 1. The third patient developed cancer after 1 symptom-free year, and had esophagectomy with colon interposition. The results of this operation justify its use in recalcitrant lower intrathoracic esophageal strictures that do not respond to antireflux operation or dilation. PMID- 2774719 TI - Amiodarone-induced complications after cardiac operation for obstructive hypertrophic cardiomyopathy. AB - The occurrence of unanticipated and seemingly unexplicable major complications of hepatic, pulmonary, and cardiac dysfunction after palliative operation for obstructive hypertrophic cardiomyopathy prompted a review of 71 sequential patients. Fifty-five patients had been treated preoperatively with beta-blockers, calcium-channel inhibitors, or both, and 16 had received amiodarone for six to 566 days (mean time, 210 days) at total doses ranging from 8 to 175 g (mean dose, 82 g) and had drug-free intervals prior to operation of zero to 457 days (mean time, 91 days). Comparisons were made between the two treatment groups and between those with and without major complications within the amiodarone-treated group. Preoperative cardiac studies, sex, age, functional class, and type of operation were not related to outcome for the entire patient cohort. In amiodarone-treated patients, the major findings were as follows: a 50% incidence of hepatic dysfunction with a tenfold increase in concentrations of serum glutamic-oxaloacetic transaminase and serum glutamic-pyruvic transaminase; a 25% incidence of pulmonary dysfunction necessitating a fourfold increase in the number of days of ventilator support; and a 19% incidence of low cardiac output syndrome with two deaths. Only 44% of the amiodarone-treated group had no serious complications. The incidence of major complications of the liver, lungs, and heart was 2%, 0%, and 2%, respectively, in patients not treated with amiodarone. Abnormal preoperative pulmonary function studies were predictive of prolonged postoperative ventilatory support. Discontinuation of amiodarone for several months prior to operation appeared to reduce the incidence of major complications. The necessary drug-free interval required preoperatively could not be determined from this retrospective experience.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2774720 TI - Viable cryopreserved aortic homograft for aortic valve endocarditis and annular abscesses. AB - Six consecutive patients with active aortic valve endocarditis, including 2 with extensive subannular aortic root abscess, were successfully treated with viable cryopreserved homograft aortic valve replacement. Two patients required extensive aortic root reconstruction with an appropriately trimmed aortic homograft to cover large abscess cavities. All patients showed resolution of infection with no perioperative mortality or clinically significant morbidity. Three patients had a minor degree of aortic insufficiency on postoperative echo-Doppler study. On follow-up at 6 to 48 months, all patients were in New York Heart Association functional class I. The resistance of the unstented homograft to infection makes it an attractive choice for patients requiring aortic valve replacement for active endocarditis. The results of surgical intervention in patients with extensive aortic root involvement may be further improved by the flexibility afforded by the homograft to be "custom-fit" to the abnormal aortic root and the ability to achieve secure abnormal aortic root and the ability to achieve secure valve fixation without use of prosthetic material. PMID- 2774721 TI - Transdiaphragmatic implantation of the automatic implantable cardioverter defibrillator. AB - A new surgical approach for implantation of the automatic implantable cardioverter defibrillator without thoracotomy was used in 12 patients, aged 46 to 72 years. Preimplantation arrhythmia was ventricular tachycardia in 7 patients and ventricular fibrillation in 5 patients. The mean ejection fraction was 19%. Six patients were at high risk for general anesthesia for a variety of medical problems, and 2 patients had had a previous cardiac operation. Epidural anesthesia was used in 8 patients without intubation. The surgical approach used a longitudinal epigastric extraperitoneal incision with access to the heart through an incision made in the central tendon of the diaphragm. Two patches and two epicardial sensing leads were placed in all patients. All patients but one could be defibrillated with 20 J or less. There was no operative mortality and minimal morbidity. There were two late deaths due to heart failure. Thus, the transdiaphragmatic approach provides an excellent exposure for automatic implantable cardioverter defibrillator implantation, avoids general anesthesia and thoracotomy, and can be used after a previous cardiac operation. PMID- 2774722 TI - Longevity of expanded polytetrafluoroethylene grafts for superior vena cava. AB - We previously reported that the expanded polytetrafluoroethylene (ePTFE) graft for superior vena cava (SVC) substitution presents the problems of flexion and kinking when the graft is long. We therefore replaced the SVC of dogs with two types of prosthetic substitutes, ePTFE (Gore-Tex) and spiral-supported ePTFE (Im/praflex), and evaluated the long-term patency of the prosthetic substitutes. Total replacement of the SVC was performed in 9 adult mongrel dogs. The substitutes were ePTFE and spiral-supported ePTFE in 5 and 4 dogs, respectively. The animals were killed about 3 years after replacement of the SVC, and the harvested specimens were histologically examined by light microscopy and scanning electron microscopy. Evaluation of ePTFE revealed late occlusion in 1 of 5 dogs. The spiral-supported ePTFE showed patency in all dogs. In the group with ePTFE grafts, light microscopic examination revealed abnormalities of endothelial cells, granulation, and necrosis. There was no hyperplasia of the subendothelial connective tissue near the center. In the animals with spiral-supported ePTFE grafts, the subendothelial connective tissue showed favorable growth even in the center of the reconstructed site. There was no granulation in the spiral supported ePTFE group. Scanning electron microscopic examination in the ePTFE group showed that endothelial cells were spindle-shaped and had an irregular surface. The spiral-supported ePTFE group showed an almost regular form of endothelial cells and no abnormalities except for the slightly spindled shape in the center. Therefore, we recommend that spiral-supported ePTFE should be used as an SVC substitute in clinical situations. PMID- 2774723 TI - Clinical experience with subxiphoid drainage of pericardial effusions. AB - To assess the effectiveness of subxiphoid pericardial tube drainage for treatment of pericardial effusion, we reviewed 41 consecutive patients who underwent this procedure during a 14-year period. The patients ranged in age from 7 months to 75 years. All were symptomatic preoperatively. The diagnosis of pericardial effusion was confirmed by echocardiogram in all but 2 patients. Eight patients had acute pericardial tamponade. Subxiphoid pericardial drainage was performed under general (n = 35) or local anesthesia (n = 6). A portion of the anterior pericardium was excised in each patient. There were no perioperative deaths. Thirty-day mortality was 19.5%; there were five late deaths. All deaths were unrelated to pericardial effusion or to the operation. One patient had recurrent effusion requiring pericardiocentesis on the 21st postoperative day. He died five days later of extensive lymphoma. Twenty-eight patients were followed from 1 month to 10 years; mean follow-up was 31.5 months. None developed recurrent effusion or pericardial constriction. We conclude that subxiphoid pericardial drainage is effective for treatment of pericardial effusion. PMID- 2774724 TI - Surgical closure of the patent ductus arteriosus in the neonatal intensive care unit. AB - Efficacy of surgical closure versus indomethacin for treatment of patent ductus arteriosus in symptomatic neonates is an ongoing controversy. In recent years, surgical closure has been performed in the neonatal intensive care unit rather than the operating room in some centers, creating further controversy. In a retrospective study of the charts of 115 sequential patent ductus arteriosus surgical closures performed in the neonatal intensive care unit in premature infants, we found no surgical morbidity or mortality. Ninety-nine of these infants of less than 33 weeks gestational age were evaluated for various factors that might influence outcome. All were operated on within 72 hours of diagnosis, with an extra-pleural approach and metal clips used for closure of the ductus. All infants were extubated at an average of 33 weeks in each age group studied unless they had underlying severe bronchopulmonary dysplasia. We conclude that surgical closure of the symptomatic patent ductus arteriosus in neonates is safe and 100% effective, with none of the reported complications of indomethacin therapy, and should be the treatment of choice in neonates aged less than 33 weeks (gestational age) at birth with symptomatic patent ductus arteriosus. Closure performed in the neonatal intensive care unit eliminates transport risks and is ultimately safer and easier than transport to an operating room. PMID- 2774725 TI - FDA recalls: how do pacemaker manufacturers compare? AB - To evaluate an apparent perception that there is no difference in reliability among the products of the major cardiac pacing system manufacturers, an extensive review of US Food and Drug Administration regulatory actions was performed. The study period was July 1974 through June 1987. The total number of affected devices was collected for each manufacturer. Available sales data were used to calculate their percentage of recalled products during two time periods. The percentage of potentially high-risk devices (Food and Drug Administration class I and II recalls) was high for one company, moderate for one, and relatively low for the rest. Potential biases in some other sources of reliability information, as well as implications for regulatory policies, are discussed. The data reported establish that there have been past deficiencies in recall management. Although further pacing device recalls are probable, appropriate early regulatory and manufacturer action should help to assure that both the immense cost and patient distress caused by pacer and related product problems in the past can be minimized in the future. PMID- 2774726 TI - Asanguineous reperfusion in a canine model of cardiopulmonary bypass and controlled postischemic work. AB - This study was designed to test the hypothesis that asanguineous reperfusion with a standard crystalloid cardioplegic solution results in improved myocardial salvage after a period of global ischemia. Four groups of 6 dogs each were placed on cardiopulmonary bypass. Control group A (work only) performed two hours of controlled work by contracting against a saline-filled left intraventricular balloon. Control group B (ischemia only) underwent 45 minutes of global normothermic ischemia before simple blood reperfusion while supported on bypass. Groups C and D were subjected to ischemia and reperfusion as in group B, followed by controlled work stress as in group A. Group D, however, received 500 mL of St. Thomas' Hospital solution immediately before blood reperfusion. Morphological analysis showed no significant injury in groups A and B, whereas group C had 11.4% +/- 2.4% necrosis of heart mass versus 2.5% +/- 1.1% in group D (p less than 0.001). Biochemical data from left ventricular biopsies showed no significant differences between groups B, C, and D. Functional analyses showed deterioration of diastolic compliance in group C (p less than 0.05), although a significant difference in systolic functional indexes could not be detected. Myocardial protection and salvage was improved by initial reperfusion with an asanguineous cardioplegic solution versus reperfusion with blood alone. PMID- 2774727 TI - Valve replacement in the right side of the heart in children: long-term follow up. AB - Twenty-five patients (16 male, 9 female) underwent right-sided valve replacement (10 pulmonary valve replacement, 14 tricuspid valve replacement, 3 tricuspid plus pulmonary valve replacement, and 2 replacements of a single atrioventricular valve) at the University of Nebraska Medical Center from June 1977 to December 1986. Twenty-one patients (84%) are long-term survivors with 2,035 months follow up (range, 41 to 143 months; mean, 96.9 months). Twenty-three Carpentier-Edwards bioprosthetic valves, one Ionescu-Shiley bioprosthetic valve, and nine St. Jude Medical valves were inserted. Follow-up of 17 patients with a Carpentier-Edwards valve ranged from 5 years 9 months to 11 years 9 months (mean, 8 years 11 months). To date there has been one reoperation after 3 years 4 months in this group. One patient who received an Ionescu-Shiley bioprosthesis required re replacement at 20 months after operation. Three of 4 patients who received St. Jude mechanical valves and are long-term survivors have required replacement after 36 to 56 months. We conclude that the Carpentier-Edwards bioprosthetic valve is a viable option in the right side of the heart in the young age group when annular size is adequate to accommodate an appropriate bioprosthesis. PMID- 2774728 TI - Transatrial membranotomy for Budd-Chiari syndrome. AB - In a 7-year period, transatrial membranotomy was performed in 11 patients with membranous obstruction of the inferior vena cava. There were 5 men and 6 women, ranging in age from 23 to 53 years. Clinical symptoms included jaundice in 4 patients, hepatomegaly in 4, leg edema or varicose veins in 10, and venous collaterals over the abdominal and chest wall in all 11 patients. Transatrial membranotomy was performed through a median sternotomy in all patients. When inferior vena cava venography revealed that the obstruction was accompanied by long segmental thrombosis, additional dilation was performed with a Hegar dilator. There was no surgical mortality. Early operative complications included pulmonary embolism in 2 patients and bleeding requiring reoperation in 1. In a mean follow-up period of 30.6 months (range, 2 to 88 months), 9 patients had no symptoms, transient pericardial constriction developed in 1 patient and resolved 1 month later, and restenosis of the inferior vena cava developed in another patient 1 year after the first operation. This latter patient received a second transatrial membranotomy followed by percutaneous balloon angioplasty of the inferior vena cava, with a satisfactory result at 8 months follow-up. We conclude that transatrial membranotomy is an effective and safe procedure for patients with membranous obstruction of the inferior vena cava. PMID- 2774729 TI - Long-term results after surgical repair of incomplete endocardial cushion defects. AB - Since 1964, 56 children (mean age, 6.7 years) underwent repair of incomplete endocardial cushion defects. Forty patients had isolated ostium primum defects. Additional congenital defects were present in 17 patients (30%). All patients underwent patch closure of the ostium primum defect and 47 of 56 patients (84%) underwent mitral valvuloplasty. Hospital mortality was 1.8% (one death). Arrhythmias developed in 7 other patients in the early postoperative period, of which six were transient and resolved completely. One patient required early pacemaker placement for complete heart block. Cumulative follow-up was 378 patient-years. There were three late deaths (5.7%), and additional operations were required in 12 patients (22.6%). Seven of these 12 patients required mitral valve replacement for severe mitral regurgitation. The mean interval between initial repair and mitral valve replacement was 4.2 years, with only three valves needing replacement within 12 months. There was a significant correlation between the severity of mitral regurgitation before initial repair and subsequent need for mitral valve replacement. Late onset atrial arrhythmias have developed in 6 patients. Current functional status has been evaluated in 50 of 52 surviving patients and 88.5% are in NYHA class I, with the remainder in class II. PMID- 2774730 TI - Resection of atriocaval adrenal carcinoma using hypothermic circulatory arrest. AB - Carcinoma of the adrenal cortex may occasionally extend through the inferior vena cava to the right atrium without actually invading the vascular endothelium. Surgical resection may result in excellent palliation and the potential for prolonged survival when no other signs of advanced disease are present. Extrapolating from our experience with renal cell carcinoma extending to the right atrium, we resected a similar adrenocortical carcinoma using hypothermic circulatory arrest. PMID- 2774731 TI - Combined gastric pull-up and microvascular jejunal transfer procedure after pharyngolaryngoesophagectomy. AB - A case of simultaneous carcinomas of the lower thoracic esophagus and the oropharynx in a 62-year-old man is reported. Reconstruction was successfully performed using a one-stage operation consisting of pharyngolaryngoesophagectomy followed by a combination of gastric pull-up and microvascular jejunal transfer procedures. The postoperative course was uneventful except for regurgitation of food, which persisted for 1 month. PMID- 2774733 TI - Controversies in management of sternal tumors. AB - The rarity of sternal tumors makes a good comparative study a difficult task. Controversies exist on questions of method of surgical diagnosis, the extent of the surgical procedure, and the different ways and means of reconstruction. We describe a case that was believed to be a clear case of chondrosarcoma but was actually a plasmacytoma. From the evidence of this case and a review of the literature we conclude that almost any plasmacytoma should be considered generalized multiple myeloma. Biopsy should be performed in all cases of sternal tumor before any surgical action is taken. PMID- 2774732 TI - Dorsal mass in hyperparathyroidism secondary to chronic renal failure. AB - A 65-year-old man had metastatic calcification forming a huge mass located on the dorsum. The calcified mass extended into the thoracic cavity and was removed; the sixth rib was also resected. Diagnosis and treatment are discussed. PMID- 2774734 TI - Ductus diverticulum aneurysm and coronary stenosis: repair using circulatory arrest. AB - The case of a 68-year-old man with advanced symptomatic coronary artery disease and large aneurysm of the diverticulum of the ductus arteriosus is presented. Both the coronary artery disease and the aneurysm were successfully repaired at the same time via median sternotomy using cardiopulmonary bypass and a brief period of profound hypothermic circulatory arrest. To our knowledge, this is the 27th reported case of such an aneurysm in an adult. PMID- 2774735 TI - Mitral annular calcification: a new technique for valve replacement. AB - Many dangers attend mitral valve replacement in the presence of dense posterior annular calcification. The procedure described has been successful in 4 patients. The major elements of this procedure include complete ultrasonic debridement of the calcification, reconstitution of the disassembled atrioventricular groove, and retention of the mitral valve leaflets. PMID- 2774736 TI - A method of retraction during reoperative coronary operations using the Favaloro retractor. AB - A method is described for using the Favaloro retractor to provide retraction during dissection of the anterior wall of the heart during reoperative cardiac operations. PMID- 2774738 TI - Left ventricular rupture. PMID- 2774737 TI - Can ventricular decompression be optimized? PMID- 2774739 TI - Use of colostomy bags for chest tube drainage. PMID- 2774740 TI - Value of transesophageal echocardiography during open heart operation. PMID- 2774741 TI - World Congress on Heart Valve Replacement... Evolution over a quarter of a century. January 15-18, 1989, San Diego, California. Proceedings. PMID- 2774742 TI - Heart valve legislation and regulation. AB - During 13 years of regulation by the FDA under the Medical Device Amendments of 1976, the process by which replacement heart valves have been developed and modified has changed. Some of these changes have been good for the public, whereas other changes are of questionable value. Conditions will never be as they were 25 years ago, but they could be closer to what was expected in 1976. As the FDA constantly seeks to improve its performance and Congress focuses on possible changes to the Act, the cardiovascular community of practitioners, inventors, and manufacturers should offer their assistance. I believe the creative spirit that enables you as pioneers to reflect on your accomplishments and contemplate even greater innovations for the future should again be applied to the process of helping the FDA improve the way it serves us--the public. PMID- 2774743 TI - In vitro testing of heart valves: evolution over the past 25 years. PMID- 2774744 TI - Pitfalls in statistical analysis of heart valve prostheses. AB - Beware of the dangers of automated analysis, especially in multiple regression, and of overinterpretation of data. Do not let yourself be manipulated by numbers. PMID- 2774745 TI - Prosthetic heart valves: design considerations. PMID- 2774746 TI - Heart valves: ten commandments and still counting. PMID- 2774747 TI - Twenty-five-year review of the Magovern-Cromie sutureless aortic valve. AB - We reviewed 25 years (4,798 patient-years) of aortic valve replacement with the Magovern-Cromie sutureless valve. Operative mortality was 11% for isolated aortic valve replacement and 15% for aortic valve replacement with concomitant cardiac procedures. Since 1981, operative mortality has declined to 4.9%. Valve-related morbidity was in the lower expected ranges for prosthetic aortic valves: ball variance, 0.3%/patient-year; paraprosthetic leak, 0.41%/patient-year; valve endocarditis, 0.43%/patient-year; valve thrombosis, 0.04%/patient-year; and embolic events, 3.95%/patient-year. The incidence of aortic valve reoperation was 0.76%/patient-year. The 5-year, 10-year, and 20-year probability of survival corrected for normal mortality was 77%, 64%, and 52% for all discharged patients. This review confirms the Magovern-Cromie valve to be a safe, durable, and efficient prosthetic valve. PMID- 2774748 TI - Wada-Cutter heart valve: overall experience at the Sapporo Medical College. AB - We performed cardiac valve replacement using the Wada-Cutter valve in 124 patients during the 9 years between 1966 and 1974: aortic valve replacement in 48, mitral valve replacement in 56, tricuspid valve replacement in 9, and multiple valve replacement in 11. Sixteen patients died within 30 days after operation, and 34 died in the late postoperative period, with a cumulative mortality rate of 40.3%. Postoperative complications included valve thrombosis in 9 patients, thromboembolism in 4, and mechanical valve failure in 5. The Wada Cutter valve, first described at the Annual Meeting of The Society of Thoracic Surgeons on January 27, 1967, in a discussion on the paper by Cooley and colleagues on mitral valve replacement with a discoid valve, attracted attention for its unique design. Four of the Wada-Cutter valves were incorporated in Liotia's total artificial heart, which was implanted clinically for the first time in Cooley's second-stage heart transplantation. It may not only claim to be the origin of today's most popular tilting-disc heart valves but also has some original concepts with regard to bileaflet and tricuspid tilting-disc heart valves. However, at that time, cardiac valve replacement with this prosthesis resulted in a high incidence of thrombosis without systemic anticoagulation and in mechanical valve failure due to hinge wear of the Teflon occluder. For these reasons, its clinical use was discontinued in 1974. If Pyrolite carbon had been adopted in construction of the valve when it first became available, the valve design could have been useful even today. PMID- 2774749 TI - The dog as a model for evaluating prosthetic heart valves. PMID- 2774750 TI - The development of the Cross-Jones caged-lens prosthesis. PMID- 2774751 TI - The Medtronic Hall heart valve: background, latest results, and future work. PMID- 2774752 TI - Elimination of the cloth sewing ring-metal interface in an effort to decrease thromboembolism. PMID- 2774753 TI - Heterologous heart valves: past, present, and future. PMID- 2774754 TI - Plastic surgery for cardiac valves: 15 years' experience. AB - We suggest that all patients with heart valve diseases should be considered for reconstructive plastic surgery, regardless of the numerous modern mechanical and biological prostheses available in a cardiac surgeon's arsenal. We have 15 years of experience, with 903 plastic surgical procedures with cardiopulmonary bypass for acquired mitral (636), aortic (51), and tricuspid (216) valve diseases. The 15-year survival rate for patients with mitral stenosis was 68% +/- 5%, and the 8 year survival rate for patients with mitral insufficiency was 81% +/- 3%. The 10 year survival rate for patients with mitral and tricuspid valve disease was 59% +/- 3% because of the initially grave condition of such patients. For the correction of acquired aortic valve disease we advocate a new type of operation: a method of stent plasty of the aortic root with two circular sutures placed on the level of the arch and fibrotic ring. In combination with gradual commissurotomy, parietal resection of leaflets and parocommissural plication are performed. This procedure is an effective method for the plastic reconstruction of the aortic valve, and it provides a good hemodynamic effect. PMID- 2774755 TI - New cardiac bioprostheses: theory, experiments, and 10 years of clinical use. AB - The biological valve "BAKS" has the following specific features: (1) it is practically devoid of immunogenicity due to fermentative-chemical treatment; (2) it is completely treated with glutaraldehyde through gradual soaking in solutions of increasing concentration; (3) the biological part is fashioned taking into account the biomechanics of the aortic root; (4) the polypropylene stent is functional due to the use of the principles of bionics in valve construction; and (5) practically no thromboemboli occur, because of the special morphologic organization of the cuff and the distant location of the bioprosthesis leaflets from the stent edge. In the Department of Heart Surgery of the National Research Center of Surgery, "BAKS" valves have been used in 237 patients undergoing isolated mitral valve replacement for rheumatic heart disease. Of these 35% were younger than 35 years, 93.7% belonged to New York Heart Association functional class IV, and 24% had had a previous heart operation. The 10-year survival rate without hospital mortality was 68.94% +/- 4.86%. Total follow-up was 11,232 patient-months (range; 6 to 118 months; mean, 57 months; 97% complete). Main causes of death and reoperation were (per patient-year) infectious endocarditis, 3.2%; spontaneous bioprosthesis degeneration, 0.96%; mechanical dysfunction resulting from damage in the manufacturing of the prosthesis, 0.74%; left atrial thrombosis and/or thromboemboli, 0.5%; sudden death, 0.2%; cardiac insufficiency, 0.3%; and other, 0.4%. PMID- 2774756 TI - The Hancock modified-orifice porcine bioprosthetic valve: 1976-1988. AB - The Hancock modified-orifice porcine valve was fabricated as a result of documented obstruction of the Hancock standard porcine valve in small sizes related to the retained muscle bar of the right coronary cusp. We implanted the first clinical Hancock modified-orifice valve in 1976, and have used this valve for aortic valve replacement to the present time. This analysis compares and contrasts the clinical performance of 401 Hancock standard and 385 Hancock modified-orifice valves over a period of 10 years. Statistical significance in actuarial curves at 120 months was noted in long-term survival and thromboemboli. There was a slightly smaller amount of structural valve degeneration and incidence of reoperation with the modified-orifice valve compared with the standard valve. The Hancock modified-orifice valve has proven to be a satisfactory aortic valve replacement device, and its complex fabrication has withstood the test of time. PMID- 2774757 TI - Actuarial analysis of a uniform and reliable preservation method for viable heart valve allografts. AB - CryoLife has developed a method for cryopreserving allograft heart valves for transplantation. Since 1984, 6,907 valves have been processed and 4,216 transplanted. Documentation was available on 2,647 transplants, 11 of which were removed for structural deterioration and 13, for nonstructural deterioration. At the end of 35 months, actuarial survival was 99.17% and the estimated freedom from reoperation, 97.16%. There have been no reports of thromboembolism or valve related death. PMID- 2774758 TI - Cryopreserved valve conduits for outflow tract reconstruction in pediatric patients. PMID- 2774759 TI - The intact bioprosthesis: the first 4 years. AB - The Intact porcine bioprosthesis became available for clinical use in 1984. The device incorporates three innovations aimed at reducing calcification and improving durability. Between October 1984 and March 1988, 221 valves were implanted in 200 patients. Sixty-two valves were implanted in the aortic position, 155 valves in the mitral position, and 4 valves in the tricuspid position. The average age was 39 years, and 27 patients were under the age of 20 years. The hospital mortality was 4.5%. The follow-up was from 6 to 48 months, and the actuarial survival at 48 months was 83%. In the group aged less than 20 years six valves have been explanted for calcific prosthetic stenosis. In the group older than 20 years postoperative catheterization studies have demonstrated satisfactory hemodynamics; in this group the results of valve replacement using the Intact valve are regarded as encouraging. PMID- 2774760 TI - Twenty-year comparison of the human allograft and porcine xenograft. AB - This study compares a retrospective consecutive series of human allografts and concurrent porcine xenografts implanted over a 10-year interval. There were 571 allograft valves and 1,351 xenograft valves implanted in the aortic and mitral position with mean follow-up of 12.8 years for the allografts and 6.2 years for the xenografts. This study compares the incidence of structural deterioration over long-term follow-up. We found that there was no significant difference between four manufacturers of porcine xenografts, in spite of substantial differences in processing techniques. We found that there was a significant difference in allografts that were premounted on stents as compared with allografts that were not premounted on stents for aortic valve replacement. We found that there was no significant difference between allografts for aortic valve replacement that were not premounted on stents and porcine xenografts implanted in the aortic position. These findings are in marked contrast to those of other reported series with the use of allograft valves. PMID- 2774761 TI - Tricuspid regurgitation associated with mitral valve disease: repair and replacement. AB - Between January 1975 and June 1988, 156 patients with combined mitral and tricuspid valve disease underwent mitral and tricuspid valve repair or replacement. There were 127 (81%) patients with tricuspid valve repair and 29 (19%) patients with tricuspid valve replacement. Hospital mortality was 14% and was strongly influenced by preoperative pulmonary hypertension (systolic pressure greater than 65 mm Hg) and poor left ventricular function (ejection fraction less than 0.4). Five-year survival for the entire series was 57% +/- 5%; 12-year survival was 44% +/- 9%. Ejection fraction was the only age-adjusted risk factor for long-term survival. Of the patients who underwent tricuspid annuloplasty, 91% +/- 4% were free from reoperation after 10 years, indistinguishable from valve replacement (90% +/- 7%). Our tricuspid annuloplasty is simple and effective, and exhibits excellent long-term durability as well as immediate hemodynamic improvement. PMID- 2774762 TI - The return of elastomer valves. AB - This paper concerns the heart valves to be used mainly in artificial hearts. Most of our tricusp semilunar valves are made of polyurethane. These valves have functioned in artificial hearts for up to 62 days, and have been implanted in sheep for 1 year without evidence of thromboembolism. Our valves have a wide opening, using redundant leaflets that are "bistable." Accelerated testing by air jet provides 1,000 closures per second. Regurgitation is measured in an apparatus with the help of a competent valve. All polyurethanes change with age, but Silastic does not. PMID- 2774763 TI - Effect of venoruton on hypoxic stress-induced neurotoxicity in mice and oxygen free radical generation by human neutrophils. AB - Venoruton offers a protection against hypoxic stress-induced neurotoxicity (convulsions and death) in mice. It also inhibits free radical generation, since it produces a concentration-dependent (5-160 micrograms/10(6) cells/ml) decrease of chemiluminescence response from human neutrophils. The maximum inhibition was observed at 140 micrograms/10(6) cells/ml. The in vivo protective effect against hypoxic stress-induced neurotoxicity has been correlated to the inhibitory action of venoruton on oxygen free radical generation. PMID- 2774764 TI - Dopamine receptors in the mouse vas deferens. AB - We have investigated the effects of dopamine on the response of the mouse isolated vas deferens to electrical stimulation and, contrary to previous investigators, have found that there are specific dopamine receptors present in this tissue. A range of dopamine antagonists have been examined vs the effects of dopamine and the Ke values obtained indicate that the receptor present is of the DA2 subtype. Domperidone, spiperone and haloperidol possess a very high affinity for the receptor, whereas the selective DA1-antagonist SCH 23390 has only low affinity. Bromocriptine was found to possess both alpha 2- and dopamine agonist activity in this preparation and it is also possible to demonstrate dopamine agonist activity of noradrenaline. In the presence of alpha 2-antagonists, the mouse vas deferens is an extremely simple preparation suitable for the rapid screening of compounds for DA2-agonist or antagonist activity. PMID- 2774765 TI - Study of the strontium response in isolated rat aorta. AB - We have studied the effects of the cumulative application of Sr2+ in isolated rat aorta in a normal and in a Ca2+-free solution containing EDTA 1 mM. Sr2+ induced a concentration-dependent contraction which was reduced by verapamil (5 X 10(-6) and 10(-7) M) and lanthanum (1 and 2 mM). Sr2+ also induced a contraction in K+ depolarized medium. In aorta strips depleted of Ca2+ by several applications of noradrenaline (10(-6) M), Sr2+ induced a dose-response contraction in a Ca2+-free solution. These findings suggest that the influx of external Ca2+ is only partly responsible for the Sr2+-induced contraction and that another intracellular mechanism is involved in the response. PMID- 2774766 TI - Approaches to the mechanism of relaxing effect of vitamin K3 on smooth muscle. AB - Smooth muscle relaxing effect of vitamin K3 was tested by using isolated rat Vas deferens, normal and K+-depolarized rat duodenum. The contractions of the rat Vas deferens elicited by noradrenaline and phenylephrine were inhibited by vitamin K3, noncompetitively. Vitamin K3 inhibited the Ca2+-induced contractions of the K+-depolarized rat duodenum in a noncompetitive manner. The inhibitory effect of vitamin K3 on the K+-depolarized rat duodenum was evaluated by comparing it with that of verapamil, a well-known Ca2+-channel blocker and of trifluoperazine, a calmodulin inhibitor. Further, it was observed that vitamin K3 exerts a dose dependent relaxing effect on the normal rat duodenum. The effect of vitamin K3 was compared with that of adrenaline, isoprenaline and papaverine. In addition, propranolol, a beta-adrenergic blocking agent, and nicotinic acid, an adenylate cyclase inhibitor, were used as tools in order to investigate the mechanism of the relaxing action of vitamin K3 on smooth muscle. PMID- 2774767 TI - Influence of nonsteroidal antiphlogistics on mouse ear inflammation induced with croton oil. AB - The oedema disk technique was used to study the effects of orally administered nonsteroidal antiphlogistics (piroxicam, phenylbutazone, proquazone, azapropazone and nifluminic acid) on the inflammation induced with croton oil in the mouse ear. This method was demonstrated to be suitable for the detection of an antiphlogistic effect. The substances examined exerted a statistically significant extent of inhibition in a dose-dependent manner. Oedema inhibition of about 50% was achieved with a dose of 10 mg/kg piroxicam; inhibition of more than 30% necessitated the administration of 10 mg/kg proquazone, 10 mg/kg nifluminic acid or 50 mg/kg azapropazone. Following administration of 90 mg/kg phenylbutazone, an inhibition of only 22.4% was observed. PMID- 2774768 TI - Nerve growth factor inhibits some acute experimental inflammations. AB - Nerve growth factor (NGF) displays an inhibitory effect on peritoneal dye leakage in mice and on some types of acute inflammation in rats, i.e. acetic acid peritonitis and paw oedema induced by carrageenin, serotonin and dextran. Activity was only present in a restricted dose range, either after subcutaneous (1-8 micrograms/kg) or subplantar (0.5-5 micrograms) injection, and was characterized by a rapid onset of response. In the carrageenin test, NGF administered s.c. was more potent than indomethacin (INDO) and betamethasone (BTM); in addition, while the activity of INDO and BTM was observed only 2-3 hr after carrageenin challenge, the response of NGF developed within 1 hr, suggesting that NGF inhibits the early phase of the oedema. NGF exhibited a different action than BTM and INDO also in serotonin and dextran paw oedema. NGF (0.008 mg/kg s.c.) inhibited the serotonin oedema as early as 15 min and reached its maximum at 1 hr, whereas BTM (0.8 mg/kg) required at least 3 hr to attain the same effect. Serotonin oedema was not inhibited by INDO (even at 16 mg/kg) up to 0.25-6 hr, proving that this model of inflammation is insensitive to the inhibitors of prostaglandin synthesis. When given subplantary, NGF reduced dextran oedema, whereas BTM and INDO were ineffective. Pretreatment with specific anti-NGF antibodies abolished all the above effects of NGF, but did not modify the anti-inflammatory activity of BTM and INDO. NGF was less effective in reducing the exudate volume on carrageenin pleurisy and did not prevent cell migration. Tested in vitro, NGF showed no direct scavenging effect on superoxide radicals. These findings suggest that NGF may be involved in some types of acute inflammation by reducing vascular permeability. PMID- 2774769 TI - In vitro hepatic drug and anesthetic metabolism of rats with dietary-induced obesity. AB - The mechanism for enhanced metabolism of inhaled anesthetics in obese rats and humans is unknown. In this study, hepatic microsomes from normal-weight chow-fed rats and rats fed a high fat diet for approximately 54 weeks to induce obesity were examined for their ability to metabolize fluorinated inhalation anesthetics. Body composition of rats on diet for 54 weeks revealed a significantly elevated lipid content of both the whole body and liver in obese compared to normal-weight rats. Protein per g liver was not significantly different. The hepatic microsomal content of cytochromes b5 and P-450 per mg protein was not different between obese and normal-weight rats. Hepatic microsomal defluorination rates of the anesthetics, methoxyflurane, enflurane and isoflurane, were not altered by high fat diets of 54 weeks duration. The activity rate of aminopyrine N-demethylase was not changed by the diet; however, p-nitroanisole O-demethylase activity was significantly increased in microsomes from obese rats to approximately 150% of control activity. Thus the enhanced in vivo anesthetic metabolism of obese Fischer 344 rats does not appear to be the result of an increase in the specific activity of anesthetic metabolizing enzymes. PMID- 2774770 TI - Influence of clonazepam on epileptic after-discharges induced by perforant path stimulation in rats. AB - The action of clonazepam (CZP) against after-discharges (ADs) induced by perforant path stimulation was studied in 11 rats with implanted electrodes. The animals passed 4 sessions: one control, one with the solvent injection, and two with the administration of CZP (either 0.1 or 1 mg/kg i.p.). The ADs were always induced 4 times with 20 min intervals, the injections took place 10 min before the second stimulation. The EEG pattern of ADs was not changed by either dose of CZP and the duration was transiently shortened by the high dose only. Incidence of recurrent ADs tended to decrease after the lower dose of CZP, the higher dose blocked them for at least 30 min. As concerns behavioral concomitants of ADs, wet dog shakes remained uninfluenced by CZP while orienting reaction was either fully blocked (by the high dose of CZP) or significantly suppressed (by the lower dose). PMID- 2774771 TI - Interactions of cocaine with barbital, pentobarbital and ethanol. AB - This study deals with the interactions of cocaine with barbital, pentobarbital and ethanol in nontolerant and tolerant male Sprague-Dawley rats. Cocaine hydrochloride (50 mg) pellets implanted s.c. in rats prior to the i.p. injections of sodium barbital (150 mg/kg dose once daily for 4 days) potentiated the hypothermic response 2 hr after the barbital injection, when maximum hypothermia occurred. The s.c. implantation of the same type of pellets prior to the i.p. injections of sodium pentobarbital (75 mg/kg dose once daily for 5 days) potentiated the pentobarbital hypnosis as measured by the duration of loss of the righting reflex in animals. Cocaine pellets (12.5 mg) implanted s.c. in rats potentiated the hypnosis induced by ethanol (3.2 g/kg i.p.) and the implantation of the same type of pellets (12.5, 25 mg) in ethanol-tolerant rats restored the ethanol hypnosis to levels observed in acutely treated animals. The course of tolerance development to barbital-induced hypothermia or pentobarbital hypnosis did not appear to be affected by cocaine. The possible role of central monoamines in the potentiation of barbital hypothermia and pentobarbital and ethanol hypnosis by cocaine is discussed. PMID- 2774772 TI - Effect of hydralazine-induced hypotension on glutamate, gamma-aminobutyric acid and some other amino acid levels in medullary regions of the rat. AB - Concentrations of glutamate, gamma-aminobutyric acid (GABA), glycine, beta alanine and taurine were measured in microdissected areas of the rostral ventrolateral medulla (RVL), nucleus tractus solitarii (NTS) and caudal ventrolateral medulla (CVL) of the rat, and the effects of hydralazine-induced hypotension on the concentrations of amino acids were examined. All five amino acids were ubiquitously present in these brainstem regions. Hydralazine-induced hypotension increased glutamate levels in the NTS and CVL regions, but decreased GABA levels in all the regions studied. The level of glycine was decreased in the RVL region after hydralazine. Hydralazine decreased beta-alanine levels in the NTS and CVL regions. Electrical stimulation of slices containing the RVL region decreased glutamate levels but increased GABA levels in tissues. These results are compatible with the hypothesis that glutamate and GABA systems in these brainstem areas are related to blood pressure regulation. PMID- 2774773 TI - Comparative effects of the antidepressants amitriptyline, mianserin and adinazolam on hemodynamics and ECG in myocardial infarcted dogs. AB - This study was undertaken to examine the effects of mianserin (MIA), a tetracyclic antidepressant, and adinazolam (ADI), a new benzodiazepine antidepressant on cardiac function and electrocardiogram in normal and infarcted hearts of anesthetized dogs, and to compare the effects with those of amitriptyline, a commonly used tricyclic antidepressant. The parameters measured were: heart rate (HR); mean arterial blood pressure (MP); aortic flow (AF); maximal rate of increase of left ventricular pressure (LV dp/dt); blood flow of left circumflex of left coronary artery (CAF) and PQ and QRS intervals. The double product (DP) was calculated from HR and the arterial pressure. AMI increased HR, DP, LV dp/dt and CAF in the normal group, while in the infarcted group, AMI increased HR, DP and CAF, but decreased LV dp/dt at 3 mg/kg. AMI at 2 and 3 mg/kg prolonged QRS intervals in the infarcted groups. MIA increased HR and DP in the normal group at doses of 1 mg/kg or more, while in the infarcted group it produced only slight effects in hemodynamic parameters and PQ and QRS intervals. ADI had little effect on hemodynamics and PQ and QRS intervals in the normal group. However, it decreased LV dp/dt, CAF, MP at 3 mg/kg in the infarcted group. In conclusion, AMI markedly influenced cardiac hemodynamics and QRS interval in the myocardial infarcted group, while, on the other hand, MIA and ADI, in clinical doses, had only a slight effect on hemodynamics and PQ and QRS intervals in the infarcted group. Thus MIA and ADI were safer than AMI in the animals with myocardial infarction. PMID- 2774774 TI - Diabetes and hypertension. Blood pressure in clinical diabetic patients and a control population. AB - Blood pressure was recorded in a group of 514 randomly selected Swiss diabetic patients (267 men and 247 women; 164 early-onset and 350 late-onset diabetics) aged from 35 to 54 years. These patients were compared with a control group from a population survey in Switzerland (877 men and 850 women). Mean systolic pressure (+/- SD) in the diabetic population was 139.3 +/- 21 mm Hg as compared with 125.5 +/- 17 mm Hg among controls. Mean diastolic pressure was 85.4 +/- 12 mm Hg in diabetic subjects as compared with 79.1 +/- 12 mm Hg in controls. The difference was reduced by about 25% after adjustment for body mass, age, and sex; 30.7% of diabetic subjects as compared with 8.2% among controls were hypertensive. Sixty-two percent of the hypertensive diabetic patients and 45% of the hypertensive controls were receiving antihypertensive treatment. In a multivariate analysis, presence of proteinuria and larger body mass had an important influence on systolic and diastolic blood pressures and the risk of hypertension. Diabetes duration had a significant influence only on systolic blood pressure. Efforts are needed in the clinical and research field to limit and clarify the harmful effects of elevated blood pressure in diabetes. PMID- 2774775 TI - Professional satisfaction of physicians. AB - Nineteen physicians were interviewed to identify how they defined and solved the problems facing their profession. Problems cited by the physicians included loss of control over medical decisions, loss of control of the referral process, the threat of malpractice suits, ethical issues facing health maintenance organization physicians, and reduction of income. The attitudes and problem solving approaches of physicians who remained satisfied with their profession are presented and compared with those of physicians who are essentially dissatisfied with the practice of medicine. Among satisfied physicians, happiness in medicine was attributed more to attitudinal adjustments than to success at the "business of medicine." PMID- 2774776 TI - Control of bleeding in patients with immune and nonimmune thrombocytopenia with aminocaproic acid. AB - Patients with thrombocytopenia have an increased risk of bleeding. We have used 18 courses of aminocaproic acid in 17 patients with either immune or nonimmune thrombocytopenia to successfully control hemorrhage associated with reduced platelet counts. The types of hemorrhage controlled included the following: vaginal, gastrointestinal, intracerebral, cutaneous, mucous membrane, subconjunctival, and renal, as well as that associated with dental extractions, tracheostomy, and sites of Penrose drains. The number of platelet and red blood cell transfusions administered decreased substantially following institution of aminocaproic acid therapy. We conclude that therapy with aminocaproic acid is safe and useful in the management of bleeding in patients with both immune and nonimmune thrombocytopenia. PMID- 2774777 TI - Physician attitudes toward cost containment. The missing piece of the puzzle. AB - A survey of 720 physicians practicing in central and western Massachusetts was undertaken to examine their attitudes toward cost-containment measures. The majority of physicians felt that major techniques (58%), major procedures (57%), inappropriate ordering of diagnostic tests (48%), and malpractice concerns (47%) were very important contributors to increasing health care costs. Physician age, practice affiliation, and specialty area were related to the perceived importance of these factors. In addition, while there was a uniform lack of prior training in cost-containment measures, 48% of all physicians felt that courses in cost containment techniques would be worthwhile. These results suggest a variety of concerns and issues that need to be considered when attempting to modify the cost containment attitudes and practices of physicians. PMID- 2774778 TI - Fine-needle aspiration biopsy of the thyroid. Diagnostic accuracy when performing a moderate number of such procedures. AB - The diagnostic accuracy of fine-needle aspiration biopsy of the thyroid was evaluated. Between June 1982 and July 1987, 354 fine-needle aspiration biopsies were performed on 289 patients with thyroid nodules. The ages of the patients ranged from 21 to 86 years (median, 45 years); 61 (21%) were men and 228 (79%) were women. Surgical confirmation of the cytologic diagnosis was obtained in 59 patients. Fine-needle aspiration biopsy identified 10% of the nodules as probably malignant and 10% as possibly malignant. Of these nodules, 30.5% were proved to be malignant by histologic examination. The accuracy of distinction between a benign (class I or II) or probably malignant (class IV) diagnosis was 95.2%. Patient acceptance of this procedure was good and complications were infrequent. These results indicate that fine-needle aspiration biopsy of the thyroid is accurate, safe, well tolerated, and easily applied, without its highly desirable features being compromised, even when a moderate number of such procedures are performed. PMID- 2774780 TI - Diagnosis of vertebral osteomyelitis in a community hospital by using computed tomography. AB - Twenty cases of vertebral osteomyelitis from three community hospitals were reviewed. Routine spine radiographs were frequently normal in the setting of active vertebral osteomyelitis. Computed tomographic scanning of the spine frequently detected changes in the vertebral end plates that were diagnostic of vertebral osteomyelitis at a time when routine spine radiographs were unrevealing. PMID- 2774779 TI - Inadequate barium enemas in hospitalized elderly patients. Incidence and risk factors. AB - The likelihood of obtaining interpretable results is as important as sensitivity and specificity in selecting diagnostic tests. We reviewed medical and radiologic records of 140 consecutive inpatients over the age of 65 years who underwent a nonemergent barium enema. In 43 (31%) of these patients, the examination was incomplete or the results were uninterpretable. Thirteen patients could not retain the barium, and 27 patients had too much stool. Characteristics associated with an inadequate barium enema included confusion (adjusted odds ratio, 3.5), fever (adjusted odds ratio, 4.1), and cachexia (adjusted odds ratio, 2.7). Characteristics more common among subjects unable to retain barium than among subjects with too much stool were diarrhea (38% vs 18%) and fecal incontinence (31% vs 0%). The high frequency of inadequate results suggests that clinicians should consider whether a barium enema is the appropriate test in elderly patients with these characteristics, and, if so, what interventions may increase the chance for success. PMID- 2774781 TI - Vitamin B12 malabsorption in patients with acquired immunodeficiency syndrome. AB - We have examined 11 patients with the acquired immunodeficiency syndrome (AIDS) for evidence of subclinical vitamin B12 malabsorption. Three subjects (27%) had low levels of vitamin B12. Eight subjects (73%), including these 3 subjects plus 5 others with normal vitamin B12 levels, had abnormal Schilling test results. In addition, 15% of an unselected population of 121 patients with AIDS and 7% of 27 patients without AIDS who were seropositive for human immunodeficiency virus type 1 (HIV-1) had low serum vitamin B12 levels. Stool cultures from the 8 subjects with abnormal Schilling test results revealed no pathogens. Intestinal involvement by Kaposi's sarcoma was found in only 1 patient. Biopsy specimens from 5 of 6 patients with vitamin B12 malabsorption, however, contained mononuclear cells harboring HIV-1, as indicated by in situ hybridization studies. Our observations suggest that vitamin B12 malabsorption is common in patients with AIDS and may be a very early manifestation of infection with HIV-1. PMID- 2774782 TI - Cigarette smoking. A risk factor for hemorrhagic and nonhemorrhagic stroke. AB - Cigarette smoking habit was studied in 621 patients with stroke and in 573 control subjects using case control methods. There was an excess of smokers among the stroke group when compared with control subjects. Relative risks of cigarette smokers compared with nonsmokers, after adjustment for the possible confounding variables for subarachnoid hemorrhage, intracerebral hemorrhage, and cerebral infarction, were 4.5, 1.8, and 3.2 for men and 2.5, 1.3, and 2.3 for women, respectively. For all subtypes of stroke combined, the increased relative risk was related to the daily intake of cigarettes, the heaviest smokers having a higher relative risk than that for light smokers. The estimated increase in relative risk among smokers was 1.5 for each 10 cigarettes smoked daily in both men and women. We conclude that cigarette smoke may be an important preventable factor for both hemorrhagic and nonhemorrhagic stroke. PMID- 2774783 TI - Accuracy of the Michigan Alcoholism Screening Test for screening of alcoholism in patients of a medical department. AB - To measure the applicability and validity of the Michigan Alcoholism Screening Test in a medical hospital department situated in the French-speaking part of Switzerland, the test was administered to 300 patients. The results of the test were validated in relation to the clinical diagnosis of alcohol abuse or alcoholism through a concordance analysis. The applicability rate was 89% and the agreement between test and clinical diagnosis was good, especially in young men. Positive and negative predictive values of the test were 0.69 and 0.92, respectively. These results suggest, therefore, that the Michigan Alcoholism Screening Test could be considered as a standardized, valuable, and transcultural screening and research instrument. PMID- 2774784 TI - Cholera in Louisiana. Widening spectrum of seafood vehicles. AB - The largest cholera outbreak in the United States in over a century occurred in Louisiana from August through October 1986. Eighteen persons in 12 family clusters had stool culture or serologic evidence of infection with toxigenic Vibrio cholerae 0-group 1. Thirteen of these persons had severe diarrhea, and 4 required intensive care unit treatment. Although all 18 survived, 1 96-year-old woman with suspected cholera died shortly after hospital admission. A case control study showed that case-patients were more likely than neighborhood control subjects to have eaten cooked crabs or cooked or raw shrimp during the week before illness. Case-patients who ate crabs were more likely than control subjects who ate crabs to have undercooked and mishandled the crabs after cooking. A third vehicle from the Gulf waters, raw oysters, caused V cholerae 01 infection in two persons residing in Florida and Georgia. All three seafood vehicles came from multiple sources. Stool isolates from the Louisiana case patients were genetically identical to other North American strains isolated since 1973, but differ from African and Asian isolates. While crabs are the most important vehicle for V cholerae 01 infection in the United States, shrimp and oysters from the Gulf coast can also be vehicles of transmission. A persisting reservoir of V cholerae 01 along the Gulf coast may continue to cause sporadic cases and outbreaks of cholera in Gulf states and in states importing Gulf seafood. PMID- 2774785 TI - Improving the utilization of screening mammography in primary care practices. AB - Screening mammography is underutilized in many primary care practices. We designed a prospective, controlled trial to evaluate two strategies for improving the utilization of mammography in an academic general medicine clinic. We assigned teams of house officers to (1) physician audit with periodic feedback, (2) a visit-based strategy directed at both patient and physician, or (3) a no intervention concurrent control arm. After 6 months, the percentage of 50- to 74 year-old women meeting the standard of an annual mammogram was 36% for patients in the control arm, 62% for patients of feedback residents, and 54% for patients of the arm receiving the visit-based strategy. Patients of female providers were slightly more likely to meet the standard, but no effects were detected for patient race, new as opposed to follow-up patient, or higher frequency of clinic visits. We conclude that audit with feedback and a new visit-based strategy of a patient cue associated with a simplification of the ordering process each greatly improved the rate of utilization of screening mammography. Practitioners could reasonably choose the strategy most suited to their own situation. PMID- 2774786 TI - Right ventricular outflow tract obstruction due to extracardiac tumors. A report of three cases diagnosed and followed up by echocardiographic studies. AB - Echocardiography has become a valuable diagnostic tool in various clinical conditions. Its use for the detection of extracardiac tumors has seldom been reported. The majority of these descriptions are of single case reports. We have recently encountered three patients (two with lymphomas and one with seminoma) who presented with signs and symptoms suggestive of right ventricular outflow tract obstruction. Two-dimensional echocardiography enabled the prompt diagnosis of extracardiac tumors compressing the heart. Moreover, echocardiography proved to be an excellent noninvasive tool for assessing the success of therapy for mediastinal tumors. PMID- 2774787 TI - Hypothyroidism and ventilator dependency. AB - Four patients with long-term ventilator dependency and severe hypothyroidism discovered in a single year are described. Correction of hypothyroidism was helpful in weaning three patients from the ventilator. The fourth patient died of other medical problems. None of these patients had goiter or clinical evidence of hypothyroidism. Hypothyroidism was discovered during workup for neurologic or cardiologic problems. Although hypothyroidism is not a common cause of ventilator dependency, it might be more common than we think. PMID- 2774788 TI - 'Natural' desiccated thyroid. A 'health-food' thyroid preparation. AB - "Natural" thyroid preparations, a type of bovine desiccated thyroid, are sold without prescription in "health-food" stores or by mail; they may or may not contain thyroid hormone. One such preparation was the cause of erratic thyroid test results in a patient who took it instead of thyroxine. Further study showed that the preparation contained biologically active thyroid hormone and was capable of causing hyperthyroidism. Natural thyroid preparations are biologically active yet unstandardized; because the hormonal content of a natural thyroid product is unknown, its use as a substitute for thyroxine can lead either to relapse of hypothyroidism or to hyperthyroidism. PMID- 2774789 TI - Failure of tonsil and nose surgery in adults with long-standing severe sleep apnea syndrome. AB - Seven adult patients with a severe form of sleep apnea syndrome (mean apnea index, 47) underwent surgery for significant structural abnormalities at nose and/or throat level (septal deviation, turbinal hypertrophy, enlarged tonsils, long uvula, pharyngeal tumor). Although a subjective benefit was claimed by most patients, the polygraphic data showed no improvement or only a modest improvement in breathing pattern, oxyhemoglobin saturation, or general sleep architecture except in one patient. In this patient the evolution of the syndrome was recent (3 years) and surgical management of a parapharyngeal tumor resulted in a cure. We conclude that in adults with sleep apnea syndrome of long-standing, surgical correction of nasal or pharyngeal abnormalities should not be expected to normalize sleep and breathing. This contrasts with the known benefits achieved by the same type of surgery in children. Surgery might nevertheless be necessary in some adults to permit the application of other therapeutic means (ie, nasal continuous positive airway pressure). PMID- 2774790 TI - Methyltestosterone-induced cholestasis. The importance of disproportionately low serum alkaline phosphatase level. AB - We describe a 64-year-old man who developed cholestatic jaundice after receiving 20 to 40 mg of methyltestosterone daily for 6 months for impotence but failed to mention it as part of his drug history. He underwent endoscopic retrograde and papillotomy before a positive history for methyltestosterone ingestion could be obtained. Since methyltestosterone is most often used for sexual impotence, the patient may be quite reluctant to mention this hormone as part of his medication. A normal or mildly elevated alkaline phosphatase level, disproportionate to the level of hyperbilirubinemia seen in this patient and in all previous reports, appears to be characteristic of this phenomenon. This pattern of liver function abnormality can be a clue to suspect methyltestosterone as the causative agent and spare the patient unneeded expensive noninvasive and potentially harmful invasive procedures. PMID- 2774791 TI - Dural trauma during lumbar puncture. PMID- 2774792 TI - Urgent hypertension. PMID- 2774793 TI - Mapping of cholinoceptive brainstem structures responsible for the generation of paradoxical sleep in the cat. AB - In order to determine the cholinoceptive brainstem structures critical for PS generation, we investigated the effect on PS induction of the injection of a small dose and volume (0.4 microgram/0.2 microliter) of the cholinergic agonist carbachol in the following caudal brainstem structures: 1) the caudal mesencephalic reticular formation, especially the nucleus pedunculopontinus pars compacta or X area; 2) the mediodorsal pontine tegmentum, in particular the nuclei locus coeruleus (LC), locus coeruleus alpha (LC alpha), peri-locus coeruleus alpha (peri-LC alpha) and laterodorsalis tegmenti (Ldt); 3) the pontine; and 4) bulbar gigantocellular (FTG) and magnocellular tegmental fields (FTM). We found that the only brainstem area from which a high amount of PS was induced by carbachol applications with short latencies, less than 5 minutes, is the mediodorsal pontine tegumentum, namely the LC alpha and peri-LC alpha, where ChAT-and TH- immunoreactive neurons are intermingled. Injections in an area immediately ventral to the peri-LC alpha induced physiological states resembling PS but lacking certain electrophysiological (PS-like) and behavioral components of PS (dissociated states I and II). The weak PS induction following carbachol administration in the anteromedial part of the FTG was due to the spread of the drug toward the efficient site since the latencies to PS onset were in the range of 20 to 60 minutes. No effects on PS generation were obtained after carbachol microinjections in the LC and the laterocaudal part of the FTG, while carbachol injections in the X area or in the bulbar FTG or FTM resulted in the increase of waking and the decrease of PS. In addition to these effects on PS induction, we also found that carbachol induced: 1) stereotyped PGO-like bursts when injected in the ventral part of the FTG and the rostral part of the FTM, 2) postural atonia with very short latencies, less than two minutes, when injected in the LC alpha and peri-LC alpha; and 3) hippocampal theta waves of 3-5 Hz persisting during light slow wave sleep (S1) when injected in and around the LC alpha and peri-LC alpha and in some points of the mediocaudal part of the FTG. These results support the hypothesis that PS is generated by highly localized neuronal populations and suggest that the mediodorsal pontine tegmentum (namely the nuclei LC alpha and peri-LC alpha) may represent a cholinoceptive PS generator. PMID- 2774794 TI - Afferent projections from the brainstem to the area hypothalamica dorsalis: a horseradish peroxidase study in the cat. AB - Experiments using the retrograde transport of horseradish peroxidase were performed in order to identify the cells of origin the ascending projections from different brainstem regions to the area hypothalamica dorsalis (aHd) in the cat. The afferent inputs to this area originate mainly from the midbrain and medulla oblongata regions. The main afferent source of the area hypothalamica dorsalis arises from the substantia grisea centralis, where a large number of labeled cells were observed bilaterally, although more abundant on the ipsilateral side. Substantial afferents reach the aHd from the nuclei vestibularis medialis and inferior and the formatio reticularis mesencephali. A modest number of peroxidase labeled neurons were observed in the nuclei ruber, interpeduncularis, substantia nigra, reticularis gigantocellularis, vestibularis lateralis, cuneatus and gracilis. From the pons, the nucleus raphe magnus sends a weak projection to the aHd. These anatomical data suggest that such area could be involved in visceral, sexual, nociceptive somatosensorial, sleep-waking and motor mechanisms. PMID- 2774795 TI - Target neurons of endogenous androgens immunocytochemically localized in male rat hypothalamus. AB - A polyclonal antiserum against androgens, i.e., testosterone, 5alpha dihydrotestosterone and androstenedione, was tested to reveal target neurons of endogenous androgens in the hypothalamus of both intact and castrated male rats. Paraffin sections of hypothalamus and testis were immunostained by using Avidin Biotin Complex method and 3-3' diaminobenzidine to visualize the immunoperoxidase complex. Conventional control experiments for method and antiserum specificity were performed. The antiserum proved to be specific for androgens, i.e., testosterone, 5alpha-dihydrotestosterone and androstenedione. The nuclear labeling observed in tissues stained by this procedure is consistent with the hypothesis that the labeled neurons contained DHT, which is the main testosterone metabolite active in the cell nucleus. The antiserum was effective in staining not only the hypothalamic neurons of intact males with normal serum levels of testosterone but also the hypothalamic neuron of castrated males with very low serum levels of testosterone. Evidence is presented indicating that the immunostaining technique represents a more specific and sensitive method to identify target neurons of endogenous androgens than autoradiography. PMID- 2774796 TI - Supraspinal inhibition of the two components of formalin-induced responses in rat dorsal horn neurons. PMID- 2774797 TI - Nucleotide sequence of 16S rRNA and phylogenetic position of the green sulfur bacterium Clathrochloris sulfurica. AB - The almost complete primary structure of the 16S rRNA from the green sulfur bacterium "Clathrochloris sulfurica" was determined by reverse transcriptase sequencing. Comparison of defined invariable parts of the molecule from representatives of 9 major lines of descent from the eubacterial kingdom shows C. sulfurica to be highly related to Chlorobium vibrioforme. The relationship between "Clathrochloris" and Chlorobium is in accord with the present allocation of these two genera into the family Chlorobiaceae. PMID- 2774798 TI - Reisolation and characterization of Clostridium longisporum, a ruminal sporeforming cellulolytic anaerobe. AB - Two strictly anaerobic strains of ruminal cellulolytic bacteria were isolated which are very similar to the original description given for Clostridium longisporum. Vegetative cells were 1 micron wide by 5 to 15 microns long. Subterminal spores were observed only when an insoluble carbon source was provided for growth. Besides cellulose, the organisms fermented cellobiose, glucose, galactose, fructose, mannose, pectin, salicin and sucrose. Xylan and xylose were not fermented. Fermentation products from glucose or alfalfa cell walls included formate, acetate, butyrate, ethanol, H2 and CO2. The GC content was 23% for one strain and 33% for the other. These isolates hydrolyzed cell wall fractions of alfalfa, in particular, hemicellulose, more rapidly and extensively than other ruminal cellulolytic species examined. PMID- 2774800 TI - [Study of hand preference in a Spanish population, by means of a questionnaire]. AB - 828 Spanish subjects answered a 12-item handedness questionnaire. Validity of the items was examined using a Principal Components Analysis. Relationship between handedness and age, sex and familial sinistrality were also examined. The results are compared with those obtained in other countries and discussed in terms of practical use and applications of the questionnaire. PMID- 2774799 TI - Purification and characterization of the pyruvate-ferredoxin oxidoreductase from Clostridium acetobutylicum. AB - The pyruvate-ferredoxin oxidoreductase from Clostridium acetobutylicum was purified to homogeneity and partially characterized. A 9.2-fold purification was achieved in a three step purification procedure: ammonium sulfate fractionation, chromatography on Phenyl Sepharose and on Procion Blue H-EGN12. The pure enzyme exhibited a specific activity of 25 U/mg of protein. Homogeneity of the pyruvate ferredoxin oxidoreductase was confirmed by native polyacrylamide gel electrophoresis and sodium dodecylsulfate (SDS)-polyacrylamide gel electrophoresis. The molecular weight was determined to be 123,000/monomer. The subunit composition of the native enzyme could not be determined because of the instability of the pure enzyme. The pyruvate-ferredoxin oxidoreductase is sensitive to oxygen and dilution during purification. The dilution inactivation could be partially overcome by the addition of 300 microM coenzyme A or 50% ethyleneglycol. A thiamine pyrophosphate content of 0.39 mol per mol of enzyme monomer was found, the iron and sulfur content was 4.23 and 0.91, respectively. The pH-optimum was at pH 7.5 and the temperature optimum was at 60 degrees C. Kinetic constants were measured in the forward reaction. The apparent Km for pyruvate and coenzyme A were 322 microM and 3.7 microM, respectively. With 2 ketobutyrate the pyruvate-ferredoxin oxidoreductase showed 12.5% of the activity compared to pyruvate. No activity was found with 2-ketoglutarate. Ferredoxin from Clostridium pasteurianum could be used as physiological electron acceptor. PMID- 2774801 TI - [An experimental pain model: the formaldehyde test]. AB - Some papers have been published in relation to alternative models of experimental pain in animals. In this work, with the aim of proving the validity, safety, reproducibility and objectivity of this model, we have compared the behaviour of the animal under the formaldehyde test before and after the intracerebroventricular administration of morphine, proving itself as an ideal model for the study of chronic pain caused by an excess of nociception. PMID- 2774802 TI - [Heterotopic gray matter: an infrequent cause of epilepsy]. AB - Heterotopia of gray matter is a developmental malformation in which ectopic cortex is found in the white matter of the brain. A case of a 27-year-old woman with generalized convulsions is reported, including the results of cerebral computed tomography and magnetic resonance imaging. In this patient, nodular masses of gray matter were present in the periventricular region. We emphasize that magnetic resonance imaging is the current method of choice for diagnosing heterotopic gray matter. PMID- 2774803 TI - [Non-reabsorptive communicating hydrocephalus: surgical results according to the diagnostic procedure]. AB - Both ex-vacuo and non-reabsorptive hydrocephalus can present with a similar clinical triad of dementia, gait disturbances and incontinence. From a prognostic point of view, however, a great difference exists due to the possibility of surgical treatment with cerebrospinal fluid shunting in non-reabsorptive hydrocephalus. The difficulty lies in a correct preoperative diagnosis. In this study 37 patients aged from 60 to 72 with a clinical history suggestive of non reabsorptive communicating hydrocephalus were evaluated; the diagnostic tests applied to them were: computerized axial tomography, infusion test with Nelson's technique and intracranial pressure monitoring. A clear correlation was observed between the clinical improvement obtained after a cerebrospinal fluid shunt had been placed and the presence of pathological computerized axial tomography (hydrocephalus without increased sulci with or without trans-ependymal edema) or the pathological infusion test (intracranial pressure increase over 2 mm Hg/min and no decrease back to the basal level once the infusion had ended). No correlation was observed between the different recordings obtained from the intracranial pressure monitoring and the surgical results. The clinical data which most easily revert are the gait disturbance, dementia and incontinence in this order and, more so, in patients with known etiology. Since non-reabsorptive hydrocephalus and ex-vacuo hydrocephalus may co-exist, mostly in elderly patients, it is important to further develop the dynamic studies of intracranial pressure with the aim of offering a more reliable surgical prognosis. PMID- 2774804 TI - [Non-paraneoplastic polioencephalomyelitis]. AB - A 60-year-old male presented with cerebellar ataxia and ocular flutter which disappeared after ten months of evolution. The patient later had three other different bouts which caused cerebral, brainstem and polyradiculoneuritis-like symptomatology. The disease evolved in 20 months and at necropsy a primary polioencephalomyelitis was found. The remitting and relapsing course of the disease is better explained by an autoimmune-mediated lesion. PMID- 2774805 TI - [Type II fucosidosis. Description of a case]. PMID- 2774806 TI - [Ischemic cerebrovascular accident and climatologic factors]. AB - The authors have studied the influence of certain meteorological factors (air temperature, atmospheric pressure and humidity) on the onset of acute cerebrovascular disorders. The investigations related to 232 persons of both sexes affected by stroke. The case material was subjected to detailed statistical analysis. On the basis of their investigations the authors conclude that there is some parallelism between the particular meteorological factors examined and development of strokes. PMID- 2774807 TI - [The anticomplementary effect of animal sera--a contribution to the precise definition of the complement-binding reaction]. AB - Photometric procedures (standardised complement fixation reaction) were used to determine the anticomplementary action of animal sera. Multiplication factors, K, of 3.0 to 5.0, related to human sera, were recorded and were found to be capable of reducing or offsetting anticomplementary serum action in CFR in terms of a definitive complement excess. Anticomplementary action of animal sera, for all practical purposes, does no longer apply to dilution ratios of 1:16. The complement excess necessary for titres of 1:4 and 1:8 should be precisely defined and can then be calculated in constant measures. Hence, titres of 1:8 may be rendered accessible to safe assessment. Titres of 1:4 will continue to be problematic. The following order of animal sera was defined in comparison to human sera: cattle, pigeon, duck, sheep, cat, turkey, swine, coypu, hen, dog. PMID- 2774808 TI - Thyroid function in relation to reproductive efficiency in postpartum buffaloes (Bubalus bubalis) during summer and winter. AB - Thyroid function was studied by estimating of plasma-protein-bound iodine (PBI), in buffaloes, from 0 to 57 days postpartum. PBI values (microgram/100 ml) were lowest on day 1 postpartum, followed by a gradual increase by day 57. The values were consistently lower (P less than 0.01) during summer (3.79 +/- 0.13 micrograms/100 ml), as compared to winter (5.06 +/- 0.27). A lower value (P less than 0.01) was obtained in animals requiring less than 30 days (3.53 +/- 0.45) or more than 30 days (4.88 +/- 0.27) for uterine involution. The values were 4.56 +/ 0.13, 5.03 +/- 0.68 and 2.72 +/- 0.50 in animals requiring less than 25, 25-50 and more than 50 days for initiation of follicular development (P less than 0.01). Similarly the values were 4.95 +/- 0.38, 3.95 +/- 0.45 and 4.03 +/- 0.59 in buffaloes having postpartum oestrus intervals less than 45, 45-90, and more than 90 days (P less than 0.01). Higher values (P less than 0.05) were obtained in conceiving (4.55 +/- 0.41), as compared to non-conceiving animals (4.21 +/- 0.31). It can be concluded that the thyroid function is depressed during summer and in poorly reproducing buffaloes. PMID- 2774809 TI - [New aspects of the physiology of milking with special reference to the teat smooth musculature in teat rubber-free extraction]. AB - The following frequencies of change between 30 kPa milking vacuum and atmospheric pressure were used in a milking experiment with single-space cups: 0.05 Hz, 0.1 Hz, 0.2 Hz, 0.35 Hz, 0.5 Hz, 0.65 Hz, 0.8 Hz, and 0.95 Hz. Milking cup pressure and instantaneous milk flow rate through the teat canal were repetitively recorded ten times per second. Four clearly distinguishable and reproducible forms of flow rate oscillations were observed across several sucking phases together with four equally distinguishable and reproducible forms of profiles of a variable milk flow rate within one sucking phase. The occurrence of those differentiated forms of milk flow was found to be correlated primarily with both the sucking phase frequency applied and the average milk flow rate. These findings seem to be indicative of active control of teat canal diameter or milk flow rate by the unstriated teat musculature. PMID- 2774810 TI - Histomorphological description of papilloma in calves in the United Arab Emirates. AB - The present study was carried out on biopsy material from papillomatous overgrowths of 17 calves in the United Arab of Emirates. Grossly, the lesions appeared as small and large wart-like overgrowths and were distributed all over the body, but more strongly concentrated in the skin of head, neck, legs, and thorax. Histological investigations revealed actively growing epithelial cells and presence of a large number of pale cells. The paleness was commonly due to degenerative changes in such cells. The cytoplasmic inclusions considered to be abnormal keratinized material, while small intranuclear, eosinophilic inclusion bodies were found in the stratum spinosum. PMID- 2774811 TI - Influence of dietary mineral imbalance on the incidence of urolithiasis in Egyptian calves. AB - The influence of certain dietary elements on the urolithiasis syndrome in cattle calves was elucidated. Calcium, phosphorus, and magnesium measurements were conducted on feed rations as well as on serum and urine samples collected from affected and normal calves. Analysis of the rations given to the animals showed phosphorus at higher levels than calcium, indicating mineral imbalance. Serum and urine of urolithic calves were characterised by high phosphorus, calcium, magnesium, urea, and creatinine levels. Physical examination of urine of affected animals showed a high degree of turbidity, a large amount of calcium carbonate, and triple phosphate as well as abundant amount of pus cells and red blood cells. The characteristic clinical symptoms of urine retention were observed. Moreover, some animals were found to urinate through an opening in front of the scrotal region. PMID- 2774812 TI - A note on post partum utero vaginal prolapse in Gir cows: estimation of serum calcium, phosphorus, proteins, and cholesterol. AB - Reported are results obtained from determination of calcium, phosphorus, protein, and cholesterol in blood serum of 10 Gir cows with uterine prolapse. Particular reference is made to possible adverse effects of hypocalcaemia in conjunction with physiological stress resulting from pregnancy and parturition. PMID- 2774813 TI - [The acid-base status of venous blood and erythrocyte hemolysate in the dog]. AB - Determination of intracellular acid-base status is reported in this paper by the example of erythrocytic haemolysate in dog. The difference between intracellular and extracellular acid-base ratios is highly significant and is of clinical relevance. Differences between species and the need for further experimental verification of the method are discussed in some detail. Reference values are suggested for orientation, on the basis of 20 experimental dogs. PMID- 2774814 TI - [Comparative studies of the acid-base status in venous, capillary and mixed blood from the ear of the dog]. AB - Ten experimental dogs were tested in twelve experimental arrangements, with a view to finding out the extent to which results of acid-base determination or blood gas analysis could be significantly affected by induced hyperaemia of the ear or by the choice of a site for blood collection, including puncture of an ear vein. No difference was secured. Hence, ear vein puncture may be used to collect so-called capillary blood. Reference is made to the author's own values for use as criteria. PMID- 2774815 TI - [The physiologic electroretinogram of the raptor bird--clinical and theoretical aspects]. AB - A method of electroretinography applicable to birds is described in this paper by the example of common buzzard (Buteo buteo L.). Electroretinograms (ERG) under dark and bright adaptation as well as flicker ERGs were recorded from 15 common buzzards, and normograms were established. Methodological reliability was verified by a tenfold test on one animal. The results are compared with ERG findings from dog and are discussed with reference to behaviour physiology and clinical diagnosis. PMID- 2774816 TI - [Microbiologic studies of the lung clearance of rats after aerogenous long term exposure to ammonia]. AB - The effects of aerogenic long-time exposure of 1,990 female Wistar rats to 30, 50, 100 and 150 nl/l of NH3 for 3, 14, 28 and 42 days on clearance of inhaled bacteria (Staphylococcus aureus, SG 511 strain) were studied together with effects on the clinical condition and behaviour of these test animals. For concentrations below 100 nl/l, action upon pulmonary clearance was found to depend above all on the length of exposure, whereas effects of 150 nl/l proved to depend more strongly on concentration. All concentrations tested tended to act on pulmonary clearance in the form of increased numbers of bacteria which remained in the lungs of the experimental animals. Clinical symptoms attributable to NH3 action were not recordable. PMID- 2774817 TI - [Anesthesia of horses in the standing position]. AB - Painful interventions can be performed on horse in standing position by means of sedative analgesia, also called standing-position anaesthesia. Combinations of anaesthetics are quite often used, in that context, for the purpose of producing analgetic effects stronger and more reliable than those that would be obtainable from one anaesthetic alone. The following combinations were comparatively tested for their analgetic and sedative effects and their effects upon the organism: Chloralhydrate with Ursonarkon (oxazolidone), Chloralhydrate with Rompun (xylazine), Chloralhydrate with morphine hydrochloride, Chloralhydrate with morphine hydrochloride and Ursonarkon, local anaesthesia in conjunction with sedation by Ursonarkon. 50 experiments were conducted on an experimental group of 10 horses under standardised conditions together with complementary tests on 71 horses under field conditions. The experimental methodology used for assessment of analgetic effects was based on defined electrical and thermic stimuli to enable determination of reactive thresholds. An objective comparison was thus possible between the above variants. Local anaesthesia in combination with complementary sedation proved to meet all demands on standing-position anaesthesia, as it was found to eliminate pain and tactile reflexes. Defence movements have to be expected, whenever preparations are used that attack the central nervous system, since while sensations of pain are suppressed, tactile stimuli may be met with reflex responses via the spinal cord and its intrinsic function. PMID- 2774818 TI - [Experimental studies of intrabronchial foreign bodies in the dog]. AB - Results obtained from clinical, endoscopic, bacteriological, and roentgenological investigations, following artificial introduction of foreign bodies into the tracheobronchial system of dogs, are reported in this paper. The foreign bodies included gauze pads, plastic halma pieces, larch, alder, and wood cones. Twenty of the 22 foreign bodies artificially placed into the bronchial tree of the experimental dogs were spontaneously coughed up, 16 of them between the 1st and 14th days from introduction. The cause underlying such high spontaneous healing rate of tracheobronchial foreign bodies in dog is discussed in some detail. PMID- 2774819 TI - [Hematologic parameters of Probstheidaer pigmy goats in relation to pregnancy and lactation]. AB - Haematological follow-up checks were performed on 30 female Probstheida breed pigmy goats, 21 of them pregnant. Erythrocyte total, haemoglobin concentration, and haematocrit (packed cell volume) declined in the last third of the gravidity period. The total leucocyte count stayed nearly constant throughout gravidity and clearly increased after parturition, primarily due to increase in neutrophilic granulocytes. PMID- 2774820 TI - [The fat mobilization syndrome in guinea pigs (Cavia porcellus L.)]. AB - Feeding experiments were applied to 82 guinea pigs, different by age, sex, and stage of reproduction, and showed that high-energy feeding and subsequent feed withdrawal could trigger off with high probability a fat mobilising syndrome with clinically manifest ketosis in animals in gravidity and lactation or subclinical ketosis in all non-gravid individuals. High-energy or restrictive feeding alone did not cause in guinea pigs any disease along the lines of gravidity toxicosis. Aspects relating to aetiological and pathogenetic comparability with ruminants are discussed in some detail. PMID- 2774821 TI - Some enzyme interrelationships in serum and organs of Egyptian camel. AB - In 7 normal healthy Egyptian one-humped camels aged 3-4 years, the relationships were studied between enzyme activities of lactic dehydrogenase (LDH), creatine phosphokinase (CPK), alkaline phosphatase (ALP), acid phosphatase (ACP), and cholonesterase (CHE) of serum and organs as well as between ACP and ALP and between LDH and CPK. Liver, heart, kidney, and spleen tissue samples as well as serum were analysed for total enzyme activity. The following results were obtained: --The heart was the organ with the highest activities of ALP, LDH, and CPK, and it contained high values of CHE, whereas the lowest activities of all enzymes were recorded from serum. The spleen exhibited of the highest activity of ACP. --Each of the serum enzymes ALP, LDH, and CHE were in strong inverse relationship with the corresponding enzymes in the liver. Strong inverse relationships existed also between serum LDH and kidney LDH as well as between CPK in serum and heart. --Direct relationships were remarkable serum LDH and that of spleen and heart as well as between serum ACP and that of liver and heart. - Interrelationships were inverse between ACP and ALP in liver, kidney, and heart, but weak direct interrelationships were characteristic between the 2 enzymes in serum and spleen. --LDH was inversely interrelated with CPK in serum and heart. PMID- 2774822 TI - Effect of chloropheniramine maleate on liver and kidney functions as well as blood count of guinea pigs. AB - The present study aimed at exploring the effect of antihistamine chloropheniramine maleate (H1-blocker) on liver and kidney functions as well as on blood count. 60 mature guinea pigs were used. Histamine or chloropheniramine maleate was given, either alone or together, intramuscularly for 7 successive days. At the end of the experimental period, blood samples were collected for determination of blood counts and of the levels of urea, creatinine, GOT, GPT, and alkaline phosphatase in the sera of different groups. The results showed significant groupwise variations in blood count, liver function as well as kidney function. PMID- 2774823 TI - [The determination of ammonia in rumen fluid]. AB - The following 3 methods of NH3 determination were compared to each other for accuracy, on the basis of their results: microdiffusion acidimetric NH3 analysis, photometric NH3 analysis, using bivalent potassium tetra-iodomercurate, and steam distillation/acidimetric NH3 analysis. The results obtained from steam distillation at pH 7.6 were found to agree with those recorded from microdiffusion. However, photometric NH3 determination, using Nessler reagent, yielded overestimated values due to interference by other rumen juice substances. PMID- 2774825 TI - [Brucella clearance as a sensitive method for the detection of cross reactions of Brucella abortus with Yersinia enterocolitica 03, 06, 09 and Salmonella urbana and Salmonella abony]. AB - Determination of the Brucella clearance rate has proved to enable assessment of Brucella immune reaction in rat, even after vaccination with Yersiniae and Salmonellae. Vaccination with Yersinia (Y.) enterocolitica O6 and O9 produced 95 per cent of "high responders", whereas 65 per cent of "high responders" and 25 per cent of "non-responders" were recorded in the wake of O3. Salmonella (S.) urbana vaccination gave 50 per cent of "high responders" and 27 per cent of "non responders", while 100 per cent "non-responders" resulted from S. dublin. Vaccination, using Brucella abortus Buck 19, gave 100 per cent "high responders". The differentiated nature of immune reactions to Y. enterocolitica O3, S. urbana, and S. abony has been attributed to an individual genetic capability of reaction to the cross-reactive antigen. PMID- 2774824 TI - [The hematocrit values and hemoglobin content of blood and the level of total protein, free fatty acids, glucose, lactate, Ca, Mg, Na, K, Pa, Fe, Fe-binding capacity, Cu and Zn in the blood plasma of newborn calves and their mothers immediately after birth]. AB - Blood samples were collected from 22 calves in three weight classes (A: 29.3 +/- 0.5 kg, B: 36.0 +/- 1.3 kg, C: 42.7 +/- 3.7 kg), 1-3 minutes after parturition and prior to uptake of foremilk as well as 24-26 hours after parturition. Other blood samples were collected from 45 calves, 5-60 minutes after parturition, and from their mothers, 3-5 or 5-60 minutes from calving. Haematocrit and haemoglobin in the blood of the calves, immediately after parturition, were higher the values recorded from adult cattle. Major differences were found to exist between individual calves regarding total protein of blood plasma. Protein levels in 14 calves were below 50 g/l, within 24-26 hours from parturition. Free fatty acids in blood plasma of calves were lower than those in cattle, 1-3 minutes from parturition, and were higher, 5-60 minutes from parturition. Glucose levels in Group C were higher than those in A and B, 1-3 minutes postpartum. Lactate in Group C was higher than that in B. An account is also given of blood plasma levels of Ca, Pa, Mg, Na, K, Cu, and Zn. PMID- 2774826 TI - [Characterizing the in vitro capacitation of motile bull sperm by the hyamine induced acrosome reaction]. AB - Described in this paper is a method to characterize capacitation of bull spermatozoa. Involved is the action of 0.005 per cent of hyamine 2389 on selected motile cells at 37 degrees C for 30 minutes to detect the number of spermatozoa capable of acrosomal reaction. The latter amount results from the percentual difference between acrosome-free spermatozoa prior to hyamine action and those after hyamine action. Acrosome-free spermatozoa can be easily identified by means of simple staining under optical light microscopy. The value thus obtained is related to the amount of spermatozoa in progressively motile in the unselected original suspension and is called "Percentage Acrosome Reaction Induction" (% ARI). The ARI capacitation-specific acts: Only small amounts of acrosome-free spermatozoa are recordable among incapacitated spermatozoa or from spermatozoa incubated in the presence of decapacitation factors (1.9 or 2.3 per cent, respectively). On the other hand, clearly increased values of 17.6 ot 26.1 per cent are obtainable from treatments with capacitation effect (high ionic strength or addition of heparin). The method is claimed to be suitable for adequate choice of conditions for improved capacitation and in vitro fertilization as well as for elucidation of specific individual differences in capacitation. PMID- 2774827 TI - [Phospholipid content of subcellular structures in skeletal muscles after halothane loading in Landrace swine in relation to mating variants and genotype]. AB - Membraneous phospholipids of subcellular structures were determined from the musculature of German Landrace pigs of the GDR, following exposure to halothane. Mating variants A (H+ male X H+ female), B (H+ male X H- female), and C (H- male X H+ female) were used for positive responders (MHS), while variants B, C, and D (H- male X H- female) were used for negative responders (MHN). Four phospholipid fractions were recorded from the muscle samples for mitochondria and microsomes (according to SR section). Differences between the MHS and MHN groups for the above fractions and without consideration of mating variants and genotype were not observed, although unambiguous responses were exhibited by all animals, either positive or negative to halothan. Significant differences with regard to the above phospholipid fractions were recordable only for variant A (MHS group) as compared to D (MHN), in other words, for the homozygous genotypes, once the above results had been rearranged within MHS and MHN along with different mating variants and genotypes. However, no unambiguous results were obtainable for the heterozygous genotypes of mating variants B and C. Possible underlying reasons are discussed in some detail. The results obtained from mating variants A and D are likely to confirm earlier findings and seem to suggest that the sarcoplasmic reticulum is the primary site of origin of susceptibility to halothane or malignant hyperthermia. PMID- 2774828 TI - [The oxygen uptake capacity of swine]. AB - Comprehensive studies into domestic pigs and wild boars together with literature data provided a basis for an assessment of aerobic metabolic capacity (VO2max) of swine. The values quoted, from 20 to 94 ml/min-1/kg, had been due to several factors of methodological approach, growth, training, and nutrition as well as to pathophysiological aspects. For full capacity utilisation of VO2max, untrained pigs can be challenged at belt velocities between 0.8 and 1.8 m/s-1 and trained animals at 5 m/s-1. PMID- 2774829 TI - Studies on antepartum prolapse of the vagina in buffalo--plasma trace element concentrations. AB - Plasma micro-element concentrations of copper, zinc, iron, and manganese were studied in 25 buffaloes at varying stages of gestation, between 7 months to term and with varying degrees of vaginal prolapse. A similar number of animals, normally pregnant at identical stages and with no previous history of antepartum vaginal prolapse, was used for control purposes. Plasma iron and manganese concentrations in affected animals were similar to values in normal pregnant animals at all stages. However, plasma copper levels were slightly but not significantly lower in affected animals at all stages, whereas plasma zinc concentrations were significantly low in affected animals from 9 months to term. Possible interactions are discussed between plasma copper and zinc levels, on the one hand, and hormones, like oestrogens and cortisol, on the other. PMID- 2774830 TI - Histopathological study into side-effect toxicity of some drugs used in treatment of cancer. AB - The effect of cis-chlorodiamine platinum (cisplatin) on different tissues of rat was studied. Nephrotoxicity and neurotoxicity were clearly observed both clinically and histologically. The minimising action of penicillamine as a chelating agent and/or lasix as a diuretic on the toxic side-effect of cisplatin was also studied. Both agents succeeded in reducing the toxic side-effect of cisplatin to some extent but failed to reduce mortality among the experimental animals. The study has also manifested liver and heart to be additional organs susceptible to damage, following cisplatin treatment. PMID- 2774831 TI - [The content of ascorbic acids in different tissues of cattle, normally developed piglets, splay-legged piglets, adult swine and dogs]. AB - The following ascorbic acid levels were recorded from different organs of cattle, with all values quoted being related to mg/100 g fresh matter: 150 +/- 20 in pituitary gland, 170 +/- 40 in left adrenal gland, 45.5 +/- 12.5 in spleen, 38.1 +/- 7.3 in liver, 30.0 +/- 8.5 in cerebrum, 23.2 +/- 7.2 in cerebellum, 16.4 +/- 6.1 in kidney, 11.0 +/- 2.9 in heart, and 9.1 +/- 2.1 in M. longissimus dorsi. The ascorbic acid level in blood plasma of normally developed piglets was 6.5 +/- 2.7 mg/dl and was thus higher with significance (p less than 0.01) than that recorded from splayleg piglets which was 2.3 +/- 0.96 mg/dl. The levels in the M. semimembranosus and M. semitendinosus in piglets of moderate birth weight were higher, as well (p less than 0.05). The liver level in pigs for slaughter was 30.8 +/- 9.0 mg/100 g lower than that in piglets. Piglets exhibited genetically founded differences in their capability of biosynthesis of ascorbic acid. The highest ascorbic acid level in dog was recorded from the pituitary and adrenal glands, values being 135.5 +/- 7.5 mg/100 g fresh matter or 90.3 +/- 37.8 mg/100 g. Their liver level was 27.9 +/- 11.9 mg/100 g. PMID- 2774832 TI - [Experimental studies on the stimulation of prenatal development in swine by PMSG treatment in early pregnancy. 1. Clinical results of embryonic development in young slaughtered sows and litter results in young and old sows after PMSG treatment on the 11th day of pregnancy]. AB - Thirty-eight gilts were slaughtered on the 25th and 39th days of pregnancy, after they had received 400 I.U. PMSG treatment on the eleventh day of pregnancy. Treated and untreated animals in a group of 140 gilts and 195 adult sows were compared with each other for post-farrowing fertility performance. Weight development of embryos obtained from the slaughtered sows depended on the number of embryos alive. The survival rate of embryos from treated sows was about 5% higher than that recorded from untreated animals. Clearly increased litter sizes which, however, were associated with lower piglet birth weights were recorded from farrowing gilts and adult sows, following PMSG treatment. The conclusion is drawn that PMSG treatment, via luteotrophic action of luteinising hormone, is capable of stabilising pregnancy-related corpora lutei, resulting in higher litter sizes. Further studies will be necessary, and emphasis will have to be laid on the problem of weight development of newborn piglets, following litter size boosting treatment. PMID- 2774833 TI - [Experimental studies on the stimulation of prenatal development in swine by PMSG treatment in early pregnancy. 2. Analytic studies of hormones in young sows after PMSG treatment on the 11th day of pregnancy]. AB - Tens gilts received 400 I.U. of Pregmagon on the 11th day of pregnancy (day of KB2 = 1 day of pregnancy), while 8 sows were used as controls. Blood was sampled 4 times a day between the 11th and 25th day of pregnancy, with an indwelling catheter being used. Progesterone, oestradiol-17 beta, and luteinising hormone were radio-immunologically determined. The hormone profiles of pregnant sows were found to differ unambiguously from those of non-pregnant animals for both concentrations and frequencies. They were indicative of close correlations and time links of gonadotrophic and steroid hormones in early pregnancy and in oestrus. PMSG treatment in pregnancy resulted in increase in the oestradiol-17 beta concentration and attenuation in pulsatile luteinising hormone release at the time of implantation. Progesterone concentrations in peripheral blood were not affected by PMSG injection. PMID- 2774834 TI - [The effect of UV rays on parasitic arthropods. 3. In vitro and in vivo studies of the effect of a fractionated UV irradiation on the development stages of Psoroptes cuniculi (Acaridida: Psoroptidae)]. AB - In vitro studies were conducted into Psoroptes (Ps.) cuniculi larvae and nymphs of undefined age and gender. 30 males and females were involved in each of the experiments. Evidence was found the life expectancy of mites exposed to daily UV irradiation for 1, 2, 3, 4 or 5 minutes was reduced with significance, as compared to non-irradiated mites or to those with only one irradiation of the same length. Developmental stages of Ps. cuniculi responded in differentiated ways to the same dose rate, when applied by one single extended or fractionated shorter irradiation. Fractionated irradiation was more often survived by females than one single extended irradiation, whereas earlier death occurred to larvae following exposure to fractionated irradiation. Mange mites were not eliminated from rabbits with moderate ear mange by fractionated locally delimited in vivo irradiation, up to 16 applications of 10 minutes each or 6 or 9 applications of 10, 20 or 40 minutes each, with one-week intervals in between. Ear mange was clinically re-manifested, after irradiations had been discontinued. PMID- 2774835 TI - [The disposition and clearance of inhaled bacteria (Staphylococcus aureus) in the lungs of piglets]. AB - Retention in the lungs of 24 piglets of bacteria inhaled following exposure to an aerosol (dv(50)4 micron) of Staphylococcus aureus (SG511 strain), with clearance periods of differentiated lengths, is reported in this paper. Aerosol inhalation led to heterogeneous deposition patterns in the lung. The highest germ count per gram of lung tissue could be re-isolated from the base lobe, while the lowest germ count was retained in the apical lobe. Germ retention in the other lung lobes was somewhere in between these findings. Such differentiation was detectable as early as 20 minutes from the onset of aerosol application and continued to be largely stable even after clearance periods of 2 and 6 hours. PMID- 2774836 TI - [The reproduction of eperythrozoonosis of swine by animal experiments after splenectomy]. AB - An account is given in this paper of equipment, techniques, clinical tests, and investigations for laboratory diagnosis required for an animal experiment on splenectomised store pigs suspicious of eperythrozoonosis (EEZ). The clinical, bacterioscopic, haematological, and biochemical data recorded from the experiment on splenectomised store pigs with suspicion of EEZ were helpful in reproducing both symptoms indicative of EEZ and relevant parameters of laboratory diagnosis. The diagnosis of EEZ, made in the first place on the basis of clinical, bacterioscopic, and haematological findings, was thus confirmed. Conclusions of general validity for users of animal experiments for EEZ diagnosis were also drawn and will prove helpful in establishing safe diagnosis in dubious cases. The animal experiment proved useful in following up the interactions between all parameters checked, which will contribute, no doubt, to better understanding of the pathophysiological processes associated with this disease. PMID- 2774838 TI - Metabolic disturbances induced by organotins through subchronic treatment in chickens. First communication: growth dynamics, carbohydrate and protein metabolism. AB - Four organotin derivatives (tributyltin acid, dibutyltin chloride, triphenyltinchloride, and triphenyltin-bis (diethyl) dithiophosphate) were tested through subchronic treatment on 19 days old chickens. Growth dynamics as well as carbohydrate and protein metabolism were investigated, in order to evaluate their effects on metabolic activity. Biochemical liver and blood constituents revealed growth retardation and general depression of metabolic activity in experimental groups. Some correlations were found to exist chemical structure, dose use for compound, and effects. Butyltins were more toxic than phenylderivatives and their effects were proportionale to the dose. PMID- 2774837 TI - The effect of xylazine on basal serum prolactin concentrations in male rats. AB - In this study the effects of the major tranquilizer, xylazine, on serum prolactin level were studied in male rats. The results showed that, unlike all other tranquilizers, xylazine produced significant decrease (P less than 0.05) in serum prolactin levels. Xylazine at doses of 2.5, 5, and 10 mg/kg body weight (b.w.) induced significant decrease in serum prolactin levels 1 h after its intramuscular injection which remained significantly low for 4 h. The inhibition produced by 5 mg/kg and the 10 mg/kg b.w. doses was observed to be stronger in both magnitude and duration than that produced by the lower dose (2.5 mg/kg). This inhibitory effect of xylazine on prolactin levels may be attributable to its dopaminergic and/or alpha adrenergic antagonist activity. However, this point needs further investigation. PMID- 2774839 TI - Metabolic disturbances induced by organotins through subchronic treatment in chickens. Second communication: mineral metabolism. AB - 4 organotin derivatives (tributyltin acid, dibutyltin chloride, triphenyltin chloride, and triphenyltinbis (diethyl) dithiophosphate) were tested through subchronic treatment in 19 days old chickens. Their effects upon mineral metabolism were studied through biochemical investigations in kidney, bone, and blood. Bone mineral disturbances (depletion of Ca/P ratio) induced Ca elimination in blood, immobilised as calcium urates in kidney, and also increased values for alkaline phosphatase, following tin accumulation in bone. Butyl and phenyltin chloride were more toxic than dithiophosphate, and the intensity of effects was proportionate to the dose. PMID- 2774840 TI - [Subacute butyric acid burden in cattle. 1. Clinical results and effects on the carbohydrate-fat metabolism and the liver function of young fattening bulls]. AB - Daily butyric acid doses of 0.5 g/kg body weight or 1.0 g/kg were intraruminally applied to 8 young fattening bulls together with regular feed rations, for 19 days, following an initial phase for adaptation. Indigestion phenomena were recordable from 30% of the animals, primarily on the early days of the experiment. Both doses produced sinusoidal beta-OH butyrate curves without major dose-dependent deviations. The concentrations of glucose and free fatty acids were indicative of temporary subclinical ketosis. Neither ASAT, ALAT, and gamma glutamyltransferase nor bilirubin nor liver glycogen were indicative of liver damage. The lower dose of 0.5 g/kg was widely tolerated, but clearly discernible disorders developed in response to the higher dose of 1.0 g/kg of butyric acid. PMID- 2774841 TI - [Subacute butyric acid burden in cattle. 2. Effect on the acid-base balance and the protein metabolism in young fattening bulls]. AB - Three weeks of butyric acid applications (0.5 g/kg and 1.0 g/kg body weight) caused strong dose-dependent strains on the acid-base balance in young fattening bulls aged 4 months. Disorders were primarily reflected in changed net values of acid-base excretion in urine. Activity of alkaline phosphatase was found to depend strongly and directly on these changes. Drastic variations were recorded also from nitrogen metabolism. PMID- 2774842 TI - [Subacute butyric acid burden in cattle. 3. Clinical results and effect on the carbohydrate-fat metabolism, the liver function and the acid-base balance in fattening bulls]. AB - A daily dose of 1.0 g/kg body weight (b.w.) of butyric acid was intraruminally applied to 7 fattening bulls (360 kg in b.w. for 3 weeks. This caused slight clinical disorders, primarily in the form of reduced b.w. gain, but more strongly pronounced changes in beta-OH butyrate and in free fatty acids, with concentrations of these rising in the first experimental week, returning to normal in the 2, and rising again in the 3rd. Glucose concentrations went up during the experiment, but its diurnal curve then was, typically, inversed against beta-OH butyrate. Signs indicative of impaired liver function were not recordable. Minor stresses on the acid-base balance were visible towards the end of the experiment. PMID- 2774843 TI - [A simple method for the quantitative determination of sperm aggregation]. AB - Described in this paper are 2 methodological variants for photometric recording of sperm aggregation. Heparin was used to induce aggregation. One of the working principles was related to aggregation-associated alteration of turbidity in an agitated cell suspension, measured by the KZM-1 coagulation-time meter, in analogy to measurement of thrombocyte aggregation. The 2nd variant was based on variation of cloudiness due to sedimentation of aggregates in a non-agitated suspension. Both methods provided equally valid information. They characterised both intensity of aggregation as a combined effect of the number and size of aggregates as well as the rate of aggregation. Photometric recording has proved to be an objectivated method for quantitative assessment of aggregation. Its use is proposed for studies into capacitation or immunological response of spermatozoa. PMID- 2774844 TI - Experimental paratuberculosis (Johne's disease)--studies on biochemical parameters in cattle. AB - Ten male Holstein-Friesian calves naturally infected by Mycobacterium paratuberculosis were experimentally re-infected orally at an average of 17 days. Monthly measurements were conduced of the following activities, in the period between post infection days 160 and 400: total protein (TPR), albumin (ALB), cholesterol (CHOL), triglycerides (TRIG), Zn and Cu concentrations as well as sorbitol dehydrogenase, lactate dehydrogenase (LDH), alpha-hydroxybutyrate dehydrogenase (alpha-HBDH), gamma-glutamyltransferase, aspartate aminotransferase (AST), alanine aminotransferase (ALT), creatine kinase (CK), alkaline phosphatase and fructose-1,6-diphosphate aldolase (ALD). TPR, ALB, TRIG, and CHOL were reduced by day 400, in conjunction with disorders of digestion and absorption. Increased activities of CK, ALD, LDH, alpha-HBDH, AST and ALT primarily indicated damage to skeletal muscle and/or liver. Serum CK and ALD activities as well as TRIG and TPR concentrations may serve as aids to specific diagnosis of paratuberculosis, particularly in the advanced stage of the disease. PMID- 2774845 TI - [Histologic and histometric studies of the epiphysis cerebri of the fattening guinea fowl (Meleagris gallopavo) after the use of different light regimens]. AB - Chicken turkey-hens aged 8 weeks were exposed to a light regime of 1 hour light to 2 hours darkness for 8 weeks. Another experimental group was exposed to permanent lighting from hatching to the 16th week of age. The epiphyses of 5 males and females of either group were histologically, histochemically, and histometrically investigated. Significant differences were found to exist between the 2 experimental groups with regard to the nuclear volumes of epiphyseal cells. Epiphyseal cell activity was found to be reduced by permanent lighting. PMID- 2774847 TI - Depressive disorders in childhood. IV. A longitudinal study of comorbidity with and risk for anxiety disorders. AB - As part of a longitudinal nosologic study of major depressive disorder (MDD), dysthymic disorder (DD), and adjustment disorder with depressed mood (ADDM) in a school-age cohort, we examined the prevalence and clinical consequences of comorbid anxiety disorders. We also estimated the risk of a first anxiety disorder and examined its predictors. Of 104 cases, 41% had anxiety disorders in conjunction with their index depression, which was more likely with MDD and DD than with ADDM. The age-corrected risk of a first anxiety disorder was 0.47 up to age 18 years. Separation-anxiety disorder was the most frequent diagnosis of anxiety, followed by overanxious disorder of childhood. Among the MDD cases with comorbidity, the anxiety disorder preceded the depression about two thirds of the time and often persisted after the depression remitted. The effect of comorbid anxiety disorder on the length of index MDD depended on the presence of other clinical features, but it did not seem to affect the risk of subsequent MDD or the course of DD or ADDM. Concurrent maternal psychopathology and poor physical health increased the risk of anxiety disorder in the children, but a history of prior separation from parental figures did not seem to have an effect. PMID- 2774846 TI - The advantage of early treatment intervention in recurrent depression. AB - Two key questions regarding the treatment of depression remain unanswered: whether early treatment intervention will shorten the length of the episode and whether a previously successful treatment will be associated with a more rapid response when administered during the subsequent episode. A group of 45 patients with recurrent major depression treated with combined pharmacotherapy and psychotherapy in a similar fashion for two consecutive episodes showed comparable mean times to stabilization of between 11 and 12 weeks. However, the early intervention in the second treatment episode significantly shortened the overall length of the depressive episode by approximately 4 to 5 months. PMID- 2774848 TI - The 24-hour profile of plasma prolactin in men with major endogenous depressive illness. AB - Plasma prolactin (PRL) levels were measured at 15-minute intervals for 24 hours in 18 men suffering from major endogenous depressive illness and in 7 age-matched healthy men. Eleven of the 18 depressed patients were restudied during clinical remission following either electroconvulsive therapy or treatment with amitriptyline hydrochloride. During the acute phase of the illness, the unipolar depressed patients had fragmented patterns of PRL secretion with an early timing of the nocturnal secretory phase of PRL, which started, on the average, 2 hours earlier than in healthy subjects. Moreover, the amplitude of the circadian variation of PRL was reduced in these patients, with subnormal PRL levels occurring during the midsleep period. This latter abnormality was also observed in bipolar patients, who had otherwise normal PRL profiles. These lower midsleep PRL concentrations were associated with a significant increase in the amount of time spent awake during the same period. Antidepressant treatment did not consistently correct the abnormalities in the patterns of PRL release observed during the acute phase of the illness. These results indicate that early timing of nocturnal PRL secretion and damping of the nighttime PRL elevation may be found in men with endogenous depressive disorders. In contrast to disturbances of the corticotropic and somatotropic axes, these abnormalities of PRL secretion may still be present during clinical remission following antidepressant treatment. PMID- 2774849 TI - Phototherapy in individuals with and without subsyndromal seasonal affective disorder. AB - Antidepressant and energizing effects of bright light exposure (phototherapy) have been widely reported to occur in patients with seasonal affective disorder. We have attempted to evaluate whether other segments of the population might benefit from phototherapy, most notably individuals with subsyndromal seasonal affective disorder, as well as healthy individuals with no winter difficulties (controls). We have studied 20 subjects in each of these two categories and have found that bright artificial light did not alter mood and behavior in controls. In contrast, individuals with subsyndromal seasonal affective disorder responded favorably to treatment with bright environmental light. A dose of 5 hours of bright light exposure, divided between morning and evening, was more effective than 2 hours of exposure. This finding may have practical implications for establishing optimal environmental lighting conditions for those individuals whose winter difficulties do not meet criteria for seasonal affective disorder. PMID- 2774851 TI - Depressive disorders. Further evidence for increased medical morbidity and impairment of social functioning. PMID- 2774850 TI - Psychiatric problems in homeless men. Lifetime psychosis, substance use, and current distress in new arrivals at New York City shelters. AB - We assessed psychiatric states in 223 men at first entry to New York, NY, municipal men's shelters, overall and differentiated by prior experience of homelessness. Instruments included a diagnostic interview (Structured Clinical Interview for DSM-III-R: Psychotic Disorders), the Short Michigan Alcoholism Screening Test, and the Center for Epidemiologic Studies of Depression Scale. The use of a "first timer" sample, and of a clinical diagnostic interview, had not, to our knowledge, been previously attempted in studies of psychiatric problems in the homeless. The majority of men had a history of mental disorder or of heavy substance use. On diagnostic interview, 17% of the men had a definite or probable history of psychosis, and another 8% had a possible history of psychosis. A confident diagnosis of schizophrenia was made in 8%. A history of alcohol or other drug abuse was evident in 58%. Cocaine was already (in 1985) the drug of choice; 27% of the study sample had used it more than 50 times. One third of the men were in extreme distress, much of it apparently acute and associated with the transition to the shelter, and 7% reported suicidal thoughts at the time of the interview. The newly homeless, compared with those who had been homeless for much of the 5 years prior to shelter entry, were younger and had fewer psychiatric problems. PMID- 2774852 TI - Social zeitgebers, biological rhythms, and transactional analysis. PMID- 2774853 TI - Histopathologic and flow cytometric analysis of adenomatous colonic polyps. AB - We evaluated the histopathology, DNA content, and proliferative activity of colonic polyps independently. Paraffin-embedded specimens were used as source material. In each case, additional sections were cut at 3 microns and stained with hematoxylin-eosin and trichrome for histopathologic analysis. For DNA analysis and measurement of proliferative activity, the polyp parts were dissected and the nonpolypoid tissue was discarded. The study was limited to those specimens that were received in our department in the years 1972 and 1977. Of the 104 polyps that were submitted for flow cytometric analysis, 36 could not be analyzed owing to excessive debris or insufficient nuclei. DNA aneuploidy was identified in 32% of the cases, with a higher value noted in larger polyps and in severely dysplastic polyps, but these values were not statistically significant. Multiple adenomas from the same patient often showed different DNA histograms. When analyzed according to the percentage of cells in S phase, no significant difference was found in proliferative activity of polyps according to DNA content or size of the polyps. These results suggest that the diagnostic significance of aneuploidy and proliferative activity in polyps must be interpreted with caution. PMID- 2774854 TI - DNA quantitation and histologic characteristics of squamous cell carcinoma of the upper aerodigestive tract. AB - DNA analysis is currently being applied to many solid tumors to determine DNA content and synthesis phase fraction. We compared DNA content measured by flow cytometry with multiple histologic parameters in 155 squamous cell carcinomas of the upper aerodigestive tract. Abnormal DNA content (aneuploidy) was identified in 107 (69%) of the neoplasms. Abnormal DNA content or aneuploidy correlated with above-median synthesis phase fraction and increased frequency of mitotic figures. Other histologic features predicting aggressive tumor behavior also correlated with abnormal DNA content and included small cords or single cell pattern of tumor invasion, high nuclear grade, and decreased stromal or desmoplastic response to the invading squamous cell carcinoma. PMID- 2774855 TI - Increasing the accuracy of fine-needle biopsy for thyroid nodules. AB - Fine-needle biopsy (FNB) is a valuable technique to use in the evaluation of thyroid nodules; however, false-negative and false-positive results do occur. At Sinai Hospital of Detroit (SHD) (Mich), a criterion was established for adequacy of an FNB specimen (ie, at least six clusters of benign cells on each of two slides prepared from separate aspirations) in an attempt to reduce the rate of false-negative diagnoses attributable to inadequate sampling. To evaluate the SHD criterion, 20 "problem" cases were selected from the SHD files and were reviewed by pathologists from three other institutions in a blind study. A total of 80 diagnoses were rendered (four institutions each reviewing 20 cases). Seven false negative diagnoses were rendered, three of which were made in cases that did not meet the SHD criterion for adequacy. An additional three false-negative diagnoses on inadequate FNB specimens were made by a physician who asked not to be identified. Implementation of the SHD criterion may reduce the frequency of false negative diagnoses. A separate study was undertaken to determine the number of FNB aspirations necessary to obtain satisfactory specimens. One hundred adequate FNB specimens from SHD files were reviewed. In 77% of cases the first two to four aspirations were adequate, but 23% of the time six to eight aspirations were necessary to obtain adequate material. PMID- 2774856 TI - Histogenesis of tubular adenomas in hereditary colonic adenomatous polyposis. AB - Tubular adenomas were studied morphometrically and histopathologically in colectomy specimens from seven children and five young adults with hereditary colonic adenomatous polyposis. In each age group and in each patient, the diameter and height of adenomas showed a log normal distribution. Both variables differed significantly among patients in each age group and also between the two age groups. In the young adults, there was a selective growth of certain adenomas. Scatter diagrams of the diameter vs height of adenomas showed that adenomas grew preferentially in the horizontal plane in early development, giving adenomas a discoid shape. Adenomas greater than 8 mm in diameter grew both horizontally and vertically. The horizontal growth was due to division of adenomatous crypts, and adenomas greater than 8 mm in diameter also exhibited elongation of crypts. PMID- 2774857 TI - Fatal acute pontocerebellar hemorrhage due to an unsuspected spheno-occipital chordoma. AB - Patients with cranial chordomas typically present with a several-month history of progressive cranial nerve palsies. We report the first case (to our knowledge) of a clinically unsuspected sphenooccipital chordoma evolving into an acute pontocerebellar hemorrhage. PMID- 2774858 TI - Primary lymphangioma of the thyroid gland. AB - A 21-year-old woman presented with a solitary, hypofunctioning right thyroid nodule. Findings of fine-needle aspiration biopsy were consistent with a thyroid cyst, but a subsequent biopsy demonstrated changes suggestive of a papillary neoplasm. Surgery was performed and a well-circumscribed 12-mm nodule was identified within the thyroid parenchyma. Microscopic examination confirmed the presence of a thyroid lymphangioma. To our knowledge, this is the first case of a primary thyroid lymphangioma reported in the English literature. PMID- 2774859 TI - Role models in pathology revisited. PMID- 2774860 TI - Role models in pathology. PMID- 2774861 TI - Chronic meningitis and vasculitis in acquired immunodeficiency syndrome. PMID- 2774862 TI - Survival of human immunodeficiency virus in blood culture systems. PMID- 2774863 TI - Small expert systems in clinical pathology. Are they useful? PMID- 2774864 TI - Proficiency testing and laboratory quality. Lessons from the Ontario program. PMID- 2774865 TI - The diagnosis of microcytic anemia by a rule-based expert system using VP-Expert. AB - We describe our experience in creating a rule-based expert system for the interpretation of microcytic anemia using the expert system development tool, VP Expert, running on an IBM personal computer. VP-Expert processes data (complete blood cell count results, age, and sex) according to a set of user-written logic rules (our program) to reach conclusions as to the following causes of microcytic anemia: alpha- and beta-thalassemia trait, iron deficiency, and anemia of chronic disease. Our expert system was tested using previously interpreted complete blood cell count data. In most instances, there was good agreement between the expert system and its pathologist-author, but many discrepancies were found in the interpretation of anemia of chronic disease. We conclude that VP-Expert has a useful level of power and flexibility, yet is simple enough that individuals with modest programming experience can create their own expert systems. Limitations of such expert systems are discussed. PMID- 2774866 TI - Reliability of white blood cell counting. AB - The Laboratory Proficiency Testing Program has successfully operated mandatory proficiency testing for 13 years in Ontario, Canada, using committees of volunteer peers. This is an alternative to gubernatorial proficiency testing. Using white blood cell (WBC) count determinations as a focus, we present our results. Ninety-six percent of participants attained WBC count results within +/- 10% of an all-methods mean and 77% attained results within +/- 5%. Ninety-six percent displayed satisfactory precision. Details of the program, ie, testing material, computer analysis, reference results, and scope of committee action, are discussed. In 1975, clinical expectations for WBC count determinations greatly exceeded most laboratories' capabilities. By 1987, participants were able to produce reliable, clinically useful WBC count results. The paramount reason for this improvement is the transition from manual to automated counting methods resulting from the stimulus of proficiency testing and the concomitant education. PMID- 2774868 TI - Pyridazine derivatives, VII. Synthesis and hypotensive activity of 3 hydrazinocycloalkyl[1,2-c]pyridazines and their derivatives. AB - The preparation of a series of 3-hydrazinocycloalkyl[1,2-c]pyridazines 7 and some derivatives as hydrazones 8, 9, triazoles 10 and pyrroles 11 are described together with their hypotensive activity in normotensive rats. PMID- 2774867 TI - Blood transfusion in medically treatable chronic anemia. Pernicious anemia as a model for transfusion overuse. AB - Transfusion practice in patients with treatable, readily recognizable, chronic anemia was reviewed because such patients only infrequently need to be transfused. Pernicious anemia with hemoglobin concentration below 100 g/L was chosen as the model for this assessment. Sixty-two (51%) of 122 patients received blood transfusion, although most patients had chronic, low-grade symptoms despite their low hemoglobin levels and could have been satisfactorily managed without transfusion. Only 34 of the 122 had findings suggesting an urgent need to raise the blood cell count, but their transfusion rate (44%) was no different from that in patients without such findings. These observations in pernicious anemia indicate that transfusion of patients with medically reversible anemia is a common problem. They further suggest that current transfusion usage overemphasizes laboratory results (ie, hemoglobin levels) at the expense of clinical assessment of severity of symptoms. Improvement of current practice is needed, particularly in view of valid concerns about the serious side effects of transfusion, shortages of available blood resources, and health care costs. PMID- 2774869 TI - [The pharmacokinetics of antilipemic agents. 5. Is 2-(4-hydroxyphenoxy)-2 methylpropionic acid a metabolite of the antilipemic ciprofibrate?]. AB - After oral administration of Ciprofibrate (1) to volunteers (n = 5) only its glucuronide, but no 1 and no 2-(4-Hydroxyphenoxy)-2-methyl-propionic acid (3) could be detected in the fresh urine. Its formation from 1 seems to be impossible on the basis of established biochemical reactions. Therefore, its presence in the urine of volunteers reported by other authors is refuted. PMID- 2774870 TI - Some new prazosin analogues. AB - The synthesis and the pharmacological properties of some new prazosin analogues are described. PMID- 2774871 TI - Researches on antibacterial and antifungal agents, X. Synthesis and antifungal activities of 1-(p-methyl-alpha-[4-(1H-pyrrol-1-yl)phenyl]benzyl)azoles and some related products. AB - The synthesis and antifungal activities against Candida albicans and Candida spp. of some pyrrole analogues of bifonazole are reported. 1-(p-Methyl-alpha-[4-(1H pyrrol-1-yl)phenyl]benzyl)imidazole was found to be equipotent or sometimes superior to bifonazole and ketoconazole, and lightly inferior to miconazole. Substitution of the imidazole moiety with other azoles retained some activities. No activity was shown when the azole aromatic rings were replaced by the heteroalicyclic ones. PMID- 2774872 TI - Arthropathy of the wrist in leprosy--what changes are caused by long-standing peripheral nerve palsy? AB - A radiographical screening study of 338 leprotic patients was performed. Clinically, according to a nerve score (NS) designed by us, 12.9% of 674 hands showed mild nerve palsy (NS 5 or 6), 75.9% moderate (NS 3 or 4), and 11.4% severe (NS less than 2). Twenty-nine hands of 26 patients (NS 4.2 on average) demonstrated abnormal changes of the wrist joint on radiographs. We classified them into four groups: (a) lunate collapse (four patients), (b) scaphoid nonunion (eight), (c) scaphoid cyst (three), and (d) trapezium OA (11). In the lunate collapse and the scaphoid nonunion groups, destructive and reconstructive changes as described by Eichenholtz were identified on plain film. These groups demonstrated remarkable instability of the stress and dynamic roentgenograms. In contrast, the scaphoid cyst and trapezium OA wrists showed neither fracture nor instability and fewer changes than the other two groups. We considered the destructive changes that had taken place in the lunate collapse and the scaphoid nonunion wrists to be neuroarthropathy due to long-standing nerve palsy. PMID- 2774873 TI - Limb-preserving operations in the treatment of malignant bone tumors. AB - Limb-preserving resections require very careful indications; in particular, the criteria of oncologic radicality must be strictly considered. The functional results can be improved compared with those of ablative surgery, while the rate of relapse-free survival is the same. Surgical therapy for metastases of bone tumors should be performed by simple and safe procedures which allow for quick rehabilitation. The most important limb-preserving methods of operation in the treatment of primary and secondary malignant bone tumors are discussed and a few examples are presented. PMID- 2774875 TI - The Minns meniscal knee prosthesis: biomechanical aspects of the surgical procedure and a review of the first 165 cases. AB - The Minns knee prosthesis has been designed so that the ligaments, soft tissues and musculature about the knee can return to their full functioning during the movement and loading that occur in usage. By utilising a third component made of polyethylene that slides back and forth in a straight line between the metallic femoral and tibial components, the knee is able to roll and slide at the plastic/metal junctions without creating high forces and loosening moments on the tibial component. The tibial tray has a central cut-out to allow the functioning of both cruciate ligaments, and the femoral component is of the total condylar design. Experimental and theoretical studies on the functioning and clinical performance of this design and the biomechanical implications of the technique of surgical implantation are described. The results of the first 165 cases, followed up for a maximum of 5 years, were ranked according to pain, mobility, and restoration of function; 75% were rated as excellent, both subjectively and objectively, 13% as good, and 9% as fair. The average range of motion measured at least 6 months postoperatively was 103 degrees. Eight knees dislocated laterally because of instability and were successfully revised using the sliding plateau without being necessary to remove the metallic components. Minimal wear has been seen on the removed menisci up to 4.5 years' use. PMID- 2774874 TI - Importance of the iliopsoas muscle in soft-tissue surgery of hip deformities in cerebral palsy children. AB - Twenty cerebral palsy patients who had undergone soft-tissue surgery at the hip (adductor tenotomy, medial lengthening of the hamstrings) were compared with a matched group of another 20 patients with a similar age range and findings and with additionally performed iliopsoas release, 2 or more years after surgery. Extension deficits of the hip did not improve with the addition of iliopsoas release. Internal rotation deformities showed equal improvement in both groups; the influence of the iliopsoas procedure was not significant. Adduction deformities, as documented on roentgenograms of the hip, showed significant improvement, however. Postural anomalies were not essentially influenced by iliopsoas release. Hip dislocations and subluxations, as assessed by the CE angles, were positively influenced by additional iliopsoas release; however, more effective improvement was obtained with ischiocrural elongation. PMID- 2774876 TI - Surgical repair of rabbit tibia osteotomy using isobutyl-2-cyanoacrylate. AB - Isobutyl-2-cyanoacrylate was employed in the surgical repair of the osteotomized rabbit tibia in vivo. Union occurred at 24.3 +/- 3.1 days postoperatively when the adhesive had been used, compared with 35.5 +/- 3.6 days when no intervention was implemented. Healing of the osteotomy was not aided by external fixation or immobilization in either case. The results indicate the feasibility of using isobutyl-2-cyanoacrylate in the repair of load-bearing bones. PMID- 2774877 TI - The difficult healing of segmental fractures of the tibial shaft. AB - Segmental fractures of the tibial shaft are always caused by a high-energy direct trauma. They are frequently associated with important soft tissue injuries, and the vascularization of the intermediate bone fragment is severely disturbed. The postoperative problems of 40 patients with 41 segmental tibial shaft fractures were reviewed. Twenty-three fractures (56.1%) were treated with a plate osteosynthesis, 18 (43.9%) with an external fixator. Thirty-seven fractures could be followed-up until bony consolidation. Bone-healing problems were seen in 29%, always in the distal fracture. A good functional result could be obtained in 78.4%. The problems of each stabilization method are discussed. The vascularization of the intermediate segment may not be endangered secondarily by the stabilization procedure. PMID- 2774878 TI - Decompression of the posterior interosseous nerve for tennis elbow. AB - Decompression of the posterior interosseous nerve (PIN) was performed in 111 cases of tennis elbow. After a median follow-up time of 5 years, 85% showed improvement and 30% were almost completely relieved of their symptoms, the latter figure being considered to represent the real frequency of PIN entrapment. It thus seems that the PIN is one etiological factor in tennis elbow, but it cannot be distinguished from other causative factors by currently available methods. The confounding factor of PIN decompression being effective in cases of tennis elbow of other origins is discussed. PMID- 2774879 TI - Reconstruction of the four major ligaments in an unstable knee joint after dislocation by solvent-preserved human fascia lata transplantation. A case report. AB - Once the opportunity for primary repair of injured knee ligaments after traumatic dislocation has been lost, ligamentous reconstruction is difficult using only autogenic tissues because of the risk of loss of function at the donor site, so other substitutes are needed. The four major ligaments in the unstable knee of a 35-year-old man were reconstructed by solvent-preserved human fascia lata three months after traumatic open dislocation. The clinical results were satisfactory. Arthroscopic examination one year later showed that the reconstructed ligaments had good thickness and tension and were composed of autologous connective tissue without evidence of rejection. The literature on dislocation of the knee and on cruciate ligament reconstruction by allograft was reviewed, and a brief introduction to solvent-preserved human fascia lata was presented. The commercialization of this material has solved some common problems concerned with using allogenic tissues. PMID- 2774880 TI - Arthroscopy and synovial hemangioma or giant cell tumour of the knee. AB - A synovial hemangioma was localized in two knees and a xanthomatous giant cell tumour in one knee by arthroscopy. It is concluded, that synovial hemangiomas will be discovered earlier and more frequently by arthroscopy. Intraarticular hemangiomas may be operated at once, but in case of hemangiomas of intermediate type an angiography is recommended. PMID- 2774881 TI - Synovial venous hemangioma of the knee joint. AB - Hemangiomas rarely involve joints and less than 100 synovial hemangiomas have been reported. A case of a localised, intermediate type of venous angioma in the knee-joint causing severe knee pain is reported here, and the characteristic features are discussed. Arthroscopy is suggested as a valuable diagnostic procedure in finding and examining such tumors. PMID- 2774882 TI - Two-stage therapy in the treatment of sacral tumors. AB - Sacral tumors are rare and may be clinically overlooked for a long period, because the symptoms and signs are often mild and non-specific. This led to frequent errors in clinical diagnosis and a long delay between the onset of symptoms and treatment. On presentation the lesions frequently expanded the anterior cortex, however, in most patients the periosteum of the sacrum and the presacral fascia form an unbroken barrier for a tumor. The pelvic viscera are not infiltrated by the tumor until late. Wide excision is difficult and often causes urogenital and/or anorectal dysfunction, but preserving the sacral nerve roots often leads to local recurrence. Surgical wide excision with a combined anterior posterior approach is considered the treatment of choice for large lesions with significant anterior intrapelvic extension. This paper reports data resulting from the treatment of five large sacral tumors with comments on the results. PMID- 2774883 TI - Across-elbow ulnar nerve sensory conduction technique. AB - Compression of the ulnar nerve across the elbow is one of the most common of the entrapment syndromes. The usual method of electrodiagnostic evaluation is to determine the motor nerve conduction for this nerve segment. Normal values for sensory conduction and amplitude changes for this nerve segment have been rarely reported, and clinical usefulness of the sensory techniques remains unclear and controversial. This study reports an ulnar nerve sensory technique for the across elbow segment. Normal data with the elbow flexed to 90 degrees and for a 10-cm nerve segment were 1.8msec, mean +2SD for sensory latency measured to onset and 1.9msec to peak. Comparable motor latency was 2.0msec. Sensory amplitude decrement across the elbow was 41% mean +2SD and 7.6% for the comparable motor amplitude decrement. Three cases of ulnar nerve compression at the elbow are reported, exemplifying that this technique appears to be useful particularly in patients with sensory, as opposed to mixed (sensory and motor), clinical abnormalities. PMID- 2774884 TI - Topical anesthetics: effects on the Achilles tendon and H-reflexes. II. Stroke patients. AB - This study determined whether the Achilles tendon reflex, H-reflex, and ankle range of motion (ROM) during ambulation undergo significant changes after application of benzocaine spray applied to the triceps surae skin area of eight stroke patients displaying spasticity in ankle plantar flexor muscles. The H reflex amplitude increased significantly (p less than 0.05) at 30 minutes after both the benzocaine (0.346 +/- 0.101V) and the placebo (air spray, 0.324 +/- 0.078V) when the placebo was given first; however, there was no significant difference between the two interventions. A significant decrease in ankle ROM occurred during midswing at 20 (placebo administered first) and 30 (benzocaine administered first) minutes after the placebo, but this decrease was not significantly greater than the change after the benzocaine. Benzocaine spray did not change motor neuron excitability level or improve the subject's ability to perform a functional task. PMID- 2774885 TI - Effects of posture on upper and lower limb peripheral resistance following submaximal cycling. AB - The purpose of this study was to determine postural effects on upper and lower limb peripheral resistance (PR) after submaximal exercise. Twelve subjects (six men and six women) completed submaximal cycle ergometer tests (60% age-predicted maximum heart rate) in the supine and upright seated positions. Each test included 20 minutes of rest, 20 minutes of cycling, and 15 minutes of recovery. Stroke volume and heart rate were determined by impedance cardiography, and blood pressure was measured by auscultation during rest, immediately after exercise, and at minutes 1-5, 7.5, 10, 12.5, and 15 of recovery. Peripheral resistance was calculated from values of mean arterial pressure and cardiac output. No significant (p less than 0.05) postural differences in PR were noted during rest for either limb. Immediately after exercise, PR decreased (55% to 61%) from resting levels in both limbs, independent of posture. Recovery ankle PR values were significantly different between postures. Upright ankle PR returned to 92% of the resting level within four minutes of recovery, compared to 76% of the resting level after 15 minutes in the supine posture. Peripheral resistance values in the supine and upright arm were not affected by posture and demonstrated a gradual pattern of recovery similar to the supine ankle recovery response (85% to 88% of rest within 15 minutes). The accelerated recovery rate of PR after upright exercise may result from local vasoconstriction mediated by a central regulatory response to stimulation from gravitational pressure on lower body circulation. PMID- 2774886 TI - Static and dynamic forward stability of occupied wheelchairs: influence of elevated footrests and forward stabilizers. AB - With 20 able-bodied subjects, three hypotheses were tested: (1) that elevating the footrests reduces the forward stability of occupied wheelchairs, (2) that placing simulated plaster casts on the occupant's legs further reduces stability, and (3) that forward stabilizers limit the extent of dynamic forward instability. Static stability was studied on a tilting platform; dynamic stability was tested by having subjects descend a ramp. Elevating one or both footrests and adding one or two simulated casts each significantly reduced static forward stability. During dynamic testing with lowered footrests, only seven subjects tipped forward, and the extent of tip was limited by the footrests. With both footrests elevated, eight subjects tipped transiently, and 12 continued to tip until the footrests hit the floor. With the addition of simulated casts, all 20 subjects tipped fully. Elevating one footrest (with or without a cast) caused only transient tips. On a high-friction floor surface, 19 and 18 subjects (with and without casts) experienced full tips or yawing falls to the side of the elevated footrest. The addition of forward stabilizers prevented wheelchairs from full tips or falls, when the users had both legs elevated, or when one of the users' legs (p less than 0.005), was elevated while located on a high friction floor (p less than 0.005). These findings have implications for wheelchair design and prescription. PMID- 2774887 TI - Cardiovascular responses and anaerobic threshold for bicycle and arm ergometer exercise. AB - Cardiovascular responses occurring at the anaerobic threshold (AT) were compared during intermittent bicycle and arm ergometry in eight healthy college students. Arm and bicycle tests used time-matched, discontinuous protocols (three-minute work stages alternated with three-minute rest intervals). Anaerobic threshold was determined by plotting expired minute volume (Ve) on oxygen consumption (VO2) and expressed as the percentage of the respective peak VO2 at which the deflection occurred. Analysis of variance revealed AT was similar for arm and bicycle tests. Absolute VO2 at AT was higher for bicycle than for arm ergometer exercise (p less than .05). Heart rate (HR) and rate pressure product (RPP) were higher for bicycle than for arm ergometry at AT (p less than .05). Moreover, a similarity in percent maximum RPP and percent maximum VO2 was observed at AT for arm ergometry, whereas percent maximum RPP was higher than percent maximum VO2 at AT for bicycle ergometry. Because AT has been suggested as an appropriate intensity of exercise for conditioning, it was concluded that a sufficient level of exercise intensity can be elicited at a lower percentage of the cardiovascular reserve for arm than for bicycle ergometer exercise. PMID- 2774888 TI - Normal range of motion of the cervical spine. AB - To evaluate the normal range of motion of the cervical spine, 70 healthy subjects were studied using radiography and clinical examination. An equal number of men and women were studied; age ranged from 12 to 79 years. Radiographs were taken in the lateral projection during maximal flexion and extension. In the frontal projection, radiographs were taken during maximal bending to the left and right. The radiographs were analyzed on a digitizing tablet linked to a computer, using preset points to indicate the motion between the vertebrae. The intraobserver error of measurement was +/- 1.8 degrees. The range of axial rotation was measured with the aid of a compass placed on the subject's head. The intraobserver error of measurement with this technique was +/- 6 degrees. The largest intersegmental flexion-extension motion occurred between C4/C5 and C5/C6. A linear decrease of motion in all directions, except in flexion, was found with age. There was no statistically significant difference in motion for men and women. The reliability of methods is discussed. PMID- 2774890 TI - Above-knee amputation with insidious pulmonary embolism and hypercoagulability secondary to protein C deficiency. AB - Pulmonary embolus can have insidious onset and unusual etiology. This case report of a 35-year-old woman with hyperthyroidism, atrial fibrillation, and an above knee amputation demonstrates the subtle presentation of pulmonary emboli. On the rehabilitation ward of a tertiary care hospital, the patient developed undulating fever to 39.6C, rapidly worsening peripheral vascular disease, and pulmonary emboli. Eventually, a protein C deficiency was found; institution of appropriate therapy resulted in rapid improvement. This case reminds physiatrists to evaluate thoroughly the cause of pulmonary thrombi. Currently available assays permit rapid elucidation of factor deficiencies in the workup of the hypercoagulable state. PMID- 2774889 TI - Groin and hip pain due to fractures at or near the pubic symphysis. AB - Three patients with fractures at or near the pubic symphysis presented with groin pain simulating hip fracture or arthritis. A 71-year-old osteoarthritic woman was treated with a nonsteroidal antiinflammatory drug (NSAID) and exercises for right sided sciatic pain after a minor fall, but developed left groin pain and tenderness over the pubic symphysis after two days of exercise. She had an impacted fracture of the left pubic symphysis which responded to use of a cane. The second patient was a 90-year-old woman with rheumatoid arthritis (on steroids) who complained of right hip pain after a series of falls in her home. Initially treated with Buck traction for a presumed hip fracture, she was later treated with heat and exercises after negative hip x-rays were obtained. Retrospective analysis of pelvic films and bone scan revealed a right pubic symphysis fracture. The third patient was an 83-year-old rheumatoid arthritic woman with inability to walk secondary to left groin pain. Pubic tomograms revealed disruption of the superior aspect, and bone scan showed increased uptake of the left pubic bone. She was treated with moist heat, rest, and NSAID. Twenty four cases of os pubis fractures without major trauma or symphysis disruption have been reported. All patients had osteoporosis, and six had rheumatoid arthritis. Our three cases are presented to increase awareness of pubic symphysis fractures as a cause for groin pain, especially in patients with osteoporosis and rheumatoid arthritis. PMID- 2774891 TI - A complication of nasogastric tube removal. AB - Numerous complications associated with the use of nasogastric tubes have been reported. The most common of these complications result from their misdirection during insertion. We report a case in which the mercury tip of a nasogastric tube became lodged within the nasal cavity during removal. This required extraction by an otolaryngologist and resulted in a delay of discharge. The spectrum of complications associated with nasogastric tube use and recommendations for safe removal are discussed. PMID- 2774892 TI - Pneumobelt for sleep in the ventilator user: clinical experience. AB - A pneumobelt with a positive pressure respirator was used for sleep for three patients with chronic respiratory insufficiency secondary to syringomyelia, poliomyelitis, and Friedreich's ataxia respectively. This device was found to be effective in improving and maintaining their daily functioning in the community or institute. PMID- 2774893 TI - Synergist erection system in the management of impotence secondary to spinal cord injury. AB - The Synergist erection system is a silicone sheath vacuum device for management of erectile dysfunction. The efficacy of this device was assessed in the spinal cord injured population. All patients were referred through a spinal cord injury center at a major medical facility. Twenty patients with neurogenic impotence, who were injured at least one year previously and who had a regular sexual partner, were evaluated. Erectile function was assessed by neurologic examination, patient and partner questionnaires, and snap-gauge evaluations. Overall, patient and partner assessments of device efficacy and sex life satisfaction with the device were very good to excellent. The device was simple to use and without significant side effects. In our initial experience, the Synergist system was an effective, safe, noninvasive alternative for the management of impotence secondary to cord injury. PMID- 2774894 TI - Training of brain injured. PMID- 2774895 TI - Reexamining factors predicting Afro-American and white American women's age at first coitus. AB - Research identifying factors associated with ethnic differences in first coitus has been limited by methodologies and samples used. This study reexamines ethnic differences in Afro-American and white American women's age of first coitus. Demographic, socialization, and decision-making factors were examined in a series of multiple regression analyses, with the prevalence of women's child sexual abuse incidents, in order to identify variables that best predicted age of first coitus. The subjects were a multiethnic community sample of 248 women, 18 to 36 years of age, residing in Los Angeles County. Their demographic characteristics were comparable on education, marital status, the prevalence of children, and income. The results indicated that women's perceptions of their parents as more influential than peers during adolescence, and being in love and ready for sex were predictors of an older age at first intercourse. Ethnicity was not significantly associated with the strongest predictors or with first coitus. Factors that best predicted first coitus were also similar for both ethnic groups. The findings suggest that in order to examine the role of ethnicity in first coitus, differences in demographic characteristics found between black and white samples need to be controlled. Similarly, multiethnic research should include variables that are relevant to both ethnic groups, as well as abusive sexual experiences, in order to understand the multiplicity of factors predicting age at first intercourse. PMID- 2774896 TI - The relation between sexual activity among children during preadolescence and/or early adolescence and sexual behavior and sexual adjustment in young adulthood. AB - This study examined whether current sexual behavior and sexual adjustment in a sample of 433 college students differed as a function of having engaged in sexual activity with other children during preadolescence (prior to age 13) and/or early adolescence (ages 13-15). Four groups were compared: subjects who only had an early adolescent sexual experience; subjects who had both preadolescent and early adolescent experiences; subjects who had no sexual experience with another child during either preadolescence or early adolescence. There were no significant differences between these groups on measures of incidence of premarital intercourse, age at first intercourse, number of different intercourse partners, sexual satisfaction, sexual arousal, or sexual dysfunctions. It was concluded that in general the simple occurrence or nonoccurrence of sexual activity among children during these developmental periods has little impact, either positive or negative, on later sexual adjustment during young adulthood. Some expections, depending on the specific types of childhood sexual activity involved, were noted. PMID- 2774897 TI - Individual and aggregate level change in sexual behavior among gay men at risk for AIDS. AB - Until an effective vaccine or treatment for AIDS is developed, the rate of spread of the epidemic will be determined primarily by the willingness of infected and at-risk individuals to refrain from behaviors implicated in the spread of the disease. Consequently, public health efforts have focused on educating these populations about the dangers inherent in certain practices. To date, the impact of these educational activities has been most extensively studied with regard to gay and bisexual men. Researchers, however, seem not always to appreciate the necessity to examine change at two levels of analysis--the individual and the aggregate because it is possible to draw different but valid conclusions about the nature of change, depending upon the level of analysis used. A series of models for examining individual and aggregate level change are described. These models are then used to examine whether there is evidence of change over a 6 month period in the sexual behavior of a sample of gay men from New York City. The data reveal evidence of a significant trend in the direction of safer sexual behavior at both the individual and aggregate level. PMID- 2774898 TI - Sexual behavior after head injury in Indian men and women. AB - Disorders in sexual function constitute one of the most prevalent and least discussed problems following head injury. The disorders are often the outcome of an interaction between the neurological sequelae, the psychological makeup of the individual, and the sociocultural context of the couple. In a study of 34 head injured patients, only 13 reached their premorbid level of sexual functioning over a period of 1 year. Deviant behavior, total loss of sexual function, and sexual dysfunction were noted in the rest. Deviant behavior was consistently associated with frontal lobe damage. Otherwise, neurological indices of head injury in the dysfunctional group were not different from those of the clinically recovered group. Associated psychiatric disturbances, gender-role differences, the impact on the marital harmony of the couple, and the role of sociocultural beliefs in the etiology of the disorders are analyzed and discussed, with a particular emphasis on Indian culture. PMID- 2774899 TI - Existence of transsexualism in the military setting. PMID- 2774900 TI - Fragmentation in general surgery. The case of head and neck surgery. PMID- 2774901 TI - Rhabdomyosarcoma: contemporary status and future directions. The Lucy Wortham James Clinical Research Award. AB - Approximately two thirds of children with rhabdomyosarcoma will be cured of their tumor and become long-term survivors. Multidisciplinary care has brought about improvements in survival. Yet our therapies of today are suboptimal in many situations and demand intense effort toward improving cure rates and quality of life. Rhabdomyosarcoma is a complex childhood malignancy with differing anatomic sites of presentation and varying histologic subtypes, each presenting with unique patterns of growth, making it inappropriate to consider the disease a single entity. Avenues of future research involve cytogenetic and molecular genetic investigations that will aid in diagnosis and screening and, it is hoped, guide clinicians to more specific therapy. PMID- 2774902 TI - Surgical treatment of recurrent colorectal cancer. Five-year follow-up. AB - Analysis of 81 consecutive patients with recurrent colorectal cancer was undertaken to evaluate the rationale and efficacy of surgical re-treatment. The disease-free interval after primary surgery and the diagnostic delay did not clearly differ between the modes of recurrences. Symptoms preceded the diagnosis of recurrence in 73% (59) of the cases, with pain being the most frequent symptom (n = 22). Of the patients, 58% (47) underwent reoperations, 38% (31) underwent reresections, and 10% (8) underwent radical resections. The overall postoperative mortality was 13%, and the postoperative morbidity was 45%. The postoperative relief of cancer symptoms after resective surgery was 8 months and, after nonresective surgery, 2 months. The median survival was 24 months for patients who underwent resections, 8 months for patients who were treated by nonresective surgery, and 15 months for patients who were treated conservatively. Radical resection clearly prolonged survival when compared with palliative resections and nonresective procedures. On the basis of these results, it was concluded that resective surgery, when possible, can improve survival and patient comfort after recurrence of colorectal cancer. PMID- 2774903 TI - Preoperative screening for HIV infection. A balanced view for the practicing surgeon. AB - Routine preoperative screening for human immunodeficiency virus (HIV) infection is becoming increasingly prevalent. Reasons in favor of routine screening include the following: (1) Knowledge of HIV status may allow the surgeon to decrease risk of infection. (2) The patient may benefit, because HIV infection may alter the risk-benefit ratio of a procedure. (3) Knowledge of HIV status will not affect how the patient is treated. Arguments against routine screening include the following: (1) Since the risk during individual procedures is low, it is unlikely that knowledge of HIV status can actually reduce risk. (2) Patient care may be negatively affected. (3) There is a possibility of false-positive results. (4) The accepted ethical standards of autonomy, confidentiality, and informed consent are not always adhered to. We explore these issues in detail. Recent work has framed the risk of surgeons and defined the reliability of diagnostic screening tests. All of these factors must be weighed before a surgeon can decide for or against a policy of routine preoperative screening. PMID- 2774904 TI - Selective vs routine use of intraoperative cholangiography. An argument. AB - We reviewed the course of 314 patients who underwent cholecystectomy at a University Hospital in 1985. Two hundred eighty-five patients underwent cholecystectomy for cholelithiasis. Preoperatively elevated liver function test results, history of jaundice or pancreatitis, or operative findings of palpable common bile duct stone or dilated extrahepatic ducts were criteria for indicated cholangiography. Of 142 patients who had cholangiography with negative results, only 31 were indicated by these criteria. In 93 patients not having cholangiography performed, the criteria were met in only 8 patients. Of 38 patients who underwent common bile duct exploration, only 29 had stones. As operative time, morbidity, and cost were demonstrably increased in patients undergoing cholangiography, a selective approach is advocated. The number of unnecessary common bile duct explorations might be cut by almost half, while the incidence of finding clinically unsuspected yet significant common bile duct stones is negligible. PMID- 2774905 TI - Evaluation of right hemicolectomy for unexpected cecal mass. AB - Ileocecal mass is occasionally encountered unexpectedly by surgeons operating for presumed appendicitis. A five-year retrospective study was performed to review the management of this problem. Thirteen patients were identified who had had right hemicolectomy performed for unexpected mass in which neoplasm, diverticular disease, or inflammatory bowel disease could not be differentiated from severe appendicitis at laparotomy. Seven patients (group 1) had a final pathologic diagnosis of appendiceal phlegmon. The other patients (group 2) had Crohn's disease, typhlitis, or neoplasm. Right hemicolectomy was performed with a morbidity of 7% and mortality of 7% in all patients. This procedure is acceptable for unexpected cecal mass. PMID- 2774906 TI - Thyroid cancer with coexistent Hashimoto's thyroiditis. Clinical assessment and management. AB - Hashimoto's thyroiditis is a common thyroid disorder. Because of the difficulty of diagnosing a coexisting thyroid cancer, its management remains controversial. We reviewed 120 cases of thyroid cancer seen in our institution during an 11-year period (1976 through 1986) and defined the clinical characteristics of patients with both entities. Thirteen patients had concomitant cancer and Hashimoto's thyroiditis. Six of the 13 patients had a history of thyroiditis before the diagnosis of thyroid cancer. The remaining seven patients had evidence of Hashimoto's thyroiditis on histologic review of the thyroid specimen. The two most common characteristics prompting surgical intervention were the presence of a nonsuppressing dominant nodule and a cold area on thyroid scan. Twelve patients underwent preoperative fine-needle aspiration cytologic examination, but only in three were the results considered to be indicative of cancer. All 13 patients remained disease free. Despite the apparent indolence of thyroid cancer associated with Hashimoto's thyroiditis, selective surgical treatment of patients with clinical thyroiditis is indicated. PMID- 2774907 TI - Patterns of relapse in 1001 consecutive patients with melanoma nodal metastases. AB - The impact of nodal tumor burden on patterns of relapse and survival was retrospectively analyzed in 1001 patients with stage III melanoma. The incidence of tumor recurrence within the node dissection field was lower in patients with 1 nodal metastasis (9%) or with no extranodal invasion (15%) than in patients with multiple involved nodes (15% to 33%) or connective tissue invasion (28%). Patients with 1 "positive" node (a node in which cancer was detected) had a 45% 5 year and 39% 10-year survival rate compared with patients who had 2 to 4 positive nodes (37% and 28%), 5 to 10 nodes (20% and 17%), more than 10 nodes (5% and 3%), or extranodal invasion (14% and 11%). The occurrence of in-transit metastases in 10% of patients after nodal dissection was not influenced by the extent of nodal tumor burden. PMID- 2774908 TI - Prognostic factors in gastric cancer with serosal invasion. Univariate and multivariate analyses. AB - Univariate and multivariate analyses of possible prognostic factors were carried out on data from 142 patients who had undergone curative resection for a carcinoma of the stomach invading beyond the muscularis propria. In the univariate analysis, factors including age, size of cancer, gross form, depth of penetration, lymph node metastasis, lymphatic invasion, width of serosal invasion, mode of invasion, volumetric shape of invasion, and stage had an individual prognostic significance. The multivariate analyses indicated that stage, lymph node metastasis, and depth of penetration were the most significant prognostic factors and that the prognosis in cases of obvious serosal invasion, or those with secondary or tertiary nodal involvement, was poor. For such patients, we prescribe postoperative intensive chemotherapy, even when a "curative" operation is done. PMID- 2774909 TI - Median sternotomy for implantable cardioverter/defibrillator. AB - The automatic implantable cardioverter/defibrillator is an accepted mode of therapy for medically refractory sustained ventricular tachycardia or fibrillation. At the Loyola University Medical Center, Maywood, Ill, 39 implantations were performed in a 14-month period. The method of implantation was the median sternotomy. Our population included 9 patients in whom sternotomies had to be redone and 17 patients with concomitant revascularization. Two patients died due to pump failure, and one major complication (infection) occurred that was directly related to the automatic implantable cardioverter/defibrillator. The median sternotomy, because of good results, continues to be our method of choice for insertion of the automatic implantable cardioverter/defibrillator. PMID- 2774910 TI - Cardiopulmonary effects of pressure support ventilation. AB - Pressure support ventilation (PSV) is a newer mode of ventilatory support that augments the patient's spontaneous inspirations to a preselected peak inspiratory pressure. We studied the effects of adding low levels of PSV (5 to 10 cm H2O) in conjunction with intermittent mandatory ventilation (IMV) on 15 patients who required mechanical ventilation for flail chest and pulmonary contusion. Patients were selected for the study if, during weaning from IMV, the following criteria were met: (1) a PaCO2 level greater than 45 mm Hg, (2) a spontaneous respiratory rate (RR) greater than 30 breaths per minute, (3) a minute ventilation (VE) greater than 9.0 L/min, and (4) spontaneous tidal volumes (VT) of less than 2 mL/kg. The PSV was added to the IMV at a level that augmented spontaneous VT to greater than 4 mL/kg. An average of 9 +/- 3 cm H2O of pressure support resulted in a fall in the level of PaCO2 (50 +/- 4 to 43 +/- 5 mm Hg), spontaneous RR (36 +/- 5 to 16 +/- 3 breaths per minute), VE (12 +/- 2 to 8.4 +/- 1.5 L/min), and dead space-tidal volume ratio from (0.68 +/- 0.1 to 0.47 +/- 0.05). Mean airway pressure and PaO2 both increased, but these changes were not statistically significant. Oxygen consumption was also unchanged. These results suggest that in patients who are difficult to wean due to respiratory muscle fatigue (characterized by increasing RR and decreasing VT), PSV normalizes lung volumes, improves ventilation, and may expedite the weaning process. PMID- 2774911 TI - The use of arm veins for infrainguinal bypass in end-stage peripheral vascular disease. AB - Thirty-six infrainguinal bypass grafts were performed in 33 patients with the use of autologous arm vein. Indications for operation were ischemic rest pain or tissue loss in all patients. The average age of the patients was 70.0 years-27% were diabetic and 66% were smokers. Sixty-five percent of the grafts were performed as secondary reconstructions. Follow-up ranged from three weeks to six years, with a mean of 12.1 months. Life-table primary and secondary patencies for all grafts are 73% and 82% at one year, respectively. Simple (noncomposite) arm vein grafts had primary and secondary patencies of 75% and 85%, respectively. The limb salvage rate was 86%. No grafts required thrombectomy for early occlusion (less than 30 days), and no graft failures have occurred beyond nine months (n = 18). Arm vein bypass grafts demonstrate excellent patency rates and provide the preferred conduit in the absence of autologous saphenous vein. PMID- 2774912 TI - Perforation complicating rifampin-associated pseudomembranous enteritis. AB - An 18-year-old man developed a perforated jejunum while receiving rifampin antituberculous chemotherapy. The perforations were located within longitudinal ulcers characteristic of pseudomembranous enterocolitis. Pseudomembranous inflammation was limited to the small intestine. The absence of colonic involvement delayed establishment of the diagnosis. Successful surgical intervention consisting of small-bowel resection with primary anastomosis was accomplished for this rare and potentially fatal complication of antituberculous chemotherapy. PMID- 2774913 TI - The rudimentary first rib. A cause of thoracic outlet syndrome with arterial compromise. AB - The symptoms of thoracic outlet syndrome are neurologic, not vascular, in more than 95% of cases. Subclavian artery compression is usually related to cervical ribs; however, congenitally abnormal first ribs may also produce vascular compromise. We review our two cases of thoracic outlet syndrome associated with significant subclavian artery compression caused by rudimentary first ribs and the prior literature emphasizing the mechanism of injury, diagnostic features, and treatment. Transaxillary resection of the first and second ribs was curative in both cases. The operative specimens demonstrated fusion of the rudimentary first rib to the second rib, with compression of the subclavian artery by a large first-rib exostosis. Patients with thoracic outlet syndrome and a rudimentary first rib should be examined for substantial vascular compromise, and, if it is found, the abnormal first and second rib complex should be resected early without prolonged conservative measures. PMID- 2774914 TI - Biological monitoring of exposure and the response at the subcellular level to toxic substances. Proceedings of the European Society of Toxicology. Munich, September 4-7, 1988. PMID- 2774916 TI - A sensitive method for the determination of urinary mercapturic acids for use in biological monitoring. PMID- 2774915 TI - 32P-postlabelling of DNA adducts in white blood cells of foundry workers. PMID- 2774917 TI - Biological monitoring of exposure to ethylene glycol ethers. PMID- 2774918 TI - The significance of urinary thioethers as indicators of exposure to alkylating agents. PMID- 2774920 TI - Application of flame atom trapping and column preconcentration techniques to the measurement of cadmium in urine. PMID- 2774919 TI - Ethylenethiourea as an indicator of exposure to ethylenebisdithiocarbamate fungicides. PMID- 2774921 TI - Different affinity of erythrocyte glutathione-S-transferase to methyl chloride in humans. PMID- 2774922 TI - The combinations of inducers of the coumarin hydroxylase-locus help investigate their mode of action. PMID- 2774923 TI - Gene structure and regulation of cytochrome P-450. PMID- 2774924 TI - Expression of P-450 enzyme activities in heterologous cells by transfection. PMID- 2774925 TI - Thymus atrophy and immunosuppression induced by organotin compounds. PMID- 2774927 TI - Effects of ammonia caramel and tetrahydroxybutylimidazole on the immune system of rats. PMID- 2774926 TI - An immunohistochemical study of dibutyltin-induced thymus atrophy. PMID- 2774928 TI - Comparative study on the toxicity of acetaminophen and mercuric chloride in normal and athymic mice and rats. PMID- 2774929 TI - Significance of serum ferritin concentrations in lung cancer and it's relation with cellular immunity. PMID- 2774930 TI - Metabolic activation of diethylstilbestrol and 7,8-benzoflavone in hamster hepatocytes. PMID- 2774932 TI - Determination of 7-(2-oxoethyl)guanine and N2,3-ethenoguanine in DNA hydrolysates by HPLC. PMID- 2774931 TI - Hypomethylation of c-myc proto-oncogene of N-nitrosomorpholine--induced rat liver nodules and of H4IIE cells. PMID- 2774933 TI - The DNA-adducts of the food mutagen and carcinogen IQ (2-amino-3-methylimidazo [4,5-f]quinoline). PMID- 2774934 TI - The role of extrahepatic organs in the first pass metabolism of N nitrosodibutylamine. PMID- 2774935 TI - Modulation of 17 alpha-ethinylestradiol and 7,8-benzoflavone metabolism in hamster liver microsomes is possibly related to hepatotumorigenesis. PMID- 2774936 TI - Metabolism and endogenous production of ethylene in rat and man. PMID- 2774937 TI - Pharmacokinetics of propylene and its reactive metabolite propylene oxide in Sprague-Dawley rats. PMID- 2774938 TI - Detection of DNA-protein crosslinks in the kidney of male B6C3F1 mice after exposure to methyl chloride. PMID- 2774939 TI - Species differences in DNA damage by butadiene: role of diepoxybutane. PMID- 2774940 TI - Determination of 7-(2-hydroxyethyl)guanine with gas chromatography/mass spectrometry as a parameter for genotoxicity of ethylene oxide. PMID- 2774941 TI - The relationships between alkylation of haemoglobin and DNA in Fischer 344 rats exposed to [14C]ethylene oxide. PMID- 2774943 TI - A simple statistical procedure for testing tumour rates in animal carcinogenicity experiments. PMID- 2774942 TI - Cisplatin binding to plasma proteins and hemoglobin in cancer patients. PMID- 2774944 TI - Prevention of liver cell damage following lipid peroxidation by depression of lysophosphatide formation. PMID- 2774945 TI - Spontaneous and xenobiotic-induced in vivo-lipid peroxidation in iron-overloaded rats. PMID- 2774946 TI - Thioether formation--activation or detoxication? PMID- 2774948 TI - Selective induction of the coumarin hydroxylase by N-containing heteroaromatic compounds. PMID- 2774947 TI - N-demethylation reactions in intact erythrocytes and erythrocyte supernatant. PMID- 2774949 TI - M-dinitrobenzene: studies on its toxicity to the testicular Sertoli cell. PMID- 2774950 TI - Dichloromethane metabolism to carbon monoxide can be induced by isoniazid, acetone and fasting. PMID- 2774951 TI - Inhibitory effect of cholephilic organic acids on hepatobiliary transport and mitochondrial respiration. PMID- 2774952 TI - Biochemical investigation of atractylis gummifera L. hepatotoxicyty in the rat. PMID- 2774953 TI - Protective effect of zinc against hepatotoxic agents in the rat liver slice system: role of metallothionein. PMID- 2774955 TI - Study of glutathione and glutathione related enzymes in acetaminophen-poisoned mice. Prevention by anethole trithione pretreatment. PMID- 2774954 TI - Differences in liver sensitivity to methyl carbamate between Wistar and Fischer 344 rats. PMID- 2774956 TI - Depletion of hepatic glutathione in rats impairs phagocytosis in vivo. PMID- 2774957 TI - Pharmacokinetics and hepatotoxicity of 2-nitropropane in rats. PMID- 2774958 TI - Effect of arsenicals on biliary excretion of endogenous non-protein thiols, mercurials and sulfobromophthalein. PMID- 2774959 TI - Renal ultrastructural alterations and cardiovascular functional changes in rats exposed to mercuric chloride. PMID- 2774960 TI - Different effects of intraperitoneally and orally administered palladium chloride on the hepatic monooxygenase system of male mice. PMID- 2774961 TI - Effect of arsenic on cellular metabolism after single or repeated injection in guinea pigs. PMID- 2774962 TI - Influence of triethylenetetramine and D-penicillamine on zinc metabolism in mice. PMID- 2774963 TI - Behavioural and neurochemical changes produced by lefetamine in two inbred strains of mice. PMID- 2774964 TI - Effects of carbamates upon various behavioural parameters in mice. PMID- 2774965 TI - The effect of gentamicin on the cockroach nerve cord. PMID- 2774967 TI - Enchytraeus albidus (Enchytraeidae, Oligochaeta) as a test organism in terrestrial laboratory systems. PMID- 2774966 TI - Soil pollution by atrazine: research on an experimental model. PMID- 2774968 TI - Effect of netilmicin and amikacin on urinary phospholipids excretion in humans. PMID- 2774969 TI - Depletion of cytochrome P-450 and alterations in activities of drug metabolizing enzymes by S-(1,2-dichlorovinyl)-L-cysteine in mouse kidney cortex. PMID- 2774970 TI - Purification and some properties of bolesatine, a protein inhibiting in vitro protein synthesis, from the mushroom Boletus satanas Lenz (Boletaceae). PMID- 2774971 TI - Eye and skin irritation induced by picolines. PMID- 2774972 TI - Canine gingival hyperplasia induction and recovery. PMID- 2774973 TI - Differing effects of chromium(III) and chromium(VI) on nucleotides and DNA. PMID- 2774974 TI - Protein-carcinogen adducts in human dosimetry. PMID- 2774977 TI - [Role of the monoaminergic system in the transmission of the effect of androgens on neurons of separate limbic structures of the rat brain]. AB - By means of the histochemical method intensity of monoamines fluorescence has been studied in 3-, 5-, 7-, 10-, 20-, 30- and 60-day-old intact and neonatally androgenized female rats. The neonatal androgenization increases fluorescent intensity of monoamines in the neuropil of the adjoining nucleus of the septum, of the nucleus in the terminal stripe bed and the caudate nucleus. This is especially evident on the 3d, 7th and 30th days. On the 5th day of the postnatal life the difference in fluorescent intensity of monoamines in the brain of control and test animals is statistically insignificant. Possible mechanisms responsible for the fluorescent intensity of monoamines and the role of the latter in transmitting the sex hormones effect to the neurons of the forebrain structures investigated are discussed. PMID- 2774975 TI - Intracellular synthesis and processing of the structural glycoproteins of turkey enteric coronavirus. AB - Pulse labeling of cells with [35S]methionine or [3H]glucosamine at different times after infection, followed by SDS-PAGE and Western immunoblotting analysis using rabbit anti-TCV hyperimmune serum, was used to resolve and identify TCV induced intracellular proteins. The viral structural proteins (gp 200, gp 140/gp 66, gp 100/gp 120, p 52, and gp 24/p 20) were detected in radiolabeled cell extracts by 9 to 12 hours post-infection, as well as two possible non-structural proteins with apparent mol.wts. of 36,000 and 32,000. The predominant 52,000 nucleocapsid protein could be detected in cell lysates as soon as 6 to 8 hours after infection; it was initially resolved as a complex of 3 closely migrating species with mol.wts. ranging from 46,000 to 52,000. Pulse-chase and immunoprecipitation experiments indicated that gp 200 arose from a putative precursor with mol.wt. of 150,000 to 170,000, that underwent glycosylation. Proteolytic cleavage of gp 200, in turn, probably yielded the gp 100 and gp 120 species. The unique TCV hemagglutinin protein originated from a primary precursor with mol.wt. of 60,000, which underwent rapid dimerization by disulfide bond formation and glycosylation to yield gp 140. The peplomeric and matrix proteins were both shown to be N-glycosylated, as indicated by their sensitivity to tunicamycin (TM) and their resistance to sodium monensin (SM). In the presence of TM, proteins with mol.wts. of 90,000, 120-130,000, and 150,000 accumulated in TCV infected cells rather than peplomeric glycoproteins, and the matrix protein E1 was only detected in its unglycosylated form. The addition of TM to the culture medium interfered with the maturation of progeny viral particles, as suggested by the absence of peplomers at the surface of the intravacuolar and extracellular virions, and the accumulation of amorphous material not found in the absence of the glycosylation inhibitor. High yields of virus replication were obtained, in the presence of SM, even at concentrations which greatly affected the cellular functions. PMID- 2774976 TI - Evidence that the fusion protein of respiratory syncytial virus exists as a dimer in its native form. Brief report. AB - The quaternary structure of respiratory syncytial virus (RSV) fusion protein has been studied. Crosslinking studies were done to stabilize the noncovalently associated proteins. These stable, heat-resistant, covalently linked complexes were analyzed by sodium dodecyl sulfate-polyacrylamide electrophoresis. In situ crosslinking studies demonstrated that the fusion protein of RSV exists as a dimer in its native form on the surface of infected cells. The purified protein was also found to be present predominantly as a dimer. In addition, the results suggest that F1 subunits may play a role in the dimerization of the fusion protein. PMID- 2774978 TI - [Features of glia growth in tissue cultures of the rat cerebrum]. AB - In the tissue culture of the newborn rat cerebrum structural peculiarities of the glial growth have been investigated, using scanning and transmissive microscopy. Glioblasts are the first to migrate into the growth zone from the explant. Formation of the glial network is accompanied with formation of multilayered structures. In the cerebral tissue culture 3 zones are distinguished differing from each other by their morphofunctional peculiarities and behavior of the glial cells: growth zone, intermediate and central ones. The growth zone is characterized with permanent moving and modification of glial cells, participating in formation of cellular cords, networks and layers. Glioblasts are predominate cells in this zone. The intermediate zone consists of multilayered glial elements, possessing a high proliferative activity. The central zone, where neuropil and neurons consisting of numerous processes are situated, is characterized with a high degree of differentiation of glial elements. The central part of the explants is covered with epitheliomorphic layer of glial cells, predominantly consisting of cytoplasmic and fibrous astrocytes. The data presented demonstrate that differentiation of glial elements into various types occurs in the cerebral cultures exclusively in the area of the neural cells localization and, possibly, under their immediate influence. PMID- 2774979 TI - [Form of the skull base and its relation with the form of the fornix]. AB - Using the material of 222 skulls from the craniological collection, correlative connections between dimensions and form of the skull base and fornix have been investigated. In accordance with the value of the wide-long parameter of the base, three forms of the skull are determined: dolichobasilar, mesobasilar and brachibasilar. PMID- 2774981 TI - [Extra- and intraorganic blood channel of the rabbit lumbar vertebrae in health and after cutting the segmentary arteries and veins]. AB - Extra- and intraorganic blood bed of the lumbar vertebrae has been investigated by means of the cast method and vital injection of the vessels with Indian ink gelatin mixture and subsequent serial translucent preparations. Existence of constant topographo-anatomical relations has been stated between the segmentary arteries and veins with the lumbar vertebrae. Peculiarities in spatial organization of the microcirculatory bed have been revealed in different zones of the vertebral body, as well as peculiarity of blood supply of the epiphyseal osseous marginal plate. Topography and localization of changes in the intraorganic vertebral blood bed have been studied under conditions of bilateral crossing of the segmentary vascular fasciculi at the level of one, two and three vertebrae. Compensatory resources of the vertebral column blood bed are discussed, when large extra-organic trunks in the lumbar part are damaged. PMID- 2774980 TI - [Configuration of the cervical part of the spinal column in various age periods]. AB - In order to estimate pathological deformities of the spinal column, it is necessary to know its normal configuration during various age periods. For this 240 men and women in age groups from 15 up to 60 years and older, having not any complaints, have been investigated. Each patient is subjected to a standard x-ray examination of the cervical part of the spinal column in 2 projections with a subsequent roentgenography In the roentgenograms (lateral projection) angles between ventral bodies CII and CVII are measured, as well as angles in every segment. Indices of the cervical lordosis for every age group in men and women are estimated. The form of the cervical part of the spinal cord in men and women is not equal and changes in different age periods. During the middle age lordosis decreases both in men and women and again increases in the elderly age. PMID- 2774982 TI - [Hemomicrocirculatory bed in the rabbit small intestine wall during ontogenesis]. AB - Hemomicrocirculatory bed has been studied in fragments of the small intestine wall, obtained from 30 rabbits of various age. During ontogenesis the number and caliber of all components of the hemomicrocirculatory bed increase, as well as density of the capillary network in connection with formation and growth of the small intestine membranes. At the age of two or three years involutive changes are observed in the blood bed of this organ. PMID- 2774983 TI - [Changes in the myocardium damaged by strophanthin]. AB - The mechanism of intoxication, produced with strophanthin (10 mg/kg) has been studied in myocardium of white rats. Area, perimeter and factor of form in mitochondria, ratio of the mitochondrial surface area with injured external membranes to the whole mitochondrial area, agranular sarcoplasmic network and T system area, changes in myofilaments, Z-lines, length of sarcomeres have been estimated. Changes in succinate dehydrogenase, lactate dehydrogenase and in reduced forms of nicotinamide coenzymes activity has been investigated histochemically. Adenosine triphosphate (ATP) prevents appearance of ultrastructural and histochemical disturbances, produced with strophanthin. However, the protective effect of ATP is not sufficient. Adenosine monophosphate, penetrating across the cell membrane, is supposed to produce a greater curative effect. PMID- 2774984 TI - [Staged quality of the transformation of the autonomic nervous system in ontogenesis]. AB - As a result of neurohistochemical and electron microscopic investigations of the autonomic nervous system (ANS) in ontogenesis of the human being and mammalia the premediatory period of its development can be divided into the stage of the nervous crest cells migration into the place of the ganglia anlage and the stage of contact of preganglionic fibers with neural elements. These two stages occur heterochronically. The mediatory period of the ANS development is conditionally divided into five stages. The first is characterized with appearance of mediators in synapses and nervous plexuses in the internal organs. The second--consists in activation of gliocytogenesis and lasts up to 7 months of the human intrauterine life, when the third stage begins--the perinatal maturation of the ANS. In the nervous plexuses myelin fibers appear, perivascular plexuses and structure of the afferent endings become more complex. The fourth stage--completion of the ANS formation--takes place when the child is more than one year of age and it lasts up to sexual maturation. The nervous fibers myelinization is completed, amount of synapses in neurons increases. Then the fifth stage begins--stabilization of the VNS. The postmediatory period takes place not simultaneously in various ganglia of the VNS and has two stages. At first it becomes evident in the sympathetic part of the VNS. Certain morphofunctional manifestations start the stage of the initial exhausion of mediators. In neurons amount of lipofuscin granules grows large, some disturbances in mitochondria and osmiophilic lamellar bodies appear. This stage of the postmediatory period can start early, for example, in the human heart on the fourth decade of life and lasts in the organ up to 60-65 years, when the terminal stage takes place--involutive degeneration of the VNS plexuses. PMID- 2774985 TI - [Changes in the ultrastructure and fibrogenic activity of rat dermal fibroblasts as affected by various doses of hydrocortisone]. AB - By means of electron microscopical morphometry and populational analysis it has been stated that hydrocortisone acetate, injected subcutaneously twice a week in dose 5 mg/kg of the body mass, produces decrease in number of intensively collagen-producing fibroblasts and increase in the part of fibroblasts and destroying cells in population of fibroblasts only in young (2-week-old) animals. The dose 10 mg/kg produces similar changes both in young and in mature (2-month old) animals. In the young animals given hydrocortisone in dose 5 mg/kg of the body mass, the mean summational area and extension of the granular endoplasmic reticulum membranes in the fibroblast section diminishes, the summational area of the mitochondrial section decreases in the section of one cell, and the derm with less thickness, in comparison with the derm of intact animals, is formed, while in mature animals, given hydrocortisone in a small dose, all the parameters mentioned do not significantly differ from the control. Hydrocortisone in dose 20 mg/kg decreases all quantitative parameters of dermal fibroblasts both in young and mature animals. The data of the correlative analysis give evidence on the presence of a strong positive connection between inhibition of the synthetic apparatus of fibroblast development under hydrocortisone effect and decrease of the derm thickness, forming during the postnatal period of ontogenesis. PMID- 2774986 TI - [Changes in tissue basophils of skin and lymphoid organs in total, deep hypothermia]. AB - The experiments have been performed on 60 white female rats with body mass 180 200 g. Under ether anesthesia the animals are cooled up to +18 degrees C of the rectal temperature, and then warmed up to +37 degrees C. Using certain morphometrical methods at staining paraffin slices with toluidine++ blue, tissue basophils (TB) in the dermis++, hypoderma, lymph nodes, thymus and spleen are studied. In response to cooling degranulation increases, some part of TB in all the organs is destroyed, this results in decreasing amount of the cells (except the thymus, where TB amount increases). The greatest pronounced decrease of TB amount occurs in the lymph node. The restorative reaction during the post hypothermic period depends on the initial lesion. There are no TB in the spleen. In different organs TB demonstrate various sensitivity to hypothermia, that is evidently connected with their microenvironment and initial state at the moment of the experiment, as well as with various role of the organs investigated in the defensive-adaptive reactions of the organism. PMID- 2774987 TI - [Compensatory-restorative processes of the thyroid gland in 1- and 3-month-old rats in health and in desympathization]. AB - In 172 white male rats 1- and 3-month-old, using electron microscopical, autoradiographical, morphometrical and radioimmunological methods, analysis of structural-functional changes of the thyroid gland has been carried out both under normal conditions and at guanethidine desympathization (15 mg/kg for 14 days after birth). Resection of 2/3 of the organ has been performed on the 3d, 5th, 7th and 15th days before sacrifice. In the 1-month-old desympathized rats hypofunctional state of the gland is observed. By the 3d month at the expense of an increased production of thyrotropin and calcitonin the thyroid status becomes normal. The dynamics of the restorative processes in the thyroid gland after resection of 1/3 of the organ in the control and test rats occurs with a similar intensity. Proliferative potency of the desympathized thyroid tissue is much higher. PMID- 2774988 TI - [A method of estimating the protein-synthesizing functions of human cardiomyocytes]. PMID- 2774989 TI - [A vacuum method for pouring toxic fluids]. PMID- 2774990 TI - [Round table discussion: One of the effective forms for advanced training of teachers]. PMID- 2774991 TI - [Significance of bacterial shock to thanatogenesis in peritonitis]. AB - Fifty-three section examinations of peritonitis with a history of 1 to 30 days were performed to microscopically study viscera and their microcirculatory bed. They revealed microcirculatory disturbances and their consequences that were characteristic of shock. They were most of all pronounced in the kidneys and lungs. The kidneys showed blood dumping with cortical ischemia, which was accompanied with dystrophic changes in the proximal nephroepithelium or focal acute renal failure (ARF) in half the cases. Seven cases displayed advanced ARF of over 8-10-day history with regeneration in the damaged tubules. There were pulmonary microcirculatory disturbances in 27 cases, 10 of them having clinical signs of the "shock" lung, i.e. dys- and atelectases, alveolar bleedings, hyalin membranes, which might be a cause of acute respiratory failure. PMID- 2774992 TI - [Involvement of the appendix in the inflammatory process in severe nonspecific chronic ulcerative colitis in children]. AB - The authors examined appendix tissues taken from 16 children and adolescents who had undergone colectomy for severe chronic ulcerative colitis. Fourteen patients had the mucosa and submucous layer involved in the chronic inflammatory process that is typical of ulcerative colitis, 5 patients showed inflammation in the muscular and subserous layers. The clinical symptomatology of appendicitis was absent. PMID- 2774993 TI - [Features of the destructive and reparative processes of the liver in various types of acute experimental peritonitis]. AB - In experiments on 135 albino rats, present-day techniques were used to examine the time-course of hepatic destructive and reparative processes during various courses of acute experimental peritonitis (AEP). The magnitude of destructive changes in the liver was found to be directly related to the severity of peritoneal lesion, degree of intoxication, and immunologic reactivity of the body. Within the first 4-5 days of AEP, the liver was regenerated mainly by intracellular hyperplasia. On days 3-4 the mitotic activity of hepatocytes markedly increased, reaching its maximum on day 5 of the experiment. Destructive and suppurative changes predominated over reparative ones in the organ in AEP treated with the immunodepressant azathioprine. In contrast, the administration of the cellular immunity stimulant, levamisole++, to the experimental animals was followed by drastically increased mononuclear infiltration, hepatic stromal cell proliferation and reparative hepatocyte regeneration. PMID- 2774995 TI - [Alveolar soft tissue sarcoma]. AB - Clinical and morphological manifestations of alveolar soft tissue sarcoma (ASTS) are presented on the basis of 19 examinations performed by the authors and data available in the literature. ASTS has been found to be more common in young women and to be usually located in the thick layers of the proximal parts of the extremities. The tumor generally shows slow growth and late occurrence of metastases. It has been demonstrated that ASTS has an organoid structure, namely alveolar grouping of cells, abundance of capillaries, and its cells contain PAS positive inclusions. In atypical ASTS, the prognosis has been found to be less favourable. The crystalloid inclusions that are absent in other soft tissue neoplasms are a characteristic ultrastructural sign of ASTS. The genesis of ASTS remains controversial but it cannot be ruled out that it is related to the elements of the APUD-system. PMID- 2774996 TI - [Experience with conducting independent work by students at a department of pathologic anatomy]. PMID- 2774994 TI - [Detection of the epithelial membrane antigen in patients with varying status of the gastric mucosa using monoclonal antibodies]. AB - To study how the normal gastric mucosa develops chronic gastritis, gastric ulcer or cancer, biopsies from 103 patients with non-tumor gastric diseases and operative specimens from 12 patients with stomach carcinoma were examined for epithelial antigen (EA). In the peroxidase-antiperoxidase reaction performed on paraffin-embedded and cryostat sections of the gastric mucosa, monoclonal antibodies (MAb) to antigens located on the membranes of fatty breast milk globules were employed, which had been presented by the Department of Biomedical Sciences, Tampere University (Finland). The MAb 111C12-identified antigenic determinant was found to occur in 12.8% of the nonmalignant gastric mucosa examined and 48% of the stomach carcinoma one. The detection of EA is not characteristic of the given portion of the gastric mucosa in carcinoma. PMID- 2774997 TI - [Ocular melanoma metastases to primary liver carcinoma]. AB - Two days after hospitalization, a 64-year-old patient with chronic coronary heart disease developed jaundice. He was diagnosed as having primary liver cancer. During the past 3 years, the patient had lost sight in the right eye. He died of hepatic and cardiac failures 8 days following hospitalization. Pathoanatomic examination revealed massive poorly differentiated carcinoma of the liver and right ocular melanoma (spindle cell one). The latter had metastasized into the episcleral tissue of the same eye, liver, and hepatic tumor tissue, and liver carcinoma had invaded the organ itself and pleura. PMID- 2774998 TI - [Gigantomastia in puberty]. AB - The authors present a case of gigantomastia in a 14-year-old girl, which was accompanied with sharp increase in both mammae. Examinations failed to show hormonal alterations, carcinomas of the genitals and hypophysis. The two mammary glands were removed. Histological examination revealed that there was no lobular structure, ductus covered with thickened or cubic endothelium were cystically enlarged, the stroma consisted of dense connective tissue. The pathological condition described occurs extremely rarely. PMID- 2775000 TI - [Preparation of histotopographic goiter sections and endometrium scrapes for relevant instant diagnosis]. AB - Histotopographic examinations of goiters and scrapes taken as a whole are valuable to the emergency pathomorphological diagnosis of thyroid and endometrial diseases essential particularly for the differentiation of adenomas and well differentiated carcinomas. The examination can be carried out only by treating fresh, non-fixed materials with a deeply cooling knife of the routine cold microtome (Model X). Harris' or Ballard's hematoxylins are best used as elective dyes. The whole instant diagnosis fully described in the paper lasts 8 to 12 minutes. PMID- 2774999 TI - [A procedure for producing film preparations of serous mesothelial integument for histologic examination]. AB - Guidelines are given on production of film preparations of the mesothelial integument by freezing a serous membrane fragment to the specimen glass. It was shown that it was possible to use these preparations to perform histological staining and enzymatic reactions. PMID- 2775001 TI - [Reflections on post-mortem diagnosis]. PMID- 2775002 TI - [The computer at the pathologist's laboratory]. AB - Computers are coming into practical use by pathologists. The computer hardware and software are briefly outlined. The software is discussed while drawing up protocols on the examination of biopsies, operative materials and autopsies. A special attention is given to the SNOP and SNOMED coding of diagnoses. How to operate on a computer is described in the paper. The latter provides evidence for applying the computer to the formulation of laboratory documents. PMID- 2775003 TI - Idiopathic central diabetes insipidus followed by progressive spastic cerebral ataxia. Report of four cases. AB - A distinctive syndrome of diabetes insipidus developed in four boys in early childhood and progressive spastic cerebellar ataxia developed in adolescence. The boys have been observed for 12 to 19 years and are currently 19 to 25 years old. In patient 1, 12 years after the onset of diabetes insipidus and 4 years after the onset of spastic cerebellar ataxia, bone lesions that proved to be histiocytosis were detected. In patient 2, calcification that developed in the cerebellar dentate nuclei was similar to calcification described in patients with histiocytosis. In the other two patients, an etiologic diagnosis has not been established. We conclude that there is a distinctive syndrome characterized by early diabetes insipidus with subsequent progressive spastic cerebellar ataxia. While histiocytosis may not account for this complex syndrome in all cases, diabetes insipidus followed by progressive spastic cerebellar ataxia merits intensive evaluation. PMID- 2775004 TI - Downbeat nystagmus associated with dolichoectasia of the vertebrobasilar artery. AB - We reviewed the case records and radiographic studies of 41 patients with primary position downbeat nystagmus seen during a 5-year period to investigate whether a relationship existed between dolichoectasia of the vertebrobasilar artery and cases of unknown cause. The cause of downbeat nystagmus could not be determined in 12 cases (29%). Two of these cases had dolichoectasia of the vertebrobasilar artery as the only identifiable abnormality. One other case had a dolichoectatic vertebrobasilar artery, but other potential etiologic factors for the development of downbeat nystagmus were present. Compression of the caudal brain stem by an enlarged and tortuous vertebrobasilar arterial system may be the cause of downbeat nystagmus in some cases unassociated with more commonly recognized causes. PMID- 2775005 TI - Electrophysiological measures during acupuncture-induced surgical analgesia. AB - Electrophysiological recordings (electroencephalograms, somatosensory-evoked potentials, cognitive-evoked potentials) were made in five patients during acupuncture-induced analgesia for removal of a thyroid tumor. The electrophysiological measures were unchanged during the operation. Acupuncture's modes of action in producing analgesia are not revealed in this study. PMID- 2775006 TI - Seasonal variation of multiple sclerosis exacerbations in North Dakota. AB - A prospective study of the relationship between exacerbations and season in 336 patients with clinically definite multiple sclerosis showed a significant monthly variation as well as a seasonal pattern of exacerbations. The data obtained are compared with earlier studies that have used varying methodologies. The results continue to support the hypothesis that undefined environmental factors influence the course of multiple sclerosis. PMID- 2775007 TI - Acquired contralateral oculomotor synkinesis. AB - A patient with a traumatic right third nerve paresis had a contralateral oculomotor synkinesis develop that involved the left upper eyelid. With infraduction in adduction of the nonparetic left globe, the left upper eyelid was elevated. Elevation of the right upper eyelid was present in adduction of the paretic eye but absent in downgaze. To our knowledge this is the first description of the pseudo-Graefe phenomenon developing contralateral to the regenerating paretic third nerve. PMID- 2775008 TI - Frontal lobe syndrome in a patient with bilateral globus pallidus lesions. AB - This article describes a patient who experienced the rapid onset of an irreversible behavioral change while vacationing in La Paz, Bolivia (altitude, 4070 m). The only lesions demonstrated on a magnetic resonance imaging scan were bilateral hemorrhages in the globus pallidus. The behavior change was characterized by apathy and lack of motivation, features commonly associated with bilateral frontal lobe disease. This case is a further demonstration of how subcortical lesions can produce behavioral syndromes that are clinically indistinguishable from classic cortical syndromes. It is cases such as this that show how a strict localizationist concept of behavioral function is too restrictive and how it is necessary to consider a wide network of neuronal interconnections when explaining the mechanism of a dissolution of complex higher functions. PMID- 2775009 TI - Magnesium sulfate and eclampsia. PMID- 2775010 TI - Basilar artery occlusion. PMID- 2775011 TI - Primary lateral sclerosis. PMID- 2775012 TI - Magnesium sulfate in the treatment of eclampsia. PMID- 2775014 TI - Brain phosphorus magnetic resonance spectroscopy in acute bacterial meningitis. AB - The metabolic basis of the encephalopathy associated with acute bacterial meningitis is unknown. The presence of cerebrospinal fluid lactic acidosis and hypoglycorrhachia suggests that intracellular acidosis or cellular energy depletion may play a role. Phosphorus magnetic resonance spectroscopy allows for the noninvasive determination of intracellular pH and relative amounts of phosphate-containing metabolites in humans. In seven normal volunteers, the intracellular pH of a mixed volume of gray and white matter was 7.00 +/- 0.04 (mean +/- SD). The apparent relative intensities of resonances from adenosine triphosphate, phosphocreatine, phosphodiesters and phosphomonoesters, and inorganic phosphate were measured. An encephalopathic patient with pneumococcal meningitis who had severe cerebrospinal fluid lactic acidosis was studied. Brain intracellular pH and relative phosphate metabolite concentrations were normal. Intracellular acidosis and bioenergetic compromise are therefore not causes of encephalopathy in this disease. This also demonstrates that the human brain can maintain tight control of intracellular pH even in the presence of marked extracellular metabolic acidosis. PMID- 2775013 TI - Hereditary motor and sensory neuropathy with optic atrophy. Ultrastructural and morphometric observations on nerve fibers, mitochondria, and dense-cored vesicles. AB - Nerve biopsy specimens from three cases of hereditary motor and sensory neuropathy with optic atrophy were studied by light and electron microscopy and by morphometry. All cases had a chronic neuropathy of the neuronal/axonal type with little, presumably secondary, demyelination. There was predominant reduction of the large-caliber population of myelinated and unmyelinated nerve fibers. The number of dense-cored vesicles in unmyelinated and small myelinated fibers was increased. Abnormal mitochondria in Schwann cells with paracrystalline inclusions, prominent cristae including paracrystalline material (cases 1 and 2), and axonal mitochondria with presumable hydroxyapatite crystals (case 3) were found. The morphologic results suggest that hereditary motor and sensory neuropathy with optic atrophy should be regarded as a separate entity within the hereditary motor and sensory neuropathy group. PMID- 2775015 TI - Normal cerebrospinal fluid dynamics. A study with intraventricular injection of 111In-DTPA in leukemia and lymphoma without meningeal involvement. AB - The cerebrospinal fluid flow pattern in seven patients with leukemia or lymphoma, but without prior meningeal or cerebral disease, was studied following introduction of indium-diethylenetriamine pentaacetic acid In-DTPA 111 in a lateral ventricle through an Ommaya reservoir. The time to egress from the ventricular system into the basal cisterns was variable but generally short. One hour after administration, the basal cisterns were clearly visible in all patients. Thereafter, kinetics throughout the cranial and spinal subarachnoid space were consistent. The flow patterns of three patients cured of meningeal dissemination and one patient with mild meningeal leukemia were similar to the normal pattern. PMID- 2775016 TI - Post-orthodontic occlusal function. AB - The significance of orthodontic treatment in the aetiology of temporomandibular dysfunction continues to be a matter of controversy. However, the evidence of any association has been generally negative. This investigation involved the examination of a study group of 87 post-orthodontic patients, the average time out of all retention being 52 months. They were compared with an untreated control group. Signs and symptoms of temporomandibular disfunction were assessed for both groups. In only one instance, soft joint click, was there found to be a significant association between the treatment category and the occurrence of the symptom, there being a higher rate of soft clicks in the post-treatment group. While this may be ascribed to orthodontic treatment, there was also a different restorative pattern in the two groups. No other significant associations were found. PMID- 2775017 TI - The effect of public or private management on patients with temporomandibular joint pain dysfunction. AB - Australians may receive free dental treatment via the public sector if they have a health care card but otherwise must seek treatment via the private sector. These two modes of dental delivery have different objectives, facilities, and patient populations. Two groups of patients, one public and one private, who presented to the same clinicians with temporomandibular joint dysfunction were studied. There were differences in age, numbers of natural teeth and some psychological features. However, the outcome to simple non-surgical management resulted in similar levels of successful treatment. PMID- 2775018 TI - The anatomic relationship of the insertion of the superior lateral pterygoid muscle to the articular disc in the temporomandibular joint of human cadavers. AB - Confusion has existed as to whether the major insertion of the superior lateral pterygoid muscle is into the articular disc or the condyle. Five human cadaver joints were studied under the dissecting microscope. This allowed superior lateral pterygoid fibres to be selectively placed under tension to determine their point of insertion and to examine the integrity of the anterior joint capsule. All superior lateral pterygoid fibres gained either direct or indirect insertion to the condyle. A classification for the variation in insertion is suggested. The fibres of the anterior joint capsule extended from the anterior rim of the condyle to the roof of the infratemporal fossa but under the foot of the disc they blended with and became indistinguishable from disc fibres. PMID- 2775019 TI - Fatal subarachnoid haemorrhage associated with dental local anaesthesia. AB - A case is described of sudden death occurring after the use of a noradrenaline containing local anaesthetic. Autopsy revealed a massive subarachnoid haemorrhage following a ruptured cerebral aneurysm. The noradrenaline in the local anaesthetic is thought to be an important factor in the cause of the rupture. It is recommended that preparations containing 1:25,000 noradrenaline not be used. PMID- 2775020 TI - The effect of varnishes and other surface treatments on water movement across the glass ionomer cement surface. II. AB - The aesthetic restorative glass ionomer cements undergo a rather prolonged setting reaction during which time they are susceptible to water uptake and water loss. If they can be maintained in isolation long enough in the oral cavity then the clinical result will be superior. A further series of surface treatments has been tested and it has been shown that immediate covering of the immature glass ionomer cement surface with light-activated bonding resin is the most effective method of limiting water movement across the surface. This restriction of water movement is not effective for all light-activated bonding resins suggesting that there may be a physico-chemical interaction occurring on the glass ionomer cement surface with certain of the resins. PMID- 2775021 TI - Requirement and supply of dental services in Victoria. AB - The appropriateness of dental manpower has become a great uncertainty in the changing practice of dentistry. This paper presents research on the requirement for and supply of dental services in Victoria between 1984 and 1996. The requirement for dental services was found to be increasing due to population growth and higher per capita demand due to decreased endentulism. The supply of dental services was found to be mildly decreasing due to balanced supplementation and attrition processes and subtle sex ratio and age distribution changes among dentists. The resulting market excess, even after consideration of idle capacity and transfer of services supplied to dental therapists, provides a marked contrast to many, but not all, developed countries. It also offers an opportunity to shape occupational and specialty distribution to the advantage of dental professions and the public. PMID- 2775022 TI - Perceptions of the value of hospital residency and clinical medicine in dental education. AB - A survey of the outlook of 81 participating dental undergraduates concerning the value of a general hospital residency programme has been compared with the perceptions of 240 graduate health professionals (dental and medical practitioners, registered nurses and others). There is convincing statistical evidence of pan-professional support for such a general hospital residency. Better medical preparation of the dental student prior to residency is strongly favoured. Closer links between medicine and dentistry are inevitable as well as being essential for both professions and the community. PMID- 2775024 TI - Postgraduate orthodontic training. PMID- 2775023 TI - Guidelines for the use of dietary fluoride supplements in Australia. AB - A survey in 1988 of brands of fluoride supplements available in a non-fluoridated town in Western Australia, and tablets described in pharmaceutical product registers, revealed that six brands of tablets and one brand of solution (drops) were on the market. Tablets contained 2.2 mg or 1.1 mg NaF; the solution contained 2.2 mg NaF per mL. All products provided age-dose schedules which would give fluoride supplementation at levels greater than the National Health and Medical Research Council guidelines. In one case, infants following the schedule would receive four times the recommended dose for the first two years of life. Compliance with several of the age-dose schedules would be certain to cause significant dental fluorosis. Whether the others caused fluorosis would depend on the quantity of fluoride in the diet, and consumption of fluoride toothpaste. The survey showed a generalized disregard on the part of the ethical pharmaceutical industry for the risk of dental fluorosis, and reveals a need for a voluntary, or legally enforced, code of conduct for manufacturers of fluoride supplements. The value of guidelines which are not monitored is doubtful. PMID- 2775025 TI - Mouthguards and the role of sporting team dentists. PMID- 2775026 TI - Apical sealing. PMID- 2775027 TI - What about the carers? AB - Home visiting can have surprising rewards for general practitioners, rewards apart from the satisfaction that the exercise of medical skill can bring. The home visit can open the door to the hidden dedicated carers who daily practise love and compassion in difficult circumstances. PMID- 2775028 TI - Caring for people at home. PMID- 2775029 TI - Patellar tendinitis ('jumper's knee'). PMID- 2775030 TI - General practice--what's wrong in the market place. PMID- 2775031 TI - Lower abdominal pain. PMID- 2775032 TI - Descriptor debate. PMID- 2775033 TI - Testing for STDs. PMID- 2775035 TI - Taking the 'in' out of incontinence. PMID- 2775034 TI - Pictorial essay. Blindness in ocular trauma and the red eye. PMID- 2775036 TI - Is your most valuable resource ignored? AB - Receptionists are important for the efficient functioning of a practice. They are the eyes and ears of the practice and become a most valuable resource. There should be both formal and informal mechanisms for them to feed back information to the practice decision makers if better practice performance is to be achieved. PMID- 2775037 TI - Calculus in Wharton's duct. PMID- 2775038 TI - Patient education. Dementia. PMID- 2775039 TI - Prospective evaluation of a flexible protocol for starting treatment with warfarin and predicting its maintenance dose. AB - We have evaluated a flexible warfarin dose induction protocol by monitoring its performance in 100 elderly inpatients. The protocol (designed by Fennerty et al., has two aims: (a) to move the prothrombin time (PT) ratio smoothly and quickly into its therapeutic range, and (b) to predict the steady-state warfarin requirement from the PT ratio measured on the fourth treatment day. It proved simple to use and reasonably successful, since after four days, 67/100 patients had achieved a therapeutic level of PT ratio, nine exceeded the therapeutic range, and 24 remained sub-therapeutic, while none had bled due to excessive anticoagulation. Maintenance dose prediction was tested by comparing the predicted and observed maintenance doses in patients within the 'therapeutic range' of PT ratio after various median times of treatment. After ten days, the observed dose was within 1 mg of that predicted in 65/86 patients (76%). This proportion became 57/77 (74%) after 18 days, and 49/79 (62%) after 34 days. PMID- 2775041 TI - Two-dimensional Doppler echocardiographic flow imaging--exploration of clinical impact and problems. AB - Recent advances in electronic engineering have allowed Doppler echocardiography to be presented in the form of a real-time two-dimensional image. The resulting image of blood flow has been described as a 'non-invasive angiogram', but the analogy with angiography should not be pushed too far since the technical determinants of these images are entirely different. Nevertheless, the colour flow map does allow rapid and direct exclusion, detection and quantitation of regurgitant and stenotic lesions, and semi-quantitative assessment of valvular regurgitation and shunts. To achieve optimum results, it is necessary to standardise recording procedure, to take account of patient variables which influence the image appearance and quality and to be aware of the possibility of artefact. As for all investigations, results which are not coherent with other echocardiographic data, with other investigations and with the clinical assessment should be subjected to particular scrutiny with the possibility of false diagnosis in mind. PMID- 2775040 TI - Cyclosporin A in the treatment of childhood glomerulonephritis. AB - Seven children with steroid resistant nephrotic syndrome (focal segmental sclerosis in six, mesangial proliferation in one) were treated with Cyclosporin A for 12 weeks. Five of these children were also resistant to cyclophosphamide. All patients had normal renal function. Cyclosporin was started at 8 mg/kg/day then increased until a trough blood level of 100-300 ng/ml (HPLC) was achieved. Three of the seven patients achieved complete remission, and the other four had a significant reduction in their proteinuria (p less than 0.05). In the three patients who achieved complete remission, relapse of proteinuria occurred within six weeks of ceasing Cyclosporin. All patients experienced some impairment in renal function with mean creatinine clearance decreasing from 129 +/- 19 to 91 +/ 13 ml/min/1.73m2 (p less than 0.05). One child was subsequently treated with Cyclosporin for 12 months. He remains in remission with a repeat renal biopsy showing no evidence of nephrotoxicity. One other child with steroid sensitive minimal change nephrotic syndrome who had severe steroid toxicity was treated with a lower dose (5 mg/kg/day) for 12 months. She remained in remission off steroids, but relapsed 16 weeks after Cyclosporin was ceased. A renal biopsy after 12 months showed no nephrotoxicity. Cyclosporin should be considered in steroid resistant nephrotic syndrome, and in children with minimal change disease who show signs of steroid toxicity and short remission period after cyclophosphamide. Serial renal biopsies are recommended with prolonged therapy. PMID- 2775042 TI - Magnetic resonance imaging in posterior circulation infarction: impact on diagnosis and management. AB - To compare the diagnostic yield of magnetic resonance imaging (MRI) with computed tomography (CT) in posterior circulation infarction, we used proton MRI with a 0.3 Tesla magnet and a 3rd generation CT scanner in 25 patients. Age-matched controls were compared in a blinded fashion. Seventeen patients (68%) showed relevant pathology on MRI not seen on CT, 11 with normal CT and six with more extensive lesions, chiefly in the brain stem. Evidence of abnormal vertebrobasilar blood flow was seen in 8/25 (32%) of patients, suggested by vascular high intensity signals on MRI. Two tissue and one flow abnormality were seen in the control group. MRI provides additional information concerning infarct site, extent and pathogenesis in posterior circulation infarction. PMID- 2775043 TI - Aspiration biopsy of palpable lymph nodes and the diagnosis of lung carcinoma. AB - Over a six-year period at this institution aspiration biopsy of palpable lymph nodes has been used in the diagnosis and follow-up of 40 primary lung cancers. Small cell carcinoma was the commonest cell type. In the majority of the patients this was the initial diagnosis of lung cancer, however, there were patients with recurrence after chemotherapy and after surgical management. Diagnosis and classification of tumour using this simple, rapid and safe procedure negates the need for more invasive and costly investigations. PMID- 2775044 TI - Inferior petrosal sinus sampling in acromegaly. AB - In view of the diagnostic value of bilateral simultaneous inferior petrosal sinus sampling (BSIPSS) in localising preoperatively the site of the microadenoma in pituitary dependent Cushing's disease, the clinical value of BSIPSS was evaluated in five acromegalic patients with equivocal or negative pituitary CT scans. Intersinus GH gradients were obtained for all patients (range 1.6-4.2) but in only one case was the gradient correctly localised to the side of the tumour. Gradients of several other pituitary hormones, particularly prolactin (range 1.6 4.0), also demonstrated gradients parallel to the GH intersinus gradients. Despite the paradoxical intersinus GH gradients, the surgeon was able to readily identify the tumour at the time of surgery. Thus BSIPSS is of little assistance to the surgeon for the preoperative radiological evaluation in acromegaly and these results caution against the universal adoption of the BSIPSS technique in the radiological assessment of all secretory pituitary microadenomas. PMID- 2775045 TI - Fibrillary glomerulonephritis--a report of two cases. AB - Two patients with an uncommon form of glomerulonephritis are described. The main clinical features were hematuria and proteinuria associated with normal renal function. The glomerular lesions consisted of mesangial hypercellularity and capillary wall thickening. Immunofluorescence was positive for IgG and C3 in both cases. Widespread deposition of microfibrils (mean diameters 17.0 nm and 18.4 nm) within mesangial areas and capillary basement membranes was seen on electron microscopy. Congo red staining for amyloid was negative. In both patients there was no evidence of underlying disease or extra-glomerular involvement and hence the disorder appeared to represent a primary glomerulonephritis. PMID- 2775046 TI - Pericarditis associated with tick-borne Q fever. AB - A case of pericarditis associated with Q fever is described. Transmission was probably via an arthropod vector, which was most likely the kangaroo tick Amblyomma triguttatum. Complete recovery occurred in association with the use of non-steroidal anti-inflammatory agents only. This is a rare presentation of Q fever implicating transmission by a novel vector. PMID- 2775047 TI - Massive benign thymoma presenting as ocular myasthenia. AB - A case of ocular myasthenia was found to be associated with a massive benign thymoma and responded to its removal. This is an exception to the generalisation that larger tumours of the thymus gland are more likely to be malignant and that thymectomy is not the treatment of choice for ocular myasthenia. PMID- 2775048 TI - Community-acquired Acinetobacter pneumonia. AB - We describe the first case report of community-acquired Acinetobacter pneumonia in Australia. Well recognised risk factors for this entity (alcoholism, diabetes mellitus and chronic lung disease) were present in our patient. His pneumonia ran a fulminant course, with death occurring within 24 hours of presentation to hospital. Whilst rare, this infection is being described with increasing frequency, particularly in developing countries including Papua New Guinea. PMID- 2775049 TI - Recombinant human erythropoietin enters the pharmacopeia. PMID- 2775050 TI - The role of bronchoalveolar lavage in the assessment of diffuse lung diseases. AB - Bronchoalveolar lavage is a safe and simple technique for sampling the inflammatory cells of the lung. However, while its use in the evaluation of pulmonary pathogenic mechanisms is both well accepted and described, its clinical utility is more controversial. Marked variation in results may occur through variation in the lavage procedure. Standardisation of the lavage technique and laboratory processing of the specimen are essential for reliable results. This review examines the current clinical role of bronchoalveolar lavage in the assessment of patients with diffuse lung diseases, and immunocompromised patients with pulmonary infiltrates. In this latter category, for patients with Acquired Immunodeficiency Syndrome, lavage is of equal efficacy to lung biopsy and can establish the cause of pulmonary infiltrates in over 90% of cases. Bronchoalveolar lavage can detect abnormalities in patients with diffuse lung diseases prior to the development of irreversible fibrosis. Lavage features have been described for sarcoidosis, cryptogenic fibrosing alveolitis, extrinsic allergic alveolitis, connective tissue diseases, and asbestosis. In cryptogenic fibrosing alveolitis lavage data may be used to indicate a subsequent deterioration in the patient's condition, or predict a favourable response to therapy. PMID- 2775051 TI - Code of practice for the use of schedule 4 substances in the pig industry. PMID- 2775052 TI - A farming systems study of abortion in dairy cattle on the Atherton Tableland. I. Reproductive performance. AB - Herd health records from 1983 to 1985 were analysed for a sample of 19 dairy farms on the Atherton Tableland in tropical north Queensland. Abortion and first service conception rates were calculated for each farm for each year. The association between abortion rate and stage of gestation at pregnancy diagnosis was investigated as well as the association between abortion rate and lactation status. There was a significant linear increase in abortion rate over the 3-year period, during which the mean rate was 7.3 +/- 2.1% (range 4.5% to 10.9%). There was also a significant variation in first conception rates during the same period, when the mean first service conception rate was 51.8% +/- 6.6% (range 42.4% to 65.8%). A significantly higher abortion rate was recorded in first lactation cows. Of 178 abortions in all lactation groups (1984), 20.3% were repeat abortions by the same cows. Of 163 abortions, a majority (80.4%) occurred during months 3 to 7 of gestation. No significant association was found between the timing of pregnancy diagnosis and occurrence of abortion. PMID- 2775053 TI - A positive association between resistance to ovine footrot and particular lymphocyte antigen types. AB - The distribution of 12 Class I ovine lymphocyte antigens (OLA) was examined in 4 flocks of sheep vaccinated against and/or challenged with Bacteroides nodosus, the transmitting agent of footrot. In a flock of 47 Corriedales in New Zealand, which had been specially bred for resistance to footrot, a higher frequency (70.2%) of OLA type SY6 was found compared with 42.9% in 49 unselected Corriedale sheep (P = 0.001). The serum antibody response of 12 selected Corriedale ewes was compared with that of 12 unselected ewes of the same age after vaccination with a multivalent footrot vaccine and the selected ewes had significantly (P = 0.01) higher agglutinin titres than the unselected ewes, 7 weeks after vaccination. In 3 trials involving 108, 120 and 135 Australian Merinos in Victoria, SYlb was associated with a reduction in the number of feet affected with severe footrot (P = 0.05, P = 0.01, P = 0.02) and in 2 of the trials there was a relationship between SY6 and high vaccinal agglutinin titres. This SY6 effect was evident in the first trial 31 days after primary vaccination (P = 0.05) and again 20 days later after secondary vaccination (P = 0.01). In the second trial, when the sheep were vaccinated 49 days after challenge, an association was again found between SY6 and high agglutinin titres (P = 0.05) after primary but not after secondary vaccination. Exposure of 157 vaccinated Merino rams to B. nodosus during a footrot outbreak in New South Wales also showed an association between low infection and SY6 and SYlb.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2775054 TI - Synthetic pyrethroid resistance in field samples in the cattle tick (Boophilus microplus). AB - First evidence of resistance to synthetic pyrethroids in the cattle tick in Australia, other than the pre-existing cross-resistance in DDT-resistant ticks, has emerged. Three new strains have been investigated and characterised. The first, detected in central Queensland, showed increased ability to detoxify pyrethroids resulting in a marginal loss of efficacy of all pyrethroid tickicides tested, except flumethrin. Subsequently two more strains have been detected, with serious implications for chemical tick control. The first, from southern Queensland, has a high level of specific resistance to flumethrin. The second, from central Queensland, has a broad spectrum resistance encompassing all pyrethroids currently in use. The toxicology and biochemistry of these new resistant strains have been investigated and alternative tickicides evaluated. The significance of these latest developments is discussed. PMID- 2775055 TI - The effect of artificial Eperythrozoon ovis infection on the growth rate of stressed and nonstressed sheep. PMID- 2775056 TI - Regression of bovine vulval squamous cell carcinoma after immunotherapy. PMID- 2775057 TI - New techniques for measuring the growth and survival of larvae of Lucilia cuprina on sheep. PMID- 2775058 TI - Fracture of the patella as a possible complication of medial patellar desmotomy. PMID- 2775059 TI - A suspected case of acute copper toxicity in a horse. PMID- 2775060 TI - Chronic renal disease in bull terriers. AB - Chronic renal failure was diagnosed in 15 Bull terrier dogs. The dogs ranged in age from one to 8 years. History and clinical findings typically included lethargy, anorexia, polyuria, polydipsia and weight loss. Affected dogs were azotaemic, had elevated serum phosphate and cholesterol, and proteinuria was apparent in all dogs tested (13/13). The concentration of urine was consistently in the nil to minimally concentrated range (specific gravities 1.011-1.017). In those dogs necropsied, both kidneys were approximately two-thirds normal size, tough in consistency, with a pale cortex and a finely nodular capsular surface. Histologically, there was marked nephron loss, diffuse interstitial fibrosis and focal dense radial fibrosis which was especially evident in the renal medulla. Tubular dilation was widespread with focal mineralisation of tubular epithelium and adjacent basement membranes. Glomeruli were often shrunken and segmentally fibrotic. Some Bowman's spaces were extremely dilated. Many less severely affected glomeruli had thickened basement membranes. PMID- 2775062 TI - The magnitude of reproductive wastage to lamb marking in 30 Merino flocks in south-west Queensland. AB - Thirty groups of Merino ewes in 6 districts of south-west Queensland were studied between 1976 and 1985 to determine the magnitude of reproductive wastage to lamb making. Relatively high pregnancy rates (77 to 100%, mean 93%) and a wide range of lamb marking percentages (10 to 115%, mean 78%) were recorded. The mean reproductive wastage due to failure to mate and failure to lamb was low (1.6 and 3.4% respectively) in 8 flocks where harnessed rams were used. This indicated that loss of lambs from birth to lamb making was the major cause of reproductive wastage in most years. PMID- 2775061 TI - The extent and cause of perinatal lamb mortality in 3 flocks of Merino sheep. AB - Autopsies were performed on lamb carcases from 2 groups of Merino ewes lambing in paddocks in spring 1978 and from 1 group lambing in pens in 1980 in southwest Queensland. These showed that the main causes of death were starvation due to failure of the lamb to obtain milk, problems at parturition causing death during or shortly after birth and, in some cases, predation. The majority of lambs died within 1 week of birth with the highest mortalities occurring in the lighter lambs. In the pen study, mean birth weight of lambs that died was 3.0 (s.d. = +/- 0.5) kg. The mean daily weight loss of lambs that died of starvation in the pens was 0.22 kg and the mean loss to autopsy was 0.35 kg. In the pen study, there were more lamb deaths, deaths from starvation, mismothering and desertion in each of 2 groups fed a below maintenance ration than in an above maintenance group. More lambs died and more lamb deaths were due to starvation in a group with unsound udders than in a sound udder group. The results are similar to those found by workers investigating perinatal lamb mortality in other areas. Their significance is discussed in relation to Merino sheep flocks in southwestern Queensland. PMID- 2775063 TI - Pathological changes in the mammary gland and biochemical changes in milk of the goat following oral dosing with leaf of the avocado (Persea americana). AB - Two varieties of avocado leaves (Persea americana var Guatemalan and var Mexican) were administered to lactating goats. The Mexican variety was without effect. The Guatemalan variety in doses exceeding 20 g fresh leaf per kg bodyweight, produced damage to the mammary gland with decreased milk production. The lesions were characterised by oedema and reddening, with clots in the large ducts. Microscopically, there was widespread degeneration and necrosis of the secretory epithelium, the necrotic cells sloughing into the lumen. There was no significant cellular inflammatory response. Concentrations of antitrypsin in the milk, indicating changes in vascular permeability, increased rapidly 15 h after a single high dose, coinciding with palpable oedema. Concentrations of NAGase, indicating cell damage, increased after 24 h. Goats given multiple doses followed a similar pattern but the initial response was delayed. The toxic principle, and its mode of action in selectively damaging mammary secretory cells, remains to be determined. PMID- 2775064 TI - Comparison of inoculation regimes for the experimental production of swine erysipelas arthritis. I. Clinical, pathological and bacteriological findings. AB - The arthritic form of swine erysipelas was induced in pigs by multiple intravenous inoculation of 2 strains of Erysipelothrix rhusiopathiae. The strains differed significantly in their arthritogenicity but not in the number of cases of lameness induced. The use of 3 intravenous inoculations instead of 5 did not significantly affect the outcome. In a second trial, the more arthritogenic strain was injected in ten-fold dilutions from 5 x 10(9) to 5 x 10(4) organisms. Pigs receiving the lower doses showed high variability in their arthritic responses that precluded sensitive analysis of the dose effects on the number of arthritic and infected joints. However, slaughter weights showed a significant negative correlation with dose. Mean slaughter weights in treatment groups varied by 14.6 kg per pig, an average weight loss of 3 kg per pig for each ten-fold rise in dose of the highly virulent strain, and significantly correlated with the number of arthritic and infected joints. Culture of homogenised synovial membrane through selective horse meat-serum broth containing kanamycin, neomycin and vancomycin identified 66% and 59% more infected joints than primary blood agar culture of synovial fluid or synovial membrane homogenate, respectively. PMID- 2775065 TI - An outbreak of bovine ephemeral fever in northeast Victoria. PMID- 2775066 TI - Ovine listeriosis in south coastal Western Australia. PMID- 2775067 TI - Biochemical and molecular identification of species of Taenia. PMID- 2775068 TI - Congenital lymphoedema in an Ayrshire-Friesian crossbred female calf. PMID- 2775069 TI - Recognition of the sucking louse Linognathus africanus on goats. PMID- 2775070 TI - Toxicity of a closantel-albendazole mixture in a flock of sheep and goats. PMID- 2775071 TI - Carcinogen in rock fern (Chielanthes sieberi) from New Zealand and Australia. PMID- 2775072 TI - Eperythrozoon prevalence and its statistical appraisal. PMID- 2775074 TI - The role of dynamic corpora cavernosography in the management of impotence. AB - Sixty eight impotent men underwent corpora cavernosography and corpora cavernosal pressure measurements during saline infusion. Nineteen of the men had internal pudendal arteriograms. Correlation between the cavernosograms and saline infusion induced pressure measurements was "good" in 56/66(84%), "approximate" in 5/66(8%) and there was no correlation in 5/66(8%). Two patients were excluded for technical reasons. The spread of results and the good correlation of the two tests speaks for the accuracy of the method. It was of value in diagnosis and will be of paramount importance if veno occlusive surgery becomes a reliable method of treatment. PMID- 2775073 TI - The effects of water soluble contrast agents on the respiratory tract. AB - The water soluble contrast agents Gastrografin (Sodium diatrizoate and meglumine diatrizoate, Schering, Berlin), Iopamiro 300 (Iopamidol, Schering, Berlin), and Dionosil Aqueous (propyliodone BP, Glaxo, England) were instilled into the tracheobronchial tree of rats in doses of either 0.1 ml and 0.25 ml. Rats being used as controls, underwent sham operations with the instillation of air instead of contrast agent. In all, 85 rats were used. All rats that had not already died from the effects of contrast agent were sacrificed 30 minutes after instillation. The relative effects of the contrast agents were measured by comparing: 1. survival time; 2. radiographic effects of the contrast agents on the lungs and; 3. pathological changes as estimated by post mortem lung section and microscopy. The least toxic agent was the one with the lowest osmotic activity, namely Aqueous Dionosil. It is therefore recommended that Aqueous Dionosil be used in preference to Gastrografin or Iopamidol for studies of the oesophagus whenever there is a danger of aspiration of contrast agent into the tracheobronchial tree. PMID- 2775075 TI - Cerebral venous malformations. AB - Cerebral venous malformations (CVM) are increasingly being recognised with the widespread use of CT scanning. Five cases are presented which demonstrate typical angiographic features and CT findings. These lesions when located in the cerebral hemispheres are benign and have been distinguished from the better known arteriovenous malformations on the basis of their characteristic angiographic features. CT findings have been considered nonspecific but our early post contrast CT scans demonstrate characteristic features suggesting that in many cases the diagnosis of cerebral venous malformations may be made on the CT scan alone. PMID- 2775076 TI - Traumatised ischial apophysis (report of six cases). AB - Six boys with traumatic ischial apophysis are reported. Two cases were diagnosed as stress apophysis and four as apophyseolysis. Two of our patients were referred to the hospital as malignant bone tumours--Ewing sarcoma and osteosarcoma. PMID- 2775077 TI - The CT appearances of ruptured abdominal aortic aneurysms. AB - There is no place for investigative CT scans in patients who have the classical triad of abdominal aortic aneurysm rupture, namely excruciating abdominal pain or backache, a pulsatile mass and hypotension. These patients require immediate surgery. However, in the absence of this triad, CT scans play an important role in the diagnosis of abdominal aortic aneurysm rupture. The CT scan findings will dictate whether the patient requires immediate surgery as in the case of acute rupture, or, whether the surgery can be delayed up to 24 hours to allow for stabilisation and hydration, as in the case of subacute and chronic rupture. PMID- 2775078 TI - Uses of direct coronal pelvic CT. AB - A technique for performing direct coronal computed tomography (CT) of the pelvis on conventional CT equipment is described. Eighteen patients have been examined by this technique and its possible applications in the evaluation of patients with anorectal and genitourinary anomalies, pre and postoperatively, are discussed. PMID- 2775079 TI - A case report of central nervous system lymphoma following immunosuppression. AB - Lymphoma is a well recognised complication of immunosuppression. A case is presented of a patient who developed CNS lymphoma thirty-three months after renal transplantation. The incidence and characteristics of lymphoma developing post transplantation and the treatment of central nervous system (CNS) lymphomas are discussed. PMID- 2775080 TI - Primary non-Hodgkins lymphoma of bone (case report). AB - Early stage primary bone lymphoma may be cured by irradiation alone with few complications using moderate doses of radiation. Some points regarding the presentation and radiological features of the disease are highlighted. PMID- 2775081 TI - Metastatic thymoma: case report. AB - A patient with myasthenia gravis who developed skeletal metastases 9 years following the complete excision of a thymoma is described. Several aspects of the case were noteworthy: (1) the original thymoma failed to demonstrate evidence of capsular invasion, (2) the association of myasthenia gravis with metastatic predominantly epithelial cell thymoma has not been previously documented, and (3) the time to development of metastatic disease is the second longest interval reported in the medical literature. The clinical implications of these features are discussed. PMID- 2775082 TI - A helpful sialography technique. PMID- 2775083 TI - Problem-solving model in radiology for medical students. AB - Current undergraduate medical education is criticized for not preparing physicians to be independent thinkers. The rapid development of new imaging techniques and the problem of escalating medical costs call for efficient patient management. The development of algorithms in imaging work-up of patient problems is an excellent example of problem solving or medical decision making. The senior elective in radiology at our institution incorporates this type of problem solving session. Small groups (15-25 students) with faculty guidance discuss 5-6 common patient problems to develop an investigative plan in imaging. Algorithms are thus developed by the group, but not presented for memorization. Small changes are then made in the case history so that the students are forced to make new hypotheses and generate a modified algorithm. Correlative costs are included. Flexibility and initiative in development of patient management algorithms are stressed. PMID- 2775084 TI - The radiological diagnosis and management of angiomylipoma of tuberous sclerosis. AB - Angiomyolipomas produce pathognomonic appearances on modern imaging methods and a tissue diagnosis is no longer required particularly when multiple tubers can be confidently diagnosed and if a CT brain scan shows periventricular calcifications. As the renal tumours are benign every effort must be made to preserve normal renal tissue. Symptomatic or large tumours can be effectively treated by transcatheter embolisation with a reduction in the size of the tumour and control of intratumoural haemorrhage. PMID- 2775085 TI - Steroid induced exophthalmos. A case report. AB - A case of steroid induced exophthalmos in a patient with systemic lupus erythematosus with renal involvement is described. Computed Tomography was used to demonstrate the increased retro-orbital fat. PMID- 2775087 TI - Unusual manifestation of extramedullary haematopoiesis in thalassaemia major (report of 2 cases). AB - 2 cases of thalassaemia reported with skeletal changes of severe haemolytic anaemia with the striking feature of extra-medullary haematopoiesis in relation to anterior ends of the rib. This is a rare finding in thalassaemia and is a manifestation of long-standing disease found in thalassaemia intermedia. PMID- 2775086 TI - Venous collaterals and metastatic disease coexisting in the retroperitoneum. PMID- 2775088 TI - Massive intramural duodenal haematoma following blunt abdominal trauma. Case report. AB - We report a case of a massive intramural duodenal haematoma following blunt abdominal trauma. The value of computed tomography and other imaging modalities is discussed. PMID- 2775089 TI - Feasibility of using proteins from Salmonella gallinarum vs. 9R live vaccine for the prevention of fowl typhoid in chickens. AB - Proteins from a field strain of Salmonella gallinarum MSG1 were compared with 9R live vaccine strain for their protection against experimental fowl typhoid in chickens. Proteins from S. gallinarum gave better protection than the 9R live vaccine as measured by clearance of challenge organism from internal organs. Proteins given twice with an adjuvant at 200 micrograms/100 g body weight resulted in 95% protection, compared with 60% protection with 9R given orally. The 9R live vaccine produced more hepatic and splenic lesions and, when administered orally as a single dose, was the least protective (60%). In the group vaccinated subcutaneously with a single dose of 9R without an adjuvant, both the challenge strain and the 9R vaccine strain were isolated from the ovaries of some birds. All chickens vaccinated with 9R strain or with proteins developed antibodies detectable by microagglutination test, and in some vaccinated groups as many as 100% of the birds developed antibody levels detected by seroagglutination. PMID- 2775090 TI - Effect of environmental-genetic interactions on Mycobacterium avium challenge infection. AB - Chickens from lines selectively bred for either a high-antibody (HA) or low antibody (LA) response to sheep erythrocytes were injected intravenously with Mycobacterium avium while being held in low, medium, or high levels of social stress for 5 days (first environment). During the remaining 6 weeks, they were held under either low or medium levels of social stress (second environment). Infection led to lesions consisting of granulomas, some of which had necrotic centers. There was a positive correlation between numbers of lesions with necrotic centers and M. avium cells recovered from livers. The numbers and nature of lesions were influenced by both genetic and environmental factors. Numbers of necrotizing lesions increased with stressfulness of the first environment. Total numbers of lesions were reduced by the medium-stress second environment, and the total number of necrotizing lesions was reduced among LA chickens in the low stress second environment. PMID- 2775091 TI - Efficacy of diclazuril against turkey coccidiosis in dose-titration studies. AB - Diclazuril, a new anticoccidial drug, was tested for its efficacy in turkeys against single Eimeria infections. Dose-titration studies indicated that diclazuril at dosages of 0.1, 0.5, 1, and 2 ppm was highly effective against the major pathogenic species-E. adenoeides, E. gallopavonis, and E. meleagrimitis-in terms of weight gain and suppression of lesions, abnormal droppings, and oocyst shedding. PMID- 2775092 TI - Enhancement of Campylobacter jejuni virulence by serial passage in chicks. AB - Four isolates of Campylobacter jejuni were studied to determine changes in virulence following six serial passages in chicks. Chicks that received invasive isolates exhibited diarrhea and depressed weight gain. Immature mice were used to assess virulence of the passaged isolates of C. jejuni. Nine-day-old mice infected with passaged isolates showed lethargy, dehydration, depression, decreased weight gain, and occult blood in feces. Mouse pups inoculated with the third and sixth chick passage levels of an invasive isolate showed significant depression in mean daily weight gain and elevated mortality compared with controls and subjects inoculated with unpassaged isolates. This study demonstrated enhancement of virulence in a C. jejuni isolate following chick passage. In contrast, three other passaged isolates failed to show any consistent increase in virulence. PMID- 2775093 TI - Evaluation of serum and secretory antibody responses to an immunodominant recombinant merozoite surface antigen, p150, using a sensitive enzyme-linked immunosorbent assay. AB - An equation obtained from linear-regression analysis of positive/negative ratios and log of enzyme-linked immunosorbent assay (ELISA) titers of coccidia-immune serum samples was used to accurately predict the antibody titers of chickens immunized with a recombinant merozoite surface protein (p150). Chickens immunized twice intramuscularly with the recombinant p150 antigen emulsified in complete Freund's adjuvant developed a dose-dependent anti-p150 antibody response 14 days after primary immunization. Serum IgG and IgM and secretory biliary IgA antibodies were detected 2 months after primary immunization. Oral challenge with live Eimeria parasites significantly enhanced both the serum and secretory anti p150 antibody titers. These results indicate that vaccination of chickens with the p150 recombinant merozoite antigen can induce a parasite-specific host immune response. PMID- 2775094 TI - Suspected fusariomycotoxicosis in sandhill cranes (Grus canadensis): clinical and pathological findings. AB - In 1985 and 1986, large-scale natural die-offs of sandhill cranes in Texas were attributed to fusariomycotoxicosis. These birds demonstrated a progressive loss of motor control to the neck, wings, and legs. Based on necropsy and/or histopathology of 31 cranes, the most common lesions involved skeletal muscle and included hemorrhages, granulomatous myositis, thrombosis, and vascular degeneration. Serum chemistry results revealed that levels of creatinine kinase, aspartate aminotransferase, and alanine aminotransferase were above published normals. However, only alanine aminotransferase was higher in clinically affected cranes than in normal cranes collected from the same area. PMID- 2775095 TI - Furazolidone toxicity in neomycin-treated turkey poults. AB - Furazolidone (FZ) toxicity was evaluated in turkey poults treated with neomycin at a dose of 20 mg/kg body weight for 5, 10, or 26 days. Neomycin treatment had no effect on FZ-induced anorexia, delayed the onset of altered electrocardiographic patterns by approximately 1 week, and did not significantly affect the development of FZ-induced cardiomyopathy. Data indicated that FZ toxicity is not significantly altered by the gut microflora. PMID- 2775096 TI - Efficacy of diclazuril against turkey coccidiosis in a floor-pen experiment. AB - Diclazuril, a new anticoccidial drug, was tested for its efficacy in turkeys against mixed Eimeria infections. A floor-pen trial indicated that diclazuril at dosages of 0.5 ppm and 1 ppm in the feed was highly effective against the major pathogenic species E. adenoeides, E. gallopavonis, and E. meleagrimitis in suppressing intestinal and cecal lesions and oocyst shedding. Weight gain and feed conversion improved, particularly at 1 ppm. PMID- 2775097 TI - Relationship between anti-Pasteurella multocida antibody titers after CU vaccination and survival after challenge. AB - The relationship between serum anti-Pasteurella multocida antibodies and survival rates after challenge was determined in turkeys vaccinated one or more times with the live avirulent Clemson University (CU) vaccine and then challenged with a virulent isolate (9481) of P. multocida in the drinking water. A microtiter agglutination test for assaying anti-P. multocida serum antibodies demonstrated a highly significant (P less than 0.001) correlation between the serum antibody titer 1 week after the initial or single vaccination and the survival rate after challenge, and a significant (P less than 0.01) correlation between the antibody titer immediately before challenge and the survival rate after challenge. A highly significant (P less than 0.0001) correlation was also observed between the antibody titer before vaccination and the survival rate after challenge. This relationship was considered the result of an anamnestic response by the CU vaccine to a previous sensitization by antigens of other microbial organisms, probably in the intestine and similar antigenically to P. multocida. In contrast, a significant (P less than 0.05) but negative correlation was seen between the antibody titer 1 week after challenge and the survival rate. This relationship was thought to be the result of a marked stimulation of the antibody titer by the systemic infection of P. multocida that subsequently killed the turkeys. PMID- 2775098 TI - Hemagglutinating activity and immunological properties of Haemophilus paragallinarum field isolates in Japan. AB - Four field isolates (S4, S10, S15, and S17) of Haemophilus paragallinarum were recovered from chickens affected with infectious coryza in widely separated regions of Japan. Their hemagglutinating (HA) activity and immunological properties were compared with those of strain 221 of serovar A/1 and strains Modesto and S1 of serovar C/2. When treated with potassium thiocyanate or hyaluronidase, all the isolates showed HA activity against formaldehyde-fixed chicken erythrocytes but not against fresh chicken erythrocytes. In the hemagglutination-inhibition (HI) test, the isolates cross-reacted with strains Modesto and S1 but not with strain 221. The immunological properties of these isolates, as determined by cross-protection tests, were similar to those of strain S1 and, to a lesser degree, strain Modesto, but not to strain 221. Our results indicated that the four field isolates belong to serovar C/2 and that the HI test is a suitable method for serotyping H. paragallinarum. PMID- 2775099 TI - The effect of chronic lead intoxication in mature chickens. AB - In a study of chronic lead intoxication in mature chickens, blood lead levels were significantly lower in hens than in roosters receiving the same oral dose of lead. It was then shown that eggshells from lead-treated hens contained 6-12 times the lead concentration of eggshells from control hens. Similarly, the lead content of egg yolks from treated hens was significantly higher than yolks from controls. Lead-treated hens laid significantly more eggs during the period of observation of nearly 3 years because of the increased frequency of laying cycles, which was almost three times that of control hens. A further observation was histologic damage to the mature testes of the rooster. PMID- 2775100 TI - Separation of turkey heterophils from blood using two-step Ficoll-Hypaque discontinuous gradients. AB - A method is presented to separate turkey heterophils from anticoagulated whole blood using two-step Ficoll-Hypaque discontinuous gradients and ammonium chloride lysis of contaminating erythrocytes. Heterophils can be isolated from multiple blood samples within 3 to 4 hours. Using this technique, 66.4 +/- 18.4% (mean +/- standard deviation) of blood heterophils were harvested. Final cell isolates averaged 96.0 +/- 2.9% heterophils with few contaminating eosinophils (2.5 +/- 2.3%) or basophils (1.6 +/- 1.8%). Cell viability, as determined by trypan blue dye exclusion, was 98.0 +/- 1.4%. PMID- 2775101 TI - The effect of biological isolation and a molt-inducing regimen on the recovery of Mycoplasma gallisepticum from commercial Leghorn hens. AB - Two trials were conducted to determine the effect of induced molt on the reisolation of Mycoplasma gallisepticum (MG) from commercial leghorn hens that had been eyedrop-inoculated with MG at 10 weeks of age. Chickens were maintained in a conventional floored chicken house on dry litter through 100 weeks of age. At age 64 weeks, 4 days (Trial 1), and at 100 weeks (Trial 2), hens were swabbed and cultured for MG and then molted in biological isolation units. Swabs were again taken at the end of each molt. No difference was observed in the number of MG isolations between molted hens and controls that did not undergo molting. However, a significant decrease in MG isolations was observed in both trials from swabs obtained when hens were housed on dry litter floors as compared with swabs taken from the same hens after 18 days (Trial 1) or 21 days (Trial 2) of confinement in isolation units. PMID- 2775102 TI - The effects of stray voltage on turkey poults. AB - Three successive flocks of turkey poults experienced cumulative mortality of 10% to 26% through the fifth week of brooding. Stray electrical voltage was suspected after no definitive laboratory diagnosis could be made and no evidence of management deficiency was found. Alternating current voltages of 0.2 to 2.5 volts were detected between waterers and the floor and between the water line and gas line. When the water line was equipment-grounded to the electrical service entrance, the subsequent flock had no mortality problem. A series of experiments was conducted to determine the sensitivity of turkey poults to alternating current. Based on these experiments, the voltage levels measured at the farm probably did not cause the mortality experienced in the three flocks. The reason for the farm problem could have been 1) the poults experienced higher voltage than was present when measurements were taken, 2) the voltage may have been intermittent, or 3) there was a difference between the farm environment and the cage battery environment in the experiments. PMID- 2775103 TI - College training and examinations. PMID- 2775104 TI - Post-concussional syndrome (PCS) PMID- 2775105 TI - Psychoanalysis: a creed in decline. PMID- 2775106 TI - Community treatment orders. PMID- 2775107 TI - Psychiatry in the community. PMID- 2775108 TI - Aboriginal deaths in custody. PMID- 2775110 TI - Transformations of narcissism. AB - The self's contrary needs for separateness and for belonging are introduced as a significant polarity in the developmental process, and one which narcissistic persons have failed to resolve in a particular way resulting in a sense of self distinction but with increasing alienation. Clinical material and material from literature are used to demonstrate this, as well as to raise the possibility that transformations of narcissism sometimes can occur quite quickly. The theoretical implications of this possibility are considered and Jungian ideas put forward as a possible explanation. Finally, brief consideration is given to the practical consequences for therapy that could follow if this understanding has some validity. PMID- 2775109 TI - Validity of the GHQ-28 in New Zealand women. AB - The GHQ-28 was validated against the short PSE in a New Zealand community study of female psychiatric morbidity. The GHQ-28 total scores were significantly correlated with the PSE scores. Higher coefficients were obtained using the scoring method of Goodchild and Duncan-Jones than with the standard scoring method. In this data set, the 3/4 cutoff had the best sensitivity and specificity. The correlations of the GHQ-28 subscales with ICD diagnostic classes and ad hoc PSE sub-scores were also statistically significant. Because the distribution of the GHQ-28 scores is positively skewed, non-parametric statistics may be preferable to the traditional Pearson's correlation coefficient. Overall, the results from this study confirm the GHQ-28 to be a valid and practical screen for presence or absence of psychiatric disorder in New Zealand women. PMID- 2775111 TI - Predicting child abuse and neglect in New Zealand. AB - We describe the three stages of our attempt to predict parenting problems and child abuse antenatally. In the first stage, we made an intuitive check list of ten items from 173 risk factors drawn from the literature. The check list was useful in predicting who would relinquish care or have major parenting difficulty in two different samples drawn four years apart and before and after some major sociocultural changes in New Zealand. In the second stage we used statistical techniques rather than intuition to maximise the predictive ability of the checklist and produced a new one of 9 items. In the third stage we validated the new list in a random sample of pregnant mothers. It was effective in predicting parenting difficulty in the 2 years after childbirth. We recommend it for routine use in a New Zealand setting. We do not know how useful the checklist will be in other cultural settings. PMID- 2775112 TI - Investigation of osteopaenia in anorexia nervosa. AB - Sixty-nine female patients, mean age 27.5 years (range 20-40), with a past or current history of anorexia nervosa (DSM III-R) had spinal trabecular bone density assessed by single energy quantitative CT scan. Current exercise and dietary calcium levels were assessed by detailed questionnaires and categorized. A semi-structured interview was used to record weight, menstruation, exercise and dietary calcium intake histories from early adolescence. Serum sex hormones and total calcium assays were measured. Bone density was significantly lower in the patients compared to 31 controls. Bone density was significantly positively correlated with body mass index, and negatively correlated with illness duration and duration of amenorrhoea. Exercise levels, dietary calcium intake and taking an oestrogen pill did not correlate significantly with bone density. Recovered patients did not have osteopaenia but they had shorter illness histories than non recovered patients. Management to minimise bone loss should focus on weight gain and resumption of normal menstruation. PMID- 2775113 TI - Alcohol-related problems in the emergency room of an Indian general hospital. AB - Alcohol-related problems made up 17.6% of the case load of psychiatric emergencies in an Indian general hospital. The police brought three-quarters of them, 45% for quarrels, street-fights and under influence of alcohol and 20% for minor offences like abusing in public. A psychiatric illness was definitely present in 40% of the cases. Only 10% of the patients with alcohol-related problems were referred for outpatient treatment. Eighty-five percent were not given any follow-up advice because the patients said they needed no help. PMID- 2775114 TI - Obsessive compulsive disorder: a sufferer's viewpoint. AB - This is a personal account of trying to live and cope with obsessive compulsive disorder (OCD) written primarily by a sufferer attending the Victorian OCD Support Group. It outlines some of the suffering and distress of having the disorder, some of the efforts and techniques used in trying to understand and cope with the disorder, the fortitude and endurance required, the difficulty in seeking and accepting treatment and some of the sufferer's hopes for a better future. PMID- 2775115 TI - The Armed Forces medical examiner system: a change for the better. AB - The armed forces of the United States of America maintain bases throughout the United States as well as in many other countries. The current situation with regard to the investigation of the approximately 2,500 non-combat deaths each year as well as other deaths occurring on military reservations in complex, confusing, and inconsistent at best. Under existing federal law, base commanders can order an autopsy on all active-duty personnel as well as on anyone dying within an area of exclusive federal jurisdiction. Base commanders unfamiliar with the law are often unwilling to order autopsies, and bodies may go to their graves leaving serious questions, such as cause and manner of death, unanswered. In an effort to rectify this situation, as well as to provide consistency in death investigations in the United States military, the Office of the Armed Forces Medical Examiner (AFME) is being established. The AFME will have its headquarters at The Armed Force Institute of Pathology (AFIP) in Washington, DC. All deaths coming under its jurisdiction will be reported in a timely manner and, when required, authorization for autopsy will be granted from the AFME. Regional deputy medical examiners will be appointed to perform autopsies and on-scene investigations. All cases and case materials will be reviewed and retained by the office of the AFME at AFIP. The quality of death investigation will be improved within the United States military by adoption of this system. PMID- 2775116 TI - Joint Committee on Aviation Pathology, fifteenth scientific session. Halton, United Kingdom, 7-9 October 1986. Proceedings. PMID- 2775117 TI - Bone scintigraphy in the evaluation of ejection injuries. AB - The Royal Air Force (RAF) experience on local back injury with all ejection seats is that 50% have vertebral fractures on radiographic examination, with or without symptoms. These aviators are placed under the care of an orthopedic specialist and restricted from flying duties for 3 months or more. About half of the remainder demonstrate positive bone scans. Until recently, RAF policy was to treat these individuals the same as those with radiographically defined fractures. The author recommends this group of pilots be examined by orthopedic surgeons, and reviewed annually to assess long-term sequelae. Meanwhile, if asymptomatic, they are allowed to return to flying duties. The RAF recently incorporated most of these recommendations into a policy change. PMID- 2775118 TI - An evaluation of proposed causal mechanisms for "ejection associated" neck injuries. AB - A major concern to the U.S. Navy has been the incidence of neck injuries sustained in aircraft ejections. Some of these injuries result in lost work days, some require specialized medical treatment and, occasionally, a neck injury is fatal. The net effect of such injuries is to increase the difficulty and cost of achieving specific levels of fleet operational readiness. At the same time, the occurrence of such injuries reduces aircrew confidence in the efficiency and safety of their escape systems. This study was the continuation of a study reported by one of the authors in 1983 (2), and this paper presents the current results in attempting to narrow the field of possible contributing factors and to possibly identify the more significant causal factors and mechanisms. PMID- 2775119 TI - The bite of Jesuits' bark. AB - Cinchonism is the well-known syndrome of quinine overdose involving disturbances of vision, hearing, and balance, which has occasional importance in aviation pathology, usually related to ingestion of tonic water. One study showed 100 mg of quinine taken in tonic water is sufficient to produce positional abnormalities of the electronystagmograph. Blood levels of quinine of about 0.2 mg.L-1 found at autopsy in pilots who died in aviation accidents in which positional cues seemed to be important suggest that quinine toxicity played a causative role. PMID- 2775120 TI - Place of biochemical tests in aircrew medical examinations. AB - The availability of sophisticated tests to quantify the function of various organs has led to the inclusion of a battery of biochemical tests in the medical examinations for aircrew. The purpose of these tests is to detect disease before it is clinically apparent so that its natural course may be altered by treatment. Even if no definitive treatment exists, the presence of a disease may alter an individual's aircrew status. A laboratory test is only useful if it answers questions that relate to patient management. The question addressed by each test should be clearly stated and the sensitivity and specificity of the test should be known. Unfortunately, many of the tests used do not suit the purpose for which they are employed as they lack efficiency. It is also important to understand how the tests may be set to influence the rate of false-positive and false-negative results. Most patients with positive tests may not have the target disorder and each will require a definitive evaluation and diagnosis. If we are unable to arrive at these diagnoses, our efforts in screening will be wasted; only aircrew will remain who have been told they might have something wrong with them, and a flight surgeon who does not know whether they are fit for flying duty or not! PMID- 2775121 TI - Probability of pathology. AB - The literature on population screening tests provides us with a well-developed statistical framework for identifying groups at risk of specific disease, taking account of the limitations of the test as a disease marker, the prevalence of the disease in the population being screened, and the relative costs of misclassification. This predictive value model has a relatively simple interpretation in the context of binary test variables (Test+/Test-). Its interpretation in the context of continuous test variables is less straightforward because we now have to draw a distinction between group risk associated with the test cut-off value, and the individual risk for a specific subject associated with his/her particular test value. Failure to appreciate this distinction can lead to a gross misinterpretation of the risk of disease for the individual test subject. PMID- 2775122 TI - Investigation of incidents of terrorism involving commercial aircraft. AB - Deaths resulting from terrorism involving aircraft have occurred incident to hijackings as well as bombings. Passengers or groups of passengers have been chosen by terrorists as the recipients of violence based on citizenship, religion, and political beliefs. They have usually been segregated from other passengers and subsequently mistreated and/or murdered. Thorough documentation of the injuries of victims is essential to the investigation of such atrocities; a medicolegal autopsy correlated with a scene investigation is of paramount importance. Aircraft bombings can create extremely sensitive political situations and public demands for quick resolution. The autopsy of victims in such circumstances, if properly conducted, can yield invaluable trace evidence leading to the identification of the explosive device. The examination of any surviving victims as well as the aircraft is also critical in reconstructing the event. Deaths occurring as the result of in-flight aircraft bombings can produce injuries by five different mechanisms, viz. blast, shrapnel, decompression, impact with the aircraft, and ground impact. PMID- 2775124 TI - The role of forensic anthropology in mass disaster resolution. AB - On Dec.12, 1985, a military charter DC-8 crashed shortly after takeoff at Gander, Nfld., Canada. All 256 aboard were killed, making this the deadliest U.S. military aircraft accident in history. The investigation team (consisting of forensic pathologists, odontologists, radiologists, anthropologists, graves registration personnel, and systems engineers) succeeded in identifying the remains of all 248 manifested passengers and 8 crewmembers. The unique contribution of anthropology necessitates that a forensic anthropologist be included in all phases of casualty resolution from recovery and initial processing to final evaluation, rather than being summoned as a last resort. This approach would yield immediate information on "unknowns" and would eliminate subsequent duplication of effort. PMID- 2775123 TI - An air photo analysis of an airplane crash. AB - Crash patterns-such as cut and damaged vegetation, gouges, debris scatter, burn areas, etc.,-and their spatial relations can be very effectively evaluated by the analysis of stereo aerial photographs. Results from the Canadian Aviation Safety Board's use of aerial photography in the Gander, Nfld., crash of Dec. 12, 1985, show that the technique can lend direct support to an investigation in several ways. It provides an overall perspective view of the regional relations of the crash patterns. It helps direct ground activities. In three-covered areas, it can help establish aircraft attitude and orientation. When combined with debris plots and attitude determinations, it can help establish the breakup sequence. And, when coupled to photogrammetric procedures, it can assign dimensional values to attitude, descent path, areas, lengths, etc. PMID- 2775125 TI - Mass fatality aircraft disaster processing. AB - On Dec. 12, 1985, a contract transport carrying 248 U.S. Army personnel crashed on takeoff at Gander, Nfld., Canada, killing all the passengers as well as the crew of eight. This was the worst aircraft accident in U.S. military history and, at the time was the fifth worst accident in aviation history. Cooperation between the governments of Canada and the United States allowed for the transport of all human remains to the U.S. Air Force mortuary facility at Dover AFB, DE, where they were processed, identified, and ultimately returned to their families for burial. Under ideal circumstances, any medical examiner's office or mortuary facility would be overwhelmed by a mass disaster of this magnitude. Before the arrival of the first shipment of bodies, a concerted planning effort was undertaken and the facility arranged so that remains would pass in a logical sequence through a series of 10 "work stations." This report details the process and outlines the logistics of the operations. PMID- 2775126 TI - U.S. Army anthropometric standards for rotary-wing aviators in the light observation helicopter. AB - U.S. Army anthropometric standards for rotary-wing aviators were examined to determine if the standards allowed an adequate fit of the aviator to the cockpit of the OH-58A "Kiowa" light observation helicopter, which now comprises the overwhelming majority of light helicopters in the active army and reserve forces. Thirty rated aviators with heights less than or equal to 70 in. were examined, and standard anthropometric measurements were made. Army regulations require these measurements on all initial-entry aviation students with heights less than or equal to 68 in. The aviators were then placed in a representative OH-58A cockpit to determine their ability to reach all control surfaces and panel switches. Several aviators greater than 68 in. tall and, therefore, not subject to anthropometric testing upon entry into army aviation, could not perform all cockpit tasks without cockpit changes beyond the limited adjustments in the OH 58A. Several had developed aid devices, especially pads to support forearm-to thigh "spot welds" to ensure right arm stability on the cyclic control. The same problem was seen with some aviators less than 68 in. in height, who had been anthropometrically evaluated. The present standards do not adequately address functional ability in the OH-58A cockpit, which is the least adjustable cockpit in the combat inventory. Design modifications to accommodate these factors exist and should be used to retrofit existing aircraft and to design future aircrafts. PMID- 2775127 TI - Failing aviator syndrome: a case history. AB - The "human factor" has long been recognized as the cause, or the contributing cause, of most aircraft mishaps. Frequently, the mishap aviator may be overstressed emotionally to the point that he makes errors of judgment, either by omission or commission. Occasionally, an educated observer can recognize this "failing aviator" before the mishap. This paper discusses the characteristics of the failing aviator syndrome and presents the case history of one who should have been recognized before the mishap. PMID- 2775128 TI - Descriptive analysis of medical attrition in U.S. Army aviation. AB - Although U.S. Army aviators are carefully screened at entry, disease develops in the aviator population with time. Improving the ability to predict and prevent such diseases necessitates proper analysis of their incidence. This information can provide the basis for future improvements in screening and prevention. A descriptive analysis of diseases for the U.S. Army aviation population is presented. The frequency of international Classification of Diseases (ICD) codes leading to disqualification from flying status is summarized and discussed. Suggestions for future screening criteria and for intervention practices are proposed. PMID- 2775129 TI - Adjustment of sleep and the circadian temperature rhythm after flights across nine time zones. AB - The adjustment of sleep-wake patterns and the circadian temperature rhythm was monitored in nine Royal Norwegian Air-force volunteers operating P-3 aircraft during a westward training deployment across nine time zones. Subjects recorded all sleep and nap times, rated nightly sleep quality, and completed personality inventories. Rectal temperature, heart rate, and wrist activity were continuously monitored. Adjustment was slower after the return eastward flight than after the outbound westward flight. The eastward flight produced slower readjustment of sleep timing to local time and greater interindividual variability in the patterns of adjustment of sleep and temperature. One subject apparently exhibited resynchronization by partition, with the temperature rhythm undergoing the reciprocal 15-h delay. In contrast, average heart rates during sleep were significantly elevated only after westward flight. Interindividual differences in adjustment of the temperature rhythm were correlated with some of the personality measures. Larger phase delays in the overall temperature waveform (as measured on the 5th day after westward flight) were exhibited by extraverts, and less consistently by evening types. PMID- 2775130 TI - Detection efficiency on an air traffic control monitoring task with and without computer aiding. AB - Future levels of air traffic control automation will incorporate computer-aided features designed to alert the controller by displaying information that will identify upcoming problems and suggest solutions. Concerns have been expressed that reliance on such aids may lead to a reduced capacity by controllers to detect and respond to computer failure. The present study employed a simulated ATC monitoring task with a computer feature designed to detect possible aircraft conflicts. The ability of subjects to detect occasional failures of the computer feature in detecting problem situations was compared with detection efficiency for these same situations when no computer aiding was provided. The hypothesis that alertness would be lower and detection less efficient with computer aiding than when no aiding was employed was not supported. Applications and limitations of the findings to the problem of complacency in automated systems are discussed. PMID- 2775131 TI - Reduction of visually-induced motion sickness elicited by changes in illumination wavelength. AB - This experiment was undertaken to assess the degree of stimulus generalization in visually-induced motion sickness. Sixteen subjects participated in six sessions in which they were exposed to a rotating field of vertical stripes for five 4-min trials. This stimulus elicited the perception of self-vection. In the first three sessions, the stripes were illuminated by one monochromatic light (red or green) and in the last three sessions, the stripes were illuminated by the other monochromatic light. Magnitude estimates of motion sickness increased significantly within sessions, but the rate at which this measure increased was significantly diminished across trials in the last three-session block. Magnitude estimates of vection increased within sessions and decreased across sessions, but did not increase with color change. These results can be explained in terms of a model of stimulus generalization and have implications for the reduction of motion sickness in applied settings. PMID- 2775132 TI - Saccadic eye movements in response to visual, auditory, and bisensory stimuli. AB - Saccadic eye movements were recorded and analyzed from eight normal human subjects. Various visual, auditory, and bisensory (visual and auditory) targets were tracked. Primary saccade latency, amplitude, duration, and peak velocity were calculated, as well as overall saccade duration (total time spent making saccades) and final eye position. Saccades made to bisensory targets employing a constant-intensity auditory component were not different from the pure visual target responses. Saccades to bisensory targets having an intermittent auditory component (with sound onset synchronous with the visual component) demonstrated a significant reduction in latency (11.3%) compared to the visual responses. The reduction occurred both for a fixed overhead sound source and for a sound source moving with the visual component. This result indicates that providing an auditory motion or localization cue alone does not reduce latency, but that a sound onset cue facilitates response time. No other response parameters were enhanced by using bisensory targets. PMID- 2775133 TI - Protection provided against the initial responses to cold immersion by a partial coverage wet suit. AB - The protection provided against the initial responses to cold water immersion by a partial coverage wet suit was assessed. Eighteen subjects performed three 2-min immersions into water at 5 degrees C. During each immersion, the subjects wore either: a) cotton overall, b) trunk and arms "wet" immersion suit, or c) "dry" immersion suit. Results showed that the dry suit provided significantly (p less than 0.05) greater protection against the initial cardiac and ventilatory responses to immersion than either the wet suit or cotton overall assemblies. The responses recorded in the wet suit were similar to, and in some cases did not differ from, the cotton overall. We conclude that immersion suit design and tests should consider all of the responses associated with accidental cold water immersion and not just those resulting in a fall in core temperature. PMID- 2775135 TI - Performance and well-being under tilting conditions: the effects of visual reference and artificial horizon. AB - It is generally agreed that the incidence of motion sickness in sailors working below deck is higher than in sailors who have the horizon as a visual reference on the bridge. This study investigated the possible beneficial effect of a projected artificial horizon as a means to prevent seasickness. Twelve subjects were exposed to angular motion in a tilting room under three experimental conditions: a) With the windows covered, allowing no visual reference from the outside world; b) With the windows uncovered, thus allowing a partial view of the environment; and c) With the windows covered and a horizon projected on the walls by a rotating laser beam. Subjects were exposed for 35 min in each condition while performing different computerised tasks. There was a reduction in well being and performance as a function of exposure time. These effects were clearly shown in the "closed cabin" condition. There were less motion sickness symptoms in the "artificial horizon" and "window" conditions. The presence of a visual reference prevented the decrement in performance found in the "closed cabin" condition. The results of this study suggest that a projected horizon might alleviate motion sickness aboard naval vessels, and thus improve the performance of sailors at sea. PMID- 2775134 TI - Effects of acute sublethal gamma radiation exposure on aggressive behavior in male mice: a dose-response study. AB - The resident-intruder paradigm was used to assess the effects of gamma radiation (0, 3, 5, 7 Gray [Gy] cobalt-60) on aggressive offensive behavior in resident male mice over a 3-month period. The defensive behavior of nonirradiated intruder mice was also monitored. A dose of 3 Gy had no effect on either the residents' offensive behavior or the defensive behavior of the intruders paired with them. Doses of 5 and 7 Gy produced decreases in offensive behavior of irradiated residents during the second week postirradiation. The nonirradiated intruders paired with these animals displayed decreases in defensive behavior during this time period, indicating a sensitivity to changes in the residents' behavior. After the third week postirradiation, offensive and defensive behavior did not differ significantly between irradiated mice and sham-irradiated controls. This study suggests that sublethal doses of radiation can temporarily suppress aggressive behavior but have no apparent permanent effect on that behavior. PMID- 2775136 TI - Irregular nocturnal breathing patterns high altitude in subjects susceptible to high-altitude pulmonary edema (HAPE): a preliminary study. AB - We studied nocturnal breathing patterns and symptoms of acute mountain sickness (AMS) during trekking in the Japanese Alps (altitude: 2,760-2,920 m) for 4 d in five subjects susceptible to high-altitude pulmonary edema (HAPE-S-S) and five control volunteers. Breathing patterns were evaluated with the impedance plethysmograph, and symptoms of AMS were evaluated by the environmental symptoms questionnaire-III score for AMS of cerebral type (AMS-C score). In both groups, the percentage of time with periodic breathing significantly increased at high altitude and the percentage in controls was significantly higher than in HAPE-S-S on the second night. In four HAPE-S-S, other disordered breathing patterns, termed "irregular breathing," were observed frequently by night at high altitude. Irregular breathing patterns were characterized by irregularly repeated oscillatory or nonoscillatory clusters of breaths with augmented tidal volume, followed by expiratory pause, apnea, or hypoventilation of various durations. All controls did not show significant changes in AMS-C score, but four HAPE-S-S showed the increase in AMS-C score on the next morning after frequent irregular nocturnal breathing. There was significant correlation between the percentage of time with irregular nocturnal breathing and AMS-C score on the next morning. These results suggest that HAPE-S-S are prone to irregular nocturnal breathing patterns at high altitude, which is associated with the development of AMS, but it was not possible to determine whether these abnormal breathing patterns are a cause or an effect of AMS. PMID- 2775138 TI - A survey of U.S. Army aeromedical equipment. AB - Medical equipment is necessary to support patients requiring air transportation, but it may not be compatible with the aviation environment. Aircraft systems may cause errors in the functioning of medical equipment, or that equipment may interfere with the aircraft. Medical equipment has been tested, primarily for fixed wing aircraft, to military standards by the U.S. Air Force. This study reports 1986 and 1987 surveys which document the use of such equipment on U.S. Army medical evacuation aircraft and compares items in current use to the U.S. Air Force's test results. Of the 115 different nonissue items reported in use, 32 have been formally evaluated, and 9 of those were judged unacceptable for use on aircraft. Only two items reported in the survey were tested inflight in helicopters. The remaining 83 items have not been tested. Helicopters have unique requirements, and the U.S. Army has begun a program to evaluate medical equipment for helicopter use. PMID- 2775137 TI - Incidence of airsickness among military parachutists. AB - This study describes the incidence of airsickness among military parachutists and analyzes the factors involved in its occurrence. Each of 45 healthy male subjects (28 students and 17 advanced parachutists) was studied. Each student participated in five parachute-jump exercises (one daily) and each advanced parachutist participated in one exercise only (proficiency). A questionnaire used for the diagnostic evaluation of motion sickness symptoms was completed by the subjects after each training exercise. A positive diagnosis of airsickness was established for 64% of the students on their first jump and for 35% of the advanced paratroopers on their proficiency jump. By the fifth jump, only 25% of the students experienced airsickness. This suggests that some students developed tolerance to airsickness after five consecutive exposures to inflight vestibular stimulation. Airsickness among student and advanced paratroopers occurred during the transport flight. This can be attributed to vestibular stimulation resulting from the aircraft maneuvers and inflight air turbulence. PMID- 2775140 TI - Cases from the aerospace medicine residents' teaching file #32, Hyperbilirubinemia. PMID- 2775139 TI - Behavioural science and outer space research. AB - This paper notes the awakening interest of NASA in the potential inclusion of behavioural scientists in the U.S. space programme, but expresses the fear that unless a major shift occurs in the attitudes of some key personnel the outcome might not be as promising as otherwise possible. It mentions the complete neglect of psychological research in the Skylab studies, and, drawing from the analogous Antarctic situation of small group isolation, suggests a way in which leeway could be made ready for the pending long-duration and space-station projects. PMID- 2775141 TI - Selective processing of threat cues in anxiety states: a replication. AB - A replication of Mathews and MacLeod's (Behav. Res. Ther. 23, 563-569, 1985) study, using a modified Stroop task, confirmed that threat words selectively interfere with the colour-naming performance of generally anxious patients, compared with normal controls. Clearer evidence was obtained of a highly specific interference effect of threat words that were congruent with the predominant worries reported by anxious patients. However, there was no evidence of a subsequent recognition memory bias for the threat words in anxious Ss. These results are discussed in relation to findings from other recent experiments investigating attentional and memory biases for threat-related information in anxiety states, and their implications for cognitive theories of anxiety are considered. PMID- 2775143 TI - Prediction of outcome with group cognitive therapy for depression. AB - This paper tested a social-cognitive model of depressive episodes and their treatment within a predictive study of treatment response. Clinically depressed volunteers were given self-efficacy questionnaires and other measures before and after they were treated with cognitive therapy, and their progress was monitored over the succeeding 12 months. Improvements in depression during treatment were closely associated with self-efficacy regarding control of mood and with self monitored levels of negative cognition. Remission over the following 12 months was predicted by the initial response to treatment, by a shorter duration of the episode prior to treatment, and by a post-treatment assessment of self-efficacy regarding control of negative cognition. Self-efficacy remained a significant predictor after post-treatment depression scores and episode duration were entered in a prediction equation. However, a programme of additional treatment based on the depression model did not result in improved depression status. Apart from the failure of the additional treatment, the results are consistent with a social-cognitive model of depressive episodes that emphasises the role of self efficacy and skills regarding control of negative moods. PMID- 2775142 TI - Anxiety sensitivity and history of panic as predictors of response to hyperventilation. AB - In this study, we examined the effects of anxiety sensitivity on the response to hyperventilation in college students with and without a history of spontaneous panic attacks. Reiss et al.'s (Behav. Res. Ther. 24, 1-8, 1986) Anxiety Sensitivity Index and Norton et al.'s (Behav. Ther. 17, 239-252, 1986) Panic Attack Questionnaire were used to select Ss. Following five min of voluntary hyperventilation, high anxiety sensitivity Ss reported more anxiety and more hyperventilation sensations than did low anxiety sensitivity Ss. A history of panic was only associated with enhanced responding to hyperventilation in Ss with high anxiety sensitivity; low anxiety sensitivity Ss who had experience with panic were no more responsive than low anxiety sensitivity Ss who had never had a panic attack. These findings suggest that high anxiety sensitivity may be a crucial determinant of panic attacks provoked by biological challenges (e.g. hyperventilation, sodium lactate infusion). PMID- 2775144 TI - The impact of anxiety on visual attention to central and peripheral events. AB - Recent reports in the literature suggest that anxious individuals show an attentional bias to mood-congruent information. Various investigators have hypothesized that such anxiety-based coding biases contribute to the maintenance of mood disorders. The present study sought to determine if attentional biases in anxious subjects extends to the perception of neutral, as opposed to affect laden, stimuli. A procedure used to determine the locus of attention to foveal and peripheral visual events was used in combination with two inter-stimulus intervals, fixed and variable, to examine anxious and non-anxious subjects' attentional biases. Mood states were established by a well-validated musical induction procedure. The results revealed an attentional bias to foveal visual events in non-anxious subjects and an attenuated or reversed (peripheral) bias in anxious subjects. The clinical implications of these findings are discussed. PMID- 2775145 TI - Interparental conflict and adolescent problem behavior: an examination of mechanisms. AB - The purpose of the present study was to examine several competing hypotheses which have been utilized to explain the negative relationship between interparental conflict and child/adolescent problems. These mechanisms of operation have included modelling, genetic transmission, disrupted parenting, the role of perceptual/appraisal processes of the conflict, and an inhibition hypothesis. One hundred and forty-two young adolescents and their mothers served as subjects. Eighty were from intact families and 62 from recently divorced families. Data were collected from the perspective of the adolescent, mother, behavioral observer, and social studies teacher. The results indicated that intact and divorced samples had to be considered separately as different pathways contributed to adolescent behavior problems in the two samples. For externalizing problems, a direct path between interparental conflict and problem behavior existed for the divorced sample whereas an indirect path through the adolescent's perceptions of the conflict existed for the intact sample. The different context in which the interparental conflict occurred for the two samples was offered as an explanation of this difference. For internalizing problems a significant direct path existed between conflict and problem behavior for both samples; however, the indirect paths through the adolescent's perceptions and through poor parenting skills contributed only for the divorced sample. The results suggest that various mechanisms appear to operate in influencing how interparental conflict influences behavior problems of young adolescents. Both the type of problem examined and the marital status of the parents appear important in determining the relative impact of the mechanisms. Implications for the behavior therapist are noted. PMID- 2775146 TI - Role of cognitive appraisal in panic-related avoidance. AB - The present study examined several dimensions of panic cognitions to test whether panic appraisals predict phobicity among panic sufferers. Thirty-five patients meeting DSM-III-R criteria for panic disorder with minimal or no phobic avoidance were compared to 40 patients meeting DSM-III-R criteria for panic disorder with agoraphobia (severe). The two groups looked strikingly similar on measures of panic symptoms, panic frequency and panic severity. As expected, patients diagnosed as having panic disorder with agoraphobia reported significantly more depression and phobic avoidance than patients with PD. Striking differences emerged on each of the following panic appraisal dimensions: (a) anticipated panic, (b) perceived consequences of panic, and (c) perceived self-efficacy in coping with panic. In each case, patients with panic disorder and agoraphobia reported significantly more dysfunctional panic appraisals than patients with panic disorder and no avoidance. Of those panic appraisal dimensions studied, anticipated panic emerged as the most potent correlate of agoraphobic avoidance. These findings support the hypothesis that cognitive appraisal factors may play an important role in the genesis or maintenance of phobic avoidance among panic patients. PMID- 2775147 TI - Checking behavior in a threatening situation. AB - The purpose of the present study was to determine whether compulsive checking was associated with greater checking behavior and slower performance in a personally relevant and potentially threatening task. Students in an abnormal psychology class completed the Maudsley Obsessive-Compulsive Inventory and the Everyday Checking Behavior Scale early in the semester. One month later during the first examination they were asked to record the number of times they went over (checked) each exam question after first answering it. The amount of time taken by subjects to complete this and the final exam was also recorded. The MOCI-check subscale and ECBS were correlated with the number of answer checks. MOCI-check scores were also correlated with the time taken to complete each exam. It was suggested that the characteristic of indecisiveness may be responsible for these relationships. PMID- 2775148 TI - 'Fear of panic': an investigation of its role in panic occurrence, phobic avoidance, and treatment outcome. AB - The concept of 'fear of fear' has recently received empirical attention regarding its role in panic occurrence and phobic avoidance. Overall, the results of such studies have indicated that anticipation of panic is positively correlated (albeit weakly) with self-reports of avoidance. The present study examined the relationship of panic anticipation--panic occurrence, phobic avoidance and treatment outcome, using a more direct measure of this fear than has been used in previous studies. Results indicated that anticipation of panic was slightly correlated with breadth and severity of avoidance, and moderately correlated with overall clinical severity. In addition, anticipation of panic was found to decrease significantly throughout treatment, but appeared to be independent of actual panic experience. These results may suggest the operation of an intervening variable which accounts for the reduction of both anticipated and actual panic events. Implications for assessment and treatment are discussed. PMID- 2775149 TI - Qualitative dimensions of worry in DSM-III-R generalized anxiety disorder subjects and nonanxious controls. AB - Revisions to DSM-III cite apprehensive expectation or 'worry' as a defining feature of generalized anxiety disorder (GAD). The quality and focus of worry reported by groups of GAD patients (n = 19), and nonanxious 'controls' (n = 26) were examined using self-monitored data. Content categorizations by independent raters showed that GAD patients worried more about illness, health and injury issues and displayed a tendency to worry more about miscellaneous 'minor' issues. These descriptor ratings differentiated the worries of GAD patients from those of non-anxious controls: perceived control over worrying, the extent to which the worry was considered realistic, and perceived success with which worry was alleviated using corrective/preventative actions. The data are related to the DSM III-R criteria for GAD and to conceptualizations of the nature of excessive worry. PMID- 2775150 TI - The refractory headache patient--I. Chronic, daily, high intensity headache. AB - Two studies on patients with Chronic, Daily, High Intensity Headache (CDHIHA) are presented. In the first, their response to various self-regulatory (biofeedback, relaxation) treatments was compared to that of case controls matched for age, duration and Ad Hoc Committee diagnoses who had 1-2 headache-free days per week (Group II) and 3-5 headache-free days per week (Group III). The CDHIHA patients had a significantly poorer response to treatment (12.7 vs 49.8% improvement for Groups II and III combined). In the second study, the psychological profiles of an enlarged sample of CDHIHA patients were compared to matched case controls from Group II and Group III. The CDHIHA patients tended to be more anxious, more hysterical and to have more non-headache somatic complaints than Groups II and III combined. PMID- 2775152 TI - Social phobia: individual response patterns and the effects of behavioral and cognitive interventions. AB - In the present study, the role of individual response patterns in the treatment of social phobic patients was investigated. Seventy-four patients were diagnosed as social phobics. On the basis of extreme scores on a behavioral test (the Simulated Social Interaction Test) and on a cognitive measure (the Rational Behavior Inventory), the response patterns of 39 patients were analyzed, and the patients themselves were classified as either 'behavioral reactors' or 'cognitive reactors'. Half of the patients with each response pattern received a behavioral focused treatment, i.e. social skills training (SST), while the other half received a cognitive oriented treatment, i.e. rational emotive therapy (RET). Patients received group therapy in eight weekly sessions. Within-group differences showed a considerable improvement in all treatment groups. Between group differences failed to lend support to the hypothesis that treatment that fits a response pattern (i.e. SST for behavioral reactors and RET for cognitive reactors) will result in a greater improvement than one that does not. PMID- 2775151 TI - The refractory headache patient--II. High medication consumption (analgesic rebound) headache. AB - 'Analgesic rebound headache' is identified by habituation of an individual to pain reducing medication, the exacerbation of headache pain a few hours after medication consumption and a marked increase in headache frequency and intensity for several weeks after medication is discontinued. We describe three studies undertaken to clarify the existence and characteristics of this proposed headache syndrome. In Study 1 we compared a group of headache sufferers who consume large amounts of analgesic medications to headache sufferers who did not consume excessive analgesics. It was found that the two groups did not differ on age, duration of headache problem or gender. However, the groups did differ on subjective headache pain (with the high medicators experiencing more headache pain than low medicators) and diagnosis (with high medicators being more likely to have a muscle contraction component to their headaches). In an analysis of drug use within the high medication group, it was found that 91% were taking some kind of analgesic and that a majority (84%) were taking more than one type of medication. In Study 2 we found that the group of high medicators were not as successful in reducing headache activity as a result of a self-regulatory behavioral treatment as the matched controls. Furthermore, there was a direct relationship between reduction and treatment success in the high medication consuming population. Lastly, in Study 3 we examined the current psychological functioning of the two groups; no differences were found between the two groups indicating the lack of 'addictive' personality characteristics as an explanation for the high medicating population. These findings all support the existence of a sub-population of headache sufferers who consume excessive amounts of analgesic medication and who are relatively refractory to behavioral treatment. PMID- 2775153 TI - Cognitive-behavior therapy in the management of chronic, occupational pain of the upper limbs. AB - Forty five subjects who experienced chronic, occupational pain of the upper limbs were randomly assigned to one of three conditions; individual cognitive-behaviour therapy (ICBT), group cognitive-behaviour therapy (GCBT) and WLC. Significant benefits were found for both ICBT and GCBT on measures of anxiety, depression, coping strategies, impact on daily living, pain and distress caused by pain. These gains were not evident in the WLC and were maintained at the 6 month follow up Minimal difference was found between ICBT and GCBT on measures of pain and psychopathology, although client evaluation ratings at the end of treatment favoured ICBT. PMID- 2775154 TI - The hyperventilation syndrome in panic disorder, agoraphobia and generalized anxiety disorder. AB - The symptom complex of panic disorder and generalized anxiety disorder suggests an etiological role for hyperventilation. The present study investigates the overlap between DSM-III-R panic disorder, panic disorder with agoraphobia and generalized anxiety disorder with hyperventilation syndrome (HVS). The anxiety disorder diagnoses were based on a structured interview, and HVS syndrome (HVS). The anxiety disorder diagnoses were based on a structured interview, and HVS determined by the so-called hyperventilation provocation test (a brief period of voluntary hyperventilation with recognition of symptoms). The overlap rates with HVS were: 48% for panic disorder, 83% for panic disorder with agoraphobia and 82% for generalized anxiety disorder. However, a pilot study on transcutaneous monitoring of carbon dioxide tension leads us to question the validity of the voluntary hyperventilation method that we used to determine HVS-status. It is unclear whether hyperventilation plays an important role in panic and general anxiety, as our overlap findings suggest. For patients who recognize the symptoms induced by voluntary hyperventilation, the hyperventilation provocation procedure provides a therapeutic means of exposure to feared bodily sensations. PMID- 2775155 TI - Hyperventilation and anxiety in panic disorder, social phobia, GAD and normal controls. AB - Patients with DSM-III Agoraphobia, Panic Disorder, GAD, Social Phobia and normal controls underwent a series of experimental procedures and measures to determine whether panic attack patients show a greater tendency towards hyperventilation that is independent from their anxiety levels. Contrary to expectations, the Agoraphobia and Panic Disorder patients did not show significantly lower levels of expired pCO2 at rest than the other anxious or non-anxious groups. However, the panic attack patients did show significantly higher levels of anxiety and hyperventilatory symptoms during a hyperventilation test and during breathing 5% CO2 in air. A strong relationship was found between hyperventilatory symptoms and anxiety in all groups of patients and in the controls. On the basis of these results it was concluded that Agoraphobia and Panic Disorder patients do not show a unique tendency toward hyperventilation, but rather that their hyperventilatory symptoms and perhaps intermittent overbreathing episodes are a function of the high levels of anxiety they experience. PMID- 2775156 TI - The role of life events in the onset of panic disorder. AB - Twenty-five panic disorder patients and fifteen obsessive-compulsive patients are compared with regard to a number of Life Events over the last 12 months prior to onset of the disorder and additionally over the total life course up until onset of the disorder. Panic Disorder patients do not differ from obsessive-compulsive disorder patients in terms of the number of life events, they experience during the last year prior to onset of their disorder. However, over the total life course, Panic Disorder patients do seem to be exposed to more Life Events than obsessive-compulsive disorder patients. The findings are discussed in light of the existing literature. PMID- 2775158 TI - Thoughts provoked by pain. AB - Despite the growing interest in the cognitive component of chronic pain, little information has been collected on the variety of thoughts provoked by pain experience. A new assessment instrument (the Cognitive Evaluative Questionnaire- CEQ) has been utilized with 127 chronic pain patients and their cognitions classified into seven discrete clusters. The results confirm the heterogeneity of pain cognitions, the majority of which are likely to play a role in enhancing or perpetuating chronic pain. The relationship of these cognitions to chronic avoidance behavior is discussed. PMID- 2775157 TI - Bulimia nervosa and dietary restraint. AB - Patients with bulimia nervosa were compared with non-bulimic restrained and unrestrained eaters on several questionnaire and interview measures related to eating patterns, preoccupation with dieting and food, and general psychopathology. Bulimic subjects did not differ significantly from non-bulimic restrained eaters on measures of fear of weight gain, dietary restraint, and the Eating Disorders Inventory (EDI) subscales of Drive for Thinness and Body Dissatisfaction, although both groups scored significantly higher on these measures than unrestrained eaters. Subjects with bulimia nervosa differed significantly from both restrained and unrestrained eaters on the Eating Habits Checklist, the Beck Depression Inventory, the EDI total score and Interoceptive Awareness, Introversion and Bulimia subscales, the Three Factor Eating Questionnaire (TFEQ), Disinhibition subscale and the Symptom Checklist 90-revised version. These findings show that bulimic patients may be quite similar to their restrained, non-bulimic counterparts on dietary concern and ideals of slenderness and suggest the importance of including a restrained control group in attempts to isolate the variables that differentiate individuals with the clinical eating disorder from their peers who demonstrate normative discontent about body weight and shape. PMID- 2775159 TI - Frequency as a moderating variable in self-report measures of negative cognition. AB - Based on responses to the Distressing Thoughts Questionnaire, subjects' most frequent depressive and anxious cognitions were selected and compared with representative low frequency thought statements. The high frequency cognitions were more emotionally intense, uncontrollable and unacceptable than the low frequency thoughts. Although high frequency anxious items were rated as more frequent than high frequency depressive statements, no differences were evident in emotional intensity and controllability. Furthermore thoughts of loss and failure were specifically predictive of dysphoria only when high frequency cognitive items were utilized. The implications of these findings for cognitive assessment issues were discussed. PMID- 2775160 TI - An epidemic of fatal posterior paralysis and sudden death in goats: a case report. AB - An epidemy of fatal posterior weakness was observed in Norwegian dairy goats with a spontaneous character (high fever, collapse, death). Clinical, postmortem, and histopathological findings indicated gastroenteritis, liver damage (necrotic foci), soft kidneys, pneumonia, and depletion of liver glycogen in goats up to 4 months of age. In older animals there was a prevalence of muscle degeneration. Indigenous goats did not exhibit any mortality, whereas the mortality rate in male crosses Norwegian X Tanzanian was 100%, regardless of their age. In young goats, the existence of a high mortality infectious syndrome with enterotoxaemia and fever is suspected, whereas older goats were probably exposed to a non infectious myodegeneration. PMID- 2775162 TI - [The effect of light intensity and the length of time under natural daylight or artificial lighting on the seasonal fertility rhythm of swine]. AB - In 7 herds half of the sows of each service area have been illuminated, additionally to the natural daylight, with artificial light during 2 years (year 1: 100 1 x; year 2: 300 1 x). From 2965 services parameters of fertility of the natural and artificial light groups have been recorded and compared within and between herds as well as seasons. Seasonal variations of fertility, as reported by other authors, have been confirmed under natural and artificial light. Generally the results under additional artificial light were better in all seasons. The duration of daylight seems to be one of the main reasons for seasonal variations of fertility. During the period of April, May and June (increasing daylength from 13 h to 17 h, but moderate temperatures from 13 degrees C to 22 degrees C) fertility was most depressed, followed by the period of July, August and September (decreasing daylength from 17 h to 12 h, temperatures from 24 degrees C to 22 degrees C). The best fertility has been recorded during winter (October to March, less than 12 h daylength). In addition to increased light intensity a period of 12 h artificial lighting appears to be favourable in winter with less than 12 h natural daylength, but it is not effective during summer with daylengths longer than 12 h. In respect to these results reducing natural daylength to 12 h during summer maintaining sufficient light intensity might be useful. PMID- 2775161 TI - [Frequency and diagnosis of chronic changes in the mammary glands of sows (abattoir findings)]. AB - The mammary glands of 1000 slaughtered sows were examined with regard to defects in teats, skin and parenchyma. For its clinical importance it is to be emphasized that 23% of all sows showed symptoms of chronic mastitis (phlegmon, abscess, granuloma, fibrosis). It can be expected that a thorough examination of the porcine mamma during the stage of involution will discover disturbances of nursing, caused by lesions in the parenchyma or in the lactiferous ducts. PMID- 2775163 TI - [Recent treatment results in feeding-related calf diarrhea with special reference to diet and Diaproof K]. AB - Appearance of diarrhea was studied in 758 calves over a period of 6 years in the "Klinik fur Klauentierkrankheiten". The incidence of the disease varied each year between 19% and 48% with a mortality rate up to 3%. Different methods of feeding were chosen and proved. Good results were obtained giving sour colostrum twice in the first day, followed by five days feeding sour milk replacer continued afterwards with sour milk. In this case the diarrhea rate was 22%; in comparison to 41% caused by normal milk products. A shortened duration of unspecific diarrhea in calves (1-2 days) was seen when Diaproof K from Atarost, a dietetic powder, was administered. Diarrhea disease with bad health conditions need a specific treatment. PMID- 2775164 TI - [The surveillance of plant hygiene in the slaughtering process]. AB - Basing on inspections of slaughterhouses it was tried to judge the effectiveness of the hygiene supervision implemented by the legislation. The organization of the control, the technological process including abattoir constructions and operations, the general hygienic aspects with special regard to cleaning and disinfection were registered. It is clearly demonstrated by grave examples (eg. wrong organization, insufficient employment of staff, incomplete knowledge, illegal practices) that nowadays in spite of a few exceptions, the supervision of hygiene in abattoirs is fragmentary. Paying attention to the conceptions of EEC committees dealing already with systematic controls, it would be well done to establish already known systems at once in the plants. According to the meat hygiene regulations exclusively official veterinarians are competent for this field of activities. These have to take the actual scientific knowledge into consideration. PMID- 2775165 TI - [Myeloid leukemia in a Gottingen miniature swine]. AB - After giving a short review of the different types of leukosis in the pig a leukosis in a Gottingen miniature breeding sow is described. The clinical symptoms were nonspecific, the pathomorphological signs were characterized by hepato- and splenomegaly and leukotic changes in kidneys and lymph nodes. By means of hematologic examinations a chronic myeloic leukosis could be diagnosed. PMID- 2775166 TI - [Various heart arrhythmias in swine (short communication)]. AB - Heart arrhythmias were observed in 7 of 147 pigs suffering from heart and circulatory insufficiencies. Endocarditis valvularis and cardiomypathy were the dominant causes of the arrhythmias. Electrocardiographic abnormalities of the cases are discussed. PMID- 2775167 TI - Comparative DNA reassociation kinetics of cranes. PMID- 2775168 TI - Arylsulfatase and beta-glucuronidase expression in green sunfish, bluegill, and their reciprocal interspecific hybrids. AB - Fish arylsulfatases (arylsulfate sulfohydrolase; EC 3.1.6.1) were resolved into cationic arylsulfatase A-like (ARSA) and anionic arylsulfatase B-like (ARSB) fractions by DEAE-Sephacel chromatography. Green sunfish (GSF) hepatic ARSA was more acidic and more thermostable than bluegill (BG) ARSA. GSF x BG interspecific hybrids preferentially expressed GSF ARSA, while BG x GSF hybrids appeared to produce a dimeric enzyme consisting of both GSF and BG ARSA polypeptides. GSF hepatic beta-glucuronidase (GUS) also proved to be more thermostable than BG GUS. Thermostabilities of GUS produced by reciprocal interspecific hybrids were very similar to that of GSF GUS. Either GSF GUS is preferentially expressed in both interspecific hybrids or both the GSF and BG GUS polypeptides are synthesized in comparable amounts, and the GSF GUS polypeptide sufficiently stabilizes the heterotetramers produced by the hybrids to produce denaturation profiles closely approximating that of the GSF enzyme. PMID- 2775169 TI - Linkage relationships of gene loci in the Medaka, Oryzias latipes (Pisces: Oryziatidae), determined by backcrosses and gynogenesis. AB - Linkage relationships of 11 enzyme loci and 2 visible mutant loci were investigated in the Medaka, Oryzias latipes, using backcrosses and gynogenesis. Results of four crosses for three loci were not in agreement with the Mendelian expectation of a 1 homozygote:1 heterozygote segregation ratio. Some locus pairs showed a significant excess of parental types at the 5% confidence limit. At the 1% confidence limit, however, results of all locus pairs analyzed showed nonsignificance. The results of sex-linked locus tests showed that no loci were sex linked at the 1% confidence limit. Under complete interference conditions, gene-centromere distances (cM) were as follows: Me, 2.6; Adh, 10; Sod, 17; Sdh, 18; Pgm, 31; Ck-A, 31; Gpdh, 32; Pgd, 45; Amy, 47; and Ldh-A, 50. High heterozygous fractions observed for Pgd, Amy, and Ldh-A suggest that exactly one crossover happened between these genes and their centromeres and that strong interference exists in chromosomes carrying these loci. PMID- 2775170 TI - Genetic differences in zinc and copper induction of liver metallothionein in inbred strains of the mouse. AB - Differences in Zn-induced levels of hepatic metallothionein (MT) in inbred strains of the mouse are described. Three low-producing strains, C57 BL/6, C57BL/10, and NIH, are identified, while C3H and CBA display the highest levels of hepatic MT following Zn treatment. These interstrain differences affect not only the level of MT protein, but also the amount of MT-bound Zn and the total hepatic Zn concentration. Both MT isoforms are equally affected. A similar interstrain difference following Cu treatment is present in C3H and C57BL/6. The origin of these interstrain differences is discussed. PMID- 2775171 TI - Cytosolic thymidine kinase activity in cultured human fibroblasts from individuals with galactokinase deficiency. AB - The structural genes for human galactokinase (GALK) and the human cytosolic form of thymidine kinase (TK1) are located on 17q21-q22. These two loci are tightly linked, and studies on Chinese hamster cell lines have shown that the expression of TK1 and GALK genes may alter simultaneously. We investigated the possibility of a dependent mutation of TK1 and GALK genes in cultured fibroblasts, obtained from two patients homozygous for the GALKG-deficient gene. Since we showed that the TK1 level varies as a function of the passage and the growth rate of a given strain, our experiments were performed on nonstored skin fibroblasts, between the third and the fifth passage for both controls and patients. We found that TK1 levels in GALK-deficient cells were almost 75% of those observed in control strains with a similar growth rate. Previous results in the literature have shown a pronounced decrease in TK1 activity in three GALK-deficient fibroblastic strains. We suggest that these disparities of TK1 levels in GALK-deficient fibroblasts may be related either to genetic heterogeneity of GALK deficiency or to differences in culture conditions. PMID- 2775172 TI - Characterization of embryo globulins encoded by the maize Glb genes. AB - Two of the most abundant proteins in maize embryos are saline-soluble, water insoluble globulins. One is a Mr 63,000 protein encoded by the Glb1 gene and the other is a Mr 45,000 component encoded by the Glb2 gene. Both proteins accumulate to high levels during embryo development and are rapidly degraded during the early stages of seed germination. Amino acid composition analysis indicates that these proteins may serve as storage reserves to provide sources of nitrogen and carbon to the germinating embryo. Amino-terminal sequence analysis of the final Glb1 gene product, GLB1, and its immediate precursor, GLB1', indicates that the latter is proteolytically cleaved near the amino terminus to form GLB1. In addition to these biochemical studies, we describe the identification of a novel maize variant which lacks the protein product of the Glb2 gene. PMID- 2775173 TI - Identification of the trans-stilbene oxide-active glutathione transferase in human mononuclear leukocytes and in liver as GST1. AB - A glutathione transferase from human mononuclear leukocytes with a high activity toward trans-stilbene oxide (GT-tSBO) has been studied in liver and blood from fetus and adults and in blood from neonates. Using starch gel electrophoresis, different phenotypes of GST1 have been determined, GST1 0, GST1 1, and GST1 2. As judged from activity measurements and the fact that only those individuals who express the null allele of GST1, the GST1 0, which has a low activity toward trans-stilbene oxide, it is concluded that the hepatic transferase GST1 is identical to GT-tSBO, as well as to hepatic transferase mu. In addition, it has been shown that the different genotypes of GST1 1 (GST1 1-1, GST1 1-0) and GST1 2 (GST1 2-2, GST1 2-0) can be separated by measuring the GT-tSBO activity in whole blood from the same individual. It is also demonstrated that GT-tSBO activity is much lower in fetal liver, approximately 10 times, compared with adult liver, while this activity seems to be unchanged in the blood from fetus and adults, as well as in neonates. PMID- 2775174 TI - Purification and characterization of rat liver glycosylasparaginase. AB - 1. Rat liver glycosylasparaginase [N4-(beta-N-acetylglucosaminyl)-L-asparaginase, EC 3.5.1.26] was purified to homogeneity by using salt fractionation, CM cellulose and DEAE-cellulose chromatography, gel filtration on Ultrogel AcA-54, concanavalin A-Sepharose affinity chromatography, heat treatment at 70 degrees C and preparative SDS/polyacrylamide-gel electrophoresis. The purified enzyme had a specific activity of 3.8 mumol of N-acetylglucosamine/min per mg with N4-(beta-N acetylglucosaminyl)-L-asparagine as substrate. 2. The native enzyme had a molecular mass of 49 kDa and was composed of two non-identical subunits joined by strong non-covalent forces and having molecular masses of 24 and 20 kDa as determined by SDS/polyacrylamide-gel electrophoresis. 3. The 20 kDa subunit contained one high-mannose-type oligosaccharide chain, and the 24 kDa subunit had one high-mannose-type and one complex-type oligosaccharide chain. 4. N-Terminal sequence analysis of each subunit revealed a frayed N-terminus of the 24 kDa subunit and an apparent N-glycosylation of Asn-15 in the same subunit. 5. The enzyme exhibited a broad pH maximum above 7. Two major isoelectric forms were found at pH 6.4 and 6.6. 6. Glycosylasparaginase was stable at 75 degrees C and in 5% (w/v) SDS at pH 7.0. PMID- 2775175 TI - Changes in both acyl-CoA:cholesterol acyltransferase activity and microsomal lipid composition in rat liver induced by distal-small-bowel resection. AB - The acyl-CoA:cholesterol acyltransferase (ACAT) activity and lipid composition of hepatic microsomal membrane were investigated 6 weeks after both 50 and 75% distal-small-bowel resection (SBR). A significant decrease in hepatic cholesteryl ester levels was observed after SBR, with a significant increase in the cholesteryl ester content of the livers of 75% SBR compared with the 50% SBR. Hepatic total acylglycerols, free cholesterol and phospholipid levels were not modified after the surgical operation. Microsomal free cholesterol was increased after both 50 and 75% SBR. However, a decrease in both microsomal ACAT activity and cholesteryl ester levels were found in microsomes (microsomal fractions) of resected rats, both changes being higher after 75 than after 50% resection. The total phospholipid content of the microsomes did not change after the surgical operation. The microsomal phospholipid fatty acid composition indicated higher changes after 75 than after 50% SBR. These results demonstrated that, in resected animals: (1) the activity of the enzyme responsible for catalysing cholesterol esterification (ACAT) is decreased, and (2) hepatic microsomal free cholesterol does not appear to influence the activity of ACAT. PMID- 2775176 TI - Effects of sepiapterin and 6-acetyldihydrohomopterin on the guanosine triphosphate cyclohydrolase I of mouse, rat and the fruit-fly Drosophila. AB - The regulation of GTP cyclohydrolase I would lead to the regulation of tetrahydrobiopterin, an important cofactor for synthesis of neurotransmitters. In an attempt to extend a previous finding [Bellahsene, Dhondt, & Farriaux (1984) Biochem. J. 217, 59-65] that GTP cyclohydrolase I of rat liver is inhibited by subnanomolar concentrations of reduced biopterin and sepiapterin, we found that this could not be verified with the enzyme from mouse liver, fruit-fly (Drosophila) heads or, indeed, from rat liver. It was shown, however, that 12 microM-sepiapterin inhibited mouse liver GTP cyclohydrolase I. Another compound, namely 6-acetyldihydrohomopterin, was also employed in the present study to explore its effect on enzymes that lead to its synthesis in Drosophila and for effects on mammalian systems; at 2-5 microM this compound was shown to stimulate one form of mouse liver GTP cyclohydrolase I and then to inhibit at higher concentrations (40 microM). Neither sepiapterin nor 6-acetyldihydrohomopterin caused any effect on the Drosophila head enzyme. On the other hand, the sigmoid GTP concentration curve for the Drosophila enzyme may indicate a regulatory characteristic of this enzyme. Another report, on the lower level of GTP cyclohydrolase I in mutant mouse liver [McDonald, Cotton, Jennings, Ledley, Woo & Bode (1988) J. Neurochem. 50, 655-657], was confirmed and extended. Instead of having 10% activity, we find that the hph-1 mouse mutant has less than 2% activity in the liver. These studies demonstrate that micromolar levels of reduced pterins may have regulatory effects on GTP cyclohydrolase I and that a mouse mutant is available that has low enough activity to be considered as a model for human atypical phenylketonuria. PMID- 2775177 TI - Evidence that activation of 2-deoxy-D-glucose transport in rat thymocyte suspensions results from enhanced coupling between transport and hexokinase activity. AB - 1. Suspensions of rat thymocytes accumulate free 2-deoxy-D-glucose (2-dGlc) within the cytosol to a concentration approx. 25-fold above the external concentration. This active accumulation was enhanced by 40 nM-phorbol 12 myristate 13-acetate (phorbol). 2. The Km for zero-trans uptake in control cells was 2.3 +/- 0.14 mM and Vmax. was 0.41 +/- 0.08 mumol/min per 10(10) cells (n = 6). In cells treated with phorbol (40 nM) the Km for zero-trans uptake was 1.2 +/ 0.13 mM and Vmax. 0.46 +/- 0.03 mumol/min per 10(10) cells (n = 6). The Km was decreased significantly by phorbol (P less than 0.01). 3. Phorbol-dependent activation of thymocytes delayed exit of free 2-dGlc into sugar-free solution and prevented exchange exit. Activation had no effect on 3-O-methyl D-glucoside (3 OMG) exit. 4. Coupling of 2-dGlc transport to hexokinase activity was determined by observing the effects of various concentrations of unlabelled cytosolic 2-dGlc on influx of labelled 2-dGlc into the hexose phosphate pool. In control cells this coupling was 0.81 +/- 0.02 and in phorbol-activated cells it was 0.92 +/- 0.01 (P less than 0.01). 5. The high-affinity inhibitor of hexokinase, mannoheptulose, inhibited uptake of 2-dGlc in both control and phorbol-treated cells. These data are consistent with a model for activation of sugar transport in which hexokinase activity is integrated with the sugar transporter at the endofacial surface. The results suggest that phorbol increases the degree of coupling transport with hexokinase activity, thereby leading to an increase in the rate of uptake of 2-dGlc, a decrease in exit of free 2-dGlc from the cytosol and an increase in free 2-dGlc accumulation. PMID- 2775179 TI - Reaction of Woodward's reagent K with D-xylose isomerases. Modification of an active site carboxylate residue. AB - D-Xylose isomerases from Streptomyces violaceoruber, Streptomyces sp., Lactobacillus xylosus, Lactobacillus brevis and Bacillus coagulans were rapidly inactivated by Woodward's reagent K. Second-order rate constants in the absence of ligands, at pH 6.0 and 25 degrees C, were 41, 36, 22, 95 and 26 M-1.min-1 respectively. Spectral analysis at 340 nm revealed that inactivation was correlated with modification of five, six, two, three and six carboxylate residues per monomer respectively. In the presence of protecting ligands, modification of one carboxylate group was prevented. The results support the idea of an active site glutamate or aspartate group that may contribute to the catalytic activity of all these D-xylose isomerases. PMID- 2775178 TI - Transport and accumulation of 2-deoxy-D-glucose in wild-type and hexokinase deficient cultured Chinese-hamster ovary (CHO) cells. AB - Hexokinase-deficient mutants and wild-type Chinese-hamster ovary cells have been used to investigate the role of hexokinase in uptake and accumulation of 2-D deoxyglucose (2-dGlc). The evidence for a specific sugar transport system in both types of cells is that there is similar saturable phloretin-sensitive uptake of 2 dGlc and 3-O-methyl-D-glucose (3-OMG) in both types of cell. In wild-type cells, 2-dGlc is accumulated to a tissue:medium ratio of 10- and in the mutant only 3 fold; 3-OMG is not accumulated by either mutant or wild-type cells. The evidence that hexokinase affects the membrane transport process is that the rate of exit of free 2-dGlc from wild-type cells is 5-fold less than from mutant cells, whereas there is no difference in the rate of loss of 3-OMG between mutant and wild-type cells. PMID- 2775180 TI - Primary structure of a dimeric haemoglobin from the deep-sea cold-seep clam Calyptogena soyoae. AB - The heterodont clam Calyptogena soyoae, living in the cold-seep area of the upper bathyal depth of Sagami Bay, Japan, has two homodimeric haemoglobins (Hb I and Hb II) in erythrocytes. The complete amino acid sequence of 136 residues of C. soyoae Hb II was determined. The sequence showed low homology with any other globins (at most 20% identity) and lacked the N-terminal extension of seven to nine amino acid residues characteristic of all the molluscan haemoglobins sequenced hitherto. Although the subunit assembly of molluscan haemoglobin is known to be 'back-to-front' relative to vertebrate haemoglobin, C. soyoae Hb II is unlikely to undergo such a subunit assembly because it lacks homology in the sequence involving subunit interaction. These structural features suggest that C. soyoae haemoglobin may have accomplished a unique molecular evolution. The distal (E7) histidine residue of C. soyoae Hb II is unusually replaced by glutamine. However, the oxyhaemoglobin is stable enough to act as an O2 carrier, since the autoxidation rate at near physiological temperature (3 degrees C) is about 3 times lower than that of human haemoglobin at 37 degrees C. H.p.l.c. patterns of peptides (Figs. 5-7), amino acid compositions of intact protein and peptides (Table 1) and amino acid sequences of intact protein and peptides (Tables 2 and 3) have been deposited as Supplementary Publication SUP 50150 (11 pages) at the British Library Document Supply Centre, Boston Spa, Wetherby, West Yorkshire LS23 7BQ, U.K., from whom copies may be obtained on the terms indicated in Biochem. J. (1989) 257, 5. PMID- 2775181 TI - Hypophysectomy does not alter the acinar zonation of gluconeogenesis or the mitochondrial redox state in rat liver. AB - The biochemical and functional heterogeneity of hepatocytes in different zones of the liver acinus may be related to the concentrations of hormones within the liver acinus. We examined the effects of hypophysectomy, which causes marked changes in plasma hormone levels and in activities of hepatic enzymes that are normally heterogeneously distributed, on the degree of metabolic zonation within the liver acinus. In hypophysectomized rats the activity of alanine aminotransferase was increased, but its normal zonation (predominance in the periportal zone) was preserved. The activity in cultured periportal and perivenous hepatocytes was increased by dexamethasone, but not by glucagon. Periportal hepatocytes from hypophysectomized rats expressed higher rates of gluconeogenesis in culture than did perivenous hepatocytes, irrespective of the absence or presence of dexamethasone, glucagon or insulin. Similar differences in rates of ketogenesis and in the mitochondrial redox state in response to glucagon were observed between periportal and perivenous hepatocytes from hypophysectomized rats as between cell populations from normal rats. Although hypophysectomy causes marked changes in hepatic enzyme activities, it does not alter the degree of zonation of alanine aminotransferase, gluconeogenesis or the mitochondrial redox state within the liver acinus. PMID- 2775182 TI - Effects of ischaemia, blood loss and reperfusion on rat muscle protein synthesis, metabolite concentrations and polyribosome profiles in vivo. AB - In adult rat gastrocnemius muscles, on reperfusion after 45 min of tourniquet ischaemia, protein synthetic rates were depressed by over half for 1 h compared to normal (12%/day), and were at least one-third below normal for up to 5 h afterwards. Ischaemia caused muscle concentrations of phosphocreatine to be depressed by 70%, and those of lactate to be elevated by 350%; the proportion of ribosomes as polyribosomes was decreased by half. Unlike the rates of protein synthesis, all of these variables returned to normal after 35 min of reperfusion. When 25% of the blood volume was removed (for 10-45 min), there were falls in the rate of gastrocnemius protein synthesis and in phosphocreatine concentration, and an increase in lactate concentration. On blood replacement, protein synthesis and metabolite concentrations returned to normal within 15 min. Polyribosome profiles were unaffected by blood loss or replacement. There were highly significant correlations between the rate of gastrocnemius protein synthesis and both phosphocreatine concentration and 1/(lactate concentration), during blood loss and replacement, i.e. during both the fall and rise in muscle energy status. We conclude that the effects of ischaemia and blood loss on protein synthesis are not equivalent. PMID- 2775183 TI - Lysophosphatidylcholine metabolism and lipoprotein secretion by cultured rat hepatocytes deficient in choline. AB - The metabolism of lysophosphatidylcholine was studied in cultured rat hepatocytes deficient in choline and methionine. Even though the cells were defective in phosphatidylcholine biosynthesis, the albumin-stimulated release of lysophosphatidylcholine (1.9 nmol/h per mg of cellular protein) was similar to that in hepatocytes supplemented with choline. Albumin also stimulated (1.4-fold) the release of phosphatidylcholine from the deficient cells. The extra phosphatidylcholine and lysophosphatidylcholine in the medium were largely recovered in the albumin fraction (density greater than 1.18 g/ml), suggesting that albumin released these lipids from hepatocytes because of binding to this protein. The secretion of glycerophosphocholine was decreased by about 40% by the addition of albumin. When choline-deficient hepatocytes were supplemented with lysophosphatidylcholine, it was transported into the cells and mainly acylated to form phosphatidylcholine, which increased in mass by 30-35% in the first 4 h of incubation. Lysophosphatidylcholine was shown to be as effective as choline in restoring the secretion of very-low-density lipoproteins to normal amounts, as judged by the secretion of triacylglycerol, phosphatidylcholine and the apolipoproteins associated with very-low-density lipoproteins. Thus phosphatidylcholine synthesis via reacylation of lysophosphatidylcholine, via the CDP-choline pathway or via methylation of phosphatidylethanolamine, will satisfy the requirements for secretion of very-low-density lipoprotein from hepatocytes. PMID- 2775184 TI - A luminometric assay for peroxisomal beta-oxidation. Effects of fasting and streptozotocin-diabetes on peroxisomal beta-oxidation. AB - 1. A luminometric assay for acyl-CoA oxidase activity is described. The assay uses the luminol/microperoxidase system to monitor continuously acyl-CoA dependent generation of H2O2. The assay is rapid, convenient, and lends itself to automation with an LKB 1251 luminometer. The assay is extremely sensitive, requiring at the most 10 micrograms of liver-homogenate protein per assay. 2. The assay can also be used to measure other oxidases, e.g. glycollate oxidase (EC 1.1.3.15), D-aspartate oxidase (EC 1.4.3.1) and urate oxidase (EC 1.7.3.3), the only modification being substitution of substrates to appropriate concentration. 3. With rat liver homogenates, spectrophotometrically measured rates of palmitoyl CoA-dependent NAD+ reduction and acyl-CoA oxidase activity [Hryb & Hogg (1979) Biochem. Biophys. Res. Commun. 87, 1200-1206] was generally found in good agreement with luminometrically measured acyl-CoA oxidase activity. 4. With liver homogenates from streptozotocin-diabetic rats, however, rates of palmitoyl-CoA dependent NAD+ reduction were consistently lower than the corresponding acyl-CoA oxidase activity. This difference was most marked with respect to luminometrically assayed acyl-CoA oxidase activity. PMID- 2775185 TI - Phosphoenolpyruvate carboxykinase from the moderate halophile Vibrio costicola. Purification, physicochemical properties and the effect of univalent-cation salts. AB - Phosphoenolpyruvate carboxykinase (PEPCK) was purified to homogeneity from the moderately halophilic bacterium Vibrio costicola. The enzyme is monomeric, with an Mr of 62,000, as determined by the Svedberg equation, by using values of s0(20,w) 4.4 x 10(-13) s, D20,w 6.13 x 10(-7) cm2.s-1 and v 0.719 cm3.g-1. Compared with other, non-halophilic, PEPCKs, the enzyme from V. costicola had a significantly lower total content of hydrophobic amino acids. The contents of glycine and serine were higher in the V. costicola enzyme (16.7 and 10.22% respectively) than in the non-halophilic PEPCKs (6.8-9.6% and 4.67-6.28% respectively). These results resemble those obtained by De Medicis & Rossignol [(1979) Experientia 35, 1546-1547] with the pyruvate kinase from V. costicola, and agree with the proposal by Lanyi [(1974) Bacteriol. Rev. 38, 272-290] of partial replacement of hydrophobic amino acids by glycine and serine to maintain the balance between hydrophobic and hydrophilic forces in halophilic enzymes. In agreement with this 'halophilic' characteristic, the PEPCK was somewhat stabilized by 1 M-KCl or -NaCl and by 20% (v/v) glycerol, and its oxaloacetate decarboxylation and 14CO2-oxaloacetate-exchange reactions were activated by KCl and NaCl up to 1 M, whereas the fixation of CO2 on PEP had a maximum at 0.025 0.05 M salt. These facts suggest that the salts, at concentrations probably physiological for the bacterium, increase the formation of the complex of oxaloacetate and ATP with the enzyme, and the liberation of the products, PEP and ADP, thus favouring PEP synthesis. PMID- 2775186 TI - Protoporphyrinogen oxidase as a molecular target for diphenyl ether herbicides. AB - Diphenyl ether herbicides induce an accumulation of protoporphyrin IX in plant tissues. By analogy to human porphyria, the accumulation could be attributed to decreased (Mg or Fe)-chelatase or protoporphyrinogen oxidase activities. Possible effects of acifluorfen-methyl on these enzymes were investigated in isolated corn (maize, Zea mays) etioplasts, potato (Solanum tuberosum) and mouse mitochondria, and yeast mitochondrial membranes. Acifluorfen-methyl was strongly inhibitory to protoporphyrinogen oxidase activities whatever their origins [concn. causing 50% inhibition (IC50) = 4 nM for the corn etioplast enzyme]. By contrast, it was roughly 100,000 times less active on (Mg or Fe)-chelatase activities (IC50 = 80 100 microM). Our results lead us to propose protoporphyrinogen oxidase as a cellular target for diphenyl ether herbicides. PMID- 2775187 TI - Rapid accumulation and sustained turnover of inositol phosphates in cerebral cortex slices after muscarinic-receptor stimulation. AB - The rapid kinetics of [3H]inositol phosphate accumulation and turnover were examined in rat cerebral-cortex slices after muscarinic-receptor stimulation. Markedly increased [3H]inositol polyphosphate concentrations were observed to precede significant stimulated accumulation of [3H]inositol monophosphate. New steady-state accumulations of several 3H-labelled products were achieved after 5 10 min of continued agonist stimulation, but were rapidly and effectively reversed by subsequent receptor blockade. The results show that muscarinic receptor activation involves phosphoinositidase C-catalysed hydrolysis initially of polyphosphoinositides rather than of phosphatidylinositol. Furthermore, prolonged carbachol stimulation is shown not to cause receptor desensitization, but to allow persistent hydrolysis of [3H]phosphatidylinositol bisphosphate and permit sustained metabolic flux through the inositol tris-/tetrakis-phosphate pathway. PMID- 2775188 TI - Localization of the 47 kDa phosphoprotein involved in the respiratory-burst NADPH oxidase of phagocytic cells. AB - A 47 kDa phosphoprotein is involved in the respiratory-burst oxidase of phagocytic cells. After stimulation of neutrophils with phorbol myristate acetate, this phosphoprotein was identified in both the cytosol and membranes. Peptide mapping of the two forms resulted in identical patterns of phosphopeptides. Dose-response curves for accumulation of phosphoprotein in the two sites were very similar, whereas the detection of the phosphoprotein in the cytosol preceded that in the membranes. The membrane-associated 47 kDa phosphoprotein was absent from the neutrophils of patients with X-chromosome linked chronic granulomatous disease, which lack cytochrome b-245, and intermediate levels were detected in the membranes of their heterozygote carrier mothers. Activation of the neutrophil oxidase system appears to be dependent upon phosphorylation of the cytosolic 47 kDa protein and its association with cytochrome b-245 in the membranes. It is probably the cytosolic factor required for reconstitution of the active oxidase in cell-free systems. PMID- 2775189 TI - A novel type of putrescine (diamine)-acetylating enzyme from the nematode Ascaris suum. AB - A cytosolic enzyme catalysing the acetylation of the diamines putrescine, cadaverine, 1,3-diaminopropane and 1,6-diaminohexane has been partially purified from reproductive tissue of the intestinal parasitic nematode Ascaris suum. The enzyme formed N-acetylated derivatives of the above diamines when incubated in the presence of acetyl-CoA. The Michaelis constants (Km) for the above diamines were 0.25 nM, 0.1 mM, 1.25 mM and 0.4 mM respectively, and the apparent Km for acetyl-CoA was 7.7 microM. sym-Norspermidine was also acetylated by this enzyme preparation, and, at a much lower rate, the enzyme acted on sym-norspermine. The common polyamines, spermidine and spermine, and histones were not substrates. Purification steps involved a freezing-and-thawing procedure to release enzyme activity from unknown inhibitors, DEAE-cellulose chromatography and affinity chromatography on cadaverine-Sepharose, from which the enzyme was eluted by increasing ionic strength. The enzyme exhibited an apparent Mr of about 38,000 40,000, and it consisted of at least two subunits, of which the catalytic one had an Mr of about 13,000. The partially purified enzyme showed no deacetylase activity, and its activity was competitively inhibited by the product N acetylputrescine, but not by CoA. The name putrescine N-acetyltransferase is suggested for this enzyme, which may have an important function in the degradation of diamines of lower eukaryotes. PMID- 2775190 TI - Characterization of the proteoglycogen fraction non-extractable from retina by trichloroacetic acid. AB - The trichloroacetic acid-insoluble 1,4-alpha-glucan fraction from bovine retina was purified and characterized. It is a proteoglycogen fraction containing a 42 kDa protein moiety similar in size to the protein moiety of the trichloroacetic acid-soluble proteoglycogen fraction. The apparent weight-average Mr of acid insoluble and acid-soluble proteoglycogens are 4.7 x 10(5) and 7.0 x 10(5) respectively. The present results support suggestions from earlier studies indicating that acid-insoluble proteoglycogen is the precursor of the acid soluble form. PMID- 2775191 TI - Synthesis of 2-aminoethylarsonic acid. A new synthesis of primary. AB - 2-Aminoethylarsonic acid was prepared from 2-choloethylarsonic acid. The route constitutes a new procedure for making primary amines from haloalkanes; chloride was displaced by treatment with 2-aminoethanol at 70 degrees C, and the product was converted into the required primary amine by treatment with periodate. PMID- 2775192 TI - Application of the synthetic method to other amines. AB - Taurine and 2-aminoethylphosphonic acid were synthesized by the method of the main paper [Geoghegan & Dixon (1989) Biochem. J. 260, 295-296], i.e. by treating the corresponding halo compound with 2-aminoethanol and then with periodate. PMID- 2775193 TI - Rat heart fatty acid-binding protein. Evidence that supports the amino acid sequence predicted from the cDNA. AB - The amino acid sequence of rat heart fatty acid-binding protein was re-examined by analysing the tryptic and the chymotryptic peptides, since some discrepancies have been reported between the sequences determined by protein analyses and that deduced from the cDNA analyses. Our result completely agreed with the amino acid sequence predicted from the cDNA analyses, providing evidence for the actual existence of the molecular species predicted from the cDNA. PMID- 2775194 TI - Interaction of chicken cystatin with inactivated papains. AB - Papain which was inactivated by covalent attachment of small substituents to the active-site cysteine, up to the size of a carbamoylmethyl group, bound with high affinity to chicken cystatin (Kd less than approximately 15 pM), although less tightly than did active papain (Kd approximately 60 fM). However, as the size of the substituent was increased further, the affinity decreased appreciably, generally in proportion to the size of the inactivating group. For instance the dissociation constants for papain inactivated with N-ethylmaleimide and [N-(L-3 trans-carboxyoxiran-2-carbonyl)-L-leucyl]-amido-(4-guanido )butane were 0.17 and approximately 10 microM respectively. The spectroscopic changes accompanying the reaction of all but the most weakly binding (Kd greater than or equal to 2 microM) inactivated papains with cystatin were similar to those induced by the active enzyme. Interactions involving the reactive cysteine residue of papain are thus not crucial for high-affinity binding of the enzyme to cystatin, in accordance with a recently proposed model for the enzyme-inhibitor complex, based on computer docking experiments. In this model there is sufficient space around the reactive cysteine in the complex for a small inactivating group, explaining the tight binding of papains with such substituents. However, larger inactivating groups cannot be accommodated in this space and therefore must displace the inhibitor out of the tight fit with the enzyme, in agreement with the observed decrease in binding affinity with increasing size of bulkier substituents. The kinetics of binding of cystatin to inactivated papains were compatible with simple, reversible, bimolecular reactions, having association rate constants of (7-9) x 10(6) M-1 s-1 at pH 7.4, 25 degrees C, similar to what was shown previously for the binding of cystatin to active papain. The rate of association of the inhibitor with either active or inactivated papain thus appears to be primarily diffusion-controlled. The decreasing affinity of cystatin for papains inactivated with groups of increasing size was shown to be due to progressively higher dissociation rate constants, consistent with the greater impairment of fit between the binding regions of the two molecules. PMID- 2775195 TI - Ganglioside GM3 sialidase activity in fibroblasts of normal individuals and of patients with sialidosis and mucolipidosis IV. Subcellular distribution and and some properties. AB - Sensitive assays for the determination of the ganglioside sialidase activity of fibroblast homogenates were established using ganglioside GM3, 3H-labelled in the sphingosine moiety, as a substrate. Ganglioside GM3 sialidase activity was greatly stimulated by the presence of the non-ionic detergent Triton X-100 and was further enhanced by salts such as NaCl; the optimal pH was 4.5. The subcellular localization of this activity was determined by fractionation using free-flow electrophoresis and found to be exclusively associated with the marker for the plasma membrane, but not with that for lysosomes. This Triton-stimulated ganglioside sialidase activity was selectively inhibited by preincubating intact cells in the presence of millimolar concentrations of Cu2+, suggesting that the activity resides on the external surface of the plasma membrane. In normal fibroblasts homogenates, ganglioside GM3 sialidase was also greatly stimulated by sodium cholate. In contrast to the Triton X-100-activated reaction, however, it was not diminished by prior incubation of intact cells in the presence of Cu2+. Only after cell lysis was Cu2+ inhibitory. the cholate-stimulated ganglioside sialidase activity thus paralleled the behaviour of the lysosomal 4 methylumbelliferyl-alpha-D-N-acetylneuraminic acid (4-MU-NeuAc) sialidase. In fibroblasts from sialidosis patients, the cholate-stimulated ganglioside GM3 sialidase activity, but not that of the Triton-activated enzyme, was profoundly diminished. In fibroblasts from patients with mucolipidosis IV (ML IV), both the Triton X-100- and the cholate-stimulated ganglioside GM3 sialidase activities were in the range of normal controls. The Triton-activated enzyme was associated with the plasma membrane in the same manner as in normal cells. Our findings suggest that, in human fibroblasts, there exist two sialidases that degrade ganglioside GM3: one on the external surface of the plasma membrane, and another that is localized in lysosomes and seems identical with the activity that acts on sialyloligosaccharides and 4-MU-NeuAc. As neither activity was found to be deficient in ML IV fibroblasts, our results argue against the hypothesis of a primary involvement of a ganglioside GM3 sialidase in the pathogenesis of ML IV. PMID- 2775197 TI - Steady-state kinetic analysis of the quinoprotein methylamine dehydrogenase from Paracoccus denitrificans. AB - A steady-state kinetic analysis was performed of the reaction of methylamine and phenazine ethosulphate (PES) with the quinoprotein methylamine dehydrogenase from Paracoccus denitrificans. Experiments with methylamine and PES as varied concentration substrates produced a series of parallel reciprocal plots, and when the concentrations of these substrates were varied in a constant ratio a linear reciprocal plot of initial velocity against PES concentration was obtained. Nearly identical values of V/Km of PES were obtained with four different n alkylamines. These data suggest that this reaction proceeds by a ping-pong type of mechanism. The enzyme reacted with a variety of n-alkylamines but not with secondary, tertiary or aromatic amines or amino acids. The substrate specificity was dictated primarily by the Km value exhibited by the particular amine. A deuterium kinetic isotope effect was observed with deuterated methylamine as a substrate. The enzyme exhibited a pH optimum for V at pH 7.5. The absorbance spectrum of the pyrroloquinoline quinone prosthetic group of this enzyme was also effected by pH at values greater than 7.5. The enzyme was relatively insensitive to changes in ionic strength, and exhibited a linear Arrhenius plot over a range of temperatures from 10 degrees C to 50 degrees C with an energy of activation 46 kJ/mol (11 kcal/mol). PMID- 2775196 TI - Co-ordinate induction of hepatic mitochondrial and peroxisomal carnitine acyltransferase synthesis by diet and drugs. AB - The present studies examined the effect of agents that induce peroxisomal and mitochondrial beta-oxidation on hepatic mitochondrial carnitine palmitoyltransferase (CPT) and peroxisomal carnitine acyltransferase [CPTs of Ramsay (1988) Biochem. J. 249, 239-245; COT of Farrell & Bieber (1983) Arch. Biochem. Biophys. 222, 123-132 and Miyazawa, Ozasa, Osumi & Hashimoto (1983) J. Biochem. 94, 529-542]. In the first studies, high fat diets containing corn oil or fish oil were used to induce peroxisomal and mitochondrial enzymes. Rats were fed one of three diets for 4 weeks: (1) low fat, with corn oil as 11% of energy (kJ); (2) high fat, with corn oil as 45% of kJ; (3) high fat, with fish oil as 45% of kJ. At the end of 4 weeks, both mitochondrial CPT and peroxisomal CPTs exhibited increases in activity, immunoreactive protein, mRNA levels and transcription rates in livers of rats fed either high-fat diet compared to the low fat diet. Riboflavin deficiency or starvation for 48 h also increased the peroxisomal CPTs mRNA. A second set of studies used the plasticizer 2 (diethylhexyl)phthalate (DEHP), 0.5% clofibrate or 1% acetylsalicylic acid (fed for 3 weeks) to alter peroxisomal and mitochondrial fatty acid oxidation. With DEHP, the mitochondrial CPT and peroxisomal CPTs activity, immunoreactive protein, mRNA levels and and transcription rate were all increased by 3-5-fold. The peroxisomal CPTs activity, immunoreactive protein, mRNA levels and transcription rate were increased 2-3-fold by clofibrate and acetylsalicylic acid, again similar to mitochondrial CPT. The results of the combined studies using both diet and drugs to cause enzyme induction suggest that the synthesis of the carnitine acyltransferases (mitochondrial CPT and peroxisomal CPTs) may be co ordinated with each other; however, the co-ordinate regulatory factors have not yet been identified. PMID- 2775198 TI - Omega-3 fatty acids increase the arachidonic acid content of liver cholesterol ester and plasma triacylglycerol fractions in the rat. AB - Recent studies have demonstrated that dietary fish oils rich in eicosapentaenoic acid (C20:5,omega 3) lower the content of arachidonic acid and its metabolites in plasma and tissue phospholipids. The present study examined the fatty acid composition of cholesterol ester and triacylglycerol fractions from plasma and livers of rats fed diets enriched with saturated fatty acids (beef tallow), alpha linolenic acid (linseed oil) or eicosapentaenoic acid (fish oil). Feeding diets containing linseed oil or fish oil for 28 days increased arachidonic acid (C20:4,omega 6) levels in the cholesterol ester fraction of liver and in the triacylglycerol fraction of the plasma lipids. Plasma cholesterol esters were depleted of C20:4,omega 6 after feeding of the diet containing either linseed oil or fish oil. The changes in C20:4,omega 6 content cannot be explained by alterations in cholesterol ester or triacylglycerol pools of plasma and liver. These results suggest that the decrease in phospholipid C20:4,omega 6 content generally observed after fish oil consumption may be partly due to a shift of C20:4,omega 6 from phospholipid to the triacylglycerol and/or cholesterol ester pools in the same tissue. Triacylglycerols and cholesterol esters may therefore play a buffering role in the homeostatic maintenance of tissue phospholipid levels of arachidonic acid. PMID- 2775200 TI - Identification of the core proteins in proteoglycans synthesized by vascular endothelial cells. AB - Proteoglycans, metabolically labelled with [3H]leucine and 35SO4(2-), were isolated from the spent media and from guanidinium chloride extracts of cultured human umbilical-vein endothelial cells by using isopycnic density-gradient centrifugation, gel filtration and ion-exchange h.p.l.c. The major proteoglycan species were subjected to SDS/polyacrylamide-gel electrophoresis before and after enzymic degradation of the polysaccharide chains. The cell extract contained mainly a heparan sulphate proteoglycan that has a buoyant density of 1.31 g/ml and a protein core with apparent molecular mass 300 kDa. The latter was heterogeneous and migrated as one major and one minor band. After reduction, the apparent molecular mass of the major band increased to approx. 350 kDa, indicating the presence of intrachain disulphide bonds. The proteoglycan binds to octyl-Sepharose and its polysaccharide chains are extensively degraded by heparan sulphate lyase. The proteoglycans of the medium contained 90% of all the incorporated 35SO4(2-). Here the predominant heparan sulphate proteoglycan was similar to that of the cell extract, but was more heterogeneous and contained an additional core protein with apparent molecular mass 210 kDa. Furthermore, two different chondroitin sulphate proteoglycans were found: one 200 kDa species with a high buoyant density (approx. 1.45 g/ml) and one 100 kDa species with low buoyant density (approx. 1.3 g/ml). Both these proteoglycans have a core protein of molecular mass approx. 47 kDa. PMID- 2775199 TI - The mobilization of ferritin iron by liver cytosol. A comparison of xanthine and NADH as reducing substrates. AB - Considerable evidence suggests that the release of iron from ferritin is a reductive process. A role in this process has been proposed for two hepatic enzymes, namely xanthine oxidoreductase and an NADH oxidoreductase. The abilities of xanthine and NADH to serve as a source of reducing power for the enzyme mediated release of ferritin iron (ferrireductase activity) were compared with turkey liver and rat liver homogenates. The maximal velocity (Vmax.) for the reaction with NADH was 50 times greater than with xanthine; however, the substrate concentration required to achieve half-maximal velocity (Km) was 1000 times less with xanthine than with NADH. NADPH could be substituted for NADH with little loss in activity. Dicoumarol did not inhibit the reaction with NADH or NADPH, demonstrating that the ferrireductase activity with those substrates was not the result of the liver enzyme 'DT-diaphorase' [NAD(P)H dehydrogenase (quinone)]. A flavin nucleotide was required for ferrireductase activity with rat and turkey liver cytosol when xanthine, NADH or NADPH was used as the reducing substrate. FMN yielded twice the activity with NADH or NADPH, whereas FAD was twice as effective with xanthine as substrate. Kinetic comparisons, differences in lability and partial chromatographic resolution of the ferrireductase activities with the two types of reducing substrates strongly indicate that the ferrireductase activities with xanthine and NADH are catalysed by separate enzyme systems contained in liver cytosol. Complete inhibition by allopurinol of the ferrireductase activity endogenous to undialysed liver cytosol preparations and the ability of xanthine to restore equivalent activity to dialysed preparations indicate that the source of reducing power for the endogenous activity is xanthine. These studies suggest that xanthine, NADH or NADPH can serve as a source of reducing power for the enzyme-mediated reduction of ferritin iron, with a flavin nucleotide serving as the shuttle of electrons from the enzymes to the ferritin iron. PMID- 2775201 TI - Primary structure of a novel 4-acetamido-4'-isothiocyanostilbene-2,2'-disulphonic acid (SITS)-binding membrane protein highly expressed in Torpedo californica electroplax. AB - Polyclonal rabbit antibodies were raised against 4-acetamido-4' isothiocyanostilbene-2,2'-disulphonic acid (SITS), an inhibitor of a variety of anion transport proteins. These antibodies specifically recognize SITS-reacted erythrocyte band 3 in immunoprecipitations and Western blots. In Western blots of SITS-reacted membrane proteins derived from vesicles of the electric organ of Torpedo californica (known to express a SITS-sensitive Cl- channel) the antibodies recognized two major species of approximately 93 kDa and approximately 105 kDa. The approximately 93 kDa protein was identified as the alpha-subunit of the Na,K-ATPase. The approximately 105 kDa protein (designated sp105) is a glycoprotein which binds to wheat-germ agglutinin and concanavalin A and is present as a disulphide-linked homodimer under non-reducing conditions. A partial amino acid sequence and a polyclonal antibody were used to clone the corresponding cDNA. sp105 is encoded in electroplax by two abundant mRNAs of approximately 6 and approximately 6.8 kb. A hybridizing mRNA of approximately 5 kb was over 200-fold and over 500-fold less abundant in brain and heart respectively. Sequence analysis of the cDNA predicted a novel protein of 697 amino acids containing eight potential N-linked glycosylation sites. Analysis of hydrophobicity indicated the presence of at least one, and possibly three, putative membrane-spanning domains. When expressed from the Sp6 message in Xenopus laevis oocytes, the protein was inserted into membranes, glycosylated and processed to form a dimer. However, no increase in 36Cl uptake or in membrane conductance could be detected. We found no effect of hybrid depleting the specific message on expression of the Torpedo electroplax Cl- channel in oocytes. Thus we conclude that this novel electroplax membrane protein is probably not a functional part of the chloride channel. PMID- 2775202 TI - The specific binding of the microtubule-associated protein 2 (MAP2) to the outer membrane of rat brain mitochondria. AB - Purified mitochondria from rat brain contain microtubule-associated proteins (MAPs) bound to the outer membrane. Studies of binding in vitro performed with microtubules and with purified microtubule proteins showed that mitochondria preferentially interact with the high-molecular-mass MAPs (and not with Tau protein). Incubation of intact mitochondria with Taxol-stabilized microtubules resulted in the selective trapping of both MAPs 1 and 2 on mitochondria, indicating that an interaction between the two organelles occurred through a site on the arm-like projection of MAPs. Two MAP-binding sites were located on intact mitochondria. The lower-affinity MAP2-binding site (Kd = 2 x 10(-7) M) was preserved and enriched in the outer-membrane fraction, whereas the higher affinity site (Kd = 1 x 10(-9) M) was destroyed after removing the outer membrane with digitonin. Detergent fractionation of mitochondrial outer membranes saturated with MAP2 bound in vitro showed that MAPs are associated with membrane fragments which contain the pore-forming protein (porin). MAP2 also partially prevents the solubilization of porin from outer membrane, indicating a MAP induced change in the membrane environment of porin. These observations demonstrate the presence of specific MAP-binding sites on the outer membrane, suggesting an association between porin and the membrane domain involved in the cross-linkage between microtubules and mitochondria. PMID- 2775204 TI - The unfolding and refolding of cytoplasmic aspartate aminotransferase from pig heart. AB - The unfolding of cytoplasmic aspartate aminotransferase from pig heart in solutions of guanidinium chloride (GdnHCl) was studied. Data from protein fluorescence, c.d. and thiol-group reactivity indicated that the enzyme was unfolded in 6 M-GdnHCl. Spectroscopic studies showed that this unfolding was accompanied by dissociation of the pyridoxal 5'-phosphate cofactor. On dilution of the GdnHCl, re-activation of the enzyme occurred in reasonable yield, provided that dithiothreitol and pyridoxal 5'-phosphate were present. The regain of activity obeyed second-order kinetics. In the absence of added dithiothreitol and pyridoxal 5'-phosphate, substantial formation of high-Mr aggregates occurred. PMID- 2775203 TI - DNA fragmentation in permeabilized cells and nuclei. The role of (Ca2+ + Mg2+) dependent endodeoxyribonuclease. AB - Permeabilized mammalian cells and isolated nuclei were used to study various aspects of DNA replication and repair. The present paper describes a progressive fragmentation of parental DNA in human lymphoblastoid cells that were permeabilized with L-alpha-lysophosphatidylcholine or with saponin and incubated at 37 degrees C in a DNA-synthesis mixture. The formation of DNA single-strand breaks (measured by alkaline elution) was linear with the time of incubation and was temperature-dependent. It was prevented by deleting Mg2+ or both Mg2+ and Ca2+ from the incubation mixture, or by the addition of EDTA. It was increased by deleting the components necessary for DNA synthesis, and by substituting Mn2+ for Mg2+ and Ca2+. DNA strand breaks also accumulated in isolated nuclei incubated in a DNA synthesis mixture, but not when Mg2+ was omitted. These results suggest that DNA fragmentation in permeabilized cells and nuclei was due to an activation of (Ca2+ + Mg2+)-dependent endodeoxyribonucleases. The integrity of template DNA needs to be ascertained when the conditions for measuring DNA synthesis in permeabilized cells or in nuclei are formulated. PMID- 2775205 TI - Photoaffinity labelling of isopenicillin N synthetase by laser-flash photolysis. AB - Isopenicillin N synthetase (IPNS) from Acremonium chrysogenum was photolabelled by laser-flash photolysis in the presence of a diazirinyl-containing substrate, 2 [3-(3-trifluoromethyl-3H-diazirin-3-yl)-phenoxy]acetyl-S- methyloxycarbonylsulphenyl-L-cysteinyl-D-valine (DCV). Labelling of IPNS by DCV is partially inhibited in the presence of an excess of L-alpha-aminoadipoyl-L cysteinyl-D-valine (ACV), the natural substrate. In the absence of light, DCV is converted into the corresponding penicillin with comparable Km but significantly depressed Vmax relative to ACV. Selective incorporation of [14C]DCV into IPNS has been demonstrated by fluorography of IPNS analysed by SDS/polyacrylamide-gel electrophoresis. Scintillation counting of labelled IPNS purified on an ion exchange f.p.l.c. column confirms this result. This methodology may be applicable for studies aimed at investigating the binding of substrates to IPNS. PMID- 2775206 TI - Effects of S-adenosyl-1,8-diamino-3-thio-octane and S-methyl-5' methylthioadenosine on polyamine synthesis in Ehrlich ascites-tumour cells. AB - The rate-limiting enzymes in polyamine biosynthesis, ornithine decarboxylase (ODC) and S-adenosylmethionine decarboxylase (AdoMetDC), are negatively regulated by the polyamines spermidine and spermine. In the present work the spermidine synthase inhibitor S-adenosyl-1,8-diamino-3-thio-octane (AdoDATO) and the spermine synthase inhibitor S-methyl-5'-methylthioadenosine (MMTA) were used to evaluate the regulatory role of the individual polyamines. Treatment of Ehrlich ascites-tumour cells with AdoDATO caused a marked decrease in spermidine content together with an accumulation of putrescine and spermine. Treatment with MMTA, on the other hand, gave rise to a marked decrease in spermine, with a simultaneous accumulation of spermidine. A dramatic increase in the activity of AdoMetDC, but not of ODC, was observed in MMTA-treated cells. This increase appears to be unrelated to the decrease in spermine content, because a similar rise in AdoMetDC activity was obtained when AdoDATO was given in addition to MMTA, in which case the spermine content remained largely unchanged. Instead, we show that the increase in AdoMetDC activity is mainly due to stabilization of the enzyme, probably by binding of MMTA. Treatment with AdoDATO had no effects on the activities of ODC and AdoMetDC, even though it caused a precipitous decrease in spermidine content. The expected decrease in spermidine-mediated suppression of ODC and AdoMetDC was most probably counteracted by the simultaneous increase in spermine. The combination of AdoDATO and MMTA caused a transient rise in ODC activity. Concomitant with this rise, the putrescine and spermidine contents increased, whereas that of spermine remained virtually unchanged. The increase in ODC activity was due to increased synthesis of the enzyme. There were no major effects on the amount of AdoMetDC mRNA by treatment with the inhibitors, alone or in combination. However, the synthesis of AdoMetDC was slightly stimulated in cells treated with MMTA or AdoDATO plus MMTA. The present study demonstrates that regulation of neither ODC nor AdoMetDC is a direct function of the polyamine structure. Instead, it appears that the biosynthesis of the polyamines is feedback-regulated by the various polyamines at many different levels. PMID- 2775207 TI - Rates of utilization of glucose, glutamine and oleate and formation of end products by mouse peritoneal macrophages in culture. AB - 1. The metabolism of mouse thioglycollate-elicited peritoneal macrophages was studied in culture for up to 96 h. 2. The rates of glycolysis, lactate formation and glutamine utilization were approximately linear with time for at least 80 h of culture. 3. The rates of glucose and glutamine utilization by cultured macrophages were approx. 500 and 90 nmol/h per mg of protein respectively. This rate of glucose utilization is at least 50% greater than that previously reported for macrophages during 60 min incubation in a shaking flask; and it is now increased by addition of glutamine to the culture medium. The rate of glutamine utilization in culture is similar to that previously reported for macrophages during 60 min incubation. The major end-product of glucose metabolism is lactate, and those of glutamine metabolism are CO2, glutamate, ammonia and alanine. 4. Oleate was utilized by these cells: 14C from [14C]oleate was incorporated into CO2 and cellular lipid. The highest rate of oleate utilization was observed when both glucose and glutamine were present in the culture medium. The presence of oleate in the culture medium did not affect the rates of utilization of either glucose or glutamine. Of the [14C]oleate incorporated into lipid, approx. 80% was incorporated into triacylglycerol and only 18% into phospholipid. 5. The turnover rate for the total ATP content of the macrophage in culture is about 10 times per minute: the value for the perfused isolated maximally working rat heart is 22. This indicates a high metabolic rate for macrophages, and consequently emphasizes the importance of the provision of fuels for their function in an immune response. PMID- 2775208 TI - Enzymic and metabolic adaptations in the gastrocnemius, plantaris and soleus muscles of hypocaloric rats. AB - 1. The effect of hypocaloric feeding (25% of normal food intake for 21 days) of rats on the enzymic and metabolic adaptations in the gastrocnemius, plantaris and soleus muscles was studied. 2. In control and hypocaloric rats the muscle relaxation rates at 100 Hz were 35.76 and 11.38% force loss/10 ms respectively. Control rats exhibited enhanced force of muscle contraction as the frequency of stimulation increased from 10 to 100 Hz, with maximum force being at 100 Hz. Hypocaloric rats exhibited a decrease in the increment of force being exerted at high frequencies, with maintenance of force at lower stimulatory frequencies. 3. In muscles of hypocaloric rats, there were significant decreases in the maximal activities of hexokinase (17.6-37.0%), 6-phosphofructokinase (22.7-34.2%), pyruvate kinase (21.2-36.0%), citrate synthase (34.1-41.5%), oxoglutarate dehydrogenase (29.4-52.4%) and 3-hydroxyacyl-CoA dehydrogenase (26.7-32.1%), whereas the activities of glycogen phosphorylase increased (23.8-43.4%) compared with control values. 4. In soleus-muscle strip preparations of hypocaloric rats, there were significant decreases in the rates of lactate production (28.1%) and glucose oxidation (32.6%) compared with control preparations. 5. Mitochondrial preparations from muscles of hypocaloric rats incubated with various substrates exhibited decreased rates of oxygen uptake compared with control preparations. 6. In muscles of hypocaloric rats (gastrocnemius and soleus), there were significant decreases in the concentrations of glycogen (P less than 0.001) and phosphocreatine (P less than 0.001) and increases in those of pyruvate (P less than 0.001), lactate (P less than 0.001) and ADP (P less than 0.001), whereas those of ATP and AMP remained unchanged. 7. Calculated [lactate]/[pyruvate] and [ATP]/[ADP] ratios exhibited significant increases (P less than 0.05) and decreases (P less than 0.05) in muscles of hypocaloric rats respectively. 8. The results are discussed in relation to the genesis of muscle dysfunction caused by malnutrition. PMID- 2775209 TI - Developmental regulation of the mRNAs for elastins a, b and c in foetal-calf nuchal ligament and aorta. AB - The data presented clearly suggest that relative amounts of mRNAs for elastins a, b and c are developmentally regulated in foetal-calf nuchal ligament and aorta and that this regulation is tissue-specific. In nuchal ligament, at earlier stages of foetal development, the relative amounts of mRNAs for elastins a and b are very low. After the foetal age of about 6 months the relative amount of mRNA for elastin b begins to increase. This is followed by an increase in the relative amount of mRNA for elastin a. In aorta, with increasing foetal age, the relative amounts of mRNAs for elastins b and c increase and decrease alternately. The relative amounts of mRNA for elastin a remain low, with only marginal increases with foetal age. A possible self-aggregation role of elastin a in elastogenesis is proposed. PMID- 2775211 TI - D-aspartate oxidase in rat, bovine and sheep kidney cortex is localized in peroxisomes. AB - D-Aspartate oxidase (EC 1.4.3.1) was assayed in subcellular fractions and in highly purified peroxisomes from rat, bovine and sheep kidney cortex as well as from rat liver. During all steps of subcellular-fractionation procedures, D aspartate oxidase co-fractionated with peroxisomal marker enzymes. In highly purified preparations of peroxisomes, the enrichment of D-aspartate oxidase activity over the homogenate is about 32-fold, being comparable with that of the peroxisomal marker enzymes catalase and D-amino acid oxidase. Disruption of the peroxisomes by freezing and thawing released more than 90% of the enzyme activity, which is typical for soluble peroxisomal-matrix proteins. Our findings provide strong evidence that in these tissues D-aspartate oxidase is a peroxisomal-matrix protein and should be added as an additional flavoprotein oxidase to the known set of peroxisomal oxidases. PMID- 2775210 TI - Oxytocin regulates the plasma membrane Ca2+ transport in rat myometrium. AB - Development of myometrium in young female rats was stimulated by administration of diethylstilboestrol. Plasma membrane and sarcoplasmic reticulum from rat myometrium were separated by a new and rapid method using a Percoll gradient. Calcium uptake was inhibited in plasma membrane vesicles isolated from oxytocin treated myometrium, while no consistent effect of oxytocin was found on the Ca2+ uptake in the sarcoplasmic reticulum. Oxytocin regulated the plasma membrane Ca2+ pump by decreasing its apparent affinity for Ca2+ without affecting its maximal velocity. The K1/2 for Ca2+ in the absence of calmodulin was 0.41 +/- 0.04 microM in normal membranes; this was increased to 0.93 +/- 0.12 microM in oxytocin treated membranes. Calmodulin decreased the K1/2 for Ca2+ to 0.27 +/- 0.027 microM and oxytocin also increased this, to 0.46 +/- 0.061 microM. The effect of oxytocin on the plasma membrane Ca2+ pump was highly dependent on the hormonal status of the animals. When the diethylstilboestrol was administered together with progesterone, the inhibitory action of oxytocin was totally suppressed, consistent with the expected action of this agent. The results suggest that regulation of the plasma membrane Ca2+ pump may be important in the prolonged elevation of intracellular Ca2+ caused by oxytocin. PMID- 2775213 TI - Bromodeoxyuridine amplifies free-radical-mediated DNA damage. AB - Elevated oxygen concentrations and paraquat, a superoxide-generating compound, induce an arrest of cells in the G2 phase of the cell cycle, which can be enhanced by adding bromodeoxyuridine (BrdU) to the culture medium. Experiments with the lipophilic peroxide cumene hydroperoxide and the free-radical scavenger vitamin E demonstrate that the BrdU-dependent G2 arrest is not mediated by lipid peroxidation. The BrdU-dependency of arrest in the G2 phase can be used as a sensitive cell biological assay to detect DNA damage elicited by oxygen free radicals. PMID- 2775212 TI - Changes in collagen stability and folding in lethal perinatal osteogenesis imperfecta. The effect of alpha 1 (I)-chain glycine-to-arginine substitutions. AB - The effect of glycine-to-arginine mutations in the alpha 1 (I)-chain on collagen triple-helix structure in lethal perinatal osteogenesis imperfecta was studied by determination of the helix denaturation temperature and by computerized molecular modelling. Arginine substitutions at glycine residues 391 and 667 resulted in similar small decreases in helix stability. Molecular modelling suggested that the glycine-to-arginine-391 mutant resulted in only a relatively small localized disruption to the helix structure. Thus the glycine-to-arginine substitutions may lead to only a small structural abnormality of the collagen helix, and it is most likely that the over-modification of lysine, poor secretion, increased degradation and other functional sequelae result from a kinetic defect in collagen helix formation resulting from the mutation. PMID- 2775215 TI - Hydroporphyrins of the meso-tetra(hydroxyphenyl)porphyrin series as tumour photosensitizers. AB - Four new hydroporphyrins [the o, m and p isomers of 5,10,15,20 tetra(hydroxyphenyl)chlorin and 5,10,15,20-tetra(m-hydroxyphenyl)bacteriochlorin] related to the tetra(hydroxyphenyl)porphyrins have been prepared. They show the expected strong absorption bands in the red region of the visible spectrum and are found to be very effective tumour photosensitizers. PMID- 2775214 TI - Studies on fatty-acid-binding proteins. The purification of rat liver fatty-acid binding protein and the role of cysteine-69 in fatty acid binding. AB - 1. A new, simple and high-yield procedure is described for the purification of hepatic fatty-acid-binding protein from rat liver using naphthylaminodecyl agarose as an affinity column. 2. Cysteine-69 is shown to react slowly, but quantitatively, with 5,5'-dithiobis-(2-nitrobenzoic acid) (DTNB), indicating that the thiol group is free, but may be buried within the protein. 3. Fatty acids do not affect the DTNB reactivity of this cysteine residue; however, cysteine reactivity is enhanced in the presence of haem and oleoyl-CoA. 4. Fatty-acid binding protein that has been modified with DTNB is still able to bind the fluorescent fatty acid 11-(dansylamino)undecanoic acid, indicating that cysteine 69 may be remote from the fatty-acid-binding site. PMID- 2775216 TI - Reaction between sheep liver mitochondrial aldehyde dehydrogenase and various thiol-modifying reagents. AB - Sheep liver mitochondrial aldehyde dehydrogenase reacts with 2,2' dithiodipyridine and 4,4'-dithiodipyridine in a two-step process: an initial rapid labelling reaction is followed by slow displacement of the thiopyridone moiety. With the 4,4'-isomer the first step results in an activated form of the enzyme, which then loses activity simultaneously with loss of the label (as has been shown to occur with the cytoplasmic enzyme). With 2,2'-dithiodipyridine, however, neither of the two steps of the reaction has any effect on the enzymic activity, showing that the mitochondrial enzyme possesses two cysteine residues that must be more accessible or reactive (to this reagent at least) than the postulated catalytically essential residue. The symmetrical reagent 5,5' dithiobis-(1-methyltetrazole) activates mitochondrial aldehyde dehydrogenase approximately 4-fold, whereas the smaller related compound methyl l methyltetrazol-5-yl disulphide is a potent inactivator. These results support the involvement of mixed methyl disulphides in causing unpleasant physiological responses to ethanol after the ingestion of certain antibiotics. PMID- 2775218 TI - The peptide encoded by angiotensin II complementary RNA does not interfere with angiotensin II action. PMID- 2775217 TI - Enhanced Co2+ activation and inhibitor binding of carboxypeptidase M at low pH. Similarity to carboxypeptidase H (enkephalin convertase). AB - Carboxypeptidases H and M differ in their distribution and other properties, but both are activated by Co2+ and inhibited by guanidinoethylmercaptosuccinic acid. The higher degree of activation or inhibition of carboxypeptidase H by these agents at acid pH has been employed to identify this enzyme in tissues. We found that the activation or inhibition of both purified and plasma-membrane-bound human carboxy-peptidase M depends on the pH of the medium. CoCl2 activated over 6 fold at pH 5.5, but less than 2-fold at pH 7.5. Guanidinoethylmercaptosuccinic acid inhibited the membrane-bound carboxypeptidase M more effectively than the purified enzyme, and the IC50 was about 25-30 times lower at pH 5.5. As purified human plasma carboxypeptidase N and pancreatic carboxypeptidase B were also activated more at pH 5.5, we conclude that the increased activation by CoCl2 is due to the enhanced dissociation of Zn2+ below the pKa of the ligands that co ordinate the cofactor in the protein. Thus increased activation or inhibition at acid pH would not differentiate basic carboxypeptidases. PMID- 2775219 TI - Are the antibodies to a peptide complementary to angiotensin II useful to isolate the angiotensin II receptor? PMID- 2775220 TI - Interferon alters the pattern of secreted proteins from Ehrlich ascites-tumour cells. AB - Treatment of Ehrlich ascites-tumour (EAT) cells with interferon (IFN) abolished their ability to secrete a 32 kDa protein that was secreted by growing EAT cells. These IFN-treated cells secreted two proteins (molecular masses 100 and 89 kDa as estimated by SDS/polyacrylamide-gel electrophoresis) that were not detected in two-dimensional gel electrophoresis of the culture fluid of untreated EAT cells. The sequence of 20 amino acids from the N-terminal end of the 32 kDa protein was very similar to portions of sequences of mouse proviral gag proteins. PMID- 2775222 TI - Purification, oligomerization state and malate sensitivity of maize leaf phosphoenolpyruvate carboxylase. AB - A method was developed for the purification of phosphoenolpyruvate carboxylase from darkened maize leaves so that the enzyme retained its sensitivity to inhibition by malate. The procedure depended on the prevention of proteolysis by the inclusion of chymostatin in the buffers used during the purification. The purified enzyme was indistinguishable from that in crude extracts as judged by native polyacrylamide-gel electrophoresis. SDS/polyacrylamide-gel electrophoresis followed by immunoblotting, and Superose 6 gel filtration. Gel-filtration studies showed that the purified enzyme and the enzyme in extracts of darkened or illuminated leaves showed a concentration-dependent dissociation of tetrameric into dimeric forms. Purified phosphoenolpyruvate carboxylase and enzyme in crude extracts from darkened leaves were equally sensitive to inhibition by malate (Ki approx. 0.30 mM) under conditions where it existed in the tetrameric or dimeric forms, but the enzyme in crude extracts from illuminated leaves was less sensitive to malate inhibition (Ki approx. 0.95 mM) whether it was present as a tetramer or as a dimer. It is concluded that changes in the oligomerization state of phosphoenolpyruvate carboxylase are not directly involved in its regulation by light. PMID- 2775221 TI - Metabolism of platelet-activating factor (PAF; 1-O-alkyl-2-acetyl-sn-glycero-3 phosphocholine) and lyso-PAF (1-O-alkyl-2-lyso-sn-glycero-3-phosphocholine) by cultured rat Kupffer cells. AB - The metabolism of platelet-activating factor (PAF; identified as AGEPC: 1-O-alkyl 2-acetyl-sn-glycero-3-phosphocholine) and lyso-PAF (lyso-GEPC: 1-O-alkyl-2-lyso sn-glycero-3-phosphocholine) was investigated in cultured rat Kupffer cells. The rat Kupffer cells accumulated [3H]AGEPC and deacetylated this compound to the corresponding [3H]lyso-GEPC, which was the major metabolic product of [3H]AGEPC. [3H]Lyso-GEPC was distributed primarily in the supernatant fraction of incubated cells throughout the experimental interval. Only a very small portion of the [3H]lyso-GEPC was further converted to 1-O-alkyl-2-acyl-sn-glycero-3 phosphocholine (alkylacyl-GPC), indicating that this acylation process was not particularly active in these cells. When [3H]lyso-GEPC was incubated with Kupffer cells, the conversion of lyso-GEPC to AGEPC via the acetyltransferase reaction increased up to 30 min and declined thereafter. Bovine serum albumin (BSA) had a substantial influence on both the cellular uptake and the metabolism of [3H]AGEPC. An increase in the BSA concentration in the incubation media reduced the cellular uptake of [3H]AGEPC and the subsequent formation of lyso-GEPC. The results of this study suggest that the hepatic Kupffer cells play an important role in the metabolism of PAF. Moreover, these results infer that the regulation of the PAF level in certain hepatic pathophysiological situations may be a consequence of the production and subsequent metabolism of this potent lipid autacoid in the Kupffer cells of the liver. PMID- 2775224 TI - Surface characteristics of phosphatidylglycerol phosphate from the extreme halophile Halobacterium cutirubrum compared with those of its deoxy analogue, at the air/water interface. AB - The relationship between area per molecule and surface pressure of monolayers of phosphatidylglycerol phosphate from extreme halophile Halobacterium cutrirubrum and its deoxy analogue, deoxyphosphatidylglycerol phosphate, spread at an air/water interface was examined. The effect of ionization of the primary and secondary acidic functions of the phosphate groups of the two lipids on surface characteristics of compression isotherms was determined by spreading monolayers on subphases with pH values ranging from below the apparent pKa of the primary ionization (pH 0) to greater than that of secondary ionization (pH 10.9). The limiting molecular area increases with decreasing pH below 2. Ionization of the primary phosphate functions of both phospholipids (with bulk pK1 values close to 4) is associated with a marked expansion of the films, as judged by values of limiting molecular area. Ionization of the secondary phosphate functions causes further expansion of the films, with the apparent pK2 of deoxyphosphatidylglycerol phosphate slightly less than that indicated for phosphatidylglycerol phosphate. Values of surface-compressibility modulus calculated from the surface characteristics of the phosphatidylglcerol phosphate monolayers showed that films spread on subphases with a pH of about the apparent pK1 of the primary phosphate functions were the least compressible. Increasing or decreasing subphase pH caused an increase in compressibility; this effect on compressibility was much less with monolayers of deoxyphosphatidylglycerol phosphate at high pH. The effect of inorganic counter-ions on monolayer characteristics of phosphatidylglycerol phosphate was examined by using subphases of NaCl concentrations varying from 0.01 to 1 M. The limiting molecular area was found to increase exponentially with respect to the subphase NaCl concentration. PMID- 2775223 TI - Postnatal changes in dolichol-pathway enzyme activities in rat liver. AB - The activity of hepatic protein N-glycosylation was compared in rats of different ages by incubating UDP-[14C]glucose with liver microsomes. Dolichyl-phosphate [14C]glucose, [14C]glucosyl-oligosaccharide-lipid and [14C]glycoproteins formed were increased after birth to maximal levels at 2 weeks; thereafter dolichylphosphate [14C]glucose remained constant, while [14C]glucosyl oligosaccharide-lipid and [14C]glycoproteins were decreased to constant levels at 4 weeks. The postnatal change in the formation of [14C]glycoproteins was similar to the change in the hexosamine content of N-glycans in liver microsomes and plasma, suggesting that the N-glycosylation of proteins in rat liver increases after birth to a maximum at 2 weeks, and thereafter decreases to a constant level at 4 weeks. The possibility of a regulatory role for dolichyl phosphate in glycoprotein synthesis in rat liver during postnatal development was eliminated by demonstrating the inefficiency of exogenous dolichyl phosphate on the postnatal changes in [14C]glycoprotein formation. The transfer of [14C]glucose from UDP-[14C]glucose to denatured alpha-lactalbumin in liver microsomes increased to a maximum at 2 weeks and then decreased to a constant level, as with transfer to endogenous proteins (i.e. the formation of [14C]glycoproteins). On the other hand, the transfer of oligosaccharide from exogenous [14C]glucosyl oligosaccharide-lipid to denatured alpha-lactalbumin reached a maximum at 2 weeks and then remained constant. These results strongly suggest that oligosaccharide lipid available for N-glycosylation is limiting in rat liver after 2 weeks post partum. The activities of dolichyl-phosphate glucose, dolichyl-phosphate mannose and dolichyl-pyrophosphate N-acetylglucosamine synthases increased until 2 weeks post partum. Thereafter, the activity of dolichyl-pyrophosphate N acetylglucosamine synthase decreased to a constant level at 4 weeks, while the activities of dolichyl-phosphate glucose and dolichyl-phosphate mannose synthases remained constant. These results suggest that N-glycosylation of proteins in rat liver increases until 2 weeks post partum, and that this depends on the activities of dolichol-pathway enzymes as a whole rather than on the activity of specific enzymes. N-Glycosylation then decreases to a constant level at 4 weeks due to decreases in the activities of enzymes responsible for oligosaccharide assembly on lipids, including dolichyl-pyrophosphate N-acetylglucosamine synthase. PMID- 2775225 TI - Secretion, cleavage and binding of complement component C3 by the human monocytic cell line U937. AB - Secretion of complement component C3 by U937 cells was studied. Preliminary evidence for a cell-associated proteolytic activity specific for C3 is given, as well as for a covalent-like binding of C3 fragments to the cell membranes. Secretion of C3, in the presence of 10 ng of phorbol 12-myristate 13-acetate/ml, is 120-140 ng/10(6) cells per 24 h on the third day after addition of the activator. As shown by SDS/polyacrylamide-gel electrophoresis, the intracellular pro-C3 (200 kDa) and the extracellular secreted C3 (alpha-chain 110 kDa and beta chain 75 kDa) are identical with the forms of C3 previously characterized from human serum. Incubation of U937 cells in the presence of exogenous radiolabelled C3 shows that membrane-bound proteinase(s), not related to the classical-pathway or the alternative-pathway C3 convertases, is (are) able to cleave C3; this cleavage leads to the binding of the resulting C3 fragments to the cell membrane through reaction of membrane acceptors with the carbonyl group of C3 revealed after disruption of the intramolecular thioester bond. The proteolysis appears to be fairly specific to C3, as C4, which also possesses an intramolecular thioester bond, is not cleaved and does not bind to the cells. p-Nitrophenyl p' guanidinobenzoate (1 mM) and di-isopropyl phosphorofluoridate (2 mM) are potent inhibitors of the proteolysis, whereas soya-bean trypsin inhibitor (1 mM), leupeptin (0.1 mg/ml) and 1,10-phenanthroline (1 mM) were ineffective. Immunological characterization of the cell-bound C3 fragments with monoclonal antibodies shows an evolution of the proteolysis of the fragments from iC3b to C3dg epitopes. Extraction of membrane-bound fragments by detergent, followed by SDS/polyacrylamide-gel electrophoresis, shows two fragments, of 43 kDa and 46 kDa, with C3dg-like characteristics. PMID- 2775226 TI - Modulation of testicular galactolipid sulphotransferase activity by phosphorylation. Stimulation of enzyme activity in vitro by an endogenous kinase. AB - Evidence is presented for a testicular protein kinase activity capable of stimulating the activity in vitro of a partially purified preparation of the testicular galactolipid sulphotransferase. This enzyme is responsible for the synthesis of the major mammalian testicular glycolipid, sulphogalactosylglycerol, and is an early marker of differentiation during spermatogenesis. This stimulatory activity has been separated by affinity chromatography, using 3',5' ADP-agarose, from both the detergent-solubilized microsomes (microsomal fractions) and the soluble fraction of the testicular homogenate. The stimulator was eluted from the affinity matrix by either a salt, or, more selectively, a cyclic AMP gradient. Thus this matrix can function as an analogue of 3',5'-cyclic AMP. The activity of the sulphotransferase stimulator was ATP-dependent and coincident with protein kinase activity. Sulphotransferase activity was also stimulated in the presence of commercial preparations of cyclic AMP-dependent protein kinase and stimulation was prevented in the presence of kinase inhibitors. Our results suggest that sulphogalactolipid biosynthesis is regulated by a phosphorylation process during spermatogenesis. In addition, our results suggest that affinity chromatography on 3',5'-ADP-agarose may provide a general method for the purification of cyclic AMP-dependent kinases. PMID- 2775227 TI - Passive diffusion of non-electrolytes across the lysosome membrane. AB - An osmotic-protection method has been used to study the permeability of rat liver lysosomes to 43 organic non-electrolytes of formula weights ranging from 62 to 1000. A lysosome-rich centrifugal fraction of rat liver homogenate was resuspended in an unbuffered 0.25 M solution of test solute, pH 7.0, and incubated at 25 degrees C for 60 min. The free and total activities of 4 methylumbelliferyl N-acetyl-beta-D-glucosaminidase were measured after incubation for 0, 30 and 60 min. Three patterns of results were seen. In pattern A the percentage free activity remained low throughout the 60 min incubation, indicating little or no solute entry into the lysosomes. In pattern B, the percentage free activity was initially low, but rose substantially during the incubation, indicating solute entry. In pattern C there was not even initial osmotic protection, indicating very rapid solute entry. The rapidity of solute entry into the lysosomes showed no correlation with the formula weight, but a perfect inverse correlation with the hydrogen-bonding capacity of the solutes. The results, which can be used to predict the ability of further compounds to cross the lysosome membrane by unassisted diffusion, are discussed in the context of metabolite and drug release from lysosomes in vivo. PMID- 2775228 TI - Decreased-activity mutants of phosphoglucose isomerase in the cytosol and chloroplast of Clarkia xantiana. Impact on mass-action ratios and fluxes to sucrose and starch, and estimation of Flux Control Coefficients and Elasticity Coefficients. AB - 1. Subcellular-compartment-specific decreased-activity mutants of phosphoglucose isomerase in Clarkia xantiana were used to analyse the control of sucrose and starch synthesis during photosynthesis. Mutants were available in which the plastid phosphoglucose isomerase complement is decreased to 75% or 50% of the wild-type level, and the cytosol complement to 64%, 36% or 18% of the wild-type level. 2. The effects on the [product]/[substrate] ratio and on fluxes to sucrose or starch and the rate of photosynthesis were studied with the use of saturating or limiting light intensity to impose a high or low flux through these pathways. 3. Removal of a small fraction of either phosphoglucose isomerase leads to a significant shift of the [product]/[substrate] ratio away, from equilibrium. We conclude that there is no 'excess' of enzyme over that needed to maintain its reactants reasonably close to equilibrium. 4. Decreased phosphoglucose isomerase activity can also alter the fluxes to starch or sucrose. However, the effect on flux does not correlate with the extent of disequilibrium, and also varies depending on the subcellular compartment and on the conditions. 5. The results were used to estimate Flux Control Coefficients for the chloroplast and cytosolic phosphoglucose isomerases. The chloroplast isoenzyme exerts control on the rate of starch synthesis and on photosynthesis in saturating light intensity and CO2, but not at low light intensity. The cytosolic enzyme only exerts significant control when its complement is decreased 3-5-fold, and differs from the plastid isoenzyme in exerting more control in low light intensity. It has a positive Control Coefficient for sucrose synthesis, and a negative Control Coefficient for starch synthesis. 6. The Elasticity Coefficients in vivo of the cytosolic phosphoglucose isomerase were estimated to lie between 5 and 8 in the wild-type. They decrease in mutants with a lowered complement of cytosolic phosphoglucose isomerase. 7. The implications of these results for regulation and for evolution are discussed. PMID- 2775229 TI - The synthesis of dermatan sulphate proteoglycans by fetal and adult human articular cartilage. AB - Non-aggregating dermatan sulphate proteoglycans can be extracted from both fetal and adult human articular cartilage. The dermatan sulphate proteoglycans appear to be smaller in the adult, this presumably being due to shorter glycosaminoglycan chains, and these chains contain a greater proportion of their uronic acid residues as iduronate. Both the adult and fetal dermatan sulphate proteoglycans contain a greater amount of 4-sulphation than 6-sulphation of the N acetylgalactosamine residues, in contrast with the aggregating proteoglycans, which always show more 6-sulphation on their chondroitin sulphate chains. In the fetus the major dermatan sulphate proteoglycan to be synthesized is DS-PGI, though DS-PGII is synthesized in reasonable amounts. In the adult, however, DS PGI synthesis is barely detectable relative to DS-PGII, which is still synthesized in substantial amounts. Purification of the dermatan sulphate proteoglycans from adult cartilage is hampered by the presence of degradation products derived from the large aggregating proteoglycans, which possess similar charge, size and density properties, but which can be distinguished by their ability to interact with hyaluronic acid. PMID- 2775230 TI - pH-dependent forms of the ferryl haem in myoglobin peroxide analysed by variable temperature magnetic circular dichroism. AB - The reaction product of myoglobin and H2O2 exists in two different forms according to the external pH. Varied-temperature magnetic-circular dichroism (m.c.d.) spectroscopy demonstrates that both contain the oxyferryl ion Fe(IV) = O. Alkaline myoglobin peroxide has often been used as a model for oxidized intermediates in the catalytic cycles of haem-containing peroxidases, but absorption and m.c.d. spectra show that the acid form is much more closely related to species such as horeradish peroxidase Compound II. The differences are tentatively ascribed to ionization of the proximal histidine ligand in alkaline myoglobin peroxide. It is also shown that the m.c.d. method allows an estimate of the zero-field splitting parameter of both forms, values of D = 28.0 +/- 3 cm-1 and 35.0 +/- 5 cm-1 being obtained for the alkaline and acid forms respectively. PMID- 2775231 TI - Cytosolic glutathione transferases from rat liver. Primary structure of class alpha glutathione transferase 8-8 and characterization of low-abundance class Mu glutathione transferases. AB - Six GSH transferases with neutral/acidic isoelectric points were purified from the cytosol fraction of rat liver. Four transferases are class Mu enzymes related to the previously characterized GSH transferases 3-3, 4-4 and 6-6, as judged by structural and enzymic properties. Two additional GSH transferases are distinguished by high specific activities with 4-hydroxyalk-2-enals, toxic products of lipid peroxidation. The most abundant of these two enzymes, GSH transferase 8-8, a class Alpha enzyme, has earlier been identified in rat lung and kidney. The amino acid sequence of subunit 8 was determined and showed a typical class Alpha GSH transferase structure including an N-acetylated N terminal methionine residue. PMID- 2775232 TI - Complete localization of the intrachain disulphide bonds and the N-glycosylation points in the alpha-subunit of human platelet glycoprotein IIb. AB - Glycoprotein IIb (GPIIb), one of the two molecular components of the inducible receptor for fibrinogen on the platelet surface, is formed from two subunits, GPIIb alpha (114 kDa) and GPIIb beta (22.5 kDa), joined by a single disulphide bond. CNBr cleavage of GPIIb, together with tryptic or endoproteinase Lys-C digestion of some of the isolated CNBr peptides, followed by amino acid and N terminal sequence analysis of the isolated fragments, allowed us to locate unambiguously all the unknown disulphide bonds and the N-glycosylation points in platelet GPIIb. It could be established that each cysteine residue in GPIIb, beginning at alpha-Cys-56, is disulphide-bonded to its nearest neighbour in the amino acid sequence. Given the extensive structural similarity among the two chain alpha-subunits of Arg-Gly-Asp adhesion receptors and the conservative positions of cysteine residues in their amino acid sequences, the intrachain and interchain disulphide-bond pattern found here in GPIIb will most probably be conserved in all two-chain alpha-subunits of these receptors. The N-linked glycosylation points found here in platelet GPIIb are the same as the five N glycosylated asparagine residues suggested after cDNA sequencing of human erythroleukaemic-cell GPIIb [Poncz, Eisman, Heindenreich, Silver, Vilaire, Surrey, Schwartz & Bennett (1987) J. Biol. Chem. 262, 8476-8482]. Some of the general features of the structure of GPIIb, such as the existence of distinct domains in the alpha- and beta-subunits, as well as the identification of well defined points in its external topography, are discussed. PMID- 2775233 TI - A study of the mechanism by which some amphiphilic drugs affect human erythrocyte acetylcholinesterase activity. AB - The effects of the local anaesthetics procaine, tetracaine and lidocaine and of the antidepressant imipramine on human erythrocyte acetylcholinesterase were investigated. All four amphiphilic drugs inhibited enzymic activity, the IC50 (the concentration causing 50% inhibition) being about 0.40 mM for procaine, 0.05 mM for tetracaine, 0.70 mM for imipramine and 7.0 mM for lidocaine. Procaine and tetracaine inhibited acetylcholinesterase activity competitively at concentrations at which they did not perturb the physical state of the membrane lipid environment, as assessed by steady-state fluorescence polarization, whereas lidocaine and imipramine displayed mixed inhibition kinetics at concentrations at which they induced an enhancement of membrane fluidity. The question was addressed as to whether membrane integrity is a prerequisite for imipramine and lidocaine action. Membrane solubilization by 1% Triton X-100 and a decrease, by dilution, in the detergent concentration to 0.05% [which is above the Triton X 100 critical micelle concentration (c.m.c.)] did not substantially affect the inhibitory potency of the two amphiphilic drugs at their IC50; in the presence of increasing detergent concentrations the inhibitory potency of imipramine was gradually decreased, but not abolished, whereas the inhibitory effect of lidocaine was only slightly diminished, even at 1% Triton X-100. It is suggested that neither competitive nor mixed inhibition kinetics arise from conformational changes of the protein driven by a modification of the physical state of the lipid environment, but from a direct interaction of the amphiphilic drugs with acetylcholinesterase. In particular, the partial loss of the inhibitory potency of imipramine and lidocaine that is observed upon increasing Triton X-100 concentration well above its c.m.c. could be explained in terms of amphiphile partition in detergent micelles and, in turn, of a decreased effective concentration of the two inhibitors in the aqueous phase. PMID- 2775234 TI - Acylation of 2-acyl-glycerophosphocholine in guinea-pig heart microsomal fractions. AB - Acyl-CoA:2-acyl-sn-glycero-3-phosphocholine (GPC) acyltransferase is required for the maintenance of the asymmetric distribution of saturated fatty acids at the C 1 position of phosphatidylcholine; however, this activity has been reported to be absent in cardiac tissue. In the present study a very active acyl-CoA:2-acyl-GPC activity was detected and characterized in guinea-pig heart microsomes (microsomal fractions); the mitochondria did not appear to possess this activity. The acyl-CoA specificity of the microsomal acyl-CoA:2-acyl-GPC acyltransferase was distinct from the corresponding acyl-CoA:1-acyl-GPC acyltransferase. These differences were due to the position of the fatty acid on the lysophospholipid rather than the composition of the fatty acids. The enzyme did not exhibit a distinct preference for saturated fatty acids, as might be expected. Our results suggest that, in the heart, control of the intracellular composition and concentration of acyl-CoAs by acyl-CoA hydrolase and acyl-CoA synthetase may play an important role in maintaining the asymmetric distribution of fatty acids in phosphatidylcholine. PMID- 2775235 TI - Lysophospholipase A2 activity in guinea-pig heart microsomal fractions displaying high activities with 2-acylglycerophosphocholines with linoleic and arachidonic acids. AB - Lysophospholipases A1 which catalyse the hydrolysis of acyl groups from 1 acylglycerophosphocholine (GPC) have been characterized in a number of mammalian tissues and do not exhibit any acyl specificity. In the present study lysophospholipase activity in guinea-pig heart microsomes (microsomal fractions) that hydrolyses 2-acyl-GPC was detected and characterized. The enzyme showed a high degree of acyl specificity. The relative rates of hydrolysis of individual 2 acyl-GPCs with different fatty acids was as follows: C18:2/C20:1/C18:1/C16:0, 14:6:1:1. When substrates were presented in pairs, the hydrolysis of each substrate by the enzyme was inhibited, but to very different extents. Of each pair of lysolipids examined (2-arachidonoyl- and 2-palmitoyl-GPC; 2-arachidonoyl- and 2-linoleoyl-GPC), the one with the expected higher rate of hydrolysis was more severely inhibited and the degree of inhibition was dependent on the concentration of the other lysolipid. The characteristics of the lysophospholipase A2 suggest the enzyme could work in concert with phospholipase A1 to release arachidonic and linoeic acids for further metabolism. The properties of lysophospholipase A2 and A1 suggest that they are different enzymes. PMID- 2775236 TI - Purification and characterization of a tartrate-resistant acid phosphatase from human osteoclastomas. AB - Tartrate-resistant acid phosphatase is one of the major enzymes produced and secreted by osteoclasts. To obtain sufficient enzyme for biochemical characterization, we have purified this enzyme from human osteoclastomas by sequential chromatography on SP-Sephadex, CM-Sephadex, hydroxylapatite, Sephadex G-150 and concanavalin A-Sepharose. The purification over the original tumour extract was about 2000-fold, with a yield of 10%. The enzyme appeared to be homogeneous when assessed by SDS/polyacrylamide-gel electrophoresis. Both gel filtration and SDS/polyacrylamide-gel electrophoresis indicated an Mr of about 30,000. The reduced and alkylated enzyme consists of two subunits with Mrs of 15,000 and 17,500. The N-terminal amino acid sequence of both subunits indicates that there is a high degree of identity between the osteoclastoma enzyme and similar enzymes purified from spleen and uterus. Using 4-methylumbelliferyl phosphate as substrate, the specific activity of the purified enzyme was 387 units.mg-1, and the Km was 284 microns. The pH optimum was 5.7. Unlike similar enzymes purified from human and bovine bone, osteoclastoma acid phosphatase is not activated by reducing agents (2-mercaptoethanol or ascorbic acid). The enzyme contains 4.8 mol of Fe2+/3+, 0.3 mol of Mn2+ and 1.7 mol of Mg2+ per mol of enzyme. Although the enzyme loses 50% of its activity in the presence of EDTA, it is not inhibited by the iron chelator 1,10-phenanthroline. However, the enzyme is activated to a small extent by Mn2+ and Mg2+. Using a variety of substrates and inhibitors, we demonstrate that there are differences between the osteoclastoma acid phosphatase and the enzyme purified from other sources. PMID- 2775237 TI - Deglycosylation of mucin from LS174T colon cancer cells by hydrogen fluoride treatment. AB - Mucin from xenografts of LS174T human colon cancer cells was treated with anhydrous HF for 1 h at 0 degree C to give a product (HFA) with over 80% of the glucosamine and hexose removed, but retaining some galactosamine, and for 3 h at room temperature to give a product (HFB) devoid of carbohydrate. Rabbit antibodies against HFA bound to HFA much more than to HFB, and bound to native mucin to an intermediate extent. Antibodies to HFB bound to HFB more than to HFA, and did not bind to native mucin. Both HFA and native mucin bound a number of lectins, but HFB did not. By SDS/polyacrylamide-gel electrophoresis and size exclusion h.p.l.c., native mucin and HFA are of apparent molecular mass greater than 400 kDa, whereas HFB is heterogeneous and of low molecular mass. On Western blots, antibody to HFA detected both high-molecular-mass mucin and a 90 kDa protein in homogenates of LS174T cells. Antibody to HFB detected a major 70 kDa band as well as higher-molecular-mass species. In tissue sections of normal colon and colon cancers, antibody to HFA showed both cytoplasmic and extracellular staining, whereas antibody to HFB generally stained only cytoplasmic antigens. These results indicate that anti-HFB antibody is specific for apo-mucin, whereas anti-HFA antibody is specific for GalNAc-apo-mucin. PMID- 2775238 TI - Abnormal synthesis of cartilage-characteristic proteoglycan in azaserine-induced micromelial limbs. AB - Administration of azaserine (250 micrograms) to day-4 chick embryos in ovo was shown to induce micromelial limbs. In the present study, biosynthesis of cartilage-characteristic proteoglycan H (PG-H) as an index of limb chondrogenesis was examined in normal and micromelial hind limbs from day-7 chick embryos by biochemical and immunological methods. (1) Metabolic labelling of the micromelial limbs with [6-3H]-glucose and [35S]sulphate, followed by analysis of labelled proteoglycans by glycerol-density-gradient centrifugation under dissociative conditions, showed a marked reduction in PG-H synthesis. (2) PG-H synthesized by micromelial limbs differed from that synthesized by normal limbs in possessing a slower sedimenting velocity and much lower amounts of chondroitin sulphates. (3) The amount of PG-H core protein in micromelial limbs was significantly decreased to about 19% on a per limb basis and about 42% on a per DNA basis of that in normal limbs, as determined by e.l.i.s.a. (4) The transition from PG-M to PG-H during limb formation was retarded in micromelial limbs as judged by an indirect immunofluorescence technique using antibodies against PG-M and PG-H. (5) The deficiency of incorporation of labelled glucose into chondroitin sulphate chains of PG-H in micromelial limbs was partially restored by using [6-3H]-glucosamine as a precursor, suggesting that the synthesis of UDP-N-acetylhexosamine, required for chondroitin sulphate chain synthesis of PG-H in micromelial limbs, was decreased. These results suggest that the reduction in the synthesis of PG-H as well as the production of an abnormal form of PG-H during a critical period of limb morphogenesis may be important factors in explaining the micromelia induced by azaserine. PMID- 2775240 TI - Reconstitution of intermediate filaments from a higher plant. AB - Immunological studies have shown that plants contain intermediate-filament antigens, but it is not known whether these proteins are capable in themselves of forming filaments. To address this problem, a detergent-resistant and high-salt insoluble fraction from carrot (Daucus carota L.) suspension cells was solubilized with 9 M-urea and then subjected to a two-step dialysis procedure, devised for the reconstitution of animal intermediate filaments. This induced the self-assembly of 10 nm filaments and large bundles of filaments. The predominant components of reconstituted material were polypeptides with apparent molecular masses between 58 and 62 kDa. These polypeptides immunoblotted with two monoclonal antibodies known to show broad cross-reactivity with intermediate filaments across the phylogenetic spectrum. This establishes that the antigens are able to self-assemble into intermediate-sized filaments. PMID- 2775239 TI - The putative 'link' glycopeptide associated with mucus glycoproteins. Composition and properties of preparations from the gastrointestinal tracts of several mammals. AB - The existence of a discrete 'link' peptide in epithelial mucins has been debated for many years. There is evidence that at least some mucins contain a specific 'link' peptide (or glycopeptide) that enhances mucin polymerization by forming disulphide bridges to large mucin glycoprotein subunits. A major difficulty has been to know whether the reported differences in putative 'link' components represent artifacts generated by inter-laboratory differences in technical procedures used in mucin purification. The present paper outlines the results of a collaborative study involving five laboratories and 53 samples of purified gastrointestinal mucins (including salivary, gastric, small-intestinal and colonic mucins) prepared by five techniques from four different animal species. An early step in mucin purification in all cases was the addition of proteinase inhibitors. Representative mucins were analysed for their composition, electrophoretic mobility in SDS/polyacrylamide-gel electrophoresis before and after disulphide-bond reduction, and for their reactivity with monospecific antibodies developed against the 118 kDa putative 'link' glycopeptide isolated from either rat or human small-intestinal mucins. Our results indicate that, despite differences in laboratory techniques, preparative procedures, organs and species, each of the purified mucins contained a 'link' component that was released by disulphide-bond reduction and produced a band on SDS/polyacrylamide gel electrophoresis at a position of approx. 118 kDa. After electroelution and analyses, the 118 kDa bands from the different mucins were found to have similar amino acid profiles and to contain carbohydrate. It would appear therefore that a 'link' glycopeptide of molecular mass approx. 118 kDa is common to all of the gastrointestinal mucins studied. PMID- 2775241 TI - Arachidonate release in neutrophils: does a lack of effect of protein kinase C inhibitors imply no involvement of protein kinase C? PMID- 2775242 TI - Autoradiographic investigations on cell shape-mediated growth regulation of lens epithelial cells in culture. AB - An autoradiographic method is described which is well suited for the determination of the labelling index in flattened as well as rounded cells. Using this method DNA synthesis of lens epithelial cells in culture was found to be dependent on cell attachment, cell flattening and intact microfilaments. Thus previous results on cell shape mediated growth regulation could be confirmed. Moreover, considering the labelling index it was possible to conclude that cell rounding or a disintegration of microfilaments did not impair ongoing DNA synthesis but did prevent cells from entering the S-phase of the cycle. PMID- 2775244 TI - [Interactions of detergents with phospholipid bilayers at sublytic concentrations -partition or binding?]. AB - Using the bubble pressure method the interaction of liposomes with detergents at sublytic concentrations was studied. The results are discussed in terms of a partition or binding model. The findings support an equilibrium partition of the surfactant between the aquous and lipid phase. For some detergents, however, concentration dependent partition coefficients were found. PMID- 2775243 TI - [Effect of tumor-promoting phorbol esters on retrovirus-infected human cells: scanning electron microscopy studies]. AB - The effects of 12-O-tetradecanoylphorbol-13-acetate (TPA) on cultivated human cells infected with a human cell line derived retrovirus were examined by using scanning electron microscopy. The most prominent immediate morphological changes were the rounding up of cell surfaces, an enhanced formation of blebs and an increasing tendency to cell detachment. The production of virus particles under TPA treatment was markedly augmented, reaching 300 to 500 particles in individual cells. The production of particles appeared nearly random over the cell surface. PMID- 2775245 TI - Effect of gliadin on the distribution of sucrase among different fractions of fetal chick intestine. AB - The effect of peptic-tryptic digested gliadin (PT-gliadin) on the increase in sucrase activity in different fractions of tissue cultured fetal chick duodenum was investigated and compared with that of monensin, a known perturbant of the Golgi complex. PT-gliadin diminished the rise in sucrase activity in the tissue homogenate, in a brush border fraction, and in the high speed supernatant, whereas the activity in a Ca2+-pelleted fraction including endoplasmic reticulum and Golgi apparatus was unaffected. In contrast, monensin caused a proportional inhibition of the increase in sucrase activity in all fractions examined. The findings might suggest that PT-gliadin is able to affect intracellular processing of sucrase with the site of attack being distal to that of monensin in the biogenesis of the enzyme. Whether the effect of PT-gliadin on fetal gut is relevant also for celiac intestine remains to be established. PMID- 2775247 TI - The influence of sex hormones on the development of sex-specific cholesterol serum levels in rats. AB - 1. The development of sex-specific cholesterol serum levels (under a fat-enriched diet) depends on the sex hormone status during the postpuberal activation phase. 2. The efficiency of postpuberal sex hormones seems to be influenced by the presence of definite sex hormone levels during the prepuberal/puberal maturation phase. 3. An influence of the perinatal sex-specific brain differentiation on the development of sex-typical cholesterol biosynthesis as reported by Carlson et al. was not demonstrable, possibly because of our special diet regimes (fat-enriched diet). PMID- 2775246 TI - Response of different mammary epithelial cell lines to a mammary derived growth inhibitor (MDGI). AB - MDGI, a 14.5-KDa protein, is a chemically defined growth inhibitor, which we have purified from lactating bovine mammary gland and characterized biologically in a mouse Ehrlich ascites mammary tumour (EAT) short term suspension culture. It has now been tested for its inhibitory activity on proliferation of four malignant mammary epithelial cell lines of human and mouse origin and normal human mammary epithelial cells. In all experiments, cells were brought to quiescence by serum or growth factor deprivation. Using [3H]TdR pulse labelling the effect of MDGI was measured on the restimulation of proliferation after medium change. MaTu and T47 D, human malignant mammary epithelial cell lines, as well as the mouse malignant mammary epithelial cell line mMaCa 20177 could be inhibited, whereas the human malignant mammary epithelial cell line MCF7 showed a slight stimulation. MDGI showed no activity on the residual DNA synthesis of all cell lines after starvation. Normal human mammary epithelial cells (HMEC) of different passages could also be inhibited. Their responsiveness seemed to be dependent on the number of passages. Cells from high passages (10-14) showed a higher sensitivity, which is also about 10 times higher than that of the malignant cell lines. Furthermore, growth factors like insulin, epidermal growth factor (EGF) and fetal calf serum (FCS), known to be potent antagonists to the MDGI activity in the EAT and, in the case of insulin, also in the MaTu culture (shown in the present study), do not abolish the inhibitory activity of MDGI on HMEC cells. These results demonstrate that the inhibitory activity of MDGI is not exclusively restricted to EAT cells studied so far. PMID- 2775249 TI - Isolation and some properties of a cathepsin E type proteinase from rat spleen. AB - Cathepsin E (EC 3.4.23.--) has been isolated from rat spleen. The procedure included autolysis at pH 4.2 which was probably the reason why we isolated a polypeptide of Mr 42 kDa instead of 90 kDa. The latter is reported in the literature to be the Mr of native cathepsin E. The enzyme dissociates under reducing conditions in two identical monomers. In our preparation a mechanism different from reduction must be active producing the 42 kDa polypeptide. This enzyme was hard to distinguish from cathepsin D (EC 3.4.23.5.) which shows similar properties such as size, substrate specificity, stability in 6 M urea, and dependence of the activity on pH. The clear distinction between the two enzymes was proven on the basis of immunochemical reactions. Antibodies to both cathepsins, D and E, did not show any crossreaction with the nonrelated antigen. PMID- 2775248 TI - Production and characterization of four monoclonal antibodies specific for human interferon-alpha-1 and -alpha-2. AB - Four monoclonal antibodies against HuIFN-alpha-1 and -alpha-2 were produced by the lymphocyte hybridoma technique. The screening for monoclonal anti-IFN antibodies was performed by two different procedures permitting the detection of neutralizing and non-neutralizing antibodies. The first antibody screening in the supernatants of hybridoma clones was carried out by an immunodot ELISA using a novel chromogen, 2-bromo-1-naphthol, for the immunoperoxidase reaction. The second screening was performed with a solid-phase bioassay. The monoclonal antibodies IIG11 and IVH2 react specifically with HuIFN-alpha-1 independently of its origin, natural or recombinant. The mAb IIG11 recognizes also an epitope on a 27 kDa interferon, probably HuIFN-alpha-8. The mAb IIG7 binds to HuIFN-alpha-2 only, whereas the mAb IIB2 binds to HuIFN-alpha-2 and also to the 27 kDa interferon and to a 25 kDa interferon, not yet further characterized. These antibodies can be used successfully for immunopurification as well as for quantification of the corresponding interferons. PMID- 2775251 TI - Going in circles: what future for ageing research? PMID- 2775250 TI - Purine compounds in mitochondria: a quantitative evaluation. AB - Applying a recently developed reverse-phase ion-pair HPLC technique we determined purine compounds in acid extracts of mitochondria isolated from rat and mouse liver, rat renal cortex, and hepatoma. Intramitochondrial purine nucleosides and bases were evaluated quantitatively for the first time. All mitochondria examined contain significant amounts of adenosine, guanosine, inosine, guanine, and hypoxanthine. Moreover, IMP was identified in all extracts. Adenine was detected in traces only. These results are in accordance with the concept of mitochondrial metabolism of purine compounds. PMID- 2775252 TI - A rapid response to a plant hormone: auxin stimulates phospholipase A2 in vivo and in vitro. AB - Addition of the active auxins indole-3-acetic acid, 2,4-dichlorophenoxyacetic acid or alpha-naphthylacetic acid to cultured soybean (Glycine max L.) cells prelabeled with ethanolamine or choline increased the radioactivity in the lysophosphatidylethanolamine (LPE) or lysophosphatidylcholine (LPC) pool within 5 min. The inactive auxin analogue, beta-naphthylacetic acid, was inactive in this response. In membranes prelabeled in vivo, either with ethanolamine or choline, and subsequently isolated from zucchini (Cucurbita pepo L.) hypocotyls, indole-3 acetic acid and 2,4-dichlorophenoxyacetic acid stimulated the conversion of phosphatidylethanolamine (PE) to LPE and of phosphatidylcholine (PC) to LPC in vitro whereas the inactive auxin analogue 2,3-dichlorophenoxyacetic acid did not. PMID- 2775253 TI - Effect of cyclosporin A and the platelet-activating factor (PAF) antagonist, BN 52021, on PAF- and antigen- induced bronchoconstriction in the guinea-pig. AB - The effects of the PAF antagonist, BN 52021, and cyclosporin A (CsA), either alone or in combination, on PAF- and antigen- induced bronchoconstriction were investigated in control and passively sensitized guinea-pigs, respectively. Although single administration of CsA alone has no effect on the PAF-induced bronchoconstriction, a marked inhibition of this phenomenon is observed when the drug is given along with an inactive dose of BN 52021. This effect of the association of the two drugs on the bronchoconstriction is also related to an action on the PAF-induced alterations in the number of leukocytes and platelets. In addition, administration of CsA for 48 hrs, which alone does not influence PAF induced bronchoconstriction, markedly increases the inhibition evoked by BN 52021. Although bolus administration of CsA has no effect on the antigen -induced bronchoconstriction, a marked inhibition of this phenomenon is observed when the drug is given for 2 days. This inhibition by CsA is not further enhanced when the animals are also treated with BN 52021. These results strengthen the hypothesis that PAF and the immune system are involved in the regulation of bronchopulmonary reactions. PMID- 2775254 TI - Characterization of human adipocyte adenosine receptors. AB - 125I-Hydroxyphenylisopropyl adenosine (125I-HPIA) was used to characterize adenosine receptors in human adipocyte plasma membranes. Steady state binding was achieved after 6 h at 37 degrees. Scatchard plots were linear, with a KD of approx. 2.5 nM, and Bmax of 360-1800 fmol/mg protein. (-)N6-phenylisopropyl adenosine (PIA) was a more potent inhibitor of binding than N-ethyl carboxamido adenosine, and (+)PIA was more than 10-fold less potent than (-)PIA, consistent with A1 adenosine receptor binding. Theophylline was a potent inhibitor of binding (IC50 approx. 10 microM). Photoaffinity cross-linking studies demonstrated that the receptor is a single subunit, Mr approx. 43 kDa. The findings demonstrate that the human adipocyte adenosine receptor is similar to the A1 adenosine receptor of rat adipocytes, although its molecular weight is higher, and its affinity for HPIA is lower than that of the rat. PMID- 2775255 TI - Prenylated proteins: demonstration of a thioether linkage to cysteine of proteins. AB - Prenylated amino acid fragments have been isolated from prenylated proteins of Chinese hamster ovary cells. Gel-exclusion chromatography indicates that these proteins are modified by two different prenyl groups. The prenyl-amino acid fragments are labeled by 35S from cysteine, and this bond is cleaved by Raney-Ni, proving that the prenyl residue is linked to protein via a thioether to cysteine. Hydrazinolysis has been used to demonstrate that the cysteine is carboxy terminal. PMID- 2775256 TI - Secretion of transferrin by human breast cancer cells. AB - Transferrin (Tf), the major iron-binding protein in the plasma of vertebrate species is an essential growth factor for cells in serum-free media and appears to be involved in the regulation of growth and differentiation of human tissues. We report here that human breast cancer cells secrete a factor immunologically similar to Tf. The secretion of Tf by the hormone-responsive cell-line MCF-7 is stimulated by 17 beta-estradiol and reduced by the antiestrogen 4-hydroxy tamoxifen. These data suggest that Tf secreted by breast cancer cells may be an additional autocrine growth factor confering selective advantages to rapidly proliferating breast cancer cells and perhaps permit tumor cell growth in poorly vascularized areas. PMID- 2775257 TI - A superactive hormonotoxin prepared with truncated diphtheria toxin. AB - A chemically truncated form of diphtheria toxin, DT51, which lacks the cell binding site but retains the membrane-translocating function, was covalently linked to luteinizing hormone (LH) and compared to similar conjugates containing diphtheria toxin (DT) or diphtheria toxin A-chain (DTA). The DT51 hormonotoxin killed cells possessing an LH receptor at concentrations similar to that of DT hormonotoxin and orders of magnitude lower than DTA hormonotoxin. The DTA hormonotoxin exhibited an LD-50 similar to that of previously reported hormonotoxins which employed DTA, ricin A-chain, or gelonin as toxic moieties. PMID- 2775258 TI - The characterization of three types of partially processed mRNA and two pseudogenes for human liver cytochrome b5. AB - We have isolated cDNA clones corresponding to partially processed human liver cytochrome b5 mRNAs. All the clones contained poly(A) sequences, and one clone had a shorter 3' non-translated sequence, indicating the use of an alternative poly(A) addition signal. In addition, all the clones contained the coding information for amino acids 87-134; however, there were two types of intron junction adjacent to the coding sequence. Detailed analysis of the Type I clones showed that the Type II intron sequence was contained within the Type I sequence, but approximately 1000 bp 5' of the Type I intron-exon junction showed alternative splicing within this intron. In addition, we have isolated two pseudogenes which lack introns, suggesting the retroviral insertion of human liver cytochrome b5 mRNA sequences into the human genome. PMID- 2775259 TI - Evidence that chromium is an essential factor for biological activity of low molecular-weight, chromium-binding substance. AB - Biologically active Low-molecular-weight, chromium-binding substance (LMCr) has been isolated from the liver of rabbits injected with potassium bicarbonate and cow's milk. This substance enhances glucose oxidation and lipogenesis from glucose in rat adipocytes [Yamamoto A. et al. (1987) Eur. J. Biochem. 165, 627 631; (1988) J. Nut. 118, 39-45]. LMCr was shown to lose its activity almost completely as an effectant of glucose metabolism when Cr was deleted under acidic conditions and separated from LMCr by EDTA-chelation and successive molecular sieve chromatography. Reincorporation of Cr3+ into apo-LMCr resulted in 50-90% recovery of its original activity. These findings suggest that the biological activity of LMCr resides in Cr. PMID- 2775260 TI - Calcium-dependent activation of human neutrophils by a synthetic ionophore. AB - Synthetic block copolymers composed of polyoxyethylene and poly-oxypropylene have been demonstrated to possess ionophore activity selective for monovalent cations and to cause histamine release from mouse mast cells and human basophils. We now report calcium-dependent release of granule contents from human neutrophils by the most active of these agents, TI30R2. At a concentration of 100 micrograms/ml (12.5 microM), net lysozyme release ranged from 17-40% after 30 minutes incubation at 37 degrees. Lysozyme release was dose-dependent over stimulus concentrations of 5-50 micrograms/ml (0.625-6.25 microM). Release was dependent upon the presence of extracellular calcium. T130R2 did not induce the release of superoxide anions over 30 minutes of incubation. As T130R2 induces sodium influx into cells, it is likely that a depolarizing influx of sodium ions in the presence of extracellular calcium constitutes a sufficient signal for granule release but not superoxide production by human neutrophils. PMID- 2775261 TI - Evidence for intra-mitochondrial degradation of the extrapeptide of ornithine aminotransferase. AB - When rat liver mitochondria that had imported a synthetic extrapeptide of ornithine aminotransferase (composed of 34 amino acids) were incubated at 25 degrees C, the extrapeptide in their matrix was degraded inside the mitochondria. The degradation of the extrapeptide did not depend on energy either inside or outside the mitochondria. The degrading activity was found exclusively in the mitochondrial soluble fraction and only inhibited by N-ethylmaleimide of eight protease-inhibitors tested. These observations show that the extrapeptide cleaved from the precursor of the mitochondrial protein in the mitochondria is degraded by some ATP-independent proteases inside the mitochondria. PMID- 2775262 TI - Brefeldin A inhibits the targeting of cathepsin D and cathepsin H to lysosomes in rat hepatocytes. AB - Effect of brefeldin A on the transport of lysosomal acid hydrolases (cathepsins D and H) was investigated in primary cultured rat hepatocytes. Both cathepsins were synthesized as proenzymes and progressively converted to mature enzymes in the control cells. However, BFA strongly inhibited the appearance of the mature enzymes in the cells in a dose dependent manner, suggesting that transport of newly synthesized lysosomal enzymes from the endoplasmic reticulum to lysosomes is blocked by the drug. The inhibitory effect by brefeldin A was reversible. Upon recovery from brefeldin A-intoxication, procathepsin D was effectively targeted into lysosomes, whereas a substantial amount of procathepsin H was found to be missorted, resulting in its secretion into the culture medium. PMID- 2775263 TI - Permeability of oxidized phosphatidylcholine liposomes. AB - Permeability of liposomes made from mixtures of unoxidized and singlet oxygen oxidized phosphatidylcholine has been related to the degree of lipid oxidation expressed as hydroperoxide moiety content in the lipids. The effect of oxidation on the liposomes permeability has been studied by fluorometry using calcein as a fluorescent probe that undergoes self quenching when highly concentrated inside liposomes. The liposomes containing 73% and 5% of hydroperoxides retain respectively 64.5 and 96.3% of calcein with respect to that retained by the liposomes made from unoxidized phosphatidylcholine. The fluorescence data show a linear relationship between the liposome permeability and the oxidation degree of lipids. PMID- 2775264 TI - Inhibition of mouse liver sialidase by plant flavonoids. AB - Flavonoids (103 species) were tested for inhibitory activity against mouse liver sialidase using sodium p-nitrophenyl-N-acetyl-alpha-D-neuraminate (PNP-NeuAc) as substrate. Isoscutellarein-8-O-glucuronide from the leaf of Scutellaria baicalensis showed most potent activity (IC50, 40 microM), and this flavone appeared to be a non-competitive inhibitor of the enzyme. This flavone inhibited the lysosomal solubilized sialidase against PNP-NeuAc and sialyllactose effectively, but not microsomal enzyme against gangliosides and colominic acid, whereas, negligible or weak inhibitory activities were observed for influenza virus sialidase, beta-galactosidase, alpha-mannosidase, and alpha-glucosidase tested. These results indicate that this flavone may be useful to elucidate the function of the lysosomal solubilized sialidase. PMID- 2775265 TI - "In vivo" (35S)methionine interaction with rat liver tRNA. AB - As part of a study to characterize the methionine role in tumorigenesis, we report that methionine sulfur interacts with rat liver tRNA "in vivo" (35S) radioactivity remained associated to the nucleic acid after a number of treatments, including tRNA deacylation. Similar data were obtained after administration of (methyl-3H) methionine, while no comparable tRNA labelling was detected when the aminoacid labelled in the aliphatic chain was given. Hplc analysis of (35S) tRNA enzymic hydrolysate showed two unidentified UV-absorbing radioactive peaks. NMR spectra of these two peaks did not reveal any thiomethyl group. PMID- 2775266 TI - Preliminary biochemical characterization of two angiotensin II receptor subtypes. AB - Two angiotensin II receptor subtypes (A and B) are described from rat and human tissues. They have been characterised using specific peptidic and non-peptidic ligands with affinities differing by 1000 fold or more. These subtypes are present in adrenal glomerulosa of both species. Human uterus contains only subtype A, whereas both subtypes are found in rat uterus. Vascular smooth muscle cells in culture express only subtype B. Dithio-threitol totally inhibits binding to subtype B, but enhances the affinity to subtype A. There is a good correlation between the affinities of the selected agonists and antagonists for the two subtypes in the various tissues tested which is a usual requirement for receptor classification. PMID- 2775268 TI - Kinetics of calcium binding to fluo-3 determined by stopped-flow fluorescence. AB - The kinetics of Ca2+ dissociation from fluo-3 was measured using stopped flow fluorimetry. Analysis of dissociation revealed, in contrast to other commonly used fluorescent Ca2+ indicators, a biexponential behaviour with two distinct dissociation rates of 550 s-1 and 200 s-1 at physiological pH and room temperature. The dissociation rate constant of the fast phase increases to 700 s 1 at physiological temperature, whereas that of the slow phase does not change markedly. While the rate constants do not depend on pH between 6.6 and 7.8, the dissociation turns out to be monoexponential at pH 5.86. The association rate of Ca2+ to fluo-3 could not be measured within the mixing dead time and is estimated to be above 10(9) M-1 s-1. Since the rate constants of fluo-3 are larger than those of other fluorescent Ca2+ indicators, fluo-3 is well suited for investigations of Ca2+ oscillations in biological systems. PMID- 2775267 TI - Tumor necrosis factor-alpha induces the phosphorylation of 28kDa stress proteins in endothelial cells: possible role in protection against cytotoxicity? AB - Tumor necrosis factor-alpha has been shown to rapidly increase the phosphorylation of three 28 kDa proteins in bovine aortic endothelial cells but not in L929 cells. Tumor necrosis factor-alpha induces the necrosis of the latter cells but not of the former. Arsenite enhanced the phosphorylation of the same 28kDa proteins as tumor necrosis factor-alpha in the endothelial cells. As stress proteins often play a protective role, we suggest that the phosphorylation of these proteins in endothelial cells may be responsible for the resistance of these cells to tumor necrosis factor-alpha. PMID- 2775269 TI - Vasoconstriction: a novel activity for low density lipoprotein. AB - Low density lipoprotein plays an important role in the pathogenesis of atherosclerosis. Cumulative addition of 1-30 micrograms/ml of LDL from normolipidemic subjects produced a dose-dependent increase in contractile tension of thoracic aortic rings from rats. The maximal LDL-induced contractile response was approximately 30% of that induced by 1 microM norepinephrine. Similar concentrations of LDL induced a dose-dependent transient increase of the concentration of intracellular free calcium, and a biphasic change of the intracellular pH in cultured rat vascular smooth muscle cells. We conclude that low density lipoprotein occurring for example in the extravascular fluid can mediate vasoconstriction by changes in cytosolic calcium and intracellular pH. PMID- 2775270 TI - Spectral evidence for non-calcium interactions of intracellular Indo-1. AB - Indo-1 is widely used to measure intracellular free calcium, [Ca2+]i, by comparing the fluorescence emission at 2 or more wavelengths with the emissions, which are assumed to be known, of Indo-1 when it is fully calcium-bound and when it is fully calcium-free. Accurate quantitation requires that these "reference" values be obtained on intracellular dye, and the full spectra of this study show that the reason is a significant spectral shift of the calcium-free peak, but not the calcium-bound. A mathematical analysis shows that the new peak must be a new state of the Indo-1 molecule, since it cannot be simply due to residual calcium in the cell. When intracellular "reference" spectra were used in the data analysis, [Ca2+]i could be calculated from whole spectra or from the ratio of observations at two wavelengths with good agreement. When extracellular "reference" spectra were used, the value calculated by the ratio method depended on the choice of wavelengths. PMID- 2775271 TI - Lipid peroxidation in Ehrlich ascites cell mitochondria is not determined by the polyunsaturated fatty acid content of the membrane. AB - Lipid peroxidation intensity is compared in Ehrlich Ascites Cell and in liver mitochondria, prepared from tumor bearing mice. Malondialdehyde formation is negligible in intact ascites tumour mitochondria, but it is significantly increased in permeabilised mitochondria and in isolated mitochondrial membranes. We suggest that the resistance against oxidative stress is a consequence of efficient protective mechanisms operating in the intact tumour mitochondria and the low level of polyunsaturated fatty acids under these circumstances cannot be the rate limiting factor in lipid peroxidation. Succinate, an effective inhibitor of mitochondrial lipid peroxidation in liver, cannot determine malondialdehyde formation in ascites tumour mitochondria. PMID- 2775272 TI - Antibodies to newly recognized murine 13-18 KDa pituitary peptides crossreact with growth hormone and prolactin from several species, including man. AB - Recently we identified five novel peptides of Mr 13,000 to 18,000 (designated P13, P14, P16, P17, and P18 according to approximate Mr) in the anterior pituitary gland of rat and man that appeared related to GH and PRL in regulation and structure. We have now raised polyclonal antibodies in the rabbit to four of these peptides--P13, P14, P17 and P18--isolated from rat anterior pituitary; the rabbit injected with P16 did not produce antibodies. Besides reacting with their respective immunogens, antisera to all four peptides crossreacted, quite unexpectedly, with human GH and with human, porcine, and ovine PRL. Antiserum to P17, in addition, crossreacted very strongly with rat PRL, while P18 antiserum crossreacted not only with human GH but also with its 20K and cleaved variants. These results provide strong evidence for the structural relatedness of these peptides to GH and PRL, and raise the possibility that they may be related functionally as well. PMID- 2775274 TI - Protease inhibitors do not prevent the killing of cultured hepatocytes by cystamine. AB - A study was made of the conditions of the killing of cultured hepatocytes by the reactive disulfide cystamine. Six to 12 mM cystamine killed up to 60% of the hepatocytes within 3 hours. The cytosolic calcium ion concentration rose prior to the loss of viability. Treatment with EGTA in a Ca2+-free medium lowered the initial Ca2+ concentration and prevented the rise in response to cystamine. However, there was no change in the number of dead cells. Furthermore, the sensitivity of cultured hepatocytes to cystamine was unaffected by the concentration of calcium in the culture medium. Addition to the culture medium of 3 protease inhibitors, leupeptin, antipain, or chymostatin, did not reduce the extent of cell killing by cystamine despite an inhibition of protein degradation. These data do not support the hypothesis that the toxicity of cystamine is necessarily mediated by proteases activated by a rise in the cytosolic calcium ion concentration. PMID- 2775273 TI - Levels of protein kinase C activity in human gastrointestinal cancers. AB - The protein kinase C (PKC) activities of tumor tissue and adjacent normal mucosa of human cancers of the esophagus (8 cases), stomach (1 case) and colon (3 cases) were measured. Considerable variations were found in the activity of PKC and in its subcellular distribution in these cancers. The PKC activities of the membrane and cytosolic fractions of the eight esophageal cancers were, however, similar to those of the adjacent normal mucosa: the average PKC activities of the tumor tissues and normal mucosa were 7.5 and 8.3 pmol/min/mg protein, respectively, in their membrane fractions and 7.9 and 7.8 pmol/min/mg protein, respectively, in their cytosolic fractions. PMID- 2775276 TI - The primary structure of a membrane-associated phospholipase A2 from human spleen. AB - The complete primary structure of membrane-associated phospholipase A2 purified from a human splenic membrane fraction was determined by sequence analysis of the peptides generated by lysyl endopeptidase and Staphylococcus aureus V8 protease cleavage. The enzyme consists of 124 amino acid residues corresponding to a molecular weight of 13,904. The primary structure reveals the characteristics of Group II phospholipases A2 and a large ratio of basic amino acid residues to acidic ones, that ratio being 3.4 : 1. PMID- 2775275 TI - Role of peroxisomal fatty acid beta-oxidation in ethanol metabolism. AB - The contribution of peroxisomal fatty acid beta-oxidation to ethanol metabolism was examined in deermice hepatocytes. Addition of 1 mM oleate to hepatocytes isolated from fasted alcohol dehydrogenase (ADH)-positive deermice in the presence of 4-methylpyrazole or to hepatocytes from fasted or fed ADH-negative deermice produced only a slight and statistically not significant increase in ethanol oxidation. Lactate (10 mM), which is not a peroxisomal substrate, showed a greater effect on ethanol oxidation. There was also a lack of oleate effect on the oxidation of ethanol by hepatocytes of ADH-positive deermice. Furthermore, in ADH-negative deermice, the catalase inhibitor azide (0.1 mM) did not inhibit the increase in ethanol oxidation by oleate and lactate. The rate of oleate oxidation by hepatocytes from fasted ADH-negative deermice was much lower than that of ethanol. These results indicate that in deermice hepatocytes, peroxisomal fatty acid oxidation does not play major role in ethanol metabolism. PMID- 2775277 TI - Self-complementary regions in human albumin mRNA encode important structural regions within the human albumin protein. AB - An analysis of the human albumin mRNA structure revealed a nonrandom distribution of self-complementary regions within the mRNA. The majority of these self complementary mRNA stretches encode important structural regions of the human albumin protein. The amino acids contained within these regions of the protein exhibit a high degree of hydrophobic complementarity which could influence local protein conformation and contribute to the biological importance of the protein structures. PMID- 2775278 TI - Cell swelling induced by the permeant molecules urea or glycerol induces immediate high amplitude thyrotropin and prolactin secretion by perifused adenohypophyseal cells. AB - The permeant molecules, urea and glycerol, evoked a prompt secretory burst of TSH and PRL when added to the extracellular medium of acutely dispersed anterior pituitary cells. Secretion of both hormones was proportional to the concentration of urea or glycerol between 26 and 104 mM (r greater than 0.89, P less than 0.001). Equivalent concentrations of the impermeant molecule, mannitol, did not induce secretion. The acute TSH and PRL secretory responses to TRH, hyposmolarity, and permeant molecules were qualitatively indistinguishable. These data support our hypothesis that cell swelling and resultant plasmalemma expansion is a potent inducer of hormone secretion. Since the secretory response to permeant molecules was not reduced in a Ca2+-free medium containing 0.1 mM EGTA, an increase in Ca2+ transport across the plasmalemma to raise cytosol Ca2+ concentration does not appear involved. PMID- 2775279 TI - Determination of multiple forms of cytochrome P-450 in microsomes from the digestive gland of Cryptochiton stelleri. AB - Polyclonal antibodies raised against purified trout cytochromes P-450 (P-450) LM2 (anti-LM2) and LM4b (anti-LM4b) were used in Western blot analyses with digestive gland microsomes from control and beta-naphthoflavone (BNF)-treated gumboot chitons Cryptochiton stelleri. An increase and decrease in staining intensity subsequent to treatment with anti-LM4b and anti-LM2, respectively, was observed in digestive gland microsomes from BNF-treated chiton. Thus, there appears to be at least two forms of P-450 in microsomes from the digestive gland of Cryptochiton; one of which is induced by BNF and perhaps is involved in benzo(a)pyrene (BP) biotransformation, and another form which is inhibited by BNF. PMID- 2775280 TI - Protein binding domains of the rat thyroglobulin promoter. AB - We have previously shown that DNA elements controlling tissue specific expression of the rat thyroglobulin gene extend 170 bp upstream of the cap site and have identified a thyroid specific nuclear factor which binds the promoter in the -60 region (site C). Here we report that the distal portion of the promoter, extending from -160 to -120, contains two contiguous DNA elements (sites A and B) which interact with the same thyroid-specific factor binding to proximal site C. A second nuclear factor, ubiquitously distributed, binds to the distal site A. Transient cotransfection-competition studies show that all the three binding sites A, B and C titrate a trans-acting factor(s) which is necessary for the transcription of the thyroglobulin gene. PMID- 2775281 TI - Lipoprotein aggregation as an essential condition of intracellular lipid accumulation caused by modified low density lipoproteins. AB - We have tested a hypothesis that aggregates of modified low density lipoproteins (LDL) play the key role in the accumulation of lipids by cells of unaffected aortic intima. It was demonstrated using analysis of relative dispersion of light transmission fluctuations as well as gel filtration on Sepharose CL-2B that LDL modified by oxidation, glycosylation, desialylation and malondialdehyde treatment form aggregates under the conditions of culture. Native LDL failed to aggregate under the same conditions. It was demonstrated that modified LDL, unlike native LDL, bring about a 2- to 3-fold rise in cholesteryl ester levels of cultured cells. Moreover, direct and strong correlation (r = 0.86) was observed between the degree of lipoprotein aggregation and the amount of cholesteryl esters accumulated. Removal of modified LDL aggregates by filtration through a 0.1 micron filter or gel filtration completely prevented the intracellular accumulation of cholesteryl esters. These findings indicate that LDL aggregates play an essential, if not the decisive, role in the intracellular accumulation of lipids in vitro. PMID- 2775282 TI - Dual loading of the fluorescent indicator fura-2 and 2,7-biscarboxyethyl-5(6) carboxyfluorescein (BCECF) in isolated myocytes. AB - Isolated rat heart myocytes were loaded with both the Ca2+ sensitive fluorescent probe fura-2/AM and the fluorescent pH indicator 2,7-biscarboxyethyl-5(6) carboxyfluorescein (BCECF/AM). Changes in [Ca2+]i and pHi were measured simultaneously using digitized video fluorescence microscopy. In measurement of [Ca2+]i and pHi, the ratios of dual-loaded cells were not different from single loaded cells. Using this method, [Ca2+]i and pHi in myocytes were 48 +/- 7 nM and 7.17 +/- 0.05. It is concluded that [Ca2+]i and pHi could be measured simultaneously in isolated myocyte using dual-loading of fura-2 and BCECF. PMID- 2775283 TI - Identification of a cell cycle-dependent gene product as a sialic acid-binding protein. AB - A Ca2+-dependent sialic acid-binding protein was purified on fetuin-Sepharose from various types of human tissue. The molecular mass was determined to be 10,315 Da by laser desorption mass spectrometry. Partial sequence analysis after cyanogen bromide cleavage that yielded one N-terminus accessible for Edman degradation revealed an identity to an internal stretch following the only methionine residue within a putative amino acid sequence (Mr 10,048), deduced from the cDNA of a cell cycle-specific gene. The reported biochemical identification is a prerequisite to infer the biological role of the so far undetected gene product. Initial glycohistochemical studies with sialic acid-(BSA biotin) raised evidence for nuclear localization of sialic acid-binding sites that might reflect, at least in part, detection of this protein. PMID- 2775284 TI - Functional significance of aminoacyl-tRNA synthetase complex in the aminoacylation of tRNA(Leu) isoacceptors. AB - Aminoacyl-tRNA synthetases, partially purified from rat liver by two different methods, were used in vitro to study aminoacylation profiles of tRNA(Leu) isoacceptors. On the basis of molecular weights, one preparation was similar to the multienzyme complex of aminoacyl-tRNA synthetases, whereas the other apparently represents a partially disrupted complex. In the aminoacylation assay, the multienzyme complex produced a profile of leucyl-tRNA isoacceptors that was similar to those found in vivo and in liver perfusion experiments. The aminoacylation profile that was obtained with the partially disrupted complex varied with the enzyme and leucine concentration used. Especially one of the tRNA(Leu) species was poorly aminoacylated at low leucine and enzyme concentration. These experiments point out that attention should be paid to the nature of the aminoacyl-tRNA synthetase preparation in experiments in which isoacceptor profiles are studied in vitro. PMID- 2775285 TI - Amino acid sequence of pheromone-biosynthesis-activating neuropeptide (PBAN) of the silkworm, Bombyx mori. AB - We have isolated two distinct pheromone-biosynthesis-activating neuropeptides (PBAN), named PBAN-I and -II, as fully oxidized forms of Met residues from adult heads of the silkworm, Bombyx mori. PBAN-I was identical with the PBAN which we had isolated before. The complete amino acid sequence of PBAN-I, a total of 33 amino acid residues, was determined as H-Leu-Ser-Glu-Asp-Met-Pro-Ala-Thr-Pro-Ala Asp-Gln-Glu-Met-Tyr-Gln-Pro-As p-Pro- Glu-Glu-Met-Glu-Ser-Arg-Thr-Arg-Tyr-Phe-Ser Pro-Arg-Leu-NH2. Synthetic PBAN-I after oxidation with H2O2 was chromatographically identical with the isolated PBAN-I. Examination of PBAN activity of synthetic analogues indicated that the carboxyl-terminal portion of PBAN-I was important for biological activity. PMID- 2775286 TI - Identification and characterization of adipokinetic hormone (Locusta migratoria) like immunoreactivity in the human cerebrospinal fluid. AB - Using an antiserum raised against locust adipokinetic hormone I, considerable quantity of adipokinetic hormone-like immunoreactivity was demonstrated in the human cerebrospinal fluid. The immunoreactivity was characterized by gel permeation and high performance liquid chromatography. The main immunoreactive component in the cerebrospinal fluid coeluted with adipokinetic hormone I. These results suggest that adipokinetic hormone may contribute to the neuronal function in the human central nervous system. PMID- 2775287 TI - Cyclosporin A-sensitive and insensitive mechanisms produce the permeability transition in mitochondria. AB - Cyclosporin A is a potent inhibitor of the mitochondrial permeability transition, possibly by blocking an inner membrane pore through which solute movements occur [Broekemeier et al. (1989) J. Biol. Chem. 264, 7826-7830]. The inhibitory effect of cyclosporin, however, is transient. Trifluoperazine, at concentrations which inhibit the mitochondrial phospholipase A2, also produces a transient inhibition. When both inhibitors are used together, the inhibitory effect is long lasting. These findings suggest that the transition can be caused by two overlapping and/or interactive mechanisms, one dependent on an inner membrane pore and the other on phospholipase A2. PMID- 2775288 TI - Purification and characterization of 81K, heat stable calmodulin-binding protein from bovine brain. AB - Heat stable calmodulin-binding protein has been purified from Triton X-100 soluble particulate fraction of bovine brain. Considerable purification was achieved with calmodulin coupled Sepharose 4B affinity chromatography. SDS-PAGE of the purified protein revealed the apparent homogeneity being 92% at Mr 81,000. Isoelectric focusing of purified 81K protein gave isoelectric point of 4.3. The amino acid composition was notable for high contents of acidic amino acids (15.0 mol% of glutamic acid and 8.1 mol% of aspartic acid) and 17.4 mol% of alanine. On alkaline 1 M urea gel electrophoresis, mobility of the purified 81K protein in the presence of Ca2+ and calmodulin became lower than 81K protein alone toward the anode; however, Ca2+ solely did not affect the mobility of this protein. Similarly, S-100 protein and troponin C showed the interaction with 81K protein and a decrease of mobility in the presence of Ca2+ in alkaline urea PAGE. Binding assay of 125I-labeled calmodulin revealed that 81K protein could bind to an equimolar of 125I-calmodulin as apparent dissociation constant (Kd) of 0.65 x 10( 6) M. PMID- 2775289 TI - In vitro translation of cytoskeletal beaded-chain filament proteins from chicken lens mRNA. AB - The beaded-chain filament is a unique cytoskeletal structure that appears in the elongating fiber cells during the differentiation of lens epithelial cells to form the mature fiber cells. This beaded-chain structure is made up of two proteins of molecular weight 95 kDa and 49 kDa. As a prerequisite for cloning the cDNAs of these proteins, newborn chicken lens total poly(A+) mRNA was translated in vitro, using a rabbit reticulocyte lysate system and [35S]-L-methionine. The labelled translation products were analyzed by one-and two dimensional gel electrophoresis followed by autoradiography. Immunoprobing of the translation products on Western blots using specific polyclonal antibodies identified the above proteins, and demonstrated the presence and expression of specific mRNAs in the neonatal chick lens, that code for the in vitro synthesis of these two cytoskeletal proteins. These mRNAs are low abundant mRNAs as compared to the crystallin mRNAs. PMID- 2775290 TI - Characterization of casein kinase II in human colonic carcinomas after heterotransplantation into nude mice. AB - Casein kinase II (CKII) activity in colorectal tumours was compared before and after heterotransplantation onto nude mice. The test revealed that the enzyme activity was about two-fold enhanced in the tumours isolated from the nude mice when compared to the respective primary tumours from which they were derived. Immunoblots using a polyclonal CKII-specific antibody showed that the increase of activity was due to a higher expression of the enzyme. Immunohistochemical studies on cross sections of nude mouse tumours showed that most of the CKII molecules were located at the peripheral part of the tumour; the central part did not show intense CKII-specific staining. PMID- 2775291 TI - Chemical phosphorylation of proteins by zinc-ATP. AB - During an examination of in vitro phosphorylation of the adipocyte lipid-binding protein (ALBP) by the insulin receptor, we detected insulin receptor-independent, chemical phosphorylation of ALBP. This activity was present in ALBP purified to homogeneity from murine 3T3-L1 cells and in recombinant murine ALBP purified from expressing E. coli cultures. Phosphoamino acid analysis revealed that chemical phosphorylation of ALBP occurred primarily on Ser residues. The phosphorylation activity occurred in the alkaline pH range from 8 to 11 and exhibited a broad temperature dependence. The reaction rate was linearly dependent upon the ATP concentration and exhibited a biphasic kinetic profile. Eight of twelve other proteins tested also underwent chemical phosphorylation. Zn+2, Mg+2, or Mn+2 promoted optimal phosphorylation of different proteins. We conclude that many proteins are capable of undergoing chemical phosphorylation. PMID- 2775292 TI - Antagonistic effect of PDGF and NGF on transcription of ribosomal DNA and tumor cell proliferation. AB - The molecular mechanism by which NGF and PDGF affect growth of tumor cells was tested in human melanoma WM 266-4 and colorectal carcinoma SW 707 cell lines. We present evidence that NGF translocated to the nucleus and bound to the chromatin of SW 707 cells, which express the cell surface and the chromatin receptor for NGF, inhibits ribosomal RNA synthesis which in consequence leads to inhibition of cell proliferation. In WM 266-4 cells, which do not express NGF receptor, NGF does not affect cell proliferation. In contrast, PDGF translocated to the nucleus of both SW 707 and WM 266-4 cells activates ribosomal RNA synthesis. We report here that NGF abolishes PDGF-activated ribosomal RNA synthesis and PDGF stimulated growth of tumor cells. PMID- 2775293 TI - The nucleotide sequence of a human cDNA encoding the highly conserved nucleolar phosphoprotein B23. AB - A cDNA clone containing the complete coding sequence for the human nucleolar phosphoprotein B23 was isolated from a Burkitt's lymphoma cDNA library by immunoscreening with human autoantibodies. The B23 clone contained a 1.3 kb cDNA insert encoding a polypeptide of 294 amino acids with a predicted molecular mass of 32,539 daltons. The deduced B23 amino acid sequence contained 2 acidic domains rich in aspartic and glutamic acid, a feature shared by a number of nuclear and nucleolar proteins. The human B23 amino acid sequence showed 98% homology with rat B23 and 68% homology with the Xenopus laevis nucleolar phosphoprotein, NO38 showing that the primary structure of B23 is highly conserved among these species. PMID- 2775294 TI - Abnormal processing of beta-Malay globin RNA. AB - Hemoglobin Malay (alpha 2 beta 2 19 Asn----Ser) has been observed in a few Malaysian patients with thalassemia intermedia. The beta Malay substitution increases the homology of the cryptic splice site at codons 17/18/19 of the beta globin gene to the donor consensus splice sequence, suggesting that the beta thalassemia associated with this mutation may be due to the generation of a new splice site. To test this hypothesis, we constructed a hybrid gene where we replaced part of a normal beta-globin gene with a PCR amplified region of the beta Malay gene. The expression of this mutant gene was studied in a heterologous transient expression system. The data show that nearly 25% of globin mRNA produced by this gene is abnormally spliced at the new splice site, providing a molecular mechanism for the beta-thalassemia associated with the mutation. PMID- 2775296 TI - The nucleotide sequence of the luxE gene of Vibrio harveyi and a comparison of the amino acid sequences of the acyl-protein synthetases from V. harveyi and V. fischeri. AB - The luxE gene of bioluminescent bacteria encodes the acyl-protein synthetase component of the fatty acid reductase complex. The complex is responsible for converting tetradecanoic acid to the aldehyde which serves as a substrate in the luciferase-catalyzed reaction. The nucleotide sequence of the luxE gene of Vibrio harveyi was determined and the amino acid sequence of the acyl-protein synthetase deduced. The protein consists of 378 amino acid residues and has a molecular weight of 42,965 daltons. Alignment of the V. harveyi enzyme with the V. fischeri acyl-protein synthetase showed 62% identity. PMID- 2775295 TI - Heparin and endothelial cell growth factor modulate collagen and proteoglycan production in human smooth muscle cells. AB - The effects of heparin and endothelial cell growth factor (ECGF) on extracellular matrix production were examined in human iliac smooth muscle cells. The cells were grown in (a) medium supplemented with heparin (100 micrograms/ml) and ECGF (75 micrograms/ml), (b) medium supplemented with ECGF (75 micrograms/ml) alone, or (c) unsupplemented medium. In the presence of heparin and ECGF, collagen production was inhibited 91-95% as compared to cultures incubated with ECGF alone or without both supplemental factors. In contrast, the production of proteoglycans was elevated 2.5 fold in the presence of heparin and ECGF. Enzymatic digestion of the proteoglycans indicated that both large and small molecular weight chondroitin sulfate proteoglycans were markedly elevated, while dermatan sulfate and heparan sulfate proteoglycans were increased to a lesser extent. The results suggest that the combination of heparin and ECGF elicits potent modulation of extracellular matrix production, with divergent effects on collagen and proteoglycan synthesis. PMID- 2775298 TI - Chronic cadmium-ethanol administration alters metal distribution and some biochemicals in rat brain. AB - The effects of cadmium (100 ppm through drinking water) and ethanol (5 g/kg by gastric gavage) administration on biogenic amines, metal distribution and certain enzymes in rat brain was investigated after 90 days of exposure. Co-exposure group revealed significant accumulation of cadmium and also increase in zinc levels compared to all the other groups. Ethanol alone decreased MAO activity and increased NE and 5-HT level while in combination with Cd, these effects were more magnified. It is, therefore, suggested that the persons consuming alcohol may be more prone to the neurotoxic effects of this metal. PMID- 2775297 TI - Testosterone increases N-acetyltransferase activity in both male and female Syrian hamster harderian glands. AB - N-acetyltransferase (NAT) activity was studied in the Harderian glands of intact and castrated (with or without subcutaneous testosterone implants) male and female Syrian hamsters. Castration in male hamsters produced a significant drop in the NAT activity. Castrated males with testosterone implants had NAT activity levels comparable to those in intact males. Ovariectomy did not modify NAT activity. Ovariectomized hamsters with testosterone implants exhibited a significant increase in the Harderian NAT activity reaching the same values as those in the glands of the male hamsters. PMID- 2775300 TI - Changes in hexokinase and glucose-6-phosphate dehydrogenase in red cells during hypo and hyperthyroidism. AB - Activities of hexokinase and glucose-6-phosphate dehydrogenase have been measured in red blood cells from thyroidectomized, triiodothyronine treated and hyperthyroid rats. After thyroidectomy, significant decrease in the activities of hexokinase and glucose-6-phosphate dehydrogenase was observed as compared to controls. The effects were reversed with triiodothyronine administration to the thyroidectomized rats. Hyperthyroidism increased both enzymes. The observations further confirm the hypermetabolic effects of thyroid hormones on the cellular metabolism. PMID- 2775299 TI - PPIX induced photohemolysis of erythrocytes partially-depleted of cholesterol. AB - The protoporphyrin IX (PPIX)-sensitized hemolysis of erythrocytes depleted of cholesterol was investigated. From 20% to 30% of the total membrane cholesterol was removed from cells by incubation with old autologous plasma or by means of interaction with L-alpha-phosphatidylcholine dipalmitoyl (DPPC) liposomes. As expected, after this treatment, the cells show an overall increase in membrane fluidity revealed by means of specific fluorescent probes. The same cells are more susceptible to the photohemolysis induced by PPIX excited by visible light, but gave no lysis in the absence of the sensitizer. As a consequence, the primary oxidative damage which is produced during irradiation can be possibly assigned to the phospholipidic and/or proteic moiety instead of the steroidal moiety. PMID- 2775301 TI - Functional significance of AMP deaminase and adenosine deaminase in the aestivating freshwater snail, Pila globosa (swainson): possible neuroendocrine involvement. AB - The functional significance of AMP deaminase and adenosine deaminase has been studied in hepatopancreas of active, aestivated and ganglionic extracts administered snails. The activity levels of both enzymes decreased in aestivating snails. Active snails injected with ganglionic extracts of aestivated snails also showed decreased activity. Contrastingly, the hepatopancreas of aestivated snails when treated with ganglionic extracts of active snails showed increased specific activities of both enzymes. The decrease or increase in the specific activities varied with different ganglionic extracts and the significance of the same is discussed. PMID- 2775302 TI - Benthiocarb toxicity on rat brain AChE. AB - Benthiocarb effect on rat brain acetylcholinesterase (AChE) has been studied to know the toxic effects of benthiocarb on mammalian cholinergic systems. From the study, it has been observed that the inhibition of AChE activity increased with increase in treatment period which is attributed to the cumulative effects of benthiocarb on AChE activity. The kinetic study revealed that there is a slight increase in Km and a marked decrease in Vmax which accounts for the non competitive inhibition of enzyme during benthiocarb intoxication. PMID- 2775303 TI - Modulation of phosphorylase kinase activity by sphingolipids. AB - Psychosine (galactosyl sphingosine) potently inhibits the activity of both nonactivated and activated by covalent modification (autophosphorylation and limited proteolysis) rabbit skeletal muscle phosphorylase kinase. Half-maximal inhibition was observed at 44 microM or 66 microM when the kinase activity was assayed at pH 6.8 or 8.2 respectively. Sphingosine was also inhibitory, but only at pH 6.8 (half-maximal inhibition was observed at 130 microM). In this respect, sphingomyelin, cerebroside and cerebroside sulfate were ineffective. On the other hand, a number of gangliosides stimulated the activity of nonactivated phosphorylase kinase at neutral pH. Among the individual gangliosides tested the activation potency was GD1a greater than GT1b greater than GM1, while GM3 was without effect. Most important, GD1a dramatically increases the activity of the kinase at low Ca2+ concentrations. Both psychosine and GD1a increased the rate of kinase autophosphorylation on alpha- subunit only, but although ganglioside induced stimulation of autophosphorylation was accompanied with an enhancement of the rate of autoactivation at pH 6.8, psychosine completely blocked autoactivation. PMID- 2775304 TI - The specificity of inhibition of debrisoquine 4-hydroxylase activity by quinidine and quinine in the rat is the inverse of that in man. AB - The kinetics of inhibition of debrisoquine 4-hydroxylase activity by quinidine and quinine in rat and human liver microsomes have been compared. Quinidine is a potent inhibitor of debrisoquine 4-hydroxylase activity of human liver (IC50: 3.6 microM). However, its stereoisomer, quinine, is some 60 times less potent (IC50:223 microM). Both compounds are able to inhibit greater than 95% of 4 hydroxylase activity. In rat liver microsomes quinine is approximately 50 times more potent an inhibitor (IC50:2.4 microM) than quinidine (IC50:137 microM). Again, 4-hydroxylase activity is inhibited by greater than 95%. Inhibition of debrisoquine 4-hydroxylase activity by both quinine and quinidine in human and rat liver is competitive. Values of Ki for quinidine in human and rat were 0.6 microM and 50 microM, whereas with quinidine the Ki values were 13 microM and 1.7 microM, respectively. The data in this paper are consistent with 4-hydroxylation of debrisoquine in both rat and human liver catalysed by a specific form of cytochrome P-450. Although both quinidine and quinine are competitive inhibitors of debrisoquine 4-hydroxylase activity in rat and man, their potency is reversed. This suggests that the nature of the active site of cytochrome P-450dbl differs between the two species, and indicates that data on the specificity of this isoenzyme in the rat should be extrapolated to man with extreme caution. PMID- 2775305 TI - Ethanol potentiates serotonin stimulated inositol lipid metabolism in primary astroglial cell cultures. AB - Serotonin-stimulated activation of phospholipase C in primary astroglial cell cultures was studied as a mean of evaluating the effect of acute ethanol exposition on this signal transduction system. The addition of 50-150 mM ethanol prior to stimulation with 10(-5) M serotonin led to a potentiation of the serotonin-induced [3H]-inositol phosphate formation and an increased incorporation of [3H]-inositol into the three phosphoinositides studied. This potentiating effect of ethanol was observed only when ethanol was added together with serotonin. No stimulatory effect of ethanol per se was found. Furthermore, ethanol had no effect on arginine-vasopressin, bradykinin or phenylephrine stimulated inositol lipid metabolism. PMID- 2775306 TI - In vitro and in vivo effect of mercury, lead and cadmium on the generation of chemiluminescence by human whole blood. AB - A method based on the use of the luminogenic substance, luminol, was developed for measuring the respiratory burst induced by phorbolmyristate acetate in 4 microliters of human whole blood. In vitro, the three cations, Hg2+, Pb2+ and Cd2+, inhibit the peak luminescence response at concentrations higher than those usually found in blood of subjects exposed to these metals. Cadmium metallothionein, however, in a concentration range similar to that found in whole blood of workers exposed to cadmium strikingly reduces the respiratory oxidative burst. In workers exposed to inorganic lead or mercury vapour, no reduction of the chemiluminescence response of whole blood was observed while a slight but statistically significant reduction was found in whole blood from cadmium exposed workers. If a similar effect occurs in lung macrophages, it might decrease the respiratory tract resistance to infection. PMID- 2775307 TI - Induction of drug-metabolizing enzymes in Gunn rat liver. Effect of polycyclic aromatic hydrocarbons on cytochrome P-450 regulation. AB - Response of congenitally jaundiced rats (Gunn rats) to administration of polycyclic aromatic hydrocarbons (PAH) was investigated and compared to that of Wistar rats. Unlike Wistar, Gunn males did not exhibit changes in the overall cytochrome P-450 content of hepatic microsomes. The first step in the induction process (i.e. presence of cytosolic receptors for PAH) was found present and functionally similar (number of sites, Kd) to that of Wistar rats from which the Gunn strain is derived. An increase in monooxygenase activities related to P-450c and P-450d isoenzymes specifically induced by PAH was noticed, whereas no effect could be detected on the glucuronidation rate of either 4-nitrophenol, testosterone or estrone. As determined by immunoquantification after Western blotting, the isoenzymatic profile of P-450 from PAH-treated male Gunn rats showed an increase of P-450c and P-450d accompanied by an equivalent decrease in P-4502c (major male-specific isoenzyme). The balance between increase in P-450c and P-450d and decrease in P-4502c may explain the absence of increase in the total P-450 in PAH-treated male Gunn rats. Such a response was not observed in PAH-treated male Wistar rats or in female rats of both strains. In contrast, the response of male Gunn rats to PB treatment was similar to that observed in Wistar rats, i.e. increase in overall cytochrome P-450 content of hepatic microsomes and of specific isoenzyme P-450b/e. A possible regulation of P-450 isoenzyme synthesis by the intracellular haem pool might be involved. PMID- 2775308 TI - Separation of the different classes of intrahepatic lipoproteins from various animal species. Their binding with 2,3,7,8-tetrachlorodibenzo-p-dioxin and benzo(a)pyrene. AB - Using several analytical methods, including sucrose density gradient and potassium bromide density gradient ultracentrifugations, we have demonstrated that liver cells contain a range of lipoproteins somewhat distinct from those found in plasma. In addition to very low-density lipoproteins (VLDL), low-density lipoproteins (LDL) and high-density lipoproteins (HDL), many heavier entities have been found in the cytosol of various animal species. These heavier entities might represent either anabolic or catabolic intermediates of lipoproteins. Labelled hydrophobic xenobiotics such as 2,3,7,8-tetrachlorodibenzo-p-dioxin or benzo(a)pyrene strongly bind to the various classes of lipoproteins and may be used as radioactive tracers in the analysis and possibly in the metabolic studies of intracellular lipoproteins. Moreover, this binding may be a prerequisite for a storage or/and a carrier--roles of lipoproteins in the intracellular distribution of lipophilic xenobiotics within the cells. PMID- 2775309 TI - Activation of mianserin and its metabolites by human liver microsomes. AB - Human liver microsomes metabolise mianserin to the stable 8-hydroxymianserin, desmethylmianserin and mianserin-2-oxide and in addition to one or more chemically reactive metabolites which bind, irreversibly, to microsomal protein. The stable metabolites were isolated by HPLC and characterized by mass spectrometry. The generation of each of these metabolites showed substantial inter-individual variation between eight sets of human liver microsomes studied. Inhibition of irreversible binding was observed with SKF-525A together with concomitant decrease in the formation of 8-hydroxymianserin and desmethylmianserin but not mianserin-2-oxide. Methimazole inhibited binding and the formation of each of the metabolites at a low concentration. Quinidine did not significantly inhibit irreversible binding but did inhibit the formation of 8 hydroxymianserin. Sulphaphenazole had no effect on irreversible binding or metabolism. The irreversible binding of mianserin was inhibited by ascorbic acid, glutathione and N-acetyl cysteine, whereas N-acetyl lysine and trichloropropane oxide had no effect. The irreversible binding of mianserin, 8-hydroxymianserin and desmethylmianserin was of the same order of magnitude however significantly greater binding was observed with the desmethyl metabolite. Incubations with [10 3H/14C]mianserin showed no change in the 3H/14C ratio when irreversible binding occurred. Inhibition of irreversible binding was demonstrated with sodium cyanide at concentrations which did not inhibit total metabolism, which suggest that metabolic activation by the cytochrome P-450 enzyme system may lead to the formation of a reactive iminium intermediate that can bind to nucleophilic groups on proteins. PMID- 2775311 TI - New photoaffinity labels for rat brain muscarinic acetylcholine receptors. AB - Localization of the ligand binding site on muscarinic acetylcholine receptors is one of the new fields of interest opened by the recent determination of their primary structures. Owing to their interesting photochemical properties, aryldiazonium salts may be considered as appropriate tools for "tagging" the agonist/antagonist binding domain and to get precise identification and positioning of covalently labelled residues along the primary sequence of these receptors. A series of aryldiazonium derivatives and some of their azido-analogs were synthesized and their reversible muscarinic binding component was assessed through competition experiments involving either the whole population of receptor sites [( 3H]QNB assay) or the super high affinity of their agonist binding sites [( 3H]OXO-M assay). Three compounds fulfilled the criteria for efficient photolabels, allowing substantial and irreversible occupation of the receptor sites to be obtained. Interestingly, the two diazonium derivatives which were selected have been previously described as potent photoprobes of the peripheral nicotinic receptor and of acetylcholinesterase, though displaying lower binding affinities for these acetylcholine binding proteins than for the muscarinic receptors. These findings, together with the all-to-none photolabelling efficiency observed for a quinuclidine derivative, substituted either by an azido or a diazonium group, are discussed. Finally, the apparent lack of binding selectivity of these new photo-affinity probes towards muscarinic receptor affinity states or subtypes should allow comparative studies of the acetylcholine binding site on different muscarinic receptor proteins, obtained either through purification procedures or expression of separate gene products. PMID- 2775310 TI - The characterization of perfluorosuccinate as an inhibitor of gluconeogenesis in isolated rat hepatocytes. AB - The effects on metabolism of the fluorinated dicarboxylic acid, perfluorosuccinate, were examined in hepatocytes from fasted rats. Perfluorosuccinate (5 mM) inhibited gluconeogenesis from lactate by 80% and from pyruvate by 40%. Significant inhibition (up to 30%) occurred at a concentration of perfluorosuccinate of 50 microM. Cellular ATP levels were not affected by perfluorosuccinate, nor was the rate of formation of ketone bodies from palmitate, although the ratio [3-hydroxybutyrate]/[acetoacetate] was increased up to 5-fold relative to the control. An increased concentration of cellular L malate was measured in the presence of perfluorosuccinate but this did not reflect inhibition of malate transport between the mitochondrial and cytoplasmic compartments. In addition, ethanol oxidation by hepatocytes was inhibited 25% by 1 mM perfluorosuccinate. Ureogenesis from ammonia was relatively insensitive to inhibition by perfluorosuccinate. In cytoplasmic extracts of rat liver, the activities of phosphoenolpyruvate carboxykinase and aspartate aminotransferase were inhibited 40-50% and 23%, respectively, by 1 mM perfluorosuccinate. The observed metabolic effects of perfluorosuccinate are consistent with inhibition of the activities of phosphoenolpyruvate carboxykinase and aspartate aminotransferase within the cytoplasm. PMID- 2775312 TI - Potentiation of benzoate toxicity by glyoxylate. Inhibition of pyruvate carboxylase and the urea cycle. AB - It has been proposed that administration of non-nitrogenous precursors to glycine is necessary to realize the full potential of benzoate metabolism as a pathway for disposal of waste nitrogen during ammonia intoxication (Coude et al., Clin Chim Acta 136: 211-217, 1984). However, when glyoxylate, a keto acid precursor to glycine, was administered with benzoate 1 hr prior to a challenge of ammonia, protection against ammonia toxicity was less successful than with benzoate alone. At the cellular and subcellular levels, glyoxylate and benzoate each inhibited the urea cycle in isolated hepatocytes and pyruvate carboxylase in isolated mitochondria. The action of each drug was associated with depletion of aspartate content in isolated hepatocytes and reduction of pyruvate-dependent incorporation of CO2 into aspartate in assays with isolated mitochondria. Depression of aspartate regeneration by inhibition of pyruvate carboxylase is a likely mechanism for impairment of urea cycle activity by both drugs. In whole animals, inhibition of pyruvate carboxylase may contribute to benzoate toxicity and the adverse influence of glyoxylate on benzoate therapy. PMID- 2775313 TI - The ability of diterpene esters with selective biological effects to activate protein kinase C and induce HL-60 cell differentiation. PMID- 2775314 TI - Human ileum phenol sulfotransferase. PMID- 2775315 TI - Characterization and post-natal development of rat cerebellum tyrosylprotein sulfotransferase. PMID- 2775316 TI - Comparative ex vivo inhibitory effects of (E)-2-(3,4-dimethoxyphenyl)-3 fluoroallylamine (MDL 72145) on amine oxidase activities in the rat. PMID- 2775317 TI - Whole-cell biosensors for environmental monitoring. AB - Concern over the pollution risk to drinking water from industry and agriculture is growing, and the need for continuous on-line monitoring recognised. There is increasing use of living organisms as the sensitive agent to detect the presence of pollutants, and whole-cell biosensors are seen to have particular advantages in such environmental monitoring. The development of a mediated amperometric biosensor, incorporating the cyanobacterium Synechococcus as the biocatalyst, for on-line herbicide monitoring is described. The biosensor is able to detect a wide range of herbicides with sites of action on the photosynthetic electron transport chain, at concentrations down to 20 micrograms litre-1 and possesses a working life of up to 7 days. The use of alginate immobilisation of the biocatalyst to overcome the problems associated with obtaining a realistic shelf life for the biosensor is discussed. PMID- 2775318 TI - Involvement of nonarticular cartilage, as demonstrated by release of a cartilage specific protein, in rheumatoid arthritis. AB - Analysis of human cartilage extracts by radioimmunoassay showed that the noncollagenous 148-kd cartilage matrix protein was present in extracts of tracheal cartilage but was undetectable in normal or arthritic joint cartilage, corroborating previous results with bovine cartilage samples. Concentrations of the protein in the circulation, as studied by radioimmunoassay, were greatly elevated in patients with rheumatoid arthritis and polyarticular juvenile rheumatoid arthritis. In contrast, patients with reactive arthritis and oligoarticular juvenile rheumatoid arthritis, as well as rheumatoid arthritis patients treated with low-dose glucocorticoids, had levels similar to those in healthy controls. The serum concentrations were not related to age. A patient with polychondritis and tracheal involvement had a high serum concentration of the protein, which decreased during plasma exchange and cyclophosphamide treatment. Studies of the release of this cartilage matrix protein, which is present in nonarticular cartilage but not in articular cartilage, should aid in the understanding of the mechanisms of cartilage involvement in disease, and the protein may become a clinically useful marker. PMID- 2775319 TI - Secretion of antibodies to types I and II collagen by synovial tissue cells in patients with rheumatoid arthritis. AB - Production of antibodies to IgG and to type I and type II collagen (CI and CII) was analyzed by enzyme-linked immunospot assay in patients with rheumatoid arthritis (RA) and patients with other inflammatory or degenerative joint diseases. Anti-CII-secreting cells, generally in high numbers, were found among mononuclear cells eluted from inflamed synovial tissue in 12 of 13 patients with seropositive RA and 9 of 14 patients with seronegative RA or with undetermined serum rheumatoid factor levels. In contrast, no anti-CII-producing B cells were present among synoviocytes from 4 patients with other joint diseases. In none of 7 RA sera did we find significant levels of anti-CII. Synovial B cells secreting antibodies specific for CI were observed less frequently in patients with RA. These results indicate that measurement of serum antibody levels is not adequate to assess actual autoantibody production in rheumatoid joints and that local autoimmune reactions to CII are common in RA, which implies that collagen reactive T cells are present within the inflamed joints of RA patients. The possible role of a local collagen autoimmunity in RA is discussed, particularly in relation to its putative role in rheumatoid factor production. PMID- 2775320 TI - Reliability and validity of six systems for the clinical assessment of disease activity in systemic lupus erythematosus. AB - Six systems for defining and evaluating disease activity in patients with systemic lupus erythematosus (SLE) (the Ropes system, the National Institutes of Health [NIH] system, the New York Hospital for Special Surgery system, the British Isles Lupus Assessment Group [BILAG] scale, the University of Toronto SLE Disease Activity Index [SLE-DAI], and the Systemic Lupus Activity Measure [SLAM]) were tested on 25 SLE patients who were selected to represent a range of disease activity. The patients were evaluated independently by 2 physicians on 2 occasions approximately 1 month apart. Differences between patients demonstrated the largest source of variation in scores, accounting for 56-84% of the total variance, depending on the instrument. Differences between physicians (i.e., error) showed the next largest variation, 11-28% of the total variance, and differences between visits made up 5-16% of the total. The BILAG, SLE-DAI, and SLAM had the best inter-visit and inter-rater reliability. Convergent validity was shown by the strong correlations of scores among the different instruments (r = 0.81-0.97). All instruments correlated highly with the physicians' clinical impression of disease but less well with their evaluation of disease severity. The number of American Rheumatism Association criteria for SLE that were met by the patients correlated poorly with the physicians' global evaluation and with the scores of the instruments. The patients' self-reported disease activity scores correlated highly with the physicians' assessments of disease activity (r = 0.85-0.91), and the mean values from self-reports and from physicians' assessments were nearly equal. In contrast, severity scores correlated less well between self-reports and physician assessments (r = 0.49-0.69), and mean self reported severity values were lower than the means from physicians. The BILAG, SLE-DAI, and SLAM systems appear to have better psychometric properties than the others for clinical research. PMID- 2775321 TI - Normotensive renal failure in systemic sclerosis. AB - Of 140 patients with "scleroderma renal crisis" encountered during a 33-year period, 15 of 131 (11%) whose blood pressures were recorded were normotensive during this complication. In comparison with 116 patients with hypertension, the normotensive patients significantly more often had microangiopathic hemolytic anemia (90% versus 38%) and thrombocytopenia (83% versus 21%). Pulmonary hemorrhage occurred in 6 normotensive patients. More normotensive patients had received high doses of corticosteroids (prednisone greater than or equal to 30 mg/day) during the 2 months immediately preceding renal crisis (64% versus 16%). A role for corticosteroids in precipitating renal crisis is suggested. The 12 month survival was significantly reduced in the normotensive patients (13% versus 35%). PMID- 2775323 TI - Development and initial validation of a dual-language English-Spanish format for the Arthritis Impact Measurement Scales. AB - Language, cultural, and educational barriers complicate efforts to validate health status questionnaires that have been translated into Spanish. To overcome these problems, a prototype dual-language format was developed for the Arthritis Impact Measurement Scales. Validity testing with 72 patients diagnosed as having rheumatoid arthritis indicated high levels of test-retest reliability, item-to scale internal consistency, and construct validity for both Anglo and Hispanic subjects. A technique for developing and pilot-testing a questionnaire written in a regional Spanish dialect is described. Linguistic considerations, questionnaire design, and other applications are discussed in light of the results obtained. PMID- 2775322 TI - Gait alterations in dogs after transection of the anterior cruciate ligament. AB - We calculated mean peak vertical forces (MFz) of each limb of 9 adult mongrel dogs before and 2 weeks, 6 weeks, and 12 weeks after left anterior cruciate ligament transection (ACLT). Five additional dogs were studied before and 2 weeks and 6 weeks after sham ACLT. The gaits of 3 dogs that had undergone ACLT 2.5 years previously were also analyzed. Preoperatively, there were no differences in the MFz of the right and left hind limbs of the 9 dogs; we found that each limb exerted approximately 70% of the dog's static body weight on the force plate. Two weeks following ACLT, the MFz of the operated limbs decreased to 25% of the static body weight, while at 6 weeks and 12 weeks after surgery, the MFz generated by the operated limbs rose to about 32% and 37% of static body weight, respectively. No change was noted in the MFz of the contralateral hind limbs. In the 3 dogs that had undergone ACLT 2.5 years earlier, the MFz in the unstable stifle joint was 50% of static body weight. At both 2 weeks and 6 weeks after surgery, the MFz values for all 4 limbs of the animals subjected to sham ACLT were comparable with baseline values. These observations indicate that the osteoarthritic changes seen in the unstable limb are associated with decreased loading of that limb, without increased (compensatory) loading of the contralateral hind limb. PMID- 2775324 TI - Comment on the article by van Kerckhove et al. PMID- 2775325 TI - Microbiology: the forefront of arthritis research in the 1990s? PMID- 2775326 TI - Treatment of Felty's syndrome with auranofin and methylprednisolone. PMID- 2775327 TI - Subcutaneous cholesterol crystal deposition and tophus formation. PMID- 2775328 TI - New isoxazole derivatives provided with antihypertensive activity. AB - A series of diazacycloalkane-quinazoline derivatives of isoxazoles were synthesized and tested in order to identify new potent and selective alpha 1 antagonists. A preliminary screening by using in vitro tests such as binding assay (3H-prazosin and 3H-rauwolscine displacement) and analysis of antagonistic activity in isolated rat aorta (norepinephrine-induced response) and in isolated rat vas deferens (clonidine-induced response) indicated that many of these compounds exhibited a good affinity and selectivity towards alpha 1-adrenergic receptors associated with potent pharmacological activity. In particular, a 3 bromo-5-isoxazolecarbonyl derivative, selected for further in vivo investigation, was provided with as high antihypertensive action as prazosin in spontaneously hypertensive rats (SHR) coupled to a shallow dose-response curve by oral route. Moreover, a higher ratio between oral antihypertensive doses in SHR and normotensive rats was found with respect to reference compound prazosin. PMID- 2775329 TI - Influence of carbohydrates on the cytotoxicity of an aqueous mistletoe drug and of purified mistletoe lectins tested on human T-leukemia cells. AB - Partially and highly purified lectins from Viscum album L. (mistletoe) cause a dose-dependent decrease of viability of human leukemia cell cultures, MOLT-4, after 72 h treatment. The LC50 of the partially purified lectin was 27.8 ng/ml, of the highly purified lectin 1.3 ng/ml. Compared to the highly purified lectin a 140-fold higher protein concentration of an aqueous mistletoe drug was required to obtain similar cytotoxic effects on MOLT-4 cells. Cytotoxicity of the highly purified lectin was preferentially inhibited by D-galactose and lactose, cytotoxicity of the mistletoe drug and the partially purified lectin were preferentially inhibited by lactose and N-acetyl-D-galactosamine (GalNAc). Two lectin fractions with almost the same cytotoxic activity on MOLT-4 cells but with different carbohydrate affinities were isolated by affinity chromatography from the mistletoe drug: mistletoe lectin I with an affinity to D-galactose and GalNAc and mistletoe lectin II with an affinity to GalNAc. The lectin fractions and the mistletoe drug inhibited protein synthesis of MOLT-4 cells stronger than DNA synthesis. Furthermore a subpopulation of MOLT-4, resistant to cytotoxic doses of both the mistletoe drug and the mistletoe lectins, was shown to exhibit a reduced amount of GalNAc and N-acetyl-D-glucosamine in their cellular glycoproteins which are probably responsible for the binding of the cytotoxic lectins. These results indicate that lectins are the main toxins in the mistletoe drug. PMID- 2775330 TI - Antimicrobial activity of julifloricine isolated from Prosopis juliflora. AB - Antimicrobial activity of julifloricine, an alkaloid isolated from Prosopis juliflora, was studied in vitro against 40 microorganisms which included 31 bacteria, two Candida species, five dermatophytic fungi and two viruses. Significant inhibitory effect was noted against Gram positive bacteria. The minimal inhibitory concentration (MIC) for Staphylococcus aureus, S. epidermidis, S. citreus, Streptococcus pyogenes and Sarcina lutea was 1 microgram/ml and against S. faecalis, S. pneumoniae, S. lactis, Corynebacterium diphtheriae, C. hofmannii and Bacillus subtilis, 5 micrograms/ml. Its effect was compared with those of identical concentrations of benzyl penicillin, gentamicin and trimethoprim. The inhibitory effect of julifloricine on Gram negative bacteria such as the species of Salmonella, Shigella, Klebsiella, Proteus, Pseudomonas, Enterobacter, Aeromonas and Vibrio was almost insignificant. Julifloricine as compared to micoanzole was found superior against C. tropicalis and responded equally to C. albicans. As compared to econazole, it was found less effective against both C. albicans and C. tropicalis. This alkaloid was found inactive against dermatophytic fungi (up to a dose of 10 micrograms/ml) and viruses which included Herpes simplex 1 and Newcastle disease virus. Julifloricine up to a doses of 1000 micrograms/25 g of mice was found nonlethal. PMID- 2775331 TI - Fluorimetric determination of norfloxacin in plasma and urine samples after thin layer chromatographic separation. AB - A thin-layer chromatographic (TLC) assay for the determination of norfloxacin (1 ethyl-6-fluoro-1,4-dihydro-4-oxo-7- (piperazinyl)-3-quinolinecarboxylic acid), a new antibacterial agent, in human plasma and urine is described. Norfloxacin was extracted from plasma samples using commercial cartridges, urine samples were simply diluted with methanol. Plasma extracts or urine samples were applied to TLC plates (silica gel). Chromatography was performed with a mobile phase consisting of methanol, ethanol and water, the atmosphere in the tank being saturated with ammonia. The fluorescence intensity of norfloxacin was enhanced by dipping the plate into a paraffin/citric acid mixture. Peaks were quantified by fluorimetric measurement (excitation 313 nm/emission 390 nm, cut-off filter). The method showed acceptable precision and linearity in the range of 0.01 to 4 micrograms/ml for plasma and 1 to 100 micrograms/ml for urine. The assay was shown to be applicable to human plasma and urine samples. PMID- 2775332 TI - [Binding of racemic indoprofen and its enantiomers to human serum albumin]. AB - Binding of Racemic Indoprofen and its Enantiomers to Human Serum Albumin. The binding to 2% and 4% human serum albumin (HSA) of (+/-)-indoprofen, (-) indoprofen, and (+)-indoprofen was examined applying a modified ultrafiltration process. The binding properties to HSA were characterized by determining the unbound portions of the drug (a), the overall binding constants (K1), the free reaction energy (delta F degrees), the apparent binding constants (k*), and slope (m). The following results were obtained: 1. Racemic indoprofen and its enantiomers show a high affinity to human serum albumin (a = 1-2%). 2. At higher HSA concentrations the free portion (a) diminishes. 3. The affinity to HSA is reduced in the order of levo-indoprofen racemic indoprofen, and dex-indoprofen. PMID- 2775334 TI - Effect of the newly synthetized calcium antagonist isopropyl methyl 2 carbamoyloxymethyl-6-methyl-4-(2,3-dichlorophenyl)-1,4-dihydropyridine-3,5- dicarboxylate on cerebral venous outflow in dogs. AB - The effects of intravenous administration of isopropyl methyl 2 carbamoyloxymethyl-6-methyl-4-(2,3-dichlorophenyl)-1,4-dihydroyridi ne- 3,5 dicarboxylate (NB-818) on mean arterial blood pressure (MBP), heart rate (HR), cerebral blood flow (CBF), cerebral vascular resistance (CVR), arteriovenous oxygen difference (AVO2D), cerebral metabolic rate of oxygen (CMRO2) and blood gases were studied using the method of the cerebral venous outflow in dogs, and compared to those of nicardipine and nimodipine. 1. NB-818, nicardipine and nimodipine (1-10 micrograms/kg) decreased MBP dose-dependently accompanied by a decrease in HR only at doses of 10 micrograms/kg (NB-818) and 3-10 micrograms/kg (nimodipine). 2. NB-818 (1-10 micrograms/kg) increased CBF dose-dependently accompanied by a decrease in CVR. When comparing the potency or duration of action, the action of NB-818 showed a slower onset and was longer-lasting than that of nicardipine or nimodipine. 3. All three drugs (1-10 micrograms/kg) did not significantly affect CMRO2, AVO2D and blood gases (pH, pCO2 and pO2). These results indicate that the increase in CBF with NB-818 is longer in duration than that with nicardipine or nimodipine, and its effect is due to the dilatation of cerebral vessels. In addition, these results suggest that NB-818 is a potent cerebrovasodilator. PMID- 2775333 TI - Cardiovascular actions of buflomedil and possible mechanisms involved. AB - Cardiovascular effects of buflomedil (Bufedil) were studied in dogs, rabbits and guinea pigs. 1. In pentobarbital-anesthetized dogs, buflomedil (0.32-5.12 mg/kg i.v.) induced a dose-dependent fall of blood pressure and a slight increase of heart rate at 0.32-1.28 mg/kg but a heart rate decrease at 2.56 and 5.12 mg/kg. 2. Buflomedil administered into the maxillary (10-320 micrograms/kg), internal carotid (40-320 micrograms/kg) and vertebral artery (20-640 micrograms/kg) increased respective blood flows dose-dependently. 3. Buflomedil (i.v.) also produced dose-dependent increases of the maxillary blood flow at 0.08-0.64 mg/kg, internal carotid flow at 1.28-5.12 mg/kg and vertebral flow at 0.32-5.12 mg/kg, respectively. These increasing effects were attenuated at larger doses because of marked hypotension. 4. Buflomedil (10 mg/kg i.v.) reduced pressor responses to norepinephrine (noradrenaline) and enhanced depressor responses to isoprenaline (isoproterenol), without affecting depressor responses to acetylcholine and positive chronotropic responses to norepinephrine and isoprenaline. 5. After buflomedil (i.v.), the femoral and coronary blood flow increased dose-dependently while renal blood flow decreased. These increasing effects were also reduced at larger doses because of hypotension. 6. Buflomedil (i.v.) induced a dose dependent increase of cardiac output at 0.16-0.64 mg/kg, biphasic changes at 1.28 and 2.56 mg/kg and a marked decrease and subsequent slight increase at a large dose of 5.12 mg/kg. 7. 4-Desmethylbuflomedil (i.v.); elicited dose-dependent biphasic changes of blood pressure at 0.64-5.12 mg/kg, and a slight increase of heart rate at 0.32-2.56 mg/kg but decreases at 5.12 mg/kg. It also elevated, dose dependently, the maxillary blood flow at 0.16-5.12 mg/kg and vertebral flow at 1.28-5.12 mg/kg.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2775335 TI - Dose-related effects of intracoronary application of nisoldipine on central and peripheral circulatory parameters. AB - In a randomized study central and peripheral circulatory parameters were determined in 12 anaesthetized mongrel dogs before and after intracoronary injection of nisoldipine and placebo. Administration of 0.2 to 0.8 micrograms/kg nisolpine was followed by a 46% to 62% decrease in coronary vascular resistance and a 109% to 141% increase in myocardial blood flow lasting 10 min. There was no significant change in myocardial contractility or peripheral circulatory parameters. An increase in dosage to 1.6 micrograms/kg did not cause a further increase in myocardial blood flow or decrease in coronary vascular resistance. However, there was a significant decrease in total peripheral resistance of up to 32% and a 36% increase in heart rate attributable to counter-regulation lasting 3 to 5 min. At this dosage level a significant decrease in myocardial contractility and an increase in left ventricular end-diastolic pressure are to be expected. This implies a major dissociation between coronary vascular effects and changes in parameters of myocardial performance and peripheral resistance after intracoronary administration of nisoldipine, an effect which is dose-related. Injection of 0.4 to 0.8 micrograms/kg would seem to be the optimal dosage range for intracoronary administration of nisoldipine producing maximum coronary dilatation without myocardial depression. PMID- 2775336 TI - Effects of the novel anti-ulcer agent 1-(5'-oxohexyl)-3-methyl-7-propyl xanthine on experimental ulcers and gastric secretion in rats. AB - The effects of 1-(5'-oxohexyl)-3-methyl-7-propyl xanthine (HWA 285) on various experimentally induced ulcers and gastric acid secretion were investigated in rats. HWA 285 (10-50 mg/kg, p.o.) inhibited restraint and water-immersion-induced stress, ulcers, indometacin- and absolute ethanol-induced gastric ulcers and mepirizole-induced duodenal ulcers in rats in a dose-dependent manner. HWA 285 (10-25 mg/kg i.d.) had inhibitory effects on acetylsalicylic acid-induced ulcers. The healing of acetic acid-induced chronic ulcers was significantly accelerated by HWA 285 (25 mg/kg p.o.) when it was given twice daily for 7 consecutive days. When given orally (twice a day, 11 doses in total) before the induction of gastric ulcers by stress, cimetidine at 100 mg/kg aggravated the ulcers, whereas, HWA 285 at 25 mg/kg had not such an effect. In conscious pylorus-ligated rats, HWA 285 (10-100 mg/kg i.p.) showed a dose-dependent inhibition on basal and desglugastrin- and 2-deoxy-D-glucose (2-DG)-stimulated gastric acid secretion. In stomach-lumen perfused rats, HWA 285 (30 mg/kg i.v.) inhibited 2-DG-stimulated gastric acid secretion but not carbachol-stimulated gastric acid secretion. These results suggest that the anti-ulcer effects of HWA 285 are produced by cytoprotective and central anti-secretory activity without peripheral anti cholinergic properties. Whether the central anti-secretory effects of HWA 285 play thereby the key role, have to be clarified in further investigation. PMID- 2775338 TI - Assessment of the preclinical activity of budotitane in three different transplantable tumor systems, its lack of mutagenicity, and first results of clinical phase I studies. AB - The antitumor activity of budotitane was investigated in three different tumor systems--the transplantable murine ascitic-colon-adenocarcinoma MAC 15A, the TD osteosarcoma of the rat, and the intramuscularly transplanted murine sarcoma 180. Marked inhibition of tumor growth was observed in the intramuscularly transplanted sarcoma 180, and cure rates of 50-80% were achieved in the colon adenocarcinoma MAC 15A. In contrast to these findings, bulotitane was inactive in the transplantable TD-osteosarcoma of the rat. Preliminary mutagenicity studies with the Salmonella typhimurium/mammalian microsome assay of Ames did not show any evidence of mutagenicity for the compound. The first results of the phase I clinical trials showed mild hepatotoxicity at a dose level of 15 mg/kg, dose limiting nephrotoxicity at 21 mg/kg, and a reversible impairment of the sense of taste, beginning at a dose of 9 mg/kg. PMID- 2775337 TI - Chemotherapeutic efficacy of ofloxacin against experimental pneumonia with Pseudomonas aeruginosa in guinea pigs. AB - The chemotherapeutic efficacy of ofloxacin against experimental pneumonia was investigated with special reference to its treatment regimen. A pneumonia model was successfully produced by inhalation of a virulent strain of Pseudomonas aeruginosa in guinea pigs immunosuppressed with cortisone acetate. One or 4 days after infection, the animals were treated orally with the fixed daily doses of ofloxacin either once a day or thrice a day for 3 consecutive days. Ofloxacin given thrice a day eliminated the organisms from the lung more efficiently than the equivalent total doses injected once a day in both series of treatment, starting 1 or 4 days after infection. The superiority of the triple dosing in chemotherapeutic efficacy of ofloxacin was found to be attributable at least to the longer retention of its pulmonary levels exceeding the antibiotic concentrations. PMID- 2775339 TI - Effects of nisoldipine on sympathetic activity, the renin-angiotensin-aldosterone system, and water-sodium-calcium metabolism in patients with essential hypertension. AB - The effects of nisoldipine (Bay k 5552), a long-acting Ca2+ antagonist, on sympathetic activity, the renin-angiotensin-aldosterone (RAA) system, the renal metabolism of water and electrolytes, and parathyroid hormone (PTH) were investigated following single dose and 4 weeks administration. The administration of nisoldipine led to the following results: 1. Mean arterial pressure (MAP) fell and heart rate slightly increased after the first dose, but did not show any appreciable change over 4 weeks treatment. 2. The urinary excretion of sodium, fractional excretion of sodium, plasma renin activity (PRA) and plasma noradrenaline concentration (pNA) were elevated initially, but the trend was to return to pretreatment levels after 4 weeks treatment. 3. A decrease in plasma aldosterone concentration was observed from the commencement of treatment. 4. Urinary excretion of calcium, fractional excretion of calcium and 24-h urine volume (UV) increased from the beginning, and maintained elevated levels after 4 weeks treatment. A decrease in body weight was also observed. 5. Plasma Ca2+ concentration did not change significantly throughout the treatment period, but PTH was decreased significantly both after 1 week and 4 weeks. 6. The percent changes in MAP (% delta MAP) after 4 weeks showed a significant negative correlation with pretreatment levels of MAP and the increment of UV (delta UV), as well as a positive correlation with pretreatment PRA or pNA levels. These findings suggest that in addition to its direct vasodilative effect, suppression of sympathetic activity and the renin-angiotensin-aldosterone system, reduction in body fluid and sodium, and a decrease in PTH and the related calciuresis may contribute to the hypotensive mechanism of nisoldipine. PMID- 2775340 TI - [The relative bioavailability of paracetamol following administration of solid and liquid oral preparations and rectal dosage forms]. AB - Determination of the Relative Bioavailability of Paracetamol Following Administration of Solid and Liquid Oral Preparations and Rectal Dosage Forms. The relative bioavailability of paracetamol from two solid and two liquid oral preparations and two rectal dosage forms, each containing 500 mg of the active ingredient, was investigated in 12 healthy male individuals. The plasma concentration-time curves of paracetamol following administration of the oral formulations were very similar; consequently there were only minor differences of the AUC0-12h (21.4, 21.9; 23.0, 22.8 micrograms.h/ml), cmax (8.8, 9.1; 10.0, 10.7 micrograms/ml), tmax (35, 25; 20, 19 min), and the terminal plasma elimination half-life t1/2 beta (2.95, 2.85; 2.86, 2.99 h) for the solid and the liquid test and reference preparations, respectively. The suppositories (test and reference formulation) differed from the oral dosage forms, but were comparable to each other with respect to AUC0-12h (18.2, 18.8 micrograms.h/ml), cmax (3.3, 3.5 micrograms/ml), tmax (1.6, 2.45 h), and t1/2 beta (3.55, 3.54 h). In all test preparations the 95% confidence limits for AUC0-12h completely were enclosed in the range of 80-120% relative bioavailability (independently of whether parametric or non-parametric statistical methods were applied); the limits for the oral formulations were quite narrow, thus indicating a highly consistent release of the active compound from the tablets as well as from the liquid dosage form. A comparison of the mean values of cmax by analysis of variance at the 80% probability level did not reveal any significant differences between the test and the corresponding reference formulations; based on non-parametric statistical methods, the 95% confidence limits for cmax were enclosed in the range of 70 130%.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2775341 TI - Free-alcohol policy on airlines. PMID- 2775342 TI - Serious assaults by inpatients. AB - Forty-nine hospital wards in the United States and Canada were surveyed during specified periods for one year to document assaults by inpatients on staff or other patients. Nine (5.7%) of the 158 assaults by adult psychiatric inpatients were sufficiently severe to require medical treatment. Four others occurred on the only children's service studied. Only one (2.6%) of 39 assaults on adult nonpsychiatric units required medical care. Injuries were rarely serious, with only four assaults in any setting leading to bedrest or missed workdays. The overall rate of assault (assaults per bed per year) on 27 adult psychiatric units was 1.36; for assaults requiring treatment, the rate was 0.08. The rate of assault of any kind on 22 adult nonpsychiatric units was 0.28 assaults per bed per year. PMID- 2775343 TI - Drowning mortality in Los Angeles County. PMID- 2775344 TI - Guidelines for autologous transfusion. PMID- 2775345 TI - Documenting informed consent for patients wearing disposable lenses. AB - Disposable contact lenses present new clinical and legal challenges to the contact lens practitioner. Although a frequent lens replacement program should reduce the opportunity for contact lens complications and improve patient compliance with lens care and follow-up procedures, problems still may arise from the manufacturing or packaging of lenses or the failure of the patient to comply with wearing instructions. Because there yet remain significant risks associated with the extended wear of hydrogel lenses, practitioners should use an informed consent agreement to assist in the communication of these risks to patients. Such an agreement also serves as evidence of the practitioner's compliance with legal requirements. PMID- 2775347 TI - Lung cancer that is not attributable to smoking. PMID- 2775346 TI - The use of intravenous ribavirin to treat influenza virus-associated acute myocarditis. AB - We studied three patients with influenza virus-associated fulminant myocarditis; one was infected by type B and the others by type A influenza virus. In one patient, dissemination of type A (H1N1) virus to the myocardium was demonstrated, and viremia complicated the clinical course despite the use of oral amantadine HCl and ribavirin aerosol. All patients were treated with iv ribavirin, two initially and the third after viremia was detected during hyperacute rejection of a cardiac transplant. No significant adverse effects could be directly attributed to therapy, and viral shedding abruptly terminated coincident with its use; however, both patients treated shortly after onset of myocarditis died. The third required support by an artificial heart, and died 8 mo later. Immunotyping of myocardial tissues in two cases revealed an initial predominance of T helper cells. Serial endomyocardial biopsies available from one of these demonstrated a subsequent marked decrease in the T helper cell population as inflammation and necrosis subsided during and following therapy. PMID- 2775348 TI - Medical genetics. PMID- 2775350 TI - Ratio of BCC to SCC. PMID- 2775351 TI - Water supply for pigs. PMID- 2775349 TI - Effect of milk on fibronectin and collagen type I binding to Staphylococcus aureus and coagulase-negative staphylococci isolated from bovine mastitis. AB - Tryptic soy broth (TSB)-grown cells of Staphylococcus aureus isolated from acute and chronic bovine mastitis bound mainly 125I-fibronectin (Fn) [corrected], whereas strains of nine species of coagulase-negative staphylococci showed a predominant interaction with 125I-collagen (Cn) [corrected] type I. A particle agglutination assay (PAA) was used to examine the interaction of coagulase negative staphylococci with 125I-Fn and 125I-Cn immobilized on latex. All 368 coagulase-negative staphylococci demonstrated high 125I-Cn and moderate to low 125I-Fn interactions in the PAA. Cn-PAA reactivity was high among strains of Staphylococcus xylosus (84.2%), Staphylococcus simulans (77.8%), Staphylococcus epidermidis (76.7%), and Staphylococcus hyicus (74.3%), whereas all six Staphylococcus capitis strains clumped Cn-PAA reagent. Incubating TSB-grown cells in 10% skim milk for 1 h decreased the 125I-Fn- and 125I-Cn-binding affinity in most of the S. aureus and coagulase-negative staphylococci, while growth in 10% skim milk for 18 h resulted in more than 90% decrease or complete loss of interaction with these proteins. Decreased 125I-Fn binding in the presence of milk was correlated with protease production but not with 125I-Cn binding. PMID- 2775352 TI - Hodgkin's disease complicating non-Hodgkin's lymphoma. PMID- 2775353 TI - Abstracting nonquantitative data. PMID- 2775354 TI - Abscess formation in sternoclavicular joint septic arthritis. PMID- 2775355 TI - [Ostomies in neonatology]. PMID- 2775356 TI - Doppler-estimated mitral valve area. PMID- 2775357 TI - Aminoglycosides enhance the adherence of Staphylococcus aureus to HeLa cells. AB - Sub-lethal concentrations of aminoglycosides enhanced the adherence of Staphylococcus aureus FDA 209P to HeLa cells, whereas beta-lactams, pyridone carboxylic acid derivatives and chloramphenicol did not. Treatment with aminoglycosides also enhanced the bacterial adherence of these cells to immobilized fibronectin and laminin, and changed the bacterial cell surface to a more hydrophilic state than exists in non-treated cells. The adherence of S. aureus was not inhibited by lipoteichoic acid, extracted from the same strain, regardless of whether the bacterial cells were treated with an aminoglycoside or not. No correlation was observed between the adherence and zeta-potential of S. aureus. PMID- 2775358 TI - DEALE-ing with life expectancy and mortality rates. PMID- 2775359 TI - Low dose low osmolar [corrected] intravenous urography. PMID- 2775360 TI - Hb Moriguchi or alpha 2 beta 2(97) (FG4)His---Tyr substitution at the alpha 1 beta 2 interface. AB - An abnormal profile of cation exchange high performance liquid chromatography for the determination of Hb A1c led to the discovery of a new hemoglobin variant with a His----Tyr substitution at position 97(FG4) of the beta chain. The variant comprised about equal proportion to normal Hb A. It showed an increased oxygen affinity, normal n value and slightly reduced alkaline Bohr effect. However, the magnitude of the functional deviation is less than that of other variants with substitutions at the same position, and the heterozygous carrier was not erythremic. PMID- 2775361 TI - Intracavernous injections of papaverine and phentolamine: correlation with penile brachial index. AB - Eighty-two patients were evaluated for erectile failure with a comprehensive history, physical examination, hormonal testing, noninvasive Doppler examination (PBI), and nocturnal penile tumescence (NPT). After these studies all patients received intracavernous injection with a combination of papaverine (50 mg) and phentolamine (1.66 mg), and both tumescence and rigidity were monitored. Rigidity response was compared with the PBI. The number of patients with a poor rigidity response in each PBI category were: 3 of 5 with a PBI of less than 0.6 (vasculogenic), 7 of 11 with a PBI of 0.6-0.75 (ambiguous), and 25 of 66 with a PBI of 0.75-1.0 (normal). These results indicate only a marginally significant association between PBI and intracavernous injection. The procedure was safe with no long-term sequelae from injection observed, and no surgical intervention was required. Complications of injections included reversible priapism in 11 patients (13.4%), transient dizziness in 10 patients (12.2%), and hematoma in 5 patients (6.2%). This study suggests that intracavernous injection with a drug combination may be a more sensitive screening test for vasculogenic impotence than noninvasive Doppler studies because it more closely simulates the erectile response. PMID- 2775362 TI - Postoperative intussusception in children. AB - Intussusception in the postoperative period is an unusual yet potentially fatal surgical complication. We present 3 illustrative cases and contrast postoperative intussusception with the more common classic childhood intussusception. Physician awareness of this condition is critical for early recognition and treatment. PMID- 2775364 TI - ESWL treatment of urinary calculi. AB - A total of 711 patients with symptomatic upper and lower urinary tract calculi underwent extracorporeal shock-wave lithotripsy (ESWL) at the Ohio Kidney Stone Center during the first six months. At follow-up 84 percent of the first 180 patients are stone-free. Retreatment was required for 2.8 percent of the patients with residual stone material. Thirty-seven percent of the treatments required cystoscopy with ureteral stent placement for manipulation of stones or delineation of distal ureteral anatomy to facilitate ESWL. Complications were minimal at less than 3 percent. PMID- 2775365 TI - Pediatric nephroscope for percutaneous renal stone removal. AB - A new 17-F nephroscope was used for percutaneous renal stone management. It appeared useful in reducing the possible main vascular injuries after percutaneous nephrolithotomy. Personal experience with pediatric as well as selected adult cases is presented. PMID- 2775363 TI - Simultaneous repair of bilateral ureteropelvic junction obstruction. AB - Fifteen children with bilateral ureteropelvic junction obstruction underwent simultaneous repair as a single procedure. Dismembered pyeloplasty and ureterocalycostomy were the two procedures used. Ten were performed through anterior subcostal incisions. Posterior lumbotomy provided adequate exposure in 5 children and further contributed to shortened hospitalizations. The functional and anatomic results were excellent. Simultaneous bilateral pyeloplasty through posterior lumbotomy is a safe and cost-effective alternative to staged procedures for bilateral ureteropelvic junction obstruction. PMID- 2775366 TI - Corporeal septal necrosis secondary to penile cylinder aneurysmal dilatation. AB - A case report of necrosis of the corporeal septum secondary to aneurysmal dilatation of a penile prosthesis cylinder is presented. Recommendations are made for surgical management. PMID- 2775367 TI - Nonoperative management of iatrogenic prostatorectal fistula. AB - Iatrogenic prostatorectal fistula is a rarely seen urologic complication of transurethral resection of the prostate and stricture dilatation with sounds. In the past, such cases have been managed with colostomy diversion of the fecal stream and suprapubic cystostomy diversion of the urinary stream and in most cases operative closure of the fistula. This case illustrates that a more conservative nonoperative approach can lead to successful closure of such a fistula in selected cases. The management of the case described here utilizes low residue dietary supplements, Foley catheter drainage, and broad-spectrum antibiotics to allow the fistula to heal. PMID- 2775368 TI - Neurogenic fibrosarcoma following radiation therapy for seminoma. AB - We report a case of radiation-induced neurogenic fibrosarcoma that developed in a patient who received radiation therapy for seminoma. The sarcoma developed within the irradiated field after a latency period of nineteen years. Although the occurrence of a secondary neoplasm is unusual, this possibility should be included in the differential diagnosis of patients who present with tumor growth after a long interval following radiation therapy. PMID- 2775369 TI - Extracorporeal shock-wave lithotripsy in hemophiliac patient. AB - We report on a patient with hemophilia A who underwent successful extracorporeal shock-wave lithotripsy without incident. We are aware of two other reported cases in the literature. The relative risks of alternative methods of stone management and the indications and risks of blood product therapy in this condition are reviewed. PMID- 2775370 TI - Arteriovenous malformation of spermatic cord. AB - A case of an arteriovenous malformation of the spermatic cord presenting as a hard scrotal mass is described. This is the first reported case of an arteriovenous malformation of the spermatic cord, and therefore this benign lesion should be included in the differential diagnosis of paratesticular masses. PMID- 2775371 TI - Method of circumferential pressure dressing of scrotum following bilateral orchiectomy. PMID- 2775372 TI - Differential diagnosis of genitourinary tumors using monoclonal antibodies to intermediate filament proteins. AB - Definitive diagnosis of poorly differentiated and metastatic neoplasms may be impossible using conventional histologic criteria. Recent developments in cell biology and immunology now enable us to answer such difficult diagnostic problems. Several varieties of structural proteins can be identified in malignant cells using monoclonal antibodies. The composition of these proteins can yield information regarding the origin of a neoplasm. Intermediate filaments are one such family of structural proteins. By characterization of these proteins, using a panel of monoclonal antibodies, poorly differentiated tumors may be definitively classified as carcinomas, sarcomas, lymphomas, or neural tumors. This approach to tumor diagnosis is now applicable to difficult problems in clinical urology. PMID- 2775373 TI - Diagnostic value of routine bone scintigraphy renal imaging in renal cell carcinoma. AB - Technetium-99m-phosphate compounds used in bone scanning are excreted by the kidney, and excellent renal images can be obtained on routine bone scintigrams. The preoperative bone scans of 49 patients who underwent radical nephrectomy for renal cell carcinoma between 1981 and 1985 were reviewed for renal imaging. Ninety-four percent of the patients had abnormal bone scan renal images (82% had focal decreased uptake, and 12% had focal increased uptake). Six percent of the renal images were symmetrical bilaterally. When bone scans are employed in the postoperative follow-up of patients with renal cancer, they can be used to assess the status of the remaining kidney. PMID- 2775374 TI - Implantation of prostatic cancer after perineal needle biopsy. PMID- 2775375 TI - Stress prostatitis. PMID- 2775376 TI - Prostatic cancer: new insights and controversies. Proceedings of a symposium. February 4, 1989, New York, New York. PMID- 2775377 TI - Extended experience with surgical treatment of stage D1 adenocarcinoma of prostate. Significant influences of immediate adjuvant hormonal treatment (orchiectomy) on outcome. AB - Concepts regarding the surgical treatment of cancer of the prostate have changed significantly at the Mayo Clinic. Rather than emphasizing radical prostatectomy only for low-grade (grade less than or equal to 2) and low-stage (less than or equal to T1/B1) lesions--which may be equally well treated at less than ten years, in regard to crude survival, by radiotherapy--we believe that radical prostatectomy is particularly suitable for lesions of higher local stages, including those with regional node extension. This view is based on a large experience (less than 2,000 cases) with the radical surgical treatment of cancer of the prostate and on the realization that conservative single-modality treatment (hormonal or radiotherapy) for advanced local Stages (C and D1) provides poor cause-specific survival and nonprogression rates and may lead to high local morbidity. The treatment of Stage D1 prostate cancer was thought to be not amenable to surgical treatment, and many have recommended observation only. In 266 patients (mean age, 64 years) followed one to twenty-one years (mean, 4.7 years), immediate adjuvant orchiectomy at the time of radical prostatectomy performed in 162 patients (61%) resulted in a highly significant (P less than 0.0001) decrease in progression compared with no immediate orchiectomy in 104 patients (39%). The ten-year overall and local nonprogression rates for those undergoing immediate orchiectomy were 80 percent and 98 percent, respectively; median time to progression for the no-immediate-orchiectomy group was less than 4.5 years, and the local recurrence rate was 25 percent at ten years. Of all the pathologic variables, only DNA ploidy pattern had a significant influence on progression and cause-specific survival. Also, in patients with D1 disease and a nuclear DNA diploid pattern, immediate adjuvant orchiectomy resulted in a nonprogression rate of 100 percent at ten years compared with virtually 0 percent in those with a nondiploid tumor and no immediate orchiectomy. Because 42 percent of the patients with D1 disease in the Mayo Clinic experience have DNA diploid tumors, adjuvant orchiectomy in this group results in no progression or prostate cancer death. Patients with Stage D1 prostate cancer and DNA nondiploid pattern undergoing prostatectomy should be entered in prospective adjuvant innovative treatment protocols since these tumors do not seem to respond to early hormonal manipulation. PMID- 2775378 TI - Prognostic factors in patients with advanced prostate cancer. AB - One hundred ten patients with metastatic prostate cancer (Stage D2) were analyzed to determine the associations among time until progression and the pretreatment testosterone level, extent of bone metastases as indicated by a semiquantitative grading scale for extent of disease, performance status, race, age, and the pretreatment level of prostatic acid phosphatase (PAP). The median follow-up period was twenty-one months, with a range of four to eighty-nine months. All patients received androgen deprivation at the time metastases were identified. A multivariate analysis demonstrated that pretreatment serum testosterone was the most significant variable associated with time until progression (P less than 0.01) and that the extent of bone metastases observed on the bone scan was the second most important variable (P less than 0.05). The following factors did not significantly correlate with progression-free intervals: age, race, and PAP. The performance status was significantly correlated, but was nonsignificant in the multivariate analysis when the model already included the testosterone level and the extent of bone metastases. Patients with a pretreatment testosterone level of less than 300 ng/dL and with more than six areas of increased uptake on the bone scan progressed more rapidly. PMID- 2775379 TI - [Value of dynamic recording of short-latency auditory evoked potentials in the diagnosis and pathogenetic characteristics of hearing loss in acoustic neuroma]. AB - Short-latency acoustic evoked potentials (SAEP) were recorded in 40 patients with vestibulocochlear neurinoma and 15 patients with unilateral cochlear hypoacusis. The results were compared with their psychophysical audiometric parameters. In the case of neurinoma, electric responses typically showed elongation of single waves and intervals between two peaks. In addition, they also displayed two other features. One of them was horizontal or ascending configuration of the curve reflecting the latency/intensity function. This indicates the absence of an electrophysiological equivalent of the phenomenon of loudness increment acceleration and, in more general terms, the stability of responses: lack of SAEP wave shortening and enhancement of acoustic stimulation level. The second feature was deterioration of the pattern and disintegration of individual complexes with a greater number of realizations. This can be attributed to the lability of nervous structures, in the case of neurinoma. This feature may also be responsible for the generally recognized concept that in neurinoma primary SAEP waves are not detectable when the routine method of recording responses to a large number of stimuli is used. These parameters are pathognomonic of neurinoma of the vestibulocochlear nerve and are never identified in the case of unilateral hypoacusis caused by cochlear lesions. PMID- 2775380 TI - [Early detection of the neurosensory component of hearing loss in patients with adhesive otitis media]. AB - Thirty patients with adhesive otitis media and 10 otologically normal subjects were examined audiometrically in a wide frequency range according to Sagalovich. It was found that this kind of audiometry may help detect early symptoms of hearing impairment on a neurosensory basis which remain unobservable in conventional audiography. It was demonstrated that hearing threshold increments in a wide frequency range correlated with the shape of the curve of bone conductivity in conventional audiography. The hearing changes in a wide frequency range were dependent on the primary disease duration and were independent of the bone-air interval value in conventional audiography. Our investigations allow the conclusion that measurement of hearing sensitivity in a wide frequency range under the conditions of bone conductivity enlarges the capabilities of current tonal audiometry and opens up new perspectives for assessing the hearing level of patients with adhesive otitis media. PMID- 2775381 TI - [Clinico-morphologic aspects of chronic mesotympanitis]. AB - The present authors examined 84 patients with chronic mesotympanitis, 72 of which showed pathological lesions of the middle ear mucosa and bone. This was confirmed by X-ray contrasting examination before surgery and histological examination of tissue samples. Histological analysis showed that the level of destructive changes in middle ear cavities depended on the disease duration. Fibrous tissues of varying degree of maturity, cholesteatoma, tympanosclerotic patches, encapsulated fragments of caries bone frequently cause blockade of the aditus which complicates the chronic process in middle ear cavities and should be regarded as an absolute indication for surgical treatment of chronic mesotympanitis. PMID- 2775382 TI - [Hemangioma of the larynx in children]. AB - Hemangiomas were diagnozed in 11 patients (4.6%) out of 235 children with chronic laryngeal stenoses of various etiology. The most frequent symptom was hoarse voice. The children examined were not older than 5 months. In 5 patients, laryngeal hemangiomas were associated with hemangiomas of other body compartments -most frequently on the skin of the face, neck or upper chest. Out of the 11 laryngeal hemangiomas 6 were located below vocal folds, 4 on gastric and aryepiglottic folds and only 1 on vocal folds. The first line method of treatment was cryosurgery. Local freezing was performed on 6 patients. They all were decannulated within 2 to 4 months after intervention. There children with disseminated hemangiomas of the face, neck and upper chest were exposed to radiotherapy. A year after, two of them were decannulated and the third one developed a postradiation scar below vocal cords. In 2 children when they were 2 or 3 years of age, laryngeal hemangiomas disappeared spontaneously without any treatment. PMID- 2775383 TI - [Treatment of the croup syndrome in children with acute respiratory viral infection]. AB - This paper reviews the results of treatment of 234 children, aged 2 months to 8 years, with the croup syndrome. The patients underwent a combined treatment with steam, oxygen and drugs in a chamber, which had certain advantages over the traditional method. It worked faster, caused no deterioration of the health status, and reduced substantially the scope of intensive care medicine measures. The method is simple, easy to use and cheap. It can therefore be recommended for a wide application in croup therapy. PMID- 2775384 TI - Occupational burnout among correctional health workers. Perceived levels of stress and social support. AB - 1. Approximately one third of the sample study fit Maslach's burnout profile, with low personal accomplishment, high depersonalization, and high emotional exhaustion. Perceived stress was a significant predictor of the sense of personal accomplishment and emotional exhaustion. 2. Both male and female subjects had low to moderate mean scores on the social support scale. Social support as measured in this study was limited to that received from coworkers and supervisors. 3. The results of this study point to a need for intervention in this setting. Specific interventions for decreasing stress and thus decreasing chances for burnout are discussed. 4. The development of a broad employee health care program is an example of a primary prevention intervention to decrease stress in this setting. Such a program would include instruction in methods of stress reduction and stress management, including exercise and relaxation techniques. PMID- 2775385 TI - Drug screening in the workplace. A drug awareness/prevention program for hospital settings. PMID- 2775386 TI - Research and clinical awards. A mark of excellence. PMID- 2775387 TI - Arthroscopic follow-up of anterior cruciate ligament reconstruction using allogeneic tendon. AB - We have made a long-term arthroscopic study of anterior cruciate ligament (ACL) reconstructions using cryopreserved allogeneic tendon in 49 knees. Not only the reconstructed ACL itself, but also the entire joints were arthroscopically evaluated from 18 through 59 months postoperatively. Physical examinations at the arthroscopic follow-up revealed that Lachman's sign was negative in 45 and mildly positive in 4 patients and that the pivot-shift sign was negative in 46 and mildly positive in 3 patients. ACL grafts did not show any biodegradation with time but maintained a thick and viable appearance, although 3 of the taut ones showed partial necrosis in the anterolateral part. Fibrillation of the patellofemoral articular surface was commonly found, although no patients complained of anterior knee pain. Degenerative changes were usually found in those patients who had resumed strenuous activity without their menisci being intact. Follow-up arthroscopy was useful for monitoring the overall structures inside the post-operative knees, enabling us to persuade the patients to regulate their activity on the basis of objective evidence. PMID- 2775388 TI - Penetrating knee injuries: the nail gun. AB - Since the development of the nail gun in the 1950s, various reports cite injuries to the head, chest, abdomen, and extremities. Few of these reports mention any nail gun injuries to the knee joint. A total of 33 patients with penetrating injuries to the knee was identified. Of these, 13 had penetrating wounds caused by power nail guns or staplers. The average age was 25 years (range, 17-40). In 10 of the 13 patients, bone involvement (femur in 6, patella in 2, tibia in 1, and both femur and patella in 1) occurred. Treatment consisted of arthroscopy with irrigation of the knee and nail removal in 10 patients. The other 3 patients underwent arthrotomy in conjunction with nail removal and irrigation. No drains were used postoperatively. I.v. cephalosporin antibiotics were given initially in all cases and were continued orally after hospital discharge. Immediate post injury follow-up varied from a few days to 3 months. Six of the 13 patients were found for follow-up 10-33 months (average 19 months) post injury. All of these returned to full duty in the home construction industry. None developed an infection or needed additional surgery. Based on this series, power nail gun knee joint wounds should have tetanus prophylaxis, arthroscopic evaluation, and irrigation of the knee joint in conjunction with nail removal, i.v. antibiotics for 12-48 h, followed by a 10-day course of oral antibiotics. Unless cultures indicate differently, a first-generation cephalosporin is recommended. PMID- 2775389 TI - Arthroscopic lateral release for patellar pain or instability. AB - Forty-five arthroscopic lateral releases were reviewed with a follow-up from 2 to 6 years (average 4 years). Satisfactory results were obtained in 60% of the patellar pain group (20 knees) and 68.5% of the instability group (19 knees). The results in osteoarthrosis (6 knees) were unsatisfactory. Postoperative hemarthrosis was infrequent (2.2%). Unfavorable prognostic factors are an incomplete release with an insufficient postoperative passive patellar tilt in the pain group and more than five preoperative dislocations in the instability group. After failure of conservative treatment, a lateral release can be reasonably used in pain syndromes with a tight lateral retinaculum and lateral patellar tracking and in milder cases of instability. PMID- 2775390 TI - The predictive value of five clinical signs in the evaluation of meniscal pathology. AB - One hundred sixty-one consecutive patients with knee pain of at least 1 year's duration were studied on a prospective basis to determine the predictive value of five common clinical tests for the diagnosis of meniscal tears. Each patient had a preoperative examination that evaluated the presence or absence of joint line tenderness, pain on forced flexion, the presence of a positive McMurray test, positive Apley grind and distraction tests, and the presence of a block to extension. The results of these tests were then compared to arthroscopic findings. This study indicates that no one test is predictive for the diagnosis of a meniscal tear; a combination of tests should be used. The presence of anterior cruciate ligament pathology will render these tests less effective for diagnosis of meniscal pathology. Chondromalacia patella is negatively correlated with the presence of joint line tenderness and pain on forced flexion. PMID- 2775391 TI - Magnetic resonance imaging of the knee: correlation with arthroscopy. AB - Magnetic resonance imaging (MRI) was used to diagnose acute and chronic intraarticular knee pathology in 23 knees. The results were compared with arthroscopic findings of meniscal, ligamentous, and articular cartilaginous pathology using a double-blind prospective protocol. The overall accuracy for meniscal tears was 78%, with a sensitivity of 88% and a specificity of 72%; for cruciate ligaments, MRI was 82% accurate, with a sensitivity of 67% [anterior cruciate ligament (ACL) only] and a specificity of 86%. In select clinical situations, MRI of the knee is a useful diagnostic tool. PMID- 2775392 TI - The role of arthroscopy in children and adolescents. AB - A retrospective review of the first 5 years' experience with arthroscopy at the Adelaide Children's Hospital was conducted. Two hundred and twelve arthroscopies were performed in 192 patients. The average period of follow-up was 5.9 months. The most common arthroscopic finding was anterior cruciate ligament (ACL) injury, followed by meniscal lesions, chondromalacia patellae, patellar dislocations, and osteochondritis dissecans. There was a high rate of associated lesions with ACL tears and acute patellar dislocation. Septic arthritis responded well to arthroscopic drainage and lavage. We concluded that arthroscopy is a safe and accurate diagnostic and therapeutic tool in childhood and adolescence. Arthroscopy is recommended when a joint is too painful to allow adequate clinical examination, in hemarthroses, for ACL injury, after acute patellar dislocation, and to treat septic arthritis. There is only a 56% chance of making a correct diagnosis on clinical grounds, which contrasts with an accuracy in excess of 99% with arthroscopy. PMID- 2775393 TI - Anterior cruciate ligament injury in children and adolescents. AB - Although the natural history of anterior cruciate ligament (ACL) injuries in the adult is well documented, the natural history of ACL injury in children and adolescents has not previously been reported. A case note review revealed 31 cases with ACL pathology out of 212 arthroscopies performed in the Adelaide Children's Hospital from November 1980 until June 1986. Partial tears were more common than complete midsubstance tears. In 27 cases there was no bony involvement. All 27 patients were available for analysis. The average age was 14.3 years, with a range of 8-18 years. Twelve of the 27 patients were younger than 14 years old. All patients completed a questionnaire and were interviewed. The average follow-up was 51 months (range 26-87 months). At the time of initial injury, 11 of the 27 patients (41%) had associated pathology. Subsequently, four patients have undergone further arthroscopic surgery, four patients have had a reconstruction of the ACL, and a further three have had reconstruction recommended. We conclude that this is not as benign an injury as was previously believed. PMID- 2775394 TI - Anterior portals in shoulder arthroscopy. AB - The anterior portal has been the major operative portal through which hand and motorized instrumentation have been introduced into the glenohumeral joint. This portal has been limited with respect to its access to structures in the anteroinferior aspect of the joint. Anatomical and clinical studies were undertaken to evaluate the safety and effectiveness of the use of an anterior inferior, as well as an anterior superior portal. Seventy-eight unembalmed cadaver specimens and 34 operative cases were used in the studies. Only an "inside out" technique using blunt instrumentation is recommended in creating the anterior inferior portal. The margin of safety with respect to the musculocutaneous nerve is increased with adduction. The use of these two anterior portals greatly enhanced our ability to visualize and work directly on lesions of the glenohumeral ligament labral complex. These anterior portals can be safely created if guidelines are carefully followed by surgeons with considerable experience in shoulder arthroscopy. PMID- 2775395 TI - Intramuscular deltoid pressure during shoulder arthroscopy. AB - A large amount of fluid extravasation into the surrounding muscle and soft tissue may occur during arthroscopy of the shoulder and particularly of the subacromial space. The tense swollen appearance of the shoulder has caused concern that the intramuscular deltoid pressure may become elevated to dangerous levels. Therefore, the intramuscular deltoid pressure was monitored in this study using a slit catheter. Although it was found that the intramuscular pressure became transiently elevated during the arthroscopic procedures, in every case the pressures promptly returned to normal levels within 30 min postoperatively. The clinical swelling and tenseness remained for a longer period. Despite a sometimes alarming amount of swelling during shoulder arthroscopy, intramuscular pressure elevations were only sustained for a short time and returned to normal levels very quickly after the cessation of fluid infusion. PMID- 2775397 TI - Arthroscopic treatment of steroid-induced osteonecrosis of the humeral head. AB - Shoulder arthroscopy was performed on a 52-year-old man for the treatment of steroid-induced osteonecrosis of the humeral head. The removal of loose bodies and joint debridement has successfully improved the patient's functional status through relief of pain, improved range of motion, and elimination of locking. This case suggests another use of arthroscopy in the treatment of shoulder pathology. PMID- 2775396 TI - Arthroscopic versus nonoperative treatment of acute shoulder dislocations in young athletes. AB - We evaluated the natural history of anterior shoulder dislocations in a young athletic population (cadets at the United States Military Academy) and compared conventional means of nonoperative treatment with early arthroscopic treatment (staple capsulorraphy or anterior glenoid abrasion). The rate of recurrent instability after a shoulder dislocation was 92% (35 of 38) in cadets treated nonoperatively. Strict adherence to a supervised nonoperative treatment program had no effect on the recurrence rate. All recurrences of instability occurred within 14 months of the initial injury. In comparison, arthroscopic treatment of acute shoulder dislocations has been successful thus far in 78% (7 of 9) of cadets followed for at least 14 months. With the high rate of recurrence of shoulder instability in young athletes, we believe that arthroscopic surgical intervention after the initial shoulder dislocation can dramatically lower the recurrence rate and should be considered as a treatment option in young athletes. PMID- 2775398 TI - Elbow arthroscopy: a new technique. AB - Elbow arthroscopy is a useful diagnostic and therapeutic tool for the orthopedic surgeon. In the standard technique, the patient is positioned supine with the arm suspended overhead and an anterolateral portal is used. We have modified this technique by placing the patient in a prone position and using a proximal medial portal. Use of the prone position improves scope mobility, facilitates joint manipulation, and provides more complete intraarticular visualization. This technique simplifies the treatment of a wide variety of elbow pathology, including loose bodies, osteochondritis dissecans, persistent synovitis, suspected cartilaginous lesions, posterior osteophytes, selected radial head fractures, and chronically undiagnosed painful elbows. PMID- 2775400 TI - Safe and effective arthroscopic evaluation and treatment of the elbow. PMID- 2775399 TI - Arthroscopically aided anterior cruciate ligament reconstruction using a new drill wire guide. AB - The authors have made a new drill wire guide of universal type used in arthroscopic operations and have named it the Rhomboid Guide because of its rhomboidal frame. This multipurpose guide has made it easy to prepare exact bone tunnels under arthroscopic control and is preferably applied to arthroscopically aided anterior cruciate ligament (ACL) reconstruction. For such reconstruction the authors make a bifurcate intraarticular substitute using the iliotibial band. The Rhomboid Guide has made it possible to perform this rather complicated procedure arthroscopically. PMID- 2775401 TI - Prevention of delayed neuronal death in gerbil hippocampus by a novel vinca alkaloid derivative (vinconate). AB - We investigated the effect of vinconate, a novel vinca alkaloid derivative, on delayed neuronal death using Mongolian gerbils. The animals were allowed to survive for 7 d after 3 or 5 min of forebrain ischemia induced by bilateral occlusion of the common carotid arteries. Morphological changes and calcium (45Ca) accumulation were evaluated in the CA1 sector of the hippocampus after ischemia. Vinconate (50, 100, and 300 mg/kg) showed protective effects against neuronal death in a dose-dependent manner when administered intraperitoneally (ip) 10 min before 5 min of ischemia. However, the administration of vinconate (100 and 300 mg/kg, ip) immediately after 5 min of ischemia showed no therapeutic effect, whereas a marked therapeutic effect of vinconate (50 and 100 mg/kg, ip) was observed when administered immediately after 3 min of ischemia. An anesthetic dose of pentobarbital (40 mg/kg, ip) also produced significant protection against neuronal death. Furthermore, a 45Ca autoradiographic study indicated that a marked calcium accumulation was found in the Ca1 sector at 7 d after 5 min of ischemia, which was consistent with the extent of histological neuronal damage. When vinconate (100 and 300 mg/kg, ip) was administered 10 min before 5 min of ischemia, the abnormal calcium accumulation was not detected in the CA1 sector. These data indicate that suppression of abnormal neuronal activity may be owing to the antagonistic action of vinconate on calcium accumulation. PMID- 2775402 TI - Characterization of the antitumor activity of a polyantigenic immunomodulator (PAI): II--Involvement of NK cells and adoptive immunotherapy. AB - Natural killer (NK) cell activity and adoptive immunotherapy were used to characterize the anticancerous effect of a polyantigenic immunomodulator (PAI). PAI consists of a mixture of inactivated bacteria and influenza virus in a peanut oil-arlacel A-aluminum monoesterate emulsion, shown previously to have antitumoral activity in mice implanted with Ehrlich's ascites tumor. The administration of PAI, its bacterial or viral component strongly increased the in vitro activity of NK cells of splenocyte populations obtained from Swiss-Webster (allogeneic) and C57BL/6J (syngeneic) mice, specially during the early post induction period. On the other hand, PAI-sensitized, allogeneic or syngeneic lymphocytes were transferred successfully to tumor-bearing mice implanted with Ehrlich's ascites tumor, reducing tumor growth and increasing survival. The results confirm our previous suggestions that PAI acts probably at the level of cellular immunity. Therefore complex polyantigenic substances such as PAI could be used directly alone, in combination with other immunoadjuvants or to sensitize in a global manner immunocompetent cells to be employed in adoptive immunotherapy. PMID- 2775403 TI - Biliary tract disease due to Fasciola hepatica: report of a case. AB - We report a case of a 23 year old woman who presented with symptoms of biliary tract disease to our University Hospital in Bayamon, Puerto Rico. A diagnosis of chronic cholelithiasis was made and the patient was taken to surgery. An adult Fasciola hepatica was recovered from the common bile duct. We review the pathobiology of this uncommon zoonosis. PMID- 2775404 TI - An unusual complication of anticoagulant therapy: bloody tears. AB - A seventy-two-year-old white male developed bleeding from a right eye subconjunctival hemorrhage. The patient had been taking warfarin and, it was immediately discontinued. Two doses of 15 mgs. each of vitamin K given parentally reduced the prothrombin time, but not the oozing of blood which finally stopped after the administration of fresh frozen plasma. Fortunately, no retrobulbar or intra-ocular bleeding occurred. This complication during the use of anticoagulants has never, to our knowledge, been reported before in the medical literature. PMID- 2775405 TI - Retention of nutrients in microwave-cooked foods. AB - The high market penetration of microwave ovens in the United States and the burst of new food products available for "heating and eating" raises questions about the nutritional impact of the relatively new technology. Based on the information available in the literature, nutrient content and retention of microwave-cooked or reheated foods is equal to or better than the same product prepared conventionally or held hot in a foodservice operation. Using recommended procedures for microwave cooking and reheating should result in products that are satisfying from both a sensory and nutritional standpoint. PMID- 2775406 TI - [An unpardonable omission]. PMID- 2775408 TI - Metabolic conversions of trichothecene mycotoxins: de-esterification reactions using cell-free extracts of Fusarium. AB - A crude cell-free extract from cultures of Fusarium sp. strain C37410-90 possessed significant esterase activity and hydrolyzed the trichothecene mycotoxin 3-acetyldeoxynivalenol (3-AcDON) to deoxynivalenol (DON) in high yield. Smaller amounts of 15-acetyl- and 3,15-diacetyl-esters of DON were also formed. The extract was capable of hydrolyzing a range of natural and semisynthetic trichothecene esters, and showed a high degree of regioselectivity towards position 3. 3,4,15-Triacetylscirpentriol (TAS) was efficiently hydrolyzed to 4,15 diacetoxyscirpenol (DAS), and no further transformation was observed. The enzyme activity was partially purified. PMID- 2775407 TI - Properties of 5'-AMP deaminase and its inhibitors with the aid of a continuous fluorimetric assay with formycin-5'-phosphate as substrate. AB - A new continuous fluorimetric assay for AMP deaminase activity is described. The method makes use of a fluorescent analog of 5'-AMP, formycin-5'-phosphate (5' FMP), which undergoes deamination to formycin B-5'-phosphate, not fluorescent at neutral pH. The pH-dependence for deamination of 5'-FMP is similar to that for 5' AMP, but shifted about 0.2 units to more acidic pH. Deamination of 5'-FMP may also be followed spectrophotometrically at 306 nm, permitting better assays of crude extracts. Some kinetic results obtained by means of the new method for AMP deaminase from chick and rabbit skeletal muscle are presented. In particular it was found that the natural product of deamination, 5'-IMP exhibited allosteric inhibition of the chick enzyme with Ki values 1.6 mM, 1.2 mM and 1.0 mM at pH 5.8, 6.5 and 7.3, respectively. Activation by diadenosine tetraphosphate, Ap4A, reported for mouse muscle AMP deaminase, has not been noted for the chick enzyme. Inhibition by the transition state analogs, coformycin and 2'-deoxycoformycin, was observed for both rabbit and chick deaminases with Ki values approximately 1 microM and approximately 1.6 microM respectively. Kinetic data for coformycin-5' phosphate show it to be a tight-binding inhibitor with Ki less than 0.6 x 10(-9) M as compared to 1 x 10(-9) M for 2'-deoxycoformycin-5'-phosphate. PMID- 2775409 TI - [Interactions of DNA topoisomerase inhibitors novobiocin and nalidixic acid with some cytotoxic agents. In vitro investigations in rat thymic and splenic cells]. AB - Interactions of novobiocin (NB) and/or nalidixic acid (NA) with some cytotoxic agents--UV light (UV), X-rays, methylmethanesulfonate (MMS), bleomycin (BM), adriamycin (AM), cis-diaminedichloroplatinum(II) (CDDP), mitomycin C (MIT), ethidiumbromide (EB), and suramin (SA)--have been investigated in thymic (T) and splenic (S) cells of the rat in vitro by measuring semiconservative (SDS) and unscheduled (UDS) DNA synthesis as well as sedimentation and viscosity of nucleoids. Combining NB (900 micrograms/ml) and/or NA (1800-3600 micrograms/ml) with UV, MMS, BM, AM, MIT, and SA resulted in additive effects on SDS and UDS. Synergistic actions were observed in T- and S-cells simultaneously treated by NB and CDDP, whereas the effects of NB could be antagonized to some extent by EB and vice versa. In X-irradiated (greater than or equal to 28 Gy) cells pretreated by NB (NA), UDS was diminished (T-cells) or enhanced (S-cells). The results are consistent with the following postulates: 1 degree in S-cells, DNA is much more supercoiled than in T-cells but in the opposite sense (positive superhelicity). 2 degrees DNA supercoiling (DNA compactness) is influenced therefore by DNA topoisomerase inhibitors and intercalating agents in a highly agent- and cell specific manner. PMID- 2775410 TI - Stabilization of actin filaments by ATP and inorganic phosphate. AB - Both inorganic orthophosphate and ATP stabilize actin filaments. This is reflected by a reduced nucleotide exchange and by a protection against filament breakdown by SDS or KI. When the filament-stabilizing effect of ATP was maximal, only about 15% of the actin subunits of the filament had bound one molecule of the nucleotide offered in the stabilizing solution. PMID- 2775412 TI - [Hydroxyiminoacetone-like reactivators of phosphorylated cholinesterases. Structure-activity relationships via molecular modelling]. AB - A structure-activity relationships (S.A.R.) is performed on a series of iminocetones acting like reactivators of phosphorylated cholinesterases. The structural and electronic molecular characteristics are computed using a molecular modelling system (Moldesign). A multidimensional statistical analysis point out the role of MEP's which are representative of the whole molecular electronic distribution. PMID- 2775411 TI - [1,4-Disubstituted 1,3-dihydro-2H-1,5-benzo- and chlorobenzodiazepin-2-ones with activity on the central nervous system]. AB - In pursuing the study on pyridodiazepinone derivatives, in order to verify the variation of biological activity induced by replacement of the heteroaromatic with an aromatic nucleus and by the introduction of chlorine on the benzene ring, a series of 1-[(dialkylamino)alkyl]-4-phenyl-1,3-dihydro-2H-1,4-benzodiazepin- 2 ones and of 7-chloro-analogues were prepared. Some benzodiazepinones and their 7 chloro-analagous were subjected to pharmacological experimentation in order to evaluate and compare their effect upon mice with regard to exploratory activity, motor coordination and spontaneous motility. In addition their anti-strychnine, anti-cardiazole, anti-amphetamine and anti-reserpine activities were also evaluated. PMID- 2775413 TI - Synthesis and antihypertensive activity of some 1,3,4-thiadiazole derivatives. AB - A series of 2-arylamino-1,3,4-thiadiazole derivatives was synthesized with the aim to find new antihypertensive compounds. The antihypertensive activity of some of these compounds was examined intraperitoneally in conscious spontaneously hypertensive rats (SHR). The tested compounds showed activity, but none of these possessed a higher potency than the reference substance guanabenz. PMID- 2775414 TI - N-trifluoroacetyl derivatives as pharmacological agents. IV--Antiinflammatory and related properties; antimicrobial activity of some polyaromatic trifluoroacetamides. AB - Taking into account both the analogy with the antiinflammatory triflamides and our previous observations on a series of trifluoroacetanilides active as acute and chronic antiinflammatory agents, the present series of polyaromatic N trifluoroacetylderivatives were prepared. Their antiinflammatory and related properties as well as antimicrobial activity were evaluated. Few derivatives were found to display significant analgesic effects (hot plate test) whereas at 50 mg/kg all were devoid of antiinflammatory effects except the benzophenone derivative (III). Instead as regards the antimicrobial screening, a selective antimycoplasmal activity was revealed in six out of ten examined compounds. PMID- 2775415 TI - Action of piracetam and clonidine on different mitochondrial populations from hippocampus. AB - The maximum rate (Vmax) of some mitochondrial enzymatic activities related to energy transduction (citrate synthase, malate dehydrogenase, NADH-cytochrome c reductase (as total activity), cytochrome oxidase) and amino acid metabolism (glutamate dehydrogenase) were evaluated in non-synaptic (free) and synaptic mitochondria from rat brain hippocampus. Three types of mitochondria were isolated from rats subjected to single i.p. treatments with piracetam (300 mg.kg 1) or with clonidine (750 micrograms.kg-1). With respect to the enzymatic pattern of three types of non-synaptic and synaptic mitochondria, in hippocampus a different maximum rate of both NADH-cytochrome c reductase and cytochrome oxidase was observed, these activities in particular being lowest in the "synaptic heavy" mitochondrial subfraction than in the "synaptic light" one; in addition, other enzyme activities are different in the "free" as compared to both the "light" and "heavy" mitochondria. This confirms that in various types of brain mitochondria a different metabolic machinery exists. Acute treatment with piracetam decreased citrate synthase, glutamate dehydrogenase, NADH-cytochrome c reductase and cytochrome oxidase activities only in the "heavy" mitochondria obtained from synaptosomes. Acute treatment with clonidine decreased the citrate synthase, NADH cytochrome c reductase and cytochrome oxidase activities only in the same type of mitochondria, i.e. synaptic "heavy" mitochondria. However, this drug increased the same enzymatic activities in "free" mitochondria, some of them being increased or decreased in "light" intrasynaptic ones. Therefore in vivo administration of piracetam mainly affects some specific enzyme activities (suggesting a specific molecular trigger mode of action) of the intrasynaptic mitochondria (suggesting a specific subcellular trigger site of action), the effect on enzyme activities by clonidine being more complex. PMID- 2775417 TI - Synthesis, antilipidemic and platelet antiaggregatory activity of 2 aminobenzimidazole amide derivatives. AB - The synthesis and preliminary pharmacological evaluation of 2-aminobenzimidazole amide derivatives are reported. None of these compounds showed antilipidemic or platelet antiaggregatory activity comparable to that of drugs used in therapy. PMID- 2775416 TI - Structure-activity relationships in 4-deoxypyrido[1',2'-1,2]imidazo[5,4 c]rifamycin SV derivatives. AB - New 4-deoxyhalogenopyrido[1',2'-1,2]imidazo[5,4-c]rifamycin SV derivatives (V VIII) have been prepared as an extention of a program which led to the synthesis of analogous pyrido- and alkylpyrido compounds (I-IV) displaying a low level of g.i. absorption. The new compounds give comparatively much lower ED50 p.o./s.c. ratios showing a recovery in the extent of oral absorption. XPS, N.M.R., and HPLC data rationalize this activity in hydrophilicity due to the electron-withdrawing inductive effect of the halogen atoms bound to the pyridoimidazo system. This effect is exerted in particular on the negatively charged N(2'), and is the opposite as that exerted by the alkyl groups present in (I-III). PMID- 2775418 TI - Amides of beta-(4-chlorophenoxy)-alpha-phenyl-ethylamines are inhibitors of cholesterol biosynthesis in vitro. AB - Amides of beta-(4-chlorophenoxy)-alpha-phenyl-ethylamines were prepared and tested for their inhibitory activity on cholesterol biosynthesis in vitro. Among the substances prepared, (II e), (II g), (II k) and (II m) had much greater inhibitory activity than clofibrate. PMID- 2775419 TI - Synthesis of substituted pyrimidines, pyrazole[3,4-d]pyrimidines and imidazo[4,5 d]pyrimidines and evaluation of their antifungal activity. AB - Some pyrimidines, pyrazolo[3,4-d]pyrimidines and imidazo[4,5-d]pyrimidines bearing the 5-nitro- and 5-aminothienyl-2-sulfide functionalities on the pyrimidine nucleus were synthesized and evaluated for their antifungal activity against several strains of yeasts and dermatophytes. 4-Amino-2-pyrimidinyl-5' nitro-2'-thienylsulfide (Va) resulted active against both yeasts and dermatophytes (about 30 fold less potent than Miconazole). Compds. (II b), (V b) and (VIII b) showed only a slight activity against dermatophytes, while the other compounds were inactive. PMID- 2775420 TI - [Synthesis and evaluation of the antifungal activity of a new series of N acylureas]. AB - Four new series of N-Acylureas (IIIa-h), (IV a-h), (Va-h), (VIa-h) were synthesized and tested for phytoiatric antimycotic activity. Only few of the tested compounds (IIIg), (IIIh), (IVf), (IVh), (Vg), (Vh), (VIg) showed a fairly good activity against P. irregulare, whereas no compounds exhibited any activity in the in vivo tests (in the preventive phase). PMID- 2775421 TI - Synthesis and some properties of a homologous series of beta-carboline-3 carboxylic esters. AB - A homologous series of esters of beta-carboline-3-carboxylic acid was prepared by a new synthetic procedure. The first members of the series are convulsant or pro convulsant agents while those with acyl residues longer than C4 show anticonvulsant activity. The affinity of the members of the series for the benzodiazepine receptor from rat brain decreases with the increasing chain length of the esters. The pentyl ester was studied in particular for its anti-convulsant effect on rats and mice treated with cardiazol. The compound also acts as a membrane stabilizer by inhibiting red cell hypotonic hemolysis and rat brain Na/K ATPase; its LD50 value is 12.5 mg/Kg and of particular interest is its lack of inhibitory effect on memory retention in mice at doses at which diazepam has inhibitory effects. PMID- 2775422 TI - [Mutagenicity testing in the sperm head test/mouse and mutagenic potency of 2 disinfectants on the basis of peracetic acid and phenols, respectively]. AB - For the improvement of the registration of data by assessment of mutagenic risk the analysis of sperm-head abnormalities have been rendered as a suitable at indirect evidence of mutagenic potency. The reproduction of the results is well. The sensitivity of the test is high. The quantitative evaluation of genotoxic effects is possible. By reason of comparatively low methodical expense the screening investigations of species mouse are suitable, before more expensive tests will be accomplished for the elucidation of the mutation type. At 35 day long intraperitoneal application the double number of sperm head abnormalities was approximately induced through Wofasteril (dose refer to main agent peracetic acid 2.6 mg/kg bw/d) and about 1/3 through cyclophosphamide (dose 25 mg/kg bw/d). With a 50% reduction of Wofasteril dose the mutagenic threshold-concentration was too low. The phenolic disinfectant Wofasept caused only slight no significant increase of the rate of sperm-head abnormalities (doses refer to the content of compounds, for Chlorocresol 1.6 mg/kg bw/d, for Clorofen 0.7 mg/kg bw/d and for detergent 4.8 mg/kg bw/d). PMID- 2775423 TI - [Chemical and biological characterization of electrofilter dusts of a waste incinerator. 1. Comparison of different extraction methods for organic dust contents and their mutagenicity]. AB - Particles collected by electrostatic precipitation from a municipal waste incinerator were used to study sample extraction methods for the mutagenicity bioassay. The Ames-Salmonella typhimurium plate incorporation method with tester strain TA 100 was employed. A series of organic solvents with different polarities was employed to identify the most efficient solvent for removing mutagens from the ashes: Soxhlet extraction with toluene and pretreatment with diluted HCl; Soxhlet extraction with toluene following 2-ethoxy-ethanol; reflux extraction with toluene: 2-ethoxy-ethanol: HCl conc.; Soxhlet extraction with dichloromethane. The results demonstrate that the amount of extractable mass correlates with the polarity of the solvents; however, the extractable mass did not correlate with the mutagenic activity of the extracts. The Soxhlet extraction with toluene and pretreatment with diluted HCl proved to be the best method for the extraction of mutagenic compounds present in particles collected by electrostatic precipitation from municipal waste incinerators, although it does not remove the maximum amount of extractable organic matter from the particles. PMID- 2775425 TI - Detoxification of formaldehyde by acetic acid bacteria. AB - Formaldehyde resistance of methylotrophic and non-methylotrophic Acetobacter strains was investigated. A facultatively methylotrophic Acetobacter methanolicus (MB58) gets rid of free formaldehyde by assimilating it. Heterotrophically growing cells tolerate 12 mM free formaldehyde. Non-methylotrophic but methanol oxidizing Acetobacter pasteurianus strains possess the same level of formaldehyde resistance. Formaldehyde resistance can be drastically lowered down to 4 mM by blocking the formate dehydrogenase by means of hypophosphite. Acetobacter spp. Martin 1 and LMG 76.10 are not able to oxidize methanol or formaldehyde via formate to CO2 and possess a significantly lower formaldehyde resistance (4 mM). Hence high formaldehyde resistance of the Acetobacter spp. investigated is based above all on a properly operating linear dissimilatory sequence. The dissimilatory RuMP cycle can hardly help detoxify formaldehyde. PMID- 2775424 TI - [Nitrated polycyclic aromatic hydrocarbons (nitro-PAH) in the suspended substances of the atmosphere. 2. Comparison of the mutagenicity of nitro-PAH and dust extracts of the air in the Ames, SOS repair induction and SCE test]. AB - Extracts of airborne suspended particulate matter were assayed in the Ames-test with strain TA 98, in the SOS chromotest (test on induction of the SOS repair) with strains E. coli PQ37 and S. typhimurium TA 1535 and in the sister chromatid exchange test. Samples from Berlin-Wedding were extracted by dichloromethane and tested up to the limits of solubility. All three test systems showed biologic activity. In the Ames- and the SOS chromotest these extracts revealed higher activity with S9-mix. 4 nitro-PAH, which are known to be present in ambient urban air, were assayed in these test systems, checking them additionally with strains TA 1538, TA 100 and TA 1535 in the Ames-test. In this test these compounds appeared to be direct acting frameshift mutagens and their activity is diminished by addition of S9-mix. On the contrary these compounds were either active at all or more active in the SOS chromotest in the presence of S9-mix. In the SCE-test only with exogenous activation a raise of the SCE frequency could be detected. PMID- 2775426 TI - Type-specific antigen of Streptococcus rattus strains (KAY1, FA1 and BHT). II. Ultrastructural localization. AB - Streptococcus rattus strains (KAY1, FA1 and BHT) were examined by electron microscopy in whole cell-mounted samples and ultrathin sections for the localization of the type-specific antigen, using specific antiserum and ferritin labelled anti-rabbit IgG as secondary antibody. In thin sections as well as whole cell-mounted samples the antigen was observed as irregular masses over the entire surface of the cells, in particular in the septal region between cells. The localization of the antigen was also examined in thin sections of a cell wall fraction prepared by treating the whole cells with glass beads in a disintegrator. Ferritin particles were observed around the outer surface, but not as many in number as those in whole cell-mounted or sectioned samples and rarely on the inner surface of the cell wall. PMID- 2775428 TI - Analysis of plasmids mediating ANT (2") and AAC(3)-II based gentamicin resistance in clinical isolates of Enterobacteriaceae. AB - The genetics of ANT(2") and AAC(3)-II mediated gentamicin resistance in Gram negative bacteria obtained from Hacettepe University Hospital in Turkey, was studied. The plasmid DNA analyzed by agarose gel electrophoresis revealed a heterogeneous plasmid population. Conjugal transfer appeared to be an efficient mechanism for the dissemination of resistance to gentamicin/tobramycin/kanamycin/streptomycin/chloramphenicol/cephalothin , which was the common resistance pattern in the population. Plasmids of 46, 60, 70 and 80 Mdal in size were found to be conjugative. Among these a 70 Mdal plasmid was isolated more frequently; it was harboured by the strains exhibiting either of the enzyme profiles, ANT(2") or AAC(3)-II. Like the substrate profiles of the donors, their enzymatic activities were also maintained in the respective transconjugants. Based on the donor and transconjugant resistance markers, agarose gel electrophoresis and transfer properties, ANT(2") and AAC(3)-II dependent gentamicin resistance was found to be plasmid-linked. However, the evidence of a possible chromosomal location for the gentamicin resistance suggested that the resistance might well be of a transposable nature. PMID- 2775427 TI - Effects of leptospiral lipopolysaccharide on rabbit platelets. AB - Leptospiral lipopolysaccharides (LPSs) extracted from Leptospira interrogans serovar copenhageni virulent strain Shibaura, serovar canicola virulent strain Moulton, and serovar hebdomadis strain Hebdomadis, were tested for their ability to induce platelet aggregation and/or lysis in rabbit platelet-rich plasma (PRP). All showed positive reactions with a release of adenosine triphosphate (ATP) and serotonin. The values, however, were different from each other. The ability of leptospiral LPS extracted from serovar copenhageni virulent strain Shibaura (I LPS) to induce platelet aggregation was the highest of all. After treatment of I LPS, the platelets developed a ruffled surface with appearance of pseudopodia as observed by transmission electron microscopy (TEM) and scanning electron microscopy (SEM). I-LPS also showed cytotoxicity for the platelets. Degenerative or lytic changes were recognized in 44.5% of the platelets which were observed 60 min after I-LPS treatment. PMID- 2775429 TI - The efficacy of 22,23-dihydroavermectin B1 (Ivermectin) acting singly or in combination with a benzodiazepine on microfilariae of Onchocerca species and Brugia pahangi (an in vitro study). AB - An in vitro study of the antinematodal action of two groups of compounds which act on the receptor complex of the inhibitory neurotransmitter, Gamma aminobutyric acid (GABA) in mammalian systems is described. The compounds, Ivermectin and two benzodiazepines, Diazepam and a water soluble Midazolam were tested singly or in combination against two microfilarial parasites Onchocerca lienalis (closely related to Onchocerca volvulus) and Brugia pahangi. The combination of ivermectin and diazepam at a concentration of 0.1 microgram/ml and 33 micrograms/ml respectively achieved the same effect on microfilarial motility as when ivermectin was given at 1 microgram/ml alone or diazepam at 66 micrograms/ml alone. Similarly when the combination of ivermectin at 0.1 microgram/ml and midazolam at 10 micrograms/ml was used it achieved the same effect as ivermectin at 1 microgram/ml alone or midazolam at 33 micrograms/ml alone. This showed that both benzodiazepines had a synergistic effect on the activity of ivermectin. The microfilariae of B. pahangi were insensitive to both groups of compounds at all concentrations used. PMID- 2775430 TI - Studies on the pathogenesis of Acanthamoeba-associated meningoencephalitis. AB - 100 indoor swimming pools were examined for the presence of free-living amoebae. Limax amoebae of the genus Acanthamoeba could be isolated from 34 samples. Naegleria spp. were not present. After axenic cultivation the pathogenicity in mice was tested. Histological as well as immunohistological procedures were compared in order to identify the amoebae in brain sections and to clarify the route of infection. The results indicate a direct invasion of the central nervous system by acanthamoebae via the nasal mucosa and the olfactory bulb. PMID- 2775431 TI - The relationship between connectivity and tolerance as revealed by computer simulation of the immune network: some lessons for an understanding of autoimmunity. AB - According to a classical, antigen-driven view of the immune system, autoimmunity is due to the presence of self-reactive lymphocyte clones which have not been eliminated. However, computer simulations of the immune network show that the greater the degree of connectivity of a clone, the greater its degree of tolerance to chronic antigenic stimulation. This tolerance does not correspond to an absence of response on the part of the system as a whole. On the contrary, stimulation by a 'tolerogenic antigen' results in widespread modification and overall activation of the whole network. This suggests that on an autopoietic network view of the immune system, autoimmunity arises not because of the presence of self-reactive clones, which is completely normal, but because such clones are inadequately connected to the network. This amounts to a complete reversal in perspective, whose significance for the clinical treatment of autoimmunity and the future of immunology is discussed. PMID- 2775432 TI - Monomeric (7S) and polymeric (19S) IgM anti-delta in acute and chronic delta infections. AB - The chromatographic profiles of IgM anti-delta in 45 acute and 24 chronic delta patients were analyzed by fast protein liquid chromatography (FPLC). Predominance of 19S IgM anti-delta was observed in the sera of 100 percent of coinfected and 62% of superinfected patients. In contrast, 7S IgM anti-delta was predominant in 83% of patients with chronic hepatitis delta. The study of the chromatographic profiles of IgM anti-delta in the development of the disease showed an association between the process of chronic delta-infection and the failure of 7S IgM anti-delta monomers to form 19S pentamers. The results showed that the test for 7S and 19S IgM anti-delta could be useful for differential diagnosis of acute and chronic hepatitis delta infection and for determining the prognosis of acute delta infection. PMID- 2775433 TI - Head CT in new geriatric psychiatry patients: a prospective study. AB - Computed tomography of the head (HCT) was studied prospectively in 42 new geriatric psychiatry patients. Scans were obtained in 88% of the sample. Subjects underwent a complete evaluation by a geriatric psychiatrist who was blind to the HCT results. The HCT was abnormal in 32 (86%) of the 37 patients who had a scan. The most frequent finding was atrophic changes, which were discovered in ten (27%) of the 37 patients. Subcortical vascular disease was found in 14 patients (38%). Mixed pictures with both vascular disease and atrophic changes were found in nine (24%). The only statistically significant predictor of an abnormal HCT was an abnormal neurobehavioral examination. While the information gained from the HCT did not add appreciably to the clinical evaluation in determining whether there was an organic or idiopathic psychiatric syndrome, it was crucial in determining the location and nature of the central nervous system lesions. PMID- 2775434 TI - Rapid cycling mood disorder in the elderly. AB - Rapid cycling mood disorder is an unusual and difficult syndrome to recognize in the elderly. A case of this disorder is presented in a patient with subtle central nervous system dysfunction who was treated for depression with tricyclic antidepressants. CNS dysfunction and antidepressants have both been identified as risk factors for rapid cycling. Successful treatment with carbamazepine lends credence to the concept of limbic system dysregulation being an underlying, important factor in cyclical affective disorder. PMID- 2775435 TI - Progressive supranuclear palsy with agitation: response to trazodone but not to thiothixine or carbamazepine. AB - A 66-year-old man with progressive supranuclear palsy is described. Although generally apathetic, withdrawn, and spontaneous in speech and behavior, he had sudden episodes of agitation, during which he was verbally threatening and physically abusive. Treatment with thiothixine and then with carbamazepine was ineffective in controlling his violent behavior. He responded temporarily to trazodone, and a recurrence of aggressive behavior was suppressed by increasing the dose of trazodone; this response may be related to trazodone's putative effect on the serotonin system. Although both carbamazepine and trazodone have been advocated for the control of aggression in organically impaired patients, they were not equally effective in this case. PMID- 2775436 TI - Use of propranolol for the control of disruptive behavior in senile dementia. PMID- 2775437 TI - Concurrent posttraumatic stress disorder in psychogeriatric patients. AB - Despite the fact that there are over 11 million World War II veterans in the United States, recent research on combat-related trauma has focused primarily on symptoms of posttraumatic stress disorder (PTSD) in Vietnam veterans. Several studies have found that the majority of Vietnam veterans who meet the Diagnostic and Statistical Manual of Mental Disorders, ed 3 (DSM-III) criteria for PTSD have an additional major psychiatric diagnosis. This study explores the presence of the diagnosis of PTSD in an inpatient sample of 42 World War II veterans with an admission diagnosis other than PTSD. Following a structured diagnostic interview, a second examiner, blind to the patients' combat history, interviewed the subjects to obtain information regarding the past and current impact of the "most stressful experience" of their lives. Subjects were instructed not to reveal the nature of the stressor until completion of the study. Fifty-four percent of the combat-exposed veterans (14 of 26) spontaneously listed combat as the most significant stressor in their life. Furthermore, 54% of the combat-exposed veterans met DSM-III criteria for past PTSD and 27% met criteria for current PTSD in addition to another axis I diagnosis. These preliminary findings underscore the need for clinicians to assess the long-term effects of combat trauma in psychogeriatric patients. PMID- 2775438 TI - HLA antigens in depressed, demented, and nondemented elderly. AB - To identify HLA antigen associations with geriatric depression, the authors typed 36 elderly patients with major depression and, for comparison, 36 patients with Alzheimer-type dementia and 29 nondemented elderly controls. The frequency for antigen Aw32 was significantly higher in the group of patients with major depression (14%) than in the demented (0%) and control (3%) groups. The frequencies for antigens Aw32 (22%) and Bw51 (22%) were significantly higher in the subgroup of 23 patients with endogenous depression than in the demented (Aw32 = 0%; Bw51 = 11%) and the control (Aw32 = 3%; Bw51 = 0%) groups. Although these results were derived from a relatively small sample (n = 101) and become nonsignificant when corrected for multiple comparisons, they suggest that HLA antigen associations may be present for only certain depressive subtypes in geriatric depression. PMID- 2775439 TI - Geographical knowledge in patients with Alzheimer's disease. AB - Geographical knowledge, a measure of remote memory for visuospatial information, was studied in mildly and moderately demented patients who met NINCDS-Alzheimer's Disease and Related Disorders Association criteria for Alzheimer's disease. Alzheimer's disease patients were moderately impaired on a test that emphasizes locating gross features of US geography and profoundly impaired in locating cities on a map of the region of the United States in which they resided. The possibility that performance on tests of geographical knowledge can be used to predict impending difficulties of demented patients in wayfinding is discussed. PMID- 2775440 TI - 'Don't know' responses in elderly demented and depressed patients. AB - The suggestion that patients having depression with reversible dementia make more "don't know" responses to cognitive questions than do demented patients was tested. Inpatients were administered the Mini-Mental Status Examination (MMSE) on admission and shortly before discharge. Errors and "don't know" responses were recorded. Groups were defined as (1) demented (n = 20; diagnosis of dementia, entrance and exit MMSE less than 24) and (2) depressed with reversible dementia (DRD, n = 11; diagnosis of major depression, entrance MMSE less than 24, exit MMSE greater than 24, delta MMSE greater than 3). Groups differed significantly on MMSE scores and errors, with demented patients scoring lower and making more errors than the DRD group. Groups did not differ significantly in "don't know" responses. Comparisons between groups on sections of the MMSE showed that demented patients scored significantly lower and made more errors than DRD patients only on the orientation section of the MMSE. The results suggest that DRD patients do not make more "don't know" responses than demented patients; however, demented patients make more errors on orientation questions. PMID- 2775441 TI - Axis II diagnoses in geriatric inpatients. AB - Little is known about personality disorders in the elderly. Review of 100 consecutive inpatient admissions revealed that 7% [corrected] received an Axis II diagnosis of personality disorder. Sixteen percent received a diagnosis of personality disorder trait. PMID- 2775442 TI - Lifetime course of chronic depression in older men. AB - The lifetime course of illness in older outpatient men who remained symptomatic despite adequate pharmacologic treatment for depression was examined. A bimodal distribution of age of onset of first major depression was found, with 75% having onset before age 35 years and 25% having onset after age 50 years. At all ages, episodes of chronic depression developed after episodes of major depression and appeared to be partially resolved major depression. In 88% of patients, anxiety disorders developed before age 35 years, preceded onset of other disorders, and continued throughout the patient's lifetime. Seventy percent developed alcoholism and 25% had a medical illness that impaired function to a significant degree. The importance of obtaining a lifetime course of illness in older patients is discussed. PMID- 2775443 TI - A correlation between cognitive performance and daily functioning in elderly people. AB - The Mini-Mental State Examination (MMSE) is widely used to detect dementia, but the diagnosis of dementia also depends on a decline in the level of daily functioning. Little is known about the relationship between performance on the MMSE and daily living abilities. This relationship was investigated in this study of an elderly population by comparing scores on the MMSE with those on both a direct assessment of everyday tasks and an indirect questionnaire about activities of daily living and physical self-maintenance. Forty-five subjects with varying mental abilities participated in the study. A significant correlation was found between MMSE scores and the measures of functional abilities; but the specificity and sensitivity to the diagnosis of dementia would be increased by assessing functional status, even indirectly, as well as cognitive ability. PMID- 2775444 TI - Synthesis and biological activity of dibenz[c,e]azepines. AB - Synthesis and pharmacological screening of 68 dibenz[c,e]azepines are described. All were inactive as antidepressant agents, but two compounds showed good anticonvulsant activity. The structure-activity relationships of this class of compounds are discussed. PMID- 2775445 TI - Synthesis and cytotoxic activity of tetrahydropyridylidene-2- and -4 sulfonamides. AB - 1,2,3,4-Tetrahydropyridylidene-4-sulfonamides, 1,2,3,4-tetrahydropyridylidene-2 sulfonamides, and 1,2,3,6-tetrahydropyridylidene-2-sulfonamides, of structures 10, 12 and 14, respectively (given in Table I), were synthesized in order to investigate the effect of nuclear substituents and the position of the sulfonamido group on cytotoxicity. The relative potency order was 12 greater than 10 greater than 14. Compounds possessing an R1 CONEt2 substituent were more potent than those possessing a R1 CN substituent. The nature of the aryl(alkyl) sulfonamido substituent was a determinant of activity, the relative potency order being 4-chlorophenyl greater than phenyl, 4-methoxy- or 4-nitrophenyl greater than methyl. 1-Methyl-4-tert-butyl-5-diethylaminocarbonyl-1,2,3,4-tetrahydro pyridylidene- 2-(4-chlorophenyl)sulfonamide (12c) was the most active cytotoxic agent, exhibiting an ED50 of 5.4 micrograms/ml in the L1210 in vitro screen. PMID- 2775446 TI - Buoyant sustained release granules based on chitosan. AB - Attempts to develop sustained release intragastric 'floating' granules based on chitosan are described, using chitosan of different degrees of deacetylation (chitosan H and L), in granular form or in laminated preparations. The granules were made from chitosan H (chitosan H granules), from a 1:1 mixture of chitosan H and L (1:1 mixture granules), from a 1:2 mixture of chitosan H and L (1:2 mixture granules), or from chitosan L (chitosan L granules). They were prepared by a method involving deacidification, had internal cavities, were immediately buoyant in both acidic and neutral fluids, and gave sustained release of prednisolone (used as a model drug). The laminated preparations, composed of a chitosan granule layer and a chitosan L membrane, were also immediately buoyant in the same fluids, and also provided sustained release of the model drug. The release properties were controlled by regulating the chitosan L content of the granules, or the chitosan L membrane thickness of the laminate. In an absorption study using beagle dogs, sustained drug absorption from these preparations was obtained. PMID- 2775447 TI - Percutaneous absorption enhancer applied to membrane permeation-controlled transdermal delivery of nicardipine hydrochloride. AB - In the design of nicardipine hydrochloride-transdermal delivery systems (NC-TDS), the enhancing and regulating effects of penetration-enhancers and permeation controlling membranes were evaluated. Laurocapram (Azone) was selected as a model enhancer. Since its enhancing effect is considered to occur in the stratum corneum, its release from ethylene-vinyl acetate copolymers (EVAc), ethylene vinyl alcohol copolymers (EVAl) or poly(2-hydroxyethylmethacrylate) (pHEMA) membranes was used as a criterion for membrane selection. The release rate was highest from pHEMA. Accordingly, a TDS consisting of a NC reservoir containing 1 w/v% Azone and a pHEMA membrane was prepared, and the effect of skin stripping on the plasma concentration of NC after NC-TDS administration was evaluated in rats. The increased ratio in drug plasma concentration caused by skin stripping was lower when the NC-TDS treatment was compared with a non-regulating NC-gel treatment. Our results suggest that the membrane permeation-controlled TDS of NC may be useful for long-term constant drug delivery with minimum dependence on skin conditions. PMID- 2775448 TI - The effect of substituted aminoalkylaminoanthraquinones on eukaryotic cells. AB - Nine aminoalkylaminoanthraquinones (I-IX) were evaluated for their cytotoxic potency against normal and malignant mammalian cells. The 1.8-di (aminopropylamino) derivative (VIII) exhibited significant activity against several tumor cell systems and had some selectivity. The toxicity of this compound was also tested in growing chick embryos. PMID- 2775449 TI - Pharmacokinetic evaluation of indomethacin nanocapsules. AB - Indomethacin-loaded polyisobutylcyanoacrylate nanocapsules were prepared by interfacial polymerization of the alkylcyanoacrylate monomer. Mean particle size of the nanocapsules ranged from 200 to 300 nm. Comparison of the results following intravenous infusion of indomethacin solution and nanocapsules to rats revealed that nanoencapsulation accelerated the extravascular distribution of indomethacin due partly to enhanced uptake of the colloidal carrier by the liver reticuloendothelial system. Following intragastric administration, the oral bioavailability of indomethacin in solution was 90%--indicating complete absorption of this drug from the gastrointestinal tract of the rat. Absorption of indomethacin nanocapsules by this route was more rapid. This was attributed either to an increase in the intensity and/or the duration of contact of the encapsulated drug with the gut wall, or to a more efficient absorption process involving paracellular pathways. PMID- 2775450 TI - The pharmacokinetics of a new sustained-release form of diclofenac sodium in humans. AB - In the present study, two sustained release diclofenac preparations were administered every 12 hours over 4 days to ten human volunteers. Diurnal profiles were recorded on the 1st and 4th days, from which pharmacokinetic parameters were calculated: particular attention was given to cumulation. One, a newly developed sustained release formulation, had a MRT of 5.5 hours, and showed surprisingly small variation coefficients [AUC ss (72-84 hrs) +/- 26%; Cmax ss (72-84 hrs) +/- 19%] after 7 administered doses; accordingly, the maximum concentrations were within a very narrow time window [tmax ss (72-84 hrs) range: 1.5-2.5 hours after administration]. Due to the selected release profiles with this formulation, there was no danger of cumulation in spite of administration every 12 hours [AUC 0-12 hrs, mean value = 1555 ng/ml x h; AUC ss 72-84 hrs, mean value = 1750 ng/ml x h]. PMID- 2775451 TI - Effect of limonene and related compounds on the percutaneous absorption of indomethacin. AB - The promoting effect of cyclic monoterpenes present in essential oils on the percutaneous absorption of indomethacin (IMC) from gel ointments was investigated in rats. As compared Azone, drug absorption was markedly enhanced by the addition of d-limonene, which is the main component of orange or lemon oils. Similar activity was observed in the cases of the l- and dl-forms of limonene, p menthane, alpha-terpinene or terpinolene. On the other hand, no effect was obtained when the additive had hydroxyl or carbonyl groups, or ether oxygen in its chemical structure. The effect of pretreatment of skin with d-limonene on subsequent percutaneous absorption of IMC was investigated in order to estimate the influence of d-limonene on the barrier properties of the skin. No effect was observed suggesting that d-limonene might reversible alter the skin structure as the barrier for the drug transport. The serum concentration of IMC increased proportionally when increasing amounts of ethanol were present in the formulation (gel ointment) containing d-limonene. Therefore, ethanol may act as the accelerating agent for the promoting activity of d-limonene. PMID- 2775452 TI - Effect of cyclohexanone derivatives on in vitro percutaneous absorption of indomethacin. AB - We have previously shown that cyclohexanone derivatives exert a promoting effect on the in vivo percutaneous absorption of indomethacin (IMC), and now describe in vitro permeation studies to gain understanding of the mechanism of action. The results of the in vitro experiment were consistent with those of the previous in vivo experiments. 2-tert-Butylcyclohexanone was the most effective of six enhancers examined. The partition coefficient of IMC was determined in a buffer octanol system containing the cyclohexanone derivatives, and the lipophilicities of these derivatives are discussed using a lipophilic index. We conclude that the cyclohexanone derivatives penetrate into the stratum corneum and alter the skin permeability of IMC by fluidizing or modifying the hard hydrophobic barrier of the corneum. PMID- 2775453 TI - Immunochemical analysis of the human chorionic gonadotrophin-like material secreted by 'normal' and neoplastic urothelial cells. AB - Material with the immunochemical characteristics of human chorionic gonadotrophin (hCG) is produced by bladder tumour cells in vitro and in vivo. In order to characterize this material further, media were collected from 17 cell cultures (three choriocarcinomas, seven bladder carcinomas and seven 'normal' urothelium). The hCG-like material was compared with pregnancy hCG and purified alpha-and beta subunits by specific radioimmunoassays. Media were also submitted to affinity chromatography and the fractions further analysed by SDS-PAGE and Western blotting. It was shown that both the neoplastic and normal urothelium produced only free beta-subunit-like material. This urothelial 'beta-hCG' has the same molecular weight and electrophoretic mobility as that present in the intact hCG of pregnancy. PMID- 2775454 TI - Identification of high molecular weight peptides in bovine adrenomedullary chromaffin granules using monoclonal antibodies to a preproenkephalin A fusion peptide. AB - Two mouse monoclonal antibodies (PE-1 and PE-2) raised to a beta-galactosidase preproenkephalin A(69-207) fusion peptide recognize pro-enkephalin A (pro-enk-A) peptides of 33-5 kDa isolated from bovine adrenal chromaffin granules. The preliminary characterization of the high molecular weight adrenomedullary pro-enk A peptides recognized by PE-1 and PE-2 is described. The high molecular weight peptides were resolved after Sephadex G-50 chromatography and high-performance liquid chromatography (HPLC) into three components (peaks I, II and III). Immunoblot analysis showed each HPLC peak to be heterogeneous. Peak I contained PE-1-and PE-2-immunoreactive peptides of 33, 29, 24 and 22 kDa; peak II contained a peptide of 22 kDa recognized by PE-2, and peptides of 24 and 22 kDa recognized by PE-1; peak III contained a PE-2-immunoreactive peptide of 15 kDa and PE-1 immunoreactive peptide of 18 kDa. Using polyclonal antibodies to peptide F and methionineenkephalin-Arg6-Gly7-Leu8 (MetEnk-RGL), the 22 kDa band cross-reacted with both MetEnk-RGL and peptide F antibodies, whilst the 24 kDa band was shown to possess predominantly MetEnk-RGL immunoreactivity. The 15 kDa (PE-2 immunoreactive) band was recognized by the peptide F but not the MetEnk-RGL antibody, whereas the polyclonal antibodies did not recognize the 18 kDa (PE-1 immunoreactive) band. We propose that the immunological and size characteristics of some of these peptides (29, 24/22, 15 kDa) suggest their similarity to the peptides of predicted molecular mass 23.3, 18.2 and 12.6 kDa previously found in bovine adrenal medulla. The results also indicate the existence of high molecular weight pro-enk-A peptides shortened at the N-terminus. The use of an immunoradiometric assay designed to measure the proenk-A-derived 18.2 kDa peptide using PE-2 and an affinity purified and radioiodinated MetEnk-RGL IgG has supported these findings. PMID- 2775455 TI - Nuclear proteins from the rat pituitary gland bind to regulatory sequences of the thyrotrophin-beta gene. AB - Interactions between DNA sequences and nuclear proteins are important in the regulation of gene expression. We have applied a gel retardation method to examine the binding of nuclear proteins from the rat pituitary gland to regulatory sequences of the rat TSH beta-subunit gene. Binding between nuclear protein and DNA is demonstrated by an alteration in electrophoretic mobility of the DNA. A 0.4 M NaCl fraction of pituitary nuclear proteins bound to a fragment of DNA containing the promoter region of the TSH-beta gene, but not to plasmid DNA or insulin cDNA of comparable size. This nuclear protein fraction also bound to fragments of DNA containing sequences from the 5'-flanking region of the gene; binding of nuclear proteins was evident as far as 1 kb 5' to the structural gene. Each of these regions of the TSH-beta gene formed a number of distinct complexes with the nuclear protein extract, distinguished by their differing binding affinities in the presence of poly(dI-dC), and by their electrophoretic mobility. These findings suggest that transcriptional regulation of the rat TSH-beta gene may be mediated by interaction of a number of nuclear proteins with regulatory sequences of DNA up to 1 kb upstream of the transcriptional start site of the gene. PMID- 2775456 TI - Differential binding of thyroid hormone receptors to mouse glandular kallikrein gene promoters: evidence for multiple binding regions in the mGK-6 gene. AB - We have used a DNA-cellulose competition assay to investigate the binding of thyroid hormone receptors to fragments of the mouse glandular kallikrein genes and the human and rat GH genes. Nuclear extracts from human lymphoblastoid IM-9 cells were incubated with [125I]tri-iodothyronine [( 125I]T3) and DNA-cellulose. The ability of cloned gene fragments to compete for radiolabelled receptors bound to DNA-cellulose was compared with that of DNA from pBR322. As previously observed, a 900 bp fragment from the human GH gene showed preferential binding to the thyroid hormone receptor. High-affinity binding was observed with a synthetic fragment of the rat GH gene encompassing positions -163 to -192 but not with a similar fragment from positions -224 to -192. Preferential binding was also observed with fragments of the mouse glandular kallikrein gene, mGK-6. Binding to the entire gene and fragments containing 2300 and 776 bp of the promoter region was identical. Detectable but reduced binding was seen with a shorter fragment. These results suggest that the T3 receptor binds to multiple sites within the first 776 bp of the mGK-6 gene promoter. Potential thyroid hormone response elements can be identified within this region of the gene. In contrast, the kallikrein gene mGK-3, which shows a different response to thyroid hormone from that of mGK-6, showed no significant binding in the comparable promoter region. PMID- 2775457 TI - The androgen-dependent rat prostatic binding protein: comparison of the sequences in the 5' part and upstream region of the C1 and C2 genes and analysis of their transcripts. AB - The complete gene encoding the polypeptide C1 of the complex androgen-controlled prostatic binding protein was isolated from a rat genomic library. A new genomic fragment (C2B) containing only the 5' part of a C2-related gene was also purified. The segments containing exon 1 and a large part of the adjacent sequences were analysed and compared with the corresponding region of the C2A gene which has been completely sequenced previously. The high structural similarity extending over a large part of all three genomic fragments suggests the duplication of a common ancestral gene, followed by a more recent duplication of the C2-coding region. However, since the structural similarity upstream of position -150 between C2A and C2B abruptly disappears and no transcripts specific for the C2B region can be detected in prostate RNA, we propose that at a later stage in evolution the C2B region was disrupted and inactivated. Despite the common origin and the similar regulation of the two active genes, C1 and C2A, the only obvious conserved structural element is the homopurine stretch located at position -400, although sequence motifs resembling steroid hormone response elements are present at several locations. PMID- 2775458 TI - Whole-cell clamp study of Xenopus embryonic cholinergic neurons. AB - Whole-cell clamped myoballs are placed into direct visible contact with the growth cones of isolated neurons in embryonic Xenopus culture to serve as probe of acetylcholine (AcCHo) release in order to determine whether these neurons are cholinergic or not. Using a G omega -seal, whole-cell recording method, the electrophysiological properties of these identified cholinergic neurons are studied. It is found that these embryonic neurons, like adult frog motor neurons, exhibit repetitive firings in a certain embryonic developing stage. A development of repetitive firings is observed simultaneously. Tracing the development of one neuron, we find that the development of repetitive firing is completed at the 48th h after fertilization. Tetrodotoxin (TTX) which blocks Na+ channels can abolish all firings; and tetraethyl ammonium chloride (TEA), the blocker of K+ channels, reverses this development, i.e. it makes the repetitive firings disappear again. These data show that the nature of the development of repetitive firings is the development of K+ channels. PMID- 2775460 TI - Studies on response characteristics of drug ise's. (III)--Erythromycin electrodes and their selectivity toward quaternary ammoniums. AB - Erythromycin sensitive electrodes have been proposed. Their selectivity toward quaternary ammoniums is described in terms of induction effect and steric hindrance effect: logKij = a1I-a2Z/R + a0, where I is induction effect index, a1, a2 and a0 are coefficients which depend on the electro-active material. A general formula has been suggested to relate the electrode selectivity to the carbon atom number (n) of the alkyl of the quaternary ammonium; logKij = A/2.7n B/(0.80+1.26n)+C, where A, B and C are coefficients which depend on the electro active material. logKij tends to a limited value C when n increases. PMID- 2775459 TI - Association of adenovirus DNA transcribed activity with nuclear matrix of host cells. AB - With gentle cell extraction techniques, various DNA components in the HeLa cells after 6 h of adenovirus infection have been obtained. Adenovirus, early transcribed regions (E2a, E1b) and a late transcribed region (L2) were used as probes in Southern hybridization, respectively. The experiment showed that only actively transcribed adenovirus DNA fragments would tightly bind to the nuclear matrix of host cells. We inferred that the nuclear matrix of host cells plays an important role in viral DNA transcription. PMID- 2775462 TI - Science versus opinion: a response to Cunningham's critique. PMID- 2775461 TI - Theoretical and computational investigations of nonlinear wave propagations in arteries. (I)--A theoretical model of nonlinear pulse wave propagations. AB - In this paper, a new theoretical model of nonlinear wave propagations in arteries with surrounding tissues was put forward. The equations of motion for the blood vessels and their peripheral tissues as a system have been derived. These equations were expressed in terms of the stresses of the vessel wall and fluid, and the geometry of the blood vessel. They can be used to solve numerically the problems for the propagations of nonlinear pulse waves in arteries together with the momentum and continuity equations of incompressible-viscous flow, as well as the constitutive equations of fluid and vessel wall. The numerical solutions can involve pressure, velocities and flowrate of the blood flow, as well as displacements, velocities and stresses of the vessel wall. These physical variables of propagations of pulse waves in arteries are all of significance physiologically and clinically. PMID- 2775464 TI - Assisting the newborn to latch on to the very large breast: help! PMID- 2775463 TI - Pig roasts, science and babies: a reply to Leventhal, Shapiro, and Bauchner. PMID- 2775465 TI - Development of a hospital breastfeeding center. PMID- 2775466 TI - Effects of two isomeric 1-aminoadamantanes on the membrane anisotropy and on alpha- and gamma-motoneurones excitability. AB - The structure-activity relationship of two isomeric 1-aminoadamantanes, 1-C ethylaminoadamantane (D 174) and 1-amino-3-ethyladamantane (D 175), on membrane anisotropy and the excitability of neurons was studied in the CNS of the rat and in the decerebrated cat. Mass spectrometric analysis showed that after a single, 40 mg/kg dose, D 174 and D 175 were unevenly distributed within the CNS of the rat, moreover the distribution pattern of the two substances was different. As measured by fluorescence depolarization in controls the membrane anisotropy was found to be higher in the older parts as compared with the younger parts of the CNS. After i.p. application of 40 mg/kg the membrane anisotropy was reduced in the cortex by D 174, whereas D 174 and D 175 increased the rigidity in striatal membranes. If cortical membranes were incubated with the substances, the fluidizing effect of D 174 was more prominent than that of D 175. In the decerebrated cat only D 174 in a dose of 5 mg/kg i.p. raised the discharge of spinal alpha-motoneurones significantly. The results suggest that the membrane architecture is more affected by D 174 as compared with D 175 which is reflected by a greater effect on membrane anisotropy as well as on the activity of spinal alpha-motoneurones. PMID- 2775467 TI - Effects of repeated administration of low doses of apomorphine in three behavioural models in the rat. AB - A low dose of the dopamine (DA) receptor agonist apomorphine (APO 0.05 mg/kg) was given repetitively and the effects were tested in three different behavioural models: reduction of spontaneous locomotion, induction of yawning and decrease in water intake in water-deprived animals. The APO-induced suppression of exploration and decrease in water intake were not affected by a previous injection of APO given 1 or 3 hours before the test dose of APO. There was a small, but significant, decrease in the induction of yawning by a previous dose of APO given 1 hour or 30 min before the test dose. However, pretreatment with APO 3 hours before the test dose did not diminish the yawning response. It is suggested that the dopaminergic mechanisms mediating APO induced yawning are different from those mediating decrease in water intake and suppression of exploration. The results are also discussed in relation to the proposed efficiency of low doses of DA agonists in the treatment of various neurological and psychiatric disorders. PMID- 2775469 TI - Low doses of atropine sulfate impair retention of a well-learned spatial task. AB - Retention of a well-learned spatial task was assessed in rats 10 minutes prior to, and 10, 20, 30, 40, and 50 minutes after treatment with 3, 10 or 30 mg/kg, iv, atropine sulfate or the equivalent volume of saline, iv. There was a variable dose effect for escape latency and choice accuracy measures of spatial retention. A relatively large dose of atropine sulfate (30 mg/kg, iv) significantly impaired choice accuracy and escape latency compared with the control group. Moreover, impairment in choice accuracy was observed with smaller doses of atropine sulfate (3, 10 mg/kg, iv) than have previously been shown to disrupt spatial retention. PMID- 2775468 TI - Exploratory hypoactivity induced by m-trifluoromethylphenylpiperazine (TFMPP) and m-chlorophenylpiperazine (m-CPP). AB - The action of m-trifluoromethylphenylpiperazine (TFMPP) and m chlorophenylpiperazine (m-CPP), inhibiting the exploratory activity (ambulation and peeping) of the rat was studied in the open field test. The effects of both these drugs were antagonized by mesulergine, metergoline and mianserin, and partly by methysergide. Spiperone showed an antagonistic action in one (mean) dose only. The effects of TFMPP and m-CPP were not antagonized by ipsapirone, gepirone, cyanopindolol, compound 21009, cyproheptadine, ritanserine, ICS 205930, idazoxan or atropine. The lesion produced by p-chloramphetamine attenuated the effects of TFMPP and abolished those of m-CPP. The obtained results permit an assumption that the TFMPP- and m-CPP-induced decrease in the exploratory activity is mediated probably by 5-HT1C receptors. PMID- 2775471 TI - Calculating the risk: reflections on the Norton Scale. PMID- 2775470 TI - The financial costs of inpatient pressure ulcers to an acute care facility. AB - The variable costs for treatment of pressure ulcers in an acute care facility that is part of a health maintenance organization were examined in a three-month, retrospective study. The average age of these patients was 75.61 and the average cost of treatment per day was $80.42. The average total variable cost per patient was $1,300.37. The average variable cost for treatment of a patient admitted for an ulcer was $3,746.03, while the average variable cost for treatment of patients admitted for other reasons was $621.02. PMID- 2775472 TI - Pressure sore risk assessment: a critique. Part I. The Gosnell scale. PMID- 2775473 TI - Clinical utility of the Braden scale for Predicting Pressure Sore Risk. PMID- 2775474 TI - Cost and efficacy of pressure ulcer management in a metropolitan visiting nurse association. PMID- 2775475 TI - Risk factors associated with pressure ulcer development in surgical patients. PMID- 2775476 TI - Noninvasive evaluation of the cutaneous circulation in the management of pressure sores. PMID- 2775477 TI - Interface pressure confusion. PMID- 2775478 TI - Another opinion on interface pressure. PMID- 2775479 TI - New substrates of polyamine oxidase. Dealkylation of N-alkyl-alpha, omega diamines. AB - 1) N-Alkyl-alpha, omega-diaminoalkanes are substrates of polyamine oxidase. 2) The compounds are oxidatively cleaved and form equimolar amounts of an aldehyde, a diamine, and H2O2. 3) Minimum structural requirements of a substrate of polyamine oxidase are two positively charged amino groups and an alkyl substituent on one or both nitrogen atoms. 4) Dealkylation of N-alkyl derivatives by polyamine oxidase in vivo is a method to accumulate diamines in brain, and to release intracellularly an aldehyde from a stable prodrug. PMID- 2775480 TI - Structure of a hemoglobin gene cluster and nucleotide sequence of three hemoglobin genes from the midge Chironomus thummi piger (Diptera, Insecta). AB - The aquatic larvae of the genus Chironomus (Diptera, Insecta) contain at least 12 different hemoglobin (Hb) variants in their hemolymph. In the present study we have analysed the structure and part of the nucleotide sequence of a Hb gene cluster cloned from the genomic DNA of Chironomus thummi piger. The cluster contains probably 6 different genes, separated by intergenic regions of various lengths. The nucleotide sequence of three putative Hb genes including the intergenic regions is presented. The inferred amino-acid sequences show clearly that two of these putative genes code for subvariants of the Hb variant VIIB. The third gene codes for a so far unknown Hb protein. As known already for other chironomid Hb genes, there are no intron sequences present in the coding regions. PMID- 2775481 TI - 4-Bromophenacyl bromide inhibits prostaglandin D2 synthesis from arachidonic acid rather than phospholipase A2 activity in liver macrophages. AB - 4-Bromophenacyl bromide at a concentration of 50 microM does not inhibit phospholipase A2 activity in liver macrophages. Rather, this compound increases the amount of radioactivity released from [3H]arachidonate-prelabeled Kupffer cells and leads to the formation of small amounts of thromboxane, prostaglandin D2 and prostaglandin E2. Also the zymosan-induced formation of thromboxane and prostaglandin E2 from endogenous sources which is thought to involve phospholipase A2 remains unaffected in the presence of this compound. The generation of superoxide and the formation of prostaglandin D2 from arachidonate and after stimulation of the cells with zymosan, however, are blocked by 4 bromophenacyl bromide. Furthermore, this compound suppresses the incorporation of externally added arachidonate into membrane lipids of the cells. 4-Bromophenacyl bromide seems, therefore, not to be a useful tool to demonstrate the involvement of phospholipase A2 in complex biological systems. PMID- 2775482 TI - Amino-acid sequence of the short subfragment-2 in adult chicken skeletal muscle myosin. AB - The amino-acid sequence of a short subfragment-2 in the amino-terminal portion of subfragment-2 (S-2) derived from adult chicken skeletal muscle myosin was completely determined. Peptides cleaved by cyanogen bromide and by lysyl endopeptidase of S-carboxymethylated S-2, and hydrolytic peptides obtained with trypsin or dilute acetic acid of larger CNBr fragments were isolated and sequenced. This region was composed of 257 amino-acid residues, and hydrophobic and charged residue repeat units were found highly conserved and with a periodicity in 7 or 28 residues. This sequence of the short S-2 fragment of chicken skeletal muscle myosin was compared with the sequence of chicken and rat embryonic skeletal muscle myosins, rabbit skeletal and rabbit cardiac muscle myosin (alpha-myosin heavy chain), and 95.3%, 86.8%, 89.9% and 94.2% sequence identities were observed, respectively. PMID- 2775483 TI - Glycogenolysis during recovery from muscular work. The time course of phosphorylase activity is dependent on Pi concentration in the abdominal muscle of the shrimp Crangon crangon. AB - 1) Glycogen is degraded in the abdominal muscle of the shrimp Crangon crangon (Decapoda, Crustacea) during the recovery period following work. The regulation of post-exercise glycogen breakdown and the properties of glycogen phosphorylase (EC 2.4.1.1) have been studied: 2) Glycogen phosphorylase exists as unphosphorylated b-form and phosphorylated a-form, the latter contains 1 molecule phosphate/subunit. Both forms of phosphorylase are dimers, isoenzymes have not been detected. 3) The purified b-form is inactive in absence of AMP and has very low affinities for AMP and Pi. For half-maximum activation 0.33 +/- 0.04 mM AMP is necessary, and the Km-value for Pi at 1 mM AMP is 48 +/- 5 mM. IMP does not affect the activity of the b-form. 4) The a-form is active without effectors, its Km-value for Pi is 5.3 +/- 1.5 mM. The proportion of phosphorylase a increases in vivo, from about 25% at rest, to approximately 90% upon work and remains at this high level during the first minutes of recovery. 5) It is concluded that the glycogenolytic flux in the abdominal muscle of the shrimp even during post exercise periods depends on the level of the a-form the activity of which is restricted in time and extent by the cytoplasmic Pi concentration (Kamp, G. & Juretschke, H. P. (1987) Biochim. Biophys. Acta 929, 121-127). PMID- 2775484 TI - Induction of tumor cytotoxicity in murine bone marrow-derived macrophages by two synthetic lipopeptide analogues. AB - Lipoprotein from the outer membrane of Escherichia coli and the synthetically prepared lipopeptides Pam3Cys-Ala-Gly and Pam3Cys-Ser-[Lys]4 derived from the N terminus of lipoprotein constitute potent macrophage and polyclonal B-lymphocyte activators. The compounds have also been shown to induce tumor cytotoxicity in murine bone marrow-derived macrophages (BMDM). Bone marrow stem cells were cultured in the presence of colony-stimulating factor 1 to yield BMDM of 98 to 99% purity at day 8. After stimulation with the lipopeptides on days 4, 6, 8 and 10 of bone marrow culture, the cytotoxic effect of BMDM on the tumor cell line L929 was determined in a [3H]thymidine release assay. Maximum tumor cytotoxicity was found on day 8 with an optimal effector/target-cell ratio of 10:1, and a duration of lipopeptide stimulation of 4 h. The supernatants of lipopeptide stimulated BMDM also showed cytotoxic activity that could be inhibited by antiserum against tumor necrosis factor alpha. The effects of the lipopeptides Pam3Cys-Ala-Gly and Pam3Cys-Ser-[Lys]4 were comparable or superior to those exerted by lipopolysaccharide. Our results demonstrate that synthetic lipopeptides are potent activators for murine BMDM and may therefore prove to be an important tool for the elucidation of the role of macrophages in the host defence mechanisms against tumor cells. PMID- 2775485 TI - Terminal phenylalanine and tyrosine biosynthesis of Microtetraspora glauca. AB - The enzymes of the terminal steps of the phenylalanine and tyrosine biosynthesis were partially purified and characterized in Microtetraspora glauca, a spore forming member of the order Actinomycetales. This bacterium relies exclusively on the phenylpyruvate route for phenylalanine synthesis, no arogenate dehydratase activity being found. Prephenate dehydratase is subject to feedback inhibition by phenylalanine, tyrosine and tryptophan, each acting as competitive inhibitor by increasing the Km of 72 microM for prephenate. Based on the results of gel chromatography on Sephadex G-200, the molecular mass of about 110,000 Da is not altered by any of the effectors. The enzyme is quite sensitive to inhibition by 4 hydroxymercuribenzoate. Microtetraspora glauca can utilize arogenate and 4 hydroxyphenylpyruvate as intermediates in tyrosine biosynthesis. Prephenate and arogenate dehydrogenase activities copurifying from ion exchange columns with coincident profiles were detected. From gel-filtration columns the two activities eluted at an identical molecular-mass position of about 68,000 Da. The existence of a single protein exhibiting substrate ambiguity is consistent with the findings, that both dehydrogenases have similar chromatographic properties, exhibit cofactor requirement for NAD and are inhibited to the same extent by tyrosine and 4-hydroxymercuribenzoate. PMID- 2775486 TI - Degradation of 5-chloro-2-hydroxynicotinic acid by Mycobacterium sp. BA. AB - Bacteria with the ability to use 5-chloro-2-hydroxynicotinic acid as sole source of carbon and energy have been isolated from enrichment cultures with 2 hydroxynicotinic acid and 5-chloro-2-hydroxynicotinic acid. According to their morphological and physiological properties, these bacteria have been classified as Mycobacterium sp. The first metabolite in the degradation pathway is 5-chloro 2,6-dihydroxynicotinic acid. 2-Hydroxynicotinic acid had an inductive effect on the degrading enzymes. Chloride was released from 5-chloro-2-hydroxynicotinic acid, chloromaleic acid and chlorofumaric acid. A degradation pathway is proposed. PMID- 2775488 TI - Isolation and structural characterization of sialic-acid-containing glycopeptides of the O-glycosidic type from the urine of two patients with an hereditary deficiency in alpha-N-acetylgalactosaminidase activity. AB - Glycopeptides have been isolated from the urine of two patients, aged 5 and 6, with a new lysosomal storage disease characterized by a deficiency in alpha-N acetylgalactosaminidase activity. Isolation of these glycopeptides was achieved using gel filtration and ion-exchange chromatography. Structural determination was done using one- and two-dimensional 500 MHz 1H-NMR spectroscopy and FAB mass spectrometry of native and derivatized glycopeptides. The following structures were inferred as being present: Glycopeptide A (up to 140 mg/l urine) (1)-(3) Neu5Ac alpha 2-3Gal beta 1-3 (Neu5Ac alpha 2-6)GalNAc alpha 1-R A1: R = Ser A2: R = Thr A3: R = Thr-Pro Glycopeptide B (up to 80 mg/l urine) (4)-(6) Neu5Ac alpha 2 3Gal beta 1-4GlcNAc beta 1-6 (Neu5Ac alpha 2-3-Gal beta 1-3) GalNAc alpha 1-R B1: R = Ser B2:R = Thr B3: R = Thr-Pro PMID- 2775487 TI - Reactivities of sulfhydryl groups in native and metal-free aminoacylase I. AB - Aminoacylase I from porcine kidney (EC 3.5.1.14) contains seven cysteine residues per subunit. Three sulfhydryl groups are accessible to modification by 4 hydroxymercuribenzoate (p-MB). The kinetics of the reaction suggest that only one of these groups affects acylase activity when modified by p-MB. Its reaction rate increases 2-3-fold when the essential metal ion of aminoacylase is removed. Modification of metal-free apoenzyme by N-ethylmaleimide (NEM) abolishes its activity without impairing Zn2+ binding. This indicates that the sulfhydryl group reacting with NEM is not directly coordinated to the metal. DTNB (5,5'-Dithio bis(2-nitrobenzoate), Ellman's reagent) also modifies three sulfhydryl groups per subunit. In this case, the reactivities of native aminoacylase and apoenzyme are not significantly different. N-Hydroxy-2-aminobutyrate, a strong aminoacylase inhibitor, substantially increases the reactivity of the slowest reacting sulfhydryl in both native enzyme and metal-free aminoacylase. It appears that binding of the inhibitor or removal of the metal ion induces conformational changes of the amino-acylase active site that render a buried sulfhydryl group more accessible to modification. PMID- 2775489 TI - The effect of sex hormones on the acinar distribution pattern of phosphoenolpyruvate carboxykinase activity in rat liver. AB - The intra-acinar distribution pattern of phosphoenolpyruvate carboxykinase activity (PEPCK) was investigated in microdissected samples of livers from normal, castrated, castrated and estradiol- or testosterone-treated, and uncastrated and testosterone- or estradiol-treated male and female rats. The total PEPCK activity showed a marked sex dependency, with 1.8 times higher activity in males. The intra-acinar distribution profiles were also sex dependent. The periportal-to-perivenous gradient was steeper in males. Castration resulted in an approximation of PEPCK activity and its acinar distribution pattern between the sexes due to a reduction in males and an increase in females. Estrogen treatment of castrated males had no further effect on PEPCK activity and its acinar gradient, whereas in ovariectomized animals the activity was reduced to levels near normal. Testosterone treatment of castrated male or female animals led to a marked increase in enzyme activity with a concomitant steepening of the acinar gradient. Administration of estradiol to normal male rats also led to a reduction in activity, together with a change in the acinar activity gradient. Testosterone treatment of normal females resulted in an induction of PEPCK activity which was most prominent in the periportal zone. The most drastic changes were observed in the perivenous zones. In all experiments a periportal-to perivenous activity gradient persisted thus marking the periportal zone as the area with highest gluconeogenic capacity. PMID- 2775491 TI - High-altitude respiration of falconiformes. The primary structures and functional properties of the major and minor hemoglobin components of the adult White-Headed Vulture (Trigonoceps occipitalis, Aegypiinae). AB - The primary structures of the hemoglobin components Hb A and Hb D of White-Headed Vulture (Trigonoceps occipitalis) are presented. The globin chains were separated on CM-Cellulose in 8M urea buffer, the components by FPLC in phosphate buffers. The amino-acid sequences were established by automatic Edman degradation of the globin chains and of the tryptic peptides in liquid phase and gas-phase sequenators. The sequences differ from those of European Black Vulture by only one mutation in the alpha A-chains (alpha 137). The alpha D-chains and the beta chains are identical. This means that for the first time identical minor components in birds have been found. An updated list of identical globin chains is presented. Hb D exhibited a higher oxygen affinity than Hb A. At pH 7.5 and 38 degrees C P50 values of 0.80 and 0.64 kPa (6.0 and 4.8 mm Hg), respectively. Both hemoglobins showed similar Bohr factors displayed a pronounced sensitivity to inositol hexakis(phosphate), which increased P50 values of Hbs A and D to 4.0 and 3.6 kPa (30 and 26 mm Hg), respectively. The molecular and physiological significance of the findings is discussed with special reference to oxygen transport by hemoglobin at high altitude. PMID- 2775490 TI - The heparin-dependent accumulation of plasma fibronectin on macrophages. AB - Previous experiments (Hormann, H. & Jelinic, V. (1980) Hoppe-Seyler's Z. Physiol. Chem. 361, 379-387) had shown that heparin promoted the binding of plasma fibronectin to peritoneal macrophages of guinea pigs. The present data reveal that this effect only takes place at higher fibronectin concentrations indicating cooperative processes, most likely association of fibronectin at the cell surface. An unspecific precipitation of fibronectin by heparin was prevented by calcium in the medium. The accumulation at the cell surface was inhibited by the following fibronectin fragments: N-terminal 30 kDa and 70 kDa containing a potential self-association site and a transamidase-reactive site; central 95 kDa which comprised a negatively charged region possibly involved in self-association as well as the so-called alternative cell-binding site, but was lacking the cell binding Arg-Gly-Asp sequence; heparin-binding 37-kDa and 60-kDa fragments. All these domains and sites, therefore, were potentially important in the assembly process at the cell surface. A peptide comprising the sequence Arg-Gly-Asp was ineffective pointing against an involvement of this fibronectin cell-binding site in the overall process. Macrophages of older animals were less capable of accumulating fibronectin under the reaction conditions. Their capability was improved after preincubation with activated plasma transglutaminase (coagulation factor XIIIa) suggesting that a cell-attached transamidase might be important for the assembly process. PMID- 2775492 TI - Carnivora: the primary structure of Weddell Seal (Leptonychotes weddelli, Pinnipedia) hemoglobin. AB - The hemoglobin of Weddell Seal (Leptonychotes weddelli, Pinnipedia) comprises two components with identical beta-chains. The alpha-chains differ in positions 15 (Gly/Asp) and 57 (Ala/Thr). We present the primary structure of the chains which have been separated by reversed-phase high-performance liquid chromatography. The sequences have been determined by automatic Edman-degradation with the film technique or the gas-phase method, using the native chains and the tryptic peptides of the oxidized chains. Compared to the corresponding human chains we found 22 substitutions in the alpha-chains and 14 in the beta-chains. In the alpha-chains exchanges involve one heme- and three alpha 1/beta 1-contacts. In the beta-chains one heme contact, one alpha 1/beta 1- and one alpha 1/beta 2 contacts are substituted. The sequences are compared to those of other Pinnipedia and Arctoidea hemoglobins. PMID- 2775493 TI - The human neutrophil elastase gene. Analysis of the nucleotide sequence reveals three distinct classes of repetitive DNA. AB - DNA sequence analysis reveals the gene encoding human neutrophil elastase to be contained on a 6-kb EcoRI fragment. The gene contains five exons and closely resembles rat mast cell proteinase II and mouse adipsin in its exon structure and intron splice phase. Non-coding regions are very rich in repetitive DNA, containing seven Alu-like segments, three distinct clustered direct repeats with monomer lengths of 53 (six repeats), 23 (three repeats) and 41 (ten repeats) nucleotides, and a 200-nucleotide AT-rich region. Protein sequence analysis, inferred from the coding regions of the gene, indicates that neutrophil elastase may contain an unusual activation peptide similar to that found in the other major neutrophil serine proteinase, cathepsin G. PMID- 2775495 TI - Isolation and complete primary sequence of a new ovine wild-type beta lactoglobulin C. AB - A new wild type of beta-lactoglobulin has been identified in the milk of sheep. It has been designated as ovine beta-lactoglobulin C. Its primary structure has been determined by direct protein microsequencing of intact protein and RP-HPLC derived tryptic peptides. The new beta-lactoglobulin C is a subtype of ovine beta lactoglobulin A with a single exchange Arg-Gln at position 148. This exchange may influence polymerisation of beta-lactoglobulin since in the crystal structure of orthorhombic bovine beta-lactoglobulin, residues 145-150 constitute a short beta sheet region involved in dimer formation by pairing of dyad-related strands. PMID- 2775494 TI - Evidence for the tight binding of human mucus proteinase inhibitor to highly glycosylated macromolecules in sputum. AB - Two extraction procedures of non-purulent sputum for the isolation of human mucus proteinase inhibitor (MPI) in its free and bound forms have been assayed. The dissociating procedure involved sputum homogenization in 1M NaCl and 4% (w/v) trichloroacetic treatment. When the soluble material was applied to a CM Trisacryl column, a non-negligible, MPI-related inhibitory activity was recovered with the highly glycosylated constituents not retained on the column; the amount of MPI released in a free form was retained and eluted from the column according to the basic character of this inhibitor. The non-dissociating procedure consisted in a high water dilution (1:12) of sputum, known to bring into solution the macromolecular, fibrillar constituents, which was followed by ultrafiltration on selected Mr cut-off membranes. All the inhibitory activity was recovered with the high Mr (greater than 100,000) fraction which was shown on SDS-PAGE to be essentially composed of strongly glycosylated material; on electrophoretic analysis under non-reducing conditions, the MPI activity was visualized as three bands which corresponded to the inhibitor released from this high Mr fraction in the presence of SDS. As mucin-type molecules are the major, highly glycosylated constituents of bronchial secretions, it is suggested that they are responsible for the entrapping of MPI within their macromolecular network; it would appear that, as well as for lysozyme, electrostatic interactions occur between the acid charges of mucins and the basic charges of MPI. The possible in vivo consequences of these interactions on MPI activity are discussed. PMID- 2775496 TI - Purification and N-terminal amino-acid sequences of bacterial malate dehydrogenases from six actinomycetales strains and from Phenylobacterium immobile, strain E. AB - Malate dehydrogenases from Streptosporangium roseum (DSM 43021), Planomonospora venezuelensis (DSM 43178), Microtetraspora glauca (ATCC 23057), Actinoplanes missouriensis (DSM 43046), Streptomyces atratus (ATCC 14046), Kibdelosporangium aridum (ATCC 39323), and from Phenylobacterium immobile, strain E (DSM 1986) were purified to homogeneity. The N-terminal amino-acid sequences were determined and compared with known prokaryotic and eukaryotic sequence data. The partial sequences from Actinomycetales enzymes include a string of amino acids which is also present in the N-terminal region of malate dehydrogenases from Thermus flavus and from mammalian cytoplasm. PMID- 2775497 TI - Biotechnology: research in animal agriculture and regulatory policy. PMID- 2775498 TI - Variation in apparent enzyme activity in two-enzyme assay systems: phosphoenolpyruvate carboxylase and malate dehydrogenase. AB - We have employed the two-enzyme assay system for phosphoenolpyruvate to investigate the effect on the apparent phosphoenolpyruvate carboxylase (PEP-C) activity of the use of malate dehyrogenase (MDH) that has been stabilized in either glycerol or (NH4)2SO4. The type of MDH stabilizer has a marked effect on the apparent activity of the PEP-C. The apparent activities of the PEP-C are 1.34 and 0.43 U/mg in the presence of glycerol and salt-stabilized MDH, respectively. The implications of the observations for diagnostic assays are discussed. PMID- 2775499 TI - Purification of two muscle enzymes by chromatography on immobilized ferric ions. AB - Two enzymes, glycogen phosphorylase and lactate dehydrogenase, were purified simultaneously in a single step. Ferric ions immobilized on a chelating gel were used as the adsorbent. Adsorption and desorption steps were accomplished by changes in buffer composition. The recoveries were better than 80% and the capacities were about 5 mg of protein per milliliter of adsorbent. The procedure worked well both on a small and on a preparative scale. The homogeneity of the purified enzymes was checked by FPLC. PMID- 2775500 TI - Joint appointments: the Deakin experience. AB - This paper explores the concept of joint appointment as a means of forming a bridge between the service sector and tertiary education systems in nursing. Joint appointments are not new, having existed in the USA and the UK in various forms since the early 1970s. The practicalities of establishing a joint appointment are described and the positive and negative aspects identified. PMID- 2775501 TI - When nurses and teachers strike: public perceptions of 'the betrayal'. AB - This article examines how the public perceived both teachers and nurses during their first strikes in Victoria. How did the community react when two previously trusted groups of essential service workers "closed shop" and walked out. Reactions towards the teachers' and nurses' actions by the press, politicians and those members of the public who expressed themselves via the media are examined. While many of the arguments used in the public debate were similar, the most significant difference in the public's reaction was related to the gender of the leaders of the respective industrial organizations. PMID- 2775502 TI - Student selection for tertiary nursing courses: efficacy of the Anderson score as a performance predictor. AB - Selection of students for undergraduate nursing courses in Victorian Institutes of Higher Education is based almost exclusively on their Victorian Certificate of Education (VCE) Anderson score. Major aims of the selection process should be maximization of academic achievement as a basis for professional development and minimization of attrition. This paper examines the efficacy of the Anderson score as a selection instrument, using statistical methods to correlate Anderson score and other VCE data with academic performance in the first year of a Diploma of Applied Science (Nursing) course. Further statistical analysis is performed on upper and lower half groupings to show the selective value of the Anderson score in the region where it is likely to be applied. PMID- 2775503 TI - Cognitive performance in pregnancy. AB - This study investigated the cognitive functioning of 33 women prior to conception and during pregnancy. Each subject completed four psychological learning tests each week at home. Every alternative week a comprehension test was administered. Six questions relating to motivation, mood and interest were asked prior to each testing session. Following conception, questions relating to the subject's perception of her cognitive performance during pregnancy were asked. On average each subject completed 49 testing sessions and no subject missed more than four testing sessions. The results of the study do not support previous claims that pregnant women become cognitively impaired or that cognitive impairment increases as pregnancy advances. Without exception, performance on the cognitive tests improved during pregnancy. PMID- 2775504 TI - Nursing process in community psychiatric nursing. AB - A review of the literature suggests there is no consensus over the role of the Community Psychiatric Nurse. This paper describes a case in which a CPN, using a comparatively simple nursing process, successfully managed the psychotherapy of a disturbed young woman in the community. Other members of the multidisciplinary team were involved but no medication was prescribed. PMID- 2775505 TI - Red blood cell sodium-lithium countertransport, blood pressure, and uric acid metabolism in untreated healthy men. AB - The relationship of red blood cell (RBC) Na/Li countertransport to the renal handling of lithium and uric acid was investigated in a sample of 176 untreated men. Subjects in the upper quintile of the Na/Li countertransport distribution (n = 40), compared to those in the two lower quintiles (n = 72), had higher serum uric acid levels (0.34 +/- 0.06 v 0.29 +/- 0.05 mmol/L, P less than 0.001) and systolic blood pressure (131 +/- 19 v 123 +/- 16 mm Hg, P less than 0.02) and slightly lower fractional excretion of uric acid (7.5 +/- 1.5 v 8.4 +/- 2.6%, P less than 0.08). The lithium fractional excretion was not significantly related to either blood pressure or RBC Na/Li countertransport. The altered uric acid metabolism in individuals with high RBC Na/Li countertransport could be the expression of an abnormality of renal tubular function. PMID- 2775506 TI - Parity and perceived job stress elevate blood pressure in young normotensive working women. AB - This study examined the effect of physiological, behavioral, and psychosocial stressors on blood pressure measured in the work environment, home environment, and during sleep in a sample of 50 normotensive working women (average age = 30.2 +/- 7.4 years; average education = 4.3 years college). The results of separate stepwise regression analyses performed on the pressures measured in each environment showed that perceived job stress (P less than .05) and body fat or mass (P less than .05) significantly elevated systolic pressure in all situations, whereas home stress (P less than .05) and number of children (P less than .05) had the most marked effect on diastolic pressure variation over the day. These results suggest that the daily variation of systolic pressure in working women is related to stress on the job, and that diastolic pressure variation is associated with home stress, which may include stress arising from child care. PMID- 2775507 TI - Abnormal contractile response of aortas from spontaneously hypertensive rats to Ca2+ after depletion of Ca2+ in Ca2+-free medium. AB - Vascular responses of aortic rings from spontaneously hypertensive rats (SHR) were compared to those of the normotensive Wistar-Kyoto rats (WKY) in three sets of experimental protocols. The responses to cumulative doses of KCl indicated that SHR aortic rings were hyperresponsive to low but not high doses of KCl compared to WKY aortic rings. After Ca depletion by prolonged incubation of the rat aortic rings with Ca2+-free, EGTA containing solution, Ca repletion resulted in contraction. The magnitude of such a contraction was dependent on the period of Ca depletion and was highly sensitive to dihydropyridine Ca channel blocker, nifedipine. Although the Ca-depleted aortic rings eventually developed to the same level of maximum tension development upon Ca repletion, it took a considerably shorter period of Ca depletion for SHR than for WKY aortic rings to reach the maximum contraction upon Ca repletion. Our findings support the view that cell membranes of vascular smooth muscle in hypertension are more excitable and more susceptible to membrane destabilization by Ca removal. PMID- 2775508 TI - Angiotensin II binding sites in the superior cervical ganglia of spontaneously hypertensive and Wistar-Kyoto rats after preganglionic denervation. AB - In the superior cervical ganglia (SCG) binding site density of angiotensin II (ANG II) was higher in adult spontaneously hypertensive rats (SHR) (571 +/- 29 fmol/mg protein) compared to that in the adult Wistar-Kyoto rat (WKY) (375 +/- 9 fmol/mg protein, P less than 0.05). The ANG II binding density was significantly decreased in the SCG of SHR (-59%, P less than 0.01) and of WKY (-39%, P less than 0.05) after unilateral preganglionic denervation (operated v sham-operated ganglia). Part of the binding sites in the superior cervical ganglia may be present in or be associated to preganglionic nerves, and the number of these sites is higher in SHR. PMID- 2775509 TI - Dietary treatment as seen by German nephrologists. Results of a questionnaire. AB - The majority of German nephrologists consider a protein restriction for patients with advanced renal failure as necessary. However, there was no consensus with regard to the diet, which should be finally applied. It was of further interest that the majority of physicians believe that only 50% of their patients adhere consistently to the diet. PMID- 2775510 TI - Improvement of anemia in patients on chronic dialysis treated by hemodiafiltration. AB - A group of patients with severe anemia on standard hemodialysis were transferred to polyacrylnitrile hemodiafiltration (HDF), which was arranged in order to obtain an ultrafiltration rate (UF) higher than 100 ml/min. During HDF, despite a significant reduction of the dialysis time, all patients had a significant decrease of predialytic BUN and serum creatinine, and a significant improvement of anemia. Furthermore, a close direct correlation was detected between the percent increase of hemoglobin and the length of time on HDF. Therefore, high-UF HDF represents a valid dialytic strategy to improve anemic states, permitting a significant reduction of the dialysis time and, thus, offering a better life quality for the patients. PMID- 2775511 TI - Amino acid losses during haemofiltration. AB - Amino acid losses were measured daily in a non-septic patient who was continuously haemofiltered for 7 days at an ultrafiltration rate of 1,000 ml/h and then for a further 7 days at 500 ml/h. During this period she received an infusion of 9 g nitrogen each day. At the higher ultrafiltration rate the mean amino acid loss was 7.9 g/24 h (SEM 0.3 g) and at the lower rate, 2.4 g/24 h (SEM 0.2 g). The losses of amino acids to the ultrafiltrate depended upon the rate of ultrafiltration and upon the free serum amino acid values (r = 0.93, p less than 0.001), but did not depend upon molecular size or charge. The serum amino acid values did not fall during continuous haemofiltration despite loss to the ultrafiltrate, suggesting that the losses were small when compared to the total body pool of free amino acids. However, in septic patients these losses may be of clinical importance in those who are continuously haemofiltered for long periods. PMID- 2775512 TI - High-flux hemodiafiltration: 5 years experience. AB - The introduction of hemodiafiltration in the substitutive treatment of chronic renal failure has arisen from the need to find new techniques that could improve the efficiency of the traditional systems and, therefore, to treat adequately chronic uremia in the shortest possible time. 61 months of experience at our institution have shown that such a goal can be achieved, offering also practical advantages such as a better quality of life for the patients as well as the possibility to treat a greater number of them. PMID- 2775513 TI - Management of patients with renal failure complicated by cerebral oedema. AB - Dialysis disequilibrium due to cerebral oedema still causes a significant degree of both morbidity and mortality. We discuss the management of 5 such cases and demonstrate the improved stability during treatment with continuous veno-venous haemofiltration. This may be due to the improved osmotic stability during haemofiltration with a resultant decrease in the osmotic gradient across the blood-brain barrier. PMID- 2775514 TI - Further investigations of the defective protein C in hemodialysis, hemofiltration and continuous ambulatory peritoneal dialysis. AB - Protein C activity was determined in patients with terminal renal failure treated in three different ways: hemodialysis (n = 20), hemofiltration (n = 7) and continuous ambulatory peritoneal dialysis (n = 7). The protein C activity was decreased in terminal uremia, independent of the kidney replacement therapy employed, compared with 21 normal controls. In the hemodialysis patients protein C activity increased significantly during a hemodialysis treatment, whereas hemofiltration treatment normalized the depressed protein C activity. In vitro experiments with dialysis and with inhibition of normal plasma with ultrafiltrates could not reveal the presence of an inhibitor of protein C in uremic plasma. PMID- 2775515 TI - Backtransport of dialysate solutes during in vitro continuous arteriovenous hemodialysis. AB - Simulated continuous arteriovenous hemodialysis (CAVHD) was performed with Renaflo anisotropic polysulfone capillary hemofilters and Biospal homogeneous PAN parallel-plate hemofilters. Inulin and glucose were present in the dialysis solution. Plasma and dialysis solution flow rates were varied as was the delivery of dialysis solution by gravity or pump. The presence of dialysis solution did not affect the components of transmembrane pressure and did not alter ultrafiltration rate. Inulin and glucose backtransported into the plasma perfusate during CAVHD with the Biospal but not with the Renaflo filters. Dialysis solution will need to be sterile and pyrogen-free even in the low-flow, low-pressure system of CAVHD. PMID- 2775516 TI - Functional impairment of protein C activity during haemodialysis--a new mechanism of extracorporeal thrombogenesis. PMID- 2775518 TI - Antinociceptive properties of lysozyme fragments. AB - The in vitro digestion of hen egg white lysozyme with artificial gastric juice gave a complex mixture of peptides, from which a peptide corresponding to the aminoacid sequence 39-53 was isolated. Its further hydrolysis with artificial enteric juice gave two smaller fragments having the aminoacid sequence 39-45 and 46-53 respectively. These products, like lysozyme, showed antinociceptive activity in rats against foot hyperalgesia induced by a subplantar injection of brewer's yeast. PMID- 2775519 TI - Particulate matter in small volume parenterals: evaluation of some technological and analytical aspects. AB - The level of particulate contamination in water small volume injections available in Italy has been determined. The influence of the ampoule size, breaking system, manual method of ampoule opening and the type of instrument used for the determination have been evaluated. The distribution of the particles inside the batch of the sample was also studied. PMID- 2775517 TI - Synthesis, antiinflammatory and antiarthritic properties of a new tiopronine gold derivative. AB - The synthesis of triethylphosphine gold complex with the alpha mercaptopropionylglycine ethyl ester (compound 3) is reported. The new compound shows an antiinflammatory and antiarthritic activity superior to auranofin. PMID- 2775521 TI - New isosorbide 5-mononitrate derivative with hypotensive activity. AB - Synthesis and pharmacological properties of the 5-fluoro-nicotinic ester with isosorbide-5-mononitrate 3 are reported. The new compound shows an in vitro activity on rabbit aortic helical strips five times higher than isosorbide-5 mononitrate. The hypotensive activity in guinea-pigs of 3 is markedly superior to that of 5-ISMN. In the rat 3 shows a bioavailability and an acute toxicity inferior to those of 5-ISMN after oral administration. PMID- 2775520 TI - Synthesis and biological properties of 1-methyl-2-[(4-aminophenyl)-sulfonyl ]amino-5-nitro imidazole. AB - The synthesis of 1-methyl-2-[(4-aminophenyl)sulfonyl] amino-5-nitroimidazole 5 is described. The new sulfonamide 5 shows a good activity against aerobic and anaerobic Gram-positive and Gram-negative bacteria. Compound 5 is well absorbed in rats after oral administration but the plasma levels are inferior to those of sulfadiazine and sulfamethoxazole. PMID- 2775522 TI - Heteroarylalkanoic acid with possible antiinflammatory activities. Note VII. AB - A series of 3-(4H-1,2,4-benzothiadiazine-1,1-dioxide-3-ylamino)-propanoic acids was synthesized in order to study their possible antiinflammatory activity and to compare it with the corresponding homologous or isoster series previously studied. Of particular interest is parent compound 1, which is unsubstituted in the benzenoid moiety and exerts a very marked inhibitory effect on carrageenan induced plantar oedema greater than that observed for any of the terms of the other series hitherto studied. The possible influence of some chemico-physical parameters on the occurrence of this antiinflammatory activity is investigated. PMID- 2775523 TI - Synthesis and hypolipidemic activity of some new esters of glycerol and 2-O methyl-glycerol with nicotinic and 5-fluoro-nicotinic acids. AB - A series of new esters of glycerol and 2-O-methyl-glycerol with nicotinic and 5 fluoro-nicotinic acids were synthesized and their hypolipidemic activities were comparatively tested. The two most interesting compounds, 5 and 12, show a higher activity than both nicotinic and 5-fluoro-nicotinic acids in the following experimental models: Triton and olive oil hyperdyslipemia and tests on old rats. PMID- 2775524 TI - [Common international names and trademarks in the pharmaceutical field]. AB - This issue describes the selection procedures to obtain the International Nonproprietary Names (DCI o INN) and Italian Nonproprietary Names (DCIt). The former are approved by WHO, the latter by the Italian Health Authority. The peculiar characteristic is that the chemically- and pharmacologically-related compounds show a common relationship with the denomination. The procedures to obtain the Proprietary Trademarks deeply differ from those governing INN. Trademarks are granted by the Patent Offices and for their protection, unlike INN, it is necessary to file the application to ale the interested Countries. Through a unique application, the international protection to the 21 Countries that ratified the Arrangement of Madrid may be obtained. Moreover this issue explains also described the rules adopted by the different Countries, first use right, expiration for non use, mechanism for their registration, means of defence and maintenance of Trademarks. PMID- 2775525 TI - Some new prazosin-like derivatives. AB - The preparation of a number of prazosin-like derivatives is reported. The new derivatives differ from the parent compound for the 2-side-chain which is represented by peculiar fragments of butyrophenone neuroleptics. The results of the pharmacological evaluation are also reported. PMID- 2775526 TI - Synthesis and antimicrobial activity of some new benzodifurans and phenanthrolines. AB - A short series of di-functionalized benzodifurans and phenanthrolines were synthesized for in vitro antimicrobial activity. Dicarboxaldehydes, chiefly those with a phenanthroline supporting moiety, proved to be most effective, showing significant fungal growth inhibition. PMID- 2775527 TI - Tyrosine and tyrosinate fluorescence of S-100b. A time-resolved nanosecond fluorescence study. The effect of pH, Ca(II), and Zn(II). AB - The properties of the tyrosine and tyrosinate emissions from brain S-100b have been studied by nanosecond time-resolved fluorescence at emission wavelengths in the range 305 to 365 nm. The effect of pH on the fluorescence has been studied at pH 6.5, 7.5, and 8.5 for the Ca(II) apo and holo forms of the protein, and for the apo and holo forms in the presence and absence of Zn(II) at pH 7.5. The fluorescence decay is biexponential at pH 8.5 and triexponential at pH 6.5 and 7.5. The three components of the decay have wavelength and metal ion dependent lifetimes in the ranges 0.06 to 1.05 ns, 0.49 to 3.76 ns, and 3.60 to 14.5 ns. The observation of a long lifetime component at wavelengths characteristic of emission from tyrosinate suggests that in class A proteins this may be a useful diagnostic of the environment of tyrosine in their native structures. The time resolved emission spectra provide evidence for efficient, subnanosecond protolysis of the excited state of the single tyrosine (Tyr17) under all conditions studied except in 6 M guanidium chloride in which the protein shows only emission from tyrosine (lambda em 305 nm), suggesting that the tyrosinate emission is a property of the tertiary structure of the native protein. The Zn(II)-dependence of the fluorescence is fully consistent with the earlier suggestion that Tyr17 is near the Zn(II) binding site and remote from the high affinity Ca(II) binding site. PMID- 2775528 TI - Lumenal hydrolysis of menhaden and rapeseed oils and their fatty acid methyl and ethyl esters in the rat. AB - Simple alkyl (ethyl) esters of polyunsaturated fish oil fatty acids have been proposed as dietary supplements, but their relative efficiency of digestion and absorption have not been determined. Using stomach tubes, we gave rats menhaden or rapeseed oils, or the corresponding methyl and ethyl esters, and determined by chromatographic methods the lipid classes and molecular species recovered from the lumen of the jejunum during the first 1 to 2.5 h of digestion. Hydrolysis of menhaden oil resulted in a preferential retention of a high proportion of the polyunsaturated long chain acids in the sn-2-monoacylglycerols and in the residual triacyglycerols, while digestion of rapeseed oil led to a preferential release of free long chain monounsaturated fatty acids. In contrast, hydrolysis of the alkyl (methyl and ethyl) esters of the fatty acids of either menhaden or rapeseed oil resulted in a composition of free fatty acids which was much more representative of the original esters. It was therefore concluded that the differential lumenal liberation of the long chain and polyunsaturated (three or more double bonds) fatty acids from fish and rapeseed oil is largely due to their characteristic distribution between the primary and secondary positions in the glycerol molecule, and to a much lesser extent to a chain length discrimination by pancreatic lipase. This study also shows that the methyl and ethyl esters are hydrolyzed about 4 times more slowly than the corresponding triacylglycerols, which is sufficient to maintain a saturated micellar solution of fatty acids in the intestinal lumen during absorption. PMID- 2775529 TI - Properties of three monoclonal antibodies that recognize an 80-kDa phytohemagglutinin-binding glycoprotein from porcine lymphocytes. AB - Monoclonal antibodies (mAbs) directed against porcine splenocyte phytohemagglutinin receptor glycoproteins were produced in BALB/c mice. Three antibody-producing, stable hybridomas were cloned and expanded in the peritoneal cavity of BALB/c mice. The mAbs (A7, B1, and H3) were purified and belong to the IgG2 subclass of immunoglobulins (kappa light chain). Each 125I-labeled mAb bound to purified porcine splenocytes with an (apparent) affinity KA congruent to 10(8) M-1 (Scatchard analysis). The number of (apparent) binding sites was 5 x 10(4) sites/cell in the case of B1 and H3, and approximately 15 x 10(4) sites/cell for A7. Immunoprecipitation experiments showed that the three mAbs recognized a single antigenic protein of Mr 80 kilodaltons (gp80). In addition, each mAb recognized a different epitope of gp80, as observed by Western blot analyses. Assessment of the relative ability of anti-gp80 mAbs to stimulate porcine splenocytes as determined by [3H]thymidine incorporation showed weak (A7 and B1) or no (H3) mitogenic activity. Cross-linked anti-gp80 mAbs were not mitogenic, except in the case of B1. In contrast, each anti-gp80 mAb (cross-linked or untreated) showed synergistic mitogenic properties when used in combination with a suboptimal concentration of phytohemagglutinin. The mechanism involved in this synergistic effect is discussed. PMID- 2775530 TI - Protein kinase C from chicken gizzard: characterization and detection of an inhibitor and endogenous substrates. AB - Protein kinase C was purified from the cytosolic fraction of chicken gizzard by Ca2+ -dependent hydrophobic interaction chromatography, anion-exchange chromatography, and hydrophobic chromatography. The molecular weight was estimated as 61,500 by gel filtration and 80,000 by denaturing gel electrophoresis, indicating that the native enzyme is a monomer. Using the mixed micellar assay, with histone III-S as the substrate, protein kinase C required Ca2+, phospholipid, and diacylglycerol for activity, with half-maximal activation at approximately 5 x 10(-7) M Ca2+ in the presence of L-alpha-phosphatidyl-L serine and 1,2-diolein. No activation by Ca2+ was observed in the absence of diacylglycerol. Protein kinase C requires free Mg2+, in addition to the MgATP2- substrate, for activity. The Km for ATP was determined to be 20 microM. Activity was sensitive to ionic strength, with half-maximal inhibition at 70 mM NaCl. Using the liposomal assay, phosphorylation of platelet P47 protein and smooth muscle vinculin was more strongly dependent on Ca2+ and lipids than was histone phosphorylation. Partial digestion of protein kinase C with trypsin yielded a constitutively active fragment. A heat-stable inhibitor and three major endogenous protein substrates of protein kinase C were also detected in chicken gizzard smooth muscle. PMID- 2775531 TI - Glucocorticoid stimulation of tetrahydrobiopterin levels and phenylalanine hydroxylase activity in rat hepatoma cells. AB - Incubation of H4-II-E-C3 rat hepatoma cells with either hydrocortisone or dexamethasone resulted in 3- to 5-fold increases in the levels of both phenylalanine hydroxylase and its essential cofactor, tetrahydrobiopterin. Maximum elevation of phenylalanine hydroxylase was noted after 24 h of incubation, whereas significant increases in tetrahydrobiopterin were found only after 48 h exposure of the cells to glucocorticoids. Removal of hormone from the culture medium resulted in rapid loss of cell tetrahydrobiopterin, but a much slower decline in the level of phenylalanine hydroxylase. Thus, although the levels of both phenylalanine hydroxylase and tetrahydrobiopterin in rat hepatoma cells are regulated by glucocorticoids, this regulation is apparently not strictly coordinated. Nevertheless, control of cellular tetrahydrobiopterin levels may be an important regulator of hepatic phenylalanine catabolism since significant increases in the ability of intact rat liver cells to hydroxylate phenylalanine were observed only after 48 h exposure to glucocorticoids, in correlation with increases in cell tetrahydrobiopterin content. PMID- 2775533 TI - Mannose toxicity in Ehrlich ascites tumor cells. AB - Mannosephosphate isomerase (MPI) showed a higher activity than hexokinase (HKM) in its ability to phosphorylate mannose in the spleen, thymus, brain, liver, striated muscles, kidneys, and testes from BALB/c mice. This led to a HKM/MPI ratio of less than 1 in all the organs and tissues mentioned. In contrast, Ehrlich ascites tumor cells obtained from the peritoneum of BALB/c mice had low MPI activity (half of the HKM activity and, therefore, a ratio of 2). Mannose, which is nontoxic to nontumor cells at a concentration of 0.1 M, induced marked in vitro mortality of the tumor cells. Incubation of Ehrlich ascites tumor cells with mannose resulted in a high accumulation of mannose-6-phosphate and a marked depletion of ATP which did not appear when the cells were incubated with glucose. These facts may explain the selective mortality caused by mannose in the tumor cells studied. PMID- 2775532 TI - Evidence of direct interaction between actin and membrane lipids. AB - Actin is a protein component of the cystoskeleton and is involved in cell motility. It is believed generally that actin filaments are attached to the cell membrane through an interaction with membranous actin-binding proteins. By using an in vitro system composed of liposomes and actin, we have shown that actin may also interact directly with the phospholipids of the membrane. Actin deposited at the surface of the liposome is organized in two regular patterns: a paracrystalline sheet of parallel filaments in register, or a netlike organization. These interactions of actin with membrane lipids occur only in the presence of millimolar concentrations of Mg2+. These results suggest that the interaction of the cytoskeleton with the membrane involves, at least in part, a direct association of actin with phospholipids. PMID- 2775534 TI - [Morphostructural features of the pleural lymphatic circulation in the pig]. AB - The morphostructural features of the lymphatic circle of swine visceral pleura were investigated by means of vital dye injection in the pleural cavity. In the animals treated as mentioned previously it was possible to observe that in the visceral pleura the superficial lymphatic network had formed the very thick mesh, while the underlying pulmonary parenchyma was not interested. This behaviour lets us suppose that the drainage of the visceral pleura is mainly a direct one. PMID- 2775535 TI - [Effect of low temperature on the axons of chick embryo in in vitro culture]. AB - Hanging drop cultures of rhombencephalon of 6-11 day chick embryos were placed for 15'-24 hours at low temperatures (0 degree, 10 degrees, 15 degrees, 20 degrees, 25 degrees). Phase contrast time-lapse cinemicrography were made of the axons outgrowth from the explants, during recovery of normal temperature (38 degrees). A number of cultures were also filmed during cooling from 38 degrees to 15 degrees or 20 degrees. It was thus possible follow the sequence of the axon changes, especially of its growth cone, and demonstrate the reversible nature of the modifications observed at some subnormal temperatures. PMID- 2775536 TI - [Purification of waste water from olive-oil pressing plants using hydrophytes. Preliminary study on the use of Eichornia crassipes]. AB - The use of Eichornia crassipes has been tested in order to depurate the waste water from olive oil factories. The control of some parameter variations during the treatment, such as COD, total azote, dissolved oxygen and pH, has given encouraging results about the depurative efficacy of employed hydrophytae. Particularly indicative is, in this regard, COD rejection of about 60%. PMID- 2775537 TI - Structure-activity relationships of hydrazono derivatives of biological interest. AB - The following hydrazono derivatives (I-XXIII) of type (A), (formula; see text) where: X = NO2 (II, IV, VI, VIII, X, XIV-XXIII), X = H (I, III, V, VII, IX, XI, XII, XIII), and Y = H (I, II); 3-Cl (III, IV); 4-Cl (V, VI); 3,4-Cl2 (VII, VIII); 2,6-Cl2 (IX, X); 2-NO2 (XI); 3-NO2 (XII); 4-NO2 (XIII, XIV); 2-F (XV); 3-F (XVI); 4-F (XVII); 2-OH (XVIII); 4-OH (XIX); 2,4-(OH)2(XX); 2,4,6-(OH)3(XXI); 2,3 (OH,NO2) (XXII); 2,4-(NO2)2 (XXIII), were prepared and tested for antibacterial and antifungal activity. All of these compounds were prepared in satisfactory yield by reaction of aromatic aldehydes with 2-furoyl and 5-nitro-2-furoyl hydrazide. The hydrazono derivatives I-XXIII prepared in this investigation were screened for antimicrobial activity by a disk-diffusion assay (Kirby-Bauer modified). The organisms used were laboratory cultures of S. aureus, S. haemoliticus, B. subtilis, M. paratuberculosis, E. coli, S. typhi, Ps. aeruginosa, K1. pneumoniae, A. niger, S. cerevisiae, C. albicans. The results of this study showed that a number of the prepared hydrazono derivatives exhibited varying degrees of activity against Gram-positive and Gram-negative bacteria. Compounds IV and XV possessed broad spectrum "in vitro" against Gram-positive and Gram-negative bacteria. Compounds XII greater than IV greater than XV showed inhibitory activity especially toward S. aureus. Compounds IV greater than XV greater than XVI were especially active against E. coli. Compounds XV greater than IV were especially inhibitory toward S. typhi and most of the prepared compounds inhibited considerably Ps. aeruginosa and K1. pneumoniae. PMID- 2775538 TI - [Sterols from Gynostemma pentafillum]. AB - The sterol fraction of Gynostemma pentafillum contains beta-sito sterol and isofucosterol. The identification of these compounds has been carried out through NMR and MS data. PMID- 2775539 TI - Prevalence of intranuclear particles in liver pathologies. AB - An ultrastructural study of the prevalence of electron dense 23-27 nm intranuclear particles was carried out on liver biopsies from patients with NANB chronic active hepatitis (CAH), Delta + CAH, HBsAg + CAH, nonviral liver pathologies and in one healthy volunteer. The particles were classified according to aggregation pattern and were found to be correlated with NANB CAH and Delta + CAH. No particles were observed in nonviral liver pathologies. A close antigenic relationship has been shown between the cytoplasmic alterations observed in NANB and delta hepatitis in chimpanzees. Our data indicate that there is a structural similarity between the intranuclear particles seen in both Delta and NANB hepatitis, thus reinforcing the hypothesis that the NANB and Delta agents are closely related. PMID- 2775541 TI - [Enzymatic methyl esterification of the protein in bovine crystalline lens in culture]. AB - In the present paper a study on the enzymatic methyl esterification of proteins in the bovine lens has been presented. The data obtained show that the synthesis of the methyl donor (AdoMet) as well as the methyl esterification of proteins are operative in the lens incubated in the presence of L-(methyl-14C) methionine and the amount of labelled methyl esters decreases during cell ageing. Furthermore, the Authors suggest the usefulness of this model system in the evaluation of the overall AdoMet metabolism in aging. PMID- 2775540 TI - [Role of prostanoids in the control of renal function in normal potassium balance and in acute experimental potassium depletion. 4. Relation of extrarenal parameters, renal function parameters and urinary excretion of prostanoids]. AB - The renal function has been evaluated by clearance (cl.) method during hypotonic polyuria and successive moderate antidiuresis induced by a low dose of lysine-8 vasopressin; four 15 min and two 60 min cl. periods were performed, respectively. Glomerular filtration rate was estimated by creatinine cl.; the osmotic cl. (Cosm, CH2O), the absolute and fractional excretions of water, sodium, potassium and chloride were determined by usual methods. The urinary concentrations of PGE2, 6-keto-PGF1 alpha (6KPGF) and TxB2 were measured by RIA. The study protocol was applied in normal potassium balance and experimental potassium balance (KD), both in absence and presence of indomethacin. In KD groups with a potassium cumulative deficit of 198.4 +/- 22.2 meq (D3; n = 6) during polyuria significant correlations are consistent with the hypothesis that the lower the plasma potassium concentration is the higher the urinary chloride excretion and the inhibition of distal fractional chloride reabsorption. Moreover, by utilizing the polyuria and antidiuresis data pool, the effects of urine flow rate changes on PGE2 and 6KPGF urinary excretions are blunted as compared to normal potassium balance (n = 14). After indomethacin treatment (D3.I) the following functional relationships are disclosed: a) the lower the kaliemia is the lower the urinary chloride and potassium excretions and the higher the fractional isosmotic reabsorption; b) the lower the urinary potassium excretion is the lower the urinary chloride excretion. In both D3 and D3.I experimental groups the positive correlation between urinary chloride excretion and urinary potassium excretion is significant. PMID- 2775542 TI - [Acid-base balance, blood lactate, blood pyruvate, and L/P ratio in albino rats raised in normobaric, hypoxic hypoxia for one or two generations]. AB - Albino rats Wistar family raised in normobaric hypoxic environment (10% O2 in N2) since one or two generations showed a displacement of the acid-base balance of the arterial blood towards acidosis and an increase of blood lactate and pyruvate when compared with normoxic controls. Found differences were significant in all considered parameters except for lactate-pyruvate ratio. Moreover in hypoxic animals of second generation these differences were quantitatively less strong. In effect when we compared the two groups of hypoxic animals between them, they showed significant differences-estimated with Duncan's test - in the pH, B.E., S.B., lactate and pyruvate values. All the above mentioned differences pointed out less blood acidification and less increase of lactate and pyruvate in hypoxic animals of second generation. The results seem to indicate the beginning of adaptative processes to the extraordinary hypoxic normobaric environment in albino rat and the evolution of these processes when named species remain in hypoxic environment for more than one generation. PMID- 2775543 TI - A contribution to knowledge of lymphatic vessels morphology in the ovary of the cat. PMID- 2775544 TI - [Identification of the root of Punica granatum in galenic preparations using TLC]. AB - The alkaloids present in the root of "Punica granatum" have been extracted by two different methods: extraction by Soxlet and extraction by steam distillation. Then the extracts have been compared by TLC chromatography using different solvents and specific chromogen reagents. The presence of pseudo-pelletierine has been confirmed in both the extractive solution by reaction with conc. K2Cr2O7. The above results explains the toxic activity of the unsuitable galenic preparations. PMID- 2775545 TI - [Determination of the range of physiologic variation of the electrical axes using P, QRS, and T waves in pregnancy]. AB - Since functional overload in pregnancy frequently induces the appearance of symptoms that could arouse suspicion of myocardiopathy, it is important to analyse and characterize all electrocardiographic modifications during a healthy subject's pregnancy. Variations of the mean electrical axis (A) of P, QRS and T waves were evaluated in 52 healthy volunteers, 17-37 years, during pregnancy. The A values were measured, in the frontal plane, at the end of both I and III quarter of pregnancy, using a method of scalar determination. The As in I and III quarters was compared with those observed in the post-partum (at 5th day) and statistical evaluations were performed (Student t-test for paired observations). In the I quarter the mean A was 40 +/- 3 degrees for P, 40 +/- 16 degrees for QRS and 32.5 +/- 9 degrees for T wave, whereas in the III quarter the mean A changed to 37 +/- 2 degrees for P, 34 +/- 18 degrees for QRS and 31 +/- 9 degrees for T. During pregnancy, all mean As significantly diverted to the left side, AP about 3 degrees, AQRS about 6 degrees and AT about 1.5 degrees. These results were also confirmed by analysis of A frequency distribution histograms. In the post-partum (5th day) the A resumed basal values (I quarter's values). These results show: i) the physiological range of AP, AQRS and AT, during pregnancy; ii) left deviation of all three As at the end of III quarter. It is possible to conclude that variation over this range, particularly for QRS, could give evidence of the onset of cardiopathy. PMID- 2775547 TI - [Biometrico-statistical evaluation of a biological sample]. AB - The total animal population percentage composition, found during period May August 1979 on tunny-fishing coco-fibres nets in Camogli (Genoa), has been valued in relation to the depth. In particular, connections between population and presence of some fish species draughted has been studied, considering ecological, reproductive and trophic habits of fishes, in order to value relations between the influence these populations exert on fishing and biological characteristics of the quantitatively more meaningful fish species. PMID- 2775546 TI - [Hereditary sensory motor neuropathy: degenerative disease or a disease with an immune-mediated pathogenesis?]. AB - The clinical data proving that some hereditary motor-sensory neuropathies (HMSN type 1) are steroid sensitive may indicate inflammatory or immunomediated mechanisms as cofactors contributing to the clinical course of these disorders. The finding of HLA-DR positivity of Schwann cells in HMSN type I along with the presence in some cases of inflammatory infiltrates in nerve sections provides further evidence for this hypothesis. PMID- 2775548 TI - [Percent composition of fatty acids in Tigriopus fulvus from rocky pools on the Ligurian coast (Copepoda harpacticoida)]. AB - The study concerns the Tigriopus fulvus specimens fatty acid composition, sampled in Ligurian coast rockpools from September 1980 to June 1981. By the study of frequency distribution it was observed that the fatty acid found in greater quantity was the palmitic one, followed by the palmitoleic, the oleic and stearic acids. Short and long chain fatty acids are less frequent. Investigation about each fatty acid concentration shows that the seasonal trends between males and females are different and the trend of some fatty acids (e.g. linolenic and stearic acid) is characteristic. PMID- 2775549 TI - [Post-partum ovarian activity in Sardinian ewes]. AB - Ovarian activity, assessed by the plasma progesterone concentrations, were studied in four groups of Sardinian breed sheep with different lambing season. The resumption of ovarian activity was shorter and similarly the proportion of ewes which had resumed ovarian activity in response to introduction of rams was greater in sheep with November and December rather than January and March lambings. The resumption of oestrus activity was delayed in sheep with a high level of lactation. PMID- 2775551 TI - [Phytochemical investigation of Adiantum capillus veneris]. AB - The sterol fraction of Adiantum capillus veneris contains beta-sito sterol, stigmasterol and capesterol identified by means of spectral data (1H-NMR and MS). PMID- 2775550 TI - [Cell adhesion in rat fibroblasts: effect of tumor promoters]. AB - In a study performed on transformed (SGS/3A) and normal syngeneic rat cells (FG/2) to identify the molecular mechanisms which regulate cell adhesion and contact inhibition in cell transformation, we investigated the effects of tumor promoters on cell to cell adhesion of rat fibroblasts. As tumor promoters we used 12-tetradecanoyl-phorbole-13-acetate (TPA) and the melittin, a polypeptide from bee venom, both substances capable of stimulating the neoplastic transformation. The intercellular adhesion assay consists in determining the percent of single cells labeled with 3H-L-leucine adhering to a confluent monolayer of unlabeled cells at different incubation times. The increase of cell-cell adhesion caused by TPA and melittin confirms what we have constantly observed in other experiments, i.e. that neoplastic cells SGS/3A always have a higher intercellular adhesion capacity than corresponding normal syngenic cells FG/2. Since one of the effects of the tumor promoters is also induction of a reversible alteration of the cytoskeleton, it is likely that their action on intercellular adhesion is regulated by a mechanism analogous to that proposed for explaining the increased intercellular adhesion observed after treatment with antimicrotubular compounds. PMID- 2775552 TI - Effect of chronic alcoholism on hepatic alcohol-dehydrogenase and aldehyde dehydrogenase activities in man. PMID- 2775553 TI - [Serum values of vitamins A, E, C and carotenoids in healthy adult subjects and those with breast neoplasia]. AB - Serum values of retinol, carotenoids, tocopherol and ascorbic acid were assayed in healthy adult females (Group A: 20 cases) and in subjects with fibrocistic mastopathy (Group B: 20 cases), benign breast neoplasms, as fibroadenomas and intraductal papillomas (Group C: 18 cases), and breast carcinoma in situ (Group D: 36 cases). Retinol and carotenoids were evaluated by spectrophotometry using trifluoroacetic acid. Tocopherol was determined by a colorimetric method involving the reduction of Fe to Fe++ by tocopherol with the formation of a red complex of the Fe++ with alpha, alpha'-dipirydyl. Ascorbic acid was estimated by a colorimetric method after derivatization with 2,4-dinitrophenylhydrazine. Our results point out that there is a highly significant decrease (p less than 0.001) of average retinol serum levels in all three patient groups as compared with group A, whereas carotenoids resulted decreased but not significantly. Tocopherol was found to be significantly lower only in groups B (p less than 0.05) and D (p less than 0.01), ascorbic acid in groups B (p less than 0.01) C (p less than 0.05) and D (p less than 0.001). PMID- 2775554 TI - Supported employment program evaluation: evaluating degree of implementation and selected outcomes. AB - The relation between the degree to which adult service agencies implemented supported employment and selected program outcomes was examined. Supported employment programs developed by adult vocational service agencies in Illinois served as the subject pool for data collection. Results indicated that clients with higher IQs received less complete support services but earned higher wages. Vocational service agencies that spent more time developing jobs seemed better at matching job requirements with clients' skills. PMID- 2775556 TI - Assessing movement control in children with mental retardation: a generalizability analysis of observers. AB - A generalizability study was conducted to determine the percentage of variance associated with observers and trials when assessing movement control in children with mild mental retardation. One group of observers received competency-based training and another group experienced informal training. A series of decision studies employing the variance component estimates indicated that different conditions of observation need to be employed based on the type of training received in movement control analysis. Observers receiving informal training needed to observe twice as many trials of the kick, jump, and overband throw compared to competency-trained observers to reach an acceptable level of reliability. PMID- 2775555 TI - Social ecology of the workplace: contextual variables affecting social interactions of employees with and without mental retardation. AB - The social interaction patterns of employees with and without mental retardation across several different competitive employment sites were observed directly; narrative recording procedures were used. The data were analyzed to determine whether there were differences between the two groups of employees and the people involved in the interactions and the time period of the interaction and whether the interaction involved a social or task-related topic. The results were discussed in relation to their implications for integrating workers with mental retardation into settings with nonhandicapped workers. PMID- 2775557 TI - Comparison of parent and teacher ratings of adaptive behavior of children with mental retardation. AB - The Adaptive Behavior Scale-School Edition was administered to 22 parents and 22 teachers, using the third party assessment method to obtain ratings of the adaptive behavior of children with mental retardation. No significant differences in parents' and teachers' ratings for Personal Self-Sufficiency, Community Self Sufficiency, and Personal-Social Responsibility were found. Teachers and parents also did not differ significantly in ratings of the importance of the behaviors subsumed by these factors. Difficulty in rating some items reflected differences in the accessibility of these behaviors for teachers and parents. Results suggest that group differences may not exist between parents' and teachers' ratings once the method of administration and familiarity with the instrument are controlled. Occasionally, however, a parent's rating may differ from a teacher's sufficiently to lead to a different classification. PMID- 2775558 TI - Study of the similar structure hypothesis with mentally retarded adults and nonretarded children of comparable mental age. AB - The similar structure hypothesis was tested by comparing the performance of mentally retarded adults and their nonretarded mental age peers on a series of Piagetian tasks. We controlled for variables that influence the testing of mentally retarded subjects and performance on Piagetian tasks. Statistical analysis revealed that five tests favored the developmental position whereas two tests favored the difference position. Qualitative analysis provided reason to question the validity of two of the seven tests. Nevertheless, the evidence still favored the developmental position 4:1. Corollaries challenged the use of vocabulary tests for matching and raised a caveat concerning the acquisition by mentally retarded adults of key concrete operations skills. PMID- 2775559 TI - The in vitro reduction of dimethylpropion. AB - A study of the in vitro metabolism of dimethylpropion using different tissue homogenates of certain animals showed that: 1. Only the two major metabolites of dimethylpropion, i.e., methylpseudoephedrine and monomethylpropion were formed. 2. Species variation was observed with regard to the reductive ability of the liver homogenates. 3. Anaerobic conditions favored in vitro reduction to form methylpseudoephedrine. 4. The liver-soluble fraction exhibited the highest enzymatic reductive activity toward dimethylpropion. 5. Significant metabolic reduction of dimethylpropion was exhibited by the soluble fraction of the kidney. PMID- 2775561 TI - Methemoglobin reduction under near physiological conditions. AB - Pure methemoglobin was prepared from fresh red cells and was used as substrate for methemoglobin reduction reaction. Two sources of methemoglobin reductase were used: (a) red cell hemolysate which was prepared by freezing and thawing of unwashed red cells; (b) purified methemoglobin reductase from bank blood. Methemoglobin reduction rate was measured in a mixture of pure methemoglobin (substrate) and hemolysate (enzyme). In other experiments the rate of methemoglobin reduction was measured in the above mixture with the addition of various other compounds such as NADH, cytochrome b5, and pure methemoglobin reductase. Only the addition of pure enzyme accelerated the rate of methemoglobin reduction. In other experiments, the rate of methemoglobin reduction was measured when the reduction reaction was carried out in the presence of various amounts of deoxyhemoglobin, globin, or albumin. It was shown that all proteins tested here decreased the reduction rate. It is concluded that (a) in the red cell, under normal conditions, only the activity of the methemoglobin reductase controls the speed of methemoglobin reduction, and (b) the inhibition of methemoglobin reduction by reduced hemoglobin is mostly nonspecific suggesting a noncompetitive reaction. PMID- 2775560 TI - Cathepsin B and L activities in gastric cancer tissue: correlation with histological findings. AB - Cathepsin B and L activities in cancerous and noncancerous mucosal tissues from 29 patients with gastric cancer were determined with a small amount of tissue homogenate. Both enzyme activities were significantly higher in cancerous tissues than in noncancerous tissues. The cathepsin B activity was higher with decreasing differentiation of the cancerous tissues, and also with increasing depth of invasion and metastasis to regional lymph nodes. Significantly high cathepsin B activity was observed in specimens of poorly differentiated adenocarcinomas, as well as in specimens from patients with extensive metastasis to n2 or n3 lymph nodes. These results suggest that high cathepsin B activity is characteristic of gastric cancer which invades and metastasizes. Therefore, in cases of marked elevation of cathepsin B activity in cancerous tissues, relatively extensive resection may be necessary to obtain a cure. PMID- 2775562 TI - The accumulation of malonyldialdehyde, an end product of membrane lipid peroxidation, can cause potassium leak in normal and sickle red blood cells. AB - This study has examined the effect of malonyldialdehyde (MDA), an end product of lipid peroxidation, on the K+ leak in normal (AA) and sickle (SS) red blood cells (RBCs). In vitro MDA accumulation in human RBCs was accomplished by treating them with exogenous standard MDA. MDA accumulation assessed by the thiobarbituric acid reactivity of in vitro MDA-treated RBCs was comparable to the RBCs in hemolytic anemias. There was a significant K+ leak in AA RBCs after in vitro treatment with MDA. The effect of MDA on the K+ leak was greater in SS RBCs. The increase in cellular K+ leak was significantly positively correlated with the extent of MDA accumulation as assessed by thiobarbituric acid reactivity. PMID- 2775563 TI - Effect of cholinergic agents on human spermatozoa motility. AB - The effect of various cholinergic agents on human spermatozoa motility was studied. Both direct-acting (e.g., acetylcholine, pilocarpine) and indirect acting (e.g., physostigmine) cholinergic agonists stimulated human spermatozoa motility. All the cholinergic antagonists (e.g., atropine, hyoscine, hexamethonium, d-tubocurarine, and succinylcholine) inhibited the spermatozoa motility. At 1 X 10(-4) M, muscarinic antagonists, atropine and hyoscine, did not influence motility, whereas nicotinic antagonists, hexamethonium, d-tubocurarine and succinylcholine, depressed motility. These observations suggest that a nicotinic-type receptor is present in spermatozoa. However, these studies did not exclude the possibility of the presence of a muscarinic receptor in spermatozoa. PMID- 2775564 TI - The regulation of fatty acid and branched-chain amino acid oxidation in cancer cachectic rats: a proposed role for a cytokine, eicosanoid, and hormone trilogy. AB - Some postulates of a hypothesis concerned with the deregulation of muscle turnover by the hypoketonemia of cachectic tumor-bearing rats were examined. Plasma concentrations of ketone bodies (D-(3)-hydroxybutyrate + acetoacetate) in rats bearing the Walker 256 carcinosarcoma were reduced by 45% (P less than 0.001) whereas the concentrations of triglyceride and free fatty acids were elevated by 223% (P less than 0.001) and 335% (P less than 0.001), respectively. Parallel with the changes in plasma, the livers of tumor-bearing animals showed decreased concentrations of KB by 35% (P less than 0.05) and increased concentrations of TG and FFA by 49% (NS) and 15% (NS), respectively. In comparison with values for the control liver (fed ad libitum), the perfused liver of animals bearing the Walker 256 tumor formed 42% (P less than 0.05) and 75% (P less than 0.05) less ketone bodies and CO2, respectively, from oleate, while TG formation was enhanced by 33% (P less than 0.001). There was two- to threefold (P less than 0.001) enhancement of [1-14C]leucine oxidation in vivo by the tumor bearing animals. The activities of branched-chain amino acid aminotransferase and branched-chain keto acid dehydrogenase were elevated by 70% (P less than 0.001) and 560% (P less than 0.001) respectively in the gastrocnemius muscle of the tumor-bearing animals. The results of the investigation supported a second proposal of the hypothesis, namely, that cancer-induced cachexia resulted in the notable elevation in the concentration of arginine vasopressin that was accompanied by parallel increases in the plasma, urine, and muscle concentrations of prostaglandin E2. The proposals of the original hypothesis have been augmented to include roles for PGE2 and the cytokine cachectin/tumor necrosis factor which may engineer all of the events depicted in the original hypothesis. PMID- 2775565 TI - Modification of LDL by platelet secretory products induces enhanced uptake and cholesterol accumulation in macrophages. AB - LDL modified by incubation with platelet secretory products caused cholesterol accumulation and stimulation of cholesterol esterification in mouse peritoneal macrophages. Its uptake by the macrophages was a receptor-mediated process, not susceptible to competition by acetyl-LDL or polyanions suggesting independence of the scavenger receptor. Stimulation of the esterification process in macrophages by this modified LDL was inhibited by the lysosomal inhibitor chloroquine, indicating requirement for cellular uptake and lysosomal hydrolysis of the lipoprotein. Within the cell, the modified LDL inhibited cellular biosynthesis of triglycerides in a manner similar to the action of acetyl-LDL but different to the effect of native LDL. In the presence of HDL, acting in the medium as an acceptor for cholesterol, a low rate of cholesterol efflux from cells incubated with this modified LDL as well as with acetyl-LDL was demonstrated. A small reduction in cholesteryl ester synthesis was found in these cells, compared to a 60% reduction in cells incubated with native LDL. Thus it was demonstrated that LDL modified by platelet secretory products could induce macrophage cholesterol accumulation even though it was recognized and taken up via the regulatory LDL receptor. PMID- 2775566 TI - Oral cancer and precancer--a dilemma. PMID- 2775567 TI - Tooth transplant record? PMID- 2775568 TI - Pre-brushing mouthrinse PLAX. PMID- 2775569 TI - Oral medicine in practice: angular cheilitis. AB - In a series of twelve articles the authors aim to cover the more common oral medicine problems likely to be encountered in dental practice. Whenever possible, clinical photographs have been used to illustrate important points, and the text is deliberately succinct and without references. In the first article, the pathogenesis, investigation and management of angular cheilitis is reviewed. PMID- 2775570 TI - The position of the inferior dental canal and its relation to the mandibular second molar. AB - Five hundred dental panoramic tomograms of patients over the age of 17 years were examined and any radiographic relationship of the mandibular second molar to the inferior dental canal noted. The position of the inferior dental canal within the mandible was also noted and compared with previous studies. In the population examined, 2% of mandibular second molars were radiographically related to the inferior dental canal and this was 2.5 times more common in women. The importance of the close proximity of the inferior dental nerve to the apex when root filling or extracting this tooth is considered. PMID- 2775571 TI - The establishment and development of new dental practices. AB - The aims of this study were to examine the factors helping and hindering the establishment of dental practices in locations not previously supporting a dental practice. A method of identifying new practices, and measuring the growth of the practices was developed. Subsequently, 44 eligible new practices were identified in five FPC areas around Manchester and the practitioners asked to participate in the study. Thirty-one dentists provided usable data, and the 19 practices which had been established for at least 2 years formed the study group for this paper. The influencing factors in starting their practices were assessed by means of a postal questionnaire; the growth of the practices was measured by the monthly throughput of estimates (courses of treatment). The establishment of a new dental practice was divided into three processes: locating the practice, setting up the practice, and the growth of the practice. Of the 19 practices that had been open for at least 2 years, the choice of practice location was usually based on local knowledge, with 12 dentists (63%) having previously lived within 10 miles of the practice. Only eight dentists (42%) received outside help in locating their practice. On the whole, there was no problem with the availability of property, with 14 dentists (74%) occupying their first choice of premises. When setting up their dental practice, 19 dentists (100%) obtained finance, and the financial institutions were generally found to be helpful. Planning permission was sought by 17 dentists (89%) and of those, 12 (63%) obtained it within 2 months. Nineteen dentists (100%) used builders and six (31%) of those experienced delays.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2775572 TI - A lateral periodontal cyst in association with a follicular cyst. AB - A case is described in which two separate developmental odontogenic cysts were associated with an unerupted lower third molar tooth. Radiological and histological examination showed that these were a lateral periodontal cyst and a follicular (dentigerous) cyst. This unusual occurrence provides substantial evidence that the periodontal cyst may have an origin from the cell rests of Malassez. PMID- 2775573 TI - Financial management. PMID- 2775575 TI - Impressions of Iceland. PMID- 2775574 TI - Public water fluoridation in Ireland: twenty-five years on. AB - In July of this year, 1989, Ireland celebrates 25 years of fluoridation of the public water supplies. No other country has had such a long experience of a national mandatory public water supply fluoridation programme. There is good reason therefore to review experiences and attempt to draw some conclusions. PMID- 2775576 TI - What is specialist practice and how would it work? PMID- 2775577 TI - 'The elimination of cross-infection in dental practice--a 5-year follow-up'. PMID- 2775578 TI - 'Audit--a cause for TMJ dysfunction'. PMID- 2775579 TI - 'Ethnic indicators of dental health for young Asian schoolchildren resident in areas of multiple deprivation'. PMID- 2775580 TI - Dentists causing harm with X-rays. PMID- 2775581 TI - 'A profile of dentists working in the general and community dental services in Scotland in 1987'. PMID- 2775582 TI - 'Future patterns of dental care--manpower implications for industrialised countries'. PMID- 2775583 TI - 'Use your Yellow Card'. PMID- 2775584 TI - Preventive dental care for toddlers. PMID- 2775585 TI - Pre-brushing mouthrinse Plax. PMID- 2775586 TI - Life after graduation: an alternative to the vocational training scheme. AB - Inspired by the coverage that the Vocational Training Scheme has been receiving recently, Josephine Drewett gives BDJ readers a rather different view of the life she chose to follow immediately after graduating from the University of Bristol Dental School. PMID- 2775588 TI - The orodental status of anorexics and bulimics. AB - This study aims to assess the dental status of anorexics and bulimics by comparison to age-matched controls. One hundred and eight individuals participated, of which 58 had an eating disorder. This group were further subdivided into bulimics who induced vomiting (33), bulimics who did not vomit (7), and anorexics (18). The caries experience (DMFS), plaque levels, gingival inflammation and buffering capacity of saliva were assessed and total vomiting episodes estimated from the product of vomiting frequency and duration. Statistical analysis (one way ANOVA) revealed no significant differences with most of the dental variables between the eating disorder groups and the controls. A linear association (Pearson correlation coefficient) between vomiting frequency, duration or total vomiting episodes and tooth wear was not found, although the frequency of pathological tooth wear is significantly high in the vomiting bulimic group, especially if the total number of vomiting episodes is greater than 1100. PMID- 2775587 TI - The use of various handwashing agents to decontaminate gloved hands. AB - It has been suggested that gloved hands could be washed between patient treatments in the dental surgery and gloves re-used, provided they are undamaged. A series of experiments are described, which evaluate the effectiveness of four handwashing agents at removing defined bacterial inoculae from two types of latex rubber glove, a dedicated dental procedure glove (Regent Biogel D) which has a rough surface and a smooth-surfaced examination glove (Microtouch). The four agents tested were povidone iodine (Betadine), chlorhexidine (Hibiscrub), 60% iso propyl alcohol, and a detergent triclosan preparation (Kleenex washcream). The Biogel D gloves required slightly shorter washing times to eradicate organisms than the Microtouch gloves. It was found that washing with water alone reduced the organisms on gloves by 300-1000-fold, but a minimum washing time of 20 seconds with povidone iodine or chlorhexidine was required to eradicate all the organisms inoculated, except bacterial spores, from both glove surfaces. Povidone iodine and chlorhexidine were more effective washing agents than iso-propyl alcohol and triclosan soap. PMID- 2775590 TI - A computer in the practice. AB - It is possible to buy a computer system, a printer and business application programs, all well designed for use in any office, for about 700 pounds. This brings computerisation within the reach of the smallest practice. In the last of his articles on practice management, Michael Wilkinson outlines how business systems can help in practice and provides a guide to the purchase of systems which can be upgraded to use specialized dental programs. PMID- 2775589 TI - Lingual abscess in a patient with anorexia nervosa. AB - A 30-year-old female patient suffering from anorexia nervosa, developed an acute submandibular cellulitis. She was found to have a lingual abscess, for which the only detectable source of infection was a grossly carious lower molar. The oral features of the more common eating disorders are described. PMID- 2775591 TI - AIDS update. PMID- 2775593 TI - Low flip angle gradient echo magnetic resonance imaging of the cervical spine at 0.3 tesla. AB - The influence of flip angle and TR on signal to noise ratio and contrast between cerebrospinal fluid (CSF) and cord was evaluated in cervical spine imaging in 5 volunteers, using gradient echo technique. All experiments were performed on a 0.3 tesla Fonar beta-3000 M scanner using solenoidal surface coils. The most useful sequence was considered to be TR/TE = 300/12 ms and 10 degrees flip angle. This sequence provided images with a 'myelographic appearance' with good delineation of cord, CSF and epidural space. The grey and white matter was also regularly visualized. The acquisition time was considerably shorter than would have been necessary if a long TR/TE spin echo sequence had been used to obtain the same contrast pattern and the sequence was not as sensitive to motion as was the spin echo sequence. The sequence was also evaluated in 10 patients with degenerative disease and in 5 with lesions in the cord. The gradient echo sequence was found to be equal to or better than short and long TR/TE spin echo sequences in demonstrating narrowing of the spinal canal and cord lesion. The drawback is the limited signal to noise ratio. PMID- 2775592 TI - Digital chest radiography with a large image intensifier. Evaluation of diagnostic performance and patient exposure. AB - A digital system for chest radiography based on a large image intensifier was compared with a conventional film-screen system. The diagnostic performance was evaluated with special reference to the digital monitor images with a modified version of receiver operating characteristic (ROC) analysis--free response ROC (FROC) analysis--on a chest equivalent phantom. Measurements of spatial resolution and energy imparted were also performed. The detectability of low contrast objects as well as spatial resolution was better for the full-size film screen radiographs than for both the digital monitor images and the 100 mm photofluorograms. The image-intensifier system has a potential for considerable dose savings in relation to the conventional technique provided that fluoroscopy is excluded in the positioning of the patients. PMID- 2775594 TI - Ultra low field magnetic resonance imaging and computed tomography in the diagnosis of lumbar disc disease. AB - Magnetic resonance (MR) examination of the lumbar spine was performed in 51 patients using a resistive magnet with a field strength of 0.02 T. The results at 105 intervertebral levels were compared with those of computed tomography (CT). Due to the extremely low field strength, an unfavourable signal-to-noise ratio degraded the image quality. Some improvement was achieved with the development of a dedicated surface coil. The diagnostic information was not comparable with that obtained with CT, nor was the image quality comparable to that obtained at higher field strengths. Compared with CT there was no false information. Therefore, it is suggested that extremely low field units may permit exclusion of pathology on the basis of a normal examination and in this way help in the selection of those patients who need further investigation and treatment. PMID- 2775595 TI - Lumbar spinal canal size of sciatica patients. AB - Seven measures at the three lowest lumbar interspaces were recorded from conventional radiographs of the lumbar spines of 160 consecutive patients with low back pain and sciatica admitted for myelography and possible surgery. Eighty eight patients were operated upon for disc herniation, and of the conservatively treated 72 patients, 18 had a pathologic and 54 a normal myelogram. The results were evaluated after one year using the occupational handicap scales of WHO. Correlations of radiographic measures to stature were moderate and to age small. After adjusting for stature and age, only the male interpedicular distances and the antero-posterior diameter of intervertebral foramen at L3 were greater than those of females. The males with a pathologic myelogram had smaller posterior disc height at L3 and a smaller interarticular distance at L3 and L4 than those with normal myelogram, likewise the midsagittal diameter at L3 and L4 in females. In all patients other measures besides posterior disc height were smaller than those for low back pain patients (p less than 0.001) or for cadavers (p less than 0.001). The only correlation between measures and clinical manifestations was between pedicular length at L3 and limited straight leg raising. Where the disc material had been extruded into the spinal canal, the interpedicular distance was significantly wider. Only anterior disc height at L3 revealed differences between good and poor outcome one year after surgery, as did the interarticular distance at S1 in patients with normal myelogram after conservative treatment. PMID- 2775596 TI - Spondylolysis and the sacro-horizontal angle in athletes. AB - The frequency of spondylolysis and the relationship between spondylolysis and the sacro-horizontal angle in 143 athletes and 30 non-athletes is reported. Athletes had a larger sacro-horizontal angle than non-athletes. The sacro-horizontal angle was larger in athletes with spondylolysis as compared with those without. An increased incidence of spondylolysis with an increased angle was demonstrated. It is suggested that an increased sacro-horizontal angle may predispose to spondylolysis, especially in combination with the high mechanical loads sustained in certain sports. PMID- 2775597 TI - In vivo measurements of the T1 relaxation processes in the bone marrow in patients with myelodysplastic syndrome. A magnetic resonance imaging study. AB - Nine patients with myelodysplastic syndrome (MDS) were examined with magnetic resonance imaging and in vivo T1 relaxation time measurements of the vertebral bone marrow in a 1.5 tesla whole body scanner. Two patients underwent transformation to acute myeloid leukemia and were evaluated at follow-up examinations. At the time of diagnosis the T1 relaxation times of the vertebral bone marrow were significantly prolonged compared with normal values. The T1 relaxation times of the vertebral bone marrow in patients with MDS showed significantly lower values compared with patients with acute leukemia and did not differ from patients with polycythemia vera. PMID- 2775598 TI - Local differences in mineral content in vertebral trabecular bone measured by dual-energy computed tomography. AB - Twelve lumbar vertebral bodies from cadavers were examined with dual-energy CT, to measure the calcium content in a big central region of interest (ROI). In each of five vertebrae the calcium content was also measured in six small ROI. After completed scanning, six small cylinders were drilled out from each vertebra, and the ash-density of each cylinder was measured. The dual-energy CT measurements correlated well with the ash-density. Both ash-density and dual-energy CT showed a significantly higher mineral content in the posterior part of the vertebrae than in the anterior part, and this difference might be responsible for problems encountered with the reproducibility of dual-energy CT. PMID- 2775599 TI - Fractures of the proximal humerus involving the intertubercular groove. AB - The purpose of this study was to analyse the involvement of the gliding surface of the biceps tendon in fractures of the proximal humerus. Fifteen patients had a fracture of the proximal humerus verified with antero-posterior and axillary radiographs. Tangential radiographs of the intertubercular groove, obtained from the shoulder joint, showed involvement of the intertubercular groove in 13 patients (87%), which could not be shown with other projections. Groove radiographs revealed in 3 patients a dislocation of the fragments of the greater tuberosity large enough to require surgical treatment, but which had not been found using conventional techniques. Therefore, a groove radiograph should be used to precise fractures of the proximal humerus. PMID- 2775600 TI - Aspiration biopsy in renal angiomyolipoma. AB - Ultrasound guided aspiration biopsy of renal mass lesions was performed in 56 patients in whom renal cell carcinoma could not be excluded due to equivocal imaging results. Cytology showed non-malignant mesenchymal cells consistent with angiomyolipoma in 12 patients. In 5 of these patients the diagnosis was ensured by open biopsy. No nephrectomy was performed. In 6 of the 7 patients not operated upon the tumours remained unchanged with no evidence of malignancy during a 3-36 months' follow-up period. Aspiration biopsy is an easy and safe method for diagnosing renal angiomyolipoma in cases where computed tomography is not diagnostic for this disease. PMID- 2775601 TI - Effects of high- and low-osmolar contrast media on renal plasma flow and glomerular filtration rate in euvolaemic and dehydrated rats. A comparison between ioxithalamate, iopamidol, iohexol and ioxaglate. AB - The effects of a slow intravenous injection of contrast media (CM) on renal function and haemodynamics were investigated in euvolaemic and dehydrated rats. Iodine-equivalent doses (1600 mg I/kg body weight) of ioxithalamate, ioxaglate, iopamidol and iohexol were used. Glomerular filtration rate (GFR) and renal plasma flow (RPF) were assessed with clearance techniques. In euvolaemic rats no statistically significant decrease in GFR or RPF was found after CM injections. In the dehydrated rats the changes in GFR were more pronounced and this was significantly decreased in the ioxithalamate and iopamidol groups while RPF was still not decreased. This study indicates that dehydration potentiates adverse effects of CM on GFR and that there may be differences between the effects of low osmolar and high-osmolar CM on GFR and also between different low-osmolar CM. PMID- 2775602 TI - Influence of vesicoureteral reflux and urinary tract infection on renal growth in children with upper urinary tract duplication. AB - The growth of the renal parenchyma was examined in children with duplicated outflow systems, vesicoureteral reflux (VUR), urinary tract infection (UTI) and no sign of obstruction. Ten patients with reflux occurring only in the caudal system (group A) and 4 patients with reflux both to the caudal and the apical system (group B) were studied shortly after their first UTI (study 1) and then 1.5 to 9 years later (study 2). The frequency of UTI was relatively high during the follow-up period. At urography, renal length and renal area were normal in group A in studies 1 and 2. Parenchymal thickness of the apical pole (APT/L) did not differ from normal values in any of the studies. Parenchymal thickness of the caudal pole (CPT/L) was significantly smaller than normal in both studies. There was also a significant decrease in CPT/L between study 1 and 2. UTI during the first year of life was associated with a greater reduction in CPT/L. The determination of renal length and renal area in children with a duplicated ureter, VUR and UTI, does not identify subjects at risk of developing renal growth retardation while serial determinations of parenchymal thickness appear to be an appropriate method. PMID- 2775603 TI - Development of the Cruveilhier-Baumgarten syndrome after endoscopic obliteration of oesophageal varices. Report of a case. AB - A patient with post-necrotic liver cirrhosis, presenting with recurrent haematemesis and melena due to oesophageal varices, received repeated endoscopic injection sclerotherapy. The Cruveilhier-Baumgarten syndrome developed 11 months after variceal obliteration. Neither rebleeding nor recurrence of varices was observed during a follow up period of 12 months after obliteration of varices. PMID- 2775604 TI - Chemical sclerosis of the gallbladder. An experimental study in pigs of the effect of absolute ethanol and polidocanol on gallbladder epithelium. AB - Chemical ablation of the gallbladder with absolute ethanol and polidocanol 3% was attempted in 23 and 10 pigs, respectively, after open transhepatic cholecystostomy. Absolute ethanol caused complete necrosis of the gallbladder epithelium in 10 pigs and partial necrosis with focally present gallbladder epithelium in 9. An intact epithelium was observed in 4 pigs but it was not possible to determine whether this epithelium was the original one, not affected by the ethanol, or regenerated after previous damage. Gallbladders with hemorrhage and hydrops were frequently encountered. Gallbladders treated with polidocanol all had an intact epithelium. PMID- 2775605 TI - Evaluation of biexponential relaxation behaviour in the human brain by magnetic resonance imaging. AB - Quantitative estimation of individual biologic components in relaxation curves obtained in vivo may increase the specificity of tissue characterization by magnetic resonance imaging. In this study, the potential of biexponential curve analysis was evaluated in T1 and T2 measurements on the human brain at 1.5 tesla. Optimal experimental conditions were carefully observed, including the use of long TR values and a very small voxel size. T1 determination was based on a 12 points partial saturation inversion recovery pulse sequence. T2 determination involved a multiple spin echo sequence with 32 echoes. No genuine biexponentiality was demonstrated in the T1 and T2 relaxation processes of white matter, cortical grey matter, or cerebrospinal fluid. Thus, a monoexponential model seems adequate for description of the relaxation behaviour in these cases. Furthermore, the results suggest that the accuracy of the measurements may not be critically dependent on the voxel size employed. PMID- 2775606 TI - Monitoring of therapy for deep vein thrombosis using magnetic resonance imaging. AB - Magnetic resonance imaging using limited-flip-angle, gradient refocused pulse sequences has been used to monitor the course of anticoagulant or fibrinolytic therapy for deep vein thrombosis in two patients. The findings demonstrate the capacity of this technique to delineate the extent of thrombosis and characterize changes in size in response to treatment. Advantages of this approach include high anatomic resolution, speed of examination and non-invasiveness, properties that make it well-suited to following the progress of therapy with potentially significant implications for improving treatment. PMID- 2775607 TI - EEG brain mapping in evaluating the time-course of the central action of DUP 996- a new acetylcholine releasing drug. AB - 1. In a double-blind, placebo-controlled study the encephalotropic effects of DUP 996, a novel phenylindolinone derivative for Alzheimer's disease enhancing the release of acetylcholine in cholinergic nerve terminals in the brain only when its release is triggered, were studied with special consideration of the pharmacodynamic time-course. 2. Thirteen healthy male volunteers aged 18-40 years received randomized and at weekly intervals, single oral doses of placebo and 30 mg DUP 996. Blood sampling for plasma concentration analysis, EEG recordings and evaluation of pulse, blood pressure and side effects were carried out at 0, 1, 2, 4, 8, 12 and 24 h. 3. Computer-assisted spectral analysis of the EEG and subsequent topographic brain mapping of the drug-induced EEG changes demonstrated significant central effects of DUP 996 suggesting vigilance-improving properties. The findings were characterized mostly by an augmentation of total power as well as by an increase of absolute power in the alpha and alpha-adjacent beta activity. 4. Time-course investigations demonstrated two pharmacodynamic peaks: a first one in the 2nd h and a second one in the 12th h. In detail CNS effects increased up to the 2nd h, showed a drop in the 4th h, increased again thereafter to peak in the 12th h. Even in the 24th h there were significant differences between DUP 996 and placebo. The latter suggests an indirect effect and/or an active metabolite, as the parent drug is rapidly absorbed and has a rather short plasma half-life between 1-3 h. 5. DUP 996-induced EEG-changes over time were most pronounced over temporo-occipital, temporo-frontal, parietal and frontal regions, e.g. over brain areas afflicted most by Alzheimer's disease. 6. Evaluation of vital signs, laboratory findings and ECG as well as adverse effects showed a very good tolerability of DUP 996. PMID- 2775608 TI - The effect of theophylline on thyrotoxic tremor. AB - 1. The effect of intravenous aminophylline on theophylline-induced tremor were studied in six hyperthyroid patients before and after treatment to euthyroidism. 2. Baseline tremor power was significantly greater in the hyperthyroid compared with the euthyroid state (P less than 0.05). 3. Aminophylline produced a significantly greater increase in tremor power in the hyperthyroid compared with euthyroid state. 4. There was a significant increase in plasma theophylline clearance and reduction in t1/2 elimination when patients were hyperthyroid but volume of distribution did not change. 5. Intravenous aminophylline potentiates the tremor produced in hyperthyroidism despite an increase in plasma theophylline clearance. A pharmacodynamic mechanism is therefore likely. PMID- 2775609 TI - Adverse drug reactions: a hospital pharmacy-based reporting scheme. AB - A pharmacy-based adverse drug reaction (ADR) reporting scheme, using pharmacists, nurses and medical practitioners as initiators of reports, was set up at the end of 1984 in the Royal Liverpool Hospital in order to encourage reporting. New reports were inspected at weekly intervals by a staff pharmacist, and a clinical pharmacologist. Reports were forwarded to the Committee on Safety of Medicines if the reaction was considered to be serious by the clinicians, or the ADR team or involved 'black triangle' drugs. The total number of ADR reports was increased eightfold by the introduction of the scheme (from 14 in 1984 to 76, 102 and 94 in 1985, 1986 and 1987 respectively), and this rate of reporting has been sustained. PMID- 2775610 TI - The pharmacokinetics of lamotrigine (BW430C) in healthy subjects with unconjugated hyperbilirubinaemia (Gilbert's syndrome). AB - A single oral dose of lamotrigine was administered to seven volunteers with Gilbert's Syndrome (unconjugated hyperbilirubinaemia). Plasma samples were assayed by high performance liquid chromatography (h.p.l.c.) and pharmacokinetic parameters were compared with those of a group of nine normal volunteers. In the subjects with Gilbert's Syndrome mean oral clearance (CLpo) was 32% lower (P less than 0.01) and the plasma elimination half-life (t1/2) was 37% lower (P less than 0.02) than in the normal controls. The amount of unchanged lamotrigine excreted in the urine was 30% greater in the Gilbert's subjects (P less than 0.01) although this only amounted to 9.5% of the administered dose. Subjects with Gilbert's Syndrome have some impairment of lamotrigine elimination but this is unlikely to be clinically important. PMID- 2775611 TI - Evaluation of the gastric absorption and emptying of drugs under various pH conditions using a simple intubation method: application to diclofenac. AB - Sodium diclofenac (50 mg) together with [14 C]-PEG as a non-absorbable marker were dissolved in 400 ml of water (A), phosphate buffer pH 7.5 (B) or a homogenized meal (C). Each of these was ingested in random order by six volunteers on 3 consecutive days. Some gastric absorption of the drug was established with C but the plasma drug concentration-time profiles mainly reflected the process of gastric emptying. PMID- 2775612 TI - The effect of pregnancy in humans on the pharmacokinetics of stable isotope labelled phenytoin. AB - 1. To investigate the mechanism of the fall in steady-state plasma phenytoin concentration relative to drug dose that occurs during pregnancy, single dose pharmacokinetic studies with stable isotope labelled phenytoin were carried out at different stages of pregnancy, and 2 to 4 months post-natally, in five epileptic women receiving regular oral therapy with the drug. 2. Steady-state apparent plasma clearances of phenytoin (dose/steady-state concentration) correlated closely with simultaneous plasma clearances of the intravenous stable isotope drug (measured as dose/AUC) suggesting that the patients were complaint with therapy when their phenytoin dosage requirement increased during the pregnancy, and that the oral drug was fully bioavailable. 3. In retrospect, two of the five subjects were probably studied too early post-natally for phenytoin elimination kinetics to have returned to non-pregnant values. Despite this, (i) the mean +/- s.d. t 1/2 for phenytoin was statistically significantly shorter in pregnancy than post-natally (31 +/- 14 vs 39 +/- 28 h), (ii) the mean +/- s.d. whole plasma clearance was also statistically significant greater (0.025 +/- 0.012 vs 0.021 +/- 0.013 kg-1 h-1) and (iii) the mean +/- s.d. Vmax for phenytoin elimination was statistically significantly greater in pregnancy (1170 +/- 600 mg day-1) than post-natally (780 +/- 470 mg day-1). Although the mean +/- s.d. apparent Km was higher in pregnancy (18.2 +/- 8.4 mg l-1, expressed in terms of whole plasma drug concentrations, compared with 10.2 +/- 7.4 mg l-1 post natally), the difference was not statistically significant. However, if the apparent Km value was expressed in terms of plasma water phenytoin concentrations the difference (pregnant 2.50 +/- 0.85 mg l-1: post-natally 1.16 +/- 0.65 mg l-1) was statistically significant. 4. Human pregnancy appears to result in an increased capacity to eliminate phenytoin. PMID- 2775613 TI - Effect of quinidine on the dextromethorphan O-demethylase activity of microsomal fractions from human liver. AB - 1. The kinetics of dextromethorphan O-demethylation were measured in microsomes prepared from five human livers, both in the absence and in the presence of quinidine. 2. For each liver and over the concentration range of dextromethorphan examined (4.2-3400 microM), this reaction involved an enzymatic component of high affinity, with an apparent Michaelis-Menten constant (Km) of 4.6 +/- 1.8 microM (mean +/- s.d.) and a maximum velocity (Vmax) of 4.2 +/- 3.5 nmol mg-1 h-1 (mean +/- s.d.). 3. Quinidine was a potent and competitive inhibitor of the activity of this component (mean Ki +/- s.d. of 0.025 +/- 0.008 microM) as it is for other oxidation reactions which have already been found to co-segregate with the debrisoquine-type polymorphism. 4. With microsomes from four of the five livers studied, there was evidence of a second enzymatic component of activity characterized by a similar Vmax and about 20-fold higher Km compared with the high affinity component. The activity of this low affinity component was unaffected by quinidine in the concentrations studied. PMID- 2775615 TI - The effect of age on the pharmacokinetics of levodopa administered alone and in the presence of carbidopa. AB - 1. The effect of age on the pharmacokinetics of levodopa administered alone and in the presence of carbidopa was investigated in young and elderly healthy volunteers. 2. The plasma clearance of levodopa following intravenous administration of 50 mg was 14.2 +/- 2.8 (s.d.) ml min-1 kg-1 in the elderly compared with 23.4 +/- 4.1 ml min-1 kg-1 in the young (P less than 0.01) which resulted in a 49% greater area under the plasma concentration-time curve (AUC) in the older subjects (P less than 0.01). The volume of distribution (Vss) was lower in the elderly (1.01 +/- 0.29 l kg-1) than in the young (1.65 +/- 0.39 l kg-1) (P less than 0.002). 3. Following oral administration of 250 mg of levodopa the AUC was 2512 +/- 588 ng ml-1h in the elderly compared with 1056 +/- 282 ng ml-1h in the young (P less than 0.002). Cmax was also significantly greater in the elderly (P less than 0.05). The bioavailability of levodopa was significantly greater in the elderly (0.63 +/- 0.12 compared with 0.41 +/- 0.16, P less than 0.01). 4. In the presence of carbidopa, the plasma clearance of intravenous levodopa (50 mg) was reduced in both age groups but remained lower in the elderly (5.8 +/- 0.9 ml min-1 kg-1 compared with 9.3 +/- 1.0 ml min-1 kg-1; P less than 0.01). This resulted in a 54% greater AUC in the older subjects (P less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2775614 TI - Comparison of Sawchuk-Zaske and Bayesian forecasting for aminoglycosides in seriously ill patients. AB - 1. Individual pharmacokinetic parameters and predicted steady-state serum concentrations of aminoglycosides were calculated by Sawchuck-Zaske (SZ) and Bayesian methods. 2. Predicted concentrations were compared with observed steady state concentrations for 36 seriously ill patients with systemic infections. Four aminoglycoside concentrations were used for the SZ method. Differing numbers of serum aminoglycoside samples were used in the Bayesian parameter estimation: one sample Bayesian used one post-infusion concentration, two sample Bayesian used a trough plus one post-infusion concentrations and four sample Bayesian used a trough plus three post-infusion concentrations. 3. 79% of the SZ predictions were with +/- 2 mg l-1 of the observed peak concentrations, and 72% of the two sample Bayesian predictions were within the same range. 82% of SZ and the two sample Bayesian predictions were within +/- 1 mg l-1 of the observed trough concentrations. 4. A confidence interval comparison of estimated pharmacokinetic parameters and precision for the predicted concentrations showed no important differences between the SZ and the two sample Bayesian. The four sample Bayesian was the most precise method. 5. We conclude that the Bayesian forecasting method utilizing a trough plus one post-infusion concentrations is as useful as the SZ method which requires three to four serum concentrations in individualizing aminoglycoside therapy for seriously ill patients. PMID- 2775616 TI - Pharmacokinetics of halofantrine in man: effects of food and dose size. AB - 1. Plasma concentrations of halofantrine (Hf) and its putative principal plasma metabolite desbutyl halofantrine (Hfm) have been measured in two separate studies after oral administration of the hydrochloride salt. 2. Six healthy male volunteers each received single oral doses of 250, 500 and 1000 mg administered after an overnight fast. A washout period of at least 6 weeks was allowed between each dose. A further 250 mg single oral dose was administered to the same six subjects in a fasting state and after a standardised fatty meal in a randomised study, again with a washout period of at least 6 weeks. 3. AUC and maximum plasma concentration (Cmax) for Hf increased in proportion to the dose from 250-500 mg. This increase was non-proportional when the dose was increased from 500 to 1000 mg. For Hfm, in the dose range 250-500 mg, AUC but not Cmax increased in proportion in the increase in dose size. The increase in these parameters was non proportional when the dose was increased from 500 to 1000 mg. Time to reach peak concentrations for Hf and Hfm and the elimination half-life of Hf remained unchanged across the dosage range. 4. Following a fatty meal, Cmax for Hf was increased from 184 +/- 115 micrograms l-1 (fasting) to 1218 +/- 464 micrograms l 1 (fed). AUC for Hf was increased from 3.9 +/- 2.6 mg l-1 h (fasting) to 11.3 +/- 3.5 mg l-1 h following a fatty meal.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2775618 TI - Individualised aminoglycoside dosage based on pharmacokinetic analysis is superior to dosage based on physician intuition at achieving target plasma drug concentrations. AB - 1. A prospective randomised trial was conducted to compare aminoglycoside dose prediction based on individually measured pharmacokinetic data, with dosage based on physician intuition. 2. After 2 days of therapy more patients in the pharmacokinetic group had achieved both peak (6-10 mg 1(-1] and trough (1-2 mg 1( 1] target plasma concentrations (P = 0.007), peaks alone (P = 0.01) and troughs alone (P = 0.01). Their mean (s.e. mean) peak concentration was 6.49 +/- 0.39 mg 1(-1) compared with 4.27 +/- 0.52 mg 1(-1) in the control group (P = 0.001), with trough concentrations of 1.44 +/- 0.22 mg 1(-1) and 0.94 +/- 0.21 mg 1(-1) respectively (P = 0.054). 3. After 5 days of therapy, peak and trough concentrations were still significantly higher in the pharmacokinetic group despite empirical dose adjustment (P = 0.01 and P = 0.013 respectively). 4. The mean (s.e. mean) daily dose of aminoglycoside was higher in the computer group (312 +/- 17 mg vs 203 +/- 13 mg, P = 0.001). 5. These findings suggest that dose estimation based on measured pharmacokinetic parameters is superior at achieving target plasma drug concentrations. PMID- 2775617 TI - L-648,051, a novel cysteinyl-leukotriene antagonist is active by the inhaled route in man. AB - 1. We have studied some of the pharmacological properties of inhaled L-648,051 which has been shown to be a selective cysteinyl-leukotriene (LT) antagonist in vitro and in vivo in various animal models. 2. The effects of three different doses (1.6, 6.0 and 12.0 mg) on the bronchoconstriction induced by inhaled LTD4 have been investigated in normal male subjects in a series of double-blind, placebo controlled studies. Furthermore, the specificity of the drug has been investigated by challenging subjects with histamine after pre-inhalation of 12.0 mg L-648,051. 3. At all doses L-648,051 partially blocked the bronchoconstriction induced by LTD4 inhalation in a dose related manner. At a dose of 12.0 mg, L 648,051 decreased the maximum fall in specific airways conductance (sGaw) (placebo, 49% vs L-648,051, 21%, P less than 0.01) and shortened the time to recovery from LTD4-induced bronchoconstriction (placebo, 41 min vs L-648,051, 19 min, P less than 0.01). 4. There was no evidence of partial agonist activity, and no effect on histamine-induced bronchospasm. Inhaled L-648,051 at all doses was well tolerated. 5. We conclude that LT antagonism is possible by the inhaled route in man. Inhaled L-648,051 is an active and selective LT-antagonist in man which is well tolerated and may prove to be a useful drug for assessing the role of leukotrienes in asthma and other lung diseases. PMID- 2775619 TI - Lack of effect of cimetidine on the pharmacokinetics of R(-)- and S(+)-ibuprofen. AB - 1. To investigate the effect of cimetidine on the pharmacokinetics of R(-)- and S(+)-ibuprofen, six healthy male volunteers received orally 800 mg racemic ibuprofen both in the drug-free state (control phase, C) and on the second day of a 3 day course of oral cimetidine, 1 g daily (treatment phase, T). The two phases (14 days apart) were randomised in a balanced cross-over manner. 2. The plasma concentrations of R(-)- and S(+)-ibuprofen were measured by high-performance liquid chromatography (h.p.l.c.). The protein binding of the enantiomers was assessed in a selection of plasma samples from each volunteer. Following alkaline hydrolysis of glucuronide conjugates, the urinary recoveries of ibuprofen and its major metabolites were measured by h.p.l.c. 3. There was no difference (P greater than 0.05, two-tailed Student's t-test; data expressed as mean +/- s.d.) between C and T phases in the total area under the plasma concentration-time curve of R( )-ibuprofen (C 4514 +/- 1063 mg 1(-1) min vs T 4665 +/- 1435 mg 1(-1) min) and S(+)-ibuprofen (C 6460 +/- 1063 mg 1(-1) min vs T 6886 +/- 1207 mg 1(-1) min). Similarly, for each enantiomer, there was no difference between the two phases in the terminal half-life, the maximum plasma concentration or the time of its occurrence. 4. Cimetidine treatment had no effect (P greater than 0.05) on the time-averaged percent unbound in plasma of R(-)-ibuprofen (C 0.419 +/- 0.051% vs T 0.435 +/- 0.060%) and S(+)-ibuprofen (C 0.643 +/- 0.093% vs T 0.633 +/- 0.053%). (ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2775620 TI - Stereoselectivity in the urinary excretion of the mercapturates of (R-) and (S-) alpha-bromoisovalerylurea in man. AB - 1. alpha-Bromoisovalerylurea (BIU) is a racemic drug that is metabolized by glutathione conjugation. The urinary excretion of the separate diastereomeric mercapturates formed from (S)- and (R)-BIU in healthy young human volunteers was investigated. 2. A pronounced stereoselectivity was observed: the mercapturate formed from R-BIU was excreted with a t1/2 of 1.5 +/- 0.4 h, while that from S BIU showed a t1/2 of 3.1 +/- 1.3 h. Moreover, 22.5 +/- 4.3 and 5.7 +/- 1.6% of the dose, respectively, was excreted as each mercapturate diastereomer in 24 h. 3. This is the first example of stereoselectivity in the elimination of a substrate for glutathione conjugation in man. PMID- 2775621 TI - Effects of ketoconazole on the polymorphic 4-hydroxylations of S-mephenytoin and debrisoquine. AB - Studies were undertaken in 12 normal, male subjects to determine whether a metabolic interaction occurs between ketoconazole and mephenytoin. A single dose (400 mg) of ketoconazole produced a reduction in the 0-8 h urinary R/S ratio of mephenytoin following oral administration (100 mg) of racemic drug and after 28 daily doses the median value was further reduced to 42.9% of its baseline value. Within 7 days following discontinuation of ketoconazole the enantiomeric ratio had returned to its pre-study value. These findings are consistent with ketoconazole being a potent in vivo inhibitor of mephenytoin's 4-hydroxylation and confirm the ability of such an interaction to be predicted by in vitro studies with human liver microsomes. By contrast, ketoconazole had a much smaller effect on the 0-8 h urinary metabolic ratio of debrisoquine, indicating that ketoconazole has a selective inhibitory effect on different forms of cytochrome P 450. PMID- 2775622 TI - Comparative effects of two antimycotic agents, ketoconazole and terbinafine on the metabolism of tolbutamide, ethinyloestradiol, cyclosporin and ethoxycoumarin by human liver microsomes in vitro. AB - Two antimycotic agents, the azole ketoconazole and the allylamine terbinafine, have been examined for their effects on the metabolism of tolbutamide, ethinyloestradiol, cyclosporin and ethoxycoumarin by human liver microsomes (n = 4) in vitro. Ketoconazole caused marked inhibition of all enzyme activities with mean IC50 values (concentration producing 50% inhibition) of 17.9 microM (tolbutamide hydroxylase), 1.9 microM (ethinyloestradiol 2-hydroxylase), 2.0 microM (cyclosporin N-demethylase), 2.1 microM (cyclosporin hydroxylase) and 25 microM (ethoxycoumarin O-deethylase). At 50 microM terbinafine concentration, inhibition was less than 5% for tolbutamide and ethoxycoumarin, approximately 12% for both cyclosporin pathways and 35% for ethinyloestradiol. Terbinafine does not have the same inhibitory potential for cytochrome P-450 isozymes as ketoconazole. PMID- 2775623 TI - Plasma protein binding of frusemide in liver disease: effect of hypoalbuminaemia and hyperbilirubinaemia. AB - The binding of frusemide was studied in the plasma of 20 healthy subjects and 45 patients with liver disease. The unbound percentage (mean +/- s.d.) of frusemide was 1.64 +/- 0.21 healthy subjects) and 2.24 +/- 0.79 (patients) (P less than 0.01). By grouping the patients on the basis of plasma albuminaemia and bilirubinaemia four clusters namely: 'normal concentrations of albumin and bilirubin' (A), 'hyperbilirubinaemia and normal albumin concentration' (B), 'hypoalbuminaemia and normal bilirubin concentration' (C) and 'hypoalbuminaemia and hyperbilirubinaemia' (D) were defined. The unbound percentage of frusemide was 1.80 +/- 0.36 in (A); 2.44 +/- 1.05 in (B); 2.23 +/- 0.38 in (C); 2.76 +/- 0.77 in (D). The figure for healthy volunteers was not different from A, whereas it was significantly lower than those for B and D (P less than 0.01) and for C (P less than 0.05). A lowered binding of frusemide was associated with hypoalbuminaemia or hyperbilirubinaemia. PMID- 2775624 TI - Co-administration of ciprofloxacin and cyclosporin: lack of evidence for a pharmacokinetic interaction. AB - Ciprofloxacin is widely reported to lower theophylline clearance in patients. Since cyclosporin and theophylline are metabolized by cytochrome P-450 enzymes in the human liver, we investigated whether ciprofloxacin could alter the pharmacokinetics of cyclosporin in healthy volunteers. There was no significant difference (P greater than 0.05) in the pharmacokinetic parameters estimated for cyclosporin without and during ciprofloxacin administration. The results of the present study suggest that ciprofloxacin is unlikely to affect the pharmacokinetics of cyclosporin to a clinically important extent at a dosage of 500 mg twice a day. PMID- 2775625 TI - Pharmacokinetics of quinine in African children suffering from kwashiorkor. AB - The pharmacokinetics of quinine were studied in seven normal African children and in six African children suffering from kwashiorkor, after an oral dose of 10 mg kg-1 of quinine hydrochloride. The two groups were similar in age but the children with kwashiorkor weighed significantly less than the control children (P less than 0.001). The children with kwashiorkor further differed from the control children in having significantly lower packed cell volume (P less than 0.001), total plasma protein and plasma albumin (P less than 0.001), and higher serum SGOT (P less than 0.05). The apparent absorption half-life was significantly longer in kwashiorkor than in controls (P less than 0.05). Similarly, the Cmax was significantly lower (P less than 0.01) in kwashiorkor than in controls. Quinine was eliminated more slowly in children with kwashiorkor, the elimination half-life being significantly longer (P less than 0.001) and the oral clearance significantly less (P less than 0.001) than in controls. It is concluded that kwashiorkor significantly affects the pharmacokinetics of quinine, and that the effect may be due to the pathological changes in the intestine and liver in this condition. PMID- 2775626 TI - Pharmacokinetics of intravenous buprenorphine in children. AB - Buprenorphine (3 micrograms kg-1) was given intravenously as premedication to small children (age 4-7 years) undergoing minor surgery. Because of the rapid decline of the plasma buprenorphine concentrations, the terminal elimination half life could not be estimated reliably. Given this constraint, values of clearance appeared to be higher than those in adults but values of Vss were similar. PMID- 2775628 TI - Potential artifacts in the use of caffeine to determine acetylation phenotype. PMID- 2775627 TI - Local anaesthetic cream for the alleviation of pain during venepuncture in Tanzanian schoolchildren. AB - The analgesic effect and the usefulness of EMLA cream 5% in connection with venous blood-sampling was investigated in 42 Tanzanian schoolchildren. Approximately 2.5 g EMLA was applied to the right cubital fossa for a minimum of 120 min. The analgesic effect was pronounced--93% of the venepunctures were pain free and no child experienced severe pain. No adverse reactions were observed and the children could continue normal school work during the application time. PMID- 2775629 TI - Drug treatment of intermittent claudication. PMID- 2775631 TI - The inherent limitations of sequential arterial bypass grafts: a hemodynamic study. AB - While proximal bypass graft flows are known to increase by the sequential technique, the possibility of a "steal phenomenon" caused by the intermediate anastomosis has been raised. We compared graft and distal flow rates using simple reversed vein versus sequential bypass grafts in a canine model. A blind segment was created by occluding the common iliac artery above and the superficial femoral artery below a profunda femoris artery equivalent, which served as runoff from the blind segment. Reversed saphenous vein harvested from the contralateral thigh in seven anesthetized dogs was used to perform a simple common iliac artery to superficial femoral artery bypass. Graft and distal superficial femoral artery flow were measured with a calibrated flow probe of appropriate diameter (3-5 mm). A sequential side-to-side vein graft to arterial blind segment anastomosis was then added and flow measurements repeated after equilibration. Mean graft flow increased by 20 cc/min with the sequential technique (p = 0.05), while distal flow actually decreased by 1 cc/min (NS). Although no "steal phenomenon" was demonstrated, distal flow was not significantly improved by the sequential technique. We conclude that no convincing case based on presumed hemodynamic superiority can be made for performing sequential bypass in preference to standard reversed vein bypass. The increased potential for technical error introduced by the additional anastomosis and the lack of any demonstrable augmentation in distal flow suggest inherent limitations of the technique, and caution against its widespread use. PMID- 2775630 TI - Proceedings of the British Pharmacological Society, Clinical Pharmacology Section. 5-7 April 1989, Bristol. Abstracts. PMID- 2775632 TI - Functional failure of patent femorodistal in situ grafts. AB - We have treated several patients who required major, proximal extremity amputations despite a patent infrainguinal in situ saphenous vein bypass graft. To determine those factors predisposing to such paradoxical limb loss, we studied a group of 45 patients who underwent 48 in situ, femorodistal bypass grafts for tissue necrosis and who maintained a patent graft throughout the perioperative period. Within this cohort, we compared two distinct subgroups: Group I, whose limbs (n = 8) ultimately required a major proximal amputation; Group II, whose limbs (n = 40) emerged with a viable foot and did not require a major amputation. There was no significant difference in the incidence of diabetes, renal failure, smoking, or postoperative ankle/brachial index between the two groups. The presence of gangrene (88% vs 45%), invasive sepsis (63% vs 23%), and combined gangrene and sepsis (63% vs 18%) was significantly (p less than 0.05) more prevalent in Group I versus Group II. Forty-three percent of patients with both gangrene and foot sepsis required a major proximal amputation despite a patent graft. Such patients are at high risk for limb loss even if they undergo successful revascularization. PMID- 2775633 TI - In situ bypass to the dorsalis pedis and tibial arteries at the ankle. AB - Over a three-year period (1984-1987), we performed 98 in situ saphenous vein bypasses to the tibial arteries in 89 patients. In 68 of these grafts, the distal anastomoses were above ankle level. All but one of these grafts were performed for limb salvage indications. Seven (10%) of these grafts were done in patients on chronic renal dialysis. In 30 grafts, the distal anastomoses were to the ankle level. Indications for surgery were risk of limb loss in all these patients, with tissue loss in 29 (97%). Six (20%) were done in patients on chronic renal dialysis. Operative mortality was 3% in both groups. Late mortality was 13% in the above-ankle group, and 27% in the ankle level group. Secondary patency for the above-ankle group was 97%, 85%, 81%, and 81% at 30 days, one year, two years, and three years. Primary patency was 91%, 67%, and 58% at 30 days, one year, and two years, after which the standard error is greater than 10%. Secondary patency for the grafts at the ankle level was 100% and 82% at 30 days and one and one half years. Primary patency rates were 93% and 68% at 30 days and one year. In situ bypass grafts at the ankle level had patency rates equivalent to grafts with distal anastomoses above the ankle. Patients with distal bypasses usually presented with tissue loss and had a higher late mortality rate. Careful follow up and operative intervention when changes in graft velocities or indices are recognized, markedly improves the durability of the in situ saphenous vein bypass. PMID- 2775634 TI - The in situ bypass above the knee. AB - The anatomical location of the saphenous vein in the distal thigh allows for construction of an in situ bypass to the above-knee popliteal artery. The authors have performed over 1400 in situ bypasses in the past 10 years. Forty-three of these have been to the above-knee popliteal artery. Thirty-three bypasses were performed for limb threatening ischemia, seven for disabling claudication and three for microemboli. Mean patient age was 67 years, 51% were males, 44% had diabetes mellitus, and 93% smoked. Grafts were followed from one to 108 months. The cumulative patency rate at two years was 90% and at four years 77%. Patency rates compare favorably to those of femoral-to-above-knee popliteal bypasses constructed using reversed saphenous vein or polytetrafluoroethylene. The authors found that the in situ femoral-to-above-knee popliteal bypass is a technically easy procedure requiring short operative times and has a low morbidity rate. In those select patients in whom a femoral-to-above-knee bypass is the procedure of choice the in situ bypass should be considered. PMID- 2775635 TI - Intravenous pentoxifylline in the treatment of rest pain: a preliminary report. AB - Twenty patients with ischemic rest pain were treated with intravenous pentoxifylline, 1,200 mg daily, for up to three weeks. Ten patients obtained sufficient relief to avoid surgical intervention. Seven of these had complete or near complete relief of rest pain, but the other three required continuing analgesia. Transcutaneous oxygen measurements showed a significant increase after the course of treatment. There were marked gastrointestinal side effects in six patients, necessitating early withdrawal from the study. Three of these six patients had shown a favorable response to medication prior to withdrawal. These preliminary results suggest that pentoxifylline may provide a sufficient increase in tissue oxygen availability to avoid, or at least postpone, surgical intervention. A double blind controlled study is required to further assess the efficacy of this drug as an intravenous treatment. PMID- 2775637 TI - Cervical wound hematoma after carotid endarterectomy. AB - Between 1974 and 1984, 1222 patients underwent carotid endarterectomy at a large community teaching hospital. Twenty-three (1.9%) of these patients required reexploration for hematoma at the endarterectomy site. We reviewed the records of these 23 patients with regard to the incidence of perioperative hypertension; the use of platelet-altering medication, heparin, protamine sulfate, and low molecular weight dextran; and the findings at reoperation. We also reviewed the records of 122 randomly selected patients who did not develop wound hematoma after carotid endarterectomy. The incidence of intraoperative and postoperative hypertension was significantly higher in the hematoma group than in the control group. The incidence of preoperative hypertension was not significantly different between the two groups. More hematoma patients received preoperative platelet altering medication (43% versus 25%), and fewer received intraoperative protamine sulfate to reverse the effects of heparin (48% versus 66%), but these differences were not significant. This study emphasizes the importance of careful hemodynamic monitoring during and immediately after carotid endarterectomy. PMID- 2775636 TI - Symptomatology and anatomic patterns of peripheral vascular disease: differing impact of smoking and diabetes. AB - We retrospectively examined the impact of smoking and diabetes on the clinical presentation and arteriographic pattern of occlusion in 227 patients evaluated for symptomatic infrainguinal arterial disease. The age at which significant symptomatology developed did not differ for diabetics and nondiabetics. Diabetics had significantly more occlusion in the large arteries of the calf, however, particularly in the peroneal and posterior tibial arteries. Despite this, the extent of occlusive disease in the pedal arch was not influenced by diabetes. Diabetics also tended to present more frequently with gangrene or ulcer (greater than 70%) when compared to nondiabetic smokers (41%, p less than .01). Smokers presented with symptomatic disease earlier than nonsmokers (p less than .0005). Intermittent claudication was strongly associated with smoking; among 33 patients with claudication, 32 were smokers. In contrast to the effect of diabetes, smokers appeared to have less extensive occlusive disease in the large arteries of the calf than nonsmokers. Nondiabetic nonsmokers constituted less than 10% of our study population and presented at a significantly older age. Nevertheless, despite the absence of either risk factor, this group also tended to present with gangrene or ulcer relatively frequently (71%). Although diabetes and smoking are both risk factors for atherosclerotic disease, we conclude that their impact on the angiographic pattern of occlusion and clinical presentation differs substantially. PMID- 2775638 TI - Analysis of inferior venacavography before Greenfield filter placement. AB - The value of routine preoperative inferior venacavography through a femoral approach was assessed in 64 patients who required a Greenfield inferior vena cava filter. Nearly 11% of the patients had an abnormality, for example, duplication of the inferior vena cava, circumaortic renal vein, interrupted or discontinuous inferior vena cava, and so on, requiring an alternate approach to placement. No deaths or complications occurred upon recognition of the anatomic variant before filter placement. In three of the seven abnormalities encountered, adequate visualization and filter placement could only have been accomplished through femoral catheterization. Preoperative cavograms before Greenfield filter placement should be routinely performed using a femoral approach in the absence of contraindications to this technique. PMID- 2775639 TI - Long-term patency of regenerated neoaortic wall following the implant of a fully biodegradable polyurethane prosthesis: experimental lipid diet model in pigs. AB - The degradation of a polyurethane vascular prosthesis, the time course and characteristics of tissue ingrowth and prosthesis replacement, and the incidence of thrombosis have been investigated in 50 young pigs. A 6-7 cm long cone-shaped prosthesis was implanted in the infrarenal aorta of 50 young growing pigs which were sacrificed at intervals from 60 to 365 days. Ten animals were controls, 25 were given aspirin 10 mg/kg of body weight/day, and 15 were fed with cod liver oil. Aortography, done at 30, 60, and 90 days, showed 100% of implants were thrombosed in the surviving controls, 55% of the aspirin group had patent grafts, and 100% of animals in the lipid diet group had patent grafts. At final graft retrieval, the aspirin group showed only three patencies, while in the lipid diet group seven out of nine animals were patent. The laboratory and morphological studies indicated that all patent prostheses were lined with tissue that resembled the intima of native aorta with a layer of smooth muscle cells which appeared complete at 180 days. From these data we conclude that the biodegradable polyurethane vascular prosthesis is reliable for experimental implants in a pig model. The lipid-rich diet of polyunsaturated fatty acids potentiates long-term patency, perhaps by preventing platelet aggregation and thrombosis, and allowing the growth of a neoendothelium and neomedia within the lumen of the prosthesis, which slowly degrade towards fatty tissue and form neoadventitia. PMID- 2775640 TI - Persistent hypoglossal artery encountered during carotid endarterectomy. AB - The hypoglossal artery is present as an anastomotic channel between the carotid and vertebrobasilar system for approximately one week during embryologic development. Rarely, it may persist into adulthood and may be encountered during cerebrovascular operations. We report a 76-year-old woman with a persistent hypoglossal artery and a symptomatic internal carotid stenosis treated successfully by carotid endarterectomy. A discussion of the embryology, radiology, and operative pitfalls follows. PMID- 2775641 TI - Liver abscess following superior mesenteric artery revascularization for acute mesenteric ischemia. AB - A case of pyogenic liver abscess following successful mesenteric artery revascularization is described in a patient with acute mesenteric ischemia. Prior to revascularization, arteriography confirmed celiac and superior mesenteric artery occlusion. Occurrence of liver abscess is explained on the basis of ischemia impairing the barrier function of the intestinal mucosa, contributing to portal bacteremia that seeds ischemic or necrotic liver. In patients with acute mesenteric ischemia, sequential sonographic examination of the liver following mesenteric revascularization is advocated for early diagnosis of liver abscess if there is clinical evidence of the sepsis. PMID- 2775642 TI - Can HLA-DR expression help in the routine diagnosis of malignant melanomas? AB - Two monoclonal antibodies, TAL-IB5 and LN3, directed at epitopes of HLA-DR were applied to a variety of benign naevi and malignant melanomas. Of the 31 naevi examined, 28 were completely unreactive. Weak staining was confined to a few cells in two intradermal naevi and there was more widespread reactivity in a halo naevus. Seven of the 25 primary cutaneous malignant melanomas were reactive with one or both of the antibodies and this reactivity was more marked in the deeper lesions. These positive cases were not felt to present diagnostic difficulties and it was concluded that TAL-IB5 and LN3 were not of use in distinguishing between benign and malignant melanocytic proliferations. PMID- 2775643 TI - Failure of a helium-neon laser to affect components of wound healing in vitro. AB - The red light of a helium-neon (He-Ne) laser has been reported to stimulate wound healing and cell growth. To investigate the nature of its influence on wound healing we have studied seven components of the healing process in vitro: human skin fibroblast, epithelial and endothelial cell proliferation, cellular migration from skin explants, collagen lattice contraction, collagen synthesis and glycosaminoglycans (GAG) secretion. We used a 5 mW He-Ne laser emitting a I mm diameter beam of wavelength 633 nm. Cellular proliferation was not affected by irradiation three times a day for 3 days. There was no effect on cellular migration or on the rate of collagen lattice contraction. The rate of collagen synthesis, measured as the incorporation of 3H-proline into collagenase-sensitive protein, was no greater than that of controls and GAG secretion did not increase in the irradiated group. We have not found any significant effects of He-Ne irradiation. PMID- 2775644 TI - Onchodermatitis--correlation between skin disease and parasitic load in an endemic focus in Ecuador. AB - Onchocerciasis is a chronic parasitic infection in which infiltration of the skin by microfilariae has been associated with a number of different pathological changes. This survey compared the prevalence of different forms of skin disease in two villages, one of which was located within the endemic zone for onchocerciasis (Zapallo Grande), in a lowland rain forest area of western Ecuador. The commonest skin diseases in both villages were scabies, pyoderma and pityriasis versicolor. In addition changes closely correlated with the presence of microfilariae in skin snips were found in Zapallo Grande--such as atrophic gluteal changes, and acute and chronic papular dermatitis. The only other skin disease associated with onchocerciasis was widespread tinea corporis due to T. rubrum. The Amerindians in the endemic onchocerciasis area were more likely than Negroes to have generalized atrophic changes of the skin, whereas in the latter group significant numbers of individuals had no obvious skin lesions but large numbers of microfilariae were detected in skin snips. Acute papular dermatitis was common in both groups and in biopsied lesions microfilariae could usually be identified within the epidermis or close to the dermo-epidermal junction. One patient had developed severe reactive onchodermatitis (Sowda). Swabs taken from onchocercal skin lesions showed no evidence of skin surface carriage of Staphylococcus aureus. Changes classically associated with onchocerciasis such as pretibial hypopigmentation (leopard skin) and hanging groin were notably absent in this population. PMID- 2775645 TI - Psychological disabilities amongst patients with port wine stains. AB - In a questionnaire study to assess psychological disabilities in 110 patients with port wine stains, 71 completed questionnaires were analysed. The questionnaire revealed a high level of psychological morbidity resulting from a feeling of stigmatization amongst these patients that was not apparent in casual social intercourse. In contrast, standard psychological screening tests for psychiatric illness, depression or anxiety revealed that these patients had similar or less evidence of morbidity than controls or other patient groups. It would appear that patients with port wine stains suffer a considerable degree of psychological morbidity which they suppress. This may be related to a need to hide their port wine stain. PMID- 2775646 TI - Histology of port wine stains after copper vapour laser treatment. AB - We report histological changes in four patients with port wine stains treated with 578 nm yellow light from a high power copper vapour laser. Histology showed that selective damage occurred to the ectatic blood-vessels in the dermis, without haemorrhage and damage to non-vascular structures, and without scarring. The initial damage to the overlying epidermis was not permanent, and the damaged ectatic vessels returned to normal size or were completely necrosed and replaced by collagen. PMID- 2775647 TI - Clinical observations on delayed pressure urticaria. AB - Repeated pressure tests at regular intervals were carried out on 48 patients with delayed pressure urticaria (DPU). Patients showed a considerable variation in response with periods of positive testing ranging from a few days to months or years. All the DPU patients had had chronic urticaria and/or angio-oedema although sometimes minor and occasional. Pressure tests were also carried out at regular intervals on seven patients with chronic urticaria who had weals at pressure sites but no history of pressure-induced weals (Kobner weals). These weals coincided with positive pressure tests and it seems likely that they all had DPU but only for a short time. Delayed dermographism was studied in eight patients with DPU. There was a good correlation in time and degree between positive pressure tests and delayed dermographism, confirming that delayed dermographism is in fact DPU provoked by a slightly different mode of pressure. PMID- 2775648 TI - Cholinergic pruritus, erythema and urticaria: a disease spectrum responding to danazol. AB - Cholinergic pruritus and cholinergic erythema are relatively rare conditions believed to represent variants of cholinergic urticaria. We report an extremely severe and unusual case demonstrating features of both these variants before evolving into more classical cholinergic urticaria. This strongly supports the view that all three syndromes are variations of the same disease. This case demonstrated a dramatic symptomatic response to danazol which has not previously been reported. PMID- 2775649 TI - Skin pigmentation associated with minocycline therapy. AB - A patient on long-term minocycline therapy developed blue-black discoloration on the legs. Skin biopsy specimens from the pigmented areas were examined by light and electron microscopy and energy-dispersive X-ray microanalysis. Pigmented granules were present at all levels of the dermis and subcutaneous fat tissues. Ultrastructural examination showed electron-dense granular material within the cytoplasm of dermal macrophages and energy-dispersive X-ray microanalysis indicated that the granules contained iron. Thyroid tissue obtained by aspiration biopsy showed the presence of fine brown granules within the cytoplasm of the follicular epithelial cells. An extract of skin from the pigmented areas was subjected to high performance liquid chromatography and minocycline was detected. PMID- 2775650 TI - Acrodermatitis chronica atrophicans with coexisting morphoea. AB - We report a case of acrodermatitis chronica atrophicans with coexisting morphoea in a British native. PMID- 2775651 TI - Epidermal MHC class II antigen expression in systemic sclerosis. PMID- 2775653 TI - British Association of Dermatologists, sixty-ninth annual meeting. 5-8 July 1989, Cambridge. Summaries of papers. PMID- 2775652 TI - Reticulate hyperpigmentation distributed in a zosteriform fashion. PMID- 2775654 TI - A flow cytometric assay for the determination of cell proliferation with a monoclonal antibody directed against DNA-methyltransferase. AB - The enzyme DNA-methyltransferase is responsible for the methylation of a newly synthesized DNA-strand. A monoclonal antibody directed against DNA methyltransferase was used to determine cell proliferation by means of flow cytometry. The reactivity of DNA-methyltransferase antibody was compared with the known proliferation markers transferrin-receptor and Ki67. All three methods showed comparable reactivity with the erythroblastic cell line K562 (86%, 81%, 76% respectively). In a second set of experiments peripheral blood mononuclear cells were stimulated with phytohaemagglutinin; in three experiments, a mean of 63% of the cells reacted with DNA-methyltransferase antibody after 72 h of culture as compared to a mean of 6% in the case of unstimulated control cells. HL60 cells were incubated with DMSO and harvested on day 5 of culture. The results obtained show that in differentiated cells the fraction positive with DNA methyltransferase antibody decreased to levels below 10%. It is concluded that the technique described is a fast and easy method for the flow cytometric determination of cellular proliferation. PMID- 2775655 TI - The inhibitory effect of serum from hairy-cell leukaemia patients on normal progenitor cells may disappear following prolonged treatment with alpha interferon. AB - The possibility that serum from hairy-cell leukaemia (HCL) patients at diagnosis may show an inhibitory effect on the in vitro colony growth of normal haemopoietic progenitor cells has been suggested. Several studies have documented the efficacy of alpha-Interferon (alpha-IFN) in inducing a complete restoration of peripheral blood values and, in some cases, a complete clinical remission. In this study we have evaluated the regulatory effect of serum, collected before and after 3 and 12 months of alpha-IFN treatment, from 10 patients with untreated HCL, on the in vitro growth of normal bone marrow CFU-GM, BFU-E and CFU-MK. The effect of conditioned media, prepared from enriched hairy cells (HC) cultured in synthetic medium, on the growth of normal haemopoietic progenitors was also investigated. The results obtained confirm that sera from untreated HCL patients display a variable degree of inhibitory activity in the progenitor cell compartments analysed. Disappearance of the inhibitory activity, particularly evident for the erythroid compartment, was found only in patients who displayed a disappearance of circulating HC and a good haematological response after prolonged (12 months) treatment with alpha-IFN. The possibility that the serum of patients with HCL may contain a haemopoietic inhibitory factor, released by the neoplastic HC population, is suggested. PMID- 2775656 TI - A new prognostic system for multiple myeloma based on easily available parameters. AB - The prognostic significance of different presenting features in 180 patients with multiple myeloma (MM) from a single institution was analysed. Out of eight variables isolated from the univariate analysis only two (blood urea and serum albumin), were significant in the multivariate model. Derived from these two simple variables, the relative risk of each patient was calculated, and subsequently two subpopulations of patients could be recognized. The first group included patients with a very active myeloma and a high risk of death soon after diagnosis, their median survival being of only 11.6 months, and the second one comprised patients with low risk of death during the first year and a median survival of 28 months. A hazard function derived from two-thirds of the patient population (training group) was successfully validated in the remaining subset of patients (test group). Finally, the three major available myeloma staging systems (Durie & Salmon's, Merlini et al's, and the one proposed by the British Medical Research Council) were tested in the present series, and only the latter one showed prognostic validity. PMID- 2775657 TI - The application of X-chromosome gene probes to the diagnosis of myeloproliferative disease. AB - X-chromosome DNA probes for the phosphoglycerate kinase (PGK) and hypoxanthine phosphoribosyl transferase (HPRT) genes were used to study clonality in haemopoietic cells from 63 women with myeloproliferative disease, idiopathic erythrocytosis, secondary erythrocytosis or normal red cell volumes. A total of 25 women (39%) were heterozygous for one of the polymorphisms associated with these genes. Clonality was demonstrated in five out of six patients with polycythaemia vera (PV) and in three other patients with myeloproliferative disease. In all cases of PV, including the patient in whom clonality was not demonstrated, cultures of peripheral blood showed growth of endogenous erythroid colonies. PMID- 2775658 TI - Acquired Zwa antigen on Zwa negative platelets demonstrated by western blotting. AB - Zwa-negative platelets that had been incubated in random donor AB plasma for several hours and subsequently cryopreserved, were found to be Zwa-positive when tested 3 years later by Western blotting. Following this serendipitous observation, we demonstrated that the Zwa antigen could be passively adsorbed onto the membrane of Zwa-negative platelets incubating for 4 h in the plasma from Zwa-positive donors. This observation supports the hypothesis that passive acquirement of Zwa antigens is a pathogenic mechanism for inducing post tranfusion purpura, and suggests that Zwa-negative platelets should not be stored in Zwa-positive plasma before transfusion. PMID- 2775659 TI - A plasma inhibitor of platelet aggregation in patients with Lassa fever. AB - Previous studies have shown that haemorrhage in Lassa fever is associated with abnormal in vitro platelet aggregation and a high mortality. In Sierra Leone we studied platelet aggregation in healthy local subjects, patients with laboratory confirmed Lassa fever and febrile patients in whom Lassa virus infection was excluded. There were no significant differences in the mean platelet counts of these groups. Patients with fulminant Lassa virus infection showed a gross depression of in-vitro platelet responsiveness to 1 and 5 microM ADP and 4 micrograms/ml collagen compared to other groups (P = 0.0004-0.0008 when compared to healthy controls, P = 0.002-0.0008 when compared to mild Lassa fever patients). When plasma samples from five of these patients were mixed 1:1 with control platelet-rich plasma, a marked inhibition of ADP-induced aggregation was observed. No inhibitory activity was detected in plasma obtained from healthy subjects or febrile control patients. The presence of inhibitor was strongly associated with the occurrence of haemorrhage (P = 0.03), depression of platelet aggregation (P = 0.004) and severity of Lassa fever (P = 0.007). PMID- 2775660 TI - Factor IX Cardiff: a variant factor IX protein that shows abnormal activation is caused by an arginine to cysteine substitution at position 145. AB - Crude barium chloride eluates prepared from 12 unrelated patients with cross reacting material positive (CRM+) haemophilia B were activated with celite eluate, the reaction products resolved after reduction by 13% SDS-PAGE, and factor IX antigenic material detected by probing with radiolabelled immunopurified rabbit anti-factor IX antiserum followed by autoradiography. Out of the 12, one sample showed faulty activation with the production of a stable reaction product with a MW compatible with that of a putative light chain activation intermediate. In order to confirm this, two oligonucleotide primers that bracketed exon 6 of the factor IX gene were constructed and used to prime a polymerase chain reaction on DNA isolated from the patient's peripheral blood leucocytes. A single 489 nucleotide DNA fragment was obtained, gel purified, subcloned into M13, and DNA sequencing carried out on both strands. A single C to T transition was discovered that changed the Arg residue at position 145, the first residue of the first bond in the activation peptide, to a Cys, a result that confirmed the inferences drawn from the activation studies. PMID- 2775661 TI - Complement sensitivity of erythroblasts and erythropoietic precursors in paroxysmal nocturnal haemoglobinuria (PNH). AB - To clarify the regulation of erythropoiesis of complement (C')-sensitive erythrocytes (E) during erythroid cell maturation and differentiation in paroxysmal nocturnal haemoglobinuria (PNH), the C' sensitivity of (1) erythroblasts from erythropoietic bursts and (2) erythropoietic precursors was examined in seven patients with PNH. For the former, a modified complement lysis sensitivity (CLS) test using the trypan blue dye exclusion method was employed. For the latter, an erythropoietic cell culture following the CLS or sucrose haemolysis (SH) test for mononuclear cells was used. Linear relationships were found between the concentrations of C' and proportions of C'-mediated haemolysed erythroblasts in both PNH and normal erythropoietic bursts. In addition, PNH erythroblasts showed hypersensitivity to C'; in the C' dilution for 50% lysis was 12.5 +/- 8.1 ml in PNH patients and 42.3 +/- 4.5 ml in normal controls. There was also a significant correlation (r = 0.919; P less than 0.01) between the proportions of PNH-III E and haemolysed erythroblasts. Significant hypersensitivity of mature erythroid progenitors (CFU-E) to C' was found in both the SH (P less than 0.01 or P less than 0.05) and CLS (r = -0.712; P less than 0.001) tests in PNH patients. However, no hypersensitivity to C' was observed at the primitive erythroid progenitors (BFU-E) level in either the PNH patients or the normal controls. These findings suggest that in PNH the property of C' sensitivity appears during differentiation and maturation from BFU-E to CFU-E and that the proportions of PNH-III E are already programmed at the level of erythroblasts. PMID- 2775662 TI - Cutaneous vasculitis after intermediate dose of methotrexate (IDMTX). PMID- 2775663 TI - Antibodies to glycosaminoglycans and cardiolipin in patients with chronic myeloid leukaemia. PMID- 2775664 TI - Spontaneous remission in a patient with chronic myeloid leukaemia. PMID- 2775665 TI - Deletions of chromosome 7 short arm in myeloid diseases. PMID- 2775667 TI - The minor head injury. PMID- 2775666 TI - Ring eosinophils in human haematological malignancies. PMID- 2775668 TI - Informational needs of patients who undergo excision of an acoustic neuroma. AB - Individuals who undergo removal of an acoustic neuroma are usually apprehensive in spite of the intrinsically benign nature of the disease. Fears surrounding the experience are related to the real risks involved in surgery near the brain and the complications which can ensue. The intensity of the patients' feelings of anxiety and uncertainty might be decreased if nurses were aware of and attended to the informational needs of these patients. In order to describe the informational needs of acoustic neuroma patients, a retrospective survey of 21 subjects who had had removal of such a tumor six to eighteen months previously was carried out. The survey determined: (1) the type of information patients received preoperatively and postoperatively (2) the type of information patients wanted (3) the type of problems experienced postoperatively and (4) the length and severity of the problems if they occurred. Content analysis indicated that the majority of subjects experienced tiredness, depression, headache, and dryness of eyes and mouth in the postoperative and convalescent phases. The actual illness experience persisted much longer than the subjects had expected. Subjects expressed explicit informational needs related to self-management after the surgery. The implications for nursing care will be discussed and the recommendations for an interdisciplinary patient education programme will be outlined. PMID- 2775669 TI - Emergency nursing priorities of the head injured patient. AB - The first priority in any emergency is always an adequate airway. The nurse is involved in clearing the mouth, inserting an oral airway, assisting with intubation, oxygen therapy and assessing continually the patient's respiratory system. The nurse must also monitor the patient's vital signs, administer intravenous fluids appropriately along with medications, insert foley catheters and note urinary output. Simultaneously, the nurse constantly observes the patient's level of consciousness and neurological status. This information must be documented carefully by the nurse amidst all this apparent chaos. This can be done only when good assessment skills, combined with knowledge of diagnosis, treatment and appropriate nursing intervention, aid the Emergency Nurse in setting priorities in the Emergency care of the head injured patient. PMID- 2775670 TI - Cancer and other mortality patterns among United States furniture workers. AB - Cause specific mortality was investigated among 36,622 members of a national furniture workers' union who were first employed in unionised shops between 1946 and 1962. Overall mortality for each race and sex group was less than expected when compared with United States death rates (white men SMR = 0.8, black men SMR = 0.7, white women SMR = 0.8, black women SMR = 0.5); however, raised risks were observed among white men employed in specific types of furniture industries and followed up for 20 or more years after first employment. Lymphatic and haematopoietic cancers were significantly raised (SMR = 1.8) among wood furniture workers followed up for at least 20 years due to excess deaths from leukaemia (SMR = 2.0) and non-Hodgkin's lymphoma (SMR = 2.0). Mortality from acute myeloid leukaemia was particularly high in this group (SMR = 4.7) based on six observed cases. Metal furniture workers followed up for at least 20 years experienced a significant excess of all cancers combined (SMR = 1.6), with non-significant increases in cancers of the lung, stomach, and colorectum. This group also had non-significant excesses of liver cirrhosis, arteriosclerotic heart disease, and cerebrovascular disease. Nasal cancer was not found to be significantly raised in this cohort, though the average follow up period may not have been sufficient to detect an excess risk for this uncommon tumour. PMID- 2775672 TI - Ecological analyses and case-control studies of gastric cancer and leukaemia in relation to DBCP in drinking water in Fresno County, California. AB - Through ecological analyses and case-control studies, the possible relation of gastric cancer and leukaemia to dibromochloropropane (DBCP) contamination of drinking water in Fresno County, California, has been examined. The ecological analyses examined the correlation between gastric cancer and leukaemia (including the lymphatic varieties), mortality rates, and DBCP concentrations in drinking water by census tract in Fresno County, 1960-83. No correlation was found between gastric cancer or leukaemia and DBCP. The gastric cancer case-control study consisted of 263 deaths from gastric cancer in the county, 1975 to mid-1984, and 1044 controls, using information on residential history and occupation of both cases and controls. Analyses were based on residence at death, as well as one and ten years before death. The case-control study did not find any relation between gastric cancer and DBCP in drinking water. Hispanics in the county were found to experience a relative risk of gastric cancer of 2.77, compared with non Hispanics. A similar case-control study consisting of 259 cases of leukaemia and 1161 controls found no relation between all leukaemia or lymphatic leukaemia and DBCP in drinking water. Farm workers, however, do appear to have an increased risk of leukaemia. PMID- 2775671 TI - Malignant lymphomas and occupational exposures. AB - The effects of potential risk factors for Hodgkin's disease (HD) and for non Hodgkin lymphomas (NHL) were evaluated in a case-referent study encompassing 54 cases of HD, 106 cases of NHL, and 275 referents, all alive. Exposure information was obtained by questionnaires posted to the subjects. Crude rate ratios were increased for various occupational exposures including solvents, welding, wood preservatives, phenoxy acids, and fresh wood (sawmill workers, lumberjacks, paper pulp workers). After further analyses based on logistic regression occupational exposures to welding and creosote remained as significant risk factors for HD. For NHL, occupational exposures to solvents, phenoxy acids, and creosote but also work as carpenter or cabinet maker and contacts with pets (other than dogs, cats, and birds) were associated with significantly increased risks. PMID- 2775673 TI - Deaths from asphyxiation and poisoning at work in the United States 1984-6. AB - A review of 4756 deaths investigated by the Occupational Safety and Health Administration (OSHA) in 1984-6 found 233 deaths from asphyxiation and poisoning, excluding asphyxiations from trench cave-ins. The highest rates were in the oil and gas industry and in utilities. Toxic gases were the largest group (65) followed by simple asphyxiants (48), mechanical causes (42), and solvents (35). Deaths from solvents were significantly more likely in young workers. Nine deaths were caused by improper air supply to respirators and five by recreational inhalation of gas or vapours. Of the 146 deaths in confined spaces, only 12% were in rescuers, fewer than previously reported. PMID- 2775674 TI - Variability in biological monitoring of organic solvent exposure. II. Application of a population physiological model. AB - A physiological population model is used to study the variability associated with the biological monitoring of solvent exposure. The model consists of a combination of a physiological compartmental model and statistical simulation technique. Variable components considered are: exposure concentration, physical workload, body build, liver function, and renal function. The model is applied to six solvents: trichloroethylene, tetrachloroethylene, methylchloroform, benzene, toluene, and styrene. Biological indicators and air monitoring are compared as predictors of exposure, both external and internal (uptake, brain concentration, reactive metabolite formation). It appears that the choice of the best indicator depends on the type of exposure which is to be predicted. The effects of the various factors, environmental, physiological, or metabolic, are quantified and discussed. It is shown that fluctuation in exposure plays a large part in the final variability of biological indicator results. Further improvements and applications of this population model are considered. PMID- 2775676 TI - Diurnal variation in peak expiratory flow rate among grain elevator workers. AB - The diurnal variation (DV) in peak expiratory flow rate (PEFR) has been studied among 132 grain elevator workers who accomplished three daily measurements of PEFR during three weeks. DV was calculated as the difference between the highest and the lowest PEFR as a percentage of the mean PEFR on each day. For the whole group the median was 5.9%. DV was higher among smokers and among workers with work related pulmonary symptoms. Analysis of variance showed that only age (p = 0.012) and smoking (p = 0.016) had a significant effect on DV. Pulmonary symptoms, total IgE, and duration of occupation had no independent impact on DV, whereas the exposure level of grain dust tended (p = 0.082) to have an independent effect. Twelve workers had an abnormally high DV (greater than 20%), of whom seven showed no signs of obstructive respiratory disease by spirometry. If only a single spirometric test had been performed the tentative diagnosis of bronchial asthma could have been missed in these seven workers. PMID- 2775675 TI - Excretion of 1,2,4-benzenetriol in the urine of workers exposed to benzene. AB - Urine samples were collected from 152 workers (64 men, 88 women) who had been exposed to benzene, 53 workers (men only) exposed to a mixture of benzene and toluene, and 213 non-exposed controls (113 men, 100 women). The samples were analysed for 1,2,4-benzentriol (a minor metabolite of benzene) by high performance liquid chromatography. The time weighted average solvent exposure of each worker was monitored by diffusive sampling technique. The urinary concentration of 1,2,4-benzentriol related linearly to the intensity of exposure to benzene both in men and women among workers exposed to benzene, and was suppressed by toluene co-exposure among male workers exposed to a mixture of benzene and toluene. A cross sectional balance study in men at the end of the shift of a workday showed that only 0.47% of benzene absorbed will be excreted into urine as 1,2,4-benzenetriol, in close agreement with previous results in rabbits fed benzene. The concentration of 1,2,4-benzenetriol in urine was more closely related to the concentration of quinol than that of catechol. The fact that phenol and quinol, but not catechol, are precursors of 1,2,4-benzentriol in urine was further confirmed by the intraperitoneal injection of the three phenolic compounds to rats followed by urine analysis for 1,2,4-benzenetriol. PMID- 2775677 TI - Correspondence between neurological symptoms and outcome of quantitative sensory testing in the hand-arm vibration syndrome. AB - To evaluate neurological symptoms in the vibration syndrome, 55 patients with vascular and neurological symptoms in the hand who had been exposed to vibration were examined. Their exposure to vibration was estimated and neurological vascular symptoms were evaluated according to symptom scales. Temperature thresholds were measured on the right thenar eminence and on the distal volar aspect of the second and third fingers held together on both sides. Vibration thresholds were measured dorsally on the second and fifth metacarpal bones and on the second and fifth fingers proximal to the nail roots. Subjects with advanced neurological symptoms had higher temperature and vibration thresholds than subjects with less advanced symptoms. No such relation was found between vascular symptoms and the outcome of sensory testing. Thus neurological but not vascular symptoms are reflected by the outcome of quantitative sensory testing. In subjects with advanced neurological symptoms the tests gave a high proportion of abnormal results, indicating that these tests may be used for the diagnosis of vibration syndrome on an individual basis. Patients with advanced vascular and neurological symptoms had higher exposure dose scores than patients with less advanced symptoms, indicating a dose response relation between vibration "dose" and neurological and vascular symptoms. PMID- 2775679 TI - Cancer mortality in the asphalt industry: a ten year follow up of an occupational cohort. AB - A historical cohort study was conducted to study the possible risk of cancer associated with exposure to asphalt. Altogether 1320 unskilled workers employed in the asphalt industry were followed up over a ten year period and compared with 43,024 unskilled men in terms of cause specific mortality. Both groups were identified from census records and followed up by an automatic record link that had been established previously between the census register, National Register, and Death Certificate Register. The cancer mortality was significantly increased in asphalt workers aged 45 or more, when five years' latency from enrolment into the study was allowed for (SMR for cancer: 159, 95% confidence interval: 106 228). Non-significant increases were seen for respiratory, bladder, and digestive cancers but a significant increase was seen for brain cancer (SMR = 500, 95% CI: 103-1461). Components of asphalt fumes may have been important to the observed association between risk of cancer and employment in the asphalt industry. PMID- 2775678 TI - Transitory postural vasomotor dysfunction in the finger after short term hand vibration. AB - The transitory effects of hand vibration (ah, w = 3.16 m/s2 during three minutes) on postural vasomotor functions of skin capillary blood flow rate in the finger were studied by the local 133xenon washout technique in ten men with vibration induced white finger (VWF), nine men professionally exposed to hand-arm vibration but without finger symptoms (HAV), and eight male controls (MC). The following postural vasomotor functions were measured: (a) the vasomuscular, non-neurogenic autoregulation, tested by raising the finger 20 cm; (b) the local venoarteriolar vasoconstrictor axon reflex, tested by lowering the finger 40 cm; and (c) the central sympathetic vasoconstrictor reflex elicited by central baroreceptors and tested by changing the body posture from supine to sitting upright. Before short term vibration the vasoconstriction elicited by central baroreceptors was increased in VWF (p less than 0.01) and normal in HAV (p greater than 0.10). The local axon reflex and the autoregulation functioned normally in VWF and HAV (p greater than 0.30). Three minutes after vibration, autoregulation was abolished and the functions of the central and local sympathetic vasoconstrictor reflexes were equally impaired in all three groups (p less than or equal to 0.01). All three vasomotor functions were completely restored 60 minutes after vibration in MC (p greater than 0.10) and also 30 minutes after vibration in one male control (p greater than 0.20). The results indicate a hyperreactivity of the central sympathetic nervous system in VWF, and a transitory, impaired function of digital arterioles after short term vibration in all groups. PMID- 2775681 TI - Influence of design characteristics on the outcome of retrospective cohort studies. PMID- 2775680 TI - Prenarcotic and neuraesthenic symptoms among Dutch workers exposed to organic solvents. AB - A population of 379 Dutch workers exposed to organic solvents was compared with a non-exposed population of 443 workers with regard to the prevalence of prenarcotic and neuraesthenic symptoms. Participants completed a questionnaire to collect information about their occupational history, exposure to organic solvents, and the occurrence of symptoms. The results of the study indicated that workers exposed to solvents have a higher reporting rate of prenarcotic symptoms than workers not exposed to solvents. The prevalence of chronic neurotoxic effects, however, in the form of neuraesthenic symptoms was only weakly associated with reported exposure to organic solvents. The influence of work stress in the development of these symptoms is perhaps more important than the role of exposure to organic solvents. It is concluded that the organic solvent syndrome type I, as defined by an international workshop, is not an important health hazard among Dutch painters. PMID- 2775682 TI - Endometrioid carcinoma of the ovary: an unusual cause of postpartum collapse. Case report. PMID- 2775683 TI - A two-dimensional self-retaining vaginal retractor for high obstetric trauma. PMID- 2775684 TI - Is it time to review antenatal screening for syphilis? PMID- 2775685 TI - The role of postoperative alkylating agent therapy in early-stage epithelial ovarian cancer. PMID- 2775686 TI - Revised FIGO staging for gynaecological cancer. PMID- 2775687 TI - Establishment of 22 pregnancies after oocyte and embryo donation. AB - Donated oocytes inseminated with partner's semen or donated embryos were transferred on 95 occasions in 28 women without ovarian function and in 21 with functional ovaries. Overall, 22 pregnancies were established, 13 after the transfer of fresh embryos and nine after the transfer of frozen-thawed embryos. Eleven of the pregnancies were established in women without ovarian function and 11 in women with functional ovaries. Nine of the pregnancies were established with donated oocytes inseminated with partner's semen and 13 with donated embryos. Fifteen healthy infants were born including one set of twins; three pregnancies are progressing normally and five miscarried. PMID- 2775688 TI - Morphometric differences between the placental vasculature of non-smokers, smokers and ex-smokers. AB - The aim of this study was to determine whether cigarette smoking during pregnancy has an adverse effect upon the placenta's capacity for gaseous exchange. Using recently developed stereological techniques, in conjunction with perfusion fixation, computer-assisted measurements were made on the placentas of 15 non smokers, 15 moderate smokers, 15 heavy smokers and 13 ex-smokers, 7 of whom stopped smoking during the course of the pregnancy. Compared with the placentas of non-smokers and of those who stopped before pregnancy, it was found that the placentas of smokers and of those who stopped after conception exhibited a reduced capillary volume fraction, and an increased thickness of the villous membrane. Although they must impair gaseous exchange across the placenta, these changes were less severe than suggested by previously published reports. Nonetheless it is clear that in order to prevent these changes women should stop smoking before conception rather than during the course of a pregnancy. PMID- 2775689 TI - Hysteroscopic endometrial ablation with the neodymium-YAG laser. AB - Over the past 3 years a series of patients referred to the gynaecological department at Stobhill Hospital with menorrhagia have been treated, as an alternative to hysterectomy, by endometrial ablation with the neodymium-YAG laser. The results in the first 25 patients with a follow-up of over 6 months are presented. The overall success rate was only 52%, but by increasing the power output of the laser energy used to 80 W the rate of success increased to 83%. Of the 25 patients 13 were selected for laser treatment because hysterectomy was considered unsuitable on account of obesity or medical and surgical conditions; the other 12 wanted to avoid a hysterectomy. The technique and its problems are discussed. PMID- 2775690 TI - Uterine activity during spontaneous labour after previous lower-segment caesarean section. AB - Uterine activity was measured in three groups of labouring women who previously had a caesarean section (CS): group A included women with a previous elective CS before labour or in the early latent phase of labour and no previous vaginal delivery; group B included women with a CS in the active phase of labour and no previous vaginal delivery; group C included women with a CS and a vaginal delivery either before or after the abdominal delivery. The active contraction area profiles in the three groups were compared with those of matched control groups of nulliparae and multiparae without a uterine scar. Group A had a uterine activity profile similar to that in control nulliparae and significantly higher than that in control multiparae. The uterine activity in group B was less than that in matched nulliparae but was similar to that in matched multiparae. Group C had significantly less uterine activity than matched nulliparae but a similar profile to that in the matched multiparae. Progress of labour into the active phase in the previous pregnancy reduces the uterine activity profile in subsequent labour. Women who had had a vaginal delivery either before or after the CS (group C) exhibited uterine activity profiles similar to multiparae, suggesting that an intact scar did not affect the uterine function. PMID- 2775691 TI - Oxytocin augmentation in dysfunctional labour after previous caesarean section. AB - Uterine activity was quantified in women with a previous caesarean scar and a slow progress of labour who needed oxytocin augmentation. Of the 63 women 49 (78%) progressed well (mean cervical dilatation rate of 1.5 cm/h) and were delivered vaginally. Fourteen women had slow progress of labour (0.3 cm/h) and were delivered by caesarean section despite adequate and similar augmented uterine activity to that in the women who were delivered vaginally. Those who were delivered by caesarean section had a significantly higher mean maximum dose of oxytocin and a longer period of augmentation. All caesarean sections were for cephalopelvic disproportion and the mean birthweight of babies born by caesarean section (3598 g) was significantly higher than that of babies born vaginally (3230 g). Satisfactory rate of cervical dilatation in the presence of optimal uterine activity is predictive of favourable outcome when oxytocin is used for dysfunctional labour after previous caesarean section. PMID- 2775692 TI - Pregnancy following simple repair of the ruptured gravid uterus. AB - Eighteen pregnancies, occurring in 15 patients in whom a simple repair of a ruptured gravid uterus had been performed previously, are reviewed. Seventeen of these had a successful outcome. There was no case of recurrent rupture. PMID- 2775693 TI - Amniotomy-induced labour is not mediated by endogenous oxytocin. AB - A technique for complete oxytocinase inhibition has been combined with a rapid serial sampling strategy to determine the plasma oxytocin concentration in eight women undergoing amniotomy for the induction of labour at term and in eight control women. Amniotomy was not associated with an increase in plasma oxytocin concentration. Furthermore, the concentrations were not increased for 20 min following the procedure. Labour was not established in any patient by the end of the 30-min study period. PMID- 2775694 TI - Growth hormone 24-h serum profiles during pregnancy--lack of pulsatility for the secretion of the placental variant. AB - Serum profiles of growth hormone (GH) were recorded for 24 h in women at different stages of normal pregnancy. Two monoclonal antibodies directed against different epitopes and unaffected by human placental lactogen were used in radioimmunoassays to distinguish the pituitary 22K-GH from the placental GH variant. The 'normal' episodic peak activity of GH in non-pregnant and first trimester pregnant women was dramatically changed into a continuous very stable secretion during late pregnancy. This change was first observed at 17 weeks gestation. It is concluded that during the second half of pregnancy, serum measurements of GH reflect a major contribution from a non-episodically secreted placental GH variant and a concomitant suppression of pituitary GH. This specific signal, i.e. a continuous GH secretion, may be an important regulator of maternal liver metabolism during pregnancy. PMID- 2775695 TI - The action of squatting in the early postnatal period marginally increases pelvic dimensions. AB - X-ray pelvimetry was performed on 43 women in the squatting and erect positions within 1 week of delivery. The act of squatting increased the transverse and antero-posterior pelvic dimensions by 1%. The theoretical mechanisms by which posture may affect dimensions are discussed. PMID- 2775697 TI - Neutrophil activation in pregnancy-induced hypertension. AB - Human neutrophil elastase may be a major mediator of vascular damage and could contribute to the vascular damage seen in women with pregnancy-induced hypertension (PIH). Elevated plasma levels of this substance will reflect neutrophil activation in vivo. To determine neutrophil activation in PIH, we studied 30 normal non-pregnant women, 32 women with normal pregnancies, 19 with mild/moderate PIH and 16 with severe PIH between 28 and 39 weeks gestation. Plasma neutrophil elastase was measured by radioimmunoassay. There was a significantly higher concentration of plasma neutrophil elastase in both mild/moderate and severe PIH than in normotensive pregnancies and this may contribute to the vascular lesion associated with PIH. Concentrations were also significantly higher in normal pregnancy than in non-pregnant women which suggests that neutrophil activation and degranulation are increased in normal pregnancy. PMID- 2775696 TI - Oral contraceptive steroids and breast secretions. AB - Breast secretions were obtained by nipple aspiration from 164 (44.7%) of 368 consecutive premenopausal non-pregnant women volunteers attending family planning clinics. Women currently taking oral contraceptive steroids were significantly less likely to yield breast secretions than women who had never taken such preparations. The effect was confined to parous women of whom 94% not taking oral contraceptives yielded breast secretions compared with only 51% currently using the pill and 60% of those with a previous history of use. The percentage of nulliparous women yielding breast secretions (30%) was significantly less than that in parous women and was not affected by a present or previous history of contraceptive steroid use. These results provide further evidence of the difference in hormone responsiveness of parous and nulliparous breasts and the potential of oral contraceptive steroids to influence breast function. PMID- 2775698 TI - The Stamey operation for correction of genuine stress incontinence in the elderly woman. AB - Forty-four elderly women underwent the Stamey procedure for urethral sphincter incompetence; six had coincidental detrusor instability. All had pre- and postoperative urodynamic assessment. At follow-up, 15 patients continued to complain of stress incontinence and 11 of urge incontinence. Overall, 27 patients still had objective evidence of genuine stress incontinence, and 15 had evidence of detrusor instability. Although the operation has minimal operative and postoperative morbidity, we do not consider its success rate satisfactory for use in the elderly. PMID- 2775699 TI - The effect of maternal bladder volume on fundal height measurements. AB - The effect of maternal bladder volume on fundal height measurements was studied in 200 non-obese Black women between 16 and 42 weeks gestation. Fundal height measurements were obtained by the same examiner immediately before and immediately after each subject voided. Examiners were blinded to fundal height measurements and the amount of urine voided. Prevoid fundal height measurements were significantly larger than postvoid fundal height measurements. The differences between pre- and postvoid fundal height measurements varied from -2.8 to 4.6 cm (mean 0.63 cm, SD 1.26). Postvoid fundal height measurements were smaller than the prevoid measurements in 69.5% of the women, and 34.5% of the differences were greater than 1.0 cm. Women who had voided within 30 min before measurement had significantly smaller differences between pre- and postvoid fundal height measurements (n = 20, mean 0.16, SD 1.22) than women who voided more than 30 min before measurement (n = 179, mean 0.68, SD 1.27). These findings indicate that women should be instructed to void within 30 min before fundal height measurements are obtained. PMID- 2775700 TI - Needle aspiration of simple ovarian cysts in pregnancy. Case reports. PMID- 2775701 TI - Darier's disease localized to the vulva. Case report. PMID- 2775702 TI - Progressive development of supernumerary teeth in cleidocranial dysplasia. AB - A 9-year-old boy suffering from cleidocranial dysplasia presented with multiple unerupted permanent teeth and five unerupted supernumerary teeth. During a 4-year observation and treatment period he developed nine more supernumerary teeth at a time when normally new teeth would no longer be forming. By the age of 13 years and 5 months a total of fourteen supernumerary teeth had been produced and it is possible that more teeth may develop in the future. PMID- 2775703 TI - The effects of social class on the uptake of orthodontic treatment. AB - The relationship between social class and uptake of orthodontic treatment was investigated in a longitudinal cohort study of 1018 children living in South Glamorgan, Wales. Previous studies have shown that working class people make less use of dental services and receive inferior dental care than middle class people. The present investigation examined the role of one factor which appears likely to contribute to this effect: namely, the uptake of orthodontic treatment by families from different social classes. If a significant association were shown then findings relating to the effectiveness of orthodontic treatment might be confounded by this social class factor. PMID- 2775704 TI - I know where I'm going. Do you? PMID- 2775705 TI - Present and future place in orthodontics for the basic removable appliance. PMID- 2775706 TI - Orthodontic band cements. PMID- 2775707 TI - Orthodontics in West Germany. PMID- 2775708 TI - Vertical parallax radiology to localize an object in the anterior part of the maxilla. AB - An evaluation has been made of four techniques of assessing, from radiographs, the position of unerupted maxillary teeth, using radio-opaque markers placed in various positions on the maxilla of a dried skull. Application of the parallax principle in a vertical plane, for which only two radiographs are needed, was found to produce as many correct conclusions as other methods. PMID- 2775709 TI - The closure of residual extraction spaces by means of traction screws: a report of two cases. AB - In those cases judged to be suitable for treatment by extractions in both arches and the use of upper removable appliances alone, the closure of excess residual space relies on mesial drift of the buccal segments. If opposing residual spaces are unequal in extent, there is a risk that space closure will be incomplete. Two cases are presented where a removable appliance was used to move a buccal segment mesially using a traction screw, and thereby close the excess residual space. PMID- 2775710 TI - Effect of ischemia on NMR detection of phosphorylated metabolites in the intact rat heart. AB - Phosphorus NMR spectroscopy is an important technique for the investigation of metabolism in tissues and intact organisms (including man). However, quantitation of the signals from an NMR experiment is difficult because it is not known from which regions of a cell metabolites are detected. It is generally believed that only metabolites free in the cytosol are observed. In this study a comparison of concentration measurements obtained by NMR and after freeze extraction was made in the normoxic and ischemic rat heart. The influence of ischemia was examined because of its potential effect on the level of phosphate metabolites in various compartments. The same fraction of ATP always appears visible to NMR, whereas inorganic phosphate is largely NMR invisible until after a period of ischemia and the phosphomonoesters are only partially observed early in ischemia. PMID- 2775711 TI - Human aldehyde dehydrogenase: coenzyme binding studies. AB - The binding of NADH and NAD+ to the human liver cytoplasmic, E1, and mitochondrial, E2, isozymes at pH 7.0 and 25 degrees C was studied by the NADH fluorescence enhancement technique, the sedimentation technique, and steady-state kinetics. The binding of radiolabeled [14C]NADH and [14C]NAD+ to the E1 isozyme when measured by the sedimentation technique yielded linear Scatchard plots with a dissociation constant of 17.6 microM for NADH and 21.4 microM for NAD+ and a stoichiometry of ca. two coenzyme molecules bound per enzyme tetramer. The dissociation constant, 19.2 microM, for NADH as competitive inhibitor was found from steady-state kinetics. With the mitochondrial E2 isozyme, the NADH fluorescence enhancement technique showed only one, high-affinity binding site (KD = 0.5 microM). When the sedimentation technique and radiolabeled coenzymes were used, the binding studies showed nonlinear Scatchard plots. A minimum of two binding sites with lower affinity was indicated for NADH (KD = 3-6 microM and KD = 25-30 microM) and also for NAD+ (KD = 5-7 microM and KD = 15-30 microM). A fourth binding site with the lowest affinity (KD = 184 microM for NADH and KD = 102 microM for NAD+) was observed from the steady-state kinetics. The dissociation constant for NAD+, determined by the competition with NADH via fluorescence titration, was found to be 116 microM. The number of binding sites found by the fluorescence titration (n = 1 for NADH) differs from that found by the sedimentation technique (n = 1.8-2.2 for NADH and n = 1.2-1.6 for NAD+).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2775712 TI - In vitro dissociation and reassociation of human alcohol dehydrogenase class I isozymes. AB - Freezing (-78 degrees C) and thawing (25 degrees C) a heterodimeric human alcohol dehydrogenase class I isozyme in the presence of 0.1 M sodium phosphate/0.1 mM DTT, pH 7.0, and the subsequent separation of the scrambled isozymes by HPLC are used to prepare homodimers from heterodimers, with recovery of enzyme activity ranging from 80 to 95%. The ratio of the three isozymes obtained from a heterodimer follows the binomial distribution of 1:2:1, indicating random reassociation of the two subunits. The physical and enzymatic properties of the reassociated isozymes are the same as those obtained directly from human liver preparations. The nature of subunit-subunit interactions of human ADH class I isozymes is examined by optimizing the conditions required for the formation of the new dimers "in vitro". The effect of a number of reagents previously used in the reversible dissociation of dehydrogenases is investigated. The coenzyme NAD+ is a potent inhibitor of the dissociation of dimers during the freeze/thaw procedure. The presence of sodium phosphate in the enzyme solution is essential during the freezing and thawing experiment. No appreciable dissociation/reassociation occurs in TES, HEPES, or even potassium phosphate. The reversible dissociation is due primarily to the decrease in pH because of the low solubility of Na2HPO4 at low temperatures. The reassociation occurs after thawing in a temperature-dependent process. There is no reactivation if the enzyme is incubated at 0 degrees C after thawing, while at 25 degrees C high recovery in activity is achieved in a time period ranging from 15 to 90 min.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2775713 TI - Detection of intermediates in the unfolding transition of phosphoglycerate kinase using limited proteolysis. AB - The accessibility of peptide bonds to cleavage by Staphylococcus aureus V8 protease bound on a Sepharose matrix was used as a conformational probe in the study of the unfolding-folding transition of phosphoglycerate kinase induced by guanidine hydrochloride. It was shown that the protein is resistant to proteolysis below a denaturant concentration of 0.4 M. The transition curve, determined by susceptibility toward proteolysis, was similar to that obtained following the enzyme activity [Betton et al. (1984) Biochemistry 23, 6654-6661]. Proteolysis under conditions where the folding intermediates are more populated, i.e., 0.7 M Gdn.HCl, gave two major fragments of Mr 25K and 11K, respectively. The 25K polypeptide fragment was identified as the carboxy-terminal domain. Its conformation was similar to that of a folding intermediate trapped at a critical concentration of denaturant, and in this form, it was not able to bind nucleotide substrates [Mitraki et al. (1987) Eur. J. Biochem. 163, 29-34]. From the present data and those previously reported, we concluded that the intermediate detected on the folding pathway of phosphoglycerate kinase has a partially folded carboxy terminal domain and an unfolded amino-terminal domain. PMID- 2775715 TI - Thermal stabilities of globular proteins. AB - Statistical thermodynamic theory has recently been developed to account for the stabilities of globular proteins. Here we extend that work to predict the dependence on temperature. Folding is assumed to be driven by solvophobic interactions and opposed by the conformational entropy. The temperature dependence of the solvophobic interaction is taken from the transfer experiments on amino acids by Tanford and Nozaki and on model solutes by Gill and Wadso. One long-standing puzzle has been why proteins denature upon heating, since the solvophobic force to fold strengthens with increasing temperature. This is resolved by the theory, which predicts two first-order phase transitions. "Cold denaturation" is driven principally by the weakening of the solvophobic interaction, but normal denaturation is driven principally by the gain of conformational entropy of the chain. Predictions of the thermodynamic state functions are in reasonable agreement with the calorimetric experiments of Privalov and Khechinashvili. Comparison of the theory with experiments suggests that there may be an additional enthalpic driving force toward folding which is not due to the solvophobic interactions. PMID- 2775714 TI - Modification of two peptides of bacteriorhodopsin with a pentaamminecobalt (III) complex. AB - Bacteriorhodopsin (bR) was regenerated from the cation-depleted blue membrane with pentaammineaquocobalt(III) tetrafluoroborate [( Co(NH3)5H2O]3+[BF4-]3). Illumination of the sample with orange light decreased the extinction at 568 nm concomitantly with a hypsochromic shift of the absorption maximum. The photocycle of this sample was inhibited, and the rate of proton pumping was reduced. Chymotryptic cleavage of the corresponding apomembrane into the two fragments C1 and C2 and their subsequent separation revealed that cobalt label is only attached to C1. The maximal incorporation of Co into this peptide was 0.3 Co/C1. After cleavage of C1 with cyanogen bromide and subsequent proteolysis with trypsin and chymotrypsin, this modification could be associated with peptides from cyanogen bromide fragments 6 and 9. The sequences were determined to be 101Val-Asp-Ala-Asp-Gln and 228Ala-Ile-Phe-Gly-Glu-Ala-Glu-Ala. These peptides contain the sequences Asp-Ala-Asp and Glu-Ala-Glu, respectively, which might be constituents of the same cation binding site. The observation that the incorporation of Co into bacteriorhodopsin is enhanced under illumination with orange light indicates that this site might be involved in the proton uptake. PMID- 2775716 TI - Diffusion of small molecules through the structure of myoglobin. Environmental effects. AB - The effect of the ambient solvent viscosity on the mobility of small molecules within myoglobin was studied by substituting Zn-protoporphyrin (ZnPP) for the native Fe-protoporphyrin and using it as an optical probe in the protein (ZnPPMb). The quenching of the ZnPPMb triplet state by oxygen, by anthraquinonesulfonate, and by methyl viologen was followed by exciting it with a laser flash and measuring its decay rate as a function of quencher concentration. The quenching rate constants were taken to measure the diffusion rate of the quencher within the protein. At room temperature, these constants were determined in aqueous and in 37% and 55% (by weight) glycerol-water solutions by measuring the ZnPPMb-delayed fluorescence at 606 nm. It was found that although the quenching rate constants varied the activation energies in the protein were very similar for the different quenchers. In aqueous solution, Ea = 6.0-7.4 kcal/mol; in 37% glycerol, Ea = 6.8-7.5 kcal/mol; and in 55% glycerol, Ea = 8.5-9.2 kcal/mol. The quenching rate of ZnPPMb by oxygen was also measured between 190K and 293K in 80% glycerol, and its triplet decay in the absence of oxygen was determined down to 120K in 88% glycerol. In all experiments, the quenching rates in the protein were compared to those of Zn-hematoporphyrin in the same solvent. The results are discussed in terms of Northrup and McCammon's gated reaction theory.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2775717 TI - Semisynthetic hemoglobin A: reconstitution of functional tetramer from semisynthetic alpha-globin. AB - The optimal conditions for the semisynthesis of alpha-globin through Staphylococcus aureus V8 protease condensation of a synthetic fragment (alpha 1 30) with the complementary apo fragment (alpha 31-141) in the presence of structure-inducing organic cosolvents and the reconstitution of the functional tetramer from semisynthetic alpha-globin have been investigated. The protease catalyzed ligation of the complementary apo fragments alpha 1-30 and alpha 31-141 proceeds with very high selectivity at pH 6.0 and 4 degrees C in the presence of 1-propanol as the organic cosolvent. A 30% 1-propanol solution was optimal for the semisynthetic reaction, and the synthetic reaction attained an equilibrium (approximately 50%) in 72 h. The synthetic reaction proceeds smoothly over a wide pH range (pH 5-8). Besides, the semisynthetic system is flexible, and it also proceeded well if trifluoroethanol or 2-propanol was used instead of 1-propanol. However, glycerol, a versatile organic cosolvent used in all other proteosynthetic reactions reported in the literature, was not very efficient as an organic cosolvent in the present synthetic reaction. The semisynthetic alpha globin prepared with 1-propanol as the organic cosolvent has been reconstituted into HbA. The semisynthetic HbA was then purified by CM-cellulose chromatography. The semisynthetic HbA is indistinguishable from native HbA, in terms of its structural and functional properties. The semisynthetic approach provides the flexibility in protein engineering studies for the incorporation of spectroscopic labels (13C- and/or 15N-labeled amino acids), noncoded amino acids, or unnatural bond functionalities, which at present is not possible with genetic approaches. PMID- 2775718 TI - Mossbauer spectroscopic study of the initial stages of iron-core formation in horse spleen apoferritin: evidence for both isolated Fe(III) atoms and oxo bridged Fe(III) dimers as early intermediates. AB - Ferritin stores iron within a hollow protein shell as a polynuclear Fe(III) hydrous oxide core. Although iron uptake into ferritin has been studied previously, the early stages in the creation of the core need to be clarified. These are dealt with in this paper by using Mossbauer spectroscopy, a technique that enables several types of Fe(II) and Fe(III) to be distinguished. Systematic Mossbauer studies were performed on samples prepared by adding 57Fe(II) atoms to apoferritin as a function of pH (5.6-7.0), n [the number of Fe/molecule (4-480)], and tf (the time the samples were held at room temperature before freezing). The measurements made at 4.1 and 90 K showed that for samples with n less than or equal to 40 at pH greater than or equal to 6.25 all iron was trivalent at tf = 3 min. Four different Fe(III) species were identified: solitary Fe(III) atoms giving relaxation spectra, which can be identified with the species observed before by EPR and UV difference spectroscopy; oxo-bridged dimers giving doublet spectra with large splitting, observed for the first time in ferritin; small Fe(III) clusters giving doublets of smaller splitting and larger antiferromagnetically coupled Fe(III) clusters, similar to those found previously in larger ferritin iron cores, which, for samples with n greater than or equal to 40, gave magnetically split spectra at 4.1 K. Both solitary Fe(III) and dimers diminished with time, suggesting that they are intermediates in the formation of the iron core. Two kinds of divalent iron were distinguished for n = 480, which may correspond to bound and free Fe(II). PMID- 2775719 TI - Solution structures of alpha-conotoxin G1 determined by two-dimensional NMR spectroscopy. AB - Two-dimensional NMR data have been used to generate solution structures of alpha conotoxin G1, a potent peptide antagonist of the acetylcholine receptor. Structural information was obtained in the form of proton-proton internuclear distance constraints, and initial structures were produced with a distance geometry algorithm. Energetically more favorable structures were generated by using the distance geometry structures as input for a constrained energy minimization program. The results of both of these calculations indicate that the overall backbone conformation of the molecule is well-defined by the NMR data whereas the side-chain conformations are generally less well-defined. The main structural features derived from the NMR data were the presence of tight turns centered on residues Pro5 and Arg9. The solution structures are compared with previous proposed models of conotoxin G1, and the NMR data are interpreted in conjunction with chemical modification studies and structural properties of other antagonists of the acetylcholine receptor to gain insight into structure-activity relationships in these peptide toxins. PMID- 2775720 TI - Characterization of lens alpha-crystallin tryptophan microenvironments by room temperature phosphorescence spectroscopy. AB - Room temperature phosphorescence techniques were used to study the structural and dynamic features of the tryptophan residues in bovine alpha-crystallin. Upon excitation at 290 nm, the characteristic signature of tryptophan phosphorescence was observed with an emission maximum at 442 +/- 2 nm. The phosphorescence intensity decay was biphasic with lifetimes of 5.4 ms (71%) and 42 ms (29%). Phosphorescence quenching measurements strongly suggest that each component corresponds to one class of tryptophans with the more buried residues having the longer emission lifetime. Three small-molecule quenchers were surveyed, and in order of increasing quenching efficiency: iodide less than nitrite less than acrylamide. A heavy-atom effect was observed in iodide solutions, and an upper limit of 5% was placed on the quantum yield of triplet formation in iodide-free solutions, while the phosphorescence quantum yield was estimated to be approximately 3.2 x 10(-4). The temperature dependence of the phosphorescence lifetime was measured between 5 and 40 degrees C. Arrhenius plots exhibited discontinuities at 26 and 29 degrees C for the short- and long-lived components, respectively, corresponding to abrupt transitions in segmental flexibility. Denaturation studies revealed conformational transitions between 1 and 2 M guanidine hydrochloride, and 4 and 6 M urea. Long-lived phosphorescence lifetimes of 3 and 7 ms were measured in 6 M guanidine hydrochloride and 8 M urea, respectively, suggesting that some structural features are preserved even at very high concentrations of denaturant. Our studies demonstrate the sensitivity of room temperature phosphorescence spectroscopy to the structure of alpha crystallin, and the applicability of this technique for monitoring conformational changes in lens crystallin proteins.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2775721 TI - Role of glycosylation on the conformation and chain dimensions of O-linked glycoproteins: light-scattering studies of ovine submaxillary mucin. AB - The effect of carbohydrate on the conformation and chain dimensions of mucous glycoproteins was investigated by using light-scattering and circular dichroism studies of native, asialo, and deglycosylated (apo) ovine submaxillary gland mucin (OSM). OSM is a large glycoprotein that is extensively O-glycosylated by the disaccharide alpha-NeuNAc(2-6)alpha-GalNAc-O-Ser/Thr. Measurements of root mean square radius of gyration, (Rg2)1/2, and hydrodynamic radius, Rh, for OSM and its derivatives were carried out as a function of molecular weight by using static and dynamic light-scattering techniques. The results were fit to the wormlike chain model for describing the dimensions of extended polymer chains. By use of this model, values of h, the length per amino acid residue, and q, the persistence length, which is a measure of chain stiffness, were obtained. These values were then used to assess the conformation and degree of chain extension of intact OSM and its partially and totally deglycosylated derivatives. Native and asialo mucin are found to be highly extended random coils, with asialo mucin having a somewhat less extended structure than intact mucin. Upon the complete removal of the carbohydrate side chains, the extended structure characteristic of intact and asialo mucin collapses to chain dimensions typical of denatured globular proteins. Conformational analyses based on the rotational isomeric state model were also performed by using the probability maps of N-acetyl-O-(GalNAc) Thr-N-methylamide as starting conformations for native and asialo mucin. The results suggest that both the glycosylated and nonglycosylated residues in native mucin may occupy a small region of conformational space having -90 degrees less than phi less than -60 degrees and 60 degrees less than psi less than 180 degrees, while a slightly broader range is found to fit asialo mucin. The proposed conformations obtained for these mucins are consistent with their circular dichroism spectra. Significantly larger ranges of phi and psi values were obtained for apo mucin, as would be expected from its circular dichroism spectra and increased flexibility. These results indicate the expanded mucin structure is the direct result of peptide core glycosylation. These observations together with the results of earlier studies indicate that steric interactions of the O-linked GalNAc residue with the peptide core are primarily responsible for the expanded mucin structure and that these perturbations extend to the nonglycosylated amino acid residues. This expanded mucin conformation must be a significant determinant of the viscoelastic properties of these molecules in solution. PMID- 2775722 TI - Effects of glycosylation on the conformation and dynamics of O-linked glycoproteins: carbon-13 NMR studies of ovine submaxillary mucin. AB - Carbon-13 NMR spectroscopic studies of native and sequentially deglycosylated ovine submaxillary mucin (OSM) have been performed to examine the effects of glycosylation on the conformation and dynamics of the peptide core of O-linked glycoproteins. OSM is a large nonglobular glycoprotein in which nearly one-third of the amino acid residues are Ser and Thr which are glycosylated by the alpha Neu-NAc(2-6)alpha-GalNAc- disaccharide. The beta-carbon resonances of glycosylated Ser and Thr residues in intact and asialo mucin display considerable chemical shift heterogeneity which, upon the complete removal of carbohydrate, coalesces to single sharp resonances. This chemical shift heterogeneity is due to peptide sequence variability and is proposed to reflect the presence of sequence dependent conformations of the peptide core. These different conformations are thought to be determined by steric interactions of the GalNAc residue with adjacent peptide residues. The absence of chemical shift heterogeneity in apo mucin is taken to indicate a loss in the peptide-carbohydrate steric interactions, consistent with a more relaxed random coiled structure. On the basis of the 13C relaxation behavior (T1 and NOE) the dynamics of the alpha carbons appear to be unique to each amino acid type and glycosylation state, with alpha-carbon mobilities decreasing in the order Gly greater than Ala = Ser greater than Thr much greater than monoglycosylated Ser/Thr approximately greater than disaccharide linked Ser/Thr.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2775723 TI - Roles of colchicine rings B and C in the binding process to tubulin. AB - The interactions of tubulin with colchicine analogues in which the tropolone methyl ether ring had been transformed into a p-carbomethoxybenzene have been characterized. The analogues were allocolchicine (ALLO) and 2,3,4-trimethoxy-4' carbomethoxy-1,1'-biphenyl (TCB), the first being transformed colchicine and the second transformed colchicine with ring B eliminated. The binding of both analogues has been shown to be specific for the colchicine binding site on tubulin by competition with colchicine and podophyllotoxin. Both analogues bind reversibly to tubulin with the generation of ligand fluorescence. The binding of ALLO is slow, the fluorescence reaching a steady state in the same time span as colchicine; that of TCB is rapid. The displacement of ALLO by podophyllotoxin proceeds with a half-life of ca. 40 min. Binding isotherms generated from gel filtration and fluorescence measurements have shown that both analogues bind to tubulin with a stoichiometry of 1 mol of analogue/mol of alpha-beta tubulin. The equilibrium binding constants at 25 degrees C have been found to be (9.2 +/- 2.5) x 10(5) M-1 for ALLO and (1.0 +/- 0.2) X 10(5) M-1 for TCB. Binding of both analogues was accompanied by quenching of protein fluorescence, perturbation of the far-ultraviolet circular dichroism of tubulin, and induction of the tubulin GTPase activity, similarly to colchicine binding. Both inhibited microtubule assembly in vitro, ALLO substoichiometrically, and both induced the abnormal cooperative polymerization of tubulin, which is characteristic of the tubulin colchicine complex. Analysis in terms of the simple bifunctional ligand binding mechanism developed for colchicine [Andreu, J.M., & Timasheff, S.N. (1982) Biochemistry 21, 534-543] and comparison with the binding of the colchicine two ring analogue, 2-methoxy-5-(2,3,4-trimethoxyphenyl)-2,4,6-cycloheptatrien-1-one [Andreu, J. M., Gorbunoff, M. J., Lee, J. C., & Timasheff, S. N. (1984) Biochemistry 23, 1742-1752], have shown that transformation of the tropolone methyl ether part of colchicine into p-carbomethoxybenzene weakens the standard free energy of binding to tubulin by 1.4 +/- 0.1 kcal/mol, while elimination of ring B weakens it by 1.0 +/- 0.1 kcal/mol. The roles of rings C and B of colchicine in the thermodynamic and kinetic mechanisms of binding to tubulin were analyzed in terms of these findings. PMID- 2775724 TI - Identification of the cysteine residue of beta-tubulin alkylated by the antimitotic agent 2,4-dichlorobenzyl thiocyanate, facilitated by separation of the protein subunits of tubulin by hydrophobic column chromatography. AB - The mechanism of action of the antimitotic drug 2,4-dichlorobenzyl thiocyanate (DCBT) has been examined in detail. Shown in previous studies to inhibit tubulin polymerization [Abraham, I., Dion, R. L., Duanmu, C., Gottesman, M. M., & Hamel, E. (1986) Proc. Natl. Acad. Sci. U.S.A. 83, 6839-6843] and to form a covalent bond preferentially with beta-tubulin [Bai, R., Duanmu, C., & Hamel, E. (1989) Biochim. Biophys. Acta 994, 12-20], DCBT has now been documented to interact at low concentrations with a high degree of specificity at cysteine residue 239 of beta-tubulin. These low DCBT concentrations also result in the partial inhibition of tubulin polymerization. Such findings strongly indicate that cysteine-239 of beta-tubulin is essential for microtubule assembly. Although alpha-tubulin is alkylated almost as well as beta-tubulin when the drug:tubulin ratio = 5:1 (Bai et al., 1989), beta-tubulin is alkylated about 25 times as extensively as alpha tubulin, almost exclusively at Cys-239, when the drug:tubulin ratio = 1:5. In addition, we find that low concentrations of DCBT do not affect the binding of colchicine to tubulin but that colchicine and related compounds do reduce the alkylation of tubulin by DCBT. This suggests that Cys-239 of beta-tubulin is not involved in the binding of colchicine to tubulin but that this amino acid residue is at least partially masked by the drug when it is bound to the protein. We also describe a column chromatography procedure (hydrophobic chromatography on decylagarose) useful for the preparative resolution of unalkylated, although denatured, alpha- and beta-tubulin. PMID- 2775725 TI - Activation energy of the slowest step in the glucose carrier cycle: break at 23 degrees C and correlation with membrane lipid fluidity. AB - Glucose transport in the rat erythrocyte is subject to feedback regulation by sugar metabolism at high but not at low temperatures [Abumrad et al. (1988) Biochim. Biophys. Acta 938, 222-230]. This indicates that temperature, which is known to alter membrane fluidity, also alters sensitivity of transport to regulation. In the present work, we have investigated a possible correlation between the effects of temperature on rate-limiting steps of glucose transport and on membrane fluidity. The dependences of methylglucose efflux and influx on cis and trans methylglucose concentrations were studied at temperatures between 17 and 37 degrees C. Membrane fluidity was monitored over the same temperature range by using electron paramagnetic resonance spectroscopy. External sugar did not affect efflux, and the Km and Vmax of sugar exit were respectively the same as the Km and Vmax of equilibrium exchange. These Km's were relatively temperature independent, but the Vmax's increased sharply with temperature. The Km and Vmax of methylglucose entry were respectively much lower than the Km and Vmax of exit and exchange. Consistent with the above, intracellular sugar greatly enhanced sugar influx, and did so by increasing the influx Vmax without affecting the influx Km. Both lines of evidence indicated that the conformational change of the empty sugar-binding site from in-facing to out-facing orientation is the rate limiting step of sugar entry into the rat erythrocyte. This was the case at all temperatures; however, the discrepancies of coefficients declined significantly with increasing temperature.2+ The temperature dependence of the slowest step (change from in- to out-facing empty carrier) was evaluated.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2775726 TI - Osmoelastic coupling in biological structures: a comprehensive thermodynamic analysis of the osmotic response of phospholipid vesicles and a reevaluation of the "dehydration force" theory. AB - A comprehensive thermodynamic analysis of the osmotic response of phospholipid vesicles is presented, using the Gibbs free energy of a vesicle suspension including the elastic contribution of the bilayer membrane. The results indicate that, in addition to the hydrostatic pressure difference across the membrane and the interbilayer pressure due to electrostatic repulsion, the elastic pressure arising from the coupling between the osmotic stress and the elasticity of the membrane (osmoelastic coupling) should participate in the osmotic response of phospholipid vesicles. The data of Cowley et al. [Cowley, A. C., Fuller, N. L., Rand, R. P., & Parsegian, V. A. (1978) Biochemistry 17, 3163-3168] and of Parsegian et al. [Parsegian, V. A., Fuller, N., & Rand, R. P. (1979) Proc. Natl. Acad. Sci. U.S.A. 76, 2750-2754] on the osmotic shrinkage of multilayer vesicles are discussed in terms of the elastic pressure and the interbilayer pressure, and the proposed "dehydration force" theory is reevaluated from the viewpoint of the present analysis. PMID- 2775727 TI - Partition behavior of a nonionic detergent, octyl glucoside, between membrane and water phases, and its effect on membrane permeability. AB - The partition equilibrium of an nonionic detergent, octyl glucoside, between the membrane phase and water and the effect of the detergent on the barrier efficiency of the vesicle membrane were studied. When the detergent concentration was lower than 4 mM in the water phase, or a mole fraction of 0.3 in the membrane phase, the partition coefficient of the detergent was independent of the detergent concentration and was 75 M-1. This value was about twice the value predicted from the critical micelle concentration. In this concentration region, the permeability of Cl- was relatively low [(2-5) x 10(-10) cm/s]. When the detergent in the membrane phase exceeded a mole fraction of 0.3, the apparent partition coefficient decreased, and the permeability of Cl- abruptly increased. These observations are explained by the following model: If the effective cross sectional areas of phospholipid molecules and detergent molecules are similar to each other, a detergent molecule in the membrane phase will be surrounded only by phospholipid molecules as long as the mole fraction of the detergent in the membrane phase is below 0.3, and in this condition, the membrane barrier efficiency is high. At a mole fraction higher than 0.3, the detergent molecules come into contact with each other, and the membrane barrier efficiency decreases. PMID- 2775728 TI - Polymorphic phase behavior of lysopalmitoylphosphatidylcholine in poly(ethylene glycol)-water mixtures. AB - The polymorphic phase behavior of 1-palmitoyl-2-lyso-sn-glycero-3-phosphocholine dispersions in excess water has been studied as a function of temperature and poly(ethylene glycol) (PEG) concentration, using proton dipolar-decoupled 31P NMR spectroscopy and turbidity measurements. The phase behavior was found to depend on both lipid concentration and PEG concentration, and most of the NMR experiments were conducted at a lipid concentration of 15 mg/mL. At low PEG concentrations (0-12 wt %), a thermotropic transition occurs at 3-5 degrees C with increasing temperature, from an interdigitated lamellar gel (L beta i) phase to a normal micellar phase. At intermediate PEG concentrations (12-20 wt %), thermotropic transitions take place with increasing temperature, first from the lamellar gel phase to a fluid cubic (Q alpha) phase and then at higher temperatures from the cubic phase to the micellar phase. At intermediate PEG concentrations above the former range (20-30 wt %), thermotropic transitions take place with increasing temperature, first from the lamellar gel phase to the cubic phase, then from the cubic phase to a normal hexagonal (HI) phase, and finally from the hexagonal phase to the micellar phase. At high PEG concentrations (greater than 30 wt %), a thermotropic transition takes place with increasing temperature from the lamellar gel phase directly to the fluid hexagonal phase. At these high PEG concentrations, the micellar phase is not attained within the accessible temperature range (less than or equal to 90 degrees C).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2775730 TI - DNA cross-linking by intermediates in the mitomycin activation cascade. AB - We have assayed the cross-linking of oligonucleotides containing repeated mitomycin-reactive CpG sites in order to assess the factors that enhance activation of the carbamoyl function at C10, yielding efficient mitomycin cross linking. Drugs studied include mitomycin C (MC), N-methylmitomycin A (NMA), and the aziridinomitosene of NMA (MS). Drugs were reduced both by catalytic hydrogenation and by diothionite. We find that cross-linking by fully reduced NMA can be increased severalfold by addition of either excess dithionite reductant or the oxidant FeCl3. Enhancement by FeCl3 is not seen with MC or MS, but excess dithionite increases cross-linking by all three compounds. We explain the action of Fe3+ by postulating production of the semiquinone of the monoadduct of mitomycin reacted at the C1-position; according to this mechanism, departure of the carbamate from C10 is more efficient for the semiquinone than for the hydroquinone. However, our results imply that the hydroquinone can also function as a cross-linking agent. Excess dithionite, beyond that required for stoichiometric reduction, activates the carbamate 2-3-fold for cross-linking. We find that the fully reduced leucoaziridinomitosene is highly unstable in solution, yet it produces efficient cross-liking. Hence, this compound is highly reactive in DNA alkylation and a good candidate for the role of primary alkylating agent. PMID- 2775729 TI - NMR studies of exocyclic 1,N2-propanodeoxyguanosine adducts (X) opposite purines in DNA duplexes: protonated X(syn).A(anti) pairing (acidic pH) and X(syn).G(anti) pairing (neutral pH) at the lesion site. AB - Proton and phosphorus two-dimensional NMR studies are reported for the complementary d(C1-A2-T3-G4-X5-G6-T7-A8-C9).d(G10-T11-A12-C13-A14-C15-A 16-T17 G18) nonanucleotide duplex (designated X.A 9-mer) that contains a 1,N2 propanodeoxyguanosine exocyclic adduct, X5, opposite deoxyadenosine A14 in the center of the helix. The NMR studies detect a pH-dependent conformational transition; this paper focuses on the structure present at pH 5.8. The two dimensional NOESY studies of the X.A 9-mer duplex in H2O and D2O solution establish that X5 adopts a syn orientation while A14 adopts an anti orientation about the glycosidic bond at the lesion site. The large downfield shift of the amino protons of A14 demonstrates protonation of the deoxyadenosine base at pH 5.8 such that the protonated X5(syn).A14(anti) pair is stabilized by two hydrogen bonds at low pH. At pH 5.8, the observed NOE between the H8 proton of X5 and the H2 proton of A14 in the X.A 9-mer duplex demonstrates unequivocally the formation of the protonated X5(syn).A14(anti) pair. The 1,N2-propano bridge of X5(syn) is located in the major groove. Selective NOEs from the exocyclic methylene protons of X5 to the major groove H8 proton of flanking G4 but not G6 of the G4-X5-G6 segment provide additional structural constraints on the local conformation at the lesion site. A perturbation in the phosphodiester backbone is detected at the C13-A14 phosphorus located at the lesion site by 31P NMR spectroscopy. The two dimensional NMR studies have been extended to the related complementary X.G 9-mer duplex that contains a central X5.G14 lesion in a sequence that is otherwise identical with the X.A 9-mer duplex. The NMR experimental parameters are consistent with formation of a pH-independent X5(syn).G14(anti) pair stabilized by two hydrogen bonds with the 1,N2-propano exocyclic adduct of X5(syn) located in the major groove. PMID- 2775731 TI - Changes in chromatin structure during the aging of cell cultures as revealed by differential scanning calorimetry. AB - Nuclei from cultured human cells were examined by differential scanning calorimetry. Their melting profiles revealed four structural transitions at 60, 76, 88, and 105 degrees C (transitions I-IV, respectively). In immortalized (i.e., tumor) cell cultures and in normal cell cultures of low passage number, melting profiles were dominated by the 105 degrees C transition (transition IV), but in vitro aging of normal and Werner syndrome cells was associated with a marked decrease in transition IV followed by an increase in transition III at the expense of transition IV. At intermediate times in the aging process, much DNA melted at a temperature range (95-102 degrees C) intermediate between transitions III and IV, and this is consistent with the notion that aging of cell cultures is accompanied by an increase in single-strand character of the DNA. Calorimetric changes were observed in the melting profile of nuclei from UV-irradiated tumor cells that resembled the age-induced intermediate melting of chromatin. It is suggested that aging is accompanied by an increase in single-stranded character of the DNA in chromatin, which lowers its melting temperature, followed by strand breaks in the DNA that destroy its supercoiling potential. PMID- 2775733 TI - Elementary steps in the formation of horseradish peroxidase compound I: direct observation of compound 0, a new intermediate with a hyperporphyrin spectrum. AB - The reaction of horseradish peroxidase (HRP) with H2O2 has been studied in 50% v/v methanol/water over the 25.0 to -36.0 degrees C temperature range by using the low-temperature stopped-flow technique. All reactions were carried out under pseudo-first-order conditions with [H2O2] much greater than [HRP]. Arrhenius plots for the pseudo-first-order rate constant kobs were linear over the 17.6 to 36.0 degrees C temperature range studied with an activation energy of 4.8 +/- 0.5 kcal/mol. Above 0 degrees C, kobs varies linearly with peroxide concentration. However, saturation kinetics are observed below -16.0 degrees C, indicating that there is at least one reversible elementary step in this reaction. Double reciprocal plots at -26.0 degrees C at pH* 7.3 for the reaction give kappa max(obs) = 163 s-1 and KM = 0.190 mM. Rapid-scan optical studies carried out at 35.0 degrees C with [H2O2] much greater than KM reveal the presence of a transient intermediate referred to as compound 0 whose conversion to compound I is rate limiting. The Soret region of the optical spectrum of compound 0 resembles that of a "hyperporphyrin" with prominent bands near 330 and 410 nm. The temperature dependencies of kappa max(obs) and KM have been measured over the -16.0 to -26.0 degrees C range and give an activation energy for kappa max(obs) of 1.6 +/- 0.7 kcal/mol and an enthalpy of formation for compound 0 of 4.0 +/- 0.7 kcal/mol. PMID- 2775732 TI - Novel inhibitors of human leukocyte elastase and cathepsin G. Sequence variants of squash seed protease inhibitor with altered protease selectivity. PMID- 2775734 TI - Mechanistic studies on beta-ketoacyl thiolase from Zoogloea ramigera: identification of the active-site nucleophile as Cys89, its mutation to Ser89, and kinetic and thermodynamic characterization of wild-type and mutant enzymes. AB - Thiolase proceeds via covalent catalysis involving an acetyl-S-enzyme. The active site thiol nucleophile is identified as Cys89 by acetylation with [14C]acetyl CoA, rapid denaturation, tryptic digestion, and sequencing of the labeled peptide. The native acetyl enzyme is labile to hydrolytic decomposition with t 1/2 of 2 min at pH 7, 25 degrees C. Cys89 has been converted to the alternate nucleophile Ser89 by mutagenesis and the C89S enzyme overproduced, purified, and assessed for activity. The Ser89 enzyme retains 1% of the Vmax of the Cys89 enzyme in the direction of acetoacetyl-CoA thiolytic cleavage and 0.05% of the Vmax in the condensation of two acetyl-CoA molecules. A covalent acetyl-O-enzyme intermediate is detected on incubation with [14C]acetyl-CoA and isolation of the labeled Ser89-containing tryptic peptide. Comparisons of the Cys89 and Ser89 enzymes have been made for kinetic and thermodynamic stability of the acetyl enzyme intermediates both by isolation and by analysis of [32P]CoASH/acetyl-CoA partial reactions and for rate-limiting steps in catalysis with trideuterioacetyl CoA. PMID- 2775735 TI - Histone-histone interaction mediates chromatin unfolding at physiological ionic strength. AB - High-resolution thermal denaturation data on chicken erythrocyte chromatin are reported over 4 orders of magnitude in NaCl concentration which includes the physiological region. A novel technique using critical-point polyacrylamide sols instead of ordinary solvents effectively stabilizes chromatin against precipitation at high salt concentrations. These sols are optically transparent from 260 to 320 nm and are thermally stable over the temperature ranges studied. At Na+ ion concentrations below 10 mM, the polyacrylamide slightly destabilizes chromatin at the nucleosome level, possibly through interactions of histones H1 and H5 with the carboxylic acid residues. At the same low salts, polyacrylamide stabilizes pure DNA against denaturation, presumably by mechanically stabilizing it against helix-distorting thermal fluctuations. In both cases, however, the polyacrylamide sols are entirely noninvasive at higher salts. Prominent low temperature thermal transitions are observed in chromatin at and above 100 mM NaCl which evidently are associated with conformational changes in DNA. Our results are in accord with the idea that histone-histone interactions at physiological ionic strengths (approximately 100 mM Na+) may be comparable to histone-DNA interactions and hence may be sufficient to promote the destabilization of the DNA helix in chromatin under these conditions. The biological implications of this are discussed, and a possible model for the local decondensation of chromatin under physiological conditions is proposed. PMID- 2775736 TI - Structure of an unmodified tRNA molecule. AB - We have used NMR to study the structure of the yeast tRNA(Phe) sequence which was synthesized by using T7 RNA polymerase. Many resonances in the imino 1H- spectrum of the transcript have been assigned, including those of several tertiary interactions. When the Mg2+ concentration is high, the transcript appears to fold normally, and the spectral features of the transcript resemble those of tRNA(Phe). The transcript has been shown to be aminoacylated with kinetics similar to the modified tRNA(Phe) [Sampson, J. R., & Uhlenbeck, O. C. (1988) Proc. Natl. Acad. Sci. U.S.A. 85, 1033-1037], suggesting that the structure of the two molecules must be similar. In the absence of Mg2+ or at [tRNA]:[Mg2+] ratios less than 0.2, the transcript does not adopt the native structure, as shown by both chemical shifts and NOE patterns. In these low Mg2+ conditions, a second GU base pair is found, suggesting a structural rearrangement of the transcript. NMR data indicate that the structure of a mutant having G20 changed to U20 is nearly identical with that of the normal sequence, suggesting that the low aminoacylation activity of this variant is not due to a substantially different conformation. PMID- 2775737 TI - Recognition and repair of 2-aminofluorene- and 2-(acetylamino)fluorene-DNA adducts by UVRABC nuclease. AB - Recognition of damage induced by N-hydroxy-2-aminofluorene (N-OH-AF) and N acetoxy-2-(acetylamino)fluorene (NAAAF) in both phi X174 RFI supercoiled DNA and a linear DNA fragment by purified UVRA, UVRB, and UVRC proteins was investigated. We have previously demonstrated that N-OH-AF and NAAAF treatments produce N (deoxyguanosin-8-yl)-2-aminofluorene (dG-C8-AF) and N-(deoxyguanosin-8-yl)-2 (acetylamino)fluorene (dG-C8-AAF), respectively, in DNA. Using a piperidine cleavage method and DNA sequence analysis, we have found that all guanine residues can be modified by N-OH-AF and NAAAF. These two kinds of adducts have different impacts on the DNA helix structure; while dG-C8-AF maintains the anti configuration, dG-C8-AAF is in the syn form. phi X174 RF DNA-Escherichia coli transfection results indicate that while the uvrA, uvrB, and uvrC gene products are needed to repair dG-C8-AAF, the uvrC, but not the uvrA or uvrB gene products, is needed for repair of dG-C8-AF. However, we have found that in vitro the UVRA, UVRB, and UVRC proteins must work in concert to nick both dG-C8-AF and dG-C8-AAF. In general, the reactions of UVRABC nuclease toward dG-C8-AF are similar to those toward dG-C8-AAF; it incises seven to eight nucleotides from the 5' side and three to four nucleotides from the 3' side of the DNA adduct. Evidence is presented to suggest that hydrolysis on the 3' and 5' sides of the damaged base by UVRABC nuclease is not simultaneous and that at least occasionally hydrolysis occurs only on the 3' side or on the 5' side of the damage site. The possible mechanisms of UVRABC nuclease incision for AF-DNA are discussed. PMID- 2775738 TI - Characterization of a cDNA for rat P-450g, a highly polymorphic, male-specific cytochrome in the P-450IIC subfamily. AB - Cytochrome P-450g (IIC13) is a highly polymorphic, male-specific rat liver isozyme which is a member of the P-450IIC subfamily. A cDNA, c5126 (1737 bp), for P-450g was isolated from a lambda gt11 library synthesized from (+g) male rat liver mRNA. Sequence analysis of the clone, c5126, revealed an open reading frame of 1473 nucleotides, which encodes for a 490 amino acid polypeptide possessing the 30 NH2-terminal residues reported for cytochrome P-450 (M-3) (P-450g) [Matsumoto et al. (1986) J. Biochem. 100, 1359-1371]. A high degree of sequence similarity (greater than 70%) exists between c5126 and the published sequences of cDNAs for members of the IIC subfamily, while its sequence similarity to other subfamilies (IA, IIB, and IIIA) was much lower (less than 55%). RNA blot analysis utilizing an oligonucleotide probe specific for P-450g revealed that P-450g mRNA was expressed in livers of male but not female Sprague-Dawley (CD) and ACI rats, indicating that the sex difference was regulated pretranslationally. Furthermore, expression of P-450g mRNA was age dependent in livers of male ACI rats (a homozygous, phenotypically high P-450g strain). However, the mRNA for P-450g was expressed equally in livers of outbred male CD rats representing either the high (+g) or the low (-g) phenotype and of inbred ACI rats (+g) representing the high phenotype, indicating that the defect in (-g) rats does not reflect differences in expression of P-450g mRNA. PMID- 2775739 TI - Thermodynamic comparison of the base pairs formed by the carcinogenic lesion O6 methylguanine with reference both to Watson-Crick pairs and to mismatched pairs. AB - A set of 10 non-self-complementary nonadeoxyribonucleoside octaphosphates, d(GGTTXTTGG) and d(CCAAYAACC), where X and Y are A, C, G, T, or O6MeG, has been synthesized by a large-scale, automated, phosphoramidite procedure. Purification was effected by reversed-phase HPLC, and the base composition was verified by analytical HPLC after enzymatic degradation to the constituent deoxynucleosides. This set of molecules was designed to allow evaluation of the nearest-neighbor dependence of each base pair. The thermal stability, expressed as Tmax, of each duplex containing one of the O6MeG base pairs, a Watson-Crick pair, or one of the mismatches possible with this set of molecules was determined over a concentration range of 5.7-200 microM. From these data the delta H degree, delta S degree, and delta G degree of each combination were calculated. In general, the relative thermal stabilities observed for the O6-methylguanine combinations confirm our previous findings that the most stable base pair is formed with cytosine rather than thymine and that all O6MeG pairs are much weaker than Watson Crick base pairs [Kuzmich, S., Marky, L. A., & Jones, R. A. (1983) Nucleic Acids Res. 11, 3393-3404; Gaffney, B. L., Marky, L. A., & Jones, R. A. (1984) Biochemistry 23, 5686-5691]. Moreover, the nine combinations containing O6 methylguanine are all of similar thermal stability, cover a much smaller range in Tmax than do the mismatches, and show little sequence dependence. PMID- 2775740 TI - Ca2+ dependence of the distance between Cys-98 of troponin C and Cys-133 of troponin I in the ternary troponin complex. Resonance energy transfer measurements. AB - We have used resonance energy transfer to study the spatial relationship between Cys-98 of rabbit skeletal troponin C and Cys-133 of rabbit skeletal troponin I in the reconstituted ternary troponin complex. The donor was introduced by labeling either troponin C or troponin I with N-(iodoacetyl)-N'-(5-sulfo-1 naphthyl)ethylenediamine, while the acceptor was introduced by labeling either protein with N-[4-(dimethylamino)phenyl-4'-azophenyl]maleimide. The extent of energy transfer was determined by measuring the quenching of the donor fluorescence decay. The results indicate first that the distance between these two sites is not fixed, suggesting that the protein regions involved possess considerable segmental flexibility. Second, the mean distance between the two sites is dependent on the metal-binding state of troponin C, being 39.1 A when none of the metal-binding sites are occupied, 41.0 A when Mg2+ ions bind at the high-affinity sites, and 35.5 A when Ca2+ ions bind to the low-affinity sites. Neither the magnitude of the distances nor the trend of change with metal ions differs greatly when the locations of the probes are switched or when steady state fluorometry was used to determine the transfer efficiency. Since the low affinity sites have been implicated as the physiological triggering sites, our findings suggest that one of the key events in Ca2+ activation of skeletal muscle contraction is a approximately 5-A decrease in the distance between the Cys-98 region of troponin C and the Cys-133 region of troponin I. PMID- 2775742 TI - Enhanced sensitivity to conformation in various proteins. Vibrational circular dichroism results. AB - Vibrational circular dichroism (VCD) spectra of several globular proteins dissolved in D2O are presented and compared to conventional UV-CD results. It can be seen that, for the alpha, beta, and alpha + beta categories of Levitt and Chothia [(1976) Nature 261, 552], VCD evidences much larger band shape variations, including sign alteration, than does UV-CD. A direct parallel is seen between the VCD of the alpha-helix found in model polypeptides and the amide I' VCD of myoglobin. Since all structural aspects of the protein contribute to the VCD on a roughly equal footing, a similar correlation of the chymotrypsin amide I' VCD with that of beta-sheet models is not as clear. In addition, the VCD of "random-coil"-type proteins is found to be clearly related to VCD results from "random-coil" polypeptides. Finally, simulations are presented to postulate the expected VCD for protein structures having conformations that lie between the limiting cases discussed here. PMID- 2775741 TI - Purification and characterization of a calcium-calmodulin-dependent phospholamban kinase from canine myocardium. AB - A Ca2+-calmodulin-dependent protein kinase was purified to apparent homogeneity from the cytosolic fraction of canine myocardium, with phospholamban as substrate. Purification involved sequential chromatography on DEAE-cellulose, calmodulin-agarose, DEAE-Bio-Gel A, and phosphocellulose. This procedure resulted in a 987-fold purification with a 5.4% yield. The purified enzyme migrated as a single band on native polyacrylamide gels, and it exhibited an apparent molecular weight of 550,000 upon gel filtration. Gel electrophoresis under denaturing conditions revealed a single protein band with Mr 55,000. The purified kinase could be autophosphorylated in a Ca2+-calmodulin-dependent manner, and under optimal conditions, 6 mol of Pi was incorporated per mole of 55,000-dalton subunit. The activity of the enzyme was dependent on Ca2+, calmodulin, and ATP.Mg2+. Other ions which could partially substitute for Ca2+ in the presence of Mg2+ and saturating calmodulin concentrations were Sr2+ greater than Mn2+ greater than Zn2+ greater than Fe2+. The substrate specificity of the purified Ca2+ calmodulin-dependent protein kinase for cardiac proteins was determined by using phospholamban, troponin I, sarcoplasmic reticulum membranes, myofibrils, highly enriched sarcolemma, and mitochondria. The protein kinase could only phosphorylate phospholamban and troponin I either in their purified forms or in sarcoplasmic reticulum membranes and myofibrils, respectively. Exogenous proteins which could also be phosphorylated by the purified protein kinase were skeletal muscle glycogen synthase greater than gizzard myosin light chain greater than brain myelin basic protein greater than casein. However, phospholamban appeared to be phosphorylated with a higher rate as well as affinity than glycogen synthase.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2775743 TI - Proton NMR assignments and regular backbone structure of bovine pancreatic ribonuclease A in aqueous solution. AB - Proton NMR assignments have been made for 121 of the 124 residues of bovine pancreatic ribonuclease A (RNase A). During the first stage of assignment, COSY and relayed COSY data were used to identify 40 amino acid spin systems belonging to alanine, valine, threonine, isoleucine, and serine residues. Approximately 60 other NH-alpha CH-beta CH systems were also identified but not assigned to specific amino acid type. NOESY data then were used to connect sequentially neighboring spin systems; approximately 475 of the possible 700 resonances in RNase A were assigned in this way. Our assignments agree with those for 20 residues assigned previously [Hahn, U., & Ruterjans, H. (1985) Eur. J. Biochem. 152, 481-491]. Additional NOESY correlations were used to identify regular backbone structure elements in RNase A, which are very similar to those observed in X-ray crystallographic studies [Wlodawer, A., Borkakoti, N., Moss, D. S., & Howlin, B. (1986) Acta Crystallogr. B42, 379-387]. PMID- 2775744 TI - 1H NMR studies of bovine and porcine phospholipase A2: assignment of aromatic resonances and evidence for a conformational equilibrium in solution. AB - Bovine and porcine pancreatic phospholipases A2, and porcine isophospholipase A2, have been investigated by one- and two-dimensional 1H NMR spectroscopy. Resonances have been assigned for 20-26 residues in each enzyme, including all the aromatic residues, by a strategy based on the semiquantitative comparison of proximity relationships deduced from NOE experiments with those seen in the crystal structure NOE experiments indicate that the loop comprising residues 59 70, which has a different conformation in the crystal structures of the bovine and porcine enzymes, has the same conformation in these two enzymes in solution. Selective changes in the line width of a limited number of resonances as a function of pH, temperature, and calcium concentration provide evidence for a local conformational equilibrium. This equilibrium involves a limited region of the protein structure around residues 25, 41, 106, and 111; it has been identified in the bovine enzyme and porcine isoenzyme but is not apparent in the porcine enzyme. PMID- 2775745 TI - 1H NMR studies of porcine calbindin D9k in solution: sequential resonance assignment, secondary structure, and global fold. AB - The 1H nuclear magnetic resonance (NMR) spectrum of Ca2+-saturated porcine calbindin D9k (78 amino acids, Mr 8800) has been assigned. Greater than 98% of the 1H resonances, including spin systems for each amino acid residue, have been identified by using an approach that integrates data from a wide range of two dimensional scalar correlated NMR experiments [Chazin, Rance, & Wright (1988) J. Mol. Biol. 202, 603-626]. Due to the limited quantity of sample and conformational heterogeneity of the protein, two-dimensional nuclear Overhauser effect (NOE) experiments also played an essential role in the identification of spin systems. On the basis of the pattern of scalar connectivities, 43 of the 78 spin systems could be directly assigned to the appropriate residue type. This provided an ample basis for obtaining the sequence-specific resonance assignments. The elements of secondary structure are identified from sequential and medium-range NOEs, values of 3JNH alpha, and the location of slowly exchanging backbone amide protons. Four well-defined helices and a mini beta sheet between the two calcium binding loops are present in solution. These elements of secondary structure and a few key long-range NOEs provided sufficient information to define the global fold of the protein in solution. Generally good agreement is found between the crystal structure of the minor A form of bovine calbindin D9k and the solution structure of intact porcine calbindin D9k. The only significant difference is a short one-turn helix in the loop between helices II and III in the bovine crystal structure, which is clearly absent in the porcine solution structure. PMID- 2775746 TI - Purple membrane: color, crystallinity, and the effect of dimethyl sulfoxide. AB - In an effort to understand the nature of chromophore-protein interactions in bacteriorhodopsin (bR), we have reinvestigated dimethyl sulfoxide (DMSO)-induced changes in bR [Oesterhelt et al. (1973) Eur. J. Biochem. 40, 453-463]. We observe that dark-adapted bR (bR560) in aqueous DMSO undergoes reversible transformation to a species absorbing maximally at 480 nm (bR480). Beginning at 40% DMSO, this change results in complete conversion to bR480 at 60% DMSO. The kinetics of the reaction reveal that this transformation takes place predominantly through the all-trans isomeric form of the pigment. Thermal isomerization of the 13-cis chromophore to the all-trans form is, therefore, the rate-limiting step in the formation of bR480 from the dark-adapted bR. As in native bR, the chromophore in bR480 is linked to the protein via a protonated Schiff base, and its isomeric composition is predominantly all-trans. The formation of bR480 is associated with minor changes in the protein secondary structure, and the membrane retains crystallinity. These changes in the protein structure result in a diminished chromophore-protein interaction near the Schiff base region in bR480. Thus, we attribute the observed spectroscopic changes in bR in DMSO to structural alteration of the protein. The 13-cis chromophoric pigment appears to be resistant to this solvent-induced change. The changes in the protein structure need not be very large; displacement of the protein counterion(s) to the Schiff base, resulting from minor changes in the protein structure, can produce the observed spectral shift. PMID- 2775747 TI - Interaction of sphingomyelins and phosphatidylcholines with fluorescent dehydroergosterol. AB - The fluorescent sterol dehydroergosterol was used as a cholesterol analogue in conjunction with multifrequency phase and modulation (1-250 MHz) fluorometry to examine whether sterols (1) interact preferentially with fluid- or solid-phase phospholipids and (2) interact preferentially with sphingomyelin in phase separated or phase-miscible cosonicated phospholipid membranes. Cosonicated small unilamellar vesicles (SUV) were produced by mixing lipids in organic solvents, drying the mixture, adding buffer, sonicating, and separating SUV. Phospholipids of synthetic as well as biological origin were utilized. In phase-separated, cosonicated SUV of dimyristoylphosphatidylcholine/distearoylphosphatidylcholine (DMPC/DSPC, 1:1 molar ratio), the fluorescent sterol (0.5 mol %) interacted preferentially with the fluid-phase lipid (partition coefficient, Kf/s = 2.6-3.4) according to four criteria. First, dehydroergosterol detected only the phase transition of DMPC, the phospholipid with the lower phase transition temperature. Second, the dehydroergosterol fluorescence polarization, limiting anisotropy, order parameter, and rotational relaxation time in the cosonicated vesicle were similar to those of dehydroergosterol in SUV composed only of DMPC. Third, the number of dehydroergosterol fluorescence lifetime components as well as the distribution in the cosonicated SUV was similar to that of dehydroergosterol in SUV composed of DMPC. Fourth, dehydroergosterol concentration-dependent self quenching was detected in DSPC SUV at much lower dehydroergosterol concentration than in DMPC SUV. Preference of dehydroergosterol for fluid-phase lipids was also observed by monitoring dehydroergosterol exchange between individually sonicated DMPC SUV and DSPC SUV after the two types of vesicles were mixed in equal proportions. In these SUV mixtures, the dehydroergosterol also partitioned into the more fluid SUV, 99:1.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2775748 TI - Development of a novel photoreactive calmodulin derivative: cross-linking of purified adenylate cyclase from bovine brain. AB - A novel photoreactive calmodulin (CaM) derivative was developed and used to label the purified CaM-sensitive adenylate cyclase from bovine cortex. 125I-CaM was conjugated with the heterobifunctional cross-linking agent p-nitrophenyl 3 diazopyruvate (DAPpNP). Spectral data indicated that diazopyruvoyl (DAP) groups were incorporated into the CaM molecule. Iodo-CaM-DAPs behaved like native CaM with respect to (1) Ca2+-dependent enhanced mobility on sodium dodecyl sulfate polyacrylamide gels and (2) Ca2+-dependent stimulation of adenylate cyclase activity. 125I-CaM-DAP photochemically cross-linked to CaM-binding proteins in a manner that was both Ca2+ dependent and CaM specific. Photolysis of forskolin agarose-purified adenylate cyclase from bovine cortex with 125I-CaM-DAP produced a single cross-linked product which migrates on sodium dodecyl sulfate polyacrylamide gels with an apparent molecular weight of approximately 140,000. PMID- 2775749 TI - Mitochondrial nicotinamide nucleotide transhydrogenase: NADPH binding increases and NADP binding decreases the acidity and susceptibility to modification of cysteine-893. AB - The mitochondrial nicotinamide nucleotide transhydrogenase is a dimeric enzyme of monomer Mr 110,000. It is located in the inner mitochondrial membrane and catalyzes hydride ion transfer between NAD(H) and NADP(H) in a reaction that is coupled to proton translocation across the inner membrane. The amino acid sequence and the nucleotide binding sites of the enzyme have been determined [Yamaguchi, M., Hatefi, Y., Trach, K., & Hoch, J.A. (1988) J. Biol. Chem. 263, 2761-2767; Wakabayashi, S., & Hatefi, Y. (1987) Biochem. Int. 15, 915-924]. N Ethylmaleimide, as well as other sulfhydryl group modifiers, inhibits the transhydrogenase. The presence of NADP in the incubation mixture suppressed the inhibition rate by N-ethylmaleimide, and the presence of NADPH greatly increased it. NAD and NADH had little or no effect. The NADPH effect was concentration dependent and saturable, with a half-maximal NADPH concentration effect close to the Km of the enzyme for NADPH. Study of the effect of pH on the N-ethylmaleimide inhibition rate showed that NADPH binding by the enzyme lowers the apparent pKa of the N-ethylmaleimide-sensitive group by 0.4 of a pH unit and NADP binding raises this pKa by 0.4 of a pH unit, thus providing a rationale for the effects of NADP and NADPH on the N-ethylmaleimide inhibition rate. With the use of N [3H]ethylmaleimide, the modified sulfhydryl group involved in the NADP(H) modulated inhibition of the transhydrogenase was identified as that belonging to Cys-893, which is located 113 residues upstream of the tyrosyl residue modified by [p-(fluorosulfonyl)benzoyl]-5'-adenosine at the putative NADP(H) binding site of the enzyme (see above references).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2775750 TI - Laser flash photolysis studies of the kinetics of reduction of spinach and Clostridium ferredoxins by a viologen analogue: electrostatically controlled nonproductive complex formation and differential reactivity among the iron-sulfur clusters. AB - We have studied the transient kinetics of electron transfer from a positively charged viologen analogue (propylene diquat), reduced by pulsed laser excitation of the deazariboflavin/EDTA system, to the net negatively charged ferredoxins from spinach and Clostridium pasteurianum. Spinach ferredoxin showed monophasic kinetics over the ionic strength range studied, consistent with the presence of only a single iron-sulfur center. Clostridium ferredoxin at low ionic strength showed biphasic kinetics, which indicates a differential reactivity of the two iron-sulfur centers of this molecule toward the electron donor. The kobsd values for the initial fast phase observed with Clostridium ferredoxin were ionic strength dependent, whereas the slow-phase kinetics were ionic strength independent. This correlates with the highly asymmetric charge distribution on the surface of the bacterial protein relative to the two iron-sulfur clusters. The kinetics corresponding to spinach ferredoxin reduction were also ionic strength dependent, and the results obtained with these kinetics and with the fast phase of the bacterial ferredoxin reduction were consistent with a mechanism involving electrostatically stabilized complex formation. For spinach ferredoxin, the second-order rate constant extrapolated to infinite ionic strength was 2-fold smaller, and the extrapolated limiting first-order rate constant was 10-fold smaller, than for Clostridium ferredoxin, indicating a smaller intrinsic reactivity of the spinach protein toward the electron donor. Differences in the rate constant values and the ionic strength dependencies with both ferredoxins are consistent with differences in cluster structure and environment and protein size and charge distribution. For both proteins, the total amount of ferredoxin reduced increased with the ionic strength.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2775751 TI - Refined crystal structure of cytoplasmic malate dehydrogenase at 2.5-A resolution. AB - The molecular structure of cytoplasmic malate dehydrogenase from pig heart has been refined by alternating rounds of restrained least-squares methods and model readjustment on an interactive graphics system. The resulting structure contains 333 amino acids in each of the two subunits, 2 NAD molecules, 471 solvent molecules, and 2 large noncovalently bound molecules that are assumed to be sulfate ions. The crystallographic study was done on one entire dimer without symmetry restraints. Analysis of the relative position of the two subunits shows that the dimer does not obey exact 2-fold rotational symmetry; instead, the subunits are related by a 173 degrees rotation. The structure results in a R factor of 16.7% for diffraction data between 6.0 and 2.5 A, and the rms deviations from ideal bond lengths and angles are 0.017 A and 2.57 degrees, respectively. The bound coenzyme in addition to hydrophobic interactions makes numerous hydrogen bonds that either are directly between NAD and the enzyme or are with solvent molecules, some of which in turn are hydrogen bonded to the enzyme. The carboxamide group of NAD is hydrogen bonded to the side chain of Asn 130 and via a water molecule to the backbone nitrogens of Leu-157 and Asp-158 and to the carbonyl oxygen of Leu-154. Asn-130 is one of the corner residues in a beta-turn that contains the lone cis peptide bond in cytoplasmic malate dehydrogenase, situated between Asn-130 and Pro-131. The active site histidine, His-186, is hydrogen bonded from nitrogen ND1 to the carboxylate of Asp-158 and from its nitrogen NE2 to the sulfate ion bound in the putative substrate binding site. In addition to interacting with the active site histidine, this sulfate ion is also hydrogen bonded to the guanidinium group of Arg-161, to the carboxamide group of Asn-140, and to the hydroxyl group of Ser-241. It is speculated that the substrate, malate or oxaloacetate, is bound in the sulfate binding site with the substrate 1-carboxyl hydrogen bonded to the guanidinium group of Arg-161. PMID- 2775752 TI - Geometry of interaction of metal ions with sulfur-containing ligands in protein structures. AB - An analysis of the geometry of binding of metal ions by cysteine and methionine residues in protein structures has been made by using the Protein Data Bank. Metal ions have a distinct model of binding to each of these residues, and this is independent of the nature of the metal center or the type of protein. Metal ions tend to approach the sulfur of Met roughly 38 degrees from the perpendicular to the plane through atoms C gamma-S delta-C epsilon. For Cys, the approach direction is such that the M...S gamma-C beta-C alpha torsional angle is about +/ 90 or 180 degrees. The side-chain conformation of the cysteine residue is affected by the presence of the metal ion; there is a shift from the g+ conformation toward g- and mainly t conformations. When two Cys residues at positions i-3 and i bind to the same metal center, there appears to be some restriction on the geometry of metal binding by the residue i; for such a residue chi 1 and M...S gamma-C beta-C alpha angles are likely to be around 60 degrees and 270 degrees, respectively. Met and Cys residues coordinating to a metal ion are usually from coil or turn regions of the protein structure. PMID- 2775753 TI - Fluorescence characterization of VU-9 calmodulin, an engineered calmodulin with one tryptophan in calcium binding domain III. AB - Absorption and fluorescence properties of VU-9 calmodulin, an engineered calmodulin in which a tryptophan residue has been introduced in position 99, have been investigated. Tryptophan 99 fluoresces with a maximum around 348 nm and is easily quenched by fluorescence quenchers such as acrylamide, indicating that the chromophore is in a polar environment and well exposed to the solvent, a location which has been reported previously for tyrosine 99 in mammalian calmodulin [Kilhoffer, M. C., Demaille, J. G., & Gerard, D. (1981) Biochemistry 20, 4407 4414]. The quantum yields of tryptophan 99 were found to be 0.19 in the absence of calcium and 0.15 in its presence. These values indicate that the chromophore is in a particular microenvironment where it is protected from the quenching mechanisms normally occurring in proteins. Steady-state fluorescence polarization measurements indicate that the protein exhibits segmental mobility both in the absence and in the presence of calcium. Binding of calcium decreases the mobility of the chromophore, a good indication for a rigidification of the protein structure. A quite rigid structure of at least the carboxy-terminal part of VU-9 calmodulin in the presence of Ca2+ is also suggested by Forster energy-transfer measurements. PMID- 2775754 TI - Time-resolved fluorescence study of VU-9 calmodulin, an engineered calmodulin possessing a single tryptophan residue. AB - An engineered calmodulin (VU-9 calmodulin), which possesses a single tryptophan residue at position 99 in calcium binding domain III, was studied by time resolved fluorescence. At least two exponential terms are needed to describe the tryptophan fluorescence decays, either in the presence or in the absence of calcium. The characteristics of the fluorescence decays are strongly dependent upon the number of calcium ions bound per molecule of VU-9 calmodulin until half of the calcium sites are occupied, i.e., three in the absence of magnesium and two in the presence of 5 mM magnesium. A clear time-dependent spectral shift is observed in the presence of calcium. The existence of an isosbestic point in the time-resolved spectra is in agreement with a two-state model. The biexponential analysis of the 340-nm fluorescence decay during calcium titration gives parameters consistent with a two-state model in which tryptophan 99 interconverts between two different conformations, characterized by a different lifetime value, with rates altered by calcium binding. This model explains the decrease in the protein quantum yield induced by calcium binding [Kilhoffer, M. C., Roberts, D. M. Adibi, A. O., Watterson, D. M., & Haiech, J. (1989) Biochemistry (preceding paper in this issue)]. PMID- 2775755 TI - Kinetic study of the slow cyanide binding to Glycera dibranchiata monomer hemoglobin components III and IV. AB - Compared to other monomeric heme proteins and the heme peroxidases, the Glycera dibranchiata monomer hemoglobin components III and IV exhibit very slow cyanide binding kinetics. This is agreement with the previously reported behavior of component II. Similar to component II, components III and IV have been studied under pseudo-first-order conditions at pH 6.0, 7.0, 8.0, and 9.0 by using a 100 250-fold excess of potassium cyanide at each pH. At 20 degrees C with micromolar protein concentrations, kobs for component III varies between 7.08 x 10(-5) s-1 at pH 6.0 and 100-fold cyanide excess and 1.06 x 10(-2) s-1 at pH 9.0 and 250 fold cyanide excess. For component IV, the values are 2.03 x 10(-4) s-1 for 100 fold cyanide excess at pH 6.0 and 4.13 x 10(-2) s-1 for 250-fold cyanide excess at pH 9.0. In comparison to other heme proteins, our analysis shows that the bimolecular rate constant (klapp) is small. For example, at pH 7.0, it is 3.02 x 10(-1) M-1 s-1 for component III and 1.82 M-1 s-1 for component IV, compared to 400 M-1 s-1 for sperm whale metmyoglobin, 692 M-1 s-1 for soybean metleghemoglobin a, 111 M-1 s-1 for guinea pig methemoglobin, and 1.1 x 10(5) M-1 s-1 for cytochrome c peroxidase. Our results also show that the dissociation rates (k-lapp) are extremely slow and no larger than 10(-6) s-1.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2775756 TI - A histidine-rich protein from the vitellaria of the liver fluke Fasciola hepatica. AB - The vitellaria are an extensive network of glandular cells and ducts distributed throughout the peripheral tissues of the liver fluke Fasciola hepatica. Eggshell precursor proteins are produced and stockpiled in the vitelline cells of mature flukes. Vitelline protein C has an extraordinary composition: the amino acid 3,4 dihydroxyphenyl-L-alanine (DOPA) and histidine each comprise about 20% of the residues, while glycine represents 41-42% in all variants of what appears to be a microheterogeneous protein family. Protein C has an apparent molecular weight of 16,000-17,000 by sodium dodecyl sulfate-polyacrylamide gel electrophoresis. Although the protein appears homogeneous following polyacrylamide gel electrophoresis in Tris-glycine with SDS and a acetic acid-urea, electrophoresis in borate, however, suggests that the vitelline protein consists of four or more closely related proteins weighing from 16,000 to 18,500. Isoelectric focusing of the protein family in the presence of 8 M urea resolved only two species having pI values of 6.89 and 6.99. A single N-terminus having the sequence H-H-W-D-G DOPA-G-DOPA-G was detected. The primary structure of vitelline protein C is characterized by a repeated motif consisting of (G-X)n, where X is Ser, DOPA, or His. Most of the His occurs as G-H repeats in a pepsin-resistant fragment of the protein. Previously, a 31-kDa protein, representing up to 6% of the total protein in the fluke, was reported [Waite, J. H., & Rice-Ficht, A (1987) Biochemistry 26, 7819-7825] to contain significant levels of DOPA.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2775757 TI - Amino acid sequence of bovine angiogenin. AB - The amino acid sequence and disulfide bridges of bovine plasma derived angiogenin were determined by sequencer analysis of the intact protein and fragments derived by enzymatic and chemical digestion. Bovine angiogenin is a single-chain protein of 125 amino acids; it contains six cysteines and has a calculated molecular weight of 14,595. In contrast to the human protein its amino terminus is unblocked. It has the following sequence: H2N-Ala1-Gln-Asp-Asp-Tyr-Arg-Tyr-Ile His-Phe10-Leu-Thr-Gln-His-Tyr -Asp-Ala-Lys- Pro-Lys20-Gly-Arg-Asn-Asp-Glu-Tyr-Cys Phe-Asn-Met30-Met-Lys- Asn-Arg-Arg-Leu-Thr - Arg-Pro-Cys40-Lys-Asp-Arg-Asn-Thr Phe-Ile-His-Gly-Asn50-Lys- Asn-Asp-Ile-Lys-Ala - Ile-Cys-Glu-Asp60-Arg-Asn-Gly Gln-Pro-Tyr-Arg-Gly-Asp-Leu70- Arg-Ile-Ser-Lys-Ser - Glu-Phe-Gln-Ile-Thr80-Ile Cys-Lys-His-Lys-Gly-Ser-Ser-Arg90- Pro-Pro-Cys-Arg-Tyr - Gly-Ala-Thr-Glu-Asp100 Ser-Arg-Val-Ile-Val-Val-Gly-Cys-Glu-Asn1 10-Gly-Leu-Pro- Val-His-Phe-Asp-Glu-Ser Phe120-Ile-Thr-Pro-Arg-His-OH. Disulfide bonds link Cys(27)-Cys(82), Cys(40) Cys(93), and Cys(58)-Cys(108). Bovine angiogenin is 64% identical with human angiogenin; like the human protein, it is homologous to the pancreatic ribonucleases, with conservation of active site residues. Two regions, 6-22 and 65-75, are highly conserved between the angiogenins but are significantly different from those of the ribonucleases, suggesting a possible role in the molecules' biological activity. PMID- 2775758 TI - Subunit structure of porcine submaxillary mucin. AB - The structure of a high molecular weight fraction of porcine submaxillary mucin was studied by using degradative techniques. Reduction of disulfide linkages released mucin subunits together with an associated protein(s) of approximately 140 kDa. The molecular weights of the subunits ranged from approximately 0.5 x 10(6) to 2.5 x 10(6). Trypsinization of subunits generated glycosylated domains and small, poorly glycosylated or nonglycosylated tryptic peptides. The glycosylated domains, which have an average molecular weight of approximately 270K, possess an unusual amino acid composition containing only nine different amino acids. The minor amino acids which are absent from the glycosylated domains but which are consistently present in both the mucin and the mucin subunits were recovered in the tryptic peptides. Pronase digestion of the glycosylated domains generated smaller fragments of approximately 17 kDa. Comparing these results to the partial cDNA sequence for porcine submaxillary mucin reported by Timpte et al. [(1988) J. Biol. Chem. 263, 1081-1088] suggests that the glycosylated domains consist of variable numbers of the 81 amino acid tandem repeat observed in the cDNA sequence. Further, the fact that porcine submaxillary mucin contains subunits, link proteins, and glycosylated domains suggests that its structure is similar to that described for cervical and intestinal mucins. Intact mucin, mucin "subunits", and the glycosylated domains are all polydisperse with respect to molecular weight, indicating that mucin polydispersity is due to variability in the number of units linked together as well as to variability in the size of the units. PMID- 2775759 TI - Chylomicron synthesis in experimental nephrotic syndrome. AB - Mesenteric lymph was collected for 48 h from rats with aminonucleoside-induced nephrotic syndrome, receiving an intraduodenal infusion of a triacylglycerol emulsion. In nephrosis, the rates of lymph flow and triacylglycerol transport were approx. 2-fold higher, but the transport of total protein and of apoproteins A-I and E was 2- to 3-fold lower than that in control rats, resulting in chylomicrons with a 3-fold approx. elevated triacylglycerol/protein ratio. Supplementation of the triacylglycerol infusate with glucose and amino acids did not increase the protein or apoA-I and apoE transport. Production or transport of B and C apoproteins in nephrotic rats was also reduced, as indicated by tetramethylurea solubility, incorporation of intraduodenally infused [3H]leucine and staining of the chylomicron proteins on SDS-PAGE gels. Apoprotein A-IV was the only chylomicron component into which the leucine incorporation was elevated, but its relative content was not increased on SDS-PAGE gels. Lymph chylomicrons of nephrotic rats were larger in size (1498 +/- 37 vs. 1235 +/- 23 A), consistent with the higher triacylglycerol/protein ratio. The concentration of all lipoprotein classes was markedly elevated in the plasma of nephrotic rats, as was that of the total A-I and E apoproteins. Intravenous injection of 125I-labelled HDL, followed by tracing of the label in lymph chylomicrons, indicated a lower rate of transfer of HDL apoproteins from plasma to lymph in nephrotic rats. We conclude that the intestinal chylomicron formation in nephrosis is characterised by an enhanced triacylglycerol transport without the appropriate apoprotein complement. This is probably due to the limited capacity of enterocytes, in marked contrast to hepatocytes, to respond to the hypoproteinemia of nephrosis with increased production and/or transport of the apoproteins. PMID- 2775760 TI - Induction of an endothermic transition in the Arrhenius plot of fatty acid uptake by lipid-depleted ascites tumor cells. AB - Cultured ascites tumor cells and their lipid-depleted variants containing 35-40% less membrane phospholipid and cholesterol were used to study uptake and metabolism of fatty acids complexed to albumin. Uptake of stearate and oleate at 37 degrees C was considerably higher in the lipid-depleted cells, but no significant difference in the affinity constants for stearate uptake of 3.70 microM for the lipid-depleted and 2.50 microM for the control cells was observed. Similar rates of uptake of both cultures were observed at lower temperatures up to 30 degrees C. The drastic increase in stearate uptake above 30 degrees C resulted in an endothermic transition in the Arrhenius plot with an activation energy of 20.8 kJ/mol versus 6.5 kJ/mol for the control cells. Uptake of stearate and oleate of the control cells was only slightly reduced by metabolic inhibitors, which was similar to stearic acid transport in the lipid-depleted variants. However, oleate uptake was substantially decreased in these variants. Incorporated stearate was esterified to about 50% in both cultures, and oleate between 85 and 90%. Mainly triacylglycerols and phospholipids with phosphatidylcholine (41%) and phosphatidylethanolamine (35%) as major polar lipid components, and also lower acylglycerols and cholesterol were found to be labeled. Under lipid-depleted conditions, a pronounced increase in the relative proportion of oleate incorporation into triacylglycerols was determined. It is suggested that fatty acid uptake is controlled by the number of active sites of the putative transport protein, which increases upon lipid depletion as shown from the V values. This increase may result from the segregation of membrane bound proteins into domains (Haeffner et al. (1986) Cell Mol. Biol. 32, 359-368), which are known to be formed as a consequence of lipid phase separation in the lipid-depleted cells. PMID- 2775761 TI - Composition and toxicity of lipids from Rhodococcus rhodochrous grown on medium containing galactose, glucose or mannose. AB - Rhodococcus rhodochrous, a producer of mycolic acid of approx. C40, exhibited a higher cellular mass yield when grown on glucose than when grown on galactose or mannose. The cellular content of the diethyl ether-soluble lipids in microorganisms cultivated on glucose or mannose varied with the incubation time, while that of microorganisms grown on galactose remained constant. The lipids extracts from cells cultivated on different hexoses and collected at the exponential phase of growth were more toxigenic; this property was related in general to the content of glycolipid. On the other hand, cells cultivated on galactose or mannose had a higher quantity of glycolipid in the exponential phase, while the glycolipid content of those grown on glucose remained approximately constant. Amongst the components of the lipid extract, the glycolipid fraction was the sole fraction bearing toxic property. Neutral plus fatty acids and phospholipids displayed no similar characteristic. PMID- 2775762 TI - Phospholipid metabolism in rat submandibular gland. Positional distribution of fatty acids in phosphatidylcholine and microsomal lysophospholipid acyltransferase systems concerning proliferation. AB - Rat submandibular gland phosphatidylcholine mainly consisted of the 1-saturated acyl-2-unsaturated acyl type. The high occupancy of unsaturated fatty acid at the C-2 position is in part explained by the preference of microsomal acyl-CoA:1-acyl sn-glycero-3-phosphocholine (1-acyl-GPC) acyltransferase for unsaturated fatty acyl-CoAs. This enzyme activity was partially inhibited by divalent cations. Ca2+ may be important for regulation of a deacylation-reacylation cycle, suggested because Ca2+ is also known to activate the deacylation enzyme, phospholipase A2. Although the presence of 1-acyl-GPC acyltransferase activity is also observed in plasma membrane of the submandibular gland, the microsomal enzyme showed properties different from the enzyme in plasma membrane in terms of its susceptibility to neural salts and detergents. Cell proliferation caused by chronic administration of isoproterenol resulted in an increase of linoleic acid at the C-2 position of phosphatidylcholine. However, this alteration did not correlate with the changes of activity and substrate specificity of 1-acyl-GPC acyltransferase and the other C-2 acylation enzyme, 1-acyl-sn-glycero-3-phosphate acyltransferase, which suggests that the alteration of fatty acid by isoproterenol treatment is due to a change of supply of substrates or specific acyl breakdown of phosphatidylcholine. PMID- 2775763 TI - Topo-dynamic characteristics of human plasma VLDL apolipoproteins and efficiency of triacylglycerol hydrolysis by lipoprotein lipase. AB - A lower accessibility to water-soluble quenchers of tryptophanyls of VLDL apolipoproteins B, E, C as compared to LDL apoB chromophores has been detected by a fluorescence quenching technique. The dynamic behaviour of the tryptophanyls of VLDL amphipathic apolipoproteins E and C did not change in the presence of a detergent, Tween-20, at sub-lytic concentrations. However, a reversible structural transition registered by the 'red' shift of the emission spectrum maximum and the changes in the quenching pattern by I- occurred under these conditions. The increase in the VLDL tryptophanyl accessibility to acrylamide and the decrease in the quenching constant were observed at partial and complete solubilization of the VLDL particles by the detergent. Dissociation of apolipoproteins from VLDL occurred after their treatment with Tween-20 or lipoprotein lipase isolated from bovine milk, and the tryptophanyl population not participating in fluorescence energy transfer on lipid phase-localized fluorescent probe pyrene appeared. In the presence of Tween-20, the relative affinity of apoE for the lipid matrix of VLDL was lower than that of apoC. Besides, the uncompetitive mode of inhibition of the LPL activity by apoC-III has been demonstrated. It is suggested that: (1) the amphipathic apolipoproteins E and C are organized as clusters on the VLDL surface and/or partially shielded by apolipoprotein B: (2) self-regulation of lypolysis may exist involving detergent like reaction product accumulation and changes in relative apolipoprotein contents. PMID- 2775764 TI - Structural relationship between the two small hydrophobic apoproteins in bovine pulmonary surfactant. AB - Lipid extracts of bovine pulmonary surfactant contain two very hydrophobic surfactant-associated proteins (SP) designated SP-B (15 kDa nonreduced) and SP-C (3.5 kDa). These two low molecular weight apoproteins were delipidated and purified on silica SEP-PAK cartridges using various reagents. Dansylation studies revealed that the 15 kDa apoprotein has three N-termini: Phe, Leu and Ile, while the 3.5 kDa apoprotein has two N-termini: Leu and Ile. In either protein, only a very small amount of N-Ile is present. Quantitative N-terminal dansylation analysis of the 15 kDa protein indicated that Phe and Leu (plus Ile) are present in a 1:1 ratio. Carboxy-terminal analysis showed that the 15 kDa protein contains C-terminal Gly, and the 3.5 kDa protein contains C-terminal Leu. Gas-phase amino terminal sequencing of the 15 kDa protein revealed almost exclusively the Phe polypeptide (SP-B). These results suggest that the 15 kDa apoprotein is not an oligomer of SP-B and SP-C. The reason that analysis of SP-B reveals N-terminal Leu and Ile by dansylation which cannot be confirmed by amino acid sequencing is not known. PMID- 2775765 TI - Human brain gangliosides: developmental changes from early fetal stage to advanced age. AB - The developmental profiles of the four major brain gangliosides, GM1, GD1a, GD1b, and GT1b, were examined in human frontal lobe covering the period from 10 fetal weeks to 80 years of age. The ganglioside concentration increased approx. 3-fold from the 10th gestational week to the age of about 5 years. Gangliosides GM1 and GD1a increased 12-15-fold during the same period. The most rapid increase of GM1 and GD1a occurred around term, during the period for dendrite arborization, outgrowth of axons and synaptogenesis. GT1b showed a quite different developmental curve. It was the major ganglioside during the 3rd to 5th gestational month, whereafter its concentration dropped rapidly to term, from which time the concentration then increased up to 50 years of age. Similar curves were found for the other gangliosides of the b-series, GD3, GD2, GD1b and GQ1b. Ganglioside 3'-isoLM1 was a characteristic early fetal ganglioside which dropped rapidly to the 5th gestational month, reached a small peak around term and then disappeared during adulthood. The concentration of gangliosides of the neolacto series was larger than that of the lacto series during the whole developmental period. In the beginning of the second trimester, 3'-LM1 constituted 2% and LD1 10% of total ganglioside sialic acid. The new findings demonstrate more dynamic changes of the ganglioside patterns during development than noted in previous studies. PMID- 2775766 TI - Receptor-mediated binding and degradation of subfractions of human plasma low density lipoprotein by cultured fibroblasts. AB - The receptor-mediated metabolism of human plasma low-density lipoprotein (LDL) subfractions was studied. LDL was isolated from healthy donors and further fractionated by density gradient ultracentrifugation into three subfractions: (I) d = 1.031-1.037, (II) d = 1.037-1.041 and (III) d = 1.041-1.047 g/ml, comprising 24 +/- 7%, 46 +/- 8% and 30 +/- 9% of the total LDL protein, respectively. As assessed by electron microscopy and gradient gel electrophoresis, the LDL particle size decreased and the relative protein content increased from fraction I towards fraction III. Fraction II had the highest (Kd 2.6 micrograms/ml) and fraction I the lowest (Kd 5.8 micrograms/ml) binding affinity to LDL receptors of human fibroblasts at 4 degrees C. The rate of receptor-mediated degradation of fraction II was also higher than that of the other two fractions at 37 degrees C. These results suggest that LDL subfractions have different rates of receptor mediated catabolism depending on particle size or composition, and therefore their metabolic fate and atherogenic properties may also differ. PMID- 2775767 TI - Bile acid synthesis by cultured rabbit hepatocytes: stimulation by three lipoprotein fractions. AB - Bile acid and cholesterol synthesis were measured in monolayer cultures of rabbit hepatocytes maintained in a defined culture medium. In the absence of lipoproteins, bile acid synthesis and secretion were correlated with cholesterol synthesis and were increased 245% by mevalonolactone (10 mM) and inhibited 45% by lovastatin (50 micrograms/ml) over 24 h. When included in the culture medium, normal rabbit plasma low-density and high-density lipoproteins increased bile acid synthesis and secretion by up to 140% of values obtained without lipoproteins in hepatocytes from normal or cholestyramine-fed rabbits. Three cholesterol-rich lipoprotein fractions (beta-very low density, low density and high density) also were isolated from rabbits fed 1% cholesterol for 14 days. When added to rabbit hepatocyte cultures, each fraction markedly increased hepatocellular cholesterol content, stimulated bile acid synthesis and secretion in a dose-dependent manner, and inhibited cholesterol synthesis from radioactive acetate. These data indicate that three different lipoprotein fractions can provide cholesterol for uptake and subsequent breakdown to bile acids by cultured rabbit hepatocytes. PMID- 2775768 TI - Seasonal variations of plasma lipids and lipoproteins in the hedgehog, an animal model for lipoprotein (a) metabolism: relation to plasma thyroxine and testosterone levels. AB - We describe a study of the seasonal variations of hedgehog plasma lipids and lipoproteins and their correlation with changes in the activities of the thyroid and testis. In ten male hedgehogs, plasma concentrations of lipids, thyroxine and testosterone were assayed each month for 1 year beginning in September, while plasma lipoproteins from five of these animals were analyzed at the same dates using density gradient ultracentrifugation. All classes of plasma lipids (cholesterol, total glycerol and phospholipids) exhibited statistically significant seasonal variations in their respective concentrations, with simultaneous maxima (cholesterol: 207 +/- 39 mg/100 ml; total glycerol: 50 +/- 9 mg/100 ml; phospholipids: 266 +/- 25 mg/100 ml) during late fall-early winter, i.e., during the period of the year when plasma levels of both thyroxine and testosterone were minimal. Plasma lipids subsequently decreased to minimal levels either in early summer (cholesterol: 129 +/- 18 mg/100 ml; phospholipids: 178 +/- 20 mg/100 ml) or in late winter (total glycerol: 22 +/- 9 mg/100 ml). Very low density lipoproteins (d less than 1.015 g/ml) were found at low levels (less than 15 mg/100 ml) during the cold months, and then became detectable as trace components only. The total concentration of the mixed lipoprotein population (i.e., low density lipoproteins, Lp(a), and high density lipoprotein (HDL)-like particles) in the d 1.015-1.065 g/ml interval decreased by almost 50% from January to February (from 164.3 to 89.2 mg/100 ml), i.e., following a 10-fold increase in the level of plasma testosterone, and immediately before the rapid doubling in plasma thyroxine concentration. The staining intensity of the electrophoretic band with migration characteristics corresponding to those of Lp(a) decreased considerably during winter. At the same period of the year, lower density (1.032-1.055 g/ml) HDL-like particles disappeared. The concentration of lipoproteins with d 1.065-1.162 g/ml, which included Lp(a) particles in addition to typical HDL, equally underwent seasonal variations. These variations consisted of two successive maxima in late fall (426.4 mg/100 ml) and late winter (458.3 mg/100 ml) with two subsequent decreases leading to minima in February (327.8 mg/100 ml) and August (257.1 mg/100 ml). Finally, very high density lipoproteins (d 1.162-1.259 g/ml) were heterogeneous, containing both cholesterol-rich (d 1.162-1.227 g/ml) and phospholipid-rich (d 1.194-1.259 g/ml) subpopulations.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2775769 TI - Examination of the potential role of the glycerophosphorylcholine (GPC) pathway in the biosynthesis of phosphatidylcholine by liver and lung. AB - The potential involvement of the glycerophosphorylcholine (GPC) pathway for the synthesis of phosphatidylcholine (PC) has been examined in rat liver and lung and in a human line, the A549 cell which possesses characteristics representative of mature alveolar type II epithelial cells. Although mitochondrial and microsomal fractions from the above sources readily incorporated radioactive glycerophosphate into lipids, the only incorporation observed with radioactive GPC was a small variable labelling with the mitochondrial and microsomal fractions from rat lung. Even with these fractions, no radioactivity from GPC was incorporated into PC or lysoPC. Attempts to increase the incorporation of GPC into lipids by manipulating the incubation conditions were unsuccessful. It was concluded that the occurrence of the GPC pathway in liver and lung is unlikely. PMID- 2775770 TI - Identity of a cytosolic neutral cholesterol esterase in rat liver with the bile salt stimulated cholesterol esterase in pancreas. AB - A neutral cholesterol esterase has been purified to homogeneity from the cytosolic fraction of rat liver. The 105,000 x g supernatant fraction of rat liver was applied to a DEAE-cellulose column to isolate a partially purified fraction of hepatic cholesterol esterase. Immunoblot analysis of the partially purified liver fraction with the anti-porcine pancreatic cholesterol esterase IgG demonstrated a single band with a molecular weight of 67,000. The hepatic protein was then isolated by immunoaffinity chromatography technique using a column constructed with antibodies prepared against the pancreatic cholesterol esterase. Characterization of the hepatic cholesterol esterase revealed that the hepatic enzyme shared antigenic epitopes with the pancreatic cholesterol esterase and was similarly activated by addition of bile salt such as taurocholate. Moreover, amino-terminal sequencing analysis of the hepatic cholesterol esterase showed an identical sequence with the pancreatic enzyme. Taken together, these results showed that the cholesterol esterases in the liver and the pancreas are very similar and possibly identical proteins. PMID- 2775771 TI - The effect of dietary linoleic acid on rat platelet sialic acid. AB - The total sialic acid content of blood platelets from rats raised for 8 weeks or 12 months on a diet containing 1% linoleic acid (1LA) was significantly lower (by over 30%) than that from those raised on an isocalorific diet containing 6% linoleic acid (6LA). The transfer of sialic acid to endogenous glycoprotein acceptor was also significantly lower (up to almost 4-fold) in 1LA platelet and megakaryocyte-rich preparations but the transfer to exogenous glycoprotein acceptor was similar in both 1LA and 6LA platelets. The megakaryocyte-rich fraction of 1LA animals showed a reduced phosphodolichol-sensitive N acetylglucosaminyl (but not mannosyl) transfer to endogenous glycoprotein compared with 6LA animals. No significant difference was found between the megakaryocytes of 1LA and 6LA animals in the incorporation of radioactive mannose and glucosamine into the glycoprotein of the whole cells. It was concluded that the decreased transfer of sialic acid to glycoproteins of platelets and megakaryocyte of animals on the 1LA diet was due to the decreased availability of sialyl acceptor. The formation of N-linked oligosaccharide was the same in both 1LA and 6LA megakaryocytes, and thus any differences in phosphodolichol-mediated N-glycosylation did not account for this decreased availability of sialyl acceptor. PMID- 2775773 TI - Regulation of cellular retention of paf-acether by extracellular pH and cell concentration. AB - The role of paf-acether as an intracellular mediator was recently challenged by studies showing that it remained cell-associated in several cell types. We showed that the level of paf-acether found in extracellular medium was strongly reduced when extracellular pH decreased and when cell concentration increased. Therefore the number of cells and extracellular pH should be taken into consideration before speculating on the release vs. retention of paf-acether. PMID- 2775772 TI - Fatty acid desaturase activities are modulated by phytosterol incorporation in microsomes. AB - The effect of phytosterol-rich diets (3% beta-sitosterol + 2% campesterol) on rat liver microsomal fatty acid desaturases, membrane dynamics and lipid composition was investigated. After a 21 day period, phytosterol was incorporated into microsomes and the membrane fluidity decreased. There were no changes in either the phospholipid composition or in the total sterol content. However, the phytosterol/cholesterol ratio increased. In the animals fed phytosterols, the delta 5-, delta 6- and delta 9-fatty acid desaturases were significantly more active than in control animals. The changes in the lipid fatty acid composition were consistent with those of the desaturase activities. Hence, it is suggested that: (1) dietary phytosterol modulates desaturase activities; (2) phytosterols make the membrane more rigid but do not induce changes in the relative phospholipid composition; (3) delta 9-, delta 5- and delta 6-desaturase activities increase when the membrane becomes more rigid without changes in the phospholipid composition. PMID- 2775774 TI - The effect of macrophage stimulation on the uptake of acetylated low-density lipoproteins. AB - The rapid uptake of modified low-density lipoproteins (LDL) by macrophages in the arterial wall may lead to their conversion into lipid-laded foam cells in atherosclerotic lesions. We have therefore investigated the effects of macrophage stimulation on their rate of uptake of modified LDL. The uptake of 125I-labelled acetyl-LDL by mouse resident peritoneal macrophages was reduced by about 60-85% by zymosan (250 micrograms/ml), by 25-45% by lipopolysaccharide (0.1-1 mg/ml) and 50-60% by phorbol myristate acetate (100 nM). The inhibition was dose-dependent and was observed at the earliest times studied (about 1 h). Binding studies at 0 degrees C showed that all three stimulating agents decreased the number of cell surface receptors for acetyl-LDL. If macrophages are stimulated in atherosclerotic lesions, this may therefore be beneficial in that it may decrease their numbers of receptors for modified LDL, although it may be harmful in other ways in that stimulated macrophages may release factors that damage the arterial wall. PMID- 2775775 TI - Stearylamine permeabilizes the lysosomal membrane to cystine and sialic acid. AB - Cystine efflux from isolated rat liver lysosomes was enhanced by concentrations of stearylamine that were above the critical micellar concentration. Lysosomal latency, pH, and activity of the proton-translocating ATPase were largely unaffected under controlled experimental conditions. Loss of lysosomal latency was observed at higher stearylamine to protein ratios consistent with a detergent like mechanism of action. Partially purified cultured fibroblast lysosomes with either defective cystine or sialic acid transport lost their stored material upon exposure to stearylamine. Concentrations of stearylamine which were effective for lysosomal efflux were highly toxic for cultured fibroblasts, thus limiting its use. Under specific conditions, stearylamine apparently selectively permeabilizes the lysosomal membrane. A similar acting, but less toxic agent may be of use in the treatment of lysosomal transport disorders. PMID- 2775776 TI - Membrane potential dependence of Fe(III) uptake by mouse duodenum. AB - Intestinal iron uptake by mouse duodenal fragments is inhibited in the absence of oxygen and glucose from the incubation medium and by a variety of metabolic inhibitors. The mechanism of energy coupling to iron uptake is, however, unclear. In vitro experiments using duodenal fragments showed Fe3+ uptake to be markedly inhibited, in a reversible fashion, by the replacement of incubation medium Na+ by K+. Addition of phloridzin to the medium failed to affect iron uptake, suggesting that the above effect was not a consequence of reduced glucose uptake. Substitution of Na+ by Rb+ also potently reduced duodenal iron uptake. Replacement of medium NaCl by either mannitol or choline chloride had no significant effect on Fe3+ uptake, thus excluding the possibility of the Fe3+ uptake process being Na+-dependent. Similar observations were made with duodenal fragments from animals with enhanced Fe3+ absorption, due to chronic hypoxia. Valinomycin (1-5 microM) increased the uptake of both glucose and Fe3+. Higher concentrations (22.5 microM) of the ionophore were inhibitory. In vivo studies (tied-off segments) using Rb+-containing medium confirmed the inhibitory effects of univalent cations on Fe3+ absorption. Enhanced absorption of Fe3+ was also demonstrable in vivo, with low concentrations of valinomycin and nigericin added to the luminal medium. These observations suggest that the Fe3+ uptake process may be dependent on the brush-border membrane potential. PMID- 2775777 TI - Scavenger receptor-mediated recognition of maleylated albumin and its relation to subsequent endocytic degradation. AB - Rat sinusoidal liver cells take up maleylated bovine serum albumin (maleyl-BSA) and its demaleylated form (demaleyl-BSA) by scavenger receptor-mediated endocytosis. Cellular binding of maleyl-BSA and demaleyl-BSA and its quantitative relation to subsequent intracellular degradation were investigated. The binding affinities of these ligands were almost equal whereas the number of binding sites for maleyl-BSA was more than twice as large than that for demaleyl-BSA. However, no difference was observed in their endocytic degradation. The amounts of maleyl BSA degraded were proportional to those bound to the cell surface up to a certain level. However, a further increase in cell-bound ligands did not affect the degradation of maleyl-BSA. Several polyanions such as fucoidin and dextran sulfate of Mr = 5000 inhibited the binding of maleyl-BSA but did not affect its degradation. In contrast, acetylated or oxidized low density lipoprotein had virtually no effect on cellular binding of maleyl-BSA but exhibited profound effects on its intracellular degradation. Similar results were obtained with rat peritoneal macrophages. Based on these data, we would propose that two binding sites are involved in the receptor-mediated ligand recognition; one is coupled to subsequent endocytic degradation, and the other serves as a binding site for polyanionic compounds. PMID- 2775778 TI - A method to distinguish between pore and carrier kinetics applied to urea transport across the erythrocyte membrane. AB - Permeability coefficients (P) measured at various penetrant concentrations (C) by the perturbation method can be plotted to distinguish simple diffusion, simple pore kinetics and simple carrier kinetics as follows: for simple diffusion, 1/P = constant; for a simple pore, 1/P = 1/Po + 1/Po[1/Kin + 1/Ko]C; for a simple carrier, 1/P = 1/Po + 1/Po[1/Kin + 1/Ko]C + 1/Po[1/(K3K4)] C2 where Po is the maximal permeability at zero penetrant concentration and the K's are combinations of kinetic constants defining each of the transport steps. (Kin and Ko are the half-saturation constant for zero-trans efflux and influx, respectively; K3 is the half-saturation constant for equilibrium exchange, and K4 is related to the mobility of the free carrier). In human erythrocytes, permeability coefficients for diethylene glycol were constant suggesting simple diffusion. For glucose, a plot of 1/P versus concentration was nonlinear indicating carrier kinetics. Plots of 1/P versus penetrant concentrations gave straight lines with positive slopes for urea in human and bovine erythrocytes and for methylurea in human red cells, indicating these penetrants follow simple pore kinetics or simple carrier kinetics in which K4 is very large. PMID- 2775779 TI - Surface potentials and electric dipole moments of ganglioside and phospholipid bilayers: contribution of the polar headgroup at the water/lipid interface. PMID- 2775780 TI - Interaction of ganglioside-containing planar bilayers with serotonin and inorganic cations. AB - The binding of serotonin and inorganic cations K+, Na+, Ca2+, Mg2+ to planar bilayers formed from mixtures of phosphatidylcholine and mono-, di- and trisialogangliosides was studied by the potentiodynamic and nonactin-induced potassium conductivity method. The theoretical analysis of the results obtained was made taking into account (1) protrusion of the ganglioside charges from the membrane surface and (2) simultaneous adsorption of ions on the bilayer surface and on the ganglioside charges protruding into the solution. It was shown that there was no specific binding of K+ and Na+. The binding constants for Ca2+, Mg2+ were determined. These constants for all the gangliosides studied were equal to 500 M-1. The determined binding constants of serotonin to various gangliosides diminish in the following order: GD3 greater than GT1b greater than GD1a greater than GM1. PMID- 2775781 TI - A synthetic peptide corresponding to the hydrophobic amino terminal region of pardaxin can perturb model membranes of phosphatidyl choline and serine. AB - Peptides corresponding to the amino terminal region of pardaxin from Pardachirus pavoninus (Gly-Phe-Phe-Ala-Leu-Ile-Pro-Lys-Ile-Ile-Ser-Ser-Pro-Leu-Phe) have been synthesized and their interaction with model membranes of phosphatidyl choline and serine studied by 90 degrees C light scattering and fluorescence spectroscopy. The amino terminal 8-residue peptide and the protected 15-residue peptide cause only aggregation of lipid vesicles. The deprotected 15-residue peptide has the ability to cause aggregation and release of entrapped carboxyfluorescein with both phosphatidyl choline and serine lipid vesicles, like pardaxin. The membrane-perturbing ability of the amino terminal 15-residue peptide can be attributed to its ability to adopt an alpha-helical conformation which is amphiphilic in nature in a hydrophobic environment. PMID- 2775782 TI - Isolation of myelin bodies from the kidney cortex of gentamicin-treated rats. AB - Myelin bodies have been isolated from the kidney cortex of gentamicin-treated rats (100 mg gentamicin sulfate/kg body weight i.p. twice daily for 3 days) by a simple procedure involving differential centrifugation followed by equilibrium density centrifugation on a discontinuous sucrose gradient. Electron microscopy and assay of acid phosphatase suggest that the myelin bodies were obtained in virtually quantitative yield, essentially uncontaminated by other cellular structures and relatively intact. The method developed here may also prove applicable for the isolation of myelin bodies arising in connection with other drug treatments and may provide information on a number of toxic side-effects of clinical importance. PMID- 2775783 TI - Differential properties of organ-specific serum opsonins for liver and spleen macrophages. AB - Earlier we reported that serum contains organ-specific opsonins which selectively enhance recognition of liposomes by macrophages in the specific organs of the reticuloendothelial system (Moghimi, S.M. and Patel, H.M. (1988) FEBS Lett. 233, 143-147). The results presented here describe the properties of these organ specific opsonins which differentiate between liver-specific and spleen-specific opsonins responsible for the enhancement of phagocytosis of liposomes by Kupffer cells and spleen macrophage, respectively. Liver-specific opsonin is a heat stable macromolecule which on heating or on freezing and thawing exhibits enhanced opsonic activity. Serum also contains a dialysable factor which inhibits its opsonic activity. On the other hand, the spleen-specific opsonin is a heat labile macromolecule which is sensitive to freezing and thawing and requires a dialysable serum co-factor for its optimum opsonic activity on spleen macrophages. Removal of this factor from serum brings about an irreversible conformational change in the opsonin. Evidence suggests that the spleen-specific opsonin may be composed of more than one different opsonin molecule. It is suggested that the serum factor(s) that inhibits liver-specific opsonic activity and enhances the spleen-specific activity may not be the same molecule, but in both the cases the factor(s) may mediate its function by modifying the process of the opsonisation of liposomes or by influencing the interaction of the opsonised liposomes with the respective cells. We propose that purification of the organ specific opsonins may provide an opportunity to target drug carriers selectively to a specific organ of the reticuloendothelial system, and help us to evaluate their role in the altered opsonin states known to exist in certain diseases. PMID- 2775784 TI - Serum opsonins and phagocytosis of saturated and unsaturated phospholipid liposomes. AB - Recently we reported that serum contains opsonins specific for hepatic and splenic phagocytic cells and that these opsonins have different properties and affinities for cholesterol-rich and cholesterol-free egg phosphatidylcholine liposomes (Moghimi, S.M. and Patel, H.M. (1988) FEBS Lett. 233, 143-147). In the present report we investigate the affinity of these opsonins for the liposomes prepared from sphingomyelin and saturated phospholipids, as measured by their effect on the uptake of these liposomes by hepatic and splenic phagocytic cells. Results presented here suggest that neither liver- nor spleen-specific opsonins have affinity for sphingomyelin or saturated phospholipid liposomes since serum fails to enhance their uptake in liver or splenic cells. On the contrary, these liposomes attract serum dysopsonins which inhibit their uptake by liver cells. Inclusion of cholesterol in these liposome preparations enhances their uptake in splenic cells but not in liver cells. It is suggested that fluidity and hydrophobicity of liposomal membranes play an important role in attracting the right opsonins which determine their phagocytic fate. PMID- 2775785 TI - Clofibrate induces carnitine acyltransferases in periportal and perivenous zones of rat liver and does not disturb the acinar zonation of gluconeogenesis. AB - Clofibrate induces hypertrophy and hyperplasia and marked changes in the activities of various enzymes in rat liver. We examined the effects of treatment of rats with clofibrate on enzyme induction and on rates of metabolic flux in hepatocytes isolated from the periportal and perivenous zones of the liver. Clofibrate induced the activities of carnitine acetyltransferase (90-fold), carnitine palmitoyltransferase (3-fold) and NADP-linked malic enzyme (3-fold) to the same level in periportal as in perivenous hepatocytes, suggesting that these enzymes were induced uniformly throughout the liver acinus. Increased rates of palmitate metabolism and ketogenesis after clofibrate treatment were associated with: a more oxidised mitochondrial redox state; diminished responsiveness to glucagon and loss of periportal/perivenous zonation. Despite the marked liver enlargement and hyperplasia caused by clofibrate, the normal periportal/perivenous zonation of alanine aminotransferase and gluconeogenesis was preserved in livers of clofibrate-treated rats, indicating that clofibrate induced hyperplasia does not disrupt the normal acinar zonation of these metabolic functions. PMID- 2775786 TI - Proteolytic inactivation of dog lung surfactant-associated proteins by neutrophil elastase. AB - The adsorption of pulmonary surfactant to an air/fluid interface is influenced by calcium-dependent interactions between its lipid and protein components. The latter include a glycoprotein of 28-36 kDa (SP-A) and two smaller hydrophobic proteins of 5-8 kDa (SP-B, SP-C). Neutrophil elastase and other proteolytic enzymes found in the alveolar washings in a variety of acute lung injuries may cleave the protein components of lung surfactant. To examine the hypothesis that free airspace elastolytic activity may thereby impair surfactant function, we analyzed the effect of neutrophil elastase on surfactant activity in vitro. The adsorption characteristics of dog surfactant and of complexes reassembled from purified surfactant components were examined after incubations with active or heat-inactivated neutrophil elastase. Surfactant preincubated with the active enzyme showed a marked concentration-dependent slowing of adsorption associated with proteolytic cleavage of SP-A. To determine whether elastase also decreases surface activity by affecting the hydrophobic proteins SP-B and SP-C, we studied the effect of incubating elastase with liposomes prepared from surfactant lipid fractions which contain SP-B and SP-C. The addition of intact SP-A to these liposomes incubated with inactive enzyme immediately enhanced adsorption speed. This enhancement was greatly attenuated in liposomes treated with active elastase, suggesting that one or both of the hydrophobic surfactant proteins had been affected by elastase. We conclude that proteolytic cleavage of surfactant proteins reduces adsorption speed in vitro and may disturb surfactant function in vivo. PMID- 2775787 TI - Triwaglerin: a potent platelet aggregation inducer purified from Trimeresurus wagleri snake venom. AB - Trimeresurus wagleri venom is the most potent inducer of platelet aggregation among the seven Trimeresurus snake venoms tested. By means of CM-Sephadex C-50 column chromatography, T. wagleri venom was separated into 19 fractions. Fraction XVI possessed the strongest aggregating activity and was further purified by Sephadex G-75 and on heparin-agarose columns, and finally Triwaglerin, with a molecular weight of 68000, was obtained. Its aggregating and ATP-releasing activity was dose-dependent and 10-times more potent than the crude venom. Triwaglerin was devoid of any of the enzymatic activities possessed by the crude venom. Triwaglerin-induced aggregation was not affected by indomethacin, creatine phosphate/creatine phosphokinase (CP/CPK), platelet-activating factor (PAF) antagonists, verapamil or heparin, but was inhibited completely by mepacrine, imipramine and forskolin and markedly by tetracaine and sodium nitroprusside. Thromboxane B2 formation caused by Triwaglerin was suppressed by mepacrine, imipramine and indomethacin. R59022 and TMB-8 caused a synergistic inhibitory effect against Triwaglerin-induced aggregation. These data suggest that Triwaglerin activates platelets in a unique action which is independent of formation of thromboxane A2 and PAF, or release of ADP. PMID- 2775788 TI - Beta-aminoglutaric acid is a major soluble component of Methanococcus thermolithotrophicus. AB - 13C- and 15N-NMR spectroscopy have been used to identify beta-aminoglutaric acid (beta-glutamic) as a major soluble component of the thermophilic, autotrophic marine methanogen Methanococcus thermolithotrophicus. This rare, non-protein amino acid has been recognized as a major dissolved free amino acid in marine sediments, but the microorganism responsible for its production has not previously been identified. The concentration of beta-aminoglutarate (beta glutamate) is about one half that of free alpha-glutamate and increases (relative to the alpha-isomer) as cells enter the stationary phase. Analysis of the 13C label distribution in a 13CO2-pulse/12CO2-chase experiment shows that label enters the beta-aminoglutarate pool after it has decayed from other small soluble molecules. This implies that beta-aminoglutarate is a catabolic product of the cells. Preliminary biosynthesis studies with labeled precursors indicate that only a single acetate moiety is incorporated in this unusual compound. This information is used to suggest possible biosynthetic pathways. PMID- 2775789 TI - The effects of ethanol on the structural stability of acetylcholine receptor and the activity of various molecular forms of acetylcholinesterase. AB - The actions of ethanol on the structural stability of acetylcholine receptor (AchR)-enriched membrane vesicles and the activity of various molecular forms of acetylcholinesterase (AchE) were investigated, using the receptor and the enzyme isolated from the electric organ of Torpedo californica. In the presence of ethanol up to 200 mM, the thermogram of AchR-enriched membranes exhibited no significant decrease in the temperature (td) of receptor transition at 57 degrees C, but a decrease in the enthalpy change (delta Hd) indicated a slight ethanol induced structural perturbation. The presence of 12.5 nmol alpha-bungarotoxin also caused a decrease in delta Hd. A complete loss of the receptor transition was observed at a higher concentration 500 nmol of alpha-bungarotoxin and no recovery of the transition was found with the addition of 200 mM ethanol. The results suggested a noncompetitive interaction of ethanol with the receptor. In the presence of 200-1000 mM ethanol, the activity of two soluble forms of AchE, a higher (117 S) aggregate and a lower (10 S) aggregate was not significantly affected. Comparing the activity of these two aggregates over a wide concentration range of ethanol (200-2000 mM) revealed no obvious difference in the level of ethanol effect between them. However, after removal of ethanol, the higher aggregate form of AchE exhibited a greater recoverability of the activity, suggesting a possible slightly greater structure-functional stability for it. Studies of soluble AchE and membrane-bound AchE showed that the presence of 200 or 600 mM ethanol caused a greater level of inhibition in membrane-bound enzyme than in soluble enzyme, possible due to a disruption of protein-lipid interaction needed to maintain the conformation of membrane-bound AchE. Interestingly, at a much higher concentration of ethanol (2.0 M), membrane-bound AchE became more resistant to ethanol than did the soluble forms of AchE. In this case, the effective concentration of ethanol felt by the enzyme was expected to be less for membrane-bound AchE, owing to ethanol's solubility in lipids. PMID- 2775790 TI - Deoxyribonucleoside triphosphate pools in regenerating rat liver: effect of hydroxyurea and exogenous deoxypyrimidines. AB - Hydroxyurea (HU) causes inhibition of DNA synthesis in regenerating rat liver due to an inhibition of the ribonucleotide reductase. We studied the consequences of a continuous HU infusion for deoxyribonucleoside triphosphate (dNTP) pools in the liver after partial hepatectomy and tried to modify imbalances by application of deoxyribonucleosides in vivo. In normal liver, an intracellular concentration of 0.16, 0.84, 0.33 and 0.27 pmol/micrograms DNA was observed for dATP, dCTP, dGTP and dTTP, respectively. In regenerating liver the dNTP pools show minor changes until 18 h after partial hepatectomy. During and after a continuous HU infusion 14--24 h after partial hepatectomy, the intracellular dNTP pools change considerably. At 19.5 h after partial hepatectomy, 5.5 h after the start of HU infusion, and at 25 h after partial hepatectomy, 1 h after termination of HU infusion, the dTTP pool was more than 10-times, and the dGTP pool about 2-times higher than in controls, while the dATP and dCTP pools remain relatively unchanged. Simultaneous infusion of HU and deoxythymidine (dThd) 14--25 h after partial hepatectomy results in a further increase of the dTTP pool during and after HU infusion. Administration of deoxycytidine (dCyd) leads to a moderate increase of the dCTP pool and a weak decrease of the dTTP pool during HU infusion. The combined application of dCyd and dThd after HU infusion had similar effects on dNTP pools as observed with dThd alone. These results show that intracellular pools of dNTPs in hepatocytes can be altered by exogenous factors in a controlled pattern. This system can be used as a model for studying the implications of induced dNTP pool dysbalances for the initiation of liver carcinogenesis by mutagenic chemicals. PMID- 2775791 TI - Ethoxylated alcohol (Neodol-12) and other surfactants in the assay of protein kinase C. AB - Most commonly used surfactants were found to be inhibitors of partially purified rat brain protein kinase C at or above their critical micellar concentrations (CMC). These include sodium lauryl sulfate, deoxycholate, octyl glucoside, dodecyl trimethylammonium bromide, linear alkylbenzene sulfonate and Triton X 100. Several detergents, including the nonionic surfactants digitonin and Neodol 12 (ethoxylated alcohol), did not inhibit protein kinase C activity, even at concentrations greater than their CMC, while the anionic surfactant, AEOS-12 (ethoxylated alcohol sulfate), inhibited enzyme activity only slightly (less than 8%). Since these latter surfactants have little or no inhibitory effect on protein kinase C, they may be of value in solubilizing cells and tissues for the determination of enzyme activity in crude extracts. Among the detergents tested, sodium lauryl sulfate and linear alkylbenzene sulfonate significantly stimulated protein kinase C activity in the absence of phosphatidylserine and calcium. This was found to be dependent on the presence of histone in the protein kinase C assay. These detergents failed to stimulate protein kinase C activity when endogenous proteins in the partially purified rat brain extracts were used as the substrate. Our results indicate that activity of protein kinase C can be modified by the conditions of the assay and by the detergents used to extract the enzyme. PMID- 2775792 TI - A simple matrix method for determining flux control coefficients in complex pathways. AB - Flux control coefficients express in quantitative terms the extent to which the steady state flux through a metabolic pathway is controlled by a particular parameter. Enzyme flux control coefficients can be calculated using matrix algebra methods which express the control coefficients in terms of parameters which can be determined experimentally (enzyme elasticities, flux ratios, metabolite ratios). This paper describes an algorithm based on a 'constraint' matrix which enables expressions for enzyme control coefficients to be written for pathways of any complexity. PMID- 2775793 TI - New galactosyllactose containing alpha-glycosidic linkage isolated from ovine (Booroola dorset) colostrum. AB - Three trisaccharides, tetra-, penta-, hexa- and certain higher oligosaccharides were obtained from ovine colostrum as free forms. The chemical structure of the three trisaccharides were determined by methylation and 13C-NMR analyses to be as follows: Gal alpha 1-3Gal beta 1-4Glc, Gal beta 1-3Gal beta 1-4Glc (3' galactosyllactose) and Gal beta 1-6Gal beta 1-4Glc (6'-galactosyllactose). Gal alpha 1-3Gal beta 1-4Glc, which had been confirmed as the oligosaccharide portion of a glycolipid prepared biosynthetically from rat spleen or bone marrow, has been identified for the first time from natural sources as a free form. The trisaccharide containing alpha-galactosyl unit is a novel compound in mammalian milk. PMID- 2775794 TI - Crystal structure of a zwitterionic detergent: n-octyl-2-hydroxyethylsulfoxide. AB - The crystal structure of n-octyl-2-hydroxyethylsulfoxide (1) (space group P2(1)/c, a = 16.516(7), b = 9.053(4), c = 8.222(4) A, beta = 97.58 degrees) was determined by X-ray diffraction methods to 0.94 A resolution and refined to R = 0.050 (Rw = 0.052). In the crystal lattice the molecules are not arranged tail-to tail, as usually observed with amphiphilic compounds, but head-to-tail and aligned in the a-axis direction. They form layers in the b, c plane which are interdigitated such that adjacent molecules in one layer are in antiparallel orientation. The packing is stabilized by intermolecular hydrogen bonds O-H--O-S. No solvent molecules were detectable. PMID- 2775795 TI - Antipeptide antibodies discriminate between different SAA proteins in human plasma. AB - Antipeptide antibodies raised against two distinct sequences of human serum amyloid A (SAA) discriminate between different plasma isoforms of this acute phase reactant. As different SAA gene products have meanwhile been identified in human plasma, the discrimination between these different isoforms may help to clarify further the time of appearance of these different forms in plasma and their potential amyloidogenicity. PMID- 2775796 TI - Free factor Xa is on the main pathway of thrombin generation in clotting plasma. AB - The effect of a synthetic pentasaccharide that specifically causes the inactivation of factor Xa on the development of prothrombinase activity in human plasma was monitored using four triggers of coagulation: (a) human brain thromboplastin; (b) contact activation; (c) factor X activating enzyme complex; (d) prothrombin activating enzyme complex. Inhibition was similar with the triggers a, b and c. With prothrombinase (d), the inhibition strongly decreased with increasing amounts of factor Va present. This indicates that only free factor Xa is inhibited. Because both the intrinsic pathway (b) and the extrinsic pathway (a) are inhibited by the pentasaccharide, we conclude that free factor Xa plays a rate-limiting role in the pathways, so that there is no reason to postulate the existence of 'supercomplexes' consisting of factors IXa, VIIIa, X(a), Va and prothrombin adsorbed on the same phospholipid particle (intrinsic system) or factor VII(a), X(a), Va and prothrombin adsorbed on tissue thromboplastin (extrinsic system). PMID- 2775799 TI - A method of neuronal spike train study based on autoregressive analysis. AB - The method of autoregressive (AR) analysis for neuronal spike trains (NST) is proposed in the paper. The AR model and the Green's function as well as the power spectral density function are used to process and analyse the neuronal interspike interval (ISI) sequences of cat's first somatosensory area of cortex (SI area) under various situations. With these methods the characteristics of the ISI sequence such as the AR order and parameters, memory property, correlativity and periodicity etc. can be extracted. PMID- 2775797 TI - Central adaptation models of the vestibulo-ocular and optokinetic systems. AB - A theoretical analysis of two models of the vestibulo-ocular and optokinetic systems was performed. Each model contains a filter element in the vestibular periphery to account for peripheral adaptation, and a filter element in the central vestibulo-optokinetic circuit to account for central adaptation. Both models account for 1 adaptation, i.e. a response decay to a constant angular acceleration input, in both peripheral vestibular afferent and vestibulo-ocular reflex (VOR) responses and 2 the reversal phases of optokinetic after-nystagmus (OKAN) and the VOR and 3 oscillatory behavior such as periodic alternating nystagmus. The two models differ regarding the order of their VOR transfer function. Also, they predict different OKAN patterns following a prolonged optokinetic stimulus. These models have behavioral implications and suggest future experiments. PMID- 2775798 TI - Spectral analysis on low frequency fluctuation in respiratory rhythm in the decerebrate cat. AB - Spectral analysis was performed on the fluctuation in respiratory intervals in vagotomized, paralyzed, and unanesthetized decerebrate cats. The respiratory interval was measured as the time interval between the onset of phrenic neural activity. When endtidal PCO2 was set at the same level as that before immobilization, the power spectral densities of the fluctuation in respiratory intervals were found to be inversely proportional to the frequency in the low frequency range of 0.001-0.1 Hz. All the tested animals showed this type of fluctuation (1/f fluctuation). In contrast, such characteristic 1/f fluctuation disappeared when the end-tidal PCo2 was raised to 50 or 60 mmHg. The spectral profile was almost flat in the frequency range of 0.001-0.1 Hz, i.e. similar to that of "white noise". This study demonstrated that the respiratory rhythm evaluated by phrenic neural discharges exhibited 1/f fluctuation and that the spectral characteristic of the fluctuation in respiratory intervals varied depending on the end-tidal PCo2. PMID- 2775800 TI - Restoration of stimulus associability, electrodermal activity, and processing resource allocation. AB - Four experiments investigated Pearce and Hall's (1980) proposal that a decrease in the predictive accuracy of a stimulus restores stimulus associability as reflected by increased orienting and controlled processing. The experiments examined the effects of miscuing or omission on stimulus associability as assessed by stimulus expectancy, electrodermal responding, and reaction time (RT) to a secondary task probe stimulus. In Experiments 1 and 2, a control group received 21 S1-S2 trials intermixed with 21 S3-alone presentations. For the experimental group, S2 was miscued by its presentation following S3 on two trials. In Experiments 1 and 2a, S1, S2, and S3 were moderate intensity stimuli, but in Experiment 2b, shock was used as S2. Experiment 1 (N = 24) demonstrated that, although there was uncertainty about whether S2 would follow S3 when S3 was re-presented following miscuing, skin conductance responses to S3 did not differ according to whether or not it had miscued the previous S2. Experiment 2a (N = 48) and Experiment 2b (N = 24) demonstrated that RT to white noise probe stimuli presented during the S3-alone presentation immediately following miscuing did not differ between experimental (miscuing) and control (no miscuing) groups. In Experiments 3 and 4, a control group received 23 S1-S2 trials. For the experimental group, S2 was omitted on two trials. In Experiment 3 (N = 24) S1 and S2 were of moderate intensity, whereas in Experiment 4 (N = 24) shock was used as S2. Reaction time to white noise probes presented during S1 did not differ according to whether or not the previous S2 was omitted. Thus, despite evidence of a reduction in the predictive accuracy of both S3 following miscuing and S1 following omission, there was no evidence of restoration of the associability of either S1 or S3. The results are discussed in terms of current theories of associative learning. PMID- 2775801 TI - Sympathetic-parasympathetic mediation of the cardiac defense response in humans. AB - This paper reports an investigation which examined the sympathetic and/or parasympathetic mediation of the heart rate response to intense auditory stimulation - the cardiac defense response (CDR) - by recording cardiac period (CP) and pulse transit time (PTT) simultaneously. Thirteen subjects underwent a physiological reaction test with a single presentation of a distorted 400-Hz sound of 109 dB, instantaneous rise time and 0.5 s duration. The results regarding the form of the CDR replicated the typical pattern with four components: two accelerative and two decelerative in alternating sequence. As regards CP and PTT changes the only coincidences occurred in the second accelerative and second decelerative components of the response. In the first two components the changes in CP and PTT moved in opposite directions. These results support a description and interpretation of the CDR in terms of both accelerative and decelerative components with both vagal and sympathetic mediation. PMID- 2775802 TI - Reporting of life events, family history of hypertension, and cardiovascular activity at rest and during psychological stress. AB - This study investigated whether relations between stressful life events and cardiovascular activity obtained during periods of rest and stress varied as a function of family history of hypertension. Within the family history of hypertension group, males exhibited a positive association between the number of negative avoidable events and resting systolic blood pressure, whereas an inverse association between these two variables was obtained for females. Among females with a family history of hypertension, inverse associations between resting diastolic blood pressure and the subjective effects of life event and number of avoidable events were obtained. Analyses revealed that diastolic blood pressure reactivity to stress was associated with those persons with a family history of hypertension who reported fewer negative life events and less subjective effects for these events. PMID- 2775803 TI - Propositional knowledge and mere responding. AB - This commentary examines views recently offered by Furedy and Riley (1987) on the nature of classical conditioning. Their analysis identifies propositional learning as a component of conditioning separate from response acquisition. They reserve to this component the label cognitive on the epistemological grounds of falsifiability. We suggest that this analysis does not do justice to the concept of cognition in human conditioning. In particular it limits the scope of propositional knowledge to a formal role in the conditioning paradigm and ignores the recent development of propositional models in cognitive science. In seeking to integrate their propositional account with animal conditioning theory they usefully map their two processes on to the conditioned response/instrumental response distinction proposed by Gormezano and Kehoe (1975). However, their propositional contingency interpretation of the Rescorla and Wagner (1972) theory ignores the essentially associative mechanism used in the model to account for interevent relations. PMID- 2775804 TI - Propositional and response processes as distinguishable and equally important aspects of conditioning: some clarifications. AB - Martin and Levey's (1988) commentary on our 1987 chapter points to the need for clearer definition of terms and much more open debate in the area of learning and conditioning. While raising some good points for further discussion, their characterisation of some issues appears to be based on a number of misinterpretations and misrepresentations of our position, and we attempt here to correct these functions. Issues which we regard as misinterpreted are those of truth value as a criterion of the cognitive, the epistemological status of a cognition as opposed to the object of the cognition, and the nature of propositional versus non-propositional learning theories. Issues which are misrepresented are those of our position on the nature of conditioning (which is called cognitive by Martin and Levey, but which is, in fact, a dual-process view), formal versus content-oriented distinctions, and the nature of human and non-human learning processes. Despite these differences between Martin and Levey and ourselves, it is apparent that such debates are necessary for furthering our understanding of the complexity and multiplicity of the processes involved in learning. PMID- 2775805 TI - Doubts on the adequacy of the principal component varimax analysis for the identification of event-related brain potential components: a commentary on Glaser and Ruchkin, and Donchin and Heffley. AB - Glaser and Ruchkin (1976) as well as Donchin and Heffley (1978) have proposed principal component varimax analysis (PCVA) for identification of event-related potential (ERP) components. In the present commentary, the assumptions on the ERP data structure of this procedure are considered. They are formalized and compared with a simpler and more restrictive hypothesized ERP data structure containing autoregressive properties. Referring to the principle of parsimony, the comparison of the two models shows the superiority of the hypothesized autoregressive structure: to fit a set of ERP data equally well, the autoregressive structure does so with considerably more parsimonious assumptions, i.e. with fewer parameters to be estimated, than the structure induced by PCVA. It is concluded that an appropriate model for the ERP data structure should take the autocorrelated nature of the ERP into account. PMID- 2775806 TI - Doubting these doubts--a reply to Collet. AB - In reply to Collet (1989) it is argued that principal component analysis (PCA) of event-related potentials is not invalidated or disproved by the arguments of his comment. The main points of this reply are as follows. First, since Collet's analysis was based on the correlation matrix only, it cannot disprove assumptions of PCA which do not constrain the correlation (or covariance) matrix. Second, his model utilizes results of PCA which invalidate the comparison and parameter count. Third, his model does not allow specific predictions and does not lead to real data reduction, which reverses Collet's argument based on the principle of parsimony. Fourth, his model is less general than PCA, as it could apply (if at all) to slow brain potentials only. PMID- 2775807 TI - On why Collet's doubts regarding the PCA are misplaced. AB - Collet's (1989) doubts regarding the efficacy of principal component analysis (PCA) as a tool in the study of event-related brain potentials (ERPs) are unpersuasive. The substantive point reported by Collet is that data points are autocorrelated over the time period during which a single, PCA-defined, ERP component predominates. Such autocorrelation has long been recognized by investigators in the field, and its confirmation by autoregressive modeling does not provide useful information about issues central to ERP data analysis. Furthermore, because he fails to take a full count of the number of parameters used in his autoregressive model his argument from parsimony is flawed. In any event, Collet's argument misperceives the heuristic mode in which PCA is used in actual studies. PMID- 2775808 TI - Effects of fear-relevance on electrodermal safety signal learning. AB - Safety signal learning in human subjects was investigated using a conditioned inhibition procedure with a shock unconditioned stimulus (US). The conditioned stimulus (CS) duration, and thus the CS-US interval, varied randomly from 20 to 50 s. Conditioning was assessed by change in tonic skin conductance level (SCL). Experiment 1 demonstrated reliable learning of a conditioned inhibition (A+/AB-) discrimination, in terms of both self-reported shock expectancy and change in SCL, in subjects who were able to report correctly the stimulus contingency. There was, however, no evidence of transfer of inhibitory properties from the safety signal B to a separately trained excitor. Experiment 2 compared two groups in which the safety signal was either fear-relevant (picture of snake or spider) or fear-irrelevant (flower or mushroom). As in previous research, there was no effect of fear-relevance on safety-signal learning. The results are discussed in terms of preparedness theory and excitatory conditioning with fear-relevant stimuli. PMID- 2775809 TI - Ovum transport in the rat oviductal ampulla in the absence of muscle contractility. AB - Ovum transport in mammalian oviducts involves two main effectors: ciliary motility and muscle contractility. To study the relative contribution of cilia to ovum transport in the rat, we blocked smooth muscle activity with isoproterenol, a beta-adrenergic agonist, and measured transport rates of surrogate ova in situ. Transport rates before isoproterenol administration were 0.04 mm/s in the cephalic ampulla and 0.03 mm/s in the caudal ampulla; rates were unchanged after administration of isoproterenol. To determine if isoproterenol affected ciliary activity, we measured ciliary beat frequency with laser-scattering spectroscopy over the effective isoproterenol dosage. Isoproterenol did not cause a significant change in ciliary beat frequency. Our results show that in the rat oviductal ampulla, ciliary motion is capable of transporting ova in the absence of muscle contractility. PMID- 2775810 TI - Ontogeny of the circadian rhythm of cortisol in sheep. AB - In this work we investigated the ontogeny of the rhythm of plasma cortisol in sheep. Plasma cortisol was measured by radioimmunoassay in blood samples obtained every 1 or 2 h, for periods of 24 or 48 h, in 13 fetal sheep (124-140 days of gestation; 130.6 +/- 1.5, mean +/- SE) and in 23 newborn (5-39 days of age). To this end, indwelling polyvinyl catheters were implanted into the femoral artery and vein in all animals. The presence of rhythm was determined by Cosinor Analysis. Newborns were separated into four groups. Group 1, newborns younger than 15 days of age (7.9 +/- 0.7 days), and Group 2, newborns older than 15 days of age (25.4 +/- 2.3), were raised under nyctohemeral conditions (12L:12D). Group 3, newborns younger than 15 days of age (11.4 +/- 0.9 days), and Group 4, newborns older than 15 days of age (22.0 +/- 1.2 days), were raised under constant light conditions. A 24-h rhythm of plasma cortisol (F) was observed in newborns over 15 days of age under both nyctohemeral: F (ng/ml) = 16.1 + 7.6 cos [15 (t-12.9)], (p = 0.01, n = 8) and constant light conditions: F (ng/ml) = 17.1 + 3.9 cos [15 (t-7.9)], (p = 0.02, n = 5). No rhythm was observed in fetal sheep or in newborn sheep younger than 15 days of age under nyctohemeral or constant light conditions. PMID- 2775811 TI - Effect of measurement conditions on quantification of hyperactivated human sperm subpopulations by digital image analysis. AB - The effect of different measurement conditions on the quantification of hyperactivated (HA) motility in human sperm by digital image analysis (DIA) was determined with respect to chamber depth, temperature, sperm concentration, time in the analysis chamber, culture medium, and type as well as concentration of extracellular protein components. In whole semen, the level of HA (less than 1%) as well as the values for all other motility parameters (curvilinear and straight line velocity, linearity of forward progression, maximum and mean lateral head amplitude, and beat cross frequency) were independent (p greater than 0.05) of temperature (24 vs. 37 degrees C). In washed sperm samples prepared by in vitro fertilization procedures, the percentage of HA cells was inversely related to measurement temperature and to albumin concentration in the culture medium. The effect of temperature on percentage of HA in washed sperm was reversible. HA analysis of washed sperm from 6 donors (3 ejaculates per donor) under defined DIA assay conditions showed no intra-donor variability (p greater than 0.05) but significant inter-donor variability (donor mean percentages ranging from a low of 3.6 to a high of 28.2). These results indicate that HA is influenced by measurement conditions, that HA is donor-dependent, and that each donor shows a characteristic level of HA. PMID- 2775812 TI - The metabolic clearance of progesterone in the pregnant rat: absence of a physiological role for the lung. AB - The metabolic clearance rate (MCR) of progesterone is among the highest for all steroid hormones studied, yet it is difficult to apportion this high MCR to specific organ contributions. The isolated lung has been shown to metabolize progesterone, and since this tissue receives the entire cardiac output, potentially it could make a major contribution to the overall MCR. This possibility was examined in the present study by measuring lung extraction of [3H]progesterone under steady-state conditions in the intact pregnant rat. Anesthetized rats (n = 6) were infused with [3H]progesterone via a femoral vein for 100 min on Day 16 of pregnancy. After the onset of steady state (40 min), four blood samples were obtained at 20-min intervals from the right ventricle and from the aorta, and the concentrations of [3H]progesterone and its metabolites were determined. Throughout the sampling period, mean arterial pressure and heart rate remained stable (two-way analysis of variance), as did the production rate (3.76 +/- 0.35 mg/day; mean +/- SEM) and the MCR (34.8 +/- 3.5 ml/min) of progesterone. Despite this high rate of clearance, there was no difference between the concentration of [3H]progesterone in arterial and right ventricular blood, indicating no net extraction of progesterone during passage through the lung. Furthermore, there was no change in the concentration of either lipid soluble or aqueous-soluble [3H]progesterone metabolites during trans-lung passage. These observations demonstrate that the lung does not contribute to the MCR of progesterone when measured under physiological and steady-state conditions. Therefore, the relationship, MCR (ml/min) = whole-body extraction (%) x cardiac output (ml/min), is upheld for progesterone in the rat. PMID- 2775813 TI - Regulation of the corpus luteum by protein kinase C. I. Phosphorylation activity and steroidogenic action in large and small ovine luteal cells. AB - The activity and steroidogenic action of protein kinase C were evaluated in small and large steroidogenic ovine luteal cells. Protein kinase C activity (per mg protein) was threefold greater in large than in small luteal cells, whereas protein kinase A activity was similar in the two cell types. Phorbol 12-myristate 13-acetate (PMA) activated protein kinase C in luteal cells as demonstrated by membrane association of 91% of available protein kinase C within 15 min of PMA treatment. Longer treatments with PMA produced cells with low protein kinase C activity (protein kinase C-deficient cells) but did not affect cellular viability or protein kinase A activity. Activation of protein kinase C caused an acute, dose-dependent inhibition of progesterone production in unstimulated large and luteinizing hormone (LH)-stimulated small luteal cells. This inhibition by PMA appeared to be specific for protein kinase C since it was greatly attenuated in protein kinase C-deficient cells and since an inactive phorbol ester, 4 alpha phorbol, had no effect on luteal progesterone production. The inhibitory locus of protein kinase C action in small luteal cells appeared to be distal to the adenylate cyclase enzyme because progesterone production was inhibited similarly in cells stimulated with LH, forskolin, or dibutyryl cyclic adenosine 3',5' monophosphate. Cholesterol side-chain cleavage activity, as measured by metabolism of 25-hydroxycholesterol, was inhibited by PMA in large, but not in small, luteal cells. These data indicate that activation of protein kinase C specifically inhibits progesterone production in both large and small ovine luteal cells, although the intracellular mechanisms invoked appear to differ in the two cell types. PMID- 2775814 TI - Antagonism of estrogen-induced prolactin release by dihydrotestosterone. AB - Previous work from our laboratory has demonstrated that progesterone can inhibit estrogen-induced prolactin release in female rats. Since androgens have been reported to mimic progesterone actions in certain systems, and to antagonize estrogen action in rat uteri, the purpose of this study was to determine whether androgens, like progestins, can inhibit estrogen-induced prolactin release. The ovariectomized (26 days of age) immature rat was used as the model for analysis of this question. Dihydrotestosterone (DHT) was chosen to be used throughout the study since it does not undergo aromatization to estrogens. In response to estradiol exposure (2 micrograms/rat), prolactin release reached peak values at 12 h and returned to control levels by 24 h. A second injection of estradiol 13 h after its initial injection stimulated a second increase in serum prolactin at 25 h. A single injection of DHT (0.8 mg/kg BW) 1 h before the second estradiol injection blocked the increase in serum prolactin. DHT had no effect on basal serum prolactin levels. The DHT inhibition of estrogen-induced prolactin release required estrogen priming. A dose dependency for the DHT effect was demonstrated, with low doses effective and high doses ineffective, in inhibiting estrogen action. This effect of DHT seemed to be androgen receptor-mediated, since flutamide blocked the effect. However, the possibility of progestin receptor mediation could not be ruled out since RU486 also blocked DHT's effect. Flutamide was also effective in blocking progesterone's inhibition of estrogen-induced action. This is perhaps consistent with an overlap of activities in androgens and progestins reported by several investigators.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2775816 TI - Changes in the blood concentrations of progesterone and 20 alpha-hydroxypregn-4 en-3-one during late pregnancy in the conscious rat: a specific role for metabolic clearance rate. AB - Near term in the rat, the blood concentration of progesterone falls while that of 20 alpha-hydroxypregn-4-en-3-one (20 alpha-DHP) increases. This is generally attributed to changes in ovarian secretion alone, but altered rates of hormone metabolism could also have a role. In the present study, therefore, metabolic clearance rate (MCR), production rate, and peripheral interconversion of progesterone and 20 alpha-DHP were measured on Day 16 of pregnancy, the time of maximal progesterone secretion, and on Day 22, one day prior to parturition. Conscious rats (n = 8 per group) were infused with either [3H]progesterone or [3H]20 alpha-DHP and the dynamics of progestin metabolism were calculated from the resultant isotopic and endogenous progesterone and 20 alpha-DHP concentrations. The blood concentration of progesterone declined by 69% between Day 16 (54 +/- 2 ng/ml) and Day 22 (17 +/- 2 ng/ml), and this was due to the combined effect of a 48% increase in the MCR and a 54% decrease in production rate of progesterone. In contrast, the production rate of 20 alpha-DHP was twofold greater on Day 22 compared to Day 16. As a result, the blood concentration of 20 alpha-DHP increased from 28 +/- 3 ng/ml on Day 16 to 40 +/- 6 ng/ml on Day 22, and this change would have been greater but for a concomitant increase (41%) in the MCR of 20 alpha-DHP. Although peripheral conversion of progesterone to 20 alpha-DHP was similar on Day 16 (transfer constant, 12.8 +/- 0.6%) and Day 22 (12.3 +/- 0.9%), the contribution of this conversion to total 20 alpha-DHP production fell from 32% to 7% between the two days.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2775815 TI - Prostaglandin F2 alpha-stimulated release of ovarian oxytocin in the sheep in vivo: threshold and dose dependency. AB - To determine the threshold of prostaglandin F2 alpha (PGF2 alpha)-stimulated oxytocin secretion from the ovine corpus luteum, low levels of PGF2 alpha (5-100 pg/min) were infused into the ovarian arterial blood supply of sheep with ovarian autotransplants. PGF2 alpha was infused for six sequential 10-min periods at hourly intervals, 6, 12, or 24 days after estrus (n = 3 for each day). Each cycle day was studied during a separate cycle. Oxytocin and progesterone in ovarian venous and carotid arterial plasma was measured by radioimmunoassay, and secretion rates were determined (venous-arterial concentration x plasma flow). In animals treated on Day 6, 5 pg/min PGF2 alpha caused a significant release of oxytocin (p less than 0.01), whereas in animals treated on Day 12, this threshold was 40 pg/min (p less than 0.05). In animals treated on Day 24, the threshold for oxytocin release was greater than 100 pg/min. PGF2 alpha did not significantly change ovarian blood flow or progesterone secretion rate on any day (p greater than 0.05). To determine residual luteal oxytocin after each threshold experiment, 5 mg PGF2 alpha was given i.m. to all animals. Significantly more oxytocin was released by Day 6 than by Day 12 and Day 24 corpora lutea, and by Day 12 than by Day 24 corpora lutea (1.2 micrograms, 0.7 microgram, and 0.3 microgram, respectively; p less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2775817 TI - Evidence for a light compensation of the inhibition of reproduction by low temperatures in the snail Helix aspersa. Ovotestis and albumen gland responsiveness to different conditions of photoperiods and temperatures. AB - Four combinations of photoperiods and temperatures have been tested on the reproduction and on the activity of the genital apparatus of the snail Helix aspersa. The results show some interaction between photoperiod and temperature and reveal a predominant effect of photoperiod that compensates for the negative effect of low temperatures. A combination of long day (LD, 18L:6D) and a temperature of 20 degrees C is the most favorable condition for egg-laying as well as for the effective functioning of the ovotestis and albumen gland. In contrast, during a short day (SD, 8L:16D), egg-laying is completely inhibited at 15 degrees C and partly inhibited at 20 degrees C; the differentiation of gametes can be observed in the ovotestis, but the mature oocytes are not released and thus they degenerate. In the albumen gland, an important synthetic activity is noticed, but cellular multiplication and the release of the secretory products decrease. These results suggest that short photoperiods induce inhibition of the (neuro)endocrine centers responsible for the control of both ovulation and egg laying. PMID- 2775818 TI - Timing of nuclear progression and protein synthesis necessary for meiotic maturation of bovine oocytes. AB - In cows, protein synthesis is required for germinal vesicle breakdown (GVBD). This study examines more closely the need for protein synthesis and the nuclear changes in the bovine oocyte during 24 h of culture. Bovine oocytes with compact and complete cumulus were washed and incubated in groups of 10 for up to 24 h in 50-microliters drops of TCM-199 supplemented with follicle-stimulating hormone (NIAMADD, 0.5 micrograms/ml), luteinizing hormone (LH) NIAMADD, 5 micrograms/ml), estradiol-17 beta (1 microgram/ml), pyruvate (20 microM), and 10% heat-treated fetal calf serum. Medium was overlaid with paraffin oil. Oocytes (n = 891) were fixed at the end of each 3-h interval from 0 to 24 h of culture, or at 24 h after addition of cycloheximide (10 micrograms/ml at 10 different times during maturation (0, 1, 2, 3, 6, 9, 12, 15, 18, 21 h; n = 175). At each time point, the chromosomal status of oocytes was evaluated, frequencies were computed, and the time spent on each step was determined. The germinal vesicle (GV) was present from 0 to 6.6 h, GVBD at 6.6 to 8.0 h, chromatin condensation at 8.0 to 10.3 h, metaphase I at 10.3 to 15.4 h, anaphase I at 15.4 to 16.6, telophase I at 16.6 to 18.0 h, and metaphase II at 18.0 to 24 h. Cycloheximide blocked oocyte maturation at GVBD, if added from 0 to 3 h; at chromatin condensation, if present from 6 to 24 h; and at metaphase I, when present from 9 to 12 h.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2775819 TI - Immunological analysis of the biochemical properties of the uterine estrogen receptor. AB - Immunohistochemical and immunochemical analysis using Western blot techniques were carried out with estrogen receptor (ER) monoclonal antibody H-222 to 1) clarify the "nuclear translocation" phenomenon of ER, 2) elucidate the primary nuclear binding site of ER, and 3) to evaluate the binding force between ER and its nuclear binding site in the uterus of ovariectomized adult mice. Exclusive nuclear localization of ER was recognized in the epithelial cells, stroma cells, and smooth muscle cells. Uterine tissues prepared from animals injected with saline, 17 beta-estradiol (E2), estriol (E3), and diethylstilbestrol (DES) exhibited almost the same ER immunostaining when they were fixed prior to sectioning (prefixation method) and frozen sections were used. On the other hand, when fresh-frozen sections were fixed before or after incubation with various solutions (postfixation method) and then treated with various salt solutions, greater differences were seen in immunostaining of ER between saline-injected and hormone-treated animals. Immunostaining of ER in control animals was low after incubation with PBS (0.01 M phosphate buffer containing 0.16 M NaCl, pH 7.2), whereas uterine tissue from hormone-injected mice showed strong nuclear immunostaining after this treatment. After treatment with 0.4 M KCl or 0.5 M NaCl, immunostaining in the uterus of both hormone-injected and control animals was completely abolished. DNase treatment caused an almost complete loss of immunostaining of ER; however, RNase digestion slightly increased immunoreactivity in both E2-injected and control animals. Quantitative analysis using sodium dodecyl sulfate-polyacrylamide gel electrophoresis and Western blot techniques showed that after incubation of tissue sections for 30 min with PBS, 0.4 M KCl, or DNase, 60%, 10%, and 30% of ER were present, respectively, compared to amount of ER present in unincubated sections. These findings suggest the following for the ER in uterine tissue; nuclear occupancy is a phenomenon that occurs due to a differential affinity between occupied and unoccupied receptors in the nucleus; after hormone treatment, the receptor levels do not fluctuate in the nucleus to the extent demonstrated by binding assays; and the properties of the ER detected in the immunohistochemical analysis are identical to those observed in biochemical studies. PMID- 2775820 TI - Estradiol-induced blockade of ovulation in the cow: effects on luteinizing hormone release and follicular fluid steroids. AB - Administration of 10 mg estradiol valerate (EV) to nonlactating Holstein cows on Days 16 of the estrous cycle prevented ovulation in 7 of 8 cows for 14 days post injection. In these 7 cows, the timing of luteolysis and the luteinizing hormone (LH) surge was variable but within the normal range. At 14 days post-treatment, each of these cows had a large (greater than 10 mm) follicle, with 558 +/- 98 ng/ml estradiol-17 beta, 120 +/- 31 ng/ml testosterone, and 31 +/- 2 ng/ml progesterone in follicular fluid (means +/- SE). A second group of animals was then either treated with EV as before (n = 22), or not injected (control, n = 17) and ovariectomized on either Day 17, Day 18.5, Day 20, or Day 21.5 (24, 60, 96, or 132 h post-EV). Treatment with EV did not influence the timing of luteolysis, but surges of LH occurred earlier (59 +/- 8 h post-EV vs. 100 +/- 11 h in controls). The interval from luteolysis to LH peak was reduced from 44 +/- 6 h (controls) to 6.9 +/- 1.5 h (treated). Histologically, the largest follicle in controls tended to be atretic before luteolysis, but nonatretic afterwards, whereas the largest follicle in treated animals always tended to be atretic. Nonatretic follicles contained high concentrations of estradiol (408 +/- 59 ng/ml) and moderate amounts of testosterone (107 +/- 33 ng/ml) and progesterone (101 +/- 21 ng/ml), whereas atretic follicles contained low concentrations of estradiol (8 +/- 4 ng/ml) and testosterone (12 +/- 4 ng/ml), and either low (56 +/- 24 ng/ml) or very high (602 +/- 344 ng/ml) concentrations of progesterone. This study suggests that EV prevents ovulation by inducing atresia of the potential preovulatory follicle, which is replaced by a healthy large follicle by 14 days post-treatment. PMID- 2775821 TI - Insulin-like growth factor I in the developing and mature rat testis: immunohistochemical aspects. AB - The distribution of insulin-like growth factor I (IGF-I; somatomedin C) was mapped in testes of different aged rats by using immunohistochemical techniques. The antiserum used, K 624, has been demonstrated to be specific for human IGF-I, as defined by several criteria. Antibodies to the M1 subunit of ribonucleotide reductase, a key enzyme in DNA synthesis, were used to visualize meiotic and mitotic cells. Cytoplasmic IGF-I-like immunoreactivity as demonstrable during the first two postnatal weeks in spermatogenic cells, in Sertoli cells, and in Leydig cells. The IGF-I-like immunoreactivity decreased in the Sertoli and Leydig cells during the third and fourth postnatal weeks, and in adult rats, only spermatogenic cells showed IGF-I-like immunoreactivity. In mature rat testes, the spermatocytes were strongly immunoreactive. During puberty and adulthood, the spermatogonia expressed subunit M1 ribonucleotide reductase immunoreactivity, whereas no IGF-I-like immunoreactivity could be detected. No extracellular immunoreactivity was observed. We propose that IGF-I and/or IGF-I-like substances, possibly formed by primary spermatocytes, are likely to be involved in differentiation processes, but not in the initiation of cell proliferation in adult testes. The autocrine and/or paracrine action of IGF-I and/or IGF-I-like substances may thus have different action in developing testes than in adult testes. Our results do, however, not allow firm statements about whether IGF-I and related substances exert their actions on Sertoli cells or spermatogenic cells. PMID- 2775822 TI - The calcium-binding protein SPARC is secreted by Leydig and Sertoli cells of the adult mouse testis. AB - In mammals, polypeptides secreted by cells of the testis are believed to influence spermatogenesis and to affect the behavior of the resident somatic cell populations. The 43,000-MW, secreted, calcium-binding glycoprotein SPARC (Secreted Protein, Acidic and Rich in Cysteine) is synthesized by a number of embryonic, fetal, and adult somatic cells and is associated with areas of cellular differentiation, proliferation, and morphological reorganization. Here, we report on the expression of SPARC in the testes of adult mice. By immunohistochemistry, SPARC was observed in the cytoplasm of Leydig cells and of Sertoli cells bearing late-stage, elongate spermatids. Testicular mRNA, translated in vitro, yielded a polypeptide of approximately 42,000 MW that bound anti-SPARC antibodies. Northern blot analysis revealed 2.3 kilobase (kb) SPARC mRNA in the testis, a size comparable to that of SPARC mRNA in nongonadal cells. Western blot assays of proteins separated by sodium dodecyl sulfate polyacrylamide gel electrophoresis revealed an immunoreactive polypeptide of 43,000 MW in purified mouse Sertoli cells and their culture supernatants. Similar assays of testis interstitial fluid revealed 43,000 MW and 30,000 MW immunoreactive polypeptides. By indirect immunofluorescence, purified mouse Leydig cells cultured 24-48 h expressed SPARC in cytoplasmic granules. Cultured Leydig cells incorporated [35S]methionine into a secreted polypeptide of 43,000 MW that was recognized by anti-SPARC antibodies. In metal binding assays, purified SPARC bound Ca2+, Fe2+ and Cu2+. The function of SPARC in testes may be to sequester or transport certain metallic cations. Our recent discovery that SPARC induces changes in shape of certain nongonadal cell types also suggests that this glycoprotein may influence the functions of both Leydig and Sertoli cells by affecting their morphology. PMID- 2775823 TI - [Status of the development of cochlear prostheses relying on electric stimulation]. AB - Inner ear prostheses, or cochlear implants, are neuroprostheses providing profoundly deaf people with sound sensations through electrical stimulation of the auditory nerve. Approximately 2,000 of these devices are currently in use worldwide. Five models are each being used by more than 50 patients. Among other features they differ from one another mainly in the design and placement of electrodes and in the particular speech coding strategy used, periodicity and tonotopy priciple being made use of to a highly varying degree. Nevertheless, 4 of the 5 devices lead to quite comparable degrees of speech understanding without additional lipreading. PMID- 2775824 TI - [Pre-ejection period controlled cardiac pacemaker]. AB - Numerous investigations have been performed in search for suitable parameters for physiologic adaptation of the pacing rate. In case of chronotropic incompetence corporeal as well as cardiac control parameters permit open or closed loop control of the pacing rate. Criteria to be considered are the patient's condition, the response time of the system, the proportionality to the oxygen uptake and the susceptibility to interference. A high specificity of the rate response is particularly important for the patient with a low cardiac reserve. The use of a parameter relating to the central hemodynamics, such as the systolic time intervals, particularly the pre-ejection period (PEP), as input signal for rate control is, therefore, of special interest. The concept presented of a PEP controlled rate adaptive pacemaker is based on the linear proportionality between PEP and the cardiac cycle length. Changing with the sympathetic tone, the PEP permits adaptation of the pacing rate in response to physical as well as emotional stress. The right ventricular PEP parallels the left ventricular one and is measured between the electrode tip and the pacemaker housing. Clinical results obtained confirm the high sensitivity and specificity of this control parameter with respect to the metabolic demand. Technical details of an implantable multiprogrammable device are dealt with. PMID- 2775825 TI - [Titanium nitride cardiac pacemaker electrodes]. AB - The sensing and pacing performance of pacemaker electrodes is characterized by the electrochemical properties of the electrodes/tissue layer; the usually smooth metallic electrode surface results in a high pass filter characteristic. Consequently, the detected intracardiac signals, which control the implantable systems, are not optimally matched to the spectral contents of the depolarisation signal. To avoid interference caused by noise (EMI, muscle potentials, etc.) a shift of the frequency of the band pass towards the lower frequency spectrum is required. As previously reported, the electrochemical properties of sintered and surface-treated electrodes prove the predicted improvement of sensing performance if titanium-nitride coated electrodes are used. Our results demonstrate their superiority above all the other electrodes presently known. The advantages can be referred to the micro-crystalline surface structure achieved by sputter-deposited electrode coatings and the kinetics of the ionic exchange. Furthermore, the acute thresholds achieved with the TiN-systems were significantly better than those of the smooth metallic surface. These results were also confirmed for chronic implants and are attributable to the known biocompatibility of titanium and its alloys. PMID- 2775826 TI - [Motion energy as a control variable for adapting stimulation frequency]. AB - An activity sensing rate-responsive pacing system is presented which adaptively controls heart rate to adjust cardiac output in response to increased metabolic demand, and more optimally restore homeostasis of the intact cardiovascular system. The current use of ventricular demand and DDD universal pacing systems, although rate and multi-parameter and multi-function programmable, are fixed at these programmed settings. These devices are adequate for patients at rest or during moderate exertion, but are suboptimal for physically active patients whose physiology requires increased oxygen supply to meet an increased cardiac demand. In the past, these patients may have experienced fatigue or dyspnea out of proportion to their cardiovascular disease. The Ergos rate-adaptive single- and dual-chamber pacing system is a second generation pulse generator which is rate responsive to a patient's increased physiologic demand by sensing a motion signal which reflects increased work load and the need for a compensating increase in heart rate. Ergos offers increased assistance to patients with sinus bradycardia who may require the rate-responsiveness with the additional advantage of AV synchrony. Clinical results show the effectiveness of the presented sensor control by motion energy for rate adaptive pacing therapy. PMID- 2775827 TI - Polymorphic phase behavior of lysophosphatidylethanolamine dispersions. A thermodynamic and spectroscopic characterization. AB - We have investigated the phase behavior of aqueous dispersions of a series of synthetic lysophosphatidylethanolamines as a function of the acyl chain length. Lysophosphatidylethanolamines exhibit phase polymorphism encompassing a well ordered crystalline phase which may arise either from a metastable interdigitated lamellar gel phase or a metastable micellar phase. The time course of interconversion between these various phases have been outlined by observing the low temperature incubation time dependence of the calorimetric thermograms. We have determined differences in structure of these phases by Raman spectroscopy and 31P nuclear magnetic resonance spectroscopy. It appears that a principal contribution to this polymorphic phase behavior lies in the nature of headgroup hydration and headgroup-headgroup interactions. PMID- 2775828 TI - Quasi-continuum models of twist-like and accordion-like low-frequency motions in DNA. AB - Formulae for calculating low-frequency twist-like and accordion-like modes of DNA molecules have been derived using a quasi-continuum model. The formulae can be employed in essentially all (viz. A, B, C, D, E, and Z) forms of DNA. Calculated results indicate that the experimentally observed low-frequency modes at 22 cm-1 for the A-form octanucleotide (d[CCCCGGGG]) and at 18 cm-1 for the B-form dodecanucleotide (d[CGCAA ATTTGCG]) may result from accordion-like motions, while those observed at 12 cm-1 and 15 cm-1 may result from combinations of twist-like oscillations excited in the intact segments of B- and A-DNA's, respectively. Frequency shifts in the low-frequency modes observed when DNA molecules undergo conformational changes among different forms are also discussed in terms of the current model. PMID- 2775829 TI - Mutual diffusion of interacting membrane proteins. AB - The generalized Stokes-Einstein equation is used, together with the two dimensional pressure equation, to analyze mutual diffusion in concentrated membrane systems. These equations can be used to investigate the role that both direct and hydrodynamic interactions play in determining diffusive behavior. Here only direct interactions are explicitly incorporated into the theory at high densities; however, both direct and hydrodynamic interactions are analyzed for some dilute solutions. We look at diffusion in the presence of weak attractions, soft repulsions, and hard-core repulsions. It is found that, at low densities, attractions retard mutual diffusion while repulsions enhance it. Mechanistically, attractions tend to tether particles together and oppose the dissipation of gradients or fluctuations in concentration, while repulsions provide a driving force that pushes particles apart. At higher concentrations, changes in the structure of the fluid enhance mutual diffusion even in the presence of attractions. It is shown that the theoretical description of postelectrophoresis relaxation and fluorescence correlation spectroscopy experiments must be modified if interacting systems are studied. The effects of interactions on mutual diffusion coefficients have probably already been seen in postelectrophoresis relaxation experiments. PMID- 2775830 TI - Evidence for ligand-induced conformational changes in proteins from phosphorescence spectroscopy. AB - Phosphorescence spectroscopy on mouse myeloma IgA J539 in rigid solution at 77K revealed the type of anomalous short-lived component in the tryptophan decay originally observed with lysozyme (Churchich, J.E., 1966. Biochim. Biophys. Acta. 120:406-412) and seen in a large number of Bence Jones proteins (Longworth, J.W., C.L. McLaughlin, and A. Solomon. 1976. Biochemistry. 15:2953-2958). The decay time of the anomalous component that results from the interaction between tryptophan side chains and disulfide linkages in proteins was observed to significantly lengthen in J539 in response to binding of a galactan antigen. With hen egg-white lysozyme in which the type of fluorescence enhancement on ligand binding seen with J539 has also been observed, phosphorescence measurements revealed a similar lengthening of the decay time of the disulfide-induced anomalous component in the tryptophan decay. These perturbations are interpreted as ligand-induced changes to the tryptophan-disulfide proximities that have been shown to exist in these structures. Given the short-range nature of the disulfide perturbation (see following article) the observations suggest, in particular when combined with x-ray crystallographic data, that phosphorescence decay-time measurements of disulfide perturbations can serve as a sensitive spectroscopic indicator of subtle conformational changes in immunoglobulins and other tryptophan-disulfide containing proteins. PMID- 2775831 TI - Distance dependence of the tryptophan-disulfide interaction at the triplet level from pulsed phosphorescence studies on a model system. AB - In the present study the distance dependence of tryptophan-disulfide interaction is examined with a view to both utilizing the interaction as a more quantitative indicator of subtle conformational changes in proteins as well as elucidating the interaction mechanism. To examine perturbations specifically at the indole triplet level 2-(3-indolyl)-ethyl phenyl ketone (IEPK) in which excitation is transferred with high efficiency to the triplet state of the indole moiety was employed. Phosphorescence decays of IEPK excited by a laser pulse in 70/30 (vol/vol) ethanolether at 77 K were measured in the presence of various concentrations of simple disulfides. The nonexponential phosphorescence decays arising from a distribution of fixed chromophoreperturber separations and the steady-state quenching of IEPK were accounted for with an exponential dependence of the quenching rate constant with distance. The small effective Bohr radius (0.8 A) that appears in the exponent emphasizes the localized nature of the interaction. Comparison of the triplet quenching rate constant obtained at quencher contact with IEPK to that estimated in proteins suggests a dependence on the triplet energy of the indole moiety and an endothermic nature for the quenching process. The study predicts that in proteins tryptophan-disulfide interactions are very localized in nature and should give rise to detectable anomalous decays only out to 2 A beyond van der Waals contact between the interacting partners. PMID- 2775832 TI - Surface pH controls purple-to-blue transition of bacteriorhodopsin. A theoretical model of purple membrane surface. AB - We have developed a surface model of purple membrane and applied it in an analysis of the purple-to-blue color change of bacteriorhodopsin which is induced by acidification or deionization. The model is based on dissociation and double layer theory and the known membrane structure. We calculated surface pH, ion concentrations, charge density, and potential as a function of bulk pH and concentration of mono- and divalent cations. At low salt concentrations, the surface pH is significantly lower than the bulk pH and it becomes independent of bulk pH in the deionized membrane suspension. Using an experimental acid titration curve for neutral, lipid-depleted membrane, we converted surface pH into absorption values. The calculated bacteriohodopsin color changes for acidification of purple, and titrations of deionized blue membrane with cations or base agree well with experimental results. No chemical binding is required to reproduce the experimental curves. Surface charge and potential changes in acid, base and cation titrations are calculated and their relation to the color change is discussed. Consistent with structural data, 10 primary phosphate and two basic surface groups per bacteriorhodopsin are sufficient to obtain good agreement between all calculated and experimental curves. The results provide a theoretical basis for our earlier conclusion that the purple-to-blue transition must be attributed to surface phenomena and not to cation binding at specific sites in the protein. PMID- 2775833 TI - Proton flux in large unilamellar vesicles in response to membrane potentials and pH gradients. AB - The transport of protons across liposomes composed of phosphatidylcholine in response to electrical potentials or pH gradients has been investigated. The results support three major conclusions. The first of these concerns the need for reliable measurements of electrical potentials and pH gradients. It is shown that the potential probe tetraphenylphosphonium and the pH probe methylamine provide accurate and self consistent measures of electrical potentials and pH gradients respectively in these systems. Second, it is shown by two independent techniques that the pH gradients induced in response to valinomycin and potassium dependent electrical potentials are significantly smaller than would be expected for electrochemical equilibrium. The pH gradients observed are stable over an 8 h time course and are sensitive to the ionic composition of the buffers employed, where the presence of external sodium results in the smallest induced pH gradients. These results are discussed in terms of current models of proton conductance across membranes. In a final area of investigation, it is shown that valinomycin and carbonyl cyanide m-chlorophenyl hydrazone (CCCP) can transport sodium ions in a synergistic manner. PMID- 2775835 TI - Phonon interpretation of inelastic neutron scattering in DNA crystals. AB - The calculated spectrum of longitudinal compressional waves on DNA polymer chains is shown to be in excellent agreement with recently performed inelastic neutron scattering measurements in hydrated, oriented DNA crystals. This opens up a previously unexplored frequency regime of DNA science and establishes the validity of the phonon extended wave description of DNA elementary excitations in this region. PMID- 2775834 TI - Form birefringence of muscle. AB - We investigate the sensitivity of measurements of muscle birefringence to cross bridge dynamics in the resting, active, and rigor states. The theory of form birefringence is reviewed, and an optical model is constructed for the form birefringence of muscle. Values for the parameters in the model are selected or deduced from the literature. As an illustration of the use of the model, plausible distributions for the orientations of cross-bridges in the resting, active, and rigor states are constructed using a model for cross-bridge dynamics suggested by Huxley and Kress (1985). The general magnitude of the predictions of our model is comparable with that of published measurements of muscle birefringence. However, the precise values of the predicted birefringence for the resting, active, and rigor states are sensitive to the assumed orientations of cross-bridges. We also investigate the dependence of muscle birefringence on sarcomere length and on disorder in the orientation of the myofilament array. We conclude that measurements of muscle birefringence can play a useful role in distinguishing between proposed models of cross-bridge dynamics. PMID- 2775836 TI - Prediction of DNA structure from sequence: a build-up technique. AB - A build-up technique has been devised that permits prediction of DNA structure from sequence. No experimental information is employed other than the force field parameters. This strategy for dealing with the multiple minimum problem requires a supercomputer to make the necessary global searches. The number of energy minimization trials that were made for each of the 16 deoxydinucleoside monophosphate conformational building blocks of DNA was 1944. As a test case, the minimum energy conformations of d(GpC) and d(CpG) to 5.5 kcal/mole were then combined to generate energy-minimized structures for d(CpGpC). The number of trials that were made for d(CpGpC) was 3752. Minima for this single-stranded trimer to 15 kcal/mole were then employed to search for minimum energy conformations of the duplex d(CpGpC).d(GpCpG). The number of starting conformations that were utilized at this stage was 1514. The lowest energy duplex had a Z-II-DNA conformation, followed by a B-DNA form at 1.2 kcal/mole. The A- and Z-I-forms as well as many novel Watson-Crick base-paired structures were found at higher energy. Finally, energy-minimized structures of d(CG)6.d(CG)6 in Z-II and B-DNA conformations were computed using torsion angles from the analogous duplex trimer minima. PMID- 2775837 TI - Sequence dependence of the B-A conformational transition of DNA. AB - We have studied, by conformational analysis, the sequence dependence of DNA conformational transition between B- and A-forms. We have considered intramolecular interactions between base pairs, without backbone, to examine their role in the conformational transition between B- and A-forms, and found that base pairs themselves usually have intrinsic conformational preferences for the B- or A-form. Calculation of all ten possible base steps shows that the base combinations, CC (or GG), GC, AT, and TA, have tendencies to assume the A conformation. Results show that it is particularly easy to slide along the long axis of the base pair for these steps, with AT and CC showing especially flat energies. These calculations show that a preference for the B- or A-conformation depends on the electrostatic energy parameters, in particular, on dielectric and shielding constants; the A-conformation is preferred for low dielectric constant or low shielding. Both the A- and B-conformations are mainly stabilized by electrostatic interactions between favorably juxtaposed atomic charges on base pairs; however, the B-conformation generally has more favorable van der Waals interactions than the A-form. These sequence-dependent conformational preference and environmental effects agree roughly with experimental observations, suggesting that the origin of the conformational polymorphism is attributable to the intrinsic conformational preference of base pairs. PMID- 2775839 TI - Ca2+ transport through lipid membrane by diastereomer cyclic octapeptides. AB - Effects of the nature and orientation of a side chain in cyclic octapeptides on Ca2+ transport were examined by using cyclo[L-Lys(Z)-Sar-L-Leu-Sar]2 (C8-L), cyclo[L-Lys(Z)-Sar]4 (C8KS), and their diastereomer cyclic octapeptides, cyclo[L Lys(Z)-Sar-D-Leu-Sar]2 (C8-D) and cyclo[L-Lys(Z)-Sar-D-Lys(Z)-Sar]2 (C8Kk). All these cyclic octapeptides were found to take a single conformation in CDCl3, and the conformation was C2-symmetric for C8-L and C8-D, and C4-symmetric for C8KS and C8Kk. They formed a complex with Ca2+. Upon complexation, C8KS accompanied isomerization of peptide bonds, but C8-D retained the arrangement of peptide bonds. The amount of Ca2+ extracted from an aqueous solution to a chloroform solution by all L cyclic octapeptide C8-L or C8KS was about twice that of Na+, but 6-8-fold smaller than that by C8-D or C8Kk including D units. These cyclic octapeptides were capable of transporting Ca2+ through a lipid membrane above the phase transition temperature, and the transport rate decreased in the order of C8Kk-C8KS greater than C8-D greater than C8-L. PMID- 2775838 TI - Ca2+ binding cyclic octapeptides having an alternating Sar and a hydrophobic amino acid in the sequence. AB - Cyclic octapeptides having alternating Sar and hydrophobic amino acid sequences, such as cyclo[Lys(Z)-Sar-Leu-Sar-Leu-Sar-Leu-Sar] (C8KL), cyclo[Glu(OMe)-Sar Lys(Z)-Sar-Leu-Sar-Leu-Sar] (C8KE, and cyclo[Lys(Suc)-Sar-Leu-Sar-Leu-Sar-Leu Sar] [C8K(Suc)L, Suc represents succinic acid], were synthesized. These cyclic octapeptides formed a complex selectively with Ca2+. Upon complexation, trans peptide bonds of Sar residues were isomerized to cis peptide bonds. C8KL and C8KE showed very similar characteristics of Ca2+ binding, extraction of Ca2+ from an aqueous solution to a chloroform solution, and Ca2+ transport through a liquid chloroform membrane. C8KL transported Ca2+ across the lipid bilayer membrane above the phase-transition temperature, while C8KE and C8K(Suc)L did not. Therefore, the transport of Ca2+ through the lipid bilayer membrane is very sensitive to the hydrophobicity of the carrier molecule. PMID- 2775840 TI - Role of water molecules in the crystal structure of Gly-L-Ala-L-Phe: a possible sequence preference for nucleation of alpha-helix? AB - The synthetic peptide Gly-L-Ala-L-Phe (C14H19N3O4.2H2O; GAF) crystallizes in the monoclinic space group P2I1), with a = 5.879(1), b = 7.966(1), c = 17.754(2) A, beta = 95.14(2) degrees, Dx = 1.321 g cm-3, and Z = 2. The crystal structure was solved by direct methods using the program SHELXS-86 and refined to an R value of 0.031 for 1425 reflections (greater than 3 sigma). The tripeptide exists as a zwitterion in the crystal and assumes a near alpha-helical backbone conformation with the following torsion angles: psi 1 = -147.8 degrees; phi 2, psi 2 = -71.2 degrees, 33.4 degrees; phi 3, psi 3 = -78.3 degrees, -43.3 degrees. In this structure, one water molecule bridges the COO- and NH3+ terminii to complete a turn of an alpha-helix and another water molecule participates in head-to-tail intermolecular hydrogen bonding, so that the end result is a column of molecules that looks like an alpha-helix. Thus, the two water molecules of crystallization play a major role in stabilizing the near alpha-helical conformation of each tripeptide molecule and in elongating the helix throughout the crystal. An analysis of all protein sequences around regions containing a GAF fragment by Chou-Fasman's secondary structure prediction method showed that those regions are likely to assume an alpha-helical conformation with twice the probability they are likely to adopt a beta-sheet conformation. It is conceivable that a GAF fragment may be a good part of the nucleation site for forming alpha-helical fragments in a polypeptide, with the aqueous medium playing a crucial role in maintaining such transient species. PMID- 2775841 TI - Two gamma-bends in the backbone conformation of [D-Ala2]-leucine enkephalin in solution. AB - The solution conformation of [D-Ala2]-leucine enkephalin in its zwitterionic form in DMSO-d6 has been monitored by one- and two-dimensional proton magnetic resonance spectroscopy at 500 MHz. The resonances from the labile amide protons and the nonlabile protons have been assigned from the shift correlated spectroscopy. The chemical shift of the amide and C-alpha protons are found to vary with temperature but in opposite directions, except the C-alpha proton of the terminal tyrosine residue. This behavior has been explained by the shifting of equilibrium between the zwitterionic and neutral forms of the [D-Ala2]-leucine enkephalin and probably conformational changes accompanying temperature variation. The low values of the temperature coefficients of leucine and glycine amide protons indicate that these protons are either intramolecularly hydrogen bonded or solvent shielded. The observation of sequential cross peaks in the nuclear Overhauser effect spectra obtained at various mixing times, tau m (200 900 ms), indicate an extended backbone, which does not corroborate with the presence of a folded structure, i.e., beta-bend type structure. The estimate of interproton distances in conjunction with the low values of temperature coefficients of the leucine and glycine amide protons and vicinal coupling constants 3JHN-C alpha H have been rationalized by the predominance of two gamma bends in the backbone conformation of [D-Ala2]-leucine enkephalin. The gamma-bend around the D-Ala residue has phi = 80 degrees and psi = 270 degrees, while the one around Phe it has phi = 285 degrees and psi = 90 degrees. PMID- 2775842 TI - Crystal structure and molecular conformation of the peptide N-Boc-L-Gly-dehydro Phe-NHCH3. AB - The peptide N-Boc-L-Gly-dehydro-Phe-NHCH3 was synthesized by the combination of N Boc-L-Gly-dehydro-Phe azlactone and methylamine. The peptide crystallizes in orthorhombic space group P2(1)2(1)2(1) with a = 5.679(2) A, b = 16.423(9) A, c = 19.198(10) A, V = 1791(2) A3, Z = 4, dm = 1.212(5) Mg m-3, dc = 1.237(1) Mg m-3. The structure was determined by direct methods using SHELXS 86. The structure was refined by full-matrix least squares procedure to an R value of 0.049 for 1509 observed reflections. The molecular dimensions are, in general, in good agreement with the standard values. The bond angle C alpha-C beta-C gamma in the dehydro Phe residue is 133.6(5) degrees. The peptide backbone torsion angles are theta 1 = -171.4(4) degrees, omega 0 = 178.2(4) degrees, phi 1 = -57.2(6) degrees, psi 1 = 141.2(4) degrees, omega 1 = -174.4(4) degrees, phi 2 = 71.5(6) degrees, psi 2 = 7.2(6) degrees, and omega 2 = -179.8(5) degrees. These values show that the backbone adopts the beta-bend type II conformation. The Boc group has a trans trans conformation. The side-chain torsion angles in dehydro-Phe are chi 2 = 1.6(9) degrees, chi 2(2, 1) = 0.5(9) degrees, and chi 2(2, 2) = 179.8(6) degrees. The plane of C2 alpha-C2 beta-C2 gamma is rotated with respect to the plane of the phenyl ring at 0.5(6) degrees, which indicates that the atoms of the side chain of the dehydro-Phe residue are essentially coplanar.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2775844 TI - Solvation thermodynamics of biopolymers. I. Separation of the volume and surface interactions with estimates for proteins. AB - The present paper is a systematic first approach to the problem of solvation thermodynamics of biomolecules. Most previous approaches have been only crude estimates of solvent contributions, and have simply assessed solvation free energy as proportional to surface areas. Here we estimate the various contributions and divide them into (a) hard-core interactions dependent upon the entire volume of solute and (b) the remainder of interactions manifested through surfaces, such as van der Waals, charge-charge, or hydrogen bonds. We have estimated the work to create a cavity with scaled-particle theory (SPT), the van der Waals interactions on the surface, and hydrogen bonds between the surface and the solvent. The conclusion here is that this latter term is the largest component of the solvation free energy of proteins. From estimates on nine diverse proteins, it is clear that the larger the protein, the more dominant is the hydrogen-bond term. In the next paper, we indicate that correlations between hydrogen-bonding groups on the surfaces could increase the magnitude of the hydrogen-bond contribution. PMID- 2775843 TI - Light scattering studies of bovine skin proteodermatan sulfate. AB - The proteodermatan sulfate (PDS) of bovine skin is a low molecular weight proteoglycan with a molecular structure consisting of a protein chain and a sulfated polysaccharide chain covalently linked at the 4-serine of the protein. Static and dynamic laser light scattering methods have been used to determine the weight-average molecular weight, Mw, zeta-average radius of gyration, Rg zeta, and zeta-average translational diffusion coefficient, Dto, zeta, of bovine skin PDS. We have also characterized the two components of PDS, i.e., the protein core and the dermatan sulfate (DS) chain. (The latter contained an N-terminal-linked penta- or tetrapeptide.) Interpretation of the PDS data is complicated by the block copolymer nature of its structure. When appropriate corrections are made, our results indicate that Mw for PDS monomer is 62,000 when dissolved in 4M guanidine hydrochloride (GdnHCl), and increases to 610,000 in 0.15M NaCl. Mw for the core protein in 4M GdnHCl is 39,000, and this also increases substantially to 650,000 in 0.15M NaCl. In contrast, Mw for the DS chain is 24,000 in 0.15M NaCl, indicating that there is minimal self-association of DS in 0.15M NaCl. Thus we conclude that the self-association of PDS involves the protein core. Comparison of Rg zeta and Rh, the average hydrodynamic radius, suggests that trace amounts of aggregation persist for the PDS and its core protein even in 4M GdnHCl. This conclusion is supported by evaluation of the second moments of the dynamic light scattering correlation function. Comparisons of the observed Dto, zeta for PDS with predicted values using hydrodynamic theory are consistent with a "lollipop" conformation for the molecule. PMID- 2775845 TI - Solvation thermodynamics of biopolymers. II. Correlations between functional groups. AB - The extent of correlations between functional groups that can form hydrogen bonds with solvent molecules has been estimated. From the observed distance distribution of functional groups on the surfaces of several proteins, and from the extent of correlation between pairs of such functional groups, we conclude that the assumption of independence of functional groups made in part I is probably a good approximation. The reason is that even when correlations exist there is, on average, cancellation of the positive and negative correlations. The relevance of hydrogen bonding with the solvent to the relative stability of different conformers of biopolymers is also indicated. PMID- 2775846 TI - The interaction of calcium (II) with DNA probed by 43Ca-NMR is not influenced by terminal phosphate groups at ends and nicks. PMID- 2775847 TI - Local dynamics in biological macromolecules. AB - The diffusive approach in the optimized Rouse-Zimm approximation to segment relaxation in the nanosecond time domain (ORZLD) is extended to consider chains of nonequivalent units as occurring in biological macromolecules. The correlation times for second-order time correlation functions of each virtual bond on the chain are calculated for some homopolypeptides, and random and regular copolypeptides. The expected correlation times for biological macromolecules organized in multiple domains are discussed via a simple model of the ORZLD hierarchy. Dynamic bond correlation times are compared with static local persistence lengths. PMID- 2775849 TI - Aggregation of amphotericin B in the presence of gamma-cyclodextrin. AB - The macrolide antibiotic amphotericin B (AmB) forms an inclusion complex with gamma-cyclodextrin (gamma-CDx), resulting in a molecularly dispersed state of the drug. The state of aggregation of AmB in different solvents has been studied by absorption (uv-vis) and CD spectroscopy. While in aqueous solutions AmB forms colloid-like multimolecular aggregates, in the presence of gamma-CDx true solutions can be prepared, which show similar spectral properties as AmB dissolved in organic solvents. The AmB-gamma-CDx complex can be isolated as an amorphous, stable, water-soluble powder, indicating that gamma-CDx is a good carrier for the solubilization of this antibiotic. Using gamma-CDx as a carrier, the danger of precipitation of the drug during parenteral or intravenous administration can be largely reduced. PMID- 2775848 TI - Free energy of hydration of collagen models and the enthalpy of the transition between the triple-helical coiled-coil and single-stranded conformations. AB - Interactions with water make an important contribution to the free energy of stabilization of the collagen triple helix, but they do not alter the structure of the triple helix, i.e., the packing geometry of the three strands. Conformational energy computations have been carried out on poly(tripeptide) analogues of collagen, with the introduction of a newly developed form of a hydration shell model to compute the free energy of hydration. The most stable triple helix formed by poly(Gly-Pro-Pro), obtained earlier from conformational energy computations [M. H. Miller & H. A. Scheraga (1976) J. Polym. Sci. Polym. Symp. 54, 171], with a structure that is very closely similar to the observed structure, is strongly favored over other three-strand complexes, both in the absence and the presence of hydration. The hydration shell model does not provide an explanation for the increased stability of the poly(Gly-Pro-Hyp) triple helix as compared to poly(Gly-Pro-Pro). It appears that the difference should be attributed to specific binding of water, and effect that is not yet included in the present version of the hydration shell model. On the other hand, this model accounts for the observed enthalpy of unfolding of a poly(Gly-Pro-Pro) triple helix to isolated single chains in solution in terms of intramolecular noncovalent interactions and the free energy of hydration. PMID- 2775850 TI - The CD of two-chain coiled coils: experiments on tropomyosin and tropomyosin segments in the tyrosine/disulfide spectral region. AB - CD experiments are reported for several coiled-coil species in the tyrosine/disulfide (approximately 250-350-nm) region. Intact noncross-linked tropomyosin (approximately 3 degrees C) shows a negative nonsymmetric band maximal at 280 nm. This spectrum is the sum over six tyrosines/chain, and has conformational significance, since it disappears on denaturation. Experiments on an excised coiled-coil segment, each of whose chains comprise residues 11-127 of the tropomyosin sequence and only one tyrosine (Y60), reveal that not all tyrosines are alike. The spectrum at 3 degrees C shows a small negative maximum at approximately 285 nm and a substantial, hitherto unknown, positive band at approximately 270 nm, the latter masked in the parent protein by the negative contribution from the other tyrosines. A noncross-linked coiled-coil segment comprising residues 142-281, in which Y60 is absent, shows no such positive band. This peculiarity of Y60 is confirmed by absorbance spectra, with the extinction coefficient of Y60 larger in benign media than the average of the other tyrosines. Intact (3 degrees C) C190 cross-linked tropomyosin is known to yield, besides tyrosine contributions, a positive maximum at approximately 300 nm. Subtracting the corresponding data for noncross-linked tropomyosin shows that the disulfide spectrum itself actually has two equal, partly resolved bands at, respectively, 250 and 280 nm. The existence of a chiral disulfide argues for a relatively rigid, perhaps strained, local coiled coil. A C190 cross-linked segment comprising residues 142-281 shows a chiral disulfide spectrum like tropomyosin's, but another segment, comprising residues 168-284, shows none; thus removal of residues 142-167 causes loss of chirality at C190, over 20 residues away. These spectra thus contain important information on the subtle local differences in coiled-coil structures. PMID- 2775851 TI - CD and small-angle x-ray scattering of silk fibroin in solution. AB - We investigated the structure of silk fibroin dissolved in water and in water organic solvent mixtures by CD and small-angle x-ray scattering (SAXS). CD spectra indicated a disordered secondary structure in water and a beta-sheet conformation in aqueous organic solvents, such as methanol, dioxane, and trifluoroethanol (in trifluoroethanol a transient form evolving toward beta-sheet conformation was seen just after dissolution). The SAXS technique indicated the presence of fibroin particles of lamellar shape. The molecular weight was 188,000 daltons in water and 302,000 daltons in aqueous methanol. PMID- 2775852 TI - A temperature-dependent Z to B to single-strand transition in d(CGCG). AB - A thermally induced left- to right-handed helical interconversion for the self complementary tetradeoxynucleotide d(CGCG) has been observed in the presence of NaCl at concentrations from 1.5 to 2.25M. Analysis of the Raman spectrum of d(CGCG) in aqueous solution as a function of temperature indicates that at low temperature a left-handed Z-helical form is the predominant species. An increase in temperature results in a decrease in the population of the left-handed form and an increase in the population of the right-handed form. Further elevation in temperature results in extensive disruption of base stacking and a loss of secondary structure. This unstacking presumably represents dissociation to a single-stranded structure. The data suggest that a temperature-dependent Z to B to single-strand transition occurs under the conditions employed. A direct Z to single-strand conversion was not identified. In contrast to previous examples, the thermally induced left- to right-handed helical conversion for d(CGCG) can occur in the absence of chemically modified nucleic acid bases, alcohol solutions, or divalent ions. PMID- 2775853 TI - On the cooperative binding of large ligands to a one-dimensional homogeneous lattice: the generalized three-state lattice model. AB - We present the general secular equation for three-state lattice models for the cooperative binding of large ligands to a one-dimensional lattice. In addition, a closed-form expression for the isotherm is also obtained, that can be used with all values of the cooperativity parameter omega(0 less than omega less than infinity) thus eliminating the need for multiple equations. PMID- 2775854 TI - Unusual condensation behavior of poly(dA)-poly(dT). PMID- 2775855 TI - Scientific standards and the design of case-control research. AB - A new controversy has emerged over the results of a case-control study alleging a causal relationship between certain non-steroidal anti-inflammatory agents (NSAIAs) and the risks of agranulocytosis and aplastic anemia. After describing the methods and results of the International Agranulocytosis and Aplastic Anemia (IAAA) study, we review the distinctive methodologic challenges of this study and the requirements for avoiding bias, and then reconcile the study results with the principles of case-control design. As a result of our analysis, we believe that the IAAA study's most important and reliable finding is its documentation of the infrequent occurrences of aplastic anemia and agranulocytosis with analgesic use. In contrast, a causal association between NSAIAs and blood dyscrasias has not been suitably established, and may well have resulted from several distinctive sources of bias. These include the effects of diagnostic-suspicion bias in case determination, of exclusion bias in choosing controls, of recall bias in determining exposure, and of publicity bias in both case selection and ascertainment of exposure. These problems could have been avoided and a more valid result obtained with closer attention to the experimental paradigm for case control research. PMID- 2775856 TI - Interaction between N-methyl-N'-nitro-N-nitrosoguanidine and 2 steroid hormones in the glandular stomach of mouse. I. Acceleration of hydrocortisone turnover by use of a salt-rich diet and the carcinogen. AB - The present study has investigated the question of whether or not hydrocortisone as a gene regulator plays a role in the expression of carcinogenic and cocarcinogenic actions of N-methyl-N'-nitro-N-nitrosoguanidine (MNNG) and NaCl at the gastric epithelium. The interaction of local hydrocortisone, MNNG and NaCl was studied in vitro and in vivo using Swiss/ICR mice of both sexes. MNNG inhibited specific hydrocortisone binding with the cytoplasmic receptor from the glandular stomach of mouse. The intake of both excess NaCl and MNNG induced an increase in hydrocortisone turnover in the glandular stomach of mouse. Likewise, administration of either excess NaCl or MNNG increased the activity of ornithine decarboxylase in the glandular stomach of mouse. Long-term use of a salt-rich diet and MNNG drink induced an irreversible reduction in water consumption without affecting NaCl consumption, a dissociation of the hydrocortisone effect. The aforementioned MNNG effect on water turnover was more marked in female than in male mice. It is suggested that NaCl and MNNG produce a state of corticosteroid stimulation and androgen depression at the glandular stomach epithelium of mouse--a reproduction of the hormonal markers of gastric cancer. PMID- 2775857 TI - Interaction between N-methyl-N'-nitro-N-nitrosoguanidine and 2 steroid hormones in the glandular stomach of mouse. II. Retardation of local dihydrotestosterone turnover by use of a rice-rich diet and the carcinogen. AB - We investigated the question of whether or not N-methyl-N'-nitro-N nitrosoguanidine (MNNG), a gastrocarcinogen with a structural resemblance to the antiandrogenic gastrosuppressant cimetidine, had a similar antiandrogenic activity in the glandular stomach of mouse. Possible influence of a rice-rich diet on the interaction of androgen with the same tissue was also studied in relation to its gastrosuppressive effect. The results obtained were as follows: 1) excess MNNG non-competitively inhibited the specific binding of 3H dihydrotestosterone (DHT) with the cytoplasmic receptor of the glandular stomach of mouse; 2) the MNNG intake slowed down local 3H-DHT turnover in the glandular stomach of mouse; 3) evidence was presented to indicate that MNNG action was antiandrogenic in nature; 4) a rice-rich diet, exerting a weight-decreasing influence on the glandular stomach, also slowed down the 3H-DHT turnover in the same tissue. It was indicated that both MNNG and a rice-rich diet produced a state of androgen depression in the glandular stomach of mouse by slowing down the turnover of local androgen and/or competing with local androgen for its receptor in the target tissue. The significance of the results was discussed in relation to the etiology of gastric cancer. PMID- 2775858 TI - Effect of antineoplastic drugs and estradiol on leucine uptake and proliferation of Ehrlich tumor cells. AB - Antineoplastic drugs (methotrexate, 5-fluorouracil, adriamycin) arrest the proliferation of Ehrlich ascites tumor cells in mice but have no influence on L leucine uptake in vitro. Tamoxifen does not influence either process. Estradiol increases both the cellular proliferation and the amino acid uptake. The absence of estrogen receptors in the cells indicates that the hormone acts on cellular proliferation through mechanisms other than activation of DNA replication, such as stimulation of amino acid transport. PMID- 2775860 TI - Actin filament content in platelets--a sensitive index of cellular reactivity. AB - Blood platelets have the capacity to participate in a number of physiological as well as pathological processes within the circulation. In order to evaluate their cellular reactivity a number of platelet function tests have been developed. The main in vitro function tests are assessment of aggregation and adhesion, secretion, arachidonate metabolism, coagulant activities and the characterization of surface membrane glycoproteins (Day and Rao, 1986). Here we measure alterations of the G-/F-actin equilibrium of platelets. High F-actin values of unstimulated platelets indicate a hyperreactivity of the cell as examined in platelets from diabetics. Determination of the actin filament content in platelets can be considered as a new sensitive function test. PMID- 2775859 TI - The influence of buflomedil on blood viscosity parameters in insulin-dependent diabetic patients: a preliminary study. AB - We have evaluated the effect of buflomedil on blood viscosity in insulin dependent diabetic patients. At the start several rheological parameters were disturbed in these patients. After 3 months of treatment with buflomedil, blood viscosity was significantly decreased at low (P less than 0.05) and high (P less than 0.05) shear rates. The decrease in whole blood viscosity was due to a significant decrease (P less than 0.05) in plasma viscosity, which could be attributed to a significant (P less than 0.01) fall in plasma fibrinogen. There was no effect on erythrocyte deformability as assessed by erythrocyte viscosity measurements. We conclude that treatment with buflomedil improved but did not normalize some rheological parameters in insulin-dependent diabetic patients. PMID- 2775861 TI - Studies on the mechanism of action of a bilayer stabilizing inhibitor of protein kinase C: cholesterylphosphoryldimethylethanolamine. AB - Cholesterylphosphoryldimethylethanolamine is a zwitterionic compound which is a good bilayer stabilizer. As has been found with many other compounds having these properties, cholesterylphosphoryldimethylethanolamine is found to be a potent inhibitor of protein kinase C in both vesicle and micelle assay systems. The kinetics of the inhibition in Triton X-100 micelles was non-competitive with respect to ATP, histone, diolein, phorbol ester and Ca2+. It has a Ki of about 30 microns. The inhibition kinetics as a function of phosphatidylserine concentration is more complex but suggestive of competitive inhibition. Cholesterylphosphoryldimethylethanolamine does not prevent the partitioning of protein kinase C into the membrane. This inhibitor lowers the Ca2+ phosphatidylserine-independent phosphorylation of protamine sulfate by protein kinase C and directly affects the catalytic segment of the enzyme generated by tryptic hydrolysis. Thus, this zwitterionic bilayer stabilizing inhibitor of protein kinase C both competes with the binding of phosphatidylserine as well as affects the active site of protein kinase C. PMID- 2775862 TI - Involvement of protein kinase A and casein kinase II in the in vivo protein kinase activities in prophase arrested Xenopus oocytes. AB - In vivo beta casein phosphorylation was analysed in Xenopus full-grown oocytes arrested in the prophase of the meiotic cell division. The phosphorylation was inhibited by the protein kinase inhibitor (PKI) and also by heparin (3 micrograms/ml; final concentration). beta casein phosphorylation was increased by spermine (2 mM). Therefore, protein kinase A and casein kinase II are both active in vivo in full-grown oocytes and may be involved in the prophase arrest of meiotic cell division. PMID- 2775863 TI - Peptide histidine valine-42 stimulates gastric acid secretion in man. AB - The effect of peptide histidine valine-42 (PHV-42) on gastric acid secretion was studied in man. PHV-42 was infused into 5 healthy volunteers at a dose of 10 pmol/kg/min. This dose caused a significant stimulation of basal gastric acid and potassium output. There were no significant changes in circulating gastrin throughout the infusion. In 2 subjects with a background of submaximal pentagastrin stimulation, PHV-42 infusion at the same dose did not alter acid secretion in either subject. The previous observation that PHV-42 is found particularly in the stomach and the new finding that it stimulates basal gastric secretion suggest the possibility that PHV-42 could have a role in local control of acid secretion. PMID- 2775864 TI - Subcellular localization of iodinated thyroid tubulin. AB - Subcellular fractions enriched in mitochondria, plasma membranes, microsomes and Golgi apparatus were obtained from thyroid glands of rats injected with I125. Autoradiography of SDS-polyacrylamide gels revealed the presence of a number of radiolabelled proteins in each membrane fraction. One polypeptide, with the same electrophoretic mobility as brain tubulin, was found in all fractions except the plasma membranes and was immunoprecipitated with commercial anti-tubulin monoclonal antibodies. Hydrolysis of Asp-Pro linkages of I125 labelled tubulin with formic acid indicated that there were iodination sites in both the carboxy terminal one third and the amino terminal two thirds of the molecule. These results, together with the absence of iodinated tubulin from the cytosolic fraction, are consistent with the idea that a population of thyroid membrane tubulin is iodinated at multiple sites either just before or after insertion into intracellular membranes where it may act as an anchorage point for microtubule membrane interactions. PMID- 2775865 TI - Bunched and dispersed carbon fiber adsorbents for dextoxication. AB - "Actilen" and "Vaulen" carbon fiber adsorbents in bunched, stapled and dispersed form for haemosorption, topical application and enterosorption have been developed. The sorbents possess homogeneously porous structure and chemically active surface which may be controlled in the process of material synthesis. Fiberous sorbents have stood toxicological trials and are now approved for clinical application. "Vaulen" enterosorbent developed by Leningrad Institute of Man-made Fibers and Composite Materials, Institute of General and Inorganic Chemistry of White Russian Academy of Sciences, Military Medical Academy and White Russian Scientific Research Sanitary Institute is recommended by the Pharmacological Committee of Soviet Ministry of Public Health to be ready for clinical application. Actilen carbon fiber adsorbent for haemosorption and topical application therapy was awarded a gold medal at the 1984 Leipzig Fair. PMID- 2775866 TI - Selected papers from the 6th University of California-at-Davis Biomedical Engineering Symposium. May 1986. PMID- 2775867 TI - Patency and durability of small diameter silicone rubber vascular prostheses. AB - This study evaluated the long-term patency and durability of 6 mm internal diameter (ID), 18-30 micron pore size replamineform silicone rubber vascular prostheses as canine aortic interposition and arteriovenous (A-V) grafts. Six prostheses (6 mm ID x 8 cm length) were evaluated as aortic grafts for 24 to 30 months, and 10 prostheses (6 mm ID x 8-10 cm length) were studied as A-V grafts from 2 weeks to 10 months. Three of the A-V prostheses were punctured for sham dialysis once or twice/week with two 16 gauge needles (total of approximately 50 needle punctures). The porous wall of the silicone rubber prostheses was incorporated with capillaries and fibrohistiocytic cellular elements from 2 weeks of implantation. This cellular incorporation remained constant up to 2 1/2 years. Needle puncture of the arteriovenous grafts over a 3 to 5 month period produced no complications such as thrombosis, perigraft hematoma formation or bleeding through the puncture site. The silicone rubber sealed the holes with no evidence of tearing. Explanted prostheses had no evidence of enlargement or false aneurysm formation. This study supports our hypothesis that Replamineform silicone rubber prostheses are hemocompatable and demonstrate long-term durability for dialysis access. Clinical evaluation of this graft is planned in the near future. PMID- 2775868 TI - New NMR probe designs for neonatal, immature and adult heart research. With a brief review. AB - We present three new radiofrequency probes for nuclear magnetic resonance (NMR) research with perfused rabbit hearts at different maturational ages. The objective of the double-tunable, cylindrical-window probe design was to achieve a highly homogeneous magnetic field throughout the 16, 25 or 30 mm diameter usable volume for consistency of comparison of measurements obtained from neonate, immature and adult rabbit hearts, respectively. This probe design tunes to 23 Sodium for rapid shimming and then, to 31-Phosphorus for measurements of pH and high energy phosphate metabolites. All three probes yielded excellent signal-to noise ratios and radiofrequency operating characteristics. We introduce these new probes here in the context of a brief review of other state-of-the-art designs for in vitro and in vivo cardiovascular research. PMID- 2775869 TI - Bile flow rates and biliary motility quantitated by intravital microscopy. AB - Intravital microscopy was adapted to document and quantitate in vivo biliary motility and bile flow rates in guinea pigs. The movement of 10 microns diameter fluorescent beads in the bile duct was used to measure bile flow rates. Using this method, bile flow rates were comparable to those determined by measuring the volume of bile collected from the papilla, but greater (P less than 0.01) than the volume of bile collected from a bile duct cannula. During intravital microscopy, biliary contractions were only detected at the choledochoduodenal junction. While fasting, the sphincter ductus choledochi contracted at 6.0 +/- 1.0 per min and the ampulla at 1.2 +/- 0.2 per min. Postprandially, sphincter contractions had a decreased frequency and an increased duration while both duration and frequency of ampullary contractions increased. The volume of bile collected from a bile duct cannula postprandially did not change. This data suggested that the choledochoduodenal junction had a propulsive function and postprandial changes in motility were due to neurohumoral factors rather than passive response to changes in bile flow rates. Intravital microscopy proved to be a sensitive in vivo technique in which to quantitate bile flow rates and biliary motility. PMID- 2775870 TI - Development of methodology for recording colonic myoelectrical activity in the infant primate. AB - In order to study developmental aspects of colonic motility, we have developed a miniaturized electrophysiologic recording system for use in the infant primate rhesus (Macaca mulatta). Technical considerations including absence of rectal valves, decreased tissue thickness and small colonic diameter limit application of standard non-surgical recording methodology in this model. In-vivo testing with 4 different bipolar electrode probe configurations yielded satisfactory quality recordings only with silver chloride suction electrodes. Using this system, colonic slow waves and spike action potentials were studied in 6 infant primates (ages 1 to 7 months) both fasting and following a standard liquid meal of 10 cc/kg. In response to feeding, colonic spike potentials increased from 7.8 +/- 1.7 to 14.2 +/- 4.1 within 15 minutes (mean spikes +/- SEM/5 min interval). The observed response of the distal colon to a meal in this model is similar to the response reported in adult humans using intraluminal recording techniques. Utilizing the described methodology, the infant primate appears to be a suitable model for investigation of developmental aspects of gastrointestinal motility and electrophysiology. These techniques have important direct applications for investigation in the human infant. PMID- 2775872 TI - Computer-aided sperm analysis (CASA): image digitization and processing. AB - The active undulations of a sperm flagellum are a basic expression of cell vitality. They reflect a number of intracellular processes, and also reveal the interaction between the sperm and its environment. The pattern of sperm-head motion during locomotion is a hydrodynamic consequence of the behavior of the flagellum. Hence, studies of sperm-head motion should provide insights into cellular function and membrane integrity. Because of its importance in fertility, considerable attention is devoted to the analysis of sperm-head motion at both a clinical and basic biological level. Historically, such work has been done by hand. Recently, new, computer-aided sperm analysis (CASA) systems have become available to automate this process. These new systems promise to advance the study of cell behavior because they facilitate the objective collection of large amounts of data at relatively low cost. At present, however, few workers understand the relative strengths and limitations of such systems. There is a tendency to uncritically accept CASA results because they are computer generated. In this article, we describe how CASA systems work, and discuss several technological and methodological problems which can produce spurious results. We argue for the development of optical, machine, and specimen preparation standards which will facilitate inter-laboratory comparisons of CASA data. PMID- 2775871 TI - Indications of plasmapheresis and selection of different substitution solutions. AB - Substitution solutions used for plasmapheresis (PH) may be human albumin, serum protein conserves or plasma. 746 plasmapheresis carried out on 88 patients with a variety of diseases were examined and the side effects due to the substitution solutions were investigated. Side effects occurred in less than 10% of the cases where the four substitution solutions were used. The least side effects were observed in treatments using human albumin as substitution. Side effects increased for serum protein conserves, followed lyophilised plasma and were highest for fresh frozen plasma. In view of these possible side effects the criteria for PH should be strictly observed and the substitution solution should meet clinical requirements. PMID- 2775873 TI - Phagocytosis by guinea pig polymorphonuclear leukocytes of liposomes stabilized with polysaccharides. AB - Hemolysate-loaded liposomes were prepared with their surface coated by polysaccharides, carboxymethylchitin, carboxymethylcellulose and carboxymethylchitosan. Phagocytosis by guinea pig polymorphonuclear leukocytes of these coated liposomes was measured in view of electrostatic interactions between the cells and the liposomes. This view revealed to hold at least in quite an early stage of phagocytosis, but some specific interactions were assumed to exist between the cells and the liposomes. N-acetyl groups of the chitin molecules were suggested to play a role in the complex processes of phagocytosis. PMID- 2775875 TI - Physico-chemical properties of hemosorption carbon surface. PMID- 2775874 TI - Polymer resins with amino acid containing pendants for sorption of bilirubin. IV. Site binding constants. AB - Site binding constants, calculated for the adsorption of bilirubin onto various lysine, arginine, or histidine containing oligopeptide-resins assuming either a one or two site binding model, are of the order of 10(4) M-1. Using these data it can be shown that there are positive cooperative effects for lysine-containing pendants, while arginine-containing pendants eventually result in negative cooperative behaviour. This difference in behaviour has been attributed to the difference in the side groups in the arginine and lysine pendants and is discussed in terms of the basicity of the amino acids, accessibility to the sites as a consequence of the flexibility or rigidity of the side group, and in terms of pi-pi electron interactions, where applicable. PMID- 2775876 TI - The detoxication with bioselective carbon sorbents. PMID- 2775877 TI - Effects of oral administration of artificial cells immobilized phenylalanine ammonia-lyase on intestinal amino acids of phenylketonuric rats. AB - Intraperitoneal injections of para-Chlorophenylalanine methyl ester and Phenylalanine solution were used to produce phenylketonuria in rats. By the use of different diets and orally administered Phenylalanine ammonia lyase (PAL) loaded artificial cells, the Phenylalanine concentration gradient between the plasma and the gastro-intestinal lumen was varied. Other changes in related amino acids levels were also studied. The transport of neutral amino acids, across the gastro-intestinal membrane to the plasma, was decreased by the presence of a high concentration of phenylalanine in the intestinal lumen. Unlike Phenylalanine free diet, oral administration of PAL loaded artificial cells to PKU rats on normal diets resulted in much lower levels of intestinal phenylalanine. PMID- 2775878 TI - Tumoricidal effect of controlled-release polymeric needle devices containing adriamycin HCl in tumor-bearing mice. AB - Controlled-release polymeric needle devices containing adriamycin HCL (ADH) were investigated by an in vitro dissolution study in normal saline solution and an in vivo antitumor activity in C3H mice bearing mammary carcinoma and nude mice bearing brain tumor. HPMC was used as a release rate regulator. The ADH released from needle devices was controlled by the types of polymer used and the addition of HPMC. EVA needle devices exhibit a zero order release behavior better than that of PLA needle devices. Tumor growth was markedly inhibited by treatment with needle devices after locally inserted into the solid tumor. The rank of antitumor activity of the needle devices is EVA greater than PLA greater than EVA-HPMC greater than PLA-HPMC. No significant changes in body weight of mice after treatment were found in treated groups as compared to controlled groups. The preliminary results of our study suggest that needle device dosage form shows a controlled release behavior and may be applicable as a drug carrier for delivery of antitumor drug in cancer chemotherapy. PMID- 2775879 TI - Life forms protectable as subjects of U.S. patents -- microbes to animals (perhaps). AB - Scientists, businessmen, universities and industries with fundamental or peripheral interests in technology as applied to life processes will be keenly interested in recent U.S. Patent Office decisions. These decisions indicate that new higher life forms, animal or plant, are proper subjects of patents if they are not naturally occurring (and are not human in the case of animals). In contrast to plants and other organisms, genetically modified animals have had no mode of protection as intellectual property except possibly as a trade secret or utility patent. The Ex parte Allen decision, reached by the Patent Office Board of Appeals and Interferences, directly addressed the issue of animal patentability in view of the broad reading of 35 U.S.C. section 101 by the U.S. Supreme Court in the Chakrabarty decision. The subject invention concerned polyploid oysters. Claims directed toward polyploid oysters produced by a particular process were rejected under 35 U.S.C. section 103 and section 101. The Board, reversing the 35 U.S.C. section 101 - based rejection in view of the Chakrabarty decision, indicated that the claimed polyploid oysters were non naturally occurring manufactures or compositions of matter within the confines of patentable subject matter under 35 U.S.C. section 101. A similar decision affecting the patentable status of plants or segments thereof had previously been reached by the Patent and Trademark Office in the case of Ex parte Hibberd, 227 U.S.P.Q. 443 (Bd. Pat. App. 1985). The Hibberd utility patent application concerned "genetically engineered" maize which had high levels of the tryptophan. PMID- 2775880 TI - Platelet disorders. PMID- 2775881 TI - [Vaginal cancer: primary invasive squamous cell carcinoma in adults]. AB - Retrospective study of 80 cases treated at the Institute Curie from 1969 to 1982. This cancer is rare; it is generally seen in old women, mostly arising in the upper third. The treatment is exclusive radiation therapy in almost all the cases, through four pelvic fields up to a dose of 45/50 Gy. A boost dose is added with a perineal field, or curietherapy. Immediate tolerance is rather good and late severe complications are rare (6%). The 5-year survival rate is 52%. The prognostic factors, according to the Cox model, are: the clinical T stage (5-year survival rate of 66% in T1-T2 stages, and 30% in T3-T4 stages), the patient's age (5-year survival rate of 65% for the patients less than 70 years of age, 40% for the older ones), complete tumor regression 3 months after the end of the treatment (5-year survival rate of 71% for those patients, and only 12 months of median survival for the others who are all dead at 36 months). PMID- 2775882 TI - [Molecular analysis of biopsies of bronchial cancers: feasibility of a systematic approach]. AB - Malignant cells can be distinguished from their normal counterpart at the DNA level: they carry molecular changes which are characteristic of the tumor type or which might have some prognostic value. Amplifications and mutations of oncogenes and loss of alleles have been reported to occur in lung cancers, but their prognostic value has not yet been estimated, mainly for technical reasons: primary fresh biopsies are usually too small for molecular investigation. From 79 biopsies (50 of which were obtained by fiberoptic bronchoscopy), DNA hybridization was performed using the Southern blot technique, with myc family genes probes and a polymorphic probe located on the short arm of chromosome 3. Our study indicates that: 1) in 88% cases, enough DNA can be obtained by 3 or 4 fiberoptic bronchoscopy biopsies: from 5 to 80 micrograms DNA with an average of 25; 2) the quality of DNA is good for analysis by the Southern blot technique; 3) the loss of allele on chromosome 3 (3p 14-23) can be detected both in the small cell and in the non small cell type, but contamination of the specimens by non tumoral tissue (based on the cytological and histological analysis of each biopsy) remains a problem for this type of study; 4) gene amplifications and rearrangements can be easily evaluated for the genes of the myc family. This pilot study shows that DNA analysis is feasible on perendoscopic biopsies. Collection and analysis of a large series of such biopsies at diagnosis is essential to define the value of DNA markers as prognostic factors in lung cancers. PMID- 2775883 TI - [Comparison of the antiemetic effectiveness of high-dose corticosteroids with synacthene in nausea induced by chemotherapy: results of a randomized study]. AB - One hundred two patients submitted to intensive chemotherapy were included in a randomized study with cross over comparing for the second course two anti emetics: tetracosactide (D1: 3 mg, D2 and D3: 2 mg/d) and methylprednisolone (D1: 240 mg, D2 and D3: 160 mg/d). Most patients presented with malignant lymphoma. All patients experienced nausea and emesis during first course of chemotherapy. Results were similar in both groups, respectively for tetracosactide and methylprednisolone: no nausea 37 versus 40%, less than 3 emesis 69% versus 73%. Secondary effects were observed in 5 and 8% of cases. Tetracosactide with a schedule of 7 mg for 3 days gives the same results than methylprednisolone 560 mg for 3 days in chemotherapy induced nausea and emesis prevention. PMID- 2775884 TI - Effects of lead shot ingestion on free-ranging mourning doves. PMID- 2775885 TI - Strain- and organ-dependent differences in induction of aryl hydrocarbon hydroxylase activity by 3-methylcholanthrene. PMID- 2775886 TI - Atrazine biodegradation in rats--a model for mammalian metabolism. PMID- 2775887 TI - In vitro and in vivo percutaneous absorption of benzo[a]pyrene from petroleum crude-fortified soil in the rat. PMID- 2775888 TI - Teratogenicity of dinoseb: role of the diet. PMID- 2775889 TI - Pathways for formation of catechol and 1,2,4-benzenetriol in rabbits. PMID- 2775890 TI - Triaryl/alkyl phosphate residues in human adipose autopsy samples from six Ontario municipalities. PMID- 2775891 TI - Effect of fabric characteristics on pesticide penetration through selected apparel fabrics. PMID- 2775892 TI - Photodecomposition of monocrotophos in soil, on plant foliage, and in water. PMID- 2775893 TI - Application of adenylate energy charge and adenine nucleotide measurements as indicators of stress in Nephtys incisa treated with dredged material. PMID- 2775894 TI - Gender-dependent problems in toxicity tests with Ceriodaphnia dubia. PMID- 2775895 TI - Acute and chronic toxicity of produced water from a North Sea oil production platform to the calanoid copepod Acartia tonsa. PMID- 2775896 TI - Nitrite-induced anemia in channel catfish, Ictalurus punctatus rafinesque. PMID- 2775897 TI - Toxicity of the organophosphorous insecticide metamidophos (O,S-dimethyl phosphoramidothioate) to larvae of the freshwater prawn Macrobrachium rosenbergii (De Man) and the blue shrimp Penaeus stylirostris Stimpson. PMID- 2775898 TI - Lead-induced biochemical changes in freshwater fish Oreochromis mossambicus. PMID- 2775899 TI - Hemoglobin and hematocrit values in the fish Oreochromis mossambicus (Peters) after short term exposure to copper and mercury. PMID- 2775900 TI - Distribution of cadmium in the pearl oyster, Pinctada albina albina (Lamarck), following exposure to cadmium in seawater. PMID- 2775901 TI - Determination of the new aromatic retinoic acid Ro 13-7410 in plasma by two dimensional gas chromatography negative ion chemical ionization mass spectrometry with selected-ion monitoring. AB - A highly sensitive and specific method for the determination of the aromatic retinoic acid Ro 13-7410 in plasma at the picogram per millilitre level is described. The method involves extraction of plasma using Extrelut-1 columns, purification of the extract with Bond Elut-NH2 cartridges, derivatization with pentafluorobenzyl bromide, and subsequent analysis by two-dimensional capillary gas chromatography using the zone-cutting technique, stable isotope dilution and selective negative ion monitoring chemical ionization mass spectrometry. A tetradeuterated analogue is used as internal standard. Quantification is possible down to 25 pg/ml using 1 ml of plasma. The coefficients of variation of the method as calculated from quality control samples are 8.5 and 4.2% at the 100 and 400 pg/ml levels. The method has been applied to the analysis of plasma of volunteers following an oral dose of 40 micrograms Ro 13-7410 and plasma of dogs following an intravenous and oral dose of 25 and 50 micrograms, respectively. PMID- 2775903 TI - Identification and determination of tert-alkylphenols in carp from the Trenton Channel of the Detroit River, Michigan, USA. AB - Whole carp from the Detroit River were analyzed by gas chromatographic mass spectrometry. Seven tertiary alkyl phenols (tert-pentylphenols, tert-butyl-tert pentylphenols, a di-tert-pentylphenol and a tri-tert-pentylphenol) and eight chlorinated derivatives of these compounds were identified from their mass spectra and confirmed with synthesized authentic standards. 2,4-Di-tert pentylphenol was the most abundant of these compounds; in one fish sample, its concentration was about 140 ppm. The same alkyl phenols were also found in technical-grade 2,4-di-tert-pentylphenol, which is manufactured at a chemical plant located near the Detroit River. Comparison of the alkyl phenol levels in carp with those in nearby sediments showed that many of these compounds are taken up by carp and that carp can be used to roughly track local sediment contamination. PMID- 2775904 TI - Alcohol: the hidden drug among substance abusers. PMID- 2775902 TI - Stable isotope dilution analysis of n-hexanoylglycine, 3-phenylpropionylglycine and suberylglycine in human urine using chemical ionization gas chromatography/mass spectrometry selected ion monitoring. AB - We describe a gas chromatographic/mass spectrometric method for the accurate determination of n-hexanoylglycine, 3-phenylpropionylglycine and suberylglycine in urine for the diagnosis of hereditary medium-chain acyl-CoA dehydrogenase (MCAD) deficiency. These acylglycines had previously been detected in urine from patients with MCAD deficiency, but their diagnostic values were unknown because of a lack of appropriate analytical methods. n-Hexanoyl(1,2-13C)glycine, 3 phenylpropionyl(2-13C,15N)glycine and suberyl(2-13C,15N)glycine were synthesized and used as internal standards. Ammonia chemical ionization was utilized to generate intense [M + H]+ ions for selected-ion monitoring quantification. The whole procedure is fast and can be performed by a low-resolution gas chromatographic/mass spectrometric system, giving accurate results over a range of three orders of magnitude (0.0167-16.7 micrograms/ml). The results from the analyses of 54 urine samples from 21 MCAD-deficient patients and various control samples using this method established that n-hexanoyglycine and 3 phenylpropionylglycine were highly diagnostic for this disease, while suberylglycine was found less specific. PMID- 2775905 TI - Addictions and the media. PMID- 2775906 TI - Is the 'new' problem drinking concept of Heather & Robertson more useful in advancing our scientific knowledge than the 'old' disease concept? AB - Heather & Robertson maintain that the problem drinking concept represents a shift from a 'pre-scientific' to a 'scientific' paradigm within the field of alcohol studies. They consider that the usefulness of a concept can best be assessed in terms of the extent to which it facilitates the testing of hypotheses. The disease concept is of no value when judged in these terms due to the aetiological assumptions that are built into it. It is argued that since Heather & Robertson's 'new' approach incorporates a set of assumptions parallel to those of the disease concept it is equally tautological, and therefore does not represent the type of change in paradigm they propose. PMID- 2775907 TI - The Addiction Research Unit of the Institute of Psychiatry University of London- II. The work of the unit's smoking section. PMID- 2775908 TI - Treating alcohol problems in Sri Lanka. AB - Treatment in settings where facilities are limited poses many challenges. Attempts are being made to use untrained but committed people to help dependent persons maintain abstinence after withdrawal. This experience makes us question the need for highly trained specialized staff in helping in this task. PMID- 2775910 TI - The homogeneity of the alcohol dependence syndrome: a factorial analysis of the SADD questionnaire. AB - The Severity of Alcohol Dependence Data (SADD) questionnaire was administered under different conditions to three groups of patients in Leeds, Derry and Omagh. The results were then factor analysed using both exploratory and confirmatory procedures. There was a consistent and strong first factor which suggests that with some small modifications the SADD is a unidimensional scale. The results are interpreted as providing further evidence for the homogeneity of the alcohol dependence syndrome. PMID- 2775911 TI - The distribution of alcohol dependence severity among in-patient problem drinkers. AB - One hundred and sixty problem drinkers admitted to in-patient care were rated according to the severity of their alcohol dependence by means of two standardized questionnaires (SADQ and SADD). A bimodal distribution of scores previously reported with the SADQ was not reproduced with either questionnaire, but there was a highly significant correlation (r = 0.806) between the SADQ and SADD scores. There was 59% agreement between the two questionnaires in their placing of scores within three categories of dependence severity. The results suggest a degree of caution in equating current estimates of minimal, mild to moderate and severe dependence on the SADQ with low, medium and high dependence, respectively, on the SADD. Some difficulties experienced by subjects in completing the two questionnaires are discussed. PMID- 2775912 TI - Cyclizine abuse among a group of opiate dependents receiving methadone. AB - Twenty opiate dependents receiving long-term prescriptions of oral methadone, were identified as being habitual abusers of the anti-emetic drug cyclizine. A semi-structured interview elicited the dosage of cyclizine used, its effects, the reasons for starting and persisting with abuse of cyclizine and the attitudes of the patients to it. Cyclizine was taken in large doses intravenously with methadone. The effects initially were of intense stimulation, often with hallucinations, sometimes with aggressive behaviour, and occasionally with epileptic fits. Subsequent depressive mood changes occurred often accompanied by a craving for cyclizine. Tolerance to the drug occurred but no clear cut withdrawal syndrome is apparent. It seems that dependence upon cyclizine occurs. The significance of these findings for doctors, pharmacists and for drug treatment units is discussed. The paucity of information on the pharmacology and pharmacokinetics is noted. PMID- 2775909 TI - An analysis of the clinical relevance of type 1 and type 2 alcoholics. AB - Predictions inherent in the proposed Type 1/Type 2 continuum of alcoholic subtypes were indirectly explored in 31 sons of primary alcoholic fathers. The fathers' alcoholism was rated on a 0-5 scale utilizing characteristics typical of the Type 2 extreme of the continuum. If a predisposition to Type 2 alcoholism is genetically transmitted, then we would have predicted that the sons of Type 2 alcoholics would be more likely than the sons of Type 1 men to show an earlier onset of drinking, as well as more alcohol and substance intake and associated problems. The results did not support any consistent trend in the correlation between the FHP fathers' alcoholic characteristics and the sons' problem picture. Potential explanations for this finding are discussed including the possibility that the Type 2 extreme might represent a separate diagnostic entity, the antisocial personality disorder, and not alcoholism itself. PMID- 2775913 TI - The social image of the young female smoker. AB - Community college students (N = 229) read a brief narrative about a young female college student and rated her on 14 bipolar scales. Half the subjects read a version in which the protagonist smoked, and half an otherwise identical version in which she didn't. Although most subjects recalled the protagonist's smoking status, very few recognized this as the focal variable in the experiment. Subjects rated the heroine less positively for social attractiveness (p less than 0.001) and personal resourcefulness (p less than 0.01) when she was represented as a smoker. They specifically considered the smoking protagonist more masculine (p less than 0.01), less feminine (p less than 0.001), less healthy (p less than 0.001), a poorer student (p less than 0.001), less wise (p less than 0.001), less self-disciplined (p less than 0.001), less sophisticated (p less than 0.001), and less gentle (p less than 0.02). Non-smoking subjects also rated the smoking heroine as less (physically) attractive (p less than 0.05), although smoking subjects did not discriminate significantly. PMID- 2775914 TI - Ecstasy and the oxygen of publicity. PMID- 2775915 TI - Fixing into intercostal vessels: a new method among drug addicts. PMID- 2775917 TI - Professional opinion on the disease concept. PMID- 2775916 TI - Fifty-five years of cocaine dependence. PMID- 2775918 TI - Velocity distribution on the membrane of a tank-treading red blood cell. AB - The kinematics of an area-conserving tank-treading disk-shaped red blood cell membrane is studied using the stream function method suggested by Secomb and Skalak (Q. Jl Mech. appl. Math. 35, Pt 2, 233-247, 1982). Two simple area conserving velocity fields are superimposed to satisfy the continuity condition at the curved edges of the disk. A differential equation for the trajectory of any material point of the membrane is derived. The requirement of synchrony of the cycle for all membrane points leads to an integral equation which determines a magnitude function. An approximate solution is made possible by assuming small trajectory deflections. PMID- 2775919 TI - Mathematical formulation and studies of the risk parameters involved in HIV transmission. AB - The probability of becoming infected with HIV is formulated in terms of the total number of sexual contacts (N), the probability that a sexual act is infectious (r) and the prevalence (p). Using the appropriate equations we studied the effect of reducing each of the risk factors on lowering the probability of infection. We show that for many realistic situations the probability of becoming infected by multiple partners is equal to the probability of becoming infected by one partner in a monogamous relationship given that the prevalence is the same in both cases; however if the multiple partners are chosen over time from a pool of a growing prevalence, then one is better off in a monogamous relationship where that partner is chosen early in the epidemic. PMID- 2775920 TI - Some applications of the P-V relation to the study of left ventricular performance. AB - There is still controversy as to which characteristics of the pressure-volume relation should be used to define myocardial contractility. In the present study a mathematical model for the left ventricle as a two-dimensional cylinder contracting radially and symmetrically was used to establish a relation between a calculated intramyocardial pressure (Dh) and the P-V relation (PVR) at end systole. Four new indices are introduced that allow a better assessment of change in inotropic state of the myocardium, namely the calculated intramyocardial pressure (Dh), the calculated resultant pressure across the inner surface of the myocardium (Dh-P) (P = cavity pressure), the work Wt related to the pressure (Dh) and the work Wd related to the pressure (Dh-P). A relation between Wt and Wd and different parts of the area under the PVR is established. Indices derived in this manner from the PVR to study changes in myocardial contractility appear to have a clear physical meaning. PMID- 2775921 TI - Successful autografting in chronic myeloid leukaemia after maintenance of marrow in culture. AB - We have previously shown that Philadelphia chromosome (Ph1)-positive cells rapidly disappear when marrow from patients with chronic myeloid leukaemia (CML) is cultured under conditions that maintain normal haematopoiesis for many weeks. The ability of marrow maintained in culture for 10 days to serve as an autograft has now been tested in three patients treated with intensive chemoradiotherapy. Two weeks after transplantation, marrow samples from all patients showed trilineage haematopoiesis. Neutrophil counts greater than 1.0 x 10(9)/l were achieved in all patients within 4 weeks, and platelet counts greater than 20 x 10(9)/l were achieved in two patients within 5 weeks. During this period of haematopoietic recovery, marrow cells were exclusively Ph1-negative in two patients and predominantly so in the third. These results suggest that engraftment can occur from Ph1-negative haematopoietic stem cells selected by maintenance of autologous CML marrow in culture for 10 days. Thus, the feasibility of using this approach to allow intensive and potentially curative therapy for CML has been established. PMID- 2775922 TI - Improved CFU-GM recoveries from marrows of neuroblastoma patients using a slightly modified immunomagnetic depletion technique. PMID- 2775923 TI - Purification and cryopreservation of peripheral blood stem cells: the impact of a Ficoll-gradient separation of cytapheresis products. PMID- 2775925 TI - Audit in internal medicine. PMID- 2775926 TI - The medical treatment of adrenal disease. AB - The medical treatment of disorders of the adrenal gland, i.e. Addison's disease, Cushing's syndrome, primary aldosteronism, congenital adrenal hyperplasia and phaeochromocytoma, is described. Although these conditions are rare and may present with subtle symptoms and signs, most are life-threatening hence correct diagnosis and treatment are essential. PMID- 2775924 TI - ARDS: time for reappraisal? PMID- 2775927 TI - The management of bone and joint infection. AB - Although infection of bone and joint does not occur frequently in the developed world, it is a serious condition when it occurs. Early diagnosis and prompt treatment are necessary to minimize the later complications of chronic osteomyelitis and destruction of articular cartilage. Despite early diagnosis and treatment, damage to the articular cartilage or growth plate may already have occurred. PMID- 2775928 TI - Why is there a high rate of schizophrenia in British Caribbeans? AB - Recent work strongly suggests a high prevalence of schizophrenia in young Caribbean men in the UK. While the aetiology of schizophrenia is not clear, it appears to have an organic basis. The hereditary patterns that have been described do not account for the pattern observed. Alternative explanations, including the possible influence of infectious agents, are being discussed. PMID- 2775929 TI - Hospital discharge and death communications. AB - A study of hospital discharge communications showed that discharged patients still consult their general practitioners before they have received discharge communications and that the information received continues to be less than ideal. Despite rapid expansion of the use of communication technology in the business community this has not yet spread to medicine where communication between secondary and primary care is only slowly improving. PMID- 2775930 TI - A case of oculopharyngeal muscular dystrophy. PMID- 2775931 TI - Primary hyperparathyroidism in patients with breast cancer. PMID- 2775932 TI - The impossibility of achieving a balance. PMID- 2775934 TI - Guidelines for benzodiazepine prescribing. PMID- 2775933 TI - Detailed explanations for the hyperventilating patient. PMID- 2775935 TI - Trauma care: evaluation before change. PMID- 2775937 TI - Concomitant treatment of neuroleptic malignant syndrome and psychosis. AB - Two cases are presented in which psychotic patients with neuroleptic malignant syndrome were treated with bromocriptine and thioridazine simultaneously, with a resulting control of both problems. The authors feel that this method needs further study, in the light of the potentially large number of patients at risk for these illnesses. The use of creatinine phosphokinase level as an indicator of value in NMS is also discussed. PMID- 2775938 TI - Predicting the productive research psychiatrist. AB - Data were obtained for some 89 psychiatrists who were responsible for 372 first author research publications over the period 1978-1984, to define predictors of productivity (rate of publishing in scientific journals). A principal components analysis suggested three key researcher dimensions, comprising 'track record', 'experience' and 'resource base' variables. The 'track record' dimension was the only significant predictor and was contributed to principally by the number of publications in the early part of the review period, number of citations to published work, rating by peers, and possessions of a research degree. PMID- 2775939 TI - Involuntary movements associated with mianserin treatment. A case report. AB - A case showing various involuntary movements during mianserin treatment and after a withdrawal of mianserin is described. This is the first case report of mianserin-induced involuntary movements. The report suggests that these symptoms can occur with a therapeutic dose of mianserin in certain susceptible patients. PMID- 2775940 TI - Lithium in pregnancy and still birth: a case report. AB - Although initially considered safe for the foetus, lithium has been shown to have teratogenic effects if used during the first trimester of pregnancy. Its use is also associated with a higher than expected frequency of still births and perinatal deaths. Our patient, in whom lithium prophylaxis was considered essential for clinical and social reasons, continued to take lithium without medical supervision throughout her pregnancy and had a still birth. We suggest avoiding the use of lithium at least during the first trimester of pregnancy. PMID- 2775941 TI - Suspected SSPE--a delayed psychiatric presentation. AB - A case of suspected subacute sclerosing panencephalitis is described, presenting to a psychiatric hospital 39 years after a natural measles infection. PMID- 2775942 TI - Prevalence of dementia. PMID- 2775943 TI - Treatment of suicidal manic depression. PMID- 2775944 TI - Chronic depression. PMID- 2775945 TI - As the years go rolling by. Drinking problems in the time dimension. PMID- 2775946 TI - Frequency of symptoms in melancholia (depressive illness) AB - Symptoms of depression were quantitatively recorded using a rating scale, for 239 men and 260 women. The frequency of the various symptoms were similar for the sexes, with a high frequency for anxiety, both psychic and somatic. The results show that the symptoms of depressive patients differ from those found in the classic descriptions. PMID- 2775936 TI - Proceedings of the British Pharmacological Society. Leeds, 12th-14th July 1989. Abstracts. PMID- 2775947 TI - Negative and depressive symptoms in schizophrenia. AB - Ninety-five schizophrenic patients were assessed using the Present State Examination, the Brief Psychiatric Rating Scale and the Scale for the Assessment of Negative Symptoms. Negative and depressive symptoms were frequent, and significant relationships among negative symptom complexes and depressive syndromes were noted. Retardation, lack of energy, slowness, and other symptoms of depression were significantly associated with the negative symptoms of schizophrenia. Depressed affect per se did not have a significant correlation with negative symptoms. PMID- 2775948 TI - The initial onset of schizophrenia and family expressed emotion. Some methodological considerations. AB - The relationships between duration of schizophrenic illness before first hospital admission, expressed emotion in key relatives, and illness course have yielded conflicting reports. This study examined the issue from a methodological perspective in a sample of first-episode schizophrenic patients. A 'best estimate' of illness onset, based on a compilation of all sources, was compared with an estimate based on parental report. Parental estimates suggested that the children of high-EE parents had been ill for significantly longer, but this difference was not confirmed by the best estimate. In most cases, the ill children of high-EE parents were living at home before hospital admission and their parents' estimates of duration were quite accurate. In the few cases in which the child was living away from home, high-EE parents strikingly overestimated duration. Children of low-EE families were more likely to be living away from home, but this factor did not explain the consistent underestimates of duration made by their parents. Although duration of illness did not relate to EE, successful engagement in out-patient before in-patient treatment was more common among children from low-EE families. PMID- 2775949 TI - The aetiology of post-traumatic morbidity: predisposing, precipitating and perpetuating factors. AB - A group of 469 firefighters were studied 4, 11 and 29 months after having an extreme exposure to a bushfire disaster. The relative importance of the impact of the disaster, personality and ways of coping were investigated as determinants of post-traumatic morbidity. Neuroticism and a past history of treatment for a psychological disorder were better predictors of post-traumatic morbidity than the degree of exposure to the disaster or the losses sustained. These results raise doubts about the postulated central aetiological role a traumatic event plays in the onset of morbidity. PMID- 2775950 TI - Is electroencephalographic monitoring of electroconvulsive therapy clinically useful? AB - Electroencephalographic (EEG) monitoring was carried out in 169 bilateral and 114 unilateral applications of electroconvulsive therapy (ECT), given to 51 patients in an everyday setting within the National Health Service by junior medical staff. In 2.5% of bilateral and 8% of unilateral applications there was disagreement between clinical and EEG assessment as to whether a fit had occurred. When an EEG fit was said to have occurred only if it lasted longer than 25 seconds, then disagreement rose to 7% in bilateral and 28% in unilateral applications; disagreement was higher with unilateral applications, as they produced more short fits than bilateral applications. If future work shows duration of seizure is clearly associated with clinical efficacy, it is suggested the case for routine EEG monitoring is greatly strengthened. PMID- 2775951 TI - Psychosocial status of 192 out-patients with HIV infection and AIDS. AB - One hundred and ninety-two out-patients with HIV infection were interviewed in a standardised manner at two London hospitals. Almost all had revealed their diagnosis to others, one-quarter receiving negative reactions from confidants. Thirty-one per cent had significant psychiatric problems, almost half of whom reported emotional problems before HIV infection. Twenty-two per cent complained of difficulties with memory or concentration, of whom 12.5% had objective cognitive impairment on brief assessment. Excessive health ruminations were an important indicator of more extensive psychological problems. This degree of psychological distress is in keeping with reports for patients with other medical conditions, and overall, patients appeared to have adapted well, despite the obvious stigma and poor prognosis of their condition. PMID- 2775953 TI - Hospital suicides: are there preventable factors? Profile of the psychiatric hospital suicide. AB - The coroner's and hospital records of 57 consecutive in-patient or day-patient suicides were examined. There was a preponderance of males, but no difference between the sexes in violent deaths. The patients were generally chronically ill, and risk of suicide continued indefinitely after diagnosis. Risk was recorded in the medical notes for 16 patients and in the nursing notes for 12, but only six were under special observation. Half the patients were thought to be improving at the time of death. Psychiatrists and coroners should pay attention to aspects such as nursing and environmental factors in suicides in order to identify those at risk. PMID- 2775952 TI - Suicide among Chinese schizophrenics in Hong Kong. AB - A descriptive study of suicides in 74 Chinese schizophrenic out-patients (43 male) is presented. The mean age at death was 31.3 years. The mean duration of illness was 8.5 years and 50 of the 74 died within ten years of onset of illness. Only five lived alone; 35 were openly employed and 20 were married at the time of death. Twenty had a history of depression, and 27 had attempted suicide previously. More females had been depressed or had attempted suicide than males. Over half were last admitted for reasons other than schizophrenic symptoms alone and ten died within one month of discharge. Eight of 71 patients followed up expressed suicidal ideas at the last psychiatric contact, but only 15 were symptomatic. Jumping was the commonest method used. Analytical studies are needed to identify risk factors in Chinese schizophrenics. PMID- 2775955 TI - Organic reaction in AIDS. AB - A case of organic brain syndrome in a patient with AIDS is described. The implications for medical and psychiatric services are discussed and problems highlighted. PMID- 2775954 TI - Reflections on psychotherapy with ageing people, individually and in groups. PMID- 2775956 TI - Gilles de la Tourette's syndrome. Amelioration following acute akinesia during lorazepam withdrawal. AB - A case of Gilles de la Tourette's syndrome (TS) is described, in which a state of akinesia developed during an attempt to withdraw lorazepam by diazepam substitution. This was followed by sustained amelioration of the TS symptoms. PMID- 2775957 TI - Treatment of mood disorder associated with Binswanger's disease. AB - Binswanger's disease is a cerebrovascular disorder affecting deep white matter and is associated with dementia and affective disturbance. In the case reported, the mood disorder was successfully treated with a combination of lithium and amitriptyline, resulting in an improved quality of life despite continuing cognitive decline. This underlines the importance of treating the affective component of organic dementing conditions on its own merit. PMID- 2775958 TI - Wernicke's encephalopathy in an 18-year-old woman. AB - An unusually young woman (18 years old) who misused alcohol and developed Wernicke's encephalopathy is described. PMID- 2775959 TI - Hyponatraemia and clomipramine therapy. AB - The fortuitous detection of SIADH is described in a patient receiving clomipramine therapy. PMID- 2775960 TI - Psychiatrists' responses to personality disorder. PMID- 2775961 TI - HIV screening. PMID- 2775962 TI - Childhood and adolescent depression. PMID- 2775963 TI - Schizophrenia: recency theory and syphilis. PMID- 2775964 TI - Tactile extinction phenomenon in schizophrenia. PMID- 2775965 TI - Violent incidents in special hospitals. PMID- 2775966 TI - Capgras' syndrome. PMID- 2775967 TI - Parasuicide in young Asian women. PMID- 2775968 TI - Melatonin and sulphatoxymelatonin in eating disorder patients. PMID- 2775969 TI - Lithium-induced paranoid hallucinatory state. PMID- 2775970 TI - Prediction of outcome after treatment for stuttering. PMID- 2775971 TI - Conversion disorders and ECT. PMID- 2775972 TI - Lipid-lowering drugs. PMID- 2775973 TI - Unsubstantiated complaints of being poisoned. Psychopathology of patients referred to the national poisons unit. AB - The psychopathology of a series of patients referred to a combined psychiatric toxicological assessment service with the specific complaint of being, or having been, poisoned is described, and related to the nature of their exposure to incriminated agents. The need for and value of this service are discussed. PMID- 2775974 TI - Depression in self-harm patients. AB - DSM-III diagnoses and responses to the Beck Depression Inventory (BDI) were examined in 71 consecutive admissions to an in-patient psychiatric crisis service following deliberate self-harm. Although 80% of the admitted patients were moderately or severely depressed according to BDI scores, only 31% were diagnosed with a major depressive episode. While all of the self-harm patients may be viewed as experiencing severe subjective distress, only a minority were shown to suffer from DSM-III depressive illness. The high depression scores on the BDI may be related to the patients' extreme distress preceding a crisis admission and to the high prevalence of personality disorders in this group of patients. PMID- 2775975 TI - Poverty of speech in schizophrenia and depression during in-patient and post hospital periods. AB - Poverty of speech, a prominent feature of the negative symptom construct in schizophrenia, was assessed longitudinally in 12 schizophrenic and 13 depressed subjects at hospital admission and about seven months after discharge in order to evaluate hypotheses concerning course and diagnostic specificity. Multiple measures of the poverty of speech construct were employed, including both clinical and quantitative indices. During the in-patient period, poverty of speech was more pronounced among depressed than schizophrenic subjects. Examination of this specific negative symptom across in-patient and follow-up evaluations indicated that poverty of speech increased among schizophrenic subjects, but remained relatively stable or declined among depressed subjects. These results suggest that the processes underlying poverty of speech may differ in schizophrenia and depression. PMID- 2775976 TI - Psychiatric clinics in general practice. Do they reduce admissions? AB - General-practice-based psychiatric clinics have increased substantially in recent years. We investigated the influence on psychiatric admissions of this style of practice in England over an 18-year period. We utilised data from a previous survey concerned with this type of work (Strathdee & Williams, 1984) and compared them with figures on psychiatric admissions. Parts of the country in which there has been greater development of general-practice-based psychiatric clinics were also those in which there has been a steeper decrease in psychiatric admissions. Further analysis showed this to be due primarily to an effect on admission of non psychotic patients. PMID- 2775977 TI - Referrals from general practitioners to psychiatrists and paramedical mental health professionals. AB - The literature on referral of patients by GPs to psychiatrists and mental health specialists is examined. Referrals to psychiatrists account for 3% of all those made by GPs, but the individual rates vary widely. The proportion of patients referred to psychiatrists and paramedical mental health workers in general practice is unknown, but probably substantial. PMID- 2775978 TI - The chronically mentally ill in community facilities. A study of quality of life. AB - The quality of life of chronically mentally ill patients in acute wards in a district general hospital, a hostel ward and group homes was compared. Within the spectrum of care of these patients, the severity of psychopathology corresponded to their placement. Analysis, including adjustments for the influence of psychopathology, showed differences between the three types of facility. Although differences existed between all types of care, residents in group homes and the hostel ward shared more similarities in quality of life than those in the district general hospital. Problems of caring for the chronically mentally ill on acute wards are highlighted. PMID- 2775979 TI - Severity of withdrawal in subjects exposed to a combination of alcohol and minor tranquillisers. AB - Fifty patients suffering from the alcohol dependence syndrome were detoxified over a 10-day period using a reducing regime of chlordiazepoxide. Twenty-four had been consuming minor tranquillisers together with alcohol prior to admission. The severity of the withdrawal syndrome was assessed daily but no differences were found between the 26 who had taken alcohol alone and the 24 who had taken a combination of alcohol and drugs. Four from each group had a transient hallucinosis and none had fits. PMID- 2775980 TI - Multiple personality. A symptom of psychiatric disorder. AB - A case is reported of a young woman presenting with symptoms of so-called multiple personality disorder. It is proposed that this condition should be viewed as a non-specific psychiatric symptom. PMID- 2775981 TI - Heartworm disease and research in Australia. PMID- 2775982 TI - Uterine activity in cows during the oestrous cycle, after ovariectomy and following exogenous oestradiol and progesterone. AB - Uterine activity was monitored in three, 2-year-old nulliparous Ayrshire heifers using intrauterine balloon-tipped catheters and pressure transducers during the oestrous cycle, after ovariectomy and following the intravenous infusion of progesterone and oestradiol-17 beta. During the oestrous cycle uterine activity, as measured by the frequency and amplitude of contractions, was greatest around oestrus and declined during the luteal phase of the cycle; there was a close correlation with peripheral progesterone concentrations. In two animals after bilateral ovariectomy spontaneous uterine activity persisted, whilst in the third animal the uterus was quiescent. In the first two heifers intravenous progesterone infusions reduced the spontaneous uterine activity, eventually completely abolishing it. There was evidence of a dose response effect at the two infusion rates. Oestradiol benzoate infusions initially inhibited spontaneous uterine activity before stimulating contractions with some evidence of a dose relationship. As demonstrated in normal cyclical and steroid-infused animals, uterine activity appears to be under the influence of both hormones although the influence of progesterone is greater. PMID- 2775983 TI - Detection of antibodies to leptospirosis in experimentally infected dogs using the microcapsule agglutination test. AB - Six puppies were infected with a virulent strain of Leptospira interrogans serovar icterohaemorrhagiae and another five animals with a virulent strain of Leptospira interrogans serovar canicola, respectively. Antibodies were examined at 3, 5, 7, 11 and 14 days after infection, using the microcapsule agglutination test (MCAT) and the conventional microscopic agglutination test (MAT). Compared with the MAT, the MCAT detected early specific IgM antibody with high sensitivity. The MCAT titres reached a peak at the 7th day after infection and declined gradually after the 11th day, while the MAT titres increased up to the 14th day. PMID- 2775984 TI - Behaviour of groups of weaner pigs in three different housing systems. AB - Behavioural observations were made on 150 3-week weaned pigs housed in pens with fully perforated floors, or a solid-floored lying area with or without straw. Observations were made during a period of high ambient temperatures and during cool weather. At high ambient temperatures pigs with part-solid floors defaecated and urinated in the lying area and showed a higher (P less than 0.01) incidence of rooting behaviour associated with wallowing. Pigs on fully perforated floors showed reduced levels of activity in hot conditions (P less than 0.01). Pigs given straw were more active (P less than 0.01) and spent 25% of active behaviour in straw directed behaviour. There was a higher incidence (P less than 0.01) of oral behaviour directed at penmates and pen fittings amongst pigs housed on fully perforated floors. PMID- 2775985 TI - The effect of monensin against swine dysentery. AB - The use of monensin sodium against naturally transmitted swine dysentery was evaluated in 4-week-old piglets, with an average weight of 8 kg, over a period of 112 days. Three treatments were compared using between two and four pens per treatment and 12 pigs per pen. Monensin was administered via the feed, either immediately post weaning to four pens of pigs (T1), or after 12 days (T2, two pens). The T1 group received monensin at the rate of 100 ppm (days 0-56), 50 ppm (days 57-84) and 25 ppm until the end of the trial. In the other group monensin was given at 100 ppm (days 12-84) and at 50 ppm (days 85-112). Unmedicated feed was given to two pens (T3). The continuous administration of monensin from weaning was effective in the control or prevention of swine dysentery. A significant (P less than 0.05) improvement, in comparison with the other two groups, was observed in terms of mortality, diarrhoea score, average daily gain (ADG) and feed conversion ratio (FCR). There was a reduction in mortality, diarrhoea score/days and an improvement in growth performance parameters in pigs treated with monensin after the disease had been established, with ADG and FCR values significantly (P less than 0.05) different compared with the untreated controls. PMID- 2775986 TI - The relationships between glycogen stores and muscle ultimate pH in commercially slaughtered pigs. AB - Small samples of liver and m. adductor (AD) were collected within 45 minutes of death from the carcasses of a total of 604 pigs killed at three bacon factories. Glycogen concentrations were measured and part of the muscle sample allowed to complete post-mortem glycolysis in order to estimate ultimate pH (pHu) values. Liver glycogen levels were also used to predict overall food withdrawal times. Muscle glycogen concentrations ranged from 2.2 to 15.3 mg/g, liver glycogen from 0.01 to 50.7 mg/g and pHu in the AD from 5.51 t 6.76. The overall average predicted fasting time was 16.5 +/- 0.54 (SEM) hours and 22% of pigs had pHu values in the AD greater than 6.2 indicative of potentially dark, firm, dry meat. Muscle glycogen concentration was positively correlated with liver glycogen (r = 0.27, P less than 0.01) and negatively correlated with predicted fasting time (r = -0.30, P less than 0.001). The pHu in the AD was negatively correlated with liver glycogen (r = -0.34, P less than 0.001) and positively correlated with predicted fasting time (r = 0.37, P less than 0.001). Therefore, pigs which had reduced concentrations of glycogen in their livers, indicative of longer food withdrawal times before slaughter, tended to have less glycogen in their muscles and a higher pHu in the meat. PMID- 2775988 TI - Disposition kinetics and dosage of cephaloridine in calves. AB - The disposition kinetics and dosage regimen of cephaloridine were investigated in calves following a single intravenous dose of 10 mg.kg-1. The distribution half life and elimination half-life were 0.16 +/- 0.02 and 1.96 +/- 0.16 h, respectively. The apparent volume of distribution was 0.64 +/- 0.06 l.kg-1 and total body clearance which represents the sum of all clearance processes, was 225.2 +/- 15.1 ml.kg-1.h-1. Based on kinetic parameters, a satisfactory intravenous dosage regimen of cephaloridine in calves would be 11.0 mg.kg-1 repeated every 8 h. PMID- 2775987 TI - Epsiprantel, a new tapeworm remedy. Preliminary efficacy studies in dogs and cats. AB - The anthelmintic potential of epsiprantel, 2-(cyclohexylcarbonyl)-4-oxo 1,2,3,4,6,7,8,12b-octahydropyrazin [2,1-a] [2]benzapine, was revealed using the tapeworms Dipylidium caninum and Taenia taeniaeformis in the cat, and Taenia pisiformis and T. hydatigena in the dog. Subsequent controlled tests in cats demonstrated oral efficacy of 100% against D. caninum with a single dose of 2.5 mg/kg. Although consistently 100% effective against T. taeniaeformis at 5 mg/kg, a single worm was found in one cat treated at 7.5 mg/kg. In experimental infections of Taenia pisiformis in dogs, 100% activity was achieved from a single oral dose of 1 mg/kg. No adverse reaction or drug-associated toxicity were observed at dose levels used. PMID- 2775989 TI - Observations on the treatment of necrobacillosis in wallabies. AB - Clinical experience of 73 cases of necrobacillosis in red-necked wallabies (Macropus rufogriseus) over a 6-year period is reviewed. Diagnostic methods and the medical and surgical treatment options are detailed. It is suggested that survival curves are necessary to assess the outcome of treatment. PMID- 2775990 TI - Different interhemispheric transfer of kanji and kana writing evidenced by a case with left unilateral agraphia without apraxia. AB - Recent neuropsychological studies have revealed that the processing of kanji (the Japanese morphograms) and kana (the Japanese syllabograms) involves different intrahemispheric mechanisms. We describe a patient showing left unilateral agraphia without apraxia for kanji, but not for kana, who was diagnosed by magnetic resonance imaging as having a lesion of the posterior body of the corpus callosum. This patient indicates that different neural pathways are used for kanji and kana not only intrahemispherically, but also interhemispherically. PMID- 2775992 TI - Tropical spastic paraparesis and human T cell lymphotropic virus type 1 in the United Kingdom. AB - Twenty-one patients with tropical spastic paraparesis (TSP), all of whom were born in the Caribbean and who had migrated to the United Kingdom, are described. All had a progressive spastic paraparesis developing many years after immigration and all 19 tested had antibodies to the human T cell lymphotropic retrovirus type 1 (HTLV1). The clinical and laboratory features and visual, auditory and somatosensory evoked potentials are described. Details of magnetic resonance scanning of the brain and, in a few cases, the spinal cord are compared with those found in multiple sclerosis. The antibody titres to HTLV1 assessed by particle agglutination, Western blot, antibody-directed cell mediated cytotoxicity and pseudotype neutralization were higher than in asymptomatic infected relatives and in patients with adult T cell leukaemia. Some, but not all, of the IgG oligoclonal bands in the CSF were directed against HTLV1. IgM oligoclonal bands directed against HTLV1 were found in 2 patients. Sixty of the 64 first degree relatives of 11 Jamaican patients with TSP were traced in the UK and the Caribbean; 20-30% of those born in the Caribbean had antibodies to HTLV1, irrespective of their present place of residence, whilst none of those born in the UK, who were the children of the patients, had antibodies. The original pathological material obtained from the Caribbean by Montgomery et al. (1964) is reviewed. These results are discussed in relation to animal retroviral neurological diseases, particularly visna in sheep which has clinical and pathological features closely similar to TSP. It is proposed that TSP is due to a HTLV1 infected lymphocyte/macrophage immune-mediated inflammatory response in the spinal cord. PMID- 2775991 TI - Anterior callosal haemorrhage. A partial interhemispheric disconnection syndrome. AB - The interhemispheric disconnection syndrome secondary to a callosal haemorrhage is exceedingly uncommon. In the present study, 3 patients with haemorrhages restricted to the corpus callosum are presented. All 3 developed a partial anterior interhemispheric disconnection syndrome: unilateral tactile anomia, unilateral agraphia, unilateral apraxia, difficulty in copying drawings, dyscalculia as well as abnormalities of somaesthetic transfer and the 'alien hand' sign. The study of these cases allowed a close examination of the association between deficits in the transfer of specific neuropsychological information and the precise topography of callosal damage. Variability in the lateralization of cognitive functions, and possible mechanisms underlying the production of callosal haemorrhages after the rupture of saccular aneurysms are also discussed. PMID- 2775993 TI - Preserved object recognition and reading comprehension in optic aphasia. AB - Optic aphasia is characterized by the ability to name from description and palpation but an inability to name visually-presented objects. Although originally attributed to a disconnection of visual information from object names, optic aphasia is often considered to be a mild form of visual agnosia. We describe a patient with optic aphasia who could access semantic information relevant to objects he could not name and comprehend written words he could not read. These data suggest that, at least in certain cases, this visual modality specific naming impairment may not be attributable to impaired visual recognition. We suggest that this patient's preserved object recognition and reading comprehension was mediated by a semantic system supported by the right hemisphere. PMID- 2775994 TI - Simple reaction times to lateralized light flashes. Varieties of interhemispheric communication routes. AB - Simple unimanual reaction times to lateralized light flashes were measured in 40 normal subjects, 4 commissurotomized patients, and a boy with callosal agenesis. In all subjects, reaction times tended to be shorter when the stimuli were presented on the same side as the response hand (uncrossed condition) than on the opposite side (crossed condition). In 2 experiments, the magnitude of the crossed uncrossed difference (CUD) was greatest in the commissurotimized patients (ranging from 35 to 96 ms), the acallosal boy showed an intermediate CUD (20 and 12 ms for the first and second experiment, respectively), and normal subjects exhibited the smallest CUD (an insignificant 1 ms difference and a significant 3 ms difference in the first and second experiment, respectively). For all subjects, reaction times increased when the stimulus light intensity was decreased (Experiment 1) or when stimulus eccentricity was increased (Experiment 2). However, the effects of these visual parameters on the CUD revealed group and individual differences. Neither stimulus light intensity nor eccentricity affected the CUD in the normals, in 1 of the commissurotomized patients, and in the acallosal boy. The CUDs in these subjects are attributed to the transfer of nonsensory information via the corpus callosum, via ipsilateral corticospinal tracts, and via the anterior commissure or ipsilateral motor pathways, respectively. The CUDs of 2 commissurotomized patients varied with stimulus eccentricity but not intensity. Subcallosal interhemispheric visual transfer is thus apparently more sensitive to stimulus eccentricity than to intensity. The final commissurotomized patient, R.Y., had slower and less accurate responses to stimuli presented in the right visual hemifield during left, but not right, hand responses. An asymmetry in subcortical visual interhemispheric communication is suspected in this patient. The disparate results amongst these subjects are discussed and contrasted with previous findings. Finally, an information processing model of cortical and subcortical interhemispheric communication is presented. PMID- 2775995 TI - Spatial and temporal contrast sensitivity in hemianopia. A comparative study of the sighted and blind hemifields. AB - Spatial and temporal contrast sensitivity was measured, under identical test conditions using spatially and temporally localized stimuli, in 4 normally sighted human subjects and in 3 healthy hemianopic subjects whose stable visual field loss exhibited foveal sparing. Testing was undertaken at central fixation and at a variety of eccentric loci along the horizontal meridian of the sighted and perimetrically blind field. In comparison with the normal (control) sensitivities obtained in this study, spatial and temporal sensitivities in the sighted hemifield in subjects with striate cortical lesions were both reduced; in addition, we were unable to demonstrate greater-than-chance performance at any extrafoveal locations in the blind hemifield. PMID- 2775996 TI - Paraesthesiae and hypaesthesia following prolonged high-frequency stimulation of cutaneous afferents. AB - The activity of cutaneous afferents was recorded in human subjects using microelectrodes inserted into individual fascicles of the median nerve at the wrist before and after a 10 min train of electrical stimuli at 200 Hz delivered to the appropriate digital nerve (via ring electrodes) or to individual afferent axons (via the microelectrode). Changes in neural activity produced by the stimulation were correlated with the time course of paraesthesiae and with changes in the ability to detect cutaneous stimuli. From approximately 20 s after the end of the stimulus train, there was a progressive increase in neural activity, and individual afferents became spontaneously active and discharged in high-frequency bursts. At this time the subjects began to experience paraesthesiae. Repetitive stimulation proximal to a complete digital nerve block induced paraesthesiae that were felt distal to the block in the insensate digit, indicating that they did not arise from the unmyelinated terminal segment of the axon or from a stimulus-induced disorder of receptor function. Recordings of the compound action potential evoked by submaximal test stimuli were made after the 10 min stimulus train and revealed evidence of an early transient increase in excitability superimposed on a long-lasting decrease in excitability, reaching a nadir approximately 30-40 min after the end of the repetitive stimulation. In parallel recordings, there was no detectable change in the cutaneous afferent volley evoked by mechanical stimulation, paraesthesiae, can be attributed directly to a disturbance in peripheral afferent fibres, while the poststimulation negative symptoms such as hypaesthesia arise from stimulation induced refractoriness at central synaptic relays. PMID- 2775997 TI - Prosopagnosia in a right hemispherectomized patient. AB - The first reported case of prosopagnosia in a right hemispherectomized woman, B.M., whose intellectual and cognitive functions were otherwise normal or only slightly impaired, is presented. She was totally unable to identify, and to experience a sense of familiarity with, faces of persons she knew, but she could evoke semantic information about them and retrieve their names from visual contextual cues. She was unaware that she was lacking face-recognition skills and that faces alone could be used to access the identity of individuals. The functional nature of her deficit was investigated through sensory, perceptual, memory, and learning tasks to determine the level at which her prosopagnosic disturbance occurred. She was defective at resolving low spatial-frequency information, but this was insufficient to explain the selectivity of her impairment. She was able to carry out cognitive operations specific to faces as long as facial identity did not have to be ascertained, and she performed as well as control subjects at deriving information about the gender, age, and emotion of faces. She was impaired at matching different views of the same faces, and multidimensional scaling analysis of dissimilarity judgements between faces indicated an inability to combine the component features into a configurational facial representation that would uniquely define each face. In contrast to recently reported cases of prosopagnosia, B.M. showed no sign of covert recognition of known faces in a learning task, and there was no indication that she could, even for a few seconds, store a faithful facial representation. The occurrence of prosopagnosia in this hemispherectomized patient confirms that this deficit can emerge without damage to the left hemisphere, and her unawareness of her deficit, which had remained unnoticed for several years, raises the possibility that other hemispherectomized patients may be prosopagnosic. The pattern of cognitive impairments displayed by B.M. indicates a perceptual basis to her disturbance and is discussed in relation to other cases of prosopagnosia. PMID- 2775998 TI - Parkinsonian deficits in serial multiarticulate movements for speech. AB - Unlike the single joint arm movements so commonly the focus of Parkinson's disease (PD) studies, orofacial movements for speech are well-learned, complex motor sequences generated without visual guidance. The present study of upper lip, lower lip, and jaw movements during speech in PD was thus aimed at determining whether (1) PD speech kinematic deficits are comparable to those often observed in simpler limb movements; (2) coordination for multimovement actions such as speech is aberrant in PD, as recently claimed; and (3) the component muscle groups involved in this behaviour manifest uniform deficits. Results indicated that despite reduced amplitudes of jaw and upper lip displacement in PD subjects, all three of these oral movements were of normal duration. Secondly, PD lower lip movements manifested no deficits and bradykinesia (reduced velocity) was only found in movements of the jaw. Finally, there was an indication of movement coordination aberrations in these parkinsonian subjects. Overall, these results not only suggest a difference between orofacial and limb movement impairments in PD, but also document the need to broaden our perspectives on this movement disorder by examining a wider range of functional motor tasks. PMID- 2775999 TI - Measurements of muscle stiffness, the electromyogram and activity in single muscle spindles of human flexor muscles following conditioning by passive stretch or contraction. AB - In experiments on adult human subjects we examined the effect on passive mechanical properties of a muscle by conditioning it with either an isometric contraction or passive muscle extension. The test measurement was the amount of muscle displacement (stiffness) and the accompanying EMG in response to a brief torque pulse. Two muscles were tested, flexor digitorum profundus (FDP) and brachialis. In FDP the discharge of single muscle spindles was recorded as well. After muscle extension and return to the initial length, passive stiffness was less than after an isometric contraction. The changes in stiffness were accompanied by changes in pattern of EMG and in the responses of muscle spindles. It is suggested that in resting muscle there are stable cross bridges between actin and myosin filaments of muscle fibres which largely determine the passive stiffness. Muscle extension leads to detachment of these cross bridges which then re-form at the longer length. Return of the muscle to its starting length leads to development of slack in muscle fibres because, stiffened by the presence of the stable cross bridges, they are unable to shorten. Slack in muscle fibres lowers their measured stiffness. Muscle contraction, on the other hand, will result in any preexisting slack being taken up by the actively shortening muscle fibres, thereby raising muscle stiffness. Stiffness in intrafusal fibres is likely to follow a similar pattern to that in extrafusal fibres, leading to changes in stretch responsiveness of muscle spindles and consequently in the reflex EMG. It is concluded that the changes in stiffness and accompanying reflexes observed in this study are likely to be seen, at least under some conditions, in normal movements. PMID- 2776000 TI - Intracerebroventricular saccharide infusions inhibit thirst induced by systemic hypertonicity. AB - The effect of intracerebroventricular (i.c.v.) infusion of various iso- and hypertonic saccharide solutions on water intake stimulated by intracarotid (i.c.) infusion of hypertonic NaCl was studied in sheep. Without an i.c.v. infusion, water intake during a 10-min period following an i.c. infusion of 4 M NaCl (1.4 ml/min over 20 min) was 1.5-2.0 litres. I.c.v. infusion of all saccharide solutions (made up in artificial cerebrospinal fluid (CSF) with no Na) tested, 0.27 or 0.7 M D-glucose, L-glucose, 2-deoxyglucose and sucrose, decreased (35 65%) water intake. In general, there was little or no difference in antidipsogenic effectiveness between the isotonic and the hypertonic solutions or between the different saccharides used. I.c.v. infusion of artificial CSF ([Na] = 150 mM) did not alter water intake. CSF [Na] was decreased by all of the saccharide infusions. CSF osmolality was increased by the hypertonic solutions, was decreased by the artificial CSF and was unchanged by the isotonic solutions infused. The observation that the antidipsogenic effectiveness of saccharides which readily cross the blood-brain barrier (BBB; D-glucose, 2-deoxyglucose) was similar to that of saccharides which do not readily cross the BBB (sucrose, L glucose) contrasts with effects reported on sodium appetite and suggests that the Na sensors involved in the inhibition of hypertonic NaCl-stimulated water intake are located close to or on the surface of the brain ventricular system, i.e. are responsive to changes in CSF [Na].(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2776001 TI - A study of proteins in the auditory system of rabbits using two-dimensional gels: identification of glial fibrillary acidic protein and vitamin D-dependent calcium binding protein. AB - Two-dimensional gel electrophoresis and computerized optical densitometry were employed to compare the relative content of proteins across major auditory brain regions in rabbits. Areas examined included the dorsal and ventral cochlear nuclei which receive the primary afferents from the organ of Corti, the lateral superior olivary nucleus which has strong reciprocal relationships with the cochlear nucleus, and the successively more rostral projections of the auditory pathways to inferior colliculus, medial geniculate and auditory cortex. Twelve proteins demonstrated significant decreases and 5 proteins significant increases in content at successively more rostral levels of the auditory system, including 2 proteins which were highly localized to the cochlear nuclei and 2 proteins greatest in amounts in the auditory cortex. One protein which was localized to the cochlear nuclei and lateral superior olive (molecular weight (MW) = 50.3, isoelectric point (pI) = 5.7) was identified as the glial fibrillary acidic protein by reaction of specific antisera on blots. Antisera to the vitamin D dependent calcium binding protein reacted specifically with one protein (MW = 27.2, pI = 4.8) which was greatest in amount in the lateral superior olive (LSO) versus other auditory regions examined. The significance of these findings rests in the potential for identifying specific markers for cellular elements that are important in auditory function and which might be lost as a consequence of developmental abnormalities or other traumas. PMID- 2776002 TI - Cholesterol conservation in skeletal muscle associated with age- and denervation related atrophy. AB - The lipid composition of muscles with age- and denervation-atrophy was assayed in whole muscle and isolated sarcolemma of rats aged 10 and 25 months. Although muscle mass decreased at least 17% during aging, muscle cholesterol concentration rose 15-20%. However, phospholipid concentrations were maintained; therefore, the cholesterol-to-phospholipid ratio increased during aging. Plasma cholesterol levels also rose 35%, but this could account for only about 10% of the age related difference in muscle cholesterol. Likewise, following denervation (7 days) muscle mass decreased by at least 30%, but muscle cholesterol-to phospholipid ratio increased; the magnitude of the denervation-induced response was unaffected by aging. To localize the source of cholesterol deposition during aging, these assays were repeated on isolated sarcolemma, sarcoplasmic reticulum, and mitochondria membrane fractions. Neither cholesterol nor phospholipid levels changed significantly with age in any of these major membrane systems. Furthermore, sarcolemmal fluidity, which depends on cholesterol content, did not vary significantly with age. At this level of resolution, it thus appears that skeletal muscle membrane phospholipid composition and fluidity do not change appreciably with age. Elevated cholesterol-to-phospholipid ratios detected in whole muscle may be due to cholesterol deposition in non-myofiber locations. PMID- 2776003 TI - Response latencies of visual cells in macaque areas V1, V2 and V5. AB - The response to moving light and dark slits was recorded from a total of 94 cells in V1, V2, and V5 (MT) in 9 anesthetized and paralyzed macaque monkeys (M. fascicularis). Using the spatial lag method2, response latencies were calculated for each cell. We obtained median latencies of 85, 96, and 94 ms for cells in areas V1, V2, and V5, respectively. The higher median latencies of V2 and V5 cells compared to V1 are commensurate with later stages of information processing, and are predictable from the anatomy of the interconnections. In addition, a distinct, second population of high-latency cells is present in all 3 regions, but is most abundant in lamina 4 of V5. These may represent either external feedback from other regions or ongoing processing. Extensive overlap of latencies in all 3 regions at both the high and low ends of their respective ranges indicates a considerable degree of parallel interaction between striate and extrastriate cortex. PMID- 2776005 TI - Phosphorus-31 nuclear magnetic resonance study of the C6 glioma cell line cultured on microcarrier beads. AB - The energetic metabolism of perfused C6 glioma cells anchored and cultured on polystyrene microcarrier beads has been studied by phosphorus-31 nuclear magnetic spectroscopy (NMR). The observation of intracellular phosphorylated compounds demonstrates the metabolic long-lasting viability of the perfused cells. The effect of glucose deprivation on energetic metabolism and intracellular pH illustrates the existence of an active aerobic glycolysis. The non-invasive study of anchored C6 cells by NMR provides a direct means to investigate the metabolism of glioma cells. PMID- 2776004 TI - Epileptiform discharges evoked in hippocampal brain slices from epileptic patients. AB - We have recorded from diseased hippocampal tissue which was surgically removed from epileptic patients for therapeutic purposes. When the perforant path was stimulated at a low frequency (1 Hz), the number of population spikes evoked in the dentate gyrus increased by a factor of as great as 8 during a 15 s train. This effect was transient. A similar epileptiform discharge could be generated in normal rat hippocampal brain slices by the same stimulus paradigm, but only in the presence of a low concentration (0.2 microM) of bicuculline. These results suggest that this frequency-dependent epileptiform discharge, evoked in the dentate gyrus of epileptic patients, may be due to a small reduction in GABAA mediated inhibition and may involve factors that lead to the initiation of seizures. PMID- 2776006 TI - Long-term structural changes in the rat hippocampal formation following cerebral ischemia. AB - Histological and immunohistochemical techniques were used to investigate the long term structural changes that occur in the rat hippocampal formation following the induction of transient forebrain ischemia. Histological analysis showed that after 6-12 months cell loss was still largely restricted to the CA1 region but within this region degeneration was progressive and culminated in a severe shrinkage of the stratum oriens and stratum radiatum. Using the immunohistochemical markers calbindin-D28K and parvalbumin, we were able to demonstrate some of the structural changes that reflect this shrinkage. Calbindin immunohistochemistry clearly illustrated that the shrinkage was primarily due to the loss of the pyramidal neurons and the framework normally provided by their long apical dendrites. Parvalbumin immunostaining demonstrated that although a few GABAergic interneurons survived the insult, their terminal network was reduced greatly and the dendrites which normally extended the length of the stratum radiatum were retracted. Additionally, the normally dense band of parvalbumin immunoreactivity in the stratum lacunosum-moleculare, thought to be indicative of a fiber bundle travelling through the CA1 region, was almost completely depleted. These data illustrate that the primary damage observed in the CA1 region following cerebral ischemia is not static but progressive and may thus have important functional implications. PMID- 2776007 TI - Corticostriatal cells in comparison with pyramidal tract neurons: contrasting properties in the behaving monkey. AB - Antidromically identified neurons projecting to the putamen (CPNs) and pyramidal tract neurons (PTNs) were recorded from motor and premotor cortex of a monkey which performed a load-bearing task with the wrist. CPNs appeared as a uniform population with very slowly conducting axons and low spontaneous activity. In contrast to PTNs, they exhibited weak, mostly insignificant correlation with graded steady-state forces, responded to torque perturbations with remarkably long latency, and seemed to discharge much later with active movement. Collateral branching of PTNs to the putamen was found to be infrequent (1%). We suggest that the putamen receives a cortical message that is strikingly different from that sent down the pyramidal tract. PMID- 2776008 TI - Fetal cortical transplants into neonatal rats respond to thalamic and peripheral stimulation in the adult. An electrophysiological study of single-unit activity. AB - Plates of presumptive sensorimotor neocortex obtained from fetal rats at 14-16 days gestation were grafted into the cerebral hemisphere of 0- to 1-day-old newborn rats. The transplants were placed into small lesion cavities in the sensorimotor cortical area made immediately prior to grafting. At 4-5 months of age, single-unit activity in the transplants (TP) or normal cortex (NCX) was recorded under ketamine HCl anesthesia using standard electrophysiological techniques. Over 90% of cells in both the transplants (n = 63) and normal cortex (n = 39) responded to ventral thalamic stimulation. Their average response latencies were similar (11.48 +/- 0.56 ms in TP. 12.77 +/- 1.20 ms in NCX, mean +/- S.E.M., no significant difference), as were their average responses of slightly more than 1 spike per thalamic stimulus (1.24 +/- 0.08 in TP, 1.07 +/- 0.01 in NCX, no significant difference). In addition, 64% (30/47) of transplant cells and 44% (14/32) of normal cells also responded to electrical stimulation of the contralateral forepaw, and here also the latencies were similar (16.11 +/- 0.67 ms in TP, 14.30 +/- 0.78 ms in NCX). The spontaneous neuronal activity observed within the transplants was also comparable to that seen in normal cortex, as measured by comparison of spontaneous interspike interval (ISI) histograms (median ISI of 84.5 for TP and 80.5 for NCX) and comparison of the burst index (% of intervals less than 5 ms, 14.7% for TP and 10.5% for NCX). These results are compared to those found in several recent studies where fetal cortex is grafted into adult hosts. PMID- 2776009 TI - Functional deficits after sustained stimulation of the perforant path. AB - Several reports have implicated the overactivity of hippocampal glutaminergic systems in neurodegenerative conditions including Senile dementia of the Alzheimer's type (SDAT). The neurobiological effects of hippocampal glutaminergic hyperactivity were studied by perforant pathway stimulation. Forty-five minutes of sustained perforant pathway stimulation produced a 50% or greater increase in motor activity 1, 2, and 3 weeks after stimulation. Robust retention deficits in a 48-h step-through passive avoidance task were evident 2 weeks post-stimulation. Furthermore, animals receiving stimulation were impaired in the acquisition of a spatial task in the Morris water maze. Stimulated animals exhibited little reduction in their escape latencies over the testing period. The learning and memory deficits were associated with a loss of CA1 and CA3 pyramidal cells and pretreatment with the N-methyl-D-aspartate antagonist MK-801 reduced this cell loss, particularly in the CA1 region of the hippocampus. These results suggest that sustained stimulation of the perforant pathway may be useful in studying neurological deficits associated with glutaminergic hyperfunction. PMID- 2776010 TI - Centrifugal innervation of the lamprey retina. Light- and electron microscopic and electrophysiological investigations. AB - Centrifugal fibers and their synaptic connections were studied in retinas of the lamprey Lampetra fluviatilis. The morphological analysis of retinofugal and retinopetal elements was performed after their horseradish peroxidase (HRP) filling through either the cut optic nerve in isolated retina preparations or after intracerebral HRP injections. In flat-mounted retinas, labeled ganglion cell bodies with their dendritic arborizations as well as centrifugal axons were found. The topography of labeled ganglion cell bodies and fibers in semi-thin plastic sections is described. The electron microscopic analysis revealed that the centrifugal terminals synapse either upon unlabeled somata or profiles containing synaptic vesicles (PCSVs). In more rare cases these boutons seem to establish synaptic contacts on ganglion cell dendrites. The target cell bodies were located within the inner part of the inner nuclear layer, whereas postsynaptic dendrites and PCSVs were mainly observed in the outer portion of the internal synaptic layer. Stimulation of the optic nerve in isolated retinas produced antidromic responses in 23 neurons and in 9 of these cells, an antidromic spike was followed by a postsynaptic potential (PSP). Ten cells yielded no antidromic response, but showed PSPs sometimes associated with spikes. The morphological and physiological evidence obtained indicate that these PSP generating cells were activated synaptically by centrifugal fibers and that in the lamprey retina, these fibers make contacts either with dendrites or somata of amacrine cells and probably with ganglion cell dendrites. PMID- 2776011 TI - Ipsilateral corticocortical projections of fibers which course within Probst's longitudinal bundle seen in the brains of mice with congenital absence of the corpus callosum: a study with the horseradish peroxidase technique. AB - In the brains of mice with congenital absence of the corpus callosum, Probst's longitudinal bundle is always present in both cerebral hemispheres. In this research, the ipsilateral corticocortical projections by the fibers in this bundle were studied by iontophoretical injections of horseradish peroxidase into different loci in the neocortex of acallosal mouse brains. Our results show that the 'intrinsic' association fibers seen in normal mice are preserved unchanged in acallosal mice and that in these mice, a considerable portion of the fibers arising from a particular cortical region and coursing in Probst's bundle terminate ipsilaterally in the same area as do the 'intrinsic' association fibers from that region. Furthermore, careful comparison of the labeling patterns in acallosal and normal mice revealed that ipsilaterally labeled cells in acallosal mice are distributed as in similarly injected normal mice. This fact strongly suggests that in spite of the presence of ipsilateral corticocortical projections by the fibers in Probst's bundle, the overall pattern of intrahemispheric connections in the neocortex of acallosal mice is not different from that of normal mice. Thus, from the present findings it can be concluded that in congenitally acallosal mouse brains, the ipsilateral corticocortical projections of fibers which arise from a given cortical region and course within Probst's longitudinal bundle are formed only in areas that also have the 'intrinsic' association projections from that region. PMID- 2776012 TI - Synaptic plasticity in the hippocampus is modulated by behavioral state. AB - The possible influence of the sleep-waking cycle on evoked neurotransmission and on the induction of long-term potentiation (LTP) and depression (LTD) was studied in the perforant path-granule cell system. Freely moving rats received a high frequency stimulus train (8 bursts at 400 Hz) during slow-wave sleep (SWS), rapid eye movement (REM) sleep, and a still-alert (SAL) behavioral state. Trains applied during SAL and REM reliably elicited LTP of the excitatory postsynaptic potential (EPSP) slope, population spike height, and spike onset latency. Granule cell excitability was also enhanced, as indicated by a leftward shift of the EPSP population spike (E-S) relation. In contrast, tetanization in SWS rarely produced 'classical' LTP and often failed to elicit any lasting change in field potentials. Furthermore, the following types of E-S change occurred almost exclusively after tetanization in SWS: (1) LTP of the EPSP accompanied by depression of the population spike, and (2) E-S potentiation without a change in EPSP. When LTP occurred, however, its magnitude was independent of the animal's behavioral state at the time of the train. In agreement with previous reports, the efficacy of low-frequency neurotransmission varied with behavioral state. A modulation index (MI) was introduced to quantify the difference between field potentials evoked in SAL and SWS. Interestingly, both the occurrence and magnitude of LTP were related to the strength of the MI, as determined in each rat before the train. After trains, the state-dependent modulation of transmission was maintained and was superimposed on LTP and LTD. The results suggest that synaptic plasticity is dynamically modulated during the sleep wakefulness cycle. PMID- 2776014 TI - A bag cell neuron-specific antigen localizes to a subset of dense core vesicles in Aplysia californica. AB - The bag cell neurons of Aplysia govern egg-laying through the release of a number of bioactive peptides which are processed from a common precursor. Immunoelectron microscopic studies suggest that sorting at the trans-Golgi segregates peptides from the amino terminal and carboxy terminal of the precursor into distinct classes of dense-cored vesicles (DCVs). Here we identify a novel bag cell specific antigen (4F6 antigen) using monoclonal antibodies (MAbs). Immunoprecipitations and Western blots demonstrate that the MAb4F6 specifically recognizes a protein of 80 kDa and does not react with the egg-laying hormone precursor, processing intermediates or final products. The 4F6 antigen is localized in a subset of DCVs which also contain peptides derived from the amino terminus of the precursor. These results further demonstrate the complexity of vesicular sorting in the bag cells and also identify a novel tissue specific antigen localized to DCVs. PMID- 2776013 TI - Distribution, possible origins and fine structure of neuropeptide Y-containing nerve fibers in the rat liver. AB - The distribution, possible origins and fine structure of neuropeptide Y (NPY) containing nerve fibers in the rat liver were investigated by immunohistochemistry, nerve transection and immunoelectron microscopy. Light microscopic immunohistochemistry showed NPY fibers forming a complex network in and around the walls (tunica adventitia and tunica media) of hepatic vessels. They were also closely associated with interlobular bile ducts. The NPY fibers in the liver were almost completely eliminated by transection of the greater splanchnic nerves just distal to the celiac ganglion. Transection of the greater splanchnic nerves just proximal to the celiac ganglion resulted in a marked decrease in NPY fibers, but a significant number remained intact. Under electron microscopy. NPY terminals without a covering of glial processes were seen not only in proximity to smooth muscle cells within the tunica media of hepatic vessels but also in the subendothelial areas of the tunica intima. Some NPY axon terminals devoid of glial ensheathment were located close to the basal lamina of interlobular bile ducts. Occasionally, single axon terminals with NPY were found in the vicinity of or in contact with hepatic cells. There was a small number of NPY fibers that had lost their glial sheaths while running toward lymphatic capillaries. These findings suggest that hepatic NPY arises from the celiac ganglion and paravertebral sympathetic ganglia, and that it is involved in more complex physiological processes than the previously described neuropeptides in the liver, which are localized exclusively to hepatic vessel walls. PMID- 2776015 TI - Intracellular neurophysiological analysis reveals alterations in excitation in striatal neurons in aged rats. AB - Intracellular recordings were used to characterize the physiological changes underlying decreases in excitation observed in striatal neurons during the aging process. Rats were divided into 3 age groups: young (3-5 months), middle-aged (10 12 months) and aged (greater than 24 months). All experiments were performed in urethane-anesthetized rats. Recordings were obtained from 33 neurons in young, 17 in middle-aged and 20 in aged rats. When identified by intracellular injections of Lucifer yellow all recorded neurons were medium-sized spiny cells. Resting membrane potentials were at least -40 mV and action potentials greater than 35 mV. Postsynaptic responses were evoked by stimulation of frontal cortex. In all recorded neurons, regardless of age, excitatory postsynaptic potentials (EPSPs) could be evoked. However, the threshold currents for eliciting both EPSPs and synaptically driven action potentials were significantly higher in neurons obtained from aged rats than those recorded in the other two groups. Other changes in excitation in aged striatal neurons consisted of absence of spontaneously occurring EPSPs, higher current to induce firing by intracellular injections of depolarizing current and an inability of orthodromically induced action potentials to follow paired stimulation pulses to the cortex at short interpulse intervals. These data were interpreted to indicate that a combination of changes in synaptic connectivity and in membrane properties underlie the decreases in excitation. Together with our previous findings obtained from aged cats these results indicate that decreased neuronal excitability is a major effect of aging in the striatum. PMID- 2776017 TI - Selective distribution of N-acetylaspartylglutamate immunoreactivity in the extrapyramidal system of the rat. AB - N-Acetylaspartylglutamate (NAAG), a neuron-specific dipeptide, was found by immunocytochemistry to be localized in specific compartments of the extrapyramidal system of the rat. Cellular and neuropil NAAG-like immunoreactivity (NAAG-IR) was evident throughout the pallidum, entopeduncular nucleus, subthalamic nucleus, and all subdivisions of the substantia nigra. By contrast, only a minority of cells of the caudate-putamen and those of the accumbens nucleus stained positively for NAAG. In general, neuronal NAAG-IR was widespread in all ventroposterior output zones of the extrapyramidal system, while cellular immunostaining was greatly reduced in the corticostriate receptive zones. These data suggest that NAAG may serve some neuronal communication function in the extrapyramidal processing circuits and output projections to the thalamus and midbrain. Additionally, neuronal NAAG immunolabeling differentiates corticostriate receptive zones from pallidal and nigral subdivisions of the extrapyramidal system in the rat. PMID- 2776016 TI - Evidence that short photoperiod-induced gonadal regression in the Mongolian gerbil is mediated by the action of melatonin in the medial hypothalamus. AB - The present study was undertaken to examine the effects of exposure to short photoperiod (SD) and treatment with subcutaneous (s.c.) or intrahypothalamic melatonin-containing beeswax implants on reproduction in the Mongolian gerbil Meriones unguiculatus. Exposure of adult female gerbils to SD (8 h light: 16 h dark) caused a significant decrease in weight of the reproductive tract (ovaries, oviducts, uterus and vagina; RTW) compared to animals maintained under stimulatory photoperiod (12 h light: 12 h dark; 81.4 +/- 8.0 mg vs 151.8 +/- 16.0 mg, respectively (P less than 0.01]. Treatment with two large s.c. implants, each containing 3 mg melatonin, mimicked the antigonadal effect of SD (68.7 +/- 3.9 mg vs 118.1 +/- 19.5 mg for the blank (melatonin-free) implant controls; P less than 0.05). Gerbils with a small melatonin-beeswax pellet (containing 0.2 mg melatonin) in the anterior hypothalamus (AH) underwent a significant reduction in RTW compared to gerbils with a blank intrahypothalamic implant (73.0 +/- 5.7 mg vs 134.6 +/- 14.5 mg, respectively; P less than 0.01). Melatonin pellets in the mediobasal hypothalamus (MBH) also induced gonadal regression, but to a lesser degree (88.7 +/- 12.6 mg; P less than 0.05 vs blank controls). Small melatonin pellets placed elsewhere in the hypothalamus or s.c. had little effect on RTW (143.4 +/- 20.9 mg and 129.2 +/- 19.7 mg, respectively). Only 25% of the gerbils with melatonin pellet in the AH or MBH had a corpus luteum compared to 73% of the blank controls (P less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2776019 TI - The role of the hippocampal-nucleus accumbens pathway in radial-arm maze performance. AB - The role of the glutamatergic hippocampal-nucleus accumbens pathway in relaying hippocampal information via the nucleus accumbens to the motor system was investigated behaviorally using the radial-arm maze paradigm in rats. Bilateral injections of kynurenic acid, a glutamate antagonist, into the nucleus accumbens increased the latency to initiate movement during performance of an 8-arm radial maze with all arms baited and with 4 arms baited. Injections of kynurenic acid did not change the number of visits to previously visited arms (i.e. working memory errors) on both versions of the 8-arm radial maze. However, on the 8-arm radial maze with 4 arms baited, injections increased the number of visits to unbaited arms (i.e. reference memory errors). Similar injections were made in rats with ibotenic acid lesions of the prefrontal cortex in order to eliminate the glutamatergic prefrontal cortex-nucleus accumbens pathway so as to investigate the glutamatergic hippocampal-nucleus accumbens pathway. These rats displayed similar deficits on the radial-arm maze as non-lesioned rats (i.e. enhanced latency to initiate movement and reference memory errors). These findings suggest that the glutamatergic hippocampal-accumbens pathway plays a role in radial-arm maze performance by transferring information required for performing a radial-arm maze to the motor system. PMID- 2776018 TI - Behavioural evidence for a bidirectional effect of systemic naloxone in a model of experimental neuropathy in the rat. AB - In animal models of inflammatory pain, we have demonstrated that the opioid antagonist naloxone induces a paradoxical analgesic effect at very low systemic doses, and a hyperalgesic effect at high doses. We have therefore proposed, that opioid systems are modified in these animals with persistent pain. The aim of the present study was to investigate the activity of naloxone through another model of pain in the rat due to a peripheral neuropathy of the sciatic nerve. The neuropathy was created by 4 ligatures around the sciatic nerve. We analyzed the effects of i.v. naloxone (3 and 10 micrograms/kg, 1 mg/kg) on the vocalization thresholds to paw pressure 8 days after the sciatic ligation. Three and 10 micrograms/kg naloxone produced a significant paradoxical antinociceptive effect on responses from the affected paw (with a mean increase of about 50 and 30% of the preinjection values, respectively) and also from the non-affected paw, although the effect was less potent. By contrast, 1 mg/kg naloxone elicited a significant hyperalgesia on responses from the affected and non-affected paw. The effects of the microdoses, but not those of the high dose, were clearly related to the vocalization thresholds measured for each rat just before injection. This study clearly shows that naloxone induces bidirectional effects in a rat model of neuropathic pain, which contradicts the current statement that neuropathic pain is opioid-resistant. The present results also suggest that these effects are not related to inflammatory processes, and may be due to modifications of opioid systems in these animals with persistent pain. PMID- 2776020 TI - Mechanism of the re-entrainment of the circadian rhythm in the rat pineal N acetyltransferase activity to an eight-hour advance of the light-dark cycle: phase-jump is involved. AB - During the re-entrainment of the rat pineal N-acetyltransferase (NAT) rhythm to an 8-h advance of a light-dark (LD) cycle accomplished by shortening of one dark period, the advanced light period phase-delayed the evening NAT rise and phase advanced the morning decline. The phase-relationship between the rise and the decline became so compressed that after the second and the third light period the NAT rhythm was not expressed even in constant darkness and reappeared only within another cycle at the time of the original night. Only after the fourth advanced light period, the NAT rhythm phase-jumped into the advanced night. PMID- 2776021 TI - Effects of chlordiazepoxide, chlorpromazine, diazepam, diphenylhydantoin, flunitrazepam and haloperidol on the voltage-dependent sodium current of isolated mammalian brain neurons. AB - The effects of chlordiazepoxide, chlorpromazine, diazepam, diphenylhydantoin, flunitrazepam and haloperidol on the voltage-dependent sodium current (INa) were studied on the hippocampal pyramidal neurons, isolated acutely from rats, using a concentration clamp technique. The drugs used here reduced dose-dependently the peak amplitude of INa without affecting its current-voltage relationship. Chlorpromazine was most potent drug inhibiting the INa among them. Chlorpromazine and diphenylhydantoin at the concentration of half inhibition (IC50; 4 x 10(-6) M and 2 x 10(-4) M, respectively) shifted the steady state inactivation curve by more than 20 mV to a hyperpolarizing direction. Both drugs also caused a use dependent inhibition of the INa. These results suggest that the drugs may block preferentially the inactivated sodium channels. While the concentrations of the drugs for inhibiting the INa are thought to be higher than those for affecting respective receptors for neurotransmitters, the results presented here may provide useful information to elucidate additional modes of action of these drugs in mammalian central nervous system. PMID- 2776022 TI - Effects of in vivo perfusion of glutamate dehydrogenase in the guinea pig cochlea on the VIIIth nerve compound action potential. AB - Glutamate is considered as the best candidate for the neurotransmission between the inner hair cell and the primary efferent neurons in the mammalian cochlea. In order to test its presence in the synapse, a degradative enzyme for glutamate, glutamate dehydrogenase (GDH) was perfused in the cochlea of guinea pigs. The intensity function of the VIIIth nerve compound action potential was recorded as a physiological test. The results show that the GDH induces a decrease in the auditory nerve responsiveness. The threshold elevation observed is dependent upon the enzyme concentration. PMID- 2776023 TI - A serotonin S2 antagonist, naftidrofuryl, exhibited a protective effect on ischemic neuronal damage in the gerbil. AB - The effect of a serotonin S2 antagonist, naftidrofuryl, on ischemic neuronal damage was examined in the gerbil. Naftidrofuryl was injected i.p. 5 min prior to a single 5-min forebrain ischemia or immediately after each of three 2-min forebrain ischemic insults at 60-min intervals. In both groups the number of intact hippocampal CA1 neurons were significantly higher than in the saline treated group. These results indicate that serotonin S2 antagonists have a protective effect against ischemic neuronal damage. PMID- 2776024 TI - Discrimination of human dorsal root ganglion cells by anti-fucosyl GM1 antibody. AB - Some neurons and surrounding satellite cells in human dorsal root ganglia were immunostained with rabbit IgM antibody against the ganglioside fucosyl GM1. They were not immunostained with the anti-GM1 antiserum. Immunohistochemical discrimination of neurons in human dorsal root ganglia by the anti-fucosyl GM1 antibody may give us an important clue to the functional identification of neurons conveying different modalities of sensation. PMID- 2776025 TI - REM sleep enhancement induced by sensory stimulation is prevented by kainic acid lesion of the pontine reticular formation. AB - It has been shown that auditory or somatic stimulation during rapid eye movement (REM) sleep is capable of producing a significant increase in ponto-geniculo occipital (PGO) spike density as well as in REM sleep duration. The purpose of this study was to determine the role of the medial pontine reticular formation (PRF) in mediating such increase of REM sleep duration. After a baseline recording whereby on the same recording day the control and the stimulus (auditory or somatic) alternated with each REM, a group of cats was lesioned with kainic acid in the PRF. The sleep-wake cycle was recorded again on days 15, 30 and 45 post-lesion, following the same procedure. The results showed no changes in REM sleep duration and PGO spike density in the lesioned animals. However, when sensory stimulation was applied it was ineffective in producing REM sleep enhancement, although it was able to increase PGO spike density. These findings suggest that the effects of sensory stimulation on REM sleep duration are accomplished through the PRF, probably by inducing an increase in the excitability levels of such neurons, and further suggests that PGO spike density and REM duration are independent of each other. PMID- 2776026 TI - GABA-like activity in in vitro slices of the rat visual cortex: immunocytochemistry and electrophysiology. AB - Using antisera raised against gamma-aminobutyric acid (GABA), GABA-like immunoreactivity was determined in in vitro slices fixed after various incubation times. Synaptic efficacy of GABAergic innervation was concurrently assessed in adjacent slices by intracellular recordings. We show that GABA-like immunoreactivity dramatically decreases already after one hour of incubation and remains low throughout the following hours. Nevertheless robust GABA-mediated synaptic potentials are recordable for more than 8 h. PMID- 2776027 TI - Corticofugal influences on the responses of bat inferior collicular neurons to sound stimulation. AB - Corticofugal influences on the responses of inferior collicular neurons (IC) to acoustic stimulation were studied by electrical stimulation of the auditory cortex. Among 471 IC neurons isolated, about 26% were affected by cortical stimulation. Responses of 103 (22%) IC neurons were inhibited and 17 (3.6%) were facilitated. The degree of inhibition was dependent upon the amplitude of both auditory and electrical stimuli. Corticofugal inhibition of the response of an IC neuron was likely due to an increase in the neuron's minimum threshold. Inhibitory latency varied with the interstimulus interval. The shortest inhibitory latency of most IC neurons was between 1 and 2 ms. The localization of the point of cortical stimulation was crucial in determining the responses of IC neurons. It is assumed that corticofugal influences on IC neurons are a part of regulatory mechanism in the centrifugal pathway for frequency analysis and acoustic orientation. PMID- 2776028 TI - Suppression of visually initiated hand movement by stimulation of the prefrontal cortex in the monkey. AB - Five adult monkeys (Macaca fuscata) were trained for the go/no-go hand movement task with discrimination between two different color stimuli. The go stimulus was accompanied by a reward when a monkey lifted a lever by wrist extension within the stimulus duration (500 ms). Whereas the no-go stimulus was not. The monkey revealed the potential specific to the no-go response in the prefrontal cortex, called 'no-go potential', i.e. surface-negative, depth-positive deflexions in the cortex of the dorsal bank of the principal sulcus and of the rostroventral corner of the prefrontal region. Effects of electrical stimulation of these prefrontal areas upon the go response were observed and analyzed in order to study functional significances of the no-go potential. The surface and depth (2.0-3.0 mm) electrodes chronically implanted respectively in various cortical areas of both hemispheres, originally used for recording cortical field potentials, were utilized for bipolar stimulation of the cortical area. A train of brief electrical pulses was delivered to the loci producible of the no-go potential at different times after the onset of go visual stimulus. The stimulation suppressed the go movement by cancelling and delaying. The grade of the suppressor effect depended on the timing of electrical stimulation after the onset of visual stimulus, and was maximal at around the time of appearance of the no-go potential. The suppressor effect was compared with that produced by stimulating some other areas in the prefrontal cortex and the premotor cortex, and was found rather unique in those areas producible of the no-go potential.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2776029 TI - Origin of thalamically projecting somatosensory relay neurons in the immature rat. AB - The locations of spinothalamic (STT) and trigeminothalamic (TTT) neurons in 14-18 day rats using retrograde transport of fluorescent latex microspheres were examined. The aim of this study was to determine whether the connections between the somatosensory relay neurons and the thalamus were established in these immature rats. The majority of the labeled STT and TTT neurons was found in the brainstem and upper cervical cord (C1-C4). These cells were distributed to a number of distinct groups. Among them, the nucleus of trigeminal spinal tract interpolaris (SP51) had the highest number of TTT cells, and the internal basilar nucleus (IB) comprised the largest population of STT cells. Except for the cells located in the dorsal portion of the ventral horn (VHd), most of the labeled STT and TTT cells were contralateral to the thalamic injection sites. This pattern of distribution of the projecting neurons in immature rats is very similar to the pattern observed in adult rats. The development of the STT and TTT projections in 14-18-day rats is therefore largely complete. This result will allow us to extrapolate our understanding of the membrane properties of projection cells obtained in the immature rats to the adult rats. PMID- 2776030 TI - Characterizing stearate probes in vitro for the electrochemical detection of dopamine and serotonin. AB - This paper describes an electrochemical method for the detection of dopamine and serotonin in vitro. Dopamine and serotonin can be distinguished from each other without interference from metabolites. 3-4-dihydroxyphenylacetic acid and 5 hydroxyindoleacetic acid. The method also provides selective differentiation of dopamine and serotonin in the presence of other possible interfering chemicals, ascorbic acid and uric acid. Specific details for voltammetric technology, electrode fabrication, electrode conditioning, paste synthesis and experimental protocol are presented. The method uses semidifferential treatment of voltammetric data in conjunction with a graphite stearate indicator electrode. The methodology is relevant to the interpretation of electrochemical signals for dopamine and serotonin in vivo in neuroanatomical substrates, richly innervated by dopaminergic and serotonergic neuronal circuitry. PMID- 2776031 TI - A comparison of the effects of morphine on 5-HT metabolism in the periaqueductal gray, ventromedial medulla and medullary dorsal horn: in vivo electrochemical studies in freely moving rats. AB - The effect of systemic morphine on serotonin (5-HT) metabolism within the dorsal raphe nucleus (DRN) has been investigated by in vivo 5-hydroxyindole electrochemical (peak '3') detection in freely moving rats. Morphine caused a weak and delayed, but naloxone-reversible, increase in peak '3'. This increase was poorly, if at all, correlated with the morphine-induced analgesia. Finally, stress and/or noxious stimulation had no effect on this signal. These results are compared with our previous studies using the same methodological approaches and show that morphine caused a significant and specific increase in 5-HT metabolism at the levels of nucleus raphe magnus (NRM) and medullary dorsal horn. Furthermore, as shown in the present paper, there was also a good correlation between the time course of such increases and the analgesic effect of morphine. These findings are discussed with reference to the involvement of 5-HT mechanisms in the so-called DRN-NRM-dorsal horn 'intrinsic analgesic system'. PMID- 2776032 TI - Commissural synapses, but not mossy fiber synapses, in hippocampal field CA3 exhibit associative long-term potentiation and depression. AB - When CA3 commissural afferents received low-frequency (weak) stimuli synchronized with a train of mossy fiber bursts (strong), associative long-term potentiation (LTP) was induced at mixed commissural and associational synapses on hippocampal CA3 pyramidal cells in vitro. In contrast, a weak mossy fiber input did not potentiate when given in phase with commissural/associational bursts. Furthermore, commissural/associational synapses receiving low-frequency stimuli out-of-phase with strong rhythmic mossy fiber input showed associative long-term depression (LTD), whereas mossy fiber synaptic strengths were not depressed when they received weak inputs out-of-phase with a strong commissural/associational input. Thus, both associative LTP and associative LTD can be induced at commissural/associational synapses, but not at mossy fiber synapses. PMID- 2776033 TI - Deep prepyriform cortex kindling differentially alters the levels of prodynorphin mRNA in rat hippocampus and striatum. AB - The effect of deep prepyriform cortex (DPC) kindling on the levels of prodynorphin mRNA (DYN mRNA) in rat hippocampus and striatum was examined under two different stimulation paradigms. Electrical stimulations were delivered to rats twice per day (slow kindling) or once every hour (fast kindling) until two consecutive stage 5 kindled seizures occurred. Animals were decapitated 24 h after reaching the second stage 5 seizure, and DYN mRNA levels in the brain were determined by RNA blot analysis. In the slow kindling model, the level of DYN mRNA in the hippocampus was reduced by 57%, whereas the level of striatal DYN mRNA was increased by 34% compared to sham-operated controls. Fast kindling induced a similar decrease in the DYN mRNA level in the hippocampus, but did not alter that in the striatum. These results, together with the previous report that kindling decreased dynorphin A(1-8) level in the hippocampus, suggest that electrical kindling decreases the biosynthesis of dynorphin peptides in the hippocampus and, in the slow DPC kindling model, also increases the gene expression of dynorphin in the striatum. PMID- 2776034 TI - Entorhinal fibers form synaptic contacts on parvalbumin-immunoreactive neurons in the rat fascia dentata. AB - The entorhinal cortex gives rise to a dense projection to the outer two-thirds of the dentate molecular layer. The main target neurons are the granule cells. This study demonstrates that entorhinal fibers labeled by anterograde degeneration also terminate on parvalbumin-containing non-granule cells in the rat fascia dentata. Since the calcium-binding protein parvalbumin was recently found coexistent with gamma-aminobutyric acid in inhibitory hippocampal neurons, the described connection provides evidence for a role of entorhinal fibers in feed forward inhibition of the granule cells. PMID- 2776035 TI - Neuropeptides in propriospinal neurones in the rat. AB - The presence of neuropeptides in propriospinal neurones has been determined in the rat. Few cervical neurones with long projections to the lumbar cord contained neuropeptides. Lumbar dorsal horn neurones with short intrasegmental projections, and ventral horn neurones with both short intra-and longer intersegmental projections commonly contained neuropeptides. From this, and previous studies, we summarise the organisation of the projections of spinal peptidergic neurones. PMID- 2776036 TI - Distribution of cholecystokinin receptors in the dorsal vagal complex and other selected nuclei in the human medulla. AB - Cholecystokinin receptors were localized in human brainstem by quantitative autoradiography, using [3H]cholecystokininoctapeptide. Receptor densities were highest in the caudal medial region of the nucleus of the solitary tract (NTS). High densities also were present in the dorsal motor nucleus of the vagus, the principle nucleus of the inferior olive, the ventral region of the NTS, and the area postrema. PMID- 2776037 TI - Kindling in spontaneous hypertensive rats. AB - Vasopressin is a neurohormone and neuromodulator with many effects on behavior. Rats lacking vasopressin have been found to develop kindled seizures more slowly with amygdala stimulation. In the present study the spontaneous hypertensive (SH) rat and rats from the parent strain, the Wistar-Kyoto (WKY) rat received amygdala and pyriform kindling. The SH rat has been reported to have increased plasma vasopressin and increased brain vasopressin release. Plasma vasopressin, osmolality and hematocrit were also measured in blood samples obtained through chronic, indwelling catheters implanted in SH, WKY normal and Sprague-Dawley rats. SH rats were found to kindle with fewer afterdischarges than WKY normal rats with both amygdala and pyriform cortex stimulation. The total afterdischarge duration required to reach each kindling stage was significantly shorter in the SH rat. Plasma osmolality and vasopressin were significantly higher in the SH rats compared to WKY normal rats and Sprague-Dawley rats. These findings provide additional evidence that vasopressin may influence the establishment of enduring behaviors such as kindled seizures. PMID- 2776038 TI - Estrogen receptor-immunostaining of neuronal cytoplasmic processes as well as cell nuclei in guinea pig brain. AB - We have recently developed an immunocytochemical technique for staining estrogen receptors in cell nuclei of some cells in the guinea pig brain. With optimization of this technique, we have now been successful in staining estrogen receptor immunoreactivity in processes of many neurons in the guinea pig brain that also contain estrogen receptor-immunoreactive cell nuclei. While reaction product is visible in cell nuclei under a wide variety of conditions, neuronal processes are darkly immunostained only with modifications of the procedure optimized for maximum sensitivity, for example, the multiple-bridge immunocytochemical procedure. Omission of Triton X-100 and/or dimethylsulfoxide, usually used to increase penetration of the antibodies, had no effect on immunostaining in processes or cell nuclei, and immunostaining was apparent in both vibratome-cut and freezing microtome-cut sections. Injection of estradiol, but not progesterone, caused the total loss of cytoplasmic estrogen receptor immunostaining, consistent with the idea that the cytoplasmic immunostaining, like the cell nuclear immunostaining is due to the presence of estrogen receptors. In all neuroanatomical regions containing estrogen receptor immunoreactive cell nuclei, associated processes of some, but not all cells were also immunostained. However, in certain areas, such as the midbrain central gray and the preoptic area, cytoplasmic staining was particularly dark. The cellular characteristics that result in immunostaining in some estrogen receptor immunoreactive cells, and not in others is under investigation. PMID- 2776039 TI - Full circle or forward. AB - In the early 70s when a parent with abuse problems named Jolly K. sought help to stop her abusive behavior, there were no services for parents. Today, nearly two decades later, there has not been much improvement with regard to the provision of services for parents. Our belief is that the dichotomy which occurred early in the field's development between those who were for the child, and those (such as Parents Anonymous) who sought to provide services to parents and were presumed to be for the parent and implicitly against the child is largely responsible for an ever more punitive approach to the problem. The solution lies in shifting our focus away from the exclusive mandate to protect the child towards support for the family unit. Such a shift should include expanding the knowledge base of the field by the inclusion of information from fields such as alcoholism, spouse abuse, and eating disorders, as well as by advocating for services which support the family. Research into the part that neuro-chemistry plays in violence should also be undertaken. The impetus for change within the field cannot come from the child protective services (CPS) system, which, as a creature of the law, can only be reactive, not pro-active. Professionals working outside the CPS system must take responsibility for change if it is to occur. PMID- 2776040 TI - The relationship between sexual abuse and substance abuse among psychiatrically hospitalized adolescents. AB - A comparative study using matched samples was conducted to investigate the relationship between sexual abuse and substance abuse. The sample included 48 adolescent psychiatric inpatients who had been sexually abused (abuse group) and 48 psychiatric inpatients without a known history of such abuse (control group) matched by age, race, sex, and primary psychiatric diagnosis. Statistically significant differences emerged between the groups in several areas. Abuse group subjects indicated more regular use of cocaine and stimulants, greater frequencies of alcohol and drug use, and more reported drunkenness and times high on drugs than their control counterparts. Explanations of the association between substance abuse and sexual victimization are explored. Discussion suggests the possibility of earlier coping strategies being related to later chemical use patterns. Implications for service delivery are offered. PMID- 2776041 TI - Self-esteem in abused chemically dependent adolescents. AB - In a random sample of 500 admissions to a residential treatment center for chemically dependent adolescents. 150 cases of physical and sexual abuse had been identified. These adolescents were matched for age, race, and socioeconomic status, with two comparison groups: a group of nonabused chemically dependent adolescents and a group of nonabused, nonchemically dependent adolescents. Self esteem was measured, utilizing the Tennessee Self-Concept Scale (TSCS), which was administered to all subjects. The abused, chemically dependent adolescents were found to demonstrate significantly lower self-esteem on all subscales when analyzed against these two comparison groups. There were negligible differences within the abused group when the TSCS scores were analyzed according to type of abuse. Aggressive/physically abused adolescents scored higher on the Physical Self subscale and the incest group scored significantly lower on the Identity subscales. These results suggest that abuse is equally devastating, regardless of the type of abuse, e.g., physical, sexual, incest, and has a long-lasting impact on self-esteem. PMID- 2776042 TI - The relationship of child protection worker attitudes to attrition from the field. AB - Child protection workers in 33 states and the District of Columbia participated in a survey conducted by the C. Henry Kempe National Center for the Prevention and Treatment of Child Abuse and Neglect to determine the attitudes and attributes of workers who terminate their careers in child protection. A year after the survey, telephone follow-up was done to identify respondents to the survey who had left the child protection field. Attributes and attitudes were then linked directly to whether workers had terminated or continued child protective service. Just 8.0% (15 of 187) of the workers had left the field. There were few differences between workers that departed and those whose services were retained. Both were generally dissatisfied with their profession at the time of the survey. The shrinking social service labor market and worker investment in the field are discussed as factors impeding turnover among child protection workers. PMID- 2776043 TI - An experimental study of gender and situation in the perception and reportage of child abuse. AB - This study examined the effects of gender, situation, and characteristics of witnesses in the perception and reportage of child abuse. Three scenarios representing themes of neglect, psychological, and physical abuse were evaluated by 144 nonprofessionals not mandated by law to report child abuse. The variables of gender and age of the child, gender of parent, and whether or not the abuse was precipitated by an act of the child were systematically manipulated to produce a 2 X 2 X 2 X 2 X 3 randomized design. Some demographic data on subjects were treated as covariates. Multivariate analysis of variance (MANOVA) was performed on the data. No gender bias in subject's evaluations of victim or perpetrator was discovered. Female subjects viewed the scenarios more critically than did males. Younger subjects were less critical of mistreatment than were older subjects. Perception of the mistreatment as serious was not a good predictor of subsequent official reporting. The scenario involving physical abuse was rated as serious by 86.1% of the subjects, but only 39.5% of these subjects indicated that they would have reported it. Subjects indicated the highest rate of reporting for the neglect scenario which they rated as less serious than physical abuse. These results suggest that official reports are unreliable as an indicator of the incidence of abuse. PMID- 2776045 TI - A group for sexually abused young children: unravelling the web. AB - This paper describes clinical material from a group for young sexually abused children. The group work combines both an educational and dynamic approach drawn from previous models. The group was clearly structured and ran over nine weeks in conjunction with a parallel caregivers' group who were informed each week of the main themes. The caregivers were also involved in evaluating the effectiveness of the therapy by completing questionnaires which recorded symptomatology. A statistical analysis based on the questionnaires showed a significant reduction in problems reported by the caregivers before and after the group therapy. The authors recommend that such therapeutic work be combined with formal evaluation in the future to assess the effectiveness of different approaches with a view to clarifying which aspects are responsible for promoting positive change. PMID- 2776044 TI - Characteristics of child sexual abuse treatment programs. AB - Within the professional community, a vast number of sexual abuse treatment programs have emerged to meet the needs of victims and their families. Significant variations among these programs can be observed due to differences in philosophy, system context, client focus, problem definition, and the treatment strategy adopted. Unfortunately, little comparative information is available regarding the operation of different programs and, more importantly, their relative treatment effectiveness. This article presents the findings from a nationwide survey of 553 sexual abuse treatment programs. The survey focused on program context, client, and service characteristics. Overall it was found that most programs are affiliated with a larger public or private agency, focus on treating victims, and rely on a combination of individual, family, dyad, and group therapy approaches. PMID- 2776046 TI - The ecological model and the study of child abuse in Nigeria. AB - Physical abuse and exploitative child labor are two common forms of child abuse in Nigeria. Exploitative child labor exists in both the formal and informal sectors where children work as hairdressers, beggars' assistants, hawkers, and as factory and agricultural workers under conditions characterized by long hours, hazardous environment, and meager remuneration. Research on the incidence of physical abuse in Nigeria is less systematic, and few empirical studies are available. Physical abuse is primarily the result of corporal punishment which has become excessive. Poverty and the existence of a dependent capitalist economy are often proffered as the primary causes of child abuse. While both explanations have some validity, their unidimensional nature limits their explanatory capacity. These explanations also lead to the belief that very little can be done to improve the quality of children's lives until the social order is restructured. The ecological model proposes that child abuse can best be understood if it is analyzed multidimensionally with emphasis on the individual, family, social environment, and cultural milieau, as well as the dynamic interaction between these levels. This model appears appropriate for the study of child abuse in Nigeria, and its application is advocated as a vehicle for improving the quality of child abuse research. PMID- 2776047 TI - Use and abuse of corporal punishment: a Caribbean view. AB - A sample of 499 Barbadian adults, aged 20 to 59 years, completed written questionnaires to indicate whether they generally approved or disapproved of corporal punishment in child rearing, the perceived advantages and disadvantages of such punishment, the methods and circumstances thought most appropriate for use, and those most inappropriate or ill-advised. Approximately 70% of respondents "generally approved" of corporal punishment, and three-quarters of the remainder considered it occasionally appropriate. There was evidence of considerable consensus as to what constitutes legitimate use of physical punishment and what is unsuitable and/or abusive, although certain differences in the responses of older and younger adults highlighted specific diversities of concern and shifts of attitude over time. The majority considered serious disadvantages to arise only if parents resorted to punishment in an unsystematic, excessive, or self-serving manner, although a small minority thought corporal punishment more generally undesirable or unproductive within the context of contemporary Barbadian society. PMID- 2776049 TI - Incest survivors: the relation of their perceptions of their parents and their own parenting attitudes. AB - The present study examined the child-rearing attitudes of incest and nonincest child sexual abuse survivors and their perceptions of their own parents' behavior. From a sample of women with a history of child sexual abuse, 40 women with children completed questionnaires designed to assess their own and their parents' child-rearing behavior in terms of the dimensions of parental acceptance and control. The data indicated that women from incestuous backgrounds had more negative perceptions of their fathers and mothers in terms of acceptance and control than women abused by men who were not related to them. Moreover, incest victims who perceived their mothers negatively endorsed autonomy promotion in their own attitudes toward child rearing. The findings are discussed in terms of (1) the lack of positive parenting models when relations with both parents are experienced as negative, (2) incest survivors' conflicts about their own early maturity, and (3) the relation of these findings to the tendency for intergenerational repetition of father-daughter incest. PMID- 2776048 TI - Post-traumatic stress in sexually abused, physically abused, and nonabused children. AB - This investigation compared the rates of post-traumatic stress disorder symptoms across sexually abused, physically abused, and nonabused psychiatrically hospitalized children matched for age, sex, and socioeconomic status. Among the sexually abused children, 20.7% met diagnostic criteria for post-traumatic stress disorder compared with 6.9% of the physically abused and 10.3% of the nonabused children. Although these overall rates were not significantly different across groups, they were significantly high to reinforce the need for further study of post-traumatic stress in childhood. Further, significant symptom rate differences across groups were found with respect to specific post-traumatic stress symptoms. Specifically, sexually abused children exhibited significantly higher rates of inappropriate sexual behaviors than either the physically abused or nonabused children. In addition, both the sexually abused and physically abused groups showed a tendency to exhibit more avoidant/dissociative symptoms as compared to the nonabused children. Results are discussed in terms of their clinical and research implications. PMID- 2776050 TI - Physical and sexual abuse in runaway youths. AB - This paper examines the extent of physical and sexual abuse among runaway youths and the association of that abuse with behavior, mental health, life events, and parental mental health. Of 291 youths who sought shelter at homes for runaway youths, almost half (141) reported a history of physical or sexual abuse. The results emphasize the need that these abused youths and their parents have for mental health services: One in five of the nonabused youths and one in three of the abused youths endorsed parental descriptions reflective of antisocial personality and/or drug problems, and runaways who were abused had a mean level of behavior problems in the clinically significant area. Multivariate analyses demonstrate that the simple existence of physical or sexual abuse impacts on self esteem and overall behavior problems regardless of other family problems. PMID- 2776052 TI - [Experiences with 184 cases of chronic hemodialysis]. AB - From 14 years' experience of 184 cases of chronic hemodialysis for ESRD, we confirmed that dialysis should begin when Ccr is 5-10 ml/min, and in individualized treatment with dialysis, prevention and treatment of renal osteodystrophy is important in patients undergoing maintenance hemodialysis. Suitable dialysis and rational nutrition can improve renal anemia. Complications decreased significantly in the recent 4-5 years, and 1-year, 5-year and 10-year survival rates were 90.9%, 77.8% and 58.8% respectively. PMID- 2776051 TI - The use of consumer injury registry data to evaluate physical abuse. PMID- 2776053 TI - [Clinical analysis of bone diseases in patients under chronic hemopurification]. AB - In this article are summed up the x-ray changes of bones, laboratory data and clinical manifestations of 62 patients treated by hemodialysis (HD), hemofiltration (HF) and HD plus HF alternately from 1978 to 1987. RESULTS: The incidence of bone disease reached 79% without significant difference between the three groups. The values of serum calcium, phosphate, alkaline phosphatase and carbon dioxide combining power (CO2CP) in these three groups were obviously abnormal. Three cases of bone necropsy showed aluminium deposits in bone tissues. We insist that to prevent the occurrence and worsening of bone disease during chronic hemopurification, reverse osmosis water should be used to prepare dialysates and substitution fluids. It is not advisable to use aluminum containing phosphate binder. The use of active VitD3 in the early stage, modulation of calcium content in dialysates, control of the intake of phosphates from foods, and giving desferrioxamine intravenously when necessary are helpful. PMID- 2776054 TI - [Hemodialysis of uremic patients with a high risk of bleeding]. AB - Sixty-three hemodialyses (HD) in 12 uremic patients with a high risk of bleeding were performed successfully. Sixty HD in 9 cases were done with low dose heparinization. An activated whole blood coagulation time (ACT) between 150 and 180 seconds was maintained during HD. Of these 60 HD, 54 were done in 5 patients with pericarditis, 4 were done in 2 patients with serious gastrointestinal (GI) bleeding and 2 were done in 2 patients with postoperative fresh wounds. Heparin free dialysis was done once in each of 3 patients. Both blood tubing and hemodialyzer were flushed with physiologic saline periodically in one patient with normal ACT, who was a patient with postoperative fresh wound. But these were not flushed in two patients with remarkably prolonged ACT. Of these patients, the first one was with postoperative fresh wound and the second was with serious bleeding in the GI tract. Our experience shows that low dose heparinization or heparin-free dialysis are suitable for uremic patients with high risk of bleeding. PMID- 2776055 TI - [Pituitary changes under CT scan before and after replacement therapy in patients with primary hypothyroidism]. AB - Pituitary enlargement was detected on CT scanning in 10 of 17 patients with primary hypothyroidism before thyroid hormone replacement therapy. The serum prolactin levels were slightly elevated in patients with pituitary enlargement. After replacement therapy with thyroid tablet, the enlarged pituitary glands were returned to normal in 6 patients when they were in euthyroid, while another patient's pituitary was still enlarged for inadequate dose of thyroid tablet. In conclusion, pituitary enlargement was frequently seen in patients with primary hypothyroidism and can be restored to normal after effective treatment with thyroid hormones. PMID- 2776056 TI - [Experimental observations on acrylic bone cement containing antitumor drugs]. AB - By methods of human osteosarcoma cell culture in vitro, 3H-TdR isotope incorporation, gas chromatography and animal test, experimental observations were made on acrylic bone cement containing antitumor drugs. The results were as follows: 1. BLMA5, DACT, Ara-c, CDDP, and ADM were more thermostable. It is possible that these drugs can endure the polymerizing heat of bone cement. 2. The effective release of BLMA5, Ara-c and DACT from bone cement persisted over 2 months. 3. Scanning electron microscopy revealed that drug particles in the bone cement decreased or disappeared after immersion of the cement in tissue culture medium or implantation of it in animal bones. This shows that drug particles can be released from bone cement in vitro or in vivo 4. Animal experimental demonstrated that the bone cement containing BLMA5 or Ara-c had no effect on the healing of soft tissue, and the injury in local bone and bone marrow adjacent to the bone cement was slight and could recover in 4-8 weeks. 5. The release of residual monomer from polymerized bone cement continued as long as one month. Although the residual monomer inhibited the growth of tumor cells slightly during the early stage, it was far from being as effective as medicated bone cement. PMID- 2776057 TI - [Diagnostic value of serum alpha-L-fucosidase in primary hepatic carcinoma]. PMID- 2776058 TI - [Studies on the rapid induction of general anesthesia]. PMID- 2776059 TI - [Study on gastric mucosal blood flow in rats with experimental gastric ulcer]. PMID- 2776061 TI - [Effects of furazolidone on brain monoamines in the treatment of peptic ulcer]. AB - The purpose of this study was to investigate the protective role of furazolidone against the formation of duodenal ulcer induced by cysteamine and the effect of furazolidone on NE, DA and 5-HT concentrations in various brain regions (telencephalon, diencephalon and brainstem). The results indicated that one dose of cysteamine (280 mg/kg) produced 90-92% ulceration with no mortality within the first 24 hours, whereas cysteamine plus furazolidone significantly decreased the duodenal ulceration from 90% to 0. Using a sensitive spectrofluorimetric method, we found that cysteamine markedly diminished the NE levels in all regions but the DA level only in telencephalon. Meanwhile, cysteamine plus furazolidone increased the DA level in the same region. This suggested that the protective role of furazolidone against the formation of duodenal ulcer induced by cysteamine in rat may be related to increased DA level in telencephalon. PMID- 2776060 TI - [Localization of ricinus agglutinin receptors in tumor cells in malignant histiocytosis]. PMID- 2776062 TI - [Changes of mucosal blood flow in the healing process of peptic ulcer]. AB - Changes of gastroduodenal mucosal blood flow (GDMBF) in the healing process of 79 cases of gastric ulcer and 118 cases of duodenal ulcer were investigated by Laser Doppler Flowmetry during endoscopy. 108 cases with no gastroduodenal lesions were used as controls. In the controls, the mucosal blood flow was greater at the corpus than at the antrum and the angle, and it was smaller at the lesser curvature than at the greater curvature. The mucosal blood flow at the antrum and the angle of the lesser curvature was the smallest. The mucosal blood flow at the anterior wall of the duodenal bulbus was lower than at the lesser curvature and the posterior wall. In patients with active gastric ulcer, GMBF were decreased significantly. The mucosal blood flow at the ulcer center and ulcer margin was lower in the active stage and it was increased markedly in the healing stage, while no marked change was observed in peripheral mucosal blood flow during the different stages. PMID- 2776063 TI - [Observations on the activity and immunologic properties of CuZn-SOD of whole blood in cancer patients]. PMID- 2776064 TI - [Metabolic characteristics of polymeric IgA in the human body]. PMID- 2776065 TI - Overcoming cultural barriers. PMID- 2776066 TI - [A clinical analysis of esophageal achalasia]. AB - Thirty-one cases of esophageal achalasia were admitted to Chang Gung Memorial Hospital between 1981 and 1986. Eighteen male patients and 13 female patients, aged from 12 to 84 years old with an average of 39 years old, were included in this series. Their chief complaints were dysphagia (83.9%), postprandial vomiting (12.9%), and food regurgitation (3.2%). The symptoms are present for an average of 2.8 years (mostly between 0.5 and 2 years) before the diagnosis is made. The clinical signs and symptoms included dysphagia, postprandial vomiting, loss of body weight, food regurgitation, abdominal fullness, cough, chest pain, belching, and choking. The tentative diagnoses at admission were achalasia, esophageal stricture R/O achalasia, achalasia R/O esophageal cancer, and esophageal cancer. Laboratory examinations showed 90.3% with absence of the gastric air shadow in chest P-A view X-ray film. Typical birds-beat deformity in barium-meal esophagogram was seen in 100%, and during esophagoscopic examination, 25% (6/24) were without abnormal findings, 66.7% (16/24) had liquid and food stasis, 8.3% (2/24) had esophagitis. Manometry of esophagus was performed in 5 cases, all had positive abnormal patterns detected, such as aperistalsis of esophageal body and incomplete relaxation of lower esophageal sphincter, but only 60% showed hypertensive lower esophageal sphincter. In these 31 cases, 3 cases refused any treatment, 9 cases received medical therapy including drug therapy(9) and pneumatic esophageal dilatation(8), and 19 cases received surgical operations. Better swallowing improvement was obtained in the surgically treated group than in the medically treated patients during follow up period. PMID- 2776067 TI - [Incidental myomectomy in cesarean section]. AB - In the retrospective study, from January 1984 to December 1987, incidental myomectomy was performed on 47 patients who received cesarean section. The control group consisted of 80 random samples who received cesarean section during the same period. The general information in both groups was similar. Postoperative infection rate was similar in both groups. Myomectomy added 11 minutes to the operation time, 112 milliliter to the operation blood loss and extended the hospital stay about one and a half day. Recovery of gastrointestinal tract function was one hour later in myomectomy group. There were no wound infection or serious morbidity in both groups. In order to estimate the value of incidental myomectomy in cesarean section, a further study of long term change of the myoma should be considered. PMID- 2776068 TI - Femoral shaft fracture treated with Hoffmann external skeletal fixator in young teens. AB - External skeletal fixation has been proved to be an effective method in treating complex femoral shaft fracture in adult patients with multiple trauma, extensive soft tissue injury or vascular injury which need reconstructive procedures. This method has the advantages of less extensive surgical exposure, easy wound access, and early ambulation. Twenty-two cases of femoral shaft fracture, between the ages of 10 and 15, were treated with the Hoffmann external skeletal fixator in Chang Gung Memorial Hospital from 1981 to 1985. The average time for union and removal of fixator was 72 +/- 8 days (from 44 to 150 days). The average leg length discrepancy was 0.6 +/- 0.3 cm. There was no deep wound infection, nonunion, rotationary deformity in closed fracture. All patients regained their range of motion of knee within 3 months after removal of the Hoffmann apparatus. The advantages of simple technique, less extensive surgical exposure, early ambulation, easy nursing care, patient comfort and no significant complications make it a good alternative method for treatment of femoral shaft fracture in young teens. PMID- 2776069 TI - Acute femoral neck fracture in children--preliminary report. AB - Nineteen children, aged 3-15 years, with acute femoral neck fracture were treated. The follow-up period ranged from 2 years to 6 years, 9 months (avg. 54.8 +/- 14.5 months). The clinical and radiological assessments were carried out according to the assessment system of Ratliff. Undisplaced fractures and all intertrochanteric fractures were treated conservatively and displaced ones by reduction and multiple pinning. The outcomes reveal 14 (79%) with good results, 2 (10.5%), fair and 3 (15.8%), poor. Four hips (21%) developed avascular necrosis with 2 requiring secondary surgical procedures. Both of them also had leg length discrepancy. Another 3 hips (15.8%) developed coxa vara, one of them had mild leg length discrepancy. PMID- 2776070 TI - Pediatric burns--2 year survey of cases admitted to the Chang Gung Memorial Hospital. AB - A total of 722 patients were admitted to the Burn Unit of Chang Gung Memorial Hospital over a 2-year period, of these 285 (39.5%) were under 15 years of age. The major cause of pediatric burns was scalding, 236 (82.8%). Most of the patients under age of 15 years had total burn surface under 20% (199 patients, 70%), and were discharged from the hospital within one month (263 patients, 91%). Treatments included debridement done in 98 patients (41.5%) and skin grafting in 81 patients (28%). Oxacillin-Resistant Staphylococcus Aureus infections were the most common complication (5.3%). The mortality rate was 5.3%. PMID- 2776071 TI - Non-traumatic perforation of colon and rectum. AB - Free perforation of the colon and rectum is an acute surgical condition. Possible factors affecting the prognosis include age, sex, underlying disease, surgical procedures, duration from onset to surgical treatment, general condition before surgery and degree of contamination. A series of 50 cases with acute, nontraumatic perforation of the colon and rectum treated at Chang Gung Memorial Hospital from 1979 to 1986 were reviewed and studied retrospectively according to these prognostic factors. The mortality rate was highest in the group with colo rectal cancer (45%). The mortality rate was 50% in the group who underwent primary closure with proximal diversion and 40% in the group who underwent resection without anastomosis. The mortality may not be related to the surgical procedure: the selection of the procedure was based on the seriousness of the illness. The mortality rate was 87% in patients with septic shock, 62% when treatment was delayed for more than 72 hours, 72% with severe contamination and 56% with poor nutritional status. Age, sex and underlying diseases were not significant contributing factors. PMID- 2776072 TI - Cystic meningioma--a case report. AB - A case of cystic meningioma is presented. The cyst in this particular case is within the tumor. Preoperatively, the diagnosis has been confused with astrocytoma, hemangioblastoma and neuroblastoma. Retrospectively, we conclude that careful evaluation of CT scan and angiogram will lead to accurate diagnosis. PMID- 2776073 TI - [Giant cell reparative granuloma in temporal bone--report of a case]. AB - Giant cell reparative granuloma has been described mainly involving the mandible and is very uncommon in the temporal bone. It is not a true neoplasm, but actually represents a local reparative reaction to hemorrhage, usually following trauma. The treatment of choice is surgical curettage of the lesion. The prognosis is usually good. Radiation therapy with small dose may be considered if the lesion is not amenable to surgical approach. This paper describe a giant cell reparative Granuloma which occurred in the temporal bone of a 41 year-old man. The patient accepted surgical treatment in 1983 but the granuloma subsequently recurred in 1986. The radiation therapy was then given approximately 5000 rads. No sign of recurrence has been found up to the time of this writing. PMID- 2776074 TI - Intestinal motility during acute Yersinia enterocolitica enteritis in rabbits. AB - To determine if Yersinia enterocolitica (YE) enteritis is associated with an alteration of intestinal myoelectric and motor activity, and with an increased rate of aboral transit, New Zealand white rabbits (500-900 g) were surgically prepared with ileal bipolar electrodes and a manometry catheter adjacent to the distal electrode. One week later animals were inoculated with 10(10) organisms of YE in 10 mL NaHCO3 (infected group) or 10 mL NaHCO3 (sham-infected pair-fed and control groups). Daily food intake, weight gain, YE excretion, and stool pattern were noted. Intestinal myoelectric and motor activity over a 6- to 8-h period before and 3, 6, and 14 days after inoculation was compared in infected (I), pair fed (PF), and control (C) groups. Intestinal transit was evaluated in I and C animals on days 3 and 6 after inoculation by measuring the distribution in the intestinal lumen of 51Cr 20 min after it was instilled directly into the jejunum. Infected animals exhibited diarrhea, fecal excretion of YE, and significantly decreased food intake, weight gain, and survival (11.4 +/- 0.6 days). Infection was associated with a significant (p less than 0.05) decrease in both the cycle period of the migrating myoelectric complex (MMC) and the total number of single, paired, and (or) clustered contractions per MMC, and a significant (p less than 0.001) increase in duration of phase III of the MMC. There was no change in intestinal slow wave frequency (19 cycles/min), motility index per MMC, or the percentage of contractions that propagated in an orad (7%) or aboral (69%) direction or that appeared stationary (25%).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2776075 TI - pH shifts evoked by neuronal stimulation in slices of rat hippocampus. AB - Extracellular pH was measured with ion-selective microelectrodes in 500-microns thick slices of the CA1 region of the rat hippocampus. The center of the slice was 0.24 pH units more acidic than the surface, thus creating a decreasing pH gradient from the surface to the center, most likely owing to increased anaerobic metabolism. Stimulation at various frequencies created a transient alkaline shift of 0.03 pH unit, followed by a sustained acidification (0.05 pH unit above baseline). The same pattern was seen in both cell body and dendritic layers. The presence of the alkaline shift in slices in vitro is especially significant, implying that it is not due to alterations in blood flow. The HCO3- -Cl- transport inhibitor SITS and the carbonic anhydrase inhibitor acetazolamide increased the alkaline shift to 0.06 and 0.23, respectively. The acid shift was influenced by the Na+-H+ transport inhibitor amiloride, with a reduction of about 50%. Possible mechanisms for these stimulus-evoked changes as discussed. The most likely cause for the alkaline shift is bicarbonate accumulation in the extracellular space. Hydrogen ion and lactic acid release are seen as the major factors contributing to the sustained acid shift. PMID- 2776076 TI - The interaction between carbamazepine and erythromycin. AB - Erythromycin has been reported to interact with the anticonvulsant, carbamazepine, in both children and adults. Toxic serum levels of carbamazepine are observed within 24 h of antibiotic administration, suggesting a mechanism not previously described for other erythromycin-based drug interactions. In rats erythromycin significantly depressed the elimination of carbamazepine in animals induced with carbamazepine for 4 days but had no effect on carbamazepine elimination in noninduced animals. Although the in vitro metabolism of carbamazepine to its epoxide by hepatic microsomes prepared from noninduced rats was significantly inhibited by erythromycin, the inhibition of carbamazepine epoxidation was greatly enhanced in carbamazepine-induced rats. In the pig the sensitivity of carbamazepine metabolism to erythromycin was much greater than in the rat, indicating the existence of a large species difference in this particular drug interaction. It is concluded that the interaction between erythromycin and carbamazepine is caused by a direct inhibition of carbamazepine oxidation by the antibiotic. PMID- 2776077 TI - A fetal-instrumented model to study age-specific responses to leukotriene D4 and prostaglandin D2 in unsedated newborn lambs. AB - Sequential studies of the pulmonary vascular response to leukotriene D4 (LTD4) and prostaglandin D2 (PGD2) in the immediate newborn period were performed in lambs, instrumented in utero and delivered vaginally. Compounds were tested in fully conscious 1.5-day-old lambs and the study was repeated 1 week later. Bolus injections of PGD2 (0.05-2.0 micrograms/kg) or LTD4 (0.01-1.0 micrograms/kg) were made into the main pulmonary artery or aorta while pulmonary blood flow and aortic, pulmonary artery, and left and right atrial pressures were monitored continuously. PGD2 was a systemic constrictor regardless of age. In lambs 1.5 days of age, it decreased pulmonary vascular pressure and resistance by 6% (p less than 0.05) and 15% (p less than 0.05), respectively, while 1 week later it increased pulmonary vascular resistance by 18% (p less than 0.05). In contrast, LTD4 was a pulmonary and systemic vasoconstrictor in both the early and late newborn, the threshold dose being between 0.01 and 0.05 micrograms/kg at either age. The decrease in pulmonary blood flow and the increase in pressure and resistance were greater in older animals. In lambs 1.5 days of age, LTD4 (1 micrograms/kg) increased pulmonary vascular resistance by 66.1% (p less than 0.05) and 1 week later by 210% (p less than 0.001). These sequential observations in the same animal indicate that unlike PGD2, LTD4 is a pulmonary vasoconstrictor regardless of age, and its effectiveness increases significantly with age. These results support previous reports that PGD2 action in the pulmonary circulation changes shortly after birth from dilation to constriction. PMID- 2776078 TI - No effect of chronic ethanol administration on the activity of alcohol dehydrogenase and aldehyde dehydrogenases in the near-term pregnant guinea pig. AB - The objective of this study was to determine the effect of chronic maternal administration of moderate-dose ethanol on alcohol dehydrogenase, low Km aldehyde dehydrogenase, and high Km aldehyde dehydrogenase activities in the guinea pig at near-term pregnancy. The activity of each enzyme in the maternal liver, fetal liver, and placenta of the guinea pig at 59 days of gestation (term, 66 days) was determined spectrophotometrically following chronic daily oral administration of two doses of 1 g ethanol/kg maternal body weight or isocaloric sucrose solution. There was no experimental evidence of ethanol-induced malnutrition in the mother or growth retardation in the fetus. There was a statistically significant increase (65%) in the microsomal cytochrome P-450 content of the maternal liver for the ethanol treatment compared with the sucrose treatment. The alcohol dehydrogenase, low Km aldehyde dehydrogenase, and high Km aldehyde dehydrogenase activities in the maternal liver, fetal liver, and placenta were not statistically different for the ethanol-treated compared with the sucrose-treated animals. This also was the case for the maternal blood and fetal blood ethanol and acetaldehyde concentrations, determined at 2h after maternal administration of 1 g ethanol/kg maternal body weight. These data demonstrate that the ethanol- and acetaldehyde-oxidizing enzyme activities in the maternal-placental-fetal unit of the guinea pig at near-term pregnancy were not changed by chronic administration of moderate-dose ethanol. PMID- 2776079 TI - The effects of fluorocitrate on renal glutamine, lactate, alanine, and oxygen metabolism in the dog. AB - Acid-base status is considered the major factor controlling renal NH4+ production from glutamine, with maximal values found in chronic acidosis. However, metabolic inhibitors have been shown to increase NH4+ production without acid-base change; the mechanism for this increase is unclear. Fluorocitrate was administered to dogs with chronic metabolic alkalosis. Following fluorocitrate total renal NH4+ production rose from 32 +/- 5 to 104 +/- 15 mumol/(min.100 mL glomerular filtration rate (GFR] (p less than 0.01) and glutamine extraction rose from 26 +/ 8 to 65 +/- 8 mumol/(min.100 mL GFR) (p less than 0.01). These values approximate maximal values found in chronic acidosis. Lactate utilization fell from 165 +/- 19 to 99 +/- 7 mumol/(min.100 mL GFR) following fluorocitrate (p less than 0.01). Citrate extraction fell to zero and alanine production rose from 27 +/- 4 to 46 +/- 7 mumol/(min.100 mL GFR) (p less than 0.01). Oxygen consumption remained unchanged following fluorocitrate, 584 +/- 29 vs. 549 +/- 29 mumol/(min.100 mL GFR). These results demonstrate that in the presence of metabolic inhibition in the kidney, ATP production remains constant. This is achieved by increased utilization of one substrate, glutamine, when the ATP production from other substrates is reduced. Thus the necessity to maintain constant ATP production appears to modulate renal NH4+ production. PMID- 2776080 TI - Inhibition of carbonic anhydrases in type I muscle fibers influences contractility. AB - We tested the effects of inhibiting the carbonic anhydrase activity of rat soleus and extensor digitorum longus muscles on the isometric contractile properties and the resistance to fatigue. SOL and EDL muscles from female rats were incubated in vitro in the presence of methazolamide, a specific inhibitor of carbonic anhydrase, before determining their contractile properties. Methazolamide had no effects on the contractile properties of the soleus muscle (10(-5) or 10(-3) M) and extensor digitorum longus (10(-3) M), except for the half-relaxation time of the soleus muscle which increased significantly. Values for half-relaxation time were significantly increased with both concentrations of the inhibitor. Muscles were then submitted to a fatigue protocol lasting 30 min. During the fatigue test, no significant difference was observed between control and 10(-5) M methazolamide soleus muscles. In presence of 10(-3) M methazolamide however, the soleus muscle showed a significantly increased resistance to fatigue compared with control preparations. No significant effect was observed with the extensor digitorum longus muscle exposed to 10(-3) M methazolamide. Results are discussed in terms of the presence of two different isoforms of carbonic anhydrase that may be associated with calcium uptake and energy metabolic processes, respectively. PMID- 2776082 TI - Cancer caused by radioactive gold rings. PMID- 2776081 TI - Effect of chronic dietary treatment with L-tryptophan on the maintenance of hypertension in spontaneously hypertensive rats. AB - Chronic dietary administration of L-tryptophan at 2.5 and 5.0% by weight reduced the elevated systolic blood pressure of spontaneously hypertensive (SH) rats. Blood pressure was reduced significantly by 3 weeks after initiation of treatment and continued to fall during the course of the 15 weeks of treatment. Body weights of the treated rats were not affected significantly by treatment, nor were daily food and fluid intakes and urine outputs. SH rats, treated with the higher dose of tryptophan, also significantly reduced their urinary outputs of epinephrine and norepinephrine compared with SH controls, while both doses of tryptophan increased urinary outputs of dopamine significantly above that of SH controls. Treatment with tryptophan increased significantly the specific binding of [125I]angiotensin II (Ang II) to membranes from the diencephalon in a dose dependent manner. Measurement of catecholamine concentration of the supernatant from homogenates used for the Ang II binding assay revealed a significant correlation between the specific binding of Ang II to brain membranes of the two tryptophan-treated groups and the concentration of norepinephrine in the supernatant. There was also a significant correlation between the specific binding of Ang II and the concentration of dopamine in the supernatant of the control group and the group treated with the higher dose of tryptophan. These results show that chronic dietary administration of tryptophan can reduce the elevated blood pressure of SH rats and support the possibility that this neutral amino acid may act via its effect on the concentration of the neurohormones, norepinephrine and dopamine, in the diencephalon to regulate the binding of Ang II to its receptors. PMID- 2776083 TI - Parasitology: diagnostic yield of stool examination. PMID- 2776084 TI - Tobacco addiction. PMID- 2776085 TI - Hyperactivity in children. PMID- 2776086 TI - Waterbeds and dyspepsia? PMID- 2776087 TI - Pacific rim publishing piracy. PMID- 2776088 TI - CMA's investment funds. PMID- 2776089 TI - Familial dysautonomia (Riley-Day syndrome). PMID- 2776091 TI - Confidentiality and HIV seropositivity: report of the Federal/Provincial/Territorial Advisory Committee on AIDS. PMID- 2776090 TI - The diagnosis and treatment of hypertension: does ambulatory pressure monitoring have a role? PMID- 2776092 TI - Using death certificates to estimate the completeness of AIDS case reporting in Ontario in 1985-87. AB - The completeness of AIDS (acquired immune deficiency syndrome) case reporting in Ontario was assessed by reviewing all AIDS death certificates compiled by the Registrar General between Jan. 1, 1985, and Dec. 31, 1987. Several demographic variables were used to match death certificates with cases reported to the provincial AIDS registry. The completeness of case reporting was then estimated by examining the ratio of reported deaths of patients with AIDS to the total number of deaths reviewed. The estimated completeness of case reporting was 81.1% in 1985, 71.5% in 1986 and 75.4% in 1987; the overall rate for 1985-87 was 75.2%. The difference in the completeness of case reporting from year to year was not statistically significant. There was a significant increase from 1985 to 1986 in the proportion of unreported cases in people who had never been married (p less than 0.02). Reporting was not associated with the patient's age, sex, occupation or place of residence. The deficiency in AIDS case reporting could adversely affect the long-term planning of health care resources and the development of programs to prevent and control the spread of AIDS. PMID- 2776093 TI - Bioavailability of iron in oral ferrous sulfate preparations in healthy volunteers. AB - The bioavailability of iron in five ferrous sulfate preparations was studied in 10 healthy male volunteers. The preparations were an oral solution, two types of film-coated tablets and two types of enteric-coated tablets. Blood samples were drawn hourly from 8 am to 6 pm on the day before each study day to assess baseline serum iron concentrations and on the study day. Spectrophotometry was used to measure the serum iron concentrations. The area under the curve (AUC), the maximum concentration and the time to achieve the maximum concentration were compared by analysis of variance. The enteric-coated preparations resulted in AUCs less than 30% of the AUC for the oral solution. The two film-coated products produced AUCs essentially equivalent to that of the oral solution. We conclude that the bioavailability of iron in the enteric-coated preparations was low, relative to that of the film-coated products and the oral solution, and that these products should not be considered interchangeable. PMID- 2776094 TI - Diabetes mellitus in Mohawks of Kahnawake, PQ: a clinical and epidemiologic description. AB - The authors report the rates of obesity, hypertension, hypercholesterolemia, smoking, and macrovascular and microvascular complications among Mohawks of Kahnawake, PQ, who have non-insulin-dependent diabetes mellitus. The data were derived from a study comparing rates of macrovascular and microvascular complications among the diabetic subjects and a nondiabetic group matched for age and sex. The data for both groups were collected by means of chart review, interview and body measurement. There were no important differences between the male and female diabetic subjects. Both sexes had high levels of obesity, hypertension, hypercholesterolemia and diabetic complications. A total of 86% of the diabetic subjects were obese; the rate was also very high (74%) among the nondiabetic subjects. The mean age at onset of diabetes, 59 years, was 10 years higher than that observed in Oneida Iroquois of Ontario. The rates of macrovascular disease among the diabetic subjects were higher than those found among Cree/Ojibwa in Ontario and Manitoba. Our findings add to the knowledge of non-insulin-dependent diabetes in North American Indians in Canada and show that there are differences between our Mohawk subjects and diabetic people of other native communities. PMID- 2776095 TI - Current concepts in trauma: 2. The Sunnybrook Medical Centre trauma program: the first 11 years. AB - Sunnybrook Medical Centre is a tertiary care teaching hospital situated in metropolitan Toronto. Its trauma unit, opened in June 1976, serves the inhabitants of metropolitan Toronto and the surrounding area (approximately 5 million). More than 3200 patients were admitted to the unit between 1976 and 1987. The criteria for admission were age at least 14 years and an Injury Severity Score (ISS) of 16 or greater, two or more significant injuries at anatomically discrete sites when the score on the Abbreviated Injury Scale was 3 or greater, or grade IV shock (systolic blood pressure of 80 mm Hg or less). The number of patients admitted annually to the unit increased over the study period. The survival rate also increased, from 76% in 1976 to 88% in 1987, although the average age and ISS of the patients remained unchanged. Less than 2% of the patients required long-term rehabilitative or chronic care. The patient profile is similar to that seen in other trauma centres in North America. The success of this program is largely the result of expeditious stabilization and transfer from referring hospitals coupled with early definitive surgical intervention. PMID- 2776096 TI - Freedom from restraint: consequences of reducing physical restraints in the management of the elderly. AB - Physical restraint is commonly used in the management of elderly people in North American hospitals and nursing homes. Between December 1981 and March 1982 the Department of Geriatric Medicine, St. Boniface General Hospital, Winnipeg, changed its practice regarding the use of such restraints. In the fiscal year 1980-81 the rate of application of physical restraints was 52 per 1000 patient days and the frequency of falls 7 per 1000 patient-days. By 1986-87 the figures were 0.3 and 8.7 per 1000 patient-days respectively; the increase in falls was not clinically significant. During the study period there was a 40% reduction in the use of chemical restraints (psychotropic drugs other than hypnotic and antidepressant agents). Here we record how this change in practice occurred and persisted. PMID- 2776098 TI - A physician's guide to lipoprotein metabolism. PMID- 2776097 TI - Poor clinical response to enteric-coated iron preparations. PMID- 2776099 TI - Expect a hot abortion debate during the cool days of autumn. PMID- 2776100 TI - Sheshatshit, Labrador: a town without hope. PMID- 2776101 TI - Language MDs use to describe AIDS may affect outlook of patients, public. PMID- 2776102 TI - Telemedicine: the best is yet to come, experts say. PMID- 2776103 TI - Mitoxantrone and high-dose cytarabine as salvage therapy for refractory non Hodgkin's lymphoma. AB - Mitoxantrone (Novantrone, NO) and high-dose cytarabine (Ara-C, AC) have each been shown in monotherapy trials to be active in non-Hodgkin's lymphoma (NHL). In the current study, a combination of the two drugs (NOAC) was administered to 31 patients with advanced NHL refractory to modern sequential chemotherapy regimens. Ara-C was administered at 3 g/m2 as a 3 hour infusion every 12 hours on day 1 (2 doses) and mitoxantrone at 10 mg/m2/day on days 2 and 3. Of the 18 patients with high-grade malignant NHL, six have attained a complete remission (CR) and two, a partial remission (PR). One CR and 5 PRs were achieved among the other 13 patients with intermediate or low-grade NHL. The median time to relapse (TTR) of patients achieving CR was 7 months with a range from 4 to 17 months. Myelosuppression with subsequent infections was the major toxicity of this regimen. The median duration of severe neutropenia (less than 0.5/nl) was 9 days with a range of 0 to 27 days and the median duration of severe thrombocytopenia (less than 20/nl), 5 days with a range of 0 to 35 days. Infectious complications during cytopenia was seen in 45.3% of the courses administered and fever of unidentified origin was seen in 42.3%. About 63% of the patients were hospitalized for intravenous antibiotic or antimycotic treatment. Other side effects were mild and included nausea, stomatitis, and transient tachycardia of greater than 100/min. Thus, this regimen was active in refractory NHL with poor prognosis, and the toxic side effects were not excessive. Evaluation of the activity of this regimen at higher dose levels of Ara-C is warranted. PMID- 2776104 TI - Surgical resection of pulmonary metastases from colorectal cancer. 10-year follow up. AB - Pulmonary resection of metastatic lesions from colorectal cancer was performed in 62 patients, and their cumulative 5-year and 10-year survival rates were 42% and 22%, respectively. The overall median survival was 24 months. The survival curve decrease even after 5 years after pulmonary resection; four of 13 patients who survived more than 5 years subsequently died of metastatic disease and only two patients survived more than 10 years. The number and size of the pulmonary metastases were significantly correlated with postthoracotomy survival. Solitary metastases less than 3.0 cm in diameter were good indicators of favorable postthoracotomy survival. There were no significant differences in survival based on Dukes' classification or location of the primary lesion. Sex, age, disease free interval between the primary tumor and appearance of metastasis, and extent of pulmonary resection had no influence on survival. It is impossible to say from our experience that surgical resection of pulmonary metastases increased the cure rate. Presumably a good 5-year survival rate after thoracotomy would be a reflection of a length bias caused by the biologic behavior of the metastatic pulmonary lesions. PMID- 2776105 TI - Bone metastases in hypernephroma. Frequency of scapular involvement. AB - A consecutive series of 95 patients with hypernephroma was studied retrospectively after it was clinically suspected that there was a propensity for this tumor to metastasize to the scapula. Fifteen patients (15.8%) have developed scapular metastases which account for 36.6% of all bone metastases in this series, the majority of which required radiotherapy for pain relief. The scapula was a solitary site of bone metastasis in the majority of patients, and, even when associated with other bone lesions, was frequently an isolated site of pain. A comparative series of 40 consecutive patients with breast cancer metastatic to bone was retrospectively studied. Twenty-five percent of these showed scapular metastases but these were all in association with multiple (greater than 3) other bone metastases; none was symptomatic or required treatment. There was a suggestion that hypernephromas spread more often to the ipsilateral scapula, but the trend did not reach statistical significance. Scapular metastasis in hypernephroma is a common and clinically significant problem, sometimes giving a clue to the primary site. The cause for this predilection is not known. PMID- 2776106 TI - Tumor thickness and prognosis in clinical stage I malignant melanoma. AB - The current grouping of patients with malignant melanoma into thin, intermediate, and thick melanomas provides a convenient but arbitrary classification which, although providing "average" survival values for each group, offers crude prognostication for the individual patient. A review of 371 patients with clinical Stage I malignant melanoma, treated during the period 1970 to 1985, was conducted. The estimated 5-year survival rate for female patients with melanomas 1.0 mm thick was 94%; for each 1-mm increment in thickness the survival rate declined by about 3%, up to the 6 mm mark, the survival rate declining thereafter by about 8% for each additional millimeter in the range of 7 to 15 mm of thickness. The estimated 5-year survival rate for male patients with melanomas 1.0 mm thick was 80%; for each 1-mm increment the survival rate declined by about 9%, up to the 10 mm mark. The proposed method of estimating the expected survival according to the patient's sex and the thickness of the primary lesion hopefully provides a more accurate and convenient method of prognostication for the clinician dealing with specific patients with intermediate or thick melanomas. PMID- 2776107 TI - Immunoreactivity of granular cell lesions of skin, mucosa, and jaw. AB - Granular cell lesions from many different sites share similar light and electron microscopic features. Immunologically, however, these lesions do not appear to be a homogenous group. This study determines the extent of immunologic heterogeneity of granular cell lesions from a wide variety of sites in skin, mucosa, and jaw. Thirty-one granular cell lesions (26 granular cell tumors [GCT] and five other granular cell lesions) from 18 different sites were evaluated immunohistochemically for keratins, vimentin, desmin, muscle actin, ACT, HLA-DR, and S-100 protein. Paraffin-embedded sections were utilized with an avidin-biotin complex immunoperoxidase technique. Except for ameloblastomas, all lesions were negative for keratin and positive for vimentin. All lesions were negative for desmin and actin. Positive ACT reactivity was found in one of seven GCT of tongue, a colonic lesion, a nose lesion, and a granular cell ameloblastic fibroma. All lesions were positive for HLA-DR except a few in which fixation appeared inadequate. S-100 immunoreactivity was found in all lesions except the congenital epulis, a GCT of the skin of the nose, a colonic lesion, and the odontogenic tumors. The antigenic profile of GCT of skin and mucosa is consistent with Schwann cell origin. However, some GCT and other granular cell lesions appear to be derived from macrophages, epithelial cells, or other cells. The expression of HLA-DR by granular cells is believed to be unrelated to cellular origin but rather to some common immunologic function. PMID- 2776108 TI - Metaplastic carcinomas of the breast. III. Carcinosarcoma. AB - The clinical and pathologic features of 70 examples of carcinosarcoma (CS) of the breast are reported. Thirty-three neoplasms had infiltrating carcinoma, seven had in situ carcinoma, and 28 had both admixed or contiguous with the sarcomatous component. Squamous carcinoma, present in 15 neoplasms, was the exclusive epithelial component of two. The admixed carcinoma often appeared distinct from the sarcoma component; however, at high magnification transitional differentiation zones and more subtle merging of infiltrating carcinoma with sarcoma were present in most neoplasms. A total of 40 neoplasms were studied by immunohistochemistry for keratins, EMA, vimentin, S-100 protein, and actin. The sarcomatous component in 55% of CS was immunoreactive for keratin, and 98% were immunoreactive for vimentin. A majority were also immunoreactive for actin (77%), and S-100 protein (55%). Ultrastructural examination of the sarcoma in eight neoplasms yielded variable nonspecific findings compatible with sarcoma. These findings indicate biphasic differentiation by cells possessing epithelial and mesenchymal characteristics and suggest myoepithelial origin or differentiation. The cumulative 5-year survival rate for CS was 49%, worse than for other forms of metaplastic carcinoma. The respective 5-year survivals for TNM clinical Stages I, II, and III were 100%, 63%, and 35%. Of patients with axillary dissection, 26% had metastases to axillary lymph nodes with carcinoma as the most frequent component to metastasize. Metastasis was an ominous sign as 33 of 34 patients who developed metastases died from tumor. Local recurrence was not as ominous as 40% who had only local recurrence subsequently died from tumor. Size and microscopic circumscription were also significant prognostic factors. PMID- 2776109 TI - Metastatic patterns in histologic variants of ovarian cancer. An autopsy study. AB - The autopsy findings of 428 patients with various histologic types of ovarian cancer were studied to determine if metastatic patterns were different. Epithelial tumors were the most frequent (89%), followed by sarcomas (7.2%). Germ cell and stromal tumors each occurred in 1.9% of cases. Sites of metastasis were nearly identical, with no statistical difference among histologic types. The peritoneum was most frequently involved (83% to 100% of cases), but lymph node metastasis was common (50% to 60% of cases). Metastasis was more common to the paraaortic lymph nodes than to the pelvic lymph nodes. In seven of eight stromal tumors, hepatic metastasis was present but did not cause the patient's death. For epithelial tumors, metastasis to distant sites was dependent on nodal and intraperitoneal disease. However, this was not true in the 31 ovarian sarcomas or the series of germ cell or stromal tumors. This finding supports a hematogenous route of metastasis for ovarian sarcomas. Understanding the metastatic potential of ovarian cancer is important in designing effective treatment regimens. PMID- 2776110 TI - The prognostic value of histologic subtypes in primary extremity liposarcoma. AB - Patients with a localized primary liposarcoma of the extremity who were treated in Memorial Sloan-Kettering Cancer Center between 1968 and 1978 were studied. The prognosis of patients with extremity liposarcoma was analyzed according to histopathologic subtypes. A system of five subtypes was used; well differentiated, myxoid, fibroblastic, lipoblastic, and pleomorphic liposarcomas. The 5-year treatment failure rates and survival rates were, respectively, 30% and 100% for well-differentiated, 25% and 88% for myxoid, 60% and 58% for fibroblastic, 100% and 40% for lipoblastic, and 64% and 56% for pleomorphic liposarcomas. Although local recurrence was present in all five subtypes, a significant increment in local failure was seen in patients with high-grade liposarcomas. Distant metastasis after the initial operation was not found in patients with well-differentiated liposarcoma and rare in the patients with myxoid liposarcoma. In contrast, 50% of the patients with fibroblastic, lipoblastic, and pleomorphic liposarcoma had a distant relapse within 5 years. PMID- 2776111 TI - Benign metastasizing giant cell tumors of bone. A DNA flow cytometric study. AB - Approximately 2% of histologically benign giant cell tumors (BGCT) of bone are complicated by lung metastases, which can progress despite their benign histologic appearance. Almost all BGCT studied by DNA flow cytometry (FCM) have been reported to be diploid. However, the very few cases with lung metastases previously analyzed were all aneuploid. To assess the usefulness of DNA FCM in predicting the metastatic potential of BGCT, seven metastasizing BGCT were studied by DNA FCM using paraffin-embedded tissue. Five were purely diploid, one was tetraploid, and one was aneuploid. The primary and the metastasis showed the same DNA distribution in all but the tetraploid case, in which the metastasis was purely diploid. A single patient, who was in the diploid group, had unresectable tumor in the lungs; she remains alive with stable disease at 30 months. The other six patients, who underwent complete resections of their lung metastases, are free of disease. These results suggest that DNA FCM is not a sensitive method for predicting the metastatic potential of BGCT since most metastasizing cases appear to be diploid. PMID- 2776112 TI - Smokeless tobacco use and oral epithelial dysplasia. AB - One hundred eight patients with a histologically confirmed diagnosis of epithelial dysplasia of the oral cavity and a prior history of smokeless tobacco (ST) usage were identified. The mean age at time of diagnosis for female patients was almost a decade later than for male patients (63.6 versus 51.2 years). In addition, women were more likely (P = 0.02) to have moderate or severe epithelial dysplasia than men. The two most common locations (buccal mucosa/vestibule and alveolar ridge/gingiva) accounted for 82.4% of all cases. In the 44 cases which specified both ST placement and biopsy site, 90.9% demonstrated epithelial dysplasia at the location used by the patient for holding the ST. When evaluating the histologic severity of epithelial dysplasia, a trend (P = 0.02) toward focal mild or mild was noted among ST users as compared to nonusers. No difference was found in the histologic grade of the lesions associated with either snuff or chewing tobacco. PMID- 2776113 TI - Composite carcinoid-adenocarcinoma of the stomach associated with multiple gastric carcinoids and nonantral gastric atrophy. AB - A case of multiple gastric carcinoids and nonantral atrophic gastritis in which the larger tumor was a composite carcinoid-adenocarcinoma is presented. The two components of the composite tumor immunohistochemically showed clear-cut diverging functional differentiations although the available evidence supported a common histogenesis from the metaplastic intestinal epithelium of the gastric mucosa. The carcinoid tissue of the composite tumor, which showed "atypical" features, also differed from the other, pure carcinoids, in which the histologic appearance was "typical." Total gastrectomy performed 1 month after the original gastric resection with antrectomy disclosed regressive changes in the endocrine cell proliferations of the gastric stump consistent with the withdrawal of a stimulating effect of the antral gastrin. PMID- 2776114 TI - Successful in vitro fertilization and embryo transfer after limited surgical treatment for tubal adenocarcinoma. AB - A 29-year-old woman with tubal adenocarcinoma stage IA was treated only with bilateral salpingectomy, pelvic lymphadenectomy, and omentectomy. Two years later the patient successfully underwent in vitro fertilization and embryo transfer, and at 39 weeks gave birth to a healthy son by cesarean section. The result of oncologic follow-up 3 years after surgery is negative. PMID- 2776115 TI - Extraosseous Ewing's sarcoma. A study of 42 cases. AB - Fifty patients at the Mayo Clinic (Rochester, MN) from 1935 to 1985 met the histologic criteria for extraosseous Ewing's sarcoma. Forty-two had soft tissue primaries without bony involvement and formed the basis for this retrospective study of the clinical behavior and management of extraosseous Ewing's sarcoma. There were 19 male and 23 female patients (mean age, 22 years). Metastases were documented in 30 of the patients, six at the time of presentation and 24 occurring up to 11 years later, most commonly to lungs or bone. Three patients were lost to follow-up. Sixteen of 35 patients (46%) had local recurrence. Overall survival was 15 of 39 (38.5%) at 5 years. Decreased survival was noted with pelvic tumors, incomplete resections, and presence of metastatic disease, whereas increased survival was associated with wide surgical resection with negative microscopic margins, adjuvant local radiation therapy, and presentation since 1970 (48% 5-year survival compared with 28% before 1970). PMID- 2776116 TI - Effects of the anticancer agent VM-26 on hexose uptake in Ehrlich cells. AB - The chemotherapeutic agent VM-26 is a membrane-interactive drug which we have previously demonstrated to be a potent inhibitor of nucleoside transport. Since the carriers mediating nucleoside and hexose transport are structurally and functionally similar, we have further characterized the membrane related properties of this agent by examining its effect on the transport and phosphorylation of hexoses in Ehrlich ascites cells. Under conditions in which only the transport component of hexose uptake was measured, VM-26 had no effect on the influx of 2-deoxyglucose, 3-0-methylglucose, or D-glucose. Glucose sensitive cytochalasin B binding was only weakly inhibited by the drug. However, VM-26 was an apparent non-competitive inhibitor of the net uptake of 2 deoxyglucose (transport and phosphorylation). Measurement of hexokinase activity in cell extracts failed to demonstrate any significant effect of VM-26 on enzyme activity. In summary, although VM-26 is a potent inhibitor of the transport of nucleosides, it has no apparent effect on the transmembrane flux of hexoses indicating a differential effect on nucleoside and hexose transporters. The ability of the drug to decrease the net accumulation of hexoses in the absence of any detectable effect on hexokinase activity warrants further investigation. PMID- 2776117 TI - Synthesis and release of glycoconjugates in vitro by human ovarian carcinoma cells isolated from effusions. AB - Human ovarian carcinoma cells were isolated as multicellular aggregates from patient effusions. Freshly isolated cells were incubated with radioactive glycoconjugate precursors and the glycoconjugates released to culture medium were analyzed. The glycoconjugates appeared to contain both O- and N-linked oligosaccharides. Both fucosylation and sialylation of glycoconjugates occurred. The results of SDS-PAGE analysis showed the presence of a very heterogeneous array of glycoconjugates with no discrete components resolved. The results of glycoconjugate analyses were independent of carcinoma histology, differentiation, progression, and patient chemotherapy. In contrast, mesothelial cells synthesized a major glycoconjugate of molecular mass 65 KDa. The heterogeneous array of carcinoma-derived glycoconjugates may be transformation-related and may have utility in tumor diagnosis and prognosis. PMID- 2776118 TI - The respiratory behavior of Lewis carcinoma cells--existence of a cyanide resistant respiration. AB - The respiratory O2 consumption of vegetative, non-necrotic, Lewis lung carcinoma cells was found to be very low compared with that of non-tumor tissues and was highly resistant to cyanide. However, the resistant rate was inhibited by salicylhydroxamic acid (SHAM) in either isolated cells or tissue fragments. In addition, this compound did not affect their cytochrome-c oxidase activity. The results support the existence of an alternative oxidase system that significantly contributes to oxygen uptake in Lewis carcinoma cells. To our knowledge, this is the first report showing significant SHAM-sensitivity of tumor respiration and perhaps of higher animal cell respiration. PMID- 2776119 TI - Molecular weight dependence of hyaluronic acid produced during oncogenic transformation. AB - Cultured chicken embryo fibroblasts synthesize two distinct molecular size classes of hyaluronic acid. The high molecular weight material (form I, 2.98 x 10(6) is the predominant species synthesized by transformed cells, whereas form II (1.42 x 10(5)) is the major product of non-transformed cells. A shift to synthesis of predominantly form I hyaluronic acid is an early transformation event in cells infected with LA24 Rous sarcoma virus and maintained at the permissive temperature for transformation (35 degrees C). Form I hyaluronic acid exhibits greater binding to preparations of cellular fibronectin and to both normal and transformed cells than does form II. Both forms bind more to transformed cells than to normal, uninfected cells. Hyaluronic acid (predominantly form I) isolated from transforming cells stimulates proliferation in growth-retarded, non-transformed cells. PMID- 2776120 TI - Interrelationship between sodium cyanate and pH in the regulation of tumor cell division. AB - Previous studies have suggested that the selective inhibitory effects of sodium cyanate on tumor metabolism in vivo may be related to a lower interstitial pH in tumors. In the present work, the influence of extracellular pH on the actions of sodium cyanate was studied with one rat hepatoma cell line (HTC) and two human colon tumor cell lines (HT29 and LS174T) and with rat hepatocytes to determine if the effects are accompanied by changes in intracellular pH. With some tumor cells, an inhibition of cell proliferation was observed when the cells were exposed to an acidic medium (pH 6.6). However, the LS174T line of human tumor cells divided at pH 6.6 essentially as fast as at pH 7.4. In the concentration range of 0.02-0.1 mg/ml, a greater inhibitory effect of cyanate on cell proliferation was observed at the lower pH. Intracellular pH was found to be influenced by the sodium ion concentration of the medium to a similar degree in the three tumor lines that were examined. The intracellular pH was found to be significantly affected by cyanate in rat hepatocytes and in two of the tumor cell lines (HT29 and LS174T). The data suggested that not only does extracellular pH influence the inhibitory effect of cyanate on tumor cell proliferation but also that cyanate can affect the regulation of intracellular pH in normal and neoplastic cells. PMID- 2776121 TI - Cytogenetic follow-up from direct preparation to advanced in vitro passages of a human malignant glioma. AB - In order to evaluate which cytogenetic evolutionary patterns take place during the in vitro establishment of a permanent glioma cell line, cytogenetic follow-up was performed on direct preparations and primary cultures from a malignant astrocytoma and on serial passages for more than 2 years of in vitro propagation. Sixteen passages were studied, and the presence of a marker chromosome in direct preparations and after in vitro growth permitted us to identify the clonal evolution of the resulting permanent cell line. Near-triploid cells present in the direct study became the main cell population in vitro; chromosomal losses and the acquisition of a few new marker chromosomes were also characteristic features, leading to a stable modal number of around 60 chromosomes in the last passages analyzed. The results provide new evidence of the existence of more than one pattern of chromosomal evolution during the in vitro establishment of human gliomas. PMID- 2776123 TI - Acute nonlymphocytic leukemia with trisomy 4. PMID- 2776122 TI - Chromosomal evolution in the progression and metastasis of human malignant melanoma. A multiple lesion study. AB - In order to distinguish those chromosomal aberrations associated with tumorigenesis from those associated with tumor progression of malignant melanoma, chromosome analysis was performed on eight tumors derived from one patient. Three common marker chromosomes, a deletion of chromosome 1, a deletion of chromosome 9, and a translocation involving chromosomes 7 and 12, were identified in each tumor. The presence of common markers in these intrapatient tumors indicates the monoclonal origin of these tumors. Furthermore, the consistent and specific involvement of chromosome 9 in both interpatient and intrapatient studies suggests the crucial role that chromosome 9 plays during the development of human malignant melanoma. In addition to common markers, different overlapping markers including those involving chromosomes 2, 3, and 6, were also identified, suggesting that chromosomes 2, 3, and 6 are most likely associated with the progression, instead of the genesis, of the tumor. Finally, lesion-specific marker chromosomes were identified in each tumor indicating the nonrandom selection and modification of the metastatic process. The nature of chromosomal evolution among the eight tumors was clearly demonstrated by the retention and amplification of specific marker chromosomes, with the latter tumors containing more overlapping markers than the early tumors and the recurrence of identical markers in the different branches of evolution. One of the last three tumors obtained immediately before the death of the patient contained all the overlapping markers identified in other tumors, which may indicate that a plateau of chromosomal evolution of these tumors has been reached. These observations demonstrate a nonrandom or programmed chromosome evolution of human neoplasia that could be intrinsic to the aneuploid nature of neoplasia. PMID- 2776124 TI - The Third International Workshop on Chromosomes in Solid Tumors (IWCST). Tucson, Arizona, February 26-28, 1989. Abstracts. PMID- 2776125 TI - Separation of fucosylated oligosaccharides using high-pH anion-exchange chromatography with pulsed-amperometric detection. AB - Fucosylated oligosaccharides of the beta Gal(1----4)GlcNAc-, beta Gal(1----4)Glc , and beta Gal(1----3)GlcNAc-series were chromatographed on a high-performance anion-exchange pellicular resin under alkaline conditions (pH congruent to 13). Fucosylation of either lactose, lactosamine (Type II chains), or lacto-N-biose (Type I chains) oligosaccharides markedly decreased the retention time (10-38 min) of the non-fucosylated form. The magnitude of the reduction was related to whether fucose replaced Gal [alpha Fuc(1----3)----GlcNAc], whether fucose was alpha-(1----2)-linked to Gal at the end of a chain, or whether fucose was linked in a subterminal position [alpha(1----3) or alpha (1----4)] to Gal or GlcNAc. The results suggest that the decreases in retention times of fucosylated oligosaccharides (10-38 min) is not attributable to the absence of a 6-OH in Fuc but instead to steric and substitution effects which affect the interaction of the most readily ionizable groups of Fuc (2-OH), Gal (2-OH), and GLcNAc (3-OH) with the stationary phase. We show that high-pH anion-exchange chromatography can effectively separate 1----2, 1----3, and 1----4 fucose positional isomers in a single chromatographic step. PMID- 2776126 TI - Lipopolysaccharides of Proteus penneri species novum. AB - The lipopolysaccharides (LPS), obtained from twenty strains of Proteus penneri, were shown to contain 3-deoxy-D-manno-2-octulosonic acid (KDO), L-glycero-D-manno and D-glycero-D-manno-heptoses, glucose, 2-amino-2-deoxyglucose, 2-amino-2 deoxygalactose, and galacturonic acid. Galactose was lacking in three LPS and, in some LPS, glucuronic acid, rhamnose, lysine, and two unknown constituents were detected. Chemotypes of the P. penneri are discussed. PMID- 2776127 TI - Structure of the capsular polysaccharide of Klebsiella ozaenae serotype K4 containing 3-deoxy-D-glycero-D-galacto-nonulosonic acid. AB - The acidic capsular polysaccharide from the museum strain 2211 of Klebsiella ozaenae serotype K4 is built up of pentasaccharide repeating-units that contain residues of D-glucose, D-mannose, D-glucuronic acid, and 3-deoxy-D-glycero-D galacto-nonulosonic acid (Kdn) in the ratios 2:1:1:1, as well as an O-acetyl group. The last-named sugar, which is reported in bacterial polysaccharides for the first time, was identified as the methyl (methyl 3-deoxynonulopyranosid)onate obtained by methanolysis of the polysaccharide. On the basis of the results of partial acid hydrolysis, Smith degradation, and computer-assisted 13C-n.m.r. analysis, it was concluded that the capsular polysaccharide has the following structure: (formula see text) PMID- 2776128 TI - Synthesis of pseudo-C-nucleosides. AB - Whereas the reaction of 1,2-O-isopropylidene-alpha-D-xylo-5-hexulofuranuronamide (1) with the Wittig reagent ethoxycarbonylmethylenetriphenylphosphorane gave 3 (1,2-O-isopropylidene-beta-L-threofuranos-4-yl)maleimide (2, 15%) and ethyl 5 carbamoyl-5,6-dideoxy-1,2-O-isopropylidene-alpha-D-xylo-hept-5-enof uranuronate (3, 76%), a similar reaction of 3-O-benzyl-1,2-O-isopropylidene-alpha-D-ribo-5 hexulofuranuronamide++ + (4) gave only 3-(3-O-benzyl-1,2-O-isopropylidene-alpha-D erythrofuranos-4-yl)mal eimide (5), 80%), and that of 3-O-benzyl-1,2-O isopropylidene-alpha-D-xylo-5-hexulofuranuronamide++ + (6) gave only ethyl 3-O benzyl-5-carbamoyl-5,6-dideoxy-1,2-O-isopropylidene- alpha-D-xylo-hept-5 enofuranuronate (7, 85%). The formation of the maleimide ring depended on the orientation and substitution of HO-3'. Compounds 2 and 5 are analogous of showdomycin. PMID- 2776129 TI - Improved synthesis of the 2-, 3-, and 4-deoxy derivatives from methyl beta-D galactopyranoside. PMID- 2776130 TI - A facile, regio- and stereo-selective synthesis of ganglioside GM3. AB - Gangliosides GM3, containing three different fatty acyl groups at the ceramide moiety, have been synthesized. Coupling of 2-(trimethylsilyl)ethyl O-(6-O-benzoyl beta-D-galactopyranosyl)-(1----4)- 2,6-di-O-benzoyl-beta-D-glucopyranoside (4), prepared from 2-(trimethylsilyl)ethyl beta-lactoside (1) by selective 3'-O benzylation, O-benzoylation, and subsequent removal of the benzyl group, with methyl (methyl 5-acetamido-4,7,8,9-tetra-O-acetyl-3,5-dideoxy-2-thio-D-glycero alpha-D- galacto - 2-nonulopyranosid)onate (5) using dimethyl(methylthio)sulfonium triflate as a glycosyl promoter, gave 2 (trimethylsilyl)ethyl O-(methyl 5-acetamido-4,7,8,9-tetra-O- acetyl-3,5-dideoxy-D glycero-alpha-D-galacto-2-nonulopyranosylonate++ +)-(2----3)- O-(6-O- benzoyl beta-D-galactopyranosyl)-(1----4)-2,6-di-O-benzoyl-beta-D- glucopyranoside (6), which was converted, via O-acetylation, selective removal of the 2 (trimethylsilyl)-ethyl group, and subsequent imidate formation, into the alpha-N acetylneuraminyl-(2----3')-lactose trichloroacetimidate 9. Glycosylation of (2S,3R,4E)-2-azido-3-O-benzoyl-4-octadecene-1,3-diol (10) with 9 afforded the beta-glycoside 11, which was converted, via selective reduction of the azide group, coupling with fatty acids, O-deacetylation, and de-esterification, into the title compounds. PMID- 2776131 TI - Isolation and identification of 3-deoxy-D-threo-hexulosonic acid as a constituent of the lipopolysaccharide of Vibrio parahaemolyticus serotypes O7 and O12. AB - Treatment of the lipopolysaccharide of Vibrio parahaemolyticus serotypes O7 and O12 with mild acid gave a compound which, on the basis of chemical analysis, g.l.c.-m.s., and 1H and 13C-n.m.r. spectroscopy, was characterized as 3-deoxy-D threo-hexulosonic acid and shown to be present as a terminal non-substituted pyranose unit. PMID- 2776132 TI - Liquid ion-exchange chromatography under pressure of milk oligosaccharides using a pulsed amperometric detector. AB - Several oligosaccharides from human milk were separated completely on a Dionex AS6 ion-exchange column under mild alkaline conditions, such that no degradation of oligosaccharides was detectable after incubation for 6 h at room temperature in the eluent buffer. In general, both the presence of fucosyl groups and branching within oligosaccharide chains tend to reduce retention times for oligosaccharides in this system. Thus, both lacto-N-fucopentaose II [beta-D-Galp (1----3)-[alpha-L-Fucp-(1----4)]-beta-D-GlcpNAc-(1--- -3)- beta-D-Galp-(1----4)-D Glc] and lacto-N-fucopentaose III [beta-D-Galp-(1----4)-[alpha-L-Fucp-(1----3)] beta-D-GlcpNAc-(1--- -3)- beta-D-Galp-(1----4)-D-Glc] were eluted before lacto-N fucopentaose I [alpha-L-Fucp-(1----2)-beta-D-Galp-(1----3)-beta-D-GlcpNAc-(1----3 )-beta-D- Galp-(1----4)-D-Glc], and all three fucopentaoses were eluted earlier than lacto-N-tetraose [beta-D-Galp-(1----3)-beta-D-GlcpNAc-(1----3)-beta-D-Galp (1----4)-D-Glc ]. 2'-Fucosyllactose [alpha-L-Fucp-(1----2)-beta-D-Galp-(1----4)-D Glc] and 3-fucosyllactose [alpha-D-Galp-(1----4)-[alpha-L-Fucp-(1----3)]-D-Glc] were separated completely under a wide range of conditions. Introduction of substituents at either the O-3 or O-4 of 2-acetamido-2-deoxy-D-glucose produced large differences in retention: lacto-N-tetraose and lacto-N-neotetraose [beta-D Gal-(1----4)-beta-D-GlcpNAc-(1----3)-beta-D-Galp-(1----4)-D-Glc] could be separated by more than 8 min. The l.c. ion-exchange chromatographic system described represents a useful addition to existing methods for separating oligosaccharides derived from glycoproteins and glycolipids. PMID- 2776133 TI - Separation by liquid chromatography (under elevated pressure) of benzyl and nitrophenyl glycosides of oligosaccharides. AB - Liquid chromatography under elevated pressure (l.c.) was employed for the separation of some benzyl and nitrophenyl glycosides of a variety of mono-, di-, tri-, and tetra-saccharides. The separation was conducted on a Waters Carbohydrate Analysis column by use of a mixture of acetonitrile-water as the mobile phase. In general, monosaccharides emerged first from the column, followed sequentially by di-, tri-, and tetra-saccharides. It was observed that the pattern of substitution imparts a noticeable effect on the elution profiles of isomeric oligosaccharides. Also, substitution of a hydroxyl group with a methyl group, or its replacement with a fluorine atom, led to a substantial decrease in retention times of some oligosaccharides. Moreover, resolution was clearly enhanced, and retention times were congruently increased by decreasing the water content of the mobile phase. PMID- 2776134 TI - Structural characterization of an anti-complementary pectic polysaccharide from the roots of Bupleurum falcatum L. AB - An anti-complementary pectic polysaccharide (BR-2-IIb), isolated from the roots of Bupleurum falcatum L., has an average molecular weight of 36,000 (gel filtration), and was subjected to methylation analysis before and after carboxyl reduction, digestion with endo-polygalacturonase, base-catalysed beta elimination, and partial acid hydrolysis. BR-2-IIb consisted mainly of galacturonic acid, arabinose, rhamnose, and galactose in the molar ratios 13.0:2.1:1.4:1.0 and contained a large enzyme-sensitive polygalacturonan region. The enzyme-resistant region (PG-1) was rich in neutral sugars and contained a backbone of 4-linked GalA and 2-linked Rha to which a highly branched arabinogalactan was attached to position 4 of some 2-linked Rha units. Partial acid hydrolysis of BR-2-IIb gave Ara-(1----3)-Ara, Ara-(1----4)-Arap, Ara-(1--- 5)-Araf, Ara-(1----6)-Gal, Gal-(1----4)-Gal, GalA-(1----2)-Rha, GalA-(1----4) Rha, GalA----Rha----Rha, Gal----Rha----Rha, and GlA-(1----6)-Gal in addition to (1----4)linked oligogalacturonides. The anticomplementary activity of BR-2-IIb was enhanced by de-esterification, but carboxyl-reduction decreased the activity. PMID- 2776135 TI - Synthetic mucin fragments. Benzyl O-beta-D-galactopyranosyl-(1----3)-O-(2 acetamido-2-deoxy-beta-D- glucopyranosyl)-(1----6)-2-acetamido-2-deoxy-alpha-D galactopyranoside and O-alpha-L-fucopyranosyl-(1----3)-O-(2-acetamido-2-deoxy beta-D- glucopyranosyl)-(1----6)-2-acetamido-2-deoxy-D-galactopyranose. AB - Benzyl 2-acetamido-6-O-(2-acetamido-2-deoxy-4,6-O-isopropylidene-beta-D- glucopyranosyl)-2-deoxy-3,4-O-isopropylidene-alpha-D-galactopyranoside (2) was obtained by acetalation of its parent disaccharide with 2,2-dimethoxypropane in hot N,N-dimethylformamide and in the presence of 4-toluenesulfonic acid. Glycosylation of 2 with 2,3,4,6-tetra-O-acetyl-alpha-D-galactopyranosyl bromide (catalyzed by mercuric cyanide), followed by removal of the protecting groups afforded the title trisaccharide 7. A second product was also isolated, which was identified as a derivative of 7 having a 2-cyanopropyl group. Glycosylation of diacetal 2 with 2,3,4-tri-O-benzyl-alpha-L-fucopyranosyl bromide (under catalysis by bromide ion), followed by systematic removal of the protecting groups furnished the title trisaccharide 13. The structures of both 7 and 13 were established by 13C-n.m.r. spectroscopy. PMID- 2776136 TI - Homologous and heterologous reactions of bacteriophages phi 41 and phi 12 on the capsular polysaccharides from Klebsiella K41 and K12. AB - The structures of the capsular polysaccharides from Klebsiella K41 and K12 are very similar and differ only in the lateral, terminal group of their respective repeating units. The bacteriophages phi 41 and phi 12 are shown to hydrolyze the same alpha-galactopyranosyl bond in each of the polysaccharides, giving rise to an oligosaccharide characteristic of the starting polysaccharide, irrespective of the phage employed. The presence of the uronic acid function is essential for the phages to be active, but the carboxyl group of the pyruvic acetal in K12 does not appear to play a role in the recognition process. PMID- 2776137 TI - Production and characterization of antisera raised to the manninotrionate group [alpha-D-Galp-(1----6)-alpha-D-Galp-(1----6)-D-gluconate]. AB - Manninotrionate [alpha-D-Galp-(1----6)-alpha-D-Galp-(1----6)-D-gluconate] was coupled to bovine serum albumin (BSA), and antisera were raised in rabbits to this carbohydrate-protein conjugate. The antisera were studied by quantitative precipitation and hapten inhibition. Antisera against the manninotrionate-BSA conjugate showed the greatest reactivity with the homologous manninotrionate-BSA antigen, but also cross-reacted extensively with a manninotrionate-ovalbumin conjugate. The antisera gave weak precipitin reactions with beef-lung galactan, guaran, gum arabic, and larch arabinogalactan. Quantitative hapten-inhibition studies with a series of galactosyloligosaccharides indicated that the antisera possess a high degree of specificity toward terminal alpha-D-Galp-(1----6)-alpha D-Galp units. The antisera did not agglutinate Ehrlich ascites tumor-cells, which have been demonstrated to contain cell-surface glycoproteins having alpha-D galactosyl end-groups. PMID- 2776138 TI - A colorimetric method for the estimation of 2-deoxy-3-C-methyl-branched sugars. PMID- 2776139 TI - Sequence-dependent reactivity of model peptides with glyceraldehyde. AB - Glyceraldehyde reacted faster with tripeptides than with dipeptides. The pH profiles of the reactions with tripeptides displayed optima in the range of 8.5 10.0, approximately 1-2 pH units higher than found with dipeptides. The second amino acid residue influences not only the rate of reaction but also the extent of formation of the product of the Amadori rearrangement, the ketoamine. The presence of histidine as the second amino acid residue of either di- or tri peptides greatly accelerated the rate of reaction perhaps by facilitating the rearrangement. Conventional amino acid analysis and liquid chromatography procedures have been used to detect intermediates and the ketoamine product. 1H N.m.r. analysis of the reduced adducts was consistent with the assigned structures. PMID- 2776140 TI - Acarbose is a competitive inhibitor of mammalian lysosomal acid alpha-D glucosidases. AB - Intraperitoneal injections (approximately 400 mg/kg of body weight) of acarbose, an inhibitor of acid (1----4)-alpha-D-glucosidase, perturb the metabolism of glycogen in the liver, resulting in excess storage of lysosomal glycogen. The metabolism of skeletal muscle glycogen was unaffected, suggesting that acarbose either does not enter the tissue or that the muscle alpha-D-glucosidase is not inhibited. The hydrolysis of maltose and glycogen by the acid alpha-D glucosidases from rat liver, rat skeletal muscle, and human placenta was inhibited competitively by acarbose. Thus, the lack of effect of acarbose upon the metabolism of muscle glycogen is due to its inability to enter the tissue. PMID- 2776141 TI - Efficacy and safety of flosequinan, given over 3 days, evaluated by continuous hemodynamic monitoring. AB - The hemodynamic effects of flosequinan, a new balanced vasodilator, were evaluated in 12 patients with chronic congestive heart failure. The drug was added to diuretics and digitalis and given as an oral dose of 100 mg, once daily in the morning, over 3 days, and hemodynamic monitoring was performed before the first dose and for 72 h thereafter. Hemodynamic improvement, peaking between 1 and 2 h after oral administration, was observed on all 3 days. On day 1 pulmonary capillary wedge pressure (PCWP) was reduced from 27.8 +/- 8.6 to 13.0 +/- 3.1 mm Hg and cardiac output (CO) increased from 3.3 +/- 0.6 to 4.5 +/- 0.9 liters/min (p less than 0.05). After 12-16 h the effect was slightly attenuated but remained significant at 24 h. A similar response was observed after the doses given on days 2 and 3. At 72 h PCWP was 15.5 +/- 4.1 mm Hg and CO 3.8 +/- 1.1 liters/min (p less than 0.05 for the difference from baseline). Heart rate was slightly increased only at 2 h after the dose. Pulmonary arterial and right atrial pressure and systemic and pulmonary vascular resistances were significantly reduced (except for systemic resistance at 72 h). In conclusion, flosequinan produces hemodynamic improvement in patients with chronic congestive heart failure. The response to subsequent doses is similar to the response to the first dose. PMID- 2776142 TI - Transient QRS axis shift to the right during right coronary artery and/or left circumflex artery spasms. AB - The QRS axis was measured in 24 patients during ergonovine malate provocation test (EM test). Of 12 patients with significant spasm of the right coronary artery (RCA) and/or left circumflex artery (LCX), the QRS axis shifted to the right in 7 patients after the EM test (mean 8.2 degrees), and the axis shifted back to the left in 9 patients after nitroglycerin administration (mean -9.1 degrees). The sensitivity of right axis shift for RCA and LCX spasm was 58% and the specificity was 80%. Thus, right axis shift seems to be associated with myocardial ischemia due to RCA and LCX spasm and to be useful for the detection of RCA and/or LCX spasms. PMID- 2776143 TI - Long QT syndrome and complete situs inversus. Preliminary report of a family. AB - The familial long QT syndrome is a rare condition that may occur with or without deafness. Dextrocardia with complete situs inversus is a familial syndrome generally found in normal subjects with a high incidence of consanguinity among the parents. In this report we describe a Jerbian family with both disorders and with several cases of sudden death. Of 27 members of this family (3 generations) in whom ECG was performed, 15 had QT prolongation (QTc greater than 0.45). Four members (2 generations) had complete situs inversus, 3 of them also had ECG evidence of QT prolongation. The combined occurrence of these rare diseases within the same family has not been previously reported. It may be due to the high incidence of consanguinity and may raise the possibility that the loci responsible for the 2 conditions are closely related and located on the same chromosome. A more extensive study of the family is being carried out. PMID- 2776144 TI - Reproducibility of treadmill exercise data in patients with atrial fibrillation. AB - Serial submaximal treadmill tests are often used to evaluate the efficacy of therapy in patients with atrial fibrillation. Since the response to serial tests can be influenced by a 'learning phenomenon', we performed maximal exercise tests on 9 patients (mean age 63 +/- 4 years) with chronic atrial fibrillation. Points of analysis for the initial and follow-up treadmill exercise tests were 3 mph/0% grade, the gas exchange anaerobic threshold, and maximal exertion. Significant (p less than 0.05) reductions in ventilation (l/min) and oxygen uptake (ml/kg/min) were observed on follow-up at a standard submaximal work load of 3.0 mph/0% grade and at the gas exchange anaerobic threshold. There was no significant alteration in these variables at maximal exertion. A reduction in heart rate was observed throughout exercise during the follow-up test with the most marked reduction (21 beats/min) occurring at 3.0 mph/0% grade. There were no differences in respiratory exchange ratio or systolic blood pressure at any point. The reduction in submaximal heart rate and gas exchange variables without a significant change in these variables at maximal exertion is consistent with a learning effect. Therefore, studies comparing consecutive submaximal exercise test responses in patients with atrial fibrillation can be misleading. PMID- 2776145 TI - Lymphocyte potassium and magnesium concentrations as prognostic factors after acute myocardial infarction. PMID- 2776146 TI - An animal model for the chronic study of ventricular repolarisation and refractory period. AB - We have developed a simple model permitting stable, chronic measurements of ventricular repolarisation and refractory period to be made in conscious, unsedated, unrestrained animals. The model utilises the ventricular paced evoked response, recorded from permanent pacemaker electrodes implanted into the right ventricle of New Zealand White rabbits. After a "bedding in" period of 18-21 d, measured variables are stable for long periods; the stimulus to T wave interval of the evoked response remains stable up to at least 150 d after electrode insertion. The principal advantage of the model lies in the control of heart rate by pacing, eliminating the requirement for unreliable methods of correction of repolarisation data for sinus rate. Surgical techniques are straightforward. The model can also be used for studies involving recordings of the intrinsic (non paced) intracardiac electrogram, as the quality of the signal obtained is consistently superior to standard methods of recording the electrocardiogram in animals. The stimulus-T interval of the paced evoked response has been found to correlate significantly (r = 0.96) with action potential duration measured by transmembrane microelectrode recordings in the isolated, arterially perfused interventricular septum. PMID- 2776147 TI - A percutaneous approach to cardiac haemodynamics in anaesthetised rats. AB - Established methods for evaluating cardiac function in small animals involve surgical manoeuvres. We describe a method for evaluating left ventricular volume (LVV) and pressure (LVP) in anaesthetised adult rats. Under fluoroscopic control a 23 G needle was inserted into the left ventricular cavity of anaesthetised normotensive WKY rats. LVV was determined by biplane angiography and LVP was measured directly. Surface electrocardiograms were recorded throughout the procedure. In 8 animals the study was repeated three times, one week apart. Animals were then sacrificed and tissues harvested for histological examination. In 8 rats, the technique was found to be reproducible and there was no evidence of functional (ECG) or pathological myocardial damage following repeated measurements. In conclusion this technique provides a reproducible method of measuring LVV and LVP, allowing longitudinal haemodynamic studies in anaesthetised rats. PMID- 2776148 TI - Homogeneous distribution and pressure dependent reduction of coronary blood flow in right ventricular free wall during coronary hypoperfusion in anaesthetised open chest dogs. AB - Relationship of coronary perfusion pressure with total and regional myocardial blood flow in right ventricular free wall was studied in 10 anaesthetised open chest dogs. The right coronary artery was perfused by an autoperfusion system from the carotid artery. Total coronary blood flow into the perfused area was measured by an extracorporeal electromagnetic flow probe. Critical perfusion pressure of the right coronary artery, defined as the lowest pressure level below which the regional wall motion deteriorated, was 39(SEM1) mm Hg. Reactive hyperaemia was noted at 60(2) mm Hg, a level well above the critical perfusion pressure. There was an inverse linear relation between the level of reactive hyperaemia and perfusion pressure. Regional myocardial blood flow was measured by a tracer microsphere technique at control condition, just above and below the critical perfusion pressures and during coronary occlusion. This correlated closely with values obtained by an electromagnetic flow probe (r = 0.94, p less than 0.001) and both values were dependent on the level of perfusion pressure. Endocardial to epicardial flow ratio remained at unity at any level of coronary perfusion pressure. Thus the level of coronary perfusion pressure was a major determinant of the regional myocardial blood flow into the right coronary artery, and autoregulation of the regional myocardial blood flow was not apparent across the wall, despite the presence of a reactive hyperaemia. PMID- 2776149 TI - Effect of diabetes on metabolic coronary dilatation in the rat. AB - There is increasing evidence that patients with diabetes mellitus are prone to ischaemic heart disease. This study examined cardiac hyperactivity and its consequent metabolically induced coronary dilatation in isolated, perfused, electrically paced rat hearts from control and spontaneously diabetic Bio Breeding (BB) rats. Cardiostimulation produced by noradrenaline, calcium, or by tachycardia elicited increases in coronary flow that were significantly lower in diabetic hearts. However, the inotropic responses to noradrenaline and calcium in diabetic preparations were comparable to control. When coronary vascular reactivity was tested with sodium nitroprusside and adenosine, a decreased dilator response was observed with adenosine in diabetic hearts while no difference was observed with sodium nitroprusside. It is suggested that failure in the adaptive coronary flow response to cardiac hyperactivity in diabetes may, in part, be responsible for the higher incidence of ischaemic heart disease in the diabetic population. PMID- 2776150 TI - Changes in right ventricular relaxation during acute anterior myocardial infarction in pigs. AB - To determine the effect of an anteroseptal myocardial infarction on right ventricular systolic and diastolic function, we studied 12 pigs before and 1 h after left anterior descending coronary artery occlusion. Total arterial occlusion was achieved by the percutaneous, transcatheter placement of a 1 mm Teflon plug into the mid portion of the artery. The resulting infarction involved 28 (SEM 3)% of the left ventricular wall, in the anterior and septal regions. A small rim of the right ventricular free wall adjacent to the septum and the right ventricular apex were also affected. End diastolic pressures in both ventricles rose significantly: left ventricular from 12(1) to 20(2) mm Hg and right ventricular from 8(1) to 10(1) mm Hg. Right ventricular peak systolic pressure increased from 29(2) to 35(2) mm Hg while left ventricular peak systolic pressure did not change. One hour after infarction the half time of isovolumic relaxation of the right ventricle was prolonged from 6.9(0.5) to 8.7(0.4) ms. Ejection fraction in both ventricles was depressed: from 46(1) to 34(2)% in the right ventricle and from 69(3) to 49(3) in the left ventricle. There was no change in either right or left ventricular dP/dt. These data suggest that right ventricular systolic and diastolic dysfunction occurs as the result of an anteroseptal myocardial infarction in pigs. PMID- 2776151 TI - Prediction of terminal atrial myocardial repolarisation from incomplete phase 3 data. AB - The duration of the monophasic action potential (MAP) carries prognostic antiarrhythmic information when the recording is done during sinus rhythm (SR) after DC conversion of atrial fibrillation (AF). This study analyses whether it is possible to predict MAP duration during sinus rhythm by analysing the atrial MAP during AF, even though complete myocardial repolarisation is never reached during this arrhythmia. We have therefore evaluated the estimated duration of the action potential (AP) and MAP by exponential extrapolation of phase 3 data. (1) AP studies were done on 11 human atrial myocardial specimens. Resting membrane potential (RMP) and AP duration were better identified when more data obtained during repolarisation were used for prediction. Thus the predicted RMP deviated on average by -0.4% of AF amplitude from the real RMP level when data to 90% repolarisation were used for extrapolation. AP duration at 90% repolarisation correlated well with the real AP duration (r = 0.88) at this level of data aquisition. (2) Continuous recording of atrial MAPs was done in 15 patients during AF and in 12 of these during SR after DC conversion. Resting myocardial repolarisation level during AF, RP(EST), and estimated MAP duration, MAPD(EST), could be calculated by exponential extrapolation in 12 patients. The actual repolarisation during fibrillation reached below 90% of the RP(EST) level in eight patients and below 70% in all 12. The MAP duration during SR could be predicted with increasing precision when data closer to the RP(EST) were used for calculation of MAPD(EST). Thus MAPD(EST) correlated well with SR MAP duration when data reaching at least 90% of RP were used (r = 0.85).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2776152 TI - Clinical significance of high frequency QRS potentials in myocardial infarction: analysis based on power spectrum of lead III. AB - Power spectrum analysis of ECG lead III QRS potentials using the Fast Fourier Transform technique was performed in 10 normal subjects and nine patients with inferior wall myocardial infarction (IWMI). A relative lowering in both low and high frequency QRS potentials was observed in the infarct group, in agreement with previous studies on power spectrum of lead II. However, contrary to earlier conclusions, the lowering was independent of a general attenuation in QRS voltages. Discriminant analysis of the frequency components showed that the high frequency components (190-310 Hz) were able to discriminate better between the two groups than the low frequency components (10-120 Hz). PMID- 2776153 TI - Physical chemical evidence of structural weakness in coronary arterial calcification. AB - Physical-chemical properties of calcified human coronary arteries were obtained through 857 electron probe microanalyses of samples of endarterectomy tissue from 12 patients and by X-ray and electron diffraction from separate samples. The calcific phase exhibited a weight percentage calcium to phosphorus ratio of 2.5 (SEM 0.15), a density of 2.95 (0.02) g.cm-3, and a crystalline unit cell volume of 530 (0.5) A3, or 53 (0.05) nm3. The phase has been characterised as a phosphorus deficient dahllite variant of apatite in which the crystal structure has been weakened by the incorporation of water molecules and tetrahedral hydroxyl groups in isomorphic substitution conforming with the McConnell-type defect. Isomorphic substitution within the apatitic cell appears sufficient to suggest that the crystal structure of the mineral deposit is weakened to the extent that means might be sought to attack the early formation of the pathological deposition. PMID- 2776154 TI - Left ventricular pressure-diameter relations in the conscious rabbit. AB - A model for the study of left ventricular (LV) contractility in a small species was developed using conscious rabbits previously instrumented with a LV catheter and ultrasonic crystals measuring LV internal diameter. Afterload increase produced by methoxamine infusion was associated with a reduction in heart rate from 272(SEM18) to 214(20) beats.min-1, p less than 0.01; and an increase in LV end systolic pressure from 76.3(4.1) to 101(6.5) mm Hg, p less than 0.001, and in end systolic diameter from 8.7(0.7) to 9.9(0.7) mm, p less than 0.01. For matched end systolic pressure and heart rate, the increase in inotropic state produced by noradrenaline infusion significantly shifted the pressure-diameter relation to the left. Similarly, end systolic pressure and diameter were significantly lowered by sodium nitroprusside infusion, with a reflex increase of heart rate; and a decrease in inotropic state produced by verapamil infusion was demonstrated by a significantly larger end systolic diameter for matched end systolic pressure and heart rate. The pressure-diameter relation was not modified by volume loading, which increased end diastolic diameter by 9.6(1.1)% with no evidence of a Bainbridge reflex. The mild depressant effect of diltiazem was not detected by peak dP/dt changes but was demonstrated by the analysis of end systolic pressure diameter relations. The instrumented rabbit thus appears to be a sensitive model for studying LV function and the cardiovascular effects of drugs. PMID- 2776155 TI - Forskolin potentiates myocardial reactive hyperaemia in the open chest dog: the contribution of adenylate cyclase. AB - Forskolin, a diterpene, directly stimulates adenylate cyclase and also potentiates receptor mediated stimulation of this enzyme by many stimulatory agonists. We exploited the potentiating effect of forskolin to test the hypothesis that activation of adenylate cyclase contributes to myocardial reactive hyperaemia, especially by release of adenosine at the time of brief coronary occlusions. In 10 open chest dogs, intracoronary forskolin infusions which produced plasma concentrations between 0.22 and 0.34 mumol.litre-1 slightly increased coronary blood flow and had no effect on haemodynamics or myocardial metabolism. Under these conditions, though peak reactive hyperaemic flow rates were not affected, forskolin infusions reversibly potentiated repayments of flow debt by 28, 25 and 27% following coronary occlusions of 15 s, 20 s and 30 s, respectively (p less than 0.05). In another seven dogs, after observations of the effects of forskolin (0.16-0.26 mumol), 10 mumol of 8-phenyltheophylline, a potent adenosine antagonist, was infused simultaneously with forskolin into the coronary arteries. Forskolin increased debt repayments by about 23-27% following 15 s, 20 s and 30 s occlusions, but with simultaneous 8-phenyltheophylline, forskolin induced increments in the debt repayments were reduced significantly (p less than 0.05). These results indicate that adenylate cyclase contributes to myocardial reactive hyperaemia, and adenosine has a significant role as metabolic regulator of reactive hyperaemia through activation of adenylate cyclase. PMID- 2776156 TI - Response of the mesenteric circulation to serotonin in normal and atherosclerotic monkeys: implications for the pathogenesis of non-occlusive intestinal ischaemia. AB - We tested the hypothesis that atherosclerosis potentiates vasoconstrictor responses in the mesenteric circulation to stimulation of serotonergic and alpha adrenergic receptors. In normal monkeys, infusion of serotonin had little effect on blood flow to the stomach, duodenum, and colon. In contrast, in atherosclerotic monkeys, serotonin produced a modest decrease in blood flow to the stomach and duodenum, and virtually abolished blood flow to the colon. Vasoconstrictor responses to phenylephrine in the stomach and duodenum were not altered by atherosclerosis, but responses were potentiated in the colon of atherosclerotic monkeys. In summary, atherosclerosis greatly potentiates vasoconstrictor responses to serotonin in the mesenteric circulation, particularly in vessels to the colon. We speculate that release of serotonin during adherence and aggregation of platelets at atherosclerotic lesions, coupled with augmented vasoconstrictor responses to serotonin, may play a role in the pathogenesis of non-occlusive mesenteric ischaemia. PMID- 2776157 TI - The adenosine hypothesis revisited: relationship between purine release and coronary flow in isolated rat heart. AB - We evaluated the adenosine hypothesis through a new approach, based on the study of the relationship between coronary flow or resistance and purine release, which is an accurate index of myocardial adenosine release. Isolated rat hearts were perfused at different work loads, in hypoxic conditions and after a short period of global ischaemia. When the results of all experiments were considered together, purine release was significantly but weakly related to coronary flow and coronary resistance (r = 0.416 v coronary flow, r = 0.378 v the reciprocal of coronary resistance, p less than 0.01). Closer relationships were obtained within the three subgroups: the correlation coefficients increased to 0.819 and 0.835 (p less than 0.001) in the hearts perfused at different work loads with normal oxygen supply, to 0.701 and 0.757 (p less than 0.02 and p less than 0.01) in the hypoxic hearts, and to 0.897 and 0.978 (p less than 0.02 and p less than 0.01) in the hearts recovering from ischaemia. The relationships between purine release and coronary flow or resistance were significantly different in the three subgroups (p less than 0.001): at any value of purine release coronary resistance was highest during hypoxia and lowest after ischaemia, while the opposite was true for coronary flow. We suggest that the adenosine hypothesis is converted into a "weaker" statement: adenosine is involved in the adjustment between heart performance and coronary resistance but other factors contribute to the regulation of coronary flow, and/or affect the response to adenosine. PMID- 2776158 TI - Computer simulation of myocardial fibrillation using a one dimensional model of excitation and recovery processes. AB - A computer model of cardiac excitation sequences and recovery processes has been employed to reproduce chaotic behaviour of the simulated tissue and to investigate how different variables of the model influence the degree of disorganisation in modelled episodes. The model emphasises the electrophysiological features of excitation transmission and repolarisation processes and introduces phenomena which are omitted or seriously simplified in most of the existing models of cardiac tissue electrophysiology. These phenomena include abnormal shapes of action potential curves corresponding to premature excitation of cells which have not fully recovered, excitation transmission based on transmembrane voltages, and the electrotonic interactions between neighbouring cells during their repolarisation phases. The model has been used to examine a one dimensional cable of simulated cells in which a central area with shortened refractoriness was used to enable the "reflection" processes to initiate conduction and repolarisation disturbances. In some cases, the chaotic nature of the reproduced episodes resembled fibrillation myocardium. The degree of the simulated chaos depended on different variables of the model. This study included a systematic evaluation of the influence of the shapes of action potential curves, of the threshold of transmembrane voltages initiating an excitation wave, of the degree of the electrotonic interactions of neighbouring cells, and of various combinations of these variables. The results showed that in this model, the maximum disorganisation was achieved when combining the negative influences of all variables, and that changing the shape of the action potential curves prevented the modelled chaos more fully than changes in the other variables. PMID- 2776159 TI - Quantitative assessment of aortic regurgitation by colour flow Doppler in an open chest canine model. AB - Colour flow Doppler maps the extent of the flow velocity disturbance of aortic regurgitation onto the two dimensional echocardiographic image of the left ventricular cavity. The spatial extent of this flow velocity disturbance expressed as a percentage of end diastolic left ventricular cavity area (CD%) was compared to regurgitant fraction (RF), measured volumetrically, in nine open chest dogs with varying degrees of surgically created aortic regurgitation (RF 0 85%). Right heart bypass controlled venous return to the left atrium and hence net left ventricular output, while total left ventricular output was measured with an aortic electromagnetic flow probe under various loading conditions, achieving mean diastolic transvalvular pressure gradients of 23-114 mm Hg, net left ventricular outputs of 750-3000 ml.min-1 and diastolic filling periods of 162-320 ms. A linear correlation between CD% and RF (r = 0.89) was demonstrated over this wide range of loading conditions. At a given transvalvular diastolic pressure gradient [68(SD9) mm Hg] CD% was linearly proportional to regurgitant aortic orifice area (r = 0.87). Thus CD% is proportional to the volumetric severity of aortic regurgitation under a wide range of haemodynamic conditions and varies appropriately with regurgitant aortic orifice area when diastolic transvalvular pressure gradient is held constant. The application of these principles to the non-invasive quantitation of valvular regurgitation by colour Doppler appears feasible. PMID- 2776160 TI - Unpredictable zero drift in intravascular micromanometer tipped catheters during long term pulmonary artery pressure recording: implications for catheter design. AB - Zero drift may be a cause of imprecision when micromanometer tipped catheters are used for intravascular pressure measurement over long periods of time. Drift of only a few mm Hg may represent a significant error when accurate recording of low vascular pressures is required. To overcome this problem a micromanometer tipped catheter has been modified so that it can be calibrated easily while it is in the circulation. Laboratory testing has demonstrated that when zero drift occurs this intravascular "reference calibration" is a valid linear function of true zero (r = 0.999). As the sensitivity of the catheter is unaffected by zero drift, it is possible to measure pressure accurately by compensating for this zero drift. During dynamic testing of two catheters, there was a mean net drift over 24 h of 0.54 mm Hg. Clinical evaluation of the catheter was undertaken in the human pulmonary circulation in eight patients (two for 48 h, five for 24 h and one for 8 h). In contrast to the laboratory findings, over the first 4 h after catheterisation there was a phase of rapid zero drift: the net drift was -1.9 (SD 3.3) mm Hg with a range of drift of 5.5 (7.4) mm Hg. Subsequently there was gradual drift: the net drift between 4 and 24 h was -0.44 (2.1) mm Hg with a range of drift of 2.8(1.0) mm Hg; and the net drift between 24 and 48 h was 3.7(2.1) mm Hg with a range of drift of 4.1(1.9) mm Hg. During long term intravascular pressure measurement with micromanometer tipped catheters, zero drift may occur unpredictably and should be quantified. PMID- 2776161 TI - Electrophysiological effects of acute ischaemia on electrically stable myocardial infarction. AB - The purpose of this study was to examine the effects of acute ischaemia superimposed on an electrophysiologically stable, small myocardial infarction, and to determine the mechanisms of induced ventricular arrhythmias, using a canine infarction model. Ten dogs without inducible ventricular tachycardia or fibrillation on the 7th day post-myocardial infarction (Group 1) and 14 control dogs (Group 2) were subjected to 30 min acute ischaemia by occlusion of the proximal left anterior descending artery. The areas of infarcted myocardium ranged from 1.0 to 20.4% (mean 8.9, SD 7.7) of total left ventricular weight. Ventricular arrhythmias were inducible by programmed electrical stimulation in eight of 10 dogs (80%) after acute ischaemia, but in only one of 14 control dogs (7%) (p less than 0.005). In seven of eight Group 1 dogs, epicardial mapping showed that ventricular arrhythmias did not originate from the epicardial region. In one dog, in which there was simultaneous epicardial and endocardial mapping, an endocardial electrogram from the boundary area between infarcted and acutely ischaemic zones recorded continuous fragmented activity. It was thus suggested that re-entry in a relatively isolated endocardial site could be attributed to the induction of ventricular tachyarrhythmias, and that the electrical instability could be significantly enhanced during acute ischaemia when underlying myocardial infarction was present. PMID- 2776162 TI - Enzymes in normally perfused and ischaemic dog hearts which release a substance with kinin like activity. AB - The presence of amidases cleaving the tripeptide VAL.LEU.ARG.pNA, and liberating from human plasma kininogen substance(s) able to contract uterine smooth muscle and to lower blood pressure (uterus contracting and hypotensive activity), has been demonstrated in vascular and muscle tissues from normally perfused and ischaemic areas of dog hearts. Studies were carried out on blood free preparations of coronary arteries and veins and normally perfused and ischaemic ventricle. All the tissues were found to contain both acid optimum (pH 6) and alkaline optimum (pH greater than 9) enzymes forming uterus contracting substance (UCS, bioassayed on isolated uterus of rats in oestrus), the highest levels of both activities being found in arterial tissues and the least in ventricle. Enzyme levels in ischaemic or normally perfused ventricle did not differ significantly. Gel filtration (Sephacryl, S-300) of coronary artery extracts gave one peak each of acid optimum enzyme with a molecular weight of 38,300 +/- 800 daltons and alkaline optimum enzyme with a molecular weight of 92,100 +/- 4000 daltons. Both acid and alkaline enzyme fractions cleaved the tripeptide substrate with pH optima identical to those for UCS formation. The acid optimum activity, both of UCS formation and tripeptide cleavage, was inhibited by pepstatin but not by aprotinin or soybean trypsin inhibitor (SBTI). The alkaline optimum activity was inhibited by aprotinin and SBTI but not pepstatin. Both acid and alkaline optimum enzymes released a hypotensive agent from a plasma protein substrate. The molecular weight and response to inhibitors of the acid optimum enzyme were similar to a cathepsin, and those of the alkaline optimum enzyme were similar to plasma kallikrein. PMID- 2776163 TI - Evidence for increased lipid peroxidation in the non-ischaemic portion of the heart with coronary occlusion. AB - Lipid peroxidation products, malondialdehyde (MDA), conjugated double bonds (CDB), and fluorescent end products (RF), were measured in porcine left ventricular myocardium. Myocardial samples were taken 15-20 min after left anterior descending coronary artery (LAD) ligation from ischaemic and non ischaemic regions. Products of lipid peroxidation were also measured in the left ventricular myocardium of sham operated pigs. Non-ischaemic regions of the hearts with LAD occlusion showed a significantly higher content of lipid peroxidation products than intact hearts of sham operated pigs. The results suggest that enhancement of lipid peroxidation reflecting increased free radical generation may contribute to myocardial damage in the non-ischaemic, apparently "healthy" portion of the heart with acute coronary occlusion. PMID- 2776164 TI - Biochemical and antiarrhythmic effects of three calcium channel antagonists in ischemic canine hearts. AB - The cardioprotective and antiarrhythmic effects of diltiazem, nilvadipine, and verapamil were evaluated in 33 dogs. The left anterior descending coronary artery (LAD) was occluded for two hours, 25 minutes after saline administration (controls); ten minutes after diltiazem (0.25 mg/kg); 15 minutes after nilvadipine (1 micrograms/kg/min); or ten minutes after verapamil (0.4 mg/kg). Changes in blood pressure and heart rate were monitored throughout the experiment. Two hours after LAD occlusion, mitochondria were prepared from ischemic and nonischemic areas and their function was measured polarographically. Fractionation of myocardial tissue from the ischemic and nonischemic areas was performed and activities of lysosomal enzymes were measured. LAD occlusion induced mitochondrial dysfunction and leakage of lysosomal enzymes in the ischemic area. Administration of the calcium antagonists preserved mitochondrial function and prevented leakage of lysosomal enzymes. All three calcium antagonists reduced the incidence of ventricular arrhythmias during ischemia. The results indicate that calcium may play an important role in the development of biochemical and electrical disturbances during ischemia. PMID- 2776165 TI - Effects of oral and intravenous defibrotide on blood viscosity in patients with peripheral obliterative arterial disease. AB - Patients with peripheral obliterative arterial disease received 400 mg of defibrotide intravenously (seven patients) or orally (nine patients). Blood and plasma viscosity were measured before therapy, at 30 minutes after and one hour after intravenous administration, and at 1, 2, 3, and 8 hours after oral administration. Thirty minutes after intravenous administration, blood viscosity at a shear rate of 30 sec-1 was reduced from 9.99 to 9.00 and at a shear rate of 180 sec-1 from 6.61 to 6.33 (P less than 0.05). Viscosity returned to baseline after 60 minutes. At 1, 2, and 3 hours after oral administration, blood viscosity at a shear rate of 30 sec-1 was reduced from 8.53 to 7.44, 6.88, and 7.19 (each P less than 0.01) and at a shear rate of 180 sec-1 from 5.88 to 5.51 (P less than 0.05), 5.14 (P less than 0.05), and 5.38 (P less than 0.01); the levels at eight hours were not significantly different from baseline values. Plasma viscosity was not affected by defibrotide. These data confirm previous evidence of a rheologic effect of defibrotide in patients with peripheral obliterative arterial disease and indicate that such an effect can be achieved with oral administration. PMID- 2776166 TI - Oral ciprofloxacin treatment of infections in geriatric patients. AB - The efficacy and safety of oral ciprofloxacin (750 mg every 12 hours) in the treatment of infections was evaluated in 84 geriatric patients. Duration of treatment ranged from three to 42 days (for a mean of 10.45 days). Satisfactory responses (cured or improved) were noted in 33 of 34 cases of urinary tract infections (97%); in 11 of 13 cases of lower respiratory tract infections (85%); in four of nine cases of skin and skin structure infections (44%); and in both cases of bone infection and bacteremia. Bacteriological cure rates were 91% of 33 urinary tract infections; 83% of 12 lower respiratory tract infections; 62% of eight skin and skin structure infections; and in both cases of bone infection and bacteremia. Three patients evaluable for clinical purposes were bacteriologically unevaluable. Overall clinical efficacy and bacteriological cure rates were 86% and 85%, respectively. Of the 78 evaluable pathogens isolated, 70 (90%) were eradicated. Adverse reactions occurred in 24 patients (29%) and included candida colonization in eight, gastrointestinal upset in six, dermatologic symptoms in five, and vaginal candidiasis, chest pain, renal failure, tremors, monocytosis, thrombocytosis, and increased serum theophylline level in one patient each. Ciprofloxacin appears to be a safe and effective treatment for infections in geriatric patients. Advantages of the oral form include cost effectiveness and decreased length of hospitalization. PMID- 2776167 TI - Efficacy of once-daily cimetidine in preventing recurrence of duodenal ulcer. AB - In a prospective multicenter trial, 88 patients with acute duodenal ulcers that were healed with ranitidine were randomly assigned to receive maintenance treatment with either cimetidine 400 mg (n = 45) or placebo (n = 43) at bedtime for six months. Ten percent of the patients experienced moderate or severe pain both during the day and at night while on placebo during the maintenance phase. The average proportion of cimetidine patients experiencing moderate or severe pain during the day or night was 50% and 80% lower than placebo, respectively. Ulcer-like symptoms prompted endoscopy in 44% (19 of 43) of the placebo patients compared with 18% (eight of 45) of patients receiving cimetidine (P = 0.009). At the completion of the maintenance study, cumulative symptomatic ulcer recurrence rates were 28% (12 of 43) for those on placebo compared with 13% (six of 45) for cimetidine patients. The adverse drug effects noted were similar between treatment groups, with no unexpected reactions reported. A low dose of cimetidine (400 mg) at bedtime effectively reduced the incidence of gastrointestinal symptoms that were severe enough to prompt endoscopy as well as the actual recurrence of ulcers in those patients who had responded to initial therapy with ranitidine, but who continued to be at increased risk of reulceration. PMID- 2776168 TI - Diflunisal and ibuprofen: effects on gastric and duodenal mucosa in patients with osteoarthritis. AB - Patients with osteoarthritis make up the largest group of users of nonsteroidal anti-inflammatory drugs (NSAIDs), but the effects of these agents on the gastrointestinal mucosa of such patients have not been well studied. This article describes a short-term comparison of two widely used NSAIDs, diflunisal and ibuprofen, in patients requiring these medications for their osteoarthritis. Efficacy, tolerability, and endoscopically documented effects of these drugs on the gastric and duodenal mucosa were assessed. Consenting, eligible patients were randomly assigned to one of the two study drugs for a two-week course. Clinical assessments were made after each week of treatment. Fiberoptic endoscopy and laboratory tests were performed before and after the treatment period. Thirty patients completed the study: 16 received diflunisal and 14 received ibuprofen. Similar improvements in pain, joint mobility, functional capacity, and joint swelling and tenderness were observed in both treatment groups. Transient, mild abdominal cramping was reported by two patients in each group; one patient receiving ibuprofen complained of transient dizziness. No patient withdrew from the study because of side effects. Follow-up endoscopy revealed slight (grade 1) changes in the gastric mucosa of two patients in each treatment group. An additional patient in the ibuprofen group had gastric erosions (grade 2) at the end of the study. Endoscopic changes were not correlated with symptoms. Diflunisal and ibuprofen were found to be similarly effective and well tolerated in the treatment of osteoarthritis. Their use may be associated with some gastrointestinal side effects even during short-term use. PMID- 2776169 TI - Measurement of quality-of-life changes in patients with Alzheimer's disease. AB - A scale was developed that appears to be a reliable and sensitive indicator of differences and changes in the quality of life of patients with Alzheimer's disease (AD) as the disease progresses. The instrument was generated from interviews with spouses and/or caregivers of AD patients, and was designed to be completed easily by the caregiver. The bipolar analog scale was based on the daily behavior of AD patients and was developed in three steps involving interviews with caregivers (step I), testing of questionnaires, and validation of the instrument. At step II, four iterative trials, each with a different version of the questionnaire, were performed for validation. The final form of the Progressive Deterioration Scale (PDS) contained 27 quality-of-life factors and was cross-validated in a second, separate study. The Global Deterioration Scale (GDS) for cognitive function was used as the external criterion for the analysis of the quality-of-life scales. Statistical analysis indicates that the PDS provides a reliable, valid, and sensitive measure of changes in the quality of life as AD progresses. The PDS achieved 80% overall accuracy in discriminating non-AD elderly patients from patients in the early, middle, and late stages of AD. This scale may provide a useful means for clinical evaluation (phase III) of potential medications to alleviate the symptoms of AD. PMID- 2776170 TI - Acetylcholinesterase activity in the adrenal chromaffin vesicles of Urodela. AB - The presence of acetylcholinesterase (AChE) activity in the adrenal chromaffin cells of Necturus maculosus and Ambystoma maculatum (Amphibia, Urodela) has been demonstrated by cytochemical method at the electron microscope level. The enzymatic activity is localized in RER and perinuclear cisternae, on the plasma membrane and within the chromaffin vesicles, both in adrenaline (A) and noradrenaline (N) cells. Moreover N cells appear to be more reactive than A cells and Necturus more reactive than Ambystoma. The possible function of the AChE activity inside the vesicles is discussed as a mechanism of protons donor or as peptidasic activity acting on various peptides present in the vesicle. PMID- 2776172 TI - Effects of mammal submandibular gland glycoderivatives on human hemostatic system. AB - The aim of this study was to investigate the effects of glycoconjugate components extracted from the submandibular glands of four mammal species (rat, mouse, rabbit, hare) on human hemostatic system. The following analyses were performed: thromboelastography and hemocoagulation screening tests (Thrombin Time, Prothrombin Time, Partial Thromboplastin Time). Findings showed that all glycoconjugates induce modifications of fibrin clot formation time, modulus of elasticity and some hemocoagulation tests (TT, PTT). The anticoagulant effects were of inhibitory type. PMID- 2776171 TI - Changes in the nucleotide metabolism of Ehrlich ascites tumour cells during their growth in vivo. AB - During the transition of Ehrlich mouse ascites tumour cells from the proliferating into the resting phase of growth a tremendous loss of purine and pyrimidine compounds was quantitated by ion-pair reversed-phase high performance liquid chromatography. This change is accompanied by a distinct decline in the incorporation rates of adenine, hypoxanthine, and adenosine. Inorganic phosphate stimulates the low rate of hypoxanthine incorporation of cells in the plateau phase, but lacks any effect on the high rate during proliferation. The mitochondria suffer structural deteriorations and decrease in their cellular content in the course of the plateau phase; however, other changes were not seen by morphometric analysis. The interrelations between nucleotide metabolism, mitochondrial content and the rates of formation and consumption of ATP are discussed. PMID- 2776173 TI - The distribution pattern of NADP+-dependent isocitrate dehydrogenase in rat liver. AB - Activities of the NADP+-dependent isocitrate dehydrogenase were measured along the entire sinusoidal path (1) between small portal tracts and central veins and (2) between regions of adjoining septal branches and central veins in the liver of male Wistar rats using a Lowry technique. The measured activities show a slight increase from the periportal to the perivenous end, whereas no such septal ) perivenous gradient could be established. These profiles of enzyme activity give further support to previous studies, suggesting functional heterogeneity of liver sinusoids and their abutting hepatocytes related to morphological differences of the sinusoidal bed. PMID- 2776174 TI - The gene for intestinal sucrase-isomaltase as member of a gene family. AB - The synthetic oligonucleotide MF59, derived from the rabbit sucrase-isomaltase cDNA sequence, hybridizes to two classes of mRNA in the rat and pig intestinal epithelium as well as to various restriction fragments within the human genome. These results strongly support the hypothesis that the sucrase-isomaltase gene belongs to a gene family. The cloning of a human cosmid containing such a sequence similar to MF59 has allowed us to identify a new member of this gene family which detects a single 6.5 Kb intestinal mRNA in the adult pig. PMID- 2776175 TI - Transfer of information from mRNA to chromosomes by reverse transcription in early development of goldfish eggs. AB - In earlier publications, we have recorded evidence that micro-injection of globin mRNA from rabbit into goldfish eggs leads to the production of rabbit globin in mature red blood cells of goldfish. This paper is concerned with the mechanism of that apparent transfer of genetic information from the cytoplasm to the nucleus. We investigate the possibility that the injected mRNA is reverse transcribed to create a corresponding cDNA in goldfish eggs. By using purified mRNA from rabbit reticulocytes and micro-injection into enucleated and nucleated goldfish eggs, we show that the production of a DNA sequence hybridizes to cloned cDNA of rabbit globin mRNA and appears to become incorporated into the chromosomes of the developing eggs. PMID- 2776176 TI - Regional histochemical aspects of xanthine oxidase activity in ischemic and reperfused small intestine of the rat. AB - The study describes regional changes of xanthine oxidase and succinate dehydrogenase activities as shown by the ischemic and reperfused small intestine of the rat. The results are obtained with enzyme histochemical methods, including densitometrical verifications, and are substantiated with biochemical enzyme determinations. The decrease of xanthine oxidase activity was best visible in the anoxic duodenum and jejunum, where the findings of histochemical enzyme determinations agreed with those achieved biochemically. The activities of succinate dehydrogenase as measured densitometrically may serve as a further control, considering also the typical intracellular distribution of the reaction products. PMID- 2776177 TI - [Long-term socio-pediatric research in Czechoslovakia]. PMID- 2776178 TI - [Childhood AIDS]. AB - The authors emphasize the present importance of AIDS in children and explain the causes of the rising trend of this syndrome in the child population. They summarize the most important epidemiological characteristics of AIDS in children, its pathogenetic differences and the ensuing clinical symptoms. Attention is drawn to the pitfalls of microbiological diagnosis of child infections caused by HIV, and the authors discuss principles, possibilities and perspectives of causal treatment of this syndrome in children. Finally they summarize contemporary experience and knowledge regarding immunization of children infected with the human immunodeficiency virus. PMID- 2776179 TI - [Repair of the dura mater in children using xenogenic pericardium]. AB - The authors report their five-year experience with the use of xenogenic calf pericardium for plastic operations of the cerebral and spinal dura mater which they introduced into neurosurgical practice in 1983. Of 165 grafts they selected 50 which they used in children for the plastic operation of the dura mater above the posterior cranial fossa, above the convexity of the brain and at the skull base. The xenogenic pericardium proved successful and resolved also the shortage of allogenic collagenous tissues (fascia lata, dura mater) used for plastic operations of the dura mater. Moreover, due to its resistance it achieved priority in some indications and localizations. When used, certain conditions must be met to ensure satisfactory incorporation (suitable size, intradural submersion, careful suture). PMID- 2776180 TI - [The effect of Saponinum album Merck on changes in the hemolytic resistance of erythrocytes in relation to age in healthy persons]. AB - The authors elaborated a method for the assessment of the haemolytic resistance of erythrocytes which tests them from the aspect of resistance of their membranes against the haemolytic action of Saponinum album Merck. The physicochemical principle of this method is quite different from the routine test of osmotic resistance of red cells. By the described method red cells of healthy male and female donors aged 4 to 77 years were evaluated. By means of linear regression a significant relationship (with a confidence of 0.999) was proved between parameter M (saponin concentration producing 50% haemolysis (and age). From the evaluation it is apparent that with advancing age in man the resistance of red cell membranes against saponin action declines. From this and from known findings on the mechanism of saponin haemolysis it may be concluded that red cells of all age groups cannot be considered equal as regards the quality of membranes and that these cells undergo certain changes in the course of the lifetime of the individual. PMID- 2776181 TI - [An unusual clinical course in a case of breast carcinoma]. AB - Breast cancer is the most frequent malignant tumour in women. It is maintained that every 12th woman suffers in her life-time from mammary cancer. The author describes a case which as to its course is rare and atypical, although occasionally mammary cancer may take such a course. A generalized tumour of the bone marrow was involved which was manifested 2.5 years before the clinical manifestation of the primary focus in the breast. The case was interesting also from the cytodiagnostic aspect and as regards the histocytological evaluation of the tumour. PMID- 2776183 TI - Changes in endoplasmic reticulum during spermiogenesis in the mouse. AB - Changes in the endoplasmic reticulum of mouse spermatids during spermiogenesis were examined by scanning electron microscopy, applying the OsO4-DMSO-OsO4 method, which permits 3-dimensional observation of cell organelles. At the same time, the endoplasmic reticulum was stained selectively by the Ur-Pb-Cu method, and 0.5 micron-thick sections were prepared for observation by transmission electron microscopy. The results demonstrated stereoscopically the mode of disappearance of the endoplasmic reticulum. In spermatids of the early maturation phase, the endoplasmic reticulum was of uniform diameter, branched and anastomosed, forming a complicated three-dimensional network throughout the cytoplasm. A two-dimensional net was also noted to have formed just beneath the plasma membrane and about Sertoli cell processes invaginating the spermatid cytoplasm. As spermiogenesis progressed, the spread-out endoplasmic reticulum gradually aggregated to form a condensed, glomerulus-like structure consisting of a very thin endoplasmic reticulum connected to the surrounding endoplasmic reticulum. This structure corresponds to the so-called "radial body". Thus, the endoplasmic reticulum may aggregate, condense, be transformed into a radial body, and be removed from the cytoplasm. The two-dimensional endoplasmic reticulum-net, just beneath the plasma membrane and surrounding processes of Sertoli cells, disappeared in spaces where the three-dimensional endoplasmic reticulum network was scarce. Both the two-dimensional endoplasmic reticulum-net structure and the three-dimensional endoplasmic reticulum network disappeared at the same time, indicating that they may be closely related. PMID- 2776182 TI - Synaptic regulation of paraventricular arginine vasopressin-containing neurons by neuropeptide Y-containing monoaminergic neurons in rats. Electron-microscopic triple labeling. AB - Synaptic regulation of arginine vasopressin (AVP)-containing neurons by neuropeptide Y (NPY)-containing monoaminergic neurons was demonstrated in the paraventricular nucleus of the rat hypothalamus. NPY and AVP were immunolabeled in the pre- and the post-embedding procedures, respectively, and monoaminergic fibers were marked by incorporating 5-hydroxydopamine (5-OHDA), a false neurotransmitter. The immunoreaction for NPY was expressed by diaminobenzidine (DAB) chromogen, and that for AVP by gold particles. The DAB chromogen was localized on the surface of the membrane structures, such as vesicles or mitochondria, and on the core of large cored vesicles. Gold particles were located on the core of the secretory granules within the AVP cell bodies and processes. The incorporated 5-OHDA was found as dense cores within small or large vesicular structures. From these data, three types of nerve terminals were discernible: NPY-containing monoaminergic, NPY-containing non-aminergic, and monoaminergic fibers. The AVP cell bodies appeared to have synaptic junctions formed by these nerve terminals as well as by the unlabeled nerve terminals which have small clear vesicles and large cored vesicles. These different types of nerve terminals were frequently observed in a closely apposed position on the same AVP cell bodies. The functional relationships of these three types of neuronal terminals are discussed. PMID- 2776184 TI - Direct connections between the R7/8 and R1-6 photoreceptor subsystems in the dipteran visual system. AB - Musca and related flies have three main photoreceptor subsystems. The R1-6 group has short axons that terminate in the cartridges of the first optic neuropile, the lamina. The cartridges are bypassed by the longer axons of R7 and R8, which run together to terminate at different levels in the underlying medulla neuropile. The present account describes a shallow, previously unidentified zone in the lamina within which R7/8 make glancing contact with R1-6. At the distal border of the cartridge over no more than 3-4 microns depth, the tangentially directed short axon of R6 squeezes between the pair from R7 and R8, forming quite large areas of mutual contact (approximately 7 microns2). Less frequently, R1 is contacted. At least some of these sites contain smaller membrane specialisations indistinguishable from the more numerous gap junctions found more proximally that interconnect the terminals of R1-6. The R7/8 junctions with R6 are of comparable size (0.15 micron 2) and likewise possess symmetrical membrane densities. They provide proposed pathways for direct electrical interaction to account for observed electrical input from R7/8 to the R1-6 subsystem. In two cases R7/8 was possibly postsynaptic to R1-6 at a multiple-contact synapse, but even if functional, these sites were so rare that they are unlikely to have much operational significance. PMID- 2776186 TI - Sustained cell proliferation in denervated skeletal muscle of mice. AB - Cellular proliferation in skeletal muscle was measured throughout the first 4 weeks after denervation. Twenty four mice had one leg denervated, and 4 groups of 6 of these mice were injected with tritiated thymidine once daily for 7 days, either during the first, second, third or fourth week after denervation. Autoradiographic labelling of muscle and connective tissue nuclei in denervated muscles was compared with innervated muscles from the opposite innervated legs of the same mice. Labelling of connective tissue and muscle (myonuclear and satellite cell) nuclei was significantly higher in denervated muscles, compared with innervated muscles on the unoperated side. There were no significant differences among labelling of nuclei in muscles denervated for 1, 2, 3 or 4 weeks. However, connective tissue labelling after 1 week of denervation was significantly higher than at later times. This study shows that nuclei of muscle and connective tissue cells proliferate and turnover at high levels for at least one month after denervation. PMID- 2776185 TI - Changes in lectin binding of lumbar dorsal root ganglia neurons and peripheral axons after sciatic and spinal nerve injury in the rat. AB - The effects of chronic lesions of rat lumbar spinal or sciatic nerves on the binding of Glycine max (soybean) agglutinin to galacto-conjugates, in small- and medium-size primary sensory neurons of the L4 and L5 dorsal root ganglia, were examined over a 580-day period. Spinal nerve section resulted in a marked decrease in the population of stained neurons within 7 days. However, despite some retrograde morphological changes triggered by axonal injury, the proportion of stained nerve cells was normalized 180 days postoperatively. This temporary decrease in perikaryal lectin reactivity was initially associated with a marked accumulation of stained material in the nerve, proximal and distal to the site of section, with similar accumulations also being noticeable at each level of injury in sciatic nerves subjected to double ligature. This may reflect the presence of glycocompounds linked to the autolysis of nerve fibers during the phase of retrograde dying-back and Wallerian degeneration. At later stages, stained deposits could be seen scattered along central and peripheral axonal processes of the dorsal root ganglion neurons in the vicinity of the cell body. They may indicate a disturbance in the peripheral turnover of glycoproteins in chronically transected nerves, with piling up of neuronal products. Sciatic nerve injury caused similar but less severe effects which, except for the L4 ganglion cells, were rapidly reversible. PMID- 2776187 TI - Comparison of the enhanced steady-state diffusion of calcium by calbindin-D9K and calmodulin: possible importance in intestinal calcium absorption. AB - The diffusion of calcium was measured using the unidirectional flux of 45Ca across an aqueous layer. The aqueous layer was bounded by two dialysis membranes and convection was eliminated by gelling the aqueous layer with agarose. The apparent self-diffusion coefficient was determined by the dependence of the tracer flux on the diffusion distance. The apparent self-diffusion coefficient increased linearly with the concentration of calbindin-D9K and calmodulin, but the effect of calmodulin was markedly less than that of calbindin-D9K. This difference is attributed to the lower association constant for calmodulin. The ion-exchange resin Chelex-100 also increased the steady-state of 45Ca, but the effect of Chelex-100 was much less efficient than the effect of calbindin-D9K. The mechanism of enhanced diffusion was attributed to an enhanced gradient of total 45Ca. These results indicate that the steady-state unidirectional calcium flux is a superposition of free calcium diffusion and bound calcium diffusion, with only a small contribution due to a 'bucket brigade' mechanism. We suggest that this phenomenon may be important in calcium absorption across the intestine. PMID- 2776189 TI - Quantitation of bovine sperm cytoplasmic calcium with Quin-2 and Fura-2: evidence that external calcium does not have direct access to the sperm cytoplasm. AB - Internal calcium levels of sperm loaded with Quin-2 in the absence or presence of exogenous calcium were 63 +/- 5 and 189 +/- 19 nM, respectively. These values were similar to those determined by Fura-2. Surprisingly, however, dye loaded sperm depleted of internal calcium did not take up calcium from the medium into the cytoplasm upon re-addition of this ion. Uptake was rapid and maximal, however, if these cells were exposed to the calcium ionophores A23187 or ionomycin. Increasing [Quin-2]i progressively lowered [Ca2+]i in spite of the presence of exogenous calcium during dye loading. This anomaly was not due to interference of the fluorophores with calcium uptake, since exogenous 45Ca2+ was taken up at the same rate and to the same extent by control and fluorophore loaded sperm. This 45Ca2+ uptake was mitochondrial and energy dependent. Also, inhibition of mitochondrial calcium accumulation during dye loading lowered [Ca2+]i to values similar to those observed for calcium depleted sperm. These results suggest an extreme impermeability of the sperm plasma membrane to direct calcium entry into the cytoplasm while substantial amounts of calcium entry occurs into the sperm mitochondria. PMID- 2776188 TI - Sarcoplasmic ionic calcium concentration in neuroleptic malignant syndrome. AB - The neuroleptic malignant syndrome (NMS) is an uncommon but serious adverse effect of antipsychotic medication. Similarities in the clinical picture, and muscle alterations, between NMS and susceptibility to malignant hyperthermia (MH) suggest common mechanisms underlying both disorders. Sarcoplasmic ionic calcium concentration ([Ca2+]i) was measured by means of Ca2+ selective microelectrodes in intact intercostal muscle fibers isolated from NMS patients and from subjects with no evidence of neuromuscular disease, who served as controls. The mean resting membrane potential and [Ca2+]i were -84 +/- 0.4 mV and 0.11 +/- 0.01 microM (mean +/- SEM) in the control subjects, while they were -84 +/- 0.6 mV and 0.51 +/- 0.02 microM in NMS muscle fibers. Only the difference in [Ca2+]i is significant (P less than 0.001). The incubation of control and NMS muscle bundles in dantrolene (10(-6) M) induced a reduction of [Ca2+]i to 0.06 +/- 0.01 microM and 0.20 +/- 0.04 microM respectively. These results show an alteration in sarcoplasmic ionic [Ca2+] in NMS muscle fibers, suggesting that a dysfunction in skeletal muscle plays some role in the pathogenesis of NMS. PMID- 2776190 TI - Quantitation of intracellular free calcium in single myocytes by Fura-2 fluorescence microscopy. PMID- 2776192 TI - [Investigation on an outbreak of allergic pulmonary alveolitis]. AB - 20 allergic alveolitis cases occurred abruptly within 10 days among teachers at a primary school in Shanghai. The cases make up 42.6% (20/47) of total staffs of the school. No patient discovered in pupils (137) though they had enough chance to contact with their teachers suffering the disease. Roentgenography and clinical findings were criteria of diagnosis. The findings of epidemiologic survey showed that the outbreak was caused by a single exposure of same agent, probably associated with sugarcane. The result of examinations in laboratory shows: 1. The content of IgE increased significantly in serum of convalescence patients. 2. Penicillium and Mucor were found as prevailing fungus strains benign isolated from the surface of sugarcane. 3. Did not find ascarid larva in sputum nor eggs in feces. In this paper we inferred reasonably that breathing of dust with fungus may be the cause of the outbreak. PMID- 2776193 TI - [A retrospective investigation of patients with gastric cancer in ward patients]. AB - A retrospective investigation of 1,079 patients with gastric cancer among 181,055 patients in a general hospital showed that 0.59% of all the ward patients suffered from gastric cancer (6:1, male preponderant) , with the age ranging from 41-70, and the peak age was between 50-60. Most (98.24%) were progressive, others (1.76%) were early gastric cancers. Many of the patients with clinical courses over 1 year before hospitalization had histories of gastropathy. Pathological examination of the early gastric cancers showed that the cancers in 15 (78.94%) out of 19 patients were due to malignant change of ulcers. However, our results were not quite similar to previous reports in the distribution, limit, number and microscopic classification of the lesions. There was no obvious discrepancy in lesion display and diagnostic accuracy among the three methods, e.g., regular examination, double contrast examination, and the endoscopy examination (P greater than 0.05). The accuracy of diagnosis might be improved by using multiple examinations of stomach and combination of gastrointestinal examination with endoscopy. PMID- 2776191 TI - Changes in internal ionized Ca2+ and H+ in voltage clamped squid axons. AB - Squid giant axons were injected with aequorin and tetraethylammonium and were impaled with hydrogen ion sensitive, current and voltage electrodes. A newly designed horizontal microinjector was used to introduce the aequorin. It also served, simultaneously, as the current and voltage electrode for voltage clamping and as the reference for ion-sensitive microelectrode measurements. The axons were usually bathed in a solution containing 150 mM each of Na+, K+, and some inert cation, at either physiological or zero bath Ca2+ concentration [( Ca2+]o), and had ionic currents pharmacologically blocked. Voltage clamp pulses were repeatedly delivered to the extent necessary to induce a change in the aequorin light emission, a measure of axoplasmic ionized Ca2+ level, [( Ca2+]i). Alternatively, membrane potential was steadily held at values that represented deviations from the resting membrane potential observed at 150 mM [K+]o (i.e. approximately -15 mV). In the absence of [Ca2+]o a significant steady depolarization brought about by current flow increased [Ca2+]i (and acidified the axoplasm). Changes in internal hydrogen activity, [H+]i, induced by current flow from the internal Pt wire limited the extent to which valid measurements of [Ca2+]i could be made. However, there are effects on [Ca2+]i that can be ascribed to membrane potential. Thus, in the absence of [Ca2+]o, hyperpolarization can reduce [Ca2+]i, implying that a Ca2+ efflux mechanism is enhanced. It is also observed that [Ca2+]i is increased by depolarization. These results are consistent with the operation of an electrogenic mechanism that exchanges Na+ for Ca2+ in squid giant axon. PMID- 2776194 TI - [The determination of toxicity of four insecticides on ground squirrel flea]. AB - This paper reports the results of toxicological effect of four insecticides on Citellophilus tesquorum sungaris. The toxicity of Deltamethrin was the strongest in four insecticides, DDVP & DDT were stronger than 1-(3,4-dichlorophenyl)-2,2,2 trichloroethyl acetate. For the LD50 of four insecticides on suckling blood female flea of two-day-age, were 1.17 x 10(-6) micrograms per flea 1.20 x 10(-3) micrograms per flea 1.25 x 10(-3) micrograms per flea & 3.46 per flea respectively. The data showed that there were marked differences in the susceptibility to the same insecticide between unsuckling blood fleas and suckling blood fleas. Male fleas were more susceptible than female fleas in suckling blood fleas. PMID- 2776195 TI - [Study on inhibiting effect of 14 insecticides on esterase of Culex tritaeniorhynchus from five geographic populations]. AB - Isoelectrofocusing technique was used to study the inhibiting effect of 14 insecticides on esterase isozymes of Culex tritaeniorhynchus from natural populations in Fuzhou, Shanghai, Qingdao, Dalian and Beijing areas. Among 14 insecticides, organophosphates were good inhibitors to all esterase isozymes, but Allethrin, Propoxur, DDT, Dieldrin had no or almost no inhibiting effect on esterase. 26 esterase isozyme bands of Culex tritaeniorhynchus were revealed by isoelectrofocusing. PMID- 2776196 TI - [The evaluation of lipoprotein as a screening test for coronary heart disease]. AB - Up to now there is no screening test suitable for coronary heart disease (CHD) among population. 38 cases of CHD diagnosed by electrocardiographic bicycle exercise and 71 cases with negative results as controls were studied concurrently to evaluate the screening test of CHD. According to the significant difference between the two groups, the ratio of TC/HDL-C.HDL-C/TC.LDL-C/HDL-C.HDL2-C/HDL3-C were selected to evaluate their validity and predictivity etc, on several cutoff vale respectively. TC/HDL-C and HDL2-C/HDL3-C were used in parallel to promote the detective value of CHD to 92%. TC/HDL-C was only selected in stepwise regression formula, so the positive likelihood of five-grade value of TC/HDL-C was calculated and different prior-test probability was estimated to predict the post-test probability of CHD. As a result cutoff value 3.2 of TC/HDL-C could be determined as atherogenic index in chinese population. PMID- 2776197 TI - Accidents/injuries of children in surgical admissions at the University Teaching Hospital in Lusaka, Zambia: a psycho-social perspective. AB - 200 children (0-14 years) with an accident/injury at the surgical admission ward of the University Teaching Hospital in Lusaka were investigated by interviewing children and parents/relatives on especially psycho-social and environmental factors of the accidents. As a result, four major potential causes could be identified: (1) Lack of supervision by parent or teacher; (2) Environmental hazards; (3) Attention seeking and (4) Cultural conflict or lower socio-economic class. On this basis various preventive measures are proposed, on the lines of improving on psycho-social stressors and controlling environmental agents, taking a developmental perspective of the child into account. PMID- 2776198 TI - Antibiotic resistance of Staphylococcus aureus isolates from community acquired soft tissue infections in Bulawayo. AB - Fifty cases of community acquired strains of Staphylococcus aureus causing superficial abscesses were tested for their sensitivity to commonly used antibiotics. Ninety-two percent of isolates were resistant to benzyl-penicillin and ampicillin. Possible causes for this very high level of resistance and the implications for antibiotic usage are discussed. PMID- 2776199 TI - Uncertain gestation and pregnancy outcome. AB - The outcome of pregnancy in 214 women with uncertain or unknown gestation was compared with that of 786 women who knew their dates. Adverse pregnancy outcome such as Cesarean Section, forceps delivery, vacuum extraction, stillbirth and neonatal mortality rates were significantly higher in the groups with uncertain or unknown gestation (P less than 0.005). A number of factors such as education of husband or wife, gestation at booking, material age, and area of upbringing were found to have a significant influence (P less than 0.05) on the ability of a woman to remember her last menstrual period. Ultrasound Scanning was not used to check the expected date of delivery. PMID- 2776200 TI - Initial experience in a special pain clinic in Nigeria. AB - The first 100 patients seen in a Pain Clinic in Nigeria are analyzed and presented. There were 53 males and 45 females aged between 11 and 65 years (means 41.3 years). A variety of ailments brought the patients to the clinic, but arthritis, back pain and spasmodic torticollis were the commonest. Methods of treatment which included acupuncture, transcutaneous nerve stimulation and trigger point injections, depended on the facilities available, the level of intelligence and economic status of the patient, particularly with regard to the use of the transcutaneous nerve stimulator. PMID- 2776201 TI - Hereditary haemorrhagic telangiectasia in Nigeria: case report. AB - A case of hereditary haemorrhagic telangiectasia is described. This is the second case report of this disorder in Nigerians. PMID- 2776202 TI - Mortality pattern in the Emergency Paediatric Unit of Ahmadu Bello University Teaching Hospital, Zaria, Nigeria. AB - Three hundred and seven (307) deaths were recorded out of 3,155 admissions into the Emergency Paediatric Unit of Ahmadu Bello University Teaching Hospital Zaria between January 1st and December 31st 1986, giving a percentage mortality of 9.9 percent. 67 percent of the patients who died were aged between one month and twenty four months, and the overall male: female ratio of deaths was 1:1.04. Measles with complications was the commonest cause of death (24.1 percent) closely followed by protein energy malnutrition (23 percent) and respiratory tract infection (18 percent). Over half of the patients (57.6 percent) died less than 24 hours after admission. As most deaths resulted from preventable conditions, the implications of this finding, and suggestions on how to improve the situation are discussed. PMID- 2776203 TI - Profile of thyroid function and urinary iodine excretion of pregnant women attending Harare Central Hospital antenatal clinic. AB - A preliminary study to determine the iodine status of pregnant women was carried out in the busy referral antenatal clinic of the Harare Central Hospital. Serum free triiodothyronine (FT3), free thyroxine (FT4), thyrotrophin (TSH), and urinary iodine, were determined in 100 pregnant women, and compared with non pregnancy control levels. Visible goitres were observed in 16 percent of the pregnant women, and 70 percent of the serum FT3 results fell below the mean value for the non-pregnancy controls. The mean serum FT4 levels were significantly increased. The serum TSH values of the pregnant and the non pregnant women showed no significant differences. No significant differences were observed between the pregnant goitrous and pregnant non-goitrous women with regard to FT3, FT4 and TSH. The urinary iodine concentration was found to be slightly higher in the goitrous pregnant women than in the non-goitrous counterparts. In 40 percent of the pregnant women the urinary iodine concentration was below 100 micrograms I/g creatinine, and in the 0-25 micrograms I/g creatinine range were 15 percent of the total patient sample. PMID- 2776204 TI - Plasma urea and creatinine levels in very low birthweight (VLBW) infants. AB - Serial longitudinal measurements of plasma urea and creatinine were made in 12 VLBW infants (Birthweight 1500 mg) for 42 postnatal days. Plasma urea and creatinine were high and very variable during the first few days of life, both stabilising to lower levels by the second week. Plasma urea stabilised to very low levels (less than 2 mmol/l) below the accepted lower limit for infants, while plasma creatinine levels (50-70 mumol/l) were within the normal range. Both parameters may be of little help in estimating renal function during the perinatal period while plasma urea may be insensitive to changes in renal function in the post perinatal period. These characteristics of plasma urea and creatinine in VLBW infants must be borne in mind when these parameters are being used to assess renal function. PMID- 2776205 TI - The young pregnant teenager--why the poor outcome? AB - Studies have repeatedly emphasised the poor obstetric outcome in teenage pregnancies. This study examined 444 teenagers of 16 years and under and demonstrated little difference in the outcome between 14 years and under group and 15 to 16 year old. The poor pregnancy outcome, however, was predominantly related to the adequacy of antenatal care. The discussion emphasises the point that teenage pregnancy is not primarily a medical problem and much effort is required to create an awareness so that prenatal care is both accessible and acceptable to the pregnant teenager. PMID- 2776206 TI - Spontaneous uterine rupture in late pregnancy caused by placenta percreta: a case report. AB - Placenta percreta is a rare but a serious complication of pregnancy. A case of spontaneous rupture of uterus at 32 weeks of gestation due to Placenta percreta is reported. A total abdominal hysterectomy was carried out. PMID- 2776207 TI - Abdominal sepsis: the identification of a high risk subgroup using the APACHE II system in twenty-seven patients. AB - The outcome of 27 severely ill patients with intra-abdominal sepsis admitted to I.C.U. was studied. The APACHE II score was done on admission, at 24 hours and at 48 hours. It proved to be an accurate predictor of hospital survival in this group of patients and implications for management are discussed. PMID- 2776208 TI - Tropical ulcers in a remote area in Zimbabwe. AB - There is a dearth of literature on tropical ulcers in the rural areas in the tropics and subtropics. Results of a study of 1680 tropical ulcer patients attending an out patient department of a clinic in a rural district in Zimbabwe over a 14 months period are presented. The ulcers were more common during the wet humid months with 63 percent of the ulcers falling in the 5-14 year age group. There was a male predominance over the female with a ratio of 1.4:1. Culture and sensitivity results of isolates from 8 patients are discussed and the need for further studies on the possible causative organism(s) stressed. Implications of such outbreaks on the already over-burdened health care system are stressed; and the need for the intensification of health education in the prevention of this disease highlighted. PMID- 2776209 TI - A prospective analysis of 620 bone marrow examinations in Zimbabwe: preliminary observations. AB - Of the 1,310 bone marrow examinations performed in a 16-month period in patients with diverse haematological, oncological and other disorders, 620 had sufficient data for analysis. Seventy-nine percent were from the two main hospitals viz: Parirenyatwa and Harare Central Hospitals. Investigation for anaemia (42.6 percent), staging of malignant disease (14.4 percent) and pancytopenia (10.3 percent) formed the commonest triad of indications for requesting the examination. There were 318 (51 percent) males, mean age +/- s.d. of 33.8 +/- 22.6 years (range 6 months to 80 years); and 302 (49 percent) females, mean age +/- s.d. of 32.6 +/- 20.7 years (range 6 months to 78 years) giving a male to female ratio of 1.1:1. Of the 620 patients studied, 452 (73 percent) were adults (M:F ratio of 1:1) mean age +/- s.d. of 42.8 +/- 17.3 years (range 16-80 years); and 168 (27 percent) were children (M:F ratio of 1.1:1) mean age +/- s.d. of 7.3 +/- 4.5 years (range 6 months to 15 years). The three commonest diseases in the combined (adults and children) group were: megaloblastic anaemia (25.2 percent); acute or chronic leukaemia (19.2 percent) and iron deficiency anaemia (10.5 percent). These three diseases respectively accounted for 32 percent, 17.5 percent and 10.8 percent of the cases in the adult (16 years and over) group; whereas in the paediatric (0-15 years) group, the top three diseases were: acute leukaemia (22 percent); Hodgkins and non-Hodgkins lymphomas (14.3 percent) and retinoblastoma (13.7 percent). These preliminary observations indicate some of the commonest haematological and oncological disorders where intense research might be beneficial to the community in Zimbabwe. PMID- 2776210 TI - Progress in postgraduate training in anaesthetics for doctors in Zimbabwe. PMID- 2776212 TI - The greater omentum: its use in the surgical management of severely infected leg soft tissue and bone injuries. Report of two cases. AB - Reported here are two cases of severe burn injuries and scarring of the lower extremities complicated by wound infection which included the involvement of bone. Both cases were managed successfully with the use of free omental graft transplanted to fill the extensive areas of tissue injury. Happily in both cases, amputations were prevented. PMID- 2776211 TI - A case report of cystitis emphysematosa and emphysematous pyelonephritis. AB - The presence of intramural gas in the urinary bladder is rare and gas in the kidney is also rare. Our patient had both conditions. We have not seen these two rare conditions ever described in one patient. Both conditions are commoner in diabetics. Nephrectomy was resorted to after unsuccessful antibiotic treatment of the emphysematous pyelonephritis. PMID- 2776213 TI - Physical and psychologic support for women following mastectomy. PMID- 2776214 TI - The erythroid-specific transcription factor Eryf1: a new finger protein. AB - The erythroid-specific transcription factor Eryf1 binds to DNA sites within regulatory regions of every member of both the alpha- and beta-globin families in chicken. The distribution of these sites suggests that Eryf1 may serve as a general "switch" factor for erythroid development. We have cloned the cDNA for Eryf1 and show that the corresponding mRNA is present in all erythroid lineages, but is absent from non-erythroid cells. We demonstrate that the cDNA encodes the specific Eryf1 binding activity found in erythrocytes. Eryf1 is a basic 38 kd protein containing a pair of highly similar "fingers" with the motif Cys-x-x-Cys x17-Cys-x-x-Cys. The amino acid sequences of these regions bear no resemblance to those found in other regulatory proteins with a similar arrangement of cysteine residues. Our evidence suggests, furthermore, that transition metal ions are unusually tightly bound, or may not be necessary for the sequence-specific DNA binding of Eryf1. PMID- 2776215 TI - A novel DNA deletion-ligation reaction catalyzed in vitro by a developmentally controlled activity from Tetrahymena cells. AB - Developmentally controlled genomic deletion-ligations occur during ciliate macronuclear differentiation. We have identified a novel activity in Tetrahymena cell-free extracts that efficiently catalyzes a specific set of intramolecular DNA deletion-ligation reactions. When synthetic DNA oligonucleotide substrates were used, all the deletion-ligation products resembled those formed in vivo in that they resulted from deletions between pairs of short direct repeats. The reaction is ATP-dependent, salt-sensitive, and strongly influenced by the oligonucleotide substrate sequence. The deletion-ligation activity has an apparent size of 200-500 kd, no nuclease-sensitive component, and is highly enriched in cells developing new macronuclei. The temperature inactivation profile of the activity parallels the temperature lethality profile specific for Tetrahymena cells developing new macronuclei. We suggest that this deletion ligation activity carries out the genomic deletions in developing macronuclei in vivo. PMID- 2776216 TI - Arabidopsis thaliana mutant that develops as a light-grown plant in the absence of light. AB - The signal transduction pathways that lead to chloroplast biogenesis in plants are largely unknown. We describe here the identification and initial characterization of a novel genetic locus which fits the criteria of a regulatory gene located in a central pathway controlling light-mediated development. In the absence of light, these Arabidopsis thaliana mutants, designated det1 (de etiolated 1), constitutively display many characteristics that are light dependent in wild-type plants, including leaf and chloroplast development, anthocyanin accumulation, and accumulation of mRNAs for several light-regulated nuclear and chloroplast genes. The switch between dark and light growth modes thus appears to be a programmed step in a developmental pathway that is defined by det1. We suggest a model where the primary role of light on gene expression is mediated by the activation of leaf development. Further, the recessive nature of the det1 mutation implies that there is negative growth control on leaf development in dicotyledonous plants in the absence of light. PMID- 2776217 TI - The polyclonal and antigen-specific IgE and IgG subclass response of mice injected with ovalbumin in alum or complete Freund's adjuvant. AB - BALB/c mice were injected ip with 1 microgram ovalbumin (OVA) in alum or complete Freund's adjuvant (cFA) and the changes of the IgE and IgG subclass serum levels and isotypes of the anti-OVA specific antibodies determined by radioimmunoassays. By Day 10, OVA in alum had induced a 5- to 10-fold increase of the IgE serum level and an initial decrease of the IgG subclass levels which subsequently increased to two to threefold over the preinjection level. OVA in cFA induced a gradual twofold increase of the IgE serum level, a rapid fourfold increase of the IgG2a level occurring by Day 7, and a gradual two to threefold increase of the other IgG subclasses. Over 90% of the anti-OVA antibodies were of the IgGl isotype with both adjuvants; OVA in alum induced slightly more IgGl anti-OVA antibodies than cFA. In contrast, the OVA in alum injected mice formed significantly more (5- to 10-fold) IgE anti-OVA antibodies than the cFA-injected mice. OVA in alum also induced a large nonspecific increase of the IgE serum level because only approximately 40% of the increase observed on Day 14 was absorbable with OVA, whereas approximately 90% the IgE increase in cFA injected mice was absorbable with OVA. The data demonstrate that mice form mainly IgGl and IgE antibodies to OVA irrespective of the adjuvant. The low specific and lack of nonspecific IgE formation by mice injected with OVA in cFA may be the result of cFA-induced interferon-gamma (IFN-gamma) production because IFN-gamma has been shown to stimulate IgG2a and inhibit IgE secretion in vitro. PMID- 2776218 TI - Tumor necrosis factor-mediated cytotoxicity by tumor-associated macrophages. AB - We have directly demonstrated that macrophages present within solid EMT6 mammary tumors (of BALB/c origin) produce TNF-alpha (TNF). These tumor-associated macrophages lysed WEHI-164, a TNF-sensitive cell line, very efficiently. This cytotoxicity was abrogated in the presence of anti-TNF antisera. In contrast, EMT6 cells, the tumor from which the macrophages were obtained, were not effectively lysed by the macrophages and were 100-fold less sensitive to lysis by recombinant mouse TNF. Thus, marked heterogeneity exists among tumors regarding sensitivity to TNF-mediated cytotoxicity. Similarly, macrophages which infiltrate into EMT6 multicellular spheroids implanted into the peritoneal cavity as well as free cells within the cavity exhibited TNF-mediated cytotoxicity of WEHI-164 cells, but failed to lyse EMT6 cells. The kinetics of lysis by these cells was similar to that of recombinant mouse TNF. PMID- 2776219 TI - Role of the fourth complement component (C4) in the regulation of contact sensitivity. III. In vivo effect of purified C4. AB - Lymph node cells obtained from CBA/J mice 4 days after painting with contact sensitizing agents such as picryl chloride or oxazolone ("4-day" cells), induce contact sensitivity into naive recipient mice by membrane-associated immunocomplexes. This immunizing capacity is abolished after incubation of the cells in serum from mice with high C4 levels (C4H), but not in serum from mice with low C4 levels (C4L), and the inhibitory activity of C4H serum is due to the activation of the early components of the classical complement pathway. The presence of 4-day cells depends on C4 levels: in fact, C4H mice lack these cells because they activate their own complement in vivo, whereas C4L mice fail to activate complement in vivo and possess 4-day cells. CBA/J (C4L) mice injected with purified C4 preparations from the C4H mice BALB/c, lose 4-day cells and show a short-term contact-sensitivity reaction, exactly as BALB/c mice, thus indicating that C4 levels play a role in the control of contact-sensitivity reaction to simple chemical haptens. PMID- 2776220 TI - Comparative effect on humoral response of four different proteins covalently linked on BSA-containing liposomes. AB - The humoral response to encapsulated BSA appears to be a classical TD antigen response with a high ratio of IgG to IgM, whereas that to covalently-linked antigen is more complex, characterized by an enhanced synthesis of IgM, leading to an equal production of IgM and IgG. In a recent paper, we observed that surface-linked Con A on BSA-containing liposomes changed the isotype distribution to encapsulated BSA so as to mimic the response to surface-linked antigen. In the present study, we compared the immune response to BSA in BALB/c mice immunized with the antigen encapsulated into liposomes coated with one of four different proteins: Con A, Myo, MSA, or PWM. The humoral response was analyzed by measurements of antibody production (total Ig, IgM, and IgG isotypes) on serum samples obtained by cardiac puncture. It can be concluded from our results that any surface-linked protein may affect the interaction between liposome-associated antigen and immunocompetent cells. PMID- 2776221 TI - Latrunculins--novel marine macrolides that disrupt microfilament organization and affect cell growth: I. Comparison with cytochalasin D. AB - The latrunculins are architecturally novel marine compounds isolated from the Red Sea sponge Latrunculia magnifica. In vivo, they alter cell shape, disrupt microfilament organization, and inhibit the microfilament-mediated processes of fertilization and early development. In vitro, latrunculin A was recently found to affect the polymerization of pure actin in a manner consistent with the formation of a 1:1 molar complex with G-actin. These in vitro effects as well as previous indications that the latrunculins are more potent than the cytochalasins suggest differences in the in vivo mode of action of the two classes of drugs. To elucidate these differences we have compared the short- and long-term effects of latrunculins on cell shape and actin organization to those of cytochalasin D. Exposure of hamster fibroblast NIL8 cells for 1-3 hr to latrunculin A, latrunculin B, and cytochalasin D causes concentration-dependent changes in cell shape and actin organization. However, the latrunculin-induced changes were strikingly different from those induced by cytochalasin D. Furthermore, while initial effects were manifest with both latrunculin A and cytochalasin D already at concentrations of about 0.03 microgram/ml, latrunculin A caused complete rounding up of all cells at 0.2 microgram/ml, whereas with cytochalasin D maximum contraction was reached at concentrations 10-20 times higher. The short-term effects of latrunculin B were similar to those of latrunculin A although latrunculin B was slightly less potent. All three drugs inhibited cytokinesis in synchronized cells, but their long-term effects were markedly different. NIL8 cells treated with latrunculin A maintained their altered state for extended periods. In contrast, the effects of cytochalasin D progressed with time in culture, and the latrunculin B-induced changes were transient in the continued presence of the drug. These transient effects were found to be due to a gradual inactivation of latrunculin B by serum and were used to compare recovery patterns of cell shape and actin organization in two different cell lines. This comparison showed that the transient effects of latrunculin B were fully reversible for the NIL8 cells and not for the mouse neuroblastoma N1E-115 cells. PMID- 2776222 TI - Immunocytochemical studies with antibodies to three proteins prominent in the isolated microtubule cytoskeleton of a trypanosomatid. AB - The cytoskeleton of Crithidia fasciculata consists of a corset of parallel microtubules enclosing the cell body and closely underlying the plasma membrane. Distinct sets of crosslinks appear to connect tubules to each other and to membrane. Our objective is to determine the composition of these crosslinks and to elucidate the basis of this spectacular example of membrane-microtubule interaction. We purified three proteins (designated COP-33, -41, and -61 by their subunit Mr), which were consistently abundant in highly purified cytoskeletons. All three bound strongly to microtubules in vitro, and the first two induced bundles through periodic crosslinking. Polyclonal antibodies against each have been used to try to localize these proteins in thin sections of cells or whole mounts of cytoskeletons. Antibodies to COP-41 bound specifically to glycosomes, organelles that encapsulate many glycolytic enzymes in these protozoa, and COP-41 has been identified as glyceraldehyde 3-P dehydrogenase. PMID- 2776223 TI - 2-Chloro adenosine triphosphate as substrate for sea urchin axonemal movement. AB - The 2-substituted ATP analog 2-Chloro ATP was tested for its capacity to support axonemal movement. The movement of sea urchin axonemes reactivated with 2-Cl ATP appeared very similar to that with ATP. Detailed waveform analysis indicated that bend angle and shear amplitude were not significantly different for ATP and 2-Cl ATP. Although wavelength differs at particular nucleotide concentrations, if normalized to the beat frequency, it is similar for ATP and 2-Cl ATP. The main difference in the movement with the two analogs was seen in beat frequency and sliding velocity. The Vmax for beat frequency and mean sliding velocity was lower for 2-Cl ATP. The apparent Km for beat frequency and sliding velocity was much lower for 2-Cl ATP. The ratio of these two effects, that is, (Vmax/Km) is higher for 2-Cl ATP. Thus 2-Cl ATP is a good substrate for axonemal movement. The significantly lower Km of 2-Cl ATP was also demonstrated by its ability to support oscillatory motion at concentrations below that for ATP. The observations identify the structures and conformation of substrate necessary to support axonemal movement. PMID- 2776224 TI - Reproductive capacity of sea urchin centrosomes without centrioles. AB - For animal cells, the relative roles of the centrioles and the pericentriolar material (the centrosomal microtubule organizing center) in controlling the precise doubling of the centrosome before mitosis have not been well defined. To this end we devised an experimental system that allowed us to characterize the capacity of the centrosomal microtubule organizing center to double regularly in the absence of centrioles. Sea urchin eggs were fertilized, stripped of their fertilization envelopes, and fragmented before syngamy. Those activated egg fragments containing just the female pronucleus assembled a monaster at first mitosis. A serial section ultrastructural analysis of such monasters revealed that the radially arrayed microtubules were organized by a hollow fenestrated sphere of electron-dense material, of the same appearance as pericentriolar material, that was devoid of centrioles. We followed individual fragments with only a female pronucleus through at least three cell cycles and found that the monasters did not double between mitoses. The observation that fragments with only a male pronucleus repeatedly divided in a normal fashion indicates that the assembly and behavior of monasters were not artifacts of egg fragmentation. Our results demonstrate that the activity that controls the precise doubling of the centrosome before mitosis is distinct and experimentally separable from the centrosomal microtubule organizing center. Our observations also extend the correlation between the reproductive capacity of a centrosome and the number of centrioles it contains (G Sluder and CL Rieder, 1985a: J. Cell Biol. 100:887 896). For a cell that normally has centrioles, we show that a centrosome without centrioles does not reproduce between mitoses. PMID- 2776225 TI - Rapid growth cone translocation on laminin is supported by lamellipodial not filopodial structures. AB - To determine the relationship between growth cone structure and motility, we compared the neurite extension rate, the form of individual growth cones, and the organization of f-actin in embryonic (E21) and postnatal (P30) sympathetic neurons in culture. Neurites extended faster on laminin than on collagen, but the P30 nerites were less than half as long as E21 neurites on both substrata. Growth cone shape was classified into one of five categories, ranging from fully lamellipodial to blunt endings. The leading margins of lamellipodia advanced smoothly across the substratum ahead of any filopodial activity and contained meshworks of actin filaments with no linear f-actin bundles, indicating that filopodia need not underlie lamellipodia. Rapid translocation (averaging 0.9-1.4 microns/min) was correlated with the presence of lamellipodia; translocation associated with filopodia averaged only 0.3-0.5 microns/min. This relationship extended to growth cones on a branched neurite where the translocation of each growth cone was dependent on its shape. Growth cones with both filopodial and lamellipodial components moved at intermediate rates. The prevalence of lamellipodial growth cones depended on age of the neurites; early in culture, 70% of E21 growth cones were primarily lamellipodial compared to 38% of P30 growth cones. A high percentage of E21 lamellipodial growth cones were associated with rapid neurite elongation (1.2 mm/day), whereas a week later, only 16% were lamellipodial, and neurites extended at 0.5 mm/day. Age-related differences in neurite extension thus reflected the proportion of lamellipodial growth cones present rather than disparities in basic structure or in the rates at which growth cones of a given type moved at different ages. Filopodia and lamellipodia are each sufficient to advance the neurite margin; however, rapid extension of superior cervical ganglion neurites was supported by lamellipodia independent of filopodial activity. PMID- 2776226 TI - Full replacement of 2-mercaptoethanol by cysteine plus selenium compounds in augmenting DNA synthesis of mitogen-stimulated mouse spleen lymphocytes. AB - Mouse spleen lymphocytes require 2-mercaptoethanol for maximal mitogenic activation in vitro. Previous studies indicate that the lymphocytes are defective in the cystine transport activity and that they require 2-mercaptoethanol to utilize cystine. 2-Mercaptoethanol catalytically carries cysteine moiety into the cells in a mixed disulfide form. Because cysteine is easily oxidized to cysteine in the culture medium, it has been not easy to precisely examine the effect of near-physiological concentrations of cysteine on the activation of lymphocytes. By controlling the cysteine content in the medium, we have reviewed the effect of cysteine to see if cysteine replaces 2-mercaptoethanol in enhancing the DNA synthesis of lipopolysaccharide-stimulated lymphocytes. It was found that cysteine was less effective than 2-mercaptoethanol, and that cysteine fully replaced 2-mercaptoethanol when a selenium compound was supplemented. The effects of cysteine and selenium compounds were apparently independent and additive. Among the selenium compounds examined, sodium selenite and L-selenocystine were much more effective in stimulating DNA synthesis than sodium selenate and L selenomethionine. PMID- 2776227 TI - Effects of D2O on the movement of chromosomes and the shortening of kinetochore spindle fibers in anaphase in dividing spermatocytes of the grasshopper, Mongolotettix japonicus. AB - Spindles in anaphase of dividing primary spermatocytes of the grasshopper, Mongolotettix japonicus, were examined with a sensitive polarizing microscope combined with a time-lapse video recorder and a cinematographic apparatus. The pole-to-pole distance of the meiotic spindles was increased and the kinetochore fibers were more birefringent in the presence of 40% D2O. However, the rate of shortening of the kinetochore fibers in anaphase was not affected by D2O. This indicates that D2O did not inhibit microtubule disassembly in anaphase, supporting the earlier observations (3, 18) that D2O did not "stabilize" the spindle microtubules at concentrations below 45%. We confirmed that D2O, at the concentration mentioned above, neither promotes nor inhibits the anaphase A. However, the overall sequence of anaphase was considerably extended in the presence of D2O, presumably due to the increased pole-to-pole distance. PMID- 2776228 TI - Uptake of retinol by cultured fibroblasts. AB - Cultured fibroblasts of adult rats were used to determine whether they could take in retinol administered to the culture medium at physiological concentration. After the administration of retinol, cells were observed with a phase-contrast fluorescence light microscope (LM) and a transmission electron microscope (TEM). Retinol and retinyl fatty acyl esters (RFAE) stored in the cells were analyzed with high-performance liquid chromatography (HPLC). It was revealed that these fibroblasts could take in retinol in the medium at a concentration of 1 x 10(-7) M and store it in lipid droplets in the cytoplasm as retinyl palmitate and other RFAE. PMID- 2776230 TI - [Pharmaceutical terminology. II. Present status and perspectives]. PMID- 2776229 TI - [Interactions of drugs with PHEMA hydrogel]. AB - Hydration of polyhydroxyethylmethacrylate (PHEMAs hydrogel with aqueous solutions of medicinal substance) renders it possible to deposit medicinal substances within the hydrogel. At the same time the concentration of the medicinal substances in the hydrogel is higher than their concentration in the hydrating solution. For the nonspecific interactions, which affect the deposition of medicinal substances in hydrogel, their surface tension is of principal importance. With decreasing surface tension the amount of medicinal substances in hydrogel is increased and simultaneously their release into the aqueous medium is decelerated. Interactions of six selected medicinal substances with PHEMA hydrogel were experimentally checked in the in vitro conditions. PMID- 2776232 TI - Inhibition of oxidative phosphorylation by organotin thiocarbamates. AB - A series of triphenyl-, tricyclohexyl- and tribenzyltin compounds have been synthesized and examined as inhibitors of mitochondrial oxidative phosphorylation. All compounds tested inhibit oxidative phosphorylation linked to succinate oxidation by potato tuber mitochondria. All of the organotin compounds inhibit ADP-stimulated O2 uptake linked to succinate oxidation with concentrations for 50% inhibition in the range 2-50 microM. This inhibition is not due to inhibition of electron transport from succinate to O2 per se: none of the organotin compounds at 50 microM substantially inhibit the rate of succinate oxidation in the presence of 2,4-dinitrophenol. Representative organotin compounds at 0.5-50 microM do not act as uncouplers of succinate oxidation. It is concluded that the organotin compounds act as energy transfer inhibitors to inhibit oxidative phosphorylation in potato tuber mitochondria. A similar mode of action of representative organotin compounds was found with rat liver mitochondria. These organotin compounds inhibit a hydrophobic Ca2+-dependent plant protein kinase in the absence but not in the presence of thiols. PMID- 2776231 TI - Isolation and characterization of dominant, pleiotropic drug-resistance mutants in Chlamydomonas reinhardtii. AB - Three independent pleiotropic drug-resistance (pdr) mutants were isolated by selecting for resistance to the anti-microtubule herbicides amiprophos-methyl (APM) and oryzalin (ORY). These three mutants and a previously isolated mutant, ani1 (anisomycin resistance), were semi-dominant in heterozygous diploids, and they displayed varying degrees of resistance to structurally and functionally unrelated inhibitors such as cycloheximide, cryptopleurine, emetine, atrazine, and nonidet P-40. Linkage analysis and genetic mapping suggested that three of the four mutants, including ani1, define a single locus, here named pdr1. The fourth mutant defined a new locus, pdr2, which is located on the left arm of linkage group VI. One pdr1 mutant exhibited unusual genetic interactions, including enhanced ts-lethality and synergistic increases in drug resistance, when combined with pdr2-1 and with herbicide-resistant alleles of three other genes. PMID- 2776233 TI - Pentachlorophenol-induced change of zeta-potential and gel-to-fluid transition temperature in model lecithin membranes. AB - We have determined zeta-potentials for dimyristoylphosphatidylcholine (DMPC) and dipalmitoylphosphatidylcholine (DPPC) membranes by measuring the electrophoretic mobility of multilayered vesicles and the temperatures of the gel-to-ripple-to fluid phase transitions of sonicated vesicles by a photometric method. Some conclusions are: (1) The zeta-potentials of DMPC and DPPC vesicles become negative due to adsorption of ionized pentachlorophenol (PCP), (2) their magnitude changes, step-like, on gel-to-fluid transition and (3) the temperature of the step-like change in zeta-potential decreases with an increase in PCP concentration. (4) PCP exhibits a large effect on membrane structure: It induces an isothermal phase change from the ordered to disordered state, which is enhanced by monovalent salt in the aqueous phase. (5) Both ionized and unionized PCP decrease the melting phase transition temperature and abolish the pretransition, (6) the unionized species increases the melting transition width and (7) the ionized species is more potent in abolishing the pretransition. (8) The shorter chain lipid (DMPC) is more sensitive to the presence of PCP; the maximum decrease in delta Tt is 13 K (DMPC) and 7 K (DPPC) in the presence of ionized PCP. We have shown experimentally, by comparing the delta Tt from photometric studies with the density of adsorbed PCP derived from zeta-potential isotherms, that (9) the shift of the melting phase transition temperature increases linearly with the density of adsorbed PCP. (10) In contrast to membranes made of negatively charged lipids, the transition temperature of DMPC and DPPC membranes in the presence of PCP further decreases in the presence of monovalent salt. The salt effect is due to screening of the membrane surface leading to enhanced adsorption of ionized PCP and a depression in transition temperature. (11) It is shown that both the adsorption and the changes of gel-to fluid phase transition temperature can be described in terms of the Langmuir Stern-Grahame model and (12) proposed that future studies of membrane toxicity of PCP should be focused on its pH dependence. PMID- 2776235 TI - Terpenoids. LIII. Antitumor activity of trichorabdals and related compounds. AB - Among the three types, enmein-, oridonin-, and trichorabdal-type, of diterpenoids from Rabdosia trichocarpa, the latter showed the highest antitumor activity against Ehrlich ascites carcinoma in mice. Their potent activities were attributed to synergistic increase arising from the presence of two active sites in one molecule. In vitro activity against HeLa cells and in vivo activity against P 388 lymphocytic leukemia of diterpenoids and related compounds were also determined, but no synergistic increase in activity due to plural active sites was observed in those cases. PMID- 2776234 TI - Cytotoxicity of cysteine S-conjugates: structure-activity relationships. AB - The cytotoxicity of cysteine S-conjugates was investigated in freshly isolated rat renal proximal tubule cells. The study was designed to determine the contribution of the thiols and of the acylating intermediates formed by cysteine conjugate beta-lyase to the initiation of cytotoxicity. Cell viability was determined by trypan blue exclusion and by lactate dehydrogenase leakage. The S conjugates S-(1,2,2-trichlorovinyl)-L-cysteine, S-(1,2,3,3,3-pentachloro-prop-1 enyl)-L-cysteine and S-(1,2,3,4,4-pentachlorobuta-1,3-dienyl)-L-cysteine, at a concentration of 0.2 mM, reduced cell viability compared to controls from 85% to less than 50% after 3 h. The alpha-chlorinated enethiols formed from these S conjugates are transformed to acylating intermediates. The S-conjugate S-(2 chlorovinyl)-L-cysteine forms an enethiol, which cannot transform to an acylating intermediate and did not reduce cell viability at 0.2 mM; at 1 mM, it resulted in a very slight reduction of cell viability after 3 h. S-(pentachlorophenyl)-L cysteine and S-benzyl-L-cysteine, which form stable thiols after metabolism by beta-lyase, were not cytotoxic at a concentration of 1 mM. The direct acting S-(2 chloroethyl)-L-cysteine (0.2 mM) reduced cell viability after 3 h from 85% to 90% (control) to 40%. The results obtained suggest that reactions of the initial thiol-metabolites with biological macromolecules do not contribute to the induction of cytotoxicity by cysteine S-conjugates and indicate that acylating intermediates formed by cysteine conjugate R-lyase induce cytotoxic effects by non-selective acylation of cellular macromolecules. PMID- 2776236 TI - Studies on topical antiinflammatory agents. I. Synthesis and vasoconstrictive activity of corticosteroid 17-succinyl esters. AB - A series of 17-succinyl derivatives of four corticosteroids was prepared. They were tested for vasoconstrictive activity in humans, using 9 alpha-fluoro-11 beta, 21-dihydroxy-16 beta-methyl-17 alpha-valeryloxy-1,4-pregnadiene-3,20-dione (betamethasone 17-valerate, BV) as a standard. The activities of the 21-chloro 17 methylsuccinate compounds (6A, 6C and 6D) were greater than that of BV. A structure-activity relationship study showed that the activities of the 21-chloro 17-methylsuccinates were more potent than those of the corresponding 21-esters. PMID- 2776237 TI - Modification of macrophage functions by Shosaikoto (kampo medicine) leads to enhancement of immune response. AB - The effects of Shosaikoto, one of the Kampo medicines, on macrophage functions were studied in mice. Oral administration of Shosaikoto (1.2 g/kg of body weight) increased the change of the membrane fluidity of macrophages and diminished prostaglandin E2 production. Moreover, macrophages from mice orally given Shosaikoto phagocytized antigen more efficiently than control macrophages, resulting in presentation of much more antigen to lymphocytes. These results suggest that Shosaikoto enhances the immune response through at least two different routes, that is, through eliminating the inhibition of lymphocyte functions by prostaglandin E2 and through presenting antigen more efficiently. PMID- 2776238 TI - Studies on the constituents of Japanese mistletoes from different host trees, and their antimicrobial and hypotensive properties. AB - The chemical constituents of Japanese mistletoes, Taxillus yadoriki Danser, Taxillus kaempferi Danser, and Korthalsella japonica Engler, epiphyting to different host trees were compared, and the antimicrobial and hypotensive properties of some isolated flavonoids were examined. Two known flavonoid glycosides, hyperin and quercitrin, were isolated from Taxillus yadoriki Danser, together with fatty acids, phytosterol, and phytosterol-glucoside. There was remarkable variation of contents of quercitrin among the plants on different host trees. From Taxillus kaempferi Danser, fatty acids, phytosterol, phytosterol glucoside, quercetin, avicularin, and taxillusin were isolated, and quercitrin and hyperin were also identified. There was no remarkable variation of compositions of flavonoid glycosides among the plants on different host trees. A known flavone glycoside, chrysoeriol-4'-O-glucoside, was isolated from Korthalsella japonica Engler, together with fatty acids, phytosterol, oleanolic acid, and phytosterol-glucoside. Chrysoeriol-4'-O-glucoside is contained in this plant irrespective of the host trees. PMID- 2776239 TI - Radioimmunoassay of 2-hydroxyesterone using antisera raised against antigenic complexes obtained by convenient methods. AB - Antigenic complexes of 2-hydroxyestrone (2-OHE1) were obtained by Mannich reaction of 2-OHE1 and bovine serum albumin (BSA) and by coupling of 2-OHE1 1 glutathione thioether to BSA using glutaraldehyde. Antiserum raised against the antigen obtained by the Mannich reaction had high affinity (Kd = 3.8 x 10(9) M-1) and relatively high specificity; cross reactivities for estrone, 4-hydroxyestrone and 2-methoxyestrone were 2.1%, 10% and 1.5%, respectively. The other antiserum also had high affinity (4.5 x 10(9) M-1) but its cross reactivities for the above three steroids were more than 100%. Concentrations of 2-hydroxyestrone in human plasma were determined by radioimmunoassay with the more specific antiserum and Sephadex LH-20 chromatography to be less than a minimum detectable amount (less than 10 pg/ml) (men), 20.9 pg/ml (women, proliferation) and 26.0 pg/ml (women, periovulation). PMID- 2776240 TI - Contribution of prostaglandins to the renal responses to magnesium lithospermate B isolated from salviae miltiorrhizae radix. AB - The involvement of prostanoids in the improvement of adenine-induced renal failure in rats by magnesium lithospermate B was studied. After intraperitoneal administration of magnesium lithospermate B to renal failure rats, the levels of glomerular filtration rate, renal plasma flow and renal blood flow were increased. Urinary excretions of prostaglandin E2 (PGE2) and 6-keto-prostaglandin F1 alpha (6-keto-PGF1 alpha) in renal failure rats were increased by the administration of magnesium lithospermate B, while that of thromboxane B2 had no effect. Pretreatment with indomethacin abolished the improving effect of magnesium lithospermate B on renal function concomitantly with markedly suppressed urinary excretion of prostanoids. These results suggest that the increased formation of PGE2 and 6-keto-PGF1 alpha might contribute to the improvement of adenine-induced renal failure in rats by magnesium lithospermate B. PMID- 2776241 TI - Effect of dietary alpha-linolenate/linoleate balance on collagen-induced platelet aggregation and serotonin release in rats. AB - Male Sprague-Dawley rats at 3 weeks of age were weaned to a diet supplemented either with perilla seed oil [alpha-linolenic acid (alpha-LnA)/linoleic acid (LA) = 3.66] or with safflower seed oil (alpha-LnA/LA less than 0.01) for 5-6 weeks. The eicosapentaenoic acid (EPA)/arachidonic acid (AA) ratio in platelet phospholipids was much higher in the perilla oil group than in the safflower oil group. Platelet aggregability determined turbidometrically varied greatly among individual animals, and the difference in platelet aggregability between the two dietary groups was relatively small when higher concentrations (15 and 20 micrograms/ml) of collagen were used. However, when platelet aggregability was determined as an all-or-none phenomenon at lower concentrations (7.5 and 10 micrograms/ml) of collagen, a very distinct difference was observed between the two dietary groups; aggregability was much lower in the perilla oil group than in the safflower oil group. Collagen-induced serotonin release from platelets was significantly reduced in the perilla oil group as compared with the safflower oil group. These results emphasize the importance of estimating aggregability at threshold concentrations of collagen and confirm that dietary manipulation of the essential fatty acid balance could be useful in reducing the thrombotic tendency. PMID- 2776242 TI - Amino acid sequences of 60B8 antigens induced in HL-60 cells by 1,25 dihydroxyvitamin D3. The antigens are identical with macrophage-related protein 14 and -8. AB - A differentiation antigen 60B8 appeared in human promyelocytic leukemia HL-60 cells which had been induced to differentiate into macrophage-like cells by treatment with 1,25-dihydroxyvitamin D3. The antigen was purified by immunoaffinity chromatography and separated into two proteins, 60B8-A and -B antigens, by reverse-phase high performance liquid chromatography (HPLC). Both proteins were digested with proteases, and the resulting peptides were subjected to amino acid sequence analysis after purification by reverse-phase HPLC. The amino acid sequences of 60B8-A and -B antigens were identical with those of the proteins MRP-14 and -8, respectively, which were recently predicted from the nucleotide sequences of their complementary deoxyribonucleic acid (cDNA) clones by Odink et al. (Nature (London), 330, 80 (1987)). Although they did not characterize the chemical properties of the two proteins, our results clearly indicate that macrophage-related protein (MRP)-14 and -8 are expressed without post-translational modification, except that the amino-terminus of MRP-14 is blocked, in differentiated HL-60 cells. PMID- 2776243 TI - Studies on peptides. CLXVII. Solid-phase syntheses and immunological properties of fragment peptides related to human malaria circumsporozoite protein. AB - A glycine-linked tetramer of Asn-Ala-Asn-Pro, a tandem repeated sequence of malaria circumsporozoite (CS) protein, was synthesized by the Boc-based solid phase method, followed by deprotection with 1 M trimethylsilyl trifluoromethanesulfonate-thioanisole in trifluoroacetic acid. In addition, three tetramer-related peptides were similarly synthesized, i.e., a 34-residue peptide [linked with TH, a proposed T-cell epitope of CS, at the C-terminus of the tetramer], a 46-residue peptide and a 59-residue peptide [linked with HA or HA', two proposed T-cell epitopes of influenza hemagglutinin protein, at the N terminus of the above 34-residue peptide]. Their immunological properties were examined by enzyme-linked immunosorbent assay, for which three different congenic strains of mouse were used to raise the specific antibodies. Despite conjugation of T-cell epitopes to the tetramer, the mice of low-responder strains to the tetramer failed to produce any antibody specific to the tetramer. However, with the aid of recombinant interleukin 2 as an adjuvant, the low-responder mice produced antibody with relatively high titers. PMID- 2776244 TI - Studies on the antihemostatic substances in herbs classified as hemostatics in traditional Chinese medicine. I. On the antihemostatic principles in Sophora japonica L. AB - By following the antihemostatic activity of the material according to Tajima's method, the antihemostatic principle was isolated from dried buds of Sophora japonica L., and identified as isorhamnetin [2-(3-methoxy-4-hydroxyphenyl)-3,5,7 trihydroxy-4H-1-benzopyran-4-one]. The antihemostatic specificity of isorhamnetin toward antihemorrhagic compounds isolated previously from hemostatic herbs used in traditional Chinese medicine was examined. PMID- 2776245 TI - A quantitative structure-activity relationship for antitumor activity of long chain phenols from Ginkgo biloba L. AB - With the aim of obtaining compounds with strong antitumor activity, a quantitative structure-activity relationship (QSAR) of antitumor phenolic compounds (long-chain phenols) was derived using the Hansch-Fujita equation. The ED50 values against Chinese hamster V-79 cells were analyzed in terms of log P as the hydrophobic parameter and the energy of the lowest unoccupied molecular orbital (ELUMO) calculated by using the modified neglect of differential overlap (MNDO) method as the electronic parameter, by means of multiple regression analysis. It was found that the activities mainly depended on log P (an optimum log P of 8.3) and a low-lying ELUMO value. 4-Undecylcatechol, selected on the basis of the above results, exhibited strong antitumor activity against Sarcoma 180 ascites and P-388 lymphocytic leukemia. PMID- 2776246 TI - Inhibition of acyl coenzyme A: cholesterol acyltransferase by 3-hydroxy-3 methylglutaryl coenzyme A reductase inhibitors. AB - Relatively high concentrations of MK-733 (simvastatin) and MK-803 (lovastatin, mevinolin), which are 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitors, were found to inhibit acyl coenzyme A: cholesterol acyltransferase (ACAT) of rabbit intestinal microsomes with IC50's of 2.0 x 10(-5) and 3.6 x 10( 5) M, respectively. Dihydroxy acid forms of both MK-733 and MK-803 did not inhibit ACAT activity. A kinetic analysis using a Lineweaver-Burk plot indicated that MK-733 is a competitive inhibitor of ACAT, with a Ki value of 1.2 x 10(-5) M. PMID- 2776247 TI - Araguspongines B, C, D, E, F, G, H, and J, new vasodilative bis-1 oxaquinolizidine alkaloids from an okinawan marine sponge, Xestospongia sp. AB - Nine new vasodilative alkaloids, araguspongines A, B (1), C (2), D (3), E (4), F (5), G (6), H (7), and J (8), were isolated from an Okinawan marine sponge, Xestospongia sp. On the basis of chemical and physicochemical evidence, the absolute stereostructures of araguspongines B, D, E, F, G, H, and J were determined respectively as 1, 3, 4, 5, 6, 7, 8, and the relative stereostructure of araguspongine C was determined as 2 having two 1-oxaquinolizidine moieties. Araguspongines B, D, and E each comprised a pair of the enantiomers, 1a and 1b, 3a and 3b, and 4a and 4b, respectively. PMID- 2776248 TI - Ionophoretic activities of oligopeptide lactones and resin-glycosides in human erythrocytes. AB - Oligopeptide lactones (theonellapeptolides) isolated from the Okinawan marine sponge Theonella swinhoei and resin-glycosides (merremosides) from the tuber of an Indonesian medicinal plant Merremia mammosa were examined regarding their activities in transporting Na+, K+, and Ca++ ions into human erythrocytes. Each of these lactones, which had been shown, using a supported liquid membrane, to have an ionophoretic effect on the alkali metal ions, transported the ions to a different extent. The ion transporting activities of these compounds were completely lost when the macrocyclic lactone structures were cleaved by sodium methylate. Resin-glycosides with an additional branched glycosyl residue showed much greater ion transporting activities than those without it. PMID- 2776249 TI - [Experimental duck hepatitis B virus infection]. AB - Cherry valley ducks were infected by intravenous injection of DHBV positive serum in order to study the intrahepatic distribution of DHBsAg and the relation of the degree of hepatic lesions to viremia and humoral immunologic deficiency after surgical removal of Bursa of Fabricius. The anti-DHBsAg serum prepared in our laboratory showed high specificity. There was no cross reaction with HBsAg and DHBsAg was found to be located in the cytoplasm of hepatocytes as well as bile duct epithelial cells which usually showed stronger staining quality. The histopathology of liver revealed normal/mild hepatitis in the control group, moderate/severe hepatitis in the infected group. In comparison, hepatitis in the infected group was more severe in the older ducks than the ducklings, in those viremia-positive ones than in the negative ones, and in the bursectomized than in the non-bursectomized ducks. Evidently, the hepatic lesions were mostly due to DHBV infection in this series, although some other environmental factors could not be ruled out entirely. The present investigation shows that Cherry valley ducks are one of the best spices for experimental DHBV infection, and bursectomized ducks with humoral immunodeficiency might provide a reliable and useful model for the study of pathogenesis of hepatitis B virus infection. PMID- 2776250 TI - ["Ghost" bodies and calcification in experimental coronary artery atherosclerosis in pigeons]. AB - Nineteen young pigeons (columba livia domestica) fed on cholesterol (0.5 g per day per bird) for 31 weeks were studied by electron microscopy focusing on calcification in coronary artery atherosclerosis. After 24-31 weeks of cholesterol feeding, smooth muscle cells (SMCs) in the media layer showed an obvious proliferation. Many of these cells had bulbous cytoplasmic pseudopod-like processes connecting with the cell body by narrow stalks. Many of the cytoplasmic pseudopodia as well as the detached cell fragments, i.e. "ghost" bodies measuring 606-2235 nm in diameter were membrane-bounded, but without basement membrane, often with a fibrillo-granular content and occasionally seen as residue of organelles of the SMCs. Additionally, in the interstitial spaces, much vesicle like deeply osmiophilic material was obtained, suggesting degradation products of SMCs. Furthermore, in the matrix, there were many calcium spherules measuring 551 3006 nm in diameter, consisted of 1-3 layers of radiating crystalline spicules. The mechanism of formation of "ghost" bodies and calcification is discussed. PMID- 2776251 TI - [Injurious effect of lipid peroxidation on human endothelial cells in vitro]. AB - Lipid peroxidation (LPO) was initiated and facilitated in cultured human endothelial cells (ECs) by treating the cells with diamidel first. The concentration of lipid peroxide in the cells and medium increased with the increase of diamide concentration. Under SEM and TEM, 0.05 x 10(-4) M diamide might induce ultrastructural changes. The prominent changes were contraction, plasma membrane blebbing, and rounding, swelling and dilatation of mitochondria. Vacuolization appeared in cells at 4.0 x 10(-4) M diamide, A decrease of prostacyclin synthesis in these cells accompanied the morphologic changes. The results showed that ECs are sensitive to LPO, suggesting that LPO may play an important role in atherogenesis. PMID- 2776252 TI - [An immunohistochemical study on pre-S proteins of hepatitis B virus]. AB - An indirect immunohistochemical technique was established to detect pre-S1 and pre-S2 proteins in liver with monoclonal antibodies, and altogether 80 samples of liver were studied. Under light microscope, pre-S1 and pre-S2 were known to be expressed in a similar way and might be divided into three patterns: diffusion type, inclusion type and membrane type. Membranous type expression of both pre-S1 and pre-S2 was associated with activity of the liver diseases and liver cell necrosis. Pre-S1 and Pre-S2 were also expressed in several samples of hepatocellular carcinoma. PMID- 2776253 TI - [Distribution of lectin-receptors in ovarian cystadenoma and cystadenocarcinoma]. AB - 55 cases of ovarian cystadenoma and cystadenocarcinoma were investigated with a panel of twelve various lectins and ABC technique. Results showed that RCA and WGA reacted with all the tumors, indicating that these two lectins are possibly functional differential markers of both ovarian mucinous and serous tumors. LCA, DBA and SJA might be of considerable help in differential diagnosis of serous cystadenoma and cystadenocarcinoma. PSA probably was a marker indicating malignant change of mucinous cystadenmas. Since there were different reactivities in mucinous and serous cystadenoma, SJA, DBA and SBA might be considered as the functional markers in differentiating these two different types of ovarian cystadenoma. PMID- 2776254 TI - [Study of haemorheology in the process of invasion and metastasis after subcutaneous transplantation of mouse uterine cervix carcinoma U14]. AB - Mouse uterine cervix carcinoma U14 was transplanted into 615-strain inbred mice. 13-14 animals were sacrificed on the 5th, 9th, 15th, and 19th day respectively. Histological and haemorheological studies were done for each mouse. Histological examination showed that tumor invasion was slight on the 5th day after transplantation (I-III grades). The invasive behaviour of tumor cells was more active on the 9th day after inoculation. On the 15th day, tumor invasive behaviour was obviously exhibited and lymphatic metastasis occurred in 17% of the cases. On the 19th day the invasive behaviour of tumor cells was over invasive grade III, and lymphatic metastasis was seen in all cases. Haemorheological investigation showed no remarkable change on the 5th day. Plasma viscosity, aggregation of red cells and blood viscosity increased significantly on the 9th day after transplantation. Contrarily, on the 15th and 19th day after transplantation, all the four haemorheological values showed significant, changes; namely, in the invasive stage, there was obvious increase in three haemorheological values; while in the metastatic stages all the four haemorheological values showed significant decrease. The results are discussed. PMID- 2776255 TI - [Electron microscopic observations of Campylobacter pyloridis in chronic gastritis]. AB - Gastric biopsies from 150 cases of chronic gastritis were studied by electron microscopy. The infection rates of Campylobacter pyloridis (CP) were 95.3% (85 cases) and 69.2% (65 cases) in superficial gastritis and atrophic gastritis respectively. A close relationship was seen between quantity of the bacteria and activity of the disease. Electron microscopy showed that CP usually damaged the columnar and pit cells of the stomach, resulting in necrosis and active inflammation of the mucosa, and infection of CP might act as a very important pathogenic factor of chronic gastritis. PMID- 2776256 TI - [Cell kinetics in intestinal metaplasia and gastric carcinoma]. AB - 48 specimens of gastric mucosa, including those of normal mucosa, intestinal metaplasia, atypical hyperplasia and carcinoma, were studied with in vitro 3H-TdR double labeling autoradiographic technique. On the basis of cell kinetics, intestinal metaplasia might be divided into two types: Type A consisted of those cases in which the values of LI, Ts and Tc were approximately closer to those of normal mucosa. The labeling cells appeared in the lower two thirds of the intestinalized glands, including small intestinal type and the complete type of colonic intestinal metaplasia. In type B, the average values of LI were higher. Ts and Tc values approximated those found in carcinoma a. Type B consisted mostly of the incomplete type of colonic intestinal metaplasia. The above evidence suggests that type B intestinal metaplasia is precancerous. PMID- 2776257 TI - [Ultrastructural studies on invasion of inner limiting membrane by malignant tumor cells]. AB - In order to observe the process of invasion, retina of rat was used as a model to substitute the inner limiting membrane of retina for the basement membrane. Retina invaded by esophageal carcinoma cells and B16 melanoma cells upon the inner limiting membrane was studied by scanning and transmission electron microscopy. The results showed that the inner limiting membrane was destroyed by the two kinds of tumor cells mentioned above. The process of destruction was followed by a series of transformation in the inner limiting membrane, i.e. folding, swelling, thickening, and granulation. The inner limiting membrane was dissolved focally as a result of transformation, and then tumor cells invaded the retina through these dissolved regions. It seems that, like a barrier, the inner limiting membrane plays a similar role as the basement membrane. PMID- 2776258 TI - [Ultrastructural study of 9 cases of cerebellar hemangioblastoma]. AB - Ultrastructural study of 9 cases of cerebellar hemangioblastoma demonstrated the presence of three major component cells: endothelial cells, pericytes, and stromal cells. These three kinds of cells share the following similar fine features: presence of micropinocytic vesicles, lots of microfilaments, hemidesmosomes, and basement membranes. Weibel-palade bodies were found not only in the endothelial and stromal cells but also in the pericytes. We support the idea that these three kinds of cells belong to a common lineage. Ultrastructurally, pericytes show less differentiation than endothelial and stromal cells. Some transitional forms between pericytes and endothelial cells, or between pericytes and stromal cells were obtained. We suggest that pericytes probably have the capacity of being transformed to endothelial and stromal cells. PMID- 2776260 TI - [primary nursing is thorough investigations of patients]. PMID- 2776259 TI - [Morphological observations of collagen type I and type III in experimental liver fibrosis]. AB - Rats receiving intravenous injection of human albumin (4 mg/rat) once biweekly developed liver fibrosis. The lesion seemed to have little relation to hepatocellular injury. The incidence of liver fibrosis increased with the length of immunization, ranging 80%-86% after 30-60 days. The whole process of experimental liver fibrosis may be divided into three phases. The first is the initial stage of fibroplasia (from the first day to the time of 15 days after start of immunization). In this phase, Ito cells were activated and collagen type I and type III began to increase. The second is the activated stage of fibroplasia (from the 15th to the 60th day after the beginning of immunization), in which collagen type I and type III reached the maximum and myofibroblasts as well as 'transitional cells' proliferated with deposition of collagen fibers. The third phase is the stage of post-fibroplasia (the period after elimination of immunization). Collagen type III diminished gradually while collagen type I remained increasing. Our findings indicated that fibroplasia occurs at the very beginning of liver injury. This suggest that treatment of liver fibrosis must be considered simultaneously with treatment of acute hepatitis. PMID- 2776261 TI - [The relation of type A behavior pattern and coronary artery disease]. PMID- 2776262 TI - [Emergency care of multiple traumatic injuries]. PMID- 2776263 TI - [Organized emergency care of critical craniocerebral injury]. PMID- 2776264 TI - [Observation and care of pediatric autism]. PMID- 2776265 TI - [100 cases of investigations on the psychological needs of in-patients]. PMID- 2776266 TI - [The relation of lesions of the testis and acute injury and chronic disease of the kidney]. AB - In this paper, the testicular routine sections of ninety autopsy cases of males between 20 and 29 years old were studied. The autopsies were performed in the department of pathology at the Bowman Gray School of Medicine of Wake Forest University in the United States. Primary pathological diagnoses were divided into acute injury (63 cases) and chronic disease (27 cases) groups. Using the following criteria, the authors divided the testicular changes into three stages: (1) The early stage (about 4th day): There was slight sloughing and disorganization of the germinal epithelium. Acute group occurred 43 cases, chronic 6 cases. (2) The middle stage (about 15th day): The basement membrane of the tubules was slightly thickened. Sloughing, disorganization and degenerative changes of various germinal cells were obvious. Giant cell formation was present. Acute group occurred 17 cases, chronic 8 cases. (3) The late stage (longer than 25 days): The diameter of the testicular tubules was obviously reduced, the basement membrane was very thickened; various germinal cells disappeared. Only Sertoli cells or just hyalinized fibrous tissues were seen. Interstitial fibrosis and Leydig cells were atrophied. These results indicated that the longer the duration, the serious the lesions. Based on the results of the above observation, the authors emphasize that the lesions of the reproductive glands play an important role in the pathogenesis of disease. It is reasonable in believing that we should use drugs or herbs which might help and protect the "Shen" and Semen for the treatment of the patients as early as possible, no matter whether or not they have sexuality impaired. PMID- 2776267 TI - [Observation of qi-gong treatment in 60 cases of pregnancy-induced hypertension]. AB - Qi-gong relaxation exercise was used for treatment of pregnancy induced hypertension(PIH). Patients exercised 3 times a day until labor. In this study, there were two groups with 60 cases of PIH who had delivered in each group, they were treated by Qi-gong for one group and by medicine for another used as control. The clinical efficacy was evaluated according to PIH combined scores showed effective for 54 cases (90.0%) in Qi-gong group and 33 cases (55.0%) for the control group (P less than 0.01). Meconium stain in amniotic fluid was present in 12 cases (20.0%) in Qi-gong group and 29 cases (48.3%) in the control group (P less than 0.05). The incidence of abnormal hematocrit (greater than 35%) before treatment was 52.4% and decreased to 23.8% (P less than 0.05) in Qi-gong, while in the control group was 35.7% before treatment and 45.2% after treatment (P greater than 0.05). The mean value of blood E2 by RIA showed increased from 22.97 +/- 13.16 micrograms/ml to 33.74 +/- 34.01 micrograms/ml after Qi-gong treatment in 29 cases. The microscopical observation of finger nail capillaries showed various degrees of improvement of microcirculation after Qi-gong exercise for 17 cases and after a course of Qi-gong treatment for 11 cases in Qi-gong group. While for the control group, there was no changes after sit-still for some time.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2776268 TI - [Studies on stimulating circulation to end stasis in scleroderma]. AB - Of 725 cases of scleroderma, 265 were of systemic type (the sex ratio being 1M:6F) and 460 of circumscribed type (the sex ratio being 1M:9F). The patients were divided into three groups and treated with three different stimulating circulation to end stasis (SCES) prescriptions. Satisfactory therapeutic effects were obtained in all. According to the clinical practice and laboratory findings, although SCES therapy exerted manifold actions on the disease, it not only softened the indurated connective tissues, tonified the body and improved the symptoms, but also improved laboratory indexes as follows: nailfold bed capillary, parameter of the peripheral blood stream in patients, content of urinary 2-ketol, 17-KS, free corten, serum joint-hexose, amino-hexose and histopathology including ultrastructure of the skin. The main effect was the improvement of circulation, especially the microcirculation and regulation of the metabolism of the connective tissues. Great attention should be paid to the drug's function of softening the indurated connected tissues. For further investigation, the authors have stressed three important points: screening of clinical symptoms and signs, examination of blood circulatory disturbances, and examination of pathological changes of the connective tissue. The necessity of developing new criteria for judging the therapeutic effects was emphasized. PMID- 2776269 TI - [Longdan jiechuan decoction in the management of bronchial asthma]. AB - Ninety-six cases of bronchial asthma (male 44, female 52; age: 7-73) were treated with oral Longdan Jiechuan Decoction. After one year follow up, the clinical efficacy was as follows: clinical curative rate 29.2%; marked effective rate 29.2% with the total effective rate of 97.9%, which were significantly higher than that in the control group treated with routine WM(P less than 0.01). The average PEF(288.2 +/- 92.5, 306.8 +/- 98.4 L/min) in the herbal group after half year and one year orally administered was significantly higher than the value of premedication (199.0 +/- 81.4 L/min) (P less than 0.01) and that of the control group (P less than 0.001). Patients condition might be further improved if the decoction were given according to the circadian rhythm of ventilation. PMID- 2776270 TI - [Genetic characteristics in yang deficiency patients]. AB - With regard to genetic aspects, the authors determined the HLA typing in 50 cases of Yang deficiency (YD) syndrome and 230 healthy controls. Rohrer index and costae arcuarial angle were also measured in 50 cases of YD syndrome and 60 healthy controls. The results showed that the distributional frequencies of HLA B5 (P less than 0.05), CW3 (P less than 0.01) and A9 (P less than 0.05) in YD were significantly lower than those in normal controls. It reflected the genetic characteristics of YD syndrome indirectly. The YD patients had higher Rohrer index (more than 1.50) than normal controls. The costae arcuarial angle of YD group was 80 +/- 14.35 degree (mean +/- SD), and that of normal controls was 69.5 +/- 11.83 degree. These indicated that fattiness was more often seen in the YD group. PMID- 2776271 TI - [Inhibitory effects of new-breviscapine on thrombosis in vivo]. AB - New-Breviscapine is an anti-platelet compound with some kinds of salts extracted from a Chinese herb Erigeron breviscapus. In aortic thrombus formation in rabbits, the platelet 5-HT release reaction and platelet destruction could be reduced by the compound, meanwhile aortic thrombosis was inhibited with a clear correlation between drug dosage and its efficacy. It was shown that new breviscapine could inhibit the production of TXB2 and 6-keto-PGF1 alpha by platelets and endothelial cells respectively. The data suggest that new breviscapine has a significant inhibitory effect on thrombus formation in vivo through suppression of platelet functions. PMID- 2776272 TI - [Effects of Codonopsis pilosula (Franch) Nannf on gastric electricity, gastric motility and gastric emptying]. PMID- 2776273 TI - [Analysis of 35 cases of pathology in yin deficiency syndrome]. AB - Thirty-five cases of the pattern of Yin deficiency were studied including 18 cases of Liver and Kidney Yin deficiency, 2 cases of Lung and Kidney Yin deficiency, 15 cases of heat invasion into Ying and Blood with deficiency both in Qi and Yin. These cases displayed the following characteristics: (1) Course of the disease was insidious, protracted and prone to frequent exacerbations. (2) Clinical manifestations resulted mostly from functional impairment or metabolic derangements in vital organs/tissues, thus manifesting pleomorphism and complexity. Pathologic changes could be seen in almost all organs and tissues, being mostly marked in the liver, adrenals, testes, gastrointestinal tract, lungs and heart. The liver showed chronic active inflammatory changes or subacute necrosis. The adrenal cortex was overtly atrophic, involving all zones. Cell cytoplasm was scant and red stained with loss of lipid vesicles. The testis was also markedly atrophic. There was interstitial edema with scattering of convoluted seminiferous tubules. There was mild hyperplasia of the basement membrane. The germinal cell layer was thin and spermatogenesis decreased. Gastrointestinal mucosa was thin generally and submucosal edema was evident. Infiltrating inflammatory cells were predominantly lymphocytes. (3) These changes could be categorized as blood stasis, chronic inflammation, necrosis and atrophy that signify degeneration with impairment or loss of function. As a whole, Yin deficiency syndrome is merely a nonspecific term that covers a conglomeration of sundry chronic disease state. PMID- 2776274 TI - [Changes of the sex hormones in female type II diabetics, coronary heart disease, essential hypertension and its relations with kidney deficiency, cardiovascular complications and efficacy of traditional Chinese medicine or qigong treatment]. AB - In this study 31 normal child-bearing women, 62 postmenopausal women, 93 cases of female type II diabetes (18 child-bearing and 75 postmenopausal cases), 53 cases of coronary heart disease (11 child-bearing and 42 postmenopausal cases) and 38 cases of essential hypertension (8 child-bearing and 30 postmenopausal cases) were investigated. The average score of Kidney deficiency was 22.9-8. 5 before treatment with the combination of TCM and WM. With the treatment of TCM in diabetes and coronary heart disease and of Qigong in essential hypertension, the score decreased to 11.5-4. 4 (P less than 0.001). Serum/saliva estradiol (E2), the ratio of E2 to testosterone (T, E2/T) and progesterone (P) decreased before treatment of TCM or Qigong. After treatment E2 and P value increased; the ovarian endocrine function was improved; the special symptoms of the diseases relieved, fasting blood glucose levels in diabetics, the frequency and severity of angina pectoris in coronary heart disease and the blood pressure in essential hypertension significantly decreased respectively (P less than 0.01). The study suggested that there are certain relations between ovarian endocrine disfunction and Kidney deficiency. The more severe the "Kidney deficiency" was, the more significant the changes of sex hormone were. PMID- 2776275 TI - [Observations on the anti-aging, antihypertensive and antihyperlipemic effect of Apocynum venetum leaf extract]. AB - The effect of Apocynum venetum leaf extract on hypertension, hyperlipemia, SOD content of erythrocyte, platelet aggregation rate, pulse wave transmission time (RP interval) and human diploid cell was studied to evaluate if it has some anti aging effects. The mean BP in 60 cases of the treated group decreased from 171 +/ 19/98 +/- 11 mmHg to 154 +/- 22/91 +/- 10 mmHg and 148 +/- 17/89 +/- 10 mmHg after treatment for 4 and 8 weeks (P less than 0.01). The HDL-C in 40 cases of hyperlipemia increased from 47.5 +/- 13 mg% to 63.9 +/- 18 mg% (P less than 0.01). These results were better than those in the control groups. delta RPF was lengthened from 10.1 +/- 6.0 ms to 15.3 +/- 7.3 ms, which indicated that the cardiac performance was improved. No significant change of platelet aggregation rate was obtained after 5-8 weeks treatment. The retarding effect on cell aging was observed by the morphologic changes of nucleus and the increase of subcultivation from 77 to 80 generations. SOD content of erythrocyte was significantly increased from 546.1 +/- 51 micrograms/gHb to 574.6 +/- 42 micrograms/gHb in 20 cases. So Apocynum venetum leaf extract might have some anti aging effects. PMID- 2776276 TI - [Changes in microstructure and ultrastructure between differentiation of cold and heat syndrome in chronic atrophied gastritis and exfoliative cells]. AB - In this paper, exfoliative cells of fur in 56 cases of chronic atrophied gastritis (CAG) with Cold or Heat syndrome was observed by means of microscopy and electron microscopy. With microscopy, the authors found that keratinization of epithelial cells of fur in Cold syndrome group of CAG were markedly fewer than those in Heat syndrome group (P less than 0.01); while pre-keratinization cells were much more than those in Heat syndrome group (P less than 0.01); the constituent ratio of complete keratinization cells of fur in the two groups were markedly different. With the electron microscopy, fibrosis changes was appeared in pre-keratinization cells of Cold syndrome patients with CAG; desmosome was disappeared; metachromasia was appeared in nucleus; fibrosis change in Heat syndrome group was not obvious. Cells were still joined to one another by fingered protrusion. There were bacterias in both Cold and Heat syndrome groups. The change of exfoliative cells of fur in Cold and Heat syndromes in CAG, probably, can offer us a microcosmic sign for its early differentiation or diagnosis. PMID- 2776277 TI - [Clinical observation and experimental study on the treatment of diarrhea due to spleen deficiency with jianpiling]. AB - The clinical and experimental results of Jianpiling for treating diarrhea due to Spleen deficiency were reported in this paper. 268 cases in the treatment group were treated with Jianpiling, 8 tablets three times daily for a consecutive period of 40-60 days. The curative rate and the total effective rate were 63.4% and 98.5% respectively. 75 cases in the control group were treated with SASP or Diphenoxylatum Co., the curative rate and the total effective rate being 38.7% and 94.7% respectively. The difference of the curative rate between the two groups was statistically significant (P less than 0.001). The excretory rate of D xylose demonstrated that Jianpiling could increase the resorptive function of small intestine. The experiment on isolated small intestine of rabbits showed that Jianpiling could strikingly inhibit the peristalsis of isolated jejunum and ileum. The effect of relieving spasm of the intestine and alleviating pain was taken by antagonising the exictative function of M-receptor for acetylcholine and directly inhibiting the intestinal smooth muscle. PMID- 2776278 TI - [Studies on the antithrombotic activity of 11 traditional Chinese herbal drugs]. PMID- 2776279 TI - [Traditional Chinese medicine in America]. PMID- 2776280 TI - [Prevention and treatment of cancer by integrated traditional and Western medicine methods]. PMID- 2776281 TI - Serum levels of coagulation-fibrinolysis factors in normal pregnancy, labor and puerperium and in cesarean section delivery. AB - Plasma levels of fibrinopeptide A (FPA), fibrinopeptide B beta 15-42 (FPB beta 15 42), high molecular weight kininogen (HMW-kg), kinin, prekallikrein and kallikrein inhibitor during pregnancy, labor, cesarean section and puerperium were studied in 170 cases of full term normal delivery and 20 cases of cesarean section delivery with 30 non-pregnant women taken as control. Significant increases of FPA, FPB beta 15-42 and kinin during normal delivery and puerperium were found. There was also a significant increase of FPA in the uterine venous blood during cesarean section. Significant decrease of HMW-kg during normal labor and also significant decrease of prekallikrein and kallikrein inhibitor after cesarean section were also seen. Our findings suggested that the hypercoagulable state during pregnancy is due to the increase of thrombin and plasmin activity, and the kallikrein-kinin system may be related to the onset of labor and post delivery uterine contraction. Increase of the FPA in the uterine blood promoted localised coagulation activity during cesarean section. PMID- 2776283 TI - Hemodynamic response to abdominal aortotomy in the anesthetized swine. AB - This study was conducted to determine the hemodynamic response to uncontrolled hemorrhage following aortotomy in anesthetized swine. Eight Yorkshire swine underwent splenectomy and stainless steel wire placement in the anterior infrarenal aorta and were instrumented with Swan-Ganz and carotid artery catheters. Following an equilibration period, the wire was pulled. This produced a 5 mm aortotomy and spontaneous intraperitoneal hemorrhage. Serial measurements of mean arterial pressure (MAP), mean pulmonary artery pressure (MPAP), and cardiac output (CO) were obtained. From baseline to 5 min after aortotomy, there was a profound decrease in MAP in conjunction with a significant decrease in CO and MPAP. After the initial 5 min period, there was a progressive elevation in MAP, CO, and MPAP. Peripheral vascular resistance (PVR) was significantly decreased after aortotomy and returned to baseline after 60 min. From these data, we conclude that aortotomy produces a rapid depression and spontaneous recovery in MAP, CO, and MPAP. Aortotomy also produces a significant decrease in PVR, which is not generally associated with hemorrhagic hypotension. PMID- 2776282 TI - Cocaine depresses the canine myocardium. AB - The effects of cocaine hydrochloride infusion on left ventricular function in the anesthetized dog were observed under controlled heart rate and blood pressure conditions. In every case an immediate decrease in performance, as evidenced by maximal + rate of change of ventricular pressure (dP/dt), occurred and was a linear function of cumulative dose. Maximal (-) dP/dt also declined, indicating a decreased rate of ventricular relaxation. Right atrial and left ventricular end diastolic pressure increased, with no change in cardiac output or cardiac work, whereas coronary flow decreased slightly. This small decrease in coronary flow was probably related to the decrease in contractile vigor rather than a direct effect of cocaine on vascular tone. Although plasma norepinephrine concentration initially increased, ventricular function did not increase and continued to decline with cumulative cocaine dose. Tissue norepinephrine levels measured in isolated heart-lung preparations were not depleted. These findings indicate a direct toxic action of cocaine on the myocardium, decreasing both contractile performance and relaxation state. Plasma cocaine levels were constant during continuous infusion of the drug, indicating that the progressive toxicity observed did not result from increased circulating cocaine. PMID- 2776284 TI - Cardiovascular changes in chronically adrenalectomized conscious rats. AB - Mean arterial blood pressure (MABP), heart rate (HR), stroke volume index (SVI), cardiac index (CI), systemic vascular resistance index (SVRI), and central venous pressure (CVP) were measured in conscious, freely moving, sham-operated (SO) and chronically adrenalectomized (ADX) rats. After 3 weeks of ADX, the rats exhibited hypotension, tachycardia, and diminished SVI and CI. From 3 to 6 weeks after surgery, the HR decreased and SVRI increased. These changes were obscured when the same measurements were obtained in the same rats under enflurane anesthesia. Cardiovascular responses to an epinephrine (0.4 microgram/kg/min) infusion were measured in conscious SO and ADX rats. The magnitude of change from baseline to peak was similar in all groups, indicating that ADX did not alter the responsiveness of the cardiovascular system to epinephrine. The peak MABP response to epinephrine in ADX rats was significantly below that of SO control rats, suggesting that ADX impaired the ability of the cardiovascular system to maintain normal arterial blood pressure. No differences were found in plasma concentrations of Na+, K+, Cl-, PO4 =, or hematocrit that would help to explain the effect of long-term adrenalectomy. The data underscore the cardio-depressant effect of enflurane anesthesia, demonstrate the importance of a conscious rat model in studying the effects of ADX on the cardiovascular system, and emphasize that the full effects of ADX occur over a period of several weeks. PMID- 2776285 TI - Index of refraction. PMID- 2776286 TI - Computerized preparation of a scientific poster. AB - We prepared an attractive and effective poster using a Macintosh computer and Laserwriter and Imagewriter II printers. The advantages of preparing the poster in this fashion were increased control of the final product, decreased cost, and a sense of artistic satisfaction. Although we employed only the above mentioned computer, the desktop publishing techniques described can be used with other systems. PMID- 2776287 TI - Protein deposits on individual hydrophilic contact lenses: effects of water and ionicity. AB - Chemical procedures have been developed for eluting deposits from individual hydrophilic contact lenses using combinations of solvents. Total protein was determined as a function of the FDA-proposed classification system for hydrogel lenses. Group IV lenses (high water content, ionic matrix polymers) contained the greatest amount of protein deposits, while group I lenses (low water content, non ionic polymers) contained the least. Group II lenses (high water content, non ionic polymers) showed an affinity for protein greater than groups I and III (low water content, ionic polymer) but significantly less than group IV. The necessary basic conditions for maximal protein contamination of hydrophilic contact lenses seems to be created through a combination of an ionic polymer existing in a polar, high water content milieu. PMID- 2776289 TI - Soft toric lenses: correcting cylinder greater than sphere. AB - We reviewed soft toric contact lens fitting success in 100 eyes that required greater astigmatic correction than spherical power correction. We found a significantly greater rate of success with lenses having back surface cylinder correction than lenses with front surface cylinder. When back surface optics are used to correct astigmatism with soft toric lenses, the success rate approaches that obtained in random studies of soft lens fitting success. PMID- 2776290 TI - Irregular astigmatism induced by annular tinted contact lenses. AB - Three patients developed irregular corneal astigmatism while wearing annular tinted soft contact lenses on a daily basis for 1.5 to 3 years. There was severe keratometer mire distortion, and photokeratoscopy revealed central and midperipheral corneal topographical irregularities in four of six eyes. In a masked protocol, scanning electron microscopy of four contact lenses revealed physical deformations in three lenses worn on affected eyes. We propose that latent stress vectors were created when the affected contact lenses were tinted. With patient usage, the stress vectors matured into physical deformations that induced irregular astigmatism. The astigmatism resolved upon discontinuing wear of these lenses, and the patients were able to wear other lenses with no recurrence of symptoms. PMID- 2776288 TI - Corneal swelling responses with extended wear in naive and adapted subjects with menicon RGP contact lenses. AB - Overnight corneal swelling responses to Menicon SF-P and EX rigid gas permeable (RGP) contact lenses were determined in 20 human volunteers previously adapted to lens wear and in five volunteers who had no prior contact lens experience. Slit lamp biomicroscopy revealed no evidence of lens adherence in either group. Overnight wear of both lenses produced greater corneal swelling in naive (8.732% +/- 1.50%) than in adapted eyes (5.016% +/- 1.10%) (P less than .00005). These results suggest that, at least for the lenses tested, adaptation to contact lens wear may down-regulate overnight swelling responses to levels at or near no lens wear or daily-wear values for the same lenses. Both the EX and SF-P lenses appear to satisfy Holden's criteria for zero residual swelling, suggesting promise for successful clinical extended wear. PMID- 2776291 TI - Bausch & Lomb CW 79 aphakic extended wear contact lens: multi-year follow-up. AB - We undertook a follow-up case study of 126 patients (146 eyes) to determine success rate and replacement rate of the Bausch & Lomb CW 79 aphakic extended wear contact lens. One hundred eighteen eyes (81%) were successful in wearing the contact lens, and 16 eyes (11%) were reported as contact lenses dropouts. Twelve eyes (8%) elected to receive intraocular lenses (IOLs). A total of 134 lenses were replaced, yielding a replacement rate of 0.3 lenses per eye per year. The average length of follow-up for successful patients was 3.7 years. PMID- 2776292 TI - Atypical amiodarone-induced keratopathy in a patient wearing soft contact lenses. AB - Antiarrhythmic therapy with amiodarone hydrochloride may produce a pattern of vortex corneal epitheliopathy or cornea verticillata. The vortex keratopathy typically occupies the lower third of the cornea, extends superiorly, and is graded according to the degree of extension. Grades I through III describe the amount of vortex change, whereas grade IV describes a generalized granular dusting in addition to the vortex pattern. Grade IV amiodarone-induced keratopathy has been reported from Europe, but no North American series have reported this more advanced epithelial change. We describe a patient who developed grade IV amiodarone-induced keratopathy while wearing soft contact lenses. Of 686 patients treated with amiodarone at the Mayo Clinic and undergoing routine follow-up, this is the first case of grade IV keratopathy we have observed. To our knowledge, this is also the first report of a patient who wore contact lenses and developed this uncommon corneal change while taking amiodarone. PMID- 2776293 TI - Electrolyte composition of lacrimal gland fluid and tears of normal and vitamin A deficient rabbits. AB - Rabbit tears and lacrimal gland fluid were collected simultaneously during pilocarpine stimulation with the goal of comparing the ionic composition of these fluids at various flow rates. Ions measured were sodium, potassium, calcium, magnesium, zinc, chloride, and bicarbonate. Human tears were also analyzed for purposes of comparison. Generally, tears and lacrimal gland fluid do not differ in ionic composition except for zinc and bicarbonate, which are in higher concentration in tears than in lacrimal gland fluid. The ionic composition of tears and lacrimal gland fluid of vitamin A-deficient rabbits was also analyzed. The maximal flow rate of lacrimal gland fluid was decreased in vitamin A deficient rabbits as were calcium levels in tears and lacrimal gland fluid, as compared with controls. Concentrations of other ions generally did not differ from normal levels, indicating that vitamin A deficiency has only moderate effects on lacrimal gland function in the rabbit. PMID- 2776294 TI - On the sources of strain and sex differences in granule cell number in the dentate area of house mice. AB - The origins of strain and sex differences in the number of granule cells in the dentate area of hippocampus were examined in a breeding study employing two inbred strains of mice that differ substantially in granule cell number. Sources of hereditary variation analyzed included autosomes, sex chromosomes, and maternal factors, including cytoplasmic and environmental. The results corroborated those of an earlier study in finding that 80% of the strain variation is attributable to autosomal differences. In addition, there appears to be a cytoplasmic factor that results in a strain-dependent sex dimorphism. The autosomal contribution is attributed to mechanisms operating during the primary phase of granule cell genesis. The possibility that the sex difference results from strain differences in mitochondrial DNA affecting rate of cell death is considered. PMID- 2776295 TI - Nerve growth factor and phorbol esters increase the number of choline acetyltransferase-positive cells in two morphologically distinct classes of basal forebrain neurons in primary cultures. AB - Nerve growth factor (NGF) has been shown to be active in the CNS as a neurotrophic agent. Cholinergic neurons of the basal forebrain are one cell type in the CNS which have been identified as a target for NGF. When dissociated cell cultures from the basal forebrain were treated for 7 days with NGF (20 ng/100 microliters), the number of choline acetyltransferase (ChAT)-immunopositive cells was increased from 30 +/- 6 to 58 +/- 3. Cholinergic cells taken from the basal forebrain exhibit 3 different morphologies: stellate, pyramidal, and bipolar. The NGF treatment was found to increase the number of stellate cells from 7 +/- 2 to 23 +/- 2 and the number of pyramidal cells from 14 +/- 2 to 26 +/- 2, but had no effect on the number of bipolar cells. The activation of protein kinase C by phorbol 12-myristate, 13-acetate (TPA) also increased the number of ChAT-positive cells in a dose-dependent manner. A maximal increase was observed with 10 ng/ml of TPA which increased the number of positive cells from a basal level of 21 +/- 4 to 42 +/- 4. As was the case with NGF, only the stellate and pyramidal cells were affected by the phorbol ester treatment. In co-addition experiments, the cultures were treated with 10 ng/100 of NGF and 10 ng/ml of TPA, with the result that there was no further increase in the number of immunopositive cells over the NGF controls. These results suggest that the mechanisms by which NGF and TPA increase the number of ChAT-positive cells are interactive at some point. The effect of TPA at the higher doses of NGF was distinctly different. When cells were treated with 20 ng/100 microliters of NGF and 0.05-50 ng/ml of TPA, the NGF response was down-regulated to the level of the vehicle-treated controls. PMID- 2776296 TI - Spatial and temporal patterns of neurotrophic activities in rat adrenal medulla and cortex. AB - We have studied the spatial distribution and temporal pattern of expression of neurotrophic factor (NTF) activity present in the rat adrenal gland. Tissue extracts of the densely innervated medulla and sparsely innervated cortex from adult and various developmental stages were assayed for their ability to promote the in vitro survival of embryonic chick ciliary (CG), dorsal root ganglia (DRG) and ventral spinal cord (SC) neurons. NTF activity was found in medulla but not in cortex extracts. NTF activity became first detectable at postnatal day (P) 12. At this developmental stage the cholinergic adrenomedullary innervation becomes functional. Specific activity successively increased in medulla extracts from P16 to P30 as revealed by the CG-assay. No further changes occurred during adulthood. In contrast, activity addressing SC neurons present in P16 and P30 medulla extracts could not be detected in adult stages P90 or P120. In DRG-assays, NTF activity could not be blocked by the addition of anti-NGF antibodies to medulla extracts. The activity was sensitive to heat and protease treatment suggesting its proteinaceous nature. At high concentrations cortex extracts had neurotoxic effects that were also seen when 10 microM of dexamethasone were added to saturated amounts of medulla extract. However, gel filtration of cortex material to remove low molecular components including corticosteroid hormones failed to reveal any NTF activity in these preparations. Adrenal NTF activity therefore appears to be restricted to the densely innervated medullary tissue. Moreover, our results also suggest a distinct temporal pattern of NTF activity in the adrenal gland. PMID- 2776297 TI - Proenkephalin opioid peptide product in the sensory ganglia of the rat: a developmental immunohistochemical study. AB - The distribution and development of Met-enkephalin-Arg6-Gly7-Leu8 (Enk-8) containing neurons in the sensory ganglia of the rat were investigated by means of immunocytochemistry using specific antiserum to this octapeptide. Enk-8-like immunoreactivity first appeared in neurons of the trigeminal ganglia of the 18 day embryo, then in the dorsal root ganglia of the 21-day embryo, thus exhibiting a rostrocaudal gradient in terms of appearance and abundance. The number of immunoreactive neurons in these sensory ganglia peaked on the 5th-7th postnatal days, with several small ones observed in each section (1.0-1.4% of total cell number). About 30-40% of these Enk-8-like immunoreactive neurons were also immunoreactive to substance P. Subsequently, Enk-8-like immunoreactivity in the sensory ganglia was decreased and was rarely detected in adult animals. However, colchicine treatment revealed the presence of several Enk-8-containing neurons per section prepared from mature rat. All these neurons were small (12.5-25 microns; mean +/- S.E.M., 19.86 +/- 3.26 microns). Some of these were also immunoreactive to substance P. These results strongly suggest that the preproenkephalin A system exists in subpopulations of both developing and matured sensory cells in the rat. Functional significance of this is discussed. PMID- 2776298 TI - Expanded retinofugal projections to the dorsal lateral geniculate nucleus and superior colliculus after unilateral enucleation in the wallaby Setonix brachyurus, quokka. AB - We removed one eye of quokkas either neonatally, before retinal innervation of visual centres, or at 35-40 days postnatal, when projections overlap bilaterally and are more widespread than in the adult. Retinal projections to the dorsal lateral geniculate nucleus and superior colliculus at postnatal day 100 were demonstrated following anterograde transport of horseradish peroxidase. There were significant reductions in the size of the dorsal lateral geniculate nucleus and superior colliculus ipsilateral to the remaining eye. However, the extent of retinofugal projections was markedly expanded in comparison to the normal input from one eye. Unexpectedly, projections were expanded to similar extents in the two series of enucleated animals although ipsilateral labelling appeared more dense after neonatal enucleation. In controls, label was restricted to eye specific regions but in enucleated animals there were no label-free zones. Nevertheless the alpha laminae remained distinct in the dorsal lateral geniculate nucleus of enucleated animals. Our findings suggest that binocular interactions are necessary for the segregation and refinement of visual projections but not for the formation of the alpha laminae. PMID- 2776299 TI - Retinal ganglion cell number is unchanged in the remaining eye following early unilateral eye removal in the wallaby Setonix brachyurus, quokka. AB - The expanded visual projections which develop after unilateral eye removal have been associated in some studies, but not in others, with the survival of more ganglion cells than normal in the remaining eye. We have addressed this issue using the small wallaby Setonix brachyurus, quokka. Moreover to determine whether more ganglion cells survive when the eye is removed at a very early stage, we have compared the effect of enucleations at two ages. These were within 3 days of birth, before optic fibres innervate visual centres, and at 35-40 days postnatal, when visual projections are exuberant. At 100 days postnatal, retinal ganglion cells were retrogradely labelled from primary visual centres and tracts with horseradish peroxidase, allowing 24 h for transport. Numbers of ganglion cells were similar between animals enucleated as neonates (X = 231,000, n = 3) and at 35-40 days postnatal (X = 218,000, n = 4). These results were comparable to those of controls (X = 227,000, n = 5). Distributions of ganglion cells were also essentially similar in experimental and control series. However, mean ganglion cell soma diameter was significantly greater than normal in both the area centralis and temporal retina after neonatal enucleation. Our results indicate that in enucleated quokkas increased ganglion cell numbers do not underlie enhanced retinofugal projections. PMID- 2776300 TI - Transient patterns of acetylcholinesterase activity in developing thalamus: a comparative study in rodents. AB - This paper describes acetylcholinesterase (AChE) activity in the dorsal thalamus of several rodents, including rat, mouse, gerbil, hamster and guinea pig. Tissue from fetal, neonatal, and adult animals was studied using histochemical techniques. Developing animals of all species display prominent AChE staining in the ventral medial geniculate nucleus and the ventral posterior nucleus, while adult animals show very light staining in these thalamic regions. Similarly, the dorsal lateral geniculate nucleus of all species shows stronger staining in developing animals than in adults. These data indicate that transient expression of AChE activity in primary sensory thalamic nuclei is a characteristic common to a variety of rodents. PMID- 2776301 TI - Low calcium-induced epileptiform activity in hippocampal slices from infant rats. AB - Ca2+-free solutions evoke spontaneous epileptiform activity in area CA1 of hippocampal slices from adult and young rats at the age of 7/8, 14/15 and 23/24 days. Studies with combined Ca2+-selective and K+-selective microelectrodes showed that this epileptiform activity commenced at higher Ca2+ levels in young than in adult animals. Unlike in disinhibition seizures, [K+]o did not rise to abnormally high levels. We further found that Ca2+ washout curves from young animals were much faster than those from adult slices, suggesting that the extracellular space is wider in young animals than in adult ones. PMID- 2776302 TI - Highly sensitive and rapid radioimmunoassay for aldosterone in plasma and cell culture medium. AB - A radioimmunoassay for aldosterone was developed using a sensitive and specific antibody and 125Iodinated-aldosterone. This assay could be used for direct determination of aldosterone in cell culture medium or after extraction of aldosterone from plasma by solid phase procedure using C18 Sep-pak cartridges. The very low cross-reactivity of the antibody with cortisol and corticosterone (0.005% and 0.04% respectively) would allow the direct determination of aldosterone in cell culture medium without any prior extraction step. Since the incubation is performed at room temperature for 1 h and then, at 4 degrees C for 15 min, the results can be obtained in less than 3 h. The assay was linear from 0.5 fmol/tube to 1500 fmol/tube with an ED50 at 30 fmol/tube. The accuracy of the assay estimated using spiked plasma samples with a known amount of aldosterone give a coefficient of correlation of 0.97 (n = 10) between the aldosterone concentrations found and expected levels. The within-assay variability for plasma aldosterone varied from 4.7 to 11.1% and the between-assay variability ranged from 13.9 to 14.2%. The coefficient of correlation between plasma aldosterone measured by this new assay or by a current assay was 0.8 (n = 43). In summary, the combination of a shortened incubation time with a simple solid phase extraction for aldosterone in serum samples represents the major advantage of the present assay over the current methodology which usually requires a chromatographic separation of the mineralocorticoid prior to radioimmunoassay. Therefore this assay would be useful in experimental studies as well as in clinical laboratory. PMID- 2776303 TI - Capillary-isotachophoretic determination of glutamine in cerebrospinal fluid of various neurological disorders. AB - A rapid and microscale technique to detect and determine L-glutamine (Gln), which is the most abundant free amino acid in human cerebrospinal fluid (Sf), was established on the basis of capillary-isotachophoresis. This system was applied to the measurement of Sf Gln concentration in various neurological disorders. The results showed that Sf Gln was increased under some pathological conditions in the central nervous system, especially those accompanying pleocytosis in Sf. PMID- 2776304 TI - Infrared immunoassay. AB - An immunoassay method based on the labelling of an antigen with a transition metal carbonyl organometallic marker and detection of the label by Fourier transform infrared (FT-IR) spectroscopy is described. The viability of this novel non-isotopic approach, termed infrared immunoassay (IRIA), has been evaluated in the quantitative determination of the tricyclic antidepressant nortriptyline. PMID- 2776305 TI - Dried blood spot glucose measurement in hyperinsulinaemic hypoglycaemia. AB - A retrospective analysis of dried blood spot glucose profiles found them to provide useful information about the progress of a child with hyperinsulinism due to nesidiodysplasia. The potential for their use in the management of such cases is discussed. PMID- 2776306 TI - [C-reactive protein in inflammatory articular diseases: comparison of concentrations in blood and synovial fluid]. AB - We evaluated the diagnostic value of measuring C-Reactive Protein (CRP) in blood and in synovial fluid for the detection of inflammatory articular diseases in 154 patients. High concentrations of CRP in blood were found in microcrystalin arthritis, polymyalgia rheumatica and Horton's disease. Our results show a good correlation between CRP and erythrocyte sedimentation rate for ankylosing spondylitis (p less than 0.01), systemic lupus erythematosus (p less than 0.01), rheumatoid arthritis (p less than 0.05), polymyalgia rheumatica and Horton's disease (p less than 0.05). The CRP measurement in blood did not separate seropositive versus seronegative rheumatoid arthritis, systemic lupus erythematosus versus rheumatoid arthritis and treated versus non-treated rheumatoid arthritis. There was a good correlation between CRP concentration in blood and in synovial fluid but the concentration was lower in synovial fluid than in blood (p less than 0.01). Then, the CRP measurement in synovial fluid does not have a higher diagnostic value than in blood. PMID- 2776307 TI - Technical and clinical evaluation of fructosamine determination in serum. AB - We evaluated a serum fructosamine (glycated serum proteins) assay for efficacy in the diagnosis and follow-up of diabetic patients. A Roche reagent kit, based on nitroblue tetrazolium reduction in alkaline medium, was used in COBAS FARA centrifugal analyzer. We demonstrated that this method is precise, linear and unaffected by serum hemolysis. However, bilirubin affected the test positively and lipemia negatively. Fructosamine (F) correlated positively with total protein (P) (r = 0.809) and albumin (r = 0.746) in a group of 48 non-diabetic individuals. A good correlation was observed between F and glycated hemoglobin from the sera of 514 patients (r = 0.794). A better correlation (r = 0.838) was obtained when F was corrected for P concentration (F/P). Different F and F/P means were calculated only in patients with overt diabetes, compared to normals. Gestational diabetes was associated with a highly significant F increase. However, its low sensitivity (21%) precludes the use of F as an effective screening test for that condition. Nevertheless, because of its simplicity, low cost and rapidity in reflecting changes in the metabolic control of diabetes, F should be considered a valuable test to assess glycemic control in diabetic patients. PMID- 2776308 TI - Reagentless determination of glucose and other constituents in blood by ATR-FT-IR spectroscopy. PMID- 2776309 TI - ALT reagent with thionicotinamide adenine dinucleotide. PMID- 2776310 TI - Multilayer fluorescent immunoassay technique. AB - We describe a new multilayer immunoassay element for the determination of haptens in undiluted serum and plasma. Polysaccharide layers are coated onto a plastic base. The signal layer contains an immobilized antibody and a fluorescent-labeled hapten. A second layer, containing a pigment, acts as an optical screen. Sample spreading is achieved by a molded grid in contact with the upper layer of the immunoassay element. After sample is added to the element, endogenous analyte competes with the labeled hapten for the binding sites of the immobilized antibody; equilibrium is reached in 4-12 min. Because of the relative liquid holding capacities of the layers and the grid, only a small amount of the free components remains in the signal layer. The signal is measured by front-surface fluorimetry. This technology has been applied to theophylline and thyroxin assays. Within- and between-run CVs range from 3% to 6%. Comparisons with fluorescent polarization immunoassays (Abbott TDx) showed excellent correlation (theophylline: r = 0.98, slope = 1.07, intercept = 0.3; thyroxin: r = 0.97, slope = 0.91, intercept = 0.8). The new method requires only one pipetting step (sample delivery) and is potentially applicable to a wide range of analytes. PMID- 2776311 TI - Patient-side immunoassay system with a single-use cartridge for measuring analytes in blood. AB - We describe an immunoassay system suited to patient-side assay of therapeutic drugs and blood proteins. The system consists of an electronic monitor and single use plastic cartridges containing dry reagents and liquid diluents. The monitor is turned on by insertion of a cartridge. To run the test, the user applies an unmeasured drop of blood to the cartridge when prompted by the monitor. All subsequent steps are performed without further user intervention and results are provided in less than 3 min. The system hemolyzes and precisely dilutes the blood. Hemoglobin concentration is measured, then the diluted blood is precisely diluted further and mixed with two dry reagents. The drug concentration is measured by a turbidimetric latex agglutination inhibition reaction. Theophylline and hemoglobin assay results for clinical samples correlate well with results of widely used comparison methods. PMID- 2776312 TI - High-molecular-mass ("biliary") isoenzyme of alkaline phosphatase and the diagnosis of liver dysfunction in cystic fibrosis. AB - The high-Mr isoenzyme of alkaline phosphatase (AP, EC 3.1.3.1), a highly sensitive index to cholestasis, was measured by liquid chromatography in 45 patients with cystic fibrosis. Results of serum tests for liver dysfunction- including gamma-glutamyltransferase, aspartate aminotransferase, alanine aminotransferase, total AP, bilirubin, and bile acids--were compared with those for high-Mr AP. Values for high-Mr AP were increased in 44.4% of our patient population, with activities ranging from 0.4 to 17.3 U/L. The upper limit in the control group was 2.5 U/L. We find increased high-Mr AP to be a more sensitive indicator of liver dysfunction in patients with cystic fibrosis than are other tests. PMID- 2776313 TI - Measuring tissue factor (factor III) activity in plasma. AB - This is a method for measuring tissue factor (TF, Factor III, tissue thromboplastin) activity in plasma by using a chromogenic substrate. As pretreatment, the euglobulin fraction of plasma was prepared by removing endogenous inhibitors and heated at 60 degrees C for 3 min to remove fibrinogen. This allowed us to measure the low TF activity in plasma that could not otherwise be measured. Neither phospholipids nor coagulation factors VII, IX, X, or Xa in the samples interfere. Within-run and day-to-day reproducibility were both good. The mean value obtained by this method for normal persons was 1.02 (SD 0.91) arbitrary units/L. A markedly high plasma TF activity of 20 arb. units/L or more was observed in patients with some types of disseminated intravascular coagulation. PMID- 2776314 TI - Isolation of the "cystic fibrosis protein" from serum. AB - "Cystic fibrosis protein" (CFP), a minor serum protein marker of the cystic fibrosis allele, was isolated from serum from patients with cystic fibrosis by use of the "FPLC" high-resolution chromatography system and preparative sodium dodecyl sulfate-polyacrylamide gel electrophoresis. CFP currently is characterized by its isoelectric point (8.4) on isoelectric focusing. However, after the first purification steps, we identified the protein, which was present in a very low concentration, by the immunosorbent assay of Hayward et al. (J Immunol Methods 1986;91:117-22), by virtue of its immunological relationship with the "CF antigen," a protein characterized in granulocytes by these same authors [Nature (London) 1985;315:513-5]. CFP, a protein of low molecular mass, about 14 kDa, appears to be strongly associated with IgG in serum. Using the same procedure with control serum permits us to assume that CFP normally is present in serum in trace amounts. PMID- 2776315 TI - Diagnosis of recessive X-linked ichthyosis: quantitative HPLC/mass spectrometric analysis of plasma for cholesterol sulfate. AB - A specific, accurate liquid-chromatographic/mass-spectrometric (HPLC/MS) method for measurement of cholesterol sulfate in plasma from normal individuals and patients with recessive X-linked ichthyosis (RXLI) is described. The method is superior to previously described techniques because it measures the analyte intact rather than after hydrolysis. Traces of free cholesterol in the sample analyzed do not add to the measured result. We used either [13C2]cholesterol sulfate or [2H6]cholesterol sulfate as internal standards, which we add to plasma before extraction. Use of such standards makes quantitative extraction unimportant. We use a single solid-phase extraction (SPE) C18 cartridge for plasma extraction. After the cartridge is washed with methanol/ammonium acetate solutions, the fraction containing the steroid sulfates is eluted with methanol, evaporated, and subjected to HPLC/MS analysis, wherein the molecular anions of analyte and internal standards are monitored. The peak ratio gives the cholesterol sulfate concentration directly. Using this method, we have diagnosed 24 patients with RXLI. Their concentration of cholesterol sulfate ranged between 41.7 and 185.3 mumol/L (mean 93.85, SD 31.2 mumol/L). In normal individuals (n = 9) the mean cholesterol sulfate concentration was 2.77 mumol/L (SD 0.62, range 2.05-3.95 mumol/L). The instrumentation required is complex, but the assay is simple: sample preparation takes about 30 min; mass spectrometry, 10 min. About 0.1 mL of plasma is required for cholesterol sulfate measurement in RXLI patients and 0.5-1 mL in normal individuals. PMID- 2776316 TI - Quantification of strontium in plasma and urine with flameless atomic absorption spectrometry. AB - This analytical method for determination of Sr in plasma and urine involves flameless atomic absorption spectrophotometry (FAAS). Drying, charring, and atomization were optimized with respect to temperature, temperature ramp, and duration for Sr in dilute HNO3 and Sr in plasma diluted 20-fold with dilute HNO3. Calibration curves (r greater than 0.995) were linear in the concentration range 5-250 micrograms/L for Sr in various media, with intercepts negligibly small except for the calibration curves in 1:1-diluted plasma and undiluted urine. The estimated detection limits for Sr in 20-fold-diluted plasma and 50-fold-diluted urine were 2 and 3 micrograms/L, respectively. Endogenous Sr in plasma and urine was estimated at 16 (SD 8) micrograms/L and 158 (SD 26) micrograms/L (n = 6), respectively. Intra- and interassay CVs were 9.1% and 5.3% for 20-fold-diluted plasma at a Sr concentration of 25 micrograms/L, and 6.9% and 4.8% at a concentration of 250 micrograms/L. The respective CVs were 8.2% and 1.2% for 50 fold-diluted urine at the low concentration, and 4.0% and 4.6% at the high concentration. In a pharmacokinetic pilot study of 2.5 mmol of Sr orally administered to a healthy volunteer, the peak plasma concentration of Sr, 4.4 mg/L, decayed bi-exponentially [t1/2, alpha = 24 h, t1/2, beta = 77 h]; the estimated first-order absorption rate constant was 0.005 min-1; and the observed decay (day 0-6) of the urinary Sr/creatinine ratio closely paralleled the plasma decay [t1/2 = 70 h]. PMID- 2776317 TI - Fully automated fluorescence assay for determining total homocysteine in plasma. AB - Homocysteine exists in human plasma as various (mixed) disulfides. Most plasma homocysteine (about 70%) is protein bound, probably via a disulfide bond to albumin, whereas homocysteine-cysteine mixed disulfide is the predominating form in the free fraction. We here present a method for the determination of total homocysteine, which includes both fractions. Plasma was initially treated with sodium borohydride to reduce the disulfide bonds, and the liberated thiols were derivatized with monobromobimane. The derivatized sample, still containing the plasma proteins, was injected onto a strong cation-exchange column, from which the homocysteine derivative was directed by column switching into a cyclohexyl silica (CH) column. The homocysteine derivative was top-concentrated on the CH column, then rapidly eluted with a steep gradient of methanol. Both the derivatization procedure and chromatography were performed with a combined sample processor and sample injector from Gilson (Model 232-401). Within-run and between run precision (CV) was less than 4%, and the detection limit of 0.2 pmol was sufficiently low for monitoring homocysteine in plasma. We verified the assay against two established manual methods for the determination of total homocysteine in plasma. This, the first fully automated assay for total plasma homocysteine, allows the unattended analysis of 70 samples per 24 h. PMID- 2776318 TI - Purification and characterization of intact lactoferrin found in the urine of human milk-fed preterm infants. AB - Little is known about the metabolic fate of ingested lactoferrin in human-milk fed term or preterm infants. Enzyme-linked immunosorbent assays and sodium dodecyl sulfate/polyacrylamide gradient gel electrophoresis (SDS-PAGGE) with immunoblots have demonstrated that the urinary excretion of lactoferrin by preterm infants fed exclusively human milk exceeded that by formula-fed infants. The origin and molecular integrity of the excreted lactoferrin, however, are unclear. We have developed extraction and separation procedures involving a stationary phase of immobilized single-stranded DNA (ssDNA) that allows the efficient (greater than 80%) and rapid isolation of pure, intact lactoferrin from infants' urine. We purified lactoferrin to apparent homogeneity from infants' urine in one step, using the immobilized ssDNA with mobile phases containing up to 6 mol of urea per liter. The purified lactoferrin was evaluated by SDS-PAGGE; silver-staining revealed one protein band at 78 kDa; immunoblots confirmed the presence of intact lactoferrin. High-performance affinity chromatography with use of immobilized metal ion (Cu2+) suggested the presence of intact, iron-saturated lactoferrin. Subsequent chromatography on high-performance reversed-phase (C18) columns independently verified sample identity and purity. PMID- 2776319 TI - Enzyme-linked immunosorbent assay for chromogranin A. AB - This is an enzyme-linked immunosorbent assay (ELISA) for determining chromogranin A (CGA) with use of a monoclonal antibody. CGA was isolated from bovine chromaffin granules. The analytical ELISA procedure for bovine CGA was developed and optimized. Typical standard curves ranged from 500 pg to 500 ng of CGA. We then studied human plasma CGA-immunoreactivity as measured by this assay. The curve for dilutions of human plasma paralleled the standard curve for bovine CGA. The intra-assay coefficient of variation for determination of human plasma CGA was 4.56%, indicating that reliable determinations can be performed for human plasma. However, further study revealed the presence of two CGA-immunoreactive substances in human plasma, one of which corresponds to the native CGA. The nature of the second immunoreactive substance still remains unknown. Nevertheless the measured CGA concentrations (ranging from 0.19 to 0.35 mg/L) in plasma are comparable with previously reported values. PMID- 2776321 TI - S-100ao protein in blood and urine during open-heart surgery. AB - Concentrations of S100a0 protein and CK-MB were measured by enzyme immunoassay in serial samples of arterial and coronary-sinus blood and urine taken from 26 patients who were undergoing mitral valve surgery. The mean concentration of arterial S100a0 in plasma was 0.32 (SD 0.28) ng/mL at the beginning of anesthesia, increased sharply after reperfusion, peaking [14.4 (SD 6.63) ng/mL] after 45 min of reperfusion, then decreased rapidly. The concentration of creatine kinase (CK) isoenzyme MB in arterial blood plasma was greatest 3 h after reperfusion [107 (SD 54.5) ng/mL]. S100a0 concentrations in urine increased dramatically after reperfusion [16,300 (SD 12,000) ng/h vs 44 (SD 32) ng/h], while CK-MB increased slightly [135 (SD 75) ng/h vs 19 (SD 12) ng/h]. These results suggest that S100a0 in cardiac muscle is released into the bloodstream during open-heart surgery and is discharged into the urine more rapidly than is CK-MB. Determination of S100a0 in plasma or urine thus may be useful for estimating damage to heart muscle during open-heart surgery. PMID- 2776320 TI - Quantifying manganese in lymphocytes to assess manganese nutritional status. AB - To clarify whether manganese nutritional status is better reflected by the manganese concentration in lymphocytes or in whole blood, we injected manganese solutions intravenously into manganese-deficient rats and determined manganese concentrations in lymphocytes, whole blood, and various tissues. The manganese concentrations in lymphocytes and tissues, but not in whole blood, were significantly less in manganese-deficient rats than in normal rats. These low values could be prevented by intravenous injection of manganese in a dose dependent manner. These results suggest that, for assessment of manganese nutritional status, measurement of manganese in lymphocytes is better than that in whole blood. PMID- 2776322 TI - HPLC analysis of brain and plasma for octanoic and decanoic acids. AB - Two methods are described for determination of octanoic and decanoic acids in plasma and brain homogenate by "high-performance" liquid chromatography with ultraviolet detection. Analysis of the underivatized acids had a detection limit of only 50 mg/L, but formation of the p-bromophenacyl ester increased the sensitivity by 100-fold, to a detection limit of 0.5 mg/L. The latter procedure gave interassay coefficients of variation of 4.1% and 4.8% for octanoic and decanoic acids, respectively. The corresponding intra-assay values were 3.95% and 4.7% (n = 6). The derivative method, applied to samples of plasma from children receiving a medium-chain triglyceride (MCT) diet, gave values in agreement with results by gas-liquid chromatography. Results have also been obtained for samples from mice, either treated with the medium-chain triglyceride diet or given infusions of sodium octanoate. PMID- 2776323 TI - Highly sensitive assays of autoantibodies to thyroglobulin and to thyroid peroxidase. AB - These highly sensitive assays are based on the interaction between thyroid autoantibodies and 125I-labeled autoantigens. Serum samples are incubated with labeled thyroid peroxidase (TPO) or thyroglobulin (Tg) to allow the formation of antibody-labeled antigen complexes. The complexes are then precipitated by addition of solid-phase Protein A. In the presence of high concentrations of TPO antibody or Tg antibody, more than 50% of the respective labeled antigen was precipitated, whereas only 1-2% was precipitated in the absence of autoantibody. Interassay CVs were 3.2% and 5.7%, respectively, for the anti-TPO and anti-Tg assays. There was no cross-reactivity between Tg antibody and TPO antibody. Results correlated highly significantly with results from other assay systems based on antigen-coated cells or plastic supports, but the assays described here were considerably more sensitive. Scatchard analysis of the assay data provided information on the affinity and serum concentration of TPO autoantibodies (ka approximately 10(9) L/mol and concentrations up to 1 g/L) and Tg autoantibodies (ka approximately 4 x 10(10) L/mol and concentrations up to 1 g/L). Overall, these assays provide a sensitive, precise, and convenient system for measuring and investigating the properties of thyroid autoantibodies. PMID- 2776324 TI - Sialidase from different sources compared for electrophoretically separating serum alkaline phosphatase fractions from liver and bone. AB - We compared sialidase (neuraminidase; EC 3.2.1.18) from Vibrio cholerae, Clostridium perfringens, and Arthrobacter ureafaciens, seeking to improve the electrophoretic separation of the liver and bone isoenzymes of alkaline phosphatase (EC 3.1.3.1) on cellulose acetate membranes. Resolution is decisively determined by the type and activity of sialidase used in the preincubation of serum sample. Sialidase from Arthrobacter ureafaciens is not suited for this method. For optimal separation of the two isoenzymes we recommend the use of sialidase from Vibrio cholerae, determination of its activity with a standard procedure such as described here (mucin or sialyl lactose as substrates), and a final concentration of sialidase activity of 2.0 or 2.9 U/L (measured with mucin or sialyl lactose) in the incubation mixture. PMID- 2776325 TI - Performance and diagnostic application of a two-site immunoradiometric assay for parathyrin in serum. AB - The "N-tact" immunoradiometric assay (IRMA) from INCSTAR for parathyrin (PTH) in serum involves a 125I-labeled affinity-purified antiserum to PTH 1-34 and an affinity-purified antiserum to PTH 39-84, the latter bound to a polystyrene bead. The mean detection limit, determined in six consecutive assays, was 4 ng/L. The within-batch CV was less than 7% in the range 15 to 2135 ng/L. The between-batch CV was 11.7% and 5.3% at 30 and 371 ng/L, respectively. Serum PTH in 14 proven cases of primary hyperparathyroidism was 49-808 (median 111) ng/L, undetectable (less than 5 ng/L) in 10 cases of primary hypoparathyroidism and in 10 cases of hypercalcemia associated with malignancy, compared with 7-39 ng/L in 45 normal subjects. PTH was 9 to 19 ng/L in four patients with familial benign hypercalcemia. In 39 patients with renal failure, apparent concentrations were 14 to 857 (median 133) ng/L, but sera from these patients pre-diluted with zero standard did not parallel dilutions of the standard, PTH 1-84. PTH concentrations were not significantly decreased in blood or serum kept at 20 degrees C for up to 6 h. After successful removal of a parathyroid adenoma, the mean half-time for disappearance of PTH in vivo in five hyperparathyroid patients was 3.3 min. PMID- 2776327 TI - Measuring creatine kinase MB isoenzyme in a maintenance hemodialysis population: chemiluminometric immunoassay and electrophoresis compared. AB - In an effort to clarify the issue of potentially false increases in creatine kinase (EC 2.7.3.2) MB isoenzyme (CK-MB) in uremia, we evaluated the CK profile of 84 persons undergoing chronic maintenance hemodialysis. We compared the performance of a new commercial two-site chemiluminometric immunoassay of CK-MB (Magic Lite; Ciba Corning Diagnostics) with that of electrophoresis on agarose gel (Cardio Trak-CK; Corning Medical). Results of the new chemiluminometric immunoassay for samples from hemodialysis patients correlated well with those of the electrophoretic method (r = 0.86, P less than 0.001), showing that neither substances in the serum of uremic patients nor CK-MM isoenzyme give false positive increases in CK-MB isoenzyme. Our evidence suggests that the chemiluminometric method may be more specific than is electrophoresis in establishing absolute CK-MB values in the diagnosis of suspected myocardial injury in this population. PMID- 2776326 TI - Microassay for screening newborns for galactosemia with use of a fluorometric microplate reader. AB - We describe a microassay for measuring galactose (Gal) and galactose 1-phosphate (Gal-1-P) in dried blood spots. After a coupled enzyme reaction involving galactose dehydrogenase (GADH, EC 1.1.1.48) and alkaline phosphatase (AP, EC 3.1.3.1) in a microplate well, NADH fluorescence is measured by a highly sensitive fluorometric microplate reader, capable of rapid measurement of fluorescence (2 min per 96 samples). Within- and between-run CVs for measurements of Gal at 90 mg/L with Gal-1-P at 130 mg/L were both less than 5% (n = 8), and analytical recoveries for Gal at 90 mg/L and Gal-1-P at 130 mg/L were 98% and 92%, respectively. Five hundred dried blood-spot samples can be assayed within 2 h, with full calculation of results by an on-line microcomputer. This rapid and reliable assay system is very useful for the routine screening of newborns for galactosemia. PMID- 2776328 TI - Lactate dehydrogenase and its isoenzymes in serum from patients with multiple myeloma. AB - Concentrations of total lactate dehydrogenase (LDH; EC 1.1.1.27) and LDH isoenzyme patterns were studied in serum of 19 patients with multiple myeloma and in 19 healthy controls. Patients were divided into three groups (pretreatment, nonresponders, and responders to treatment), based on their clinical status at the time of blood sampling for LDH. The LDH values were found to be significantly higher (P less than 0.05) in the pretreatment group and in the nonresponders than in the responders and the control group, the mean +/- SE values being 445 +/- 35 and 532 +/- 75 units/mL vs 349 +/- 75 and 190 +/- 7.1 units/mL, respectively. Compared with responders and healthy controls, newly diagnosed patients and nonresponders had slight diminutions in LDH-1 and LDH-2, but increased LDH-3. We conclude that determination of LDH and its isoenzymes in serum can be of value as prognostic factors in patients with multiple myeloma. PMID- 2776329 TI - Reversed-phase HPLC separation of plasma norepinephrine, epinephrine, and dopamine, with three-electrode coulometric detection. AB - We present a method involving minor modifications of previous techniques, in which we use an ion-pair reversed-phase HPLC separation with three-electrode coulometry. Isocratic baseline separations can be obtained in 5 min. The sample preparation procedure, involving extraction with alumina at low temperature, allows good reproducibility (within-run and between-run CVs less than 10%) and improved sensitivity (less than 5 pg of each catecholamine per extract). This method allows approximately 70 low-cost plasma catecholamine analyses to be done in a working day. PMID- 2776330 TI - Urinary excretion of some proteins and enzymes during normal pregnancy. AB - Total protein (TP), albumin (Alb), transferrin (TRF), retinol-binding protein (RPB), N-acetyl-beta-glucosaminidase (NAG), alanine aminopeptidase (AAP), gamma glutamyltransferase (GGT), and creatinine (Cr) were measured in random (untimed) urine samples from 29 nonpregnant women and from pregnant subjects (11 in the first trimester, 34 in the second, and 37 in the third). The excretion of TP, Alb, TRF, NAG, and AAP (relative to creatinine) and the RBP concentration were all higher (P less than or equal to 0.05) in the second and third trimesters compared with values for the nonpregnant controls. The GGT/Cr ratio was significantly higher only in the third trimester. The increase in low-molecular mass proteins and tubular enzymes suggests that at least part of the increase in Alb, TRF, and TP results from decreased tubular reabsorption. We conclude that excretion of both high- and low-molecular-mass proteins is increased during pregnancy. PMID- 2776331 TI - Three direct spectrophotometric methods for determination of total bilirubin in neonatal and adult serum, adapted to the Technicon RA-1000 analyzer. AB - We adapted three bichromatic spectrophotometric methods for determining total bilirubin in serum, for use with the Technicon RA-1000 analyzer. The borate buffer (BOR) of Hertz et al. (Scand J Clin Invest 1974;33:215-30), the caffeine buffer (CAF) of Vink et al. (Clin Chem 1988;34:67-70), and the combined borate caffeine buffer (B-C) of Franzini and Cattozzo (Clin Chem 1987;33:597-9) were compared. All methods required only 10 microL of serum, were precise (between batch CVs less than 4.2%, analyte range 64-310 mumol/L), linear to 1000 mumol/L, and insensitive to interference from hemoglobin to 5 g/L. Lipemia, carotene, and methemalbumin interfered positively with each method but insignificantly unless in supranormal concentrations. Only the BOR method was sensitive to protein matrix effect. Neonates' results obtained with all three methods compared well with a Jendrassik-Grof-based technique. However, samples from adults with cholestasis were overestimated, particularly by the CAF method, but the BOR and B C methods would be suitable for "stat" bilirubin analysis in these samples. PMID- 2776332 TI - Fast, stable method for harvesting leukocytes for measuring intracellular magnesium. AB - A new method for isolating blood leukocytes and measuring intracellular leukocyte magnesium is based on three successive centrifugations (1300 x g, 5 min, 22 degrees C), with no use of Ficoll, followed by two washes. We express the leukocyte magnesium concentration in micromoles of magnesium per gram of protein. Magnesium is measured by atomic absorption spectrophotometry, protein by the classic Lowry method. With the method 8% to 28% of the leukocytes are isolated and 0% to 0.025% of the erythrocytes. Of the isolated leukocytes 86% to 93% are viable. The magnesium concentration is constant at centrifugal forces greater than 1000 x g, at a centrifugation time of 5 to 15 min, and with use of two or three washes. However, the cells lose 1% of their magnesium content per hour when samples are left at 22 degrees C. The temperature influences this. In blood samples from 98 volunteer blood donors, mean leukocyte magnesium concentrations were 26.4 (SD 3.9) mumol/g. There was no significant correlation between the magnesium concentration and the relative amount of neutrophils. PMID- 2776333 TI - Long-chain aliphatic fatty acids and phytanic acid simultaneously measured by dual-column capillary chromatography. AB - A method is described for simultaneously measuring long-chain aliphatic fatty acids and phytanic acid in plasma, for the diagnosis of disorders associated with peroxisomal defects, eliminating the need for two separate chromatographic runs to resolve all of the analytes. In addition, the simultaneous, dual-column analysis allows confirmation of the identity and quantity of the individual fatty acids, thus adding a degree of certainty when results are used for interpretation and differential diagnosis of the many clinical manifestations of peroxisomal defects. PMID- 2776334 TI - Test-strip method for measuring lactate in whole blood. AB - We have developed a dry reagent strip system for measuring lactate in whole blood. The test strip contains lactate oxidase (no EC number assigned), horseradish peroxidase (EC 1.11.1.7), and N-ethyl-N-(2-hydroxy-3-sulfopropyl)-m toluidine. The system is designed to measure with a reflectometer the color that developed in the test strip, although the lactate concentration can be estimated without the reflectometer. The between-run coefficients of variation for controls at three concentrations were 2.9-5.3%. The lactate concentrations in blood samples from healthy subjects before and after exercise correlated well (r = 0.97) with the results measured by the comparison method with the use of lactate oxidase. This dry reagent strip system provides a convenient and rapid test for measuring blood lactate in clinical and sports medicine. PMID- 2776335 TI - Evaluation of the Olympus PK310 automated enzyme immunoassay system. PMID- 2776336 TI - Delta-aminolevulinic acid in plasma by free amino acid analysis. PMID- 2776337 TI - Therapeutic agents affecting amino acid chromatograms. PMID- 2776338 TI - Excretion of urinary enzymes after extracorporeal shock-wave lithotripsy. PMID- 2776339 TI - Evaluation of a particle-enhanced immunoassay for quantifying C-reactive protein. PMID- 2776340 TI - Rapid determination of total homocysteine in plasma. PMID- 2776341 TI - IgA-CK-BB complex with CK-MB electrophoretic mobility can lead to erroneous diagnosis of acute myocardial infarction. AB - This patient, on admission, presented with a tentative diagnosis of myocardial infarction: the electrocardiogram showed a nonspecific ST-segment and T-wave abnormalities, and total creatine kinase (CK; EC 2.7.3.2) activity was slightly increased (238 U/L). However, a high electrophoretic value for CK-MB (50% of total CK activity) and the electrophoretic pattern of lactate dehydrogenase (EC 1.1.1.27) isoenzymes ruled out myocardial infarction. The isoenzyme migrating as CK-MB was found later to contain no immunologically normal CK-M subunits, and it was bound to IgA. A mixture of the patient's serum and a human serum control containing all CK isoenzymes showed altered electrophoretic mobility only for CK BB, indicating that the patient's serum contained antibodies to the B unit of CK. Elution from a Sephadex G-200 column showed that the peak at which most of the anodic CK was eluted corresponded to a molecular mass of approximately 200 kDa. Evidently this atypical isoenzyme was an IgA-CK-BB complex. Because this macro CK type 1 can mimic CK-MB, it may therefore be a source of confusion. PMID- 2776342 TI - Lactate dehydrogenase in serum of patients performing an exercise test. PMID- 2776343 TI - Hazard of commercial antiserum cross-reactivity in monoclonal gammopathy evaluation. PMID- 2776344 TI - More on albumin and thyroid hormones. PMID- 2776345 TI - Aqueous-based glucose control solutions for use with glucose reagent-strips and meters. PMID- 2776346 TI - Estimation of brain lesion size based on quantifying CK-BB in serum. PMID- 2776347 TI - Colorimetric screening method for microalbuminuria: intra-individual variability for untimed day specimens. PMID- 2776348 TI - The effect of hypoalbuminaemia, hyperbilirubinaemia and renal failure on serum fructosamine concentration in non-diabetic individuals. AB - We have investigated the effects of hypoalbuminaemia, hyperbilirubinaemia and renal failure on serum fructosamine concentration in 39 non-diabetic patients. All patients were hypoalbuminaemic (median serum albumin 25 g/l, range 12-34 g/l). Group 1 (n = 19) were patients with hypoalbuminaemia alone, group 2 (n = 7) with hypoalbuminaemia and impaired renal function (median serum creatinine 226 mumol/l, range 154-461 mumol/l) and group 3 (n = 13) were subjects with hypoalbuminaemia and hyperbilirubinaemia (median serum bilirubin 34 mumol/l, range 19-83 mumol/l). Serum fructosamine was significantly lower in all three groups compared to age-matched normoalbuminaemic controls, but there was no significant difference in fructosamine concentrations between the groups. There was a correlation between fructosamine concentration and serum albumin. (r = 0.82, p less than 0.001) in all three groups combined. Serum fructosamine did correlate with serum bilirubin in patients with normal renal function (r = 0.0, p less than 0.001). In patients with abnormal renal function there was no correlation between serum fructosamine and either urea (r = 0.22, ns) or creatinine (r = 0.31, ns). Albumin is the major factor affecting serum fructosamine concentrations. Moderate hyperbilirubinaemia does not affect fructosamine concentration. No difference in fructosamine concentration could be demonstrated in patients with renal failure. PMID- 2776349 TI - Measurement of propionate turnover in vivo using sodium [2H5]propionate and sodium [13C]propionate. AB - The outcome for children with inherited disorders of propionate metabolism is poor. To facilitate development of improved treatment in these conditions, we described techniques for the estimation of the rate of production and removal of propionate in vivo. Propionate turnover was determined in 4 healthy adults using continuous infusions of sodium [2H5]propionate and sodium [13C]propionate. The mean fasting plasma propionate concentration measured by a sensitive technique employing high performance liquid chromatography, following a two-stage extraction procedure and derivatisation with bromophenacyl bromide, was 3.3 mumol/l (SD 0.5). The isotopic enrichment of the bromophenacyl propionate derivative was measured by gas chromatography/mass spectrometry and mean propionate turnover was calculated to be 17.6 mumol/kg per h (SD 5.9). These methods allow rapid (less than 3 h) assessment of propionate turnover in man and are suitable for application in children with inherited disorders of propionate metabolism. PMID- 2776350 TI - Evidence that free gamma carboxyglutamic acid circulates in serum. AB - We report a rapid, sensitive and reproducible method to measure free gamma carboxyglutamic acid (GLA) in serum using precolumn derivatization with O phthalaldehyde, reversed-phase chromatography and deproteinization of serum by ultrafiltration. Serum free GLA level in 62 healthy adults was 167 +/- 46 pmol/ml and was increased (302 +/- 195 pmol/ml) in 14 patients with primary hyper parathyroidism, a disease characterized by an increased bone turnover. Peptide bound GLA averaged 413 pmol/ml. In rabbits receiving massive doses of warfarin during 6 days there was a time- and dose-dependent decrease of serum free GLA but a significant fraction was still measurable. These data indicate that free GLA circulates and originates both from the metabolism of the vitamin K-dependent clotting factors and from bone metabolism. PMID- 2776351 TI - Human serum immuno-reactive copper, zinc-superoxide dismutase assayed with an enzyme monoclonal immunosorbent in patients with digestive cancer. AB - Two types of monoclonal antibodies, N4 and N6, were raised against human copper, zinc-superoxide dismutase (Cu,Zn-SOD). An enzyme-linked immunosorbent assay for Cu,Zn-SOD was developed in sandwich method using these monoclonal antibodies. The measurable assay range was 1.0-100 micrograms/l and the coefficient of variation within and between series were 7.5% and 8.1%. Sera of 154 healthy control subjects displayed a low level (14 micrograms/l) of immunoreactive Cu,Zn-SOD with a logarithmic normal distribution. On the other hand, serum Cu,Zn-SOD levels were significantly elevated in patients with various digestive cancers. PMID- 2776352 TI - Serum selenium in liver cirrhosis: correlation with markers of fibrosis. AB - In 55 patients with alcoholic cirrhosis and in 47 healthy individuals we assayed the concentration of selenium in serum (S-Se) by proton induced X-ray emission, the aminoterminal peptide of type III procollagen (NPIIIP) by RIA and the plasma fibronectin (FN) by immuno-nephelometry, together with routine biochemical tests. S-Se was lower in cirrhosis than in controls (0.57, SD 0.20 vs 0.92, SD 0.16 mumol/l; p less than 0.001) and was more reduced in ascitic than in compensated patients (0.50, SD 0.19 vs 0.66, SD 0.17 mumol/l; p less than 0.001). Regression analysis showed a positive correlation of S-Se with serum albumin and FN, whereas necrotic or inflammatory activity seems unrelated to S-Se; a negative correlation was found between S-Se and NPIIIP, suggesting a protective role of selenium against fibrosis. PMID- 2776353 TI - Effects of protracted hypothyroidism on pituitary function and structure in endemic cretinism. AB - Pituitary function and structure were assessed in 69 endemic cretins from western China. In hypothyroid cretins (TSH greater than 10 mIU/l), CT imaging of the pituitary revealed adenoma in five of 20 (25%) and partially empty sella (PES) in a further eight of 20 (40%). The majority of tumours were microadenomas and showed a relation with higher levels of serum TSH but not with duration of hypothyroidism. Dynamic pituitary testing with TRH and GnRH in four patients with adenoma on CT gave a flat TSH response but significant rises in serum PRL, GH, LH and FSH concentrations. Hyperprolactinaemia (greater than 350 mIU/l) was present in hypothyroid cretins only (13 of 26; 50%) and serum PRL showed a curvilinear relation with serum TSH levels (r = 0.7, P less than 0.0001). Hypogonadism was seen in approximately half the cretins with high PRL levels. Our data suggest that severe protracted thyroid hormone deficiency may result in thyrotrophin adenomas of the pituitary gland. Disturbances of growth, puberty, and sexual function in endemic cretins are explained by the secondary effects of thyroid hormone deficiency on pituitary function. PMID- 2776354 TI - Corticosteroid-binding globulin in depression. AB - We undertook this study to evaluate the role of plasma free and total cortisol, and corticosteroid-binding globulin (CBG) in depression. Plasma was collected from 15 drug-free depressed patients and 15 age and sex-matched control subjects at 0900 and 2300 and at 1600 following an oral dose of dexamethasone. Depressed patients had elevated concentrations of both free and total cortisol at all time points studied. The binding capacity and affinity of plasma CBG for cortisol was similar in both groups at all times studied. No differences in CBG measures were noted if the depressed subjects were divided into elderly or younger subjects and dexamethasone suppression test (DST) suppressors or non-suppressors. PMID- 2776355 TI - Rhythms of serum melatonin in patients with spinal lesions at the cervical, thoracic or lumbar region. AB - The neural pathway essential for the diurnal rhythm of serum melatonin was studied in humans. Blood samples from 17 patients with chronic lesions of cervical (n = 8), low thoracic or lumbar (n = 9) spinal cord were collected at 0200, 0400, 1000 and 1400 h of their normal light-dark cycle. Blood samples were also collected from eight control subjects at 0200 and 1400 h. No special treatment of food, drug or photoperiod was implemented. Serum melatonin was extracted by dichloromethane and determined by radioimmunoassay. In patients with cervical spinal lesions (C3-C7), it was found that serum melatonin levels were low and no diurnal rhythm was observed. Conversely, diurnal rhythm of circulating melatonin with significantly higher levels (P less than 0.01) in the dark period were observed in individuals with injuries at the low thoracic or lumbar regions (T9-L2). In the second experiment, blood samples from two other patients were collected for three consecutive days during acute period of spinal injuries (cervical or upper thoracic region) and serum melatonin concentrations were determined. Again, there were low levels of serum melatonin with no observable diurnal rhythm in the patient with cervical lesion (C4-5). However, diurnal rhythms were maintained with high levels in the dark period in the patient with upper thoracic spinal (T2-3) transection. Our data suggest that the cervical region of the spinal cord is part of the neural pathway essential for the diurnal rhythm of pineal melatonin secretion in human beings. PMID- 2776357 TI - Serial studies on the affinity and heterogeneity of human autoantibodies to thyroglobulin. AB - The functional affinity and heterogeneity of autoantibodies to thyroglobulin (Tg) were measured by an IgG subclass-specific solid-phase competition ELISA in patients with autoimmune thyroid disease. High-affinity IgG1 and IgG4 antibodies formed the major anti-Tg response. Both titre and affinity of IgG3 and IgG2 anti Tg were generally low but in some Hashimoto's disease patients high-affinity IgG2 anti-Tg were found and IgG2 anti-Tg, unlike those of other subclasses, showed very restricted heterogeneity. The affinity of IgG4 anti-Tg was similar in patients with thyroid disease and their clinically euthyroid (normal) relatives. In contrast, a progressive increase in IgG1 anti-Tg affinity was seen in clinically euthyroid individuals compared with their relatives with thyroid disease and high titred Hashimoto's disease patients, suggesting that either rising titres of high affinity IgG1 anti-Tg or affinity maturation of IgG1 anti Tg may be indicative of impending hypothyroidism. PMID- 2776356 TI - C-myc gene binding factors in peripheral blood mononuclear cells from patients with systemic lupus erythematosus (SLE). AB - We characterized the nuclear proteins with specific binding ability against c-myc gene by gel-shift assay in cell extracts of peripheral blood mononuclear cells (PBMC) from SLE patients and SLE-prone mice with use of distinct c-myc fragments. With the fragment named Fmyc in our experiments, two kinds of complexes which we call C1 and C2 respectively were found in PBMC from SLE patients and SLE-prone mice. The C1 was shown to be inducible in PBMC from healthy persons without nascent protein synthesis after lectin binding to the cell and found to be elevated in the SLE patients and in all of the established cell lines we examined. The C2 seemed to be peculiar to SLE subjects. The binding site of the C1 factor (C1F) and C2 factor (C2F) which forms C1 and C2 respectively with Fmyc appeared to be common and were found to reside at 51 kbp sequence (from XhoI to Sau3A) of exon I of c-myc gene. Interestingly, XhoI site of the binding site was highly demethylated in PBMC of SLE patients as compared with healthy persons. The roles of these binding factors for the pathogenesis of SLE are discussed. PMID- 2776358 TI - Relation of parietal cell and thyroid antibodies to the state of gastric mucosa and basal serum gastrin levels during a 6-year follow up. AB - Two groups of volunteers (199 in total, 149 of whom were a random sample of an urban population) were examined twice, with a 6-year interval, for the occurrence of parietal cell antibody (PCA) and thyroid microsomal antibodies (TMA). The antibody findings were compared with the antral and fundal gastric mucosal state, and with the fasting serum gastrin-17 level. During the study period, two new PCA and four new TMA cases appeared. There were no significant changes in the state of gastric antral/fundal mucosa in relation to PCA and/or TMA persistence or appearance, as compared with the gastric mucosa changes in the whole random population sample. However, a good correlation was observed between PCA and basal serum gastrin elevation. PMID- 2776359 TI - Charge distribution of plasma IgA in IgA nephropathy. AB - The spectrotype of plasma IgA in patients with IgA nephropathy was studied by isoelectric focussing. Densitometry of the gels showed a significant increase in the anionic region at isoelectric points (pI) 4.7-5.1 (P = 0.02) and a reduction in the cationic region pI 5.8-6.0 (P = 0.03) in patients (n = 15) compared with controls (n = 8). Measurement of the IgA concentration in eluates of sequential slices of the gels showed that the ratio of anionic-to-cationic IgA, using pI 5.6 as the dividing point, was significantly greater in patients (n = 10) than in controls (n = 10) (P = 0.03). Two different methods of analysis have therefore demonstrated an increased proportion of anionic and decreased proportion of cationic IgA in the plasma of patients with IgA nephropathy. PMID- 2776361 TI - Isolation and functional studies of granulated lymphocytes in first trimester human decidua. AB - Granulated lymphoid cells (CD2+, CD7+, CD38+, NKH1+, CD3-, CD5-, CD4-, CD8-, CD25 ) are prominent in human endometrial stroma in the late secretory phase of the menstrual cycle and in early pregnancy, and may play an important role in implantation and placentation. Cell suspensions enriched for granulated lymphoid cells were prepared from first trimester human decidua using a panning technique; cells were labelled with the monoclonal antibody NKH1 and separated by adherence to immunoglobulin-coated plates. The enriched cells were characterized with a panel of monoclonal antibodies using an indirect immuno-alkaline phosphatase method, and subjected to various functional assays. Most cells in the enriched preparations showed the characteristic morphology of granulated lymphocytes in smears stained with toluidine blue or May Grunwald Giemsa. CD45+ cells were obtained up to 98 +/- 1% purity (n = 10) and CD2+ cells were enriched up to 84 +/ 4%. The enriched populations were efficient effectors in a K562 chromium-release assay but showed minimal proliferative response to phytohaemagglutinin, concanavalin A, ionomycin and phorbol 12, 13 dibutyrate (PdBU), interleukin 1 or interleukin 2. The precise lineage and in vivo function of decidual granulated lymphocytes remains to be established. PMID- 2776360 TI - Appearance of IgG and IgA antibodies in human bile after tetanus toxoid immunization. AB - Humans immunized intramuscularly with one dose of tetanus toxoid exhibited IgG, and in some cases IgA antibody, in their bile as well as serum. Both isotypes appeared in bile transiently with titres declining after about day 10 for both classes. These kinetics resembled those of the serum IgA response but were markedly different to those for IgG antibody in serum. Measured IgG titres in bile were between 0.07 and 4.2% of those in paired sera, and IgA titres were between 6.8 and 124% of sera. Peak responses in bile, while generally of smaller size, exceeded those of paired sera when expressed as antibody/mg of IgG or IgA present. This calculation showed that during the peak response bile was up to nineteen-fold more abundant in IgG antibody than was serum taken at the same time, and up to forty-five-fold more for IgA. Enrichment of antibody in bile is not consistent with the Ig of bile being solely conferred by plasma, and may mean the involvement of local synthesis too. This study indicates that tetanus toxoid immunization of humans results in biliary antibody and raises the possibility of intra-hepatic antibody production for export to the intestinal tract in man. PMID- 2776362 TI - Capillary-localized low-affinity antibody-antigen complexes act as a focus for the deposition of high-affinity complexes. AB - The hypothesis that low-affinity antibody-antigen complexes localized in the glomerular capillary wall can act as a focus for the subsequent deposition of complexes containing high-affinity antibody was tested with three experimental systems: (1) Experimental zinc deficiency was used to modulate antibody affinity and to determine its effect on the development of glomerulonephritis. Low affinity (LA) mice fed a zinc-containing diet (Zn+) produce low-affinity antibody and develop glomerulonephritis when injected daily with antigen. However, LA mice fed a zinc deficient diet (Zn-) produce high-affinity antibody and do not develop chronic glomerulonephritis. Furthermore, when LA mice fed on a Zn+ diet and given daily antigen injections for 25 days were then given a Zn- diet and 25 further daily antigen injections, they developed glomerulonephritis more severely than did control LA mice given Zn+ diet throughout the whole experiment; (2) Immune complex localization was induced in LA mice by daily injections of ovalbumin and then i.v. injection of preformed high affinity anti-DNP-DNP-HSA complexes. These localized in the glomerular capillary wall in ovalbumin-injected animals in contrast to their mesangial localization in controls; and (3) High-affinity mice (HA) were given injections of preformed high- or low-affinity anti-DNP-DNP-HSA complexes and then 50 daily injections of DNP-HSA. The localization of complexes in HA mice following daily antigen injection was markedly influenced by the immunochemical characteristics of the complexes initially injected. These results suggest that the capillary localization of small, low affinity antibody containing antibody-antigen complexes acts as a focus for the subsequent localization of larger, high-affinity antibody-containing complexes. PMID- 2776364 TI - Nursing challenges and educational models. PMID- 2776363 TI - Immunotoxic potential of N-ethyl, N-nitrosourea (ENU) in CD1 mice. AB - The immunotoxic potential of ENU, a potent and transplacental neurocarcinogen, was evaluated in male CD1 mice. The animals received i.p. injections of ENU--0, 2, 8 or 32 mg/kg body weight, in citrate-phosphate buffer, twice weekly for three weeks. Splenic lymphocytes were cultured in the presence of mitogens, lipopolysaccharide, pokeweed mitogen, concanavalin A and phytohaemagglutinin. Mixed lymphocyte cultures in the presence of allogeneic cells were also tested. Blastogenic response decreased in a dose-dependent manner, as measured by the 3H thymidine uptake by splenocytes. Primary antibody production by splenic lymphocytes from animals challenged with a T-dependent antigen (sheep red blood cells) was stimulated at low doses but depressed at the highest dose group compared with the controls, whereas T-independent cell response showed no significant change. Our results suggest that exposure to repeated, low levels of ENU significantly alters the immune status of CD1 mice. The effects appear to be somewhat selective to T cell processes, based on in vivo responses to T-dependent and T-independent antigens. PMID- 2776365 TI - Liver metastasis in cancer of the stomach and its dependence on the histology of the primary tumor: an autopsy study on 102 cases. AB - The case records of 102 patients who had died of gastric cancer between 1975 and 1983 were evaluated. Special emphasis was given to an analysis of the metastatic liver involvement in relation to various histological classifications. The results show a strong preponderance of liver involvement by differentiated adenocarcinomas without intra- or extracellular mucin production, whereas signet ring cell carcinomas or adenocarcinomas with a major extracellular mucin production seem to avoid the liver. If the liver is being involved by the latter tumors, the degree of involvement remains low. Other relationships between certain histologies and the subsequent spread are briefly reported and compared with available data from the literature. The impact on adjuvant therapeutic strategies is discussed. PMID- 2776366 TI - Demonstration of the organ preference of liver selected 'high metastatic' Lewis lung tumor cell line. AB - The experimental metastasis patterns of 'low metastatic' Lewis lung tumor (LLT) and liver selected 'high metastatic' LLT-HH were studied following their arterial dissemination. In previous reports it was shown that both tumor lines develop metastases only in the first encountered organ. Here the liver preference of the liver selected cell line is demonstrated. The model of two LLT cell lines can provide experimental evidence for both the 'mechanical' and 'seed and soil' theories of metastasis formation, depending on the site of tumor cell injection. PMID- 2776367 TI - Replating efficiency of metastatic melanoma cells from lymph node and subcutaneous sites does not predict patient survival. AB - The efficiency of replating of cells from primary colonies grown in semisolid medium has been used to detect and quantitate self-renewal in vitro. A positive correlation has been found by others between the replating efficiency of cells from myelogenous leukemia and patient survival. In the current study we measured primary and secondary replating efficiency of metastatic melanoma cells from subcutaneous tissues or lymph nodes of twelve patients and related these results to patient survival from time of biopsy. No relationship was found between primary and secondary plating efficiency nor for primary or secondary replating efficiency and survival. These results suggest that colony-forming melanoma cells grown under anchorage-independent conditions do not identify a stem cell population important for survival distinct from highly proliferative cells. These studies do not, however, rule out the possibility that a non-clonogenic transitional cell population exists in the tumor. PMID- 2776368 TI - High incidence of chromosomal lesions involving C-heterochromatin in four human melanoma lines. AB - Cytogenetic analysis of early in vitro cultures derived from human melanomas, two primary tumors (Me 10538, Me 1402) and two metastatic lesions in the same patient (Me 665/1, Me 665/2) showed non-random involvement of C-heterochromatin in clonal chromosome rearrangements. Marker chromosomes with C- and DA-Dapi-positive bands were identified in one of the metastases, Me 665/1 (m1) and in the two primary tumors, Me 10538 (m2) and Me 1402 (m3). C-positive fragments predominated in the other metastasis, Me 665/2, which lacked C-regions intercalated in rearranged chromosomes, and were also detected with appreciable frequency in the Me 665/1 and Me 1402 cells. The frequencies of marker chromosomes and their mean number per cell allowed m2 and m1 to be considered as early markers of tumor formation and m3 as a marker of tumor progression. Dissection of chromosome structure, including the origin of the intercalated C-band, has so far been achieved only with the m2 chromosome of the primary tumor Me10538. This was the only cell line which displayed few C-fragments and a narrow chromosomal distribution with a well defined mode. A gradient of malignancy could be detected in the four cell lines, by local and disseminated tumor growth in xenotransplanted mice, with the two primary melanomas 10538 and the 1402 cells at the lowest and upper extremes. This gradient closely parallels the increase in cytogenetic heterogeneity and C heterochromatin lesions from the 10538 to the 1402 cells. PMID- 2776369 TI - Effect of dipyridamole on invasion of five types of malignant cells in organ culture. AB - Dipyridamole (DPD) has been shown to inhibit the motility of cells in culture. We have tested the effect of DPD on the invasion in confronting organ culture of the following malignant cell lines: mouse MO4 cells; rat NBT II bladder tumor cells; human SA4 glioblastoma cells; mouse LLC H61 lung carcinoma cells; and mouse F87 C1.6T2 melanoma x lymphocyte hybrid cells. At concentrations of 20 micrograms/ml or higher, DPD inhibited the invasion of all cell types into embryonic chick heart. In serum-free culture medium the anti-invasive concentration of DPD was about ten times lower. Anti-invasive concentrations of DPD also inhibited proliferation of the malignant cells. Both inhibition of invasion and of proliferation were reversible. PMID- 2776371 TI - Abstracts. Annual meeting, Canadian Society for Clinical Investigation, The Royal College of Physicians and Surgeons of Canada, and participating societies. Edmonton, Alberta, September 22-25, 1989. PMID- 2776372 TI - AIDS in obstetrics. PMID- 2776373 TI - AIDS in obstetrics. PMID- 2776370 TI - Comparative study on Lewis lung tumour lines with 'low' and 'high' metastatic capacity. III. Glycosaminoglycan synthesis, transport and degradation in cell lines. AB - The glycosaminoglycans (GAGs) of low (LM) and highly metastatic (HM) cell lines of the Lewis lung tumour (3LL) were compared using [3H]glucosamine labelling techniques. The GAGs isolated from nuclei, cytoplasm, pericellular fractions and medium were analysed by cellulose acetate electrophoresis and by digestion with specific enzymes, and the following conclusions were drawn. 1. Increased cellular uptake and incorporation of [3H]glucosamine into glycoconjugates of the cytoplasm was a typical feature of the highly metastatic cell line after a 48-h labelling. However, there was no elevated radioactivity in glycolipids. 2. Radioactivity of the purified GAGs was two and three times higher in nuclear and cytoplasmic fractions of HM cells than in those of LM cells. There was much less difference between the two cell lines in the pericellular fractions. 3. A definite change from chondroitin sulphate to dermatan sulphate dominancy was recorded in each GAG fraction. Higher heparan sulphate labelling was observed in the cytoplasmic and pericellular GAGs of HM cultures. 4. In the post-labelling period about three times more GAG was present in the extracellular compartment of the HM cultures compared with the LM cultures. 5. In the LM cultures the total GAG-associated radioactivity decreased by 73 per cent in the 48-h chase period whereas in the HM cultures it decreased by only 30 per cent. This indicates a higher rate of GAG degradation in the LM cultures. PMID- 2776374 TI - AIDS in women: epidemiology. AB - Several facts concerning the distribution of AIDS in U.S. female populations are clear. This disease has made significant inroads, in a quantitative sense, into the female segment of our society as documented by AIDS surveillance data, information on pregnant women and parturients, and by screening data from the military. The impact on women in the reproductive years, on the reproductive health of these women, and on the reproductive outcome of their pregnancies is of substantial concern. Monitoring epidemiologic trends in certain groups will require clever and creative strategies like those of Hoff and colleagues. Additional data may be derived from the CDC's Family of Surveys that will examine HIV prevalence in five groups (in addition to the newborn infant survey described above): intravenous drug users, patients admitted to hospitals, sexually transmitted disease clinic patients, women's health and reproductive health clinics, and tuberculosis clinics. It is hoped that the data obtained from these studies, as well as data gathered on college students and Job Corps applicants, will contribute additional information on HIV infection in women. Monitoring the progress of the AIDS epidemic in women will be difficult. Even more difficult will be the effort to respond to the epidemic in the women it most frequently affects: the poor, minority, disenfranchised women who may be involved in illegal activities (drug use, prostitution, illegal immigration) who are not well networked into the medical and social services of our society. PMID- 2776375 TI - Prenatal HIV counseling and testing. PMID- 2776376 TI - Perinatal transmission of HIV infection: the ethics of prevention. PMID- 2776377 TI - The case against mandatory prenatal testing for HIV. PMID- 2776378 TI - New tests for the prediction of ovulation. AB - With improvements in basic science understanding and technology, it is predictable that within the next decade, more reliable and accurate methods of ovulation prediction will be available. The former may result from the exploration of gonadal peptides and their measurement whereas the latter may result from the ever-increasing resolution of ultrasonographic imaging. The current state of the art in predicting ovulation involves the combination of several of the described techniques (cervical mucus, urinary LH, ultrasonography). Used skillfully together they serve the infertility specialist well. PMID- 2776379 TI - The use of ultrasound in infertility. PMID- 2776380 TI - Application of computer technology to reproductive endocrinology. AB - Data manipulation and information management activities are as central to physicians as writing is to the literary profession. It is not surprising that the computer, as an information tool, has become important and accepted in many aspects of our professional lives. Computer applications can significantly help in daily patient care activities as well as serve as instruments for advancing and managing medical knowledge. Even if the rate of computer technology change slows down from its exponential increase in the last decade, useful software applications will continue at the same or faster rate since they do not now, fully utilize existing hardware features. This presents an exciting future for all information management, decision-rich professions. PMID- 2776381 TI - The treatment of infertility: legal and ethical concerns. PMID- 2776382 TI - Congenital apnea with medullary and olivary hypoplasia: a pathologic study with computer reconstructions. AB - We report a three-month-old infant with congenital central apnea who was ventilator-dependent throughout his brief life. At autopsy the most significant findings were localized to the medulla and included severe tegmental necrosis involving respiratory-related sites and olivary hypoplasia. Golgi impregnations of the cerebellum demonstrated several Purkinje cells with changes consistent with experimental olivary ablation. The majority of Purkinje cells, however, were normal; this observation suggests that in an early and subtotal olivary lesion, the incomplete complement of olivary neurons maintains sufficient collateral axonal branches to compensate for decreased cell number. Computer graphics enabled us to dissect the components of the complex medullary pathology and examine them individually and in selected combinations in three dimensions. Computer reconstruction aided the identification and dating of a malformative lesion (first trimester) from a later (second/third trimester), superimposed destructive lesion. This report suggests that the synthesis of complex morphologic data in human neuropathology into meaningful three-dimensional visual displays by computer reconstruction facilitates their comprehension. Computer reconstruction is especially valuable in the elucidation of 3-D topographic relationships in functionally and architecturally complex regions such as the brain stem. PMID- 2776383 TI - Absence of septum pellucidum and polymicrogyria: a forme fruste of the porencephalic syndrome. AB - Two cases are presented of absence of the septum pellucidum associated with bilateral polymicrogyria. In one case a circumscribed, completely enclosed cavity was present in the white matter of one cerebral hemisphere, different in structure from typical prenatal porencephaly. It is suggested that these cases represent a "forme fruste" of the syndrome of absent septum, bilateral porencephaly, polymicrogyria and heterotopia and may be ascribed to a similar, if less severe, encephaloclastic process of debatable etiology, operating around the midterm of pregnancy. PMID- 2776384 TI - Morphometry of unmyelinated nerve fibers. AB - Based on the literature and personal experiences, methods for planning, performing, and evaluating morphometric studies of unmyelinated nerve fibers (UF) in nerve biopsies are recommended and available control values presented. UF assessment should include total endoneurial area of the entire nerve specimen, size of the evaluated area, number of fascicles studied, final magnification of the respective electron micrographs, counts of registered UF, number per nerve and density per mm2 of all UF as well as of original UF, the respective histograms, and counts of degenerating UF, UF-type Schwann cell nuclei and "empty" UF-type Schwann cell complexes. PMID- 2776385 TI - Wernicke's encephalopathy in acquired immune deficiency syndrome (AIDS): a case report. AB - A 40-year-old male, with established AIDS developed cachexia and dementia. At autopsy opportunistic infections were found. An additional neuropathological finding was Wernicke's encephalopathy. Although malnutrition is common in AIDS patients, it seems that Wernicke's encephalopathy is rare in AIDS. Nevertheless, it is suggested that a therapeutic trial with parenteral thiamine may be useful in AIDS patients with amnestic syndrome and dementia. PMID- 2776386 TI - Severe cerebral atrophy in progressive supranuclear palsy: a case report. AB - A 60-year-old woman with a history of hypertension and chronic headache initially presented with irritative personality change and mild but steadily progressive dementia and oral tendency, left-sided hemiplegia, intense nuchal stiffness, and swallowing difficulty in the later stage. She died of bronchopneumonia at the age of 76. The brain showed marked loss of nerve cells with gliosis in the cerebral cortex and fibrillary gliosis in the white matter in addition to the typical pathological findings of progressive supranuclear palsy (PSP): extensive subcortical neurofibrillary tangles (NFTs) and loss of nerve cells with gliosis accentuated in the globus pallidus, Luys body and substantia nigra. In many case reports on PSP, the cerebral cortex is described as normal or within normal limits [Jellinger 1971, Steele et al. 1964], and to our knowledge, there is no reported case of severe cortical atrophy as seen in this case. The differential diagnosis of this case is also discussed. PMID- 2776388 TI - Program schedule & abstracts presented at the Society of Nuclear Medicine, 14th annual Western Region Meeting. Monterey, California, October 19-22, 1989. PMID- 2776387 TI - First Austrian Neuroscience Winter Meeting. Kitzbuhel, March 16-18, 1989. Joint meeting of the Austrian Societies for Neuropathology, Neurooncology, and Neuroimmunology. Abstracts. PMID- 2776389 TI - Fetal monitoring. PMID- 2776390 TI - The drug analysis laboratory: a resource for teaching clinical pharmacology to students and residents. PMID- 2776391 TI - Pathway-selective sex differences in the metabolic clearance of propranolol in human subjects. AB - This study determined the total clearance of propranolol and the partial clearances through each of its three primary metabolic pathways after administration of an 80 mg single oral dose in 28 young, white subjects (13 women; 15 men). The oral clearance of propranolol was significantly higher (63%, p less than 0.02) in the men (65.7 +/- 7.7 ml/min/kg; mean +/- SE) than in the women (40.2 +/- 6.2 ml/min/kg). This sex difference was mainly attributable to a 137% higher clearance through the P-450-mediated side-chain oxidation in the men (p less than 0.001). There was also a 52% higher clearance through glucuronidation in the men (p less than 0.02). In contrast, the clearance through the P-450-mediated ring oxidation was not different between men and women. After administration of simultaneous intravenous doses of hexadeuterium-labeled drug (0.1 mg/kg) to 11 of the subjects, there were no differences between men and women in volume of distribution or half-life. Moreover, there were no sex differences in plasma and blood binding of propranolol. This study thus demonstrates that higher plasma levels of propranolol occur in women than in men after oral doses and suggests that some drug metabolizing enzymes, but not others, are regulated by sex hormones in human beings. PMID- 2776393 TI - Use of buprenorphine in the treatment of opiate addiction. I. Physiologic and behavioral effects during a rapid dose induction. AB - A new, rapid dose-induction procedure was used in the evaluation of buprenorphine hydrochloride (buprenorphine) as a treatment for opiate dependence. Nineteen heroin-dependent men were given buprenorphine sublingually in ascending daily doses of 2, 4, and 8 mg and then maintained on 8 mg daily. The observations of the transition from heroin to buprenorphine for the first 4 days are described. During this period, subjects reported significantly elevated ratings of "good effects" and feelings of "overall well-being" and decreased ratings of "overall sickness." Data from subscales of the Addiction Research Center Inventory indicated increasing euphoria and decreasing dysphoria and sedation after buprenorphine administration. Subjects and observers consistently identified buprenorphine as an opiate and not as an opiate antagonist. These findings indicate that a rapid dose induction with buprenorphine is acceptable to heroin dependent persons and that it causes minimal withdrawal symptoms. PMID- 2776392 TI - Multiple pathways of propranolol's metabolism are inhibited by debrisoquin. AB - We investigated the effect of debrisoquin on propranolol metabolism in six normal subjects who were extensive metabolizers of debrisoquin. Each subject was studied on two occasions. On the first occasion, each subject received oral propranolol (80 mg) alone; on the second occasion, 7 days later, each subject received a dose of propranolol (80 mg) 30 minutes after the administration of oral debrisoquin (40 mg). Oral propranolol clearance was reduced 33% +/- 16% (p less than 0.05) by the administration of debrisoquin. As predicted, the 4-hydroxypropranolol partial metabolic clearance was significantly (p less than 0.05) inhibited by debrisoquin. However, the side-chain oxidation pathway, as measured by naphthoxylactic acid, was also significantly (p less than 0.05) inhibited by debrisoquin. Debrisoquin administration did not change the renal clearance of any of the metabolites. These data support the usefulness of the in vivo inhibition model in the prediction of cosegregation of routes of metabolism. However, for propranolol, pathways of its metabolism that are not thought to cosegregate with debrisoquin was also inhibited. PMID- 2776394 TI - Contribution of quinidine metabolites to electrophysiologic responses in human subjects. AB - The quinidine metabolites 3-hydroxyquinidine, 2'-oxoquinidione, and quinidine-N oxide and the contaminant dihydroquinidine have been shown to have electrophysiologic activity. This study investigated the time-dependent contributions of quinidine, dihydroquinidine, and the quinidine metabolites to the electrophysiologic effects of a prolonged quinidine infusion in 14 patients referred for management of symptomatic ventricular tachyarrhythmias. Electrophysiologic testing and blood sampling were done at baseline and every 5 minutes throughout a 110-minute quinidine infusion. Changes in ventricular effective refractory periods correlated significantly with serum concentrations of quinidine-N-oxide (r = 0.54; p less than 0.001), 3-hydroxyquinidine (r = 0.50; p less than 0.001), and time (r = 0.52; p less than 0.001) but did not correlate with the quinidine concentrations (r = 0.19). Multiple linear regression revealed that only 3-hydroxyquinidine and time contributed independently to changes in the ventricular effective refractory period. Quinidine concentration was the only variable that contributed independently to changes in ventricular tachycardiac cycle lengths. Time was the only variable that correlated independently with changes in QRS and QTc durations. These data indicate that active metabolites accumulate during an intravenous infusion that attains therapeutic quinidine levels and that quinidine and its metabolites may have different electrophysiologic effects. PMID- 2776395 TI - Making biomedical research a national priority. PMID- 2776396 TI - The newly dead as research subjects. PMID- 2776397 TI - Patients versus surrogates: whose opinion counts on ethics review panels? PMID- 2776398 TI - Testimony of the American Federation for Clinical Research concerning the 1990 budget for the National Institutes of Health before the Subcommittee on Labor, Health and Human Services, and Education Committee on Appropriations United States House of Representatives. PMID- 2776399 TI - AFCR guidelines for the responsible conduct of research. PMID- 2776400 TI - Medical Research Society, summer meeting. 29 and 30 June 1989, Leeds. Abstracts. PMID- 2776401 TI - Transplanting fetal tissue: how ethics and emotions interact. PMID- 2776402 TI - CDH studies rural injury rates and compares Colorado death rates to national rates. PMID- 2776403 TI - What is accreditation? PMID- 2776404 TI - Mycobacterial diseases. PMID- 2776405 TI - In vitro susceptibility of Pseudomonas mallei to antimicrobial agents. AB - Pseudomonas mallei was isolated from pus samples obtained from 34 mallein positive horses. The isolates were subjected to in vitro sensitivity test using 16 different antimicrobial discs. All isolates (34) were sensitive to sulfamethizole, gentamycin, tetracycline, sulfathiazole, kanamycin, tobramycin, streptomycin and a combination of trimethoprim and sulfamethoxazole while none of them were sensitive to cephalothin, colistin, ampicillin, penicillin and nitrofurantoin. Rifapicin, chloramphenicol and carbenicillin were effective against 32, 26 and 18 isolates respectively. The minimum inhibitory concentrations (MICs) of gentamycin, tetracycline, tobramycin, sulfamethizole, streptomycin, rifampicin and a combination of trimethoprim and sulfamethoxazole were 0.28, 0.38, 0.67, 1.40, 3.40, 5.86 and 5.30 micrograms/ml, respectively. PMID- 2776406 TI - In vitro determination of phagocytosis and intracellular killing of Brucella melitensis by goat's polymorphonuclear phagocytes. AB - One hundred and forty samples of goats serum taken from animals suspected of having brucellosis, have been studied by trying to assess the phagocytosis in vitro of Brucella melitensis Rev-1 by polymorphonuclear neutrophil phagocytes opsonized with antibrucella serum. The serum agglutination test and the Coombs antiglobulin test were carried out with the serum samples. The opsonization ingestion, intracellular killing and germ killing power of the serum were also assessed. The results demonstrate that the phagocytic activity of the polymorphonuclear neutrophils opsonized by a particular serum can be of use to determine its titre; its opsonic activity varies according to whether the serums are inactivated or not. Likewise it shows the resistance of Brucella meilitensis Rev-1 to digestion by caprine polymorphonuclear neutrophils, this resistance being independent of the animal's degree of infection. PMID- 2776407 TI - Guidelines for research practice in Australia: NHMRC Statement & Professional Codes. AB - The guidelines for research practice with human participants offered in the National Health and Medical Research Council's 'Statement on Human Experimentation and Supplementary Notes' and a number of professions' Codes of Ethics were examined in terms of the principles of beneficence, respect for persons and justice. Clear differences emerged between the Professional Codes and the NHMRC Statement, particularly in the areas of confidentiality, reporting of research results and further use of data. The question of whether the NHMRC Statement is sufficiently comprehensive to guide research in many fields is considered. PMID- 2776408 TI - Implementing a public cholesterol screening campaign: the North Coast experience. AB - Several community-based interventions in the United States have indicated that it is possible to economically screen the blood cholesterol levels of large numbers of the population and to assist those with elevated levels to reduce their blood cholesterol. The North Coast Cholesterol Check Campaign was designed to involve existing community health staff and community volunteers in a Health Promotion Campaign to: increase community awareness of the importance of cholesterol levels in relation to coronary heart disease; to offer participants immediate blood cholesterol analysis; and to offer dietary advice to those participants who were above the recommended 5.5 mmol/L level. Fifty-two Cholesterol Check Points were conducted on the North Coast of NSW between 1 September and 15 December, 1987. Each Check Point featured a rapid cholesterol analysis with a finger-prick procedure on the Boehringer-Mannheim Reflotron System and immediate dietary counselling by trained staff for participants with elevated levels. A total of 12,067 persons participated in the Campaign: 43 per cent were found to have cholesterol levels that exceeded the recommended desirable levels set by the Australian National Heart Foundation. A 4-5 month follow up of 61 per cent (3,164) of these individuals indicates that 72 per cent lowered their blood cholesterol levels and 65 per cent reduced their BMI. Mean cholesterol change was 0.65 mmol/L and mean BMI change was 0.51. The results indicate the potential for similar community-based nutrition education programmes to reduce cholesterol levels in Australia. This paper details the rationale for the North Coast Cholesterol Check Campaign and the issues concerned with implementation of the campaign. PMID- 2776410 TI - Alcohol and other drugs: the prevention paradoxes. AB - This paper asks what prevents the prevention of alcohol and drug use problems. Five prevention paradoxes can be identified, all of which may well be interfering with our attempts to reduce the problems associated with drug use. Drug problem preventers should be aware of these paradoxes and, thus, be able to avoid becoming ensnared by them. PMID- 2776409 TI - Healthy Cities (Australia) Project: issues of evaluation for the new public health. PMID- 2776411 TI - The incidence and notification of measles in Australia. AB - The incidence of measles in Australia in 1986 was estimated as 43 per 100,000 population, high by the standards of countries where immunization levels are high, low by the standards of countries where immunization levels are low. It is estimated that only 5 per cent of cases are notified in New South Wales, one of only 2 States which require notification. The reasons for this, its significance and a possible remedy are discussed. PMID- 2776412 TI - Social class as indicated by area of residence: a mortality study within an Australian industrial population. AB - The influence of social class on morbidity and mortality is well known and, in many epidemiological settings, its role as a potential confounding variable must be addressed. In occupational studies, particularly those based within a single industry, it is difficult to measure social class by scales based on occupational prestige. In a population study within the Australian petroleum industry, the all cause mortality of males has been examined by social class, as indicated by area of residence, specifically, postcode. Rates of mortality were higher in the lower social classes, and the gradient was similar to that observed previously. The mortality rate of the lowest social class group relative to the highest was 1.73, and the test for trend was significant (p = 0.003). Whilst adjustment for smoking reduced the gradient somewhat, a social class effect remained. PMID- 2776413 TI - Work satisfaction, unionism and militancy amongst nurses. AB - In recent years there has been a substantial increase in attitudinal and industrial militancy amongst nurses. This paper examines some of the factors associated with this change, in the context of the 50-day strike by Victorian nurses in late 1986. Using data collected from 125 nurses in a large public hospital in Melbourne, it is shown that dissatisfaction with the levels of autonomy, pay and intrinsic work rewards were of greatest concern to nurses at that time, and contributed to their growing unrest and attitudinal militancy. This suggests that measures such as professionalisation and salary restructuring may help to alleviate some of the grievances of nurses, but are unlikely to resolve other important issues that contribute to their discontent. PMID- 2776414 TI - New Zealanders' attitudes to health care policy. AB - A fully national sample of over 1,000 New Zealanders were questioned about their attitudes to various health care policy issues. In general terms there was greater support for a publicly-provided health care system than for a privatized free market approach. Almost half the respondents were agreeable to a tax increase so as to improve public health care provision and a similar proportion were against it. Advertising by doctors to increase competition between them was supported by only 33 per cent of the sample. However, the need for more information about doctors' performance was expressed by 49 per cent. On the subject of priorities between high technology and low technology medical expenditure, the sample was fairly evenly divided with almost 40 per cent of the sample favouring each option. There were some differences between various sectors of the population in the attitudes held. In general terms, those with the greatest need for health care and those with the least financial resources were more strongly in favour of public provision. PMID- 2776415 TI - The influence of practitioner and practice characteristics on service activity levels in a New Zealand general practice sample. AB - The impact of practitioner and practice-related characteristics on service activity levels in general practice is assessed. It is hypothesized that while initial medical contact is largely patient-initiated and hence influenced by broader social factors, the subsequent provision of services within the medical system is more likely to be determined by organisational and professional factors. The data are drawn from a one per cent sample of all weekday general practice office encounters in the Hamilton Health District recorded over a twelve month period from February 1979. The average encounter involved three services: typically a history or examination, a prescription and a request for follow-up. Activity levels were measured as the number of services received from the general practitioner by patients in the course of the medical encounter. The broad social characteristics of patients had little impact on activity level. Descriptors of patient health condition, and related attributes such as age and gender, were only moderately predictive of the number of services received. Practitioner and practice-related characteristics seemed to exert little influence, even after controlling for case mix. The strongest predictor of the number of services provided was the identity of the patient's doctor. Of the 30 per cent of variation in total service use explained by the model, half was accounted for by practitioner identity. PMID- 2776416 TI - Monitoring regional geriatric assessment teams: analysis of client flows and outcomes. AB - The Commonwealth Government funding of the Geriatric Assessment Program began in 1984. The Program included an evaluation component, and this paper reports findings for three Regional Geriatric Assessment Teams (RGATs) in Victoria focusing on (1) the identification of different starting points in the flow of clients to the RGATs, (2) the relationships between different starting points and (3) recommended care plans, and the relationships between (2) and final outcome, particularly whether or not this involved admission to nursing home care. The role performed by RGATs is reviewed in the context of introducing mandatory assessment, the success of which will depend on the effectiveness of RGATs not only in differentiating need for and securing admission to nursing home care but also in assessing for, accessing and initiating alternative services. PMID- 2776417 TI - Perceptions of AIDS: a pilot comparison with views of other selected disorders and their implications for further research. PMID- 2776418 TI - Conspecific recognition in the chimpanzee (Pan troglodytes): cardiac responses to significant others. AB - The ability of a chimpanzee (Pan troglodytes) to recognize photographs of conspecifics was evaluated with heart-rate measures. Heart rate was recorded before, during, and after viewing photographs of an aggressive chimpanzee, a friendly companion animal, and an unfamiliar chimpanzee. The subject displayed a differential pattern of heart-rate response to the stimulus animals, without prior experience with the photographs. Responses to the aggressive animal were acceleratory, which suggests a defensive response. Respiratory sinus arrhythmia suggested that this response was associated with sympathetic activation. In contrast, responses to the familiar animal were minimal, whereas cardiac deceleration was observed in response to the strange chimp, which likely reflects an orienting response. Results suggest the chimpanzee is able to recognize photographs of individual conspecifics and that heart-rate change can reflect the nature of established social relationships between chimpanzees. PMID- 2776419 TI - Species-specific auditory preference of bobwhite quail chicks (Colinus virginianus) is altered by social interaction with siblings. AB - This study examined whether reinstating specific aspects of the normally occurring postnatal setting (ongoing social interaction with siblings during rearing and/or testing) would influence bobwhite quail chicks' attraction to their species-typical maternal call. Results revealed that incubator-reared chicks exhibit a strong preference for the species-typical bobwhite maternal call over a group of same-aged siblings in simultaneous choice tests at 24 hr and 48 hr after hatching, but only if the birds are kept in relative social isolation. No preference for the maternal call was found at 24 hr or at 48 hr if chicks were reared in a group of same-aged chicks from hatching and tested to the maternal call vs. siblings or the maternal call paired with a live adult bobwhite hen vs. siblings. These results raise doubts about the appropriateness of the usual methods of isolation rearing in the study of species-typical perceptual preferences and underscore the importance of considering features of the natural social context in the analysis of early perceptual and social behavior. PMID- 2776420 TI - Recognition of food by individual, food-naive, weaning rats (Rattus norvegicus). AB - To control and observe first feeding experiences, pups were reared without access to food. At weaning age, individual pups received simultaneous access to a palatable, noncaloric diet and a similar diet containing starch. Each diet contained a flavor cue. Within 20 min of sampling both diets pups preferentially ingested the caloric alternative. Further tests indicated that pups learned a preference for flavor cues paired specifically with ingestion of starch. In caloric discrimination tests in which the diets were not distinguished by artificial flavors, pups did not show the rapid preference for the caloric diet seen in earlier experiments. We suggest that recognition and preference for the caloric diet is based on its rapid postingestive effects rather than readily preferred sensory features of the starch. Our findings demonstrate the abilities of individual, food-naive pups to rapidly recognize food and indicate a role for associative learning in the onset of independent feeding. PMID- 2776421 TI - Serial learning with wild card items by monkeys (Cebus apella): implications for knowledge of ordinal position. AB - We investigated monkeys' knowledge of the ordinal positions of stimuli that formed a 5-item serial list, ABCDE, by means of wild card items (W) that could substitute for items in the original series. In Experiment 1, training with wild cards was given on 3-, 4-, and 5-item series. In the last of these series, the wild card substitutions created five wild card sequences, WBCDE through ABCDW. During the final 10 sessions of training with each of two different wild cards (Items x and Y), the 3 subjects were able to successfully complete almost 60% of the wild card sequences. In Experiment 2, the two wild cards were presented on the same trial in 10 different double wild card sequences (e.g., AXCDY). The 2 monkey subjects correctly completed about 59% of the double wild card sequences during the final two training sessions. The performance levels achieved on single and on double wild card sequences, although well below that observed on the baseline sequence ABCDE (90% or better), support the view that the monkeys possessed some knowledge regarding the ordinal position of each baseline item. Consequently, an associative chain interpretation, which does not provide for knowledge of ordinal position, falls short as a complete account of the monkey's capacity for serial learning. PMID- 2776422 TI - Multiple measures of hand-use lateralization in the ring-tailed lemur (Lemur catta). AB - Evaluated a free-ranging matriline of 13 ring-tailed lemurs (Lemur catta) from videotaped records for lateralized hand use with 2 tasks and 4 measures: food reaching, feeding posture, duration of food holding, and manipulation of food between mouth and hand while eating. Binomial z scores determined 7 lemurs to be left preferent in reaching, 3 right, and 3 ambipreferent. Ideographic analyses suggested possible sex-linked and early experience twin effects. When compared to right and ambipreferent lemurs, left reach preferent lemurs used the left hand more but bimanuals grasped less in food holding and also engaged in less hand mouth food manipulation. The tendency to manipulate food was not correlated with bimanual holding but was inversely related to left hand holding and directly related to right hand holding. These patterns are discussed as possible precursors of human bimanual manipulation. PMID- 2776423 TI - Perioral somatosensory determinants of nursing behavior in Norway rats (Rattus norvegicus). AB - Prior to assuming the upright crouching posture over their pups during nursing bouts, lactating rats typically engage in several oral behaviors, including nuzzling, licking and rearranging pups. By acutely depriving dams of various aspects of perioral stimulation from pups (with anesthesia of the mystacial pads or of the tongue, with mouth suturing, or with muzzling), we found the following: (1) Distal stimulation from pups maintains proximity-seeking behavior, but is insufficient to stimulate nursing behavior. (2) Lack of tongue feedback decreases pup licking and hastens the onset of crouching. (3) Snout, but not tongue, contact with pups is required for hovering over them. (4) The position of the dam while hovering over her litter enables the pups to gain access to her ventrum, thereby provoking her upright, crouching posture. (5) Older pups are capable of bypassing the dam's perioral attentions and stimulating crouching directly by burrowing under the dam's ventrum. PMID- 2776424 TI - Discriminability, loudness, and masking in the rat (Rattus norvegicus): a confirmation and extension. AB - In Experiment 1, rats discriminated between two sound pressure levels (SPL) of a pure tone: standard (STD) SPLs of 84 and 74 dB and comparison (CO) SPLs 4, 14, and 24 dB below STD were tested in quiet and 60 dB noise at 4 and 12.5 kHz (24 conditions). The decibel difference between STD and CO accounted for only 43.52% of the variance in the signal detection measure of sensitivity, d', across conditions, whereas the loudness difference (LD = STD0.35 - CO0.35) accounted for 89.82% of the variance in d'. These results confirm and extend previous observations that: (a) equal decibel differences are not equally discriminable; (b) loudness for the rat increases as a power function of SPL with an exponent of 0.35: and (c) masked loudness is a linear function of loudness in quiet. In Experiment 2, the assumptions of normal distribution and equal variance implicit in the use of the d' measure were examined. Receiver operating characteristic curves that were well approximated by straight lines of unit slope in normal normal coordinates were obtained and thereby validated the use of d' in Experiment 1. PMID- 2776425 TI - omega-Hydroxyacid derivatives in the epidermis of several mammalian species. AB - 1. omega-Hydroxyacids from the acylceramides and acylglucosylceramides of mammalian epidermis were examined by thin-layer and gas-liquid chromatography to determine their degree of unsaturation and chain-length distributions. The species examined included human (Homo sapiens), pig (Sus scrofa), mouse (Mus musculus) and rat (Rattus rattus). 2. Within a species, the omega-hydroxyacids from the acylceramide and acylglucosylceramide were essentially identical. 3. The human omega-hydroxyacids proved to be mainly saturated with C30:0 being the major entity. 4. The pig contained similar saturated, monoenoic and small amounts of dienoic omega-hydroxyacids, with C30:0, C32:1 being the major entities. 5. The mouse and rat contained C32:0 and C34:1 as the major components. PMID- 2776426 TI - An effective method for plasma lipoprotein separation: studies of various animal species. AB - 1. Plasma lipoprotein separation by density gradient ultracentrifugation largely depends on visual examination based on the natural yellow pigments of lipoproteins. 2. In non-human species and in humans with dyslipoproteinemia, some lipoproteins are not well visualized due to the lack of pigments. 3. Using a fluorescent probe in minute quantity (1,6 diphenyl-1,3,5-hexatriene) we were able to demonstrate an effective plasma lipoprotein separation using a discontinuous density gradient ultracentrifugation technique. 4. Plasma lipoproteins of human, chicken, rat and carp were compared showing the unique character of carp HDL. PMID- 2776427 TI - Purification and characterization of chymotrypsin, trypsin and elastase like proteinases from cod (Gadus morhua L.). AB - 1. Chymotrypsin, trypsin and elastase have been purified from the pyloric caeca of cod. 2. The enzymes were separated by affinity/hydrophobic chromatography on phenyl-butyl-amine (PBA) substituted sepharose. Chymotrypsin eluted in two separate isozyme fractions whereas trypsin and elastase eluted in separate fractions consisting of two closely-related polypeptide chains as revealed by SDS polyacrylamide electrophoresis and isoelectric focusing. 3. The cod enzymes consist of single polypeptide chains with apparent molecular weights of about 27,000 Da as shown by denaturing polyacrylamide gel electrophoresis. 4. The cod proteinases were retarded on gel filtration media. The retardation increased with increasing pressure. 5. Isoelectric focusing analysis shows that the cod enzymes have isoelectric points in the range between 5 and 7. 6. The cod proteinases are rapidly inactivated when stored at low pH's. PMID- 2776428 TI - Myosin light chains of guinea-pig striated muscles. Similarities and differences with rat myosin light chains. AB - 1. Myosin light chains of guinea-pig striated muscles have been screened by two dimensional gel electrophoresis and compared to rat myosin light chains. 2. The fast type light chains 1F and 3F, slow type light chains 1S and 2S, and embryonic type light chain 1E are shown to differ in the two rodents; only the fast type light chains 2F co-electrophorese on the gel. 3. In guinea-pig, as in rat, ventricle muscle light chains appear the same as the 1S and 2S light chains and atrial light chain type 1 the same as the 1E light chain. We show that this embryonic light chain of guinea-pig myosin is difficult to identify and may be confused with the adult 1F light chain. PMID- 2776429 TI - Isolation and primary structure of the C-peptide of proinsulin from the European eel (Anguilla anguilla). AB - 1. The primary structure of the C-peptide of proinsulin from the European eel has been established as: DVEPLLGFLSPKSGQENEVDDFPYKGQGEL. The peptide was isolated from the extract of eel pancreas in a yield that was approximately equimolar with insulin. A comparison with the predicted structures of C-peptides from other teleost fishes has identified a domain in the central region of the peptide that has been more highly conserved than the rest of the molecule. PMID- 2776430 TI - Lipid and apolipoprotein distribution as a function of density in equine plasma lipoprotein. AB - 1. Equine lipoproteins were isolated from plasma by density gradient ultracentrifugation and apolipoprotein composition determined by SDS polyacrylamide gel electrophoresis. 2. VLDL and IDL were present at low concentration (0.2 mg/ml). Two apoB components of Mr corresponding to human apoB 100 and one apoB-48-like component were represented in VLDL fraction. 3. LDL-1 and LDL-2 subfractions have displayed an almost equal concentration (0.4 mg/ml). Two apoB-100-like components were the major apolipoproteins in each fraction. Small amounts of apoB-48-like component were detectable in LDL-1 and LDL-2. 4. HDL-2 represented a major class of equine lipoproteins (1.8 mg/ml). ApoA-1-like component was the dominant protein in HDL-1, HDL-2 and HDL-3. Dimeric apoA-II like components were slightly represented in HDL subfractions. 5. HDL-3 displayed the same apolipoprotein pattern as HDL-1 and HDL-2, but two further minor proteins of Mr 20,000 and 14,000 were detected. 6. VHDL represented a minor class of lipoprotein (0.2 mg/ml). ApoA-I-like component was the major apolipoprotein of VHDL. Small amounts of apoA-IV-like, apoE-like, and Mr 55,000 protein were detectable. 7. ApoC-like of Mr lower than 10,000 was represented in all equine lipoprotein classes. PMID- 2776431 TI - Enzymatic properties of glyceraldehyde-3-phosphate dehydrogenase from fish muscle. AB - 1. Glyceraldehyde-3-phosphate dehydrogenase was isolated from the ordinary muscle of red sea bream Pagrus major, Pacific mackerel Scomber japonicus and carp Cyprinus carpio by ammonium sulfate fractionation, followed by DEAE-Sepharose CL 6B and DEAE-cellulose column chromatography and Sephadex G-150 gel filtration, and examined for enzymatic properties. 2. Their optimum pH values in the backward reaction ranged from 7.8 to 8.2, and Km values from 1.56 to 1.90 mM. 3. Irrespective of the species of fish, the enzymatic activity was non-competitively inhibited by inorganic phosphate in the backward reaction. Divalent metal ions were not necessary to activate these glyceraldehyde-3-phosphate dehydrogenases. In the presence of 1 mM Zn(2+), these enzymes showed relative activities of 42 64% the activities measured in the absence of those ions. 5. Thermal stability of carp enzyme was higher than those of red sea bream and Pacific mackerel; the enzyme activity of the latter two species was almost lost on incubation at 45 degrees C for 10-20 min, whereas carp enzyme retained half the activity even when incubated at 60 degrees C for 30 min. PMID- 2776432 TI - Plasma and cellular zinc levels and membrane lipid composition in streptozotocin diabetic rats. AB - 1. Lipid and zinc analyses were conducted on liver mitochondrial and microsomal membranes as well as erythrocyte ghosts from streptozotocin (STZ) treated animals. 2. In STZ animals, analysis of phosphatidylcholine (PC) and phosphatidylethanolamine (PE) fatty acids revealed an increase in palmitic acid and a corresponding decrease in stearic acid. 3. Polyunsaturated fatty acids were also affected, with an increase in 18:2, decrease in 20:4 and an increase in 22:6 in STZ animals compared to controls. 4. The change in fatty acid composition was observed in all three membrane fractions. 5. Plasma zinc levels in STZ animals were elevated while no difference was observed in membrane bound zinc. 6. Thus, while there appears to be both altered trace metal as well as membrane lipid metabolism in STZ treated animals, membrane bound zinc does not seem to be affected. PMID- 2776434 TI - A comparison of the structure and properties of human, rat and rabbit serum transferrin. AB - 1. The chemical and physical properties of human, rat and rabbit serum transferrins were compared. 2. The proteins were found to differ in heat stability, iron release, their behaviour during electrophoresis in SDS polyacrylamide gels, and their sulphur amino acid content. 3. The results are discussed in relation to the possible role of disulphide bridges in maintaining the shape and flexibility of the three transferrins, and in their appearance during the evolution of the transferrin family. PMID- 2776433 TI - Concentrations of volatile fatty acids and acetate production rates in the forestomachs of grazing camels. AB - 1. Concentration profiles of volatile fatty acids (VFA), fluid volumes and turnover rates, and acetate production rates were measured in two different seasons in the forestomachs of four fistulated dromedary camels grazing in the Kenyan thornbush savannah. 2. VFA profiles and average concentrations were similar under both feeding conditions but, due to a smaller fluid turnover, VFA outflow to lower gastric sections in the dry season was reduced by almost 50%. 3. The mean acetate production rate fell from 2234 mmol/hr in the green season to 816 mmol/hr in the dry season, i.e. by approximately 64%. PMID- 2776435 TI - Comparison of the property of a novel isozyme E (formerly null mutant, O) with other isozymes of hemolymph acid phosphatase of the silkworm. AB - 1. A novel acid phosphatase isozyme E (formerly null mutant 0) was partially purified by ammonium sulfate fractionation, DEAE-Sephacel and Sephacryl S-200 column chromatography, and its properties were compared with those of other isozymes of the silkworm hemolymph. 2. The isozyme E was extremely heat labile and showed lower pH-stability than those of others. 3. Three isozymes hydrolyzed p-nitrophenyl phosphate, alpha-naphthyl phosphate, alpha-naphthyl phosphate and glucose-1-phosphate strongly. The isozyme E showed about 50% hydrolyzing activity for alpha-naphthyl phosphate as compared to those of A and B. 4. Activities of three isozymes were inhibited by tartaric acid, sodium fluoride, ammonium molybdate and potassium diphosphate. Inhibitory effects of Cu(2+) and HG(2+) were most remarkable against E isozyme. PMID- 2776436 TI - Distinct pulmonary and hepatic forms of flavin-containing monooxygenase in sheep. AB - 1. Flavin-containing monooxygenase (FMO) in pulmonary and hepatic microsomes from sheep was analyzed by western blotting by probing with antibodies raised against FMO purified from rabbit lung and pig liver. 2. Pulmonary microsomes from sheep contain a single major protein which cross-reacts with the antibody to rabbit lung FMO, but no band can be observed when probed with the antibody to the pig liver enzyme. Likewise, sheep liver microsomes contain a protein which cross reacts with the antibody to pig liver FMO, but no significant staining is observed following incubation with antibody to the lung enzyme. 3. Sheep pulmonary and hepatic microsomal FMO also display a difference in activity toward chlorpromazine and n-dodecylamine. 4. Preliminary evidence suggests that sheep FMO may be induced (liver) or repressed (lung) during pregnancy. 5. Sheep are similar to rodents (rat, mouse, guinea pig, hamster and rabbit) in having distinct forms of pulmonary and hepatic FMO. The immunochemical and catalytic difference between sheep liver and lung FMO is similar to that of rabbit. PMID- 2776438 TI - Interactive graphic editor for analysis and enhancement of medical images. AB - We have developed an interactive graphic editor to define subregions within a volume of medical images arranged in serial sections. The editing methods include tracing and automatic growing of connected components defined by the gray level range. The editor performs a statistical analysis of the signal contained in each subvolume and is used in studies of magnetic resonance (MR) signal in medical images. The graphic editor is also used for creating 3D views from MR images based on the new volume-rendering algorithm. The editor transforms the volume of images by remapping their gray levels and by multiplanar cuts. The ability to suppress regions having the same signal intensity as the region of interest is important in generating an unobstructed view of the anatomical structures. PMID- 2776437 TI - Developmental patterns of peroxisomal enzymes in amphibian liver during spontaneous and triiodothyronine-induced metamorphosis. AB - 1. Liver catalase, D-amino acid oxidase, urate oxidase of Alytes obstetricans and Xenopus laevis (anuran amphibians) and fatty acyl-CoA oxidase of Alytes were present at all post-embryonic stages. 2. Catalase and D-amino acid oxidase activities increased during spontaneous metamorphosis of the two species. 3. During triiodothyronine-induced metamorphosis of Alytes larvae, catalase and D amino acid oxidase activities increased after a latent period. 4. Our results suggest that expression of some hepatic peroxisomal enzymes is modulated by thyroid hormones. PMID- 2776440 TI - Microcomputer programs for complex epidemiologic procedures. I. Computation of adjusted rates. AB - In epidemiological cohort studies one measure of association based directly on incidence or mortality rates is the excess rate. This measure is defined as the excess in these rates between two groups with different exposure experience. At times the computation of these excess rates separately for each of the categories of a risk factor is crucial, as with these rates we can then determine whether the factor exerts a dose-response effect that may implicate a causal relation. Recently an indirect method of standardization has been reported, which computes the excess rates for a factor that are adjusted for the confounding effects of several other factors. The method involves a complex iterative procedure that cannot be carried out easily without the aid of a computer. The objective of this communication is to make available a microcomputer program that has been written to implement this laborious computation. In this pedagogic note the adjustment method is described and the application of the microcomputer program is illustrated. PMID- 2776439 TI - An algorithm for the quantification of ST-T segment variability. AB - A template boundary algorithm which quantitatively determines repolarization (ST T segment) variability in a normal population has been developed. The algorithm defines an initial ST-T template for comparison with successive beats. Variability is quantified using boundary limits around the template which are widened, when necessary, to included incoming ST-T segments. The boundaries at the end of each hour are stored and the collection of boundaries over a set of normal subjects quantifies the normal variation over the entire ST-T segment. The algorithm can be used to determine prospectively normal ST-T variability based on a regression analysis of R-wave or T-wave amplitude, and QT interval. Application of these boundary predictions should be useful in distinguishing repolarization changes secondary to ischemia from normal variability. PMID- 2776441 TI - Microcomputer programs for complex epidemiologic procedures. II. Test for equality and trend of adjusted rates. AB - The microcomputer program presented in Part I of this series (M. H. Dong, Comput. Biomed. Res. 22, 349 (1989)) is useful for computing adjusted excess rates. That program, however, does not provide a means for a quantitative analysis of the adjusted rates computed for the categories of a risk factor. At times it is crucial for us to determine whether after adjustment a factor exerts a dose response effect that is statistically significant. Recently a hypothesis test for analyzing such an effect has been reported. The test is based on score statistics obtained directly from a product model assumed for the excess rate. The objective of this second part is to continue to make available a microcomputer program that has been written to implement the computation of these score statistics, which likewise entails a complex and lengthy iterative procedure. In this communication the test is described and the application of the microcomputer program is illustrated. PMID- 2776442 TI - Localization of cutaneous lesions in digital images. AB - Digital imaging could potentially provide a rapid, objective, and quantitative means of detecting changes in important skin conditions, especially the dysplasic nevus syndrome. Image analysis techniques can be applied to digital images to automate the search for changes in moles or other features. Consistent determination of lesion boundaries, perimeter, and area in digital images is a vital first step in this process. In this paper, we show how bilaterally symmetric Laplacian-of-a-Gaussian filters can be used to recover the borders of selected lesions while remaining robust with respect to factors such as the camera point spread function and additive noise. Tests on real and synthetic images demonstrate that lesion borders, area, and perimeter can be obtained with a high degree of reliability. Boundaries are routinely found to within +/- 0.2 pixels, and area and perimeter measurements vary by less than 10% when imaging spot targets and actual cutaneous lesions under a realistic range of experimental conditions. PMID- 2776443 TI - A-to-D conversion from paper records with a desktop scanner and a microcomputer. AB - A novel method for digitizing signals contained in paper records is presented. This method is based on the use of an inexpensive optical scanner to translate the image on paper into a binary, bit map data structure. Several algorithms which recognize the signal line in the bit map and translate it into a series of numbers which are equivalent to the output of electronic analog-to-digital converters are described. The method was validated by comparison both with idealized test patterns of varying frequency content and with electronically digitized pressure and pressure time derivative tracings from chronically instrumented dogs. The root mean square error for the physiological signals was 3.5-3.9% of peak-to-peak full scale, corresponding to roughly 50% more than the thickness of the signal line on the paper. PMID- 2776445 TI - PROPOV-K: a FORTRAN program for computing a kappa coefficient using a proportional overlap procedure. AB - The computer program PROPOV-K allows the computation of an unweighted kappa coefficient for expressing interrater agreement in the general case in which multiple raters (not necessarily fixed in number) formulate a variable number of multiple diagnoses for each subject. PROPOV-K assesses agreement among lists of multiple diagnoses composed of nonordered categories. PROPOV-K calculates a kappa coefficient on the basis of estimating proportion of agreement between two diagnostic formulations as the ratio of the number of agreements between specific categories over the number of different specific categories mentioned in the two diagnostic lists. When multiple raters formulate a variable number of multiple diagnoses for each subject, the use of a kappa coefficient has been limited to researchers since there are no generally available computer programs. The purpose of this paper is to present a FORTRAN computer program allowing the computation of a kappa coefficient for the case mentioned above and to illustrate its use with examples respectively involving multiple psychiatric and multiple physical diagnoses. PMID- 2776444 TI - Elliptic fourier analysis of cell and nuclear shapes. AB - The elliptic Fourier analysis (EFA) is proposed to characterize the cell and nuclear shape. The principal feature of this method is that it decomposes shapes with a closed contour into subshapes each of which maintains a closed contour. A set of homogeneous, nonredundant descriptors, independent of the contour rotation and translation, is computed from the elliptic Fourier coefficients. These descriptors also account for the contour size and resolution. The paired analysis of the cell and nuclear shape provides an exhaustive and accurate definition of the nucleoplasmic configuration. PMID- 2776446 TI - Compressed spectral arrays for the analysis of 24-hr heart rate variability signal: enhancement of parameters and data reduction. AB - Heart rate variability signal in the form of an R-R interval tachogram is detected in Holter type 24-hr ECG recordings. Spectral analysis is carried out over consecutive nonoverlapping records, and the information is displayed in the form of a compressed spectral array through parametric techniques. The trends of spectral parameters such as low-frequency (LF) and high-frequency (HF) powers and central frequencies are also plotted, together with the classical mean R-R value and variance relative to each single spectrum. These parameters quantify the effect of sympatho-vagal balance on heart rate control during the 24-hr period and provide important elements for the diagnostic evaluation of various pathologies, like hypertension. A spectral compression algorithm which checks the position of the poles relative to LF and HF bands inside the unitary circle in the complex zeta-plane is also developed. Applications of this procedure are foreseen in the clinical evaluation of ambulant patients as well as in the study of physical and psychological stress. PMID- 2776447 TI - SESAM-DIABETE, an expert system for insulin-requiring diabetic patient education. AB - SESAM-DIABETE is an interactive educational expert system that provides personalized advice and therapeutic recommendations for insulin-requiring diabetic patients. Because of its sophisticated explanation facilities, this system is intended to complete the more traditional educational tools for diabetic patients. It has been developed using an original essential expert system, namely SESAM, itself implemented in an upper-layer of Lisp, MBX. Its control structure uses a top-down strategy to solve a problem; i.e., it decomposes the current problem into subproblems easier to solve, this method being recursively applied to each subproblem. All information about patients is kept in a Patient Medical Record, which allows their follow-up. This system is currently available from their home for selected patients through the French telematic network TELETEL and is under clinical evaluation. PMID- 2776448 TI - Computer prediction of congestion in the obstetric ward. AB - A computer system was developed to predict congestion of the obstetric ward in the near future. The admittance and stay in the obstetric ward of every registered patient are simulated based on the table of reservation and observed data of hospital stay, and from this the number of inpatients (occupied beds) is predicted. If the expected date of confinement of every obstetric patient is put into the computer and the information on patients who have already given birth is deleted, it is possible to obtain a reasonably accurate prediction. PMID- 2776449 TI - Tree graphs of RNA secondary structures and their comparisons. AB - To facilitate comparison of RNA secondary structures each structure is represented as an ordered labeled tree. Several alternate secondary structures yielding a set of trees can be computed for any given RNA molecule (sequence). Frequently recurring subtrees are searched in this set of trees. The consensus structure motifs are then selected and used to construct a secondary structure model of the RNA. Given the difficulties involved in RNA secondary structure calculations, this procedure may significantly improve our predictive capabilities. In addition, the change of secondary structures between two different RNA sequences is described as a transformation of ordered trees. The transferable ratio of tree A from tree B is defined as a proportion of the largest common subtrees in trees A and B occurring in tree A. The method is applied to the study of the mechanism of human alpha 1 globin pre-mRNA splicing. In the study, two tentative splicing mechanisms, A and B, with different orders of intron excision from alpha 1 globin pre-mRNA have been stimulated. A possible relationship between the structural features of the secondary structures and the order of intron excision in the pathway of precursor splicing of human alpha 1 globin is discussed. PMID- 2776450 TI - Implementation of a computerized patient advice system using the HELP clinical information system. AB - A COMputerized Patient Advice System (COMPAS) was designed to test the feasibility of using the HELP clinical information system to direct the respiratory therapy of intensive care (ICU) patients acutely ill with adult respiratory distress syndrome. A modified black-board control architecture allowed the application of knowledge in either a forward or a backward chaining mode. Expert clinicians recommended decision logic and actions for five different modes of ventilatory support. The clinical staff used COMPAS to manage the ICU ventilatory support of five patients for a total of 624 hr. During that time there were 407 decision-making opportunities. COMPAS automatically generated therapy suggestions 379 (93.1%) times and the clinical staff accepted COMPAS's recommendation in 320 (84.4%) of these cases. These results suggest that the ventilatory support of severely ill ICU patients can be managed by a clinical information system using a blackboard control architecture. PMID- 2776451 TI - A computer program for analyses of vital statistics-based occupational mortality data. AB - Routinely collected vital statistics mortality data (death certificate data) on occupation and industry are useful for (1) generating hypotheses about potential occupational hazards and (2) identifying occupational mortality differentials possibly associated with socioeconomic and life-style factors. This paper presents a Fortran program that analyzes occupational mortality using vital statistics and census data. The user can form any desired grouping of age, race, occupation (or industry), and cause of death codes for analysis. The program also allows stratification on social class or other user-defined correlates of occupation such as smoking behavior. Furthermore, program output can be used for Poisson regression analysis of mortality rates. PMID- 2776453 TI - Nonlinear SPICE models for physiologic systems. AB - Most biological systems are nonlinear but investigators interested in modeling them often make linear approximations to avoid performing tedious manual calculations. SPICE (Simulation Program with Integrated Circuit Emphasis, developed at the University of California, Berkeley, CA), an electrical circuit simulation program, is frequently used for creating and analyzing linear network models of physiologic and pathophysiologic processes. However, few investigators use the full capabilities of the program by modeling nonlinear elements. We developed six nonlinear SPICE elements, allowing simplified modeling of most commonly encountered physiologic processes. These are provided as subcircuits that can be easily incorporated into existing SPICE models. Included are voltage and current controlled nonlinear resistors, capacitors and inductors. In addition, we describe adders, multipliers, powers, inverse, and derivative functions. PMID- 2776452 TI - Experimental data acquisition and manipulation by microcomputer. AB - To improve experiment management, we developed a microcomputer system which automatically displays, collects, manipulates and stores data in real-time. Upon completion of all experiments, it automatically performs statistical analysis, prints graphs and stores the results. The components required to accomplish these tasks include: (1) a microprocessor and visual monitor; (2) transducers, each with preamplifier, filter and amplifier; (3) couplers from each amplifier to the computer; (4) software to direct display, manipulation, statistical analysis and storage of data; and (5) hardware to allow real-time graphic and hard copy display. The resulting system allows sampling rates up to 300 Hz and accuracy of 0.20% full scale, 0-200 mm Hg. It provides great flexibility, efficiency and reliability in data management, and thereby facilitates the organization and completion of research protocols. It simplicity of design and operation makes it easy to use, and it is extremely cost effective. We present a method of laboratory microcomputerization as a practical alternative for management of physiological experimentation. PMID- 2776454 TI - A program for the computation of power and determination of sample size in hierarchical experimental designs. AB - We have devised a program that allows computation of the power of F-test, and hence determination of appropriate sample and subsample sizes, in the context of the one-way hierarchical analysis of variance with fixed effects. The power at a fixed alternative is an increasing function of the sample size and of the subsample size. The program makes it easy to obtain the power of F-test for a range of values of sample and subsample sizes, and therefore the appropriate sizes based on a desired power. The program can be used for the 'ordinary' case of the one-way analysis of variance, as well as for hierarchical analysis of variance with two stages of sampling. Examples are given of the practical use of the program. PMID- 2776455 TI - BOOMER, a simulation and modeling program for pharmacokinetic and pharmacodynamic data analysis. AB - BOOMER is an improved version of an earlier non-linear regression program, MULTI FORTE. Rather than the user writing a FORTRAN subroutine, models are defined by means of the parameters which make up the model. Models based on differential equations are specified by means of zero-order, first-order, or Michaelis-Menten type rate constants. Doses (in units of mass) are translated into the usually observed concentration units by a reciprocal volume parameter. Integrated equation models are specified in terms of baseline terms, exponential terms, or the emax function with slope term as described by the Hill equation. Time points can be specified as parameters to specify dose times, infusion start/stop times, or lag times. With careful selection of parameters quite complex models can be specified. The user has a choice of differential equation solvers and fitting algorithms. PMID- 2776456 TI - Logistic regression model for the assessment of microalbuminuria and microproteinuria in insulin-dependent diabetic patients at risk. AB - Diabetic microalbuminuria, which predisposes to the irreversible macroproteinuria and terminal renal failure, has been shown to be reversible by stringent metabolic control. In this study, using logistic regression, 23 patients with insulin-dependent diabetes mellitus were evaluated. Basing on the reported biochemical changes in patients with diabetes mellitus, the relationship between microalbuminuria and serum biochemistries was assessed. Four biochemical parameters were shown to be significantly related to the amount of microalbuminuria and microproteinuria. The microalbuminuria as assayed by rocket immunoelectrophoresis is closely correlated with the microproteinuria as measured by the Coomassie dye binding method and both have a significant relationship with plasma creatinine, bicarbonate, albumin and globulin as assessed by the Minitab computer program and the Biomedical Data Package--Logistic Regression computer program. The relationship with bicarbonate and creatinine can be due to a decrease in glomerular filtration rate associated with more advanced microproteinuria. The relationship with albumin and globulin is the result of impaired albumin synthesis by the liver in diabetes mellitus. From these data, two simple equations which can provide a relative risk factor with rough quantitative assessment for microproteinuria and microalbuminuria are derived. Thus, from these four parameters available from relatively simple blood biochemistries, assessment can be made of the severity of coexisting diabetic proteinuria. The measurement of the latter is not readily available and is more costly and tedious. This assessment together with the finding of a decrease in albumin, slight increase in creatinine and decrease in bicarbonate associated with the more severe microalbuminuria can be used to alert the diabetologist in implementing tighter metabolic control and other interventional methods before irreversible macroproteinuria develops. PMID- 2776458 TI - XIIIth International Complement Workshop. September 10-15, 1989, San Diego, CA, USA. Abstracts. PMID- 2776457 TI - On the possibility of 'real-time' Monte Carlo calculations for the estimation of absorbed dose in radioimmunotherapy. AB - Dosimetry calculations of monoclonal antibodies (MABs) are made difficult because the focus of radioactivity is targeted for a nonstandard volume in a nonstandard geometry, precluding straightforward application of the MIRD formalism. The MABDOS software addresses this shortcoming by interactive placement of a spherical perturbation into the Standard Man geometry for each tumor focus. S tables are calculated by a Monte Carlo simulation of photon transport for each organ system (including tumor) that localizes activity. Performance benchmarks are reported that measure the time required to simulate 60,000 photons for each penetrating radiation in the spectrum of 99mTc and 131I using the kidney as source organ. Results indicate that calculation times are probably prohibitive on current microcomputer platforms. Mini and supercomputers offer a realistic platform for MABDOS patient dosimetry estimates. PMID- 2776459 TI - Postnatal care: getting off to a good start. PMID- 2776460 TI - Maternity care. High hopes. PMID- 2776461 TI - Laryngeal carcinoma. PMID- 2776462 TI - Continence advice. PMID- 2776463 TI - Community nurse profile. Practice makes perfect. PMID- 2776464 TI - Evaluation of the FemTest device pre- and post-sterilization. AB - A study was conducted at the Universidad Austral, Valdivia, Chile, School of Medicine, to evaluate the safety, ease of use and effectiveness of the FemTest device* (FT), a new instrument to evaluate tubal patency. A total of 110 interval women were admitted to the trial between February 1985 and August 1986, all of whom wanted to be sterilized. The mean age of the women was 32.2 years and the mean number of live births was 3.1. Women underwent FT and hysterosalpingography (HSG) procedures pre- and post-sterilization in order to compare the results. Sixty-seven women were surgically sterilized and forty-three women were sterilized with transcervical application of methylcyanoacrilate. Complications and complaints experienced by the study participants included mild to moderate discomfort during FT procedures. Assessment of patient discomfort was not done during the HSG procedures. FT and HSG findings agreed in 97.2% of the women prior to sterilization. The simplicity and effectiveness of the FT procedure suggests it will be an excellent method to test for tubal patency after a non-surgical female sterilization procedure. PMID- 2776465 TI - Men, blue collar work and drinking: alcohol use in an industrial subculture. AB - We present the findings of research designed to identify the social and environmental precursors of heavy drinking in a population of white assembly-line workers. Using a primarily qualitative approach, we examine alcohol use in relation to the sociocultural characteristics of individuals' community and workplace environments and their early-life socialization experiences. The sample consists of 30 men--15 heavy drinkers and 15 moderate drinkers--who were drawn from the workforce of a large durable goods manufacturing plant that closed in 1982. Workers' accounts of their own and coworkers' drinking suggest that a heavy drinking subculture existed in the workplace. Within this culture, drinking was a normal part of work life, and served to improve social relationships, reduce boredom and dissatisfaction, and to express solidarity in defiance of management rules and working conditions. Membership in this subculture, we believe, was most important for those men who had no interests or social involvements outside the workplace. We compare the characteristics of workers who chose to join this subculture (the heavy drinkers), with those who did not (moderate drinkers). Factors that predicted involvement in the heavy drinking subculture were: a sociocultural background where heavy male drinking was normative, lack of extra work social resources, and leisure activities restricted to coworkers and work related contexts. Conversely, moderate drinkers tended to come from moderate drinking backgrounds, and had considerable community and social group involvements that included family and peer networks to the virtual exclusion of coworkers. PMID- 2776466 TI - Somatization of psychiatric illness in Mediterranean migrants in Belgium. AB - Mediterranean migrants with acute psychiatric problems show a predominance of dramatic somatization in their symptom patterns, when compared with Belgian patients with similar psychiatric problems and admitted after identical recruiting and referral procedures. D.S.M. III diagnoses of the Mediterranean patients, however, reveal neither a correspondingly high incidence of somatoform disorders nor histrionic personalities. Adult and adolescent Mediterranean migrants appear to convey psychological problems through contrasting forms of somatization. Adolescents somatize mainly through self-inflicted symptoms, whereas adults express somatization in a more 'natural' way--insubjective bodily sensations, psychophysiological symptoms or psychosomatic syndromes. The main reason for acute psychiatric admission among Belgian adolescents is outward aggressive behaviour. In Mediterranean adolescents in Belgium it is a combination of somatization and aggression in self-inflicted physical symptoms. PMID- 2776467 TI - Compliance and the patient's perspective: controlling symptoms in everyday life. AB - Non-compliance with medical advice is poorly understood. Most of the existing literature considers the problem only from the doctor's point of view. We undertook a diachronic, qualitative study of the illness experiences of 19 women to try to understand non-compliance from the patient's perspective. Three-fourths of our study group had ceased to follow their doctor's recommendations by four months post-diagnosis. Their non-compliance could not be explained by the fact that the women held understandings of their illnesses which were incongruent with their physician's; nor were they unable to understand the diagnosis they received. A consideration of the roles that their diagnosis and treatments played in their daily lives proved more useful in explaining their failure to follow physicians' recommendations. Patients' use of treatments reflected their desire to control symptoms within the constraints of their daily routines. PMID- 2776468 TI - Misunderstanding as therapy: doctors, patients and medicines in a rural clinic in Sri Lanka. AB - In this paper I want to draw attention to the integration of Western medicine into therapeutic choices among patients in rural Sri Lanka. These patients' interpretation and use of Western pharmaceuticals is discussed in relation to the Ayurvedic theory of balance. The influence of this theory on people's ideas of health and illness is highlighted in encounters where laymen and professionals alike use Western medicines according to context and their respective perspectives. Such therapeutic encounters are used to describe how the meaning of therapy is negotiated and communicated. The modes of perception used by doctors and patients seem to be mutually exclusive but each has its own logic. Western medicines are used as a symbolic means which help the patients and the practitioners of Western clinical medicine in a rural health unit to communicate through - rather than despite - "misunderstandings" based on their differing cultural assumptions about the body, about disease and about therapy. This argument is raised in relation to recent theoretical discussions among medical anthropologists concerning doctor-patient relationships, asymmetric medical relations and the analysis of meaning systems. PMID- 2776469 TI - A double-blind comparison of flurbiprofen with diflunisal in the treatment of acute ankle sprains and strains. AB - Fifty patients with acute ankle sprains/strains were treated with either 100 mg flurbiprofen or 500 mg diflunisal twice daily in a double-blind fashion for 18 days or until symptoms of the injury resolved. Tolerability of the drugs was evaluated by recording the occurrence of adverse drug reactions and monitoring laboratory parameters. Efficacy measurements were performed at enrollment and at Visit 2-Day 7, Visit 3-Day 14 and Visit 4-Day 21 to determine relief of symptoms and return to normal activities. Patients in both treatment groups exhibited marked improvement by Visit 2-Day 7 with almost complete recovery by Visit 3-Day 14. Flurbiprofen patients had a significantly shorter duration of therapy. Results from three of the six physician assessments were marginally to significantly superior for patients in the flurbiprofen group. The only reported adverse event was mild gastro-intestinal intolerance in a patient receiving diflunisal. Flurbiprofen and diflunisal appear to be effective and well-tolerated medications for the treatment of acute ankle sprains and strains. PMID- 2776470 TI - Red blood cell filterability during incubation and its dependence on RBC shape, glucose and serum albumin: a study in the diabetic ob/ob-mouse. AB - Red blood cell (RBC) filterability in the obese-hyperglycaemic ob/ob-mouse is markedly impaired compared with the lean controls. A new RBC filtration device with improved time resolution was used to study this phenomenon in relation to RBC shape-transformations and the effects of glucose and albumin. In ob/ob-mice, but not in controls, filterability increased with time; however, the difference between the mice remained significant after 2 h. Stomatocytosis (cup shaped RBCs) was in the order of 80-90% in both types of mice and 56% in human blood. The proportion of stomatocytes decreased linearly with time, most rapidly in the ob/ob-mice. Only 1% echinocytes (crenated RBCs) was seen after 2 h of incubation. In the absence of serum albumin stomatocytosis was initially 40% and declined further during incubation. Echinocytes showed the opposite reaction, increasing from about 10% to 55%. Glucose, 20 mM, caused an immediate increase in filterability but had no corresponding effect on the RBC shape transformations. PMID- 2776471 TI - Correlation of humoral immune response with clinical presentation, pulmonary lesions and mortality patterns of goats experimentally infected with peste des petits ruminants virus. AB - The patterns of humoral immune response, measured by enzyme-linked immunosorbent assay and the development of clinical signs, pulmonary lesions and mortality patterns were studied in goats experimentally infected with peste des petits ruminants virus (PPRV) or Kata virus. It was possible to classify the animals into high and low responders according to the pattern of humoral immune response. The high responders had a prolonged, chronic infection characterized by a giant cell pneumonia which was sometimes complicated by bronchopneumonia. Such animals survived beyond 1 month. The low immune responders had a subacute or acute clinical presentation. In the former case, the animals developed an uncomplicated giant cell pneumonia and died within 1 month of infection. Those with the acute symptoms developed pulmonary congestion and oedema and succumbed to the infection in 1 week. The clinical and pathological response of goats to PPRV infection, and ultimately the outcome of the infection correlated well with the ability of the goats to mount specific antibodies to PPRV. PMID- 2776472 TI - Effect of cell age on the quenching of erythrocyte membrane protein fluorescence. AB - The accessibility of membrane protein tyrosyl and tryptophanyl residues for fluorescence quenchers (acrylamide and iodide) was compared in membranes isolated from various age fractions of bovine erythrocytes. An increase in the quenching efficiency of membrane protein fluorescence was found with advancing erythrocyte age, as demonstrated by elevated values of the Stern-Volmer constant. These results provide evidence for a progressive change in membrane protein organization during erythrocyte aging, enhancing the availability of membrane proteins for interactions with external factors. PMID- 2776473 TI - Nifedipine decreases the mitotic activity of adrenocortical cells in early stage of adrenal regeneration. AB - The influence of nifedipine, a calcium channel antagonist, on adrenal regeneration was investigated by evaluation of mitotic activity of adrenocortical cells. It was found, that nifedipine given at a daily dose of 10 mg/kg, reduced the proliferation of regenerating adrenal cortex on the fourth day after adrenal enucleation, but the inhibitory effect of nifedipine became insignificant on the eighth day after the operation. PMID- 2776474 TI - Exclusion of Usher syndrome gene from much of chromosome 4. AB - Usher syndrome is an autosomal recessive disease characterized by dual sensory impairments; affected individuals are born with a sensorineural hearing loss and ultimately lose their sight as retinitis pigmentosa develops. Conventional protein markers previously tested in a Louisiana Acadian kindred suggested tentative linkage to vitamin D-binding protein on chromosome 4. DNA linkage studies do not confirm this linkage relationship and exclude much of chromosome 4 as the site of the Usher syndrome gene in these families. PMID- 2776475 TI - An automated system for karyotyping mouse chromosomes. AB - A system developed for interactive automated analysis of human chromosomes has been modified for use with mouse cells. The system is described, with emphasis on those features that facilitate retaining for different preparations or even different species. Some performance figures are presented. PMID- 2776476 TI - Molecular cytological differentiation of active from inactive X domains in interphase: implications for X chromosome inactivation. AB - A fluorescence in situ hybridization method using a biotinylated DNA probe specific for the centromeric region of the human X chromosome was used to differentiate the genetically active from the inactive X in interphase cells. With this technique, we were able to interpret both the relative position and the degree of condensation of the X chromosomes within the nucleus. We first established the specificity of fluorescence labelling of the hybridized probe by comparing its location and appearance (either dense or diffuse) when associated with a sex chromatin body (SCB) in early passage normal human female fibroblasts. In these cells, where the presence of inactive X chromatin was verified by identification of a 4',6-diamidino-2-phenyl indole (DAPI)-positive SCB in 85% of the cells examined, the X chromatin fluorescence was always associated with the SCB. The signal was dense in structure in 98% and peripheral in location in 80% of the nuclei. A second type of signal, diffuse in form, was observed in 85% of the nuclei and presumably represents the location of the active X chromosome. It was located peripherally or centrally with equal frequency and was not associated with any identifiable nuclear component. This diffuse signal was the major type associated with human male fibroblasts. In rodent x human hybrid cells containing a human inactive X, the fluorescent signal was associated with an SCB-like structure in only 13% of the nuclei; it was dense in 66% of the nuclei and equally peripheral or central in location. This indicates an alteration in the interphase structure of the human inactive X chromosome in hybrid cells which may explain its known instability with respect to genetic activity in such systems. PMID- 2776477 TI - The alpha 2 chain of type 1 collagen does not map to mouse chromosome 16 but maps close to the Met proto-oncogene on mouse chromosome 6. AB - The gene locus for the alpha 2 chain of type 1 collagen (Cola-2) was previously assigned to chromosome 16. Here we demonstrate, utilising both somatic cell hybrid analysis and genetic linkage analysis, in an interspecific Mus domesticus x Mus spretus cross that Cola-2 fails to cosegregate with mouse chromosome 16, but is linked to the Met proto-oncogene on chromosome 6. PMID- 2776478 TI - Characterization of an X;X translocation by cytological analysis and in situ hybridization. AB - An X;X chromosomal translocation was ascertained by conventional cytogenetic analysis in a phenotypically normal woman with secondary amenorrhea. In situ hybridization was performed with previously mapped X-specific DNA sequences to study the rearrangement at the molecular level. The results allowed us to demonstrate that the subject is monosomic for the distal region of the short arm of the X and trisomic for the distal region of the long arm. PMID- 2776479 TI - The DNA content of Chinese hamster meiotic metaphase chromosomes. AB - DNA values of Chinese hamster male meiotic metaphase chromosomes were measured by slide-based Feulgen cytometry. All the autosomes were distinguishable on the basis of their DNA content. No significant differences were found between the autosomes of the two male animals studied, but a significant difference was found in the DNA content of the sex-chromosome pair between these two animals. PMID- 2776480 TI - Chromosomal and regional localization of the genes for UMPH2, APRT, PEPD, PEPS, PSP, and PGP in mink: comparison with man and mouse. AB - Segregation of mink biochemical markers uridine 5'-monophosphate phosphohydrolase 2 (UMPH2), adenine phosphoribosyltransferase (APRT), phosphoserine phosphatase (PSP), phosphoglycolate phosphatase (PGP), peptidases D (PEPD) and S (PEPS), as well as mink chromosomes, was investigated in a set of mink x mouse hybrid clones. The results obtained allowed us to make the following mink gene assignments: UMPH2, chromosome 8; PEPD and APRT, chromosome 7; PEPS, chromosome 6; and PSP and PGP, chromosome 14. The latter two genes are the first known markers for mink chromosome 14. For regional mapping, UMPH2 was analyzed in mouse cell clones transformed by means of mink metaphase chromosomes (Gradov et al., 1985) and also in mink x mouse hybrid clones carrying fragments of mink chromosome 8 of different sizes. Based on the data obtained, the gene for UMPH2 was assigned to the region 8pter----p26 of mink chromosome 8. The present data is compared with that previously established for man and mouse with reference to the conservation of syntenic gene groups and G-band homoeologies of chromosomes in mammals. PMID- 2776481 TI - Chromosome mapping of the growth hormone receptor gene in man and mouse. AB - Pituitary growth hormone (GH) is essential for normal growth and development in animals and GH deficiency leads to dwarfism. This hormone acts via specific high affinity cell surface receptors found in liver and other tissues. The recent cloning and sequencing of cDNAs encoding human and rabbit GH receptors (GHR) has demonstrated that this receptor is unrelated to any previously described cell membrane receptor or growth factor receptor. We have used the cloned human GHR cDNA to map the GHR locus to the proximal short arm of human chromosome 5, region p13.1----p12, and to mouse chromosome 15 by Southern blot analysis and in situ hybridization. While human chromosome 5 carries several genes for hormone and growth factor receptors, GHR is the only growth-related gene so far mapped to the short arm. Inasmuch as GHR is the first gene with apparently homologous loci on human chromosome 5 and mouse chromosome 15, it identifies a new homologous conserved region. In humans, deficiency of GH receptor activity probably causes Laron-type dwarfism, an autosomal recessive disorder prevalent in Oriental Jews. In mice, the autosomal recessive mutation miniature (mn) is characterized by severe growth failure and early death and has been mapped to chromosome 15. Our assignment of Ghr to mouse chromosome 15 suggests this as a candidate gene for the mn mutation. PMID- 2776482 TI - High resolution chromosome banding in the Norway rat, Rattus norvegicus. AB - High resolution banded chromosomes were prepared from a synchronized culture of rat fibroblasts. A maximum of 457 bands per haploid chromosome set were observed. This represents a two-fold increase when compared to the number of bands visualized in mid-metaphases using standard procedures. By reference to both G- and Q-banded karyotypes, we constructed improved idiograms of rat chromosomes at 300- and 400-band stages, respectively. PMID- 2776483 TI - Regional mapping of the human gene encoding the novel pituitary polypeptide 7B2 to chromosome 15q13----q14 by in situ hybridization. AB - Genetic sequences encoding the novel pituitary polypeptide 7B2 were isolated from a human pituitary cDNA library. Hybridization analysis of a panel of human x mouse cell hybrids with a 7B2 cDNA probe indicated that the locus for the human 7B2 gene is probably located on chromosome 15. In situ hybridization analysis of metaphase chromosomes allowed the regional localization of the 7B2 gene to chromosome 15 at q13----q14. PMID- 2776484 TI - Mapping of the creatine kinase M gene to 19q11----q12 in the rabbit genome. AB - The chromosomal localization of the gene for creatine kinase M has been determined to be on rabbit chromosome 19 at q11----q12 by in situ molecular hybridization. The results show significant cross-hybridization of the creatine kinase, muscle (CKMM) probe to the previously mapped creatine kinase, brain (CKBB) locus at 20q13----qter, and therefore provide independent support for the localization of CKBB at that site. PMID- 2776486 TI - Physical mapping of probes proximal to the fragile X locus (FRAX) confirms the order F9-DXS105 (cX55.7)-DXS98 (4D8)-FRAXA. AB - A woman with an abnormal karyotype, (46,X,der(X) (pter----q27::q27----q21), was analyzed using DNA probes in the region Xq27----qter. The results indicate that she is trisomic for the Factor IX locus, disomic for the locus DXS105 (cX55.7) and monosomic for the loci DXS98 (4D8), DXS52 (St14) and Factor VIII. This confirms the absence of the region Xq28 in the abnormal chromosome. Furthermore, the presence of only one copy of 4D8 and two copies of cX55.7 places the DXS98 locus distal to Factor IX and closer to the fragile X locus than DXS105. PMID- 2776485 TI - Localization of human adenosine deaminase (ADA) gene sequences to the q12--- q13.11 region of chromosome 20 by in situ hybridization. AB - The gene for human adenosine deaminase (ADA), an enzyme constitutively expressed in all tissues investigated so far and deficient in some cases of severe combined immune deficiency, was previously assigned to chromosome 20 by syntenic analysis, using somatic cell hybrids and quantitative enzyme studies on patients with chromosome abnormalities. Attempts at regional localization of ADA through indirect approaches have so far resulted in uncertainties, as well as apparent inconsistencies. In situ hybridization of high-resolution somatic and pachytene chromosomes using a 3H-labeled cDNA probe of the ADA gene localized the gene to 20q12----q13.11. Rearrangements involving this region have been reported in various human hematological malignancies; in this regard, possible implications of the physical proximity of the ADA gene locus to that of SRC, an oncogene previously localized to the same region of chromosome 20, are briefly discussed. PMID- 2776487 TI - Paramyotonia congenita and myotonic dystrophy are not allelic disorders. PMID- 2776488 TI - Studies of X-chromosome inactivation in trisomies. AB - Previous studies of human triploidy have implicated the autosomes in the regulation of activity of X-linked genes. To determine if the influence of the extra autosomal set in triploids was attributable to a specific autosomal gene, we examined the pattern of DNA replication in females trisomic for 18 of the possible 22 autosomal trisomies. We find no evidence that a single gene or chromosome in triplicate can effect X-chromosome replication or activity. Our results suggest either that more than one locus in triplicate is required to maintain the activity of two X chromosomes, or that the influence of the extra autosomal set in enabling the activity of more than a single X chromosome is mediated indirectly, perhaps through the agency of increased nuclear size or changes in the cell cycle. PMID- 2776489 TI - Molecular analysis of chromosome 1 abnormalities in neuroblastoma. AB - Tumor cells from 70% of neuroblastoma patients contain a deletion of part of the short arm of chromosome 1, indicating that this chromosomal region includes a gene involved in tumor formation. To more precisely evaluate the boundaries and mechanisms involved in generating these deletions, we have examined four neuroblastoma cell lines using a combination of somatic cell hybridization, isozyme analysis, and nucleic acid hybridization employing both standard and restriction fragment length polymorphic probes. The data suggest that the truncation of chromosome 1 in these neuroblastomas was most likely due to a complex translocation and deletion mechanism rather than a simple unbalanced translocation or terminal or interstitial deletion. This conclusion is supported by the frequent removal of MYCL from the altered chromosome 1 to another chromosome. Furthermore, the data suggest that the frequency of breakpoints previously assigned by karyotypic analysis to bands other than 1p32 in neuroblastomas may be overestimated. Finally, this study identified a breakpoint at 1p32 that was localized between the genes JUN and MYCL for one neuroblastoma thus establishing the order of these genes as centromere, JUN, MYCL, telomere. We conclude that the observed breakpoints within chromosome 1p in human neuroblastoma are not as variable as previously described and suggest the results of this study provide evidence for the involvement of specific DNA sequences within 1p32 in the generation of neuroblastoma. PMID- 2776490 TI - Localization of the gene coding for parathymosin to chromosome 17 in humans. AB - Parathymosin is a 101-amino acid polypeptide involved in the regulation of cellular immunity. In situ hybridization of rat parathymosin cDNA to human metaphase chromosomes localized the gene for human parathymosin to the q12----q22 region of chromosome 17. PMID- 2776491 TI - The sex-chromosome constitution and early postimplantation development of diandric triploid mouse embryos. AB - Diandric triploid mouse embryos were produced by standard micromanipulatory techniques, using eggs isolated from female mice with a normal chromosome constitution that had been mated to homozygous Rb(1.3)1Bnr males (which carry a large metacentric "marker" chromosome, viz., a Robertsonian translocation involving chromosomes 1 and 3). The tripronucleate embryos were transferred to the oviducts of pseudopregnant mice, which were subsequently autopsied at about midday on the 10th day of gestation. Although a relatively small number of the isolated conceptuses consisted of morphologically abnormal egg-cylinder-like structures or empty gestational sacs, most were at clearly distinguishable embryonic stages, from the primitive streak stage to embryos with about 20 pairs of somites present. These embryos all appeared to be morphologically normal but were substantially smaller than normal (diploid) fertilized embryos analyzed at similar stages of development. A total of 63 diandric triploid conceptuses were recovered and analyzed cytogenetically. They were G-banded to determine their sex chromosome constitution and confirm their diandric triploid status. No obvious difference was observed in the developmental potential of the 58,XXX class of diandric triploids, compared to that of the 58,XXY class. The ratio of 58,XXX to 58,XXY embryos was close to the expected ratio of 1:2, assuming that unfertilized eggs have an equal chance of becoming fertilized by an X- or a Y-bearing spermatozoon and that the additional (i.e., "donor") male pronucleus also has an equal chance of having either an X or a Y sex chromosome present. However, the development of the 58,XYY class appeared to be restricted, even at the stage of gestation analyzed, in that no embryos with this genetic constitution were observed that had progressed beyond the early somite stage. The present findings are discussed in relation to the cytogenetic findings in human triploid conceptuses, the majority of which are spontaneously aborted during the first half of pregnancy. In man, the 69,XYY class (equivalent to the 58,XYY class in our study) is only rarely encountered, and it has been assumed that these triploid embryos are probably lost at a very early stage of gestation. PMID- 2776492 TI - Biological characterization of bone tumors. PMID- 2776494 TI - Immunohistochemical investigation of chordomas: histogenetic and differential diagnostic aspects. AB - Chordomas are rare tumors of neuroectodermal origin and often show a very heterogeneous histological picture. In a combined histochemical and immunohistochemical study of 32 chordomas collected in the Bone Tumor Registry of Westphalia we were able to show that the immunoreactivity of the cells in both chordoma and notochordal structures are in close relationship with the extracellular matrix and depends more on the metabolic activity of these cells than on the origin of the cells of the neuroectoderm. All tumor cells show a bimodal immunoreaction with cytokeratin and vimentin, as well as a strong immunoreaction with the oncofetal markers CEA and AFP. The differentiation of chordomas from other malignant tumors, mainly the myxoid variant of chondrosarcoma, may cause major difficulties, especially if only a little biopsy material is available. Here we can see that in tumors with bimodal immunoexpression of vimentin and cytokeratin, as can be found in chordomas, the further use of antibodies offers a reliable differential diagnostic tool. The positive reaction of chordomas with all epithelial tumor markers offers a clear differentiation from chondrosarcomas, which, unlike chordomas, do not express cytokeratin. The identification of a marker profile by employing common antisera is of major value in the differentiation of chordoma from other epithelial or mesenchymal tumors. PMID- 2776493 TI - Flow cytometric DNA analysis of bone tumors. AB - Flow cytometric DNA analysis was performed in a total of 203 bone tumors, benign and malignant. In more than 80% of cases the material studied was paraffin embedded tumor tissue, mainly from the archives of the Bone Tumor Registry of Westphalia in Munster. Compared with ethanol-fixed fresh tumor samples, the variation coefficient in DNA histograms of the stored material was increased by a factor of 1.2-1.5, which means that resolution was decreased and that, in many cases, accurate cell cycle analysis was not feasible. However, the results of cell cycle analysis in bone tumors, even if performed on optimally fixed specimens, have to be evaluated with caution and full reference to the corresponding histological slides, since these histograms are apt to show various superpositions from the inflammatory infiltrate. The assessment of DNA ploidy is unimpaired if, in agreement with most researchers today, deviations smaller than +/- 10% from the diploid standard are still defined as DNA diploid, peridiploid, or pseudodiploid. The coefficient of variation should be kept as low as possible. If it is between 10% and 15%, the near-diploid stemlines with DNA indices of 0.9 or 1.1 may be hard to delineate. On account of the particularly marked regressive changes, the resolution of DNA histograms was most strongly impaired in chondromatous tumors, whereas it was mostly excellent in highly cellular viable tumor tissue, such as that from Ewing's sarcoma or osteoblastoma. On the whole, there was a distinct correlation between DNA ploidy and the biological behavior of bone tumors (Table 8). The highest rates of DNA aneuploidy were found in highly malignant OSs (18/21) and FSs (14/16), thus reflecting their poor prognosis. Of six juxtacortical OSs, three well-differentiated parosteal OSs and two periosteal OSs were DNA diploid, whereas one highly malignant surface OS and five highly malignant extraskeletal OSs, all DNA aneuploid, corresponded fully to the medullary OSs. Judging by preliminary results, adjuvant preoperative chemotherapy (COSS 80/82: Bosing et al. 1987) may reduce the rate of DNA aneuploidy and, consequently, of stem cell heterogeneity in general. A selective destruction of those stemlines that respond particularly to chemotherapy appears probable. In contrast to their high malignancy, Ewing's sarcomas showed an unexpectedly low proportion of DNA aneuploid stemlines (14/24). The comparatively favorable prognosis of MFH of bone is reflected in a lower rate of aneuploidies (2/10), which is also rather low (probably too low) when compared to our own data from soft tissue MFH (9/19).(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2776495 TI - Immunohistological demonstration of osteonectin in normal bone tissue and in bone tumors. AB - Osteonectin is a noncollagenous protein of bone which is believed to be bone specific, since its concentration in bone tissue is 500- to 1000-fold higher than in other connective tissues. Immunohistochemistry with polyclonal osteonectin antibodies shows a highly specific marking of actively matrix-producing osteoblasts. Osteonectin is involved in the process of osteoid maturation and mineralization. Immunohistochemistry of osteonectin antibodies proved to be a valuable tool in the diagnosis of bone tumors. Since osteonectin production seems to be an early event in the differentiation of cells of the osteoblastic lineage, immunoreactivity of osteonectin antibodies is observed in types of osteosarcoma lacking osteoid production (anaplastic, fibroblastic) while corresponding types of soft tissue tumors remain unstained. PMID- 2776496 TI - Tumor bone formation in different osteosarcomas: topological, biochemical, and histochemical analyses. PMID- 2776497 TI - The proliferation behavior of bone tumors investigated with the monoclonal antibody Ki-67. AB - Specimens of several tumor entities at various grades of malignancy were selected from the Bone Tumor Registry of Westphalia for an immunohistological study of their proliferation behavior. Using the monoclonal antibody Ki-67 directed against a nuclear antigen present in all active phases of the cell cycle (G1, S, G2, and M), we were able to demonstrate the growth fractions in tissues with an atypical rate of proliferation, implying an increased risk of malignant transformation. In the 97 cases examined we found a good correlation of the biological proliferation behavior with the expression of the nuclear antigen Ki 67. Moreover, our immunohistological results are comparable with the data from the same tumor entities obtained by other methods such as flow cytometry and autoradiography. Thus the monoclonal antibody Ki-67 provides an excellent marker for labeling the growth fraction in a human tissue. Its practical impact lies in the differential diagnostic analysis of the proliferation rate in a given tumor and its possible grading, and in pre- or posttherapeutic monitoring of patients and the establishment of a prognosis. PMID- 2776499 TI - Parents' observations of the effect of a sexual-abuse prevention program on preschool children. AB - A questionnaire survey of 233 parents (approximately a 30% sample) of very young children receiving a school-based sexual abuse prevention program reported a general absence of adverse effects. The authors discuss the relative significance of the study. PMID- 2776498 TI - Stages of adolescent testing of social workers in an alternative school setting. AB - Many of the problems faced by a new social worker at an alternative school for adolescents are unique to the setting. The students often distrust and fear new persons. Fearing rejection, they develop unique defense systems against it. The new social worker must pass a rigorous period of testing before being trusted. This article discusses the dynamics, importance, and successful handling of such an experience by a new worker. PMID- 2776500 TI - [A new experimental model for direct in vivo observation of microcirculation in microsurgery]. AB - The anatomical conditions and a method of preparing of a vascular-nervous isolated flap of the musculus cremaster in rat have presented. It is an example of the experimental model of the free muscular flap with the central course of vessels. This new model offers wide possibilities of in vivo observation of changes in microcirculation after using of various operations as well as drugs. PMID- 2776501 TI - [Injuries of the cervical segment of the spinal cord in alcoholic intoxication. Preliminary report]. AB - The clinical documentation of 777 patients treated for traumatic injury of the cervical spinal cord has been analyzed. A comparison of consequences of accidents, neurologic and functional results of treatment in two groups of patients: admitted for treatment while being drunk and sober, has been presented. There were 246 intoxicated persons (32 per cent of the patients) in the analyzed group. An analysis of the data has indicated a smaller degree of spinal cord injury and better neurologic and functional results in patients that were not intoxicated by alcohol on admission. A statistic analysis (chi-square test)has shown that the quoted relationships have a high degree of probability. The authors have criticized incomplete documentation in previously used preliminary examination charts and have introduced a modified examination chart including data about the degree of a patient's sobriety. PMID- 2776502 TI - [Use of contractors in unstable fractures of the thoraco-lumbar spine]. AB - The results obtained after the use of contractors in surgical treatment of 30 vertebral body fractures with their wedging and lesion of the posterior ligaments, while the posterior wall of the vertebra in the thoracic-lumbar spine was preserved, has been presented. It is a relatively simple surgical method enabling stabilization of fracture, reconstruction of the vertebral canal and improvement of neurological condition. PMID- 2776503 TI - [Evaluation of the functional state of the hip joint after alloplasty]. AB - The use of the Charnley test and the Lazansky test in evaluation of function of the hip after alloplasty has been presented. The authors believe that the Lazansky test gives a more complete evaluation of hip joint condition but on the other hand the less complicated Charnley test enables quick evaluation of the hip, even at the out-patient clinic. The use of numerical methods of functional evaluation makes treatment results objective and fully comparable. PMID- 2776505 TI - [Effect of Corynebacterium parvum preparation on selected immunologic indicators and clinical results in patients with chronic post-traumatic osteomyelitis]. AB - Nineteen patients with chronic post-traumatic staphylococcal osteitis++ of a mean 5-years-clinical course were given intramuscularly 3.5 mg of Coparvax for two weeks. An increase of IgG concentration in the serum, starting from the 8th week of observation, and a marked increase of the ability of absorbtion and destruction of staphylococci by the neutrophils of the peripheral blood have been found. It has been accompanied by subsidence of clinical symptoms of ostitis in 13 patients and a marked decrease of intensity of the inflammatory process in 4 other patients. No effect has been found in two patients. PMID- 2776504 TI - [Early results of surgical reconstruction of anterior cruciate ligaments of the knee joint by the Jones method]. AB - The results of anterior cruciate ligament reconstruction in 26 patients, including 14 sportsmen, have been presented. The Jones method was used. The results of reconstruction were evaluated at 6-28 months after operation. Instability was diagnosed using the anterior drawer symptom and Lachman symptoms as well as the Jacobsen's radiological method. In evaluation of treatment results the 4-grade subjective evaluation scale and the Lysholm-Gillquist point test were used. The advantages of this method of reconstruction, consisting in removal of subjective pain, and the disadvantages, consisting in incomplete removal of instability symptoms of the joint, have been presented. PMID- 2776506 TI - [Electric excitability of the peroneal muscles in congenital equinovarus deformity]. AB - Irritability of the peroneal muscles by stimuli of the rectangular current in infants with congenital club foot was examined. Examinations were performed immediately before surgery in patients in general Ketamine anesthesia. The first group contained children with unilateral congenital club foot and the normal extremity was examined for comparison. In the group of children with bilateral club foot, one of the feet was examined twice about 4 months apart. A decrease of irritability of the peroneal muscles was found before operation. After operation this irritability reached the proper values. The authors think that the peroneal muscles in congenital club foot are stretched and that after correction of deformation their length and tension become normal. PMID- 2776507 TI - [Psychogenic contractures of the joints]. AB - Three cases of rare functional psychogenic contractures in girls aged 6, 12, and 14 years have been presented. The contractures occurred suddenly, without an underlying reason and without pain. The diagnosis was given after elimination of other diseases. Recovery without recurrence was obtained after simulate rehabilitation, psychotherapy, and psychogagia for 4-8 week. PMID- 2776508 TI - [Epiphysiolysis of the femur head in hypogonadism of pituitary origin]. AB - A case of a twenty years old male patient with unilateral slipped upper femoral epiphysis has been presented. An accompanying pituitary hypogonadism was revealed on physical examination and laboratory tests. Reports from literature of hormone related epiphyseolysis have been discussed. The authors believe that the presented case of slipping has its origin in the found hormone deficiency. PMID- 2776509 TI - [A stand for measuring hand grip power and manipulation strength during simultaneous and symmetrical work of both hands]. AB - The measurement system in which a stand for tensometric measurement of working grips power during simultaneous and symmetrical work of both hands is enclosed has been described. PMID- 2776511 TI - [Surgery in our time--stability in transition]. PMID- 2776510 TI - [The first experience using C-D equipment in the surgical treatment of idiopathic scoliosis (preliminary report)]. AB - The authors treated surgically 21 patients with scoliosis by intersegmental posterior spondylodesis with use of the Cotrel-Dubousset instrumetarium. The surgical method and results have been presented. The mean age of the patients was 14.6 years. The used method produced great correction (70 per cent) of scoliosis; its another equally important advantage is the possibility to restore physiological curvatures of the spine and removal of gibbus. The intra obtained operationally perfect internal frame stabilization of a corrected scoliotic segment of the spine enables standing positioning and mobilization of a patient several days after operation, securing the operated on child maximum of psychical comfort. The mean follow-up was 18 months. PMID- 2776512 TI - [Possibility for autologous blood donation--gambol process]. PMID- 2776513 TI - [Practice organization and practice equipment for an operatively active newly established surgeon]. PMID- 2776514 TI - [Extent of postoperative care and protection from spurious accusations]. PMID- 2776517 TI - Symposium on Cellular Basis of Morphogenesis. Madrid, Spain, 18-20 October 1988. PMID- 2776515 TI - Differential decondensation of mitotic chromosomes during hypotonic treatment of living cells as a possible cause of G-banding: an ultrastructural study. AB - The chromosomal ultrastructure of Chinese hamster cells treated with 0.075 M KCl a solution ordinarily used for making preparations of spread chromosomes - was studied. The hypotonic treatment was shown to result in differential decondensation of chromosomes which consists in the uneven distribution of deoxyribonucleoprotein (DNP) fibrils along chromatids. Fixation of cells with methanol acetic acid causes an abrupt restructuring of chromosomes. However, the DNP preserves its uneven distribution along chromatids. As seen on ultra-thin sections of marker nucleolus organizer chromosomes, the densely packed regions may correspond to G-bands detected in the selfsame chromosomes by standard methods of differential staining. The results suggest that the capacity of chromosomes for differential staining is based on the different resistance of G- and R-bands to the decondensing action of hypotonic solutions on living cells. PMID- 2776516 TI - Methylation of ribosomal cistrons in diploid and tetraploid Odontophrynus americanus (Amphibia, Anura). AB - Odontophyrynus americanus (Amphibia, Anura) genomic DNA from diploid and tetraploid specimens was treated with restriction enzymes sensitive to cytosine and adenine methylation (5 meC and 6 meA). In both diploids and tetraploids a high proportion of the total DNA was not cleaved by 5 meC-sensitive enzymes as observed on agarose gels stained with ethidium bromide. The DNAs were transferred to nitrocellulose filters and hybridized with cloned fragments containing sequences of Xenopus laevis 28S and 18S ribosomal DNA (rDNA). A high level of methylation of the ribosomal repeat units was revealed by 5 meC-sensitive enzymes in blood, liver, kidney and testis tissues. Adenine was methylated to a lesser degree and similarly in the rDNA from both germinative and somatic tissues. Comparison of the results obtained with DNA of diploids and tetraploids showed that methylation of ribosomal genes was increased in tetraploid genomes of adult frogs, but exact quantitative determinations could not be performed by this methodology. Cloning of the 28S region of the rDNA repeat unit was performed in the lambda gtWES lambda C vector. Restriction patterns obtained with methylation sensitive enzymes using diploid and tetraploid derived clones confirmed the high level of methylation of the corresponding region of the ribosomal repeat unit in genomic DNAs. The implications of these results in the regulation of expression of the ribosomal genes in diploids and tetraploids are discussed. PMID- 2776518 TI - Factors specifying cell lineages in the leech. AB - As in arthropods, several major organ systems in leeches, including body musculature, nervous system and nephridia, are organized into a fixed number of longitudinally iterated units called segments. Many cells, especially neurons, can be uniquely identified from segment to segment. Leech embryos comprise identified cells, which facilitates developmental analysis. So far as it is known, cell lineages in leech are largely determinate. Prior to first cleavage, cytoplasmic reorganization generates domains of yolk-deficient cytoplasm called teloplasm. In situ hybridization experiments suggest that teloplasm is enriched for polyadenylated RNAs. During the first three, unequal cell divisions, teloplasm is segregated to macromere D'; normally, this cell alone cleaves further to generate five bilateral pairs of embryonic stem cells, M, N, O/P and Q teloblasts. Centrifugation experiments have shown a causal link between inheritance of teloplasm and the cleavage pattern that generates teloblasts. Teloblasts undergo highly unequal divisions, generating a longitudinal array of segmental founder cells called m, n, o, p and q blast cells, from which the definitive segmental tissues arise via further stereotyped cell divisions. Microinjecting new-born teloblasts or their precursors with polyadenylic acid induces the formation of supernumerary teloblasts. This discovery permits further analyses of factors specifying the five cell lines generating segmental tissues of the leech. PMID- 2776519 TI - The establishment of regional identity in the Xenopus blastula. AB - The molecules involved in the commitment of Xenopus cells to particular germ layers are unknown. The question has been investigated for the cells of the blastula in in vivo cell transplantation assays and in vitro aggregation assays. Using the former technique, we have shown that vegetal cells become committed before gastrulation, even when placed in inappropriate sites. We could find no evidence of regional determination within the endoderm germ layer at the early gastrula stage. In aggregation assays, animal and vegetal cells sorted incompletely at the mid-blastula stage and more efficiently at the gastrula stage. Their behaviour may be mediated by differential expression of adhesion molecules, which so far remain unidentified. PMID- 2776520 TI - [Anticoagulant management of patients with cardiac valve prostheses]. AB - This article reports the methods and results of anticoagulant management in 653 patients with China-made Bjork-Shiley mode Tilting Disc Cardiac Valve Prostheses. The total incidence of thromboembolic complications and valve thrombosis is 0.98 per 100 patient-years during the anticoagulation. The incidence of anticoagulant related hemorrhage is 1.86 per 100 patient-years. In the anticoagulant period, 61 surgical operations were performed on 58 patients. The results showed that anticoagulant can be maintained in minor, superficial operations where blood ooze can be arrested by compression, temporarily discontinued in elective operations, and reversed abruptly by injecting Vitamin K1 in urgent operations. In addition we handled the contradictions between anticoagulant therapy and menses, contraceptive, pregnancy or delivery (29 patients) for 303 female patients favorably. We conclude that our methods gave excellent results, and were reasonable and practicable. PMID- 2776521 TI - [An evaluation of long-term results of closed commissurotomy of mitral stenosis]. AB - Closed mitral commissurotomy was performed in 206 consecutive cases with mitral stenosis from 1965 to 1987. Follow-up study from 8 months to 22 years showed that both early and long term postoperative results were satisfactory for mitral stenosis even in cases combined with mild mitral regurgitation. The long-term survival rate of this group of patients was 95.58% and the average time of maintenance of cardiac function classes I and II was 10.83 +/- 2.11 years. The influence of valvular calcification or high pulmonary arterial pressure on long term effects was not serious, but preoperative atrial fibrillation or congestive cardiac failure might cause lead to poor results, indicating the benefit of early operation before their development. The peak period of restenosis with rapid decrease in cardiac function was 8-10 years postoperatively, and therefore more attention should be paid in this period to the decision of whether a reoperation is needed. PMID- 2776522 TI - [Therapeutic experiences with Budd-Chiari syndrome: report of 100 cases]. AB - One-hundred cases of Budd-Chiari syndrome were treated from December 1982 to March 1988. There were 62 males and 38 females. Their ages ranged from 15 to 62 years averaged 32.6 years Seventy-six cases had intractable ascites, 56 had esophageal varices and 22 had upper gastrointestinal bleeding. There were 37 cases with membranous obstruction, 57 with occlusion of the inferior vena cava above the confluence of the hepatic veins and 6 with occlusion of hepatic veins. Eighty-one cases (81%) were operated upon. Operative mortality was 8.6% (7/81). Follow-up from 2 to 63 months revealed that 60 operated cases (74.1%) had good results, while 11 of 19 (58%) patients treated conservatively died within two months after admission. It is concluded that the operative procedure must be tailored to the etiology and pathology. The mesoatrial shunt is the operation of choice for occlusion of the retrohepatic IVC and hepatic veins, the cava-atrial shunt for occlusion of the IVC and patent hepatic veins, membranotomy for IVC web, and the meso-caval shunt for intrahepatic venous occlusion. For those who also have superior vena cava compression syndrome, an innominate-atrial shunt should be added. PMID- 2776523 TI - [Male breast cancer: clinical, pathologic and immunohistochemical study]. AB - Forty-three cases of male breast cancer treated in the past 3 decades, comprising 1.92% of total cases of breast cancer in both sexes during the same period, were analyzed. Local skin involvement occurred in half of the patients. 67.7% of the patients presented axillary lymph node metastases and 82.9% were in stage II and III. Non-infiltrative and infiltrative specific cancers were diagnosed in 2 cases each, and infiltrative non-specific in 39 cases. Retrospective determination of estrogen receptor (ER) and carcinoembryonic antigen (CEA) in 33 specimens revealed positive ER in 57.6% and positive CEA in 72.7%. The more advanced the clinical stage, the higher is the positive rate of ER. Cases with positive CEA usually carried a more invasive process and a poorer prognosis. Immunohistochemical investigation in male breast cancer patients was valuable in the selection of post-operative adjuvant endocrine therapy or chemotherapy. Postoperative rise in serum CEA in patients with positive CEA may indicate recurrence. PMID- 2776524 TI - [Surgical treatment of aneurysm of the membranous ventricular septum: report of 27 cases]. AB - Twenty-seven patients aged 4 to 26 years with aneurysm of the membranous ventricular septum were operated on in Shanghai Chest Hospital, from August 1985 to April 1987. Of the patients, 22 were diagnosed by left ventriculography, and were found to be associated with other cardiac defects such as VSD, ASD. All the patients had an uneventful early postoperative course and excellent late results. It is emphasized that a thorough recognition of the lesion and complete repair of the malformation are important in the avoidance of residual shunt and recurrent defects. PMID- 2776525 TI - [Blood gas analysis of varicocele, spermatic vein and peripheral vein]. AB - Blood gas analysis was carried out in 80 cases of varicocele. The PO2 of the spermatic vein was lower than that of peripheral vein (P less than 0.01). There was also a significant difference of PO2 between I. and III. of varicocele (P less than 0.05). Blood of the spermatic vein showed metabolic acidosis. It is suggested that hypoxemia of the testes may affect spermatogenic function. PMID- 2776527 TI - [Evolution of autologous graft interface in rats: experimental study]. AB - With purpose to study the evolution of autologous venous graft interface, an experimental model utilizing an autologous venous patch to repair an infrarenal abdominal aortic defect in rats was developed. A small piece of both the jugular vein and the aorta were first excised. After implantation and reestablishment of blood flow, the animals were subsequently sacrificed in groups of 3 at the following intervals: 10 seconds, 1 minute, 10 minutes, 30 minutes, 1 hour, 6 hours, 12 hours, 24 hours, 7 days, 30 days and 90 days. All the patches and adjacent aortae were collected and studied using scanning electron microscopy, with the following results: 1) the endothelial lining of both the autologous vein patch and the adjacent aorta is destroyed before implantation due to operative manipulation; 2) after blood flow reestablishment, the patch and adjacent aortic interfaces are reactive to platelets and other blood cells; 3) New endothelial lining begins to appear from the 7th day after implantation, but the regeneration is not complete at 3 months. From the model, it is deducted that the endothelial repair of autologous venous patch and its adjacent aorta involves a very slow process. PMID- 2776526 TI - [Treatment of upper urinary calculi using a non-immersed extracorporeal shock wave lithotriptor]. AB - The authors modified the China-made extracorporeal shock wave lithotriptor (Dornier HM3) (ESWL), and successfully developed the first home-made non-immersed extracorporeal shock wave lithotriptor not necessitating anesthesia. From 8 September 1987 to 8 February 1988, the authors treated 250 patients with stones of the upper urinary tract with their ESWL device. Stones were completely fragmented in 194, partially in 44, and not disintegrated in 12 cases. The overall fragmentation rate of calculi was 95.2%. Followup from 1 to 6 months showed that 128 patients were cured, and 11 patients were markedly improved. This ESWL equipment works well, and can be used clinically in selected cases. PMID- 2776528 TI - [Observations on the effect of omental transplantation to the traumatized spinal cord]. AB - Experiments with 2 groups of different animals were carried out to observe the effect of wrapping the traumatized spinal cord with transplanted omentum. In the first group, the spinal cords of 20 rabbits were uniformly impacted with a force of 11.2g x 10cm = 112gcf, and the cord specimens prepared in different times after injury were examined under light and electron microscopes. In the second group, the spinal cords of 14 cats were equally struck with a force of 25g x 20cm = 500 gcf, and the animals were checked for motor function and somatosensory evoked potential (SEP) of their hind limbs. The results found in the rabbits in the first group showed that the transplanted omentum was adherent to the cords within 24 hours, and there were vascular communications between them after 72 hours, as shown by the presence of dye in the cord vessels, which had been injected into the omental vessels. The histologic destructions appeared in these cords were obviously less severe than those in the control ones. Motor functions and SEP, demonstrated in the animals in the second group, were favorable in the cords of cats with omental transplantation (P less than 0.05). According to the findings in these experiments, we tend to believe that omental transplantation to the traumatized cord is of some benefit. PMID- 2776529 TI - [A ten years' experience with 613 mitral valve replacements]. AB - This study was performed to assess the effect of factors on early and late mortality of isolated MVR in 613 patients. The tilting disc valve was used in 480 and the porcine xenograft bioprosthesis in 133 patients between Sep. 1978 and Nov. 1987. The overall early mortality rate was 4.89%. A comparative analysis showed that five factors (emergency operation, biventricular hypertrophy with serain, pulmonary hypertension, function class IV, and reoperation) significantly increased the early mortality rates (P less than 0.01). A 10-year follow-up study showed that the late mortality rate was significantly higher in patients with mitral insufficiency, function class IV and left ventricular hypertrophy with strain (P less than 0.01). The authors emphasize that the MVR must be performed early before the factors affecting the operative outcome are fully developed. Successive treatment with digitalis and/or diuretics should be continued in early postoperative period for 6-12 months to improve the cardiac function. Owing to the well-known durability of the bioprosthesis the authors prefer the use of mechanical valve. PMID- 2776531 TI - [Ankle arthroscopy in clinical application: a preliminary report]. AB - The results of arthroscopy or arthroscopic synovectomy on 31 ankle joints in 24 cases were reported. All the patients were followed for 2 to 10 months with an average of 6 months. The results were as follows of the 26 rheumatoid arthritis: excellent in 5 ankles (19.2%), good in 8 (30.8%), fair in 7 (26.9%), and poor in 6 (23.6%), of the three traumatic arthritis: good in one and fair in two; of the remaining 2: good in 1 tuberculous synovitis and fair in 1 chronic pyogenic arthritis. The operative procedure, indications and value of ankle arthroscopy together with its advantages were discussed in detail. PMID- 2776530 TI - [Experimental observations on spinal cord injury produced by electrifying the vessels of the cord in dogs]. AB - To make the ischemic effect on spinal cord clear, different vessels of the cord of 38 dogs, in 5 groups, were electrically cauterized individually or in combination. The animals in each group were sacrificed in due time periods, and the pathology of corresponding segment of each cord was observed grossly and under electron as well as light microscopes. The findings were described in this paper. As a consequence, the dogs in each group manifested paraplegia varying in degrees. However, dogs with the anterior cord artery and unilateral radicular artery, or both the anterior and posterior cord arteries cauterized developed irreversible, complete paraplegia. Cauterization of the anterior cord artery, or the posterior cord artery and unilateral radicular artery, or the radicular artery on both sides, gave rise to reversible, incomplete paraplegia. Anatomy of vessels of the spinal cord of other 9 dogs were dissected and studied. Their presence and distribution were cited and referred to the discussion about the effect of ischemia induced by electrifying them individually or in combination. PMID- 2776532 TI - [Mitral valve replacement after closed mitral commissurotomy]. AB - From June 1978 to Dec. 1987, 35 cases of MVR were performed. All of these patients had closed mitral valvocommissurotomy before. Our experiences show: 1. The main causes of high mortality and morbidity are pericardial adhesion and blood oozing, poor exposure of mitral valve, and prolonged operative time. Therefore, it is wise not to do too much dissection, and to use biatrial incision. With these techniques, good results were obtained. The mortality decreased from 41.2% to 6.25%, the morbidity of postoperative complications decreased from 23.5% to 12.5%. 2. The important factors influencing late results were poor cardiac function and chronic atrial fibrillation. In this series, surgical mortalities of patients with CF of degree 4(NYHA) and degree 3 were 30% and 13.1%. So the main point is to discover the patients as early as possible and to advise them surgery whenever needed. PMID- 2776533 TI - [Value of colonoscopy in postoperative care of colorectal carcinoma]. AB - From 1981 to 1986, fiberoptic colonoscopy was performed in 2225 patients, of whom 356 cases (16%) were operated on for colorectal carcinoma and followed up for three months to twenty years. 27 cases were detected to have a second primary cancer and 1 case third primary cancer. In addition, 1 case of carcinoid, 6 cases of in-situ cancers, and 77 cases of adenomas were found. Among the 138 asymptomatic cases, 8 were proved to have a second cancer and 6 to be in early stage. Among the remaining 218 symptomatic cases, 26 with second cancers and 10 in the early stage were detected. The study shows that periodic colonoscopic examinations are mandatory for asymptomatic postoperative patients. PMID- 2776534 TI - [Scrotopenile inversion: a report of 4 cases]. AB - From Sep. 1980 to July 1987, 4 cases of scrotopenile inversion were treated surgically. There were complete and partial scrotopenile inversion in 2 cases respectively. A pedicle skin tube of scrotum was used to prolongate the urethra and correct the curved penis. The operation was performed at a time in 3 cases and satisfactory results were obtained in all 4 cases. PMID- 2776535 TI - [Bladder stones in women: a report of 24 cases]. AB - The authors report 24 female cases of cystolithiasis (18 adults and 6 children) that accounted for 8.5% (24/283) of the total cases of cystolithiasis admitted to our hospital during 1960-1987. In none of the cases correct diagnosis was established during the first visit to the hospital. One patient was suspected of having an ovary cyst and 23 cases (95.8%) were exclusively diagnosed as urinary infection. Predisposing factors were quite obvious in 16 cases. Three patients had recurrent bladder stones. The causes, clinical features, prevention methods, and diagnosis of female cystolithiasis are discussed. PMID- 2776536 TI - [Observation of the ultrastructure of smooth-muscle cells in the narrow segment of the ureter in children with congenital hydronephrosis]. AB - The smooth-muscle cells of narrow segment in the ureter with congenital hydronephrosis in 5 cases were studied by transmission electron microscope. The result showed that the smooth-muscle cells of the narrow segment lack of myofilaments, dense body and dense patch in cells membrane. The above mentioned structures are functional deficient basis of the smooth-muscle cells in the ureter. Its deficiency results in the poor peristalsis function of the narrow segment of the ureter in congenital hydronephrosis. The cause and treatment principle in congenital hydronephrosis were discussed. PMID- 2776537 TI - [An experimental study on the use of the umbilical vein in blood vessel transplantation and its clinical application]. AB - An experimental study of human umbilical vein in the use of femoral artery and jugular vein transplantation was carried out, and three patients suffering from superior vena caval obstruction were operated on by umbilical vein transplantation. The patients were followed up for 4-7 months with good results. It was found that the umbilical vein was a very good alternative in blood vessel transplantation for its lacking valves, its even caliber, its easiness to obtain, its length of up to 20 cm and a caliber of 0.3-1.0 cm, its ability to bear a pressure of up to 300 mmHg, and its causing no rejection after glutaraldehyde pretreatment. The processing and preserving of the umbilical vein were presented in detail, and its clinical implication was discussed. PMID- 2776538 TI - [A study on the histologic basis of human bile duct peristalsis]. AB - In 62 human cadavers, full length specimen of bile duct including right hepatic intersegmental duct (from fetus, infants, children and adult up to 74 yrs of age) was examined with light and electron microscopy. 1 for longitudinal maximum section, 61 for cross serial section of each of 6 selected tissue blocks stained with HE for general survey, Mallory, Van-Gieson stain and PAP anti-desmin for smooth muscle, Weigert stain for elastic fiber. No muscle bundles were found in the bile-duct. Some cases have scattered smooth muscle cells in the fibrous duct wall, with the frequency in pancreatic portion as 54/62, supraduodenal portion 33/62, common hepatic 15/62, right hepatic 2/61, and intrahepatic o/62, but never in full layers, circular or longitudinal, nor right joint of cell membrane existed. Total area of muscle cells measured in slide is less than 8% that of the fibrous wall. No myofibroblast was found. It is concluded that, there is no characteristic histologic structure of contractile potential and wave transmission. There is no other contractile element in intrahepatic duct capable of initiating propulsive movement. The so-called bile duct movement is most likely passive and should not be interpreted as peristalsis. PMID- 2776539 TI - [Vesicles and the formation of cholesterol monohydrate crystals (CMC) in human bile]. AB - Vesicles have recently been proved to be a nonmicellar mode of cholesterol dissolution and transportation in bile. It was reported that the aggregation of vesicles was a very important step for the formation of CMC. With 9-10 days' observation by transmission electron microscopy, vesicles were found in all the 3 gallbladder, 3 hepatic and 3 T-tube bile from 7 gallstone patients, 2 hours after centrifuged (2 h, 37 degrees C, 100,000g). The four-consecutive steps of CMC's formation were found to be: (1) novoformation of vesicles (25-50 nm), (2) "precrystals" (60-75 nm) appearing on the surface of the aggregates, (3) "precrystals" growing into submicroscopic CMC (600-750 nm long), (4) submicroscopic CMC and microscopic CMC (about 10,000 nm). "Precrystal" was believed as a new finding and it might be the very early step of the nucleation of CMC. PMID- 2776540 TI - [Experimental study of antigastroesophageal reflux by preservation of the lower esophageal sphincter]. AB - Gastroesophageal reflux and its resultant esophagitis are common complications following removal of the middle and lower part of the esophagus as well as the gastric cardia with reconstruction by simple esophagogastrostomy. Twenty-one dogs were randomly divided into 3 groups: (1) LES preserving group; (2) Nissen's fundoplication group; (3) Sweet's esophagogastrostomy group. Results by esophageal manometry, X-ray video tape recorder, and pathological examination respectively, 3 months postoperatively were compared. Esophageal manometry showed that the pressure of the preserved LES was still present. X-ray video tape recorder revealed that antireflex function was present in the preserved LES. Pathological examination confirmed no signs of reflux esophagitis in the mucosal specimen of the preserved LES group. We concluded that LES is the main barrier of gastroesophageal reflux. The intrathoracic LES could still have the function of anti-reflux. PMID- 2776541 TI - [Comprehensive classification and surgical treatment of injury of the thoracolumbar spine]. AB - Based on the theory of three-column of spine and in combination with the findings on CT scannings, particularly the status of the spinal canal, of 47 patients sustained trauma of thoracolumbar spine, a comprehensive classification has been proposed and described in the paper. 26 patients out of the 47, who had had signs of neurological damage and spinal instability, were operated upon and their spines were stabilized with Harrington-Luque instrumentation. 14 of the patients treated operatively enjoyed, at the time of follow-up, the satisfactory result. We have been convinced that this comprehensive classification serves as a very good guidance in selection the procedure of treatment, operation or conservatism, and in predicting prognosis. PMID- 2776542 TI - [Clinical significance of congenital fusion of cervical vertebrae: a report of 87 cases]. AB - Based on clinical analysis of 87 cases with congenital fusion of cervical vertebrae, the clinical significance of these lesions was discussed in detail. It was found that the C 2-3 and then the C 3-4 were the sites of frequent involvement. Fusion of 2 to 3 segments was common and showed no clinical signs of abnormality, nor associated with any other malformations. While fusion of multiple segments, though rare, was often associated with other anomalies such as short neck, lowered posterior hair line, webbed neck and malformation of internal organs and other bones. Single lesion does not give rise to symptoms until late when degenerative changes have taken place in the unfused vertebrae in most cases, or following trauma in occasional patients, usually of neurologic upsets. However, fusion at several especially levels, fusion of C 2-3 with occipitalization of atlas predisposes the nerve to damage. In short, remedy is only necessary for cases with symptoms: conservative treatment for those with symptoms caused by radiculopathy, and operation for those with symptoms of myelopathy. PMID- 2776543 TI - [Early diagnosis of atlanto-axial tuberculosis]. AB - Spinal tuberculosis at the atlanto-axial level is often overlooked or misdiagnosed for a considerable period of time, until when there has developed subluxation or other obvious complications. In order to make early diagnosis of this lesion, we analysed 30 such patients of our own and found that the positive X-ray film findings, such as thickening and widening of the soft tissue shadow of the retropharyngeal wall could hardly be concerned as an early sign, subluxation of the joint and destruction of bone were definitely quite a late occurrence. While long lasting pain in the upper cervical region and limitation of motions of the neck were constantly present prior to any other positive findings. Complaints of these subjective symptoms, particularly in young person, we would emphasize, are the early signals of tuberculosis and should be cared until being proved otherwise. PMID- 2776544 TI - [Lumbar discectomy and forominotomy]. AB - 17 patients, 11 males and 6 females, aged from 25 to 65 years (41.5 years, on average), suffered from lumbago and/or sciatica in various patterns, were operated upon. Lumbar discectomy and forominotomy were performed on 12 cases, and forominotomy only on 5. Follow-up of all the 17 patients found excellent and good results in 88.3% (15/17). Based on the experience from this small series of patients, we would suggest: forominotomy should be done on cases in whom neither disc protrusion nor yellow ligament thickening nor recess narrowing could be found, or the corresponding nerve root could not get free and still remain tight after discectomy, or the nerve root sustained tenderness on pressure when the operation was carried out under local anesthesia. PMID- 2776545 TI - [Vertebrectomy in treating fracture-dislocation of the spine with paraplegia]. AB - From April 1980 to August 1984, 11 cases of fracture--dislocation of spine at the level of T-11 to L-2 with obvious kyphosis at the site of displacement, with paraplegia, were treated by vertebrectomy through posterior median approach. The operations were performed 2 to 28 weeks, averaging 8 weeks, after injury. 5 of the 9 patients who had complete paraplegia suffered also causalgia in both legs. The other 2 had incomplete paraplegia only. Follow-up study, 4 years and 5 months post-operation on average, revealed complete reduction of the fracture dislocation in 10 patients and incomplete in one, getting solid bony union in all. Concerning the neurological findings of the 9 complete paraplegic patients, 5, who had suffered from causalgia got varying degree of relief, 5 regained sensation of pain in region 2 segments lower, of the 2 incomplete paraplegic patients, 1 regained sensation of pain in both legs and muscular power of degree 4 in both thighs, so that walking became possible, while the another one fell into complete paraplegia, because of compression of the cord at T-10 happened during operation and showed no signs of recovery afterward. PMID- 2776547 TI - [Experimental study on the treatment of spinal cord injury with transplantation of the greater omentum]. AB - The effects of pedicled omentum transplantation without vascular anastomosis in treating traumatic spinal cord injury in animals were observed. The shaped omentum was spread on the surface area of the injured part of the cord with its edges stitched to the cut-open edges of dura matter. Six hours later, the transplanted omentum and the covered cord surface stick together, becoming tighter and tighter with the time on until the omentum, arachnoid and pia matter stick fast. At the same time, newly developing capillaries sprouted out on the cord surface, growing inwards into the white matter upto 0.2mm at about 3 to 4 weeks; there mixing with neurofibers. During this period of time, (1 to 4 wks. after transplantation), the pathology in the treated group and the control group were obviously different: the focal hemorrhage, the necrosis of neurocytes and the degeneration of neurofibers were much less in degree and extent in the former group than that in the latter; the survivors of neurocytes and neurofibers were also great more in the treated group. PMID- 2776546 TI - [Kinematic effects of discectomy on the lumbar spine: an experimental study]. AB - By way of 3-dimensional measurement, the kinematics of the lumbar spine after discectomy were studied on 8 specimens of functional spinal units from cadavers. Each specimen was subjected to discectomy performed as on living body, the specimen was then, with proper load, fixed on a frame specially made for passive motion, imitating that of a person. Records of the 3-dimensional motions, before and after discectomy, were compared carefully. The data demonstrated that discectomy of lumbar spine did bring about definite ill-effect on kinematics of the spine, initiating immobility. PMID- 2776548 TI - [Cystic sacrococcygeal lesions]. AB - Eleven out of twelve cases of sacrococcygeal cystic lesions, 10 females and 2 males, with ages ranging from 12 to 64 underwent surgical excision with the pathological diagnosis of teratoma in 1, dermoid in 4 and epidermal cyst in 6. Most lesions were multicystic and located in the perirecto-coccygeal region, some are extending into the pelvic cavity. Occult lesions may bulge toward the rectal lumen and thus could be early detected by digital examination or proctoscopy. Early surgery is advocated for fear of malignant change and secondary infection and coccygectomy advised to ensure satisfactory exposure. PMID- 2776549 TI - [Clinical significance of the relation of primary or secondary hepatic ducts and their surrounding vessels]. AB - It is necessary that surgeons, who perform the operation on the primary and secondary hepatic ducts, should be familiar with the topography of these ducts and their surrounding vessels. A total of 22 "frame-specimens" of cadaveric liver (FSL) were built by the authors, from which the length of left and right hepatic ducts (LHD, RHD), right anterior lobe duct (RAD), the distance from the confluence of RAD and right posterior lobe duct (CAP) to the visceral surface of the liver, and the projection point of CAP on the diaphragmatic surface of Liver were all directly measured. The relationship between these proximal hepatic ducts and their surrounding vessels was also observed. Based on this study the authors proposed a new approach to incision of the whole length of LHD, RHD and RAD. The stenotic opening of right posterior lobe duct (RPD) can be exposed through the lumen of RHD. In 18.2% of 22 FSLs, the right posterior lobe artery was found in the lateral angle formed by RAD and RPD. To prevent the damage of this artery, which may cause intrahepatic hematoma, and its rupture into biliary tract, the cholongiotomy incision at the stenotic opening of RPD should be made within the lateral-superior quadrant of it close to the horizontal level. PMID- 2776550 TI - [An experimental study on preventing gallstone formation by exogenous cholecystokinin]. AB - It is well known that stasis of lithogenic bile in the gallbladder is an important factor in cholesterol gallstone formation. In this study, hamsters fed with standard lithogenic diet were given physiologic dose of exogenous cholecystokinin-octapeptide daily to facilitate emptying of the gallbladder. It was found that there was significant reduction in the gallstone formation. This study suggests that gallbladder motility is closely correlated with cholesterol gallstone formation, and administration of exogenous cholecystokinin-octapeptide can effectively prevent gallbladder stasis and reduce the incidence of cholelithiasis. This method may be useful for gallstone prophylaxis in high-risk individuals. PMID- 2776551 TI - [A study of collangenic polypeptide in gallstones and its role in stone formation]. AB - Observations on sections of human gallstone with electron microscope and analysis of glycoprotein extracted from the stone for amino acids and sulfuric rachiles radicals demonstrated that it was sulphatized glycoprotein and that the fibrous strauds of protein might be precollange-collagenic polypeptide. Inflammation was an important factor in the formation of gallstone. Increased and deposited collangenic polypeptide as nuclei with positive charges in the acid circumstances could combine not only with acid polysaccharide with negative charges into glycoprotein, but also with pigment or/and cholesterol stone with negative charges into crystal, and occupied all spaces of the fibroid structure. Deposition of cations such as K+ Na+, Ca++, increased the size of the stone. The authors pointed out that the acid polysaccharide could prevent the collangenic polypeptide from digestion of proteinase. Therefore, weak base should be first used in solution of gallstone to hydrolyze the acid polypeptide. PMID- 2776552 TI - [Secretory immunoglobulin A levels of the bile in cholelithiasis]. AB - Secretory immunoglobulin A (SIgA) in the bile was measured in 71 patients with cholelithiasis and in a control group of 10 patients without hepatobiliary disease, by using enzyme immunoassay specific to SIgA. Bile SIgA levels of patients with pigment stone, positive culture of bile for bacteria in a all of them, were significantly lower than that in control group (P less than 0.005); constituent ratios of SIgA in total immunoglobulins were markedly lower than that in the control (P less than 0.001); relative coefficient of excretion of SIgA was also significantly lower than that in the control (P less than 0.001). In patients with infectious cholecystolithiasis, bile SIgA concentrations were lower than that without infection (P less than 0.01), and that in the control (P less than 0.01). These results suggest that there is certain relation between biliary tract infection and low concentrations of bile SIgA. PMID- 2776553 TI - [Observations on the function of Oddi's sphincter in patients with primary bile duct stones]. AB - We recorded the pressure of Oddi's sphincter (SO) in 54 patients with gall stones and 25 patients as controls who had no biliary disease. Endoscopic manometry used in this study recorded the dynamic changes of the intraluminal pressure of SO as well as the static pressure of the common bile duct. It was found that in control group, common bile duct pressure was 1.54 +/- 0.15 kPa, basic pressure of SO 2.12 +/- 0.22 kPa, SO-bile duct pressure difference 0.58 +/- 0.07 kPa, and SO peak pressure 5.56 +/- 0.47 kPa, respectively. There was no significant difference between patients with gallbladder stones and secondary cholelithiasis and those in control group. But the pressure of SO was significantly lower in patients with primary bile duct stones than that in controls. This phenomenon indicates that in such patients the contraction strength of SO is weak or lost. This may explain retrograde cholangitis often seen in some patients. We suggest that in order to prevent retrograde cholangitis, adequate procedure should be taken in operation on patients with functional impairment of SO. PMID- 2776554 TI - [Hepatoenterostomy with a hepatobiliary "basin". A report of 209 cases]. AB - A basin type of hepatoenterostomy was performed in 209 cases of hepatolithiasis with ductal strictures in our hospital between 1983 and 1987. The 12 word Pithy formula technique, 2 methods, and 7 approaches for the exposure of primary to tertiary hepatobiliary ducts were nimbly adopted for releasing ductal strictures and removing gallstones. A wide hepatobiliary "basin" with neat edge and smooth inner surface was eventually formed. Then a loop of jejunum 20-30 cm in length was used to anastomose with the hepatobiliary "basin" and a combined installation against bile reflux was set up. A Roux-y reconstruction (91 cases) or a jejunal interposition between the intrahepatic ducts and duodenum (118 cases) with a hepatobiliary "basin" was completed finally. In 95.2% of cases, the "basin" was located under the visceral surface of the liver. Postoperative complications included stress ulcer (20 cases), anaerobic septicaemia (2 cases), with mortality rate of 1.4%. Eighty-three percent of patients were followed up for an average period of 21.5 months. There was no reoperative case during the follow up period. The satisfactory result accounted for 90.9% in this series. The authors believe that hepatoenterostomy with a hepatobiliary "basin" is a preferable operation for hepatolithiasis with ductal strictures. PMID- 2776556 TI - [Iatrogenic hemobilia: clinical manifestation, diagnosis and management]. AB - In the last 4 years, we had 8 cases of iatrogenic massive bleeding from the biliary duct following operations on the liver and bile ducts. It seemed to us that it was not an infrequent complication. In this communication, the clinical manifestations, diagnosis and management of the complications were presented with special emphasis on the importance of angiography in the diagnosis of this condition. In this series, 6 cases were treated successfully by trans-catheter embolization. It is believed that embolization is safe, reliable, and should be the procedure of choice in the treatment of this complication. PMID- 2776555 TI - [Surgical treatment of biliary tract disease in elderly patients]. AB - A retrospective study 94 cases of elderly patients with biliary tract disease. The overall postoperative mortality rate was 6.4%. Among the 94 cases there were 50 cases of acute cholecystitis, of which 15 cases were complicated by acute obstructive suppurative cholangitis, and 44 cases of chronic cholecystitis. 80 cases had gallstones (85.1%). Associated diseases were found in 56 cases (59.6%) before operation, most of them were cardiovascular diseases (53.2%). During operation 23 cases were monitored by ECG, and abnormal ECG developed in 6 cases although the operations were all carried out uneventfully. It is suggested that after adequate preoperative preparation, aggressive surgical intervention should be considered for acute biliary tract disease in elderly patients. PMID- 2776558 TI - [Surgical treatment of Wolff-Parkinson-White syndrome with local intramyocardial injection of absolute alcohol: a report of 12 cases]. AB - Between April 1985 and April 1987, 12 patients with Wolff-Parkinson-White syndrome were treated with local intramyocardial injection of absolute alcohol. Of the 12 patients, 9 were type-A, 3 were type-A and B. The results were satisfactory. The authors emphasize the precision of mapping and exact intramyocardial injection with minimal dosage of absolute alcohol. PMID- 2776557 TI - [Extracorporeal shock wave lithotripsy of staghorn stones]. AB - One hundred forty-seven cases of staghorn calculi were treated with HM-3 Dornier lithotripter. The stone located at the right tract in 71, the left 65 and 11 bilaterally. Fifteen cases had stones larger than 6 cm in length, the biggest size was 11 cm in diameter. Majority of the patients in this group underwent multiple ESWL treatment. PCN was needed in only 4 cases. For safety reason, The interval between two ESWL treatment should be more than 1 week. All stones were completely fragmented and discharged no longer than 4 months. The overall procedural complications were relatively low and not severe. Hematuria occurred in all the patients, fever in 8.8% and pain in 12.2%. The results of this study indicate that the majority of staghorn stone could be treated satisfactory with ESWL. PMID- 2776559 TI - [Surgical management of chylothorax: a report of 65 cases]. AB - Sixty-five cases of chylothorax treated at the Shanghai Chest Hospital over the past 30 years are reviewed. The causes of chylothorax in this series were mainly traumatic and postoperative (47/65). Two cases were associated with chylopericardium and another 2 with chylous sputum. The authors believe that untreated chylothorax is a serious, often life-threatening entity and that the following principles are applicable in its management: (1) If daily chyle loss exceeds 1000 ml in adults with no tendency of subsidence, surgery is indicated especially in the effusion may lead to disastrous nutritional and immunologic consequences; (2) Ligation of the thoracic duct is effective by a mass ligature encircling all tissues between the azygos vein and the aorta. The most favorable site for ligation is immediately above the diaphragm. Over dissection of the thoracic duct should be avoided; (3) The proper surgical approach is on the side of the effusion in unilateral chylothorax, but right side approach is preferred in case of bilateral chylothorax or when the origin of chylous fistula is unknown; (4) Pleurodesis is indicated for those cases if the duct is not obviously present or chyle comes from the pleural lymphatics. Concentrated glucose solution with or without Talc suspension is recommendable. PMID- 2776560 TI - [Surgical treatment of intracranial venous sinus injury. A report of 111 cases]. AB - The article analysed 111 cases of intracranial venous sinus injury which were treated in recent 26 years. The cure rate is 77.5% and the mortality rate is 22.5%. The diagnosis and treatment of intracranial venous sinus injury were discussed. Some principles for repairing the lacerations and surgical techniques were introduced. Temporary extracranial shunt of superior sagittal sinus to control bleeding during operation was recommended also. PMID- 2776561 TI - [Optimal conditions for the storage of split-thickness skin at 4C]. AB - Split-thickness human skin must, out of necessity, be stored for days to years prior to usage as a burn wound covering. This study was designed to utilized three different parameters of tissue viability in order to determine optimum conditions for skin survival at 4 degrees C for various periods of time in RPMI 1640 media. Viability was determined by 1) trypan blue dye exclusion of trypsinized basal cells (TBC), 2) 14C-leucine incorporation into TBC, and 3) in vitro skin explant growth. Electron microscopy was also done on selected samples. METHODS: Split-thickness (0.2-0.3 mm) cadaveric skin (obtained within 24 hours of death) was divided into 6 tubes containing RPMI-1640 (pH 7.3) supplemented with 10% Nu-serum and 25 mM Hepes. The ratio of skin to media varied from 0.2 to 8.0 cm2/ml. The samples were then stored at 4 degrees C for up to 4 weeks with weekly changes of media. RESULTS: Following 7 days storage, optimal viability (as determined by averaging the viabilities obtained from the above assays) was found for samples stored at a ratio of 2 cm2/ml (90.3 +/- 4.2%). Samples stored at ratios between 1.0 and 6.0 cm2/ml all maintained acceptable viabilities (i.e., greater than 78%), while samples at either 0.2 or 8.0 cm2/ml were both about 57% viable. EM demonstrated edema in all samples. The viability of skin stored for 4 weeks at 2-4 cm2/ml decreased dramatically after 2 weeks. CONCLUSION: RPMI-1640 is an excellent medium for the storage of split-thickness skin at 4 degrees C, 2 4 cm2/ml, for up to 7 days. Because of the high viability retained in skin stored under these conditions, further long term storage in liquid nitrogen should provide good quality tissue for transplantation. PMID- 2776563 TI - [Limb lengthening by way of slow distraction of the epiphysis. An experimental study]. AB - The results of limb lengthening by way of slow distraction of the appropriate epiphyceal plate on 25 lamb limbs were investigated clinically and radiologically, and scrutinized histologically by light- and electron microscopic examinations. It has been proved that lengthening of 0.4 mm per day by way of slow distraction would not cause epiphysiolysis, and that lengthening took place as a result of increased osteogenesis and augmented endochondral ossification in the epiphyseal plate, being induced by distraction at a slow rate. Points about limb lengthening by way of epiphysiolysis and of slow distraction of epiphysis were compared and discussed. PMID- 2776562 TI - [Hemodynamic effects of naloxone in early acute pancreatitis in the dog and its efficacy in treating acute pancreatitis]. AB - Naloxone, an opiate receptor blocker, has been shown in earlier studies to have positive effect on cardiovascular function in a variety of diseases in which the secretion of endogenous opioid peptides was suspected. In this communication, a dog model of acute pancreatitis (AP) was made by intraductal injection of fresh trypsin-bile mixture, in which the hemodynamic changes were measured, the therapeutic efficacy of naloxone was evaluated. Pancreatitis was characterized by a fall in SAP, CO, dp/dt, an increase in PVR, SVR and the early reduction of pancreatic blood flow (QP). Administration of naloxone produced a significant increase in QP and led to normalization in SAP, CO, dp/dt, PVR and, SVR. In addition, Naloxone significantly reduced the severity and mortality of AP. These results suggest that naloxone appears to limit the progression from edematous to hemorrhagic pancreatitis through preserving QP at the early phase of AP. We propose the hypothesis that endogenous opiates may play a role in the pathophysiology of AP. PMID- 2776564 TI - [Experimental study of cementless fixation of pearl-surfaced hip arthroplasties]. AB - Femoral head replacement with pearl-surfaced prosthesis was performed on one side of each of 33 mongrel dogs. 30 of the implants inserted were without cement fixation while the other 3 with for comparison. The specimens were taken out in times of 2 weeks, 1,2,4,6, and 8 months after implantation for radiologic, histologic and biomechanical studies. In 2 weeks' specimens, quite an amount of new bone tissues were found in the interspaces among the pearls on the surface of the prosthesis; by the end of the first month, the interspaces were full of new bone, commencing lamination and progressing to become denser and denser up to 2 months when it appeared as dense as that of cortex. Biochemically the combination strength in the cementless group as a rule, was stronger than that in the control group. Some specimens, the portion in which the prosthetic stem had been embedded, were equally divided into 3 segments, upper middle and lower, to measure the combination strength at different sites. The tested values showed that the strength ratio was 4:2:1 corresponding to the upper, middle and lower segment. It is convincible that the pearl-surfaced hip prosthesis provides reliable stability without cement and it could be safely applied in clinical use. PMID- 2776565 TI - Flow cytometry in oceanography. PMID- 2776566 TI - Overview of flow cytometry and image analysis in biological oceanography and limnology. PMID- 2776567 TI - Flow cytometry and phytoplankton. AB - Flow cytometry and sorting are now an important technology in aquatic research. Simultaneous measurements of individual particle cell size, fluorescence, and light scatter properties are directly applicable to current topics in aquatic research. Flow sorting may be employed to obtain subsets of cells for analysis by conventional methods. The manner in which rapid, precise measurements of single cells are made is complex, and the application of this technology to aquatic samples is subject to many analytical constraints. Flow cytometric measurements of algal cell size and pigment autofluorescence are relative and are therefore dependent on the optical configuration and variability of the instrument. Specific types of reference materials are used to establish the validity of analyses: 1) instrument standards, 2) fluorescence controls, and 3) internal stain standards. The selection and application of standards and controls are discussed in the context of allometric (cell size versus pigment fluorescence) and ataxonomic (pigment color groups) methods. The widespread acceptance of particular reference materials among research groups will result in comparable data sets describing aquatic particle distributions. PMID- 2776568 TI - Optical plankton analyser: a flow cytometer for plankton analysis, I: Design considerations. AB - The design criteria for a flow cytometer (FCM) for the analysis of field samples of phytoplankton are described. The criteria are based on the occurrence of a wide variety of particle sizes in field samples, normally at low concentrations. The instrument should be able to analyse cells and colonies from 0.5 to 500 microns diameter and of over 2,000 microns length. A minimum flow rate of 4 microliters.s-1 was calculated from natural plankton concentrations. Commercially available FCMs are not suited to measure this range of sizes at this rate. Further limitations of standard FCMs are uneven illumination or incomplete processing of long signals. In addition, long filamentous colonies can break into small fragments caused by too high acceleration in the standard flow cuvette. Recognition of these limitations is of importance for the flow cytometry of phytoplankton. The new design was developed to avoid these limitations. A dynamic range 5 to 6 decades could be accomplished by a combination of logarithmic amplifiers, a slit-shaped focal spot, and a pulse integration system that can process long pulses. Multilaser capability to identify different phytoplankton species, a low fluid shear cuvette, and a trigger gate-extension for inhomogeneously fluorescent algal filaments were included in the design. PMID- 2776569 TI - Optical plankton analyser: a flow cytometer for plankton analysis, II: Specifications. AB - An analysing flow cytometer, the optical plankton analyser (OPA), is presented. The instrument is designed for phytoplankton analysis, having a sensitivity comparable with commercially available flow cytometers, but a significantly extended particle size range. Particles of 500 microns in width and over 1,000 microns in length can be analysed. Sample flow rates of up to 55 microliters/s can be used. Also, the dynamic range of the instrument is significantly increased for particles larger than about 5 microns. The optics, hydraulics, and electronics of the instrument are described, including the best form for a low fluid shear cuvette. The new pulse quantification technique we call digital integration is presented. This technique is essential for the instrument to handle both short and very long particles with a large dynamic range. Test measurements demonstrating particle size range and dynamic range are presented. Dynamic ranges of 10,000 and 100,000 were typically observed, measuring field samples with Microcystis aeruginosa colonies, whereas one sample showed a dynamic range of 10(6). A simple method for interpretation of time of flight (TOF) data in terms of particle morphology is presented. The specifications of the instrument are given. PMID- 2776570 TI - Use of a neural net computer system for analysis of flow cytometric data of phytoplankton populations. AB - Flow cytometry has been used over the past 5 years to begin detailed exploration of the distribution and abundance of picoplankton in the oceans. Light scattering and fluorescence measurements on individual plankton cells in seawater samples allow construction of population signatures from size and pigment characteristics. The use of "list mode" data has made these studies possible, but on-shore analysis of copious data does not permit on-site reexamination of important or unexpected observations, and overall effort is greatly handicapped by data analysis time. Here we describe the application of neural net computer technology to the analysis of flow cytometry data. Although the data used in this study are from oceanographic research, the results are general and should be directly applicable to flow cytometry data of any sort. Neural net computers are ideally suited to perform the pattern recognition required for the quantitative analysis of flow cytometry data. Rather than being programmed to perform analysis, the neural net computer is "taught" how to analyze the cell populations by presenting examples of inputs and correct results. Once the system is "trained," similar data sets can be analyzed rapidly and objectively, minimizing the need for laborious user interaction. The neural network described here offers the advantages of 1) adaptability to changing conditions and 2) potential real time analysis. High accuracy and processing speed near that required for real time classification have been achieved in a software simulation of the neural network on a Macintosh SE personal computer. PMID- 2776571 TI - Algorithm to estimate cell biovolume using image analyzed microscopy. AB - This paper describes an algorithm for calculating the biovolume of cells with simple shapes, such as bacteria, flagellates, and simple ciliates, from a 2 dimensional digital image. The method can be adapted to any image analysis system which allows access to the binary cell image--(i.e., the pixels, or (x,y) points, composing the cell. The cell image is rotated to a standard orientation (horizontal), and a solid of revolution is calculated by digital integration. Verification and a critical assessment of the method are presented. The algorithm accounts for irregularities in cell shape that conventional methods based on length, width, and geometrical formulas do not. PMID- 2776572 TI - Kinetics of bacterial processes in natural aquatic systems based on biomass as determined by high-resolution flow cytometry. AB - The two primary kinetic constants for describing the concentration dependency of nutrient uptake by microorganisms are shown to be maximal rate of substrate uptake and, rather than the Michaelis constant for transport, specific affinity. Of the two, the specific affinity is more important for describing natural aquatic microbial processes because it can be used independently at small substrate concentrations. Flow cytometry was used to evaluate specific affinities in natural populations of aquatic bacteria because it gives a convenient measure of biomass, which is an essential measurement in the specific-affinity approach to microbial kinetics. Total biomass, biomass in various filter fractions, and the specific affinity of the bacteria in each fraction were determined in samples from a near-arctic lake. The partial growth rate of the pelagic bacteria from the 25 micrograms/liter of dissolved amino acids present (growth rate from the amino acid fraction alone) was determined to be 0.78 per day. By measuring activity in screened and whole-system populations, the biomass of the bacteria associated with particles was computed to be 427 micrograms/liter. PMID- 2776573 TI - Shipboard analytical flow cytometry of oceanic ultraphytoplankton. AB - Shipboard analysis of marine ultraphytoplankton by flow cytometry is a powerful method to classify these cells according to in vivo fluorescence characteristics and size. At present, this ataxonomic-allometric approach allows recognition of phycoerythrin-containing cyanobacteria, cryptomonads, very small red-fluorescing cells (presumably prochlorophytes), and eukaryotic algae of various sizes in many open ocean samples. The speed at which flow cytometric analysis can be performed on freshly collected samples permits a high degree of sampling resolution in both space and time. A flow cytometric view is presented of the vertical distribution of ultraphytoplankton at various sites in the north Atlantic and of experiments wherein phytoplankton were incubated in an artificial light gradient and under simulated in situ conditions. PMID- 2776574 TI - Separation and concentration of phytoplankton populations using centrifugal elutriation. AB - Centrifugal elutriation is a technique for separating particles on the basis of their sedimentation velocity, an expression of size, shape, and specific gravity. Unialgal cultures, mixtures of two phytoplankton cultures, and natural seawater samples were elutriated to determine the feasibility of this technique for collecting fractions of different cell cycle phases, separating two phytoplankton species, and concentrating cells from dilute samples. Elutriation resulted in the separation of a culture of Dunaliella tertiolecta and Phaeodactylum tricornutum into homogeneous fractions of each species. Cells in the natural seawater sample were concentrated by nearly 2 orders of magnitude. Centrifugal elutriation provides an alternative cell separation and concentration technique when large numbers of cells are required. PMID- 2776575 TI - Variance within homogeneous phytoplankton populations, I: Theoretical framework for interpreting histograms. AB - A framework is presented for interpreting frequency distributions of volume or fluorescence as measured by a flow cytometer on homogeneous phytoplankton populations. The framework, based on both laboratory experience and theoretical concepts, is illustrated with the use of a simulation model. Asynchronous, synchronous, and phased populations were simulated, with constant and variable growth patterns over the cell cycle. Though simulations produced a wide variety of histogram shapes, including multimodal distributions, the primary difference between asynchronous and synchronous/phased distributions lies in their temporal variation. Histograms that are constant in time indicate asynchronous populations; when populations are not asynchronous, their histogram shapes vary with a periodicity on the same time scale as the cell cycle. A probability density function for the case of asynchronous populations with a constant growth rate is derived. When fitted to simulated histograms this two-parameter density function yields estimates of the two parameters: mean and variance of cell volume (or mass) at age 0. PMID- 2776576 TI - Variance within homogeneous phytoplankton populations, II: Analysis of clonal cultures. AB - In part I of this series of articles, a framework was presented for interpreting histograms of volume or fluorescence as measured by a flow cytometer on homogeneous phytoplankton populations. In this paper, the analytical framework is applied to flow cytometric histograms from laboratory experiments involving clonal phytoplankton cultures. The density function derived in part I was modified to include a third parameter representing a linear shift of the origin. This modified density function was fitted to chlorophyll fluorescence histograms for populations believed to be asynchronous (grown in continuous light) and also to histograms from populations grown on a 14:10 (h:h) light/dark cycle. Near synchronous subpopulations sorted from an asynchronous population were also analyzed. In populations in which underlying assumptions (asynchronous divisions, constant growth) are valid, curve fits provide estimates of the inherent variability among cells at age 0. The implication of fitting the density function to populations in which these assumptions are not valid is discussed. PMID- 2776577 TI - Variance within homogeneous phytoplankton populations, III: Analysis of natural populations. AB - A theoretical framework for interpreting flow cytometric histograms from homogeneous phytoplankton populations was developed in part I of this series of articles and applied to chlorophyll fluorescence histograms from clonal cultures in part II. In this paper, we demonstrate the application of this framework to the analysis of cell volume distributions found in a natural assemblage of phytoplankton from the Gulf of California. Flow cytometric analyses of a surface water sample incubated for a period of 61 h revealed the sequential growth and decline of three distinct subpopulations. Cell volume distributions for each subpopulation measured at different times were analyzed, and the theoretical density function described in parts I and II was fitted to these distributions. The range of cell volumes within each subpopulation was similar to that predicted for asynchronous populations. PMID- 2776578 TI - Carbon dynamics of logarithmetic and stationary phase phytoplankton as determined by track autoradiography. AB - Track autoradiographic analysis of photosynthetic radiocarbon incorporation at the cellular level indicated that the carbon uptake rate and carbon pool size of exponentially growing (log phase) Scenedesmus cells was threefold that of stationary phase cells, while carbon turnover rates were similar. Carbon fixation was uncoupled from growth and cell division in the stationary phase cells, which were larger and contained less chlorophyll per unit volume than log phase cells. Changes in the temporal pattern of isotope incorporation were evident at the cell level prior to the cessation of division and transition to stationary phase, while bulk carbon fixation responded only the second day after cell division ceased. The carbon uptake patterns of a marine nanoplankter from a nutrient enriched natural sample resembled that of log phase cells while the control population pattern resembled that of stationary cells. The physical, biochemical, and metabolic differences between log and stationary phase cells are potentially measurable by flow cytometry procedures currently in use and under development. The use of flow cytometry to sort cell types for analysis by track autoradiography and subsequent correlation of metabolic characteristics with flow cytometry signatures is a feasible means of investigating the heterogeneity of phytoplankton metabolic state in the marine environment. PMID- 2776579 TI - Rapid analytical technique for the assessment of cell metabolic activity in marine microalgae. AB - A standard method for the assessment of cell viability has been developed for marine phytoplankton using an inexpensive stain, fluorescein diacetate (FDA), at .75 microM for 10 min. A flow cytometer was used as the fluorescence detector, providing an assessment of viability for each individual particle. Cell size and chlorophyll fluorescence per cell were assessed simultaneously, permitting an assignment of viability to specific subpopulations, thus increasing the power of the technique. A reasonable correspondence between FDA mean fluorescence intensity per cell and an independent metabolic indicator, photosynthetic capacity measured by 14C, was found. Both FDA mean fluorescence intensity and photosynthetic capacity vary as a function of cell volume. Recovery after extended periods of darkness indicate that cells that are FDA negative may not be dead, but merely quiescent or inactive. PMID- 2776580 TI - Discrimination of eukaryotic phytoplankton cell types from light scatter and autofluorescence properties measured by flow cytometry. AB - Flow cytometric methods for recognizing several groups of eukaryotic marine phytoplankton were tested using 26 laboratory cultures. Each culture was divided into three aliquots, and these samples were analyzed for 1) Coulter volume; 2) light scatter (magnitude and polarization properties of forward scattered light and magnitude of right-angle scattered light) and autofluorescence emission (phycoerythrin and chlorophyll); and 3) autofluorescence excitation (by 488 nm and 515 nm light). Three kinds of cells could be easily distinguished from others in the culture collection: 1) The two cryptophytes and the rhodophyte had high phycoerythrin/chlorophyll ratios; 2) the two coccolithophores depolarized forward scattered light; and 3) the two pennate diatoms scattered only a relatively small amount of light in the forward direction compared with that at right angles. Mean chlorophyll fluorescence excited by blue light relative to that excited by green light was highest in the four chlorophytes, but there was overlap between some of these and some other kinds of cells. Unresolved cell types included centric diatoms, dinoflagellates, and naked coccolithophores. Forward light scatter and Coulter volume were closely related (except for the pennate diatoms) over a range of about 0.01 to 30 pL (equivalent spherical diameter about 3 to 40 microns), according to a logarithmic function. PMID- 2776582 TI - Using phytoplankton and flow cytometry to analyze grazing by marine organisms. AB - Phytoplankton can, through their autofluorescent characteristics, be thought of as tracer particles in much the same way as fluorescent microspheres when used in particle uptake experiments. Flow cytometric techniques can be used to differentiate phytoplankton from other suspended particles by the two primary autofluorescing photosynthetic pigments, chlorophyll and phycoerythrin. Based on these characteristics, phytoplankton assemblages have been used to assess grazing rates, particle selectivity, and endocytotic abilities in various marine species, from single-celled organisms to higher invertebrates. PMID- 2776581 TI - A flow cytometric approach to assessing the environmental and physiological status of phytoplankton. AB - Individual particle analysis using a flow cytometer (FCM) was made on natural phytoplankton communities in oligotrophic waters. Our objective was to develop an assay to yield information on the nutrient history of individual cells using FCM. Results from nutrient assays showed that both biovolume and total red fluorescence are affected by the nutrient conditions in the incubator. The light effect was measured by changes in the chlorophyll content of the cells, and after the 12 h incubation the cells seemed well adapted to the light conditions. The estimated kinetic constant for the chlorophyll synthesis averaged 1.5 x 1.0(-2) h 1, whereas the growth rate calculated from the changes in the cell numbers changed from 0.14 to greater than 2.5 doubling per day. The smallest size fraction presented the highest growth rate (greater than 2.5 doublings per day). The relationship between the total red fluorescence as estimated with the FCM and the biovolume revealed that the cells from the 2 m samples at the beginning of the experiment were probably nutrient limited. Important changes in the size of the cells under nutrient limitation were also observed. The FCM data suggest that the FCM is a valuable tool for estimating the relative growth response and nutritional state of natural phytoplankton populations. PMID- 2776583 TI - Pharmacokinetics of intravenous terbutaline in asthmatic children. AB - Seven asthmatic children were given terbutaline intravenously. The intact drug was measured in plasma and urine, and its conjugates were measured in urine. The decreasing plasma concentrations of terbutaline did not attain a terminal slope until 8-12 h after dosing. This was most likely due to different kinetics of the enantiomers. The terminal half-life was 8.8-15.8 h. Body clearance was 2.73-5.44 ml/min/kg, two-thirds of which were of renal origin. The volume of distribution (Vss) was 1.28-1.83 l/kg. The disposition pharmacokinetics of terbutaline do not rationalize a higher dose per kg body weight in children than in adults. PMID- 2776584 TI - Comparison of high-dose opioid antagonist effects on ovine fetal cardiovascular function. AB - The opioid antagonists, naloxone (NOX) and naltrexone (NTX), were found to produce dose-dependent increases in fetal mean arterial pressure over a dose range of 5-80 mg/kg. There was a concomitant decrease in fetal heart rate up to 40 mg/kg. Above this dose, NOX and NTX caused an increase in heart rate as well as blood pressure. NTX produced similar effects in maternal ewes, although at lower doses (mg/kg) than those needed for fetal lambs. There were no age-related differences in antagonist effects in two fetal age groups studied (100-116 and 124-144 days of gestation). The partial antagonist, levallorphan (LVL), produced effects which were qualitatively similar to those produced by NOX and NTX in doses up to 20 mg/kg. These effects were not stereospecific, as the enantiomer of LVL, dextrallorphan, produced similar effects at equal doses. Pretreatment with the alpha 1-adrenoreceptor antagonist, prazosin, abolished the opioid antagonist effects on fetal blood pressure. We postulate that high doses of opioid antagonists activate sympathetic systems to increase fetal blood pressure through mechanisms which do not involve interactions with mu, delta or kappa opioid receptors. PMID- 2776585 TI - A moderate concentration of ethanol alters cellular membrane potentials and decreases contractile force of human fetal heart. AB - The effects of ethanol, although well studied in the adult myocardium, have been little studied in fetal tissue. Experiments in pregnant animals suggest that ethanol compromises fetal myocardial performance, in utero; however, the physiological mechanism(s) remains obscure. The present report examines, in vitro, the effects of a moderate concentration of ethanol (20 mM) directly on cell membrane potentials and contractility of human fetal left ventricle as determined using intracellular microelectrodes and microforce transducers. We observed significant decreases in action potential amplitude, upstroke velocity, duration of repolarization, and the force of contractions. These effects were reversible. As ethanol crosses the placenta, our findings suggest that moderate concentrations of ethanol, as occur during 'social drinking', may temporarily compromise fetal myocardial performance in utero. PMID- 2776586 TI - Adjustment to diabetes mellitus in preschoolers and their mothers. AB - Although preschool-aged children with diabetes might be at increased risk for both general and disease-specific psychological adjustment difficulties, this issue has not been investigated. We evaluated both general and diabetes-related adjustment of 20 preschool-aged children and their mothers. The mothers completed the Child Behavior Checklist, Parenting Stress Index, Parents' Diabetes Opinion Survey, and the Preschool Diabetes Behavior Checklist. The latter measure was constructed specifically for this study to measure the frequency of oppositional and avoidance behaviors of children regarding diabetes management tasks. Mothers reported that their children displayed significantly more internalizing behavior problems (anxiety, depression, withdrawal) and were a significantly greater source of parental stress compared with corresponding nondiabetic normative group samples. Also, certain maternal attitudes about diabetes and its treatment were correlated with the children's disease-specific behavior problems. The children's general psychological adjustment, however, was not predictive of these diabetes specific behavior problems. PMID- 2776588 TI - Evaluation of albumin excretion rate in overnight versus 24-h urine. AB - This study was performed to assess whether the albumin excretion rate (AER) measured in overnight urine (N-AER) and 24-h urine (24-h AER) gives comparable results. For this reason we evaluated N-AER and 24-h AER on the same day from 35 control subjects, 57 patients with insulin-dependent diabetes mellitus (IDDM), and 63 patients with non-insulin-dependent diabetes mellitus (NIDDM). AER values obtained from the two urine collection procedures were significantly different (P less than .01), with 24-h AER approximately 30% higher than N-AER. Moreover, when the same cutoff value (20 micrograms/min) was used to define the normal range, 21% of IDDM patients and 6.3% of NIDDM patients had on the same day normal N-AER and abnormal (greater than 20 micrograms/min) 24-h AER. Although N-AER values were significantly correlated to 24-h AER values (r = 0.67, P less than .001), it was not possible to assess an N-AER value able to predict a 24-h AER value greater than 20 micrograms/min. In conclusion, N-AER and 24-h AER cannot be used as an equivalent method to establish AER. PMID- 2776587 TI - Proteinuria in Mexican Americans and non-Hispanic whites with NIDDM. AB - Mexican Americans have a threefold greater prevalence of non-insulin-dependent diabetes mellitus (NIDDM) than non-Hispanic Whites as found in the San Antonio Heart Study, a population-based study of diabetes and cardiovascular disease. In addition, Mexican-American diabetic subjects have higher levels of glycemia than non-Hispanic White diabetic subjects. We therefore hypothesized that the prevalence of clinical proteinuria would be greater among Mexican-American diabetic subjects (n = 317) than among non-Hispanic White diabetic subjects (n = 67). Clinical proteinuria, defined as greater than or equal to 1+ on the Ames Albustix test, was 2.82 times more prevalent in Mexican-American diabetic subjects compared with non-Hispanic White diabetic subjects adjusting for age and duration (95% confidence interval [CI] = 1.05, 7.55; P = .039). After controlling for other possible confounding variables (i.e., glycemia, systolic blood pressure, smoking, and insulin use), the excess of proteinuria in Mexican American diabetic subjects was only slightly attenuated, although the statistical significance became borderline (odds ratio [OR] = 2.59, 95% CI = 0.91, 7.32; P = .072). The prevalence of microalbuminuria (greater than 30 mg/L) was also significantly higher in Mexican-American diabetic subjects than in non-Hispanic White diabetic subjects (OR = 3.54, 95% CI = 1.28, 9.81; P = .015). We also compared previously diagnosed Mexican-American diabetic subjects (n = 243) from San Antonio with previously diagnosed non-Hispanic White diabetic subjects in Wisconsin (n = 476).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2776589 TI - Patient-oriented criteria for evaluation of self-monitoring of blood glucose devices. PMID- 2776590 TI - Pediatric primary care for children with type I diabetes. PMID- 2776591 TI - Accident risk of the diabetic driver. PMID- 2776592 TI - The nonphysician endocrinologist. Has Osler's nightmare come true? PMID- 2776593 TI - Single-visit screening of diabetic complications. PMID- 2776594 TI - Difficulties in evaluating urinary specimens after local mitomycin therapy of bladder cancer. AB - In order to describe the cytological changes induced by mitomycin in urinary specimens, we re-examined cytological specimens from patients with recurring bladder cancer treated by long-term intravesical mitomycin therapy after transurethral resection. Local mitomycin therapy causes an increase of leukocytes and urothelial cells, especially of the umbrella-cell type, in urinary specimens. During and after the application of mitomycin, the nucleus and the cytoplasm of urothelial cells are enlarged, usually proportionally. Urothelial cells frequently show a giant nucleus, multiple prominent nucleoli, and an enlarged foamy cytoplasm of the umbrella-cell type. Anisokaryosis is also seen. Such cytological changes are more remarkable later in the course of therapy and after the end of therapy, and they often confuse cytological interpretation. However, the nuclei of urothelial cells are usually translucent and not hyperchromatic, and there is rarely a coarse chromatin pattern. On the other hand, in positive specimens during or after local mitomycin therapy, usually a number of tumor cells showing nuclear enlargement, hyperchromatic nuclei, coarse chromatin pattern, and/or increased nuclear-cytoplasmic ratio are found beside the atypical cells changed by mitomycin. PMID- 2776595 TI - Cytologic criteria for subclassification of Hodgkin's disease using fine-needle aspiration. AB - Hodgkin's disease (HD) is increasingly being evaluated by fine-needle aspiration (FNA); however, criteria to subclassify HD into its four subtypes--nodular sclerosis (NS), mixed-cellularity (MC), lymphocyte-depleted (LD), and lymphocyte predominant (LP)--has not been established. In order to evaluate criteria for subclassification, all FNA cases of HD obtained over a 5-yr period at Indiana University Medical Center that had confirmatory surgical biopsies were reviewed. The number of Reed-Sternberg (RS) cells was quantitated in each cytologic case and statistically analyzed by subgroup, using analysis of variance (ANOVA). LD had the highest mean (means) number of RS cells (means = 51) with NS and MC having similar means (means = 7 and 6, respectively). Only one case of LP was identified and therefore could not be analyzed statistically. Fibrosis and the presence of RS variants were qualitatively assessed and were not helpful in distinguishing the subtypes of HD. Although the quantitation of RS cells may be used to identify LD types of Hodgkin's disease, MC and NS cannot be separated reliably on this criterion alone. Although FNA can be used to diagnose HD, stage a patient, or assess efficacy of chemotherapy, subtyping of HD should still be done on histologic sections of excised lymph nodes. PMID- 2776596 TI - Gleason grading of prostatic adenocarcinoma on fine-needle aspiration. AB - We attempted to use the Gleason grading scheme on fine-needle aspiration (FNA) of the prostate by examining 31 prostate aspirates that had concomitant surgical pathology tissue for correlation. A set of criteria is delineated in which it is proposed that Gleason grading is possible on FNA of the prostate by evaluating aspirated tissue fragments. Cell cytology, including qualitative nucleolar appearance, is not significantly helpful in this approach. PMID- 2776597 TI - Ultrastructural histochemistry of mesotheliomas and adenocarcinomas in malignant effusions. AB - The results of electron microscopic examination of cytologic specimens from six cases of mesothelioma and 10 cases of metastatic carcinoma of different origins are presented. The formation of cell clusters in malignant effusions from the two neoplasms has been thoroughly investigated: in mesotheliomas, cells had longer, more slender microvilli than in carcinomas and more abundant bundles of intermediate filaments; the central cavity often seen in the clusters frequently contained collagen and showed basement membrane production. The application of periodic acid-silver methenamine (PASM) and phosphotungstic acid (PTA) demonstrated a peculiar ultrastructural difference in cell coat staining in the two tumor types: in mesotheliomas, PTA and PASM were consistently negative along the outer surface of the cell aggregates, while carcinomas displayed a positive reaction either on the outer surface or on both inner and outer surfaces of the clusters. The diagnostic significance of the above-mentioned difference between the two neoplasms will require further investigation in a larger number of cases. PMID- 2776598 TI - Fine-needle biopsy: comparison of cellular yield with and without aspiration. AB - Fine-needle biopsies with and without aspiration were performed on 103 lesions, and the cellular yields obtained by the two techniques were compared. A scoring system was devised by which the amount of material obtained in each needle stick was estimated. The mean score/stick for fine-needle biopsy with aspiration was 2.7; for biopsy without aspiration, it was 2.9. The results of this study indicate that there is no significant difference in the amount of cellular material obtained by the two techniques. It is concluded that needle biopsy without aspiration may be performed routinely with good results. PMID- 2776599 TI - Fine-needle aspiration cytology of superficial lymph nodes. AB - A series of 244 enlarged superficial lymph nodes was examined by fine-needle aspiration cytology. Twenty-nine smears (11.9%) were inadequate for study. Of the remaining 215, 108 were negative, 13 suspicious for malignancy, and 94 positive. Forty-five excisional biopsies were performed correlating the cytologic and histologic findings. There were two cytologic false-negative results; both were patients who had been treated for carcinoma and whose aspirates were cytologically negative. Of the 13 samples reported as suspicious for malignancy, there were three epidermoid carcinomas, nine reactive hyperplasias, and one non Hodgkin's lymphocytic lymphoma. Of the positive cases, 83 were metastatic tumors, and 11 were malignant lymphomas (two non-Hodgkin's lymphomas and nine Hodgkin's lymphomas). The criteria used in the interpretation of these aspirates and the problems of differential cytological diagnosis are discussed. In spite of the drawbacks of inadequate and false-negative smears, fine-needle aspiration cytology is valuable in preliminary diagnosis of diseased lymph nodes and subsequent management. PMID- 2776600 TI - The aspiration cytology of pulmonary hamartomas. AB - Cytodiagnosis of pulmonary hamartomas (PHs) by transthoracic fine-needle aspiration (FNA), successful in 11 of a series of 14 cases, has been found to rely less on the presence of mature cartilage than on the recognition of fibromyxoid fragments. These fragments, wispy yet discrete, consisting of variable numbers of fibroblasts embedded in fibrillary ground substance, can be distinguished from fibrous tissue and mucus, both of which they may resemble. Mature cartilage is distinctive when present, but it is seen in a minority of cases. Bronchial cells and adipocytes, integral components of PHs, are of no diagnostic value unless associated with fibromyxomatous tissue or cartilage. Chest wall "contaminants" that may cause pitfalls in diagnosis, such as bone, skeletal muscle, and fibrous tissue, are described and illustrated. The differential diagnosis of biphasic lesions containing epithelial cells and mesenchyme, including dermoids and blastomas, is discussed. With knowledge of the radiologic appearance of target lesions, confident cytodiagnosis of PHs is possible if attention is paid to subtle, yet specific, background features in aspirated material. PMID- 2776601 TI - Marginal vacuoles in metastatic thyroid carcinoma: a case report. AB - A case of metastatic follicular carcinoma to the iliac bone in a 78-yr-old woman is presented. Fine-needle aspiration biopsy (FNAB) smears showed numerous, cohesive tumor cell groups with moderately abundant cytoplasm and distinctive, peripherally situated pink-staining vacuoles on May-Grunwald-Giemsa stain. The presence of marginal vacuoles strongly suggested the possibility of metastatic thyroid carcinoma. Immunohistochemical studies performed on a concomitant needle core biopsy showed immunoreactivity for thyroglobulin, supporting a thyroid derivation for this metastasis. To our knowledge, this is the first reported case in which marginal vacuoles ("flame cells") have been identified in a malignant thyroid condition. PMID- 2776602 TI - Diagnosis of retinoblastoma by fine-needle aspiration and aqueous cytology. AB - This article reports the cytodiagnosis of three cases of retinoblastoma in children aged 1.5, 2.5, and 5 yr. Two of them were diagnosed by fine-needle aspiration cytology of the primary tumor and one by aqueous cytology. The tumor cells were usually round to oval, small and uniform, with scanty cytoplasm; they generally occurred in closely packed clusters of variable sizes. We discuss the differential diagnosis of retinoblastoma with other round-cell tumors of childhood involving the orbit. PMID- 2776604 TI - Argyrophil carcinoma of the breast: a cytologic, histochemical, and ultrastructural study of a case. AB - Aspirate from an argyrophil carcinoma ("carcinoid") of the breast showed malignant dispersed epithelial cells. With Diff-Quik, the cytoplasm was seen to be abundant, with prominent eosinophilic granularity. The nuclei were fairly uniform, round or oval, and eccentric and had a finely stippled chromatin pattern. On histology, the tumor appeared typical for argyrophil carcinoma, and staining with Grimelius for argyrophilic granules was positive. Membrane-bound neurosecretory granules were seen on electron microscopy. PMID- 2776603 TI - Epithelioid hemangioendothelioma: report of a case diagnosed by fine-needle aspiration. AB - A case of epithelioid hemangioendothelioma suggested by fine-needle aspiration biopsy is reported. The clinical, cytological, histopathological, and postmortem findings are described. The diagnosis was confirmed by cyto-histoimmunochemical studies. PMID- 2776605 TI - Cytopathology consultations: what are the challenges, pitfalls, and liabilities? PMID- 2776606 TI - An intriguing finding in malignant effusions. PMID- 2776607 TI - Clinical measurement of dyspnea. AB - How often have you had a patient turn to you in distress, complaining of shortness of breath and wanting you to provide relief? This situation is often as distressing for the nurse as it is for the patient because there are few recommended nursing interventions designed to assist such patients. The author presents a nursing assessment tool for the dyspneic individual, which can be used to document the effectiveness of interventions for these patients. PMID- 2776608 TI - Traumatic fetal death. AB - Trauma during pregnancy increases the mortality risk to both victims: mother and child. The critical care nurse assumes a major role in assessing needs from both the trauma and obstetric perspectives. Collaboration between the critical care and obstetric nurse is essential to meet the complex physical, emotional, social, and spiritual needs of the entire family. A bereavement protocol can be helpful in suggesting specific interventions for long-term follow-up of the family suffering fetal loss. PMID- 2776609 TI - Diabetes insipidus versus syndrome of inappropriate antidiuretic hormone. AB - Diabetes insipidus (DI) and the syndrome of inappropriate antidiuretic hormone (SIADH) are two endocrine disorders presenting a challenge to the critical care nurse. The challenge lies in the recognition and assessment of the effects on the patient's fluid balance and in the planning of interventions to prevent complications. PMID- 2776610 TI - Clinical research: gaining access to patients. AB - Gaining access to patients to conduct nursing research can be a difficult problem, especially in a critical care setting. This author describes techniques that can be used to select and establish research in your own or other hospitals. PMID- 2776612 TI - Preparation techniques for ACLS exam. AB - This author presents specific techniques for the critical care nurse to use in preparing for the Advanced Cardiac Life Support (ACLS) certification examination. Techniques that help the inservice instructor or manager to assist the nurse in preparation for this certification exam are also included. PMID- 2776611 TI - Legal perspective on gaining access to patients. PMID- 2776613 TI - Developing printed materials for patient education. AB - While most nurses recognize the educational needs of their patients, time has become a major deterrent to optimal teaching. This is especially true in critical care, where patients are being transferred earlier or directly discharged. Written information which is available to the patient at home can help to bridge this gap. Because "ready made" materials are limited and often costly, this article will discuss the steps of creating printed materials tailored to your patients' needs. PMID- 2776614 TI - Legal commentary: developing printed materials for patient education. PMID- 2776615 TI - Research rewards for the critical care nurse. PMID- 2776616 TI - Nursing diagnosis. Powerlessness in critical care patients. AB - The critical care environment, with its fast-paced tempo, its vast technology, and its many invasive procedures, carries the potential for creating feelings of powerlessness within patients, their families, and even in the nurses who work there. This article examines the nursing diagnosis of powerlessness and its etiologic factors. The authors present a challenging case in which creative nursing techniques decrease powerlessness for a partially paralyzed and intubated patient. PMID- 2776617 TI - Reducing complications of thoracic gunshot wounds. AB - With the persistent presence of violence in our urban areas and the availability of guns, penetrating injuries as a result of firearm use continue to be a challenge for the emergency, surgery, and operating room nurse. Because gunshot wounds may be rapidly fatal, an understanding of firearms and the injuries they produce, as well as their possible complications, can assist the critical care nurse in caring for patients with gunshot wounds to the chest. Thoracic trauma is present in 50% of all trauma patients and is the cause of death in 25% of these victims. Penetrating trauma from violent episodes accounts for approximately 50% of cases of chest trauma in the urban setting. PMID- 2776618 TI - Ethical considerations in conducting clinical research. AB - Each step of the research process has specific ethical considerations. This article presents the ethical aspects that the nurse researcher needs to incorporate into a clinical research project and that the critical care staff nurse can use to identify potential unethical research practices involving critical care patients. PMID- 2776619 TI - Legal perspective on ethical considerations in conducting clinical research. PMID- 2776620 TI - Re-evaluating the role of the charge nurse. AB - Charge nurses are used in most critical care units to facilitate quality patient care by serving as resources to the nursing staff. These authors suggest strategies for initiating or evaluating the charge nurse role in critical care. Interviews with critical care charge nurses show how different viewpoints remain regarding this key role of the charge nurse. PMID- 2776621 TI - Legal commentary. PMID- 2776622 TI - Differing viewpoints about charge nurse role. PMID- 2776623 TI - Multimethod teaching modules. AB - The information in this article is for a wide variety of nurses who find themselves in a teaching role: the critical care nurse orienting another nurse (experienced or new graduate); the critical care manager who needs to present an inservice program; and the educator or clinical specialist looking for a new way to present the same information. The author describes how self-paced modules for inservice education offer variety to learners since learners choose the teaching strategy that best suits their learning styles. PMID- 2776624 TI - Supervising unlicensed technicians in critical care. AB - As the nursing shortage continues and there is an increased demand for technicians and other nurse extenders, critical care nurses may be asked to supervise numerous types of other health care workers. This nurse-attorney author describes the legal aspects of the situation for the licensed nurse who supervises registered or unregistered, unlicensed technicians. PMID- 2776625 TI - Homology between the cDNAs encoding phosphoprotein p19 and SCG10 reveals a novel mammalian gene family preferentially expressed in developing brain. AB - We have isolated and sequenced a rat testis cDNA encoding p19, a 19-kD cytosolic phosphoprotein that is abundant in immature brain, testis, and neuroendocrine tumor cells. The cDNA was identified using bovine brain p19 peptide sequences, which indicate that the gene encoding p19 has been highly conserved during mammalian evolution. Using Northern blot analysis on rat tissues, p19 mRNA was readily detected in brain and testis and showed a 15-fold greater abundance in newborn than in adult brain. Low levels of p19 mRNA were observed in spleen, kidney, and heart, but not in liver. Thus, the expression of the gene encoding p19 shows a strong tissue preference and is developmentally regulated. The predicted amino acid sequence of p19 is highly homologous to that of SCG10, another protein expressed in the developing rat nervous system, suggesting that the two proteins serve similar functions. Based on a comparison of the two cDNAs, we conclude that p19 and SCG10 are encoded by distinct but related genes constituting a novel gene family. PMID- 2776626 TI - Regulatory elements controlling the basal and drug-inducible expression of glutathione S-transferase Ya subunit gene. AB - The synthesis of the glutathione S-transferase Ya subunit is induced in the mammalian liver by chemicals such as phenobarbital and 3-methylcholanthrene. To study the mechanism of this induction, the 5'-flanking region of a mouse glutathione S-transferase Ya subunit gene was fused to the structural gene for chloramphenicol acetyltransferase. The fusion gene was introduced into hepatoma cells for the assay of the expressed acetyltransferase activity. At least two cis regulatory elements were identified in the 5'-flanking region of the Ya gene: one, responsible for the basal level of expression, is present in the sequence up to -0.2 kb; another, responsible for the inducible expression by aromatic compounds such as beta-naphthoflavone and 3-methylcholanthrene, is located in the sequence from -0.2 kb to -1.6 kb. The inducible element was functional only in cells with normal aromatic compound receptors, and it retained responsiveness to beta-naphthoflavone when transfected into homologous (mouse) or heterologous (rat, human) hepatoma cells. A 150-bp region upstream from the transcription initiation site of the mouse Ya gene was investigated for cis-acting transcriptional elements that are recognized by specific DNA-binding proteins. We show by DNase I foot-printing assays using extracts from liver nuclei that the Ya gene promoter contains, in addition to the TATA and CCAAT boxes, a more distal element that binds a protein which is probably related to the family of nuclear factor 1 (NF1). PMID- 2776627 TI - Transcriptional activation of an intermediate filament protein gene in mice with retinal dystrophy. AB - We are interested in understanding neuronal interactions that regulate expression of specific genes in glial cells in the nervous system. In the normal mouse retina, the glial intermediate filament protein (GFAP) is not detectable in Muller cells, the predominant glial cells in the retina. Photoreceptor degeneration resulting from retinal degeneration (rd) mutation or environmental light damage, however, leads to the appearance of GFAP in Muller cells. We have investigated the mechanism underlying GFAP accumulation in these retinas. Western blotting analysis, steady-state mRNA level comparisons, and nuclear run-on assays show that transcription of the GFAP gene is activated in these retinas. In situ hybridizations with retinal sections and solitary Muller cells establish that GFAP mRNA levels are elevated in Muller cells. These results show that disruption of neuron-glia interactions resulting from photoreceptor degeneration leads to activation of the GFAP gene in glial cells of mice with retinal dystrophy. The functional significance of this glial response and the need for GFAP expression remain to be understood. PMID- 2776628 TI - Screening for mouse retinal degenerations. I. Correlation of indirect ophthalmoscopy, electroretinograms, and histology. AB - Mice with hereditary retinal degeneration have provided excellent models for human disease of the biochemical and physiological events occurring in retinal degeneration. Since a number of mouse models are available for other human conditions, more mouse retinal degenerations would be expected to be known; however, finding new models has proved difficult since the search has usually involved laborious histologic screening. We applied the clinical technique of indirect ophthalmoscopy to screen mice for retinal degeneration and then used electroretinography and histology to determine whether true retinal degeneration was present. A Dawson-Trick-Litzkow microfiber corneal electrode was used to record the electroretinogram since the fiber does not occlude the pupil in these small eyes. Normal control values were developed. As an example of the success of the technique, one strain, lethal spot (ls) on indirect ophthalmoscopy appeared to have a retinal degeneration, but these mice had a normal electroretinogram indicating a primary optic atrophy. Likewise, one ls heterozygote that was tested as a control animal and was not suspected of having a retinal degeneration had an abnormal electroretinogram and peripheral retinal degeneration. PMID- 2776629 TI - Screening for mouse retinal degenerations. II. Molossinus MOLC and MOLD strains. AB - Using screening techniques of indirect ophthalmoscopy, electroretinography, and histology, we found inbred strains of Mus musculus molossinus to have a variable onset of retinal degeneration, which may present with early loss of outer segments and photoreceptor nuclei. The early affected mice have constricted vessels, optic atrophy, and markedly abnormal electroretinograms. An intermediate form of retinal degeneration was identified with slight arterial narrowing on ophthalmoscopy and electroretinogram amplitudes approximately 50% of normal. From this preliminary study the hereditary pattern is unclear. The mice with early onset of retinal degeneration share features seen in rd mice, but in a number of the molossinus the degeneration is slower with only a partial loss on electroretinogram amplitude. PMID- 2776630 TI - Pattern visual evoked cortical potential measurement of luminance threshold in retinitis pigmentosa. AB - We measured the luminance threshold in eight patient (12 eyes) with retinitis pigmentosa using pattern reversal visual evoked cortical potentials (PVECPs). With decreasing pattern luminance (0 to 3.0 log unit neutral density filters), the amplitude of the p 100 component decreased linearly. Luminance threshold was determined by extrapolating the regression line of amplitude as a function of luminance to 0 microV. Our results showed that luminance threshold measured by PVECP was approximately 1.2 log units higher in patients with retinitis pigmentosa than in age-matched normal controls. Thus the PVECP may provide a way of quantitatively evaluating central retinal visual function in patients with retinitis pigmentosa. PMID- 2776631 TI - Recovery after severe ethambutol intoxication--psychophysical and electrophysiological correlations. AB - Six patients with severe ocular side effects caused by therapeutical doses of the tuberculostatic drug ethambutol were investigated during the course of recovery with psychophysical and electrophysiological methods. Three patients developed an optic atrophy with permanently reduced vision as a likely consequence of additional risk factors such as diabetes, alcohol abuse, and reduced kidney function. The severity of the neuritis of the optic nerve was not related to the total intake of ethambutol. The likelihood of a permanent ocular damage increased sharply if the visual acuity had dropped below a value of 1/10. permanently prolonged latency of the P-100 component was found in visual evoked potentials even in cases with good recovery from ethambutol-induced damage. The recovery of color vision could be monitored very well with the Farnsworth-Munsell 100-Hue Test which revealed a diffuse impairment of color discrimination with a slight prevalence of the red-green axis. In addition to the known disturbances of the red-green antagonistic neurons, it could be demonstrated by measuring transient tritanopia and spectral sensitivity functions that ethambutol also affects the blue-yellow antagonism at the retinal level. PMID- 2776632 TI - Electrophysiology and perimetry in acute retrobulbar neuritis. AB - Eighteen patients with acute retrobulbar neuritis were examined by visual field analysis and electroophthalmological recordings. The visual fields were measured to 30 degrees with the automatic perimeter Octopus 201. The pattern-evoked cortical potential showed an increased P-100 latency followed by a decrease in 12 patients during the first two weeks of the disease. This latency change cannot be explained by remyelinization. Teh positive component of the pattern ERG (P-50) was reduced in all acutely affected eyes in comparison with the fellow eye. During recovery, the amplitude of the positive PERG component increased to normal, but remained slightly reduced in comparison with the response from the fellow eyes. Thirteen patients out of 18 were clinically and electrophysiologically diagnosed as having unilateral retrobulbar neuritis. However, static perimetry showed paracentral scotomas in the fellow eye in 5 cases. Recovery of the severely affected eye was accompanied by complete normalization of the visual field in the fellow eye. Thus static perimetry seems to be a more sensitive test than even the visual evoked potentials for detecting lesions in the visual pathway. PMID- 2776633 TI - Pattern electroretinogram peak times as a clinical means of discriminating retinal from optic nerve disease. AB - Fifty-two patients with unilateral or bilateral retinal or optic nerve disease exhibited abnormal peak times and/or amplitudes in the pattern electroretinogram. While this abnormality in patients with optic nerve diseases was confined to an amplitude reduction, 40% of the eyes with retinal diseases exhibited additionally a peak time delay of the p and/or q component. We conclude that recording of pattern electroretinogram peak times provides an additional means to distinguish retinal from optic nerve diseases. PMID- 2776634 TI - Evoked potential and preferential looking correlates of the oblique effect in 3 month-old infants. AB - Sensitivity for vertical and horizontal gratings is higher than for obliquely oriented gratings, a phenomenon known as the oblique effect. We compared visual evoken potential and preferential looking estimates of the oblique effect in nonastigmatic 3-month-old infants and found that orientation effects occurred more frequently by visual evoked potential measure than by preferential looking. PMID- 2776636 TI - Position statement: registered care technologist proposal. PMID- 2776635 TI - Age-related changes in the first order Weiner kernel visual evoked potential. AB - Visual evoked potentials were obtained from 112 subjects (215 eyes) aged 5 to 79 years with fast random stimuli. The stimulus (the presence or absence of the initiation of a reversal) and response (voltage measurements) were used in calculating the first order Wiener kernels to obtain the visual evoked potentials. Five check sizes were used to stimulate each eye. The implicit time of the major negative wave showed a significant increase with age for each check size used. Regression lines for the implicit time vs age data for male subjects were significantly different from those of females. The y-intercepts were lower and the slope of the regression lines were consistently steeper for males. Thus the rate of increase in implicit time was higher in males. The relationship of the amplitude of the major wave to age did not appear to be linear. The data suggested that a second-order polynomial curve might be an appropriate representation of the relationship. PMID- 2776637 TI - How effective are your patient education materials? Guidelines for developing and evaluating written educational materials. AB - Written educational materials are an essential component of a comprehensive education program. To be effective and useful, educational materials must meet the specific needs of the target patient population. Many available educational materials may not meet the needs of your patients, therefore efforts to develop appropriate written educational tools may be necessary. Developing quality educational materials include several steps: conducting a needs assessment, establishing learning objectives, writing the text, and evaluating the piece. The quality of the text is often determined by readability. The text should be written on a level that is appropriate for the patient group. Content and style, layout, color, and illustrations all influence readability and quality. Most important, good quality educational materials help promote the relationship between the patient and the health care professional as well as enhance patient knowledge and self-care. PMID- 2776638 TI - Importance of periodic reeducation of hospital-based nurses in capillary blood glucose monitoring and an evaluation of the usefulness of reflectance meters. AB - Precision and accuracy of capillary blood glucose measurements performed by general staff nurses were assessed before and after a modest reeducation program both with and without the use of reflectance meters. A total of 380 capillary glucose determinations were performed by nurses and the hospital laboratory on the same samples. Prior to reeducation, nurses using meters were more accurate than those reading visually, but no difference was found in precision. Reeducation improved precision equally in both groups while improving accuracy only in the group using meters. While glucose readings with the use of reflectance meters were statistically more accurate than those read visually, the percentage of readings within 10% and 20% of the laboratory readings was the same. Thus, the increased accuracy observed with meters may have little practical significance, suggesting that their use might better be based on other considerations, such as user confidence, convenience, cost, and quality control. Periodic education is, however, an essential component of any quality assurance program. PMID- 2776639 TI - Patient perceptions of diabetes treatment goals. AB - The current treatment of type II noninsulin dependent diabetes mellitus (NIDDM) and obesity involves complex regimens for weight reduction and improvement in metabolic control that necessitate active participation by the patient in establishing treatment goals and strategies. However, well-documented rates of nonadherence suggest that weaknesses may exist in patient-provider communications that preclude such patient participation. This study examines patient perceptions of diabetes treatment goals as established with their health care providers. Fifty-four individuals with type II NIDDM and obesity were surveyed. To determine the degree of congruence between patient and health care provider, the physicians of study participants were also surveyed. A 53% discrepancy rate was found to exist in the area of overall treatment goals. In addition, a 57% and 43% rate of discrepancy was found for the specific goals of weight loss and blood glucose levels, respectively. Further findings and the implications for practice are discussed in this paper. PMID- 2776640 TI - Performance of seven blood glucose testing systems at high altitude. AB - Consumers and health care professionals expect blood glucose monitoring systems to consistently generate results that are close to actual blood glucose levels. Numerous environmental, physiologic, and operational factors can affect system performance, yielding results that are inaccurate or unpredictable. This study examined the effect of one factor--high altitude--on the performance of seven blood glucose monitoring systems. One of the systems overestimated blood glucose results; the other six systems underestimated blood glucose values (more than the expected variance). The findings of this study support previous reports of altered blood glucose monitoring system performance at high altitude. Diabetes educators can use this information when counseling consumers who reside or who plan to visit locations at high altitude. PMID- 2776641 TI - Position statement: effective utilization of blood glucose monitoring. PMID- 2776642 TI - [Determination of cell nuclear DNA content in leiomyoma and leiomyosarcoma of gastro-intestinal tract (G-I)]. AB - Nuclear DNA content was measured by microspectrophotometry in 15 biopsy specimens from patients with G-I smooth muscle tumors (3 leiomyomas and 12 leiomyosarcomas subdivided into 3 groups with 4 cases to each). The mean DNA value increased steadily as follows: leiomyomas (14.39 +/- 0.62 Au); leiomyosarcoma Grade I (19.78 +/- 2.39 Au); Leiomyosarcoma Grade II (26.39 +/- 1.60 Au); leiomyosarcoma Grade III (30.66 +/- 2.39 Au). The difference of DNA value in the 4 groups had statistical significance (P less than 0.05-0.01). These results suggest that microspectrophotometric measurement of nuclear DNA content may serve as an objective quantitative method for diagnosis of G-I tract smooth muscle tumors and classification of leiomyosarcoma. PMID- 2776643 TI - [Risk analysis of fuzzy states in data of case-control study for stomach cancer in Heilongjiang Province]. AB - Data of case-control study of 241 cases of stomach cancer were analyzed by method of risk analysis of fuzzy states. The findings showed that alcohol consumption, smoking, chronic gastritis, insufficient vegetable intake, and frequent hard or salted food eating were the risk factors of stomach cancer in Heilongjiang area. It indicated that multiplicative effect existed in chronic gastritis with alcohol drinking or alcohol drinking with salted vegetable intake with OR of 5.53 and 1.80, respectively. PMID- 2776644 TI - [Cytotoxic effect of hyperthermia and nitrocaphane on malignant HEp-2 cells]. AB - Cytotoxic effect of hyperthermia combined with Nitrocaphane (NC) on HEp-2 cells was detected by colony formation assay. The results showed: 1. There was significant synergetic effect on survival fraction of HEp-2 cells when the heat was at 43 degrees C and 44 degrees C and NC at 0.5-4.0 micrograms/ml; 2. There was almost no effect on the cell survival when the heat was at 39 degrees C and 41 degrees C for 1 hr without NC; however, the cytotoxicity of NC (1.0 micrograms/ml) was enhanced when temperature was at 39 degrees C and 41 degrees C; 3. The sequence between heat and NC could influence the synergism. When the heat at 43 degrees C, 60 min and NC at 1.0 micrograms/ml were used simultaneously, the cytotoxicity was the strongest (SF = 0.025). When the heat was given 1-4 hr before or after the drug, the cytotoxicity was decreased. These results suggest that, over the range of 39-44 degrees C, the synergetic effects of hyperthermia and NC on malignant HEp-2 cells provide certain cell biologic basis for clinical application of local or systemic hyperthermia combined with NC. PMID- 2776645 TI - [Surface ultrastructure of familial gastrointestinal adenomatosis]. AB - Fourty-one adenomas from 13 cases of familial gastrointestinal adenomatosis, with 6 samples of normal colonic mucosa, 4 well differentiated adenocarcinomas and 2 villous adenomas as control, were examined by scanning electron microscopy. The surface feature of the adenomas was classified into three types: tubular, branching and irregular, based mainly on the irregularity of the enlarged and distorted crypts. There is close relationship between surface architecture and inner histologic pattern, especially the degree of atypia. The more irregular the surface architecture, the higher the atypia in histology. Those of tubular type are mostly tubular adenomas with mild dysplasia, while the majority of branching type are villous or villous-tubular adenomas with moderate or severe dysplasia. Irregular type usually implies malignant transformation. The results suggest that the observation and evaluation of the surface structure of familial adenomatosis be of great value, as a supplementary procedure, in identifying premalignancy and early malignancy in adenoma-carcinoma sequence. PMID- 2776646 TI - [Stereoscopy in the pathologic diagnosis of adenoma and carcinoma of colon]. AB - Quantitative analysis of 10 cases of normal mucosa, 15 cases of villous adenoma and 20 cases of carcinoma of colon was studied by stereoscopic technique (Coherent Test System A 100). The results showed that there was statistical significance (P less than 0.01) in 6 parameters including Volume Density (Vv), Surface Density (Sv), Mean Diameter (D), Number Density (Nv) of nucleus and Mean Curvature Density (Kv) and Surface Curvature (K) of the gland, The new method of pathologic morphometry to differentiate adenoma from carcinoma was provided for clinical diagnosis. This method is more scientific, not only being different from the classical pathologic diagnosis, but also avoiding personal subjectivity. Colon adenoma was divided into two subtypes (A and B) according to the threshold of parameter. (Type A below the threshold and Type B above the threshold). Type A is well differentiated adenoma, but Type B tends towards malignancy. The higher the stereoscopic parameters, the higher the malignant tendency. Histologic parameters showed the objective index in pathologic diagnosis. PMID- 2776647 TI - [Application of isolation traction of aortic arch and upper part of the thoracic aorta in operation on cancer of the esophagus]. AB - Isolation traction of aortic arch and upper part of thoracic aorta was performed by pulling and rotating them rightwards during operation on cancer located in the mid-segment of esophagus with serious adhesions. In 35 patients operated on, 33 cancers were resected with resection rate of 94%, including 21 by radical resection (60%) and 12 by palliative operation (34%). The method was to isolate the aortic arch and the upper part of thoracic aorta sufficiently and ligate the severed intercostal arteries and veins securely. While isolating the aorta, we pulled and rotated it with a strip of bandage and exerted strength evenly and gently as long as the operation field was exposed clearly. Otherwise, the heart function may be compromised. When isolating the aorta, a slight drop of blood pressure could be observed in some cases. It could recover immediately as we stop pulling and replaced the aorta in situ. According to our clinical experience, its advantages were: 1. It can prevent and treat the bleeding of hemiazygos vein. None of the 33 patients with adhesion and infiltration between the tumor and hemiazygos vein bled during the operation, even with the hemiazygos vein torn and bleeding. Bleeding could be stopped with ease because of good exposure; 2. It can extend the limit of resection and raise the resection rate; 3. It can broaden the space between the aorta and esophagus which is convenient for esophagogastrostomy on the esophagus bed, and 4. It can secure ligation of thoracic duct to prevent chylothorax. PMID- 2776648 TI - [Primary malignant melanoma of the vagina--report of 8 cases]. AB - Eight patients with primary malignant melanoma of the vagina are reported. They were all localized in the vagina with typical histologic features. Fontana and S 100 protein stain were positive. The prognosis was poor. Seven of them died and one was lost in the follow-up. Most of them (5/7) died in 1-2 years after treatment, but two survived for more than 5 years. In this paper, one case of vaginal cellular blue nevus was also suggested and the differential diagnosis from malignant melanoma was emphasized. The histogenesis of this tumor is briefly discussed. PMID- 2776649 TI - [Urinary complications following radical hysterectomy for 621 patients with cancer of uterine cervix]. AB - The chief urinary complications following radical hysterectomy for 621 patients with cervical cancer are reported. Bladder and ureteral injury occurred in 0.16% and 0.64% of patients. The incidence of ureteral fistula was also very low (0.16%). Temporary retention of urine was one of the most common urinary complications with occurring rate of 43%. The incidence was related to the type of radical hysterectomy. The incidence of urinary tract infection was 14.33% which was related to the retention of urine. The results of urine culture showed that the main pathogens of infection were B. aeruginosus and Escherichia coli. Impairment of kidney function, usually unilateral, was the major late urinary complication. The severity, causes and prevention of urinary complications are briefly discussed. PMID- 2776650 TI - The human red blood cell glyoxalase system in diabetes mellitus. AB - Methylglyoxal and other alpha-oxoaldehydes are formed from glycolytic intermediates and may be involved in the development of diabetic microangiopathy. Glyoxalase I and glyoxalase II metabolise methylglyoxal to D-lactic acid, via the intermediate S-D-lactoylglutathione. The activities of the glyoxalase enzymes and the concentrations of methylglyoxal and S-D-lactoylglutathione were measured in erythrocytes of 45 control and 85 diabetic subjects (41 with retinopathy and 44 uncomplicated). The concentration of S-D-lactoylglutathione was increased in diabetic patients vs. controls (21.4 +/- 9.3 vs. 12.4 +/- 4.8 mumol/l, P less than 0.001), as was methylglyoxal (3.6 +/- 2.3 vs. 1.4 +/- 0.2 mumol/l, P less than 0.001). There were no significant differences in the activities of glyoxalase I and glyoxalase II between diabetic patients and controls. For insulin-dependent patients only, those without retinopathy had a higher activity of glyoxalase II than those with retinopathy (P less than 0.05). A group of age- and duration-matched insulin-dependent diabetic patients with retinopathy also had a higher activity of glyoxalase I compared with a group of diabetic patients without retinopathy (P less than 0.025). This study provides evidence for elevated concentrations of oxoaldehydes in diabetes mellitus which might have pathogenic significance. PMID- 2776651 TI - Increased intraglomerular thrombin formation in diabetic microangiopathy. AB - Estimations of soluble fibrin monomer complexes (SFMC) in plasma are a convenient index of thrombin activation. Renal venous-arterial differences in plasma SFMC concentrations were determined in 16 randomly chosen diabetic patients by sampling directly and simultaneously from the renal artery and vein according to the method of Seldinger. In all subjects, SFMC concentrations were higher in the renal vein than in the renal artery, indicating that the kidney is an important source of SFMC. Venous-arterial differences were markedly elevated in patients with severe renal and retinal microangiopathy coupled with hypertension. The hypothesis is advanced that elevated plasma SFMC levels lead to abnormal fibrin deposits in lesioned glomeruli and retinal vessels. It is postulated that plasma SFMC may be a useful parameter for the assessment of diabetic vascular complications. PMID- 2776652 TI - Glucose tolerance during pregnancy in Asian women. AB - The present study was aimed at examining differences in gestational diabetes mellitus (GDM) between two ethnic populations (immigrant Asians and indigenous White Caucasians) residing in Leicester, U.K. The study was divided into two parts: to determine the prevalence of GDM and to determine the level at which glycaemia may impose a risk to the mother and the foetus. Of a total of 12,005 pregnancies (4561 Asian and 7444 White Caucasian), over a 3-year period, 314 (6.8%) Asian and 504 (6.7%) White Caucasian were given a 75-g oral glucose tolerance test (OGTT) at 28-32 weeks for indications of 'large for date' pregnancies, hydramnios, glycosuria, a history of previous abortions, stillbirths, congenital abnormalities or glucose intolerance, and family history of diabetes. Abnormal glucose tolerance (AGT) was taken as a 2-h venous plasma glucose greater than or equal to 7.8 mmol/l which reverted to normal when formally tested during the puerperium (WHO criteria, 1985). AGT was found in 1.38% Asian and 0.87% White Caucasian pregnancies (P less than 0.01). This was further divided into impaired glucose tolerance (IGT) (2-h value 7.8-11.1 mmol/l) and gestational diabetes mellitus (GDM) (2-h value greater than or equal to 11.1 mmol/l). IGT was found in 1.2% Asian and 0.84% White Caucasian pregnancies (P less than 0.01), and GDM in 0.18% and 0.02% respectively (P less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2776654 TI - Analysis of secondary failure to sulfonylureas in type 2 diabetics. A retrospective study for 1976-1987. AB - Secondary failure to sulfonylureas was analyzed retrospectively in order to establish its dependence upon: age of patient at the onset of diabetes, duration of disease, sex, body mass, smoking and diabetic familial anamnesis. A series of 220 cases of type 2 diabetes lasting 1-25 years (mean 8.75 +/- 4.9 years) constituted the subject of study. The age of patients ranged from 31 to 77 years (mean: 63.3 +/- 9.9 years). The mean period of effective management with sulfonylureas equalled 8.75 +/- 4.9 years and was slightly longer in men (9.2 +/- 5.2 years) than in women (8.3 +/- 4.6 years). The age at onset of diabetes and the duration of effective treatment were found to be inversely proportional. The treatment of patients who developed diabetes before the 50th year of age was effective longer (X 10.1 +/- 5.3 years) than that of those with later onset of disease (X 7.9 +/- 4.5 years). This difference was statistically significant (P less than 0.001). In addition, the period of drug effectiveness was significantly longer in obese men (10.1 +/- 5.5 years) than in obese women (8.8 +/- 4.2 years, P less than 0.05). No correlation was found between secondary failure to sulfonylureas on the one hand and smoking and familial occurrence of diabetes on the other. PMID- 2776653 TI - Fructose-related glycation. AB - We investigated in vitro the effect of the polyol pathway on the formation of advanced Maillard reaction products which have fluorescence and cross-links. Bovine serum albumin supplemented with various concentrations of glucose, fructose or sorbitol was incubated for 14 days. The fluorescence intensity was higher after incubation with fructose than after incubation with glucose. However, no significant increase in fluorescence intensity was found after incubation with sorbitol. These results suggest that in the polyol pathway fructose plays an important role in the formation of advanced Maillard products. PMID- 2776656 TI - Re: Diabetic osteopenia. PMID- 2776657 TI - [Activation of pheromonal promoters of aggression in laboratory mice of the C57BL/6 line upon the action of diazepam]. PMID- 2776655 TI - Estimation of cholesterol loading of the low-density lipoprotein fraction in diabetic subjects without ultracentrifugation. AB - We report here a new formula for estimating apolipoprotein (apo) B concentration in the low-density lipoprotein (LDL) fraction from measurements of plasma triglyceride and apoB. ApoB in plasma and in the triglyceride-rich lipoprotein fraction (VLDL, d less than 1.019) and plasma triglyceride were measured in 112 subjects, including 56 diabetics. There was a significant correlation between VLDL-apoB and plasma triglyceride (Y = 0.07X + 1, r = 0.73, P less than 0.001). We calculated LDL-apoB according to this formula: LDL-apoB = total apoB - (0.07 x total triglyceride + 1). We found an excellent relationship between LDL-apoB (total apoB - VLDL-apoB) and calculated LDL-apoB (Y = 1.0X + 1, r = 0.96, P less than 0.001). This new formula will enable us to estimate the apoB concentration in the LDL fraction without ultracentrifugation. PMID- 2776658 TI - [Understanding of psychological comfort in the interpretation of driving behavioral forces]. PMID- 2776659 TI - Pharmacokinetics of fosfomycin in normal and burn patients. Effect of probenecid. AB - The pharmacokinetics of fosfomycin are modified in burn patients, suggesting a net tubular secretion in such patients. In an attempt to verify this hypothesis, five healthy normal volunteers were studied The pharmacokinetics of fosfomycin were studied with and without probenecid. In the absence of probenecid, the renal clearance of the drug was equal to that of creatinine. With probenecid, the renal clearance of fosfomycin decreased, whereas creatinine clearance did not. This result suggests the existence of a tubular secretion, which might be enhanced in burn patients. PMID- 2776660 TI - [Magnetic resonance tomography of the breast. The results of 253 examinations]. AB - Requirements for diagnostic magnetic resonance imaging (MRI) of breast disease were defined on the basis of 253 examinations over 4 1/2 years. The results were compared with those of mammography in 207, with histological findings in 145 cases. Examinations after injection of 0.1 mmol/kg Gd-DTPA (gadolinium diethylene triamino-penta-acetate) and measurement of the same sections at short intervals proved to be the most informative MRI technique for the differentiation of benign and malignant changes. Carcinomas had a rapid initial rise in signal of more than 90% over the pre-injection level within one minute of contrast-medium administration. In 163 of 207 cases MRI provided information additional to mammography (confirmation or exclusion of a carcinoma; exact localization of a malignant process; differentiation between carcinoma and scar tissue; diagnosis of a tumour close to the thoracic cavity; changes near a prosthesis). Analysing only the examinations done with contrast-medium (144), there was a 99% sensitivity. There have been no false-negatives so far. Despite the high cost and time required, MRI of the breast is indicated when mammography, ultrasound and clinical features provide unclear and (or) discrepant findings. PMID- 2776661 TI - [Hemangioma of the left coronary artery with a fistula into the pulmonary artery]. AB - A 32-year-old man had for about four months been suffering from discomfort in the left thorax unrelated to exertion. Coronary angiography revealed a haemangioma, 40 mm in diameter, which arose from the anterior descending branch of the left coronary artery with a connecting fistula to the main pulmonary artery. The tumour could not be demonstrated by either echocardiography or computed tomography, but magnetic resonance imaging showed an inhomogeneous structure in the basal region of the interventricular septum without increased signal intensity after injection of contrast medium. The tumour was not resected because of its small size and the minor symptoms which could not be proven as being tumour related. Repeat examinations (coronary angiography and magnetic resonance imaging) at six-month intervals are planned. PMID- 2776663 TI - [Follow-up in systemic lupus erythematosus]. PMID- 2776662 TI - [Local recurrence--surgically avoidable or a biological characteristic?]. PMID- 2776664 TI - [Serology in Yersinia enterocolitica infection]. PMID- 2776665 TI - [Radionuclide ventriculography. The significance of global and regional ejection fractions and Fourier amplitude and phase in the diagnosis of exertion-dependent ischemia]. AB - Electrocardiograms and radionuclide ventriculograms were obtained at rest and on exercise in 23 patients (20 men and 3 women, mean age 53.4 years) with exercise dependent myocardial ischaemia after infarction, as well as in 22 persons (17 men and 5 women, mean age 43 years) without clinical, electrocardiographic and biochemical evidence of coronary heart disease. Among the ischaemia patients exercise-dependent loss of motility, as measured by regional ejection fraction and Fourier amplitude, occurred in 95% (50% of controls) in one sector, in 78% (4.5% of controls) in the two sectors with the highest contractility at rest, and in 74% (0% of controls) in three sectors. On exercise, phase shifts occurred in 87% (27% of controls). When combining the exercise-ECG, global ejection fraction as well as regional motility loss in one sector, in the two sectors with the highest contractility at rest and in three sectors, at least two of the five criteria of abnormality were present in 91.3% of the ischaemia patients, compared with at most one criterion in 90.9% of controls. The results indicate the greater diagnostic value of regional than global measures of ventricular function and emphasize the importance of radionuclide ventriculography as an addition to exercise electrocardiography in the pre-invasive diagnosis of coronary heart disease. PMID- 2776666 TI - [Extracorporeal shockwave lithotripsy in chronic pancreatitis]. AB - Extracorporeal shock wave lithotripsy was performed on eight patients (six men, two women; mean age 46.3 years, range 36-58) with predominantly stone-induced obstructive pancreatitis. Stones in the pancreatic duct were smashed in one session to such an extent that the fragments were eliminated spontaneously via the ostium which had previously been split endoscopically. Repeat lithotripsy to achieve complete removal was necessary in only two patients. In one there were multiple concrements along the entire length of the main pancreatic duct; the other had a cherry-sized stone near the bifurcation of the accessory pancreatic duct. There were no serious complications. After successful removal of the stones all patients were free of pain which before had required strong analgesics to control. Six patients remained pain-free during a follow-up period of two eight months. Pain again occurred in the other two, but it was less frequent and milder. PMID- 2776667 TI - [The assessment of suicidal inclination by the nonspecialist physician]. PMID- 2776668 TI - [17th Environmental Health Seminar: "Mycotoxins in Feed and Food of Animal Origin". WHO Collaborating Centre for Research and Training in Veterinary Public Health and the Hannover School of Veterinary Medicine. Proceedings]. PMID- 2776669 TI - [The significance of mycotoxicoses for humans and animals]. AB - The paper gives a survey on the most important mycotoxicoses, the corresponding fungi imperfecti, and the mycotoxins produced by these fungi. Structure/activity relationships are shown. PMID- 2776670 TI - [Conditions for the formation of mycotoxins in animal feed]. AB - The development of moulds and the production of mycotoxins are closely related, but the optima of environmental factors for both do not necessarily coincide. Depending on the species, the percentage of toxinogenic strains differs considerably. Complex substrates, with a high content of carbohydrates, are favoured. Over a wide range of temperature toxin-production is possible, also at a very low partial pressure of oxygen. Too few is known about the factors, which promote toxin-production in the field. There seems to be a dependence on the area, where the grain is grown, and on the weather during the year of cropping, but the influence of methods of plant production, fertilization, plant protection and choice of cultivars have to be investigated. PMID- 2776671 TI - [The significance of mycotoxin assimilation for the productivity and health of animals]. AB - In the last decade an increasing occurrence of feed intoxications of Austrian domestic animals could be observed. According to specific cases and one experimental study using fattening pigs, the clinical symptoms laboratory findings of blood and feed samples are described. Based on the case history, the clinical symptoms of the incriminated animals and by exclusion of other diseases an etiologic correlation with the feed and the course of disease, a feed intoxication could be diagnosed. By corresponding microbiologic as well as mycotoxicologic positive results of the examined feedstuffs the diagnosis "mycotoxicosis" could be confirmed. PMID- 2776672 TI - [The dust and microbial content in a horse stable during the use of a dust binding agent]. AB - Dust in horse barns is assumed to contribute to pulmonary disease, it is attempted to reduce the airborne dust by soaking or sprinkling the hay before feeding. Both means cause considerable efforts and increase the relative humidity of the air. This is why a commercial dust-binding agent (Revesto pur) was used in a pilot investigation which was carried out during 2 weeks - one week for control and one week using the agent - in a private horse barn where three horses were regularly stable. The airborne dust was measured by a continuously working instrument. Once a day (7.00 a.m.) the number of airborne germs was estimated. The dust is reduced to 0.03 mg/m3 during the night, (8.00 p.m. to 6.00 a.m.), as compared to the control (0.05 mg/m3). However, the total dust content during 24 h increases after spraying with the aid of the instruments supplied by the manufacturer to 0.12 mg/m3 (control 0.07 mg/m3). The airborne germs show a decreasing tendency after application of the agent. The use of the sprayers is very time-consuming, their use inside of the barn obviously increases the particles in the air. Thus, it seems advisable to spray outside of the stable. Further investigations are necessary in order to evaluate whether the reduction of the dust during night which was indicated in this study may have a positive clinical effect. PMID- 2776673 TI - [Direct detection of Actinobacillus (Haemophilus) pleuropneumoniae in the lungs of swine]. AB - By means of cultural examination, coagglutination test (CT) and indirect fluorescent-antibody-technique (IFAT) a total of 199 lung specimens from necropsy pigs from Northwestern Germany with symptoms of pleuropneumonia was examined for Actinobacillus (Haemophilus) pleuropneumoniae (AP). The CT was used to detect type specific antigens in lung extracts and the IFAT was performed on tissue sections. Both tests were found to be specific. Detection and identification of AP by either test were successful in 68 of 199 lung specimens. AP was isolated out of 40 lungs, antigen detection by CT was successful in 40 and by IFAT in 65 lung samples. In 26.5% of the positive samples AP was demonstrated only by IFAT. In 4.4% of the positive specimens AP was demonstrated only by cultural examination, but the detected serovars were not accounted in IFAT and CT. In 44.1% of the positive specimens AP was isolated or detected by all three techniques. The predominating serovar was serovar 9 followed by 2 and 7. One field isolate could be identified as serovar 3 and another one as serovar 10. Furthermore one isolate was untypable. IFAT and CT were limited for detection of serovars 2, 7 and 9. Detection of multiple serovars in few lung samples was successful only by IFAT. Indirect fluorescent-antibody-technique was found to be more sensitive than coagglutination test and cultural examination. On the other hand CT was found to be less time consuming and easier to evaluate than other tests. By this, coagglutination test seems to be preferable in examining large numbers of lung samples. PMID- 2776674 TI - [The prevention of injuries in greyhounds]. AB - The analysis of 154 greyhound injuries shows a significant lower incidence of injuries in the case of proper preparing for the race. The prevention of injuries was carried out during the whole training-season. These optimally prepared dogs showed a better race performance and were able to take part in more races. PMID- 2776675 TI - Comparative studies on the effect of continuous intravenous infusion of some sulphonamides on blood and urine glucose levels in buffaloes. AB - Three groups of five clinically healthy buffaloes each were injected intravenously with sulphadiazine, sulphadimidine and sulphamerazine in a dose of 100 mg/kg b. wt. (as a singly initial dose of 40 mg/kg b. wt. an subsequently the plasma level kept constant by a continuous intravenous infusion of a maintenance dose of 20 mg/kg per hour over a period of 3 hours). It was found that, 1) sulphadiazine, sulphadimidine and sulphamerazine increase the plasma glucose levels at 1, 2, 2.5 and 3.5 hours from the start of i.v. infusion. 2) The glucose concentration in urine increased in the buffaloes infused i.v. with sulphadiazine. 3) The glucose level in urine of buffaloes infused i.v. with sulphadimidine and sulphamerazine was slightly increased. 4) The concentrations of sulphadiazine, sulphadimidine and sulphamerazine in plasma reached its highest level, 2.5, 2 and 2.5 hours during the i.v. infusion, respectively, then declined rapidly. 5) The concentrations of sulphadiazine, sulphadimidine and sulphamerazine in urine reached their highest concentrations 3.5 hours after i.v. infusion. PMID- 2776676 TI - [The pathomorphology of endocardiosis in swine]. AB - In a total of 2653 slaughter pigs of the breeds Large White, Pietrain and Belgic Land Race the hearts were examined grossly ad histopathologically as to the occurrence of endocardiosis of the atrioventricular valves. This lesion occurred with high incidence. Endocardiosis of the V. mitralis was diagnosed in 63.2% and endocardiosis of the V. tricuspidalis in 17.7% of pigs. In 33.6% of animals the valves proved to be normal. Possible pathogenetic factors are briefly discussed. PMID- 2776678 TI - [Scanning electron and light microscopic studies of the surface epithelium of the rete testis and epididymis of the boar. I. Rete testis and efferent ducts]. AB - The use of the scanning electron microscope gave a three dimensional representation of the epithelial surface. Additionally, light microscopy revealed the representative structure of the epithelium. The rete testis showed a single layer of cubic epithelial cells. Short and dense microvilli were found on the surface. Sporadically a single, cilia-like structure was recognized. An extratesticular rete testis was identified. The flowing transition of the epithelium between the rete testis and the efferent ductuli occurred at different levels, so that both kinds of epithelial structures were recognized in the same area. The efferent ductuli were composed of a single columnar epithelium consisting of two cell types, principal cells and ciliated cells. The ciliated cells were recognized by their cilia protruding into the lumen. The principal cells showed microvilli on their surface and bleblike apical protrusions which erupt into the lumen. PMID- 2776677 TI - [Infection with Nematodirus battus (Crofton and Thomas, 1951) and pasture eimeriosis in lambs in Germany (case report)]. AB - An outbreak of eimeriosis in suckling lambs occurring two weeks after turn out on pasture is reported. In the same flock, Nematodirus battus infection was detected for the first time in Germany. PMID- 2776679 TI - [Expert opinion on the division of the idea of covering and fertilization inability in boars]. PMID- 2776680 TI - [Patient compliance with antihypertensive medications]. PMID- 2776681 TI - Behavioural state transitions in healthy and growth retarded fetuses. AB - The transitions, i.e. time intervals between two different behavioural states, were studied in 10 healthy and 10 growth retarded fetuses (IUGR) in near term pregnancies. In healthy fetuses, transitions usually lasted less than 3 min whereas IUGR fetuses showed a longer duration when compared to healthy fetuses. Moreover, a significant trend in the change of state variables (fetal heart rate, fetal eye movements and fetal gross body movements) was evident in healthy fetuses: fetal heart rate was the first variable to change in transitions from 1F to 2F and the last variable to change in transitions from 2F to 1F. On the other hand IUGR fetuses showed a random sequence in order of change. These findings were substantiated by the intraindividual consistency evidenced in repeated recordings. In conclusion the analysis of transitions differentiates between healthy fetuses and those affected by IUGR. PMID- 2776682 TI - Heart rate variation in normal infants and victims of the sudden infant death syndrome. AB - Infants who later succumb to the sudden infant death syndrome (SIDS) exhibit lower overall heart rate variability during waking than do other infants. This study attempts to determine which type or types of heart rate variation are reduced in SIDS victims. Long-term recordings of heart rate and respiration were obtained from normal infants and infants who later died of SIDS, and heart rate variation in three frequency bands was examined: respiratory sinus arrhythmia (periods 0.9-3.0 s), 'mid-frequency' (periods 4.0-7.5 s) and 'low-frequency' (periods 12-30 s). All three types of heart rate variation were diminished in SIDS victims under 1 month of age during waking and rapid eye movement (REM) sleep compared with controls. Partitioning heart rate effects showed that in waking, and to a lesser extent in REM sleep, the reduction in all types of heart rate variation exceeded that which would have been predicted based on higher heart rates in SIDS victims. No heart rate-independent reduction in any type of heart rate variation was observed in quiet sleep. This state-dependent reduction in three types of heart rate variation could indicate an abnormality of autonomic control mechanisms during waking and REM sleep in infants who later succumb to SIDS. PMID- 2776684 TI - Abstracts of papers presented at the Neonatal Society meeting. February 1989. PMID- 2776683 TI - Behavioral state distribution throughout 24-h video recordings in preterm infants at term with good prognosis. AB - Behavioral state distribution in 19 preterm infants at term with good developmental prognosis was studied by 24-h video recordings. The preterm infants of shortest gestation had longer time awake and this was concentrated in the daytime. On classifying behavioral states by Prechtl's criteria, the preterm infants had a smaller amount of state 1 than healthy term infants; but a similar amount of state 5 in awake time. Preterm infants were thought to have accelerated development in terms of diurnal sleep-awake rhythm, and decelerated development in terms of the content of sleep manifested by the amount of state 1. PMID- 2776685 TI - Synthesis, characterization, and ion exchange behavior of antimony(V) phosphate: selective adsorption of cadmium and mercury on its column. AB - Antimony(V) phosphate has been prepared as a new inorganic ion exchanger suitable for the selective adsorption of cadmium and mercury, the two chief polluting metals. The materials possesses good ion exchange capacity and stability, both thermal and chemical. It has also been characterized and an empirical formula has been proposed on the basis of its chemical analysis and certain instrumental studies like infrared spectroscopy, X-rays, thermogravimetry, derivative thermogravimetry, differential thermal analysis, and pH titrations. PMID- 2776686 TI - Effects of natural exposure to copper and zinc on egg size and larval copper tolerance in white sucker (Catostomus commersoni). AB - Sucker eggs were collected from a metal-contaminated site where previous collections had documented a maternal yolk factor associated with an increased larval copper tolerance during yolk nutrition. In this study, white sucker eggs were divided into groups which were water hardened and/or incubated at the contaminated site or a reference (control) site. Incubation at the contaminated site was associated with a decreased egg size and an increased deformity rate, but had no effect on fertilization rate or larval size. Incubation in contaminated streams increased the larval whole-body metal content, and decreased the tolerance and resistance of larvae exposed to copper in laboratory bioassays. An increase in water temperature accelerated the developmental rate of the larvae, but had no detectable effect on copper tolerance. Although metals did enter the eggs during water hardening, there was no difference in egg metallothionein content, and the lack of obvious hepatic activity until several days after hatching may prevent the formation of protective proteins. The authors hypothesize that the transfer of metals to white sucker eggs in association with yolk precursors, and the subsequent mobilization of these metals during yolk utilization, can account for the observed differences in larval tolerance and growth. PMID- 2776687 TI - A comparative analysis of the acute toxicity of technical-grade pyrethroid insecticides and their commercial formulations. AB - Seventy-two-hour LD50 studies involving the fenvalerate formulation, Pydrin 2.4 E.C., and the permethrin formulation, Ambush, were performed with male Swiss mice to compare the toxicity of the commercial formulations to that of the technical grade pyrethroids. Comparison of the formulation ip and po LD50 values and the lethality of technical-grade pyrethroids revealed an increased toxicity of the technical-grade material when administered as the commercially formulated products. The calculated ip and po LD50 values for Pydrin 2.4 E.C. and Ambush were calculated to be 62 and 72 mg/kg, respectively, whereas those for Ambush were 429 and 424 mg/kg. Administration of doses of technical-grade fenvalerate which corresponded to the amount of fenvalerate contained in the calculated LD99 value of Pydrin resulted in no deaths. Administration of the LD99 value of Ambush, as the technical-grade product, resulted in no deaths following ip administration, whereas the po value resulted in 100% death. The data indicate an effect of the Pydrin formulation vehicle on fenvalerate toxicity, whereas the Ambush vehicle did not enhance permethrin toxicity. Technical-grade material in general was more toxic following po than ip administration suggesting the corn oil vehicle may have reduced ip absorption. PMID- 2776688 TI - Lead and cadmium in stone loach (Noemacheilus barbatulus L.) from three rivers in Derbyshire. AB - Fish Noemacheilus barbatulus L. (stone loach) were caught at about 4-week intervals from single sites in three Derbyshire rivers, with different concentrations of cadmium and lead in sediments and water, during a 1-year sampling program. Fish were classified by age, site, and sampling occasion. Growth was allometric and affected by temperature. A steady state of cadmium burden was reached by fish of 2 years old or more but not by younger fish. For lead, fish rarely showed an increase in body burden. Differences in body size accounted for most of the variation in cadmium levels between loach of different age groups but were less important for lead levels. The exponent for body weight was not affected by age of fish and was about 0.79 +/- 0.06 for cadmium and 0.13 +/- 0.21 for lead. There was some correlation between cadmium levels in fish of different age groups taken at the same time from any site; levels of significance were higher when differences due to body size were discounted. Then, sampling time did not explain a significant part of the residual variation. Fluctuations in the cadmium and lead burdens for fish in the same age group from each of the sites were correlated for some comparisons. Loach from sites with higher metal concentrations had higher levels of both cadmium and lead. It is suggested that cadmium uptake from food contributed considerably to the body burden of loach. PMID- 2776689 TI - Fluoride-induced changes in carbohydrate metabolism in the tissues of fresh water crab Barytelphusa querini. AB - Exposure of fresh water crab Barytelphusa querini to a sublethal concentration of NaF (30 ppm) caused significant alterations in the carbohydrate metabolism. In an exposure span of 15 days the crab was observed to have marked depletion in glycogen and total free sugar levels. A significant elevation in "active" and "total" glycogen phosphorylase activity was observed. The activity changes of lactate dehydrogenase reflected changes in tissue lactate levels and succinate dehydrogenase activity had a tissue specificity. PMID- 2776690 TI - Acute and subacute toxicity study of inhaled methyl isocyanate in Charles Foster rats. AB - Charles Foster male and female rats were exposed only once to 3.52 and 35.32 ppm doses of methyl isocyanate in separate experiments for 10 min each in an acute toxicity study, while in subacute toxicity experiments, they were exposed to 0.212, 0.265, and 0.349 ppm doses for 30 min daily, for 6 days, by inhalation. Clinical signs, mortality, body and organ weights, and changes in hematology and clinical pathology were routinely monitored to determine the principal organ sites damaged on exposure to the gas. During exposure, animals were observed to have congestion in eyes, lachrymation, nasal secretion and dyspnea, progressively increasing ataxia, and immobility. Uncoordinated movements were also observed, indicating effects on the nervous system. Upon microscopic examination of the viscera, pathological findings confined to bronchial tree, lung parenchyma, liver, and kidneys were observed. PMID- 2776692 TI - Carbofuran transfer and persistence in drained agricultural soils related to their structure and adsorption properties. AB - Carbofuran (Curater 5G) behavior was studied in two drained cornfield soils, clay and loamy-clay, for 2 successive years. Different dissipations were observed in each soil for the same time period (8 weeks in 1985, 9 weeks in 1986). The authors found drained water from organic mater-rich soil to possess a higher carbofuran content, with 7.1-13.7 and 2.5-5.0% of the applied dose for clay and loamy-clay soils, respectively. The major part of these percentages arose from the drained waters associated with rainfall occurring during the first 2-3 weeks after application. Laboratory experiments confirmed the influence of the soil structure and its properties on carbofuran adsorption, and consequently on carbofuran leaching under field conditions. PMID- 2776691 TI - Influence of dietary protein deficiency on lead-copper interaction in rats. AB - The influence of dietary protein deficiency on the effects of exposure to lead or its combination with copper was investigated in rats. The administration of lead (100 ppm in drinking water) inhibited the activity of blood delta-aminolevulinic acid dehydratase; decreased hemoglobin, brain dopamine, and 5-hydroxytryptamine; and increased urinary excretion of delta-aminolevulinic acid, blood zinc protoporphyrin, and tissue accumulation of lead more markedly in animals fed a protein-deficient diet (10% casein) than in those fed a normal diet (21% casein). The simultaneous supplementation of copper (100 ppm in diet) reduced some of the lead-induced alterations and body uptake of lead more efficiently in animals fed a normal diet than in those fed a protein-deficient diet, which shows that the beneficial effects of copper in lead toxicity are adversely affected by low dietary protein. PMID- 2776693 TI - The intake of cadmium in the Kempen, an area in the south of The Netherlands. AB - In The Netherlands many areas with soil pollution have been detected. The largest polluted area is a zone of 350 km2 in the Kempen, in the south of The Netherlands. This Kempen zone is polluted with heavy metals, especially cadmium (Cd) and zinc (Zn), emitted from metal factories in the Netherlands and in Belgium. Because of the high Cd in soil, vegetables grown in that area contain relatively high Cd concentrations. The Cd uptake by inhabitants of these areas- especially individuals consuming vegetables from their own gardens--therefore is considerably increased. This Cd intake is shown to be higher than the provisionally tolerated weekly uptake of Cd set by the WHO. The role of smoking in Cd intake is discussed. PMID- 2776695 TI - Studies on congenital hypothyroidism and results of three and half years of compulsory screening program in Slovak Socialist Republic. AB - In the introduction the results of previous retrospective study (1975-79) including 312,259 newborns and of preliminary screening program including 31,780 newborns are briefly summarized. After January 1st, 1985 a compulsory screening of congenital hypothyroidism (CH) was started in the whole territory of Slovakia using the estimation of thyroxine in dry blood spot obtained from a heel prick on 5th day after birth. In suspected cases a complete clinical and laboratory examination was made including TSH estimation by RIA and after January 1st, 1988 by IRMA. The organization of screening program is described in detail. During three and half year period 286,469 newborns were examined which represented almost 100 percent of all newborns. A total of 44 cases of CH was found out of them 13 cases of athyreosis, 3 cases of ectopic thyroid and 28 cases of dyshormonogenesis (among them 5 cases with goiter and 23 cases without goiter). The average incidence of CH was 1:6874. Until January 1st, 1988 (when only T4 estimation was used as a first step) the recall rate was 2.32% and the treatment was started before 25th day after birth, while after the use of TSH by IRMA from dry blood spot in suspected cases (i.e. after January 1st, 1988) the recall rate decreased to 0.82% and the treatment was started before 14th day of life. In addition, the data on 39 cases of TBG deficiency and on regional differences in their incidence are reported. Some remarkable differences in the incidence of total CH and of its individual variants between West, Central and East Slovakia with different historical, cultural, economical and genetical background as well as in some ethnic groups (Gypsies) are also presented. PMID- 2776696 TI - Experience with neonatal screening for congenital hypothyroidism in Hungary. AB - The experience obtained in one of two Hungarian screening centers for congenital hypothyroidism (CH) is reported which is based on the examinations of dried blood samples tested with the aid of TSH-RIA developed in this laboratory. During the past six years (1982-88) and CH was diagnosed in 54 cases out of a total of 306,265 newborns (prevalence: 1:5470). The recall rate because of increased TSH values was 0.28-0.29% within the last two years. The triple of this had to repeat for technical reasons (imperfect samples, borderline results). Within the last year the treatment of diagnosed infants with L-thyroxine was started at the average age of 13 days. The history of three missed cases is briefly reported. Four out of 54 patients (7.4%) died in infancy. Since the pituitary sensitivity for TSH suppression by replacement doses of L-thyroxine appeared to be decreased in several cases, the control of free thyroxine levels is preferred to avoid the clinical hypo- or hyperthyroidism. The shortening of the present three days TSH RIA method, the extension of systematic examination of TSH binding antibodies and psychological studies are in progress. PMID- 2776694 TI - Incidence of thyroid hormone autoantibodies in patients with thyroid diseases with respect to diagnosis, other types of autoantibodies, duration of disease and treatment. AB - Thyroid hormone autoantibodies (THAA] were estimated in a total of 149 patients (139 women and 10 men) with various thyroid diseases. THAA were found in a total of 22 patients (all women), i.e. 14.7%. In 8 of them both T4Ab and T3Ab were found, while T4Ab only were found in 4 patients and T3Ab only in 10 patients. The highest incidence of THAA was found in patients with diffuse lymphocytic thyroiditis (i.e. 11 cases out of a total of 64 patients) and similarly high incidence was in patients with suspected autoimmune goiter but without thin needle biopsy (i.e. 5 cases out of a total of 21 patients). If only the patients with manifested or silent hypothyroidism were selected, T4Ab were found exclusively in this group, while the incidence of T3Ab was 3 times higher as that in patients without hypothyroidism. Though the incidence of T4Ab in patients with positive antithyroglobulin and antimicrosomal antibodies was 3 times higher than in negative ones, the difference was not significant. No correlation was found between the incidence of THAA on one hand and the duration of disease, the duration of treatment and the drug used for treatment on the other. However, a significant correlation was found between the incidence of THAA and the presence of goiter (P less than 0.05). PMID- 2776697 TI - Interdisciplinary aspects of iodine prophylaxis in German Democratic Republic. AB - Endemic goiter still occurs in several European countries. Alimentary iodine deficiency could be proved as the main cause of endemic prevalence. Extensive epidemiologic surveys showed the great medical and economical impact of this matter for the GDR. Over 200 million Marks might be spent for diagnosis and treatment of thyroid patients per year. Also in the field of veterinary medicine and animal production iodine deficiency plays an important role. Under the conditions of iodine deficiency the fodder containing nitrate and glucosinolates (e.g. bruised rape extraction) results in additional goitrogenic effects (so called indirect or relative iodine deficiency). Due to iodine deficiency disorders considerable losses of yields in cattle, pigs and sheep occurred. The content of iodine in animal products used for human nutrition was subsequently low. Considering the ecological implication of these problems an Interdisciplinary Iodine Commission within the Society for Endocrinology and Diseases of Metabolism of the GDR was established. Together with the governement authorities it worked out corresponding recommendations for the prophylaxis and control of its efficiency. In 1986 the iodination of most of the packed salt (32 mg KIO3/kg = = 19 mg I/kg) and the administration of iodinated mineral mixtures for the animal production were started for pigs in the whole territory of GDR and for cattle in the southern counties of the GDR only. These activities have been accompanied by information of TV as well as in the newspapers and medical journals. Thus, an improved supply of iodine to the population through iodinated table salt and animal products can be taken into account. The efficiency of these prophylactic measures is controlled interdisciplinarily.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2776698 TI - Lesions of the hypothalamic paraventricular nucleus and norepinephrine turnover in rats. AB - The effects of bilateral lesions of the hypothalamic paraventricular nuclei (PVN), of rats with a mean weight of 260 g body, on eating habits and body weight, as well as on sympathetic nervous system (SNS) activity in interscapular brown adipose tissue (IBAT) were investigated. In 59 of 131 Sprague-Dawley female rats, PVN lesions resulted in hyperphagia and obesity. Although lesions were considered successful when more than 50% of the PVN was destroyed histologically, such lesions were observed in 35.9% (47/131) of all lesioned rats and all of these 47 rats were obese. Therefore, in this study, these 47 rats which were confirmed histologically, were designated as "PVN-lesioned rats". Plasma insulin levels in these 47 PVN-lesioned ats were more than double those of the controls. However, no significant differences were observed between plasma glucose levels in PVN-lesioned and control groups. Norepinephrine turnover, a reliable indicator of SNS activity, in IBAT, heart and pancreas was similar in PVN-lesioned and sham operated control animals, even under contrasting conditions of feeding (ad libitum and fasting) and temperature (22 degrees C and 4 degrees C). It is concluded that PVN lesions produce hyperphagia, obesity and hyperinsulinemia in rats with an average body weight of 260g without affecting the SNS activity in IBAT, heart or pancreas. PMID- 2776699 TI - Steroid hormone receptors in the uterus and ovary of immature rats treated with gonadotropins. AB - We administered either saline (group A) or 10 IU of pregnant mare serum gonadotropin (PMS; groups B and C) to female immature rats. Fifty-three hours later, the rats were injected with saline (groups A and B) or 30 IU of human chorionic gonadotropin (hCG; group C). The rats were decapitated 17 h after the last treatment, and the serum levels of progesterone (P4) and estradiol (E2) were measured by specific radioimmunoassays (RIA). The receptor levels of progesterone (PR) and estrogen (ER) in the uterus and ovaries were measured and the dissociation constant (Kd) of PR was obtained. The highest serum level of P4 was found in group C and that of E2 in group B. Cytosol levels of PR and ER in the uterus and ovary of the group B were the highest. It was indicated that the PMS treated-group (B), which had developing follicles in the ovary and the high serum level of E2, showed the highest concentration of ER and PR in both the ovary and the uterus. In the PMS and hCG-treated group (C), the uterine and ovarian steroid receptors decreased probably because of the luteinization and the high serum level of P4. The Kd uterine PR value was less than that of ovarian PR. PMID- 2776700 TI - Endoscopic diagnosis of minute, small, and flat early gastric cancers. AB - We reviewed the diagnostic process in 6 minute, 6 small and 9 flat early cancers detected preoperatively, and in additional 12 flat cancers that were found in resected stomachs only at histology between 1976 and 1986. The limit of the size of cancer detectable preoperatively was 4 mm. Endoscopically, 7 out of 12 minute and small cancers detected preoperatively showed obvious morphological changes, while the others showed only color changes with or without erosion. Lesions with morphological changes significantly invaded the mucosa more often than those with no such changes (p = 0.010). Among flat cancers, color change was significantly more frequently observed in cancers involving the whole mucosa than in those confined to the superficial part of the mucosa (p = 0.015). Redness and discoloration were significantly more frequent in the differentiated and undifferentiated groups, respectively (p = 0.005). This study suggests that morphological and color changes are important indicators of minute or small cancers, especially those involving the whole mucosa. PMID- 2776701 TI - Comparison of snare and large forceps biopsies in the histologic diagnosis of gastric vascular ectasia in cirrhosis. AB - To compare snare and large forceps biopsies in the histologic diagnosis of gastric vascular ectasia (GVE) in cirrhosis, two groups of patients were studied: (a) 8 cirrhotic patients in whom endoscopy disclosed multiple gastric red spots (GRS), and (b) 5 cirrhotic patients with no GRS. Histologic examination of snare specimens identified dilated capillaries in the mucosa of the stomach in 75% of the cirrhotic patients with GRS, while large forceps specimens enabled the diagnosis of GVE only in 20% of the cases (p less than 0.05). Morphometric analysis of snare specimens demonstrated a significantly greater mean mucosal capillary cross-sectional area in cirrhotic patients with GRS than in cirrhotic patients without these lesions (p less than 0.05), while no differences in this parameter was observed in large forceps specimens. These findings indicate that gastric mucosal specimens obtained with large forceps are not useful for establishing the histologic diagnosis of GVE in cirrhotic patients with GRS. PMID- 2776702 TI - The endoscopic intratumor administration of OK-432 in gastric cancer unsuitable for surgery. AB - In eleven patients with gastric cancer who could not be operated on because of advanced age, refusal of surgery, or the presence of complications, the streptococcal preparation OK-432 was administered, both intradermally and by direct injection into the tumor under endoscopic guidance. Via gastric x-ray and endoscopic examinations, the tumor was observed to disappear in two cases-one advanced cancer and one early gastric cancer endoscopically. Particularly in the latter case repeated biopsies revealed no evidence of cancer cells. All patients developed fever after intratumor injection, but in no case was it necessary to discontinue administration, and no other serious side effects were noted. The endoscopic injection of OK-432 appears to be a safe and useful form of therapy for gastric cancer unsuitable for surgery. PMID- 2776703 TI - The effect of bisacodyl on whole-gut irrigation in preparation for colonoscopy. AB - The cleansing effect of whole-gut irrigation with a balanced electrolyte solution (BES), with or without pretreatment with bisacodyl, was compared, in order to establish whether bisacodyl reduces the duration and side effects of whole-gut irrigation. Bisacodyl at a dose of 20 mg in 2 days reduced the duration of the whole-gut irrigation procedure. No side-effects related to bisacodyl were demonstrated. We therefore consider bisacodyl to be a useful and inexpensive adjunt for colonic preparation of patients receiving whole-gut irrigation. PMID- 2776704 TI - The endoscopic spectrum of colonic mucosal injury following aortic aneurysm resection. AB - Ischemic colitis is a serious complication of aortic aneurysm resection. A knowledge of the endoscopic appearance and the clinical course of various forms of colonic mucosal injury is important for the clinician who has to decide which patient should be carefully monitored after aneurysm resection. This article reports on 48 patients with colonic mucosal injury, subdivided into non-specific lesions and ischemic colitis. Details are given of the endoscopic picture and the clinical course. It is concluded that only the gangrenous form of ischemic colitis is of clinical significance, and is related to bowel perforation and late stricture formation. PMID- 2776705 TI - A thread as a nidus of a common bile duct calculus--findings during endoscopic lithotripsy. AB - Suture material can serve as a nidus for common bile duct calculi. We saw an unusually long thread projecting from a mixed common duct stone in a woman 30 years after cholecystectomy. The calculus was removed endoscopically after mechanical lithotripsy. The implications of this observation, in particular as a potential complication, are discussed. PMID- 2776706 TI - Impacted duodenoscope removed with the aid of a second endoscope. PMID- 2776707 TI - Endoscopic sclerosis in bleeding ulcers. Can results be improved? PMID- 2776708 TI - Endoscopic removal of a trichobezoar. PMID- 2776709 TI - Development of new pharmacological agents for epilepsy: lessons from the kindling model. AB - The greatest value of the kindling model for new therapy of epilepsy almost certainly lies in elucidating the molecular basis of its development and persistence. Such an understanding may provide a foundation for therapies aimed at prevention or perhaps even cure of some forms of human epilepsy. PMID- 2776710 TI - Pharmacokinetics of old, new, and yet-to-be-discovered antiepileptic drugs. AB - The pharmacokinetics of antiepileptic drugs have been investigated extensively during the last two decades. It has become evident that the therapeutic management of epileptic patients would be significantly improved with the elimination of the drawbacks associated with existing antiepileptic drugs. Based on the information accumulated to date, the following set of principles is proposed: (1) The requirement of central nervous system (CNS) penetration automatically creates vulnerability to CNS toxicity. (2) The narrower the therapeutic range of a given drug, the more limiting its pharmacokinetic properties become. (3) The requirements of chronic administration and compliance place narrow limits on the optimum half-life (24 h). (4) The practice of polytherapy and the potential for pharmacodynamic and pharmacokinetic interactions make it necessary to simplify metabolic schemes (i.e., use of metabolically directed design approaches). (5) New antiepileptic drugs have shown that widely different structures are associated with anticonvulsant properties- it becomes important to minimize toxicity and optimize pharmacokinetic characteristics early in the development of future antiepileptic drugs. (6) Yet to-be-discovered antiepileptic drugs will probably include biotechnology-based pharmaceuticals. Such biologic agents as neuropeptides present a new set of pharmacokinetic requirements because they are generally receptor targeted, they do not cross absorption barriers easily, and they are labile and subject to degradation. PMID- 2776711 TI - Antiepileptic drug development program: a cooperative effort of government and industry. AB - The most important step in antiepileptic drug discovery is the choice of an appropriate animal model for the initial screening as well as for the more complex procedures that elucidate mechanisms of action. The currently available models fall short in their inability to identify all drugs for all types of seizures in a mechanism-independent manner. Nevertheless, spontaneous models of epilepsy are the most commonly used, and chemically or electrically induced seizures in rodents can also identify potential anticonvulsants. In the latter models, the intensity of the seizure stimulus is of paramount importance. The Antiepileptic Drug Development Program evaluates approximately 800 compounds each year, using two models for preliminary screening. One model assesses the ability of a compound to prevent seizure spread; the other weighs the ability to raise seizure threshold. In vivo tests, featuring amygdala- and corneal-kindled seizures, and in vitro assays, employing gamma-aminobutyric acid (GABA) receptors and synaptosomal uptake of adenosine, define drug-drug interactions and elucidate the pharmacological profiles of potential anticonvulsants. PMID- 2776712 TI - Further characterization of serum alkaline phosphatase from male and female beagle dogs. AB - Alkaline phosphatase (AP) from the sera of both male and female beagle dogs was partially purified and then analyzed for the presence of AP isoenzymes having intestinal or osseous characteristics as detected by bromotetramisole inhibition or wheat germ lectin agarose electrophoresis, respectively. The sera from both sexes were similar in regard to the presence of AP isoenzymes with intestinal (16 vs. 20%) or osseous (19 vs. 23%) characteristics, but serum AP from the male had a greater sialic acid content and only the male serum contained a detectable constitutive acidic (pI = 3.4) AP isoenzyme. This was similar to a serum AP isoenzyme previously found elevated in the sera of dogs afflicted with hyperadrenocorticalism or of dogs treated with certain corticosteroids. PMID- 2776713 TI - Clearance and distribution of acid-stable trypsin inhibitor (ASTI). AB - The clearance, organ distribution and metabolic pathway of the acid-stable trypsin inhibitor (ASTI) were studied in mice using 125I-labeled urinary trypsin inhibitor (UTI), the most typical ASTI in the urine. Following intravenous injection of 125I-UTI, the radioactivity disappeared rapidly from the circulation with a half-life of 4 min for the initial part of the curve. Gel filtration of plasma samples revealed that the rapid disappearance of the radioactivity was due to elimination of free inhibitor from the plasma. 125I-UTI was cleared primarily in the kidney. Gel filtration of urine samples showed that part of the radioactivity in the urine appeared at the same elution volume as 125I-UTI in the plasma, indicating that the origin of UTI was ASTI in the plasma. PMID- 2776714 TI - Aldehyde dehydrogenase from human erythrocytes: structural relationship to the liver cytosolic isozyme. AB - Human red cell aldehyde dehydrogenase (ALDH) resembles the liver cytosolic isozyme in numerous physicochemical properties. This study was undertaken to establish the structural relationship between the erythrocyte and liver ALDH isozymes. The purified red cell ALDH was S-(14C)-carboxymethylated, and cleaved with trypsin. The tryptic digest was fractionated using Sephadex and reversed phase chromatography. All peptides analyzed were identified within the liver cytosolic enzyme structure. In each case the sequence obtained corresponds exactly to a segment from the human liver cytosolic ALDH. Thus, the erythrocyte enzyme, by virtue of its chemical and structural identity with the liver cytosolic enzyme, may serve as a suitable peripheral enzyme model to understand the cause and mechanism of alcohol abuse-related changes in liver cytosolic ALDH that has been found to be reduced in alcoholics. PMID- 2776715 TI - Purification and properties of microsomal carboxypeptidase N (kininase I) in human placenta. AB - Carboxypeptidase N (kininase I, EC 3.4.17.3) was found in human placenta and purified 600-fold. The enzyme was solubilized from membrane fractions with Triton X-100 and was purified by affinity chromatography with histargin, a potent inhibitor of this enzyme. The pH optimum of the enzyme was 7.8. The Km values for L-hippuryl-L-lysine and bradykinin were 1.25 and 0.43 mmol/l, respectively. The apparent molecular mass (Mr) of the enzyme determined by gel filtration was estimated to be 280,000, which is identical to that of the human serum enzyme. We propose that the placenta is a major source of carboxypeptidase N and thus may be involved in the physiological control of fetal circulation by regulating the kallikrein-kinin and renin-angiotensin systems. PMID- 2776717 TI - Jet anaesthesia in horses. PMID- 2776716 TI - Chronic and severe laminitis: a critique of therapy with heart bar shoes and hoof wall resection. PMID- 2776718 TI - Sequential clinical and synovial fluid changes associated with acute infectious arthritis in the horse. AB - Infectious arthritis was induced experimentally in one tarsocrural joint of six horses by intra-articular injection of 1 ml Staphylococcus-saline suspension containing 9 x 10(4) to 3 x 10(6) organisms. The corresponding contralateral joint was injected with 1 ml of saline and served as a control. The progression of the induced infectious arthritis was assessed over a nine-day period by clinical examination and sequential synovial fluid analysis with pH and lactate measurements. Changes in synovial fluid were present before clinical signs of infectious arthritis were manifested. The diagnostic value of different synovial fluid parameters at various stages of infection was determined. Cellular changes initially preceded the biochemical changes. Total leucocyte counts showed a significant increase within 24 h (up to 100 x 10(9)/litre) with great variability in subsequent measurements. Neutrophilia over 90 per cent and pH under 6.9 were the most consistent findings in the infected synovia. Increased total protein was also significant and was progressive throughout the experiment. Serum and synovial glucose difference and synovial lactate had more diagnostic value in the acute stages than in the chronic stages. The control joints elicited an inflammatory response manifested by increased leucocyte count, moderate neutrophilia, slightly increased total protein concentration, and slightly decreased pH, but all reactions were minor in comparison to those in the infected joints. PMID- 2776720 TI - Iohexol myelography in the horse. AB - Iohexol, a water soluble non-ionic contrast agent, was evaluated for myelography in the horse. Both 300 and 350 mg iodine/ml iohexol gave diagnostic cervical myelograms. Pathological changes were limited to extradural oedema and an increase in the number of white blood cells and specific gravity in the cerebrospinal fluid two days after myelography. This increase in white blood cells in the cerebrospinal fluid was, however, much less than that recorded by other authors using metrizamide and iopamidol contrast media. These findings indicate that iohexol is a less irritant myelographic contrast agent than those previously evaluated in the horse. PMID- 2776721 TI - Equine mastitis--a review of 28 cases. AB - Mastitis was diagnosed in 28 mares. Cytological evaluation of milk samples showed large numbers of neutrophils in 72 per cent and bacteria in 33 per cent. Aerobic bacteria were cultured from 71 per cent of samples. Streptococcus zooepidemicus was the most common isolate (37 per cent). Gram-negative species accounted for 42 per cent. Determination of the probability for antimicrobial susceptibility of bacterial isolates from mares with mastitis indicated that a trimethoprim sulphonamide combination would be active against more than 75 per cent of isolates while penicillin would be active against less than 60 per cent. Systemic antibiotics, frequent milking, hotpacks and/or hydrotherapy and, if possible, infusion of an intramammary antibiotic preparation is recommended for treatment of equine mastitis. PMID- 2776719 TI - The influence of corticosteroids on sequential clinical and synovial fluid parameters in joints with acute infectious arthritis in the horse. AB - Infectious arthritis was induced experimentally in one tarsocrural joint of six horses by intra-articular injection of 1 ml Staphylococcus aureus-saline suspension with the addition of 200 mg methylprednisolone acetate. The corresponding contralateral joint was injected with 1 ml of saline with the addition of 200 mg methylprednisolone acetate, and served as a control. The purpose of the experiment was to examine the effect of corticosteroids on the acute clinical signs of infectious arthritis, and the associated changes in synovial fluid, to separate the effects of a steroid injection from those of infection alone. This should aid early diagnosis of infection. The progression of the infectious arthritis was assessed over nine days by clinical examination and sequential synovial fluid analysis. The corticosteroids masked the clinical signs in some horses for up to the third day although changes in the synovial fluid were present earlier. Cellular changes preceded biochemical changes initially. Leucocyte counts showed a significant increase in cell numbers after infection was established. Persistent neutrophilia, over 90 per cent, together with a pH under 6.9 were the most consistent findings in the infected synovia. Total protein values were lower in infected joints with, than those without, corticosteroids; although there was a progressive rise in total protein concentration throughout the experiment in both groups. Serum and synovial glucose difference and synovial lactate had very little diagnostic value because significant increases due to the corticosteroids were documented in the control joints. PMID- 2776722 TI - Injuries to the cranial cruciate ligament and associated structures: summary of clinical, radiographic, arthroscopic and pathological findings from 10 horses. AB - The clinical, radiographic, arthroscopic and pathological findings of 10 horses with injury to the cranial cruciate ligament are presented. The most consistent clinical signs included moderate to severe distension of the femoropatellar joint and a Grade III to a Grade V out of V lameness. Craniocaudal instability could be elicited in five horses under general anaesthesia and in one conscious horse. Radiographic evaluation of the stifles revealed that avulsion fracture of the medial intercondylar eminence was the most common finding in six out of 10 horses. Arthroscopic examination of the affected femorotibial joints were performed in five horses. This confirmed the presumptive diagnosis of cranial cruciate ligament injury or rupture. Post mortem examinations were performed on two horses which documented partial tears of the cranial cruciate ligament. PMID- 2776723 TI - Fluorometric evaluation of large and small intestinal ischaemia in the horse. AB - Arteriovenous (ischaemic strangulating obstruction, ISO) and venous obstructions (haemorrhagic strangulating obstruction, HSO) were created for 70 min in the small intestine of eight anaesthetised horses, and ISO was created in four horses for 2 h and four horses for 3 h at the sternal and diaphragmatic flexures of the large colon. Five minutes following release of the occlusions, sodium fluorescein 20 per cent (0.5 mg/kg bodyweight intravenously) was administered. Serial quantitative measurements of serosal surface fluorescence of the injured segments and a control segment were made at 2, 10, 15, 20 and 30 mins using a fibreoptic perfusion fluorometer. Significant differences in fluorescence were seen in small intestine segments between HSO vs control, ISO vs HSO, but not ISO vs control segments. In the large colon, significant differences were seen between the fluorescence in the ischaemic 3 h ventral colon and control segments, and a trend for difference in fluorescence between the 2 and 3 h ischaemic segments. Differences in fluorescence between 2 vs 3 h dorsal colon segments and 2 or 3 h dorsal colon vs control segments were not significant. PMID- 2776724 TI - The construction of the heart bar shoe and the technique of dorsal wall resection. AB - This paper describes a method of fabricating and fitting heart bar shoes and a technique of dorsal hoof wall resection. The rationale behind the treatments and criteria for their use are described. Radiographic technique is also discussed. This article reports the treatment of a series of clinical cases described in an accompanying article (p370). PMID- 2776725 TI - Treatment of solar prolapse using the heart bar shoe and dorsal hoof wall resection technique. AB - This paper describes the treatment of 10 horses suffering from acute laminitis using the heart bar shoe and a dorsal hoof wall resection technique. All cases had progressed to prolapse of the tip of the pedal bone covered by solar corium through the horny sole; in one case the exposed tip of the distal phalanx became visible. Nine cases of distal phalangeal rotation and one case of distal displacement of the distal phalanx (sinking) are described. Two animals were destroyed because of the degree of lameness, one remains slightly lame at the trot and the remaining seven have returned to their previous use at comparable levels of performance. PMID- 2776726 TI - Plasma carnitine concentrations in the horse following oral supplementation using a triple dose regime. PMID- 2776727 TI - Agenesis of the corpus callosum with cerebellar vermian hypoplasia in a foal resembling the Dandy-Walker syndrome: pre-mortem diagnosis by clinical evaluation and CT scanning. PMID- 2776728 TI - Rostral displacement of the palatopharyngeal arch in a seven-month-old Hanoverian colt. PMID- 2776729 TI - Surgical retrieval of a broken jugular catheter from the right ventricle of a foal. PMID- 2776730 TI - Direct N-terminal sequence analysis of rat liver plasma membrane glycoproteins separated by two-dimensional polyacrylamide gel electrophoresis. AB - Nine previously uncharacterized membrane glycoproteins from normal rat liver have been analyzed by amino acid sequencing from two-dimensional polyacrylamide gel electrophoresis (2-D PAGE) after transblotting to Immobilon-P membranes. Three of these components show altered levels of expression in liver tumors. A single electroblotted polyacrylamide gel yielded sufficient quantities of these glycoproteins for amino acid sequencing and the N-terminal structure could be determined for four of them. The remaining five glycoproteins of interest were not sequenceable in this manner, presumably because they had blocked N-termini. Prior to electrophoresis, two enrichment methods were applied to the crude liver membrane preparations: affinity chromatography with concanavalin A to isolate the plasma membrane glycoproteins and then fast protein liquid chromatography on Superose 12 to obtain components having a specific range of molecular weights. These materials were next subjected to 2-D PAGE using pH 4-6 carrier ampholytes in the first dimension and 7.5% sodium dodecyl sulfate gels in the second. The proteins were then electroblotted to Immobilon-P membranes and located by staining with Coomassie Brilliant Blue R-250. Our results demonstrate that N terminal sequencing (gas-phase) can be achieved on polypeptides obtained from approximately 250 micrograms of total glycoproteins applied to a single 2-D gel. PMID- 2776731 TI - Study of human cerebrospinal fluid proteins by size exclusion-high performance liquid chromatography and two-dimensional gel electrophoresis. AB - Cerebrospinal fluid (CSF) proteins were separated into three main fractions by size exclusion-high performance liquid chromatography (SE-HPLC). Subsequent analysis of each fraction by two-dimensional gel electrophoresis (2-DE) facilitated the detection of trace components in CSF and additionally provided more information about the native properties of various proteins. Certain proteins are present in a polymeric form and appear in the high molecular weight SE-HPLC fraction. In the middle molecular weight SE-HPLC fraction we found a CSF specific transthyretin-related protein by immunoblotting with polyclonal antibodies to transthyretin. Possible interpolypeptide disulfide bonds of such polymeric proteins were studied using a nonreducing 2-DE system. This procedure revealed that all apolipoprotein E monomers in CSF, which are synthesized in astrocytes, are linked by disulfide bonds. In the CSF from a patient with clinically definite multiple sclerosis (MS), novel proteins appeared in the high molecular weight SE-HPLC fraction, which are obscured by other proteins if total CSF is analyzed. PMID- 2776732 TI - Elevated plasma levels of haptoglobin in Duchenne muscular dystrophy:electrophoretic variants in patients with a severe form of the disease. AB - Analysis of plasma proteins of Duchenne muscular dystrophy (DMD) patients and normal age-matched boys using two dimensional gel electrophoresis and densitometry indicated a three-fold increase in the average haptoglobin level in DMD plasma. Two electrophoretic variants of haptoglobin in which the alpha 2 chain had more basic or more acidic spots were found in DMD patients with a rapidly progressing form of the disease. The basic variant was present in relatively low amount. Possible reasons for the elevated haptoglobin levels are discussed. PMID- 2776733 TI - Demonstration of cell-ricin interaction by electrophoretic light scattering. AB - Electrophoretic light scattering has been used to investigate the interaction of ricin, a vegetal toxin, with cells. This technique allowed measurements in the presence of free ligand and proved particularly useful for the study of a system with low affinity. The electrophoretic mobility of erythrocytes and oligodendrocytes was found equal to 2.08 x 10(-8) and 2.35 x 10(-8)m2s-1V-1, respectively. Upon ricin binding, these values decreased significantly. This change was related to the saturation of the binding sites. The specificity of the interaction was demonstrated by conducting the experiments in the presence of lactose. This specific inhibitor fully prevented the ricin-cell interaction. PMID- 2776734 TI - Fixation of amino acids and oligopeptides by freeze-drying in polyacrylamide gel electrophoresis. AB - Following polyacrylamide gel electrophoresis in an acetic/formic acid buffer, pH 2.0, in fabric reinforced gels, amino acids and oligopeptides could successfully be fixed in the gel by freeze-drying. Lyophilization of the fabric reinforced polyacrylamide gel after electrophoresis resulted in a dry film which absorbed ninhydrin solution quickly and uniformly, thus improving the detection limit for amino acids and oligopeptides with molecular weights ranging from 189-1045. Most amino acids were detected with a sensitivity of 0.1-0.25 microgram and for oligopeptides the detection limit was found to be 0.5-5 microgram. PMID- 2776735 TI - Heterogeneous nature of human complement factor B: an electrophoretic approach for the analysis of its oligosaccharide chain structure and its physiological breakdown products. AB - Factor B is a glycoprotein which plays an essential role in the alternative pathway of complement activation. It carries the proteolytic activity of the convertases, and its physiological breakdown products Ba and Bb have some effects on the cells of the immune system. Human factor B exhibits a microheterogeneity and five isoforms are present in serum. The nature and origin of the microheterogeneity was investigated by using electrophoretic techniques. Treatments of factor B with neuraminidase and glycopeptidase F show that this microheterogeneity is mainly due to differences in its sialic acid content, varying from seven to eleven residues per molecule, and resulting in different oligosaccharide structures. However, deglycosylated factor B reveals a residual, nonallotypic variation in the Bb region of the polypeptide backbone. We confirm the presence of four asparagine-linked oligosaccharide chains of the complex type in native factor B, two of which are located in the Ba fragment, and the two others in the Bb fragment. The prevalent isoform of the native protein carries two sialic acid residues per oligosaccharide chain. Biosynthesis experiments show that the microheterogeneity of secreted factor B from HepG2 cells is acquired during the processing of its glycans. However, in vitro-secreted factor B is more heterogeneous than the serum protein. We propose a structural model for the microheterogeneity of the native protein and its physiological fragments. We discuss as well the feasibility of electrophoretic techniques to deal with microheterogeneity analysis. PMID- 2776736 TI - A two-dimensional electrophoresis procedure for single meristems of different forest species. AB - High resolution two-dimensional electrophoresis, with isoelectric focusing in the first dimension and electrophoresis in sodium dodecyl sulfate in thin acrylamide gels in the second dimension, has been applied to separate the proteins of single meristems (200-300 microns) from Sequoiadendron giganteum, Sequoia sempervirens, Pseudotsuga menziesii, Picea abies, Pinus pinaster, Eucalyptus gunnii and Populus nigra. The technique may prove an efficient tool for studying inter- and intraclonal differences in meristem cultures of forest species, especially when referring to cloning from meristems of selected trees in relation to the rejuvenation process. PMID- 2776737 TI - Fast isoelectric focusing of milk proteins on small ultrathin polyacrylamide gels containing urea. AB - The preparation of 0.45 mm thin polyacrylamide gels, containing urea, for horizontal micro isoelectric focusing of milk proteins with PhastSystem is described. Isoelectric focusing in the small gels, stained either with Coomassie Brilliant Blue R-250 or with the more sensitive silver stain, affords a fast and sensitive procedure for an analysis of milk and cheese proteins. The procedure can be effectively exploited in detecting adulteration in ovine cheese with bovine milk. PMID- 2776738 TI - Repel-Silane induced alteration of group specific component subtypes using LKB Immobiline DryPlates. AB - Group specific component (GC) band patterns of sensitive blood samples may be altered by Repel-Silane. Alterations occur when isoelectric focusing is performed with LKB Immobiline DryPlates rehydrated in a reswelling cassette using Repel Silane as a hydrophobic additive. In two cases Repel-Silane converted common GC subtypes into apparent rare types. PMID- 2776739 TI - Symmetric and asymmetric manual materials handling, Part 2: Biomechanics. AB - Earlier studies of the biomechanics of handle placement and angles on boxes in Manual Materials Handling have been limited to sagittally symmetric tasks. This study extends the results to a palletization/depalletization task with considerable asymmetric movement. Part 2 shows how body posture, hand/handle interface, and disc compressive force change in this asymmetric task. The results were not too different from the earlier studies of symmetric tasks, except that a 'traditional' handle position in the upper part of each lateral face (the 2/2 position) proved more effective than had been anticipated. PMID- 2776740 TI - Effects of VDT resolution on visual fatigue and readability: an eye movement approach. AB - The effects of VDT resolution on visual fatigue and readability were studied. Two kinds of displays with different resolutions (1664 x 1200 pixels and 720 x 350 pixels) and fonts were used. In the first experiment, the subjects read from each display for 1 h to induce fatigue. Reading speed and blink rate while reading were measured. Eye movements during visual smooth pursuit tracking tasks were studied before and after reading; quantitative scoring of eye movement performance showed no significant changes. In the second experiment, readability tests with three different character sizes on both displays were conducted and resulting reading eye movements were analysed. For readability of sufficiently large characters, no significant difference between the high and the standard VDT could be detected. However, for very small characters, higher resolution improved readability. PMID- 2776741 TI - Cardiac strain among women workers in an industrial laundry. AB - Occupational heat exposure standards define permissible thermal conditions on the basis of metabolic heat production. However, even when energy expenditure is low, upright posture and repetitive upper limb motion may influence thermoregulatory behaviour through increased cardiovascular stress. The present study was undertaken to examine the relationship between work activity, thermal exposure and cardiac strain among women laundry workers engaged in sedentary, repetitive work activity. Ambient temperatures, work activity and heart rate were recorded during complete work shifts for 11 women over three days in summer and three days in winter. Workstation temperatures were significantly higher in summer. Analysis of continuous recordings of heart rate with respect to work activity showed (i) parallel increases in pulse rate and dominant arm movement frequency; (ii) different patterns of heart rate fluctuations for the two work cycles, with peaks during particular sub-tasks and when arms were in elevated positions. Recommended limits for cardiac strain indices were surpassed in both seasons, although in summer they were exceeded significantly more frequently. The part of cardiac effort attributable to thermoregulatory adjustments was also higher in summer while the fraction reflecting metabolic needs did not change with the season. These findings demonstrate high levels of cardiac strain in this work situation and raise the question of redefining heat exposure standards to include the prevention of excessive cardiac strain resulting from cumulative effects of heat load and ergonomic stressors. PMID- 2776742 TI - Physiological responses to working with fire fighting equipment in the heat in relation to subjective fatigue. AB - Heart rate (HR), rectal temperature (Tre), blood pressure, temperature and relative humidity changes inside clothing were measured on 18 professional firemen (mean age 29.4 +/- 7.4 yr, VO2 max 41.4 + 8.8 ml kg-1 min-1) wearing fire fighter's uniforms (SU) or aluminized, fire resistant, impermeable clothing with self contained breathing apparatus (FE). The subjects exercised on a cycle ergometer with a work load of 1.5 W kg-1, at 39 +/- 1 degree C and at 70 +/- 5% relative humidity. They stopped exercising at a point of subjective fatigue and overheating which--according to their judgement--would cause them to stop working during real fire fighting. The working time until fatigue for subjects wearing FE was considerably lower than the corresponding value for SU. The HR and Tre values rose progressively throughout the exercise with no tendency to reach a plateau. In some cases the HR reached near maximal level. The Tre continued to rise even during 10 min of recovery and in many subjects exceeded 39 degrees C. These data showed that despite spontaneous termination of exercise, the limit of tolerance was reached by most of the subjects. PMID- 2776743 TI - The effect of posture on the responses to cycle ergometer exercise. AB - Nine male subjects performed submaximal and maximal exercise on a cycle ergometer while sitting on the saddle or on a chair behind the cycle ergometer with the legs horizontal. Data for oxygen uptake, respiratory variables, heart rate, and systolic blood pressure during exercise showed that there are no essential differences between these two positions. PMID- 2776744 TI - Physiological effects of a mouth-borne heat exchanger during heavy exercise in a cold environment. AB - A mouth-borne heat and moisture exchanger (HME) was tested. Nine healthy subjects performed an incremental-load cycle ergometry test to exhaustion, breathing once through the HME and once through a similar device without heat-exchange function (control). HME substantially increased inspired gas temperatures and decreased expired gas temperatures measured at the mouth; at 260 W (pulmonary ventilation (VE) approximately 1001 min-1) these changes amounted to + 15 degrees C and -5 degrees C, respectively. The breathing resistance was increased by HME but remained well within tolerable levels even during severe exercise. This was reflected in the subjective assessments of breathing resistance and breathing discomfort which, at any given workload, were rated similarly in the HME and control conditions. Also, time to exhaustion as well as oxygen uptake and VE at a given workload were unaffected by HME. That even at high pulmonary ventilations HME provided a good heat-exchange function while keeping breathing resistance relatively low suggests HME to be a useful aid for individuals suffering from cold-induced bronchospasm. PMID- 2776746 TI - Hypercalcemia. PMID- 2776747 TI - Large intramolecular movement in human complement protein C3 induced by methylamine. A small-angle scattering study using monoclonal antibodies as markers. AB - The reaction of methylamine with complement protein C3, which involves cleavage of a labile thiol ester bond, yields a large intramolecular rearrangement. This is shown by small-angle neutron and X-ray scattering using a Fab antibody as a marker. For the C3(Fab) 1:1 complex, the methylamine reaction yields an increase in the radius of gyration, R, from 4.6 nm to 6.0 nm. In the absence of Fab the corresponding R values increase from 4.4 nm to 5.1 nm. It is estimated that the methylamine-induced increase in R may correspond to a movement of the epitope to a position 5 nm away from the centre of gravity of the C3 molecule. In agreement with this finding, the maximum distance within the C3(Fab) complex increases from 16 nm to 22 nm as a result of the methylamine reaction. In order to explain this conformational change, it is tentatively suggested that the methylamine-induced cleavage of the C3 thiol ester bond leads to a domain rotation within the C3 molecule. In agreement with this idea, the data is consistent with a model which enables a globular domain within the molecule to rotate without redistributing the molecular mass more than that corresponding to the radii of gyration observed. PMID- 2776745 TI - Muscle response to pneumatic hand tool torque reaction forces. AB - Surface electromyography was used for studying the effects of torque reaction force acting against the hand, on forearm muscle activity and grip force for five subjects operating right angle, air shut-off nutrunners. Four tools having increasing spindle torque were operated using short and long torque reaction times. Nutrunner spindle torque ranged between 30 Nm and 100 Nm. Short torque reaction time was considered 0.5 s while long torque reaction time was 2 s. Peak horizontal force was the greatest component of the reaction force acting against the hand and accounted for more than 97% of the peak resultant hand force. Peak hand force increased from 89 N for the smallest tool to 202 N for the largest tool. Forearm muscle rms EMG, scaled for grip force, indicated average flexor activity during the Torque-reaction phase was more than four times greater than the Pre-start and Post Shut-off phases, and two times greater than the Run-down phase. Flexor EMG activity during the Torque-reaction phase increased for increasing tool peak spindle torque. Average flexor rms EMG activity, scaled for grip force, during the Torque-reaction phase increased from 372 N for the 30 Nm nutrunner to 449 N for the 100 Nm nutrunner. Flexor rms EMG activity averaged during the Torque-reaction phase and scaled for grip force was 390 N for long torque reaction times and increased to 440 N for short torque reaction times. Flexor rms EMG integrated over the torque reaction phase was 839 Ns for long torque reaction times and decreased to 312 Ns for short torque reaction times. The average latency between tool spindle torque onset and peak initial flexor rms EMG for long torque reaction times was 294 ms which decreased to 161 ms for short torque reaction times. The average latency between peak tool spindle torque, just prior to tool shut-off, and peak final rms EMG for long torque reaction times was 97 ms for flexors and 188 ms for extensors, which decreased for short torque reaction times to 47 ms for flexors and 116 ms for extensors. The results suggest that right angle nutrunner torque reaction forces can affect extrinsic hand muscles in the forearm, and hence grip exertions, by way of a reflex response.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2776748 TI - Folding of thermolysin fragments. Hydrodynamic properties of isolated domains and subdomains. AB - Sedimentation analysis in the analytical ultracentrifuge has been used to characterize the size and shape of thermolysin and a number of its fragments obtained by chemical or enzymatic cleavage of the protein. Four fragments (121 316, 206-316, 225/226-316 and 255-316) originate from the C-terminal domain, and two (1-155 and 1-205) from the N-terminal domain of the intact molecule. In aqueous solution at neutral pH the hydrodynamic properties of the C-terminal fragments, except 255-316, are consistent with compact homogeneous monomers. Fragment 255-316 is a monomeric species below 0.08 mg/ml concentration and forms a dimer above this concentration. Dimerization does not lead to changes in fragment conformation, as determined by far-ultraviolet circular dichroic measurements, but to an increase of 5.6 degrees C (to 68.2 degrees C at 1.0 mg/ml) in the temperature for thermal unfolding and a corresponding increase of 4.6 kJ/mol in the free energy of unfolding. Fragments derived from the N-terminal domain show a strong tendency to form high-molecular-mass aggregates. Previous experiments utilizing circular dichroic measurements and antibody binding data suggested that the C-terminal fragments listed above are able to refold in aqueous solution at neutral pH into a stable conformation of native-like characteristics [Dalzoppo, D., Vita, C. & Fontana, A. (1985) J. Mol. Biol. 182, 331-340] (and references cited therein). Present data establish that all these C terminal fragments are globular monomeric species in solution (at concentrations approximately 0.1 mg/ml) and thus represent 'isolated' domains (or subdomains) with intrinsic conformational stability typical of small globular proteins. PMID- 2776750 TI - Structure and activity of proteins from pathogenic fungi Phytophthora eliciting necrosis and acquired resistance in tobacco. AB - The phytopathogenic fungi Phytophthora cryptogea and Phytophthora capsici cause systemic leaf necrosis on their non-host tobacco; in culture they release proteins, called cryptogein and capsicein, which elicit similar necrosis. In addition, both proteins protect tobacco against invasion by the pathogen Phytophthora nicotianac, the agent of the tobacco black shank, that is unable to produce such an elicitor. Cryptogein causes visible leaf necrosis starting at about 1 microgram/plant, whereas 50-fold as much capsicein is required for the same reaction. Capsicein induces protection even in near absence of leaf necrosis. The activities of both elicitors are eliminated upon pronase digestion. They are proteins of similar Mr (respectively 10,323 and 10,155) and their complete amino acid sequences were determined. They consist of 98 residues, with some internal repetitions of hexapeptides and heptapeptides. 85% identity was observed between both sequences: only two short terminal regions are heterologous, while the central core is entirely conserved. Secondary structure predictions, hydropathy and flexibility profiles differ only around position 15 and at the C-terminus; these modifications could play a role in the modulation of their biological activities. After a search of the sequence data bases, they appear to be novel proteins. PMID- 2776749 TI - Purification and characterization of 55-kDa protein with 3,5,3'-triiodo-L thyronine-binding activity and protein disulfide-isomerase activity from beef liver membrane. AB - Beef liver membranes were shown to have different kinds of 3,5,3'-triiodo-L thyronine binding proteins including the 55-kDa protein which had been reported to have this activity in many cells by affinity labelling with N-bromoacetyl 3,5,3'-[125I]triiodo-L-thyronine. In order to characterize the molecular features of these binding proteins, the 55-kDa protein was purified from a beef liver membrane fraction abundant in the plasma membrane. The protein was solubilized with 0.5% Chaps and purified by chromatography on gel filtration, hydroxyapatite, and Mono Q anion-exchange columns. The purity was confirmed with reversed-phase HPLC and SDS/PAGE. Consequently, 0.4% of the total proteins in the membrane fraction was recovered as the 55-kDa protein. One fourth of the amino acid composition of this protein was Glx (14.6%) plus Asx (11.7%) and the pI of this protein was 4.5. The purified protein has triiodothyronine-binding activity with a Kd of 57 nM which is similar to the high-affinity binding site of the membranes. The anti-(55-kDa protein) sera specifically recognized the 55-kDa protein of beef, rat and human cells. The immunoglobulin G fraction of the anti (55-kDa protein) sera inhibited triiodothyronine binding to the beef liver membrane fraction. The purified protein also showed the activity of protein disulfide-isomerase (EC 5.3.4.1) as determined by reactivating scrambled ribonuclease. These data strongly suggested that the multi-functional 55-kDa protein which has triiodothyronine-binding activity and the activity of protein disulfide-isomerase, which is also reported to be the beta subunit of prolyl-4 hydroxylase, glycosylation-site-binding protein of oligosaccharyl transferase and iodothyronine 5'-monodeionidase, could be significant in the action of triiodothyronine towards the target cells. PMID- 2776751 TI - Unesterified long-chain fatty acids inhibit thyroid hormone binding to the nuclear receptor. Solubilized receptor and the receptor in cultured cells. AB - Unesterified long-chain fatty acids strongly inhibited thyroid hormone (T3) binding to nuclear receptors extracted from rat liver, kidney, spleen, brain, testis and heart. Oleic acid was the most potent inhibitor, attaining 50% inhibition at 2.8 microM. Oleic acid similarly inhibited the partially purified receptor and enhanced dissociation of the preformed T3-receptor complex. The fatty acid acted in a soluble form and in a competitive manner for the T3-binding sites, thereby reducing the affinity of the receptor for T3. The affinity of the receptor for oleic acid (Ki) was 1.0 microM. In HTC rat hepatoma cells in culture, fatty acids added to the medium reached the nucleus and inhibited nuclear T3 binding; oleic acid being the most potent. T3 binding of the cells was reversibly restored in fresh medium free of added fatty acids. Oleic acid did not affect all the T3-binding sites in the HTC cells: one form (80%) was inhibited and the other was not and these two forms were commonly present in all rat tissues examined. Thus, fatty acids inhibited the solubilized nuclear receptor as well as a class of nuclear T3-binding sites in cells in culture. PMID- 2776752 TI - Specific programs of myosin expression in the postnatal development of rat muscles. AB - The expression of myosin during postnatal development was studied in a dozen muscles of the rat. All muscles displayed the usual sequential transitions from embryonic to neonatal and to adult isomyosins. However, we observed that these transitions did not take place uniformly. Thus, half-transition times for the appearance of the adult intermediate and fast myosin extended from seven days for diaphragm, the most precocious muscle of all those examined, to 23 days for male rat masseter. Besides the large differences between their half-transition times, we noticed that the transition curves displayed different slopes, covering different periods. Differences between muscles mainly affected the neonatal-to adult transition rather than the embryonic-to-neonatal transition, since the embryonic-type myosin disappeared from all muscles examined except for one, at about the same time, by the end of the first week after birth. In addition, the appearance of slow myosin varied for each muscle and did not follow curves parallel to those for intermediate and fast myosins. These results indicate that each muscle of the rat is subjected to a specific program of myosin isoform transitions during postnatal development. PMID- 2776753 TI - Biochemical and biophysical analysis of pseudoknot-containing RNA fragments. Melting studies and NMR spectroscopy. AB - Three overlapping RNA fragments containing the pseudoknot, as found in the tRNA like structure of turnip yellow mosaic virus (TYMV) RNA, have been isolated and purified. Site-directed cleavage of TYMV RNA by RNase H, followed by ammonium sulphate precipitation and ion-exchange HPLC, yielded a pure preparation of a 3' terminal, 112-nucleotide TYMV RNA fragment. Transcription of TYMV cDNA by T7 RNA polymerase, resulted in the isolation of an 88-nucleotide fragment. Finally, a 44 nucleotide fragment containing the TYMV RNA pseudoknot and strongly resembling the aminoacyl acceptor arm of the viral RNA was also synthesised using T7 RNA polymerase. The three fragments were isolated in milligram amounts and used for biochemical structure mapping, ultraviolet melting studies and NMR spectroscopy. Chemical modification with diethyl pyrocarbonate and sodium bisulphite and enzymatic digestion with RNase T1 confirmed the presence of the pseudoknot in the 44-nucleotide fragment. Also the analogue of the T-stem and T-loop of the tRNA like structure of TYMV RNA was found. The results of modification at various temperatures in Mg2+-containing buffers were in general agreement with optical melting studies. Ultraviolet melting analysis of the longer fragments revealed their greater complexity and the results appear similar to those obtained for some tRNA species. To obtain direct biophysical evidence for base-pairing and stacking interactions in the pseudoknot, NMR studies were initiated. The first proton-NMR spectra ever obtained for plant viral RNA fragments are presented. NMR spectra were recorded at various buffer conditions and at various temperatures. The spectra for the 112-nucleotide and 88-nucleotide fragment are too complicated to be solved at present. In the case of the 44-nucleotide fragment, however, the imino proton resonances are well separated and this system turns out to be most promising for structural studies. PMID- 2776754 TI - Structure of the human lysosomal acid phosphatase gene. AB - We have isolated a 12-kb genomic clone, which encodes human lysosomal acid phosphatase (LAP), a lysosomal membrane glycoprotein. The human LAP gene has a size of about 9 kb and contains 11 exons (83-947 bp in size). The signal sequence and the first eight amino acids of the LAP protein are encoded by exon 1, the remaining luminal domain by exons 2-10 and the transmembrane and cytoplasmic domains, as well as the 3'-untranslated region, by exon 11. The sequence of the LAP gene confirmed the sequence deduced from the cDNA clone except for nucleotide 1917 in the 3'-untranslated region, where T is changed to C. The 5'-flanking sequence shows promoter activity, as analysed by coupling to bacterial chloramphenicol acetyltransferase. S1-nuclease-protection and primer-extension analysis demonstrate transcription initiation at multiple sites clustering within 23 bp upstream of the translation-initiation codon. Sequences characteristic for promoter regions like TATA-box and CAAT-box sequences could not be identified at typical positions. The absence of these sequences, the high GC content (63.5%), two GC boxes and a region complying with the properties of a CpG island, indicate that LAP is a housekeeping gene. PMID- 2776755 TI - Investigation of RecA--polynucleotide interactions from the measurement of LexA repressor cleavage kinetics. Presence of different types of complex. AB - The proteolysis of the LexA repressor in the presence of RecA and various polynucleotides was studied by measuring the fluorescence decrease of LexA upon cleavage. The results were compared with the DNA binding of RecA to investigate the presence of multiple DNA-RecA complexes. All single-stranded polydeoxyribonucleotides (DNA) efficiently stimulated the proteolysis and the maximum activation was reached in the presence of three or four nucleotides of polynucleotide per monomer of RecA. The stimulative effect was decreased in the presence of larger amounts of poly(dA), poly(dT) or heat-denatured DNA, whereas the excess of single-stranded DNAs chemically modified with chloroacetaldehyde did not present such an inhibitory effect, despite the fact that a second DNA molecule is likely to interact with RecA as monitored by the intrinsic fluorescence of these DNA species. The complicated cleavage promotion and inhibition pattern is tentatively explained by a three-state model assuming that RecA may interact with three single-stranded DNA molecules. According to this model, occupation of the first site would be necessary and sufficient for cleavage promotion, the second site would be neutral with respect to cleavage and the occupation of the third site would inhibit LexA cleavage at least partially. Double-stranded natural DNA did not stimulate cleavage, even under conditions where RecA binds quantitatively to the DNA. No polyribonucleotides (RNA) examined showed a significant stimulative effect either, nor did they appear to interact with RecA. PMID- 2776756 TI - Sequential 1H-NMR assignment and solution structure of bovine pancreatic ribonuclease A. AB - Assignments for 1H-NMR resonances of most of the residues of bovine pancreatic ribonuclease (RNase A) have been obtained by sequence-specific methods. Identification and classification of spin systems have been carried out by two dimensional phase-sensitive correlated spectroscopy (360 MHz) and single relayed coherence transfer spectroscopy. Sequence-specific assignments have been achieved by phase-sensitive two-dimensional nuclear Overhauser effect spectroscopy. To overcome the problem of spectral overlap use has been made of (a) an exhaustive analysis of partly exchanged RNase A (spectra in D2O), (b) a comparison with the subtilisin-modified enzyme (RNase S) and (c) small spectral perturbations caused by changes in pH and temperature. The secondary structure elements have been identified from the observed sequential, medium and long-range nuclear Overhauser effects together with data from amide-exchange rates. All information collected leads to the conclusion that the crystal and the solution structures are closely similar. PMID- 2776757 TI - Structural homology between glycophorins C and D of human erythrocytes. AB - Glycophorin C (GPC) and D (GPD) are minor glycoproteins which are believed to be important for the structural integrity of the red cell membrane. We have investigated the structural relationship between these glycoproteins by both immunological and structural investigations: 1. A rabbit anti-serum produced against GPD reacts strongly with GPC and the abnormal glycoproteins of Gerbich: 2, -3 and Gerbich: -2,3 red cells, and recognizes most probably the homologous C terminal portions of GPC and GPD. The two molecules however differ at their N terminus. 2. One-dimensional mapping of the peptides obtained after tryptic, chymotryptic, V8 protease or acid cleavage of 125I-labelled GPC and GPD, indicated that GPC and GPD are structurally related but some differences were found indicating that additional peptides were generated from GPC. 3. The partial primary structure of GPD was determined. The sequencing data are consistent with the assumption that GPD represents an abridged version of GPC that comprises residues approximately 21/29-128 and exhibits a N-terminal residue that is blocked by an as yet undefined group. PMID- 2776758 TI - Two isoforms of smooth muscle myosin regulatory light chain in chicken gizzard. AB - We isolated a cDNA clone for a new isoform of chicken smooth muscle myosin regulatory light chain (MRLC) from a cDNA library of embryonic chicken gizzard. The deduced amino acid sequence was different in 10 amino acid residues from the previously reported polypeptide sequences of chicken gizzard MRLC. The in vitro transcription/translation product from the cDNA comigrated with a minor isoform of chicken gizzard MRLC (L20-B) in a two-dimensional gel electrophoresis. This isoform was detected only in the embryonic gizzard and was slightly more acidic than the predominant isoform (L20-A). The partial polypeptide sequence of L20-A was confirmed to be identical to the previously reported MRLC sequence. Nevertheless, Northern blot analysis showed that L20-B-related mRNAs were present in both the embryonic and adult gizzard. Non-denaturing pyrophosphate polyacrylamide gel electrophoresis showed that the in vitro transcription/translation product could be associated with native myosin when mixed and coprecipitated in a low-ionic-strength buffer with adult chicken gizzard myosin. Moreover, the coprecipitated translation product was phosphorylated in vitro by chicken gizzard myosin light chain kinase apparently more rapidly than L20-A on the native myosin heavy chain. From these findings, we concluded that at least two isoforms of smooth muscle MRLC exist in chicken gizzard and that their expression may be regulated translationally depending on the developmental stage. PMID- 2776759 TI - Novel inhibitors and substrates of bilirubin: UDP-glucuronosyltransferase. Arylalkylcarboxylic acids. AB - The in vitro inhibitory potency of 20 structurally related alkanoic and arylalkanoic acids has been investigated on rat liver UDP glucuronosyltransferase. These compounds were tested on the microsomal and purified enzyme, and a cloned cDNA expressed in COS 7 cell cultures. Among all the acids tested, 7,7,7-triphenylheptanoic acid was the most powerful inhibitor of bilirubin:UDP-glucuronosyltransferase with a lower effect on 1-naphtol, androsterone and testosterone glucuronidation. The inhibition was competitive towards the microsomal and purified bilirubin:UDP-glucuronosyltransferases with Kiapp values of 12.0 microM and 1.6 microM, respectively. Twenty analogues were examined, and the results showed that their inhibitory potency on bilirubin:UDP glucuronosyltransferase activity was a function of at least three structural features (a) the presence of a hydrophobic triphenyl moiety; (b) the length of the aliphatic chain and (c) the presence of a carboxylic group. These inhibitors were also tested as possible substrates of UDP-glucuronosyltransferases. The strongest inhibitors were poor substrates of rat liver microsomal UDP glucuronosyltransferases. However, 7,7,7-triphenylheptanoic acid was actively glucuronidated by purified bilirubin:UDP-glucuronosyltransferase, in contrast to its analogues with decreasing alkyl chain length. In addition, glucuronidation of this molecule was enhanced by clofibrate treatment but could not be detected in Gunn rats, which are deficient in bilirubin:UDP-glucuronosyltransferase, further indicating that the glucuronidation of this compound was catalysed by bilirubin:UDP-glucuronosyltransferase. The results suggest that 7,7,7 triphenylheptanoic acid may be a useful structural probe to investigate the molecular basis of glucuronidation of bilirubin and carboxylic acids. PMID- 2776760 TI - The Na+-motive terminal oxidase activity in an alkalo- and halo-tolerant Bacillus. AB - An alkalo- and halo-tolerant aerobic microorganism has been isolated which, according to microbiological analysis data and the ribosomal 5S RNA sequence, is a Bacillus similar, but not identical, to B. licheniformis and B. subtilis. The microorganism, called Bacillus FTU, proved to be resistant to the protonophorous uncoupler carbonylcyanide m-chlorophenylhydrazone (CCCP). The fast growth of Bacillus FTU in the presence of CCCP was shown to require a high Na+ concentration in the medium. A procedure was developed to exhaust endogenous respiratory substrates in Bacillus FTU cells so that fast oxygen consumption by the cells was observed only when an exogenous respiratory substrate was added. The exhausted cells were found to oxidize ascorbate in the presence of N,N,N',N' tetramethyl-p-phenylenediamine (TMPD) in a cyanide-sensitive fashion. The ascorbate oxidation was coupled to the uphill Na+ extrusion which was stimulated by CCCP and a penetrating weak base, diethylamine, as well as by valinomycin with or without diethylamine. Operation of the Bacillus FTU terminal oxidase resulted in the generation of a delta psi which, in the Na+ medium, was slightly decreased by CCCP and strongly decreased by CCCP + diethylamine. In the K+ medium, CCCP discharged delta psi even without diethylamine. Ascorbate oxidation was competent in ATP synthesis which was resistant to CCCP in the Na+ medium and sensitive to CCCP in the K+ medium as if Na+- and H+-coupled oxidative phosphorylations were operative in the Na+ and K+ media, respectively. Inside-out subcellular vesicles of Bacillus FTU were found to be competent in the Na+ uptake supported by oxidation of ascorbate + TMPD or diaminodurene. CCCP or valinomycin + K+ increased the Na+ uptake very strongly. The process was completely inhibited by cyanide or monensin, the former, but not the latter, being inhibitory for respiration. The data obtained indicate that in Bacillus FTU there is not only H+ motive but also Na+-motive terminal oxidase activity. PMID- 2776761 TI - Assay and purification of the adenosylcobalamin-dependent 2-methyleneglutarate mutase from Clostridium barkeri. AB - A continuous spectrophotometric assay was developed for the adenosylcobalamin dependent 2-methyleneglutarate mutase from Clostridium barkeri. Thereby the product (R)-3-methylitaconate is converted by the delta-isomerase from the same organism to 2,3-dimethylmaleate which absorbs at 240 nm, much higher than both parent compounds (delta epsilon = 3.7 mM-1.cm-1). In addition a discontinuous assay using the facile formation of 2,3-dimethylmaleic anhydride in aqueous solution at pH 0-1 (delta epsilon = 4.0 mM-1.cm-1 at 256 nm) was established. The mutase and the isomerase were purified together by chromatography on quaternary amine-Sepharose (Q-Sepharose) and on cyanocobalamin-agarose. The enzymes were separated and obtained in homogenous forms by preparative PAGE in non-denaturing buffer. Both enzymes appear to be homotetramers with subunits of 70 kDa (mutase) and 50 kDa (isomerase). The equilibrium constants for both reactions were determined at I = 0.1 M and 25 degrees C: K1, app = [(R)-3-methylitaconate].[2 methyleneglutarate]-1 = 0.26 +/- 0.04, K2,app = [2,3-dimethylmaleate].[(R)-3 methylitaconate]-1 = 7.40 +/- 0.21. PMID- 2776762 TI - Alterations in plasma lipoproteins and apolipoproteins associated with estrogen induced hyperlipidemia in the laying hen. AB - The laying hen represents a physiological model in which the mechanisms of action of estrogens on lipid transport can be evaluated. The plasma lipoproteins in the laying hen were subfractionated into discrete particle species by isopycnic density gradient ultracentrifugation and the physicochemical properties and apolipoprotein contents of individual subfractions evaluated. The qualitative and quantitative aspects of this estrogen-specific profile were then compared to those of the immature chicken. As observed earlier, estrogens induced dramatic elevation in very-low-density lipoproteins (VLDL) (up to 900 mg/dl). Indeed, triglyceride-rich lipoproteins with densities up to 1.035 g/ml, i.e. VLDL and their remnants, behaved as a continuum which displayed little variation in size (20.5-21 nm), electrophoretic mobility (beta-like) and apolipoprotein content; apo B-100 (540 kDa) predominated while apo A-I (27 kDa), apo VLDL-II (19 kDa) and an apo-C-like protein (13 kDa) were present as minor components. The typical high density lipoproteins (HDL) in the immature chicken were replaced by a lipoprotein population whose physicochemical properties were quite distinct. Thus these particles were distributed as a single, asymmetric peak over the density range 1.030-1.158 g/ml, a wide interval which overlapped that of apo-B-rich particles at its lower limit. The rho 1.030-1.158 g/ml lipoproteins were present at concentrations (approximately equal to 200 mg/dl) some twofold to threefold lower than those of HDL in immature birds. Furthermore, they displayed physical and chemical properties in common with both low-density lipoproteins (LDL) and HDL and were LDL-like in exhibiting beta mobility but HDL-like in size (9-15 nm diameter). Their protein moiety was also HDL-like in its predominant content of apo A-I; small amounts of apo VLDL-II and the apo-C-like protein were also detected. Substantial amounts of lipid were found at rho greater than 1.195 g/ml: such substances are absent in the immature chicken and may reflect the presence of vitellogenins. The hyperestrogenic state in the laying hen is therefore associated with major modifications in lipoprotein and apolipoprotein profile. Such modifications may be of relevance to clinical disorders involving estrogen induced hyperlipidemia. PMID- 2776763 TI - Water in the active cavity of copper/zinc superoxide dismutase. A water 1H nuclear-magnetic-relaxation-dispersion study. AB - Water 1H-nuclear-magnetic-relaxation-dispersion (NMRD) measurements of solutions of several copper/zinc superoxide dismutase isoenzymes as well as mutants of the human isoenzyme have been performed in order to monitor the presence of exchangeable water at the copper(II) center. The results have been compared with other spectroscopic features of the various derivatives and with their catalytic efficiency. The decrease in the amount of water in the first coordination sphere, detected through NMRD, parallels, in most cases, the increase in the tetragonal nature of the copper ion. On the other hand, the catalytic activity seems unrelated to the presence of water. Most strikingly, the Ile137 mutant of the human isoenzyme, approximately equal to 90% active, has no water in the copper coordination sphere; this is taken as evidence that the electron transfer is not a water-mediated process. The variation in the pH dependence of NMRD data between the wild-type enzyme and the human Ile137 mutant has been found to parallel the variation in the pH dependence of activity. PMID- 2776764 TI - Molecular oxygen and the state of geometric isomerism of intermediates are essential in the carotene desaturation and cyclization reactions in daffodil chromoplasts. AB - The membrane-bound carotenogenic reaction sequence in daffodil chromoplasts can be subdivided in vitro into three reaction segments by varying the incubation parameters O2 and light. In the first segment, 15-cis-phytoene is desaturated to 15-cis-zeta-carotene (trans elimination of hydrogen) in the dark and in the presence of O2 as an essential cofactor. A photoisomerization of the 15-cis double bond of the accumulated zeta-carotene to trans is the prerequisite for the function of the second segment, the desaturation to 7,9,9',7'-tetra-cis-lycopene (prolycopene, cis elimination of hydrogen). The role of O2 as an electron acceptor is discussed and evidence for an oxidoreductase acting as a redox mediator between the desaturase (forming the polyene chromophore) and O2 is presented. A certain analogy to the desaturation of stearoyl-carrier protein, which also occurs in plastids, is proposed. The third segment, the cyclization of prolycopene, is active only in the absence of O2 and involves additional cis trans isomerization reactions. PMID- 2776765 TI - O-linked GlcNAc in serotype-2 adenovirus fibre. AB - Serotype-2 adenovirus fibre is shown to possess an O-linked GlcNAc residue and to have affinity for wheat germ agglutinin. The cytoplasmic and nuclear fibres are both glycosylated. Glycosylation seems to take place in the cytoplasm since most of the [14C]GlcN-labelled fibre is found in this compartment, little label being associated with the microsomes. Glycosylation of the fibre was not affected by inhibitors of N- and O-glycosylation. A variation in fibre glycosylation is observed among adenovirus. Among the serotypes tested, only serotype-5 adenovirus (another subgroup C virus) also incorporated [14C]GlcN into its fibre, but did not possess affinity for wheat-germ agglutinin. The GlcNAc is located in the N terminal two-thirds of the fibre and more probably in the N-terminal one-third. The free or penton-base-associated fibres are similarly glycosylated. These results suggest that glycosylation is not involved in viral adsorption and in assembly with the capsid penton base. Thus, glycosylation might be a characteristic feature of subgroup C viruses. PMID- 2776766 TI - The effect of aqueous methanol cryosolvents on the heat- and cold-induced denaturation of lactate dehydrogenase. AB - The effect on the low-temperature-induced denaturation temperature of various concentrations of methanol has been studied for lactate dehydrogenase. The results have been compared to similar data for the thermal denaturation temperature. Extrapolations of the low-temperature data show that, in a physiological buffer in the absence of methanol, the cold denaturation temperature would be -30 degrees C. Data obtained with high concentrations of methanol indicate that residues are exposed to a similar degree upon either heat- or cold-induced denaturation. Aggregation does not occur in the cold-denatured protein. Cold-induced denaturation is fully reversible at a protein concentration of 250 micrograms/ml. The spectra of the two denatured forms are similar. PMID- 2776767 TI - Analysis of the cDNA for phospholipase A2 from honeybee venom glands. The deduced amino acid sequence reveals homology to the corresponding vertebrate enzymes. AB - A cDNA expression library was constructed from worker bee venom glands and screened with an antibody against phospho lipase A2. The nucleotide sequence of a positive clone with the largest insert showed an open reading frame that codes for part of the signal peptide, the pro-region and the entire mature enzyme of the bee venom phospholipase A2 precursor. This sequence differs in the central region from the one determined by Shipolini et al. [FEBS Lett. 17, 39-40 (1971)] in showing, among other exchanges, two additional cysteines. The revised sequence of bee venom phospholipase is similar to the pancreatic enzyme in the spacing of cysteines and the presence of several amino acids known to be part of the active site or the Ca2+-binding region in identical positions. Moreover, these parts of the bee protein can be fitted into the three-dimensional structure determined for the bovine pancreatic phospholipase A2 [Dijkstra et al. (1981) Nature 289, 604 606]. Contrary to earlier suggestions, we therefore conclude that the bee venom enzyme shows some homology to phospholipases from mammalian pancreas and snake venoms. PMID- 2776768 TI - Thyroid hormone regulation of nuclear-encoded mitochondrial inner membrane polypeptides of the liver. AB - The effects of thyroid hormone on nuclear-encoded mitochondrial inner membrane proteins were investigated by in vitro translation of the endogenous mRNA present in a postmitochondrial fraction from the livers of rats treated in vivo with hormone. The levels of the mRNAs were estimated by quantitative immunoabsorption of the translation mixture. Total protein synthesis was increased 2.6-fold after 4 days of in vivo hormone treatment, but only 10-15% of the polypeptides were dramatically altered (greater than 5-fold). Among the most highly elevated were cytochrome c1 (greater than 10-fold increase) and the Rieske iron-sulfur protein of the cytochrome bc1 complex. Other inner membrane proteins (core protein 1, beta subunit of F1 ATPase, subunit IV of cytochrome oxidase, 3-hydroxybutyrate dehydrogenase) and non-mitochondrial proteins (rat serum albumin, beta 2 microglobulin) were not altered significantly by hormone treatment. Cytochrome c1 and the Rieske protein increased after 12 h of hormone treatment, a relatively early response in mammalian mitochondrial biogenesis. The possible significance of this response for the regulation of mitochondrial synthesis and assembly is discussed. PMID- 2776769 TI - Structural analysis of the carbohydrate chains of a mouse monoclonal IgM antibody. AB - A mouse monoclonal IgM antibody, directed against human blood group B determinant, was isolated from hybridoma culture growth medium. Chemical analysis indicated presence of N- and O-linked oligosaccharides. The N- and O-linked carbohydrate chains were liberated using two different conditions of reductive alkaline degradation. Structural analysis was carried out on the isolated chains using chemical analysis, 500-MHz 1H-NMR spectroscopy and fast-atom-bombardment mass spectrometry. The following composite structures of the N-linked chains were found: (formula; see text) where R = OH for biantennary structures and R = Neu5Ac alpha 2-3Gal beta 1-4 GlcNAc beta 1- or Neu5Ac alpha 2-3Gal beta 1-3[Neu5Ac alpha 2-6]GlcNAc beta 1- for triantennary structures. The O-linked oligosaccharides, found in the light chains, were shown to have the structure Neu5Ac alpha 2-3Gal beta 1-3GalNAc. The native IgM antibody could be separated on a concanavalin-A Sepharose column into two subfractions, differing in the presence of a high mannose-type oligosaccharide. PMID- 2776770 TI - Nuclear-magnetic-resonance investigation of the cooperative homodimeric hemoglobin from the mollusc Scapharca inaequivalvis. Molecular and electronic structure of the cyano-met derivative. AB - The proton nuclear-magnetic-resonance spectra of the cyano-met complexes of the cooperative dimeric and tetrameric hemoglobins from the mollusk Scapharca inaequivalvis have been investigated and compared to those of other structurally characterized oxygen binding hemoproteins. For these proteins, cooperativity is displayed even in the homodimer and preliminary X-ray structural data reveal an unusual back-to-front assembly with intersubunit contacts involving the EF helices [Royer, W. E., Love, W. E. + Fenderson, F. F. (1985) Nature (Lond.) 316, 277-280]. The pattern of hyperfine shifts is very similar for the dimer and tetramer chains, but distinctly different from those of previously characterized low-spin, ferric heme proteins. Individual heme resonances are identified by reconstituting the protein with specifically deuterated hemes. While the axial interactions involving the proximal and distal histidines are very similar to that in myoglobins and other hemoglobins, both the heme contact shift pattern and the amino acid dipolar shift pattern reflect a significantly reduced asymmetry. The decreased spread of the non-cordinated amino acid signals is interpreted in terms of a rotation of the magnetic axes relative to those in myoglobin or other hemoglobins, rather than a change in the magnetic anisotropy. The decreased spread of the heme methyl contact shifts supports this conclusion and is consistent with an orientation of the proximal histidine with the imidazole ring rotated by about 30-40 degrees relative to that in other structurally characterized proteins. Although resonances associated with a complex pattern of alternate heme orientations can be detected immediately after reconstitution of the protein, the isolated protein was found to exhibit insignificant equilibrium heme rotational disorder. PMID- 2776771 TI - Differential induction of peroxisomal and microsomal fatty-acid-oxidising enzymes by peroxisome proliferators in rat liver and kidney. Characterisation of a renal cytochrome P-450 and implications for peroxisome proliferation. AB - The induction of renal fatty-acid-oxidising enzymes has been investigated following short-term exposure to a group of structurally diverse peroxisome proliferators and compared to the more extensively documented hepatic responses in the rat. There was a marked compound dependence on induction of both cytochrome P-450-IVA1-dependent omega-hydroxylation of lauric acid and enzymes of the peroxisomal fatty acid beta-oxidation pathway (measured as cyanide insensitive palmitoyl-CoA oxidation and enoyl-CoA hydratase). Cytochrome P-450 IVA1 (or a very closely related isoenzyme in the same gene family) was a major constitutive haemoprotein in rat kidney microsomes and actively supported the omega-hydroxylation of lauric acid. This activity was induced 2-3-fold by peroxisome proliferators such as clofibrate, di-(2-ethylhexyl)phthalate, bezafibrate and nafenopin. By using a cDNA probe to the cytochrome P-450 IVA1 gene in Northern blot analysis, we have shown that increased renal and hepatic omega-hydroxylation of lauric acid, after treatment with peroxisome proliferators is a consequences of a substantial increase in the mRNA coding for this haemoprotein. In addition, programming of an in vitro rabbit reticulocyte translation system with both renal and hepatic RNA resulted in the synthesis of similar (if not identical) cytochrome-P-450-IVA1-related polypeptides. Furthermore, we have provided Western blot evidence that both rat liver and kidney microsomes contain two closely related cytochrome P-450 IVA1 polypeptides, the major one characterised by a monomeric molecular mass of 51.5 kDa (identical to authentic, purified hepatic cytochrome P-450 IVA1) and a minor one of 52 kDa. The kidney-supported fatty acid omega-hydroxylase activity was refractory to inhibition by a polyclonal antibody to liver cytochrome P-450 IVA1, which may be related to the existence of two closely related (but immunochemically distinct) fatty acid hydroxylases in this tissue. Our studies have also demonstrated that certain of the compounds tested (including clofibrate, bezafibrate and nafenopin) induced renal fatty acid beta-oxidation, mirroring the increased omega hydroxylase activity in the endoplasmic reticulum. Our studies have also indicated that the kidney was more refractory to induction of the endoplasmic reticulum and peroxisomal fatty-acid-oxidising enzymes than the liver. Taken collectively, our data is strongly suggestive of a possible linkage of the renal fatty acid oxidative enzymes in these two organelles, a situation that also occurs in the liver. In addition, our studies have provided a possible conceptual framework that may rationalise the decreased susceptibility of the k PMID- 2776772 TI - Characterization of pre-rRNA components in ribosomal precursor particles from macronuclei of Tetrahymena thermophila. AB - Ribosomal precursor particles were extracted from purified macronuclei of Tetrahymena thermophila and separated in sucrose gradients. The RNA components of major particle fractions were isolated and analyzed by Northern blot hybridization using cloned rDNA fragments. A tentative scheme of preribosome maturation was established based on the RNA constituents and corresponding processing steps occurring in the different particle classes. The primary transcript of ribosomal genes, the unspliced precursor rRNA, was found in some experiments in the upper region (less than 40S) of sucrose gradients run for short times. This is in accordance with earlier results by others indicating that slowly sedimenting ribonucleoprotein (RNP) structures may exist as a transitory stage of preribosome formation. Usually, however, unspliced pre-rRNA was only found in 80S preribosomes, where splicing occurred as indicated by the presence of splice intermediates and products only in this fraction. In addition, the further processing of spliced pre-rRNA at three major sites in variable temporal order took place in the 80S preribosomes, i.e., (i) the cleavage at or near the 5'end of the 17S rRNA sequence, (ii) the central cleavage in the internal transcribed spacer (ITS2) between the 5.8S and 26S rRNA sequence, and (iii) the cleavage in the ITS1 at or near the 3' end of the 17S rRNA sequence. Only the latter event was found to result more or less immediately in the division of the 80S preribosomes into separate precursors (p40S and 60S) of the small and large ribosomal subunits. If the alternative pre-rRNA cleavage site in the ITS2 was used first the 80S preribosomes retained their integrity. The conversion of the p40S precursors into nuclear 40S subribosomal particles was correlated with the processing of pre-17S rRNA into 17S rRNA. In the 60S ribosomal precursor particles the processing of pre-26S rRNA, including the formation of precursors (ITS and 7S RNA) to 5.8S rRNA, occurred. A substantial proportion of 26S rRNA molecules isolated from these particles already contained the central hidden break as indicated by the presence of 26S rRNA alpha- and beta-subfragments. The major pre-rRNA processing by-products, IVS and ETS RNA, were partly associated with preribosomes and partly present as free RNAs in the supernatant of sucrose gradients. This indicates that they are liberated and degraded mainly outside the particles in which they are formed. In contrast, the initiation fragment (IF), a small promoter-proximal transcript, was exclusively associated with large particles.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2776773 TI - Small proteoglycan synthesis by skin fibroblasts cultured from elderly donors and patients with defined defects in types I and III collagen metabolism. AB - The relative synthesis of two different types of small proteoglycans with potentially distinct roles in tissue function (PGI and PGII) was investigated in human skin fibroblast cultures initiated from donors of increasing age (fetal to 92 y) and from patients with defined defects in type I and type III collagen metabolism. Because these two small proteoglycans are not distinguished by the usual methods of ion-exchange and sieve chromatography, we have separated them using gel electrophoresis and confirmed this by specific immunoprecipitation. Small proteoglycans of the PGII type were the predominant species found in the medium of all cultures from normal donors, regardless of age. Most of the mutant cell lines showed a profile of small proteoglycan synthesis like that of the normal cells (i.e., predominantly PGII) although an increased ratio of PGI/PGII was seen for two cell strains from patients with Ehlers-Danlos syndrome type IV characterized by intracellular accumulation of type III procollagen. We conclude that mutations affecting collagen primary structure and secretion appear to have little effect on the cells' synthesis and secretion of small proteoglycans. These findings fail to support an hypothesis suggesting that the metabolism of normal cellular synthetic products (proteoglycans) is altered by abnormal cellular processing of a defective product (collagen). PMID- 2776774 TI - Down-regulation of membrana granulosa cell gap junctions is correlated with irreversible commitment to resume meiosis in golden Syrian hamster oocytes. AB - One of the currently popular hypotheses for the regulation of meiotic resumption in mammalian oocytes proposes that the preovulatory surge of luteinizing hormone causes down-regulation of follicular gap junctions, which in turn disrupts transfer of a meiotic arrester from the somatic cells into the oocyte. The present study has investigated this hypothesis by examining the integrity of membrana granulosa cell gap junctions during the period of irreversible commitment to maturation of golden Syrian hamster oocytes in vivo. Our results have revealed a significant progressive decrease in the fractional area of cell surface occupied by gap junction membrane with increasing percentage of oocytes irreversibly committed to mature (1.946% and 0.921% fractional gap junction area at 0% and 100% oocytes irreversibly committed to mature, respectively, P less than 0.05). This net loss of membrana granulosa cell gap junctions from the cell surface was accompanied by a significant decrease in density of gap junction particles, whether they were arranged in rectilinear or non-rectilinear packing patterns. Furthermore, the number of gap junction particles per unit area of surface membrane scanned also underwent a significant progressive decrease with increasing percentage of oocytes irreversibly committed to mature. These data with the hamster are consistent with the hypothesis that down-regulation of membrana granulosa cell gap junctions may be of central importance in the regulation of gonadotropic stimulation of meiotic resumption in mammalian oocytes. PMID- 2776775 TI - Endocytosis by African trypanosomes. I. Three-dimensional structure of the endocytic organelles in Trypanosoma brucei and T. congolense. AB - African trypanosomes multiply rapidly during the course of infection obtaining nutrients from the host blood and other body fluids. The organelles involved in endocytosis were revealed ultrastructurally using horseradish peroxidase (HRP) and colloidal gold coupled to bovine transferrin (Au-Tf) or bovine serum albumin (Au-BSA). At 0 degree C the markers bound to the cell surface and neither entered the flagellar pocket nor were internalized. Upon warming to 37 degrees C, the markers were found in the flagellar pocket and appeared to enter all the intracellular endocytic organelles within 5 min. Serial sectioning of resin embedded cells was employed to obtain pseudo three-dimensional views of these organelles. The organelles involved were of three types: (1) small vesicles and cisternae (20-25 nm in diameter), (2) large tubular networks (200 nm diameter) similar to endosomes of mammalian cells, and (3) large lysosome-like vesicles. These organelles were located between the flagellar pocket and the nucleus and were also associated with one face of the Golgi apparatus. In pulse-chase experiments HRP was not detected in intracellular organelles after 410 min but Au Tf was seen in residual bodies. No exocytosis of Au-Tf from the flagellar pocket was observed. The data suggests that the processes of endocytosis in these parasitic protozoa may be similar to the endocytic processes found in mammalian cells. PMID- 2776776 TI - Endocytosis by African trypanosomes. II. Occurrence in different life-cycle stages and intracellular sorting. AB - Horseradish peroxidase (HRP) and colloidal gold-labeled proteins enter many of the endocytic organelles of bloodstream forms of Trypanosoma brucei and T. congolense. However, the colloidal gold markers were excluded from substantial parts of the pathway that contained HRP. Morphometric studies revealed that HRP entered organelles that accounted for approximately 5% of the total cell volume while transferrin-gold entered organelles that comprised approximately 2% of the total cell volume. In addition, large colloidal gold particles were excluded from organelles that contained smaller gold particles. Antibodies, raised against the variable surface glycoprotein, when applied to thawed cryosections were found to label structures from which endocytosed colloidal gold coupled to bovine serum albumin (BSA) was excluded. Endocytosis was shown to occur in two in vitro propagated forms of trypanosomes, similar to those found in the insect vector (Glossina spp.). The mammal-infective metacyclic forms were similar to bloodstream forms in that they endocytosed HRP and colloidal gold markers but excluded colloidal gold from approximately 3% of the endocytic organelles. Estimation of the flagellar pocket volumes of bloodstream form T. brucei showed that this organelle occupied 0.5% to 1.4% of the total cell volume. The flagellar pocket volume of T. congolense varied between life-cycle stages, with a fractional volume of 4.4% for bloodstream forms, 2.3% for metacyclic forms and 1.4% for procyclic forms. Endocytosis of HRP, but not of protein-gold markers, occurred in procyclic (uncoated) forms. Endocytosis by procyclic forms has heretofore not been reported.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2776777 TI - Monensin and chloroquine inhibit transfer to lysosomes of endocytosed macromolecules in cultured mouse peritoneal macrophages. AB - The effects of the Na+/H+ ionophore monensin and the weak base chloroquine on lysosomal uptake of endocytosed macromolecules were studied in cultured mouse peritoneal macrophages using horseradish peroxidase (HRP) and ferritin as exogenous tracers. The lysosomes were first loaded with HRP using a pulse-chase protocol. The cells were then exposed to ferritin for 30 to 120 min, either in control medium or in medium containing 3 microM monensin or 50 microM chloroquine. Semiquantitative electron microscopic analyses indicated that the uptake of ferritin into HRP-labeled lysosomes was inhibited in the drug-treated cells, and that the tracer particles accumulated in endosomes. At the same time the volume density of the endosomes was increased, fourfold by monensin and threefold by chloroquine; with the latter drug there was also an increase in lysosome volume density. Further, both drugs decreased the rate of endocytosis as measured biochemically, but not in proportion to the reduction of lysosomal ferritin uptake. After withdrawal of the drugs, cell morphology returned to normal and transfer of ferritin from endosomes to HRP-labeled lysosomes was resumed. The recovery was more rapid and complete in monensin-treated than in chloroquine-treated cells. On the basis of these findings and earlier investigations demonstrating that monensin and chloroquine both raise the pH in acid cell compartments, it is suggested that the transfer of soluble and not only membrane-bound macromolecules from endosomes to lysosomes is modulated by the pH in these organelles. PMID- 2776778 TI - Anti-thrombin activity in cultured aortic and capillary endothelial cells: binding, internalization and degradation of thrombin. AB - Thrombin (Th) binds specifically to confluent cultures of adult bovine aortic (ABAE) and bovine brain capillary (BBC) endothelial cells. Saturation of 125I-Th binding is observed after 1 h exposure to the ligand and at an extracellular concentration of 0.5 and 1.0 microgram/ml for ABAE and BBC cells, respectively. Under optimal conditions both ABAE and BBC cultures bind about 2 to 5 ng/10(6) cells, which represents about 20% of Th binding to bovine corneal endothelial (BCE) cells. Under optimal conditions less than 30% of the total cell associated 125I-Th is internalized in ABAE and BBC cells, while in BCE cells the extent of internalization is more than 50%. The internalized 125I-Th is degraded both in ABAE and BBC cells as previously demonstrated in BCE cells. As analyzed by SDS PAGE, 17%, 22% and 77% of the bound 125I-Th is in complex with anti-thrombins (anti-Ths) in BBC, ABAE and BCE cultures, respectively. ABAE cells possess 3 types of complexes, one which appears only on the cell surface with a molecular weight of 78 kDa, and two others which appear only in the conditioned medium (CM) with molecular weights of 84 and 85 kDa. BBC and BCE cells demonstrate only one type of complex with a molecular weight of 77 kDa which appears both on the cell surface and in the CM. The 125I-Th 77 kDa complex formed in the CM of BCE cells is recognized and bound by BBC cells and ABAE cells.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2776780 TI - XIth Congress of the European Society of Cardiology. 10-14 September 1989, Nice, France. Abstracts. PMID- 2776781 TI - Treatment planning in vulvar cancer patients. AB - Peculiarities of metastatic spread, recurrences and treatment results were studied in 148 vulva cancer patients, indications to adequate treatment were specified with respect to age, local and regional tumour spread. Efforts to apply on a wider scale preventive and therapeutic removal of inguinofemoral lymph nodes, to make vulvectomy and lymphadenectomy more radical, employment of radiotherapy with fast electrons lead to a substantial improvement of prognosis. PMID- 2776779 TI - Separation of the lipid bilayer from the membrane skeleton during discocyte echinocyte transformation of human erythrocyte ghosts. AB - The membrane skeleton, a protein lattice at the internal side of the red cell membrane, is principally composed of spectrin, actin and proteins 4.1 and 4.9. We have examined negatively stained red cell ghosts and demonstrated, on an ultrastructural level, a separation of the lipid bilayer from the membrane skeleton during echinocytic transformation. The electron micrographs of discoidal red cell ghosts suspended in hypotonic buffer revealed a filamentous reticulum that uniformly laminated the entire submembrane region. transformation of the discoidal ghosts into echinocytic form, as induced by incubation in isotonic buffer, resulted in a disruption of skeletal continuity underlying the surface contour of the membrane spicule. The submembrane reticulum extended into the base and the neck of the spiny processes of the crenated ghosts but was absent at the tip of these projections. In addition, membrane vesicles without a submembrane reticulum were detected either attached to the tips of the spicules or released into the supernatant from the echinocytic ghosts. Protein analysis revealed that the released vesicles were enriched in bands 3, 4.1 and 7 and contained very little of the membrane skeletal proteins, spectrin and actin. The data indicate that during echinocyte formation, parts of the lipid bilayer physically separate from the membrane skeleton, leading to a formation of skeleton-poor lipid vesicles. PMID- 2776782 TI - Endometrial adenocarcinoma: therapeutic impact of preoperative histopathologic examination of endometrial tissue. AB - Adenocarcinoma of the endometrium is diagnosed by the histologic evaluation of endometrial tissue. In stage I disease, five-year survival depends upon a number of prognostic factors. Histologic grade and type of carcinoma are most important. The need for pelvic and para-aortic lymphadenectomy is often based on the preoperative histologic grade and type of tumor. The purpose of this study was: 1) to compare preoperative histology of endometrial carcinoma to that found at hysterectomy, 2) to determine if preoperative histology can accurately predict depth of myometrial invasion or extra-uterine spread, 3) to determine whether para-aortic lymphadenectomy could be deleted based only on the preoperative finding of well differentiated carcinoma. In 19 (28%) of the 68 patients studied, the histologic grade or pattern at hysterectomy was different from that found preoperatively. In seven (13%) of the 52 "good prognosis" patients with grades 1 and 2 preoperative histology, hysterectomy revealed a more serious histologic type. Three of the seven (43%) had extrauterine spread. In the 16 "poor prognosis" patients with preoperative grade 3 or papillary serous/clear cell carcinoma, 14 (88%) had a similar histologic pattern at hysterectomy. Three of these patients had metastatic disease. Depth of myometrial invasion could not be predicted by preoperative histology even though the data suggested that extrauterine spread could. Clinical stage I endometrial carcinoma, grade 1 or 2, should not be treated without para-aortic nodal sampling based only on a supposedly favorable preoperative histologic pattern. Confirmed para-aortic nodal disease will alter the fields of post-operative radiation therapy should that become necessary. In these patients, however, pelvic lymphadenectomy is not justified.2 + PMID- 2776783 TI - Monoclonal antibodies in serological, immunoscintigraphic and immunocytochemical diagnosis of epithelial ovarian cancer. AB - In present work the Authors examine the utility of CA 125 assay in patients affected by epithelial ovarian cancer. It is stressed that marker negativity does not necessarily imply the absence of disease. On the other hand the Authors underly the almost total absence of false positives, the only problem being with cases of benign gynaecological pathologies. The CA 125 assay appears to provide informations in the evaluation of response to therapy. Finally they note two more recent applications of monoclonal antibodies: first, marking these substances with radioisotopes; second, immunohistochemistry that shows the presence and location of the antigen at the histological level. (By editorial staff). PMID- 2776784 TI - Surgery and radiotherapy in the treatment of early stage uterine sarcomas. AB - Twenty-three patients with early stage uterine sarcomas underwent surgery (5 patients) or surgery and pelvic irradiation (18 patients). Twelve (52%) of the patients developed a recurrence: relapsing disease was pelvic in 3 (25%) of them, extrapelvic in 8 (66.7%) and both pelvic and extrapelvic in one (8.3%). Out of the whole series the 2- and 5-year actuarial survival rates were 61% and 33% respectively. Among the patients with leiomyosarcoma the 2- and 5-year actuarial survival rates were 54% and 39% respectively. Among the patients with carcinosarcoma the 2- and 5-year actuarial survival rates were 66% and 23% respectively. The high incidence of extrapelvic recurrences after locoregional treatment seems to suggest the use of an adjuvant chemotherapy in the management of patients with early stage uterine sarcomas. PMID- 2776785 TI - Familial ovarian cancer: a study of 11 families. AB - In a group of 152 ovarian cancer patients, 11 cases with familial recurrence were investigated (7.23%). Of the families evaluated we found 26 patients with ovarian cancer and twenty two with different cancers in other sites. In ovarian cancer the familial aspect, despite its relatively low frequency, is one of the few factors for identifying "high risk" patients, thus allowing effective secondary prevention. PMID- 2776786 TI - The therapy of verrucous carcinoma of the vulva. Observations on three cases. AB - Vulvar verrucous carcinoma is a distinct variant of squamous cell carcinoma, with a very low biological aggressiveness. Surgery is considered to be the elective treatment, even if there is no agreement in literature about the extent of surgical resection. Radiotherapy cannot be used in the management of this neoplasia. Sometimes this therapeutic modality induces an anaplastic transformation of the tumor, which can turn into a more aggressive malignancy. In this paper the clinical histories of 3 patients with vulvar verrucous carcinoma are discussed, in particular as regards therapy. PMID- 2776787 TI - Can pregnancy aggravate the course of non-Hodgkin's lymphoma? AB - The Authors present three cases of Non-Hodgkin's Lymphoma (NHL) in pregnancy and discuss about problem of diagnosis and management of NHL in this condition. They stress that the diagnosis of NHL in pregnancy is delayed and the clinical progression of lymphoma is probably influenced by hormonal and immunological changes occurring during pregnancy. On the other hand the management of NHL is problematic because radiotherapy is potentially teratogenic. (By editorial staff). PMID- 2776788 TI - Concanavalin A--horse radish peroxidase (Con A-HRP) labelling technique in detection and prognosis of cancer of uterine cervix. AB - The lectin binding capacity of the exfoliated epithelial cells of the uterine cervix was investigated with a modified concanavalin A - horse radish peroxidase labelling procedure. The normal healthy females exhibited a distinct rise in the percentage of labelled cells in comparison to those bearing squamous cell carcinoma. In the treated group, the responsive patients again exhibited a higher labelling percentage than the non-responsive patients - showing that the method is of both diagnostic and prognostic significance. PMID- 2776789 TI - Dedifferentiating endometrial adenocarcinoma. Report of a case. AB - A case of well differentiated endometrial adenocarcinoma in a 70 year-old patient is reported, which evolved to undifferentiated small cell after being treated with chemotherapy for six months. The possible mechanisms of dedifferentiation are briefly discussed. PMID- 2776790 TI - Abstracts of the scientific meeting of the Dutch Society of Nuclear Medicine. March 17, 1989, Meppel. PMID- 2776791 TI - Improved detection of coronary artery disease by estimated myocardial thallium uptake. AB - Myocardial thallium uptake has been assessed at the time of thallium scanning in a group of 50 male patients undergoing coronary arteriography and 10 young healthy volunteers. The net thallium dose injected was obtained by counting the dose prior to injection using the gamma camera and counting the syringe and IV cannula after injection. Significantly higher levels of myocardial thallium uptake were obtained in both the volunteers and patients with normal coronary anatomy (1.36% +/- 0.32%, n = 10 and 0.93% +/- 0.26%, n = 9, respectively) compared to patients with single, double or triple vessel coronary artery disease (0.63% +/- 0.19%, n = 11; 0.70% +/- 0.20%, n = 15; 0.67 +/- 0.18, n = 15, respectively). Exercise tests were positive in 46% of patients with coronary artery disease with an overall predictive accuracy of 56%. Thallium scans were positive in 68% of patients at a specificity of 89%. If the range of myocardial thallium uptake from the patients with normal coronary arteries is used to define a lower limit of normal, then the sensitivity of the thallium scan with thallium uptake is 90% with a predictive accuracy of 90% in the detection of significant coronary artery disease in this group of patients. Thus, estimation of total % thallium uptake is a simple index which yields useful diagnostic clinical information. PMID- 2776792 TI - Fatty acid myocardial imaging using 123I-beta-methyl-iodophenyl pentadecanoic acid (BMIPP): comparison of myocardial perfusion and fatty acid utilization in canine myocardial infarction (occlusion and reperfusion model). AB - To evaluate the relationship between myocardial perfusion and fatty acid metabolism in canine myocardial infarction, 16 dogs were studied using thallium and 123I-beta-methyl-iodophenyl pentadecanoic acid (BMIPP). Eight dogs (group A) had left anterior coronary arterial occlusion (6 h ligation), 6 dogs (group B) had reperfusion (3 h ligation and 1 h reperfusion) and 2 dogs served as the normal control. Myocardial imaging with BMIPP was excellent, owing to its higher uptake and longer retention in myocardium and rapid blood disappearance in addition to diminished liver and lung uptake. The mean half time value which was generated from the BMIPP myocardial washout curve, was significantly larger in the reperfused myocardium. The gamma camera imaging showed uncoupling of BMIPP and thallium (BMIPP uptake greater than thallium uptake) in five dogs in group B. On the other hand, all dogs in group A had a persistent defect in BMIPP and thallium uptake. Our findings indicate that the combination of BMIPP and thallium for myocardial imaging supply different information about the zone of infarction and ischemia, which may be useful for the assessment of myocardial viability. PMID- 2776793 TI - A measurement of regional portal blood flow with Xe-133 and balloon catheter in man. AB - This investigation was undertaken to measure regional portal blood flow of the liver. The measurement was performed by injecting 133Xe into the proper hepatic artery through a balloon catheter and then occluding the proper hepatic artery with an inflated balloon. Data were collected using a gamma camera, and washout curves were generated. They were analyzed by the initial slope method and Kety Schmidt equation. The average regional portal blood flows were: 59.31 +/- 13.04 ml/100 g per min, 58.71 +/- 14.14 ml/100 g per min and 37.12 +/- 10.11 ml/100 g per min in hospital controls (11), patients with chronic hepatitis (10) and those with liver cirrhosis (56), respectively. In the patients with cirrhosis, the regional portal blood flow was significantly reduced (P less than 0.01). The reproducibility of this method was satisfactory. The measurement of regional portal blood flow will be useful to evaluate underlying liver injuries and determine indications of a transcatheter arterial embolization of the liver. PMID- 2776794 TI - An unusual scintigraphic pattern in sickle cell patients. AB - We reviewed the nuclear medicine files of all patients enrolled in the sickle cell disease clinic who had had scans performed within the previous 5 years. We specifically looked for patterns of tracer uptake in these scans that would correlate with the severe anemia and consequent bone marrow hyperactivity of sickle cell patients. Thirty-three patients were included (21 men and 12 women) with a mean age of 26.8 years (range 17-48 years). The appearance of each of these patients' most recent scans was examined in the areas of the distal femurs, the proximal tibias and the distal tibias; a distinct triangular shaped pattern of increased activity was identified in these areas in a majority of patients. Thirty-three patients without sickle cell disease served as age-matched controls. This pattern was seen in 65.1% (95 out of 146 images) of the sickle cell patients' delayed images and 80.4% (82 out of 102 images) of their blood pool images. In contrast, the control patients demonstrated the triangular pattern in none of their blood pool studies (0%) and only 10.9% of their delayed bone images (P less than 0.001). The mean age of sickle cell patients with this pattern is 25.6 years which was significantly lower than that of those without this pattern (mean = 37.5 years, P less than 0.05). Given the high prevalence of this unique scintigraphic pattern in a group of patients with known accelerated bone marrow function, these findings may be scintigraphic evidence of bone marrow expansion. The patient's age appears to be an important factor in visualization of this pattern. PMID- 2776795 TI - Kinetic data of in-vivo labeled granulocytes in humans with a murine Tc-99m labelled monoclonal antibody. AB - Twenty-five patients were examined in vivo with 99mTc labelled monoclonal antibodies; 15 with suspected infections with an antigranulocyte antibody (BW 250/183), 10 with suspected recurrence of a colorectal carcinoma with an anti CEA antibody (BW 431/26). Both antibodies were IgG1 isotypes. In the patients with suspected infections no change of the peripheral leukocyte count could be observed after the antibody injection (1 mg, n = 9; 0.5 mg, n = 1; 0.25 mg, n = 6). In 2 patients examined with the anti CEA antibody (2 mg), a significant decrease of the peripheral leukocyte count could be observed. The recovery rate of the 99mTc antibody labelled granulocytes was calculated to be about 10%. The increase of the antibody-antigen binding was calculated to be 0.2%/min. In vivo the organ distribution curves demonstrated an increase of 99mTc activity over spleen and bone marrow of 1.1%/min, which was interpreted as antigen-antibody reactivity. The organ distribution curves of the anti granulocyte antibody over spleen and bone marrow showed typical binding characteristics to the local granulocyte epitopes. The curves over other organs showed a simple perfusion pattern. The curves of the anti CEA antibody showed a perfusion pattern over all the examined organs. A sham dialysis model in one patient with renal insufficiency undergoing regular dialysis treatment demonstrated the viability of 99mTc antibody labelled granulocytes in vivo. The kinetic patterns of the 99mTc antibody in patients with Crohn's disease were interpreted as CEA binding of the antibody in the bowel wall. PMID- 2776797 TI - Enhancement of clearance of plant lectins as radiopharmaceuticals by chemically glycosylated antilectin antibody. AB - The influence of chemical glycosylation on clearance of plant lectins, employed as radiopharmaceuticals, was assessed. Controlled chemical modification of the antibody to concanavalia ensiformis agglutinin did not affect its immunologic activity, but led to rapid clearance from circulation. In tumor-bearing mice, notable increases of selected tumor/non tumor ratios even after only 1 h of presence of the galactosylated antibody to the lectin in circulation were observed. Similarly, galactosylated antibody to pisum sativum agglutinin caused significant increases of tumor/non tumor ratios. PMID- 2776796 TI - Metabolism of methyl-branched iodo palmitic acids in cultured hepatocytes. AB - The metabolic fate of methyl-branched iodo fatty acids was studied in primary culture of rat hepatocytes. We compared 16-iodo-2-R,S-methyl palmitic acid (2 Me), which can be beta oxidized, with 16-iodo-3-R,S-methyl palmitic acid (3-Me) which can be beta oxidized only after an initial alpha oxydation and with 16-iodo 2,2-dimethyl palmitic acid (2,2-Me2) and 16-iodo-3,3-dimethyl palmitic acid (3,3 Me2) which cannot be beta oxidized at all. The normal fate of natural fatty acids was given by comparative experiments with [1-14C] palmitic acid. Monomethyl branched iodo fatty acids were taken up in the same range as palmitic acid but more than dimethyl-branched iodo fatty acids. After a 15-h incubation, acido soluble products (ASP) accounted for 75% of the radioactivity taken up as 16-iodo 2-methyl palmitic acid, 50% as other methyl-branched iodo fatty acids and only 30% as palmitic acid, which indicated that all the methyl-branched iodo fatty acids underwent a strong deiodination process. Fatty acids were esterified in the following order: palmitic acid greater than 16-iodo-3-R,S-methyl palmitic acid greater than 16-iodo-2-R,S-methyl palmitic acid greater than 16-iodo-2,2-dimethyl palmitic acid greater than 16-iodo-3,3-dimethyl palmitic acid. Cultured hepatocytes, labelled for 3 h with the various fatty acids and reincubated for 12 h without fatty acid, secreted large amounts of free dimethyl-branched iodo fatty acids as compared to the monomethyl ones and palmitic acid.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2776799 TI - European Association of Nuclear Medicine Congress. August 28, 1989-September 1, 1989, Strasbourg, France. Abstracts. PMID- 2776800 TI - [Three-country meeting on electron microscopy. Meeting of the Austrian Society for Electron Microscopy, meeting of the Swiss Society for Electron Microscopy, 24th meeting of the German Society for Electron Microscopy, 22d colloquium of the Study Groups for Electron Microscopy Direct Imaging and Surface Analysis. Salzburg, 10-16 September 1989. Abstracts]. PMID- 2776798 TI - Mechanism of 201Tl uptake in tumours. AB - We have studied the mechanism of tumour uptake of 201Tl by in vivo and in vitro studies. In a series of patients with breast cancer (n = 26), lung cancer (n = 56) and lymphoma (n = 15), the time course of tumour uptake of 201Tl paralleled that in the myocardium with almost identical times of peak uptake being obtained in tumours and myocardium. In a patient with hepatic metastases from colonic cancer undergoing laparotomy, 99mTc labelled microspheres and 201Tl were injected into the hepatic artery and biopsies of metastatic and normal liver tissue obtained. The tumour to normal liver activity ratios for 201Tl were one tenth of those for 99mTc microspheres. In the final part of the study, cells from a lung cancer tissue culture line were incubated for 30 min with 201Tl with and without the addition of cardiac glycoside, which acts a sodium potassium pump blocker. The cells exposed to the cardiac glycoside showed markedly decreased uptake of 201Tl compared to the cells not so exposed (0.6% +/- 0.1% vs 11.8 +/- 0.7.2% of the administered dose). The mechanism of 201Tl uptake of tumours is similar to that in the myocardium. Sodium potassium pump activity appears to be more important than tumour blood flow. 201Tl uptake may provide a useful means of studying tumour viability. PMID- 2776801 TI - Eighth meeting of the Italian Association for Cell Biology and Differentiation. Salsomaggiore Terme (Parma), 16-19 October 1989. Abstracts. PMID- 2776802 TI - The role of repeat transurethral resection in stage A1 carcinoma of the prostate. AB - Between 1983 and 1987 repeat transurethral resection (TUR) was performed in 20 patients with a diagnosis of stage A1 prostatic carcinoma. The average weight of the resected tissue in the repeat TUR was 8.81 g (range 3-20 g). In 5 of 20 cases (25%) residual prostatic cancer was identified. By adding the number of foci with cancer obtained at the initial operation with the repeat TUR, 16 cases (80%) remained as A1 and 4 cases (20%) were reclassified (upstaged) to A2. The usefulness of this technique in the restaging of patients with incidental carcinoma of the prostate is analyzed. PMID- 2776803 TI - Electrical resistance of appliances as a cause of urethral stricture following transurethral resection of prostate. AB - We performed transurethral resection for prostatic hypertrophy on 128 patients, and encountered 6 causes of postoperative urethral stricture. As they occurred during a short period, we investigated the causes. An electrical check revealed electrical resistance of more than 10,000 omega in the electric cord of a resectoscope. When an unused loop was connected with three used cords (No. 1, 2 and 3) and a new cord, the resistances were 2,000, 5,000, 0.9 and 0.5 omega, respectively. Moreover, the respective resistances were 15,000, 1,150,000, 1.3 and 0.9 omega when a used loop was tested. These findings suggested that the excessive resistance resulted from the use of a worn cord and that the used loop caused the postoperative urethral stricture. PMID- 2776804 TI - Two years clinical experiences with extracorporeal shock-wave lithotripsy and transurethral ureterolithotripsy for ureteral stones at Osaka City University Hospital. AB - From July 1985 to June 1987, 303 patients with ureteral stones were treated by either extracorporeal shock-wave lithotripsy (ESWL) or transurethral ureterolithotripsy (TUL). The ureteral stones were classified into two groups, upper and lower ureteral stones. The upper ureteral stone was defined as a stone located above the pelvic brim in radiological examinations. ESWL was performed using a Dornier lithotriptor HM-3. For TUL, following the insertion of a guide wire and dilatation of the intramural ureter by ureteral bougie, a ureteroscope was introduced into the ureter. The success rate included both patients who became stone free and patients whose stones were disintegrated into less than 4 mm. The success rate of ESWL for upper ureteral stones was 90%, and 8.5% were treated subsequently by TUL. The success rate of TUL for upper ureteral stones was 42%, and the remaining required another session of TUL or another procedure, mainly ESWL. On the other hand, the success rate of TUL for lower ureteral stones was 71%, and the remainder also required another session of TUL or another procedure, mainly ESWL. The efficacy of TUL for stone street was comparably low by the evaluation done at 5 days after the procedure. However, almost all patients with stone street, which had developed after ESWL treatment, became stone free several weeks after TUL and insertion of a stent catheter. Major complications or side effects for ESWL were fever of more than 37.5 degrees C (7.5%) and pain attacks (8.9%).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2776805 TI - Risk factors in outpatient extracorporeal shock wave lithotripsy. AB - At present, outpatient extracorporeal shock wave lithotripsy (ESWL) is practiced in many centers for the treatment of urinary calculi. The safety of outpatient treatment is difficult to assess, no appropriate indications and criteria for patient selection have been established. In a retrospective study 1,203 patients, treated with ESWL using the Dornier HM-3 lithotriptor for the first time over the year 1986, were evaluated to analyze possible risk factors for outpatient ESWL. By multivariate analysis various pretreatment factors were investigated for their relation with complications arising from ESWL therapy. It was shown that stone size and sex of the patient were the strongest determining factors. In the present study a low-risk group (5% complications) could be identified, suitable for outpatient treatment, corresponding to 74% of the patient population. The remaining patients (26%) are at higher risk (18% complications) and should be considered for hospital treatment. PMID- 2776806 TI - Successful treatment of radiation cystitis with hyperbaric oxygen. AB - This report describes the results of hyperbaric oxygen therapy in 10 patients with radiation-induced cystitis. Severe macroscopic hematuria was present in all patients and was resistant to current therapy. Previously 8 patients had been treated for bladder carcinoma and 2 for prostatic carcinoma with 60 Gy radiotherapy. Hyperbaric oxygen therapy consisted of 20 sessions of 100% oxygen inhalation at 3 bar pressure for 90 min. In 6 patients the macroscopic hematuria stopped completely and it decreased in the other patients. These 4 patients had recurrent or residual bladder malignancies. PMID- 2776807 TI - Severe arterial insufficiency in impotence confirmed with an improved angiographic technique: the impact of smoking and some other etiologic factors. AB - Arteriography of the penile arteries in patients with pharmacologic erection has been performed by our group since 1983. Pathological Doppler findings and weak response to locally administered papaverine or alpha-blocking agents in these impotent men led to pharmacoangiography in 17 of 372 patients with erectile dysfunction; of these 372 patients 130 (35%) had subnormal penile blood flow according to Doppler ultrasonography. Only one had a proximal lesion (occlusion of the right common iliac artery) while the rest had distal lesions. Three patients were nonsmokers and the remaining 14 patients (82%) were smokers or had smoked previously. Only 2 of the 14 had other predisposing diseases. PMID- 2776808 TI - Long-term interferon treatment in metastatic renal cell carcinoma. AB - 20 patients with progressive metastatic renal cell carcinoma entered a trial in which the effect of a long-term 6-month regimen of recombinant interferon alpha 2b (rIFN) was studied. 15 patients were evaluable. 4 remissions were detected: 1 complete, and 3 partial. All remissions were seen within 3 months of the start of treatment. We conclude that a 3-month rIFN treatment in metastatic renal cell carcinoma is sufficient to make a distinction between responders and non responders. A review of the recent literature supports this conclusion. PMID- 2776809 TI - Urinary citrate excretion in patients with urolithiasis and normal subjects. AB - Citrate is a normal constituent of urine which combines with calcium to form a soluble salt. Urinary citrate excretion was examined in patients with urolithiasis and normal subjects by a specific enzymatic technique. There was a considerable overlap in the urinary citrate excretion between normal subjects and stone-formers, but the citrate-creatinine ratio, the citrate-calcium ratio and the citrate-magnesium-calcium ratio, which were all highly significantly lower (p less than 0.001) in stone-formers than in controls, proved most reliable in discriminating between these groups. PMID- 2776810 TI - Correlation of embryonic development and adult neoplastic changes of human prostate. AB - We have studied embryonic and fetal differentiation of the human prostate in relation to androgen-producing Leydig cell differentiation. We have studied the differentiation of human prostatic glands and the synthesis of acid phosphatase in vivo and in vitro. These studies have shown that the mesenchyme at the level of the openings of the para- and mesonephric ducts to the urethra was the local initiator of prostatic differentiation. All prostatic acini developed by epithelial outgrowths from the urethral epithelium. None of them grew from para- or mesonephric ducts. However, the epithelium on the colliculus seminalis differed from the rest of the urethral epithelium morphologically and in acid phosphatase content. Androgens accelerated differentiation in vitro and acid phosphatase activity was shown to be present in prostatic urethral epithelium and prostatic acini both in vivo and in vitro. According to these studies embryonic differentiation gives no direct answer to the localisation of adult neoplastic changes in different parts of the prostate, although in the posterior part there might be a mixture of cells from ductal and urethral epithelium. Secretion of acid phosphatase seems to be a constitutional phenomenon of this part of epithelium and is partly regulated by androgens. Epitheliomesenchymal interaction is important in differentiation and the role of this interaction in adult diseases might be valuable to be studied. PMID- 2776811 TI - Delayed nonurothelial metastatic lesions to the penis: a report of two cases. AB - Metastatic lesions to the penis are uncommon and originate most often from other genitourinary primaries. Diagnosis is usually easy, as the primary is already known in most cases. The metastases can very rarely be isolated and delayed for several years after the treatment of the primary tumor. We report two cases of penile metastases from nonurothelial primary lesions. A sigmoid adenocarcinoma was the primary in one case, a renal adenocarcinoma in the other. These two cases were distinctly unusual, as the metastases were delayed for several years after the treatment of the primary. Treatment was palliative with early death in both cases. PMID- 2776812 TI - Adenomatoid tumours of the male genital tract. Review of 5 men presenting with an intrascrotal swelling subsequently diagnosed as an adenomatoid tumour. AB - Adenomatoid tumours of the male genital tract are not commonly diagnosed pre operatively and there is some controversy regarding their management. We reviewed the case notes of 5 men who presented between 1980 and 1987 with an intrascrotal swelling subsequently diagnosed as an adenomatoid tumour. 3 had a testicular swelling and 2 of these underwent an orchidectomy. 2 had epididymal swellings and local excision was performed. The histopathology and management of adenomatoid tumours are discussed. PMID- 2776813 TI - Ureteral tumor with multiple Bowen's disease forty-two years after exposure to arsenic. AB - We report a case of ureteral tumor associated with Bowen's disease in a 67-year old man. The patient has a history of occupational exposure to arsenic 42 years before. Arsenic produces multiple cancers and these cancers are characterized by a long period of latency. PMID- 2776814 TI - Educating all children: ten years later. AB - This article reviews the Tenth Annual Report to Congress on the Implementation of The Education of the Handicapped Act (EHA), covering the 1986-1987 school year. In addition to reporting the current status of services (i.e., numbers of students served, their placement, resources allocated and needed for their support), the report also discusses and cites data pertinent to (a) transition from secondary education; (b) state and federal efforts anticipating full implementation of preschool special education services under Public Law 99-457; and (c) the classification of students with learning disabilities. Some directions for research on special education at a national level are suggested. PMID- 2776816 TI - Criteria for the choice and definition of healthy volunteers and or patients for phase I and phase II studies in drug development. Commentary on an action for cooperative research. PMID- 2776815 TI - Follow-up of postsecondary-age rural learning disabled graduates and dropouts. AB - This article reports the dropout rates, basic skills competency levels, and employment status of a group of semi-rural learning disabled postsecondary-age youth and a control group of nonlearning disabled same-age peers. Findings indicated significantly higher dropout rates and significantly lower basic skills competency levels among learning disabled youth. Learning disabled graduates and dropouts were not different in how they fared in the employment market for the group, nor were they different compared to peers. Educational implications of these findings and future suggestions for follow-up research are discussed. PMID- 2776817 TI - Lidocaine treatment of neonatal convulsions, a therapeutic dilemma. AB - Three infants with neonatal convulsions were given lidocaine infusions for three days, three weeks and three months, respectively, and the plasma concentrations of lidocaine and its metabolites were analyzed by HPLC. After a prolonged infusion there was considerable accumulation of the metabolites. This may account for the difficulty of stopping the infusion without relapse of the seizures. PMID- 2776819 TI - The pharmacokinetics of ceftriaxone and cefotaxime in cirrhotic patients with ascites. AB - We have compared in two separate studies the kinetics of ceftriaxone and cefotaxime in 8 cirrhotic patients with ascites and 8 control subjects after a single 20 min intravenous infusion of 1 g of each drug. The apparent volumes of distribution (Vz) were found to be significantly higher in cirrhotics than in control subjects (0.87, versus 0.49, l.kg-1, for cefotaxime and 0.23 versus 0.13 for ceftriaxone). The elimination kinetics of ceftriaxone were similar in the two groups. In contrast, the total and non-renal clearances of cefotaxime were reduced in cirrhotic patients. The two drugs rapidly entered the ascitic fluid. Peritoneal concentrations of ceftriaxone were higher than 7 micrograms.ml-1 from the second hour after the infusion and were 8.9 micrograms.ml-1 at 24 h. Peritoneal concentrations of cefotaxime were higher than 4 micrograms.ml-1 from 0.5 to 8 h after the infusion. PMID- 2776820 TI - Use of prescription forgeries in a drug abuse surveillance network. AB - Data on forged prescriptions in Sweden in 1982-1986 were studied as an indicator in an epidemiological survey of medication abuse. The annual number of prescription forgeries doubled during the 5-year period. Psychotropic drugs accounted for 62% and analgesics for 25% of all forgeries. Benzodiazepines were the major single drug group, comprising 52% of all forgeries during the period. The major benzodiazepines on the market in Sweden (diazepam, oxazepam, nitrazepam and flunitrazepam) were the subject of largest number of forgeries. When calculated in relation to the utilization (either total sales or the number of prescriptions), the analgesics codeine, pentazocine and ketobemidone were clearly at the head of the list, suggesting greater abuse liability of these drugs. It is suggested that the data on forged prescriptions can be used as a "signalling mechanism" in epidemiological surveillance of medication abuse, aimed at detecting changes in the prevalence as well as in the pattern of abuse. PMID- 2776818 TI - The hyperventilation-induced ischaemia model in human neuropharmacology: neurophysiological and psychometric studies of aniracetam and 3-OH aniracetam. AB - Standardized hyperventilation in young subjects induces changes in the EEG, a decrease in the velocity of the cerebral blood flow and a decline in cognitive performance, which are comparable to those occurring in patients with cerebral ischaemia. The anti-ischaemic properties of aniracetam and 3-OH aniracetam were tested in this model. A single oral dose of 3-OH aniracetam 1500 mg appeared to have the most pronounced effect on hyperventilation-induced EEG changes and cognitive deterioration. The test drugs had no effect on the heart rate or blood flow velocity. The effects agree with those of other drugs classified as nootropics. PMID- 2776821 TI - Sustained-release and instant-release verapamil in treatment of angina pectoris. AB - The efficacy of a sustained-release preparation of verapamil (verapamil-SR) has been compared with that of a conventional instant-release formulation (verapamil IR) in 10 patients with stable angina pectoris treated for 3 weeks with both preparations. The diurnal serum concentrations of verapamil and norverapamil did not differ significantly during treatment with verapamil-IR 120 mg t.i.d. and verapamil-SR 360 mg once daily, but verapamil-SR 240 mg produced significantly lower serum concentrations. The differences did not affect the exercise capacity or the occurrence of ST-segment depression during maximal exercise. Verapamil-SR was well tolerated. A multiple instant-release dosage regime can now be replaced by once daily administration of the sustained-release preparation. PMID- 2776822 TI - Comparison of trimethadione and antipyrine as indicators of oxidative drug metabolizing capacity in man. AB - Ten healthy male volunteers were given trimethadione (TMO) 4 mg/kg and antipyrine (AP) 500 mg alone or concomitantly to determine whether the metabolism of the drugs was mediated by the same or closely related forms of cytochrome P-450. Whether administered alone or together the clearance (CL) and half-life (t 1/2) of TMO and AP were the same, and there was a good correlation between the CL and t 1/2 of TMO and AP (alone r = 0.755 and 0.623, respectively; coadministered r = 0.771 and 0.503, respectively). Excretion of AP and its main metabolite and the clearance for production of AP metabolites after AP was administered alone were not significantly different when TMO and AP were taken together. When the two drugs were administered alone or coadministered, the correlation between the CL of TMO and the excretion of 3-hydroxymethyl-3-norantipyrine (NORA) was close (alone r = 0.734, coadministered r = 0.749). The correlation between the CL of TMO and CLm of NORA when TMO and AP were given alone or concomitantly was 0.762 and 0.772, respectively. The findings suggest that TMO metabolism and the formation of NORA in healthy subjects are mediated by a closely related form(s) of the cytochrome P-450 system. PMID- 2776823 TI - Pharmacokinetics and tolerance of a new penem antibiotic, FCE 22101, in healthy volunteers after a single intravenous dose. AB - The clinical tolerance and pharmacokinetics of FCE 22101 (sodium (5R, 6S)-6-[(1R) hydroxyethyl]-2-carbamoyloxymethyl-2-penem-3-carboxylate), a new penem antibiotic, have been studied after giving a single i.v. dose of 4 mg.kg-1 to ten healthy male volunteers. The pharmacokinetics was estimated according to a two compartment open model. The peak plasma concentration (Cmax) was 15.5 (1.08) micrograms.ml-1, mean (SEM). FCE 22101 was rapidly cleared from the systemic circulation [t 1/2 lambda z = 44.2 (4.2) min; CL = 7.21 (0.47) ml.kg-1.min-1]. The mean apparent volume of distribution at steady-state was 246 (16.9) ml.kg-1. The mean residence time relative to the 10 min infusion was 39.4 (1.5) min. Urinary recovery of FCE 22101 showed wide inter-subject variation, ranging from 10.2 to 53.6% of the dose. No subject complained of adverse effects. PMID- 2776824 TI - Comparative pharmacokinetics of zidovudine (AZT) and its metabolite (G.AZT) in healthy subjects and HIV seropositive patients. PMID- 2776825 TI - Use of ranitidine in young infants with gastro-oesophageal reflux. PMID- 2776826 TI - Interception of the development of self tolerance in fetal lambs. AB - Investigation of the nature of immunological self tolerance has usually relied upon experimental protocols in which the tolerant state is interrupted in mature animals with the production of autoimmune disease. While such research has improved the understanding of those processes operative in overt autoimmunity, it has not been informative in relation to events associated with the establishment of self tolerance. Any description of this state which is to be based on observation will necessitate the use of experimental systems that permit observation of animals during the development of self tolerance. The present experiment entailed intervention approximately one third of the way through the gestation period of fetal lambs. An earlier experiment had established that 54 day fetal lambs would accept allografts of adult skin. This indicated that the capacity to discriminate between self and non-self had not been acquired at that age. Fetuses at this stage of gestation were submitted to either partial or total removal of the thyroid gland. The excised tissue was then implanted in nude mice for periods of 5 to 9 weeks. It was subsequently replaced subcutaneously, either in the original donor or in another fetus at a comparable stage of gestation. At postmortem examination, several weeks later, self implants in lambs from which the thyroid gland had been completely removed displayed autoimmune thyroiditis of varying degrees of severity. However, self implants in partially thyroidectomized animals were uniformly free from autoimmune manifestations. This implied that these reactions had not been directed against contaminating murine tissues in the implants replaced in completely thyroidectomized lambs. All allogeneic implants were subject to vey heavy lymphocytic infiltration, usually with accompanying necrosis consistent with allograft rejection. This was taken as an indication that hypothyroid fetal lambs had become immunocompetent by the time of thyroid reimplantation. Spontaneous immunological reactivity against reimplanted self thyroid tissue by thyroidectomized lambs was interpreted as a failure to acquire the capacity for self recognition as a result of antigen deprivation. PMID- 2776827 TI - Suppression of antibody responses to the acetylcholine receptor by natural antibodies. AB - Some relationships between "natural" physiological autoreactivity and antibody responses against the acetylcholine receptor (AChR) were investigated. Collections of unselected monoclonal antibodies were derived from nonmanipulated newborn mice of susceptible (BALB.B) and resistant (BALB/c) mouse strains, and screened for reactivity with heterologous AChR. Five in 200 BALB/c but none in 200 BALB.B clones were found reactive. Four of these anti-AChR antibodies were analyzed for connectivity to nine other antibodies in the same collection, and three of them found to react with a particular natural anti-idiotype. The functional in vivo significance of such natural idiotypic complementarities in the anti-AChR response could then be investigated. Treatment of BALB/c newborn animals with low (100 ng) or high (100 micrograms) doses of natural anti-idiotype significantly suppressed their anti-AChR antibody response when immunized as adults. The utilization of natural anti-idiotype reagents with broad reactivity patterns might overcome the known idiotype heterogeneity of the autoimmune antibody response to AChR and provide a strategy in prophylactic and therapeutic manipulation of disease development. PMID- 2776828 TI - Comparison of selective and complete inhibitors of enkephalin-degrading enzymes on morphine withdrawal syndrome. AB - We investigated the effects of thiorphan, a selective inhibitor of endopeptidase 24.11 'enkephalinase', kelatorphan ((R)-3-(N-hydroxy-carboxamido-2 benzylpropanoyl)-L-alanine), and RB 38 A ((R)-3-(N-hydroxycarboxamido-2 benzylpropanoyl)-L-phenylalanine) two almost complete inhibitors of enkephalin metabolism, on the naloxone-precipitated morphine withdrawal syndrome in rats. Inhibitors administered intracerebroventricularly reduced several symptoms of the withdrawal syndrome. Jumping, chewing and tooth chattering were decreased by all drugs. The rise in plasma corticosterone and the hypothermia were reduced by kelatorphan and RB 38 A whereas rhinorrhea was blocked by thiorphan, tremor by kelatorphan and diarrhoea by RB 38 A. Other signs remained unchanged. These data suggest that an increase in opioid receptor occupancy by endogenous opioid peptides, protected from biotransformation specially by mixed inhibitors reduced the severity of the morphine abstinence symptoms in rats. PMID- 2776829 TI - Effect of cholecystokinin on acetylcholine turnover and dopamine release in the rat striatum and cortex. AB - The effect of sulfated cholecystokinin (CCK-8S) on acetylcholine turnover (TRACh) and dopamine (DA) release in the rat cerebral cortex and striatum was studied in unanaesthetized animals in vivo. CCK-8S (1 mg/kg s.c.) decreased TRACh in the fronto-parietal cortex but not in the striatum. This effect was prevented by peripheral (10 mg/kg i.p.) but not central (1 microgram i.v.t.) administration of the peripheral CCK receptor antagonist CR 1409. In a separate study, CCK-8S decreased 3-methoxytyramine (3-MT) levels (an index of DA release) in the fronto parietal cortex and in the striatum. CR 1409 appeared to have a partial agonist action, reducing cortical and striatal 3-MT levels, and only partially reversing the effect of CCK-8S in the striatum. These data indicate that peripheral administration of CCK-8S decrease TRACh in the cortex but not in the striatum and that this action is mediated by peripheral-type CCK receptors possibly located outside the CNS. CCK-8S also reduces DA release in the cortex and in the striatum, and this effect appears to be mediated by a mechanism of action different from that modulating cortical TRACh. PMID- 2776830 TI - Characterization of contractile prostanoid receptors on human airway smooth muscle. AB - In human bronchial rings the thromboxane A2 (TxA2) mimetic, U46619, produced cumulative concentration-related contractions up to a maximum of 141 +/- 23% of the response induced by carbachol or acetylcholine. The geometric mean EC50 value was 3.2 X 10(-8) M (95% confidence interval: 1.2, 8.9 X 10(-8) M) (n = 5). Contractions to U46619 were unaffected by atropine (10(-6) M) or verapamil (10( 5) M), but were competitively antagonized by the TxA2 antagonist GR32191 with a pA2 value of 8.40 +/- 0.41. The maximum contractile response to prostaglandin (PG) F2 alpha was smaller (90 +/- 9%, n = 13) and the potency was less (EC50 = 2 X 10(-6) M) than that of U46619. Contractions to PGF2 alpha were also competitively antagonized by GR32191 with a pA2 value of 8.18 +/- 0.08. Concentration-response curves to PGE2 were biphasic, relaxation at concentrations from 10(-9) to 10(-6) M and contraction from 10(-6) to 3 X 10(-5) M. GR32191 10( 7) M inhibited the contractile portion of the response curve in 8 of 11 tissues. Based on these results we conclude that U46619, PGF2 alpha and PGE2 all contract human airways by stimulation of the TxA2 (TP) receptor. PMID- 2776831 TI - Indomethacin and acetylsalicylic acid block neurogenic plasma protein extravasation in rat dura mater. AB - Leakage of 125I-bovine serum albumin was measured in rat dura mater, conjunctiva, eyelid and lip, after unilateral electrical stimulation of the trigeminal ganglion. In one animal, 99Tc-human serum albumin leakage was imaged in ipsilateral facial tissues. Pretreatment with indomethacin 1 mg/kg i.p. decreased leakage in dura mater but not in extracranial tissues. When extravasation was expressed as a ratio of stimulated to unstimulated sides, indomethacin 1 mg/kg, or acetylsalicylic acid 50 mg/kg decreased this ratio from 1.80 to 1.27 (P less than 0.01) or from 1.84 to 1.21 (P less than 0.01), respectively. Dexamethasone (1 mg/kg i.p. tid X 1 day) caused only a very small decrease. Only large doses of indomethacin (10 mg/kg) or acetylsalicylic acid (50 mg/kg) reduced substance P (SP)-induced leakage in the dura. The latter results suggest that both drugs block plasma extravasation by acting on neuropeptides-induced changes in vascular permeability and/or smooth muscle contractility. However, inhibition of SP release from sensory axons cannot be excluded at concentrations which block neurogenic plasma extravasation but not SP-induced plasma leakage. Together, these results provide a possible mechanism for the therapeutic effects of indomethacin and acetylsalicylic acid in headache. PMID- 2776832 TI - Doxofylline exerts a prophylactic effect against bronchoconstriction and pleurisy induced by PAF. AB - The effect of doxofylline, a new xanthine drug with a low incidence of side effects in the central nervous, renal and gastroenteric system, on the actions of PAF-acether on bronchopulmonary functions was studied. Doxofylline inhibited: (1) PAF-induced bronchoconstriction in vitro, and the concomitant generation of TXA2 like activity in perfused guinea-pig lungs; (2) PAF-induced bronchoconstriction in vivo and the concomitant release of TXA2-like activity into the circulation; (3) PAF-acether-induced pleurisy and the liberation of type C4 leukotriene into the rat pleural cavity. The results suggest that doxofylline, like theophylline, is able to counteract the bronchoconstriction induced by PAF-acether and, in addition, displays anti-inflammatory properties. These pharmacological data support the notion that doxofylline exerts a prophylactic effect against the respiratory damage induced by mediators, such as PAF-acether, of lung bronchial hyperreactivity; its mechanism of action is unusual, it has slight antagonistic activity at A1- and A2-adenosine receptors. PMID- 2776833 TI - Effects of MCI-154 on Ca2+ activation of skinned human myocardium. AB - We investigated the effects of MCI-154, a new inotropic agent, on tension development in saponin-skinned human trabeculae carneae. The skinned fibers were activated by buffer solutions containing varying concentrations of Ca2+ (10(-8) 10(-4) M). In the sigmoidal tension vs. pCa (-log[Ca2+]M) relationship, the Ca2+ concentration required for half-maximal activation was shifted leftward in the presence of MCI-154. Furthermore, maximal Ca2+-activated tension development was increased in a concentration-dependent manner by MCI-154. Our results suggest that the inotropic effect of MCI-154 may be due, in part, to an increased sensitivity of the myofilaments to Ca2+ and enhancement of maximal Ca2+-activated tension development. PMID- 2776834 TI - The use of ryanodine and calcium channel blockers to characterize intra- and extracellular calcium pools mobilized by noradrenaline in the rat vas deferens. AB - Ryanodine (0.03-10 microM) abolished the phasic component of the contractile response to noradrenaline in the rat vas deferens but had less effect on the tonic component of this response. In contrast, nifedipine and methoxyverapamil (D600, 0.3-0.8 microM) blocked only the tonic component of the noradrenaline, adrenaline or phenylephrine-induced contractions. These results suggest that the phasic component of the noradrenaline-induced response is related to the release of intracellular calcium whereas the tonic phase of the contraction involves calcium influx via membrane channels sensitive to dihydropyridine and diphenylalkylamine calcium channels blockers. PMID- 2776836 TI - Stress-induced enhancement of dopamine and acetylcholine release in limbic structures: role of corticosterone. PMID- 2776835 TI - Effects of anticholinergic drugs on regional brain neurotensin concentrations. AB - Chronic treatment with atropine sulfate (20 mg/kg), atropine methyl bromide (20 mg/kg), or scopolamine (2 mg/kg) did not increase neurotensin concentrations in the nucleus accumbens or caudate nucleus. Chronic co-administration of atropine sulfate did not alter the increases in neurotensin concentrations in the nucleus accumbens and caudate nucleus produced by chronic treatment with haloperidol (1 mg/kg). The anticholinergic properties of antipsychotic drugs apparently do not mediate the increases in neurotensin concentration observed after chronic treatment with antipsychotic drugs. PMID- 2776837 TI - Interaction of telenzepine with muscarinic receptors in mammalian sympathetic ganglia. AB - The interaction of the antimuscarinic drug telenzepine with muscarinic receptors was studied in rabbit and rat isolated superior cervical sympathetic ganglia. Radioligand binding demonstrated two muscarinic receptor sites in rabbit ganglia, with the characteristics of M1- and M2-receptors. Telenzepine bound to the M1 sites with a KI of 0.94 nmol/l and to the M2 sites with a KI of 17.8 nmol/l; the corresponding values for pirenzepine were 18.6 and 588 nmol/l; for AF-DX 116 the values were 891 and 33 nmol/l respectively. [3H]Telenzepine dissociated from the M1-receptors with a half time of 46 min at 37 degrees C. Electrophysiological experiments demonstrated that telenzepine reduced the amplitude of the extracellularly recorded slow excitatory postsynaptic potential and the slow inhibitory postsynaptic potential (ED50: 38 and 253 nmol/l respectively). In rat ganglia, application of muscarine or the M1-receptor agonist McN-A-343 increased the amplitude of submaximal population action potentials. This facilitation of synaptic transmission was potently blocked by telenzepine and pirenzepine but only weakly by AF-DX 116 (ED50: ca. 30, 150 and 20 mumol/l, respectively). It is concluded that telenzepine blocks the generation of the slow excitatory postsynaptic potential and the excitatory action of muscarine and McN-A-343 via an action on muscarinic M1-receptors. PMID- 2776838 TI - Effect of adrenalectomy on correlation of analgesia with tissue content of morphine. AB - Adrenalectomy potentiated the antinociception of s.c. morphine (1.9-fold) but not that of i.c.v. morphine. After s.c. administration, the semilogarithmic plots of morphine content (plasma, brain, cerebrospinal fluid (CSF) or spinal cord) and morphine antinociception showed linearity for both sham-operated (SHAM) and adrenalectomized rats (ADX), and the regression lines for ADX showed leftward shifts (1.5-1.9-fold) compared with those for SHAM. After i.c.v. administration, the semilogarithmic plots of morphine content in brain or CSF and morphine antinociception showed linearity for both groups without difference in the regression lines for SHAM and for ADX, and the correlation between spinal morphine and antinociception was poor. Morphine was distributed in both brain and spinal cord after s.c., but was predominantly found in brain after i.c.v. administration. These results suggest that increased sensitivity to morphine is the main cause of adrenalectomy-induced potentiation of morphine antinociception and that adrenalectomy increases the sensitivity to morphine at the spinal site and/or potentiates the synergistic interaction of supraspinal and spinal morphine action. PMID- 2776839 TI - Behavioral aspects of GABAergic-dopaminergic interactions in the central nervous system. AB - GABAergic-dopaminergic relationships in rats were analysed quantitatively by means of behavioral studies. Acute and long-term haloperidol administration induced significant leftward displacement of the control dose-response curves for picrotoxin but not those for strychnine or 3-mercaptopropionic acid (3-MPA). Apomorphine given acutely increased the sensitivity of the animal to strychnine but not to picrotoxin or 3-MPA. In animals that presented convulsion a stereotyped gnawing and/or licking behavior was observed immediately after the ictus activity as a consequence of the combined acute administration of haloperidol and picrotoxin. Long-term haloperidol treatment increased the gnawing and/or licking behavior immediately before and/or after the ictus activity induced by picrotoxin (1 and 72 h after haloperidol withdrawal) or 3-MPA (72 h after withdrawal). A possible effect of the drugs employed on the DA nigroamygdaloid and/or the GABA-striatonigral fiber systems is discussed. PMID- 2776840 TI - Effect of aclarubicin on contractile response of rat aorta. AB - The effect of aclarubicin on vasocontractility was investigated using aortic strips isolated from rats. The aortic strips from rats injected i.p. with aclarubicin (4 mg/kg body weight per day for 5 consecutive days) showed diminished contractile responses to KCl and phenylephrine in comparison with the controls injected with 0.9% saline. In vitro preincubation of rat aorta with aclarubicin (20-80 micrograms/ml) attenuated the aortic contractile responses to KCl and phenylephrine compared with the control preincubated with 0.9% saline. These results suggest that aclarubicin reduces the contractility of vascular smooth muscle directly. PMID- 2776841 TI - Prepulse inhibition of the acoustic startle response is disrupted by N-ethyl-3,4 methylenedioxyamphetamine (MDEA) in the rat. AB - N-Ethyl-3,4-methylenedioxyamphetamine (MDEA) is a derivative of methylenedioxyamphetamine (MDA), a substituted amphetamine with demonstrated abuse liability. MDA, MDEA and a third substituted amphetamine, methylenedioxymethamphetamine (MDMA), all produce a destructive action on central serotonin neurons and appear to induce some similar behavioral effects. The present study investigated the effects of racemic MDEA and its stereoisomers on prepulse inhibition of the acoustic startle response, a behavioral model of sensorimotor gating that is sensitive to psychostimulant drugs. Rats were subjected to 122 dB[A] acoustic noises, some of which were preceded by a weak 80 dB[A] prepulse noise. In vehicle-injected control rats, the prepulse induced a significant decrease in startle amplitude when compared to trials in which startle stimuli were not preceded by prepulses. Administration of racemic MDEA (0.3-10.0 mg/kg) and (+) MDEA (0.1-3.0 mg/kg) induced a significant attenuation in prepulse inhibition, while (-) MDEA (0.3-10.0 mg/kg) did not. Racemic MDMA (0.3-10.0 mg/kg) produced similar though not significant effects. These results confirm a stimulant-like behavioral effect of MDEA despite its relatively modest effects on dopamine markers, and support findings that the (+) stereoisomers of substituted amphetamines are more potent than tha (-) stereoisomers in producing psychostimulant-like biochemical and behavioral effects. PMID- 2776842 TI - Neuropeptide Y (NPY): a coronary vasoconstrictor and potentiator of catecholamine induced coronary constriction. AB - The vasoactive effect of neuropeptide Y (NPY) a peptide commonly found in perivascular nerves, including those of the heart, was assessed in the coronary circulation of the isolated perfused dog heart and in superfused segments of isolated canine coronary arteries. The intracoronary administration of 0.7-23.5 nmol NPY to hearts during beta adrenergic blockade produced a dose-dependent increase in coronary vascular resistance ranging from 0.10 to 0.49 mmHg.min-1.ml 1.100 g-1 without changes in myocardial oxygen consumption. The potency of NPY as a coronary vasoconstrictor was about 250 times that of noradrenaline. Pretreating the coronary system of these hearts with NPY caused a marked potentiation of the vasocontractile effect of noradrenaline, displacing its dose-response curve to the left in a non-parallel fashion. The addition of 0.2-3.7 nmol NPY did not induce contraction in superfused helical segments of large coronary arteries but it potentiated the tension developed in response to 0.18 microM adrenaline in a concentration-dependent manner. Pretreatment of these arteries with 3.7 nmol NPY caused a significant leftward displacement of the adrenaline contractile effect. These results show that NPY is a potent coronary vasoconstrictor and a potentiator of the contractile effect of catecholamines and support the hypothesis that NPY may participate in the regulation of coronary vascular resistance. PMID- 2776843 TI - Facilitation of [3H]acetylcholine and [3H]5-hydroxytryptamine release from rat cerebral cortex synaptosomes by a factor extracted from the skin of the Australian frog Pseudophryne coriacea. AB - A partly purified extract of the skin of the Australian frog Pseudophryne coriacea (PsC) evoked the release of [3H]acetylcholine [( 3H]ACh) and of [3H]5 hydroxytryptamine [( 3H]5-HT) from superfused rat cerebral cortex synaptosomes prelabeled with [3H]choline or [3H]5-HT, respectively. The PsC-evoked release of both transmitters was sensitive to tetrodotoxin and was strictly Ca2+-dependent. The release of [3H]5-HT caused by PsC was unaffected by the 5-HT uptake inhibitor citalopram. Activation of muscarinic autoreceptors by ACh or of serotonin autoreceptors by 5-HT depressed the PsC-evoked release of [3H]ACh or of [3H]5-HT, respectively. It is concluded that PsC elicits a Ca2+-dependent exocytotic-like transmitter release, possibly by opening Na+ channels in the presynaptic membrane. PMID- 2776844 TI - Isolation and purification of acetylcholine receptor proteins by affinity chromatography. AB - In order to further molecular investigations on the binding capacity of acetylcholine receptors, a method was developed for the affinity chromatography of the nicotinic acetylcholine receptor. Reversibly binding cholinergic ligand groups were used as affinity ligands, instead of the well known snake venom alpha toxins. These ligands are small in size, chemically well defined and fixed to long spacer chains (at least 40 nm). One ligand, with a pharmacologically stabilizing effect on the receptor, was a derivative of gallamine. Another, with a depolarizing effect, resembled carbamoylcholine and a third was a derivative of decamethonium. The receptor proteins were isolated from Torpedo marmorata electric organs. Preparation included solubilization with a non-ionic detergent, alkaline treatment to extract peripheral membrane proteins and affinity purification. The receptor proteins eluted from the three affinity resins were identical in their assembly of subunits (alpha, beta, gamma and delta) but of different purity. Receptor proteins were obtained on a large scale within a short time and under mild conditions for elution with the affinity ligands of the decamethonium or the gallamine type. This was a considerable advantage compared to the use of alpha-bungarotoxin. PMID- 2776845 TI - Inhibition of nucleoside transport by a new series of compounds related to lidoflazine and mioflazine. AB - A new series of compounds related to the nucleoside transport inhibitors, lidoflazine and mioflazine, is introduced. The influence of these derivatives on nucleoside-specific transport proteins was studied in two ways. First, a rapid, non-radioactive assay was developed for the screening of this type of material for actual transport inhibition in human erythrocytes. The method is based on the dose-dependent reversal of the inhibition of inorganic phosphate release induced by inosine when human erythrocytes are suspended in a phosphate-free medium. It enables the estimation of the potency and specificity of this new series of nucleoside transport inhibitors, most of which are highly active (EC50 values as low as 13 nM). Second, the displacement of a radiolabeled transport inhibitor, [3H]nitrobenzylthioinosine, was examined. All compounds were capable of displacing specific [3H]nitrobenzylthioinosine binding to crude and solubilized plasma membranes of calf lung tissue, displaying affinities in the nanomolar range. Pseudo-Hill coefficients derived from the shape of the displacement curves were significantly greater than unity for most derivatives, in contrast to values of approximately unity obtained for dipyridamole and analogs. These findings were incorporated in a mathematical model describing the interaction of mioflazine analogs with the transport protein, suggesting that one molecule of mioflazine is capable of displacing two or more molecules of [3H]nitrobenzylthioinosine at a time. The consequences of this model regarding the nature of the transport protein are discussed. PMID- 2776846 TI - Inhibition of inositol phospholipid hydrolysis in endothelial cells by pentobarbital. AB - Barbiturates alter cardiovascular function, in part by an effect on vascular cells. However, a biochemical mechanism for the effect is unknown. We have, therefore, studied the effect of barbiturates on inositol phospholipid hydrolysis in cultured rat aortic endothelial cells. Hydrolysis was stimulated by angiotensin II, norepinephrine and phenylephrine. Pentobarbital, and other barbiturates, inhibited hydrolysis at pharmacological and clinical concentrations (0.1-0.5 mM). The inhibition by pentobarbital was concentration-dependent, reversed by washing, and was decreased by high concentrations of angiotensin II. Kinetic studies gave an apparent Km of hydrolysis by angiotensin II of 1.2 nM, which showed mixed inhibition by pentobarbital (Ki = 0.45 mM). Schild analysis of data obtained from pentobarbital inhibition curves also showed a deviation from a competitive type inhibition. [125I]Angiotensin II was bound to a high-affinity receptor (Kd = 1.2 nM), which showed a competitive type inhibition of binding by pentobarbital (0.5 mM). Although inhibition of [125I]angiotensin II binding appeared to be competitively inhibited by pentobarbital, the data, taken together, point to a deviation from a simple competitive type inhibition. PMID- 2776847 TI - Interaction of dihydrotetrabenazine binding activity with immobilized lectins. AB - High-affinity dihydrotetrabenazine binding activity was solubilized by treatment of crude bovine striatal synaptosomes with cholate and incubated with lectins immobilized on sepharose. Both concanavalin A and wheat germ lectin sepharose removed dihydrotetrabenazine binding activity from the cholate extract, and this removal was prevented by inclusion of the appropriate hapten sugars. These results imply that the dihydrotetrabenazine binding subunit of the synaptic vesicle catecholamine/serotonin (5-HT) transporter, or a vesicle component tightly associated with it, is glycosylated. PMID- 2776848 TI - Waterborne outbreak of Campylobacter enteritis after outdoors infantry drill in Utti, Finland. AB - Diarrhoea, abdominal pain, malaise and fever affected 75 of the 88 conscript soldiers in Utti, Finland after an outdoors infantry drill. Campylobacter jejuni, heat-stable serotype 3/43/59, was isolated from 37 out of 63 men investigated. A clear serological response was evident in the risk group and negligible in the control group. The entire population at risk was interviewed. The outbreak was associated with the consumption of untreated surface water. C. jejuni, heat stable serotype 3/43/59, was isolated on two occasions from the water source. PMID- 2776849 TI - Occupational exposure to Streptococcus suis type 2. AB - Antibody titres to Streptococcus suis type 2 were measured with an enzyme linked immunosorbent assay (ELISA) in four occupational groups in New Zealand. No veterinary students, 9% of dairy farmers, 10% of meat inspectors and 21% of pig farmers were seropositive to S. suis type 2. The development of antibody to S. suis type 2 was associated with occupational contact with pigs or their meat products. Subclinical infection with S. suis type 2 appears to occur in humans and the antibody produced is of only short duration. The annual incidence of subclinical infection and seroconversion in pig farmers may approach 28%. Thus S. suis type 2 may be one of the most infectious potentially zoonotic agents present in New Zealand, although very rarely resulting in clinical disease. PMID- 2776850 TI - DNA fingerprinting of Streptococcus uberis: a useful tool for epidemiology of bovine mastitis. AB - A simple and reproducible typing system based on restriction fragment size of chromosomal DNA was developed to compare isolates of Streptococcus uberis obtained from the bovine mammary gland. The endonuclease giving the most useful restriction patterns was Hind III. Although seven other endonucleases (Bgl 1, Eco R1, Not 1, Pst 1, Sfi 1, Sma 1, Xba 1) were also tested in the system. An image analyser was used to obtain a densitometric scan and a graphic display of the restriction patterns. Such a system will allow large scale data storage for future computer-aided comparison. PMID- 2776851 TI - Methicillin-resistant Staphylococcus aureus from China characterized by digestion of total DNA with restriction enzymes. AB - A series of clinical isolates of methicillin resistant Staphylococcus aureus (MRSA) from two hospitals in China was examined. Fragment patterns obtained by digestion of total cellular DNA with restriction enzymes were used to characterize the isolates, in combination with phage-typing, antibiotic resistance profile, and plasmid profile. Digestion of total cellular DNA with restriction enzymes was most useful in discriminating between isolates and yielded additional information on the relatedness of non-identical isolates. In one hospital a single strain, resistant to a large number of antibiotics, had apparently become endemic. In the second hospital a number of distinct but related strains were present. The isolates were also related but not identical to the strain of MRSA endemic at the London Hospital. PMID- 2776853 TI - Outbreaks of diarrhoeal illness on passenger cruise ships, 1975-85. AB - We reviewed data from the Vessel Sanitation Program (VSP), established by the US Public Health Service in 1975, to describe the epidemiology of shipboard diarrhoeal outbreaks, determine the risk of outbreak-related illness among cruise ship passengers, and evaluate changes in rates and patterns of shipboard diarrhoeal illness since the VSP was implemented. When the programme began, none of the cruise ships passed periodic VSP sanitation inspections; since 1978, more than 50% of ships have met the standard each year. On cruises lasting 3-15 days and having at least 100 passengers, diarrhoeal disease outbreaks investigated by the Centers for Disease Control decreased from 8.1 to 3.0 per 10 million passenger days between 1975-79 and 1980-85. The proportion of outbreaks due to bacterial pathogens (36%) did not change. Seafood cocktail was implicated in 8 of 13 documented food-borne outbreaks. The risk of diarrhoeal disease outbreaks on cruise ships appears to have decreased since implementation of the VSP but has not been eliminated. PMID- 2776852 TI - Occurrence of drug-resistant bacteria in communal well water around Port Harcourt, Nigeria. AB - A total of 108 raw water samples was collected from 36 wells at nine shanty settlements around Port Harcourt, Nigeria, over a period of 7 months. Samples were analysed for their bacteriological quality. Selected bacterial strains isolated from the samples were tested for their susceptibility to ten commonly used antibiotics. The organisms isolated include Pseudomonas spp., Klebsiella spp., Staphylococcus spp., Proteus spp., Enterococcus faecalis, Aeromonas spp., Escherichia coli, Chromobacterium spp., Flavobacterium spp., and Serratia spp. Out of 300 strains tested, 23 (6.9%) were susceptible to all the antibiotics, 277 (92.3%) were resistant to at least one antibiotic and 232 (77.3%) were resistant to two or more antibiotics. The epidemiological significance of these results is discussed. PMID- 2776854 TI - Specific marrow localization of an 131I-labeled anti-myeloid antibody in normal dogs: effects of a "cold" antibody pretreatment dose on marrow localization. AB - Tumor recurrence and regimen-related toxicity remain major obstacles in the successful use of marrow transplantation as therapy for hematologic malignancies. By attaching radionuclides to monoclonal antibodies (MoAbs) targeted at myeloid associated antigenic determinants, a more effective and directed delivery of therapy may be possible without increasing toxicity. We investigated the biodistribution over time of an anti-myeloid antibody (DM-5) labeled with trace amounts of 131I in normal dogs. This study demonstrates the ability to target marrow with a high degree of selectivity, achieving marrow/blood ratios of 25 30:1 with the greatest concentration in any other organ being a tissue/blood ratio of 1.4:1 for stomach at 48 h. A pretreatment dose of unlabeled antibody effectively reduced early hepatic uptake by 80%, resulting in improved marrow localization with an estimated 58.6% of the injected dose localized in marrow within 2 h following infusion, compared to 32.8% without pretreatment. The marrow concentration clearance curve for the radioimmunoconjugate revealed an initial short half-life (4.75 h), suggesting rapid internalization, digestion, and release of free iodine (dehalogenation). This view was supported by a corresponding rise in trichloroacetic acid-non-precipitable activity during this period. Methods aimed at decreasing dehalogenation may result in longer residence time of the radionuclide within the marrow space, resulting in more effective tumor cell kill. This approach may provide a way to improve upon the current results obtained with marrow transplantation as treatment for patients with leukemia and other hematologic malignancies. PMID- 2776855 TI - Hemopoiesis during thiamphenicol treatment. I. Stimulation of stem cells during eradication of intermediate cell stages. AB - Continuous treatment of C57bl/6 mice for 4 days with the cytostatic antibiotic thiamphenicol revealed a dual response of hemopoietic cells. On one hand, morphologically recognizable erythroid precursors and late progenitors (erythroid colony-forming units; CFU-E) and, to a lesser extent, granuloid precursors were found substantially reduced. On the other hand, early granuloid (granulocyte macrophage colony-forming units; CFU-GM) and erythroid (erythroid burst-forming units; BFU-E) progenitors increased on day 3 to 220%-240% and 120%-130% of the control value, respectively. This was accompanied by a decline of the initial spleen colony-forming units (CFU-S) (day 8) pool size to approximately 60%. These patterns were similar in the bone marrow and the spleen. In addition, the tritiated thymidine kill of femoral and splenic CFU-S rose significantly (p less than 0.05) from 16% +/- 3% to 38% +/- 2% and from 3% +/- 1% to 17% +/- 2%, respectively. A sudden decline of peripheral reticulocytes between days 2 and 3 from 2.8% +/- 0.3% to 0.6% +/- 0.2% was observed, whereas the hematocrit gradually decreased from day 1 to day 4 from 45.2% +/- 0.1% to 39.3% +/- 0.3%. The white blood cells were not affected. From these results we conclude that stem cells were stimulated as a consequence of the suppression of the intermediate cell stages. As analyzed in the accompanying paper, this confirms a prediction stated by a quantitative theoretical concept of in vivo stem cell regulation. PMID- 2776856 TI - Hemopoiesis during thiamphenicol treatment. II. A theoretical analysis shows consistency of new data with a previously hypothesized model of stem cell regulation. AB - In a recent theoretical model of stem cell regulation, specific quantitative assumptions were made about an in vivo feedback process from erythroid and granuloid precursor cell stages to the spleen colony-forming units (CFU-S), erythroid burst-forming units (BFU-E), and granulocyte-macrophage colony-forming units (CFU-GM). Utilizing specific effects of the antibiotic thiamphenicol (TAP), new experiments have been performed to challenge this model. Here these data are treated in an analysis that implies three steps. First, model assumptions about TAP toxicity are justified. The toxic TAP effects on erythroid and granuloid precursors are quantified as a continuous reduction of the normal amplification coefficient for CFU-E (down to 1/250), proerythroblasts, basophilic erythroblasts, and proliferating granuloid precursors (down to 1/4). Second, the original model predictions for the behavior of CFU-S, CFU-GM, and BFU-E are compared with the corresponding data. Third, discrepancies are discussed and it is demonstrated that adjustment of one single parameter resolves most of them. Thus one can quantitatively explain the experimental results for CFU-S, BFU-E, and CFU-GM by an activation of the regulatory process postulated: the decline in erythroid (and granuloid) cell numbers enhances the cycling of CFU-S while their self-renewal probability is reduced; consequently CFU-S numbers decline; as more cells differentiate towards BFU-E and CFU-GM per unit time the cell numbers of these cell stages increase. Thus the new data on stem cell behavior during TAP treatment support the hypothesis of a feedback from erythroid and granuloid precursors to the stem cells. PMID- 2776857 TI - Genetic models in brain and behavior research, Part II. Progress report. PMID- 2776858 TI - Morphological integration in the cranium during anuran metamorphosis. AB - We examined the role of thyroid hormone in mediating morphological integration between cranial cartilage and bone during anuran metamorphosis. Exogenous T3 applied to premetamorphic tadpoles (Bombina orientalis) via intracranial implants of plastic micropellets precociously induced typical metamorphic changes in both tissues, but also dissociated the relative timing of developmental events between them. Morphological integration between the two primary cranial tissues is achieved in part by each tissue responding independently to endocrine factors and does not reflect a tight developmental coupling between them. PMID- 2776859 TI - Serotonin-stimulated protein phosphorylation in aortic smooth muscle cells. AB - The effects of serotonin on the formation of inositol phosphates and protein phosphorylation were examined in cultured smooth muscle cells. Serotonin stimulated the formation of [3H]inositol monophosphate, [3H]inositol bisphosphate and [3H]inositol trisphosphate. This effect was prevented by 5-HT2 specific antagonist, 6-methyl-1-(1-methylethyl)ergoline-8-carboxylic acid, 2-hydroxy-1 methylpropyl ester [Z]-2-butenedioate (LY53857). Serotonin stimulated the phosphorylation of many polypeptides, among which a 20 kDa polypeptide was the most prominent. The phosphorylation was also inhibited by LY53857. LY53857 alone produced no effects on protein phosphorylation. The 20 kDa polypeptides were also phosphorylated by the addition of 12-O-tetradecanoylphorbol-13-acetate. These results suggest that serotonin stimulates protein phosphorylation through 5-HT2 receptors and possibly activates protein kinase C in intact vascular smooth muscle cells. PMID- 2776860 TI - In vivo effects of immunostimulating lipopeptides on mouse liver microsomal cytochromes P-450 and on paracetamol-induced toxicity. AB - Immunomodulating lipopeptides lauroyl-L-Ala-gamma-D-Glu-LL-A2pmNH2-Gly (RP 44.102) and lauroyl-L-Ala-gamma-D-Glu-LL-A2pmNH2 (RP 56.142) were found to protect mice against the hepatotoxicity of paracetamol, which is due to cytochrome P-450 dependent formation of toxic metabolites and radicals. In fact they decreased the amount of hepatic microsomal cytochrome P-450, and the level of CCl4-induced lipid peroxidation. In contrast lauroyl-L-Ala-gamma-D-Glu-DD A2pmNH2 (RP 53.204), which only differs by the configuration of the two chiral carbons of A2pm (diaminopimelic acid) and is not an immunomodulating agent, failed to protect against poisoning by paracetamol and had no effect on the level of hepatic cytochrome P-450 or the microsomal CCl4-induced lipid peroxidation. This provides a clear connection between the immunostimulating properties of a compound and its effects on xenobiotic biotransformations. PMID- 2776861 TI - Paternal allocation of sequestered plant pyrrolizidine alkaloid to eggs in the danaine butterfly, Danaus gilippus. AB - Pyrrolizidine alkaloid sequestered by adult male Danaus gilippus from plants is transferred in large measure to the female at mating, and by the female to the eggs. The eggs, presumably, are protected as a result. The male's courtship pheromone, danaidone, derived from the sequestered alkaloid, may function to advertise the male's alkaloid-donating capacity. PMID- 2776862 TI - Membrane resistance properties of pineal photoreceptors in the trout. AB - Intracellular recordings were obtained from pineal photoreceptors of the trout Salmo irideus. Illumination produced graded hyperpolarizing responses whose time course resembled that of retinal cones in lower vertebrates. Current-voltage relations were derived by using a voltage-clamp technique in the dark and during illumination. Membrane resistance values obtained in the dark were about 550 M omega, and they increased during illumination. The extrapolated reversal potential of the photocurrent is about 55 mV above the dark membrane potential, indicating that an ionic mechanism similar to that in retinal photoreceptors may be involved. PMID- 2776863 TI - Immunoelectron microscopy of rhodopsin and vitamin A in the pineal organ and lateral eye of the lamprey. AB - Rhodopsin- and vitamin A-immunoreactive sites were studied in the pineal organ of the larval and adult brook lamprey (Lampetra planeri Bloch), as well as in the retina of the larval lateral eye, at the electron microscopic level. In the pineal organ, several types of photoreceptor cells could be distinguished by their morphology and the immunoreactivity of their outer segments. The different kinds of photoreceptor cells were located at different levels of the pineal organ according to their distance from the "pineal window". The most superficial level, the so-called pellucida, appears to represent an exclusively "cone-type" area containing slender, rhodopsin-immunonegative (UV-blue-sensitive?) photoreceptors only. The second level, the pineal retina, contained predominantly rod-type photoreceptors, i.e., large, strongly rhodopsin-immunopositive (green-sensitive) photoreceptors medially, and few, small, weakly rhodopsin-immunopositive (blue green-sensitive?) cells bilaterally. At the deepest level, the pineal atrium, there were both rod- and cone-type photoreceptor cells, the latter possibly representing red-sensitive elements. Vitamin A immunoreactivity was found in the outer segments of the pineal photoreceptor cells, in the cytoplasm and mitochondria of inner segments and perikarya, as well as in nuclear euchromatin and compact nucleoli. A similar gold labelling of organelles was observed in the ependyma and pineal neurons. The vitamin A immunoreaction of the outer segments suggests retinoids are present as chromophores of the photopigments. In the peripheral retina of the larval lateral eye, vitamin A immunoreactivity was found in some organelles of the undifferentiated photoreceptor cells, neurons, pigment epithelium and Mullerian cells. The localization of immunoreactive vitamin A in nuclei, nucleoli and cytoplasm including mitochondria appears to strengthen the case for an interaction of retinoids in the function of these organelles. PMID- 2776864 TI - Why is alsynite fiber glass sheet attractive to stable flies? Optical and behavioural studies. AB - The fiber glass material Alsynite (Sequentia Corporation) is known to be an effective visual attractant to stable flies, Stomoxys calcitrans. The basis for this attractiveness is not certain, but is found to correlate with high near-UV reflectivity. While examining the transmission properties of Alsynite, it was found that the ratio of short- to long-wavelength photons shifts from 0.17 to 0.77, depending on the angle of the Alsynite relative to the source and the detector. This shift occurs suddenly at an angle of 15 degrees from the normal. To the human eye this shift results in an iridescent blue halo appearing around a light source and at the boundaries of illuminated objects. The phototactic response of stable flies to the 15 degrees off-axis spectral condition, as measured behaviourally, is greater than or equal to their phototactic response to a tungsten source more than 20 times the spectrally corrected intensity. This demonstrates a real preference for the off-axis photon ratio and may in part explain why Alsynite is attractive to stable flies in field situations. PMID- 2776865 TI - Metabolic rate, heart rate, and tailbeat frequency during sustained swimming in the leopard shark Triakis semifasciata. AB - Heart rate, metabolic rate, and tailbeat frequency were simultaneously recorded from seven leopard sharks (Triakis semifasciata) during steady swimming at controlled speeds to evaluate the usefulness of heart rate as a measure of field metabolic rate. Heart rate was monitored by acoustic telemetry using a frequency modulated ECG transmitter. Metabolic rate was measured as oxygen consumption in a swimming tunnel respirometer. For instrumented sharks, mean resting oxygen consumption rate and heart rate were 105.3 +/- 35.6 (SE) mg O2.kg-1.h-1 and 36.6 +/- 1.8 (SE) beats.min-1, respectively. While swimming at the maximum sustained speed (0.84 +/- 0.03 lengths.s-1) for 30-60 min, these rates were 229.3 +/- 13.2 mg O2.kg-1.h-1 and 46.9 +/- 0.9 beats.min-1. Although a significant linear regression was obtained between metabolic rate and heart rate, a low overall correlation coefficient may result from the existence of separate individual regressions and confounding changes in stroke volume and/or arteriovenous oxygen difference. Heart rate was approximately as closely correlated with oxygen consumption rate as swimming speed was. A significant linear relationship was obtained between tailbeat frequency and swimming speed to speeds of 0.75 lengths.s-1. PMID- 2776866 TI - Maxillo-mandibular surgery for obstructive sleep apnoea. AB - Many therapeutic approaches, including mandibular surgery, have been proposed for the treatment of obstructive sleep apnoea syndrome. In the largest study of its type yet reported, 54 patients (population A) underwent mandibular surgery: 36 had palato-pharyngoplasty and inferior sagittal osteotomy of the mandible with hyoid myotomy and resuspension, and 18 (population B) had maxillo-mandibular hyoid advancement, a procedure consisting of palato-pharyngoplasty, inferior sagittal osteotomy of the mandible with hyoid myotomy and, several months later, a maxillo-mandibular osteotomy. Criteria for procedure selection and for evaluation of results were pre-set, and clinical and polygraphic follow-up occurred 6-8 months after final surgery. In population A, 32 of the 36 patients had improved; but only 20 were evaluated as "satisfactory". In contrast, all of the population B patients were judged satisfactory. Four of the population B patients received nasal continuous positive airway pressure (CPAP) before any surgery, and both approaches gave similar good polygraphic results. The degree of skeletal cranio-facial deficiencies, particularly retrognathia, is crucial for procedure selection. We describe potential procedural risks and problems. PMID- 2776867 TI - Sites and sizes of fat deposits around the pharynx in obese patients with obstructive sleep apnoea and weight matched controls. AB - It has been suggested that deposition of fat in the soft tissues surrounding the upper airway may be an important factor in the pathogenesis of obstructive sleep apnoea (OSA) in obese subjects. We have used magnetic resonance imaging to determine the site(s) and size(s) of fat deposits around the upper airway in six obese patients with OSA (116-153% of ideal body weight) and five weight-matched controls without OSA (107-152% of ideal body weight). In all subjects, large deposits of fat were present postero-lateral to the oropharyngeal airspace at the level of the soft palate. Significantly more fat was present in these regions in the patients with OSA (p = 0.03). Fat deposits in the soft palate were observed in 4 of the 6 patients with OSA but none of the controls. Fatty streaks were observed in the tongue in 2 of the 5 controls and 3 of the 6 patients with OSA. Fat deposits were observed anterior to the laryngopharyngeal airspace, in submental regions, in all obese subjects. This study shows that more fat is present in those areas surrounding the collapsable segment of the pharynx in patients with OSA, compared to equally obese control subjects without OSA. PMID- 2776868 TI - Bronchial responsiveness to inhaled methacholine in epidemiological studies: comparison of different indices. AB - We evaluated the sensitivity and specificity of different indices drawn from the forced expiratory curve in order to detect the best one for evaluating bronchial reactivity in the general population, and particularly, for distinguishing between normal and asthmatic subjects. 654 subjects, between 15 and 64 years of age, who were representative for age and sex of the general population of a small Lombardy town (Italy), were studied. Of the total sample, 448 subjects were clinically normal and asymptomatic, 87 were symptomatic or with acute upper respiratory disease within 30 days before the challenge with methacholine, 43 with allergic rhinitis, 26 asthmatics and 50 chronic bronchitics. All the subjects who had a baseline FEV1 greater than 85% predicted underwent methacholine challenge. Provocative LnDoses of a 6, 10, 15% fall in FEV1 (LnPD6, LnPD10, LnPD15) and provocative LnDose causing FEV1 to fall more than 2 SD below the mean of 5 FEV1 measurements following buffer inhalation (LnTD) were evaluated. Furthermore we calculated the "Dose-Response slope" (SL) proposed by O'Connor. The cut-off value of each index to define a responder was calculated by discriminant analysis of the response to the challenge in normal and in the asthmatic group. Sensitivity, specificity and predictive value of LnPD6, LnTD and SL were 79, 74, 14%; 71, 74, 13% and 46, 97, 48% respectively. LnPD10 had the best sensitivity (83%) with a high specificity (83%), but, as compared to LnPD15, whose sensitivity was 79% and specificity 89%, a lower predictive value (21% vs 27%).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2776869 TI - Optimal inhalation technique with terbutaline Turbuhaler. AB - The bronchodilator response after four different modes of inhalation of 0.25 mg terbutaline from a Turbuhaler was assessed, in a double-blind cross-over study, of 14 asthmatic children aged 8-14 yrs (mean 11.6 yrs). The children inhaled as fast as possible (mean peak inspiratory flow rate = 53 l.min-1), because fast inhalations have been found to be more efficient than slow inhalations when the Turbuhaler is used. Tilting the head back during inhalation and a breath-holding pause of 10 s after the inhalation had no significant effect upon bronchodilation. Furthermore, the response was the same whether the children inhaled from residual volume (RV) or functional residual capacity (FRC). These results suggest that this new inhaler can be used with a very simple inhalation technique without any loss of effect. A simple inhalation technique is likely to facilitate teaching and improve compliance. PMID- 2776870 TI - Breath-actuated inhalers: comparison of terbutaline Turbohaler with salbutamol Rotahaler. AB - Two breath-actuated inhalers, the Turbohaler and the Rotahaler, were compared in 24 patients with chronic asthma using an open, cross-over study design. Patients were treated with terbutaline (500 micrograms) and salbutamol (400 micrograms) four times daily, each trial period lasting three weeks. Mean morning peak expiratory flow (PEF) values were higher during Turbohaler treatment, but were similar 15 min after inhaler use. The Turbohaler was found to be easier to use than the Rotahaler. PMID- 2776871 TI - Lung mechanics and their relationship to lung volumes in pulmonary sarcoidosis. AB - Pulmonary sarcoidosis was studied with respect to lung mechanical properties and to the influence of these on lung volumes. Sixty-six patients, with histological support for the diagnosis of sarcoidosis, and radiological signs of pulmonary involvement, i.e., stage II or III, were studied. The static pressure/volume (P/V) curves showed that the static elastic recoil pressure (PelL) tended to be increased at a given percentage of predicted total lung capacity (TLC). Reduction of static lung compliance (CstL) was a typical finding. At maximal inspiration PelL was abnormally low in 20 subjects, including in the main those with recent onset of the disease and older patients. The possibility of a greater inflammatory activity at the site of mechanical receptors in the lungs and airways of these patients is proposed. Pulmonary resistance, measured at a given PelL, was usually increased signifying bronchial involvement. TLC, residual volume (RV) and functional residual capacity (FRC) were lower in current smokers and ex-smokers than in lifelong nonsmokers. This may be due to synergistic effects of the inflammatory processes caused by smoking and sarcoidosis. A reduced vital capacity (VC) mainly reflected a low CstL but also obstruction with increased RV. Forced expiratory volume in one second (FEV1) reflected lung stiffness and obstruction equally. Lung mechanics revealed functional abnormalities which were not obvious from the standard tests, particularly in patients with respiratory symptoms. PMID- 2776872 TI - The effect of aminophylline on respiratory and limb muscle contractility in man. AB - The effect of oral aminophylline on respiratory muscle and quadriceps femoris strength was compared with placebo in five normal subjects. A double-blind randomized cross-over protocol, spanning 2-3 wks, was followed. Aminophylline was taken before both placebo and active drug periods to establish correct dosage, to allow tolerance to side-effects to develop, and to keep the two limbs of the study identical and double-blind. Maximal static inspiratory and expiratory mouth pressures at residual volume and total lung capacity, respectively, maximal sniff transdiaphragmatic pressure, maximal voluntary quadriceps femoris contraction force and theophylline levels were measured during placebo and active drug periods. For the group, there were no significant differences between respiratory or quadriceps muscle strength on aminophylline and on placebo although there was a tendency for greater values on aminophylline. Mean theophylline level was 14.6 mg.l-1 (range 8.4-25.0 mg.l-1). We conclude that aminophylline produces no enhancement of skeletal muscle strength, at therapeutic dosage in normal subjects. PMID- 2776873 TI - A 10 year follow-up of semi-annual screening for early detection of lung cancer in the Erfurt County, GDR. AB - A prospective and controlled study for early detection of lung cancer in the county of Erfurt with a follow-up of 10 years is presented. A collective of 41,532 males born between 1907 and 1932 was screened by chest fluorography at 6 month intervals and compared with a control group consisting of 102,348 males of the same age, who were screened at intervals of about 18 months. No significant reduction of overall mortality and of lung cancer mortality was achieved. Semi annual screening brought about a higher detection rate (9%/6.5%), an increase in the resection rate (28%/19%) and higher 5 and 10 year survival rates (52%; 27%/39%; 19%) of resected patients than screening in 18 month intervals. Among those patients who refused resection or were surgically untreatable, the difference in survival rates between the two investigation groups lasted only up to the 12 months barrier. This is regarded as the effect of the lead-time bias. Fluorographic screening is effective only in patients with peripheral cancers. Patients resected for central lung cancers did not show differences in the survival rates. In both investigation groups considered together surgical therapy was possible mainly in those patients who had been detected by screening (resection rate: 48%; 5 yr survival rate: 26.9%). The resection rate of all the others amounted to 9%, the 5 yr survival rate to 1.4%. Therefore we consider fluorography to time as the only chance for lung cancer control of high risk groups in spite of the absence of reduction of lung cancer mortality. PMID- 2776874 TI - Room temperature influences output from the Wright jet nebulizer. AB - Standardization of the solute output from the Wright nebulizer is necessary in nonspecific bronchial challenge to obtain reproducible results. Airflow and driving pressure are known determinants of the output. In an epidemiological study, in which day-to-day variations in room temperature occurred, we found the reproducibility of the output from a Wright nebulizer to be outside the range of acceptance. We have, therefore, examined to what extent ambient temperature and humidity might influence the output from three Wright nebulizers. The solute output was linearly correlated not only to flow (r = 0.98) and driving pressure (r = 0.90) but also to room temperature (r = 0.96). The mean output increased approximately 23% when room temperature was increased from 19 to 24 degrees C. This is equivalent to an increase in airflow of more than one litre. Ambient humidity did not influence the nebulizer output. When temperature was included in the calibration procedure, the coefficient of variation of the output decreased from 5 to 2%. This emphasizes the need for calibration of the Wright nebulizer with regard to ambient temperature as well as to airflow and pressure, especially in epidemiological field studies in which large variations of temperature are likely to occur. PMID- 2776875 TI - Neisseria sicca pneumonia and bronchiectasis. AB - Neisseria sicca, although considered a harmless saprophyte, has been recognised as an etiologic agent in three cases of pneumonitis, and rare cases of endocarditis, meningitis, and osteomyelitis, particularly in immunocompromised hosts. We report the case of a 76-year-old man with a community-acquired pneumonia, in whom both sputum samples and bronchial secretions obtained with bronchoscopic protected catheter brush grew pure culture of N. sicca with abundant polymorphonuclear neutrophils. Dramatic clinical improvement only occurred after initiation of an appropriate antibiotherapy according to susceptibility spectrum of the isolated N. sicca. Bronchiectasis underlying lesions were disclosed by computed tomography. N. sicca should be added to the list of commensal organisms able to cause pulmonary infection. Moreover, the association of N. sicca and bronchiectasis has never been published. PMID- 2776877 TI - Snoring or bubbling? PMID- 2776876 TI - Agenesis of the lung. AB - Agenesis of the lung is extremely rare. Developmental defects of the lung are usually associated with other congenital malformations. Half of all reported patients die either at birth or within the first 5 yrs of life. We report a case of right lung agenesis with absence of the left kidney, and fusion anomaly between ribs 4 and 5 on the left hemithorax. PMID- 2776878 TI - Identity of GD1C, GT1a and GQ1b synthase in Golgi vesicles from rat liver. AB - Competition experiments using GM1b, GD1a and GT1b as substrates, and as mutual inhibitors for ganglioside sialyltransferase activity in preparations of Golgi vesicles derived from rat liver, suggested that sialyl transfer to these three respective compounds, leading to gangliosides GD1C, GT1a and GQ1b, respectively, is catalyzed by one enzyme. These results are incorporated into a model for ganglioside biosynthesis and its regulation. PMID- 2776879 TI - Synthesis of alkylating oligonucleotide derivatives containing cholesterol or phenazinium residues at their 3'-terminus and their interaction with DNA within mammalian cells. AB - 5'-[32P]-labelled alkylating decathymidylate [4-(N-2-chloroethyl)N methylaminobenzyl]-5'-phosphamide derivatives containing cholesterol or phenazinium residues at their 3'-termini were synthesized and used for alkylation of DNA within mammalian cells. The uptake of the cholesterol derivative by the cells and the extent of DNA alkylation are about two orders of magnitude higher than those of a similar alkylating derivative lacking the groups at the 3' termini. The presence of the phenazinium residue at the 3'-terminus of the oligonucleotide reagent does not improve the reagent uptake by the cells but drastically increases the DNA modification efficiency. PMID- 2776880 TI - Tissue specific distribution of calcyclin--10.5 kDa Ca2+-binding protein. AB - Expression of calcyclin in different cell lines and mouse tissues was determined with polyclonal antibodies raised against calcyclin from Ehrlich ascites tumour (EAT) cells. The protein was detected in mouse skeletal and cardiac muscle, in lung, kidney and spleen, and was especially enriched in mouse smooth muscle as well as in rat fibroblasts. No positive immunological reaction was detected in mouse brain, liver and intestine and some tumourigenic cell lines. The level of calcyclin mRNA found in different cells and tissues corresponded well to the calcyclin level estimated by immunoblotting. The calcyclin-like protein was purified from mouse stomach and appeared to be very similar to the EAT protein. PMID- 2776881 TI - Antithrombin Cambridge, 384 Ala to Pro: a new variant identified using the polymerase chain reaction. AB - An antithrombin III variant was identified in the plasma of a female patient with a history of recurrent thromboses. The variant was shown to have normal antigenic levels but reduced heparin and progressive inhibitory activity consistent with an abnormality affecting function at the reactive centre. Polymerase chain reaction amplification of exon 6 of the gene with direct sequencing showed a point mutation resulting in the substitution of a proline for alanine at position 384. This substitution will predictably alter the conformation of the peptide loop containing the reactive centre of the molecule. PMID- 2776882 TI - Intracellular targetting signals of polymeric immunoglobulin receptors are highly conserved between species. AB - A rat liver cDNA library, constructed in the plasmid expression vector pUEX, was immunoscreened using a rabbit polyclonal antiserum raised against rat liver Golgi membrane proteins. A sub-set of isolated clones were shown to encode the rat polymeric immunoglobulin receptor (pIgR). DNA sequence analysis of these clones provided the complete coding sequence of rat pIgR. Subsequent alignment of rat, rabbit and human predicted amino acid sequences demonstrated that the greatest degree of homology between the three pIgRs lies in their cytoplasmic tails; a region previously shown to be important for correct targetting and trancytosis of rabbit pIgR [(1984) Nature 308, 37-43]. PMID- 2776883 TI - Identification of the ferroxidase centre in ferritin. AB - Ferroxidase activity in human H-chain ferritin has been studied with the aid of site-directed mutagenesis. A site discovered by X-ray crystallography has now been identified as the ferroxidase centre. This centre is present only in H chains and is located within the four-helix bundle of the chain fold. PMID- 2776884 TI - An increase in intracellular free calcium is an early event during differentiation of cultured human keratinocytes. AB - The effect of [Ca2+]o on [Ca2+]i in cultured human keratinocytes was studied using dual-wavelength microspectrofluorometric techniques. The results show that increasing [Ca2+]o from 70 microM to 1 mM causes an early rise in [Ca2+]i complete by 2 h. Heterogeneity within cultures was demonstrated. The [Ca2+]i in spontaneously differentiated cells of low Ca2+ cultures was similar to that of Ca2+ induced differentiated cells. The increase in [Ca2+]i preceded the morphological changes and growth inhibition induced by increasing [Ca2+]o. These observations are consistent with an increase in [Ca2+]i mediating differentiation of human keratinocytes. PMID- 2776885 TI - Adenosine formation by isolated rat kidney mitochondria. AB - Isolated rat kidney mitochondria are able to generate extraordinary amounts of adenosine. About one-third of the adenosine formed only results from the degradation of adenine nucleotides. Pyridine nucleotides may contribute to adenosine formation. Nevertheless, there must be an additional, as yet unidentified, acid-insoluble compound in mitochondria which is able to form a significant portion of adenosine. PMID- 2776886 TI - Heterogeneous activation of protein kinase C during rat liver regeneration induced by carbon tetrachloride administration. AB - During rat liver regeneration induced by carbon tetrachloride administration, the protein kinase C alpha subspecies was activated in a heterogeneous fashion, a higher number of hepatocytes expressing the protein kinase C alpha subspecies being detected in the pericentral zone than in the periportal zone. This zonal heterogeneity became maximal at 24 h after the treatment. The distribution of hepatocytes expressing the protein kinase C alpha subspecies was roughly coincident with that of hepatocytes exhibiting DNA synthesis. These results suggest that protein kinase C may play a crucial role in liver regeneration. PMID- 2776887 TI - Calmodulin-independent bovine brain adenylate cyclase. Amino acid sequence and nucleotide sequence of the corresponding cDNA. AB - An individual catalytic component of calmodulin-independent adenylate cyclase has been isolated from bovine brain cortex. Affinity chromatography on an immunosorbent was used. The amino acid sequence of adenylate cyclase as well as the corresponding nucleotide sequence of the cDNA has been determined. cDNA of adenylate cyclase encodes a protein consisting of 834 amino acid residues and the signal peptide (19 amino acid residues). A series of adenylate cyclase isoforms has been found. A homology between adenylate cyclases from bovine brain, E. coli and Bordetella pertussis has been revealed. PMID- 2776888 TI - A model for the molecular organization of cytochrome beta-561 in chromaffin granule membranes. AB - The CD spectrum of reduced cytochrome (cyt.) beta-561 in chromaffin granule membranes resembles that of mitochondrial cyt. beta 1 and indicates possible heme heme interaction in the protein. Based on spectroscopic data and analysis of the amino acid sequence, a model of cyt. beta-561 is suggested, in which the protein carries two transmembrane-localized hemes, each coordinated by two histidines. The model accounts for the presence of two different forms of cyt. beta-561 in chromaffin granule membranes and provides a mechanism of transmembrane electron transfer by this hemoprotein. PMID- 2776889 TI - Viability assessment of preimplantation concepti: a challenge for human embryo research. PMID- 2776890 TI - Successful microsurgical removal of a pronucleus from tripronuclear human zygotes. AB - We have microsurgically extracted a pronucleus from 11 tripronuclear human zygotes under two different experimental conditions. One group of six zygotes was incubated in cytochalasin D for 30 minutes before manipulation. The remaining five zygotes were manipulated without preincubation in cytoskeletal relaxing agents. When cytoskeletal relaxants were used, all six embryos survived manipulation and cleaved. One embryo arrested spontaneously at the two-cell stage; all others cleaved to at least four cells, and one embryo reached the advanced morula stage. Of the five eggs manipulated without prior cytochalasin D and colcemid treatment, none survived for more than 30 minutes after manipulation. In none of the tripronuclear eggs was it possible to definitely identify the male pronuclei. Because development was interrupted for karyotyping, it is likely that these embryos would have otherwise continued to develop to more advanced stages. These results indicate that it is possible to microsurgically "epronucleate" tripronuclear human zygotes and obtain further development and that use of cytoskeletal relaxants facilities this manipulative procedure. However, because epronucleated embryos have significant developmental potential, chromosome studies are needed to confirm complete removal of a male pronucleus before such techniques can be applied clinically. PMID- 2776891 TI - Embryonic development after microsurgical repair of polyspermic human zygotes. AB - Correction of polyspermy through pronucleus extraction in the absence of membrane relaxants was applied to 25 polyspermic human zygotes. Nine zygotes survived the procedure, and seven cleaved normally (two of which were fixed for chromosome analysis); two proceeded to compact and one cavitated. Eighteen of the polyspermic zygotes (14 with three pronuclei and 4 with four pronuclei) were obtained from zona pellucida-intact oocytes, and seven (1 five-pronucleate 3 four pronucleate, and 3 three-pronucleate) from previously zona-drilled oocytes. Survival and cleavage occurred in all groups except in four- and five-pronucleate zona-drilled zygotes. Criteria used to identify male pronuclei were (1) pronucleus-associated sperm tails, (2) increased pronucleus size, and (3) greater distance (relative to female pronuclei) from the second polar body. Sperm tails were never seen and pronucleus size usually was identical. Therefore, the third criterion was used, although its reliability should be further evaluated. Until complete pronucleus removal techniques and reliable pronucleus selection criteria are perfected, embryo replacement after polyspermy correction could result in aneuploidy and molar pregnancy. PMID- 2776892 TI - Prediction of ovulation. AB - The purpose of this investigation was to evaluate all available ovulatory diagnostics with respect to sensitivity, specificity, diagnostic specificity (predictive value of a positive test, PVP) and diagnostic sensitivity (predictive value of a negative test, PVN). Twenty-one ovulatory women with more than 3 years of infertility problems were included in the study. PVP and PVN were highest for detection of urinary luteinizing hormone (LH) peak at ovulation (PVP = 90%, PVN = 95%) and for serum-estradiol peak 1 day before ovulation (PVP = 83%, PVN = 97%). The predictive values were lower for all other tests. The PVP (54%) and PVN (90%) were rather low for detection of ovulation with vaginal electric impedance. However, all ovulations were predicted when urinary LH peak and vaginal impedance were combined. Two women were stimulated with human chorionic gonadotropin to investigate a possible connection between the LH peak and the preovulatory vaginal electric impedance. No close connection between them could be demonstrated. Basal body temperature should not be used for the prediction of ovulation (PVP = 25%). We suggest that ovulation should primarily be predicted from the identification of the urinary LH peak and that other methods be supplementary. PMID- 2776893 TI - Disappearance of exogenously administered human chorionic gonadotropin. AB - Concentrations of human chorionic gonadotropin (hCG) were measured after intramuscular hCG administration in 34 patients undergoing ovarian stimulation in an in vitro fertilization program. Serum hCG levels were detectable by an immunoenzymetric assay up to 14 days after injection. Individual variation in hCG concentration after injection could be minimized by expressing the daily hCG level as a fractional distribution of the value observed 36 hours after hCG administration (hCG0). In nonpregnant patients, less than 10% of the hCG0 value was found on day 10. The disappearance rate measured 36 hours after injection of hCG was exponential with a mean half-life of 2.32 days. These findings are significant for ovarian stimulation protocols, including exogenous hCG, with respect to timing and accuracy of quantitative pregnancy testing. PMID- 2776894 TI - The luteinizing hormone surge: timing and characteristics in the plasma and urine after clomiphene citrate treatment. AB - Clomiphene citrate (CC) has been used to influence the timing of ovulation. To evaluate the effects of CC on the timing of the luteinizing hormone (LH) surge, we examined the LH surge in 10 cycling normal women for 3 cycles each, during an untreated cycle (control) and during treatment with 50 mg CC (CC 50) and 150 mg CC (CC 150) daily on days 5 to 9. Length of control cycles (mean +/- standard error of the mean) was 28.5 +/- 1.1 days and was not significantly different from either CC 50 (28.2 +/- 0.6 days) or CC 150 cycles (29.0 +/- 0.4 days). LH surge occurred on day 16.4 +/- 1.2 in control, 16.5 +/- 0.5 in CC 50, and 17.1 +/- 0.7 in CC 150 cycles. Similarly, luteal phase lengths were not significantly affected by CC treatment. Individually, however, the effect of CC on the timing of the LH surge depended on when the LH surge occurred in corresponding control cycles. If the control cycle LH surge occurred on day 16 or earlier, CC significantly delayed it. If the normal LH surge occurred on day 18 or later, CC advanced it. During CC 50 treatment, the LH surge was advanced by 1 to 7 days in 3 cycles, unchanged in 2, and delayed in 5 cycles by 1 to 9 days. Detection of urinary LH surge was reliable in CC-treated cycles and correlated well with the day of plasma LH surge.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2776895 TI - Selective reduction in multiple gestations: pregnancy outcome after transvaginal and transabdominal needle-guided procedures. AB - Selective fetal reduction was performed in the first trimester of pregnancy in 20 women with multifetal gestations after ovulation induction with human menopausal gonadotropin (hMG). In 10 women (group A) reduction was performed transabdominally, and in 10 women (group B) the transvaginal approach was used. The transvaginal technique achieved penetration of several gestational sacs without withdrawing the needle from the uterus. Fetal termination using either procedure occurred with intrafetal injection of potassium chloride. Six (60%, group A) and eight (80%, group B) patients delivered healthy newborns. One patient (group B) is at 30 weeks' gestation. Four (40%, group A) and one (10%, group B) aborted 1 day to 8 weeks after the procedure (1 septic abortion, each group). Our results suggest that transvaginal fetal reduction offers a better outcome, with minimal complications, to patients referred for selective continuation of pregnancy. PMID- 2776897 TI - Establishment of a nonanonymous donor oocyte program: preliminary experience at the University of Southern California. AB - Transvaginal ultrasound-directed oocyte retrieval was performed on eight women functioning exclusively as gamete donors for 10 patients with ovarian failure. Donors included sisters, personal friends, and compensated participants selected by the recipient couple. Oocyte donors underwent controlled ovarian hyperstimulation and transvaginal oocyte aspiration. Thirteen initiated cycles resulted in 11 embryo transfers and six ongoing pregnancies. There were no complications, and all donors stated a willingness to undergo the procedure again. The use of nonanonymous oocyte donation appears both efficacious and efficient and is recommended as an option for achieving pregnancy in women with ovarian failure. PMID- 2776896 TI - Mood disorders, psychiatric symptoms, and distress in women presenting for infertility evaluation. AB - Women who undergo treatment for infertility frequently report depression, but it is crucial to distinguish between subjective distress, symptoms, and clinical depressive disorders. In the initial assessment of a prospective, longitudinal study, 59 women presenting for infertility treatment were compared with 35 women presenting for routine gynecological care. Infertility patients and controls were not significantly different on self-report measures of partner satisfaction, sexual functioning, or self-esteem. There was also no difference in psychiatric symptomatology, or in the percentage of subjects who were currently experiencing or had ever experienced a major depressive episode. However, the infertility patients perceived themselves to have been already quite affected by their inability to conceive. For instance, 49.2% reported changes in their sexual functioning and 74.6% reported changes in their mood. PMID- 2776898 TI - Human chorionic gonadotropin, estradiol, and progesterone profiles in conception and nonconception cycles in an in vitro fertilization program. AB - In 22 consecutive in vitro fertilization cycles stimulated with purified follicle stimulating hormone, human chorionic gonadotropin (hCG), estradiol (E2), and progesterone (P) were measured every 3 days during the luteal phase. All serum measurements were normalized to the day of hCG administration (day 0). There was a total of nine pregnancies; two were biochemical pregnancies, whereas 7 of the 22 women had clinical pregnancies (31.8%). Of these, two miscarried and five had term pregnancies (three singleton, two twin). Conception cycles could be differentiated from nonconception cycles by serum E2 levels on day 8 (P = 0.035), by hCG levels on day 11 (P = 0.03), and by P levels on day 14 (P = 0.001). From days 8 to 11, hCG levels plateaued in conception cycles and decreased in nonconception cycles. However, during that period, E2 and P fell in both groups of women. This decline in sex steroids, which was observed in both conception and nonconception cycles, may well negatively influence endometrial development during the peri-implantation period and compromise conception, resulting in failure to conceive, biochemical pregnancy, and early miscarriage. PMID- 2776899 TI - Is routine examination of the male partner of any prognostic value in the routine assessment of couples who complain of involuntary infertility? AB - The purpose of this study was to determine whether routine examination of the male partner is of value in assessing couples complaining of involuntary infertility. The relationship between male age, a previous paternity, male physical characteristics, and fertility outcome was examined. Life table analysis was performed after accounting for known female factors. Five hundred forty-four couples were recruited to the study. All conceptions were independent of treatment to either partner in which the female partner was found to be "normal" on investigation. Although male age and several physical characteristics were related to fertility outcome when all couples were examined, this was, by virtue of these variables, being related to female age and the length of involuntary infertility before investigation. When only those couples were examined in which the female partner was normal on investigation (n = 250), past paternity (x1(2) = 4.21, P = 0.040, RR = 1.81) was the only variable that retained a significant relationship to fertility outcome. It was concluded that routine examination of the male partner is of no prognostic value for couples complaining of involuntary infertility. PMID- 2776900 TI - Seminal vesicles: a source of trophoblast lymphocyte cross-reactive antigen. AB - Maternal recognition of allotypic trophoblast lymphocyte cross-reactive (TLX) antigens is proposed to be involved in immunologic acceptance of the allogeneic fetus. The presence of TLX antigens in seminal plasma suggests that sensitization can occur before fertilization and implantation. In this study, the origin of TLX antigens within the male reproductive tract was investigated. Analysis of split ejaculates and immunohistological examinations of male accessory gland tissues showed the luminal epithelium of seminal vesicles as the source of seminal plasma TLX antigens. This finding suggests that seminal vesicles may play a role in the immunology of human reproduction. PMID- 2776901 TI - New data confirming a circannual rhythm in spermatogenesis. AB - Our study demonstrates a circannual rhythm in spermatogenesis by 2697 spermiograms of healthy probands and subfertile patients. This rhythmicity is valid both for fertile as well as for subfertile men. In both groups, the lowest values of sperm count occurred in the summer while the peak values occurred in the winter and spring. For basal diagnostic purposes in male hypofertility, spermiograms should be obtained before or after the summer months. In oligospermia seasonal fluctuation in sperm density should be taken into account in in vitro fertilization and in artificial insemination, homologous. PMID- 2776902 TI - The long-term predictive value of the zona-free hamster ova sperm penetration assay. AB - Three hundred sixty-nine infertile couples were followed for 2 to 5 years in a study designed to determine the clinical long-term predictive value of the zona free hamster ova sperm penetration assay (SPA). Semen analysis (SA), SPA, and a full infertility workup were done in all cases, and only couples in whom the female had no evident cause of infertility were included in the study. During the follow-up period, 106 couples (29%) achieved a pregnancy. Sixteen percent of 131 men who had an SPA of 0%, 23% of 120 men with 1% to 19%, and 48% of 118 men who had a penetration of greater than 19% impregnated their wives 2 to 5 years after the assays. Significant difference in fertility prognosis was found between those who had an SPA greater than 19% and those with an SPA less than 20% (48% versus 20%). Sperm penetration assay greater than 19% was predictive of higher pregnancy rates in both oligospermic (41% versus 17%) and unexplained infertile couples (52% versus 24%). The specificity and positive predictive values of the SPA were higher than those of the SA (77% versus 57% and 48% versus 37%). These findings emphasize the value and importance of the SPA in determining the long-term fertility potential of men. PMID- 2776903 TI - Coculture of human zygotes on fetal bovine uterine fibroblasts: embryonic morphology and implantation. AB - Zygotes from in vitro fertilization patients (n = 116) were randomly allocated to culture in either conventional plastic petri dishes or coculture on a monolayer of fetal bovine uterine fibroblasts. Embryos (n = 288) remained 26 to 32 hours in these culture systems. Video tape recording for later morphological analysis (11 parameters) was performed on 117 conventionally cultured and 104 cocultured embryos, shortly before replacement, by an independent observer, unaware of the culture conditions for each embryo. A significantly greater number of cocultured embryos (52%) had "good" morphology (zero or only one abnormal characteristic) as compared with conventionally cultured embryos (30%). The most outstanding morphological characteristic of cocultured embryos was the expanded appearance of their blastomeres. The incidence of implantation per embryo increased from 13% to 19% when the coculture rather than conventional culture system was used, and the incidence of ongoing pregnancy per patient after coculture doubled to 35%. PMID- 2776905 TI - [The size of the overlapping of the gingival margin in Class II amalgam fillings examined in the teeth and their radiographic images]. AB - 200 Class II extracted teeth provided with amalgam filling were examined. The size of the overlapping of the fillings were measured on the X-ray pictures and in the transverse section of the teeth embedded in self-cementing plastic under a stereomicroscopy by means of an ocular micrometer. The mean overlapping of the fillings was 0.52 +/- 0.44 millimeters on the teeth and 0.48 +/- 0.43 millimeters on the X-ray pictures. There was no significant difference between the values obtained by both methods. On the upper teeth [teeth: 0.64 +/- 0.50 millimeter, X ray: 0.59 +/- 0.48 millimeters (significantly) P less than 0.001] the overlapping of the fillings was greater than on the lower ones (teeth: 0.39 +/- 0.49 millimeters, X-ray: 0.36 +/- 0.33 millimeters). The other comparisons did not show any significant difference by either method. The oro-vestibular extension of the overlapping gingival filling borders was, on the average 3.45 +/- 1.25 millimeters and amounted to 46.25 +/- 15.94% of the width of the surfaces. The percentual oro-vestibular extension of the gingival filling borders was significantly greater (p less than 0.05) on the premolars than on the molars. The gingivally overlapping filling showed also an oral and/or vestibular overlapping. PMID- 2776904 TI - Amniotic fluid as in vitro fertilization culture medium. PMID- 2776907 TI - [Pathogenesis of temporomandibular dysfunction. II. Statistical method]. AB - The variables of the epidemiologic assessments concerned with the aetiology of the mandible joint disfunction were examined in the course of statistical analyses, in general, in their pairwise connections and possibly a multi-variable linear regression calculation was employed. In the course of the examination, for establishing the linear, empirically tested model of the aetiology of the mandible joint disfunction a new type statistical method, the LISREL (Linear Structural Relationship) method was employed. An advantage of this assessment consists in that not only observed variables may figure as the variables of the structural equation but also latent variables which cannot be observed but it is supposable that they are factors of the observed variables. This statistical method is described in closer details in the article in connection with the forming of the aetiological model. PMID- 2776906 TI - [Etiology of tumors of the oral cavity]. AB - The profession, habit, oral hygiene, residence, sex and age of 100 patients with malignant tumors of the oral cavity are compared with those of 100 control patients. The male, rural population of low culture, smoking habit and regular consumption of alcohol was found to be the most endangered group. A regular check up and enlightenment of this social group is therefore suggested. PMID- 2776909 TI - Getting involved is key to nursing's future. PMID- 2776908 TI - [Experience with the treatment of blow-out fractures associated with pinching of the oculomotor nerve]. AB - Observations of blow out fractures causing diplopy with m. rectus inf. pinching and their successful treatment are reported on. Importance of early recognizing and of correct diagnosis are emphasized. Because of the nature of injuries of such type and of the situation of traumatologic care the patients get mostly to traumatological, oral surgery departments where the troubles of eye movement are not always recognized since it can be eclipsed by an eyelid oedema or by periorbital haematoma. The surgeon is frequently confronted with an unsolvable task by relayed observation and forming cicatrization. Then, the healing results are significantly worse, than in our first case. In case of treating facial injuries the cooperation of the oculist, the laryngologist, the odontologist, the neurosurgeon is indispensable. PMID- 2776910 TI - Functions of the Board of Nursing. PMID- 2776911 TI - What agencies are available for nursing research funding and how can the funds be obtained? PMID- 2776913 TI - A salute to nursing students--key to positive public image & recruitment: marketing nursing. PMID- 2776914 TI - A salute to nursing students--changes in the self-concept of the emerging professional nurse. PMID- 2776912 TI - Computer technology in nursing. PMID- 2776915 TI - Nursing supply and demand: an overview and update. PMID- 2776917 TI - Reliability of the "kiss of death" method for evaluation of intercellular communication: effect of cloning and culture technique. AB - I explored the effect of genetic (cloning) and non-genetic (arrangement of the method and quality of culture serum) factors upon variability of the results obtained by using the "kiss of death" method for evaluation of intercellular communication in Chinese hamster cells V79-4. Cloning had neither quantitative (intraspecies communication) nor qualitative (interspecies communication) effects. Of the non-genetic factors, the time interval of application of transferred agent (thioguanine) after plating the cells and the agent concentration were investigated. These factors did not influence significantly the results. Intercellular communication was more intensive in a less rich medium containing bovine serum than in a richer medium containing foetal calf serum. On the basis of the results obtained I conclude that the higher variability of intercellular communication values determined by the "kiss of death" method is not due to an error in the experimental method used but probably reflects the real changes in these values that occur with time in cell populations. PMID- 2776916 TI - Immunomodulatory action of double-stranded RNA in unirradiated and irradiated mice. AB - Double-stranded RNA (ds RNA) stimulates the regional graft-versus-host reaction (GVHR) in mice irradiated with 3 Gy or 5 Gy (but not 7 Gy) of gamma-rays; in control animals GVHR is not influenced. Sensitization of animals to delayed-type hypersensitivity (DTH) reaction is suppressed by ds RNA in both irradiated and unirradiated mice. In the antibody formation to sheep and blood cells (SRBC) ds RNA given before immunization inhibits the switch of IgM to IgG. When injected simultaneously with or after immunization, ds RNA markedly stimulates antibody formation. The differences in the influence of ds RNA on individual immune reactions can be explained by its different action on the regulatory mechanisms. PMID- 2776918 TI - Daily and seasonal variations in Na+, K+, Ca2+ and Mg2+ contents in the cingulate cortex of the mouse brain. AB - Daily changes in Na+, K+, Ca2+ and Mg2+ contents in the cingulate cortex of mice housed under controlled light/dark (LD) conditions were investigated for a 24 hour period in spring, summer, autumn and winter. The total ion content in the mineralized tissue was evaluated by absorption/emission flame spectrophotometry. In nearly all the tested cation contents significant daily concentration changes were found with a maximum in the dark phase of the LD cycle. The differences in wave form and mean cingulate cortex ion contents throughout the year suggest that the rhythms undergo seasonal variations. The functional importance of daily and anual fluctuations in the brain cation concentrations has been discussed. PMID- 2776919 TI - The relationship between basal metabolic rate (BMR) and concentrations of plasma thyroid hormones in fasting cockerels. AB - A correlation between the Basal Metabolic Rate (BMR) and the level of rT3, and occasionally between BMR and T3 or T4 was found in 12 month fasting cockerels. The birds were fasted for 48 hrs and BMR was measured eight times (before fasting, at 6, 12, 24, 30, 36, and 48 hrs of fasting, and 4 hours after fasting). Blood samples for plasma collection were taken immediately after measuring the BMR. During starvation a decrease in BMR was observed. After refeeding BMR returned to the starting level. The decrease in BMR was accompanied by an increase in rT3 and T4 plasma levels. Between BMR and levels of T4 and rT3 negative coefficients of correlation were observed (r = -0.20 and r = -0.42, respectively). Contrary to this, the T3 level declined and was correlated with BMR (r = 0.62). After refeeding, the T3 level rapidly increased against the control value. Moreover, a high coefficient of correlation (r = -0.39) was found between the level of T3 and rT3. The data show that the reduction in plasma T3 level and increase in the rT3 one during starvation may be due to inhibition of deiodination of T4 to T3, since rT3 is a competitive inhibitor of this reaction. The presented results support the suggestion that in birds T3 is the metabolically active thyroid hormone, and rT3 antagonizes this effect. PMID- 2776920 TI - [The effects of the intracerebroventricular administration of cimetidine on hemodynamics in conscious rats: relation to the sympathetic nervous system]. AB - Histamine H2-receptor antagonists administered into the central nervous system have been shown to increase arterial pressure (AP) in anaesthetized animals (Paakkari et al., 1982). Few studies have been reported on the effects of centrally administered cimetidine (CIM), one of the histamine H2-receptor antagonists, in conscious animals. However, the mechanism of the pressor action of histamine H2-receptor antagonists remains unclear. The present study was designed to investigate the hemodynamic effects of intracerebroventricular (i.c.v.) CIM and the interaction between the sympathetic nervous system and histamine receptor system in conscious rats. Male Wistar rats weighing 200 gr were prepared for the experiment under a conscious and minimally restricted state. Five micrograms of i.c.v. saline (SAL-ICV group, n = 5) did not produce significant changes in mean arterial pressure (MAP) or heart rate (HR) (MAP from 85.6 +/- 3.4 to 86.0 +/- 4.3 mmHg and HR from 395.0 +/- 13.9 to 395.2 +/- 8.2 bpm, respectively). Twenty micrograms of i.c.v. phenoxybenzamine (POB-ICV group, n = 6) decreased MAP from 95.8 +/- 4.1 to 85.2 +/- 3.1 mmHg, -10.7 +/- 2.2 mmHg as delta MAP, and increased HR from 392.5 +/- 8.5 to 435.3 +/- 13.9 bpm, +42.8 +/ 6.8 bpm as delta HR. Two-hundred micrograms of intravenous (i.v.) POB (POB-IV group, n = 5) also decreased MAP from 96.0 +/- 4.3 to 71.0 +/- 5.1 mmHg, -25.0 +/ 2.7 mmHg as delta MAP, and increased HR from 395.8 +/- 10.5 to 473.0 +/- 12.4 bpm, +77.2 +/- 7.6 bpm as delta HR. The changes in MAP and HR were much greater in the POB-IV group than those in the other two groups. The subsequent i.c.v. administration of 250 micrograms of CIM induced an increase in MAP (+19.4 +/- 1.7 mmHg as delta MAP) and a decrease in HR (-36.4 +/- 3.1 bpm as delta HR) in the SAL-ICV group, which continued for at least 30 minutes producing peak effects 2 minutes after i.c.v. administration of CIM. However, an elevation of MAP caused by i.c.v. CIM was much more inhibited in the POB-ICV group than in the POB-IV group (+2.5 +/- 0.7 mmHg as delta MAP in the POB-ICV group and +5.0 +/- 1.3 mmHg as delta MAP in the POB-IV group, respectively).(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2776921 TI - [The effect of RU486 and progesterone on luteal function during pregnancy]. AB - In order to investigate the role of progesterone in the maintenance of pregnancy, an anti-progesterone agent, RU486 (RU) was injected subcutaneously into pregnant rats on day 12 (D12), and morphological changes of the uterus as well as endocrinological changes were observed. In all rats injected with RU, abortion occurred with macroscopic and microscopic intrauterine hemorrhage and degeneration or delivery of conceptuses. Endocrinologically, the levels of progesterone decreased rapidly 48 hours after the injection, while the levels of estradiol showed a tendency to increase. As progesterone is mainly produced by the corpus luteum but not by the placenta in rats, the decrease in progesterone is suspected to be due to luteolysis. Then in order to clarify the mechanism of luteolysis induced by RU and the effects of progesterone on this phenomenon, the dynamics of the luteotrophic factors (estradiol, LH, PRL) and specific binding capacity of the ovaries to LH/hCG were investigated in D7 pregnant rats treated with RU 1 mg/kg alone (RU group) or with both RU 1 mg/kg and progesterone 50mg/kg (RU + P group). The serum levels of progesterone in the RU group decreased significantly after 72 hours of administration, while those in the RU + P group remained within the levels of the control group. However, serum levels of luteotrophic factors in the RU group did not decrease, and some of them were even higher than those in the control group. In the RU + P group, luteotrophic factors remained within control levels. On the other hand, the specific bindings of LH/hCG to ovarian homogenates decreased significantly after 72 hours in the RU group. But in the RU + P group, the specific bindings were kept at the same levels as the controls. Scatchard analysis of these results disclosed that in the RU group, both affinity and numbers of receptors decreased compared to the controls, and that in the RU + P group only affinity decreased transiently and afterwards recovered quickly. From these results, it is concluded that deterioration of affinity and numbers of ovarian LH/hCG receptors seems to be one of the factors which induce luteolysis in pregnant rats treated with RU, and that progesterone can spare the effect of RU on the corpus luteum during pregnancy. PMID- 2776922 TI - [Radioimmunoassay of vasopressin in unextracted random urine; clinical application for screening of central diabetes insipidus]. AB - The concentration of unextracted urinary arginine vasopressin (UAVP) was directly measured by high-sensitive radioimmunoassay (AVP-RIA Kit, Mitsubishi Petrochemical Co., Ltd.). Urine was diluted to eliminate interference of nonspecific substance without prior extraction. When urine aliquots were diluted in 4 to 32 fold in assay buffer, the relationship between UAVP concentration and dilution ratio corresponded exactly in a linear regression line. The elution pattern on Sephadex G-25 of UAVP immunoreactivity was identical with that of synthesized AVP. The AVP concentration in unextracted urine was not significantly different from that of extracted urine by Sep-Pak C18 column (Water Associates, Milford MA). The mean recovery of added AVP to urine specimens was 101.1 +/- 9.8% (mean +/- SD). The immunoreactivity of UAVP was not modified by either albuminuria (50 and 100 mg/dl) or glycosuria (1000 g/dl). Mean coefficients of variance between-assay and within-assay were 8.3% and 6.6% respectively. In normal subjects (n = 28), significant correlation was observed between UAVP concentration and simultaneously measured plasma AVP (r = 0.701, p less than 0.001). Moreover, AVP concentration in random urine was significantly correlated with AVP excretion in 24 hr-urine (r = 0.703, p less than 0.05, n = 9), and this suggested that random UAVP concentration may indicate daily UAVP secretion. In normal subjects, AVP concentration in random urine was widely scattered from 9.2 to 470.6 pg/mg Cr (89.5 +/- 76.4 pg/mg Cr, n = 211). In patients with diabetes insipidus (DI), UAVP concentration (1.6 to 13.0 pg/mg Cr, 6.94 +/- 2.77 pg/mg Cr, n = 25) was significantly lower (p less than 0.001) than that of normal subjects. UAVP concentration in a patient with primary polydipsia (43.2 pg/mg Cr) was not similar to that of ID but to that of normal subjects. UAVP concentration in 2 patients with SIADH was not more than that of normal subjects, indicating that random UAVP concentration is not suitable for detecting inappropriate AVP secretion. In this study, it is suggested that patients of random UAVP concentration below 13.0 pg/mg Cr should be recommended other intensive examination to diagnose DI, even though 2 normal subjects (0.9%) were incorrectly estimated as DI. In conclusion, radioimmunoassay of AVP in unextracted random urine is easy to sample and assay, and useful in screening polyuric patients. PMID- 2776923 TI - Proceedings of the International Symposium on the Chemical Mediators on Skin Inflammation. Sendai, August 25-27, 1988. PMID- 2776924 TI - Lucigenin-induced chemiluminescence in human neutrophils in the process of chemotactic migration measured in a modified Boyden chamber. AB - To the question of whether an oxidative metabolism of neutrophils occurs in the process of chemotactic migration, we have already demonstrated that formyl peptide and zymosan-activated serum effectively induced lucigenin-dependent chemiluminescence (CL) in a specially devised Boyden chamber. In the present study we confirmed this and, furthermore, demonstrated that superoxide dismutase partially suppressed the neutrophil chemotaxis to formyl-peptide and concanavalin A, suggesting the participation of superoxide in a chemotactically migrating mechanism. However, monocyte-derived chemotactic factor did not cause any light emission, irrespective of its chemotactic activity. Based on these results, neutrophil chemotactic factors seem to be divided into two types, that is, oxidative metabolism-related and nonrelated. To the former group of chemotactic factors a premature activation of oxidative metabolism in neutrophils may start even at the initial stage of chemotaxis, and these primed cells may respond with a respiratory burst to higher concentrations of the chemoattractant itself or to other chemical mediators present at the site of inflammation. PMID- 2776925 TI - A factor capable of increasing vascular permeability in Sq14 mouse squamous cell carcinoma. PMID- 2776926 TI - Significance of histamine metabolism in skin lesions of human and murine lupus erythematosus. PMID- 2776927 TI - Microenvironmental factors make connective tissue cells either destructive or productive. PMID- 2776928 TI - Several animal models of oxidative stress to the skin. PMID- 2776929 TI - Biological and biochemical responses of skin fibroblast to oxidative stress induced by Fe3+-ascorbate. PMID- 2776930 TI - Plasma concentrations of complement-modulating proteins (C1 inhibitor, C4 binding protein, factor H and factor I) in inflammatory dermatoses with special reference to psoriasis. AB - By using single radial immunodiffusion, plasma levels of four complement modulating proteins, i.e. C1 inhibitor (C1INH), C4-binding protein (C4bp), factor H and factor I were measured in 42 psoriatic patients and in 60 patients with other inflammatory skin diseases in comparison with 27 normal controls. In psoriatic patients and those with related pustular dermatoses, the levels of C4bp, factor H and factor I were significantly increased. They correlated well with both extent of skin changes and disease activity. In contrast, in nonpsoriatic inflammatory dermatoses only factor H values were significantly increased in toxic erythema and factor I in atopic dermatitis. These results offer additional support for the hypothesis that the complement system is involved in psoriasis and related sterile pustular dermatoses. PMID- 2776932 TI - Sugar specific cellular lectins of Phallusia mamillata hemocytes: purification, characterization and evidence for cell surface localization. AB - Cellular lectins (CLs) of Phallusia mamillata were demonstrated in protein preparations obtained by salt fractionation from hemocytes sonicated in a suitable medium. Since the lectins from the precipitated fraction bind sugars containing D-galactosyl groups, they were purified by affinity chromatography on Sepharose. SDS-PAGE under reducing conditions showed that CLs are formed of two components of apparent MWs approximately 36,900 and 35,090 and thus differ from serum lectins (SLs) (MW about 62,200). The "shrinkage" observed when SLs were examined under nonreducing conditions suggest the presence of intrachain disulphide bonds which can affect the molecular structure of the SLs. CL-SL differences were also revealed by the nonidentity reaction of the immuno precipitate in immunodiffusion using an anti-SL immune serum. The capacity of hemocytes to form rosettes or clumps with erythrocytes demonstrated that they possess alpha-lactose specific CLs on their surfaces. PMID- 2776931 TI - Characteristics and pathophysiological roles of extracellular phospholipase A2 in inflamed sites. AB - Extracellular phospholipase A2 found in inflamed sites of human and rat was purified and characterized. Phospholipase A2 isolated from peritoneal exudates of rat treated with casein, that isolated from human synovial fluids in rheumatoid arthritis, that secreted from activated platelets of rat and rabbit share common structural and biochemical features. Possible roles, dynamics and regulation of these extracellular phospholipases in inflammatory processes will be discussed. PMID- 2776933 TI - Activation of trout macrophages and production of CRP after immunization with Vibrio anguillarum. AB - To examine the mechanism of the protection of rainbow trout (Salmo gairdneri) against Vibrio anguillarum in the early stage of immunization, the activation of macrophages and production of C-reactive protein (CRP) were investigated. Fish immunized with formalin-killed bacteria emulsified in Freund's complete adjuvant (FCA) resisted intraperitoneal challenge with living bacteria seven and ten days after immunization. The activation of macrophages was demonstrated by a significant increase of the chemiluminescent (CL) response and phagocytic activity. These fish also showed a significant increase of the CRP level in sera. Fish immunized with V. anguillarum alone or injected with FCA, however, did not resist the challenge. Though FCA itself increased CRP level and the sera enhanced phagocytic activity, increase of CL activity was weak. These results indicated that the increase of CL activity and opsonising effect of CRP on the phagocytosis of specifically activated macrophages concern to host defense in the early stage of infection. PMID- 2776935 TI - Tryptic digestion of Xenopus IgM and IgY molecules. AB - Xenopus IgM and IgY molecules were digested by trypsin. Their respective fragments were separated by gel filtration and immunoadsorption. The purified fragments were characterized by SDS-PAGE and immunoblotting. Tryptic digestion of Xenopus IgM resulted in the release, at a low yield, of hexameric Fcmu, and of monovalent Fabmu fragments. The digestion of Xenopus IgY antibodies led to the recovery of divalent and monovalent Fab nu fragments. The antigen-binding property of these fragments was demonstrated. No Fc nu fragments of appreciable size could be detected. PMID- 2776937 TI - New microsurgical concepts II. Cornea, posterior segment, external microsurgery. Proceedings of the International Ophthalmic Microsurgery Study Group. Funchal/Madeira, May 21-25, 1988. PMID- 2776934 TI - Ultrastructural study of the response of eosinophil granule cells to Aeromonas salmonicida extracellular products and histamine liberators in rainbow trout Salmo gairdneri Richardson. AB - Intraperitoneal injections of Aeromonas salmonicida extracellular products (ECP), Compound 48/80 and Concanavalin A were found to degranulate the eosinophil granule cells (EGC) in the lower intestine and rectum of the rainbow trout Salmo gairdneri Richardson. Ultrastructurally, the EGC response resembled the anaphylactic granule extrusion of mammalian mast cells. Varying degrees of granule vacuolation and loss of electron density occurred. Labyrinthine channels were observed at the peak of degranulation. EGC response however, differed from mammalian mast cells in two respects. Firstly, degranulation involved the release of intact electron lucent granules and the subsequent disintegration of the granule matrix extracellularly. Mammalian mast cells on the other hand, release their granules by direct exocytosis. Secondly, the 48/80 and Con A-stimulated EGC degranulation was inhibited by antihistamines, promethazine and cimetidine. In mast cells, antihistamines do not prevent granule release but block histamine receptors in target cells. The degranulation of the ECGs was a non-cytotoxic event and the cells were capable of regeneration. As soon as the cells lost most of their granules, increased cytoplasmic activity was observed. This involved the expansion of the Golgi-endoplasmic reticulum complex. PMID- 2776936 TI - Differential cyclophosphamide sensitivity of suppressor function in Xenopus, the clawed toad. AB - Thymocyte and Splenocyte cultures from in vivo immunised Xenopus were assayed to test their suppressive capacity. Immunisation with TNP-Polyvinylpyrrolidone induced suppression. Suppression induced by the haptenated antigens, TNP-Red blood cells, TNP-Lipopolysaccharide, and TNP-Ficoll affected the anti-TNP antibody response of splenocytes from TNP-PVP immunised animals. Pretreatment with cyclophosphamide revealed both a sensitive and insensitive suppression capacity in Xenopus laevis. PMID- 2776939 TI - Small incision intraocular lens: past, present and future. AB - Research indicates that silicone is comparable to or exceeds PMMA as an intraocular lens material. Insertion of silicone lenses does, however, continue to be a source of discussion and studies continue to develop more affective insertion instrumentation. Hydrogel also appears to be a viable material for intraocular lenses. Because hydrogel can be dehydrated and inserted flat in the eye with forceps, there is no problem with insertion instrumentation. Studies with these lens materials is preliminary and ongoing. Future work will include work with acrylics, endocapsular surgery (liquid gels, injectable and inflatable lenses), a teledioptric lens for macular degeneration, and an intraocular biofocal. The future also holds further silicone and hydrogel studies and the possible development of other materials for intraocular lenses all in search of the optimum intraocular lens material and design. PMID- 2776940 TI - Comparing like with like: a prospective study of hydrogel and polymethylmethacrylate lenses. PMID- 2776941 TI - First results with soft lens implants. PMID- 2776944 TI - Pseudophakic bullous keratopathy in Switzerland. PMID- 2776943 TI - Filtering surgery in low tension glaucoma. PMID- 2776945 TI - Transverse incisions in the treatment of astigmatism combined with radial keratotomy. Preliminary results. PMID- 2776947 TI - Vacuum fixation of corneal lenticules for refractive surgery. AB - Using the rotating lamellar keratome, a simplified method for nonfreeze shaping of corneal tissue was developed. A set of refractive molding forms was designed for a standardized lenticule diameter. The fixation of the lenticule was achieved by a system of suction holes. A mechanical fixation ring was not required, as the total shearing force exerted by the rotating blade is neutralized even by a low suction setting. Different surface properties (polished, matt, rough) were compared, showing an influence of the surface structure on friction and thus lenticule fixation. With our optimized molding form, the lenticule is safely retained at a suction of 2.5 m H2O. PMID- 2776938 TI - Three ophthalmological instruments: the rotating contact glass holder, the cutying forceps and the diamond cystotome. AB - Three new ophthalmological instruments are described: a rotating contact glass holder for easier control of the three-mirror Goldmann or other diagnostic contact lens which must be rotated on the eye; a suture-tying forceps combined with a sapphire blade, combining the tying and cutting functions in one instrument and a diamond cystotome for anterior capsulectomy with a cutting edge of unequalled sharpness. PMID- 2776948 TI - Autologous corneal refractive microsurgery. A new technical approach. PMID- 2776949 TI - Importance of pupillary diaphragm for vitrectomy with intraocular silicone in hemodialysis patients. PMID- 2776946 TI - Prospective study of corneal astigmatism after standardized cataract incision: a pilot study. PMID- 2776950 TI - Micropuncture of retinal vessels. PMID- 2776951 TI - Microscissors for vitreo-retinal surgery. PMID- 2776952 TI - Is danazol a useful treatment in unexplained primary infertility? AB - 39 patients with primary unexplained infertility were treated in a double-blind placebo-controlled study of danazol. 14 patients completed a treatment course of danazol and 17 of placebo. One patient in the placebo group conceived during the 12 months follow-up period, and none in the danazol group. Danazol does not seem to be an effective treatment for unexplained primary infertility. PMID- 2776954 TI - Fetal heart rate accelerations in second-stage labour; two case reports. AB - Two cases of umbilical cord compression are reported in which variable decelerations in the fetal heart rate in the first stage of labour progressed to marked periodic accelerations in the second stage. A respiratory acidosis was present at birth in both cases. PMID- 2776955 TI - Teratoma of the placenta, a case report. AB - A mature solid teratoma of the placenta is presented. Like the other six, previously reported, cases it was located on the placental surface, between amnion and chorion. The nature of the tumor as well as its differential feature with fetus acardius amorphus are discussed. PMID- 2776956 TI - Solitary thick intra-uterine membranes not associated with the amniotic band syndrome; three case reports. AB - Three cases in which a single intra-uterine membrane with a free and thickened edge was identified by ultrasound antenatally are presented. The bands turned out to be thickenings of the fetal membranes. In one case intra-uterine adhesions were documented by hysterosalpingography (HSG) and hysteroscopy before conception. One infant suffered from hypospadias. The diagnosis of intra-uterine bands or membranes should turn our attention to a possible intra-uterine pathology. PMID- 2776953 TI - Intracervical 17 beta-oestradiol before induction of second-trimester abortion with a prostaglandin E1 analogue. AB - 28 consecutive patients (17.5 weeks pregnant, range 15-21 weeks) referred for therapeutic termination of pregnancy were randomized for pretreatment overnight with either intracervical gel containing 50 mg 17 beta-oestradiol or placebo gel. The induction-abortion time with pessaries containing 16,16-dimethyl-trans-delta 2-prostaglandin E1 methyl ester was significantly reduced in the oestrogen group (median value of 11.5 versus 15 hours). The beneficial effect of oestradiol priming was primarily caused by a reduction of the number of women with high cervical resistance and prolonged induction-abortion time (90 percentiles of 15.5 and 34 hours). Thus, oestrogen pretreatment might reduce the cervical trauma due to the prostaglandins as well as the incidence of cervical incompetence in later pregnancies. PMID- 2776957 TI - Diurnal variation of plasma and saliva oestrogen, progesterone, cortisol and plasma dehydroepiandrosterone sulphate in late pregnancy. AB - The diurnal variation of plasma oestrone (E1), oestradiol (E2), oestriol (E3), progesterone (P), cortisol (F) and dehydroepiandrosterone sulphate (DHAS) and saliva E1, E2, E3, P and F was investigated in matched plasma, and saliva samples were obtained hourly from 08.00 to 24.00 h and at 04.00, 07.00 and 08.00 h from nine pregnant women (3 at 30, 3 at 34 and 3 at 38 weeks gestation). A diurnal variation in plasma and saliva cortisol levels was found in all subjects and in plasma DHAS in 8 out of 9 subjects. No consistent diurnal variation was found at any gestation in any of the other hormones in plasma or saliva. There was a significant correlation between saliva E3 and P levels at 30 weeks gestation but no other consistent correlations between hormone levels were found at any gestation. PMID- 2776942 TI - The first American experience with the multifocal lens. AB - Ten patients were implanted with the multifocal posterior chamber intraocular lens at The Ohio State University. Follow-up ranged from 6 weeks to 7 months. Best case corrected visual acuity better than 20/40 was 100%. PMID- 2776958 TI - Transverse uterine incision for cesarean delivery of the transverse-lying fetus. AB - Low-isthmic transverse uterine incision was performed in 66 patients during Cesarean section indicated for transverse fetal lie. No significant differences were noted in the 1 and 5 min Apgar scores among fetuses delivered before or after rupture of the membranes. In only 5 (7.6%) of these cases was the incision converted into an inverted-T. The 1 min Apgar score was significantly lower in this group (6.0 +/- 1.3) compared to the rest of the group (7.5 +/- 1.7, P less than 0.01), however, the 5 min score showed no significant difference. No significant complications were noted in the post-operative course of mother and fetuses. We concluded that the transverse uterine incision is safe for the Cesarean delivery of the transverse-lying fetus. PMID- 2776959 TI - Serum progesterone and human chorionic gonadotropin in very early pregnancy: implications for clinical management. AB - We studied beta-human chorionic gonadotropin (beta-HCG) and progesterone (P) in maternal serum in 71 patients with a positive urine pregnancy test with a threshold of 50 U HCG/liter urine and an ultrasound examination without demonstrable fetal heart beat. Patients were divided into three groups: ongoing intra-uterine pregnancy of more than 12 weeks duration (n = 23), ectopic pregnancy (n = 14), and abnormal intra-uterine pregnancy (blighted ovum, early spontaneous abortion) resulting in dilatation and curettage (n = 34). We found that both beta-HCG and progesterone levels were significantly lower in abnormal pregnancies but that there was less overlap between the progesterone values in normal, ectopic and abnormal pregnancy as compared to beta-HCG levels. There was a positive correlation between beta-HCG levels less than 5000 mU/ml and serum progesterone in ectopic pregnancies but not in normal or abnormal intra-uterine pregnancies. The size of the gestational sac correlated with serum beta-HCG levels but not with serum progesterone levels in normal intra-uterine pregnancies. We conclude that serum progesterone levels (cut-off point 15 ng/ml) in very early pregnancy can be helpful to differentiate between normal intra uterine pregnancy and abnormal intra-uterine or ectopic pregnancy. PMID- 2776960 TI - Enhanced survival of motoneurons in the chick lateral motor column: effects of embryonic skeletal muscle extracts and myoblast-conditioned medium. AB - Muscle-derived factors have shown neurotrophic effects in culture, but their possible effects on the maintenance of embryonic motoneurons have not been demonstrated in vivo. Soluble extracts derived from embryonic chick muscle, or medium conditioned by chick myoblasts, were instilled onto the chorioallantoic membrane (CAM) between the 5th and 11th days of incubation. Counts of the lumbar lateral motor column (LMC) at embryonic day 12 revealed modest but significant increases (12-15%) in motoneuron number for these experimental groups as compared with control treatments. The results suggest that sustaining effects of muscle derived factors on motoneurons may be demonstrated on the developing LMC by the simple expedient delivery via the CAM, and that these factors can modify the normal program of cell death occurring during this critical period of development. PMID- 2776961 TI - Mitogenic effect of estradiol on MCF-7 human breast cancer cells can be modulated by serum. AB - The MCF-7 human breast cancer cell line responds to estradiol stimulation in vitro by increased proliferation only if prolonged subcultures in dextran-coated charcoal-treated fetal calf serum have been made previously. This growth stimulation is not obtained when cells are grown in medium containing 5% untreated fetal calf serum. We describe here the culture conditions under which we obtain a reproducible estradiol effect on cell growth. PMID- 2776963 TI - Obesity- and sex-related alterations in growth hormone messenger RNA levels. AB - The secretion of growth hormone (GH) is abnormal in genetically obese Zucker rats. Measurements of pulsatile GH release and circulating GH levels in lean (Fa/?) and obese (fa/fa) rats have shown that both are reduced in the latter. We have studied pituitary GH gene expression in order to understand the role of GH synthesis in this abnormality. Obese animals have lower pituitary GH mRNA levels than lean controls. Within each genotype a sex difference was observed with the female animals having lower GH mRNA levels than the males. It is unlikely that the GH abnormality is due to a generalized pituitary defect because prolactin mRNA levels were the same in all four groups of rats. PMID- 2776962 TI - Differential adhesion of metastatic rat mammary carcinoma cells to organ-derived microvessel endothelial cells and subendothelial matrix. AB - The in vitro adhesion rates of rat 13762NF mammary adenocarcinoma cell clones of different spontaneous metastatic potentials to cloned microvessel endothelial cell monolayers and their subendothelial extracellular matrix were investigated. In this system, high rates of adhesion of the cloned tumor cell lines to syngeneic target (lung) organ-derived subendothelial matrix correlated with spontaneous metastatic potential, whereas adhesion to the lung microvessel endothelial cell apical surfaces occurred at lower rates and was not highly significantly different among the tumor cell lines. Adhesion rates to bovine aortic large vessel, and human brain and human meningeal microvessel endothelial cell monolayers were, in general, lower than those found with syngeneic lung microvessel endothelial cells, and did not correlate with spontaneous metastatic potential. Growth of endothelial cells in fetal bovine serum or platelet-poor horse serum did not affect the results, suggesting that in this system metastasis associated organ-adhesive specificity is determined at the level of the subendothelial matrix. PMID- 2776964 TI - Selective recognition between embryonic afferent neurons of grasshopper appendages in vitro. AB - Selective affinity between afferent neurons has been proposed as a major mechanism underlying the assembly of the insect peripheral nervous system during development. Afferent insect neurons establish adhesive interactions in vivo that are resistant to proteolytic degradation by elastase and independent of the basal lamina. We have tested whether afferent neurons express selective affinity for one another under more simplified and controlled conditions in vitro. We report here that (1) afferent neurons from dissociated embryonic tissue selectively aggregate within 80 min when incubated with rotation, (2) afferent axons establish and maintain fasciculation in vitro, and (3) afferent neuronal processes in vitro preferentially contact the somata of other afferent neurons in a mixed field of cells. PMID- 2776965 TI - An aberrant retinal pathway and visual centers in Xenopus tadpoles share a common cell surface molecule, A5 antigen. AB - A monoclonal antibody A5 (MAb-A5), which was raised against Xenopus tadpole tectal cells, recognizes a cell surface-related protein molecule (A5 antigen) expressed on the visual centers of Xenopus tadpoles (S. Takagi, T. Tsuji, T. Amagai, T. Takamatsu, and H. Fujisawa, 1987, Dev. Biol. 122, 90-100). The present immunohistochemistry using MAb-A5 indicated that, in addition to the visual centers, A5 antigen was expressed on the general somatic sensory tract in the medulla and spinal cord of Xenopus tadpoles. As the general somatic sensory tract has been shown to be a pathway for ectopically transplanted retinal axons (M. Constantine-Paton and R. R. Capranica, 1976, J. Comp. Neurol. 170, 17-32; M. J. Katz and R. J. Lasek, 1979, J. Comp. Neurol. 183, 817-832), we examined whether retinal axons transplanted close to the spinal cord or medulla preferentially grow into the A5 antigen-positive general somatic sensory tract. We performed eye transplantation at embryonic stages and detected precise locations and trajectories of transplanted retinal axons within the medulla and spinal cord in tadpoles after filling retinal axons with horseradish peroxidase (HRP). HRP histochemistry in combination with MAb-A5 immunohistochemistry indicated that almost all HRP-filled transplanted retinal axons joined the A5 antigen-positive general somatic sensory tract. These findings suggest the involvement of A5 antigen in specific cell-cell recognition between retinal axons and their targets. PMID- 2776967 TI - The survival of early chick sympathetic neurons in vitro is dependent on a suitable substrate but independent of NGF. AB - The neuronal cell population of lumbosacral sympathetic ganglia from 7-day-old chick embryos is characterized by a high proportion of cells with the ability to proliferate in culture (Rohrer and Thoenen, 1987). It is now demonstrated that neither proliferation nor survival of these neurons depend on the presence of nerve growth factor (NGF). However, neuronal survival did depend on the culture substrate used: on laminin, E7 neurons survived and their number increased due to proliferation, whereas on fibronectin (FN) or a substrate of molecules from heart cell-conditioned medium (HCM) a significant number of the cells died during early culture periods. Less than 70 and 50% of the number of neurons surviving on a laminin substrate were found on FN and HCM, respectively, after 3 days in culture. Although NGF did not affect neuronal survival, a small increase in neurite extension on these substrates was observed in the presence of NGF. Furthermore, although NGF did not prevent neuronal death after extended culture periods, this could be prevented by elevated extracellular potassium concentrations. Sympathetic neurons of E8 chick embryos however showed a strikingly different response to NGF compared with those of E7: whereas neuronal survival on laminin was not influenced by NGF, a significant effect of NGF on survival and on neurite extension was observed for E8 neurons on a HCM substrate. In contrast to cells from E7 and E8 embryos, the majority of neurons from E11 chick embryos required NGF for survival even on a laminin substrate as described previously (D. Edgar, R. Timpl, and H. Thoenen, 1984, EMBO J. 3, 1463-1468). These results demonstrate that while sympathetic neurons from E7 chick embryos do not depend on the soluble neurotrophic factor NGF for survival in vitro, they are dependent on molecules of the extracellular matrix. With increasing age, the survival requirements demonstrated in vitro change toward the classical pattern of NGF dependency. Low amounts of laminin-like immunoreactivity were shown to be present in sympathetic ganglia of E7 chick embryos which were then shown to increase as development proceeded. These data indicate that laminin may play a role in the survival and development of chick sympathetic neurons not only in vitro, but also in vivo. PMID- 2776969 TI - Expression of L1 and N-CAM cell adhesion molecules during development of the mouse olfactory system. AB - The expression of the neural adhesion molecules L1 and N-CAM has been studied in the embryonic and early postnatal olfactory system of the mouse in order to gain insight into the function of these molecules during development of a neural structure which retains neuronal turnover capacities throughout adulthood. N-CAM was slightly expressed and L1 was not significantly expressed in the olfactory placode on Embryonic Day 9, the earliest stage tested. Rather, N-CAM was strongly expressed in the mesenchyme underlying the olfactory placode. In the developing nasal pit, L1 and N-CAM were detectable in the developing olfactory epithelium, but not in regions developing into the respiratory epithelium. At early developmental stages, expression of the so-called embryonic form of N-CAM (E-N CAM) coincides with the expression of N-CAM, whereas at later developmental stages and in the adult it is restricted to a smaller number of sensory cell bodies and axons, suggesting that the less adhesive embryonic form is characteristic of morphogenetically dynamic neuronal structures. Moreover, E-N CAM is highly expressed at contact sites between olfactory axons and their target cells in the glomeruli of the olfactory bulb. L1 and N-CAM 180, the component of N-CAM that accumulates at cell contacts by interaction with the cytoskeleton are detectable as early as the first axons extend toward the primordial olfactory bulb. L1 remains prominent throughout development on axonal processes, both at contacts with other axons and with ensheathing cells. Contrary to N-CAM 180 which remains detectable on differentiating sensory neuronal cell bodies, L1 is only transiently expressed on these and is no longer detectable on primary olfactory neuronal cell bodies in the adult. Furthermore, whereas throughout development L1 has a molecular form similar to that seen in other parts of the developing and adult central nervous systems, N-CAM and, in particular, N-CAM 180 retain their highly sialylated form at least partially throughout all ages studied. These observations suggest that E-N-CAM and N-CAM 180 are characteristic of developmentally active structures and L1 may not only be involved in neurite outgrowth, but also in stabilization of contacts among fasciculating axons and between axons and ensheathing cells, as it has previously been found in the developing peripheral nervous system. PMID- 2776968 TI - Mitochondrial gene expression in male germ cells of the mouse. AB - Inheritance of the mitochondrial genome is known to be exclusively maternal. To determine whether the loss of paternal mitochondria could be due to a deficiency of RNA in the spermatozoal mitochondria, the expression of mitochondrial genes was studied in testicular cells at various stages of spermatogenesis and in epididymal spermatozoa. The presence of mitochondrial transcripts was examined by Northern blot analysis using probes for the following mitochondrially encoded genes: 12 S and 16 S ribosomal RNAs and a group of mRNAs including cytochrome oxidase subunits I and II (COI-COII), cytochrome b (cyt b), adenosine triphosphatase (ATPase) subunits 6 and 8, and subunit 1 of the respiratory chain NADH dehydrogenase (ND1). Comparison of total testicular RNA preparations from prepuberal (6, 8, 12, 16, 18, 20, 22, and 30 days old) and sexually mature (45 days old) mice revealed no major qualitative or quantitative differences in the levels of the mitochondrial transcripts described above. Similar results were observed from enriched preparations of type A and B spermatogonia and interstitial cells obtained from the testes of 8-day-old mice. Transcripts for COI-COII, ATPase 6, or ND1 were reduced in amount in the enriched preparations of pachytene spermatocytes, round spermatids, and residual bodies when compared to the amount in total testis or liver RNA. Transcripts of all the mitochondrial genes analyzed were present in RNA preparations isolated from sperm midpiece tails obtained after sonication of epididymal spermatozoa. These studies demonstrate that (a) during testicular development the levels of mitochondrial RNA in total testicular extracts show no major qualitative and quantitative differences; (b) the mitochondrial transcripts in enriched populations of type A and type B spermatogonia are not different from those obtained from total testes extracts; (c) mitochondrial transcript levels gradually decrease in enriched preparations of pachytene spermatocytes, round spermatids, and residual bodies; and (d) the mitochondrial rRNAs and mRNAs encoded by several mitochondrial genes can be isolated from sperm midpiece tails. PMID- 2776972 TI - Decreased activity of Blastocladiella emersonii zoospore ribosomes: correlation with developmental changes in ribosome-associated proteins. AB - Ribosomal proteins isolated from dormant zoospores were compared to the ribosomal proteins found in the active growth phase by two-dimensional polyacrylamide gel electrophoresis. Zoospore ribosomes were found to contain a set of five proteins, designated Z1 to Z5, which were not present in growth phase ribosomes. The Z1-Z5 proteins were not removed by high-salt washes using either 1 M KCl or 1 M NH4 Cl. The Z1 protein is found associated with zoospore 60 S subunits while Z2-Z5 are bound to 40 S subunits. Zoospore monoribosomes and polyribosomes contain comparable levels of each of the five proteins. Approximately 60 min. after sporulation is induced, the Z1-Z5 proteins begin to accumulate on the ribosomes with the highest levels of these proteins found associated with ribosomes at the zoospore stage. During germination, the proteins gradually disappear and are not detectable on the ribosomes after 4 hr of germination. The presence of the Z1-Z5 proteins correlates with a decrease in in vitro protein synthetic activity of the fungal ribosomes. The data are consistent with the hypothesis that the proteins regulate translation by completely blocking protein synthesis on a subset of ribosomes while the remainder of the ribosomes function at normal rates. PMID- 2776966 TI - Evidence for a change in expression of DNA ligase genes in the Pleurodeles waltlii germ line during gonadogenesis. AB - The expression of DNA ligase genes was studied using the nuclear transplantation approach in the germ line of Pleurodeles waltlii (P. waltlii) just before and during gonadogenesis. Germ cell (GC) nuclei were isolated from larvae of P. waltlii and transplanted into unfertilized Ambystoma mexicanum eggs. DNA ligase activity in these eggs was then analyzed after sucrose gradient fractionation. The activity of DNA ligase I (heavy form, 7.5 S) of P. waltlii was present when the transplanted GC nuclei were isolated before the first histological appearance of gonadogenesis. At the beginning of genital ridge formation and thereafter, DNA ligase I activity was replaced by that of DNA ligase II (light form, 7 S). Expression of form I was found to be sensitive to inhibitors of translation and transcription, while that of form II was not. Therefore, the change in DNA ligase activity of the transferred nuclei of P. waltlii germ cells was assumed to be the consequence of a change in gene activity, namely, the repression of the gene encoding DNA ligase I. This change in the gene-regulated state could be linked to protein modifications of the chromatin. These results indicate that, at the beginning of gonadogenesis, germ cells receive information leading to a new state of differentiation. PMID- 2776971 TI - Myosin isoform transitions in regeneration of fast and slow muscles during postnatal development of the rat. AB - Regeneration of rat fast (gastrocnemius medialis) and slow (soleus) muscles was examined after degeneration of myofibers had been achieved by injection of cardiotoxin into the hindleg during the first week after birth. Myogenesis in the regenerating muscles was compared to postnatal myogenesis in the contralateral and in control muscles. Synthesis of embryonic and neonatal myosin isoforms was initiated 3 days after injury. These forms were gradually replaced by the intermediate and fast adult isoforms (type II fiber myosins), whose synthesis followed the same curve in regenerating, contralateral, and control muscles. In contrast, synthesis of the slow myosin isoform (type I fiber myosin) was greatly delayed in injured muscles, but eventually became equal to its synthesis in contralateral and control muscles. It therefore appears that synthesis of type II fiber myosins is similarly regulated, probably by thyroid hormone, in developing regenerating and normal muscles, while synthesis of type I fiber myosin depends on other factor(s). PMID- 2776970 TI - Teloplasm formation in a leech, Helobdella triserialis, is a microtubule dependent process. AB - Fertilized eggs of the leech Helobdella triserialis undergo a cytoplasmic reorganization which generates domains of nonyolky cytoplasm, called teloplasm, at the animal and vegetal poles. The segregation of teloplasm to one cell of the eight-cell embryo is responsible for a unique developmental fate of that cell, i.e., to give rise to segmental ectoderm and mesoderm. We have studied the cytoplasmic movements that generate teloplasm using time-lapse video microscopy; the formation and migration of rings of nonyolky cytoplasm were visualized using transmitted light, while the movements of mitochondria into these rings were monitored with epifluorescence after labeling embryos with rhodamine 123, a fluorescent mitochondrial dye. To examine the likelihood that cytoskeletal elements play a role in the mechanism of teloplasm formation in Helobdella, we examined the distribution of microtubules and microfilaments during the first cell cycle by indirect immunofluorescence and rhodamine-phalloidin labeling, respectively. The cortex of the early embryo contained a network of microtubules many of which were oriented parallel to the cell surface. As teloplasm formation ensued, microtubule networks became concentrated in the animal and the vegetal cortex relative to the equatorial cortex. More extensive microtubule arrays were found within the rings of teloplasm. Actin filaments appeared in the form of narrow rings in the cortex, but these varied apparently randomly from embryo to embryo in terms of number, size, and position. The role of microtubules and microfilaments in teloplasm formation was tested using depolymerizing agents. Teloplasm formation was blocked by microtubule inhibitors, but not by microfilament inhibitors. These results differ significantly from those obtained in embryos of the oligochaete Tubifex hattai, suggesting that the presumably homologous cytoplasmic reorganizations seen in these two annelids have different cytoskeletal dependencies. PMID- 2776974 TI - A myosin isoform repressed in hypertrophied ALD muscle of the chicken reappears during regeneration following cold injury. AB - A library of monoclonal antibodies specific for myosin heavy chain (HC) was used to study myosin expression in regenerating fibers. The response to cold injury of slow skeletal ALD muscle previously induced to eliminate SM1 myosin by weight overload was compared to that of its contralateral control. Native gel electrophoresis combined with immunoblotting demonstrated that slow SM1 myosin HC eliminated from hypertrophic muscle reappeared both at the site of active regeneration and unexpectedly, also distal to the site of injury. The regeneration response of hypertrophied muscles was similar to that of the controls. In addition to SM1 myosin HC, ventricular-like and embryonic/fast isoforms were also expressed in both muscles during the early stages of regeneration and disappeared as the muscle fibers matured. These observations demonstrate that regenerating slow muscle fibers reexpress myosins' characteristic of developing muscle irrespective of the myosin phenotype prior to injury. The reappearance of repressed myosin HC in the hypertrophied ALD muscle is consistent with the presence of newly differentiated myonuclei. PMID- 2776973 TI - Culture conditions affect the cholinergic development of an isolated subpopulation of chick mesencephalic neural crest cells. AB - Although neural crest cells are known to be very responsive to environmental cues during their development, recent evidence indicates that at least some subpopulations may be committed to a specific differentiation program prior to migration. Because the neural crest is composed of a heterogeneous mixture of cells that contributes to many vertebrate cell lineages, assessing the properties of specific subpopulations and the effect of the environment on their development has been difficult. To address this problem, we have isolated a pure subpopulation of chick mesencephalic neural crest cells by fluorescence no-flow cytometry after labeling them with monoclonal antibodies (Mabs) to a 75-kDa cell surface antigen that is associated with high affinity choline uptake. When cultures of chick mesencephalic neural crest cells are labeled with these Mabs and a fluorescent second step antibody, approximately 5% of the cells are antigen positive (A+). After sorting, 100% of the resulting cultured mesencephalic neural crest cells are A+. The Mabs we used also label all of the neurons of the embryonic chick and quail ciliary ganglion in vivo and in vitro. We have compared the effect of various cell culture media on the isolated neural crest subpopulation and the heterogeneous chick mesencephalic neural crest from which it was derived. A+ cells were passaged and grown in a variety of media, each of which differently affected its characteristics and development. A+ cells proliferated in the presence of 15% fetal bovine serum (FBS) and high concentrations (10-15%) of chick embryo extract, but did not differentiate, although they retained basal levels of choline acetyltransferase (ChAT) activity. However, in chick serum and high (25 mM as opposed to 7 mM) K+, and heart-, iris , or lung-conditioned medium, all of which are known to promote survival and/or cholinergic development of ciliary ganglion neurons, the cells ceased to proliferate and all of the cells in the culture became "neuron-like" within 10 days. No neuron-like cells were found in liver-, notocord-, or neural tube conditioned media if FBS was used. When A+ cells were eliminated either by complement-mediated cytotoxicity or by laser-ablating A+ cells during no-flow cytometry, all ChAT activity was also eliminated, and no neuron-like cells or ChAT activity was found in cultures during a subsequent 3-week culture period.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2776977 TI - Segmental specificity and lateral asymmetry in the differentiation of developmentally homologous neurons during leech embryogenesis. AB - This paper describes the embryonic development of three leech neurons which undergo spatially regulated patterns of differentiation. In leeches, the nervous system arises from an iterated array of embryonic cell lineages, and each neuron is represented by a set of bilaterally symmetric and segmentally repeated homologs. Two of the cells discussed here, the neurons nz4 and mz3, stain with antibodies to the neuropeptides SCP and FMRFamide during the course of their embryonic differentiation, but only a subset of the initially immunoreactive homologs continue to express this immunoreactivity into postembryonic life. Those nz4 cells which retain immunoreactivity are referred to as RAS neurons, and the persistently immunoreactive mz3 cells referred to as CAS neurons. The subset of homologs which show persistent expression is segment specific, such that the mature RAS and CAS neurons occupy different segmental domains. In addition, both neurons display a final pattern of expression which is laterally asymmetric, with only one of the two homologs in each segment maintaining the RAS or CAS phenotype. Asymmetric differentiation can occur in either orientation for any given segment, although there is a very strong tendency for the persistently immunoreactive cells to lie on opposite sides of successive segments. The fate of the transiently immunoreactive homologs is unclear, but labeling with intracellular lineage tracers suggests that there are some mz3 neurons which survive late into postemobryonic life and never express detectable levels of immunoreactivity. Intracellular lineage tracers also allowed us to follow the development of a third neuron, mz4, which does not stain for either peptide. The mz4 neuron is initially paired, but undergoes an asymmetric pattern of cell death which also shows a strong tendency to alternate sides in successive segments. These spatially coordinated patterns of neuronal survival and/or differentiation suggest that cell interactions play a role in determining the developmental choices made by individual neurons, and a subsequent paper will characterize those interactions through experimental manipulation. PMID- 2776976 TI - Promotion of embryonic chick limb cartilage differentiation by transforming growth factor-beta. AB - This study represents a first step in investigating the possible involvement of transforming growth factor-beta (TGF-beta) in the regulation of embryonic chick limb cartilage differentiation. TGF-beta 1 and 2 (1-10 ng/ml) elicit a striking increase in the accumulation of Alcian blue, pH 1-positive cartilage matrix, and a corresponding twofold to threefold increase in the accumulation of 35S-sulfate- or 3H-glucosamine-labeled sulfated glycosaminoglycans (GAG) by high density micromass cultures prepared from the cells of whole stage 23/24 limb buds or the homogeneous population of chondrogenic precursor cells comprising the distal subridge mesenchyme of stage 25 wing buds. Moreover, TGF-beta causes a striking (threefold to sixfold) increase in the steady-state cytoplasmic levels of mRNAs for cartilage-characteristic type II collagen and the core protein of cartilage specific proteoglycan. Only a brief (2 hr) exposure to TGF-beta at the initiation of culture is sufficient to stimulate chondrogenesis, indicating that the growth factor is acting at an early step in the process. Furthermore, TGF-beta promotes the formation of cartilage matrix and cartilage-specific gene expression in low density subconfluent spot cultures of limb mesenchymal cells, which are situations in which little, or no chondrogenic differentiation normally occurs. These results provide strong incentive for considering and further investigating the role of TGF-beta in the control of limb cartilage differentiation. PMID- 2776978 TI - The growth of axons in three-dimensional astrocyte cultures. AB - The environment of the adult central nervous system (CNS) does not support axon regeneration. We have been unable to replicate this behaviour using monolayer cultures of glia, so we have developed a technique for three dimensional culture of glial cells. We have examined the growth of axons from embryonic and postnatal retina and dorsal root ganglia (DRG's) through purified three-dimensional astrocyte cultures. Neither postnatal DRG's nor adult retina were able to grow axons through astrocytes from cultures 3 weeks or more old, although some DRG axons grew in astrocyte cultures which were 10 days or less old. However axons from embryonic DRG's and retina grew axons profusely into even elderly astrocyte cultures. All the tissues grew axons into three-dimensional Schwann cell cultures. The behaviour of axons in three-dimensional glial cultures therefore reproduces the behaviour of axons in vivo. PMID- 2776975 TI - NCAM in the differentiation of embryonic lens tissue. AB - The role of the neural cell adhesion molecule (NCAM)2 in ocular lens differentiation was investigated in chicken embryos. Changes in expression of NCAM were documented by immunohistology of frozen sections. This analysis revealed that NCAM diminished during lens fiber differentiation, in contrast to the gap junction-associated protein MP26 which became more abundant. The form of NCAM expressed was determined by Western blot analysis of proteins extracted from the different regions of the Embryonic Day 6 lenses. All regions expressed NCAM with an apparent molecular weight of 140 kDa and relatively low levels of polysialylation. The function of NCAM in lens differentiation was investigated using antibodies that inhibit NCAM-mediated adhesion. Two parameters that change during maturation of the lens epithelial cells were monitored: the thickness of the tissue, indicating the length of lens cells, and the particle arrangement of gap junctions, reflecting the state of junctional differentiation. When epithelial cell explants of Embryonic Day 6 lenses were cultured for 5 days, the cells elongated and displayed an increase in the loose, random intramembranous particle arrangements characteristic of maturing lens fiber gap junctions. When the explants were cultured in the presence of anti-NCAM Fabs, the epithelia were thinner than in matched controls and had particle arrangements characteristic of a less mature state. The expression of NCAM during lens differentiation and the effects of attenuating NCAM function suggest that adhesion mediated by NCAM is an essential event in lens cell differentiation. PMID- 2776980 TI - EPC. European Pancreatic Club, XXIst meeting. Glasgow, September 20-23, 1989. Abstracts. PMID- 2776981 TI - American Auditory Society--reemphasis of mission. PMID- 2776979 TI - Expression of tumor necrosis factor at a specific developmental stage of mouse embryos. AB - We investigated the expression of the tumor necrosis factor (TNF) gene during development of mouse embryos, and observed its transient expression on Days 9 and 10 of gestation. We also detected a 25-kDa protein showing immunological cross reactivity with mouse TNF antibody in an extract of 10-day embryos. These results suggest that TNF plays a role in mammalian ontogenesis. PMID- 2776982 TI - Norms for disproportionate loss in speech intelligibility. AB - The audiometric records of 324 subjects with sensorineural hearing loss, presumed to be cochlear, were analyzed in order to develop norms for "disproportionate loss" in speech intelligibility. From the scatterplot relating PBmax to PTA2 (average of HTLs at 1,000, 2,000, and 4,000 Hz), and the scatterplot relating SSImax to PTA1 (average of HTLs at 500, 1,000, and 2,000 Hz), linear boundaries were constructed encompassing approximately 98% of observed values. A speech intelligibility score (PB or SSI) may be considered "disproportionately poor" if it falls below this empirically derived boundary. PMID- 2776984 TI - Open-set speech recognition in children with a single-channel cochlear implant. AB - We evaluated the ability of profoundly deaf children using the 3M/House single channel cochlear implant to understand speech without the aid of speechreading. Fifty-one implanted children over the age of 5 years, who had sufficient cognitive and language skills, were tested using word and sentence stimuli presented in an open-set, auditory-only mode. Fifty-two percent of the children demonstrated some open-set performance on word identification, while 41.5% did so on sentence comprehension. Children who scored open-set had a shorter duration of deafness than those who did not. A larger proportion of children using oral communication demonstrated open-set speech recognition than those using total communication. A multiple regression analysis indicated that communication method accounted for the largest proportion of variability in performance on both the word and sentence tasks. Children achieving open-set auditory recognition, however, included both those using oral communication and those using total communication, children deafened by meningitis and those born deaf, and children with varying durations of deafness. PMID- 2776983 TI - Word recognition skills of children and adults in background noise. AB - This study compared the word recognition performance of 4 to 6 year old children and adults on the Word Intelligibility by Picture Identification (WIPI) Test presented via sound field in quiet and in a background of multitalker noise and pink noise. Although the adults had no difficulty recognizing speech in all situations, the children performed significantly poorer in both noise conditions. Furthermore, the multitalker noise proved to be more adverse than the pink noise on speech discrimination. PMID- 2776985 TI - Follow-up survey of the elderly who failed a hearing screening protocol. AB - A combined use of pure-tone screening and the Hearing Handicap Inventory for the Elderly (HHIE) has been proposed by Ventry and Weinstein (Asha 1983;25:37-42) to meet an increasing need to identify the elderly with possible hearing problems. The purpose of this study was to discern what follow-up action was taken by the individuals who failed the protocol and received a referral. One hundred and seventy-seven elderly people were screened. Thirty-eight (22%) out of 177 people received either Priority 1, 2, or 3 and were referred for further audiological or medical evaluations. Out of these 38, 25 were contacted for a follow-up telephone interview approximately 4 months after the screening. Thirteen (52%) out of 25 individuals followed our recommendation and received further evaluation. Audiological or medical treatment was recommended for all these individuals, 11 (85%) of whom actually accepted recommended treatment. The remaining 12 out of 25 individuals did not seek further evaluation for various reasons. This study presented several scenarios of what happened to those elderly people who failed the Ventry and Weinstein screening protocol. PMID- 2776987 TI - Comparison of the mastoid to vertex and mastoid to high forehead electrode arrays in recording auditory evoked potentials. AB - The ipsilateral mastoid to vertex and ipsilateral mastoid to high forehead electrode arrays were found to have equal efficacy in recording the auditory brain stem and middle latency responses in both open and closed filtered conditions. It is concluded that the ipsilateral mastoid to high forehead electrode array is a valid clinic alternative for use in evoked response testing. PMID- 2776986 TI - Probe-tube microphone measures of ear-canal sound pressure levels in infants and children. AB - Probe-tube microphone measures of ear-canal sound-pressure levels were obtained for 31 children under 5 years of age. These data were compared to similar measures from a group of 21 adults. The intrasubject variability was smallest for the frequency range from 750 to 3000 Hz and at no frequency did the mean standard deviation exceed 3 dB. Real ear to coupler differences for the children showed the same pattern as a function of frequency as for adults but were significantly larger. A systematic decrease in real ear to coupler differences was observed with increasing age between 1000 and 3000 Hz. An estimate of ear-canal volume did not appear to be a clinically useful predictor of real ear to coupler differences. PMID- 2776990 TI - AIDS education for senior managers. PMID- 2776988 TI - The convergence-of-everything theory. PMID- 2776989 TI - AIDS management: five hospitals compared. PMID- 2776991 TI - Board effectiveness: how the CEO can help. PMID- 2776992 TI - Incentives for the nursing profession. PMID- 2776993 TI - Forming a committee? Consider alternatives first. PMID- 2776994 TI - Selling the organization: the last step. PMID- 2776995 TI - Survival in the '90s. PMID- 2776996 TI - Aboriginal AIDS strategy, Ottawa. PMID- 2776997 TI - New journal devoted to AIDS, New York. PMID- 2776998 TI - Dirty words: health care rationing. PMID- 2777000 TI - Type 2 (non-insulin-dependent) diabetes mellitus, migration and westernisation: the Tokelau Island Migrant Study. AB - The migration of Tokelauans from a traditional atoll in the Pacific to urban New Zealand is associated with an increased prevalence and incidence of Type 2 (non insulin-dependent) diabetes mellitus over the period 1968-1982. During the same period, a lesser but definite increase is seen among non-migrants in Tokelau. The age standardised prevalence rates rose from 7.5 and 11.7 to 10.8 and 19.9 per 100 respectively in the male and female migrants compared with an increase from 3.0 and 8.7 to 7.0 and 14.3 per 100 in the non-migrant males and females respectively. The incidence of diabetes is shown to be consistently higher in the migrants compared to the non-migrants giving relative risks of 1.5 in males and 1.9 in females. The factors most likely contributing to this difference, are changes to a higher calorie, high protein diet, higher alcohol consumption, a greater weight gain and altered levels of physical activity in the migrants. A number of populations in the Pacific have been shown to have a low rate of diabetes in their traditional setting, but may have a genetic predisposition for diabetes which responds to factors in the urban industrialised environment and life-style. The social and economic changes taking place in Tokelau are also clearly increasing the risk of diabetes. To reverse these trends and prevent the development of complications of Type 2 diabetes, it will be important to institute preventive programmes and to follow up the population in both environments for long-term outcomes, including mortality. PMID- 2776999 TI - Oestrogen and progestogen receptors in endometrium and myometrium at the time of blastocyst implantation in pregnant diabetic rats. AB - A suitable hormonal environment is a prerequisite for blastocyst implantation. Experimental diabetes was previously shown to modify the hormonal milieu and produce alterations in oestrogen receptor kinetics in the uterine tissue. In the present work, oestrogen and progestogen receptor levels were measured on the morning of day 6 of pregnancy in normal and in streptozotocin-induced diabetic rats, both in implantation sites and in interembryonic segments of endometrium and myometrium. Receptor levels were different in the implantation sites compared to the interembryonic segments of endometrium, both in the control and in the diabetic animals. Indeed, implantation sites were characterized by lower oestrogen receptor levels in cytosol and higher progestogen receptor levels in cytosol and nuclei. However, compared to the control rats, the diabetic rats had lower oestrogen receptor levels in implantation sites, both in cytosol and nuclei. In the myometrium, the differences between sites or between types of rats were minimal. Plasma levels of oestradiol were lower in diabetic rats than in control animals, whereas progesterone levels were similar. A 20% lower implantation rate was found in diabetic rats, compared to normal rats. These results show that the specific distribution of oestrogen and progestogen receptors between implantation sites and interembryonic segments was preserved in the diabetic rats; however the absolute level of oestrogen receptor was lower. This abnormal endocrine milieu might arise from a lower oestradiol level and a decreased oestradiol/progesterone ratio in the circulating blood. Whether the lower implantation rate in diabetic rats might be a consequence of the overall disturbed hormonal status remains to be elucidated. PMID- 2777002 TI - Identification of the cell surface molecule involved in sexual cell fusion of Dictyostelium discoideum. AB - Dictyostelium discoideum was used as a model system for elucidating the molecular mechanism of sexual cell fusion. In heterothallic strains NC4 and HM1 of D. discoideum, complements in mating type, amoeboid cells acquire fusion competence only under certain environmental conditions, such as the presence of excess water and a certain period of darkness, to fuse sexually. The surface of cells which acquired fusion competence was found to possess specific antigens. Monovalent antibodies prepared from rabbit antiserum against fusion-competent NC4 cells inhibit the sexual cell fusion of these cells completely. Two specific antigenic proteins, 39 and 138 k Da in relative molecular mass and specific for fusion competent cells, were detected. Only one, the 138-k Da protein, was capable of neutralizing the fusion-inhibitory activity of the monovalent antibody. These results show that the 139-k Da protein is the one involved in the sexual cell fusion of NC4 and HM1 strains in D. discoideum. PMID- 2777003 TI - Stage-specific polypeptide and villin expression during thyroid-hormone-induced substitution of the amphibian intestinal epithelium. AB - Treatment of anuran tadpoles with 5 nM 3,3',5-triiodo-L-thyronine (T3) results in the complete substitution of the intestinal epithelium. We have examined the developmental pattern of protein synthesis in Alytes obstetricans intestinal epithelium using two-dimensional gel electrophoresis. Four different types of changes have been observed. The group I polypeptides (Mr: 41,500; 44,500; 51,500; 55,000 and 101,000) are only synthesized during the first week of hormonal treatment. They are specific of the primary (larval) epithelium. On the other hand, polypeptides referred to as Group II (Mr: 47,000; 48,000; 58,000; 66,500, pl 5.2; 99,500 and 102,000) are not detected until day 8. They are characteristic of the secondary tissue. Polypeptides of Group III (Mr: 42,000, pl 5.15 and 5.25; 42,500, 47,500, pl 5.25 and 5.55) expressed between the 6th and 8th day of T3 treatment, are specific of growing stem cells. During this critical period, Group IV polypeptides (Mr: 63,500; 66,500, pl 6.35; 105,000, pl 5.5 and 5.55) are not synthesized. The protein of Mr 105,000 (pI 5.5 and 5.55) is immunologically related to villin, a core protein of intestinal microvilli. Expression of this protein has been analyzed by immunoreplica and immunocytochemical procedures during differentiation of basal stem cells into secondary absorptive epithelial cells. The results have been compared to that obtained during spontaneous metamorphosis. PMID- 2777005 TI - Basement membrane and epithelial features of fetal-type Leydig cells in rat and human testis. AB - The basement membranes of developing Leydig cells in fetal and newborn testis of rat were studied by ultrastructural and immunocytochemical methods. Fetal-type Leydig cells in prenatal rats were organized in irregularly outlined groups in the interstitium and were extensively surrounded by ultrastructurally identifiable basement membranes and immunocytochemically localized laminin and collagen type IV. Prenatal Leydig cell precursors had small patches of laminin and collagen type IV on their surfaces, which indicated that changes in extracellular matrix took place during their differentiation to mature fetal-type Leydig cells. Additionally, ultrastructural evidence was obtained for a basement membrane surrounding the fetal human Leydig cells similar to that in fetal rats. Soon after birth the rat fetal-type cells gathered into distinct clusters surrounded by delicate envelope cells and a discontinuous basement membrane. Basement-membrane structures, laminin, and collagen type IV were observed between the clustered cells as well. The basement membranes covering large cell surface areas of the fetal-type Leydig cells in fetal and newborn rats differed from those of the adult-type cells, which, according to our earlier study, are covered only by small patches of basement membrane. The difference between the basement membranes of the fetal- and adult-type rat Leydig cells further supports the concept of two different Leydig cell populations. The earlier findings of the epithelial nature of the Leydig cells agree with the observation of basement membranes in the Leydig cells. PMID- 2777004 TI - Nucleotide sequences and expression of cDNA clones for boar and bull transition protein 1 and its evolutionary conservation in mammals. AB - During spermatogenesis, the nucleoproteins undergo several dramatic changes as the germinal cells differentiate to produce the mature sperm. With nuclear elongation and condensation, the histones are replaced by basic spermatidal transition proteins, which are themselves subsequently replaced by protamines. We have isolated cDNA clones for one of the transition proteins, namely for TP1, of bull and boar. It turned out that TP1 is a small, but very basic protein with 54 amino acids (21% arginine, 19% lysine) and is highly conserved during mammalian evolution at the nucleotide as well as at the amino-acid level. Gene expression is restricted to the mammalian testis, and the message first appears in round spermatids. Thus production of TP1 is an example of haploid gene expression in mammals. The size of the mRNA for TP1 was found to be identical in 11 different mammalian species at around 600 bp. Hybridization experiments were done with cDNAs from boar and bull, respectively. The positive results in all mammalian species give further evidence for the conservation of the TP1 gene during mammalian evolution and its functional importance in spermatid differentiation. PMID- 2777001 TI - Cell surface antibodies in type 1 (insulin-dependent) diabetic patients. II. Presence of immunoglobulins M which bind to lymphocytes. AB - A standardized cell surface antibody assay was used to measure binding of circulating human immunoglobulins to rat or piglet splenocytes. In 100-fold diluted serum fractions, lymphocyte surface antibodies were detected in 30% of Type 1 (insulin-dependent) diabetic patients under 20 years of age but in none of 33 control subjects. Binding occurred with T and B lymphocytes, appeared unrelated to Fc receptors or protein glycosylation and was not attributable to insulin or albumin antibodies. At clinical onset of the disease, the lymphocyte surface antibodies belonged primarily to the IgM-class. Their presence was positively correlated to that of IgM-pituitary cell surface antibodies and their absorption by anterior pituitary cells occurred as well as by splenocytes. Lymphocyte surface antibodies remained present during the first years of insulin treatment. They were also detected in first degree relatives of lymphocyte surface antibody-positive patients. It is unlikely that IgM-lymphocyte surface antibodies mark the destructive process in the pancreatic B cell population. They may, instead, express a state of immune reactivity which precedes the formation of IgG-autoantibodies and therefore be associated with an event in the development of diseases such as Type 1 (insulin-dependent) diabetes. PMID- 2777006 TI - The animal issue: report from the front. PMID- 2777007 TI - NIH funding. PMID- 2777009 TI - [Negative post-ischemic T waves in variant angina]. AB - The clinical and prognostic significance of negative T waves on the basal electrocardiograms of patients with unstable angina has been recently investigated with controversial results. Moreover, there is little data regarding this phenomenon in patients with variant angina. In order to evaluate the significance of negative post-ischemic T waves in patients with variant angina, 72 patients underwent Holter recording and coronary angiography. Negative T waves were present in 38 out of 72 patients (53%): they were anterior in 24 cases and inferior in 14 cases. The negative T-wave phenomenon was present in 29 patients on admission and showed up in 9 patients during hospitalization. Holter recording showed no significant differences between patients with or without negative T waves with regards to: 1) the proportion of symptomatic transient myocardial ischemic attacks; 2) the frequency of arrhythmias during transient myocardial ischemic attacks; 3) the maximum duration of transient myocardial ischemic attacks; 4) the maximum degree of ST elevation during transient myocardial ischemic attacks. Negative T waves on the anterior leads showed a moderate sensitivity (54%) and total predictive accuracy (52%), as well as a lower specificity (43%) and negative predictive accuracy (15%) for a significant stenosis of the left anterior descending coronary artery. This was due to the presence of several patients with left anterior descending artery stenosis and without negative T waves. On the other hand, negative T waves on the inferior leads were characterized by high sensitivity (85%), specificity (80%) and total predictive accuracy (82%) for a significant stenosis of the right coronary artery and/or the circumflex artery.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2777008 TI - [Echocardiographic and electrocardiographic aspects indicative of necrosis caused by isolated disease of the right and circumflex coronary artery]. AB - The value of 12-lead electrocardiogram (ECG) and two-dimensional echocardiography (2D-ECHO, wall motion abnormalities) in recognizing myocardial infarction due to left circumflex and right coronary artery disease was evaluated in 75 patients (aged 26-69 years, within 3 months of myocardial infarction) with single vessel disease (luminal stenosis greater than or equal to 70%). Twenty-five patients (pts) had left circumflex disease and 50 right coronary artery disease. In the group of pts with left circumflex disease, 13 (52%)--group I--showed asynergy limited to the postero-lateral wall and 12 pts (48%)--group II--had more extensive asynergy involving both the postero-lateral and the infero-posterior wall. No pts with left circumflex disease demonstrated asynergy of the interventricular septum. Good correlations were found between the site and extent of asynergy and the location of left circumflex narrowings: 9--group I pts- (69.2%) had obtuse marginal branch disease and 8--group II pts--(67%) had proximal left circumflex disease. Patients with right coronary artery disease were subdivided as follows: group I: 35 pts (70%) with asynergy of infero posterior wall and posterior septum; group II: 11 pts (22%) with extensive asynergy of infero-posterior, postero-lateral walls and posterior septum; group III: 4 pts (8%) with asynergy limited to the infero-posterior wall. The location of right coronary artery narrowings had no relation to the site and extent of infarct asynergy in pts with single right coronary artery disease.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2777010 TI - [Prognostic meaning of the echo-dipyridamole test in recent non-Q myocardial infarct]. AB - The aim of this study was to evaluate the usefulness of the dipyridamole echocardiography test soon after non Q wave myocardial infarction. Forty-two consecutive patients admitted to the Coronary Care Unit for a first episode of a non Q wave myocardial infarction were enrolled. Dipyridamole-echocardiography test and exercise stress test were performed on 29/42 patients without clinical or electrocardiographic evidence of residual ischaemia, before hospital discharge (from 7 to 15 days after admission). They were followed-up for 1 to 15 months (mean 11.9) or until one of the following clinical end points occurred: recurrence of myocardial infarction, angina or cardiac death. Over a period of 4 minutes, 0.56 mg/kg of dipyridamole was infused intravenously. The test was considered positive when a new transient wall motion abnormality was confirmed by two independent observers. According to these criteria a positive test was observed in 7/29 patients (24%) and a negative one in 22/29 (76%). The exercise stress test was positive in 12/27 patients (44%). Subsequent coronary events occurred in all the patients (100%) with positive dipyridamole-echocardiography test and in 7/22 patients (32%) with negative dipyridamole-echocardiography test (p less than 0.001). Five out of the 7 patients with positive test who underwent coronary angiography showed multivessel coronary artery disease. The sensitivity, specificity and positive predictive value of dipyridamole-echocardiography test for the identification of patients at risk for subsequent coronary events were respectively 50%, 100%, 100%, while for exercise stress test these values were 83%, 86% and 75%.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2777013 TI - [Cardiologic protocols for judging fitness for competition sports. Cardiologic Organizational Committee for Sports Fitness]. PMID- 2777011 TI - [Potentiating effect of a supine position on ischemia induced by exercise]. AB - Though sitting bicycle and treadmill are the commonest devices used in exercise stress testing, supine ergometric test shows some advantages, especially in research investigations. The latter allows better ECG and blood pressure recordings during exercise. Recently, a greater frequency of ST-segment depression has been reported with supine vs upright exercise, but some doubt as to the ischemic significance of this result has been raised. Thus, we compare the ECG and hemodynamic pattern during upright and supine bicycle exercise in 50 subjects with chest pain, without prior myocardial infarction: 31 had documented coronary artery disease (CAD) and 19 had normal coronary vessels. In a subgroup (22 CAD patients and all subjects without CAD) a measurement of myocardial perfusion was performed during exercise using thallium-201 radionuclide ventriculography. Initial work-load and the further graded increases were identical for both postures. The frequency of ST-segment depression was higher during supine exercise (84% vs 74%). The increase in sensitivity (+7% vs CAD) was wider if a more direct measurement of myocardial ischemia was adopted as gold standard (+13% vs TI-201 responses) and was not associated with a decreased specificity (Tab. II). In the supine position the threshold of exercise-induced ST-segment depression was significantly lower. Chest pain appeared more frequently and at a lower work-load. Accentuation and precocity of exercise induced ischemia in the supine-position could be attributed to an increased imbalance between supply and demand of MVO2 at equivalent work-load, heart rate changes, systolic blood pressure and double product were significantly higher.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2777012 TI - [Surgical results in mitral insufficiency: prognostic value of the indices of left ventricular function]. AB - Left ventricular function is a major prognostic factor in patients with mitral regurgitation, but the ability of echocardiographic and hemodynamic parameters to predict the surgical result is controversial. We investigated the prognostic role of various pre-operative indices of left ventricular function in 23 consecutive patients who underwent successful surgical correction of chronic mitral regurgitation. At a mean follow-up of 20 +/- 16 months, patients underwent echocardiography and radio-nuclide angiography and were grouped according to the post-operative left ventricular ejection fraction. Group A was made up of 16 patients with a left ventricular ejection fraction greater than or equal to .45: they showed post-operative reduction of the left ventricular end-diastolic diameter (from 36.3 +/- 3.2 to 30.5 +/- 4.5 mm/m2; p less than .001) and of the radius/thickness ratio (from 3.5 +/- 0.6 to 2.9 +/- 0.6; p less than .01). In 7 patients (group B), post-operative left ventricular ejection fraction was less than .45 and no significant changes in the left ventricular end-diastolic diameter (from 41.5 +/- 2.7 to 36.9 +/- 6.1 mm/m2; NS) or the radius/thickness ratio (from 3.9 +/- 0.9 to 3.4 +/- 1.0; NS) were observed. During the follow-up all group A patients remained asymptomatic or minimally symptomatic, whereas 2 group B patients died of refractory left ventricular failure. Pre-operative left ventricular volumes and diameters, both at end-diastole and end-systole, were significantly greater in group B patients.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2777015 TI - Primary small intestinal adenocarcinoma diagnosed by endoscopic examination prior to operation. AB - Progress in diagnostic procedures has made it possible to diagnose neoplasms of the gastrointestinal tract preoperatively. However, preoperative diagnosis of tumors of the small intestine remains difficult. We report here detection of an adenocarcinoma of the jejunum by endoscopic examination prior to operation. A 73 year-old woman was admitted with complaints of intermittent periumbilical pain, nausea, and vomiting. An upper gastrointestinal series showed an abnormal segmet 10 cm distal to the duodenojejunal flexure. Small intestinal endoscopic examination revealed a tumor with a crater and an irregular surface of mucosa near the duodenojejunal flexure, and annular constriction due to tumor extension, and endoscopic biopsy specimens contained tissue from a poorly differentiated adenocarcinoma. Wide resection, including the duodenum, proximal jejunum, and adjacent mesentery was performed. The resected tumor was confirmed histologically to be a poorly differentiated adenocarcinoma of the jejunum. PMID- 2777016 TI - Angiomyolipoma of the colon: a new entity in colonic polypoid lesions. AB - A 67-year-old man with angiomyolipoma on the sigmoid colon is reported. The colonic polyp was pedunculated and diagnosed histologically after endoscopic polypectomy. Angiomyolipoma is one of the benign hamartomas arising principally in the kidneys of patients with or without tuberous sclerosis. Extrarenal angiomyolipoma is rare and this may be the first report of colonic angiomyolipoma. PMID- 2777014 TI - Estradiol receptors in the cytosol of peripheral blood mononuclear cells in hepatitis B virus carriers treated with interferon-alpha. AB - Estradiol receptors in the cytosol of peripheral blood mononuclear cells and the effects of interferon-alpha (IFN-alpha) on estradiol receptors were studied in asymptomatic hepatitis B virus (HBV) carriers, patients with chronic hepatitis B and normal controls. The level of estradiol receptors in the cytosol of mononuclear cells was significantly lower in asymptomatic HBV carriers and patients with chronic hepatitis B, compared to normal controls. This low level of cytosol estradiol receptors in patients with chronic hepatitis B was increased by the administration of IFN-alpha. In addition, when peripheral blood mononuclear cells from patients with chronic hepatitis B were incubated with IFN-alpha in vitro, the level of cytosol estradiol receptors also increased by increasing the concentration of IFN-alpha. We previously reported that the response of mononuclear cells to estrogen is impaired in HBV carriers, and our present results suggested that this may be due to the low level of estradiol receptors in the cytosol of mononuclear cells. PMID- 2777017 TI - Portal hypertension secondary to intrahepatic arterio-portal shunt in primary amyloidosis: a case report. AB - Portal hypertension is a rare complication in hepatic amyloidosis. We experienced a case of a 40-year-old man with primary amyloidosis and advanced esophageal varices. Angiographic procedures clearly demonstrated portal hypertension secondary to intrahepatic arterio-portal shunting. Hepatic arterial embolization brought about a disappearance of the A-P shunt and portal hypertension, though rebleeding occurred. To our knowledge, this is the first case report in which the pathogenesis of portal hypertension in hepatic amyloidosis was elucidated. PMID- 2777018 TI - Extrahepatic portal venous obstruction of different pathogenesis in pancreatic diseases: reports of 4 autopsy cases with chronic pancreatitis and pancreatic carcinoma. AB - Four autopsy cases of extrahepatic portal venous obstruction associated with pancreatic diseases, 1 case of pancreatitis and 3 cases of pancreatic carcinoma, are presented. The pathogenesis of portal obstruction was different in each case; old thrombosis with recanalization due to chronic pancreatitis with pseudocysts formation in 1 case, fresh thrombosis due to intraportal venous catheterization for pancreatic carcinoma in 1 case, fresh thrombosis probably due to pancreatitis accompanying pancreatic carcinoma in 1 case, and direct invasion of pancreatic carcinoma into the portal vein in the remaining 1 case. Morphologic evidence for portal hypertension was present in each case. In the pancreatitis case and one pancreatic carcinoma case with portal tumor invasion, both of which had chronic portal obstruction, there were many thin-walled vascular channels (cavernous transformation) around the occluded portal vein. Their endothelia were positive for factor VIII-related antigen and Ulex europaeus lectin I, implying that these vessels were hepatopetal blood vascular collaterals. It was shown that pancreatic diseases resulted in portal venous obstruction by several different mechanisms and chronic portal obstruction in pancreatic diseases led to the formation of hepatoperal blood vascular collaterals. PMID- 2777020 TI - Carbohydrate antigen type 2 chain N-acetyllactosamine (2NAcLc) as a histological marker of rat parietal cells. PMID- 2777019 TI - A case of neurofibroma located in the retroperitoneum involving the uncinate process of the pancreas. AB - A case of solitary neurofibroma in the retroperitoneum involving the uncinate process of the pancreas, which has been reported in only one case in Japan and less than 20 cases in the world literature, is described. A 57-year-old male complained of back pain and microhematuria. Plain and enhanced abdominal computed tomography (CT) indicated an 8 x 6 cm hypovascular tumor located in the uncinate process. We initially assumed it to be a cancer of the pancreas. His physical examination and blood chemistry result were normal. Various diagnostic imaging methods however, disclosed a rare type of tumor. The tumor was resected by pancreaticoduodenectomy and histological examination revealed it to be neurofibroma. PMID- 2777021 TI - Prostaglandins protect primary cultured rat hepatocytes against carbon tetrachloride-induced damage. PMID- 2777022 TI - Effect of continuous arterial infusion of protease inhibitor on experimental acute pancreatitis. PMID- 2777026 TI - Steatohepatitis associated with limb lipodystrophy. AB - Two patients who presented with steatohepatitis had acquired partial lipodystrophy. This association has not previously been well documented. A common pathophysiological mechanism in lipodystrophy, obesity-associated nonalcoholic steatohepatitis, and alcoholic liver disease is possible. PMID- 2777025 TI - Membranous obstruction of the inferior vena cava associated with a myeloproliferative disorder: a clue to membrane formation? AB - Although membranous obstruction of the inferior vena cava is frequently assumed to be a congenital defect, it has recently been hypothesized that it could be acquired and secondary to thrombosis at the ostium of hepatic veins. We report the case of a membranous obstruction of the inferior vena cava responsible for isolated hepatomegaly in a young Frenchman. No known cause of thrombosis was found but spontaneous formation of erythroid colonies occurred on bone marrow cultures. This indicated the existence of a latent myeloproliferative disorder, a frequent cause of hepatic vein thrombosis. We suggest that this association of a membranous obstruction of the inferior vena cava with a known, albeit often overlooked, cause of hepatic vein thrombosis provides strong support to the thrombosis theory of membrane formation. PMID- 2777023 TI - Pancreatic kallikrein gene expression: effects of glucocorticoids in vivo and in vitro. AB - We examined the role of glucocorticoids in the regulation of pancreatic glandular kallikrein gene expression in vivo and in vitro. Adult male rats were adrenalectomized (Adx). Corticosterone pellets were administered to maintain either physiologic (Adx 1+) or high physiologic (Adx 3+) plasma corticosterone levels. Pancreatic kallikrein mRNA levels were examined by Northern hybridization and quantitated by slot-blot hybridization. Adrenalectomy resulted in a 75% +/- 14% (n = 4) increase in kallikrein mRNA as compared with sham-operated controls. This increase was completely reversed by exogenous corticosterone replacement to normal physiologic concentrations. Replacement with high corticosterone levels (Adx 3+) resulted in a decrease of kallikrein mRNA levels to 53% +/- 4% (n = 4) of controls. A significant negative correlation was observed between individual kallikrein mRNA levels and plasma corticosterone (r = -0.81, n = 12). In vitro, using the rat pancreatic acinar cell line AR42J, dexamethasone decreased kallikrein mRNA steady-state levels in a time- and dose-dependent manner. These data, therefore, indicate that physiologic concentrations of plasma corticosterone decrease pancreatic kallikrein mRNA levels in vivo, and that this is a direct effect on pancreatic acinar cells. PMID- 2777024 TI - Effects of iron loading on free radical scavenging enzymes and lipid peroxidation in rat liver. AB - A comparison of the antioxidant protective system and presence of lipid peroxidation was made between rats iron-loaded by two different mechanisms. Superoxide dismutase activity, glutathione peroxidase activity, and reduced glutathione concentrations, together with malondialdehyde production, were measured in the livers of rats chronically iron-overloaded by (a) parenteral iron (primarily Kupffer cell iron deposition) and (b) dietary carbonyl iron (mainly parenchymal iron deposition). In carbonyl iron-treated rats, hepatic superoxide dismutase activity was significantly decreased, whereas hepatocyte lipid peroxidation, as measured by malondialdehyde levels, was significantly increased when compared with control rats at or above iron concentrations of 100 and 185 mumol/g dry wt, respectively. However, no significant decrease in superoxide dismutase activity or significant increase in malondialdehyde levels was observed in iron dextran-treated rats. Glutathione peroxidase activities and reduced glutathione concentrations in rats, iron-loaded by either method, were not significantly different from those of control animals. These results suggest that the deposition of iron in the reticuloendothelial cells of the liver does not lead to lipid peroxidation; however, iron deposited in the parenchymal cells of the liver may lead to an altered free radical antioxidant protective system, resulting in lipid peroxidation in these cells at a similar level of iron loading. We conclude that the cellular site of iron deposition as well as the hepatic iron concentration is important in determining iron-induced liver injury. PMID- 2777027 TI - Pancreatic duct-portal vein fistula. AB - We describe a case of pancreatic duct-portal vein fistula discovered by endoscopic retrograde cholangiopancreatography, with confirmatory computed tomography and angiographic studies. The fistula was associated with chronic pancreatitis that was complicated by recurrent gram-negative bacteremia and peripheral subcutaneous fat necrosis, although pancreatic pseudocyst was not present. Even though surgical treatment was recommended, medical complications precluded surgery and the patient recovered with supportive therapy only. Follow up endoscopic retrograde cholangiopancreatography showed spontaneous closure of the fistulous connection. PMID- 2777028 TI - Prevalence of acute enteric viral pathogens in acquired immunodeficiency syndrome patients with diarrhea. AB - Diarrhea due to enteric pathogens is an important complication of advanced human immunodeficiency virus infection. Whereas numerous bacterial and parasitic agents have been implicated, the role of pathogenic enteric viruses is less clear. Stools from 153 human immunodeficiency virus seropositive men were tested by electrophoresis, enzyme-linked immunosorbent assay, and immune electron microscopy for the presence of rotaviruses (group A and non-group A), adenoviruses, and Norwalk agent. Virus was detected in 9% of the patients with acquired immunodeficiency syndrome, 3% of the patients with acquired immunodeficiency syndrome-related complex, and none of the seropositive men without these diagnoses. Virus detection was not more likely in stool from patients with diarrhea. PMID- 2777029 TI - Salmonella bacterial adherence and penetration of mucosal cells: inducing role of the epithelium. PMID- 2777030 TI - Tumor necrosis factor in alcoholic hepatitis. PMID- 2777033 TI - Dysplasia and adenocarcinoma in Barrett's esophagus. PMID- 2777032 TI - Aerobic exercise and mouth-to-cecum transit time. PMID- 2777031 TI - Does methyl tert-butyl ether result in an empty gallbladder? PMID- 2777034 TI - Kerckring duodenal folds in celiac disease. PMID- 2777035 TI - Cimetidine and alcohol absorption. PMID- 2777036 TI - Presence of HBV DNA and HBeAg in serum of an anti-HBs-positive individual. PMID- 2777037 TI - Serum immunoglobulin G antibody levels for Campylobacter pylori diagnosis. PMID- 2777038 TI - Discordance between flow cytometric abnormalities and dysplasia in Barrett's esophagus. AB - Eighty-six specimens from 25 patients with Barrett's epithelium were analyzed by both histology and flow cytometry. Of these, 73 were without dysplasia and 13 had dysplasia (7 low grade, 6 high grade). Eight of the nondysplastic specimens were aneuploid and another 15 had increased G2. Among the dysplastic specimens, two were aneuploid and two had increased G2. These data were grouped into four classifications: type 1 (65 specimens), specialized columnar epithelium (Barrett's) without dysplasia and no aneuploidy; type 2 (8 specimens), Barrett's epithelium without dysplasia and an aneuploid cell population; type 3 (11 specimens), Barrett's epithelium with dysplasia and no aneuploidy; and type 4 (2 specimens), Barrett's epithelium with dysplasia and aneuploidy. Distribution by type was 76%, 9%, 13%, and 2%, respectively. We conclude that histologic dysplasia and aneuploidy are often discordant. They may identify separate subgroups at risk, or when concordant, may reflect an increased cancer risk in that population. Further study will define the role of histology and flow cytometry in the screening and management of patients with Barrett's esophagus. PMID- 2777039 TI - Clearance of spontaneous gastroesophageal reflux in awake and sleeping infants. AB - Thirty infants less than 12 mo old (19 with pathologic gastroesophageal reflux and 11 symptomatic controls) underwent continuous monitoring of distal esophageal pH with simultaneous pharyngeal and multiple-site esophageal manometry to compare acid clearance times of awake and asleep reflux episodes. While awake, acid clearance times of the two groups were equivalent. While asleep, mean acid clearance time increased in subjects with pathologic reflux greater than 500% while remaining essentially unchanged in symptomatic controls. No difference in minimum pH attained during sleep reflux, in percentage of swallows resulting in esophageal peristalsis, or in the frequency of secondary peristaltic waves was found to explain the difference in sleeping acid clearance times in the two groups. However, there was a significant difference between the groups with respect to swallowing rate (p less than 0.01). During sleeping reflux episodes, subjects with pathologic reflux swallowed 0.5 +/- 0.1 times per minute (mean +/- SEM), whereas controls who refluxed swallowed 3.5 +/- 1.3 times per minute. During awake reflux episodes the swallowing rates were equivalent in the two groups, 4.1 +/- 0.4 and 4.7 +/- 0.7 per minute, respectively. We conclude that low swallowing rate during sleeping reflux episodes is primary to the delayed clearance of sleeping reflux in these infants. PMID- 2777040 TI - Long-term efficacy and safety of omeprazole in patients with Zollinger-Ellison syndrome: a prospective study. AB - To determine the long-term efficacy, safety, and toxicity of omeprazole, we studied 40 patients with Zollinger-Ellison syndrome given omeprazole for 6-51 mo (median 29). The mean daily dose of omeprazole required to control gastric acid secretion was 82 +/- 31 mg. Thirty-one patients required omeprazole once per day. In 9 patients acid output was not controlled by 120 mg once per day, but was controlled by 60 mg every 12 h. The daily dose of omeprazole correlated with the previous dose of histamine H2-receptor antagonist (r = 0.89, p less than 0.001), basal acid output (r = 0.43, p less than 0.01), and maximal acid output (r = 0.39, p less than 0.02) but not with serum concentration of gastrin (r = -0.32). Increases in the dose of omeprazole were required in 9 patients. Twenty-nine patients had mild peptic symptoms with acid outputs less than 10 mEq/h while taking histamine H2-receptor antagonists. Symptoms resolved completely in 23 patients and partially in 3 when taking omeprazole. Omeprazole prevented mucosal disease in all patients including 17 in whom histamine H2-receptor antagonists had produced only partial resolution despite acid output being less than 10 mEq/h and in those with symptoms during omeprazole therapy. Omeprazole therapy was not associated with any significant side effects, nor with any evidence of hematologic or biochemical toxicity. Serum concentrations of gastrin did not change significantly during therapy. In 6 patients treated with omeprazole for 1 yr there was no change in basal or maximal acid output. In all patients, gastric morphology and histopathology demonstrated no evidence of gastric carcinoid formation. These results demonstrate that with long-term treatment of up to 4 yr, omeprazole is safe, with no evidence of hematologic, biochemical, or gastric toxicity. Furthermore, omeprazole remained effective, with only 23% of patients requiring an increase in dose, and continued to control symptoms in patients who had not been entirely symptom-free despite high doses of histamine H2-receptor antagonists. Omeprazole is now the drug of choice in patients with Zollinger Ellison syndrome. PMID- 2777041 TI - Inhibition of stress-induced gastric injury in the rat by glutathione. AB - Glutathione metabolism occurs via interorgan cycles in which hepatic synthesis of reduced glutathione and its transfer to extrahepatic tissues play an important role. To elucidate the physiologic significance of the cycles and tissue thiol status during stress-induced gastric mucosal injury, dynamic aspects of glutathione metabolism were analyzed in rats that were treated with water immersion restraint. This treatment induced gastric mucosal lesion with concomitant decrease in the levels of perchloric acid-soluble thiols in various tissues, particularly in the liver and stomach. During the treatment, glutathione levels markedly decreased in the liver but not in other tissues. Depletion of hepatic glutathione by buthionine sulfoximine, a specific inhibitor for gamma glutamyl cysteine synthetase, markedly decreased hepatic glutathione levels and increased the gastric injury. Intraperitoneal injection of reduced glutathione significantly increased plasma levels of glutathione and inhibited the occurrence of gastric injury without affecting intracellular glutathione levels. These results indicate that extracellular glutathione and its interorgan metabolism might play a critical role in the protection of gastric mucosa particularly when animals were challenged with various stress. PMID- 2777043 TI - Geographic origins of Jewish patients with inflammatory bowel disease. AB - Ulcerative colitis and Crohn's disease are more common among Jews than among non Jews. Despite the existence of studies on the prevalence and incidence of inflammatory bowel disease in relation to the continent of residence or origin, there are no studies on the specific countries of origin of Ashkenazi Jewish patients. We report here the first analysis of 233 U.S. Jewish patients by defined world regions and subregions. Using two different sets of controls (a self-referred Jewish population for Tay-Sachs disease carrier detection and a sample of Jewish persons ascertained through unrelated studies from the same hospital as our patients), we found a significant excess of patients of middle European origin relative to those of Polish or Russian origin. These observations suggest that the inflammatory bowel disease gene(s) are more prevalent in the Jewish population that originated in middle Europe than in those from Poland and Russia. These results further suggest that Jewish patients with inflammatory bowel disease probably represent a nonrandom genetically predisposed subset of the Jewish population. This provides further evidence for the genetic contribution to inflammatory bowel disease in general, and to its higher risk in the Jewish population. PMID- 2777042 TI - Assessment of lactose absorption by measurement of urinary galactose. AB - Individuals with sufficient intestinal lactase hydrolyze ingested lactose to galactose and glucose and these monosaccharides are absorbed. Lactose is not digested completely when intestinal lactase activity is low and the disaccharide is malabsorbed. Breath hydrogen excretion after lactose ingestion is used commonly to diagnose lactose malabsorption. However, no direct tests are currently used to assess lactose absorption. We tested a new method of assessing lactose absorption in 26 healthy individuals. Each subject ingested 50 g of lactose. Participants were evaluated for lactose malabsorption using a standard 3 h breath hydrogen test. In addition, the urinary excretions of galactose, lactose, and creatinine were quantitated for 3-5 h after lactose ingestion. On the basis of breath hydrogen analysis after lactose ingestion, 12 individuals were lactose malabsorbers (defined as a rise in the breath hydrogen concentration of greater than 20 parts per million above the baseline value). The 14 subjects who did not malabsorb lactose by breath hydrogen testing (defined as a rise in the breath hydrogen concentration of less than or equal to 20 parts per million above the baseline value), had significantly more galactose in their urine 1, 2, and 3 h after lactose ingestion than lactose malabsorbers. The ratio of excreted lactose to excreted galactose was significantly decreased in lactose absorbers compared with lactose malabsorbers (p less than 0.001). Determination of the ratio of urinary galactose to urinary creatinine separated lactose absorbers from lactose malabsorbers completely (p less than 0.001). We conclude from this study that the determination of urinary galactose, urinary lactose/galactose ratio, and urinary galactose/creatinine ratio may be used to assess lactose digestion and absorption in healthy adults. PMID- 2777044 TI - Intestinal motor activity in experimental hyperthyroidism in conscious dogs. AB - The small intestinal motor effects of experimental hyperthyroidism were studied in 8 conscious dogs to reveal possible mechanisms of accelerated small bowel transit in hyperthyroidism. Six strain gauge transducers were implanted on the small intestine of each dog. Long-term hyperthyroidism was induced by subcutaneous administration of 100 and 200 micrograms/kg.day of thyroxin. Application of thyroxin did not interrupt the cyclic fasting motor activity. Thyroxin (100 micrograms/kg.day) caused a slight increase in the period of the migrating motor complex (p less than 0.05). The maximum contractile frequency rose dose-dependently up to 11% (p less than 0.05). During phase 2 and the digestive state the contraction frequency increased up to 29% and 27%, respectively (p less than 0.05). More contractions occurred in groups during the digestive state in hyperthyroidism. Half of the dogs showed giant migrating contractions during thyroxin administration, whereas those contractions were not observed during the control period. We conclude that fasted and postprandial intestinal motility is changed in experimental hyperthyroidism. Acceleration of small bowel transit may be caused by changes in contractile pattern of phase 2 and the digestive state or by the increased frequency of giant migrating contractions. PMID- 2777045 TI - Psychological and physiological characteristics of patients with severe idiopathic constipation. AB - This study prospectively evaluated psychological profiles and selected parameters of colonic and anorectal sensorimotor function in 25 consecutive patients who were referred for severe idiopathic constipation. Measurement of colonic transit of radiopaque markers divided patients into those with normal transit (n = 10) and those with slow transit (n = 15). As measured by the Hopkins Symptom Checklist, patients with normal transit constipation demonstrated significantly higher scores for psychological distress in the global symptoms index and nine clinical subscales than did those with slow transit constipation and gastrointestinal control subjects (n = 25). Both groups with constipation had decreased rectal sensation compared with controls but there was no relationship to rectal compliance or threshold of internal sphincter relaxation. There was also no relation between abnormalities of anorectal parameters, including expulsion dynamics, and psychological profiles in two groups. Measurement of colonic transit and psychological profiles in patients with severe idiopathic constipation identify two groups of patients with respect to possible pathogenesis of symptoms. Accordingly, different therapeutic approaches may be required, one behaviourally and psychologically based and the other focused on the possible modification of disordered colonic transit. PMID- 2777047 TI - Effect of Roux-en-Y biliary diversion on Campylobacter pylori. AB - To assess the effect of biliary diversion on gastric colonization by Campylobacter pylori, we undertook a retrospective histologic study of 24 patients with symptomatic bile reflux after peptic ulcer surgery, who had endoscopic gastric biopsies performed before and after a Roux-en-Y operation. The time interval between the preoperative and postoperative endoscopic examinations ranged from 0.8 to 9.8 yr (mean 4.7 yr). The partial gastrectomy specimen, which had been resected at the initial operation, was available for assessment in 12 patients (50%). Biopsy specimens were assessed for the presence of C. pylori and scored for severity of reflux gastritis by the use of a histologic grading system. Ten of the 12 partial gastrectomy specimens (83%) were C. pylori positive. Only 13 of the 24 patients (54%) were C. pylori-positive before the Roux-en-Y operation, rising to 22 (92%) after biliary diversion (p = 0.008). The median reflux score was 6 in the partial gastrectomy specimens; it rose to 11 before the Roux-en-Y operation and fell again to 6 after biliary diversion (p less than 0.001). These results suggest that C. pylori may recolonize the gastric remnant after biliary diversion. PMID- 2777046 TI - Effect of secretin on bile formation in rats with cirrhosis of the liver: structure-function relationship. AB - To investigate whether the hypercholeresis seen in cirrhotic humans and animals is due to ductular proliferation or altered inactivation of secretin, or both, we studied the response of bile flow and biliary erythritol clearance to synthetic porcine secretin in rats rendered cirrhotic by chronic exposure to phenobarbital/carbon tetrachloride (n = 11) and untreated control rats (n = 5). Bile duct mass was determined morphometrically. Furthermore, plasma disappearance of secretin was measured by radioimmunoassay. Basal bile flow did not differ between the two groups. Whereas secretin had no effect in the control group, it stimulated bile flow by 49% +/- 33% in the cirrhotic group (p less than 0.001). Erythritol bile-to-plasma ratio was lower and biliary bicarbonate concentration higher in the cirrhotic rats, suggesting some ductular contribution to bile flow even in the absence of secretin. Biliary bicarbonate concentration did not increase further during secretin administration, whereas bile salt concentration decreased from 27 +/- 6 to 18 +/- 4 mM. The elimination half-life of secretin was not affected by cirrhosis, averaging 5 +/- 2 min in both groups. Bile duct volume was increased in cirrhotics (2.9% +/- 1.4% vs. 0.2% +/- 0.1%; p less than 0.01) and showed an excellent correlation with the maximal secretin-induced increment of bile flow. Our results suggest that the proliferating ductules contribute to bile flow and that increased secretin responsiveness is not due to altered pharmacokinetics in cirrhotic rat liver. PMID- 2777048 TI - Detection of hepatitis B virus X gene protein and antibody in type B chronic liver disease. AB - The genome of the hepatitis B virus contains a sequence (X gene) whose role is unclear. The almost complete region of the hepatitis B virus X gene was expressed in Escherichia coli, with the resulting protein being approximately 17 kilodaltons in molecular weight. Sera from 139 subjects were analyzed by Western blot analysis. Of the hepatitis B surface antigen-positive patients, anti-X was not found in 4 patients with acute hepatitis and in 12 healthy carriers, but was present in 41% (21/51) of the patients with chronic hepatitis, 63% (15/24) of those with liver cirrhosis, and 46% (12/26) of those with hepatocellular carcinoma. The expression of the X product in the liver tissues (43 hepatitis B surface antigen-positive patients) was investigated using an indirect immunohistochemical method. The X protein was observed in 64% (21/33) of the patients with chronic hepatitis and 50% (5/10) of those with liver cirrhosis, and was found when the serum was negative for anti-X. Hepatitis B core antigen was frequently expressed together with the X protein in the liver. The conclusions reached were that the frequency of anti-X increases with the length of chronic hepatitis B virus infection, that anti-X may suppress the expression of the X protein in the liver, and that the X protein may be related to hepatitis B virus replication. PMID- 2777049 TI - [The value of postoperative irradiation in endometrial cancer of pathohistologic stage I]. AB - In a prospective therapeutic study, 571 cases of endometrial cancer in pathological stage I were treated initially with total hysterectomy and received 6 weeks after surgery double high-dose-rate iridium 192 irradiation of the vagina (afterloading technique). The single dose was 700 cGY (at 2 cm distance from the applicator axis). Postoperative treatment planning was based on the prognosticators of depth of myometrial invasion and tumor grading with subtypes. External irradiation was prescribed only for patients with poor prognostic factors (Cobalt-60,5600 cGY on the pelvis wall, 30 fractions). At the time of this report, the patients had been followed up for 6 to 96 months after their original therapy. Survival was calculated by the life table method. 327 cases with slight tumor infiltration, independent of the tumor morphology, received postoperative vaginal irradiation only. Survival rate was 90.6%. 27 cases with tumor infiltration of the middle third of the myometrium and grade 1 tumors, received also only vaginal irradiation. Survival rate was 100%. 101 cases with tumor infiltration of the middle third of the myometrium and grade 2 and 3 tumors, received vaginal irradiation plus external irradiation. Survival rate was 89.9%. 116 cases with tumor infiltration of the external third of the mymetrium and any tumor grade, received vaginal irradiation plus also external irradiation. In these patients with poor prognosis, the survival rate was 85%. Differences between groups are not significant. Considering the treatment group with good prognosis and the group with poorer prognosis and the additional external irradiation, the survival figures were quite similar (90.6% and 87.9% respectively). In spite of the unfavorable situation of patients with poor prognosticators, treatment results after the additional external irradiation were rather similar to those cases with good prognosticators and without external irradiation. The value of external irradiation in cases of endometrial cancer in stage I with unfavorable prognosticators seems to be quite clear. This therapy improvement was all the better, because side effects of external irradiation were low (0.2% rectovaginal fistulas) and in case of irradiation of the vagina only, no severe side effects occurred. Relapse rate for the treatment group with good prognosis and vaginal irradiation only was 0.6% (2 from 354) and for the group with poor prognosis and additional external irradiation 2.8% (6 from 217) respectively. PMID- 2777053 TI - [Maternal mortality, its definition and assessment. Report of maternal mortality at the Bamberg Gynecologic Clinic 1963-1988]. AB - During the period of observation from 1963-1988 (26 years) 16 maternal deaths during pregnancy, birth and post partum were registered among 59,681 births at the Departm. of Obstetr. and Gynaec. Bamberg. This corresponds to a maternal mortality ratio of 0.26%. Thirteen of the deaths were direct material deaths, three cases of death belong in the category of indirect deaths. In this timeframe 4,257 (7.13%) C-sections were done. The rate of C-sections has almost tripled during the last 26 years, increasing from 3.6% in 1963 to 10.1% in 1988. In 10 cases maternal death followed a C-section. Taking the complete period of observation into account, the mortality rate after C-section of 2.34% is about 20 times higher than the mortality risk after vaginal delivery. This heightened mortality risk after C-section is clearly diminishing. In the years 1973-1982 the C-section mortality rate was only 6 times higher than maternal deaths after vaginal deliveries. PMID- 2777054 TI - [Perioperative anxiety behavior of IVF patients and a suitable simplified analgo sedation procedure in transvaginal follicle puncture]. AB - In the present prospective study, perioperative anxiety was investigated in 52 patients, who underwent transvaginal follicular centesis for IVF treatment. Also the surgical and anaesthesiological procedures are described. The mean age of the patients was 32.2 years, and the mean period of desire for children 9.1 years. On average, six stimulation cycles were carried out. In an operation with a duration of approx. 20 minutes, an average of six oocytes were collected. As an alternative to general anaesthesia, an analgosedation, given intravenously with midazolam (0.1 mg/kg) and fentanyl (2 micrograms/kg) has been described. This necessitates continuous anaesthesiological monitoring due to respiratory depression, induced by the risk of medication. In our study, IVF patients who had a long history of desire for children, in some cases with several previous operations, show a low to moderate anxiety level before the operation. "Hospital routine" has evidently led to this low anxiety level, which is maintained after the operation. PMID- 2777051 TI - [Prognostic factors in medullary breast cancer]. AB - In 55 patients with medullary carcinoma of the breast follow-up data over an average period of 68.1 +/- 35.3 months were recorded. The histological slides of all tumors were retrospectively classified according to the same criteria. The parameters registered were: tumor-size, histological grading, receptor status, necrosis of tumor tissue, cellularity of the stroma, status of axillary nodes, reactive changes of axillary nodes and tumor invasion of lymphatic vessels. The importance of each parameter registered for disease-free survival and overall survival was calculated statistically using the log-rank-test. Of all parameters, only the nodal status of the axilla proved prognostically significant. Metastases of axillary nodes were demonstrable in only 31% of all MC. The incidence of nodal involvement proved to be less than in non medullary breast cancers. In 15 (27.3%) of the patients, progression of the tumor occurred. All women with distant metastases i.e. 12 (21.8%) died of the disease, whereas patients with only local recurrence of breast cancer are still alive. 72.7% of the patients showed relapse free survival. Other parameters of proven prognostic value in breast cancers like receptor status and histological grading were of no relevance to the survival in MC. Prediction of prognosis depends on the correct classification of the tumor subgroup according to strict microscopical and macroscopical criteria. PMID- 2777050 TI - [Experiences with the squamous cell carcinoma antigen, a new tumor marker for cancer of the uterine cervix]. AB - Squamous cell carcinoma (SCC) antigen was first described 1977 by Kato et al. in patients with carcinoma of the cervix uteri. SCC serum levels can be measured with a radioimmunoassay (Abbott), in our investigation 2.0 ng/ml were taken as the upper limit of the standard range. In 35 healthy women there were no elevated SCC serum levels. In only 2 of 50 patients with benign gynaecological diseases SCC was also elevated. 59% of the 102 patients with primary and 70% of the 63 patients with recurrent cervical cancer showed pathologic values, CEA was elevated in 32% and 51% respectively; the mean serum concentrations increased with the stage of the disease. 68% of 142 patients with squamous cell carcinoma had elevated levels, in 5 of 9 adenosquamous carcinomas and in 3 of 14 adenocarcinomas SCC was in the pathological range. 13 of 60 patients with breast, endometrial and ovarian cancer showed elevated values. SCC shows a high specificity and a high sensitivity for squamous cell carcinomas of the cervix uteri. The tumor marker might be helpful in the control of the primary therapy and follow-up of cervical cancer patients. PMID- 2777052 TI - [Prenatally diagnosed intestinal obstruction--contribution of pediatric surgery]. AB - The diagnosis of a small intestinal obstruction was made prenatally between the 31st and 36th week of pregnancy in 7 patients with neonatal ileus. Five newborns showed a meconium-peritonitis, a meconium-ileus and the last a ileal atresia. These were compared with newborns with small intestinal obstruction, which had not been diagnosed prenatally. The analysis of our hospital information indicates, that primarily serious forms of ileus and intestinal perforations are diagnosed prenatally, whilst isolated small intestinal obstruction often avoids diagnosis. For this reason, diagnostic punctation of the foetal abdomen contribute little to the establishment of the etiology of the obstruction and should be avoided. On the other hand, punctation of a foetal ascites can, through pressure reduction of the abdomen, lengthen the duration of pregnancy and permit a spontaneous birth. PMID- 2777056 TI - [Unusual site of misinterpreted bone metastases in irradiated stage IIb cervix cancer]. AB - Bone metastases from cervical carcinoma are rare. Their frequency is reported to be 1.9-4.6%. Because of their rarity, the skeletal lesions remain inevident for a long time. A case of unusual unrecognized metastases from a stage IIb cervical carcinoma, which were localized in the bones for the foot, is described. PMID- 2777055 TI - [Disseminated intravascular coagulation disorder in the 2d trimester of pregnancy. Case report from the 16th week of pregnancy with spontaneous parturition at term]. AB - After exercising on a trampoline, a 29-year-old primigravidae in the 16th week of gestation was admitted to our hospital with the clinical signs of premature ablatio placentae and acute coagulation disturbances with disseminated intravascular coagulation and uncontrolled secondary hyperfibrinolysis. The coagulation disturbance was stabilized by conservative therapy (Substitution with fresh-frozen-plasma (ffp), whole blood and low-dose heparin treatment without having to terminate the pregnancy by evacuation of the uterus. An appropriate antifibrinolytic treatment was not performed in this case. The continuous controls of fibrinmonomeres and reptilase time indicate the possibility of a persisting latent coagulation disturbance after the acute phase. Thus, the necessity of a low-dose heparin therapy after an acute coagulation disturbance becomes evident. PMID- 2777057 TI - Ca2+-antagonistic properties of phospholipase A2 inhibitors, mepacrine and chloroquine. AB - The effects of putative phospholipase A2 inhibitors mepacrine and chloroquine on membrane ionic currents were studied in intact frog atrial trabeculae. Both agents decreased slow calcium channel current Isi and fast sodium channel current If. Isi was affected twice at least in comparison to If. Half-block of Isi was observed at approximately 10(-6) mol/l mepacrine and at approximately 10(-5) mol/l chloroquine. These effects on transmembrane ionic transport should be considered when using the above agents as phospholipase inhibitors or antiarrhythmic drugs. PMID- 2777059 TI - Histones of nucleolar-associated chromatin from hamster liver. PMID- 2777058 TI - Low calcium treatment provokes persistent spiking in tonic crayfish muscle. PMID- 2777060 TI - Relation of muscle cell contraction and calcium distribution in sarcomere. AB - A model of activation of muscle contraction has been proposed. It is based on calcium diffusion and binding to specific regulatory sites in a sarcomere. Calcium ions activate interactions of contractile proteins and thus the generation of force. The model quantifies the relation between calcium released from intracellular stores and the elicited force. PMID- 2777061 TI - Intracellular free [Ca2+] in human skeletal muscle with myopathic carnitine deficiency. AB - Carnitine is required for the transport of activated long chain fatty acids through the mitochondrial inner membrane. We measured the intracellular free calcium concentration [( Ca2+]i) by means of a calcium selective microelectrode in skeletal muscle biopsies obtained from nine patients in which myopathic carnitine deficiency (MCD) was diagnosed, and from six subjects with no evidence of neuromuscular disease. Intact intercostal muscle bundles were dissected and then split for electron microscopic studies and electrophysiological measurements. The [Ca2+]i in muscle fibers from MCD patients was 0.46 +/- 0.02 mumol.l-1 (mean +/- SEM) and 0.10 +/- 0.01 mumol.l-1 in control subjects. At the electron microscopic level, the predominant abnormality was the presence of lipid vacuoles between the myofibrils. These results show that in patients with myopathic carnitine deficiency there is a significant increase in the resting myoplasmic calcium concentration which might be related to a malfunction of some mechanisms responsible for the homeostasis of intracellular calcium. PMID- 2777062 TI - Degradation of 2-bromo-, 2-chloro- and 2-fluorobenzoate by Pseudomonas putida CLB 250. AB - Pseudomonas putida strain CLB 250 (DSM 5232) utilized 2-bromo-, 2-chloro- and 2 fluorobenzoate as sole source of carbon and energy. Degradation is suggested to be initiated by a dioxygenase liberating halide in the first catabolic step. After decarboxylation and rearomatization catechol is produced as a central metabolite which is degraded via the ortho-pathway. After inhibition of ring cleavage activities with 3-chlorocatechol, 2-chlorobenzoate was transformed to catechol in nearly stoichiometric amounts. Other ortho-substituted benzoates like anthranilate and 2-methoxybenzoate seem to be metabolized via the same route. PMID- 2777063 TI - Identification of a repetitive DNA sequence specific to Mycobacterium paratuberculosis. AB - A 0.2-kb DNA sequence specific to Mycobacterium paratuberculosis, the causative organism of Johne's disease, was isolated from a partial genomic library. The sequence was part of a larger repetitive DNA element and was present in strains of M. paratuberculosis from cattle, sheep, goat, deer and also a woman with Crohn's disease but not in M. paratuberculosis strain 18. The sequence was not present in strains of 19 other mycobacterial species including 31 reference serotype strains of the M. avium-M. intracellular-M. scrofulaceum (MAIS) complex, some strains of which are closely related to M. paratuberculosis. The sequence may be useful for developing a diagnostic test for Johne's disease. PMID- 2777064 TI - Co-ordinated expression of the components of iron transport (mycobactin, exochelin and envelope proteins) in Mycobacterium neoaurum. AB - Mycobacterium neoaurum was grown with a range of iron concentrations from 0.01 to 4.0 micrograms/ml. Synthesis of the extracellular siderophore, exochelin, the intracellular iron storage compound, mycobactin and the iron-repressible envelope proteins were co-ordinately expressed. All three components of the iron transport system were synthesized when low amounts of iron (0.01 to 0.2 micrograms/ml) were added to the medium and were repressed when the iron concentration was increased to 0.5 micrograms/ml and above. These results re-inforce the conclusion that the iron-regulated proteins do fulfil an essential function in iron metabolism. PMID- 2777065 TI - Evidence for the presence of a new NAD+-dependent formate dehydrogenase in Pseudomonas sp. 101 cells grown on a molybdenum-containing medium. AB - The facultatively methylotrophic bacterium Pseudomonas sp. 101, grown on methanol in presence of molybdate, contains a new formate dehydrogenase (N-FDH) catalyzing NAD+-dependent oxidation of formate. The activity of this N-FDH could also be measured in presence of artificial electron acceptors, ferricyanide and 2,6 dichlorophenol indophenol. This new enzyme is absent in cells grown on a methanol containing medium with tungstate, where only another two, previously described formate dehydrogenases, which are active only with NAD+ or only with artificial acceptors, respectively, were determined. The N-FDH was partially purified by a combination of ion-exchange and gel-filtration chromatography, and was shown to differ in its properties from the known NAD+-dependent counterpart. PMID- 2777066 TI - Isolation of 9-hydroxy-delta-tetradecalactone from lipid A of Pseudomonas diminuta and Pseudomonas vesicularis. AB - A lipid component was isolated from the fatty acid fraction of acid hydrolysates of lipid A derived from Pseudomonas diminuta JCM 2788 and Pseudomonas vesicularis JCM 1477 lipopolysaccharides. By structural analysis of the lipid and its trimethylsilyl and acetyl derivatives by thin-layer chromatography, gas chromatography-mass spectrometry, mass spectrometry, infrared spectrometry and 13C-NMR, it was identified as 9-hydroxy-delta-tetradecalactone. PMID- 2777067 TI - Actin in Mucor rouxii. AB - Rhodamine-conjugated phalloidin was used to analyze the actin distribution during hyphal formation in Mucor rouxii. The occurrence of actin patches in the cortical region of the cells was seen in the initial stages of growth. A fungal 43 kDa protein was isolated by affinity chromatography on DNase I-sepharose. This peptide was identified on immunoblots when polyclonal antibodies against rabbit muscle actin were used as a probe. These results indicate: (1) that changes in actin localization accompany the hyphal development and (2) the fungal 43 kDa protein shares properties that are common to muscle actin. PMID- 2777068 TI - Linkage detection tests under heterogeneity. AB - A two-parameter (admixture) test (Lod2) for the detection of linkage which allows for heterogeneity is described. Lod score values for this test which lead to comparable type 1 error probabilities as the conventional (homogeneous) single parameter lod score test (Lod1) are derived. For example, a Lod2 value of 3.70 corresponds to the conventional lod score (Lod1) value of 3.0. In terms of power to detect linkage, the Lod2 test is advantageous only for moderate to large pedigrees (autosomal dominant inheritance with high penetrance) and when the proportion of linked families is low (less than 40%). Otherwise, there appears to be no serious disadvantage in using the conventional Lod1 test when heterogeneity is present. PMID- 2777069 TI - The impact of altered fitness on the risk of illness in relatives. AB - Altered fitness of affected individuals can substantially influence the pattern of risk of illness in relatives. This altered risk can result from both changes in the distribution of genotypes and changes in the genotype-specific proportion affected or GSPA. This report examines the impact of altered fitness on the GSPA in relatives of affected probands, under a simple genetic model. The model assumes that illness results from a generalized single major locus and that fitness is dependent only upon phenotype. It is shown that i) in progenitors of probands (e.g., parents and grandparents), GSPA can vary widely as a function of the fitness of affected individuals; ii) the change in GSPA is equal in parents and grandparents; and iii) in non-progenitors (e.g., offspring, siblings, uncles/aunts), GSPA is independent of fitness effects. The GSPA in parents and grandparents is a function both of the relative fitness of affected individuals (F) and the penetrance (Q) that can be approximated by the simple formula: GSPA = FQ/(FQ + 1 - Q). The successful application of model-fitting methods for the detection of single gene variation to complex phenotypes that significantly alter fitness may, in certain circumstances, require the incorporation of "fitness effects" into the analytic model. PMID- 2777070 TI - Phenotypic effects of apolipoprotein structural variation on lipid profiles: II. Apolipoprotein A-IV and quantitative lipid measures in the healthy women study. AB - Apolipoprotein A-IV (APO A-IV) is a major protein component of mesenteric lymph chylomicrons and very-low-density lipoproteins. It is found in plasma predominantly unassociated with major lipoprotein fractions and in high density lipoproteins. APO A-IV exhibits structural heterogeneity owing to two codominant alleles, APO A-IV*1 and APO A-IV*2, that occur in Caucasian and black populations. In vitro experimental evidence indicates that APO A-IV may be a cofactor for the lecithin:cholesterol acyltransferase enzyme, may be involved in reverse cholesterol transport, and may play an important role in the modulation of lipoprotein lipase activity. In this study we have investigated the effect of two APO A-IV phenotypes, APO A-IV 1-1 and APO A-IV 2-1, on quantitative lipid measures in a group of 453 white women being followed through menopause for changes in cardiovascular risk. At baseline all women were premenopausal. Of the nine lipid measures, triglycerides showed a marginally significant effect caused by phenotype. The APO A-IV 2-1 heterozygotes had lower average triglycerides than the 1-1 homozygotes (P = .053). PMID- 2777071 TI - Modeling the age-of-onset function in segregation analysis: a causal scheme for leprosy. AB - Several methods have been proposed to take into account the variable age of onset of a disease in genetic analysis. A different approach is presented from an etiological point of view. To illustrate the method, we used leprosy, an infectious disease with a variable age of onset depending on both the time of contamination with the bacillus and the latency of the disease; the role of a major gene in the susceptibility to this disease has been recently detected. The age-of-onset function was modeled to account for the two temporal processes: contamination event and incubation period. For genetic analysis, this function was combined with the probability of being susceptible to the disease, which was expressed by the use of regressive models. To test this new approach, ten sets of 500 nuclear families were simulated considering different hypotheses of contamination risks, which were either constant or dependent on contacts with contagious leprosy patients, and varying the extent to which the disease is heritable. Analyses of these data using two versions of the model indicate that the model can detect familial correlations in variable age of onset and discriminate between the different simulated effects. PMID- 2777076 TI - Cell-specific expression of the prolactin gene in transgenic mice is controlled by synergistic interactions between promoter and enhancer elements. AB - Prolactin gene expression is restricted to the lactotrophic and somatomammotrophic cells of the anterior pituitary. In transgenic mice, a fusion gene consisting of 3 kb of prolactin 5'-flanking region fused to a firefly luciferase or human growth hormone (hGH) reporter gene is expressed at high levels with the strict tissue and cell-type specificity that is characteristic of the endogenous prolactin gene. High levels of expression require two cis-acting regions: a distal enhancer (-1.8 to -1.5 kb) and a proximal region (-422 to +33 bp). Each of these regions alone can direct low levels of fusion gene expression to prolactin-producing cell types in transgenic mice, but a synergistic interaction between these regions is necessary for high levels of expression. The ontogeny of the prolactin transgene expression closely follows the appearance of high levels of a POU homeo-domain transcription factor, Pit-1, that has been shown previously to bind structurally related sequences in both the distal enhancer and proximal regions and to activate the expression of the prolactin gene in vitro. Unexpectedly, transgenes containing the distal enhancer removed from its normal context are expressed in both the prolactin-producing lactotrophs and the thyroid-stimulating hormone (TSH)-producing thyrotrophs, thereby suggesting that sequences flanking this enhancer are necessary to restrict expression to the correct cell type within the pituitary. These data indicate that distinct processes of gene activation and restriction are necessary for the fidelity of cell-type-specific expression within an organ. PMID- 2777072 TI - The distribution of debrisoquine metabolic phenotypes and implications for the suggested association with lung cancer risk. AB - Debrisoquine hydroxylation exhibits wide inter-individual variation in Caucasian populations. After similar doses of the drug, extensive metabolizers excrete up to several hundred times more of the urinary metabolite 4-hydroxy-debrisoquine than do poor metabolizers. The phenotypes have traditionally been defined by the metabolic ratio (MR), or the molar ratio of debrisoquine to its chief metabolite recovered in an aliquot of an eight hour urine sample, after a test dose of the drug. Deficient metabolism is inherited as an autosomal recessive condition. We have reanalyzed previously published data from a study of lung cancer patients and controls using a computerized optimization method to more accurately estimate the parameters describing the three phenotypic distributions. Using these new distributions to categorize controls, we show that Hardy-Weinberg conditions are now fulfilled. When the newly defined phenotype parameters are employed to assign the phenotypes of cases and controls, a highly significant difference in phenotype distribution between cases and controls is still observed. This result supports the hypothesis that the debrisoquine metabolic phenotype may be associated with lung cancer susceptibility. PMID- 2777075 TI - V(D)J recombination: a functional definition of the joining signals. AB - Two conserved DNA sequences serve as joining signals in the assembly of immunoglobulins and T-cell receptors from V-, (D)-, and J-coding segments during lymphoid differentiation. We have examined V(D)J recombination as a function of joining signal sequence. Plasmid substrates with mutations in one or both of the heptamer-spacer-nonamer sequences were tested for recombination in a pre-B-cell line active in V(D)J recombination. No signal variant recombines more efficiently than the consensus forms of the joining signals. We find the heptamer sequence to be the most important; specifically, the three bases closest to the recombination crossover site are critical. The nonamer is not as rigidly defined, and it is not important to maintain the five consecutive As that distinguish the consensus nonamer sequence. Both types of signals display very similar sequence requirements and have in common an intolerance for changes in spacer length greater than 1 bp. Although the two signal types share sequence motifs, we find no evidence of a role in recombination for homology between the signals, suggesting that they serve primarily as protein recognition and binding sites. PMID- 2777073 TI - Predicting intrauterine growth retardation in sibships while considering maternal and infant covariates. AB - Data on 6,210 full-term sibships (gestational age greater than 36 weeks) reconstructed from birth certificates registered in Maryland between 1980 and 1984 were used to study sibship aggregation and recurrence risk of intrauterine growth retardation (IUGR) while considering maternal and infant covariates. In this study, IUGR was defined as being below the 10th percentile for race-, sex-, and gestational-age-specific birth weight based on all births registered in Maryland during 1984. Maternal factors (race, age at delivery, marital status, amount of prenatal care, concurrent illnesses, and complications during pregnancy) and infant factors (congenital malformations and first born child or not) were used as covariates in a modified logistic regression model which allowed correlation among sibs. First-time mothers who were under age 30 years, unmarried, received too little prenatal care, or had any reported pregnancy complications were at high risk of delivering an infant with IUGR. Even given the effects of these risk factors, however, there was a significant correlation in risk among full sibs (r = .237 +/- .028), which, combined with information on risk factors, can be used to estimate sibling recurrence risk for IUGR. PMID- 2777074 TI - A 3' exonuclease activity degrades the pseudogene 5S RNA transcript and processes the major oocyte 5S RNA transcript in Xenopus oocytes. AB - Transcription of the major oocyte 5S RNA gene (o) and pseudogene (psi) of Xenopus laevis yields different RNAs with three different homologous systems: oocyte microinjection, whole oocyte extract, and fractionated TFIIIA + TFIIIB + TFIIIC components. Those peculiar results are caused by a 3' RNA exonuclease activity, which is inhibited in the oocyte extract, that rapidly degrades the pseudogene 5S RNA but does not degrade as readily the chimeric RNA transcripts generated by HindIII-truncated 5S RNA pseudogenes. The same, or a similar, RNase activity processes the 130- and the 142-base-long transcripts of the major oocyte 5S RNA gene into mature 120-base-long 5S RNA. We performed site-specific mutagenesis on the somatic 5S RNA gene and changed specific nucleotides on the somatic 5S RNA. These studies indicated that the structure that confers stability to the 5S RNA in vivo and in vitro is the 9-bp helix formed in 5S RNA, but not in psi 5S RNA, by the complementary 5' and 3' ends of the molecule. PMID- 2777077 TI - Developmental control of promoter-specific factors responsible for the embryonic activation and inactivation of the sea urchin early histone H3 gene. AB - We have begun an investigation of the molecular basis for the temporal embryonic expression of the early histone H3 gene of the sea urchin Strongylocentrotus purpuratus. Cloned constructs exhibit the proper temporal regulation following microinjection into one-cell zygotes of the related sea urchin species, Lytechinus pictus. Deletion analysis of the upstream promoter region of the H3 gene revealed several regions that are involved in both positive and negative control. DNase I footprinting, mobility shift, and methylation interference experiments reveal multiple sequence-specific DNA-binding proteins that interact with at least five distinct regions within 200 bp upstream of the RNA initiation site. Extracts prepared from staged embryos revealed that the ability of the factors to bind their target sequences was regulated. Proteins bound at four different sites were detected only at stages when the H3 gene was active transcriptionally. In addition, three different forms of a CCAAT-binding protein also are regulated temporally. The activity of these protein(s), however, correlates inversely with the transcriptional activity of the gene. The TATA box and CCAAT sequences are all that is required for expression of low levels of H3 transcripts with the proper temporal pattern. This approach should be useful in understanding the mechanisms used to regulate temporal patterns of gene expression during early embryogenesis. PMID- 2777079 TI - Expression of achaete and scute genes in Drosophila imaginal discs and their function in sensory organ development. AB - Several kinds of sensory organs (SOs) appear in stereotyped positions on the adult Drosophila cuticle. The generation of these SOs requires the activity of the achaete (ac) and scute (sc) genes. To investigate whether ac and sc also provide spatial information for the positioning of SOs, we have analyzed the patterns of expression of these genes in the wing imaginal disc around the time that SO precursors are being specified. We find that expression coincides with and is restricted to areas of the disc where these precursors are known to be located. In the loss-of-function sc mutant, sc RNA is depleted in a single area located in the region where the precursor for the suppressed macrochaeta should be found. Moreover, some, and probably all, SOs require expression of these genes to reach the earliest detectable differentiated state. These and other results presented here, together with the finding that expansion of the areas of ac and/or sc expression causes the development of ectopic SOs, indicate that ac and sc promote the determination of SO precursors and delimit the regions of the imaginal discs where they can develop. PMID- 2777078 TI - An avian muscle factor related to MyoD1 activates muscle-specific promoters in nonmuscle cells of different germ-layer origin and in BrdU-treated myoblasts. AB - We isolated the cDNA encoding a myogenic factor expressed in embryonic chick breast muscle by virtue of its weak hybridization to the mouse MyoD1 clone. Nucleotide sequence analysis and amino acid comparison define this clone, CMD1, as encoding a protein similar to mouse MyoD1. CMD1 encodes a polypeptide smaller than MyoD1, 298 versus 318 amino acids, respectively, and is 80% concordant by amino acid sequence overall. The basic and myc domains required for myogenic conversion of mouse 10T1/2 'fibroblasts' to myoblasts with MyoD1 are completely conserved in CMD1. CMD1 is just as efficient as the mouse homolog in myogenic conversion of 10T1/2 cells and coactivates the endogenous mouse MyoD1 gene in the process. The efficiency of myoblast conversion depends on the levels of CMD1 expression and suggests that the cellular concentration of CMD1 plays a role in the onset of myogenesis. Transient expression of CMD1 in a variety of nonmuscle cells from different germ-layer origins activates both cotransfected muscle specific promoters and, in some cases, endogenous muscle-specific genes. 5 Bromodeoxyuridine (BrdU) treatment of chicken and mouse myoblasts reduces the expression of CMD1 and MyoD1, respectively, and may explain how this thymidine analog inhibits myogenesis and the activity of transfected muscle-specific promoters in BrdU-treated myoblasts. Transient expression of CMD1 in BrdU-treated myoblasts reactivates cotransfected muscle-specific promoters. CMD1 activates muscle-specific promoters in cotransfections regardless of cell type, whereas 'housekeeping' or constitutive promoters can be activated moderately, unaffected, or repressed, depending on the promoter and cell background. The rate and degree of myogenic conversion may be more restricted by cell phenotype than by germ layer origin. PMID- 2777081 TI - Zeta-crystallin, a novel protein from the guinea pig lens is related to alcohol dehydrogenases. AB - zeta-Crystallin is a major component of the water-soluble proteins of the guinea pig lens. We have constructed a lens cDNA library from one- to seven-day-old guinea pigs in the plasmid Bluescript KS+ and used the 16 amino acid (aa) sequence of a CNBr peptide to design an oligodeoxyribonucleotide probe. Analysis of two positive clones and direct sequence of the 5' end of the RNA resulted in the completion of a most probably full-length mRNA comprising 1842 nucleotides (nt). The ATG start codon occurs 83 nt downstream from the 5' end. The open reading frame, ending with a stop codon at nt position 1070, predicts a protein of 328 aa with a calculated Mr of 35,071. Comparison of the amino acid sequence with the National Biomedical Research Foundation protein data base reveals a significant similarity of zeta-crystallin with the enzyme of the alcohol dehydrogenase family. PMID- 2777082 TI - Down-regulation of vimentin gene expression during myogenesis is controlled by a 5'-flanking sequence. AB - During myogenesis, the intermediate filament proteins vimentin and desmin are differentially expressed. While desmin levels increase dramatically, vimentin mRNA levels decrease substantially. Here, we show that transfected whole- and mini-vimentin-coding genes (Vim) are expressed in fibroblasts (mouse L cells) and down-regulated during muscle cell differentiation in culture. Functional assays with 5'-end Vim::cat constructs demonstrate that this repression is controlled by a 5'-element (nt -321 to -160). This region is distinct from Vim promoter elements (nt -160 to +71) which do not contribute to vimentin's down-regulation during myogenesis. PMID- 2777080 TI - Nucleotide sequence of the rat gamma-crystallin gene region and comparison with an orthologous human region. AB - The sequences of a 51-kb region containing the cluster of five rat gamma crystallin-coding genes (CRYG) and of a 7-kb region surrounding the sixth rat CRYG gene were determined. Approximately 78% of the total sequence represents intergenic DNA. We also sequenced 22 kb of DNA from the human CRYG gene cluster. All CRYG genes are associated with CpG-rich regions. The sequence similarity between the human and rat gene regions drops sharply (to 65%) in intronic and 3' flanking regions but decreases only gradually in the 5'-flanking region. Highly conserved regions (greater than 80%) are found as far upstream as 1.5 kb. Overall intergenic distances are conserved. The human region contains much more repetitive DNA (24% vs. 10%) but less simple-sequence (sps) DNA (0.7% vs. 4%) than the rat region. Almost all repeats and spsDNA elements are located in the intergenic region. The location of repetitive and spsDNA differs between the orthologous regions and these elements were probably inserted after the evolutionary separation of rat and man. The Alu repeats in man and the B3 repeats in the rat are close copies of their respective consensus sequences and bordered by virtually perfect repeats. In contrast, the B1 and B2 repeats in the rat have diverged considerably from the consensus sequence and the surrounding direct repeats are usually imperfect. Thus the dispersion of the B1 and B2 repeats in the rat probably preceded that of the B3 repeats. Within the rat genomic region the spacing of Z-DNA elements is surprisingly regular, they are located about 12 kb apart. A search for putative matrix-associated regions suggests that the rat CRYG gene cluster is organized into two chromosomal domains. PMID- 2777083 TI - Cloning and analysis of the 5' portion of the human type-III procollagen gene (COL3A1). AB - We have isolated overlapping clones containing the 5'-terminal portion of the human pro-alpha 1(III) collagen gene (COL3A1). This has enabled us to extend our previous studies and thus generate a restriction map of nearly 64 kb of DNA encompassing all of COL3A1 and more than 20 kb of flanking sequences. Aside from the complete nucleotide and amino acid sequences of type-III N-pre-propeptide, this study has established the number of the corresponding exons, whose relative organization deviates from the pattern observed in the analogous regions of type I procollagen genes, COL1A1 and COL1A2. Moreover, we have sequenced 1628 bp of the 5'-flanking region of COL3A1, from the transcription start point (tsp) to an AluI repetitive element. Pairwise comparison with the analogous segment of the mouse gene has showed 78% sequence similarity in nearly 270 bp immediately preceding the tsp and including the TATA element and a presumptive NF-1 binding site. Relatively close to the tsp, but upstream from the region of homology with the murine gene, a potential AP-1 binding site has also been identified. PMID- 2777084 TI - Protein-DNA interactions in the 5' region of the mouse alcohol dehydrogenase gene Adh-1. AB - The mouse alcohol dehydrogenase-encoding gene, Adh-1, is expressed at high levels in adult liver. We have begun analysis of the regulation of this gene, focusing upon specific DNA-protein interactions. Preliminary deletion mapping of the 5' region indicated that a 521-bp fragment extending from nucleotide (nt) -468 to +53 (relative to the transcription start point) could direct chloramphenicol acetyl transferase synthesis in hepatoma cells. We therefore focused upon this 468 to +53 fragment. Using the gel mobility-shift assay, we detected at least four different complexes between proteins extracted from nuclei of mouse liver or hepatoma cells and regions within the -468 to +53 fragment. Two of the DNA protein complexes can be competed with a 43-bp region from nt -90 to -48, and an oligodeoxyribonucleotide spanning this region forms two complexes. The strongest of these two DNA-protein complexes has been localized by methylation interference experiments to the palindromic sequence CACGTG located between nt -57 and -62. This region is identical in the related human ADH2 gene, and may represent a novel regulatory sequence. PMID- 2777085 TI - Restriction maps for the cottontail rabbit herpesvirus (CTHV) genome. AB - The sites for restriction endonucleases ApaI, BamHI and PvuII in the genome of the cottontail rabbit herpesvirus were localized. The physical mapping of the 150 kb DNA was facilitated by peculiarities of the genome structure, namely the presence of repetitive DNA and of invertible segments, and by the analysis of overlapping cosmid clones. PMID- 2777086 TI - Isolation and nucleotide sequence of a sesquiterpene cyclase gene from the trichothecene-producing fungus Fusarium sporotrichioides. AB - The trichodiene synthase gene (Tox5) has been isolated from the fungus Fusarium sporotrichioides, and its nucleotide (nt) sequence determined. A lambda gt11 library of F. sporotrichioides DNA was screened with antiserum against trichodiene synthase (TS). DNA fragments were isolated which encode a portion of the Tox5 gene. In subsequent screening of the library we employed one of these DNAs as a probe and identified several recombinant phage containing the entire Tox5 gene. The gene consists of a 1182-nt open reading frame (ORF) which contains a 60-nt intron and specifies a Mr 43,999 protein. The deduced amino acid sequence of the ORF was identical to sequences determined for several CNBr peptides from purified TS. Southern and Northern analyses indicated that the Tox5 gene is present in a single copy and is transcribed into an mRNA of about 1450 nt. Upstream from the start codon, 'TATA'-like sequences and a short repeated sequence resembling the 'CCAAT' box were observed. The primary structure described for TS is the first such report for a member of the terpene cyclase group of enzymes. PMID- 2777087 TI - Variant chromosomal arrangement of adult beta-globin genes in rat. AB - The genomic organization of three haplotypes of beta-globin genes was determined to resolve the question of the number of those genes in rat. Haplotype a, found in inbred strain DA, has three genes or pseudogenes, while haplotypes b, found in AO, Y5 and Wistar strains, and c, found in Wistar strain, have five genes or pseudogenes each. In haplotypes b and c, the first gene is of beta major type and the remaining four are of beta minor type. Partial sequencing of six out of 13 genes shows that duplications of beta minor genes are causing polymorphism in a number of genes. Also, in haplotype b two beta minor genes have a 6.5-kb intron 2, while in haplotype c only one beta minor gene contains such a large intron 2. The three structurally different haplotypes described are not interconvertible by single recombination events. The results indicate that the rat has the highest number of adult beta-globin genes found in mammals so far. PMID- 2777091 TI - Management of infectious diseases in the elderly. Proceedings of a symposium. May 19, 1988, Anaheim, California. PMID- 2777088 TI - The complete sequence of the rabbit erythroid cell-specific 15-lipoxygenase mRNA: comparison of the predicted amino acid sequence of the erythrocyte lipoxygenase with other lipoxygenases. AB - We report the complete sequence of the rabbit reticulocyte (RBC) 15-lipoxygenase (LOX) mRNA as deduced from (i) sequencing cDNA recombinants isolated by screening cDNA libraries or polymerase-chain-reactions, and (ii) the sequence originating from the transcription start point obtained by primer extension-sequencing reactions. Like the human leukocyte 5-LOX mRNA, the RBC 15-LOX mRNA contains a very short 5'-untranslated region with a long 3'-untranslated region. But, unlike the human leukocyte 5-LOX mRNA, the RBC 15-LOX mRNA contains an intriguing repeated sequence (ten copies with the consensus sequence C4PuC3TCTTC4AAG) just after the translational stop codon, which may be involved in its regulation during reticulocyte maturation. Comparison of the RBC 15-LOX mRNA sequence with those of the previously published human 5-LOX mRNA and the soybean 3-LOX gene shows only a few short regions of sequence similarity. However, the predicted amino acid sequences of the encoded LOX enzymes show certain conserved regions that are presumably involved in their catalytic activity, in particular a cluster of five conserved histidines that we predict chelate the iron moiety involved in the active site. PMID- 2777089 TI - Organization and nucleotide sequence analysis of a ribosomal RNA gene cluster from Streptomyces ambofaciens. AB - The Streptomyces ambofaciens genome contains four rRNA gene clusters. These copies are called rrnA, B, C and D. The complete nucleotide (nt) sequence of rrnD has been determined. These genes possess striking similarity with other eubacterial rRNA genes. Comparison with other rRNA sequences allowed the putative localization of the sequences encoding mature rRNAs. The structural genes are arranged in the order 16S-23S-5S and are tightly linked. The mature rRNAs are predicted to contain 1528, 3120 and 120 nt, for the 16S, 23S and 5S rRNAs, respectively. The 23S rRNA is, to our knowledge, the longest of all sequenced prokaryotic 23S rRNAs. When compared to other large rRNAs it shows insertions at positions where they are also present in archaebacterial and in eukaryotic large rRNAs. Secondary structure models of S. ambofaciens rRNAs are proposed, based upon those existing for other bacterial rRNAs. Positions of putative transcription start points and of a termination signal are suggested. The corresponding putative primary transcript, containing the 16S, 23S and 5S rRNAs plus flanking regions, was folded into a secondary structure, and sequences possibly involved in rRNA maturation are described. The G + C content of the rRNA gene cluster is low (57%) compared with the overall G + C content of Streptomyces DNA (73%). PMID- 2777090 TI - High efficiency vectors for cosmid microcloning and genomic analysis. AB - We describe the construction and use of cosmid vectors designed for microcloning, gene isolation and genomic mapping starting from submicrogram amounts of eukaryotic DNA. These vectors contain (1) multiple cos sites to allow for simple and efficient cloning using non size-selected DNA; (2) bacteriophage T3 and T7 promoter sequences flanking the cloning site to allow for the synthesis of end specific probes for chromosome walking; (3) a selectable gene for immediate gene transfer of cosmid DNA into mammalian cells; (4) recognition sequences for specific oligodeoxyribonucleotides to allow rapid restriction mapping; (5) unique NotI, SacII or SfiI sites flanking the cloning site to allow for removal of the cloned DNA insert from the vector. These cosmid vectors allow the construction of high quality genomic libraries in situations where the quantity of purified DNA is extremely limited, such as when using DNA prepared from purified mammalian chromosomes isolated by fluorescence-activated cell sorting. PMID- 2777092 TI - Urinary tract infections in the elderly. AB - Urinary tract infection (UTI) is common in the elderly, with a prevalence of approximately 20% in women over 65 years of age. The elderly are predisposed to UTI by anatomic changes in the genitourinary system, by underlying disease, by instrumentation, and by residing in long-term care settings. Indwelling urinary catheters are a frequent cause of UTI, and catheter-associated sepsis is the most common cause of gram-negative sepsis in hospitals. Resistant organisms, prevalent in long-term care settings and hospitals, are increasingly responsible for UTI. Empiric antibiotic therapy has changed with the availability of new agents that cover resistant organisms. Oral antibiotics are appropriate for most UTIs; however, more serious infections require parenteral therapy. Length of antibiotic therapy is generally increased for UTI in the elderly. PMID- 2777094 TI - Special considerations for antimicrobial therapy in the elderly. AB - The elderly are at increased risk of infection and suffer higher morbidity and mortality than younger people. Diagnosis of etiologic agents is frequently difficult. Alterations in pharmacokinetics in the elderly affect antibiotic choice. beta-lactam antibiotics and the fluoroquinolones are appropriate agents for the therapy of a wide range of infections in the elderly. Aminoglycosides should be used with caution in this age group due to the elderly's increased susceptibility to aminoglycoside-induced toxicity. PMID- 2777093 TI - Infectious diseases of the skin. AB - Pathologic changes in the skin of elderly individuals increase their susceptibility to skin infections. These changes include thinning, decreased secretions, and reduced immune function. This paper will discuss the most important viral, fungal, bacteriologic, and parasitic infections of the skin in the elderly and the appropriate treatment of these infections. PMID- 2777096 TI - Immune function in the elderly. AB - Normal aging is accompanied by diverse changes in the immune system. Altered function of both T- and B-cells can be shown by losses in proliferative ability and interleukin-2 and interferon synthesis. Granulocyte function is decreased. Although there can be elevations in immunoprotein levels, antibody formation is decreased in most elderly individuals. Response to immunization varies greatly in the aged. This paper discusses the changes in immune function in the elderly, and the clinical implications of these changes. PMID- 2777095 TI - Treatment of nosocomial pneumonia: monotherapy versus combination therapy. AB - Pneumonia accounts for 15% of all nosocomial infections, and mortality case rates are as high as 60%. Aspiration of oropharyngeal flora is the most common antecedent to nosocomial pneumonia. Patients with chronic lung disease, depressed levels of consciousness, or who are intubated are at increased risk of developing pneumonia. We conducted two comparative, prospective studies using monotherapy with third-generation cephalosporins--the first comparing cefoperazone with combination therapy, and the second comparing cefoperazone monotherapy with ceftazidime monotherapy--for the treatment of nosocomial pneumonia in mildly to moderately ill patients. We found that both cefoperazone monotherapy and ceftazidime monotherapy were as effective as standard two-drug combinations (clindamycin/gentamicin or cefazolin/gentamicin). When total antibiotic costs were compared, cefoperazone monotherapy was the least expensive regimen. PMID- 2777097 TI - Design features and surgical use of a cannulated extrusion needle. AB - A cannulated extrusion needle was designed as a modification of the standard 20 gauge extrusion by including an inner 24-gauge flexible cannula that can be extended up to 18 mm beyond the metal tip. Indications for use of the instrument are reviewed along with selected case histories demonstrating its use. The instrument is used primarily for internal subretinal fluid drainage in eyes with complex retinal detachments caused by proliferative vitreoretinopathy. The flexible cannula is guided into the subretinal space through an open peripheral retinal break and the subretinal fluid is evacuated during a simultaneous fluid/air exchange. The positive pressure of the automated air pump creates a pressure gradient sufficient to achieve passive egress of subretinal fluid through the cannula. Active suction is avoided because of the risk of posterior retinal incarceration into the cannula tip. In addition, the cannula can be used to remove hemorrhage, gas, or silicone oil in the subretinal space. PMID- 2777098 TI - Progressive visual loss in adults with retinopathy of prematurity (ROP). AB - Two visually monocular patients with retinopathy of prematurity, followed up for 14 and 5 years, developed progressive visual loss in their twenties and thirties, respectively. In one patient, who underwent no surgery, visual acuity deteriorated from 20/30 to 20/400 over a 14-year period. The second patient had surgery for retinal detachment. Visual acuity after surgery was 20/60. In the ensuing 2 years it dropped to counting fingers and the visual field constricted to 10 deg. We suggest that changes in the retinal pigment epithelium may compromise the photoreceptors in some ROP patients, thus leading to visual deterioration. PMID- 2777099 TI - Twenty-five cases of relaxing retinotomy using a nanosecond Nd Yag laser (Yag retinotomy). AB - The results of the first 25 retinotomies performed with a nanosecond Nd Yag Laser (Nanolas, Biophysic Medical) between September 1986 and July 1987 are described. This technique was chosen in order to avoid additional surgery and anesthesia in patients requiring a relaxing retinotomy. Treated eyes were usually filled with silicone oil. Simple contact anesthesia and a three-mirror lens were sufficient. Energy was set at 10-15 mJ, 50 Hz burst mode, 10 degrees cone angle. The aim of the treatment was to eliminate a residual inferior traction, to remove silicone oil (19 cases), or to obtain reapplication at the posterior pole. Results were positive in 18 cases and negative in 7, but unsuccessful Nd Yag laser treatment may be corrected with surgical retinotomy. The main complication is hemorrhage, which usually subsequently decreases and does not affect the prognosis. PMID- 2777100 TI - Retinal and choroidal ischemic syndrome, digestive tract and renal small vessel hyalinosis, intracerebral calcifications and phenotypic abnormalities: a new family syndrome. AB - A new family syndrome is described that affected three of seven siblings and another patient who had been abandoned at birth but came from the same area of France. All four patients were young women with a very peculiar phenotype, poikiloderma and greying of the hair, and idiopathic non-arteriosclerotic cerebral calcifications. Pathological studies demonstrated small-vessel hyalinosis due to basal membrane thickening, mainly in the digestive tract, kidneys and calcified areas of the brain. The clinical and biological expressions of these vascular changes varied. Peripheral retinal ischemic syndrome and chorioretinal scars were found in the ocular fundi of three patients. Malabsorption and protein-losing enteropathy was the main problem in all four, and was the cause of one patient's death. A subarachnoid hemorrhage due to a right sylvian aneurysm also occurred in two of the three sisters and was lethal for one. Nephropathy with renal failure and systemic hypertension is the major problem of the two surviving patients. PMID- 2777102 TI - Fundus changes associated with Behcet's disease. AB - Between 1973 and 1987 we recorded 300 cases of Behcet's disease with fundus changes. Our routine preview of each case included examination with the Goldman three-mirror contact lens, ophthalmoscopy, referral for laboratory tests, color fundus photography and, most importantly, fluorescein angiography. The ophthalmological findings led to the proper diagnosis in 254 (85%) of our cases. Fluorescein angiography revealed incipient fundus changes in 38 eyes of 19 medically diagnosed patients with no visual complaints and normal fundi on ophthalmoscopy. Eighty-six percent of our cases had or developed diverse fundus changes bilaterally. The fundus changes we encountered most frequently were hyperemia of the optic disc, macula edema, retinal edema, vascular sheathing, retinal exudate, and retinal hemorrhage. With the exception of eyes with very poor prognoses, only 184 of the 403 eyes that were followed up for 3-120 months (median 12) experienced new insults in the posterior segment; 40 of these became totally blind while 59 maintained their visual status. Early diagnosis is necessary for proper treatment patients with Behcet's disease. Fluorescein angiography is required for early diagnosis and for monitoring the posterior segment involvement closely. This is the most characteristic and often the most serious consequence of Behcet's disease; it may also the first indicator of the disease. PMID- 2777103 TI - Contrast sensitivity versus static visual field testing during experimental elevation of intraocular pressure. AB - Contrast sensitivity testing has been recommended as a more sensitive indicator of early visual loss than visual field testing. Using gravity inversion to induce an intraocular pressure rise, we performed contrast sensitivity testing on each eye of 10 normal subjects in the upright and inverted positions. Contrast sensitivity results were not altered in the head-down position, even though in 5 of the 10 subjects (7 of 20 eyes), visual field alterations on static perimetry were elicited during inversion. In both of these evaluations, the subject's results in the upright position served as the control, freeing us from reliance upon age-matched populations. We conclude that precise measurement of static thresholds with automated perimetry is more sensitive than routine contrast sensitivity testing in detecting visual dysfunction related to transient acute elevations of intraocular pressure. PMID- 2777101 TI - Vitrectomy and fluid/silicone-oil exchange for giant retinal tears: 5 years follow-up. AB - A series of 64 eyes, in 64 patients with giant retinal tears, treated by vitrectomy and fluid/silicone-oil exchange, has been reviewed after 5 years. Anatomical success was achieved in 73% of cases and visual function in successful cases ranged from 6/6 to NPL; 66% achieved acuities of 6/60 or better and 32% had vision of 6/18 or better. These results compare favourably with those in a previous series reported after 6 months and 18 months. Epiretinal membrane proliferation and shortening accounted for the majority of retinal redetachments while macular abnormalities, especially pucker, were responsible for a poor visual outcome. Glaucoma is the most serious long-term complication of the surgical method and occurs most frequently in aphakic eyes. Retention of the crystalline lens, whenever possible, the creation of a 6 o'clock iridectomy in aphakic eyes, early removal of silicone oil and a conservative approach to the use of scleral buckles are recommended. PMID- 2777105 TI - Plasma exchange in the therapy of Behcet's disease. AB - Present therapies for Behcet's disease are unsatisfactory in many cases. We investigated the role of plasma exchange in four patients with severe Behcet's retinitis who were unresponsive to standard medical therapies. Plasma exchange induced a rapid reduction of ocular inflammation with improved visual acuity in all cases. In patients with severe Behcet's retinitis, plasma exchange is able to interrupt the acute inflammatory activity, but relapses may occur. PMID- 2777104 TI - Malignant transformation of an iris melanocytoma. A case report. AB - A 34-year-old Caucasian woman was diagnosed as having a pigmented iris tumor showing recent growth and satellite lesions. The tumor was associated with pigmentation of the anterior chamber angle and secondary unilateral glaucoma. After local excision, histopathologic studies revealed the plump polyhedral cells typical of melanocytoma. However, the examination of additional sections showed evidence of malignancy. The diagnosis of a melanocytoma that transformed into malignant melanoma was made and later confirmed by electron microscopic studies. Following surgical excision of the tumor, the eye maintained normal intraocular pressure. There was no evidence of recurrence 4 years after surgery. PMID- 2777106 TI - Transvitreal retinochoroidal biopsy. AB - Biopsies from retina and/or choroid were performed through a transvitreal approach in 14 patients during the 2-year period 1984-1986. A 20-gauge fine needle was used. The transvitreal approach was chosen because exact location of the biopsy could be documented by video recording and/or by photography. The needle was guided either by a stereotactic micromanipulator or by hand. Immediately after biopsy laser burns were placed around the biopsy hole. Light microscopical and, in selected cases, transmission electron microscopical examination of the material obtained showed malignant melanoma, choroidal haemorrhage, leukaemic infiltration of the choroid, intraretinal fibrosis in detached retina, atrophic retina after vasculitis and malignant lymphoma of the uvea. More than 2 years after biopsy, no retinal detachment due to the biopsy or any tumour-seeding has been observed. Two cases of vitreous haemorrhage cleared spontaneously. No visual impairment was related to the biopsies. PMID- 2777107 TI - Uveal damage in secondary glaucoma. A morphometric study. AB - In a morphometric study, we investigated histopathologic changes in the ciliary body and retinal pigment epithelium in eyes with secondary glaucoma. Eyes with malignant melanoma served as controls. The mean thicknesses of the ciliary muscle and inner connective-tissue layer of the pars plicata were significantly lower (P less than 0.001) in glaucomatous than in melanomatous eyes, as was the mean width of the stromata of ciliary processes (P less than 0.001). With increasing age, the ciliary muscle in melanomatous eyes became significantly thinner (P less than 0.001). The width of the stroma at the base of the ciliary process was significantly correlated with the thickness of the inner connective-tissue layer of the pars plicata in both groups of eyes (P less than 0.001). The mean number of ciliary processes was significantly lower in glaucomatous than in melanomatous eyes (P less than 0.001), as was the mean height of pigment epithelial cells in the midperipheral retina P less than 0.05). The present study revealed quantitative glaucomatous tissue changes in the ciliary body and retinal pigment epithelium. PMID- 2777110 TI - "Aging Differently". 42nd annual scientific meeting, the Gerontological Society of America. November 17-21, 1989, Minneapolis, Minnesota. Abstracts. PMID- 2777108 TI - Lipid fluorophores of the human crystalline lens with cataract. AB - It has been established that the development of cataract is accompanied by the formation of various fluorophores in the lipid fraction of the lens. These lipid fluorescing products have been separated chromatographically according to polarity and molecular weight. It is shown that the initial stages of the development of cataract are characterized by the appearance of lipid fluorophores in the near ultraviolet and violet regions of the spectrum (excitation maximum 302-330 nm, emission maximum 411 nm) with low polarity and a small molecular weight; the maturing of the cataract is characterized by an increase in the intensity of the long-wave fluorescence of the lipids in the blue-green region (430-480 nm) and by the formation of polymeric high-molecular-weight fluorescing lipid products with high polarity. It has been demonstrated that the appearance of lipid fluorophores in the crystalline lens is associated with the free radical oxidative modification of the phospholipids and fatty acids in cataract. PMID- 2777112 TI - HHS sued over preadmission screening. PMID- 2777111 TI - When whiting out won't work. PMID- 2777109 TI - Lesion and regeneration of the anterior and posterior lens capsule and cortex in rabbits Nd:YAG laser. AB - With a mode-locked Nd:YAG laser set at various energy levels, anterior and posterior capsular and cortical lesions were produced in the lens of rabbits. Biomicroscopic and Scheimpflug examinations showed the anterior lesion to be healing in a whitish scar that was restricted to the area of the original lesion. Histology and transmission electron microscopy (TEM) demonstrated the proliferation of epithelial cells that produced a new, continuous, basement membrane-like capsule. In the area of the lesion collagenous material, myofibroblast-like cells and macrophages were found. Laser-induced lesions in the posterior lens capsule and lens protein resulted in damage to the capsule and grey opacity of the lenticular proteins, which remained unchanged for 6 weeks. Neither inflammatory nor epithelial cells appeared within the locally damaged lens. Macrophages migrated from the vitreous into the lesion; they were observed either in intercellular clefts or within a lens fibre, almost completely taking up their cross section. PMID- 2777114 TI - Life care elders not abandoned. PMID- 2777113 TI - How to wear a belt. PMID- 2777115 TI - Nursing home: Part III. PMID- 2777116 TI - Successful series for health education. PMID- 2777117 TI - What you can expect of nurse's aides. PMID- 2777120 TI - Weaving a safety net. PMID- 2777119 TI - Incontinence products: which is best? PMID- 2777121 TI - Pressure ulcers: one bed or another? PMID- 2777122 TI - The right tool for the job. PMID- 2777123 TI - Staging Alzheimer's disease. PMID- 2777118 TI - Parkinson's mime. PMID- 2777124 TI - Something in common. PMID- 2777126 TI - Diagnostic clues in the past. PMID- 2777128 TI - CA 125 in human milk and serum. AB - CA 125 serum concentrations drawn immediately following delivery exceeded 35 U/ml in all cases (median 276 U/ml). One week post partum elevations of CA 125 were still found, but the median level decreased to 45 U/ml. Six weeks after parturition no positivity was detected in the serum (median 12 U/ml). Considerable CA 125 levels were present in the human milk 1 week after delivery (median 208 U/ml). CA 125 was still found in the milk after 6 weeks (median 153 U/ml). We conclude that positive CA 125 concentrations in the serum after parturition derive from an antigen transfer to the maternal circulation during the placental separation. Furthermore, CA 125 seems to be synthesized by the lactating breast. PMID- 2777125 TI - Point by point: predicting elders's falls. PMID- 2777129 TI - Premature rupture of the fetal membranes, the phases of the moon and barometer readings. AB - Over a 2-year period, 1,516 births were investigated to determine whether the onset of parturition could be correlated with the phases of the moon or to barometric height. 1,269 births started spontaneously, and of these, 254 (20%) started with premature rupture of the fetal membranes (PROM). No association was observed between the phases of the moon and deliveries beginning with PROM or with deliveries beginning without PROM. 1,302 of the women had regular menstrual cycles before pregnancy, and among these no specific relationship was found between the phases of the moon and the first day of the last menstruation before pregnancy. No relationship was found between the frequency of PROM and the barometric height. Variations in barometric height up to 9 h before the fetal membranes ruptured did not influence the frequency of PROM. Deliveries with PROM occurred significantly more often among primipara than among multipara. PROM occurred more frequently during night-time in the 8-hour period between 10 p.m. and 6 a.m. These results suggest that the causes of PROM are not correlated to the phases of the moon or to meteorological variations. PMID- 2777127 TI - Effects of histamine and serotonin on the contractility of isolated pregnant and nonpregnant human myometrium. AB - The effects of histamine and serotonin and their antagonists on contractile activity of pregnant and nonpregnant human uterine strips were studied. Both histamine and serotonin (5-HT) increased contractions, pregnant preparations were more responsive than nonpregnant ones. The effects of histamine and 5-HT were blocked by pyrilamine and methysergide, respectively. Pyrilamine (10(-7)-10(-6) M) acted as a competitive antagonist of the effect of histamine, whereas methysergide (10(-7)-10(-6) M) inhibited the response to 5-HT in a noncompetitive manner. Cimetidine and ketanserine were completely ineffective at the doses tested. It is suggested that the increase of contractile activity observed at the end of pregnancy could be partly mediated by the effect of histamine and 5-HT on smooth muscle of the human myometrium. PMID- 2777131 TI - Familial clustering in the polycystic ovarian syndrome. AB - To assess the degree of familial clustering and the mode of inheritance of the polycystic ovarian syndrome (PCO), the prevalence of PCO-related symptoms among first- and second-degree relatives of 132 PCO patients and 71 controls was studied using questionnaire data. 19.7% of male first-degree relatives of PCO patients were reported to have early baldness or excessive hairiness, as opposed to 6.5% of relatives of controls. For female first-degree relatives, the percentages for PCO-related symptoms were 31.4 and 3.2, respectively, in the two groups. In a subgroup of 52 families of PCO patients where one of the parents was reported to have symptoms, 35% of brothers and 58% of sisters had symptoms. Although autosomal dominant inheritance could be excluded as an explanation for PCO in the whole data set, the findings were consistent with this mode of inheritance for a sizeable fraction of families. X-linked dominant inheritance of PCO could be discarded. PMID- 2777130 TI - Use of cefuroxime in preventing postcesarean infection in high-risk patients. AB - Prophylactic antibiotic therapy is accepted for prevention of postceasarean infection in certain risk groups. Of the antibiotic regimens presented none appears superior. Patients having a cesarean section (CS) more than 6 h after membrane rupture were given three doses of cefuroxime (1.5 g every 8th hour) in a prospective study. This prophylaxis was as efficacious as a 7-day treatment with cefuroxime and cefadroxil. The infection rate was 21% which should be compared to approximately 50% when no prophylaxis was given. Patients with membrane rupture of less than 6 h and having a most urgent CS received the same 24-hour prophylaxis. No postoperative infection was recorded. Women having a CS with an ongoing uterine infection were treated with cefuroxime alone or combined with metronidazole. All but one (91%) had an uneventful recovery. PMID- 2777132 TI - Plasma retinol-binding protein in human uterine cervical dysplasias and cancer. AB - Plasma concentrations of retinol-binding protein (RBP) were measured in a cross sectional study of asymptomatic normal menstruating women (n = 94) who obtained Pap smears and participated in a double-blinded nutritional survey. Controls (n = 45) were women with negative cervical cytology, normal colposcopy and no known gynecologic pathology or dysfunction. Cases (n = 49) were subjects with abnormal cytology and colposcopically directed biopsy that established cervical epithelial dysplasias histopathologically in the previous 12-month period. In addition, 8 women with cancer of the cervix were also investigated. The mean plasma concentration of RBP was significantly lower in cases than in controls (p less than 0.001). In normal females, the follicular phase of the menstrual cycle was increased. This increase was absent in the plasma of patients with cervical dysplasias (p less than 0.05). The data direct attention to a possible etiologic association between RBP in human cervical epithelial abnormalities and cancer. PMID- 2777133 TI - Significance of initial plasma steroid concentrations in the prognosis of 'nonendocrine' malignant ovarian tumors. AB - The prognostic value of progesterone (P), androstenedione (A), Estradiol, Testosterone, 20 alpha-hydroxy-progesterone, sex hormone binding globulin, and albumin (Alb) was investigated in 51 women with ovarian carcinoma. All patients had observation periods greater than 5 years. The plasma concentrations of P, A, and Alb and the P/Alb and A/Alb ratios showed a significant correlation with the observation time of the patients. P, P/Alb, Alb, and A/Alb separately or in combination showed the highest prognostic specificity and sensitivity. The patients with a plasma concentration above an optimal limit or above mean + 2 SD of a control group of 20 postmenopausal women were grouped together. The groups with P/Alb, A, A/Alb, and Alb above the limit showed an equal survival rate as patients in FIGO stage IV. Patients with a high A/Alb ratio and a high testosterone concentration showed an even poorer prognosis than FIGO stage IV patients. Among the patients in stage IV the A/Alb ratio and sex hormone binding globulin gave additional prognostic information on the stage. The steroid concentration is not only related to tumor volume, as shown earlier, but also reflects the prognosis of the disease. PMID- 2777134 TI - Serum lactic dehydrogenase and primary carcinoma of the ovary. AB - Serum lactic dehydrogenase (LDH) was evaluated in 51 patients with primary carcinoma of the ovary. An increased activity of this enzyme was found in 69% of the patients. The mean +/- SD activity of LDH correlated significantly with stage of disease: 200 +/- 73 U/l in stages 1 and 2, 295 +/- 107 U/l in stages 3A and 3B, and 362 +/- 91 U/l in stages 3C and 4. Moreover, LDH activity correlated significantly with the histological type of the tumor: 170 +/- 57 U/l in mucinous, 300 +/- 107 U/l in serous, 330 +/- 106 U/l in endometroid, and 352 +/- 98 U/l in undifferentiated carcinoma. Normal activity of LDH was observed in 86% of patients in stages 1 and 2, but in only 21% of patients in stages 3 and 4. Serum LDH activity was not found to be a good predictor of late prognosis of the disease, and it did not correlate with the surgical findings on second-look laparotomy. In addition, LDH activity did not correlate with the surgical debulking effort. However, after completion of cytoreductive surgery and adjuvant therapy, LDH did correlate with the course of the disease. It is concluded that LDH may have a role in the evaluation of a patient with carcinoma of the ovary or with a pelvic mass. PMID- 2777137 TI - Bleeding and thrombosis in chronic myeloproliferative disorders: relation of platelet disorders to clinical aspects of the disease. AB - Bleeding and thrombosis are a major cause of morbidity and mortality in myeloproliferative disorders (MPD). This study evaluates the relation between thrombohemorrhagic complications and platelet abnormalities in different subgroups of MPD. In 57 MPD patients thrombohemorrhagic complications occurred in 71% of patients with polycythemia rubra vera and 50% of patients with osteomyelofibrosis and primary thrombocythemia but in only 29% of patients with chronic myelogenous leukemia. Increased beta-thromboglobulin and platelet factor 4 plasma levels, platelet aggregation defects, and increased dispersion of the platelet volume distribution curve were most frequent in those subgroups where most serious thrombohemorrhagic complications were observed, and multiple platelet-related abnormalities were often found simultaneously. Fibrinopeptide A plasma levels were rarely elevated, however. Our results indicate that platelet abnormalities associated with bleeding and thrombosis are primarily determined by the clinical subgroup of myeloproliferative disease. PMID- 2777136 TI - Successful outcome of pregnancy complicated by giant myoma and severe heparin induced osteopenia. AB - A case of giant myoma and severe heparin-induced osteopenia during pregnancy is reported. The increased risk of osteopenia with heparin treatment during pregnancy is stressed. PMID- 2777138 TI - Effect of physical training on thrombotic tendency in rats: decrease in thrombotic tendency measured by the He-Ne laser-induced thrombus formation method. AB - The effect of physical training on thrombotic tendency was assessed in rats. Exercise was done on a flat treadmill for 30 min at a rate of 1,400 m/h (submaximal speed), 5 times a week for either 1.5 or 3 months. The thrombotic tendency was measured by the He-Ne laser-induced thrombus formation method in microvessels of mesentery, i.e. measurement of the number of laser irradiations necessary to induce stasis of blood flow by occlusive thrombus formation. An increase in the number of irradiations necessary to induce occlusive thrombus formation was observed in arterioles, but not in venules after physical training for 1.5 and 3 months. PMID- 2777140 TI - Factor XIII of blood coagulation modulates collagen biosynthesis by fibroblasts in vitro. AB - The effect of activated factor XIII (FXIIIa), the transglutaminase of blood coagulation, on some cellular functions was studied in skin and lung fibroblasts in vitro. FXIIIa repressed the overall protein synthesis and mainly collagen synthesis in a concentration-dependent manner and induced modifications in the proportion of the different types of newly synthesized collagen. The repression of collagen synthesis occurred in cells cultured on plastic (-40%), on coated fibronectin (-53%), on coated collagens (-38%) and within a collagen lattice ( 16%). Preincubation of the cells with FXIIIa and labelling in its absence also resulted in such an inhibition. However, when embedded into a fibrin lattice cross-linked by FXIIIa, fibroblasts displayed a higher biosynthetic activity than in untreated fibrin gel. These results suggest that FXIIIa acts through a modulation of the cell-matrix interactions. PMID- 2777135 TI - Endometrial reaction to intrauterine device in pregnancy. AB - It is generally assumed that the intrauterine device (IUD) exerts its action by altering endometrial receptivity for the implanting embryo. The most frequently encountered endometrial reaction reported in the presence of an IUD is a chronic inflammatory reaction which may be responsible for the alterations in the normal physiology of the human endometrium. In order to evaluate the endometrial response to the IUD when pregnancy occurs with the device in situ, we have examined the morphology of decidual tissue obtained during interruptions of pregnancy of 32 patients who had conceived in the presence of IUDs. Twenty-three decidual specimens, obtained during interruption of pregnancies without an IUD, served as controls. The incidence of chronic inflammatory reaction was 6.25% in the presence of an IUD and 4.34% in the control group. The incidence of chronic endometritis reported in nonpregnant IUD users is higher (14-100%) than the incidence of chronic endometritis observed in both groups. This observation may be the result of the generally observed alterations in the immune system during a normal pregnancy, but may also be interpreted as a primary reduced endometrial reaction to the IUD, consequently leading to the contraceptive failure in this group. PMID- 2777139 TI - Comparison of human normal, full-term, fetal and adult plasminogen by physical and chemical analyses. AB - Human fetal plasminogen was isolated from fetal cord blood obtained from full term normal newborns. Two fetal plasminogen preparations were characterized by physical analyses and compared to adult human Glu-plasminogen. The protein concentration of plasminogen in each full-term fetal plasma was approximately 50% of the concentration found in adult plasma. The specific activity of the isolated plasminogen from both full-term fetal plasmas was 28.8 +/- 1.5 IU/mg protein, approximately the same as that of adult Glu-plasminogen. No significant difference was observed in the rate at which plasmin was generated from the normal fetal plasminogen and the adult Glu-plasminogen using streptokinase, urokinase, and tissue plasminogen activator. Electrophoretic analyses in an acrylamide gel/sodium dodecyl sulfate dissociating system showed that the fetal plasminogens and the adult Glu-plasminogen were the same molecular size. Analyses in an acrylamide gel isoelectric focusing system indicated that fetal and adult plasminogen both contained the same twelve isoelectric forms, however, there was a slight difference in the distribution of the isoelectric forms. The fetal and adult plasminogens both contained 792 +/- 1 amino acid residues, and there were no significant differences in amino acid composition between the fetal and adult preparations. These comparisons indicate that normal, full-term, fetal and adult Glu-plasminogen are identical. PMID- 2777141 TI - Education for health social work: opportunities and constraints in schools and hospitals. PMID- 2777142 TI - Integrating social work and public health education: a clinical model. AB - In Florida, the need for clinically oriented social workers with expertise in planning and evaluating maternal and child health programs has led to the establishment of a joint master of social work and master of public health degree program. This program has a clinical social work concentration combined with a public health concentration in maternal and child health content, administration, and research design. The philosophy and development of the program, the course content and degree requirements, the field placement content, issues regarding student acceptance and advisement, faculty appointments, and program directions and goals are discussed. Descriptions of both the social work and public health programs that operate the joint-degree curriculum and the differing perspectives are outlined as well as skills that students obtained through their participation in the program. PMID- 2777143 TI - Psychosocial responses to the threat of HIV exposure among people with bleeding disorders. AB - The findings of a state-wide needs assessment of people with bleeding disorders at risk of human immunodeficiency virus (HIV) infection are reported. The effects of the threat of HIV exposure on the psychosocial functioning of respondents is assessed. A total of 394 of 796 (49 percent) persons aged 14 years and older responded to a questionnaire. Psychological distress, marital distress, AIDS related dating problems, and AIDS-related sexual problems were examined. Potential predictors were illness-related indicators, subjective assessments of sources and consequences of vulnerability to HIV, social sources of distress such as AIDS-related isolation and discrimination, and behaviors respondents engaged in to assess or reduce their risk of infection. The implications of these findings for service provision are discussed. PMID- 2777144 TI - Job-related stress and coping among home-care workers with elderly people. AB - Little is known about the job-related stress of home-care workers from the point of view of the workers themselves. Thirty-two home-care workers from six community-based, home-care programs sponsored by New York area Catholic Charities agencies were studied. The subjects predominantly were female, white, observant Christians, with a median age of 49 years. Test scores revealed little reported stress; however, interviews revealed significant stress that resulted primarily from interpersonal interactions, affective tasks, and insufficient pay. Coping strategies appeared to include denial, identification with clients, altruism. Low pay was the workers' primary dissatisfaction. The authors suggest ways that social workers, administrators, and supervisors can improve their work with home care workers and encourage advocacy and social action on behalf of these workers. PMID- 2777147 TI - Mutagenicity of rutin and the glycosidic activity of cultured cell-free microbial preparations of human faeces and saliva. AB - Genotoxic testing of flavonol glycosides, which account for most of the human intake of flavonoids, is dependent on the use of enzymatic extracts that exhibit beta-glycosidic activity. This study was aimed at characterizing further the beta glycosidic activity of cultured cell-free microbial extracts from human faeces (faecalase) and saliva (salivase). Using o-nitrophenyl-beta-D-galactoside as substrate, the optimum pH and apparent Km and energy of activation were shown to be 7.6, 3.5 x 10(-4) M and 8.65 kcal/mol, respectively, for faecalase, and 7.4, 8.7 x 10(-5) M and 3.8 kcal/mol, respectively, for salivase. Rutin (quercetin-3-O rutinoside) was shown to be a competitive inhibitor for faecalase, whereas no inhibitory activity could be found for salivase. Enzymatic hydrolysis of rutin gave the mutagenic product quercetin that was detected in the Ames assay and using high-performance liquid chromatography. PMID- 2777148 TI - Influence of dietary protein and gut microflora on endogenous synthesis of nitrate and N-nitrosamines in the rat. AB - Groups of four germ-free (GF) and conventional (CV) rats were given purified diets containing either 50 or 200 g lactalbumin/kg for 2 wk and their urinary excretion of nitrate was measured. Urinary excretion of N-nitrosoproline was also measured in one of the three experiments. Both GF and CV rats given the high protein diet excreted significantly more nitrate and N-nitrosoproline than those given the low-protein diet. On both diets GF rats excreted more nitrate than their CV counterparts but N-nitrosoproline excretion was not affected by environment. Groups of 11 GF and CV rats given diets containing sesame meal with or without a supplement of lysine-HCl for 2 wk, excreted similar amounts of nitrate on both diets, but more nitrate was excreted by GF rats than by their CV counterparts. N-nitrosoproline excretion by rats given the lysine supplement was higher in both environments. It is concluded that endogenous synthesis of nitrate is mediated by mammalian tissues rather than microflora and that dietary protein is an important source of nitrogen for the synthesis, although surplus amino acids from an imbalanced protein source do not act as precursors of endogenously formed nitrate. Some of the synthesized nitrate or its precursors appears to be metabolized by the microflora in the CV rat. PMID- 2777149 TI - Chronic toxicity/carcinogenicity studies of sulphamethazine in B6C3F1 mice. AB - A chronic feeding study was carried out in B6C3F1 mice with sulphamethazine (SMZ). The test substance was administered in the diet at dose levels of 0 (control), 300, 600, 1200, 2400 and 4800 ppm for 24 months. Mice were killed after 12, 18 and 24 months of continuous dosing. Body weights and food consumption were measured weekly, and mortality was recorded daily. All animals received a complete necropsy and histopathological examination, the results of which were analysed statistically. A slight decrease in body-weight gain was noted for mice of all dose groups with females showing the greater effect. Food consumption based on g food/g average body weight was relatively constant among the controls and various dose groups. The mortality rate for males and females of the control groups (8 and 8%, respectively) was higher than that for males and females of some of the higher dose groups. Neoplastic lesions associated with the ingestion of SMZ in the diet included follicular cell adenomas of the thyroid gland. At the 24-month necropsy, the incidence of this lesion for males and females of the 4800-ppm dose groups was 33 and 26%, respectively. Non-neoplastic dose-related lesions observed in both males and females included follicular cell hyperplasia (diffuse and focal) of the thyroid gland, haematopoietic cell proliferation of the spleen and pigmentation of the spleen. In females, pigmentation of the lymph nodes and hyperplasia of the mammary gland were also noted. PMID- 2777145 TI - Nonresidential services to elderly people. PMID- 2777150 TI - Acute inhalation toxicity of ammonium perfluorononanoate. AB - Ammonium perfluorononanoate (CAS Registry No. 4149-60-4) is a white powder that can become airborne. Its acute inhalation toxicity in male rats was studied. Male rats were exposed for single 4-hr periods to dust concentrations ranging from 67 to 4600 mg/m3. The LC50 was determined to be 820 mg/m3, with the lowest concentration causing death being 590 mg/m3. Ammonium perfluorononanoate was classified as moderately toxic by the acute inhalation route. Exposure to ammonium perfluorononanoate caused a pronounced increase in liver size. The acute toxicity of ammonium perfluorononanoate appears to be similar to that of its 8 carbon homologue, ammonium perfluorooctanoate, but considerably less than that of the 10-carbon homologue, perfluoro-n-decanoic acid. PMID- 2777146 TI - A study on the carcinogenicity of human diets in rats: the influence of heating and the addition of vegetables and fruit. AB - The influence of dietary factors such as total composition, thermal processing, and the addition of vegetables and fruit on the tumour rate in rats was studied in a long-term experiment. Groups of 50 male and 50 female Wistar rats were fed one of the following diets: a semi-synthetic animal diet (A, control); diet A to which vegetables and fruit were added (B); an uncooked human diet (meat, bread and eggs) supplemented with semi-synthetic compounds (C); diet C with fried or baked products (D); a complete human diet consisting of heated products, vegetables and fruit prepared according to mean consumption figures in The Netherlands (E). The animal diets (A and B) contained 26.0 energy (E)% protein, 21.6 E% fat, 52.4 E% carbohydrate and 10.7% (w/w) fibre. The human diets contained 13.2 E% protein, 40.6 E% fat, 46.2 E% carbohydrate and 5% (w/w) fibre. The rats were fed ad lib. for 142 wk. In males and females fed human diets (C, D or E) hepatocellular vacuolization was observed. Male rats (but not female) fed the human diet had a significantly (P less than 0.02) higher incidence of epithelial tumours than those fed the animal diet. This increase was mainly due to tumours of the pituitary and thyroid. Frying and baking of food products (diet D) and the addition of vegetables and fruit (diet E) induced minor differences in tumour rate, but they were not statistically significant. PMID- 2777152 TI - A sensitive analytical procedure for the detection of N-nitrosamides via their alkylating activity. AB - Based on a method for trapping direct-alkylating intermediates with scavenger reagents possessing a nucleophilic side-chain and an N-nitroso group as a marker, a sensitive test system for the detection of N-nitrosamides and related compounds has been developed. N-Nitroso-N-tert-butylglycine is an effective scavenger reagent for this purpose. It reacts readily with diazoalkanes released from N nitrosamides on treatment with alkali to form the corresponding esters which are analysed by gas-liquid chromatography using a thermal energy analyser. The method is easy to perform and specific for N-nitroso compounds that decompose to non polar diazoalkanes on treatment with alkali. A determination limit of 2 ng solids/sample was established for methylated NTBG formed from N-methyl-N-nitro sourea following treatment with alkali. PMID- 2777151 TI - Trapping of reactive intermediates from the nitrosation of primary amines by a new type of scavenger reagent. AB - N-Methyl-N-nitrosoethanolamine has been used as a scavenger reagent for the in vitro detection of unstable alkylating intermediates. The nucleophilic hydroxy group of the scavenger reagent binds with electrophiles to yield chemically stable ethers, which are analysed using gas-liquid chromatography with the highly sensitive and specific chemiluminescence detector, the thermal energy analyser. In contrast to other test systems for the in vitro detection of alkylating species, non-physiological reaction conditions are avoided and direct conclusions on the structure of the reaction products can be drawn. This test system is shown to be effective for investigating the alkylating capacity of primary amines on nitrosation. From methylamine to butylamine the yield of alkylated scavenger is low, decreasing with elongation of the carbon chain. In contrast, nitrosation of aniline, benzylamine or phenylethylamine leads to much greater yields of alkylated scavenger. These compounds should therefore be included in risk assessment of endogenous nitrosation of primary amine precursors. PMID- 2777153 TI - Dietary aluminium and Alzheimer's disease. PMID- 2777154 TI - Determination of length of human upper limb long bones from their fragments. AB - It is impossible to measure directly the length of fragmentary or broken long bones. It is in order to calculate the height (stature) of the individual, using magnification factors. An attempt has been made to devise a method of calculating the length from such fragments for the three long bones of the upper limb. PMID- 2777155 TI - The positioning and magnification of faces and skulls for photographic superimposition. AB - In the identification of persons living or dead, or of skulls, the technique of photographic superimposition of laboratory images on existing original portraits has frequently been used. The applicability of the technique and the confidence in the results have always depended very much on the professional acceptance and experience of forensic specialists. Defined preconditions, improved methods and clear-cut directions on how to posture the head or the skull and how to magnify its photographic laboratory image, not only help to standardize and simplify procedures, but also increase the accuracy and credibility of the resulting diagnoses. A systematic approach with standard photographic equipment is presented. The validity of the results is discussed. PMID- 2777156 TI - A comparison of post-mortem ethanol levels obtained from blood and subdural specimens. AB - Post-mortem subdural ethanol levels have been proposed as a useful test in certain forensic cases involving head trauma, particularly when the time interval from injury to death may have caused a lowering of the blood ethanol concentration to insignificant or undetectable levels. This study of 75 autopsied persons from whom both blood and subdural ethanol levels were obtained, shows the usefulness of the subdural ethanol level, especially where there is a prolonged or unknown post-traumatic time interval. Use of such a test is recommended in these situations. PMID- 2777158 TI - A fatal case of oral ingestion of toluene. AB - A 51-year-old male ingested orally a large quantity of toluene and died about 30 min later. The presence of toluene in body fluids and tissues was confirmed by gas chromatography and gas chromatography/mass spectrometry. Tissue distribution of toluene showed that the liver detected the highest content of toluene (433.5 micrograms/g), except for the stomach contents, followed by pancreas (88.2 micrograms/g), brain (85.3 micrograms/g), heart (62.6 micrograms/g), blood (27.6 micrograms/g), fat (12.2 micrograms/g) and finally cerebrospinal fluid (11.1 micrograms/g). PMID- 2777157 TI - Detection of S-methylfenitrothion, aminofenitrothion, aminofenitroxon and acetylaminofenitroxon in the urine of a fenitrothion intoxication case. AB - A 23-year-old male attempted suicide by ingesting approximately 50 ml of 5% fenitrothion emulsion, and vomited soon afterwards. He was admitted to a hospital about 3 h after ingestion. He recovered and was discharged from hospital 3 days after admission. The serum cholinesterase activity (normal range: 175-440 I.U.) was only 29 at 3 h, 32 at 1 day, 59 at 2 days and 75 at 3 days after ingestion. Fenitrothion and its metabolites in the body fluids were extracted by an Extrelut column extraction method, detected by a gas chromatograph equipped with either a hydrogen flame ionization detector or a flame photometric detector, and confirmed by a gas chromatograph-mass spectrometer. Fenitrothion concentration in the blood was 169.5 ng/g at 3 h after ingestion. The half life of blood fenitrothion concentration was found to be about 4.5 h. Fenitrothion metabolites, 3-methyl-4 nitrophenol, aminofenitrothion, aminofenitroxon, acetylaminofenitroxon and S methylfenitrothion, were detected in the urine samples. All of them except S methylfenitrothion were detected in the urine samples collected up to 62 h after ingestion. It would appear therefore that fenitrothion poisoning can be determined by detection and analysis of the metabolites in urine even if fenitrothion has not been detected in the blood. PMID- 2777159 TI - Gm and Km frequencies in West Germans: usefulness of typing Gm(1,2,3,10,21) and Km(1,3) in paternity cases. AB - The immunoglobulin allotypes G1m(1,2,3) and G3m(10,21) were typed in 2855 unrelated West German adult individuals. 1455 individuals were typed for the factors Km(1,3). Phenotype and haplotype frequencies are reported. The usefulness of this routine typing programme in paternity tests is demonstrated in three case reports. PMID- 2777160 TI - HIV-related deaths outside medical institutions in Stockholm. AB - During a 3-year period (August 1st, 1985 to July 31st, 1988) a systematic investigation of medico-legal autopsy cases with regard to the presence of antibodies for HIV-virus was carried out at the Department of Forensic Medicine in Stockholm, Sweden. Prior to autopsy, blood samples were taken from femoral or subclavian veins and were investigated by use of ELISA-screening and Western blotting test. During the first year of study, HIV infection was demonstrated in 11 out of 3464 deaths (0.32%), during the second year in 29 out of 3483 deaths (0.83%), and during the last year in 13 out of 3107 deaths (0.42%). It was shown that 48 out of the total of 53 HIV positive cases were previously registered, but information about the infection was available to the autopsist in only 27 cases. Drug addicts dominated 41 of 53 cases. There were only eight homo- and bisexual males, two non drug addict Central Africans and two persons who received blood transfusions. Eight of the 53 persons died of natural causes whereas 45 deaths were due to violence and drugs. The causes of death of the HIV positive drug addicts were compared to the causes of death of the HIV negative addicts. The HIV positive drug addicts tended to die suddenly in connection with the intravenous administration of heroin and at lower blood concentrations of morphine more often than the HIV-negative addicts. No increase in the suicide frequency was noted in drug addicts in Stockholm during the studied period. PMID- 2777163 TI - [10 years' experience with rytmonorm. Round table discussion. 27 May 1989, Munich. Abstracts]. PMID- 2777164 TI - [Josamycin fights germs even within the cell. A broad-spectrum antibiotic in respiratory tract infections. Abstracts from the International Pneumology Symposium. Madrid, 7-8 April 1989]. PMID- 2777162 TI - Injuries due to deliberate violence in areas of Denmark. V. Violence against women and children. Copenhagen Study Group. AB - As part of an European-South American study of deliberate violence cases of violence against women greater than or equal to 15 years of age and violence against and among children under the age of 15 years were registered at 3 Danish emergency wards and at the Institute of Forensic Medicine in Copenhagen. 352 cases of violence against women and 46 cases of violence against children were registered in the three emergency wards corresponding to rates of about 1.6/1000 per year for women, 0.6/1000 per year for boys and 0.7/1000 per year for girls in a provincial/rural district, the catchment region of Holbaek County Hospital, 3.4/1000 per year for women, 2.8/1000 per year for boys and 0.6/1000 per year for girls in a mainly middle income area of the metropolis Copenhagen, the catchment region of Frederiksberg Hospital, and 4.0/1000 per year for women, 4.0/1000 per year for boys and 0.9/1000 per year for girls in a mainly low income area of Copenhagen, the catchment region of the Rigshospital. Nineteen live adult female victims and 17 dead adult female victims of violence were registered in the Institute of Forensic Medicine in Copenhagen, where also one was registered as a victim of homicide. Nearly half of the adult live female victims of violence had been injured at home while this was the case for approximately three fourth of the dead victims. In 35% of the live cases the husband was the aggressor and in 12% a former cohabitant. In 71% of the homicide cases the husband was the aggressor. The live women appeared to have fewer but more serious lesions than men. The pattern of deliberate violence against women appears to be associated with socio-economic and cultural factors. In cases with a preceding quarrel there is statistically a link to alcohol intoxication. In half of the cases of violence against children the aggressor was known to the victim, in 15% the aggressor was one of the parents, while 42% of the cases were violence among children. The pattern of violence according to sex, and the distribution and severity of lesions for 10-14 years old children showed resemblance to the situation for adults. The lesions were more serious in young infant victims, especially boys, than in adult victims. PMID- 2777165 TI - [Regulation of fat metabolism to reduce coronary risk. Product workshop "Clinical results with Normalip 250 N." Copenhagen, 3 June 1989. Abstracts]. PMID- 2777161 TI - The occurrence of HIV antibodies in drug addicts autopsied at the University Institute of Forensic Medicine in Copenhagen in 1987. AB - In 1987 a total of 89 intravenous drug addicts were admitted to medico-legal autopsy at the University Institute of Forensic Medicine in Copenhagen. Totally 10 cases were reactive by the Elisa test and five of these, or 7% of the total material tested, could be confirmed by the immuno-blotting test. The other five cases must be considered as false positive, possibly due to antibodies against cellular antigens. Among the five real positive cases, four were known before hand while in one case the HIV-positivity was not known. These findings - together with the possibility of false negative reactions - especially regarding persons with acute HIV-infection, requires special precautionary measures when autopsies of drug addicts are performed. PMID- 2777168 TI - Effects of a superovulatory dose of pregnant mare serum gonadotropin on follicular steroid contents and oocyte maturation in rats. AB - Our previous study has shown that superovulatory treatment with pregnant mare serum gonadotropin (PMSG) in rats caused marked alterations in ovarian and serum steroid responses and coincidental increase in degenerate oocytes (Yun et al., 1987). This study examined the effects of superovulatory treatment (20 IU PMSG) on follicular steroid contents and oocyte maturation. Immature female rats aged 28-30 days were injected with 4 or 20 IU PMSG and sacrificed at 24, 48, 60, and 72 hr. Compared to control regimen, follicular content of progesterone (P) in superovulated rats significantly (P less than .05) increased at 48 hr. Androgen (A) content significantly (P less than .01) decreased below control level at 24 hr but significantly (P less than .05) increased above control level at 48 hr and 60 hr. There was no significant change in 17 beta-estradiol (E) content between the two groups. In control regimen, the ratio of A/E sharply decreased and the ratios of P/E and P/A increased steadily from 24 hr. However, superovulatory regimen showed a consistently steady state in the overall ratios of follicular steroids after 24 hr. Nuclear maturation of the majority of control oocytes recovered from oviducts at 72 hr was synchronized at metaphase II, whereas superovulated oocytes displayed different stages varying from prophase I to metaphase II at 24, 48, and 72 hr. The results provide direct evidence of atypical ovulations in superovulated oocytes with premature or asynchronous nuclear maturation and demonstrate a close relationship between meiotically aberrant oocytes and abnormal follicular steroidogenesis following superovulation with PMSG in rats. PMID- 2777169 TI - Analysis of the first cell cycle in the cross between hamster eggs and human sperm. AB - Golden hamster eggs fused with human sperm were pulsed with bromodeoxyuridine to determine the timing of S-phase and the length of the first cell cycle in this hybrid cross. Fused eggs were fixed and pronuclei scored for incorporation of the thymidine analogue detected by indirect immunofluorescence. Although S-phase started synchronously 3-3.5 hr after coincubation of sperm and eggs, its duration was variable such that two-cell stages appeared at 16 hr while a proportion of pronuclei was still engaged in DNA synthesis. Unlike rodent sperm chromatin, human sperm chromatin was able to participate in DNA synthesis well before its maturation into a fully developed pronucleus. Human sperm chromatin appears able to function under conditions different in several respects from those in human eggs. PMID- 2777167 TI - Structure of the zona pellucida and cumulus oophorus in three species of native Australian rodents. AB - The sperm head of many Australian hydromyine rodents has three curved hooks projecting from its anterior margin; the structure of the hooks has been characterized, but their function is unknown. In this study, we have investigated whether the hooks might have evolved to assist sperm penetration through more formidable egg vestments, particularly the zona pellucida. Cumulus-oocyte complexes were obtained from two species that possess a three-hooked sperm head (Pseudomys australis and P. nanus) and one species that does not (Notomys alexis) and examined by light and electron microscopy. After fixation in the presence of ruthenium red, the zona pellucida was found to consist of a fibrillar meshwork, but there were no interspecific structural differences. A corona radiata was absent, and the cumulus extracellular matrix was composed of filaments and electron-dense granules in each species. Measurements of the zona thickness in freshly ovulated, unfixed oocytes revealed that it was thinnest (7.8 microns) in P. australis, which has a three-hooked sperm head, and thickest (11.4 microns) in N. alexis, the species in which the ventral hooks are absent. Hence, no correlation was found between the thickness of the zona pellucida or the structure of the cumulus-oocyte complex, and the presence of three hooks on the sperm head. We conclude, therefore, that it is unlikely that the evolution of the three-hooked sperm head is an adaptation for penetration of increased barriers around the oocyte. PMID- 2777166 TI - Influence of cumulus cell processes on oolemma permeability and lethality of isolated mouse oocytes cultured in Ca2+-free medium. AB - Cumulus cell processes remaining in the zona pellucida of mouse oocytes mechanically isolated from the ovary have been indirectly visualized by labeling their actin microfilament core with rhodaminyl-phalloidin. If the isolation of the oocytes is performed in Ca2+-free medium, the presence of such processes allows the entry into the cell of low molecular weight molecules (such as 5-6 carboxyfluorescein) and contributes to the death of the cell in such experimental conditions. Following dissolution of the zona pellucida (by enzymatic or acidic treatment) the oocyte is no longer permeable to small molecules and becomes resistant to Ca2+-free medium, probably as a consequence of the collapse of cumulus cell processes. The role of cumulus cell processes and gap junctions in the permeability of mechanically isolated ovarian oocytes is discussed. PMID- 2777170 TI - Microtubule assembly is required for the formation of the pronuclei, nuclear lamin acquisition, and DNA synthesis during mouse, but not sea urchin, fertilization. AB - Microtubule assembly is required for the formation of the male and female pronuclei during mouse, but not sea urchin, fertilization. In mouse oocytes, 50 microM colcemid prevents the decondensation of the maternal meiotic chromosomes and of the incorporated sperm nucleus during in vitro fertilization. Nuclear lamins do not associate with either of the parental chromatin sets although peripherin, the Pl nuclear peripheral antigen, appears on both. DNA synthesis does not occur in these fertilized, colcemid-arrested oocytes. This effect is limited to the first hours after ovulation, since colcemid added 4-6 hours later no longer prevents pronuclear development, lamin acquisition, or DNA synthesis. Neither microtubule stabilization with 10 microM taxol nor microfilament inhibition with 10 microM cytochalasin D or 2.2 micrograms/ml latrunculin A prevent these pronuclear events; these drugs will inhibit the apposition of the pronuclei at the egg center. In sea urchin eggs, colcemid or griseofulvin treatment does not result in the same effect and the male pronucleus forms with the attendant accumulation of the nuclear lamins. The differences in the requirement for microtubule assembly during pronucleus formation may be related to the cell cycle: In mice the sperm enters a meiotic cytoplasm, whereas in sea urchin eggs it enters an interphase cytoplasm. Refertilization of mitotic sea urchin eggs was performed to test the possibility that this phenomenon is related to whether the sperm enters a meiotic/mitotic cytoplasm or one at interphase; during refertilization at first mitosis, the incorporated sperm nucleus is unable to decondense and acquire lamins. These results indicate a requirement for microtubule assembly for the progression from meiosis to first interphase during mouse fertilization and suggest that the cytoskeleton is required for changes in nuclear architecture necessary during fertilization and the cell cycle. PMID- 2777171 TI - Changes in the distribution of intramembranous particles and filipin-reactive membrane sterols during in vitro capacitation of golden hamster spermatozoa. AB - Membrane alterations accompanying in vitro capacitation of hamster spermatozoa were examined using the freeze-fracture technique with or without use of filipin, a sterol-binding probe. In the spermatozoa prior to or at 10 min after start of incubation in capacitating medium, large (about 11 nm) and small (8-9 nm) intramembranous particles (IMPs) were present in the periacrosomal region of the sperm plasma membrane (PAPM). Filipin sterol complexes (FSCs) were densely (about 500/micron 2) distributed in the PAPM prior to incubation. The density of FSCs in the PAPM was reduced by 70-80% of the original density by 2 hr of incubation. At the same time, small patches of IMP-free areas appeared in the plasma membrane above the equatorial and middle segments of the acrosome. By the end of 3 hr of incubation, the majority of small IMPs had disappeared from the PAPM. Remaining large and small IMPs tended to aggregate in the PAPM. During incubation in capacitation medium, "cords," or linear arrangements of closely packed IMPs, appeared near the posterior ring of the sperm head. These observations strongly suggest that the acrosome reaction of the hamster spermatozoa is preceded by the removal (deletion) of filipin-reactive sterols (FRSs) and the disappearance of small IMPs from the lipid bilayer of PAPM. PMID- 2777172 TI - X-Y chromosome dissociation in mouse strains differing in efficiency of spermatogenesis: elevated frequency of univalents in pubertal males. AB - Dissociation of the X-Y chromosome bivalent in diakinesis-metaphase I spermatocytes of adult mice was significantly more frequent in the CBA strain (29%) than in C57, KP, or KE strains (7-11%). Autosome dissociation (1-5%) involved only the smallest chromosome pairs. Elevated frequency of X-Y dissociation in the CBA strain correlates with significantly lower testes weight and lower yield of spermatogenesis, which suggests that sex bivalent dissociation may be responsible for some loss of spermatogenic cells. However, sperm quality is not affected, the percentage of normal spermatozoa and their fertilizing capacity being higher in CBA than in the remaining strains. Two congenic strains, KE and KE.CBA (the latter with the Y chromosome introduced from CBA), had the same level of X-Y dissociation, suggesting that the Y chromosome plays no role in the determination of this character. In comparison with adult males, pubertal (27 29 day-old) males had twice as high a frequency of X-Y dissociation in KE and KP strains, and combined frequencies of dissociated sex and autosome bivalents were significantly higher in pubertal males of all tested strains. Although the level of chromosome dissociation is not sufficient to explain increased mortality of germ cells observed in pubertal males, it could be one of the contributing factors. PMID- 2777173 TI - Monospermy and polyspermy after partial zona dissection of reinseminated human oocytes. AB - Partial zona dissection (PZD), a zona drilling method that uses mechanical force to open the zona pellucida while the oocyte is shrunken in a sucrose solution, was applied to 121 unfertilized 1-day-old mature human oocytes prior to reinsemination. The 115 surviving oocytes were divided into three groups in which the duration between sucrose addition and reinsemination was varied: I) Less than 20 minutes, II) 21 to 45 minutes, and III) longer than 45 minutes. There was a trend toward a reduced fertilization and polyspermy rate as the time between sucrose exposure and insemination in sucrose-free medium increased. Moreover, there was a statistically significant reduction in the number of oocytes penetrated by more than four sperm in group III (0/41) versus group I (7/34), and in group III, parthenogenetic development was observed. The incidence of polyspermy was also increased in oocytes manipulated more than 25 hours after retrieval compared with those manipulated 21-24 hours after recovery, supporting the idea that aged oocytes have a reduced ability to block polyspermy. Oocyte contraction in sucrose occurred in three different patterns: spherical, pear shaped, and crenated. Both the fertilization and polyspermy rates were significantly higher in the crenated group. These results indicate that changes resembling activation occur following sucrose exposure and that sucrose activation can be used to reduce the risk of polyspermic fertilization in zona drilling procedures. In addition, the pattern of shrinkage in sucrose can be used as an indicator of oocyte receptivity to sperm penetration. PMID- 2777175 TI - Primordial germ cell development in cultures of dispersed central disks of stage X chick blastoderms. AB - Central disk fragments cut from stage X chick blastoderms were dispersed and cultured on glass coverslips. After 48 hr of incubation the cultures showed various degrees of organization into three-layered aggregates in which no axis development was observed. Primordial germ cells (PGCs) were detected in all cultures. The number of PGCs was found to be correlated to the initial cell concentration in the suspension. By regression analysis it was found that in cultures initiated from 10 central disks or more, the mean number of PGCs per fragment was constant and matched the number of PGCs found for intact control central disks incubated for the same length of time. It appears that in cultures of stage X, the morphologic expression of PGCs is related to the level of differentiation and organization of the somatic cells in the culture, which, in turn, is dependent on the initial concentration of cells in the culture. PMID- 2777176 TI - Membrane specializations associated with the acrosomal complex of sea urchin sperm as revealed by immunocytochemistry and freeze fracture replication. AB - Observations, employing freeze fracture replication and electron microscopic immunochemistry, have been carried out to determine structural correlations of the plasma membrane domain occupied by a 210 kDa protein involved in the acrosomal reaction of sea urchin sperm and recognized by the monoclonal antibody, J10/14 (Trimmer et al.: Cell 40:697-703, 1985; Proceedings of the National Academy of Sciences of the United States of America 83: 9055-9059, 1986). Immunogold-J10/14 staining of acrosome-intact sperm was intense along the flagellum and a narrow collar just posterior to the sperm apex that surrounded the acrosomal complex (acrosomal vesicle and subjacent anterior nuclear fossa containing g-actin). Counts of gold particles revealed a density (average number of particles/micron2 of surface area) eightfold greater along the plasma membrane associated with the acrosomal complex than membrane delimiting the remainder of the sperm head. The collar of J10/14 staining was isomorphic with a dense aggregation of intramembranous particles in the P-face of the plasma membrane and a thin cytoplasmic region that surrounded the acrosomal complex. In acrosome reacted sperm, intense J10/14 staining was distributed along the flagellum and sperm head; prominent anterior staining was not apparent in all specimens. The density of gold particles associated with plasma membrane delimiting components of the former acrosomal complex, nucleus and mitochondrion, as well as the total average number of particles along the entire sperm surface, were increased in sperm acrosome-reacted with A-23187. Concomitant with this change in staining was the disappearance/reduction of the collars of intramembranous particles and cytoplasm. These observations indicate that plasma membrane components (210 kDa protein and intramembranous particles) and the collar of cytoplasm which are associated with the acrosomal complex are functionally, as well as structurally related. Analyses of particle density distributions along acrosome- and non acrosome-reacted sperm suggest that the different staining patterns observed may be brought about by the recognition of cryptic sites at the time of the acrosomal reaction. PMID- 2777177 TI - Effects of semen preservation on boar spermatozoa head membranes. AB - Head plasma membranes were isolated from the sperm-rich fraction of boar semen and from sperm-rich semen that had been subjected to three commercial preservation processes: Extended for fresh insemination (extended), prepared for freezing but not frozen (cooled), and stored frozen for 3-5 weeks (frozen thawed). Fluorescence polarization was used to determine fluidity of the membranes of all samples for 160 min at 25 degrees C and also for membranes from the sperm-rich and extended semen during cooling and reheating (25 to 5 to 40 degrees C, 0.4 degrees C/min). Head plasma membranes from extended semen were initially more fluid than from other sources (P less than 0.05). Fluidity of head membranes from all sources decreased at 25 degrees C, but the rate of decrease was significantly lower for membranes from cooled and lower again for membranes from frozen-thawed semen. Cooling to 5 degrees C reduced the rate of fluidity change for plasma membranes from the sperm-rich fraction, while heating over 30 degrees C caused a significantly greater decrease. The presence of Ca++ (10 mM) lowered the fluidity of the head plasma membranes from sperm-rich and extended semen over time at 25 degrees C but did not affect the membranes from the cooled or frozen-thawed semen. The change in head plasma membrane fluidity at 25 degrees C may reflect the dynamic nature of spermatozoa membranes prior to fertilization. Extenders, preservation processes and temperature changes have a strong influence on head plasma membrane fluidity and therefore the molecular organization of this membrane. PMID- 2777174 TI - Development in vitro of investment-free marsupial embryos during cleavage and early blastocyst formation. AB - Twenty embryos at the cleavage-arrested four-cell stage of the brown antechinus, Antechinus stuartii, were used to develop a method to obtain investment-free embryos by incubation at 35 degrees C in 2.5% pancreatin, 0.05% trypsin, and 0.05% pronase. Control intact embryos and the investment-free embryos were incubated in Dulbecco's Modified Eagle's Medium with high glucose and 10% foetal calf serum in 5% CO2 in air at 35 degrees C for 48 h. Release of embryos from the investments (shell, mucoid, and zona pellucida) took 4-4 1/2 h in pancreatin, 6 h in trypsin, and 55 min to 1 1/4 h in pronase. Embryonic survival in vitro was best following pronase digestion. Pronase concentrations of 0.05%, 0.1%, 0.25%, 0.5%, and 1.0% were used to free one- to 16-cell stage embryos of brown antechinus and the stripe-faced dunnart, Sminthopsis macroura, from their investments. Postincubation survival and development of embryos in vitro was best using between 0.05% and 0.25% pronase. Blastomeres in both intact and investment free embryos shared similar characteristics during cleavage and blastocyst formation. The combined effect of these characteristics was that in intact embryos, no morula was formed, and the blastocyst developed, when cell numbers were high enough (about 32 cells), as a unilaminar structure flattened against the zona pellucida and without an inner cell mass. In investment-free embryos, the blastomeres dispersed over the base of the culture vessel. The investments were necessary to confine the blastomeres, to provide a surface for blastomere flattening, and to allow normal cellular associations to develop. PMID- 2777178 TI - Chemical N-desulfation of heparin negates its ability to capacitate bovine spermatozoa. AB - Heparin specifically and saturably binds to bovine spermatozoa and stimulates capacitation as assessed by the ability of spermatozoa to undergo a zona pellucida-induced acrosome reaction (AR) in vitro. However, the structural features of heparin important for capacitation are poorly understood. The purpose of this study was to determine the importance of the sulfate content of heparin for its potency to bind to bull spermatozoa and promote agglutination and capacitation. The pyridine salt of heparin was N-desulfated, which reduced its mean sulfate content from 19.7% to 11.6%. The N-desulfated heparin was then resulfated by incubation with trimethylamine sulfur trioxide for 6, 12, or 24 hr, raising sulfate to original concentrations. Heparin but not N-desulfated heparin competed with [3H]-heparin to bind to spermatozoa. Heparin at 11.6 micrograms/ml reduced [3H]-heparin binding by half when competing with a saturating concentration of the radiolabeled compound (12 micrograms/ml). N-desulfated heparin did not displace [3H]-heparin. Heparin, resulfated 6 hr or 12 hr, was equal to native heparin in binding potency. Heparin at 50, 100, or 250 micrograms/ml caused more than 40% of the cells to head-to-head agglutinate in aggregates of 8 or more. N-desulfated heparin did not cause agglutination. After spermatozoa were incubated with 0, 5, 10, 50, 100, or 250 micrograms/ml of heparin for 4 hr, 100 micrograms/ml of lysophosphatidylcholine (LPC)-induced AR within 20 min in 21.3, 37.7, 27.8, 45.3, 54.2, or 42.5% of the cells, respectively. Sperm exposed to the same concentrations of N-desulfated heparin exhibited AR of 17.7, 27.3, 24.3, 22.5, 27.7, or 33.8%, respectively, following exposure to LPC. Resulfated heparin did not agglutinate or capacitate spermatozoa. In conclusion, N-desulfation of heparin abolished heparin's ability to bind to, agglutinate, and capacitate bovine spermatozoa. Resulfation of N desulfated heparin restored binding activity but not agglutination or capacitation activity. PMID- 2777179 TI - Cumulus cell dispersion induced by estradiol in mouse oviduct in vitro. AB - Dispersion of cumulus cells in nonmated mice is completed in the oviduct 15-20 h after ovulation. Oviducts, isolated 1 h after ovulation (13 h post-human chorionic gonaditropin), were cultured in vitro for 40 h. In these oviducts, denuded oocytes were first seen at 30 h of culture, indicating that cumulus dispersion proceeded at a slower rate in vitro. Oocyte denudation was accelerated in a dose-dependent manner by the addition of estradiol to the culture medium in which oviducts were incubated. The addition of progesterone or cycloheximide to the culture medium strongly inhibited oocyte denudation even in the presence of estradiol. When isolated cumuli were incubated in the absence of oviductal tissue, the rate of cell dispersion was slower than that of cumuli incubated inside the oviduct and the addition of estradiol to the culture failed to accelerate this process. On the basis of these data, we propose that cumulus cell dispersion is accelerated by an estrogen-dependent protein produced by the oviduct and that this effect of estrogen is antagonized by progesterone. PMID- 2777184 TI - Lipid-bound sialic acid in diabetes. PMID- 2777180 TI - Rates of lactate appearance and disappearance and brain lactate balance after oral glucose in the dog. AB - After glucose ingestion, arterial lactate concentrations increase. Although it is presumed that this is due to an increase in lactate production, rates of lactate appearance have not been measured after oral glucose nor has the major site of its production been identified. Since brain takes up a substantial portion of an oral glucose load but does not store appreciable amounts of glucose, it is possible that brain could be an important site for postprandial lactate formation. Therefore, to investigate the contribution of the brain to the increase in arterial lactate after glucose ingestion and to determine whether changes in lactate appearance or disappearance were predominantly involved, we measured lactate fluxes and brain lactate balance in dogs after intraduodenal administration of glucose (1.6 g/kg). Although systemic lactate appearance increased significantly after glucose administration (from 22 +/- 3 to 33 +/- 9 umole/kg/min, P less than 0.05), brain lactate output did not change (0.62 +/- 0.5 vs 0.74 +/- 0.5 umole/min). We conclude that after glucose ingestion, arterial lactate increases as a result of an increase in the rate of lactate appearance and that brain does not make a significant contribution to this. PMID- 2777183 TI - Effects of high glucose and sorbitol pathway on lipid peroxidation of erythrocytes. PMID- 2777185 TI - Aminopeptidase (arylamidase) activity in discrete areas of the rat brain: sex differences. PMID- 2777186 TI - Kinins are not liberated by working skeletal muscle in the majority of patients with essential hypertension. PMID- 2777188 TI - Mechanism of action of thyroxine (T4) on the biogenesis of mitochondria using antibiotic-free system: a gerontological survey. AB - For the biogenesis of mitochondria from rat liver two different genetic systems are responsible, the nucleo-cytoplasmic system, covering 85-90% of the protein, and the mitochondrial system (10-15%). These data have been confirmed by experiment. Both protein fractions were separated by phosphate buffer (pH 11.5), in which only one of them is soluble. The experiments were performed with 3 age groups of rat: 1, 3 and 24 months. The ratio of both protein fractions was not dependent on rat age. The activities of the two genetic systems were examined by the in-vivo incorporation rate of 14 C-leucine. For the mitochondrial genetic system this rate was approximately equal in all of the age groups, while that for the nucleo-cytoplasmic genetic system was reduced in the 24 month group. Hence an age-dependence is demonstrated for the nucleo-cytoplasmic genetic system. The results of our investigation permit the conclusion that the role of the mitochondrial genetic system increases at senescence. To investigate the effect of T4 on the biogenesis of mitochondria, both protein fractions were estimated also in liver of rats treated with T4. The result showed that there was an increase for all the age groups for protein only of nucleo-cytoplasmic origin. Since it is known that T4 stimulates the biogenesis of mitochondria and increases its protein content, it could be inferred that the action of T4 is channelled through the nucleo-cytoplasmic system independent on age, and that the nucleus plays the major regulatory role in the biogenesis of mitochondria. PMID- 2777181 TI - Prostaglandin precursor fatty acids in serum and bile as influenced by oophorectomy, contraceptive steroids and pregnancy. An experimental study in the cat. AB - Variations in the occurrence of prostaglandin precursor fatty acids might be of importance for the pathogenesis of gallstones. Pregnancy and use of contraceptive steroids increase the risk of gallstones. The present study reports the relative fatty acid composition in serum and biliary phospholipids studied by gas-liquid chromatography in four groups of female cats, which were on a standard diet: 1) oophorectomized animals, 2) animals on contraceptive steroids, 3) pregnant animals and 4) control animals. It was consistently found that the portions of palmitic and linoleic acid were higher and stearic and arachidonic acid were lower in biliary than in serum lecithin. In biliary lysolecithin, sphingomyelin and cephaline there were only small portions of linoleic and negligible amounts of arachidonic acid. Oophorectomy, contraceptive steroids or pregnancy did not induce any gross changes in the fatty acid pattern of lecithin in serum or bile. In animals treated with contraceptive steroids a reduced portion of linoleic acid was seen in the bile lecithin, and in pregnant animals there was a reduction of omega 3 and omega 6 fatty acids in biliary lecithin. PMID- 2777182 TI - Radioimmunoassay for non-enzymatically glycated serum proteins. AB - We have developed a radioimmunoassay (RIA) for nonenzymatically glycated serum proteins. The polyclonal antibodies prepared against reduced glycated human albumin were specific for the glucitollysine residues of serum proteins. Serum proteins from diabetic patients (n = 25) contained 5.3 +/- 2.8 nmoles of glucitollysine/mg protein, compared to 2.0 +/- 0.2 in controls (n = 20). The intra- and inter-assay variables were 3.2-6.2% and 4.4-8.6%, respectively. Results from this assay procedure correlated well with those from the boronate affinity chromatography procedure (r = 0.94; P less than 0.001). The data suggested that diabetic serum proteins contained at least 2.5 times as much immunochemically detectable glucitollysine residures as normal serum proteins after reduction of the proteins with sodium borohydride. PMID- 2777187 TI - The lung as a target organ for thyroxine. AB - The isolated perfused in situ rat lung preparation was used to investigate the chronic effect of thyroxine on the intermediary metabolism in the mammalian lung. Treatment with thyroxine caused stimulation of the rate of glucose utilization (91 +/- 11 mumol/g dry weight/hr versus 54 +/- 5 mumol/g dry weight/hr). The increase in the rate of glucose uptake was not accompanied by a similar increase in lactate output. Alanine and pyruvate release were also similar in both groups. The implication is that oxidative metabolism of glucose was increased. This study provides the first unequivocal evidence that the mammalian lung is a target organ for thyroxine. PMID- 2777191 TI - Effect of nadolol on plasma lipids in hyperthyroidism. AB - The effect of Nadolol treatment on lipid subfractions in a group of 23 hyperthyroid patients was assessed in a randomised double-blind placebo controlled trial lasting six weeks, carbimazole being given to both groups from weeks 2 to 6. Clinical and biochemical euthyroidism was seen in both groups at 6 weeks; no effect of nadolol on peripheral monodeiodination of T4 to T3 was observed. At time 0 there were significant negative correlations between total cholesterol and free T3 (r = 0.68), and free T4 (r = 0.54). In the Nadolol group there were significant rises between 0 and 6 weeks in total cholesterol (52.6%, P less than 0.01), LDL cholesterol (30.3%, P less than 0.01) and HDL cholesterol (18.2%, P less than 0.05). HDL cholesterol rose significantly in the placebo group (12.4%, P less than 0.05) but there were no significant increases in LDL cholesterol or total cholesterol. The rise in triglyceride during this period in the Nadolol group (64.7%, P less than 0.05) was significantly greater (P less than 0.05) than the rise in the placebo group (8.8%). Nadolol increases triglyceride more than placebo during the early management of hyperthyroidism. PMID- 2777189 TI - A comparison of metformin versus guar in combination with sulphonylureas in the treatment of non insulin dependent diabetes. AB - Twelve non-obese non insulin dependent diabetics whose mean +/- SE fasting blood glucose was 12.9 +/- 0.9 mmol/l despite maximal doses of sulphonylureas, received 8 weeks of guar (5 g tid before meals) and 8 weeks of metformin (0.5 g tid) following a six week washout period, in a cross-over design. Guar significantly lowered fasting cholesterol and triglyceride concentrations but did not alter glucose concentrations. Conversely, metformin significantly reduced fasting and post-prandial glucose concentrations but had no influence on plasma lipids. PMID- 2777190 TI - Possible thyrotrophs insensitivity to dopamine in hyperprolactinaemic amenorrhoeic patients. AB - The study assessed the sensitivity of the thyrotrophs of hyperprolactinaemic patients to a physiological dose of dopamine (DA). Eight hyperprolactinaemic amenorrhoeic patients received 4-hour infusions of either DA (0.4 micrograms/kg x min) or glucose. Twelve normal women served as controls. In normal women the mean thyrotrophin (TSH) concentration declined significantly (P less than 0.05) from 81 +/- 6.6% of basal levels during glucose infusion to 59 +/- 5.8% of basal levels during DA infusion. In contrast DA infusion to hyperprolactinaemic patients caused no significant reduction in TSH levels compared to glucose infusion (DA infusion 68 +/- 4.7% of basal levels; glucose infusion 73 +/- 4.9% of basal levels). DA infusion caused a significant reduction in serum prolactin (PRL) levels both in hyperprolactinaemic patients (P less than 0.001) and normal women (P less than 0.02), but the PRL suppression was significantly (P less than 0.05) less pronounced in the hyperprolactinaemic patients, compared to normal women. We propose that the abnormal PRL as well as TSH secretion in hyperprolactinaemic amenorrhoeic patients may be due to a common defect. Both the lactotrophs and the thyrotrophs may be relatively insensitive to dopaminergic inhibition. PMID- 2777192 TI - Plasma transferrin levels in abnormal endocrine states. II. The changes in various endocrine states. AB - The clinical significance of the measurement of plasma transferrin (Tf) in patients with hypophysial disorders was reported in our previous paper. In the present study, we determined plasma Tf levels in 55 patients with various endocrine states and considered their clinical significance compared with plasma somatomedin-C (SM-C) levels. Plasma Tf levels decreased significantly in patients with anorexia nervosa (P less than 0.02), hyperthyroidism (P less than 0.05), primary hypothyroidism (P less than 0.05), and Cushing's syndrome (P less than 0.05), while they were elevated significantly in pregnancy (P less than 0.01) or females using estrogens (P less than 0.05). The former two declines were considered a reflection of the malnutritional state since a significant negative correlation was observed between plasma Tf levels and the percentile deficit from the ideal body weight in patients with anorexia nervosa (P less than 0.01), or between plasma Tf and elevated T3 levels which induce hypermetabolism in patients with hyperthyroidism (P less than 0.01). A significant correlation was observed between the SM-C and Tf levels in these subjects (including normal controls and patients with hypophysial disorders) as a whole (r = 0.79, P less than 0.001). These data indicate that plasma Tf is changeable according to the endocrine and nutritional conditions with good correlation to the SM-C, and it is suggested that Tf also operates as a growth factor in vivo. PMID- 2777193 TI - Bezafibrate lowers VLDL concentrations without modifying its structure. PMID- 2777194 TI - Pituitary-gonadal response to extreme cold exposure in healthy men. PMID- 2777195 TI - Plasma oxytocin concentrations in pigs after water deprivation and during rehydration. PMID- 2777197 TI - Role of milk secretion in transport of prolactin from blood into milk. AB - In a first experiment prolactin was shown to be uniformly distributed in the milk of dairy cows. Accumulation of prolactin in milk increased with milking interval although milk prolactin content was proportionally greater after 2 h than accumulation of milk. Concentration of milk prolactin and total transfer of prolactin into milk was greater in mammary glands of cows milked just prior to initiation of intravenous infusion of exogenous prolactin. Similarly, inhibition of milk secretion as induced by intramammary infusion of colchicine, markedly reduced milk prolactin concentration and total transfer of prolactin into milk 5h following start of intravenous infusion of exogenous prolactin. Data indicate that transfer of prolactin from blood into milk during established lactation occurs primarily in conjunction with milk secretion. PMID- 2777196 TI - The influence of the duodenal passage on postprandial neurotensin release in dogs. AB - All types of gastric resections induce an abnormal release of gastrointestinal hormones. The missing duodenal passage seems to be the most important factor for these disturbances. In the present study we have examined the effect of exclusion and restoration of the duodenal passage on the postprandial release of neurotensin in dogs. After feeding a standard canned dog meal, exclusion of the duodenal passage by a Billroth-II-resection caused a significant increase in postprandial neurotensin release compared to the control group (peak levels 52 +/ 5.6 to 29 +/- 6 pg/ml preoperatively, integrated output 2132 +/- 228 to 3604 +/- 213 pg/ml x 150 min. p less than 0.05). Reconstruction of the duodenal passage by the Biebl-Henly-Soupault-procedure tended the elevated neurotensin levels towards normal (peak levels 36 +/- 4.8 pg/ml, integrated output 2448 +/- 236 pg/ml x 150 min., p less than 0.05). From our data we conclude that changes in intestinal transit time are responsible for the pathological increase in neurotensin release after exclusion of the duodenal passage. PMID- 2777198 TI - A correlation between microalbuminuria and anti-insulin antibodies in type I diabetics. AB - A link between circulating anti-insulin antibodies and diabetic glomerulopathy has been suggested. This paper presents two different studies aiming to detect a relationship between incipient nephropathy (indicated by microalbuminuria) and anti-insulin antibodies. In 64 type I diabetics, overnight urinary albumin excretion during an exercise-test was found to be correlated with systolic blood pressure (r = 0.258 p less than 0.05), anti-insulin antibodies (r = 0.258 p less than 0.05), and glycosylated hemoglobin (r = 0.258 p less than 0.05) whereas no correlation was found among these three parameters. In another group of 80 type I diabetics, urinary albumin excretion during a standardized exercise-test was also correlated with anti-insulin antibodies (r = 0.360 p less than 0.001). In this latter group, diabetics with elevated (greater than 200 microU/ml) levels of anti insulin antibodies had higher values of microalbuminuria after exercise (p less than 0.001) when compared to those with lower or undetectable levels, although they did not differ with respect to blood pressure and glycemic control. Therefore, we confirm preliminary reports indicating a statistical relationship between anti-insulin antibodies and microalbuminuria. We hypothesize that anti insulin antibodies may be an additional factor of risk in the pathogenesis of early (reversible) stages of diabetic nephropathy. PMID- 2777199 TI - Anthropometric variables and metabolism in polycystic ovarian disease. AB - Anthropometric, endocrine and metabolic variables, were examined in women with polycystic ovarian syndrome (PCO), and in normal control women. Obese women with PCO had higher plasma insulin values than non obese women with PCO, but lean body mass, glucose tolerance, plasma triglycerides and blood pressure were not different in spite of almost twice the body fat mass in the obese PCO women. However, in comparisons between non-obese PCO and control women, with equal body fat mass, the PCO women had higher blood pressure, plasma triglycerides and insulin, as well as a tendency to increased lean body mass. Both PCO groups had a high waist/hip ratio and larger abdominal fat cells than controls, indicating a preferential abdominal accumulation of adipose tissue. In comparison with abdominal adipocytes, femoral adipocytes were larger and had higher lipoprotein lipase activity in the control women, while in the PCO women these regional differences were not found. Basal and norepinephrine stimulated lipolysis were higher in the abdominal than femoral adipocytes in all groups. Substitution of the PCO women with ethinyl estradiol plus desogestrel during 6 months resulted in a regression of clinical androgenic symptoms as well as a normalization of plasma concentrations of free testosterone and sex hormone binding globulin. However, neither body composition nor metabolism were normalized. It was concluded that body fat distribution is more closely related to hypertension and metabolic derangements than total fat mass in the PCO syndrome. It is suggested that the relative paucity of femoral adipose tissue is due to a lack of specific effects of progesterone on adipocytes in this region. PMID- 2777201 TI - Defect in the net transport of cholesterol from cultured fibroblasts to serum of hypothyroid patients. PMID- 2777202 TI - Effect of ursodeoxycholic acid on bile acid metabolism in primary biliary cirrhosis. AB - We have compared the effect of ursodeoxycholic acid with placebo on the clinical state, blood liver chemistries and serum and urinary bile acids in four patients with primary biliary cirrhosis. All parameters were evaluated monthly, and bile acid composition was measured by capillary gas-liquid chromatography. At the time of admission, all patients showed intense pruritus, and their serum alkaline phosphatase, AST and ALT levels were elevated 4.3, 2.7 and 2.3 times over control values. Serum bile acids were elevated almost 38-fold with 2.5 times more cholic acid than chenodeoxycholic acid. Urinary bile acid output was elevated 28 times the control values, and 36% were 1 beta-hydroxycholic acid, 1 beta hydroxydeoxycholic acid and hyocholic acid (3 alpha,6 alpha, 7 alpha-trihydroxy-5 beta-cholanoic acid). Three months of placebo administration did not significantly affect the clinical or biochemical presentations, and the serum and urinary bile acid composition did not change. In contrast, ursodeoxycholic acid feeding (12 to 15 mg per kg per day) for 6 months abolished pruritus in two and lessened itching in two subjects and reduced serum alkaline phosphatase, AST and ALT levels by 21, 35 and 47%, respectively. The mean values for the total serum bile acid concentrations in these patients declined 26% from the pretreatment value, but the proportion of ursodeoxycholic acid increased from 3 to 40% of the total bile acids; thus, total fasting serum endogenous bile acid levels decreased almost 50%. Similar changes were noted in the urinary bile acids, in which ursodeoxycholic acid became the major bile acid, and approximately 18% were hydroxylated at C-1, C-6 and C-21.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2777200 TI - Different insulin antibody formation in diabetic patients treated with crystallized or highly purified insulins is a transient phenomenon. PMID- 2777203 TI - A pilot, double-blind, controlled 1-year trial of prednisolone treatment in primary biliary cirrhosis: hepatic improvement but greater bone loss. AB - A randomized, double-blind, 1-year pilot study of prednisolone treatment for primary biliary cirrhosis was undertaken. Nineteen patients received 30 mg prednisolone per day initially, with a maintenance dose of 10 mg per day. Seventeen patients received placebo. The groups were matched for age, menopausal status, hepatic histological stage and bilirubin. Treatment was well tolerated without dropouts. Two patients receiving prednisolone developed diabetes, one a duodenal ulcer and one depression. One patient receiving placebo died for liver failure after 3 months. Cholestatic symptoms (itch and fatigue) improved on prednisolone. There was significant (prednisolone vs. placebo) improvement in transaminase (p = 0.0214), alkaline phosphatase (p = 0.0032), procollagen III peptide (p = 0.0103), immunoglobulin G (p = 0.0012) and liver histology (p = 0.016); these changes were greatest among noncirrhotic patients. No patient developed skeletal symptoms. Fifty-seven per cent had abnormal triolein breath tests prior to treatment, and 65% had abnormally low calcium absorption tests. Calcium absorption increased significantly in the treated group vs. placebo at 2 weeks (p less than 0.02), but not at 1 year. Femoral photon absorptiometry fell in the prednisolone group after 1 year (-3.5% vs. placebo +0.5%, p less than 0.05), as did trabecular bone volume (-6% vs. -2.8%, p less than 0.005) and resorption surface (-11% vs. +2%, p less than 0.02) on serial bone biopsy. Prednisolone seems to exert a favorable hepatic effect in primary biliary cirrhosis but at the expense of increased bone loss to approximately twice the expected rate. Prednisolone treatment merits further assessment in primary biliary cirrhosis over a longer period, with attention to selection of patients most likely to benefit and continuing observation of bone mass to better establish the "cost/benefit" ratio. PMID- 2777208 TI - Hepatic denervation alters hemodynamic response to hemorrhage in conscious rats. AB - We investigated the effect of liver denervation on cardiovascular homeostasis. Three days after surgical denervation of the liver, hemodynamic studies (radioactive microsphere method) were conducted in conscious rats. The efficacity of the liver denervation procedure was confirmed by a significant decrease in norepinephrine content in various lobes of the liver. Liver denervation did not affect either systemic or splanchnic resting hemodynamics. However, hemorrhage (2 ml per 100 gm body weight) induced a decrease in cardiac index which was significantly more marked in rats with liver denervation (-62 +/- 3%) than in sham-operated rats (-47 +/- 5%; p less than 0.05). This more severe response to hemorrhage may be due to a lack of portal territory vasoconstriction since the fraction of cardiac output reaching portal territory did not decrease during hemorrhage in rats with liver denervation (16 +/- 1% to 14 +/- 1%) but significantly decreased in sham-operated rats (from 15 +/- 1% to 11 +/- 1%, p less than 0.05), this value being significantly lower, after hemorrhage, in sham operated rats than in denervated rats. The results confirm the lack of tonic neural influence on hepatic circulation during physiological experimental conditions and indicate that hepatic nerve function has a significant contribution to the overall cardiovascular homeostasis. PMID- 2777205 TI - Taurocholate transport by basolateral plasma membrane vesicles isolated from human liver. AB - Transport of taurocholate into the hepatocyte against unfavorable chemical and electrical gradients occurs via a sodium-dependent, carrier-mediated transport system. Although this cotransporter has been characterized in the rodent, it has not been demonstrated in man. Therefore, we utilized human liver, obtained via multiorgan donation but not used for transplantation, to prepare basolateral (sinusoidal) liver plasma membrane vesicles by a Percoll gradient method. Na+,K+ ATPase, a marker enzyme for the basolateral domain, was enriched 28.9-fold in the final membrane fraction compared with homogenate, whereas the bile canalicular membrane enzymes Mg++-ATPase and alkaline phosphatase were enriched only 3.4- and 6.4-fold, respectively. Marker enzyme activities for endoplasmic reticulum, lysosomes and mitochondria were not enriched compared with homogenate. Integrity of the membrane vesicles was confirmed by the demonstration of Na+-dependent concentrative uptake of the amino acid L-alanine (estimated intravesicular volume of 0.59 microliter per mg protein). An inwardly directed 100 mM Na+ gradient stimulated the initial rate of 2.5 microM taurocholate uptake and energized a transient 2-fold accumulation of the bile acid above equilibrium ("overshoot"). In contrast, uptake was slower and no overshoot occurred with a K+ gradient. A negative intravesicular potential, created by altering accompanying anions or by valinomycin-induced K+ diffusion potentials, did not enhance taurocholate uptake, suggesting an electroneutral cotransport mechanism. Chloride as the accompanying anion stimulated the initial rate of uptake compared with anions of lesser or greater lipid permeability. Na+-dependent taurocholate (4 microM) uptake was significantly inhibited by 250 microM cholate, taurocholate, glycocholate, taurochenodeoxycholate and bromsulfophthalein.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2777213 TI - The liver disease of asymptomatic patients with elevated aminotransferases. PMID- 2777211 TI - Prednisolone for primary biliary cirrhosis--good news, bad news. PMID- 2777207 TI - Replication of duck hepatitis B virus in primary duck hepatocytes and its dependence on the state of differentiation of the host cell. AB - Primary duck hepatocytes obtained from Pekin ducks congenitally infected with duck hepatitis B virus were used to monitor expression of viral proteins and replication of viral DNA in cell culture. Duck hepatitis B virus core antigen, duck hepatitis B virus pre-surface antigen and duck hepatitis B virus DNA were detectable for at least 12 days after cell plating. Whereas expression of duck hepatitis B pre-surface antigen was constant during this time, expression of duck hepatitis B core antigen and of viral DNA rapidly declined. This diminished production of viral components in vitro was paralleled by a change of the hepatocytes toward a fibroblast-like morphology. Supplementation of cell culture medium with 2% dimethyl sulfoxide, a solvent known to maintain the differentiated state of cultured cells, retained competence of the cultured hepatocytes to express duck hepatitis B core antigen and duck hepatitis B virus DNA at high levels. In a second set of experiments, duck hepatitis B virus negative hepatocytes were infected with duck hepatitis B virus from serum of congenitally infected ducks. Dimethyl sulfoxide remarkably improved the competence of cultured duck hepatocytes to become productively infected. This function was maintained for at least 12 days postplating. PMID- 2777210 TI - Portal hypertension and ascites in acute hepatitis: clinical, hemodynamic and histological correlations. AB - We attempted to ascertain the mechanism of portal hypertension and ascites complicating acute hepatitis in 66 patients who underwent transvenous liver biopsy and measurement of hepatic venous pressure gradient. Increase in hepatic venous pressure gradient was related to the severity of acute hepatitis, as indicated by the significant correlation between the values for hepatic venous pressure gradient and serum bilirubin, serum albumin or coagulation factor V, and by its higher value in patients with, than in patients without, encephalopathy. Hepatic venous pressure gradient was higher in patients with, than in patients without, ascites (12.5 +/- 3.4 vs. 8.4 +/- 3.6 mmHg, respectively; p less than 0.001). No ascites was clinically detectable in the patients in whom hepatic venous pressure gradient was below 6 mmHg. We tested the hypothesis that sinusoidal collapse due to liver cell dropout was a major factor in portal hypertension. Semiautomatic determination of the fractional area of sinusoidal collapse on chromotrope-stained sections and automatic measurement of Sirius red stained collagen fiber density were performed. Hepatic venous pressure gradient significantly correlated with fractional sinusoidal collapse area (r = 0.61, p less than 0.001) and with Sirius red-stained collagen fiber density (r = 0.43, p less than 0.01). We conclude that portal hypertension in the course of acute hepatitis is related to the severity of liver damage and is a major factor in the development of ascites. Portal hypertension is mainly determined by intrahepatic vascular space being reduced by the collapse of sinusoids. PMID- 2777212 TI - The differentiation of cholesterol and pigment gallstones. PMID- 2777209 TI - Mechanisms of a clonidine-induced decrease in portal pressure in normal and cirrhotic conscious rats. AB - The effects of clonidine on portal pressure and splanchnic blood flow were studied in conscious rats with sinusoidal portal hypertension due to cirrhosis induced by bile duct ligation. In cirrhotic and sham-operated rats, clonidine (20 micrograms per kg body weight, intravenously) significantly reduced portal, pressure from 19.0 +/- 0.6 to 14.5 +/- 1.0 mmHg and from 9.8 +/- 0.9 to 7.3 +/- 0.5 mmHg, respectively. No significant change in systemic hemodynamics was observed. In cirrhotic rats, clonidine reduced portal pressure, probably by producing a significant increase in portal tributary vascular resistance leading to a 25% decrease in portal tributary blood flow (radioactive microsphere method). In sham-operated rats, clonidine reduced portal pressure presumably by decreasing hepatic portal vascular resistance, since no significant change in portal tributary blood flow was observed. In both groups, clonidine administration significantly decreased plasma noradrenaline concentration. Placebo administration produced neither significant hemodynamic nor significant plasma noradrenaline concentration change. These findings indicate that the sympathetic regulation of the splanchnic circulation is impaired in cirrhotic rats. PMID- 2777214 TI - The American Association for the Study of Liver Diseases. 40th annual meeting and postgraduate course. October 28-31, 1989, Chicago, Illinois. Abstracts. PMID- 2777204 TI - Primary sclerosing cholangitis: natural history, prognostic factors and survival analysis. AB - The natural history of primary sclerosing cholangitis was assessed in 174 patients; 37 were asymptomatic and 137 had symptoms related to underlying liver disease. At the time of diagnosis, the mean age was 39.9 years, 66% of the primary sclerosing cholangitis patients were male and 71% had associated inflammatory bowel disease, most commonly chronic ulcerative colitis. Long-term follow-up (mean: 6.0 years; range: 2.7 to 15.5 years) was available in all patients. During follow-up, 59 (34%) of the patients died: 55 in the symptomatic group and four in the asymptomatic group. Median survival from the time of diagnosis of primary sclerosing cholangitis at the Mayo Clinic was 11.9 years. Survival in the asymptomatic group was significantly decreased compared with that in a control population matched for age, race and sex. Multivariate analysis (Cox proportional hazards regression modeling) revealed that age, serum bilirubin concentration, blood hemoglobin concentration, presence or absence of inflammatory bowel disease and histologic stage on liver biopsy were independent predictors of high risk of dying. The development of a multivariate statistical survival model is a major step in identifying individual primary sclerosing cholangitis patients at low, moderate and high risk of dying. Such models will be useful for stratifying patients in therapeutic trials, in patient counseling and in patient selection and timing of liver transplantation. PMID- 2777206 TI - Bile acids inhibit endotoxin-induced release of tumor necrosis factor by monocytes: an in vitro study. AB - Endotoxins play an important role in the pathogenesis of complications of surgery in obstructive jaundice. Preoperative treatment with orally administered deoxycholic acid prevented endotoxin-related complications, such as renal malfunction. Other bile acids, however, were less effective, and the mechanism of action is not known. Endotoxin toxicity is considered to be largely mediated by tumor necrosis factor/cachectin, a cytokine release by mononucler phagocytes. Therefore, we studied the influence of different bile acids on endotoxin-induced tumor necrosis factor production by monocytes in vitro. Bile acids inhibit tumor necrosis factor production through a direct inhibitory effect on the monocytes. Deoxycholic acid was the most effective, chenodeoxycholic acid was less effective and ursodeoxycholic acid was ineffective in the concentrations used. Bile acids did not inactivate endotoxin as measured in a chromogenic Limulus amebocyte lysate assay. The therapeutic effect of bile acids in obstructive jaundice can be explained by an inhibition of endotoxin-induced tumor necrosis factor release by mononuclear phagocytes. PMID- 2777218 TI - Prognosis of ovarian carcinomas: prediction by histoquantitative methods. AB - Prediction of prognosis of ovarian carcinomas by morphometric, histopathological and clinical indices was estimated in 105 tumours. Morphometric parameters included mitotic activity index, volume-corrected mitotic index (M/V index), volume fraction of neoplastic epithelium, nuclear area, nuclear perimeter, shortest and longest nuclear axis and form factor of nucleus. Cox's multivariate regression model showed that the clinical stage was the best predictor of prognosis followed by the M/V index, which expresses the mitotic activity as the number of mitotic figures per square millimeter of neoplastic epithelium in the microscope field. In all tumour subgroups studied the M/V index was the best prognostic factor and for stage I tumours it was the only parameter selected by the Cox's model as a significant and independent prognostic predictor. We conclude that the M/V index can be used as a significant prognostic factor in ovarian carcinomas. PMID- 2777215 TI - A study of 39 retinoblastomas with particular reference to morphology, cellular differentiation and tumour origin. AB - A series of 39 retinoblastomas was studied using light microscopy and immunohistochemistry for localization of neurone-specific enolase and glial fibrillary acidic protein. Thirty-eight retinoblastomas (97.4%) occurred in children less than 6 years of age: one was in a 61-year-old man (2.6%); the mean age, excluding the 61-year-old, was 32.1 months. Unilateral tumours were found in 74.4% of patients and bilateral tumours in 25.6%; bilateral lesions occurred in a younger age group, mean age of 21.7 vs 35.9 months. The male to female ratio was 1.4:1. Morphologically, arrangement of tumour cells into trabeculae was noted in 69.2% of retinoblastomas and glomerulus-like structures in 43.6%. These two patterns of cellular arrangement were encountered where the choroid and sclera were invaded by neoplastic cells. Homer Wright rosettes were observed in all tumours. Flexner-Winstersteiner rosettes in 33.3% and fleurettes in 2.6%. Differentiation into neoplastic neurones as well as in the form of Flexner Winstersteiner rosettes and fleurettes was noted in 46.1%, neoplastic ependymal cells in 100.0%, astrocytes in 58.9%, oligodendrocytes in 23.1%, and glioblastomas in 2.6%. These data suggest that retinoblastoma is a primitive stem cell neuroectodermal tumour with the capacity for differentiation in both neuronal and neuroglial directions. PMID- 2777216 TI - Basement membrane deposition in benign and malignant naevo-melanocytic lesions: an immunohistochemical study with antibodies to type IV collagen and laminin. AB - Patterns of basement membrane deposition were investigated in benign and malignant naevo-melanocytic lesions using antibodies to type IV collagen and laminin. Paraffin sections required pretreatment with 6 M guanidine-HCl in addition to pepsin pretreatment. Basement membrane deposition was found around clusters as well as individual naevo-melanocytic cells in contact with dermal stroma. However, between keratinocytes and intra-epidermally located naevo melanocytic cells, basement membrane immunostaining could not be detected. Tumour cell-stromal interaction is apparently a prerequisite for basement membrane deposition in naevo-melanocytic lesions. Basement membrane discontinuities, in the absence of inflammatory infiltrate, appeared, in doubtful cases, to be evidence in favour of malignant melanoma. The general pattern of basement membrane deposition in benign and malignant lesions was found to be similar and therefore of no help in differential diagnosis. Identification of hyaline bodies, which show immunoreactivity with antibodies to basement membrane components, may be helpful in distinguishing between Spitz naevi and malignant melanomas. Detection of vascular invasion, a prognostic indicator in malignant melanoma, is facilitated by basement membrane immunostaining. PMID- 2777222 TI - The bad-mad dilemma for public psychiatry. PMID- 2777223 TI - Titicut Follies: patients' rights and institutional reform. PMID- 2777217 TI - Morphological and immunohistological study of testicular lymphomas. AB - We have studied normal testis, seminomas and malignant lymphomas of the testis using routine stains and a panel of antibodies directed against lymphoid and basement membrane antigens. The results show that normal testis contains, at most, a minor population of T-lymphocytes: seminomas contain mixed T- and B-cell populations with a predominance of B-lymphocytes; and most primary lymphomas are B-cell tumours of large centroblastic type. Solid testicular lymphomas presenting secondarily to acute lymphoblastic leukaemias showed intact seminiferous tubular basement membranes with predominantly interstitial lymphomatous infiltrates, whereas the tubules in primary cases were over-run by lymphoma cells and basement membranes were disrupted. PMID- 2777224 TI - Psychological test standards and clinical practice. PMID- 2777221 TI - Orcein-positive granules in liver cell carcinoma. PMID- 2777219 TI - An investigation of NCRC11 immunoreactivity in normal and neoplastic epithelia of the female genital tract and ovary. AB - NCRC11 is a monoclonal antibody raised against human mammary carcinoma cells. The prognostic value of tumour cell immunoreactivity to NCRC11 in breast cancer has been shown previously. This study describes NCRC11 immunoreactivity in a wide range of normal and neoplastic epithelial types from the female genital tract and ovary. In the tumours examined, a wide range of staining patterns was seen. The implications of these findings are discussed in relation to the potential uses of this antibody in diagnosis and monitoring of gynaecological diseases. PMID- 2777225 TI - Ongoing treatment of a Hmong widow who suffers from pain and depression. PMID- 2777228 TI - Chronic mental illness and the criminal justice system. AB - A total of 260 family members responded to a survey seeking information about their mentally ill relatives' contacts with the criminal justice system. Reports by family members indicated that the mentally ill relatives were mainly men in their early thirties with a diagnosis of schizophrenia or bipolar disorder; they had had an average of four admissions to a state mental hospital. The majority had been arrested, but only a fifth had been convicted of a crime. Substance abuse and noncompliance with psychiatric medications were significant predictors of arrest. Family members overwhelmingly attributed the arrests to psychiatric crises, and in about half the cases a failed attempt at commitment had preceded the arrest. However, only a minority of the mentally ill relatives were taken to a hospital at the time of the arrest. The findings highlight the need for closer collaboration between mental health specialists and law enforcement personnel. PMID- 2777226 TI - Diagnosis and treatment of attention deficit disorder in two general hospital clinics. AB - In two clinics in military general hospitals, the charts of all children with a presumptive diagnosis of attention deficit disorder who were prescribed psychostimulants (N = 68) were audited to assess the quality of the primary physicians' evaluation and treatment. The audit instrument, constructed by a multidisciplinary team, indicated high interrater reliabilities, high face and concurrent validity, and moderate internal consistency. The audit found that only 51.5 percent of the children being treated with psychostimulants met the audit criteria for attention deficit disorder. A school intervention plan was documented in only 16.2 percent of the cases, and a psychotherapy intervention in only 19.1 percent; low rates were also found for other treatment and follow-up criteria. Overall, the assessment, the follow-up care, and the overall quality of care were found to be inadequate or less than adequate in about two-thirds of the cases. PMID- 2777232 TI - Community residential treatment for elderly psychiatric patients. PMID- 2777229 TI - Predicting discharge and follow-up status of hospitalized adolescents. AB - The functioning of 58 adolescent psychiatric patients at hospital admission, discharge, and one-and-a-half-year follow-up was examined in relation to six predictor variables: level of precipitating stress, primary process thinking on the Rorschach test, cognitive inefficiency, severity of psychopathology, maladaptive behavior on the unit, and process versus reactive illness. Severity of psychopathology and cognitive inefficiency were significantly related to the adolescents' functioning at all three observation points. High precipitating stress and short duration of symptoms (that is, in reactive illnesses) were associated with significantly better functioning at follow-up. Primary process thinking on the Rorschach was correlated with severe disturbances on admission, but was unrelated to outcome at discharge or follow-up. Maladaptive behavior on the unit was unrelated to functioning at any time. The authors concluded that outcome for hospitalized adolescents is determined by key patient differences and is systematically predictable. PMID- 2777230 TI - Involuntary medication and the case of Joyce Brown. AB - In October 1987, Joyce Brown became the first homeless person removed from New York City's streets and hospitalized under a city initiative that authorized evaluation of "gravely disabled" homeless persons for admission to inpatient psychiatric treatment. Miss Brown's highly publicized and ultimately successful court battle to prevent a course of forced medication is described. Her refusal of medication was upheld based on her capacity to understand the proposed treatment and to express a partially rational opinion about it. The author, who served as independent psychiatric consultant to the court on the decision about Miss Brown's involuntary medication, uses the case to illustrate some of the problems of involuntary psychiatric intervention, including the commitment of competent patients and the lack of a coherent approach to persistent treatment refusal. PMID- 2777227 TI - Clinicians' experiences in combining medication and psychotherapy in the treatment of borderline patients. AB - Combining pharmacotherapy and psychotherapy in the treatment of borderline personality disorder is increasingly common, yet the experiences of clinicians who use the two modalities have not been studied. Forty psychotherapists were surveyed about their prescribing practices with borderline patients. Results corroborate the clinical impression that therapists' decisions about medication use are influenced by psychosocial factors as well as by target symptoms. Therapists were most likely to prescribe medications when they felt pessimistic about patients' capacity to benefit from psychotherapy and were rarely willing to prescribe medications for patients who had a history of substance abuse or suicide attempts. An average of 47 percent of the borderline patients in the therapists' practices misused prescription medications. Patients were most likely to abuse medications after experiencing an interpersonal loss or failure. PMID- 2777220 TI - Adrenal lipoma: a rare tumour of the adrenal gland. AB - We report a case of an adrenal lipoma, a very rare lesion first described in 1899 and of which a total of six cases have previously been reported (Lange 1966, Page, De Lellis & Hough 1986). Five of these cases were found incidentally at post mortem. In one case an acute hypertensive episode intra-operatively simulated the signs of phaeochromocytoma and contributed directly to the patient's death (Lange 1966). Intra-operative hypertension also occurred in our patient. PMID- 2777234 TI - Diagnosing pseudodementia. PMID- 2777233 TI - A model of consultation in occupational psychiatry. PMID- 2777236 TI - Relocating elderly patients. PMID- 2777235 TI - Use of methylphenidate. PMID- 2777231 TI - Factors associated with increased hospital stay by elderly psychiatric patients. PMID- 2777237 TI - Quality assurance. PMID- 2777238 TI - NAS research unit supports ready access to condoms, drug treatment to halt AIDS spread. PMID- 2777239 TI - Faculty development in the pathology department: a 1988 symposium of the Association of Pathology Chairmen. PMID- 2777241 TI - Eosinophilic products lead to myocardial damage. AB - Eosinophils have been associated with endomyocardial fibrosis. However, their effect on the myocardium and the reactions they elicit have not been emphasized. We describe four patients with extensive myocardial eosinophilic infiltration with and without endomyocardial fibrosis. Patients with a short duration of disease had eosinophilic infiltrates, myocardial eosinophilic abscesses containing granular eosinophilic material, and/or Charcot-Leyden crystals with and without profuse histiocytic and giant cell reaction with granuloma formation. In the early phase, the granular eosinophilic material can be visualized by the Luna stain and/or by electron microscopic examination. In patients with a long duration of symptoms, well-developed granulomas and profuse fibrosis are seen and eosinophilic material may not be visualized. Toxic eosinophil granular protein may be involved in the development of these lesions. PMID- 2777240 TI - Morphometric distinction of low- and high-grade dysplasias in gastric biopsies. AB - Substantial agreement has previously been demonstrated between qualitative and morphometric grading of gastric dysplasia. In the present study, a further attempt is made to quantitatively define the dysplastic changes in relation to associated benign or malignant changes of gastric mucosa. In total, 232 cases were studied and were associated with benign peptic ulcer (89 cases), histologically proven gastric cancer (88 cases), and gastritis-associated mild, moderate, and severe dysplasias (55 cases). The analysis showed that one discriminant function consisting of seven morphometric features is sufficient to separate the regenerative and cancer-associated cases. The classification results obtained on the basis of this discriminant function in both training and testing sets are encouragingly similar, indicating that the classification is reliable. This was further confirmed by the results of the application of this rule in the mild, moderate, and severe dysplasia biopsies (the above-mentioned gastritis associated cases) used in a previous study. The quantitative analysis permits two grades, instead of three, to be distinguished: low-grade and high-grade dysplasia. PMID- 2777242 TI - Anaplastic and sarcomatoid carcinoma of the small intestine: a clinicopathologic study. AB - Carcinomas involving the jejunum and ileum are rare tumors. During a review of small intestinal neoplasms, six primary carcinomas of jejunum or ileum with an anaplastic and sarcomatoid histology were identified. At presentation, three of the patients had symptoms related to metastatic disease and three had symptoms referable to the local tumor. The tumors were large (greater than 4.5 cm in diameter), usually endophytic masses composed of large cells with eosinophilic cytoplasm, anaplastic nuclei, and prominent nucleoli. In many areas, the cells had a spindled configuration. Mucin positivity was identified in all six cases. Electron microscopic findings in two cases were indicative of epithelial differentiation. The tumors behaved aggressively; all five patients for whom there was clinical follow-up died of metastases within 40 months. The six anaplastic and sarcomatoid carcinomas were compared with 29 typical adenocarcinomas arising in the jejunum or ileum. Only two of the latter group had symptoms referable to distant metastases at presentation. These tumors also tended to be smaller at presentation (11 tumors were less than 4 cm in greatest dimension). Of 25 patients with typical adenocarcinomas who had acceptable follow up, 18 (72%) died of disease and five (20%) were alive with no evidence of disease after 5 years. We conclude that anaplastic and sarcomatoid carcinoma is a rare variant of small intestinal carcinoma with an aggressive clinical course. PMID- 2777243 TI - Ultrastructural morphometric analysis of papillary neoplasms: biological and diagnostic relevance. AB - Ten papillary adenocarcinomas of thyroid origin (P-Thy), ten papillary adenocarcinomas of ovarian origin (P-Ov), and eight papillary neoplasms of non thyroid/non-ovarian origin (P-Other) were morphometrically compared using 19 distinct quantitative nuclear and nucleolar parameters as a database for diagnosis. The selected cases consisted of 16 primary and 12 metastatic neoplasms. It was determined that the P-Thy group had a significantly smaller nucleolar area (NuA) and nucleolar perimeter (NuP), and smaller SDs of nuclear area (NA), NuA, and NuP compared with the P-Ov and P-Other groups (P less than .05). The P-Ov group had a significantly smaller SD of NA compared with the P Other group (P less than .05). The P-Ov group exhibited the greatest variability among the papillary neoplasms. Linear regression analysis indicated that in the P Thy group alone there was a significant correlation between mean nuclear form factor (4 pi A/P2) and mean NuA (r = -.82; P less than .01), and mean NP and mean NuA (r = +.77; P less than .01). Linear regression analysis also indicated that in the P-Ov group alone, there was a significant correlation between mean NA and mean NuA (r = +.75; P less than .02). Morphometric domains were established using statistically significant sets of variables that distinguished between the groups. The application of three-dimensional computerized cluster analysis techniques indicated that the P-Thy group consistently had the smallest morphometric domains. It was concluded that ultrastructural morphometric analysis of papillary neoplasms has diagnostic potential and reveals interesting biological relationships among distinct nuclear features in the different groups of neoplasms. PMID- 2777244 TI - Mallory body clustering in adenomatous hyperplasia in human cirrhotic livers: report of four cases. AB - We report four cases of liver cirrhosis in which seven nodules of adenomatous hyperplasia (AH) were present. Each nodule contained one to several foci of hepatocytes with Mallory bodies (MBs). All of these foci were well-circumscribed lesions located within the nodules of AH. The cells containing MBs showed variable degrees of atypia. At least two of the foci were considered to represent a recent proliferation of the cells containing MBs, possibly premalignant foci, because they showed resistance to the accumulation of stainable iron in siderotic background. From these observations, it was suggested that the MB-containing hepatocellular clusters in AH might have occurred as the result of proliferation in small foci and that at least some of them may be related to hepatocarcinogenesis in humans. PMID- 2777246 TI - Morphometric discrepancies in HBsAg-positive cells in chronic liver disease. PMID- 2777245 TI - Cryptococcosis of the placenta in a woman with acquired immunodeficiency syndrome. AB - Multiple microscopic colonies of encapsulated budding yeasts morphologically consistent with Cryptococcus sp were found in the maternal (intervillous) space of the placenta from a woman with AIDS. The patient contracted acquired immunodeficiency syndrome from her affected husband, who had died of the disease 3 years previously. The woman, who was in her sixth pregnancy at term, became symptomatic 1 month before delivery with malaise, oral thrush, and cervical lymphadenopathy. Tests for human immunodeficiency virus and serum hepatitis were negative. Cryptococcus neoformans was cultured in the blood and herpes simplex virus type II was isolated from the cervix. On the second postpartum day, the patient had difficulty breathing and died suddenly. Post-mortem examination disclosed a massive pulmonary embolus and disseminated infection with Cryptococcus organisms. PMID- 2777247 TI - Primary papillary serous neoplasia of the peritoneum. PMID- 2777248 TI - Gm and Km allotypes in 74 Chinese populations: a hypothesis of the origin of the Chinese nation. AB - This paper reports the distribution of immunoglobulin Gm and Km allotypes in 74 Chinese geographical populations. These populations are derived from 24 nationalities comprising 96.6% of the total population of China. A total of 9,560 individuals were phenotyped for Gm(1,2,3,5,21) factors, and 9,611 were phenotyped for Km(1). Phylogenetic trees were constructed on the basis of Gm haplotype frequencies and genetic distances. The results of cluster analysis show the heterogeneity of the Chinese nation, and confirm the hypothesis that the modern Chinese nation originated from two distinct populations, one population originating in the Yellow River valley and the other originating in the Yangtze River valley during early neolithic times (3,000-7,000 years ago). Frequencies of the Gm haplotype of 74 Chinese populations were compared with those of 33 populations from major racial groups. The results suggest that during human evolution, the Negroid group and Caucasoid-Mongoloid group diverged first, followed by a divergence between the Caucasoid and Mongoloid. Interrace divergence is high in comparison with intrarace divergence. There appear to be two distinct subgroups of Mongoloid, northern and southern Mongoloid. The northern and southern Mongoloid have Gm1;21 and Gm1,3;5 haplotypes as race associate markers, respectively. Furthermore, the Caucasian-associated haplotype Gm3;5 was found in several of the minorities living in the northwest part of China. The presence of the Gm3;5 haplotype is attributed to the Caucasians living in Central Asia throughout the Silk Road. The amount of Caucasian admixture has been estimated. In contrast to the Gm haplotype distribution, Km1 gene frequencies showed a random distribution in the populations studied. PMID- 2777249 TI - Sister chromatid exchange analysis of the 15q11 region in Prader-Willi syndrome patients. AB - Prader-Willi syndrome (PWS) is a sporadic disorder in which about half of cases have a 15q12 deletion. Although a small number of cases have other rearrangements involving 15q12, the rest of the cases appear to have normal chromosomes. Clinical similarities among all these patients regardless of the karyotype strongly suggests a common etiology. To investigate the nature of this common etiology, we analyzed sister chromatid exchange (SCE) at the 15q11-13 region in 10 PWS patients with the chromosome deletion, 12 PWS patients with normal chromosomes, and 11 normal control individuals. While SCE at the q11-13 region was absent on the 15q12 deleted chromosome, the percentage of SCE on chromosome 15 at q11 was statistically higher for PWS with normal chromosomes (10.1%) compared to that for normal controls (1.9%) and the normal homologue (2.2%) in deleted patients (chi 2 = 7.7982, df = 2, P less than 0.025). The data suggest relative instability of DNA at the 15q11 region in PWS patients. PMID- 2777250 TI - Rejoining between 9q+ and Philadelphia chromosomes results in normal-looking chromosomes 9 and 22 in Ph1-negative chronic myelocytic leukemia. AB - Rearrangement of the breakpoint cluster region (bcr) and the chromosomal location of c-abl and 3'-bcr were studied in two patients with Philadelphia chromosome (Ph1)-negative chronic myelocytic leukemia (CML). One patient (patient 1) had a normal karyotype and the other (patient 2), 46,XY,inv(3)(q21q26). Both patients showed the bcr rearrangement by Southern blot analysis with a 1.2kb 3'-bcr probe. In situ hybridization studies demonstrated the location of the homologous sequences of bcr on chromosome 22 in patient 1, and on chromosomes 9 and 22 in patient 2. These findings indicate that the morphologically normal-looking chromosomes 9 and 22 in patient 2 are the result of a retranslocation between chromosomes 9q+ and 22q-, abnormalities which were first formed by a standard Ph1 translocation. PMID- 2777251 TI - Inheritance of mitochondrial aldehyde dehydrogenase: genotyping in Chinese, Japanese and South Korean families reveals dominance of the mutant allele. AB - Genotyping of mitochondrial aldehyde dehydrogenase (ALDH I) was performed in enzymatically amplified DNA of 20 Chinese, Japanese and South Korean families (85 individuals) and in 113 unrelated persons by employing allele-specific oligonucleotide probes and dot blot hybridization. Genotyping individuals with phenotypic deficiency of ALDH I activity always showed the presence of at least one mutant allele. The data are compatible with a model assuming dominant inheritance of the mutant allele, which we have previously suggested on the basis of a population study. PMID- 2777252 TI - Heterogeneity of chromosomal breakage levels in epithelial tissue of ataxia telangiectasia homozygotes and heterozygotes. AB - The objective of this study was to obtain an estimate of the frequency distribution of spontaneous chromosomal breakage occurring in vivo in oral epithelia of 20 ataxia-telangiectasia patients (A-T homozygotes) and 26 parents (A-T obligate heterozygotes). Samples of exfoliated cells were obtained from each individual by swabbing the oral cavity and preparing air-dried slides. The percentage of exfoliated cells with micronuclei (MEC frequency) was used as an in vivo indicator for the amount of chromosomal breakage occurring in the tissue. As a population group, MEC frequencies of the A-T patients differed significantly from controls (mean for A-T patients, 1.51; for controls, 0.29; P less than 0.01). However, the values observed in individual patients ranged from MEC frequencies 10- to 12-fold above control values, to frequencies overlapping the upper values observed in the controls. Similarly, MEC frequencies observed among the A-T heterozygotes differed significantly from controls (mean for A-T heterozygotes, 1.02, mean for controls, 0.29; P less than 0.01). However, only 16 of the 26 individuals sampled had MEC frequencies greater than 0.5%, the 90th percentile for controls (compared with 16 of the 20 A-T patients examined). Of the A-T patients 11 had been previously assigned to complementation groups on the basis of sensitivity to x-irradiation. Seven of the patients belonged to group A and had MEC frequencies ranging from 0.3% to 1.9% with the remaining patients belonging to group C with MEC frequencies of 0.2% to 0.9%. The data presented in this paper suggest that although levels of spontaneous breakage in epithelial tissues of A-T patients and A-T obligate heterozygotes are often significantly elevated, this is not the case in all individuals. PMID- 2777254 TI - Familial ring (20) chromosomal mosaicism. AB - Ring (20) chromosomal mosaicism defined by two cell lines (one normal and the other with the ring) has been demonstrated in lymphocyte and fibroblast cultures from three members of a family through two generations. Two carriers of the ring chromosome were affected and showed the typical signs of r(20) syndrome including mental retardation, microcephaly, behavioral disorders, and epilepsy. The epilepsy is characterized by complex partial seizures sometimes evolving secondarily into generalized tonic-clonic seizures and is poorly controlled by or resistant to medical treatment. The mother of the two patients, also a carrier of ring (20) chromosomal mosaicism, was clinically and phenotypically normal and did not exhibit any signs of epilepsy. Lymphocyte and fibroblast cultures from the most severely affected sib, the proband, contained the highest percentage of cells with ring (20) chromosome and revealed the greatest instability of the ring. Though it is assumed that the ring (20) chromosome arose from terminal breakage and reunion in both arms, no loss of genetic material could be documented cytogenetically. Yet the question arises of how ring chromosomal mosaicism can be passed on. One explanation might be that a chromosome 20 predisposed to terminal lesions or breaks is transmitted from the mother to her offspring. Inherited instability of this type might lead to de novo formation of the ring. PMID- 2777253 TI - Mapping studies of the serum cholinesterase-2 locus (CHE2). AB - Serum cholinesterase (butyrylcholinesterase, EC 3.1.1.8, BChE) is controlled by two genetic loci, CHE1 and CHE2. The CHE1 locus has been mapped to 3q, but the map location of CHE2 is uncertain. In an effort to clarify the location of CHE2, we combined all the published linkage analysis data for CHE2 (as summarized in the Keats Linkage Database) with the data from the UCLA Linkage Database. Exclusions with substantial portions of the genome could be made (notably with portions of chromosomes 1, 2, 3, 4, 6, 7, 8, 9, 14, 16, 18, 19, 20, 22, and LG1). Although not quite statistically significant (zeta = 2.51), loose linkage (theta = 0.32) of CHE2 with the haptoglobin locus on 16q22 was the most likely conclusion from the family data. In addition, calculating the lod score between CHE2 and the available linkage map of chromosome 16 (markers HBA, PGP, FRA16A, and HP) resulted in an overall lod score of 3.2. This result is particularly intriguing given the hybridization of a BChE cDNA (designated CHEL3) to the same region. Resolution of the issue will require more detailed linkage studies of CHE2 on chromosome 16 and a better understanding of the relationship between the CHE1 and CHE2 loci with respect to production of serum cholinesterases. PMID- 2777255 TI - Chromosomal localization of human aspartate aminotransferase genes by in situ hybridization. AB - The localization of the human genes for cytosolic and mitochondrial aspartate aminotransferase (AspAT) has been determined by chromosomal in situ hybridization with specific human cDNA probes previously characterized in our laboratory. The cytosolic AspAT gene is localized on chromosome 10 at the interface of bands q241 q251. Mitochondrial AspAT is characterized by a multigene family located on chromosomes 12 (p131-p132), 16 (q21), and 1 (p32-p33 and q25-q31). Genomic DNA from ten blood donors was digested by ten restriction enzymes, and Southern blots were hybridized with the two specific probes. Restriction fragment length polymorphism was revealed in only one case for cytosolic AspAT, with PvuII, while no polymorphism for mitochondrial AspAT was found. PMID- 2777256 TI - Increased spindle resistance to antimicrotubule agents in cells prone to chromosomal nondisjunction. AB - The cytological behavior of the spindle apparatus was studied in cells prone to nondisjunction (ND), i.e., PHA-stimulated lymphocytes derived from children suffering from different types of neoplasia. These cells, which exhibited a high frequency of nonspecific aneuploidy, revealed an increased resistance of the spindle fibers to colchicine, podophyllotoxin, and cold, which was several times that of lymphocytes derived from healthy children. The results are in accord with previous findings showing a high resistance of spindle microtubules to the antimicrotubular agents colchicine, podophyllotoxin, vinblastine, and cold in PHA stimulated lymphocytes derived from individuals prone to meiotic ND. It is therefore assumed that high resistance of the spindle apparatus to antimicrotubule agents characterizes cells at high risk for aneuploidy, and possibly, the overstabilized spindle fibers are responsible for failure of chromosomal disjunction. PMID- 2777257 TI - DNA haplotypes and frameworks linked to the beta-globin locus in an Austro Asiatic population with a high prevalence of hemoglobin E. AB - DNA haplotypes (HT) and frameworks (FW) linked to the beta-globin locus were determined by restriction fragment analysis using eight restriction enzymes on chromosomes bearing the Hb A gene (HBB*A) or the HbE gene (HBB*E) in the So, an Austro-Asiatic population of northeast Thailand with an HBB*E frequency near 0.5. All HBB*E genes were present with FW2, and only two haplotypes were observed (25 HT 27-2, -+- +-; 10 HT 41-2, +----++-). In a control group from the general population of Northeast Thailand the HT distribution was more diverse, and 2 of 20 HBB*E genes were present in FW 3. High frequencies of HBB*E in FW 3 in Southeast Asia are apparently limited to the Khmer population of Cambodia. There were no differences in the hematologic parameters in subjects homozygous for HBB*E/FW2 or HBB*E/FW3. PMID- 2777258 TI - Linkage disequilibrium for DNA haplotypes near the cystic fibrosis locus in two south European populations. AB - Three polymorphic DNA marker loci (INT1L1, D7S23 and D7S399) map to a chromosomal region that is very close to the cystic fibrosis (CF) locus in terms of genetic distance. These marker loci have been used to analyse the linkage disequilibrium in 137 CF families from two South European countries (Italy and Spain). The markers can be analysed for differences in linkage disequilibrium more easily in these populations than in North Europeans, in whom the disequilibrium between the allelic systems defined by the probes and CF is much greater and on a "plateau" through the genetic region. The different levels of disequilibrium found in the studied populations suggest that D7S399 and D7S23 are both closer to CF than INT1L1, and provide additional information on the origins and homogeneity of the CF defect. PMID- 2777259 TI - Cytosine methylation and the fate of CpG dinucleotides in vertebrate genomes. AB - The dinucleotide CpG is a "hotspot" for mutation in the human genome as a result of (1) the modification of the 5' cytosine by cellular DNA methyltransferases and (2) the consequent high frequency of spontaneous deamination of 5-methyl cytosine (5mC) to thymidine. DNA methylation thus contributes significantly, albeit indirectly, to the incidence of human genetic disease. We have attempted to estimate for the first time the in vivo rate of deamination of 5mC from the measured rate of 5mC deamination in vitro and the known error frequency of the cellular G/T mismatch-repair system. The accuracy and utility of this estimate (md) was then assessed by comparison with clinical data, and an improved estimate of md (1.66 X 10(-16) s-1) was derived. Comparison of the CpG mutation rates exhibited by globin gene and pseudogene sequences from human, chimpanzee and macaque provided further estimates of md, all of which were consistent with the first. Use of this value in a mathematical model then permitted the estimation of the length of time required to produce the level of "CpG suppression" currently found in the "bulk DNA" of vertebrate genomes. This time span, approximately 450 million years, corresponds closely to the estimated time since the emergence and adaptive radiation of the vertebrates and thus coincides with the probable advent of heavily methylated genomes. An accurate estimate of the 5mC deamination rate is important not only for clinical medicine but also for studies of gene evolution. Our data suggest both that patterns of vertebrate gene methylation may be comparatively stable over relatively long periods of evolutionary time, and that the rate of CpG deamination can, under certain limited conditions, serve as a "molecular clock". PMID- 2777260 TI - Different Hoechst 33342 and DAPI fluorescence of the human Y chromosome in bivariate flow karyotypes. AB - The staining properties of AT-specific dyes Hoechst 33342 and DAPI as revealed by Hoechst 33342/mithramycin and mithramycin/DAPI bivariate human flow karyotype patterns are different for chromosomes rich in heterochromatin. The peak corresponding to chromosome Y of a given cell line is higher on the A/T axis with mithramycin/DAPI staining than with mithramycin/Hoechst. The chromosome 1 was found slightly more fluorescent in mithramycin/DAPI than in mithramycin/Hoechst as judged by the slight displacement of its area on the Hoechst-DAPI axis. The other peaks did not show major differences. On the same flow karyotypes, chromosomal rearrangements were detected. PMID- 2777261 TI - An unusual translocation associated with recurrent spontaneous abortions. AB - The authors report a case of 11;17 translocation associated with recurrent spontaneous abortions, and request contact with colleagues who have observed similar cases. PMID- 2777262 TI - Congenital hyperthyroidism with reciprocal translocation t(1;17)(q25;q21). AB - The authors report a case of 1;17 translocation and request contact with colleagues who have observed similar cases. PMID- 2777263 TI - On the parental origin of the deletion in Angelman syndrome. PMID- 2777264 TI - Non-random aberrant breakpoints in chronic myelogenous leukaemia revisited. A call for a collaborative study. PMID- 2777265 TI - An introduction to the practice, prevalence and chemical toxicology of volatile substance abuse. AB - 1. Volatile substance abuse is largely a teenage practice; it is estimated that in the UK 3.5-10% of young people have at least experimented and that 0.5-1% are current users. 2. The products abused are many and varied but only about 20 chemical compounds, notably toluene, chlorinated solvents such as 1,1,1 trichloroethane, fuel gases such as butane and aerosol propellants, are commonly encountered. 3. The acute hazard varies with the compound, product and mode of abuse. Mortality in the UK is now about 100 per year, from all social classes, 90% of whom are male. 4. Chronic toxicity is difficult to assess, partly because of the diversity of products abused. However it is clear that some long-term abusers suffer permanent damage to the central nervous system, heart, liver and kidney. 5. Toxicological analysis may be relied upon for confirmation of diagnosis, providing attention is paid to the kinetics of excretion and stability in the sample. 6. Responses include codes of practice for the sale of products and educational strategies; legislation has also been enacted. There is little evidence that any of these measures have made a significant impact on the problem. PMID- 2777266 TI - Use and abuse of volatile substances in industry. AB - 1. Although there are trends towards the use of 'safer' or non-solvent materials, the overall consumption of solvents will probably not change very much over the next few years. Substitution of solvents by 'safer' materials is a complex and difficult process and the rate of change is correspondingly slow. 2. HSE exposure data show that generally industry controls most solvent use quite well. High personal exposures are not widespread and tend to occur in a fairly small number of premises involving 'end user' processes (mixing, spraying, etc). 3. Exposure in industry is generally to mixtures of solvents rather than single substances. The degree to which abuse is a contributory factor in exposure is uncertain, but there is probably greater opportunity for abuse to occur in 'end user' processes. 4. The experience of the author and colleagues in the HSE supports the evidence for the occurrence of volatile substance abuse (particularly of organic solvents) in industry but the extent of the practice is not known. 5. The proposed Control of Substances Hazardous to Health Regulations (COSHH) will bring greater emphasis on the assessment of risks to health in industry, which must include the potential for abuse, together with appropriate training and supervision. PMID- 2777267 TI - Diagnosis and treatment of acute poisoning with volatile substances. AB - 1. The acute toxicity of many volatile compounds is similar, being more related to physical properties than to chemical structure. 2. Volatile substance abusers experiences euphoria and disinhibition but this may be followed by nausea and vomiting, dizziness, coughing and increased salivation; cardiac arrhythmias, convulsions, coma and death occur in severe cases. 3. Laboratory analysis of blood and urine samples collected up to 24 h post-exposure may be helpful if the diagnosis of volatile substance abuse is in doubt. 4. There is only a weak correlation between blood toluene and 1,1,1-trichloroethane concentrations and the clinical features of toxicity, possibly because of rapid initial tissue distribution and elimination. 5. Recovery normally occurs quickly once exposure has ceased but support for respiratory, renal or hepatic failure may be needed as well as treatment for cardiac arrhythmias. Therapy with intravenous acetylcysteine should be considered in cases of acute carbon tetrachloride poisoning. PMID- 2777268 TI - Mechanism of sudden death associated with volatile substance abuse. AB - 1. Sudden death is a recognized hazard of volatile substance abuse and may occur during exposure or in the subsequent hours. Intoxication may also lead to indirect deaths due to trauma. 2. Specific post-mortem features have not as yet been identified either macroscopically or microscopically in VSA-related deaths. Toxicological examination for volatile substances of all unnatural teenage deaths is strongly recommended. 3. Four mechanisms for acute, direct VSA-related deaths are discussed, viz anoxia, vagal inhibition, respiratory depression and cardiac arrhythmia. Of these, cardiac arrhythmia due to 'sensitization' of the heart to adrenaline is probably the most common and is well documented in experimental conditions. 4. Deaths from cardiac arrhythmia during or soon after VSA are unpredictable, unpreventable and resuscitation is rarely successful. Previous uneventful sessions of abuse provide no protection from this mode of death. PMID- 2777269 TI - Chronic non-neurological toxicity from volatile substance abuse. AB - 1. Most of the evidence for chronic non-neurological toxicity from volatile substance abuse is derived from case reports. 2. Factors important in assessing these reports are the marked variations in exposure conditions and in the composition of the products abused. 3. In a young and otherwise healthy population, any chronic organ toxicity arising from VSA has to be gross in order to become clinically apparent. This may partially explain the relatively low incidence of reporting. 4. Toluene and the chlorinated hydrocarbons 1,1,1 trichloroethane and trichloroethylene can cause permanent damage to the kidney, liver, heart and lung, in certain volatile substance abusers. PMID- 2777270 TI - Volatile substance abuse: evaluation and treatment. AB - 1. A scheme for the identification and evaluation of volatile substance abusers is outlined which emphasizes the need for medical history, drug history, emotional/behavioural and dependency questionnaires and physical examination. 2. Poor initial evaluation may lead to non-recognition of dependent abusers who may present later with more serious problems. 3. Suggestions for prevention and treatment of chronic abusers are discussed and some advice for parents is outlined. PMID- 2777272 TI - Government, trade and industry and other preventative responses to volatile substance abuse. AB - 1. Since the early 1960s the USA has attempted to combat the problem of volatile substance abuse through legislation including restricting sales, banning 'sniffing', labelling and adding unpleasant smells to abused products. None of this legislation appears to have had the desired effect. 2. VSA has been a growing problem in Britain since the 1970s and presently kills two people per week. The British Government initially adopted a low profile approach, although legislation restricting the sale of abused products was introduced in 1985. 3. In 1984 the British Adhesives Manufacturers Association founded Re-Solv, the society for the prevention of solvent and volatile substance abuse; it is now an independent national charity. Re-solv believe that a broad education programme is needed to combat VSA and are involved in many such projects. PMID- 2777271 TI - Volatile substance abuse: the role of agencies in the community in prevention and counselling. AB - 1. Voluntary agencies fulfill a need by providing information on volatile substance abuse to schools, the parents/guardians of abusers and, last but by no means least, the abusers themselves. 2. Consideration of case file data from the period 1982-1987 shows that the average age of clients has dropped from 15.9 years (n = 70) to 13.3 years (n = 312) while the male:female ratio has dropped from 8:1 to 3:1. 3. In 1982, 80% of clients 'sniffed' glue but by 1987, 42% of new clients claimed to abuse butane and 23% aerosols. Of the 945 clients counselled, 41 have since suffered 'sudden sniffing death'. 4. Voluntary agencies can offer intensive, confidential counselling of abusers in an informed setting. It is hoped to extend the services provided outside the Greater London area and to provide residential care for those in need. PMID- 2777273 TI - Volatile substance abuse within a health education context. AB - 1. Drug education has to involve exposure not only to knowledge about drug and volatile substance abuse, but also to the effect that attitudes, values, external influences and personal and social skills have on drug behaviour. 2. Such education has also to consider the methods used, the learning process itself, and the need for self-esteem to be enhanced during this process. 3. There is a need to develop personal and social skills which will form the foundation for considering areas such as volatile substance abuse. The school must be supported by the home and by the community. 4. A range of practical resources produced by TACADE (The Advisory Council on Alcohol and Drug Education) allow the translation of this theory of drug education into a practical approach within education. PMID- 2777274 TI - Serological differentiation of the potato-cyst nematodes Globodera pallida and G. rostochiensis: II. Preparation and characterization of species specific monoclonal antibodies. AB - Hybridomas producing antibodies which react with thermostable protein antigens isolated from the potato cyst nematode species Globodera rostochiensis (TSRoP) and G. pallida (TSPaP) were isolated. Three of the isolated hybridomas (WGP 1, WGP 2 and WGP 3) produce antibodies that react with preferent affinity with protein antigens isolated from G. pallida, and two (WGR 11 and WGR 12) produce antibodies which bind preferentially to G. rostochiensis. Binding constants were determined to quantitate the differences in affinity of WGP 1, WGP 2, WGP 3, WGR 11 and WGR 12 for the protein antigens from both nematode species, and to asses the similarity in affinity for either protein antigen with respect to the other non-specific antibodies. In immunoblotting experiments a binding could be demonstrated, for most antibodies, to two thermostable proteins with apparent molecular weights of 20.6/20.8 kD for G. rostochiensis and 20.5/21.0 kD for G. pallida. the reactivity of the monoclonal antibodies with thermostable protein antigens from other common cyst nematodes was also investigated. All monoclonal antibodies, which are not specific for TSRoP or TSPaP, bind to thermostable proteins of these cyst nematode species. The use of some of the isolated monoclonal antibodies to improve the diagnosis of potato cyst nematodes in soil samples is discussed. PMID- 2777275 TI - Specific, high affinity colchicine binding monoclonal antibodies: development and characterization of the antibodies. AB - Nine colchicine specific monoclonal antibodies have been developed by immunizing BALB/c mice with a colchicine-keyhole limpet hemocyanin (Col-KLH) conjugate prepared using a bishydroxysuccinimide coupling reagent. Of four immunization procedures examined, intraperitoneal injection of the antigen attached to acid treated E. coli resulted in the maximum antigen specific antibody titers. A colchicine bovine serum albumin (Col-BSA) conjugate, prepared using a water soluble carbodiimide coupling technique, formed the basis of an enzyme linked immunosorbent assay used for screening hybridomas for colchicine specific antibody secretion and for determining the relative affinity and specificity profile of the monoclonal antibodies. All antibodies demonstrated high affinity, saturable binding to colchicine and low cross-reactivity with a panel of compounds structurally related to colchicine. The IC50 for the highest affinity antibody, C44, was 3.6 +/- 0.84 nM colchicine in the competitive enzyme immunoassay. The affinity of this antibody determined from Scatchard analysis of antibody binding to tritiated colchicine was 0.66 +/- 0.11 nM. Antibody C44 has the level of specificity and affinity suitable for a sensitive and selective immunoassay of colchicine for monitoring therapeutic drug levels. In addition, this antibody provides a specific pharmacologic antagonist for studies of colchicine's therapeutic mechanism and has the potential to reverse colchicine toxicity. PMID- 2777276 TI - Monoclonal antibody to SER immune suppressor detects polymeric forms of haptoglobin. AB - A series of monoclonal antibodies has been developed which is directed to a serum immunosuppressive factor, known as suppressive E-receptor factor (SER). SER, purified from the body fluids of cancer patients, is a polymeric form of haptoglobin, which is 100-1,000 times more potent an immunosuppressor than normal plasma haptoglobin and is immunochemically analogous to the neonatal form. Unlike the neonatal haptoglobin found in cord blood, SER, however, does not contain bound-hemoglobin. One group of monoclonal antibodies described in this study detects the polymeric forms of haptoglobin (SER) under non-denaturing conditions, but fails to recognize SER under the denaturing conditions of SDS-PAGE. A second group of monoclonal antibodies reacts only with the alpha subunit of haptoglobin but not with the beta subunit; in contrast, the commercially prepared polyclonal antisera to haptoglobin react with both the alpha and beta subunit. The average level of SER in normal human plasma (n = 19) was 1.0 micrograms/ml, regardless of age or sex. Since macrophages appear to secrete SER but do not synthesize haptoglobin, SER may represent an oxidized form of plasma haptoglobin generated from macrophages activated during an inflammatory response. These studies suggest that SER may be a negative feed-back regulator of immune response produced by activated macrophages. PMID- 2777277 TI - Monoclonal antibodies against rat glutathione S-transferase isoenzymes 2-2 and 3 3. AB - Monoclonal antibodies were prepared against rat glutathione S-transferase isoenzymes 2-2 and 3-3. Three clones were capable of specifically differentiating their respective antigens from other rat isoenzymes as well as human isoenzymes, in ELISA and on Western blot. One clone produced antibodies specific for isoenzyme 2-2, and 2 hybridomas were specific for isoenzyme 3-3. Balb/c mice did not respond to immunization with glutathione S-transferase isoenzymes 1-1 and 4 4. However, an immune response was obtained in some other strains of mice, with differential H-2 haplotypes, notably CBA/BrARij mice and CBA/CaHRij-T6 mice for isoenzyme 1-1 and CBA/BrARij mice for isoenzyme 4-4, which offers perspectives for obtaining additional specific monoclonal antibodies against these glutathione S-transferases. PMID- 2777279 TI - Open-loop control of the freely-swinging paralyzed leg. AB - An experimental model has been used to study issues that are relevant to the use of electrical stimulation to help paralyzed individuals walk. Modulated stimulation sequences for the quadriceps muscles were manually selected using an iterative trial-and-error procedure to cause the knee angle to follow a specific movement pattern (desired trajectory). Four paraplegic subjects were tested before and after an eight-week program in which the quadriceps were exercised daily with electrical stimulation. It was found that 12.6 +/- 2.9 iterations were required to approximate the desired trajectory. The average error of the final match between the actual and desired trajectories was 2.1 degrees +/- 0.7. Repeated responses were extremely consistent; the average difference between successive trials was less than 1 degree in 81 percent of the trials. When the stimulation sequence was repeated every 3 s for 50 cycles, however, there was a progressive degradation in the response, even in exercised legs, that demonstrated the limitations of open-loop control. Stimulus modulation envelopes for all four subjects were similar in shape (although varied in amplitude) indicating that the iterative process can be shortened by starting with an "average" modulation envelope. Stimulation sequences achieved accurate matches of the desired trajectory on subsequent days when adjusted by a simple gain factor. The relevance of these results to multichannel control of walking is discussed. PMID- 2777278 TI - Colon carcinoma-associated glycoproteins recognized by monoclonal antibodies CO 029 and GA22-2. AB - Two murine monoclonal antibodies (MAb) CO-029 and GA22-2 are described which reacted specifically with the human gastrointestinal tumor cell lines LS180 and SW1222, respectively. CO-029 specific antigen was found by immunoprecipitation and Western blotting to be a highly expressed protein consisting of a single polypeptide chain of 32kDa. The gastric tumor associated antigen GA22-2 was a 185kDa polypeptide which did not comigrate with the 180 kDa carcinoembryonic antigen (CEA), neither was it immunologically crossreactive with the latter. Both CO-029 and GA22-2 antigens were shown to be glycosylated by their retention on Sepharose-lectin columns. CO-029 was highly bound by wheat germ agglutinin indicating the accessibility of N-acetylglucosamine or N-acetyl-neuraminic acid residues. GA22-2 showed higher specificity to soybean agglutinin inferring the preferential accessibility of galactose or N-acetylgalactosamine-like residues on its saccharide moiety. PMID- 2777280 TI - Electrode models for electric current computed tomography. AB - This paper develops a mathematical model for the physical properties of electrodes suitable for use in electric current computed tomography (ECCT). The model includes the effects of discretization, shunt, and contact impedance. The complete model was validated by experiment. Bath resistivities of 284.0, 139.7, 62.3, 29.5 omega.cm were studied. Values of "effective" contact impedance zeta used in the numerical approximations were 58.0, 35.0, 15.0, and 7.5 omega.cm2, respectively. Agreement between the calculated and experimentally measured values was excellent throughout the range of bath conductivities studied. It is desirable in electrical impedance imaging systems to model the observed voltages to the same precision as they are measured in order to be able to make the highest resolution reconstructions of the internal conductivity that the measurement precision allows. The complete electrode model, which includes the effects of discretization of the current pattern, the shunt effect due to the highly conductive electrode material, and the effect of an "effective" contact impedance, allows calculation of the voltages due to any current pattern applied to a homogeneous resistivity field. PMID- 2777281 TI - A model of acoustic transmission in the respiratory system. AB - A theoretical model of sound transmission from within the respiratory tract to the chest wall due to the motion of the walls of the large airways was developed. The vocal tract, trachea, and the first five bronchial generations are represented over the frequency range from 100 to 600 Hz by an equivalent acoustic circuit. This circuit allows the estimation of the magnitude of airway wall motion in response to an acoustic perturbation at the mouth. The radiation of sound through the surrounding lung parenchyma is represented as a cylindrical wave in a homogeneous mixture of air bubbles in water. The effect of thermal losses associated with the polytropic compressions and expansions of these bubbles by the acoustic wave is included and the chest wall is represented as a massive boundary to the wave propagation. The model estimates the magnitude of acceleration over the extrathoracic trachea and at three locations on the posterior chest wall in the same vertical plane. The predicted spectral characteristics of transmission are consistent with previous experimental observations. This theoretical approach suggests that the locations of the spectral peaks are a strong function of the geometry and the wall properties of the airways, while the attenuation at higher frequencies is primarily associated with the absorption of sound in the parenchyma. PMID- 2777282 TI - Computer model for simulation of first transit cardiac radionuclide curves--I. AB - A discrete-time, lumped-parameter mathematical model of the human cardiopulmonary circulation as it appears during a first-transit radionuclide study is developed. Eleven compartments, four delays, and 26 transfer paths are modeled, including the entire circulation from an input compartment before the vena cava to an output compartment after the aorta. The 26 transfer paths include forward and reverse flow through the heart valves, backflow from the atria into the veins, and five types of shunts. A method of modeling continuously-variable delay segments with only discrete-time sample points is devised to allow more versatility in specifying delays. The model simulates discrete time-activity curves for the various compartments of the cardiopulmonary system. The curves are obtained for end-systole and end-diastole. Simulation of curves indicative of a normal heart and several heart defects is presented. The use of this model for computer analysis of first-transit cardio-radionuclide curves is discussed. PMID- 2777283 TI - Optimal fitting of computer model simulations to first transit cardiac radionuclide curves--II. AB - A discrete-time, lumped-parameter mathematical model of the human cardiopulmonary circulation as it appears during a first-transit radionuclide study has been described. An optimal fitting process is used to match curves obtained from the model to curves obtained from first transit studies in order to estimate the parameters of the subject's heart. The development of the optimization technique is described in this paper. The results of testing the effects of overlapping compartments and errors in delay estimates are presented. A parameter determination analysis is performed by applying the optimization algorithm to simulated data. This analysis technique provides a method of estimating many parameters of heart function using a single, simple, rapid procedure. Results of clinical studies will be presented subsequently. PMID- 2777284 TI - Local convolution in ectomography. AB - In tomographic imaging, using limited angular sampling, details outside the imaged section are displaced along circles of blur. In ectomography, these are eliminated by a spatial convolution process. It is shown that the convolution function has to be as long as the projected dimension of the imaged object perpendicular to the section and twice the dimension parallel to the section. PMID- 2777285 TI - The Prony spectral line estimation (PSLE) method for the analysis of vascular oscillations. AB - The Prony spectral line estimation (PSLE) technique is implemented and tested on data consisting of sinusoids mixed with Gaussian noise and on recordings of oscillatory diameter changes (vasomotion) of arterioles. It is concluded that the PSLE method is well suited for the spectrum analysis of short oscillatory diameter records. PMID- 2777286 TI - Ability of the Lapicque and Blair strength-duration curves to fit experimentally obtained data from the dog heart. AB - The objective of this study was to determine the ability of the empirical Lapicque and theoretically derived Blair expressions for excitation to fit experimentally obtained threshold current values to evoke a ventricular extrasystole using rectangular-wave stimuli applied to the dog heart. The data points were fitted to both expressions and the ability of each to predict the measured values was determined. The Levenberg-Marquardt (L-M) algorithm was used to fit the Lapicque and Blair expressions. The Lapicque data were also fitted to the linear charge-duration expression of Weiss (W). It was found that the ratio of the predicted to measured current was slightly different from one 0.95 (L-M) and 1.06 (W) for the Lapicque and 0.92 (L-M) for the Blair expression. Thus, there appears to be little difference between the ability of the expressions to fit the same experimentally obtained data. The L-M Lapicque fit is best for the short durations range; the Weiss-Lapicque fit overestimates in the short duration range and underestimates near chronaxie. The L-M Blair fit is best for the short duration range and poor for the durations near the membrane time constant. PMID- 2777287 TI - Social support, hardiness and psychological well-being in women with arthritis. AB - The purpose of this study of women with rheumatoid arthritis (n = 12) was to determine whether or not social support and hardiness are predictors of psychological well-being when the severity of the women's rheumatoid arthritic disease process is statistically controlled. The findings suggest that satisfaction with social support and hardiness are indeed significant predictors of psychological well-being in women with rheumatoid arthritis, regardless of the severity of illness. PMID- 2777288 TI - Nursing in a hospital-based hospice unit. AB - The purpose of this ethnographic study was to describe and analyze the ways in which registered nurses interacted with those terminally ill and acutely ill patients typical of a hospital-based hospice unit. Participant observation and informal interviews were used to collect data. Field notes were analyzed systematically using a constant comparative method of qualitative analysis. Data analysis revealed that patients' responsiveness rather than "acute," or "terminal" labels determined the quality of the nurses' interactions with them. Humanistic caring was found to be the unifying focus of care for both acutely ill and terminally ill patients. PMID- 2777289 TI - The lesbian childbearing experience: assessing developmental tasks. AB - Selected nursing theories about the childbearing experience are examined as they apply to the assessment of the pregnant lesbian couple. A review of the women's health literature suggests that the lesbian pregnancy experience is characterized by the use of donor insemination, social discrimination and a dependence on peer rather than family networks for social support. Based on these sociocultural constraints, the authors propose that the lesbian couple is faced with greater barriers than are heterosexual parents to achieving the developmental tasks of "safe passage" and acceptance by others of the pregnancy. Future research should document how a lesbian identity affects the pregnant woman's relationship with her mother, her partner's psychosocial development as a parent and the maternal infant attachment process. Nursing guidelines for assessing parental role development are presented. PMID- 2777290 TI - Spouses' experiences during pregnancy and the postpartum: a program of research and theory development. AB - A program of nursing research was established to test a theory proposing that wives and husbands have similar pregnancy-related experiences. The research was guided by a conceptual framework of the family as a living open system. Findings were conflicting from three studies that investigated the relationship between spouses' strength of identification and similarities in changes in various body image components during and after pregnancy; taken together the findings suggested that spouses do not have similar patterns of change in their body images during pregnancy and the postpartum. Two other studies investigated the relationship between spouses' strength of identification and similarities in their reports of physical and psychological symptoms during pregnancy and the postpartum. In these studies the spouses reported similar physical and psychological symptoms during pregnancy and the postpartum. There was no evidence, however, in any of the studies of a relationship between spouses' strength of identification and similarities in their pregnancy-related experiences. The validity of the theory of similar pregnancy-related experiences and the credibility of the conceptual framework of the family as an open system are questioned. PMID- 2777291 TI - Guarded alliance: health care relationships in chronic illness. AB - A multiphase, qualitative study of ongoing health care relationships from the perspective of the chronically ill patient and family confirmed that such relationships evolve over time through three predictable stages: naive trust, disenchantment and guarded alliance. In the final stage, four patterns of health care relationships were identified: hero worship, resignation, consumerism and team playing. The configuration of these relationships in guarded alliance is explained by dimensions of the core variable of reconstructed trust--patients' trust in a health care professional and their trust in their own competence. PMID- 2777292 TI - A proposal for a men's health nurse practitioner. AB - The educational preparation of a men's health nurse practitioner (MHNP) is proposed. The MHNP's scope of practice would address the complex health needs of men from a holistic perspective with emphasis on the knowledge and skills necessary for providing comprehensive primary care. Need for the MHNP is discussed, and scope of practice is delineated. Conclusions are drawn regarding the future of the MHNP in the scheme of total health care. PMID- 2777293 TI - Normative power of chief executive nurses. AB - This study sought to determine if there was a significant difference in the equality of power of chief executive nurses and other executives with similar titles in a hospital organization. A 36-item Power Assessment Inventory was used to collect the data from 96 chief nurse executives and 147 other executives in the same institutions. The findings showed the nurse executive to be more powerful in overall normative power, prestige and esteem, as well as legitimacy of position. The chief executive nurse was found to be equal with the other executives regarding symbols of power. These results indicate that nurse executives are having a significant impact on the business of health care and health care administration and imply that nurses should cease referring to themselves and their profession as being powerless. PMID- 2777294 TI - Professional nursing in Iraq. AB - This paper examines professional nursing in Iraq, with emphasis on selected sociopolitical policies and the role of women. A baccalaureate program in nursing was established at the University of Baghdad in 1963, followed by a masters' program in 1986. Although modernization policies encouraged the development of nursing, the profession was influenced negatively by the restricted role and low status of women in Arab society. Shortly after the ceasefire in the Iran-Iraq war, the professional nursing program was closed by the government. The analysis suggests that nursing leaders have not had access to sources of power through a role in policy making and thus have not been able to ensure the development of the profession. PMID- 2777295 TI - Rethinking moral reasoning theory. AB - Many nursing studies on moral reasoning and ethics have used Kohlberg's theory of moral development. The body of knowledge that resulted from these studies indicated that nurses and nursing students had consistently lower than expected levels of moral reasoning. Educational offerings were developed to assist nurses to improve their moral reasoning. This article explores the cognitive developmental theory of moral development as one way of determining the moral development of nurses. Since this theory of moral reasoning focuses on the rational thought of the individual and does not consider the impact of the environment, it is of limited applicability in nursing. A new theory of morality needs to be developed--a more holistic one that will include both universal principles and contextual tissues. PMID- 2777296 TI - Coronary venous retroperfusion--beyond lytic therapy. PMID- 2777297 TI - Detection of silent myocardial ischemia by Holter monitoring and its relation to severity of coronary artery disease. AB - Thirty-five patients of chronic stable angina, unstable angina and post MI angina, who were on medical treatment, underwent 24 hours Holter monitoring and coronary angiography to find out the incidence of Silent Myocardial Ischemia (SMI) and its relation to anatomic severity of coronary artery disease. Total duration of Holter monitoring was 835.32 hours (average 23.40 hours per patient) with 48 ischemic episodes out of which 16 were painful and 32 painless. Total duration of painful episodes was 189 minutes and that of painless episodes was 428 minutes (70% was constituted by SMI). Out of 35 patients, 6 (17.14%) had SMI; 2 of 17 (11.7%) of chronic stable angina, 2 of 8 (25%) of unstable angina, and 2 of 10 (20%) of post-infarction angina patients. On analysis of coronary angiogram, all 6 (100%) patients with SMI, and only 22 out of 29 (76%) without SMI, had severe multiple coronary artery disease. Thus, although the overall incidence of SMI in this series is low, its presence invariably indicates a severe degree of coronary artery disease. PMID- 2777298 TI - Silent myocardial ischaemia in patients with angiographically proven coronary artery disease. AB - Twenty patients with angiographically proven coronary artery disease (CAD) were evaluated by Holter monitoring for assessment of total ischaemic burden during daily activities. Thirteen patients revealed ischaemia on Holter monitoring (symptomatic-2, silent-4 and both types-7). As compared to symptomatic ischaemia, the silent myocardial ischaemic episodes were more frequent (25 vs 10 episodes), longer in duration (15-53 minutes vs 8-45 minutes), occurred at lower heart rates (65-75/minute (mean 68) vs 70-90 per minute (mean 76) and silent ischaemic episodes exceeded symptomatic ones in both morning (10 vs 4) and evening (15 vs 6) peaks. Occurrence of symptomatic as well as silent ischaemia had no relation to rest, activity, left ventricular functions, and there was no difference in the extent (1-3mm) and type (horizontal or downsloping) of ST-segment depression. We conclude that in patients with significant coronary artery disease, silent myocardial ischaemia is more frequent than the symptomatic ischaemia during daily activities. It occurs at lower heart rates, lasts longer, and bears no relation to rest, activity or left ventricular function. Evening peaks may be as frequent or more than the morning peaks. Holter monitoring thus is helpful for assessment of total ischaemic burden in CAD patients. PMID- 2777299 TI - Clonidine suppression test--an evaluation of its diagnostic significance in hypertensive patients. AB - The Clonidine Suppression Test (CST) was performed in 8 patients with Labile hypertension (Group I), 8 patients with mild and moderate Essential hypertension (Group IIa), 8 patients with severe Essential hypertension (Group IIb) and 6 patients with pheochromocytoma (Group III). The mean plasma catecholamine (CA) levels as estimated by a Spectrofluorimetric method were significantly reduced 3 4 hours after administration of clonidine (5 micrograms/kg) by mouth in Group I, IIa & IIb patients. Plasma norepinephrine levels fell from 1.82 +/- SEM 0.35 ng/ml to 1.03 +/- 0.11 ng/ml (p less than 0.05) in Group I, 1.64 +/- 0.36 ng/ml to 0.88 +/- 0.12 ng/ml (p less than 0.025) in Group IIa, 1.23 +/- 0.16 ng/ml to 0.86 +/- 0.12 ng/ml (p less than 0.005) in Group IIb patients. Plasma epinephrine levels fell from 0.35 +/- 0.06 ng/ml to 0.16 +/- 0.03 ng/ml (p less than 0.05) in Group I, 0.34 +/- 0.04 ng/ml to 0.22 +/- 0.03 ng/ml (p less than 0.01) in Group IIa, 0.33 +/- 0.06 ng/ml to 0.18 +/- 0.03 ng/ml (p less than 0.025) in Group IIb patients. The blood pressure and heart rate showed a similar response. By contrast, in patients with pheochromocytoma, the mean plasma CA levels did not show any significant fall, and even rose during the CST, but, when repeated post operatively, showed normal suppression. No serious side effects were noticed. We conclude that the CST is a safe and reliable test for the diagnosis of pheochromocytoma.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2777300 TI - Comparison of exercise and dipyridamole equilibrium blood pool scintigraphy (EBPS) in angina pectoris. AB - Twelve patients with exertional angina underwent exercise treadmill testing, exercise equilibrium blood pool scintigraphy (Ex EBPS). Dipyridamole equilibrium blood pool scintigraphy (Dip EBPS) and coronary angiography by the Judkin's technique. Dipyridamole was infused through a venous cannula placed in the antecubital vein, in a dose of 0.56 mg/kg over four minutes. Four patients had single vessel disease, three double vessel disease, four triple vessel disease, and one had normal coronary arteries. Exercise equilibrium blood pool scintigraphy was found to have a sensitivity of 81%, and a positive predictive value for significant coronary artery disease of 100%. Dipyridamole EBPS had a sensitivity of 72% with a positive predictive value of 100%. The occurrence of regional wall motion abnormalities, following dipyridamole infusion, occurs up to fifteen minutes after exercise, and, therefore, serial acquisition for up to 20 minutes after the infusion is recommended. In patients with angina, who are unable to exercise because of orthopaedic disabilities or peripheral vascular disease, dipyridamole stress blood pool scintigraphy is a feasible alternative. PMID- 2777301 TI - Dominant right ventricular dilated cardiomyopathy: clinical, echocardiographic and haemodynamic profile. AB - Ten patients of dominant right ventricular dilated cardiomyopathy (RVDCM) seen over a period of three years in this institution are described. There were six males and four females in the age range of 6.50 years. Presenting features were right ventricular failure (7), paroxysmal supraventricular tachycardia (2), and one patient was detected on routine chest skiagram. All patients had characteristic electrocardiographic and radiologic features. 2D-echocardiographic examination revealed enormous dilatation of right atrium, ventricular cavity and outflow tract, interatrium and ventricular septum concave to the right, pre systolic pulmonary valve opening, small left atrium and ventricle. Pulsed doppler echocardiogram revealed varying degree of tricuspid incompetence in all. Four patients underwent haemodynamic and cineangiographic studies showing left ventricular involvement in one. The patients have been followed up on digitalis, diuretics and quinidine with variable response to treatment. One patient died of uraemia, and one female patient recovered completely following delivery. Dominant RVDCM is a distinct clinical entity with typical features and with typical features and ill-defined natural history. PMID- 2777302 TI - Experience with balloon valvuloplasty in pulmonary stenosis. AB - Fourteen patients of pure valvular pulmonary stenosis of moderate to severe degree underwent balloon valvuloplasty in the Department of Cardiology, SSKM Hospital, Calcutta. Haemodynamic study revealed that immediately after valvuloplasty, right ventricular pressure dropped down from 125 +/- 17.18 mmHg. to 56.67 +/- 8.72 mmHg. (mean +/- SD). Restudy was done in each case after 4 weeks, which showed that right ventricular systolic pressure had further dropped down to 46.71 +/- 5.06 mmHg. (Mean +/- SD). Patients were further followed up for 6 to 15 months (mean 10 months). During the follow-up period, all the patients remained asymptomatic. Drop of right ventricular systolic pressure was maintained except in one case in which the peak systolic pressure gradient across the pulmonary valve was raised to 61 mmHg. from 24 mmHg., the gradient achieved immediately after valvuloplasty. PMID- 2777303 TI - Brain abscess in cyanotic congenital heart disease. AB - Twenty-eight patients of cyanotic congenital heart disease (CHD) complicated with brain abscess were reviewed. There were 22 males and 6 females with a mean age of 9.1 +/- 5.5 years. Tetralogy of Fallot was the commonest cyanotic CHD observed. Transposition of great arteries (PS), tricuspid atresia with VSD, PS and double outlet right ventricle with VSD comprised 25% of the cardiac lesions. Febrile illness was the commonest mode of presentation (42.86%). Frontal lobe was the commonest site of abscess localization (37.5%) followed by parietal lobe (32.5%). Multiple abscess were seen in 32.14% and in 35.7% the pus was sterile on culture. Twelve patients died (mortality -42.8%), and autopsy reports were available in 6. Infective endocarditis was suspected in 7 on clinical grounds, while at autopsy, out of 6 only 2 had evidence of right-sided endocarditis. There was no correlation of mortality with age, sex, type of micro-organism, site of abscess localization and the nature of heart disease. Multiple abscesses, features of raised intracranial tension and associated meningitis/ventriculitis predicted a grim outcome. PMID- 2777304 TI - Coronary arterio-venous fistula from left main stem to pulmonary artery. AB - We describe a patient with coronary arteriovenous fistula discovered during routine coronary angiography for evaluation of ischaemic heart disease. Angiography revealed a rare anomaly connecting left main stem to pulmonary artery. PMID- 2777306 TI - Complete intraventricular dissociation. Electrocardiographic manifestation of a rare intracardiac complete dissociation. AB - Complete Intraventricular Dissociation manifesting as dual ventricular rhythm was observed on surface electrocardiography in two middle-aged males with acute myocardial infarction. The first patient had a dominant accelerated (AV) junctional rhythm, and there was a sudden emergence of an additional independent slow and regular idioventricular escape rhythm. These ventricular complexes were bizarre and markedly widened, waveform with prolonged undulating electric potentials. In the second case, the emergence of a dominant idioventricular rhythm was coexistent with an additional independent escape rhythm with monophasic wider agonal ventricular complexes. Terminal tracings recorded later were essentially the same, except that an ill sustained ventricular fibrillation had replaced the ectopic agonal beats, and there was an enhanced automaticity in the dominant ventricular part. The sites of ectopic ventricular rhythms were thought to be in the ischaemic damaged ventricular myocardium, with a surrounding zone of conduction block. PMID- 2777305 TI - Severe syphilitic aortic regurgitation with bilateral critical coronary ostial stenosis. AB - A forty-year-old male with syphilitic severe aortic regurgitation and critical bilateral coronary ostial stenosis, proved by cardiac catheterization and angiocardiography, is presented. He underwent successful aortic valve replacement and coronary artery bypass grafting with gratifying results. PMID- 2777307 TI - Subaortic stenosis associated with anomalous right ventricular muscle bundle and ventricular septal defect. AB - A rare case of biventricular outflow tract obstruction in the form of discrete subaortic membrane and hypertrophic anomalous right ventricular muscle bundle associated with ventricular septal defect is presented. PMID- 2777308 TI - Aortoarteritis presenting as coarctation of aorta. AB - An interesting case of Aortoarteritis with clinical features simulating congenital coarctation of aorta (COA) is presented. Clinical pointers of differentiation of these conditions are discussed. Relevant literature is reviewed. PMID- 2777309 TI - Study of interaction between catechin and native and modified bovine serum albumin by physico-chemical methods. AB - The interaction of native and modified bovine serum albumin (BSA) with catechin, a flavanoid having vitamin P activity, has been studied using equilibrium dialysis, pH-metric, viscosity and spectrophotometric methods. The order of reactivity of catechin binding to proteins was found to be: esterified BSA greater than BSA greater than formylated BSA greater than acetylated BSA with log K values of 3.778, 3.879, 3.748 and 3.813 and free energy change equal to -5.11, 5.16, -5.07 and -5.15 kcal/mole, respectively. PMID- 2777310 TI - Model biological microemulsions: Part I--Phase behaviour and physicochemical properties of cholesteryl benzoate and sodium deoxycholate contained microemulsions. AB - Phase behaviour and some physicochemical properties of cholesteryl benzoate contained microemulsions of xylene and heptane with water using sodium deoxycholate and butan-1-ol as surfactant and co-surfactant respectively have been studied. While the microemulsion area of xylene depends insignificantly on the surfactant/co-surfactant ratio, that of heptane shows appreciable dependence. At surfactant + co-surfactant percentage of 50 or above, both the systems become oil continuous. With respect to time and temperature, the microemulsion systems have been found to be very stable. At low percentage of water, the xylene system is considerably viscous; that of heptane is less viscous but shows viscosity maximum at 45% water. Cholesterol in xylene has given greater viscosity than cholesteryl benzoate. The equivalent conductance of both the systems increase with increasing water content and the values are comparable. Unlike normal electrolyte solutions, the products of equivalent conductance and viscosity (the Walden product) sharply rise with increased water content, which suggests a special mechanism of conduction via 'channel' formation. The overall rigidity of the microemulsions is suggested by their lower specific volumes and compressibilities at all compositions. The excess specific volumes and excess compressibilities at different percentages of water are presented. PMID- 2777312 TI - Interaction of antitumour agent mitoxantrone with poly[d(G-C)]--a circular dichroic study. AB - The binding of antitumour drug mitoxantrone [1,4-dihydroxy-5, 8-bis [2-(2-hydroxy ethyl)amino)ethyl)amino)-9, 10-anthracenedione] to the synthetic polynucleotide poly[d(G-C)] was studied by circular dichroic titrations. The interaction induced intense chiroptical properties in the visible (688 nm) as well as the ultraviolet (260, 320 nm) region in an otherwise optically inactive drug. The interaction occurs in two stages, one below a drug/nucleotide ratio of 0.11 and other above this value. The second mode of interaction causes an almost cooperative enhancement of the visible induced circular dichroism (ICD). PMID- 2777311 TI - Increased lipid peroxidation in the erythrocytes of kidney stone formers. AB - The level of lipid peroxidation was significantly increased in erythrocytes and erythrocyte membrane in patients with stone disease. Increased activities of catalase and acetylcholinesterase in the erythrocyte membrane were observed, while hemolysate displayed no significant change in superoxide dismutase activity. The amount of phospholipids in the RBC membrane of patients was significantly increased. Peroxidation was stimulated by oxalate in vitro and was further enhanced in the presence of ferrous ion. The changes in lipid peroxidation and antioxidant enzymes are suggestive of chemical alteration of the RBC membrane during urolithiasis. PMID- 2777313 TI - Comparative analysis of surface components of adult, micro-filariae and infective larvae of Brugia malayi. AB - A comparative analysis of surface proteins of adult, microfilariae and infective larvae of Brugia malayi, the human filarial parasite, has been carried out using IODOGEN (1,3,4,6-tetrachloro-3,alpha 6 alpha-diphenyl-glycoluril) and lactoperoxidase methods. SDS-polyacrylamide gel electrophoretic and autoradiographic analyses revealed the presence of 9 proteins (15-200 kDa) in adults, while microfilariae and infective larvae showed 8 and 6 proteins (15-120 kDa), respectively. The pattern of proteins radiolabelled by IODOGEN method was very similar to that of proteins labelled by the lactoperoxidase method. Since these proteins are released by the protease treatment of whole parasites, they are likely to be present on the surface of the parasite. PMID- 2777315 TI - On a thermodynamic model of biological growth. PMID- 2777314 TI - Effects of cadmium treatment in vitro on the uptake and release of [3H]serotonin by human blood platelets. AB - Effects of cadmium treatment on human platelets were studied with respect to uptake and release of 5-[3H]hydroxytryptamine (5-HT). The uptake of 5-[3H]HT in the presence of varying concentrations of CdCl2 (0.001-10 mM) was inhibited significantly with respect to control platelets and the inhibition was maximum at 1 mM CdCl2 concentration. From studies on the kinetics of 5-[3H]HT uptake a higher Km and significantly lower Vmax for CdCl2-treated platelets were observed. CdCl2 stimulated spontaneous release but inhibited thrombin-induced release of 5 [3H]HT. Spontaneous release of 5-[3H]HT induced by CdCl2 was not significantly altered in the presence of externally available CaCl2 (1 mM). PMID- 2777317 TI - Liquid membrane phenomenon in the biological actions of benzodiazepines. AB - The liquid membrane phenomenon in benzodiazepines has been studied. Transport of glycine, GA-BA, noradrenaline, dopamine and serotonin in the presence of the liquid membranes generated by the benzodiazepines in association with lecithin and cholesterol has been studied. The data indicate that modification in permeabilities in the presence of the liquid membranes is likely to make a significant contribution to several biological actions of the benzodiazepines. PMID- 2777316 TI - Temperature-absorption transition spectroscopy: a technique for estimating the relative charge densities on thiolated phosphate groups in nucleic acid analogues. AB - Various polynucleotides with well-defined sequences at low salt concentration have been studied using temperature-absorbtion transition spectroscopy to understand their conformations. It has been observed that the adopted technique can fairly estimate the relative charge densities at the thiolated phosphate groups in nucleic acid analogues at low salt concentrations. PMID- 2777319 TI - Enzymes of carbohydrate metabolism in fast-growing Rhizobium grown on hexoses or succinate. AB - Enzymatic evidence supports that succinate mediates repression of hexose catabolising enzymes in fast-growing Rhizobium sp. (Cicer arietinum). Enzymes of the Embden-Myerhof-Parnas, Entner-Doudoroff and pentose phosphate pathways were found present in hexose-grown cells but not in succinate-grown cells. These however could be induced by the presence of hexoses. PMID- 2777318 TI - Further simplification of the general analysis of the intercalative drug-DNA interaction. AB - The application of McGhee and von Hippel's general equation [J. Mol. Biol., 86 (1974), 469-489, Eq. (15)] to the analysis of the interaction of intercalative drugs with DNA has been further simplified. The value of n can now be determined mathematically, using a simple function, and without any approximation. It is also established that the summation of squared deviation of (( (nu/c), nu)) points would be minimum for and only for the true set of (K,n,omega) of the interaction system. The method incorporating the simplification has been applied to determine the binding parameters of adriamycin-DNA interaction according to the above general equation. PMID- 2777320 TI - Age-related changes of glycogen metabolism in human fetal heart. AB - The changes in the activities of three important glycogen metabolising enzymes, viz. glycogen synthetase, glycogen phosphorylase and alpha-D-glucosidase, along with glycogen content have been measured in adult human heart and human fetal heart collected at 13-36 weeks of gestation. At an early period, particularly 13 16 weeks of gestational age, the activity of glycogen synthetase and glycogen content were found to be maximum. However the activity of glycogen phosphorylase remained constant throughout the gestation and that of alpha-D-glucosidase showed a peak at 25-28 weeks of gestation, thereby indicating that fetal heart tissue has the capacity to utilise glycogen for energy. PMID- 2777321 TI - Detection and estimation of 3,4-dehydroproline. AB - A method has been described for the detection and estimation of 3,4 dehydroproline using initial oxidation with isatin or H2O2 and subsequent reaction with p-dimethylamino benzaldehyde (Ehrlich reagent). The method is sensitive enough to detect as low as 0.6 micrograms of 3,4-dehydroproline/sq. cm on paper chromatogram. 3,4-dehydroproline could also be estimated by the classical H2O2-oxidation procedure employed for hydroxyproline apparently yielding the same chromophore on a molar basis. However, when estimated by the chloramine-T oxidation method, its sensitivity was only 1/100th of that of 4 hydroxyproline. The usefulness of these procedures in the detection and estimation of 3,4-dehydroproline has been described. PMID- 2777322 TI - Chromotropic character of bacterial acidic polysaccharides: Part II--Induction of metachromasy in cationic dye pinacyanol chloride by Klebsiella K10 capsular polysaccharide. AB - The acidic capsular polysaccharide isolated from Klebsiella K10 exhibited chromotropic character with respect to induction of metachromasy in the cationic dye pinacyanol chloride (1-ethyl-2-[3-(1-ethyl-2(1H) quinolylidene)propenyl]quinolinium chloride). Klebsiella K10 polymer consists of hexasaccharide repeating units containing one residue of glucuronic acid along with other neutral sugars in each repeating unit. It induces a metachromatic blue shift in the visible absorption spectrum of the dye from 600 nm to 500 nm. The spectral changes have been studied during interaction of the dye cations with the polyanions at different polymer/dye molar ratios. The polyanion-dye compounds are formed with polymer/dye stoichiometry of 1:1, indicating formation of stacking conformation. The complete reversal of polymer-induced metachromasy has also been observed by the addition of ethanol and urea. PMID- 2777323 TI - Biologically active polymer supports based on cellulosic derivatives: synthesis and kinetic study. AB - Bioactive cellulose derivatives have been synthesised by coupling enzymes/antibiotics on carboxymethyl cellulose acid chloride and cellulose carbonate. The effect of pH and temperature on the enzymatic activity of amyloglucosidase immobilised on cellulose carbonate was studied. Michaelis-Menten kinetics have been obeyed to the first degree of approximation despite the restricted mobility of the attached enzyme on the polymer support. Lineweaver Burk plots for the amyloglucosidase immobilized on carboxymethyl cellulose acid chloride at ambient pH with cellulose carbonate at pH 8 have also been plotted. The Michaelis-Menten constant for the immobilized amyloglucosidase on cellulose carbonate at pH 8 was 9.1 mM, and the activation energy for starch hydrolysis was 21.8 kcals/mole. PMID- 2777326 TI - Influence of supplementation of saturated alkanes on the membrane properties of Microsporum gypseum. AB - Microsporum gypseum cells grown on saturated alkanes of different chain lengths (C10, C12, C14, C16 and C18) exhibited increased levels of total phospholipids and sterols. A significant increase in the content of phosphatidylcholine was observed in alkane-grown cells. Increased saturation of phospholipid fatty acid was observed with all the alkanes studied, which was mainly due to the decreased amount of C18:1 and C18:2 with concomitant increase in the levels of palmitic acid. The affinity for glycine changed in alkane-supplemented cells as compared to glucose-grown cells. 1-Anilino-naphthalene-8-sulphonate (ANS) binding to the spheroplast membrane demonstrated increased binding sites in supplemented cells. These results are discussed in terms of the effect of altered lipid composition on the membrane structure and function of this fungus. PMID- 2777325 TI - Mode of action of iron on arylsulphatases under acute lead acetate treated conditions in rats. AB - Arylsulphatases A, B and C were found to be inhibited in liver and kidney tissues under lead acetate-treated conditions (both in vivo and in vitro) in rats. When lead acetate-treated animals (in vivo) were supplemented with ferric ammonium citrate (in vivo), a remarkable recovery was found in the activities of all arylsulphatases A, B and C whereas ferric ammonium citrate itself had no effect on the activities of arylsulphatases. When both the in vivo and in vitro lead acetate-treated arylsulphatases were supplemented with the purified ferritins (in vitro) it was observed that lead-induced inhibition of the activities of arylsulphatases was successfully reversed. It was also found that ferritins were able to bind a large quantity of lead. These results indicated that ferritins were directly involved for reactivation of arylsulphatases which were inhibited by lead. It was well established that a response to iron administration in rats was an immediate de novo stimulation of ferritin biosynthesis. Iron might therefore protect the enzymatic activities of arylsulphatases by enhancing the level of ferritin in liver and kidney tissues which is known to bind a large quantity of lead thereby ameliorating their toxic effects in the living system. PMID- 2777324 TI - Spectrophotometric measurements on verdo-myoglobin: relevance to the oxidation of ferri-myoglobin by chlorite ion. AB - Spectrophotometric observations on verdo-myoglobin, reconstituted from apomyoglobin and verdo-heme and its oxidation products, are described. Relevance of these results to the oxidation of ferri-myoglobin by chlorite ion is also discussed. PMID- 2777327 TI - Hair cycle and the histogenesis of pillar tumours. AB - In a study of 50 tumours of pilar origin, it was observed that tumours arise from each cell type depending upon the phase of the hair cycle. Thus nevoid lesions arise from the pluripotent cells of the early anagen phase; tumours from the hair matrix, outer root sheath and inner root sheath arise during the anagen phase, and the keratoacanthomas during the interphase between anagen and telogen. Basal cell epitheliomas can arise at any phase. It was observed that the tumours arising during the anagen phase from the fully differentiated follicles formed the bulk (88%) and the keratoacanthoma simulating the catagen/telogen phase was rare in consonance with the length of each phase. It is proposed that the inner root sheath tumours be named trichilemmomas and the outer root sheath tumours trichochlamydomas to distinguish them from one another. PMID- 2777328 TI - Spontaneous complete remission in acute lymphoblastic leukaemia. AB - Case records of 78 patients of acute lymphoblastic leukemia have been reviewed. Complete remission occurred in seven cases following an episode of septicemia and supportive care. PMID- 2777329 TI - Histochemical studies on the distribution of certain dehydrogenases in squamous cell carcinoma of cheek. AB - Histochemical distribution of lactate, isocitrate and succinate dehydrogenases in normal oral epithelium and in well differentiated squamous cell carcinoma of cheek region was studied. Lactate dehydrogenase, isocitrate dehydrogenase, and succinate dehydrogenase activity was found to be more in the malignant cells. Succinate and lactate dehydrogenase presented a conspicuous pattern in which the cells located at the periphery of the malignant sheets in well differentiated squamous cell carcinoma showed moderate to intense activity as compared to cells in the central portion. The results are discussed and it is suggested that the enhanced glycolysis and subdued function of the tricarboxylic acid cycle is not a universal criterion during malignancy as reported in the previous investigations. PMID- 2777330 TI - Granular cell variant of acute lymphoblastic leukaemia. AB - A rare morphological variant of acute lymphoblastic leukaemia in a ten years old child is described. Ninety five percent of the lymphoblasts had significant number of course granules in the cytoplasm. Diagnostic and prognostic significance of this variant is discussed. PMID- 2777331 TI - Cancer cervix complicating pregnancy: a case report. AB - A case of invasive carcinoma cervix in a 25 years woman complicating labour is presented with brief review of literature. PMID- 2777332 TI - Extraosseous giant cell tumour of lung. AB - A rare case of Extraosseous Osteoclastoma like giant cell tumour of the lung is presented. PMID- 2777334 TI - Lymphocyte activation: changes in intracellular adenosine triphosphate and deoxyribonucleic acid synthesis. AB - Stimulation of human lymphocytes from 20 individuals with phytohaemagglutinin (PHA) for 60 min resulted in a fall in intracellular adenosine triphosphate (ATP) of 35% compared to unstimulated controls of 19% (p less than 0.001). There was a significant (p less than 0.01) correlation (r = 0.57) between ATP decrease at 60 min and deoxyribonucleic acid (DNA) synthesis at 72 h in PHA-stimulated cells. The technique described here is simple, rapid and has possible application in immunodiagnosis and immunologic monitoring. PMID- 2777333 TI - Electron beam irradiation in treatment of skin carcinoma. AB - Thirty seven cases of carcinoma of skin treated with electron-beam irradiation over a period of three years have been analysed retrospectively. Majority of lesions were in head and neck and basal-cell carcinoma was the commonest histological type. Of twenty-one patients followed, seventeen (81%) achieved complete remission and remained disease free for a period of one to three years. Cosmetic results were excellent. Role of electron-beam in the management of these superficial cancers and its advantage over the conventional radiation therapy methods have been highlighted. Radiation therapy utilising electron-beams form a very useful modality in the management of skin cancers, especially those arising in head and neck. PMID- 2777336 TI - Symposium on Theoretic Immunology. Utrecht, The Netherlands, May 1989. Selected papers. PMID- 2777335 TI - Follicular cells of tonsils metabolise more deoxycytidine than other cell populations. AB - Nine subpopulations of tonsillar lymphocytes and the unseparated cells were compared in their utilization of exogenous deoxycytidine ([5-3H]CdR) and thymidine ([3H]TdR). Uptake phosphorylation and incorporation of labeled precursors were determined in B and T lymphocytes, in low density (LD; enriched in S phase cells) and in high density (HD; enriched in G0/G1 phase cells) cell fractions as well as in LD and HD subfractions of B and T lymphocytes, and in cells isolated from follicles of tonsils. As expected, LD cells and B lymphocytes were more active in TdR incorporation than HD cells and T lymphocytes. However, the ratio of [5-3H]CdR to [3H]TdR in their total phosphorylation and incorporation into DNA was much lower than the expected value of 1: about 0.5 for total phosphorylation and about 0.3 for incorporation in all subpopulations, except for the follicular cells, where these ratios were 1.0 and 0.7, respectively. These results show that the relative utilization of the two pyrimidine deoxyribonucleoside precursors varies among different lymphocyte subpopulations. However, this variation is not due to the different rate of DNA synthesis; rather, it depends on the differentiation stage of lymphocytes occurring in the germinal center of the follicles. PMID- 2777337 TI - Serological distance coefficients. AB - We define experimentally measurable similarity coefficients S[A,B/C] that specify the extent to which a pair of substances, A and B, are similar in the context of a diverse reagent, C, which can be a non-immune serum. We describe how this definition can be applied to mixtures of antibodies, for example the antibodies of two serum samples, A and B. A "distance coefficient" D[A,B/C] between two sera, A and B, in the context of C, is defined as one minus the similarity coefficient of the two sera in the same context. We discuss the problem of the experimental measurement of these coefficients, and the possible use of the coefficients in the diagnosis and prognosis of disease conditions. PMID- 2777339 TI - Typing for HLA-DPB1*03 and HLA-DPB1*06 using allele-specific DNA in vitro amplification and allele-specific oligonucleotide probes. Detection of "new" DPB1*06 variants. AB - DP gene typing using in vitro DNA amplification combined with sequence-specific oligonucleotide probes has recently been reported. The resulting DNA amplification was specific for the HLA-DPB locus. Typing for the individual DPB alleles was exclusively dependent on the hybridizations of the probes but hampered by close sequence homology between different DP alleles yielding complex patterns of reactivity with a panel of probes. We report the combined use of allele-specific DNA in vitro amplification and allele-specific oligonucleotides in typing for DPB1*03 and DPB1*06. Complete concordance with PLT typing was observed for the DPB1*03 alleles, while in the DPB1*06 group, at least three variant DPB1*06 alleles were identified which have not been described previously. PMID- 2777340 TI - High frequency of H-2E0 alleles among wild mice. PMID- 2777341 TI - Complete sequences of DQA1 and DQB1 cDNA clones corresponding to the DQw4 specificity. PMID- 2777338 TI - Genetic and serological heterogeneity of the supertypic HLA-B locus specificities Bw4 and Bw6. AB - Gene cloning and sequencing of the HLA-B locus split antigens B38 (B16.1) and B39 (B16.2) allowed localization of their subtypic as well as their public specificities HLA-Bw4 or -Bw6 to the alpha-helical region of the alpha 1 domain flanked by the amino acid positions 74-83. Comparison of their amino acid sequences with those of other HLA-B-locus alleles established HLA-Bw6 to be distinguished by Ser at residue 77 and Asn at residue 80. In contrast, HLA-Bw4 is characterized by at least seven different patterns of amino acid exchanges at positions 77 and 80-83. Reactivity patterns of Bw4- or Bw6-specific monoclonal antibodies reveal two alloantigenic epitopes contributing to the HLA-Bw4 or -Bw6 specificity residing next to the region of highest diversity of the alpha 1 domain. PMID- 2777343 TI - Virulence of Vibrio vulnificus strains isolated from seafoods. AB - A study was carried out on the relation between virulence of V. vulnificus assessed by LD50 in mice and other markers. V. vulnificus strains isolated from seafoods had LD50 ranging from 10(3)-10(7) for mice. Strains showing LD50 10(6) or less were generally haemolytic and settled after boiling. Resistance to bactericidal action of serum and ability to take up congo red was shown by all the strains. PMID- 2777342 TI - Neutralisation of the new cholera toxin by antiserum against crude enterotoxin of cholera toxin gene-positive Vibrio cholerae 01 in rabbit ileal loop model. AB - The enterotoxicity of the new cholera toxin (NCT) prepared from cholera toxin gene-negative (CT-) V. cholerae 01 strains isolated from human diarrhoeal and environmental sources was assayed in rabbit ileal loops and the toxin unit was calculated to be 24 micrograms of protein. The enterotoxicity of the NCT preparations were completely neutralised by the antiserum raised against the enterotoxin preparation from the CT+ V. cholerae 01 strain 569B at 1 in 16 dilution in ileal loops. The antiserum contained 1 unit of antitoxin in 85 x 10( 4) ml amount. The data indicate that the antiserum prepared against the enterotoxin of CT+ strain contains antibody against the NCT and can neutralise the toxin in vivo. The observations also suggest that CT+ strains liberate the NCT simultaneously with CT and the latter gets eliminated during the process of purification. PMID- 2777344 TI - Use of eluates of filter paper blood spots in ELISA for the serodiagnosis of leprosy. AB - Blood samples were collected from 59 leprosy patients and 35 normal healthy subjects by veni-puncture and finger prick methods to obtain serum samples and blood spots on filter paper respectively. The serum samples at 1:300 dilutions and the eluates of dried blood spots at 1:40, 1:80, 1:160 and 1:320 dilutions were applied in ELISA to measure the antibody levels (IgM) against synthetic ND-O BSA antigen. The antibody levels were found to be high in the multibacillary leprosy patients than the pauci-bacillary patients irrespective of whether serum samples or eluates were used. The OD values obtained at 1:160 dilution of the eluates were equivalent to that of values obtained at 1:300 dilution of the serum samples. The positivities differ in different dilution of the eluates, showing the highest in the 1:40 dilution and the lowest in the 1:320 dilution. PMID- 2777345 TI - An ultrastructural study of donovanosis. AB - In an ultrastructural study undertaken on donovanosis, the inflammatory response was studied along with the fine structure of causative organisms, Calymmatobacterium granulomatis. Macrophages were seen to be activated and showed presence of numerous filopodia and increase in the number of lysosomes and rough endoplasmic reticulum. Many cells showed vacuoles of varying size in the cytoplasm some of which contained the organisms. Other cells seen included plasma cells, polymorphonuclear cells and sparse lymphocytes. In one case few multinucleated giant cells and dendritic cells with long cytoplasmic processes making cell-cell contact with other inflammatory cells were seen. Such cells have not been described in donovanosis so far. The organisms showed surface structures like pili and vesicles, the role of which is yet to be clearly understood. PMID- 2777347 TI - Preliminary investigation on antibacterial activity of some marine diatoms. AB - Seven species of marine diatoms were cultured under defined laboratory conditions. Air dried algal powder was used for extraction with different solvents in sequence. The algal extracts were tested against various bacteria by paper disc method. Nitzschia longissma, Skeletonema costatum and Biddulphia sinensis were effective against the test bacteria. Hemidiscus hardmannianus, Coscinodiscus centralis and Asterionella japonica showed moderate antibacterial activity. Pleurosigma elongatum exhibited no activity. The antibacterial substances were fully extracted by the organic solvents. Only in the active algal species, was activity noted in the aqueous extracts. PMID- 2777346 TI - Effect of heat-shock & nutritional stress on the expression of a neutral thiol protease in Leishmania donovani promastigotes. AB - The soluble intracellular protease was partially purified from L. donovani promastigotes. The activity of this enzyme increased with increase in temperature from 25 degrees C to 37 degrees C and was active optimally at 70 degrees C. This protease activity appeared to be decreased due to heat-shock of the promastigotes for 4 h at 37 degrees C and increased due to nutrient starvation. Inhibition of the protease by p-chloromercuribenzoate and iodoacetamide suggested that this enzyme could be a thiol protease. PMID- 2777348 TI - Primary carcinoma of gall bladder--a review of thirty six cases. AB - The study presents the clinicopathological findings in thirty six cases of primary carcinoma of gall bladder diagnosed at SKIMS Srinagar over a period of four years (1983-86). Particular attention was paid to age, sex, presenting symptoms, presence of gall stones and site of metastasis. Majority of patients were found to be middle aged females (24 out of 36 cases). Most common presenting symptom was abdominal pain and duration of symptoms was two months or less in majority of cases. Gall stones were found in 55.5% cases. Diagnosis of primary gall bladder carcinoma was an incidental histopathological finding in 22% patients. Well differentiated adenocarcinoma was found to be the commonest type of malignancy (77.7%). 33% cases had widespread metastatic disease at the time of operation and liver was the commonest site of invasion (47.2%). Follow up records of 21 out of 36 patients available show only two patients to be alive till date with more than two year follow up and in both these cases carcinoma was an incidental histopathological diagnosis at cholecystectomy. Rest of the patients had died within 5-6 months after surgery. This reinforces the poor outcome for primary gall bladder carcinoma patients irrespective of treatment unless diagnosed and treated at a very early stage. Long term survival can be expected in incidentally found carcinoma at cholecystectomy. PMID- 2777349 TI - Antibiotic sensitivity of enterobacteriaceae by disc diffusion and rapid fermentation sensitivity test methods. AB - A total of 400 strains of Gram negative bacilli were examined both by conventional disc diffusion (DD) and by rapid fermentation sensitivity test (RFST) methods. Various strains which were examined included Esch. coli Kleb. aerogenes, Kleb. pneumoniae, Prot. vulgaris, Prot. mirabilis, Prot. morgani, Prot. rittgeri and Providencia. The antibiotics used were streptomycin, chloramphenicol, kanamycin, gentamycin and ampicillin. The correlation between the two methods was found to vary from 75 to 98 per cent. By RFST method the results are obtained within six hours. The limitations of this method are (i) it cannot be used for Pseudomonas aeruginosa as it does not ferment glucose, (ii) it cannot be used for antibiotics active only at acidic pH like tetracycline and (iii) partial or intermediate sensitivity cannot be tested by this method. On the other hand, it is a simple, inexpensive, rapid and reliable method feasible in small laboratories also. The results are not affected by the size of inoculum or quality of medium (agar) used. Thus, it is very helpful especially when immediate antibiotic sensitivity is required. PMID- 2777350 TI - Mycotic keratitis in Madras. AB - Corneal scrapings from 698 clinically suspected cases of mycotic keratitis were investigated for evidence of fungal infection. Of these, 322 were found to be positive by direct examination and/or culture. The infection was predominantly seen in the age group 21-50. Men were more frequently affected than women. Majority of the patients were either agricultural workers or out door manual labourers and 66.8% of them gave a definite history of antecedent corneal trauma due to vegetable or soil matter. Asperyllus flavus was the commonest causal agent isolated from 55 cases (17.1%), followed by A. niger (13.7%), A. fumigatus (10.9%), A. terreus (1.2%), A. glaucus (0.9%), and Pseudoallescheria boydii (0.6%). The order of occurrence of the genera of fungi isolated was Aspergillus, Acremonium, Curvularia, Fusarium, Candida, Syncephalastrum, Penicillium, Aureobasidium, Drechslera, Cladosporium, Rhizopus, Alternaria, Mucor, Pseudoallecheria and lastly Paecilomyces and Trichoderma from one case each. PMID- 2777351 TI - In vitro comparative activity of kanamycin, gentamicin and sisomicin--a new aminoglycoside, against clinical isolates. AB - 540 strains of bacteria isolated from various clinical materials comprising 440 strains of Gram negative bacilli and 100 strains of Gram positive cocci were tested for their susceptibility in vitro to Kanamycin, Gentamicin and a new aminoglycoside antibiotic Sisomicin (Ensamycin). The sensitivity pattern revealed that 68.88% of the strains were sensitive to Kanamycin, 82.9% to Gentamicin and 89.0% to Sisomicin. The effectiveness of Sisomicin is comparatively greater (6.1%) than the other two aminoglycosides. In particular a considerable number of Gentamicin resistant Pseudomonas aeruginosa (12.3%) were found to be sensitive to Sisomicin which is a highly desirable property. Existence of about 11% Sisomium resistant strains even before the wide usage of this antibiotic is note worthy. PMID- 2777352 TI - Identification of C-3 on polyacrylamide gel by pre-staining the normal human serum with Remazol Brilliant Blue and raising monospecific anti C-3 antibody. AB - Based on our earlier work we hereby describe pre-staining of normal human serum with Remazol Brilliant Blue (RBB) to precisely locate the third component of complement system (C3,B1C) on polyacrylamide gels. Testing the dye-protein complex eluted from different immunoreactive post-transferrin (origin to transferrin) components against the standards anti-C3 antibody in various gel precipitation techniques, revealed that the prominent band just posterior to the centrally placed transferrin is of complement. Subsequent to its identity, we also evolved a method to raise an anti-C3 antibody. The resulting antibody was found to be monospecific when assessed in different gel precipitation procedures. PMID- 2777353 TI - Mediastinal non-Hodgkin's lymphoma involving right heart and dorsal vertebra. PMID- 2777354 TI - Effects of sewage contaminated river water on liver and kidney. An ultrastructural study. PMID- 2777355 TI - Cytologic diagnosis of thymoma by fine needle aspiration. PMID- 2777356 TI - "Aplastic anemia-paroxysmal nocturnal hemoglobinuria syndrome". PMID- 2777357 TI - Giant cell tumour of the sphenoid bone--a case report. PMID- 2777358 TI - Distribution of neurotoxic esterase in certain brain regions of laboratory animals. AB - Certain organophosphorous compounds caused the inhibition of 'neurotoxic esterase' present in central nervous system. The role of this enzyme is different from that of cholinesterase. The level of neurotoxic esterase in brain, corpus striatum and spinal cord of rats, mice, guineapigs and hens was measured. Maximum level of the enzyme was found in hens, followed by guineapigs, rats and mice in the order. The concentration of the enzyme was higher in corpus striatum greater than whole brain greater than spinal cord. The determination of the normal level of neurotoxic esterase may be useful in monitoring the exposure to organophosphorous compounds. PMID- 2777359 TI - Effect of yogasanas on the visual and auditory reaction time. AB - Visual and auditory reaction time (VRT, ART) was studied in 83 healthy male subjects of 30-40 years of age who had never practiced yogasanas before. These subjects were divided into two groups viz. Group A whose VRT and ART was determined after 1 hr. yogasanas and Group B whose ART and VRT was determined after 6 weeks yogasanas training programme. VRT and ART showed a significant reduction in Group A (P less than .05) and Group B (P less than .001). PMID- 2777360 TI - Effect of verapamil on gastric acid secretion and ulceration by pyloric-ligation and aspirin in albino rats. AB - Verapamil at doses 5, 10, 20 and 40 mg/kg, intraperitoneally (ip) and 40 mg/kg, orally reduced incidence of ulceration by Pyloric-ligation. Similarly verapamil inhibited aspirin-induced ulceration at a dose 40 mg/kg, orally and ip. Effect of verapamil on gastric acid secretion was also studied. At low dose it increased acid secretion significantly (5 mg/kg, ip) and at high dose (40 mg kg, ip and orally) it significantly decreased volume of secretion. This indicates that reduction of acid secretion contributes little to the antiulcer activity of verapamil because antiulcer effect was seen even at doses which did not decrease acid secretion. PMID- 2777362 TI - Biphasic effect of apomorphine on rodent motility. PMID- 2777361 TI - A comparative study of creatinine clearance rate in type I (IDDM) and II (NIDDM) diabetic patients. AB - The endogenous creatinine clearance test was done in 14 Type I and 15 Type II poorly controlled diabetic patients and compared with respective age matched healthy volunteers. Type I diabetics had significantly lower creatinine clearance rate, body mass index and serum albumin levels when compared to their control group. In Type II diabetics these values remained unaltered. Both Type I and Type II diabetics had significantly higher blood sugar and glycosylated haemoglobin levels. The creatinine clearance rate had significant positive correlation with patients' body mass index and serum albumin levels. This suggests that the undernutrition of Type I diabetics may be responsible for the decreased creatinine clearance. PMID- 2777363 TI - Relationship between birth weight and zinc status of newly born infants and their mothers. PMID- 2777364 TI - Effect of stress on behaviour in rats. AB - The pattern of activity obtained in rats on a regimen of one hour access to food and water was compared to the activity pattern seen when immobilization stress was added to the same regimen. Food and water were provided at the same time of the day. Immobilization stress decreased the body weight, increased the time taken for grooming, maintaining at the same time the food intake. The water intake also increased significantly but the alcohol intake was variable, 3 of the rats showing an increased intake while the rest showed a decreased intake under this stress regimen. The pattern of activity changed from hyper-activity during food restriction alone to increased activity restricted to the first half of the testing time during added immobilization. PMID- 2777365 TI - Cochlear toxicity of streptomycin in man. AB - Thirty five patients of either sex suffering from tuberculosis were administered streptomycin 0.75 g (im daily, upto 14 yr and above 45 yr of age) and 1 g (im daily for age 15-45 yr) with other antitubercular drugs and followed for audiological status. Five patients were dropped as they developed vestibular dysfunction. Varying degree of hearing loss was detected in 4 of 10 patients in group I (below 15 yr), in 2 of 9 patients in group II (15-45 yr) and in 6 of 11 patients in group III (above 45 yr). Cochlear toxicity of streptomycin was not found to be related to does or duration of therapy. Supportive therapy restored hearing in 2 patients of group I and 1 of group II. None of the patients in group III showed recovery. It is recommended that patients on long-term streptomycin therapy should be periodically subjected to audiometric examination to detect any hearing loss. PMID- 2777366 TI - Effect of stress on maternal behaviour. AB - Primiparous female rats subjected to foot shock and/or immobilization stress were tested for maternal behaviour (MB) by determining the pup retrieval rate (PRR) for 5 minutes. On the third day after parturition PRR significantly decreased when foot shock was given and the fall was more pronounced after immobilization both with and without foot shock. The animals exhibited enhanced MB on the 12th day as compared to the third day, but the stressful situations produced significant decreases in MB qualitatively similar to the third day. By the 20th day when the weaning was in progress the MB decreased to the 3rd day levels. This change in the MB may be due to the changes in the pattern of prolactin secretion during the post partum period. PMID- 2777367 TI - Effects of long term feeding of acetone extract of Momordica charantia (whole fruit powder) on alloxan diabetic albino rats. AB - Acetone extract of whole fruit powder of Momordica charantia a given orally daily lowered the blood sugar and serum cholesterol levels to normal range after 15 to 30 days in alloxan diabetic rats. The blood sugar once lowered after 30 days treatment did not increase even after 15 days of discontinuation of the treatment. PMID- 2777368 TI - Characterization of the macrophage subset affected and its response to a T suppressor factor (TsFmp) found in cryptococcosis. AB - Previous reports from our laboratory described the detection of a suppressor factor which inhibited the phagocytic activity of a macrophage subset in murine cryptococcosis and in classical models of immune tolerance. The suppressor factor was originally named PIL (phagocytosis-inhibiting lymphokine) but has recently been renamed TsFmp (T suppressor factor for macrophage phagocytosis) because it was found to resemble the antigen-specific I-J-restricted suppressor factors described by others. The current investigation revealed that TsFmp acted rapidly upon the macrophage (15 min or less) to exert its effect of inhibiting the phagocytic process. The time for the macrophage to recover from the effects of TsFmp was likewise very rapid. The ability of TsFmp to inhibit phagocytosis was limited to engulfment of particles by Fc and mannan receptors and did not extent to phagocytosis via complement receptors or by nonspecific mechanisms. The macrophage subset that responded to TsFmp was determined to be in the I-A+ and I J-IM+ subset. PMID- 2777369 TI - Antibody response to Ehrlichia risticii and antibody reactivity to the component antigens in horses with induced Potomac horse fever. AB - The antibody response and the antibody reactivity to component antigens of Ehrlichia risticii were studied in horses with induced Potomac horse fever. These horses had no detectable antibodies to E. risticii in their preinoculation (PrI) sera by indirect fluorescent-antibody assay and enzyme-linked immunosorbent assay (ELISA). All the horses exhibited typical disease features following experimental infection and responded with specific antibodies, as measured by ELISA and indirect fluorescent-antibody assay. A primary antibody response was detected in 70% of the horses, while a secondary-type antibody response was detected in 30% of the horses by ELISA. In the primary antibody response, a distinct titer was observed at 2 weeks postinoculation (PI), when the immunoglobulin M (IgM)/IgG ratio was 2 to 5, and the overall antibody titer peaked at 6 to 8 weeks PI. The secondary-type antibody response exhibited a characteristic titer at 1 week PI, the IgM and IgG titers were about equal at 2 weeks PI, and the overall antibody titer peaked at 6 weeks PI. A transient depression in the IgG response at 4 weeks PI was observed in both response types. The antibody was maintained at a high titer for over a year in all horses. Western immunoblot reactivity showed that the antisera collected from these infected horses at 4 to 5 weeks PI recognized some or all of the six major E. risticii component antigens (70, 55, 51, 44, 33, and 28 kilodaltons), all of which were apparent surface components. The 6- to 8 week PI antisera recognized up to 16 component antigens, including 9 major antigens (110, 86, 70, 55, 51, 49, 44, 33, and 28 kilodaltons). However, the PrI sera of these horses showed reactivity at various intensities with one to seven of the component antigens. There was no apparent correlation between this reactivity pattern and the subsequent antibody response types. PMID- 2777370 TI - Cloning and expression of Staphylococcus saprophyticus urease gene sequences in Staphylococcus carnosus and contribution of the enzyme to virulence. AB - The urease gene of Staphylococcus saprophyticus CCM883 was cloned and expressed in Staphylococcus carnosus TM300. In vitro translation of the cloned DNA sequences revealed six polypeptides (of 70, 47, 29, 27, 20, and 17 kilodaltons) that were associated with enzyme activity. Introduction of the cloned genes into a urease-negative mutant of S. saprophyticus restored the virulence of this strain, confirming our previous suggestion (S. Gatermann, J. John, and R. Marre, Infect. Immun. 57:110-116, 1989) that this enzyme is a major virulence factor of the organism and contributes mainly to cystopathogenicity. PMID- 2777371 TI - Regulation of serum tumor necrosis factor in glucocorticoid-sensitive and resistant rodent endotoxin shock models. AB - Bolus injection of lethal or sublethal doses of endotoxin or lipopolysaccharide (LPS) results in the rapid and transient rise in tumor necrosis factor (TNF) levels in serum in mammals. TNF levels peak between 1 and 2 h after LPS injection in mice and guinea pigs and approach basal levels by 6 h. Although the kinetics of TNF in serum appear similar between these two species, guinea pigs respond to a lethal dose of LPS of 20 mg/kg by producing approximately 10-fold more TNF than mice do. These two endotoxin shock models also differ in their sensitivity to glucocorticoids. TNF levels in serum are not reduced in the lethal endotoxin shock model in guinea pigs after treatment with dexamethasone at 25 mg/kg. In contrast, TNF levels in mouse serum are inhibited by more than 90% after treatment with dexamethasone at 3 mg/kg. Coincident with the TNF peak in serum is a leukopenia which approaches control levels by 6 h in dexamethasone-treated mice, while remaining depressed in dexamethasone-treated guinea pigs. Treatment with dexamethasone at 25 mg/kg did not save guinea pigs from endotoxin lethality, whereas long-term survival of mice under identical conditions was apparent. These results suggest that the relative glucocorticoid resistance observed in guinea pigs is also apparent in a lethal endotoxin shock model in which dexamethasone does not modulate TNF levels or result in increased survival as occurs in mice. The lack of clear efficacy for steroid therapy in human clinical septic shock trials would suggest that the guinea pig endotoxin model may be a more predictive system than the mouse model for the identification of novel agents useful in the treatment of endotoxin shock. PMID- 2777372 TI - Intraperitoneal host cellular responses and in vivo killing of Bacteroides fragilis in a bacterial containment chamber. AB - A bacterial containment chamber was used to evaluate the peritoneal cellular response to Bacteroides fragilis during intraperitoneal challenge. This containment system was also used to determine the fate of bacteria within the peritoneal cavities of animals immunized, either actively or through adoptive transfer of cells or cell lysates, with the capsular polysaccharide of B. fragilis. This system demonstrated that the dominant cell types in the peritoneal cavities within 48 h of implantation of the containment chambers containing B. fragilis were neutrophils and macrophages. However, the early cellular response in immunized animals included an increase in the lymphocyte population within 4 h of challenge which was not detected in naive animals. In immunized animals, a later dramatic increase in the lymphocyte population at approximately 4 to 6 days following implantation of the containment chambers occurred. This increase in the lymphocyte population in immunized animals coincided with a decline in the viable bacterial counts within the chambers from 10(8) to 10(9) CFU/ml to less than 10(2) CFU/ml. A similar decline was not seen in naive animals challenged in the same manner. Killing of B. fragilis within containment chambers occurred when spleen cells, T cells, or lysates of T cells from actively immunized animals were passively transferred to naive recipient animals. It was shown that the factor responsible for bacterial killing was not antibody mediated, since bacteria contained within dialysis sacs with an exclusion of 50 kilodaltons were still killed in this model. Moreover, removal of T cells from adoptively transferred cell populations before transfer abrogated the decline in viable bacterial populations. The postulated mechanisms by which this bacterial killing occurred are discussed. PMID- 2777373 TI - Differences in adhesion of Pseudomonas aeruginosa to mucin glycopeptides from sputa of patients with cystic fibrosis and chronic bronchitis. AB - Pseudomonas aeruginosa is the most prominent colonizer of the respiratory tract of patients with cystic fibrosis, but it is not known why this occurs. P. aeruginosa adheres to mucins from normal individuals, but mucins from cystic fibrosis patients have not been studied. To compare adhesion to mucins from cystic fibrosis with other mucins, we prepared highly glycosylated mucin glycopeptides from cystic fibrosis and chronic bronchitis patients by ion exchange and gel-filtration chromatography and measured the adhesion of P. aeruginosa 1244 to these glycopeptides. We found (i) that the most mucinlike glycopeptides from P. aeruginosa-infected cystic fibrosis sputa showed less bacterial adhesion than did the corresponding bronchitis samples, (ii) that the most adhesive activity in cystic fibrosis samples came from a fraction that contains O and N glycopeptides and may be in part a degradation product of P. aeruginosa infection, and (iii) that highly glycosylated glycopeptides of the most acidic species (sialylated and sulfated) showed no adhesion at all. A single cystic fibrosis sample not infected by P. aeruginosa showed better binding in the adhesion-positive fractions than did the infected sputa. These studies suggest that cystic fibrosis mucins may be altered after infection is established, resulting in less binding to some fragments. However, since the clinical picture shows heavy mucus colonization, other receptors, such as cellular glycolipids which have been shed into mucus, may be contributing to this colonization. PMID- 2777375 TI - Augmentation of the neutrophil response to Naegleria fowleri by tumor necrosis factor alpha. AB - Conditioned medium from phytohemagglutinin-stimulated human mononuclear leukocytes, previously shown to activate neutrophils for amoeba killing, was found to contain high levels of tumor necrosis factor alpha (TNF-alpha) by an enzyme-linked immunosorbent assay. The effects of human recombinant TNF-alpha on the response of human neutrophils to the pathogenic free-living amoeba Naegleria fowleri was studied in vitro. The data showed that recombinant human TNF-alpha augmented the neutrophil respiratory burst (assessed by the cytochrome c reduction assay and lucigenin-dependent chemiluminescence assay) in response to amoebae opsonized with human serum. The priming effects of TNF-alpha were transient; marked enhancement was found with short 5- to 30-min preincubations of neutrophils with the cytokine. The enhancement of oxygen radical production was evident with 20 U of TNF-alpha per 10(6) neutrophils and continued to increase with up to 100 U. TNF-alpha also augmented the neutrophil lysosomal enzyme release in response to N. fowleri. The results support previous reports suggesting an important role of neutrophil cytokine activation for effective immunity against free-living amoebae. PMID- 2777374 TI - Chemical differences in lipopolysaccharides from Actinobacillus (Haemophilus) actinomycetemcomitans and Haemophilus aphrophilus: clues to differences in periodontopathogenic potential and taxonomic distinction. AB - While Actinobacillus actinomycetemcomitans has been associated with rapidly progressive periodontal destruction in man, the closely related Haemophilus aphrophilus has not been related to periodontal disease. This may be due to differences in composition and structure of the lipopolysaccharides (LPS) of these dental-plaque bacteria, since LPS probably exerts a series of detrimental effects on the periodontium. LPS was prepared by the phenol-water procedure from the type strains of A. actinomycetemcomitans and H. aphrophilus, purified by hexane extraction and ultracentrifugation, and analyzed with gas chromatography and gas chromatography-mass spectrometry. While the lipid content of LPS from A. actinomycetemcomitans constituted 35.4%, it was only 18.4% in H. aphrophilus: 3 hydroxytetradecanoic and tetradecanoic acids were 21.1 and 14.3% in A. actinomycetemcomitans and 10.9 and 7.5% in H. aphrophilus. There were qualitative and quantitative differences in the polysaccharide portions of their LPS. A actinomycetemcomitans contained both D-glycero-D-mannoheptose and L-glycero-D mannoheptose (7.8 and 11.3%); H. aphrophilus contained only L-glycero-D mannoheptose (17.4%). The rhamnose, fucose, galactose, glucose, and glucosamine/galactosamine contents in A. actinomycetemcomitans were 2.6, 5.2, 10.1, 22.4, and 5.2%, respectively; in H. aphrophilus, they were 2.1, 2.6, 19.4, 36.4, and 3.7%. Chemical differences in LPS from A. actinomycetemcomitans and H. aphrophilus may contribute to the divergence in periodontopathogenic potential of these organisms and help taxonomic differentiation. PMID- 2777376 TI - Analysis of endotoxin fever in rabbits by using a monoclonal antibody to tumor necrosis factor (cachectin). AB - A murine monoclonal antibody to rabbit tumor necrosis factor (TNF; cachectin) was injected intravenously into an endotoxin-treated rabbit to examine the role of endogenous TNF in fever. Both early and late peaks of biphasic fever evoked by the endotoxin injection were suppressed by the antibody. TNF activity was detected in an endotoxin dose-dependent manner in the blood 1 h after the endotoxin injection, which was coincident with the early-peak fever. Although the late-peak fever responded to the antibody, no significant TNF activity was detected in the blood obtained 1 h before the peak response. The blood was found to contain endogenous pyrogen activity, which was stable after heating at 70 degrees C for 30 min and resistant to in vitro treatment with the antibody. Rabbit TNF injection also elicited biphasic fever in rabbits, the second phase of which was found to be mediated by the similar endogenous pyrogen. These results suggest that endogenous TNF plays an important role in eliciting a febrile response to endotoxin. PMID- 2777377 TI - Purification, composition, and activity of two bactenecins, antibacterial peptides of bovine neutrophils. AB - Extracts of granules of bovine neutrophils are known to exhibit a marked antibacterial activity in vitro. By a simple, two-step chromatographic procedure, we have resolved two peptide components of the antibacterial system. They were named Bac-5 and Bac-7 from the general term bactenecin and had molecular masses of about 5 and 7 kilodaltons, respectively. Over 45 and 20% of the amino acid residues in the two bactenecins are proline and arginine, respectively. The remaining amino acids are mainly hydrophobic (isoleucine, leucine, and phenylalanine). Both Bac-5 and Bac-7 efficiently kill Escherichia coli, Salmonella typhimurium, and Klebsiella pneumoniae. They also arrest the growth of Enterobacter cloacae (MICs, 25 to 200 micrograms/ml) but not of Proteus vulgaris, Staphylococcus aureus, and Streptococcus agalactiae (MIC, greater than 200 micrograms/ml). Finally, Bac-7 but not Bac-5 has MICs of less than or equal to 200 micrograms/ml for Pseudomonas aeruginosa and Staphylococcus epidermidis. From the comparison between the efficient bactericidal concentrations in vitro and the estimated content of bactenecins in neutrophils (125 ng of Bac-5 and Bac-7 each per 10(6) cells), it is reasonable to conclude that the two cationic peptides may exert a major role in host defense against at least some microorganisms. PMID- 2777379 TI - Inhibition of coaggregation between Fusobacterium nucleatum and Porphyromonas (Bacteroides) gingivalis by lactose and related sugars. AB - The coaggregation of Fusobacterium nucleatum PK1594 and Porphyromonas (Bacteroides) gingivalis PK1924 was inhibited equally well by lactose, N-acetyl-D galactosamine, and D-galactose, which caused 50% inhibition of coaggregation at 2 mM sugar concentration. Other sugars such as D-galactosamine, D-fucose (6-deoxy-D galactose), and alpha-methyl- and beta-methyl-D-galactosides also inhibited coaggregation. Sugar specificity was apparent, since neither L-fucose, L rhamnose, N-acetyl-D-glucosamine, nor N-acetylneuraminic acid was an inhibitor. Protease treatment of the fusobacterium completely abolished coaggregation, whereas it had no effect on the coaggregating activity of the porphyromonad. Although numerous lactose-inhibitable coaggregating pairs are known to occur among gram-positive bacteria, this report and the accompanying survey (P. E. Kolenbrander, R. N. Andersen, and L. V. H. Moore, Infect. Immun. 57:3194-3203, 1989) are the first studies demonstrating the extensive nature of this type of interaction between gram-negative human oral bacteria. The significance of galactoside-inhibitable coaggregations between these two potential periodontal pathogens is discussed. PMID- 2777378 TI - Coaggregation of Fusobacterium nucleatum, Selenomonas flueggei, Selenomonas infelix, Selenomonas noxia, and Selenomonas sputigena with strains from 11 genera of oral bacteria. AB - Twenty-eight strains of Fusobacterium nucleatum and 41 Selenomonas strains, including S. sputigena (24 strains), S. flueggei (10 strains), S. infelix (5 strains), and S. noxia (2 strains), were tested for their ability to coaggregate with each other and with 49 other strains of oral bacteria representing Actinobacillus, Actinomyces, Bacteroides, Capnocytophaga, Gemella, Peptostreptococcus, Porphyromonas, Propionibacterium, Rothia, Streptococcus, and Veillonella species. Selenomonads coaggregated with fusobacteria and with Actinomyces naeslundii PK984 but not with any of the other bacteria, including other selenomonads. In contrast, fusobacteria coaggregated with members of all genera, although not with all strains of each species tested. Each fusobacterium strain appeared to have its own set of partners and coaggregation properties, unlike their partners, whose coaggregation properties in earlier surveys delineated distinct coaggregation groups. Coaggregations of fusobacteria with the 63 gram-negative strains were usually inhibited by EDTA, whereas those with the 27 gram-positive strains were usually not inhibited. Likewise, lactose inhibitable coaggregations were common among some strains of fusobacteria and some strains from each of the genera containing gram-negative partners but were rarely observed with gram-positive partners. Heating the fusobacteria at 85 degrees C for 30 min completely prevented coaggregation with most partners, suggesting the involvement of a protein on the fusobacteria. Heat treatment of many of the gram-negative partners not only enhanced their coaggregation with the fusobacteria but also changed lactose-sensitive coaggregations to lactose insensitive coaggregations. Although fusobacteria coaggregated with a broader variety of oral partner strains than any other group of oral bacteria tested to date, each fusobacterium exhibited coaggregation with only a certain set of partner strains, and none of the fusobacteria adhered to other strains of fusobacteria, indicating that recognition of partner cell surfaces is selective. The strains of F. nucleatum are heterogeneous and cannot be clustered into distinct coaggregation groups. Collectively, these results indicate that coaggregation between fusobacteria and many gram-negative partners is significantly different from their coaggregation with gram-positive partners. The contrasting variety of partners for fusobacteria and selenomonads supports the concept of coaggregation partner specificity that has been observed with every genus of oral bacteria so far examined. PMID- 2777380 TI - Human hyperimmune globulin protects against the cytotoxic action of staphylococcal alpha-toxin in vitro and in vivo. AB - Alpha-toxin, the major cytolysin of Staphylococcus aureus, preferentially attacks human platelets and cultured monocytes, thereby promoting coagulation and the release of interleukin-1 and tumor necrosis factor. Titers of naturally occurring antibodies in human blood are not high enough to substantially inhibit these pathological reactions. In the present study, F(ab')2 fragment preparations from hyperimmune globulin obtained from immunized volunteers were tested for their capacity to inhibit the cytotoxic action of alpha-toxin in vitro and in vivo. These antibody preparations exhibited neutralizing anti-alpha-toxin titers of 80 to 120 IU/ml, whereas titers in commercial immunoglobulin preparations were 1 to 4 IU/ml. In vitro, the presence of 2 to 4 mg of hyperimmune globulin per ml protected human platelets against the action of 1 to 2 micrograms of alpha-toxin per ml. Similarly, these antibodies fully protected human monocytes against the ATP-depleting and cytokine-liberating effects of 0.1 to 1 microgram of alpha toxin per ml. Intravenous application of 0.5 mg (85 to 120 micrograms/kg of body weight) of alpha-toxin in cynomolgus monkeys elicited acute pathophysiological reactions which were heralded by a selective drop in blood platelet counts. Toxin doses of 1 to 2 mg (170 to 425 micrograms/kg) had a rapid lethal effect, the animals presenting with signs of cardiovascular collapse and pulmonary edema. Prior intravenous application of 4 ml of hyperimmune globulins per kg inhibited the systemic toxic and lethal effects of 1 mg (200 micrograms/kg) of alpha-toxin. In contrast, normal human immunoglobulins exhibited no substantial protective efficacy in vitro and only marginal effects in vivo. It is concluded that high titered anti-alpha-toxin antibodies effectively protect against the cytotoxic actions of alpha-toxin. PMID- 2777381 TI - Release of merozoite dense granules during erythrocyte invasion by Plasmodium knowlesi. AB - We used immunoelectron microscopy to study the fate of dense granules during the invasion of erythrocytes by Plasmodium knowlesi merozoites. When merozoites entered host cells, dense granules moved to the pellicle, released their contents into the parasitophorous vacuole space, and then moved into fingerlike channels of the vacuole membrane. This is the first report showing that the content of dense granules of P. knowlesi is different from the contents of rhoptries and micronemes and is associated with the formation of channels from the parasitophorous vacuole. PMID- 2777382 TI - Virulence, persistence, and immunogenicity of Yersinia enterocolitica O:8 aroA mutants. AB - The virulent Yersinia enterocolitica strain 8081 killed BALB/c mice within 5 days of oral infection with a 50% lethal dose of log10 7.1, whereas an aroA mutant of 8081, YAM.1, and the plasmidless variant 8081c failed to kill mice. Unlike 8081, YAM.1 and 8081c did not persist or grow in the Peyer's patches, mesenteric lymph nodes, livers, or spleens of mice. Mice immunized orally with single doses of live YAM.1 were poorly protected against a lethal 8081 challenge, whereas mice immunized with three doses of YAM.1 were moderately well protected. PMID- 2777383 TI - Identification of an immunodominant antigenically conserved 32-kilodalton protein from Cowdria ruminantium. AB - Western blotting (immunoblotting) of Cowdria ruminantium antigens with goat or mouse antiserum identified a periodate-resistant, proteinase K-sensitive immunodominant antigen of 32,000 daltons. This protein, designated Cr32, could be demonstrated in goat choroid plexus infected with one of two different Cowdria stocks. Antisera against nine different Cowdria stocks from Africa and the Caribbean region recognized Cr32, which indicates that this protein contains conserved antigenic determinants. PMID- 2777384 TI - Immunoelectron microscopy of lipopolysaccharide in Chlamydia trachomatis. AB - Monoclonal antibodies (MAb) specific for Chlamydia trachomatis lipopolysaccharide (LPS) and major outer membrane protein (MOMP) were used for immunoelectron microscopy analysis. MAb specific for MOMP showed strong reaction with the chlamydial surface, whereas MAb specific for LPS showed strong association of gold particles with the periphery of the chlamydial body. After fixation of the chlamydia cells, the reactivity was, however, similar to the anti-MOMP reactivity. Enzyme-linked immunosorbent assay showed that MAb specific for LPS could remove LPS from the chlamydial membrane. PMID- 2777385 TI - Small airways function in workers processing polyvinylchloride. AB - In a polyvinyl chloride (PVC) processing plant, 20 workers employed as machine attendants and calender operators, and thus exposed to PVC thermal degradation products (PTDP) and phthalic acid esters (PAE; up to 2 mg/m3), were studied. The control group was 19 unexposed workers. The exposed subjects had more symptoms from eyes and upper airways than the controls, probably mainly associated with PTDP. Two (10%) exposed workers had mild work-related asthma vs no control; five (25%) vs one (5%) symptoms of unspecific bronchial hyperreactivity. One exposed subject had a significantly raised level of IgG against phthalic anhydride, indicating that sensitization can occur in PVC processing. No significant differences were found between exposed and control subjects with regard to spirometry (VC, FEV1, FEF50, FEF75) or volume of trapped gas (VTG, an indicator of small airways disease) before or after metacholine inhalation. Thus, we could not find effects of PTDP or PAE on the small airways. PMID- 2777386 TI - Quantitative estimation of aesthesiometric thresholds for assessing impaired tactile sensation in workers exposed to vibration. AB - To evaluate the usefulness of aesthesiometric threshold testing in the quantitative assessment of peripheral sensorineural disorders occurring in the hand-arm vibration syndrome, two point discrimination (TPD) and depth sense perception (DSP) thresholds were measured by means of two aesthesiometers in the fingertips of 65 forestry workers exposed to chain saw vibration and 91 healthy males unexposed to local vibration or neurotoxic chemicals. Among the healthy subjects, divided into three age groups, there was no difference in the mean values of TPD and DSP thresholds. Assuming 1.28 or 2 standard deviations above the mean to be the upper limits of normality, in the present study the threshold values for TPD were 2.5 and 3.13 mm, respectively. Using the same assumptions, the normal threshold values for DSP were 0.36 and 0.49 mm. Among the 65 chain saw operators the prevalence of peripheral sensory disturbances was 70.8%. On the basis of the aesthesiometric results obtained for the group of 46 chain sawyers affected with sensorineural symptoms and a control group of 46 manual workers, the specificity of the aesthesiometric testing method was found to range between 93.4 and 100%, while the sensitivity varied from 52.2 to 71.7%. In its predictive value aesthesiometry had a positive accuracy of 84.6-96.0% and a negative accuracy of 42.8-50.0%. Aesthesiometric testing was able to differentiate between normals and vibration workers with sensory disturbances on a group basis (P less than 0.001), but due to the high rate of false negatives among vibration exposed patients, it was unsuitable to confirm objectively sensorineural symptoms on an individual basis.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2777387 TI - Hearing of forest workers with vibration-induced white finger: a five-year follow up. AB - To examine the association between vibration-induced white finger (VWF) and hearing loss, 108 male forest workers who regularly used vibrating tools were followed up for five years. Case-control pairs matched for initial age and hearing level and exposure time to noise during the study period were selected from men with and without VWF. The hearing levels significantly worsened during the follow-up period at 2, 4 and 8 kHz in the affected cases but only at 8 kHz in the controls. Since threshold shift at 4 kHz, which is a typical effect of noise exposure, was significant only in the affected cases, it is suggested that the hearing of people with VWF was more vulnerable to noise. A pathological change causing VWF might also increase the susceptibility of hearing to noise damage. PMID- 2777389 TI - Urinary metabolite levels in workers handling p-tert-butylphenol as an index of personal exposure. AB - Occupational exposure to p-tert-butylphenol (PTBP) was studied in a workplace where workers were engaged in packing this alkylphenol in bags or transporting the bags by fork-lift. The geometrical mean of eight-hour-time-weighted-average (8 h-TWA) value for personal ambient PTBP level of the packers was 0.39 mg/m3 (n = 15), higher than that of the carriers (0.10 mg/m3, n = 5). Amounts of PTBP collected in the respirators used by the workers were in proportion to the 8 h TWA values but lower than the estimated theoretical amounts; considerable amounts of PTBP were assumed to be absorbed through the respiratory tract. The urine excreted during the latter half of the shift showed the highest levels of PTBP (geometrical mean: packer, 5.07 micrograms/ml, n = 20; carrier, 3.03 micrograms/ml, n = 8). When the workers were away from the workplace, PTBP levels decreased; most was excreted within 24 h. Correlation between the urinary PTBP levels and 8 h-TWA values was significant (r = 0.46, n = 19, P less than 0.05), but its extent was weak. The total amounts of urinary PTBP excreted for 24 h after the start of the shift were two to three times higher than the estimated respiratory absorption of PTBP; PTBP was assumed to be absorbed not only through the respiratory tract but also through intact skin. It was concluded that the personal ambient PTBP level is not a suitable index for personal exposure, and biological monitoring via the PTBP level in the urine excreted at the end of the each shift is useful for the evaluation of personal exposure. PMID- 2777388 TI - Changes induced by short-term xylene exposure in human evoked potentials. AB - Nine healthy male volunteers were exposed to m-xylene for 3 h in the morning and 40 min in the afternoon with a 40-min break in between. The atmospheric m-xylene concentrations were either stable at 8.2 mumol/l (200 ppm) or they fluctuated (5.2-16.4 mumol/l; 135-400 ppm) with peaks of 16.4 mumol/l and duration of 20 min at the beginning of each exposure session. The subjects were either sedentary or exercised at 100 W for 10 min at the beginning of each session during both exposure types. The two control days, with and without exercise, were similar to the exposure days but without exposure. Evoked potentials were recorded in the morning before the exposure and immediately after the morning and afternoon sessions. Visual evoked potentials were studied to a pattern reversal stimulus (pattern VEP) and to a light flash (flash VEP). For pattern VEPs the latencies of P50, N70, P100, N135 and P170 as well as the peak-to-peak amplitude of N70 to P100 were measured. For flash VEPs the latencies of P50, N70, P100, N150 and P200 as well as the peak-to-peak amplitude of P100 to N150 were measured. Short latency auditory evoked potentials arising in the brainstem (BAEP) were recorded for a click stimulus. The peaks I, II, III, IV and V were identified from the grand averages. The effect of various exposure paradigms was evaluated by comparing the individual changes on an exposure day to those during the control days.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2777390 TI - Raynaud's phenomenon of fingers and toes of miners exposed to local and whole body vibration and cold. AB - In a study of 27 underground miners exposed to hand or whole-body vibration, cold or other vasoconstrictive environmental factors, higher prevalences of Raynaud's phenomenon in both fingers and toes were found than in a control group not exposed to vibration. There were no Raynaud-like phenomena among miners not exposed to vibration. There was a positive correlation between the two locations. This may mean a general susceptibility of vasospasm, but it seems more probable that the disorders are caused by vibration exposure to fingers and toes. PMID- 2777391 TI - Diurnal variations of blood pressure in shift workers during day and night shifts. AB - The dependence of blood pressure upon internal rhythms and the short-term effects of shift rota on the blood pressure were investigated in shift workers. Blood pressure was measured every 30 min using automatic records for 24h in 17 physically working men in a chemical factory during their morning and night shifts. There were no differences of the mean blood pressure between the respective sleeping phases or between the working periods. The amplitudes of circadian blood pressure variations were equal. There was a phase difference of 8h corresponding to the lag between the working periods. At this 8-h lag the hourly means of the 24-h blood pressure were closely correlated (r=0.69). Comparisons of 24-h blood pressure profiles during the first and last days of night shift week showed that the effects of night work on the blood pressure were already fully developed within the first 24h (r=0.86). Thus the diurnal variations of the blood pressure are determined by the working and sleeping periods and largely independent of endogenous rhythm. There is no short-term alteration of the mean 24-h blood pressure after shift rota. PMID- 2777393 TI - Cardio-respiratory studies on glass bangle workers. AB - Cardio-respiratory functions were recorded in 18 glass bangle workers (Belanias) who worked near the belan furnace continuously for 2 h. The workers were exposed to high ambient temperature (tDB 38.2 degrees C +/- 3.4 degrees C) and thermal radiation (tG 46.2 degrees C +/- 5.1 degrees C) during their work. The physiological responses recorded after the work spell at 1 (R1) 3 (R3) and 5 (R5) minute intervals exhibited incomplete recovery. The oral temperature remained significantly high (0.74 degrees F +/- 0.27 degrees F) even at R5 and never reached pre-work value. Similarly the heart rate values remained very high (26.4 +/- 5.4 beats/min) at R1, (10.7 +/- 3.9 beats/min) at R3 and (4.01 +/- 2.4 beats/min) at R5 periods during recovery, thereby showing that heart rate did not regain the pre-work status. The incomplete recovery in heart rate revealed cardiac stress in the exposed workers. Besides the cardiac stress, the cardiac cost of the work under the prevailing hot conditions in the glass bangle industry was very high, adding further to circulatory strain in these workers. Almost all the exposed workers were found to have hyperventilation syndrome characterized by increased respiratory frequency and tidal volume resulting in ventilatory stress induced by physical and physiological heat. PMID- 2777392 TI - Occurrence and specificity of IgE antibodies to isocyanates in occupationally exposed workers. AB - The levels of IgE antibodies specific for toluene-diisocyanate (TDI), diphenylmethane-diisocyanate (MDI) and hexamethylene-diisocyanate (HDI) were determined in eight workers with an unequivocal history of professional asthma, all having been exposed to isocyanates in the working atmosphere. Five workers were examined at the clinical onset of asthma. They had serum IgE antibodies specific for TDI, MDI and HDI, and depressed pulmonary ventilation parameters. In contrast, three workers, who had only a mild bronchial obstruction at the time of testing, had no anti-isocyanate IgE antibodies. The results indicated that asthma was induced by type I allergic reaction, but other pathogenetic mechanisms of bronchoobstruction could not be completely ruled out. PMID- 2777394 TI - Climatic factors and peritonitis in CAPD patients. AB - From March 1983 to December 1987 the relation of the occurrence of all episodes of peritonitis in CAPD patients to climatic factors, such as temperature and relative humidity was examined. Altogether 389 episodes were recorded in 239 patients. Peritonitis due to Staphylococcus epidermidis, Gram-negative organisms and culture-negative episodes was most frequent during the hot months of the year, June to October. The occurrence of peritonitis due to Staphylococcus aureus was uniformly distributed throughout the year. Relative humidity did not seem to affect the frequency of peritonitis. PMID- 2777395 TI - Gore-tex versus Oreopoulos peritoneal catheters: clinical evaluation and comparison. AB - Ten Gore-tex and ten Oreopoulos peritoneal catheters were evaluated in a comparative clinical trial with an average follow-up of 13 1/2 months per catheter. Catheter survival was significantly poorer in the Gore-tex group (p = 0.0016) because of catheter-related complications like tunnel infections, fissure, migration and painful catheter which made it necessary to remove seven Gore-tex catheters. Substantial corrections of the Gore-tex catheter design are proposed. PMID- 2777396 TI - Removal of cephalosporins by continuous arteriovenous ultrafiltration (CAVU) and hemofiltration (CAVH). AB - Cephalosporins are used with increasing frequency for sepsis treatment in patients receiving CAVU and CAVH. The different cephalosporins share the same basic molecular structure, yet they exhibit varied extent of plasma protein binding. Different amounts of the antibiotics may be removed by the ultrafiltration procedure because of these variations of physicochemical properties. We evaluated the sieving of eight new cephalosporins across the hemofilter membrane using an in vitro model. Bovine blood was perfused through polysulfone membranes at blood and ultrafiltrate flow rates of 100 and 20 ml/min respectively. Arterial plasma, venous plasma and ultrafiltrate drug concentrations were used to determine sieving coefficients. The sieving coefficients correlated well with the ultrafiltrate-arterial plasma drug concentration ratio (r = 0.679-0.972) but poorly with the extent of protein binding. Factors other than protein binding may therefore affect the drug sieving. Based on the findings, it was predicted that 0.2-21.9% of the daily cephalosporin dose may be removed by the CAVU and CAVH treatment. The need to alter drug dosages depends on the techniques of the ultrafiltration and hemofiltration procedure, the kinetics of the cephalosporins in patients, the sensitivity of the pathogen and the nature of the infection. PMID- 2777397 TI - Conceptual and design features of a practical, clinically effective intravenous mechanical blood oxygen/carbon dioxide exchange device (IVOX). AB - Conceptual and design features of a new intravascular blood gas exchange device include: placing multiple, thin-walled microporous hollow fibers in an elongated arrangement with a small overall outside diameter; covering the outer surface of each microporous hollow fiber with an ultra-thin continuous silicone coating; forming the hollow fibers into a configuration that produces disturbed flow of blood over the external surface of each fiber; placing the device in the subject's vena cava through a femoral or jugular venotomy; producing a flow of oxygen through the lumens of the hollow fibers, permitting exchange of oxygen and carbon dioxide between the venous blood outside and the gas inside the hollow fibers. Based on these principles, a practical, easily insertible, disposable, intravenacaval blood gas exchange device (IVOX) has been fabricated. Currently, devices with from 2,000 to 6,000 square centimeters of gas transfer surface area are being placed in the vena cavae of dogs and sheep for up to 7 days without altering the animal's hemodynamics, without producing serious hematologic sequelae, and with the capability of transferring in excess of 100 ml of oxygen and carbon dioxide to and from the venous blood of an intact, awake, standing animal. Clinical trials on human subjects with severe, acute, potentially reversible respiratory failure are in the planning stage. PMID- 2777398 TI - Surface modification of copolyether-urethane catheters with poly(ethylene oxide). AB - Pellethane 2363 80A catheters were modified with poly(ethylene oxide) in order to improve their blood compatibility. Contact angle measurements showed that Pellethane 2363 80A surfaces had increased wettability after this modification. The results of in vitro blood compatibility tests showed that surface modification with poly(ethylene oxide) resulted in a five-fold reduction of platelet deposition. Activation of coagulation was not affected. PMID- 2777399 TI - Clinical application of cascade filtration combined with glassbead adsorbents in cancer patients. AB - Cascade filtration (CF) was applied to patients with advanced cancers. To selectively remove immunosuppressive factors with molecular weight lower than albumin, adsorbents combined with CF were examined. Among 11 kinds of adsorbents, glassbead adsorbents with pore size 100A were the most effective in adsorbing such substances. Clinically, a column packed with glassbead adsorbents was concomitantly used with CF. The second filtrate was passed through the column and returned to the patient. The removal rate of immunosuppressive substances with molecular weight lower than albumin was only 20% by CF alone, but more than 50% by CF combined with glassbead adsorbents. Clinical symptoms such as severe back pain and general malaise were drastically improved during and after therapy. These results suggest that CF combined with glassbead adsorbents is an effective adjunctive modality to cancer therapy. PMID- 2777400 TI - Abstracts of the XVIth ESAO Congress. European Society for Artificial Organs. Brussels, 13-15 September 1989. PMID- 2777401 TI - Evaluation of renal functions--a computer programme. AB - The authors describe the operational characteristics of a computer programme, which they developed and routinely use, to facilitate the evaluation of renal function tests data. Upon input of the necessary biochemical parameters the values of the various clearances, fractional excretions and other indices and ratios obtained from renal function tests are calculated. The computer programme provides an output of diagnostic commentaries in text format for further evaluation by the attending physician. The programme is written in FORTRAN IV language. PMID- 2777402 TI - Long-term spectral analysis of heart rate variability--an algorithm based on segmental frequency distributions of beat-to-beat intervals. AB - Reduced heart rate variability has been reported as a predictor of long-term mortality in recent myocardial infarction patients. However, it has not been systematically investigated whether the reduction in heart rate variability in those post myocardial infarction patients who later suffer death or severe arrhythmias is caused by a reduction of short-term variability of heart rate (such as respiratory arrhythmia) or whether the differences in long term variability (such as diurnal rhythm) are involved. In order to perform such an evaluation, a new algorithm has been developed which permits different wavelength components (including the long-term components due to diurnal rhythm) of heart rate variability to be approximated. In general, the method uses segmental frequency distributions of durations of intervals between successive normal cardiac beats. To assess the spectral components of heart rate variability, a scale of wavelength limits is used and for each limit of this scale, the algorithm excludes the rate changes of wavelength longer than the given bound. The method was applied to the analysis of electrocardiograms recorded in 14 post myocardial infarction patients who later suffered death or ventricular tachycardia, and in 14 other randomly selected patients with an uncomplicated course following acute myocardial infarction. The rate variability spectra obtained for both groups of patients were compared statistically and the results showed that the groups of positive and negative cases were most significantly distinguished when including both short- and long-term components of heart rate variability. Separate evaluation of different wavelength components showed that the very long-term components of heart rate variability were more powerful in distinguishing between positive and negative cases than the short term components. PMID- 2777403 TI - Seroepidemiologic survey for antibodies to human retroviruses in human and non human primates in Brazil. AB - The prevalence of antibodies to HTLV-I and HIV-I in Brazil was determined by testing sera from: (a) 119 members of an isolated Amazonian community of African origin; (b) 100 voluntary blood donors in Rio de Janeiro; (c) 215 patients treated at the Hematology Service, National Cancer Institute, Rio de Janeiro, and (d) 44 Cebus apella New World monkeys, wild-caught in Amazonia. Anti-HTLV-I was detected in 1 (0.84%) of 119 Amazonians, in 8 (3.72%) of the 215 patients and in none of the blood donors or monkeys. The high prevalence found in patients included 4 (5.79%) of 69 with non-Hodgkin lymphoma, 2 (5.88%) of 34 with Hodgkin lymphoma, 1 (16.66%) of 6 patients with diagnosis of anemia and 1 (20%) of 5 with HIV-I infection. Anti-HIV-I was found in 7 (14.89%) of 47 patients and in none of the other groups. The high incidence of HTLV-I infection in the patient group suggests that this retrovirus is endemic in parts of Brazil. PMID- 2777404 TI - Expression of TGF-beta and procollagen type I and type III in human gastric carcinomas. AB - To elucidate the difference between scirrhous and non-scirrhous gastric carcinomas, we examined the expressions of TGF-beta, procollagen type I and type III in 7 gastric carcinoma cell lines and 37 gastric carcinoma tissues, and also examined the effect of TGF-beta on the expression of procollagen mRNA by TMK-I cells. TGF-beta mRNA was detected in all the tumors examined in vivo and in vitro. Interestingly, 9 (90%) of 10 scirrhous gastric carcinomas revealed higher levels of TGF-beta mRNA than normal tissues, while 8 (38%) of 21 well differentiated adenocarcinomas had higher TGF-beta mRNA levels than normal tissues. As for procollagen mRNA, most of the human gastric carcinoma cell lines expressed type-I procollagen mRNA and MKN-I expressed type-III procollagen mRNA. Furthermore, procollagen type-I mRNA accumulation in TMK-I cells was increased by exogenous TGF-beta. Most of the tumor tissues from surgical specimens expressed higher procollagen mRNA than normal tissues. These results indicate that TGF-beta produced by carcinoma cells might stimulate collagen synthesis not only by fibroblasts but also by carcinoma cells themselves, leading to diffuse fibrosis of scirrhous gastric carcinomas. PMID- 2777406 TI - Colorectal carcinoma in Hong Kong Chinese. A pathological survey of 1,117 cases, 1972-1981. AB - Hong Kong Chinese, when compared with the world population, have an intermediate incidence rate for colorectal carcinoma. The purpose of this retrospective analysis of a large number of colorectal carcinomas (1,117 cases) was to explore possible differences between this series and others, and to re-examine the divergent features reported in a smaller series. The present study revealed a distribution by age, sex, site and Dukes' stage, as well as histopathological features, which were analogous to those reported from other countries. Thus, while the incidence is lower in this group, the other manifestations of the disease are very similar to those seen elsewhere. The implication is that, apart from varying incidence, there is a global similarity among colorectal tumours. PMID- 2777405 TI - Histologic types of breast carcinoma in relation to international variation and breast cancer risk factors. WHO Collaborative Study of Neoplasia and Steroid Contraceptives. AB - Associations between breast cancer risk factors and histologic types of invasive breast carcinoma were studied in 2,728 patients. Lobular and tubular carcinomas occurred with increased relative frequency in most high-risk groups. The proportion of these types increased with age to a maximum at 45-49 years and decreased in the following decade. Significantly increased proportions of lobular and tubular carcinomas were also associated with high-risk countries, prior benign breast biopsy, bilateral breast cancer, concurrent mammary dysplasia, high age at first live birth, never-pregnant patients compared to those with a first live birth before age 20, private pay status, and length of education. Nonsignificant increases were associated with family history of breast cancer, less than 5 live births, less than 25 months total of breast feeding, use of oral contraceptives or IUD, and high occupational class. As a general trend, the higher the overall relative risk, the higher the proportion of lobular and tubular carcinomas. The occurrence of other histologic types also increased with increased breast cancer risk, but to a smaller degree than for lobular/tubular carcinomas. It is suggested that all hormonally related, socio-economic and geographic risk factors exert their effect by selectively increasing number of lobular cells at risk. Family history of breast carcinoma and age over 49 years did not follow the general trend parallel increases in the proportion of lobular/tubular carcinomas and breast cancer risk, and may operate through other mechanisms. PMID- 2777407 TI - Familial susceptibility to breast cancer: a complex inheritance. AB - The main results of segregation analysis aimed at identifying a major genetic factor involved in susceptibility to breast cancer are reviewed. They show that the existence of a single major gene is not sufficient to explain the distribution of the disease observed in the families concerned and suggest that the genetic inheritance involved is heterogeneous and complex. Heterogeneity has been explored in various studies according to epidemiological criteria. From these analyses, genetically homogeneous subgroups emerged (for instance families with breast cancer only or with affected males). The study of such homogeneous subgroups might help to better locate the susceptibility gene(s) on the chromosome map by analysis of genetic linkage using different markers. The results of segregation analysis depend on how epidemiological factors are taken into account. It is of major importance that epidemiological data on the proband (i.e., the individual prompting selection of a family) as well as on the members of his/her family are taken into consideration to improve understanding of the complexity of breast cancer transmission. PMID- 2777408 TI - A survey of the human T-cell lymphotropic virus type I (HTLV-I) in south-western Colombia. AB - To evaluate altitude of birthplace and residence as factors associated with geographic clustering of HTLV-I infection in Colombia, we sampled a total of 670 current residents of the South Pacific coastal lowland and of upland regions (Cali and environs) of the Valle and Cauca Provinces, located at an altitude of 3,100 ft. Among the 255 lowland study subjects, 4.3% had antibody against HTLV-I, compared to 0.9% of the 415 upland study subjects. A hypothesis emerging from this study is that the lower socio-economic status of lowland residents and associated diseases, particularly untreated syphilis and other sexually transmitted diseases, may explain the increased HTLV-I seropositivity rates in this population. PMID- 2777409 TI - Generation of a recombinant mouse-human chimaeric monoclonal antibody directed against human carcinoembryonic antigen. AB - A procedure was devised for the identification and specific cloning of functionally rearranged variable region immunoglobulin (Ig) gene segments from genomic DNA of a murine hybridoma cell line which produces a high-affinity monoclonal antibody (MAb) directed against human carcinoembryonic antigen (CEA). The cloned, functionally-rearranged murine Ig H-chain and L-chain variable region gene segments were incorporated into plasmid vectors capable of directing the expression of a chimaeric mouse-human antibody molecule with human (gamma 4, kappa) constant region sequences. Expression plasmids were transfected into a mouse myeloma cell line by electroporation and transfectomas secreting functional chimaeric antibody selected. Chimaeric antibody generated by transfectomas was analysed and shown to compete effectively with its murine counterpart for binding to the CEA epitope, and to have an equivalent antigen-binding affinity. This anti CEA recombinant antibody should find application in in vivo diagnosis by immunoscintigraphy of human colonic carcinoma, and possibly also in therapy of the disease, overcoming some of the difficulties associated with the repeated use of non-human immunoglobulins in human patients. PMID- 2777410 TI - HMFG1 antigen: a new marker for carcinomatous meningitis. AB - Carcinomatous meningitis is a devastating metastatic complication of systemic carcinoma, which may occur insidiously, accompanied by a confusing spectrum of clinical symptoms and signs. In the absence of reliable diagnostic tumour markers, the diagnosis is established by the demonstration of malignant cells within the cerebrospinal fluid (CSF). Cytological techniques requiring skillful interpretation are occasionally negative in the presence of established disease, and when positive may indicate leptomeningeal malignancy of such advanced nature that effective palliation is difficult. Biochemical tumour marker technology offers the potential of reliable diagnosis in early disease states, prior to the appearance of exfoliated malignant cells. In a series of 100 patients, we assayed for an epithelial associated glycoprotein (HMFGI antigen) in CSF obtained at lumbar puncture. In 18 of 20 patients with carcinomatous meningitis, this high molecular-weight glycoprotein was detectable in the CSF. The antigen was also present in 2 patients with neoplastic meningitis complicating lymphoma and medulloblastoma, but was not detected in the CSF of the remaining 78 patients. PMID- 2777411 TI - Early and late stages of foreign-body carcinogenesis can be induced by implants of different shapes. AB - Implanted foreign bodies of certain shapes, especially large non-perforated polymer films, induce subcutaneous sarcomas in a high percentage of mice and rats; in contrast, implants of other shapes, e.g., perforated or minced films or Millipore filters with 0.45 microns pores, are non-carcinogenic or only weakly carcinogenic. Experiments described in this report have shown that when carcinogenic non-perforated film was removed at 3.5 months after implantation and one of the "non-carcinogenic" foreign bodies listed above was implanted into the same subcutaneous sites, a high percentage of sarcomas was induced. The same non carcinogenic or weakly carcinogenic foreign bodies implanted in the mice after total body gamma irradiation or after single injection of ethylnitrosourea induced subcutaneous sarcomas in significantly higher percentages of animals than the same foreign bodies implanted in control mice. Our data suggest that foreign bodies of "non-carcinogenic" or "weakly carcinogenic" shapes can act as efficient promoters of subcutaneous carcinogenesis initiated by other agents such as implanted "carcinogenic" foreign bodies, ionizing radiation or chemical carcinogen. PMID- 2777412 TI - Stability of phenotypic and genotypic traits during the establishment of a human neuroblastoma cell line, IGR-N-835. AB - A prerequisite for the study of biological characteristics in neuroblastoma is the establishment of cell lines from tumors of patients. For our study a neuroblastoma cell line, IGR-N-835, was established from a primary tumor. During in vitro establishment of this line morphological changes were observed. IGR-N 835 exhibited both anchored cells and floating clusters. When cultured on bovine endothelial corneal cellular matrix, all tumor cells anchored to the matrix and proliferated, giving a continuous cell line. IGR-N-835 was studied in vitro and in vivo. Treatment with retinoic acid resulted in cell growth arrest and morphological differentiation. IGR-N-835 was highly tumorigenic in nude mice, exhibited a doubling time of 65 hr and was able to form colonies in methyl cellulose with a cloning efficiency of 0.46%. Immunocytochemical studies showed reactivity of this line and its primary passages with CE7 monoclonal antibody (MAb). Cytogenetic analyses revealed stable mode and markers resulting from structural changes in chromosomes 10, 11 and 21 with no homogeneously staining regions or double minute chromosomes. Genomic amplification and overexpression of the N-myc oncogene exhibited by the patient's tumor remained unchanged in nude mouse xenografts and the IGR-N-835 cell line. These phenotypic and genotypic traits were unchanged during establishment of this neuroblastoma line. IGR-N-835 could therefore constitute a suitable material for the study of the biology or therapeutics of human neuroblastoma. PMID- 2777413 TI - Intraperitoneal and subcutaneous xenografts of human ovarian carcinoma in nude mice and their potential in experimental therapy. AB - Human ovarian carcinomas (HOC) were established s.c. and i.p. in nude mice and the biological characteristics were investigated for 4 xenografts. HOC8 and HOC18, derived respectively from a primary tumor of the ovary and a pleural effusion (from 2 different patients) were established s.c. in nude mice. HOC10 and HOC22, derived from the ascites of 2 patients, were directly established as ascites after i.p. injection in nude mice. The s.c. and i.p. growth behavior of the 4 HOC lines was investigated. HOC18, HOC8 and HOC22 cells produced progressively growing tumor after s.c. injection but HOC10 ascites would not grow s.c. The cell suspension derived from HOC18 only produced carcinomatosis upon i.p. injection, while HOC8 cells produced both ascites and carcinomatosis. The 2 ascites HOC10 and HOC22 produced ascites in nude mice, but only HOC22 formed i.p. carcinomatosis. Histopathological characteristics of the patients' primary tumors persisted in nude mice, regardless of the site of tumor implantation. DNA histograms of the xenografts closely matched the patients' tumors and remained stable at different passages. Cisplatin, adriamycin and cyclophosphamide given i.v. were tested against HOC8 and HOC18 growing s.c. and HOC22 and HOC10 growing i.p. HOC8 showed a significant response to DDP and almost no sensitivity to ADR and CTX. HOC18 showed only moderate growth delay with all 3 drugs. Mice bearing HOC10 and HOC22 ascites had a prolonged survival time after DDP and ADR treatment. PMID- 2777414 TI - Site-associated expression of endogenous tumor lectins. AB - The expression of endogenous lectins was compared in mouse Lewis lung carcinomas growing in the kidney or subcutaneously. A panel of carbohydrates coupled to a biotinylated carrier molecule (bovine serum albumin), biotinylated desialylated glycoproteins and sulfated polysaccharides were used in histochemical assays to detect the presence and distribution of carbohydrate receptors. Heterogeneous staining patterns were observed with most carbohydrates in sections of tumor tissue from both anatomic sites, and staining intensities also varied within each section. At least 2 populations of cells were identified at each site, of which one had receptors for all carbohydrates, while the other had no receptors for melibiose, sialic acid, or alpha-glucosides (maltose and glucose). There were quantitative differences in expression of endogenous lectins by tumors growing s.c. or in the kidney; 3LL cells growing in the kidney bound 6 out of 10 carbohydrates to a greater extent than 3LL cells in s.c. tumors. Conversely, 3LL cells in s.c. tumors bound heparin and asialofetuin to greater extents than cancer cells in kidney tumors. Biochemical analyses of detergent extracts of tissues subjected to affinity chromatography and subsequent SDS-PAGE revealed quantitative and also qualitative differences in lectins between tumors growing in the 2 anatomic sites. PMID- 2777415 TI - Rabbit blastocoelic fluid regulation of tumor-cell proliferation in vitro. AB - To determine whether rabbit blastocoelic fluid could inhibit tumor-cell proliferation, day-9 and day-12 embryonic fluids, together with autologous and homologous sera, were collected from pregnant or pseudopregnant rabbits and tested against 13 different cell lines and on human carcinoma cells in primary culture. An inhibitory effect on cell proliferation was observed in the presence of blastocoelic fluids, but not with homologous or heterologous sera. This suppression was higher with samples collected at day 12 than at day 9 of pregnancy. No such inhibition could be detected on one-cell rabbit embryos or on freshly prepared uterine stromal or myometrial cells. In addition, the inhibitory activity on tumor cells was completely reversible upon removal of the fluids. Incorporation of 3H-thymidine, 3H-uridine and 35S-methionine revealed that, in the presence of blastocoelic fluids, both DNA and RNA syntheses were rapidly inhibited. Inhibition of protein synthesis did not occur before 24 hr of treatment. We conclude that rabbit blastocoelic fluid suppresses the proliferation of tumor cells via inhibition of RNA and DNA synthesis by a process which may involve the expression of growth-suppression gene(s). PMID- 2777417 TI - Doxorubicin resistance in P388 leukemia--evidence for reduced drug influx. AB - Multi-drug resistance (MDR) in cancer cells is associated with reduced drug accumulation. Although intensively studied, the mechanism of this process remains ill-defined. We have now developed a new, rapid and quantitative method of measuring uptake of doxorubicin by these cells, in which the fluorescence of accumulated drug is rapidly quenched by DNA in the cell nucleus. Pre-treatment of cells with deoxyribonuclease eliminates DNA from non-viable, permeable cells, and this obviates the spurious fluorescence quenching that made previous application of this technique useless. Our data strongly suggest that the drug passively diffuses into cells. The rate of this diffusion into drug-resistant cells is considerably lower than that found in drug-sensitive cells. The ratio of the rates of drug entry in these cell types could fully account for the differences between the cell lines in doxorubicin growth-inhibitory activity. In these experiments no evidence for the previously proposed active efflux mechanism was found in either cell line. PMID- 2777416 TI - Localization and imaging of radiolabelled monoclonal antibody against squamous cell carcinoma of the head and neck in tumor-bearing nude mice. AB - Nude mice carrying human squamous-cell carcinoma xenografts were given i.v. injections of radiolabelled monoclonal antibodies (MAbs). MAb E 48, which reacts with squamous-cell carcinomas, was labelled with 131I, while a second control MAb of similar immunoglobulin subclass was labelled with 125I. Both antibodies were injected simultaneously, then the mice were scanned with a gamma camera or their tissues were removed and antibody uptake was calculated as a percentage of the injected dose. Uptake of E 48 reached a peak value of 16%/g on day 3, while uptake of the control antibody was less than 1.8%/g. By 24 hr after injection tumor could be visualized without subtraction techniques. At days 3 and 7, only xenografts were visible on imaging. These findings suggest that E 48 is capable of high specificity in targeting isotopes to squamous-cell carcinomas in an experimental setting. PMID- 2777418 TI - Detection by in situ hybridization of messenger RNAs of collagen types I and IV in murine mammary cancer. AB - Ten breast carcinomas developing in C3H/Bi female mice were studied by an in situ hybridization technique using cDNA probes encoding alpha-I chains of collagens of types I and IV. The results obtained are compared to histochemical data on antibodies to collagens of types I and IV and ultrastructural observations on these tumors. Immunohistochemistry has revealed the presence of type-IV collagen in basement membranes lining intraductal and well-differentiated cancer nests. Type-I collagen was detected in the stroma surrounding these cells. There was no cellular labelling when these antisera were used. In situ hybridization has shown that type-IV collagen mRNA is detected in non-invasive intraductal and well differentiated tumor cells and in endothelial cells in the stroma. Good correlation between detection of type-IV collagen lining these cells and evidence of mRNA by in situ hybridization was thus observed. Invasive cancer cells did not express hybridization grains with the type-IV collagen probe. Type-I collagen mRNA was visualized in stromal cells, probably fibroblasts and myofibroblasts as shown by electron microscopy. The most active cells were localized close to non invasive areas. Our data indicate persistent in-vivo biosynthesis of type-IV collagen by some cancer cells that produce their own limitative environment; they suggest that type-IV collagen is not produced by invasive tumor cells and that stromal cells lining the non-invasive regions have a peculiar behavior. PMID- 2777420 TI - Therapeutically relevant differences in the pharmacokinetical and pharmaceutical behavior of ibuprofen lysinate as compared to ibuprofen acid. AB - The pharmacokinetic properties of ibuprofen p.o. given either as a lysine salt or as acid to eight young, healthy male volunteers was investigated. Ibuprofen lysinate, administered after overnight fasting, produced peak plasma concentrations significantly earlier and higher than ibuprofen acid. A similar difference was observed when the drugs were given following a standardized breakfast. Under these conditions the lat-time was significantly shorter for the lysine salt than for the acid. The pharmacokinetic differences are likely to result from the faster dissolution rate of ibuprofen lysinate. They indicate that the administration of ibuprofen as lysine salt before meals may be advantageous if rapid and reliable onset of pain relief is required. PMID- 2777419 TI - Protein binding characteristics of a new bronchodilator, 1-methyl-3 propylxanthine (MPX), in different species. AB - The protein binding of a new bronchodilator, 1-methyl-3-propylxanthine (MPX), in different animal species sera (human, dog, rabbit, rat and mouse) was investigated in vitro by ultrafiltration method. Interspecies differences in the binding affinity and binding capacity for MPX were observed. The dissociation constant (Kd1) for the high affinity binding site of human serum was approximately 17 times higher than that of rat serum. Those of rat serum and rabbit serum were nearly equal. On the other hand, the binding indices (n1p1/kd1) of human serum and rat serum were comparable. The binding of MPX to various proteins such as human serum albumin (HSA), alpha 1-acid glycoprotein (AGP) and isolated human lipoproteins was also investigated. The binding of MPX to HSA was lower than that of human serum protein but the number of specific binding sites (n1) in human serum was in agreement with that in HSA. The binding curves of MPX to AGP and lipoproteins were almost linear and the binding percentages were less than 7% in both cases. These data suggest that MPX is exclusively bound to albumin and that AGP and lipoproteins are of little importance in the protein binding of MPX. The present data appear to be useful for predicting the role of protein binding on the pharmacokinetics of MPX in different animal species. PMID- 2777421 TI - Single-dose pharmacokinetics of flurbiprofen granules and tablets in healthy volunteers. AB - The bioavailability of granules and tablet flurbiprofen in 100 mg single dose was crossover compared in 6 healthy volunteers (mean aged 26.8 years). The granules showed an earlier peaktime and a lower maximum concentration than the tablet. Area under the curve and half-time in terminal phase were similar, with the granule relative bioavailability of 0.98. PMID- 2777423 TI - Pupillographic evaluation of the mydriatic effect of ibopamine solution. AB - The mydriatic effects of ibopamine solution at the concentrations of 0.25%, 0.50%, 1% and tropicamide solution at the concentration of 1% were evaluated in 22 clinically healthy volunteers. The study was conducted at single dose, instilling 1 drop of each concentration of ibopamine and of tropicamide in one eye and 1 drop of placebo in the other. The pupillary diameter was measured by photographic pupillography immediately before and at 10, 20, 30, 45, 60, 90, 120, 180, 240 min after each instillation. Immediately before and 45 min after each instillation, visual acuity was also measured for both near and distant objects. The ibopamine solution exerted a dose-related mydriatic effect in both magnitude and duration. The mean maximum pupillary diameters were 5.5, 8.0, 9.1 mm with ibopamine at 0.25%, 0.50%, 1% and 8.6 mm with tropicamide. The mean times to reach the maximum pupillary diameter were 60, 54, and 50 min with the three concentrations of ibopamine, and 47 min with tropicamide. The duration of the mydriatic effect was less than 4 h with ibopamine and very much more with tropicamide. No effect on accommodation was found with ibopamine, while a cycloplegic effect was constantly noted with tropicamide. On the basis of the results obtained, it is concluded that ibopamine is to be preferred when mydriasis is required with good absolute values and brief duration (examinations of the fundus, examinations with Goldmann's lens, etc.), without cycloplegia. PMID- 2777422 TI - Improved orthostatic dysregulation record after administration of a sustained release form of urapidil. AB - The efficacy and safety of urapidil has been demonstrated in a long-term treatment. However, a relatively good record of side effects has been marred by reports of orthostatic dysregulation. This study was designed to examine the blood pressure lowering effect, tolerability and pharmacokinetics of a sustained release formulation of urapidil. Twelve patients received either 60 mg of sustained-release urapidil (Ebrantil 60) or 50 mg urapidil for experimental reference as a fast-release tablet in single or multiple doses in a randomized, double-blind fashion. To ensure the double blind-character of the study, the tablets were encapsulated. Blood samples for the determination of urapidil (HPLC) were drawn before and at 0.5, 1, 1.5, 2, 3, 4, 6, 8, 10 and 12 h post application. Blood pressure was measured at 0.5, 1.5, 3, 8, 10 and 12 h post application. An orthostatic test was performed before and at 1, 2, 4 and 6 h post application. Twelve h after the first application, patients received a second capsule or encapsulated tablet and continued medication for two days. On day four, the same procedure as on day one was repeated, except that patients received no evening medication and blood samples and blood pressure were measured at 24, 28 and 32 h post application on the fifth day. The Cmax of sustained release urapidil was 44% lower than for the single tablet dose and 37% lower after multiple dosing. The peak-trough fluctuation of the steady-state serum concentrations was 29% lower for the sustained-release capsule (138 +/- 45%) compared to the tablet (195 +/- 83%).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2777424 TI - Bioavailability study of fosfosal and codeine administered alone or in combination. AB - Fosfosal (2-phosphonoxybenzoic acid) is a new salicylic acid derivative which is used for treating inflammatory disease as well as in analgesic therapy. On the other hand, codeine together with acetylsalicylic acid is widely used in patients who require analgesic treatment for mild to moderate pain. The present study was carried out in ten healthy subjects to assess the pharmacokinetic profiles of single oral doses of fosfosal (1,200 mg) and codeine (30 mg) when administered alone or in combination. Blood samples were drawn on each study day and salicylic acid and codeine plasma concentrations were determined by HPLC and enzyme immunoassay methods, respectively. Individual pharmacokinetic parameters were calculated according to standard procedures and the magnitude and rate of bioavailability were tested using a 95% confidence internal approach. Results indicated no statistical differences in any of the kinetic parameters studied except for tmax values which were higher for fosfosal combined with codeine (2 +/ 0.39 h) when compared to fosfosal alone (1.55 +/- 0.35 h). Regarding codeine compared in combination with fosfosal, no significant differences were observed in Cmax and AUC values, while tmax showed a higher value for the combination (1.75 +/- 0.6 vs 0.85 +/- 0.32 h). Although statistical differences in the elimination constant rate and MRT were found between both codeine administrations, these cannot be considered significant in clinical terms. The changes in bioavailability rate observed for both drugs when administered together provide support for the use of this combination in a single formulation. PMID- 2777425 TI - A study of plasma and cardiac tissue concentrations of ceftriaxone (Rocephin) in open heart surgery. AB - Postoperative infection following cardiac surgery procedures is a serious complication. Cephalosporines are frequently used in prophylaxis. The aim of this study was to determine whether adequate therapeutic concentrations of ceftriaxone were present in cardiac tissues and plasma after 2 g single dose administered intravenously. Twenty-four consecutive patients undergoing open heart surgical procedures enrolled in the study. The antibiotic concentration was measured by agar well diffusion method. Samples of plasma were taken simultaneously of tissue removal in order to determine the antibiotic penetration. Tissue concentrations in the cardiac appendage, in the mitral and aortic valves and in the vessels of the graft exceeded MIC of the anticipated pathogens and especially high concentration was detected in pericardiac tissue during the time of operation. Therapeutic level was achieved against only certain strains of Pseudomonas. PMID- 2777426 TI - Plasma protein binding of ethinyloestradiol: effect of disease and interaction with drugs. AB - The protein binding of ethinyloestradiol (EE2) was investigated in the plasma from 14 healthy volunteers, 10 patients with hyperbilirubinemia, 10 patients with liver cirrhosis and 10 patients with renal failure. Binding assay was performed by equilibrium dialysis at 37 degrees C. The unbound fraction (mean +/- SD) of EE2 was 1.17 +/- 0.12 (volunteers), 2.74 +/- 0.77 (hyperbilirubinemics; p less than 0.001) 1.51 +/- 0.31 (cirrhotics; p less than 0.01) and 1.44 +/- 0.11 (renal failure; p less than 0.001). Studies with isolated albumin and alpha-1-acid glycoprotein showed that albumin is the major plasma protein to bind EE2. Warfarin (75 microM) and diazepam (75 microM) increased by 5.0% and 3.0%, respectively, the unbound fraction of EE2 when albumin concentration was 15 microM. Under similar conditions, digitoxin did not modify the binding of EE2. At therapeutic concentrations, warfarin and diazepam did not affect the binding of EE2 in plasma. PMID- 2777427 TI - Comparison of the pharmacokinetics of intravenously administered rac-baclofen and its (-)-(R)- and (+)-(S)-enantiomers in dogs. AB - Baclofen is a centrally acting muscle relaxant marketed as the racemate. Since only the (-)-(R)-enantiomer is pharmacologically active, the pharmacokinetics of rac-baclofen and its enantiomers were studied individually in the same group of dogs to determine if there was any stereospecificity in the drug's kinetics after a single intravenous dose. High-pressure liquid chromatography was used to determine concentrations in plasma and urine. A major difference was found in the urinary recovery of the unchanged drug. Only about 50% of the dose of the clinically used racemate appeared as unchanged drug in the urine; whereas the active (-)-(R)-isomer was for the most part renally excreted (85%). Irrespective of isomeric composition, the renal clearance was dependent upon the creatinine clearance. Differences in non-renal clearance could not be explained by stereoselective formation of the gamma-hydroxymetabolite. It is concluded that in the dog, the active enantiomer is also pharmacokinetically preferred. PMID- 2777429 TI - Platelet GABA-aminotransferase in epileptic patients. AB - Platelet GABA-aminotransferase (GABA-T) activity was determined in 12 adults (six healthy volunteers and six long-term treated epileptic patients) and 17 children (six non-epileptic, and 11 long-term treated epileptic patients). Platelet GABA-T activity was about 60% higher in the epileptic patients than in the controls, both in adults (14.7 +/- 8.6 versus 8.8 +/- 3.5 pmol/min/mg of protein,) and children (13.1 +/- 4.8 versus 8.3 +/- 3.3 pmol/min/mg of protein, p less than 0.05). The relationship between this increase and either epilepsy or anti epileptic treatment should be clarified in further studies. PMID- 2777428 TI - Pharmacokinetics and acute side-effects of nifedipine given as slow-release tablets or liquid-filled capsules. AB - The pharmacokinetics and acute adverse effects of nifedipine were studied in a cross-over, single dose (20 mg) study on ten healthy young volunteers. From the liquid-filled capsules, nifedipine was absorbed rapidly (tmax at 30-40 min). From tablets, the peak concentration was 79-88% lower and occurred 74-133 min after ingestion; also the bioavailability was lower, as indicated by on average 39% lower area under curve values after tablets. All the volunteers experienced side effects: the most common (nine out of the ten) and the most intense was headache. One volunteer withdrew because of unbearable vomiting and headache. Also others felt nauseous (six out of nine who continued) and four of them vomited. After tablets, the dizziness was markedly less than after capsules, but the more slowly appearing symptoms such as headache and nausea were similar after both types of drug products. By using slow-release tablets instead of capsules it seems possible to avoid some side-effects of nifedipine, but this benefit is gained at the expense of bioavailability. PMID- 2777430 TI - Enhancement of nonspecific resistance to bacterial infections and tumor regressions by treatment with synthetic lipid A-subunit analogs. Critical role of N- and 3-O-linked acyl groups in 4-O-phosphono-D-glucosamine derivatives. AB - Enhancement of nonspecific resistance against Pseudomonas aeruginosa infection and regression of growth of Meth A fibrosarcoma by chemically synthesized lipid A subunit analogs, 4-O-phosphono-D-glucosamine derivatives carrying 3-O- and N linked acyl groups, were investigated. Compounds carrying an (R)-3 hydroxytetradecanoyl (C14-OH) group at the 2-N-position with (R)-3 tetradecanoyloxytetradecanoyl [C14-O-(C14)] or (R)-3-dodecanoyloxytetradecanoyl [C14-O-(C12)] groups at the 3-O-position, termed GLA-60 or GLA-63, respectively, showed strong activity about one-tenth that of natural lipid A. The protective activity of compounds carrying an (R)-3-hexadecanoyloxytetradecanyl group instead of a C14-O-(C14) or C14-O-(C12) group was very weak. GLA-59 carrying the same acyl components as those of GLA-60 but with reversed binding sites showed significant but not so strong protective activity. The activity of compounds possessing a tetradecanoyl group instead of a C14-OH group in GLA-60 or GLA-63 was weaker than that of GLA-60 or GLA-63. Intravenous or intratumoral administration of GLA-59, GLA-60 and GLA-63 induced significant regression of Meth A fibrosarcoma in terms of tumor size, tumor weight and number of cured mice. The activity of GLA-59 was almost equivalent to that of GLA-60. None of the tested compounds exhibited significant pyrogenicity at a dose of 10 micrograms/kg in rabbits. PMID- 2777431 TI - Enhancement of prolactin (PRL)-stimulated mitogenesis of Nb2 rat lymphoma cell cultures by insulin-like growth factor I (IGF-I). AB - IGF-I stimulated the mitogenesis of Nb2 cells in the presence of suboptimal mitogenic concentrations of prolactin (PRL, 0.01 or 0.1 ng/ml). In the presence of 1 ng/ml or 10 ng/ml, concentrations of PRL that produced a maximal or near maximal mitogenic response in Nb2 cells, the addition of insulin-like growth factor-I (IGF-I) at 5 or 10 ng/ml did not further enhance mitogenesis. This effect was selective for IGF-I since IGF-II, epidermal growth factor (EGF), insulin, transforming growth factor-beta (TGF-beta) or platelet-derived growth factor (PDGF) did not stimulate mitogenesis in the presence or absence of PRL. That the ability of IGF-I to stimulate mitogenesis of these cells required PRL was suggested by the ability of PRL antiserum to block the IGF-I effect. Monoclonal antibody to IGF-I reduced the mitogenic response to one identical to PRL alone. In the presence of a suboptimal mitogenic concentration of PRL, IGF-I was an equally effective comitogen when added at 0 time or at 6 h after PRL stimulation, suggestive of an effect of IGF-I in late G1 phase of the cell cycle. Effects of IGF-I on ornithine decarboxylase, a G1 enzymatic marker, were compatible with this interpretation. In order to be assured that IGF-I exerted its action through a receptor-mediated process, we evaluated the presence of IGF I receptors on Nb2 cells. Receptors were present which bound IGF-I greater than IGF-II much greater than insulin. The IC50 was 35 nM for IGF-I, 280 nM for IGF-II and 875 nM for insulin.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2777432 TI - Antihypertensive effect of an immunosuppressive agent, cyclophosphamide, in genetically hypertensive rats of the Lyon strain. AB - The effect of a pharmacological immunosuppression on the development of hypertension and the part played by hormonal secretions of the thymus in this disease were investigated in genetically hypertensive rats (LH) of the Lyon strain. For this purpose, systolic blood pressure (SBP) was measured in cyclophosphamide-treated LH rats and in neonatally thymectomized LH rats receiving thymostimulin, a thymus extract. Cyclophosphamide treatment delayed the onset and attenuated the full development of hypertension in LH rats whereas it had no effect on SBP in normotensive rats (LN). Thymectomized LH rats also exhibited a significantly decreased SBP as compared to sham-operated controls. Thymostimulin treatment slightly increased the SBP of thymectomized LH rats but did not restore it to the level seen in sham-operated animals. These results showed that thymic hormonal secretions did not seem to be involved in the initiation of hypertension. By contrast, the fact that a reduction of hypertension could be obtained either by thymectomy or cyclophosphamide treatment suggested that immune disorders, mediated by thymus-dependent cellular reactions, could be of pathogenic importance in the development of hypertension in LH rats. PMID- 2777434 TI - Hydroxylysine excretion does not indicate collagen damage with downhill running in young men. AB - The purpose of this study was to determine whether urinary excretion of hydroxylysine (HO-Lys) is increased following prolonged, predominantly downhill running. Such an increase would be evidence of exercise-induced collagen damage. Each of ten young men performed a treadmill running test to determine VO2peak (an approximation of VO2max) followed by 60 min of intermittent running on -10% slope. Total urine excreted from 48 h pre-exercise to 96h post-exercise was collected in 8-h samples for measurement of HO-Lys. In addition, both urinary 3 methylhistidine (3-MeHis) excretion and serum creatine kinase (SCK) activity were measured as indicators of muscle tissue damage. In no sampling period was post exercise HO-Lys excretion altered compared with pre-exercise (e.g., pre-exercise: 82.2 +/- 9.6 mumol.24 h-1, mean +/- SE; 51.0 +/- 3.7 mumol.g creatinine-1; post exercise: 72.9 +/- 2.0 mumol.24 h-1; 47.0 +/- 1.5 mumol.g creatinine-1). SCK activity was increased (346%) 24 h post-exercise, but not immediately, 48 h, or 72 h post-exercise. 3-MeHis excretion was not altered following exercise. There were no strong associations between HO-Lys excretion and either of the markers of muscle damage. We concluded that no evidence of exercise-induced collagen damage was provided by urinary HO-Lys excretion. PMID- 2777433 TI - Anti-inflammatory and immunosuppressive properties of the bis benzylisoquinolines: in vitro comparisons of tetrandrine and berbamine. AB - Tetrandrine and berbamine are two naturally occurring analogues with a bis benzylisoquinoline structure. Comparative in vitro studies show that tetrandrine has significantly greater suppressive effects on adherence, locomotion and 3H deoxyglucose uptake of neutrophils, as well as the mitogen-induced lymphocyte responses and mixed lymphocyte reactions. Also, tetrandrine displayed anti oxidant activity while berbamine did not. By contrast, berbamine demonstrated a significantly greater capacity for inhibition of NK cell cytotoxicity. These results show that tetrandrine is superior to berbamine in most aspects of anti inflammatory and immunosuppressive activity. Since these two alkaloids differ by only one substitution in the side chain of one of the benzene rings, these findings may provide further insight into structure-activity relationships and clues to the synthesis and development of active analogues of this promising class of drugs for the treatment of chronic inflammatory diseases. PMID- 2777435 TI - Comparison of maximum aerobic power, maximum anaerobic power, and skinfold thickness of elite and nonelite junior wrestlers. AB - The purpose of this investigation was to identify physiologic differences between elite high school-age wrestlers and nonelite wrestlers of comparable age, weight, and training experience. Two groups of junior wrestler, elite (n = 18) and nonelite (n = 18) were measured for maximum aerobic power (treadmill run), maximum anaerobic power of the arms and legs (Wingate test), and skinfold thickness. On the average (+/- SE) elite juniors had a VO2max of 52.6 +/- 2.0 ml/kg.min-1, 376 +/- 20 W for arm power, and 540 +/- 25 W for leg power. The nonelite group had a VO2max of 51.5 +/- 1.4 ml/kg.min-1 and 331 +/- 22 W and 467 +/- 29 W for arm and leg power, respectively. Ttests were computed to identify differences between the groups. The results revealed significant differences in four skinfold thicknesses, absolute anaerobic leg power, and relative anaerobic power of arms and legs. It was concluded that relative maximum anaerobic power is distinctly greater in elite high school wrestlers than less successful peers. In light of the results, it may be of benefit for wrestlers of lower caliber to decrease body fat, increase fat-free weight, and increase total body power through training. PMID- 2777436 TI - Eccentric and concentric torque-velocity characteristics, torque output comparisons, and gravity effect torque corrections for the quadriceps and hamstring muscles in females. AB - The purpose of this study was to assess and compare eccentric (ECC) and concentric (CONC) torque output of the quadriceps and hamstring muscles and to analyze the effect of gravity effect torque (GET) correction on the calculation of the hamstring/quadriceps peak torque quotient (H/Q quotient). Twenty female subjects performed maximal voluntary CONC and ECC contractions of the quadriceps and hamstring muscles at five isokinetic lever arm velocities from 60 degrees/s to 360 degrees/s. Peak torque was measured and corrected for GET. Mean ECC torque did not significantly change with increasing ECC velocity for either the quadriceps or hamstring muscles (P greater than 0.05). Mean CONC torques were significantly lower than the corresponding ECC torques (P less than 0.05) and decreased with increasing CONC velocity. At each test velocity, the CONC H/Q quotient was significantly lower than the corresponding ECC H/Q quotient (P less than 0.05). Mean H/Q quotients did not significantly change with increasing velocity for either the CONC or ECC tests (means: 0.46 and 0.57; P greater than 0.05). Mean H/Q quotients not corrected for GET significantly increased with increasing velocity for the CONC (0.61 to 0.78; P less than 0.05), but not ECC tests (0.66 to 0.71; P greater than 0.05). The results indicate that the ECC torque-velocity curve is essentially level for both quadriceps and hamstring muscles. The present findings point strongly toward the necessity of correcting for GET when calculating both CONC and ECC H/Q quotients.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2777437 TI - Effect of physical activity on lumbar spine and femoral neck bone densities. AB - The lumbar spine and femoral neck densities of 123 and 141 normal adult women (50 +/- 10 years), respectively, measured by dual photon absorptiometry, were correlated with the number of hours of walking per day associated with their regular daily activities. This measure of exercise, obtained by detailed questionnaire and interview, was analyzed because it is regular, seasonally stable, and quantifiable. Both lumbar spine and femoral neck densities were significantly correlated with walking, with 0.8% and 1.9% increases in average bone density per hour of daily walking, respectively. This increase in density is substantial, considering that the age-related rate of bone loss in the same population is 0.7% and 0.5% per year of lumbar spine and femoral neck, respectively. This means that, on the average, a woman walking one additional hour per day has a femoral neck bone density comparable to that of a women 4 years younger who does not pursue this additional activity. This physical activity-associated enhancement of bone density may be critical at old age when osteoporosis is clinically manifested. PMID- 2777438 TI - A comparative study of blood lactate tests in swimming. AB - Three different modes of lactate tests were studied. Eleven male competitive swimmers performed the tests (n.100 m, n.300 m, 2.100m + 2.400 m) within 5 days. Swimming velocity (V) vs blood lactate (BLa) and V vs heart rate (HR) curves were averaged. In V vs BLa comparisons, the BLa values of 4 mmol.l-1 in 2.400 m, 3 mmol.l-1 in n.300 m, and 2 mmol.l-1 in n.100 m modes were found to correspond to the same V. Although the resting BLa values were similar before the testing occasions, the initial BLa value in very easy swimming was lower in the n.300 m than in the n.100 m mode. The elimination of lactate most probably caused this difference. The highest BLa value was measured in the n.100 m (14.9 mmol.l-1) and 2.100 m (13.6 mmol.l-1) exercise modes demonstrating a higher rate of anaerobic energy production than in the n.300 m or 2.400 m test modes. In HR vs V comparison, the n.300 m and 2.400 m modes demonstrated similar HR values in relation to V. To measure the whole intensity area, a combination of tests should be applied by performing an incremental set with several steady-state loadings (aerobic) and one or two 100 m swims (anaerobic) in one test session. PMID- 2777439 TI - Stress fracture of the rib in an elite oarsman. AB - This paper documents an unusual case of a stress fracture of the ninth rib in an elite oarsman. A 25-year-old male presented with a 3-day history of right-sided chest pain aggravated by deep inspiration and movements simulating rowing. The athlete was treated initially as having a soft tissue injury; however, a technetium-99 bone scan confirmed the diagnosis. Routine radiographs of the ribs were negative. The pain and symptoms were confined to the anatomical area of the fracture along the anterolateral portion of the rib where the serratus anterior muscle originates. An analysis of the stroke mechanics involved in rowing implicated the serratus anterior muscle as being a major contributor to the repetitive stress that resulted in the injury. The primary etiological factor was errors in the training program. The athlete responded to simple conservative measures and was able to return to competitive rowing in 1 month's time. PMID- 2777440 TI - Pediculosis capitis and the stubborn nit. PMID- 2777441 TI - A preliminary study on the link between PUVA and skin cancer. AB - One hundred four psoriatic patients who had 8-methoxypsoralen-ultraviolet light A (PUVA) treatment between 1975-1987 were investigated to determine if skin cancer had ever occurred during or after the therapeutic period. Incidence data of skin cancer was applied to this group of patients to measure the expected number of patients with skin cancer. The significance of observed number versus expected of PUVA-treated patients with skin cancer was analyzed. The authors did not observe a significant increase of patients with skin cancer. PMID- 2777442 TI - Drug-induced toxic epidermal necrolysis treated with cyclosporin. AB - A 35-year-old woman developed toxic epidermal necrolysis secondary to phenytoin. Because the life-threatening eruption was resistant to prednisone and high-dose methylprednisolone therapy, cyclosporine therapy was initiated. Within 24-48 hours, the eruption stabilized and the patient improved. PMID- 2777443 TI - Basal cell and squamous cell carcinoma of the skin in Finland. Site distribution and patient survival. AB - Long-term survival of patients with basal cell (BCC) and squamous cell carcinoma (SCC) of the skin and site distribution of the lesions were studied using ample nationwide cancer registry data. The material consisted of 23,975 patients with BCC and 2,927 patients with SCC diagnosed in Finland from 1967 to 1981. The proportion of patients with lesions in the head and neck region was 77.5% in men and 81.4% in women for BCC and, 75.7% in men and 75.8% in women for SCC. The 5- and 10-year relative survival rates (RSRs) of patients with BCC were very close to 100%. The 5-year RSR of patients with SCC diagnosed from 1974 to 1981 was 87.7% in men and 84.0% in women. In patients with SCC the worst prognosis was for lesions of the scalp and neck in men (80.2%) and for those of the ears in women (73.2%). PMID- 2777444 TI - Malignant angioendotheliomatosis. Reclassification as an angiotropic lymphoma. AB - A 70-year-old woman with chronic edema of the lower limbs was diagnosed as having a "malignant angio-endotheliomatosis," because histologic examination showed a strict intravascular location of a malignant proliferation. Immunochemical studies actually disclosed the lymphomatous origin of malignant cells. The recent literature regarding the nosology of this rare condition is reviewed. PMID- 2777446 TI - Possible carbamazepine-induced reversible onychomadesis. PMID- 2777445 TI - Plasminogen activators and antiplasmin activity in atopic dermatitis. AB - Cutaneous deposits of fibrinogen activity in lesional skin, plasmatic fibrinolytic activity, and antiplasmin activity (alpha 2 macroglobulin, alpha 1 antitrypsin and antithrombin III) were evaluated in a group of ten patients with atopic dermatitis and in a sex- and age-matched control group. Plasma fibrinolytic activity was increased in the acute phase of the disease (p less than 0.05). The levels of circulating antiplasmins appeared similar in the patients and the control group. Cutaneous fibrinolytic activity was increased in the acute phase of the disease in 5 of 5 cases, suggesting a role of the fibrinolytic system in the amplification of the inflammatory phenomenon in that phase of the disease. In the chronic lichenified phase, CFA was decreased in 3 of 5 cases leading to an excessive deposit of fibrin in the skin. This could be correlated with the abnormal vascular response (blanching phenomenon). On the basis of these data, the therapeutic use of the antifibrinolytic agents only seems rational in the acute phase of the disease. PMID- 2777448 TI - Perforating granuloma annulare. PMID- 2777447 TI - Congenital cutaneous candidosis. PMID- 2777449 TI - The use of readily available photosensitizers for vitiligo in Nigeria. PMID- 2777450 TI - Poikiloderma atrophicans vasculare in patient with Sjogren syndrome. PMID- 2777451 TI - Exudative discoid and lichenoid chronic dermatitis: does it exist or should it be discarded? PMID- 2777452 TI - Vitiligo repigmentation with Anapsos (Polypodium leucotomos) PMID- 2777453 TI - Psoriasis and autoimmune disorders. PMID- 2777454 TI - Treatment-resistant atopic dermatitis controlled with cyclosporin A. PMID- 2777455 TI - Dermatoses of the umbilicus. PMID- 2777456 TI - The burning truth. PMID- 2777457 TI - The National Student Dermatology Association--debut. PMID- 2777458 TI - Experimental and theoretical studies of anthelmintics: oxfendazole and its imidazo[1,2-a]pyridine-2-carbamate isomer. AB - Mice experimentally infected with Trichinella spiralis were used to test the therapeutic effectiveness of an anthelmintic, methyl 6 (phenylsulfinyl)imidazo[1,2-a]pyridine-2-carbamate, against the immature and adult worms during the intestinal phase of infection. A single oral dose of 100 mg kg-1 of the drug on the third day after exposure to infection was totally ineffective against the adult worms as determined at necropsy on day 6. Neither higher unit dosages of the drug, division of the daily oral dose, nor increasing the length of the treatment period from 1 to 4 days enhanced drug activity in vivo. Furthermore the drug was inactive as a single oral dose against the immature worms at all of the dosages tested (12.5-400 mg kg-1). These results are in marked contrast to those obtained previously with oxfendazole (methyl 5[6] (phenylsulfinyl)benzimidazole-2-carbamate) under comparable experimental conditions and clearly indicate that the two compounds are not anthelmintically equivalent in the T. spiralis-infected mouse system in spite of their similar structural features. A quantum mechanical study of these drugs was undertaken and a hypothesis for the inactivity of the imidazo[1,2-a]pyridine-2-carbamate isomer is proposed. PMID- 2777459 TI - Anthelmintic resistance and the control of ovine ostertagiasis: a drug action model for genetic selection. AB - A site-specific genetic prediction model is presented, which examines the influences of different anthelmintic treatment regimens on selecting for drug resistance within a sheep management system. The model exploits the power of modern microcomputers to integrate factors such as parasite strain, geographic location, management practice and genetic fitness to identify effective control regimens which do not lead to resistant Ostertagia circumcincta strains over a 30 year horizon. The potential use of the model as a farm level management-support tool is discussed. PMID- 2777460 TI - Killing of Leishmania donovani by activated liver macrophages from resistant and susceptible strains of mice. AB - Leishmania donovani is an obligate intracellular protozoan parasite of macrophages; liver macrophages are, however, the only population of cells which express the resistant Lsh gene phenotype when these cells are infected in vitro. It was of interest to study in vitro the action of Con A-stimulated spleen cell lymphokines (LK) to protect or to cure liver macrophages from infection by L. donovani. Liver and peritoneal macrophages (PEC) from resistant (C57L/J) and susceptible (C57BL/6J) mice were infected in vitro with promastigotes before or after LK treatment; the percentage of infected macrophages was determined 4, 24, 48 and 72 h post-infection. Both macrophage populations were protected or cured by treatment with lymphokines; the cells of the resistant strain were protected or cured more effectively than those of the susceptible strain. The capacity for cure or for protection following LK treatment of liver and PEC macrophages was similar within each strain. Supernatants from the IL-2-produced MLA-144 cell line had no effect to protect or cure macrophages. This study indicates that the response of macrophages to the action of LK is also important in determining the susceptibility of mice to L. donovani; this model in vitro provides a good approximation of the response of macrophages to therapy. PMID- 2777461 TI - Population biology of the parasitic phase of Ostertagia circumcincta. AB - Four current models for the parasitic phase of the Ostertagia circumcincta life cycle were evaluated with respect to their ability to represent the outcome of experimental infection studies and the population biology of the parasite in the field. Neither of the two discrete-time models was able to mimic the rise and fall in parasite numbers that characterize trickle infection experiments. When the infection rate is constant, both models predict that parasite numbers will eventually reach an asymptotic equilibrium value. This happens because both models are formulated such that parasite mortality is constant when the infection rate is constant. The two continuous-time models are able to mimic trickle infection experiments because both of them represent parasite mortality as an increasing function of the infection rate and the duration of infection. However, the continuous-time models do not adequately represent the demography of the parasitic phase in the field because neither of them takes any account of the effect of variations in infection rate from host to host on the overall mean parasite death rate. PMID- 2777462 TI - H and 13C n.m.r. studies of serum from normal and Echinococcus multilocularis infected jirds. AB - The major components of the 13C and high field region of the 1H nuclear magnetic resonance (n.m.r.) spectra of normal and Echinococcus multilocularis infected jirds were identified and compared. Substantial depletion of the glucose and fatty acid chains from lower density lipoproteins was detected in sera from infected animals. In addition, this proliferating metacestode markedly changed the appearance of the spectral region recently assigned to N-acetyl protons of carbohydrate side chains of N-acetylated glycoproteins. PMID- 2777463 TI - Effects of irrigation on appearance and survival of infective larvae of goat gastro-intestinal nematodes in Guadeloupe (French West Indies). AB - In Guadeloupe (French West Indies), faeces from naturally infected goats were deposited during the dry season on three plots, irrigated with long (plot A) or short herbage (B) and non-irrigated with long herbage (C). Microclimatic data and the evolution of L3 population size in faeces, on soil surface and on herbage were followed over a period of 26 days. The initial nematode egg population was comprised of 58% Haemonchus contortus (HC), 25% Trichostrongylus colubriformis (TC) and 17% Oesophagostomum columbianum (OC). Temperature and water content varied in time and space (soil, faeces, herbage) from homogeneous in A to very heterogeneous in C. In A and B, population dynamics were similar with higher values of maxima in A. Larval peaks occurred on day 9 after deposition in faeces in plot A: 23.1, 39.1 and 17.2 L3/100 eggs, respectively for HC, TC and OC; the same day in soil: 1.9, 0.6 and 3.1 L3/100 eggs. On day 26 it remained less than 1 L3/100 eggs in both soil and herbage for the three species. In C, only TC larvae were observed coming, after rain, from eggs in which hatching had been delayed. It was difficult to separate the respective effects of temperature and water content on the development of the eggs, but irrigation gave favourable conditions for all eggs to develop into larvae. Pasture rotation with 28-35 days of regrowth should minimize the increased risk of infection for the goats due to irrigation. PMID- 2777464 TI - Observations on egg production by Toxocara pteropodis. AB - Studies in juvenile Pteropus poliocephalus showed an average daily egg production by Toxocara pteropodis of 25,000 per female, with concentrations of up to 16,000 epg. regardless of whether eggs were fertile or infertile. Production commenced as early as 35 and as late as 48 days post-partum and rose to plateau average levels over about 10 days. For 23 days one bat passed infertile eggs which, over 2 days, were then replaced completely by fertile eggs. The implicit delay in maturation of a male nematode suggests that transmammary passage of larvae to suckling bats may persist for at least 3 weeks. Patency was terminated by the spontaneous expulsion of worms. If male worms were lost first, the egg output converted from fertile to 100% infertile within 48 h and the females were devoid of spermatozoa, suggesting that T. pteropodis copulate at least once daily. In prolonged infections, worm fecundity and egg fertility diminished, so that females with stored spermatozoa were producing mixtures of fertile and infertile eggs. PMID- 2777465 TI - Carbohydrate metabolism in adult schistosomes of different strains and species. AB - In this comparative study the carbohydrate metabolism of Schistosoma japonicum, S. haematobium, S. intercalatum, S. bovis and three strains of S. mansoni was investigated. No large differences were found in the protein and glycogen contents of all species involved. In all species investigated, lactate was the main end product of carbohydrate breakdown. However, all parasites degraded part of the glucose to CO2 via the Krebs cycle. No difference was observed in the contribution of this aerobic process to energy production in the three strains of S. mansoni investigated. The differences in Krebs-cycle activity between the five schistosome species investigated were very small. Therefore, this study refutes the idea that significant differences exist in the carbohydrate metabolism of various schistosome species or strains. PMID- 2777466 TI - Extraction and identification of a 31,000 mol.wt glycoprotein antigen of Ostertagia circumcincta by sera from resistant sheep. AB - Under similar extraction conditions, Triton X-100 sonicates gave higher yields of protein from third stage larvae and adult O. circumcincta than seven other detergents tested. Using sera from sheep which had been experimentally defined by both immunological and parasitological parameters as being either resistant or susceptible to O. circumcincta, a molecule from Triton X-100 extracts of third stage O. circumcincta larvae was identified which reacted preferentially with sera from resistant sheep. This molecule has a molecular weight of 31,000 and preliminary characterization studies revealed it to be a glycoprotein which was not found in later larval stages or adult worms. Antibodies to this 31,000 mol.wt antigen were present in sera of sheep as early as 3 weeks after experimental infection with O. circumcincta. PMID- 2777467 TI - Pathological and haematological responses of cats experimentally infected with Toxocara canis larvae. AB - Responses of eight adult cats to one or two infections with larvae of Toxocara canis were studied up to 39 days post infection (DPI). Clinically, all cats remained normal throughout the study. The major necropsy finding was multifocal, white to grey nodules mainly within the liver, lungs and kidneys; live larvae were found in liver nodules. Histologically, the nodules were eosinophilic granulomas. Granulomas containing a larval section were observed mainly within the liver. All infected cats had variably severe, eosinophilic arteritis and bronchiolitis and medial hypertrophy and hyperplasia of the pulmonary arteries. No inflammatory eye lesions were detected. Circulating eosinophil levels increased in all infected cats; peak values of 15,790 and 10,050 eosinophils microliters-1 were observed at 25 or 32 DPI in cats receiving a single or double infection, respectively. Bone marrow of all infected cats exhibited marked eosinophilic hyperplasia which did not correlate with the level of circulating eosinophilia. Thus, infection of cats by the larvae of T. canis causes disseminated eosinophilic and granulomatous disease with marked pulmonary artery and airway lesions. PMID- 2777468 TI - Genetic characterization of three strains of Hymenolepis diminuta at 39 enzyme loci. AB - The technique of allozyme electrophoresis was applied to three strains of Hymenolepis diminuta to distinguish between three hypotheses [(1) multiple species, (2) genetically distinct founder stocks and (3) response to differential selection among similar stocks] proposed to account for metabolic differences among strains. There was no evidence from the 39 enzyme loci established that the three strains represented more than one species. In the absence of knowledge of the population structure of H. diminuta in the wild, electrophoretic data herein could not distinguish between the latter hypotheses. Nevertheless, all three strains were distinguishable on electrophoretic profiles and allelic similarities between strains question the view of their proposed origins. PMID- 2777469 TI - Geographic variation in Giardia karyotypes. AB - Chromosomes of 41 stocks of Giardia duodenalis derived from humans and 14 stocks from other animal species were analysed by field inversion gel electrophoresis (FIGE). These stocks have two predominant karyotypes as judged by FIGE which appear to fit a geographic distribution. Under FIGE conditions used to optimize the detection of size variation in Giardia chromosomes, five or six major chromosomes could be identified. Most of the stocks derived from North America have three major chromosomes smaller than 800 kb while most of the Australian stocks have four. A few exceptions, and minor variations, of these karyotypes were observed. It was estimated that not all of the DNA entered the gel, the remainder being trapped conformations or very large chromosomes. Karyotypes of Giardia stocks from different animal hosts and human sources within a geographical region are similar. PMID- 2777470 TI - Population evolution of the free-living stage of goat gastrointestinal nematodes on herbage under tropical conditions in Guadeloupe (French West Indies). AB - In Guadeloupe (French West Indies), paddocks were contaminated with gastrointestinal helminth eggs by young goats during the rainy season and the dry season. The evolution of L3 population size on herbage was followed over a period of 56 days. The major genera were Haemonchus and Trichostrongylus. It was shown that the L3 appeared on herbage 7-14 days after the beginning of contamination (DAC), and the L3 population sizes were maximal between the 14th and the 21st DAC. The maximum duration of larval survival ranged between 49 and 56 days. There was a marked depressive effect by the dry season on eggs hatching and L3 development with some arrested egg hatching in Trichostrongylus. The climatic events and the amount of dry matter on pastures during the grazing period appeared as the main important factors which could interfere with the overall evolution of the L3 population size and there was no preferential direction of L3 migration from faeces to herbage. PMID- 2777471 TI - Pasture populations of cattle nematode larvae in Guadeloupe (French West Indies). AB - The development of numbers of third-stage (L3) larvae of gastrointestinal nematodes after pat (faeces) deposition by heifers is described, using a mathematical model, for seven experiments carried out in Guadeloupe (French West Indies). A dramatic rise in L3 population size occurred on herbage near pats, 17 25 days after pat deposition. There was no clear relationship between climatic data and L3 population dynamics. However, 5 successive days of rainfall induced the resumption of larval migration in two experiments. Changing the unit of expression of L3 population size (100 L3 m-2 vs 1000 L3 per kg DM) did not alter estimates of the model parameters. The evolution of L3 population of Haemonchus and Cooperia were similar. PMID- 2777472 TI - Echinostoma caproni in mice: studies on the attachment site of an intestinal trematode. AB - During infection in mice Echinostoma caproni is attached to the mucosa of the small intestine with the ventral sucker (acetabulum). The morphology, histology and dynamics of attachment sites from primary infections were examined. The sites were highly characteristic microscopically, and consisted of a plug of grasped mucosa occupying the cavity of the ventral suckers. The mucosa in the area of the small intestine where the parasite resided showed marked villous atrophy and crypt hyperplasia. The cellular composition of the attachment sites did not appear significantly different from what was seen in other parts of the mucosa in the residential area, and the study did not reveal any specific cellular host response at the attachment site. After mechanical removal of the parasites from unfixed tissue in saline, the attachment sites gradually reduced in size and disappeared. It is suggested that the attachment sites are only temporary structures, formed by the mechanical grasp of the ventral sucker as the parasites move about in the residential area of the intestine. PMID- 2777473 TI - In vitro adherence of bovine erythrocytes infected with Babesia bovis to thrombospondin and laminin. AB - This study was undertaken to examine how eight putative adhesive agents bound to plastic surfaces affected the capacity of bovine erythrocytes, infected with either virulent or avirulent strains of Babesia bovis, to adhere in vitro. Thrombospondin (TSP) induced B. bovis-infected bovine erythrocytes to adhere and adherence was augmented when the infected blood was cultured for 24 h before the assay. Moreover, TSP also caused erythrocytes infected with avirulent strains of B. bovis to adhere to plastic in vitro. Laminin promoted the adherence of infected, and to a lesser extent, of uninfected erythrocytes. PMID- 2777474 TI - Scanning electron microscopic observations of adult Baylisascaris procyonis (Nematoda). AB - The scanning electron microscope was used to illustrate the microtopographic features of the caudal end of adult male Baylisascaris procyonis. The male tail was relatively long, smoothly attenuated and often had a small button-like or mucronate termination. The preanal papillae were situated ventrally in two slightly divergent and somewhat irregularly spaced rows. Anterior and posterior to the anus were two slightly raised roughened patches consisting of several rows of small spines. Just anterior to the anus along the outer margin of the preanal roughened patch was a large double medioventral papilla. There were five pairs of postanal papillae with the first pair just posterior to the anus being double while the remaining four pairs were more closely associated in a group near the tail end. The second pair were also double papillae; however, in a few specimens they were not fused and appeared as two single closely associated papillae. The last three pairs of papillae were single. The fourth pair of caudal papillae were the phasmids and in the center of each was a ringed pore-like opening. The spicules of the male had a highly sculptured surface with a pincher-like terminal end. PMID- 2777475 TI - Design, synthesis and antibacterial activity of cecropin-like model peptides. AB - In order to investigate structure-activity relationships of cecropins, model peptides that mimic certain structural features of the cecropin molecules were designed and synthesized. The conformational analysis of cecropins and the design of the model peptides were based on Chou-Fasman calculations. The peptides were synthesized by solid-phase methods and purified by reverse-phase liquid chromatography on C18-silica columns. Their secondary structures were studied by circular dichroism measurements. Antibacterial activities against seven test organisms were determined and compared to the activities of the natural cecropins A and B. These results were discussed on the basis of structural features of the model peptides and on model mechanisms. It was concluded that high antibacterial activity for this class of compounds requires a basic helical amphipathic N terminal segment that is connected to a hydrophobic helical C-terminal segment by a flexible non-helical hinge region. PMID- 2777476 TI - Conformational stability of antamanide and analogs. Crystal structure of perhydrosymmetric antamanide, cyclic (-Val-Pro-Pro-Cha-Cha-Val-Pro-Pro-Cha-Cha-). AB - The synthetic perhydrogenated symmetric analog of the cyclic decapeptide antamanide is biologically inactive, although the conformation of the molecule and the crystal packing are very similar to that of the active symmetric analog of antamanide. In fact, the same conformation for the molecule has now been found in six polymorphs of uncomplexed antamanide and its analogs. The differences between the active and inactive antamanide analogs are displayed dramatically in the conformations of their metal ion (Na+ or Li+) complexes, thus suggesting strongly that for physiological activity antamanide is not in the conformation assumed by the uncomplexed molecule, but rather in the conformation assumed by the complexed state of natural antamanide. The present structure crystallizes in space group P2(1)2(1)2(1) with a = 20.515(14) A, b = 21.316(16) A, c = 17.128(16) A and four peptide molecules in the unit cell. There are three cocrystallized water molecules at full occupancy intrinsic to the peptide, and several more water molecules or other solvent molecules at partial occupancy. The formula of the peptide is C66H106N10O10.4-H2O.2X. PMID- 2777477 TI - Antigenic sites on ribonuclease A. Synthetic peptides corresponding to the sites 37-42 and 83-88 on ribonuclease A show immunogenicity. AB - Two hexapeptides NH2-Lys-Asp-Arg-Cys-Lys-Pro-COOH and NH2-Asp-Cys-Arg-Glu-Thr-Gly COOH corresponding to the strong hydrophilic regions 37-42 and 83-88, respectively, on ribonuclease A were synthesized by solid-phase method. These synthetic peptides showed antigenic characteristics and provided an experimental validity to the prediction made earlier, supporting the view that highly hydrophilic regions on the protein have a good correlation with their being potentially antigenic. PMID- 2777478 TI - Immuno-affinity purification of specific antibodies against human gastrin releasing peptide (h-GRP) by the h-GRP(1-8)-linked polydimethylacrylamide resin. AB - A new method for immuno-affinity purification of specific antibodies against human gastrin releasing peptide(h-GRP) was developed. The antiserum GP(No. 6201) elicited by h-GRP-BSA conjugate was heterogeneous and reacted not only with h-GRP and its fragments but also partially with other structurally related peptides, such as other GRPs (porcine, canine, and chicken), bombesin, and neuromedin-C. To obtain specific antibodies against human GRP, antiserum GP was purified by column chromatography on the amino-terminal octapeptide h-GRP(1-8)-linked polydimethylacrylamide resin. The antibody thus obtained was highly specific to amino-terminal sequence of h-GRP and hardly reacted with other GRPs (porcine, canine and chicken), bombesin, and even carboxy-terminal h-GRP fragments in ELISA. PMID- 2777479 TI - The direct access method of teaching reading and the diagnosis and remediation of reading disability. AB - A distinction among reading disabled children based on whether phonetic or semantic deficits predominate has important implications for remediation. Two kinds of reading disability are related to two distinct aspects of the indirect phonological approach used in the vast majority of reading instructions. This approach to determining the meaning is a conversion of the written form of a word to its phonetic counterpart, making the comprehension auditory. Phonetic reading disabled children have a difficulty with the first step in the process, converting the written word to its sound. Semantic reading disabled children can convert the word to its sound, but this does not lead to determining meaning. Significant gains in performance, may occur by using a direct access to meaning, rather than through the intermediary of sound. The Direct Access approach to reading has one premise: Do not use a "word to sound to meaning" approach. The results of a demonstration project indicate the Direct Access approach to reading can be very useful for many reading disabled children. PMID- 2777480 TI - Detection of event related potentials. AB - A statistical approach is presented which provides efficient procedures to detect both Event Related Potential (ERP) and its spectral structure. Situations where undesirable signal or "artifact" is present, are considered. In these cases, a "noise" sample can be used which complements the insufficient knowledge given for the sample where we expect to detect the ERP. In this approach, Hotelling's T2 statistic for one and two samples arises as a natural detector of ERPs. Under the assumption of stationarity these statistics are calculated by approximate expressions in the frequency domain. For Brainstem Auditory Evoked Potentials, ROC curves confirm that the T2 statistic has higher detection rates than various indices proposed in the literature. A frequency decomposition of the T2 statistic yields a succession of complex versions of Student's t statistic that characterize the spectral structure of the ERP. Different assumptions about the recordings of ERP are discussed and several generalizations are suggested. PMID- 2777481 TI - Visuospatial disorders and related lesions of the brain. AB - Ten right-handed patients suffering from visuospatial impairment were examined. The impairment was ascertained by a test requiring visual organization (picture completion). The patients did not suffer from other neuropsychological disorders (e.g., aphasia, dementia). Furthermore, psychiatric symptoms and defective oculomotion (gaze paresis, ocular paresis) were controlled. CT scan data revealed that in 4 patients the impairment was associated with lesions of the posterior right hemisphere. All lesions involved the central optic pathways and were accompanied by visual field defects. On the other hand, 6 patients turned out as suffering from damage of the cerebellum or brainstem. The available electronystagmographical data revealed impaired visual fixation, an oculomotor defect characterizing gaze apraxia, the diagnostic marker of Balint's syndrome. PMID- 2777482 TI - Subtle/obvious MMPI scales identify attention deficit disorder alcoholics. AB - Earlier research has demonstrated that alcoholics with or without attention deficit disorders, residual type (ADDRT) can be differentiated by Minnesota Multiphasic Personality Inventory (MMPI) Clinical Scale Profiles. This study addressed the question of whether that differentiation was made by virtue of subtle or obvious aspects of the MMPI item pool. Groups of 30 of male alcoholics with or without ADDRT were individually matched on age and education variables. Statistically significant differences were found for the D-O, HY-O, HY-S, PD-O, PA-O, PA-S, MA-O, MA-S, ES and A scales. PMID- 2777483 TI - Dead cells can be phagocytosed by any neighboring cell in early developing rat brain. AB - We investigated phagocytosis in vitro, on tissue samples of rat brain from 10th to 18th embryonic days. Our results show that, in the early stage of development, degenerated cells can be phagocytosed by any neighboring cell in the brain. The phagocytosing cells were of the same type as the others and did not resemble microglia in the samples obtained from 10th to 14th embryonic days. In embryonic rat brain microglial cells have been reported to appear after the 12th day, while phagocytosing cells were already observed in our 10- and 12-day materials as well. The general ability of embryonic rat brain cells to phagocytose is further supported by the results of horseradish peroxidase studies. Typical microglial cells could be observed in our 16- and 18-day materials. On the basis of our results we do not intend to modify the notion on the origin of microglia. Our concept is that the microglia gradually replaces the multipotential cells of the embryonic brain in their "cleaning-off" function as the differentiation of these latter cells progresses. PMID- 2777484 TI - Processing of emotional cues in patients with dementia of the Alzheimer's type. AB - Previous research on patients with dementia of the Alzheimer's type (DAT) has focused primarily on intellectual and memory deficits. The present study investigated another aspect of cognitive functioning, that of processing of emotional cues. Subjects included 30 DAT patients and 13 normal controls who were asked to identify emotional expressions in pictured faces and in tone of tape recorded sentences. A battery of neuropsychological tests was also administered. DAT patients were impaired on all tasks as compared to controls of comparable age, education and previous occupation. Multiple regression analyses demonstrated that the two emotional tasks were the most highly correlated of all the tasks for the patient sample. This relationship is discussed as validating the emotional tasks as measures of emotional cue processing rather than reflecting deficits based only on other task dimensions. PMID- 2777485 TI - HRNB factors with simultaneous-successive marker variables. AB - The Halstead-Reitan neuropsychological Battery (HRNB) was factor-analyzed along with a simultaneous and successive processing index form, the WISC-R. Using 970 learning disabled children, a four factor solution was found to represent the underlying structure best. The factors included: (1) Simple Motor, (2) Tactile Kinesthesis with simultaneous processing demands, (3) Memory/Attention with interpretable loading on the successive processing index, and (4) Noverbal Visual Spatial Memory with simultaneous processing demands. PMID- 2777486 TI - Children as informants of neuropsychological symptomology: the child neuropsychological symptom inventory. AB - Despite the rapid growth in child neuropsychology, there remains a paucity of measures which examine neuropsychological symptomology in children. In keeping with the need to understand the history and dimensions of children's presenting problems, the present investigation assessed the utility of a self-report neuropsychological symptom inventory with children. Study I examined the internal consistency of the Child Neuropsychological Symptom Inventory (CNSI) while Study II examined the stability of children's responses over a two week delay. Results indicate that the CNSI is a relatively stable instrument for assessing children's self-report of neuropsychological symptomology. The data were interpreted as lending support for having children act as self-informants. PMID- 2777487 TI - Loudness scales from loudness processes: a multivariate approach. AB - Five subjects were required to judge the loudness of pure tones that varied in intensity and duration (Experiment 1), in intensity and frequency (Experiment 2), or in duration and frequency (Experiment 3). Results of all three experiments were consistent with the respective models of sensory integration expected to underlie the various judgmental tasks (multiplicative for the first experiment, unidimensional for the latter two). Despite the use of common stimulus values across experiments and instructions to judge solely loudness, different loudness scales emerged. This outcome supports a task dependent, multirepresentative scheme for loudness. PMID- 2777488 TI - Effects of arousal and directed attention on hemispheric asymmetry in a finger tapping dual-task paradigm. AB - In the present study we investigated the effects of concurrent verbal (reading) and nonverbal (humming) cognitive tasks on right- and left-hand finger-tapping in relation to hemispheric asymmetry in right- and left-handed females and males. The aim of the study was to investigate effects of attending either to the cognitive or manual task, and effects of differences in arousal attributed to the various tasks. The results revealed decreased finger-tapping frequency in males, and especially in right-handers, during execution of both the reading and humming task. For the reading task, the interference was lateralized, with a greater decrease in tapping frequency in the right hand. No interference was observed in the female groups. Biased attention to the cognitive or manual task did not have any effect on finger-tapping. However, increased arousal was observed during execution of the humming task, thus indicating this to be a mediating factor in finger-tapping interference. PMID- 2777489 TI - Melanocyte stimulating hormone (MSH) in the restless-legs syndrome. PMID- 2777490 TI - Experimental research of a set as a means of a set as a means of understanding specific characteristics of psychological constitutions. AB - Primary specific characteristics of psychological reactions, typical of the individual and undoubtedly influencing the formation and dynamics of his character, can be defined as "psychological constitution." Experimental study of peculiarities of an individual's set by the method elaborated by D.N. Uznadze and his school was chosen as a way to elicit psychological constitution. The manner in which the subject creates a model of the situation and the rate at which this model is destroyed when it fails to correspond to the perceptual data, appear to be the central question. A conceptual approach is suggested for evaluation of experimental data as characteristics of the individual's psychological constitution. It turns out thereby to be possible, theoretically and experimentally, to single out 8 basic types of psychological constitutions, or "primary psychotypes." PMID- 2777491 TI - The neurophysiological bases of high IQ. AB - It is suggested that the study of human intelligence must ultimately involve the study of brain processes which limit the availability of information. Consideration of EEG/intelligence studies suggests that inconsistent findings may have arisen partly from the expectation of simple rectilinear relationships where relationships are likely to be curvilinear. There are also theoretical and technical problems such that it is difficult to specify what conventional EEG procedures measure. The EEG evoked potential (EP) data described in this paper were obtained with a new and more powerful analytical procedure based on methods and concepts of systems analysis. With this procedure, EP responses are used to ascertain the relative values of parameters which quantify differences in the transmission characteristics of thalamocortical neuron populations. The results obtained from a study of 48 subjects indicate that high IQ is associated with combinations of neurological parameters which determine an intermediate degree of "arousability" in the cerebral cortex and related structures. This relationship is accounted for in terms of the generally optimal effect that an intermediate degree of arousability would have on different neurophysiological processes mediating the acquisition, retention and utilization of information. Thus, with some important qualifications, middling arousability can be conceived as the neurophysiological basis of high general intelligence or "g". PMID- 2777492 TI - Neuroepidemiology of Parkinson's disease: analysis of mortality data for the U.S.A. and Georgia. AB - Death rates for Parkinson's Disease (PD) in the U.S.A. and the state of Georgia were investigated for the period 1979-83. Age adjusted death rates for the U.S.A. were greater in whites than blacks and greater in men and women. No differences were found in Georgia between urban and rural counties. Death rates were not higher in countries containing paper mills. PMID- 2777493 TI - Further studies on the effect of ASF factor on Cl- permeability across the Deiters' neurone plasma membrane. AB - Experiments have been performed in order to assess whether the antisecretory factor (ASF) can influence the permeation of Cl- ions across the Deiters' neurone plasma membrane in the outward direction. ASF is a naturally occurring, acidic protein with a molecular weight of about 60,000, which specifically inhibits enterotoxin-induced intestinal secretion. Both basal and "intracellular" GABA activated Cl- permeability was studied, and the result confirmed the existence of GABAA receptors on the Deiters' membrane cytoplasmic side. ASF completely abolished the effect of "intracellular" GABA on Cl- permeability in the outward direction. However, ASF did not influence the basal Cl- permeability in the outward direction. PMID- 2777494 TI - Neurotrophic action of leupeptin, a protease inhibitor on ventral spinal cord in culture. AB - Studies with organotypic culture of ventral spinal cord revealed that leupeptin, a protease inhibitor at 10(-4) to 10(-10) M exerts a marked growth-stimulating effect. The presence of leupeptin, the neuritic extension of ventral spinal cord exceeds control values 1.5-4.9 times. The growth zone of spinal cord explants increases in the leupeptin treated cultures. The possible mechanism of trophic effect of leupeptin on cultured ventral spinal cord was briefly discussed. PMID- 2777496 TI - Hepatic mitochondrial membranolysis repairing by spermidine. AB - Hepatic mitochondrial membrane lysis is caused due to excess vitamin A, has been repaired by spermidine. This fact has been proved by estimating membrane proteins, lipids, phospholipase A2 activity and membrane phospholipids of rat liver mitochondria by studying the effect of spermidine on membranolytic effect of excess vitamin A. Spermidine has been found to inhibit the activity of phospholipase A2 and thus stabilize the hepatic mitochondrial membranes in the hypervitaminoic A model, that is to say, the spermidine tries to bring down the enormously elevated levels of phospholipase A2 by administration of excess vitamin A in rats. PMID- 2777495 TI - Facilitory role of thyroid hormone in vitamin A uptake in the rat testes. AB - The inter-relationship of hormones and retinol (vit. A) metabolism is under investigation in our laboratory. The investigation is designed to study the role of thyroid hormone (tetraiodothyronine, T4) in the uptake of vit. A in various rat tissues. Adult male thyroidectomized (Tx) rats, partially vit. A deficient, were administered intragastrically tritium-labeled vit. A. Twenty-four hours later, the level of radioactivity was measured in the blood plasma, liver, kidneys, testes and urine collected for 24 hrs. The data showed that in Tx rats, there was a significant decrease (P less than .01) in the level of radioactivity in the kidneys, testes and urine; in blood plasma and the liver, there was a significant increase (P less than .01). In Tx rats, treatment with T4 restored 50 70% of the radioactivity lost in the kidneys, testes and urine. The endogenous vit. A level in Tx rats treated without and with T4 followed essentially the same pattern. The capacity of cellular retinol binding protein (CRBP) to bind exogenously added vit. A was examined. The data showed a decrease in the binding capacity of CRBP in Tx rats. We conclude that T4 facilitates the uptake of vit. A in the target tissues by regulating CRBP synthesis or degradation. PMID- 2777497 TI - Effects of vitamin E and selenium deficiencies on rat capillaries. AB - Capillaries in the retina and rectus muscles of vitamin E and selenium deficient rats were examined by electron microscopy. In vitamin E deficient rats, retinal capillaries showed thickening of the basement membranes of the endothelial cells. On the other hand, capillaries in the muscles had thin basement membranes, and hemorrhages occurred due to the breakdown of endothelial cells. In selenium deficient rats no significant abnormalities were seen in retinal or muscle capillaries. Although selenium has been considered to be similar to vitamin E as an antioxidant, the present study suggests that they are different. The effect of vitamin E on capillary basement membranes varies from tissue to tissue. PMID- 2777498 TI - In vivo effects of vitamin E on peritoneal macrophages and T-kininogen level in rats. AB - In order to clarify the modulating effect on macrophages by vitamin E, we investigated the in vivo effects of vitamin E on the peritoneal macrophages and T kininogen level in rats. Peritoneal injections of vitamin E for 6 successive days resulted in a significant increase of leucocytes, mostly consisting of macrophages, in the peritoneal cavity. Namely, in the case of 5 mg vitamin E per rat (400 g body weight), the number of leucocytes in the peritoneal cavity and T kininogen level in plasma showed 171.57 +/- 15.96 X 10(6) per rat and 1372 +/- 364 micrograms/ml, whereas the placebo vehicle was 28.54 +/- 8.24 X 10(6) and 315 +/- 130, respectively. Macrophages, in which alpha-tocopherol contained approximately 158.2 ng/10(6) cells after exogenous vitamin E treatment, showed less acid phosphatase activity and less O2- generation than that treated with placebo vehicle. In contrast, the acid phosphatase activity of cellfree peritoneal exudate fluid with vitamin E increased approximately two to three-fold as compared to the placebo vehicle. From these results, we discussed the relationship between in vivo effects of vitamin E on peritoneal macrophages and T kininogen induction. PMID- 2777499 TI - Vitamin E and selenium in preterm infants: lack of effect on clinical patency of ductus arteriosus. AB - Levels of antioxidant defenses, which include vitamin E and Se-dependent GSH-Px, are generally relatively low in the fetus and neonate. Se-dependent GSH-Px and vitamin E are known to modulate biosynthesis of eicosanoids and therefore could have the potential for affecting patency or closure of the ductus arteriosus after birth. We evaluated some indices of antioxidant defense in sick LBW infants in relationship to one another as well as to clinical PDA, and investigated the effects of producing a rapid rise in serum vitamin E levels in some of these infants. Twenty-nine sick preterm infants (B. W. 750-1750 g) were randomized into control and vitamin E supplemented groups; the latter received dl-alpha tocopherol IM., commencing within 12 hours of birth, to a total dosage of 175 mg/kg over four weeks. Most E-supplemented infants attained serum tocopherol levels greater than 0.50 mg/dl (12 mumol/l) within 24 hours of the first dose. Vitamin E supplementation did not influence clinical patency or closure of the ductus arteriosus, and no correlation could be established between serum levels of alpha-tocopherol, Se, GSH-Px or NPS and PDA. At 4 weeks vitamin E-supplemented infants had serum levels of the other antioxidant indices that were not significantly different from the non-supplemented babies. PMID- 2777500 TI - Kinetic analysis of the effect of luminal pH on transport of folic acid in the small intestine. AB - Transport of folic acid in the small intestine is markedly affected by luminal pH and is optimal at pH 5.5-6.5. To clarify the nature of this pH sensitivity, we measured transport of [3H] folic acid into rat jejunum at pH 5.5 and 7.4, at folic acid concentrations of 1 to 30 microM, using the influx chamber method. At this range of concentrations, uptake of folic acid exhibited Michaelis-Menten kinetics. In order to determine the kinetic parameter which is pH sensitive, we have fitted a modified Michaelis-Menten equation to the pooled data at the two pH conditions such as they share a common Vmax but distinct Km values. This model fitted closely the experimental data (F = 0.693), yielding Km values (+/- SE) of 24.22 (+/- 5.96) and 36.32 (+/- 8.73) microM for pH 5.5 and 7.4 respectively. The difference in the Km at the two pH conditions was statistically significant (p less than 0.01). The change in affinity for folic acid transport at the two pH conditions may reflect different membrane carriers, or may be due to protonation of a membrane carrier and/or the folic acid molecule, favored at low pH. PMID- 2777501 TI - Vitamin C lowers mutagenic and toxic effect of hexavalent chromium in guinea pigs. AB - The mutagenic effect of intraperitoneally injected K2Cr2O7 was significantly higher in vitamin C-deficient guinea pigs than in animals fed diet with high vitamin C content. Mutagenic and toxic effects of hexavalent chromium were more expressed in vitamin C-deficient guinea pigs administered K2Cr2O7 in drinking water: the number of micronuclei in polychromatic erythrocytes of bone marrow was increased, and the activity of O-demethylase and the levels of cytochromes P-450 and b5 in liver microsomes were decreased. In guinea pigs fed high vitamin C diet the same doses of bichromate in drinking water evoked no mutagenic changes in the bone marrow and no changes in microsomal enzymes in the liver. These results indicate that high intake of ascorbic acid in the diet reduces mutagenic effects of K2Cr2O7 and its toxic influence on drug metabolizing enzymes in hepatocytes. The protective effect ascorbic acid consists most probably in the enhanced extracellular and intracellular reduction of hexavalent chromium to the less toxic and less mutagenic trivalent chromium. PMID- 2777502 TI - The influence of anesthesia and surgery on plasma cortisol and tissue ascorbic acid levels in the guinea pig. AB - The influence of methoxyflurane anesthesia alone compared to anesthesia and laparotomy surgery on plasma cortisol (PC) levels and tissue ascorbic acid (AA) levels was examined in adult male albino guinea pigs (485 +/- 7 g) consuming 500 mg AA/kg diet. Anesthesia resulted in a 60% decrease in food intake on day 1 after treatment, while surgery resulted in a 71% decrease. By day 4, food intake for both groups was equal to that of control animals. Body weight decreased 5-7% on day 1 after both treatments; recovery of body weight to pre-treatment levels was slowest in the animals exposed to surgery. After anesthesia alone, PC levels were twice that of controls by 1 hr and the five-fold higher peak PC level was observed at 9 hr. Surgery induced a more immediate five-fold rise in PC level that plateaued at 1 hr. PC levels decreased to levels similar to the control animals after 72 hr after both treatments. Weight, percent water, and AA levels of tissues examined at seven days after treatment were similar among groups. The results indicate that the adrenal cortical response to surgery is of the same magnitude as for anesthesia alone, although the peak PC level is more quickly achieved. Tissue AA levels are similar seven days after surgery or anesthesia alone even though elevated PC levels sustained for several days. PMID- 2777503 TI - Inositol and choline levels in the diet and neutral lipid hepatic content of lactating rat. AB - During lactation a methionine supplemented low protein diet or a sufficient protein diet containing 40% of fructose induced an important hepatic lipidosis. Inositol supplementation, but not choline supplementation, strongly reduced, in the case of a low protein diet, and suppressed, in the case of a sufficient protein diet, this lipidosis. PMID- 2777504 TI - Lower levels of vitamin C in plasma and urine of Japanese male smokers. AB - We studied the vitamin C status of smokers and nonsmokers among staff members of our university in 1982. This paper describes the results from the 1983-85 studies. Plasma vitamin C levels (M +/- SD, mg/dl) from smokers and nonsmokers, respectively, were as follows: 0.49 +/- 0.15 (n = 51) and 0.72 +/- 0.23 (n = 73) in 1983, 0.56 +/- 0.13 (n = 48) and 0.84 +/- 0.21 (n = 88) in 1984, and 0.52 +/- 0.15 (n = 56) and 0.86 +/- 0.24 (n = 93) in 1985. The differences between smokers and nonsmokers are all highly significant. Urinary vitamin C levels (M +/- SD, mg/dl) from smokers and nonsmokers, respectively, were 1.8 +/- 0.6 and 2.6 +/- 0.9 in 1983 and 2.0 +/- 0.7 and 2.9 +/- 1.0 in 1984. These differences between the two groups are also highly significant. Both groups were similar in age, height, weight, general health parameters, and vegetable and fruit consumption. Plasma and urinary vitamin C levels were significantly higher in smokers taking vitamin C supplement than in those not taking vitamin C supplement. PMID- 2777505 TI - Nutritional status in Linxian, China: effects of season and supplementation. AB - The ability of a supplement to counteract seasonal alterations in nutritional status for certain vitamins was studied in Linxian, an area in northern China with high rates of esophageal cancer. 150 subjects took one daily pill from April to August (16 weeks), whereas 50 subjects did not take any supplement. Deficiencies of ascorbic acid, riboflavin, folic acid, retinol and tocopherol were prevalent at the outset of the study. The changes in diet occurring between the end of the winter (April) and the start of the autumn vegetable harvest (August) were reflected in greatly improved ascorbic acid status and slightly improved riboflavin status. Plasma retinol, tocopherol, alpha-carotene and beta carotene were little affected by season, whereas erythrocyte folate levels declined. The ascorbic acid, riboflavin, folate, retinol and tocopherol status of the supplemented subjects was significantly improved. After 16 weeks of supplementation, erythrocyte folate levels of subjects with esophageal dysplasia were improved but remained significantly lower than those of normal supplemented subjects, targeting folic acid as a nutrient of particular interest in this precancerous condition. PMID- 2777506 TI - Relationship between serum ferritin, erythrocyte protoporphyrin and transferrin saturation in Mauritanian free living children. AB - Serum ferritin, serum iron, total iron-binding capacity (TIBC) and erythrocyte protoporphyrin were measured in a group of 69 children (6.4 +/- 3.6 years) living in a rural area of Mauritania. The predictive value of low serum ferritin was calculated for each iron parameter. A serum ferritin value above 12 micrograms/l was present in 50.2% of children with abnormal serum iron, in 59.0% of those with abnormal TIBC, in 60.3% of those with abnormal transferrin saturation and in 60.0% of those with abnormal erythrocyte protoporphyrin. The percentages varied from 88.0 to 94.8% for a predictive value of serum ferritin of less than 50 micrograms/l. Nearly 35% of children had biochemical evidence of iron deficiency, i.e. 2 abnormal independent iron parameters or more, including serum ferritin of less than 12 micrograms/l. Nearly 32% had probable iron deficiency, i.e. 2 abnormal independent iron parameters, with a serum ferritin value between 13 and 50 micrograms/l. PMID- 2777508 TI - Effect of supplementation with vitamin A or plant carotenes on plasma retinol levels among young Egyptian males. AB - Thirteen young Egyptian males with initial low plasma retinol level were divided into three groups and received single oral vitamin A dose of 200,000 IU, or carotene supplement in the form of boiled spinach leaves, providing roughly 617 RE/day or carrots providing 394 RE/day. The three supplements were equally effective, when the plasma retinol level was measured 40 days later. On a price basis, the vitamin A capsules and the carrots were much cheaper than the spinach supplement. PMID- 2777507 TI - Nutrition evaluation and mutagenicity testing of freeze-dried distiller's grains with solubles. AB - Distiller's grains with solubles (DGS) was obtained from a commercial fermentation of 90% corn and 10% wheat for ethanol production. The DGS was freeze dried and proximate analysis resulted in 17.6% protein, 5.5% fat, 3.0% ash, 17.3% moisture, 21.6% neutral detergent fiber, and 35% carbohydrate by difference. Fatty acid analysis and amino acid analysis were similar to those of corn. Tryptophan was the limiting amino acid with a chemical score of 47. Protein Efficiency Ratio (PER) was 1.49. Mutagenicity testing of lipid and aqueous extracts of DGS in the Ames Salmonella mammalian microsome assay were negative. PMID- 2777509 TI - The effect of vitamin A deficiency on the secretion of saliva and two salivary glycoproteins in the adult rat. PMID- 2777510 TI - Vitamin A deficiency in rats enhances intestinal transport of calcium and oxalate in vitro. PMID- 2777511 TI - Regulation of the metastasis of murine ocular melanoma by natural killer cells. AB - In the current study we examine parameters affecting the metastasis of ocular tumors of in vivo derived B16F10 melanoma. In C57BL/6J beige (bg/bg) mice, with low NK activity, metastasis to the lungs was increased and survival time decreased. In C57BL/6J normal (+/+) mice treatment with PK136, a highly specific monoclonal anti-NK antibody (Ab), caused a depletion of NK cytotoxic activity, as demonstrated using a standard 51Cr release assay. In animals bearing ocular tumors, treatment with PK136 Ab resulted in significantly increased pulmonary metastasis and an altered pattern of metastasis. The effect of combined treatment protocols using LS2616 (linomide) and cyclophosphamide (Cy) was examined in enucleated and unenucleated animals. Treatment with LS2616 and Cy resulted in a significant decrease in mean pulmonary metastases (MPM), a decreased frequency of metastasis to the submandibular lymph nodes and an increase in mean survival time. In enucleated mice this combined treatment protocol resulted in apparent cures, the lowest MPM and the longest survival time observed. When tumor-bearing mice were treated with either silica, carrageenan or sublethal gamma irradiation, no effect on metastasis or survival was observed. This study demonstrates the importance of the NK cell as a primary effector cell for the control of metastasis from in vivo derived ocular B16F10 melanoma. PMID- 2777512 TI - Fenestrated subendothelial basement membranes in human retinal capillaries. AB - A correlated TEM and SEM study of human retinal capillaries and their associated basement membranes (BMs) was carried out. Control tissues show that these vessels are comprised of a continuous layer of endothelial cells separated from overlying intramural pericytes by a discontinuous subendothelial BM (EBM) which accommodates endothelial cell-pericyte (periendothelial) junctions. Three types of junctions exist, including: (1) "peg-and-socket" arrangements where cytoplasmic processes of the two cell layers interdigitate; (2) adhering plaques similar to desmosomes; and (3) cell/cell contacts where adjacent cell membranes appear to fuse or remain separated by a approximately 2 nm space. Following detergent solubilization, acellular retinal capillaries maintain their cylindrical histoarchitectures and all BM components are imaged by TEM and SEM. Topographical (SEM) studies of cryofractured samples show EBM surfaces with numerous (approximately 1.5/microns 2) oval fenestrations (100-450 nm diameter) that correlate well with EBM discontinuities occupied by periendothelial junctions in control tissues. It seems possible that these structures may play an important role in diabetic retinal neovascularization where pericytes are known to degenerate selectively. In this condition, preformed EBM deficiencies could facilitate endothelial cell migration and sprout formation, leading ultimately to the sequelae of proliferative diabetic retinopathy. PMID- 2777513 TI - Comparative study of vitreous oxygen tension in human and rabbit eyes. AB - For the first time, vitreous oxygen tension in the human vitreous body was measured using a polarographic oxygen electrode during vitreous surgery. The same method was used in a rabbit experimental model. In the human eye, the mean oxygen tensions of the anterior peripheral vitreous body, central vitreous body and posterior vitreous body were 16.7 +/- 3.7 mm Hg (mean +/- 1 SD), 15.9 +/- 2.8 mmHg and 19.9 +/- 4.8 mm Hg, respectively, while the preretinal oxygen tension of the detached retina was 30.0 +/- 4.8 mm Hg. In the rabbit eye, the mean oxygen tensions of the anterior peripheral vitreous body, central vitreous body and posterior vitreous body were 13.9 +/- 4.3 mm Hg, 16.0 +/- 3.5 mm Hg and 22.5 +/- 2.1 mm Hg, respectively. The preretinal oxygen tension of the attached retina in the rabbit eye was 39.5 +/- 3.4 mm Hg, while that of the detached retina decreased to 4.3 mm Hg. When comparing human with rabbit eyes, it appears that the vitreous oxygen tensions are similar, except over the detached retina, even though the ocular circulation differs. We believe that human retinal vasculature plays an important role in perfusing the detached retina with relatively high levels of oxygen. PMID- 2777514 TI - Choriocapillaris regeneration in the rabbit. Ultrastructure of new endothelial tube formation. AB - After experimental destruction of the retinal pigment epithelium (RPE) by intravenous injection of sodium iodate, the rabbit choriocapillaris (CC) atrophies. This report studies the subsequent regeneration of the CC with the goal of identifying sources of new CC and mechanisms by which new endothelial tube is formed. Light and transmission electron microscopic methods were used. The CC appeared to regenerate from three sources: choroidal venules, remnant CC and newly produced cells. Whatever the source, new endothelial tube was formed by extensions of the endothelium that sealed off new lumenal space by junctional complexes. This process was always confined to the tissue space within remnant sleeves of basement membrane left behind by initial atrophy, and which served as a substrate for endothelial movement. The endothelium of new endothelial tube was initially thick and unfenestrated. It became thinner and fenestrated by a process of cavitation, in which cavities continuous with the lumen pushed into the thick endothelial cytoplasm towards its abluminal side. At this site new fenestrae were formed. Fenestrae were initially scattered about the endothelial tube, but with its maturation became localized on the side facing the regenerated RPE. PMID- 2777515 TI - Vitreous modulation of migration and proliferation of retinal pigment epithelial cells in vitro. AB - Retinal pigment epithelial (RPE) cell migration and proliferation are believed to play a role in the pathogenesis of proliferative vitreoretinopathy (PVR). Since PVR develops in situations where vitreous contacts the RPE, we sought to determine whether human vitreous contains factors that stimulate proliferation and migration of RPE cells. We found that postmortem human vitreous stimulates migration but not proliferation of human RPE cells under serum-free conditions in vitro. Stimulation of proliferation of RPE cells and fibroblasts was observed, however, following admixture of albumin with the vitreous. These findings suggest that vitreous contributes modulators that stimulate some functions of RPE cells that are believed to play a role in the pathogenesis of PVR. PMID- 2777516 TI - The role of wax and sterol esters of meibomian secretions in chronic blepharitis. AB - We analyzed the fatty wax esters and sterol esters found in the expressed lipid secretions of six patients from each of six clinical groups of chronic blepharitis, plus eight normal controls. Using gas liquid chromatography (GLC), 12 peaks corresponding to equivalent chain lengths (ECL) of 33.6, 35.4, 36.1, 37.3, 38.2, 39.2, 40.1, 41.2, 42.1, 43.2, 44.9 and 45.7 were found in the fatty wax esters and five peaks corresponding to ECL 19.1, 20.0, 21.1, 22.0 and 23.2 were found in the sterol esters. The clinical groups showed significant differences in several of these components. Sterol and wax esters represent the largest fraction of the total meibomian lipid secretion. The finding that the blepharitic groups exhibit biochemical differences in the distribution of these esters indicates that the esters may play a role in the disease process, perhaps by providing a preferential substrate for normal flora which we have shown to have lipolytic capabilities. The resultant de-esterification could alter the tear film and contribute to ocular irritation. In addition, the differences seen in the composition of the ester fraction of the meibomian secretion could lead to differences in melting point, which, in turn, could affect viscosity and surface tension of the tear film, leading to changes in breakup time and to secretion stagnation within glands. PMID- 2777517 TI - Quantitative analysis of wide-field specular microscopy. II. Precision of sampling from the central corneal endothelium. AB - The precision of the measurement of mean endothelial cell area obtained by sampling with small-field and wide-field specular microscopy from the central 4 mm of human corneal endothelium was studied by comparing endothelial cell parameters from individual specular micrographs in vivo to the results obtained by montaging the micrographs from the entire central 4 mm of the same corneas. The small samples were at least 10% from the true mean cell size of all cells of the central 4 mm in any endothelium other than that with the most homogeneous pattern. A new algorithm for sampling with these two specular microscopes will need to be derived to permit a more precise measure of the mean area of endothelial cells in the central 4 mm of the human corneal endothelium. PMID- 2777518 TI - Role of spherical aberration in contrast sensitivity loss with radial keratotomy. AB - A technique is described to determine the change in image contrast as a result of the spherical aberration induced by the radial keratotomy procedure. The hypothesis that the loss in contrast sensitivity of the RK eye is due to the change in spherical aberration postsurgically, is found to be acceptable for some patients. However, this is not a sufficient explanation in all cases. This conclusion may be due to assumptions inherent in the technique derived for calculating spherical aberration or to other factors of importance in the post-RK eye. PMID- 2777519 TI - Elastic fibers in the rat exorbital lacrimal gland duct system. AB - In the rat, each paired subcutaneous exorbital lacrimal gland overlies the retromandibular area. The fibrous cord containing its ducts passes over the masticatory muscles to the temporal canthus. Thus, the lacrimal system must accomodate both jaw and lid movements. To see whether elastic fibers exist to modulate alterations in tension caused by such movements, light and electron micrographs were made of its duct system. The innermost elastic fibers are connected by elaunin fibrils and oxytalan microfibrils to the lamina densa, particularly near the hemidesmosomes. The innermost elastic fibers appear to be longitudinal and about 0.2 micron from the lamina densa. Circumferential fibers exist about 0.8-3.2 microns from that structure. More peripheral fibers of both orientations also exist. Light microscopy of the extraglandular duct demonstrated circumferential fibers near the basement membrane and longitudinal and angular elastic fibers amid the collagenous layers. Some of the longitudinal fibers assume a loose cross-weave. Intraglandularly, as duct size diminishes elastic fibers progressively decrease in number and size until the smallest ducts have none. Thus, an elastic gradient exists. It is believed that recoil of the angular elastic fibers aids distension of the large and medium ducts when secretion is great and that recoil of the circumferential ones permits those duct diameters to diminish when secretion does. The longitudinal elastic fibers would allow all but the smallest ducts to recoil from the stretching of much of the exorbital lacrimal duct system accompanying blinking and other facial movements. PMID- 2777521 TI - Monocular geometry is selectively distorted in the central visual field of strabismic amblyopes. AB - Strabismic amblyopia is associated with a distorted perception of visual space. The aim of our study was to investigate the monocular space perception of strabismic observers at several locations in the central and peripheral visual field. We tested nine observers with strabismic and/or anisometropic amblyopia, two strabismic subjects with alternating fixation and two normal control subjects. The task was to align a light stimulus with two vertically arranged reference marks. Testing conditions included three separations of the references along the vertical meridian (10 degrees, 20 degrees and 40 degrees) as well as several presentation sites of the vertical references in the nasal and temporal peripheral visual field (5 degrees, 10 degrees and 20 degrees from fixation). Performance with the amblyopic eye was clearly impaired as compared to the nonamblyopic eye. For alignment along the vertical meridian, all amblyopic eyes showed increased uncertainty in their position judgements. Most of the squinting eyes of amblyopes also displayed a systematic lateral displacement of the test stimulus in relation to the reference marks, in the most extreme case up to almost 7 degrees. Usually, larger errors were found with wider separations of the reference marks. In the peripheral field, the differences between the amblyopic and the nonamblyopic eye diminished or disappeared. Thus, monocular geometry appears to be selectively impaired in the central visual field of the deviated eye of strabismic amblyopes. These spatial distortions might be related to the different states of binocular correspondence in the central vs. peripheral visual field, shown by some strabismic amblyopes. PMID- 2777520 TI - Different patterns of retinal correspondence in the central and peripheral visual field of strabismics. AB - We tested the state of retinal correspondence at different positions in the visual field of ten observers with strabismic and/or anisometropic amblyopia, four strabismic subjects with alternating fixation and three normal controls. Correspondence was evaluated by the subjective displacement of dichoptic stimuli; to estimate the displacement, we used red-green filters, Bagolini striated glasses, polarizing filters and a phase-difference haploscope. Strabismic observers (amblyopes and alternators) frequently showed variations in the angle of anomaly (ie, the amount of shift of space coordinates in the squinting eye) between different regions of the visual field. Correspondence tended to be closer to normal in the central field and more anomalous in the periphery. These findings cannot be explained by the progressive loss of localization sensitivity with increasing eccentricity. We suggest that the different patterns of retinal correspondence in the central and peripheral visual field of some strabismic observers might be due to a mechanism of selective stabilization of binocular connections in the peripheral visual field, where the larger corresponding areas overcome a limited misalignment of the eyes. In the central visual field, normal correspondence is preserved, and diplopia has to be prevented by interocular suppression. PMID- 2777522 TI - Retinocortical time exhibits spatial selectivity. AB - We recorded simultaneous electroretinograms and visual evoked potentials to pattern-reversal stimulus in ten normal subjects employing check sizes subtending 7.5, 15, 30, 60, 120, 240 and 480 min of visual arc. The mean peak latency of the pattern electroretinogram (PERG) b wave decreased logarithmically with increasing check size. The mean peak latency of the pattern visual evoked potential (PVEP) P100 component was shortest for 30 min check size and was longer at both smaller and larger check sizes, a phenomenon termed spatial selectivity. Retinocortical time (RCT) was calculated as the latency difference between the PVEP P100 peak and the PERG b wave. The RCT also exhibited spatial selectivity similar to that of the PVEP P100 component; mean RCT was shortest for 30 min check size and was longer at both smaller and larger check sizes. Implications are discussed in light of our current knowledge of the origins of the PERG and PVEP and visual processing of pattern-reversal stimuli. Simultaneous recording of PERGs and PVEPs in patients with disease of the afferent visual pathways employing a large range of check sizes may increase the diagnostic sensitivity of visual electrophysiologic testing. PMID- 2777524 TI - Near-ultraviolet circular dichroism of bovine high molecular weight alpha crystallin. AB - High molecular weight (HMW) alpha-crystallin isolated from cow nucleus has a molecular weight greater than 5 x 10(6) Daltons. Its particle dimensions have been reported to be over 500 nm. It is derived mainly from low molecular weight (LMW) alpha-crystallin. The conformational change as LMW alpha-crystallin is converted into HMW alpha-crystallin was studied by near-ultraviolet circular dichroism (NUV-CD). The main concern in measuring CD for protein aggregates with particle dimensions as high as HMW alpha-crystallin and with an irregular shape is the contribution of differential scattering. The differential scattering becomes increasingly more important for particles with dimensions greater than 1/20th the wavelength of light. This contribution was minimized by increasing the acceptance half-angle of detection. The present data indicate that bovine HMW alpha-crystallin has a different tertiary structure from LMW alpha-crystallin. PMID- 2777523 TI - Evidence for a neural basis of age-related visual field loss in normal observers. AB - Many studies have reported a decrease in visual field sensitivity as a function of increasing age in normal individuals. This age-related sensitivity loss has mainly been attributed to reductions in pupil size and transmission losses of the ocular media (particularly the lens), although neural losses in the retina, optic nerve and visual cortex have also been suggested. We evaluated the role of preretinal factors on normal visual field changes associated with aging. The central visual field of both eyes of 62 normal subjects (ages 20 to 72) were evaluated with Program 30-2 of a modified Humphrey Field Analyzer. Three test procedures were employed: (1) a standard visual field evaluation; (2) a yellow target on a yellow background condition (530 nm cutoff filter) to minimize the influence of lens transmission losses with age; and (3) a large target/high background luminance "yellow on yellow" test condition (530 nm cutoff filter, 635 asb background, Size V target) to minimize both pupil size and lens effects on central visual field sensitivity. In addition, relative lens absorption estimates were obtained for each subject. All three test conditions revealed a loss in visual field sensitivity with increasing age (approximately 0.8 dB per decade) but no meaningful differences were found among the three test procedures. Relative lens density increased with age but was not related to visual field sensitivity for any of the three test conditions. These data suggest that normal age-related visual field sensitivity changes are primarily due to neural losses rather than preretinal factors. PMID- 2777526 TI - A comparison of dual-energy digital radiography and screen-film imaging in the detection of subtle interstitial pulmonary disease. AB - An ROC study is described which compares the performance of three types of images -conventional screen-film, single-energy digital and dual energy bone cancelled (soft tissue) digital--in detecting subtle interstitial pulmonary disease. Marginally detectable nodular and reticulonodular patterns (12 different patterns of each) were superimposed over the lungs of a frozen human chest phantom to simulate the clinical situation. The digital images were formatted on film at full size (ie, 35 cm X 43 cm). A total of 156 images (52 of each type, of which 28 were normal and 24 had simulated pathology) were used in the study and read by five experienced chest radiologists. Using a paired t-test, the areas under the individual ROC curves were compared for three combinations of images--single energy digital and conventional, soft tissue digital and conventional, and soft tissue and single-energy digital. No statistically significant difference was observed between the conventional and single-energy digital images. The readers performed better with both conventional and single-energy digital images than with the soft tissue digital images at statistically significant levels (P = 0.05 for conventional vs. soft tissue digital and P = 0.02 for single-energy digital vs. soft tissue digital). The results suggest that there is no advantage in employing dual-energy soft tissue images to assist in diagnosing interstitial disease in the clinical setting. They also suggest that spatial resolution requirements are less demanding in digital chest systems that obtain scatter-free images than in digital systems utilizing conventional scatter control techniques. PMID- 2777525 TI - Development of acuity in a primate model of human infantile unilateral aphakia. AB - We are studying infant rhesus monkeys that have been reared under various conditions of deprivation to model infantile unilateral aphakia. Grating acuity was assessed in these monkeys from birth to approximately 1 year of age using the quick acuity card procedure. We found that an uncorrected aphakic eye develops little or no pattern vision. Undercorrection or near point optical correction of an aphakic eye with an extended-wear contact lens coupled with continuous occlusion of the opposite eye sometimes results in normal development of acuity in the aphakic eye but does so only at the cost of loss of vision in the occluded eye. Fifty percent partial occlusion coupled with near-point correction of the aphakic eye results in similar development of acuity for both eyes during the time tested. Monkeys wearing near-point correction in the aphakic eye and without any occlusion of the other eye show surprisingly good residual acuities in their aphakic eyes. Based on these results we conclude that aphakic eyes should be treated by providing them with an optical correction, and that occlusion of the opposite eye should be used cautiously. PMID- 2777527 TI - The retrorenal spleen. Implications for percutaneous left renal invasive procedures. AB - An uncommon but potentially disastrous situation for invasive percutaneous renal procedures is the presence of the spleen behind the upper left kidney. We have termed this anatomic variant "retrorenal spleen." In a computed tomographic (CT) review of 73 patients aged 16 to 86, we found a frequency of retrorenal spleen of 21.1% in the supine and 15.4% in the prone patient. In most individuals with this variant, the spleen was behind the lateral fifth and the superior fourth of the left kidney. The majority (80.0%) of these patients were age 50 or over. However, in only 7.6% would the posterior splenic position pose a risk to posterolateral percutaneous approaches of less than 30 degrees into the upper left collecting system. No patient had retrorenal spleen at the mid-hilar level in either the supine or prone position. Posterolateral approaches up to 40 degrees into the renal hilus are 100% safe from intervening spleen. PMID- 2777529 TI - Streptococcal antigen-induced dislocation and dysplasia of the hip in newborn rats. Radiologic and histologic evaluation of a model of congenital dislocation of the hip. AB - Dislocation of the hip developed in 62% of newborn rats with streptococcal antigen-induced synovitis. Age at the time of the induction of synovitis is critical since dislocation is not observed in older rats. Synovitis with distention and laxity of the joint capsule is most likely responsible for the hip dislocation. Although congenital dislocation of the hip in children is not mediated by an inflammatory process, the current model of dislocation of the hip in rats is similar in being critically age-dependent, and associated with ligamentous laxity. Our model may be helpful in studying this important clinical entity. PMID- 2777528 TI - Sternocostal joints. Anatomic, radiographic and pathologic features in adult cadavers. AB - Using radiographic-pathologic correlation, we studied the sternocostal joints derived from 27 consecutive cadavers and one additional cadaver with rheumatoid arthritis. Radiographic findings that were tabulated included joint space narrowing, sternal or costal osteophytes, articular calcification, vacuum phenomena, and the degree of ossification of the costal cartilages. The first sternocostal joint could be classified as either a synchondrosis or synostosis in every instance; however, a joint cavity lateral to the first sternocostal joint represented a normal variation and was seen radiographically in 10 specimens. The second sternocostal joint was synovial in type and intimately related to the manubriosternal joint; cavitation within this joint was present bilaterally in 36% of our specimens. Degenerative changes in the sternocostal articulations were characterized much more frequently by sternal osteophytes than by costal osteophytes or joint space narrowing. Calcification compatible with chondrocalcinosis was observed in two cadavers. Radiographic and pathologic evidence of synovial inflammation was evident in the sternocostal joints of the rheumatoid specimen. PMID- 2777530 TI - Contrast-enhanced MRI of tumors. Comparison of Gd-DTPA and a macromolecular agent. AB - The study aim was to define potential differences and advantages in magnetic resonance (MR) patterns of tumoral contrast enhancement using either a small molecular, extracellular fluid contrast enhancer [Gd-DTPA] or a macromolecular agent [albumin-(Gd-DTPA)20], designed for primary intravascular biodistribution. MR images of 25 mice with implanted fibrosarcomas were obtained before and repeatedly for up to 120 minutes after injection of either Gd-DTPA [0.2 mmol/kg, n = 11] or albumin-(Gd-DTPA) [0.0029 mmol/kg, n = 14]. Histologically, this hypovascular tumor contained zones of viable tissue and non-viable, necrotic tissue. Using either type of contrast media, the viable portions enhanced strongly, up to 152% and the necrotic portions enhanced poorly, less than 31%. However, the time-course of enhancement differed between contrast agents. Gd-DTPA tended to provide maximal enhancement soon after administration with no significant changes over two hours. Enhancement from albumin-(Gd-DTPA) was weak initially, corresponding to tumor hypovascularity, but over two hours the signal of the viable tumor zones progressively increased in intensity. This gradual tumoral accumulation of the macromolecular agent within the tumor was considered to reflect abnormal capillary permeability, associated with neovascularity. Thus, the increasing intensity within the neoplastic tissues over time, reflecting abnormal capillary permeability for macromolecules, may serve as a useful, albeit indirect, marker of neoplasia. PMID- 2777531 TI - Plasma electrolyte status following enteroclysis in patients with partial small bowel obstruction. PMID- 2777532 TI - Renal perfusion model for NMR spectroscopy. PMID- 2777533 TI - Development of an effective short introductory course in diagnostic radiology. AB - As part of a general medical curriculum renewal, a new one-week course in diagnostic radiology was given to students at the beginning of their third year. The course format consisted of didactic presentations to the entire class, a single afternoon session of small group discussions of unknowns, and three daily case-of-the-day unknowns with prizes for correct responses. One hundred fifty eight students were tested on the first and last days of the course; testing consisted of two parallel 46-item multiple choice questions given in a crossed design. Questions covered radiographic anatomy and pathology as well as proper test ordering. Differences in achievement before and after the course as measured by the pre- and post-tests were highly significant. The class achieved a mean of 27 (59%) correct responses on the pre-test and a mean of 37 (80%) on the post test (F(1156) = 15.79; P less than .001). The reliability coefficient of the pre- and post-tests was about .30. A course critique was returned by 88 students. There was anticipated variation in the evaluations of the different didactic lecturers. Instructors receiving the highest scores were cited for their enthusiasm, clarity, and the relevance of their presentation. Conversely, those receiving low marks were cited as being unenthusiastic and boring, merely presenting example after example of radiographic abnormalities with little explanation. The afternoon small group discussions were perceived as the best part of the course. Despite the fact that moderator experience ranged from second year resident to full professor, the seminars received uniformly positive comments. PMID- 2777534 TI - Asbestos-related pleural and parenchymal fibrosis: detection with high-resolution CT. PMID- 2777535 TI - The classification and nomenclature of viruses: summary of results of meetings of the International Committee on Taxonomy of Viruses in Edmonton, Canada 1987. PMID- 2777536 TI - A scheme for viroid classification. AB - A scheme for viroid classification is proposed based on the nature of the strictly conserved core sequence present in the central portion of the secondary structure of viroids. In this scheme, all of the known viroids can be classified as potato spindle tuber-type viroids consisting of two viroid groups and avocado sunblotch-type viroids containing one viroid group. PMID- 2777538 TI - Distribution of homologies among the genomes of several actinophages of Faenia and Saccharopolyspora as determined by DNA hybridization. AB - The DNA of phi FR114, a temperate phage of the thermophilic actinomycete Faenia rectivirgula, was hybridized with the genomes of 11 different phages of Faenia and Saccharopolyspora. This revealed several regions (modules) within the phi FR114 DNA which were distributed independently among the genomes of the other phages. The genome of the lytic phage 121, originally described for Sap. erythraea, exhibited a similar modular organization. So far no functions of the possible modules are known. PMID- 2777537 TI - Rapid, random evolution of the genetic structure of replicating tobacco mosaic virus populations. AB - The effects of temperature and type of host on the evolution of variants in replicating populations of tobacco mosaic virus (TMV) originating from an in vitro RNA transcript of a cDNA clone were studied. The phenotypic markers measured were temperature-sensitive (ts) replication and induction of necrotic local lesions (nl) on Nicotiana sylvestris. The proportions of ts variants were about the same under all conditions tested, but changes in temperature or host had strong effects on proportions of nl variants. During replication at elevated temperatures in tobacco or tomato, percentages of nl variants were reduced rapidly to about one tenth their initial values. In contrast, when virus replicated at 25 degrees in tobacco, little change in the average proportion of nl variants was observed, and in tomato, only a slight average reduction occurred. Virus replicating at 25 degrees in Solanum nigrum or Petunia hybrida suffered effects similar to those observed in tobacco or tomato, respectively. However, at 25 degrees in Physalis floridana, there was strong selection against nl variants, which eventually reduced them to essentially undetectable levels. In all hosts tested at 25 degrees, surprisingly large, apparently random changes in the proportion of nl variants occurred in individual plants. These experiments showed that virus populations can evolve rapidly on a time scale of days, and that an element of randomness is an important component in the initiation of change. PMID- 2777539 TI - Gout. PMID- 2777540 TI - Paternalistic plantation mentality. PMID- 2777541 TI - Automatic implantable cardioverter defibrillator: report of the first two implants in Hawaii. AB - Sudden cardiac death is the major cause of death in the United States today, claiming over 400,000 victims each year, or one per minute. In the majority of cases, the underlying mechanism is malignant ventricular tachyarrhythmia, with the common substrate being abnormal myocardium from ischemic heart disease or congestive cardiomyopathy. PMID- 2777542 TI - Therapeutic use of dapsone in idiopathic thrombocytopenic purpura. PMID- 2777543 TI - Effect of heterogeneity of human population in cell radiosensitivity on the extrapolation of dose-response relationships to low doses. AB - Presented are the results of an investigation of the dose-response relationship for the yield of chromosome aberrations in peripheral blood lymphocytes of persons with some hereditary diseases which represent the high risk group with respect to the increased incidence of malignant tumors and decreased life span. Despite substantially different absolute radiosensitivities of chromosomes, the variations of the alpha/beta ratio determining the extrapolation of experimental dose-response relationships to low doses did not prove to be too high, the mean deviation from the control being 15%. This points to the possible practical use of the dose-response relationships averaged over the human population as a whole. PMID- 2777545 TI - Tetracycline in uranyl nitrate intoxication: its action on renal damage and U retention in bone. AB - In acute intoxication, uranium (U) not only inhibits bone formation but its excretion in urine also causes renal damage. The former effect is ameliorated by tetracycline (TC), probably due to its chelation property, which might also prevent U deposition in bone. Chemical determination of U incorporated in bone and a histological study of the kidneys were performed on animals injected with U and then treated with TC. The results showed that TC was unable to prevent the binding of U to bone while it exacerbated U-induced renal damage. PMID- 2777544 TI - A sensitive method for the determination of Th in body fluids. AB - A method involving neutron activation followed by simple radiochemical separation was developed and applied to determine the concentrations of Th in blood serum and urine. The method is sufficiently sensitive to detect 0.025 ng of 232Th. The average concentration of Th found in the blood serum and urine of subjects from normal environments is 7.9 ng L-1 and 2.7 ng L-1, respectively. PMID- 2777546 TI - Estimation of absorbed dose due to gas bremsstrahlung from electron storage rings. AB - We have studied characteristics of the bremsstrahlung produced in electron storage rings by interactions with residual gas in vacuum chambers. Quantitative estimates of intensity, absorbed dose and shielding requirements are given. PMID- 2777547 TI - Increased indoor Rn levels due to actinide containing mineral collections displayed in living areas. AB - Collection of crystals ranging from quartz to U or Th containing minerals is a widespread spare time activity in Switzerland. Radon emanation from stones displayed in showcases in the living area may contribute considerably to elevated Rn levels in the indoor air. Time-averaged Rn gas measurements in 35 homes of subscribers to a journal for mineral collectors showed an unexpected statistically significant increase of 98 Bq m-3 in the Rn level of the room containing the collections compared to the levels measured in a control room on the same floor. Using ICRP Publication 50 conversion factors for indoor exposure to Rn decay products, the additional effective dose equivalent contracted was estimated to amount to an average of 2.7 mSv y-1. Although the 220Rn emanation rate, as measured in the display cases, was considerable in several cases, the dose from 220Rn decay products in the living area remained always a small fraction of the Rn dose. Remedial actions for crystal collections containing considerable amounts of U- or Th-based minerals are suggested. PMID- 2777548 TI - Estimating Rn-induced lung cancer in the United States. AB - The proportion of lung cancer deaths attributable to Rn among residents of single family homes in the U.S. (approximately 70% of the housing stock) is estimated using the log-normal distribution of Rn concentrations proposed by Nero et al. (1986) and the risk model developed by the National Academy of Sciences' BEIR IV Committee. The risk model, together with the exposure distribution, predicts that approximately 14% of lung cancer deaths among such residents (about 13,300 deaths per year, or 10% of all U.S. lung cancer deaths) may be due to indoor Rn exposure. The 95% confidence interval is 7%-25%, or approximately 6600 to 24,000 lung cancer deaths. These estimated attributable risks due to Rn are similar for males and females and for smokers and nonsmokers, but higher baseline risks of lung cancer result in much larger absolute numbers of Rn-attributable cancers among males (approximately 9000) and among smokers (approximately 11,000). Because of the apparent skewness of the exposure distribution, most of the contribution to the attributable risks arises from exposure rates below 148 Bq m 3 (4 pCi L-1), i.e., below the EPA "action level." As a result, if all exposure rates that exceed 148 Bq m-3 (approximately 8% of homes) were eliminated, the models predict that the total annual lung cancer burden in the U.S. would drop by 4-5%, or by about 3800 lung cancer deaths, in contrast to a maximum reduction of 14% if all indoor Rn exposure above the 1st percentile were eliminated. PMID- 2777549 TI - Nuclear accident dosimetry intercomparison studies. AB - Twenty-two nuclear accident dosimetry intercomparison studies utilizing the fast pulse Health Physics Research Reactor at the Oak Ridge National Laboratory have been conducted since 1965. These studies have provided a total of 62 different organizations a forum for discussion of criticality accident dosimetry, an opportunity to test their neutron and gamma-ray dosimetry systems under a variety of simulated criticality accident conditions, and the experience of comparing results with reference dose values as well as with the measured results obtained by others making measurements under identical conditions. Sixty-nine nuclear accidents (27 with unmoderated neutron energy spectra and 42 with eight different shielded spectra) have been simulated in the studies. Neutron doses were in the 0.2-8.5 Gy range and gamma doses in the 0.1-2.0 Gy range. A total of 2,289 dose measurements (1,311 neutron, 978 gamma) were made during the intercomparisons. The primary methods of neutron dosimetry were activation foils, thermoluminescent dosimeters, and blood sodium activation. The main methods of gamma dose measurement were thermoluminescent dosimeters, radiophotoluminescent glass, and film. About 68% of the neutron measurements met the accuracy guidelines (+/- 25%) and about 52% of the gamma measurements met the accuracy criterion (+/- 20%) for accident dosimetry. PMID- 2777550 TI - Kinetic model of the distribution of 239Pu in the beagle skeleton. AB - A model is presented to analyze the retention of Pu in the major deposition organs of the beagle dog and predict the dynamic behavior of skeletal labels. The kinetic part describing the gross organ distribution was represented by a compartment model. A fit to empirical retention equations of liver and skeleton yielded skeletal clearance corresponding to turnover rates of 93.8% y-1 and 3.8% y-1 in trabecular and cortical bone, respectively. Initially about 9% of skeletal Pu is deposited in cortical bone. The blood flow changes over a period of 3000 d from an initial 0.15% of the injected dose per day to 0.05% d-1 at the end of this period. More than 100% of the injected Pu is recirculated back to the skeleton during this interval. The calculation of the label dynamics showed that nearly complete volumization of Pu was only possible assuming a very high affinity ratio of forming vs. resting surfaces and high bone turnover rates. There was a steady increase in the fractional activity of surface and secondary diffuse labels in cortical bone whereas in trabecular bone these labels showed maximum activity at about 2 y after injection. The Pu concentration on pre existing trabecular bone surfaces that were not remodeled within 3000 d post injection increased by a factor of 3.6. The model may be applied to single bones or the skeleton as a whole. The flow of Pu in the blood can be derived in human cases where urinary excretion rates are available. With the blood flow known, the model enables one to simulate the dynamic behavior of skeletal labels even for very general conditions of human contamination, including inhalation. PMID- 2777551 TI - Summary statements from the Second Conference on Radiation Protection and Dosimetry. PMID- 2777553 TI - Dietary intake of stable I and some aspects of radioiodine dosimetry. PMID- 2777552 TI - A survey of winter, summer and annual average 222Rn concentrations in family dwellings. PMID- 2777554 TI - Personal radiation monitoring services in Kenya. PMID- 2777555 TI - Two ways of determining the 222Rn emanation coefficient. PMID- 2777556 TI - Chernobyl-derived 137Cs and 134Cs in heather plants in northwest England. PMID- 2777557 TI - Leukemia from Ra: 'data gaps' or 'scientific evidence'? PMID- 2777558 TI - Safety limits for the release of short-lived radionuclides. PMID- 2777559 TI - Reassessment of 137Cs in soils from Chernobyl fallout. PMID- 2777560 TI - Chernobyl radioactivity in Turkish tea: a response. PMID- 2777561 TI - On the unit of dose equivalent and the linear hypothesis. PMID- 2777562 TI - Seizing the initiative. PMID- 2777563 TI - Shortage of professional nursing practice: a reframing of the shortage problem. AB - The nursing shortage is discussed in terms of supply, demand, and wages, and the current situation is compared with previous nursing shortages. Reasons for the shortage are examined and reframing the problem from a shortage of nurses to a shortage of professional nursing practice is suggested as a strategic first step in solving the problems of nurse staffing in acute care general hospitals. Four kinds of shortage situations are identified; only one kind, vacancy, results from vacant positions. The other three types, transient, position, and scheduling, are the result of administrative decisions regarding the use of nursing personnel. A fundamental restructuring of how hospitals use nurses is needed, and this solution will in the long run be more effective in solving the shortage problem than is the effort simply to add more nurses into the existing system. PMID- 2777564 TI - Use of pulse oximetry in critically ill adults. AB - Pulse oximetry represents a major advance in noninvasive oxygenation monitoring in critically ill adults. Its technology has given practitioners a safe, accurate, and continuous method for assessing arterial oxygen saturation. A comprehensive understanding of the variables of oxygen transport and hypoxemia is essential to ensure correct data interpretation. The accuracy and clinical limitations of pulse oximeters and sensors are presented in this article. The clinical utility of pulse oximetry monitoring in critically ill adults is discussed, with consideration given to patient selection and specific procedures that incur hypoxemic risk. Issues of quality assurance and risk management that surround the use of pulse oximetry are addressed. PMID- 2777565 TI - Comparison of electrode site preparation techniques. AB - A posttest-only control group design was used to study the effects of two electrode site preparation techniques on reducing electrical potential across a pair of disposable skin electrodes. Sixty health volunteers were randomly divided into one control and two treatment groups of 20 subjects each. Within each group, the treatment was further assigned randomly to either the right or left forearm. Analysis of variance and paired t test analyses were used to compare group differences. Skin preparation by using One Step Skin Prep significantly decreased skin potentials (-1.90 mV) whereas the group in which ECG Prep Pads were used and the control group had no significant change. PMID- 2777566 TI - A standard of care for the nursing diagnosis of ineffective airway clearance. AB - The American Nurses' Association defines nursing as the diagnosis and treatment of human responses to actual and potential health problems. The process of nursing assessment and diagnosis facilitates the identification of actual and potential health problems and the organization and direction of the planning, implementation, and evaluation of nursing care in striving for optimal patient outcomes. The nursing diagnosis of ineffective airway clearance describes a problem for which many hospitalized patients are at risk because of either acute or chronic illness. Admission to the intensive care unit is often necessary to attain and maintain airway patency, and both autonomous nursing and collaborative interventions are implemented. Standards of nursing care guide professional practice and provide a method of assessing quality of care and achievement of patient outcomes. The standard of care developed for ineffective airway clearance encompasses the areas of etiology, defining characteristics, assessment criteria, process criteria, outcome criteria, and evaluation. PMID- 2777567 TI - Effect of nursing contact on the stress response of patients being weaned from mechanical ventilation. AB - A prospective, randomized study was undertaken to determine the effect of direct nursing contact on the stress response of patients being weaned from mechanical ventilation. Twenty-six patients being weaned via T-piece for the first time were randomly assigned to either an experimental or a control group. Patients in the experimental group received touch and verbal interaction during weaning whereas the control group did not. Strict control was maintained over the patient's environment during the data collection period, including restriction of all nonessential medical and nursing interventions. No significant increases were found in heart rate or mean arterial pressure in either the control or experimental group during weaning. Respiratory rate 5 minutes after the ventilator was discontinued increased from baseline in both the control (18.0 to 24.4 breaths/min, p = 0.03) and experimental (18.0 to 22.4 breaths/min, p = 0.04) groups. Because both groups had similar responses to weaning, the differences between the groups was nonsignificant and therefore the hypothesis was not supported. PMID- 2777568 TI - Retention of cardiopulmonary resuscitation skills among nursing personnel: what makes the difference? AB - The American Association of Critical-Care Nurses' Position Statement on cardiopulmonary resuscitation (CPR) certification states that "nurses who care for the critically ill must have annual BCLS or CLS certification...." Review of literature, however, did not reveal any studies among nurses that examined the question of whether Basic Cardiac Life Support (BCLS) was superior to other forms of CPR education, such as Basic Life Support-A (BLS-A) (Heartsaver). The purpose of this 2 by 3 factorial design study was to examine the relationship between the method of instruction and the quality of retention of one-person CPR skills at 4 and 8 months after the initial class. The two methods of instruction under consideration were a BLS-course A (hospital-wide Heartsaver course) and a BLS course C (Basic Cardiac Life Support course). In addition, the variable of potential use of CPR skills was studied. The three levels of potential use (high, medium, low) were identified according to the area of work, such as critical care, general medical-surgical, and obstetrics-psychiatric, respectively. Other variables that were described in the literature were education, practice of skills, current position, years in profession, previous CPR training, motivation, and felt level of competence. These variables also were included in the study to find out the total variable impact on CPR retention. At least 30 registered nurses were selected from each of the high, medium, and low use areas and randomly assigned to one of the instruction groups.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2777569 TI - Early seizures in patients with acquired immunodeficiency syndrome without mass lesions. AB - Generalized tonic-clonic seizures in persons infected with the human immunodeficiency virus have usually occurred in the setting of space-occupying lesions in the brain. Seizures have also been known to occur in patients with acquired immunodeficiency syndrome-related dementia. Two patients, each with prior history of human immunodeficiency virus infection, had seizures early in the course of their illness. Neither patient had evidence of space-occupying lesions or dementia at the time of admission for the seizures. Patients with human immunodeficiency virus infection may present with seizures and may not have a clinically detectable focus for their seizures. PMID- 2777570 TI - Who owns the patient? PMID- 2777571 TI - Slow code, partial code, limited code. PMID- 2777572 TI - Nonthrombolytic therapy for acute myocardial infarction. PMID- 2777573 TI - Tritium toxicity in postnatally developing mouse brain: neurochemical changes after continuous exposure. AB - Since tritium may emerge as a major radiopollutant, an attempt has been made to evaluate changes in total cholesterol, phospholipid and glycogen content in the postnatally developing mouse brain from 1 to 6 weeks of age; the exposure, at a dose level of 11.1 kBq (0.3 microCi)/mL of 3H, through maternal drinking water, was from gestation day 15 until the last interval studied (after a maternal priming injection). The brain-to-body weight ratio was increased during postnatal development as compared to that of sham-irradiated controls. The phospholipid concentration decreased significantly in all age groups. By contrast, glycogen content tended to increase from 1 to 5 weeks of age, and cholesterol content increased by 40.35 and 44.75% during the 2nd and 3rd weeks, respectively, and returned to a near normal level at later intervals. PMID- 2777574 TI - Synthesis of iodine-125 labeled 3-quinuclidinyl 4'-iodobenzilate. AB - Iodine-125 labeled 3-quinuclidinyl 4'-iodobenzilate has been prepared via the reaction of the corresponding boronic acid with sodium [125I]iodide in the presence of a mild oxidant. PMID- 2777575 TI - Biodistribution and radiation absorbed dose of (N-methyl[11C])pyrilamine: a histamine H-1 receptor radiotracer. AB - The in vivo biodistribution for (N-methyl[11C])pyrilamine in mice is reported for various times after i.v. bolus injection, together with estimates of the radiation absorbed dose for the same radiotracer in man. More than 60% of the injected dose was excreted via the kidneys in urine after 90 min post injection. The brain regional distribution in mice showed a favorable hypothalamus-to cerebellum ratio, indicative of H-1 receptor binding, encouraging in vivo histamine H-1 receptor imaging studies in man. PMID- 2777576 TI - Hemoglobin radiolabeling: in vitro and in vivo comparison of iodine labeling with iodogen and a new method for technetium labeling. AB - Radiolabeled hemoglobin may be a useful tool in the study of the body distribution of hemoglobin solutions developed as plasma expanders with oxygen transporting capacity. The present investigation compares the suitability of two radiolabeling techniques for hemoglobin. 125I labeling of hemoglobin with Iodogen as iodinating agent caused major changes in the chromatographic behaviour and an accelerated plasma clearance of the labeled hemoglobin in rats. A recently developed two-step procedure for 99mTc labeling gave better results. The label had only minimal influence on the chromatographic behaviour of hemoglobin. In vivo, no free label occurred in the circulation and no transfer of the label to other plasma proteins took place. The plasma clearance of 99mTc-labeled hemoglobin in rats was slowed. However, this could be explained entirely by diminishing glomerular filtration, probably by inhibition of the dissociation of the hemoglobin molecule into dimers. The plasma clearance of hemoglobin modified by intramolecular cross-linking, which prevents dissociation of the molecule into dimers and thus excretion by the kidney, was not influenced by the label. We conclude that the 99mTc labeling procedure is suitable for in vivo distribution studies of hemoglobin when it is taken into account that the urinary excretion is underestimated. For cross-linked hemoglobin, which is more promising as plasma expander, no such restriction exists. PMID- 2777577 TI - Feasibility study of fluorine-18 labeled dopa for melanoma imaging. AB - Feasibility of fluorine-18 labeled L-dopa for melanoma imaging was investigated. In B16 melanoma-bearing mice given 2-[18F]fluoro-L-dopa, the radioactivity in the B16 decreased for the first 60 min and then remained constant, while all other tissues investigated decreased with time. High tumor uptake ratios for all other tissues except for the pancreas were obtained at 120 min. 6-[18F]Fluoro-L-dopa showed a similar tissue distribution. However, the B16 uptake was about half that value for the 2-fluoro analogue. A higher incorporation rate of 2-[18F]fluoro-L dopa into the acid-precipitable fraction of the melanoma also showed that the 2 [18F]fluoro-L-dopa was a preferable melanin precursor. Among the four kinds of non-melanoma tumors in mice or rats three tumors showed an uptake of 2 [18F]fluoro-L-dopa similar to the B16 at 60 min. However, larger melanoma-to tissue uptake ratios were observed when compared to non-melanoma tumors. PMID- 2777578 TI - Estimation of ERPF in adults from plasma clearance of 131I-hippuran using a single injection and one or two blood samples. AB - The plasma clearance of [131I]o-iodohippurate, which is an estimate of effective renal plasma flow, can be measured from one or two blood samples drawn after an i.v. bolus of tracer. The most widely used method is based on a single sample. Here, it is shown that the error (relative to a complete curve of six or more blood samples) can be halved by using two samples rather than one. Since the one sample method is satisfactory for most clinical purposes, the two-sample method is recommended only when special accuracy is needed. PMID- 2777579 TI - Thin layer chromatographic detection of kryptofix 2.2.2 in the routine synthesis of [18F]2-fluoro-2-deoxy-D-glucose. AB - A simple procedure for the detection of 4,7,13,16,21,24-hexaoxa-1,10-diazabicyclo (8.8.8) hexacosane (Kryptofix 2.2.2) in the final solution of [18F]FDG prepared by the aminopolyether supported nucleophilic substitution of 1,3,4,6-tetra-O acetyl 2-O-trifluoromethanesulfonyl-beta-D-mannopyranose (Hamacher et al., 1986) has been developed. Presence of Kryptofix 2.2.2 in the routine production of [18F]FDG was detected using methanol/ammonium hydroxide (9:1) solvent system. A method to remove Kryptofix from [18F]FDG solution has been suggested. PMID- 2777580 TI - Sucralfate delays gastric emptying of liquids and solids in duodenal ulcer patients. AB - Gastric emptying studies were performed on nine healthy volunteers and ten duodenal ulcer (DU) patients utilizing a dual radionuclide technique to assess simultaneously emptying rates of liquid (111In labeled water) and solid (99mTc sulfur colloid labeled chicken liver) components of a meal. One gram of sucralfate was compared to placebo in separate days in a randomized double-blind crossover fashion. Subjects ingested the radiolabeled test meal 1 h after receiving medication, and gastric emptying was monitored for 3 h using a gamma camera interfaced with a computer. We found that DU patients had significantly faster gastric emptying of solids (P less than 0.05) compared to normals on the placebo days, while liquid emptying rates were similar. Sucralfate, in the DU patients, significantly (P less than 0.05) slowed gastric emptying of water from 20 to 40 min and emptying of the solid component from 100-160 min after the meal compared to placebo. In normal subjects, gastric emptying of liquids and solids was not significantly affected by sucralfate. We conclude that slowing of gastric emptying, possibly mediated through aluminum ions, occurs in DU patients on sucralfate. This may be one mechanism by which sucralfate enhances healing and decreases recurrence of duodenal ulcer. PMID- 2777581 TI - A new cholescintigraphic agent: ruthenium-97-DISIDA. AB - These are the first human experiments with 97Ru-DISIDA, a potentially new alternative to 131I-rose bengal where delayed imaging is indicated. 97Ru has a convenient half life. A DISIDA labeling kit was utilized to prepare the radiotracer for 17 patients (age 6 weeks-84 years). The cholescintigraphic data correlated well with other imaging procedures and with clinical findings. Dosimetric calculations were carried out and were compared with the radiation burden associated with the use of 99mTc-DISIDA and 131I-rose bengal. PMID- 2777582 TI - Pharmacokinetics of a radioiodinated monoclonal antibody F(ab')2 fragment in a xenograft model with circulating antigen. AB - The pharmacokinetics of 131I-labeled OC 125 F(ab')2 antibody fragment were investigated in athymic mice bearing OVCAR-3 ovarian carcinoma xenografts, a model in which the CA 125 antigen is present in serum. Nine antibody doses between 0.1 and 650 micrograms were studied. Optimal tumor to normal tissue ratios were obtained at 100-200 micrograms of F(ab')2. At most antibody doses, the pre-injection level of circulating CA 125 appeared to influence the localization of 131I activity in tumor, liver and spleen. PMID- 2777583 TI - Synthesis of 6-[18F]fluoropyridoxal and radioactivity distribution in rat at 60 min. AB - 6-[18F]Fluoropyridoxal was synthesized by the flourination of a propylamine derivative of pyridoxal (pyridoxal Schiff base) with 18F-labelled acetylhypofluorite. Two different fluorinating agents, 5% F2 in N2 and acetylhypofluorite, were investigated with nonradioactive material. The evaluation of reactions in CH3CN and chloroform showed CH3CN to be the better solvent and CH3COOF to be the better fluorinating reagent. The synthesis gave a radiochemical yield of about 18% (expressed at the end of synthesis) and required 35-40 min to complete. The specific activity of the final radiopharmaceutical at the end of the synthesis was about 25.9 GBq/mmol (700 mCi/mmol). The tissue distribution of 6-fluoropyridoxal in rat at 60 min is also reported. A large concentration in liver and kidney indicates that this radiopharmaceutical could be of special interest in the imaging of liver functions. The concentration in the brain might also allow in vivo PET imaging of the 6-(fluoropyridoxal) uptake if a high efficiency PET scanner is used. PMID- 2777585 TI - Conditions of radioiodination with iodogen as oxidizing agent. AB - Different factors that give the maximum iodination of proteins by iodogen method have been evaluated. The quantity of iodogen was varied from 2 to 20 micrograms; pH from 3 to 9; the quantity of bovine serum albumin (BSA) from 25 micrograms to 2 mg; the 131I activity from 200 microCi to 5 mCi and the reaction time from 2 to 30 min. The maximum iodination of proteins is achieved with iodogen-to-iodide molar ratio of 100-200 and iodogen-to-protein molar ratio of 1-2 at pH 6-8 for 10 15 min at room temperature. PMID- 2777584 TI - Dual-isotope measurement of lung water. AB - Iodine-131-labeled iodo-antipyrine and 99mTc-labeled erythrocytes were used to measure water content in lungs. These radioactive tracers were injected into 11 dogs with injured lungs. Blood samples were drawn and the animals sacrificed. The lungs were removed, weighed and homogenized. Samples of blood and lung homogenate were assayed for 131I and 99mTc. Samples were also weighed before and after drying to a constant weight at 70-76 degrees C. Extravascular lung water was determined by the dual-isotope technique and again by gravimetric analysis. The average ratio of the results from the two different methods was 1.14 +/- 0.20. The two methods were also compared by regression analysis and the correlation coefficient was 0.97 +/- 0.09. PMID- 2777586 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- 2777587 TI - [Immunoscintigraphy with 99mTc marked melanoma antibody in patients with malignant melanoma]. AB - In 38 patients with malignant melanoma 44 radioimmunoscintigraphies (RIS) with 99mTc labeled F(ab')2 fragments of an anti-melanoma monoclonal antibody (225.28S, Tecnemab-K, Sorin Biomedica) have been performed. No side effects have been observed even in the patients with repeated RIS. Overall 81% (35/43) of all lesions were detected by imaging and 9 lesions have been previously unknown. Sensitivity and specificity was highest for lymphnode metastases with 100% each. Poor imaging was observed in lung and mediastinal metastases (2/7) as well as small skin metastases. RIS has to be studied for its clinical value in staging of lymphnode metastases preoperatively in patients undergoing regional lymphnode dissection. PMID- 2777588 TI - [Traffic injuries in the Tessin Canton in 1982 and in 1985. Epidemiology, surgery and socioeconomic aspects]. AB - In the paper we present the results of an epidemiological study we conducted upon injuries due to road accidents in Canton Ticino. We investigated into 1471 injured patients admitted to hospital during 1982 in Canton Ticino, all the in- and out-patients at the Ospedale Civico during 1985 and all the seriously injured patients in road accidents where the scientific police (SIR) were called in. 106 (8%) patients died, 206 (15%) were seriously injured (87 patients with chronic infirmity) and 1062 had slight injuries. The total lesions were 2900 and 839 surgical operations were necessary. These patients needed a total of 7804 days of hospitalization (677 days in the intensive care unit). Motorcycles represented 46.5 of the involved vehicles. The major risk groups by age are: 14-17-year-olds (motorcyclist), 18-29-year-olds (automobilists and motorcyclists), up to 13 and over 60 years of age (pedestrians). The percentage of the total road accidents which occur at the week-end is of 49.4%. At peak hours (17.00 p.m.) the percentage of accident is 8.1% (115 accidents) and in the small hours the percentage is of 5.5% (74 accidents). The annual hospitalization costs amounted to 3,200,000 SFr., whereas the real costs corresponding to production loss, social expenditures (25.737 were the days of disability) and in- and out-patient care are as high as 100 million francs. PMID- 2777589 TI - [Immunosuppression caused by surgery and severe trauma]. AB - The present prospective study was performed to describe physiological immunosuppressive effects dependent on minor surgical interventions and an immunodeficiency syndrome after major surgery and severe trauma. Parameters of cellular and humoral immunity were monitored in 64 patients of the Department of Surgery of the University Hospital Zurich preoperatively and on days 1, 2, 3 and 4 after selective surgery or polytrauma. 22 patients were multiply traumatized (mean ISS 34.7 +/- 13), 14 patients underwent Y-grafting of the abdominal aorta, 11 resection of colorectal carcinoma, 8 cholecystectomy and 9 inguinal herniotomy. There could be seen a decrease of parameters of cellular immunity (absolute lymphocyte count, CD-4-/CD-8-cell-ratio and release of IL2-receptors), a decrease of humoral defense (immunoglobulins and complement factors) and an increase of macrophage activation (serum levels of neopterin). PMID- 2777590 TI - [Epidural administration of morphine by a completely implantable device (Port-a Cath)]. AB - The analgesia for patients suffering from incurable tumors is a major problem. The parenteral administration of opioids causes disagreable side effects. The development of completely implantable devices which permit the epidural administration of morphine offers higher quality analgesia with less side effects. Being easy to use, these devices allow cancer patients to remain at home, whereas otherwise they would need to be hospitalized for effective treatment of pain. PMID- 2777591 TI - [Implantable catheter system for ambulatory parenteral antibiotic chemotherapy. A prospective study]. AB - 17 patients with infectious diseases needed a long-term parenteral antibiotic therapy. Therefore a subcutaneous catheter system (Port-a-Cath) was implanted for intravenous application of the antibiotic drugs. With a total dwelling-time of 952 patient/days no catheter super-infection was observed. Due to postoperative hematoma in an anticoagulated patient one catheter system was not functioning temporarily. One had to be removed on suspicion of a fungous colonization which could not be verified after bacterial examination. Quality of life for all patients was unaltered so that ambulant therapy was possible in almost 20%. PMID- 2777592 TI - [Prevention of infection at the operative site: irrigation with iodine derivatives, or NaCl. A prospective and randomized study in general surgery]. AB - A prospective randomized study was undertaken among 540 patients submitted to a surgical operation. The operative site and the wall before skin closure have been washed either with saline or with Betadine-R solution. Bacteriological samples were taken before irrigation. The contamination rate reached 60% in visceral surgery, 30% in bone surgery. Postoperative wound sepsis nearly reached 6%. There was no difference between the NaCl and Betadine groups. PMID- 2777594 TI - [Diagnostic and therapeutic concepts in breast neoplasms]. AB - Therapeutic decisions in breast cancer are no longer as simple and straightforward as they were. Radical masectomy has long ceased to be a routine application to every patient. A number of patients are now candidates for conservative surgery combined with irradiation. Patients who still require total mastectomy with axillary clearance may wish to undergo immediate or delayed breast reconstruction. In our department most patients with breast tumors are first seen in the outpatient clinic, where diagnostic work-up is completed and the therapeutic concept is discussed. If necessary, consultation with the radiotherapist and the plastic surgeon is available. Our diagnostic and therapeutic concepts are summarized in Fig. 1 and Table 1. PMID- 2777593 TI - [Therapeutic possibilities in hand burns]. AB - Four methods of treating the burned hand are possible: conservative treatment of superficial dermal burns, tangential excision and immediate grafting of deep dermal and barely full thickness burns, granulation method with late grafting of deep dermal to deep full thickness burns, flap procedures of full thickness burns. The tangential excision and grafting of deep dermal and barely third degree burns has improved the well being of the patient by good functional and cosmetic results, less hospitalization time (10-14 days) and less pain. The procedure is described. Tangential excision is contraindicated in the very deep burn. In these the growth of granulations or in certain cases the application of skinflaps will produce better results. Important as to the result is the aftercare consisting of compression gloves and physiotherapy. Even with progress the deep burn remains a devastating injury to the delicately operating hand. Nevertheless the appropriate therapy can achieve good results. PMID- 2777595 TI - [Experience with the ultrasonic aspirator in surgery of benign goiter]. AB - In 60 cases intracapsular resection of goiter was performed by using ultrasonic aspirator. The superior pole vessels and the inferior thyroid artery were not touched, the recurrent laryngeal nerve was not identified. Minimal hemorrhage in the intra- and postoperative period, operation time saving in comparison with conventional subtotal thyroidectomy, no temporary and no permanent damage to the recurrent laryngeal nerve and no wound infection were observed. Not suturing the remnants of thyroid optimal blood supply was obtained. There were no hypoparathyroidism and but one case of hypothyroidism. PMID- 2777597 TI - [Surgery of retroperitoneal pheochromocytoma]. AB - Retroperitoneal pheochromocytomas are very uncommon tumors. During the last 10 years only 3 cases have been operated on in our clinic. Two of them were primary retroperitoneal paragangliomas. These two patients are now well and without recurrence 1 and 10 years respectively after operation. The third patient had retroperitoneal metastases of an adrenal pheochromocytoma. Now, after 1 year he has disseminated metastases without response to therapy with (131I)metaiodobenzylguanidine (MIBG). The surgical procedure includes often extended resection and replacement of retroperitoneal blood vessels and requires therefore an experienced surgical team and optimal anesthetic management (Swan Ganz-katheter). In two cases the aorta was resected and replaced with a Dacron graft. Reimplantation of both renal arteries into the graft was necessary in one case. Further interventions were: nephrectomy (2x), resection and ligation of the inferior vena cava (1x), resection and replacement of the left renal vein (1x). PMID- 2777596 TI - [Long-term results following conservative and surgical treatment of infantile hypertrophic pyloric stenosis]. AB - From 1960 to 1970, 314 children (male:female = 3.9:1) were treated in our hospital for infantile hypertrophic pyloric stenosis (IHPS) (group 1 operatively: n = 216; group 2 conservatively: n = 98). The aim of the present study was to evaluate whether patients with IHPS do frequently have complaints in the upper gastrointestinal tract at long term. RESULTS: 1. Using the patients' files, a retrospective analysis of the familiar predisposition, symptoms, course of treatment and duration of ward treatment was made. Mortality due to operation was 0%, the postoperative rate of complications was low. 2. 17-27 years after treatment, the patients were questioned as to their subsequent health. 175 returned questionnaires able to be evaluated. According to these, only few of these patients had the symptoms of delayed gastric emptying (frequent vomiting, nausea). The velocity of gastric emptying has been measured for 53 patients for both solids and fluids (2.2 MBq 99mTc Sn colloid in a standard solid meal or in 300 ml of apple juice). There was no significant difference between the two groups, and the results were comparable to normal controls. CONCLUSION: Surgical therapy is superior to the conservative one, since the patient feels better sooner, complications are seldom and correspond with the long-term results of conservative therapy. PMID- 2777598 TI - [Paraesophageal hiatal hernia--risks and surgical indications]. AB - During a 25-year period, 40 patients with paraoesophageal hiatus hernia were operated on by narrowing of the hiatus and gastropexy. The main symptoms were: epigastric pain (40%), reflux symptoms (25%), cardiac symptoms (20%), dysphagia (20%) and dyspnea (8%). Six patients were free of symptoms. Anaemia was present in 33%, gastric ulcer in 15%. Six patients (18%) had to be operated on as emergencies because of gastric ulcer complications in 4 (3 perforations, 1 severe bleeding) and incarceration in 2 patients. Considering the important risk of acute complications in paraoesophageal hernia an elective gastropexy seems generally advisible--also in patients with few or no symptoms, provided there are no contraindications. PMID- 2777599 TI - [The pathomorphology of the liver after unilateral hepatic duct obstruction with laboratory-chemical observations of the course in the dog]. AB - In an experimental study the morphological and functional changes of the liver with unilateral hepatic duct obstruction were investigated over a period of 13 months. In 4 series different parts of the liver were excluded of the bile drainage by hepatic duct ligation after cholecystectomy (group I = 25%, group II = 50%, group III 75%, group IV = 100% of the liver, series V = control group was cholecystectomy only. The clinical outcome, biochemical parameters, liver biopsy were examined regularly. Bacteriologic investigation of the bile and hepatic flow measurement were performed at the beginning and at the end of the study. RESULTS: The clinical symptoms were discrete and the biochemical parameters showed a typical course. After 6 weeks, atrophy of the excluded liver with contralateral compensatoric hypertrophy was found. The microscopic correlation was the secondary sclerosing cholangitis (SSC). After 6 weeks, a concentric periductal fibrosis was to be observed in the periportal area. After 12 weeks, bile duct vanishing with persistence of the arteries and veins was found. After 36-48 weeks, biliary cirrhosis and total destruction of the liver parenchyma was found respectively. Simultaneously a chronic disturbance of the hepatic perfusion was seen. It was caused by a perivenous fibrosis of the terminal vein with obliteration of the lumen by endangiitic proliferations and cavernous transformation. The genesis of SSC seemed not be be influenced by bile contamination. The ligated as well as the unligated bile ducts were infected in 20-50% only. There was no difference in the liver specimens with sterile or contaminated bile. The hepatic flow measurement showed a reduction of the portal blood flow and a rise of the arterial flow depending on the amount of the excluded liver. A better understanding of the pathophysiological sequelae of the unilateral hepatic duct obstruction suggests that the drainage by surgical or radiological methods may not invariably be necessary. PMID- 2777600 TI - [Experimental studies on shock-wave cholelithotripsy]. AB - An experimental device for extracorporeal shock-wave cholelithotripsy has been tested. It is characterized by an electromagnetic acoustic source and focussing of the stones by ultrasound. After in vivo experiments with 45 calculi twelve pigs, seven of them with surgically implanted human gallstones, were treated. Most concrements were only partially disintegrated. A combination with MTBE litholysis improved the results. The by far most important complication we saw were extensive hemorrhages in the basal segments of both lungs. The quite different anatomy suggests that shock-wave cholelithotripsy in man will not be accompanied by severe lung lesions. Patients suffering from gallbladder stones should be treated in the prone position and in deep inspiration. A maximum of 2,000 shock-waves with an energy of 18 to 20 kV should be administered in one session. PMID- 2777601 TI - [Incidence of recurrence following surgery of perforating and non-perforating complications in Crohn disease]. AB - From 1980-1987 131 patients were operated for Crohn's disease. Among these 73 patients had perforated (PC) free perforation, abscess, fistula, and 47 had nonperforating complications (NC). Ileums, bleeding, stenosis reoperations (58 pts, 44%) were seen more often in the PC-group (57%) compared to 31% in the NC group. Furthermore there was a high concordance in the indication for the initial and subsequent operations. PMID- 2777602 TI - [Computer-assisted drug therapy of incomplete ileus]. AB - Auscultation of bowel sounds has a decisive position in management of intestinal paralysis, although personal bound interpretation and documentation may give rise to problems. Our computerized electronic analysis system of bowel sounds permits easy objectivation of auscultation findings. This noninvasive method is optional a repeatable. We investigated 15 patients suffering from intestinal paralysis using this method. Good correlations between clinical findings and the results of our analysis allow reliable estimations of therapeutic measurements. Dosage of drugs influencing peristalsis is facilitated. PMID- 2777603 TI - [Suspected appendicitis: immediate surgery or observation?]. AB - Ruptured appendicitis involves a morbidity rate greater than that of negative exploration, and estimations of morbidity as high as 15% for negative laparotomy have been accepted by various investigators. We undertook a prospective analysis of 450 patients admitted to our hospital with suspected acute appendicitis, to identify those aspects in differentiating diseases that required surgery from those permitting observation. A prompt appendectomy was performed in 265 patients (59%). The appendix was normal in 4% of them. 185 patients were observed clinically and by laboratory investigations. None of them had to be operated on during the following 12 months of out-patient observation. We may conclude that clinical observation by an experienced physician may decrease the rate of negative laparotomies. PMID- 2777604 TI - [Early treatment of varicocele in children and adolescents]. AB - Since 1970 we perform the prophylactic operation of grade II and III varicocele during childhood and puberty, even if there were overtreatment. Varicocele may very early interfere with testicular development and already causes histological changes in boys at the beginning of puberty. We have made a follow-up study of 25 adult men, who have been operated by high resection of spermatic vessels during childhood (mean age 13 years). Results are very good: no testicular atrophy and in nearly all cases a normal sperm count or only slight OAT-syndrome. Compared with a group of non-treated men of the same age sperm counts are better and the number of fertile sperms higher. For that reason we recommend treatment as early as possible in childhood and puberty. PMID- 2777606 TI - [Stress protection in plate osteosynthesis: myth or reality?]. AB - It is generally admitted that plate fixation of fractures results in reduced stress (stress protection) and subsequent structural adaptation of bone (bone loss). The analysis of the stress pattern and the reduction of deformation work in plated bones is a prerequisite for the assertion that bone loss is stress related. The strain field within bones under eccentric axial load has been analyzed theoretically and verified experimentally. The difference between the reduction of stress obtained using the flexible plate materials is small. Reduction of plate stiffness does not result in proportional improvement of the bone strain. PMID- 2777607 TI - [The dynamized external fixator. Use and problems]. AB - We report our experience with 11 patients treated with an external fixator that was dynamized at some stage of the treatment. In 7 patients bone union occurred without any other measures, 2 patients were protected in a cast after the external fixator removal, while 2 patients developed a non union that was plated and subsequently healed. According to these experiences, dynamization of an external fixator seems to be a reliable and elegant way to treat simple open shaft fractures, the method is however not advocated for more complex or comminuted fractures. PMID- 2777605 TI - [Acute mesenterial infarcts--results of surgical therapy]. AB - Forty-five patients with mesenteric infarction documented by laparotomy or autopsy were reviewed. 35% of the patients had superior mesenteric artery occlusion by embolus, 27% by thrombosis, 11% had venous thrombosis, 9% nonocclusive mesenteric ischemia, and 18% were unclear. The mortality rate was 60% within half a year postoperatively. 22% had inoperable lesions, 46% underwent bowel resection, and 32% were managed by revascularization. In the group treated by bowel resection (n = 21) 30% died, in the group treated by revascularization 80% of the patients died. PMID- 2777608 TI - [Plate osteosynthesis in humeral shaft fractures. Indications and results]. AB - Non operative management of humeral shaft fractures is well recognized as the standard of care for uncomplicated injuries. Operative treatment of humeral fractures may be performed when limited indications are present as in patients with multiple trauma including ipsilateral forearm injuries, arterial injury or primary radial nerve palsy. 18 patients with humeral shaft fractures underwent open reduction and internal fixation (ORIF) using the AO plating technique at the Kantonsspital Chur from 1980 to 1986. Follow-up was available for 17 patients of whom 16 suffered from multiple injury trauma. The broad DC plate combined with lag screws was used in most cases. Two brachial artery transections were repaired at the time of primary osteosynthesis by the same surgeons with full functional recovery. Concomitant nerve injuries were repaired primarily in one case and postprimarily in 3 more cases. The overall result was excellent in 9 patients, good in 5 patients, fair in 2 patients and poor in one patient with complete brachial plexus injury. Bone healing was uneventful in all 17 patients. No infection and no delayed union or pseudarthrosis has been observed. PMID- 2777609 TI - [Therapeutic concepts in infected hip prosthesis]. AB - In the period from January 1980 to December 1987, 62 patients with infected hip joint arthroplasties were treated. The duration of observation was on average 37 months (minimum 12 months, maximum 91 months). The choice of treatment modality depended on the type of infection, the state of anchorage of the endoprosthesis, the general condition of the patient, the type of bacterium and the state of the tissue surrounding the implant. 42 arthroplasties (67%) healed primarily. The remaining 20 were subject to 46 further operations (2.3 relapse operations/patient). 14 subsequently healed (23%) and six cases remained definitively infected. PMID- 2777610 TI - [Muscle-flap plasty in fractures of the tibial pilon]. AB - It is not rare in fractures of the distal lower leg, that precarious soft-tissue conditions compromise the outcome of early osteosynthesis. Because of oedema and haematoma the wound is widely split open and its primarily closure is perilous. In such a situation the stabilized fracture can be covered primarily with a local muscle-flap, such as extensor digitorum communis or peronaeus brevis. In the last 2 years we have chosen this solution in 6 cases. PMID- 2777612 TI - [Isolated rupture of an iliacus aneurysm]. AB - A retrospective analysis of 23 patients with isolated iliac aneurysms is presented. The age of the 23 men ranged from 49 to 89 years (mean +/- SE: 72.2 +/ 8.4 y). All patients had pain, nineteen (83%) were in shock, in only 11 (48%) an abdominal mass was palpable. Fifteen (65%) of the aneurysms were located in the common iliac artery, 5 (22%) in the internal and 3 (13%) in the external iliac artery. Their diameter ranged from 3 to 12 cm (mean +/- SE: 7.8 +/- 2.6 cm). Resection with an unilateral graft interposition was done in 12 (52%), a Y-graft implanted in 8 (35%) and an endoaneurysmorrhaphy of the internal aneurysm performed in 2 patients. Early mortality was 22% and was not statistically different from the 28.6% mortality in ruptured abdominal aneurysm resections performed in the same time. Because of the substantial risk of rupture with high mortality elective operative intervention should be considered for isolated iliac aneurysms with a diameter more than 3 cm. PMID- 2777611 TI - [Should Volkmann's great triangle be screwed?]. AB - The accurate reposition of the posterior tibia ridge is a technically exacting undertaking. On the basis of 22 screwed--all done ventrally--and 11 non-screwed Volkmann's triangles which are more than a third of the lateral extension of the distal tibia joint surface can be shown that a screwing in faulty position is worse than non-screwing. Consequently it is better to omit screwing or to do the reposition visually with the corresponding access. PMID- 2777613 TI - ["Bidirectional tunneler": an improved tunneler and shunt instrument for vascular surgery]. AB - When autologous veins or vascular prostheses are implanted for bypass operations or hemodialysis shunts, the use of an appropriate tunneling device is recommended. In order to avoid perigraft hemorrhage and allow undelayed graft incorporation, the tunneler should match the diameter of the implant. Interchangeable shafts with various lengths and blunt tips of various diameters are prerequisites for versatile applicability. The tunneling instrument designed by Kelly and Wick was until now the most versatile on the market. Its main drawback is a handle that is welded to one end of the shaft thus preventing "bi directional" use. We therefore developed a modified "Bi-directional Tunneler". Its handle can be attached to both ends of the shaft and allow at the same time torsional rigidity for directional guiding. Thus, e.g. in a femoro-popliteal bypass, the distal anastomosis can be accomplished first, followed by the introduction of the "Bi-directional Tunneler" from the knee to the groin. In a further step the tip and handle are interchanged and the graft is also passed from the knee to the groin. Thus, the "Bi-directional Tunneler" offers hitherto unknown versatility in bypass as well as in hemodialysis shunt surgery. PMID- 2777614 TI - ["Insitutom RC": a new instrument for valve incision in in-situ vein bypass]. AB - The "in situ" bypass technique was first used by Cartier in 1960. It has only slowly gained acceptance among vascular surgeons. In part this can be explained by the lack of an easy and reliable method to render vein valves incompetent. The instruments most widely used for this purpose have been developed by Hall, Gruss and Leather ("Valve Stripper", "Insitucut" and "Valve Cutter", respectively). Based on theoretical considerations and practical experience, we have developed a new instrument for the incision of vein valves: the Insitutom RC. Unlike other instruments, it allows rotation control of the cutting blade and thus enables the surgeon to incise the valve cusps more precisely and reliably. PMID- 2777615 TI - [Totally implantable catheters. Experience at the University Hospital Center Vaudois from March 1984 to December 1987]. AB - With cancer patients, the venous access remains a major problem. It causes phlebitis, venous sclerosis, skin necrosis and sepsis. Its maintenance implies careful nursing and a great dependence for the patient. Arterio-venous fistulas have been abandoned and replaced by Hickman-type subcutaneous indwelling catheters. These have a complication rate, mainly infectious, of about 0.4/100 days. The development of totally implanted catheters diminishes even more this rate and improves the patient's comfort. In this article we report the experience gained from 100 cancer patients equipped with 107 catheters. 31 complications occurred over a total time of 15,421 days, this averages a rate of 0.2 complications/100 days. The respectively rate of thrombosis and infections are of 0.02/100 days each. In 61% of the cases the whole system was functional after management of the complication. This results confirm the excellent tolerance of the system, its minimal rate of complication and its great possibility of reutilization. PMID- 2777616 TI - [Treatment of soft tissue sarcoma. A multidisciplinary approach]. AB - The treatment of soft tissue sarcomas is at present a multidisciplinary process. In Switzerland, patients are too often referred to specialized centers after an inadequate management. The general principles of biopsy, surgery, radiotherapy and chemotherapy are reviewed in the light of the biological behaviour of these tumors. Emphasis is made on the role of adjuvant chemotherapy that is not yet established and that is the subject of an ongoing Swiss Study. A collaboration to the study of the Swiss centers and the surgeons is needed in order to improve the quality of treatment of these tumors. PMID- 2777617 TI - [Acute arterial occlusion of the extremities. Rate of success following simple embolectomy and following combined procedures]. AB - Acute arterial obstruction of the extremities represents the most common emergency in vascular surgery. Diagnosis is based on the typical history and clinical symptoms. Emboli in vessels without atherosclerotic changes can be removed by simple embolectomy. In atherosclerotic arteries or in cases of acute thrombotic occlusion preoperative angiography is recommended in order to perform extensive reconstructive procedures. 400 arterial reconstructions for acute obstruction of the extremities were analysed. 46 operations were done in the upper extremities. In the majority of the cases simple embolectomy was successful. Limb salvage was 100% although one embolectomy and one bypass procedure failed to restore full revascularization. Complication and mortality rate was low. 354 lower limbs were operated. 274 extremities could be saved (77.4%). Among 80 poor results 48 major amputations had to be done (13.5%). Perioperative mortality was 12.4%. Death was mainly attributed to myocardial infarction. PMID- 2777619 TI - [Liquid crystal contact thermography--a new screening procedure in the diagnosis of deep venous thrombosis]. AB - In search of a sensitive, simple, non-invasive screening method in the diagnosis of Deep Vein Thrombosis (DVT) we become aware of the recent possibility of Liquid Crystal Contact Thermography (LCCT). From October 1987 all patients over 40 years of age undergoing visceral surgery were examined on the second postoperative day by means of the LCCT Method. Furthermore patients of the traumatological clinic with high risk for DVT (hip surgery) were controlled. In case of positive thermography or uncertain interpretation a phlebography was performed and thermography repeated. Until the end of February 1988 316 patients were submitted to LCCT. In the beginning of the study pathologic and iatrogenic factors which lead to a rise in temperature of the leg, caused differential diagnostic problems. In the course of the study the LCCT turned out to be a reliable screening method in the diagnostic of DVT. In our study the LCCT has a sensitivity of 94%. The specificity was, as expected, a bit lower and is 86%. The high sensitivity and somewhat lower specificity (which is without consequence for the patients) shows that LCCT is well suited as screening method, especially since it is non-invasive. Differential diagnostic aspects are discussed. PMID- 2777618 TI - [Development of a small-lumen vascular prosthesis coated with autologous endothelial cells]. AB - A new compliant prosthesis with a monolayer of autologous endothelial cells (ENC) has been developed. It consists of a porous polyurethane-siloxane-copolymer reinforced by a polyester network to prevent excessive dilatation. On the inner surface an ENC monolayer is established before implantation by a cell culture procedure. The prosthesis displays compliance (13.2 +/- 3.0 x 10(-4) mmHg-1) comparable to native arteries. It is non-kinkable (minimal radius of curvature less than 5 mm). Burst resistance, remaining deformation, cut out force and tensile strength are superior to standard values. ENC-coverage in excess of 95% of the inner surface was produced in vitro using a lining procedure. The monolayer of confluent cells was demonstrated to consist of endothelial cells by their characteristic cobblestone morphology, the expression of factor VIII related antigen and the specific uptake of Dil-Ac-LDL. The unstimulated prostacyclin production was similar both in native veins as well as in lined prostheses. Antithrombogenicity of the endothelial cell lining was demonstrated in 24 h animal implants. PMID- 2777620 TI - [Surgery of traumatic aortic rupture]. AB - This report describes the clinical presentation, diagnosis, surgery and results of patients with acute traumatic rupture of the aorta in a series of 21 consecutive patients. Direct cross-clamping without additional methods of spinal cord protection was used in 18/21 patients (86%). Direct suture was possible in 12/21 patients (60%). In the remaining patients, the repair was carried out by interposition of a Dacron graft. Overall mortality was 7/21 patients (33%). However, in 3 patients with severe polytrauma irreversible brain damage was the cause of death whereas 2 patients died from septicemia and myocardial infarction, respectively. No paraplegia nor paraparesis occurred in the surviving patients which were operated by direct cross-clamping of the aorta and rapid reanastomosis without additional methods of spinal cord protection. PMID- 2777621 TI - [Intestinal necroses in severely injured patients without abdominal trauma]. AB - Bowel necrosis in the critical trauma patient without abdominal involvement or preexisting vascular disease is a known but rare complication. During 1977-1986 we observed 31 cases in 2530 patients. Symptoms were unspecific, and since most of the patients were artificially ventilated, pain and tenderness were of little diagnostic value. Twenty-three patients presented with paralytic ileus, fifteen with diarrhea, and four with melena. In eleven patients diagnosis was made clinically, and in twenty patients at autopsy. Twenty-three patients died from septic shock, six from cerebral complications, and one from myocardial infarction. Risk factors for bowel necrosis were fluid restriction, hypotension, hypoxemia, venous congestion, vasoconstrictive drugs, paralytic ileus, and constipation. PMID- 2777622 TI - [Surgery of inguinal hernia]. AB - In a retrospective analysis the long-term results--mean 13 years--after herniotomy and Bassini-repair are discussed. The recurrence rate based on questionnaire was 10.5%, based on clinical examination 23% for first operation. Considering our results it's--in accordance with the literature--evident that both clinical examination and long-term control are important for the evaluation of the real recurrence rate. Regarding the results we are performing a modified Shouldice repair now. PMID- 2777623 TI - [Dorsal ganglion of the wrist joint: a trivial, minor surgery intervention?]. AB - A small operation which is thought to be trivial with a recurrence rate of 30 to 40 percent. The dorsal ganglion of the hand arises from the typical predilection site in the dorsal portion of the scapholunate ligament. By excising the capsular attachments over the scapholunate ligament we can significantly reduce the recurrence rate to only a few percent. But the absence of recurrence doesn't guarantee for certain that the patients are painfree. In spite of the operation one third of the patients complain of persisting pain which is often due to an irritation of the posterior interosseous nerve (PIN) by the ganglion. A selective dissection and resection of the PIN proximal to the radiocarpal unit as a partial dorsal wrist denervation is proposed. This shows that the indication for the operation must be evaluated thoroughly. PMID- 2777624 TI - [Indications and results of interlocking nailing of the femur]. AB - Since the introduction of an interlocking nail in 1972, different systems have been developed for the management of unstable femoral fractures. At the Clinic for Traumatology at the University Hospital of Zurich, the system of Grosse and Kempf was utilized until 1986, after which the AO universal nail system has been and still is used. Between 1981 and 1987, 63 femoral fractures in 62 patients have been treated with interlocking nails. The fractures were produced by a variety of mechanisms of injury, of which 75% were caused by traffic accidents. Associated injuries to other organ systems were sustained by 73% of the patients, overall there were 33% considered to have multiple trauma. 25% of the fractures were open. 44% (n = 28) required stable fixation, 15 were dynamized. The remaining 35 fractures were treated with dynamic nailings, 8 proximal and 27 distal. 15% were open nailings. Following dynamic stabilization full weight bearing was obtained after 56 and stable fixation after 120 days. A bridging callus was observed after an average of 8 weeks, and cortical bridging at 26 weeks following nailing. Complications included displacement of transversal screws in 3, local infections around the distal or proximal transversal screws in 3 and osteomyelitis at the fracture site in 3 cases. PMID- 2777625 TI - [Total hip prosthesis with or without preventive use of antibiotics]. AB - 514 patients with total hip replacement were operated in 3 years in our county hospital. The patients were divided in two groups: 1. high risk patients: these patients had an antibiotica prophylaxis with 3 doses of 2 g of cefamandole beginning at the time of the induction of the anaesthesia; 2. patients without risks: they had no antibiotica. The two groups of patients were controlled at 3 and 12 months after the operation. 159 patients had a risk for an infection and had antibiotica, 355 patients had no antibiotica. The infection rate after 1 year was 0.6% in the group of patients with antibiotica, and 1.4% in the group of patients without antibiotica. This gave no statistical significance. The only statistical difference between the 2 groups was a significantly higher rate of urinary infection in the group with antibiotica. Thus it has been shown that urinary infections after total hip replacement correctly treated with antibiotica are not a high risk for an infection in the prosthesis. We conclude that antibiotica prophylaxis for total hip replacement in patients with high risk factors (like diabetes, corticotherapy, intraarticular injection, obesity and operation on the same hip) may help to have a postoperatively low infection rate, in our case 0.6%. PMID- 2777626 TI - Gene frequencies in natural and laboratory populations of Drosophila nasuta. AB - Gene arrangement frequencies of different chromosome types of three inversions, IIL-2, III-35 and III-2 are reported in some natural and laboratory populations of Drosophila nasuta. In general, the frequencies of inversion heterozygotes for these inversions are in excess of what is expected under Hardy-Weinberg equilibrium in both natural and laboratory populations. This suggests that these inversion heterozygotes are heterotic to the species as far as viability is concerned. Similar to what occurs in the cosmopolitan species, chromosomes with standard gene sequences are more frequent than inverted gene sequences in this species. The scarcity of inversion homozygotes is due to reduced viability of their carriers, which probably have lethal or sublethal combinations of alleles in the inverted sections of their chromosomes. Further, the inversion frequencies in laboratory populations follow the frequencies in natural populations. PMID- 2777627 TI - Electrophoretically detectable genetic variation in natural and hatchery stocks of Atlantic salmon in Finland. AB - To survey the genetic resources of Atlantic salmon (Salmo salar L.) stocks in Finland, an electrophoretic study was made of natural and hatchery stocks. The stocks were compared with the nearest stocks in the USSR, and the effects of hatchery rearing were evaluated. The genetic variation within and between stocks was measured from 20 samples, of which three (Kola, Neva and Onega) were from the USSR. Twenty-five enzyme loci were examined, of which six were polymorphic: AAT 4, IDH-3, ME-3, MDH-3, PGM-1, and SDH-1. The mean heterozygosity of all the populations was 4.2% (1.0-7.2). For the natural salmon stocks of the Arctic Ocean, the mean heterozygosity was 6.3%, for the natural stocks of Atlantic salmon in the Baltic 4.8%, for the hatchery stocks 3.6%, and for the lake salmon (Salmo salar m. sebago Girard) 1.8%. The results are in agreement with the hypothesis that the amount of variation depends on the effective population size and that culture diminishes variation by decreasing the effective population size. All the stocks originating from different rivers differed from each other with statistical significance. The most unique stocks were the River Kola stock and the lake salmon stock from Lake Saimaa. The genetic distances were consistent with the geographic distance between the rivers from which the stocks originated. Stress is laid on the importance in fish culture of maintaining separate stocks and using larger brood stocks. PMID- 2777628 TI - High-resolution studies on late-replicating segments (G + C bands) in mammalian chromosomes. AB - High resolution of late-replicating segments (G + C bands) in chromosomes of human, cattle and water buffalo was obtained by using 5-bromodeoxyuridine incorporation early in the cell cycle, simultaneous with methotrexate treatment combined with reduced colcemid treatment and addition of ethidium bromide, which increased the proportion of prometaphase cells. Giemsa counterstaining, following fluorescence microscopy observation and treatment with 2 x SSC, improved the resolution of the banding patterns, particularly in the pericentromeric regions. Acrocentric bovine and water buffalo chromosomes, which were seen to be C positive by fluorescence microscopy observation and C-negative after counterstaining, showed the presence of subcentromeric G-positive bands within the heterochromatic blocks of several chromosomes. PMID- 2777629 TI - Mitotic cells in different lymphocyte subsets in unfractionated cultures stimulated by phytohaemagglutinin or pokeweed mitogen. AB - Unfractionated peripheral blood lymphocytes were cultured in the presence of either phytohaemagglutinin (PHA) or pokeweed mitogen (PWM) for 3 and 6 days. The subpopulations of mitotic lymphocytes were determined by an immunoperoxidase technique. Our results demonstrate that the proportion of mitotic B cells is approximately equal in PHA- and PWM-stimulated cultures. The frequency of mitotic CD22+ B cells varied from 3% to 5% and that of cells positive for the monoclonal antibodies anti-lambda and anti-kappa from 5% to 7%. We also showed that PHA stimulates mitoses in CD8-positive suppressor cells more effectively than does PWM. The mean proportion of CD8+ cells in mitosis was 29% when cultured with PHA for 3 days and 17%, in the presence of PWM. Culturing for 6 days with PHA increased the proportion of mitotic CD8+ cells, but PWM stimulation did not affect the frequency of mitoses in this lymphocyte subgroup. PMID- 2777631 TI - Familial occurrence of cancer and heteromorphism of the heterochromatic segment of chromosome 1. AB - During the last decade, evidence has been forthcoming in support of the correlation between heteromorphism of human chromosome 1qh and the incidence of various malignancies in the carriers of such heteromorphism. We present data from a family with hereditary predisposition to cancer. In this family, five members in a sibship of seven developed ovary and/or colon carcinoma at comparatively young ages. A further 4 cases of malignant disease were ascertained, when a pedigree of 36 family members of 3 generations was constructed. Chromosome analysis was carried out in G- and C-banding from peripheral blood cultures of 19 family members. Distinct heteromorphism in the chromosome 1qh region was detected in 15 (79%) of them, including all 3 cancer patients investigated. PMID- 2777630 TI - Karyotypic evolution in a human mucoepidermoid carcinoma. AB - Chromosomes were studied in cultured material from two different areas of a human mucoepidermoid carcinoma. The detailed banding analyses showed no less than 41 different karyotypes. Comparisons between these revealed (1) that the tumour probably had originated with a normal, diploid stemline; (2) that the progression had mainly proceeded by steps in a hyperdiploid direction, by, as a rule, sequential numerical deviations; and (3) that there existed at least eight further, different, evolutionary products from the original stemline. The complex progressional pattern disclosed in the present case contrasts with cytogenetical data documented for most human benign as well as malignant tumour types. PMID- 2777632 TI - Further analyses of the evolutionary characteristics of a sequentially studied human malignant mesothelioma. PMID- 2777633 TI - Localization of the equine major histocompatibility complex (ELA) to chromosome 20 by in situ hybridization. PMID- 2777634 TI - Glycoconjugates of the intestinal epithelium of the domestic fowl (Gallus domesticus): a lectin histochemistry study. AB - A lectin histochemical study was performed on formalin-fixed paraffin-embedded tissues of duodenum, jejunum, ileum, caecum and colon from six fasted and six non fasted 8-week-old chickens (Gallus domesticus). The purpose of this study was to identify in situ the pattern of carbohydrate residues present on the luminal surface of the intestinal epithelium. Ten biotinylated lectins with different sugar specificities were used as probes, and avidin-biotin-peroxidase complex (ABC) was used as a 'visualant'. The most significant finding was the binding pattern of Lens culinaris agglutinin to various segments of the intestines. The luminal surface of the small intestinal epithelium did not stain with this lectin. In the colon the luminal surface was lightly stained, while the caecal luminal surface was intensely stained. Throughout the intestine the luminal surface stained with Canavalia ensiformis agglutinin, Ricinus communis agglutinin I and wheatgerm agglutinin, but it did not stain with Dolichos biflorus agglutinin. These findings indicated that, throughout the intestine, the luminal surface contains glycoconjugates with either N- or O-linked glycoprotein, or both, with terminal non-reducing beta-galactosyl and sialyl residues. Furthermore, the caecal surface is rich in N-linked glycoproteins with an alpha (1----6)-linked fucosyl residue near the glycosidic linkage. The potential significance of these observations and the role of glycoconjugates in host parasite interaction (i.e. Eimeria sp. versus Gallus domesticus) are discussed. PMID- 2777635 TI - The immunohistochemical localization of superoxide dismutase activity in the avian epithelial growth plate. AB - Superoxide dismutase (SOD) is a 'scavenger' enzyme which catalyses the dismutation (reduction-oxidation) of the superoxide anion (O2-.), a toxic free radical generated during normal cellular respiration. Light microscopy employing immunohistochemistry was utilized for localizing SOD activity in the chick epiphyseal cartilage. Antibodies to mammalian liver CuZn-SOD were prepared and the avidin-biotin-peroxidase technique (ABC complex) was utilized to localize activity for this enzyme in the growth plate cartilage. The localization of enzyme activity varied in accordance with the characteristic zonation pattern of the growth plate (zone of proliferation, zone of maturation, zone of cell hypertrophy and zone of matrix calcification). In the upper regions of the epiphyseal cartilage (the zones of proliferation and maturation), where the vascularity is poor and the oxygen tension low, SOD activity was localized within the chondrocytes. No extracellular activity was observed. However, in the lower regions of the growth plate (the zones of cell hypertrophy and matrix calcification), where both the vascularity and the oxygen tensions are increased, SOD activity was intense in both the chondrocytes and the surrounding extracellular matrix. Thus, the distribution of SOD enzyme activity in this tissue seems to vary in accordance with the level of oxygen present. The significance of the extracellular SOD activity, seen in the lower aspects of the growth plate cartilage, may indicate the sensitivity of matrix components, especially collagen, to toxic free radicals such as the superoxide anion. PMID- 2777637 TI - Comparison of glycoconjugates at the surface of developing type II pneumocytes and Clara cells. AB - The apical surface coat of type II pneumocytes and Clara cells in pre- and post natal rat lung was examined with lectin histochemical methods. Lectins from Helix pomatia (HPA), peanut (PNA) and Maclura pomifera (MPA) were conjugated with horseradish peroxidase and used to stain paraffin sections of fixed lung with or without certain pre-treatments. HPA and MPA were observed to react with almost all type II pneumocytes at postnatal day 1. Type II pneumocytes that stained with a sialidase-PNA sequence increased from a few positive cells at postnatal day 5 to many in the adult. It has been reported that the surface coat of type II pneumocytes closely resembles that of Clara cells in its staining with histochemical methods employing cationic dyes or lectins including MPA and PNA. However, staining with HPA, especially after periodic acid oxidation, revealed many type II pneumocytes with strong reactivity but showed only a few Clara cells that were faintly positive. HPA also stained alveolar macrophages. The HPA affinity of macrophages, however, was labile to oxidation with periodic acid or galactose oxidase unlike that of type II pneumocytes. This difference suggests that HPA recognizes more than one type of sugar structure. PMID- 2777636 TI - Sialic acid in colonic mucin: an evaluation of modified PAS reactions in single and combination histochemical procedures. AB - Two new histochemical procedures for detecting sulphated and non-sulphated sialomucin in colonic mucosa were assessed: the saponification-Alcian Blue pH 1 periodic acid-phenylhydrazine-Schiff method (KOH-AB pH 1-PAPS) and the mild periodic acid modification of this (KOH-AB pH 1-mPAS). Using normal colonic mucosa obtained from 11 non-cancer patients, the mPAS and PAPS techniques were tested for specificity and reproducibility for staining sialic acid, either alone or in combination with Alcian Blue. A spectrophotometric method was devised to quantify the uptake of both Schiff and Alcian Blue stain by sections. At low temperature and pH 5.5, the mPAS procedure had improved specificity over the PAPS procedure, and after saponification it could be used to stain O-acetyl substituted sialic acid. When used in combination with Alcian Blue at pH 1, however, underestimation of the sialic acid content occurred owing to interference between Alcian Blue and Schiff dyes. Interference was even greater with KOH-AB pH 1-PAPS procedure for both sialic acid and sulphate components. We conclude that caution must be exercised in interpretation of the staining results obtained with these new combination methods and that more accurate information on the sialic acid and sulphate content of colonic mucin is obtained by staining serial sections with the mPAS technique and Alcian Blue pH 1 alone. PMID- 2777638 TI - Ultrastructural cytochemistry of non-specific esterase in murine peritoneal macrophages. AB - Non-specific esterase (NSE) activity was demonstrated in glutaraldehyde-fixed monolayers of murine peritoneal macrophages. Using 2-naphthylthiol acetate (NTA) as substrate and Fast Blue BB as coupling agent a strong osmiophilic reaction product was obtained. The reaction product was observed as electron-dense dots covering cisterns of the rough endoplasmic reticulum, Golgi saccules and vesicles, or as large aggregates in lysosomes. Using alpha-naphthyl butyrate (ANB) as substrate and hexazotized pararosaniline as coupling agent the osmiophilic reaction product was observed extracellularly on the plasma membrane as an electron-dense continuous layer, whereas intracytoplasmic staining of lysosomes was rare. Substitution of the coupling agents in the respective media resulted in a slight reaction with the ANB medium whereas with the NTA medium reaction product was observed only in lysosomal structures. The substrate specificity of the different types of esterases was confirmed after isoelectric focusing on thin-layer polyacrylamide gels. The results indicate that in murine peritoneal macrophages different types on NSE are detected with NTA and ANB, having distinct ultrastructural localizations. PMID- 2777639 TI - Dexamethasone and corticosterone receptor sites. Differential topographic distribution in rat hippocampus revealed by high resolution autoradiography. AB - High resolution light microscopic autoradiography was used, together with regional surveys and combined acridine orange staining, to define in rat hippocampus cellular and subcellular sites of concentration and retention of 3H dexamethasone and to compare the topographic pattern of labeling with that of 3H corticosterone. Nuclear uptake of 3H dexamethasone in the hippocampus is demonstrated for the first time in vivo. With 3H dexamethasone, strongest nuclear radioactive labeling was observed in certain glial cells throughout the hippocampus, followed by strong nuclear labeling in most neurons in area CA1 and in the adjacent dorsolateral subiculum and weak nuclear labeling in granule cells of the dentate gyrus. Neurons in areas CA2, CA3, CA4, and in the dorsomedial subiculum and indusium griseum showed little or no nuclear labeling after 3H dexamethasone. With 3H corticosterone, strongest nuclear labeling was observed in neurons in area CA2 and in the dorsomedial subiculum and indusium griseum, followed by area CA1, then CA3 and CA4; the dentate gyrus contained scattered strongly labeled cells among cells with intermediate nuclear labeling. At the subcellular level, evidence for both nuclear and cytoplasmic accumulation of label was found. The results indicate that dexamethasone and corticosterone have both nuclear and cytoplasmic binding sites and that particular patterns of target cell distribution exist, characteristic for each agent. This suggests a differential regulation of cellular functions for the two compounds. Corticosterone nuclear binding appears to be more extensive and encompasses regions with dexamethasone binding. Whether in certain of these common regions corticosterone binds to the same receptor as dexamethasone, which seems possible, or to different receptors, remains to be clarified. PMID- 2777640 TI - A histochemical localization on Maclura pomifera lectin during osteogenesis. AB - Mandibular condyles of 4-week-old Wistar strain rats and mandibles of ICR strain mice from 14 days gestation stage to 2 days postnatal stage were used to investigate the localization of Maclura pomifera lectin (MPA) during two modes of osteogenesis. During endochondral ossification of the mandibular condyle, MPA was only localized at the peripheral regions of calcified cartilage after the destruction of chondrocyte lacunae. Bone extracellular matrix (ECM) was not reacted with MPA. In intramembranous ossification of mice mandibles, MPA was stained intensively in the early bone ECM. The intensity of the MPA reaction decreased during bone development. In both cases of osteogenesis, chondroclasts and osteoclasts showed the strong affinity to MPA. These results indicated that the time- and position-specific changes within ECM proceeded during osteogenesis and that MPA was the useful probe to detect chondroclasts and osteoclasts. PMID- 2777641 TI - The effect of lead incorporation on the elemental composition of earthworm (Annelida, Oligochaeta) chloragosome granules. AB - The elemental compositions of chloragosome 'granules' in the earthworm Lumbricus rubellus living in non-polluted (Dinas Powys) and heavily Pb-polluted (Wemyss) soils were determined by fully quantitative electron probe X-ray microanalysis. P, Ca, S and Zn were the major elemental components of the chloragosomes. High Pb concentrations were found in chloragosomes of Wemyss animals; Pb was not detected in chloragosomes of Dinas Powys animals. Partial correlation and regression analysis indicated that the in vivo accumulation of Pb by chloragosomes was accompanied by diminished chloragosomal Ca concentrations. Pb is bound by P containing ligand(s) in the chloragosome matrix. The sequestration of Pb by chloragosomes results in the detoxification of the metal by accumulative immobilization. PMID- 2777642 TI - Ultrastructural electron probe X-ray microanalytical reaction product identification of three different enzymes in the same mouse resident peritoneal macrophage. AB - Simultaneous cytochemical enzyme localization procedures for peroxidase (PO) plus acid phosphatase (AcP-ase) and/or aryl sulphatase (AS) have been investigated at the ultrastructural (EM) level. Electron probe X-ray microanalysis (EPMA) will identify and differentiate the reaction products. Dual reaction product localization of PO plus AcP-ase or alternatively PO plus AS have been obtained in the same mouse resident peritoneal macrophage. This has been acquired by first performing a PO-reaction followed by AcP-ase or followed by AS. In both cases PO related reaction products (PODAB/Os or PODAB/Pt) were localized in nuclear envelope (NE) and rough endoplasmic reticulum (RER). Cells were identified by this reaction product as resident macrophages. Reaction products from the AcP-ase related cerium (AcP-aseCe), localized in lysosomes have been identified and differentiated from the PO-related osmium containing products. Similarly AS related barium (ASBa), localized in lysosomal structures and (R)ER was identified and differentiated. Triple reaction product localization of PO followed by AcP ase plus AS could also be obtained. In this case, PO-related platinum containing reaction products (PODAB/Pt or PODAB/Os) in NE and RER has been identified and differentiated from the AcP-ase related lysosomal cerium (AcP-aseCe) and the AS related barium localized in lysosomal and (R)ER structures. Reversing the sequences in both dual cytochemical procedures: AcP-aseCe or ASBa followed by PODAB/Os (or PODAB/Pt) resulted in AcP-aseCe or ASBa activity related reaction products only. Reversing the sequence in the triple reaction procedures (ASBa followed by AcP-aseCe) resulted in the absence of the barium containing reaction products. By application of OsO4 postfixation with aminotriazole (ATR) additives the detrimental effects upon the various precipitates have been confirmed. In LM studies, using rat intestine and non-metal identification reactions for two of the enzymes (pararosaniline for AcP-ase, DAB for peroxidase), the influences of the metal ions used in EM were tested on the appearance of the coloured reaction products. Cerium ions used in EM for detection of AcP-aseCe activity have been shown to influence the PODAB visibility in LM and EM experiments. From the AS reaction media components neither barium ions nor p-nitro catachol sulphate influenced the LM visibility of the PO reaction. PMID- 2777643 TI - Evidence for heterogeneity of the DPA and DPB alleles derived from a DRw11,DQw7,DPw4 cell line. AB - We have previously reported the complete sequence of the cDNAs corresponding to the alleles at the polymorphic loci (DRB1, DRB3, DQA1, DQB1) of the DRw11(5) cell line Swei. We now report the nucleotide and derived amino acid sequence of the alleles at the remaining two polymorphic loci, DPA1 and DPB1, from Swei, which types as DPw4b. Comparison of the DPw4b alpha sequence with previous DP alpha sequences indicates that it is identical to the DP alpha chains of DPw4 and DPw2. However, the DPw4b alpha cDNA encodes a unique 3' untranslated region that corresponds to sequences contained within the last intron of the DP alpha genomic gene. These results indicate that alternative splicing occurs within the Swei DP alpha RNA. Comparison of the DPw4b beta sequence with previously reported DP beta sequences indicates that the first domain is identical to the sequence of the DP beta chain derived from the Burkhardt (Burk) cell line, but that the second domain differs by two amino acids. In addition, a single amino acid difference from DPw2 at position 69 in the first domain of the DPw4b beta chain suggests that this residue is important in determining DP specificity. Furthermore, comparison with other DP beta DNA sequences suggests that variable regions occur at positions 8-11, 55-57, and 84-87. PMID- 2777644 TI - Aggressive management of second primary tumors in survivors of hereditary retinoblastoma. AB - Survivors of hereditary retinoblastoma are at increased risk for the development of second primary tumors, most commonly osteosarcoma. Recent molecular genetic data demonstrate that a pleiotrophic effect of the retinoblastoma gene may be responsible for the development of these sarcomas. This report describes the incidence of second nonocular malignancies among 53 infants seen at Stanford University Medical Center who have been followed a median of 11.7 years. Of these, 42 initially had bilateral disease and eleven had unilateral disease. Of 53 infants, 50 received irradiation either as part of the initial therapy or as treatment for recurrent disease. The actuarial survival for the entire group is 67% at 30 year follow-up with a median survival of 79% at 11.7 years. Eight patients developed eleven second primary tumors. All occurred in the group having hereditary retinoblastoma. Eight were within the previously irradiated field and three were at distant sites. The second tumors included seven osteosarcomas, one angiosarcoma, one rhabdomyosarcoma, one malignant fibrous histiocytoma, and one unclassifiable round blue cell tumor. The actuarial incidence of the development of a second primary malignancy was 6% at 10 years, 19% at 20 years, and 38% at 30 years. The latent period from treatment of retinoblastoma to the diagnosis of malignancy ranged from 5.2 years to 36.2 years (median 16 years). An aggressive approach with combined modality therapy including radical resection, re irradiation and/or chemotherapy was used to treat these second primary tumors in five of eight patients. In four of the five, there was no evidence of disease at 22-72 months following treatment. In the three patients who did not receive aggressive combined treatment, there were no survivors. These data confirm the previously reported risk of developing a second primary tumor among survivors with hereditary retinoblastoma. Careful long-term follow-up for this genetically susceptible group is essential for early detection and implementation of curative therapy. PMID- 2777645 TI - A clinical study of 407 cases of nasopharyngeal carcinoma in Hong Kong. AB - Four hundred and seven cases of nasopharyngeal carcinoma were analyzed retrospectively; 403/407 were evaluable for recurrence and survival. Parapharyngeal boost significantly decreased local recurrences in parapharyngeal diseases without base of skull involvement (T2p), but not with base of skull involvement (T3p). Enhanced local control of T2p with boost was significant without neoadjuvant chemotherapy. Tumors localized within the nasopharynx (T1) and tumors with nasal involvement (T2n) suffering from local persistences after external radiation therapy were treated with an intracavitary afterloading method. They had survival and recurrence rates comparable to complete responders to external radiation therapy. Patients with bulky cervical nodes (maximal diameter greater than or equal to 4 cm, N1-N3), treated with neoadjuvant chemotherapy with cis-diamminedichloroplatinum II and 5-fluorouracil, had a regional failure rate, distant metastasis rate, actuarial survival rate, and disease-free survival rate comparable to those with smaller nodes treated with external radiation therapy alone. A simple modification of the Ho's classification by regrouping the T-stages into 'early T-stages' and 'advanced T stages' and by combining the N1 and the N2 has greatly increased the power of the system in predicting local recurrence and distant metastasis, respectively. There was an overall improvement of the actuarial survival rate and disease-free survival rate over the historical control, and its significance is discussed. PMID- 2777646 TI - Serum markers for prediction of pulmonary radiation syndromes. Part I: Surfactant apoprotein. AB - Detection of a biochemical marker indicating radiation lung injury prior to the onset of clinical pathologic events could prove valuable in patient management. An increased level of alveolar surfactant is one of the earliest detectable changes following lung irradiation, starting within hours of irradiation and persisting a maximum of 2-6 weeks. However, because broncho-alveolar lavage is impracticable and endothelial cell damage due to radiation results in changes in permeability of vessel wall with leakage of alveolar proteins into serum, identification of serum markers was sought. A series of experiments in rabbits are described that clearly demonstrate serum surfactant apoprotein is an accurate marker and predictor for later lethal radiation pneumonitis. At 3-7 days after graded single doses to lung, surfactant was found in the serum paralleling the dose response for lethality. Control studies with a physiologic agent such as terbutaline release alveolar surfactant, but no serum surfactant was detected. Monitoring serum surfactant could direct preventive intervention prior to clinicopathologic manifestation of pulmonary radiation syndromes. PMID- 2777647 TI - Repair of sublethal damage in two human tumor cell lines grown as multicellular spheroids. AB - Multicellular tumor spheroids (MTS) provide a suitable in vitro model to study radiation sensitivity of tumor cells. Two cell lines of human origin, obtained from a neuroblastoma (NB-100) and a squamous cell carcinoma (HN-1), were exposed to graded doses (4-9 Gy) of radiation with 18 MV photons. Radiation was applied either as a single or as a split dose with an interval of 6 hr to determine the extent of sublethal damage repair. Treated spheroids regrew at approximately the same growth rate as control multicellular tumor spheroids, preceded by a static or regression phase. Radiation response was quantified in terms of regrowth delay, expressed as the time needed for treated spheroids to obtain an 8-fold increase of the initial volume at the time of irradiation. Data obtained from regrowth delay analysis were used to calculate the extent of sublethal damage repair, showing for the squamous cell carcinoma line a fractionally higher capacity to repair sublethal damage than the neuroblastoma line. Repair increased with larger dose fractions in both cell lines. Our results show that multicellular tumor spheroids from the two cell lines used in this study are best applicable at relatively high total radiation doses. This makes multicellular tumor spheroids a suitable model for the in vitro evaluation of clinical treatment rationales such as hyperfractionation. PMID- 2777648 TI - The use of lymphoscintigraphy in treatment planning of primary breast cancer. AB - A technique is described for the use of lymphoscintigraphy in treatment planning of primary breast patients. During simulation of the treatment fields, the positions of the internal mammary nodes are projected back toward the source onto the patient skin surface and are marked by radio-opaque markers for visualization on films. Exact solutions for the coordinates of these surface projection points are derived. Approximate solutions are also given which are independent of the isocenter location and primarily dependent on the treatment field gantry angle. If a typical couch angle and field size are assumed, the projection points can be calculated for various gantry angles prior to simulation. Generally, a decision can then be made beforehand whether it would be better to use deep tangents or a separate field to treat the internal mammary nodes. During simulation, the surface projection points serve as visual and fluoroscopic guides to field design and optimization. A method is also presented for projecting the internal mammary node positions onto a single transverse patient contour for conventional 2 dimensional treatment planning. By accurately showing the projected location of the node with respect to the field edge, adequate treatment margin can be assured. PMID- 2777649 TI - Optimal coverage of peritoneal surface in whole abdominal radiation for ovarian neoplasms. AB - Patterns of failure in ovarian carcinoma include early seeding of the entire peritoneal cavity. Inability to encompass the anatomic extent of the peritoneal cavity is a possible factor leading to relapse. However, little has been published regarding technical advances in optimal coverage of the peritoneal surface in whole abdominal radiation. In the Department of Radiation Oncology at the University of Michigan, 21 consecutive patients were analyzed prospectively in regard to adequate coverage of peritoneum in the treatment of advanced ovarian carcinoma. Simulation and focused blocks were designed to treat the whole abdomen. CT treatment planning studies were obtained with the entire peritoneum identified as the target volume. Simulator designed blocks were projected over the CT scans throughout the treatment volume. Dose volume histograms were used to calculate the amount of target volume missed for each treatment plan. All treatment plans demonstrated different degrees of volume miss, ranging from 1 cm3 to 837.3 cm3 with a median of 137.9 cm3 overall. Volume missed directly correlated with increasing patient weight and flatter pelvic shape, but poorly with AP separation. This was especially evident for patients requiring treatment at extended distances in both the supine and prone positions. We conclude that bony landmarks are poor guidelines in designing pelvic blocks, especially in heavy patients and patients requiring treatment in both prone and supine positions. CT treatment planning is helpful to ensure optimal peritoneal coverage. PMID- 2777650 TI - A comparison of heat and radiation sensitivity of three human glioma cell lines. AB - Three human glioma cell lines were tested for radiation and hyperthermia sensitivity and compared to the responses of a normal human fibroblast cell line. The radiation response of the glioma cell lines exhibited a large shoulder on the radiation survival curve indicating radioresistance when compared to the more radiosensitive fibroblast cell line. The hyperthermia response for the glioma cell lines was qualitatively similar to responses reported for other cell lines. When compared to normal human fibroblasts the glioma cells were found to be more sensitive to hyperthermia than the normal fibroblasts indicating hyperthermia may be a promising method or adjunct to radiotherapy in the treatment of resistant glioma cells or tumors. The results also show that both the radiation and thermal response is influenced by cell culture conditions and growth status. Two of the cell lines grown to confluency and treated in confluency showed an increased radiation resistance at low doses and the cell lines showed decreased resistance at high doses compared to cells plated to confluency (see Methods and Materials). An increased thermal resistance, especially at the lower heating temperatures, was also observed for cells grown to confluency. Measurements of residual glucose in the culture medium at the time of irradiation was about the same for the two culture methods (55%-65%). Cell cycle analysis showed that the differences were not related to changes in cell cycle distribution. PMID- 2777651 TI - Carcinogenic effects of scattered dose associated with radiation therapy. AB - Ionizing radiation has long been recognized as a weak carcinogen, and the risk of developing a radiation induced neoplasm after exposure to therapeutic radiation has been established. In the case of therapeutic radiation for treatment of existing malignancies, concomitant risk factors for second malignancies can confound the effect of radiation alone. This study presents a model for evaluating the isolated contribution of ionizing radiation to the induction of second malignancies in cancer patients, and presents estimates of the expected number of second malignancies induced in selected sensitive sites by scatter radiation during radiotherapy for cancer. The study focused on the year 1987, during which it was estimated that 192,761 new cancer patients received radiotherapy as part of their initial treatment plan. The model predicted that radiation may induce 63-84 secondary breast cancers, 64-72 secondary thyroid cancers, 94-157 secondary lung cancers, and 489-707 secondary leukemias over the remaining lifetime of this patient population. This represents a lifetime incidence of 0.7% for leukemia, and 0.3% for the solid tumors. This incidence must be placed in perspective with the current concepts of cancer management, such as combined modality therapy that may carry a risk of carcinogenesis greater than either modality alone, and when the alternatives to radiotherapy may be nonexistent or may be cosmetically or functionally undesirable. The information presented may be used in weighing the risks and benefits of alternative treatments for cancer. PMID- 2777653 TI - The influence of extensive bone erosion on local control in non-orbital rhabdomyosarcoma of the head and neck. AB - To investigate a recent report suggesting extensive bone erosion (EBE) as an important prognostic factor in head and neck rhabdomyosarcoma, a retrospective review was performed of 32 patients with gross residual and/or metastatic non orbital head and neck rhabdomyosarcoma treated between the years 1971-1987. Treatment consisted of surgery, radiation therapy (median primary dose, 5000 cGy) and combination chemotherapy according to the Memorial Sloan-Kettering Cancer Center (MSKCC) T2 and T6 protocols. The MSKCC staging system was used: Stage II, 23 patients; Stage III, 6 patients; and Stage IV, 3 patients. With a median follow-up of 48 months (range 17 months to 13 years), the overall survival and local control rates were 72% (23/32) and 75% (24/32), respectively. Local control was achieved in 11/11 patients without extensive bone erosion (Stages II, 9/9; III, 1/1; IV, 1/1) as compared to 13/21 patients (Stages II, 10/14; III, 2/5; IV, 1/2) with extensive bone erosion (p = 0.02). Our data appear to support the recently reported finding that extensive bone erosion is an important predictor of local failure. PMID- 2777652 TI - Sebaceous carcinoma of the ocular adnexa: radiotherapeutic management. AB - A total of 30 patients with histologically confirmed sebaceous carcinoma of the ocular adnexa were evaluated at our institution from 1974-1986. There were 18 women and 12 men in the series with a median age of 61 years. Ten cases received radiotherapy with curative intent. Four patients were treated definitively with doses ranging from 45-63.0 Gy over 4-7 weeks. Six patients received post operative radiotherapy to the parotid bed and ipsilateral cervical lymph node chain for parotid metastases developing within 36 months of initial surgical treatment. Patients with lower lid lesions and significant pagetoid histologic components were more likely to develop parotid lymph node metastases. Local control at the primary site after radiation and/or surgery was 90% with follow-up ranging from 2-10 years. Overall disease specific actuarial survival at 5 years was 96%. Radiation therapy is an effective treatment modality in adnexal sebaceous carcinoma. With employment of careful technique and state-of-the-art technology, long term local control and survival with satisfactory cosmetic and functional results can be anticipated. PMID- 2777654 TI - Conservative treatment for lower gynecological tract malignancies in children and adolescents: the Institut Gustave-Roussy experience. AB - Between 1972 and 1986, 37 patients with lower genital tract malignancies were treated with intracavitary or interstitial brachytherapy. Thirteen patients presented with clear cell adenocarcinoma, 14 patients with embryonal rhabdomyosarcoma, 6 patients with endodermal sinus tumor, 3 patients with sarcoma, and 1 patient with an undifferentiated tumor. FIGO classification was: Stage I, 16%; Stage II, 47%; and Stage III, 37%. Treatment policy included initial exploratory laparotomy with lymph node biopsy and ovarian transposition, chemotherapy (except in clear cell adenocarcinoma) and/or external radiotherapy prior to interstitial brachytherapy. Chemotherapy consisted of a combination of VAC-Ad (V = vincristine, A = D actinomycin, C = cyclophosphamide, Ad = adriamycin) in rhabdomyosarcoma and sarcomas, and MAC-Ad (M = methotrexate) in endodermal sinus tumor. External radiotherapy was used in seven patients: in one to reduce a bulky clear cell adenocarcinoma (20 Gy) and in six for pelvic nodal involvement (45 Gy). Brachytherapy techniques depended on tumor site and extent, and on the anatomy of the patients. Vulvar tumors were implanted with iridium-192 wires by an afterloading plastic tube technique. Cervical and vaginal tumors were treated with individually tailored moulded vaginal applicators loaded with either cesium-137 or iridium-192, with or without interstitial implants by plastic tube or guide gutter technique. Computerized dosimetry allowed calculation of treatment volumes and doses delivered on the tumor and adjacent critical organs. The prescribed dose (including external radiotherapy) was 60-75 Gy with 1-3 brachytherapy applications of a low dose rate (0.2 Gy/hr). Six patients are dead: one from chemotherapy complication, three of metastases (two sarcomas, one endodermal sinus tumor) and two of pelvic failures and metastases (two clear cell adenocarcinoma). The overall disease free 5-year survival is 72%. Actuarial 5 year local control is 84%, but including salvage is 94%: three (two rhabdomyosarcoma, one clear cell adenocarcinoma) of the five local failures were salvaged by surgery, chemotherapy and/or brachytherapy. Metastases occurred in six patients, one (sarcoma) salvaged by chemotherapy and external radiotherapy. Complications requiring surgery occurred in five patients: two hydronephroses, one urethral stricture, one ileo-cecal obstruction, and one vesicovaginal fistula. Twelve of the 17 patients (71%) over 12 years of age are normally menstruating. Two patients have produced three normal children. This multidisciplinary management of lower gynecological tract tumors including brachytherapy is both conservative and effective. PMID- 2777655 TI - Remote afterloading intraluminal brachytherapy in the treatment of rectal, rectosigmoid, and anal cancer: a feasibility study. AB - From 1981 to 1986, 28 patients (27 evaluable) were treated with intraluminal brachytherapy (ILBT) using a remote afterloading technique for persistent or recurrent anal, rectal and rectosigmoid cancers. Eighty-nine percent underwent previous surgery for colorectal cancer. Seventy-seven percent of the patients received external beam irradiation (ERT) as a part of the present treatment. Intraluminal brachytherapy was given with a 2 cm diameter cylinder and the dose per fraction ranged from 440 cGy to 840 cGy at 0.5 cm from the surface of the cylinder. Follow-up ranged from 1 to 74 months with a median of 12 months. Patients were divided into two groups. Group I consisted of 15 patients receiving elective ILBT; Group II: 13 patients with recurrent disease. Seventy-one percent of the patients in Group I and 39% of the patients in Group II achieved local control. The majority of patients tolerated treatment well with only transient reactions. However, three patients (11%) developed grade 3 (G3) complications requiring surgical intervention. Eight patients developed moderate complications- grade 2 (G2)--requiring only conservative treatment. This study has identified several factors which appear to influence the risk of developing complications with this combined treatment, using remote afterloading apparatus, among which are technique of previous external beam irradiation, treatment length, anatomical location, intraluminal brachytherapy fractionation, and total cumulative dose (ERT + ILBT). This experience suggests that intraluminal brachytherapy appears to be an acceptable form of treatment, as a boost to external beam radiation therapy, in the management of rectal and colorectal cancers. PMID- 2777656 TI - Determination of parameters for the linear-quadratic model for radiation-induced lung damage. PMID- 2777657 TI - An alternative explanation for the radiosensitization of AIDS patients. PMID- 2777658 TI - The effect of dose on local control of prostate cancer. PMID- 2777659 TI - Treatment of uveal melanomas with charged particles. PMID- 2777660 TI - Premenopausal breast cancer patients treated with conservative surgery, radiotherapy and adjuvant chemotherapy have a low risk of local failure. AB - The use of adjuvant chemotherapy in premenopausal breast cancer patients with positive nodes is now routine, but the optimal local treatment of these patients is uncertain. To determine the effect of adjuvant chemotherapy on the likelihood of local recurrence as the first site of failure in premenopausal patients treated with conservative surgery (CS) and radiotherapy (RT), we examined the outcome of 74 patients treated with CS, RT, and adjuvant chemotherapy and compared it to the outcome in 192 patients treated with CS and RT alone. Adjuvant chemotherapy consisted of four or more cycles of either a doxorubicin-containing regimen or cyclophosphamide, methotrexate, and 5-fluorouracil. All patients were less than 50 years old, had UICC-AJCC Stage I or II breast cancer treated between 1968 and 1981, had gross excision of the primary tumor, and had a total radiation dose to the primary tumor bed of greater than or equal to 6000 cGy. Factors predicting for local recurrence, such as extensive intraductal carcinoma and age less than 35, were equivalent in the two groups. Women treated with adjuvant chemotherapy had significantly worse T- and N-stages than women treated with conservative surgery and radiotherapy alone: 61% versus 36% had T2 tumors (p = 0.0003), 34% versus 6% had clinically positive nodes (p less than 0.0001), and 97% versus 4% had pathologically positive nodes (p less than 0.0001). Despite the poorer prognosis of patients treated with adjuvant chemotherapy, within 5 years of diagnosis, 4% of patients who received adjuvant chemotherapy had their initial relapse in the breast and 24% had initial failure elsewhere, compared with 15% local failure first and 14% failure elsewhere first for those treated without chemotherapy (p = 0.01). We conclude that premenopausal patients with positive nodes treated with combined modality therapy (conservative surgery, radiation therapy, and adjuvant chemotherapy) have a low risk of local recurrence as a first site of failure. These results suggest a possible interaction between radiation therapy and chemotherapy in their effects on local tumor control. PMID- 2777661 TI - Prognostic factors of breast recurrence in the conservative management of early breast cancer: a 25-year follow-up. AB - Between 1960 and 1980, 518 patients with T1, T2, N0, N1a, invasive breast cancer were treated by limited surgery at Institute Curie with (183 patients) or without (335 patients) axillary node dissection, followed by radiation therapy to breast and nodes. Median follow-up was 8.6 years (1.3 to 25 years). Fifty-six breast recurrences occurred, including 49 breast recurrences alone, 3 simultaneous breast and node recurrences, and 4 simultaneous breast recurrences and metastasis. Five-year, 10-year, and 15-year actuarial risks of breast recurrences were 7 +/- 1%, 11 +/- 1.5%, and 18 +/- 3%, respectively. Univariate analysis of 14 clinical and pathological prognostic factors revealed that local control in breast was significantly impaired by young age, premenopausal status, inadequate gross surgical excision, extensive ductal in situ component, and endolymphatic extension. On multivariate analysis with a Cox regression model, the most important contributors to local breast control in order of importance were age (p less than 10(-4), relative risk = 2.44), adequacy of surgery (p = 0.003, relative risk = 2.78), and endolymphatic extension (p = 0.03, relative risk = 2.98). The 5 year actuarial survival rate following breast recurrence was 73%, and was significantly worse when breast recurrence occurred in the first 3 years after treatment: 44% versus 87%, respectively (p less than 0.01). This study confirms the relationship between young age and low breast control rates, and demonstrates the importance of adequate initial surgical procedures. It emphasizes the adverse prognosis of early breast recurrences as compared to the relatively favorable outcome of late recurrences. PMID- 2777662 TI - Conservative surgery and radiation therapy in breast carcinoma: local recurrence and prognostic implications. AB - Conservative surgery with radiation therapy has been used with increasing frequency at Yale-New Haven Hospital since the late 1960's, resulting in a minimum evaluable follow-up time of 5 years on 278 patients treated prior to 1982. The radiation therapy technique generally encompassed treatment to the breast and regional lymph nodes of 4600 cGy with an electron beam boost to the tumor bed of 6400 cGy. Axillary dissection was performed in 19%, adjuvant chemotherapy in 7.3%, and adjuvant hormonal therapy in 5.7%; 65% were clinical Stage I and 35% were clinical Stage II. As of July 1987, with a minimum evaluable follow-up of 5 years and a median follow-up of 7.46 years, the actuarial 5- and 10-year survival for all 278 patients was 83% and 67%, respectively. The breast recurrence-free rate was 91% at 5 years and 80% at 10 years. Whereas the 5-year survival was significantly greater for clinical Stage I patients (91% vs 68%, p = .01), the breast recurrence-free rates did not significantly differ between clinical Stage I & II (93% vs 88%). There were 31 patients who failed in the breast alone as the first site of failure; 67% were at or near the primary site whereas 33% were distinctly removed from the primary site. Salvage mastectomy was performed in 25 patients, repeat wedge resection in two patients, and biopsy only in four patients. Axillary nodes were positive in five (33%) of 15 evaluable patients undergoing axillary dissection at the time of recurrence. The 5-year actuarial survival following local recurrence for the 31 patients was 48% at a mean follow-up of 5.06 years. The local recurrences were further subclassified into localized breast recurrences (LBR), defined clinically as greater than 3 cm and/or with dermal involvement. The 22 patients experiencing localized breast recurrences tended to occur later (median time to recurrence 4.3 years) than the nine patients experiencing a diffuse breast recurrence (median time to recurrence 2.9 years). At last follow-up, three (14%) of the 22 localized breast recurrences had subsequently failed distantly and none had subsequent local failure, whereas four (44%) of nine diffuse breast recurrences had subsequent distant failure and five (55%) of the nine diffuse breast recurrences experienced further local disease. The 5-year actuarial survival following salvage treatment was 90% for the localized breast recurrences and only 13% for the diffuse breast recurrences. PMID- 2777663 TI - Tumor margin assessment as a guide to optimal conservation surgery and irradiation in early stage breast carcinoma. AB - Between 1982 and 1985, 108 women with AJC Stage I and II invasive mammary carcinoma were treated to 115 breasts with conservative surgery and irradiation. The irradiation dose was adjusted to the histopathological normal tissue margin around the carcinoma in the tumor excision specimens. Margins were arbitrarily determined negative, close, and positive with normal tissue margins in the inked tumor excision specimens of greater than 5 mm, 2-5 mm, and less than 2 mm, respectively. Negative, close, and positive tumor margin patients were treated to radiation doses of 60, 65, and 70 Gy, respectively. The boost in excess of 50 Gy was directed to the tumor bearing quadrant of the breast using interstitial Ir 192 implants for doses greater than or equal to 70 Gy. The draining lymphatics were irradiated to 50 Gy except in patients with tumor in the lateral half of the breast and no axillary lymph node metastases. Histopathological evaluation of re excision specimens revealed the difficulty of obtaining negative margins for tumors greater than 2 cm. By our criteria, 54% of the patients had a positive resection margin. None of the patients experienced a local recurrence at 60 months median follow-up. Three patients failed regionally, two in un-irradiated lymph node areas, one in the skin of the contralateral breast; five patients failed systemically. Overall and disease-free survival for Stages T1/N0, T1/N1, T2/N0 was 100 and 95%, respectively, and for T2/N1, 90 and 80%, respectively. The cosmesis was excellent in 66% of the patients with minimal treatment related complications. Carefully planned standardized irradiation with assessment of resection margins yields both excellent local control rates and cosmetic results. PMID- 2777664 TI - Late cosmetic outcome after conservative surgery and radiotherapy: analysis of causes of cosmetic failure. AB - Although the majority of patients with early breast cancer treated with conservative surgery and radiotherapy have acceptable cosmetic outcomes, the specific causes of a less-than-acceptable result are not well known. To assess the technical factors associated with late cosmetic failure, we reviewed the records of 593 patients treated with conservative surgery and radiotherapy at the Joint Center for Radiation Therapy, Boston, between 1968 and 1981. Median follow up was 76 months with a range of 37-186 months. Using a 4-point scoring system (excellent, good, fair, poor) patients were noted to have cosmetic "failure" if scored as either fair or poor. Cosmetic results were similar at 3, 5, and 7 years with excellent or good scores seen in 88%, 90%, and 78% of patients, respectively. Three technical factors were associated with a significant worsening of the cosmetic results. The resection of 70 cm3 or more of breast tissue was more common among the failed patients than among matched patients with good or excellent results (p = 0.03). Eighty-nine percent of patients treated with a tangent pair technique had excellent results at 5 years compared to 69% of patients treated with a three-field technique (p = 0.004). The use of a larger volume implant was associated with a greater risk of a fair or poor cosmetic result compared to the use of a smaller volume implant. We conclude that overall cosmesis has been acceptable in this series, but there are technical (surgery and radiotherapy) factors which can be modified to optimize the cosmetic result without compromising local tumor control. PMID- 2777666 TI - The second carcinoma of the anterior two-thirds of the tongue after successful radiotherapy to the tongue. AB - Of 221 patients with carcinoma of the mobile tongue treated by radiotherapy, 129 survived without local recurrence for 5 years or longer after initial treatment. These 129 patients were studied to determine the incidence of second carcinoma of the tongue which first appeared more than 5 years after the initial treatment. Modalities of irradiation were radium needle implantation and intraoral electron irradiation for 105 and 24 patients, respectively. Twenty-two of the patients were found to have second carcinoma of the tongue. The incidence appeared to increase as the amount of radiation given increased. No obvious relationships were observed between the second carcinoma and modality of irradiation, T classification, presence of leukoplakia before the treatment, degree of histological differentiation, or degree of radiation injury. There were moderate to severe radiation injuries in 50% of the patients treated by radium needle implantation. It is likely that most of the second carcinomas of the tongue represent the late appearance of one of the multicentric foci of the tumor, not a regrowth of the residual primary tumor. In spite of the rather high rate of second carcinoma of the tongue, radiotherapy remains an excellent modality of treatment when patients are properly selected. PMID- 2777665 TI - Radiation therapy for pathologic stage III Hodgkin's disease with and without chemotherapy. AB - Ninety-eight patients with pathological Stage (PS) III Hodgkin's disease treated between 1969 and 1984 were retrospectively analyzed. Treatment consisted of radiation therapy (RT) alone in 46 patients and combined radiation therapy and chemotherapy (CMT) in 52 patients. The median follow-up was 10 years (range 3-19 years). Fifteen-year year survival for patients with Stage III1-is better than for Stage III2 patients (82% vs 53%; p = .014). Patients with Stage III1A have a favorable prognosis regardless of treatment modality. The probability of freedom from relapse at 15 years for patients with pathological Stage III1A treated with radiation therapy is 70%, compared to 83% for pathological Stage III1A patients treated with combined modality therapy (p = .56). In patients with pathological Stage III2A, III1B, and III2B relapses were less frequent with the use of combined modality therapy compared to radiation therapy. We conclude that pathological Stage III1A patients may be treated with radiation therapy alone; the other subsets of patients benefit from combined radiation and chemotherapy. PMID- 2777668 TI - Histological evidence for nonperfused vasculature in a murine tumor following hydralazine administration. AB - The effect of the vasodilator hydralazine on tumor vascular function has been evaluated in C3H/He mice bearing subcutaneously implanted SCCVII squamous cell carcinoma. Changes in microregional perfusion following hydralazine administration were observed using a double fluorescent staining technique. Hydralazine-induced alterations in tumor blood flow were measured using laser Doppler flowmetry. The results obtained indicate that hydralazine causes a dose dependent reduction in functional tumor vasculature implying complete flow stasis and/or vascular collapse in some vessels. Fifteen minutes after a dose of 10 mg/kg intravenously, perfusion in 36 +/- 5% (SEM) of tumor vessels was completely abolished. In addition to cessation of perfusion in individual vessels, hydralazine eliminated flow in large patches of vasculature distributed non uniformly throughout the tumor. Hydralazine (10 mg/kg i.v.) resulted in a 67 +/- 5% (SEM) reduction in tumor red blood cell (RBC) flow as measured by laser Doppler techniques. The mean number of moving red blood cells declined by 35 +/- 8%, suggesting a reduction in microvascular volume. These results support the hypothesis that following hydralazine administration, perfusion stops completely in some blood vessels probably as a result of vascular collapse or flow stasis. PMID- 2777667 TI - Effect of X-irradiation on the stomach of the rat. AB - A model for localized 300 kV X-irradiation of the rat stomach was developed. After irradiation with single doses, three distinct gastric disorders were observed which occurred at different latency times. Acute death 2-3 weeks after irradiation was caused by an erosive and ulcerative gastritis and occurred in all animals given 28.5 Gy without diet, in 17% of the animals given 28.5 Gy plus diet, and in 13% of the animals given 23 Gy. Subacute to chronic fatal disorders 4 weeks to 7 months after irradiation were seen as stomach dilatation and gastroparesis, associated with the replacement of the normal gastric mucosa by a hyperkeratinized multilayered squamous epithelium. These disorders occurred in 40 100% of the animals after doses between 16 Gy and 28.5 Gy (+diet). An ED 50 value of 19.2 Gy (16.5-21.2 Gy, 95% confidence interval) was calculated for this gastroparesis. Late gastric obstruction exceeding 7 months after irradiation was seen in the rats because of profound changes in the gastric wall in 13-18% of the animals after doses between 23 Gy and 14 Gy. In animals surviving these three periods, an atrophic mucosa and intestinal metaplasia developed. From functional and morphohistological studies, it can be concluded that there are differences in the pathogenesis of the fatal radiation damage for each of these periods after irradiation. PMID- 2777670 TI - The kinetics of vascular thermotolerance in SCK tumors of A/J mice. AB - Development of thermotolerance has been observed in diverse biological systems. Despite the important role of blood circulation in heat-induced tissue damage, little is known about vascular thermotolerance. The kinetics of vascular thermotolerance in SCK tumors of A/J mice was investigated in this study. A single heating at 43.5 degrees C or 44.5 degrees C for 1 hr caused marked damage in tumor vasculature, as demonstrated by a marked decrease in Rb-86 uptake (% of injected dose/g of dried tissue). The tumor vasculature became resistant or tolerant to subsequent heatings at those temperatures when the tumors were preheated at 42.5 degrees C for 1 hr. Vascular thermotolerance became significant at 5 hr and reached its maximum at 18 hr after preheating at 42.5 degrees C. When the vascular thermotolerance was at its peak, heating at temperatures as high as 44.5 degrees C for 1 hr could not reduce the tumor blood flow. The vascular thermotolerance decayed considerably but not completely at 72 hr after the preheating. The vascular thermotolerance may exert a profound implication on the response of tissues, including tumors, to multiple heatings. PMID- 2777669 TI - Ureteral injury following experimental intraoperative radiation. AB - Beagle dogs were randomized to receive a range of total dose delivered in three different protocols. Sixteen dogs received external beam radiation therapy (EBRT), 32 dogs received intraoperative irradiation (IORT), and 32 dogs received combinations of external beam radiation therapy and intraoperative irradiation. A sublumbar field was irradiated which always included the left ureter. Dogs were observed for 5 years; sequential excretory urograms were done at 6 months, and 1 and 5 years. Morphometric analysis of tissues were also done. The canine ureter tolerated 17.5 Gy intraoperative irradiation with no evidence of injury and 25 Gy intraoperative irradiation with a low probability of injury. The ED50 for radiographic abnormalities was 32.9 Gy. When 50 Gy external beam radiation therapy was given prior to intraoperative irradiation, the ureter tolerated 10 Gy intraoperative irradiation with no evidence of injury and 17.5 Gy with a low probability of injury. The ED50 was 29 Gy intraoperative irradiation after EBRT. The external beam radiation therapy had little effect on the ureter when given alone or prior to intraoperative irradiation. Clinical signs of renal disease occurred only in dogs who had received bilateral ureteral irradiation intraoperatively at doses of 32.5 Gy intraoperative irradiation and 25 Gy intraoperative irradiation after external beam radiation therapy. Histologic evidence suggests that the chronic injury of the ureter expressed at 5 years is of vascular etiology. The early injury may be due to ulceration of the epithelium. PMID- 2777671 TI - The growth and cell kinetics of a secondary tumor after radiation or surgical treatment of the primary tumor. AB - Early transplants of a spontaneous mouse fibrosarcoma (FSa II) were used to investigate whether radiation or surgical treatment of a tumor in the leg altered the growth or cell kinetics of a second tumor in the axilla. The volume doubling times and in vivo Bromodeoxyuridine labeling indices of the axillary tumors were the same in the control group and in the groups which received 70 Gy to the leg tumor or normal leg. After surgical removal of the leg tumor, there was small reduction in the time to reach 1500 mm3 (4.0 vs 4.6 days) and an increase in Bromo-deoxyuridine labeling index at Day 3 (18% to 24%) in the axillary tumors. In all groups, there was a fall in labeling index with time reflecting increasing tumor size. PMID- 2777672 TI - Results of radiotherapy for thyroid ophthalmopathy. AB - Between October, 1978 and August, 1986, 35 patients with thyroid ophthalmopathy were treated with radiotherapy. Twenty-eight patients had treatment with corticosteroids prior to radiotherapy and either progressed on steroids or relapsed during tapering. Seven patients with contraindications to steroids were treated primarily with radiotherapy. After radiotherapy, 25 patients (71%) did not require any further steroids or orbital decompression and ten (29%) failed. Patients who required steroids or decompression for active disease after radiotherapy were considered treatment failures. A total of 14 (40%) patients required eye muscle or lid surgery for correction of stable soft tissue defects after radiotherapy, more commonly in patients treated with radiotherapy after steroids or decompression than those irradiated primarily; the median time between radiotherapy and surgery was 8 months (range 1-48). Various factors were examined for prognostic significance in predicting radiotherapy failure. Review of the interval between onset of eye disease and radiotherapy demonstrated that six of ten (60%) failures versus only five of 25 (20%) successful treatments received radiotherapy within 6 months of onset of eye disease. No relation between outcome and sex, age or hyperthyroid versus euthyroid Graves' disease was apparent. Radiotherapy has been used for patients with thyroid ophthalmopathy who failed steroids, decompression, or had steroid contraindications. Morbidity of radiotherapy was minimal and most patients were spared the morbidity of continued steroid therapy. PMID- 2777673 TI - Consequences of breast irradiation in patients with pre-existing collagen vascular diseases. AB - Exaggerated acute and late effects were observed in three of four women with pre existing collagen vascular disease (CVD) within 2 years after definitive megavoltage radiation therapy for breast carcinoma. Five women with breast carcinoma, who developed CVD 3 months to 10 years after radiation therapy, had no complications. An abnormally severe reaction was observed during treatment of one patient with discoid lupus. The patient developed moist desquamation that persisted for a month, requiring early termination of treatment. One year after treatment, the patient developed paresthesias in the ipsilateral arm. A planned reduction of the prescribed dose in a second patient with progressive systemic sclerosis did not prevent intense erythema at the end of treatment, followed 14 months later by chest wall necrosis, which eventually required multiple surgeries including chest wall resections. The third patient, who had systemic lupus erythematosis, developed necrosis 2 years after treatment, which progressed over 12 years to osteoradionecrosis of the clavicle, sternum and rib cage. Multiple surgeries to repair the defect were complicated by flap necrosis and pleurocutaneous fistulas. The fourth patient died 6 months after radiotherapy without apparent sequelae. None of the patients had evidence of recurrent carcinoma. A history of collagen vascular disease appears to be a contraindication to breast conservation or for elective irradiation for breast cancer. PMID- 2777674 TI - Definitive irradiation for localized non-Hodgkin's lymphoma of breast. AB - A diagnosis of primary non-Hodgkin's lymphoma (NHL) confined to the breast or breast and ipsilateral lymph nodes was biopsy proven in 19 patients who presented to our institution between 1970 and 1984. Four patients were treated with a modified radical mastectomy, and one with chemotherapy only. The remaining 14 patients comprise the basis of this study. All patients were clinically staged. There were 12 patients with 1A-E disease and two with IIA-E disease. All patients were treated with breast radiation. The axillary nodes were included in seven of the patients and two, in addition, received "mantle" irradiation. The majority of the patients received between 3500-4400 cGy, but four received lower doses. One patient, with Stage IIA-E disease, received 6 months of systemic chemotherapy, followed by 3500 cGy to the breast and axilla. Three of the 14 patients relapsed within the treated area, with a local control rate of 78%. One was salvaged with a mastectomy and remains alive and well 15 years after diagnosis. Seven of the 14 patients relapsed distantly, including two with local failures, but only three have died of disease. An additional two patients have died of other causes without evidence of disease, for a survival of 66% at 48 months (Kaplan-Meier Calculations). PMID- 2777675 TI - Endobronchial irradiation for malignant airway obstruction. AB - An afterloading endobronchial irradiation (EBRT) technique using Iridium-192 (Ir 192), was piloted for malignant airway obstruction. Under bronchoscopic guidance, a catheter is threaded distal to the lesion. Orthogonal radiographs and computerized tomographic (CT) scans are obtained for dosimetry. Forty implants in 38 patients have been performed. Thirty-two patients had lung cancer; 23 had received prior irradiation and eight had prior chemotherapy. Eight patients underwent pre-endobronchial irradiation laser excision. Median implant duration was 50.5 hr; median dose at 1 and 2 cm from source center was 50 and 20 Gy, respectively. The procedure was well tolerated with four long-term complications (10.5%). Twelve of 38 patients are currently alive with a median survival of 5+ months and a range of 1 to 21+ months. Changes in performance status (PS), symptom resolution, radiographic demonstration of re-aeration of atelectatic lung, changes in pulmonary function (PFT), and post-endobronchial irradiation bronchoscopy were used to assess response. Seventy percent of the patients' remaining life was rendered symptom-free or improved. A 70% radiographic response was noted. Fourteen patients underwent post-endobronchial irradiation bronchoscopy with 12 complete responses. Endobronchial irradiation, therefore, appears to be a safe, effective technique to palliate malignant airway obstruction. PMID- 2777676 TI - Irradiation synchronized with respiration gate. AB - A respiratory gating technique was developed for radiotherapy of tumors unable to remain stable due to respiration. Irradiation was started and stopped with a microwave oscillator of a linear accelerator controlled by gating signals at specific points in the respiratory cycle. This technique was tested in a phantom specially designed to simulate a patient with lung cancer and in clinical therapy for lung tumors of seven patients. A mask was used to check ventilation in the phantom and airbags were used to measure thoracoabdominal pressure in patients and in the phantom; this enabled us to detect the excursion of the tumors. Low sensitivity film for verification demonstrated the efficacy of this technique. The gated irradiation was proved to ensure more precise radiotherapy for tumors located close to the diaphragm. PMID- 2777677 TI - The clinical advantages of I-125 seeds as a substitute for Ir-192 seeds in temporary plastic tube implants. AB - In August of 1986 at William Beaumont Hospital, Iodine-125 (I-125) seeds were introduced in the clinical practice as a substitute for Iridium-192 (Ir-192) seeds in patients undergoing temporary plastic tube interstitial implants. Through February 1988, 108 I-125 implants were performed in 105 patients. Acute and chronic toxicity was indistinguishable from Ir-192. However, improved radiation safety and a dynamic dosimetric program have resulted from this endeavor. Because of the multiple clinical advantages of I-125, we feel that this should be considered the isotope of choice in temporary interstitial plastic tube implants. PMID- 2777678 TI - Field matching considerations in craniospinal irradiation. AB - Radiotherapy of the craniospinal axis in leukemia and medulloblastoma patients usually involves parallel-opposed lateral cranial fields adjacent and orthogonal to a posterior spinal field. Most current treatment protocols require rotation of the cranial fields to compensate for the divergence of the spinal field such that the adjacent field edges abut along the match line in the mid-saggital plane. Some departments introduce gaps up to 1-2 cm wide between the matched fields out of concern for overdosing the spinal cord. The behavior of the dose distribution was studied in the junction region of divergence-compensated fields as the separation of their edges varied from 0.5 cm overlap to a gap 1 cm wide. Composite dose profiles and isodose maps were calculated for 60Co and 4 MV photon beams using static and moving junction (feathering) techniques. When the fields are appropriately matched there is no gap between them in the mid-saggital plane and the dose varies smoothly across the junction. Gapping of divergence compensated fields is detrimental to dose uniformity, producing underdosage in a volume that extends to all depths in the body. With proper localization, there is no way that the commonly accepted critical dose for myelopathy can be exceeded in typical treatments of leukemia patients. It can occur in the treatment of medulloblastoma patients only in the unlikely situation where there is gross overlapping of the adjacent fields. Feathering may be considered as a safety margin against spinal cord damage in medulloblastoma but it is superfluous in leukemia. The importance of treatment machine quality assurance and verification of patient set up geometry are emphasized. PMID- 2777679 TI - Evaluation of lung dose correction methods for photon irradiations of thorax phantoms. AB - Radiation absorbed dose in lung is measured and calculated using several algorithms available on commercial treatment planning systems. Phantoms resembling the human thorax are used and irradiated with small and large photon beams of 60Co, 4, 6, and 10 MV X ray energies. The applicability and usefulness of the different calculation methods in clinical situations is discussed. PMID- 2777680 TI - An integrated logistic formula for prediction of complications from radiosurgery. AB - An integrated logistic model for predicting the probability of complications when small volumes of tissue receive an inhomogeneous radiation dose is described. This model can be used with either an exponential or linear quadratic correction for dose per fraction and time. Both the exponential and linear quadratic versions of this integrated logistic formula provide reasonable estimates of the tolerance of brain to radiosurgical dose distributions where there are small volumes of brain receiving high radiation doses and larger volumes receiving lower doses. This makes it possible to predict the probability of complications from stereotactic radiosurgery, as well as combinations of fractionated large volume irradiation with a radiosurgical boost. Complication probabilities predicted for single fraction radiosurgery with the Leksell Gamma Unit using 4, 8, 14, and 18 mm diameter collimators as well as for whole brain irradiation combined with a radiosurgical boost are presented. The exponential and linear quadratic versions of the integrated logistic formula provide useful methods of calculating the probability of complications from radiosurgical treatment. PMID- 2777682 TI - Controlling multiple myeloma. PMID- 2777683 TI - Confinement rearing of calves. PMID- 2777681 TI - Linear-quadratic model isoeffect relations for proliferating tumor cells for treatment with multiple fractions per day. AB - A modified linear-quadratic model isoeffect relation that includes the effect of proliferation is proposed. As for a planned course of therapy, the treatment time T and the number of fractions N are not independent variables; the new isoeffect relation involves only the fraction size d and the total dose D, but differs from the unmodified linear-quadratic model isoeffect relation and predicts higher isoeffect doses for small dose fractions. Using the new isoeffect relation it is explicitly shown, for a simple model, that decreasing the fraction size will improve the therapeutic ratio only if multiple fractions per day are given. PMID- 2777684 TI - Etymologic considerations. PMID- 2777685 TI - Urine odor eliminators. PMID- 2777686 TI - Emotion: the inescapable element in practice. PMID- 2777687 TI - Decision-tree analysis of treatment alternatives for left displaced abomasum. AB - This study evaluates treatment alternatives for left displaced abomasum (LDA) in dairy cattle. The technique of decision-tree analysis was used to evaluate 3 treatment possibilities. A computerized spreadsheet decision tree was used for the evaluation. Results of this investigation suggested that surgical treatment had the highest expected monetary value. Closed surgical techniques had expected monetary values close to the surgical techniques. Rolling the cow had the lowest expected monetary value, but the expected monetary value for rolling was higher than the expected monetary value for selling. If an LDA recurs after treatment, surgical and closed surgical treatments are preferred over rolling. From this study, we can conclude that surgical and closed surgical treatment alternatives are preferred if expected monetary values are considered. Rolling is preferred over selling the cow. However, if an LDA recurs, selling the cow is preferred over rolling. PMID- 2777688 TI - Epidemiologic investigation and control of an epizootic of anaplasmosis in cattle in winter. AB - An epizootic of anaplasmosis affecting 18 of 90 beef cows in winter on a western Illinois ranch was investigated to determine the probable source and mode of transmission. The cause of the epizootic was Anaplasma caudatum. Cows were classified as sick, convalescent, or carrier on the basis of blood smear, complement fixation, or modified rapid card agglutination test results. Patterns of movement did not suggest a common exposure prior to assembly of cattle at the affected ranch. The combination of clinical stages and temporal pattern of the epizootic was compatible with exposure on one or more occasions after arrival of cattle on the ranch, most likely during herd vaccination or ear tagging. A serologic testing and treatment program was initiated to rid the herd of infection. Seventeen surviving cows were treated 3 times with 20 mg of oxytetracycline/kg, IM, at 5-day intervals. At the end of the 6-month follow-up period, 1 of 17 cows was still serologically positive and was treated with a second regimen of oxytetracycline. We believe that eradication of A caudatum was successful, because no clinical cases of anaplasmosis have been reported on the ranch during the last 3 vector seasons. PMID- 2777689 TI - Compensatory weight gain in steers recovered from oak bud toxicosis. AB - Cattle that had recovered from clinical oak bud toxicosis (as assessed by normal BUN and serum creatinine values and good appetite) performed better than did clinically normal herdmates when weight gain and feed efficiency were compared. Both groups had a rate of weight gain (oak bud-exposed cattle, 1.76 kg/steer/d; control cattle, 1.57 kg/steer/d) that exceeded the feedlot mean value (approximately 1.4 kg/d) for cattle (of similar starting weight and diet) that had zeranol implants, and the difference was significant (P less than 0.005) for both groups. The difference in weight gain performance of oak bud-exposed cattle, compared with control cattle, was not highly significant; however, the improved feed efficiency was significantly (P less than 0.05) better than that in controls (2.57 kg of feed/kg of weight gain vs 3 kg of feed/kg of weight gain). On the basis of accepted criteria (increased rate of weight gain and efficiency of feed conversion), the group of oak bud-exposed cattle of this study had compensatory weight gain. Thus, cattle with good evidence of clinical recovery from oak bud toxicosis can be expected to perform in the feedlot at least as well as cattle not exposed to oak bud toxicosis, and may have compensatory weight gain. PMID- 2777690 TI - Apparent toxicosis associated with lily-of-the-valley (Convallaria majalis) ingestion in a dog. AB - Lily-of-the-valley (Convallaria majalis), an ornamental plant found in many urban settings, was believed responsible for the sudden collapse and death of a one year-old mixed-breed dog. Postmortem examination revealed C majalis leaf fragments in the small intestine. The dog had gross and histologic lesions consistent with cardiac shock. Because C majalis contains cardiac glycosides that have digitalis-like activity, apparent C majalis intoxication was suspected in this dog on the basis of history, exposure to the plant, clinical signs of disease, postmortem lesions, and evidence of plant parts in the intestinal tract. A toxicologic assessment of excessive exposure to C majalis was based on the aforementioned criteria. PMID- 2777692 TI - Treatment of teat obstruction in a cow by transfer of oral mucosa and temporary implantation of an intraluminal tube. AB - A dairy cow was examined because of extensive obstruction of a teat cistern. The teat was treated by surgical resection of scar tissue, transplantation of an oral mucosal autograft, and temporary implantation of a silastic tube. The silastic tube became dislodged from the teat, and was surgically removed 30 days after the initial surgery. The cow subsequently had 2 normal lactations. Prior to the third postoperative lactation, the cow developed severe udder edema. During lactation, the surgically treated teat became hard and was difficult to milk. The cow was then culled. PMID- 2777691 TI - Disseminated adenocarcinoma with ocular involvement in a cat. AB - Disseminated adenocarcinoma was associated with unilateral uveitis and multiple subcutaneous nodules in an 8-year-old domestic shorthair cat. Erythroleukemia and hind limb paresis developed over a 5-month period. At necropsy, numerous sites of metastases were found that had histologic features similar to the neoplasm in the left eye. Neoplastic cells were identified in the lungs, mediastinum, muscles, subcutaneous tissues, lymph nodes, and vasculature associated with the meninges of the brain and spinal cord. Morphologic associations were not found between erythroleukemia and the neoplastic process. PMID- 2777693 TI - Lateral luxation of the superficial digital flexor tendon from the calcaneal tuber in two horses. AB - Lateral luxation of the superficial digital flexor tendon from the calcaneal tuber occurs in horses as a result of tearing or rupture of the medial retinaculum of the tendon. This report describes the repair of this condition in 2 Thoroughbred race horses, using a surgical technique in which 2 cancellous bone screws were placed in the calcaneus lateral to the tendon, along with suturing the medial retinaculum. PMID- 2777694 TI - Postanesthetic compartmental syndrome in a horse. AB - After surgery, high intramuscular pressures were measured in a horse with clinical signs of postanesthetic myopathy that developed following a 2.25-hour surgical procedure. In the postoperative period, tests for muscular and neurologic integrity were made, including measurement of intracompartmental muscle pressure. PMID- 2777695 TI - Evaluation of heparin for prophylaxis of equine laminitis: 71 cases (1980-1986). AB - The records of 71 horses with small intestinal disorders requiring surgical correction were disorders requiring surgical correction were reviewed to compare the prevalence of laminitis in those horses treated prophylactically with heparin and the prevalence of horses not treated with heparin. The prevalence of laminitis was 13% (9/71), and there was no significant difference (P less than 0.05) in the prevalence of laminitis between the 2 groups. The lack of significant benefit after treatment with heparin indicates that further work needs to be done on the equine coagulation system before heparin can be advocated for prevention of laminitis. PMID- 2777696 TI - Intestinal atresia in calves: 22 cases (1978-1988). AB - A retrospective study of 22 calves afflicted with intestinal atresia was performed to determine typical signs of disease, treatment, and survival rate. All 22 calves, except 2 heifers with atresia ani and rectovaginal fistula, were examined when they were between 1 and 10 days old because of depression, anorexia, abdominal distention, and lack of feces. All calves had been observed to stand and suckle shortly after birth. Survival rate was influenced by the atretic segment affected: 0% (0/2 surgically treated) for atresia jejunal; 42% (5/12 examined) or 71% (5/7 recovering from general anesthesia) for atresia coli; and 63% (5/8 examined) or 71% (5/7 surgically treated) for atresia ani. Survival appeared to depend principally on early recognition, anatomic site affected, and successful surgical establishment of a patent intestinal tract. PMID- 2777697 TI - Fringe benefits received by veterinarians, 1987. PMID- 2777698 TI - What is your diagnosis? Proximal humeral fracture. PMID- 2777699 TI - Additions to commentary on serologic testing. PMID- 2777700 TI - Taking a second hard look at Borrelia burgdorferi. PMID- 2777701 TI - Animal patents. PMID- 2777702 TI - Evaluation of practical dry dog foods suitable for all life stages. AB - We evaluated the nutritional adequacy of 2 dry-type commercially prepared dog diets by use of a gestation/lactation/growth protocol outlined by the Association of American Feed Control Officials. Both diets were formulated to contain minimal concentrations of nutrients, compared with canine nutrient requirements listed in the 1974 or 1985 National Research Council publications. Although there were no significant differences in the performance of dogs fed either diet, only one of the diets (diet 2) passed the complete life-stage protocol test. The nutritional profile of diet 1 was only sufficient to support a claim of complete and balanced nutrition for adult maintenance. Any commercial dry dog food meeting the nutrient levels in diet 2, and of similar nutrient bioavailability, should also pass an Association of American Feed Control Officials complete life-stage protocol test. PMID- 2777703 TI - ECG of the month. Sinus arrhythmia and Mobitz type-II secondary atrioventricular block. PMID- 2777704 TI - Brucellosis. PMID- 2777705 TI - Clinical signs associated with pseudorabies in dogs. AB - Clinical signs in dogs with pseudorabies (Aujeszky's disease) were tabulated from 25 confirmed cases. The duration of disease was short, ranging from 6 to 96 hours. Eight dogs were euthanatized. Of those not euthanatized, 12 (71%) died within 24 hours of onset, 16 (94%) died within 48 hours, and only 1 (6%) lived longer than 48 hours (96 hours) after the onset of clinical signs. All of the dogs had ptyalism, 84% were restless, 84% were anorectic, 76% were atactic, and 64% wandered aimlessly. Sixty-four percent of the dogs had tachypnea, 60% had dyspnea, 56% vocalized, 52% were pruritic, 48% held their necks rigidly, 36% vomited, 36% had muscle spasms, 36% were aggressive, 28% had trismus, and 24% had dysphagia. Five of 25 dogs (20%) had abnormal pupillary light responses. Two of the 25 dogs circled and 2 walked backwards. Each of the following were detected once: blindness, ptosis, facial paresis, excessive lacrimation, head-tilt, head pressing, signs of abdominal pain, and photophobia. All dogs had been exposed to swine, although in some instances the farmer was unaware pseudorabies existed in the herd or believed it was not in the herd on the basis of negative results on serologic testing. PMID- 2777706 TI - Field trial of theophylline in cattle with respiratory tract disease. AB - A field trial was conducted to determine the efficacy of theophylline in relieving respiratory distress associated with bovine respiratory disease complex (shipping fever). Theophylline (as aminophylline capsules) was administered PO at a dosage of 28 mg/kg of body weight daily for 3 days to 20 calves with naturally acquired disease. Twenty similarly affected calves from the same group were given a placebo, and all calves were administered antibiotics concurrently. Respiratory rate and rectal temperature decreased and physical appearance improved in both groups of calves and was attributed to antibiotic administration or to natural remission of the disease. Five of the calves administered theophylline died; however, no calves administered the placebo died. Plasma theophylline concentration was greatly increased, compared with that determined in clinically normal calves in a pilot study. Bovine respiratory tract disease and/or concurrent antibiotic administration appear to cause such a rapid accumulation of lethal concentration of theophylline that its use should be restricted to hospitals capable of monitoring plasma theophylline concentration. PMID- 2777707 TI - Clinical, radiographic, pathologic, and genetic features of osteochondrodysplasia in Scottish deerhounds. AB - Clinical, radiographic, pathologic, and genetic features of a form of osteochondrodysplasia in 5 related Scottish Deerhound pups from 2 litters were evaluated. All pups appeared to be phenotypically normal at birth. At approximately 4 or 5 weeks, exercise intolerance and retarded growth were observed. Kyphosis, limb deformities, and joint laxity gradually developed. Radiography of the affected pups revealed skeletal changes characterized by abnormalities in long bones and vertebrae, with involvement of epiphyses, growth plates, and metaphyses. Short long bones and vertebrae and irregular and delayed epiphyseal ossification were most noticeable in younger pups; in older pups, bony deformities became more prominent. In skeletally mature dogs, osteopenia and severe deformities were seen. The histologic changes of the growth plate were compatible with a diagnosis of chondrodysplasia. Growth plate chondrocytes contained periodic acid Schiff-positive, diastase-resistant cytoplasmic inclusions. A single autosomal recessive mode of inheritance was suspected. PMID- 2777708 TI - Cottonseed meal (gossypol) toxicosis in a swine herd. AB - Cottonseed meal (CSM) that contained a high concentration of free gossypol was inadvertently used as a protein supplement, without appropriate iron supplementation, for a swine herd in Illinois. Fifty percent of 300 grower and finishing swine died, and an additional 20% became ill during a 4- to 6-week period. Clinical signs included respiratory distress and abdominal distention. At necropsy, the hearts were diffusely pale, flaccid, and rounded because of dilatation of all 4 chambers, the livers were large and congested, and hydropericardium, hydrothorax, and ascites were evident. Histologic changes consisted of diffuse myocardial fiber atropy with perinuclear vacuolation, and multifocal myocardial and skeletal muscle necrosis. Changes in the liver included marked centrilobular congestion, loss of hepatocytes, and fatty degeneration. Differential diagnoses included monensin, selenium, and gossypol toxicoses, and vitamin E/selenium deficiency. Analyzed feed samples did not contain monensin. Feed selenium concentrations ranged from 428 to 1,513 micrograms/kg, and iron concentrations from 160 to 180 mg/kg. Cottonseed meal (3 to 10%) was detected by feed microscopy. A sample of the 40% protein supplement contained 19% CSM and 1,300 mg of free gossypol/kg, whereas feed samples contained 200 to 400 mg of free gossypol/kg. The history, clinical signs, pathologic findings, and feed analyses were compatible with a diagnosis of gossypol toxicosis. Cottonseed meal, a high-protein supplement used widely in southern United States, may contain gossypol (a polyphenolic binaphthalene pigment), which in its free form is especially toxic to simple-stomached animals. If CSM is used, supplementation with ferrous sulfate is recommended at a 1:1 weight ratio with free gossypol, up to 400 mg of FeSO4/kg. PMID- 2777710 TI - Use of videoendoscopy during exercise for determination of appropriate surgical treatment of laryngeal hemiplegia in a colt. AB - Videoendoscopy of the larynx during treadmill exercise was used to determine the surgical treatment of upper airway obstruction in a Standardbred colt. Surgical correction of right-sided laryngeal hemiplegia, first by laryngoplasty, then subtotal arytenoidectomy, was ineffective. Videoendoscopy indicated, and upper airway flow mechanics confirmed, that the laryngeal opening was adequate at rest, but obstruction occurred during exercise. On the basis of the appearance of the larynx during high airflow rates on slow-motion playback of the videorecording, total arytenoidectomy was performed, which permitted the horse to race successfully. Videoendoscopy of the upper airway during exercise accurately predicted airflow impedance and permitted salvage of this racehorse, indicating that this is a practical, useful technique that will improve evaluation of upper airway obstructions in the horse. PMID- 2777709 TI - Pseudallescheria boydii keratomycosis in a horse. AB - The fungal organism Pseudallescheria boydii was isolated from the cornea of a Quarter Horse with ulcerative keratitis. Despite aggressive hourly medication through a subpalpebral lavage system, with drugs including miconazole and natamycin, the cornea developed a stromal abscess. Orbital exenteration was performed after 3 weeks. The fungal isolate was later determined to be resistant to all 8 antifungal drugs tested. Microscopic examination of the cornea revealed fungal hyphae throughout the corneal stroma and penetrating the Descemet membrane. Pseudallescheria boydii has not been implicated previously as a cause of keratomycosis in horses or in other domestic animals, although cases in human beings have been described. PMID- 2777711 TI - Surgical treatment of accessory teat and gland cistern complexes in three cows. AB - The diagnosis of accessory teat and gland cistern complexes, a technique used for surgical removal of the fistulae, a method for connecting 2 complexes at the level of the teat cisterns, and complications observed after the procedures are described for 3 cows. All cows produced greater than 8,000 kg of milk during the lactation in which surgery was performed. The surgical procedure may be economically justified in cows that are high milk producers or have the genetic potential for high milk production. PMID- 2777712 TI - Orthovoltage radiotherapy of primary lymphoma of bone in a dog. AB - A 1 1/2-year-old castrated Boxer with a progressive left forelimb lameness of 1 month's duration had a solitary immunoblastic B-cell lymphoma of the proximal portion of the ulna. This primary lymphoma of bone was successively treated with orthovoltage radiation (45 Gy divided into 10 fractions over 22 days). The dog gradually regained normal gait function and did not develop any local recurrence over 34 months. In dogs, primary lymphoma of bone is a rare primary bone tumor, and the ulna is an unusual location for extranodal lymphoma. Local administration of radiation appears to be an effective treatment, allowing retention of normal function. PMID- 2777714 TI - Factors affecting incisional complication rates associated with colic surgery in horses: 78 cases (1983-1985). AB - From May 1, 1983 to April 1, 1985, 142 operations were performed on horses with signs of acute abdominal pain (colic), using a ventral midline incision. Seventy eight horses lived for at least 15 days after surgery or had acute dehiscence and were included in the study. Seventy horses had surgery once, and 8 horses had surgery 2 or more times. Six-month follow-up evaluation was obtained for 66 horses that had 1 surgery and for 6 horses that had multiple surgeries. Incisional complications included drainage (including infection), acute dehiscence, hernia, and suture sinus formation. The effects of preoperative peritoneal fluid presence, enterotomy or resection, suture material and pattern used in the linea alba, type of skin closure and use of a sutured-on stent bandage on the incidence of incisional complications were investigated. The complication of incisional infection rate associated with a near-far-far-near suture pattern vs simple interrupted pattern in the linea alba was the only statistically significant (P less than 0.05) difference observed. PMID- 2777713 TI - Testicular feminization in a cat. AB - Testicular feminization, caused by an inherited defect of the androgen receptor, was diagnosed in a domestic cat. Individuals affected with this syndrome are genetic males that have testes but fail to undergo masculinization because the internal and external genitalia cannot respond to androgens. The affected cat had the external appearance of a sexually normal female, but during surgery for ovariohysterectomy, only 2 abdominal gonads were found. Mullerian (uterus) or wolffian (epididymides) derivatives were not present. Only testicular tissue was found in histologic sections of the gonad. A normal male chromosome constitution (38,XY) was found in karyotypes prepared from lymphocyte cultures. High affinity binding of dihydrotestosterone was undetectable in fibroblasts cultured from genital skin of the affected cat, indicating that the cytosolic androgen receptor was nonfunctional. Pedigree analysis indicates that this is an X-linked disorder in cats, as it is in other mammals. Accurate diagnosis and genetic counseling are advocated to reduce the prevalence of the disorder. PMID- 2777715 TI - What is your diagnosis? Vascular ring anomaly. PMID- 2777716 TI - What is your diagnosis? Unremoved penrose drain and osteomyelitis of spinous processes of T3 to T6. PMID- 2777717 TI - Apparent fertility of human spermatozoa from the caput epididymidis. AB - Fifty-one patients with obstructive azoospermia caused by blockage at the caput epididymidis have been followed for 4 years after undergoing "specific tubule" vasoepididymostomy, bypassing the corpus and cauda. The patency rate was 73%, and the pregnancy rate was 31%. There was no correlation between sperm count and pregnancy rate, but there was a strong correlation with sperm motility. With less than 20% motility, only 15% of the patients became pregnant, but with greater than 20% motility postoperatively, 58% became pregnant. If the wife was over 30 years old, only 21% got pregnant. If the wife was under 30, 67% got pregnant. "Redo" cases were just as likely to succeed as "first-time" attempts. In the "patent" cases, 43% of patients with spermatozoa that never reached or traversed the corpus or cauda epididymidis produced a pregnancy. Spermatozoa from the proximal caput produced a 33% pregnancy rate, whereas spermatozoa from the distal caput produced a 50% pregnancy rate. One-half of the pregnancies occurred more than 2 years postoperatively. PMID- 2777718 TI - The effect of tumor necrosis factor on human sperm motility in vitro. AB - Tumor necrosis factor (TNF alpha) is present in elevated levels in peritoneal fluid from infertile women with endometriosis. The effect of TNF alpha on human sperm motility in vitro was evaluated utilizing peritoneal fluid from infertile women with minimal endometriosis containing 0, 100, 400, or 800 U of TNF alpha/ml as well as similar concentrations of recombinant human TNF alpha. No reduction in progressive and total motility was found at recombinant TNF alpha concentrations of 100 U ml. However, 500 and 1000 U of recombinant TNF alpha/ml caused a significant reduction in progressive and total sperm motility after 4 and 21 hours of incubation when compared with controls. Similarly, peritoneal fluid containing 100 U of TNF alpha/ml did not significantly reduce progressive and total sperm motility after either 4 or 21 hours of incubation; but peritoneal fluid containing 400 U of TNF alpha/ml reduced progressive sperm motility after 4 and 21 hours and total sperm motility after 21 hours of incubation. Peritoneal fluid with a TNF alpha concentration of 800 U/ml caused a significant reduction in both progressive and total sperm motility after 4 and 21 hours when compared with controls of TNF alpha-negative peritoneal fluid. The addition of polyclonal rabbit anti-TNF alpha antibody or 30-min heat inactivation at 56 C of TNF alpha positive peritoneal fluid reversed the inhibitory effect on sperm motility. The ability of TNF alpha to cause a significant reduction of sperm motility in vitro suggests that this may be a mechanism for the infertility observed in women with minimal endometriosis. PMID- 2777719 TI - Cytochalasin D inhibits penetration of hamster eggs by guinea pig and human spermatozoa. AB - Fertilization experiments using zona-free hamster eggs and spermatozoa from both guinea pig and human were conducted in the presence of cytochalasin D to evaluate the possible role of actin filaments in fertilization processes. When the actin filament inhibitor, cytochalasin D, was added to fertilization media at concentrations of 10 to 30 microM, penetration of eggs was significantly inhibited. Preincubation of the eggs with cytochalasin D and washing prior to addition of spermatozoa had no effect on penetration as quantitated by the number of swollen heads in the egg cytoplasm. However, spermatozoa preincubated with cytochalasin D and subsequently washed prior to egg addition showed reduced penetration of the same magnitude as when spermatozoa and eggs were coincubated with cytochalasin D. Both the percentage of zona-free eggs showing decondensed sperm heads and the penetration indices (total decondensed spermatozoa/total eggs) were significantly affected when spermatozoa were exposed to cytochalasin D. The DMSO vehicle used to dissolve cytochalasin D had little effect on the number of decondensed heads. When the concentration of cytochalasin D was increased (DMSO remaining constant) in human sperm experiments, percent penetration decreased and progressively fewer decondensed spermatozoa were recorded, indicating dose-responsiveness to cytochalasin D. Motility parameters of human spermatozoa were not altered at any of the concentrations of cytochalasin D tested. Neither guinea pig sperm motility nor acrosome reaction was altered significantly by cytochalasin D or the DMSO vehicle. These experiments suggest that cytochalasin D may be an inhibitor of some fertilization processes such as sperm penetration or sperm head decondensation. PMID- 2777720 TI - Identification of androgen binding-protein (ABP) from testis and epididymis of the seasonal rodent, Octodon degus (Molina, 1872). AB - ABP, a Sertoli cell secretory product, was identified in the seasonal rodent Octodon degus (Molina, 1872). It was shown to be present in cytosols from the testis and epididymis. It migrated with an Rf of 0.37 on nondenaturing polyacrylamide gels. Ligation of the vas efferens caused the disappearance of ABP from the epididymis and its accumulation in the testis, indicating its testicular origin. Binding to [3H]5 alpha-DHT was specific and completely reversible, with an apparent Kd of 3.5 +/- 0.4 X 10(-9) M. Half-times of association and dissociation were at 15 and 120 minutes, respectively. Binding equilibrium was achieved at 120 minutes. Steroid affinity relative to the best competitor, 5 alpha-DHT, was 0.27 for testosterone, 0.06 for 17 beta-estradiol, and 0.01 for cyproterone acetate. The presence and similar characteristics of ABP in a wide variety of mammals, including those with special reproductive strategies such as seasonal breeding, suggests that this protein may play a general role in the mechanisms regulating spermatogenesis, probably affecting the transport and concentration of androgens in the testis and epididymis. PMID- 2777721 TI - Cyclophosphamide in the male rat: new pattern of anomalies in the third generation. AB - Several abnormalities, such as postnatal deaths and behavioral impairments, have been previously reported in the progeny of male rats exposed to the cytostatic drug cyclophosphamide 60 days prior to mating. The anomalies were transmitted to the second generation (F2). The present results concern the third generation. Two experimental groups have been studied: a hybrid group, resulting from crosses between control subjects and either experimental F2 males or females, and a nonhybrid group, obtained by mating experimental F2 subjects together. Significant abnormalities were found in all experimental groups, whether the F2 subjects were male or female. F2 females had smaller litters whether they were mated with control or experimental males. Body weight was significantly increased in both hybrid and nonhybrid males. Increased postnatal mortality and learning deficit were also observed in the hybrid group. Such complex phenotypic changes confirm that frequent mutations probably have been inherited from the treated males but also suggest that genetic rearrangements have occurred from one generation to the next. PMID- 2777723 TI - Teaming up for animal agriculture. American Dairy Science Association and American Society of Animal Science, combined annual meeting. July 31-August 4, 1989, Lexington, Kentucky. Abstracts. PMID- 2777722 TI - Possible role of elongated spermatids in control of stage-dependent changes in the diameter of the lumen of the rat seminiferous tubule. AB - Adult male rats were treated with a single dose of 650 mg/kg methoxy acetic acid to deplete the seminiferous tubules specifically of pachytene and later spermatocytes. The effect of this treatment and the subsequent maturation depletion of later germ cell types on the diameter of the seminiferous tubule and its lumen and the area of the seminiferous epithelium were studied in relation to the stages of the spermatogenic cycle. At 21 days after methoxy acetic acid treatment, the diameter of the tubule and the area of the epithelium were reduced below control values at all stages, consistent with the reduced number of early (stage VIII) or late (all other stages) spermatids. Unexpectedly, diameter of the lumen was also reduced at all stages other than VIII, and especially at stage VII. In controls, lumen diameter at stages VII and VIII was increased by approximately 50% compared with earlier and later stages. In rats treated 21 days previously with methoxy acetic acid no change occurred at stage VII (lacking elongated spermatids) while a normal increase did occur at stage VIII (lacking round but not elongated spermatids). At earlier times after methoxy acetic acid treatment when stage VII tubules were depleted of pachytene spermatocytes alone (3 days) or together with early spermatids (7 days), the diameter of the lumen was not significantly different from the control value. These data suggest that lumen diameter may be regulated by elongated spermatids, especially at stages VII and VIII. PMID- 2777724 TI - Rapid flow cytometric studies of Borrelia burgdorferi phagocytosis by human polymorphonuclear leukocytes. AB - The interactions between a strain of Borrelia burgdorferi and human polymorphonuclear leukocytes were studied by flow cytometry in the presence of specific or non-specific opsonizing factors. The capacity of the borrelias to stimulate leukocyte metabolism was also investigated. The results indicated that a low phagocytosis by isolated purified polymorphonuclear leukocytes did occur in the presence or absence of specific antibodies. Within whole blood the percentages of phagocytosting leukocytes increased in the presence of non specific opsonizing factors. No stimulation of the oxidative metabolism stimulated by Borrelia was observed and PMA or zymosan stimulation of leukocytes was inhibited by the spirochaetes. PMID- 2777725 TI - The distribution and ecology of Malassezia furfur and cutaneous bacteria on human skin. AB - The prevalence and abundance of Malassezia furfur on clinically normal skin at 20 sites has been determined. All of the 16 subjects studied (young adults) had high counts on the upper trunk and on at least one site on the head. Counts obtained from the lower trunk and upper thighs of male subjects were considerably higher than those from female volunteers. Organisms isolated, grouped according to their colony morphologies, had distributions consistent with those noted for 'Pityrosporum ovale' and 'P. orbiculare' in previous studies. Mean M. furfur counts were compared with aerobic and anaerobic bacterial counts performed at the same sites. Propionibacteria and M. furfur distributions were similar but not identical. Some factors which might limit the range of M. furfur are discussed. PMID- 2777726 TI - In-vitro activity of dapsone and two potentiators against Mycobacterium avium complex. AB - The efficacy of dapsone against Mycobacterium avium, M. intracellulare, M. kansasii, M. fortuitum and M. tuberculosis was determined by disc elution in agar. The minimal inhibitory concentration at which 90% of the colony forming units were inhibited (90MIC) by dapsone was 8 mg/l for M. avium, M. intracellulare and M. kansasii and greater than or equal to 32 mg/l for M. tuberculosis and M. fortuitum. The 90MICs were confirmed by culturing these test organisms with dapsone in the BACTEC 460 system. Reduction of the 90MIC from 8 mg/l to 2 mg/l was observed by combining dapsone with either or both of the potentiators tested. The dapsone-potentiator combinations had no effect on the bacteria with 90MICs of greater than or equal to 32 mg/l. The clinical relevance of this drug combination against M. avium complex infections remains to be evaluated. PMID- 2777727 TI - Pharmacokinetics and tissue penetration of cefepime. AB - The pharmacokinetics of cefepime were studied following a 2 g intravenous infusion, by measuring concentrations in plasma, inflammatory fluid and urine. Mean peak plasma concentrations of 193.1 mg/l were achieved at the end of the 30 min infusion. The mean plasma elimination half-life was 2.1 h. Penetration into inflammatory fluid was rapid, with mean peak levels of 91.5 mg/l occurring 0.9 h after the end of the infusion. Urinary elimination accounted for 98.9% of the dose within 8 h. Therapeutic plasma levels (greater than 2 mg/l) were present for at least 8 h after the end of the infusion, suggesting that twice or three times daily dosing should be sufficient to treat infections due to susceptible organisms. PMID- 2777728 TI - Gentamicin and low dose piperacillin in febrile neutropenic patients. AB - One hundred and twenty-seven febrile neutropenic patients were randomized to receive empirical antibiotic therapy with intravenous gentamicin and 12 g/day or 8 g/day piperacillin. Despite a high incidence of Hickman catheter infections by antibiotic-resistant bacteria, there was an overall response in 56% of patients and no difference in the numbers responding to each antibiotic regimen. In addition, the duration of fever was not significantly different in the two groups of patients. The majority of the unresponsive patients responded to the addition of further antibiotics and there were only two infection related deaths. The results suggest that high dose antibiotics are not essential for the initial empirical therapy in febrile neutropenic patients. PMID- 2777730 TI - Non-specific membrane permeability and aminoglycoside action. PMID- 2777729 TI - Survey of Bacteroides fragilis susceptibility patterns in France. AB - The in-vitro activities of 19 antimicrobial agents were determined by an agar dilution technique against 300 isolates of the Bacteroides fragilis group, collected from several French hospitals during 1987 and 1988. Results were compared with data determined for strains isolated in 1977. Amongst beta-lactam antibiotics, amoxycillin + clavulanic and imipenem displayed the best activity, although two strains resistant to both amoxycillin clavulanate and imipenem were obtained in the 1987-1988 survey. Chloramphenicol was invariably active against isolates from both periods. Much more resistance to clindamycin was seen in isolates from the more recent survey. Resistance to 5-nitroimidazoles was not observed in isolates from the 1977 survey but was present in a few isolates from the more recent study. PMID- 2777731 TI - BSAC breakpoint recommendations. PMID- 2777732 TI - Bactericidal activity of ciprofloxacin against Staphylococcus aureus. PMID- 2777733 TI - Susceptibility of fifteen Chlamydia trachomatis strains isolated in Greece. PMID- 2777735 TI - Multiple plasma exchanges successfully maintain a young adult patient with Crigler-Najjar syndrome type I. AB - Plasmapheresis has been shown to reduce total and free bilirubin levels in acute exacerbations of Crigler-Najjar syndrome, type I (CNS-TI), but its effectiveness in long-term management has not been reported. An 18-year-old (yo) male with CNS TI, who required prolonged daily high-intensity phototherapy to prevent cerebral nervous system symptoms, developed increasingly frequent bouts of confusion, nausea, and vomiting associated with free bilirubin concentrations (fbcs) greater than 10-15 nmol/L. Pending consideration of orthotopic liver transplantation, plasma exchange (approximately 3 liters per procedure) was begun in 12/84 using the IBM/COBE 2997 with 5% albumin as replacement fluid. Frequency of treatments was guided by twice weekly fbcs, with plasma exchange for fbc greater than 10-15 nmol/L. Pre-exchange and postexchange fbcs ranged from 27.5 to 11 nmol/L and 9.2 to 2 nmol/L, respectively. Seventy-two exchanges were performed over a 28 month period. Irreversible CNS damage did not occur, and the patient underwent successful liver transplantation in April of 1987, with complete correction of his metabolic disorder. He remains well 18 months following transplantation. PMID- 2777734 TI - Bone marrow histological patterns in B-cell and T-cell prolymphocytic leukemia. AB - Bone marrow trephine biopsies from 30 cases of prolymphocytic leukemia (PLL), 16B and 14T were studied. The bone marrow infiltration by the neoplastic prolymphocytes showed the following four histological patterns: interstitial, mixed (interstitial-nodular), mixed (interstitial-diffuse), and diffuse. The most frequent pattern was the mixed (interstitial-nodular) seen in 40% of cases. In comparison with available data from patients with chronic lymphocytic leukemia, the bone marrow involvement in PLL differs by the absence of the pure nodular pattern and by the presence of a mixed (interstitial-diffuse) type, seen in 5 cases. No significant differences between the histological patterns in B- and T PLL were observed. All the cases reviewed had reticulin fibrosis which was more intense in the T cases and in those with a diffuse pattern. The findings described here will help in the further characterization of these lymphoproliferative disorders. PMID- 2777736 TI - Techniques, indications, and toxicity of therapeutic hemapheresis in children. AB - Although therapeutic hemapheresis has grown dramatically in the past decade, its utilization and popularity in pediatrics remain limited. The lack of well-defined indications for treatment and technical difficulties in the management of hemapheresis for small patients have prevented its widespread use. However, there have been more than 130 reports describing the use of hemapheresis in children less than 15 years of age, including more than 20 reports describing it in children less than 5 years. Only one controlled trial of hemapheresis in children has been published. It studied the use of plasma exchange for the treatment of diabetes mellitus. In general, practitioners depend upon the accepted indications in adults to justify usage of this therapy in children. Unfortunately, major differences exist in the adult and pediatric presentation of certain diseases and there has not been universal acceptance of the indications for this therapy in children. Numerous technical difficulties continue to plague the development of hemapheresis therapy in pediatrics and therefore continue to limit the number of studies undertaken. The major technical difficulties include vascular access and excessive extracorporeal volume. These problems are not insurmountable since several patients less than 1 year of age have been successfully treated by hemapheresis. The various techniques used in these cases will be discussed. Additional problems unique to the pediatric population are the difficulty in getting approval for research studies that involve minors, the complexity of informed consent, the problem of patient cooperation and compliance, and the difficulty of explaining a complicated procedure to children of varying developmental levels.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2777737 TI - AIDS in Canada. AB - Since the first case of AIDS was diagnosed in 1982, there have been over 2,300 cases, as of February 1989, in Canada. The epidemiological pattern of the cases in Canada follows that of the United States with the exception of intravenous drug users. In 1983, the federal government created a National Advisory Committee which is active in advising the Minister of National Health and Welfare on issues for the control and management of AIDS in Canada. In 1985, a $39 million program was announced. An enhanced program of AIDS control was established in July of 1987 with the creation of the Federal Center for AIDS (FCA). This has involved a substantial increase in financial and personnel resources. Canada plays a significant role internationally vis-a-vis AIDS; $10 million has been provided to the World Health Organization. The FCA is a WHO Collaborating Centre. In June of 1989, Canada will host the Vth International Conference on AIDS in Montreal. PMID- 2777738 TI - Abstracts of challenges of apheresis. A joint annual meeting of the American Society for Apheresis (tenth annual meeting) and the Society of Hemapheresis Specialists, Ltd. (eleventh annual meeting). Jacksonville, Florida, April 6-8, 1989. PMID- 2777739 TI - Preparation of leukocyte-poor platelets by filtration. AB - There is evidence that leukocyte contaminating red blood cells and platelet concentrates are responsible for refractoriness to platelet transfusions. The efficacy of a cotton-wool filter to remove leukocytes from red blood cells has been documented previously. The present study was designed to evaluate whether the cotton-wool filters can effectively remove leukocytes from platelet concentrates. Sixty pools of random-donor platelets and single-donor plateletpheresis products were filtered through a cotton-wool filter. The efficacy of filtration was determined by measuring the absolute numbers of leukocytes and platelets and subpopulations of mononuclear cells. The average platelet loss was 8% per pool of random platelets and 10% per plateletpheresis product. The average leukocyte removal was 99% from a pool of random platelets and plateletpheresis concentrates collected by CS-3000 and 90% from plateletpheresis concentrates harvested by single-stage COBE/IBM-2997. The filtration removed 100% of granulocytes, 95% of monocytes, 90% of B-lymphocytes, and 85% of T-lymphocytes. We conclude that filtration through a cotton-wool filter is an efficient and cost-effective method for preparation of leukocyte poor platelets. PMID- 2777741 TI - Amino acid sequence of a long-chain neurotoxin homologue, Pa ID, from the venom of an Australian elapid snake, Pseudechis australis. AB - Pa ID, a long-chain neurotoxin homologue, was isolated from the venom of an Australian elapid snake, Pseudechis australis, and its amino acid sequence was determined by conventional methods. Pa ID was an acidic protein (pI = 6.2) and consisted of 68 amino acid residues. It did not show binding activity to the acetylcholine receptor of an electric ray (Narke japonica) nor lethal effect on mice, though the amino acid sequence is homologous with those of long-chain neurotoxins isolated from other elapid snakes (homology, 39-51%). In the sequence of Pa ID, a structurally invariant residue (Tyr-22) and two functionally invariant residues (Val/Ala-49 and Lys/Arg-50) in snake venom neurotoxins are replaced by a cysteine, an arginine, and a methionine residue, respectively, and furthermore, four common residues in long-chain neurotoxins, Gly-17, Ala-43, Ser 59, and Phe/His-66 are replaced by a glutamic acid, a threonine, a threonine, and a valine residue, respectively. The conformational change of the protein molecule caused by these replacements and the removal of a positive charge at position 50 are probably the reasons why Pa ID has lost the lethality. PMID- 2777740 TI - I-protein forms cage-like aggregates of myosin in vitro. AB - I-protein was mixed with myosin before or after myosin filaments were reconstituted. In both cases, I-protein seemed to accelerate the myosin assembly. The binding of I-protein to myosin filaments was tested by sedimentation experiments and SDS-polyacrylamide gel electrophoresis. In a low ionic strength solution at pH 6.5, the binding ratio of I-protein to myosin was 1:40 by molar ratio when the I-protein molecules highly specifically bound to myosin filaments. I-protein could maximally bind to myosin filaments at the molar ratio of 1:2.7. In this case, excess I-protein molecules remained in the supernatant after sedimentation, although the unbound I-protein could still bind to myosin filaments. Electron microscopic observations revealed that I-protein bundled myosin filaments in the low ionic strength solution (pH 6.5). Cage-like structures which were very similar to the Mg-paracrystals of non-muscle myosins were formed at pH 7.2. In gel filtration, the apparent molecular mass of I protein was 100 kDa, while it was 50 kDa in SDS gel electrophoresis. Therefore, I protein is regarded to be a homodimer of a 50 kDa subunit and can divalently bind to myosin molecules. PMID- 2777742 TI - Refined purification and characterization of Z-protein. AB - Using an improved procedure, Z-protein was prepared from myofibrils of chicken breast muscle. The yield of pure Z-protein increased to 10 mg per kg of muscle. The chain weight of Z-protein was 55,000 in the presence of SDS. However, Z protein was eluted before aldolase (Mr 158,000) in Sephacryl S-400 column chromatography, and, therefore, it appeared to exist as a tetramer in a physiological salt solution. Z-protein had at least four isopeptides whose isoelectric points ranged from pH 6.0 to 6.4. Anti-Z-protein antiserum reacted equally with these isopeptides. The extinction coefficient of Z-protein at wavelength 278 nm was 4.2 (1%; light path, 1 cm). Z-protein which was purified according to this improved method did not bind to F-actin and alpha-actinin in a physiological salt solution. PMID- 2777743 TI - Synchrotron X-ray scattering study of chromatin condensation induced by monovalent salt: analysis of the small-angle scattering data. AB - Small-angle X-ray scattering experiments were carried out on rat thymus chromatin in "native" and "H1-depleted" states at various NaCl concentrations using synchrotron radiation. From the analysis of cross-sectional Guinier plots, the radius of gyration of the cross section (Rc) and the mass per unit length (Mc) of native chromatin were evaluated. In the absence of NaCl, the cross section of chromatin filament has a radius of gyration of 3.44 nm, suggesting the structure corresponding to the "10 nm" filament. With increasing NaCl concentration, the Rc value increases steeply to 6.74 nm at 5 mM NaCl and then gradually to 8.82 nm at 50 mM NaCl, whereas the Mc value, which is determined relative to that of tobacco mosaic virus (TMV), increases steadily from 1.58 nucleosomes per 10 nm in the absence of NaCl to 7.66 nucleosomes per 10 nm at 50 mM NaCl. However, since calibration with TMV tends to overestimate the Mc value, the actual Mc values may be less than those values. Above about 40 mM NaCl, aggregation of chromatin is suggested. Similar analysis of H1-depleted chromatin confirmed that H1-depleted chromatin takes a more disordered structure than native chromatin at low ionic strength and does not undergo a definite structure change upon further addition of NaCl. PMID- 2777744 TI - Interaction of bilirubin with gangliosides. AB - Gangliosides seem to play an important role in the interaction of the neurotoxic pigment bilirubin with the synaptosomal plasma membrane (Vazquez et al. [1988] J. Biol. Chem. 263, 1255-1265). In this report, a further characterization of the bilirubin-ganglioside interaction is presented. The interaction is fast, and it is observed at any pH in the range 7.0-9.0. The characteristics of the interaction are different from those observed with other membrane lipids, including sphingomyelin. A model of binding to a single population of sites is able to adequately fit the experimental data. This model predicts a decrease in the tendency of bilirubin to interact with gangliosides and an increase in the binding capacity as the pH is decreased from 8.0 to 7.0. Our data would suggest a role for gangliosides in explaining the preferential accumulation of bilirubin in some areas of the brain and the toxic effect of this pigment in neuronal membrane related functions. PMID- 2777745 TI - Partial purification and characterization of sialate O-acetylesterase from bovine brain. AB - From bovine brain an esterase was purified 2,600-fold in an overall yield of 5.6%. For the isolation ion-exchange chromatographies, gel filtration, and preparative isoelectric focusing were used. The molecular mass is 56 kDa after gel chromatography on Sephacryl S-200 and 51 kDa after HPLC, the pH-optimum at 7.4, and the isoelectric point in the range of pH 5.8-6.1, as estimated from preparative isoelectric focusing. The substrate specificity of this enzyme was tested with various naturally occurring O-acylated sialic acids, synthetic carbohydrate acetates, and other esters. Besides aromatic acetyl esters such as e.g. alpha-naphthyl acetate, the highest preference was for N-acetyl-9-O acetylneuraminic acid, followed by N-acetyl-4-O-acetylneuraminic acid. Other primary acetyl esters such as 6-O-acetylated D-glucose and 2-acetamido-2-deoxy-D mannose were not hydrolyzed. The 9-O-acetyl derivative of the naturally occurring unsaturated sialic acid 2-deoxy-2,3-didehydro-N-acetylneuraminic acid, however, is a substrate for this esterase. Whereas N-acetyl-9-O-acetylneuraminic acid as a component of sialyllactose is nearly as well hydrolyzed as the corresponding free sialic acid, O-acetylated sialoglycoconjugates with high molecular weights (mucins, serum glycoproteins, gangliosides) are not hydrolyzed by this esterase. N-Acetylated sialic acids are better substrates than the analogous N-glycoloyl derivatives. Esterification of the carboxyl function of sialic acids prevents the action of the esterase on the O-acetyl groups. The enzyme has no carboxyl esterase or amidase activity, and does not act on acetylcholine. It hydrolyzes almost exclusively acetyl esters. Inhibition studies suggest that it has a catalytically active serine residue.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2777746 TI - Primary structure of H2-proteinase, a non-hemorrhagic metalloproteinase, isolated from the venom of the habu snake, Trimeresurus flavoviridis. AB - The complete amino acid sequence of and the locations of disulfide bridges in H2 proteinase, a major non-hemorrhagic proteinase isolated from the venom of the habu Trimeresurus flavoviridis, have been determined and compared with those of HR2a, one of the hemorrhagic metalloproteinases in this venom. The strategy involved consisted of structural analysis of peptides in digests with cyanogen bromide, lysyl endopeptidase, trypsin, Staphylococcus aureus V8 protease and thermolysin. Peptides were purified by gel filtration followed by reversed-phase HPLC. H2-proteinase is a non-glycosylated single chain polypeptide consisting of 201 amino acids with an amino-terminal pyroglutamic acid, a calculated molecular weight of 22,991 and a net charge of +14 at neutral pH. There was no evidence of heterogeneity of the sequence. H2-proteinase has a typical zinc-chelating sequence and its overall sequence identity with HR2a is 73.6%. The 3 disulfide bridges in H2-proteinase link Cys-117 to Cys-196, Cys-158 to Cys-180, and Cys-160 to Cys-163, in the same manner as in the case of HR2a. In striking contrast to HR2a, it contains en extra free cysteine residue at position 94 which becomes reactive to a sulfhydryl reagent in the presence of a denaturant. PMID- 2777747 TI - Dermatan sulfate formation in gastrulae of the sea urchin Clypeaster japonicus. AB - Gastrullation of sea urchin embryos is arrested in sulfate-free sea water. This developmental arrest has been considered to be due to lack of sulfation of glycosaminoglycans in the extracellular matrix of the embryos. In the present study, we characterized a dermatan sulfate type component formed in gastrula stage embryos of the sea urchin Clypeaster japonicus and examined the effects of sulfate deprivation on the formation. Glycosamino-glycans were prepared from gastrula-stage embryos incubated with [3H]acetate in normal and sulfate-free sea water. Enzymatic analyses indicated that embryos formed a glycosaminoglycan of the dermatan sulfate type which contained an N-acetylgalactosamine-6-sulfate containing disaccharide as a major unit, plus a minor unidentified component. Under sulfate-free conditions, embryos formed an under-sulfated chondroitin/dermatan sulfate copolymer which mainly consisted of non-sulfate, glucuronic acid-containing (chondroitin) disaccharide units. These results suggest that sulfate deprivation diminishes not only the degree of sulfation but also the formation of L-iduronic acid-containing (dermatan) disaccharide units in dermatan sulfate in sea urchin embryos. PMID- 2777748 TI - An actin-depolymerizing protein in embryonic chicken skeletal muscle: purification and characterization. AB - In embryonic skeletal muscle, a large amount of non-polymerized actin exists in the cytoplasm (Shimizu and Obinata [1986] J. Biochem. 99, 751-759). A 19-kDa protein (called 19K protein) which binds to G-actin was purified by sequential chromatography on DNase I-agarose, hydroxylapatite, SP-Sephadex, and Sephadex G 75, from the sarcoplasmic fraction of embryonic chicken skeletal muscle. This protein decreased the extent of actin polymerization at a steady state and increased the monomeric actin in a concentration-dependent fashion; it also caused quick depolymerization of F-actin, as determined by spectrophotometry at 237 nm, viscometry, DNase I inhibition assay, and electron microscopy. The molar ratio of 19K protein and actin interacting with each other was estimated to be 1:1. From these results, 19K protein was regarded as being actin depolymerizing protein. The amount of 19K protein in muscle decreased during development. The inhibitory action of 19K protein was removed by myosin or heavy meromyosin, and actin filaments were formed on the surface of myosin filaments when myosin filaments were added to a mixture of actin and 19K protein in a physiological salt solution. We propose that actin assembly is dually controlled in the developing muscle by the inhibitor(s) and an accelerator (myosin); this mechanism may enable the ordered assembly of actin and myosin in the early phase of myofibrillogenesis. PMID- 2777749 TI - Assembly of transcriptionally inactive chromatin in vitro. AB - We have successfully uncoupled the previously interlocked activities of chromatin assembly and in vitro transcription promoted by the Xenopus oocyte S-150 cell free extract. Our isolated fraction catalyzes extensive chromatin assembly measured both by changes in DNA topology and Micrococcal nuclease digestions. The assembly of chromatin is slowed by the exogenous addition of ATP. In the absence of exogenously added ATP, the fraction forms a chromatin template that is transcriptionally inert. Addition of small amounts of the HeLa cell extract (S 100) converts these templates into transcriptionally active ones without disrupting the chromatin structure. Our protocol defines a method for the isolation of a fraction from the Xenopus cell free extract that catalyzes the assembly of transcriptionally inactive chromatin. We characterize this reaction and establish conditions for the transcriptional activation of these inactive minichromosomes. PMID- 2777750 TI - Multiple forms of phospholipase A2 in arthritic synovial fluid. AB - Phospholipase A2 (PLA2) has been purified to homogeneity from human arthritic synovial fluid. The activity resolved into multiple peaks by preparative HPLC. The most abundant peak (A) was present in synovial fluid from patients with rheumatoid arthritis, osteoarthritis, and psoriatic arthritis. A second major peak (B) was variable and lower in relative abundance, but was distinguishable from peak A by its stimulated activity in the presence of either 0.5 M Tris or 0.1% sodium deoxycholate (DOC), in addition to its longer HPLC column retention time. Both peaks required Ca2+ and showed optimal activity in DOC/phosphatidylcholine (PC) mixed micelle assays between pH 8.0 and 9.0. Both peaks showed higher activity with PC as substrate than with PI, however peak A exhibited higher activity with PE than PC. Upon preparative SDS-polyacrylamide gel electrophoresis, both peaks of PLA2 activity were resolved as proteins of approximately 14,000 Da. The N-terminal sequence obtained from purified peak A material matched that of a recent similar isolate (Hara et al. (1988) J. Biochem. 104, 326-328). PMID- 2777751 TI - Negative cooperativity of chicken ovotransferrin on Al(III)-binding. AB - Chicken ovotransferrin, an iron binding protein, has two metal binding sites (amino (N) and carboxy (C) terminal sites). It binds Cu(II), Al(III), Co(II), and other metals, as well as Fe(III). In this study, the selectivity and cooperativity of the N and C sites on Al(III), Co(II), and Tb(III) binding were investigated. Metals were classified into two groups according to their site preference. Co(II) and Al(III) bound to the N site more preferably than to the C site, whereas Tb(III) bound to the C site more preferably. On Fe(III) binding, the binding constant of Fe(III) becomes larger when the other site is already occupied. Thus, positive cooperativity is seen. In the present study, the binding cooperativities of Co(II), Tb(III), and Al(III) as to the N and C sites were investigated. On Co(II) and Tb(III) binding, no cooperativity was observed, as in the case of Cu(II) [Yamamura, T. et al. (1985) in Proteins of Iron Storage and Transport (Spik, G., Montreuil, J., Crichton, R.R., & Mazurier, J., eds.) pp. 53 56, Elsevier Science Publ. B.V., Amsterdam]. In contrast, negative cooperativity was observed on Al(III) binding. Based on a model proposed by Yamamura et al. [Yamamura, T. et al. (1985) ibid.], the ratio of the binding constants, KC/KN, and the stacking coefficient, Kst, were estimated. KC/KN is 2.2 +/- 0.4 for the Tb(III) ion, 0.5 +/- 0.1 for the Co(II) ion, and 0.12 +/- 0.02 for the Al(III) ion. Kst (= 1 in a non-cooperative case) is 0.98 +/- 0.02 for the Tb(III) ion, 1.03 +/- 0.02 for the Co(II) ion, and 0.55 +/- 0.22 for the Al(III) ion. PMID- 2777752 TI - Amino acid sequence of porcine cardiac muscle troponin C. AB - Troponin C is the Ca2+-receptive protein located on the thin filament of striated and cardiac muscle. We have determined the amino acid sequence of troponin C obtained from porcine cardiac muscle by sequencing and aligning the lysyl endopeptidase and Staphylococcus aureus V-8 protease peptides. It was composed of 161 amino acid residues with a blocked N-terminus. The sequence of porcine cardiac troponin C was identical with that of bovine cardiac troponin C. PMID- 2777753 TI - Sensitization of Edman amino acid derivatives using the fluorescent reagent, 4 aminofluorescein. AB - The ability to analyze amino acid derivatives at the femtomole level is one of the most interesting challenges in the field of protein microsequencing. 2 Anilino-5-thiazolinone amino acids, obtained by Edman degradation, were quantitatively derivatized with fluorescent primary amines. The most fluorescent reagent tested was 4-aminofluorescein. The amino acid derivatives sensitized with this reagent were separated using reversed-phase high-performance liquid chromatography and identified at the 100 attomole level. Incorporation of this method into the operation of a conventional automated sequencer is also described. PMID- 2777754 TI - Activation of L-lysine epsilon-dehydrogenase from Agrobacterium tumefaciens by several amino acids and monocarboxylates. AB - The activation of lysine epsilon-dehydrogenase [EC 1.4.1.] by L-lysine was dependent on lysine concentration and was accompanied by association of the dimeric enzymes to a tetramer. The lysine concentration required for the half maximal activation was 0.28 mM, which was lower than the Km value for L-lysine. In addition to L-lysine, several compounds, which were neither substrates nor inhibitors, activated the enzyme. The compounds which activated the enzyme have common structural characteristics: they have both a carboxyl group and a hydrophobic side chain. These activators also induced the association of the enzyme. The activation of the enzyme occurred well over the pH range 5.0 to 7.5, and the maximal activation was obtained by preincubation for 5 min at 30 degrees C and pH 7.4, when 5 mM L-lysine or 6-aminocaproate was used as an activator. NADH binding experiments indicated that about 2 mol of NADH bind to 1 mol of the tetrameric enzyme: the dimeric enzyme has one catalytic site. Binding experiments with n-[1-14C]heptanoate and L-[U-14C]lysine showed that approximately 2 mol of ligands bind to 1 mol of the dimeric enzyme and L-lysine could not bind to the catalytic site of the enzyme in the absence of NAD+. These results indicate the presence of one catalytic site and two activator binding binding sites in the dimeric enzyme. PMID- 2777755 TI - Aluminum enhances the stimulatory effect of NaF on prostaglandin E2 synthesis in a clonal osteoblast-like cell line, MOB 3-4, in vitro. AB - The effect of NaF on prostaglandin E2 (PGE2) synthesis in a clonal osteoblast like cell line, MOB 3-4, was examined in the presence of Al3+. The MOB 3-4 cell line, which was derived from neonatal mouse calvaria, displays many osteoblastic characteristics, including the biosynthesis of PGE2. In the absence of Al3+, 1 mM NaF increased PGE2 synthesis (per well) to about 340% of the control level, whereas NaF at lower concentrations (below 0.1 mM) did not show such a significant effect. In the presence of 10 microM Al3+, NaF concentrations ranging from 0.01 to 1 mM increased PGE2 synthesis in a dose-dependent manner, though 10 microM Al3+ had no effect by itself. Similar effects were observed on alkaline phosphatase (ALP) activity per well, but a stimulatory effect of NaF on protein synthesis was observed only in the presence of 10 microM Al3+. These data demonstrated that PGE2 synthesis per protein was increased by NaF alone, and this effect was markedly enhanced by the addition of AlCl3. ALP activity per protein was, however, significantly increased by NaF in the absence of AlCl3. Taken together with our previous finding that Al3+ enhances the NaF-induced Ca2+ mobilization in MOB 3-4 cells, these results suggest that F- combined with Al3+ (i.e., AlF4-) is a more potent stimulator of PGE2 synthesis in cells than F- alone, and that the AlF4- -enhanced PGE2 synthesis may be caused by an increase in cytosolic free Ca2+ concentration during activation of the G protein by AlF4-. PMID- 2777756 TI - Thermally adaptive changes of mycolic acids in Mycobacterium smegmatis. AB - The effect of growth temperature on mycolic acid composition in eight strains of Mycobacterium smegmatis was investigated by gas chromatography/mass spectrometry. A change in growth temperature from 45 to 20 degrees C caused a shift in the subclass and molecular species composition of mycolic acids. The relative amount of alpha'-mycolic acids to alpha-mycolic acids decreased, and that of hydroxy mycolic acids increased at lower temperatures. Moreover, the proportion of shorter-chain species of alpha-mycolic acids increased, and those of longer-chain species of alpha-mycolic and hydroxy mycolic acids decreased. This observation seems to be due to the changes of the chain length of meromycolates because the alpha-alkyl chain unit of mycolic acids was not affected. The ratio of odd to even carbon-numbered alpha-mycolates decreased as the growth temperature was lowered. In contrast, the molecular species composition of alpha'-mycolic acid was not influenced by the growth temperature. PMID- 2777757 TI - Inhibitory effects of poly(L-aspartic acid) on the assembly of brain microtubules and the interaction of microtubule-associated protein 2 with F-actin in vitro. AB - The effects of poly(L-aspartic acid) (PLAA) on microtubule assembly and microtubule-associated protein (MAP) 2-actin interaction were examined in vitro. PLAA inhibited assembly of rat brain microtubules and induced rapid disassembly of already formed microtubules. Inhibition was stronger by PLAA with a high molecular weight than that by low molecular weight. The ratios of 47 kDa PLAA to microtubule proteins causing 50% inhibition of the assembly and disassembly were 0.015 and 0.04 (w/w), respectively. Both MAP 1 and MAP 2 were bound to a PLAA Sepharose 4B affinity column, while tubulin was not retained by the column. PLAA caused selective dissociation of MAP 1 and MAP 2 from microtubules polymerized by taxol. It is therefore concluded that PLAA interacts specifically with MAPs. PLAA also inhibited the MAP 2 induced cross-linking of actin filaments, showing an almost complete inhibition at a PLAA to MAP 2 ratio of 1:5,000 (w/w). Binding experiments of PLAA with digested MAP 2 by chymotrypsin using affinity chromatography and sedimentation experiments showed that PLAA was preferentially bound to a 35 kDa fragment which includes the microtubule- and actin-binding domain of the MAP 2 molecule. These results suggest that PLAA suppressed the functions of MAP 2 through a domain which is located in the 35 kDa fragment. PMID- 2777758 TI - Stimulation of the human heat shock protein 70 promoter in vitro by simian virus 40 large T antigen. AB - Simian virus 40 large tumor (T) antigen stimulates transcription from the SV40 late promoter and some cellular genes. We report here the novel finding that purified T antigen preferentially stimulates transcription from the human heat shock protein 70 promoter in an in vitro transcription system. T antigen is thus capable of stimulating transcription by a process that does not require synthesis of other proteins and that may involve a direct interaction with preexisting cellular factors. PMID- 2777760 TI - Activation of a flavoprotein by proteolysis. AB - Chymotryptic digestion of brain pyridoxine-5-P oxidase brings about a 4-fold enhancement of the catalytic power (Vmax/KM) using pyridoxine-5-P as substrate in the assay mixtures. The chymotrypsin-treated enzyme is less susceptible to inhibition by pyridoxal-5-P than the native enzyme. Fragments arising from limited proteolysis were separated by affinity chromatography using P-pyridoxal Sepharose as supporting matrix. Catalytically active fractions, eluted by pyridoxine-5-P (5mM), displayed three bands when analyzed by sodium dodecyl sulfate-polyacrylamide gel electrophoresis. The molecular masses of the three protein bands are considerably lower than 28 kDa, the molecular mass of monomeric pyridoxine-5-P oxidase. Spectroscopic studies, absorption, fluorescence, and circular dichroism revealed that the microenvironment surrounding the cofactor flavin mononucleotide is not perturbed by limited proteolysis. PMID- 2777759 TI - Transcriptional regulation of the parathyroid hormone-related peptide gene by glucocorticoids and vitamin D in a human C-cell line. AB - A parathyroid hormone-related peptide (PTHRP) has been identified in human tumors associated with the syndrome of humoral hypercalcemia of malignancy. The PTHRP and parathyroid hormone (PTH) genes appear to have arisen by duplication and to represent members of a gene family. PTHRP mRNAs have been demonstrated in a number of normal tissues, but little is known concerning the regulation of PTHRP gene expression in any site. We studied PTHRP gene expression in TT cells, a human C-cell line which also produces calcitonin and calcitonin gene-related peptide. We found that both the synthetic glucocorticoid, dexamethasone, and the active vitamin D metabolite, 1,25-dihydroxyvitamin D3, decreased steady-state PTHRP mRNA levels in TT cells in a time- and dose-dependent fashion. The dexamethasone effect was completely blocked by the glucocorticoid antagonist RU 486. 24,25-dihydroxyvitamin D3 was found to be inactive. Neither dexamethasone nor 1,25-dihydroxyvitamin D3 appeared to influence PTHRP mRNA stability in TT cells, and both agents were shown by nuclear transcription run-off assay to decrease PTHRP gene transcription. These findings indicate that the PTHRP gene is under the transcriptional control of glucocorticoids and vitamin D in a cell line with prototypical neuroendocrine features. PMID- 2777761 TI - Structure of the cDNA encoding transcobalamin I, a neutrophil granule protein. AB - Transcobalamin I (TCI) is a member of the R binder family of vitamin B12 binding proteins. It is a major protein constituent of secondary granules in neutrophils. We have isolated and characterized full length cDNA clones encoding TCI in order to determine whether its expression is coordinately regulated with the appearance of secondary granules and whether it is consequently a useful marker of granulocyte development. Partial amino acid sequences of human R protein were obtained from tryptic digestion fragments. Using the polymerase chain reaction, a partial TCI cDNA probe was isolated by selective amplification of a region of cDNA located between two oligonucleotides deduced from the available partial amino acid sequences. The amplified probe was then used to obtain full length clones from a granulocyte cDNA library. Identity of the clones was confirmed by matching DNA sequence to known peptide amino acid sequence. TCI is transcribed to a single 1.5-kilobase mRNA species. The predicted protein sequence is 433 amino acids long. We have compared the sequence of TCI to that of rat intrinsic factor. The two proteins have areas of extensive homology which implicate regions potentially important for vitamin B12 binding. TCI mRNA was present in late neutrophil precursors but absent from uninduced and induced HL60 cells. PMID- 2777762 TI - Two glycosphingolipid sialyltransferases are localized in different sub-Golgi compartments in rat liver. AB - A highly purified Golgi preparation from rat liver was fractionated on a sucrose density gradient and the activity of two sialyltransferases, CMP-NeuAc: Gal beta 1----4Glc-Cer (lactosylceramide) alpha-2----3sialyltransferase; Sat-1), and CMP NeuAc:Gal beta 1----3GalNAc beta 1----4(NeuAc alpha 2----3) Gal beta 1----4Glc Cer (GM1 ganglioside) alpha 2----3sialyltransferase; SAT-4), involved in the biosynthesis of gangliosides were assayed in the collected fractions. These two activities were recovered in different regions of the gradient; SAT-1 was found in a more dense region than SAT-4. This distribution coincided with that of two N Asn linked oligosaccharide processing enzymes (UDP-GlcNAc:lysosomal enzyme precursor GlcNAc-1-phosphotransferase and UDP-Gal:ovalbumin galactosyltransferase), assumed as putative markers of cis- and trans-Golgi cisternae, respectively. These findings are consistent with the assembly of ganglioside oligosaccharide chains occurring in different sub-Golgi compartments. PMID- 2777764 TI - Characterization of point mutations in the collagen COL1A1 and COL1A2 genes causing lethal perinatal osteogenesis imperfecta. AB - Type I collagen mutations in a group of patients with lethal perinatal osteogenesis imperfecta were identified in fibroblast RNA by a new method which can detect, by chemical modification and cleavage, single mismatched bases in heteroduplexes formed between mRNA and normal cDNA probes. Control cDNA probes spanning the area of the pro-alpha 1(I) and pro-alpha 2(I) chains likely to contain the mutations were radioactively labeled and used to form heteroduplexes with total patient RNA. Treatment of these heteroduplexes with hydroxylamine followed by cleavage of the cDNA strand at reactive bases by piperidine identified mismatches in the pro-alpha 1(I) cDNA in four patients. In the fifth patient a mismatch was detected in the pro-alpha 2(I) cDNA. To characterize these mutations the regions containing the mismatches were amplified by the polymerase chain reaction, cloned, and sequenced. All were heterozygous single base mutations which led to the substitution of glycine residues in the helical region of the pro-alpha-chains. The substitutions were pro-alpha 1(I) Gly973 and Gly1006 to Val, Gly928 to Ala, Gly976 to Arg, and pro-alpha 2(I) Gly865 to Ser. These mutations emphasize the importance of the Gly-X-Y repeating amino acid sequence for normal collagen helix formation and function in the extracellular matrix. PMID- 2777763 TI - Calcium induces membrane translocation of 12-lipoxygenase in rat platelets. AB - Translocation of soluble 12-lipoxygenase to membranes was examined in rat platelets. Preincubation of platelet homogenates with 0.1-10 microM Ca2+ resulted in an increase in 12-lipoxygenase activity of the particulate fraction with a concomitant decrease in that of the soluble fraction. Kinetic parameters of 12 lipoxygenase of the soluble and membrane fractions were not changes in the presence of 10 microM Ca2+. Ca2+-induced association of 12-lipoxygenase to the particulate fraction was dependent on the amounts of platelet-soluble and membrane fractions but not on the incubation temperature. 12-Lipoxygenase activity associated with the particulate fraction was completely dissociated by reducing the concentration of Ca2+ to 10 nM. Ca2+-induced association of the enzyme also occurred in the boiled- and trypsin-treated membranes but was significantly reduced in the phospholipase A2-treated membranes. Soluble 12 lipoxygenase also associated to liposomes in a Ca2+-dependent manner. Pretreatment of platelets with thrombin (0.5-5 units/ml) significantly caused a translocation of soluble 12-lipoxygenase to particulate fraction; in the time course study, the translocation was observed at the thrombin pretreatment of 1, 5, and 10 min. These results suggest that stimulation of platelets is followed by the translocation of soluble 12-lipoxygenase to membranes, which is mediated by physiological concentration of Ca2+. PMID- 2777765 TI - Involvement of the carboxyl-terminal propeptide of beta-glucuronidase in its compartmentalization within the endoplasmic reticulum as determined by a synthetic peptide approach. AB - The proenzyme form of beta-glucuronidase is compartmentalized in large quantities within the endoplasmic reticulum by binding to the esterase, egasyn. Also, the propeptide of the proenzyme form of beta-glucuronidase is likely located at the carboxyl terminus. We have, therefore, tested if this carboxyl-terminal peptide is important in binding to egasyn. A polyclonal antibody to a 30-mer synthetic peptide, corresponding to the carboxyl-terminal 30 amino acids of pro-beta glucuronidase, provided evidence that egasyn binds to the carboxyl terminus of beta-glucuronidase. This antibody interacted with proenzyme beta-glucuronidase egasyn complexes in which one, two, or three egasyn molecules were bound to the beta-glucuronidase tetramer, but not with those complexes (M4) which contained four egasyn molecules. We interpret these results as indicating that all available carboxyl termini of the beta-glucuronidase proenzyme tetramer are shielded by egasyn in the M4 complexes. The same antibody did not recognize the mature lysosomal form of beta-glucuronidase, indicating that only the proenzyme form of microsomal beta-glucuronidase contains the original carboxyl terminus. Also, the synthetic 30-mer was found to be a specific and potent inhibitor (50% inhibition at 1.3 microM) of the esterase activity of purified egasyn but exhibited little inhibitory activity toward other purified esterases including a rat trifluoroacetylated esterase or egasyn esterase from another species. Together, these data describe a potent interaction of the exposed carboxyl terminus of precursor glucuronidase with the esterase catalytic site of egasyn, which in turn results in the specific localization of glucuronidase within the lumen of the endoplasmic reticulum. PMID- 2777767 TI - Plasma selenium-dependent glutathione peroxidase. Cell of origin and secretion. AB - Human plasma glutathione peroxidase (GSHPx) has been shown to be a glycosylated selenoprotein distinct enzymatically, structurally, and antigenically from known cellular glutathione peroxidases. The extracellular location of the enzyme and the fact that it is glycosylated suggested that it is a secreted protein. Utilizing mutually non-cross-reactive antibodies to human cellular and plasma GSHPx, we conducted a search to determine the tissue of origin for plasma GSHPx. The cells screened were endothelial cells because they are the main source of extracellular superoxide dismutase, HL-60 cells (myeloid cell line) because they are the main source of extracellular H2O2, and Hep G2 cells (hepatic cell line) because they are the source of many plasma proteins. Human umbilical vein endothelial cells were metabolically labeled with either [35S]methionine or [75Se]selenious acid, and HL-60 cells and Hep G2 cells were metabolically labeled with [75Se]selenious acid. Proteins were immunopurified from the labeled cells and their media with either anti-red blood cell (RBC) GSHPx IgG or with anti plasma GSHPx IgG. Utilizing anti-RBC GSHPx IgG, only the cellular form of the enzyme was precipitated from all the cells tested but not from their media. When anti-plasma GSHPx IgG was applied to the cells and their media, a selenoprotein was precipitated only from the media of Hep G2 cells. When Hep G2 cells were incubated in the presence of the carboxylic ionophore monensin, an intracellular selenoprotein could be detected using anti-plasma GSHPx IgG. The precipitation of the cellular form from all three cell types was partially inhibited by preincubation of the anti-RBC GSHPx IgG with purified RBC GSHPx while the precipitation of the selenoprotein from the medium of Hep G2 cells by anti-plasma GSHPx IgG was prevented by preincubation of the antibody with purified plasma GSHPx. We suggest that plasma GSHPx is synthesized by and secreted from hepatic cells. This is, to the best of our knowledge, the only known selenoprotein with a defined function that has been shown to be synthesized for secretion by mammalian cells. PMID- 2777766 TI - Respiratory burst oscillations in human neutrophils and their correlation with fluctuations in apparent cell shape. AB - Neutrophils pretreated with phorbol 12-myristate 13-acetate (1-10 nM) and stimulated with low concentrations of chemotactic agonists (1-10nM) exhibited a marked increase in respiratory burst activity that was characterized by regular oscillations. These were accompanied by parallel oscillations in turbidity having the same phase and period. Four different agonists, f-Met-Leu-Phe, complement fragment C5a, platelet-activating factor, and leukotriene B4, induced virtually identical oscillations, with mean periods of 7.9 +/- 0.6 s (respiratory burst) and 7.9 +/- 0.8 s (turbidity) at 37 degrees C. No burst oscillations were observed at high agonist concentrations (50-100 nM) unless the fungal metabolite 17-hydroxywortmannin was added prior to stimulation. In the absence of phorbol 12 myristate 13-acetate, the respiratory burst activity was inhibited by 17 hydroxywortmannin, the protein kinase C inhibitor staurosporine, and calcium depletion, while agonist-dependent turbidity changes including the oscillations were unaffected. Turbidity changes reflect corresponding changes in cell size and/or shape, suggesting that cyclic alterations in morphology such as lamellipod extension and retraction physically affect the catalytic efficiency of the membrane-bound burst enzyme NADPH-oxidase. The oscillations appear to be controlled via receptor-dependent activation mechanisms which do not involve PKC activation or the rise in internal calcium presumably derived from phospholipase C activation. PMID- 2777769 TI - Anomalous pressure dissociation of large protein aggregates. Lack of concentration dependence and irreversibility at extreme degrees of dissociation of extracellular hemoglobin. AB - The effects of hydrostatic pressure on the extracellular hemoglobin of Glossoscolex paulistus were investigated by studies of light scattering, intrinsic protein fluorescence, filtration chromatography, and oxygen binding. Pressure promoted a large decrease of light scattering consistent with the dissociation of the hemoglobin. Pressures up to 1.7 kbar caused dissociation with reversibility of the light scattering and fluorescence properties after return to atmospheric pressure. Higher pressures provoked additional dissociation with increasing loss of reversibility. After complete dissociation by incubation at 2.5 kbar followed by decompression, the protein continued mostly dissociated. The dissociated forms were distributed in two populations as based on size exclusion chromatography, one corresponding to small dissociated units (average Mr = 33,000) and the other population corresponding to the one-twelfth subunit (260,000 Mr). The pressure dissociation curves showed no significant dependence on protein concentration suggesting that the native hemoglobin population exists in a distribution of free-energies of association. Both the decrease of concentration dependence and the loss of ability to reassemble seem to increase with the complexity and size of the protein aggregate. These findings permit the conclusion that increased heterogeneity of free-energies of association with the size of the aggregate may result in the molecular individuality of large protein complexes such as subcellular particles and viruses. PMID- 2777768 TI - Isolation and characterization of Chinese hamster ovary cell mutants defective in amino acid transport System L. AB - The Chinese hamster ovary cell line CHO-tsH1 is a temperature-sensitive leucyl tRNA synthetase mutant that shows temperature-dependent regulation of the amino acid transport responsible for accumulating leucine, System L. At nonpermissive temperatures, CHO-tsH1 cells are unable to grow because they are unable to incorporate leucine into protein. As a result, System L activity is increased. We have isolated mutants from CHO-tsH1 that have constitutively de-repressed System L activity. These mutants are temperature-resistant as a result of increased intracellular steady-state accumulations of System L-related amino acids, which compensates for the defective synthetase activity. In this study, we have subjected one of these regulatory mutant cell lines (C11B6) to a tritium-suicide selection, in which L-[3H]leucine was used as a toxic substrate. Three mutant cell lines, C4B4, C5D9, and C9D9 that showed reduced System L transport activity were isolated. The decreases in the initial rates of System L transport activity lead to reduced steady-state accumulations of System L-related amino acids. In contrast to the parental cell line, C11B6, the transport-defective mutants are temperature-sensitive because the reduced intracellular pool of leucine can no longer compensate for the defective synthetase activity. PMID- 2777770 TI - The primary structure of a protein carboxyl methyltransferase from bovine brain that selectively methylates L-isoaspartyl sites. AB - Protein L-isoaspartyl methyltransferase (PIMT) transfers the methyl group of S adenosyl-L-methionine to free alpha-carboxyl groups of atypical L-isoaspartyl residues in proteins. The complete primary structure of the type I isoform of bovine brain PIMT was determined by sequence analysis of peptides generated by endoprotease Lys-C, trypsin, cyanogen bromide, and endoprotease Asp-N digests. The correct composition of every peptide was verified by fast atom bombardment mass spectrometry. The efficiency of sequencing by tandem mass spectrometry was examined for several peptides by comparing its speed and accuracy with automated Edman degradation. Tandem mass spectrometry was used to determine the structure of the NH2-terminal blocked peptide derived from a hydroxylamine cleavage. PIMT is 226 residues with Mr = 24,500 and contains acetyl alanine as the amino terminal residue. The partial sequence (141 residues from 8 tryptic peptides) of a homologous human red cell PIMT (Gilbert, J. M., Fowler, A., Bleibaum, J., and Clarke, S. (1988) Biochemistry 27, 5227-5233) shows a 97% identity with the corresponding peptides of the bovine brain enzyme. The complete brain enzyme sequence reported here bears no significant homology to any other known class of methyltransferase including those which methylate the side chain gamma-carboxyl group of receptor proteins involved in bacterial chemotaxis. PMID- 2777771 TI - Structural studies of fertilization-associated carbohydrate-rich glycoproteins (hyosophorin) isolated from the fertilized and unfertilized eggs of flounder, Paralichthys olivaceus. Presence of a novel penta-antennary N-linked glycan chain in the tandem repeating glycopeptide unit of hyosophorin. AB - New glycoproteins of 100-120 kDa were isolated from the unfertilized eggs of flounder, Paralichthys olivaceus. Compositionally indistinguishable glycopeptides of 6 kDa were also purified from the activated or fertilized eggs. These high and low molecular mass glycoproteins are characterized by high (about 85%) carbohydrate content. Although some heterogeneities exist in the amino acid sequences, the 6-kDa glycopeptides (decapeptides with single large N-linked glycan chains), isolated from the fertilized eggs are the repeating units of the high molecular mass glycoproteins. As judged from several distinctive features the 100-120-kDa glycoproteins are apparently major components of cortical alveoli of flounder eggs and are regarded as members of glycoproteins we have defined under the name of "hyosophorin" (Kitajima, K., Inoue, S., and Inoue, Y. (1989) Dev. Biol. 132, 544-553). Composition analysis, Smith degradation, hydrazinolysis nitrous acid deamination, permethylation analysis, and 400-MHz 1H NMR spectroscopy provided evidence for the structure of a novel penta-antennary glycan chain attached to the repeating unit (decapeptide) of the protein core. The structure thus determined is: (Formula: see text). The presence of a unique class of carbohydrate-rich glycoproteins (H-hyosophorin) in the unfertilized eggs, their conversion to the repeating unit (L-hyosophorin) at fertilization, and the finding of a free glycan chain that was formed by scission between the GlcNAc and Asn residues of L-hyosophorin, in the fertilized eggs including embryos of 4-11-h postinsemination, support the view that these molecules may be important in fertilization and subsequent development. PMID- 2777772 TI - Differences in environment of FAD between NAD-dependent and O2-dependent types of rat liver xanthine dehydrogenase shown by active site probe study. AB - Rat liver deflavoxanthine dehydrogenase has been prepared by incubating native enzyme with calcium chloride. On reconstitution with FAD, about 85% of the original activity is recovered, all which is the O2-dependent type. In contrast, when dithiothreitol-treated deflavoenzyme is incubated with FAD, the recovery of activity is almost the same as above, but most of the recovered activity is of the NAD-dependent type. Deflavoenzyme with or without previous treatment with dithiothreitol was also reconstituted with two artificial FAD analogues, 8 mercapto-FAD and 6-OH-FAD. The difference spectra between the reconstituted enzymes and the initial deflavoenzyme indicate that, in each case, the FAD analogue is bound in its neutral form in dithiothreitol-treated enzyme, whereas it is bound in the anionic form in enzyme without previous dithiothreitol treatment. Furthermore, the protonated forms can be converted into the anionic forms on storage with a concomitant change of activity from the NAD-dependent to the O2-dependent type. This clearly indicates different environments around FAD in the two types of enzyme protein, which are shown to be interconvertible through oxidation-reduction of enzyme cysteinyl residues. PMID- 2777773 TI - Cyanide and methylisocyanide binding to the isolated iron-molybdenum cofactor of nitrogenase. AB - 19F NMR and x-ray absorption experiments have been performed with both the isolated FeMo cofactor and the MoFe protein of nitrogenase in search of direct evidence for substrate or inhibitor binding. Using 19F NMR as a probe and p CF3C6H4S- as the receptor ligand, the data show that the nitrogenase inhibitors CN- and CH3NC bind to the isolated FeMo cofactor-RFS- complex in N methylformamide with a finite formation constant. Their binding increases the electronic relaxation time of the complex and increases the life-time of the FeMo cofactor-p-CF3C6H4S- bond, Parallel molybdenum K edge and extended x-ray absorption fine structure experiments show that CH3NC does not bind to molybdenum. Although CO and N3- both relieve CN- and CH3NC inhibition of electron flow through nitrogenase, unlike the latter, they do not appear to bind to isolated FeMo cofactor. In experiments with the dithionite-reduced MoFe protein, we did not detect any changes in the molybdenum K edge or extended x-ray absorption fine structure spectra upon addition of CO, N2, C2H2, NaCN, CH3NC, or azide demonstrating that either these substrates and inhibitors do not bind to molybdenum or that the FeMo cofactor site of nitrogenase is inaccessible to substrate binding except under turnover conditions. PMID- 2777774 TI - Purification and characterization of a platelet-derived growth factor and heavy metal-modulated nuclear protein. AB - Platelet-derived growth factor (PDGF), fibroblast growth factor, and heavy metal salts such as sodium arsenite stimulated BALB/c-3T3 cells to synthesize a 31-kDa protein(s) (termed p31) in a concentration-dependent manner. p31 was also synthesized in response to 12-O-tetradecanoylphorbol-13-acetate (TPA). V8 protease digestion of p31 purified from PDGF-, TPA-, and arsenite-treated cells showed identical fragmentation patterns, demonstrating that these agents modulate synthesis of the same (or a highly similar) protein. TPA-induced p31 synthesis was cell cycle-specific, occurring in density-arrested but not exponentially replicating cells. p31 was readily labeled with [35S]methionine but not with [35S]cysteine. Thus it is not a metallothionein. The protein associated with nuclei. It appears to be highly hydrophobic because solubilization required detergents or organic solvents. Reverse-phase high performance liquid chromatography (HPLC) provided further evidence of hydrophobicity. p31 has been purified to homogeneity using sodium dodecyl sulfate gels with electroelution and reverse-phase HPLC. It has an isoelectric point of 6.8. Its nuclear localization and amino acid analysis demonstrate that p31 is not heme oxygenase, a 32-kDa arsenite-induced microsomal protein. Stimulation of p31 synthesis by growth factors, PDGF and fibroblast growth factor; a tumor promoter, TPA; and heavy metal salts suggests that there is overlap in the pathways for mitogenic stimulation and heavy metal stress. PMID- 2777775 TI - A rapid reaction study of anthranilate hydroxylase. Evidence for a catalytically important conformational change during slow initial turnover with anthranilate. AB - Rapid reaction kinetics of the flavoprotein anthranilate hydroxylase from Trichosporon cutaneum were examined for reactions involving anthranilate, the native substrate. As was reported earlier for the nonhydroxylated substrate analogue, salicylate, some reactions in the first turnover with anthranilate occur slower than those in subsequent turnovers (Powlowski, J., Massey, V., and Ballou, D. P. (1989) J. Biol. Chem. 264, 5606-5612). Evidence is presented for slow conformational changes that occur both on binding of the aromatic ligand and on reduction of the enzyme. These changes are apparently important for rapid anthranilate binding to occur in turnovers subsequent to the first. Moreover, bound anthranilate is required for rapid reduction of enzyme-bound FAD by NADPH. Studies to probe the accessibility of reagents to modified flavins that had been incorporated into the apoenzyme indicate that anthranilate binding causes a conformational change in the protein, allowing increased access to the benzene ring moiety of the flavin. An unusual isotope effect with (R)-NADPD (4(R)-2H] NADPH) is observed on Kd rather than on kred, which is consistent with a model involving slow interconversion of enzyme-substrate complexes before productive binding of NADPH and reduction of the enzyme flavin. PMID- 2777776 TI - Resonance Raman spectroscopy of horseradish peroxidase derivatives and intermediates with excitation in the near ultraviolet. AB - Resonance Raman enhancement of derivatives and intermediates of horseradish peroxidase in the near ultraviolet (N-band excitation) results in intensity and enhancement patterns that are different from those normally observed within the porphyrin Soret (B-band) and alpha-beta (Q-band) absorptions. In particular it allows the resolution of resonance Raman spectra of horseradish peroxidase compound I. The bands above 1300 cm-1 can be assigned to porphyrin vibrational modes that are characteristically shifted in frequency due to removal of an electron from the porphyrin ring. The resonance Raman frequency shifts follow normal mode compositions. Relative to resonance Raman spectra of compound II, the v4 frequency (primarily Ca-N) exhibits a 20 cm-1 downshift. The v2, v11, and v37 vibrational frequencies whose mode compositions are primarily porphyrin Cb-Cb, exhibit 10-20 cm-1 upshifts. The v3, v10, and v28 frequencies, whose mode compositions are primarily Ca-Cm, exhibit downshifts. The downshifts for v3 and v10 are small, 3-5 cm-1; however, the downshift for v28 is 14 cm-1. These frequency shifts are consistent with those of previously published resonance Raman studies of model compounds. In contrast to reports from other laboratories, the data presented here for horseradish peroxidase compound I can be attributed unambiguously to resonance Raman scattering from a porphyrin pi-cation radical. PMID- 2777777 TI - A novel 58-kDa protein associates with the Golgi apparatus and microtubules. AB - With the aim of identifying proteins involved in linking microtubules to other cytoplasmic structures, microtubule-binding proteins were isolated from rat liver extracts by a taxol-dependent procedure. The major non-tubulin component, a 58 kDa protein (designated 58K), was purified to homogeneity by gel filtration chromatography. To aid further characterization of 58K, purified preparations of the protein were used as immunogen for the production of monoclonal antibodies. Five different monoclonals were obtained, and each of these reacted on immunoblots of liver homogenates with a single band that comigrated with 58K. Based on the results of immunochemical, peptide mapping, and microsequencing experiments, 58K was found to be unrelated structurally to similarly sized cytoskeleton-associated proteins, such as tubulin, tau, vimentin, or keratin, and to represent a new protein species. Several in vitro properties of 58K were found to be characteristic of microtubule-associated proteins. For instance, 58K cosedimented quantitatively with microtubules out of liver extracts, stimulated polymerization of tubulin, and bound to microtubules in a saturable manner. In contrast to traditional microtubule-associated proteins, however, 58K was not found to be distributed uniformly along microtubules in cells. Immunofluorescence microscopy of cultured hepatoma cells revealed, instead, that 58K is associated principally with the Golgi apparatus. Moreover, Golgi membranes isolated from rat liver were observed by immunoblotting to contain significant levels of 58K, which, upon subfractionation of the membranes, partitioned as if it were a peripheral membrane protein exposed to the cytoplasmic side of the Golgi. These collective results have been evaluated in terms of earlier evidence that the intracellular position and structural integrity of the Golgi relies on the presence and organization of microtubules. In that context, the observations reported here suggest that the in vivo function of 58K is to provide an anchorage site for microtubules on the outer surface of the Golgi. PMID- 2777778 TI - Chloroplast ribosomal protein gene rps12 of Chlamydomonas reinhardtii. Wild-type sequence, mutation to streptomycin resistance and dependence, and function in Escherichia coli. AB - The chloroplast rps12 gene encoding ribosomal protein S12 from wild-type as well as from streptomycin-resistant and -dependent mutants of Chlamydomonas reinhardtii was cloned and sequenced. At least six mRNA transcripts ranging in size from 800 to 4800 nucleotides were found to contain the rps12 coding sequence. As in Escherichia coli and Euglena, the C. reinhardtii rps12 gene is continuous, in contrast to its trans-spliced structure in higher plants. However, rps12 of C. reinhardtii is no longer immediately adjacent to the rps7 gene encoding ribosomal protein S7 as it is in other organisms. The deduced amino acid sequence of C. reinhardtii S12 protein shows strong homologies (48-79% identity) to S12 protein sequences of other organisms, but it has extra amino acid residues at its C terminus. Single base pair changes at different sites result in streptomycin-resistant or -dependent mutants with amino acid changes identical to comparable mutations in the E. coli S12 protein. The chloroplast rps12 gene is also expressed under the control of its own promoter in E. coli cells, and the C. reinhardtii S12 protein produced assembles into the E. coli ribosomes where it appears to function efficiently. PMID- 2777779 TI - Identification of the functional promoter regions in the human gene encoding the myosin alkali light chains MLC1 and MLC3 of fast skeletal muscle. AB - The human gene encoding the alkali myosin light chains (MLC) 1 and 3 of fast skeletal muscle has been isolated. Two separate start sites for transcription have been identified by S1 analysis of muscle RNA. The nucleotide sequences of both proximal promoter regions have been determined and compared to the corresponding gene regions of other species. Several conserved promoter elements were located within 140 nucleotides upstream of the mRNA cap site, whereas further upstream no homologous sequences were found. Unidirectional 5' deletion mutants of both MLC promoters were used to direct bacterial chloramphenicol acetyltransferase activity in transient transfection assays of muscle and nonmuscle cells. Approximately 120 nucleotides of the MLC1 promoter and 80 nucleotides of the MLC3 promoter were sufficient for the transcriptional activation in primary myotubes and to a lower degree also in fibroblasts and hepatocytes. The preferential expression in muscle cells was not dependent on the conserved MLC consensus sequence, CCTTTTATAG, but it absolutely required the CCAT box or the CAT-like box in the MLC1 and MLC3 promoters, respectively. The weak activity of the MLC1 promoter was markedly enhanced in myotubes when DNA from the 3' gene flanking sequence was included in the chloramphenicol acetyltransferase constructs. PMID- 2777780 TI - Isolation and characterization of amaranthin, a lectin present in the seeds of Amaranthus caudatus, that recognizes the T- (or cryptic T)-antigen. AB - A lectin (Amaranthin) present in the seeds of Amaranthus caudatus has been isolated by fractionation on DEAE-cellulose followed by affinity chromatography on Synsorb-T beads (Gal beta 1,3GalNAc alpha-O-R-Synsorb). The lectin appeared homogeneous by gel electrophoresis at pH 4.3 and gave a single protein band by sodium dodecyl sulfate-polyacrylamide gel electrophoresis with Mr = 33,000 36,000. A native Mr = 54,000 was determined by gel filtration suggesting that amaranthin exists as a homodimer. Compositional analysis revealed high amounts of acidic and hydroxyamino acids and relatively large amounts of lysine, methionine, and tryptophan for a plant protein. Amaranthin formed a precipitate with asialo bovine submaxillary mucin, asialo-ovine submaxillary, porcine submaxillary mucin, asialo-fetuin and asialoglycophorin. Hapten inhibition of precipitate formation between amaranthin and asialo-ovine submaxillary indicated that the T disaccharide and its alpha-linked glycosides (Gal beta 1,3GalNAc alpha-O-R; R = OH, methyl, -(CH2)8-COOCH3, allyl, o-nitrophenyl, or benzyl) were the best inhibitors. N-Acetylgalactosamine, the only monosaccharide which inhibited precipitation, was 350-fold less effective than Gal beta 1,3GalNAc alpha-O-R. Hapten inhibition with derivatives of the T-disaccharide suggested that the C'-4 axial hydroxyl group of the galactosyl moiety, and the C-4 axial hydroxyl group, and the C-2 acetamido group of the GalNAc unit are the most important loci for lectin interaction. NeuAc alpha 2,3Gal beta 1,3GalNAc alpha-O-(CH2)8CO2CH3 was as potent an inhibitor as Gal beta 1,3GalNAc alpha-O-(CH2)8CO2-CH3, and amaranthin was precipitated by NeuAc alpha 2,3Gal beta 1,3GalNAc alpha-O-BSA (where BSA is bovine serum albumin), indicating that the amaranthin-combining site tolerates substitutions at the C'-3 hydroxyl group. Amaranthin was precipitated by a Gal beta 1,3GalNAc alpha-O-BSA glycoconjugate but not by the anomeric Gal beta 1,3GalNAc beta-O-BSA glycoconjugate illustrating that the disaccharide must be linked alpha in order to interact with the lectin. Metal ions do not appear to be required for lectin activity. A study of pH dependence showed significant precipitate formation between pH 4 to 9 with a maximum at pH 5. Hapten inhibition and glycoconjugate precipitation assays were also conducted for peanut (Arachis hypogaea) agglutinin. A comparison between the carbohydrate-binding specificities of amaranthin and peanut (Arachis hypogaea) agglutinin is discussed. PMID- 2777781 TI - A regulatory element in the ApoCIII promoter that directs hepatic specific transcription binds to proteins in expressing and nonexpressing cell types. AB - To better understand the mechanisms that determine cell type-specific gene expression, we have examined the transcriptional activity of a 13-nucleotide long sequence element, designated C3P, located in the promoter of the apoCIII gene. We demonstrate that this element is required for high levels of apoCIII gene expression in hepatic cells and is sufficient to determine hepatic specific expression when introduced into a heterologous promoter. A protein was identified in hepatic cell nuclear extracts, designated AF-1, that binds to this sequence and is presumably responsible for its transcriptional activity in hepatic cells. Even though the C3P element is not active in HeLa cells, a protein with C3P binding specificity was identified in HeLa cell nuclear extracts. While the HeLa protein is similar to the hepatic AF-1 in its binding specificity and relative abundance, it has approximately twice the molecular weight of the hepatic protein, indicating that they are different proteins or different forms of the same protein. A variety of murine tissue types, including those that do not express the apoCIII gene, were found to contain C3P binding proteins. We conclude that the cell type-specific activity of the C3P element is not due to the absence of C3P binding proteins in nonexpressing cells but is the result of qualitative differences in C3P binding proteins in different cell types. PMID- 2777782 TI - Dephosphorylation of cofilin accompanies heat shock-induced nuclear accumulation of cofilin. AB - Cofilin is a widely distributed 21-kDa actin-modulating protein that forms intranuclear actin/cofilin rods in cultured fibroblastic cells exposed to heat shock or 10% dimethyl sulfoxide. In this study, cofilin was shown to be phosphorylated on a serine residue in cultured rat fibroblastic 3Y1 cells. Two dimensional gel electrophoresis revealed that about 50% of the cofilin was phosphorylated in 3Y1 cells at 37 degrees C. Exposure of the cells to heat shock at 43 degrees C induced dephosphorylation of cofilin. The dephosphorylation of cofilin was detected about 30 min after the temperature shift and was completed within 120 min. Moreover, treatment of cells with 10% dimethyl sulfoxide also caused the dephosphorylation of cofilin. However, incubation of the cells with an isotonic NaCl solution, which induced cytoplasmic actin/cofilin rods, did not induce dephosphorylation of cofilin. Other cellular stress agents such as 6% ethanol or 50 microM sodium arsenite, which caused some heat shock responses in cells, did not induce dephosphorylation of cofilin. Thus, cofilin dephosphorylation was closely correlated with its nuclear accumulation. Incubation of the enucleated 3Y1 cells at 43 degrees C still induced dephosphorylation of cofilin, suggesting that the dephosphorylation occurred mostly in the cytoplasm in intact cells. It is likely that cofilin is dephosphorylated in the cytoplasm prior to its nuclear accumulation. PMID- 2777783 TI - Complete activation of protein kinase C by an antipeptide antibody directed against the pseudosubstrate prototope. AB - It has been proposed that the regulatory domain of protein kinase C contains a pseudosubstrate site between amino acid residues 19 and 36 (House, C., and Kemp, B. E. (1987) Science 238, 1726-1728). Antiserum raised against this peptide sequence has now been shown to completely activate protein kinase C in the absence of calcium and phospholipids. Pre-clearing the antiserum with resin immobilized pseudosubstrate peptide eliminates the ability of the serum to activate protein kinase C. Activation is not the result of degradation of the enzyme to a calcium- and phospholipid-independent fragment; the activated protein kinase remains intact. Although there are minor sequence differences in the pseudosubstrate region, the three principal protein kinase C isoforms (alpha, beta, and gamma) are recognized and apparently activated by the same pseudosubstrate antiserum. These results provide strong evidence that the pseudosubstrate region, presumably by interacting with the substrate binding site, is responsible for maintaining the catalytic domain in an inactive state. We propose that incubation of protein kinase C with the pseudosubstrate antiserum renders the catalytic domain accessible to protein substrates in a manner analogous to the conformational changes induced by physiological activators such as phospholipids. PMID- 2777784 TI - Purification and characterization of trehalase inhibitor from hemolymph of the American cockroach, Periplaneta americana. AB - An endogenous proteinaceous inhibitor of trehalase (alpha,alpha-trehalose-1 glucohydrolase: EC 3.2.1.28) has been isolated and purified from the serum of resting adult American cockroaches, Periplaneta americana. Purification procedures involved decreasing ionic strength, gel filtration, and reversed phase high performance liquid chromatography. Homogeneity was confirmed by polyacrylamide gel electrophoresis and end group analysis. The purified protein inhibited trehalase activity in a dose-dependent manner and was estimated to have a molecular weight of 86,000 and to contain sugar chains. An automated gas-phase sequencer was used to determine the following sequence for the N-terminal amino acid residues: H-Ala-Ilu-Pro-Thr-Pro-His-Val-Tyr-Lys-Val-X-Val-Pro-Asp-Gly-Ala-Le u-Asn-Asp. PMID- 2777785 TI - A synthetic peptide containing the IKVAV sequence from the A chain of laminin mediates cell attachment, migration, and neurite outgrowth. AB - Laminin is a basement membrane glycoprotein which consists of A, B1, and B2 chains. Laminin has diverse biological activities including promoting cell adhesion, migration, differentiation, growth, and neurite extension. Synthetic peptides from the active region of the A chain were prepared and tested for their biological activity. A 19-mer peptide (designated PA22-2), from just above the carboxyl globule on the long arm of the A chain, was found to promote cell adhesion, spreading, migration, and neurite outgrowth. By testing smaller sequences within the 19-mer peptide, a constituent pentapeptide, IKVAV (Ile-Lys Val-Ala-Val), was identified as the active site for cell adhesion and neurite outgrowth. These data suggest that this sequence is one of the principle sites in laminin which regulate cellular behavior. PMID- 2777786 TI - Purification of the bovine rod outer segment Na+/Ca2+ exchanger. AB - Optimal conditions for solubilization and stabilization of the Na+/Ca2+ exchanger from rod outer segments were examined. The exchanger was found to be most stable at low detergent concentrations (7.5 mM 3-[(3-cholamidopropyl)dimethylammonio]-1 propane-sulfonate), greater than or equal to 100 mM NaCl, pH 7.0-7.5, and with 0.1% added soybean asolectin. The sulfhydryl-modifying reagent, dithiothreitol, caused a loss of exchanger activity and was omitted throughout the purification procedure. These conditions were used to purify the Na+/Ca2+ exchanger from rod outer segments by a combination of selective solubilization, ion exchange, and wheat germ agglutinin chromatography. The procedure achieves a 336-fold increase in exchanger specific activity. The presence of exchanger activity most closely correlates with a polypeptide of molecular mass 215-kDa. Exchanger activity in both the crude rod outer segments and the purified exchanger is specifically dependent upon the presence of K+ in the assay medium; neither choline nor Li+ can substitute for K+. PMID- 2777787 TI - Regulation of the rabbit cytochrome P-450 3c gene. Age-dependent expression and transcriptional activation by rifampicin. AB - The macrolide antibiotic rifampicin is a potent inducer of cytochrome P-450 mediated drug metabolism in humans and rabbits. In this report, we demonstrate that in immature rabbits, rifampicin activates the transcription of the Cyp3A6 gene which encodes P450IIIA6 (cytochrome P-450 3c). The maximum increase in transcription was seen at 12 h following administration of rifampicin. Northern and slot blot analyses indicate that mRNAs corresponding to P450IIIA6 accumulates during the period of increased transcription and persist at 18 h when the rate of transcription has returned to basal levels. P450IIIA6 protein accumulates in liver microsomes over this period. At 24 h a greater than 10-fold increase in microsomal P450IIIA6 protein is detected by immunoblotting using a monoclonal antibody to P450IIIA6. The rate of microsomal progesterone 6 beta-hydroxylase activity is also elevated when compared to untreated rabbits, and this enzyme is activated in vitro by alpha-naphthoflavone. To determine whether this enzyme is stimulated by alpha-naphthoflavone in intact cells, COS-1 cells were transfected with an expression vector harboring the coding region of a P450IIIA6 cDNA. Our results demonstrate that the transfected COS-1 cells exhibit progesterone 6 beta hydroxylase activity that is stimulated by alpha-naphthoflavone added to the culture medium. PMID- 2777788 TI - Mono-sulfated globopentaosylceramide from human kidney. AB - A novel sulfated glycosphingolipid that belongs to the "globo-series" was isolated from human kidney. This lipid was purified from a pooled kidney preparation by chloroform/methanol extraction, mild alkaline treatment, DEAE Sephadex and silicic acid column chromatographies, and preparative thin layer chromatography. The structure and the properties were studied by infrared spectroscopy, two-dimensional proton magnetic resonance spectroscopy, negative secondary ion mass spectrometry, solvolysis, compositional and methylation analyses, monoclonal antibodies, and sulfatide-binding proteins. From the results of the above analyses, the structure of this glycolipid was proposed to be HSO3 3Gal beta 1-3GalNAc beta 1-3Gal alpha 1-4Gal beta 1-4Glc beta 1-1ceramide. The proton resonance at 3.93 ppm of the H-3 of the sulfated nonreducing terminal galactose of this lipid was downfield-shifted (delta 0.48 ppm), as compared with H-3 of the internal beta-galactose because of the electronegativity of the sulfate ester. This sulfated lipid reacted with a monoclonal anti-SSEA-3 (MC-631) (Kannagi, R., Cochran, N. A., Ishigami, F., Hakomori, S., Andrews, P. W., Knowles, B. B., and Solter, D. (1983) EMBO J. 2, 2355-2361), whose epitope is R 3GalNAc beta 1-3Gal alpha 1-4Gal beta 1-R', on thin layer chromatograms and solid phase radioimmunoassay. This lipid also bound to the 125I-labeled sulfatide binding protein, thrombospondin. The yield of this sulfated glycolipid was 0.19 nmol/g of tissue, which was about 0.09 and 0.5 mol % of galactosyl and lactosyl sulfatides in human kidney. PMID- 2777789 TI - Characterization of the promoter region and 3' end of the human insulin receptor gene. AB - The insulin receptor is an essential protein present on the surface of virtually all cells. Little is known about the control of the level of this protein on cellular surfaces, but it has been found that the level of insulin receptor protein correlates roughly with the level of insulin receptor (IR) gene transcripts within cells. Although the protein-encoding region is only about 4000 base pairs (bps), there are multiple species of IR mRNA ranging in size from 5400 to 9400 bps. We have found that the variation in size of these transcripts is due to multiple 3' ends, presumably reflecting alternative polyadenylation, so that the final IR exon ranges in size from 1400 to 5400 bps. The IR gene promoter is like other housekeeping promoters in that it has no TATA or CAAT boxes, is extremely GC-rich, and has multiple transcriptional initiation sites primarily within a 300-bp GC-rich region. Reporter gene analysis using IR promoter chloramphenicol acetyltransferase (HIRcat) fusion plasmids established regions responsible for promoter activity and verified the localization of the major IR gene transcriptional initiation sites. However, transfection with HIRcat plasmids containing regions from -153 to -1818 resulted in increased utilization of the most 5' IR gene mRNA initiation sites in transfected relative to untransfected cells. Reporter gene analysis also established that a region of the IR promoter and first exon containing all of the transcriptional initiation sites is more active in HepG2 than CV1 cells. Because the steady-state level of expression of the IR gene is much higher in HepG2 than CV1 cells, the results of the reporter gene analysis may reflect tissue-specific differences in IR gene transcription. Such tissue-specific transcriptional regulation would be a novel finding in a housekeeping promoter. PMID- 2777790 TI - Alternative cleavage of the cachectin/tumor necrosis factor propeptide results in a larger, inactive form of secreted protein. AB - Cachectin/tumor necrosis factor is initially synthesized as a 26 kilodalton prohormone. This molecule is 76 (human) or 79 (mouse) amino acids longer than the mature protein, as a result of additional residues present at the amino terminus. A short hydrophobic stretch of amino acids serves to anchor the prohormone in lipid bilayers; the mature protein, as well as a partially processed form of the hormone, are secreted after cleavage of the propeptide. We have analyzed the cleavage of the murine propeptide as it occurs in RAW 264.7 cells and now report that scission occurs at a site within the propeptide fragment, 10 residues before the amino-terminal leucine of the mature protein. This incompletely processed form of the molecule also begins with a leucine residue. Although secreted as a soluble product, it is biologically inactive in the L-929 cell cytotoxicity assay. PMID- 2777791 TI - Membrane protein changes in an L1210 leukemia cell line with a translocation defect in the methotrexate-tetrahydrofolate cofactor transport carrier. AB - We report on membrane protein changes in an L1210 leukemia cell line with a highly specific defect in the function of the methotrexate (MTX)-tetrahydrofolate cofactor transport carrier. This clonal line, MTXrA, made 100-fold resistant to MTX, was derived in a single step and exhibited stable resistance over 120 generations in the absence of drug. The transport defect was associated with a 10 fold decrease in influx Vmax without a change in influx Km. There was no difference between the MTXrA and parent lines in the levels or affinities of specific cell surface binders for MTX nor in the labeling of the 44-kDa membrane protein upon treatment with the specific affinity label, N-hydroxysuccinimide ester of tritiated MTX. Consistent with impaired carrier function was the observation that trans-stimulation of MTX influx by intracellular 5 formyltetrahydrofolate observed in the parent line was not demonstrated in the MTXrA line. The transport defect was highly specific for the MTX-tetrahydrofolate cofactor transport carrier. Initial uptake rates for 5-fluoro-2'-deoxyuridine and 2-deoxyglucose were unchanged and influx and net transport of alpha aminoisobutyric acid were, in fact, increased. There was no cross-resistance of this line to phenylalanine mustard or cytosine arabinoside, agents that utilize specific amino acid and nucleoside transport carriers, respectively. SDS polyacrylamide gel electrophoresis of purified plasma membrane preparations stained with Coomassie Blue revealed several protein differences between the parental and MTXrA lines. Most prominent is a band at approximately 190 kDa which ran with slightly greater mobility than a lesser staining band in the parent line. [3H]Borohydride labeling of cells also identified a distinct protein peak in the MTXrA line at approximately 190 kDa eliminated by prior treatment of cells with neuraminidase. Absence of expression of protein or mRNA related to the multidrug resistance gene as well as lack of cross-resistance to daunorubicin or trimetrexate indicate that this mechanism of resistance to MTX is completely unrelated to the multidrug resistance phenomenon observed with high molecular weight heterocyclic compounds. These data represent the first demonstration of membrane protein differences in a highly resistant L1210 murine leukemia cell line with a marked unique defect in MTX transport which appears to be related to impaired mobility of the tetrahydrofolate-cofactor carrier. Further studies are now required to elucidate the possible role of one or more of these proteins in the transport defect. PMID- 2777792 TI - Troponin I switching in the developing heart. AB - Monoclonal antibodies identify two distinct isoforms of troponin I in rat cardiac muscle, one predominant in the embryonic and fetal heart and one predominant in the adult heart. The two isoforms can be resolved by sodium dodecyl sulfate polyacrylamide gel electrophoresis, with apparent molecular weights of 27,000 and 31,500, respectively. The adult isoform is specifically recognized by a monoclonal antibody that is unreactive with the embryonic variant, while two other monoclonal antibodies recognize both isoforms. A monoclonal antibody to cardiac troponin T was used to isolate by affinity chromatography the troponin complex from adult and neonatal rat heart. Affinity purified troponin from neonatal heart was found to contain both the embryonic and adult isoforms of troponin I. Comparative immunoblotting analysis with different muscle tissues shows that embryonic troponin I is identical with respect to electrophoretic mobility and pattern of immunoreactivity to the major troponin I isoform found in adult slow skeletal muscle. Troponin I switching may be implicated in developmental changes involving Ca2+ and pH sensitivity of the contractile system and response to beta-adrenergic stimulation. PMID- 2777793 TI - Molecular cloning and nucleotide sequence of cDNAs encoding the precursors of rat long chain acyl-coenzyme A, short chain acyl-coenzyme A, and isovaleryl-coenzyme A dehydrogenases. Sequence homology of four enzymes of the acyl-CoA dehydrogenase family. AB - cDNAs encoding the entire coding regions of the precursors (p) of rat long chain acyl-CoA (LCAD), short chain acyl-CoA (SCAD) and isovaleryl-CoA dehydrogenase (IVD) have been cloned and sequenced. Three cDNAs for rat liver LCAD together cover a 1440-base pair region. These cDNAs encode the entire 430-amino acid sequence of pLCAD, including the 30-amino acid leader peptide and the 400-amino acid mature LCAD. A single 1773 base pair cDNA for rat SCAD covers the entire coding region (414 amino acids), including the 26-amino acid leader peptide and the 388-amino acid mature peptide. Four identified IVD cDNAs, when combined, encompass a 2104 base region, and encode 424 amino acids including a 30-amino acid leader peptide and the 394-amino acid mature peptide. The identities of all cDNA clones have been confirmed by matching the amino acid sequences predicted from the respective cDNAs to the amino-terminal and tryptic peptide sequences derived from the corresponding purified rat enzyme. Comparison of the sequences of four rat acyl-CoA dehydrogenases, including LCAD, MCAD, SCAD, and IVD, and two of their human counterparts (MCAD and SCAD) reveals a high degree of homology (57 invariant and 92 near invariant residues: 30.6-35.4% of identical residues in pairwise comparisons), suggesting that these enzymes belong to a gene family and have evolved from a common ancestral gene. PMID- 2777794 TI - A thermodynamic study of the interaction of tubulin with colchicine site ligands. AB - The bicyclic colchicine analogue 2-methoxy-5-(2',3',4'-trimethoxyphenyl)-2,4,6 cycloheptatrien-1-on e (MTC) has been used to study the thermodynamics of specific ligand binding to the colchicine site of tubulin, employing isothermal reaction microcalorimetry. The binding of MTC to purified calf brain tubulin, in 10 mM sodium phosphate buffer, pH 7.0, is characterized by delta H degree = -19 +/- 1 kJ.mol-1, delta G degree = -31.8 +/- 0.6 kJ.mol-1, and delta S degree = 43 +/- 5 J.mol-1.K-1 at 298 K, with a slight variation in the temperature range from 283 to 308 K. The binding thermodynamics of colchicine and allocolchicine are similar to MTC under the conditions examined, suggesting related molecular interactions of the three ligands with the protein binding site. The standard enthalpy changes of binding of colchicine and MTC at 308 K coincide within experimental error. Therefore the more favorable free energy change of binding of colchicine must come from a larger binding entropy change (by about 20 J.mol-1.K 1). This difference could be attributed to the presence of the middle ring of colchicine, which is absent in MTC. Consistently, a similar entropy change is observed by the comparison of allocolchicine to MTC binding at several temperatures. In addition, allocolchicine binding is about 6 kJ.mol-1 less exothermic than MTC binding, which could be attributed to the presence in allocolchicine of a substituted phenyl ring instead of the colchicine-MTC tropolone ring. The present results and analysis are fully compatible with the previously proposed bifunctional binding of colchicine and MTC (through their trimethoxybenzene and tropolone moieties) to a bifocal protein binding site, and also with a partial immobilization of intramolecular rotation of MTC upon binding, which in colchicine is already constrained by its middle ring (Andreu, J. M., Gorbunoff, M. J., Lee, J. C., and Timasheff, S. (1984) Biochemistry 23, 1742-1752). PMID- 2777795 TI - Identification of angiotensin-(1-7) in rat brain. Evidence for differential processing of angiotensin peptides. AB - Tissue and plasma forms of angiotensin (Ang) peptides were characterized by reverse-phase high performance liquid chromatography and three specific radioimmunoassays. This method allowed resolution of 10 Ang peptides and revealed distinctive distributions for the three principal Ang peptides in the brain, adrenal gland, and plasma. In extracts from the rat hypothalamus, approximately equimolar amounts of Ang-(1-7), Ang-II, and Ang-I were detected (1.10, 1.18, and 1.45 pmol/g of tissue, respectively). A similar profile was observed in the medulla oblongata and amygdala, although the content of these three peptides was 40-70% less than that seen in the hypothalamus. In the adrenal gland, the predominant peptide was Ang-II (1.07 pmol/g); levels of Ang-(1-7) (0.19 pmol/g) and Ang-I (0.14 pmol/g) were approximately 20% that of Ang-II. In plasma, the major angiotensin was Ang-I (0.13 pmol/ml), with lower levels of Ang-(1-7) and Ang-II (0.01-0.02 pmol/ml). This study is the first demonstration of the endogenous presence of Ang-(1-7) in central and peripheral tissues of the rat. Moreover, the data suggest tissue-specific processing of angiotensins, with Ang (1-7) being a predominant Ang peptide in the central nervous system. In light of the recent biological properties described for this peptide, Ang-(1-7) may represent an active member of Ang peptides in the brain. PMID- 2777796 TI - Rat granulosa cell apolipoprotein E secretion. Regulation by cell cholesterol. AB - We have demonstrated previously that cultured rat ovarian granulosa cells synthesize and secrete apoE, and this production of apoE is increased by agents that stimulate protein kinase A (cyclic AMP-dependent enzyme) (for example, cholera toxin) and protein kinase C (Ca2+/phospholipid-dependent enzyme) (for example, 12-O-tetradecanoylphorbol-13-acetate, a phorbol ester). In the studies presented in this report, we have examined the effect of changes in cell cholesterol synthesis on the production of apoE by rat ovarian granulosa cells. Mevinolin, an inhibitor of hydroxymethylglutaryl (HMG)-CoA reductase (the rate limiting enzyme in cholesterol synthesis), and 4,4,10 beta-trimethyl-trans-decal 3 beta-ol, an inhibitor of squalene cyclization, both attenuate the cholera toxin or 12-O-tetradecanoylphorbol-13-acetate stimulation of granulosa cell apoE secretion and apoE mRNA content in a dose-responsive manner. The inhibitory effect of mevinolin is reversed by the concomitant administration of mevalolactone, which provides the cells with the product of the reaction catalyzed by HMG-CoA reductase. Steroidogenesis per se has no effect on apoE production. Aminoglutethimide, which blocks the rate-limiting step in steroidogenesis, has no effect on apoE or apoE mRNA. The data indicate that products of HMG-CoA reductase (isoprenes, cholesterol and/or cholesterol metabolites) are required along with stimulators of protein kinases A and C, to regulate ovarian granulosa cell apoE production. PMID- 2777798 TI - Sequence of the gene for murine complement component C4. AB - The gene for murine complement component C4 lies in the S region of the murine major histocompatibility (H-2) complex; in this paper, we report the nucleotide sequence of this gene. The present sequence extends from a SmaI restriction enzyme cleavage site near the 5' end of the gene to a KpnI restriction enzyme cleavage site 569 nucleotides 3' of the polyadenylation site. The sequence spans 15,956 base pairs and together with previously reported data provides a complete sequence extending from the site of transcriptional initiation to the polyadenylation site. The sequence reveals that the C4 gene has 40 introns which range from 75 to 1089 base pairs in length and which include three murine B1 middle repetitive elements, a MT repeat element, and an apparently novel repeat sequence that is also found in noncoding regions of the murine beta glucuronidase, lymphotoxin (TNF-beta), and rat alpha-crystallin genes. An intron splits the protein coding sequence precisely at the site of proteolytic activation of C4 by complement protease C1s; however, except for this one case, the intron positions show no striking relationship to the structural features of the C4 protein. The length of the murine C4 gene relative to the isotypic C4A and C4B genes in man suggests the independent loss of a 6-kilobase intron from both murine and human C4 genes. PMID- 2777797 TI - Isolation and sequence of cDNA clones encoding rat phosphatidylinositol transfer protein. AB - Phosphatidylinositol (PtdIns) transfer protein is a cytosolic protein that catalyzes the transfer of PtdIns between membranes. It is expressed in organisms from yeast to man, and activity has been found in all animal tissues examined. Using antibodies prepared against bovine brain PtdIns transfer protein, lambda gt11 rat brain cDNA libraries were screened and several clones isolated. DNA sequence analysis showed that the cDNAs encoded a polypeptide of 271 amino acids with a mass of 31,911 Da. Comparison of the deduced amino acid sequence with N terminal sequence data obtained for the intact purified bovine brain protein and rat lung phospholipid transfer protein verified that the cDNAs were PtdIns transfer protein clones. The predicted protein shows no significant sequence similarity to other known (phospholipid)-binding proteins. DNA blot hybridization suggests that the rat genome may contain more than one gene encoding PtdIns transfer protein. RNA blot hybridization reveals that the PtdIns transfer protein gene is expressed at low levels in a wide variety of rat tissues; all tissues examined showed a major mRNA component of 1.9 kilobases and a minor component of 3.4 kilobases. The isolation of clones encoding rat PtdIns transfer protein will greatly facilitate studies of the structure and function of PtdIns transfer proteins and their role in lipid metabolism. PMID- 2777799 TI - The effects of E7 and E11 mutations on the kinetics of ligand binding to R state human hemoglobin. AB - Association and dissociation rate constants for O2, CO, and methyl isocyanide binding to native and distal pocket mutants of R state human hemoglobin were measured using ligand displacement and partial photolysis techniques. Individual rate constants for the alpha and beta subunits were resolved by comparisons between the kinetic behavior of the native and mutant proteins. His-E7 was replaced with Gly and Gln in both alpha and beta subunits and with Phe in beta subunits alone. In separate experiments Val-E11 was replaced with Ala, Leu, and Ile in each globin chain. The parameters describing ligand binding to R state alpha subunits are sensitive to the size and polarity of the amino acids at positions E7 and E11. The distal histidine in this subunit inhibits the bimolecular rate of binding of both O2 and CO, sterically hinders bound CO and methyl isocyanide, and stabilizes bound O2 by hydrogen bonding. The Val-E11 side chain in alpha chains also appears to be part of the kinetic barrier to O2 and CO binding since substitution with Ala causes approximately 10-fold increases in the association rate constants for the binding of these diatomic ligands. However, substitution of Val-E11 by Ile produces only small decreases in the rates of ligand binding to alpha subunits. For R state beta subunits, the bimolecular rates of O2 and CO binding are intrinsically large, approximately 2-5-fold greater than those for alpha subunits, and with the exception of Val-E11----Ile mutation, little affected by substitutions at either the E7 or E11 positions. For the beta Val-E11----Ile mutant the association rate and equilibrium constants for all three ligands decreased 10-50-fold. All of these results agree with Shaanan's conclusions that the distal pocket in liganded beta subunits is more open whereas in alpha subunits bound ligands are more sterically hindered by adjacent distal residues (Shaanan, B. (1983) J. Mol. Biol. 171, 31-59). In the case of O2 binding to alpha subunits, the unfavorable steric effects are compensated by the formation of a hydrogen bond between the nitrogen atom of His-E7 and bound dioxygen. PMID- 2777800 TI - Analysis of a recycling-impaired mutant of low density lipoprotein receptor in familial hypercholesterolemia. AB - A mutant low density lipoprotein (LDL) receptor with abnormal ligand binding and recycling abilities was found in a patient with familial hypercholesterolemia. The molecular weights of the precursor and the mature form of the receptor were 72,000 and 115,000, respectively, which were about 45,000 smaller than those of the normal receptor. The mutant receptor was concluded to be present on the cell surface because the mature form was susceptible to Pronase digestion, and specific monoclonal antibody against the LDL receptor (IgG-C7) could bind to the cell surface. This mutant receptor could not bind LDL, but could bind other ligands for the LDL receptor, beta-migrating very low density lipoprotein, and the apolipoprotein E-lipid complex. After the receptor bound to the ligand, it disappeared from the cell surface of the mutant cells faster than that of normal cells, showing that, in the mutant cells, the receptor was not efficiently recycled back to the cell surface. Southern blotting of the genomic DNA from the patient showed a large deletion of about 12 kilobases around the epidermal growth factor precursor homology domain. For further characterization of the mutant, we cloned a 9.4-kilobase EcoRI/XbaI fragment, which was expected to contain the deletion joint. Mapping and sequencing analyses of the receptor gene showed that exons 7-14 were deleted. The nucleotide sequence suggested that this mutation may have occurred by recombination between repetitive Alu sequences in introns 6 and 14 of the receptor gene. The recombination brought about a complete deletion of the gene coding the epidermal growth factor precursor homology domain. The characteristics of the receptor protein produced by this mutation were similar to those of an artificial mutation constructed by Davis et al. (Davis, C. G., Goldstein, J. L., Sudhof, T. C., Anderson, R. G. W., Russell, D. W., and Brown, M. S. (1987) Nature 326, 760-765) in which the whole gene coding this domain was deleted. The clinical phenotype of the patient having this mutation was similar to that of so-called "receptor-defective" type familial hypercholesterolemia, in which cells show detectable, but markedly reduced activity of the LDL receptor. PMID- 2777801 TI - Circular dichroism studies on synthetic signal peptides indicate beta conformation as a common structural feature in highly hydrophobic environment. AB - The conformations of synthetic peptides corresponding to signal sequences of chicken lysozyme and Escherichia coli proteins alkaline phosphatase and lipoprotein (wild-type) and their "variants" with a charged amino acid in the hydrophobic region, have been studied by circular dichroism spectroscopy in trifluoroethanol and micelles of sodium dodecyl sulfate, Brij 35, and sodium deoxycholate. In trifluoroethanol and aqueous mixtures of trifluoroethanol, the "wild-type" and variant signal sequences show similar conformational behavior. The wild-type signal peptides show increasing amounts of beta-structure going from sodium dodecyl sulfate to deoxycholate micelles (i.e. increasing order of hydrophobicity). The variant signal sequences, however, are largely unordered in micelles. The absence of beta-structure in variant signal sequences which do not initiate protein translocation across membranes, strongly suggests that the ability of signal sequences to adopt beta-structure in a highly hydrophobic environment is important for function. PMID- 2777802 TI - Restrained least squares refinement of native (calcium) and cadmium-substituted carp parvalbumin using X-ray crystallographic data at 1.6-A resolution. AB - Carp parvalbumin coordinates calcium through one carbonyl oxygen atom and the oxygen-containing side chains of 5 amino acid residues, or 4 residues and a water molecule, in a helix-loop-helix structural motif. Other calcium-binding proteins, including calmodulin and troponin C, also possess this unique calcium-binding design, which is designated EF-hand or calmodulin fold. Parvalbumin has two such sites, labeled CD and EF. Each of the calcium-binding sites of refined structures of proteins belonging to this group has a 7-oxygen coordination sphere except those of the structure of parvalbumin as it was reported in 1975. This structure had been refined at 1.9 A using difference Fourier techniques on film data. The CD site appeared to be 6-coordinate and the EF site 8-coordinate. Results of NMR experiments using 113Cd-substituted parvalbumin, however, indicate that the sites are similar to one another with coordination number greater than 6. To resolve the inconsistency between crystallographic and NMR results, 1.6 A area detector data was collected for native and cadmium-substituted parvalbumin; the structures have been refined to R factors of 18.7% and 16.4%, respectively, with acceptable geometry and low errors in atomic coordinates. Differences between the parvalbumin structure described in 1975 and the present structure are addressed, including the discovery of 7-coordination for both the CD and EF sites. PMID- 2777803 TI - Antistasin, a leech-derived inhibitor of factor Xa. Kinetic analysis of enzyme inhibition and identification of the reactive site. AB - Antistasin is a 119-amino acid protein isolated from the salivary glands of the Mexican leech Haementeria officinalis. The determination of the primary structure of antistasin revealed that the protein is highly disulfide-bonded with a 2-fold internal homology. Antistasin exhibits a potent anticoagulant activity purportedly due to the selective inhibition of Factor Xa (Tuszinsky, G. P., Gasic, T. B., and Gasic, G. J. (1987) J. Biol. chem. 262, 9718-9723). In the present study a detailed kinetic analysis of the inhibitory interaction between antistasin and Factor Xa was performed. In addition, the specificity of antistasin was examined by testing its ability to inhibit a variety of serine proteinases. Utilizing purified antistasin and a tripetidyl p-nitroanilide substrate, antistasin was shown to act as a reversible inhibitor of Factor Xa which exhibits slow-tight binding kinetics. Antistasin reacts stoichiometrically with Factor Xa with inhibition displaying a mixed, primarily competitive type. The inhibition is partial in the presence of Ca2+ and becomes complete in the absence of Ca2+. The estimated dissociation constant for the enzyme-inhibitor complex is between 0.31 and 0.62 nM. After binding to Factor Xa, antistasin is cleaved at a single site to yield a modified inhibitor. Automated gas-phase sequence analysis of the modified inhibitor indicates the arginine residue at position 34 in antistasin occupies the P1 position of the reactive site. These data indicate that the leech has evolved a highly selective and potent inhibitor of coagulation Factor Xa that shares several mechanistic similarities with other serine proteinase inhibitors. PMID- 2777804 TI - Cloning and characterization of the mouse gene that encodes the peptide core of secretory granule proteoglycans and expression of this gene in transfected rat-1 fibroblasts. AB - A mouse liver genomic library was probed with a 450-base pair AccI----3' gene specific fragment of a mouse bone marrow-derived mast cell proteoglycan cDNA to isolate 15-18-kilobase (kb) genomic clones containing the gene that encodes the peptide core of mouse secretory granule proteoglycans. Based on the nucleotide sequences of its 2.0-3.5-kb subcloned fragments, this mouse gene consists of three exons. The first exon contains 41 base pairs of untranslated nucleotides that are present in the 5' region of the transcript and also encodes the hydrophobic 25-amino acid signal peptide. The second exon encodes a 48-amino acid sequence that would be predicted to be the N terminus of the peptide core after the signal peptide has been removed in the endoplasmic reticulum. The third exon encodes a 79-amino acid sequence that includes the 15 amino acids immediately preceding an alternating serine-glycine 21-amino acid sequence for glycosaminoglycan attachment, and the subsequent C-terminal 43 amino acids; this exon also contains the 424 untranslated nucleotides present in the 3' region of the transcript. Primer extension and S1 nuclease protection analyses were performed to determine the transcription initiation site of the mouse gene. Rat-1 fibroblasts were cotransfected with the selectable marker pSV2 neo and a lambda clone (lambda MG-PG1) to obtain two rat-1 fibroblast cell lines that had the mouse secretory granule proteoglycan gene integrated into their genomes. RNA blot analysis of both cell lines revealed the presence of the 1.0-kb secretory granule proteoglycan peptide core mRNA transcript, indicating that lambda MG-PG1 contained the entire mouse secretory granule proteoglycan peptide core gene including some of the regulatory elements in its promoter region. The gene that encodes the peptide core of mouse secretory granule proteoglycans is the first proteoglycan gene to have its complete exon/intron organization determined and to be transfected and expressed in another cell type. PMID- 2777805 TI - Nature of thrombin-induced sustained increase in cytosolic calcium concentration in cultured endothelial cells. AB - It has recently been appreciated that thrombin induces the retraction of endothelial cells resulting in an alteration of the integrity of the monolayers. We studied thrombin-induced changes in cytosolic calcium concentration (Ca2+i) using microfluorometry of fura-2-loaded single cells, cell topography (scanning electron microscopy), and cytoskeleton (rhodamine phalloidin) in endothelial cells. Thrombin caused an initial and sustained phase of an increase in Ca2+i. Pretreatment with pertussis toxin abolished both phases of Ca2+i response. Sustained phase of thrombin effect required extracellular calcium. Pretreatment of endothelial cells with indomethacin protracted the sustained phase, whereas a lipoxygenase inhibitor, nordihydroguaiaretic acid curtailed it. Thrombin caused a marked retraction of confluent endothelial cells coincident with the sustained phase of Ca2+i response. This was paralleled by the formation of gaps in F-actin distribution at the periphery of the cells. Pretreatment of endothelial cells with nordihydroguaiaretic acid blunted the thrombin-induced cell retraction. Microinjection of various putative messengers into the endothelial cells showed that initial Ca2+ mobilization is not sufficient to account for sustained elevation of Ca2+i. The sustained response required microinjection of phospholipase A2 or co-injection of phospholipase A2 with phosphatidylinositol 4,5-bisphosphate-specific phospholipase C, phosphatidylinositol 1,4,5 trisphosphate, or CaCl2, further implying that thrombin receptor(s) can be coupled to both phospholipases C and A2. Sustained elevation of Ca2+i was a necessary prerequisite for the thrombin-induced changes in endothelial cell topography. PMID- 2777806 TI - Isolation and characterization of a cDNA clone encoding the lima bean lectin. AB - The complete amino acid sequence of the lima bean (Phaseolus lunatus) lectin was deduced from the nucleotide sequence of a cDNA clone. The lectin appears to be synthesized as a prepeptide consisting of a signal sequence of 21 residues and a mature protein of 241 amino acids. Comparison of the lima bean lectin sequence to the sequences of other leguminous seed lectins indicates regions of extensive homology. Northern blot analysis showed absence of lectin mRNA in the leaves, roots, or stems of 16-day-old lima bean plants. PMID- 2777807 TI - cDNA cloning and expression of oxysterol-binding protein, an oligomer with a potential leucine zipper. AB - Feedback repression of the genes encoding the low density lipoprotein receptor and several enzymes of the cholesterol biosynthetic pathway is mediated by 25 hydroxycholesterol and other oxysterols. In this study, we have cloned a rabbit cDNA encoding an oxysterol-binding protein that may play a role in this regulation. The predicted amino acid sequence revealed a protein of 809 amino acids with two distinctive features: 1) a glycine- and alanine-rich region (63% of 80 residues) at the NH2 terminus, and 2) a 35-residue leucine zipper motif that may mediate the previously observed oligomerization of the protein. When transfected into simian COS cells, the rabbit cDNA produced a protein that exhibited the same affinity and specificity for sterols as the previously purified hamster liver protein. Immunoblotting analysis showed that the rabbit cDNA encodes both the 96- and 101-kilodalton forms of the oxysterol-binding protein that were previously observed. The availability of an expressible cDNA for the oxysterol-binding protein should help elucidate its role in sterol metabolism. PMID- 2777808 TI - Temperature-dependent expression of a collagen splicing defect in the fibroblasts of a patient with Ehlers-Danlos syndrome type VII. AB - In this article we report the characterization of the molecular lesion in a patient with Ehlers-Danlos syndrome Type VII and provide evidence that a de novo substitution of the last nucleotide of exon 6 in one allele of the pro-alpha 2(I) collagen gene produces normally spliced mRNA and transcripts from which exon 6 sequences have been outspliced as well. Unexpectedly, the expression of the alternative splicing was found to be temperature-dependent, for missplicing in cellula is effectively abolished at 31 degrees C and gradually increases to 100% at 39 degrees C. In contrast, in a similar patient harboring a substitution in the obligatory GT dinucleotide of the 5' splice site of intron 6, complete outsplicing of exon 6 sequences was found at all temperatures. PMID- 2777809 TI - Microtubules are involved in the secretion of proteins at the apical cell surface of the polarized epithelial cell, Madin-Darby canine kidney. AB - Microtubule-disrupting drugs (nocodazole, colchicine) and cytochalasin D, which inhibits the polymerization of the actin microfilaments, were used to study the role of the cytoskeleton in protein secretion in the polarized Madin-Darby canine kidney (MDCK) epithelial cells. Two proteins were analyzed. The gp 80 glycoprotein complex, which in untreated cells is sorted into the apical pathway and lysozyme, which is released randomly at both cell surfaces in transfected MDCK cells. Our results show that cytochalasin D has no influence on the transport of the gp 80 complex and lysozyme to either cell surface. However, in the presence of nocodazole or colchicine the secretion of both proteins at the apical cell surface is reduced by 50% with a concomitant increase in the basolateral release. These data suggest that microtubules are necessary for an efficient secretion of proteins at the apical cell surface of MDCK cells. In regard to the yet unresolved discrepancy concerning the involvement of microtubules in the transport of membrane proteins to the apical surface of MDCK cells, our results are consistent with the data of Rindler et al. (Rindler, M. J., Ivanov, I. E., and Sabatini, D. D. (1987) J. Cell. Biol. 104, 231-241) who observed a nonpolarized delivery of the influenza virus hemagglutinin in the presence of nocodazole or colchicine. PMID- 2777810 TI - Mechanism of genotoxicity of diethylstilbestrol in vivo. AB - Diethylstilbestrol (DES) is a carcinogen in humans and rodents which has eluded mechanistic clarification of its carcinogenic action. In vitro and in vivo, binding of DES to DNA has been found previously, but covalent DNA adducts could not be identified. In this study, the nature of binding was investigated by 32P postlabeling, a rapid and highly sensitive assay for covalent DNA damage, to distinguish between a genotoxic or epigenetic mechanism of carcinogenesis by DES. A unique and distinct DNA adduct pattern was observed in kidney, liver, uterus (or testes) of female (or male, respectively) Syrian hamsters treated with a single injection of DES (200 mg/kg body weight). This set of DNA adducts closely matched patterns generated in vitro by reaction of diethylstilbestrol-4',4'' quinone with DNA or 2'-deoxyguanosine 3'-monophosphate. The major and several minor DES-DNA adducts in vivo had identical chromatographic mobilities in 11 different solvent systems with corresponding adducts obtained in vitro. The major adduct spot, generated in vitro by reaction of diethylstilbestrol-4',4''-quinone and DNA, was chemically unstable (half-life at 37 degrees C: 4-5 days). The persistence in vivo of these DNA modifications was low (biological half-life: 14 h) presumably because of chemical instability in concert with DNA repair. After injection of identical dosages of DES, adduct concentrations were 4-6-fold higher in females than in males. These results demonstrate that DES is capable of covalently modifying DNA. Moreover, diethylstilbestrol-4',4"-quinone is the major reactive metabolic intermediate responsible for the genotoxic activity of DES. Tumors are expected to arise only in rapidly dividing cells due to the short biological lifetimes of DES-DNA adducts. PMID- 2777811 TI - Renaturation of ovotransferrin under two-step conditions allowing primary folding of the fully reduced form and the subsequent regeneration of the intramolecular disulfides. AB - A two-step procedure was found to be useful for the efficient refolding of a complex protein, ovotransferrin. In the first step, the reduced and denatured form of the protein was incubated at a low temperature in a nondenaturing buffer containing reduced glutathione; in the second step, the reduced form was reoxidized at a higher temperature in the presence of oxidized glutathione. Under these conditions, the fully reduced forms of ovotransferrin and its half molecules were almost quantitatively reoxidized to regain iron-binding abilities and conformations, very similar to the native form. The circular dichroism spectra revealed that at low temperatures the fully reduced forms have partially folded conformations, which are fluctuating like "molten globule" states. The reoxidization kinetics compared between whole ovotransferrin and the two half molecules supported independent refolding of the N- and C-terminal domains. PMID- 2777812 TI - Chromatin aggregation depends on the anion species of the salts. AB - The effects of anions on chromatin aggregation may be classified into three categories. First, monovalent anions, glutamate, acetate, chloride, and thiocyante, follow the lyotropic series in their effects on both H1 histone displacement and chromatin aggregation. Second, alkyl carboxylates and dicarboxylates differ in their ability to induce chromatin aggregation depending on charge density, suggesting possible interference by bulky alkyl chains with neutralization (screening) of closely spaced positive protein charges. Third, the multivalent anions, citrate3- and SO4(2-), bind tightly to histone and disrupt nucleosomes and thus interfere with chromatin aggregation. Substantial differences in chromatin aggregation were observed with different species of anions. At salt concentrations of 0-500 mN and pH 7.0, as much as 70% of the chromatin could be induced to aggregate by monosodium glutamate and sodium acetate, whereas only 10% or less was precipitated by NaSCN, Na2SO4, and Na3citrate. The physiological anion composition of the nucleus is not known; however, the anion effects discussed in the present work suggest a potential for regulation of chromatin condensation in higher eukaryotes. PMID- 2777813 TI - Structural and functional analysis of an enhancer GPEI having a phorbol 12-O tetradecanoate 13-acetate responsive element-like sequence found in the rat glutathione transferase P gene. AB - We have recently identified a typical enhancer, termed GPEI, located about 2.5 kilobases upstream from the transcription initiation site of the rat glutathione transferase P gene. Analyses of 5' and 3' deletion mutants revealed that the cis acting sequence of GPEI contained the phorbol 12-O-tetradecanoate 13-acetate responsive element (TRE)-like sequence in it. For the maximal activity, however, GPEI required an adjacent upstream sequence of about 19 base pairs in addition to the TRE-like sequence. With the DNA binding gel-shift assay, we could detect protein(s) that specifically binds to the TRE-like sequence of GPEI fragment, which was possibly c-jun.c-fos complex or a similar protein complex. The sequence immediately upstream of the TRE-like sequence did not have any activity by itself, but augmented the latter activity by about 5-fold. PMID- 2777814 TI - A dense core vesicle protein is restricted to the cortex of granules in the exocrine atrial gland of Aplysia california. AB - We have generated a monoclonal antibody (mAb) 5E10 which recognizes an antigen localized to dense core vesicles (DCVs) in the atrial gland of Aplysia californica. mAb5E10 immunoprecipitates an abundant 57-kDa glycoprotein (atrial gland granule-specific antigen, AGSA) which is a soluble component of atrial gland DCVs. Electron microscopy reveals that AGSA immunoreactivity is restricted to the region between the dense core, which contains neuropeptide immunoreactivity, and the membrane of atrial gland DCVs. AGSA was purified by immunoaffinity chromatography, and the amino acid sequences of both N-terminal and internal cyanogen bromide fragments were determined. This information was used to isolate a 2.8-kilobase cDNA which encodes a 47-kDa protein. The predicted amino acid sequence contains the micro-sequenced peptides, an N-terminal hydrophobic signal sequence, and four N-linked glycosylation sites, but does not contain any significant homologies to database sequences. Northern blots and light level immunocytochemistry demonstrate that the AGSA gene is specifically expressed in the atrial gland. The identification of a protein localized to the cortex of DCVs suggests that this region has a specialized role in the function of these vesicles. PMID- 2777815 TI - Stimulation of collagen gene expression by ascorbic acid in cultured human fibroblasts. A role for lipid peroxidation? AB - Ascorbic acid stimulates collagen gene expression in cultural fibroblasts (Lyons, B. L., and Schwartz, R. L. (1984) Nucleic Acids Res. 12, 2569-2579), but the mechanisms responsible for this effect are poorly understood. In the presence of the transitional metal iron, ascorbic acid could induce lipid peroxidation with the formation of reactive aldehydes. Since another aldehyde, acetaldehyde, the first metabolite of ethanol, also stimulates collagen transcription in cultured fibroblasts (Brenner, D. A., and Chojkier, M. (1987) J. Biol. Chem 262, 17690 17696), we investigated whether ascorbic acid induces lipid peroxidation in cultured cells and if this is the mechanism by which ascorbic acid stimulates collagen gene expression. Ascorbic acid (0.2 mM) induced lipid peroxidation in cultured human fibroblasts judging by the production of thiobarbituric acid reactive substances and carbonyl groups, and by the presence of malondialdehyde- and 4-hydroxynonenal-protein adducts. Ascorbic acid stimulated (2-3-fold) the net production of collagen relative to total proteins, the levels of procollagen alpha 1 (I) mRNA and the transcription of this gene. Inhibition of the ascorbic acid-induced lipid peroxidation in cultured human fibroblasts with alpha tocopherol (50 microM) or methylene blue (10 microM) prevented the stimulation of collagen gene expression. The addition of malondialdehyde (200 microM), a product of lipid peroxidation, to cultured human fibroblasts also increased 2-3-fold collagen production and procollagen alpha 1 (I) mRNA levels. Thus, ascorbic acid induces lipid peroxidation and reactive aldehydes and this step may be necessary for the stimulation of collagen gene expression by ascorbic acid in cultured human fibroblasts. PMID- 2777816 TI - The relative effects of collagen fiber orientation, porosity, density, and mineralization on bone strength. AB - This investigation determined the relative importance of collagen fiber orientation, porosity, density, and mineralization in determining the tensile strength of bovine cortical bone. Thirty-nine specimens were tested for failure stress and the values of eight histologic and compositional parameters: collagen fiber orientation, wet and dry apparent density, percent mineralization of the bone matrix, and several components of porosity (Haversian canals, Volkmann's canals, and plexiform vascular spaces). Linear regression analysis showed that collagen fiber orientation was consistently the single best predictor of strength. Mineralization of the bone matrix was generally a poor predictor of strength. Density and porosity ranked between these variables in importance. Multiple regression equations containing all significantly correlated variables achieved correlation coefficients of 0.607 for plexiform bone and 0.881 for osteonal bone. Also, separate analysis of plexiform and osteonal specimens showed that the latter group was weaker even though it was less porous, apparently because it had collagen fibers which were less longitudinally oriented. This study suggests it is feasible to develop better empirical formulae for the prediction of cortical bone strength than are currently available if a variety of variables is introduced. Additional data are needed to confirm these results. PMID- 2777817 TI - Biomechanical analyses of surgical correction techniques in idiopathic scoliosis: significance of bi-planar characteristics of scoliotic spines. AB - Biomechanical analyses of Harrington distraction, Harrington distraction compression, Cotrel and Luque correction techniques simulated mechanically on a three-dimensional mathematical model of scoliotic spines are developed and relationships between mechanical forces and achievable corrections are derived in terms of Cobb angle, vertebral inclination from the frontal plane, and bi-plane bending stiffness of motion segments. For all four systems, nomograms between Cobb angles and corrective forces with correction factors as parameters are prepared in terms of given bi-plane characteristics of scoliotic spines. Parametric studies to show the influence of the torsion plane bending stiffness of motion segments and vertebral inclinations from the frontal plane on the mechanical effectiveness of the surgical correction techniques are presented. The mechanical effectiveness of each of the four surgical correction techniques determined with the use of this model compares reasonably well with the clinical findings. PMID- 2777818 TI - Postural kinematics of trumpet playing. AB - This paper examines the effects of anthropometry on body posture of trumpeters playing in standing position. Sixteen virtuosi trumpeters were photographed while hitting three notes (low C, high F and high F sustained) during performance of musical tasks. Initial standing posture and anthropometric data were recorded. Six body segment angles were computed and a vectorial sum was obtained to describe whole body posture in neutral and playing conditions. Horn angle and dental overbite were also computed. Earlier results showed that the musical task has no effect on playing posture. One-way ANOVA showed notable differences between the neutral posture and the note-related playing postures. A multiple regression model showed that in addition to the note effect, anthropometric variables, mainly neck length, explain the changes in playing posture. Horn angle is determined by the dental overbite. The importance of the anthropometric variables in playing the more demanding notes indicate that anthropometry may act to constrain trumpeters' performance. PMID- 2777820 TI - Sensitivity of temporomandibular joint force calculations to errors in muscle force measurements. AB - A two-dimensional, five-muscle model was used to determine the degree of precision required for accurate calculation of temporomandibular joint force magnitude and direction. The sensitivity of the calculations to each variable were assessed by incrementing each variable through its presumed biological range and were expressed as rate of change in the joint force per unit change in each variable. Sensitivity of the calculations to variables depends upon both bite force direction and bite position. The bite force direction with maximum precision for joint force magnitude produced minimal precision for joint force direction. The accuracy needed for each muscle force varied greatly. The effect of error for each muscle parameter depended upon the magnitude, direction, and moment arm length of the muscle force relative to those of the resultant muscle force. If each of the five muscle forces was known to the nearest 1% of total muscle force magnitude, 1 degree of muscle force direction, and 1 mm of moment arm length, temporomandibular joint force magnitude could be calculated to the nearest 4 kg and joint force direction to the nearest 7 degrees. It is not known whether this precision for the muscle forces is possible. PMID- 2777819 TI - The measurement of afterload, vascular input impedance, and power distribution in aorto-femoral bypass. AB - The effects of aorto-femoral bypass grafts on the vascular input impedance, and the ratio of pulsatile to total power were studied in eight dogs. Unilateral ileo femoral stenosis was simulated and comparisons were made between the input impedance and power distribution in healthy and simulated disease situations. Input impedance magnitude spectra and phase were displayed graphically and it was shown that the presence of the simulated disease increases the ratio of pulsatile to total power as measured in the abdominal aorta from 7.5 to 14.8% (p less than 0.05). This suggests that the presence of the stenosis creates an impedance mismatch thus causing reflected waves to propagate proximally towards the heart. It was concluded that the way in which the heart transfers fluid power into the arterial bed was compromised by the presence of the ileo-femoral partial stenoses. It is further suggested that the system described in the paper makes it possible to quantitatively assess afterload, vascular input impedance and cardiovascular power distribution as a quasi-real time diagnostic procedure. PMID- 2777821 TI - Strain rate dependence of the mechanical properties of reindeer antler and the cumulative damage model of bone fracture. AB - Carter and Caler have produced a 'cumulative damage' model for the fracture of bone, based on creep experiments on human bone, which has been corroborated by monotonic tensile tests on bone, loaded at various strain rates. Monotonic tensile tests on reindeer's antler, which has a lower modulus of elasticity than human bone, produce very similar results. Unlike human bone, reindeer antler always shows a large post-yield strain, and it is possible to distinguish pre yield and post-yield behaviour. The 'final stiffness' (ultimate stress/ultimate strain) is invariant with strain rate. This is confirmation that bone fractures when a certain amount of damage has accumulated. However, reindeer antler shows a considerable post-yield increase in stress. This is difficult to accommodate in a cumulative damage model. PMID- 2777822 TI - Linear propagation of pulsatile waves in viscoelastic tubes. AB - An experimental and theoretical analysis is made of pulsatile wave propagation in deformable latex tubes as a model of the propagation of pressure pulses in arteries. A quasi one-dimensional linear model is used in which, in particular, attention is paid to the viscous phenomena in fluid and tube wall. The agreement between experimental and theoretical results is satisfactory. It appeared that the viscoelastic behaviour of the tube wall dominates the damping of the pressure pulse. Several linear models are used to describe the wall behaviour. No significant differences between the results of these models were found. PMID- 2777823 TI - The effect of constraint on the mechanical behaviour of trabecular bone specimens. AB - The effect of the boundary conditions between trabecular bone specimens and the test columns of the testing machine was studied together with the effect of side constraint on the mechanical behaviour of trabecular bone during axial compression. Cylindrical specimens taken from the upper tibial epiphysis of autopsy knees were tested non-destructively by cyclic compression to 0.8% strain under different conditions. Fixation of the specimens to the test columns by a thin layer of bone cement increased the stiffness by 40% and reduced the energy dissipation to 67% of those measured under unconstrained conditions (p less than 0.001). The thin cement layer alone increased the stiffness 19% and reduced energy dissipation to 86% (n.s.). When the machine was equipped with polished steel columns coated by a film of low-viscous oil, both the stiffness and the energy dissipation were reduced to 93% of those measured under standard conditions (p less than 0.005). Trabecular bone specimens tested side-constrained by the surrounding trabecular bone (in situ) showed a 19% larger stiffness than that measured during later testing of the corresponding machined specimens (p less than 0.005) whereas the energy dissipation was not altered significantly. The same specimens showed a 22% increase of stiffness and a 68% increase of energy dissipation when they were side-constrained by a closely fitting steel cylinder (p less than 0.005). PMID- 2777824 TI - Pressure drop and flow rate measurements in a human aortic bifurcation cast for steady and pulsatile flow. AB - Pressure drop and flow rate measurements in a rigid cast of a human aortic bifurcation under both steady and physiological pulsatile flow conditions are reported. Integral momentum and mechanical energy balances are used to calculate impedance, spatially averaged wall shear stress and viscous dissipation rate from the data. In the daughter branches, steady flow impedance is within 30% of the Poiseuille flow prediction, while pulsatile flow impedance is within a factor of 2 of fully developed, oscillatory, straight tube flow theory (Womersley theory). Estimates of wall shear stress are in accord with measurements obtained from velocity profiles. Mean pressure drop and viscous dissipation rate are elevated in pulsatile flow relative to steady flow at the mean flow rate, and the exponents of their Reynolds number dependence are in accord with available theory. PMID- 2777825 TI - An investigation of Bioglass powders: quality assurance test procedure and test criteria. AB - Bioglass, in bulk form, has been used to bond to the body's hard and soft tissues in many surgical and dental applications over the past 18 years. There is also a large potential use of Bioglass, in powder or paste from, to fill irregular shaped bony defects caused by local or systemic disease, congenital malformations, or trauma in the fields of otolaryngology and dental sciences. A quality assurance test procedure to analyze powdered Bioglass to guarantee that the bioactivity of the glass has been maintained during manufacturing was developed. Herein states the quality assurance test procedure, test variables, and test criteria to assure the bioactivity of Bioglass powders made from known bioactive bulk Bioglass samples. Also described herein is the path taken to develop the test procedure and test criteria and experiments performed to study the test variables. PMID- 2777826 TI - Elastic properties and strength of a novel small-diameter, compliant polyurethane vascular graft. AB - Tensile properties and pressure-diameter-axial force relations of a newly developed small-diameter arterial graft were determined and compared to those of commercially available grafts and natural arteries. The material was synthesized from 4,4'-diphenylmethane diisocyanate, polytetramethylene glycol, and polyethylene oxide, chain-extended with ethylene glycol. Porous conduits (3-mm internal diameter) were fabricated of this material by means of a phase separation technique, and their outer surfaces were covered with woolly polyester net in order to prevent excessive dilation. Mechanical tests indicated that the polyurethane graft has distensibility and strength similar to that of natural arteries, and has been proved to be useful for the arterial reconstruction, particularly for the replacement of small-diameter blood vessels. PMID- 2777827 TI - Fatigue properties of acrylic bone cement: S-N, P-N, and P-S-N data. PMID- 2777828 TI - Fatigue of acrylic bone cement--effect of frequency and environment. AB - This study was conducted to investigate some fundamental fatigue testing variables as they apply to the response characteristics of acrylic bone cement. Cyclic loading under load control was conducted at frequencies of 1, 2, 5, 10, and 20 Hz in air at room temperature. At a tensile stress range of 0.3-20.0 MPa the fatigue life increased linearly with logarithmic frequency. The effect of conditioning and testing in saline at both room temperature and 37 degrees C at similar stress levels and a frequency of 10 Hz were also examined. When compared to dry testing at room temperature, testing in saline at 37 degrees C resulted in a reduction in fatigue life while testing in saline at room temperature produced an increase in fatigue life. Of a number of statistical distributions considered, the Weibull was found to be the most appropriate in documenting the findings of this investigation. A companion fractographic investigation of the failure surfaces demonstrated distinct regions of crack growth and fast fracture. PMID- 2777829 TI - Elimination of nickel, cobalt, and chromium following repeated injections of high dose metal salts. AB - A study was conducted to determine the ability of hamsters to eliminate in the urine, or store in the organs, large quantities of metal salts given over a period of several months. In addition, the effect of prior immunization on metal ion clearance was determined. The results indicated that nickel was rapidly eliminated in the urine and that the level in the organs was similar to that of control animals. Cobalt was eliminated more slowly than was nickel. The organ levels of cobalt were similar to those of control animals with a slight elevation in the liver of the injected animals. Chromium was eliminated in the urine very slowly, was red cell associated, and the levels were elevated in all the organs (liver, lung, spleen, kidney) compared to control. Prior immunization with metal salts increased the storage of chromium. PMID- 2777830 TI - Heparinizable segmented polyurethanes containing poly-amidoamine blocks. AB - A poly-ether-urea-urethane was synthesized by copolymerization of 4,4' diphenylmethanediisocyanate (MDI), propanediamine, and poly-oxytetra-methylene glycol (M.W. 1000). Two other corresponding copolymers were also synthesized by adding amino terminated poly-amidoamine macromonomers, purposely synthesized, so as to insert relatively small amounts (6 and 15 weight %) of two types of poly amidoamine segments in the final product. Of the three copolymers several physicochemical and mechanical properties have been determined, and their heparin adsorption ability, blood compatibility, and cytotoxicity evaluated. PMID- 2777831 TI - Transformation of biphasic calcium phosphate ceramics in vivo: ultrastructural and physicochemical characterization. AB - Specially prepared biphasic calcium phosphate (BCP) macroporous ceramics consisting of an intimate association of beta tricalcium phosphate (beta-TCP) and hydroxyapatite (HA) with beta-TCP/HA weight ratios of 15/85, 35/65, and 85/15 were implanted in surgically created periodontal osseous defects in dogs and recovered after 6 months. A decrease in average size of crystals in BCP ceramics and an increase in the size of microporosities in the surface and at the core of the ceramic after implantation were observed, indicating that in vivo dissolution has taken place. The resorbability (reflecting in vivo dissolution) of BCP ceramics depended on their beta-TCP/HA ratios, the higher the ratio, the greater the resorbability. The formation of microcrystals with crystallographic properties and Ca/P ratio similar to those of bone apatite crystals were also observed. The abundance of these crystals were directly related to the beta TCP/HA ratio of the BCP ceramic before implantation. The formation of the bone apatite-like crystals may be due to the precipitation of calcium and phosphate ions released from the dissolving ceramic crystals (the beta-TCP component dissolving preferentially to the HA component). Results from this study suggested that one of the means of controlling resorbability (in vivo dissolution) of BCP ceramic is by varying its beta-TCP/HA ratio. PMID- 2777832 TI - Surface characterization of the cuticle of Dirofilaria immitis. AB - The surface reactivity of the dog heartworm (D. immitis) was evaluated by comprehensive contact angle measurements and a platelet retention test. Contact angle data yielded calculated surface energy terms very similar to those previously reported for intact vascular endothelium. The platelet test revealed the native worm surface to be nonreactive, retaining fewer platelets than glass or worms whose surfaces had been modified by extraction with acid and high salt solutions. The cuticular morphology of the heartworm was studied with both light and electron microscopy, the latter coupled with ferritin-conjugated double-layer immunolabeling to reveal adsorbed host protein on the cuticle surfaces. Multiple attenuated internal reflection (MAIR) IR spectroscopy confirmed the general composition of this surface layer to be glycoproteinaceous. Morphological and histochemical studies confirmed and extended previous descriptions of nematode cuticle, adding ultrastructural detail on cortical, medial, and basal layers. A trilaminar membrane, apparently corresponding to a mammalian cell membrane (plasmalemma), constituted the external cortical layer as observed in high magnifications. The existence of a glycocalyx of varying thickness was demonstrated in ruthenium red-stained sections. MAIR IR spectra showed this glycoproteinaceous film to appear, in fully hydrated samples, as a loose biological gel. Ferritin-antibody conjugate labeling confirmed the presence of adsorbed dog albumin, dog immunoglobulin class G (IgG) and dog complement fraction 3 (C3) in the cuticular surface layer. It is likely, therefore, that D. immitis heartworms demonstrate long-term thromboresistance at least in part due to their passive low-surface-energy overcoating with host proteins. PMID- 2777833 TI - The influence of calcium phosphate ceramics and glass-ceramics on cultured cells and their surrounding media. AB - The cytotoxicity of hydroxyapatite (HA), tricalcium phosphate (TCP), and two types of apatite-containing glass-ceramics designated A.W-GC and A.W.CP-GC was evaluated by the direct contact method using V79 cells. Compatibility of the cells was assessed as a function of cellular attachment and subsequent growth using scanning electron microscopy. Although all of the tested materials have surfaces available for cellular attachment, cell growth was markedly inhibited by HA sintered at 600 degrees C and 900 degrees C, and slightly inhibited by HA sintered at 1200 degrees C, TCP and the glass-ceramics. In attempts to clarify the cause of this toxicity, the interactions of the ceramics with culture medium was assessed by measurement of calcium (Ca), inorganic phosphate (P), magnesium (Mg), pH and albumin content in the medium. The grade of toxicity corresponded to the degree of reduction of Ca, P, and albumin in the medium. Furthermore, surface reactions of the ceramics were demonstrated to vary in both mode and degree depending on their chemical structure and level of microporosity. Thus, the surface reactivity of ceramic materials should be always taken into account in discussing their biocompatibility in vivo. PMID- 2777834 TI - Effects of a grooved titanium-coated implant surface on epithelial cell behavior in vitro and in vivo. AB - The effects of a grooved titanium-coated substratum on epithelial (E) cell behavior were studied in vitro and in vivo. V-shaped grooves, 10 microns deep, were produced in silicon wafers by micromachining, a process which was developed for the fabrication of microelectronic components. The grooved substrata were replicated in epoxy resin and coated with 50 nm of titanium. More E cells were found attached to the grooved titanium surfaces than to adjacent smooth surfaces. In comparison to the smooth surfaces where clusters of E cells were randomly oriented, on the grooved surfaces, clusters of E cells were markedly oriented along the long axis of grooves. Grooved and smooth titanium-coated epoxy implants were placed percutaneously in the parietal area of rats. Electron and light microscopic observations indicated that E cells were tightly attached to the implant surfaces and this attachment is through basal lamina-like and hemidesmosome-like structures. In the grooved portion of the implant, E cells interdigitated into the grooves and had rounded nuclei. Histomorphometric measurements indicated that there was a shorter length of epithelial attachment, longer length of connective tissue attachment, and less recession in the grooved, compared to the smooth portion of implants after 7 and 10 days. These results indicate that horizontal grooves produced by micromachining can significantly impede epithelial downgrowth on titanium-coated epoxy implants. PMID- 2777835 TI - Duplex stainless steels for osteosynthesis devices. AB - The austenitic stainless steels used today for the manufacture of osteosynthesis devices are sensitive to crevice corrosion. In this study the corrosion properties of some duplex stainless steels were evaluated and compared to traditional austenitic stainless steels. According to our results the following ranking was established: 23Cr-4Ni less than AISI 316L less than ASTM F138 less than 22Cr-5Ni-3Mo less than 27Cr-31Ni-3.5Mo less than 25Cr-7Ni-4Mo-N. In particular the results showed that the high-performance 25Cr-7Ni-4Mo-N duplex stainless steel, with high molybdenum and nitrogen contents, can be considered not susceptible to crevice corrosion in the human body. The duplex stainless steels have also better mechanical properties at the same degree of cold working compared with austenitic stainless steels. Hence the 25Cr-7Ni-4Mo-N duplex stainless steel can be considered a convenient substitute of ASTM F138 for orthopedic and osteosynthesis devices. PMID- 2777836 TI - In vitro and ex vivo platelet interactions with hydrophilic-hydrophobic poly(ethylene oxide)-polystyrene multiblock copolymers. AB - Hydrophilic-hydrophobic multiblock copolymers synthesized from telechelic oligomers of poly(ethylene oxide) (PEO) and polystyrene (PS) have been used to study the influence of hydrophilic and hydrophobic balance on interfacial interactions of these surfaces with blood components. In vitro coagulation assays show no inherent ability of these amphiphilic surfaces to affect contact activation or coagulation factors. In vitro platelet adhesion and release reactions from rabbit platelet-rich plasma were shown to be greatest on Biomer and PS homopolymer surfaces and least on cross-linked PEO surfaces, with the PEO PS block copolymers demonstrating intermediate responses. These same substrates were tested in a new low-flow, low-shear arterio-artery shunt system in rabbits. Whole blood occlusion times were not a direct function of hydrophilic content as both PEO and PS homopolymers and Biomer showed short occlusion times, while PEO PS block copolymers prolonged occlusion times considerably, depending on composition. Overall, results suggest that PEO-PS block copolymers promote unique whole blood responses in contrast to homopolymer and Biomer controls which are more complex than direct correlations to bulk hydrophilic and hydrophobic contents. PMID- 2777837 TI - Proximal femoral focal deficiency. Evidence for a defect in proliferation and maturation of chondrocytes. AB - Proximal femoral focal deficiency is a rare congenital malformation, characterized by a failure of normal development of the proximal part of the femur. To our knowledge, there have been no reports on the histology of fetal growth plates that are affected by this disorder. To characterize this focal developmental anomaly further, we studied the histopathology of the growth plates and epiphyses from a twenty-one-week fetus with unilateral proximal femoral focal deficiency. Although the shape of the cartilaginous anlage of the fetus appeared normal, the growth plate of the proximal part of the involved femur was markedly abnormal. The major findings were: (1) striking failure of the proximal growth plate to migrate proximally, away from the central part of the diaphysis, and failure of formation of a normal growth plate; (2) failure of organization of proliferative and hypertrophic chondrocytes into longitudinal columns; (3) truncation of an immature hypertrophic zone that had abnormal septal architecture; and (4) disorganized vascular invasion with a honeycomb rather than a columnar pattern of primary trabeculae. In contrast, the histological characteristics of the growth plates from the distal part of the femur and from all other long bones were normal. PMID- 2777838 TI - Complications of heparin therapy after total joint arthroplasty. AB - The cases of 112 patients who were treated intravenously with heparin for thromboembolic disease after total joint arthroplasty were reviewed. The over-all frequency of bleeding complications that were associated with therapy with heparin was approximately 30 per cent. In patients who were treated within six days after total joint replacement, the frequency of bleeding complications was 45 per cent. The prevalence of bleeding problems declined to 15 per cent in patients who were treated more than one week after arthroplasty. In roughly 35 per cent of the patients, therapy with heparin had to be discontinued because of complications. Thrombocytopenia developed in fewer than 5 per cent of the patients. It was concluded that anticoagulation therapy with heparin for clinically unimportant thromboembolic problems in the immediate postoperative period is not justified. PMID- 2777839 TI - Femoral fracture during non-cemented total hip arthroplasty. AB - A study of the data on 1,318 consecutive non-cemented total hip-replacement arthroplasties revealed thirty-nine intraoperative fractures of the femur (3 per cent), only half of which were diagnosed intraoperatively. The fractures occurred in the proximal region of the femur or at the tip of the stem of the prosthesis. Most were incomplete and minimally displaced, and they did not jeopardize the stability of the femoral component. All complete proximal fractures were stabilized with a four-fifths-coated or fully coated prosthesis to provide distal fixation, and, when diagnosed intraoperatively, were fixed with cerclage wiring. When an incomplete fracture near the tip of the stem was discovered postoperatively and the posterior part of the femoral cortex was intact, a spica cast was applied, and the patient was instructed in protected weight-bearing. For a complete fracture at the tip of the stem, we recommend open reduction and internal fixation. No statistical difference was found with respect to residual pain, the score for walking, or the stability of the implant when we compared the results for the patients who had a fracture with those for the patients who did not. Modifications in surgical technique resulted in a decrease in the incidence of fractures (p less than 0.05). PMID- 2777840 TI - Osteochondral fractures of the dome of the talus. AB - Twenty-four patients who had an osteochondral fracture of the dome of the talus were examined by plain radiography, magnetic resonance imaging, computerized tomography, and, when indicated, scintigraphy. When plain radiographs of the ankle are relied on for the diagnosis of an osteochondral fracture of the talus, many lesions remain undiagnosed. Stage-I osteochondral fractures show no diagnostic changes on plain radiographs, and Stage-II lesions are usually subtle and, therefore, are often overlooked by both radiologists and clinicians. The use of scintigraphy as a screening procedure and of magnetic resonance imaging for patients who have positive scintiscans showed that osteochondral fractures are more common than has previously been indicated in the literature. Scintigraphy should be used to assess patients when there is clinical suspicion of an osteochondral fracture but the plain radiographs appear to be negative. Patients who have positive scintiscans should be assessed by magnetic resonance imaging. Patients who have abnormal plain radiographs will derive no major benefits from magnetic resonance imaging; for all but one of these patients, computerized tomography was adequate for staging the fracture. PMID- 2777841 TI - Fractures in patients who have myelomeningocele. AB - Thirty-seven (20 per cent) of 186 children who had myelomeningocele whose records were reviewed had sustained a total of seventy-six fractures. The frequency with which the fractures occurred was related directly to the level of neurological involvement. Thirteen (41 per cent) of the patients who had involvement at the thoracic level, fifteen (36 per cent) who had involvement at the upper lumbar level, eight (10 per cent) who had involvement at the lower lumbar level, and one (3 per cent) who had involvement at the sacral level sustained fractures. Sixty five (86 per cent) of the fractures occurred before the child was nine years old, fifty-eight (76 per cent) were judged to be secondary to the limb being in a cast, and seventy-four (97 per cent) involved the lower extremity. Eleven patients, all of whom had thoracic or upper lumbar involvement, sustained fractures of multiple extremities. All fractures of the lower extremity were distal to the level of neurological involvement; they occurred predominantly in the femur in patients who had thoracic involvement and in the tibia in patients who had lumbar involvement. All of the metaphyseal and diaphyseal fractures healed satisfactorily, whether they were treated by immobilization in a plaster cast or in a bulky Webril dressing, although there were fewer complications in the latter group. The seven fractures that involved the physeal plate were a major problem, as three (43 per cent) had delayed union and two (29 per cent) developed premature growth arrest. PMID- 2777842 TI - Chondrosarcoma of the spine. AB - Twenty patients were diagnosed as having chondrosarcoma of bone that originated in the spine and, except for one, were treated surgically at the Mayo Clinic. The patients' ages ranged from eighteen to seventy years. Pain in the area of involvement was the first symptom in nearly all patients. Nearly one-half of the patients had detected a mass before being diagnosed. In addition, nine patients had neurological symptoms and signs when they were first seen. All patients had a surgical biopsy of the lesion, often combined with decompressive laminectomy. Five patients received postoperative radiation therapy in various dosages. No patient received adjunctive chemotherapy. All but five patients died of local progression of the disease. The five-year survival rate was 55 per cent. The median length of survival was six years. Although it is rare, chondrosarcoma of the spine can usually be identified on radiographs. Preoperative assessment must include computed tomography, magnetic resonance imaging, and, possibly, arteriography to assess the precise extent of the disease. Although surgical ablation often is technically difficult, a wide excision should be attempted. If this is not obtainable, postoperative radiation therapy should be considered. PMID- 2777843 TI - Aspiration biopsy of primary neoplasms of bone. AB - Aspiration biopsy of bone is a simple and relatively safe diagnostic tool that had a diagnostic accuracy of 72 per cent in thirty-one patients who had a primary bone tumor that was suspected of being malignant and of 83 per cent in twelve patients who had a suspected giant-cell tumor. However, twenty-six primary lesions of bone that were thought likely to be benign were not as easily and definitively diagnosed (an accuracy rate of 23 per cent), and for these lesions, multiple needle-aspiration samples or open biopsy provides greater diagnostic accuracy. PMID- 2777844 TI - Surgical treatment of adolescent idiopathic scoliosis. A comparative analysis. AB - Three hundred and fifty-two patients had a one-stage posterior spinal arthrodesis between 1960 and 1984 using one of four types of instrumentation: a Harrington distraction rod, Harrington distraction and compression rods, Harrington distraction and compression rods with a device for transverse traction, and a Harrington distraction rod with sublaminar wires. All of the patients were female (age-range, eleven to nineteen years), and all had idiopathic scoliosis with a single right or double thoracic curve. The minimum length of follow-up was two years. No significant difference was found among the four groups relative to the amount of correction that was obtained at operation or maintained two years after operation. An average of 13.5 per cent of correction was lost during follow-up in the patients who were treated with postoperative immobilization, and an average of 27 per cent was lost in the patients who were treated with sublaminar wires without immobilization. The use of a straight Harrington rod reduced normal thoracic kyphosis, the addition of a compression rod corrected hyperkyphosis, and the use of a rod with sublaminar wires corrected thoracic hypokyphosis or thoracic lordosis. PMID- 2777845 TI - Comparative assessment of gait after limb-salvage procedures. AB - We performed metabolic studies of gait in eighteen patients who had had above-the knee amputation, block resection and arthrodesis of the knee, or block resection and rotationplasty for a malignant tumor of the distal end of the femur or the proximal end of the tibia. According to the measurement of consumption of oxygen, the patients who had had rotationplasty walked most efficiently. Those who had had arthrodesis used more oxygen and walked at a slower rate. PMID- 2777846 TI - Calcaneal osteotomy and tendon sling for the management of calcaneus deformity. AB - A one-stage operation for severe post-poliomyelitic calcaneus deformity was done in seventy-seven feet of seventy-seven patients. The operation consisted of osteotomizing the calcaneus to increase the lever arm and to reshape the hind part of the foot and using a posterior sling formed from the peroneus brevis and tibialis posterior to provide plantar-flexion power. We were able to evaluate sixty-six patients more than three years after the operation. Most of the patients had improvement in the appearance and function of the foot as a result of the operation. PMID- 2777847 TI - Necrosis of the skin over the metacarpal as a result of functional fracture bracing. A report of three cases. AB - Use of a functional brace for the treatment of a fracture of a metacarpal caused necrosis of the skin under the dorsal pad in three patients. In order to evaluate the mechanism of the necrosis, we made in vivo and in vitro measurements of pressures that are typically found under the pad. We found that the pressures easily exceeded 260 millimeters of mercury. Pressures of this magnitude have been shown to cause necrosis of the skin. Orthopaedic surgeons should be aware of this problem when using the brace, and perhaps a wider pad should be used to distribute the force. PMID- 2777849 TI - Post-traumatic proximal radio-ulnar synostosis. Results of surgical treatment. AB - During a period of forty-two years, twenty patients who had a post-traumatic proximal radio-ulnar synostosis were treated by excision of the area of synostosis and various concurrent procedures in an attempt to restore rotation of the forearm. The time from injury to operation averaged eighteen months, and the postoperative follow-up averaged forty months. Results were graded on the basis of improvement in the arc of rotation of the forearm. After excision of the area of synostosis in the fifteen patients for whom data were available, the intraoperative arc of passive rotation averaged 121 degrees. At the most recent follow-up, the range of active rotation averaged 55 degrees for all twenty patients. Four patients had an excellent result; three, good; four, fair; and nine, poor. The outcome of this type of surgical treatment varies, but roughly half of the patients can be benefited. PMID- 2777848 TI - Fracture of the hook of the hamate. AB - We removed the fracture fragment from fifty-nine patients who had an isolated fracture of the hook of the hamate. Preoperatively, all had complained of pain and tenderness on the ulnar side of the palm or on the dorsal ulnar aspect of the wrist. Most fractures were thought to have occurred while the patient was swinging a racquet, golf club, or baseball bat. Some fractures were caused by striking the palm on a solid object, by falling on the palm, or by a crush injury to the hand. Most of the fractures were diagnosed conclusively on a carpal tunnel roentgenogram or on a special oblique roentgenogram of the wrist supinated. We now believe that computed axial tomography is the best imaging technique for demonstrating this fracture. Except for two patients who had a crush injury, all of the patients returned to their regular occupational and athletic pursuits. There were no surgical complications. PMID- 2777850 TI - Treatment of unstable intertrochanteric and subtrochanteric fractures in elderly patients. Primary bipolar arthroplasty compared with internal fixation. AB - Thirty-seven consecutive patients who were more than seventy-five years old and had an unstable intertrochanteric or subtrochanteric fracture were treated by primary bipolar arthroplasty from 1983 through 1986. The functional results, according to the rating scale of Merle d'Aubigne, were rated as good or excellent in 75 per cent of the patients and remained almost unchanged with time. Roentgenographic follow-up showed early bone formation around the extramedullary part of the femoral component. The results in this prospective group of patients were compared with those in a similar but retrospective control group of forty two patients who were treated by internal fixation from 1979 through 1982 and in whom early full weight-bearing was not possible. In the bipolar arthroplasty group, rehabilitation was easier and faster, and the incidences of pressure sores, pulmonary infection, and atelectasis were significantly lower (p less than 0.05). The early walking with full weight-bearing that the bipolar arthroplasty made possible is considered to be a major contributing factor to these results. PMID- 2777851 TI - Epidemiology of fractures of the distal end of the radius in children as associated with growth. AB - We determined the annual incidence of fracture of the distal end of the radius for patients of all ages and both sexes in the province of Saskatchewan, using two data sets: data on hospital admissions for 1970 through 1984, and data on physician billing for 1978 through 1985. The rate of occurrence of this fracture in children, by age and sex, was compared with longitudinal data on the velocity of growth that was collected during the same time for children from the same population. We compared the incidences of the fracture with the results of studies on the levels of activity in children and adolescents during growth. We also compared the age-specific incidence of the fracture in children with the incidence in adults. For both data sets, the age at the peak incidence of fracture of the distal end of the radius almost perfectly matched the age at which peak velocity of growth in height occurs for boys and girls. For girls, the peak incidence occurred between the ages of 11.5 and 12.5 years and for boys, between 13.5 and 14.5 years; these ages corresponded to the mean peak velocity of growth at 11.9 years for girls and 14.3 years for boys. The age-adjusted incidence of the fracture in male subjects was highest at fourteen years and was not exceeded by that in female subjects until fifty-three to fifty-four years.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2777852 TI - Treatment of open fractures of the tibial shaft: Ender nailing versus external fixation. A randomized, prospective comparison. AB - A randomized, prospective study comparing Ender nailing with external fixation for open fractures of sixty-three tibiae (sixty patients) was undertaken. Ender nailing proved to be at least as effective as external fixation with respect to seven parameters: time to union, tibial alignment, total number of operations, ranges of motion of the knee and ankle, pain, presence of infection, and complications. Ender nailing is a safe alternative to external fixation for grade I and grade-II open fractures. It should not be used for comminuted fractures, which might shorten about the nails. PMID- 2777853 TI - The course of the superior gluteal nerve in the lateral approach to the hip. AB - The superior gluteal nerve and its branches were dissected bilaterally in ten cadavera. The patterns of branching and the distribution of the branches were identified. The reference point for measurements was the mid-point of the superior border of the greater trochanter. Two patterns of neural branching were thus established. The points of termination of all branches formed an arcuate pattern along the middle one-third of the deep surface of the gluteus medius muscle. The so-called safe area of the gluteus medius muscle was found to be as much as five centimeters adjacent to the greater trochanter. If this distance is not exceeded by the intramuscular incision, the risk to the superior gluteal nerve and its branches will be minimum. PMID- 2777854 TI - Tumoral calcinosis: successful medical treatment. A case report. PMID- 2777855 TI - Chylous leakage after arthrodesis using the anterior approach to the spine. Report of two cases. PMID- 2777856 TI - Transient osteoporosis of the hip of pregnancy. Two cases complicated by pathological fracture. PMID- 2777857 TI - Ewing sarcoma in a phalanx of an infant's finger. A case report. PMID- 2777858 TI - External fixation of the clavicle for fracture or non-union in adults. PMID- 2777859 TI - Hyperthermic regional perfusion using membrane- instead of bubble-oxygenators. An experimental and clinical study. AB - To achieve adequate tissue perfusion during hyperthermic regional perfusion, perfusion pressures should be maintained at near normal mean systemic arterial pressures. During experimental as well as during clinical perfusions however, unphysiologically high perfusion flows were needed to keep the perfusion pressure at the desired level. Since both high perfusion flows and high perfusion pressures have been associated with the post-operative complications such as severe edema and tissue damage, as well as with an increased leakage of perfusate to the systemic circulation, low perfusion flows have been used in regional perfusion. High perfusion flows in our previous experimental studies were attributable to a marked reduction in vascular resistance. This decrease is believed to be caused by the release of vasodilatory constituents of damaged blood cells, and it is the extra-corporeal circuit, and in particular the bubble oxygenator that is thought to be responsible. The superior haemocompatibility of membrane-oxygenators over bubble-oxygenators has been established in cardio pulmonary bypass. We compared the use of a membrane-oxygenator with that of a bubble-oxygenator in regional perfusion to see if more normal haemodynamics could be maintained and vasodilatation prevented. In the experimental as well as in the clinical perfusions the use of a bubble-oxygenator required unphysiologically high perfusion flows to maintain the perfusion pressure at the level required to obtain an adequate microcirculation. In contrast the use of a membrane-oxygenator permitted a nearly physiological perfusion flow to maintain an adequate perfusion pressure as well as an adequate micro-circulation.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2777860 TI - Relation of serum lipoproteins and lipids to the ABO blood groups in patients with intermittent claudication. AB - In the present study we investigated the serum lipoprotein and lipid levels in patients with intermittent claudication (n = 66), divided according to their blood groups in the ABO system (bloodtype A, n = 40 and bloodtype "non-A", n = 26). We again found the expected predominance of blood type A (61%). However, we found no significant differences in any of the biochemical variables between patients belonging to blood group A and "non-A". Fifty-seven of the patients had arteriographies done and the arteriograms were evaluated blindly by a radiologist according to occlusive and stenotic atherosclerotic lesions. However, as previously suggested by other investigators, we were not able to demonstrate any significant differences between the number of occlusions and stenotic lesions when dividing the patients into blood group A and "non-A". The biochemical differences between patients with either occlusive or stenotic atherosclerotic lesions were also tested and found without any significance. IN CONCLUSION: the serum lipoprotein and lipid levels in the present study do not give an obvious explanation, why patients with blood group A seem more liable to develop atherosclerosis than those with blood group "non-A". PMID- 2777861 TI - Management of internal carotid artery occlusion. AB - Although attempts to restore patency of occluded internal carotid arteries are now rarely made, endarterectomy in the contralateral artery, external carotid endarterectomy and until recently EC/IC bypass have remained surgical options in the management of such patients. Over a four-year period at this institution 104 patients underwent carotid endarterectomy for stenosis. In this group the contralateral carotid was patent (Group A). Fifty-four patients with unilateral carotid artery occlusion underwent contralateral endarterectomy (Group B), 8 underwent ECA/ICA bypass (Group C) and 4 an ECA endarterectomy (Group D). No statistically significant difference was noted in perioperative stroke and death rates for Groups A and B were (1% and 1%) and (3.7% and 1.9%) respectively. One Group C patient died from perioperative stroke (12.5%). For late events the life table adjusted annual rates for stroke and mortality were similar, Group A (stroke 2.1% and death 5%), and Group B (stroke 1.6% and death 5%). In Group C stroke rate was 10% and death 3%. All four patients undergoing ECA endarterectomy were relieved of their symptoms. It is concluded that in patients with internal carotid artery occlusion TEA may be performed with perioperative morbidity and mortality rates comparable to those when the opposite carotid artery is patent. The late outcome for stroke compares favorably with the reported natural history of the disease and outcome for such patients treated medically in the Joint Study of Extracranial Occlusion and EC-IC Bypass Study. External carotid artery endarterectomy appears useful in the treatment of embolic events on the occluded side. ECA/ICA bypass does not appear to confer benefit. PMID- 2777862 TI - Acute or delayed surgical treatment of traumatic rupture of the descending aorta. AB - During a 20 year period, 33 patients with traumatic rupture of the descending thoracic aorta were operated upon. In the absence of an indication for acute surgery our policy was to defer operation at least 4 weeks after the trauma. Six patients were operated upon within 24 hours (Group I), 5 after 4-13 days due to suspected expansion of mediastinal widening (Group IIa), 10 were operated upon electively after 4-12 weeks (Group IIb), and 12 were operated upon for chronic traumatic aneurysms (Group III). The number of operative deaths/reoperations due to bleeding were: Group I, 2/1; Group IIa, 1/2; Group IIb, 0/0; and Group III, 1/0. There were no late deaths related to the operation or the inserted prosthesis. Of 26 survivors, 21 underwent a follow-up study 1.5-20 years (mean 8.2 years) postoperatively. Except for 6 patients with paralysis of the left recurrent laryngeal nerve none of the patients had sequelae which could be related to the operation or the inserted prosthesis. CT-scanning of the chest revealed neither pseudoaneurysms nor significant stenosis in the suture lines or prosthetic areas. The results indicate that delayed operation of traumatic thoracic aortic ruptures on selected patients may be performed with acceptable results. PMID- 2777863 TI - Prevention of spinal cord ischemia by monitoring spinal cord perfusion pressure and somatosensory evoked potentials. AB - The pressure difference between mean distal aortic pressure (MDAP) and cerebrospinal fluid pressure (CSFP), defined as relative spinal cord perfusion pressure (SCPP), and somatosensory evoked potentials (SEP) were monitored intraoperatively to detect and prevent intraoperative ischemic spinal cord injury in 19 patients who required cross-clamping of the descending thoracic aorta. Temporary axillo-femoral shunt utilizing a 10 mm woven Dacron tube graft was employed in 10 patients and partial cardiopulmonary bypass in nine. Ischemic SEP changes were seen in five patients. Two patients, whose SCPPs were 32 and 35 mmHg, experienced the complete loss of SEP and developed paraplegia. In the other three cases, increase of MDAP and/or withdrawal of cerebrospinal fluid (CSF) were performed to increase the SCPP to more than 40 mmHg when ischemic SEP changes occurred. SEP gradually recovered in two cases. The other patient underwent reimplantation of intercostal arteries since the ischemic SEP changes did not revert. These three patients recovered without any neurological deficit. In the other 14 cases without ischemic SEP changes, SCPP was kept at more than 40 mmHg during aortic cross-clamping. We conclude that the maintenance of SCPP at more than 40 mmHg by increasing MDAP and/or withdrawing CSF is an effective procedure in preventing postoperative paraplegia. PMID- 2777864 TI - Abdominal aortic aneurysms. Risk factors and complications and their influence on indication for operation. AB - From January 1982 to June 1986 475 patients underwent operation for abdominal aortic aneurysm (AAA) with reconstruction by tube graft or bifurcation graft. Patients were subdivided into 2 groups, those operated upon either electively or those operated upon urgently. The overall hospital mortality following elective intervention was 4.9%, following emergency intervention 36.5%. In patients operated upon electively preoperative risk factors such as history of myocardial infarction or coronary artery disease did not influence mortality. In patients operated upon urgently, however, the postoperative mortality was significantly higher (p less than 0.005) in those with a history of myocardial infarction or coronary artery disease. Postoperative morbidity in the emergency group (2.7 complications per patient) was significantly higher than in the elective group (0.94 complications per patient). These results show that early elective operation on asymptomatic aneurysms and younger patients with few risk factors can prevent rupture and reduce postoperative mortality to an acceptable level. PMID- 2777865 TI - Aorto-caval fistula: a clinical spectrum. AB - Ten cases of aortocaval fistula (ACF) associated with abdominal aortic aneurysm (AAA) were reviewed. In 5 cases the ACF became apparent after evacuation of the thrombus; only 5 patients presented with features of patent ACF. Four patients in addition presented with extra-caval rupture of the aneurysm. Based on these variables, a classification relating ACF and AAA was developed. In this series all patients were male with a mean aneurysm size of 8.5 cm. All patients required bifurcation grafts for reconstruction. A multifactorial etiology related to enlargement and rupture of all aneurysms seems to apply to ACF. Eight of 10 patients survived. Awareness of this entity and proper preparation allow for successful outcome in the treatment of this condition. PMID- 2777866 TI - Effects of cigarette smoking on outcome of femoral popliteal bypass for limb salvage. AB - A retrospective 5-year follow-up study of 83 femoral-popliteal bypass operations for severe ischemia (79 patients) is presented. There were no operative deaths. At one month, cumulative patency rates (CPR) and limb salvage rates (LSR) were 86.8% and 96.4% respectively. At 5 years, CPR, LSR and cumulative survival were 50%, 79.4% and 71.6% respectively. Post-operative smoking habits were strongly related to CPR and LSR. Smoking more than 5 cigarettes per day adversely affected CPR's. At 5 years, CPR of non-smokers and smokers of up to 5 cigarettes per day (47 patients) was 67.7% and for smokers of more than 5 cigarettes per day (32 patients) it was 44.7% (P less than 0.045). Smoking more than 15 cigarettes per day had an adverse effect on LSR's. Smokers of more than 15 cigarettes per day (17 patients) had a 5-year LSR of 58.5% compared with 89% for non-smokers and smokers of up to 15 cigarettes per day (62 patients) (P = 0.009). For 20 limbs requiring thrombectomy LSR was 100% at 1 year and 57.5% at 5 years. CPR's and LSR's were not significantly influenced by pre-operative smoking, diabetes, run off or level of distal anastomosis relative to the knee joint. Based on zero operative mortality and 96.4% limb salvage at 1 year, it is concluded that an aggressive approach toward revascularization for limb salvage is well justified in most patients.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2777867 TI - The femoropopliteal segment as a source of peripheral atheroembolism. AB - The concept of atheromatous embolisation from ulcerated plaques in non-aneurysmal arteries is well recognised but little attention has been paid to lesions in arteries below the inguinal ligament as a source of emboli. Twenty eight of 42 patients (66%) who presented with atheroembolism to the lower limbs had an embolic source in the femoropopliteal segment, with only a third with an identifiable source lesion in the aorta or iliac vessels. A characteristic clinical presentation, combined with a typical appearance on arteriography, usually allows a confident diagnosis to be made, yet many of these patients still have their ischaemic symptoms and signs wrongly attributed to occlusive disease. Successful management depends on early recognition and correction of the source lesion. The treatment of choice is a bypass procedure with appropriate vessel ligation. The majority of ischaemic lesions recover, or the damage is limited to minor digital amputations which will heal primarily. Surgical correction is successful in preventing further embolic episodes. PMID- 2777868 TI - Effect of preclotting and precoating agents on seeded venous grafts. AB - This study evaluated the effect of whole blood preclotting (WB), fibronectin (FB) and "Cell Tak" (CT) precoating on the patency rate of seeded vena cava grafts. Ten cm x 8 mm ID ringed PTFE grafts were implanted in the vena-cavae of 29 dogs. Aspirin (325 mg po qd) was administered pre-operatively and continued post operatively. After preclotting or precoating, all grafts were seeded with porcine endothelial cells. The 32 day patency rates were: 67%, 67% and 37% for WB, FB and CT, respectively (p less than 0.5 CT vs FB, WB). Endothelialized surfaces ranged from 67 +/- 35, 43 +/- 41 to 28 +/- 45% respectively for WB, FB and CT (p less than 0.05 CT vs WB). Preclotting time was shortest for WB technique. We conclude that: 1) FB and WB grafts have the highest patency rate with WB preclotting being a more cost effective and less time consuming technique; 2) endothelial seeding and Aspirin may make vena cava grafting possible. PMID- 2777869 TI - Pressure index in hypotensive or hypertensive patients. AB - Pressure index (brachial/ankle systolic pressure) has been used in vascular surgery for many years and it has been assumed that its value is independent of the systemic pressure. The purpose of this study was to determine whether this assumption is true. Two hundred patients having cardiac catheterisation were studied by measurements of aortic or brachial pressure and ankle systolic pressure using Doppler ultrasound. These measurements were done during catheterisation for cardiac investigation, during operation and in the intensive care unit. None of these patients had peripheral arterial disease. A non-linear relationship was found between the systemic pressure and the systolic ankle pressure. For systemic pressure less than 100 mmHg or greater than 200 mmHg, the ankle pressure was on average 25% lower. For systemic pressure 100 mmHg to 200 mmHg, the ankle pressure was the same or slightly higher. In conclusion, in normal limbs the PI is 1.0-1.2 when the systolic pressure is between 100 and 200 mmHg, but in patients with hypotension or hypertension, it may be less than 1.0. This is an important observation which will prevent vascular surgeons from making erroneous diagnoses of arterial disease in the presence of hypertension or hypotension. PMID- 2777870 TI - The application of a new method of limb blood flow measurement using a radioactive isotope and a gamma camera. AB - To evaluate a new method for limb blood flow measurement using a radioactive isotope and a gamma camera, blood flow measurements have ben made on 108 patients with peripheral vascular disease. Thirty-six patients had ischaemic rest pain, of whom two had previously undergone unilateral amputation. Five had bilateral symptoms, giving 29 asymptomatic limbs and 41 limbs with critical ischaemia. In 72 patients with intermittent claudication a series of exercise tests were attempted, in 33 these were unsatisfactory; 13 patients had a greater than 20% variability in the maximum walking distance between four tests and in 20 walking distance was limited by factors other than claudication. In these 33 patients the limb blood flow to the symptomatic leg was 3.95 (1.36-11.08) ml/100 ml of tissue/minute. This is not significantly different from the limb blood flow to the symptomatic leg of the 39 patients who satisfactorily completed four exercise tests, 3.75 (1.08-8.25) ml/100 ml of tissue/minute. In these 39 patients the mean pain-free walking distance was 40 metres and the mean maximum walking distance was 63 metres. The limb blood flow to the 41 symptomatic limbs of 36 patients with rest pain was 1.90 (0.90-4.49) ml/100 ml of tissue/minute, which is significantly less than that obtained in claudicants. There was a wide range of blood flow values found in the asymptomatic limbs of all the patients and in many cases the flow was markedly reduced from normal. This method of limb blood flow measurement is accurate and reproducible and may be recommended for assessment of peripheral vascular disease. PMID- 2777871 TI - Hydatid cyst fistula into the aorta. AB - A case is presented of fistula formation between a primary hydatid cyst and the abdominal aorta which we believe is the first in the world literature. The patient underwent surgery with a diagnosis of aneurysm of the coeliac trunk. During the operation the presence was discovered of a hydatid cyst opening into the aorta. It was dealt with by partial resection and closing of the communication. Three months later the patient was readmitted with a new bleeding episode which resulted in a fatal outcome. PMID- 2777872 TI - Chylous ascites following abdominal aortic aneurysmectomy: surgical management with a peritoneovenous shunt. AB - The development of chylous ascites after emergency repair of a ruptured abdominal aortic aneurysm (AAA) is an extremely rare complication with potentially grave mechanical, nutritional, and immunologic consequences. A 54-year-old man with recurrent, symptomatic chylous ascites ultimately required insertion of a peritoneovenous shunt after non-operative measures failed to provide relief. This is the fourth reported case of chylous ascites following ruptured AAA and only the second treated by peritoneovenous shunt placement. PMID- 2777873 TI - Sequential mammary artery grafts in one hundred and twenty consecutive patients: indications, operative technique, 6 months postoperative functional and angiographic controls. AB - In the hope of establishing the internal mammary artery (IMA) as a true but superior substitute for the saphenous vein (SV) we reviewed our initial experience in complex IMA grafting. The first 120 consecutive patients, having received at least one sequential IMA graft were analyzed. The length of the IMA pedicle was the only limitation imposed on its use. Technical artifices enhancing the versatility of the IMA are described. The significant peri-operative myocardial infarction rate was 3.3%. There was no cardiac operative mortality, and 1 late mortality (0.8%). Excellent functional results were illustrated by a 2.5% rate of residual angina and dyspnoea. Six months postoperative angiographic controls could be performed in 70% of the patients: all of the sequential mammary conduits were patent, as were 95% of the anastomoses. By contrast 87.2% of the concomitant venous anastomoses were still functioning. With the expanding utilization of the free graft, IMA is expected to become a true, better and all round substitute for the saphenous vein. PMID- 2777874 TI - Prospective study of feasibility of routine use of multiple internal mammary artery anastomoses. AB - A study of 100 consecutive patients requiring multiple coronary artery bypasses was undertaken to evaluate the feasibility of routine use of multiple internal mammary artery (IMA) anastomoses. In 99 patients the IMA was used and in 80 patients bilateral IMA bypasses were done. In 15 patients multiple anastomoses with a single IMA precluded the need for bilateral IMA bypasses. In only 4 patients were bilateral IMA left to be contraindicated. By combination of use of both IMAs, free grafts and sequential grafts, the IMA accounted for 70% of the 318 anastomoses in these 100 patients. Scrupulous attention to technique and the use of the operating microscope are necessary to achieve multiple IMA anastomoses. It was concluded that the IMA can be used to supply the majority of anastomoses needed for coronary artery revascularization in nearly all patients. PMID- 2777875 TI - Open-heart surgery in infants using pulsatile high-flow cardiopulmonary bypass. AB - Pulsatile high-flow cardiopulmonary bypass (2.5 l/m2/min with a rectal temperature of 28 degrees C) combined with the Pulsatile Bypass Pump (Kontron Instrument) has been used at Fukuoka Children's Hospital in 259 cases of open heart surgery in patients less than 1 year of age for a period of 5 years beginning July 1982. The overall results were satisfactory with a surgical mortality of 6.2% (VSD: 96 cases/2 deaths, TGA: 48/1, TAPVD: 34/3, Complete ECD: 15/1, IAA: 10/1, DORV: 10/1, HLHS: 7/4, TOF: 6/0, Truncus Art: 5/0, Others 28/3). The mean duration of cardiopulmonary bypass was 123 +/- 50 minutes during which time the patients had a positive water balance of only 28 +/- 38 ml per kg of body weight. The lowest positive water balance was noted in the patient group with 60-75 mmHg in peak systolic pressure and 30-45 mmHg pulse pressure divided by the pulsatile wave form. This value was significantly lower than other groups of patients with lower or higher peak systolic and pulse pressures. Urinary output during the first 24 hours after operation was 4.1 +/- 1.3 ml/kg/hour. Weight gain on the first postoperative day was 10 +/- 43 g per kg of body weight, and the duration of postoperative respiratory support was 4 +/- 5 days. In conclusion, pulsatile high-flow cardiopulmonary bypass is useful in infant open heart surgery in light of operative techniques, water balance and postoperative recovery. PMID- 2777876 TI - Inferiorly based internal mammary conduit to the circumflex coronary artery. AB - The use of an inferiorly based internal mammary artery graft is described here as a satisfactory method of achieving sufficient lengths of vessel to graft to the inferior aspect of the heart. PMID- 2777877 TI - Angiographic, electrocardiographic and surgical features of single coronary artery producing myocardial ischaemia. AB - A patient is described in whom an unstenosed single coronary artery was associated with angina and syncope. Full clinical documentation of the patient with ambulatory electrocardiography, angiography, surgical findings and stress testing before and after bypass grafting are described. PMID- 2777878 TI - Surgical treatment of anomalous origin of the left coronary artery in infancy. AB - Two cases of anomalous origin of the left coronary artery (LCA) from the pulmonary artery (PA) are reported in which early surgical correction was achieved by an end-to-end anastomosis of the left subclavian artery (LSA) to the LCA, with cardiopulmonary bypass and deep hypothermia. The clinical improvement was rapid and the left ventricular function recovered almost completely. We recommend this type of surgical correction, early in life, for infants in severe cardiac failure and anomalous origin of the LCA. PMID- 2777879 TI - Anomalous origin of right pulmonary artery from the ascending aorta. AB - Anomalous origin of one pulmonary artery from the ascending aorta without associated intracardiac defects is a rare congenital malformation. About 60 anatomic and surgical descriptions have been reported in the literature. Up to 1974, 22 of the 50 reported cases underwent surgical correction with a 40% mortality rate. The natural history without surgery is poor with a very high mortality during the first year of life. Successful anatomic correction of anomalous origin of right pulmonary artery from the ascending aorta in a 6 months old female is reported. PMID- 2777880 TI - Surgical excision of papillary endocardial tumors. PMID- 2777881 TI - Abstracts of papers presented at the twenty-ninth annual meeting of the American Society for Cell Biology. 5-9 November 1989, Houston, Texas. PMID- 2777883 TI - Abnormal fatty acid utilization by cultured cardiac cells from 7-day-old obese Zucker rats. AB - Fatty acid utilization by muscle and nonmuscle heart cells in culture has been investigated in the 7-day-old Zucker rat to determine if this tissue could contribute to the lower energy expenditure reported in obese rats at the onset of obesity. The partitioning of oleate to oxidation and esterification products and the effect of genotype on this partitioning according to cell types were studied. Results showed that the fatty acid beta-oxidation and its esterification in neutral lipid was decreased by 30% in beating muscle cells from obese animals when compared with those from lean animals. In contrast, nonmuscle cells exhibited a decreased beta-oxidation alone. A similar fatty acid composition of the phospholipids was found in non-muscle cells of obese animals and their lean litter mates. In muscle cultures, palmitic and oleic acids are lower in cells of obese rats than in those of lean rats. The present study indicates that a defect in energy metabolism could be found in heart cells at the onset of obesity, suggesting that this defect is determined by intrinisic factor(s). PMID- 2777882 TI - Stabilization by heparin of acidic fibroblast growth factor mitogenicity for human endothelial cells in vitro. AB - The effects of heparin and other glycosaminoglycans (GAGs) on the mitogenicity and stability of acidic fibroblast growth factor (aFGF) were studied. The mitogenic activity of aFGF was assayed utilizing cultured adult human endothelial cells (AHECs) isolated from iliac arteries and veins as target cells. In most experiments, aFGF purified from bovine brain was employed; in some experiments recombinant bovine aFGF was used and qualitatively similar results were obtained. In the presence of heparin, bovine aFGF at doses between 0.5 and 1.0 ng/ml (30-60 pM) elicited half the maximum AHEC growth over a 4-day period depending on the cell line tested; in the absence of heparin, significant growth was not observed at aFGF concentrations less than 10-20 ng/ml. This effect of heparin was dose dependent over the range 0.1-10 micrograms/ml (half-maximum dose, 2 micrograms/ml). The mitogenic activity of bovine aFGF for AHECs decreased by 50% after preincubation in culture medium without cells at 37 degrees C for 2 1/2 to 3 hours. In contrast, the mitogenic activity of bovine aFGF preincubated in the presence of heparin-containing culture medium without cells was dramatically stabilized (half-life 24-29 hours). These effects also were observed in serum free medium. Several GAGs structurally related to heparin such as chondroitin-4 sulfate, chondroitin-6-sulfate, dermatan sulfate, and hyaluronic acid neither potentiated nor stabilized aFGF mitogenic activity. However, heparan sulfate from bovine lung was found to be nearly as active as heparin in both these effects. These data suggest that the binding and stabilization of mitogens by extracellular and tissue-associated heparan sulfates might play important roles in the regulation of AHEC growth. PMID- 2777884 TI - Asymmetric distribution of phospholipids in the membrane of vesicles released during in vitro maturation of guinea pig reticulocytes: evidence precluding a role for "aminophospholipid translocase". AB - Guinea pig reticulocytes lose their transferrin (Tf) binding activity during maturation, in the form of vesicles (exosomes) released into the extracellular medium. Vesicles were prepared from cultures of reticulocytes to study the possible externalization of a particular membrane-associated activity, i.e., that of "aminophospholipid translocase." Analysis of the peptide composition of these vesicles revealed that the major proteins are the Tf receptor and another peptide (70kDa), which is probably the "clathrin-uncoating ATPase" described by Johnstone et al. (1987). The exosome had a lipid composition similar to erythrocyte membrane, although with a lightly but significantly lower phosphatidylethanolamine content. The aminophospholipid distribution in the vesicle membrane was determined by fluorescamine labeling. The exosomes showed an asymmetric aminophospholipid distribution similar to that of erythrocytes. "Aminophospholipid translocase" activity was absent, as no transverse diffusion of spin-labeled phospholipids occurred over more than 2 hours at 37 degrees C. PMID- 2777886 TI - HSP70-related proteins in bovine skeletal muscle. AB - Constitutive expression of HSP70-related proteins was detected in a variety of bovine tissues using a specific antibody. All tissues contained a 73 kilodalton protein. A lower molecular weight form (72 kilodaltons) that co-migrated on two dimensional gels with the stressed-induced HSP70 was present in high levels in bovine skeletal muscle, but absent from rat skeletal muscle. Two-dimensional gel analysis revealed several isoforms for both the 73 and 72 kilodalton forms. Purification of HSP70-related proteins from bovine skeletal muscle, thymus gland and rat skeletal muscle demonstrated that the antibody recognized all the forms present in the tissue homogenates. The two proteins are similar but distinct as detected by one-dimensional peptide mapping. The lower molecular form was not present in fetal tissue but was detectable in newborn animals, suggesting that the levels are regulated during development. PMID- 2777887 TI - Generation of osteoclasts from hemopoietic cells and a multipotential cell line in vitro. AB - Osteoclasts are the cells that resorb bone. It is generally presumed, on the basis of indirect experiments, that they are derived from the hemopoietic stem cell. However, this origin has never been established. We have developed an assay for osteoclastic differentiation in which bone marrow cells are incubated in liquid culture on slices of cortical bone. The bone slices are inspected in the scanning electron microscope after incubation for the presence of excavations, which are characteristic of osteoclastic activity. We have now incubated bone marrow cells at low density, or a factor-dependent mouse hemopoietic cell line (FDCP-mix A4) with 1,25 dihydroxyvitamin D3 (a hormone which we have previously found induces osteoclastic differentiation) with and without murine bone marrow stromal cells, or with and without 3T3 cells, on bone slices. Neither the bone marrow cells nor the bone marrow stromal cells alone developed osteoclastic function even in the presence of 1,25 dihydroxyvitamin D3. However, extensive excavation of the bone surface was observed, only in the presence of 1,25 dihydroxyvitamin D3, on bone slices on which bone marrow stromal cells were cocultured with low-density bone marrow cells or the hemopoietic cell line. Similar results were obtained when the bone marrow stromal cells were killed by glutaraldehyde fixation; 3T3 cells were unable to substitute for stromal cells. These results are strong evidence that osteoclasts derive from the hemopoietic stem cell and suggest that although mature osteoclasts possess neither receptors for nor responsiveness to 1,25 dihydroxyvitamin D3, the hormone induces osteoclastic function through a direct effect on hemopoietic cells rather than through some accessory cell in the bone marrow stroma. The failure of 3T3 cells, which enable differentiation of other hemopoietic progeny from this cell line, to induce osteoclastic differentiation suggests that bone marrow stroma possesses additional characteristics distinct from those that induce differentiation of other hemopoietic cells that are specifically required for osteoclastic differentiation. PMID- 2777885 TI - Protamine selectively inhibits collagen synthesis by human intestinal smooth muscle cells and other mesenchymal cells. AB - Collagen synthesis is a major function of human intestinal smooth muscle (HISM) cells and contributes to intestinal fibrosis in chronic inflammatory bowel disease. As an extension of previous in vitro studies of the role of heparin in regulating HISM cell proliferation and collagen synthesis, the effect of protamine sulfate was studied. Protamine decreased collagen production by 50% in confluent and proliferating cultures. This effect was concentration-dependent and was selective for collagen in that neither noncollagen production nor DNA accumulation in the culture plates was affected. Other human mesenchymal cells which produce collagen, such as dermal fibroblasts and aortic smooth muscle cells, responded to protamine in a similar fashion. Protamine has a strong cationic charge and is rich in lysine and arginine. To determine which of these properties was important in decreasing collagen production, the effect of protamine was compared to that of other polyionic compounds. Poly-L-lysine decreased collagen production to a lesser degree than protamine. Poly-L-arginine was toxic to the cells. Poly-L-glutamic acid, which has an opposite charge to protamine, had no effect. These findings suggest that both the number and the arrangement of lysyl residues, in addition to positive charge, are important. Binding assays demonstrated that protamine did not inhibit collagen production by binding to ascorbate in the culture medium. Electrophoretic separation and chromatography of collagen types expressed following protamine treatment showed that the ratio of type I to type III collagen remained 2:1. This observation suggests that suppression of collagen production is not specific to a particular collagen type. The selective inhibition of collagen production by protamine provides an important tool to study the regulation of collagen production in human cells and may also provide potential therapy of fibrotic disorders. PMID- 2777888 TI - Cultures of fibroblasts in fibrin lattices: models for the study of metabolic activities of the cells in physiological conditions. AB - Two techniques for fibroblast culture in three-dimensional fibrin matrices (fibrin lattices) were used to study the behavior and metabolism of cells in this physiological support. When the fibrin lattices were prepared in silicone-coated glass petri dishes, fibroblasts induced retraction of lattices to an extent dependent on both cell density and serum concentration, the cells stopped dividing, and their protein and collagen syntheses proceeded at a lower rate, like that in collagen lattices. When fibrin lattices were prepared in plastic petri dishes, the matrix attached to the walls, there was no retraction, and the protein synthesis was very active even as regards collagen. The optimal concentration of ascorbic acid in nonretracting fibrin lattices was lower (10 micrograms/ml) than in monolayers (50 micrograms/ml). The comparison of collagen and fibrin lattices showed that the collagenic nature of the lattice was not compulsory for supporting the phenomenon of retraction and that fibroblasts, when exposed to a stress in a fibrin matrix prevented from retracting, secreted far more collagen. PMID- 2777889 TI - Comparison of uptake kinetics in freshly isolated suspensions and short-term primary cultures of rat hepatocytes. AB - The apparent kinetics of uptake of various model substrates were examined for hepatocytes in suspension and primary culture up to 72 h. The ability of hepatocytes to take up taurocholate and ouabain was decreased in culture. Vmax for uptake of both substrates diminished rapidly with increasing time in culture. An increase in Km was observed in cultures 6 h after plating, but there was no further change with prolongation of culture time. The decrease of uptake of taurocholate and ouabain during culture may be due to the reduction in the number of transport carriers plus a decrease of affinity of the carrier to substrates. The nonsaturable component of cadmium uptake was much reduced in cultured cells compared with the suspensions. The saturable process was lower in 6 h culture but increased to a level comparable with the fresh cells at longer culture time. No significant change was found in the Km between suspensions and cultures. Uptake of alpha-aminoisobutyric acid was greater in culture while that of 3-O-methyl-D glucose was relatively stable but about one-half that found in cell suspension. Thus, uptake of two substrates, taurocholate and ouabain, is clearly compromised with increasing time in primary culture, while uptake of the other substrates does not reflect such a dramatic decrease. It is therefore apparent that the cell preparation of choice in uptake studies depends on the substrate and the nature of the experiments. PMID- 2777890 TI - ATP-resistant variants of transformed mouse fibroblasts. AB - Addition of ATP to cultures of transformed mouse fibroblasts, 3T6 cells, resulted in cell growth inhibition, whereas the growth of the non-transformed counterparts, 3T3 cells, was only slightly affected. The inhibition was found to be specific for adenine nucleotides, and concentration dependent. At relatively low concentrations (e.g., 1.0 mM) the effect of ATP was cytostatic, whereas at higher concentrations (e.g., 1.0 mM) a cytotoxic effect was exerted. ATP resistant variants of 3T6 cells were selected by exposure of cultures to gradually elevated concentrations of ATP. The variants were found to resemble the non-transformed counterparts, 3T3 cells, more than the 3T6 parent cells, by the following criteria: ATP-induced alterations in the membrane potential, changes in membrane permeability, cell growth inhibition, and colony formation on soft agar. The data indicate that long exposure of the transformed cells to external ATP results in redifferentiation and reduction in their tumorigenicity. PMID- 2777891 TI - Effects of platelet-derived growth factor on bone formation in vitro. AB - Platelet-derived growth factor (PDGF) is a polypeptide found in a variety of tissues, including bone, where it could act as an autologous regulator of skeletal remodeling. Therefore, a recombinant B chain homodimer of human PDGF was studied for its effects on bone formation in cultured rat calvariae. PDGF at 10 100 ng/ml stimulated [3H]thymidine incorporation into DNA by up to sixfold and increased the DNA content and the number of colcemid-induced metaphase arrested cells. This effect was observed in the fibroblast and precursor cell-rich periosteum. As a result of its mitogenic actions, PDGF enhanced [3H]proline incorporation into collagen, an effect that was observed primarily in the osteoblast-rich central bone. The effect of PDGF was not specific for collagen since it also increased noncollagen protein synthesis. In addition, PDGF increased bone collagen degradation. PDGF and insulin-like growth factor (IGF) I had additive effects on calvarial DNA synthesis, but PDGF opposed the stimulatory effect of IGF I on collagen synthesis and IGF I prevented the PDGF effect on collagen degradation. In conclusion, PDGF stimulates calvarial DNA synthesis which causes an increased number of collagen-synthesizing cells, but PDGF also enhances bone collagen degradation. PMID- 2777892 TI - Rapid deformation of "passive" polymorphonuclear leukocytes: the effects of pentoxifylline. AB - Entry times for spherical (no pseudopods) polymorphonuclear leukocytes (PMNs) into a 4 microns micropipet have been measured as a function of pipet suction pressure (2,500-20,000 dyn/cm2) and concentration of the drug pentoxifylline (PTX, 0.1-10.0 mM). For control cells (0 mM PTX), entry rates (reciprocal entry times) increased almost linearly with increasing suction pressure, indicating a Newtonian-like behavior. With incubation in PTX solutions, entry rate vs. suction pressure became increasingly non-linear, suggesting a shear-thinning effect for the dissipative structure. At a given suction pressure the rate of entry showed a dose-dependent increase with increasing PTX concentration, the effect being most pronounced at high suction pressures (20,000 dyn/cm2). Also, with increasing PTX concentration two other effects were observed: i) there was a decreased incidence of cells that displayed pseudopodia, and ii) there was an increased incidence of cells forming hernias and an increased streaming of cell cytoplasm during aspiration. The first observation points to a down-regulation of the cell's functional ability to "activate" in response to surface/chemical stimuli, and the second indicates that both the cortical and cytoskeletal networks are weakened either by disruption and/or reduction in density of the protein polymers. These observations are in line with other recently published experiments which suggest that the rheological effects of pentoxifylline on PMNs may be associated with the state of actin. PMID- 2777893 TI - Temperature-dependent oligomerization of hsp85 in vitro. AB - The failure of conventional subcellular fractionation methods to identify interactions between the bulk of hsp85 and other cellular structures suggested that critical stress protein interactions might be detectable only at elevated temperatures. This was confirmed by showing that incorporation of hsp85 and grp95 into sedimentable complexes in Triton X-100 extracts of L929 cells increased progressively over the 30 degrees C-43 degrees C temperature range. Whereas several other proteins, including hsp110 and hsp69, became sedimentable under these conditions, this effect required temperatures of approximately 43 degrees C and was only partially detergent-dependent. In contrast, hsp85 became sedimentable at temperatures as low as 33 degrees C, and this effect was highly detergent-dependent. Temperature-dependent conversion of purified hsp85 to a sedimentable form was shown to result from limited oligomerization of the protein, which occurred in the presence of detergent. Since the detergent requirement could be met by a variety of compounds, including sphingosine, these findings suggest that hsp85 oligomerization may occur when intact cells are exposed to elevated temperature. PMID- 2777894 TI - RNA synthesis and stability in UV-irradiated and nonirradiated mouse L cells. AB - In mouse L cells, relatively low doses of UV light (e.g., about 35 J/m2) induced the rapid breakdown of the molecules of many RNA species transcribed shortly before irradiation. This included 28S, 18S, 5.8S, and 5S rRNA, U1, U2, U3, U4, and U5 small nuclear RNA, but not the main band of transfer RNAs or 7SL RNA. At higher UV doses, an RNA band that contains tRNAleu was also degraded rapidly after UV irradiation. RNA molecules synthesized long before irradiation (e.g., 22 h for small RNAs, 4 h for large rRNAs) were not affected. Our results suggest that the maturation and/or assembly into fully mature ribonucleoprotein particles of several small RNA species is not completed 4 h after transcription. The effect of UV radiation occurred in mouse L cells, but not in human HeLa or KB cells. In a previous report, L cells were transformed by DNA transfection with two mouse U1b RNA genes, named U1.1 and U1.2. We observed now that, in L cells transformed with the U1.2 gene, the ratio of radioactivity in the apparent U1b and U1a RNA precursors after 5 min of labeling was about 20 times higher than a) this ratio in briefly labeled L cells that had been transformed with the U1.1 gene, and b) the ratio of radioactive mature U1b and U1a RNA after 20 h of chase in L cells transformed with the U1.2 gene. These results suggest that very high levels of U1b RNA are transcribed from the exogenous U1.2 gene copies, followed by the rapid degradation of most of these transcripts. PMID- 2777895 TI - Neutral amino acid transport in human synovial cells: substrate specificity of adaptative regulation and transinhibition. AB - Neutral amino acid transport was characterized in human synovial cells. The amino acids tested are transported by all three major neutral amino acid transport systems, that is, A, L, and ASC. The model amino acid 2-aminoisobutyric acid (AIB) was found to be a strong specific substrate for system A in synovial cells. When cells were starved of amino acids, the activity of AIB transport increased, reaching a maximum within 1 h. The stimulation of transport activity was not blocked by cycloheximide and would thus appear to be related to a release from transinhibition. Similarly, the decrease in the activity of AIB transport observed after the addition of alpha-methyl-aminoisobutyric acid (meAIB) appeared to be related to transinhibition. However, using a different approach, that is, amino acid starvation followed by incubation with 10 mM meAIB and transfer to an amino acid-free medium with or without cycloheximide supplementation, a clear increase in AIB uptake, due both to derepression and a release from transinhibition, was observed. Unlike human fibroblasts, the depression of system A in these synovial cells was not serum-dependent. The process of derepression was observed only after preloading with meAIB. Neither AIB nor alanine produced this phenomenon. Moreover, alanine preloading led to a large increase in AIB transport activity due to a release from transinhibition. These observations indicate that the process of derepression and release from transinhibition are specific to the substrates present in the culture medium prior to amino acid starvation. PMID- 2777896 TI - Casein accumulation in distended rough endoplasmic reticulum of collagen gel cultivated mouse mammary epithelia. AB - Mouse mammary epithelial cells cultivated on collagen gels synthesize and secrete casein in a hormone-dependent manner. Fine-structure electron microscopy of secretory cultures revealed numerous cytoplasmic structures surrounded by membrane that is studded with ribosomes. The structures appear to be distended rough endoplasmic reticulum (RER). Electron microscope protein A-colloidal gold immunolocalization showed casein antiserum-specific deposition of gold particles over the RER cytoplasmic vesicles in cells provided insulin, prolactin, and hydrocortisone (IPF). Nonimmune antiserum showed no gold particle deposition over these cytoplasmic structures. Epithelia provided only insulin showed no such cytoplasmic vesicles nor any specific deposition of gold particles. Immunoblot analysis of cell lysate and culture medium showed casein only in IPF-treated cultures. It appears that the casein secretory pathway in collagen gel cultured mammary epithelia is blocked at the step that fuses RER vesicles to Golgi membrane. The data raise questions regarding the processing and maturation of casein and the mechanism of casein secretion in these cultures. PMID- 2777897 TI - Intranuclear distribution of the human myeloid cell nuclear differentiation antigen in HL-60 cells. AB - Based on solubility properties, the human myeloid cell nuclear differentiation antigen exists as at least two distinct populations. Most is easily extracted from isolated nuclei in 0.35 M NaCl, while 20 percent resists such treatment. Compared to undigested nuclei, both the amount of myeloid cell nuclear differentiation antigen (MNDA) released from nuclei after DNase I treatment and the amount resisting further extraction in 0.35 M NaCl increased after DNA was digested with DNase I. Under these conditions, there was a concomitant decrease in the amount of MNDA that was extractable with 0.35 M NaCl. Mixing nuclear protein extracts that contain MNDA with nuclei from cells that do not express this protein demonstrated that the MNDA redistributes from the freely soluble form to the nuclear residual fraction as a consequence of DNase I digestion. These data are consistent with a model in which the amount of MNDA that is tightly bound to salt-washed nuclei is held constant in the presence of an excess of unassociated MNDA in the nucleus, and that the level of MNDA binding to this nuclear fraction increases in proportion to the extent of DNA damage resulting from DNase I digestion. PMID- 2777898 TI - Modulation of growth of human carcinoma SW-13 cells by heparin and growth factors. AB - This study reports on the effects of heparin, basic and acidic fibroblast growth factors (bFGF and aFGF, respectively), and transforming growth factor type-e (TGFe) on the growth of a human adrenocortical carcinoma cell line, SW-13. Heparin has previously been shown to inhibit growth in several cell types, including smooth muscle cells, certain fibroblasts, and epithelial cells, and to modulate the effects of fibroblast growth factors. Whereas bFGF and aFGF bind tightly to heparin and elute from a heparin-Sepharose column with 2 M NaCl and 1.6 M NaCl, respectively, TGFe binds to heparin with lower affinity and can be eluted from heparin-Sepharose column with 0.5 M NaCl. TGFe is a polypeptide unrelated to FGF, is present in neoplastic and nonneoplastic tissues, and stimulates the growth of certain epithelial cells and fibroblasts in soft agar and monolayer. Since the growth of SW-13 cells is stimulated by TGFe and by bFGF, we hypothesized that heparin would inhibit the growth of SW-13 cells by binding to these growth factors and that the effects of heparin could be overcome with the addition of either growth factor. Our experiments confirmed that heparin inhibits the growth of SW-13 cells. A dose-dependent growth inhibition was observed in both monolayer and soft agar. The inhibition in monolayer was partially reversed upon heparin withdrawal. The effects of heparin in both monolayer and soft agar were at least partially overcome by TGFe and by basic or acidic FGF. Overall protein synthesis does not appear to be affected by heparin as measured by [35S]methionine uptake. In contrast, epidermal growth factor (EGF) and insulin-like growth factor I (IGF-I) were unable to overcome heparin-induced inhibition both in monolayer and in soft agar. Heparin also inhibited [3H]thymidine incorporation in AKR-2B and partially inhibited AKR-2B cell stimulation by TGFe; however, it further potentiated the already potent stimulation by bFGF. We propose that heparin, TGFe, bFGF, and aFGF modulate the growth of SW-13 cells and possibly of other epithelial cells in complex ways and that heparin-like substances present in the extracellular matrix play an important role in the control of epithelial growth. PMID- 2777899 TI - Ultrastructural analysis of acute immune thrombocytopenia in mice: dissociation between alterations in megakaryocytes and platelets. AB - Thrombopoiesis was studied in mice after the induction of acute immune thrombocytopenia with platelet antiserum (PAS). Utilizing electron microscopy, we examined platelets and megakaryocytes (MK) obtained 4, 8, 12, 24, 48, 72, and 120 hr after administration of PAS. Four to 24 hr after injection of PAS, the majority of bone marrow MK were normal in size and organelle distribution. The demarcation membrane system (DMS) extended normally throughout the mature cell cytoplasm at these times. However, approximately 50% of MK observed 48 hr and 72 hr after injection of PAS were significantly larger than normal, and often had demarcation membranes confined to an area between a peripheral organelle deficient zone and a central nuclear zone. The median values for sectional areas of platelets obtained 8-72 hr after administration of PAS were significantly greater than the median value for sectional areas of platelets in a pooled control sample. The proportion of cytoplasm to surface-connected canalicular system appeared greater than normal in most large platelets from the PAS samples; and increased numbers of profiles of Golgi complex and endoplasmic reticulum were observed. By 48 hr post-injection of PAS (at which time the modal ploidy class of MK has shifted from 16N to 32N; Corash et al., Blood 70:177, 1987), most platelets were normal in size and cytoplasmic appearance. At 120 hr post injection of PAS, virtually all platelets exhibited a normal size and complement of organelles, and MK also had returned to normal. Our data indicate that in response to acute thrombocytopenia, MK prematurely release platelets which differ from normal platelets in size and cytoplasmic appearance. There was a marked dissociation between alterations in platelets and MK, since a statistically significant increase in platelet sectional area occurred 40 hr before the shift in modal ploidy class of MK, and platelet size subsequently decreased toward normal during the period that has been shown to be associated with the maximum shift in MK ploidy. These results strongly suggest that the characteristics of platelet release do not depend on the ploidy or cytoplasmic characteristics of MK. PMID- 2777900 TI - The Na+,K+,2Cl- -cotransport system in HeLa cells and HeLa cell mutants exhibiting an altered efflux pathway. AB - We have investigated the characteristics of a transport system in HeLa cells, which turned out to be very similar to a previously described Na+, K+, 2Cl- cotransport system. For further understanding about the physiological role of the cotransporter, we have mutagenized HeLa cells and selected progeny cells for growth in low potassium (0.2 mM) medium. The selected HeLa cells (LK1) exhibited alterations in the Na+,K+,2Cl- -cotransport system. LK1 cells showed a remarkable reduction of 86Rb+ efflux via the cotransporter when compared to the parental HeLa cells. In contrast, bumetanide-sensitive potassium influx, measured by 86Rb+ uptake, was increased in the LK1 cells (increase in Vmax). Km values of the cotransporter in HeLa cells and LK1 mutants revealed similar properties for 86Rb+ and 22Na+ uptake. In addition, (3H)-bumetanide binding studies were carried out on intact HeLa cells; 1.7 pmol/mg protein (3H)-bumetanide was specifically bound to HeLa parental cells, which could be calculated to a number of 103,000 binding sites/cell. LK1 cells present, 1.44 pmol/mg protein, specifically bound (3H) bumetanide and, respectively, 137,000 binding sites/cell. The LK1 cells also exhibited an increase in the number of (3H)-ouabain binding sites as well as an increase in the activity of the Na+,K+-ATPase, expressed as a function of ouabain sensitive 86Rb+ uptake. Furthermore, LK1 cells were different in the concentrations of intracellular Na+ (increases) and K+ (decreases) when compared to the HeLa parental cells. When grown in low K+ medium (0.2 mM K+), protein content and cell volume were increased in the LK1 cells, while the DNA content was not significantly different between both cell lines. PMID- 2777902 TI - ATP hydrolysis by ischemic mitochondria. AB - Cellular ATP levels are determined by the rates of ATP production and ATP hydrolysis. Both phenomena are affected by ischemia. Mitochondrial enzymes are damaged, inhibiting this organelle's ability to make ATP. Mitochondria are also uncoupled by ischemia and have the ability to hydrolyze ATP. We designed a series of experiments to determine whether decreased production or increased hydrolysis of ATP was the primary effect of mitochondrial damage. Rat hearts were subjected to 45 min of warm ischemia in order to induce irreversible cell damage. ATP or ADP was injected into cuvettes containing mitochondria isolated from normal myocardium or myocardium damaged by ischemia. Luciferin-luciferase, which fluoresces in the presence of ATP, was also added to the tubes as an indicator of ATP levels. Mixtures of uncoupled and coupled mitochondria were made and compared with the mitochondria damaged by ischemia. The results showed that mitochondria damaged by prolonged ischemia hydrolyze ATP more rapidly than normal mitochondria; however, normal mitochondria can easily compensate for increased ATP hydrolysis when in mixture with equal amounts of uncoupled mitochondria. These data suggests that the low cellular levels of ATP following irreversible ischemia are primarily due to decreased ATP synthesis and not to increased hydrolysis. PMID- 2777901 TI - Involvement and relative importance of at least two distinct mechanisms in the effects of 2-mercaptoethanol on murine lymphocytes in culture. AB - 2-Mercaptoethanol (2-ME) exerts several effects on murine lymphocytes in culture that might explain its ability to enhance survival and growth of these cells. The uptake of the essential amino acid cystine and consequently the maintenance of intracellular glutathione levels are enhanced by 2-ME. Furthermore, 2-ME (even in the disulfide form) causes lymphocytes to release thiols into the culture medium. These effects might protect the cells from oxidative damage. The additional cystine provided by treatment of lymphocyte cultures with 2-ME might also allow adequate protein synthesis to support survival and/or growth. This study was conducted to assess the relative importance of the antioxidant and protein synthesis effects of 2-ME. As expected, 2-ME increased cystine uptake at all concentrations that enhanced growth and survival, but four nonthiol antioxidants that enhanced growth and/or survival either did not substantially affect cystine uptake or decreased it and did not affect the release of cystine or its products. The results presented here demonstrate that antioxidant protection is necessary and sufficient for lymphocyte survival and that cystine uptake in untreated lymphocytes is sufficient to support the protein synthesis needed for survival and limited growth. However, we also noted that concentrations of 2-ME that stimulated maximal growth more than doubled protein synthesis as measured at 8 hr. Thus the portion of the effects of 2-ME not accounted for by antioxidant action could be accounted for by enhanced protein synthesis. PMID- 2777903 TI - Protein kinase C inhibitor H-7 alters the actin cytoskeleton of cultured cells. AB - The effects of the protein kinase C inhibitor H-7 on the actin cytoskeleton of cultured cells (Swiss 3T3 and PTK2) are described. As documented by fluorescence microscopy and the higher-resolution technique of photoelectron microscopy, the effects are rapid and dramatic; exposure to 30 microM H-7 in culture medium for less than 6 min is sufficient to induce a significant reduction in the numbers and thickness of actin microfilament bundles and alterations in the morphology of cell-cell boundaries in PTK2 cells. One-hour exposure to 30 microM H-7 results in nearly complete depletion of normal actin microfilament bundles from all of the cell types examined, without dramatic changes in overall cell shape. The intermediate filament and microtubule cytoskeletal networks did not appear to be affected to any extent over the times and doses examined. Forty-five minutes of exposure of Swiss 3T3 cells to 200 microM of either HA1004 (which is comparable to H-7 with respect to inhibition of cyclic nucleotide dependent kinases) or to the protein kinase C inhibitor sangivamycin did not induce the actin alterations characteristic of H-7. In addition, depletion of protein kinase C from Swiss 3T3 cells by means of phorbol ester-induced down-regulation did not prevent the effects of H-7 on the actin cytoskeleton. These results demonstrate that the protein kinase C inhibitor H-7 has a specific and rapid effect on the actin cytoskeleton, and furthermore H-7 may have biochemical effects beyond those mediated by inhibition of protein kinase C or the cyclic nucleotide dependent kinases. PMID- 2777904 TI - Transforming growth factor-beta and fibroblast growth factor act synergistically to inhibit collagen II synthesis through a mechanism involving regulatory DNA sequences. AB - Transforming growth factor-beta (TGF-beta) and fibroblast growth factor (FGF) are two growth factors that will modulate chondrocyte growth and matrix synthesis. Here we report that these two growth factors act in a synergistic fashion to suppress the synthesis of type II collagen by embryonic chicken sternal chondrocytes. Treatment of chondrocytes with 20 ng/ml TGF-beta or 100 ng/ml FGF (acidic or basic) results in a 60-70% suppression of expression of the pro alpha 1 chain of type II collagen. By comparison, when chondrocytes are exposed to a combination of 1 ng/ml TGF-beta and 10 ng/ml FGF, a complete suppression of type II collagen synthesis was observed. Epidermal growth factor (EGF), platelet derived growth factor (PDGF), or insulin-like growth factor-1 (IGF-1) produce no suppression of synthesis either individually or in combination with TGF-beta. The decreased expression of the protein results from a decrease in the steady-state level of the mRNA transcript coding for type II procollagen, as indicated by a northern analysis. Finally, chondrocytes transfected with a plasmid carrying the CAT gene driven by the collagen II promoter/enhancer sequence displayed high levels of CAT activity when cultured in control media, but treatment of the cells with a combination of the two growth factors resulted in a dramatic reduction of CAT activity, indicating diminished promoter activity. These results suggest that both TGF-beta and FGF can down-regulate transcription of the collagen II gene through regulatory DNA sequences in the promoter and/or enhancer region. In addition, the finding of synergy suggests that these two growth factors may act through different pathways. PMID- 2777905 TI - Histones synthesized at different stages of myogenesis are differentially degraded in myotube cells. AB - We recently reported that cultures of terminally differentiating myotube cells synthesize histones in reduced but significant amounts in comparison with proliferating myoblasts (Wunsch et al., 1987, Dev. Biol., 119: 85-93). In this study, the stability of myotube histone has been determined, comparing the degradation of de novo-synthesized histones in nascent (day 3) and maturing (day 4) myotubes with histones in the same cells that had been previously made during myoblast proliferation (day 1). Histones synthesized in proliferating myoblasts and myotubes were pulse-labeled with 3H-lysine and chased up to seven days, followed by determinations of radioactivity remaining in histone bands using fluorography of one- and two-dimensional polyacrylamide gels. Considered in aggregate, core histones synthesized de novo in nascent (day 3) myotubes were degraded most rapidly, followed by myotube histones that had been previously made during the proliferative phase (day 1) of myogenesis. De novo-synthesized histones in maturing (day 4) myotubes were relatively stable. Individual histone classes were degraded in the following order of increasing half-life, regardless of the differentiative stage at which they were synthesized: H2A.Z, H2A, H2B, H3(.2, day 1; .3, days 3 and 4), H4. PMID- 2777906 TI - Differential regulation of basic protein phosphorylation by calcium phospholipid and cyclic-AMP-dependent protein kinases. AB - Myelin basic protein, an 80-kilodalton (kDa) protein in rat oligodendrocytes, and an 80-kDa basic protein in neuroblastoma x neonatal Chinese hamster brain explant hybrids were phosphorylated extensively when the cells were treated with either phorbol esters (TPA) or diacylglycerols (e.g., oleyoyl-acetylglycerol). TPA stimulated phosphorylation was inhibited by pre-incubation with 50 microM psychosine (galactosyl-sphingosine), confirming that it is mediated through the phospholipid-dependent protein kinase C (PK-C). Surprisingly, phosphorylation of these proteins was inhibited by incubation of cells with agents which result in activation of cyclic-AMP-dependent protein kinase (dibutyryl cyclic AMP or forskolin). In contrast, phosphorylation of other nonbasic proteins, for example, the oligodendrocyte-specific 2',3'-cyclic nucleotide phosphohydrolase, was stimulated under these conditions (Vartanian et al.: Proceedings of the National Academy of Sciences of the United States of America 85:939, 1988). The possible role of cyclic AMP in activating specific phosphatases or restricting the availability of diacylglycerol for PK-C activation is discussed. PMID- 2777907 TI - Molecular modeling in the design of phospholipase A2 inhibitors. AB - The X-ray structures of pancreatic bovine and porcine phospholipases A2 have been used along with interactive computer graphics to design conformationally rigid, novel compounds (1-meta-hydroxybenzyl-2-substituted acenaphthenes) directed at the active sites of these enzymes. In vitro testing confirmed that the designed compounds are potent inhibitors of the porcine pancreatic phospholipase A2 and exhibit both stereoselectivity and structure-activity relationships that are consistent with the proposed mode of binding. These compounds take advantage of a hydrophobic "slot" positioned between residues Leu-2 and Tyr-69 while positioning hydrogen-bonding functionality directed at the nd1-N of His-48. Experimental evidence shows a regioselective preference for this H-bond acceptor. A second part of the strategy used a tethered amine to displace the essential calcium providing a bisubstrate analog. PMID- 2777908 TI - A phorbol ester and phospholipid-activated, calcium-unresponsive protein kinase in mouse epidermis: characterization and separation from protein kinase C. AB - The phosphorylation of an Mr 82,000 protein (p82) in the Triton X-100 extract of the particulate fraction of mouse epidermis is dependent on the phorbol ester 12 O-tetradecanoylphorbol-13-acetate (TPA) or diacylglycerol and phospholipid and, contrary to protein kinase C (PKC)-catalyzed phosphorylation, cannot be activated by calcium plus phospholipid. The novel p82 kinase differs also from PKC in many other respects, such as substrate specificity, turnover rate, and sensitivity to inhibitors. The p82 kinase can be separated from PKC by chromatography on phenyl sepharose and does not react with a polyclonal PKC antiserum. Like PKC, the novel kinase phosphorylates its substrate on threonine and serine, but not on tyrosine. Similar to PKC, the epidermal p82-kinase system is down-modulated after TPA treatment of mouse skin, with a half-life of around 5 h. Down-modulation is also accomplished by the phorbol ester RPA, but not by the Ca2+ ionophore A23187, and it is inhibited by the immunosuppressive agent cyclosporin A. In addition to down modulation, TPA treatment of the animals activates a phosphatase that dephosphorylates phosphorylated p82 in the extract of the particulate fraction. PMID- 2777909 TI - Design and synthesis of conformationally restricted phospholipids as phospholipase A2 inhibitors. AB - The use of conformationally restricted phospholipids 1 and 2 has been employed to understand the conformational preference of phospholipase A2 (PLA2) for substrate phospholipids. Inhibition of porcine pancreatic PLA2 with 1 and 2 indicated a two to fivefold preference for the distal isomer 2 over the proximal isomer 1. Based upon these studies, both side-chains of the substrate phospholipid appear to occupy the lipid binding domains near the active site with the side-chains further apart most preferred by PLA2. PMID- 2777910 TI - Differential effect of dexamethasone on the regulation of phospholipase A2 and prostanoid synthesis in undifferentiated and phorbolester-differentiated U937 cells. AB - The human undifferentiated histiocytic cell-line U937 can be induced to differentiate by incubation with 12-0-tetradecanoylphorbol-13-acetate (TPA) into macrophage-like cells. Dexamethasone reduced the prostaglandin production in TPA differentiated U937 cells dose dependently, whereas undifferentiated U937 cells were dexamethasone insensitive. Concomitantly phospholipase A2, the enzyme liberating the prostaglandin precursor arachidonic acid, was inhibited by dexamethasone in TPA-differentiated but not in undifferentiated U937 cells. The activity of lysophosphatide acyltransferase, the key enzyme of fatty acid reacylation into phospholipids, remained unchanged both in undifferentiated and TPA-differentiated U937 cells. The data suggest that responsiveness to glucocorticoid-dependent regulation of prostanoid synthesis is acquired by cells of the monocyte-macrophage lineage late in differentiation. PMID- 2777912 TI - 'Corkscrewing', as evidence for force generation within a detergent-extracted microtubule translocation system from insect ovaries. AB - Microtubule-based translocation channels within the ovaries of the hemipteran insect Notonecta have been isolated by microdissection, and then detergent extracted to leave a bundle of some 30,000 aligned microtubules. On addition of ATP and other hydrolysable nucleotides the microtubule bundle contorts into a helical configuration, a property we have called 'corkscrewing', before straightening again. This we believe to be indicative of force generation within the bundle. Electrophoretic analysis of the bundle of native microtubules reveals many polypeptides apart from the tubulins, and a number of these comigrate with microtubule-associated proteins (MAPs), which copolymerize with tubulins in reassembled microtubules from the same system. Corkscrewing does not occur if the microtubule bundle is pretreated with salt, a procedure that removes MAPs from microtubules, suggesting that the force is generated by a MAP or MAPs. In addition, certain minor polypeptides comprising the native microtubules are ATP sensitive, a property expected of a microtubule motor. PMID- 2777911 TI - Modified hydroxyethylmethacrylate hydrogels as a modelling tool for the study of cell-substratum interactions. AB - The interactions between cells and their extracellular substratum environment are complex and difficult to study. Defined, synthetic substrata are valuable tools for experimentally determining the role of ionic and receptor-specific interactions between cells and their substrata. Hydrogels have been modified to contain stoichiometrically defined quantities of both positive and negative charge as well as specific proteins. These synthetic surfaces are water-rich matrices that possess hydroxyl groups, positive and negative ionized charges and native proteins, and can be considered as models of extracellular matrices on which an assessment of charge contribution and macromolecular content and specificity can be addressed with respect to cell-matrix interactions. This study shows that simple gels made of polyhydroxyethylmethacrylate do not support the spreading of cells but that the generation of copolymers by the addition of monomers that contain ionizable functional groups, will permit cell spreading. These simple modifications do not lead to cellular proliferation, yet when collagen is entrapped in the hydrogel substratum, proliferation occurs. The proliferative rate of cells grown on collagen-containing surfaces may be modified by altering the stoichiometry of the ionizable polymers used to make the surface. This study describes a synthetic, definable model for the study of cell substratum interactions and control. PMID- 2777913 TI - Interaction of Drosophila 27,000 Mr heat-shock protein with the nucleus of heat shocked and ecdysone-stimulated culture cells. AB - The intracellular localization and expression of hsp27 (heat-shock protein 27) were investigated by cellular fractionation and immunofluorescence microscopy in Drosophila S3 cells. In unstressed cells, hsp27 is expressed in only 2% of the cells, whereas following heat shock, during recovery or after induction by ecdysone, the protein is detected in all cells. Under all these conditions, hsp27 appears to be concentrated in the nuclear region as revealed by immunofluorescence. During heat shock, this hsp is localized primarily in the nucleus with an enrichment in the perinucleolar region. However, the cellular fractionation data indicate that the nature of hsp27 interaction with nuclear components greatly differs depending on whether or not cells were subjected to elevated temperatures. After heat shock, hsp27 is resistant to non-ionic detergent extraction. In cells allowed to recover at normal temperature and in those where its synthesis was induced by the molting hormone, ecdysone, this hsp is readily solubilized by detergent. These data suggest that, following heat shock, hsp27 may become physically associated with some nuclear component(s) that are resistant to detergent extraction. PMID- 2777914 TI - Methotrexate-induced morphological changes mimic those seen after heat shock. AB - The survival of cells cultured in medium containing the chemotherapeutic drug methotrexate (MTX) is related directly to drug concentration. Changes in DNA resulting from a severe imbalance in the cells' nucleotide pools are thought to account for this cytotoxicity. We have attempted to clarify the gross biochemical changes that might lead to cell death. DNA strand breaks occur in cells treated with high concentrations of MTX but it is not clear that these are sufficient to account for cytotoxicity at lower doses. We observed dramatic changes in cytoskeletal morphology. Gross reorganization of the cytoskeleton is shown by immunolabelling but is high-lighted dramatically when cells are lysed to leave 'nucleoids'. The nature of the changes seen in MTX-treated cells is characteristic of the cells' general stress response, seen originally following heat shock. This study shows that other factors, such as changes in cytoskeletal function, must be considered together with any contribution from DNA damage, in order to account for the lethal effects of MTX. PMID- 2777915 TI - Characterization of the fission yeast cdc10+ protein that is required for commitment to the cell cycle. AB - We have used antiserum raised against a beta-galactosidase-cdc10+ fusion protein to identify the protein product of the cdc10+ start gene of Schizosaccharomyces pombe. This gene is required for progress through the G1 phase of the cell cycle and for activating processes such as the increase in histone mRNA level in preparation for S phase. The protein has an apparent molecular weight of 87,000 and is phosphorylated on multiple serine residues. The protein remains phosphorylated throughout the mitotic cell cycle and shows no significant steady state changes in level. The antiserum has also detected a protein similar in size to p87cdc10 in human cells. PMID- 2777916 TI - Differential partitioning of plasma membrane proteins into the triton X-100 insoluble cytoskeleton fraction during concanavalin A-induced receptor redistribution. AB - The plasma membrane proteins of Dictyostelium discoideum were characterized with respect to their partitioning into the Triton-insoluble cytoskeleton fraction of the cell during concanavalin A-induced capping. Two fractions of plasma membrane associated concanavalin A were identified; one that immediately associated with the cytoskeleton fraction via cell surface glycoproteins, and one that partitioned with the cytoskeleton only after extensive cell surface glycoprotein cross-linking. Three major classes of polypeptides were found in the plasma membrane that differed with respect to their partitioning properties into the cytoskeleton fraction. The temporal order of association of the polypeptides with the cytoskeleton during concanavalin A-induced capping corresponded to the strength of their association with the cytoskeleton fraction as determined by pH and ionic strength elution from unligated cytoskeletons. PMID- 2777917 TI - Oligodendrocytes repel axons and cause axonal growth cone collapse. AB - We have examined the interactions between axons regenerating from dorsal root ganglia (DRGs) derived from newborn rats and oligodendrocytes cultured by three different techniques. Cultures examined after 2 days have a profuse outgrowth of axons from the DRGs, forming a dense mat on the culture surface. However, the axons avoid growing on oligodendrocytes; axons are seen all around these cells, but do not grow over them. We have also performed time-lapse video studies of the interactions between axonal growth cones and oligodendrocytes. Axons grow normally until their growth cone comes into direct contact with an oligodendrocyte, following which the growth cone remains motile for 30-60 min, but without making any progress over the cell. The growth cone then suddenly collapses, and the axon retracts, leaving a thin strand in contact with the cell. After this a new growth cone is usually elaborated and the process repeated. Oligodendrocytes are therefore inhibitory to axonal growth, and this may partially explain the failure of axons to regenerate in the mammalian central nervous system. PMID- 2777918 TI - A gene for the suppression of anchorage independence is located in rat chromosome 5 bands q22-23, and the rat alpha-interferon locus maps at the same region. AB - Cell hybrids between malignant mouse hepatoma cells and normal rat fibroblasts with approximately one set of chromosomes from each parent exhibited remarkable karyotypic stability. Most chromosomes of both parents were retained even after prolonged culture in vitro. Normally, such hybrids showed suppression of the transformed phenotype and formed no colonies in soft agar. However, two hybrids, BS140 and BS181, formed a few colonies in soft agar when many cells were seeded, and also occasional foci of cells were detected piling up in monolayer cell cultures. We isolated soft agar colonies (a-subclones) and sub-clones from foci (h-subclones) of both hybrids, and, as a control, subclones of cells from random areas without foci of one hybrid (BS181 p-subclones). When tested for soft agar growth, cells from the a- and h-subclones of both BS140 and BS181 formed colonies at frequencies comparable to the malignant mouse hepatoma parent, whereas the control cells of the BS181 p-subclones (like the normal rat parental cells) yielded no soft agar colonies. All the cell lines were subjected to detailed karyotype analysis in G-banding, which resulted in the finding that cells from the original BS140 hybrid contained at least one copy of each rat chromosome, whereas BS140 a- and h-subclones had lost both copies of rat chromosome 5. Similarly, the original BS181 hybrid contained at least one copy of each rat chromosome, whereas BS181 a- and h-subclones displayed a deletion of the segment q22-23 of rat chromosome 5. In contrast, the control BS181 p-subclones contained one or two copies of non-deleted rat chromosome 5. The conclusion is that a gene for the suppression of anchorage independence is located in the segment 5q22-23. We propose to call this gene SAI1 (for suppression of anchorage independence). Using Southern blotting, we tested whether any of several gene probes, known to correspond to DNA sequences in rat chromosome 5, were homologous to sequences in the deletion. Only one probe, corresponding to the active alpha1-interferon gene, was shown to be located within the deletion. Hence, the SAI1 gene is closely linked to the alpha 1-interferon gene, and might be identical to this locus. PMID- 2777919 TI - Glycophorin expression in murine erythroleukaemia cells. AB - We have identified mature and putative precursor forms of glycophorins expressed in a virus-transformed murine erythroleukaemia (MEL) cell line and compared them with their normal erythroblast counterparts. The following differences were found: (1) the two major MEL cell glycophorins (apparent Mr values 29-30 and 43(x10(3] have greater mobility on polyacrylamide gels than their normal gp-3 and gp-2 counterparts, due at least in part to differences in their oligosaccharide sidechains; (2) MEL cell gp-3 consists of two discrete proteins; and (3) there are more potential glycophorin precursors in MEL cells than in normal mouse erythroblasts. Four proteins, with apparent Mr values of 21, 23, 26 and 27(x10(3], have tentatively been identified as glycophorin precursors, based on the following findings: (1) they are immunologically related to the glycophorins; and (2) their synthesis was induced by dimethyl sulphoxide coincidentally with that of gp-3 and gp-2. They do not appear to be glycoproteins, as evidenced by their lack of incorporation of [3H]galactose, [3H]glucosamine or [3H]mannose. In contrast, gp-3 and gp-2 incorporated [3H]galactose and [3H]glucosamine but not [3H]mannose. Partial characterization of the glycan moieties of MEL cell glycophorins indicates that they consist mostly of tri- and tetrasaccharides, with no indication of any N-linked chains. Hence, the glycans of MEL cell glycophorins are mostly (if not all) O-linked. Furthermore, treatment with N glycanase did not change their electrophoretic mobility on polyacrylamide gels. MEL cell glycophorins were also shown to be modified by phosphoryl and fatty acyl groups. PMID- 2777921 TI - The secretory vesicle in living Paramecium is acidic. AB - In Paramecium, secretory proteins are packaged within membrane-bounded vesicles in a condensed form. This form expands when the proteins are released. We have now determined that a proton gradient is present in the secretory vesicles of living Paramecium. Acridine Orange, used as an in vivo indicator of acidic compartments, stained the secretory vesicles in both wild-type and mutant cells. Addition of the two agents that dissipate proton gradients (protonophores), namely, 2,4-dinitrophenol (DNP) and carbonylcyanide m-chlorophenylhydrazone (CCCP), eliminated this staining. Washed cells re-established their intravesicular acidity. Effects of sodium azide on vesicular acidity suggest that proton transport in these vesicles involves an ATP-dependent mechanism. PMID- 2777920 TI - Coated vesicles from chicken liver bind ferritin. AB - The iron-storage protein ferritin was found to be associated with highly purified coated vesicles (CV) from chicken liver. Chicken liver ferritin was morphologically similar to ferritin from horse spleen and could be isolated using a specific anti-ferritin monoclonal antibody. This antibody recognized a 240 X 10(3) Mr form of chicken ferritin but not the 22 X 10(3) Mr ferritin subunit after protein transfer to nitrocellulose. CV purified by controlled-pore glass bead chromatography also contained ferritin when assayed by monoclonal anti ferritin antibody using a sensitive enzyme-linked assay. Ferritin remained associated with CV even after re-chromatography. Ferritin particles were observed to be associated with CV by electron microscopy. CV-associated ferritin could be quantitatively removed from CV by treatment of the CV with 0.5 M-Tris-HC1 + 2M urea at pH 8.5, conditions that also lead to dissociation of the clathrin lattice. Triton X-100 detergent treatment did not affect the association of ferritin with CV. These results indicate that purified CV from chicken liver contain ferritin in association with the clathrin lattice. The possible functional significance of this association is discussed. PMID- 2777923 TI - NCL-SG3: a human eccrine sweat gland cell line that retains the capacity for transepithelial ion transport. AB - An ion-transporting human epithelial cell line, NCL-SG3, has been established by simian virus 40 (SV40) infection of primary cultures from eccrine sweat glands. The line has been passaged 38 times (over 100 population doublings), has an aneuploid karyotype but has not undergone any 'crisis'. The cells have retained epithelial morphology and expression of cytokeratin, the intermediate filament characteristic of epithelial cells. Approximately 85% of the population shows at least weak co-expression of vimentin, an intermediate filament associated with mesenchymal and some other non-epithelial cell types in vivo. In addition, SV40 large T-antigen is present, in a predominantly nuclear localization. Electrically resistant cell sheets are formed on dialysis tubing and cellulose-ester permeable supports. Electrogenic ion transport can be stimulated by the beta-adrenergic agonist isoproterenol (10(-6) M) and by lysylbradykinin (10(-7) M) but not by the cholinergic agonist carbachol at 10(-6) M). PMID- 2777922 TI - Cytoplasmic, nuclear, membrane-bound and secreted [35S]methionine-labelled polypeptide pattern in differentiating fibroblast stem cells in vitro. AB - Methods for the selective enrichment of various subpopulations of the human skin fibroblast cell line HH-8 have been developed. These methods permit the selection of homogeneous populations of the three mitotic fibroblast cell types MF I, II and III, and the four postmitotic cell types PMF IV, V, VI and VII. These seven cell types exhibit differentiation-dependent and cell-type-specific patterns of [35S]methionine-labelled polypeptides in total soluble cytoplasmic and nuclear proteins, also in membrane-bound proteins, and in secreted proteins. In the differentiation sequence MF II-MF III-PMF IV - PMF V - PMF VI 14 cell-type specific marker proteins have been found in the cytoplasmic and nuclear fraction, also 24 cell-type-specific marker proteins have been found in the membrane-bound protein fraction, and 11 cell-type-specific marker proteins in the secreted protein fraction. Markers in spontaneously arising and experimentally selected or induced populations of a single fibroblast cell type were found to be identical. PMID- 2777924 TI - A serum factor inducing neurite retraction of morphologically differentiated neuroblastoma x glioma NG108-15 cells. AB - It is well established that serum plays an important role in cell proliferation and differentiation. In this study, we have identified a serum factor that induces rapid neurite retraction of morphologically differentiated NG108-15 cells, cultured in serum-free medium containing 1 mM-dibutyryl cyclic AMP. The serum fraction of Mr greater than 30 x 10(3) induces neurite retraction in a manner identical to that of the whole serum. The neurite retraction activity in serum appears to be acid- and heat-stable. The molecular weight of the serum neurite retraction factor (NRF) has been demonstrated to be approximately 70 x 10(3) by gel permeation on LKB-Ultrogel AcA-44. The neurite retraction activity is dose-dependent, and the time required for half-maximal activity (t1/2) is 1.8 min. NRF is present in sera of various species studied, including human, cattle, sheep, rabbit and horse, but not in tissue extracts of kidney, heart, lung skeletal muscle, and brain of the rat. However, rat spleen and liver homogenates, at a protein content of 1 mg ml-1, caused slight neurite retraction. It is noteworthy that NRF is not detectable in cerebral spinal fluid. Our data on the properties of serum NRF indicate that it differs from all of the well-established growth factors, namely, NGF, EGF, PDGF, FGF, NSILA, ECGF and TGF. Further studies on purified NRF will delineate the biological role(s) of this serum factor in the process of maturation and differentiation of developing neurones. PMID- 2777925 TI - The kinetics of cell-substratum detachment mediated by trypsin: a comparison of normal and Duchenne fibroblasts. AB - In previous studies of cell-cell and cell-substratum adhesion, we have identified differences in the behaviour between human skin fibroblasts cultured from normal individuals and patients with Duchenne muscular dystrophy (DMD). In these studies, monolayer cultures were dissociated by trypsinization and no detectable difference was noted in the efficiency of cell dissociation between normal and DMD fibroblast cultures. However, a detailed study by Kent has suggested that Duchenne fibroblasts exhibit increased sensitivity to trypsin. We have re investigated this finding using an assay that directly measures the number of cells remaining attached to a substratum following trypsinization. In a series of experiments using cultures derived from five normal and five DMD individuals, we can detect no significant difference in the trypsin-induced detachment rates between normal and DMD skin fibroblasts. This observation applies to both growth phase and stationary-phase cell cultures. This inconsistency with previously reported data on the trypsin-sensitivity of DMD cells is considered in terms of the different assays used and the effects of trypsin on cell-cell and cell substratum adhesion. The relationship between abnormalities in the behaviour of DMD cells and the localization and primary structure of the DMD gene product are also discussed. PMID- 2777926 TI - Ultrastructural changes accompany inhibition of proteoglycan synthesis in chondrocytes by Cyclofenil diphenol. AB - Cyclofenil diphenol, a weak non-steroidal oestrogen, profoundly inhibits [35S]proteoglycan synthesis in cultures of Swarm chondrosarcoma chondrocytes under conditions in which protein synthesis is only marginally reduced. In the present experiments it was shown that after a 40-min treatment with Cyclofenil diphenol (90 micrograms ml-1) most of the normally abundant Golgi stacks in these cells disappeared and after 60 min they were absent. After 2-3 h treatment the cisternae of the endoplasmic reticulum (ER) were grossly distended and transformed into large ribosome-studded vesicles containing flocculent and filamentous material. These changes were dependent on the concentration of Cyclofenil and were fully reversible within 21 h of withdrawing the drug. The ultrastructural changes differed in some aspects if protein synthesis was blocked with cycloheximide for 15 min or 180 min before and during treatment with Cyclofenil. The Golgi disappeared but the ER cisternae, though distended, formed a continuous network and swollen ribosome-studded vesicles did not develop. However, non-membrane-bounded structures containing lipid droplets and material of low electron density developed in the cytoplasm under these conditions. The ultrastructural changes induced by Cyclofenil differ from those induced by monensin and diethylcarbamazine, suggesting that the drug acts at a different point in the secretory pathway for macromolecules. PMID- 2777927 TI - Cell growth kinetics, division asymmetry and volume control at division in the marine dinoflagellate Gonyaulax polyedra: a model of circadian clock control of the cell cycle. AB - A new method of determining the dependence of cell growth on the initial cell volume in the absence of cell division is presented. The assumptions are that volume in a certain period of time is either increasing or decreasing, but not both, and is independent of the history of cells. Applying this method to Gonyaulax polyedra in a 12h light-12h dark cycle, growth in volume between the 3rd and 12th hours of the light period is found to be more exponential-like than linear. The magnitude of growth in the time period is determined solely by cell volume and environmental conditions, not by cell age. All cells decrease in volume slightly in the dark from the 12th to 23rd hour, and then increase a little from the 23rd to 3rd hour of the following day. Cell division in this species is significantly asymmetric, and the extent of asymmetry is estimated mathematically. Simulations based on the growth patterns and the asymmetric division reveal that cell division must at least partly depend on the volume of cells. The dependence of conditional cell division probability on cell volume is then experimentally determined. The probability is zero up to a certain cell volume, and then it gradually increases to a plateau level, which is less than unity. Neither the strict size control model nor the transition probability model is fully consistent with the observed shape of the conditional probability function. A hybrid model postulating a 'sloppy' critical volume with a constant probability of division above that volume adequately accounts for the conditional probability. With the use of the observed volume growth law, cell division dependence on volume, and the extent of asymmetry in cell division, cell volume distributions are successfully simulated for cells growing in a 12h light-12h dark cycle. Another simulation reveals that the true coefficient of variation in generation time is 33%. On the basis of these findings, a model of the cell cycle is presented that incorporates the circadian clock as a cyclic G1 phase. According to this scheme, cells satisfying the minimum cell volume requirement between the 12th and the 18th hour probably exit to the replication/segregation sequence ending in division, and re-enter the cyclic portion after a fixed time interval. PMID- 2777928 TI - Cell volume and dry weight of cultured Tetrahymena. AB - Cultures of Tetrahymena pyriformis, T. hegewishi and T. malaccensis have been studied with regard to control of cell volume and cellular dry weight. Cell volume was measured on cells suspended in 0.9% sodium chloride + 0.1% sodium azide using a Multisizer cell counter (Coulter). Tetrahymena were grown at different temperatures and under various up- or downshift conditions. In all cases the changes in cell volume are paralleled by changes in cellular dry weight. The volume and the dry weight of a Tetrahymena cell are determined by the particular medium and the growth temperature. Large cells are seen in concentrated media and at low growth temperatures resulting in cell volumes up to 17,000 microns 3, whereas starving cells decrease gradually towards 700 microns 3 or even smaller sizes. It is proposed that lag phase observed at up- and downshift is to a large extent due to the necessary adjustment of the cell volume to the new conditions. PMID- 2777929 TI - Facts and trends in cerebral blood flow and metabolism: synopsis of brain '89. PMID- 2777930 TI - Postnatal changes in local cerebral blood flow measured by the quantitative autoradiographic [14C]iodoantipyrine technique in freely moving rats. AB - The postnatal changes in local cerebral blood flow in freely moving rats were measured by means of the quantitative autoradiographic [14C]iodoantipyrine method. The animals were studied at 10, 14, 17, 21 and 35 days and at the adult stage. At 10 days after birth, rates of blood flow were very low and quite homogeneous in most cerebral structures except in a few posterior areas. From these relatively uniform levels, values of local cerebral blood flow rose notably to reach a peak at 17 days in all brain regions studied. Rates of blood flow decreased between 17 and 21 days after birth and then increased from weaning time to reach the known characteristic distribution of the adult rat. The postnatal evolution of local cerebral blood in the rat is in good agreement with previous studies in other species such as dog and humans that also show higher rates of cerebral blood flow and glucose utilization at immature stages. However, in the rat, local cerebral blood flow and local cerebral glucose utilization are not coupled over the whole postnatal period studied, since blood flow rates reach peak values at 17 days whereas glucose utilization remains still quite low at that stage. The high rate of cerebral blood flow in the 17-day-old rat may reflect the energetic and biosynthetic needs of the actively developing brain that are completed by the summation of glucose and ketone body utilization. PMID- 2777931 TI - Pial arterial pressure contribution to early ischemic brain edema. AB - The effect of pial arterial pressure (PAP) on brain edema was examined in cats with middle cerebral artery (MCA) occlusion. Measurements of PAP and regional CBF (rCBF) were collected in the central core and the peripheral margin of the MCA territory over 180 min post MCA occlusion. Brain water content in each region was determined at the end of the experiment. MCA occlusion resulted in decreased PAP and rCBF in both the core (PAP = 13 mm Hg, rCBF = 9 ml/100 g/min) and the peripheral region (PAP = 15 mm Hg, rCBF = 18 ml/100 g/min). Brain edema developed in both the core and the peripheral region. Brain water content was correlated inversely with PAP in the core region and positively in the peripheral region. The results indicate that decreased blood flow contributes to cytotoxic edema in the core, and a hydrostatic pressure gradient preferentially enhances edema formation in the peripheral region. Maintenance of high perfusion pressure early after ischemia onset may suppress brain edema in the core region. PMID- 2777932 TI - Dynamics of extracellular metabolites in the striatum after middle cerebral artery occlusion in the rat monitored by intracerebral microdialysis. AB - The aim of this study was to measure changes in the extracellular fluid (ECF) concentration of lactate, pyruvate, purines, amino acids, dopamine, and dopamine metabolites in the striatum of rats subjected to focal cerebral ischemia, using intracerebral microdialysis as the sampling technique. Microdialysis probes were inserted into the lateral part of the caudate-putamen bilaterally 2 h before the experiment. Ischemia was induced by permanent middle cerebral artery occlusion (MCAO) on the left side. Microdialysis samples were analyzed by high performance liquid chromatography. Following MCAO, the concentration of lactate, adenosine, inosine, and hypoxanthine rose markedly in the ECF on the occluded side, while there was no significant change in pyruvate. These changes were accompanied by dramatically elevated levels of aspartate, glutamate, taurine, gamma-aminobutyric acid, and dopamine. There was also a marked increase in alanine/tyrosine, while minor or no changes occurred with other amino acids. Concomitantly, the ECF level of the dopamine metabolites 3,4-dihydroxyphenylacetate and homovanillic acid decreased. There was no significant increase in any of the metabolites measured on the right, nonoccluded side. In relation to the concept of excitotoxicity in brain ischemia, it is concluded that during the acute stage of focal cerebral ischemia, the ECF is flooded with both potentially harmful (e.g., aspartate, glutamate, and DA) and protective (e.g., taurine, GABA, and adenosine) agents. The relative importance of these events for the development of cell death in the ischemic penumbra needs to be elucidated. In addition, lactate, inosine, and hypoxanthine, measured in the ECF by intracerebral microdialysis, may prove to have diagnostic and/or prognostic value in neurometabolic monitoring of the ischemic brain. PMID- 2777933 TI - Influence of lactate accumulation on calcium content of ischemic and postischemic brain. AB - In this study, the cerebral hemisphere content of calcium as well as selected parameters of oxidative metabolism and electrophysiological function were assessed in normoglycemic and hyperglycemic rats that were exposed to ischemia produced by electrocautery of the vertebral arteries and reversible occlusion of the carotid arteries. In hyperglycemic animals, 0.5 h of ischemia was associated with large accumulations of lactate (27 mmol/kg), whereas normoglycemic animals showed lesser lactate accumulation (17 mmol/kg). At this sampling time (0.5 h of ischemia), both groups of ischemic animals showed tissue calcium contents that were unchanged from preischemic control levels. In normoglycemic animals, release of the carotid clamps and recirculation for 1.5-24 h was associated with normalization of lactate, ATP and phosphocreatine, clinical behavior, and EEG. During this 24 h of recirculation, cerebral calcium levels showed no changes. Hyperglycemic ischemic animals recirculated for 1.5-24 h showed a persistent lactic acidosis, depressed ATP and phosphocreatine, gross EEG abnormalities, seizures, and a high mortality rate. Again, during this 24 h period, cerebral calcium content showed no changes from preischemic control or from the matched saline-treated group. These data suggest that significant accumulation of calcium in brain tissue is not an early event in ischemic-hyperglycemic brain damage, and thus does not provide support for a role of calcium in the production of this form of ischemic damage. PMID- 2777934 TI - Functional, behavioral, and histological changes induced by transient global cerebral ischemia in rats: effects of cinnarizine and flunarizine. AB - Temporary cerebral ischemia (15 min) produced by "four-vessel occlusion" in the rat causes neurological disorders, changes in behavior (locomotor hyperactivity), and neuronal damage in the neocortex, striatum, and especially the CA1 zone of the hippocampus. We have studied the effects of two calcium overload blockers, flunarizine (50 mg/kg p.o. twice a day) and cinnarizine (100 mg/kg p.o. twice a day), on these alterations. Cinnarizine markedly improved the functional abnormalities of ischemia but had little or no effect upon the neuronal damage. In contrast, flunarizine provided far greater neuronal protection but with less obvious effects upon behavioral parameters. However, there was evidence of sedation 2 h after treating animals with this dose of flunarizine that might have masked any positive effect of the drug on behavior. We conclude that under the present experimental conditions, there is no correlation between the early and late behavioral changes observed following a temporary cerebral ischemic episode and the histological damage observed in certain vulnerable neurons, particularly in the hippocampus, 72 h after the insult. PMID- 2777935 TI - NMR spectroscopic investigation of the recovery of energy and acid-base homeostasis in the cat brain after prolonged ischemia. AB - The effects of 1 h of complete global ischemia on the recovery of high-energy phosphates, intracellular pH (pHi), and lactate in the cat brain in vivo was investigated by 31P and 1H NMR spectroscopy. Ischemia led to a decrease in creatine phosphate (CrP), nucleoside triphosphates (NTP), and pHi, while inorganic phosphate and lactate increased. Intracellular pH decreased from a control value of 7.07 +/- 0.04 to 6.17 +/- 0.12 after 1 h of ischemia (N = 7). The degree of metabolic recovery after recirculation was variable. In three animals CrP and NTP were detected within 4 min and NTP increased to greater than or equal to 90% of control within 1 h; these levels were maintained for the 3 h of observation. In four other animals, CrP and NTP reached only 20 to 80% of control; however, high-energy phosphates decreased and lactate increased spontaneously between 1 and 2.5 h. Immediately following recirculation, pHi decreased further by an average of 0.3 units. The rate of recovery of cerebral pHi was slower than that of PCr and NTP for the majority of animals. Recovery of pHi was not detected for an average of 32 min after recirculation--by this time, NTP had attained 80 +/- 10% of their preischemic level. Recovery of pHi (and lactate) was not observed in two animals where PCr and NTP recovered transiently to only 30-43% of the preischemic level. Recovery of cerebral pHi was markedly heterogeneous in one animal, since two Pi peaks were detected shortly after recirculation.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2777936 TI - Brain capillary 46,000 dalton protein is cytoplasmic actin and is localized to endothelial plasma membrane. AB - The most abundant protein of the brain capillary, which makes up the blood-brain barrier (BBB) in vivo, is a protein that migrates at a molecular weight of approximately 46 kDa on sodium dodecylsulfate-polyacrylamide gel electrophoresis (SDS-PAGE). The bovine brain capillary 46 kDa protein was purified by SDS-PAGE and Sephadex G-25 gel filtration. The purified protein migrated as a single band of molecular weight of approximately 42,000 Da on subsequent SDS-PAGE followed by silver staining. The protein was digested by trypsin and tryptic peptides were analyzed by reverse phase high-performance liquid chromatography (HPLC). Two of these peptides, 11 and 18 amino acids in length, were sequenced and found to be identical to amino acid sequences corresponding to portions of cytoplasmic actin. The SDS-PAGE gel-purified 46 kDa protein was also subjected to limited proteolysis using S. aureus V8 protease, and this resulted in the formation of a prominent 31 kDa doublet as well as smaller proteolytic fragments, and these fragments were of identical molecular weight to those generated from limited proteolysis of bovine actin. Electron microscopic immunoperoxidase studies with primary cultures of bovine brain capillary endothelium showed that immunoreactive actin is intimately associated with the plasma membranes. In conclusion, the brain capillary 46 kDa protein is cytoplasmic actin and is localized to the endothelial plasma membrane. Modulations of brain capillary endothelial actin may play a role in the regulation of BBB permeability. PMID- 2777937 TI - Serotonin potentiates noradrenaline-induced vasoconstriction through 5-HT1-type receptors in guinea pig basilar artery. AB - Based on the previous finding that 5-hydroxytryptamine (5-HT) co-exists with norepinephrine (NE) in cerebrovascular sympathetic nerve fibers and can be released during electrical nerve stimulation, the postjunctional interaction between the two amines was studied in isolated basilar artery of guinea pig. A low concentration of 5-HT, which in itself has little or no constrictive effect, potentiated the weak contraction of NE by almost 300%. The amplification was antagonized by methiothepin, but not by ketanserin, and it could be mimicked by methysergide. The marked potentiation is thus probably associated with the 5-HT1 like receptors, which earlier have been found to mediate the direct vasoconstrictive action of 5-HT in this vessel preparation. PMID- 2777938 TI - Retrograde catheterization of the right internal jugular vein for serial measurements of cerebral venous oxygen content. AB - Serial measurements of CBF and metabolism require multiple cerebral venous blood samples. Retrograde catheterization of the right internal jugular vein is easily performed at a point 2.5-3 cm lateral to, and 2 cm above, the medial end of the right clavicula. Complications are few and minor. In 1/80 (1.25%) cases the carotid artery was punctured during cannulation. Insertion of the catheter for 16 18 cm reduces contamination with extra-cerebral blood to a minimum. PMID- 2777939 TI - [A case of sacrococcygeal chordoma]. AB - The authors describe a case of sacrococcygeal chordoma which was detected in a 49 year old male subject in the course of a clinical examination. Bone X-rays and CT scans confirmed the diagnosis of sacral tumor, and radical excision was performed via combined abdominal and sacral approach. The chief characteristics of these rare tumors are further discussed, with particular focus on the therapeutical problems arising in relation with the fact that surgical removal, alone, can prevent tumor recurrences. PMID- 2777940 TI - [Revascularization of the inferior mesenteric artery through an endoaortic approach. A prospective series of 51 cases]. AB - From January 1, 1986 to December 31, 1987, 170 subrenal abdominal aortic aneurysms were operated on using a technique involving systematic revascularisation of the inferior mesenteric artery each time this was possible. The electively chosen revascularisation method was endo-aortic reimplantation which was carried out on 51 occasions out of 53 revascularisations. The post operative mortality was zero. Post-operative angiographic examination via the arterial route was systematically performed. 5 post-operative occlusions occurred. In these patients undergoing inferior mesenteric revascularisation, there was only one single case of severe ischemic colitis which subsequently resolved. Endo-aortic reimplantation of the inferior mesenteric artery would thus appear to be the procedure of choice for the prevention of ischemic colitis when the ostium is not stenosed or occluded. PMID- 2777941 TI - [Does the use of prolaminacid (Ethybloc) reduce mortality in cephalic duodenopancreatectomy?]. PMID- 2777942 TI - [Residual lithiasis of the common bile duct. Surgical or endoscopic treatment?]. AB - The authors report their experience concerning residual lithiasis of the common bile duct, while trying to define the respective place of surgery and endoscopy in this condition. There is a clear female predominance in their series, the mean age being 41 years. The indications for surgery and endoscopy are discussed and the means of prevention are reviewed. PMID- 2777943 TI - Major depression in later life. PMID- 2777944 TI - Accuracy and precision in the determination of Stokes radii and molecular masses of proteins by gel filtration chromatography. AB - The accuracy and precision of the estimates of hydrodynamic parameters of globular proteins obtained by inverse regression from gel filtration chromatographic data are discussed. The usefulness of gel filtration chromatography as the basis for a rapid and reliable method for the determination of the Stokes radius and the molecular mass is considered. The discussion is supported by an analysis of the models already proposed in the literature, and is based on the precision of the estimates. PMID- 2777945 TI - High-performance liquid chromatography of proteins on N-methylpyridinium polymer columns. AB - Two types of 4-methylpyridinium polymers (4VP-DVB-Me and 4VP-EG-Me, cross-linked with divinylbenzene and ethylene glycol dimethacrylate, respectively) were employed for the analysis of proteins in ion-exchange high-performance liquid chromatography. These polymers had different physical properties in the dry state, but showed similar retentions in size-exclusion chromatography using carbohydrate standards. Generally, the 4VP-EG-Me column was superior to the 4VP DVB-Me column with regard to separation and recovery of proteins. PMID- 2777946 TI - Fluorimetric determination of vitamin K3 (menadione sodium bisulfite) in synthetic animal feed by high-performance liquid chromatography using a post column zinc reducer. AB - A high-performance liquid chromatographic (HPLC) method for analysis of vitamin K3 (menadione), as the water-soluble sodium bisulfite salt, in synthetic animal feed is described. The menadione sodium bisulfite (MSB) is extracted with aqueous methanol, converted to oil-soluble menadione with sodium carbonate, and partitioned into n-pentane. After evaporation, the menadione is dissolved in methanol and analyzed by reversed-phase HPLC. The menadione is reduced on-line to its fluorescent 1,4-dihydroxy analogue by zinc reduction prior to fluorescence determination at 325 nm excitation wavelength and 425 nm emission wavelength. The fluorescence response was linear in the range 1 to 100 ng of menadione injected. Recovery experiments were performed on synthetic animal feed spiked at 20 and 200 mg/kg levels of MSB. Average recoveries from feed were greater than 90% with an average relative standard deviation of 5.5%. Additional confirmation of menadione in actual feed extracts was performed using capillary gas chromatography-Fourier transform infrared spectroscopy (GC-FT-IR). The HPLC-fluorescence and GC-FT-IR methods had lower limits of detection of 20 micrograms/kg and 2 mg/kg, respectively. PMID- 2777948 TI - Immobilized metal-ion affinity chromatography of human growth hormone. PMID- 2777947 TI - Multiresidue method for fungicide residues in fruit and vegetables. PMID- 2777949 TI - Determination of rubidium, sodium, calcium and thiamine in a pharmaceutical preparation by capillary isotachophoresis. PMID- 2777950 TI - Dot immunobinding assay of high-performance liquid chromatographic fractions on poly(vinylidene difluoride) membranes. PMID- 2777951 TI - Determination of 17-oxosteroid sulphates in serum by ion-pair extraction, prelabelling with dansylhydrazine and high-performance liquid chromatography with fluorescence detection. AB - A new high-performance liquid chromatographic (HPLC) method with fluorescence detection is described for the direct determination of four serum 17-oxosteroid sulphates. Each serum sample was deproteinated with methanol, the methanol was evaporated and 17-oxosteroid sulphates in the residue were extracted with benzene as ion pairs in the presence of tetrapentylammonium ion. The ion pairs were labelled with dansylhydrazine and the hydrazones were separated by HPLC on a Capcell-Pak C8 (silicone polymer-coated silica gel modified with octyl groups) reversed-phase column using methanol-0.5% (w/v) sodium acetate-50% (v/v) acetic acid (57:42:1, v/v/v) as the mobile phase. The eluent was monitored with a fluorometric detector at an excitation wavelength of 330 nm and an emission wavelength of 540 nm. PMID- 2777952 TI - Analysis of natural and modified amino acids and hexosamines by reversed-phase high-performance liquid chromatography. PMID- 2777953 TI - Chromatographic fractionation of proteins at high organic solvent modifier concentrations. PMID- 2777954 TI - Isolation and purification of a fibrinogenolysin from the venom of the saw-scaled viper (Echis carinatus) by high-performance liquid chromatography. PMID- 2777956 TI - International Symposium on Chromatography. Rehovot (Israel), November 14-17, 1988. Proceedings. PMID- 2777955 TI - An improved method for the separation and quantification of glutathione S transferase subunits in rat tissue using high-performance liquid chromatography. PMID- 2777957 TI - Improved high-speed counter-current chromatograph with three multilayer coils connected in series. I. Design of the apparatus and performance of semipreparative columns in 2,4-dinitrophenyl amino acid separation. AB - A compact desktop model of a high-speed counter-current chromatograph holds three identical multilayer coils in the symmetrical positions around the rotary frame to maintain perfect balance of the centrifuge system without the use of a counterweight. These multilayer coils are connected in series to make up a total capacity of 400 ml while the unique gear arrangement on the rotary frame establishes a twist-free mechanism of the flow tubes so that continuous elution can be performed without the use of rotary seal. The high performance of the present system was successfully demonstrated in separations of 10-250 mg of 2,4 dinitrophenyl amino acid mixtures in a two-phase solvent system composed of chloroform-acetic acid-0.1 M hydrochloric acid (2:2:1, v/v/v). PMID- 2777958 TI - Improved method for continuous UV monitoring in high-speed counter-current chromatography. AB - Continuous UV monitoring of the effluent in high-speed counter-current chromatography often encounters difficulty mainly due to the thermolabile nature of the mobile phase which tends to develop turbidity in the flow cell under a slight shift of the ambient temperature. This problem was effectively solved by inserting a fine PTFE tube (3 m x 0.46 mm I.D.) between the column outlet and the UV monitor and immersing a large portion of the tube into a waterbath heated at 30 degrees C. A similar tube was applied at the outlet of the UV monitor to create back pressure which suppressed gas bubble generation from the mobile phase. By the combined use of these devices, noiseless UV tracing was successfully demonstrated in two model experiments using thermolabile two-phase solvent systems: separation of flavonoids from the sea buckthorn ethanol extract with chloroform-methanol-water (4:3:2, v/v/v) and separation of bacitracin components with chloroform-ethanol-water (5:4:3, v/v/v). PMID- 2777959 TI - Identification of some human urinary metabolites of the intoxicating beverage kava. AB - Methane chemical ionization (CI) gas chromatography-mass spectrometry (GC-MS) has been used to identify some of the human urinary metabolites of the kava lactones following ingestion of kava prepared by the traditional method of aqueous extraction of Piper methysticum. All seven major, and several minor, kava lactones were identified in human urine. Observed metabolic transformations include the reduction of the 3,4-double bond and/or demethylation of the 4 methoxyl group of the alpha-pyrone ring system. Demethylation of the 12-methoxy substituent in yangonin (or alternatively hydroxylation at C-12 of desmethoxyyangonin) was also recognised. This product was isolated by high performance liquid chromatographic analysis of crude urine extracts and characterised by methane CI GC-MS. In contrast to the situation prevailing in the rat no dihydroxylated metabolites of the kava lactones, or products from ring opening of the 2-pyrone ring system, were identified in human urine. GC-MS analysis of urine can be readily utilised to determine whether donors have recently consumed kava. PMID- 2777960 TI - Isolation of drug residues from tissues by solid phase dispersion. AB - A new method based on solid phase dispersion of tissue for the subsequent isolation of drugs is reported. By blending tissues with a polymeric phase bound to a solid support one obtains a semi-dry material which can be used as a column packing material from which one can isolate drugs in a stepwise fashion based on the solubility characteristics of the drugs in this matrix. The applicability of this approach for multidrug residue extraction from a single sample is demonstrated for compounds representing the organophosphate, benzimidazole anthelmintic and beta-lactam antibiotic drug classes. PMID- 2777961 TI - Purification of rabbit liver aldehyde oxidase by affinity chromatography on benzamidine sepharose 6B. AB - Highly purified rabbit liver aldehyde oxidase was prepared in high yield using affinity chromatography on Benzamidine Sepharose 6B. Rabbit liver was homogenised, heat treated and ammonium sulphate was added to the supernatant to give a crude preparation of the enzyme. Aliquots of the crude preparation were chromatographed on a Benzamidine Sepharose 6B column at pH 9 and the aldehyde oxidase was eluted by a benzamidine containing buffer. This single affinity step resulted in a 38-fold increase in purity over the crude preparation with an 84% recovery of enzyme activity. Further purification on a Mono Q ion-exchange column gave an additional 1.7-fold increase in specific activity to yield a highly purified preparation of the enzyme. The new method described is considerably simpler and faster than ones hitherto employed and gives a much better yield of the highly purified enzyme. PMID- 2777962 TI - Isocratic separation of seven benzimidazole anthelmintics by high-performance liquid chromatography with photodiode array characterization. PMID- 2777963 TI - Simultaneous analysis of different species involved in hexaglycine hydrolysis. PMID- 2777964 TI - Residue analysis of the herbicides cyanazine and bentazone in sugar maize and surface water using high-performance liquid chromatography and an on-line clean up column-switching procedure. PMID- 2777965 TI - Isolation of hydroxy fatty acids from livers of carbon tetrachloride-treated rats by thin-layer chromatography. PMID- 2777966 TI - Eighth International Symposium on High-Performance Liquid Chromatography of Proteins, Peptides and Polynucleotides. Copenhagen (Denmark), October 31-November 2, 1988. Proceedings. PMID- 2777967 TI - High-performance liquid chromatography of amino acids, peptides and proteins. XC. Investigations into the relationship between structure and reversed-phase high performance liquid chromatography retention behaviour of peptides related to human growth hormone. AB - The gradient elution behaviour of eight synthetic peptides encompassing residues [6-13] of human growth hormone, i.e. Leu1-Ser-Arg-Leu-Phe-Asp-Asn-Ala8, has been investigated, by using an octadecylsilica, a butylsilica, and a polymeric fluorocarbon as stationary phases. Quantitative expressions, derived from the linear-solvent-strength theory and the general plate-height theory, were used to assess the influence of gradient time on the relative retention and bandwidths of these peptides. It was demonstrated that the chromatographic properties of the cyclised imide form involving Asp6 are consistent with the formation of a highly stabilised amphipathic helix, while the open-chain alpha- and beta-rearranged forms eluted as less rigid structures. The putative hydrophobic contact region consists of two leucine residues and one phenylalanine residue. From an analysis of the retention and bandwidth data obtained at pH 9, a surface-induced molecular reorientation of the beta-linked peptides was observed, in which the repulsion of the aspartyl carboxyl group from the hydrophobic stationary phase directs the C terminal moiety away from the sorbent surface. Furthermore, the fluorocarbon sorbent exhibited characteristics favourable for use in preparative purification of these peptides. The present results demonstrate the sensitivity of reversed phase high-performance liquid chromatography (RP-HPLC) to monitor small changes in the interactive behaviour of peptides with hydrocarbonaceous ligands and aquo organic solvent combinations in reversed-phase systems. These observations further illustrate the general utility of HPLC for investigating the conformational behaviour of peptides at solid-liquid interfaces. PMID- 2777968 TI - High-performance liquid chromatography of amino acids, peptides and proteins. XCI. The influence of temperature on the chromatographic behaviour of peptides related to human growth hormone. AB - The influence of temperature on the gradient elution properties of synthetic peptides related to residues [6-13] of human growth hormone, e.g., Leu1-Ser-Arg Leu-Phe-Asp-Asn-Ala8, has been studied by using both an octadecylsilica and a polymeric fluorocarbon stationary phase. Correlation of changes in the solute hydrophobic contact area and affinity for the stationary phase, as given by S and log k0 values respectively, revealed that the alpha- and imide forms are more conformationally stable than the beta-linked peptide. In addition, negative values of the standard entropy change, delta S0 assoc, for the transfer of the solute to the stationary phase, were observed for both alpha- and beta-linked peptides. These results are indicative of an increased ordering of the system upon solute adsorption and implies that the open-chain peptides exist in solution in more flexible conformations, while the helical structure of the cyclised imide is more rigid and constrained. The implications of the relative conformational stability of these peptides in their role as insulin-potentiating agents is also discussed. PMID- 2777969 TI - Retention behaviour of paracelsin peptides on reversed-phase silicas with varying n-alkyl chain length and ligand density. AB - As part of further investigations on the characterization of the ligand-induced conformational stabilization of peptides, two series of n-alkyldimethylsilyl bonded silicas have been prepared. In series A the n-alkyl chain length, n, of the bonded phase was varied between 1 and 20 carbon atoms at a constant ligand density. In series B the ligand density, alpha exp, was gradually changed from 0 to 4.1 mumol/m2 on a C1, C4, C6, C8 and C18 bonded phase. The retention behaviour of four peptides of the paracelsin family were examined under isocratic conditions, using a ternary mobile phase of water-methanol-acetonitrile (22:39:39, v/v/v). Plots of k' versus n showed pronounced maxima between n = 2 and 4 carbon atoms, followed by a decrease by a factor of 3 at n = 5, whereas above 5 carbon atoms only a slight increase in k' was observed. The selectivity behaviour of the paracelsins A-D can be mainly rationalized by interaction of the amphiphathic polypeptide 3.6(13) (alpha)-helix with the hydrophobic ligand and protrusion of the key amino acid residues at positions 6 and 9 in the sequence. However, from experiments with a polystyrene stationary phase it is evident that hydrophobic interactions and different partition coefficients also contribute to the resolution of the paracelsin peptides. Furthermore, Van 't Hoff plots confirm significant free energy changes associated with retention. These observations provide the basis for evaluating the enthalpic and entropic changes associated with peptide interactions with n-alkyl silicas. PMID- 2777970 TI - Protein conformation changes as the result of binding to reversed-phase chromatography column materials. AB - The conformational changes of the protein alpha-chymotrypsinogen which may take place on reversed-phase chromatographic material of differing hydrocarbon chain lengths e.g. C4, C6, C8, C10 and phenyl, have been studied by circular dichroism as a function of 1-propanol concentration and pH of the solvent before and after binding to the reversed-phase material. PMID- 2777971 TI - Stereochemical recognition of enantiomeric and diastereomeric dipeptides by high performance liquid chromatography on a chiral stationary phase based upon immobilized alpha-chymotrypsin. AB - A series of 24 enantiomeric and diastereomeric dipeptides were chromatographed on a chiral stationary phase (CSP) based upon immobilized alpha-chymotrypsin (ACHT). The ACHT-CSP was able to resolve stereochemically a number of the enantiomeric D,D- and L,L-dipeptides as well as the diastereomeric D,D-/L,L- and L,D-/D,L dipeptides. The solutes were also chromatographed on a N-tosyl-L-phenylalanine chloromethyl ketone-deactivated form of the ACHT-CSP, where stereochemical separations were also achieved. The results of this study suggest that binding interactions between the dipeptides and the ACHT-CSP occur at the active site of the ACHT and at other hydrophobic sites on the ACHT molecule. PMID- 2777972 TI - Efficient endotoxin removal with a new sanitizable affinity column: Affi-Prep Polymyxin. AB - A new affinity column packing for removal of endotoxins has been prepared by coupling USP drug-quality polymyxin B to Affi-Prep, a novel synthetic macroporous polymer. Affi-Prep Polymyxin binds endotoxins from a number of different strains of gram-negative bacteria. Endotoxin binding is not significantly affected by 10 mg/ml of bovine serum albumin or human immunoglobulin G, by 1 mg/ml sodium dodecyl sulphate, or by 1 mg/ml deoxycholate. Affi-Prep Polymyxin is stable to treatment with 1.0 M sodium hydroxide, an important property for sanitizing the resin. The resin shows a high ligand stability, since no leakage of polymyxin B from the packing could be detected. Affi-Prep Polymyxin exhibited the highest endotoxin binding efficiency when compared with several commercial agarose affinity packings. PMID- 2777973 TI - Isolation of a specific membrane protein by immunoaffinity chromatography with biotinylated antibodies immobilized on avidin-coated glass beads. AB - Avidin-coated, solid glass beads have been used as an immobilization support for attaching biotinylated antibodies. These beads have been packed into analytical, semi-preparative and preparative columns and used to isolate the B27 histocompatibility anigen (HLA) from human lymphocytes. The beads provided a suitable column material for all three chromatographic procedures and, depending on the size of the immunoaffinity column, B27 antigen could be isolated in nanogram to microgram quantities. Polyacrylamide gel electrophoresis demonstrated the presence of only a single band in the immunoaffinity peaks isolated by all three procedures. Enzyme-linked immunosorbent assay analysis of these immunoaffinity-isolated materials revealed that they were biologically active and could be used to determine the levels of anti-B27 antibodies in clinical studies. PMID- 2777974 TI - Coated silica supports for high-performance affinity chromatography of proteins. AB - Polymer-coated silica supports are potentially good stationary phases for high performance affinity chromatographic separations of proteins. Silica beads have been coated with a polysaccharide (dextran or agarose), substituted by a calculated amount of positively charged diethylaminoethyl functions in order to neutralize the negatively charged silanol groups of silica and to facilitate the formation of a hydrophilic polymeric layer on the inorganic surface. The silica based supports were prepared in two steps. First, the silica was impregnated with a solution of diethylaminoethylated polymer, and then the coating polymer was crosslinked in order to avoid leakage of the polymeric layer. The supports present minimal non-specific interactions with proteins, as tested by high performance size-exclusion chromatography. These coated silica supports were coupled with active ligands, such as protein A, concanavalin A and heparin, by conventional coupling methods. The resulting affinity stationary phases were tested by the elution of proteins in order to study their performance in high performance affinity chromatography. PMID- 2777976 TI - New porous organic microspheres for high-performance liquid chromatography. AB - A process for producing spherical porous organic microspheres, based on urea formaldehyde (UF) polymer, has been developed. These microspheres exhibit exceptional mechanical strength and resiliency and have minimal tendency toward shrinking or swelling in aqueous, organic, or hydroorganic media. The geometric parameters of the microspheres are conveniently adjusted by process variables, which allow precise control of pore and particle dimensions. The surface of the UF microsphere contains organic functional groups suitable for chemical modification so that ligands of choice may be covalently attached for operation in the anion-exchange or hydrophobic interaction modes. PMID- 2777975 TI - High-performance liquid chromatography of amino acids, peptides and proteins. XCII Thermodynamic and kinetic investigations on rigid and soft affinity gels with varying particle and pore sizes. AB - In these investigations Cibacron Blue F3GA was immobilized on soft gels, porous silicas, and non-porous glass beads. Hen egg white lysozyme, human serum albumin and yeast alcohol dehydrogenase were used as adsorbates with the dye-affinity sorbents. Batch experiments with continuous monitoring of protein concentration were employed to evaluate thermodynamic and kinetic behaviour of these proteins in finite bath systems. The observed adsorption kinetic rates of interaction of the above proteins with each of the dye-affinity sorbents were found to decrease with increasing protein molecular weight. Equilibration times, in the batch experimental mode, of the adsorption of lysozyme on the dye-affinity sorbents varied from 20 s for the non-porous glass beads with a size range of 20-40 microns to more than 60 min in the case of a porous sorbent with a particle diameter of 100-300 microns and 60 nm pore size. Furthermore, equilibration times, which represent the overall adsorption rates incorporating all the non equilibrium effects, increased with all affinity systems when adsorption took place in the non-linear portion of the isotherm. The most dramatic increase was observed when sorbents with relatively high protein size to pore size ratios, lambda, were employed. PMID- 2777977 TI - Immunological-chromatographic analysis of lysozyme variants. AB - Immunological-chromatographic analysis (ICA) was used to evaluate the cross reactivities of eight lysozyme variants with five different immobilized monoclonal anti-hen-egg-white lysozyme antibodies. ICA is a dual-column high performance liquid chromatography-based method in which an immunoaffinity and a conventional analytical column are coupled with a switching valve. Antigens are first captured on the affinity column and then desorbed and concentrated on the second column, where they are separated further. This arrangement permits antigen antibody interactions occurring on the affinity column to be monitored on-line with the second column. The ICA system was used to perform direct and competitive inhibition binding immunoassays with unlabeled antigens. Seven of the eight lysozymes tested bound to all five immobilized monoclonal antibodies. Competitive inhibition of binding of hen egg white lysozyme to the monoclonal antibody, HyHel 5, was measured by using the variants Japanese quail and bobwhite quail lysozymes as inhibitors. The ratio of the amount of bobwhite quail to Japanese quail lysozyme required to give 50% inhibition of binding of hen egg white determined by ICA compares well with the results obtained by other investigators who used an enzyme-linked immunosorbent assay plate binding assay. PMID- 2777978 TI - Comparison of protein A, protein G and copolymerized hydroxyapatite for the purification of human monoclonal antibodies. AB - Protein A Superose, protein G Sepharose fast flow and copolymerized hydroxyapatite were used for the purification of human monoclonal antibodies against HIV 1. Both desalted culture supernatant and a prepurified protein solution were used as starting materials. The different runs were compared with respect to yield and recovery of biological activity. The biological activity (specific reactivity) was checked by antigen enzyme-linked immunosorbent assay with recombinant antigen. The human monoclonal antibodies could not be selectively eluted from the hydroxyapatite but elution could be effected from the protein A Superose at pH 4.0 and from protein G at pH 3.0. The eluted immunoglobulin G was distributed over a broad pH range when protein G Superose was used. Biologically active material could be obtained from protein A Superose and protein G Sepharose fast flow. PMID- 2777979 TI - High-performance liquid chromatography of amino acids, peptides and proteins. XCIII. Comparison of methods for the purification of mouse monoclonal immunoglobulin M autoantibodies. AB - A comparison of methods for the purification of naturally occurring mouse monoclonal autoantibodies, of the immunoglobulin M (IgM) isotype, has been performed to determine the optimal strategies for the isolation of IgM from ascites fluid and in vitro tissue culture hybridoma supernatants. In order to quantify each purification procedure, the concentration of IgM in eluted fractions was determined by using a double-sandwich mu-chain-specific anti-IgM enzyme-linked immunosorbent assay, and the purity of the IgM was determined by a bicinchoninic acid-based protein assay and sodium dodecyl sulphate-polyacrylamide gel electrophoresis (SDS-PAGE). The most efficient single-step purification was based on size-exclusion chromatography on high-resolution Superose 6 HR 10/30 fast protein liquid chromatography (FPLC) columns. This procedure resulted in recoveries of monoclonal IgMs of ca. 71-86% with purities between 68 and 86%. Single-step chromatography of monoclonal IgM, on Superose 6 FPLC columns resulted in a 21-fold purification of IgM, prepared by the in vitro culture of hybridoma cells in dialysis membrane. Size-exclusion chromatography, performed with Sephacryl S-300 columns, resulted in reduced resolution of monoclonal IgM, with yields of ca. 57-80% and purity of ca. 42-58% compared with the high-resolution Superose 6 FPLC columns. "Non-ideal" size-exclusion chromatography on Superose 6 FPLC columns resulted in selective retention of monoclonal IgMs and elution of IgM with high-ionic-strength buffers in the trailing peak. Recovery of IgM with this strategy was high (ca. 82-92%) but the purity was not comparable to the single-step fractionation of IgM on Superose 6 FPLC columns. Single-step anion- and cation-exchange and mixed-mode hydroxyapatite chromatography resulted in only partial purification of monoclonal IgM with the applied procedures. With these latter separation techniques, monoclonal IgM was eluted with a variety of other ascites fluid or supernatant proteins, including those with apparent molecular weights identical to those of mouse IgG and albumin. Sequential purification of monoclonal IgMs by Mono Q anion exchange, followed by Superose 6 FPLC columns, resulted in a 2- to 3-fold purification of IgM but did not separate IgM from high molecular-weight contaminants with apparent molecular weights similar to those of alpha 2-macroglobulin and IgG. Enrichment of monoclonal IgM from ascites fluid by ammonium sulphate precipitation revealed increasing IgM recovery with increasing ammonium sulphate final concentrations up to 60%.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2777980 TI - Separation and purification of component proteins of the cytochrome P-450 dependent microsomal monooxygenase system by high-performance liquid chromatography. AB - The component proteins of the hepatic microsomal monooxygenase system, including various cytochrome P-450 isozymes, were separated and isolated from liver microsomes of untreated rabbits by Aminohexyl Sepharose and high-performance liquid chromatography (TSK preparative DEAE 5-PW, Bio-Rad HPHT). In addition to the known cytochrome P-450 isozymes, two new isozymes and one variant of the major isozyme were isolated. The monooxygenase activity was reconstituted by incorporating the purified proteins into liposomal membranes. PMID- 2777981 TI - Fast separation of biological macromolecules on non-porous, microparticulate columns. AB - The use of high-performance liquid chromatographic columns for the separation of proteins and nucleic acids is gradually increasing in biochemical laboratories. The efficiency of these columns for such separations has been much lower than that achievable for the separation of smaller molecules. Non-porous microparticulate packings are the logical answer one arrives at after consideration of the chromatographic behaviour of proteins. Non-porous stationary phases are described for the separation of proteins, peptides and nucleic acids. The stationary phases used are TSK-Gel NPR-C18, TSK-Gel NPR-DEAE, TSK-Gel NPR-SP and HYTACH MicroPell C18. A number of fundamental properties of columns based on these sorbents were evaluated, such as permeability, retention behaviour towards small and large molecules, load capacity and stability. Instrumental requirements for these columns are discussed and some applications described. PMID- 2777982 TI - Properties, in theory and practice, of novel gel filtration media for standard liquid chromatography. AB - The influence of experimental parameters on the separation result in gel filtration may readily be predicted from a few basic equations, as demonstrated with the aid of experimental observations on Sephacryl HR. Excellent agreement between the predicted resolution and that determined experimentally was found for parameters such as temperature, particle size, column length, flow velocity, sample volume and gel porosity. The theoretical prediction of an optimum sample volume for a constant processing rate was also experimentally verified. An exhaustive investigation of the physical, chemical and functional properties of Sephacryl HR was undertaken to facilitate the interpretation of experimental observations. PMID- 2777983 TI - Peptide mapping and internal sequencing of proteins electroblotted from two dimensional gels onto polyvinylidene difluoride membranes. A chromatographic procedure for separating proteins from detergents. AB - Direct sequence analysis of proteins electroblotted from two-dimensional polyacrylamide gels onto immobilizing matrices provides an efficient technique for obtaining N-terminal sequence data for proteins not amenable to purification by reversed-phase high-performance liquid chromatography (RP-HPLC). We present in this paper a procedure for obtaining peptide fragments from electroblotted proteins for internal amino acid sequence analysis. First, Coomassie Blue-stained proteins are extracted from polydivinylidene difluoride membranes, using a detergent mixture of sodium dodecylsulfate and Triton X-100. Proteins are then separated from the detergent mixture by a chromatographic procedure which relies on the ability of proteins to interact with certain reversed-phase sorbents at high organic solvent concentrations. Under these conditions, detergents and Coomassie Blue are not retained and pass through the column. Proteins are recovered by simultaneously: (i) introducing trifluoroacetic acid into the mobile phase and (ii) decreasing the organic solvent concentration. After proteolytic fragmentation, peptides are purified by microbore-column (1-2 mm I.D.) RP-HPLC for microsequence analysis. PMID- 2777984 TI - Correlation of protein retention times in reversed-phase chromatography with polypeptide chain length and hydrophobicity. AB - The use of amino acid retention or hydrophobicity coefficients for the prediction of peptide retention time behaviour on hydrophobic stationary phases is based on the premise that amino acid composition is the major factor affecting peptide retention in reversed-phase chromatography. Although this assumption holds up well enough for small peptides (up to ca. 15 residues), it is now recognized that polypeptide chain length must be taken into account when attempting to equate retention time behaviour of larger peptides and proteins with their overall hydrophobicity. In the present study, we have examined the reversed-phase retention behaviour of 19 proteins of known sequence on stationary phases of varying hydrophobicity and ligand density. From the observed protein retention behaviour on C4, C8 and C18 stationary phases under gradient elution conditions, we have been able to correlate the observed retention times of proteins ranging in molecular weight from 3500 to 32,000 dalton and in chain length from 30 to 300 residues with their overall hydrophobicity (based on retention parameters derived from small peptides) and the number of residues in the polypeptide chain. The retention behaviour of the proteins on the C4, C8 and C18 columns was also compared to that obtained on supports containing lower ligand densities (phenyl ligands). The maintenance of native or partially folded protein conformation on the phenyl columns, resulting in lower retention times than would be expected for fully denatured proteins, underlined the importance of efficient protein denaturation for satisfactory correlation of protein retention times with protein hydrophobicity. In addition, the effectiveness of increasing temperature and/or ligand density of the stationary phase in denaturing proteins was also demonstrated. PMID- 2777985 TI - Evaluation of advanced silica packings for the separation of biopolymers by high performance liquid chromatography. VI. Design, chromatographic performance and application of non-porous silica-based anion exchangers. AB - The linear solvent strength model of Snyder was applied to describe fast protein separations on 2.1-micron non-porous, silica-based strong anion exchangers. It was demonstrated on short columns packed with these anion exchangers that (i) a substantially higher resolution of proteins and nucleotides was obtained at gradient times of less than 5 min than on porous anion exchangers; (ii) the low external surface area of the non-porous anion exchanger is not a critical parameter in analytical separations and (iii) microgram-amounts of enzymes of high purity and full biological activity were isolated. PMID- 2777986 TI - Strong cation-exchange high-performance liquid chromatography of peptides. Effect of non-specific hydrophobic interactions and linearization of peptide retention behaviour. AB - Strong cation-exchange chromatography (strong CEX) is probably the most useful mode of high-performance ion-exchange chromatography (IEC) for peptide separations. Although the hydrophobic character of high-performance ion-exchange packings, often giving rise to mixed-mode contributions to solute separations, has long been recognized, a systematic approach to examining the effect and magnitude of the hydrophobicity of these packings during IEC of peptides has so far been lacking. In the present study, we report the synthesis of three series of positively charged peptide polymers which vary significantly in overall hydrophobicity and polypeptide chain length (5-50 amino acid residues): Ac-(Gly Lys-Gly-Leu-Gly)n-amide, Ac-(Leu-Gly-Leu-Lys-Ala)n-amide and Ac-(Leu-Gly-Leu-Lys Leu)n-amide (n = 1, 2, 4 6, 8, 10). We have examined non-specific hydrophobic interactions of these peptides with both silica-and polymer-based ion-exchange packings, demonstrating how these interactions are overcome by the addition of acetonitrile to the mobile phase. It was also shown that removal of non-specific hydrophobic interactions may be necessary just to elute peptides from the ion exchange matrix. In addition, from the observed retention times of these three peptide polymer series and other peptides which vary substantially in charge density, net charge, polypeptide chain length and hydrophobicity, we have established a simple approach to linearization and, thus, prediction of peptide retention behaviour in CEX. PMID- 2777987 TI - High-performance liquid chromatography of amino acids, peptides and proteins. LXXXIX. The influence of different displacer salts on the retention properties of proteins separated by gradient anion-exchange chromatography. AB - The influence of eight different displacer salts on the retention properties of four globular proteins, ranging in molecular weight from 14,000 to 43,000, was investigated by using the Mono-Q strong-anion-exchange resin as the stationary phase. Proteins were eluted under gradient conditions with a range of alkali metal halides to vary systematically the anion and cation species in the series F , Cl-, and Br- and Li+, Na+ and K+. Protein Zc values (i.e. slopes of the ion exchange retention plots, derived from the dependency of the logarithmic capacity factor log k' on the concentration of the ionic displacer) generally increased when both the anion and cation were either chaotropic, e.g. KBr, or kosmotropic, e.g. NaF, in nature. Conversely, Zc values decreased when the displacer salt contained an anion-cation combination of a chaotropic and a kosmotropic ion, e.g. KF. These results indicate that the lyotropic properties of salts are additive in their effect on the interactive properties of proteins in anion-exchange chromatography. The Zc values were also found to depend on the manner in which the ionic strength was manipulated to affect elution, i.e. isocratic or gradient change in concentration of the displacing salt. Thus, isocratic experiments and gradient experiments with varied gradient time or varied flow-rate were observed to result in log k' versus log l/c dependencies with non-coincident Zc values. The relationship between protein Zc values, the electrostatic contact area or ionotope, Ac, and the electrostatic potential of the protein surface psis, is discussed. PMID- 2777988 TI - Improved separation speed and efficiency for proteins, nucleic acids and viruses in asymmetrical flow field flow fractionation. AB - The performance of the asymmetrical flow field-flow fractionation channel has been improved by the use of a much thinner (0.12-mm) channel than before and by flow programming (stepwise gradient elution). The thinner channel contributes to a decreased zone broadening which enables complete resolution in a shorter time. Three protein peaks, representing molecular weights from 12,000 to 136,000, wer completely resolved within 3 min. Flow programming speeds up the elution of the high-molecular-weight materials which occur late in a fractogram. This enabled separation of a small plasmid fragment (700 base pairs) from the large amounts of a big fragment (4600 base pairs) in 30 min and improved detection of a presumed trimer of albumin. Two viruses (1.8 10(6) and 50 10(6) daltons) were eluted as narrow peaks within 5 min. PMID- 2777989 TI - Ester and related derivatives of ring N-pentafluorobenzylated 5 hydroxymethyluracil. Hydrolytic stability, mass spectral properties, and trace detection by gas chromatography-electron-capture detection, gas chromatography electron-capture negative ion mass spectrometry, and moving-belt liquid chromatography-electron-capture negative ion mass spectrometry. AB - One consequence of radiation damage to DNA is the conversion of thymine to 5 hydroxymethyluracil (HMU). In order to sensitively detect this DNA adduct by gas chromatography (GC) or high-performance liquid chromatography (HPLC) with electron-capture detection techniques, it is necessary to derivatize it. This study was designed to select an optimum ester derivative of the aliphatic hydroxyl group on HMU. N1, N3-Bis(pentafluorobenzyl)-HMU was formed as a parent derivative, and from this a series of esters. Also O-pentafluorobenzyl and O tetrafluorobenzyl ether derivatives were prepared. Of the esters the pivalyl derivative was the best choice because it formed easily, was relatively stable to aqueous hydrolysis (t 1/2 = 9.8 days at pH 11.5, 24 degrees C) and gave a response at fmol levels by GC and LC comparable to that of the ethers. Unanticipated was a good response as well for the parent derivative, a free hydroxyl compound, by GC and LC at this level. The work also demonstrates a high performance by LC-electron-capture negative ion mass spectrometry with a belt interface for the trace detection of derivatives of this type. PMID- 2777990 TI - Purification of synthetic oligonucleotides on a weak ion-exchange column. AB - A weak ion-exchange column (PVDI 4000-5) was used to purify oligonucleotides of relatively large size. The purification of polynucleotides was very rapid, they were separated according to size and retained all their properties relevant to genetic engineering experiments. PMID- 2777991 TI - High-performance liquid chromatography of amino acids, peptides, proteins and polynucleotides. XCIV. Solid-phase hybridization of complementary oligonucleotides. AB - The ability of synthetic oligonucleotides to specifically hybridize to a complementary oligonucleotide immobilized on an anionic stationary phase has been investigated. A sigmoidal melting curve was obtained when oligonucleotide duplex formation on the column was plotted against hybridization stringency over the ionic strength range 0.2-0.42 M. These studies confirm a rapid method for determining the relative melting temperature of hybridized oligonucleotide complexes and provide a basis for the selection of stringency conditions optimal for various synthetic oligonucleotide probes. PMID- 2777993 TI - High-performance liquid chromatofocusing and column affinity chromatography of in vitro 14C-glycated human serum albumin. Demonstration of a glycation-induced anionic heterogeneity. AB - High-performance liquid chromatofocusing of human serum albumin (HSA) after in vitro glycation with purified [14C]glucose has shown that with increasing glycation time a progressive increase in two major anionic fractions (pI 4.8 and 4.65) occurs, while the pI 4.9 fraction decreases in parallel. As early as after 5 days of glycation time, the [14C]glucose content in the anionic fractions was markedly higher than in the pI 4.9 fraction. After 10 and 15 days of glycation, a considerable heterogeneity of 10-15 components could be demonstrated. In addition, phenyl-boronic acid (PBA) affinity chromatography was applied and an enrichment of the more glycated species could be obtained using this method. We conclude that, in contrast to previous reports, glycation of HSA induces anionic heterogeneity (in accordance with the theoretically expected loss of positively charged amino groups) and, although the efficiency in separating non-glycated from monoglycated HSA was found to be very low, an enrichment of these anionic species can be achieved using PBA affinity chromatography. PMID- 2777992 TI - Separation of two molecular forms of human estrogen receptor by hydrophobic interaction chromatography. Gradient optimization and tissue comparison. AB - High-performance hydrophobic interaction chromatography (HPHIC) was used to separate and characterize two molecular forms of estrogen receptor with a SynChropak propyl hydrophobic column (300 A pore size). The linear gradient utilized earlier with a polyether-bonded column (2 to 0 M) ammonium sulfate in 40 min, gave poor resolution with the propyl column. However, resolution was maximized with either an initial ammonium sulfate concentration of 1 M (40-min gradient) or with a two-phase gradient (2 to 0.5 M in 10 min, 0.5 to 0 M in 30 min). This indicated that the propyl column was more hydrophobic than the polyether column. Estrogen receptor separated into two isoforms, either in the presence [MI, retention time (tR) = 13-14 min; MII, tR = 20-21 min] or absence (I, tR = 21-23 min; II, tR = 31-33 min) of the estrogen receptor stabilizing reagent, sodium molybdate. Similar isoforms were observed in cytosols from human breast tumors, uterus, and MCF-7 breast cancer cells. Unlike others, MCF-7 estrogen receptor did not show MI. Since MCF-7 cells contain 90,000 dalton heat shock proteins (HSP-90), HSP-90 is probably not directly involved in MI formation. Sodium molybdate selectively interacted with isoform II and converted it to MI. All isoforms appeared to be high-molecular-weight proteins (greater than 60 A) when subsequently analyzed by high-performance size-exclusion chromatography. Interestingly, when estrogen receptor was immobilized on the stationary phase, no change was detected in either hydrophobicity or steroid binding capacity. After 16-18 h, immobilized receptor was eluted with a slightly longer tR. During incubation on the column, component MI was converted into I and/or II. HPHIC appears to be a rapid, yet gentle procedure for isolating large receptor complexes in significant quantities with high recoveries. This allows one to discern the complicated structure-function relationships of estrogen receptor and associated non-receptor proteins and provides information about the on-column behavior of complex proteins. PMID- 2777994 TI - Polymer support synthesis. XV. Behaviour of non-porous surface-coated silica gel microbeads in oligonucleotide synthesis. AB - Non-porous silica gel microbeads of diameter 1.5 microns have been investigated as supports for oligonucleotide synthesis. In the preparation of oligothymidylates of chain length up to 150 bases, with 5'-di-p anisylphenylmethyl-3'-phosphoramidite as an intermediate, the average yields per chain elongation were up to 99%. Lower overall yields were observed in the case of a support which developed a strong tendency towards aggregation after the build up of an oligonucleotide coating. PMID- 2777995 TI - Reversed-phase liquid chromatography of proteins with strong acids. AB - Small organic acids are generally used as pairing agents at less than 1% concentration in reversed-phase chromatography (RPC) of proteins. When the protein is very hydrophobic and insoluble, as in the case of membrane proteins, up to 60% aq. formic acid has been used. This paper reports a study of the influence of acid concentration on both chromatographic retention and protein structure in RPC. Chromatographic retention increases in proportion to the concentration of organic acid in the mobile phase up to some intermediate concentration. Use of still higher concentrations of acid results in a sharp drop in chromatographic retention with a change in selectivity. The data indicate that the structure of proteins in strong acids are different from that in weak acids. This work examines the reason for this decrease in chromatographic retention at formic and trifluoroacetic acid concentrations above 30% (v/v). Spectroscopic studies show that protein conformation continuously changes with the addition of acid. PMID- 2777996 TI - Blotting of proteins onto Immobilon membranes. In situ characterization and comparison with high-performance liquid chromatography. AB - The electrophoretic transfer from polyacrylamide gels to Immobilon [poly(vinylidene difluoride)] membranes of various proteins differing in molecular masses from 14,000 to 200,000 was performed, using both a semi-dry blotting apparatus and a standard blotting chamber. The blotted proteins were analyzed and sequenced with and without staining, and the initial yields of the degradation were examined. Furthermore, protein purification by blotting after one- and two-dimensional gel electrophoresis was compared with conventional HPLC methods. Optimum blotting conditions for in situ enzymatic or chemical cleavages of the proteins on the blots are described, and for the in situ hydrolysis followed by amino acid analysis and cysteine determination. PMID- 2777997 TI - Automated enantioseparation of amino acids by derivatization with o phthaldialdehyde and n-acylated cysteines. AB - The enantioseparation of standard mixtures composed of protein DL-amino acids was performed by reversed-phase high-performance liquid chromatography of the corresponding diastereomeric isoindolyl derivatives, formed by automated precolumn derivatization with o-phthaldialdehyde (OPA) and a series of N-acyl-L cysteines(Acyl-Cys). A photodiode-array detector, operating at 338 nm, was used for detection. In order to evaluate systematically the influence of the structures of the acyl group in the chiral thiol reagents, a series of novel N acyl-L-cysteines was synthesized [acyl = n-butyryl, isobutyryl (i-But), pivaloyl, benzoyl) and the chromatographic behaviour of the diastereomers formed was compared with those of already known reagents, N-acetyl-L-cysteine and N-ter. butyloxycarbonyl-L-cysteine. All Acyl-Cys derivatives of DL-amino acids were resolved. In particular, i-But-Cys gave the highest resolutions for most of the amino acid enantiomers in comparison with the other Acyl-Cys. Investigation of yoghurt using OPA-acetyl-Cys demonstrated the applicability of the method to a complex food matrix and the occurrence of D-Asp, D-Glu and D-Ala in this dairy product. PMID- 2777998 TI - Liquid chromatographic analysis of amino and imino acids in protein hydrolysates by post-column derivatization with o-phthalaldehyde and 3-mercaptopropionic acid. AB - A method for the simultaneous determination of imino and amino acids is reported. The method, based on the derivatization of amino acids, separated by ion-exchange chromatography, by reaction with alkaline hypochlorite and o-phthalaldehyde-3 mercaptopropionic acid, increases the sensitivity towards imino acids to the picomole level. The use of 3-mercaptopropionic acid gives intensely fluorescent derivatives and improves the stability of primary and secondary amino acid fluorophores towards oxidation. The accuracy and reproducibility of the method are increased by using three internal standards. The determination of all amino and imino acids present in protein hydrolysates, including tryptophan, in a single run is demonstrated. PMID- 2777999 TI - High-performance liquid chromatography for cyclosporin measurement: comparison with radioimmunoassay. AB - The large inter-patient variability in cyclosporin pharmacokinetics coupled with the agent's narrow therapeutic index with adverse effects resulting from supratherapeutic levels, necessitates individualization of drug dosage and therapeutic monitoring of cyclosporin blood levels. The performance of a liquid chromatographic method for the measurement of cyclosporin was evaluated and the results obtained by this method and by a specific radioimmunoassay were correlated. The method described is sensitive, selective, reproducible and easier to perform than other chromatographic methods. It is suitable for the daily measurement of cyclosporin in batches of up to 40 samples and the results correlate well with another chromatographic method and with the specific radioimmunoassay. PMID- 2778000 TI - Effects of mobile phase composition on the chromatographic and electrochemical behaviour of catecholamines and selected metabolites. Reversed-phase ion-paired high-performance liquid chromatography using multiple-electrode detection. AB - The effects of pH, ionic strength, organic modifier, heptanesulphonic acid and citric acid content of a high-performance liquid chromatography mobile phase on the chromatographic and electrochemical behaviour of norepinephrine, epinephrine, dopamine, 3,4-dihydroxybenzylamine, 3,4-dihydroxyphenylethylene glycol, 3,4 dihydroxyphenylalanine and 3,4-dihydroxyphenylacetic acid in a reversed-phase system have been systematically studied. Optimal mobile phase conditions have been derived allowing the separation and reductive-mode detection of these compounds, applicable to both alumina and ion-paired solvent extracts of plasma. It is demonstrated that mobile phase composition significantly affects the sensitivity of a triple-electrode electrochemical detection system, in reductive and oxidative modes, and that electrochemical pre-treatment of mobile phase is required to attain maximum detector sensitivity in the reductive mode. PMID- 2778001 TI - Application of a new radiometric high-performance liquid chromatographic assay to define physostigmine pharmacokinetics in guinea pigs. AB - A sensitive high-performance liquid chromatographic method was developed to determine pharmacokinetic parameters of [3H]physostigmine from serial plasma samples from guinea pigs. Physostigmine was totally resolved from its metabolite, eseroline. The limit of sensitivity was 0.05 ng/ml from 0.2 ml plasma. Extraction efficiency was 99.6%. Within-run and among-run coefficients of variation (n = 6) for 0.2, 0.75, 1.5 and 2.5 ng/ml [3H]physostigmine ranged from 0.7 to 20% and 16 to 32%, respectively. Physostigmine (5 micrograms/kg) intramuscularly administered to the guinea pig (n = 6) reached maximum serum concentration (1.5 ng/ml) in 26 min. The apparent volume of distribution and systemic clearance were 1.4 l/kg and 26 ml/min/kg, respectively. This method was successful in defining physostigmine pharmacokinetic parameters in guinea pigs and can be employed for other small animal pharmacokinetic studies. PMID- 2778002 TI - Determination of arteether in blood plasma by high-performance liquid chromatography with ultraviolet detection after hydrolysis acid. AB - A reversed-phase high-performance liquid chromatographic method is described for determination of the antimalarial agent arteether in blood plasma based on its decomposition in acidic medium and measurement of the major decomposition product, which has been identified as an alpha,beta-unsaturated decalone. Linear calibration curves were obtained in the range 0-250 ng/ml arteether and the recovery of the drug from plasma was found to be quantitative. There is no interference from desoxyarteether, the putative major metabolite of arteether. The method has been applied to the measurement of arteether in the plasma of rats given 110 mg/kg by intramuscular injection of the drug as a solution in sunflower oil. PMID- 2778003 TI - Evaluation of a versatile reversed-phase high-performance liquid chromatographic system using cethexonium bromide as ion-pairing reagent for the analysis of glucuronic acid conjugates. AB - An ion-pair high-performance liquid chromatographic technique has been developed to reduce the elution times of both glucuronic acid conjugates and their free aglycones. The chromatographic system combines the use of a reversed-phase column (LiChrospher CH-18; 5 microns) and a mobile phase of methanol (70-80%)-0.01 M phosphate buffer (pH 6.0) containing 2.5 mM cethexonium bromide as counter-ion at a flow-rate of 1 ml min-1. The hydrophobicity of this quaternary ammonium ion pairing reagent and the high content of the organic modifier in the mobile phase provide close and short elution times for a wide structural variety of compounds (i.e. alcohols, phenols, steroids, carboxylic acids) and their conjugates with glucuronic acid (capacity factors lower than 7.5), without compromising the selectivity with respect to endogenous compounds of the microsomal incubation medium and urine. Advantages of cethexonium bromide over conventional tetrabutylammonium salts are clearly demonstrated, and the described system was applied to the simultaneous quantitation of clofibric acid and its acylglucuronide in human urine and validated for a pharmacogenetics purpose. PMID- 2778004 TI - Separation of the enantiomers of phenprocoumon and warfarin by high-performance liquid chromatography using a chiral stationary phase. Determination of the enantiomeric ratio of phenprocoumon in human plasma and urine. AB - The enantiomers of the chiral coumarin-type anticoagulants phenprocoumon, warfarin and p-chlorophenprocoumon were separated by high-performance liquid chromatography on a chiral stationary phase (Nucleosil-Chiral 2) and normal-phase conditions. Chromatographic peak identification was performed with authentic reference compounds of the enantiomers and on-line UV spectra comparison. This method was applied to the determination of the enantiomeric ratio of phenprocoumon in plasma and urine extracts from patients under racemic drug therapy. The limit of detection (50 and 80 ng/ml) and precision (less than 5%) of the method are adequate for pharmacokinetic and enantioselective disposition studies, respectively, of phenprocoumon. No racemization was detected during the extraction procedures. PMID- 2778005 TI - Measurement of catecholamines, their precursor and metabolites in human urine and plasma by solid-phase extraction followed by high-performance liquid chromatography with fluorescence derivatization. AB - A high-performance liquid chromatographic method is described for the determination in human urine and plasma of catecholamines, their precursor and metabolites [amino compounds (norepinephrine, epinephrine, dopamine, normetanephrine, metanephrine, 3-methoxytyramine and L-DOPA), acidic compounds (3,4-dihydroxymandelic acid, 3,4-dihydroxyphenylacetic acid, vanillylmandelic acid and homovanillic acid) and alcoholic compounds (3,4 dihydroxyphenylethyleneglycol and 4-hydroxy-3-methoxyphenylethyleneglycol)]. Urine (0.5 ml) containing 3,4-dihydroxybenzylamine and 4-hydroxy-3 methoxycinnamic acid (internal standards) is deproteinized with perchloric acid, and the resulting solution is fractionated by solid-phase extraction on a strong cation-exchange resin cartridge (Toyopak IC-SP S) into two fractions (amine fraction and acid-alcohol fraction), which include 3,4-dihydroxybenzylamine and 4 hydroxy-3-methoxycinnamic acid, respectively. Plasma (0.7 ml) is deproteinized in the presence of 3,4-dihydroxybenzylamine (internal standard) in the same manner, and the resulting solution is directly used as an acid-alcohol fraction, while an amine fraction is obtained as for urine. Each fraction is subjected to the previously established ion-pair reversed-phase chromatography with post-column derivatization involving coulometric oxidation followed by fluorescence reaction with 1,2-diphenylethylenediamine. The detection limits, at a signal-to-noise ratio of 5, of the compounds measured in urine are 300 pmol/ml for the two mandelic acids, 2-7 pmol/ml for the other acidic and alcoholic compounds, 12 pmol/ml for L-DOPA and 0.6-2 pmol/ml for the other amino compounds; the corresponding values for plasma samples are 80, 0.5-3, 10 and 0.6-3 pmol/ml, respectively. PMID- 2778006 TI - Highly sensitive determination of catecholamine and serotonin concentrations in plasma by liquid chromatography-electrochemistry. PMID- 2778008 TI - Separation of two erythrocyte prolidase isoforms by fast protein liquid chromatography; application to prolidase deficiency. PMID- 2778007 TI - Purification of the pancreatic stone protein by high-performance liquid chromatography. PMID- 2778009 TI - High-performance liquid chromatographic determination of aminopeptidase P activity in Fischer F344 rat serum and kidney. PMID- 2778010 TI - Applicability of capillary gas chromatography to study caffeine distribution in the developing chicken egg. PMID- 2778011 TI - Determination of isosorbide dinitrate and its metabolites in plasma by gas chromatography on a capillary column with electron-capture detection. PMID- 2778012 TI - Contribution to the determination of chloroquine in biological fluids. PMID- 2778013 TI - Determination of dabequin in biological fluids by gas chromatography with a nitrogen-selective detector. PMID- 2778014 TI - Gas chromatographic identification of urinary metabolites of insect repellent N,N diethylphenylacetamide on inhalation exposure in rats. PMID- 2778015 TI - Determination of oxytetracycline in plasma from rainbow trout using high performance liquid chromatography with ultraviolet detection. PMID- 2778016 TI - Determination of serum sulphonylureas by high-performance liquid chromatography with fluorimetric detection. PMID- 2778017 TI - Determination of free and total metaproterenol in human plasma by high performance liquid chromatography with fluorimetric detection. PMID- 2778018 TI - Simple, rapid and sensitive reversed-phase high-performance liquid chromatographic method for the determination of mefenamic acid in plasma. PMID- 2778019 TI - Efficient high-performance liquid chromatographic system for protein purification. AB - An efficient high-performance liquid chromatographic system, consisting of an affinity column and a high-performance size-exclusion column, was developed and applied to the purification of growth hormone receptors from rabbit livers. When a 6-ml sample of Triton X-100 extracts containing 16 mg of protein was applied to the system, 1200-fold purified receptor with a 10% recovery of binding activity from homogenates was obtained within 3-4 h. The purified receptor exhibited one main band on sodium dodecyl sulphate polyacrylamide gel electrophoresis, and the affinity constant (Ka = 6.0.10(9) M-1) was found to be comparable with that of 1% Triton X-100 extract (4.4.10(9) M-1). The injection of 1 ml of 3 M urea solution prior to receptor elution with 10 ml of 6 M urea solution was effective in removing non-specific binding proteins. PMID- 2778020 TI - Simultaneous determination of pseudouridine and creatinine in untreated urine by ion-pair liquid chromatography with diode-array ultraviolet detection. AB - A simple procedure for the simultaneous determination of pseudouridine and creatinine in urine using ion-pair high-performance liquid chromatography with ultraviolet detection is described. It consists of simply diluting the filtered urine with mobile phase (1:20) followed by direct chromatographic injection. A single analysis takes only 10 min. This method has been applied to the analysis of urine samples from normal donors and patients with different types of cancer. The mean values, means, of the peak-area ratio of pseudouridine to creatinine were 61.79.10(-3) and 81.92.10(-3) for male and female normal donors, respectively. Out of twenty-five urine samples of patients with cancer examined, nineteen (all the forteen males included) had values higher than means + 2 sigma. PMID- 2778021 TI - Application of the fast protein liquid chromatographic system and MonoQ HR 5/5 anion exchanger to the separation of nucleotides. AB - The applicability of a new type of anion exchanger, MonoQ HR 5/5, and the Pharmacia-LKB fast protein liquid chromatographic (FPLC) system to the separation of nucleotides is described. The elution characteristics of adenosine-5'-, cytidine-5'-, uridine-5'-, guanosine-5'-mono-, -di- and -triphosphates and inositol-5'-monophosphate reference compounds, and of nucleotides originating from various biological samples, are optimized by varying the concentration gradient programme with ammonium phosphate buffer. Some practical examples of biological interest for monitoring the metabolic changes of nucleotides are presented. PMID- 2778023 TI - Identification and determination of 1 alpha,25-dihydroxyvitamin D3 in rat skin by high-performance liquid chromatography and radioreceptor assay. AB - Endogenous 1 alpha,25-dihydroxyvitamin D3 [1,25-(OH)2D3] in normal rat skin was identified by using thermal isomerization to convert the metabolite into its pre isomer, high-performance liquid chromatography (HPLC) and displacement potency with a chick intestinal cytosol receptor. When the metabolite in normal rat skin was determined by a radioreceptor assay after purification by Sep-Pak silica cartridge column chromatography and HPLC, the concentration was 71.0 +/- 6.6 pg/g of wet tissue (mean +/- S.D.). It is also shown that [3H]-1,25-(OH)2D3 and [3H] 25-hydroxyvitamin D3 administered intravenously in the mouse are located in the skin. These results suggest that the metabolite may play an important role in the skin. PMID- 2778022 TI - Separation of porphyrin isomers by high-performance liquid chromatography. AB - A high-speed reversed-phase high-performance liquid chromatographic method using an octadecylsilyl 3 cm long (3 microns particle size) column to separate the free acids of uroporphyrins I and III and coproporphyrins I and III from each other, and from the type I isomers of several other porphyrin carboxylic acids, is described. Separation of the porphyrins was achieved in less than 8 min, and injections were possible every 12 min. The detection limits of uroporphyrin, coproporphyrin, and mesoporphyrin were 75, 45, and 35 fmol (at a signal-to-noise ratio of 2), respectively. Application of the method to the determination of urinary and liver porphyrin patterns is shown. PMID- 2778024 TI - Rapid and sensitive determination of aprindine in serum by gas chromatography using a surface ionization detector. AB - A rapid and highly sensitive method for the determination in serum of aprindine, an antiarrhythmic drug, was developed employing gas chromatography with a surface ionization detector. No interfering peak from endogenous substances appeared when an organic phase was directly injected into the system after single extraction from a serum sample. A standard curve obtained was linear up to the serum level of 6 micrograms/ml, and the limit of sensitivity was 16 pg. The method described is applicable to routine therapeutic monitoring of serum concentrations of aprindine. PMID- 2778025 TI - High-performance liquid chromatographic method for the determination of salicylic acid and its metabolites in urine by direct injection. AB - A direct injection method has been developed for the determination of salicylic acid and its metabolites in urine. Urine samples are treated with hydroxylamine to convert salicyl acyl glucuronide to salicylhydroxamic acid, which can be accurately quantitated by direct injection into a high-performance liquid chromatographic system along with salicylic acid, gentisic acid and salicyluric acid. Salicyl phenolic glucuronide is quantitated by difference after hydrochloric acid hydrolysis at 65 degrees C with no loss of salicylic acid by sublimation or hydrolytic loss of salicyluric acid. This method has been applied to urine samples from human subjects and the results are discussed. PMID- 2778026 TI - Detection of rabies virus RNA in the central nervous system of experimentally infected mice using in situ hybridization with RNA probes. AB - Rabies virus is usually demonstrated in human or animal tissues using antigen detection or viral isolation techniques. Rabies virus RNA can be demonstrated in paraffin-embedded tissues using in situ hybridization. Negative (-) sense 35S- and 3H-labeled RNA probes, specific for rabies virus nucleocapsid protein mRNA, were used for the detection of rabies virus RNA in the nervous system of mice experimentally infected with fixed and street strains of rabies virus. In situ hybridization signals were compared with rabies virus antigen demonstrated with immunoperoxidase staining. Rabies virus RNA and antigen were also demonstrated in the same neurons using a double-labeling technique. In situ hybridization has potential applications as a diagnostic test for rabies and in studies of rabies pathogenesis. PMID- 2778027 TI - Growth of rubella virus in a glass bead propagator. AB - A glass sphere propagator with an air lift pump to circulate the medium, has been successfully used to produce large volumes of rubella virus. The system was productive, flexible and easy to operate. PMID- 2778029 TI - Preparation of soluble, biologically active alfalfa mosaic virus coat protein and its CaCl2-induced degradation. AB - A method for the preparation of soluble protein from five biologically distinct alfalfa mosaic virus (AMV) isolates is described. Highly purified AMV was dissociated with 1 M CaCl2 in 10 mM sodium acetate, pH 6.0, and the precipitated RNA was removed by centrifugation. The protein was dialysed against 10 mM sodium acetate, pH 6.0, containing 0.1 M CaCl2. If the salt concentration was reduced further, proteins from some AMV isolates precipitated. Proteins prepared by this method were shown to be immunoreactive and to activate the infectivity of the AMV genome. However, during prolonged exposure of the protein to buffers containing 0.1 M CaCl2, it undergoes slow proteolysis thereby losing its ability to activate the AMV genome but not its immunoreactivity. PMID- 2778028 TI - Development of a monoclonal antibody for use as an amboceptor in complement fixation tests. AB - A monoclonal antibody for use as a haemolytic amboceptor in complement fixation tests was developed. The monoclonal antibody selected was investigated in parallel with conventional rabbit amboceptor. The results with the monoclonal amboceptor were at least as good as with the rabbit amboceptor. Production of the monoclonal amboceptor was attained provided that hybridoma growth factor was added to the culture medium. PMID- 2778030 TI - An enzyme-linked immunosorbent assay (ELISA) for the detection and quantification of antibodies against swine vesicular disease virus (SVDV). AB - A liquid phase blocking sandwich ELISA has been compared with virus neutralisation for testing pig sera for antibodies against swine vesicular disease (SVD) virus. Highest infectivity titre of SVD virus was obtained using a multiplicity of infection of 30 pfu/cell and harvesting after 21 h. Titres obtained for 300 clinically normal animals were assessed by ELISA and 89% were found to be 1/6 or less. Results were skewed and spread up to 1/45. Comparison of known positive sera resulted in a correlation between the two methods of 0.68 and showed that a virus neutralisation titre of 1/16 was equivalent to 1/40 (log10 1.61) by ELISA. Variation in results obtained by replicate testing using ELISA and virus neutralisation was almost identical. Overlap between positive and negative sera was shown to be reduced to 1-1/2 fold in ELISA. Therefore, the ELISA correlated well with virus neutralisation and has several advantages over the latter. PMID- 2778031 TI - Production of antiserum to a non-structural potyviral protein and its use to detect narcissus yellow stripe and other potyviruses. AB - A protein, of apparent molecular weight 72,000, was purified from experimentally infected narcissus plants with yellow stripe symptoms utilising SDS polyacrylamide gel electrophoresis. This protein was excised from the gels and used to prepare antiserum, which reacted specifically with cytoplasmic cylindrical inclusions in ultra-thin sections of virus-infected cells and, in immunoblots, with the 72 kDa protein in preparations containing cytoplasmic inclusions. The antiserum reacted in ELISA with leaf extracts from yellow stripe diseased plants of four narcissus cultivars but not with extracts from comparable symptomless plants. In tests with extracts of plants infected with seven definitive potyviruses, reactions were obtained with bean yellow mosaic and iris mild mosaic viruses. Virus-specific reactions in dot-blot ELISA were dependent on the presence of Tween 20 in the extraction buffer. In contrast, an antiserum to the putative cytoplasmic inclusion protein of alstroemeria mosaic virus reacted only with SDS-treated leaf extracts of infected plants. In limited tests, the method of purifying cytoplasmic inclusion protein was successfully applied to four definitive potyviruses, suggesting that it may be generally applicable to potyviruses and of use for preparing antisera when purification of virus particles is difficult. PMID- 2778032 TI - Regulation of growth hormone secretion and messenger ribonucleic acid accumulation in human somatotropinoma cells in vitro. AB - GH secretion and mRNA levels were measured in cultured cells obtained from six human pituitary somatotroph tumors to investigate their hormonal and intracellular regulation. The responses were variable between tumors, but, in general, mRNA levels were less responsive than GH release to in vitro manipulation. GH-releasing factor [GRF-(1-29) amide; 10 nM] increased GH release and mRNA levels in three of four tumors tested to 30-97% above control values, but the fourth tumor was unresponsive. Somatostatin (1 microM) inhibited GH release significantly in four of the six cases, to 35-79% of control levels, but had no inhibitory effect on GH mRNA accumulation, in contrast to earlier studies on rat pituitary tissue. Bromocriptine (100 nM) likewise inhibited GH release (50 75% of control), but not GH mRNA levels, in the four tumors tested. Forskolin (10 microM; used to activate adenylate cyclase) stimulated GH release and mRNA levels in the two cases that responded most clearly to GRF, but had no significant effect in the other tumors; however, the phorbol ester 12-O-tetradecanoyl phorbol 13-acetate (100 nM) had no consistent effect on mRNA levels despite stimulating secretion in four of six cases. Thus, there was considerable variation in responses among the tumors tested; however, the responsiveness to GRF was approximately paralleled by that to forskolin, consistent with the suggestion that adenylate cyclase activity and responsiveness are variable among these tumors. Furthermore, the divergent effects of somatostatin on GH release and mRNA suggest uncoupling between its receptor and transcriptional regulatory mechanisms. PMID- 2778033 TI - Dietary carbohydrate content determines responsiveness to growth hormone in energy-restricted humans. AB - To determine if diet composition influences responses to GH, we fed 11 obese women diets containing 12 Cal/kg ideal BW (IBW) for 2 5-week study intervals. Nonprotein calories were supplied to 6 subjects as 72% carbohydrate (high carbohydrate diet), and 5 subjects received 80% of their nonprotein calories as lipid (high lipid diet). Protein intake was constant (1.0 g/kg IBW) in both groups. During 1 study interval we gave injections of GH (0.1 mg/kg IBW) every other day for 3 weeks (weeks 2-4), and in the other interval injections of vehicle were given. Subjects ingesting the high carbohydrate diet excreted significantly less urinary nitrogen [660.2 +/- 124.1 mmol/day (mean +/- SD)] than those who received high lipid (794.2 +/- 198.5 mmol/day; P less than 0.001), and GH injections reduced nitrogen excretion in the high carbohydrate subjects (532.8 +/- 123.8 mmol/day), but not in the high lipid subjects (743.7 +/- 126.6 mmol/day). The subjects receiving the high carbohydrate diet had a significant increase in serum insulin-like growth factor-I (IGF-I; from 36.2 +/- 9.7 to 55.9 +/- 6.6 nmol/L) and urinary C-peptide excretion (from 43.9 +/- 25.6 to 60.8 +/- 29.4 nmol/day) in response to GH. The IGF-I response attenuated slowly over the 3 week treatment interval. On the other hand, the high lipid group had lesser increases in IGF-I (from 31.0 +/- 6.5 to 41.7 +/- 8.8 nmol/L) and C-peptide excretion (from 24.3 +/- 28.9 to 29.8 +/- 32.8 nmol/day), and IGF-I concentrations declined to control values after only 5 days of GH injection. We believe that this initial IGF-I response was due to an antecedent 35-Cal balanced diet. The mean increment in serum FFA 4 h after GH injection was significantly less in subjects fed the high lipid diet (0.53 +/- 0.40 meq/L) than in those fed the high carbohydrate diet (0.83 +/- 0.43 meq/L). GH injections produced more body fat loss than injections of vehicle whether expressed as percent body fat lost (GH, 3.7 +/- 1.0%; vehicle, 2.8 +/- 0.7%, P less than 0.05) or as the fraction of weight lost as fat (fat loss/weight loss; GH, 0.81 +/- 0.13; vehicle, 0.64 +/- 0.08; P less than 0.005). There was an inverse correlation between the percentage of body fat lost and mean urinary C-peptide excretion during GH injections (r = -0.70; P less than 0.05), suggesting that stimulation of insulin secretion by GH might antagonize the tendency of GH to promote fat loss.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2778034 TI - Radial and vertebral bone density in white and black women: evidence for racial differences in premenopausal bone homeostasis. AB - The reasons for a different incidence of osteoporotic fractures in white and black women are unknown. Previous racial comparisons of bone mass have been limited by racial differences in body weight and socioeconomic, health, and nutritional status. This cross-sectional study examined bone density in 105 black and 114 white healthy nonobese women, 24-65 yr old, using dual photon absorptiometry of the lumbar spine and single photon absorptiometry of the distal radius. Bone density at both sites was higher in blacks at all ages than in whites. When adjusted for age and body mass index, mean bone density was 6.5% higher in blacks at both spine and radius (P less than 0.0001). The cross sectional rate of decline of vertebral bone density was similar between races; however, radial density increased 3.8%/decade (P = 0.03) in premenopausal blacks under age 46 yr, while it declined 3.2%/decade (P = 0.09) in premenopausal whites. The racial difference in slopes in these premenopausal women is significant (P = 0.002). These findings suggest that attainment of higher peak bone mass and delayed onset of bone loss contribute to the lower incidence of osteoporotic fractures in black women. PMID- 2778035 TI - Prospective studies of muscle capillary basement membrane width in prediabetics. AB - In 1968, this laboratory reported that muscle capillary basement membrane thickening was present in approximately 50% of nondiabetic individuals who had a strong genetic predisposition for developing diabetes mellitus. In the present manuscript we report the 20-yr follow-up observations in this group of prediabetics. We were able to obtain information regarding the presence or absence of diabetes in 17 of 33 subjects (51.5%). In these 17 individuals, 8 (47%) developed diabetes over the ensuing 20+ yr of observation. Initial (1964) glucose tolerance tests in the subjects that developed diabetes were not significantly different from those that did not develop diabetes. One- and 2-h glucose values on follow-up (4-8 yr later) glucose tolerance tests were significantly higher in the group that developed diabetes. On initial biopsy, muscle capillary basement membrane width was similar in the 2 groups; in the follow-up specimens the mean muscle capillary basement membrane width tended to be greater in the group that ultimately developed diabetes, but this difference was not statistically significant. However, in the group that developed diabetes the follow-up muscle capillary basement membrane width increased significantly compared to the initial measurement, whereas in the nondiabetic group the muscle capillary basement membrane width decreased with time (diabetics, +75.50 +/- 23.66; nondiabetic, -14.44 +/- 28.71 A/yr; P less than 0.05). Seven of 8 (87%) of the individuals who developed diabetes showed progressive thickening of their muscle capillary basement membrane thickness, whereas in the nondiabetic group 5 of 8 had a decrease in width. These results suggest that an increase in muscle capillary basement membrane width over time might serve as a marker to detect individuals who are at increased risk to develop diabetes. The detection of an increased susceptibility for diabetes could potentially allow for interventions that could delay or prevent the development of diabetes. PMID- 2778036 TI - Metabolic clearance rates of synthetic human growth hormone in children, adult women, and adult men. AB - The MCR of biosynthetic human GH was studied in 12 prepubertal children, 9 adult women, and 13 adult men. Subjects received a constant infusion of biosynthetic GH, and clearance was calculated by dividing the infusion rates by steady state serum concentrations of GH. We found that adult men have a significantly more rapid MCR of human GH than women (125.2 +/- 7.6 mL/min.m2 in men; 89.4 +/- 7.7 mL/min.m2 in women) and that both men and women have a significantly more rapid MCR of human GH than prepubertal children (66.8 +/- 7.7 mL/min.m2). Sex differences in GH clearance rates may account at least in part for the lower mean serum GH concentrations in pubertal, but not prepubertal, males compared to those in females. The differences in clearance between prepubertal children and adult women and men suggest that the male-female differences in GH clearance are due to androgen effects on GH clearance or on the relative proportions of free and protein-bound GH in serum. PMID- 2778037 TI - Reduced bone mass in reproductive-aged women with endometriosis. AB - Cortical and trabecular bone masses were measured by quantitative computed tomography of the distal radius in 41 women (30 +/- 1 yr) with endometriosis documented by laparoscopy and compared to those in 35 normal women (32 +/- 1 yr). Hormonal status was assessed, and a subset of 10 women with endometriosis underwent evaluation of calcium absorption and excretion. Menstrual cycles were regular in all women, and hormonal medication had not been administered during the 3 months before evaluation. Estradiol and progesterone varied as expected with the day of the cycle. Fasting calcium excretion was normal. Mean cortical and trabecular bone mass values in women with endometriosis were compared to those in the normal women. Women with endometriosis had significantly decreased cortical and trabecular bone mass. Cortical bone mass in normal subjects was 1263 +/- 11 Hounsfield units (HU), whereas in endometriosis, cortical bone mass measured 1133 +/- 16 HU (P less than 0.0001). Normal trabecular bone mass was 226 +/- 10 HU compared to a mean trabecular bone mass of 173 +/- 9 HU (P less than 0.0001) in endometriosis. Despite the decrease in bone mass documented by quantitative computed tomography, hormonal and calcium dynamics were normal and, therefore, did not appear to be significant etiological factors in regard to the bone loss. Since immunological abnormalities have been reported in association with endometriosis, immune factors may play a role in the development of bone loss in endometriosis and might be of pathogenic significance in this reproductive disorder. PMID- 2778038 TI - Pulse amplitude and frequency modulation of parathyroid hormone in plasma. AB - Inconclusive reports on pulsatile secretion of PTH in man have been published. In this study PTH was measured by intact and PTH-(44-68) assays. Central venous blood sampling was performed every 2 min in 10 healthy men between 6-9 h and in 3 male patients with osteoporosis for over 6 h. Pulsatile PTH secretion was identified for healthy men and controls. Narrow pulses and bursts of narrow pulses (broad pulse) could be distinguished. Six narrow pulses per h with 26 +/- 16 ng/L amplitude and 1 burst of narrow pulses/h were detected for the intact hormone. One narrow pulse/h with 25 +/- 12 ng/L amplitude and 1 burst of narrow pulses (broad pulse) every 2 h were found (Pulsar) for PTH-(44-68). Intact and PTH-(44-68) exhibit in part a concordant pattern. Results from 3 patients with osteoporosis show a decreased amplitude and frequency of pulsatile PTH secretion. The same decreased pattern was demonstrated in a postmenopausal osteoporotic woman. A constant decline in ionized calcium elicits major secretory episodes of PTH, and ionized calcium increases after major secretory episodes of PTH. We conclude that pulsatile secretion of PTH in healthy young men is the physiological mode of secretion. Low pulsatile secretion of PTH might be related to low turnover osteoporosis. PMID- 2778039 TI - Calcium-dependent release of N-terminal fragments and intact immunoreactive parathyroid hormone by human pathological parathyroid tissue in vitro. AB - The regulation of PTH secretion by extracellular calcium was studied in parathyroid tissue obtained from patients with hyperparathyroidism (adenoma or hyperplasia) using both an amino (N)-terminal RIA as well as an immunoradiometric assay (intact assay) specific for the intact hormone. The parathyroid glands separated into three major groups when examined in terms of absolute amounts of PTH secreted, degree of suppressibility, and set-point for calcium (the concentration of calcium causing half-maximal inhibition of PTH release). In cell preparations from group A (two different adenomas, two hyperplastic glands from a patient with renal failure, and a hyperplastic gland from a patient with hypophosphatemic rickets), both assays showed comparable PTH release (agreeing within 2-fold), similar degrees of suppressibility and similar, if not identical, set-points. In group B (two adenomas and one hyperplastic gland from a patient with renal failure), PTH secretion, as measured in the N-terminal assay, was 3- to 6-fold more than that measured in the intact assay. The set-points and maximal degrees of suppressibility were, however, still comparable. In group C [two adenomas and one gland from a patient with hypophosphatemic rickets (the sister of the patient in group A)], no suppressibility was observed when PTH release was measured using the intact assay (i.e. less than 50% suppression of PTH release at 2-3 mM Ca2+). In one of these three glands, the N-terminal assay was used in addition to the intact assay, and no suppressibility was present with either assay. Thus, in general, the effects of extracellular Ca2+ on PTH secretion from pathological parathyroid tissue were similar when assessed with both an N terminal and an intact assay, at least with respect to setpoint and maximal suppressibility. In a few cases, maximal PTH release was greater when measured with the N-terminal assay, consistent with substantial release of N-terminal fragments in addition to intact PTH. In addition, nonsuppressible glands were not uncommon when PTH release was measured by the intact assay, confirming previous studies with less specific assays. PMID- 2778040 TI - Effects of sandostatin on plasma chromogranin-A levels in neuroendocrine tumors. AB - We have determined the effects of Sandostatin (SMS 201-995, Sandoz) on chromogranin-A (CgA) in the blood of 14 patients with neuroendocrine tumors of the gastroenteropancreatic axis, 7 with carcinoid tumors, 5 with gastrinomas, and 1 each with a glucagonoma and tumor-secreting vasoactive intestinal peptide. Two thirds of the patients had elevated plasma CgA. Sandostatin administration suppressed CgA in 12 of the 14 patients. In 8 of 10, the clinical response to Sandostatin paralleled the reduction in CgA levels. There was a strong correlation between the change in CgA levels and the respective blood concentration of the hormone produced by the tumor. Serial measurement of CgA may provide an additional means of monitoring these tumors and their secretory activity where other measures are not available. PMID- 2778041 TI - The effect of a meal on circulating steady-state progesterone levels. AB - Five fasting women had a steady-state concentration of progesterone (P) established by a constant intravenous infusion of P during the early proliferative phase of a spontaneous menstrual cycle. Alterations in the levels of P after the ingestion of a balanced liquid meal were sought. Eight studies were performed utilizing the five women. P levels decreased in all observations; the mean (+/- SE) decrease was 34.2 +/- 0.2% 60 minutes after the meal (p = 0.0001). By contrast, mean cortisol (F) levels increased 29.5 +/- 14.4% (p = 0.11) 60 minutes after the meal and postprandial F levels were variable both within and between individuals. The correlation between the change in P and F, 60 minutes after the meal, was not significant (r2 = 0.015, p = 0.77). These findings indicate that: 1) The postprandial state is associated with a transient and large increase in the metabolic clearance rate of P and/or a change in the volume of distribution of P and 2) Increased F levels after meals alone do not appear to account for a postprandial decrease in P. PMID- 2778043 TI - Immunology of pregnancy: quo vadis? PMID- 2778042 TI - Human sperm antigens corresponding to sperm-immobilizing antibodies in the sera of women with infertility of unknown cause: personal review of our recent studies. PMID- 2778045 TI - Gland and epithelium formation in vitro from epithelial cells of the human endometrium. AB - As is often the case with cell culture, normal human endometrial epithelial cells show a low, squamous shape with flattened nuclei and lack three-dimensional morphology in in-vitro culture systems. Here we report the first well differentiated epithelial culture system using basement membrane extracts (BME) from an Engelbreth-Holm-Swarm tumour (EHS tumour). In this model, BME regulated the reconstruction of glandular formation and subsequent reformation of the epithelium by epithelial cells. An electron microscopic study clearly indicated that there were two distinct types of cells grown on the substrate. The first, having a high columnar shape, formed the glandular epithelium, and the second, having a cuboidal shape, covered the surface of the BME. Study of epithelial reformation indicated that the regeneration of superficial epithelium could occur, following the development of the glandular formation, in a helix-like pattern. Total protein secretion was greater when the cells were grown on the BME than on plastic. Thus, normal human endometrial epithelial cells cultured on the BME assumed a phenotype and morphology characteristic of those in vivo. PMID- 2778044 TI - Ultrasonic assessment of the endometrium as a predictor of oestrogen status in amenorrhoeic patients. AB - Thirty consecutive amenorrhoeic patients were assessed with regard to the following: medical history, physical examination, pelvic ultrasonography, serum levels of 17-beta oestradiol (E2), other relevant serum hormones and the response to a progesterone challenge test. The results showed a correlation coefficient of 71% (P = 0.001) between the E2 levels and the endometrial width and of 52% (P = 0.03) between the testosterone levels and the E2 levels. Linear regression of endometrial width against E2 levels showed beta = 0.018 (R2 = 22%, P = 0.02). Patients with an endometrial width of 4 mm or less reported no bleeding or only scanty bleeding following progesterone and all the patients with an endometrial width of greater than 5 mm responded to progesterone with normal menstrual bleeding. PMID- 2778046 TI - Effects of varying doses of HCG on the evolution of preovulatory rabbit follicles and oocytes. AB - To determine the effects of insufficient or excessive doses of human chorionic gonadotrophin (HCG) on ovulation, varying single doses from 5 to 100 IU were administered to 40 does in oestrus. A total of 371 preovulatory follicles and oocytes were observed. Low doses of HCG (5-10) started resumption of meiosis, but no ovulation occurred. Higher doses progressively induced nuclear maturation (prometaphase, metaphase I, metaphase II). Simultaneously increasing doses initiated ovulation of some of the follicles, then of most of the follicles. Unruptured follicles, mostly with oocytes in metaphase II were frequent and depending on the dose, these were preovulatory, haemorrhagic or luteinized. The administration of different doses demonstrated the possible dissociation of several mechanisms leading to ovulation. The induction of nuclear maturation requires lower doses of HCG than luteinization. Follicular rupture requires even higher doses. Premature luteinization induces intrafollicular ovum retention without (LUF syndrome) or with follicular rupture. These mechanisms of ovulation explain the effects of blunted luteinizing hormone surges or inadequate HCG administration. PMID- 2778047 TI - Strategies for the treatment of hirsutism. PMID- 2778048 TI - Effects of anti-sperm antibodies on human sperm ultrastructure and function. AB - The ultrastructural appearance of a highly motile population of spermatozoa from a fertile donor was evaluated following antibody labeling with each of several sperm head-directed anti-sperm antibodies (ASAs) and subsequent incubation in a capacitating medium in vitro. Acrosomes were classified into categories which are believed to represent stages in the acrosome reaction. Quantitative analysis revealed no difference in acrosomal morphology of antibody-labeled sperm between treatment groups despite a varying degree of enhancement or inhibition of sperm egg-penetrating ability. We conclude that ASAs affect gamete interaction through mechanisms other than an alteration in the acrosome reaction. PMID- 2778050 TI - Fertility prognosis in IVF treatment of patients with cancelled cycles. AB - Among 429 patients admitted in our in-vitro fertilization (IVF) programme during the last 3 years, 106 experienced cancellation of one or more treatment cycles. A low oestrogen (E2) response represented by far the main reason for cancellation (144/184). Significantly lower clinical pregnancy rates were found in the group of patients with low E2-cancelled cycles (E2CC) as compared to the rest of the IVF population (13 versus 37%). Further comparison between these groups showed only little or no difference in the mean age of patients, basal FSH levels, number of egg collections, rate of oocytes obtained and fertilized per trial and mean embryonic vitality score. A large majority of E2CC patients were found to belong to the tubal infertility group (75%) as opposed to a lower proportion of tubal cases among other IVF patients (56%). E2CC tubal patients showed a lower pregnancy rate than other cases with abandoned cycles and also than other tubal patients (8.9 versus 25 and 35%, respectively). Mean numbers of previous laparotomies, of attempts at oocyte retrieval and of oocytes recovered per trial were similar in tubal patients with or without E2CC. However, in the E2CC tubal group mean age and basal FSH levels were somewhat higher, whereas E2 peak values and fertilization rates were lower, leading to a greater proportion of trials without embryo transfer. Embryonic scores and the E2/P ratio at day 3 of the luteal phase did not differ significantly. It may be concluded that cancelling of a cycle because of a low E2 response in a patient with tubal infertility is indicative of a poor prognosis in further IVF trials. PMID- 2778049 TI - Vaginal intratubal insemination (VITI) and vaginal GIFT, endosonographic technique: early experience. AB - A new technique for vaginal intratubal insemination (VITI) and transvaginal gamete intra-Fallopian transfer (TV-GIFT) using endosonography has been developed. A total of 47 infertile couples were treated using a K-JITS 1000-1100 catheter (William Cook, Australia; Jansen Anderson Intratubal Transfer Set) introduced by Jansen and Anderson in Sydney, Australia, and endosonographic control with a Kretz Combison 310 echograph and a 5/7.5 MHz vaginal sectorial transducer. In 40 couples, the VITI technique was used, and in the other seven couples, TV-GIFT was used. Fifteen pregnancies (37.5%) were obtained in 63 VITI cycles (23.8% per treatment cycle) and three with TV-GIFT (42% per treatment cycle). A review is also presented of the migration--sedimentation technique used for management of male factor in an artificial insemination programme. PMID- 2778051 TI - Repeated mid-cycle tests of in-vitro sperm penetration (Kremer tests) in healthy women during three menstrual cycles. AB - The outcome of Kremer testing has been evaluated daily, during the mid-cycle, in 15 healthy women over three menstrual cycles, using a permanent and a variable normal, male donor. There was a significant correlation (r = 0.539; t = 6.33; P less than 0.001, n = 100; Spearman rank correlation with correction for ties) between the results obtained with the two men. The best Kremer test results were seen on the day of the LH peak and the two preceding days. No correlation was present between serum oestradiol levels and Kremer test results except on the day before the LH surge. Enough cervical mucus for Kremer testing was obtained when serum oestradiol levels were a mean of 693 pmol/l (range 214-2140). Variations in Kremer test results obtained in one woman's menstrual cycle were of the same magnitude as the difference between women. Four women had a favourable mid-cycle Kremer test result in all three cycles studied, six women had a favourable mid cycle Kremer test result during two of their three cycles and five women only during one of the three cycles studied. The outcome of the Kremer test was not directly correlated to the quality of the cervical mucus as evaluated by the scoring system used by WHO. It is suggested that the Kremer test, performed with two male donors daily during the mid-cycle in three menstrual cycles, affords results that will allow reliable prediction of conceptional potential. PMID- 2778053 TI - Ultrastructure of a 4-cell human embryo developed in vivo. AB - The ultrastructure of a 4-cell human embryo undergoing development in vivo is described. The embryo recovered from the Fallopian tube 130 h after a single episode of intercourse and 70 h after the luteinizing hormone peak in plasma, was partially surrounded by cumulus cells. The blastomeres, of even size, were nucleated and had a similar distribution of cytoplasmic organelles. No signs of abnormality or cellular degeneration were observed. Transmission electron microscopy of serial sections revealed the presence of primitive desmosomes between cells, abundant vesicles within the blebs of the outer sheet of the nuclear membrane, blebbing of the inner sheet of the nuclear membrane and close association between the inner sheet of the nuclear membrane and the intranuclear annulate lamellae. Nucleolar precursors lacking the structural organization of mature nucleoli were also found. Similarities and differences between this and other preimplantation human embryos reported earlier are analysed. PMID- 2778052 TI - An evaluation of semen analysis and in-vitro tests of sperm function in the prediction of the outcome of intrauterine AIH. AB - Twenty-nine couples with an average of 5 years of infertility were selected for treatment by intrauterine insemination of washed semen (AIH). The criteria for selection were (i) the female partner showed no detectable fertility disorders by routine screening; (ii) the male partner showed subnormal semen quality on conventional semen analysis. Ovulation was stimulated uniformly with clomiphene citrate and precipitated with human chorionic gonadotrophin (HCG). Inseminations were performed 31-32 h post-HCG, with the day of HCG determined by ultrasound monitoring of follicular development. The fertilizing capacity of the male partners' spermatozoa was tested in vitro using donated human oocytes and/or the zona-free hamster oocyte penetration assay. Up to eight cycles of AIH were alternated with cycles of natural intercourse. While no pregnancies occurred in the group during normal coital cycles, the AIH pregnancy rate was 17% per couple, but only 3% per insemination cycle. Four further pregnancies were achieved spontaneously in couples from the study group within 3 years of completion of the AIH therapy and four patients became pregnant following subsequent GIFT or IVF treatments. Neither of the in-vitro tests was helpful in predicting the outcome of AIH, spontaneous pregnancy nor of subsequent assisted conception procedures. PMID- 2778054 TI - Premature chromosome condensation after in-vitro fertilization. AB - During an in-vitro fertilization programme, 320 inseminated oocytes showing neither formation of pronuclei nor cell cleavage were studied cytogenetically. Fourteen of 17 oocytes exhibiting no extrusion of a polar body were characterized by an approximately diploid set of metaphase II chromosomes with four of these oocytes also showing an additional set of prematurely condensed sperm chromosomes of the G1-phase (G1-PCC). These chromosomes were single chromatids. Among 211 oocytes characterized by polar body extrusion, the same type of chromosomes were found in 22, along with metaphase II chromosomes in the haploid range. This phenomenon can be explained by the permanent arrest of the oocytes at metaphase II after sperm penetration, which allows the presence of cytoplasmic chromosome condensing factors to remain, leading to the induction of PCC in the sperm nucleus. In single cases, PCC was also observed in fertilized eggs that had formed two or three pronuclei. In these cases, PCC resulted either from distinct pronuclear asynchrony or interchromosomal asynchrony within the chromosome set. PMID- 2778055 TI - Human sperm-zona pellucida binding, sperm characteristics and in-vitro fertilization. AB - The number of sperm bound to the zona pellucida (ZP) were counted on 660 oocytes that failed to fertilize in vitro from 162 patients. Oocytes from clutches in which some fertilized had significantly more sperm bound to the ZP than did those from clutches in which all oocytes failed to fertilize. Oocytes from patients in whom all were not fertilized and no sperm bound to the ZP were able to bind normal fertile donor sperm after storage in ammonium sulphate solution. The number of sperm bound to the ZP was significantly related to the proportion of sperm with normal morphology and normal intact acrosomes in semen, sperm concentration inseminated, sperm motility and viability. The number of sperm bound to the ZP, sperm normal morphology, diagnosis of male infertility and sperm concentration in semen were significantly related to the fertilization rate by logistic regression analysis. Thus the number of sperm bound to the ZP is an indicator for IVF success and low binding appears to be more frequently associated with sperm defects than oocyte defects. PMID- 2778056 TI - The use of Albuminar 5 as a medium supplement in clinical IVF. AB - Human serum and Albuminar 5 (A5) were compared as medium supplements to Earle's solution containing pyruvate in clinical IVF. One-hundred patients in each group showed a fertilization rate of 60% with serum and of 62% with A5. The overall pregnancy rates in the serum and A5 groups were 20 and 24%, respectively. The incidence of failed fertilization (6-7%) and of multipronucleate oocytes (4-5%) was similar in both groups. At 37 degrees C, sperm survived less well in A5 although the rate of fertilization was not reduced. Blastocyst formation was not seen in 'spare' embryos grown in vitro in medium containing 15% v/v A5. PMID- 2778057 TI - Improved quality of human embryos when co-cultured with human ampullary cells. AB - Cultured human, ampullary, epithelial cells obtained from fertile women undergoing hysterectomy were evaluated for the support of human embryonic cleavage and growth in vitro. Twelve patients provided 23 embryos for co-culture with subcultured ampullary cells grown in T6 + 15% patient's serum and 18 embryos for growth in T6 + 15% patient's serum alone (controls). Of embryos co-cultured with ampullary cells, 78% cleaved to the compacted embryo stage and 69% cavitated as compared with 50 and 33% respectively for controls (P less than 0.01). Only 30% of co-cultured embryos reached the expanded blastocyst and 26% underwent hatching as compared with 28% for both stages in controls. At the 2 - 4- and 6 - 8-cell stages, 91 and 87% of co-cultured embryos showed an absence or slight fragmentation as compared with 72 and 61% respectively for embryos grown in medium alone (P less than 0.01). None of the co-cultured embryos showed unequal sized blastomeres while 22% of controls showed unequal cleavage. Embryos grown with ampullary cells cleaved slightly faster than controls. Scanning electron micrographs showed that ampullary cells collected from co-cultures were all of the secretory type with several microvilli and apical protrusions. It is clear that subcultured human ampullary cells support human embryonic cleavage and yield a reasonable number of good quality embryos up to the cavitation stage. Development past the expanded blastocyst and hatching stages seems to involve another critical phase with its own specific requirements. PMID- 2778058 TI - Termination of early human pregnancy with RU 486 (mifepristone) and the prostaglandin analogue sulprostone: a multi-centre, randomized comparison between two treatment regimens. AB - A multi-centre, randomized trial was conducted to compare the efficacy and side effects of two combination regimens of the antiprogestin RU 486 and the intramuscular PGE2 analogue sulprostone for termination of early pregnancy (amenorrhoea up to 49 days). Women in the 3-day group (n = 125) received 25 mg RU 486 twice daily for 3 days plus a single injection of 0.25 mg sulprostone in the morning of the third day of antiprogestin treatment. In the 4-day group (n = 126), RU 486 was given for 4 days and the sulprostone injection in the morning of the fourth day. Treatment outcome in the two groups was similar. Overall, 88.8% had a complete abortion, 6.8% an incomplete abortion and 2.4% were treatment failures; in the remaining 2% treatment outcome could not be determined. Only three of the six women with treatment failure still had detectable fetal heart activity when the pregnancy was terminated by vacuum aspiration two weeks after the start of treatment. Five of the 17 interventions for incomplete abortion were carried out as emergency procedures because of heavy bleeding; two of these five women were given a blood transfusion. The majority of the curettages (10/17) were performed in one centre. If the data from this centre and the women with undetermined treatment outcome were excluded, the rates for complete abortion, incomplete abortion and treatment failure in the remaining six centres were 93.6, 3.7 and 2.7%, respectively.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2778059 TI - Rapid and sensitive method for the detection of serum hepatitis B virus DNA using the polymerase chain reaction technique. AB - We have developed a rapid procedure for the detection of serum hepatitis B virus (HBV) DNA using the polymerase chain reaction (PCR) technique. HBV DNA is released from virions by incubating serum with 0.1 M NaOH for 60 min at 37 degrees C. The mixture is brought to neutral pH with HCl, and the HBV DNA sequences are detected by agarose gel electrophoresis and ethidium bromide staining after PCR amplification with two successive sets of primer pairs. The detection limit of this method (i.e., 10(-5) pg of HBV DNA) is equivalent to that previously determined by one round of PCR amplification and Southern blot hybridization analysis. The advantages are that the assay can be completed in 1 day, is very sensitive, and does not require the use of radiolabeled reagents. PMID- 2778060 TI - Production of a toxic shock syndrome toxin variant by Staphylococcus aureus strains associated with sheep, goats, and cows. AB - A toxic shock syndrome toxin (TSST) variant with an isoelectric point (pI) of 8.6 produced by an ovine-associated Staphylococcus aureus strain was described previously. Analysis of additional strains associated with sheep, goats, cows, and humans by isoelectric focusing with immunoblotting using monoclonal antibodies revealed that all 18 strains associated with sheep and all 12 strains associated with goats produced the TSST variant. Only 1 of 10 bovine-associated strains and no human-associated strains produced the variant, whereas the others produced TSST-1 (pI between 7.0 and 7.2). Sodium dodecyl sulfate-polyacrylamide gel electrophoresis with immunoblotting indicated that both TSST-1 and the TSST variant had a molecular size of 24 kilodaltons. PMID- 2778061 TI - Immunoglobulin A antibody response to respiratory syncytial virus structural proteins in colostrum and milk. AB - Immunoglobulin A (IgA) antibody response to respiratory syncytial virus (RSV) structural proteins in colostrum and milk was investigated by a radioimmunoprecipitation assay. By using [35S]methionine-labeled RSV-infected HEp 2 cells and antiserum to human IgA as the capture antibody, IgA antibody responses to large glycoprotein, fusion protein, nucleoprotein, phosphoprotein, and matrix protein were demonstrated in colostrum and milk. The IgA antibody response was mainly directed against fusion protein, whereas IgA activity against matrix protein was more variable and was not comparable to the antibody responses to other structural proteins. Maternal mammary IgA response after RSV infection in the infant was monitored in four cases, and the appearance of anti-RSV IgA activity against several RSV structural proteins was observed in convalescent stage milk samples of two mothers in whom RSV infection was demonstrated. PMID- 2778062 TI - False-positive result in Limulus test caused by Limulus amebocyte lysate-reactive material in immunoglobulin products. AB - Limulus amebocyte lysate (LAL)-reactive material other than endotoxin was detected in the plasma and urine of patients after intravenous immunoglobulin therapy. Thirty-seven vials of six different immunoglobulin products were analyzed for the LAL-reactive material by combined use of a conventional chromogenic Limulus test and a chromogenic endotoxin-specific test. The amount of LAL-reactive material in reconstituted immunoglobulin solutions ranged from a mean (standard deviation) of 10.2 (2.1) to 2,448.1 (988.9) pg/ml, and there were statistically significant differences among the six brands. The levels of LAL reactive material in plasma increased in proportion to the amounts contained in the immunoglobulin products administered. The material accumulated in the blood with repeated administration. Urinary excretion of the material was less than 5% of the total amount administered. Such material seems to be derived from the cellulose-based membranes used during preparation of the blood products. Thus, interpretation of Limulus test results of patients receiving immunoglobulin therapy requires special consideration. PMID- 2778063 TI - New fluorescence assay for the quantitation of fungi. AB - Quantitative determination of fungal mass is easily achieved with a new procedure that detects particle epifluorescence. Fungi are detected after exposure to a fluorescent stain (Fungiqual; CIBA-GEIGY Corp., Summit, N.J.) by using a fluorescence particle concentration analyzer. This report describes a simple fluorescence method for quantitation of either yeast or mycelial forms of fungi. The nature of the staining reaction was studied, and a practical application of this procedure for determination of fungal susceptibility to an antifungal agent is presented. PMID- 2778064 TI - Tracheal tube biofilm as a source of bacterial colonization of the lung. AB - Biofilm formation in tracheal tubes, its bacterial content, and its interaction with ventilator gas flow were investigated. At least 50 mg (dry weight) of biofilm was found in 30 of 40 tracheal tubes used in intensive care patients for 2 h to 10 days. Electron microscopy showed bacteria in this layer, and quantitative studies showed that bacterial counts could reach up to 10(6)/cm of tube length. Bacteria were cultured from the patient side of 18 of 78 heat and moisture exchanger-microbiological filter units removed from ventilator circuits. Particles were shown to detach from tracheal tube luminal biofilm and were projected up to 45 cm from the tracheal tube tip. Following contamination of the tracheal tube biofilm with a patient's own gastrointestinal flora, entrainment of bacteria in the inspiratory gas flow provides a mechanism for initial and repeated lung colonization. PMID- 2778065 TI - Diarrheal disease caused by enterotoxigenic Bacteroides fragilis in infant rabbits. AB - Enterotoxigenic Bacteroides fragilis caused severe, nonhemorrhagic, watery diarrhea when 10(9) CFU of a porcine or human isolate was administered orogastrically to 3-day-old rabbits. The bacterium colonized the intestinal tract with a predilection for the large intestine (10(9) CFU/g of cecal contents). Diarrhea occurred at an average of 4.6 days postinoculation, and 84% of rabbits were dead or moribund at an average of 8.8 days postinoculation. The disease was characterized by watery diarrhea and dehydration. Severe histologic lesions including inflammation, exfoliation of epithelial cells, and crypt hyperplasia were observed throughout the colon. There was no indication of bacteremia or of bacterial adherence to or invasion of intestinal epithelial cells. Rabbits inoculated with nonenterotoxigenic B. fragilis were colonized with B. fragilis but did not develop clinical disease or intestinal lesions. While the pathogenesis of this disease is undefined, clinical signs of disease and histologic changes were consistent with a mechanism of net secretion of fluid into the small intestine and decreased absorption of fluid from the large intestine. Enteric disease caused by enterotoxigenic B. fragilis in infant rabbits was similar to naturally occurring enteric disease associated with the bacterium in humans and livestock. This study established that enterotoxigenic B. fragilis is enteropathogenic in intact infant rabbits. PMID- 2778067 TI - Isolation and characterization of catalase-negative and catalase-weak strains of Campylobacter species, including "Campylobacter upsaliensis," from humans with gastroenteritis. AB - During 1987 and 1988, nine strains of catalase-negative or -weak Campylobacter species were isolated in Alberta, Canada. DNA hybridization studies demonstrated that seven strains were "Campylobacter upsaliensis," one strain was highly homologous with Campylobacter jejuni DNA, and one strain was a campylobacter unrelated to the other two species. All "C. upsaliensis" strains were hippurate negative, and six of seven were susceptible to cephalothin. The unusual variant of C. jejuni was hippurate positive and cephalothin resistant, whereas the unclassified strain was hippurate negative and resistant to intermediate levels of cephalothin. All patients from whom "C. upsaliensis" was isolated had diarrhea. Five of the patients were children two years old or younger, and two were adults. In this study, all catalase-negative and -weak strains were isolated from stool specimens by using a charcoal-based selective medium containing 32 micrograms of cefaperazone per ml and which was described by Hutchinson and Bolton (D. N. Hutchinson and F. J. Bolton, J. Clin. Pathol. 37:956-957, 1984). PMID- 2778066 TI - Toxoplasma antigens recognized by immunoglobulin G subclasses during acute and chronic infection. AB - The immunoglobulin G (IgG) subclass response to Toxoplasma gondii antigens during the acute and chronic stages of T. gondii infection were studied by using immunoblots with reduced antigen (RA) and nonreduced antigen (NRA) preparations. Serum samples were from individuals with acute or chronic T. gondii infection, and sequential samples were from women who seroconverted during gestation and were treated with spiramycin. IgG1 antibodies were predominant in sera from each of the groups and recognized a large number of RA and NRA. In the latter group of patients, IgG1 and IgG3 were the first antibodies to appear in response to the infection. In all groups, an antigen with a molecular weight (MW) of 30,000 was the most intensely stained and frequently recognized by IgG1 antibodies in NRA preparations. In RA preparations, antigens of MW 35,000 and 30,000 were the most intensely stained and frequently recognized by IgG1 antibodies. An antigen with an MW of 22,000 was intensely stained in the IgG1 immunoblots of the NRA preparation and to a lesser extent in the RA preparation. In contrast to immunoblots with IgG1 antibodies, very few antigens in the RA and NRA preparations were detected by IgG2 and IgG3 antibodies; IgG4 antibodies rarely detected any antigens. Of interest was that IgG2 antibodies detected antigens distributed over the entire MW range, whereas those detected by IgG3 antibodies were located mostly below the 35,000 MW marker. Enzyme-linked immunosorbent assay results paralleled those of the immunoblots in that IgG1 antibodies were predominant. PMID- 2778068 TI - Enterobacter hormaechei, a new species of the family Enterobacteriaceae formerly known as enteric group 75. AB - The name Enterobacter hormaechei is proposed for a new species of the family Enterobacteriaceae, formerly called Enteric Group 75, which consists of 23 strains, 22 of which were isolated from humans. DNAs from 12 E. hormaechei strains tested were highly related to the type strain (ATCC 49162) by DNA hybridization, using the hydroxyapatite method (80 to 97% in 60 degrees C reactions; 80 to 90% in 75 degrees C reactions). The strains were most closely related (50 to 63%) to Enterobacter cloacae, Enterobacter dissolvens, Enterobacter taylorae, and Enterobacter nimipressuralis. E. hormaechei strains were positive within 48 h for the following: Voges-Proskauer test; citrate utilization (Simmons and Christensen); urea hydrolysis (87%); ornithine decarboxylase; growth in potassium cyanide (KCN); malonate utilization; production of acid from D-glucose, L-arabinose, cellobiose, dulcitol (87%), D galactose, maltose, D-mannitol, D-mannose, L-rhamnose, sucrose, trehalose, and D xylose; acid production from mucate; nitrate reduction; and o-nitrophenyl-beta-D galactopyranoside. Delayed positive reactions were seen in tests for arginine dihydrolase, gas from D-glucose, acid from alpha-methyl-D-glucoside, and acetate utilization. E. hormaechei was negative in tests for indole production; H2S production; phenylalanine deaminase; lysine decarboxylase; gelatin hydrolysis; acid production from D-adonitol, D-arabitol, erythritol, glycerol, i(myo) inositol, melibiose, raffinose, and D-sorbitol; esculin hydrolysis; DNase; lipase; and tyrosine clearing. Variable reactions occurred in tests for methyl red, motility, and tartrate. All strains tested were susceptible or moderately susceptible to amikacin, azlocillin, cefotaxime, ceftazidime, ceftriaxone, chloramphenicol, gentamicin, mezlocillin, moxalactam, piperacillin, trimethoprim sulfamethoxazole, sulfisoxazole, thienamycin, tobramycin, and trimethoprim. All strains tested were resistant to nitrofurantoin; the majority were resistant to ampicillin, cefoxitin, and cephalothin. Four isolates were from blood; most other isolates were from wounds or sputum. PMID- 2778069 TI - Colony immunoblot assay for the detection of staphylococcal toxic shock syndrome toxin 1 (TSST-1) with anti-TSST-1 F(ab')2 fragments. AB - Toxic shock syndrome toxin 1 (TSST-1), an exoprotein of Staphylococcus aureus, is strongly implicated in the pathogenesis of TSS. Detection of TSST-1, however, is often hindered in immunoassays because of the cosecretion of protein A, a genetic trait which appears to be coordinately expressed with other exoproteins in S. aureus. We developed a colony immunoblot assay for rapid screening of TSST-1 producing S. aureus using TSST-1-specific rabbit F(ab')2 fragments. The sensitivity and specificity of this method were compared with those of a quantitative noncompetitive enzyme-linked immunosorbent assay (ELISA) for 34 S. aureus isolates (17 TSS-associated and 17 non-TSS-associated isolates). Cosecreted protein A in culture supernatants was evaluated by a quantitative competitive ELISA. The results clearly indicated the superiority of F(ab')2 fragments in eliminating nonspecific reactivity of protein A in the colony immunoblot assay. The sensitivity of the immunoblot with TSST-1-specific F(ab')2 was similar to that with whole immunoglobulin G (94 versus 82%, respectively; P = 0.601, Fisher's exact test), but the specificity was markedly improved (94 versus 59%, respectively; P = 0.039). Among TSST-1-negative isolates (as determined by ELISA), strains which gave false-positive results in the immunoglobulin G immunoblot assay produced higher amounts of protein A than strains which gave true-negative results (P = 0.08, Mann-Whitney rank sum test, one tailed). Among strains positive for TSST-1, the level of TSST-1 detected in culture supernatants correlated inversely with the amount of protein A secreted (rs = -0.64; P less than 0.01, Spearman rank correlation). These findings validate the utility of a rapid screening method for the detection of TSST-1-producing S. aureus and support the concept of coordinate secretion of exoproteins in S. aureus. PMID- 2778070 TI - Three cases of neonatal meningitis caused by Enterobacter sakazakii in powdered milk. AB - Three cases of neonatal infection caused by Enterobacter sakazakii are reported from the Department of Neonatal Intensive Care, the National University Hospital, Reykjavik, Iceland. These infections occurred during a 9-month period in 1986 and 1987. Two of the neonates, who were normal at birth, survived but were left with brain damage. The third, who had Down's syndrome and severe cardiac malformations, died. The same organism was also grown from groin and anal swabs from a healthy neonate. E. sakazakii was not isolated from any environmental sources in the neonatal wards or in the milk kitchen, but it was grown from several lots of the powdered-milk formula used in the hospital. The four E. sakazakii strains isolated from the neonates were indistinguishable from 22 strains grown from the formula. Their biotypes, plasmid DNA profiles, and antibiograms were identical. PMID- 2778071 TI - Optimization of a medium for the rapid urease test for detection of Campylobacter pylori in gastric antral biopsies. AB - We developed a buffered azide-free urea medium which is sensitive, specific, and nontoxic for rapid detection of Campylobacter pylori in gastric biopsies. Detection of urease produced by the organism provides the basis for the test. The substrate is urea in monobasic sodium phosphate buffer, and phenol red provides indication of the pH change that results from urease activity. A rapid change from yellow to red occurs in the presence of C. pylori, even at low concentrations of the organism. A slower color change occurs with higher concentrations of other urease producers, such as Yersinia enterocolitica and Proteus mirabilis. Experience with 51 patients with our medium showed excellent results in detection of C. pylori in gastric mucosal biopsies. In clinical research and practice, a rapid bedside test will be helpful for rapid diagnosis of C. pylori-positive patients. PMID- 2778072 TI - Enterococci highly resistant to penicillin and ampicillin: an emerging clinical problem? AB - Sixteen clinical isolates of ampicillin-resistant enterococci (ARE) were recovered from the microbiology laboratory of a 450-bed rehabilitation medical center from January 1981 to September 1987. These isolates were detected when a disk diffusion test using 10 micrograms of ampicillin on a blood agar plate revealed no zones of inhibition. Tube macrodilution tests yielded an MIC of greater than or equal to 16 micrograms of ampicillin per ml. None of the isolates were penicillinase producers by the chromogenic cephalosporin disk test. Ten isolates were Enterococcus faecium, four isolates were E. raffinosus, one isolate was E. gallinarum, and one isolate was not identified (lost). There were 6 male and 10 female patients. The sources of isolates were urine (n = 7), wound (n = 5), ascitic fluid (n = 2), blood (n = 2), peritoneal catheter tip (n = 1), Bartholin's cyst abscess (n = 1), rectal swab (n = 2), and pancreatic abscess (n = 1). The organism was isolated from multiple sites in 4 patients, was a pure culture isolate in 5 patients, and was part of a polymicrobial flora in 11 patients. Six patients were diabetic, and four had liver cirrhosis. All but four patients had received at least one antibiotic within 3 weeks of ARE isolation. The MICs (micrograms per milliliter) for 50 and 90% of isolates tested, respectively, were as follows: ampicillin, 64 and 64; penicillin, 128 and greater than 128; vancomycin, 1 and 2; gentamicin, 4 and 16; ciprofloxacin, 1.6 and 3.2; imipenem, 128 and greater than 128; and daptomycin (LY146032), 1.6 and 6.4. ARE may be an emerging pathogen in the hospitalized patient population. PMID- 2778073 TI - Pleural infection caused by Legionella anisa. AB - The first case of infection caused by Legionella anisa with isolation of the organism is reported here. The presence of L. anisa in the water supply of the hospital and the isolation of this species in the pleural fluid of a patient suffering from nosocomial pleurisy confirm the potential pathogenicity of this Legionella species. PMID- 2778075 TI - Pathogenicity in two cases of Staphylococcus schleiferi, a recently described species. AB - Staphylococcus schleiferi is a new species of coagulase-negative staphylococcus first described in April 1988 (J. Freney, Y. Brun, M. Bes, H. Meugnier, F. Grimont, P. A. D. Grimont, C. Nervi, and J. Fleurette, Int. J. Syst. Bacteriol. 38:168-172, 1988). There are few data in the literature on its pathogenicity. We report two cases in which its role as an opportunistic nosocomial appears to be incontestable. PMID- 2778074 TI - Comparison of media for screening of diarrheic stools for the recovery of Clostridium difficile. AB - Recoveries of Clostridium difficile from stool specimens by using three media, cycloserine-mannitol agar (M-CMA), cycloserine-mannitol-blood agar (M-CMBA), and cycloserine-cefoxitin agar (M-CCA), were compared. Of 321 clinical specimens, 37 yielded C. difficile. Thirty-four were positive on M-CCA, 21 were positive on M CMA, and 20 were positive on M-CMBA. M-CCA recovered significantly more C. difficile than did M-CMBA or M-CMA. PMID- 2778076 TI - Catheter infection caused by an unusual pathogen, Agrobacterium radiobacter. AB - The genus Agrobacterium is composed of several phytopathogenic species occurring worldwide in soils. One nontumorigenic species, Agrobacterium radiobacter, has occasionally been isolated from clinical specimens, but its pathogenic role in these cases has been difficult to ascertain since agrobacteria are usually isolated in association with other bacteria. We report the case of a central venous catheter infection and present the characteristics of A. radiobacter. PMID- 2778077 TI - Species identification of Aeromonas strains based on carbon substrate oxidation profiles. AB - Twenty clinical strains each of Aeromonas hydrophila, Aeromonas caviae, and Aeromonas sobria were evaluated for their abilities to oxidize one or more of 95 carbon sources on a GN Microplate (BIOLOG, Hayward, Calif.). Nine substrates yielded good, discriminatory values for the three species tested. The panel appears to be useful for the species identification of Aeromonas isolates originating from human material. PMID- 2778078 TI - Identification of monounsaturated fatty acids of Aerococcus viridans with dimethyl disulfide derivatives and combined gas chromatography-mass spectrometry. AB - Location of the double-bond position of monounsaturated fatty acids of Aerococcus viridans was accomplished by combined gas chromatography (GC)-mass spectrometry analysis of dimethyl disulfide (DMDS) derivatives. The monoenoic fatty acids from whole bacterial cells were converted to methyl esters and then to DMDS adducts and analyzed by capillary GC-mass spectrometry. The mass spectra of DMDS adducts gave an easily recognizable molecular ion (M+) and two major diagnostic ions attributable to fragmentation between the two CH3S groups located at the original site of unsaturation. Two relatively novel acids that distinguish aerococci from bacteria of closely related genera were identified as C16:1 omega 9c and C16:1 omega 9t from their mass spectrometry fragmentation patterns and retention characteristics on nonpolar capillary GC columns. PMID- 2778079 TI - Use of terpene-based solvents (Hemo-De, Histoclear, and Shandon and BDH xylene substitutes) in place of xylene in the Ehrlich indole test. AB - Although less effective than xylene and Kovacs reagent as indole extractants, Hemo-De and Shandon xylene substitute can be used in the Ehrlich indole test if a less toxic solvent is desirable. In doubtful cases, xylene should be used. Because of the blocking action shown in the test, use of indole-nitrite broth cannot be recommended. PMID- 2778080 TI - Problems with the disk diffusion test for detection of vancomycin resistance in enterococci. AB - A total of 53 strains of enterococci, including recently isolated strains with high-level resistance to vancomycin, were tested for vancomycin susceptibility by broth microdilution and disk diffusion using Mueller-Hinton media with and without supplementation with 5% blood. By using currently published parameters of the National Committee for Clinical Laboratory Standards for the disk diffusion test, we found that strains for which MICs were 8 to 32 micrograms/ml were incorrectly placed in the susceptible or intermediate category, which caused both very major (1.9%) and minor (11.5%) errors. When we used newer, recently proposed breakpoints for vancomycin, we found 13.5% minor errors but no very major errors. Changing disk diffusion breakpoints to less than or equal to 14 mm for resistant [corrected] and greater than or equal to 15 mm for susceptible [corrected] would eliminate the problem for the strains with MICs of 32 micrograms/ml but not for those with MICs of 8 micrograms/ml. For those strains, it is necessary to perform an MIC test to differentiate them from strains with MICs of less than or equal to 4 micrograms/ml. PMID- 2778081 TI - Isolation of Campylobacter upsaliensis from stool specimens. PMID- 2778082 TI - Cell and fiber responses to cementum from periodontitis-affected root surfaces after citric acid treatment. AB - The purpose of this study was to assess connective tissue and epithelial responses to periodontitis-affected cementum (from exposed roots of human teeth) after surface demineralization with citric acid. Cementum specimens were obtained from root surfaces covered by calculus. 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. 4 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 1 day, a distinct zone of surface demineralization was not present on the surface of the cementum in the experimental group, although such a zone was present on the dentin surfaces of the same specimens. Histometric comparisons between experimental and control groups at 1 day showed no differences in cell attachment or length of cementum surface within connective tissue. By 10 days, there was a trend for greater cell attachment to demineralized cementum, but the differences were not statistically significant. Although connective tissue fiber attachment has been shown to occur to demineralized dentin and to normal cementum in this model system, fiber attachment did not occur to the cementum in the present study.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2778083 TI - Clinical effects of root debridement in molar and non-molar teeth. A 2-year follow-up. AB - 12 patients were studied longitudinally to monitor the effects of basic periodontal therapy in molar and non-molar teeth. Periodontal sites were grouped into molar furcation sites, molar flat-surface sites and non-molar sites. Clinical measurements were taken at baseline and directly followed by full mouth root debridement. Subsequently, measurements were taken every 3rd month until 24 months. At each of these appointments, the patients were monitored for their oral hygiene performance and given supragingival prophylaxis. The mean results indicated that initially moderately deep and deep molar furcation sites responded less favorably to therapy compared to non-molar sites and molar flat-surface sites of similar probing depth. Initial improvements in probing measurements for moderately deep and deep molar furcation sites were limited and also tended to revert during the observation interval. Identification of individual sites with probing attachment loss disclosed that 25% of molar furcation sites lost probing attachment as compared to 7% for non-molar sites and 10% for molar flat-surface sites. These results corroborate previous findings and call for additional or alternative treatment regimens for periodontal furcation pockets. PMID- 2778084 TI - Diagnostic problems of periodontitis-like lesions caused by eosinophilic granuloma. AB - Eosinophilic granuloma is the localized and mildest form of histiocytosis X. It is a destructive osseous lesion characterized by large numbers of eosinophils and histiocytes. The etiology of the disease is unknown. Frequently the jaws, including the periodontium, are involved and the disease stimulates severe localized periodontitis. A case of eosinophilic granuloma of the jawbone is presented. The pertinent clinical features are emphasized and possible problems in the interpretation of clinical periodontal features are discussed. PMID- 2778085 TI - The effectiveness of root debridement in open flap procedures by means of a comparison between hand instruments and diamond burs. A SEM study. AB - The goal of the present in vivo study was to evaluate human roots by means of scanning electron microscopy (SEM), after treating the root surfaces either with conventional hand instruments or with newly developed diamond burs. Peculiar root anatomy often makes perfect instrumentation with hand instruments difficult or impossible. On 20 teeth destined for extraction because of severe periodontitis, the root surfaces were exposed by mucoperiosteal flap procedures. Ten roots were then planed using fine curettes, and 10 were instrumented using diamond burs. Following extraction, the root surfaces were stained and photographed. Stained areas were examined by SEM. On the 20 test teeth, 79 surfaces were evaluated. From these, 381 stained zones were checked by SEM for the presence of bacteria. A total of 216 stained areas from teeth treated by hand instruments was evaluated; 15 of these (6.9%) contained bacteria. Of roots treated by diamond burs, 165 stained areas were evaluated; 9 (5.5%) exhibited bacteria. Thus, both methods resulted in root surfaces that were essentially bacteria-free. PMID- 2778086 TI - Serum IgG antibodies reactive with lipoteichoic acid in adult patients with periodontitis. AB - IgG antibody levels to lipoteichoic acid (LTA), prepared from Streptococcus mutans cells, were determined by enzyme-linked immunosorbent assay in serum samples from 149 subjects. An extract from Bacteroides gingivalis and lipopolysaccharide from Escherichia coli 055:B5 served as control antigens. The reference group comprised 28 systemically and periodontally healthy adults. The main test groups were: 52 persons with gingivitis only, and 69 patients with periodontitis. Within those groups, 37 patients had insulin-dependent diabetes mellitus, another 20 patients were prospective or renal transplant recipients. The periodontitis patient group showed significantly (p less than 0.05) higher mean antibody value and higher frequency of extreme antibody responses to both LTA and B. gingivalis than the gingivitis group. LPS did not discriminate between the groups. Multiple regression analysis with gingivitis scores as the dependent variable selected plaque scores, anti-LTA antibody values and general health status as significant (p less than 0.05) regressors. The variance in radiographical alveolar bone loss was significantly (p less than 0.05) explained by age and by antibody values to B. gingivalis and to LTA. The patients with extreme immunological responsiveness to LTA or to B. gingivalis had about twice as much alveolar bone loss as those with normal serological reactivity. The results support the contention that LTA modulates the progression of periodontitis in humans. PMID- 2778087 TI - Probing site configuration in patients with untreated periodontitis. A study of horizontal positional error. AB - This study examined the morphology of 487 probing sites in patients with untreated periodontitis, using a constant force probe (0.25 N, 0.5 mm) and flexible stent with guide grooves, at 3 adjacent points per site, 6 sites per tooth. Sites were classified into 9 configuration types according to the relationship of the 3 adjacent points. Duplicate measurements were made and sites were analysed with special reference to whether a slight horizontal movement was likely at the second examination. 60% of individual point probing measurements were exactly reproduced, but only 23% of site configurations. 65% of configuration change was accountable on the basis of slight horizontal shift of the probe. Only 13% of configurations required the postulate of other forms of probing error. These results suggest that probing reproducibility is not always an indication of site reproducibility, and that the variation of probe position in the transverse plane is an important source of probing error, even when a stent is used. PMID- 2778088 TI - A combination of platelet-derived and insulin-like growth factors enhances periodontal regeneration. AB - The combination of platelet-derived growth factor (PDGF) and insulin-like growth factor one (IGF-1) has previously been shown to enhance repair of soft tissue wounds. Here we report initial observations following application of PDGF and IGF 1 to periodontitis-affected teeth in beagle dogs. 1 micrograms of PDGF and IGF-1 in an aqueous gel was applied to the root surfaces of test teeth following open flap debridement. Control sites received the gel alone. Block biopsies of the teeth and surrounding bone were taken 2 weeks after treatment. Histologic analyses of control specimens revealed a long junctional epithelial attachment, and no new bone or cementum formation. In contrast, growth factor treated sites exhibited significant amounts of new bone and cementum formation. A nearly continuous layer of osteoblasts lined the newly formed bone, and there was a dense cellular "front" at the coronal extent of the new bone. These preliminary results suggest that in vivo application of the combination of PDGF and IGF-1 may enhance regeneration of the periodontal structures. PMID- 2778089 TI - Approvable letters in the FDA new drug approval process. PMID- 2778090 TI - Profile of clinical pharmacologists in the United States. AB - The need for clinical pharmacology in research and education, drug development, and health care delivery is well known. However, a current profile of those working in the field is not available. The ACCP authorized a survey of clinical pharmacologists to provide such a profile. Members of the ACCP or ASCPT were solicited by mail with a self-assessment questionnaire. A response rate of 37% was obtained. Demographic findings agree well with a previous study2 limited to those with the M.D. Our results reveal that most clinical pharmacologists are between 30-59 years of age, have an MD, PhD or PharmD degree; most of those with MDs list their primary specialty as internal medicine, pediatrics, psychiatry, or anesthesiology. They affiliate with the respective departments (including pharmacology) in academia or hold positions in industry or government, but few are in clinical therapeutics per se. About 20% of those with only a MD or PharmD degree cite employment in health care delivery. However, a higher percentage of these respondents work in research and education rather than in drug development or health care delivery. For those with only a PhD, more work in drug development and research and education than in health care delivery. The highest proportion of respondents with any doctoral degree work in the Northeast. The average income is a function of rank, doctoral degree, specialty, department appointment, and type and location of employer. The profile of a typical clinical pharmacologist is presented. An analysis of clinical pharmacology manpower from several perspectives reveals a marked deficit, but the field itself is professionally and economically attractive. Lack of a well defined career track in academia and a poorly defined clinical role for MD clinical pharmacologists are proposed as reasons limiting entry of trainees. These and other results of the survey support an increased emphasis on training programs. Clinical pharmacologist involvement in health care delivery and drug development must be increased if the safe and effective use of new drugs is to be realized. Nine assessments and initiatives are formulated to accomplish this goal within the next decade. PMID- 2778091 TI - Variability in the pharmacokinetics of nisoldipine as caused by differences in liver blood flow response. AB - We investigated whether the effect of nisoldipine on liver blood flow depends on its route of administration. Ten healthy subjects took nisoldipine I.V. (infusion) and orally (without and with sotalol pretreatment). Pharmacokinetics of nisoldipine was assessed and liver blood flow (ICG clearance) was measured before dosing and at the end of the infusion or during absorption. During I.V. infusion the ICG plasma clearance increased by only 14%, whereas the increase was 60% during absorption of nisoldipine. Nisoldipine increases liver blood flow considerably only during the absorption phase. A positive correlation was found between the increase in liver blood flow during absorption and the systemic availability of nisoldipine, suggesting that the differences in liver blood flow response to nisoldipine substantially contribute to the variability in pharmacokinetics of the drug. PMID- 2778092 TI - The impact of antianginal drug therapy on asymptomatic myocardial ischemia. AB - This study addresses the effect of the three major classes of antianginal agents on asymptomatic myocardial ischemia in patients with chronic stable angina pectoris. The authors found that each class (given as monotherapy) resulted in a 50% reduction in asymptomatic ischemia (both in the number of episodes and the ST product). Dual therapy resulted in an overall four fold reduction compared to placebo. Therapy also resulted in a beneficial alteration in the frequency distribution of asymptomatic ischemia. Stratification into three age groups demonstrated an equal prevalence of asymptomatic ischemia in each. All ages had nearly equivalent reductions in asymptomatic ischemia by monotherapy and dual therapy, but the youngest age group seemingly responded better to monotherapy than did the oldest age group. PMID- 2778093 TI - The effect of verapamil on the pharmacokinetic disposition of theophylline in cigarette smokers. AB - In a randomized cross-over study the effect of verapamil on the pharmacokinetics of theophylline was evaluated in eight cigarette smoking male volunteers. Theophylline was administered as an intravenous infusion of aminophylline, 6 mg/kg based on ideal body weight, over 30 minutes in the control phase. In the treatment phase, aminophylline was administered after a four day regimen of oral verapamil 80 mg every 8 hours. Serial blood samples were collected over a 24 hour period following aminophylline administration. Theophylline serum concentrations were determined by a fluorescence polarization immunoassay, the Abbott TDxR. Theophylline clearance decreased by 11.5%, from a mean (+/-SD) of 1.39 +/- 0.38 mL/min/kg in the control phase to 1.23 +/- 0.21 mL/min/kg with the co administration of verapamil (P = 0.104). Theophylline elimination rate constant decreased by approximately 9.4% from 0.171 +/- 0.032 to 0.155 + 0.023 hr-1 during the treatment phase (P = 0.085). The area under the curve (AUCo alpha) and volume of distribution at steady-state (Vss) for theophylline were also not statistically different between the two study phases. These results are inconsistent with those of other investigators and the relevance of a potential theophylline-verapamil drug interaction remains unclear. PMID- 2778094 TI - Effect of altering small bowel transit time on sustained release theophylline absorption. AB - The relationship between variations in small bowel transit time (SBTT) and the absorption of theophylline from a sustained-release product was evaluated in a three-way, randomized, crossover study in 12 healthy male nonsmokers. Subjects received sustained-release theophylline (600 mg) with loperamide (8 mg every 6 hour x 8 doses). metoclopramide (15 mg every 6 hour x 8 doses) or placebo (every 6 hour x 8 doses). Theophylline solution (400 mg) was used as a reference standard. Serum samples were collected periodically for 72 hours for theophylline concentration determinations. SBTT was measured by the lactulose hydrogen breath test. Compared with placebo (98 +/- 53 min), SBTT was increased with loperamide (211 +/- 87 min; P less than 0.001) and decreased with metoclopramide (55 +/- 18 min; P less than 0.001). Loperamide decreased the rate, but not the extent of theophylline absorption from this product. This was evident from the reduced Cmax, the prolonged Tmax, and the decreased fraction of the dose absorbed at 24 hours, while the area under the curves remained the same. In contrast, metoclopramide had no effect either on rate or extent of absorption. The data suggest that the effect of loperamide on these absorption parameters was due to an increase in the dissolution time of this sustained-release product. PMID- 2778095 TI - The influence of gastric emptying on droxicam pharmacokinetics. AB - Droxicam is a new nonsteroidal anti-inflammatory drug that is a pro-drug of piroxicam. The influence of gastric emptying rate on droxicam pharmacokinetics has been investigated in eight healthy male volunteers. A single, 20 mg dose was administered p.o. together with 1500 mg of paracetamol. Gastric transit was experimentally modified by administration of propantheline (45 mg, p.o.) or metoclopramide (10 mg, i.v.) simultaneously with the droxicam and the paracetamol. Plasma levels of paracetamol were used as markers of gastric transit. The plasma concentrations of piroxicam, the active substance from droxicam, were determined by a high-performance liquid chromatographic method. The pharmacokinetic parameters of droxicam were: Cmax = 1.03 +/- 0.16 micrograms/mL (mean +/- SD). Tmax = 11.1 +/- 5.7 hr, AUC = 115.7 +/- 29.6 micrograms hr/mL, T 1/2 a = 2.64 +/- 0.72 hr. T 1/2 el = 73.6 +/- 16.7 hr, CL/F = 3.06 +/- 0.80 mL/min and MRT = 111.1 +/- 23.5 hr. Following modification of gastric emptying, only Tmax (droxicam + metoclopramide = 25.0 +/- 10.8 hr and droxicam + propantheline = 20.8 +/- 8.8 hr) underwent significant change (P less than 0.05). These results indicate that absorption rate of droxicam has been modified but bioavailability does not suffer modification in conditions of altered gastric emptying. PMID- 2778096 TI - Nonlinear kinetics of trimipramine in depressed patients. AB - An increase of the dose of trimipramine (TM) results in a markedly disproportionate increase of the steady-state plasma concentration of the major active metabolite desmethyltrimipramine (DMT). Ten patients receiving 75 mg/day of TM had a mean steady-state plasma concentration of 53.8 ng/ml TM and 26.3 ng/ml DMT. Ten others receiving 150 ng/ml TM had a mean concentration of 122.5 ng/ml TM and 133.8 ng/ml DMT. This is most likely due to the saturation within therapeutic dosage range of the subspecies of cytochrome P-450 responsible for hydroxylation of DMT. Available data on metabolism of tricyclic antidepressants shows that the hydroxylation of desmethylimipramine (desipramine) but not that of desmethylamitriptyline (nortriptyline) reaches saturation within therapeutic dosage range. Clinicians should take into consideration the possibility of dose dependent kinetics when adjusting the dose of tricyclic antidepressants. This finding highlights the value of monitoring of blood levels of antidepressants. PMID- 2778098 TI - Pharmacokinetics of a new macrolide, roxithromycin, in infants and children. AB - The pharmacokinetics of roxithromycin was investigated after oral administration of 2.5 mg/kg doses given 12 hours apart during 6 days in infants and children. These 18 subjects suffering from a respiratory tract infection were divided into three age groups: group I less than 18 months, group II less than 5 years, group III less than 13 years. At day 6, the elimination plasma half-life had an average value (mean +/- SD) of 19.8 +/- 9.7 h (group I), 21.0 +/- 9.4 h (group II) and 20.8 +/- 6.9 h (group III), respectively. The maximum concentration of roxithromycin (Cmax) was attained between 1 and 2 hours after dosing with mean values of 10.1 +/- 3.0 mg/l (group I), 8.7 +/- 4.9 mg/l (group II), 8.8 +/- 7.0 mg/l (group III). All the calculated pharmacokinetic parameters did not significantly differ from one group to another. The kinetics of roxithromycin in infants and children seemed to be age independent and showed no accumulation after repeated doses. During 12 hours, the plasma concentrations were above MIC of microorganisms generally present in respiratory tract infections. Two daily doses of 2.5 mg/kg of roxithromycin 12 hours apart may be proposed in infants and children. PMID- 2778097 TI - Impaired absorption of tetracycline by colestipol is not reversed by orange juice. AB - Nine volunteers received a 500 mg oral dose of tetracycline hydrochloride in three trials: A: With 180 ml water; B: With 30 gm colestipol in 180 ml water; C: With 30 gm colestipol in 180 ml orange juice. Tetracycline concentrations in multiple urine samples collected during 48 hours after each dose were determined by high pressure liquid chromatography. The three trials did not differ significantly in 48 hour cumulative urine volume (3086 vs 3207 vs 3194 ml for Trials A, B, and C). However, the three trials differed significantly in 48 hour excretion of tetracycline (F = 28.2; P less than .001). During Trial A, mean excretion was 237 mg; this was significantly (P less than .05) reduced to 109 mg in Trial B and 104 mg in Trial C. However, Trials B and C were not different. Thus, coadministration of tetracycline with colestipol significantly impairs tetracycline absorption by more than 50%. Mixing colestipol with orange juice does not alter colestipol-induced impairment of tetracycline absorption. PMID- 2778099 TI - Absence of tobramycin pharmacokinetic and creatinine clearance variation during the menstrual cycle: implied absence of variation in glomerular filtration rate. AB - During the menstrual cycle, a 20% increase in creatinine clearance (CL(CR] has previously been reported between the menstrual (phase 1) and late luteal (phase 4) phases. Tobramycin pharmacokinetics and CL(CR) were studied in eight healthy women with documented, regular, ovulatory menses. During the first and fourth phases of the menstrual cycle (as determined by urinary luteinizing hormone peak and basal body temperature shift), subjects received tobramycin by intravenous bolus. Tobramycin half-life, total body clearance, and volume of distribution were not significantly different between the two study phases. No significant change in total urinary creatinine excretion or CL(CR) was seen between phases. Total 24 hour urinary recovery of tobramycin was 98-99.7%. We conclude that no significant changes in renal function, as evaluated by tobramycin pharmacokinetics and CL(CR), occur between these hormonally different phases of the menstrual cycle, and that urinary recovery of a single dose of tobramycin is nearly complete within 24 hours in premenopausal women with normal renal function. PMID- 2778101 TI - Density of neurons and synapses in the cerebral cortex of the mouse. AB - Quantitative anatomical investigations provide the basis for functional models. In this study the density of neurons and synapses was measured in three different areas (8, 6, and 17) of the neocortex of the mouse. Both kinds of measurements were made on the same material, embedded in Epon/Araldit. In order to determine the synaptic density per mm3, the proportion of synaptic neuropil was also measured; it was found to be 84%. The cortical volume occupied by cell bodies of neurons and glia cells amounted to 12%, that by blood vessels to 4%. The total average was 9.2 x 10(4) neurons/mm3 and 7.2 x 10(8) synapses/mm3. About 11% of the synapses were of type II. The density of neurons increased with decreasing cortical thickness; thus the number of neurons under a given surface area was about constant. The synaptic density, on the other hand, was almost constant in the three areas, the number of synapses under a given cortical surface area tended, therefore, to increase with cortical thickness. The average number of synapses per neuron was 8,200, with a tendency to increase with increasing cortical thickness. Shrinkage of the tissue was also measured for various staining techniques. No shrinkage occurred during perfusion with 3.7% formaldehyde or with a solution of buffered paraformaldehyde and glutaraldehyde and during fixation in situ. Electron microscopical material showed almost no shrinkage, whereas Nissl-preparations on paraffin-embedded material had only 43% of their original volume. After Nissl stain on frozen sections the volume had shrunken to 68% and after Golgi impregnation and embedding in celloidin to 70%. The total volume of the neocortex was 112 mm3 (both hemispheres together). The total number of neurons was thus 1.0 x 10(7) and the total number of synapses 8.1 x 10(10). PMID- 2778100 TI - Corticopontine projection in the rat: the distribution of labelled cortical cells after large injections of horseradish peroxidase in the pontine nuclei. AB - The distribution of cortical cells projecting to the pontine nuclei in rats was studied by making large injections of horseradish peroxidase that filled the basilar pons and measuring the density of labelled cells in each cortical area. All retrogradely labelled cells were layer V pyramidal cells. The highest densities of labelled cells were observed in the motor areas. The lowest densities were in temporal association cortex and perirhinal cortex. Visual cortical areas, including the primary visual cortex, provided a major source of pontine projections. The distribution of corticopontine cells within the primary visual cortex was studied in more detail. In all cases the highest density of labelled cells was observed in the region of cortex that represents the nasal visual field. Control injections into brainstem regions adjacent to the pontine nuclei produced a much lower absolute density of retrogradely labelled cortical cells and the distribution of those cells was different from that observed following pontine injections. We conclude that every area of the rat's cerebral cortex projects to the pontine nuclei and that there are consistent variations in the density of the projections both between and within areas. PMID- 2778102 TI - Transient GABA immunoreactivity in cranial nerves of the chick embryo. AB - The distribution and time course of gamma-aminobutyric acid (GABA) immunoreactivity was investigated in the cranium of the chick embryo from 2 to 16 days of incubation (E2-16). A fraction of nerve fibers transiently stains GABA positive in all cranial motor nerves and in the vestibular nerve. Cranial motor nerves stain GABA-positive from E4 to E11, including neuromuscular junctions at E8-11; labeled fibers are most frequent in the motor trigeminal root (E6-9.5). Substantial GABA staining is present from E4 to E10 in a subpopulation (1-2%) of vestibular ganglion cells. Their peripheral processes are labeled in the vestibular endorgan, predominantly in the posterior crista. Some GABA-positive fibers are present in the olfactory nerve (after E5) and in the optic nerve (after E9.5); their immunoreactivity persists throughout the period investigated. Transient GABA immunoreactivity follows "pioneer" fiber outgrowth and coincides with the formation of early synaptic contacts. GABA-containing neurons may change their neuronal phenotype (loss of GABA expression) or they may be eliminated by embryological cell death. Periods of cell death were determined in cranial ganglia and motor nuclei by aggregations of pycnotic cells in the same embryonic material. The periods of embryonic cell death partly coincide with transient GABA immunoreactivity. The function(s) of transient GABA expression is unknown. Some lines of evidence suggest that GABA has neurotrophic functions in developing cranial nerves or their target tissue. In the developing neuromuscular junction, GABA may be involved in the regulation of acetylcholine receptors. PMID- 2778104 TI - Prenatal development of retinocollicular projections in the rabbit: an HRP study. AB - The prenatal development of the rabbit's retinal projections to the superior colliculus (SC) was studied by using anterograde transport of horseradish peroxidase injected intraocularly. Fetuses aged embryonic day 21 (E21) to E29 and an adult rabbit were examined. Gestation in the rabbit is 30-31 days. On E21 contralaterally projecting retinal fibers invade across the entire SC. Their distribution is initially diffuse within the superficial laminae, but by E29 they have a distinct stratified appearance. Ipsilaterally projecting retinal fibers invade the rostral half of the SC on E21. By E23 they cover the entire SC and overlap the contralateral fibers both tangentially and radially. The ipsilateral fibers for the most part are sparsely distributed, but they form a dense focal distribution in the rostrolateral quarter of the SC. This focus straddles the stratum griseum superficiale/stratum opticum (SGS/SO) border. On E25 the ipsilateral fibers maintain their widespread distribution and focal rostrolateral concentration. By E27 they are excluded almost entirely from the caudal half of the SC and are reduced in density in the rostromedial quarter of the nucleus. On E29 the ipsilateral terminal field forms distinct patches and bands that are restricted to the rostrolateral quarter of the SC and are confined to the SGS/SO border. Thus, a few days before birth the pattern and location of the ipsilateral retinocollicular projection resemble those seen in the adult. The early widespread distribution of the ipsilaterally projecting retinal fibers to the SC and their eventual restriction in the fetal rabbit are consistent with the development of this projection in other mammalian orders. PMID- 2778103 TI - Embryonic development of the chick primary trigeminal sensory-motor complex. AB - The objective of this study is to define the development of all components in the chick embryonic trigeminal primary sensory-motor complex, from their first appearance through the formation of central and peripheral axonal projections up to stage 34 (8 days of incubation). This was accomplished by two labeling procedures: application of the monoclonal antibody HNK-1, which binds to the precursors of all these components except the placode-derived neurons, and application of HRP to axons cut immediately distal to the trigeminal ganglion. Single immunopositive motor neuron precursors are present at stage 12. These accumulate in the transient medial motor column, whose neurons initiate axon outgrowth by stage 13-14, concomitant with the onset of translocation of their somata to form the definitive trigeminal lateral motor column (LMC). Initially these translocating somata accumulate on the medial margin of the LMC. Beginning on incubation day 5, axons growing from newly formed motor neurons pass beside the lateral margin of the LMC, and the nuclei of these cells subsequently follow this pathway. These events follow a rostral-to-caudal sequence, and this phase of motor nucleus formation is complete by day 8. The lateral translocation of some caudally located nuclei is arrested beginning on day 5. This cessation, which proceeds rostrally, demarcates neurons that form the dorsal motor nucleus of the trigeminal complex. Sensory neurite formation is initiated in ophthalmic placode derived cells at stage 14.5, one stage later by maxillomandibular neurons, and from mesencephalic V cells at stage 15. Neural crest cells do not initiate axon formation until at least day 4 to 5. Following application of HRP distal to the condensing ganglion at stage 16, labeled ophthalmic nerve projections appear in contact with the wall of the hindbrain centrally and overlying the optic vesicle peripherally. Fibers forming the descending tract elongate rapidly, reaching the level of the VIIth nerve root (200 microns caudal to the trigeminal root) by stage 18 and the cervical cord by stage 22. Labeled terminal arborizations of descending trigeminal afferents are first visible at stage 22 and are evident along the entire descending and proximal ascending tracts by stage 27. Later developing descending axons grow in close association with existing trigeminal fibers, though a few growth cones are consistently evident superficial to the other fibers. No projections different from those reported in adult birds are seen, nor are there any contralateral afferent projections.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2778105 TI - Comparative study of glutamate decarboxylase immunoreactive boutons in the mammalian inferior olive. AB - An antiserum raised against rat glutamate decarboxylase was used to map GABAergic boutons in the inferior olive of rabbit, cat, rhesus monkey, and human. A description of the human periolivary region is also included. The inferior olive of each species contained a dense GABAergic innervation, but immunostaining intensities varied among regions. These intensities were evaluated visually and photometrically, and the sizes and frequencies of occurrence of boutons in various olivary subnuclei were measured. The beta nucleus in all species was intensely immunostained and contained the largest boutons. The caudal subdivision of the dorsal accessory olive stained with a lower intensity than the beta nucleus, but contained similarly large GABAergic boutons. By visual analysis, the rostral subdivision and the subnucleus a of the medial accessory olive and the principal olive were stained with an intermediate intensity, and these regions contained small GABAergic boutons. Photometric analysis of focal regions of the neuropil, however, revealed species differences in teh staining intensity of the principal olive, which was lowest in rabbits and highest in primates. In all species, the lowest immunostaining intensity was observed in the subnucleus b of the medial accessory olive. Species variations in bouton sizes and regional staining intensities were observed in the dorsal cap and the dorsomedial cell column. The heterogeneous staining pattern and regional variation of bouton size argue for the existence of separate GABAergic projections to discrete regions of the inferior olive. Since glutamate decarboxylase immunostaining patterns in the olive are largely similar across species, the afferent projections producing these patterns may also be similar. PMID- 2778106 TI - Distribution of phenylethanolamine N-methyltransferase cell bodies, axons, and terminals in monkey brainstem: an immunohistochemical mapping study. AB - Adrenaline (epinephrine) is an important candidate transmitter in descending spinal control systems. To date intrinsic spinal adrenergic neurons have not been reported; thus adrenergic input is presumably derived from brainstem sites. In this regard, the localization of adrenergic neurons in the brainstem is an important consideration. Maps of adrenergic cell bodies and to a lesser extent axons and terminal fields have been made in various species, but not in monkeys. Thus, the present study concerns the organization of adrenergic systems in the brainstem of a monkey (Macaca fascicularis) immunohistochemically mapped by means of an antibody to the enzyme phenylethanolamine N-methyltransferase (PNMT). PNMT immunostained cell bodies are distributed throughout the medulla in two principal locations. One concentration of labeled cells is in the dorsomedial medulla and includes the nucleus of the solitary tract (NTS), the dorsal motor nucleus of the vagus (X), and an area ventral to X in a region of the reticular formation (RF) known as the central nucleus dorsalis (CnD) of the medulla. A few scattered cells are observed in the periventricular gray just ventral to the IVth ventricle and on midline in the raphe. The second major concentration of PNMT-immunostained cells is located in the ventrolateral RF, lateral and dorsolateral to the inferior olive (IO), including some cells in the rostral part of the lateral reticular nucleus (LRN). Terminal fields are located in the NTS, X, area postrema (AP), and the floor of the IVth ventricle in the medulla and pons. A light terminal field is also observed in the raphe, particularly raphe pallidus (RP). A heavy terminal field is present in locus coeruleus (LC). Fibers labeled for PNMT form two major fiber tracts. One is in the dorsomedial RF extending as a well organized bundle through the medulla, pons, and midbrain. A second tract is located on the ventrolateral edge of the medulla and caudal pons. Fibers in this tract appear to descend to the spinal cord. A comparison with maps of other catecholamine neurons in primates is discussed, confirming that the distribution of the adrenergic system in monkeys is similar to that described in the human. PMID- 2778107 TI - Vasopressin and oxytocin systems in the brain and upper spinal cord of Macaca fascicularis. AB - This paper describes the vasopressin (VP) and oxytocin (OXT) immunoreactive structures in the brain and upper spinal cord of the adult male and female Macaca fascicularis. Immunocytochemistry following intraventricular application of colchicine displayed VP neurons in the diagonal band of Broca (DBB), bed nucleus of the stria terminalis (BST), medial amygdaloid nucleus, dorsomedial hypothalamic nucleus, area of the locus coeruleus (LC), solitary tract nuclei (NTS), and the dorsal horn of the cervical spinal cord in addition to those known to exist in the paraventricular, supraoptic, and suprachiasmatic hypothalamic nuclei. Furthermore, a dense accumulation of VP fibers was observed in areas such as the DBB, medial septum, BST, amygdala, hippocampus, ventral tegmental area, periaquaductal gray, dorsal and ventral raphe, area of Forel, LC region, parabrachial nuclei, and NTS. The lateral septum and lateral habenula displayed no and very few VP fibers, respectively. No extrahypothalamic OXT neurons were found in the brain of this macaque monkey. Dense concentrations of OXT fibers were demonstrated in the amygdala, NTS, and marginal layer of the cervical spinal cord. No sexual dimorphism was found in this primate VP or OXT system. The results show a distribution of the central VP and OXT systems in this primate which is quite different from that in the rat. However, in various aspects it agrees with current data on the VP and OXT systems of the human brain. The present results suggest, therefore, that this monkey might serve as a better model for the human VP system than the rat. PMID- 2778108 TI - Effects of prenatal exposure to ethanol on neocortical development: II. Cell proliferation in the ventricular and subventricular zones of the rat. AB - Prenatal exposure to ethanol alters the generation of neocortical neurons; ethanol reduces the numbers of neurons generated between gestational day (G) 12 and G19 but paradoxically increases neuronogenesis after G19. The present study used [3H]thymidine autoradiography to examine the effects of ethanol on the proliferation of cells in the two cortical germinal zones, the ventricular and subventricular zones. Pregnant rats were fed one of three diets: a liquid ethanol containing (6.7% v/v) diet (Et), a nutritionally matched isocaloric liquid diet (Ct), or chow and water (Ch). Fetuses were administered with [3H]thymidine on G13, G17, or G20 and killed 45-60 minutes later. Autoradiographs were prepared to identify radiolabeled and mitotic cells. Additional brains from 13-23-day-old fetuses were processed for cytoarchitectonic analyses. The size of the lateral ventricles in the fetuses was not significantly affected by the prenatal exposure. Both the ventricular and subventricular zones were evident throughout the period from G13 to G23. In all three groups, the ventricular zone was thickest from G13 to G17, but from G15 on, the ventricular zone of Et-treated fetuses was significantly thinner than those of either controls. On G13, G17, and G20, the labeling index (the ratio of radiolabeled cells to the total population) was significantly less in Et-treated fetuses. The mitotic index was similar in Et , Ch-, and Ct-treated fetuses. The subventricular zone of all fetuses was most prominent during later fetal ages and it was thicker in Et-treated fetuses than in controls. Moreover, the labeling and mitotic indices for the subventricular zone of Et-treated rats were significantly greater than for controls. Thus, ethanol had different effects on the two neocortical germinal zones: the proliferation of ventricular cells was inhibited, whereas the proliferation of subventricular cells was stimulated. These data suggest that ethanol-induced changes in neuronogenesis result from alterations in proliferative activity. PMID- 2778109 TI - Anatomical study of the connections of the primary auditory area in the rat. AB - The aim of the present study was to identify in the rat the overall input-output pattern of connections of the primary auditory field, with special attention to the topographical organization of the geniculocortical auditory projection. By using cytoarchitectural criteria, three temporal cortical fields were distinguished in the rat: Te1, Te2, and Te3. The primary auditory field Te1 is characterized by a relatively specific differentiation of its layers when compared with other temporal fields. The afferent and efferent connections of Te1 were identified by using the retrograde and anterograde transport of wheat germ agglutinin conjugated with horseradish peroxidase (WGA-HRP). The results indicate that Te1 is connected by a dense and reciprocal system of fibers with the auditory thalamus. Based on the nomenclature of Morest ('64) in the cat, five cytoarchitectural subdivisions of the medial geniculate complex (MG) were identified in the rat: ventral (MGv), dorsal (MGd), medial (MGm), suprageniculate (Sg), and peripeduncular (PPA). The major rostrocaudal extent of the MGv is connected to Te1. The surrounding cortical fields Te2 and Te3 do not receive a projection from the MGv, except from its most caudal pole. The MGv projection is topographically organized. When the deposit area of the tracer is shifted from dorsal to ventral upon Te1, the corresponding labeled zone within the MGv moves from rostral to caudal, whereas a cortical displacement of the deposit area of the tracer from rostrodorsal to caudoventral leads to a medial to lateral shift of the labeled zone in the MGv. In addition, more dorsal parts of the MGv project on more dorsal sectors of Te1. Te1 receives a sparser, topographically organized projection from the deep dorsal subdivision of the MGd. The MGm and the lateral part of the posterior group of thalamic nuclei (Pol) also distribute fibers to the primary auditory field. Te1 is reciprocally connected by a system of callosal fibers with the contralateral homotypic cortex. Finally, Te1 sends fibers to the dorsal and, to a lesser extent, external cortices of the inferior colliculus, caudomedial caudate-putamen complex, and caudoventral thalamic reticular nucleus. PMID- 2778110 TI - Cyclosporine therapy for psoriasis: serum creatinine measurements are an unreliable predictor of decreased renal function. AB - With increasingly widespread use of cyclosporine for the treatment of psoriasis, it is imperative to identify reliable markers of cyclosporine-induced nephrotoxicity. Five patients with extensive psoriasis and no significant preexisting renal disease were treated with oral cyclosporine (average dosage, 5 mg/kg per day; average duration of treatment, 9 weeks). Changes in serum creatinine measurements made immediately before and at the end of treatment were compared with changes in glomerular filtration rate as determined by 125I iothalamate clearance. During treatment, the average serum creatinine value only increased from 1.0 +/- 0.2 to 1.1 +/- 0.3 mg/dl (+/- standard deviation), whereas iothalamate-based estimates of glomerular infiltration rate decreased from 100 +/ 22 to 63 +/- 37 ml/min/1.73 m2 (p less than 0.02). Simultaneous 125I-iothalamate and 24-hour creatinine clearances were obtained in two patients at the end of treatment and at 2 weeks after cyclosporine therapy. Glomerular filtration rates determined by iothalamate clearance were 14% to 30% lower than those calculated by 24-hour creatinine clearances. Neither serum creatinine measurements nor creatinine clearances (whether calculated or measured) accurately reflect the cyclosporine-induced decline in renal function as determined by glomerular filtration rate. In contrast, 125I-iothalamate clearance is a more accurate measurement of glomerular filtration rate, which provides a sensitive marker for monitoring potential cyclosporine-induced nephrotoxicity. PMID- 2778111 TI - Pruritus associated with nocturnal wakenings: organic or psychogenic? AB - Pruritus that interferes with sleep is generally diagnosed as having an organic rather than a psychogenic basis. We compared the dermatologic and psychosocial parameters of 79 inpatients with psoriasis with moderate to severe pururitus with (W group; n = 46) and without (NW group; n = 33) wakenings from sleep in association with pruritus. At the time of the patients' admission, compared with the NW group the W group had more severe depressive psychopathologic features (p less than 0.05); were possibly alcoholic, according to behavioral criteria for alcoholism (p less than 0.005); reported a higher daily alcohol consumption (p less than 0.05); and had symptoms suggestive of periodic movements in sleep, or nocturnal myoclonus (p less than 0.05), a sleep physiologic disorder. The two groups did not differ with respect to pruritus severity or other dermatologic parameters at the time of admission or during inpatient treatment. Contrary to the generally accepted criterion for the organicity of pruritus, psychiatric and possibly sleep pathologic factors rather than primary dermatologic factors determined the wakenings from sleep as a result of pruritus. PMID- 2778112 TI - Psoriasis therapy: comparative studies with a hydrocolloid dressing, plastic film occlusion, and triamcinolone acetonide cream. AB - The efficacy of a new hydrocolloid dressing occlusion, alone or with 0.1% triamcinolone cream, was compared with triamcinolone acetonide alone or under plastic film occlusion in the treatment of localized plaque-type psoriasis. Thirty-eight patients were randomly assigned to one of four bilateral, paired comparison treatment groups. Patients underwent 3 weeks of treatment, after which they were followed up for an additional week. After 3 weeks hydrocolloid occlusion with triamcinolone acetonide yielded a significantly better response than the cream alone or the hydrocolloid dressing alone, but the new dressing was comparable to a plastic film occlusive dressing of triamcinolone acetonide. After discontinuation of treatment, however, the sites that had been treated with hydrocolloid-occluded triamcinolone acetonide retained the better results. Topical steroids under hydrocolloid occlusive dressing may be a useful alternative to steroids alone for treatment of localized recalcitrant psoriasis. PMID- 2778113 TI - Chlorambucil--an effective corticosteroid-sparing therapy for pyoderma gangrenosum. AB - A 21-year-old man, with a past history of severe aphthosis and arthritis between age 5 and 15 years, presented at age 18 years with a large leg ulceration, which developed after minor trauma. At that time he was otherwise healthy and taking no medications. Between 1983 and 1986 the patient failed to respond to intensive topical care to the ulcer, two attempted skin grafts, oral prednisone (up to 200 mg/day), sulfasalazine, dapsone (200 mg/day), multiple trials of intralesional triamcinolone acetonide, hyperbaric oxygen, azathioprine, methotrexate, clofazimine, minocycline, and three courses of pulse methylprednisolone therapy. Therapy with chlorambucil (4 mg/day) resulted in progressive improvement and complete healing with eventual cessation of all other therapy. The use of chlorambucil in pyoderma gangrenosum may be an effective adjunctive steroid sparing therapy. PMID- 2778114 TI - Do topical corticosteroids modulate skin irritation in human beings? Assessment by transepidermal water loss and visual scoring. AB - The efficacy of topically applied corticosteroid formulations of different potencies on irritant skin reactions was assessed in human beings. Chronic irritant contact dermatitis was produced by repeated application of a low molarity sodium lauryl sulfate solution. Neither corticoid nor vehicle inhibited visible response to the irritant. Barrier function, as measured by transepidermal water loss, was impaired. The corticoid formulations and the vehicles did not significantly influence barrier function. These data raise the question of the value of certain topical corticoids and vehicles in chronic irritant contact dermatitis when the irritant is not removed. PMID- 2778115 TI - Papillary mesenchymal bodies: a histologic finding useful in differentiating trichoepitheliomas from basal cell carcinomas. AB - To distinguish a basal cell carcinoma (BCC) from a trichoepithelioma can be difficult even for an experienced dermatopathologist. Previously reported differentiating histologic features are relative criteria that may be shared by both tumors. In a review of 30 consecutive cases each of trichoepitheliomas, keratotic BCC, and routine BCC, classic criteria were compared with papillary mesenchymal body formation. Papillary mesenchymal bodies are distinct fibroblastic aggregations that represent abortive attempts to form the papillary mesenchyme responsible for hair induction. Papillary mesenchymal bodies were observed in 93% of all trichoepitheliomas, 7% of all keratotic BCC, and 0% of all routine BCC. Hair bulb formation was observed in 30% of trichoepitheliomas and in none of the BCC. We conclude that papillary mesenchymal body formation is an easily recognizable histologic criterion that is more reliable in differentiating these two tumors than standard criteria, including epidermal connections, keratinization, calcification, foreign body reaction, fibrosis, stromal retraction, tumor mucin, ulceration, frondlike epithelial pattern, and the inflammatory response. PMID- 2778116 TI - Skin hyperreactivity response (pathergy) in Behcet's disease. AB - Behcet's disease is very difficult to diagnose because its clinical signs overlap with those of other systemic diseases. Thus there is a clear need for nonclinical diagnostic criteria for Behcet's disease. The nonspecific cutaneous hyperreactivity response, pathergy, may serve as an important diagnostic indicator. A test for pathergy may also clarify the role of an immune complex mechanism in the pathogenesis of Behcet's disease. In our study of 11 patients with Behcet's disease, deposition of immunoglobulins or complement was not found 4 hours after histamine or saline injection. In contrast, 24 hours after histamine or saline injection, 10 of 11 patients responded positively both clinically and histologically during the active stage of their disease. Vasculitis was noted in only two patients. Thus in most patients no evidence of an immune complex mechanism was observed. We conclude that any nonspecific intracutaneous injection is a good clinical tool for the diagnosis of Behcet's disease. PMID- 2778117 TI - Validity of patch test screening trays in the evaluation of patients with allergic contact dermatitis. PMID- 2778118 TI - Kaposi's sarcoma and Mycobacterium avium-intracellulare with cellulitis in patient with acquired immunodeficiency syndrome. PMID- 2778119 TI - Behcet's disease with severe cutaneous necrotizing vasculitis: response to plasma exchange--report of a case. PMID- 2778121 TI - Reply to review of Psychocutaneous Disease. PMID- 2778120 TI - Cyclosporine therapy for severe atopic dermatitis. PMID- 2778122 TI - Delayed shear-induced dermatographism and delayed pressure-induced dermatographism are distinct entities. PMID- 2778123 TI - Photopatch testing: a three-year experience. PMID- 2778124 TI - Marked increase of liver transaminases after khellin and UVA therapy. PMID- 2778125 TI - Mechanisms and therapy of aging skin. Proceedings of a symposium held at the American Academy of Dermatology, forty-seventh annual meeting. Washington, D.C., December 6, 1988. PMID- 2778126 TI - The ultraviolet-irradiated hairless mouse: a model for photoaging. AB - The hairless mouse is proving to be a relevant model for the systematic study of photoaging. As in humans, with chronic ultraviolet radiation, these mice develop elastic fiber hyperplasia, followed by elastosis and ultrastructural degradation. Collagen is damaged and its metabolism is altered, while the normally low levels of proteoglycans and glycosaminoglycans are greatly increased. With this model we have described the effects on dermal connective tissue of UVB (290 to 320 nm), UVA (320 to 400 nm), and the combination of the two. We have also assessed the protective effects of sunscreens. We found that a significant amount of photodamage was repaired when ultraviolet radiation was stopped. Subepidermally in a former region of elastosis, a band of new normal dermis was laid down. Enhancement of the repair was achieved with topical all-trans-retinoic acid in a time- and dose-dependent manner. Retinoic acid was also found to induce angiogenesis in unirradiated mice. PMID- 2778127 TI - Optical profilometry: an objective method for quantification of facial wrinkles. AB - Facial fine lines and wrinkles can be faithfully captured by silicone rubber impression materials. Computerized digital image processing of such specimens provides objective measurement of the skin's topography, which has a significant degree of correlation with clinical grading. Optical profilometry provides a dimension of objectivity that can complement clinical assessment in the study of agents that may be useful in the therapy of photodamaged skin. PMID- 2778128 TI - Guidelines for the use of topical tretinoin (Retin-A) for photoaged skin. AB - Topical tretinoin (Retin-A) enhances the appearance of photoaged skin by effacing fine wrinkles, bleaching pigmented "age spots," improving surface texture, and inducing a rosy glow. A media blitz about Retin-A has resulted in a rush of patients to physicians, many of whom have had little experience with this drug. As a result, many patients receive too little information and often improper instructions regarding the best way to apply tretinoin. Misuse and misconceptions are common. Tretinoin is not a cosmetic preparation to be applied according to individual whims. Patients require detailed instructions to obtain maximal benefits, as well as an appreciation of the time frame for these to appear. This article presents current guidelines for the proper use of Retin-A. PMID- 2778129 TI - Paradoxical social effects on response to cold during ontogeny of the common white-toothed shrew, Crocidura russula. AB - Postnatal development of thermoregulatory responses to cold differs between shrews measured singly or in groups as a litter. Single shrews increase their metabolic response to cold within 14 days to maintain normothermia. Shrews measured in groups show little or no metabolic response to cold and do not reach normothermia before the 19th day. Lower body temperatures in groups are explained by torpor, which obviously needs the prerequisite of forming a group. Oxygen consumption of the singly measured shrews depends upon body mass. PMID- 2778130 TI - Further demonstration of the ambient temperature dependence of the annual biological cycles in the edible dormouse, Glis glis. AB - In the male edible dormouse, it has been proposed that the annual temperature cycle is the major external factor triggering annual biological rhythms in this hibernating species. The present study was designed to explore (i) the effects of suppression of the annual thermoperiodic cycle under natural photoperiodic conditions, and (ii) the effects of acute exposure to a warm environment on basal plasma T4 levels observed during hibernation. The results of the first experiment demonstrate an absence of circannual cycles of hibernation, body weight, and endocrine thyroid and gonadal functions in the absence of annual fluctuations of temperature (constant warm environment at 24 degrees C) despite the maintenance of a normal photoperiodic cycle. On the other hand, acute exposure to 24 degrees C during the late stage of hibernation stimulated thyroid function as expressed by a consistent transitory rise in plasma T4 concentrations, which was maximal within 7 days and restored to basal levels after 14 days. These findings are in close agreement with the concept that in the edible dormouse, the annual thyroid cycle is synchronized with the annual temperature cycle. Moreover, the present study, combined with prior data indicating that the thyroid cycle induces the testis cycle, suggests that the ambient temperature cycle may be intricately involved in the control of neuroendocrine cycles in dormice, although the mechanism is still unknown. PMID- 2778131 TI - Radiologic screening for von Hippel-Lindau disease: the role of Gd-DTPA enhanced MR imaging of the CNS. AB - Thirty-seven members of a family with von Hippel-Lindau disease (VHL) were prospectively screen for CNS hemangioblastomas; 10 family members were previously known to have VHL. Radiographic studies included noncontrast magnetic resonance (MR) imaging of the head (all patients) and spine (34 patients) and contrast enhanced CT (CCT) of the head (all adult patients). Eleven patients had Gd-DTPA enhanced MR (CMR) of the head and 10 patients had CMR of the spine. Sixteen patients had radiographic evidence of CNS hemangioblastomas and all but six patients were symptomatic. Using comparable studies, CMR of the head demonstrated more lesions than the other modalities (31, 22, and 19 for CMR, MR, and CCT, respectively). Furthermore, CMR better separated tumor from edema, as well as cystic from solid components. Contrast enhanced MR was superior to noncontrast MR of the spine in lesion detection (31 vs. 4; p less than 0.001). Noncontrast MR was particularly limited in four patients with syringomyelia. We conclude that postcontrast MR of the head and spine is the best currently available means of detecting hemangioblastomas associated with VHL. PMID- 2778132 TI - Dilated Virchow-Robin spaces in cryptococcal meningitis associated with AIDS: CT and MR findings. AB - We present two patients with AIDS complicated by cryptococcal meningitis who displayed focal hypodense nonenhancing lesions in CT in the basal ganglia with corresponding areas of increased T2 and decreased T1 signal on magnetic resonance (MR). These lesions corresponded precisely to the distribution of the perforating arteries. Review of pathological specimens showed these lesions to be small cystic collections of cryptococcal organisms in the perivascular spaces of the arteries with minimal or no inflammatory reaction. The cryptococcal organisms spread from the basal cisterns through the Virchow-Robin spaces, dilating these spaces, to ultimately propagate in the basal ganglia, internal capsule, thalamus, and brain stem. Such lesions have been described as characteristic for cryptococcosis in the pathology literature before the AIDS epidemic, but the radiological manifestations have not been reported previously. The changes appear characteristic for cryptococcosis, which generally incites no host response in the form of perifocal edema or enhancement. These findings in a young adult, with otherwise normal CT or MR scans, may be the first indication that the patient has AIDS. The T2-weighted image sequences are more sensitive in the detection of these lesions when compared to CT or T1-weighted MR images. PMID- 2778133 TI - Thickening of dura surrounding meningiomas: MR features. AB - Thickening of the dura in continuity with a convexity meningioma was noted on T1 weighted magnetic resonance (MR) images in seven patients. In five cases the corresponding CT image of the lesions was typical of meningioma. In two other cases the CT image of the lesions was atypical, owing to cyst formation in one and extensive edema in the other. After intravenous injection of paramagnetic contrast medium in four patients, the thickened dura demonstrated contrast enhancement at a variable distance from the tumor. In three patients the thickened dura was confirmed surgically. Pathology, available in one case, showed the thickened dura to correspond to tumoral extension within or around the dura. Magnetic resonance demonstration of thickening of the dura in continuity with a mass at the cerebral convexity may prove to be of importance in the differentiation of atypical lesions on CT and MR, especially with lower field magnets. Moreover, it could provide useful information to the neurosurgeon for more complete resection of the tumor. PMID- 2778134 TI - Displacement of the quadrigeminal plate in tumors of the fourth ventricle: MR appearance. AB - Magnetic resonance studies of 12 fourth ventricle tumors were reviewed. The relationship between the tumor and surrounding structures, such as the corpus medullare, the superior medullary velum, and the quadrigeminal plate, was assessed on midsagittal inversion recovery images. Two of the 12 tumors displaced the superior medullary velum superiorly. Seven of the 12 tumors displaced the corpus medullare posteriorly. The superior medullary velum was not recognized in 10 cases and the corpus medullare in 5. Ten of 12 quadrigeminal plates were displaced superoposteriorly due to focal enlargement of the cerebral aqueduct secondary to large intraventricular tumors. In the remaining two cases the tumor was not large enough to enlarge the cerebral aqueduct. The larger the tumor was, the more frequent was the displacement of the quadrigeminal plate. On T2-weighted images, CSF flow-void sign was seen around the tumor in 5 of 12 cases. We consider superoposterior displacement of the quadrigeminal plate to be a relatively constant and reliable sign accompanying fourth ventricle tumors. PMID- 2778135 TI - High signal intensity lesions of the chest in MR imaging. AB - The majority of pathologic lesions in the lung and mediastinum have relatively long T1 and T2 relaxation times and consequently yield medium to low signal intensity on T1-weighted images. Pulmonary lesions with high signal intensity on T1-weighted images are unusual and raise a special group of diagnostic considerations. In the current study, a mass with a lesion/fat signal intensity ratio of greater than 0.7 on a T1-weighted sequence was considered high signal intensity. The nature of these masses was ganglioneuroma or ganglioneuroblastoma (n = 3), atrial lipoma (lipomatous atrophy of the interatrial septum) (n = 3), pheochromocytoma (n = 2), bronchogenic cyst (n = 2), lymphangioma (n = 1), teratoma (n = 1), and a variety of primary and metastatic tumors of the mediastinum and lung. A single pathologic structure of these lesions was not present, but rather several underlying tissue compositions were noted, including fat, subacute hemorrhage, myxoid material, and cellular composition with high cytoplasmic/nuclear ratio. Thus, high signal intensity lesions of the thorax on T1-weighted images should suggest a number of differential diagnoses. PMID- 2778136 TI - Computed tomography of pseudotumoral pleural fluid collections in the azygoesophageal recess. AB - Pleural fluid in the azygoesophageal recess may present as a mass lesion on plain films of the chest. This occurs in the absence of underlying parenchymal or pleural pathology. Computed tomography proves to be useful in demonstrating the location of the abnormal fluid collection and in differentiating it from mass lesions. PMID- 2778138 TI - Computed tomography of portal vein thrombosis: unusual appearances and pitfalls in diagnosis. AB - In a review of 25 cases examined by CT in whom the diagnosis of visceral vein thrombosis had been made, we encountered four cases in which problematic CT findings led to an error in diagnosis by the prospective interpreter. In one case, gas in collateral periportal veins mimicked an abscess; in one case, segmentally occluded portal veins resembled dilated bile ducts; and in one case, expansion of the inferior mesenteric vein was interpreted as a pancreatic pseudocyst. One additional case of multiple intrahepatic stones mimicked calcified portal vein thrombus. Although most cases are straightforward, there is a spectrum of findings in visceral vein thrombosis that may lead to confusion; alternative imaging techniques may be necessary in these situations. PMID- 2778137 TI - Chondrosarcoma of the sternum: CT features. AB - Eleven sternal chondrosarcomas were reviewed with radiologic emphasis on the CT findings. Typical clinical presentation was a large painless anterior chest wall mass in an elderly individual. In six cases the chest radiograph strongly suggested an underlying cartilaginous neoplasm owing to the appearance of typical mineralized cartilage matrix, i.e., a pattern of stippled, flocculent, or curvilinear ("rings and arcs") calcifications. Calcifications were detected on CT in all 11 patients. Excepting the three smallest lesions, averaging 4 cm in diameter, on CT the tumors exhibited a scalloped or lobulated contour, also typical for cartilaginous neoplasms. Six tumors were centered in the sternal body, four in the xyphoid process, and one in the manubrium. In addition, CT was especially important in localizing the lesion when the tumor was either small in size or centered in the xyphoid process (where all four chondrosarcomas grew in an inferior direction). Because of its ability to detect subtle matrix mineralization and delineate the extent and probable origin of the tumor, CT strongly favored the preoperative diagnosis of sternal chondrosarcoma and was also helpful in surgical management. PMID- 2778139 TI - Pneumoperitoneum resembling air in the biliary tree: CT features. AB - The various CT appearances of free abdominal air have been described. We present a hitherto undescribed CT manifestation of this condition. When subhepatic free air tracks along the porta hepatis and suspensory ligaments of the liver, it may resemble biliary air. PMID- 2778140 TI - CT and MR imaging of advanced Zollinger-Ellison syndrome. AB - The CT and magnetic resonance (MR) findings in 13 patients with advanced Zollinger-Ellison syndrome are described. In eight patients (62%) one or more primary tumors were found with both methods. All patients with proven liver metastases (n = 7) were identified by MR. Computed tomography was positive in six of these patients. Three patients with lymph node metastases were identified on CT and MR and one patient had bone metastases. Computed tomography and MR were inferior to selective arteriography in the detection of multiple lesions of the pancreas in a patient with multiple endocrine neoplasia-I syndrome. On the T1 weighted MR images, the primary tumors demonstrated no consistency with regard to their signal intensity relative to the adjacent pancreatic parenchyma. All gastrinomas had an increased relative signal intensity on the T2-weighted images with the exception of a calcified tumor. Liver and lymph node metastases had a low signal intensity on the T1-weighted images and an increased signal intensity on the T2-weighted images. The signal intensity of primary tumors and metastases was independent of size. In conclusion, MR was able to detect abnormalities based on its outstanding lesion/normal tissue contrast, whereas CT diagnosis was based mostly on contour distortion. For the current technique, MR is considered at least equal to CT. PMID- 2778141 TI - MR imaging of liposarcomas: correlation of MR features and histology. AB - The magnetic resonance (MR) imaging features of liposarcoma were correlated with histology in 15 patients. The MR findings for liposarcoma were not specific. The six myxoid liposarcomas and two atypical lipomatous tumors, however, had distinctive MR features, i.e., nodular masses of slightly heterogeneous intermediate to high signal intensity (SI), intermingled with high SI septa on T1 weighted images. The T2-weighted images demonstrated the relative reversal of these regional SI characteristics. Additionally, MR correctly identified the presence of fat in all eight cases in which it was pathologically present. The fat in two atypical lipomatous tumors was inseparable on MR from the subcutaneous fat. Magnetic resonance appears useful for preoperative staging and follow-up studies of liposarcomas. It may be helpful in identifying patients with myxoid liposarcoma and atypical lipomatous tumors who have longer survival times. PMID- 2778142 TI - Intramuscular myxoma: MR features. AB - Intramuscular myxoma is a benign mesenchymal lesion consisting of bland spindled cells embedded in an avascular myxoid stroma. On CT, intramuscular myxoma presents as a well-demarcated, homogeneous, low density mass situated within skeletal muscle. The attenuation of the lesion is slightly greater than water but less than that of the surrounding normal muscle, with typical values between +10 and +60 HU. There is scant magnetic resonance (MR) literature on the appearance of intramuscular myxoma; the few MR spin echo images that have been published characterize it as a homogeneous mass with signal intensity less than or equal to skeletal muscle on T1-weighted and brighter than fat on T2-weighted pulse sequences. We present two cases of intramuscular myxoma with imaging characteristics that differ from those previously reported. PMID- 2778143 TI - MR appearance of fibrous dysplasia. AB - Magnetic resonance (MR) imaging is utilized in diverse clinical circumstances for evaluation of the musculoskeletal system. Consequently, common benign skeletal lesions may be detected incidentally following MR scan obtained for unrelated reasons. The spectrum of MR appearances of fibrous dysplasia has not been previously reported. We retrospectively reviewed all radiologic images (including the MR scans) of 11 sites of fibrous dysplasia encountered in seven patients. On MR, the fibrous dysplastic lesion causes an "expanded" bony contour and is characterized by decreased signal on T1-weighted image. The signal on T2-weighted MR scan is variable, however. Since fibrous dysplasia is a (relatively) common skeletal lesion that can be encountered incidentally, all radiologists should be familiar with its MR appearance. Furthermore, in the unlikely possibility of surgical intervention, MR is useful in determining the extent of disease within the affected bone and planning the preoperative strategy. PMID- 2778144 TI - Proton MR chemical shift imaging using double and triple phase contrast acquisition methods. AB - Conventional chemical shift magnetic resonance (MR) imaging with the phase contrast technique has a number of limitations with respect to quantitative accuracy. The hypothesis of this study is that the accuracy of phase contrast chemical shift MR may be improved by increasing the number of basis images from two to three. Water and fat images were obtained from phantoms and volunteers with a 1.5 T MR system using double and triple acquisition phase contrast chemical shift methods. Longitudinal relaxation time and relative water and fat content were calculated from these basis images. The T1 relaxation times of the aqueous component of composite phantoms were determined more accurately using the triple acquisition method than with the double acquisition method. In vivo studies demonstrate that the triple acquisition method separated fat and water signals more accurately and showed less field inhomogeneity dependence than the modified double acquisition method. The new method also provided a map of static field magnetic inhomogeneity and tissue magnetic susceptibility. The triple acquisition phase contrast chemical shift imaging technique should improve the prospect for quantitative tissue characterization in clinical MR. PMID- 2778145 TI - Carotid body tumor: flow sensitive pulse sequences and MR angiography. AB - The magnetic resonance (MR) appearance of carotid body tumors has been previously described. Classically, these lesions are well circumscribed and highly vascular and cause a characteristic separation of the external and internal carotid arteries. Hypointense foci within these tumors are seen on T1-weighted images. The T2-weighted images snow a "salt and pepper" pattern. We report a carotid bifurcation glomus tumor that exhibited the above features on conventional MR. Multiplanar gadolinium enhanced MR as well as flow-sensitive MR techniques including small flip angle gradient refocused images and MR angiography were performed. Magnetic resonance angiography demonstrated the abnormal morphology of the carotid bifurcation. Axial gradient refocused images revealed evidence of flow within the lesion. The findings were then correlated with postcontrast CT, arterial digital subtraction angiography, and histopathology. PMID- 2778146 TI - MR findings in rhinocerebral mucormycosis. AB - A case of rhinocerebral mucormycosis evaluated by magnetic resonance (MR) imaging is presented, with inflammatory changes in the paranasal sinuses and orbit. Extension of the infection into the cavernous sinus, with cavernous sinus thrombosis and internal carotid artery narrowing, was well demonstrated on pre- and postgadolinium MR images. Infarctions in the anterior choroidal artery distribution suggested intracranial invasion of basal arteries, and watershed distribution infarctions attested to the tenuousness of flow through a narrowed cavernous carotid artery. Magnetic resonance effectively demonstrated the wide array of findings possible in rhinoorbitocerebral mucormycosis. PMID- 2778147 TI - CT evaluation of adult epiglottitis. AB - Epiglottitis, a rapidly progressive, potentially lethal, cellulitis involving the epiglottis and larynx, is a medical emergency with the rapid onset of airway compromise. Diagnosis is established by lateral neck radiography and visualization of the inflamed epiglottis and supraglottic tissues by laryngoscopy. The case presented here demonstrates the CT features of acute adult epiglottitis. PMID- 2778148 TI - Neurilemoma of the tongue: MR findings. AB - Neural tissue tumors of the oral cavity are rare. They are found most commonly in the tongue and arise from the sheaths of peripheral nerves, neuroglia, and neurons. We report magnetic resonance findings in a case of neurilemoma of the tongue. PMID- 2778149 TI - Tuberous sclerosis: increased MR detection using gradient echo techniques. AB - The case of a child with a pervasive developmental disorder secondary to tuberous sclerosis is presented. Magnetic resonance images demonstrated several areas of decreased signal on both T1- and T2-weighted conventional spin echo sequences. The abnormal areas became more conspicuous on the gradient echo images. The increase in conspicuity of the parenchymal brain lesions in the gradient echo images was presumably secondary to magnetic susceptibility effects. PMID- 2778150 TI - Subdural hematoma in the setting of internal carotid artery occlusion: CT studies. AB - A 72-year-old woman with previously symptomatic internal carotid artery occlusion subsequently presented with an acute hemispheric deficit. The patient was initially diagnosed as having an ischemic infarction but eventually was shown to have a subacute subdural hematoma with delay in surgical evacuation and a major permanent deficit. We speculate that internal carotid artery occlusion may predispose the patient to greater morbidity from subdural hematoma. Patchy hemispheric infarction may reflect greater vulnerability to extrinsic hemispheric compression in the setting of carotid occlusion. This case illustrates the necessity for vigorous pursuit of the diagnosis of subdural hematoma in patients presumed to have transient ischemic attacks or acute cerebral infarction. PMID- 2778151 TI - Primary myxoma of the cranium: CT findings. AB - A case of 17-year-old girl with primary myxoma of the cranium is presented. The lesion ballooned the inner and outer tables of the cranium and expanded intracranially, causing neurologic deficits. The lesion is rare and its radiographic, including CT, features are described. PMID- 2778153 TI - Angiosarcoma of the liver mimicking cavernous hemangioma on dynamic CT. AB - A case of hepatic angiosarcoma showed findings similar to those of cavernous hemangioma on dynamic CT, angiography, and magnetic resonance imaging. The tumor was histologically confirmed as angiosarcoma of cavernous pattern. PMID- 2778152 TI - MR and CT findings in pulmonary artery sarcoma. AB - Pulmonary artery sarcomas are a rare and frequently forgotten cause of pulmonary artery occlusion. We present a case report that details magnetic resonance and new CT findings, which may help establish early diagnosis of this infrequently encountered tumor. PMID- 2778154 TI - Delayed enhancement of ascites following high-dose contrast CT for liver metastases. AB - Enhanced ascites has been described as a pathognomonic CT sign of urinary peritoneal fistula. We have seen two cases of slowly enhancing ascites demonstrated with delayed contrast CT in the absence of urinary-peritoneal fistula. Knowledge of this phenomenon is important because hyperdense enhanced ascites can simulate urinary-peritoneal fistula or intraperitoneal hemorrhage. PMID- 2778155 TI - Painful Horner syndrome associated with occlusion of the extracranial internal carotid artery: MR imaging. PMID- 2778156 TI - MR imaging of cervical spinal cord infarction. PMID- 2778157 TI - Injected air mimicking leptomeningeal metastases on lumbar myelography: CT diagnosis. PMID- 2778158 TI - Subtracted synthetic images in Gd-DTPA enhanced MR. AB - The evaluation of Gd-DTPA contrast enhancement (CE) in high intensity tissues on T1-weighted magnetic resonance images, such as fat and bone marrow, is quite difficult. In this study, we used subtraction and subtracted color images in an attempt to show more clearly the Gd-DTPA CE. In addition, we also carried out sequential post-Gd-DTPA imaging to assess the changes in enhancement of lesions with time. Twenty patients were studied with these methods and our results are illustrated. PMID- 2778159 TI - Effect of amount and composition of feed given over three lactations on the performance of the dairy cow. AB - Eighty-nine autumn-calving first calf and adult Friesian cows participated in an experiment on the effect of feeding over three lactations on milk production and live weight change. Fixed daily allowances of digestible energy (DE) formed two of the treatments (h, H; moderate, M). Diets of similar composition were used for both treatments and rations were weighed daily for each cow. The cows within these treatments were re-randomized to H or M at second and again at third parturition on experiment. A further treatment (ALF), applied continuously over three lactations, consisted of the M allowance of compound feed, weighed daily for each cow, plus as lib. weighed, group-fed forages. The ALF animals were randomized for each lactation into two groups both of which received the same total compound feed allowance over the first 26 weeks of lactation. For one group (Flat) equal amounts were given daily whilst for the other group (Step) the daily amount was decreased monthly. After week 26 equal rations were fed. Hay, maize silage and grass silage formed the forages in winter. Grass, cut for the H and M groups but grazed for the ALF group, provided the summer forage. Energy intakes covered some 80-110% of requirements. Yields of milk and of milk solids responded similarly for both parties. In the first experimental lactation, treatment H led to greater yields compared with M. H also led to smaller losses of live weight in early lactation, equal gains in mid lactation, and smaller gains in late lactation and the dry period, compared with M. Extension of H into a second lactation increased the advantage in milk and solids yields observed in the first lactation on experiment. Recovery of body reserves on treatment M continued. Treatment H in a second lactation on experiment after M in the first lactation led to even greater compensatory gains in live weight at the expense of milk production. There was no effect in the third lactation of experiment of treatments applied in the first lactation. Treatments H and M applied factorially over lactations 2 and 3 gave the same pattern of treatment effects as in lactations 1 and 2. Treatment ALF broadly supported the same milk yield and live weight change as treatment H but improved fat, protein and lactose yields. Within treatment ALF, Flat and Step distribution of compound led to equal performance. Multiple lactation effects of ALF equalled those of H. The effects on milk composition of H compared with M treatment were variable. In general an advantage accrued to ALF over M but without long term effects. PMID- 2778160 TI - Short-term effects of frequent milking of dairy cows. AB - When six cows were milked every 4 h over 48 h the average milk yield per cow increased by 10.7% for the last 24 h period compared with the previous 5 d. Milk composition was similar to pre-experimental values although fat content was 0.5% lower in the last 24 h. The somatic cell count rose to twice the pre-experimental value over the first 24 h but was not significantly different by the second 24 h. It appears that cows responded quickly to an increased frequency of milking and milk of an acceptable composition was produced. This has implications for management of milk production where quotas are in operation and for robotic milking systems. PMID- 2778161 TI - Characterization of multiple forms of lactophorin isolated from bovine milk whey. AB - A glycoprotein that reacted to the antisoluble glycoprotein of bovine milk fat globule membrane was purified from the proteose-peptone of whey and designated lactophorin. Lactophorin was separated into seven components. Lactophorin and the seven components were rich in aspartic acid, threonine, serine, glutamic acid, leucine, and lysine. The content of threonine, glycine, isoleucine, lysine, and arginine varied in each component. The ratio of fucose, mannose, galactose, N acetylgalactosamine, N-acetylglucosamine, and sialic acid of lactophorin, which contains about 18% saccharide, were 1, 6.6, 10.3, 5.5, 9.7, and 11.6, respectively, while the respective ratio of the seven components were 1, 5 to 6, 7 to 9, 3 to 4, 6 to 8, and 4 to 12. Sialic acid content varied in each component. Protein-carbohydrate linkage was N- and o-glucoside linkage. Lactophorin consisted of seven polypeptides (I to VII) with apparent molecular weights 17,000 to 67,000. Bands I, II, VI, and VII were glycoprotein. Bands VI and VII were major and had antigenicity to anti-soluble glycoprotein, while bands I to V were minor polypeptides. Component 1 consisted of only one polypeptide (VII), whereas the components 2 to 7 contained two major (VI, VII, or both) and several minor polypeptides. The sedimentation pattern of each component was a single and almost symmetrical peak. Sedimentation coefficient was 3.79 to 5.64 S and also varied in lactophorin. The results indicate that lactophorin has multiple forms. PMID- 2778162 TI - Influence of breed and hormones on production of milk proteins by mammary explants from prepubertal heifers. AB - Effects of hormone treatment and breed on lactogenic responses were studied in organ culture of mammary tissue obtained from prepubertal Angus or Holstein heifers. Donor animals were treated with injections of estradiol and progesterone for 7 d and were killed on d 15 after initial injection. Explants were cultured for up to 96 h in a basal medium containing insulin, hydrocortisone, and triiodothyronine or a stimulatory medium, further supplemented with prolactin. Concentrations of alpha-lactalbumin and alpha s1-casein were measured in media and explant homogenates by radioimmunoassay, as an index of lactogenesis. In selected cultures, 3H-labeled amino acids were added to assess de novo protein synthesis. Addition of prolactin to medium elicited marked increases in accumulation of alpha s1-casein but had less effect on content of alpha lactalbumin or [3H]protein in media or explant homogenates. Explants from Holstein heifers consistently produced more alpha-lactalbumin, casein, and total protein than those from Angus heifers, reflecting their inherent superiority in ability to produce milk. Breed differences were more readily detected among cultures exposed to prolactin. Demonstration of breed differences in biosynthetic capacity of mammary tissue suggests a possible means for early selection of dairy heifers. PMID- 2778163 TI - Comparative digestion in sheep and cattle fed different forage to concentrate ratios at high and low intakes. AB - Effect of maintenance and ad libitum intakes on digestibility of different feed fractions was studied with six ruminally fistulated cows and six ruminally fistulated wethers to validate the use of sheep as a model for cattle. Complete diets were made up of ratios of alfalfa:cracked corn and soybean meal of 80:20, 55:45, and 30:70. The regression coefficient of the line relating organic matter digestibility with proportion of concentrate in the diet was smaller for the cows at ad libitum intake than for the other groups. Increasing the intake caused a decrease in digestibility of different fractions. The depression in digestibility was greater for the 30:70 forage:concentrate diet than for the others. At high intake, digestion values in the cows were less than those in the sheep for all diets. An increase in intake depressed the digestion of cell wall fractions and cell solubles including starch in cows, whereas in sheep, an increase in intake reduced cell wall digestion and to a lesser extent cell solubles, without affecting starch digestion. The digestive physiology of these species is sufficiently different to preclude the use of sheep data in formulating nutrient requirements for cows. PMID- 2778164 TI - Relation of intake to digestibility of diets containing soyhulls and distillers dried grains. AB - Fifty-four multiparous Holstein cows were used to compare the influence of intake on digestibility of three diets. All diets contained a 50:50 ratio (dry basis) of ammoniated corn silage and concentrate. The control concentrates consisted of corn, oats, and soybean meal. The two test concentrates contained either 43.8% soyhulls or 71.6% corn distillers dried grains with solubles. Each diet was fed at three intakes. Dry cows were fed one times maintenance intake, cows producing 10 to 20 kg milk daily were fed at twice maintenance, and cows producing 27 to 49 kg daily were fed ad libitum (four times maintenance). Digestibilities of DM for the control, distillers grains, and soyhull diets, respectively, were: for dry cows, 84.1, 66.6, and 78.8%; for medium producers, 76.6, 53.8, and 74.2% and for high producers, 60.5, 44.3, and 62.8%. At ad libitum intake, the DM, NDF, ADF, and CP digestibilities were lower for control than for the soyhulls diet. Discounts per unit of maintenance of 9.3, 11.2, and 6.8% were obtained for the control, distillers grains, and soyhull diets. These results confirm the generally accepted concept of energy discounts for grain-soybean meal diets, but discounts were higher than reported previously. Compared with the control diet soyhulls appears to lower, and distillers grains increase, the discount. PMID- 2778165 TI - Plasma tocopherol in sheep and cattle after ingesting free or acetylated tocopherol. AB - Two trials were carried out to evaluate the bioavailability of dl-alpha tocopherol and dl-alpha-tocopherol acetate administered to sheep and cattle in a single oral dose. In the first trial, two groups of five sheep were used. They received 100 mg/kg body weight of either dl-alpha-tocopherol or its acetylated form. The blood plasma alpha-tocopherol tolerance curve area was higher in the dl alpha-tocopherol group than in its ester form. The time to reach maximum plasma alpha-tocopherol concentration was less in the dl-alpha-tocopherol group than in its ester form. In a second trial, four heifers received the two forms (50 mg/kg body weight) in rotation after an appropriate washing period between the two dosings. Again, plasma tolerance curve area was greater in the cattle following administration of dl-alpha-tocopherol than its acetylated form. PMID- 2778166 TI - Influence of protein percentage and degradability on performance of lactating cows during moderate temperature. AB - Sixty high producing Holstein cows (15/treatment) averaging 157 d postpartum were offered the following diets: high protein (18.5%), high rumen degradability (60%); high protein (18.0%), medium degradability (41%); medium protein (15.4%), high degradability (61%); medium protein (15.0%), medium degradability (46%). All diets contained 32% corn silage, 15% alfalfa haylage, and 10% whole cottonseed. Degradabilities were determined by the ficin method and were lowered by replacing soybean meal with meat and bone meal and brewers dried grains. Cows were milked three times daily and the study was conducted from May 11 to June 23 in Provo, UT during ascending day temperatures but cool nights. Milk yields were not different for the respective treatments (36.9, 35.4, 34.8, and 36.7 kg/d), but milk fat was higher at high protein degradability: 3.11, 2.89, 3.04, 2.78%, respectively, resulting in a tendency toward higher FCM. Lower acetate and propionate and acetate:propionate ratios were observed for medium degradability diets and were consistent with lower milk fat. Rumen NH3, butyrate, valerate, isovalerate, 2 methyl butyrate, and blood urea N were higher for cows on high protein diets but were not affected by degradability. Serum glucose and cortisol were not significantly affected by protein treatment, but serum triiodothyronine was lower on high protein; the interaction effect for thyroxine was significant. PMID- 2778167 TI - Effects of Rumen-Mate on lactational performance of Holsteins fed a high grain diet. AB - Three Latin-square trials were conducted to determine the effects of supplementing Rumen-Mate, a commercial buffer containing KCl, NaCl, and Mg and Na carbonates, on lactation performance of Holsteins. Cows were fed a basal ration of 40% corn silage and 60% concentrate in Trials 1 and 2, and 40% corn silage, 55% concentrate, and 5% alfalfa hay in Trial 3 (DM basis). In Trial 1, treatments were: basal diet, or basal diet supplemented with either 1% NaHCO3, or 1, 3, or 4.4% Rumen-Mate. Increasing dietary Rumen-Mate resulted in a linear increase in milk fat production and concentration with no difference between 1% Rumen-Mate and 1% bicarbonate. There was a significant linear decrease in milk protein concentration, but not production, with increasing concentrations of Rumen-Mate. In Trial 2 treatments were: basal diet, or basal diet supplemented with either .8% NaHCO3, 2.6% Rumen-Mate, .5% MgO, .8% NaHCO3 plus .5% MgO, or 1.8% Rumen-Mate plus .8% NaHCO3. Organic matter and CP intakes and milk protein yield and concentration were decreased by Rumen-Mate with a nonsignificant increase in milk fat concentration. Data from Trials 1 and 2 were combined with data from Trial 3, which compared basal diet, 1% bicarbonate, and 3% Rumen-Mate. The combined data showed a larger increase over basal diet in milk fat yield and concentration for 2.6 to 3% Rumen-Mate vs. .8 to 1% bicarbonate. Rumen-Mate did not decrease DM intake or protein yield relative to basal diet but did decrease protein yield 34 g/d compared with that of bicarbonate. PMID- 2778168 TI - Diurnal pattern of plasma cortisol in preruminant calves fasted or fed different milk proteins. AB - The objective was to clarify the possible role of meals in the nycthemeral evolution of cortisol and the influence of intestine absorption kinetic of nutrients. Preruminant calves were fed two kinds of diets, a conventional curdled milk and a milk that did not curdle in the abomasum. These calves were also fasted for 24 h. Blood was sampled regularly during a 24-h period under three different dietary situations. Daily mean plasma cortisol was lower in calves fed uncurdled milk than in those fed curdled milk or fasted. Diurnal changes in plasma cortisol were characterized in fed animals by sharp postprandial decreases; the morning meal induced a more intense decrease than the evening one, which was followed by a regular increase of cortisol concentrations overnight. Between meals, several peak values were detected at the same times in all animals with both kinds of meals. The postprandial decreases did not occur in fasted animals, and peak values could not be linked to those occurring when animals were fed. Thus, cortisol secretion by adrenals seemed to be influenced by nutrient intestinal absorption, whereas during fasting different mechanisms were involved. PMID- 2778169 TI - Effect of intrauterine and intramuscular administration of recombinant bovine interferon alpha 1 on luteal lifespan in cattle. AB - Intrauterine and intramuscular administration of interferon was tested for effectiveness in extending luteal lifespan in cattle. Intrauterine infusion of 1 mg of recombinant bovine interferon-alpha I1, twice daily, to lactating dairy cows from d 14 to 21 after estrus extended interestrous interval (30.4 +/- 1.91 d versus 24.8 +/- .58 d) and functional lifespan of the corpus luteum (28.4 +/- 2.01 d versus 23.6 +/- .75 d). In another experiment, twice daily intramuscular injection of 20 mg interferon to Simmental heifers from d 15 to 19 extended interestrous intervals (24.6 +/- 1.36 d versus 20.6 +/- .49 d) and functional lifespan of the corpus luteum (23.2 +/- .37 d versus 20.2 +/- .73 d). In a third experiment, pubertal dairy heifers received twice daily intramuscular injections of 0, 2.5, 5.0, or 10.0 mg/injection of interferon from d 14 to 21 after estrus. The three interferon-treated groups had longer interestrous intervals and functional luteal lifespans than the control group. Interestrous intervals were 22.0 +/- .68, 24.0 +/- 1.14, 24.6 +/- 1.17, and 25.4 +/- .97 d, respectively. The present data strengthen the theory that an interferon-alpha-like molecule can regulate luteal function in cattle. Such a regulatory compound might prove useful in schemes to reduce embryonic mortality caused by aberrant secretion of embryonic interferon. PMID- 2778170 TI - Effect of feeding gossypol in cottonseed meal on growth, semen quality, and spermatogenesis of yearling Holstein bulls. AB - Yearling Holstein bulls were fed a corn silage ration supplemented with either cottonseed meal with gossypol or soybean meal in two trials to evaluate the effect of feeding gossypol on reproductive characteristics. In Trial 1, roughage to concentrate ratio was 88:12 and was fed for 60 d. In Trial 2, roughage to concentrate ratio was 50:50 and was fed for 42 d. Cottonseed meal concentrate had 3.03 g total gossypol/kg DM. Cottonseed meal concentrate was fed to provide 6 and 30 mg total gossypol/kg BW per d in Trials 1 and 2. Ejaculates were collected twice weekly via artificial vagina and critiqued for quantity and quality before and after thawing and after postthaw incubation. Leptotene spermatocytes to Sertoli cell ratio in stage 1 tubules was used to evaluate spermatogenesis. Growth characteristics and tissue total gossypol concentrations were also evaluated. No gossypol was found in plasma taken before, during, or after Trial 1 or from body organs or plasma taken during or after Trial 2. No signs of gossypol toxicity were observed, and growth characteristics were similar on both rations. Gossypol in cottonseed meal fed at low to moderate concentrations was not deleterious to seminal quantity or quality, and spermatogenesis was unaffected by treatment. PMID- 2778171 TI - Epidemiology of metabolic disorders in dairy cattle: association among host characteristics, disease, and production. AB - Logistic regression was used to investigate the effects of host characteristics, production, and 23 veterinary diagnoses on the odds of contracting seven metabolic disorders among 61,124 Finnish Ayrshire cows that calved during 1983. Cows in higher producing herds were at increased risk of parturient paresis, udder edema, and ketosis. Cows that had higher previous yields were at increased risk of parturient and nonparturient paresis and ketosis. All of the metabolic disorders except udder edema were directly interrelated. Dystocia, prolapsed uterus, other infertility, and abortion were not risk factors for any of the seven metabolic disorders; however, retained placenta, early metritis, traumatic reticuloperitonitis, acute and chronic mastitis, and foot or leg injury each were direct risk factors for at least two metabolic disorders. PMID- 2778172 TI - Isolation and identification of coagulase-negative Staphylococcus species from bovine body sites and streak canals of nulliparous heifers. AB - Heifers (n = 103) ranging in age from 1d to 2 yr were sampled to determine the coagulase-negative staphylococcal flora of haircoat, nares, vagina, teat skin, and streak canal. A total of 2706 staphylococal strains were identified from 3612 bacterial isolates. Other genera or groups identified included Bacillus, Micrococcus, Corynebacterium, and coliforms. Staphylococci were identified utilizing a simplified biochemical scheme. Staphylococcus xylosus, S. chromogenes, and S. warneri were the predominant species recovered from anatomic sites and streak canal. Staphylococcal strains identified from specific body sites (expressed as percentage of heifers harboring these species) were: nares 74% S. xylosus and 48% S. warneri; haircoat, 70% S. xylosus and 57% S. chromogenes; vagina, 60% S. chromogenes and 54% S. xylosus; teat skin 62% S. chromogenes and 61% S. warneri; streak canal 53% S. chromogenes, and 43% S. warneri. The prevalent staphylococcal strains identified differed from heifers in confined housing compared with heifers on pasture. Differences observed in distribution of Staphylococcus species among body sites, particularly those between teat skin and streak canal, suggest that establishment of staphylococcal microflora depends on the ability of a species to adapt to and colonize anatomic sites as well as on environmental conditions present. PMID- 2778173 TI - Correlations among first and second lactation milk yield and calving interval. AB - Estimates of genetic correlations were .17 between first lactation milk yield and concurrent calving interval, .10 between second lactation milk yield and first calving interval, and .82 between first and second milk yields. Corresponding phenotypic correlations were .27, .16, and .58. Heritability estimates were .27 and .25 for first and second lactations and .15 for calving interval. Estimates were averages of two samples of 15 New York State herds averaging 144 AI-sired Holstein cows and 30 sires. Milk yields were 305-d, mature equivalent. Calving interval was days between first and second freshening. First milk records without a second freshening were included. Multiple-trait animal model included separate herd-year-season effects for first and second milk yields and calving interval. Numerator relationships among animals within herd, except for daughter-dam relationships, were included. The REML with the expectation-maximization algorithm was used to estimate (co)variance matrices among genetic values and environmental effects for the three traits. Results indicate a need to adjust milk records for the phenotypic effects of current and previous calving interval. The genetic association, however, between fertility and milk yield appears small. Genetic improvement of 450 kg of milk yield may result in 2 added d to first calving interval. PMID- 2778174 TI - The effect of thermal history on porcelain expansion behavior. AB - Porcelain-fused-to-metal restorations are fixed several hundred degrees above the glass-transition temperature and cooled rapidly through the glass-transition temperature range. Thermal expansion data from room temperature to above the glass-transition temperature range are important for the thermal expansion of the porcelain to be matched to the alloy. The effect of heating rate during measurement of thermal expansion was determined for NBS SRM 710 glass and four commercial opaque and body porcelain products. Thermal expansion data were obtained at heating rates of from 3 to 30 degrees C/min after the porcelain was cooled at the same rate. By use of the Moynihan equation (where Tg systematically increases in temperature with an increase in cooling/heating rate), the glass transition temperatures (Tg) derived from these data were shown to be related to the heating rate. PMID- 2778176 TI - The colors of mixtures of dental opaque porcelains. AB - The colors of mixtures of dental opaque porcelains and modifiers were measured with use of the CIE L*a*b* uniform color space. Mixtures of dental porcelains were tested to duplicate the range of human tooth colors. Vertical movements in the yellow and blue directions were obtained. Horizontal movements in the red and green directions were achieved. Reflectance measurements were made with use of a spectrophotometer with an integrating sphere. Spectrophotometer measurements were converted to absolute reflectance and then used to calculate CIE a*b* values for a 2 degrees standard observer and for illuminant C. Movements in the yellow, red, blue, and green directions for adequate simulation of the tooth color range can be demonstrated with use of dental opaque and modifier porcelains. PMID- 2778175 TI - A rapid heating and cooling rate dilatometer for measuring thermal expansion in dental porcelain. AB - Herein we describe a dilatometer that consists of a low-mass infrared furnace for rapid heating or cooling, an optical pyrometer, and a laser interferometer. The dilatometer facilitates observations of thermal expansion at rates comparable with those in dental laboratory practice over the temperature range necessary for comparison of thermal expansion of dental porcelain and alloy. Examples of thermal expansion data obtained at a 600 degrees C/min heating rate on NIST SRM 710 glass and dental porcelain are reported. To a limited extent, thermal expansion data above the glass-transition temperature range of dental porcelain were obtained. A shift of the glass-transition temperature range to higher temperatures was observed for both materials, compared with data obtained at 20 degrees C/min. PMID- 2778178 TI - Adjustment of frequently used chi-square procedures for the effect of site-to site dependencies in the analysis of dental data. AB - Donner and Banting (1988) presented a method of adjusting the standard chi-square test for the comparison of proportions when this procedure is applied to multiple site dental data. The adjusted procedure allows for a comparison of two or more groups of subjects with respect to the prevalence over all sites of a specified characteristic, while taking site-to-site dependencies into account. In this paper, similar adjustments are presented for two other frequently used chi-square procedures, the chi-square test for linear trend and the Mantel-Haenszel test. Examples are given. PMID- 2778177 TI - Possible roles of partial sequences at N- and C-termini of amelogenin in protein enamel mineral interaction. AB - The purpose of this study was to assess the functional significance of homologous sequences of mammalian amelogenins at their N- and C-termini. A porcine 5-kDa fragment corresponding to the N-terminal 45 residues of amelogenins was purified from the secretory enamel. The decapeptide TDKTKREEVD corresponding to the C terminal 10 residues of amelogenins was synthesized according to conventional solid-phase procedures. The inhibitory activity of both moieties on apatite crystal growth was determined in a supersaturated solution having an ionic composition similar to that of the fluid phase separated from porcine secretory enamel. The 5-kDa amelogenin fragment was sparingly soluble in neutral solutions and (in condensed forms because of aggregation) showed no significant inhibition of crystal growth, whereas the fragment molecules pre-adsorbed onto the seed crystals yielded modest inhibition of hydroxyapatite precipitation. However, their inhibitory activity was significantly lower than that of parent porcine amelogenin (25-kDa molecular mass). The high solubility of synthesized decapeptide allowed us to determine the adsorption isotherm onto hydroxyapatite at 37 degrees C, at an ionic strength similar to that of the enamel fluid. The obtained adsorption isotherm was described by a Langmuir model; the adsorption affinity and the maximum adsorption sites were 6.2 mL/mumol and 0.53 mumol/m2, respectively. As expected from the low adsorption affinity, the peptide showed a much weaker inhibition of apatite crystal growth than the parent amelogenin.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2778179 TI - Modeling of jaw-head-neck dynamics during whiplash. AB - Clinicians report signs and symptoms of temporomandibular joint (TMJ) disorders in many patients who have experienced automobile rear-end collisions involving neck hyperextension (whiplash). In order for relationships between TMJ disorders and rear-end collisions to be explored, the dynamic response of the jaw to hyperextension of the neck associated with automobile rear-end collisions needs to be quantified. To achieve this goal, we extended an existing head-neck model by adding a movable jaw, and performed preliminary computer simulations of the jaw movements during rear-end collisions at 6.71 ms-1 (15 mph) and 13.41 ms-1 (30 mph). The initial computer simulations produced promising kinematic and dynamic results, such as: relative angle between the head and jaw (jaw-opening angle), predicted TMJ torques, and displacement and linear acceleration of the jaw's center of mass. However, the absolute values and time course of our results must be viewed with caution, since the jaw model has not yet been validated with experimental data. Nevertheless, the modeling approach, detailed in this study, shows good promise for eventually providing quantitative dynamic information about the jaw-head-neck system during impulsive loading. PMID- 2778181 TI - Dental materials: a glance back ... but a hard look into the future. PMID- 2778180 TI - Finite element method simulation of bone resorption beneath a complete denture. AB - Bone resorption beneath a maxillary complete denture was simulated by the finite element method, assuming that a threshold of compressive strain exists in the alveolar bone above which the resorption occurred. The pattern of predicted resorption was observed when 100 N of force was applied to three positions occlusally, and 20 N was applied facially. Moreover, we observed the effect of rebasing the denture after initial resorption. The results indicate that resorption was initiated on the facial and occlusal surfaces of the alveolar ridge and proceeded palatally. The resorption was greater as the occlusal load point moved facially and when the force was applied in the facial direction. When the load point was toward the facial, rebasing the denture accentuated the resorption, but when the load point was toward the palatal, the resorption was almost the same regardless of rebase. The pattern of simulated bone resorption was similar to that reported from clinical observations, which suggests that the resorption may be associated with compressive strains developed in the alveolar bone. The results argue for the importance of occlusal adjustment of dentures to move the occlusal load point palatally and produce balanced occlusion in protrusion and lateral excursions, especially after a rebase procedure. PMID- 2778182 TI - Aesthetic problems in chemical peeling. AB - Questionnaires were mailed to six physicians experienced in chemical peels regarding common problems encountered in the procedure. They are: Thomas H. Alt, M.D., Minneapolis, MN; Samuel J. Stegman, M.D., San Francisco, CA; James J. Stagnone, M.D., Albuquerque, NM; Robert Kotler, M.D., Los Angeles, CA; William H. Beeson, M.D., Indianapolis, IN; and Paul S. Collins, M.D., San Luis Obispo, CA. Their answers are presented in a panel format. PMID- 2778183 TI - The art of chemical peeling. PMID- 2778184 TI - The Jessner's + TCA peel: a medium-depth chemical peel. AB - The Jessner's + TCA peel, a method of chemexfoliation, is a combination of two acidic compounds. It has been found to be an effective peeling procedure that produces a medium-depth peel for photoaging skin, actinic keratoses, and rhytides. PMID- 2778185 TI - Depths of chemexfoliation induced by various concentrations and application techniques of trichloroacetic acid in a porcine model. AB - The depth of wounds created by various concentrations and application techniques of trichloroacetic acid (TCA) in a porcine model is evaluated. The depth of tissue necrosis increased with the concentration of TCA. Tape occlusion did not deepen the wound but rather decreased its depth. An inverse relationship of wound depth to epidermal thickness is described. PMID- 2778186 TI - Stability-time profile of trichloroacetic acid at various concentrations and storage conditions. AB - Trichloroacetic acid (TCA) is a deliquescent chemical widely used for a variety of procedures. Stability of various concentrations of TCA in both amber glass and plastic bottles stored under refrigeration and at room temperature was measured at several time points. Extended stability data suggest that TCA potency is stable for 23 weeks and would best be maintained in glass amber bottles stored under refrigeration. PMID- 2778187 TI - Decreased leukocyte ferrochelatase activity in erythropoietic protoporphyria. AB - We studied the porphyrin metabolism of a 7-year-old Japanese boy with erythropoietic protoporphyria (EPP) and his family members. Leukocyte ferrochelatase activity was markedly decreased in this patient, being approximately 12% of the mean value of normal controls (4 aged-matched healthy boys). In contrast, leukocyte delta-aminolevulinic acid (ALA) synthase activity was normal. The free protoporphyrin content of erythrocytes was greatly increased (4.3 mg/100 ml RBC), while erythrocyte ALA dehydratase and porphobilinogen (PBG) deaminase activities were 1.7- and 2.2-fold of respective control values. A survey of his family revealed that 12 of 19 members probably had manifest EPP or were EPP carriers. These results suggest that, in EPP, there might be an inherited impairement of ferrochelatase activity which gives rise to an elevation of erythroblast ALA dehydratase and PBG deaminase activities to compensate for a resultant decrease in heme production. PMID- 2778188 TI - Morphea profunda--a cutaneo-pulmonary variant with profuse sweating. AB - A 51-year-old Japanese male developed morphea profunda over a plaque of pigmented sweating skin on the left chest extending deeply into the lung. Eight years previously, he noted a brown pigmented spot on the left axilla which started to enlarge over the left chest in a band-like manner. Later, the involved skin hardened with profuse sweating. Chest X-ray examination and computer tomography revealed a thickening of the left chest wall and a nodular mass lesion in the left lower lung field. Biopsy specimens from lung, chest wall, and overlying skin revealed a granulomatous tissue in the parenchyma and a marked fibrosis extending from the deep dermis to the pleura. There were no findings suggestive of malignancy or chronic infectious disease. We assume that the process of morphea in this patient extended deeply from the skin to the lung. PMID- 2778189 TI - Histopathologic features of superficial granulomatous pyoderma. AB - Study of the histopathologic pattern of 28 cases of superficial granulomatous pyoderma demonstrated an ulcerative, verrucous pyoderma of the superficial dermis. Focal abscesses in the subepidermis or dermis were juxtaposed with granuloma formation and plasma cell inflammation. Hemorrhage and granulation tissue were present. The clinical lesions are indolent, and this feature is confirmed by chronic inflammatory elements, including sinus tract formation and focal fibrosis. Superficial granulomatous pyoderma must be added to the histologic differential diagnosis of the vegetative and ulcerative granulomas: blastomycosis, tuberculosis verrucosa cutis, and bromoderma. PMID- 2778190 TI - A giant calcifying pseudocyst seen in a patient with overlap syndrome. AB - A case of female with a large cystic tumor in her infrascapular region is reported. The tumor was 8 cm x 7 cm in size. Histologically, it was a pseudocyst with calcification. The patient showed no abnormal renal functions other than proteinuria. Because she had suffered from overlap syndromes of systemic lupus erythematosus, progressive systemic sclerosis, and suspected dermatomyositis, we diagnosed this a unique case of dystrophic calcinosis. There have been several reports of cases with connective tissue diseases showing subcutaneous calcification, but to our knowledge no such giant calcifying pseudocyst has ever been reported. PMID- 2778191 TI - Arteriovenous malformation with an ulcer of the foot--report of a case. AB - An unusual case of arteriovenous malformation (AVM) associated with ulcer arising on the sole of the left foot is reported. This ulcer was precipitated by pregnancy. After a split thickness skin graft repaired the ulcer, diffuse AVM was found on the left lower leg by arteriography. All the involved vessels were totally excised and the course was comparatively good. Clinical manifestations of AVM, incidences of ulcer in AVM, histological differentiation from Kaposi sarcoma, and treatment of AVM are discussed. PMID- 2778193 TI - A case of epidermotropic metastatic mammary carcinoma. AB - A special type of metastatic carcinoma to the skin, epidermotropic carcinoma, is thought to be a parasitic occupation of malignant tumors in the epidermis. A patient, a 56-year-old Japanese woman who had had a mastectomy because of mammary carcinoma thirteen months earlier, developed a metastatic skin tumor in the operation wound and another area of mammary skin. Histologically, almost only the epidermis was occupied by multifocal metastatic tumor nests, so the tumor was a type of epidermotropic metastatic carcinoma. Moreover, some tumor nests were found to be eliminated from the epidermis. Like other types of metastatic skin tumor, nevus pigmentosus, and amyloidosis, epidermotropic metastatic carcinoma can show transepithelial elimination. PMID- 2778194 TI - Nevus of ota with nevus of Ito--report of a case with cataract. AB - A 53-year-old Japanese male patient with both nevus of Ota and nevus of Ito developed cataract of the eye ipsilateral to the side of the nevi. In this patient, cataract might have appeared in a close pathogenetic relationship with nevus of Ota. PMID- 2778195 TI - Cytochemistry of trichohyalin granules: a possible role for cornification of inner root sheath cell in the hair follicle. AB - We studied ultracytochemically how trichohyalin granules (TGs) were involved in the cornification of the inner root sheath (IRS) cells in the hair follicle. After storing unfixed mouse skin samples in glycerol and then low ionic strength salt solution (G-LISS), the TGs reduced electron-dense amorphous material (EDM) to various degrees, with the appearance of filamentous material in routine staining. As the IRS cells were differentiating, these changes in the TGs became successively prominent; Some TGs consisted of the filamentous material and residual granular EDM, showing a "filamentogranular structure". In the cells in transition to cornified cells, or transitional cells, the EDM of the TGs disappeared and consisted of only filamentous material which was intertwined with keratin filaments (KFs). The internal substructure of the TGs induced by the G LISS treatment stained well with ethanolic phosphotungstic acid, which reacts with basic proteins, and the KFs associated with the TGs also stained well. In skin samples not treated with G-LISS, the TGs of the transitional cells often exhibited fibrogranular structure after PTA staining to detect tissue basic proteins, suggesting a release of PTA stainable proteins(s) by the TGs in living transitional cells. The KFs of the cornified cells were more intensively stained and thicker (about 20 nm wide) than those of the differentiating IRS cells. These findings suggest that the TGs may contain at least two kinds of basic proteins; One is G-LISS-soluble, and the other is a very insoluble filamentous protein. These protein materials may be added to or incorporated into the KFs in the cornified cells with the disappearance of the TGs, since the KFs are markedly thick with PTA staining. PMID- 2778192 TI - Pemphigus vegetans presenting as scrotal tongue. AB - A case of scrotal tongue is described. Histological and immunofluorescent findings revealed that this case was pemphigus vegetans, which should therefore be added to the differential diagnosis of scrotal tongue. PMID- 2778197 TI - WHO organizes first international gathering of AIDS service organizations. PMID- 2778196 TI - Guidelines for regulatory changes in nursing education and practice to promote primary health care. PMID- 2778198 TI - Graduate nurses' adjustment to initial employment: natural field work. AB - This study used natural field work methods in order to understand initial employment for new graduate nurses. The researcher participated in the first 3 to 4 months of the nurses' employment in general hospital settings. Background information related to the introduction of the comprehensive nursing courses in New Zealand is included, together with an overview of the research methodology. The five major themes which emerge from the study are presented and discussed, indicating that the rhetoric and practice of the school of nursing is different from the rhetoric and practice of nursing within general hospital settings. It is argued that management practices which support the ideals of the New Zealand comprehensive nursing courses and a total qualified nursing workforce have yet to occur. There are implications in this study for nursing education and nursing practice. PMID- 2778199 TI - The meaning of visual impairment to visually impaired adults. AB - The purpose of this study was to explore the subjective meaning of visual impairment in the context of day to day life to adults whose visual impairment began in their adult years. Information was elicited through interviews from 25 people whose visual impairment ranged from an inability to see ordinary print to no light perception. Hermeneutics, as elaborated by Ricoeur, was used in the interpretation of the texts (transcribed interviews). A core variable, adjusting to a visual impairment, and five distinct categories, each with subcategories, emerged from the data. The meaning of visual impairment was derived from the manner in which the categories interrelated with the process of adjusting. PMID- 2778200 TI - Smoking: a decision-making dilemma for the vascular patient. AB - This descriptive study examined the differences in beliefs and social influences between patients who decided to quit or to continue smoking following diagnosis of chronic peripheral vascular disease. A consecutive quota sample of 20 patients who had quit smoking (quitters) and 22 who had continued smoking (continuers) agreed to participate in the study. There were no statistically significant differences between quitters and continuers in demographic characteristics, clinical variables and perceived social influences. Statistically significant differences were found between groups in beliefs about and attitudes towards the risk of continued smoking. These findings underline the need to investigate more fully the factors which influence patients' decisions to quit or to continue smoking. Further investigation may also provide detailed information on the role of risk perception in influencing this decision-making process. PMID- 2778201 TI - Communication: a tool for the negotiation of independence in families with adolescents. AB - It is generally agreed that promoting effective communication in families is a desirable goal for health professionals. Many nurses are consulted by families for direction in managing a multitude of issues. A paucity of literature addressing both adolescent communication and communication in families with adolescents, prompted us to embark upon a programme of research which has examined how adolescents expand their abilities to communicate and explored how adolescents and their families perceive communication within their family. This paper reports on a qualitative study that explored through serial in-depth interviews, parents' and teenagers' perceptions of communication in their families. The conceptualization developed from the study data characterizes communication as a tool used by families. The families' abilities to use the tool effectively, however, is greatly influenced by feelings about the topic or issue under discussion. A major theme in our data is adolescent independence. What this means for parents and adolescents and how this developmental task influences the communication patterns used within the families is discussed. PMID- 2778202 TI - Philosophy and health. AB - This paper employs a philosophical approach in order to explore the nature of the concept of health. It is designed to provoke further thought and discussion by posing a number of questions such as 'What is health?' and 'How is ill-health experienced?'. The authors argue that some philosophical ability is necessary to enable the professional carer to reflect clearly and logically on both their theory and practice. In addition this paper argues that professional carers should aim to achieve a balance between science and humanism. Also reasons are suggested why a role should be given to non-scientific language in the planning of individual-centred care. PMID- 2778203 TI - A practical approach to creative teaching: an experiment. AB - The purpose of this experiment was to see if creative teaching methods would prove effective when included in a school of nursing teaching programme. This would be demonstrated by significant differences in levels of achievement in assessments and a demonstration that the knowledge gained was applied to the clinical situation. Didactic teaching methods were exchanged for a more creative approach without alteration of the course structure. The quasi experimental method was used, with four introductory courses of 20 nursing students at two separate district schools as the sample, two groups acting as the control groups and two as the experimental groups. The teaching sessions introduced medical problems associated with poor oxygenation, particularly those consequent to heart disease. The teaching was supported by appropriate care planning within the Roper et al. (1981) theoretical framework. Three distinct areas were identified; fact learning, e.g. anatomy and physiology, problem identifications and planning for nursing, intervention and skill learning. Students in the experimental groups were given work sheets and facilities for self learning whilst those in the control groups continued with a traditional lecture/demonstration format. The results of the experiment were evaluated by testing all four groups using multiple choice objective tests, essays, problem solving and nursing intervention exercises and practical assessments. The findings showed that the experimental groups did no better in the multiple choice objective tests or in the essays than the control groups but they did do significantly better in the problem identification and planning for nursing intervention exercise. In the assessment of practical skills there was no difference between the groups in skill performance but the experimental groups were able to apply the theory significantly better than the control groups. PMID- 2778205 TI - Rehabilitation information and health beliefs in the post-coronary patient: do we meet their information needs? AB - Twenty-five patients, admitted through a Coronary Care Unit with their first myocardial infarction (MI), were interviewed close to discharge home about (a) their perceptions regarding the causes of their MI and (b) their knowledge of coronary heart disease (CHD) risk factors. Psychosocial factors (overwork, stress, worry) were the most frequently cited causes of MI, with smoking and being overweight or overeating the most frequently cited physical causes. Knowledge of CHD risk factors concentrated on smoking, being overweight and dietary factors, although psychosocial factors were relatively frequently cited. High levels of satisfaction with staff-patient communication were expressed, but knowledge of advice given was generally vague or imprecise and concentrated on dietary modification. Smoking was well-recognized by smokers as a risk factor but less commonly related to their own MI. The main recommendation is for coronary rehabilitation information programmes to be more individualized to the patients' specific needs, based on a Personal Risk Factor and Health Beliefs Assessment for all patients. PMID- 2778206 TI - A plea for replication studies. PMID- 2778204 TI - Learning clinical teaching skills at the baccalaureate level. AB - Nurses returning to work after obtaining their baccalaureate degree in nursing find increased expectations to participate in student and staff clinical education. Often these nurses are not prepared for this role. This paper describes a project that involved final year post-diploma registered nurse students in the clinical teaching of second year basic degree students in a baccalaureate nursing programme. Results of a pilot study to determine if the perceptions of the students involved in the teaching project changed following the experience, show a more positive change in teacher behaviours in these student tutors compared to students doing a traditional clinical experience. Course evaluations indicate the experience increased knowledge and comfort in clinical teaching and point to positive changes in the perceptions of behaviours conducive to clinical teaching. PMID- 2778207 TI - Variables related to research utilization in nursing: an empirical investigation. AB - The purpose of the correlational study was to identify variables which were related to utilization of research in the clinical area. A convenience sample of 59 nurses from a community hospital in the southwest part of the United States was utilized for the sample. The concepts of attitude, support and availability were identified through the literature and used as independent variables for this study. Scales were developed from past research and tested for validity and reliability. Results indicated that attitude and availability were related to research utilization (R = 0.65, P less than or equal to 0.00). In addition, the support of administrators was also important in determining research use. Results from this study can be used to develop strategies to increase research utilization. PMID- 2778208 TI - Battered wives and female alcoholics: a comparative social and psychiatric study. AB - In this study 49 women seeking hospital treatment for wife battering injuries were compared with 49 female alcoholics and a control group consisting of 49 women treated in hospital for accidents. At one time or another two-thirds of the female alcoholics had been battered and the majority of these women showed the same pattern of severe, prolonged abuse as the 49 women seeking hospital treatment for wife battering injuries. The women in these groups were also similar in that many of them had experienced violence in their own childhood environment, in that they had cohabited with more men than the women in the control group and in that the frequency of depressive symptoms was high. An analysis restricted to the battered women in each of the three groups revealed similarities between them. The battered women in the control group did not, however, show any signs of more severe psychopathology or alcoholism. It is concluded that mental health is of crucial importance for the woman's ability to break away from an abusive male. PMID- 2778209 TI - Managing chronic illness in the family: women as caretakers. AB - This paper is based on an ethnographic study examining how families caring for a chronically ill child in the home construct their experiences of illness. The role of women caretakers is examined, and it is argued that the term family glosses over the work that women do in caretaking. The 'ideology of competence' which determines women's subjective experiences is discussed, and the notion is forwarded that health professionals rely upon this ideology to get the job of caretaking done in the home. Some implications of this discussion for health care delivery are presented. PMID- 2778210 TI - Modelling and role-modelling: integrating nursing theory into practice. AB - This article contrasts two clinical cases using a relatively new paradigm and theory, modelling and role-modelling. The concepts and linkages from modelling and role-modelling are presented and are the basis for analysing the outcomes of of two patients. The case study approach communicates an understanding of the theory modelling and role-modelling and assists nurses to develop expertise in its use. PMID- 2778211 TI - An investigation of the developmental influences on nurses' motivation for their continuing education. AB - This author investigated these influences by use of a questionnaire. It was distributed to 90 second-year students and 89 staff nurses, working in three London hospitals. The tool was developed from a literature search, which looked at motivational theories, research into nurse retention and attitudes and interest in continuing education. No similar studies were found. An assumption was made that students are idealistic about their continuing education and staff nurses pragmatic. That is, the role change from student to staff nurse alters the perspective on career and continuing education needs. Eighty-one per cent of the questionnaires were returned. Results indicated that students decided their future training needs on how much they enjoyed a particular experience, and on their expectation of furthering their skills in that area; whereas staff nurses wanted management training and skills and knowledge in looking after critically ill patients. A number of respondents were considering leaving nursing, because of poor staffing and salary; this dissatisfaction was greatest amongst the staff nurse respondents. The investigation identified the need for commitment from both service and education to the concept of continuing education for nurses as crucial to improving patient care, and support and help for staff and students to assess their needs and be informed of choices and resources. PMID- 2778212 TI - Psychomotor skills laboratories as self-directed learning: a study of nursing students' perceptions. AB - Fifty-nine baccalaureate nursing students were surveyed regarding their preferred method of learning psychomotor skills necessary for clinical practice. In addition, 12 faculty members were also asked to express their opinions of the best way for students to learn psychomotor skills. The use of a self-directed clinical laboratory was supported by both students and faculty in this study. Hands on and visual pre-clinical experiences with adequate equipment were the major factors influencing the students' requests for clinical laboratories. Faculty expressed the same concerns about equipment and human resources, but their support of the laboratory was tempered and based on the presence or absence of adequate human resources and equipment available to students in the clinical setting. PMID- 2778213 TI - That which empowers. PMID- 2778214 TI - This isn't what I expected: the changing landscape of nursing education. PMID- 2778215 TI - Building an infrastructure for international health promotion and disease prevention: the Peace Corps Fellows Program. PMID- 2778216 TI - The moral dilemma of rationing nursing resources. PMID- 2778217 TI - Finally, it's time. PMID- 2778218 TI - Getting our act together. PMID- 2778220 TI - Facilities for nursing research: a critical need, an emerging challenge. PMID- 2778219 TI - Autonomy: where are we going? PMID- 2778221 TI - Values held by nursing faculty and students in a university setting. AB - An ever-expanding wealth of life-preserving high technology and scientific knowledge, coupled with expanded autonomy of nurses, has created for them ethical and moral dilemmas. As society's values are changing, manifested by an accelerated crime rate, malfeasance in high places, and seeming social indifference, have nurses maintained their ethical equilibrium? This article reports the findings of a descriptive study that examined the professional and personal values of nursing faculty in a large midwestern school of nursing and compares them with those of generic students entering the program. Faculty demonstrated a significantly higher commitment to the American Association of College of Nursing professional value, human dignity, than to the values of equality (P less than .05) and esthetics (P less than .01). Also, there was a significantly higher commitment to altruism than esthetics (P less than .05). Results showed that entering students were more alike on personal values (Rokeach Values Survey) than different from the faculty who teach them. PMID- 2778223 TI - Learning styles of baccalaureate nursing students and attitudes toward theory based nursing. AB - The purpose of this study was to investigate personal and environmental factors related to undergraduate and post-RN nursing students' attitudes toward theory based nursing from Kolb's experimental learning theory perspective. The study is part of a larger project designed to test aspects of Kolb's theory in the nursing population. Hypotheses about relationships among learning styles, perception of environmental press, experience in nursing, attitudes toward theory-based nursing, preferred nursing theory, and preferred method of learning theory were proposed for investigation. Seventy-six post-RN and 121 upper-level generic baccalaureate nursing students each completed two measures of personal learning style, a measure of perception of environmental press of nursing learning environments, and a nursing theories questionnaire. Learning style and environmental press perceptions were found to be significantly related to attitudes toward theory-based nursing. Concrete learners and subjects who perceived nursing environments to be predominantly concrete were significantly less positive toward theory-based nursing than abstract learners. Experience in nursing was found to be related to perception of environmental press. Learning style was not found to be significantly related to preferred method of learning nursing theories nor to preferred nursing theory for practice. Implications for nursing education are discussed. PMID- 2778222 TI - Nurses' and physicians' perceptions of nursing authority. AB - This study compared perceptions of 163 nurses and physicians of the current and ideal status of the decision-making authority of professional nurses. Each nurse and physician agreed or disagreed with 25 items, in two contexts, in the Authority in Nursing Roles Inventory (ANRI). Items in the ANRI describe a variety of nursing roles, functions, and behaviors in health and patient care. The results of the study were statistically significant overall both between and within professional groups. Disparities in several specific areas were revealed. The findings support the premise that in spite of expanded nursing roles emphasizing nursing authority, there are disagreements between nurses' and physicians' perceptions of the current and ideal authority of nurses as well as areas of dissatisfaction within each professional group. Implications of continuing conflicts between nurses and physicians as barriers to professional nursing role enactment, as well as strategies to address the problem, are discussed. PMID- 2778224 TI - Aerospace nursing: the new frontier. AB - Since the days of Florence Nightingale and the Crimean War, nursing has been involved in shaping the environment to make it more conducive to human existence. With the emergence of the Space Age the environment has broadened to encompass not only Earth and its ionosphere, but its moon and sister planets as well. To date, nursing has been successful in developing theories that address human environmental interactions. However, the environment of the 21st century will be vastly different from the environment of the 1980s. In the 21st century, macroutilization of space will become a reality. Such broad-based use of space will include space industrialization and manufacturing, satellite solar power generation, and space habitation. In order to achieve long-duration space flights and habitation, human needs and responses to microgravity must be addressed. This article discusses the physiological and psychological stresses that have an impact on the ability of humans to achieve space habitation and nursing's role in that endeavor. The nursing knowledge base needed to establish the discipline as a major contributor to space health science is discussed. An educational strategy for the development of this knowledge at both the master's and doctoral levels is proposed. PMID- 2778225 TI - Managing abnormal Pap smears: comments on two articles. PMID- 2778227 TI - Susceptibility to AIDS: what college students do and don't believe. AB - In-depth, qualitative discussion using the nominal group technique examined freshmen's perceived susceptibility to AIDS and barriers to prevention. Groups were led by dormitory resident advisors as a follow-up to a survey questionnaire of college students' knowledge and beliefs about AIDS. Students' comments showed that many misunderstandings lay behind an apparent understanding of the facts about AIDS. These findings underscore how imperative it is that college health education programs be attuned to the needs and address the deficiencies of the particular student body. In-depth, qualitative research techniques such as the nominal group are described as useful in tailoring AIDS prevention to the specific campus audience and are an appropriate introduction to an AIDS-education session. Suggestions, based on students' comments, are made for improving AIDS prevention programs on campus. PMID- 2778226 TI - Knowledge about AIDS and reported risk behaviors among black college students. AB - This study surveyed 975 undergraduates attending a large East Coast university during the spring semester of the 1987/88 academic year. A convenience sample of predominantly black students (94%) participated. Overall, knowledge of basic AIDS related facts was satisfactory. Raw scores on the 25-item knowledge scale ranged from 7 to 25, with a mean of 20.5 (82%) and a mode of 22 (88%). Selected questions on how HIV is not transmitted, however, posed some problems for respondents. Less than 30% of respondents knew that the AIDs virus was not transmitted by insects; less than 80% knew that AIDS was not transmitted on toilet seats, through blood donations, kissing, and coughing. The survey also asked students whether they had ever engaged in certain behaviors that put them at risk of HIV infection. Approximately 17% of respondents had experienced anal intercourse, 6.5% reported use of heroin, 32.6% reported having had multiple sex partners, and 16% had been treated for a sexually transmitted disease. Students who reported engaging in high-risk behaviors had statistically significant lower mean knowledge scores than those who reported not engaging in those same high risk behaviors. Results of the study support the need to increase efforts to deliver AIDS information specifically targeted to individuals who may be engaged in high-risk behaviors. Special health education programs must be designed to focus attention on risk behaviors (ie, unprotected anal intercourse) instead of risk groups (ie, homosexual and bisexual males). PMID- 2778228 TI - Leaving, longing, and loving: a developmental perspective of migration. AB - Migration has a profound impact on a person's life. The author attempts to establish that dealing with the loss of country resembles the developmental task in late adolescence of mourning the childhood parents and may, in fact, serve as a parallel process. Mourning as a result of loss of country is examined; this is followed by a look at the threat to identity posed by the migration process. The point is made that a country is an object, a nonhuman object, with which one develops a relationship. Attention is paid to nostalgia, in which the ideational content tends to be nonhuman rather than human. Similarities of a parent and a country are pointed out, as well as similarities between parent loss and loss of country. Finally, the parallel between mourning the childhood parents and mourning following loss of country is highlighted in a case vignette. PMID- 2778229 TI - Patterns of smokeless tobacco use among university athletes. PMID- 2778231 TI - Peer educators reach college students with nutrition information. PMID- 2778230 TI - Peer review for the nurse-directed health service. PMID- 2778232 TI - Coping with competitors coast to coast. PMID- 2778233 TI - Nutrition in kidney disease. PMID- 2778234 TI - Blood pressure changes with age in two ethnic groups in Fiji. AB - Blood pressure was studied in urban and rural samples of the Melanesian and Indian populations of Fiji during a National Cardiovascular Disease and Diabetes Survey in 1980. Mean blood pressures rose with age and tended to be higher in urban than in rural populations, particularly in the middle age range. There was no clear or significant difference between the ethnic groups. When the prevalence of hypertension was studied (using WHO criteria) similar age, geographic and ethnic differences were found. Comparisons with data from 1960 revealed no significant change in mean blood pressures during the 20-year interval. Rural populations were leaner and appeared to consume less salt than did urban groups. There were positive and significant correlations between blood pressure and triceps skinfold thickness in most subgroups. PMID- 2778235 TI - Allergic respiratory disease in grain workers: the role of storage mites. AB - One hundred thirty-three grain-store workers employed at a regional grain store in Essex, U.K., participated in a survey of respiratory symptoms, lung function, bronchial responsiveness to methacholine and skin tests, and specific IgE to occupational allergens, including extracts of five storage-mite (SM) species and grain extracts. Previously reported associations between occupational respiratory symptoms and cigarette smoking, and symptoms of bronchial hyperresponsiveness to methacholine were confirmed. This study also disclosed significant associations between work-related symptoms (WRS) and positive skin tests and/or specific IgE to SMs, but not between WRSs and positive skin tests or specific IgE to Dermatophagoides pteronyssinus, or between WRSs and positive skin tests to grain. These findings suggest that in United Kingdom grain workers, allergic responses to SMs may be another factor responsible for WRSs in grain-store workers. PMID- 2778236 TI - Progesterone-responsive urticaria and eosinophilia. AB - A 30-year-old black albino woman was first observed with a 4-year history of monthly urticarial episodes associated with hypereosinophilia. Hives consistently began at the end of menses and lasted for 1 to 2 weeks. A comprehensive evaluation excluded underlying malignancy and infection. There was no evidence of extracutaneous visceral involvement consistent with the primary hypereosinophilic syndrome. A 6-month prospective evaluation was performed, during which daily hive symptoms were recorded and weekly determinations of eosinophils, serum total IgE, progesterone, estradiol, and 24-hour urine histamine were obtained. Eosinophil counts (range, 4002 to 37,350 cells per cubic millimeter) increased in association with the onset of hives and decreased to baseline levels after their resolution. The 24-hour urine histamine peaked at the onset of each urticarial episode. When serum progesterone levels increased, the hives were quiescent and peripheral eosinophils decreased to baseline levels. Progesterone caused in vitro dose-related inhibition of antihuman IgE-induced histamine release from peripheral basophils of this patient. Treatment with oral medroxyprogesterone resulted in remission of urticaria and a decrease in eosinophil counts. This patient represents a unique case of chronic cyclic urticaria and hypereosinophilia that appears to be modulated by the effects of progesterone. PMID- 2778237 TI - Corticosteroid-dependent idiopathic anaphylaxis: a report of five cases. AB - Idiopathic anaphylaxis (IA) is a life-threatening disease that is being increasingly recognized. In patients with frequent episodes of anaphylaxis, prednisone controls the events and then either induces remission or suppresses the manifestations of the disease until a spontaneous remission occurs. We report five patients with IA who have recurrent episodes whenever prednisone is tapered below a threshold dose, ranging from 15 to 65 mg every other day. These patients demonstrate the concept of a threshold dose of prednisone that may exist in a subset of patients with IA, and they provide further evidence of the previously reported efficacy of corticosteroids in the treatment of IA. We use the term corticosteroid-dependent IA to refer to the serious problem of chronic IA requiring maintenance prednisone therapy. PMID- 2778238 TI - Serial studies on the functional affinity and heterogeneity of antibodies of different IgG subclasses to phospholipase A2 produced in response to bee-venom immunotherapy. AB - High functional affinity and high titer IgG4 antibodies to phospholipase A2 were produced by allergic patients in response to bee-venom immunotherapy. In contrast, the affinity of IgG1 antibodies decreased after immunotherapy, and both the titer and affinity of IgG1 antiphospholipase A2 remained significantly lower compared to IgG4 1 to 2 years after treatment. Analysis of affinity heterogeneity suggested a loss of IgG1 high-affinity antibody-producing clones during immunotherapy and a preferential expansion of IgG4 clones. High-affinity IgE antibodies were found in untreated allergic patients, and preliminary results suggest that immunotherapy may result in an early marked decrease in the affinity of IgE antibodies. PMID- 2778239 TI - Late-onset allergic reactions, including serum sickness, after insect stings. AB - Allergic reactions after insect stings may have a delayed onset, differing from the usual immediate anaphylactic pattern. Ten patients, aged 6 to 78 years, had allergic reactions 1 to 2 weeks after an insect sting. Six patients had had multiple stings preceding the reaction. In two instances, immediate anaphylaxis also occurred. Four of the 10 patients had serum sickness-type reactions; two other patients had more severe anaphylactic symptoms, including throat edema. All patients in this group had venom-specific IgE; four of the 10 patients had serum venom-specific IgG. Eight patients subsequently received venom immunotherapy (VIT). There have been no reactions from seven re-stings. Five patients had generalized hives starting 6 to 24 hours after an insect sting. All patients in this group had venom-specific IgE; three patients have received VIT. Two other patients developed hives, one with throat edema 3 days after an insect sting. Both patients had high titers of serum venom-specific IgE; neither patient has received VIT, one patient because of extreme sensitivity. These observations suggest that after an insect sting, patients may develop delayed-onset allergic symptoms that range from typical anaphylaxis to serum sickness and are mediated by venom-specific IgE. VIT is recommended for patients with these reactions. PMID- 2778240 TI - Major basic protein and eosinophil-derived neurotoxin concentrations in nasal lavage fluid after antigen challenge: effect of systemic corticosteroids and relationship to eosinophil influx. AB - The late-phase response to nasal challenge with antigen is associated with a mixed inflammatory cell influx in which the eosinophil demonstrates the earliest and greatest proportionate rise. We investigated the evidence for activation of the eosinophil during the late response by measuring the concentration of the eosinophil-derived mediator major basic protein (MBP) and the eosinophil-derived neurotoxin (EDN) in nasal-lavage fluids before and for 11 hours after antigen challenge in 13 subjects with seasonal allergic rhinitis. The subjects received oral prednisone (20 mg three times daily) or placebo in a double-blind, crossover manner for 2 days before each of two antigen challenges. After placebo pretreatment, significant increases over diluent baseline (4.5 +/- 0.4 ng/ml) occurred in the levels of MBP in nasal-lavage fluid during the early (9.8 +/- 2.9 ng/ml; p less than 0.005) and late (15.3 +/- 4.8 ng/ml; p less than 0.01) responses to antigen challenge. Significant increases (p less than 0.05) in the concentration of EDN also occurred during the late response to antigen that correlated with the levels of MBP (r = 0.48; p less than 0.001). The cumulative late-phase increase in MBP correlated closely (rs = 0.96; p less than 0.005) with the total influx of eosinophils. Oral prednisone pretreatment significantly reduced the mean of each subject's peak late-phase concentration of both MBP (30.7 +/- 5.8 ng/ml versus 13.3 +/- 4.3 ng/ml; p = 0.005) and EDN (885 +/- 659 ng/ml versus 71 +/- 41 ng/ml; p less than 0.05). These data provide evidence for eosinophil degranulation during the late response and inhibition of this response by prednisone, supporting its pathogenetic role. PMID- 2778241 TI - Task-related variation in airborne concentrations of laboratory animal allergens: studies with Rat n I. AB - To define airborne allergen exposure during various tasks with rats in a laboratory, concentrations of allergen Rat n I were measured by radioimmunoassay in extracts from filters in personal air sampling devices that were worn by laboratory workers while they were performing these tasks. The tasks included feeding, cage cleaning, handling, injection, surgery, and sacrifice. Median concentrations encountered during feeding or cleaning (21 ng/m3) and injection or handling (13 ng/m3) were higher than those associated with surgery or sacrifice (3.1 ng/m3; p less than 0.01). Area samples in animal-holding rooms contained 3.4 ng/m3 during animal handling and 2.3 ng/m3 at other times. Very low concentrations were found in air outside the handling room, in unused laboratories, or outside air. We concluded that certain tasks incur a higher risk of allergen exposure but that exposure may occur anywhere within an animal laboratory environment. PMID- 2778243 TI - Fluctuations of serum IgA and its subclasses in allergic bronchopulmonary aspergillosis. AB - Exacerbations of allergic bronchopulmonary aspergillosis (ABPA) are characterized by chest roentgenographic infiltrates, peripheral blood eosinophilia, and elevation of total serum IgE. Also elevated are serum immunoglobulin antibodies directed against Aspergillus fumigatus, IgE-Af, serum IgG-Af, and serum IgA-Af. We measured serum IgA-Af, IgA1-Af, and IgA2-Af by ELISA to determine whether elevations of IgA-Af occurred before or during an exacerbation (like IgG-Af) or after (like IgE-Af). Ten exacerbations of ABPA were studied in seven patients with an average of 10 serial sera per patient analyzed. We used an indirect amplified ELISA with Af initially sensitizing microtiter wells. A "serologic" rise of immunoglobulin Af was identified when optical densities were twice the baseline sera. Serum IgA-Af was elevated over baseline before (n = 5) and during (n = 1) the time of an exacerbation. Serum IgA1-Af was elevated over baseline before (n = 5) or at the time (n = 5) of an exacerbation in all 10 cases. Serum IgA2-Af was elevated before (n = 2) and during (n = 5) exacerbations. Analogous to total serum IgE and IgG-Af, these experiments demonstrate substantial elevations of serum IgA-Af, IgA2-Af, and particularly, IgA1-Af before or during exacerbations characterized by roentgenographic infiltrates. The data are consistent with a contributory role of IgA-Af in the pathogenesis of ABPA. PMID- 2778242 TI - IgG antibody against formaldehyde human serum proteins: a comparison with other IgG antibodies against inhalant proteins and reactive chemicals. AB - Immune responses to formaldehyde (F) have been recorded for seven decades. More recently, sensitive assays for antibody against F-human serum albumin (HSA) have been reported. IgG antibody against F-HSA has been said to correlate with symptoms against F-HSA. We report on 61 serum samples analyzed for IgG antibodies against F-HSA. IgG antibodies against F-HSA were most prevalent in subjects who had received intravenous F. In no case (either presumed symptomatic to F or with IgG antibody against F-HSA) was there a correlation of serologic results with symptoms. We also reviewed inhalation disease caused by chemicals and proteins acting as immunogens and report that at this time there is no evidence that gaseous F meets the criteria for causation of inhalational IgG-mediated lung disease by clinical or serologic studies. Very high IgG antibody levels occur in respiratory immunologic inhalational disease, and the absence of these high IgG levels against F is strong evidence against F or F proteins being an inhalational antigen of significance. PMID- 2778244 TI - Immunochemical characterization of cocos nucifera pollen. AB - The Cocos nucifera pollen, as one of the sources of allergen responsible for immediate hypersensitivity reaction, was confirmed by skin prick test, bronchial provocation test, and RAST. The whole pollen extract (WPE) of C. nucifera was fractionated by combination of gel filtration and ion-exchange columns with fast protein liquid chromatography (Pharmacia, Uppsala, Sweden). Three protein peaks designated Cocos II, Cocos VI, and Cocos VII exhibited allergenic properties, as tested by skin prick test, direct IgE ELISA, bronchial provocation test, and immunoblot analysis. In RAST inhibition, Cocos IIa (a high-molecular-weight protein) obtained by fractionation of Cocos II on Mono Q column (fast protein liquid chromatography) (Pharmacia) was found to be the most potent allergen in Cocos WPE, followed by Cocos VI and Cocos VII, which are low-molecular-weight proteins. The reference patterns of Cocos WPE on crossed immunoelectrophoresis and thin-layer isoelectric focusing were established for future standardization of Cocos WPE to be used in the diagnosis and immunotherapy of allergic patients. PMID- 2778245 TI - The use of inhaled medications in school by students with asthma. Committee on Drugs, American Academy of Allergy and Immunology. PMID- 2778246 TI - Anaphylaxis apparently caused by a cottonseed-containing candy ingested on a commercial airliner. PMID- 2778247 TI - Vibratory urticaria associated with bladder-wall infection with the yeast Torulopsis glabrata. PMID- 2778248 TI - More on patient compliance. PMID- 2778249 TI - Psychoneuroimmunology: blaming the victim? PMID- 2778250 TI - Day care in teaching hospitals. PMID- 2778251 TI - Intersecting epidemics: black teen crack use and sexually transmitted disease. PMID- 2778252 TI - The professional attitudes and practice characteristics of male and female specialists. AB - Using data obtained from a mail survey of 119 female and 140 male specialists conducted in Quebec in 1983-1984, we compared men and women on their attitudes and on the organizational, professional, and clinical characteristics of their medical practices. Analyses were performed separately for medical and surgical specialists. Gender differences in the clinical practice of medical specialists were found, with women reporting greater attention to the social, preventive, and human aspects of patient care than men. Among surgical specialists, women expressed more favorable attitudes toward the social component in health care than their male colleagues. They also differed from men on indicators measuring various practice characteristics. These findings may reflect gender differences in type of surgical specialty, since the majority of female surgeons were in ophthalmology. Overall, fewer women specialists reported that they had assumed administrative responsibilities. The implications of these results are discussed in the context of the increasing feminization of the medical profession. PMID- 2778253 TI - Effects of vinyl chloride on liver function of exposed workers, evaluated by measurements of plasma clearance of the 99mTc-N-2,4-dimethylacetanilido iminodiacetate complex. AB - In 77 males exposed occupationally to vinyl chloride (VC), the plasma clearance (Cl) of 99mTc-N(2,4-dimethylacetanilido)iminodiacetate ('HEPIDA' complex) was determined. The results were juxtaposed with a scaled assessment of liver parenchyma performance based upon clinical examination and a series of biochemical tests. Detection of the diagnosable damage of liver parenchyma by means of the reduced clearance was sensitive (90%) at the reasonable specificity of 74%. Probability of exclusion of liver damage in patients with the clearance above 240 ml min-1 1.73 m-2 amounted to 92%. There was a significant correlation between degree of exposure to VC and the frequency of low clearance values. It appears that the periodic determination of the 99mTc-HEPIDA clearance in workers exposed to VC allows the assessment of incipient liver damage and signals the need for prophylactic measures. PMID- 2778254 TI - A rapid digestion method for analysis of nickel compounds in tissue by electrothermal atomic absorption spectrometry. AB - Quantification of nickel in animal soft tissue is of toxicological interest. A digestion method applying the use of microwave ovens for irradiating samples in Teflon digesters was developed. An acid mixture containing nitric acid (16 M, 1.0 ml g-1 tissue), hydrochloric acid (6 M, 0.5 ml g-1 tissue) and H2O2 (30%, 1.0 ml g-1 tissue) and irradiation at 600 W for 5 min were required for complete dissolution of tissue matrices and nickel compounds. Analyses of Ni in National Bureau of Standards Reference Material 1566 oyster tissue gave 0.87 +/- 0.24 micrograms g 1(mean +/- SD, n = 5), which was in agreement with the NBS certified value of 1.03 +/- 0.19 micrograms g-1. Recoveries of 1-300 micrograms Ni added as nickel sulfate (highly soluble), nickel subsulfide (moderately soluble in biological fluids and acid) or nickel oxide (green high-temperature oxide, low solubility in biological fluids and acid) to lung, liver, lymph node and kidney were quantitative, except in the case of nickel sulfate added to kidney, where recovery was less than quantitative for 1-10 micrograms Ni. The method appears effective for digestion of a variety of tissues requiring Ni analyses. PMID- 2778255 TI - Renal and hepatic toxicity of N-arylsuccinimides in Fischer 344 rats. AB - The role of aromaticity in the nephrotoxic potential of N-arylsuccinimides was studied in male Fischer 344 rats. Rats were administered a single intraperitoneal (i.p.) injection of an N-arylsuccinimide derivative (0.4 or 1.0 mmol/kg) or sesame oil (2.5 ml/kg), and the renal function monitored at 24 and 48 h. The parent compound in this series, N-phenylsuccinimide (NPS), had previously been shown to induce only minimal renal effects, having no effect on urine volume, blood urea nitrogen concentration, kidney weight, p-aminohippurate accumulation or renal morphology. Only an increase in tetraethylammonium uptake has been observed following NPS administration to rats. These effects were not enhanced by reducing aromaticity (N-cyclohexylsuccinimide (NCS]. Compounds with increased aromaticity N-(1-naphthyl)succinimide (NNS), N-(1-anthracenyl)succinimide (1-NAS) and N-(9-anthracenyl)succinimide (9-NAS)--also only weakly affected renal function. However, NNS (1.0 mmol/kg) and, to a lesser degree, 9-NAS (1.0 mmol/kg) proved to be hepatotoxins. Liver damage was most pronounced near central vein regions of the lobule and least evident around periportal sites. Damaged liver tissue exhibited unusually large deposits of connective tissue and hypertrophied hepatocytes with numerous vacuoles in their cytoplasm. Therefore, derivatives of NPS with increased or decreased aromaticity relative to the parent compound do not exhibit the ability to induce moderate or marked nephrotoxicity. However, increasing aromaticity did produce the derivatives NNS and 9-NAS, which are hepatotoxins. These compounds represent the first members in this series of compounds to induce acute hepatotoxicity. PMID- 2778256 TI - Control of nephrotoxicity in the rat during repeated cis-platinum treatments. AB - The nephrotoxicity of cis-platinum (CDDP) in the rat can be controlled throughout a series of weekly administrations of CDDP (each of 5 mg kg-1, i.v.) for at least three weeks by a combination of protective measures involving pretreatment with dithiocarbamates and diuretics and the administration of appropriate dithiocarbamates given 1 h after the CDDP. The use of dithiocarbamates with polar substitutents is effective in removing both renal and hepatic deposits of platinum from rats subsequent to its administration and in this respect these compounds are significantly superior to meso-2,3-dimercaptosuccinic acid (DMSA) in the rate at which platinum is removed and in the amounts removed. The most effective of the dithiocarbamates remove ca. 70% of the platinum from the kidneys and the liver; the least effective remove ca. 50% of the platinum from these organs when given at a level of 1.57 mmol kg-1 i.p. for 6 days subsequent to the administration of CDDP. Acetazolamide was shown to be much less effective in preventing renal damage than the dithiocarbamates and was not effective in reducing renal or hepatic levels of platinum. Pretreatment with sodium diethyldithiocarbamate 12 h prior to the administration of the CDDP was more effective in preventing renal damage than the administration of this compound 30 min before the cis-platinum. Several dithiocarbamates are found to be superior to sodium diethyldithiocarbamate in reducing renal platinum burdens of rats given CDDP at the level of 6 mg kg-1, and dose-response curves for the removal of renal and hepatic platinum were determined for sodium N-methyl-D-glucamine dithiocarbamate (NaG).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2778258 TI - Complex mixture effects on the dermal absorption of benzo[a]pyrene and other polycyclic aromatic hydrocarbons from mouse skin. AB - To study the dermal penetration of benzo[a]pyrene (BAP) in relation to other polycyclic aromatic hydrocarbons (PAHs), a complex mixture of PAHs was applied to the backs of CD-1 mice, and the dermal residence times of BAP and eleven other PAHs were determined using gas chromatography. The dermal penetration of BAP was found to be representative of the other PAHs studied, with a dermal half-life of 6.7 h. Half-lives of the other eleven PAHs ranged from 5.0 to 8.8 h. The dermal half-life of BAP applied in a volatile organic solvent, rather than a PAH mixture, was 3.0 h. The effects of five complex organic mixtures, with boiling points ranging from 300-700 degrees F to greater than 850 degrees F, on the dermal residence time of BAP was studied by adding radiolabeled BAP to the mixtures, and applying them to the backs of mice. All of the mixtures studied increased the dermal residence time of BAP by amounts ranging from 1.8-fold to 6.9-fold. PMID- 2778259 TI - Sebaceous gland suppression as a short-term test of the cutaneous carcinogenic activity of mineral oils. AB - Forty-seven mineral oils were tested for their ability to induce sebaceous gland suppression in female C3H/HeN or CF1 mice. Six groups of five mice were treated with zero, one, two, three, four or six epidermal applications of one or more of three volumes (0.2, 0.1 or 0.05 ml) of the test substance. The sebaceous gland suppression indices were calculated from the total numbers of sebaceous glands and hair follicles in nine sections of treated skin from each mouse. Suppression curves were drawn by plotting the mean suppression indices against the number of applications of each oil sample. The suppression curves were compared with the cutaneous carcinogenic potentials of these mineral oils, assessed by long-term skin bioassays. All the carcinogenic oil samples induced suppression of sebaceous glands. The non-carcinogenic samples had no significant suppressant activity. There was a correlation between cutaneous carcinogenic activity and suppressant potential for all tested samples. Results of the suppression tests considered, together with the kinematic viscosities of the test substances, enabled accurate prediction of their cutaneous carcinogenic potential. PMID- 2778257 TI - 3-Hydroxypropylmercapturic acid: a biologic marker of exposure to allylic and related compounds. AB - 3-Hydroxypropylmercapturic acid [3-OHPrMCA, S-(3-hydroxypropyl)-N-acetyl-L cysteine] was quantitatively measured by high-performance liquid chromatography (HPLC) in the urine of rats given allylamine.HCl (5, 25, 50, 100 and 150 mg kg 1), acrolein (13 mg kg-1), allylalcohol (64 mg kg-1), allylchloride (76 mg kg-1), allylbromide (120 mg kg-1), allylcyanide (115 mg) and cyclophosphamide (160 mg kg 1) by gavage in water. 3-OHPrMCA was measured by HPLC in 24-h urine collections; the lower detection limit was 1.25 micrograms or 5.6 nmol ml-1. Various doses of allylamine resulted in 3-OHPrMCA excretion at a fairly constant percentage of the dose, ca. 44-48% at 0-24 h and 3% at 24-48 h, indicating rapid metabolism through glutathione conjugation in the first 24h. Similarly, 3-OHPrMCA was recovered in the urine of rats given acrolein (78.5%), allylalcohol (28.3%), allylchloride (21.5%), allylbromide (3.0%), allylcyanide (3.7%) and cyclophosphamide (2.6%). These data indicate that 3-OHPrMCA can be used as a marker of exposure to allylic and other compounds that lead to the metabolic formation of acrolein. PMID- 2778260 TI - Renal handling of 2-methyl-4-chlorophenoxyacetic acid (MCPA) in rats. AB - Following i.p. administration of various doses of 2-methyl-4-chlorophenoxyacetic acid (MCPA), ca. 50% is excreted during a 5-h diuresis experiment. After i.p. administration of MCPA, virtually no distribution occurs (Vrel = 18% of the body weight). Renal excretion of MCPA can be accelerated by inhibition of its renal tubular reabsorption. The distinct inhibition of renal excretion of MCPA by simultaneous administration of probenecid or p-aminohippurate (PAH) indicates the active tubular transport of MCPA; this transport process can be stimulated by treatment of rats with triiodothyronine. Active tubular transport of MCPA was confirmed by measurement of MCPA accumulation in renal cortical slices, both under aerobic and anaerobic conditions. Accumulation of MCPA under anaerobic conditions indicates an additional passive uptake and binding of MCPA in kidney tissue in accordance with the high degree of binding to plasma albumin (85%). PMID- 2778261 TI - A new method for long-term inhalation toxicity studies for bronchospasmolytic aerosol formulations in dogs. AB - In routine inhalation toxicity studies laboratory animals are exposed under dynamic exposure conditions to different steady-state concentrations of a test compound. The relevant exposure concentration is the analytically determined time weighted average concentration in the vicinity of the breathing zone of the animals. If the intended use of a bronchospasmolytic aerosol is taken into account, a non-steady-state exposure regimen might be more appropriate. Using this approach local effects of high aerosol concentrations on the respiratory tract were investigated in dogs by daily head/nose-only exposure for 1 h for 4 weeks. Four groups of four dogs were exposed to 20, 40 and 80 bursts of a bronchodilator formulation using a modified metered dose inhaler. The analytically determined mean concentration of the active ingredient (prostaglandin) in the breathing zone was 43.1, 92.2 and 193.9 micrograms l-1 air, respectively. Maximum concentrations were determined by simulation. The aerosol was in the respirable range (mass median aerodynamic diameter approximately 1.2 microns, geometric standard deviation approximately 1.4). A kinetic model was developed to simulate the mean and maximum non-steady-state concentration for an exposure regimen of 20, 40 and 80 bursts per hour under dynamic exposure conditions. The model was based on first-order inhalation chamber kinetics. The kinetic model was validated experimentally by comparing measured mean and simulated mean concentrations. In all exposure groups the simulated maximum concentrations were ca. 80 mg of test compound (formulation) per litre of air. Plasma levels were elevated in a dose-dependent manner as evidence of the validity of the test model employed. PMID- 2778262 TI - The dermal carcinogenic potential of unrefined and hydrotreated lubricating oils. AB - Unrefined lubricating oils contain relatively high levels of polycyclic aromatic hydrocarbons (PAH) and have been shown to induce tumors in mouse skin. Exxon has developed a new method of refining these materials, a severe hydrotreatment process that is optimized for PAH removal. The specific objectives of the current study were to assess PAH reduction and then to evaluate directly the dermal carcinogenic potential of the materials that spanned the range of products produced by this method. The test samples included unrefined light and heavy vacuum distillates from a naphthenic crude oil, as well as the corresponding severely hydrotreated products. Two sets of samples were prepared to assess the effects of various operating parameters in the reactor. Additionally, positive (benzo[a]pyrene), negative (white mineral oil) and vehicle (toluene) control groups were included to assess the sensitivity and specificity of the bioassay. Each sample was applied in twice-weekly aliquots to the backs of 40 male C3H mice. In the analytical studies, significant reductions in the levels of several specific PAH were demonstrated. In the dermal carcinogenesis studies, the unrefined oils and the positive control induced tumors and also significantly reduced survival. None of the mice treated with severely hydrotreated oils or with the negative or vehicle controls developed skin tumors, and survival of these mice was not significantly different from the control. Thus, the data demonstrated that this new, severe hydrotreatment process was an effective means of converting carcinogenic feedstocks to non-carcinogenic products. PMID- 2778263 TI - Effects of aflatoxin on the immune system of the chick. AB - A decreased antibody response to injected sheep red blood cells and weight losses to the extent of 25-38% were observed in the bursa Fabricii and thymus in chicks fed an aflatoxin diet (10% w/w) for 3 weeks. The immune organs did not show any significant histopathological changes. The antibody titre decreased from day 6 of treatment onward until the 15th day, when the antibody titre had disappeared completely in the test chicks. The body weight gain was also less in test chicks (9.7-37.3%) given test feed or test feed along with Salmonella pullorum in water (10(8) cfu ml 1) in comparison to chicks given toxin-free diet and water after 3 weeks of feeding trials. The disappearing component in the test chicks' liver homogenate was found to be antigenic by immunoelectrophoretic studies. PMID- 2778264 TI - Isolation of human monoclonal antibody isoproteins by preparative isoelectric focusing in immobilized pH gradients. AB - A method for preparative isolation of human monoclonal antibody isoproteins is described in the present paper. A human monoclonal antibody directed against the transmembrane protein gp 41 from the human immunodeficiency virus (HIV-1) was used in this study. The antibody belongs to the IgG1 subtype and exhibits antibody dependent cellular cytotoxicity. The resolving power of conventional preparative protein separation techniques such as ion-exchange chromatography, chromatofocusing and lectin affinity chromatography is too poor for a complete separation of isoproteins. The more sophisticated technique of chromatofocusing on FPLC-based material (Mono P, Pharmacia) did not satisfy our expectation. With semipreparative IEF in immobilized pH gradients we were able to prepare the different isoproteins of a human monoclonal antibody in milligram amounts. No significant difference between the single isoproteins with respect to specificity and avidity to the recombinant antigen (rec gp 160) was detected. Therefore, we assume that the separation conditions did not influence the immunochemical nature of the antibody and significant denaturation and/or precipitation of the IgG did not occur. Furthermore the method affords preparative separation with resolution equivalent to analytical runs. Experiments for scale up and further characterization of isoproteins (carbohydrate composition, amino acid analysis, half life times etc.) are in progress. PMID- 2778265 TI - A simple and sensitive spectrophotometric method for the quantitative determination of solid supported amino groups. AB - A simple and sensitive method for the quantitative determination of free amino groups on solid support is described. This approach is a modification of Ngo's [(1986) J. Biochem. Biophys. Methods 12, 349-354] method reported earlier. The method is based on the reaction of the solid support with an excess of 5'-O-(4,4' dimethoxytrityl)-thymidine-3'-O-(2,4-dinitrophenyl) succinate (DTDS) in the presence of a catalytic amount of 4-dimethylaminopyridine. After removing the excess reagent, solid support is treated with perchloric acid to release 4,4' dimethoxytrityl cation into the solution. The released 4,4'-dimethoxytrityl cation, which has a strong absorption at 498 nm (epsilon 498 = 70,000), is then determined spectrophotometrically. A comparative study of DTDS, N-succinimidyl-3 (2-pyridyldithio)propionate and 4,4-dimethoxytrityl chloride is also included. The method was found to be very useful to determine those amino groups which are available for functionalization of solid supports, especially, monitoring the functionalization of solid supports for affinity chromatography and synthesis of biopolymers. PMID- 2778266 TI - Neurons of the rostral fastigial nucleus are responsive to cardiovascular and respiratory challenges. AB - The rostral fastigial nucleus (rFN) of the cerebellum has been implicated in the neural control of the cardiovascular and respiratory systems. Electrical stimulation and electrolytic lesions of this region produce changes in both cardiovascular and respiratory function. It has been suggested that some of these changes may result from effects on fibers of passage rather than on cell bodies of origin within the rFN. In the present study, extracellular recordings demonstrated a high percentage of units within rFN, as well as in adjacent areas, which responded to induction of acute increases or decreases in arterial blood pressure. Furthermore, units were identified in rFN which responded to respiratory stimuli as well as to changes in blood pressure. Out of the population tested, no units responding to respiratory stimuli were found in areas adjacent to rFN. In addition, a high percentage of neurons tested for response to passive movement also showed changes in firing rate to either cardiovascular or respiratory challenges, or both. Several units were identified (mostly in rFN), whose basal firing pattern was respiratory-related. This suggests the presence of cell bodies of origin within the rFN whose function is related to cardiorespiratory activity. PMID- 2778267 TI - Spontaneous junction potentials and slow waves in the circular muscle of isolated segments of guinea-pig ileum. AB - Spontaneous electrical activity was recorded with intracellular microelectrodes from cells within the circular muscle of isolated, 2 cm long, intact segments of guinea-pig ileum that were unstretched, and in segments that had been slit open along the entire length of either their mesenteric or antimesenteric border and pinned flat under a minimum of tension. Intact segments usually exhibited fast spontaneous irregular oscillations in membrane potential (mean 1.6 Hz) which were unaffected by hyoscine (0.5 microM), the substance P antagonist D-Arg1, D-Pro2, D Trp7.9, Leu11-substance P (10 microM), hexamethonium (100 microM), propranolol (1 microM) or phentolamine (1 microM) but were blocked by tetrodotoxin (0.4 microM) or apamin (0.4 microM). This irregular spontaneous activity is deduced to be due to ongoing firing of inhibitory motor neurons. After blockade with apamin or tetrodotoxin, a slow wave-like activity with a mean frequency of 16.4 cycles/min and maximum amplitude 2-14 mV was observed in 47% of intact segments. The amplitude of slow waves waxed and waned with a mean frequency of 0.9 cycles/min. Spontaneous cholinergic (hyoscine-sensitive) excitatory junction potentials were observed in some preparations. In contrast, in the majority of opened segments the resting membrane potential was quite stable, although slow waves that were similar to those in intact segments were observed in 14% of preparations. These studies indicate that spontaneous inhibitory junction potentials and slow waves can be recorded in intact segments of guinea-pig ileum. Their relative absence in opened segments suggests their normal expression is facilitated by the circumferential integrity of the intestine. PMID- 2778268 TI - Effects of middle cerebral artery occlusion on baroreceptor reflex control of heart rate in the rat. AB - Neurons in the insular cortex have recently been shown to innervate medullary autonomic nuclei such as the nucleus tractus solitarii (NTS). The present study examines the effect of lesioning the insular cortex on baroreceptor-heart rate reflex in conscious rats. We did this by occluding the stem of the left proximal middle cerebral artery which causes a lesion of the insular and adjacent lateral frontoparietal cortices. Nine and 10 days after lesioning or sham operation, reflex heart rate responses were recorded following i.v. doses of the pressor agent phenylephrine and the depressor agent sodium nitroprusside. Baroreceptor reflex parameters were determined by computerized sigmoidal curve-fitting. The overall contribution of the sympathetic and the cardiac vagus were assessed by using peripherally acting muscarinic and beta-adrenoceptor antagonists, respectively. Lesioned rats were compared to sham-operated rats. Lesioning the insular cortex did not affect mean blood pressure and heart rate. However, the lesion selectively enhanced reflex vagal bradycardia that occurred when mean blood pressure was artificially elevated. A greater vagal bradycardia with no change in the upper plateau indicated that ischemia was acting entirely on the baroreflex-dependent vagal cardiac motoneurons. There was no effect on the sympathetic heart rate range but the normalized gain of the sympathetic component was increased in those lesioned rats. These observations suggest that the unilateral cortical lesion chronically affected the baroreceptor control of heart rate through mechanisms differentially affecting the vagus and the cardiac sympathetic nerves. PMID- 2778269 TI - Distribution and density of neuropeptide Y-immunoreactive nerve fibres and cells in the horse urinary bladder. AB - The distribution and density of neuropeptide Y (NPY)-immunoreactive nerve fibres and cells were determined in the urinary bladder of the horse by using the peroxidase-antiperoxidase (PAP) immunohistochemical method. Numerous undulating NPY-immunoreactive nerve fibres were found throughout the vesical wall, sometimes forming nerve bundles which ramified repeatedly as they coursed through the connective tissue septa to give rise to smaller bundles or single fibres which projected into the muscle fascicles forming muscular nerve plexuses, mainly in the bladder base. In the submucosa of this region, NPY-immunoreactive fibres formed a rather dense subepithelial plexus. Numerous NPY-immunoreactive nerve fibres supplied blood vessels and were widely distributed on the vascular adventitia constituting rich perivascular nerve plexuses. In addition, intramural ganglia containing NPY-immunoreactive nerve cell bodies and fibres were identified at the uretero-vesical junction. These results suggest that the equine urinary bladder possesses a rich NPY-peptidergic innervation which shows regional variations in the density of the muscular and subepithelial plexuses, the bladder base being the most richly innervated region. At least some of these NPY immunoreactive nerve fibres have an intrinsic origin in ganglion cells within the vesical wall. PMID- 2778271 TI - Rationing health care--should it be done? AB - 1. The utilitarian view supports allocation of goods to meet the needs of the greatest number of people; Lamm contends that the only just rationing would be according to age. 2. Some theorists assume that all individuals will live relatively healthily until the end of their natural lifespan; they do not distinguish between therapeutic medications and those that alleviate suffering. 3. According to intergenerational arguments, children should receive priority in funding, with the elderly at the lower end of the scale. 4. The Advisory Panel of the Office of Technology Assessment recommends rationing based on prognosis and quality of life; however, good prognostic skills are lacking and there is no consensus on quality of life. PMID- 2778270 TI - Cardiovascular responses and changes in neural activity in the rostral ventrolateral medulla elicited by electrical stimulation of the amygdala of the rat. AB - Electrical stimulation of the central nucleus of the amygdala (ACe) in anesthetized animals produces a decrease in arterial pressure (AP) as a result of an overall decrease in peripheral resistance. As the cardiovascular neurons that presumably mediate these changes are located in the rostral ventrolateral medulla (RVLM), we recorded spontaneous activity from 89 histologically verified units in the RVLM of urethan-anesthetized rats. Twenty-two of these units were classified as cardiovascular neurons because their spontaneous activity was inhibited by baroreceptor stimulation (2-4 micrograms phenylephrine i.v.) and displayed a cardiac cycle-related rhythmicity. Single or twin pulses (0.5 ms, 180 +/- 55 microA) delivered once per second to arterial depressor sites in the ipsilateral ACe inhibited the activity of 18 of these neurons and excited 4. In 27 additional barosensitive neurons that lacked cardiac cycle rythmicity, a similar distribution of effects was obtained by electrical stimulation of the ACe: 13 inhibited, 5 excited, 9 not affected. Finally, 40 non-barosensitive units were found; stimulation of the ACe inhibited the activity of 16, excited 12 and had not effect in 12. These results are interpreted to indicate that the differential effects of ACe stimulation on different vascular beds are mediated probably by differential influences on cardiovascular neurons in the RVLM, and that functions other than respiratory and cardiovascular control are represented in the RVLM. PMID- 2778272 TI - HIV and the older adult taking the necessary precautions. AB - 1. With the awareness that the population of older adults with whom nurses and other health-care workers come in contact may indeed be HIV infected, the need for universal precautions becomes imperative in all health-care settings. 2. The subpopulations of older adults in which HIV infection is most likely to be concentrated are the same as those for any other age group; ie, homosexual and bisexual men, IV drug users and their partners, people who have received blood products, and sexual partners of people who are HIV infected. 3. It is important for nurses to recognize that older adults may be manifesting the signs of symptoms of AIDS; for example, some people diagnosed with Alzheimer's disease may actually have AIDS-related dementia. 4. Gerontological nurses need to be the initiators of implementing universal precautions in their health-care settings. PMID- 2778273 TI - How to reduce the risk of postmenopausal osteoporosis. AB - 1. The potential magnitude of health-care resources necessary to provide for the complications of postmenopausal osteoporosis is staggering considering that the average women lives 25 years after menopause. 2. The development of postmenopausal osteoporosis is influenced by endocrine and metabolic changes as well as age and sex-related effects on bone. 3. Nurses are increasingly being put in the position of improving the quality of life of women with postmenopausal osteoporosis as well as teaching preventive measures to populations at risk for developing the disease. 4. Therapy for postmenopausal osteoporosis includes the appropriate treatment of the acute problems and the prevention of further bone loss. Therapy must take into account the individual nature of the disease with different approaches to management utilized. PMID- 2778274 TI - Becoming immune to loneliness helping the elderly fill a void. AB - 1. The extent to which one is able to fulfill needs and escape loneliness in later life depends on available relationships and one's creative interactions with others. 2. Persons immune to loneliness have characteristics that permit growth and constructive behaviors when faced with a loss or change. 3. Loneliness in old age occurs because interactions and communications from others are ignored and are not accepted by others. 4. Knowledge of an individual's level of creative potential is relevant for nurses planning interventions for mobilizing a support system for the lonely elderly. PMID- 2778275 TI - Caregivers of the elderly: a new clientele for nursing. PMID- 2778276 TI - Communicating with advanced-stage dementia patients: the application of sullivanian theory. PMID- 2778277 TI - Home health care--providing a missing link. AB - 1. If nurses are to provide the continuity of care that helps patients at home achieve expected patient outcomes, nurses must diagnose actual and potential health problems and design a plan of care. 2. Before patient outcomes can be identified, nurses must first recognize, assess, and describe the patient's defining characteristics. 3. The study found that nurses use a limited range of nursing diagnoses and incompletely document the care they give. 4. Results of the study indicated that nurses provide continuity of care between the hospital and home; there is also a need for home-based health care to provide support for elderly caregivers whose health is less than good. PMID- 2778279 TI - [Maternal mortality at the Hospital Center of Libreville (1984-1987)]. AB - Maternal mortality at the University Hospital of Libreville was 152.5 for every 100,000 live births. There were 48 maternal deaths out of 31,799 deliveries carried out between 1984 and 1987. The principal causes were: haemorrhage in 45.8%, infections in 20.8%, intercurrent diseases in 20.8%, vasculo-renal syndromes in 10.4% and thromboses in 2%. The main differences between this country and developed countries were the large number of haemorrhages and the rarity of thrombosis. Poor prognostic factors were SS sickle-cell disease in 10.4% of the cases who died and in deaths due to anaemias, of which 25% were due to haemorrhage connected with the afterbirth. Complications occurring in the 1st trimester of pregnancy caused nearly a third of all maternal deaths. Complications of abortion occurred in 16.6% and of extra-uterine pregnancies in 14.6%. If the maternal mortality rate is to be reduced it is important to have a proper blood bank. The risks of caesarean section are ten times greater than of vaginal delivery, although it is a good way out for difficult situations. The indications for the operation have to be carefully considered. Comparing the statistics reported from Cotonou, the University Hospital in Libreville has a lower incidence of maternal mortality but it is too high and requires real progress to be made. PMID- 2778278 TI - [Social acceptability of screening for HIV seropositivity in pregnant women. An inquiry in the Paris region]. AB - Current debate about screening strategies for HIV during pregnancy is not limited to clinical and epidemiologic arguments; ethical and social concerns about the risk of stigmatization against HIV carriers are also taken into account. Therefore, data on public perception of AIDS and attitudes toward preventive measures against the disease can be of interest. In December 1987, a survey was carried out, through personal interview, in a representative sample (900 individuals selected by the quota method) of the 10.5 million inhabitants 18 years of age and over, in the Paris region. 9.8% of the women declared having been tested for HIV, at least once, during 1987, and 20% of these tests were part of prenatal care. Mandatory screening for HIV among pregnant women is supported by 78.6% of the respondents while only 64% support screening during premarital examinations and a minority (37.8%) is in favour of mandatory screening for the whole population. 48.5% of respondents share the misperception that transmission from mother to fetus always happens, and 70% think that women who are HIV carriers should renounce pregnancy: willingness to support mandatory screening for pregnant women is significantly higher among individuals who share these two beliefs. PMID- 2778280 TI - [Incidence of sister chromatid exchanges (SCEs) in idiopathic male sterility. Preliminary study]. AB - Studies of SCE show a marked increase in the field of diseases correlated with DNA replication defects. A number of cases of idiopathic sterility and oligospermia can be placed in this group. The aim of the present study is to explore the frequency of SCEs in subjects with idiopathic sterility, oligospermia and oligo-astheno-terato-zoospermia. Results were obtained by the Perry and Wolff method. Our study of the incidence of SCEs does not show a significant difference between sterile and oligospermic patients and control subjects, for chromosomes of the A, B, C, D, F and G groups. The only chromosomes with a slight increase of SCE frequency were chromosomes 16 and 18. Because of the small number of cases studied, further work to elucidate the situation is necessary. PMID- 2778281 TI - [Comparative study of the lipid composition of seminal fluid and ovulatory peritoneal fluid in humans]. AB - Sperm capacitation is accompanied by changes in the lipid composition of the sperm membrane. The purpose of this study is to compare the lipid composition of the semen with that of peritoneal fluid. These two media have opposite effects on sperm capacitation. Cholesterol, triglyceride and phospholipids were measured in seminal fluid (15 specimens) obtained by sperm centrifugation immediately after liquefaction and in the peritoneal fluid at ovulation (15 specimens) obtained through transvaginal puncture. The lipid composition of these two media is different from that of serum. Seminal fluid is characterized by a high level of phospholipids, 14.79 +/- 3.67 g/l as against 0.53 +/- 0.12 g/l in peritoneal fluid. The level of cholesterol is identical in the two media. The cholesterol/phospholipid ratio is therefore lower in seminal fluid than in peritoneal fluid (0.022/0.79). Lecithins are raised in peritoneal fluid as are sphingomyelins and the phosphatidylethanolamines, which are the most important phospholipids in seminal fluid. It therefore can be postulated that the cholesterol/phospholipid ratio, which is low in seminal fluid, and its richness in sphingomyelin brings about stabilization of the membrane cover which corresponds to a decapacitated state, whereas the cholesterol/phospholipid ratio, which is higher in peritoneal fluid, makes for greater fluidity, and this corresponds to the state of capacitation. These preliminary results obtained from human material do not in any way contradict those obtained from animal studies. PMID- 2778282 TI - [Choriocentesis: comparison of the effectiveness of a new choriocentesis needle and a transcervical biopsy forceps]. AB - 71 samples taken by the transabdominal route were compared with 71 samples taken by forceps through the cervix. A fine (1 mm) transabdominal choriocentesis needle with a thin wall (0.1 mm), a short bevel, and a lateral hole was made to bring together simplicity, effectiveness and safety; success was obtained in 95% of the cases (39/41) of our last 41 samples on the first attempt. For comparison with the forceps, the success rate on the first attempt was only 66% (26/41), but it rose to 97.5% if the patient could take 3 attempts at most. The forceps made it possible to collect a mean quantity large enough (19.9 mg) but it was quite variable (16.7 mg being the range) of complete villi, whereas the choriocentesis needle only gathered a smaller volume (12.7 mg) but more reliable (the range being 3.7 mg). The villi were fragmented, however. To work out the study of the DNA and the karyotype, there is a choice between the forceps and the needle. This choice depends principally on the damage the two techniques can do. This has not been worked out yet in our study except indirectly. PMID- 2778283 TI - [The glucose perfusion test: value in detecting fetal distress]. AB - The authors use an intravenous dose of 0.5 g glucose/kg. body weight as a fetal stimulation test in one hundred pregnant patients after the 34th week. Glucose produced a remarkable increase of fetal heart rate variability, as well as an increase in the number of fetal movements and accelerations. Those fetuses lacking reactivity before and after the glucose test presented, in 55.5% of the cases, neonatal depression. This suggests that glucose perinatal surveillance is of utmost importance in these cases. The glucose overload test presents a clear advantage with respect to the oxytocin test, which is the total absence of labor stimulation and this may not be desirable in cases of prematurity or previous uterine scars. PMID- 2778284 TI - [Ovarian seminoma and pregnancy. Apropos of a new case]. AB - The case of a 35-year-old primigravida with a 21-week intrauterine gestation and concurrent dysgerminoma of the ovary (stage Ic) is presented. A total hysterectomy with bilateral salpingo-oophorectomy was performed, followed by postoperative chemotherapy using cisplatin, bleomycin and vinblastine. The patient has done well since treatment, and is without evidence of recurrent disease 19 months later. Both radiation and chemotherapy are highly effective treatment modalities for dysgerminoma. For those patients with disease presenting in stages Ib, Ic, II and III who wish to maintain fertility, unilateral oophorectomy followed by combination chemotherapy may be curative and spare ovarian function. PMID- 2778285 TI - [Chondrosarcoma of the soft parts of the thoracic wall. Apropos of a case after surgery and irradiation of breast adenocarcinoma]. AB - We are reporting here a case of chondrosarcoma of the soft tissues of the thoracic wall. As far as we can tell it is the first case published in the world. The tumour appeared 13 years after radical mastectomy and radiotherapy for an adenocarcinoma of the breast. The tumor was greyish-white in appearance and hard, but friable and haemorrhagic. Clinically and biologically it looked like an inflammatory mass. This disappeared when the tumour had been removed but recurred 6 days post-operatively when nodules showing that it had permeated the tissues appeared. Histological and immunohistochemical examination confirmed the diagnosis. We discuss the clinical and histological aspects of the case and state what we found in the literature about other sarcomas that have followed adenocarcinomata of the breast that had been irradiated and operated on. The role of radiotherapy in bringing about this tumour is discussed, including the relationship between the site of the tumour and the dose and field of irradiation. The prognosis is particularly bad in this type of sarcoma which was induced by irradiation. PMID- 2778286 TI - [Burns and pregnancy. A case of severe burn occurring at the beginning of pregnancy. Maternal and fetal survival]. AB - The authors report a case of a severe thermal burn (70% of the surface of the body) in a pregnant woman who had 15 weeks amenorrhoea. The survival of the mother and the continuation of the pregnancy to term allowed a normal live baby to be born. As far as the authors know this is the fourth case history of a severe (more than 60% of the body) burn published occurring in the first trimester of pregnancy and carried through successfully to term. A study of the literature has shown that the physiopathological results of severe burns do explain the usually poor prognosis for mother and fetus. Large quantities of prostaglandins are released into the circulation of the mother because of the thermal insult to tissues and because of the infection that usually accompanies such burns. These prostaglandins can stimulate the myometrium, which gives rise to fatal obstetric complications. The urgent acute treatment for a severe burn in a pregnant woman, which should preferably be carried out in a special centre, consists in water and electrolyte resuscitation, assisted respiration and prevention of bacterial contamination. These measures are just as important for the fetus. At the same time obstetric care should be started. Good collaboration between the obstetricians and those who carry out the resuscitation all bring about the measures that are needed to allow the mother and fetus to survive. PMID- 2778287 TI - [Glanzmann's thrombasthenia and pregnancy. Contribution of plasma exchange before scheduled cesarean section]. AB - Glanzmann's thrombasthenia is a thrombopathy which affects primary hemostasis due to a qualitative or quantitative abnormality of membrane glycoproteins IIb-IIIa. The treatment of hemorrhages is usually associated with the transfusion of packed red blood cells and platelet concentrates. If massive allo-immunisation occurs, the transfusion will prove to be inefficient. A case of a cesarean section was scheduled after therapeutic plasmapheresis and platelet transfusions in a massively allo-immunised patient with Glanzmann's thrombasthenia. The plasma exchange made it possible to reduce to trace levels the concentrations of anti PLA1 and anti-PLA2 antibodies, thus making platelet transfusions hemostatically efficient. The cesarean section was therefore safely performed when the bleeding time was normalized. PMID- 2778288 TI - [Transvaginal hysterectomy. Sub-serous technic]. AB - Intramyometrial coring is a useful method to reduce the size and increase the accessibility to the fundus uteri during vaginal hysterectomy, avoiding unnecessary traction on the utero-ovarian pedicles. A circumferential incision of the isthmus, 5 millimeters deep, gives access to an avascular plane between the myometrial mass and the superficial muscular layer and serosa of the uterus. Coring is easy, safe, non-hemorrhagic and allows the extension of indications of the vaginal route for hysterectomy. PMID- 2778289 TI - [Carcinoma of the cervix stages Ib, II, III. Results of treatment and prognostic factors. Retrospective analysis of 396 cases]. AB - Between 1976 and 1986 we have treated 396 patients with carcinoma of the uterine cervix, stages Ib, II and III. The mean age was 54.2 years. The staging system used was the FIGO classification, modified according to the Institut Gustave Roussy criteria. There were in stage Ib 117 cases, in early stage II 124 cases, in late stage II 63 cases and in stage III 92 cases. Treatment methods used were radiotherapy and surgery combined for localised pelvic lesions (stage Ib and stage II) and radiotherapy alone for those cases that were central and going out to the side wall of the pelvis (late stage II and stage III). The actuarial five year survival rate was 91% for stage Ib, 67% for early stage II, 48% for late stage II and 28% for stage III. The main causes of failure were recurrence in the pelvis in 15% of treated areas and distant metastases in 13%. The state of the lymph nodes was another prognostic factor but the histological subtype and age were not. 7% of cases had severe complications (urinary, digestive and lymphatic). PMID- 2778290 TI - [Irradiation in the treatment of adenocarcinoma of the ovary. Retrospective study of 44 cases]. AB - In order to better assess the place of radiotherapy in the treatment of ovarian carcinoma, the length of survival in 44 patients treated with irradiation has been examined. 44 patients, with nil or minimal (less than 2 cm) residual disease, were found among 92 patients with invasive ovarian carcinoma treated consecutively in our center from 1976 to 1986. Treatment included laparotomy for 42 patients. Debulking surgery was complete in 9 stage I and 10 stage II patients. Those patients also received abdominopelvic (16 cases) or pelvic (3 cases) irradiation. Residual tumour was left in the 25 remaining patients (2 with stage IIc, 18 with stage III, and 5 with stage IV) who further underwent various regimes of polychemotherapy (9 without and 16 with cisplatin) followed by second look laparotomy. 25 patients had no (8 patients) or minimal (17 patients) residual disease after this second laparotomy and they underwent abdominopelvic irradiation. Overall 3-year survival was 68%, 3-year survival was 80% for stage I and II patients treated by radiotherapy after initial complete debulking surgery, and 58% for advanced stages treated by radiotherapy after chemotherapy and second look laparotomy, 3-year survival was 71% for 18 patients with stage III. Tolerance for irradiation was significantly decreased after chemotherapy and this prevented a complete dose being delivered to 32% of the patients. A late severe complication was noted in only one case. For stage I or II our results are close to those already published by others.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2778292 TI - Transferrin degradation by gastrointestinal fluids of suckling and weanling rats. AB - Dietary transferrins are postulated to play a number of biological roles in the developing gastrointestinal tract. A prerequisite for such roles is survival in the gastrointestinal lumen. To evaluate luminal transferrin digestion during development, 125I-transferrin was incubated in vitro with luminal fluid from the stomach and small intestine of 12-day old suckling and 31-day old weanling rats, followed by analysis of degradation products. At both ages, the rate of degradation to trichloroacetic acid soluble material was maximum in the mid jejunum and lowest in the stomach. Transferrin hydrolysis by weanling fluid was 2 10 times greater than suckling depending upon the particular segment. Chromatography of small intestinal reaction mixtures on Sephacryl S-200 revealed label eluting between intact transferrin and free iodine: two such peaks were generated with suckling fluid and one with weanling. Electrophoresis on SDS polyacrylamide gels showed two major bands of Mr 69K and 20K; the former was the predominant reaction product with suckling intestinal fluid and the latter with weanling. Both methods showed small amounts of apparently intact transferrin. Results indicate substantial yet incomplete luminal degradation of transferrin which is more pronounced in the weanling than in the suckling. This survival is compatible with potential biological functioning of dietary transferrin or one of its breakdown products within the gastrointestinal tract. PMID- 2778291 TI - Effects of strenuous maternal exercise on fetal organ weights and skeletal muscle development in rats. AB - The purpose of the present study was to observe the effects of strenuous maternal aerobic exercise throughout gestation on fetal outcome in the rat. The strenuous exercise intensity consisted of a treadmill speed of 30 m.min-1 on a 10 degrees incline, for 120 min.day-1, 5 days.week-1. The rats were conditioned to run on a motor-driven treadmill by following a progressive two-week exercise program, so that by the end of the two weeks the rats were capable of running comfortably at this strenuous intensity in the non-pregnant state. Following the two-week running programme, the rats were paired by weight and randomly assigned to either a pregnant group that continued the running program throughout gestation (pregnant runner), or a pregnant group that did not continue the running program throughout pregnancy (pregnant control). At birth the neonates born to the pregnant running group did not differ in average neonatal body weight values, number per litter or total litter weight values when compared to controls, nor were superficial gross abnormalities observed in neonates born to the pregnant control or pregnant running groups. The strenuous maternal exercise intensity did not alter neonatal organ weight values (brain, heart, liver, lung, kidney), nor neonatal skeletal muscle (gastrocnemius, sternomastoid, diaphragm) when compared to control values. It is suggested that maternal exercise of this intensity throughout gestation does not affect fetal outcome in the rat, and may be due to the animals accustomization to the strenuous exercise protocol prior to pregnancy. PMID- 2778294 TI - Influence of repeated exposure to rapidly developing hypoxaemia on the arousal and cardiopulmonary response to rapidly developing hypoxaemia in lambs. AB - Experiments were done on four lambs to determine if repeated exposure to rapidly developing hypoxaemia influences the cardiopulmonary and arousal response from sleep. Each lamb was anaesthetized and instrumented for sleep staging and measurements of arterial haemoglobin oxygen saturation. No sooner than three days 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 hypoxaemia when the animal was breathing 5% oxygen for approximately 100 epochs of sleep. Arousal occurred from both sleep states during rapidly developing hypoxaemia but was delayed in active sleep compared to quiet sleep. The time to arousal and the decrease in arterial haemoglobin oxygen saturation were significantly increased with repeated exposure to rapidly developing hypoxaemia during both quiet sleep and active sleep. Thus, our data provide evidence that repeated exposure to rapidly developing hypoxaemia produces an arousal response decrement in lambs. Since it is possible that alterations in the arousal response to respiratory stimuli play a role in sudden infant death, studies to investigate the mechanism of the arousal response decrement following repeated exposure to rapidly developing hypoxaemia are warranted. PMID- 2778293 TI - Interpreting the carboxyhaemoglobin concentration in fetal cord blood. AB - We calculated the fetal-to-maternal carboxyhaemoglobin concentration ratio in 19 mother-infant pairs at the time of term delivery. Mothers, who had a less than 10% drop in their carboxyhaemoglobin concentration during labour, had an average ratio of 1.40 +/- 0.19. For mothers whose carboxyhaemoglobin concentrations dropped by 10% or more during labour, the average fetal-to-maternal carboxyhaemoglobin concentration ratio was 1.83 +/- 0.48. There was a strong correlation (r = 0.82) between the percent change in maternal carboxyhaemoglobin concentration during labour and the fetal-to-maternal carboxyhaemoglobin concentration ratio at the time of delivery. We conclude that increased CO elimination during labour may be accompanied by rapid changes in the maternal carboxyhaemoglobin concentration, leading to a spuriously high fetal-to-maternal carboxyhemoglobin concentration ratio at the time of delivery. PMID- 2778295 TI - Ontogeny of the circadian variation of plasma prolactin in sheep. AB - The ontogeny of circadian rhythms is unknown. The newborn sheep has a circadian rhythm of temperature; to study the ontogeny of other rhythms, we examined the 24 h variation of plasma prolactin concentration in fetal and newborn sheep. To this effect, we measured plasma prolactin concentration in chronically catheterized fetuses (n = 7) and in newborn lambs raised under short day nycthemeral (12 light:12 dark, n = 13) or constant light conditions (n = 5). Indwelling catheters were implanted into the jugular vein and carotid artery of late gestation fetuses (0.9 gestation) and newborns (5-29 days old). Experiments were performed 4 or more days after surgery. Lambs were kept in a canvas sling and were fed cow's milk either by mouth or through a nasogastric catheter at established time intervals. Haematocrit, pH, and blood gases were measured before and after the experiments in all cases and remained within normal values. Lights were on and room temperature was maintained constant during the whole experiment. Samples were obtained every 1-2 h for 24 h in fetuses and newborn lambs under nycthemeral conditions and every hour for 48 h in newborn lambs kept under constant light. Plasma prolactin was measured by radioimmunoassay. The presence of a 24 h rhythm was determined by Cosinor analysis. Fetuses, aged 129 +/- 6 days (SD) n = 7, showed a variation in plasma prolactin concentration with a period of 24 h that fits the equation: plasma prolactin (ng ml-1) = 97.0 + 15.4 cos 15 (t-23.0), P = 0.035.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2778296 TI - Peer review always helps but never cures. PMID- 2778297 TI - Context and the sociological study of stress. An invited response to Pearlin (Vol. 30, No. 3). PMID- 2778298 TI - The structural contexts of stress. An invited response to Pearlin (Vol. 30, No. 3). PMID- 2778299 TI - Uncertainty and the lives of persons with AIDS. AB - This article uses interview data to explore how 23 gay and bisexual men who had AIDS were affected by and managed uncertainty. Before diagnosis these individuals had to find ways to cope with uncertainty about their risk of contracting AIDS and about their initial symptoms. After diagnosis they had to find answers to their questions about why they contracted this disease, whether they would be able to function in the short run, whether their illness would kill them, and whether they would be allowed to live and (if death was unavoidable) to die with dignity. The data suggest that persons with AIDS respond to the uncertainties of their illness by attempting to assert as much control as possible over their lives, through such divergent strategies as seeking and avoiding knowledge about their illness. PMID- 2778300 TI - The twain meet: empirical explanations of sex differences in health and mortality. AB - Health statistics routinely show higher morbidity and health services use for women, while mortality rates are higher for men. This analysis empirically identifies reasons for women's poorer health. It is based on retrospective (interview) and prospective (health diaries) data from the Health In Detroit Study. Three kinds of risk factors, which may help explain females' excess, are considered: acquired risks, psychosocial aspects, and health-reporting behavior. Men and women differ markedly in acquired risks: smoking and job hazards are higher for men, but inactivity, nonemployment, stress, and many other factors are higher for women. Psychosocial aspects predispose women to more illness and health care. Women also had keener interest in the survey. When all of the risk factors are controlled, the morbidity gap narrows considerably. In fact, indicators of general and chronic health reverse to reveal higher morbidity for men. Similarly, females' excesses for therapeutic care (short- and long-term disability, medical visits, lay consultation, drug use) diminish when risks and morbidity level are controlled. They actually reverse to a male excess for disability and medical care. Though most of the unveiled male excesses are statistically nonsignificant, their pattern allows a reasonable interpretation. Our results are closely compatible with recent analyses of sex mortality differences in several California sites, which could not eliminate men's mortality excess by controlling for social factors. In conclusion, contemporary women's poorer health profile stems largely from their roles and stress (acquired risks), and to a smaller degree from their health attitudes. When social factors are taken into account, health data suggest a disadvantage for men, and mortality data maintain men's disadvantage. Do the reasons lie in biology? PMID- 2778301 TI - Role incongruence and gender variation in the provision of prison mental health services. AB - Correctional administrators are equipped with a variety of responses to manage problematic inmate behavior. The forms of these responses range from subtle coercion in the context of everyday prison life to segregative placements that include protective custody, disciplinary confinement, and mental health residential services. Using logistic regression, the present study examines the disproportionate placement of female inmates in mental health facilities. The results suggest that placement differences for male and for female inmates reflect both psychiatric need and differential responses to role-incongruent behavior. PMID- 2778302 TI - Occupational prestige in the health care delivery system. AB - In this study ethnic and gender differences in occupational prestige of health care workers are used to measure the extent of inequality in the health care delivery systems of large SMSAs. Aggregate characteristics of these communities and of their health care delivery systems are used to explain variations in occupational prestige among health workers. The analysis is guided by Blau's macrostructural theory of intergroup relations. It employs 1980 U.S. Census information on the number of men, women, whites, blacks, and Hispanics in 19 health occupations in the 31 largest SMSAs. The results include a description of the size of the health care delivery systems and the proportions of women and minority workers in the systems, as well as the average occupational prestige of categories of respondents, their level of concentration among the occupations, and the relative presence of respondents in the occupations of physicians and registered nurses. Multivariate regression analysis is used to explore intergroup differences in occupational prestige. As deduced from Blau's theory, groups with greater relative occupational dispersion, greater political participation, advanced education, and higher sex ratios have greater relative occupational prestige in the health care delivery system. PMID- 2778304 TI - Abstracts of the 24th meeting of the European Association for the Study of the Liver. Munich, F.R.G., 30 August-2 September, 1989. PMID- 2778303 TI - Knowledge acquisition processes: dissemination of expert recommendations to general practice dentists. AB - We examined structural determinants of general practice dentists' knowledge of the most recent American Heart Association recommendations for the prevention of bacterial endocarditis. Using data from a 1986 national telephone survey of 578 respondents (response rate = 81%), we developed and analyzed a structural model, in which we investigated the contributions to knowledge by age, professional practice settings, colleague networks, and formal educational experiences. Age, practice organization, and institutional affiliations are direct contributors to knowledge. Formal professional channels of reeducation do not contribute directly to knowledge level; rather, their effect is expressed through institutional affiliations. PMID- 2778305 TI - Immunocytochemical localization of creatine kinase M in canine myocardial cells: most creatine kinase M is distributed in the A-band. AB - The localization of creatine kinase (CK) M in canine myocardium was immunocytochemically studied by a direct immunoperoxidase method. Specific antiserum against CK-M was produced in rabbits immunized with canine CK-MM. An anti-CK-M Fab'-horseradish peroxidase conjugate was prepared by the maleimide method. Frozen sections prepared from fixed canine myocardium were stained with the conjugate and observed by light and electron microscopy. In light microscopy of longitudinal sections, CK-M showed a cross-striated pattern consisting of distinct broad and narrow brown bands. Immunoelectron microscopy revealed that the regions of the broad and narrow brown bands corresponded to the A-band and the Z-line, respectively. Most CK-M in the A-band was associated with the thick fibers, and a small amount of CK-M was found in the M-line. These findings suggest that ATP regeneration from the ADP produced by myosin ATPase is related to the participation of this CK associated with the thick fibers rather than that of the M-line-bound CK. Creatine kinase M was also found in the sarcolemmal membrane, the membranes of the sarcoplasmic reticulum, and the mitochondrial outer and inner membranes. This report provides new information for understanding the physiological role of the phosphorylcreatine shuttle in the myocardial energy transport system. PMID- 2778306 TI - Vasopressin gene expression in the normal and Brattleboro rat: a histological analysis in semi-thin sections with biotinylated oligonucleotide probes. AB - We analyzed expression of the vasopressin (AVP) gene in semi-thin sections in normal and Brattleboro rats by using in situ hybridization and immunohistochemistry. AVP mRNA was detected as follows: vibratome sections of rat hypothalamus were hybridized with a biotinylated oligonucleotide probe, embedded in Araldite, and cut into semi-thin sections which were reacted with streptavidin alkaline phosphatase and the appropriate substrate. Adjacent serial sections were treated by immunohistochemistry to detect AVP or oxytocin immunoreactivity. In normal rat, AVP mRNA can be detected in magnocellular neurons of the supraoptic and paraventricular nuclei and in parvocellular neurons of the suprachiasmatic nucleus. AVP mRNA was present throughout the cytoplasm of the cell bodies, their processes, and in punctate structures in the vicinity of the AVP cell bodies. Most neurons containing AVP mRNA also contain AVP immunoreactivity, but the staining intensity was not consistently correlated for each reaction. A few neurons contained AVP mRNA without detectable AVP immunoreactivity. In the Brattleboro rat, staining intensity of the reaction was lower than in normal rat and the AVP mRNA was restricted mostly to the periphery of the cytoplasm. In this strain, the neurons containing the AVP mRNA did not contain AVP or oxytocin immunoreactivity. These results demonstrate that neuropeptide mRNA can be detected in semi-thin sections with a biotinylated oligonucleotide probe, and that AVP gene deletion provokes modification of the intracellular localization of the AVP mRNA. PMID- 2778307 TI - Capping of HLA antigens in human lymphocytes as followed by immunogold label fracture. AB - We used immunogold label-fracture to follow the migration of HLA I class and HLA II class antigens during capping as induced by specific monoclonal antibodies. Capping is achieved through a process of clustering and "consolidation" of clusters into larger patches and, finally, a single cap. All receptors appear to cluster from the very start, with no "stray" molecules joining already formed patches. Characterization of exoplasmic and protoplasmic fracture-faces of capping cells fails to reveal any corresponding accumulation of intramembrane particles and/or subtler rugosities. Our results are consistent with the concepts that view the migration of capping molecules as contemporaneous with the efflux of noncapping integral membrane proteins. PMID- 2778309 TI - Silver enhancement of tissue mercury: demonstration of mercury in autometallographic silver grains from rat kidneys. AB - The autometallographic silver enhancement method has been applied increasingly to detect trace amounts of mercury in preparations of biological tissue. It has, however, been difficult to establish the presence of a core of mercury within the silver grain by direct methods such as energy dispersive X-ray analysis. In the present work, a sample of autometallographic silver grains was prepared from kidneys of rats exposed to mercury in the drinking water. Frozen sections from the kidneys were silver-enhanced and subsequently all organic material was removed by enzymatic digestion. The remaining pellet of silver grains was analyzed by proton-induced X-ray emission (PIXE) and mercury was demonstrated in an amount of 0.1-0.5% compared to silver. In addition, it was demonstrated that two pools of catalytic mercury compounds exist, probably corresponding to sulfide and selenium-bound mercury. PMID- 2778308 TI - Characterization of the cytoskeleton of isolated chick osteoclasts: effect of calcitonin. AB - We investigated the effects of calcitonin (CT) and parathyroid hormone (PTH) on the distribution of actin, tubulin, vimentin, and on cell size in cultured chick osteoclasts. In addition, we studied the effects of colchicine on intracellular acidity. Osteoclasts were isolated from the endosteum of 2-3-week chick tibias and were maintained under culture conditions for 5 days. The cells were treated with CT for 30 min or PTH for 60 min and were observed after immunocytochemical staining of cytoskeletal proteins. In untreated cells, actin was found in both a filamentous and a punctate staining pattern, with indented or invaginated regions free of punctate spots. The tubulin distribution in untreated cells was characterized by a pattern of microtubules radiating from the cell center and running parallel to the cell edge. Vimentin staining was usually localized to the perinuclear area. There were no changes in cytoskeletal element distribution or morphology attributable to PTH treatment. Osteoclasts treated with CT were more irregularly shaped, contained more retraction fibers, and were more rounded, with a denser array of cytoskeletal elements in the cell center. In addition, the mean area of the CT-treated cells was significantly less than that of the untreated cells. The actin distribution after CT treatment was still characterized by both a filamentous and a punctate pattern. After CT treatment, vimentin staining appeared more centrally localized than in untreated cells and tubulin staining revealed microtubules which now extended to the retracted cell margin. These results indicate that isolated osteoclasts respond to CT by significant morphological changes which are reflected in the distribution of the major cytoskeletal elements. Disruption of the microtubular system by colchicine treatment also resulted in an initial increase in intracellular acidity, suggesting the involvement of microtubules in the movement of acid-laden vesicles to the exterior. PMID- 2778310 TI - Acid giemsa technique for rapid identification of mitotic cells. AB - We developed a rapid technique for differential staining of compacted chromatin as a tool for screening of large tissue culture cell populations for mitotic cells. With a combination of acid Giemsa staining and counterstaining, differential staining of mitotic cells and classification according to stage of mitosis can be accomplished at magnifications as low as x 50-100 (objectives of x 5-10). The mapped and classified cells can then be de-stained and re-studied for DNA content by Feulgen staining and/or for uptake of radioactive DNA precursors by autoradiography. The staining and de-staining procedures outlined do not affect the reproducibility and accuracy of DNA content measurements or measurements of radioactive uptake. Therefore, this technique can be used for cell kinetic analysis by the percentage labeled mitoses method and for cytophotometric studies of mitotic segregation. PMID- 2778311 TI - Participation of the sympathetic nervous system in hypertension in rats with subtotal renal ablation. AB - To clarify the role of the sympathetic nervous system in the development of hypertension in chronic renal failure, plasma levels and urinary excretions of catecholamines were evaluated in male Sprague-Dawley rats. The renal mass of the rats was reduced by removing one kidney and two-thirds of the contralateral kidney (5/6 nephrectomy). Five-sixths nephrectomy was followed by significant increases in serum creatinine (to 0.55 +/- 0.03 mg/dl) and urea nitrogen (to 42.9 +/- 3.8 mg/dl). There was a concomitant increase in mean blood pressure, measured directly by an implanted aortic catheter, in comparison with control rats (155.3 +/- 8.3 versus 123.6 +/- 3.3 mmHg, P less than 0.01). Both plasma levels and urinary excretion of norepinephrine and epinephrine were elevated in the 5/6 nephrectomized rats compared with controls. Mean blood pressure correlated negatively with 24-h creatinine clearance (r = -0.66, P less than 0.05), and positively with plasma norepinephrine (r = 0.83, P less than 0.01) and urinary excretion of norepinephrine (r = 0.63, P less than 0.05). These results suggest that not only the decrease in renal function, but also hyperactivity of the sympathetic nervous system, may be involved in the pathogenesis of hypertension in rats with subtotal renal ablation. PMID- 2778313 TI - Potassium conductance and oscillatory contractions in tail arteries from genetically hypertensive rats. AB - Tail arteries isolated from the stroke-prone substrain of the spontaneously hypertensive rat (SHR-SP) exhibit oscillatory contractile responses to norepinephrine. Simultaneous recording of force generation and membrane potential (Em) has previously demonstrated that the contractile phase of these oscillations is associated with bursts of calcium-dependent action potentials. The smooth muscle cells are electrically quiescent during the relaxation phase of the oscillations. The present studies were designed to test the hypothesis that this quiescent period results from the stimulation of a calcium-activated potassium conductance (gKCa) in the cells responsible for triggering the bursting activity. Isolated tail artery strips from SHR-SP and Wistar-Kyoto rats (WKY) were prepared for measurement of isometric force generation or for simultaneous recording of force and Em. The channel-specific toxins apamin (4 x 10(-7) mol/l) and charybdotoxin (4.7 x 10(-8) did not alter the oscillatory pattern of contraction in response to norepinephrine. Oscillations were converted to sustained contraction by barium (10(-4) mmol), quinidine (5.8 x 10(-5) mmol) and elevation of extracellular potassium (20 mmol/l). Em recordings show that both potassium and barium convert bursting activity into tonic firing. Only 20 mmol/k+ caused significant depolarization in addition to that produced by norepinephrine. In contrast, quinidine appears to alter oscillatory behavior by interfering with calcium-spike generation. Norepinephrine-induced electrical activity is diminished in the presence of quinidine. These results suggest that potassium conductance plays an important role in controlling Em, electrical spiking and therefore oscillatory contractile activity in response to norepinephrine in the tail arteries of SHR-SP.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2778314 TI - Clinical evaluation of the Colin ABPM 630 at rest and during exercise: an ambulatory blood pressure monitor with gas-powered cuff inflation. AB - The Colin ABPM 630 is a silent, gas-powered (CO2) ambulatory blood pressure monitor which uses both ausculatory and/or oscillometric methods to measure blood pressure. We compared simultaneous, same-arm blood pressures obtained with the monitor with those made by two blinded, skilled clinicians using a mercury column and teaching stethoscope. In a second study, the monitor readings were also compared with opposite-arm intra-arterial recordings of blood pressure. The group mean systolic blood pressures obtained by the Colin monitor via the Korotkoff mode were almost identical to the mercury column readings (127.8 +/- 19.4 versus 128.1 +/- 19.3 mmHg, P = NS) and the limit of agreement (2 standard deviations) for the differences in the two methods was +/- 9 mmHg. The diastolic blood pressure obtained by the Colin monitor was significantly lower than the clinician's readings (-6.0 +/- 5.9 mmHg, P less than 0.0001). Similar findings were obtained with the oscillometric mode, however, the mean systolic blood pressure given by the monitor was slightly higher than that given by the mercury column (1.9 +/- 4.5 mmHg, P less than 0.001). In contrast to the mercury column comparisons, the mean diastolic blood pressure obtained with the monitor was nearly the same as the mean intra-arterial diastolic blood pressure for both the Korotkoff (0.1 +/- 5.6 mmHg) and the oscillometric modes (1.2 +/- 6.3 mmHg). During 100-watt bicycle exercise, there was a considerably greater scatter in the individual comparisons of the monitor and intra-arterial blood pressure than that seen in the measurements at rest, but the group means were again similar.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2778312 TI - Effects of complete renal denervation and selective afferent renal denervation on the hypertension induced by intrarenal norepinephrine infusion in conscious rats. AB - To test the hypothesis that continuous intrarenal norepinephrine (NE) infusions produce hypertension via activation of afferent renal nerves (ARN), rats were subjected to complete renal denervation (RN-x), selective renal deafferentation (ARN-x) or sham surgery, prior to infusion of NE. In the pre-infusion period, mean arterial pressure (MAP) was significantly lower in RN-x than in ARN-x or sham-operated rats. Plasma renin concentration (PRC) was significantly reduced following ARN-x, but not RN-x. During 5-day intrarenal infusions of 4, 12 or 36 micrograms NE/kg per h, MAP rose to similar levels in RN-x and sham-RN-x rats. However, RN-x rats exhibited significantly elevated PRC levels, suggesting that denervation supersensitivity masked the possible effects of RN-x. In sham-RN-x rats, MAP increased significantly more during intrarenal infusion of 12 micrograms NE/kg per h than during intravenous infusion of the same amount. In ARN-x rats, MAP rose to a similar degree during intravenous and intrarenal infusions. The pressor responses in the ARN-x rats, however, were not significantly smaller at any point than those in intact rats. PRC rose to comparable levels in ARN-x and intact rats. Thus, in normotensive rats, efferent renal nerves (ERN) but not ARN are of functional significance in maintaining basal blood pressure. ARN may be involved in the control of renin release. Since neither RN-x nor ARN-x attenuated the development of hypertension, renal nerves are not necessary for the full expression of hypertension in this model. PMID- 2778315 TI - Nexus junctions between vascular smooth muscle cells in the media of the thoracic aorta in normal and hypertensive rats. A freeze-fracture study. AB - Freeze-fracture electron microscopy and image analysis have been used to study the nexus junctions (NJ) between smooth muscle cells in the media of the thoracic aorta of normal and hypertensive Sprague-Dawley rats. The NJ found in both groups revealed particles on the P-face and depressions or pits in the E-face. Within each face, particle- or pit-free areas were identified in some junctions. NJ are usually surrounded by a narrow area devoid of particles and in certain fracture planes a close relationship of NJ with smooth endoplasmic reticulum was seen. Larger and more irregular NJ were found in the hypertensive group than in the controls. The differences observed in the hypertensive animals may be associated with an increase in tangential tension in the vessel wall. PMID- 2778316 TI - Two better cell lines for making hybridomas expressing specific T cell receptors. AB - Two variants of the AKR thymoma BW5147 have been isolated which can no longer express functional TCR alpha- and beta-chains. By generating hybridomas with these variant fusion lines, TCR of any normal T lymphocyte, including TCR gamma/delta, can be studied at a clonal level, without interference of the BW5147 derived receptor chains. In this study one of the variants has been useful in identifying the reactivity to allogeneic MHC Ag of BW5147 itself. PMID- 2778317 TI - Identification of an acidic ribosomal protein reactive with anti-Sm autoantibody. AB - Autoantibody to Sm Ag is a highly specific marker for the diagnosis of SLE. The Sm Ag exists in the cell nucleus as part of a ribonucleoprotein complex containing five small nuclear RNA. The major immunoreactive Sm species have been reported to be three polypeptides of m.w. 28,000/29,000 (B/B') and 16,000 (D). We report here that a m.w. 21,000 peptide is another major target of anti-Sm antibody. This peptide was originally identified by Western blotting as an acidic ribosomal protein (RP21) reactive with IgG from some SLE patients. Anti-RP21 is distinct from anti-ribosomal P protein antibody (anti-P) which has been previously identified as a lupus-specific autoantibody. Cell fractionation experiments showed that RP21 existed only in the ribosomal fraction and was never detected in other cellular compartments including nuclei. However, when nuclear extracts were used as Ag sources in immunoblotting, affinity-purified anti-RP21 was found to react with m.w. 28,000 and 16,000 peptides, suggesting that anti RP21 reactivity might be due to the cross-reaction of anti-Sm. This was further confirmed by the evidence that two kinds of murine anti-Sm mAb independently derived from MRL/lpr mouse recognized RP21. These results indicate that anti-Sm antibodies in SLE are reactive with both nuclear and ribosomal ribonucleoproteins. Previous reports have described certain similarities, i.e., antibody subclass restriction and incidence, of anti-Sm and anti-P in both humans and autoimmune mice. Our present study demonstrated a close physical association of target molecules reactive with anti-Sm and anti-P, and might, therefore, provide some clue to the origin of these two types of lupus-specific autoantibodies. PMID- 2778318 TI - Thrombospondin and fibronectin are synthesized by neutrophils in human inflammatory joint disease and in a rabbit model of in vivo neutrophil activation. AB - Using 35S-methionine metabolic labeling, we studied de novo synthesis and secretion of proteins by activated polymorphonuclear neutrophils (PMN) from two different sources. PMN isolated from inflammatory synovial fluid of patients with inflammatory joint disease were first analyzed. The protein synthetic activity of these cells was compared with that of nonactivated PMN isolated from the peripheral blood of the same patient. Similar studies were conducted on glycogen activated PMN from the peritoneal cavity of rabbits and results were compared with nonactivated peripheral blood PMN isolated from the same rabbit. Cells were labeled for a period of 16 to 20 h and supernatants were analyzed by one and two dimensional gel electrophoresis. In both models, the activated PMN showed a marked increase in the synthesis and secretion of thrombospondin as identified by immunoisolation with antibodies to this protein. The production of thrombospondin by activated cells paralleled a similar increase in production of another extracellular matrix and cell adhesion protein, fibronectin. The proportion of thrombospondin synthesis and secretion relative to total protein was approximately 1% in both human- and rabbit-activated PMN. For fibronectin, this proportion was in the 0.02% range. Although fibronectin mRNA accumulation in activated PMN could be demonstrated by Northern blots, we were not able to obtain similar results for thrombospondin mRNA. This could be caused by the rapid turnover of this transcript because it is known to contain an adenine uridine rich 3' untranslated sequence. We conclude that activated PMN are capable of producing thrombospondin. Furthermore, glycogen-activated rabbit peritoneal fluid PMN represent a valuable and relevant source of activated PMN for studying the protein synthetic events of these cells in the context of inflammation. PMID- 2778319 TI - Differential antigen presentation by cloned populations of mouse splenic macrophages. AB - Soft agar colonies of mouse splenic macrophages differ in their ability to process and present complex Ag to T cell hybridomas. To determine if the basis for this differential activity was the synthesis of molecules that might interfere with the activity of either the hybridoma or the indicator cells used for the bioassay of IL-2, culture supernatants were compared from Ag-presenting and nonpresenting cultures for their content of suppressor activity, using mitogen-treated mouse SC. No correlation was found between a colony's Ag presenting activity and its secretion of suppressor factors, nor did colonies unable to present Ag release factors that interfered with the detection of IL-2. In a second approach, paired subcultures from individual colonies were tested for their ability to present, to the same hybridoma, both native Ag and the "preprocessed" peptide of the Ag. The presentation of native Ag was restricted to the progeny of a minority of the cloned macrophage progenitors, but all of the progeny cultures presented the peptide. Together, these results suggest that the basis for differential Ag presentation may be in the manner in which the cloned macrophages degrade and process ingested Ag. PMID- 2778320 TI - MHC restriction of the antibody repertoire to secretory antigens, and a major allergen, of the nematode parasite Ascaris. AB - Humans vary considerably in the antigen specificity of their immune responses to parasitic nematodes, and in the infection loads of individuals living in the same environment. The possibility that the former has a genetic basis operating through repertoire control of the immune system was investigated using infection of mice with the nematode Ascaris. The specificity of the antibody response was examined using excretory/secretory (ES) materials of the parasite as target Ag. No strain of mouse was found to recognize all of the potentially antigenic components of ES, and the Ag recognition patterns varied considerably from strain to strain. Using H-2 congenic mice on both the BALB and B10 backgrounds, it was established that the antigen recognition patterns were MHC-determined. Focusing on one particular component of ES, of Mr 14,000, only H-2s strains responded in IgG. This MHC restriction of the repertoire was confined to infection, and broke down under adjuvant-assisted immunization with the purified protein. The Mr 14,000 molecule was also found to be a potent allergen in a passive cutaneous anaphylaxis assay, and the IgE response to it was also restricted to H-2s. This haplotype was, however, a low IgE responder on the SJL background. There is, therefore, MHC control of the specificity of the immune response to this molecule, but non-MHC control of the amplitude of the IgE antibody response to it. Hybrids between responder and nonresponder strains (BALB/c x SJL)F1, responded to the Mr 14,000, but their responses to other ES components could not be predicted from the response patterns of parental strains. For example, the BALB/c parent responded to a 118-kDa component, but the SJL parent and the F1 progeny did not. Moreover, the response to a 41-kDa Ag was substantially down regulated in the F1, whereas both parental strains responded vigorously. This new model system, therefore, has implications for MHC control of responses to the allergens of pathogens, and for the complex immunoregulation in heterozygotes in the context of infection. PMID- 2778322 TI - Surgeon, surgery and clinical research. PMID- 2778321 TI - Rat natural killer cells synthesize fibronectin. Possible involvement in the cytotoxic function. AB - The ability of NK cells to synthesize and secrete fibronectin (FN), an extracellular matrix glycoprotein which plays a key role in many biologic processes including cellular adhesion, morphology, cytoskeletal organization, cell migration, and invasiveness, was studied. By using affinity-purified polyclonal antibodies directed against human cellular or plasma FN, the presence of FN was evidentiated on Percoll-purified rat large granular lymphocyte or on a large granular lymphocyte tumor cell line (CRC) by flow cytometry and immunoelectron microscopy. Its expression increased after NK cell activation by poly I:C administration. Biochemical analysis by immunoprecipitation and SDS-PAGE indicated that FN was associated to cell surface and secreted in the supernatant in a molecular form similar to that of FN from L929 fibroblasts. In an attempt to understand the role of FN in the NK cell function, we found that an antibody against human plasma FN and its F(ab')2 fragment inhibited NK cytotoxicity against YAC-1 target at the effector cell level. Inhibition occurred at the postbinding level, because F(ab')2 anti-FN inhibited induction of phosphatidylinositol hydrolysis by YAC-1 target cells, whereas binding to target cells was not affected. The possible role of FN in the NK cytotoxic function is suggested. PMID- 2778323 TI - Pregnancy outcome in short statured women. AB - Three hundred and forty short statured mothers (height less than 145 cm) were compared with 680 mothers (height more than 145 cm) who served as control to isolate problems associated with pregnancy and labour in the former. Short statured mothers hailed from poorer social class and had an unhealthy family and past history and higher incidence of pelvic deformities and abnormal presentations. They had a lower possibility of delivering vaginally and higher incidence of instrumental deliveries. Their offsprings were likely to be less in weight and suffered from a significantly higher incidence of stillbirth and neonatal death. All this made a short statured mother a high-risk patient. PMID- 2778324 TI - Ketamine-diazepam anaesthesia in surface and major plastic surgical operations. AB - Ketamine hydrochloride seems to be equally suitable for surface and major plastic surgical operations where controlled ventilation is required. Controlled ventilation performed by less amount of muscle relaxant where patients were ventilated with air only sparing the O2 and N2O. Fifty patients undergoing various operations including major plastic surgery were divided into two groups. In group A, an infusion of 500 mg ketamine hydrochloride, 20 mg diazepam in 500 ml of 5% dextrose was used as anaesthetic and in group B, the same drip was started and pancuronium bromide 0.08 mg/kg IV was given when eyelash reflexes were lost. Mean durations of anaesthesia were 70.4 minutes and 90.2 minutes in groups A and B respectively. Mean doses of ketamine hydrochloride required were 310 mg and 370 mg in groups A and B respectively. Decurarisation was done in usual way in group B patients. The induction, maintenance and recovery were smooth and uneventful in all cases. Moreover no difficulty was encountered in reversing residual curarisation in any of the patients in group B. Mean rise of systolic BP was 12.5 mm Hg and that of pulse rate was 20/minute in group A. In group B, mean rise of systolic BP was 10 mm Hg and that of pulse rate was 16/minute. PMID- 2778325 TI - Unusual cavernous haemangioma. PMID- 2778327 TI - Unethical. PMID- 2778328 TI - 'Perestroika' in IMA. PMID- 2778326 TI - Admission to postgraduate courses: methodology for conducting MCQ type evaluation. PMID- 2778329 TI - Effect of exercise stress on the bronchospastic response of asthmatics in remission. AB - Twenty asthmatics in remission phase were subjected to exercise stress by running on level ground for 6 minutes and the degree of airway obstruction was measured by a peak flowmeter. The response was compared to 20 normal healthy volunteers. The prevalence of exercise induced asthma (EIA) was observed to be 75% among the asthmatics with male preponderance. A 100% response was seen in asthmatics of more than 25 years age. EIA was more, and so was the degree of response, as the duration of illness increased. The maximal fall in PEFR from its basal value was seen in the 6th minute after stopping the exercise in majority of the cases. No positive response was observed among the healthy controls. PMID- 2778331 TI - Prognostic significance of exercise testing three weeks after myocardial infarction. AB - Treadmill exercise test was performed in 50 patients aged 35-60 years, 3 weeks after myocardial infarction. Thirty-two had anterior and 18 had inferior wall transmural myocardial infarction. Cardiac events like angina, reinfarction and sudden death were more common in patients with positive stress test. Thus treadmill testing in the early postinfarction period is of great prognostic value. PMID- 2778330 TI - Significance of serum leucine aminopeptidase in tumours of female genital tract. AB - Serum leucine aminopeptidase (LAP) was estimated in 57 female patients with tumours of the genital tract and compared with 50 age-matched controls. Serum LAP was increased in leiomyomas (p less than 0.01) but significant rise was seen in leiomyosarcomas and endometrial carcinoma of the uterus (p less than 0.001). No increase in serum LAP level, above mean control value was observed in carcinoma of cervix. LAP levels were also increased in cystadenomas of the ovary (p less than 0.01) and highly significant increase, noted in cystadenocarcinomas and dysgerminoma stage III (p less than 0.001). However, no increase of enzyme activity was observed in poorly differentiated papillary carcinoma of the ovary. The serum enzyme level was higher in cystadenocarcinomas as compared to solid ovarian carcinomas in the same clinical stage. PMID- 2778332 TI - Experience with danazol in the treatment of advanced breast cancer. AB - Danazol, a known effective agent for the treatment of benign breast disease and in endometriosis, was used in cases of advanced breast cancer with metastasis in bone, lung or in soft tissues. Out of 17 patients who received danazol, only 4 (23%) responded well. Postmenopausal patients responded better than premenopausal. Three out of the 4 responder received full course of radiotherapy and chemotherapy prior to danazol treatment. Out of the 13 non-responders, treatment could not be continued in 10 patients, either due to inability to meet up with the recurrent expenses of the cost of drugs or the patient was lost to follow-up or due to death. The rest 3 patients did not show any response at all to this drug, among them 2 were premenopausal. PMID- 2778333 TI - Rupture of the uterus with expulsion of the foetus. PMID- 2778334 TI - Liver function tests in cholecystitis. PMID- 2778335 TI - Problems of rural surgical practice. PMID- 2778336 TI - Management of acute diarrhoeas in children in rural areas. PMID- 2778337 TI - Expression of ABH, Lewis and related tissue antigens in the human thymus. AB - Expression of ABH, Lewis and related antigens was studied in the thymus of children of known ABO, Lewis and secretor status using a panel of specific reagents. ABH and Lewis antigens partly under control of the secretor status were expressed on the Hassals' bodies and a large fraction of the medullary epithelial cells. The sialyl-Lea antigen was only present on some Hassals' bodies of Lewis positive individuals. ABH but not Lewis antigens were also present on cortical epithelial cells but this was independent of the secretor status. The X, sialyl-X and Y antigens were only expressed on Hassals' bodies irrespective of the ABO, Lewis or secretor phenotype. Furthermore, the anti-X and sialyl-X antibodies labelled a subset of leucocytes of all the individuals tested. These results show that the genetic control of the expression of ABH and Lewis glycosidic tissue alloantigens in the thymus is different on cortical and medullary epithelial cells and stress the heterogeneity of the thymus epithelial cells. PMID- 2778339 TI - The first ten years--self-inflicted epidemics. PMID- 2778338 TI - The influence of the BoLA-A locus on reproductive traits in cattle. AB - Associations between the major histocompatibility complex (MHC) and reproductive performance have been reported in humans, mice, rats, pigs and chickens. Only the A locus of the bovine major histocompatibility complex (BoLA-A) has been well characterized, and 42 alleles of this locus have been identified in American cattle. Four studies were conducted to examine the association between alleles of the BoLA-A locus and reproductive performance. Testis size, which is an indicator of early puberty and increased fertility in young bulls, was examined in 440 yearling bulls from nine breeds with a gene substitution model that included the effects of breed, sire, age of dam and age or weight of the bull. Estimated breeding value for twinning was examined with a gene substitution model with 204 cattle from a herd with a high frequency of twinning. Fertility of potential partners having BoLA-A locus alleles in common was examined in a prospective study involving 101 pure-bred Hereford cows mated by artificial insemination to four pure-bred Hereford bulls. The effect of homozygosity on birth weight, preweaning weight gain and post-weaning weight gain was estimated in a sample of 683 calves from nine breeds; 22% of the calves were apparently homozygous and 78% were heterozygous at the BoLA-A locus. There were significant and large effects of some BoLA-A locus alleles on paired testicular volume, but the analyses on the other traits did not show significant associations. Substitution of the W6.1 allele for the W9A allele reduced paired testicular volume by 150 +/- 44 cm3. The W6.1 allele has now been shown to influence a reproductive trait, a production trait and susceptibility to an economically important disease. Selection for these traits may influence the frequency of the large number of alleles at the BoLA-A locus. PMID- 2778340 TI - Bottle-feeding can prevent transmission of HTLV-I from mothers to their babies. AB - Breast-feeding is a major factor in the vertical transmission of human T lymphotropic virus type I (HTLV-I). We studied whether such transmission may be prevented by bottle-feeding. HTLV-I infection was detected by both HTLV-I antigen and antibody tests. Thirty bottle-fed babies were examined 24 months after birth; only one was found to be HTLV-I antigen-positive. This infection rate was lower than that for breast-fed babies in whom HTLV-I antigen was detected in 24 of the 31 24-month-old babies born to HTLV-I positive mothers in a previous study. These results suggest that most vertical transmission of HTLV-I is attributable to breast-feeding and can be prevented by bottle-feeding. PMID- 2778341 TI - Experimental infection of baboons (Papio cynocephalus anubis) with Chlamydia pneumoniae strain 'TWAR'. AB - Two infant baboons (Papio cynocephalus anubis) were inoculated with Chlamydia pneumoniae strain 'TWAR', one in the conjunctiva, nasopharynx and oropharynx, the other in the trachea. Both remained well during 8 weeks of observation. C. pneumoniae infection persisted for at least 8 weeks after inoculation. Chlamydia pneumoniae seems to be of low virulence in baboons and capable of causing chronic infection. PMID- 2778343 TI - Cavitating pneumonia due to Trichosporon beigelii in a patient with acute myeloid leukaemia. AB - A 21-year-old man with acute myeloid leukaemia developed cavitating pneumonia while neutropenic and on broad spectrum antibiotics following induction chemotherapy. Trichosporon beigelii was isolated from several samples of sputum. He was successfully treated with amphotericin B. Previous reports of lung infection with this organism are reviewed. PMID- 2778342 TI - Infectious mononucleosis with acute thrombocytopenia. AB - Three cases of severe acute thrombocytopenia complicating infectious mononucleosis are described. Although spontaneous remission may be a feature of this rare complication, in each of these cases steroid therapy resulted in a rapid rise in the platelet count. PMID- 2778344 TI - Meningitis due to Streptococcus mitis cross-reacting with Streptococcus pneumoniae. PMID- 2778345 TI - Infective sacroiliac arthritis and psoas abscess caused by Streptococcus milleri. PMID- 2778346 TI - Mycobacterium malmoense infection presenting as a mediastinal mass in a child. PMID- 2778347 TI - Disseminated penicilliosis associated with HIV infection. PMID- 2778348 TI - Idiosyncratic reaction to nebulised ribavirin in an artificially ventilated neonate. PMID- 2778349 TI - Antigen-presenting cells in the induction of contact hypersensitivity in mice: evidence that Langerhans cells are sufficient but not required. AB - One explanation for the fact that certain genetically defined strains of mice prove to be resistant to effects of low dose ultraviolet B radiation on the induction of contact hypersensitivity is that ultraviolet B resistant mice possess a second pathway for antigen presentation through the skin--a pathway that is independent of epidermal Langerhans cells and beyond the reach of the damaging effects of ultraviolet B light. As a corollary, ultraviolet-B susceptible mice would be expected to be deficient in this pathway. Several experimental strategies were employed to determine whether Langerhans cells are required for the induction of contact hypersensitivity by epicutaneously applied hapten. The results reveal that tape-stripped skin supports the induction of contact hypersensitivity, whereas surgical excision of hapten-painted skin within 1 h of application fails to permit the development of contact hypersensitivity. Because the former selectively eliminates epidermal Langerhans cells while the latter deletes both Langerhans cells and dermal antigen-presenting cells, we conclude that either Langerhans cells or dermal cells are sufficient to provide antigen presentation in the induction of contact hypersensitivity. When large amounts of hapten are painted epicutaneously, or when hapten is injected subcutaneously or painted on sub-dermal tissues, contact hypersensitivity also results, indicating that induction of contact hypersensitivity does not require that antigen processing and presentation be provided by cutaneous cells. Reasons are presented for concluding that under physiologic circumstances induction of contact hypersensitivity by epicutaneous hapten application relies primarily upon the antigen-presenting capabilities of epidermal (Langerhans cells) and dermal cells. PMID- 2778352 TI - Reduced superoxide dismutase activity in xeroderma pigmentosum fibroblasts. AB - This study was performed in order to assess the possible protective effect of superoxide dismutase (SOD) on ultraviolet (UV) damage in xeroderma pigmentosum (XP) fibroblasts. SOD activity in fibroblasts originating from seven xeroderma pigmentosum (XP) patients was significantly lower than that in normal cells (p less than 0.005). Average SOD activity in XP cells belonging to complementation group A was 3.68 +/- 0.54 (n = 7) and that in normal human cells was 5.79 +/- 1.59 (n = 6). Addition of SOD before and during UV irradiation (UVB and UVC) to the cells caused no change in the amount of unscheduled DNA synthesis and UV survival. A possible involvement of reduced SOD in XP and a possible protective effect by SOD on UV damage is discussed. PMID- 2778351 TI - Abnormal proliferation and aging of cultured fibroblasts from pigs with subcutaneous fibrosis induced by gamma irradiation. AB - In vivo, fibrotic disorders, which may be due either to injury or disease, are characterized by overproliferation of fibroblasts and overproduction of connective tissue. In vitro, however, most of the fibrotic cell lines studied exhibited no differences in growth potential compared with control cell lines derived from normal skin. In the present study, we investigated the in vitro behavior of fibroblasts derived from pigs with subcutaneous fibrosis induced by gamma irradiation. The cells were isolated from the scar tissue six to 20 months after irradiation. In primary cultures, the cells derived from the fibrotic lesions exhibited greater attachment efficiency and faster proliferation than those of the cells derived from the normal skin of the same animal. In long-term cultures, the differences between normal and fibrotic cells were still greater: the normal skin cells underwent 17 population doublings and then died, whereas the fibrotic cells exhibited a prolonged lifespan, and were still actively proliferating after 80 population doublings. Cell morphology and the number of chromosomes were modified throughout subcultures. These results imply that in the scar tissue active fibrotic cell proliferation continued for years after irradiation and that this activation was expressed in vitro. Therefore, in this pig fibrosis model, the data acquired in the present in vitro studies closely resemble that obtained from earlier in vivo observations. PMID- 2778350 TI - Ultrastructural studies of acantholysis induced in vivo by passive transfer of IgG from endemic pemphigus foliaceus (Fogo Selvagem). AB - Intraperitoneal (IP) injections of IgG from patients with Endemic Pemphigus Foliaceus [Fogo Selvagem (FS)] cause acantholysis in BALB/c mice (JID. 85:538, 1985). The dynamic ultrastructural changes of FS IgG-induced acantholysis in mice are the subject of this study. FS IgG was injected IP into neonatal BALB/c mice. Skin and serum was studied at 0, 1, 3, 6, 12, 18, and 24 h post injection by immunofluorescence (IF), electron microscopy (EM), and immuno-EM. Binding of FS IgG in the intercellular spaces (ICS) of the basal cell layer was seen by IF within 1 h and was strongest at 12 h. IgG binding affected the spinous and granular cell layer by 12 h, then faded and remain localized only in the basal cell layer at 24 h. By immuno-EM, IgG binding was diffuse along the keratinocyte surface. Edema of the ICS in the basal cell layer was present at 1 h by EM. At 12 h, there was microvillous formation with intact desmosomes at the tip of the projections. Splitting of desmosomes (forming half desmosomes) and acantholysis primarily affecting the granular cell layer were most prominent between 12 and 24 h. The plaques of the half desmosomes gradually disappeared and tonofilaments retracted into the cytoplasm. Detaching keratinocytes showed vacuolization, swollen mitochondria, and internalization of intact desmosomes and half desmosomes (remnants of split desmosomes). This investigation shows that the ultrastructural changes observed in the epidermis of patients with FS can be duplicated in experimental animals by IP injection of FS IgG. Further, FS IgG may have direct effects on the assembly/disassembly of desmosomes. PMID- 2778353 TI - Psychotropic adjuvant analgesic drugs for cancer pain. AB - Narcotic analgesics are the mainstay of pharmacological interventions for cancer pain. There is however growing awareness that psychotropic drugs, in particular the antidepressants, are useful adjuvant analgesic agents in the management of cancer pain. In addition many of these drugs are important in the treatment of psychiatric complications of cancer. Unfortunately cancer patients with pain are most vulnerable to such problems as depression, anxiety and delirium. For the clinician who wants to provide comprehensive management of cancer pain, familiarity with the indications and usefulness of psychotropic drugs will be most rewarding. PMID- 2778354 TI - Use of methylphenidate as an adjuvant to narcotic analgesics in patients with advanced cancer. PMID- 2778355 TI - Victories and losses on the cancer pain front. PMID- 2778356 TI - Prophylactic benztropine for antiemetic precipitated extrapyramidal symptoms during cancer chemotherapy. PMID- 2778357 TI - Cancer pain relief in Paraiba, Brazil. PMID- 2778358 TI - Influence of the pain and symptom control team (PSCT) on the patterns of treatment of pain and other symptoms in a cancer center. AB - To assess the influence of a pain and symptom control team on the pattern of prescription of pharmacologic and nonpharmacologic treatments for cancer pain, we reviewed the charts of 100 consecutive patients admitted to the Cross Cancer Institute during 1987 and 100 patients admitted during 1984. The average daily dose of parenteral morphine per patient was 44 +/- 26 mg in 1987 versus 34 +/- 38 mg in 1984 (p less than 0.05). In 1987 and 1984, only 31 and 22% of the analgesics were ordered around the clock respectively (P:NS). Approximately half of the patients in 1987 and 1984 were prescribed antiemetics and two-thirds of the patients were prescribed laxatives. Parenteral narcotics were prescribed subcutaneously in 0/52 cases in 1984 versus 21/63 cases in 1987 (33%, p less than 0.01). The pattern of prescription of narcotics by residents changed significantly during the last four weeks of rotation as compared to the first four weeks. We conclude that there have been some changes in the modality of treatment of pain that are probably due to changes in the pattern of prescription by the residents and continued improvement in assessment of pain by nurses. However, in several areas of treatment the impact of a pain and symptom control team remains minimal. PMID- 2778359 TI - Effects of biofeedback on childbirth pain. AB - A study of the effects of biofeedback on the pain of childbirth was conducted. Forty primigravidae were randomly assigned to either an experimental group or a control group. The experimental group was given a series of training sessions in biofeedback and used biofeedback equipment during labor. All subjects were monitored during the labor and delivery period for their reports of pain using a visual analogue scale (VAS) and a verbal descriptor scale (VDS). Results showed that women using biofeedback during childbirth reported significantly lower pain: from admission to labor and delivery (p less than 0.05:VDS; p less than 0.01:VAS), at delivery (p less than 0.005:VDS), and 24-hr postpartum (p less than 0.01:VDS). Also, women in the biofeedback group labored an average of 2 hr less and used 30% fewer medications. The results of this study suggest that EMG biofeedback may be effective in reducing levels of acute pain experienced by childbearing women. PMID- 2778361 TI - Experience with oral morphine for cancer pain relief. AB - The authors report a prospective survey of 88 patients with cancer pain who were treated with oral morphine solution during a period of 140 days at the Pain Relief Unit, Kidwai Memorial Institute of Oncology, Bangalore. A high percentage of pain relief was achieved at the end of the first week of titrated therapy; relief was maintained at satisfactory levels throughout the study period in a majority of patients (86%). Interruption of oral morphine administration was necessitated by intractable vomiting in two patients. The majority of patients (65%) did not manifest any side effects, and appropriate medication successfully managed those who did. Oral morphine therapy for cancer pain offers effective pain relief with minimal side effects in the majority of patients. PMID- 2778360 TI - Clinical observations on controlled-release morphine in cancer pain. AB - The authors report the data from two studies on the use of controlled-release morphine sulphate tablets for cancer pain relief. This preparation allows just two administrations per day, in comparison with immediate release oral aqueous morphine solution. The first study, a randomized trial carried out on 70 patients suffering from advanced cancer pain, evaluated the analgesic efficacy and side effects of this drug. The second, an open study of 113 patients, assessed analgesic efficacy, incidence of side effects, and the effects of age on dose. The analgesia provided by controlled-release morphine administration proved to be superimposable to those of the oral aqueous morphine solution. Moreover, the use of controlled-release morphine was associated with a statistically significant reduction of some side effects. Ninety-one percent of patients needed controlled release morphine every 12 hr, while 9% required it every 8 hr. PMID- 2778362 TI - Cancer pain management with a controlled-release oral morphine preparation. AB - An open-label pilot study was conducted to assess the efficacy and acceptability of a controlled-release oral morphine formulation, MS Contin tablets, when administered "by the clock" two to three times daily as a substitute for opioids given on request to patients with pain caused by advanced cancer. Initially, four hourly does of standard "immediate-release" oral morphine sulfate tablets were substituted for the patients' prior analgesic medication and titrated to individual needs. Forty of the 47 patients enrolled in the study were subsequently switched to an eight-hourly MS Contin regimen (three patients became too ill to continue the study, and four left the study during the immediate release titration phase because of adverse reactions that may have been drug related). Small "rescue" doses of standard oral morphine were available to the patients, but they were taken infrequently. Twenty-one of the 37 patients maintained on the eight-hourly schedule consented to be treated with, and were subsequently stabilized on, MS Contin administered every 12 hr, with a reduction of over 20% in their average daily morphine dose. Most of the patients rated the controlled-release medication superior to the standard oral morphine tablets in terms of both convenience and adequacy of relief. PMID- 2778363 TI - Sickness impact profile: a measure of dysfunction with chronic pain patients. AB - Although chronic pain may affect all facets of a patient's life, there is no generally accepted method of measuring the extent of the disability experienced. This component of a larger study examined changes in usual activities and relationships for patients experiencing chronic nonmalignant pain, in order to understand the impact of pain on an individual's life. The effect of pain intensity and depression on the performance of usual daily activities was assessed by the Sickness Impact Profile (SIP). The sample of 34 subjects, 17 women and 17 men, rated their pain as moderate to severe on a linear analogue scale (mean 64). Thirty percent of subjects were moderately to severely depressed as measured by the Beck Depression Inventory (mean 21). The SIP scores indicated severe disruption in daily activities and relationships for this sample. Significant correlations between the SIP and visual analogue scales measuring coping adequacy and activity levels were interesting and warrant further study. PMID- 2778364 TI - Measurement of nausea. PMID- 2778365 TI - Management of postoperative pain in patients on methadone maintenance. PMID- 2778366 TI - Autonomic failure in patients with advanced cancer. PMID- 2778367 TI - Rate and time distribution of relapses in multibacillary leprosy. AB - Of the 47,068 patients registered in the Polambakkam Leprosy Center between 1955 and 1982, we selected 1886 cases having shown bacteriological positivity at any time during this period, whatever their classifications at registration, and subsequently found bacteriologically negative. After an average follow-up period of 10 years, 243 relapses were observed, giving a crude relapse rate of 12.8 per person-years of observation and a cumulative probability of relapse of 18.9%. Relapse rates were found to be dependent on regularity during smear-positive and negative periods; a regularity greater than 75% in the smear-positive period proved to be particularly important. The results show no evidence that relapses occurring after 3 years of negativity could be reinfections, and that the relapse rate was still affected by regularity 7 years after negativation. The median delay of relapses was found to be 4.4 years and was not affected by the regularity of treatment. PMID- 2778368 TI - Short-term multidrug therapy in multibacillary leprosy--review of 80 cases in two provinces of China (1983-1988). AB - Thirty-three active multibacillary patients from nine counties of Weifang Prefecture, Shandong Province, and 47 active cases from Menla County, Yunnan Province, People's Republic of China, were treated with 24 and 27 months of multidrug therapy (MDT), respectively, in 1983. Clinical assessments, smears, and histopathologic examinations were carried out independently by study teams from the Institutes of Dermatology of these two provinces. Reexaminations at 12-14 months and at termination of therapy showed marked improvement, and there was continued improvement at 12-18 and 33 months on follow up. Conversion of the bacterial index to negativity was 0/33, 5/47 for the patients from Shandong and Yunnan provinces, respectively, at the end of MDT and 2/33 at 12 months' and 17/47 at 18 months' follow up, which increased to 21/33 and 26/44 at 33 months' follow up. Regression of specific infiltration was about 21%-100% after 24-27 months of MDT; further regression to 95%-100% occurred at 33 months' follow up. PMID- 2778369 TI - Serum lactate dehydrogenase in murine leprosy: source and isozymes. AB - The bulk of the lactate dehydrogenase (LDH) that increases in the serum of mice infected with Mycobacterium lepraemurium (MLM) derives from the liver and corresponds to the isozyme V. MLM-induced granulomas continuously arise in the liver and steadily increase in size until the animal's death. Growing granulomas push the adjacent hepatocytes away and cause them to disrupt and to release their cytoplasmic contents, including LDH. The LDH is then picked up by the infiltrating phagocytes and/or admixed with the circulating blood. Other LDH containing organs (including the testis with its additional isozyme LDH-X) in the infected or normal animals do not seem to significantly contribute to the serum levels of LDH. The study of the liver-associated histochemical and biochemical changes in this controlled model of murine leprosy allows us to gain insight into the overall pathology of this mycobacteriosis. In some respects this sheds light on the liver involvement in human leprosy; a subject on which results of all sorts have been published. PMID- 2778370 TI - Impact of MDT on incidence rates of leprosy among household contacts. Part 1. Baseline data. AB - This preliminary study from Gudiyatham Taluk, the leprosy control area of the Schieffelin Leprosy Research & Training Centre, investigated the incidence rates of leprosy among household contacts during the period 1970-1985. The incidence rates of leprosy among the household contacts prior to and during the initiation of multi-drug therapy are presented here. The overall incidence rate among the household contacts was 4 per 1000 person-years at risk. Contacts of multibacillary and paucibacillary cases had a relative risk of 3-6 times and 2-4 times the risk of leprosy in the general population, respectively. The incidence rates among children were higher than adults; the peak age-specific incidence rate was between 5-9 years, and nearly one third of the primary cases were children. These findings are presented and the methodological issues discussed. PMID- 2778371 TI - Demonstration of antidapsone antibody in leprosy patients. PMID- 2778372 TI - [Surgical treatment of renal cell carcinoma associated with pulmonary metastasis]. AB - Fifty-nine nephrectomies have been performed in patients with renal cell carcinoma during a 15-year-period from 1973 to 1987 in Fukuoka University Hospital. Of whom 13 had pulmonary metastasis and 10 had other organ metastasis. The 1, 3, 5-year survival rates in patients with metastasis were significantly worse than those without metastasis. No significant difference was observed between the survival rates in patients with pulmonary metastasis and other organ metastasis. Only 1-year-survival rate was better in patients with delayed metastasis after nephrectomy than that of patients with synchronous lung metastasis to the primary tumor. Resection of pulmonary metastasis was performed in 6 patients. Four of them, however, underwent another resection for recurrence in the lung. The average survival periods of the patients with and without surgical removal of pulmonary metastasis were almost same in the alive cases, but in the dead cases there was observed a 26-month-longer survival period in patients undergoing resection of metastatic lesion than those without resection. In conclusion, resection of pulmonary metastasis may not bring eradication of the disease in the majority of cases. However, aggressive surgery for pulmonary metastasis should be accepted because no effective adjuvant therapy is practically available in the treatment of renal cell carcinoma. Additionally, a case was reported of spontaneous regression of a pulmonary metastasis seen in a 61-year-old male with renal carcinoma. The lesion showed an apparent regression after radical nephrectomy on chest films and completely disappeared at 8 months postoperatively. After 9 months disease-free period, heterotopic recurrence developed in the same lung.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2778374 TI - [Effect of remission induction chemotherapy on blood coagulability in patients with gynecological malignancies]. AB - In 12 patients (38 courses) with gynecological malignancies who had been treated with remission induction chemotherapy, we measured the levels of ESR, Platelet, PT, APTT, Hepa T, AT III, alpha 2 PI, FDP and D-dimer, and we also measured such molecular markers as Fibrinopeptide A (FPA), Fibrinopeptide B beta 1-42 (FPB beta 1-42), and Fibrinopeptide B beta 15-42 (FPB beta 15-42) before and after chemotherapy. Then the relation between the post chemotherapeutic trends and prognosis for patient with gynecological malignancies were investigated. 1) Before chemotherapy, the levels of ESR, FDP, D-dimer and FPB beta 1-42 were increased, PT and APTT were shortened significantly in cases on groups IIIrd and IVth stage compared with in cases on groups Ist and IInd stage (p less than 0.05). The levels of FPA were also high, but there was no significant differences. The levels of FPB beta 15-42 were almost same in both groups. However, the each markers indicated the existence of chronic DIC in cases of group IIIrd and IVth stage. 2) One week after chemotherapy, the levels of ESR, fibrinogen, FDP and FPA were decreased, while FPB beta 1-42 and FPB beta 15-42 were increased, suggesting elevated fibrinolytic activity. Two weeks after chemotherapy, there was stronger tendency to coagulation dominant again, but it was only temporary. Three weeks after chemotherapy, the hemostatic balance was regained. 3) In patient with complete remission after effective chemotherapy, their coagulability data were showed within normal range, however, some cases with poor prognosis were not able to obtain the recovery of hemostatic balance, and the levels of molecular markers were significantly elevated. Coagulative activity was more enhanced than fibrinolytic activity in patients with progressive gynecological malignancies, but hemostatic balance was maintained clinically. The hemostatic balance was disrupted by the chemotherapy, but this balance was regained for the IIIrd week. Accordingly, the recovery of hemostatic balance with effective chemotherapy is related to the prognosis for patients with gynecological malignancies, and the levels of molecular markers may be able to expect the prognosis for patients. PMID- 2778376 TI - [Abstracts of the twenty-sixth meeting of the Japan Society for Cancer Therapy]. PMID- 2778375 TI - [Response of human lymphocytes to phytohemagglutinin (PHA) as measured by fluorescence polarization technique--differences between malignant conditions and benign or healthy conditions]. AB - Percoll gradient (density: 1.081 g/cm3) centrifugation of peripheral venous blood yielded two layers of mononuclear cells. Preliminary study using lower lymphocyte layer revealed that there were significant differences in lymphocyte fluorescence polarization changes after PHA stimulation between malignant conditions and benign or healthy conditions, while such differences were not apparent by use of upper lymphocyte layer. According to these preliminary results, we studied fluorescence polarization changes after PHA stimulation in lower lymphocyte layer obtained from 242 individuals, including 49 apparently healthy women, 93 patients with benign gynecological tumor, 17 patients with severe dysplasia of the uterine cervix and 83 patients with malignant gynecological tumor. Stimulation index (R) was defined as the ratio between the degree of polarization before PHA stimulation (P CONTROL) and the degree of polarization after PHA stimulation (PPHA): R = PPHA/PCONTROL. R values of less than unity (R less than 1) indicate stimulation with PHA, and R values of greater than unity (R greater than or equal to 1), non-stimulation with PHA, respectively. R values of less than unity (R less than 1) was found in 118 of 142 (83.1%) healthy women or patients with benign tumor, 5 of 17 (29.4%) patients with cervical dysplasia, and 13 of 83 (15.7%) patients with malignant tumor, respectively. Preoperative R values of greater than unity decreased to R values of less than unity in 17 of 20 (85.0%) patients who received complete resection of the malignant lesion, while decline of R values was noted only in 8 of 22 (36.4%) patients who received incomplete resection of the lesion and/or chemotherapy or radiation. Present findings indicate that fluorescence polarization changes after PHA stimulation in lymphocytes isolated by Percoll gradient facilitate feasible detection of various malignancies.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2778373 TI - [Clinical significance of bone scintigraphy for early detection of bone metastasis from breast cancer]. AB - Forty four patients, presenting metastasis only to bone from a primary breast cancer previously undergone mastectomy from 1975 to 1985 at Kinki University Hospital, were investigated for the purpose of early detection of bone metastasis. Clinical follow up and bone scintigraphy at regular interval were the most important to detect the early phase of bone metastasis. The patients with early phase of bone metastasis, detected by regular scintigraphy in every 6 months, had the frequent metastatic lesions in rib and sternum as well as lumbar. These metastatic lesions could not be found by X-ray examination but were confirmed by aspiration cytology. Among the tumor markers, Al-p and LDH, rather than CEA and Ca, were more useful for the diagnosis of early phase of bone metastasis. PMID- 2778377 TI - [Hazard ratio estimated from a proportional hazard model including two strongly correlated prognostic factors]. AB - Estimates of hazard ratio from hypothetical survival data were examined, under the condition that the survival is affected by two prognostic factors X1 and X2 with two discrete values (0, 1) which are strongly correlated. Survival curves from the data were assumed to fit an exponential function. As an example, following numbers of subjects were used; 100 cases with X1 = 0 and X2 = 0, 10 cases with X1 = 1 and X2 = 0, 10 cases with X1 = 0 and X2 = 1, and 100 cases with X1 = 1 and X2 = 1. When the hazard ratio of X1 = 1 or X2 = 1 to X1 = 0 and X2 = 0 was 3, univariate analysis gave reasonable estimates around 3. Under the same condition, estimates of hazard ratio from multivariate analysis including the two variables X1 and X2 varied widely, depending on the survivals of 20 cases with X1 = 1 X2 = 0 or X1 = 0 X2 = 1. Probability of having extremely deviated estimates was demonstrated. The result illustrated successfully some points we should take into account when proportional hazard models including strongly correlated variables are applied. PMID- 2778378 TI - [Potent effects of the prostaglandin synthesis inhibitor indomethacin on the cellular immune response in gastrointestinal cancer patients]. AB - An increased level of prostaglandin E2, which is produced in carcinoma tissue, has been suggested to be involved in immunosuppression in cancer patients. This study examines the hypothesis in which the inhibition of prostaglandin production by a nonsteroidal anti-inflammatory agent, indomethacin, could modulate cancer induced cellular immunosuppression. The experimental results demonstrated (i) a restoration of cellular immune reaction (NK activity of spleen monocytes) followed by tumor regression in subcutaneously transplanted colon adenocarcinoma 26-bearing BALB/c mice, which received 0.002% water solution as drinking water from day 0 or 7 of tumor transplantation, compared with indomethacin-untreated mice, (ii) an improved cellular immune response (PHA-and Con A-augmented lymphocyte blastogenesis, NK activity and LAK activity of peripheral venous blood monocytes) in 19 stomach cancer and 11 colorectal cancer patients before surgery, who received a daily oral dose of 75 mg indomethacin for 7 days, and in 8 colorectal cancer patients after curative surgery, who received a daily oral dose of 600 mg tegafur and 50 mg indomethacin for 1 month or longer, compared to patients without indomethacin treatment. It suggests, therefore, that the prostaglandin synthesis inhibitor, indomethacin, may restore cellular immunity, and may provide a good therapeutic tool against cancer of the gastrointestinal tract. PMID- 2778379 TI - [Effects of photodynamic therapy on cell kinetics of cultured human cancer cells in reference to its cytocidal effects]. AB - Photodynamic therapy (PDT) for cancer is a relatively new technique that has been used clinically in the treatment of a variety of neoplasms. In this report, the effects of PDT on cell kinetics of the two cultured human lung cancer cell lines (PC-6, PC-9) were investigated in reference to its cytocidal effects. The cellular uptake of hematoporphyrin derivative (HpD) was dependent on external HpD concentration. And in the same external HpD concentration, PC-9 cells incorporated more HpD than did PC-6 cells. On the other hand, PC-6 cells were more susceptible to PDT than did PC-9 cells. This finding is explainable for the reason that PC-6 cells incorporate more HpD per unit protein content in single cells than do PC-9 cells. Analysis of DNA histogram obtained by flow cytometry showed that a shift in the histogram peak to hypodiploid occurred at severe cytocidal effect of PDT, and this finding expressed the cell killing characterized by cell lysis after PDT. At moderate cytocidal effect of PDT, a prolongation of G2/M phase of the cell cycle caused by the inhibition of protein synthesis was observed. And partial synchronization was ascertained. These findings indicate the possibility for synergistic antitumor effect of PDT in combination with other therapies. PMID- 2778380 TI - [Results of the treatment of Hodgkin's disease: the importance of establishing and executing a protocol]. AB - A retrospective analysis was performed on 32 patients seen at Keio University Hospital and its affiliated hospitals from 1976 to 1987. Twenty-two patients were treated with our protocol, and the other 10 were not for several reasons. In this study, we compared the results of the treatment of these two groups. There were 20 males and 12 females. Age ranged from 13 to 72 years with a median value of 36 years. Histologically, six had lymphocytic predominance, 12 nodular sclerosis, 14 mixed cellularity. In the protocol group, seven were clinical stage I, 12 were CS II, two were CS III, and one was CS IV. Nine patients in the protocol group underwent staging laparotomy, and four CS II patients were upstaged to PS III. In the non-protocol group, five were CS I, four were CS II, one was CS III. According to the protocol, staging laparotomy was done excepting CS III.IV patients and some of CS I patients. In case of CS I without laparotomy, pathological stage(PS) I.II, or PS III1 with minimal splenic involvement, they were treated with radiation only. The rest of the patients were treated with chemotherapy and booster irradiation. Ten-year survival and 10-year relapse-free survival were 100%, 75%, respectively in the protocol group. In the non-protocol group, they were 31% and 32%, respectively. When picking up 17 patients treated by the authors through the whole process, 10-year survival and 10-year relapse free survival were 100%, 92%, respectively.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2778381 TI - [Abstracts of the 26th meeting of the Japan Society for Cancer Therapy]. PMID- 2778382 TI - [Histopathological study regarding the protective effect of elastase on cis platinum-induced renal toxicity]. AB - A histopathological study was effected by using rats to evaluate whether or not elastase has a protective effect on the renal toxicity of cis diamminedichloroplatinum (II) (CDDP). It was found that CDDP caused disorders mainly to the renal tubule--that is, atrophic and necrotic changes of the tubular epithelium. When elastase was used concomitantly with CDDP, such changes were considerably inhibited so that a relatively large part of the normal tissue architecture was preserved. The increase of the total platinum levels in the renal tissues was significantly suppressed with the addition of elastase and in the enzyme histochemical observation, the activity of the lysosomal enzymes and the alkaline phosphatase was maintained. The detailed mechanism of the protective effect of elastase against CDDP renal toxicity is unknown. However, these results suggested that elastase inhibited the platinum deposits in the renal tissue and played a role in the stabilization of the lysosomal and the plasma membranes, thus protecting the kidneys. PMID- 2778383 TI - Multiple primary malignant neoplasms of the head and neck. AB - This report analyzed the 7,763 cases treated at T.W.M.C., where radiotherapy has been mainly used, between 1968 and 1984. Of these, 258 cases (3.3%) had multiple primary malignant neoplasms, among which 88 cases involved head and neck cancer. The incidence averaged 1.6% during the first 5 years, but increased to an average of 5.7% during the last 5 years. Among head and neck cancer the incidence of multiple primary malignant neoplasms was 8.5% (88/1,033) and the incidence has been gradually increasing annually. Cancers of the head and neck were frequently combined with another primary lesion in the head and neck area or in the digestive tract, especially esophagus and stomach, followed by one in the both cases. The great majority of cancers in the head and neck occurred as the first cancer at age 60-70. The head and neck region is where the respiratory system and digestive system, including lymphatic organs originate and where the external carcinogenic factors enter into the body. These data suggested that multiple primary malignant neoplasms have been increasing in number and becoming an increasing problem. The possibility of multiple primary malignant neoplasms should not be forgotten in routine cancer related clinical work. PMID- 2778384 TI - [Effect of the time interval between irradiation and chemotherapeutic agents on normal tissue damage--comparison between in vivo in vitro experiments]. AB - Experiments have been carried out to determine the effect on the cell survivals at different time intervals between irradiation and chemotherapeutic agents (BLM, cisDDP, ADM and ACNU) in either the in vivo or the in vitro system. The intestinal epithelial assay was applied on the in vivo system. The clonogenic cell survivals of V79 cells, both in the proliferative and the plateau phases, were determined in the in vitro system. The V79 cells in the plateau phase were more sensitive to BLM, cisDDP and ACNU than those in the proliferative phase, however, the result was reverse with ADM. When BLM, cisDDP or ACNU was combined with irradiation at different time intervals, the response of the plateau phase V79 cells to combination therapies were very similar to those of the intestinal epithelial cells. On the other hand, V79 cells in the proliferative phase, which were treated with ADM and irradiation, showed the similar response as the intestinal cells. These results suggest that studies of chemo-radiotherapy with cultured cells which are sensitive to chemotherapeutic agents might be suitable to expect the in vivo damage of the normal tissue. PMID- 2778385 TI - [Studies on the clinical significance of type III procollagen peptide in sera as a tumor marker in patients with ovarian tumors]. AB - Usefulness of type III procollagen peptide (P-III-P) in sera as tumor marker was investigated in patients with ovarian tumors. A concentration of P-III-P in sera was measured by radioimmunoassay. The mean P-III-P values for 72 females as healthy controls were 8.5 +/- 2.7 ng/ml. Therefore, the cut-off value (Mean + 2 SD) was set at 13.9 ng/ml. The positive rates of healthy controls were 4.2%. For patients with benign ovarian tumors, the mean P-III-P values were 8.7 +/- 2.3 ng/ml, and the positive rates were 0%. For patients with ovarian tumors of borderline malignancy, the mean P-III-P values were 8.0 +/- 1.5 ng/ml, and the positive rates were 0%. In both of benign and borderline malignant cases, the false positive rates of tumor markers such as TPA, IAP, CA-125 and CA 19-9 were relatively high. For patients with malignant ovarian tumors, the mean P-III-P values were 19.7 +/- 9.9 ng/ml at pretreatment, 10.4 +/- 1.0 ng/ml at post treatment and 17.3 +/- 1.9 ng/ml at recurrence. The positive rates were 69.2% at pre-treatment, 0% at post-treatment and 100% at recurrence. In relation of histology, the positive rates were particularly high in patients with serious cystadenocarcinoma and embryonal carcinoma. In conclusion, P-III-P in sera was very useful as tumor marker in diagnosis of malignant ovarian tumors, while it was not aided to detect the early cancers. PMID- 2778386 TI - [Clinical analysis of 26 cases of multiple primary cancer]. AB - Of 412 head and neck cancers in the Department of oral Surgery, Sapporo Medical College from 1976 to 1987, 26 cases (6.3%) were multiple primary cancers. One of these cases was triple cancer. The ages of these 26 cases ranged from 42 to 81 (average 61 year-old) with 20 males and 6 females (3.3:1). As to the interval between the first and second cancer, five cases (20%) were synchronous and twenty cases (80%) were metachronous in our series. Of the five synchronous, three were found by careful examination at the time of admission to our department. The stomach and head and neck cancers were frequently observed as the first cancer of metachronous cases. Second primary cancers occurred in the head and neck region were 64% and those in other regions were 36%. On the other hand, digestive cancer was predominant in the additional cancer to the index cancer (66.7%). These numbers emphasize that patients with head and neck cancers are in a cancer-prone group that develops digestive cancers. These findings have important implications in follow up policy. PMID- 2778387 TI - [Enhancing effect by anti-cancer drugs on growth inhibition of colon carcinoma in nude mice by monoclonal antibody and complement]. AB - We investigated the possible sero-therapeutic application of monoclonal antibody A7 against human colorectal cancer. In complement dependent cytotoxicity, A7 showed 59% cytotoxicity against SW1116 cells. In addition, the killing of tumor cells by A7 and C was enhanced when the tumor cells were pretreated with 2 micrograms/ml mitomycin and 40 micrograms/ml adriamycin. Next, we evaluated the in vivo antitumor effect of A7 alone and combined with MMC on human colon cancer (Colon-6) bearing nude mice. The group injected with A7 alone showed definite antitumor effect compared with the non-treated group. The A7+MMC group (MMC: 4mg/kg, A7: 1 mg/body, two times) showed enhanced antitumor effect compared with the groups administered A7 alone or MMC alone. PMID- 2778389 TI - HIV blood test counseling: AMA physician guidelines. PMID- 2778388 TI - Psychotherapy with AIDS patients. AB - AIDS patients and others with HIV infections experience a variety of psychosocial stresses. These stresses lead to many situational reactions and adjustment problems. Psychotherapy can be of great benefit in helping AIDS patients to deal with these difficulties. Eight essential content areas are presented that should be addressed in the psychotherapy of all AIDS patients. By examining each of these areas, the intense psychosocial issues associated with HIV infection are dealt with. The overall quality of life for AIDS patients is, therefore, improved. PMID- 2778391 TI - On behalf of an historic and exemplary redesign of education. PMID- 2778390 TI - HIV blood test counseling. AB - This manuscript provides physicians with a brief outline of pretest and posttest counseling to accompany HIV testing. PMID- 2778392 TI - Program and abstracts of the twenty-sixth national meeting of the Society for Leukocyte Biology. Marco Island, Florida, October 12-15, 1989. PMID- 2778393 TI - [Throbbing buttocks syndrome]. AB - The authors define the "throbbing buttocks syndrome" which can in fact correspond to different pathological entities: aneurysm of the persistent sciatic artery and/or congenital or traumatic arteriovenous fistula of the hypogastric and gluteal vessels. Seven cases are reported: 1 case of aneurysm of the persistent sciatic artery complicated by truncal embolism and fissuring which was treated successfully by occlusive endoaneurysmorrhaphy; and 6 cases of arteriovenous fistulas (1 traumatic and 5 congenital). In all cases of arteriovenous fistula the technique used involved initial embolization which was complicated by anterior ligature of the hypogastric artery and then by excision of the malformation which was extremely hemorrhagic in some cases. Out of these 6 cases, results have been satisfactory for 5 and incomplete for the remaining one. PMID- 2778394 TI - [Aneurysms of digestive arteries. What are the indications?]. AB - Twelve cases of visceral artery aneurysms have been retrospectively reviewed in order to evaluate the results of the various therapeutic decisions. Aneurysms were located on splenic (n = 5), hepatic (n = 1), celiac (n = 3), superior mesenteric (n = 1), pancreatico-duodenal arteries (n = 1) and superior mesenteric artery branches (n = 2). Among two patients operated on for ruptured aneurysms, one patient who suffered from free intraperitoneal hemorrhage died after the operation. All patients operated on with unruptured aneurysms survived. Among two patients who were not operated on because of the small size of the aneurysms, one died suddenly a few years later from an unknown cause which may have been a rupture, and the second one was lost from the survey. Our results and those in the literature suggest that surgical treatment (or in some cases percutaneous embolization) is indicated in any symptomatic aneurysm and in most asymptomatic aneurysms except in splenic artery aneurysms. The latter should be operated on only when the diameter is more than 2.5 cm or when they are found in pregnant women or in women with child-bearing capacity. PMID- 2778395 TI - [Therapeutic approach to pulmonary embolism]. AB - The purpose of this study is the retrospective evaluation of the treatment of 196 cases of pulmonary embolism. Therapeutic attitude was standardized. Intravenous heparin followed early on by oral anticoagulants remains the basic treatment of the majority of patients (74%). This treatment could be associated with: (1) Fibrinolysis with urokinase bolus at the time of massive pulmonary embolism with clinical and hemodynamic signs of shock (14%). No severe hemorrhagic complication was observed. 2) Inferior vena caval interruption in case of contraindications or failure of anticoagulation (29%). Only one death was observed in this study. PMID- 2778396 TI - [Theoretical and practical problems posed by the measurement of capillary filtration by radioactive tracers]. AB - Screening for abnormal capillary filtration in the limbs with radioactive tracers requires the use of molecules of a known hydrodynamic radius. The molecule labeling should be obtained with a pure gamma-emitting radioactive atom, presenting a steady bond with the molecule, in vivo. Indium-111-labeled albumin appears to be the best tracer, and should be injected concurrently with the technetium 99m-labeled erythrocytes. The latter tracer permits assessing volume variations induced by the venous blood return block needed to obtain a capillary pressure increase. A qualitative estimation of lymphatic flow, and screening for abnormal permeability of the lymphatic vessels must be carried out as part of any capillary filtration study protocol. PMID- 2778397 TI - [Edematous syndromes caused by capillary hyperpermeability. Diffuse angioedema]. AB - Edema due to increased capillary permeability (ICP) may be diffuse or localized. Local edemas (Quincke edema, angioneurotic edema) are most often allergic or very rarely due to a defect in C1-inhibitor. Generalized edemas due to ICP share the following clinical features: Fluid retention (subcutaneous edema and diffused swelling) is predominant in lower limbs; it is worsened by orthostatism and warmth and alleviated by decubitus and cold, with important weight variations between morning and evening. It is associated with enhanced thirst, hypotension, oliguria, headaches and blood volume reduction; secondary hyperaldosteronism is the main mechanism. These troubles are due to ICP, associated with lymphatic drainage abnormalities; ICP is measured by the isotopic Landis Test. This abnormality is present in several diseases. Idiopathic orthostatic edema (IOE) is frequent and often unrecognized, occurring mainly in women, often associated with luteal insufficiency. Iatrogenic complications (diuretic and laxative abuses) are frequently superimposed. ICP may be corrected by vitamins P (rutin, anthocyanosides, diosmin, Ginkgo biloba extracts...) Cyclic shock due to ICP is rare. It is characterized by cyclic edema and shock with hypovolemia, hypoproteinemia; the mechanism of shock is a severe loss of fluid and protein from the vascular bed. It is often associated with monoclonal gammapathy and complement activation. In our personal case, the trouble in CP was present all along the disease with permanent edema and low blood pressure (especially in orthostatism). Vit "P" and Ginkgo biloba extracts were able to partially improve CP and the clinical troubles. However, in spite of this treatment a fatal shock occurred after ten years follow-up. Episodic angioedema associated with eosinophilia was first described by Gleich.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2778398 TI - [Aortic aneurysm with vena cava thrombosis occurring in Behcet's disease]. AB - We report a case of Behcet's disease complicated by aortic aneurysm and contiguous vena cava thrombosis due to compression. Arterial aneurysms are uncommon in the course of Behcet's disease and are associated with a poor prognosis owing to the risk of rupture. Vena cava thrombosis is found in 10% of cases; pulmonary embolism is infrequent. Venous and arterial lesions usually evolve independently. In most cases they are consecutive to vasculitis. The case reported herein is uncommon because of simultaneous and contiguous venous and arterial lesions. Eighteen months after aorto bi-iliac graft and inferior vena cava ligature, there is no recurrence of thrombosis nor aneurysm with a treatment including heparin, colchicine and azathioprine. PMID- 2778399 TI - [Management of patients with varicose veins presenting with a history of deep venous thrombosis]. AB - The notion of a history of deep venous thrombosis in patients with varicose veins has often been at the origin of a contemplative attitude toward this pathology. What used to be an act of vigilance has now become plain negligence, if not a therapeutic error. Indeed, the difficulty in diagnosing an acute episode explains the many false positive results obtained; moreover, the variability of the evolution of true venous thrombosis should no longer cause one to adopt a monolithic attitude. In this indication, noninvasive investigating procedures allow distinguishing quite different situations occurring in these patients. In a substantial number of cases, no deep vein circulatory abnormality can be found. Treatment should address primary varicose veins. For those patients with deep venous thrombosis sequelae, such studies allow us to differentiate between occlusion/restriction states from devalvulation, and to detect the precise location of such sequelae, as well as their impact on circulatory function. When occlusion is found, varicose veins, which may be supplementary veins, are left untouched. When devalvulation occurs as an isolated phenomenon, superficial vein insufficiency is of primary importance. Treatment is the more complete that deep reflux will promote relapse through all existing leakage points. If, regardless of this treatment, deep reflux causes significant disturbances, surgical revalvulation should be recommended. More complex cases combining persisting occlusion with devalvulation call for a graded attitude. Noninvasive investigating procedures coupled with phlebography allow us to assess the part played by the various anomalies in causing the disorders.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2778400 TI - [Elastic support in 1988]. AB - After several remarks concerning physiology and physiopathology, we discuss the different physical aspects of compression and its use in therapy. We then consider, first, the choice of a bandage to reduce edema and secondly, that of an appropriate elastic stocking to maintain the therapeutic results. PMID- 2778401 TI - [Apropos of the natural history of sub-inguinal grafts]. PMID- 2778402 TI - Just too d--- much tobacco raised in Georgia! PMID- 2778404 TI - PRO review Part II: Surgical review activities. PMID- 2778403 TI - The health and economic burden of cigarette smoking in Georgia in 1985. AB - Using the estimated prevalence of current and former cigarette smoking among Georgians, death certificate data in 1985, and the available literature on smoking-related health risks, we estimated the health and economic impact of cigarette smoking in Georgia in a single year. We estimated, using relatively conservative assumptions, the mortality and years of life lost prematurely, as well as the costs of medical care for ill individuals, lost wages due to death, and lost wages due to illness attributable to smoking. In 1985, past or present smoking was the cause of death for more than 7,700 Georgians, accounting for over 120,000 years of expected life lost prematurely, and with an overall societal cost exceeding $1.5 billion dollars. Cardiovascular diseases were the major cause of all estimated deaths associated with smoking. The prevalence of current smokers is higher in Georgians than the national average; this approach to examining the risks may be useful in lowering that prevalence by influencing patient education in Georgia. PMID- 2778405 TI - One internist's view of the RBRVS. PMID- 2778406 TI - A review of georgia SIDS autopsy reports for a 2-year period. AB - Procedures carried out in autosies of presumed sudden infant death syndrome (SIDS) victims in Georgia during 1983-1984 were compared to standard criteria found in the literature and in a Georgia publication. One hundred fifty-one complete autopsy reports were available for the study. Although autopsies did not change the presumed cause of death for most SIDS victims, less than half the autopsies included what some experts believe to be an adequate basis for determining SIDS as the cause of death--a careful medical history, a thorough external and internal examination, selected histologic review, total body X-ray, and (perhaps) cultures of heart, blood, and lung tissue. The autopsies compared more favorably to a published Georgia standard that did not include the medical history, but they still over-utilized toxicology screening, underutilized microscopic study, and rarely recorded any rationale for performing ancillary procedures. PMID- 2778407 TI - Effect of oral zinc supplements on diaper rash in normal infants. AB - A total of 89 normal newborn infants received 10mg oral zinc supplements daily for 4 months and 90 others received a placebo. The zinc supplemented group had a significant reduction in the incidence of diaper rash, and they gained slightly more in height and weight, although the growth differences were not significant. PMID- 2778409 TI - The Supreme Court's ruling in the Webster case: implications for Georgia physicians. PMID- 2778410 TI - The treatment of chronic hypertension in children and adolescents. PMID- 2778408 TI - Dietary fluoride supplements for children--the role of the physician. AB - 1. All children should receive one form of systemic fluoride and appropriate forms of topical fluoride. 2. If a child is not receiving optimally fluoridated water, the dentist or physician should prescribe dietary fluoride supplements (tablets or drops). 3. The correct dosage must be determined based on patient age and fluoride content of the patient's main water source(s). 4. Special attention is necessary concerning fluoride intake for children breast feeding or consuming infant formula. 5. To arrive at the correct fluoride dose, these steps should be followed: A. Always have a sample of the main drinking water source (usually home water) analyzed for the fluoride content before prescribing a fluoride supplement, if you do not have other specific knowledge of water fluoride content. The Medical College of Georgia (Department of Oral Biology - Dr. Whitford) provides water fluoride assay services. B. When the fluoride content of the water has been determined, the fluoride level and the child's age should be matched on Table 1 to arrive at the correct supplement dose. 6. Dr. Alderman, Director of the Office of Dental Health, Division of Public Health, Georgia Department of Human Resources, can provide lists of communities in Georgia that are optimally fluoridated. PMID- 2778411 TI - Commissions and bioethics. PMID- 2778412 TI - The President's Commission: the need to be more philosophical. AB - This paper argues, contrary to what has sometimes been claimed, that public commissions need to be more philosophical than they have been in analyzing crucial bioethical issues. It argues (a) that the failure of the President's Commission to develop and use even simple distinctions between life and personhood led to flaws in both its discussion of death and its discussion of persistent vegetative patients, and (b) that its treatment of access to health care fails to develop a coherent approach precisely because it is based on no serious philosophical reflections about justice in health care. PMID- 2778413 TI - Committees and commissions in the United Kingdom. AB - In the United Kingdom there have been few committees or commissions dealing specifically with biomedical ethics, and where such bodies have been set up they have merely reported on a specific topic and then disbanded. However, there may well be standing committees in the future, of which the Voluntary Licensing Authority for Human In Vitro Fertilisation and Embryology is a precursor. This paper surveys the work of three special committees or working groups which have reported in the period 1970 to the present. Of these the Warnock Committee is by far the most important, and the issues which it raises are discussed with specific reference to the place of philosophers and theologians on such bodies. It is concluded that, although there has been some movement in the UK toward the utilization of those with special skills and knowledge in the field of bioethics, much more could be done in this regard. PMID- 2778414 TI - Australian commissions and committees on issues in bioethics. AB - We examine the role of Australian state and federal committees and law reform commissions in bioethics. Most have been concerned with in vitro fertilization and embryo research. We find deficiencies in the standards of reasoning about the underlying ethical issues raised by these techniques. We suggest stronger representation of those with a background in ethics. PMID- 2778415 TI - Commissions and biomedical ethics: the Canadian experience. AB - Canadians frequently have recourse to public commissions as a means of dealing with contentious public policy issues. This essay examines the role of philosophers and philosophy in nine such commissions, all of which have dealt with issues in biomedical ethics. The principal findings of this essay are that philosophers have not been used extensively by these commissions, and that the philosophical aspects of the issues under investigation have been dealth with quite inadequately. The essay concludes with suggestions for an expanded role for philosophers in such commissions. PMID- 2778416 TI - Ethics committees in France. AB - Leading biologists and physicians in France have been considering bioethical problems for several decades. In 1983 an important new forum for bioethical discussion in France was created, with the establishment of the Comite Consultatif National d'Ethique pour les Sciences de la Vie et de la Sante (C.C.N.E.). This committee has produced numerous important opinions and reports on such topics as research involving human subjects, fetal tissue research, and the new reproductive technologies. At the local level the discussion of bioethical questions is carried on by ethics committees, which are charged with the responsibility of reviewing research protocols. PMID- 2778417 TI - Ethics committees for "high tech" innovations in Japan. AB - Although ethics committees in Japan have been developing in major medical schools and in some hospitals, their members are usually medical professionals from the same institution. The lack of national legislation for setting up ethics committees permits only a voluntary code of standards for doing clinical research work in high tech medical applications. The author argues for the necessity of more open debate on bioethical issues and proposes the participation of the lay public and bioethicists in Ethics Committee in Japan. PMID- 2778418 TI - Blue-ribbon commissions and political ethics in the Federal Republic of Germany. AB - The paper presents an overview of political and professional committees in the Federal Republic of Germany dealing with issues of biomedical ethics. The prevailing tendencies of paternalistic attitudes, the worst-case-scenario argumentation method, and the unfortunate practice of applying general principles rather than mid-level principles in the assessment of concrete challenges in treatment and regulation are analyzed. PMID- 2778419 TI - Comparison of the hemodynamic changes following left atrial and peripheral venous administration of protamine during cardiac surgery. AB - The hemodynamic effects of left atrial administration of protamine for heparin reversal were compared with the peripheral venous route. One hundred patients, undergoing cardiac surgery, using cardiopulmonary bypass (CPB) at Siriraj hospital were randomly allocated into two equal groups of fifty. The preoperative and operative characteristics of the two groups were comparable. After the termination of CPB, protamine sulfate was administered over 3 minutes via the left atrium in group I, and via the peripheral vein in group II. The hemodynamics were measured before and 5, 15 and 30 minutes after protamine administration. There were no statistically significant differences in heart rate (HR), arterial blood pressure (BP), and central venous pressure (CVP) between the groups. After administrating protamine and adequate maintaining the preload in both groups of patients within the normal range, the HR did not change from immediate post CBP control values. The arterial BP was not changed for 5 minutes, thereafter, significantly elevated toward the preoperative baseline values. This data indicates that the left atrial injection of protamine does not provide any hemodynamic advantages over the peripheral venous administration. PMID- 2778420 TI - Mycobacterium other than tubercle bacilli in various environments in Bangkok. AB - This research was designed to isolate Mycobacterium other than tubercle bacilli in various environments in the Bangkok area, in 1987. The results were as follows, one hundred samples of soil yielded 1 Mycobacterium gordonae, 2 M. chelonei, 57 M. fortuitum, 1 Nocardia asteroides, one hundred samples of natural water from the Chao Phraya River and the canals of Chao Phraya River yielded 2 M. chelonei, 18 M. fortuitum, 1 N. asteroides and 1 N. brasiliensis, thirty samples of tap water yielded 3 M. gordonae. But thirty samples of water from swimming pools were negative for Mycobacterium. PMID- 2778421 TI - Short and long term mortality after acute myocardial infarction as predicted by two-dimensional echocardiography. AB - We have non-invasively determined the extent of the acute myocardial insult shortly after admission in a large group of patients with acute myocardial infarction. There appeared a fairly sharp distinction between patients with low and high likelihood of in-hospital death and one year mortality on the basis of echocardiographic findings. The use of wall motion score index and ejection fraction in the prediction of short term mortality (in-hospital death) is good, but the prediction of long term mortality is not that good, since several patients survived up to one year even with high wall motion score index (greater than 2.2) or low ejection fraction (less than or equal to 35%) on admission. One year survival is high up to 90 per cent in patients with low wall motion score index or high ejection fraction on admission. PMID- 2778422 TI - Evaluation of ofloxacin in the treatment of mucopurulent cervicitis: response of chlamydia-positive and chlamydia-negative forms. AB - The treatment of mucopurulent cervicitis in nonpregnant women was evaluated in a randomized study. Subjective and objective criteria were used to assess the response of cervicitis to therapy. Forty-three patients (Group I) were treated with Ofloxacin, 100 mg orally twice daily for 10 days, and forty-five patients (Group II) were treated with Ofloxacin, 200 mg orally twice daily for 7 days. Both produced significant improvement in subjective and objective signs of cervicitis; decreasing clinical symptoms, eliminating mucopurulent endocervical findings, and eradicating C. trachomatis. Overall, of the chlamydia-positive form the complete response of Ofloxacin treatment in mucopurulent cervicitis was 18 (60.0%), the partial response was 10 (33.3%), and resistance was 2 (6.6%) of the 30 patients (p = 0.6592). Of the chlamydia-negative form the complete response was 38 (65.5%), the partial response was 20 (34.5%) of the 58 patients (p = 0.9463). C. trachomatis eradication was satisfactory between both treatment regimens; 28 (93.3%) of the 30 women in chlamydia-positive form. This trial shows that both regimens are also beneficial in the treatment of mucopurulent cervicitis either C. trachomatis positive or C. trachomatis negative, and do not differ significantly between both groups (p = 0.1375). No side effects were observed. PMID- 2778424 TI - Intermittent exophthalmos. AB - A 28-year-old woman is reported with intermittent exophthalmos and acute orbital hemorrhage which developed after a warning symptom of recurrent positional headache. The cause was proven to be a primary orbital varix. Conservative measure was considered in this case. The characteristics of the primary orbital varix are presented and the problems of diagnosis and treatment are discussed. PMID- 2778423 TI - Emergency room assessment and adrenaline treatment of patients with acute asthma of different severity. AB - The adequacy of emergency room assessment and treatment of patients with acute severe asthmatic attacks was evaluated by analyzing the course of 451 visits of 348 patients to Chulalongkorn hospital's Emergency Room. Eighty-five per cent of the patients had an initial index score of greater than or equal to 4 and an average peak expiratory flow rate of 92.16 +/- 46.3 L/min. The discharge index score was 85 per cent with a score of less than or equal to 3 and an average peak expiratory flow rate of 192 +/- 40.3 L/min. Our study indicated that the predictive index proposed by Fischl et al correlated with the severity of airway obstruction; however, the initial index did not help with emergency room decision making in predicting which patients might be hospitalized, have a relapse or be discharged. In fact, in our emergency room department, the index score to determine airway obstruction and the pattern of response to treatment were better predictors of the outcome, which was classified into three categories: non responsive or minimally responsive, responsive, and partially responsive. By using conventional clinical criteria (i.e. recumbent position with elimination of laboured breathing, disappearance of dyspnea and reduction of wheezing), there was a 93 per cent accurate determination in the episodes of patients who responded sufficiently to the emergency room treatment to allow their discharge. The remaining 7 per cent of those seeking emergency treatment were hospitalized, which is a lower incidence than that of others series.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2778425 TI - Physical and biochemical characterization of the qacA gene encoding antiseptic and disinfectant resistance in Staphylococcus aureus. AB - We have previously cloned a 3.5 kb fragment from the Staphylococcus aureus multiresistance plasmid pSK1 which carries the qacA determinant responsible for linked resistance to acriflavine (Acr), ethidium bromide (Ebr), quaternary ammonium compounds (Qar), propamidine isethionate (Pir), and diamidinodiphenylamine dihydrochloride (Ddr). This report presents a biochemical and physical analysis of qacA and shows the widespread carriage of this gene on S. aureus resistance plasmids. Tn5 insertion mutagenesis defined the extent of qacA to within 2.40 kb of pSK1 DNA. Examination of the expression of insertion and deletion mutants of the cloned qacA sequences in both maxicells and minicells led to the association of a 50 kDa protein, designated QacA, with the AcrEbrQarPirDdr phenotype. Based on fluorimetric and isotopic assays used to determine the extent of accumulation of ethidium bromide by S. aureus strains harbouring pSK1, we propose that the basis of AcrEbrQarPirDdr in S. aureus is a qacA-mediated efflux system. PMID- 2778426 TI - Effect of Chlamydia trachomatis infection on ciliary activity in single cells from cultures of human nasal polyps. AB - We have tested the hypothesis that the ciliary activity of epithelial cells from human nasal polyps is altered after infection with Chlamydia trachomatis. Ciliated epithelial cells from human nasal polyps were cultured and infected with C. trachomatis. The measurement of ciliary beating was based on a technique which enables one to monitor a fraction of a single ciliated cell. A marked decrease of ciliary beating frequency versus time was observed 24 h after infection with C. trachomatis. About 50% of the cilia of infected cells were paralysed 48 h post infection. The potential effect of C. trachomatis infection on the physiological functions dependent on cilia is discussed. PMID- 2778427 TI - New probability matrices for identification of Streptomyces. AB - The character state data obtained for clusters defined in a previous phenetic classification were used to construct two probabilistic matrices for Streptomyces species. These superseded an original published identification matrix by exclusion of other genera and the inclusion of more Streptomyces species. Separate matrices were constructed for major and minor clusters. The minimum number of diagnostic characters for each matrix was selected by computer programs for determination of character separation indices (CHARSEP) and a selection of group diagnostic properties (DIACHAR). The resulting matrices consisted of 26 phena x 50 characters (major clusters) and 28 phena x 39 characters (minor clusters). Cluster overlap (OVERMAT program) was small in both matrices. Identification scores were used to evaluate both matrices. The theoretically best scores for the most typical example of each cluster (MOSTTYP program) were all satisfactory. Input of test data for randomly selected cluster representatives resulted in correct identification with high scores. The major cluster matrix was shown to be practically sound by its application to 35 unknown soil isolates, 77% of which were clearly identified. The minor cluster matrix provides tentative probabilistic identifications as the small number of strains in each cluster reduces its ability to withstand test variation. A diagnostic table for single membered clusters, constructed using the CHARSEP and DIACHAR programs, was also produced. PMID- 2778428 TI - Respiration in the cysts and trophozoites of Giardia muris. AB - Cysts and trophozoites of the parasitic protozoon Giardia muris both showed respiratory activity but respiration in cysts was only 10 to 20% that of trophozoites. The O2 dependence of respiration in cysts and trophozoites showed O2 maxima above which respiration decreased. The O2 concentration at which the respiration rate was greatest was higher for cysts than trophozoites. The effects of various inhibitors on cyst and trophozoite respiration suggested that flavoproteins and quinones play some role in respiration. The substrate specificities and the effects of inhibitors on G. muris trophozoites were similar to those observed for Giardia lamblia. Metronidazole, the drug most commonly used in the treatment of giardiasis completely inhibited respiration and motility in trophozoites; however, it had no effect on either respiration or viability in cysts. Menadione, a redox cycling naphthoquinone, stimulated then completely inhibited respiration in cysts and trophozoites; a complete loss of cyst viability or trophozoite motility was also observed. The effects of menadione on G. muris may indicate that redox cycling compounds have potential as chemotherapeutic agents for the treatment of giardiasis. PMID- 2778429 TI - Purification and characterization of the 2-oxoglutarate dehydrogenase complex from Dictyostelium discoideum. AB - The 2-oxoglutarate dehydrogenase complex was isolated from the cellular slime mould, Dictyostelium discoideum, and purified 113-fold. The enzyme exhibited Michaelis-Menten kinetics and the Km values for 2-oxoglutarate, CoA, and NAD were 1.0 mM, 0.002 mM, and 0.07 mM, respectively. The Ki value for succinyl-CoA was determined to be 0.004 mM and the Ki for NADH was 0.018 mM. AMP had positive effects whereas ATP had negative effects on the enzyme activity. The kinetic constants determined in this study and the reaction mechanism suggested can now be incorporated into a transition model of the tricarboxylic acid cycle during differentiation of D. discoideum. PMID- 2778430 TI - Regulation of glucose transport in Candida utilis. AB - The transport systems for glucose present in Candida utilis cells, growing in batch and continuous cultures on several carbon sources, have been studied. Two different systems were found: a proton symport and a facilitated diffusion system. The high-affinity symport (Km for glucose about 15 microM) transported one proton per mole of glucose and was partially constitutive, appearing in cells grown on gluconeogenic substrates such as lactate, ethanol and glycerol. It was also induced by glucose concentrations up to 0.7 mM and repressed by higher ones. The level of repression depended on the external glucose concentration at which cells had grown in a way similar to that shown by the maltose-uptake system, so both systems seem to be under a common glucose control. Initial uptake by facilitated diffusion, the only transport system present in cells growing at glucose concentrations higher than 10 mM, showed a complex kinetic dependence on the extracellular glucose concentration. This could be explained either by the presence of at least two different systems simultaneously active, one with a Km around 2 mM and the other with a Km of about 1 M, or by the allosteric or hysteretic behaviour of a single carrier whose apparent Km would oscillate between 2 and 70 mM. PMID- 2778431 TI - Purification and some properties of two forms of chitinase from mycelial cells of Mucor rouxii. AB - Chitinase activity was measured in extracts of mycelial cells of Mucor rouxii as a function of the culture age. There was a peak of specific activity at the mid exponential phase of growth (10 h), which paralleled chitin synthase activity. An additional peak of chitinase with higher specific activity was detected in 4 h cultures, which coincided with the onset of germination. Purification of chitinase activities from the cytoplasm revealed two enzymes, I and II, with different molecular mass and ionic charge. Antibodies induced with chitinase I did not cross-react with chitinase II. Both enzymes digested nascent chitin preferentially over preformed chitin, yielding diacetylchitobiose as the sole product of hydrolysis. PMID- 2778432 TI - Cloning and nucleotide sequence of the isoamylase gene from a strain of Pseudomonas sp. AB - A strain of Pseudomonas sp., SMP1, isolated from a soil sample collected in the Monterotondo area (Rome), secreted isoamylase activity into the culture medium. The enzyme was purified and optimal reaction and stability conditions were determined by varying pH and temperature. The chemico-physical properties of the enzyme were similar to those of the isoamylase purified in Japan more than 20 years ago from 'Pseudomonas amyloderamosa' strain SB15. A genomic library of SMP1 was prepared in Escherichia coli using pUC12 as vector. Two isoamylase-producing colonies were identified out of 6300 screened. The hybrid plasmids isolated from the two clones showed common restriction patterns. The chromosomal portion of one of these plasmids (pSM257) was completely sequenced. Comparison between the deduced amino acid sequence of the isoamylase and the published sequences of other amylolytic enzymes showed the presence of conserved domains. PMID- 2778433 TI - An immunoprotective monoclonal antibody directed against Leptospira interrogans serovar copenhageni. AB - A monoclonal antibody (mAb) was prepared by hybridoma technology in BALB/c mice immunized to Leptospira interrogans serovar copenhageni. This mAb agglutinated serovars copenhageni and icterohaemorrhagiae to high titres and protected hamsters, dogs and monkeys against challenge with a virulent strain of serovar copenhageni. The mAb gave protection to hamsters at dilutions up to 1 in 1000; at a 1 in 10 dilution the protective effect lasted for at least two weeks. Biochemical analysis by SDS-PAGE and Western blotting indicated that this mAb reacted with an epitope of a carbohydrate nature. PMID- 2778434 TI - The persistence of Chlamydia trachomatis elementary body cell walls in human polymorphonuclear leucocytes and induction of a chemiluminescent response. AB - Human polymorphonuclear leucocytes (HPMN) were incubated with [35S]methionine labelled Chlamydia trachomatis (serovar L2/434/Bu) elementary bodies (EB) and EB cell walls. No net loss in the TCA-precipitable radioactivity was observed over 24 h in the HPMN that had taken up EB cell walls. SDS-polyacrylamide gel electrophoresis of the labelled C. trachomatis EB and EB cell wall proteins extracted from the HPMN at 2 and 24 h after infection demonstrated the persistence of most of the chlamydial cell wall polypeptides. Analysis of extracts of the HPMN that had taken up either EB or EB cell walls on Urografin density gradients at 2 and 24 h after infection, and electron microscopic observations on fractions representing the peaks, demonstrated the persistence of the EB cell walls in the HPMN. Electron microscopic observations of HPMN that had taken up EB or EB cell walls demonstrated EB cell walls in the HPMN phagosomes at 24 h after infection. The HPMN exposed to EB and EB cell walls of C. trachomatis gave chemiluminescent (CL) responses with peaks respectively 12 and 7 times greater than the peak value of the control. The significance of the persistence of the EB cell wall polypeptides and cell walls in the HPMN and activation of the HPMN to produce oxygen radicals (i.e. a CL response), and its possible relation to rheumatic diseases, is discussed. PMID- 2778435 TI - Nucleotide sequence of papaya mosaic virus RNA. AB - The RNA genome of papaya mosaic virus is 6656 nucleotides long [excluding the poly(A) tail] with six open reading frames (ORFs) more than 200 nucleotides long. The four nearest the 5' end each overlap with adjacent ORFs and could code for proteins with Mr 176307, 26248, 11949 and 7224 (ORFs 1 to 4). The fifth ORF produces the capsid protein of Mr 23043 and the sixth ORF, located completely within ORF1, could code for a protein with Mr 14113. The translation products of ORFs 1 to 3 show strong similarity with those of other potexviruses but the ORF 4 protein has only limited similarity with the other potexvirus ORF 4 proteins of 7K to 11K. PMID- 2778436 TI - Vaccinia virus encodes a family of genes with homology to serine proteinase inhibitors. AB - Nucleotide sequencing of a region of the vaccinia virus genome proximal to the right inverted terminal repeat (ITR) identified two open reading frames (ORFs) encoding proteins of 39K and 40K with amino acid homology to each other, to another vaccinia virus gene near the opposite end of the virus genome and to the superfamily of serine proteinase inhibitors (serpins). Serpins have now been found in poxviruses from the genera orthopox (cowpox and vaccinia viruses), leporipox (myxoma virus) and avipox (fowlpox virus). One of the vaccinia virus serpins identified here (B13R) shares 92% amino acid identity with the serpin from cowpox virus and 46% and 19% identity with vaccinia serpins B24R and K2L, respectively. The amino acid sequence of B13R reported here differs at 11 positions from a recently reported sequence and contains an additional three internal residues. The serpin genes near the right ITR are separated by 8 kb of DNA. Both genes contain early transcriptional termination signals just downstream of the ORFs and are transcribed in a rightward direction towards the end of the genome. Analysis of mRNAs from virus-infected cells demonstrated that all three vaccinia virus serpin genes are transcribed early during infection. The amino acid sequences at the active sites of these serpins suggest that they may inhibit serine proteinases of differing biochemical specificities. The possible functions of these genes are discussed. PMID- 2778438 TI - Differential phosphorylation of the nucleoprotein of influenza A viruses. AB - An analysis of the nucleoprotein (NP) of 29 different influenza A viruses by phosphopeptide fingerprinting revealed three prototype patterns. The first, which was a complex pattern consisting of six to seven phosphopeptides, another which was relatively simple consisted of two or three phosphopeptides, and a third one which was complex but was missing the main phosphopeptide shared by the two other patterns. Phosphoserine was the only labelled phosphamino acid detected. A tentative deduction of two of the phosphate attachment sites (serine residues at positions 3 and 473) could be made by comparison of the known amino acid sequences of the NPs of 25 strains. No correlation was found between species specificity or subtype or year of isolation of the strains. During the infectious cycle the fingerprint underwent significant changes, indicating subtle phosphorylation and dephosphorylation of the NP at various stages during viral multiplication. Most of the phosphopeptides were metabolically stable; however one major phosphopeptide, which was not found in the NP of mature virions, exhibited a high turnover (presumably serine at position 3). The phosphopeptide fingerprint could be significantly influenced in vivo by the specific stimulation of cellular protein kinase C by the phorbol ester 12-O-tetradecanoylphorbol 13 acetate or by its inhibition with the isoquinoline sulphonamide H7.H7 specifically inhibited the replication of influenza A viruses by deregulation of viral protein synthesis without interfering with the multiplication of a parainfluenza virus (Newcastle disease virus), an alphavirus (Semliki Forest virus) or a flavivirus (West Nile). Therefore the correct phosphorylation of the NP of influenza viruses appears to be essential for influenza virus replication. PMID- 2778437 TI - Isolation and characterization of canine distemper virus nucleocapsid variants. AB - Nucleocapsid (NC) variants expressed by the Onderstepoort strain of canine distemper virus (CDV) were ultrastructurally and biochemically characterized. Three isolated variants were defined which corresponded to the three variants observed within the cytoplasm of infected cells. Dense NC (D-NC), isolated on discontinuous caesium chloride (CsCl) isopycnic gradients, had an average density of 1.2971 +/- 0.0042 g/ml. Ultrastructurally, D-NC were 1620.0 +/- 112.1 nm in length with a 20.1 +/- 1.3 nm outer and a 5.8 +/- 0.7 nm inner core diameter. The D-NC protein composition was 89.7% of a 61K protein (N), 8.4% of a 75K protein (P) and 1.9% of a 160K to 200K protein (L). A single species of nucleic acid, 15 kb in length, was isolated from D-NC. Light NC (L-NC), similarly isolated, had an average density of 1.2894 +/- 0.0040 g/ml. L-NC differed ultrastructurally from D NC in that poor resolution of NC subunits, a larger outer diameter (32.0 +/- 2.8 nm), and a greater inner core diameter (10.4 +/- 0.6 nm) were observed. The average L-NC strand length was 1574.4 +/- 115.8 nm. The protein composition was the same as D-NC with the exception of an additional 70K protein, representing 4.0 to 7.7% of the total L-NC protein mass. A 15 kb nucleic acid was also identified in L-NC, although heightened sensitivity of encapsidated L-NC nucleic acid to non-specific nuclease degradation was observed. The ratio of D-NC to L-NC isolated from individual virus preparations varied and was independent of viral infectivity. A third NC variant, defective-NC (Df-NC), was also identified. This had the lowest density on CsCl gradients (1.2460 +/- 0.0046 g/ml). The Df-NC structures were truncated to a uniform length of 87.0 +/- 5.8 nm. Diameter measurements were between those of D-NC and L-NC, being 24.4 +/- 1.4 nm (outer) and 6.9 +/- 0.4 nm (inner core). Like L-NC, the 70K protein was present but in greater amounts, representing as much as 43.7% of the total Df-NC protein mass. RNase A-sensitive nucleic acid was isolated from Df-NC which ranged in size from 1.16 to 0.67 kb with a majority of the material being 0.86 kb in length. For both L-NC and Df-NC, canine CDV convalescent serum reacted with viral N and P proteins in Western blot analyses but not with the 70K protein, suggesting a host cellular origin for the latter. PMID- 2778439 TI - Gangliosides influence experimental influenza virus infection in mice. AB - Influenza virus infection in mice may be either stimulated or partially prevented by certain gangliosides, depending on the experimental conditions employed. When injected prior to virus infection gangliosides increased the mortality rate, whereas preincubation with the virus before infection had a protecting effect. Hybrid mice resistant to influenza virus became highly susceptible to infection after injection of a specific ganglioside whereas the corresponding antiganglioside antiserum protected virus-susceptible mice against infection by the virus. These results are discussed in the light of earlier findings that various gangliosides enhance non-specific binding of influenza virus, whereas gangliosides of the GT1b and GD1b type are able to act as specific virus receptors and to promote virus penetration. PMID- 2778440 TI - The immunoglobulin G subclass responses of mice to influenza A virus: the effect of mouse strain, and the neutralizing abilities of individual protein A-purified subclass antibodies. AB - The IgG subclass responses to cold-adapted (ca) influenza A/Queensland/6/72 virus and purified haemagglutinin H3 was assessed in C57BL/6 and BALB/c mice. In BALB/c mice IgG2a was present as the major subclass in serum, lung and salivary secretions after two doses of ca virus. In contrast, the serum response in C57BL/6 mice was predominantly IgG1 after primary and secondary inoculations of ca virus. However, in lung and salivary secretions no specific subclass was dominant. When purified H3 was used as the inoculum, serum responses were dominated by IgG1 in BALB/c mice after two inoculations whereas all four subclasses were present at equal levels in C57BL/6 mice. Overall the lung and salivary responses detected in C57BL/6 mice were lower than those observed in BALB/c mice with all four subclasses contributing equally to the response in BALB/c mice. The neutralizing and haemagglutination inhibition abilities of the four Protein A-Sepharose-purified IgG subclasses differed between the BALB/c, C57BL/6 and CBA/CaH mice strains. IgG1 and IgG2a were most effective in BALB/c mice and in C57BL/6 and CBA/CaH mice, IgG2a and IgG2b. These results are discussed in terms of the differing abilities of replicating and non-replicating virus to stimulate differential responses in mice and the TH1 and TH2 helper cell concept. PMID- 2778441 TI - Viral interference in the tick, Rhipicephalus appendiculatus. I. Interference to oral superinfection by Thogoto virus. AB - Interference between arboviruses in a naturally infected tick vector is reported for the first time. Rhipicephalus appendiculatus nymphs were dually infected with Thogoto (THO) virus, a tick-borne virus, similar to members of the family Orthomyxoviridae. In the first series of experiments examining 'inter-stadial' interference, larvae were orally infected with a temperature-sensitive (ts) mutant, and after moulting the nymphs were superinfected with the wild-type (wt) virus. In the second series of experiments examining 'intra-stadial' interference, nymphs were dually infected by interrupted feeding; the time interval between infective feeds was either shorter than 24 h or lasted for 10 days. Interference was demonstrated by the inability of wt virus to replicate in ticks previously infected with ts virus. Both inter- and intra-stadial interference were observed and complete interference was detected in 78% of dually infected nymphs. A pool of dually infected ticks, in which intra-stadial interference had been detected, failed to transmit the superinfecting virus after moulting. PMID- 2778442 TI - Viral interference in the tick, Rhipicephalus appendiculatus. II. Absence of interference with Thogoto virus when the tick gut is by-passed by parenteral inoculation. AB - Genetic reassortment of Thogoto (THO) virus has been demonstrated in dually infected Rhipicephalus appendiculatus ticks. However previous results showed that oral superinfection is inhibited by interference. To ascertain the site of THO viral interference, ticks were infected parenterally or orally with a temperature sensitive (ts) mutant of THO virus. Infected ticks were then challenged with wild type (wt) THO virus via parenteral inoculation. Intra-stadial superinfection was carried out by parenteral inoculation of newly infected engorged ticks whereas inter-stadial superinfection involved inoculation of engorged ticks infected at the previous stage. In both instances viral interference was not observed, i.e. the challenge virus replicated and was delivered by bite to susceptible hosts. Therefore when the gut is bypassed, R. appendiculatus ticks are apparently permissive to dual infection even when there is a delay in the presentation of the superinfecting virus. These results demonstrate that interference following superinfection per os does not occur in the salivary glands, but may occur in the gut and possibly in a secondary site of viral replication such as the synganglion. PMID- 2778443 TI - Nucleotide sequence of the 3'-terminal region of cymbidium ringspot virus RNA. AB - The nucleotide sequences of cDNA clones corresponding to 2569 nucleotides from the 3' end of cymbidium ringspot tombusvirus (CyRSV) RNA were determined. This region contains three open reading frames giving rise to three predicted protein products, two of which had been identified in previous studies. The 3' non-coding region is 351 nucleotides long. The amino acid sequence of CyRSV coat protein has striking similarities with that of tomato bushy stunt tombusvirus, particularly in the S domain. No homology was found between the protein encoded by the second largest open reading frame and the corresponding product of other plant viruses. PMID- 2778444 TI - HIV genome in peripheral blood mononuclear cells of seronegative regular sexual partners of HIV-infected subjects. AB - We have investigated the presence of the human immunodeficiency virus (HIV) by using in situ hybridization on peripheral blood mononuclear cells (PBMCs) from seronegative regular sexual partners of HIV-infected subjects. The cells were hybridized with a 9 kilobase (kb) Sstl-Sstl lambda BH 10 probe, which was able to recognize both viral mRNA and proviral cDNA. Labeling was done by chemical insertion of an antigenic sulfone group in cytosine moieties and was visualized by a double-antibody immunohistochemical reaction. In all the subjects studied, the HIV genome was present. The HIV infected cells showed morphological aspects consistent with that of lymphocytes and monocytes. Our data suggest that the anti HIV seronegative individuals who are regular sexual partners of HIV-infected subjects may be HIV-infected. PMID- 2778445 TI - Seroepidemiology of hepatitis B virus, hepatitis D virus, and human immunodeficiency virus infections among parenteral drug abusers in southern Taiwan. AB - A total of 390 parenteral drug abusers (PDAs) at the Kaohsiung Municipal Narcotics Abstention Institute were examined for markers of hepatitis B virus (HBV), hepatitis D virus (HDV), and human immunodeficiency virus (HIV). All sera were tested for hepatitis B surface antigen (HBsAg), surface antibody (anti-HBs), and core antibody (anti-HBc) by radioimmunoassay (RIA) and for antibody to HIV (anti-HIV) by enzyme-linked immunosorbent assay (ELISA). Hepatitis B e antigen (HBeAg) and antibody to HDV (anti-HDV) were also tested for HBsAg-positive serum samples. Although the HBsAg-positive rate (22.1%) among PDAs was similar to that of the general population in southern Taiwan, the HBV infection rate (99.2%) and the anti-HDV-positive rate (78.5%) among HBsAg-positive subjects were significantly higher than those of the general population in southern Taiwan (P less than 0.0001). None of the PDAs studied were positive for anti-HIV. The levels of serum glutamic oxaloacetic transaminase (SGOT) and serum glutamic pyruvic transaminase (SGPT) among PDAs were significantly higher than those of the general population in southern Taiwan (P less than 0.0001). The more frequent the institutionalisation, the higher the infection rates with HBV and HDV and elevated levels of SGOT and SGPT. Horizontal transmission through parenteral drug abuse may be considered a possible reason for the significantly higher rates of HBV and HDV among parenteral drug abusers. PMID- 2778446 TI - Acute type A hepatitis presenting with hypotension, bradycardia, and sinus arrest. AB - The cardiovascular complications of viral hepatitis are not widely recognized. Profound hypotension and a variety of dysrhythmias, including sinus arrest, have been reported in association with viral hepatitis, but most of these cases were described before the advent of specific viral serologic markers. Furthermore, previous instances of cardiovascular complications occurred during the course of an established viral syndrome. We report the cases of two previously healthy women who presented with unexplained hypotension and bradycardia as the initial manifestations of acute icteric hepatitis A. This phenomenon appears to represent a variant clinical presentation of a common viral entity. PMID- 2778447 TI - A dynamic study of the intrafamilial spread of hepatitis B virus infection: relation with the viral replication. AB - A total of 848 household contacts of 285 hepatitis B surface antigen (HBsAg) chronic carriers were included in a prospective study. Of the total number of contacts negative for hepatitis B virus (HBV) markers at baseline, 330 relatives of 145 HBsAg carriers were observed over a mean period of 20.1 months. Among all household contacts, 284 (33.5%) were found positive for at least one HBV marker. The prevalence of HBV markers was significantly higher among the contacts of more than one HBsAg carrier (75.9%) than among those with only one (26.0%) (P less than .001). The presence of hepatitis B e antigen (HBeAg), specific HBV-DNA polymerase (HBV-DNAp), HBV-DNA, and polymerized human serum albumin (pHSA-R) in the index case was associated with a significantly higher incidence of HBV markers among household contacts. During the follow-up, the number of household contacts initially negative for HBV markers who became infected was found to be in direct relation to the presence of HBeAg, HBV-DNAp, HBV-DNA and pHSA-R in the index case. PMID- 2778449 TI - A mammalian cell agar-diffusion assay for the detection of toxic compounds. AB - A method using murine P-388 leukemia or human HT-29 colon carcinoma cells was developed for the bioautography of potential antitumor agents. Of 18 cancer chemotherapeutic drugs and natural products tested, all were detected by toxicity at 0.01 or 1.0 micrograms with P-388 cells, and 11 of the 18 were detected at 10 micrograms or less with HT-29 cells. Bioautography of a crude extract of Pseudoplexaura wagenaari and subsequent purification yielded the known compound crassin acetate. With modification, the assay detected specifically toxic DNA binding agents. PMID- 2778448 TI - Bullatacin and bullatacinone: two highly potent bioactive acetogenins from Annona bullata. AB - Screening of crude extracts of the bark of Annona bullata showed cytotoxic and pesticidal activities. By monitoring with brine-shrimp lethality, two novel, extremely potent acetogenins, bullatacin [1] and bullatacinone [2], were isolated. Spectral and chemical methods identified bullatacin as a diastereomer of asimicin. Bullatacinone represents bullatacin with the lactone cleaved and reformed at the 4-OH. Compounds 1 and 2 show selective cytotoxicities in human tumor cell lines, and certain susceptible cells give ED50 values as low as 10( 12)-10(-15) micrograms/ml. Bullatacin was pesticidal at concentrations as low as 1 ppm, but bullatacinone lacked pesticidal activities. The known compounds liriodenine and (-)-kaur-16-en-19-oic acid were also isolated and were lethal to brine shrimp but were not significantly cytotoxic. PMID- 2778450 TI - 7-O-methylhorminone and other cytotoxic diterpene quinones from Lepechinia bullata. AB - Three cytotoxic diterpene quinones, 6,7-dehydroroyleanone [1], horminone [2], and 7-O-methylhorminone [3], were isolated from an MeOH extract of Lepechinia bullata after bioassay-directed fractionation. Compound 3 is a new compound whose structure was determined through spectroscopic analysis. PMID- 2778452 TI - Isolation of flavonoids and a chalcone from Helichrysum odoratissimum and synthesis of helichrysetin. AB - 3,5-Dihydroxy-6,7,8-trimethoxyflavone, 3-O-methylquercetin, and helichrysetin were isolated from the flowers of the Rwandese medicinal plant, Helichrysum odoratissimum. Because of inconsistencies of the mp of the latter chalcone, a synthesis of helichrysetin was developed. 3-O-Methylquercetin was shown to be an active principle as it displayed antimicrobial activity. PMID- 2778451 TI - New humantenine-type alkaloids from Gelsemium elegans. AB - The alkaloid extract of the whole plant of Gelsemium elegans has afforded four new alkaloids: N-desmethoxyrankinidine [1], 11-hydroxrankinidine [3], 11 hydroxyhuman-humantenine [4] and humantenirine [6]. The structures of 5 was established through X-ray crystallographic analysis, and the structures of the other three new alkaloids were deduced by spectral analysis (1H, 13C, APT, 2D COSY and 2D-HETCOR). PMID- 2778453 TI - A new bioactive derivative of avarol from the marine sponge Dysidea avara. AB - A new derivative of avarol, monoacetyl avarol, has been isolated from the sponge Dysidea avara. The structural elucidation and biological activities are reported. PMID- 2778454 TI - Toxicants from mangrove plants, V. Isolation of the piscicide, 2-hydroxy-5 methoxy-3-undecyl-1,4 benzoquinone (5-O-methylembelin) from Aegiceras corniculatum. AB - Extracts of the twigs and stems of the mangrove plant Aegiceras corniculatum demonstrated toxicity to fish (Tilapia nilotica). 5-O-Methylembelin was isolated and was shown to be toxic to fish at a concentration of 1 ppm within a period of 75 min. The structure of 5-O-methylembelin was determined by a study of spectroscopic properties and comparison with an authentic synthetic sample. PMID- 2778455 TI - Bioactive compounds from the root of Myrsine africana. AB - Bioactivity-directed fractionation of the EtOH extract of the roots of Myrsine africana, using lethality to brine shrimp, led to the isolation and identification of emodin and 2-hydroxychrysophanol as cytotoxic components, the latter being a new natural product. Nepodin and 5-methoxy-7-hydroxyphthalide were also isolated but were not significantly cytotoxic. PMID- 2778456 TI - 12,13-Deoxytrichoverrins from Myrothecium verrucaria. AB - The structures of two new diastereoisomeric 12,13-deoxytrichothecenes have been established by a combination of nmr and mass spectroscopy. PMID- 2778457 TI - Pattern recognition study of QSAR substituent descriptors. AB - Parameter values for 59 common substituents and 74 descriptors used in QSAR studies were compiled. This data matrix was analysed by a variety of multivariate techniques. Linear regression confirmed that lipophilicity can be factorized into two terms, one related to molecular bulk and the other to polarity. Principal component analysis (PCA) of parameters revealed 5 significant principal components and a grouping of lipophilic, steric and electronic parameters. The different loadings of parameters with 5 PCA were also explored. The classification of substituents by cluster analysis (CA) proved rather disappointing. In contrast, the SIMCA method classified substituents of increasing bulk into 5 groups of increasing polarity. PMID- 2778458 TI - Highly conformationally constrained halogenated 6-spiroepoxypenicillins as probes for the bioactive side-chain conformation of benzylpenicillin. AB - The halogenated 6-spiroepoxypenicillins are a series of novel semisynthetic beta lactam compounds with highly conformationally restricted side chains incorporating an epoxide. Their biological activity profiles depend crucially on the configuration at position C-3 of that epoxide. In derivatives with aromatic containing side chains, e.g., anilide, the 3R-compounds possess notable Gram positive antibacterial activity and potent beta-lactamase inhibitory properties. The comparable 3S-compounds are antibacterially inactive, but retain beta lactamase inhibitory activity. Using the molecular simulation programs COSMIC and ASTRAL, we attempted to map a putative, lipophilic accessory binding site on the PBPs that must interact with the side-chain aromatic residue. Comparative computer-assisted modelling of the 3R-, and 3S-anilides, along with benzylpenicillin, indicated that the available conformational space at room temperature for the side chains of the 3R- and the 3S-anilides was mutually exclusive. The conformational space for the more flexible benzylpenicillin could accommodate the side chains of both the constrained penicillin derivatives. By a combination of van der Waals surface calculations and a pharmacophoric distance approach, closely coincident conformers of the 3R-anilide and benzylpenicillin were identified. These conformers must be related to the antibacterial, 'bioactive' conformer for the classical beta-lactam antibiotics. From these proposed bioactive conformations, a model for the binding of benzylpenicillin to the PBPs relating the three-dimensional arrangement of a putative lipophilic S2 subsite, specific for the side-chain aromatic moiety, and the 3 alpha-carboxylate functionality is presented. PMID- 2778460 TI - Classification of epidemiologic research. PMID- 2778459 TI - Charge calculations in molecular mechanics 7: application to polar pi systems incorporating nitro, cyano, amino, C=S and thio substituents. AB - A previously described method for calculating partial atomic charges in molecules has been applied to a variety of different functional groups with pi electrons. The pi charges have been determined by varying the relevant Hukel coulombic and resonance integrals so as to reproduce the experimental dipole moments of known compounds. These include nitro, cyano, mercapto and thiocarbonyl compounds, anilines and a series of heterocyclic ring compounds involving nitrogen, oxygen and sulphur atoms. The calculated dipole moments are in good agreement with experimental values and are a considerable improvement on other calculated values, while requiring only a fraction of the computational time necessary for more rigorous methods. The resulting pi densities compare favourably with other theoretical (CNDO, MNDO and STO-3G) methods. PMID- 2778461 TI - What is directionality? PMID- 2778462 TI - "Directionality" in epidemiologic research. PMID- 2778463 TI - Directionality, timing, and sample selection in epidemiologic research design. PMID- 2778464 TI - Directionality and scientific inference. PMID- 2778465 TI - Blockage of urinary catheters: role of microorganisms and constituents of the urine on formation of encrustations. AB - Long-term indwelling urinary catheters may become blocked in some patients by formation of encrustations made up of aggregated struvite crystals while other patients rarely develop blocked catheters. We have designated these groups as "blockers", "intermediates" or "non-blockers". To further understand this phenomenon we followed 32 catheterized elderly women in a nursing home. Catheters were changed six times at 2 week intervals. Patients tended to remain as "blockers", "intermediates" or "non-blockers" consistently over time. There were no significant differences in use of antibiotics, clinical manifestations of urinary infection or fever among the groups. "Blockers" were significantly more often colonized with Proteus mirabilis and Providencia stuartii than "non blockers", and significantly less often with Klebsiella pneumoniae. However, there was no evidence of interference among the organisms. "Blockers" excreted a significantly more alkaline urine, and lesser amounts of magnesium, urea and phosphate in their urine. Two "blockers" in whom Proteus sp. were eliminated by coincidental antimicrobial therapy converted to "non-blockers". These findings support the concept that "blockers" are patients who have prolonged colonization with urease producing Proteus mirabilis and Providencia stuartii. PMID- 2778466 TI - Modeling percentage change: a potential linear mirage. AB - The percentage change over time in a variable such as serum creatinine or blood pressure is a potentially appealing outcome measure for longitudinal studies of prognosis or therapy. We demonstrate that when the baseline value of the variable used in the calculation of the percentage change outcome is included in a linear regression model as an independent predictor, a quadratic relationship between the baseline level and the predicted outcome level of this same variable is inevitably masked by the linear regression model. Misinterpretation of the percentage change model has resulted in conflicting results regarding the value of serum creatinine as a prognostic marker in lupus nephritis. We illustrate the problem and resolve the conflict using data on 87 patients with lupus nephritis. A straightforward alternative approach to the use of percentage change as an outcome is proposed: it is not subject to the problems of interpretation noted in the percentage change model. PMID- 2778467 TI - Regional and urbanization differentials in coronary heart disease mortality in the United States, 1968-85. AB - Regional and urbanization differentials in coronary heart disease (CHD) mortality among white males aged 35-74 years have been examined during 1968-78 and 1979-85. Many of the differentials in CHD mortality found during 1968-78 persisted during 1979-85, e.g. the west had the lowest death rates. Fringe metropolitan (suburban) areas had low rates, and CHD death rates continued to decline, albeit at a faster rate. The urbanization pattern observed for the south differed from that for other regions; the core metropolitan area had the lowest CHD death rates in the south, but the highest in the other regions. The removal of arteriosclerotic cardiovascular disease deaths from the CHD rates under ICD-9 resulted in decreases in CHD mortality between 1978 and 1979 with large decreases in the South and in core metropolitan areas. Indeed, decreases in the core metropolitan areas of the midwest and west were so large that the urbanization pattern changed. PMID- 2778468 TI - Risk of functional decline among well elders. AB - Active lifestyles may delay the onset of the functional consequences of chronic disease, potentially increasing active life expectancy. We analyzed the Longitudinal Study of Aging (LSOA) to test the hypothesis that elders participation in an active lifestyle prevents loss of function. Focusing on the cohort aged 70-74 who reported being able to carry 25 lb, walk 1/4 mile, climb 10 steps and do heavy housework without help and without difficulty at baseline, decline was defined as no longer being able to perform these tasks independently and without difficulty 2 years later. Using multivariate logistic regression, results reveal that those who did not report regularly exercising or walking a mile were 1.5 times more likely to decline than those who did, controlling for reported medical conditions and demographic factors. Similar findings (with different models) were observed for both men and women. Findings suggest the potential value of programs oriented toward the primary prevention of functional decline. PMID- 2778470 TI - Adverse effects of drug banning. PMID- 2778469 TI - Should study subjects see their previous responses: data from a randomized control trial. AB - To test the relative merits of administering questionnaires with previous responses available (the informed condition) or unavailable (the blind condition), we administered blind and informed versions of a quality of life questionnaire (the Chronic Respiratory Disease Questionnaire, or CRQ) in a randomized, double-blind trial of bronchodilators in chronic airflow limitation. The responsiveness of the two methods, as reflected in the p-values associated with salbutamol and theophylline effects were comparable for three of the four dimensions of the CRQ. The data suggested possible increased responsiveness of the informed method for the emotional function dimension of the questionnaire. Changes in the informed CRQ dyspnea and fatigue dimensions showed stronger correlations with changes in spirometry, 6 minute walk distance, and rating of dyspnea after the walk test than did blind administration. Further, changes in all four CRQ dimensions showed stronger correlations with corresponding global ratings using the informed questionnaire. These results suggest that by letting study subjects see their previous responses the validity of subjective measures of health status in clinical trials can be improved. PMID- 2778471 TI - The time lag between menarche and marriage as a risk factor for cervical dysplasia. PMID- 2778472 TI - The goal of nursing research. PMID- 2778473 TI - Community participant-observation: issues in assessing diverse cultures. PMID- 2778474 TI - Community nursing diagnosis. AB - The community health nursing faculty at Kent State University in Kent, OH developed a community assessment tool in accordance with the health pattern typology described by Gordon (1982). The purpose of the tool is to facilitate students' use of the nursing process with communities and to provide students and faculty the opportunity to explore the process of developing community nursing diagnoses. PMID- 2778475 TI - STD patients' knowledge about AIDS and attitudes toward condom use. AB - Patients (N = 71) from a sexually transmitted disease (STD) clinic in an urban setting were surveyed to determine their knowledge about acquired immune deficiency syndrome (AIDS) and attitudes toward condom use. Overall knowledge scores were high with a mean score of 22 on the 28-item true-false questionnaire. No statistical significance was found between AIDS-knowledge scores and condom use behavior. The majority of subjects or their partners had STD symptoms and multiple partners within a 6-month period. Thirty percent of the respondents reported using condoms at least 25% of the time. In response to open-ended statements about condoms, 10 beliefs were mentioned most frequently. The majority of subjects reported protection against sexually transmitted disease and preventing pregnancy as the most important reasons for condom use. "Avoids getting AIDS" only ranked as the eighth most salient belief and few subjects with multiple partners in the previous 6-month period even cited this belief. Other significant beliefs about condom use included decreased feeling, worry about breakage, decreased pleasure for partner, uncomfortable, feeling safe, inconvenient, and not romantic. The most significant referent (normative belief) influencing condom-use decision making was "mother" in younger subjects and "sexual partner" for older subjects. The sexual partner had unfavorable attitudes toward condom use. These results indicate the need to incorporate attitudes and normative beliefs to change condom-use behavior. PMID- 2778476 TI - Enhancing self-care in diabetes management using self-regulatory processes. AB - Findings from recent research on the self-regulatory process in Type II diabetes mellitus have clinical relevance for nurses and other diabetes educators. We analyzed a symptom self-regulation model and its relationship to demographic and therapeutic variables in persons with Type II diabetes mellitus. The model suggested that when such diabetic clients experienced disease-related symptoms, they used these symptoms as signals of abnormal blood glucose and took action to relieve these symptoms and improve their blood-glucose level. These actions were often judged by the investigators to have no immediate effect on blood-glucose level or, in some cases, to potentially worsen blood glucose. In this article, intervention strategies for nurses and other professionals engaged in diabetic education are developed to improve objective validation of symptom accuracy and to modify some perceptions held by the client with noninsulin-dependent diabetes and, in particular, those clients using oral agents. PMID- 2778477 TI - A description of community health nursing practice with the community-based elderly. AB - Current Medicare policy does not reimburse for the maintenance and prevention services provided by community health nurses (CHNs) in the management of those community-based elderly who are at risk of institutionalization due to chronic disease and/or functional dependence. Before CHNs can legitimately expand their practice into the area of management of chronic disease in the elderly, they must develop a better understanding of the relationship between the needs of this population and community health nursing practice. This study is one effort to build the desired data base to demonstrate the value of CHN involvement with the community-based elderly. PMID- 2778478 TI - Surgical adjuvant therapy of large-bowel carcinoma: an evaluation of levamisole and the combination of levamisole and fluorouracil. The North Central Cancer Treatment Group and the Mayo Clinic. AB - A total of 401 eligible patients with resected stages B and C colorectal carcinoma were randomly assigned to no-further therapy or to adjuvant treatment with either levamisole alone, 150 mg/d for 3 days every 2 weeks for 1 year, or levamisole plus fluorouracil (5-FU), 450 mg/m2/d intravenously (IV) for 5 days and beginning at 28 days, 450 mg/m2 weekly for 1 year. Levamisole plus 5-FU, and to a lesser extent levamisole alone, reduced cancer recurrence in comparison with no adjuvant therapy. These differences, after correction for imbalances in prognostic variables, were only suggestive for levamisole alone (P = .05) but quite significant for levamisole plus 5-FU (P = .003). Whereas both treatment regimens were associated with overall improvements in survival, these improvements reached borderline significance only for stage C patients treated with levamisole plus 5-FU (P = .03). Therapy was clinically tolerable with either regimen and severe toxicity was uncommon. These promising results have led to a large national intergroup confirmatory trial currently in progress. PMID- 2778479 TI - Spondylectomy for malignant tumors of the spine. AB - Spondylectomy is the complete surgical removal of all parts of one or more vertebrae above the sacrum. We report our initial experience with spondylectomy in eight patients with malignant tumors of the spine operated on over a 7-year period (1980 to 1986). Four patients had primary neoplasms of the spine, and four others had solitary metastases to the vertebrae. Following surgery, five patients underwent radiation therapy (RT) and chemotherapy depending on histology of the tumor. Radiographic confirmation of tumor resection was obtained on all patients. Pain relief was noted in all patients, and six patients with preoperative neurological deficits improved. There was no surgical mortality, and one patient developed wound dehiscence following surgery. Six of the eight patients are alive with a median follow-up of 36 months, and local control was achieved in six of the eight patients. These preliminary data suggest that malignant tumors of the spine can be completely resected using a staged approach. In potentially responsive tumors, systemic chemotherapy is recommended between the two operations to reduce the risk of systemic dissemination. PMID- 2778480 TI - Management of postchemotherapy residual mass in patients with advanced seminoma: Indiana University experience. AB - Thirty-six patients with advanced seminoma treated with cisplatin combination chemotherapy were evaluated to assess the significance of postchemotherapy residual radiographic mass. All patients had a minimum follow-up of 2 years. Of the 36 patients 21 had an evaluable residual radiographic mass after completion of chemotherapy. Twelve of these patients had a less than 3 cm maximal transverse diameter residual mass, and nine had a greater than 3 cm persistent mass postchemotherapy. Only three of these 21 patients underwent postchemotherapy retroperitoneal lymph node dissection, and the histopathology revealed only necrotic fibrous tissue. The remaining patients were followed by close observation including repeat abdominal computed tomography (CT) every 3 months the first year and every 6 months the second year (or until normal); further therapeutic intervention was given only on evidence of progressive disease. Nineteen of these 21 patients have no evidence of disease, including eight of nine with greater than 3 cm persistent radiographic abnormality. The optimal management for advanced seminoma patients with a persistent radiographic mass postchemotherapy remains unresolved. However, based on this small series, we feel that observation is a viable option, reserving radiotherapy or chemotherapy for those patients who subsequently develop progressive disease. PMID- 2778481 TI - Etoposide, dexamethasone, cytarabine, and cisplatin in vincristine, doxorubicin, and dexamethasone-refractory myeloma. AB - Based on remarkable activity in refractory lymphomas, a combination of etoposide, cisplatin (both administered by 4-day continuous infusions), cytarabine (Ara-C), and dexamethasone (EDAP) was evaluated in 20 patients with advanced myeloma refractory to standard melphalan and prednisone (MP) and/or vincristine, Adriamycin (doxorubicin; Adria Laboratories, Columbus, OH), and dexamethasone (VAD) and even to high doses of melphalan (HDM) (seven patients). Forty percent of patients responded regardless of previously recognized risk factors (eg, duration of drug resistance, tumor mass, and serum lactic dehydrogenase [LDH] level). While the median survival was only 4.5 months, patients with good performance (Zubrod less than 2) and low or intermediate tumor stage survived more than 14 months compared with only 2 months for the remaining group. EDAP could be readily administered in the outpatient clinic, but neutropenic fever prompted hospital admission in 80% of patients, half of whom developed penumonia and sepsis, a fatal outcome in four patients. Severe myelosuppression was of short duration, so that subsequent cycles could be administered every 3 to 4 weeks. No serious extramedullary toxicity, including renal toxicity, was encountered. Marrow toxicity and hence infectious complications may be reduced by elimination of Ara-C without compromising treatment efficacy. We conclude that the lack of cross-resistance with VAD and even HDM makes EDAP or a similar combination an attractive regiment to be formally explored in an alternating sequence with VAD in high-risk myeloma. PMID- 2778482 TI - A prospective ophthalmic evaluation of patients with acute myeloid leukemia: correlation of ocular and hematologic findings. AB - We report the results of a prospective 2-year study of the ocular manifestations of myeloid leukemia. Fifty-three patients underwent complete ophthalmic evaluation prior to the initiation of treatment as well as during the course of their disease. All ocular abnormalities were confined to the retina and optic nerve and were present in 34 patients, 30 of whom had either hemorrhages or cotton-wool spots alone or in combination. These findings were unrelated to age, sex, French-American-British (FAB) classification, and pretreatment leukocyte count or hematocrit. Patients with retinopathy had significantly lower platelet counts than those without retinopathy. Three patients had funduscopic evidence of optic nerve edema. None of these had clinical evidence of CNS leukemia. The presence of retinopathy was unrelated to therapeutic response. There was complete resolution of all ocular findings in those patients surviving the induction phase of therapy. PMID- 2778483 TI - Intermediate-dose intravenous methotrexate and mercaptopurine therapy for non-T, non-B acute lymphocytic leukemia of childhood: a Pediatric Oncology Group study. AB - Methotrexate (MTX) and mercaptopurine (MP) are the mainstays of continuation therapy for acute lymphocytic leukemia (ALL). These drugs are stored in tissues as active metabolites. Relapse in ALL might reflect failure to achieve adequate intracellular drug levels. Assured (parenteral) delivery of higher doses of MTX and MP should maximize tissue levels of these drugs by overcoming individual variations in absorption, metabolism, clearance, and compliance. Fifty-nine children with ALL at lower risk of relapse received 12 intensive MTX/MP courses immediately after 4 weeks of standard vincristine, prednisone, and asparaginase induction. Each 2-week intensive course included: MTX, 200 mg/m2 intravenous (IV) push then 800 mg/m2 IV over 24 hours on day 1; MP, 200 mg/m2 IV push then 800 mg/m2 IV over 8 hours on day 2; MTX, 20 mg/m2 intramuscularly on day 8; and MP, 50 mg/m2 orally daily on days 8 to 14. After the 6 months of intensive therapy, continuation therapy was weekly MTX/MP (as on days 8 to 14) for 1 or 2 years. Age based MTX was given intrathecally (IT) for CNS prophylaxis. All patients entered remission. Three patients relapsed: bone marrow (at 24 and 37 months), and bone marrow and CNS (at 34 months). There were no isolated CNS relapses or deaths in remission. Event-free survival at 4 years is 94% (SE, 7%) by Kaplan-Meier analysis. Toxicities (infection, mucositis) occurred in less than 10% of intensive MTX/MP courses. However, a child with Down's syndrome withdrew after three courses because of recurrent severe mucositis. Further studies of this regimen are in progress. PMID- 2778484 TI - The association between high-dose cytarabine neurotoxicity and renal insufficiency. AB - We reviewed the medical records of 110 consecutive patients at our institution who had acute leukemia and received high-dose cytarabine (Ara-C; HDAC) in order to analyze risk factors associated with HDAC neurotoxicity (NT). There were adequate records on 101 patients who received 147 courses of HDAC. Twenty-six treatment courses (18%) were complicated by NT. The median time of NT onset was 5 days (range, 1 to 10 days), and NT was reversible in 16 of 21 survivors (76%). Patients with severe NT (grades 3 to 4) were less likely to have complete reversal of their neurological deficit than those with mild NT (P less than .1). In our patients, there was no significant association between previously described risk factors (age over 49 years, male gender, CNS disorder, and cumulative HDAC dose greater than 48 g/m2) and incidence of NT. However, treatment courses involving HDAC given during renal insufficiency (serum creatinine greater than or equal to 1.5 mg/dL or an increase in serum creatinine greater than 0.5 mg/dL) were much more likely to be complicated by any degree of NT during administration of HDAC (62%) and severe NT (42%) than those given during normal renal function (8% and 3%, respectively; P less than .001). Of the treatment courses involving patients with estimated creatinine clearances less than 60 mL/min, 76% were complicated by NT compared with 8% of treatment courses involving patients with clearances greater than 60 mL/min (P less than .001). HDAC courses with neurotoxic patients had higher serum creatinines (2.1 +/- 1.4 v 1.1 +/- 0.6 mg/dL), greater increases in serum creatinine (+ 0.5 +/- 0.8 v + 0.07 +/- 0.3 mg/dL), and lower estimated creatinine clearances (61 +/- 35 v 91 +/- 29 mL/min) than those courses with nonneurotoxic patients (P less than .001, all parameters). Patients receiving HDAC during renal insufficiency are at high risk for developing NT. Dose reduction of HDAC should be considered for patients with renal insufficiency. PMID- 2778485 TI - Acanthocytosis associated with myelodysplasia. AB - Dysplastic hematopoiesis associated with erythrocyte macrocytosis is a morphologic hallmark of myelodysplasia. We report the cases of six patients with myelodysplasia in which acanthocytosis was the predominant red blood cell (RBC) abnormality. In each case acanthocytes represented 5% to 10% of circulating RBC forms and was the primary reason for referral in two cases. None of the patients had comorbid conditions known to be associated with acanthocyte formation. Myelodysplasia should be considered in the differential diagnosis of acanthocytosis, particularly in the anemic, elderly individual. Acanthocytosis may be a harbinger of an unrecognized, hematologic stem-cell disorder. PMID- 2778486 TI - Addition of verapamil to overcome drug resistance in multiple myeloma: preliminary clinical observations in 10 patients. PMID- 2778487 TI - Adverse interactions between cytotoxic drugs and hormonal agents in human breast cancer cells. PMID- 2778488 TI - Malignant tumors in patients with human immunodeficiency virus infection: a report of 580 cases. PMID- 2778489 TI - Epidural compression from metastatic tumor with resultant paralysis. AB - To determine the value of the usually given 'urgent' palliative radiotherapy in paraplegic patients with epidural compression from metastatic tumor, 20 consecutive cases treated between 1981 and 1986 were retrospectively analyzed. Bronchogenic and prostatic carcinoma were the more common extraspinal sources of metastasis. Epidural metastasis involved the thoracic spine in most cases. The onset of neurological symptomatology was frequently within two weeks prior to hospitalization. The majority of the subjects received at least 3000 cGy given in 10 to 15 fractions. Symptomatic (pain relief) response rate was 78 (7/9) percent. The observed period of survival averaged 2.5 months after treatment. This study reaffirmed the little chance for recovery of lost limb(s0 motor function. None of the patients (most of whom were paraplegic from two to 90 days pre-irradiation) became ambulatory including the two in whom irradiation was administered within 24 hours from the onset of paraplegia. PMID- 2778490 TI - Sensitivity of glioma and fetal brain cell lines to natural killer cytolysis in a monolayer assay. AB - We have developed an in vitro assay for Natural Killer (NK) cell cytolysis of and binding to substrate attached human glioma and fetal brain cells. The monolayer cells were labeled with [51Cr] and the effectors were directly sedimented onto these substrate attached target cells. Using this method we screened several glioma and fetal brain cell lines. The results indicate that the majority of gliomas are NK resistant, however two of the tested lines (U251MG and BN3) were relatively sensitive as were the fetal brain cell lines (CHI and CHII). We conclude that this monolayer assay for NK cytotoxicity and binding of glioma targets is a reproducible and valid method for assessing NK sensitivity, and should have applications in the study of other cultured solid tumors and substrate attached cells. PMID- 2778491 TI - Photosensitization of human glioma cells by chalcogenapyrylium dyes. AB - Chalcogenapyrylium (CP) dyes which are specifically activated by red and near infrared light (600-900 nm) were examined as potential photosensitizers for photochemotherapy of malignant gliomas. Eleven CP dyes of varying chemical structure and redox potential were evaluated for selective toxicity against glioma and normal skin fibroblast cell cultures both before and after light activation. Eight of eleven CP dyes exhibited differential toxicity to tumor over fibroblast cells at dye concentrations of 1.0 microM. Dose dependent toxicity was seen both in the dark and after laser light activation. The toxicity of two of the CP dyes was significantly enhanced by photoactivation with 800 nm light. The CP dyes that absorb light maximally between 775 and 850 nm, in the range of excellent light penetration through brain, appear to be promising candidates as photosensitizers for treating malignant brain tumors. PMID- 2778494 TI - Abstracts for the Eighth International Conference on Brain Tumor Research and Therapy. September 10-13, 1989, Zermatt, Switzerland. PMID- 2778492 TI - Calmodulin content in human central nervous system tumors. AB - Benign and malignant brain tumors and normal cerebral cortex were assayed for calmodulin content by enzymatic and radioimmunoassay techniques. Normal cerebral cortex contained more (8.31 +/- 1.27 vs 3.30 +/- 0.42 micrograms/mg protein) calmodulin than the brain tumors. The contents of calmodulin in the malignant glioblastomas were significantly higher than the meningiomas (5.41 +/- 0.31 vs 2.97 +/- 0.16 micrograms/mg protein). These differences were independent of tumor location and persisted when calmodulin content was normalized for DNA rather than protein content. This data supports differences in the tissue calmodulin contents with normal cortex greater than primary malignant tumors greater than benign tumors greater than metastatic tumor tissue. PMID- 2778493 TI - Interstitial hyperthermia of experimental brain tumor using implant heating system. AB - New experimental system of induction hyperthermia for brain tumor using ferromagnetic implant with low Curie point has been developed. The metal implant is cylindrical needle and made of Fe-Pt alloy with low Curie point suitable for hyperthermia (50-60 degrees C). Induction coil and generator which produce maximum power of 200W and variable frequency of 100-500kHz, yielding magnetic power of 16.7Oe, have been developed. Interstitial hyperthermia was made on rat brain tumor model (T9 gliosarcoma) by this system. Significant effects of single hyperthermia (45 degrees C for 30 minutes) were observed by the extension of life span and morphological changes of the tumor. PMID- 2778495 TI - Crystallographic properties of a series of synthetic hydroxyapatites. AB - The crystallographic properties of hydroxyapatites synthesized at temperatures of 200 degrees C, 500 degrees C, 900 degrees C and 1250 degrees C, designated HAP200, HAP500, HAP900 and HAP1250, respectively, were studied using X-ray powder diffraction. Values of a-axis length for the hydroxyapatites ranged from 9.406 A to 9.416 A, which were smaller than the corresponding value for stoichimetric hydroxyapatite, a = 9.418 A. Generally, the a-axis length decreased with the synthesis temperature, except for HAP500 which showed the smallest value. Crystallinity of the hydroxyapatites, measured by X-ray diffraction peak broadening as full width at the half-maximum value (FWHM), increased with the synthesis temperature, although HAP500 showed a decrease. These results suggest that the synthetic hydroxyapatites contained some carbonate ions, probably at the A-site of the apatite structure, and that the structure was depleted of carbonate ions at about 500 degrees C. PMID- 2778496 TI - A clinicoradiological study of maxillary osteomyelitis. AB - Eleven cases of maxillary osteomyelitis were studied clinically and radiologically. Clinically, the molar area was most affected. The average age of the patients was 47 years and there was no sex difference. Radiologically, the spotty type of osteolytic change was the most frequent, and osteosclerosis was rare. Sequestrum was not a clear feature radiologically. The features of maxillary and mandibular osteomyelitis were compared and the findings discussed. PMID- 2778497 TI - Possibilities and limits of brachycurietherapy in brain tumors. AB - Brachicurietherapy represents a low dose-rate irradiation able to deliver high focal doses within relatively small tumor volumes. Its application to brain tumors utilizing the stereotactic techniques is nowadays considered with growing interest. The Authors analyze, on the basis of their personal experience, the possibilities and the limits offered by this therapeutic procedure in neuro oncology. The choice of the sources and their modality of application, the definition of the optimal dose/time and dose/volume ratio are the main problems taken into consideration and discussed. PMID- 2778498 TI - Some differences in steroid receptors between meningeal and neuroepithelial tumors. AB - In our study we evaluated the presence of steroid hormone receptors in a large series of endocranial tumors and investigated the possible correlations between receptor presence and levels and patient's age and sex. Our data indicate that steroid receptor behavior in the neoplasias considered is quite different from that observed in endocrine-related tumors, such as breast and endometrial cancer. Moreover, in neuroepithelial tumors an interesting difference between male and female subjects has been found regarding the receptor distribution in poor differentiated neoplasias. PMID- 2778499 TI - The trend of serum CA125 levels during the first three courses of chemotherapy as a predictor of second-look findings in patients with ovarian carcinoma. AB - The serum CA125 levels were monitored monthly in a group of 20 patients with ovarian carcinoma undergoing a six-month chemotherapy cycle. None of the 8 patients with serum CA125 levels higher than 65 U/ml before the third course of chemotherapy had negative second-look findings at the end of chemotherapy. Conversely, no evidence of disease at surgical re-evaluation was found in 9 out of 12 (75%) patients with antigen levels lower than 65 U/ml before the third chemotherapy course; on the other hand, none of the 4 patients of this group in whom serum CA125 values fell below 65 U/ml only after the third course, achieved a complete surgical response. Among the 9 patients in whom second-look surgery documented a complete response, 8 had CA125 levels below 35 U/ml and one had CA125 values above 35 U/ml but lower than 65 U/ml at the three-month check-point. These data suggest that the trend of serum CA125 levels during the first three courses of chemotherapy is a strong predictor of second-look findings in patients with ovarian carcinoma at the completion of treatment. PMID- 2778502 TI - Third International Symposium on Technetium in Chemistry and Nuclear Medicine. Padua (Italy), september 6-8, 1989. Abstracts of the communications. PMID- 2778500 TI - Measurement of urinary albumin excretion (UAE) in diabetic patients: immunonephelometry versus radioimmunoassay. AB - We have compared the chemico-clinical characteristics of an immuno-nephelometric technique (INA) with those of a solid-phase radioimmunoassay (RIA) method for the measurement of urinary albumin excretion (UAE) in diabetic patients. The UAE was evaluated in 227 diabetics; all, except 9, were Albustix-negative. The calibration of the nephelometer apparatus every time before the assay did significantly improve the accuracy and precision of the INA method. Similar values were obtained with the two methods (INA = 2.1 + 0.95 RIA, n = 227, r = 0.969) through all the ranges of albumin concentration explored. INA seems as suitable as RIA for the assay of UAE in diabetics. The two methods are comparably accurate and precise. However, RIA appears more sensitive than INA, while immunonephelometric system is easier and faster to perform (up to 200 samples can be assayed in about 1 hour, while 2-4 hours are necessary with RIA), with fewer handling steps. The INA instrumentation is automated and the reagents are more stable and less hazardous than those used in RIA. However, due to the cost of the nephelometer apparatus, the INA technique may be employed by those laboratories which have already this instrumentation or by those which will use it in the next future for the assay of other analytes in addition to albumin. PMID- 2778503 TI - [To chart our own course: a challenge to nursing leaders]. PMID- 2778504 TI - [The current critical issues confronting public health nursing and resolutions in the U.S.A]. PMID- 2778501 TI - Monodisperse labeled aerosol to visualize airflow redistribution in the lung after a mucokinetic drug. AB - A technique based on inhalation of nebulized albumin minimicrospheres labeled with 99mTc (HAMM) was applied to visualize the redistribution of convective ventilation in the lung after a mucokinetic drug treatment. A randomized double blind study comparing the effect of 7 days treatment with 800 mg daily oral sobrerol versus placebo in two groups of 10 patients each, affected by chronic bronchitis, was performed. Routine pulmonary function tests (PFT) and alveolar arterial (Aa) gradients of oxygen and carbon dioxide were performed. Both PFT and Aa gradients did not show significant modification, but the inhomogeneity of HAMM deposition resulted significantly reduced after sobrerol treatment. By means of HAMM technique it was possible to show objectively the reduction of bronchial obstruction secondary to sobrerol treatment. PMID- 2778506 TI - [Public health nursing and productivity measurement. Are home visits the right focus?]. PMID- 2778505 TI - [Intervening with families of demented elderly]. PMID- 2778508 TI - [Proceedings of the nursing paper presentations from the Nursing Research Committee (N.R.C.)]. PMID- 2778507 TI - [National project of the Department of Health (D.O.H.)--medical care network system]. PMID- 2778509 TI - [A survey of emergency room nursing staff's traits]. PMID- 2778510 TI - [A study of preoperative concerns of patients undergoing craniotomy]. PMID- 2778512 TI - [Family therapy]. PMID- 2778511 TI - [Stressors and coping strategies of a quadriplegic patient]. PMID- 2778513 TI - [Reminiscence therapy and application]. PMID- 2778514 TI - The faculty fellowship program: uniting service and education. AB - The outcomes of the pilot year for this project met the goals of increased faculty clinical skills, increased nursing personnel at the unit level and the completion of specified projects based on identified clinical needs. Continued development of the Faculty Fellowship Program will yield further opportunity to study benefits, such as increased student performance in the acute care setting, increased recruitment of graduate nurses and improved integration of nursing education and service in addressing health care issues. PMID- 2778516 TI - Nursing retention--preventing the domino effect. PMID- 2778515 TI - Setting standards and evaluating nursing performance with a single tool. AB - Establishing standards for the desired quality of nursing care requires identifying clear expectations for professional practice and evaluating related performance by objective, quantifiable criteria. The authors describe development of a job description/evaluation tool, the analysis of that process, and the initial findings of pilot testing. PMID- 2778517 TI - Electronic mail basics. AB - Electronic mail can improve productivity, preserve resources, and contain costs in nursing organizations. Because of its speed, reliability, and convenience, electronic mail virtually eliminates "telephone tag," drastically reduces the turnaround time for responses to messages, produces documentation of conversations, reduces the need for travel and face-to-face meetings, and improves the information processing efficiency of all who use this computer age tool. PMID- 2778518 TI - Psychiatric intervention in the community hospital emergency room. AB - Community hospitals are seeing an increasing number of patients with psychiatric problems in their emergency rooms (ERs). Nurse administrators can decrease extended ER psychiatric patient waiting, and the disruptive behavior which may result, by using an interdepartmental team of ER and mental health unit RNs able to perform psychiatric assessments. This can be accomplished through a competency program based on collaboration. PMID- 2778519 TI - Challenging yesterday's ideas. PMID- 2778520 TI - Factors associated with role stress in middle managers. PMID- 2778521 TI - Nursing research image at Beth Israel Hospital, Boston. PMID- 2778522 TI - A human capital approach to ICU nurse retention. AB - Nursing staff turnover is a critical personnel problem for nursing administrators and top hospital management. High turnover rates degrade the quality of patient care. They are economically dysfunctional when they reduce the capacity of hospital units; the facility loses revenues which can in turn exacerbate retention problems. Good management practice requires that nursing staff turnover be closely and routinely monitored with indices reporting both personnel numbers and staff experience status. The author describes an approach to the prevention of dysfunctional turnover levels by the establishment of retention objectives funded in the hospital budget. PMID- 2778523 TI - Convergent-beam diffraction, Part I. PMID- 2778524 TI - Symmetry analysis. AB - The crystal point- and space-group determination method using convergent-beam electron diffraction (CBED) is reviewed. Crystal symmetry elements that can be observed by CBED are discussed. PMID- 2778525 TI - Practical phase identification by convergent beam electron diffraction. AB - The purpose of this article is to present a practical guide to the identification of phases in the analytical electron microscope with the aid of convergent beam electron diffraction. There is included a step-by-step approach to phase analysis, from the possible choices of the form of the specimen through how to explore reciprocal space in order to perform a full phase identification, either by symmetry analysis or by simple comparison of a pattern observed in the microscope with a previously recorded pattern (fingerprinting). There is a strong emphasis on practical hints and useful shortcuts. PMID- 2778526 TI - Techniques of convergent beam electron diffraction. AB - The techniques required to record standard convergent beam electron diffraction patterns in an analytical electron microscope are discussed in detail, with emphasis on the design of electron optics in commercial instruments. Practical comments are included on specimen preparation, the influence of crystal defects, tilting to major zone axes, and alignment of the instrument. The influence of parameters under experimental control such as probe size, accelerating voltage, temperature, specimen thickness, and convergence angle is discussed in detail. Some comments are included on the alignment and limitations of large angle patterns formed by a defocused probe. PMID- 2778528 TI - The impact of AIDS on women's lives and implications for nurse-midwifery practice. PMID- 2778529 TI - Integrating HIV/AIDS risk assessment into a nurse-midwifery practice. PMID- 2778527 TI - Raising our HIV consciousness. PMID- 2778530 TI - Counseling women regarding high risk behaviors associated with HIV infection. PMID- 2778531 TI - Adapting universal precautions in a CNM service. PMID- 2778532 TI - Confidentiality in the HIV antibody testing process. PMID- 2778533 TI - A sample protocol for HIV counseling and testing. PMID- 2778534 TI - Knowledge, attitudes, and beliefs of HIV seronegative women about AIDS. PMID- 2778535 TI - AIN-76 diet: should we change the formulation? AB - This is a summary of the AIN-76 Workshop held on March 19, 1989, at the FASEB meetings in New Orleans, LA. The purpose of this preliminary workshop was to discuss whether or not changes should be made in the formulation of the AIN-76 rodent diet. The following are highlights of some of the recommendations made by various expert committees, but they do not constitute a new formulation of the rodent diet: 1) fat should comprise no less than 10% by weight of the diet, and the fatty acid content should be standardized; 2) there should be some standardization of the source of cellulose fiber, and the amorphous form is better than the crystalline form; 3) the level of dietary vitamin E should be raised by 50% if the dietary fat content is increased to 10%; 4) one suggested alternative to decrease the incidence of nephrocalcinosis in rats consuming the AIN-76 diet for long periods is to decrease the calcium phosphate dibasic content to 400 g/kg mineral mixture; and 5) the level of manganese should be decreased to 10 mg/kg diet. PMID- 2778536 TI - Protein digestion in weanling pigs: effect of feeding regimen and endogenous protein secretion. AB - Protein digestion and absorption were measured in weanling pigs (5 wk of age) using a total digesta collection procedure. In the first experiment, the objective was to measure the fate of nitrogenous digesta as it passed from the stomach to the terminal ileum when pigs were either allowed ad libitum access to feed or were fed four equal meals per day. Pigs were fed a standard corn-soybean meal diet in this experiment. There were no differences in flow rate or retention time of dry matter or nitrogen, and no differences in apparent nitrogen digestibility between the two feeding regimens. More than 80% of the soluble protein in the stomach and 65% in the small intestine was between 2,000 and 15,000 molecular weight. The molecular weight profiles of the soluble proteins were relatively constant throughout the small intestine, indicating that the products of protein hydrolysis were absorbed rapidly. The objective of the second experiment was to compare protein digestion and absorption in pigs fed a corn soybean meal diet with those fed a protein-free diet. The molecular weight profiles of soluble protein were similar for the two groups of pigs. The data indicate that most of the endogenous enzymes were hydrolyzed rapidly, since little soluble protein corresponding to the molecular weight of pancreatic enzymes was detected. PMID- 2778537 TI - Megadose effects of vitamin C on vitamin B-12 status in the rat. AB - Effects of ascorbic acid ingestion on the severity of vitamin B-12 deficiency were investigated by feeding weanling rats experimental diets containing 0-100 micrograms of vitamin B-12 activity per kg of diet, with or without 6.0 mg of ascorbic acid per ml supplied in drinking water for 15 wk. This daily consumption of up to 150 mg of ascorbic acid did not impair growth, but did result in significantly higher concentrations of ascorbic acid in plasma, liver, adrenal glands and feces. When rats were fed diets deficient or marginally deficient in vitamin B-12, liver concentrations of vitamin B-12 were markedly lower than in liver of rats fed adequate vitamin B-12. Ascorbic acid ingestion raised values significantly in the vitamin B-12-deficient diet group. Urinary methylmalonic acid was significantly elevated in the deficient rats. However, it was significantly reduced to more normal values by ascorbic acid in rats with both low and marginal vitamin B-12 status, as defined by dietary and liver concentrations of vitamin B-12 activity. Although coprophagy was not prevented, rats showed no increased consumption of feces with the higher ascorbic acid content. Thus, the results of this research indicate that vitamin C ingestion partially protects rats from vitamin B-12 deficiency. PMID- 2778538 TI - Maternal and fetal selenium concentrations and their interrelationships in dairy cattle. AB - Paired dam-fetus serum, whole blood and liver samples were collected from 101 pregnant dairy cattle at slaughter to establish mean values for fetal tissue selenium concentration and to determine relationships between maternal and fetal selenium status. Samples were assayed for selenium concentration in serum, whole blood and liver and for whole blood glutathione peroxidase (GSH-Px) activity. Fetal age was estimated from fetal crown-to-rump length. Mean fetal liver (2.14 micrograms/g dry wt) and serum (21.4 ng/ml) selenium concentrations and whole blood GSH-Px activity (21.6 mu/ml) differed (P less than 0.0001, 0.0001 and 0.01, respectively) from corresponding maternal values (0.95 micrograms/g liver dry wt; 44.0 ng/ml; 16.7 mu/ml, respectively), while no differences were found between whole blood or erythrocyte selenium concentrations. Fetal liver selenium concentration was greater than corresponding maternal liver selenium in 99% (96/97) of the dam-fetal pairs, suggesting efficient placental transfer and fetal concentrating ability. Maternal liver selenium concentration was most highly correlated to all fetal tissue selenium concentrations and used to develop prediction models. These data suggest that selenium efficiently passes the placenta, and based on published values of adequate adult liver selenium concentrations and maternal-fetal relationships, we suggest an adequate liver selenium concentration in the bovine fetus to be greater than 2.2 micrograms/g liver dry wt, and in whole blood, greater than 120 ng/ml. PMID- 2778539 TI - Absorption of inorganic, trivalent chromium from the vascularly perfused rat small intestine. AB - The absorption of inorganic, trivalent chromium (Cr) by the rat small intestine was investigated by quantifying three components of the absorptive process: 1) Cr uptake from a test meal, 2) Cr transport into the circulation and 3) Cr retention by the intestine. An in vitro, in situ double-perfusion technique was used in which the intestinal vasculature, from the superior mesenteric artery to the portal vein, and the intestinal lumen, from the duodenum to the ileum, were perfused simultaneously. The vasculature was perfused with a synthetic "plasma" (vascular perfusate) while the lumen was perfused with a nutrient-rich solution (intestinal perfusate) at concentrations of trivalent Cr of 0.2-20 mumol/l (10 1000 ppb). Dose-response curves, in which Cr transport, retention and uptake were plotted against the luminal Cr concentration, revealed that Cr absorption is a nonsaturable process. Regardless of the Cr concentration of the intestinal perfusate, 5.90 +/- 0.33% (mean +/- SEM) of the test dose was taken up from the meal, 5.52 +/- 0.33% was transported into the vascular perfusate and 0.38 +/- 0.03% was retained by the small intestine. Based on the criterion of saturability, it was concluded that inorganic, trivalent Cr is absorbed by the nonmediated process of passive diffusion in the small intestine of rats fed a Cr adequate diet (1.44 micrograms Cr/g diet). PMID- 2778540 TI - Kinetic modeling of selenium metabolism in nonpregnant ewes. AB - The kinetics of selenium metabolism in three nonpregnant ewes were studied by the intravenous injection of 75Se-sodium selenite and measurement of radioactivity responses in blood, tissues and excreta. Stable selenium measurements were also made to determine selenium intake, excretion in feces and urine, and mass of selenium in tissues. Immediately following tracer injection, there was a rapid disappearance of radioactivity from plasma reflecting the uptake of the element by the liver and blood cells. The decrease in plasma radioactivity ceased abruptly by 30-45 min, and was followed by an increase to a peak by 3-4 h and a more gradual biphasic decline thereafter. A kinetic model of selenium metabolism in the whole animal was constructed employing the SAAM/CONSAM computer program. The multiphasic response of plasma radioactivity during a physiological steady state was explained on the basis of rapid hepatic uptake of selenium and its subsequent reappearance in the circulation in protein-bound form followed by further metabolism and excretion of the element. The model provides reference parameter values for 75Se-sodium selenite kinetics in selenium-replete, mature nonpregnant ewes for comparison with the kinetics in animals whose selenium status may be altered. PMID- 2778541 TI - Maternal and fetal vitamin E concentrations and selenium-vitamin E interrelationships in dairy cattle. AB - Paired dam-fetus liver and serum samples were collected from 101 pregnant dairy cattle at slaughter to determine mean fetal and maternal liver and serum vitamin E concentrations, relationships between maternal and fetal vitamin E status and interrelationships between selenium and vitamin E status. Fetal age was estimated from fetal crown-to-rump length. Fetal alpha-tocopherol concentration ranged from 0 to 31.4 micrograms/g dry wt with a mean of 7.1 micrograms/g dry wt and from 0 to 0.92 micrograms/ml with a mean of 0.29 micrograms/ml for liver and serum, respectively. Mean maternal liver (12.5 micrograms/g dry wt) and serum (2.16 micrograms/ml) alpha-tocopherol concentrations and vitamin E to cholesterol ratio (1.45) were 1.8, 7.4 and 3.5 times greater (P less than 0.0001) than fetal means, indicating limited placental transfer of vitamin E to the fetus. Gestational age had no effect on maternal vitamin E concentration, however, fetal tissue alpha tocopherol concentration declined (P less than 0.05) with fetal age. Maternal serum alpha-tocopherol concentration and fetal age were found to best predict fetal alpha-tocopherol concentration in serum. Interrelationships between selenium and vitamin E status were minimal. These data suggest inefficient placental transfer of vitamin E, resulting in minimal protection of the neonate from vitamin E-deficiency disease as a result of prepartal maternal supplementation. PMID- 2778542 TI - Dietary fructose as compared to glucose and starch increases the calcium content of kidney of magnesium-deficient rats. AB - The effects of feeding diets containing fructose, glucose or starch with or without added magnesium (Mg) on tissue levels of calcium (Ca) in weanling rats were investigated. Rats were fed their respective diet for 4 wk and then fasted overnight. After decapitation, blood was immediately collected, and liver, kidney and heart were removed to determine their Mg and Ca content. Relative kidney and liver weights were greatest in the rats fed the fructose diet. Hypomagnesemia was observed in all animals fed a Mg-deficient diet regardless of carbohydrate source (1.71 vs. 2.27 mg Mg/dl plasma for Mg-deficient vs. Mg-adequate groups, respectively). Among Mg-deficient groups, starch-fed rats had the highest level of plasma Mg, while fructose-fed rats had the highest level of kidney Mg. Although plasma and liver Ca levels were not significantly different among the groups, Ca content of the kidney and heart was greatest in animals fed a Mg deficient diet with fructose. This was especially evident in the Ca content of the kidney, which was 8- to 9-fold greater than that of all other experimental groups. The results of the present study demonstrate the presence of a synergistic interaction between fructose and Mg deficiency that increases Ca levels in certain soft tissues, especially the kidney. PMID- 2778543 TI - Orotic aciduria due to arginine deprivation: changes in the levels of carbamoyl phosphate and of other urea cycle intermediates in mouse liver. AB - The orotic aciduria induced in mammals by arginine deprivation is believed to result from accumulation of carbamoyl phosphate in liver, but this accumulation has never been demonstrated in vivo during arginine deprivation. There has been disagreement even on the basal levels of carbamoyl phosphate. In this report we show, using an improved assay, that the hepatic level of carbamoyl phosphate is very low (less than 1.3 nmol/g) in the fasted mouse or after a meal containing a mixture of amino acids including arginine, and that it increases dramatically (up to 180 nmol/g liver) after a meal without arginine. We estimated a fast turnover for carbamoyl phosphate, and we found a marked correlation between liver carbamoyl phosphate and urinary orotate, and also between urinary orotate and intake of an arginine-free diet. These results support the hypothesis that accumulation of carbamoyl phosphate in liver mitochondria, its efflux from this organelle and its utilization by the cytosolic pyrimidine pathway cause the orotic aciduria of arginine deprivation. We assayed liver acetylglutamate (the activator of carbamoyl phosphate synthesis) and several intermediates of the urea cycle and found that low levels of ornithine partly explain the accumulation of carbamoyl phosphate during arginine deprivation. However, acetylglutamate and citrulline were increased, and the potential significance of these changes is discussed. PMID- 2778544 TI - Effect of carnitine on propionate metabolism in the vitamin B-12--deficient rat. AB - Acyl-CoA thioesters are generated during the oxidation of organic acids in mammalian systems. Vitamin B-12 deficiency is associated with decreased L methylmalonyl-CoA mutase activity, and consequent accumulation of propionyl-CoA and methylmalonyl-CoA. The formation of propionylcarnitine from propionyl-CoA and carnitine provides an alternative pathway to remove propionyl-CoA from cells. Hepatocytes isolated from vitamin B-12--deficient rats metabolized propionate (1 mM) to CO2 and glucose at only 23% and 12%, respectively, of the rates observed in hepatocytes from control animals. In contrast, no difference was seen in rates of pyruvate metabolism by hepatocytes from control and vitamin B-12--deficient rats. Addition of carnitine (10 mM) to hepatocyte incubations increased the rate of propionylcarnitine formation 10- to 20-fold without altering conversion of propionate to CO2 or glucose. The rate of propionylcarnitine formation was not affected by vitamin B-12 deficiency. When carnitine (10 mM) was added, propionylcarnitine generation represented 65-71% of total propionate utilization in hepatocytes isolated from vitamin B-12--deficient rats. Gluconeogenesis from [1-14C]pyruvate was inhibited by 1 mM propionate in hepatocytes from vitamin B-12 -deficient rats. No effect of 1 mM propionate on glucose formation from pyruvate was seen using hepatocytes from control rats. Intraperitoneal administration of L carnitine resulted in a significant increase in urinary propionylcarnitine excretion from vitamin B-12--deficient rats, but not from control animals. The results demonstrate that exogenous carnitine can significantly enhance propionyl group utilization via the formation of acylcarnitines under the conditions of impaired acyl-CoA metabolism associated with vitamin B-12 deficiency. PMID- 2778545 TI - Activities of branched-chain amino acid--degrading enzymes in liver from rats fed different dietary levels of protein. AB - The relationships among dietary protein intake, plasma branched-chain amino acid (BCAA) and keto acid (BCKA) concentrations, and liver BCAA-degrading enzyme activities were investigated in rats fed, for 5 h/d for 2, 6 or 9 d, diets containing from 0 to 50% casein. Plasma, liver and muscle BCAA concentrations were proportional to protein intake over the entire range tested; plasma BCKA concentration, however, was proportional only in the range from 0 to 20% casein, after which a plateau was reached. By d 2, liver cytosolic BCAA aminotransferase activity had increased in rats fed 50% casein; by d 9, activity had increased in rats fed 0 or 5% casein as well. Liver mitochondrial BCAA aminotransferase activity was unresponsive to dietary treatment. Basal liver BCKA dehydrogenase activity and the percent active complex were proportional to protein intake on d 2 and 6. On d 2, total BCKA dehydrogenase activity was the same in all groups; by d 6, total activity had increased in rats fed 30 or 50% casein. We conclude that although the adaptive changes in BCAA-degrading enzyme activities are small, they are sufficient to compensate for excessively high or low protein intakes, so that tolerable concentrations of BCAA and BCKA are maintained. PMID- 2778546 TI - Growth, metabolic and endocrine responses of broiler cockerels given a daily subcutaneous injection of natural or biosynthetic chicken growth hormone. AB - The effects of daily injection of natural chicken growth hormone (ncGH) or recombinant-derived chicken growth hormone (rcGH) on growth, heat production rate, plasma hormone levels and body composition were determined in rapidly growing broiler chickens. Beginning at 3 wk of age, eight broiler chickens were given a daily injection of either bicarbonate buffer (control), 100 or 200 micrograms ncGH/kg body wt, or 200 micrograms rcGH/kg body wt for 14 d. Blood samples were taken preinjection and 4 h postinjection on d 7 and 14 of chicken growth hormone (GH) treatment. Compared to preinjection levels, plasma GH levels at 4 h postinjection were significantly (P less than 0.05) elevated by daily injection (per kg body wt) of 100 micrograms ncGH (2.3-fold), 200 micrograms ncGH (5.5-fold) or 200 micrograms rcGH (6.4-fold). Although exogenous chicken GH treatment failed to increase body weight gain, ncGH injections did increase (P less than 0.05) body fat content to 117% that of the control group. Daily injection of chicken GH did not alter plasma levels of immunoreactive insulin like growth factor-I (IGF-I), thyroid hormones, insulin, glucagon or glucose. Feed efficiency, heat production rate and respiratory quotient were also not affected by chicken GH treatment. Plasma levels of nonesterified fatty acids were elevated (P less than 0.05) by treatment with 200 micrograms ncGH/kg body wt. In contrast to domestic mammals, it is apparent that exogenous chicken GH can not be used to increase lean body mass or improve productive efficiency in chickens. Our results indicate that exogenous chicken GH exerts a strong lipogenic, rather than lipolytic, action in rapidly growing broiler cockerels. PMID- 2778548 TI - The quantities of nutrients recommended by the NRC abate the effects of a toxic alcohol dose administered to rats. PMID- 2778547 TI - Reduced locomotor activity of rats made histidinemic by injection of histidine. AB - Acute histidinemia was provoked in 30-d-old male Wistar rats by injecting intraperitoneally either histidine alone (0.5 mg/g body wt) or histidine (0.25 mg/g body wt) plus the histidase inhibitor nitromethane (0.73 mg/g body wt). Histidase activity was approximately 90% inhibited in rats receiving nitromethane. Serum histidine in both groups reached levels similar to those of histidinemic patients. Rats were subjected to the open field behavioral task, and the number of rearings and crossings were counted. A consistently lower locomotor activity was observed in the histidinemic rats. It is proposed that reduced locomotor activity and its relationship to psychomotor development should be investigated in histidinemic children. PMID- 2778549 TI - In vivo detection of retroviral particles in mice with hybridoma induced ascites. AB - Ascites induced by hybridoma cells following their injection into pristane-primed peritoneal cavities of BALB/c mice is often associated with the formation of intra-abdominal tumors related to the transplanted cells. These tumors and adjacent abdominal and extra-abdominal organs were excised and examined by electron microscopy. Clusters of viral particles were seen in nearly all cells composing the hybridoma tumors. The viral particles were usually present in rough ER cisternae of the transplanted tumor cells and at times were observed budding from the cisternal membranes. Individual viral units were doughnut shaped, 80-85 nm in diameter, with two concentric shells of which the outer one was more electron dense. No exogenous viral particles were detected in the peritoneally growing hybridoma cells. All non-tumor tissues examined such as liver, spleen, lung, brain and circulating WBC were free of virus. These findings provide further evidence of viral contamination of hybridomas and demonstrate the mode of persistence of such contamination when cells are placed in-vivo. PMID- 2778550 TI - Effect of ischemia and 24 hour reperfusion on ATP synthesis in the rat kidney. AB - The ability of renal tissue to synthesize ATP was examined in adult Sprague Dawley Rats immediately following normothermic ischemia of 30, 45, 60 and 90 minutes and upon reperfusion for 24 hours. Following ischemia the rate of ATP synthesis decreased progressively. It was 64.5% of the control at 45 minutes and 10.4% after 90 minutes of ischemia. Reperfusion of the ischemic kidneys for 24 hours restored ATP biosynthesis to control, nonischemic levels in kidneys subjected to ischemia up to 45 minutes (101.8 +/- 13.9% vs 64.5 +/- 2.5% p less than 0.02). However, after 60 minutes of ischemia, reperfusion had no effect (59.3 +/- 4.4% vs 51.7 +/- 7.5%) and reperfusion following 90 minutes of ischemia was associated with decrease ATP synthesis (10.4 +/- 2.2% vs 3.3 +/- 0.9% p less than .001). We conclude that mitochondrial function is restored by reperfusion when normothermic ischemic interval is 45 minutes or less. However, ischemic intervals longer than 45 minutes produce non-reversible impairment of ATP synthesis and the marked reduction following 90 minutes of ischemia signifies possible transition to a non-viable state. PMID- 2778551 TI - Effect of fatty acids and their derivatives on mitochondrial structures. AB - Reye's Syndrome (RS) is characterized by encephalopathy, fatty degeneration of viscera and high levels of free fatty acids which are implicated in cellular toxicity. We have examined the effects of octanoic acid (C8:0), palmitic acid (C16:0) and oleic acid (C18:1) on rat liver mitochondrial swelling by spectroscopic and microscopic techniques. Of the fatty acids tested oleic acid had a greater effect than palmitic acid while octanoic acid had no effect. Acyl CoA derivatives produced greater mitochondrial swelling than either acyl carnitine or free fatty acids. However, identical amounts of palmitoyl-CoA and oleoyl-CoA were required to produce the same degree of swelling. Addition of carnitine (2mM) to oleoyl-CoA reduced the mitochondrial swelling significantly thus suggesting that the toxicity of the fatty acids may be reduced by conversion to their carnitine derivatives. Twice the concentration of oleoyl-carnitine was required to produce half the maximum swelling as compared to oleoyl-CoA. Ultrastructural profiles of mitochondria treated with oleic acid, oleoyl-CoA and oleoyl-carnitine demonstrated greater swelling with oleoyl-CoA than with oleic acid or oleoyl-carnitine. These results suggest that carnitine may protect the mitochondria from damage by the fatty acids and their acyl-CoA derivatives in Reye's Syndrome. PMID- 2778553 TI - The process of measuring patient outcomes. AB - Today patient outcomes have become an important indicator of quality in health care agencies that are attempting to insure high quality, cost-effective care. These patient outcomes must be developed in the context of nursing standards. This article addresses the establishment of such standards according to specific guidelines and measurable by methods or tools that adhere to the principles of measurement theory. PMID- 2778552 TI - A replication study: analysis of bacterial contamination of intravenous administration sets in use for 72 hours. PMID- 2778554 TI - A survey of District Nurses Association's research interests. PMID- 2778555 TI - Access and acceptance in clinical nursing research. AB - As clinical research comes to the forefront of nursing research endeavors, the issues of access to clinical sites and acceptance of both the researcher and the project become increasing important. This paper discusses these issues within the framework of politics and ethics. Emphasis is placed on maintaining the integrity of the research while gaining entry and winning acceptance. PMID- 2778556 TI - Exploring the institutional review board process. AB - This article presents both the content required in preparing a proposal for review by an institutional review board (IRB) and the process involved in gaining approval. The six categories of a research proposal related to protection of human subjects are described, i.e., characteristics of the groups involved; special groups; type of consent; confidentiality of data; possible risks involved; and non-beneficial research. Federal requirements for ensuring informed consent are presented. The politics involved in winning approval for a nurse principal investigator are identified. PMID- 2778558 TI - Drosophila mutants with progressive atrophy in dorsal longitudinal muscles. AB - We have characterized six chemically induced mutations of the Drosophila dlm defective (d l m d) gene. The mutants are flightless, but they have an otherwise normal appearance. By electron microscopic examination, a focal atrophy was found in their dorsal longitudinal muscle (DLM) fibers, but no abnormalities in nerve conduction or synaptic transmission were detected by electrophysiological tests. The nerve-evoked muscle spike also seemed to be normal, except that the resting potential of DLM in mutant flies was lower and their membrane excitability was higher than those in the wild type flies. The possible causes of the DLM degeneration in this strain are discussed. PMID- 2778557 TI - Encephalopathy and polyneuropathy induced by organic solvents. AB - Twenty-six patients with previous heavy exposure to organic solvents were admitted to a neurological department during a 1 1/2 year period. They were studied with a battery of tests, including general medical and neurological examinations, neuropsychological tests, electroencephalography (EEG) and neurography with electromyography (EMG), and cerebral computerized tomography (CT). The presenting complaints were compatible with encephalopathy and/or polyneuropathy. When patients with alternative diagnosis were excluded, 17 patients (65%) of the initial group were diagnosed as belonging to the organic solvent syndrome. These patients had a mean time of solvent exposure of 23.9 years, ranging from one to 45 years. EEG and cerebral CT showed minor deviations only as did the neurological examination. These methods proved nevertheless of importance in excluding alternative etiologies. Neuropsychological test performances were markedly reduced, especially short-term memory. All patients were injured by occupational exposure to organic solvents, most often from painting and lacquering. Encephalopathy was a more frequent finding than polyneuropathy, and most often classified as slight or marked, whereas severe encephalopathy was not found in the present group. PMID- 2778559 TI - Persistent hypersynchronization of neocortical neurons in the mocha mutant of mouse. AB - A recessive mutation in the mouse at the mocha locus (mh, chromosome 10) modulates the synchronous synaptic activation of neocortical neurons, resulting in a constant 6-7 Hz (theta) wave pattern in the electrocorticogram. The gene linked brain rhythm is unaffected by motor behavior and cannot be desynchronized by sensory stimuli. This exemplary neurological mutation affecting cortical excitability is the first to reveal clearly that the predominance of a specific pattern of spontaneous brain wave activity can be inherited as a recessive trait. PMID- 2778560 TI - Lymphangioendothelioma of the liver in a neonate. AB - The case report describes the clinical features, imaging findings, and pathology of a lymphangioendothelioma that almost entirely replaced the liver parenchyma in a neonate. No other organs were involved. PMID- 2778561 TI - Arthritis as the initial manifestation of inflammatory bowel disease in early infancy. AB - We report a 10-month-old infant who had arthritis as the initial clinical manifestation of ulcerative colitis. Arthritis is considered to be the most common extraintestinal manifestation of IBD in adults and children. This case emphasizes that arthritis may be the earliest manifestation of IBD even in the very young infant. PMID- 2778563 TI - Monosaccharide intolerance complicating protracted diarrhea in infants. PMID- 2778562 TI - Decompensated cardiomyopathy mimicking hepatitis in a 13-year-old girl. AB - The name of a 13-year-old girl diagnosed as having idiopathic dilated cardiomyopathy was removed from the cardiac transplant list because a hepatitis like picture developed that coincided with evidence of decompensation of her cardiac function. On admission, there was only modest evidence of cytolysis (ALT level, 115 U/L) and of cholestasis (bilirubin level, 3.0 mg/dl), but there was severe prolongation of her prothrombin time (28 s). This was followed by elevation of both her transaminases and bilirubin levels. A liver biopsy sample showed extensive necrosis involving both the central and midlobular zones, while periportal areas revealed dilated sinusoids and steatotic multinucleated hepatocytes. A brief improvement of both her liver and her heart was followed by rapid deterioration of the functions of both. Attention is drawn to the relationship between reduced cardiac output and hepatic dysfunction secondary to massive cytolysis. PMID- 2778564 TI - Diagnosis of giardiasis. PMID- 2778565 TI - Meconium ileus and its equivalent as a risk factor for the development of cirrhosis: an autopsy study in cystic fibrosis. AB - Although dehydrated obstructing mucus is thought to account for the obstructive pathology involving the lungs, the pancreas, the reproductive system, and the intestinal tract, its relationship with CF-associated liver disease remains largely hypothetical and little is known about possible risk factors. Complete clinical and autopsy records were available in 38 of 73 deaths occurring over a 10-year period. The liver was normal in only five cases, and they were all infants. Steatosis was the only lesion present in 9, hypoxic liver disease was documented in 8, and biliary cirrhosis in 16 (focal in 10 and multilobular in 6). There was no relationship between the presence of cirrhosis, gallbladder abnormalities, age at death, and clinical status recorded during the year precoding their demise. Mucus plugs characterized by amorphous eosinophilic material within proliferated bile ductules were present in 75% of children with focal or multilobular biliary cirrhosis as opposed to 14% in those without (p = 0.015). A history of meconium ileus or its equivalent was recorded more frequently (p = 0.038) in those with cirrhosis. Finally, biliary cirrhosis was invariably present when there was a history of meconium ileus or its equivalent and when mucus plugs were noted. These findings suggest that patients with intestinal obstruction are at greater risk for the development of cirrhosis and that strategies should be developed to increase the detergent capacity of bile and its flow in order to decrease the viscosity of mucus in the biliary tree. PMID- 2778566 TI - Gastroesophageal reflux associated with respiratory abnormalities during sleep. AB - To determine whether gastroesophageal reflux (GER) might be a factor in the pathogenesis of apnea in certain infants, we analyzed the frequency of prolonged central apnea (greater than 15 s) and of numerous irregularly repeated short apneas (5-15 s) ("respiratory dysfunction") in infants with an apparent life threatening event (ALTE) (group 1, n = 62), in control infants (group 2, n = 387), and in infants with GER pathologic findings (group 3, n = 60). Finally, the incidence of GER was analyzed in 76 infants with a respiratory dysfunction during sleep (group 4). Gastroesophageal reflux was investigated using 24-h esophageal pH monitoring; respiration during sleep was investigated by polysomnography. The pH monitoring data and results of sleep investigation were analyzed in a double blind study. A great number of infants who had an ALTE appeared to suffer from GER (42%, 26 of 62 infants), especially if the ALTE occurred while the infant was awake (52%, 14 of 27 infants). In the control infants, pH monitoring data were abnormal in 8.5%; respiratory dysfunction was observed in 5%. In those with a respiratory dysfunction, GER was detected in 75% (15 of 20 infants). In those with GER, respiratory dysfunction was observed in 45% (15 of 33 infants). In groups 3 and 4, respiratory dysfunction was associated with abnormal pH data in 40-43%. If, in the infants with a respiratory dysfunction, the GER pathologic symptoms were treated efficiently (normalization of pH data), respiratory dysfunction disappeared in 92%.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2778567 TI - Area under pH 4: advantages of a new parameter in the interpretation of esophageal pH monitoring data in infants. AB - Twenty-four-hour continuous esophageal pH monitoring has become the preferred test to quantify acid gastroesophageal reflux. Agreement has been achieved that acid gastric content reflux into the esophagus constitutes a major cause of reflux esophagitis; we therefore calculated the "area under pH 4" (A) in 560 consecutive pH monitorings in infants 1-12 months old and related this parameter (A) to the reflux index (RI): RI less than 10%: A 185 +/- 295 (mean +/- 1 SD); RI 10-19%: A 1,046 +/- 1,206; RI 20-29%: A 1,967 +/- 2,038; RI 30-39%: A 3,307 +/- 2,955; RI greater than 40%: A 7,977 +/- 7,227. A higher RI is associated with a greater area under pH 4 (p less than 0.001); the high SD obtained in each group, however, illustrates the great variability in surface (or acidity of the reflux episodes) in all groups. Esophagoscopy and biopsy were performed in 112 infants (20%). Specificity in the prediction of (mild) esophagitis was higher for the area under pH 4 (88%) compared with the RI (50%). The sensitivity of both parameters was comparable (96 versus 93%). Our results strongly suggest that in young infants, the acidity of the reflux episodes (the area under pH 4) is a determining factor in the prediction of esophagitis. These data need to be confirmed by more studies before general application of this parameter can be advised. PMID- 2778569 TI - The urinary excretion of polyethylene glycol as a test for mucosal integrity in children with celiac disease: comparison with other noninvasive tests. AB - We compared the results of various noninvasive tests with small bowel histology in 61 children with celiac disease. The most sensitive predictors of small bowel histology were serum levels of anti-gliadin antibodies (AGAs) (90%) and the urinary excretion of polyethylene glycol (PEG) (69%). The sensitivity for the fecal fat analysis was 61% and for the D-xylose test 34%. The specificity was 96% for both the PEG and the D-xylose tests, 92% for the fecal fat, and 68% for AGAs. The predictive value of the PEG test was significantly better than that of D xylose (p less than 0.05). The best combination of tests for the prediction of small bowel histology was the PEG test and the measurement of serum levels of AGAs. Agreement in the results of these two tests helps to time appropriately the second and third small bowel biopsies. PMID- 2778568 TI - Effects of topical anesthetic agents on Campylobacter pylori. AB - The susceptibility of Campylobacter pylori was determined for the two topical anesthetic agents commonly used prior to gastroscopy. Campylobacter pylori proved to be extremely sensitive to the anti-infective activity of benzocaine, the active ingredient in most commonly used topical anesthetic agents, with minimum inhibitory concentrations of 0.14 mg/ml. However, lidocaine-containing agents did not interfere with the growth of this microorganism. Specifically, in patients with histologic evidence of C. pylori, the bacterium was recovered from significantly more patients anesthetized with lidocaine than with benzocaine. Thus, the use of benzocaine-containing topical anesthetic agents limits recovery of Campylobacter pylori from clinical specimens and might account for the low colonization rates reported in some recent publications. PMID- 2778570 TI - Fecal secretory immunoglobulin A in breast milk versus formula feeding in early infancy. AB - We studied the effects of breast milk feeding versus formula feeding during the first 8 weeks of life on the development of local gastrointestinal humoral immune response by measuring fecal secretory immunoglobulin A (SIgA). Forty-four infants were studied and classified into two groups: breast milk (n = 21) and standard Enfamil without iron (n = 23). The fecal specimens were analyzed at birth and 2, 4, and 8 weeks of age. Radial immune diffusion (RID) technique was used to assay the fecal SIgA during these four ages. Marked SIgA changes were detected in the breast milk-fed group. At birth, no fecal SIgA was detected in either group. At 2, 4, and 8 weeks, significant differences were found between the two groups (p4 less than or equal to 0.001 and p8 less than or equal to 0.001). This phenomenon of enhanced fecal SIgA in breast-fed infants versus standard formula-fed infants is not caused solely by the presence of IgA in breast milk; it represents a stimulatory effect of breast milk on the gastrointestinal humoral immunologic development. The possible active stimulatory role of breast milk on the development of immunologic competence and host defense is discussed. These data suggest an additional advantage of breast milk feeding during early life by the protective role of the earlier and enhanced production of SIgA in the gastrointestinal tract. PMID- 2778571 TI - Maternal-neonatal serum vitamin A concentrations. AB - Prevention of neonatal vitamin A deficiency is related to the adequacy of maternal vitamin A stores. In this study we investigated maternal and cord serum vitamin A and retinol-binding protein (RBP) values in an Indian population including, for the first time, clinically vitamin A-deficient mothers. Twenty eight maternal-neonatal pairs were selected from maternal cohorts of high socioeconomic status without clinical evidence of vitamin A deficiency (group I) and low socioeconomic status with conjunctival xerosis and Bitot's spots (group II). Maternal education, caloric and vitamin A intakes, weight, height, hemoglobin, and birth weight were significantly lower in group II. Serum vitamin A levels were significantly higher in group I mothers and newborns as were RBP levels in group I mothers. However, a significant difference between groups I and II in cord blood RBP was not observed. Upon correlation of maternal vitamin A levels with cord blood vitamin A levels, a logarithmic relationship was revealed, suggesting saturable transplacental transport of vitamin A. PMID- 2778572 TI - Histopathologic features of the liver in pediatric acquired immune deficiency syndrome. AB - Autopsy and liver biopsy specimens from 30 pediatric patients with acquired immune deficiency syndrome (AIDS) or AIDS-related complex (ARC) were retrospectively reviewed. Of 28 cases with histologic abnormalities, the following findings were noted singly or in combination: giant-cell transformation, cytomegalovirus inclusions, Kaposi's sarcoma, diffuse lymphoplasmocytic infiltrate, granulomatous hepatitis, mild portal inflammation, necrosis around central veins, steatosis, and cholestasis. For the most part, abnormalities in the liver were not predictive of those in other organs, but the two children with the diffuse parenchymal lymphoplasmocytic infiltrate also had lymphoid interstitial pneumonitis (LIP). Liver histopathology in pediatric patients with AIDS shares some features with that in adults, but appreciable differences are noted. In particular, these differences include the higher frequency of giant-cell transformation and the lower frequency of granulomas in children and the observation of diffuse lymphoplasmocytic infiltrate associated with LIP. PMID- 2778574 TI - Rechallenge following an early life exposure to a high-cholesterol diet enhances diet-associated alterations in intestinal permeability. AB - This study was undertaken to test the hypothesis that the intestinal transport response to a high-cholesterol (2%) diet (HCD) is influenced by prior exposure to HCD at an earlier age. Uptake was assessed using an in vitro technique, and rabbits were fed one of four dietary regimens: chow for 20 weeks, chow for 14 weeks followed by HCD for 6 weeks, chow for 2 weeks followed by 4 weeks HCD followed by chow for 14 weeks, or 2 weeks chow followed by 4 weeks HCD followed by 8 weeks chow and then 6 further weeks with HCD. The passive jejunal uptake of octanoic, lauric, cholic, and taurocholic acids was greater in animals previously exposed at an earlier age to HCD, as compared with those first exposed to HCD at a later age. Furthermore, the effect of HCD on the passive permeability properties of the intestine lasted for as long as 14 weeks after the animals were switched from HCD back to chow. These alterations in permeability properties occurred in the absence of changes in the intestinal mucosal surface area and were not explained by differences in the rabbits' body weight gain, food consumption, or mucosal surface area of the jejunum or ileum. Thus, (a) early changes in animals' dietary content of cholesterol may have prolonged effects on intestinal transport function, and (b) this early feeding experience with cholesterol may alter the adaptive pattern of the intestine when animals are exposed to a dietary cholesterol challenge at a later age. PMID- 2778573 TI - Hemodynamics during increased intraluminal pressure in the ileum of suckling swine. AB - Studies of intestinal hemodynamics during increased abdominal and intraluminal pressure in adult animals (canine and feline) have shown that blood flow is practically unchanged at pressures up to 35-40 mm Hg. In the young animal, however, decreased total intestinal blood flow has been shown at pressures of 15 mm Hg or greater. To help characterize the effect of intraluminal pressure on intestinal circulation, we have studied pressure-flow relationships in an isolated loop of terminal ileum in piglets 2-14 days of age (mean, 6.1 +/- 3.7 SD, n = 14) with a mean weight of 1,745 +/- 345 SD. Intraluminal pressure was increased from 0-50 cm of water pressure in 10-cm steps of two min' duration. Blood flow was reduced with every increase in intraluminal pressure and significantly reduced at pressures of 20 cm of water or more. The calculated peripheral vascular resistance increased with every increment of intraluminal pressure. Analysis of the relationship of arterial blood pressure to changes in blood flow suggests that blood flow reductions are greater in animals with lower blood pressure at every level of intraluminal pressure studied. Increased intraluminal pressure could be a mechanism of intestinal mucosal ischemia in the newborn, particularly affecting those with low arterial blood pressure. PMID- 2778575 TI - Virulence of a variant of Paracoccidioides brasiliensis that exists in the yeast form at room temperature. AB - Paracoccidioides brasiliensis (ATCC 60885) produces conidia that, when plated in enriched media and incubated at 21-25 degrees C, give rise to a yeast-form variant (YRT) (ATCC 46678). The virulence of this variant for BALB/c mice has been compared with that of the yeast and conidia produced by the parent isolate. Adult female mice were inoculated intravenously with 10(7) viable cells of YRT or yeast, or 5 x 10(5) viable conidia. Mice were weighed weekly, and three mice were sacrificed at 1, 2, 3, 4 and 8 weeks post-inoculation and their organs weighed and prepared for determination of viable counts (colony forming units; c.f.u.). Animals infected with yeast cells or with conidia exhibited little weight loss in comparison with that seen in the YRT-infected mice which began to lose weight 1 week post-challenge. Organ weights increased in the YRT group, while the changes in the remaining two groups were minor. The c.f.u. from these organs also increased in the YRT-infected mice, whereas the infection in the yeast-and conidia-infected mice was self-limiting. A proportion (16.6%) of the YRT-infected animals died during the observation period. Conversely, no deaths occurred in the remaining groups. These results indicate that the YRT variant possesses increased virulence. PMID- 2778576 TI - Foot infections due to Hendersonula toruloidea and Scytalidium hyalinum in coal miners. AB - A total of 250 coal miners were screened for mycotic skin infections. Sixty-six (34.8%) miners had clinical lesions on their feet which proved to be of mycotic etiology by direct microscopy and culture. Hendersonula toruloidea, the commonest etiological agent, was the sole agent recovered from 23 (34.8%) of the positive cases and was also isolated from three (4.5%) cases of mixed infection with dermatophytes (two cases with Trichophyton rubrum and one with Trichophyton mentagrophytes var. mentagrophytes). Scytalidium hyalinum was recovered as the sole causal agent in four (6.1%) patients and from one case of mixed infection with T. mentagrophytes var. mentagrophytes. The dermatophytes isolated as sole etiological agents included T. mentagrophytes var. mentagrophytes (13 isolates) T. rubrum (10), Trichophyton tonsurans (5), Epidermophyton floccosum (4) and Microsporum gypseum (3). The toe web was invariably involved in all cases of H. toruloidea and S. hyalinum infection and was also the commonest site of infection by dermatophytes. Occasionally the sole, toe and finger nails were also involved. Other body sites were infrequently involved and then only in infections caused by dermatophytes. The epidemiology of H. toruloidea and S. hyalinum infections is reviewed. PMID- 2778577 TI - HLA-A29 and genetic susceptibility to chromoblastomycosis. AB - The distribution of 12 HLA-A, 14 HLA-B, seven HLA-C, seven HLA-DR and three HLA DQ antigens was determined in 32 non-consanguineous white Brazilians suffering from chromoblastomycosis and 77 healthy controls, matched for ethnic background, sex and age and living in the same geographical area. A significant difference between the two groups was seen only in respect to one HLA-A antigen: A29 was present in 28% of patients as opposed to 4% of the controls (P corrected = 0.03). This finding indicates that susceptibility to chromoblastomycosis may be influenced by a gene located on chromosome 6, in the region of the major histocompatibility complex. The relative risk for an HLA-A29 carrier to develop chromoblastomycosis was estimated as 10. PMID- 2778578 TI - Wall ultrastructure of Arthroderma vanbreuseghemii ascospores. AB - Ascospore cell wall formation in Arthroderma vanbreuseghemii was investigated ultrastructurally by the freeze substitution method. Using this procedure it was confirmed that the mature ascospore cell wall consisted of an inner electron translucent layer and an outer electron-dense layer, both of which originated as precipitates of electron-dense granules between the double membrane system of the ascospore initial. The outer wall layer showed a mottled appearance between two electron-dense boundaries of different thickness. The boundaries were undetectable with the conventional glutaraldehyde and osmium tetroxide fixation procedure. Wheat germ agglutinin-colloidal gold complex reaction products were detected in the inner layer of the cell wall by a post-embedding method. PMID- 2778579 TI - Invasive aspergillosis in an alpaca (Lama pacos). AB - An invasive form of aspergillosis in an alpaca (Lama pacos) is described, with dissemination causing small abscesses and multifocal areas of necrosis in the lung, heart, spleen and kidneys. Histological sections showed hyphae morphologically compatible with an Aspergillus species. Direct immunofluorescent testing confirmed the diagnosis of aspergillosis. PMID- 2778580 TI - The significance of ductal shunting during extracorporeal membrane oxygenation. AB - The purpose of this study was to evaluate the significance and direction of shunts at the level of the foramen ovale or ductus arteriosus in full-term newborns with neonatal respiratory failure who were placed on extracorporeal membrane oxygenation (ECMO). A decrease in left ventricular dimension was expected when infants were placed on ECMO but did not occur. A left-to-right shunt was demonstrated at the ductal level in nine of 12 infants early in the course of ECMO before pulmonary resistance decreased. Presumably, the lack of change in the left ventricular dimension when infants were placed on bypass was due to a left-to-right shunt at the ductal level with ductal flow replacing the right heart output, being drawn into the bypass circuit. PMID- 2778581 TI - An improved technique for in situ esophageal myotomy and proximal pouch mobilization in patients with esophageal atresia. AB - The use of a modified endotracheal tube in the mobilization of the upper pouch in patients with esophageal atresia is described. While aiding mobilization in all patients the tube was particularly helpful in the performance of circular myotomy where this was necessary. The tube and the operative technique are described. PMID- 2778582 TI - Ischemic injury to newborn rabbit ileum: protective role of human superoxide dismutase. AB - The effectiveness of human superoxide dismutase (hSOD) in the prevention of reperfusion injury was evaluated in a rabbit ileal loop model. Weanling white New Zealand rabbits, 6 weeks of age and weighing 500 to 1,000 g, were used. Intraluminal administration of SOD (5 mg/kg) was studied in 12 animals with each animal serving as its own control. In an additional 12 animals, parenteral SOD in a dose of 5 mg/kg in seven animals and 10 mg/kg in five animals was evaluated, while five additional control animals received parenteral saline. The effect of reperfusion injury was evaluated in each bowel loop by interruption of blood supply for five minutes, followed by reperfusion. Blood was drawn at 0, 16, 20, 24 hours in the parenteral group for measurement of hSOD levels by radioimmunoassay. The loops were studied pathologically for extent of mucosal damage. In the intraluminal group, nine of 12 loops without SOD v three of 12 loops with SOD showed necrosis when rendered ischemic (P = .0196). In the parenteral group 22 of 24 loops were normal when pretreated with SOD and subjected to ischemia v five of ten when no SOD was given (P = .0139). In the parenteral group, mean baseline level of hSOD was 0.42 +/- 0.26 micrograms/mL. Levels peaked at 16 hours (3.64 +/- 1.75 micrograms/mL) and progressively decreased at 20 hours (2.85 +/- 1.34 micrograms/mL) and 24 hours (1.82 +/- 1.15 micrograms/mL). This preliminary animal study suggests that hSOD may be an effective method for the prevention of postischemic bowel injury, adding to the literature on the protective effects of SOD in various models of intestinal ischemia. PMID- 2778583 TI - Use of the appendix stump in the treatment of meconium ileus. AB - Three neonates with meconium ileus who failed to respond to non-operative measures were successfully treated by appendicectomy and irrigation with Gastrografin into the small bowel via the appendix stump. The meconium was emptied out and the stump ligated. This method avoids enterotomy, enterostomies or resection of bowel. The post-operative course is simplified and hospital stay decreased. Removal of the appendix precludes future disease of this organ which may be problematic in patients with cystic fibrosis. PMID- 2778584 TI - Necrotizing enterocolitis and volvulus in the premature neonate. AB - Premature infants presenting to the neonatal intensive care unit at the Hospital for Sick Children with a surgical abdomen over a 5-year period were studied retrospectively to determine the factors leading to the diagnosis of malrotation with volvulus and necrotizing enterocolitis (NEC). Fifteen preterm infants (less than 37 weeks) were diagnosed as having volvulus, and 54 had surgically treated NEC. Those with NEC were more likely to be systematically ill with grossly bloody stools, abdominal tenderness, and thrombocytopenia (P less than .005). Bilious vomiting and bilious gastric residuals were the only hallmarks of volvulus (P less than .005). Although the radiographic findings of thickened bowel walls and intramural air were significantly related to NEC, the accuracy and interobserver reliability in diagnosing these features was variable as was the ability to distinguish NEC from volvulus or normal on plain abdominal radiographs. Volvulus is an important cause of surgical abdomen in the preterm infant and can be misdiagnosed as NEC. An unusual course or the presence of bilious vomiting in any patient thought to have NEC should alert the clinician to the possibility of this diagnosis. PMID- 2778585 TI - The piebald-lethal murine strain: investigation of the cause of early death. AB - Forty-eight piebald-lethal (PL) mice with distal aganglionosis and 42 normal littermates (LM) were studied to determine the cause of early death. PL mice were noted to be smaller than their LM and to have normal albumin and immunoglobulin levels for the first 30 days of age. As PL mice aged, a significant decline in albumin with a concomitant rise in immunoglobulin levels was demonstratable. Systemic sepsis with enteric organisms was found in 10% of sacrificed PL mice and in 38% of spontaneously dying PL animals. Histologic examination of PL aganglionic and ganglionic colon demonstrated no evidence of enterocolitis. Ganglionic colon of PL mice contained a flattened, thinned mucosa. The early death of PL mice is related to generalized debilitation from prolonged distal colonic obstruction resulting in a decrease in immunologic integrity and an increased susceptibility to sepsis. PMID- 2778586 TI - Regional differences in the pattern of neurogenic responses in the aganglionic colon from congenitally aganglionic rats. AB - The pattern of innervation in the aganglionic colon and internal anal sphincter from cogenitally aganglionic rats was studied and compared with that of control littermates. In normoganglionic colon and anal sphincter, electrical stimulation evoked excitatory or inhibitory junction potentials followed by a contraction or relaxation, respectively. These responses were abolished by tetrodotoxin and atropine selectively abolished the excitatory effects, indicating that the colon or anal sphincter is innervated by intrinsic cholinergic excitatory and noncholinergic inhibitory nerves. In congenitally aganglionic rats, electrical stimulation evoked excitatory and inhibitory responses in sphincteric regions, while only excitatory responses were observed in distal segments. Excitatory responses were weak in proximal segments of the aganglionic colon and electrical stimulation failed to evoke neurogenic responses. These results indicate regional differences in the functional innervation of extrinsic nerve fibers in the aganglionic colon from congenitally aganglionic rats and the usefulness of congenitally aganglionic rats as an animal model for Hirschsprung's disease. PMID- 2778587 TI - Quantitative assessment of the stage of neuronal maturation in the developing human fetal gut--a new dimension in the pathogenesis of developmental anomalies of the myenteric plexus. AB - There are two main theories of the normal development of the enteric nervous system: the classical theory suggests that the enteric neuroblasts migrate along the alimentary tract in a single cranio-caudal direction. However, the second theory postulates a dual gradient of neuronal development. The present study aims to support the second theory and contribute to the understanding of the pathogenesis of Hirschsprung's disease and its allied gut motility disorders. Using a histomorphometric method, quantitative estimation of the myenteric intraganglionic neuronal development was made in tissues from various selected levels of the gut in 32 normal human fetuses of 11 to 24 weeks ovulation age. A parallel study with special chromatin staining was carried out from these materials to investigate different neurons in the myenteric plexus. Development of intraganglionic neurons was shown to be more advanced in the esophagus, less so in the rectosigmoid and least so in the ileocecal region: the mean values of neuronal and nuclear volume were found in the esophagus greater than in rectosigmoid and ileocecal region as ovulation age progressed. Intraganglionic mitotic figures were detected at all the selected levels of the gut. A decrease of the mitosis index as age progressed was observed. We showed that myenteric neurons followed a dual gradient of development proceeding from both ends to the middle of the gut in mid-trimester human fetuses. Our findings are compatible with the suggestion that any alterations in the fetal gut microenvironment may affect seriously the normal development of a multipotential precursor cell population resulting in various congenital anomalies of the myenteric plexus. PMID- 2778589 TI - Separation of conjoined twins using chest wall prosthesis. PMID- 2778588 TI - Fetus in fetu or not? AB - A case of sacrococcygeal teratoma is presented with characteristics of fetus in fetu. The clinical implications of teratomatous tissue in an inguinal node are presented. PMID- 2778590 TI - Successful separation of a conjoined biliary tract in a set of omphalopagus twins. AB - Omphalopagus twins were separated in the first 48 hours of life. Preoperative evaluation did not disclose either their conjoined intestines or their conjoined biliary tract; intraoperative evaluation, including an operative cholangiogram, was required to determine if separation was possible. The intestines were divided to give each infant an equal share, and an hepaticoenterostomy was constructed in each of the twins. PMID- 2778591 TI - Children feel the pressure too. PMID- 2778592 TI - Pelvic inflammatory disease in the adolescent. AB - Pelvic inflammatory disease is one of the most serious complications of sexually transmitted diseases. It is a medical and public health problem of great magnitude, and adolescents are at greater risk for its development than any other age group. Its sequelae of infertility, ectopic pregnancy, chronic pelvic pain, and dyspareunia may have a devastating impact upon a teenager's life. The epidemiology, pathogenesis, clinical features, differential diagnosis, and management and prevention of this clinical syndrome are presented. PMID- 2778593 TI - Parental perceptions of vulnerability of formerly premature infants. AB - This study explores a possible precursor of the vulnerable child syndrome, a constellation of behaviors thought to develop as a result of excessive parental anxiety. Healthy 3-year-old children who had been born prematurely were compared to children born at term, using a single instrument. Mothers of premature infants reported a significantly greater sense of vulnerability about their children than did mothers of term infants. Antecedents and correlates of vulnerability are explored. Mothers with more education reported a greater sense of vulnerability than did less well-educated mothers, while mothers who reported greater well being and marital satisfaction reported a lower sense of vulnerability. A greater sense of vulnerability was associated with more behavior problems and more somatic and internalizing symptoms. The data have important implications for nurses caring for infants in neonatal intensive care units, as well as in pediatric ambulatory and hospital settings. PMID- 2778595 TI - Acute lymphocytic leukemia treatment: effects on learning. PMID- 2778594 TI - Teaching inner-city mothers about family planning and prenatal and pediatric services. AB - One hundred thirty-five young, black, inner-city, pregnant women assessed the usefulness of a videotape designed by community health nurses to increase the self-care practices of low-income minority women with regard to their prenatal, pediatric, and family planning health needs. Seventy percent of the women rated as very useful information on the availability of health care and the protocols of public health clinics. The women also stated that they would tell others about public health care services and intended to make use of these services themselves as a result of viewing the videotape. The viewers' responses help clarify the preferred modality, content, and length of patient education for medically and socioeconomically high-risk pregnant women who tend to underuse preventive and primary health care. PMID- 2778596 TI - Choosing quality child care programs. PMID- 2778597 TI - Lyme disease: an elusive diagnosis. PMID- 2778598 TI - Pediatric nurse practitioner education. PMID- 2778599 TI - Coronal positioning of existing gingiva: short term results in the treatment of shallow marginal tissue recession. AB - Although not a new procedure, coronal positioning of existing gingiva may be used to enhance esthetics and reduce sensitivity. Unfortunately when recession is minimal and the marginal tissue is healthy, many periodontists do not suggest treatment. This article outlines a simple surgical technique with the criteria for its use which results in a high degree of predictability and patient satisfaction. PMID- 2778600 TI - Focal dermal hypoplasia. Current concepts and differential diagnosis. AB - Focal dermal hypoplasia syndrome (FDH) is a congenital disorder of mesodermal derivation with some ectodermal participation. The disorder, first described in 1962, is characterized by tenacious defects consisting of thinning of the skin; herniations of adipose tissue; abnormal skin pigmentation and other skeletal, dental, ocular, hair, and nail abnormalities. A rare instance of focal dermal hypoplasia syndrome is reported as characterized by papillary gingival hyperplasia. Differential diagnostic guidelines that separate focal dermal hypoplasia from a host of other skin and mucous membrane disorders are discussed along with therapeutic modalities and the possible relationship of human papillomavirus to focal dermal hypoplasia syndrome. PMID- 2778601 TI - The effect of a new electric toothbrush on supragingival plaque and gingivitis. AB - This study tested the effectiveness of a rechargeable electric toothbrush, Interplak, in removing supragingival plaque and resolving gingivitis. Forty adults with gingivitis were randomly assigned to either a "manual" or "electric" group. Detailed oral hygiene instructions were given and a blind examiner assessed plaque scores before and after brushing, toothbrush abrasion, and gingival inflammation at baseline, 1, 2, and 4 weeks. Subjects using the electric brush had significantly lower (P less than 0.05) mean plaque and gingival inflammation scores. The electric group's plaque scores fell from 77% at baseline to 28% (before brushing) and 14% (after brushing) at 4 weeks; the manual group's dropped from 75% to 50% and 30% (before and after brushing, respectively). The mean G.I. for the electric group fell from 1.65 at baseline to 1.28 at 4 weeks, while the manual group's scores decreased from 1.65 to 1.43. The results suggest that the electric brush removed supragingival plaque and resolved gingivitis better than the manual brush over a 28-day period. However, a telephone survey conducted 6 months later indicated that most subjects were not using the device twice a day as they had during the study. PMID- 2778602 TI - Porous hydroxyapatite grafts in chronic subcrestal periodontal defects in rhesus monkeys: a histological investigation. AB - The purpose of this investigation was to evaluate the histologic response to replamineform (porous) hydroxyapatite grafts in chronically inflamed, surgically created, periodontal pockets in Rhesus monkeys. Forty-eight subcrestal defects were surgically created in 8 Rhesus monkeys. Orthodontic wires were adapted to the base of the defects and left in place for 8 weeks. The defects were randomly assigned a treatment modality so that 8 granular porous and 8 block porous hydroxyapatite grafts were done. Eight sites were left as unoperated controls. Twenty-four contralateral sham-operated sites were treated by open curettage. Histometric measurements of the length of regenerated connective tissue attachment were recorded. Block hydroxyapatite, granular hydroxyapatite, and sham operated sites exhibited similar amounts of regenerated connective tissue attachment, which was significantly greater than that which occurred in unoperated controls. Newly formed bone was observed within the porous channels of the hydroxyapatite grafts as well as in direct apposition on the surface of implant particles. New bone, cementum, and periodontal ligament was observed in grafted sites and in defects treated by open curettage. In some instances healing occurred by means of a long junctional epithelium. Histology confirmed that unoperated defects remained as unhealed, inflamed periodontal pockets. The results of this study suggest that porous hydroxyapatite grafts have the potential to regenerate the attachment apparatus in primates. PMID- 2778603 TI - Periodontitis in a patient with chronic neutropenia. AB - The aim of this investigation was to obtain information about the composition and the morphology of the microorganisms that inhabit the root surface of a patient with chronic neutropenia and severe and progressive periodontitis. In addition, gingival biopsies were studied by both scanning and transmission electron microscopy (SEM and TEM) to look for bacteria within the gingiva. Dark field microscopy (DFM) revealed 50% spirochetes, 30% motile rods, and 20% coccoid forms. Fourteen extracted teeth studied by SEM showed that the distribution of different bacterial morphotypes varies along the root surface and spirochetes are the prevailing bacteria on the most apically located plaque. TEM analyses of gingival tissue revealed no bacterial invasion within the gingiva. This study suggests that spirochetes may play an important role in the etiology of periodontitis associated with chronic neutropenia. In spite of neutropenic status, there was no bacterial invasion into the gingiva, suggesting that host reaction to dental plaque has not been abolished in this condition. PMID- 2778604 TI - The development during pregnancy of pyogenic granulomas superimposed upon a congenital hemangioma: a case report. AB - A case of a 25-year old female school teacher with pyogenic granulomas of the gingiva developing during her first pregnancy in the area of a congenital hemangioma is described. The recurrence of the pyogenic granulomas of the gingiva during the second pregnancy could be successfully prevented by scaling and root planing prior to and bi-weekly professional tooth cleaning during pregnancy period. Hormonal changes during pregnancy were in this case found not to influence the development of gingival pyogenic granulomas during maintenance of optimal dental hygiene. PMID- 2778605 TI - Periodontal diseases in the U.S. in 1981: prevalence, severity, extent, and role in tooth mortality. AB - Prevalence, severity, and extent of periodontal diseases as well as the role of periodontal diseases in tooth mortality are described for persons 19 years and older in the U.S. in 1981. The data were collected with a household probability sample of non-institutionalized persons living in the contiguous 48 states. Plaque and calculus scores were collected for six index teeth. All permanent teeth present and capable of being assessed were scored for gingivitis; pocket depths were measured on the mesial of each tooth with a periodontal probe. Examinations were conducted by trained dentists calibrated on specific criteria. Only 15% of persons in the U.S. in 1981 were free from any sign of periodontal diseases. Periodontitis (pockets greater than or equal to 4 mm) affected approximately 36% of the population. Advanced periodontitis (pockets greater than or equal to 6 mm) was present in 8% of the population and was usually found on only one or two teeth when present. End-stage periodontal destruction requiring extraction of teeth was found in only 4% of all persons while less than 20% of all missing teeth were listed as missing due to periodontal disease. PMID- 2778606 TI - An estimate of periodontal treatment needs in the U.S. based on epidemiologic data. AB - It has generally been assumed, based on previous epidemiologic and utilization studies as well as the increasing elderly population, that there would be an increasing need for periodontal treatment. Analysis of a more recent household epidemiologic survey conducted in 1981 indicates that the need for treatment of periodontitis is less than previous estimates. These epidemiologic data have been translated into treatment needs through a series of conversion rules derived from previous studies and current patterns of treatment, and applied to the 1985 U.S. population. The total periodontal services needed for scaling, surgery, and prophylaxes would require 120 to 133 million hours and $5 to $6 billion annually if the total population were treated for periodontitis over a 4-year period. Only 11% of the total hours needed would be for scaling and surgery whereas 89% would be needed for prophylaxes. Expenditures for periodontal treatment total approximately 10% of the amount being spent on dental care in 1985. On the basis of these data, it seems unlikely that there will be a substantial increase in the need for periodontal treatment in a growing and aging U.S. population. These figures represent the upper limits of treatment need and are reduced by factoring in current utilization of periodontal treatment. PMID- 2778607 TI - Effectiveness of sodium fluoride on tooth hypersensitivity with and without iontophoresis. AB - The purpose of this study was to assess the short and long term reduction of dentinal hypersensitivity by a single application of sodium fluoride with and without iontophoresis. Two teeth in each of 16 patients were blindly evaluated before and after treatment, and at 1, 3, and 6 months. A blast of air and tactile pressure were used to assess pain. Results indicate that there is significant, immediate reduction in dentinal hypersensitivity with the use of iontophoresis that is lost with time. The use of sodium fluoride alone had no effect. Sodium fluoride with iontophoresis was demonstrated to have an immediate post treatment effect (P less than .001) that lasted through the 3-month observation period. The data suggest that iontophoresis may be a useful adjunct to sensitivity therapy and that an immediate therapeutic effect may be achieved. The efficacy of the use of sodium fluoride alone is obscured by the natural reduction of root sensitivity observed with time. PMID- 2778608 TI - Effect on periodontal status of rotary electric toothbrushes vs. manual toothbrushes during periodontal maintenance. I. Clinical results. AB - The purpose of this study was to compare the Rotadent rotary electric toothbrush with conventional toothbrushing for its effectiveness in controlling supragingival plaque and gingival inflammation in periodontal maintenance patients. Forty subjects who had received periodontal treatment, including periodontal surgery, for moderate to advanced periodontitis and were on a 3-month periodontal maintenance were divided into two equal groups matched for age and sex. One group used conventional toothbrushing, dental floss, and toothpicks and the other used only the rotary electric toothbrush for a 12-month study period. Single-blind clinical assessments (Plaque Index, Gingival Index, bleeding tendency, pocket depth, and loss of attachment) were made at baseline and at 3, 6, 9, and 12 months after baseline. Subgingival debridement was performed 1 week after the baseline assessment and the 6- and 12-month examinations. Plaque removal was reinforced at 3-month intervals. Both groups had significantly improved scores (P less than 0.01) for Gingival Index and bleeding tendency during the 12-month period, but no differences were found between the groups at any examination. These results indicate that the rotary electric toothbrush is as effective for plaque removal and control of gingival inflammation as a combination of conventional toothbrushing, flossing, and toothpicks for patients in periodontal maintenance. PMID- 2778609 TI - Effect of periodontal status of rotary electric toothbrushes vs. manual toothbrushes during periodontal maintenance. II. Microbiological results. AB - We compared the use of a rotary electric toothbrush with conventional toothbrushing for their effectiveness in modulating the subgingival microbiota. Forty subjects who had received periodontal treatment for moderate to advanced periodontitis and were on 3-month periodontal maintenance were divided into two equal groups matched for age and sex. One group used only the rotary tooth cleaner and the other group used conventional toothbrushing, dental floss, and toothpicks for 12 months. Subgingival plaque samples (two sites per patient) were taken from 10 subjects per group at baseline, 6 months, and 12 months and analyzed for percentage of obligate anaerobes and colony-forming units of black pigmented Bacteroides, Fusobacterium, Actinomyces, Streptococcus, and Veillonella spp. The percentage of spirochetes and motile rods was determined by darkfield microscopy. Results showed that levels of obligate anaerobes, Fusobacterium, and Actinomyces and percentage of spirochetes and motile rods decreased significantly (P less than 0.05), while levels of Streptococcus spp. increased (P less than 0.05) for both groups. However, there was no significant difference between the two groups, indicating that the rotary tooth cleaner and conventional toothbrushing are equally effective in controlling gingivitis and fostering a less pathogenic microflora. PMID- 2778610 TI - A supernumerary tooth located at the facial of a mandibular lateral incisor: a case report. PMID- 2778611 TI - Effect of subgingival irrigation. PMID- 2778612 TI - Estimating periodontal treatment needs from epidemiological data. PMID- 2778613 TI - Factor structure of the Millon Clinical Multiaxial Inventory (MCMI) with an offender sample. AB - One thousand two hundred inmates were given the Millon Clinical Multiaxial Inventory (MCMI) in a midwestern reception and diagnostic center. Two groups of 600 were randomly divided, and their test results were subjected to a principal components factor analysis. Four factors were derived in both groups and were similar, indicating successful cross-validation. Three of the four factors bore similarity to factors found in other samples (drug abusers, psychiatric population, Viet Nam veterans), and the fourth was unique to the offender population. PMID- 2778614 TI - Assessment of depression in adolescents: objective and projective measures. AB - This study is a multimethod assessment of depressive features in a sample of 60 adolescent inpatients. The purpose of the study was to examine the relationship between self-report measures of depression and Rorschach variables commonly associated with depression. Patients represented a variety of diagnostic categories in order to determine whether information gathered through assessment instruments was related to the Diagnostic and Statistical Manual of Mental Disorders (3rd ed. [DSM-III], American Psychiatric Association, 1980) diagnoses of depression. Findings indicated that this sample of adolescents was highly defensive and emotionally constricted. There were several significant relationships between self-report measures and Rorschach indicators of depression. However, in general, the Rorschach variables were not strongly related to depression. The self-report measures were more accurate than Rorschach variables in discriminating between depressed and nondepressed subjects. PMID- 2778615 TI - Psychometric properties of Loevinger's Sentence Completion Test in an adult psychiatric outpatient sample. AB - Little research has been conducted on Loevinger's Washington University Sentence Completion Test of Ego Development in adult psychiatric outpatients. The measure is a promising method of assessing a construct of personality and character functioning that should be useful in research on psychopathology and in choosing treatment modalities. The data presented in this study address the question of the psychometric adequacy of the measure in this segment of the subject population. Specifically, estimates of interrater reliability, internal consistency, and test-retest reliability are presented for a sample of 42 adult outpatients. In addition, the relationship between total protocol ratings and item sum scores is explored. PMID- 2778616 TI - Searching for projection in the Rorschach. AB - The issue of assumptions concerning projection and the Rorschach is discussed in relation to the Rorschach response process and the process of projection. Some data suggest that some minus answers may evolve because of projection, but the limited nature of the findings indicate that these types of projected answers will be difficult to identify in most cases. Findings concerning passive and aggressive movement responses, morbid content responses, and movement answers, coded using a new special score for positive cooperative interaction (COP) in human and animal movement responses, suggest that most projections will manifest in responses that depart from and/or embellish the stimulus field. Caution is recommended about attempting to interpret single answers tht appear to be projections, because most any might be the product of simple stimulus classification. PMID- 2778617 TI - Rorschach comparisons of male juvenile sex offenders and nonsex offenders. AB - Published research is limited on the psychological characteristics of juvenile sex offenders as a subgroup separate from other juvenile delinquents. This study compares 45 male adolescent sex offenders on the Rorschach with a matched group of nonsex adolescent offenders. The two groups differed in total number of responses. Eliminating those protocols of questionable validity due to low productivity in combination with a high lamba, a statistically significant difference in the number of anatomy responses given by the two groups was found. With this exception, the personality characteristics of adolescent sex offenders were similar to those of adolescents who commit only nonsexual crimes. It should be noted, however, that the scoring categories analysed were not exhaustive and that the groups may differ on more recently proposed Rorschach subscales. PMID- 2778618 TI - The anxiety thermometer: a validation study. AB - The aim of our study was to provide validation and reproducible data for the anxiety thermometer. This thermometer is either a continuous or a 10-point Likert type scale on which subjects are asked to rate their anxiety feelings at a particular moment. It is a quick way to measure state-anxiety. As a validation criterion the State-Trait Anxiety Inventory (STAI) A-State scale was used. To test the reproducibility of the thermometer, a test-retest correlation coefficient was calculated, with a retrospective second thermometer score. The ego-threatening situation used was a written examination. Two experiments were carried out during different examination conditions. The data consistently indicated that the validity and reproducibility of the anxiety thermometer is fair (correlation coefficients between .60 and .78) In the second study, the possible influence of two factors on the retrospective scores were additionally tested. PMID- 2778619 TI - Masculinity, femininity, and multiple regression: comment on Zeldow, Daugherty, and Clark's "Masculinity, Femininity, and Psychosocial Adjustment in Medical Students: A 2-Year Follow-Up". AB - Inappropriate applications and interpretations of multiple regression analyses by Zeldow and his associated (Zeldow, Clark, & Daugherty, 1985; Zeldow, Daugherty, & Clark, 1987) are discussed as are several general interpretive and statistical issues. To perform and interpret multiple regressions, several characteristics of this statistical approach must be taken into account. Of critical importance is the order in which variables are entered, the choice of regression approaches, the direction of an effect upon entering the model, and the manner in which the interpretation of interaction effects varies as a function of the presence or absence of main effects. Because Zeldow et al. (1985, 1987) did not consider these factors, their regression analyses were not run as stated and are difficult to interpret. Five hypothetical outcomes in androgyny research and an example involving actual data are presented. PMID- 2778620 TI - Three scales of alexithymia: do they measure the same thing? AB - The psychometric properties of three scales of alexithymia were examined in a sample of 187 female undergraduates. The Shalling Sifneos Personality Scale (SSPS) and the Minnesota Multiphasic Personality Inventory (MMPI) Alexithymia scale had little internal consistency. The scored archetypal test with nine elements (SAT9) had very low interrater reliability. As predicted, the tree measures were not significantly related to one another and the SSPS had a more clearly defined factor structure than the MMPI scale. The MMPI and SSPS scales were differentially related to measures of symptomatology but were similarly related to extraversion, absorption, and SAT scores. Of the three scales, the SSPS appeared to have the highest content validity. The results suggest that alexithymia is not a unitary construct and that its reification as such may be premature. PMID- 2778621 TI - [Chromopharmacokinetics of acetylsalicylic acid administered rectally the rabbit]. AB - Five white rabbits are given by rectal route a single dose of 100 mg of Aspirin at regular hours: 7 a.m.; 10 a.m. and 2 p.m. the 7 a.m. administration results in lowest CMAX and AUC and the slowest elimination, whereas 10 a.m. and 2 p.m. administration results in the highest CMAX and AUC and shortest elimination time. PMID- 2778622 TI - Preparation of beta-aminomethyl-beta-benzoylpropionic acids and related cis beta aminomethyl-gamma-phenyl-gamma-butyrolactones as potential antibacterial agents. AB - The synthesis of beta-aminomethyl-beta-benzoylpropionic acids (V) and beta aminomethyl-gamma phenylbutyrolactones (VI) is described. The cis stereochemistry of compounds VI was unambiguously established by NOE experiments carried out with Vla. Antibacterial activity was studied; MIC of each derivate was determined by agar dilution in Muller-Hinton medium and application of Steers' replicator. PMID- 2778624 TI - Preparation and pharmacokinetic and pharmacodynamic evaluation of hydroxy propyl cellulose-ethyl cellulose microcapsules containing piretanide. AB - Hydroxy propyl cellulose (HPC)-ethyl cellulose (EC) microcapsules containing piretanide were newly by a solvent evaporation technique and their slow-release properties were evaluated on dissolution properties in vitro and pharmacokinetic and pharmacodynamic parameters in beagle dogs. The dissolution behavior of piretanide from the microcapsules in dissolution media of pH 1.2-6.8 and the plasma piretanide level in beagle dogs varied dependently on the contents of HPC and EC. As compared with ordinary piretanide tablet on the market, the HPC-EC10 (5:3) microcapsule showed the controlled dissolution behavior, sustained plasma piretanide level, almost same AUC (area under curve), slow urinary piretanide excretion, decreased urine excretion maximum rate, and no difference in the cumulative urine volume and cumulative urinary electrolytes (Na+, K+, Cl-) excretion. HPC-EC microcapsules containing piretanide sufficiently satisfied the conditions which slow-release preparations must have. PMID- 2778623 TI - [Reactions and interactions of drugs]. PMID- 2778626 TI - Intestinal absorption kinetics using a laminar flow model. AB - The drug concentration profile at non-steady state in the intestine was simulated using a laminar flow model. The transport equation with cylindrical coordinates was solved by a finite difference method to stimulate the concentration profile in the tube and the exit cup-mixing concentration. A drug with a various wall permeability coefficient (Pw = zero or 10(-5) to 10(-3) cm/s) and diffusion constant (D = 10(-6) to 10(-4) cm2/s) was assumed to be introduced into the tube in a pulse form. The spatial intervals of the grid and the time step were varied to yield the optimum condition for calculation. The concentration profile in the tube as the time elapsing and the exit cup-mixing concentration versus time profile were shown graphically. Pw and D influenced the concentration profiles. This suggests the possibility of the estimation of Pw and D by determining the exit cup-mixing concentration after a pulse input to a perfused intestine under a laminar flow condition. PMID- 2778625 TI - Effects of cimetidine on quinidine distribution and tissue pH in rats. AB - To elucidate the mechanism(s) of the decrease of the volume of distribution at steady state (Vdss) and the tissue-to-plasma concentration ratio (Kp) of quinidine after cimetidine treatment, the following were studied; (1) the effect of cimetidine on the tissue binding of quinidine in vitro, (2) the non-linear tissue distribution of quinidine and (3) the effect of cimetidine on tissue pH. The in vitro binding of quinidine to rat tissue homogenates was not affected by cimetidine treatment. The tissue distribution of quinidine in rats was linear from 1 to 5 micrograms/ml of plasma concentration except for lung. The plasma disappearance of 5,5-dimethyl-2,4-oxazolidinedione (DMO) after a 200 mg/kg intravenous injection was fitted to a two compartment open model. In the cimetidine-treated rats (50 mg/kg), the pharmacokinetic parameters of DMO, such as the plasma total body clearance (Cltot), Vdss and the rate constant at the terminal phase (beta) increased to 230, 110 and 210% of those of the non-treated rats, respectively. The intracellular pH calculated by Kp of DMO increased significantly in liver, spleen, intestine, brain, muscle and skin. This suggests that cimetidine decreased the tissue-to-plasma pH partition coefficient (q) of unbound quinidine in several tissues. The decreases of Vdss and Kp of quinidine by cimetidine was attributed to the decrease of q resulting from the increase of tissue pH. PMID- 2778627 TI - Effect of acute-phase proteinase inhibitors on chemotaxis of rat polymorphonuclear leukocytes in vitro. AB - Rat serum obtained at 24 h after subcutaneous injection of carrageenin significantly suppressed chemotaxis of rat polymorphonuclear leukocytes (PMNs) in vitro. alpha 2 Acute-phase macroglobulin (alpha 2APM), alpha 1 proteinase inhibitor (alpha 1 PI) and cysteine-proteinase inhibitors (CPIs) are present at high concentration in the 24-h serum and known as acute-phase reactants in rats. These acute-phase proteinase inhibitors were purified from inflamed rat serum or exudate and their effect on PMN chemotaxis was studied by Boyden's method in vitro. alpha 2 APM (4 mg/ml) significantly suppressed PMN chemotaxis while alpha 1M was without effect, though both alpha 2APM and alpha 1M had a similar anti proteinase activity. The results suggest that alpha 2APM suppressed PMN chemotaxis through the mechanism unrelated to its anti-proteinase activity. On the other hand, alpha 1PI (1 and 3 mg/ml) slightly but significantly suppressed PMN chemotaxis, whereas CPI-1 and CPI-2 had no inhibitory effect. These results suggest that alpha 2APM and alpha 1PI play a role in suppression of PMNs infiltration into the inflammatory site in the late-phase of acute inflammation. PMID- 2778628 TI - Self-perpetuating development of encoding biases in person perception. AB - It was hypothesized that encoding (interpretive) biases may develop in a self perpetuating manner through biased, self-supportive encoding (even in the absence of any objectively supportive evidence). This process was investigated in 3 experiments with different stimulus materials (matrices of digits, silhouettes of persons, descriptions of personal problems). In the learning phase of each study, Ss nonconsciously acquired some encoding bias. In the testing phase, Ss' encoding of new material was predictably biased, and, consistent with the self perpetuation hypothesis, the strength of the bias gradually increased over the segments of the material, even though the material did not contain any evidence supportive of the bias. Given the ambiguity of many (particularly social) stimuli, the self-perpetuation process may play a ubiquitous role in the development of interpretive categories and other individually differentiated cognitive dispositions. PMID- 2778629 TI - Accountability: a social magnifier of the dilution effect. AB - This research demonstrated that accountability can not only reduce judgmental bias, but also exacerbate it--in this case, the dilution effect. Ss made predictions from either diagnostic information alone or diagnostic information plus mixtures of additional data (nondiagnostic information, additional diagnostic data pointing to either the same conclusion or the opposite conclusion). Relative to unaccountable Ss, accountable Ss (a) diluted their predictions in response to nondiagnostic information and (b) were more responsive to additional diagnostic information. The accountability manipulation motivated subjects to use a wide range of information in making judgments, but did not make them more discriminating judges of the usefulness of that information. PMID- 2778630 TI - Effect of memory perspective on retrospective causal attributions. AB - Two studies examined whether people's retrospective causal attributions might be mediated by the visual perspective from which events are recalled. In Study 1, pairs of Ss participated in "get-acquainted" conversations and made a series of attribution ratings for their performance. They returned 3 weeks later to rerate their performance on the same attribution scales and to indicate the perspective from which they remembered their earlier conversation. Ss reported either "observer" memories in which they could "see" themselves from the outside or "field" memories in which their field of view matched that of the original situation. Study 2 was identical to Study 1 with the exception that Ss' memory perspectives were manipulated via verbal instructions. In both experiments, conversations that were recalled from an observer's perspective were attributed more dispositionally. These results suggest that the different perspectives from which events can be recalled function much like the divergent visual perspectives available to actors and observers in immediate, everyday experience. Discussion of these results focuses on how they further understanding of the contradictory findings reported in the literature on temporal shifts in attributions. PMID- 2778631 TI - Cognitive and affective bases of opinion survey responses. AB - Two experiments investigated the determinants of agreement with propositions that advocated social privileges for either people in general or specific social groups. Liking for the group to which a group-specific proposition referred had a contrast effect on agreement with a related general proposition that was considered immediately after it, but had a positive influence on agreement with a general proposition that did not occur until several items later. The latter effect was eliminated by instructing Ss to base their judgments on the consequences of the policies described in the propositions. Instructions to base judgments on affective reactions to the propositions produced contrast effects of group-specific propositions on judgments of general ones regardless of whether these items were separated or together in the questionnaire. PMID- 2778632 TI - Aging and susceptibility to attitude change. AB - Two hypotheses about the relation between age and susceptibility to attitude change were tested. The impressionable years hypothesis proposes that individuals are highly susceptible to attitude change during late adolescence and early adulthood and that susceptibility drops precipitously immediately thereafter and remains low throughout the rest of the life cycle. The increasing persistence hypothesis proposes that people become gradually more resistant to change throughout their lives. Structural equation models were applied to data from the 1956-1960, 1972-1976, and 1980 National Election Panel Studies in order to estimate the stability of political attitudes and unreliability in measures of them. The results support the impressionable years hypothesis and disconfirm the increasing persistence hypothesis. A decrease in the over-time consistency of attitude reports among 66- to 83-year-olds was found to be due to increased random measurement error in their reports, not to increased attitude change. PMID- 2778633 TI - Self-evaluation maintenance and the mediational role of emotion: the perception of friends and strangers. AB - Two studies examined the causal role of emotional arousal in self-evaluation maintenance processes. In previous work, Tesser and Campbell (1982) found that Ss were most charitable in their perception of another's performance when self relevance was low and the other was close. If emotional arousal mediated this pattern of behavior, then the pattern of behavior should be replicated when arousal is present but attenuated when arousal is misattributed or low. The misattribution hypothesis was tested in Study 1. Study 2 was a correlational study in which physiological arousal and misattribution were measured. The results supported the prediction that SEM processes would be attenuated when arousal was attributed to external sources. The misattribution effect was particularly pronounced among more highly aroused Ss. The results are discussed in terms of their implications for the SEM model and person perception. PMID- 2778634 TI - The relation between type A behavior and chronic emotional distress: a meta analysis. AB - A meta-analysis was conducted of studies examining the relation between Type A behavior and chronic emotional distress as measured by standard psychological scales. Aggregating across all studies, the average effect size was .27, indicating a positive association between Type A and chronic dysphoria; however, there was considerable variability in the size of the relation among studies. Partitioning by Type A measure revealed that Structured Interview-assessed Type A was unrelated to chronic dysphoric emotions; however, most of the self-report measures of Type A behavior were moderately correlated with upset. The Framingham Type A Scale and the Bortner Scale showed the strongest relations. Thus, contrary to the traditional view, Type A measured by self-report does have some emotional concomitants, although they are not in the pathological range. Also discussed are how the results bear on the proposal that the maladjusted personality confers coronary risk, the implications for reported associations between Type A and illness complaints, and for the study of the Type A as a social psychological construct. PMID- 2778636 TI - Women's theories of menstruation and biases in recall of menstrual symptoms. AB - Previous research is consistent with the proposition that people use implicit theories of personal stability or change in remembering the attributes they possessed in the past. However, there has been little systematic investigation of the relation between these implicit theories and memory biases. In this study, the relation between women's theories of menstrual distress and their recollections of physical and affective symptoms was examined. Ss completed daily questionnaires in which they evaluated themselves on several physical and affective symptoms. Later, some Ss were asked to recall the ratings they had made on a day when they were menstruating; others recalled a day when they were not menstruating. At the time of recall, all Ss were in the intermenstrual phase. Finally, Ss completed a measure designed to assess their theories of how they are typically affected by menstruation. The recollections of Ss who recalled the menstrual state were biased so as to be consistent with their theories of menstrual distress: The more a woman believed in the phenomenon of menstrual distress, the more she exaggerated, in recall, the negativity of her symptoms during her last period. The recollections of women asked to recall the intermenstrual state were unrelated to their theories of menstruation. Furthermore, consistent with previous research, the daily questionnaire ratings revealed that physical symptoms varied with menstrual cycle phase, whereas affective symptoms did not. Finally, comparisons between subjects' theories and daily ratings revealed that, on average, women exaggerate the degree to which they experience changes during menstruation. PMID- 2778635 TI - Relations between anger expression and cardiovascular reactivity: reconciling inconsistent findings through a matching hypothesis. AB - Previous psychophysiological research has demonstrated that both anger expression and anger suppression are related to cardiovascular responses, but in an inconsistent fashion. The present study tested the following hypotheses: (a) that the influence of anger expression style on psychophysiological responses would be limited to Ss exposed to an anger instigation, and (b) that the specific pattern of psychophysiological responses would vary as a function of whether Ss were induced to use their preferred vs. nonpreferred mode of anger expression style in response to the instigation. Seventy-eight male college undergraduates were randomly assigned to work on a task with either an annoying or a pleasant confederate and subsequently to write either a negative or a positive evaluation of the confederate. Blood pressure was measured intermittently and heart rate continuously throughout task performance and a subsequent 15-min rest period. Ss' preferred method of anger expression had been previously assessed by a self report questionnaire. Systolic blood pressure results generally were consistent with the hypotheses. Implications of the findings for the etiology of cardiovascular diseases are discussed. PMID- 2778637 TI - Personality types and hetero- versus auto-hypnosis. AB - The Multivariate Personality Inventory (MPI; Magaro & Smith, 1981), the Harvard Group Scale of Hypnotic Susceptibility (HGSHS; Shor & Orne, 1962), and the Inventory of Self-Hypnosis (ISH; Shor, 1970) were used to investigate the relationship between personality style and hypnotic procedure in the determination of hypnotic susceptibility. On the basis of MPI scores, a normal college population was segregated into 5 personality styles: hysteric, manic, depressive, character disorder, and compulsive. The hysteric personality was found significantly more hypnotizable than the other personality types in the HGSHS induction context, whereas the compulsive personality was found significantly more hypnotizable in the ISH induction context. Results are discussed in terms of personality and situational factors in relation to previous hypnotic susceptibility research. PMID- 2778639 TI - Some determinants of factor structures from personality-trait descriptors. AB - Three determinants of the factor structures of personality traits are investigated. The 1st, selection of variables, was controlled by using 57 bipolar scales, selected to be representative of common trait terms. In analyses of 7 data sets, variants of the "Big Five" factors were always found. Factor similarities were very strong for the 3 largest factors, which were transformed into general evaluation and 2 descriptive dimensions. As a 2nd determinant, judgments about real people were compared with judgments about the conceptual relations among traits. Factor structures based on the 2 types of judgments are similar, but those based on conceptual judgments tend to be simpler. The 3rd determinant involved the degree of restriction of the sample to evaluatively homogeneous targets. Restriction of range reduced the size of all factors, especially Factor II. Findings from previous studies are integrated within this framework. PMID- 2778638 TI - Influence of mood on health-relevant cognitions. AB - Three experiments assessed the effects of mood on symptom appraisal, health behavior self-efficacy, outcome expectations, and perceptions of vulnerability. Ss in Experiments 1 and 2 were acutely ill, whereas Ss in Experiment 3 were healthy. In each experiment, happy, sad, and neutral moods were induced. In Experiment 1, Ss who experienced sadness reported more aches and pains and greater discomfort than happy Ss. Sad Ss were less confident that they could carry out illness-alleviating behaviors. Experiments 2 and 3 demonstrated that mood's influence on vulnerability perceptions is moderated by health status. Although mood had little impact on perceptions of vulnerability among ill Ss, probability estimates of future negative health-relevant events among healthy Ss were mood sensitive. Seeing oneself as invulnerable to future negative events was accentuated among happy Ss and attenuated among sad Ss. Mood may be an important determinant of care seeking, adherence, and recovery from illness. PMID- 2778640 TI - The Fourth Conference on Mitral Valve Prolapse. Tokyo, July 30-31, 1988. PMID- 2778641 TI - [A case of mitral valve prolapse simulating mitral tumor or vegetation]. AB - We observed a case of mitral valve prolapse (MVP) mimicking mitral tumor or vegetation. The patient was a 34-year-old man. He complained of palpitation and precordial oppression. Shaggy and mass echoes of the anterior mitral valve were recorded by M-mode and two-dimensional echocardiograms. The "mass" echo was confirmed to by originated in a markedly myxomatous change of the spongiosa layer of the mitral valve at operation. These problems on echocardiographic diagnosis of MVP and mitral "mass", such as mitral tumor or vegetation, were discussed in detail. PMID- 2778642 TI - [Association of sustained ventricular tachycardia and a mid-systolic click: a case report]. AB - A 27-year-old woman had a history of palpitation at the age of nine. Ventricular tachycardia (VT) was detected four years ago and treatment with procainamide was started. Physical examination disclosed nothing abnormal other than an apical mid systolic click. Electrocardiogram and chest radiograph were normal, and echocardiogram disclosed borderline mitral valve prolapse (MVP). VT was not provoked by exercise, and Holter monitorings of electrocardiogram were always within a normal limit. Angiography was normal. Electrophysiological study disclosed VT by left ventricular stimulation and the earliest activation was at the apex, VT was abolished by early stimulation from the right ventricular apex. The association of a mid-systolic click and VT was interesting in this case. When the patient had a systolic click at the outpatient clinic, VT frequently occurred within a month (six of seven times), while VT did not occur without an audible systolic click (three of four times). Although it is uncertain whether VT of this patient has any relationship to MVP or to the click, these problems remain to be solved in the future. PMID- 2778643 TI - [Pathoetiological aspects of mitral valve prolapse]. AB - Myxomatous lesion of the mitral valve, a major pathological factor in mitral valve prolapse (MVP), was analyzed in 33 cases with idiopathic MVP, 34 with secondary MVP, 30 with hypertension, 11 with right ventricular hypertrophy, and 28 control subjects. Area of the myxomatous lesion expressed as a percent area in the cross-section of each valve leaflet was obtained in each zone. With the increasing age, the % area increased particularly in the posterior leaflet and the area expanded from the rough zone to the basal zone. Compared with other conditions, the mitral valve in idiopathic MVP had extensive myxomatous lesion of 50% or more in the % area. Histologically, this area showed diffusely distributed lesion from the fibrosa to the ventricularis, disappeared collagen fibers, and disrupted elastic fibers irregularly located. Electron-microscopically, these disruption or disappearance were replaced by young mesenchymal cells. It was concluded that the increase in a myxomatous lesion is the essential pathological finding in idiopathic MVP, but this lesion may be developed secondarily in other conditions, though not so extensive. PMID- 2778644 TI - [Production of experimental infective endocarditis in rabbit mitral valve prolapse induced by vagus stimulation]. AB - An experimental model of bacterial endocarditis was developed in rabbits with mitral valve prolapse which was induced by vagus stimulation. Endocarditis was produced by injecting bacteria including pseudomonas pseudoalkaligenes (pathogenic for rabbits) and streptococcus viridans taken from human beings. Both bacteria induced bacterial endocarditis with high incidence, which was augmented by higher dose or earlier administration of bacterial after producing mitral valve prolapse. Similarly, verruca was produced more frequently by higher dose of bacteria or earlier administration of bacteria. The present data are similar to those of human beings, so that it is helpful to a study of bacterial endocarditis in a clinical setting. PMID- 2778645 TI - [Systolic time intervals in mitral valve prolapse syndrome]. AB - Systolic time intervals (STI) were measured in 135 patients with mitral valve prolapse syndrome (MVP). These patients were categorized as Group II (no or trivial mitral regurgitation) and Group III (moderate or severe regurgitation). The controls consisted of 120 normal subjects (Group I). The Group II patients tended to have increased ETc and shortened PEP. The Group III patients tended to have prolonged Q-I and decreased QIIc and ETc, reflecting mitral regurgitation. It was suggested that autonomic nervous system, especially sympathetic nerve, may play a role in changes of STI of the Group II patients. PMID- 2778646 TI - [Transesophageal echocardiographic findings of mitral valve prolapse]. AB - Transesophageal echocardiography (TEE) is a new approach to the investigation of the heart, at a closer range without interference from lung tissue or ribs. In this study, we evaluated 15 patients with mitral valve prolapse by TEE. All patients had a pansystolic murmur and severe mitral regurgitation by left ventriculography. Seven patients underwent cardiac surgery. The presence of ruptured chordae tendineae was confirmed in all these patients at the time of operation. The transesophageal echocardiographic finding of mitral valve prolapse was a circular or coiled cusp or whip-like protrusion of a scallop into the left atrium in systole. TEE disclosed ruptured chordae tendineae in all of the seven patients with ruptured chordae tendineae confirmed by surgery, whereas transthoracic echocardiography disclosed only one. In the remaining patients, TEE disclosed chordal rupture in six. The prolapsed sites by TEE were coincident with those by cardiac surgery in each patient. By three-dimensional construction of the mitral valve using TEE, the direction of mitral regurgitant jet was correctly visualized. In conclusion, TEE is useful in evaluating patients with mitral valve prolapse and is a sensitive method for detecting ruptured chordae tendineae. PMID- 2778647 TI - Keratinophilic fungi from the duck nails in Egypt. AB - The mycoflora of one hundred and sixty of duck nail samples, collected from the duck Farm, Faculty of Agriculture, Assiut University, were examined. Using the soil plate technique and Sabouraud's dextrose agar, thirty six species appertaining to twenty genera of keratinophilic fungi were isolated. Chrysosporium was the genus most frequently isolated (50% of the samples). Aspergillus and Penicillium occurred in low incidences (13.1 and 12.5% of total samples). Trichophyton rubrum was found to colonize few of the duck nail samples (2.5%) as well as some other fungal species previously reported as pathogenic to man and animals (Aspergillus fumigatus, Scopulariopsis brevicaulis and Paecilomyces lilacinus). PMID- 2778648 TI - Detection of an insensitive ornithine-carbamoyltransferase in strains of Pseudomonas syringae pv. phaseolicola with different phytotoxin-generating capacities. AB - Independently of their capacity to produce phytotoxins, strains of Pseudomonas syringae pv. phaseolicola contain two ornithine carbamoyltransferases (OCT, EC 2.1.3.3) which differ in resistance to phaseolotoxin and Orn-P(O) (NH2)-NH-SO3 H (PNSOrn). At 18 degrees C, the optimal temperature for product formation, the balance of the two types of OCT was shifted in favour of the insensitive type in phaseolotoxin producing strains, and in favour of the sensitive one in strains with little or no toxin production. The results suggest a causal relationship between the existence of an insensitive enzyme and the synthesis of toxins. PMID- 2778649 TI - Inhibition of ornithine carbamoyltransferase from Pseudomonas syringae pv. syringae W50 by phaseolotoxin. AB - In contrast to the producer of phaseolotoxin and Orn-P(O)(NH2)-NH-SO3H (PNSOrn), Pseudomonas syringae pv. phaseolicola, which possesses a sensitive and an insensitive type of ornithine carbamoyltransferase (OCT, E.C. 2.1.3.3.), in Pseudomonas syringae pv. syringae W50, an organism which produce neither phaseolotoxin nor PNSOrn, only one type of OCT could be detected. This enzyme is highly sensitive to phaseolotoxin. This result supports our hypothesis that the existence of an insensitive ornithine carbamoyltransferase is an important prerequisite for the synthesis of phaseolotoxin in P. syringae pv. phaseolicola and that this enzyme does not occur generally in P. syringae spec. PMID- 2778650 TI - A new potential prodrug to improve the duration of L-dopa: L-3-(3-hydroxy-4 pivaloyloxyphenyl)alanine. AB - L-3-(3-Hydroxy-4-pivaloyloxyphenyl)alanine (1, NB-355) is a novel L-dopa prodrug. After oral administration with carbidopa in rats, 1 demonstrated 2.3 times longer duration (MRT) and 1.4 times larger bioavailability (AUC) on plasma L-dopa concentrations than those of L-dopa itself. Similar results were obtained in dogs. The prolonged profile of L-dopa was parallel to that of carbidopa, and the intact ester was undetectable in rat plasma. After intravenous administration in rats, 1 was converted quickly and completely to L-dopa in the systemic circulation. It was also noted that the oral LD50 value of 1 was greater than 6 g/kg in mice. These data suggest that 1 will offer long-lasting L-dopa therapy for the treatment of Parkinson's disease with little concern about toxicity. PMID- 2778651 TI - Pharmacokinetics and saturable renal tubular secretion of zidovudine in rats. AB - The purpose of this study was to assess the effects of dose on the pharmacokinetics of zidovudine (3'-azido-3'-deoxythymidine; AZT) in rats. Zidovudine (AZT) was administered intravenously at doses of 10, 50, 100, and 250 mg/kg. Plasma and urine AZT concentrations were determined by HPLC. Plasma AZT concentrations declined rapidly with a terminal half-life ranging from 0.76 h at a dose of 10 mg/kg to 1.58 h at 250 mg/kg. Total clearance (CLT) was similar at the doses of 10 and 50 mg/kg, with values of 2.80 and 2.73 L/h/kg, respectively. However, there was a trend toward nonlinearity at the dose of 100 mg/kg (CLT = 2.13 L/h/kg) and a significant decrease in CLT (1.22 L/h/kg) at the dose of 250 mg/kg. Nonrenal clearance remained unaffected by dose with a mean value of 0.98 L/h/kg. Renal clearance (CLR) was similar at the doses of 10 and 50 mg/kg, with values of 1.89 and 1.37 L/h/kg, respectively. However, significant decreases in CLR were observed at the doses of 100 (CLR = 1.30 L/h/kg) and 250 mg/kg (CLR = 0.57 L/h/kg). The maximum transport capacity (Tmax) and the Michaelis-Menten constant (Km) for renal tubular secretion obtained after simultaneously fitting plasma concentration-time profiles at the four doses to a renal clearance model were 215.5 +/- 82.1 mg/h and 119.3 +/- 80.5 mg/L, respectively, thereby yielding an unbound secretory intrinsic clearance (CLus,int) of 1.81 L/h. The high Tmax and Km values account for the high CLR of AZT and explain the linearity of CLR over a wide range of AZT plasma concentrations.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2778652 TI - Age-related change in tissue-to-plasma partition coefficient of cefazolin for noneliminating organs in the rat. AB - Age-related changes in tissue distribution characteristics of cefazolin, a cephalosporin antibiotic, were examined for noneliminating organs of rats. The in vivo tissue-to-plasma partition coefficients (Kp,vivo) varied markedly among different ages and organs. In particular, muscle and skin acted as reservoirs for cefazolin distribution. There were also marked differences in interstitial fluid space (IS), determined using [14C]inulin, among different ages and organs. For muscle and bone, the magnitude of the age-related changes in Kp,vivo of cefazolin and IS was in the order of 1-week-old greater than 7-week-old = 100-week-old greater than 50-week-old rats. This is well correlated with the age-related changes in the volume of distribution at the steady state of cefazolin per body weight (Vdss/BW) and the extracellular fluid volume per body weight (Vecw/BW) determined previously using [14C]inulin. The predicted Kp value (Kp,pred) was estimated by incorporating the serum protein binding parameters of cefazolin, the IS values, and an interstitial-to-plasma albumin concentration ratio (AR) into equations derived from an extracellular fluid model. The Kp,pred values exhibited a fairly good correspondence with the Kp,vivo values determined for various organs, except gut, in rats of all four ages. These results suggest that the determinant of the age-related change in Vdss/BW is the difference in the IS value of muscle and bone, while the age-related change in serum protein binding plays only a modest role. PMID- 2778653 TI - Comparative pharmacokinetics of coumarin anticoagulants. XLIX: Nonlinear tissue distribution of S-warfarin in rats. AB - The serum protein binding of the oral anticoagulant drug warfarin varies widely among rats and largely accounts for corresponding variations in the total serum clearance of the drug. The hepatic uptake of warfarin is concentration dependent despite the concentration independence of the free fraction of warfarin in serum over a wide concentration range. This investigation was designed to determine the distribution of the S enantiomer of warfarin in rats as a function of warfarin concentration, free fraction in serum, dose, and time. Two groups of rats, one with relatively low (0.0043) and the other with relatively high (0.0105) average serum free fraction values, were selected from a large number of adult male Sprague-Dawley rats. All animals received an iv injection of S-warfarin, either 0.25 or 1.0 mg/kg, and were sacrificed at intervals over a period of 10 d. Concentrations of S-warfarin in serum, liver, kidneys, muscle, and fat were determined by HPLC. The tissue:serum concentration ratio (T:S) of the drug was highly concentration dependent, but was independent of dose, time, and (except for fat) free fraction in serum. The T:S for fat was higher in animals with the larger serum free fraction values. The T:S of S-warfarin for the liver was greater than 10 at low concentrations and reached a limiting value of 0.25 at relatively high concentrations of the drug. In general, the T:S versus concentration profiles of S-warfarin are consistent with the presence of two classes of binding sites in the tissues, one with very high affinity and low capacity, the other with lower affinity and apparently unlimited capacity under the experimental conditions.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2778655 TI - In vitro sodium salicylate release from a sucrose polyester matrix. AB - Sucrogel H-70, a recently synthesized polyester of sucrose, was investigated as a potential drug delivery matrix. In this study, the release of sodium salicylate was examined from a reservoir-controlled release device. It is shown that sodium salicylate release follows zero-order kinetics in the three media studied (i.e., water and simulated gastric and intestinal fluids). PMID- 2778654 TI - Pharmacokinetics of trimethoprim in the rat. AB - The pharmacokinetics of trimethoprim was studied in male Sprague-Dawley rats following the intravenous administration of trimethoprim at a dose of 25 mg/kg. Plasma and tissue levels of trimethoprim, as a function of time, were determined by reversed-phase high-performance liquid chromatography. The disposition of trimethoprim was described by both a two-compartment open model with elimination from a central compartment and a noncompartmental method. For the compartmental analysis, the terminal elimination rate constant, elimination half-life, apparent volume of distribution in the central compartment, apparent volume of distribution in the central compartment based on the area under the plasma concentration-time curve, and volume of distribution at steady state, were determined to be 0.007 min-1, 99 min, 2059 mL/kg, 5729 mL/kg, and 2473 mL/kg, respectively. Noncompartmental pharmacokinetic parameters were obtained by the statistical moment theory. The estimates for mean residence time, clearance, and volume of distribution at steady state of trimethoprim were calculated to be 52 min, 40 mL.min-1kg-1, and 2097 mL, respectively. Tissue distribution of trimethoprim followed a biphasic phenomenon with a maximum concentration at 30 min for heart, lung, spleen, liver, kidney, seminal vesicles, and muscle, and at 45 min for testicles, 20 min for prostate gland, and less than 10 min for brain. The data show that compared with the plasma concentration, higher levels of trimethoprim were found in heart, lung, spleen, liver, kidney, prostate gland, and seminal vesicles; a similar concentration was found for muscle, but lower levels of trimethoprim were found for brain and testicles. PMID- 2778656 TI - Polymorphism of estramustine. AB - As the solubility in water of the cytotoxic drug estramustine is less than 1 mg/L, polymorphism can have an impact on the bioavailability of orally administered drug. Therefore, the solid state characteristics of estramustine samples, crystallized from different solvents, were investigated by means of X ray crystallography, thermal analysis, and IR spectroscopy. The DSC data indicated the existence of several phases. Four forms--A, B, C, and D--were confirmed. Phase A was obtained when crystallizing from solvents with a moderate or low dieletric constant (less than approximately 24). This form was an anhydrate and found to be the stable one. When crystallizing from methanol, metastable solvates, with approximately 0.5 mol for phase B or approximately 1 mol for form C, were precipitated. Both types were transformed to phase A during storage. This desolvation was accelerated by heating. Crystallizing from a mixture of acetone and water resulted in a monohydrate, form D, which was converted to the anhydrous type A upon heating. As forms B, C, and D were solvates which transformed to another crystal form upon desolvation, they were polymorphic solvates of the anhydrate, type A. Symmetry and unit cell dimensions of the stable form of estramustine (phase A) were determined by means of a single crystal X-ray technique (orthorhombic, a = 23.90, b = 20.69, c = 8.76, space group P212121). In addition, the crystallographic parameters of form D were deduced from calculations based on powder diffraction data. PMID- 2778657 TI - Predicting the solubility of sulfamethoxypyridazine in individual solvents. I: Calculating partial solubility parameters. AB - Sulfamethoxypyridazine, a representative model of a drug molecule, is used to test the extended Hansen method for estimating partial solubility parameters of solid compounds. Solubilities are determined in polar and nonpolar solvents. The method provides reasonable partial parameters for the sulfonamide, and it may be useful in obtaining partial parameters for other drug molecules. A four-parameter extended Hansen approach involving proton donor and acceptor parameters is used in fitting the data to a theoretical model. A term, Wh, is introduced as an empirical measure of solute-solvent interactions due to hydrogen bonding. The use of the empirical term Wh allows the researcher to fit experimental solubilities and thus design regression models and equations which provide a reasonable prediction of solubilities of a polar drug in a number of very different solvents. A Flory-Huggins size correction term improves the prediction of sulfamethoxypyridazine solubilities in these irregular solutions. PMID- 2778658 TI - Micellar solubilization of a new antimalarial drug, beta-arteether. AB - beta-Arteether (1) is a new antimalarial drug derived from artemisinin (2, quinghaosu). Compound 1 is quite water insoluble, but very soluble in a variety of organic solvents. Solubilization in a variety of surfactants was investigated to obtain higher concentrations of 1 in aqueous solutions. Anionic and cationic surfactants exhibited dramatic solubilizing ability for 1, while nonionic surfactants showed significantly lower solubilizing ability. The solubilization data are analyzed on the basis of a pseudo-phase model with 1 exhibiting a high partition coefficient into the micellar phase. An empirical model is presented to identify the possible sites of solubilization of 1 in the micelle. PMID- 2778659 TI - Effects of hydrotropic agents on the solubility, precipitation, and protein binding of etoposide. AB - Etoposide, a commonly used anticancer agent, has an aqueous solubility of 0.2 mg/mL. It is formulated for intravenous use as a more concentrated solution (Vepesid; 20 mg/mL) with polysorbate 80 and with cosolvents. In this work, hydrotropic agents such as sodium benzoate, sodium o-hydroxybenzoate (sodium salicylate), sodium 2,5-dihydroxybenzoate (sodium gentisate), and the sodium salts of 2,4-dihydroxy- and 2,6-dihydroxybenzoic acid and of 2,4,6 trihydroxybenzoic acid have been used as alternative solubilizers of etoposide. The weakest and strongest interactants with etoposide were, respectively, sodium benzoate and sodium 2,4,6-trihydroxybenzoate. The effect of mono- and dihydroxybenzoates on etoposide solubility was intermediate. Although sodium 2,4,6-trihydroxybenzoate is the most efficient solubilizer, its use is limited by its own low aqueous solubility. The effect of sodium salicylate and other formulation ingredients on the in vitro protein binding and precipitation of etoposide upon dilution with normal saline and human plasma has been studied. Etoposide binds to the extent of 94% to human serum albumin (HSA) and human plasma, but only 24% to bovine serum albumin (BSA) in vitro. Sodium salicylate significantly decreased the binding of the drug to both HSA and human plasma, whereas the components of Vepesid did not. Dilution of Vepesid (1:2 and 1:3) with plasma in vitro resulted in immediate precipitation, while the corresponding dilutions of etoposide aqueous solution (20 mg/mL in 2 M sodium salicylate) produced no precipitate for the first hour. PMID- 2778660 TI - Sustained release of isomazole from matrix tablets administered to dogs. AB - Isomazole matrix tablet formulations, with various concentrations of hydroxypropyl methylcellulose (HPMC) hydrogel, were prepared and tested for sustained-release activity. Sustained-release activity was determined by administering isomazole test formulations orally to conscious dogs, instrumented with an indwelling left ventricular pressure transducer, and monitoring cardiac inotropic changes for 12 h thereafter. The HPMC hydrogel incorporated into the tablets at a concentration of 20-30% did not significantly change the magnitude of inotropic response or duration of action. Increasing the HPMC concentration to 40 and 42.5% in the formulations decreased the peak LVdP/dt60 response (cardiac inotropic activity) to isomazole, increased the response duration, and maintained the area under the curve (AUC) of LVdP/dt60 versus time. Higher concentrations of HPMC decreased both LVdP/dt60 peak activity and AUC without producing a sustained response. A very narrow range of HPMC concentration in the matrix tablet is thus required to achieve isomazole sustained-release activity. PMID- 2778661 TI - Synthesis and in vitro antibacterial activity of some 1 (difluoromethoxyphenyl)quinolone-3-carboxylic acids. AB - We report on the synthesis of N-1-phenylquinolones in which the difluoromethoxy moiety is utilized as a halogen replacement. The antibacterial activity is discussed with reference to N-1-halophenylquinolones. PMID- 2778662 TI - Electrochemical behavior and polarographic determination of auronofin. AB - Auronofin in a 50% ethanol:water solution yields, on the dropping mercury electrode, a reduction wave whose E1/2 is a function of pH in the 2 less than pH less than 9 range (E1/2 = -0.036-0.054 pH), and acquires a constant value above pH 9 (E1/2 = -0.50 V, versus saturated calomel electrode). The influence of the variables which affect the reduction process of auronofin in tripotassium phosphate medium was studied. The electrochemical process is reversible and diffusion controlled. Coulometry showed that one electron is involved in the reduction of the drug. Analytical methods are proposed for the determination of auronofin at micromolar levels by DC and DP polarography, with relative standard deviations of 3.2 and 2.4%, respectively. PMID- 2778664 TI - Physicochemical and structural studies of triamterene. AB - It has been shown by several physicochemical techniques that the existence of different crystal forms of triamterene, as well as the crystalline products from different solvents with distinct differences in melting points, does not necessarily imply polymorphic crystal forms. The crystalline structure for triamterene is reported herein, revealing a N,N-dimethylformamide molecule and a water molecule within the crystal lattice. Triamterene crystallizes in a face centered orthorhombic space group, Fdd2 (#43), when grown from aqueous solutions of dimethylformamide (N,N-DMF). In addition, the asymmetric unit contains a partially occupied molecule which is situated on a crystallographic twofold axis. Weak hydrogen bonding occurs between atoms O(1) and N(7), with a distance of 2.66 A, O(1) and N(5) with a distance of 2.96 A, O(2) and N(1), at two different symmetry sites of 2.99 A, and N(2) and N(7), with a distance of 2.91 A. The different solvated crystalline triamterene specimens have different melting points depending on organic solvation, water, or both. PMID- 2778663 TI - High-performance liquid chromatographic assay of diltiazem and six of its metabolites in plasma: application to a pharmacokinetic study in healthy volunteers. AB - A sensitive and specific reversed-phase high-performance liquid chromatographic assay for simultaneous determination of plasma concentrations of diltiazem and six of its metabolites known to occur in humans is reported. Using 2 mL of plasma, the lower limit of quantitation of the assay was less than 10 ng/mL of diltiazem and each of the metabolites, with coefficients of variation of less than 10%. The assay was successfully applied to determine the kinetics of diltiazem and its major metabolites in four healthy volunteers after each received a single 90-mg oral dose of diltiazem. In addition to the previously reported two major metabolites in humans, deacetyl diltiazem (M1) and N monodemethyl diltiazem (MA), another previously unreported major metabolite, deacetyl N-monodemethyl diltiazem (M2), was present at comparable concentrations to M1 and MA in all four volunteers. In addition, another metabolite, deacetyl diltiazem N-oxide (M1-NO), which was previously found most abundant in urine, was also estimated in the plasma of two volunteers. Two other known human metabolites, deacetyl O-demethyl diltiazem (M4) and deacetyl N,O-didimethyl diltiazem (M6), were not detected in any of the four study subjects. The average maximum plasma concentrations of M1, M2, MA, and M1-NO were 10, 15, 26, and 13%, respectively, of the mean maximum diltiazem concentrations. PMID- 2778665 TI - Improved anticonvulsant activity of phenytoin by a redox brain delivery system I: Synthesis and some properties of the dihydropyridine derivatives. AB - Nine chemical delivery systems (CDSs) were synthesized for the efficient transport of phenytoin (DPH) across the blood-brain barrier. The CDSs were based on a dihydropyridine in equilibrium quaternary pyridinium ion redox system which relies on chemistry similar to the NADH in equilibrium NAD interconversion for activity. The chemical carriers, derivatives of trigonelline, 1 alkylcarboxynicotinamide, 3-pyridylacetic acid, and N-methylpicolinic acid, were esterified with 3-(hydroxymethyl)phenytoin. The CDSs proved to be more lipophilic (5-23 times) than DPH. The 1-alkylcarboxydihydronicotinamide CDSs, excluding the sterically hindered one (11e), were quite unstable in rat tissue homogenates and hydrolyzed to release DPH. In human blood, however, they were found to be much more stable (75 times) toward hydrolysis. All other CDSs were oxidized quantitatively to the corresponding pyridinium ion in rat brain homogenates. These compounds were found to possess the required physicochemical characteristics for delivering DPH into rat brain. PMID- 2778666 TI - Determination of beta-carboline derivatives in biological samples by high performance liquid chromatography with fluorescence detection. AB - An assay procedure for measuring plasma, urine, and feces levels of seven beta carbolines and possible metabolites is described. The drugs are extracted with diethylether or, alternatively, with a commercially available automated extraction device after adding an appropriate internal standard. Separation from matrix constituents is performed by reversed-phase high-performance liquid chromatography (HPLC) followed by fluorescence detection. The carboxylic acid metabolites of the beta-carbolines have to be esterified before HPLC measurement. The detection limits are 0.2 ng/mL for beta-carbolines and 2 ng/mL for their metabolites. Plasma levels and pharmacokinetic parameters of six different beta carbolines in healthy male volunteers following iv or po treatment are described. Total clearance ranged from 17 to 52 mL/min/kg and the terminal half-life ranged from 1 to 4 h. The absolute bioavailability exhibited a range from less than 1 to 61%. PMID- 2778667 TI - Acid catalyzed hydrolysis of a series of zopiclone analogues. AB - The pKa values of acid-base equilibria involved in the protonation of zopiclone and analogues are determined by UV-visible absorption spectrometry and pH-metry. Hydrogen ion catalysis is evidenced in the carbamate hydrolysis. PMID- 2778668 TI - Enantiomeric interaction of flurbiprofen in the rat. AB - Flurbiprofen [FL, (+/-)-2-(2-fluoro-4-biphenylyl)propionic acid] is a 2 arylpropionic acid nonsteroidal anti-inflammatory drug which is commercially available as a racemate. The anti-inflammatory activity of FL, however, appears to be mainly due to the S enantiomer. Recently, it has been postulated that, in both humans and rats, the two enantiomers of FL may interact when racemic doses are given. This study examines the above postulate in the rat by administration of single iv doses of racemic FL (10 mg/kg), and R- and S-FL (5 mg/kg of each). Plasma concentrations (0-12 h) of the enantiomers were measured using a stereospecific HPLC assay. A significant interaction was noticed between the enantiomers: mean AUC +/- SD of R-FL was reduced from 115.3 +/- 21.3 to 49.0 +/- 10.4 mg/L.h as a result of S-FL coadministration. A trend towards reduced S-FL plasma concentration was also evident when the enantiomer was given as the racemate [mean AUC +/- SD; 176.8 +/- 37.7 racemate versus 241.4 +/- 86.2 mg/L.h alone]. The reduction in S-FL, however, was not significant due perhaps to the observed interanimal variation. While the enantiomeric interaction caused a significant enlargement of the volume of distribution of R-FL, it failed to alter the terminal half-life of the enantiomer. It is suggested that the interaction is a result of displacement from plasma protein binding sites of one enantiomer by the other. PMID- 2778669 TI - Variability in the absorption and disposition of erythromycin estolate in humans. AB - The inter- and intrapersonal variability in the absorption and disposition of erythromycin estolate in humans was assessed by comparing total erythromycin serum concentrations in five subjects who each received a single erythromycin estolate tablet on three separate occasions under identical experimental conditions. Coefficients of variation for the pharmacokinetic parameters Cmax, Tmax, AUC0-12, MRT, and t1/2 were of a similar magnitude when calculated between subjects in any one administration phase or between phases. In addition, serum concentrations of both erythromycin base (active component) and erythromycin propionate were selectively determined in the same subjects only during the final two phases of the study. Comparison of AUC0-12 values showed that the percentage of the total area (base and ester components) present as erythromycin base remained relatively constant between administrations (mean values of 14.5 and 11.2%), with low coefficients of variation between subjects (10.8 and 11.6%). Discrepancy value calculations revealed that the variability in serum concentration-time profiles between the three phases of the study fell into the "small"-to-"moderate" classification. From these data it is apparent that intrapersonal variations in the absorption and disposition of erythromycin estolate are of a similar magnitude to interpersonal variations and should be borne in mind in the design and interpretation of comparative bioavailability studies involving similar formulations of this compound. The relative proportions of erythromycin base and propionate did, however, remain fairly constant both between treatments and between subjects. PMID- 2778670 TI - Water evaporation rates from a model of stratum corneum lipids. AB - Water evaporation rates were measured from thin samples of a model layered structure of stratum corneum lipids with 32% water. A model with only free fatty acids present gave the lowest evaporation rates, while a model with only oleic acid gave values approximately 50% higher. Using the total lipid spectrum of stratum corneum gave a structure with an evaporation rate between those mentioned above. The diffusion coefficients calculated were one to two orders of magnitude higher than those of stratum corneum, reflecting the influence of the proteinous part of the latter structure. A sample with only saturated fatty acids gave extremely high evaporation rates; in fact, they were of the same magnitude as those from an unprotected water surface. PMID- 2778671 TI - Pharmacokinetics of morphine and its surrogates. IX: Discrepancies among infused buprenorphine plasma concentrations sampled from different veins. AB - When blood was drawn from the brachial vein of the dog upon infusion of buprenorphine hydrochloride in saline through a plastic catheter into the jugular vein, the post-infusion jugular vein plasma concentrations observed during the first 15 min of the post-infusion distributive phase were significantly higher than the highest observed brachial vein plasma concentrations at the time of cessation of infusion. When blood was drawn from the jugular vein following infusion of buprenorphine hydrochloride into the left brachial vein, the post infusion left brachial plasma concentrations during the first 15 min of the post infusion distributive phase were significantly higher than the highest jugular and contralateral brachial vein concentrations observed just before and after the cessation of infusion. Dependent on whether the plasma concentrations sampled from the infused catheter or another catheter were used, the apparent calculated total body clearances differed by 25-39%. These results demonstrated that the observed differences in the post-infusion buprenorphine concentrations in plasma obtained from different veins were not due to any drug-induced changes in the circulatory physiology of the dog. Evidence is presented to show that the discrepancies were due to the repartitioning of the catheter-bound drug into the blood drawn through the catheter for assay, which significantly increased the apparent blood concentration of drug, not-withstanding the fact that only an extremely small fraction (0.004-0.009) of a simulated 1-3-h infused dose partitioned into the plastic catheter. When buprenorphine hydrochloride was administered by a bolus injection, there was no significant partitioning of drug into the infusion catheter.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2778672 TI - Non-micelle forming bile acids increase biliary gentamicin excretion in the rat. AB - To investigate whether non-micelle forming bile acids are able to increase biliary gentamicin excretion, male Sprague-Dawley rats were anesthetized with pentobarbital and fitted with a biliary fistula. After a control period of 30 min, dehydrocholate, taurodehydrocholate, or norursodeoxycholate were administered iv at doses of 2 or 10 mumol.min-1.kg-1. Taurodehydrocholate increased bile flow and biliary gentamicin clearance similarly in a dose dependent fashion. Its unconjugated analogue, in contrast, increased gentamicin clearance fourfold, while increasing bile flow only 1.6-fold. This suggests that other than purely osmotic phenomena were involved. This effect was even more marked for the short-chain bile acid, norursodeoxycholate. At a dose of 2 mumol.min-1.kg-1 it increased bile flow by 30%, but gentamicin clearance by 210%; a similar discrepancy between choleresis and gentamicin clearance was observed at the higher dose tested. It may be concluded that conjugated triketo bile acids increase biliary gentamicin clearance by osmotic choleresis. Unconjugated triketo bile acids and nor-bile acids, to an even greater extent, increase gentamicin clearance much more markedly than bile flow; other effects, such as the putative cholahepatic shunt pathway, are responsible for this phenomenon. This novel therapeutic principle might be useful in achieving therapeutic biliary antibiotic concentrations or in treating gentamicin intoxication in patients with renal insufficiency. PMID- 2778673 TI - Predicting the solubility of sulfamethoxypyridazine in individual solvents. II: Relationship between solute-solvent interaction terms and partial solubility parameters. AB - In the first paper in the series, an expanded system of parameters was devised to account for orientation and induction effects, and the term Wh was introduced to replace delta 1h delta 2h of the extended Hansen solubility approach. In the present report, a new term, Kh = Wh/delta 1h delta 2h is observed to take on values larger or smaller than unity depending on whether the hydrogen bonded solute-solvent interaction is larger or smaller than predicted by the term delta 1h delta 2h. The acidic delta a and basic delta b solubility parameters are used to represent two parameters, sigma and tau, suggested by Small in his study of proton donor-acceptor properties. The Small equation, including a heat of mixing term for hydrogen bonded species, is shown to be capable of semiquantitative evaluation. A partial molar heat delta H2h of hydrogen bonding is calculated using delta h and Wh terms; delta H2h is found to be correlated with the logarithm of the residual activity coefficient, In alpha R, a term representing strong solute-solvent interaction. The terms Wh, delta H2h, and In alpha 2R may be used to test the deviation from the geometric mean assumed in regular solution theory, and to replace the hydrogen bonding terms of the extended Hansen three parameter model. The solubility of sulfamethoxypyridazine in 30 solvents is used to test the semiempirical solubility equations. The results are interpreted in terms of partial solubility parameters and the proton donor-acceptor properties of the solvents. PMID- 2778674 TI - Gas-liquid chromatography-mass spectroscopy determination of clopamide in plasma. AB - A gas-liquid chromatography-mass spectroscopy (GLC-MS) method for the determination of clopamide (1) in human plasma was developed to evaluate the pharmacokinetics and bioavailability of 1 in humans. The method is specific, sensitive, and rapid and allows routine analysis as required for extensive pharmacokinetic studies. The assay procedure involves addition of furosemide (2) as an internal standard to plasma, separation on Sep Pack-C18 cartridges, elution by ether: methanol (1:1), evaporation, and subsequent derivatization with trimethylanilinium hydroxide in methanol (Methelute). Then, 5 microL of the reaction mixture is injected into a GLC-MS system which consists of a 1% SE-30 on Gas Chrom Q (100-120 mesh) glass column. The MS information was obtained under the following conditions: ionization beam energy 70 eV, ion source 200 degrees; and m/e 372 for single ion monitoring. The retention times for 1 and 2 were 0.6 and 1.0 min, respectively. The limit of detection is 10 ng/mL of 1 in plasma and the calibration curve was shown to be linear between 10 and 500 ng/mL of 1. After repeated analysis of spiked plasma samples, the coefficient of variation ranged from 5.1 to 8.3%. The recovery from the extraction procedure was 92 +/- 2.2%. Spiked samples frozen at -20 degrees C were stable for at least 8 weeks. The method has been successfully used in a pharmacokinetic study with po dosing of 5 mg of 1 to eight healthy volunteers. Peak plasma concentrations of 197 +/- 56 ng/mL were observed after 1.1 +/- 0.34 h. No measurable concentration of 1 beyond 12 h after dosing was observed. PMID- 2778675 TI - Release studies from lyotropic liquid crystal systems. AB - A temperature-composition diagram of systems containing the nonionic surfactant polyoxethylene (20) isohexadecyl ether (1) and water was established. Three different anisotropic areas existed over the concentration range 33-80% of 1. Release of salicylic acid from liquid crystalline phases of 1 into aqueous buffer across lipoidal barriers was also studied. Rates of transfer as a function of percent loading from a neat mesophase containing 37% of 1 and also from systems with different molecular packing were determined. Apparent activation energies of transfer from an ordered solvent containing 37% of 1 and from an isotropic medium of the same chemical composition were found to be 33.3 and 9.4 kcal/mol, respectively. These findings suggest a pronounced effect of medium structure on the interfacial resistance of the barrier. PMID- 2778676 TI - Interactive simulation of nonuniform bolus and infusion dosing in linear compartmental models. PMID- 2778677 TI - Variable effects of laurocapram (Azone) on rectal cefoxitin absorption in rats. PMID- 2778678 TI - Tibial torsion. Normal values in children. AB - In-toeing and out-toeing are common foot problems, and frequently are caused by torsional abnormalities of the tibia. Malleolar position, and thus tibial torsion, was measured in 281 children, 1 1/2 to 6 years of age, with a Tractograph, and normal values for the different age groups were determined. The authors discuss the clinical significance of torsional abnormalities of the tibia regarding gait. PMID- 2778679 TI - Neuropathic foot ulcer prevention in diabetic American Indians with hallux limitus. AB - Infected neuropathic ulcerations are the leading cause of diabetes-related partial foot amputations at the Phoenix Indian Medical Center. Ten hallucal ulcerations in seven American Indian patients with hallux limitus were resolved by local wound care and partial first metatarsophalangeal joint resection. The average length of postsurgical follow-up care was 28.8 months. There have been no recurrences of the plantar hallux ulcerations in any of the patients. PMID- 2778680 TI - Surgical approach for enlarged peroneal tubercles. AB - The peroneal tubercle is an anatomic landmark consistently found on the lateral aspect of the calcaneus. Its enlargement can be either congenital or acquired. In the past, surgical treatment of enlarged tubercles has consisted of simple excision of the tubercle. The authors have presented a technique to preserve the gliding facet that is often found on the inferior surface of the tubercle. PMID- 2778681 TI - Pedal polydactyly. A case report. AB - Polydactyly is a common pedal deformity with great variation in clinical presentation. There is a tendency toward a higher incidence in previously affected families, but the actual occurrence rate of the different forms of polydactyly has not been agreed upon in the literature to date. Most authors agree that the isolated deformity is an expression of an autosomal dominant gene with varied penetrance. Syndromatically associated polydactyly is inherited as an autosomal recessive trait. Surgical intervention should be attempted as early as possible. Correction should be undertaken only after a thorough clinical and radiographic evaluation has been performed. The patient's postoperative goals should always be considered. It is not necessary to remove the supernumerary digit if it does not interfere with the foot's function and comfort. Cosmesis should not be the chief consideration. The surgeon should strive to return the foot to a more normal contour while maintaining or improving foot function. PMID- 2778682 TI - In-shoe casting technique for specialized sports shoes. AB - The use of vacuum casting to create better-fitting orthoses for special athletic shoes has been discussed. By vacuum-forming a negative cast within the confines of special athletic shoes, such as bicycling cleats or fencing shoes, a better fitting orthosis can be fabricated with little or no special adjustments or modifications necessary to create the best fit and function. PMID- 2778683 TI - 50 patients with an ion transfer unit, the Phoresor by Iomed. PMID- 2778684 TI - Evolution of excimer laser corneal surgery. AB - Interest in the potential of the excimer laser for refractive surgery was generated by a series of experiments performed in IBM's T.J. Watson laboratories. The development of photoablative decomposition was applied to corneas with immediate implication for corneal refractive control. Scientific investigations demonstrated that submicron erosion ablation of material was possible without damage to remaining tissues. After refinement of the beam and analysis of thresholds, we subsequently demonstrated that healing of large ablated areas in rabbits and then primate eyes would occur without scar formation or loss of transparency. This prompted a number of commercial efforts to develop this device for both refractive and general corneal surgical applications. The early clinical investigations show that a predictable refractive change could be induced in a cornea and this change was stable over many months. Furthermore, the transparency of the cornea was unimpaired. These favorable early results have led to a number of clinical investigations of excimer laser corneal surgery including refractive keratectomy, a direct laser keratomileusis. PMID- 2778685 TI - Scanning slit delivery system. AB - We describe the structure and function of a delivery system designed for use with an argon fluoride excimer laser for corneal surgery. The basic principle of the delivery system is to shape the laser beam with a slit mask to a defined configuration. The image of the slit is moved across the cornea in a mathematically defined pattern to ablate a given amount of tissue, creating a new anterior radius of curvature for the cornea. The location of the beam on the cornea is determined by a rotating dove prism and a translating spherical lens, each of which is controlled by computer-regulated servomotors. The system is versatile and can be used for laser myopic or hyperopic keratomileusis, for correction of astigmatism by surface ablation, for creation of radial or transverse linear cuts, for excision of corneal buttons, and for uniform lamellar corneal smoothing procedures. The delivery system is currently used in the laboratory for the ablation of nonhuman primate corneas. PMID- 2778686 TI - Fibronectin on excimer laser and diamond knife incisions. AB - The experiment was designed to illustrate the difference between the diamond knife and the excimer laser (ArF 193 nm) on keratotomy incisions. The histopathologic effect of fibronectin applied to these wounds was observed. Fibronectin demonstrated a chemotactic effect on fibroblasts and increased the amount of newly synthesized collagen deposited at the incision sites. The excimer laser incisions treated with fibronectin had 43% more fibroblasts per 2,500 microns 2 than the excimer laser incisions not treated with fibronectin. The adjustable diamond knife incisions treated with fibronectin had 42% more fibroblasts than the adjustable diamond knife incisions not treated with fibronectin. The excimer laser ArF 193 nm incisions had 18% more fibroblasts in the incision area than the adjustable diamond knife incisions independent of fibronectin usage. This indicates that the excimer laser incisions and the diamond knife incisions may have different healing mechanisms--perhaps because of the distinctive modes of action of these instruments. PMID- 2778687 TI - Excimer laser ablation of the human lens at 308 nm with a fiber delivery system. AB - A 308 nm excimer laser has been used with a fiber delivery system to perform ablation of the human lens. Preliminary results demonstrate the system's ability to ablate lens nucleus and cortex selectively, preserving the anterior and posterior capsules. The total delivered energy necessary to ablate a human lens ranged from 35 to 63 joules. Laser tissue interaction and ablation rates were computed for the different components of the human lens (capsule, cortex, nucleus) for the operatively useful energy densities (fluences). Operative experience suggests that cortex and nucleus can be ablated while preserving the capsule if an adequate irrigation and aspiration system is developed. These results also suggest that this modality may be adequate for performing endocapsular cataract extraction. Laser tissue interactions were also computed at variable distances between the fiber tip and tissue. As this distance increased, the spread of the beam increased and a significant increase in energy was necessary to induce tissue ablation. This was due to the decrease in fluence with increasing distance to the target tissue and/or the absorption and scattering of the delivered energy within a short distance from the fiber tip by the ablated material. Evidence of a sonic effect was also present. PMID- 2778689 TI - Visual thresholds in aphakia and pseudophakia. AB - Following extracapsular senile cataract extraction, visual thresholds were measured in 15 aphakic eyes corrected with glasses and compared with an appropriately matched group of 23 eyes with poly (methyl methacrylate) posterior chamber lenses. All subjects were six months to three years postoperative and had 20/30 or better visual acuity. The paramacular dark adapted threshold, the foveal luminance threshold, and the glare effect on both thresholds were not significantly different in the two groups despite the optical differences between aphakic and pseudophakic correction. PMID- 2778688 TI - Clinical evaluation of the effect of acetylcholine on the corneal endothelium. AB - A transient corneal edema is often seen after the injection of acetylcholine solution in the anterior chamber during cataract surgery. Ninety eyes of 90 patients scheduled for extracapsular cataract extraction with posterior chamber intraocular lens implantation were randomly assigned to two groups: one which received acetylcholine solution in the anterior chamber and one, a control group, which received only external conjunctival pilocarpine drops as a miotic. At three days, endothelial folds (P = .04) and corneal edema (P = .01) were more pronounced in the acetylcholine group; at seven days, endothelial folds were more severe (P = .04) in the acetylcholine group. At 30 days, the acetylcholine group showed a 37.2% increase (P = .01) of the endothelial cell area, whereas the control group showed a 7.08% increase. The difference between the groups was statistically significant (P = .05). Anterior chamber fluorophotometry at 30 days showed an increase of the corneal transfer coefficient that was higher but not significant in the acetylcholine group. We suggest caution in the intraoperative use of acetylcholine solution, particularly in those eyes showing a preoperative compromise of the endothelium. PMID- 2778690 TI - Neodymium: YAG laser capsulotomy with a biconvex intraocular lens. AB - There are optical and mechanical advantages of the biconvex posterior chamber intraocular lens (IOL) following cataract surgery. A clinical study of Nd:YAG laser capsulotomy in eyes with biconvex IOLs was undertaken. The lenses were made of injection-molded poly(methyl methacrylate) without laser spacing. Using specified techniques, YAG laser capsulotomy was performed in 19% of 436 eyes without significant damage to the IOL and without affecting visual acuity or glare disability. PMID- 2778691 TI - Epithelial downgrowth following wound dehiscence after extracapsular cataract extraction and posterior chamber lens implantation: surgical management. AB - Epithelial downgrowth occurred along a fistulous (nonfiltering) tract containing an incarcerated anterior capsular flap after extracapsular cataract extraction and posterior chamber lens implantation complicated by wound dehiscence. Months later, a YAG posterior capsulotomy was performed before it was realized that posterior capsule opacification was associated with epithelial downgrowth involving the posterior capsule. Surgical management of epithelial downgrowth after extracapsular cataract extraction and posterior chamber lens implantation is discussed, with emphasis on the role of combined cryotherapy, dissection of the retrocorneal membrane, and complete removal of the capsular bag. Histopathologically, we found it difficult to differentiate lens epithelial cells from corneal epithelial downgrowth within the capsular bag, but monoclonal antibody for keratin may help identify corneal epithelial cells. PMID- 2778692 TI - Intraocular lens removal for chronic cystoid macular edema. AB - Intraocular lenses were removed from ten eyes with chronic cystoid macular edema demonstrated by fluorescein angiography. No corneal transplantation was done at the time of intraocular lens removal. Five eyes achieved a visual acuity of 20/50 or better. Exchange for a posterior chamber intraocular lens did not appear to have an adverse affect compared to simple intraocular lens removal. PMID- 2778693 TI - Ocufen and pupillary dilation during cataract surgery. AB - A random, masked prospective study was performed on 100 patients having elective extracapsular cataract extraction to evaluate the ability of Ocufen (flurbiprofen) to maintain dilation of the pupil. All the patients received a standard dilating regimen; half also received Ocufen drops. Surgery was recorded with a video camera attached to the operating microscope. Magnification was kept constant. Pupil diameters were measured on a calibrated video screen at four different stages of the operation: at the beginning, post-capsulotomy, post nucleus delivery, and at the end. The age, sex, and iris color of each patient were recorded. Preoperative pupillary diameters were not statistically different between the control and Ocufen groups. The Ocufen-treated group maintained pupillary dilation better on the average and had a much smaller incidence of pupil constriction greater than 2 mm. PMID- 2778694 TI - Capsular opacification associated with silicone implants. AB - This study compares the incidence of significant posterior capsular opacification in the 12 months following surgery in patients who received a sulcus-fixated silicone lens, a bag-fixated poly(methyl methacrylate) (PMMA) lens, or a bag fixated silicone lens. All procedures were performed by the same surgeon using the same technique. The incidence of capsulotomy was 16.5% with sulcus-fixated silicone lenses, 7.9% with PMMA lenses, and 4.8% with bag-fixated silicone lenses. This confirms the impression that earlier opacification occurs with sulcus-fixated silicone lenses, but the low incidence of opacification with bag fixated silicone lenses suggests the cause is not the silicone but the location of lens fixation. PMID- 2778695 TI - Measurement of postoperative intraocular lens tilting and decentration using Scheimpflug images. AB - A three-dimensional, in vivo method for determining the position of implanted intraocular lenses (IOLs) using an image-processing technique has been developed. Two images of the anterior segment of the eye with an implanted IOL were photographed with a Scheimpflug camera at slit-lamp angles of 90 degrees and 180 degrees. After geometrical correction, the contours of the original images were enhanced using binarization and curve-fitting techniques. These images afforded calculation of the angle of tilt of the IOL optic axis relative to a standard reference line which connected the center of anterior corneal surface curvature with the geometrical center of the pupil. The extent and direction of IOL decentration could also be shown. The IOL image in the posterior chamber was expressed as a wire-frame figure. This method provides several kinds of biometry in pseudophakic eyes. PMID- 2778696 TI - Consultation section. Superiorly placed trabeculectomy for chronic open angle glaucoma. PMID- 2778698 TI - Avoiding capsulorhexis complications with extracapsular cataract surgery. PMID- 2778697 TI - Residual monomer in Ridley lens. PMID- 2778699 TI - Polycarbonate intraocular lenses. PMID- 2778700 TI - Clouded judgment or greed? PMID- 2778701 TI - Cardiopulmonary resuscitation of the pregnant woman. PMID- 2778702 TI - Trauma in pregnancy. PMID- 2778703 TI - Hemorrhagic emergencies in obstetrics. PMID- 2778704 TI - Hypertensive crisis and the perinatal period. PMID- 2778705 TI - Neonatal sepsis. PMID- 2778706 TI - Newborn resuscitation in the delivery room. PMID- 2778707 TI - Efficacy of erythromycin acistrate (2'-acetyl erythromycin stearate) and erythromycin stearate in experimental infections in mice. AB - The efficacy of erythromycin stearate (ES) and its 2'-acetyl ester (erythromycin acistrate, EA) was compared in eight experimental infections in mice of both sexes. In two studies the mice were made leukopenic by whole-body irradiation. Four absorption studies were also performed in parallel. In Streptococcus pneumoniae peritonitis, the protective dose 50% (PD50) value of EA and ES, given s.c., did not differ from each other. The bioavailability of EA was slightly inferior to that of ES. In three other peritonitis studies (2 Staphylococci and 1 Streptococcus), where the treatments were given s.c., EA seemed to lag behind ES in efficacy. The parallel absorption experiment showed, however, that, as compared to ES, only about one-half of EA was released from the s.c. injection site to the blood. The adjusted PD50 values of both erythromycins were about the same, with one exception. When the treatments were given i.p. both erythromycins were equally effective, and the difference in bioavailability was minor. On the contrary, the efficacy of 2'-ethylsuccinyl erythromycin was only about one-tenth that of the other erythromycins as was also the bioavailability. Oral treatment gave similar therapeutic results with EA and ES, with similar bioavailabilities, too. In the muscle abscess model, single s.c. injections of EA and ES were equally effective in reducing the growth of Staphylococcus aureus. These results suggest that there is no great difference in the in vivo antibacterial performance of ES and its 2'-acetyl ester, although the absorption problems complicate the interpretation. Hence EA performs better than expected if only the hydrolyzed drug were useful. PMID- 2778708 TI - Oxygen dependence of omeprazole clearance and sulfone and sulfide metabolite formation in the isolated perfused rat liver. AB - Severe acute hypoxia is known to inhibit markedly the elimination of oxidatively metabolized drugs by the isolated liver. However, little is known of the degree of hypoxia required to produce inhibition of drug elimination by oxidative pathways in the intact organ. This study, in the isolated perfused rat liver, examined the oxygen dependence of the hepatic elimination of omeprazole, a drug which undergoes extensive oxidative metabolism in the rat. The relationship between hepatic oxygen supply and the production of omeprazole's oxidative sulfone and reductive sulfide metabolites was also examined. Rat livers were perfused at 15 ml/min with a perfusate containing 5 micrograms/ml of omeprazole in a single-pass design. Omeprazole clearance and the formation clearance of the two metabolites were measured in each liver during normal oxygenation, at different levels of hypoxia and after reoxygenation. There was a linear relationship between omeprazole clearance and oxygen delivery over the whole range studied. Production of the sulfone was similarly oxygen-dependent whereas the sulfide was only detectable after a significant reduction in oxygenation. In a further group of experiments the oxygen dependence of omeprazole clearance was shown to not be altered when the concentration of drug was lowered to 1 microgram/ml. This study shows that oxygen delivery is a critical determinant of the rate of oxidative drug metabolism in the isolated liver and supports the contention that reductions in hepatic oxygen supply may significantly alter the hepatic disposition of oxidatively metabolized drugs in vivo. PMID- 2778709 TI - Models of hepatic elimination: implications from studies of the simultaneous elimination of taurocholate and diazepam by isolated rat liver under varying conditions of binding. AB - Various kinetic models have been developed to describe the elimination of substances by the liver, but there is no agreement about which model is the most appropriate, as experimental evaluation is incomplete and results conflict. We have shown previously that hepatic elimination of taurocholate is best described by models that embody a high degree of sinusoidal heterogeneity or mixing, whereas another study showed that elimination of diazepam is best described by models that embody a low degree of sinusoidal heterogeneity or mixing. To investigate this discrepancy we examined, in the isolated perfused rat liver, the simultaneous elimination of taurocholate and diazepam. The effect on hepatic availability of varying unbound fraction (fu) in a single pass, steady-state system was studied in six experiments for taurocholate (fu, 0.066-0.966) and diazepam (fu, 0.051-0.675) by varying perfusate albumin concentration (0-60 g l 1). As before, elimination of taurocholate was best described by models that embody a high degree of sinusoidal heterogeneity or mixing (i.e., venous equilibrium model, dispersion model with dispersion number = infinity). Diazepam elimination was best described by models that embody a low degree of sinusoidal heterogeneity or mixing (undistributed sinusoidal model, dispersion model with low dispersion number = 1.04). A third model, a distributed model incorporating heterogeneity of sinusoidal blood flows and intrinsic clearances, fitted the data for both taurocholate and diazepam. The fitted coefficients of variation of both flow and intrinsic clearance among the sinusoids were large for taurocholate (176 and 164, respectively), but for diazepam blood flow was large (200) whereas that for intrinsic clearance was small (0.807).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2778710 TI - Inhibitory actions of a novel benzothiazepine derivative, TA3090, on the electrical and mechanical responses of the rabbit mesenteric artery. AB - Actions of diltiazem and TA3090 [(+)-(2S, 3S)-3-acetoxy-8-chloro-5-[(2 dimethylamino)ethyl]-2,3-dihydro-2- (4-methoxy-phenyl)-1,5-benzothiazepine-4-(5H) one maleate] on smooth muscle cells of the rabbit mesenteric artery were investigated using the microelectrode and tension recording methods. Diltiazem (greater than or equal to 10 microM) but not TA3090 (less than or equal to 100 microM) depolarized the membrane of the rabbit mesenteric artery. TA3090 (greater than or equal to 3 microM) inhibited the action potential and K-induced contraction (128 mM) more than diltiazem (IC50 for action potential, 6.7 microM for TA3090 and 11 microM for diltiazem in the presence of 5 mM tetraethylammonium; IC50 for phasic and tonic K-induced contractions, 3.1 and 0.1 microM, respectively, for TA3090 and 10 and 1 microM for diltiazem). When the membrane was depolarized previously by high concentrations of K in Ca-free solution, TA3090 more potently inhibited the K-induced contraction (128 mM). As a consequence, the concentration-response curve shifted to the left, suggesting that this agent produces voltage-dependent inhibition. Recovery of the amplitudes of action potential and contraction evoked by 128 mM K required a much longer period with TA3090 than diltiazem after removal of these agents and the recovery of the K-induced contraction was also voltage-dependent. Repetitive application of short stimulating pulses (50 musec, 30 Hz) produced an action potential on the excitatory junction potentials. TA3090 inhibited the action potential without change in the amplitude of excitatory junction potentials.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2778711 TI - Liposome-mediated delivery of gadolinium-diethylenetriaminopentaacetic acid to hepatic cells: a P-31 NMR study. AB - Delivery of gadolinium-diethylenetriaminopentaacetic acid (Gd-DTPA) (a magnetic resonance imaging contrast agent) to hepatic cells via liposomes used as carriers was demonstrated and monitored by P-31 NMR spectroscopy at 162 MHz on a perfused rat liver model. The penetration of Gd-DTPA into hepatic cells was reflected by a 41% reduction in the longitudinal relaxation time of the beta phosphorus atom of intrahepatic ATP used as an index of the contrast agent presence. The perfusion of free Gd-DTPA did not affect the relaxation index nor did liposomes devoid of paramagnetic agent. There was no indication of interference of Gd-DTPA, free or encapsulated in liposomes, with liver energetic metabolism. Alterations of hepatic magnetic resonance imaging signal induced by Gd-DTPA containing liposomes might help to assess the functional state of the parenchyma and pinpoint the intracellular compartment as opposed to the intravascular space. PMID- 2778712 TI - Antioxidants protect against glutamate-induced cytotoxicity in a neuronal cell line. AB - The effects of reducing agents and antioxidants on L-Glutamate (Glu)-induced cytotoxicity were examined in the N18-RE-105 neuronal cell line. The cytotoxicity by Glu (1 and 10mM) was potentiated by exposure to growth medium containing a low concentration of cystine (5-100 microM), instead of the normal medium containing 200 microM cystine. In contrast, the toxicity was suppressed by increasing the cystine concentration to 500 to 1000 microM. Reducing agents, cysteine (30-1000 microM), dithiothreitol (10-250 microM) and glutathione (GSH, 10-1000 microM) also protected the cells against the cytotoxicity of 10 mM Glu in a concentration dependent manner. The antioxidants vitamin E (10-100 microM), idebenone (0.1-3 microM) and vinpocetine (10-100 microM) also provided marked protection against the cytotoxicity of Glu (10 mM) or quisqualate (1 mM). Antioxidants also prevented the delayed cell death caused by lowering the concentration of cystine in the medium to 5 microM. Incubation of the cells with 10 mM Glu caused a marked decrease in cellular GSH levels. Although cysteine and dithiothreitol prevented the GSH reduction caused by Glu, antioxidants did not. The cellular levels of oxidants were assessed using 2,7-dichlorofluorescin, a probe that accumulates within cells and is converted to a fluorescent product by oxidation. Glu (10 mM) caused a marked increase in such fluorescence, whereas vitamin E and idebenone reduced markedly the number of fluorescent cells to control levels even added with 10 mM Glu. These results indicate that oxidative stress due to loss of cellular levels of GSH is one mechanism whereby Glu/quisqualate exert cytotoxicity and suggest that centrally active antioxidants may reduce neuronal damage in pathologic conditions associated with excessive Glu release. PMID- 2778713 TI - A stereoselective central hypotensive action of atenolol. AB - Previous studies have demonstrated that propranolol can lower arterial pressure through an action within the central nervous system. The purpose of this study was to determine 1) whether the hydrophilic beta blocking drug atenolol which is devoid of membrane stabilizing activity can reduce arterial pressure through a central action and 2) whether this action is stereoselective for the (-)-, or beta receptor blocking enantiomer. Studies were conducted in the anesthetized spontaneously hypertensive (SH) rats in which the cardiovascular effects of (-)- and (+)- atenolol were compared after i.v. or intracisternal administration. Intravenous injection of 100 micrograms/kg of (-)-atenolol reduced mean arterial pressure 25 +/- 5 mm Hg (P less than .02) and lowered heart rate 58 +/- 7 bpm (P less than .02). The same dose of (+)-atenolol i.v. produced no significant changes in either mean arterial pressure or heart rate. Similarly, intracisternal (-)-atenolol, 66 micrograms/kg, significantly (P less than .05) reduced mean arterial pressure and heart rate whereas the same dose of the (+)-isomer was without effect. When the i.v. dose of (-)-atenolol was lowered to 33 micrograms/kg, heart rate was decreased markedly but mean arterial pressure was not reduced. In contrast, 33 micrograms/kg of intracisternal (-)- atenolol significantly reduced mean arterial pressure 17 +/- 6 mm Hg and reduced heart rate. These results suggest that atenolol possesses a central hypotensive action that is selective for the (-)-, beta receptor blocking enantiomer. PMID- 2778714 TI - In vitro evidence that urine composition affects the fraction of active furosemide in the nephrotic syndrome. AB - Diuretic resistance to furosemide in the nephrotic syndrome (NS) may result from binding of drug to filtered albumin within the renal tubule. In buffer solutions intended to partially mimic the luminal environment of the distal nephron during the NS, we examined several chemical properties to determine their effect on furosemide-albumin binding equilibria. Dissociation constants were obtained by measuring furosemide's quenching of human serum albumin's intrinsic tryptophan fluorescence over ranges of pH, ionic strength (IS) and osmolarity. Neither pH nor osmolarity significantly affected binding; however, incremental increases in IS between 0.0 and 1.0 produced increases in Kd from 0.65 +/- 0.05 to 34.38 +/- 1.72 microM, resulting in a 5- and 28-fold increase in the unbound furosemide fraction when the furosemide-albumin concentrations were 3.0:5.0 and 10.0:45.0 microM, respectively. Our results indicate that human serum albumin contains one high affinity binding site for furosemide that is sensitive to IS. Because of changes in the concentrations of reactants as well as IS that can occur in nephron segments distal to furosemide's site of action, we conclude that the amount of unbound (i.e., pharmacologically active) drug in voided urine will not necessarily correspond to the amount at the active site. To clinically assess the pharmacodynamic consequence of protein binding in the NS, changes in the concentration of the reactants and IS in the distal nephron must be minimized so that the unbound furosemide measured in voided urine will accurately reflect the amount at the drug's active site. PMID- 2778715 TI - Differential association of T-2 and T-2 tetraol with mammalian cells. AB - The interactions of T-2 and its metabolite T-2 tetraol (hereafter tetraol) with CHO (Chinese hamster ovary cells) and CHO ribosomes were studied. T-2 was about 300-fold more potent at inhibiting protein synthesis in CHO than was tetraol. Association of T-2 with CHO was highly specific and achieved a maximum at a concentration producing complete inhibition of protein synthesis. Association of tetraol with CHO was of low specificity, but the specific fraction did correlate with the dose-response curve for protein synthesis inhibition. Binding of both T 2 and tetraol to isolated CHO ribosomes was quantitatively similar and highly specific. With isolated ribosomes, each toxin competed effectively for the binding of the other. Using intact cells, tetraol competed for T-2 cell association, but not the converse. The kinetics at physiological temperature for total and specific T-2 cell association were much more rapid than those for tetraol. Furthermore, the rate of tetraol-cell association was indistinguishable from the rate for cellular uptake of tritiated water. At 0 degrees C, there was a substantial association of T-2 with cells, whereas none was observed with tetraol. The kinetics of dissociation of both toxins from CHO were similar. We conclude that T-2 rapidly crosses the cell membrane of cells and binds to the intracellular target, the ribosomes. In contrast, tetraol is taken up by the cell much more slowly, and many more toxin molecules are found in the cell than there are ribosomes. It would appear that the main physical property of the toxins that brings about these results is the relative hydrophobicities of the molecules.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2778716 TI - Nonpeptide angiotensin II receptor antagonists. III. Structure-function studies. AB - A series of 1-benzylimidazole-5-acetate derivatives defining the critical substituents on the phenyl ring was synthesized in order to improve on the affinity of 2-butyl-4-chloro-1-(2-nitrobenzyl)imidazole-5-acetate, sodium (S 8308) for the angiotensin II (AII) receptor. The analogs, substituted with -1-(4 carboxybenzyl) (EXP6155),-1-[4-(2-carboxybenzamido)benzyl] (EXP6159) and the 5 methylacetate of EXP6159 (EXP6803), were found to inhibit the binding of [3H]AII to AII receptors in rat adrenal cortical microsomes with 9-, 35- and 107-fold higher affinity, respectively, than that of S-8308 (IC50, 15 X 10(-6) microM). Scatchard analysis of the [3H]AII binding revealed that in the presence of EXP6155 (10(-6) M), the dissociation constant for AII was increased from 1.2 to 3.9 X 10(-9) M, whereas the total number of binding sites remained unchanged, suggesting a competitive nature of antagonism. A similar order of affinity or potency (saralasin much greater than EXP6803 greater than EXP6159 greater than EXP6155 greater than S8308) was observed in various in vitro and in vivo assays: rat smooth muscle cells AII binding, 45Ca++ influx in rat aortic rings, contractile response in isolated rabbit aorta and AII-induced pressor response in anesthetized rats. Responses (45Ca++ and contraction) elicited by norepinephrine or by KCl were unaltered by these agents at concentrations of up to 10(-4) M. In addition, they exerted no direct effect on the activity of rabbit angiotensin converting enzyme and rat renin. In conscious renal artery-ligated rats, EXP6155, EXP6159 and EXP6803 were p.o. inactive, but caused a rapid decrease in mean arterial pressure when administered i.v.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2778717 TI - Ethanol and inositol 1,4,5-trisphosphate release calcium from separate stores of brain microsomes. AB - The effects of ethanol and inositol 1,4,5-trisphosphate (IP3) on releasable Ca stores were examined in microsomes isolated from mouse whole brain. Ca release was monitored by determination of changes in the extra-microsomal Ca concentration using Indo-1, a fluorescent Ca indicator. In the absence of ATP, ethanol released Ca from microsomes in a concentration-dependent manner, with a threshold for Ca release between 25 and 50 mM. Ethanol-induced release of microsomal Ca was reduced by approximately 50% after ATP-stimulated uptake of Ca, indicating that the ethanol-releasable pool was diminished by ATP-dependent uptake of Ca into an ethanol-insensitive microsomal pool. Release of Ca produced by ethanol was linear with concentration (up to 400 mM). By contrast, IP3-induced Ca release was saturable and was dependent on prior ATP-stimulated Ca uptake. Simultaneous addition of ethanol and IP3 produced additive responses. These results show that pharmacologically relevant concentrations of ethanol release Ca from an IP3-insensitive intracellular Ca store. Furthermore, our results demonstrate the existence of at least two releasable stores of Ca in brain microsomes. PMID- 2778718 TI - Mechanism of cyclosporine A-induced renal vasoconstriction in the rat. AB - The use of the immunosuppressant cyclosporine A (CSA) is limited by its toxicity. Both acute and chronic administration of CSA lead to renal vasoconstriction and decreased renal blood flow and glomerular filtration rate. The present studies were designed to elucidate the mechanism(s) involved in acute CSA-induced changes in renal hemodynamics. Infusion of CSA resulted in a concentration-dependent increase in perfusion pressure in isolated rat kidneys perfused at constant flow. Phenoxybenzamine blunted this response, and therefore a small component of CSA induced renal vasoconstriction can be attributed to CSA-induced norepinephrine release from nerve terminals in this preparation. The response was antagonized profoundly, but not blocked completely, by nifedipine and methoxyverapamil, consistent with the hypothesis that a large component of CSA-induced vasoconstriction is mediated by Ca++ influx through potential-operated channels in vascular smooth muscle cells, and perhaps in nerve terminals as well. However, CSA-induced activation of such channels cannot account entirely for CSA-induced vasoconstriction because, in the presence of K-depolarization and Ca++ channel blockade, CSA still produced a small increase in renovascular resistance. This latter response was blocked entirely by quinacrine but not by meclofenamate. Neither quinacrine nor meclofenamate alone affected CSA-induced renal vasoconstriction. Therefore, products of phospholipase A2 activity, but not products of the cyclooxygenase pathway, may be involved to some small extent. In conclusion, CSA-induced increases in renovascular resistance are complex and appear to be produced not only by actions on vascular smooth muscle cells per se but also by actions on nerve terminals. PMID- 2778719 TI - Assessment of the role of A1/A2 adenosine receptors mediating the purine antinociception, motor and autonomic function in the rat spinal cord. AB - The effects on nociception, motor and autonomic function produced by the intrathecal administration of three adenosine analogs: N6-(L-2-phenylisopropyl) adenosine, N6-cyclohexyladenosine and 5'-(N-ethylcarboxamido)-adenosine were examined in rats. Over the range of 0.3 to 1.0 nmol these agents produced a dose dependent antinociception in the hot plate and tail-flick tests. In addition, 5' (N-ethylcarboxamido)-adenosine and N6-(L-2-phenylisopropyl)-adenosine both suppressed the chemically evoked writhing response as well as the touch-evoked hyperesthesia normally observed in rats receiving low doses of intrathecal strychnine. These adenosine analogs examined at doses higher than 1.5 nmol produced a dose-dependent motor impairment as measured behaviorally and by electromyography, and an increase in the volume distention required to evoke micturition. Statistically significant effects on heart rate or blood pressure were not observed at any of the doses tested. The effects of the adenosine analogs on nociceptive and motor endpoints were partially antagonized by pretreatment with intrathecal caffeine (2 mumol). These results suggest a probable association of spinal adenosine receptors with a number of spinal sensory and motor systems other than those involved with nociceptive processing. PMID- 2778721 TI - Pharmacokinetics and pharmacodynamics of prednisolone in obese rats. AB - The pharmacokinetics and pharmacodynamic response to prednisolone were examined in dietary-induced obese rats and matched controls. Pharmacokinetic parameters were examined in absolute and weight normalized terms. After an i.v. dose (range, 4.0-6.3 mg/kg) of prednisolone adjusted to achieve similar initial prednisolone plasma concentrations, the time course of glucocorticoid receptors in hepatic cytosol and hepatic tyrosine aminotransferase (TAT) activity were examined. Plasma prednisolone concentrations declined biexponentially with time. Mean (S.D.) for prednisolone plasma clearance normalized for total body mass (TBM) was 2.3 (0.9) liters/hr/kg in normal rats and 2.7 (0.7) liters/hr/kg in obese rats. The volume of distribution at steady-state averaged 0.82 (0.46) liters/kg of TBM in normal rats vs. 1.08 (0.40) liters/kg of TBM in obese rats. Base-line receptor levels for obese rats were 53% higher than control levels. A model to describe simultaneously kinetics and receptor-mediated dynamics was used to analyze the data and obtain estimates for the efficiency of TAT induction. This efficiency parameter in obese rats was 22% of controls, reflecting the innate degree of diminished TAT response. This decreased response in obese animals may indicate a need for joint pharmacokinetic/dynamic considerations in dosing obese individuals with corticosteroids. PMID- 2778720 TI - Pharmacologic discrimination between receptor heterogeneity and allosteric interaction: resultant analysis of gallamine and pirenzepine antagonism of muscarinic responses in rat trachea. AB - The antagonism of muscarinic receptor-mediated contraction of rat trachea by a range of muscarinic antagonists was quantified by Schild and resultant analysis. Dose-response curves to carbachol, muscarine and oxotremorine were shifted to the right by gallamine and pirenzepine in a parallel manner with no change in maximal response ostensibly indicating simple competitive inhibition. However, Schild analysis indicated differences in the blockade and estimated pKb values with each agonist for both gallamine and pirenzepine. This suggested either that the responses to these three agonists were mediated by a heterogeneous receptor population in this tissue or that the blockade produced by gallamine and by pirenzepine was not competitive. Further Schild analysis with the muscarinic antagonists scopolamine, atropine, 4-diphenylacetoxy-N-methyl piperidine methiodide and (11 [(2-[(diethylamino)methyl]-1-piperidinyl]acetyl)-5,11- dihydro 6H-pyrido[2,3-b][1,4]benzodiazepine 6-one) with carbachol, muscarine and oxotremorine indicated simple competitive antagonism of a homogeneous population of muscarinic receptors. Therefore, the competitivity of binding of atropine, gallamine and pirenzepine with the scopolamine binding site was measured with the recently reported technique of resultant analysis. With this method the effect of various concentrations of the test antagonist on the antagonism produced by specified concentrations of the reference antagonist scopolamine was measured and the equilibrium dissociation constant of the test antagonist-receptor complex estimated. These data indicated that atropine and scopolamine bind to a common binding site on the muscarinic receptor, but that scopolamine and both gallamine and pirenzepine bind to mutually exclusive sites. This result is mine and pirenzepine are allosteric modulators of muscarinic receptors which bind at sites other than that utilized by agonists.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2778723 TI - Effect of pulmonary venous congestion on respiratory rate in dogs. AB - 1. The effect of pulmonary venous congestion on the respiratory rate was examined in dogs anaesthetized with alpha-chloralose. The study was done on both spontaneously breathing and artificially ventilated animals. Pulmonary venous congestion was produced by partial obstruction of the mitral valve sufficient to raise the left atrial pressure by 5 mmHg. 2. In artificially ventilated dogs, pulmonary venous congestion increased significantly the activity in phrenic nerves. Both the number of bursts/min and the total number of impulses/min increased. However, there was no significant change in the number of impulses/burst. 3. In spontaneously breathing dogs, pulmonary venous congestion produced a significant increase in the frequency of breathing with a significant shortening of the inspiratory and expiratory durations. 4. Cooling of the cervical vagi to 8-9 degrees C abolished both the above responses. 5. Pulmonary venous congestion (left atrial pressure +5 mmHg) stimulated the rapidly adapting receptors of the airways. This effect was abolished by cooling the ipsilateral vagus proximally to 8-9 degrees C. 6. It is concluded that pulmonary venous congestion increases the respiratory rate reflexly in dogs. The afferent pathway for this reflex response resides in the vagus and the rapidly adapting receptors are likely to be the receptors involved in this response. PMID- 2778722 TI - Paraventricular and supraoptic bursting oxytocin cells in rat are locally regulated by oxytocin and functionally related. AB - 1. Oxytocin was pressure injected through a glass micropipette into a supraoptic (SON) or paraventricular nucleus (PVN) while recording the electrical activities of oxytocin cells in a contralateral nucleus, to see whether oxytocin acts locally in the magnocellular nuclei to control their bursting activity and whether the oxytocin cells of the four magnocellular nuclei were functionally interconnected during suckling. To test the rapidity of these relations, similar intranuclear injections were realized with acetylcholine, known to rapidly increase the background activity of oxytocin cells. The effects of intranuclear injections of oxytocin and acetylcholine were tested before and after interhemisphere sections of various dimensions. 2. Injecting oxytocin (1 ng in 100 nl) into a magnocellular nucleus (5 times into the PVN and 15 times into the SON) facilitated the occurrence and increased the amplitude of bursts of the oxytocin cells in both the contralateral PVN and SON. This facilitatory effect was similar to that induced by intraventricular injection of the same dose of oxytocin, though slightly delayed and lower. 3. Injecting acetylcholine (0.6 microgram in 100 nl) into the SON (7 times) induced a rapid and sustained increase in the background activity of oxytocin cells in both the contralateral PVN (2 times) and SON (5 times) within the same delay (less than 15 s). This excitatory effect was similar to that induced by an intraventricular injection of 5 micrograms acetylcholine. The effects on bursting activity were not considered in this study. 4. Neither the injections of oxytocin or acetylcholine outside but near the magnocellular nuclei (200-500 microns), nor the intranuclear injection of 100-200 nl of cerebrospinal fluid-like medium, modified the background activity, the frequency and amplitude of bursts of the oxytocin cells in the nucleus contralateral to the injection site. 5. After interhemisphere sections most oxytocin cells were silent, bursts occurred in an erratic manner, and their amplitude was attenuated and irregular (more than the 20% variation normally recorded in non-operated rats). Moreover, the amplitudes of successive bursts of pair-recorded supraoptic-supraoptic (SO-SO) oxytocin cells, highly related in control conditions (correlation coefficient, r = 0.68 to 0.98) were no longer correlated after interhemisphere section (r = 0.24 to -0.61), but all bursts remained synchronized.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2778724 TI - The transport and metabolism of the uridine mononucleotides by rat jejunum in vitro. AB - 1. Both uridine 3'-monophosphate (3'-UMP) and uridine 5'-monophosphate (5'-UMP) when perfused through the lumen of isolated rat jejunum gave rise to uracil as the only transported pyrimidine appearing in the serosal medium; neither the nucleotide nor the nucleoside could be detected in the serosal fluid. 2. There was a low level of the nucleoside, uridine, in the luminal fluid after the nucleotide had passed through the jejunal segment. Luminal nucleoside appearance was more marked from the 3' form of the nucleotide. 3. The hydrolysis of the nucleotides to the nucleoside form occurred via a brush-border membrane enzyme, which had the same maximal velocity (Vmax) for the two nucleotides (699 +/- 35 and 747 +/- 10 nmol min-1 (mg protein)-1 for 3'-UMP and 5'-UMP, respectively) but a different Michaelis constant (Km) so that 3'-UMP (Km = 58 +/- 3 microM) hydrolysis is favoured over 5'-UMP hydrolysis (Km = 108 +/- microM) at lower concentrations. 4. At 0.05 mM, luminal 3'-UMP gave rise to a higher rate of serosal uracil appearance than luminal 5'-UMP, but at higher luminal concentrations (0.1-0.2 mM) the rate of serosal uracil appearance was the same from both nucleotides. 5. The transmural transport of uracil from the uridine mononucleotides is discussed with reference to the metabolism and compartmentalization of the small intestine responsible for the appearance of the free pyrimidine in the serosal fluid. PMID- 2778725 TI - Factors affecting the predictability of pseudo-random motion stimuli in the pursuit reflex of man. AB - 1. Experiments have been performed on human subjects to determine the principal mechanisms underlying the break-down in performance during ocular pursuit of pseudo-random target motion stimuli composed of a mixture of two, four or six sinusoids. As observed in a previous experiment there was a reduction in the ratio of eye velocity to target velocity (eye velocity gain) for lower-frequency components of the stimulus whenever the highest frequency exceeded 0.4 Hz, but the following effects were also observed. 2. Using a combination of four sinusoids in which the three lowest frequencies (0.11, 0.24 and 0.37 Hz) had a constant peak velocity (3 or 6 deg/s) it was shown that an increase in the velocity of the highest frequency (0.78 or 1.56 Hz) caused a progressive decline in gain of the low frequencies and a significant reduction in phase lag for the highest-frequency component. 3. Using a combination of two sinusoids (0.44 and 1.56 Hz), in which the peak velocity was varied over a wide range (4-32 deg/s), it was shown that the reduction in low-frequency gain was dependent on the velocity ratio between the frequency components rather than their absolute velocity. 4. Experiments using a combination of either four or six sinusoids in which the two highest frequencies were very close have revealed a true enhancement in the gain of the highest-frequency component in relation to other frequency components of the stimulus. 5. In the same experiments the phase relationships in the response were shown to vary according to the frequency range of the stimulus in such a way that phase advance was normally present at the lowest frequency even when this ranged up to 0.89 Hz. 6. When the oculomotor system was passively stimulated by allowing the subject to fixate a tachistoscopically illuminated stationary target, pseudo-random target motion induced a response which exhibited characteristics similar to those of active pursuit; that is, enhancement of the gain of the highest frequency and phase advance at the lowest frequency. 7. During passive stimulation the changes in gain of the low frequencies with increasing frequency of the highest-frequency component were not consistent with those of active pursuit. However, increasing the velocity of the highest-frequency component to simulate the retinal velocity error conditions of normal active pursuit caused a significant decrease in low frequency gain and a subjective effect of high-frequency dominance similar to that observed during active pursuit.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2778726 TI - Descending influences on the cutaneous receptive fields of postsynaptic dorsal column neurones in the cat. AB - 1. The influence of activity in descending systems on the cutaneous receptive field properties of postsynaptic dorsal column (PSDC) neurones has been investigated in chloralose-anaesthetized cats. The main aim of the study was to determine whether the receptive field boundaries of PSDC neurones are under the control of systems descending from the brain. 2. Single-unit recordings were made from the ascending axons of PSDC units in the dorsal columns. Receptive fields were analysed using light tactile and noxious mechanical and thermal stimuli, both before and during a reversible block of spinal conduction produced by cooling the cord rostral of the recording site. 3. The light tactile excitatory fields of PSDC neurones were largely unaffected by the cold-block procedure. 4. In contrast, both the sensitivity of PSDC neurones to noxious stimuli and the area of skin from which they could be effectively excited by such stimuli were found to be profoundly modified by interruption of descending activity. Two thirds of the units excited by noxious pinch responded more vigorously in the cold-blocked state and one-half from an expanded area of skin. Responses to noxious radiant heat were similarly modified. 5. Inhibition evoked in PSDC neurones, whether by light tactile or noxious stimuli, involved predominantly segmental mechanisms since it remained effective in the cold-blocked state. 6. It is concluded that neurones of the PSDC system are amongst those dorsal horn neurones with receptive field geometries which may be modified by activity in descending systems. PMID- 2778727 TI - Unloading of tendon organ discharges by in-series motor units in cat peroneal muscles. AB - 1. The discharges from individual Golgi tendon organs of peroneus tertius and brevis muscles were recorded in anaesthetized cats during the isometric contractions of single motor units. Upon combined contractions of several motor units, two sorts of unloading effects were observed. 2. First, the contraction of a motor unit which, by itself, was without action on a tendon organ could produce a reduction in the response of the receptor to one of its activating motor units. Unloading effects exerted by such in-parallel motor units could effectively interfere with the actions of in-series motor units on the receptor. 3. Second, the contraction of a motor unit activating a tendon organ could reduce the response of this tendon organ to the contraction of another of its activating units. This new type of unloading effect, exerted by in-series motor units, was demonstrated by the fact that the simultaneous contraction of both units elicited less discharge from the receptor than the contraction of a single unit. 4. Unfused contractions of a fast-type motor unit eliciting a response in which the tendon organ discharge was driven 1:1 at the frequency of stimulation of the motor unit, could exert unloading actions on the response of the receptor to another motor unit eliciting a higher discharge frequency. 5. In-series unloading actions were exerted not only by fast-type motor units developing large forces, but also by relatively small slow-type motor units. 6. The high incidence of in parallel and in-series unloading effects suggests that their consequences may be functionally significant. When large numbers of motor units are being recruited in a muscle, unloading effects might result in a limitation of the Ib afferent discharges from this muscle, preventing an excessive increase of autogenetic inhibition. PMID- 2778728 TI - Pacemaker activity in the proximal lower oesophageal sphincter of the dog. AB - 1. The electrical and mechanical activities of different regions of the canine lower oesophageal sphincter were measured using the single sucrose gap technique. 2. Spontaneous electrical activity was found in the region 0-6 mm oral to the squamocolumnar border. 3. The electrical activity consisted of bursts of spikes superimposed on slow waves. The slow-wave frequency ranged from 0.6 to 5 min-1 in different muscle strips. 4. The slow wave-spike complex and associated contraction were insensitive to tetrodotoxin and atropine. 5. In the pacemaker region, electrical stimulation of intrinsic nerves evoked excitatory junction potentials (atropine sensitive), inhibitory junction potentials (non-adrenergic) and post-stimulus excitation. 6. Increase in the frequency of the slow waves was obtained by muscarinic receptor stimulation (carbachol 10(-7) M) and 10 mM-KCl. 7. The distal lower oesophageal sphincter exhibited a high basal tension but did not show spontaneous electrical activity and stimulation of intrinsic nerves revealed only non-cholinergic, non-adrenergic inhibition. 8. The electrical slow wave activity observed in the proximal sphincter may constitute the control mechanism for the phasic nature of the contractile activity seen during both the postprandial period and phase III of the interdigestive migrating myoelectric complex. 9. The neural cholinergic activity present in the proximal lower oesophageal sphincter suggests the possibility of neural modulation of the myogenic control activity. PMID- 2778729 TI - Fatigability of rat hindlimb muscle: associations between electromyogram and force during a fatigue test. AB - 1. An experimental protocol designed to assess fatigability in motor units (Burke, Levine, Tsairis & Zajac, 1973) has been applied to the whole muscles of anaesthetized adult rats, and the association between the electromyogram (EMG) and force was monitored over the course of the test. 2. Both test muscles (soleus and extensor digitorum longus) exhibited a wide range of fatigability, which was defined as the decline in isometric peak force at 6 min, such that the data could be separated into five levels of fatigability. Fatigue indices for each test muscle were distributed across three levels. 3. The EMG was quantified with four measures of amplitude, four of duration, and one interaction term (area). Correlation analyses indicated that the EMG was adequately represented by one measure of amplitude (absolute amplitude), one of duration (peak-to-peak duration) and area. The best single measure was area. 4. The EMG-force associations for soleus varied markedly among its three fatigability groups. In contrast, over the course of the test, all three extensor digitorum longus groups displayed qualitatively similar EMG-force associations. 5. Multiple regression analyses indicated that the EMG parameters were able to predict peak force better for extensor digitorum longus than for soleus. Furthermore, for both test muscle, the prediction was best for the most fatigable group. 6. The associations between EMG and force exhibited three patterns for the two test muscles and three levels of fatigability. These differences suggested variation in the mechanisms, related to both fibre-type composition and susceptibility to fatigue, that dictate the performance elicited by this particular stimulus regimen. The mechanisms seem to include both intracellular and transmission processes. PMID- 2778731 TI - Dynamics of coronary adjustment to a change in heart rate in the anaesthetized goat. AB - 1. We have previously shown that steady-state coronary flow during auto regulation and metabolic rate changes is predicted by a mathematically expressed theory which assigns control of coronary vascular resistance to tissue PO2. Our present purpose was to test the applicability of this theory to the non-steady state as exemplified by a sudden step change in heart rate. 2. The theory predicted that the response time of change of resistance in these circumstances would be slower with constant-flow perfusion of the coronary bed than with constant-pressure perfusion, and that with constant-pressure perfusion only, the rate of adaption of resistance would be dependent on the level of pressure used. 3. These predictions were tested in open-chest goats with cannulation of the left main coronary artery and perfusion with alternately constant pressure or constant flow. Sudden step changes in heart rate were induced by pacing to induce rapid transients in myocardial metabolic rate. 4. The half-time of subsequent change in perfusion pressure-flow ratio, which in the dynamical state is not equal to resistance, was 15.7 +/- 0.4 s (mean +/- S.E.M.), which was statistically shorter than for constant flow (22.2 +/- 0.5 s, P less than 0.001). 5. The half-time of subsequent change in perfusion pressure-flow ratio with constant-pressure perfusion was 14.4 +/- 0.6 s at low pressure and 17.0 +/- 0.6 s at high pressure (P less than 0.001). 6. The results differed from those predicted by the theory, in that the changes described above were preceded by a rapid (5 s) step change in pressure-flow ratio, up with an increase in heart rate and down with a decrease in heart rate. We postulated that this was a mechanical effect due to greater compression of the coronary microvasculature with more frequent contractions. 7. To test this hypothesis, we measured changes in coronary blood volume by integrating the difference between arterial inflow and venous outflow. These experiments showed a decrease in coronary blood volume with heart rate increase and vice versa. 8. Abolition of autoregulation and metabolic regulation was achieved with maximum vasodilatation of the coronary bed with adenosine. A sudden switch in heart rate then produced the initial step change in pressure-flow ratio, but not the subsequent adaptation over 13-25 s. This confirmed that the former effect is attributable to a passive mechanical mechanism. PMID- 2778730 TI - Fall in intracellular pH and increase in resting tension induced by a mitochondrial uncoupling agent in crayfish muscle. AB - 1. The influence of the mitochondrial uncoupling agent carbonylcyanide-m chlorophenylhydrazone (CCCP) upon resting tension and intracellular pH (pHi) was studied in the dactyl opener muscle of the crayfish. pHi was measured with liquid sensor H+-selective microelectrodes. 2. CCCP (10(-6)-10(-5) mol l-1) induced a reversible, tonic contracture which was associated with a depolarization of the membrane potential. Both effects were augmented by a fall and inhibited by a rise in extracellular pH. The action of CCCP on tension was not mimicked by cyanide + oligomycin or by cyanide + dicyclohexylcarbodiimide nor was it inhibited by pre exposure to these agents. 3. CCCP produced an initial alkalosis of less than 0.1 units and thereafter a fall in pHi of 0.4-0.6 units during which the sarcolemmal H+ driving force decreased from 61 to 15 mV. The apparent influx of H+ due to CCCP had a maximum of 2.7 mequiv l-1 min-1. The CCCP-induced acidosis was unaffected by iodacetate (0.5 mmol l-1) but it was inhibited by a depolarization of the membrane potential. 4. The contraction caused by CCCP was not due to the simultaneous fall in pHi since an intracellular acidosis of equal magnitude, produced by propionate (50 mmol l-1), did not lead to force generation. In addition, propionate had an inhibitory effect on the depolarization and contracture caused by CCCP. 5. Both the depolarization and the contracture caused by CCCP were inhibited by gamma-aminobutyric acid (GABA). The contracture was blocked by Cd2+, Mn2+ and by a nominally Ca2+ -free medium but not by a pre exposure to caffeine (20 mmol l-1). Cd2+ and Mn2+ had no influence on the fall of pHi caused by CCCP. 6. It is concluded that CCCP induces a sarcolemmal H+ conductance which leads to a fall in pHi and to a depolarization of the membrane potential. This depolarization activates sarcolemmal, voltage-dependent calcium channels and thereby induces an increase in tension. The initial alkalosis produced by CCCP may be due to a transient uptake of H+ by mitochondria. PMID- 2778734 TI - Responses of electroreceptors in the platypus bill to steady and alternating potentials. AB - 1. This is a report of further observations on the response characteristics of electroreceptors in the bill of the platypus, Ornithorhynchus anatinus, first described by Gregory, Iggo, McIntyre & Proske (1987). 2. The main finding is that, with the bill immersed in water, applying a potential difference between large plate electrodes on either side of the bill, produced detectable responses in a population of electroreceptors to field strengths as low as 4 mV cm-1. Threshold for individual receptors lay between 4 and 25 mV cm-1. 3. An electric dipole placed in the water close to the receptive field could also elicit responses, threshold being lowest when the cathode was near the centre of the field. On several occasions the most sensitive spot was seen, under the microscope, to correspond to the mouth of a mucous sensory gland (Andres & Von During, 1984). Response intensity fell when the dipole was moved further away, the drop being less steep in a direction over the top of the bill towards the mid line. 4. For individual receptors the latency of the first impulse initiated by supramaximal voltage pulses was 1.1-1.8 ms. Latencies tended to be shorter when the site of the receptor lay closer to the recording electrodes. Plotting each latency against conduction path length for eleven receptors gave an approximately linear relation from which was calculated an average axonal conduction velocity of 56 m s-1. The plot yielded an estimate of impulse initiation time of 0.8 ms. It is argued that this is too short to include a synaptic delay. A peripheral synapse is found in all non-mammalian electroreceptors. 5. Electroreceptors responded to both steady and rapidly changing potential gradients. For ramp shaped gradients of 1-50 V s-1 peak firing rate was approximately proportional to log stimulus velocity. In response to sinusoidal potential changes a 1:1 relation between each afferent impulse and the peak of the stimulating waveform could be obtained over the range 12-300 Hz. Threshold was at its lowest at 50-100 Hz. Tuning curves measured with the bill immersed in water were little different from those obtained by focal stimulation with the bill in air. 6. It is concluded that platypus electroreceptors, supplied by the trigeminal nerve, and which are therefore not part of the acoustico-lateralis system as in non-mammalian electroreceptors, are also unique in not having a peripheral synapse. Furthermore, they are able to respond to both steady and rapidly changing voltage gradients.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2778733 TI - Effect of extracellular adenosine triphosphate on electrical properties of subconfluent Madin-Darby canine kidney cells. AB - 1. The present study has been performed to test for an influence of extracellular ATP on the potential differences across the cell membrane (PD) in subconfluent MDCK cells utilizing conventional microelectrodes. 2. In the absence of ATP, the mean measured PD was -47.5 +/- 0.3 mV (+/- S.E.M., n = 320). Application of 10 mumol/l ATP leads to rapid (less than 2 s) hyperpolarization of the cell membrane by -18.5 +/- 0.4 mV (n = 221), reduction of input resistance by 14 +/- 1 M omega (n = 106) and increase of the sensitivity of PD to alterations of extracellular potassium. 3. The concentration needed for half-maximal effect (K1/2) of ATP is approximately 0.5 mumol/l. ATP-gamma-S (K1/2 approximately 0.4 mumol/l) aand ADP (K1/2 approximately 0.9 similarly effective, whereas up to 1 mmol/l AMP or adenosine does not significantly alter PD. Application of 10 mumol/l theophylline, 1 mumol/l phentolamine and 10 mumol/l indomethacin does not blunt the hyperpolarizing effect of ATP. 4. The ATP-induced hyperpolarization is completely abolished in the presence of 1 mmol/l quinidine but only incompletely by 0.1 mmol/l quinidine or 1 mmol/l barium. In calcium-free extracellular fluid (1 mmol/l EDTA added) PD is 18.5 +/- 1.7 mV (n = 18). With reduced extracellular calcium, the hyperpolarizing effect of ATP is blunted (-12.3 +/- 1.6 mV, n = 18) and only transient. 5. In conclusion, ATP hyperpolarizes MDCK cells by increasing the potassium conductance. The activation of potassium channels requires calcium. PMID- 2778735 TI - The specificity of pyrimidine nucleoside transport and metabolism by rat jejunum in vitro. AB - 1. 5-Methyluridine perfused through the lumen of isolated loops of rat jejunum gave rise to serosal thymine as the major species transported across the epithelial layer; no serosal 5-methyluridine was detected. 2. At 0.1 mM-luminal 5 methyluridine there was enhanced transmural transport of thymine (P less than 0.001) when compared with either 0.1 mM-thymine or 0.1 mM-thymidine as the luminal substrate for thymine transport. 3. At low luminal concentrations (0.025 mM) thymine was a significantly better substrate (P less than 0.001) for the transport of the free pyrimidine than either of the two nucleosides (thymidine or 5-methyluridine). 4. Luminal deoxyuridine gave rise to uracil as the major species appearing in the serosal secretion. High luminal concentrations of deoxyuridine (0.5 and 1.0 mM) gave rise to low levels of the nucleoside in the serosal fluid. 5. As a consequence of the specificity of the mucosal phosphorolysis the ribonucleosides are favoured over the deoxyribonucleosides as substrates for transmural pyrimidine transport. PMID- 2778732 TI - Dual effects of intracellular magnesium on muscarinic potassium channel current in single guinea-pig atrial cells. AB - 1. The effects of internal Mg2+ ions on the muscarinic acetylcholine (ACh) receptor-mediated K+ currents were investigated in single atrial cells of guinea pigs, using the whole-cell and inside-out modes of the patch-clamp technique. 2. During cell dialysis in the whole-cell-clamp condition, the depletion of internal Mg2+ increased outward muscarinic K+ currents but decreased inward currents, thereby reducing the inwardly rectifying property of the channels. 3. When inside out patches were prepared, channel availability was abolished and was reactivated by internal application of guanosine 5'-triphosphate (GTP) or its non hydrolysable analogue, 5'-guanylyl imidodiphosphate (GppNHp), in the presence of Mg2+. GppNHp led to a recovery of the channels also in the nominal absence of Mg2+ (0[Mg2+]i). 4. The activation of single-channel currents by intracellular GTP and Mg2+ was dose-dependent. Both concentration-response curves were fitted by saturation kinetics with Hill coefficients of 1, and the half-maximum doses were 24 +/- 8 microM for GTP and 67 +/- 14 microM for Mg2+. The effects of Mg2+ on activation of K+ currents were additive with those of GTP, suggesting the presence of two independent binding sites for GTP and Mg2+. 5. The single-channel conductance became virtually ohmic when measured at nominally zero [Mg2+]i while GppNHp was used to recover the channel activity. Micromolar [Mg2+]i reduced the unitary amplitude of single open-channel currents in a dose- and voltage dependent manner, showing half-blocking doses of 293 microM at +40 mV and 115 microM at +60 mV. 6. Voltage-dependent kinetics of Mg2+ block were described using equations based on Eyring rate theory (Woodbury, 1971; Hille, 1984), where the coefficient for voltage dependence (delta) was 0.63. 7. Intracellular Mg2+, at a physiological concentration, has a dual action on the muscarinic K+ channel: first Mg2+ activates the channel in the presence of GTP through GTP-binding proteins (G proteins), and secondly it blocks outward currents through the channel, thereby causing the inwardly rectifying property. PMID- 2778737 TI - The effect of stimulation of left atrial receptors on coronary blood flow in anaesthetized dogs. AB - 1. To determine whether stimulation of atrial receptors reflexly affects coronary blood flow, experiments were performed in seven dogs anaesthetized with alpha chloralose. The left upper and middle pulmonary vein-atrial junctions and atrial appendage were stretched by distension of small balloons. Coronary blood flow was measured using an electromagnetic flowmeter positioned around the origin of the left anterior descending or circumflex coronary artery. 2. Following prevention of the reflex increase in heart rate by atrial pacing or propranolol, distension of the small balloons was shown to result in a decrease in mean coronary blood flow. 3. Cooling of the cervical vagosympathetic nerve trunks to 9 degrees C abolished the response of a decrease in mean coronary blood flow to distension of the balloons. 4. The response of a decrease in mean coronary blood flow was abolished by bretylium tosylate. 5. It was shown that a decrease in mean coronary blood flow occurred in response to stimulation of left atrial receptors, and that this decrease was reflex in nature. This reflex response is likely to involve atrial receptors discharging into afferent myelinated vagal fibres, and the efferent limb involves cardiac sympathetic pathways. PMID- 2778736 TI - Systemically administered glycine protects against strychnine convulsions, but not the behavioural effects of high pressure, in mice. AB - 1. The effects of intraperitoneal administration of glycine were studied on the behavioural effects of raised ambient pressure in mice, compared with the effects of such administration on the actions of chemical convulsants. 2. Glycine did not alter the onset pressures for the occurrence of tremor, myoclonic jerks or clonic convulsions, when the ambient pressure was raised using helium. 3. Glycine showed a protective action against the convulsant effects of strychnine. 4. No protective action of glycine was found against the convulsant actions of pentylenetetrazol or bicuculline. 5. It is suggested that the results provide evidence that the high pressure neurological syndrome and strychnine convulsions have different neurophysiological origins. PMID- 2778738 TI - Pertussis toxin inhibits endothelium-dependent relaxations to certain agonists in porcine coronary arteries. AB - 1. Pertussis toxin inactivates Gi-protein, which mediates the inhibitory effects of receptors on adenylate cyclase. The effects of the toxin on endothelium dependent and independent relaxations were determined in porcine coronary arteries. 2. Arterial rings (with and without endothelium) were suspended for isometric tension recording in organ chambers filled with modified Krebs-Ringer bicarbonate solution (maintained at 37 degrees C, gassed with 95% O2 and 5% CO2). 3. Incubation of the tissues with pertussis toxin (100 ng/ml for 60 min) virtually abolished the endothelium-dependent relaxations produced by the alpha 2 adrenergic agonist, UK 14304, and by 5-hydroxytryptamine. Endothelium-dependent relaxations to thrombin and to aggregating platelets were markedly reduced, whereas those produced by bradykinin were only minimally affected. Endothelium dependent responses produced by the calcium ionophore (A23187) and by adenosine diphosphate were not altered by pertussis toxin. 4. Pertussis toxin did not affect the direct, endothelium-independent relaxations produced by nitric oxide, or by adenosine diphosphate. 5. These experiments demonstrate that pertussis toxin interferes with the release of endothelium-derived relaxing factor(s) evoked by certain, but not all, endothelial activators. The release of endothelium-derived relaxing factor(s) may occur through different pathways involving Gi-protein-dependent and independent mechanisms. PMID- 2778739 TI - Group II-activated lumbosacral interneurones with an ascending projection to midlumbar segments of the cat spinal cord. AB - 1. In anaesthetized cats, single-unit microelectrode recordings were made in the lateral funiculus at L6, from the axons of lumbosacral interneurones discharged by hindlimb group II muscle afferents. 2. The level of the ascending projection of these interneurones was investigated by antidromic activation of their axons in the lateral funiculus from different spinal levels. The majority of units encountered were found to have an ascending projection to at least the L4 level and, of these, most (85%) did not project beyond the L4 or L3 segments of the cord. 3. The axons studied were discharged by group II afferents primarily from knee extensor muscles. Some units were discharged in addition by cutaneous and/or joint afferents. 4. The implications of this ascending projection are discussed. PMID- 2778741 TI - Enterocyte-lymphocyte interactions in the follicle-associated epithelium of the mouse Peyer's patch. AB - 1. Measurements of membrane potential (Vm) have been carried out in the follicle associated epithelium of the mouse Peyer's patch to investigate possible site dependent anomalies in enterocyte development. Initial heterogeneity in Vm values obtained from carrying out random impalements in the upper third of the follicle associated epithelium could be described as arising from the presence of three different cell populations. 2. The predominant cell type in this epithelium (T1) had a mean Vm of -35.3 mV which was partly depolarized by increasing concentrations of K+. These cells were not stained with the vital dye Neutral Red. Two other types of cell (T2L and T2H) were recorded together as consecutive negative jumps in Vm, but only in areas of the epithelium previously stained with Neutral Red. T2L behaved like T1 cells to K+ but with a low Vm of -23.3 mV. T2H cells had a high mean Vm of -47.5 mV showing transient hyperpolarization to increasing K+ concentration. 3. The electrophysiological and non-staining properties of T1 cells are similar to those expected from mature enterocytes. The anatomical size, site, staining properties and Vm of T2H cells correspond to those expected for intraepithelial lymphocytes. The low Vm, K+ depolarization and close association of T2L with T2H cells are typical of properties predicted for an immature-type of antigen-transporting enterocyte known to be present in this type of epithelium. 4. The possibility that intraepithelial lymphocytes either slow or reverse a more normal process of development of enterocytes in their immediate vicinity is discussed along with wider aspects of enterocyte-lymphocyte interactions leading to the transfer to enteric antigens across these modified cells. PMID- 2778740 TI - Ventrolateral medullary neurones: effects on magnitude and rhythm of discharge of mesenteric and renal nerves in cats. AB - 1. Discharge of whole mesenteric and renal nerves was recorded in eighteen chloralose-anaesthetized, artificially respired cats. 2. Inhibition of tonic activity of neurones within the rostral ventrolateral medulla (RVLM blockade) by bilateral application of glycine caused significant reductions in discharge of renal and mesenteric nerves, arterial blood pressure and heart rate. The decrease in discharge of renal nerves was significantly greater than that of mesenteric nerves. 3. During the response to glycine application, the spinal cord was transected at the first cervical segment. The magnitude of renal nerve discharge after transection was not different from that during blockade of the RVLM. On the other hand, mesenteric nerve activity increased following spinal cord transection, returning to control levels. 4. Power spectral analysis revealed that mesenteric and renal nerves discharged with periodicities ranging from 1 to 6 Hz. Application of glycine to the RVLM reduced the slow rhythm in firing of mesenteric and renal nerves similarly. Transection of the spinal cord resulted in further reduction in the rhythmicity in discharge of both nerves. 5. The results indicate that excitatory drive from the RVLM is crucial for the maintenance of on going discharge of renal, but not of mesenteric nerves. However, such inputs are apparently essential to maintain the slow rhythm in firing of both nerves. PMID- 2778743 TI - Stimulus-related potassium changes in the organ of Corti of guinea-pig. AB - 1. Potassium concentration was measured with double-barrelled K+-selective microelectrodes within the organ of Corti in the first turn of the guinea-pig cochlea. 2. Penetration of the electrode from scala tympani through the basilar membrane was accompanied by an increase in K+ resting level from 3.0 mmol/l in perilymph to 3.4 mmol/l in cortilymph (n = 8). K+ resting level was not significantly different in various extracellular regions of the organ of Corti. On penetration of the cuticular plate, the K+ level reached 140 mmol/l simultaneously with the occurrence of a +80 mV endocochlear potential. Impalement of hair cells and supporting cells was accompanied by an increase in K+ level, but intracellular K+ level was not systematically measured. 3. Stimulation with pure tones over the frequency range 500 Hz to 25 kHz produced changes in the K+ level in the organ of Corti. The magnitude of these changes was dependent on stimulus frequency and intensity. At high sound intensities the K+ level in the tunnel of Corti could increase by typically 1 mmol/l, while a maximum increase of 3 mmol/l with respect to the resting level was observed immediately adjacent to inner hair cells. 4. During brief exposures to moderate intensity, pure tone acoustic stimulation (10 s, less than 80 dB SPL (sound pressure level] of frequency 4 kHz or greater the K+ level in the extracellular fluid of the organ of Corti rose monotonically to a steady peak level. On cessation of the stimulus the K+ level fell monotonically with a time constant of about 2 s to a level close to the pre-stimulus level. In some cases this level was slightly above the pre-stimulus level. 5. For brief exposures to moderate intensity sound (10 s, less than 80 dB SPL) the extracellular potential in the organ of Corti became more positive. The amplitude of this sound-evoked change adapted during stimulation to a level approximately one-fifth of its initial value. Upon cessation of the stimulus the potential fell transiently below its pre-stimulus level, before recovering to that level. The time constant of these changes was between 2 and 3 s. 6. Iso-response tuning curves for the sound-evoked elevation in K+ level in the organ of Corti in animals in good condition were similar to iso-rate tuning curves for primary afferent fibres reported previously.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2778742 TI - Measurement of renal function in unrestrained conscious rats. AB - 1. Inulin clearance and lithium clearance (used as a marker of end-proximal fluid delivery) were measured in unrestrained conscious rats without the use of catheters. Lithium was added to the food and [14C]inulin was administered via an osmotic minipump implanted in the peritoneal cavity; blood was sampled from the tail. 2. Urinary excretion rates and body weight fell during the 24 h after implantation of the minipump. Within 4 days, however, excretion rates and the rate of gain of body weight were indistinguishable from pre-implantation values. 3. During the rats' active period (i.e. the hours of darkness) urinary excretion rates of sodium, potassium and water were greater than during the inactive period. Inulin clearance, lithium clearance and fractional lithium excretion were also greater during the active period. Fractional distal reabsorptive rates of sodium and water (calculated using lithium clearance) did not differ significantly between the two phases of the light-dark cycle. 4. The experimental procedures used in this study provide an assessment of renal function which involves minimal disturbance to the animal. The results suggest that circadian variations in urinary excretion are caused largely by variations in glomerular filtration rate, accompanied by minor changes in fractional proximal fluid reabsorption. PMID- 2778745 TI - [Development of occupational asthma. Based on E.F.R. monitoring of 23 cases]. AB - Occupational asthma can either improve or develop into chronic respiratory insufficiency. It is often difficult to predict which course will be followed. Here we report the follow-up of respiratory function of 23 patients with occupational asthma of at least one year's standing, due to various substances; several prognostic factors are discussed. PMID- 2778744 TI - [Challenge provocation tests and nonspecific bronchial hyperreactivity in occupational asthma]. AB - The aim of the study is to determine the interest of realistic challenge (nasal and bronchial) in occupational respiratory symptoms appearing during work. 75 patients were included in the study. The protocol included prick tests, measuring total and specific IgE, spirometry and metacholine test to assess bronchial hyperreactivity (BHR), realistic challenge by rhinomanometry and plethysmography measuring NR (nasal resistance) and RWA (Airway resistance). The test was considered positive if the RWA and/or NR were increased by 100%. 68% of the tests were positives in rhinomanometry and/or plethysmography. There is an BHR in 68% cases of occupational asthma. There is a quite strong correlation between the positivity of the realistic tests and the existence of a non specific BHR. PMID- 2778746 TI - [Asthma in industry: what products? What professions?]. AB - Some examples of chemicals and occupational asthma are summarized. Industrial asthma are characterized by a large number of risks in relation with a large number of chemicals and uses. Occupational physicians are well informed of risks and work practices in the factories. PMID- 2778748 TI - Brainstem auditory-evoked potentials in Holstein cows. AB - Brainstem auditory-evoked potentials (BAEP) were recorded from 29 Holstein cows in a typical clinical setting. The latencies of five positive peaks in the BAEP were measured, and latency-intensity functions were determined. The BAEP was similar to that reported in humans, dogs, horses, and other species. The responses were reproducible for each cow, with low variability between cows. Four peaks (I, II, III, V) were present in all recordings, and a fifth (IV) was present infrequently. All peak latencies decreased as click-stimulus intensity increased. The threshold for detection of the BAEP was higher than expected for the cow compared with the horse. PMID- 2778747 TI - Clinical feline toxoplasmosis. Serologic diagnosis and therapeutic management of 15 cases. AB - Clinical toxoplasmosis was diagnosed in 15 cats by correlating serologic evidence of infection and clinical signs to either response to therapy or histopathologic demonstration of the organism. Ophthalmic manifestations, primarily involving the anterior segment, were common. Other common physical examination abnormalities included muscle hyperesthesia, fever, and weight loss. Response to therapy was variable, but administration of clindamycin hydrochloride resulted in resolution of all clinical signs not involving the eyes in surviving animals. This drug, alone or in combination with corticosteroids, led to total resolution of clinical signs in four of four cats with active retinochoroiditis and in six of nine cats with anterior uveitis. Four of the 15 cats had concurrent infection with feline immunodeficiency virus (FIV). Feline leukemia virus antigen or antibodies to feline infectious peritonitis virus were not detected. PMID- 2778750 TI - Cerebrospinal fluid analysis and clinical outcome of eight dogs with eosinophilic meningoencephalomyelitis. AB - Eight dogs, 14 weeks to 5.5 years of age, had signs of diffuse or multifocal meningoencephalomyelitis. The total white cell counts of the cerebrospinal fluid (CSF) ranged from 11 to 5,550 cells/microliters; the percentage of eosinophils ranged from 21% to 98%. The total CSF protein content range was 19 to 1,430 mg/dl. On necropsy, two dogs had granulomatous encephalomyelitis due to protozoan infection. The other six dogs, of which three were Golden Retriever dogs, appeared to have an idiopathic eosinophilic meningoencephalitis; four of these dogs recovered. The significance of eosinophils in CSF and the possible emergence of a new encephalitic syndrome of dogs involving a hypersensitivity to an unknown agent is also discussed. PMID- 2778749 TI - Splenomegaly in dogs. Predictors of neoplasia and survival after splenectomy. AB - Splenomegaly confirmed by surgery or necropsy in 100 dogs was diagnosed histologically as benign neoplasia (n = 1), primary splenic malignancy (n = 59), neoplastic metastases (n = 6), and nonneoplastic disease (n = 34). Dogs with known systemic disease, such as lymphoma and mast cell tumor, that caused splenomegaly were not included in the study. Hemangiosarcoma was the most common splenic disease (43 cases). Overall mean age of the dogs was 10.7 years, the most common breed was German Shepherd dog, and 72 of the dogs weighed more than 21 kg. Dogs with anemia, nucleated red blood cells, abnormal red blood cell morphology, or splenic rupture had a significantly greater chance of having splenic neoplasia (P less than 0.002). A multivariable logistic regression analysis found that the presence of anemia and splenic rupture in dogs with splenomegaly was up to 69% accurate in predicting presence of splenic neoplasia. After splenectomy, the median survival time of dogs with splenic neoplasia was 13 weeks. For dogs with nonneoplastic splenomegaly it was at least 36 weeks. PMID- 2778751 TI - Diagnostic ultrasound unknown. Aortic valvular insufficiency secondary to valvular endocarditis. PMID- 2778752 TI - Tumor-associated erythrocytosis in a dog with nasal fibrosarcoma. AB - Erythrocytosis (hematocrit, 79%) was diagnosed in an 8-year-old, neutered female, mixed-breed dog with an intranasal fibrosarcoma. Both serum and tumor erythropoietin (Ep) activities were elevated, as determined by the polycythemic exhypoxic mouse model, and the Ep activity was neutralized in that model by rabbit anti-Ep antibodies. Tumor resection normalized the hematocrit. PMID- 2778753 TI - New association for veterinary diagnostic laboratories called the Veterinary Laboratory Association (VLA) PMID- 2778754 TI - Opening of the Comparative Cancer Center (CCC) PMID- 2778755 TI - Antiendothelial cell antibodies. PMID- 2778756 TI - Effect of auranofin on resorption, prostaglandin synthesis and ultrastructure of bone cells in cultured mouse calvaria. AB - Auranofin (AF) in concentrations between 3 x 10(-7) and 3 x 10(-6) mol/l stimulated bone resorption in cultured neonatal mouse calvariae significantly with 1 x 10(-6) mol/l being most potent. Complete inhibition by 5 x 10(-7) mol/l indomethacin and increased medium concentrations of prostaglandin (PG) E2 and 6 keto-PGF1 alpha after 72 h indicate a PG mediated mechanism. Morphology revealed active osteoclasts. Cytotoxic effects were observed with 3 x 10(-6) and 1 x 10( 5) mol/l AF with osteocytes and osteoblasts being considerably more sensitive than osteoclasts. The latter concentrations inhibited bone resorption stimulated by parathyroid hormone (PTH) 1,25-dihydroxyvitamin D3, PGE2, thrombin and interleukin 1. The stimulatory effect of AF on PG production and subsequent bone resorption could limit its therapeutic usefulness. PMID- 2778757 TI - Antiphospholipid antibodies in the connective tissue diseases: their relation to the antiphospholipid syndrome and forme fruste disease. AB - Anticardiolipin antibodies (aCL) were measured in the sera of patients with different connective tissue diseases and spondyloarthropathies. Elevated antibody binding was found in systemic lupus erythematosus (SLE), rheumatoid arthritis, scleroderma, primary sicca syndrome, dermatopolymyositis and psoriatic arthritis but not in ankylosing spondylitis. The 15 highest binding SLE patients included 10 with Raynaud's phenomenon, 5 with livedo reticularis, 7 with vasculitis, 3 with major thrombotic episodes and 3 with spontaneous abortions. aCL were also measured in patients with these clinical features in isolation. Seven of 18 patients with multiple thromboses and 3/22 with multiple spontaneous abortions had raised aCL binding. Normal or near normal levels were found in patients with idiopathic thrombocytopenia, livedo reticularis, a single cerebral thrombosis and uncomplicated myocardial infarction. PMID- 2778758 TI - Antiphospholipid arterial vasculopathy. AB - We describe 3 relatively young patients who developed arterial occlusions in a limb requiring amputation. All 3 had antiphospholipid antibodies (APLA). In one, these appeared as part of the clinical and serologic spectrum of systemic lupus erythematosus and in the other 2 as a component of a primary antiphospholipid syndrome. Their arterial angiograms showed gradual narrowing of the arterial lumen and the histopathologic study showed striking intimal and medial proliferation as well as some increase in thickness of the adventitia. There was little evidence of thrombosis but in the 2 patients who were amputated early there was mononuclear cell infiltrate of the large arteries and in all 3 there was also leukocytoclastic vasculitis in the skin and/or muscle. We believe this represents a new form of vasculopathy, probably related to the presence of APLA, possibly triggered by the occurrence of vasculitis. PMID- 2778760 TI - Patellar tendon rupture in systemic lupus erythematosus. AB - We investigated the frequency of patellar tendon rupture in our patients with systemic lupus erythematosus (SLE) in order to characterize the features that might predict rupture and compared our experience to that described in the literature. Four of 180 patients with lupus seen in the last 10 years had patellar tendon rupture. Duration of disease ranged between 7-20 years. Each patient was in clinical remission at the time of rupture. Each patient also had deforming arthritis of the hands. All had been taking prednisone from 7 to 15 years and all had side effects associated with prednisone therapy, such as moon facies, compression fractures and osteonecrosis. Review of the literature reveals 17 patients with tendon rupture. All had disease of long duration, had been taking corticosteroids for prolonged periods and had minimal or no disease activity at the time of rupture. Deforming hand arthropathy was present in all patients, when mentioned. No cases of tendon rupture had been reported in patients not taking chronic corticosteroid therapy. Therefore, tendon rupture in SLE appears to be associated with extended disease duration, chronic corticosteroid therapy, evidence of steroid induced musculoskeletal complications, minimal disease activity and deforming hand arthropathy. PMID- 2778759 TI - Relationship between antiphospholipid antibodies and recurrent fetal loss in patients with systemic lupus erythematosus and apparently healthy women. AB - We studied 199 patients with systemic lupus erythematosus (SLE) who had been at risk for recurrent fetal loss. Thirty-six had had recurrent fetal loss. These patients, plus a group of 38 healthy women with history of recurrent fetal loss and a group of healthy women who had had at least 3 pregnancies, were tested for antiphospholipid antibodies (APLA) of the 3 major immunoglobulin isotypes using an ELISA method with cardiolipin as antigen. Thirty of the 36 patients with SLE with recurrent fetal loss, 23 of the 163 patients with SLE without recurrent fetal loss, 3 of the 38 healthy women with recurrent fetal loss and no healthy woman with normal obstetric histories had APLA. In all but 3 of the patients with SLE with recurrent fetal loss these included APLA of the IgG isotype. Considering the odds ratio of having recurrent fetal loss as 1 for those patients with SLE without APLA, we found it to be 10.54 times higher in patients with SLE with high titer APLA. Titers of IgG APLA were also 3.2 times higher in patients with SLE with recurrent fetal loss than in those without. We conclude that recurrent fetal loss associates strongly with APLA of the IgG isotype. PMID- 2778761 TI - Pilot study of etretinate in psoriatic arthritis. AB - A 2-center pilot study compared clinical and laboratory outcomes in 40 patients with psoriatic arthritis before and after treatment for 8 to 24 weeks with the vitamin A derivative, etretinate. The number of tender joints fell from 22.0 +/- 8.75 before treatment to 11.44 +/- 8.50 after treatment (p = .000). The duration of morning stiffness was 101.95 +/- 62.45 min before therapy and 44.53 +/- 82.10 min after treatment (p = 0.0004). Similar highly clinically and statistically significant improvement was seen in all clinical outcome measures and in the erythrocyte sedimentation rate. Primarily mucocutaneous side effects were seen in 39/40 patients and resulted in treatment termination before 24 weeks in 9 patients. PMID- 2778762 TI - Characterization of uveitis associated with spondyloarthritis. AB - At a university based referral clinic, 236 consecutive patients with uveitis were evaluated by a rheumatologist; 13% of these patients had spondyloarthritis including 17 patients with Reiter's syndrome and 13 patients with ankylosing spondylitis (AS). The uveitis associated with AS or Reiter's syndrome had distinctive characteristics; it was acute in onset, unilateral, frequently recurrent, and spared the choroid and retina. Two thirds of the patients with spondyloarthritis were not suspected or known to have Reiter's syndrome or AS before referral. Since many diseases of the joints also affect the uveal tract, the recognition of the specific pattern of uveal involvement can greatly facilitate the differential diagnosis. PMID- 2778763 TI - Dark skin discoloration of finger joints in juvenile arthritis. AB - We examined the frequency of a known but poorly described finding, darkened skin over the proximal interphalangeal joints in patients with polyarticular juvenile arthritis. Examining a consecutive group of patients we found that 77% showed this sign. It reflects the presence of or previous episodes of inflammation of these joints. The reason for this finding is unknown. PMID- 2778764 TI - Lack of association between hypothyroidism and chondrocalcinosis. AB - The association between hypothyroidism and calcium pyrophosphate dihydrate deposition disease (CPPD) is controversial. We studied the prevalence of chondrocalcinosis, the roentgenographic marker of CPPD by obtaining anteroposterior knee roentgenograms in 49 hypothyroid patients over the age of 40 years, and compared them with knee roentgenograms in 31 euthyroid patients matched for age and sex. Only 2 hypothyroid patients and one euthyroid control had knee chondrocalcinosis. Our results indicate that hypothyroid patients have no greater prevalence of chondrocalcinosis compared to euthyroid subjects. There are also no difference in the degree and prevalence of osteoarthritis between the 2 groups, although hypothyroid patients may have a higher prevalence of periarticular osteopenia. PMID- 2778765 TI - Cartilage hypertrophy following canine anterior cruciate ligament transection differs among different areas of the joint. AB - Transection of the canine anterior cruciate ligament is used widely as a model of osteoarthritis (OA). The results from studies using this model have sometimes differed, but various areas of the joint have been compared. In other studies, the exaggerated chondrocyte synthetic response in the medial femoral condyle in this model which leads to hypertrophic repair was characterized. In this study the magnitude of this reaction was analyzed in 8 anatomically defined areas of the joint using 28 dogs followed from 3 days to 64 weeks after transection of the anterior cruciate ligament, 8 nonoperated control animals and 7 sham operated control animals. The results show that the in vivo reaction differs markedly among different anatomical areas of the joint. This suggests that the response is modulated by differences in the biomechanics of the joint. Furthermore, it suggests caution in comparing results of studies of OA cartilage if different areas of the joint have been used. PMID- 2778766 TI - Uridine diphosphoglucose dehydrogenase activity in normal and osteoarthritic human chondrocytes. AB - The activity of uridine diphosphoglucose dehydrogenase (UDPGD), a key enzyme in the synthesis of proteoglycans was measured by a quantitative cytochemical method in normal and in osteoarthritic (OA) human cartilage. Normal adult chondrocytes showed low UDPGD activity, which was about half the activity of glucose-6 phosphate dehydrogenase of the same specimens. No significant increase in UDPGD activity was noted in OA chondrocytes. The lack of significantly enhanced UDPGD activity in OA indirectly agrees with studies showing normal 35S uptake in this disease and might explain in part the inability of chondrocytes to cope with continuous proteoglycan loss. PMID- 2778767 TI - Giant cell arteritis of the female reproductive tract associated with temporal arteritis. AB - A woman with giant cell arteritis of the reproductive tract is described. This is the 15th such case reported. This diagnosis led to the subsequent finding of biopsy proven temporal arteritis. The patient's illness responded favorably to corticosteroid therapy. PMID- 2778768 TI - Juvenile scleroderma and collagenous colitis. The first case. AB - We report the first case of coexisting progressive systemic sclerosis and collagenous colitis in a 12-year-old girl. PMID- 2778770 TI - Sjogren's disease with adult onset Still's disease. PMID- 2778769 TI - Scleromyxedema serum increases proliferation but not the glycosaminoglycan synthesis of dermal fibroblasts. AB - In comparison to normal fibroblasts cultured in parallel, scleromyxedema fibroblasts grew less well, synthesized increased amounts of glycosaminoglycans (GAG) in vitro and had ultrastructural abnormalities. Serum obtained from a patient with scleromyxedema increased in vitro fibroblast proliferation but not the GAG synthesis per cell. Serum obtained after therapy, at the time when clinical improvement was observed, continued to stimulate fibroblast proliferation. Thus the serum factor stimulating the fibroblast proliferation did not modulate their GAG synthesis and had no direct relationship to disease activity. PMID- 2778772 TI - Chorea as the initial presentation of oral contraceptive related systemic lupus erythematosus. PMID- 2778771 TI - Multicenter evaluation of synovectomy. PMID- 2778773 TI - HLA-B27 and B12(B44) in Crohn's disease with ankylosing spondylitis. PMID- 2778774 TI - What is the purpose of the Joint Alignment and Motion Scale? PMID- 2778775 TI - Community care again: a need for definition. PMID- 2778777 TI - Male erectile dysfunction. PMID- 2778776 TI - Italian psychiatric care: an update. PMID- 2778778 TI - Breast cancer screening. PMID- 2778779 TI - Lymphopenia in rheumatoid arthritis. AB - Lymphopenia is a recognized but poorly studied feature of rheumatoid arthritis (RA). We set out to establish the prevalence and significance of lymphopenia in RA. A group of 66 RA patients was studied for one year. During this time 10 (15%) had persistent lymphopenia (lymphocyte count less than 1.00 X 10(9)/l) without evidence of Felty's syndrome. A separate study of lymphocyte subsets in 13 lymphopenic RA patients showed marked reduction in T-cell numbers with normal circulating B-cell numbers. The numbers of CD4 and CD8 positive T-cells were equally depressed. Lymphopenia may indicate more severe disease. It was not influenced by changes in disease activity or therapy. PMID- 2778781 TI - Epidemiology and experimental toxicology--is there a meeting ground? Discussion paper. PMID- 2778780 TI - Treatment of periscaphoid osteoarthritis by Silastic scaphoid implant. AB - Periscaphoid osteoarthritis may arise de novo or as a sequel of an established non-union of a scaphoid fracture. The treatment of resultant pain and disability often presents a difficult problem since internal fixation and/or bone grafting of the pseudoarthrosis may fail to relieve the symptoms due to degenerative change. Many methods of alleviating these symptoms have been suggested in the past. We have reviewed the experience of the Windsor Orthopaedic group in the use of Silastic scaphoid implants. PMID- 2778782 TI - Sarawak: our elective. PMID- 2778783 TI - Cat-scratch disease presenting with arthropathy of the ankles. PMID- 2778784 TI - Febrile ulceronecrotic Mucha Habermann disease: a fatality. PMID- 2778785 TI - Potentiation of warfarin anticoagulation by topical methylsalicylate ointment. PMID- 2778786 TI - Systemic embolism from mitral vegetation in scleroderma. PMID- 2778787 TI - Non-axial proptosis without diplopia secondary to maxillary pyomucocele. PMID- 2778788 TI - Autopsy proven pulmonary embolism in hospital patients. PMID- 2778789 TI - Origins of the AIDS viruses: HIV-1 and HIV-2, fact or fiction? PMID- 2778790 TI - Angiotensin-converting enzyme inhibition in diabetic nephropathy. PMID- 2778791 TI - ACE inhibitors in hypertension: assessment of taste and smell function in clinical trials. AB - Taste and smell disturbances are infrequently reported adverse effects of treatment with captopril and are even less frequently reported with other ACE inhibitors. These adverse effects have been attributed to the chemical structure of the drugs used, although this relationship is the matter of some debate. A link between the taste disturbance associated with ACE inhibitors and changes in plasma zinc concentration has also been suggested, but again the evidence for this relationship is equivocal. One problem facing research in this area has been the lack of reliable assessment techniques for the quantitative evaluation of smell and taste function. Three quantitative methods for evaluating taste and smell function are described, together with the results of a pilot study aimed at evaluating the potential ease of application of these techniques in a larger group of patients. In this double-blind, crossover pilot study, 8-week treatment with lisinopril (20-40 mg once daily) was compared with captopril (25-50 mg twice daily) in 12 hypertensive patients. The two drugs produced similar falls in lying and standing blood pressure and neither drug produced a significant alteration in smell recognition, or olfactory or taste threshold. None of the minor changes observed appeared to correlate with either plasma zinc concentrations or intra erythrocyte zinc levels. This study provides important observations on the use of these new techniques. Based on the wide variability of results obtained, the design of further clinical studies must address and overcome the many factors (age, sex, smoking, etc.) which may confound the study of drug effects on taste and smell. PMID- 2778792 TI - Production of an extracellular toxic complex by various strains of Pseudomonas cepacia. AB - Six isolates of Pseudomonas cepacia, representing various serotypes of the organism and possessing similar degrees of virulence in mice, were examined for their production of an extracellular toxic complex (ETC) in vitro. This compound is lethal for mice and produces extensive lung pathology in rats; it is composed of a surface carbohydrate antigen, lipopolysaccharide and protein. All six isolates produced the ETC. The LD50 values for the six ETC preparations ranged from 395 micrograms for strain 61g to 1750 micrograms for strain 90ee. Only two of the six ETC preparations contained ketodeoxyoctonate detectable by the methods used, and these two were the most toxic. Rabbit antiserum to the ETC of a serotype D strain could significantly protect mice only against serotype D strains. Examination of the various phases of growth of P. cepacia showed that there was extracellular release of the ETC beginning in the early logarithmic phase and continuing through the late stationary phase. The presence of the ETC in the supernatant fluids was due to release of this material rather than to cell lysis. In addition, at least one strain of P. cepacia was shown to produce an alginic acid-like compound. PMID- 2778793 TI - Strategies for molecular characterisation of methicillin- and gentamicin resistant Staphylococcus aureus in a Canadian nosocomial outbreak. AB - Sixteen methicillin-resistant Staphylococcus aureus (MRSA) isolates, from a single nosocomial outbreak, were tested for molecular and phenotypic relationships. Two of the 16 outbreak strains were gentamicin resistant (Gmr) and the plasmids that they carried were characterised by reverse field electrophoresis, restriction endonuclease analysis and gene hybridisation. The gentamicin-resistant (Gmr) strains harboured two plasmids, a Gmr plasmid of 36.5 kb and a cryptic plasmid of 25.4 kb, whereas the other 14 isolates contained only the cryptic plasmid. Gentamicin resistance was encoded by a 2.5-kb HindIII fragment of the 32.8-kb plasmid and is similar to the 2.5-kb HindIII fragment also described for S. aureus Gmr plasmids from Australia and the USA. The Gmr plasmid was non-conjugal and was cured by ethidium bromide at a frequency of 4%. Two MRSA strains isolated subsequently from the same hospital were also Gmr and had identical plasmid and restriction endonuclease profiles to the two Gmr strains studied initially. Two other S. aureus isolates from the original carrier detected in this study and from his son were methicillin and gentamicin susceptible and had novel profiles. Since large plasmids show anomalous migration in agarose gels, more definitive analyses than simple plasmid identification should be considered when studying nosocomial outbreaks. PMID- 2778794 TI - Purification and characterisation of Clostridium difficile toxin A by bovine thyroglobulin affinity chromatography and dissociation in denaturing conditions with or without reduction. AB - Highly purified toxin A of Clostridium difficile was obtained by bovine thyroglobulin affinity chromatography followed by two sequential anion-exchange chromatography steps on Q Sepharose FF and Mono Q. After Q Sepharose FF chromatography of a thyroglobulin affinity-purified toxin A preparation, two major peaks of cytotoxicity representing toxins A and B were detected. The homogeneity of the final toxin A preparation obtained from Mono Q anion-exchange fast protein liquid chromatography was ascertained by gel electrophoresis developed by silver stain. The mol. wt of toxin A in non-denaturing conditions was estimated to be 520-540 Kda by native polyacrylamide gel electrophoresis (PAGE) developed by silver stain. In contrast, with sodium dodecyl sulphate (SDS) PAGE under reducing or non-reducing conditions, a major band of 240 Kda and 10 minor and 27 faint bands (non-reduced conditions), or four minor and 31 faint bands (reduced conditions) were detected after silver staining. In two dimensional PAGE, the seven minor bands of greater than 240 Kda obtained by non reducing SDS-PAGE migrated to the 240-Kda position after reduction with beta mercaptoethanol. PMID- 2778795 TI - Evidence for the presence of specific binding sites for corticoids in mouse liver plasma membranes. AB - The specific binding of [3H]cortisol to plasma membranes purified from mouse liver, studied by the ultrafiltration method, shows the existence of specific binding sites for cortisol. The kinetic parameters of this binding are KD = 4.4 nM and Bmax = 685 fmol/mg protein in presence of 1 microM of corticosterone. With respect to the binding of 4 nM [3H]cortisol to the membrane, the affinities of the steroids decreased in the following order: deoxycorticosterone greater than corticosterone greater than progesterone greater than cortisol greater than prednisolone greater than testosterone greater than 20 beta-hydroxyprogesterone greater than cortisone. Estradiol, dexamethasone, ouabain and triamcinolone acetonide do not have affinity for this binding site. Neither Ca2+ nor Mg2+ affected the binding of [3H]cortisol to the plasma membranes. Likewise, the presence of agonists and antagonists of alpha and beta-adrenergic receptors did not modify the binding of [3H]cortisol. The results suggest that the plasma membrane binding site characterized is more specific for corticoids and is different from nuclear glucocorticoid and progesterone receptors. PMID- 2778796 TI - Characterization of sodium and pyruvate interactions of the two carrier systems specific of mono- and di- or tricarboxylic acids by renal brush-border membrane vesicles. AB - The experiments reported in this paper aim at characterizing the carboxylic acid transport, the interactions of pyruvate and citrate with their transport sites and specificity. The study of these carriers was performed using isotopic solutes for the influx measurements in brush-border membrane vesicles under zero trans conditions where the membrane potential was abolished with KCl preloading with valinomycin or equilibrium exchange conditions and delta psi = 0. Under zero trans condition and delta psi = 0, the influence of pyruvate concentrations on its initial rates of transport revealed the existence of two families of pyruvate transport sites, one with a high affinity for pyruvate (Kt = 88 microM) and a low affinity for sodium (Kt = 57.7 mM) (site I), the second one with a low affinity for pyruvate (Kt = 6.1 mM) and a high affinity for sodium (Kt = 23.9 mM) (site II). The coupling factor [Na]/[pyruvate] stoichiometry were determined at 0.25 mM and 8 mM pyruvate and estimated at 1.8 for site I, and 3 when the first and the second sites transport simultaneously. Under chemical equilibrium (delta psi congruent to 0) single isotopic labeling, transport kinetics of pyruvate carrier systems have shown a double interaction of pyruvate with the transporter; the sodium/pyruvate stoichiometry also expressed according to a Hill plot representation was n = 1.7. The direct method of measuring Na+/pyruvate stoichiometry from double labeling kinetics and isotopic exchange, for a time course, gives a n = 1.67. Studies of transport specificity, indicate that the absence of inhibition of lactate transport by citrate and the existence of competitive inhibition of lactate and citrate transports by pyruvate leads to the conclusion that the low pyruvate affinity site can be attributed to the citrate carrier (tricarboxylate) and the high pyruvate affinity site to the lactate carrier (monocarboxylate). PMID- 2778797 TI - Inhibition of hexose transport in the human erythrocyte by 5, 5'-dithiobis(2 nitrobenzoic acid): role of an exofacial carrier sulfhydryl group. AB - The sulfhydryl reagent 5, 5'-dithiobis (2-nitrobenzoic acid) (DTNB) was used to study the functional role of an exofacial sulfhydryl group on the human erythrocyte hexose carrier. Above 1 mM DTNB rapidly inhibited erythrocyte 3-O methylglucose influx, but only to about half of control rates. Efflux was also inhibited, but to a lesser extent. Uptake inhibition was completely reversed by incubation and washing with 10 mM cysteine, whereas it was only partially reduced by washing in buffer alone, suggesting both covalent and noncovalent interactions. The covalent thiol-reversible reaction of DTNB occurred on the exofacial carrier, since (i) penetration of DTNB into cells was minimal, (ii) blockade of potential uptake via the anion transporter did not affect DTNB induced hexose transport inhibition, and (iii) DTNB protected from transport inhibition by the impermeant sulfhydryl reagent glutathione-maleimide-I. Maltose at 120 mM accelerated the covalent transport inhibition induced by DTNB, whereas 6.5 microM cytochalasin B had the opposite effect, indicating under the one-site carrier model that the reactive sulfhydryl is on the outward-facing carrier but not in the substrate-binding site. In contrast to glutathione-maleimide-I, however, DTNB did not restrict the ability of the carrier to reorient inwardly, since it did not affect equilibrium cytochalasin B binding. Thus, carrier conformation determines exposure of the exofacial carrier sulfhydryl, but reaction of this group may not always "lock" the carrier in an outward-facing conformation. PMID- 2778800 TI - Radiological seminar CCXLXII: CT of adrenal gland pheochromocytoma. AB - Herein, we have described our experience with CT and pheochromocytomas arising from the adrenal gland over a recent six year period. In all of our patients who underwent CT scanning, localization of the tumor was successful. CT remains an accurate means for localization of adrenal pheochromocytomas. PMID- 2778798 TI - Effects of monensin on ATP levels and cell functions in rat liver and lung in vitro. AB - Effects of the proton-alkali cation-exchanging ionophore, monensin, on aspects of cellular metabolism and ionic exchanges have been studied in rat tissues in vitro. Incubation of liver slices at 38 degrees C with 0.1 microM monensin induced time-dependent vesiculation, initially in the Golgi region, reduction of ATP content and of protein synthesis. At 1 microM, monensin also reduced net, active movements of K+, Na+, Cl- and water in liver slices and inhibited state 3 respiration in isolated mitochondria. The respiratory inhibitor, amytal, similarly reduced ATP content and protein synthesis at concentrations lower than those inhibiting ion transport in slices. Low concentrations of monensin (0.1-1.0 microM) had similar effects on ATP and ion transport in slices of adult lung. By contrast, late-fetal liver and lung were much less sensitive to monensin; in these tissues, glycolysis sustained substantial levels of ATP. Monensin also induced vesiculation of the Golgi apparatus in fetal lung cells. It is concluded that by lowering ATP levels, monensin can markedly alter various metabolic activities in those cells which depend primarily on oxidative phosphorylation for their metabolic energy. PMID- 2778801 TI - The big brown bag. PMID- 2778799 TI - Inhibition of electrical coupling in pairs of murine pancreatic acinar cells by OAG and isolated protein kinase C. AB - Gap junctional coupling was studied in pairs of murine pancreatic acinar cells using the double whole-cell patch-clamp technique. During stable electrical coupling, addition of OAG (1-oleoyl-2-acetyl-sn-glycerol) induced a progressive reduction of the junctional conductance to the detectable limit (approximately 3 pS). Prior to complete electrical uncoupling, various discrete single channel conductances between 20 and 100 pS could be observed. Polymyxin B, a potent inhibitor of the protein kinase C (PKC) system, completely suppressed OAG stimulated electrical uncoupling. Dialysis of cell pairs with solutions containing PKC, isolated from rat brain, also caused electrical uncoupling. The presence of 0.1 mM dibutyryl cyclic AMP and 5 mM ATP in the pipette solution, which serves to stabilize the junctional conductance, did not suppress the effects of OAG or isolated PKC. We conclude that an increase of protein kinase C activity leads to the closure of gap junction channels, presumably via a PKC dependent phosphorylation of the junctional peptide, and that this mechanism is dominant over cAMP-dependent upregulatory effects in the experimental time range (less than or equal to 1 hr). A correlation of the observed single channel conductances with the appearance of channel subconductance states or various channel populations is discussed. PMID- 2778803 TI - Effects of polyoxyethylene-modified superoxide dismutase on reperfusion induced arrhythmias in isolated rat and guinea-pig hearts. AB - Effects of a newly introduced polyoxyethylene-modified superoxide dismutase (SOD POE) with prolonged plasma half life (10 h) on reperfusion induced arrhythmias were examined using a 15 min left anterior descending coronary artery (LAD) occlusion followed by reperfusion in the isolated perfused rat and guinea-pig hearts. LAD occlusion was performed by compressing the artery using a suction cup placed on the LAD to which negative pressure was applied. The LAD occlusion was repeated twice at an interval of 20 min. Drugs were infused from 10 min prior to the occlusion to 3 min after reperfusion at either first or second trial of the occlusion and release. ECG was monitored throughout the experiments. In the control group (rat hearts), arrhythmias including ventricular fibrillation (Vf) (incidence, 64.3 to 83.3%), ventricular tachycardia (VT) (66.7 to 84.6%), premature ventricular contraction (PVC) and premature atrial contraction (PAC) occurred immediately after reperfusion and lasted for 1 to 3 min. In both groups treated with SOD-POE (10 U/ml) or native human SOD (10 U/ml), the incidence of Vf and VT was 0% and the number of PVCs significantly decreased. Lidocaine (5 x 10( 7) M, 10(-6) M) also reduced the incidence of VT and the number of PVCs. In guinea-pig hearts, the occlusion and release induced Vf (50%), VT (80%), PVCs and PACs. Both SOD-POE and SOD markedly depressed the incidence of Vf (0%) and VT (14.3% in both groups) and decreased the number of PVCs and PACs. Results demonstrate that SOD-POE has the same pharmacological activity as SOD does in preventing reperfusion induced arrhythmias in isolated rat and guinea-pig hearts, suggesting that it will provide a novel therapeutic approach for preventing oxygen radical-related injury in myocardium and other tissues. PMID- 2778802 TI - Doxorubicin-induced calcium release from cardiac sarcoplasmic reticulum vesicles. AB - Doxorubicin, an anthracycline glycoside antibiotic which has been widely used for treatment of several types of cancer (Goormaghtigh and Ruysschaer, 1984), displays a clinically important cardiac toxicity (Young et al., 1981) that can be dissociated from the antitumor activity. Although the main sites of toxicity have been postulated to be on the muscle membranes (Goormaghtigh and Ruysschaer, 1984; Harris and Doroshow, 1985), no information is available for a direct doxorubicin effect on the Ca2+ fluxes in cardiac sarcoplasmic reticulum (SR). Previous studies have shown that micromolar doxorubicin triggers Ca2+ release from skeletal SR vesicles (Zorzato et al., 1985). The objective of this study was to examine the effect of doxorubicin or caffeine on Ca2+ fluxes in cardiac SR in the presence of various Ca2+ release inhibitors. Addition of either doxorubicin (C1/2 = 5 microM), or caffeine (C1/2 = 0.8 mM) triggered Ca2+ release from canine cardiac SR loaded with 45Ca2+ in the presence of 2 mM ATP. The maximal amount of Ca2+ release triggered by doxorubicin (38% of the total loaded Ca2+) was significantly higher than that released by caffeine (25%). Plots of the amount of Ca2+ release triggered by 20 microM doxorubicin or 2 mM caffeine vs. free Ca2+ concentration were a bell-shaped, with maximal Ca2+ release at 0.2 microM Ca2+. Ca2+ release triggered by either 20 microM doxorubicin or 2 mM caffeine was inhibited by ruthenium red (0.1 to 2 microM), ryanodine (1 to 100 microM) or tetracaine (0.1 to 1 mM), whereas 2 mM caffeine did not further activate Ca2+ release triggered by 50 microM doxorubicin, suggesting that the drugs may share the same Ca2+ release channel. PMID- 2778804 TI - Interaction of amiodarone and desethylamiodarone with the cardiac muscarinic receptor in vitro. AB - We studied the interaction of amiodarone hydrochloride (Cordarone) and its major metabolite desethylamiodarone with the muscarinic receptor in purified canine cardiac sarcolemmal vesicles by measuring equilibrium binding of the muscarinic antagonist [3H]quinuclidinyl benzilate (QNB) and carbachol displacement of [3H] QNB. At a [3H]-QNB concentration of 0.02 nM, equilibrium binding was inhibited by amiodarone and desethylamiodarone with an IC50 of 6.86 x 10(-6) M and 2.25 x 10( 6) M, respectively. The presence of increasing concentrations of [3H]-QNB in the incubation medium was able to reverse the inhibition seen with 1 x 10(-6) M amiodarone. Scatchard analysis of [3H]-QNB saturation isotherms (37 degrees C, pH 7.4) in the presence of 1 x 10(-6) M amiodarone showed an apparent increase in equilibrium dissociation constant (Kd) over control from 0.045 +/- 0.002 nM to 0.084 +/- 0.001 nM while maximal binding capacity (Bmax) was unaffected: 10.8 +/- 1.14 and 10.5 +/- 1.48 pmol/mg (means +/- S.E.M., n = 3), respectively. The inhibitory effect of amiodarone on equilibrium binding was highly dependent on the drug:membrane phospholipid mole ratio with effects beginning at a ratio of less than 0.1:1. Hill plot analysis was consistent with the interaction of [3H] QNB at a single site in the presence or absence of amiodarone. Amiodarone (3 x 10(-6) M) decreased the pseudo-first order forward rate constant of [3H]-QNB (0.02 nM) with the muscarinic receptor (kobs = 4.05 +/- 0.61 x 10(-4)/s under control conditions and 2.36 +/- 0.15 x 10(-4)/s in the presence of amiodarone).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2778805 TI - Inhibition of 3H-quinuclidinyl benzylate binding to cardiac muscarinic receptor by long chain fatty acids can be attenuated by ligand occupation of the receptor. AB - Phospholipase A2 (PLA2) inhibits ligand binding to sarcolemmal muscarinic receptors in heart. To determine whether this effect of PLA2 is mediated by membrane accumulation of non-esterified fatty acids (FFA), the effect of selected fatty acids on the binding of 3H-quinuclidinyl benzylate (3H-QNB) to purified canine sarcolemmal membranes before and after PLA2 treatment was examined. Equilibrium 3H-QNB binding was inhibited by 5 min exposure of membrane vesicles to oleic, linoleic or arachidonic acid (IC50 = 6.3 +/- 0.9, 9.9 +/- 1.1, and 6.8 +/- 0.4 microM, respectively); the saturated fatty acids, stearic and palmitic acid (10 microM) had no effect. Scatchard analysis of equilibrium binding isotherms showed that the effect of the unsaturated fatty acids to inhibit 3H-QNB binding reflected a decrease of Bmax and a reduction of the affinity of the remaining receptors. The effect of unsaturated fatty acids was dependent on the mole ratio of fatty acid to membrane phospholipid present (FFA/PL ratio). Washing of fatty acid-treated membranes with bovine serum albumin (BSA) resulted in partial recovery of both maximal binding (Bmax) and affinity. The fatty acid induced reduction of Bmax was also attenuated if binding was started by simultaneous addition of 3H-QNB and FFA. Similarity of the FFA induced effects on 3H-QNB binding to sarcolemmal muscarinic receptors to those induced by PLA2 suggest that membrane accumulation of unsaturated fatty acids underlies in part the effect of PLA2. Furthermore, modification of the receptor-ligand interaction by changes in the membrane lipid composition may be prevented by ligand occupation of the receptor. PMID- 2778806 TI - Modification of cardiac action potential by photosensitizer-generated reactive oxygen. AB - Evidence implicating reactive oxygen species (ROS) in reperfusion-induced arrhythmias is accumulating rapidly [1,2]. However, surprisingly little is known about the effects of ROS on cardiac electrophysiology. Such knowledge would improve our understanding of reperfusion-induced arrhythmias. Photosensitizers and light are known to produce a variety of ROS. They might, therefore, be useful for investigating oxygen-mediated cell injury. To our knowledge, such an approach has not been used to investigate ROS-induced alterations in the electrophysiological properties of cardiac muscle. The purpose of this paper is to demonstrate (1) the feasibility of using photosensitizers for such an investigation, and (2) some advantages photosensitizers offer when combined with single cell and patch pipette methodologies. A comparison of the electrophysiological alterations produced by photosensitizer-generated ROS to the reported effects of xanthine-xanthine oxidase or organic hydroperoxides suggests that the electrophysiological alterations produced by superoxide initiated reactions and/or lipid peroxidation are similar to those produced by photosensitizers and light. PMID- 2778807 TI - Ethanol inhibits electrically-induced calcium transients in isolated rat cardiac myocytes. AB - The fluorescent Ca2+ indicator fura-2 was used to follow cytosolic Ca2+ transients during excitation-contraction coupling in suspensions of isolated rat heart cells induced to beat synchronously by electrical field stimulation. The Ca2+ transient reached a maximum at about 30 ms after application of the electrical stimulus and then relaxed to the basal level over the following 200 ms. Treatment of the myocytes with 0.25 to 2.0% ethanol (40 to 340 mM) caused a decrease in the peak of the Ca2+ transient, with no apparent change in the time to peak. This effect of ethanol occurred progressively over a period of about 1 min before a new stable state was achieved. At 1% ethanol the peak Ca2+ level was reduced by 50%. Ethanol reversed the stimulatory effect of isoproterenol on peak Ca2+ and at high levels of ethanol the beta-adrenergic agonist no longer caused any enhancement of the Ca2+ transient. Ethanol did not cause any marked change in the basal Ca2+ level between beats. The effects of ethanol were readily reversible. These results suggest that the negative inotropic effect of ethanol observed in intact cardiac muscle preparations may result in part from interference with the Ca2+ fluxes responsible for excitation-contraction coupling in ventricular myocytes. PMID- 2778809 TI - Leakage of heart fatty acid binding protein with ischemia and reperfusion in the rat. AB - Fatty acids and their metabolites have been implicated as a cause of myocardial damage during ischemia. Fatty acid binding protein (FABP), an abundant low molecular weight protein present in the cytosol of myocytes, has been postulated to be a key fatty acid carrier protein in the myocardium. Postulating that loss of FABP during ischemia could cause an increase in unbound intracellular fatty acids contributing to myocardial damage, we measured plasma FABP levels during 60 min of myocardial ischemia followed by 60 min of reperfusion in the rat. Peak levels were seen 15 min after reperfusion. Plasma levels were higher with larger areas of myocardial ischemia (1720 +/- 528 ng/ml vs. 216 +/- 76 ng/ml with smaller areas, P less than 0.02). Tissue levels after 60 min of ischemia and 60 min of reperfusion were decreased by over 50%, (1.0 +/- 0.3 mg FABP/g wet wt compared with 2.9 +/- 0.4 mg FABP/g wet wt in normal myocardium, P less than 0.005). The data is consistent with the proposal that loss of FABP contributes to the myocardial damage associated with ischemia and reperfusion. Additional studies are needed to determine the exact role of FABP in the regulation of fatty acid metabolism in the heart. PMID- 2778808 TI - Effect of oxygen tension on the anti-oxidant enzyme activities of tetralogy of Fallot ventricular myocytes. AB - Since the chronically cyanotic tetralogy of Fallot (TOF) myocardium is more sensitive to reperfusion injury after cardiac surgery than the adult myocardium, we decided to study the regulation of myocardial superoxide dismutase (SOD), catalase and glutathione peroxidase by oxygen tension. TOF myocytes were cultured at a Po2 of 150 mmHg for 30 days to establish the culture. The cells were then cultured at Po2 of 150 and 40 mmHg and the myocyte antioxidant enzymes measured at days 3, 7, 14 and 21. On day 21 the myocytes cultured at Po2 of 40 mmHg were then cultured at 150 mmHg and SOD and catalase activities measured on days 28 and 35. Although there were no differences in the rates of incorporation of 35S methionine into the myocytes at either Po2 on these days, the myocytes scavenger enzyme levels were significantly higher by day 14 when cultured at a Po2 of 150 mmHg than at a Po2 of 40 mmHg. With the increase in oxygen tension from 40 to 150 mmHg, SOD and catalase activities increased significantly by day 35. The myocytes cultured at Po2 40 mmHg were more sensitive by day 7 to an hypoxanthine-xanthine oxidase generated free radical injury than the Po2 150 mmHg cultured cells. The regulation of these enzyme activities by oxygen tension and the increased sensitivity to free radical injury of the myocytes cultured at an oxygen tension of 40 mmHg provide putative evidence that the chronically cyanotic myocardium may be less well protected than the normally perfused myocardium against oxygen mediated free radical injury and be at higher risk for cardiovascular surgery. PMID- 2778810 TI - Reperfusion-induced arrhythmias are critically dependent upon occluded zone size: relevance to the mechanism of arrhythmogenesis. AB - The relationship between reperfusion-induced arrhythmias and the size of the occluded zone was examined. The isolated perfuse rat heart was used because its negligible collateral flow maximizes susceptibility to arrhythmias and reduces variability. Ischemia lasting 10 min was followed by 10 min of reperfusion. A constant-pressure perfusion system (which precludes coronary steal) permitted measurement of the rapidity of restoration of coronary flow. Mean occluded zone sizes of 0, 7.2 +/- 1.1, 19.5 +/- 1.5, 45.8 +/- 1.7, 30.1 +/- 4, and 100% of the total ventricular weight were obtained by sham ligation, distal, medial and proximal ligation of the left main coronary artery, right arterial ligation and the induction of global ischemia, respectively. Occluded zone size correlated positively (r = 0.86, P less than 0.001) with a linearly-additive arrhythmia score irrespective of the site of ischemia (left versus right ventricle). In globally ischemic hearts, ventricular fibrillation (VF) depended upon ventricular beating rate during ischemia, occurring only if the rate exceeded 150 beats/min. If this factor were taken into consideration, VF incidence exhibited a sigmoidal relationship with occluded zone size. During the first min of reperfusion, the rapidity of restoration of coronary flow was inversely related to occluded zone size (P less than 0.001) and had a small but significant effect on the severity of arrhythmias; slow recovery of flow increased susceptibility. We conclude that when reperfusion is elicited at the moment of peak susceptibility to arrhythmias, VF incidence is determined principally by occluded zone size. Heart rate during ischemia becomes relevant at rates less than 150 beats/min, when a protective effect is seen. Since VF incidence was 100% in hearts reperfused after global ischemia, an interface between non-ischemic tissue and reperfused tissue is therefore unnecessary for arrhythmogenesis during reperfusion, and flow of injury current between non-ischemic and reperfused tissue can be ruled out as a mechanism of arrhythmogenesis. The initiation of reperfusion-induced arrhythmias must therefore take place within the reperfused tissue. PMID- 2778811 TI - Immunolocalization of ornithine decarboxylase in rat heart atria. AB - Mammalian atrial myocytes secrete a potent natriuretic and diuretic factor, atrial natriuretic peptide (ANP), in response to volume expansion or elevations of right atrial pressure. ANP is synthesized in the atrial atrial myocytes and stored in cytoplasmic secretory granules. Ornithine decarboxylase (ODC) is the initial rate-limiting enzyme in the biosynthesis of polyamines, organic cations which are essential for various aspects of DNA, RNA and protein synthesis, structure, and function. The enzyme has been reported to be localized predominantly in the cytoplasm. A polyclonal antibody elicited against ODC was used to analyse the intracellular distribution of the enzyme protein within atrial myocytes at the ultrastructural level through the use of a post-embedding immunogold technique. In control animals, the density of gold particles associated with the atrial granules was seven to 30-fold higher than that detected in association with other subcellular structures. Administration of Isoproterenol increased atrial of Isoproterenol increased atrial ODC activity 18 fold and the density of the immunolabelling of the atrial myocytes five-fold. Statistically significant increases in the density of labelling after stimulation occurred in association with the atrial granules and the nucleus. After isoproterenol stimulation, 60% of the immunodetectable ODC protein in the atrial myocyte was found in association with the atrial granules. The atrial granules were demonstrated to contain ANP by immunocytochemical analysis of adjacent sections. PMID- 2778812 TI - The impaired tolerance of the recently infarcted rat heart to cardioplegic arrest: the protective effect of orotic acid. AB - After myocardial infarction, a reduced mass of non-infarcted myocardium remains to maintain cardiac output. This acutely stressed, non-infarcted myocardium exhibits many metabolic disturbances, and undergoes a process of acute hypertrophy. These stress-induced disturbances may reduce the tolerance of the heart to the global ischaemia of cardioplegic arrest and may explain the increased mortality and morbidity associated with cardiac surgery in patients with recent myocardial infarction. We postulated that orotic acid, a pyrimidine precursor which augments the rate of protein synthesis during hypertrophy, might improve the response of the recently infarcted heart to cardioplegic arrest. Myocardial infarction was induced in rats by coronary ligation, and after 2 days or 3 days the hearts were excised and perfused on the working heart apparatus. After measurement of work capacity, the hearts underwent 1 hour of hypothermic cardioplegic arrest. Post-arrest function was then measured and expressed as a percentage of the pre-arrest value. A group of sham-operated, non-infarcted hearts served as controls. There were two distinct findings: (1) when subjected to hypothermic cardioplegic arrest 2 days after myocardial infarction, hearts recovered only 49% of pre-arrest function, compared with 80% recovery in non infarcted controls (P less than 0.001). Three days after infarction, recovery had improved to 68% (P less than 0.01 vs. 2 days, P less than 0.05 vs. non infarcted). (2) Treatment with oral orotic acid following infarction augmented recovery from cardioplegic arrest to 83%, 2 days after infarction (P less than 0.001 vs. untreated) and to 87%, 3 days after infarction (P less than 0.01 vs. untreated).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2778813 TI - Energy-linked regulation of mitochondrial fatty acid oxidation in the isolated perfused rat heart. AB - Regulation of beta-oxidation under various metabolic conditions and energy loads was studied by employing a newly developed method for assaying 3-hydroxyacyl-CoA and 2-trans-enoyl-CoA intermediates of fatty acid oxidation. A 66% inhibition of oleate oxidation with a concomitant 68% inhibition of oxygen consumption resulted in a 81% decrease in the carnitine/acyl-carnitine ratio, but the concentrations of 2-trans-enoyl-CoA and 3-hydroxyacyl-CoA esters did not change significantly and the acid-insoluble acyl-CoA content did not change. The acetyl-CoA concentration increased three-fold, however, and there was a simultaneous tendency for the NADH/NAD+ ratio to shift towards oxidation. The results suggest that the main regulatory site of fatty acid oxidation resides at an early step in the pathway. Since the concentrations of the acyl-CoA derivatives identified did not undergo major changes even though the acyl-carnitine concentration changed some rate limitation must already occur at the steps of acyl transport into the mitochondria or the carnitine acyltransferase II. PMID- 2778814 TI - Contribution of S-adenosylhomocysteine to cardiac adenosine formation. AB - The S-adenosylhomocysteine (SAH) hydrolase inhibitor adenosine dialdehyde was used in isolated guinea pig hearts to determine the contribution of the transmethylation pathway to cardiac adenosine formation. This inhibitor did not alter cardiac hemodynamics but effectively inhibited SAH-hydrolase activity under in vitro and in vivo conditions. In normoxic perfused hearts adenosine dialdehyde (10 microM) caused tissue levels of SAH to linearly increase at a rate of 160 pmol/g/min over 60 min. At the same time adenosine dialdehyde decreased release of adenosine into the coronary effluent perfusate by 16 pmol/min (34%). Hypoxic perfusion (30% O2) of guinea-pig hearts increased release of adenosine from 43 to 3700 pmol/min. However, rate of SAH formation in the presence of adenosine dialdehyde was only slightly enhanced from 160 to 200 pmol/g/min and adenosine dialdehyde did not significantly alter the hypoxia induced adenosine release. Since all experiments were performed in the presence of the adenosine deaminase inhibitor EHNA (5 microM) the results demonstrate: (1) the transmethylation pathway of the heart contributes one third to global cardiac adenosine production under normoxic conditions and provides a constant source of adenosine independent of tissue oxygenation. (2) The majority of SAH-derived adenosine is salvaged most likely via adenosine kinase. (3) The hypoxia induced adenosine production is predominantly derived from enhanced 5' AMP hydrolysis. PMID- 2778816 TI - Biochemical and functional effects of nucleoside transport inhibition in the isolated cat heart. AB - With increasing periods of normothermic ischemia, increasing amounts of mainly inosine and hypoxanthine are released in reperfusates of isolated working cat hearts. Nucleoside transport inhibition (soluflazine; 1 x 10(-7) M) markedly reduces the total release, but increases the release of adenosine. Tissue levels of adenine nucleotides are reduced by 50% after 32 min of ischemia with an almost equivalent, parallel, rise in inosine and hypoxanthine. Subsequent reperfusion leads to a complete removal of the catabolites and a restoration of the energy charge, but not to any recovery of the sum of nucleotides. Nucleoside transport inhibition has no effect on the changes in the nucleotides, but induces a marked accumulation of adenosine during ischemia and prevents the rapid escape of the nucleosides--not of hypoxanthine--upon reperfusion. Cardiac function markedly deteriorates after 20 and 32 min of ischemia. Transport inhibition completely prevents the decrease in cardiac output and pressure-rate product without any effect on normoxic performance. It is suggested that the prolonged presence of adenosine and of inosine may exert a protective effect. PMID- 2778815 TI - Diastolic dysfunction of perfused rat hearts induced by hydrogen peroxide. Protective effect of selenium. AB - Oxidant substances such as hydrogen peroxide are postulated to cause cardiac dysfunction and injury in a number of pathological conditions. Selenium is an essential nutrient which serves as an oxidant defense through the selenoenzyme glutathione peroxidase. This enzyme metabolizes hydrogen peroxide; its activity in rat heart is reduced to 5% of control by selenium deficiency. Left ventricular function of selenium-deficient and control rat hearts was studied in a Langendorff preparation under isovolumic conditions. A stabilization period of 20 min was followed by a 70 min infusion of hydrogen peroxide at 375 or 1500 nmol/min. When no hydrogen peroxide was infused, perfusion for 90 min had no effect on systolic or diastolic function and no effect of selenium deficiency was detected. Hydrogen peroxide infusion into selenium-deficient hearts at 375 nmol/min led to impaired isovolumic relaxation and a substantial increase in end diastolic pressure after 45 min which worsened progressively until the experiment was terminated. By contrast no effect was observed on systolic contractile function as assessed by peak pressure or developed pressure. Infusion of this dose of hydrogen peroxide into control hearts had no significant effect on diastolic or systolic function. However, infusion of 1500 nmol hydrogen peroxide/min into control hearts caused diastolic dysfunction after 30 min without affecting systolic function. These results indicate that hydrogen peroxide injury to the perfused rat heart is manifested by diastolic dysfunction before systolic dysfunction occurs. Selenium deficiency lowers the dose of hydrogen peroxide needed to cause diastolic dysfunction. This suggests that the selenoenzyme glutathione peroxidase protects the heart against hydrogen peroxide injury. PMID- 2778817 TI - 10th European Section Meeting, International Society for Heart Research. September 7-9, 1989, Rotterdam, The Netherlands. Abstracts. PMID- 2778818 TI - DNA flow cytometry in early breast cancer: a step in the right direction. PMID- 2778819 TI - Heparin analogues: a new family of anticancer drugs. PMID- 2778820 TI - Cooperative group evaluating diagnostic imaging techniques. PMID- 2778821 TI - The Bethesda System unveiled; revamps Pap smear reporting. PMID- 2778822 TI - System of Scientific Advisory Boards at the National Cancer Institute. AB - This article describes the Boards of Scientific Counselors of the National Cancer Institute (NCI) and focuses on their role and their relationship to the other advisory boards used by NCI in the governance of the National Cancer Program. The advisory boards consist of the President's Cancer Panel, the National Cancer Advisory Board, the Boards of Scientific Counselors of the four programmatic divisions, and the Frederick Cancer Research Facility Advisory Committee. Each of these boards is an element of the organized system by which NCI obtains its scientific advice. The system provides a forum in which scientific directions and priorities are debated, ideas for research initiatives compete, and advice is given on the allocation of research and training funds. This article is a sequel to a number of earlier papers reviewing the corporate management structure that has been developed over the past decade at NCI. PMID- 2778823 TI - Correlation of pretreatment proliferative activity of breast cancer with the response to cytotoxic chemotherapy. AB - That most cytotoxic agents act specifically against actively proliferating cells is well-recognized. In this study, we attempted to correlate pretreatment S-phase fractions (SPF) measured on DNA histograms with regression of the tumor mass after the administration of neoadjuvant chemotherapy. Tumor cells were obtained from 60 previously untreated, premenopausal patients with no metastases and with noninflammatory disease by fine needle sampling without aspiration. We could evaluate DNA ploidy in all patients and SPF in 50 or 83% of them. Tumor responsiveness was significantly related to SPF. The 12 patients who had SPF of 10% or more showed demonstrable regression; six had complete responses. None of the other parameters tested, i.e., DNA ploidy, histopathologic grade, or hormone receptor content, correlated with response. We believe this information may prove valuable for clinicians as they make their decisions regarding patient therapy. PMID- 2778825 TI - Emergence of the drug-resistant phenotype in tumor subpopulations: a hybrid model. AB - A mathematical model is proposed that describes the emergence of drug resistance in a tumor cell population. The model is termed a hybrid in the sense that the population-wide dynamics are described by a stochastic birth-death-migration model with transition probabilities dependent on the deterministic distribution of drug within the average cell. In the model, the probability that a cell dies is proportional to the concentration of drug within the target site in the cell. The micropharmacology describing the distribution of drug within the average cell is described by a standard well-mixed compartment model. Possible mechanisms that can confer drug resistance on a cell are described: decreased drug uptake, increased drug efflux, intracellular metabolism or inactivation, or both, of a drug, and a change in the level or sensitivity of a target. The biologic mechanisms underlying resistance and potential strategies for overcoming it are discussed within the context of our model. Results from a numerical simulation are presented as verification of the initial theory. PMID- 2778824 TI - Augmentation of antiproliferative activity of interferon alfa against human bladder tumor cell lines by encapsulation of interferon alfa within liposomes. AB - Present therapy for human bladder cancer includes the intravesical administration of antiproliferative agents, such as recombinant human interferon alfa (IFN alpha). The administration of cytotoxic molecules encapsulated in liposomes could provide a more efficient method for such therapy. Therefore, we determined whether encapsulation of the recombinant human IFN-alpha hybrid BBDD within liposomes will produce antitumor effects against the human bladder cancer cell line 253J superior to those observed with free IFN-alpha. Adherent cells were cultured in medium alone, in medium containing different concentrations of IFN alpha, or in medium containing multilamellar liposomes (phosphatidylcholine phosphatidylserine at a molar ratio of 7:3) that encapsulated saline or IFN alpha. Cell growth was determined 96-120 hours later. Additional control groups consisted of target cells cultured with free IFN-alpha or with IFN-alpha plus liposomes containing saline. Cytostasis mediated by free IFN-alpha alone or IFN alpha in the presence of liposome-saline was identical and ranged from 0%-30% (10 IU/mL) to 45%-70% (1,000 IU/mL). Liposomes containing saline produced no effects. Liposome-encapsulated IFN-alpha produced significantly greater growth inhibition than free IFN-alpha: 40%-70% (10 IU/mL) and 80%-90% (1,000 IU/mL), respectively. Moreover, a 253J variant subline selected for resistance to free IFN-alpha was sensitive to IFN-alpha presented in liposomes. These data suggest that the encapsulation of antiproliferative agents such as IFN-alpha in liposomes can improve therapeutic results. PMID- 2778826 TI - Correlation of MDR1 gene expression with chemotherapy in neuroblastoma. AB - Forty-one neuroblastoma tumor specimens have been analyzed by Northern and slot blot hybridization techniques with human MDR1 gene probes. Only one of 15 (6%) tumors from patients who had not received chemotherapy exhibited high levels of MDR1 transcripts, while 11 of 26 (42%) treated tumors showed high levels of MDR1 expression (Fisher exact test: P = .03). The results indicate that the level of MDR1 mRNA expression is associated with previous chemotherapy, including drugs that select the multidrug resistance phenotype in vitro regardless of neuroblastoma tissue origin or N-myc content in the genome. For the 26 treated neuroblastomas, the number of nonresponsive tumors was found to be significantly higher among those with high levels of MDR1 mRNA. PMID- 2778827 TI - Correlation of growth capacity of human tumor cells in hard agarose with their in vivo proliferative capacity at specific metastatic sites. AB - The purpose of this study was to determine whether the degree of anchorage independent growth of human tumor cells in increasing concentrations of agarose correlated with the capacity of the cells to produce experimental metastases in nude mice. Human melanoma, breast carcinoma, and colon carcinoma cells from parental lines and variants selected in vivo for metastasis and in vitro cloned lines were plated into medium containing 0.3%, 0.6%, 0.9%, or 1.2% of agarose. These cells were also injected into nude mice: intravenously for melanoma, into the mammary fat pad for breast carcinoma, and into the spleen for colon carcinoma. Production of tumor cell colonies in dense agarose (greater than 0.6%) correlated with production of experimental metastases in the lung (melanoma, breast carcinoma) or liver (colon carcinoma). We conclude that the degree of anchorage-independent growth of tumor cells can predict their biological behavior and metastatic potential in vivo. Thus, this technique may be useful for the isolation of metastatic cells from heterogeneous human neoplasms. PMID- 2778828 TI - Toxicity of levamisole and 5-fluorouracil in human colon carcinoma cells. AB - The combination of 5-fluorouracil (5-FU) with the immunomodulator levamisole (Lev) has been clinically tested in patients with metastatic colorectal carcinoma and as adjuvant therapy following primary tumor surgery. In some studies in advanced disease, the addition of Lev to 5-FU improved the median duration of response; in the adjuvant setting, the combination was associated with improvement in the disease-free survival. We studied whether Lev was directly toxic to three human colorectal carcinoma cell lines (HCT 116, SNU-C4, and NCI H630). We also evaluated the toxicity of Lev in combination with 5-FU in these three cell lines. Lev inhibited the growth of all three colorectal cell lines, but only at concentrations two logs above that achieved with a standard 150-mg oral dose of Lev. In cell growth studies, 500 and 1,000 microM Lev increased the toxicity of 5-FU in HCT 116 cells in an additive fashion. In clonogenic assays, continuous exposure to 10 or 100 microM Lev was minimally toxic and did not enhance the lethality associated with a 24-hour exposure to 5-FU in any of the cell lines. Lev alone at 1,000 microM decreased colony formation by 45% in HCT 116 cells. A combination of 1,000 microM Lev with 10 microM 5-FU resulted in a decrease in HCT 116 colony formation from 54% to 6% of control levels. Continuous exposure of NCI-H630 cells to 500 microM Lev decreased colony formation to 76.5% of control levels; when Lev was combined with 50 microM 5-FU, colony formation was decreased from 59.5% to 27.5% of control levels. We conclude that at concentrations achievable with conventional doses of Lev, there was no evidence of direct toxicity in these colorectal cell lines. Furthermore, an additive interaction with 5-FU was evident only at suprapharmacologic doses of Lev. PMID- 2778829 TI - Dietary fat intake and breast cancer risk. PMID- 2778830 TI - Environmental tobacco smoke in passenger cabins of commercial aircraft. PMID- 2778831 TI - Liposomal encapsulation: making old and new drugs do new tricks. PMID- 2778832 TI - Keeping cells in their place: the role of tumor suppressor genes. PMID- 2778833 TI - Essentials of patent law. PMID- 2778835 TI - Occupational risks of bladder cancer in the United States: II Nonwhite men. AB - Occupational risks of bladder cancer among nonwhite men were assessed based on interviews with 126 cases and 383 controls conducted during the National Bladder Cancer Study, a population-based, case-control study conducted in 10 areas of the United States. Our findings indicated that nonwhite men who were ever employed as auto workers have an elevated risk of bladder cancer [relative risk (RR) = 2.3; 95% confidence intervals (CI) = 0.8-6.4] with a significant positive trend in RR with increasing duration of employment (P = .017) and with the RR rising to 4.7 for those employed at least 10 years. Dry cleaners, ironers, and pressers also experienced increased bladder cancer risk (RR = 2.8, CI = 1.1-7.4). Nonsignificant excesses of similar magnitude to those seen among white men were found for nonwhite men employed in several other occupations. Overall, our findings suggest that the risk of occupational bladder cancer among white and nonwhite men is similar. When inconsistencies between whites and nonwhites did occur, they appeared either due to chance or possibly racial differences in exposure among men within the same industry and occupation. In all, we estimate that the population attribute risk for occupation among nonwhite U.S. men is 27% (CI = 9% to 56%), which is slightly higher than the estimate of 21% to 25% previously reported for white U.S. men, although this difference was not statistically significant. PMID- 2778834 TI - Occupational risks of bladder cancer in the United States: I. White men. AB - We examined the relationship between occupation and bladder cancer risk using data obtained from interviews conducted with 2,100 white males with bladder cancer and 3,874 population controls during the National Bladder Cancer Study, a population-based, case-control study conducted in 10 areas of the United States. The strongest evidence of increased risk among white men was observed for painters, truck drivers, and drill press operatives. For painters, the overall relative risk was 1.5 [95% confidence intervals (CI) = 1.2-2.0]. Among painters who started working prior to 1930, a significant trend in risk with increasing duration of employment as a painter was apparent; the relative risk for such painters employed 10 or more years was 3.0. For truck drivers and drill press operatives, overall risks were 1.3 (CI = 1.1-1.4) and 1.4 (CI = 0.9-2.1), respectively. We observed a significant, positive trend in risk with increasing duration of employment in each of these occupations, with relative risks peaking at approximately two for long-term workers. Excess risks were also observed for workers in several other occupations. In all, we estimate that 21%-25% of bladder cancer diagnosed among white men in the United States is attributable to occupational exposures. PMID- 2778837 TI - Levels of disialogangliosides in sera of melanoma patients monitored by sensitive thin-layer chromatography and immunostaining. AB - Levels of GD2, GD3, and 9-O-acetyl GD3 were monitored in sera of patients with melanoma and healthy adults with two monoclonal antibodies that specifically detect these gangliosides. By direct measurement of radioactivity in the immunolabeled chromatogram, GD2 could be detected in normal sera at 2 ng/mL. Serum levels of GD2 and GD3 were increased approximately sixfold and fivefold, respectively, in patients with disseminated melanoma, compared with those of healthy adults. The acetylated derivative of GD3, which is highly specific for melanoma cells, was not detected in serum. This sensitive assay allows the quantitation of tumor-associated gangliosides that are circulating in sera of melanoma patients. PMID- 2778838 TI - Heterogeneity of hematopoietic cells immortalized by v-myc/v-raf recombinant retrovirus infection of bone marrow or fetal liver. AB - The J2 recombinant retrovirus expressing v-myc/v-raf (also known as MYC/RAF1) immortalized macrophages from the bone marrow of lipopolysaccharide-responsive mouse strains, producing the ANA-1 cell line from C57BL/6 mice and the INF-3A cell line from C3H/HeN mice. In contrast, J2 recombinant retrovirus infection of the fetal liver from C57BL/6-Ly-5a mice immortalized a cell line (GGD) that did not exhibit the characteristics of mature macrophages. The GGD cell line was classified as leukocytic on the basis of its expression of the Ly-6B.2, Fc gamma R, and Ly-5.2 antigens. Our results indicate that the J2 recombinant retrovirus selectively immortalizes macrophages from the bone marrow of C57BL/6 and C3H/HeN mice but immortalizes cells without definitive macrophage characteristics from murine fetal liver under the same culture conditions. PMID- 2778836 TI - Pharmacokinetics and tissue distribution of doxorubicin encapsulated in stable liposomes with long circulation times. AB - We have previously reported on liposome formulations with reduced uptake by the reticuloendothelial system, prolonged circulation time, and enhanced accumulation in transplanted tumors. One of these formulations, consisting of hydrogenated phosphatidylinositol (HPI), hydrogenated phosphatidylcholine (HPC), and cholesterol (Chol) (HPI-HPC-Chol), and a control formulation, consisting of phosphatidylglycerol (PG), phosphatidylcholine (PC), and Chol (PG-PC-Chol), were loaded with doxorubicin (DXR) and injected intravenously into BALB/c mice for pharmacokinetic studies. Although both formulations were similar in vesicle size, fraction of negatively charged lipid, and drug-to-lipid ratio, there were striking pharmacokinetic differences. DXR was cleared much faster in PG containing liposomes than in HPI-containing liposomes. Liposome-associated drug was detectable in plasma up to 5 hours after injection in the case of PG-PC-Chol and as late as 72 hours after injection in the case of HPI-HPC-Chol. In agreement with the plasma clearance curves, peak drug concentrations in the liver were observed at 1/2, 5, and 24 hours after injection for free DXR, DXR in PG-PC-Chol, and DXR in HPI-HPC-Chol, respectively. Both types of liposomes reduced considerably the amount of drug accumulating in the heart compared with that accumulating after injection of free DXR. PMID- 2778839 TI - Combination chemotherapy with doxorubicin, dacarbazine, and ifosfamide in advanced adult soft tissue sarcoma. Canadian Sarcoma Group--National Cancer Institute of Canada Clinical Trials Group. AB - Forty-three adult patients with locally advanced or metastatic soft tissue sarcoma entered a pilot study of combination chemotherapy comprising 50 mg of doxorubicin/m2 by intravenous bolus, 850 mg of dacarbazine/m2 by 1-hour infusion, and 5 g of ifosfamide/m2 by 24-hour infusion with mesna uroprotection. The overall response rate in 40 assessable patients was 25% with two complete remissions. Twenty-four episodes of infection occurred in 148 courses (16%). These infections were usually associated with neutropenia (granulocyte count less than 0.5 X 10(9)/L), which occurred in 70% of the courses. These results do not differ from those elicited by each agent alone, and may reflect inadequacies of dose intensity or scheduling, or evaluation in a study population with adverse prognostic factors. PMID- 2778841 TI - Vaginal douching. PMID- 2778840 TI - Gallbladder carcinoma and retroperitoneal fibrosis: a rare combination. AB - Retroperitoneal fibrosis secondary to carcinoma of the gallbladder has not been reported previously. Such a combination is reported and a review of the pertinent literature presented. PMID- 2778842 TI - The dehiscence of health care. PMID- 2778843 TI - Magnetic resonance imaging of infratentorial congenital brain malformations. AB - The common infratentorial congenital malformations of the brain were analyzed with magnetic resonance imaging at the Children's Memorial Hospital in Chicago over a 2-year period. Over 200 children with one of the following congenital malformations were imaged using magnetic resonance: Dandy-Walker malformations, Chiari malformations, and cerebellar aplasia-hypoplasia malformations. The characteristic findings in each of these disorders are described based on the magnetic resonance image scans along with the clinical spectrum. PMID- 2778844 TI - Outrageous and beyond the bounds of decency. PMID- 2778845 TI - Evaluation of exposure of health care personnel to ribavirin. AB - Reports that ribavirin was teratogenic in animals raised concerns of female health care personnel about possible occupational exposure during the care of infants having respiratory syncytial virus infections. Under simulated operational conditions, experiments were conducted to measure ribavirin residues in room air, in surface wipe samples, and in personal sampling devices worn by volunteers. There was exposure to a dispersible dust, presumably dried ribavirin, deposited inside the croupette or hood and on the bedding. Based on personal sampler data, it was estimated that, in a 12-h shift, the primary health care individual could inhale 2.4-9.1 micrograms ribavirin/kg bw.d. Recommendations to reduce the exposure of staff included the wearing of appropriate surgical gloves and a NIOSH-approved disposable respirator for dusts and mists while attending to the needs of the patients. PMID- 2778846 TI - Prevention and antagonism of acute carbofuran intoxication by memantine and atropine. AB - Male Sprague-Dawley rats administered with a sublethal acute dose of carbofuran (1.5 mg/kg, sc) developed the observable toxic signs of anticholinesterase nature within 5-7 min. The toxic signs with increasing propensity to maximal severity including tremors, generalized muscle fasciculations, and convulsions were evident during 15 min to 1 h and lasted for 2 h. Thereafter, signs were seen up to 3 h with reduced intensity. By the end of 3.5 h toxic signs were completely subsided. Maximal acetylcholinesterase (AChE) inactivation occurred at 1 h in discrete brain regions (cortex, stem, striatum, and hippocampus) and hemidiaphragm muscle when most severe signs of toxicity were also evident. A single sc dose of memantine HCl (MEM, 18 mg/kg) and atropine sulfate (ATS, 16 mg/kg) 60 and 15 min, respectively, prior to carbofuran administration completely prevented the expected gross toxic signs and significantly (p less than .01) attenuated the carbofuran-induced inhibition of AChE activity. When given therapeutically, this combined treatment completely reversed the clinical evidence of carbofuran toxicity within 15 min and also markedly reduced AChE inactivation. Memantine or atropine when given alone was less effective compared to their combined administration. The results of this study suggested that, in addition to cholinolytic effects of atropine, memantine may prevent and antagonize the acute toxicity of carbofuran by (a) protection of AChE activity and its rapid reactivation from inhibition and (b) rapid elimination of carbofuran. PMID- 2778848 TI - Role of metallothionein in biliary metal excretion. AB - We have studied the effect of acute induction of metallothionein on the biliary excretion of a bolus of metal in the rat. Female Sprague-Dawley rats were administered zinc chloride (6.5 mg/kg) or dexamethasone (2 mg/kg), ip in saline daily for 3 d; control animals received saline alone. Zinc causes a 17-fold induction in hepatic metallothionein levels, while dexamethasone caused a 5-fold induction. A bolus of metal chloride, either zinc, mercury, or cadmium, 1 mg/kg iv, was administered, and bile and plasma samples were collected and analyzed for metal content. At 3 h the rats were killed, livers excised, and both metallothionein and the metals associated with metallothionein estimated. Cadmium was excreted into the bile in inverse proportion to the hepatic metallothionein content, while metallothionein content did not appear to bear any relationship to biliary excretion of mercury or zinc. Metallothionein from rats pretreated with zinc contained twice as much zinc per molecule of metallothionein as that found in control rats. Cadmium, which exhibits a very high affinity for metallothionein, replaced this zinc found in association with metallothionein. Conversely, mercury only partially replaced the zinc associated with metallothionein, and a bolus of zinc was completely unable to bind to the already zinc-saturated metallothionein. Consequently, the bolus zinc was found associated with alternative cytosolic proteins, here termed the high-molecular-weight fraction. These findings support the hypothesis that the inhibitory effect of metallothionein on the biliary excretion of metals is dependent on the ability of the metal in question to replace any existing metals associated with metallothionein. Biliary metal excretion was directly proportional to the free metal content, regardless of the metal studied. Consequently, acute induction of metallothionein was inhibitory to biliary cadmium excretion, slightly inhibitory to biliary mercury excretion, and without effect on biliary zinc excretion. PMID- 2778847 TI - Carcinogenesis in rats by nitrosodialkylureas containing methyl and ethyl groups given by gavage and in drinking water. AB - The carcinogenic effects in male and female F344 rats of four nitrosodialkylureas containing methyl or ethyl groups have been compared by two modes of administration, gavage in oil solution or dissolved in drinking water. Weekly doses of 20 and 40 mumol were given to each rat by either route and treatment lasted usually 30 wk, resulting in a total dose per rat of 0.6 or 1.2 mmol. Nitrosodimethylurea and nitroso-1-methyl-3-ethylurea gave rise primarily to tumors of the nervous system, whereas nitrosodiethylurea and nitroso-1-ethyl-3 methylurea gave rise to tumors of the mammary gland, lung, intestinal tract, nervous system, and testicular mesotheliomas. The effect of nitrosodimethylurea was weaker than that of the other three compounds, as measured by rate of mortality with tumors. Drinking water treatment was less effective than treatment by gavage, by the same criterion. The tumorigenic effects paralleled those of the corresponding monoalkylnitrosourea, suggesting the presence in the target organs of receptors for which ethylnitrosoureas or methylnitrosoureas, respectively, have affinity. PMID- 2778849 TI - Effect of 1,3-dinitrobenzene on prepubertal, pubertal, and adult mouse spermatogenesis. AB - Exposure of prepubertal, pubertal, and adult mice to 0, 8, 16, 32, 40, or 48 mg 1,3-dinitrobenzene (m-DNB)/kg body weight and measuring responses 1-25 d posttreatment (dpt) demonstrated significant effects on testicular function only at 48 mg/kg dosage. m-DNB had no effect on body or testis weights with the exception of reduced adult mouse testis weights at 22 dpt with 48 mg/kg (p less than .05). None of the exposures resulted in detectable levels of germinal epithelial cells in the ductus epididymis. Exposure of prepubertal and pubertal mice to m-DNB caused only minimal nonsignificant changes in the relative percent of testicular cell types present up to 25 dpt. The adult mice testicular cell type ratios, in particular the round and elongating spermatid populations, changed significantly at doses of 48 mg/kg. Also, a reduction in the percent tetraploid cells occurred at d 1, suggesting these cells may be a primary target of m-DNB action. Caput and caudal sperm from mice exposed to m-DNB prior to puberty did not demonstrate an increased susceptibility to DNA denaturation when analyzed by the sperm chromatin structure assay. However, in pubertal mice, m-DNB exposure further exaggerated the abnormal chromatin structure that normally characterizes sperm during the onset of sperm production. In adult mice, 48 mg/kg resulted in increased susceptibility to DNA denaturation of caput sperm chromatin at 11 dpt (p less than .05) and in caudal sperm at 22 dpt (p less than .01). The abnormal chromatin structure of cauda sperm from adult mice was highly correlated with sperm head morphology abnormalities (ABN; 0.82 to 0.95, p less than .01, 11 and 22 dpt, respectively), but showed lower correlations with dose (0.60 to 0.79, p less than .01, 11 and 22 dpt, respectively). For pubertal mice, a positive relationship was also observed between the variation of sperm chromatin structure abnormalities and ABN. The effect of m-DNB on testicular function in prepubertal and pubertal mice appear to be less pronounced than in adult mice. Furthermore, following exposure to the same dosage, the effect of m-DNB is less severe in adult mice than that observed for adult rats as reported in the companion paper. PMID- 2778850 TI - Flow cytometric analysis of effects of 1,3-dinitrobenzene on rat spermatogenesis. AB - Exposure of 100-d old rats to 1,3-dinitrobenzene (m-DNB) at dosages up to 48 mg/kg resulted in disruption of spermatogenesis as measured by flow cytometry (FCM) of acridine orange-stained sperm and testis cells. One day (d 1) after a single exposure to 48 mg/kg m-DNB, FCM measurements of caput epididymal fluid cells demonstrated the presence of testicular germinal epithelial cells apparently sloughed off into the epididymis. Also, at d 1 after the same exposure, a decrease in pachytene spermatocytes was observed. By d 16 after exposure to 32 or 48 mg/kg, testicular damage was evidenced by an alteration of cell type ratios in FCM-analyzed populations of testicular cells. Extensive recovery of cell type ratios occurred by d 32. At d 16, dosages of 32 and 48 mg/kg caused alterations of sperm chromatin structure as determined by the flow cytometric sperm chromatin structure assay (SCSA); 48 mg/kg caused alterations at both d 16 and d 32. Exposure to m-DNB caused a dose response increase in percent sperm head morphology abnormalities (%ABN) assessed in cauda epididymal and vas sperm. A slightly higher correlation existed between dose and SCSA alpha t values (d 16, .78; p less than .01) than between dose and %ABN (d 16, .70; p less than .01). Also, a higher correlation existed between standard deviation of alpha t (SD alpha t) values and %ABN (.97; p less than .01) than between dose and %ABN (.70; p less than .01). This study demonstrated rapid and unique FCM procedures originally derived for reproductive toxicology studies in mice to be equally useful for studies in rats. PMID- 2778851 TI - Effects of sulfur oxides on eicosanoids. AB - Ultrafine metal oxides and SO2 react during coal combustion or smelting operations to form primary emissions coated with an acidic SOx layer. Ongoing work in this laboratory has examined the effects of sulfur oxides on pulmonary functions of guinea pigs. We have previously reported that 20 micrograms/m3 acidic sulfur oxide as a surface layer on ultrafine ZnO particles decreases lung volumes, decreases carbon monoxide diffusing capacity, and causes lung inflammation in guinea pigs after 4 daily 3-h exposures. It also produces bronchial hypersensitivity following a single 1-h exposure. The importance of this surface layer is demonstrated by our observation that 200 micrograms/m3 of sulfuric acid droplets of equivalent size are needed to produce the same degree of hypersensitivity. This study characterized the concentration-dependent effects of in vivo exposures to sulfur oxides on arachidonic acid metabolism in the guinea pig lung, and investigated the time course and the relation between eicosanoid composition and pulmonary functions. We focused specifically on four cyclooxygenase metabolites of arachidonic acid, that is, prostaglandins (PG) E1, F2 alpha, 6-keto prostaglandin F1 alpha, and thromboxane (Tx) B2, and two groups of sulfidopeptide leukotrienes (C4, D4, E4, and F4). Guinea pigs were exposed to ultrafine ZnO aerosol (count median diameter = 0.05 microns, sigma g = 1.80) with a layer of acidic sulfur oxide on the surface of the particles. Lung lavage was collected after exposures, and the levels of arachidonic acid metabolites were determined using radioimmunoassay (RIA). Concentration-dependent promotion of PGF2 alpha and concentration-dependent suppression of LtB4 were observed. The increased PGF2 alpha was associated with depressed vital capacity and diffusing capacity of the lungs measured in guinea pigs exposed to the same atmosphere described in a previous study. There is no causal relationship between the levels of other arachidonic acid metabolites and the pulmonary functional changes after exposures to these aerosols. PMID- 2778852 TI - Non-specific cardiovascular depressant effect of methyl isocyanate (MIC) in rats. AB - Methyl isocyanate (MIC) either inhaled (5, 10 mg/lit) or administered by intravenous (5, 10, 28 mg/kg) or subcutaneous (1300, 1500 mg/kg) routes produced a dose dependent fall in blood pressure (BP) and heart rate (HR) in anaesthetised rats. Higher doses (10 mg/lit inhalation, 10 & 28 mg/kg i.v., 1500 mg/kg s.c.) increased the lung body weight index (LBI) and tracheobronchial resistance (TBR) concomitant with gross pulmonary damage and edema. However, lower doses (5 mg/lit inhalation, 5 mg/kg i.v., 1300 mg/kg s.c.) produced the cardiovascular depressant effect without affecting LBI, lung morphology and TBR. The effects of MIC on BP, HR and TBR were not counteracted by muscarinic, histaminic and 5-HT receptor blockers and by vagotomy. Studies with hydrolysis products of MIC showed that relatively large doses of methylamine (MA) and dimethylurea (DMU) (i.v.) produced cardiovascular depressant effects, without affecting the LBI & TBR. The results indicate that the cardiovascular depressant effect of MIC may not be entirely a sequel to its effect on respiratory organs, release of vasoactive substances or its hydrolysis products. A non-specific cardiovascular depressant effect of MIC is suggested. PMID- 2778853 TI - Mutagenicity tests on propiverine hydrochloride. AB - 1. The reverse mutation test was carried out on propiverine hydrochloride (P-4) at dose range of 5-500 micrograms/plate use Salmonella typhimurium strains, TA100, TA98, TA1535 and TA1537, and Escherichia coli strain WP2uvrA. As compared with solvent-treated control, no significant increases were observed in the number of revertant colonies in all tester strains in both systems with and without mammalian metabolic activation (S9 Mix). 2. The chromosomal aberration test was also carried out on P-4 using cultured Chinese hamster lung cells (CHL). The cells were treated with P-4 at the doses of 5, 10, 20 and 40 microM without S9 Mix and at 62.5, 125, 250 and 500 microM with S9 Mix. No significant differences were found in the incidence of structural- and numeral-aberrations of chromosomes in both systems with and without S9 Mix. 3. These results indicate that P-4 has no mutagenic activity. PMID- 2778854 TI - Antigenicity tests on propiverine hydrochloride in guinea pigs and mice. AB - Antigenicity of propiverine hydrochloride (P-4), a newly developed drug for pollakisuria, was investigated in guinea pigs and mice. 1. Two strains of mice (BALB/c and C3H/He) showed no production of antibodies against P-4 inoculated with aluminum hydroxide gel (alum) as an adjuvant, judged by the heterologous passive cutaneous anaphylaxis (PCA) test using rats. On the other hand, antibodies against P-4-ovalbumin (OVA) conjugate inoculated with alum was definitely detected. 2. In the studies with guinea pigs, both the inoculation of P-4 alone and of P-4 with Freund's complete adjuvant (FCA) as an adjuvant did not produce positive reactions in any of homologous passive cutaneous anaphylaxis (PCA), active systemic anaphylaxis (ASA) and passive hemagglutination (PHA) tests. On the other hand, the inoculation of P-4-OVA conjugate with FCA produced positive reaction in all of PCA, ASA and PHA tests. 3. In the active cutaneous anaphylaxis (ACA) test in guinea pigs inoculated with P-4-OVA conjugate with FCA, positive reaction was produced by eliciting injection of P-4-human serum albumin (HSA). 4. In the Schultz-Dale reaction test, any animals in any groups showed no positive reaction to both eliciting antigens, P-4 and P-4-HSA. 5. These findings showed that P-4 had no antigenicity in guinea pigs and mice. PMID- 2778855 TI - Effect of alpha-naphthylisothiocyanate on blood clearance of 99mTc-phytate in dogs. AB - The effect of alpha-naphthylisothiocyanate (ANIT) on blood clearance of 99mTc phytate (99mTc-P) in dogs was examined, and blood clearance test of 99mTc-P was compared with the cases of serum transaminase test or serum bilirubin test. Serum transaminase and bilirubin levels in dogs increased after ANIT administration, however, the degree of increase in these parameters was much lower than the cases in rats. The disappearance rate of 99mTc-P from blood in dogs decreased with the increase in dose of ANIT and with the passage of time after the ANIT administration. Changes of the blood clearance of 99mTc-P after ANIT treatment in dogs may be influenced by the disorder in the hepatocytes rather than in the bile ductule cells. The blood clearance test of 99mTc-P in dogs showed a sensitive reaction for the acute hepatic dysfunction induced by ANIT equally to the serum transaminase test or the serum bilirubin test. PMID- 2778857 TI - [Bacteriological study of chronic paranasal sinusitis]. AB - Analysis was done on the bacteria flora and the antibiotic sensitivity of 533 maxillary sinuses in 430 patients with chronic sinusitis treated at the Kaohsiung Medical College Hospital during the past 10 years. Among antral flora, Streptococcus sp. were the most common (212 strains, 38.4%), followed by Staphylococcus epidermidis (140 strains, 25.4%) and Staphylococcus aureus (33 strains, 5.9%). These three G(+) bacteria made up 70% (69.87%) of the total. The percentage of gram-negative and anaerobic bacteria was 20.8% and 8.7%, respectively. Of the total bacteria cultures, 17.8% showed no-growth. These results were similar to those reported in a similar study 10 years before. For the Streptococci and Staphylococci (70% of the total number), the most susceptible antibiotics in vitro were cephalosporin, followed in order by clindamycin, erythromycin, chloramphenicol, and cotrimoxazole. The effectiveness of ampicillin, gentamicin, minocycline appears to have been decreasing in the past 10 years. Tetracycline and penicillin effectiveness was worse. The susceptibility spectrum of the G(-) bacteria did not appear greatly changed from 10 years ago, for example, colistin and newly-synthesized aminoglycoside were rather sensitive. In addition a review was conducted of related papers of the past 70 years with a discussion of some controversial problems. PMID- 2778856 TI - Multiplicity of spontaneous lung tumors in CD-1 mice. AB - The multiplicity of the spontaneous lung tumor in CD-1 mice was investigated in 413 males from 6 different control groups of 2-year carcinogenicity studies with agrochemicals. Among a total of 152 lung tumor bearers, 95 (62.5%) were seen with 1 nodule, 36 (23.7%) with 2 nodules, and 14 (9.2%) with 3 nodules. Three males bore 4 nodules and each of 5, 7, 9 and 10 nodules was seen in one male, respectively. In one control group 20 out of 30 lung tumor bearers had 2 or more nodules presenting a significant heterogeneity among the control groups in terms of the multiplicity of lung tumor nodule. PMID- 2778858 TI - [Self-concept of school-age children: the norm in Kaohsiung]. AB - This study has two objectives: (1) to establish the norm of three graphical projective tests (Children's Social-Self Test, Children's Attitude Inventory and Children's Self-Concept Inventory), and (2) to explore the influence of sex, order of birth, social economic status of family, and leadership of class that effect self-concept of the school-age children. These subjects are selected from elementary schools in Kaohsiung, twenty-two classes are drawn out from each grade by systemic-random sampling. Then two classes are drawn out from 22 classes at random to arrange retest for reliability. The total subjects are 6207 students. From October 1987 to June 1988, six researchers are divided into three group to conduct the test. Besides establishing the norm, we find results from analysis of data as follow: 1. The reliability and validity of three graphical projective tests are good, they can be used for assessing the self-concept of school-age children. 2. The grade, sex, order of birth, social economic status of family, leadership of class all influence the self-concept of school-age children. 3. The self-concept and the grade has negative correlation. 4. The self-concept and the social economic status of family has positive correlation. 5. The girls have higher self-concept than the boys. 6. The order of first-born or second-born has higher self-concept than the others. 7. The ones who are leaders of class have higher self-concept than the others. PMID- 2778860 TI - [Extent of the gastric antrum in duodenal ulcer patients]. AB - The extent of the gastric antrum in duodenal ulcer patients and the relationship between the first antral branch of the vagal nerve and proximal delimitation of antrum were examined using resected gastric specimens of 46 duodenal ulcer patients. It has been demonstrated that: (1) There was a variable extent of measured distance from the pyloric ring to the antrum-corpus boundary (intermediate zone), and it ascended with age along the lesser curvature. (2) The intermediate zone was a transitional change of the fundic and pyloric gland area. The change on the lesser curvature was abrupt, but on the greater curvature it was gradual. It displaced distally on the greater curvature, and was found to be symmetrical on the anterior and posterior walls. (3) The proximal delimitation of the antrum lay on the lesser curvature where the first antral branch of the vagal nerve reached the lesser curvature topographically. (4) At the lesser curvature, the antrum-corpus boundary was found to be located within +/- 2 cm from the first antral branch in 93.5% of the cases. It may be a useful landmark to decide the proximal boundary of gastric antrum while performing antrectomy. (5) The shrinkage factor for specimens after 10% formalin fixation appeared to be between 0.7 and 0.9. PMID- 2778859 TI - [Erythrocyte deformability in experimental state and diseased RBC]. AB - By Reid's functional test of erythrocyte deformability, the filtration time of 1 ml 5% erythrocyte suspension through a 5 micron nucleopore membrane was measured from 18 normal people and 19 patients with thalassemia. In the control group, the filtration time at 37.0 degrees C and pH 7.4 was 3.26 +/- 0.38 sec. Erythrocyte deformability was constant while blood temperature stayed between 35.0 degrees C and 42.0 degrees C. However the erythrocyte filtration time prolonged as the blood became alkaline or incubated for more than 2 hours. The filtration time of blood was 4.56 +/- 1.02 sec for thalassemia patients, significantly different (p less than 0.01) as comparing to the normal control group. Poor deformability in diseased blood could be explained by membrane defect. Erythrocyte deformability is a good rheological indicator if the physiological conditions of blood is controlled well. PMID- 2778861 TI - [Lead intoxication in shipscrapping employees in Taiwan]. AB - The shipscrapping industry in Taiwan is located at Kaohsiung harbor. The scrapping yard at Kaohsiung can be divided into the "Da-Jen" area and the "Da Lin" area, including 23 and 13 docks respectively. About 5000-8000 dock workers are employed in the yard. Because shipscrapping has been considered to be a "temporary" industry by the secondary metal dealers, so the dealers did not well equip and offer the appropriate safety and health programs for the industry. Of those who work on the docks the metal burners are those most continuously exposed to substantial amounts of inorganic lead and other unidentified metals along with health stresses such as noise, asbestos, explosions and accidents. In this study, 140 oxyacetylene torch metal burners (83 working on scrapping ships and 57 working at the yard) and 21 dock workers without direct lead exposure as the control group were included. The mean values of blood lead and urine lead were 63.22 +/- 22.04 micrograms/d1 and 122.15 +/- 44.10 micrograms/1 for metal burners on the ship, and 65.25 +/- 37.11 micrograms/d1 and 101.54 +/- 37.11 micrograms/1 for the metal burners at the yard, values for the control group were 37.24 +/- 20.63 micrograms/d1 and 67.62 +/- 38.39 micrograms/1 respectively. The subjective symptoms mainly were fatigue, numbness over extremities, headache and dizzness. There were 49 metal burners, 35% of the total burners examined in this study, whose blood lead exceeded 80 micrograms/d1 with more than 2 suspicious intoxication symptoms. The precautions in terms of environmental mornitoring, medical surveillance and engineering control should be taken. PMID- 2778863 TI - A case of gigantiform cementoma associated with multiple unerupted teeth. AB - Both the occurrence of gigantiform cementoma in the jaws or multiple unerupted teeth are very rare conditions. The purpose of this paper is to report on a case of a combination of these two conditions and to review relevant literature. A 47 year-old dwarfish male was referred to our Oral and maxillofacial Surgical Department with the chief complaint of pain and swelling in the right lateral nasal region with the discharge of pus from the right upper premolar area. Clinical and roentgenographic examinations revealed that there were 17 unerupted teeth and some radiopaque and radiolucent shadows on both jaws. This patient was treated with saucerization and extraction of unerupted teeth on the right upper and lower jaws for controlling infected lesions. A surgical specimen was sent for histopathological examination and the report indicated gigantiform cementoma. PMID- 2778862 TI - Surgical treatment of bleeding and perforated peptic ulcer diseases. AB - From 1977 to 1988, 556 patients underwent emergency surgery for complicated peptic ulcers. Among them, 409 patients were for treated perforations and 147 for hemorrhages. In the perforated ulcer category, the morbidity rate was 12.5% and mortality rate 6.8%. For bleeding ulcers, the morbidity rate was 27.2% and mortality rate 14.9%. Several risk factors, such as age, interval of time between perforation and surgery, blood loss, associated disease, and shock were found to have created a higher operative risk. A definitive surgery including vagotomy and drainage, vagotomy and antrectomy, partial gastrectomy and highly selective vagotomy could be safely performed with an acceptable mortality for properly selected cases. Follow-up results also indicated better scores in this group of patients. We concluded that a definitive ulcer operation is safe, acceptable and curative for low risk patients with perforated or bleeding ulcers. PMID- 2778864 TI - [The chemistry of quaternary aporphine alkaloids]. AB - Methine and isomethine bases and bismethine compounds can be derived together from the treatment of excess diazomethane on quaternary aporphine alkaloids. The result of this reaction can be described as the E2 mechanism. Heat treatment of aporphine N-oxides produces Cope elimination and forms phenanthrene hydroxylamine derivatives. The biogenetic pathway from aporphines to phenanthrenes can be elucidated by this reaction. PMID- 2778865 TI - Intraoperative antegrade colon irrigation--in the management of obstructing left sided colon cancer. AB - The management of obstructing left-sided colon cancer remains controversial. The advent of intraoperative antegrade colonic irrigation (I.A.C.I.) has allowed primary anastomosis to be performed in the obstructed bowel. From July 1985 to Feb. 1989, there were eleven patients with obstructing left-sided colon cancer admitted to Changhwa Christian Hospital. Eight of these patients, five men and three women, age ranged from 31 to 80 years old, accepted the I.A.C.I. procedure and followed by the one-staged operations. The I.A.C.I. procedure was advocated by Dudley et al in 1980. Postoperatively, there was no case which suffered from clinical leakage or sepsis, except two cases with mild wound infection. Consequently, there was no operative mortality. PMID- 2778866 TI - [Diagnosis and treatment of adult polycystic kidney disease]. AB - A review of 20 polycystic kidney disease patients in admitted to Kaohsiung Medical College Hospital is herein reported. In this series 60% of the patients were in the fourth to sixth decades of life at the time of diagnosis. The average age was 50 years. The disease was generally more commonly found in the females than in male subjects. Flank pain and gross hematuria was the most common presenting symptom in these cases. In 70% of the patients hypertension were noted, besides 55% of patients have associated liver cysts and 9% of the patients have associated pancreatic cystic diseases. In a comparison of ultrasonography, CT scans, renal angiography, intravenous pyelography and retrograde pyelography in the evaluation of polycystic kidney disease, it was found that CT scans and ultrasonography had more than a 90 per cent diagnostic accuracy rate, while intravenous pyelography had only a 30 percent accuracy rate. Because of improved treatments such as antibiotic and hemodialysis techniques the five-year survival rate of patients, with polycystic kidney diseases, may be increased. PMID- 2778867 TI - [The effects of metrizamide myelography on electroencephalographic changes]. AB - Metrizamide, a non-ionic water soluble contrast medium, is used in myelography for detecting spinal cord lesions. Because it is an injection in the subarachnoid space, the effects on the central nervous system following metrizamide myelography should be studied. Electroencephalography can offer a non-invasive and objective method for evaluating the functions of the central nervous system. From September to December 1986, 30 cases which had received cervical or lumbar metrizamide myelography were collected. After myelography, in addition to a history review and neurologic examination, electro-encephalography was carried out within 24 hours. If the EEG record revealed abnormal, a series of EEG follow ups were conducted until recordings were normal. The incidence of clinical adverse effects following Metrizamide myelography was 53.3% and 66.6% respectively in cervical and lumbar injections. No significant difference was found between the two groups. Secondly, the abnormal rate of the EEG record was 40.0% and 60.0% following cervical and lumbar myelography. The difference was also not significant. Lastly, the relation between clinical adverse effects and an abnormal EEG records was poor in cervical metrizamide myelography but good in lumbar myelography. The conclusions suggested by this research that the clinical adverse effects and the abnormal EEG record after metrizamide myelography are transient and are reversible changes. The mechanism of complications following cervical and lumbar metrizamide are different. Although complications may occur following cervical and lumbar metrizamide myelography, it remains a practical method in detecting spinal cord lesions. PMID- 2778868 TI - [The effect of gastrectomy on cholecystokinin (CCK) release and gallbladder contraction in patients with early gastric cancer--preliminary report]. AB - Gastrectomy has been implicated in cholelithiasis. Impaired gallbladder motor function after the operation has been thought to be one of the major mechanisms. This study was undertaken to determine the effect of gastrectomy on release of cholecystokinin and contractile motility of gallbladder in five patients with early gastric cancer. After 14 hours fast, the gallbladder area was estimated by ultrasonography every 10 minutes for 120 minutes both before and after oral administration of 200 ml of Clinimeal. Blood samples were collected simultaneously via a peripheral vessel for measurement of plasma CCK levels by radioimmunoassay. Gallbladder contraction correlated well with the elevation of plasma CCK levels indicating that CCK might be one of the major factors governing gallbladder contraction both in pre- and post-gastrectomized conditions. Compared with preoperative cases, the postgastrectomized patients showed a significantly exaggerated postprandial response of CCK release in the initial 60 minutes, however, their gallbladder, responding to rapid reduction of plasma CCK levels, refilled significantly earlier. Postprandial rapid gastric emptying was thought to be related to the exaggerated postprandial CCK release, and the early refilling of the gallbladder might be attributed to the indefinite vagal or sympathetic denervation that might occurs during the necessarily wide lymph node dissections for gastric cancer operations. PMID- 2778869 TI - [Experimental control study of fasciolopsiasis in Taiwan]. AB - This study was conducted from March 1985 to September 1987 among the pupils of Chung-Ying Primary School of Hsia-Ying township in Tainan Country, Southern Taiwan. Health education revealed the preferred control method against Fasciolopsis infection in this study. The education method included lectures, demonstrations of parasites and home visits at regular intervals. The subjects included the staff and children of the school and all family members. At the same time, the children infected with Fasciolopsis were treated with praziquantel in June, 1986. Fecal material of the all primary school children of Hsia-Ying township was examined with the antiformin-ether concentration method. One year before control the positive rate of Fasciolopsis was 25.1%. One year after control in March 1986, it was decreased to 9.5%. Two and a half years after control in September 1987, it was farther brought down to 1.0%. The x2-test of positive rate showed statistically different. Health education with medication is recommended for the control of fasciolopsiasis. PMID- 2778870 TI - A highly suspected radiation-associated thyroid cancer: report of 1 case. AB - The association between head and neck irradiation and the development of malignant thyroid tumor is well established. The first case was detected by Duff and Fitzgerald in 1950, and it was well documented in publications during the 1950's and early 1960's. But it was rarely reported in Taiwan. Incident rates of irradiation-induced thyroid cancer of 6% to 7% have been reported. These patients developed tumors on an average of 20 years after X-ray exposure and were nearly all under 35 years of age. We reported a case with a female patient, who was treated with 60Co for eosinophilic granuloma in her occipital area at the age of 4 to 5 years. Twenty years later, it was observed that she had developed thyroid cancer. We once again refer to the literature to draw the attention to the public in regard to radiation-associated thyroid cancer in Taiwan. PMID- 2778871 TI - Duplication of the aortic ring. An artifact in echocardiography. AB - Duplication or widening of the aortic ring is commonly observed in echocardiography. This imaging artifact arises from refraction of a portion of the sound beam by an unossified costal cartilage in the anterior chest wall. When the cartilage is situated in line with the edge of the aortic ring or just lateral to it, the artifact is produced. Given the anatomy of the costal cartilages, chest wall, and heart, the amount of refraction is calculated and compared with the amount of refraction actually observed in scans. The degree of duplication or widening of the aortic ring depends directly on the curvature of the costal cartilage and the distance between the cartilage and the aortic ring. PMID- 2778872 TI - Nuclear factors that bind to the enhancer region of nondefective Friend murine leukemia virus. AB - Nondefective Friend murine leukemia virus (MuLV) causes erythroleukemia when injected into newborn NFS mice, while Moloney MuLV causes T-cell lymphoma. Exchange of the Friend virus enhancer region, a sequence of about 180 nucleotides including the direct repeat and a short 3'-adjacent segment, for the corresponding region in Moloney MuLV confers the ability to cause erythroid disease on Moloney MuLV. We have used the electrophoretic mobility shift assay and methylation interference analysis to identify cellular factors which bind to the Friend virus enhancer region and compared these with factors, previously identified, that bind to the Moloney virus direct repeat (N. A. Speck and D. Baltimore, Mol. Cell. Biol. 7:1101-1110, 1987). We identified five binding sites for sequence-specific DNA-binding proteins in the Friend virus enhancer region. While some binding sites are present in both the Moloney and Friend virus enhancers, both viruses contain unique sites not present in the other. Although none of the factors identified in this report which bind to these unique sites are present exclusively in T cells or erythroid cells, they bind to three regions of the enhancer shown by genetic analysis to encode disease specificity and thus are candidates to mediate the tissue-specific expression and distinct disease specificities encoded by these virus enhancer elements. PMID- 2778874 TI - A system for studying the selective encapsidation of hepadnavirus RNA. AB - All hepadnaviruses produce multiple genome-length RNA species, only one of which is encapsidated into subviral core particles prior to reverse transcription. To study the encapsidation mechanism, we developed a system in which the packaging of genetically marked target genomes of duck hepatitis B virus is mediated by factors supplied from a separate (helper) plasmid that encodes encapsidation functions. In the helper plasmid, the synthesis of the viral core and polymerase proteins was driven by a simian virus 40 promoter; the RNA produced by this construct was itself inefficiently packaged and was not active as a template for reverse transcription. Cotransfection of this construct with mutant genomes bearing frameshift lesions in either core or polymerase cistrons resulted in the successful packaging and reverse transcription of the mutant genomes. This system should allow definition of both the cis- and trans-acting elements of the encapsidation pathway. PMID- 2778873 TI - Characterization of enhancer elements and their mutations in the long terminal repeat of feline endogenous RD-114 proviruses. AB - To locate the enhancer regions of the feline endogenous RD-114 long terminal repeat (LTR), we examined expression of the chloramphenicol acetyltransferase gene driven by various segments of the U3 region from two different proviral loci (CRL3 and CR1). Transient expression assays demonstrated that the primary signal sequence for transcription enhancement was located within the 63-base-pair (bp) element of the CRL3 DNA occurring between positions -184 and -121 from the CAP site (+1), whereas the similar region of CR1 was almost inactive. This element from both CRL3 and CR1 contained a single 30-bp sequence (direct repeat [DR]-B2) found in duplicate tandem copies in the LTR of the infectious RD-114 provirus. Two 9-bp inverted repeats marked the DR-B unit of the active element, and a prominent base deletion in one of these repeats in CR1 DNA appeared to be related to loss of enhancer activity. Another segment of CRL3 (-296 to -184), also displaying enhancer function, contained tandem repeated sequences (DR-A1 and DR A2). The Dr-A2 unit, which lacked the 5' 20-bp sequence of the 47-pb DR-A1, could not function as an enhancer by itself, but it contributed to enhancer effects in cooperation with either the DR-A1 or DR-B2 region. The CR1 LTR contained a single DR-A1 sequence with extensive mutations, and the region (-313 to -181) containing this DR-A1 unit was nonfunctional, similar to the DR-B2 region of CR1. Site directed mutagenesis analysis of another enhancer element, an octamer motif occurring between CAAT and TATA boxes of all RD-114 LTRs sequenced, revealed that this element was necessary for full enhancer function of the U3 region but with a variable effect, depending on the cell types in which chloramphenicol acetyltransferase expression was determined. PMID- 2778875 TI - Genital mucosal transmission of simian immunodeficiency virus: animal model for heterosexual transmission of human immunodeficiency virus. AB - An animal model for the heterosexual transmission of human immunodeficiency virus (HIV) was developed by the application of simian immunodeficiency virus (SIV) onto the genital mucosas of both mature and immature, male and female rhesus macaques. Virus preparations were infused into the vaginal vaults or the urethras (males) of the animals through a soft plastic pediatric nasogastric feeding tube. The macaques that were infected by this route (six males and nine females) developed SIV-specific antibodies, and SIV was isolated from peripheral mononuclear cells of all seropositive animals. One male and one female infected by this route developed severe acquired immunodeficiency syndrome-like disease with retroviral giant-cell pneumonia. As few as two inoculations of cell-free SIV containing 50 50% tissue culture infective doses induced persistent viremia. Cell free virus preparations were capable of producing infection by the genital route. Much higher doses of virus were required to transmit SIV by this route than are required for transmission by intravenous inoculation. Thus, it appears that the mucous membranes of the genital tract act as a barrier to SIV infection. Spermatozoa and seminal plasma were not required for the genital transmission of SIV. Rarely, SIV was recovered from mononuclear cells in semen and vaginal secretions. The SIV-rhesus macaque model is suitable for assessing the role of cofactors in heterosexual transmission of HIV and will be useful for testing the effectiveness of spermicides, pharmacologic agents, and vaccines in preventing the heterosexual transmission of HIV. PMID- 2778876 TI - Fatty acid acylation of vaccinia virus proteins. AB - Labeling of vaccinia virus-infected cells with [3H]myristic acid resulted in the incorporation of label into two viral proteins with apparent molecular weights of 35,000 and 25,000 (designated M35 and M25, respectively). M35 and M25 were expressed in infected cells after the onset of viral DNA replication, and both proteins were present in purified intracellular virus particles. Virion localization experiments determined M25 to be a constituent of the virion envelope, while M35 appeared to be peripherally associated with the virion core. M35 and M25 labeled by [3H]myristic acid were stable to treatment with neutral hydroxylamine, suggesting an amide-linked acylation of the proteins. Chromatographic identification of the protein-bound fatty acid moieties liberated after acid methanolysis of M25, isolated from infected cells labeled during a 4-h pulse, resulted in the recovery of 25% of the protein-bound fatty acid as myristate-associated label and 75% as palmitate, indicating that interconversion of myristate to palmitate had occurred during the labeling period. Similar analyses of M25 and M35, isolated from infected cells labeled during a 0.5-h pulse, determined that 46 and 43%, respectively, of the protein-bound label had been elongated to palmitate even during this brief labeling period. In contrast, M25 and M35 isolated from purified intracellular virions labeled continuously during 24 h of growth contained 75 and 70%, respectively, myristate-associated label, suggesting greater stability of these proteins or a favored interaction of the proteins containing myristate with the maturing or intracellular virion. PMID- 2778877 TI - Cloned hepatitis delta virus cDNA is infectious in the chimpanzee. AB - A head-to-tail trimer of a full-length cDNA clone of the hepatitis delta virus (HDV) genome was examined for infectivity by direct inoculation into the liver of a chimpanzee that was already infected with hepatitis B virus. Five weeks after inoculation, a marked elevation of serum alanine aminotransferase activity was observed, followed by the appearance of high levels of HDV RNA and antigen in both liver and serum and a high level of viral particles in the serum. A transient suppression of hepatitis B virus replication was evident during the acute phase of HDV infection. Seroconversion for antibodies to delta antigen occurred 3 weeks after the onset of the disease. These results demonstrate that a typical HDV infection can be initiated by inoculation of a susceptible animal with recombinant HDV cDNA. PMID- 2778878 TI - The terminal regions of adenovirus and minute virus of mice DNAs are preferentially associated with the nuclear matrix in infected cells. AB - The interaction of viral genomes with the cellular nuclear matrix was studied by using adenovirus-infected HeLa cells and minute virus of mice (MVM)-infected A-9 cells. Adenovirus DNA was associated with the nuclear matrix both early and late in infection, the tightest interaction being with DNA fragments that contain the covalently bound 5'-terminal protein. Replicative forms of MVM DNA were also found to be exclusively matrix associated during the first 16 to 20 h of infection; at later times viral DNA species accumulated in the soluble nuclear fraction at different rates, suggesting a saturation of nuclear matrix-binding sites. MVM DNA fragments enriched in the matrix fraction were also derived from the terminal regions of the viral genome. However, only the subset of fragments which possess a covalently bound 5'-terminal protein (i.e., DNA fragments in which the 5' palindromic DNA sequences are in the extended duplex rather than the hairpin conformation) were matrix associated. These observations suggest that the DNA-matrix interactions are, at least in part, mediated by the viral terminal proteins. Since these proteins have previously been shown to be intimately involved in viral DNA replication, our results further indicate that an association with the nuclear matrix may be important for viral genome replication and possibly also for efficient gene transcription. PMID- 2778879 TI - Nucleotide sequence required for resolution of the concatemer junction of vaccinia virus DNA. AB - The mature form of the vaccinia virus genome consists of a linear, 185,000-base pair (bp) DNA molecule with a 10,000-bp inverted terminal repetition and incompletely base-paired 104-nucleotide hairpin loops connecting the two strands at each end. In concatemeric forms of intracellular vaccinia virus DNA, the inverted terminal repetitions of adjacent genomes form an imperfect palindrome. The apex of this palindrome corresponds in sequence to the double-stranded form of the hairpin loop. Circular plasmids containing palindromic concatemer junction fragments of 250 bp or longer are converted into linear minichromosomes with hairpin ends when they are transfected into vaccinia virus-infected cells, providing a model system with which to study the resolution process. To distinguish between sequence-specific and structural requirements for resolution, plasmids with symmetrical insertions, deletions, and oligonucleotide-directed mutations within the concatemer junction were constructed. A sequence (ATTTAGTGTCTAGAAAAAAA) located on both sides of the apex segment was found to be critical for resolution. Resolution was more efficient when additional nucleotides, TGTG, followed the run of A residues. Both the location and sequence of the proposed resolution signal are highly conserved among poxviruses. PMID- 2778880 TI - Characterization of the translational defect to fiber synthesis in monkey cells abortively infected with human adenovirus: role of ancillary leaders. AB - Synthesis of the fiber protein of human adenovirus serotype 2 (Ad2) is 100-fold lower in abortively infected monkey cells, compared with productive infections, despite only a 5- to 10-fold reduction in fiber mRNA levels. Previously Anderson and Klessig (Proc. Natl. Acad Sci. USA 81:4023-4027, 1984) demonstrated a direct correlation between the productive nature of the infection, efficient synthesis of the fiber protein in vivo, and the presence of the x or y ancillary leaders on 10 to 25% of fiber messages. To determine at what level in translation these leaders might be important, the relative rate of initiation and elongation of each class of fiber message was assessed. The presence of the y ancillary leader in productively infected cells increased the rate of initiation about twofold, although translational elongation was similar on all fiber messages. However, the rate of elongation of all fiber messages was threefold slower in abortively infected than in productively infected cells. This reduced elongation rate in abortive infections was specific for fiber. The similar distribution of fiber mRNAs on polysomes in both infections suggests that initiation must also be partially blocked in abortive infections. Since the majority of the fiber mRNA even in productive infections did not contain the ancillary leaders, the initiation and elongation defects in the abortive infection cannot be fully explained by the absence of these leaders. Therefore, other factors in the infected cell must be influencing the rate of translation. PMID- 2778882 TI - Common cleavage pattern of polysialic acid by bacteriophage endosialidases of different properties and origins. AB - The cleavage specificities of seven bacteriophage endosialidases degrading the alpha 2-8-linked polysialic acid common to bacterial polysaccharides and to the cell adhesion molecule N-CAM were investigated. The bacteriophages studied represented five different phenotypic groups by protein and DNA fragment analysis and two different morphology groups by electron microscopy. Characterization of the fragments arising from the native or chemically modified substrates of different sizes showed that cleavage specificity was influenced by enzyme concentration. At the initial phase of degradation, at concentrations ranging from 20- to 100-fold, the minimum substrate size was an oligomer of eight (in one case, nine) sialic acid units that was preferably cleaved at the same position. Under exhaustive conditions, the oligomers were degraded further, and each enzyme type had its own specificity. The similar initial cleavage of polysialic acid by endosialidases associated with phages of different properties and morphology suggests a conserved mechanism of enzyme-substrate interaction. This mechanism may be conformationally determined and related to the specific properties of polysialic acid in other molecular interactions. PMID- 2778881 TI - The cytoplasmic domain of simian immunodeficiency virus transmembrane protein modulates infectivity. AB - A striking characteristic of the simian immunodeficiency virus (SIV) and of the human immunodeficiency virus type 2 (HIV-2) is the presence of a nonsense mutation in the env gene resulting in the synthesis of a truncated transmembrane protein lacking the cytoplasmic domain. By mutagenesis of an infectious molecular clone of SIVmac142, we investigated the function of the cytoplasmic domain and the significance of the env nonsense mutation. When the nonsense codon (TAG) was replaced by a glutamine codon (CAG), the virus infected HUT78 cells with markedly delayed kinetics. This negative effect was counterselected in vitro as reversion of the slow phenotype frequently occurred. The sequencing of one revertant revealed the presence of a new stop codon three nucleotides 5' to the original mutation. Deletions or an additional nonsense mutation introduced 3' to the original stop codon did not modify SIV infectivity. In contrast, the same deletions or nonsense mutation introduced in the clone in which the stop codon was replaced by CAG abolished infectivity. These results indicated that the envelope domain located 3' to the stop codon is not necessary for in vitro replication. However, the presence of this domain in SIV transmembrane protein leads to a reduced infectivity. This negative effect might correspond to a function controlling the rate of spread of the virus during in vivo infection. PMID- 2778883 TI - Temperature-sensitive mutants identify crucial structural regions of simian virus 40 large T antigen. AB - We have completed the cloning and sequencing of all known temperature-sensitive, amino acid substitution mutants of simian virus 40 large T antigen (tsA mutants). Surprisingly, many of the mutants isolated from distinct viral strains by different laboratories are identical. Thus, 17 independently isolated mutants represent only eight distinct genotypes. This remarkable clustering of tsA mutations in a few "hot spots" in the amino acid sequence of T antigen and the temperature-sensitive phenotypes of the mutations strongly suggest that these amino acids play crucial roles in organizing the structure of one or more functional domains. Most of the mutations are located in highly conserved regions of T antigen that correlate with DNA binding, protein-protein interactions, or ATP binding. With the exception of one mutant with a lesion in the putative ATP binding region, all the mutants are temperature sensitive for DNA replication. PMID- 2778885 TI - Appraisal of adjuncts to prevent acute renal failure after surgery on the thoracic or thoracoabdominal aorta. AB - We evaluated 1525 consecutive patients who had undergone thoracic or thoracoabdominal aortic surgery to ascertain the factors associated with the development of acute renal failure. Complete data were available in 1233 patients who were treated recently, and these were analyzed. Acute renal failure, severe enough to require dialysis, developed in 5.5% of this group (68/1233): 2.3% and 7%, respectively, for descending (9/391) and thoracoabdominal repairs (59/842). Of interest, on multivariate analysis, both renal artery endarterectomy for occlusive disease (p = 0.0006) and chronic dissection (p = 0.03) were associated with significantly less acute renal failure. On multivariate analysis, the significant independent predictors (p less than 0.05) of acute renal failure were preexistent renal dysfunction, evidence of diffuse atherosclerosis, the use of the pump bypass, and markers of hemodynamic instability. Contrary to earlier reports based on a smaller number of patients, we found that neither the use of pump bypass (7% acute renal failure), atriorenal bypass (8% acute renal failure), nor cold Ringer's lactate (3% acute renal failure) appeared to significantly avert the complication of acute renal failure. Indeed, pump bypass appeared to be deleterious (p = 0.0146) and perfusion with cold Ringer's lactate was not without risk. Furthermore, in a prospective evaluation of angiotensin converting enzyme blockers, we were unable to show that they afforded renal protection after transient renal ischemia. This study has clarified the clinical problems associated with acute renal failure and lays the foundation for future research. PMID- 2778884 TI - Deletions in a recombinant retrovirus genome associated with its expression in embryonal carcinoma cells. AB - We analyzed embryonal carcinoma cell lines infected with a recombinant Moloney murine leukemia virus. Lines that carried but did not express the neo gene retained a provirus of LTR-gag-pol-neo-LTR, where LTR is a long terminal repeat, whereas all G418-resistant lines deleted regions that included the primer binding site and the splicing donor site. This suggested the presence of multiple inhibitory elements. PMID- 2778886 TI - Resection of abdominal aortic aneurysm in patients with low ejection fractions. AB - The perioperative and long-term survival of patients who undergo resection of abdominal aortic aneurysm is often determined by coexisting cardiac disease. This study evaluates the influence of left ventricular ejection fraction on both perioperative and long-term morbidity and mortality. Preoperative ejection fraction was measured in 104 of 208 patients undergoing elective abdominal aortic aneurysm resection. Nineteen patients were found to have ejection fractions less than 0.35, and this group was compared to 85 patients with ejection fractions greater than 0.35. The two groups did not differ significantly in terms of age, sex, preoperative renal function, or smoking status. The groups were significantly different with respect to the prevalence of prior myocardial infarction (79% of the low ejection fraction group vs 31% of the high ejection fraction group) and symptoms equivalent to New York Heart Association class II or greater (47% of the low ejection fraction group vs 24% of the high ejection fraction group) but not prior myocardial revascularization procedure (42% of the low ejection fraction group vs 31% of the high ejection fraction group). Surgical factors including aneurysm size, duration of aortic cross-clamping, and extent of arterial replacement did not differ significantly between the two groups. The perioperative mortality was not significantly different (low ejection fraction, 5%; high ejection fraction, 2%). The cumulative life-table survival of the two groups was not statistically different. Two patients in the low ejection fraction group died in the follow-up period, yielding a 4-year actuarial survival of 0.74. This is compared to 10 deaths and actuarial survival of 0.63 (p = NS) in the high ejection fraction group. We conclude that patients should not be denied aneurysm resection solely on the basis of left ventricular ejection fraction. PMID- 2778887 TI - Retroperitoneal lymphocele after abdominal aortic surgery. AB - Lymphoceles may occur as a result of lymphatic injury during abdominal aortic surgery. These lymphatic collections may occur as a retroperitoneal mass or as groin lymphoceles. Four cases are presented in which persistent retroperitoneal lymphoceles were discovered 2 to 8 years after surgery. Reexploration of the groin and repeated aspirations of lymphatic fluid failed to control the drainage. Reexploration of the retroperitoneum documented lymphatic injury, which was controlled by ligation of the lymphatics with suture. A review of the literature discloses five similar reported cases of retroperitoneal lymphocele and 12 cases of chylous ascites after abdominal aortic surgery. Clearly, avoiding lymphatic injury or immediate repair of any lymphatic injuries will prevent this problem. Once a persistent lymphocele has developed, aspiration will establish the diagnosis. Our experience would suggest that reexploration of the retroperitoneum is required to control the drainage and to prevent possible graft infection. PMID- 2778888 TI - Acquired immunodeficiency syndrome and mycotic abdominal aortic aneurysms: a new challenge? Report of a case. AB - The case of a 64-year-old white man with acquired immunodeficiency syndrome and ruptured abdominal aortic aneurysm infected with Salmonella is presented. Five points related to this case are addressed. It is feared that the vascular surgeon may face patients with acquired immunodeficiency syndrome and abdominal aortic aneurysms infected with Salmonella with increasing frequency in the future. This case raises medical, ethical, and moral questions. PMID- 2778889 TI - Noniatrogenic pediatric vascular trauma. AB - Twenty-four noniatrogenic pediatric vascular injuries in 20 patients (75% male; mean age, 14 years) were treated during a 3-year period. Of 18 arterial and six venous injuries, 65% were penetrating and 35% were blunt injuries. Eighty percent of all patients had significant associated injuries that required repair. Angiography was performed in 13 of 20 patients, with four performed during surgery. Repair methods were ligation in two of six venous injuries and three of 18 arterial injuries, primary repair in three of six venous injuries and six of 18 arterial injuries, and autogenous saphenous vein graft in seven of 18 arterial injuries. Exploration and debridement, thrombectomy, and nonoperative management were used in one arterial injury each. Fasciotomy was employed in six of 13 arterial injuries in the extremities. There was one operative death, no reoperations, and no early or late amputations. Mean follow-up of 27 months demonstrated normal palpable and Doppler pulses (by noninvasive testing) distal to all arterial repairs. This study supports an aggressive approach to the diagnosis and treatment of noniatrogenic pediatric vascular trauma, emphasizing the liberal use of fasciotomy and meticulous vascular repair for the successful management of these challenging injuries. PMID- 2778891 TI - What is the role of carotid arterial resection in the management of advanced cervical cancer? AB - From 1977 through 1988, 16 patients underwent carotid artery resection and reconstruction or simple ligation in the treatment of advanced cervical carcinomas. Three patients underwent carotid artery ligation, with postoperative transient ischemic attacks, which resolved, in one patient. In the remaining 13 patients, interposition saphenous vein grafts were used to reconstruct the resected carotid arteries. In one of these 13 patients, the previously unresected carotid artery ruptured and was treated by carotid artery resection with interposition vein grafting and coverage by a myocutaneous flap. There were two immediate postoperative strokes, with excellent neurologic recovery in one, and one late postoperative stroke (6 months). There was one postoperative death. Adjunctive intraoperative irradiation (1500 to 2000 rad) was employed in 15 patients to decrease the risk of recurrent disease. Since 1982, pectoralis major muscle flaps have been constructed in all patients to cover the vein grafts, with no subsequent carotid artery blowouts. Seven patients are free of cancer more than 1 year after surgery. In conclusion, carotid artery resection for the treatment of advanced cervical carcinomas may be accomplished with acceptable morbidity and mortality rates in carefully selected cases. Coverage of the vein graft by a myocutaneous flap appears to protect against carotid artery blowout. Intraoperative irradiation appears to decrease significantly the local recurrence rate of these aggressive tumors. PMID- 2778890 TI - Management of renovascular hypertension in the elderly population. AB - This article summarizes our experience with the operative management of renovascular hypertension in a contemporary population of elderly patients. During a recent 18-month period 35 of 74 patients (47%) undergoing an operation for renovascular hypertension at our center were in their seventh (21 patients) or eighth (14 patients) decade of life (mean age, 68 years). There were 17 men and 18 women with blood pressures ranging from 176/90 mm Hg to 280/215 mm Hg (mean, 213/121 mm Hg). Twenty-seven patients (77%) had renal insufficiency (serum creatinine greater than or equal to 1.3 mg/dl). Nineteen patients had severe insufficiency (serum creatinine greater than or equal to 2.0 mg/dl), with five of these patients being dependent on dialysis. Thirty-three of 35 patients (94%) had evidence of organ-specific atherosclerotic damage as manifested by cardiac disease (72%), cerebrovascular disease (37%), or renal insufficiency (77%). Operative management consisted of unilateral revascularization in 17 patients (includes three contralateral nephrectomies), bilateral renal revascularization in 17 patients, and primary nephrectomy in one. Simultaneous aortic replacement was performed in nine patients. There were two operative deaths (5.7%) and two postoperative graft thromboses (4%). Hypertension was cured (three) or improved (27) in 30 of the 33 survivors (91%). Renal function was improved in six and worsened in two patients with severe non-dialysis-dependent renal insufficiency. Three of five patients who were dependent on dialysis before surgery were removed from dialysis after renal revascularization. On follow-up (mean, 10.3 months) we found that five patients had died. This article emphasizes the complexity of atherosclerosis in the current population presenting for operative management of renovascular hypertension.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2778892 TI - Traumatic false aneurysm of the common carotid artery presenting as a mediastinal mass: a case report. AB - A 42-year-old man came to another institution with chest pain and a cough and was found to have a 15 cm mass on the left side of his chest. Carcinoma was suspected but not proved, and a course of chemotherapy was administered. Two years later he was referred to Duke University Medical Center after he experienced a thromboembolic event in his left upper extremity. A CT scan and angiogram of the chest showed a large false aneurysm located 5 cm from the origin of the left common carotid artery and filling the anterior mediastinum. Additional history was obtained of multiple stab wounds to the left side of the chest 7 years before admission. The aneurysm was treated with sequential saphenous vein bypass grafting of right common carotid to left common carotid to left subclavian artery, followed by aneurysm thrombosis induced with wire coils. The differential diagnosis of a chest mass should include aneurysms of the great vessels. PMID- 2778893 TI - Axillopopliteal bypass grafting: indications, late results, and determinants of long-term patency. AB - In the last 12 years we have performed 55 axillopopliteal bypass graftings with 6 mm polytetrafluoroethylene grafts for limb salvage in 50 patients who were at high risk for limb loss. Indications for this procedure were (1) severe atherosclerotic disease of the common, superficial, and deep femoral arteries (33 cases); (2) failed aortofemoral bypass grafting with sufficient fibrosis or disease progression in the deep femoral artery (five cases); (3) insufficient hemodynamic and clinical improvement after axillofemoral bypass grafting (10 cases); and (4) sepsis in the groin from a previously infected graft (seven cases). The 30-day operative mortality rate was 8%, and the 5-year cumulative patient survival rate was 40%. Overall 1-, 3-, and 5-year cumulative primary graft patency rates were 58%, 45%, and 40%, respectively. Comparable limb salvage rates were 83%, 68%, and 58%. Repeat operations increased 5-year patency rates from 40% to 59% (p less than 0.05). Three-year patency rate for grafts placed in the presence of poor angiographic runoff in one vessel was 62% and for good angiographic runoff (two to three vessels) it was 57% (NS). Grafts to the above knee popliteal artery had a patency rate of 67% at 3 years, whereas for grafts that crossed the knee joint it was 51% (NS). Three-year patency rate for 24 straight axillopopliteal grafts was 42%, and for 31 sequential axillofemoral popliteal grafts it was 74% (p less than 0.05). These results show that axillopopliteal bypass grafting is justified when other standard operations are not possible in patients who are in imminent danger of limb loss, and that every possible effort should be made to use the common or deep femoral artery as part of a sequential axillofemoral-popliteal procedure. PMID- 2778894 TI - What is the proper role of polytetrafluoroethylene grafts in infrainguinal reconstruction? AB - Polytetrafluoroethylene grafts have been used extensively for infrainguinal vascular reconstruction either as the conduit of choice or as a substitute when saphenous vein is unavailable. Although numerous studies have shown satisfactory early patency rates, the long-term efficacy of these grafts in a large number of patients for specific indications and in various positions has been less well defined. From 1977 to 1987 we used four PTFE grafts from three different manufacturers to perform 300 infrainguinal reconstructions on 240 patients on our vascular service. The indications for surgery were disabling claudication in 28% and limb salvage in 72%. The 30-day operative mortality of 1% was not different from the 1.4% associated with infrainguinal autogenous vein grafting. The 5-year cumulative patency rate achieved with all infrainguinal polytetrafluoroethylene grafts was 35%, significantly higher for grafts placed for claudication (57%) than those placed for limb salvage (24%). There were no significant differences between the above-knee and below-knee locations for distal anastomoses regardless of indication, but femoropopliteal grafts provided significantly higher 5-year patency (37%) than infrapopliteal grafts (12%). Comparison of the 5-year patency rates among the three manufacturers of polytetrafluoroethylene grafts showed no significant differences. Fifty-four polytetrafluoroethylene grafts that failed underwent 67 revisions after catheter thrombectomy or thrombolysis, which resulted in a minimal 11% 5-year patency rate. Based on this experience, it is concluded that infrainguinal polytetrafluoroethylene prostheses provide significantly inferior results when compared with autogenous reconstruction. PMID- 2778895 TI - Lymphoscintigraphy to confirm the clinical diagnosis of lymphedema. AB - Confirmation of the diagnosis of lymphedema often requires lymphangiography, a procedure that is painful for the patient and technically demanding. Radioisotope lymphoscintigraphy is a relatively new technique that uses technetium 99 m antimony trisulfide colloid to produce a diagnostic image similar to a lymphangiogram. The procedure requires a single subcutaneous injection in the involved extremity, and images are obtained 3 hours later. It is technically easy to perform, produces minimal discomfort for the patient, and has no adverse effects. We have recently used radioisotope lymphoscintigraphy to evaluate 17 patients with extremity edema. These patients initially had a presumed diagnosis of lymphedema involving the upper or lower extremity. Lymphoscintigraphy confirmed the diagnosis of lymphedema in 12 (70.6%) patients. In five of the 17 patients (29.4%) the clinical impression of lymphedema was not supported by lymphoscintigraphy, leading to alternative diagnoses such as lipomatosis, venous insufficiency (two patients), congestive heart failure, and disuse edema. In all patients with secondary lymphedema the lymphatic system in the involved extremity could be partially visualized. Conversely, three of four patients with primary lymphedema had no ascent of the tracer from the foot and no lymphatic channels could be visualized. Lymphoscintigraphy is relatively easy to perform, safe, minimally invasive, and not uncomfortable for the patient. It is useful in differentiating lymphedema from other causes of extremity edema, allowing institution of appropriate therapy. PMID- 2778896 TI - Hypercholesterolemia impairs endothelium-dependent relaxations to aggregating platelets in porcine iliac arteries. AB - The purpose of the present study was to examine in peripheral arteries whether the endothelium plays a protective role against aggregating platelets and whether the responses to platelets are altered by hypercholesterolemia. Male Yorkshire pigs were fed either a normal diet or a 2% high-cholesterol diet for 10 weeks. Endothelium-dependent responses were examined in vitro. In isolated iliac arteries from control animals, aggregating platelets caused contractions that were significantly inhibited by the endothelium. In rings with endothelium from pigs fed a cholesterol diet, the contractions were augmented and no difference was noted between rings with and rings without endothelium. In rings taken from control pigs contracted with prostaglandin F2 alpha, aggregating platelets caused endothelium-dependent relaxations, which were attenuated by blockade of adenosine diphosphate or serotonin. Adenosine diphosphate and serotonin also caused endothelium-dependent relaxations. In arteries from cholesterol-fed animals, the inhibitory effects of the endothelium to aggregating platelets, adenosine diphosphate, and serotonin were impaired. These experiments indicate that in porcine iliac arteries the endothelium exerts inhibitory effects on the responses to aggregating platelets, which are mediated by adenosine diphosphate and serotonin released from platelets. Hypercholesterolemia impairs the endothelium dependent relaxations to aggregating platelets caused by reduced relaxations to adenosine diphosphate and serotonin and unmasks the contractions evoked by aggregating platelets. This may increase the level of vascular tone, decrease blood flow and increase platelet aggregation, and eventually facilitate the occurrence of peripheral arterial occlusive disease. PMID- 2778897 TI - Optimal graft diameter: effect of wall shear stress on vascular healing. AB - Arterial walls tend to adapt to maintain a specific wall shear stress. The formation of neointimal hyperplasia and endothelial cell healing of polytetrafluoroethylene grafts may also be governed by wall shear stress, which suggests that an optimal graft diameter may exist. To test this, 40 polytetrafluoroethylene grafts with internal diameters of 3, 6, and 8 mm were inserted end to end in the femoral and carotid arteries of 10 mongrel dogs. Total flow and diameter were measured, and grafts were stained with Evans blue dye, fixed by pressure perfusion, and analyzed by computer for anastomotic neointimal thickening, graft pseudointimal thickening, and degree of endothelial coverage. Mean calculated shear stress was 41 dyne/cm2 for the 3 mm grafts, 7 dyne/cm2 for the 6 mm grafts, and 3 dyne/cm2 for the 8 mm grafts. Fifteen weeks later the patency rate was 0 of 10 for the 3 mm grafts, 16 of 20 for the 6 mm grafts, and 7 of 10 for the 8 mm grafts. The mean graft shear stress was calculated to be 10 dyne/cm2 for the 6 mm grafts and 4 dyne/cm2 for the 8 mm grafts. Pseudointima lining the graft was composed of disorganized protein and cell remnants. The rough surface contained no overlying endothelium. Anastomotic neointima contained a layer of well-organized smooth muscle cells covered by a single layer of polygonal-shaped endothelial cells. A transition zone of thrombus, which is sandwiched by a wedge of smooth muscle cells near the graft surface and covered by endothelial cells, is described. Mean thickness of pseudointima of the patent 8 mm grafts was 150 microns thicker than that of the 6 mm grafts. Anastomotic neointimal thickness was 110 microns thicker in the 8 mm grafts compared with the 6 mm grafts. Among the 6 mm grafts, the carotid grafts had an average initial shear stress of 10 dyne/cm2, whereas the femoral grafts averaged a lower 5 dyne/cm2 and yielded pseudointima and neointima that were 40 microns thicker. The percent graft surface area covered with neointima did not differ among the grafts of differing diameter either proximally or distally. Lower shear stresses produced greater amounts of pseudointimal thickening within polytetrafluoroethylene grafts and neointimal thickening at their anastomoses. Conversely, the high shear stress from small-diameter grafts was associated with poor graft patency. These results suggest that an optimal graft diameter may help to prevent neointimal hyperplasia and graft thrombosis. PMID- 2778898 TI - Does open fasciotomy contribute to morbidity and mortality after acute lower extremity ischemia and revascularization? AB - A retrospective review was undertaken of 127 lower extremity fasciotomies performed for compartment syndrome after acute ischemia and revascularization in 73 patients with vascular trauma and 49 patients with arterial occlusive disease. One hundred twelve (88%) fasciotomies were performed early (at the time revascularization); 15 (12%) were delayed because of late compartment syndrome diagnosis. Ninety-four (77%) patients had more than one accepted indication for fasciotomy. Double-incision fasciotomy was used in 98 (77%) extremities, single incision fasciotomy was used in 19 (15%), and fasciotomy-fibulectomy was used in 10 (8%). Fasciotomies were closed in 88 (69%) patients an average of 14 days after surgery. Seven patients needed multiple skin grafting procedures or myocutaneous flaps to close the wound; none compromised limb salvage. Five other patients had minor wound infections that resolved. Functional status returned to preoperative levels by the time of discharge from the hospital in 59 (48%) patients. Thirty-one (24%) patients had residual lower extremity disability related to delayed union of the fracture (five), chronic neuropathy (20), leg swelling (one), or ischemic nonhealing fasciotomy wounds (three); two patients had unrelated disabilities. Fourteen (11%) amputations were required for refractory limb ischemia; two (1.6%) were required for wet gangrene of the foot, which infected the fasciotomy site; the others had open noninfected incisions. Eighteen (15%) patients died of cardiopulmonary failure or multisystem failure or both, without fasciotomy-related problems. Open fasciotomy for compartment syndrome after acute lower extremity ischemia and revascularization was associated with an increased risk of minor wound morbidity. However, limb loss and death resulted from persistent ischemia and underlying systemic disease processes or injuries, but not from open fasciotomy wound complications. PMID- 2778899 TI - Percutaneous laser probe femoropopliteal angioplasty: a preliminary experience. AB - Percutaneous laser probe "hot tip" angioplasty procedures were performed on 47 occluded femoropopliteal artery segments in 27 men and 10 women ranging in age from 31 to 92 (mean, 64.7) years. Indications for the procedure included claudication in 29 (78%) segments, and the occlusion lased was greater than 7 cm in length in 51% of the procedures. Failure to recanalize the occlusion occurred in 14 (30%) segments, and recanalization followed by in-hospital reocclusion occurred in seven (15%) segments, yielding an initial failure rate of 45%. Initial failures were noted in 40% of the less than 3 cm occlusions, 33% of the 4 to 7 cm occlusions, and 54% of the greater than 7 cm occlusions. In nine (43%) instances in these 21 failures there was extension of the occluded segment or decline of the ankle/brachial index or both, precipitating the need for surgery in three (18%) of these 17 patients. Among the successfully treated group, 17 (65%) of these vessels in 15 patients reoccluded from 1 to 14 (mean, 3 1/2) months after the procedure. Cumulative patency among the successfully lased vessels was 69% at 1-month, 38% at 6 months', 29% at 12 months', and 14% at 15 months' follow-up. Fifteen-month patency was 7% of the entire series of 47 vessels treated. Eighteen complications occurred after 15 (32%) of these 47 procedures. Based on these results, the widespread application of laser probe angioplasty cannot be justified without further clinical and laboratory investigation. PMID- 2778901 TI - Suprarenal mycotic aortic aneurysm: surgical management and follow-up. PMID- 2778900 TI - Routine revascularization with resection of infected femoral pseudoaneurysms from substance abuse. PMID- 2778902 TI - Redeclared war on illegal drugs: most agree with intent, but how? PMID- 2778903 TI - Lasker Award often prologue to Nobel Prize. PMID- 2778904 TI - Professional football player suspensions re-emphasize problems of steroid abuse. PMID- 2778906 TI - From the Centers for Disease Control. Surgeon General's Workshop on Health Promotion and Aging: summary recommendations of the Medication Working Group. PMID- 2778905 TI - From the Centers for Disease Control. Measles--United States, 1988. PMID- 2778907 TI - Immunotherapy and asthma. PMID- 2778908 TI - Linking payment for care to informed consent. PMID- 2778910 TI - Tuberculosis among migrant farm workers. PMID- 2778911 TI - Physicians: check that blood pressure. PMID- 2778909 TI - Treatment with thyroid hormone. PMID- 2778912 TI - Percutaneous lumbar diskectomy. PMID- 2778914 TI - From the Office of the General Counsel. Physician participation in assisted suicide. PMID- 2778915 TI - A piece of my mind. Mrs Rodell. PMID- 2778913 TI - Primary prevention of hypertension by nutritional-hygienic means. Final report of a randomized, controlled trial. AB - A 5-year trial involving 201 men and women with high-normal blood pressure at baseline demonstrated the ability to reduce the incidence of hypertension in participants randomized to nutritional-hygienic intervention compared with a control group. The incidence of hypertension was 8.8% among 102 intervention group participants vs 19.2% among 99 control group members. The odds ratio for the incidence of hypertension in the control group was 2.4. Mean trial blood pressure also was lower in the intervention compared with the control group (-1.2 and -1.9 mm Hg, respectively, for diastolic blood pressure at work-site and office visits and -1.3 and -2.0 mm Hg, respectively, for systolic blood pressure at the two sites). Net weight loss in the intervention group averaged 2.7 kg during the trial; sodium intake was reduced by 25% and reported alcohol intake decreased by 30%. The majority of intervention participants also reported an increase in physical activity. Effect on blood pressure was related particularly to degree of weight loss. Results indicate that even a moderate reduction in risk factors for hypertension among hypertension-prone individuals contributes to the primary prevention of the disease. PMID- 2778917 TI - Abortion negates human potential. PMID- 2778916 TI - Abortifacient development should not be stifled. PMID- 2778918 TI - Children having babies: a survey of cesarean section rates in women younger than 17 years. PMID- 2778920 TI - Preliminary results may open door to gene therapy just a bit wider. PMID- 2778919 TI - Prospective study on cocaine use prior to delivery. PMID- 2778921 TI - From the Food and Drug Administration. PMID- 2778922 TI - From the Centers for Disease Control. Year 2000 national health objectives. PMID- 2778923 TI - From the Centers for Disease Control. Contribution of birth defects to infant mortality--United States, 1986. PMID- 2778924 TI - From the Centers for Disease Control. Varicella outbreak in a women's prison- Kentucky. PMID- 2778925 TI - The exposure of health care workers to ribavirin aerosol. PMID- 2778926 TI - Educating patients about HIV. PMID- 2778927 TI - The reporting of AIDS. PMID- 2778929 TI - The Department of Defense's external civilian peer review of medical care. PMID- 2778928 TI - Recommendations for mammography in the presence of advanced age and coexisting disease. PMID- 2778930 TI - Inferring cortical function from the patient's job: he made grass trimmer, but could he have made Vice President? PMID- 2778931 TI - Exporting US postgraduate fellowship training overseas. PMID- 2778933 TI - Assessing the physical health of homeless adults. AB - Information on the physical health of homeless adults is potentially biased either by sampling strategy or by measurement of physical health. Studies that used comprehensive health measures (self-reported and objective measures) relied on samples from shelters or hotels. However, more representative community-based studies relied on self-reports or ratings. We conducted the first study to use both a community-based sample (N = 529) and comprehensive measures of health (an interview, a limited physical examination, and blood testing). Shelter dwellers compared with homeless persons sampled elsewhere were less likely to have used illegal drugs, to have been victimized, to have injured skin, and to have elevated aspartate aminotransferase levels and mean corpuscular volumes. Sixty two percent of persons observed to have high blood pressure were unaware of their condition. Sampling only shelter dwellers, or relying only on reports of illness by homeless adults, may mask or underestimate existent health problems that are revealed by community-based sampling techniques and more objective measures. PMID- 2778934 TI - Apolipoprotein B-100 Hopkins (arginine4019----tryptophan). A new apolipoprotein B 100 variant in a family with premature atherosclerosis and hyperapobetalipoproteinemia. AB - A 43-year-old woman with severe coronary artery disease and hyperapobetalipoproteinemia was heterozygous for an abnormal Msp I apolipoprotein B (APOB) gene fragment because of the absence of the MspI site around codon 4046 in exon 29 of the APOB gene. Using the polymerase chain reaction technique, 134 base pairs containing the mutant Msp I site were amplified, cloned, and sequenced. The mutation was a C to T transition, substituting tryptophan for arginine at amino acid position 4019 of the mature ApoB-100 protein. Seven relatives of the proband had the same mutation, which has been called "ApoB-100 Hopkins." Only three of seven relatives with the mutation had hyperapobetalipoproteinemia; one was borderline while two other relatives without the mutation had hyperapobetalipoproteinemia. Mutant low-density lipoprotein (LDL) was bound and degraded to a greater extent than normal LDL in cultured human fibroblasts. In conclusion, a new mutation, ApoB-100 Hopkins, was not linked to the hyperapobetalipoproteinemia phenotype, which also was segregating in this family. The increased affinity of this mutant LDL for the LDL receptor may be due to a specific effect of ApoB-100 Hopkins or to altered LDL size and composition. PMID- 2778932 TI - Physicians and acquired immunodeficiency syndrome. What patients think about human immunodeficiency virus in medical practice. AB - Are patients concerned about going to a physician who is infected with human immunodeficiency virus (HIV) or one who is treating HIV-infected patients? To answer these questions, we surveyed a nationwide sample of 2000 interviews (response rate, 75%). Forty-five percent of all respondents believed that physicians who were HIV infected should not be allowed to continue to practice. More than half of those who had seen a physician in the past 5 years said they would change physicians if they knew their physician were HIV infected, while one fourth said they would seek care elsewhere if their physician were treating people with HIV disease. These data suggest that patients are concerned about HIV in their physicians' offices. The American Medical Association recommends that HIV-infected physicians continue to practice as long as there is no risk to their patients. Physicians and the public need to be educated about this policy and its appropriateness. PMID- 2778936 TI - Physicians and acquired immunodeficiency syndrome: a reply to patients. PMID- 2778935 TI - Emerging concepts in the treatment of HIV infection in children. PMID- 2778937 TI - New requirements for authors: signed statements of authorship responsibility and financial disclosure. PMID- 2778938 TI - A piece of my mind. Midnight visiting hour. PMID- 2778940 TI - Remission induction in refractory Crohns disease using a high calorie whole diet. AB - Eleven patients with severe refractory Crohns disease were treated with a high calorie, whole diet. Eight patients achieved remission with a drop in DAS from 13 to 4 (t = 6.31, p less than 0.001) and reversal of subacute obstruction in all cases. Nutritional parameters including weight, triceps skinfold thickness, arm muscle area, and serum albumin increased in all patients. The diet was well tolerated with a mean treatment period of 20 days. Clinical relapse of disease occurred in all cases within 9 months (mean 6 +/- 2 months). The mechanism of action of a high calorie diet (HCD) is unclear and warrants further study but antigen or specific food exclusion does not appear to be required as judged by this study. PMID- 2778939 TI - Inhibited amino acid uptake in skeletal muscle during starvation. AB - Amino acid uptake in skeletal muscle is reduced during different catabolic conditions such as sepsis, endotoxic shock, and uremia. The present study was designed to determine the effect of another catabolic condition, starvation, on amino acid transport in skeletal muscle. Male Sprague-Dawley rats (40-60 g) were starved for 24, 48, or 72 hr and soleus (SOL) muscles were removed intact and incubated for 2 hr in a medium consisting of Krebs-Henseleit bicarbonate buffer (pH 7.4) with glucose (5 mM), [14C]-inulin, and [3H]-alpha-aminoisobutyric acid (AIB). Amino acid uptake was determined from intracellular to extracellular ratio of AIB following incubation. AIB uptake was significantly reduced after 24 hr of starvation and remained low with further fasting. After 72 hr the AIB distribution ratio was approximately 50% of initial value. Amino acid uptake returned to normal within 24 hr after refeeding of animals that had been starved for 72 hr. Plasma (0.25 ml) from starved rats, added to the incubation medium (2.75 ml) of muscles from nonfasted rats, significantly inhibited AIB uptake. The present results suggest that amino acid uptake in skeletal muscle is progressively reduced during starvation, an effect that may be mediated by a circulating factor(s) present in blood. PMID- 2778941 TI - Catabolic effect of dexamethasone in patients with major head injuries. AB - In the records of our extensive metabolic studies on trauma victims, we found 16 head injured patients who had no other major injuries. Among them, nine had been given dexamethasone for at least 6 days. The other seven had not received any corticosteroids. There was no significant difference in the Glasgow Coma Scales of the treated and untreated groups. Metabolic balance studies were carried out for at least 3 days, including the periods when the treated patients were receiving dexamethasone. Mean nitrogen balance was -0.296 +/- 0.03 g/kg/day for the treated group and -0.182 +/- 0.03 g/kg/day for the untreated group. This difference was significant (p = 0.02, t-test). Our metabolic data are also consistent with those of other published studies, which used other corticosteroids and somewhat different methodologies. Thus, it is clearly established that corticosteroids cause significant degrees of catabolism in head injured patients, beyond what would "normally" be expected in such patients if they did not receive these drugs. PMID- 2778943 TI - Central venous thrombosis related to the silastic Hickman-Broviac catheter in an oncologic population. AB - The use of subcutaneously implanted, Dacron cuffed, central venous silastic catheters (Hickman/Broviac catheter [HC/BC]) has not eliminated catheter related central venous thrombosis (CR-CVT). HC/BC related CR-CVT was identified and followed in 15 oncology patients. Median time period to CR-CVT was 155 days (range 15-638). No correlation was established to patient age, sex, diagnosis, coagulation status, use, longevity, technique, or site of placement. Fourteen patients were treated with anticoagulation and/or thrombolytic therapy. Of seven patients treated with HC/BC in situ, one required HC/BC removal to achieve CR-CVT resolution. Median follow-up post-CR-CVT was 362 days (range 34-1622). No patient suffered untoward long-term sequelae. Nine patients had 11 catheters placed following resolution of CR-CVT. None had repeat thrombosis. CR-CVT incidence in a single 12-month period was 3.7% (7/190). The placement of HC/BC in an oncology population is an acceptably safe method for long-term venous access. PMID- 2778942 TI - Effect of whey proteins, their oligopeptide hydrolysates and free amino acid mixtures on growth and nitrogen retention in fed and starved rats. AB - The effects of alimentary whey proteins given, as whole proteins (WP), controlled trypsin and chymotrypsin hydrolysate oligopeptides (WPH), or a free amino acid mixture (AAM), on growth, nitrogen retention, and steatorrhea were assessed in 24 Wistar rats (250 to 300 g) after 72 hr of starvation and 24 to 96 hr of realimentation and in 24 controls. The three diets had the same caloric, nitrogen, vitamin, and mineral contents. Rats had free access to the liquid diets. Only rats which ate the whole diet (90 cal) were included in the study. No differences in steatorrhea and fecal nitrogen were observed. The absorption rate was over 95% on the three diets. In contrast, weight gain was statistically better on WPH (+9% after 96 hr of realimentation) than on WP (+5%) or AAM (+2%). This was associated with a statistically higher nitrogen retention at all time periods studied, which was a result of a significant lower nitrogen urinary excretion. Similar results were obtained in controls. This better growth was a result of a better protein synthesis and lower ureagenesis. PMID- 2778944 TI - Reinsertion of a gastrostomy tube using the Seldinger technique. AB - By using the Seldinger technique to recannulate a contracted fistula tract with a small catheter, a stenosed fistula tract can be progressively dilated. A new gastrostomy tube can then be inserted, thus avoiding a reoperation. PMID- 2778945 TI - A simple method of repositioning the wayward central venous catheter. AB - Malposition of a central venous catheter occurs despite improvements in catheter design and regardless of the skill of the physician. A simple method of repositioning a central venous catheter has been successful in 25 of 25 attempts. Documentation of the rationale for the use of this technique is provided using x rays. PMID- 2778946 TI - [The concept of secondary brain injury in head trauma]. PMID- 2778947 TI - [Anesthetic management of elderly patients in open heart surgery]. AB - In the National Cardiovascular Center, 46 patients whose ages were above 70 underwent open heart surgery from 1977 to 1986. Twenty of them received AC bypass and 5 had repair of the rupture of ventricular septum or left ventricular aneurysm. Among them 2 had also insertion of left ventricular assist device because of acute myocardial infarction (MI). Eighteen underwent mitral and/or aortic valve replacement. The other 3 were operated on because of atrial myxoma etc. Preoperatively, in ischemic heart disease group, due to resultant heart failure, one third of the patients were given catecholamines. In valvular heart disease group, angina pectoris and old MI were also common. Beside arrhythmias, respiratory complications, renal dysfunction and diabetes mellitus, neurological complications such as brain infarction were prominent in both groups. Hospital mortality was 15% in AC bypass group, 40% in acute MI group and 11.1% in VHD group. In 36 patients who left hospital, mean NYHA class improved after operation. The mortality rate and symptomatic improvement demonstrate that cardiac surgery can be performed with acceptable risk in elderly patients. Anesthesiologists should manage them carefully, considering the problems stated above. PMID- 2778948 TI - [The effect of hemodilution on capillary blood flow and arteriovenous shunt after resuscitation in dogs]. AB - The present study was designed to elucidate the adverse effects of temporary circulatory arrest upon the capillary blood flow and arteriovenous shunt and additionally to observe how hemodilution may improve such microcirculatory deterioration. The organ capillary blood flow and organ fraction of cardiac output were measured by the microsphere (phi 9 microns) trapping method in 14 organs. Simultaneously, the arteriovenous shunt rate was measured by continuous collection of drained venous blood at 4.8 ml.min-1 for two minutes from the brain, kidney, liver, splanchnic organs, skeletal muscle of the pelvic limb and all systemic circulatory organs. In five non-hemodiluted dogs (C group), the capillary blood flows decreased in the thyroid gland and pancreas at 30 minutes after circulatory arrest, and in these organs as well as in the brain and stomach at 90 minutes after the arrest. Change in the fraction of cardiac output was similar to that in the capillary blood flow. The arteriovenous shunt rate was unchanged after circulatory arrest. The remaining ten dogs were hemodiluted with dextran-70 solution either before (Pre group, five dogs) or after (Post group, five dogs) circulatory arrest. Both groups of hemodilution maintained the capillary blood flow and showed no alteration of the arteriovenous shunt rate after circulatory arrest, except for an increase in the systemic arteriovenous shunt rate in the Pre group. These results suggest that hemodilution maintains the capillary blood flow at a normal level and ameliorates the oxygen supply into organs after circulatory arrest. PMID- 2778950 TI - [Lung lavage and artificial surfactant replacement therapy--animal experimentation and clinical application]. AB - Lung lavage may cause a surfactant deficient condition. We examined the effect of artificial surfactant replacement on the post-lavage condition in rabbits and in a patient with alveolar pulmonary proteinosis. Adult rabbits (n = 21) were subjected to whole-lung lavage, and the PaO2 was made to decrease to less than 70 mmHg (FIO2 = 1.0). In the replaced group (n = 11), an artificial surfactant which was a saline suspension of lipids (mixture of dipalmitoylphosphatidylcholine, phosphatidylglycerol and tripalmitin) was administered into the airway. The PaO2 was elevated to a level higher than 400 mmHg at 30 min after the surfactant replacement. On the other hand, the PaO2 in the non-replaced group (n = 10) remained below 100 mmHg. In the patient with alveolar pulmonary proteinosis, we performed the artificial surfactant replacement after the therapeutic lung lavage. By the replacement, the PaO2 increased from 89 mmHg (FIO2 = 1.0) to 128 mmHg. These results demonstrate the therapeutic effects of surfactant replacement on the acute respiratory failure induced by lung lavage. PMID- 2778949 TI - [Effect of continuous epidural infusion of morphine for postoperative analgesia on pituitary-adrenocortical function]. AB - Plasma levels of cortisol, ACTH and beta-endorphin like immunoreactivity (beta ELI) were measured to evaluate postoperative pain relief with epidural morphine and systemic analgesics in conjunction with endocrine functions in 16 patients who underwent gastrectomy. Eight of these patients (epidural morphine group) obtained postoperative analgesia with continuous epidural infusion of morphine with a pump as in our previous report. A bolus of epidural morphine was administered through an indwelling thoracic (Th8,9) catheter at 3 hrs prior to the proposed end of the surgery, which was followed with continuous epidural infusion of morphine at a rate of 0.167-0.042 mg.hr-1 with a pump (CADD-PCA, Model 5200P, Pharmacia) during and after anesthesia and surgery with gradual decrease in dose until the third postoperative day. The remaining eight patients (systemic analgesics group) repeatedly received systemic pentazocine and buprenorphine when needed. Plasma cortisol levels increased significantly at the end of surgery and after in both groups. However plasma concentrations of cortisol in the epidural morphine group were significantly lower than those in the systemic analgesics group on the first and second postoperative days. Plasma levels of ACTH and beta-ELI increased significantly at the end of surgery but returned to levels of the previous day in both groups postoperatively. Our study suggests that continuous epidural infusion of morphine is adequate for postoperative pain relief and has suppressing effect on plasma cortisol levels as compared with systemic analgesics regimen. PMID- 2778951 TI - [The alterations of serum colloid osmotic pressure, serum protein and water balance during prolonged anesthesia]. AB - The changes of serum colloid osmotic pressure (COPm), serum protein and water balance were examined in 9 patients during and for 2 weeks after operation which required prolonged anesthesia. The values of serum total protein (TP), serum albumin (Alb) and COPm decreased by about 17% three hours after the start of anesthesia and by 15%, 20% and 24%, respectively, after 18 hours. These values returned to each preoperative value about one week after the operation. The correlation coefficients (the values in parentheses were calculated using data obtained during anesthesia) comparing COPm to TP, Alb and calculated colloid osmotic pressure (Landis' equation) were 0.661 (0.710), 0.480 (0.649) and 0.666 (0.727). There was no correlation between COPm and water balance. When COPm was 17.5mmHg or lower, calculated colloid osmotic pressure value was higher than COPm as the Alb/TP ratio decreased. Decreases in the values of COPm and serum protein during operation were considered to have been caused mainly by increased capillary permeability. PMID- 2778952 TI - [Antagonistic effect of 4-aminopyridine derivatives on dTc induced block]. AB - A new muscle relaxant antagonist, 4-aminopyridine (4-AMP), has various problems related to its side effects. In order to obtain 4-AMP derivatives with less side effect and the same antagonizing effect on dTc block as that of 4-AMP, three types of derivatives were synthesized. They were 4-methylaminopyridine (4-MAMP), 4-dimethylaminopyridine (4-DAMP), and 4-trimethylaminopyridine (4-TAMP). For the purpose of studying their effects on neuromuscular junction, the antagonistic effects of the three derivatives on the dTc block were compared with those of 4 AMP, by using rat diaphragm preparation in vitro, and rat sciatic nerve tibialis anterior muscle preparation in vivo. These three derivatives exhibited earlier onset time compared with 4-AMP, but their efficacy was lower in terms of ED50 in vivo and in vitro. Also their duration of effect was shorter than 4-AMP. In particular, the ED50 of 4-DAMP was much larger (9 times that of 4-AMP), and its duration of effect was shorter (11 minutes), indicating that it is unsuitable as a practical antagonistic agent. ED50 of 4-TAMP was the closest to that of 4-AMP (three times that of 4-AMP), and it exhibited effects earlier than 4-AMP (one fourth that of 4-AMP), but was inferior in duration of effect (13 minutes). With respect to antagonistic effects, these three agents cannot be described as perfect, and development of new derivatives will be required. PMID- 2778954 TI - [Anesthetic management of a patient with acromegaly complicated with hyperthyroidism]. AB - A rare anesthetic experience of a 30-year-old woman with acromegaly complicated with Basedow's disease is reported. After the thyroid function was successfully controlled by drug therapy, resection of pituitary adenoma was performed under general anesthesia. Anesthesia was induced and maintained with NLA. No problem was observed during the operation and postoperative period. Careful attention should be paid to the management of circulation, respiration, metabolism and endocrinium through the perioperative period. PMID- 2778953 TI - [Isobaric and hyperbaric bupivacaine 0.5% solution for spinal anesthesia]. AB - The effects of spinal anesthesia with 0.5% isobaric and hyperbaric (8% glucose) bupivacaine were investigated in 45 patients who had lower limb or lower abdominal surgery. The patients were divided into 3 groups. Group 1 patients received 3 ml of 0.5% isobaric bupivacaine. The patients in group 2 and 3 received 3 or 2 ml of 0.5% hyperbaric bupivacaine (8% glucose). Blood pressure dropped in all groups. The decrease in blood pressure was so severe in group 2 that vasopressors were required in 70% of cases. The average segmental level of analgesia was T9 in group 1, C8 in group 2 and T4 in group 3. Complete motor blockade was obtained in all the patients. Time to complete motor blockade of the lower limbs was 12.6 min in group 1, 5.5 min in group 2 and 8.4 min in group 3. Duration of analgesia and motor blockade were 387.4 min and 303.7 min in group 1, 373.5 min and 300.0 min in group 2 and 318.9 min and 228.9 min in group 3. These results suggest that adequate surgical anaesthesia could be obtained with 3 ml of 0.5% isobaric bupivacaine and 2 ml of 0.5% hyperbaric bupivacaine. PMID- 2778955 TI - [A case report of reflex sympathetic dystrophy treated with nifedipine]. AB - Reflex sympathetic dystrophy (RSD) refers to a symptom complex observed after nerve injury and consists primarily of severe burning pain associated with sensory, vasomotor and trophic phenomena. A 54-year-old male had undergone nephrectomy. At surgery left XIth intercostal nerve had been injured by cautery. After a few weeks following surgery, the patient developed progressive deep burning pain, stabbing sensation and dysesthesia in the left abdominal region. Analgesics and narcotics were ineffective. We diagnosed his case as RSD. He received nifedipine 10mg sublingually. Pain relief was obtained within 10min and lasted for 6hs. Consequently, nifedipine therapy was started at a daily dose of 30 to 60mg. His symptoms were markedly improved within 4 weeks. After 3 months his pain resolved. At the present, some pain often returns, but nifedipine is effective. Nifedipine may be useful as a drug for the management of reflex sympathetic dystrophy. PMID- 2778956 TI - [Atrioventricular block (Wenckebach type) induced by atropine during 5% pethidine spinal anesthesia]. AB - A 38-year-old male received internal hemorrhoidectomy under spinal anaesthesia. Subarachnoid puncture was performed between the L4-5 lumbar interspace by a 25 gauge disposable spinal needle under sitting position. Forty five mg of 5% pethidine was injected into the subarachnoid space. The level of analgesia was L3. After 15 minutes, sinus brady-dysrhythmia was observed on ECG monitor. Heart rate dropped to 37 beats.min-1 and blood pressure was 85/39 mm Hg. Following administration of atropine 0.5mg intravenously, atrioventricular block (Wenckebach type) was observed. In a short period, ECG changed to normal sinus rhythm but PQ interval remained at 0.2 msec (1st degree AV block), but blood pressure returned to normal. Thereafter no ECG change was observed during intra and postoperative periods. PMID- 2778957 TI - [Epidural anesthesia for a patient with Charcot-Marie-Tooth disease, bronchial asthma and hypothyroidism]. AB - The patient was a 75-year-old male with a history of Charcot-Marie-Tooth disease (CMT), bronchial asthma and hypothyroidism simultaneously. Epidural anesthesia was planned for the open reduction of a femur fracture. CMT is one of the hereditary motor and sensory neuropathies, and there may be no report in Japan that epidural anesthesia was applied to a patient with CMT. It has been suggested that neuromuscular disease is a contraindication to epidural anesthesia, but the patient had such a severe gait disturbance that he might not be able to walk by himself postoperatively without any aggravation of the neuropathy. In addition, there existed the other simultaneous complications, especially severe respiratory insufficiency. Therefore we dared to administer epidural anesthesia. The epidural anesthesia was safely performed during the operation and there was no untoward effects postoperatively. PMID- 2778958 TI - [Radiotherapy of esophageal cancer: the local effect and prognosis]. AB - The correlation between the local effect and the prognosis of 124 esophageal carcinomas treated curatively with irradiation has been examined. The local effect at 40 Gy was found to correlate well with the prognosis. A high local control rate can be expected in cases of a superficial type, a tumorous type and in some cases of an ulcerative type, even though no change was seen in Ba study at 40 Gy. In well advanced ulcerative cases, in infiltrative cases, and in cases that show no change at 40 Gy, the radiation method should be altered positively after 40 Gy to achieve better local control because metastases are relatively few. PMID- 2778959 TI - [Radiation therapy of endometrial carcinoma]. AB - From January 1976 to May 1988, 67 patients with an endometrial carcinoma were treated at the Department of Radiology of Tohoku University. Of these, 35 patients, including 19 state III cases, were treated with irradiation alone. The remaining 32 patients, including 14 stage I cases, where treated with irradiation after surgery. The five-year survival rate of all cases, which include cases treated with irradiation alone and cases treated with postoperative irradiation, were 44.5%, 40.8%, and 45.0%, respectively. The local control rate in the irradiation cases alone was 57.1%. It seems that elaborate planning of intracavitary irradiation is essential for improved the prognosis of an unresectable endometria carcinoma. PMID- 2778960 TI - [A case of adenocarcinoma of the nasal cavity associated with syndrome of inappropriate secretion of antidiuretic hormone(SIADH)]. AB - An inappropriate antidiuretic hormone secretion (SIADH) has been recognized as the cause of hypotonic hyponatremia, and the occurrence of this syndrome, accompanied by an ADH-producing adenocarcinoma in the nasal cavity, is reported. In February, 1987, a 50-year-old male, showing sights of delirium, disorientation, and irritability was admitted to the hospital. The patient was observed to be healthy, except for a neck lymphnode metastasis that was present up to the time of his hospitalization. The hyponatremia was incidentally found, although dehydration or intravascular volume depletion were not noted. These neuropsychiatric symptoms were considered to be associated with hyponatremia due to SIADH. He had had a partial maxillectomy, a neck dissection, and irradiation to the nose and nasal cavity 32 months earlier, and then underwent a surgical resection of the neck metastasis; he had a total of 10 other operations before the onset of the symptoms. Upon initial inspection, since neither an intracranial invasion nor a brain metastasis was found, we diagnosed that his symptoms were due to an autonomic disturbance caused by surgical and mental "stress". When he died of cardiac failure due to a mediastinal invasion 8 months after the onset of SIADH, tumor tissues was extirpated in an autopsy and was then cultured. In this manner, it was proved that the tumor cells had been producing ADH. This procedure clarified that the syndrome had resulted from an ADH-producing tumor of the nasal cavity. PMID- 2778961 TI - [Squamous cell carcinoma of the lung metastasized solitary cystic formation in the cerebellum]. AB - A 54-year-old male previously diagnosed as having a lung squamous cell carcinoma T2N2M0 in stage III A was readmitted to our hospital, as he was complaining of a gait disturbance. A brain CT, an MRCT scan, and vertebral arteriography revealed that the lung carcinoma had metastasized as a solitary cystic formation in the right cerebellum. Thus, a craniotomy, a cyst fluid aspiration, and tumoral resection was performed. Histopathological findings of the cyst wall indicated a squamous cell carcinoma, and the protogram of the cyst fluid found it similar to that of the serum. These findings suggest that destruction of the blood-brain barrier by the invasion of the carcinoma caused an exudation of serum, resulting in the accumulation of cyst fluid. PMID- 2778963 TI - [A papillary-cystic neoplasm of the pancreas, a calcifying-inverted variant]. AB - A calcifying-inverted variant of a papillary-cystic neoplasm (PCN) is reported, presenting presented the same histological and cellular features, and similar immunohistochemical characteristics and the ultrastructure of a papillary-cystic neoplasm of the pancreas (PCN) that usually afflicts younger women. It took the form of a partiality of a capsule, a common trait for a PCN, and proliferated on infiltrating the pancreatic parenchyma. The case involves a 51-year-old woman, whose PCN was detected by an abdominal X-ray that showed a calcified shadow in a health examination, though there was no palpable abdominal tumor. Usually, a PCN is detected by palpation tumor. Thus, the author demonstrates the existence of PCN variants, characterized by intrapancreatic infiltrating proliferation and an incomplete cyst formation or intratumoral calcified foci, and reports on variants of the usual PCN. PMID- 2778962 TI - [Two cases of leiomyosarcoma of the duodenum]. AB - Two cases of a leiomyosarcoma of the duodenum are reported. The first patient, a seventy-year-old woman, had experienced repeated instances of melena. She was diagnosed as having a leiomyosarcoma of the duodenum preoperatively, and was successfully given a pancreatoduodenectomy. The second patient, a fifty-one year old woman, also had experienced instances of melena. Similarly, she was diagnosed an having leiomyosarcoma of the duodenum preoperatively, and was given a partial gastrectomy. A pathological examination showed little mitosis in either patient. The first patient is still alive three months after the operation, and the second patient also has been surviving for twelve years postoperatively. PMID- 2778965 TI - [36th meeting of the Japanese Society of Clinical Pathology. Kyoto, 5-7 October 1989. Abstracts]. PMID- 2778966 TI - [31st meeting of the Japanese Society of Gastroenterology. Asahakawa, 5-7 October 1989. Abstracts]. PMID- 2778964 TI - [Two cases of anorectal malignant melanoma]. AB - Although on anorectal malignant melanoma is relatively rare, we report two cases, that of a 88-year-old woman, and a 78-year-old man. Both patients were admitted to the hospital due to rectal bleeding and were diagnosed as having rectal carcinoma. Following an abdominoperineal rectal amputation, a pathological examination of the resected specimens revealed a malignant melanoma. Thus, it is necessary to carry out a careful examination of patients with tumors of the anorectal region when there is the least suspicion of a malignancy. PMID- 2778967 TI - Toxoplasma gondii: a simple method for titration of infectivity with monolayer cells. AB - A simple method for assessing the infectivity of Toxoplasma gondii using primary cultured monolayer cells has been devised. Statistic analysis important for interpreting the results of such experimentation was made. In this method, the number of intracellular toxoplasmas and the percentage of confluency of the monolayer were measured. The latter value was used for conversion of the number of intracellular toxoplasmas per unit area to the percentage of infective toxoplasmas. A linear dose-response relationship between the number of intracellular toxoplasmas per unit area and that of toxoplasmas inoculated was demonstrated with primary cell monolayers from the lungs of two-day old inbred golden hamsters and the kidneys of newborn mice and newborn Wistar Imamichi strain rats. On the average, 37% of the toxoplasma organisms harvested from the peritoneal exudate of mice on the third or fourth day of infection were found to be infective. This value compares very favorably with the value 40% reported previously. PMID- 2778968 TI - Entamoeba polecki infection in a Southeast Asian refugee in Japan. AB - We report the first human case of Entamoeba polecki infection found in Japan. Cysts of E. histolytica-like amoeba were detected in a stool sample from a female Cambodian refugee. The cysts were morphologically investigated after stained by the modified Kohn's method. The amoeba was identified as E. polecki by the findings that the cyst had frequently an inclusion mass, usually one or very rarely two nuclei, frequently a darkly stained nucleus, and some other characteristics. This protozoan parasite is essentially non-pathogenic to humans, but it is morphologically similar to and often confused with E. histolytica, a pathogenic species. Therefore, it is very important in laboratory diagnosis to differentiate the former from the latter. PMID- 2778969 TI - [29th meeting of the Japanese Society of Nuclear Medicine. Otsu, 19-21 October 1989. Abstracts]. PMID- 2778970 TI - [Nursing problems concerning patients undergoing drainage treatment]. PMID- 2778971 TI - [Management of apprehension and pain experienced by patients during drainage placement]. PMID- 2778972 TI - [Prevention of problems associated with drainage placement]. PMID- 2778973 TI - [Innovation in a shower bath of a patient having a PTCD tube for an extended period]. PMID- 2778974 TI - [Drainage with a pouch--prevention of secondary infection and protection of the skin]. PMID- 2778975 TI - [Innovation of a cover for the drained fluid container during drainage]. PMID- 2778976 TI - [Maintenance of physiological functions during thoracic drainage--assistance in maintaining the pulmonary and motor functions]. PMID- 2778977 TI - [Nursing of a patient with an indwelling ventricular drain]. PMID- 2778978 TI - [Nursing of a patient with placement of a pericardial drain for the treatment of cardiac tamponade following open heart surgery]. PMID- 2778979 TI - [Pre- and post-operative nursing of a patient with thoracic drainage]. PMID- 2778980 TI - [Nursing of a patient with an indwelling Dennis tube for the treatment of adhesion ileus]. PMID- 2778981 TI - [Nursing of a patient with suture dehiscence following total gastrectomy]. PMID- 2778982 TI - [Nursing of a patient with percutaneous transhepatic cholangiography with drainage (PTCD)--a patient scheduled for surgery and another planning to expand daily activities prior to discharge]. PMID- 2778983 TI - [Findings from the drained fluid]. PMID- 2778984 TI - [Advantages and disadvantages of drainage therapy]. PMID- 2778985 TI - [Technologically advanced medical care and professional nursing]. PMID- 2778986 TI - [Questions and answers on respiratory care: respiratory rehabilitation and self care of a patient who suffers from chronic respiratory insufficiency but has limited knowledge of the disease]. PMID- 2778987 TI - [Questions and answers on circulatory care: health education of a patient with a permanent pacemaker at the time of discharge]. PMID- 2778988 TI - [Questions and answers on the care of digestive diseases: health education of a patient with Osler's disease (hereditary hemorrhagic telangiectasia) at discharge following gastrectomy]. PMID- 2778989 TI - [Questions and answers on urological care: prevention of hemorrhage following TUR P (transurethral prostatectomy)]. PMID- 2778990 TI - [Questions and answers on the care of the motor system: assistance of a patient who is scheduled for anterior cervical decompression fusion but uninterested in preoperative physical training]. PMID- 2778991 TI - [Questions and answers on pediatric care: administration of drugs to a 3-year-old child who refuses medication]. PMID- 2778992 TI - [Questions and answers on gyneco-obstetrical care: assistance of a new mother who has difficulties in early ambulation and acceptance of her infant following a cesarean section]. PMID- 2778993 TI - [Questions and answers on emergency care: physician's order prohibiting posture changes and nurses' responses concerning a patient with traction following injuries in a traffic accident]. PMID- 2778994 TI - [Questions and answers on psychiatric care: nursing records of psychiatric patients]. PMID- 2778995 TI - [Training prior to discharge for patient's self care: self care by patients with cerebrovascular disorders]. PMID- 2778996 TI - [Life quality of patients with chronic obstructive pulmonary disease]. PMID- 2778997 TI - [Nursing study on self care by diabetic patients. 4. Self care activities and the ego state of the diabetic patient]. PMID- 2778998 TI - [Need for nursing philosophy]. PMID- 2778999 TI - [Development of clinical training programs and transitions in cooperation with hospital departments]. PMID- 2779000 TI - [Study on specific plans for clinical training and cooperation between the school and clinical facilities]. PMID- 2779001 TI - [Reflection on the self through educational evaluation: a learning experience for an instructor in clinical training]. PMID- 2779002 TI - [A study on the cooperation between the school and instructors of clinical training: analysis of processes at the conference for instructors in clinical training]. PMID- 2779003 TI - [A survey on simple everyday technique: with special reference to manual dexterity]. PMID- 2779004 TI - Effects of various drugs on bladder function in conscious rats. AB - In the present study, we attempted to evaluate the effects of various intravenous administered drugs, which had been shown to influence bladder function in anesthetized animals, on the cystometrogram in conscious rats placed in a restraining cage. Thiopental, diazepam, baclofen, clonidine and flavoxate, considered to act on the micturition center in the brain stem, hardly increased bladder capacity (time to micturition in cystometrogram) in conscious rats, but morphine, indomethacin and lidocaine, considered to act on the micturition center in the sacral cord or bladder mechanoreceptors, increased it. In a chronic conscious rat, histopathological findings show that the bladder tissue at 2 days after implantation of the catheter to the bladder showed experimental cystitis characterized by severe edema in the submucosa and an increase in prostaglandin E2 content, which is thought to stimulate directly and/or indirectly the capsaicin-sensitive sensory fiber in the afferent branch of the micturition reflex, and there was hyperreflexia characterized by decreases in both bladder capacity and urine volume. In conclusion, cystometrography in conscious rats placed in a restraining cage is thought to be a useful model for evaluating the true effect of a newly developed agent on bladder function. PMID- 2779005 TI - Abnormal lipid metabolism in adjuvant arthritic rats. AB - This study examined the altered lipid metabolism and effects of drug treatments during the development of adjuvant arthritis in rats. Before its onset (day 9 post-adjuvant), large decreases were noted in the serum total cholesterol, high density lipoprotein (HDL) cholesterol and triglyceride levels and, in particular, a large decrease in the lecithin-cholesterol acyltransferase activity. A large increase in the serum phospholipid level was also noted. As the arthritis progressed, the serum total cholesterol and HDL-cholesterol levels were rapidly reversed, finally reaching a level significantly higher than normal, together with rises in the serum free-cholesterol and lipid peroxide levels. These changes in serum lipids and enzyme activity could be normalized by treatment with cyclophosphamide, an immunosuppressive agent, but other than the serum triglyceride level, were not affected by treatment with indomethacin, a nonsteroidal anti-inflammatory drug, despite the fact that both drug treatments almost completely suppressed the progression of arthritis. These findings suggest that the abnormal lipid metabolism induced by adjuvant injection is not associated with the inflammatory activity, but associated with the immunopathologic response. PMID- 2779006 TI - Relaxation of airway smooth muscle induced by potassium in the presence of Ca antagonists. AB - We examined K+-induced relaxation instead of contraction in the presence of Ca antagonists by measuring isometric tension in the tracheal smooth muscle isolated from guinea pigs. Cumulative administration of KCl (10-90 mM) induced a concentration-dependent contraction. When the muscle was pretreated with low concentrations of Ca-antagonists, cumulative administration of KCl caused a mild contraction, followed by a moderate relaxation. In the muscle pretreated with high concentrations of Ca-antagonists, KCl revealed a concentration-related relaxation without contraction. The potency ratios of Ca-antagonists to reverse the KCl-induced contraction to relaxation were nifedipine : verapamil : diltiazem = 94:4:1. This order of potency was quite similar to that of Ca-antagonists to relax the muscle precontracted with KCl (30 mM). Magnitudes of KCl (30 m,) induced relaxation in the presence of Ca-antagonists were similar to those caused by Ca-antagonists in the KCl (30 mM)-precontracted muscles. Thus, K+-induced relaxation in the airway smooth muscle in the presence of Ca-antagonists may be due to the voltage-dependent increase in binding of Ca-antagonists to calcium channels. PMID- 2779007 TI - Adrenergic function and the development of analgesic tolerance to morphine. AB - Whether or not the suppressive effect of alpha- and beta-adrenergic blockers, phentolamine and propranolol, on the development of tolerance to morphine could be substituted for each other was investigated in mice. Daily co-administration of either one of the blockers with morphine suppressed the development of analgesic tolerance to morphine as far as the treatment was continued without affecting the analgesic effect per se; however, the suppressive effect was lost from the day of the substitution for the other blocker and tolerance developed as rapidly as in the control group treated with morphine alone. Co-administration of both blockers with morphine also maintained the analgesic effect on the 1st day for 10 days, but when the administration of either one or both blockers was eliminated from the 6th day, the development of tolerance was initiated. These results suggest that the mechanisms of alpha- and beta-blockers for the suppression of the development of analgesic tolerance to morphine are different from each other and that adrenergic blockers may produce a specific alteration in the mechanism for the development of tolerance to morphine. PMID- 2779008 TI - Influence of carotid chemoreceptors on the vagal reflex-induced tracheal constriction. AB - In this study, the effects of carotid chemoreceptors on reflex tracheal constriction were investigated in anesthetized, paralyzed, and artificially ventilated mongrel dogs. Reflex tracheal constriction was measured as changes in the intratracheal pressure of an air-filled balloon introduced into the rostral side of the transected trachea. A hypoxic condition was produced by ventilating the dog with 12% O2-88% N2. The reflex tracheal constriction induced by histamine inhalation to the bronchial side was reduced by section of the bilateral sinus nerves. The hypoxic condition significantly potentiated the reflex tracheal constriction induced by histamine inhalation. The potentiated reflex tracheal constriction during hypoxia was abolished by section of the bilateral sinus nerves. The afferent electrical stimulation to the central cut end of the vagus nerve caused a reflex tracheal constriction. The reflex tracheal constriction was significantly potentiated by hypoxia, and the potentiating response was abolished by section of the bilateral sinus nerves. The infusion of NaCN into the bilateral carotid arteries significantly potentiated the reflex tracheal constriction. The NaCN-induced potentiating effect was abolished by section of the bilateral sinus nerves. These results suggest that hypoxia potentiates the vagal reflex-induced tracheal constriction and that the hypoxia-induced potentiating effects may be mediated by carotid chemoreceptors. PMID- 2779009 TI - Species and sex differences in the inhibitory action of the corticosteroid alclometasone dipropionate on the hepatic drug-metabolizing system. AB - The effect of successive administration of the corticosteroid alclometasone dipropionate (ACM) on the hepatic drug-metabolizing system was examined using male and female rats. Although some pharmacological changes such as increases in plasma enzyme activity, lipid level and protein concentration appeared similarly in ACM-treated male and female rats, the activities of 7-alkoxycoumarin O dealkylase, especially the O-depropylation activity, decreased dose-dependently by ACM administration only in male rats. ACM did not affect the hepatic drug metabolizing activity in female rats and mice of both sexes. Also, ACM did not inhibit androgen-independent aniline hydroxylase activity even in male rats. The time course of changes of the drug-metabolizing system in male rats showed a rapid decrease in cytochrome P-450 content and O-depropylation activity following successive treatments with ACM, but there was a slow onset in the decreases of the O-demethylation and O-deethylation activities of 7-alkoxycoumarin. When ACM was withdrawn, the O-demethylation and O-deethylation activities rapidly returned to their control levels, while recovery of the O-depropylation activity was slow. These results suggested that ACM inhibits the hepatic drug-metabolizing enzyme activity associated with a specific form(s) of androgen-dependent cytochrome P 450 in male rats. PMID- 2779010 TI - Effect of minaprine on changes in monoamine contents in Mongolian gerbils with 5 min occlusion of common carotid arteries. AB - Effects of minaprine, a psychotropic drug, on changes in monoamines and their metabolites were examined in Mongolian gerbils with 5-min occlusion of the common carotid arteries. Noradrenaline (NA), dopamine, serotonin (5-HT), 5-hydroxyindol acetic acid, homovanillic acid and 3,4-dihydroxyphenyl acetic acid contents in the cortex, hippocampus and striatum remained unaltered during a 5-min occlusion. NA levels in the cortex, hippocampus and striatum and 5-HT levels in the hippocampus and striatum significantly decreased 30 min-2 hr after re circulation. Particularly, minaprine significantly inhibited the decrease of 5-HT in the hippocampus. These observations suggest that the effect of this drug on delayed neuronal death in the CA1 neurons in the hippocampus in Mongolian gerbils with occluded common carotid arteries may be related to the serotonergic system. PMID- 2779011 TI - Effects of CV-3611, a new free radical scavenger, on ischemic heart failure in conscious beagle dogs. AB - The effects of CV-3611, a new free radical scavenger, on coronary circulation failure and infarct size after ischemia/reperfusion were studied in conscious beagle dogs. The dogs underwent occlusion of the left circumflex coronary artery for 60 min and then were reperfused for 14 days. The dogs were divided into three groups: a control group, a pre-treated group that received CV-3611 or alpha tocopherol, and a post-treated group that received CV-3611. During occlusion, varying degrees of ventricular arrhythmia were noted; after reperfusion, the arrhythmia tended to become severe. CV-3611 at a daily dose of 10 mg/kg or 30 mg/kg and alpha-tocopherol at a daily dose of 60 mg/kg reduced the incidence of overall post-occlusion arrhythmia. Coronary blood flow in the control group was reduced to 20% of the preocclusion level at 7 days after reperfusion, whereas in the CV-3611 and alpha-tocopherol treated groups, the decreased coronary flow was remarkably suppressed. The infarct size for the CV-3611- and alpha-tocopherol treated groups, measured at 14 days after reperfusion, was reduced by 70% when compared with the control group. Based on these observations, it is proposed that CV-3611 exerts its beneficial effects on ischemic tissue by protecting against oxygen free radical-mediated damage induced by ischemia/reperfusion. PMID- 2779012 TI - Studies on antinephritic effect of TJ-8014, a new Japanese herbal medicine, and its mechanisms (1): Effects on original-type anti-GBM nephritis in rats and platelet aggregation. AB - In this study, we investigated the antinephritic effects of TJ-8014 and crude drugs in TJ-8014, in comparison to dipyridamole, on original-type anti-GBM nephritis in rats. TJ-8014 (2.0 and 3.0 g/kg/day, p.o., for 12 days) markedly inhibited the urinary protein excretion and the elevation of the plasma urea nitrogen (UN). In addition, TJ-8014 was effective in inhibiting the histopathological changes of hypercellularity and adhesion in glomeruli. Although dipyridamole (0.4 g/kg/day, p.o., for 12 days) had no effect on the plasma UN level, it was as effective as TJ-8014 on the other parameters. When each crude drug which constitutes TJ-8014 was given p.o., daily at 0.2 g/kg, only. Holen was effective in inhibiting the urinary protein excretion as well as histopathological changes. Ginseng radix reduced both the hypercellularity and the adhesion, while Bupleuri radix. Glycyrrhizae radix and Zizyphi fructus reduced only the hypercellularity. TJ-8014 and dipyridamole inhibited the platelet aggregation in normal and nephritic rats. These results indicate that TJ 8014, like dipyridamole, has a beneficial effect on original-type anti-GBM nephritis in rats and the antinephritic action of TJ-8014 may be partly due to the antiplatelet action of this agent. PMID- 2779013 TI - Blockade of enkephalinergic and GABAergic mediated locomotion in the nucleus accumbens by muscimol in the ventral pallidum. AB - The mu-opioid agonist, DAGO, and the indirect GABAA antagonist, picrotoxin, produced a dose-dependent increase in horizontal motor activity following injection into the nucleus accumbens that was independent of dopamine release. Injection of muscimol into the ventral pallidum antagonizes the motor stimulant effect of dopamine agonists. It was shown that muscimol abolished the locomotor stimulant effect of DAGO microinjection into the nucleus accumbens, and partially antagonized the effect of picrotoxin. PMID- 2779014 TI - The mode of action of indomethacin, aspirin and melatonin on the blockage of the first ovulation in immature rat pretreated with PMSG. AB - The purpose of this paper was to evaluate the anti-ovulatory effects of indomethacin, aspirin and melatonin by examining the LH sensitive 13,14 dihydroprostaglandin F2 alpha forming capacity in rat ovary. When ovulation was blocked by aspirin or melatonin, the forming capacity was strongly suppressed, and these effects were reversed by hCG injection. However, the ovulation blockage by indomethacin did not accompany the inhibition of the forming capacity. These results show that aspirin and melatonin block the ovulation via the hypothalamus pituitary level, and indomethacin acts directly on the ovary. PMID- 2779016 TI - [Focal point in evaluation of the health care of the aged]. PMID- 2779017 TI - [Health care of the aged and the evaluation of the service]. PMID- 2779015 TI - Enhancing activity of anthranilic acid on adjuvant arthritis in rats and antibody formation in mice. AB - Anthranilic acid (ANA), a metabolite of tryptophan, was examined for its immunopotentiating properties. Administration of ANA (12 mg/kg/day, p.o.) significantly enhanced the development of adjuvant arthritis in rats, although not in a dose-related manner. ANA tended to enhance adjuvant disease moderately suppressed by pretreatment with cyclophosphamide (CY), an immunosuppressive agent. ANA (3-30 mg/kg/day, p.o.) also caused a dose-related enhancement in the antibody formation to sheep erythrocytes (SRBC) in mice. PMID- 2779018 TI - [Evaluation of health examination services of the aged]. PMID- 2779019 TI - [Evaluation of the health education program for diabetic patients: activities at Yono-shi, Saitama Prefecture in the past 5 years]. PMID- 2779020 TI - [Evaluation of group activities in regional rehabilitation programs--effects of functional trainings of stroke patients and conditions for group activities]. PMID- 2779022 TI - [Medical check-up of the aged. 15. Psychiatric diseases (2)]. PMID- 2779021 TI - [Nursing in daily scenes. 26. Dressing and being dressed (7)]. PMID- 2779023 TI - [Localized health care activities in Shimane Prefecture. 31. Summary of the localized health care activities and an overview on the comprehensive health programs]. PMID- 2779024 TI - [Evaluation of training of newly appointed public health nurses: a survey on new nurses and their supervisors in Yamagata Prefecture]. PMID- 2779025 TI - Postoperative infection prophylaxis for upper gastrointestinal tract surgery--a prospective and comparative randomized study of cefoxitin and ceftizoxime. AB - A prospective and randomized clinical study was conducted in order to compare cefoxitin (CFX) and ceftizoxime (CZX) as prophylactic antibiotics. Two hundred and three consecutive cases of elective upper gastrointestinal tract surgery, performed at our institute between January, 1983, and March, 1986, were entered in the trial. The patients were assigned randomly, before surgery, to the CFX or to the CZX group. Two grams of the assigned antibiotic was first administered during surgery and then continued at a dose of 1 gram, every 8 hrs for a total of 4 days. One patient was withdrawn from the study due to an allergic reaction. Both groups were comparable in sex, age, underlying disease, diagnosis, operation, and preoperative laboratory data. There were 18 infections related to the operation in the CFX group, while there were only 3 in the CZX group (p less than 0.001). The number of unrelated infections in each group was 6 and 6 respectively (NS). No special differences were found between the two groups regarding the kinds of microorganisms isolated, and no significant differences were seen in the adverse effects of either antibiotic. Our study demonstrated that ceftizoxime was more efficient than cefoxitin in preventing postoperative infection, following upper gastrointestinal tract surgery. PMID- 2779026 TI - The clinical value of serum CA15-3 assay postoperatively in breast cancer patients. AB - Serum carbohydrate antigen (CA15-3) values were examined in 300 normal subjects in order to determine the standard value of this antigen. The clinical relevance of repeatedly assaying this marker in patients with or without recurrent breast cancer postoperatively was compared with assaying the serum carcinoembryonic antigen (CEA) values. The upper limit of CA15-3 was calculated as being 25.3 U/ml in the normal subjects and the distributions of CA15-3 values were not markedly different among the normal subjects, even if they had been selected according to sex or age. Moreover, no differences were observed among normal women who had been randomly selected according to the age distribution of the breast cancer patients. Thirty samples taken from the breast cancer patients postoperatively revealed values of higher than 25 U/ml and 73 samples showed lower levels. The serum CEA values were positive in 16 samples and negative in 85 samples. Although the accuracy of the CEA assay was about 10 per cent higher than that of the CA15 3 assay, its low positive rate was unsatisfactory for effective use in the breast clinic. The results of this study suggest that serum CA15-3 is not detectable unless there is a relatively large number of tumor cells. The higher false positive rate of the CA15-3 assay should therefore be considered as suggesting recurrence. PMID- 2779027 TI - Difference in main lymphatic pathways from the lower esophagus and gastric cardia. AB - Lymphatic pathways draining the lower esophago-cardiac region were studied in 17 patients with carcinoma of the lower esophagus or gastric cardia, by measuring radioisotope uptakes in the regional lymph nodes. The uptakes were most remarkable in lower mediastinal and upper gastric lymph nodes, when the radioactive colloid was injected at the lower esophagus. A lesser degree of uptakes were observed both in other mediastinal and abdominal lymph nodes. On the contrary, a high degree of uptakes were detected only in abdominal lymph nodes, when the colloid was injected at the gastric cardia. The results indicated that main lymphatic pathways originating from the lower esophagus advance both upward and downward, and that those from the gastric cardia make their way downward to upper gastric, para-celiac and para-aortic lymph nodes. The actual incidences of lymph node metastases were also studied in 108 patients with carcinoma of the lower esophagus and 93 patients with carcinoma of the gastric cardia. In the former group, very high incidences were observed in lower esophageal and upper gastric lymph nodes. In the latter group, the incidence was most remarkable in upper gastric lymph nodes and far less significant in lower mediastinal lymph nodes. The results confirmed those of the radioisotope study. The importance of dissection of para-aortic lymph nodes near the left renal vein was also stressed. PMID- 2779029 TI - The surgical treatment of congenital tracheal stenosis--a report of two cases. AB - Two patients with congenital tracheal stenosis, one who had segmental type stenosis and the other who had extensive type stenosis, were surgically treated at our hospital. The patient with segmental tracheal stenosis was successfully treated by resection and anastomosis. Five years postoperatively, although she was asymptomatic, endoscopic examination revealed a circumferential stricture with an inner diameter of about 3 mm in the upper trachea. A second operation was thus performed to remove the stenotic trachea and her postoperative course was uneventful. The second patient was a male whose extensive tracheal stenosis was associated with vascular ring and tracheal bronchus. Division of the vascular ring was not effective and a tracheoplasty using costal cartilage was performed twice, also unsuccessfully. He is now managed with a tracheostomy, using a long endotracheal tube which was specially designed for him. A recent bronchoscopy revealed a flaccid distal trachea. In this report, we also discuss the technical problems associated with treating congenital tracheal stenosis. PMID- 2779028 TI - The protective effects of trimetazidine on normothermic ischemic myocardium in rats. AB - The protective effects of trimetazidine on postischemic cardiac function were studied using isolated working rat heart preparations in which global ischemia had been induced with normothermic cardioplegia. After 30 minutes of reperfusion, following a 25 minutes period of ischemia, the addition of 10(-6) M or 10(-5) M trimetazidine to the cardioplegic solution significantly increased the per cent recovery of the cardiac output: from 54.8 +/- 4.1 per cent in the control group to 81.0 +/- 3.2 per cent (p less than 0.01) and 79.6 +/- 4.0 per cent (p less than 0.01), respectively, although lower (10(-7) M) or higher (10(-4) M) doses of the drug failed to result in any change. 10(-5) M trimetazidine also produced a significantly greater recovery of both the postischemic aortic flow: from 47.8 +/ 4.9 per cent to 72.2 +/- 3.8 per cent (p less than 0.01) and coronary flow: from 80.6 +/- 2.9 per cent to 105.2 +/- 6.3 per cent (p less than 0.002). However, trimetazidine did not influence the recovery of either aortic pressure or heart rate. These results suggest that trimetazidine does give some protection to the heart during ischemia and reperfusion. PMID- 2779030 TI - Spontaneous choledochoduodenal fistula complicating peptic ulcer disease--a case report. AB - Spontaneous choledochoduodenal fistula is a rare complication of peptic ulcer disease, the surgical therapy of which is generally directed towards the ulcer disease itself, in the form of vagotomy with antrectomy or gastrojejunostomy. The case reported herein is of a 40 year old man who presented with a spontaneous choledochoduodenal fistula which was successfully treated by a truncal vagotomy and posterior retrocolic gastrojejunostomy. Such procedures as cholecystectomy, common bile duct exploration and bilio-enteric reconstruction, should only be performed in the case of a biliary stricture, which occurs rarely. PMID- 2779031 TI - [Interposition graft method in the treatment of aortic regurgitation associated with aneurysm of the ascending aorta]. AB - Interposition graft method, total replacement of the ascending aorta with a valved conduit and reimplantation of the coronary artery by an interposed graft with some modifications, had been exclusively used for the treatment of aortic regurgitation associated with an aneurysm of the ascending aorta in consecutive 7 cases. Clinical improvement is apparent and postoperative angiographic study revealed a satisfactory coronary and aortic appearance with no leakage, pseudoaneurysm formation nor compression of the graft. This technique proved to be a reliable and safe method for the treatment of aortic regurgitation associated with an aneurysm of the ascending aorta with no mortality nor modality. PMID- 2779032 TI - [Application of epicardial approach technique to the anterior-paraseptal type Wolff-Parkinson-White syndrome]. AB - The patient with the anterior-paraseptal type WPW syndrome was operated upon with closed heart technique (so-called epicardial approach) of cryosurgery. Following intraoperative electrophysiologic studies, with ultrasonic aspirator, the epiannular fat-pad of the anterior right atrium was completely dissected to the epicardial side of the tricuspid annulus. Then the anterior paraseptal accessory pathway on the tricuspid annulus was ablated by cryosurgery (-65 degrees C, 3 min, total 9 trials). With this method, cardiotomy and establishment of cardiopulmonary bypass were not necessary to divide the accessory pathway, and significant hemodynamic instability was not caused. But in the case of accessory pathway near interatrial septum (for example, anterior paraseptal or posteroseptal) WPW syndrome, although cryoprobe was applied just adjacent to the AV node, careful ECG monitoring throughout cryosurgery obviated the injury to the AV node. PMID- 2779033 TI - [A case of the management of developed collateral vessels through left thoracotomy of recurrence of right bronchiectasia with hemoptysis]. AB - A 40-year-old woman, with a previous history of right S1, S2 segmentectomy and right middle lobectomy for bronchiectasis with hemoptysis at the age of 24, was admitted for frequent hemoptysis. As a result of a chest roentgenogram, a CT scan and bronchographic examination, a recurrence of bronchiectasis in the right ventral segment of the upper lobe (S3) and the right superior segment of the lower lobe (S6) was diagnosed. The bronchial arteriogram and aortogram showed four vessels going into this region and a shunt lesion was located on located on the proximal side of the pulmonary artery. If a right pneumonectomy had been done, pulmonary function would have gotten worse. If a right thoracotomy had been performed, there would have been much bleeding from the entering vessels. Therefore, a left thoracotomy was preformed and those vessels ligated. The patient is doing well one year after the operation without hemoptysis. PMID- 2779034 TI - [Axillary vertical incision thoracotomy sparing pectoralis major muscle and latissimus dorsi muscle: an approach for patent ductus arteriosus]. AB - The technique of an axillary vertical incision thoracotomy sparing pectoralis major muscle and latissimus dorsi muscle for a closure of patent ductus arteriosus is presented. After an mid-axillary vertical incision, serratus anterior muscle is incised on the third intercostal space between pectoralis major muscle and latissimus dorsi muscle. The space between serratus anterior muscle and rib cage (Spatium intermusc. thoracale) is dissected with a finger, through this space the 3rd intercostal thoracotomy is performed in the axillary and dorsal portion. The ventral part of intercostal muscle is incised from inside of the thoracic cavity for sparing the pectoralis major muscle. We performed this technique in two patients aged 1 year, and secured equally good operative fields as could be secured by the original axillary vertical incision thoracotomy described by Browne. PMID- 2779035 TI - [Surgical experiences of Cor triatriatum in infancy]. AB - Three operative cases with Cor triatriatum, age ranged from 30 days to 16 months, were presented. All types were IB1 of Lucas-Schmidt's classification and one patient was associated with right upper PAPVC. One patient died of low output syndrome due to preoperative shock. Communication of abnormal diaphragm in left atrium varied from small and multiple to 5 mm in diameter. Their preoperative diagnoses were established by two-dimensional echocardiogram prior to angiocardiogram and the intracardiac communications were well evaluated by color doppler echocardiogram which was superior to angiocardiogram in this evaluation. Postoperatively, no abnormal diaphragm were detected in two survivors. The diagnosis and operative procedure for this anomaly were discussed on. PMID- 2779036 TI - [A case report of ascending-abdominal aorta bypass in the treatment of atypical coarctation]. AB - A 45-year-old woman, who had atypical coarctation of the aorta due to aortitis syndrome, underwent ascending-infrarenal abdominal aorta bypass successfully. A woven dacron prosthesis of 14 mm in diameter was anastomosed to the ascending aorta. The course of the graft arranged to pass through a hole cut into the diaphragm across the omental sac behind the pancreas to the infrarenal abdominal aorta. This operation is approached through a midline sternal-splitting and abdominal incision, accordingly pulmonary complication and injury to major collateral vessels associated with lateral thoracotomy can be avoided. PMID- 2779037 TI - [A case report of aneurysm of the sinus of Valsalva due to infectious endocarditis with ASR]. AB - A case (56 year-old, female) of the aneurysm of sinus of Valsalva due to infectious endocarditis with aortic stenosis and regurgitation was described. The patient was successfully operated upon by patch closure of the orifice of the aneurysm and aortic valve replacement with Medtronic Hall 23A. Post operative course was uneventful and discharged from the hospital at 37 post operative days in good condition. PMID- 2779039 TI - [A clinical experience of signs of compression in the neighboring organs after operation with Carpentier's method in dissecting aneurysm of the aorta]. AB - A patient with a DeBakey IIIb type dissecting aneurysm of the aorta was treated with Carpentier's method. But after surgery the thromboexclusion procedure at the pseudo-lumen was insufficient. Fourteen months after surgery the left lung area suddenly became opaque, suggesting the possibility of impending rupture of the aneurysm. Therefore the patient underwent emergency surgery in which another permanent clamp was attached to the peripheral end of the aneurysm. After this operation, the aneurysm became reduced in size and the left lung inflated again, but an aorto-pulmonary fistula was formed 24 days later. After 6 months after second surgery, the patient began to experience dysphagia and dyspnea on exertion. Detailed examinations showed that these symptoms were caused by compression of the esophagus, bronchus and pulmonary artery by the permanent clamp. That is, this clamp, which possibly moved during organic change and size reduction of the aneurysm, seems to have compressed the adjoining organs enough to cause dysfunction. Such a compression of the neighboring organs can be regarded as one of problems originating from Carpentier's method, and shows that the procedure is not problem free yet. PMID- 2779038 TI - [A case of a two-chambered right ventricle associated with aneurysm of the sinus of Valsalva]. AB - A 51-year-old male with a two-chambered right ventricle associated with an aneurysm of sinus of Valsalva, who underwent successful surgical repair without ventriculotomy, is reported. Preoperative right ventriculogram revealed that the right ventricle was divided by the anomalous muscle bundle, and the aneurysm of sinus of Valsalva growing from the right coronary sinus protruded just below the pulmonary valve. The right ventricular pressure was 107/10 mmHg and the pressure gradient between the right ventricle and the pulmonary artery was 88 mmHg. Trans pulmonary arterial resection of the aneurysm of Valsalva sinus was performed and the anomalous muscle bundle was successfully removed through the pulmonary arteriotomy and the right atrial incision. Post-operative right ventricular pressure dropped to 42 mmHg, and there was no stenosis in the right ventricle. PMID- 2779040 TI - [A case of dumbbell neurogenic tumor in the posterior mediastinum]. AB - We have recently experienced a dumbbell tumor that developed in the posterior mediastinum in a 64-year-old male. The patient suffered from dorsalgia one year and a half previously. Chest X-ray examinations revealed a well-defined boundary in the right posterior mediastinum. Myelography followed by computerized tomographic scanning (CT) revealed that the tumor developed in a paravertebral area linked with a vertebral canal through an intervertebral foramen and destructed a rib in growing in the paraspinal muscular layer. Longitudinal incision of about 10 cm was made downward from immediately above the first thoracic spinous process, and the chest was opened by posterolateral incision extending into the muscles of the back in an arc shape. The tumor was entirely excised by additional laminectomy. Since malignant schwannoma was diagnosed histologically, Linac X-ray of 50 Gray was given. The patient is now enjoying his healthy daily life with no postoperative complication 2 years after operation. Myelography followed by CT was proved to be quite useful in evaluating a relationship between the tumor and the spinal cord in the diagnosis of this disease. PMID- 2779041 TI - [A case of primary lung cancer associated with diffuse panbronchiolitis]. AB - Pulmonary resection was performed for primary lung cancer of a 72-year-old patient which was associated with diffuse panbrochiolitis that required home oxygen therapy. The preoperative total pulmonary vascular resistance at rest was 564 dyne.sec.cm-5/m2, but thoracotomy and reduction surgery were possible by strict respiratory and circulatory control. The troublesome postoperative pulmonary phthisis was dealt with through extended control by means of total parenteral nutrition and use of the Heimlich valve. PMID- 2779042 TI - [A case report of atypical coarctation of the aortic arch with thoracic aortic aneurysm]. AB - A 30-year-old woman was admitted to our hospital because of the abnormal shadow on chest X ray film and paralysis of right fingers. The preoperative aortogram and DSA showed atypical coarctation of the aortic arch with thoracic aortic aneurysm. We successfully performed extra-anatomical bypass with a 14 mm Cooley low porosity Ducron graft between ascending aorta and discending aorta. Her postoperative course was uneventful and discharged one month after the operation. PMID- 2779043 TI - [Replacement of omniscience mitral valve in suboptimal opening]. AB - This 57-year-old female of MS had been treated by MVR with a 25 mm Omniscience valve on October 26, 1983. She was doing well until November 1984 when she developed general malaise and dyspnea. She was hospitalized again on June 3, 1985. Studies including echocardiogram and cardiac catheterization revealed mitral stenosis. The echocardiogram showed rapid blood stream toward the interventricular septum. The maximum opening angle of the disc was measured 30 degrees on the cine film. The cardiac catheterization showed increased PA and PA wedge pressures. The Omniscience valve was replaced with a 25 mm SJM valve on July 19, 1985. The postoperative course was uneventful. The postoperative echocardiogram and cardiac catheterization showed significant improvements in flow pattern and intracardiac pressure. She is doing well as an instructor of Japanese dancing after discharge from the hospital. PMID- 2779044 TI - [Report of 108 patients with valvular heart disease who underwent re-operations through repeated median sternotomy incision]. AB - 108 patients who underwent redo median sternotomy between January 1975 and April 1988 were studied to determine factors affecting risk of cardiac reoperations. (1) Seventeen of 108 patients died, yielding an overall mortality of 15.7%. (2) Preoperative diagnosis had a significant correlation with mortality, which was higher with prosthetic valve endocarditis (50.0%) than with all other indications for reoperation. (3) Operative mortality was related to pre-reoperation functional class: 8.7% for New York Heart Association (NYHA) class II, 9.8% for class III and 27.8% for class IV. (4) Based on the degree of urgency, elective reoperation had a mortality of 5.4%, while emergency procedures carried a mortality of 61.5%. (5) Cardiac catheterization information was available in 53 patients. The pulmonary artery pressure was higher in the died group. There were no significant differences in pulmonary capillary wedge pressure and cardiac index between the survived and died. (6) Operation time, aortic cross clamp time and pump run were significantly longer in the died than in the survived group. The died had more blood loss during operative procedure. To decrease operative mortality, technical improvement and increased experience were necessary for surgeons. We prefer to free entirely pericardial adhesion to facilitate mobilization and evacuate air, and to make intra-cardiac procedure more easier and safety. Furthermore early reoperation before irreversible deterioration occurs was necessary since myocardial function was found to be a major determinant of surgical results. PMID- 2779045 TI - [Direct aortic reimplantation for BWG syndrome including mitral valve repair]. AB - Direct aortic reimplantation is the ideal treatment for the BWG syndrome, but is often impossible to obtain a sufficient length of the coronary artery without undue tension on the vessel. We experienced a 6-year-old boy whose left coronary artery was originated from pulmonary trunk widely distant from aorta. Direct reimplantation was successfully performed taking care of excising the ostium of the anomalous vessel as a largest flange and mobilizing the coronary artery from the adjacent tissue sufficiently. Mitral valve regurgitation is also a poor prognosis factor of BWG syndrome. We performed direct reimplantation and mitral valve repair (anterior commissuroplasty) simultaneously to a 3-year-old boy of BWG syndrome with severe mitral valve regurgitation. Postoperative data showed improvement of cardiac performance. Possibility of recovering the papillary muscle function by valve repair without replacement was suggested. PMID- 2779047 TI - [A case report of subdiaphragmatic pulmonary sequestration]. AB - A 32-year-old man with extralobar pulmonary sequestration under diaphragm is reported. The patient was admitted because of abnormal shadow on chest X-ray film without any complaints. Chest roentgenogram showed a homogenous density at the left cardiophrenic angle. Aortogram demonstrated an abnormal artery arising from the abdominal aorta to left subphrenic mass shadow. On laparotomy a large cystic mass connected with diaphragm was found behind the stomach and removed successfully. The postoperative course was uneventful. The histological diagnosis was subphrenic pulmonary sequestration. The frequency, localisation, pathogenesis of pulmonary sequestration are discussed. PMID- 2779046 TI - [Internal mammary artery grafting to the circumflex coronary artery]. AB - The in-situ left internal mammary artery (LIMA) was anastomosed to the circumflex coronary artery (Cx) in 20 patients. The right internal mammary artery, the saphenous vein and the right gastroepiploic artery were also utilized to bypass the other coronary arteries. Sequential LIMA grafting to the diagonal branch and CX was performed in 2 patients. The sites of LIMA anastomosis were 15 obtuse marginal branches and 5 posterior lateral branches. All LIMA-Cx anastomoses were performed with single 8-0 polypropylene continuous suture technique. Mean number of distal anastomosis was 3.1 ranged from 2 to 4. Mean aortic cross clamp time was 68.5 minutes ranged from 42 to 87 minutes, and mean cardiopulmonary bypass time was 116.6 minutes ranged from 73 to 167 minutes. One patient died of renal failure at 22nd postoperative day, and the other patients were alive with relief of angina. New Q wave was noted in 1 patient. Postoperative angiogram at mean 2.0 months showed 100% patency of LIMA in restudied 12 patients. We concluded that the in-situ LIMA grafting to Cx system can be done with acceptably low mortality and excellent patency rate, and its utilization is particularly desirable in younger patients. PMID- 2779048 TI - [Clinical experiences with a new membrane oxygenator with low priming volume (D702 MASTER FLO 51), studies during pulsatile and constant flow perfusion]. AB - The newly developed oxygenator "D702" is a compact hollow fiber membrane oxygenator with a priming volume of 170 ml. The maximum flow allowance is 4 liters per/minute. We used this oxygenator in 16 patients (11 infants and children, and 5 adults) undergoing various open heart surgery, and function of this oxygenator was studied. Pulsatile cardiopulmonary bypass was performed in 8 patients and nonpulsatile constant flow perfusion was employed in the remaining 8 patients. Our clinical experience showed excellent maintenance of PaO2 and PaCO2 during both pulsatile and constant flow bypasses. A low pressure drop was encountered across the membrane oxygenator, and therefore, this oxygenator is applicable for pulsatile cardiopulmonary bypass. The D702 is a very useful and applicable for a wide range of patients from infants to adults with a small body structure. PMID- 2779049 TI - [A new valved conduit with commissures using a glutaraldehyde preserved equi pericardium]. AB - We developed a new valved conduit with commissures using a glutaraldehyde preserved equine pericardium, and implanted this prosthesis between the right ventricle and the pulmonary artery in the dog to examined the movement of the valve. Our new prosthesis consists of a conduit and three leaflets. Each leaflet is sutured to the inner surface of the conduit to form a valve. The adjacent free edges of the leaflets are sutured together by placing a mattress stitch 2 mm from their attachment to the conduit so that the leaflets form commissures. These commissures are designed to facilitate prompt coaptation of the three leaflets in diastole. A radiopaque marker is anchored to the center of the free edge of each leaflet and to the outer surface of the conduit to investigate its movement. The movement of the radiopaque markers studied by cineangiography revealed good coaptation of three leaflets in diastole and their full opening in systole. These findings demonstrated that the valve in our prosthesis might function well to prevent regurgitation across it. PMID- 2779050 TI - [Surgical treatment of metastatic lung cancer arising from the colon and rectum]. AB - Ten cases of surgically resected pulmonary metastases arising from colorectal cancer were analyzed. Five year survival rate of these patients was 14%. Only one patient survived more than five years, whose primary and metastatic lesions were not so progressive without lymph node metastasis. The rate of regional lymph node metastasis was 25% and the patients with positive nodes died or had recurrence within 2 years. Serum CEA level was useful as a tumor marker and high-level of serum CEA after operation suggested remnant disease. PMID- 2779051 TI - [A case of mediastinal undifferentiated carcinoma]. AB - A 33-year-old man showing the right anterior mediastinal mass on his chest x-ray film admitted to our hospital. At thoracotomy extirpation of the cystic tumor was performed. The tumor was 7 x 7 x 5 cm in size and contained coffee-coloured fluid. Histological examination confirmed undifferentiated carcinoma. Postoperatively he was treated with 60Co 50 Gy and chemotherapy. He has been well 4 years after operation. PMID- 2779052 TI - [Angiographic findings in a patient with spontaneous hemopneumothorax]. AB - We experienced one patient with spontaneous hemopneumothorax in whom angiography was performed preoperatively. The patient was a 23-year-old female and her plain chest X-ray revealed an index-finger-tip-sized bulla at the left apex and a narrow restiform shadow connecting the pleural cupola with the bulla. Left subclavian arteriography revealed preoperatively that the restiform shadow consisted of aberrant vessels branched from the left costocervical trunk and distributed in and around the bulla at the apex. In the present study very rare angiographic findings and excised specimens obtained from the patient are shown, with reference to surgical indication of spontaneous pneumothorax. PMID- 2779053 TI - [Total anomalous pulmonary venous connection in adult: report of a case]. AB - Total anomalous pulmonary venous connection (TAPVC) is a cardiac disorder that seldom permits survival into adulthood without surgical correction in infancy. We reported a successful total correction in a 47-year-old man with TAPVC. Cardiovascular angiography demonstrated the features of Darling I a type TAPVC. Cardiac catheterization showed Qp/Qs: 5.8, Pp/Ps: 0.31, Rp/Rs: 0.06 and mild pulmonary hypertension. On operation, the posterior wall of left atrium anastomosed to the common pulmonary vein over 4 cm length, ASD (5.0x3.8 cm) was closed with patch, and the communicating vein was ligated. The patient made uneventful postoperative recovery and is well 3 months following surgery. PMID- 2779054 TI - [Surgical repair of common atrium associated with persistent left superior vena cava draining into the left atrium]. AB - A case of 54-year-old female of common atrium associated with persistent left superior vena cava (PLSVC) draining into the left atrium and absence of the coronary sinus was experienced. The corrective surgery was done by using a horseshoe-shaped autologous pericardial patch to make a new atrial septum to allow the PLSVC draining into the right atrium. Since the common atrium is frequently associated with maldrainage of the PLSVC, the surgical treatment should be determined according to existence of the PLSVC and its opening site. PMID- 2779055 TI - [Bypass operation adaptable to stature increase in child with atypical coarctation of the aorta]. AB - A 9-year-old girl was admitted with hypertension and severe congestive heart failure. Upon physical examination, a discrepancy of blood pressure between arm and leg was noted. Aortography revealed narrowing about 5 cm in length at the midportion of the descending thoracic aorta. Bypass operation of the narrow segment was performed under mild hypothermia with the diagnosis of atypical coarctation of the aorta. It was supposed that the patient might outgrow the graft and the graft would become too small for grown-up patient in diameter and length, then the haemodynamics would become less satisfactory and too much tension on the suture line would occur. A woven Dacron graft, 10 mm in diameter, 15 cm in length, was anastomosed proximally and distally to the coarcted segment at a distance of about 6 cm. So, the graft was disposed in a C-shaped configuration. It was expected that the arch of the graft would open more widely with increase of her stature, even if the graft does not increase in length. She has been followed for twelve years. Hypertension of upper extremity and arm-to leg gradients of the systolic blood pressure were recognized from two years after the operation, particularly with exercise. However, cardiomegaly and left ventricular hypertrophy in ECG were improved. She appears to have been developing normally with no cardiac symptoms. Estimating from angiography, the distance between proximal and distal anastomoses stretched about 2 cm during the period of rapid growth, though calcification of the graft had been seen from four years after the operation, perhaps due to increased calcium turnover in childhood. PMID- 2779056 TI - [A case of emergency replacement of SAM disk valve prosthesis for disk detachment]. AB - A 47-year-old patient had undergone the mitral valve replacement using a SAM disk prosthesis in 1977. 15 years and 10 months after the first operation, she successfully underwent emergency replacement with a St. Jude Medical valve prosthesis because of detachment of the disk of the SAM prosthesis and now she is doing well. PMID- 2779057 TI - Effects of various cryoprotectants on the survival of mouse embryos cryopreserved by the quick freezing method. AB - The effects of concentrations of glycerol, ethylene glycol or dimethylsulphoxide (DMSO) in the presence of either 0.25 M lactose or sucrose on the post-thaw survival of mouse quickly-frozen compacted morulae were studied. In this method, the embryos were directly frozen in liquid nitrogen (LN2) vapor at approximately 170 degrees C for 2 min before being plunged into LN2. High survival rates of frozen-thawed embryos were obtained when the freezing medium contained 3 M ethylene glycol with either 0.25 M lactose or sucrose (76.5 and 70.2%, respectively). When the embryos were frozen in glycerol, significantly high survival was obtained with 3 M glycerol + 0.25 M sucrose (73.5%, P less than 0.001). However, a freezing medium containing DMSO with either sugar gave lower survival rates. At a higher concentration of 4 M, ethylene glycol with 0.25 M lactose gave significantly higher survival rate than glycerol or DMSO (P less than 0.05). Significantly higher rates were obtained at 2 M with all 3 cryoprotectants when the freezing medium contained lactose rather than sucrose (P less than 0.05). This study showed that glycerol and ethylene glycol were effective cryoprotectants in the quick freezing of mouse embryos, while DMSO was less effective. In addition, the protective effects of these cryoprotectants are affected by their concentrations and the type of sugar used. PMID- 2779058 TI - Micronucleus test in mice fed on an irradiated diet. AB - A mutagenicity study was carried out in mice fed on a gamma-irradiated diet. As an indicator of mutagenic activity, we observed an incidence of micronuclei in erythrocytes. The average body weight of the mice fed on the diet irradiated to dose range of 400-1,000 kGy decreased, and the mice fed on the 800-1,000 kGy irradiated diet died during the period from 8 to 14 days after the start of feeding. On the other hand, when the mutagenic activity of the irradiated diet was tested by observing occurrence of micronucleus in erythrocytes, no significant increase was recognized. These results indicated that the irradiated diet had no mutagenic activity, even though it possessed a toxic effect on the growth of mice. PMID- 2779059 TI - Electrocardiogram studies in llamas. AB - Electrocardiograms (ECG) of 3 captive llamas (Lama glama) were recorded by a telemeter at a farm in Japan. The pattern of the ECGs was similar to the ruminant pattern in the AB lead position. QRS and T-waves were discordant in polarity except in one llama, where the polarity of the T wave changed according to the HR. In the quiet state, the HR varied between 60-80/min depending on the nervousness of the llama. After running and after being held, the HR increased to more than 100/min. During the recordings there were some variations of the HR which could be due to respiratory arrhythmia. Second-degree AV block and supraventricular premature complexes were also found in two llamas. PMID- 2779060 TI - Pathology of anomalous junction of the pancreaticobiliary ductal system: mutagenicity of the contents of the biliary tract and nuclear atypia of the biliary epithelium. AB - Congenital biliary dilatation is frequently complicated by biliary tract cancer, and anomalous junction of the pancreaticobiliary ductal system, a major factor constituting the pathology of this disease, is considered to be important as a background for carcinogenesis in the biliary tract. To clarify the mechanism of carcinogenesis in the biliary tract under the circumstance of anomalous junction, we evaluated the mutagenicity of the contents of the biliary tract in patients with congenital biliary dilatation and analyzed the nuclear atypia of the biliary epithelium by fluorocytometry. A mutagenicity test using Bacillus subtilis showed positive results in 6 of 12 patients. Since mutagenicity correlates well with carcinogenicity, these results suggest the necessity of separation surgery between the bile and pancreatic ducts in patients with anomalous junction regardless of the presence or absence of biliary dilatation. On the other hand, DNA histograms of the nuclei of gallbladder epithelial cells produced by fluorocytometry in 4 patients revealed a high incidence of polyploid DNA in 2 patients with marked hypertrophic changes. These patients were also positive for mutagenicity of the contents of the biliary tract, suggesting that mutagens are involved in the atypia at the cellular and nuclear levels. PMID- 2779062 TI - Abstracts: meetings of the Keio Medical Society. 1988 and 1989. PMID- 2779061 TI - Health policy and implementations in Tanzania. AB - This paper describes the current health policy in Tanzania and its implementations. The present health policy in Tanzania originated from Arusha declaration of 1967, the country's most popular national policy after independence. Arusha declaration proclaims socialism and self-reliance, which has had important impact on the form and content of the present country's health policy in mainland Tanzania. Much of the wide-spread health care services infrastructure that is evident now in rural areas of Tanzania mainland is a result of the re-emphasis of the Arusha declaration in 1971. In Tanzania, the Ministry of Health has the responsibility for elaborating the health policy, ensuring that strategies and appropriate program are developed to give effect to the policy. In the present health policy discussed, the goal is seen to have shifted from having one dispensary in each village to one primary health unit in each village. One dispensary is intended to serve several villages together. In Tanzania, according to the present health policy, the village primary health care are mainly preventive oriented and only being managed by short term trained health staff. The candidate for training in each village is selected, among the village residents, by the villagers themselves. The primary health care system adopted by Tanzania is viewed as the only way through which it can achieve the social goal of health for everyone by the year 2000, provided the present political will which is evident continue, and enough availability of, human, financial and material resources.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2779064 TI - [A new method of detecting the arrhythmogenic activity of the heart ventricles]. PMID- 2779063 TI - [Blood lipids and lipid peroxides in the families of patients with ischemic heart disease]. AB - Levels of some fractions of blood neutral lipids and lipoperoxides were compared in the families of patients with coronary heart disease. The patients and their relatives (including healthy ones) were found to show a statistically significant increase in the atherogenic index, total cholesterol, low density lipoprotein cholesterol, triglyceride, total lipid, and lipoperoxide concentrations and a decrease in high density lipoprotein cholesterol levels as against controls. The changes in the values of lipids and lipoperoxides in the families of patients with coronary heart disease were homogenous and might be one of the pathogenetic links in the formation of hereditary predisposition to atherosclerotic cardiovascular diseases which might be detected in a prehospital period. PMID- 2779065 TI - [Effect of ethacizine on the chronic stimulation threshold]. PMID- 2779067 TI - [Surgical treatment of occlusive diseases of the carotid and subclavian arteries]. PMID- 2779066 TI - [Use of enterosorbents and hemosorption in the treatment of ischemic heart disease]. PMID- 2779068 TI - [Antithrombogenic activity of the vascular wall in patients with diabetes mellitus and its role in the development of vascular complications]. PMID- 2779069 TI - [Possibility of objective evaluation of the pain syndrome in ischemic heart disease using skin electrothermometry]. PMID- 2779070 TI - [Characteristics of systemic macro- and microcirculation in meningococcal meningitis]. PMID- 2779071 TI - [A case of intraoperative laser angioplasty of the coronary arteries]. PMID- 2779073 TI - [Effect of lipids on thrombocyte aggregation in patients with ischemic heart disease]. AB - Platelet lipid composition was studied in healthy subjects and patients with coronary heart disease (CHD) and effects of various phospholipids (PL) were examined on aggregatory parameters. The patients with CHD was found to show higher levels of lysophosphatidylcholine (LPC), phosphatidic acid (PA), cholesterol (Chol), increased Chol/PL of saturated fatty acids, elevated malonic dialdehyde and lower phosphatidylinositol (PI) concentrations. Addition of liposomes from various PL classes to platelet-rich plasma indicated as follows. Phosphatidylserine (PS) liposomes caused a decrease in the platelet aggregation both in healthy subjects and CHD patients. Phosphatidylcholine- (PC), phosphatidylethanolamine- (PE), PI-, and LPC-liposomes increased the platelet aggregation in healthy subjects. Incubation of PE- and PI-liposomes with platelet rich plasma from CHD patients resulted in lower platelet aggregation, whereas that of PC and LPC liposomes led to its increase. In CHD patients, the changes in the platelet lipid composition were likely to occur due to stimulation of lipid peroxidation and activation of platelet phospholipases, and diminished platelet aggregation caused by addition of PI- and PE-liposomes was likely to be associated with reconstruction of lipid composition and reduction of substrates of the phosphoinositide cycle. PMID- 2779072 TI - [Blood lipids as a factor of hereditary susceptibility to ischemic heart disease]. AB - Examination of 166 families of the patients who had sustained myocardial infarction revealed aggregation of coronary heart disease in the families and the atherogenic shifts in the parameters of lipid turnover, which were caused by significant influences of genetic factors. The close relatives of the postinfarction patients were shown to display a large proportion of monogenic forms of hyperlipoproteinemias. PMID- 2779074 TI - [Effect of alpha-tocopherol combined with finoptin on the level of lipid hydroperoxides in plasma lipoproteins and on the functional activity of thrombocytes in patients with exertion-induced stable stenocardia]. AB - Thirty three patients with stable effort-associated angina (Functional Class II) were examined. Enhanced lipid hydroperoxide levels in plasma lipids from the patients were found to play a pathogenetic role in the disturbance of platelet microcirculatory homeostasis. The calcium antagonist finoptin used in combination with alpha-tocopherol made it possible to decrease lipid hydroperoxide levels in low density lipoproteins and malondialdehyde concentrations in platelets, to prevent abnormal cyclic nucleotide metabolism in them and to increase tolerance to physical exercise. PMID- 2779075 TI - [Prognostic significance of total blood cholesterol level and the possibility of dietary correction of hypercholesterolemia in the population]. AB - In a population of males aged 40-59 years, a routine epidemiological survey was performed, which was followed by a 5-year follow-up to examine the mortality rates and incidence of myocardial infarction and stroke treated by an active prophylactic measure program (Group 1) and conventional regimen (Group 2). The total cholesterol levels of 260 mg/dl or more were found to be of highly prognostic value to death from all causes, largely cardiovascular diseases, to development of myocardial infarction, stroke, and to higher risk of fatal cases of the diseases. It was ascertained that it was difficult to modify the dietary habits in subjects of mature age. By the end of the fifth follow-up year, the examined patients from Group 1 showed a reduction in the mean level of total cholesterol and hypercholesterolemia rates, following by a decrease in total and cardiovascular mortality by 6.5 and 5.7%, respectively, the incidence of myocardial infarction and stroke and the risk of death from these complications becoming lower. PMID- 2779076 TI - [Prevalence of ischemic heart disease, arterial hypertension and dyslipoproteinemia in persons with disorders of glucose tolerance]. AB - Among 3490 males and females aged 20-69 years, oral glucose tolerance testing (GTT) revealed diabetes mellitus (DM) and abnormal glucose tolerance (AGT) in 94 and 401 persons, respectively. The prevalence of coronary heart disease (CHD), arterial hypertension (AH), and dyslipoproteinemias (DLP) was examined in groups of subjects that had normal GTT indices, patients with DM, and persons with AGT. In the latter, the prevalence of CHD was found to significantly higher than in those with normal GTT indices and be increased with severity of carbohydrate metabolic disturbances. The prevalence of AH did not drastically differ in persons with AGT and those with normal carbohydrate metabolism. The prevalence of DLP was significantly higher in subjects with AGT than in those with normal GTT values. It was also ascertained that DLP, as opposed to AH, was more meaningful as a risk factor for the development of CHD in persons with AGT and patients with DM. PMID- 2779077 TI - [Newly developed stenocardia: fibrinolysis and hemostasis at rest and during physical exercise after myocardial infarction]. AB - Postmyocardial infarction patients with angina of new onset showed increased blood levels of fibrinogens, soluble fibrin and fibrinogen-fibrin degradation products one month after the acute onset of MI, while their baseline fibrinolysis had been normal. A variety of fibrinolytic disorders were revealed in response to physical stress. PMID- 2779078 TI - [Prospective trends in studies on the role of lipoproteins in human atherogenesis: their effect on disease progression, diagnostic value and the possibility of corrective interventions]. PMID- 2779079 TI - [Status of central hemodynamics in patients with hypertension and secondary arterial hypertension]. AB - A study was undertaken to examine 285 patients with hypertensive disease and 187 with secondary arterial hypertension. Their hemodynamic parameters were assessed by a radionuclide method. It was found that there were various blood circulatory types at each stage, no matter what the clinical type of the disease. The state of central hemodynamics was demonstrated to be associated with interaction of cardiac and peripheral mechanisms responsible for blood circulatory regulation. PMID- 2779080 TI - [Positive effect of the adaptation to periodic anoxia in patients with idiopathic arrhythmia in the atmosphere exposure chamber]. PMID- 2779082 TI - [Possibilities of echo- and Doppler echocardiography in the diagnosis of congenital coronary fistulas]. AB - A complex ultrasound examination makes it possible to tentatively differentiate a coronary fistula and recommend to perform coronary angiography. The tentative diagnosis of coronary fistula can be made on the basis of a set of the following sings: location of aneurysmally enlarged ostium and proximal segment of a coronary artery along with an intact contralateral one; recording of abnormal turbulent systolic and diastolic blood flow in the aneurysmally enlarged coronary artery. The location of coronary distal segments and the site of the coronaryfistular shunt are a complicated problem that awaits further exploration. PMID- 2779081 TI - [Decreased thresholds of pain sensation and defense flexor reflex in patients with ischemic heart disease]. AB - It was demonstrated that patients with coronary heart disease with coronary angiographically documented stenosing coronary atherosclerosis and frequent episodes of angina pectoris had significantly higher pain threshold in response to electric skin irritation and greater defense unconditioned flexor reflex R-III threshold than healthy subjects and patients with chest pain of extracoronary genesis. PMID- 2779083 TI - [Partial congenital absence of pulmonary artery cups]. PMID- 2779084 TI - [Functional state of the left heart in aortic regurgitation of varying degrees]. AB - An attempt was made to noninvasively assess the myocardial reserve by using a bimanual isometric exercise (BIE) in patients with aortic failure depending on the degree of aortic regurgitation (AR). The patients with Grade I AR, like healthy subjects, showed their responses to BIE, by significantly enhancing systolic BP, heart rate (HR), left ventricular ejection fraction (LVEF), stroke index and decreasing the end systolic volume of the left ventricle, which indicated that the left ventricle had great compensatory potentialities. With physical exercise, the patients with Grade II AR displayed an inadequately small increase in LVEF and velocity of myocardial circular fiber contractions, which suggested latent ventricular failure and was an indicator of diminished myocardial reserve. In response to BIF, there was a significant reduction in LVEF along with a substantial increase in the maximal size of the left atrium in the patients with Grade III AR, attesting that myocardial functional potentialities were considerably reduced. PMID- 2779085 TI - [Use of obsidan in patients with myocardial infarction]. AB - An assessment of antiarrhythmic efficiency of obsidan by means of repeated 24 hour ECG monitoring with tape recording was made in 42 patients with a documented anterior transmural and macrofocal myocardial infarction. A marked and significant antiarrhythmic effect of obsidan was demonstrated with respect to most arrhythmias, particularly high-grade ventricular extrasystoles. The drug is shown to have a favorable effect on the size of the peri-infarction++ area. A moderate negative inotropic effect of obsidan did not provoke clinical signs of heart failure. In the absence of contraindications, obsidan is recommended for use since the very first days of myocardial infarction. PMID- 2779086 TI - [Accuracy of the rheographic method of evaluating stroke volume]. AB - The results of stroke volume determination by means of integral tetrapolar body rheography (ITBR) and M-echocardiography were compared in 78 individuals, while Doppler cardiography was used as the reference method. Fairly high accuracy of stroke volume measurement by ITBR and its advantages over echocardiography, particularly the possibility of calculating the stroke volume irrespective of the heart size, are demonstrated. The accuracy of the ITBR determination declines in patients with severe heart failure. PMID- 2779087 TI - [Study of spontaneous acetylcholine-dependent tachyarrhythmias using isolated specimens of the right canine atrium by bilateral mapping of the spread of excitation]. AB - The authors examined tachycardias induced by administering acetylcholine (AC), 1 2 micrograms into the artery of sinus node (ASN) of an isolated specimen of the canine right atrium, which had spontaneous automatism. Bilateral multielectrode mapping was employed. The episodes of tachycardia occurred during AC-induced arrest of sinus rhythm. In 81% of the cases, episodes of arrhythmia consisted of 2-3 beats, in 19%, 6-150 beats. The mapping revealed a focal picture of activation during short-term episodes of arrhythmia and transition from a focal type of activation to the re-entry in most cases of "prolonged" episodes. With this, excitation circulation might be detected only on one side of the specimen, in the presence of the focal activation picture, on the other. Focus-re-entry transition is proposed to be caused by a mechanism associated with heterogeneous refractoriness of atrial tissue. PMID- 2779089 TI - [Ethanol withdrawal syndrome in the pathogenesis of alcoholic heart damage]. AB - In an ultrastructural and functional study of rat hearts, some animals had received liquid food containing ethanol (36.1% of total caloric intake) for 14 weeks (group 1); in half of the rats (group 2), ethanol-containing diet was at regular intervals replaced by an alcohol-free diet (five three-day cycles). Animals on dry forage and water or ethanol-free liquid diet were taken as controls. The study has suggested that recurrent ethanol abstinence syndrome may be a leading pathogenetic factor of alcoholic heart damage. PMID- 2779088 TI - [Increasing myocardial tolerance of global ischemia and reperfusion injury using a synthetic peptide]. AB - The synthetic tripeptide Tyr-Pro-Arg was tested for its cardioprotective effect when added to the cardioplegic solution or when used during reperfusion (R) after "global myocardial ischemia" (GMI). After the baseline functional parameters had been recorded, the isolated perfused hearts (IPH) from rats with the working left ventricle were subjected to 30-minute GMI at 37 degrees C. When the tripeptide was added to the cardioplegic solution (3.10(-9) M), the degree of the functional recovery of IPH was higher after GMI than when a "pure" cardioplegic solution was applied. The functional parameters of IPH were restored to a considerable extent (up to 70-100%) when the tripeptide was added to the perfusate in the same concentration during R following GMI of 30-minute duration at 37 degrees C. Without the tripeptide, the function of IPH was not restored. Thus, the synthetic analogue of the endogenous opioids, Tyr-Pro-Arg" enhances the tolerance of rat IPH myocardium to exposure to GMI and R. PMID- 2779090 TI - [Effect of trimecaine on myocardial contractility and the rhythmoinotropic properties of the myocardium in hypoxia]. AB - In the papillary muscles from 14 adult rats and myocardial specimens from 14 newborn ones, trimecaine in doses of 1.10(-6) and 5.10(-6) g/ml produced a dose dependent negative inotropic effect, reversed the rhythmoinotropic correlation into a negative one and minimized the efficiency of postextrasystolic potentiation. Trimecaine in the former dose reduced hypoxic damage of myocardial specimens in the both groups as reflected by a smaller amplitude of hypoxic contracture and better contractility recovery following a hour hypoxia. It is suggested that reduction in hypoxic contracture and damage to the myocardium occur in the presence of trimecaine from limited Ca2+ entry into myocytes via the Na-Ca turnover mechanism. PMID- 2779091 TI - Studies on the mechanism of rubidium-induced kaliuresis. AB - Renal clearance and electron microprobe methods were used 1) to elucidate the effects of chronic rubidium administration on potassium transport and 2) to localize, by the use of amiloride in acute experiments, the tubule site of interaction between rubidium and potassium. Substitution of drinking water by a 50 mM rubidium chloride solution for 9 to 11 days led to significant hypokalemia (plasma potassium 2.5 +/- 0.1 mM; plasma potassium plus rubidium 3.3 +/- 0.1 mM). Compared to a control group (reduction of plasma potassium to 3.4 +/- 0.1 mM by short-term potassium depletion) with a fractional potassium excretion of 2.1 +/- 0.3%, rubidium-treated rats excreted potassium at a much higher rate of 14.6 +/- 3.0%. The potassium content of principal cells was, however, significantly lower in rubidium-treated than in potassium-deprived animals. Similar to experiments in which rubidium was given acutely (3 hours), chronic rubidium administration was associated with preferential accumulation of rubidium in all tubule cells relative to potassium. Rubidium clearances were uniformly below those of potassium. Amiloride abolished the difference between rubidium and potassium clearances and sharply reduced the excretion of both cations. In view of the known site of action of amiloride, this suggests a distal tubule site of rubidium action on potassium transport. Amiloride also reduced or abolished the preferential uptake of rubidium into all but intercalated tubule cells. Marked cell heterogeneity of rubidium accumulation into intercalated cells was observed: One subpopulation, with low cell chloride, retained rubidium more effectively than another subpopulation with high cell chloride. PMID- 2779092 TI - Effects of uninephrectomy and high protein feeding in cyclosporine nephropathy. AB - Using a recently described rodent model of chronic cyclosporine nephropathy (CCN), the effects of uninephrectomy (UNx) and high protein feeding on the development of CCN were studied. After 28 days of i.p. cyclosporine (Cs; 25 mg/kg/day) in UNx and sham nephrectomized (SNx) rats, the single kidney GFR was higher in UNx animals (0.55 +/- 0.09 vs. 0.29 +/- 0.05 ml/min, P less than 0.04) as was RPF (3.05 +/- 0.46 vs. 1.45 +/- 0.37 ml/min, P less than 0.04). Morphometric evaluation of the chronic tubulointerstitial lesion (TI) demonstrated lower scores and relative protection in the UNx group (16.48 +/- 3.52 vs. 64.76 +/- 18.30, P less than 0.01). In separate groups of rats undergoing UNx or SNx and subsequent treatment with Cs, dry kidney weights confirmed that compensatory renal hypertrophy was present in UNx animals. The modulating effect of dietary protein on the lesion of CCN was studied in UNx rats fed a 5% or 60% protein diet during the period of Cs treatment. At the end of the study period animals fed the high protein diet demonstrated a higher RPF (3.19 +/ 0.58 vs. 1.58 +/- 0.29 ml/min, P less than 0.04), higher GFR (0.55 +/- 0.07 vs. 0.35 +/- 0.04 ml/min, P less than 0.05) and lower TI score (64.45 +/- 17.35 vs. 130.32 +/- 23.48, P less than 0.04) when compared with animals consuming a low protein diet. We conclude that the relative renal vasodilation induced by partial ablation of renal mass and high protein feeding affords some protection against the development of CCN. PMID- 2779093 TI - A Na-K-Cl cotransporter in isolated rat papillary collecting duct cells. AB - Lactate production and ion fluxes were measured in isolated rat papillary collecting duct cells (PCD) to gain further insight into the transport properties of the papillary collecting duct. Lactate production was found to be inhibited by bumetanide in a dose-dependent manner, a maximum inhibition of 22% was obtained at 10(-4) M bumetanide and an apparent Ki of 10(-8) M was determined. Bumetanide inhibition of lactate production was dependent on the presence of sodium and chloride. Chloride removal inhibited lactate production also by 20%. Bumetanide (10(-4) M) inhibited by 35% sodium uptake into PCD cells exposed to 10 mM ouabain and chloride uptake into ion depleted PCD cells by 40%. In addition, this bumetanide-sensitive chloride uptake was dependent on the presence of sodium and potassium in the incubation medium. Furthermore, 86Rb uptake into these cells was significantly reduced in the presence of 10(-4) M bumetanide. These data provide evidence for the operation of a Na-K-Cl cotransport system in rat papillary collecting duct cells. This transport system might be involved in active chloride transport in the papillary collecting duct and/or volume regulation of the PCD cells. PMID- 2779094 TI - Plasma lipids and acyltransferase activities in experimental nephrotic syndrome. AB - Lecithin:cholesterol acyltransferase (LCAT) and lysolecithin acyltransferase (LAT) are two activities carried out by the same plasma enzyme, but require different apoprotein activators. The LCAT reaction takes place primarily on high density lipoproteins (HDL) and is activated by serum albumin, whereas LAT takes place on low density lipoproteins (LDL) and is inhibited by albumin. In nephrotic syndrome (NS), the levels of serum albumin are reduced, whereas the LDL levels are increased, and therefore, the ratio of LAT/LCAT activities should be increased. To test this hypothesis, we estimated the lipid levels and the two enzyme activities in experimental NS induced in rats by the injection of anti Fx1A antibody (passive Heymann nephritis). As found in other nephrotic conditions, the plasma lipid levels rose progressively as the proteinuria increased and the serum albumin concentration declined. In addition, the ratio of LAT/LCAT activities increased by about fourfold after nine days of induction of nephritis. The LCAT activity correlated positively and the LAT activity negatively with serum albumin levels. The esterified cholesterol correlated positively with LCAT activity in normal rats but negatively in nephrotic animals, indicating that most of the cholesteryl esters in NS may be non-LCAT derived. The free cholesterol/lecithin ratio, a known risk factor for atherosclerosis, increased significantly in nephrotic rats. Furthermore, since the increase in the LAT activity produces more disaturated lecithins, another putative risk factor, the cumulative risk of coronary heart disease may be increased in long-term NS. PMID- 2779096 TI - Urinary ammonium measurement by the auto-analyzer method. PMID- 2779097 TI - Abstracts. German Society of Nephrology, 19th congress. Gottingen, Federal Republic of Germany, September 25-28, 1988. PMID- 2779098 TI - Abstracts. Societe de Nephrologie. Bruxelles, Belgium, October 21-22, 1988. PMID- 2779099 TI - Abstracts. Swiss Society of Nephrology, 20th annual meeting. Lausanne, Switzerland, December 1-2, 1988. PMID- 2779095 TI - Treatment of nephrotic hyperlipoproteinemia with gemfibrozil. AB - Hypercholesterolemia is a known complication of the nephrotic syndrome. Patients with persistent proteinuria and prolonged hypercholesterolemia are probably at increased risk for cardiovascular disease. Until recently there has been no safe and effective treatment for this disorder. The effects of gemfibrozil on plasma lipids and lipoproteins in hypercholesterolemic patients with the nephrotic syndrome were therefore studied. Eleven patients with the nephrotic syndrome were studied in a randomized, double-blind placebo-controlled trial with six-week treatment periods. Gemfibrozil 600 mg or placebo was administered twice a day. There was a third unblinded period in which seven patients received gemfibrozil plus the bile acid-binding resin, colestipol, 10 grams twice a day. Gemfibrozil treatment produced a marked reduction in plasma triglyceride (51%, P = 0.001) and a 15% decrease in plasma total cholesterol (P = 0.003). Low density lipoprotein cholesterol decreased 13% (P greater than 0.05), high density lipoprotein cholesterol increased 18% (P = 0.006) and the ratio of low density lipoprotein to high density lipoprotein cholesterol fell 26% (P = 0.01). Apolipoprotein A-l was unchanged while apolipoprotein B decreased 26% (P = 0.006). Four patients were unable to complete period 3 because of gastrointestinal symptoms. The remaining patients had further improvement in plasma lipids and lipoproteins with the combined therapy: total cholesterol further decreased 26%, triglycerides decreased 17%, low-density lipoprotein cholesterol decreased 36%, high-density lipoprotein to high-density lipoprotein cholesterol fell 33%. Gemfibrozil improved lipid and lipoprotein cardiovascular risk factors without major toxicity. Persistent elevations in total plasma and low-density lipoprotein cholesterol during gemfibrozil treatment, however, indicate the need for individualized drug therapy. PMID- 2779100 TI - [An open letter to Prof. Ia.D. Vitebskii]. PMID- 2779101 TI - [Prevention and treatment of pulmonary complications after surgery of the abdominal organs]. PMID- 2779102 TI - [The first experience using a contact laser scalpel in surgery]. PMID- 2779103 TI - [Principles of closed aspiration-irrigation treatment of contaminated and suppurative wounds]. PMID- 2779104 TI - [A method of reinfusion of blood]. PMID- 2779105 TI - [Treatment of external intestinal fistula with ferromagnetic suspension]. PMID- 2779106 TI - [Restoration of eyebrows lost due to burns]. PMID- 2779107 TI - [Surgical treatment of recurrent goiter]. PMID- 2779108 TI - [Endothelization of vascular prostheses using human cultured endothelial cells]. PMID- 2779109 TI - [Roentgenoendovascular laser recanalization combined with an intravascular prosthesis using nitinol spiral]. PMID- 2779110 TI - [Osteogenic sarcoma of the breast]. PMID- 2779111 TI - [Successful surgical treatment of acute disorders of mesenteric circulation]. PMID- 2779112 TI - [Successful treatment of pheochromocytoma]. PMID- 2779113 TI - [Giant condylomata acuminata]. PMID- 2779114 TI - [Possibility of intraoperative reinfusion of blood in coloproctology]. AB - The possibility of conducting intraoperative reinfusion of blood in coloproctology is appraised on the basis of complex microbiological, cytological, and biochemical study of blood of patients who underwent operation for various diseases of the large intestine. It was found that blood escaping into the abdominal cavity during operations on the large intestine is hemolized to a great measure and contains many bacteria, and therefore such blood cannot be used for transfusion. At the same time, if blood is collected directly from the pulsating vessel its contamination, marked distortions of its formed elements, and hemolysis above admissible values can be avoided. The dependence on the time of blood collection, whether before or after the intestine is opened, has not been established. PMID- 2779115 TI - [Study of parameters of central hemodynamics in patients during hemodialysis]. AB - The article discusses the results of study of the cardiac output (CO) and circulation blood volume (CBV) in patients at the beginning and end of hemodialysis. The dynamics of changes of these parameters during hemodialysis was studied in 31 patients (42 sessions). The CO and CBV reduced significantly. In a group of 10 patients who felt worse, the CO reduced by more than 30 per cent in 7, the CBV diminished by 25 and 30 per cent in 2, and CBV and CO reduced by more than 30 per cent in 1 patient in relation to the initial level. The CO and CBV were measured by means of the method of dilution of electroimpedance indicators. PMID- 2779116 TI - [Mathematical modeling of the degree of nephroarteriolosclerosis in vasorenal hypertension]. AB - Comparison of the findings of clinical, instrumental, and laboratory examination of patients with vasorenal hypertension with the results of morphological analysis of renal bioptic material showed that multivariate regression analysis of the parameters of examination of the patients provides for authentic calculation of the quantitative index of nephroarteriolosclerosis--the vascular index of the afferent arterioles of the renal glomeruli. The calculated values of the vascular index for both kidneys are criteria for choosing the method of operative intervention in vasorenal hypertension. PMID- 2779118 TI - [Ways of increasing surgical activity at a polyclinic]. AB - More than 13,000 operative interventions were conducted under out-patient conditions during a period of 5 years. From their analysis, the authors believe that the conditions for raising surgical activity in an out-patient clinic are as follows: the creation of operating-dressing ward blocks and wards for temporary stay, organization of transportation of patients to their home and subsequent visiting by medical personnel. Careful selection of patients, adequate preoperative management, good anaesthesiological service and postoperative care improve the results of treatment. PMID- 2779117 TI - [Value of rheovasography and thermography in the diagnosis of varicose veins of the legs in the practice of expert evaluation of work capacity]. AB - The article deals with the problems of using such new modern diagnostic methods as rheography and thermography in objective assessment of the degree of functional disorders in patients with lower limb varicosis. The authors describe the examination method, the necessary apparatus, and the evaluation of the qualitative and quantitative parameters on the basis of the information obtain. The results of the examination provide the possibility to determine exactly the degree of chronic venous insufficiency, judge the condition of the valvar apparatus of the veins, appraise the compensatory possibilities of the vascular wall and the clinical prognosis, and consequently, to solve more objectively the questions of expert medical assessment of the working capacity. PMID- 2779119 TI - [Tactics in using the subclavian vein for infusion therapy]. AB - The author calls for limiting the indications for puncture and catheterization of the subclavian vein and recommends maximal use of the subcutaneous veins of the extremities with their adequate preparation and care. It is emphasized that catheterization of the subclavian vein should be considered as one of the last means for adjusting infusion therapy according to strict indications with due considerations for the contraindications, which are pointed out in the work. PMID- 2779120 TI - [Acute appendicitis in patients with diabetes mellitus]. AB - The clinical course of acute appendicitis was studied in 39 patients suffering from diabetes mellitus. Destructive forms of acute appendicitis prevailed in these patients, the pain syndrome was moderate, and the temperature reaction, rigidity of muscles of the anterior abdominal wall, and changes in the blood leukocyte count may be absent. Postoperative purulent complications occurred in 47% of patients. PMID- 2779122 TI - [Treatment of non-lactation suppurative mastitis]. AB - The author analyses the case records of 238 patients who were treated at the clinic for nonpuerperal mastitis during a period of 10 years. Concomitant diseases were encountered in 31.7% and trauma of the breast in 14.1% of patients. Staphylococcus was the main causative agent (in 85%) of nonpuerperal mastitis. Surgical operation was the method of choice in the treatment of this form of mastitis; it was undertaken in 237 of the 238 patients. Emphasis is placed on the necessity of making sparing incisions which ensure good immediate results and the best cosmetic effect. PMID- 2779121 TI - [Use of helium-cadmium lasers in the complex treatment of suppurative diseases in patients with diabetes mellitus]. AB - Study of 174 patients with various suppurative diseases and diabetes mellitus showed that treatment with helium-cadmium laser beam with a wave length of 441.6 nm by a single exposure to 4.5 J leads to rapid abatement of the inflammatory reaction, cleansing and acceleration of the regeneration processes in the purulent wounds, expands the possibilities of surgical treatment with good functional and cosmetic results of plastic operations, which reduces the time of complete wound healing by 1.5 times. PMID- 2779123 TI - [X-ray irradiation of donor blood in the complex treatment of suppurative diseases]. AB - The authors discuss the use of donor blood after isolated exposure to X-rays in the complex treatment of 65 patients with various suppurative diseases. The therapeutic complex included in all cases transfusion of 250 ml of irradiated blood and subsequent antibiotic therapy. Study of antibiotic (penicillin) pharmacokinetics showed increase of its biological activity and prolongation of its presence in the blood in therapeutic concentrations for 24-48 hours. A scheme of antibiotic therapy in transfusion of irradiated blood is suggested. A formula for calculating the optimal irradiation dose is given. It is concluded that transfusion of irradiated blood followed by injection of an antibiotic raises the efficacy of antibiotic therapy, reduces the term of treatment, and increases the effect of postoperative management. PMID- 2779124 TI - [Experience using clinical games in training in clinical surgery]. AB - The method of business games developed and used for 5 years may be used successfully in practical training of late-year students of medical institutes in surgery. It expands the possibility of the traditional training methods essentially, promotes better learning of the material, the formation of skill in diagnosis and reaching practical decisions, and acquiring experience in contact with the patients and their relatives. PMID- 2779125 TI - [Increased level of tryptophan fluorescence in the blood serum in generalized suppurative infection]. AB - It was established in animal experiments that in generalization of purulent infection, the most probable sources of the increased blood serum tryptophan content, determined by the fluorescence method, are the muscles, lungs, and, to a lesser measure, the liver, which are invaded by P. aeruginosa and St. aureus. The increase of the level of tryptophan fluorescence in blood serum, which is encountered in generalization of purulent infection, does not correlate with the level of cortisol, insulin, and proteolytic activity in the blood; it also does not occur in pyrogenal-induced fever. PMID- 2779127 TI - [Effect of low- and moderate-frequency ultrasonic waves on the course of suppurative wound process]. AB - The author conducted a clinico-laboratory and morphological evaluation of the effect of low- and moderate-frequency ultrasonics on the course of a purulent wound process. He found that ultrasonic waves of different frequency subbands differ in their effect on wound healing. The use of low-frequency ultrasonics is most expedient in phase 1, preference is given to ultrasonics of the moderate frequency subband in phase 2. PMID- 2779126 TI - [Value of correcting microcirculatory disorders of inflammatory foci in the treatment of infection]. AB - Experience in the treatment of 94 patients with sepsis is discussed. Studies showed that microcirculatory disorders occurring around the inflammatory focus are among the main causes of insufficient efficacy of antibiotic therapy. For correction of the microcirculatory changes, the authors suggest (in addition to vasodilators, inhibitors of proteases and heparin used earlier for this purpose) transfusion of chilled plasma which is a antithrombin-III donator. As the result of such treatment mortality reduced from 45.8 to 16.7%. PMID- 2779128 TI - [Treatment of suppurative-necrotic wounds of the extremities]. AB - The article discusses the authors' experience in treating pyonecrotic and poorly granulating wounds of the upper and lower extremities in 158 patients; proteolytic enzymes, application of carbohydrate sorbents, and helium-neon laser radiation were used in 66 cases. With such method of treatment, the wounds healed without cutaneoplasty in 75% of cases. In 25% of cases free cutaneoplasty was performed after preparation of the wound surface. The terms of wound healing reduced 1.5-2 times as compared to that in the traditional methods of treatment. PMID- 2779129 TI - [Diagnosis and treatment of suppurative processes caused by non-clostridial anaerobic microflora]. AB - One hundred and fifty patients suffering from various purulent diseases (60 persons) and postoperative purulent complications (90 persons) caused by nonclostridial anaerobes were examined. Nonclostridial anaerobic bacteria were isolated most frequently in acute mastitis, paraproctitis, and postinfectious abscesses among patients of the first group and after appendectomy and resection of the large intestine among those of the second group. The character of the wound discharge, the location of the focus of infection, the tendency of the purulent process to form a great number of cavities and fistules, bacterioscopy of the native material, etc. help in establishing the diagnosis (before the results of bacteriological tests are obtained). Purulent processes caused by a combination of anaerobic cocci and aerobic flora take a particularly unfavourable course. Antibiotic therapy should consists of high doses of one or two antibiotics combined with metronidazole and nystatin. PMID- 2779131 TI - [Evaluation of the healing of skin wounds inflicted by steel scalpels with various degrees of sharpness]. AB - Experiments on 200 animals and clinical use of 300 scalpels differing in the width of the cutting edge showed that operative lineal skin incisions made with a sharp instrument (a ruby knife, razor, scalpel with a 0.8 microns cutting edge) heal better and quicker than those inflicted with a blunt scalpel of serial production with a cutting edge 12.5 microns wide. Such blunting of scapels occurs after two operations and traditional methods of sterilization of the instruments. Mechanical damage of the instruments during cleansing and washing is most important in the clinic. PMID- 2779130 TI - [Ambulatory treatment of suppurative wounds with cooled glycerin]. AB - Experiments were conducted on 106 albino rats under ether anesthesia. The effect of cooled glycerin, liquid nitrogen, ultrasonics, and their combinations on the course of an inflammatory process was studied. Cooled glycerin was used in the clinic in the treatment of 141 patients as the result of which the period of temporary incapacity reduced 1.4 times as compared to that in the traditional methods of wound cleansing. PMID- 2779132 TI - [Retroperitoneal phlegmon of the iliac fossa]. AB - The results of treatment of 32 patients with retroperitoneal phlegmon in the region of the iliac fossa are analysed. The authors revealed many diagnostic errors in the prehospital stage (in 29 of 32 patients) owing to which hospitalization was delayed: 7 patients had purulent fistulas, leakage of pus was discovered during the operation in 20 patients. Due to a nonradical intervention (superficial opening of the phlegmon, sometimes under local anaesthesia) 9 patients were subjected to a second operation. The operation must be conducted under general anesthesia without fail and consist not only in opening of the phlegmon but also in careful inspection for possible leakage of pus and fistulas. PMID- 2779133 TI - [Diagnosis and treatment of echinococcosis in an unusual location]. AB - Data on 52 cases of hydatid disease of a rare localization are discussed. The patients were divided into two groups: first--hydatid disease of the viscera (42) and second--hydatid disease of the subcutaneous fat and the muscles (10). The diagnosis of hydatid disease of the viscera of rare localization was established by a complex of methods (radiological, scanning, laboratory tests, and serological studies). Laparoscopy and pneumoperitoneumography helped in making the precise preoperative diagnosis. Diagnostic puncture of the formed mass is important in the diagnosis of hydatid disease of the skeletal muscles and subcutaneous fat. The method of choice, basically, is closed echinococcectomy with complete or partial excision of the fibrous capsule with removal of the residual cavity depending on the localization of the cyst. PMID- 2779134 TI - [Attestation examination and its role in the evaluation of the degree of professional qualifications of a surgeon]. PMID- 2779136 TI - [Results in Pediatric Oncology 13. Proceedings of the Society of Pediatric Oncology and the German Working Group on Leukemia Research and Treatment in Childhood]. PMID- 2779135 TI - [Is a discussion on infection necessary?]. PMID- 2779137 TI - [Ototoxicity of cisplatin in children with malignant diseases]. AB - Ten out of 20 children with malignant diseases who received cisplatin in combination with other drugs developed hearing impairment primarily at the higher and rarely also at the lower frequencies. The CDDP-ototoxicity was found to be dose-related and irreversible. Audiometric abnormalities were symmetrical and bilateral. Two patients had symptomatic hearing impairment. Ototoxicity was more severe with higher individual and higher cumulative doses. CNS-irradiation increases the ototoxic effect of CDDP. Audiometric testing at the beginning of chemotherapy and during chemotherapy is important to find out preexisting disturbances of hearing function and to recognize early developing hearing loss. PMID- 2779138 TI - [Need for standardized pain therapy in pediatric oncology patients]. AB - Pain-management in pediatric-oncological patients is an interdisciplinary task. The working group pain--therapy of GPO tries to work up an analgesic concept for this group of patients. Pre-existing experience in the therapy with sustained release Morphine and Metamizol should be considered. The documentation-system is just worked up, we ask all pediatric oncological groups to cooperate. PMID- 2779140 TI - [Integration of psychosocial services into the management of the child with cancer]. AB - The integration of colleagues from psychosocial occupations into the traditional team of doctors and nurses demands a holistic treatment concept, the general desire for interdisciplinary action, and readiness for patience in the process of mutual learning. The acceptance of the psychosocial services by the patient and his/her family is frequently determined by the acceptance by physicians and nurses. The members of the psychosocial team are confronted with the following tasks.: 1. Developing a trustful relationship with the patient and his/her parents, 2. Setting up a history of family dynamics, 3. Practical assistance in matters of hospital routines, 4. Assistance in the emotional aspects of coping with the disease, 5. Rendering support to a patient and his/her family at death, 6. Leading and moderating groups of parents who live with so called "residual fear" or are mourning a child. Colleagues of the psychosocial team, who have to be able to cope with these existentially demanding tasks within a relationship to patients and their families over an extended period of time should have sufficient professional identity, adequate professional competence, and a certain foundation of life experience. PMID- 2779139 TI - [Quality of life and symptoms of residual damage in cerebellar tumors in children and adolescents]. AB - At the departments of neurosurgery and pediatrics of the University Hospital of Hamburg 21 patients after neurosurgery and radiation of cerebellar tumors have been examined as to neuropsychological, neurological and ophtalmological disabilities. A standardized questionairy for the parents concerning different aspects of their children's quality of life (physical, mental, social health and functional limitations) was performed. 16 children showed minor neurological signs with no or mild disability, in 5 children severe disability was found. In 4 patients morphological changes in the eyeground, in 2 patients amblyopia was detected. 19 patients underwent a neuropsychological examination. The group of patients with medulloblastoma or ependymoma (n = 10) scored in nearly all tests below the group with astrocytoma (n = 9). 3 out of 7 patients in the medulloblastoma or ependymoma group had to abandon school, one patient needs special education. All patients with astrocytoma performed fairly well at school. Parents of patients with medulloblastoma or ependymoma classified their children's quality of life not as good as did parents of children with astrocytoma. The amount of objective disability had no influence on the parents estimation of their children's quality of life. Besides the neurological examination the neuropsychological and quality of life assessment proved to be an essential part of follow up. For a more comprehensive understanding of quality of life, qualitative assessment strategies should be included in further research. PMID- 2779141 TI - [Psychological management of children with cancer and their families]. AB - A psychologist's different working fields in a children's cancer center are represented using the empiric datas of basic documentary material. The kind of psychological care was adapted to the individual requirements of the patients and their families. In most of the parents a low- or medium-grade support was adequate to their needs (40 per cent and 49 per cent). Only some families with severe problems needed more intensive psychological care (11 per cent). 58 per cent of the patients themselves were contacted. 46 per cent of them then required a more intensive psychological care. The list of topics - as coping with the disease and the therapy (49 per cent), behaviour problems resulting from the disease - and therapy - related circumstances (26 per cent), family problems (21 per cent) late effects and rehabilitation (14 per cent), specific problems resulting from the troubles in interaction and communication often seen on oncologic floors (5 per cent) - and the kind of psychological interventions - as primary contacts (11 per cent), supportive care (37 per cent), crisis oriented individual sessions (5 per cent), educational advice (14 per cent) and consultations in familiary problems (33 per cent) - show the different fields and posibilities of psychological care. The evaluation of all datas shows that in most cases supportive psychosocial care of the patients and their families was sufficient. Some specific problems - as individual troubles of the parents, conflicts in partnership, problems with the siblings, and difficulties in social contacts - gain more importance with the permanence of the disease - related stress. In these case specific psychological intervention becomes very important. PMID- 2779143 TI - [Microcirculation in patients with systemic scleroderma during treatment using hyperbaric oxygenation]. AB - Hyperbaric oxygenation treatment of systemic scleroderma has a favourable effect on microcirculatory changes whose positive dynamics can be demonstrated by conjunctival biomicroscopy. These changes include accelerated blood flow and decrease in the degree of erythrocyte aggregation. The method can be used for the objective assessment and for prognosis of the effectiveness of hyperbaric oxygenation treatment in patients with systemic scleroderma. PMID- 2779142 TI - [Hemostatic changes in various clinical courses of influenza]. AB - Data are given on the changes in the hemostatic system in 42 patients with uncomplicated influenza and in complications (pneumonia, bronchitis, aggravation of ischemic heart disease). In the acute period of the disease they were characterized by hypercoagulation which was most pronounced in patients with influenza complicated by pneumonia. In cases of aggravation of ischemic heart disease functional platelet activity during convalescence decreases but the plasma link of hemostasis remains activated and fibrinolytic blood activity inhibited. Functional platelet activity in dynamics of the disease increases which should be taken into consideration in pathogenetic therapy. PMID- 2779144 TI - [Effectiveness of pharmacologic and non-pharmacologic methods of restoring bronchial patency]. AB - Assessment is given of the effect of the medicamentous (administration of oral and inhalation of expectorant agents) and non-medicamentous (sauna) methods of treatment of disorders of mucociliary transport. The effect of the treatment was judged by its influence on the time of expectoration with sputum of blood containing agents after their inhalation. The most effective method for the restoration of bronchial drainage proved to be the use of expectorants administered by inhalation and less effective sauna. Therapeutic methods should be chosen with consideration of the degree of mucociliary insufficiency. PMID- 2779145 TI - [Effect of hyperbaric oxygenation on the hemostasis system in patients with diabetic angiopathies]. PMID- 2779146 TI - [Analysis of the cause of death in patients with steroid-dependent bronchial asthma]. AB - Description is given of 11 patients with a severe form of protracted corticosteroid-dependent asthma. They died in status asthmaticus. Most of these patients had protracted status asthmaticus and cardiopulmonary failure. Pneumonia with toxic liver and kidney affection developed in some of them in parallel with glucocorticoid therapy. Long-term glucocorticoid treatment may give rise to vasculitis and thromboembolism of the pulmonary trunk. The principal disease can be aggravated by infection, administration of histoglobin, decrease in the dose of glucocorticosteroids or their discontinuation. PMID- 2779147 TI - [A case of total situs inversus of the internal organs associated with splenomegaly and hypersplenism]. PMID- 2779148 TI - [The Sneddon syndrome]. PMID- 2779150 TI - [Etiology, clinical aspects and treatment of neuroses and neurosis- like conditions]. PMID- 2779149 TI - [The Giaccai syndrome as a cause of the development of trophic leg ulcers]. PMID- 2779151 TI - [Nonspecific (paratuberculous) reactions in the practice of an internist]. PMID- 2779152 TI - [Hepatogenic ulcer (various aspects of its pathogenesis)]. AB - Functional and morphological state of the stomach and duodenum was studied in 98 patients with liver cirrhosis. Hepatogenous ulcer was revealed in 21.7 per cent of the patients with alcoholic and in 25 per cent of those with viral liver cirrhosis. A specific feature of the condition was the development of ulcer in reduced gastric acid production and its asymptomatic course. The incidence of gastric and duodenal affections in liver cirrhosis was significantly higher in pronounced portal hypertension. Study of the portal blood flow with Doppler ultrasonography can reveal the risk group (patients with pronounced portal hypertension) which has high probability of the development of erosion-ulcerous lesions. These patients require obligatory medical checkups with gastric and duodenal endoscopy 2-3 times a year. PMID- 2779154 TI - [Clinico-morphologic correlations in functionally compensated chronic glomerulonephritis]. PMID- 2779153 TI - [Immunoreactive trypsin in the blood serum of patients with endogenous hypercorticism]. AB - Basal immunoreactive serum trypsin (RIT) was determined in comparative study of 46 patients with adrenocortical hyperfunction and 24 patients with hypocorticism for specifying the potentialities of the diagnostic test. Excess of endogenous corticosteroids is accompanied by a marked increase in the RIT serum concentration, this increase is particularly pronounced in Itsenko-Cushing syndrome and in exacerbations of Itsenko-Cushing disease in comparison with its level in Itsenko-Cushing disease remission. The presence of steroid diabetes had no significant RIT changes in Itsenko-Cushing disease. Attendant chronic pancreatitis that developed in patients with adrenocortical hyperfunction had no influence on blood serum RIT content. In patients with adrenal steroid deficiency who did not take glucocorticoids the serum RIT concentration was lower than that in those who constantly used hormones. RIT is increased in cases of chronic pancreatitis combined with chronic adrenal insufficiency. Measurement of the basal serum RIT may contribute to the diagnosis of pancreatitis in patients with hypocorticism but provides no information on this pathology in patients with endogenous hypercorticism. PMID- 2779155 TI - [Various current clinical aspects of the problem of "the kidney and the stomach"]. AB - Analysis of specific features of stomach pathology in 174 patients with various clinical manifestations of chronic glomerulonephritis has demonstrated peculiar nephrogenous gastropathy in these patients. Clinical assessment of the secretion excretion relationship was carried out in patients with intact renal function and chronic renal insufficiency of various degree of manifestation. PMID- 2779156 TI - [The role of anti-phospholipid antibodies in the development of thrombotic complications and in obstetrical pathology]. AB - Examination of 115 women for detection of phospholipid antibodies (PLA), lupus anticoagulant and cardiolipin antibodies has demonstrated that in the absence of PLA all pregnancies terminated in the birth of full-term healthy children, while in their presence there were repeated abortions and (or) intrauterine death of a fetus. Obstetrical pathology in women in the presence of PLA was attended by venous and arterial thrombosis, thrombocytopenia, cerebral vasculitis and vascular affections, which is typical of the picture of the antiphospholipid syndrome. A new approach has been suggested to the treatment of such patients with reduction of the activity of lupus anticoagulant and cardiolipin antibodies owing to which pregnancy can be terminated in the birth of viable children. PMID- 2779157 TI - [Late diastolic mitral regurgitation]. AB - Late diastolic mitral regurgitation (diastolic backflow of blood from the left ventricle to the left atrium at the end of left-ventricular diastole) is registered by Doppler echocardiography in patients with acquired heart defects and dilated cardiomyopathy. This phenomenon is based on the appearance at the end of left-ventricular diastole of the left ventricle/left atrium pressure gradient which is opposite to a normal relationship. Late diastolic regurgitation is more often encountered in patients with incompetence of the mitral and aortic valves. It is caused by disturbances of the work of the left heart and of kinetics of the mitral valve in relatively low frequency of cardiac contractions and is encountered in sinus rhythm and atrial fibrillation, and does not depend on the value of the transmural diastolic gradient. The clinical significance of mitral regurgitation remains unclear. PMID- 2779158 TI - [Changes of the interventricular heart septum in various forms of cardiomyopathy]. AB - A pathomorphological study included hearts of 52 patients who died of various forms of cardiomyopathy, 10 hearts of subjects who died of chance causes (control) and 30 hearts in 3 groups of comparison for revealing changes in the interventricular septum in the dilatation, hypertrophic and restrictive forms of cardiomyopathy. Use was made of postmortem coronarography and cardioventriculography, the WHO standard anatomical method, histological and histochemical methods and separate weighing of cardiac portions. A complicated structure of the interventricular septum pathognomonic for each form of cardiomyopathy was revealed which had an influence on the intracardiac hemodynamics. PMID- 2779160 TI - [Diagnosis and treatment of myxoma of the right heart ventricle]. PMID- 2779159 TI - [Detection of concomitant pathology in patients with arterial hypertension by structural and functional changes of erythrocyte membranes]. AB - The values of the Na-Li+ countertransport rate and the degree of monoclonal antibody binding with the erythrocyte membranes were compared in patients with different forms of arterial hypertension (AH) to identify combined pathology and the precursors of surgery effectiveness. Among the 27 examined AH patients 7 underwent surgery in accordance with the initial clinical diagnosis. The membrane tests helped to detect 3 patients with combined pathology: chronic pyelonephritis or chronic diffuse glomerulonephritis in combination with AH. Thus, the membrane tests were found to supplement each other in the assessment of surgery effectiveness and the perspectives for identification of combined pathology in patients with symptomatic AH of renal genesis. PMID- 2779161 TI - [Value of the end part of the ECG ventricular complex during exercise test in patients with acquired heart defects]. AB - The dynamics of the end part of the ECG ventricular complex (ST--T) has been studied during multistage treadmill test in 305 patients with a rheumatic heart defect with intact coronary circulation and in 52 healthy subjects. In 20 per cent of the patients analysis of the ECG at rest is not sufficient for interpreting ST--T since during the test the ST--T changes can be increased (more commonly in mitral defect) or the complex can be normalized (more often in aortic defect). The relationship between the positive and negative ST--T dynamics with preserved central hemodynamics in the treadmill test has been proved. Assumptions have been advanced that explain the ST--T changes in physical exercise in patients with heart defects; the degree of the preserved myocardial function can be evaluated according to the ECG dynamics in the treadmill test. PMID- 2779162 TI - [Immunoglobulin E in systemic lupus erythematosus]. PMID- 2779163 TI - [Prostaglandins in Itsenko-Cushing syndrome]. AB - The results of the study of depressor (PGE+A) and pressor (PGF2 alpha) prostaglandins in the blood plasma and of PGE2 and PGF2 alpha excretion in the urine of 52 patients with an acute stage of Itsenko-Cushing disease are presented. It has been established that the different components of the PG system have dissimilar changes: the absence of differences in the content of depressor and significant increase in pressor PG, which may be the cause of hypertension in Itsenko-Cushing disease. Stress due to insulin hypoglycemia and furosemide load brought about disturbances in the reaction of the PG system, which were more pronounced in the system pressor component. Disturbances of the PG system which were more pronounced in the presence of stable hypertension were established in all patients. PMID- 2779165 TI - Let's get it together. PMID- 2779164 TI - [Clinical aspects, pathogenesis and treatment of encephalopathy and coma in suppurative meningitis and hepatitis]. PMID- 2779166 TI - The essential healer. PMID- 2779168 TI - Postmortem tricyclic antidepressant concentrations: assessing cause of death using parent drug to metabolite ratio. AB - In 9 of 13 medical examiner cases in which death was caused by tricyclic antidepressant (TCA) overdose, the mean postmortem liver and blood concentrations were 200 micrograms/g and 4.0 micrograms/mL, respectively. In comparison, in 4 of 13 cases in which the causes of death were not TCA related but involved therapeutic doses of TCA, the mean liver and blood levels were 29.0 micrograms/g and 1.3 micrograms/mL, respectively. The parent drug to major metabolite ratio in liver was 6.3:1 in overdose cases and 0.5:1 in therapeutic cases. The ratio in blood was greater than 1.0 in both overdose and therapeutic ingestions. We concluded that liver TCA concentrations should be quantitated to specify manner of death. For cases in which the manner of death was ambiguous, the liver parent drug to major metabolite ratio aided in the decision process. PMID- 2779167 TI - GC/MS confirmatory method for etorphine in horse urine. AB - A highly sensitive procedure for GC/MS determination of etorphine in horse urine is described. This assay provides both specificity and reliability and is particularly well suited for the confirmation of radioimmunoassay screening procedures usually used for etorphine. After solvent extraction and purifications, the etorphine is characterized as a pentafluoroacetic derivative (PFAA) by using mass fragmentography. The detection limit is 0.1 ng/mL in urine; the coefficient of variation of the estimations is 10.9%. The procedure has been validated after on-field administration of 5 to 90 micrograms of etorphine to five thoroughbred horses (10 to 180 ng/kg). PMID- 2779169 TI - Drinking drivers in Sweden who consume denatured alcohol preparations: an analytical-toxicological study. AB - In the course of analyzing blood samples from drunk drivers, several low molecular weight volatiles were occasionally identified in addition to ethanol on the gas chromatograms. Among 21, 153 blood specimens analyzed during 1986, 77 contained ethanol as well as other volatile agents at the following mean concentrations: ethanol 2090 mg/L (range 830-3410), methanol 49.6 mg/L (range 20 178), acetone 88.3 mg/L (range 12-307), 2-propanol 32.2 mg/L (range 4-99), 2 butanone 49.2 mg/L (range 5-144), and 2-butanol 23.2 mg/L (range 4-64). A technical alcohol widely available in Sweden, trade name T-red, contains 92% w/w ethanol, 2% w/w acetone, and 5% w/w 2-butanone. A red coloring agent and a substance to impart a bitter taste (bitrex) are added to deter consumption. The drinking drivers who consumed technical alcohol were on average older (43 years compared with 35 years) and had higher mean BAC (2090 mg/L compared with 1767 mg/L). Those who drank denatured alcohol were more often apprehended while driving small motorcycles (mopeds) than were control groups of DWI offenders. The use of technical alcohol for intoxication might reflect, at least in part, the high costs and restricted availability of conventional alcoholic beverages in Sweden. PMID- 2779170 TI - Bovine blood lead reference material. AB - A protocol is described for the preparation and characterization of bovine blood lead (Pb) reference material (RM). Adult bovine animals are orally dosed with Pb as Pb(NO3)2, and blood is collected directly from the jugular vein into 5-mL evacuated, low-Pb glass tubes containing EDTA as anticoagulant. The blood is cooled to 4 degrees C for 24 h and frozen and stored at -20 degrees C. Over 400 RMs were prepared and certified for reference values (RV) since the inception in 1974 of the Childhood Blood Lead Proficiency Testing Program. Five reference laboratories employing blood Pb methods of various principles were used to certify the RV, representing the true value, of 5 representative RMs containing 6.4-54.0 micrograms Pb/mL. Intertube homogeneity was verified by reference laboratories determining blood Pb in 20 tubes of 150 tubes collected from each of the 5 representative RMs. Intratube homogeneity was verified by an internal laboratory determining Pb in 12 consecutive 10-microL samples from 5 mL of blood in each of 3 representative RMs. Pb was unchanged in 37 bovine blood Pb RMs containing EDTA as anticoagulant after storage at -20 degrees C for 32-48 months. PMID- 2779171 TI - An in vitro study of the effects of acetaldehyde on Intoxilyzer 4011AS-A results. AB - A series of practical experiments were conducted to determine whether physiologic concentrations of acetaldehyde could produce an apparent ethanol concentration in breath alcohol analyses using the Intoxilyzer 4011AS-A. Aqueous ethanol:acetaldehyde standards were prepared and analyzed following the same protocol used for testing individuals arrested for driving while intoxicated. The average response of the Intoxilyzer to concentrations of acetaldehyde vapor are reported. Results clearly demonstrate that physiologic breath concentrations of acetaldehyde will not significantly affect the results of a breath alcohol test when an Intoxilyzer 4011AS-A is used for the analysis. PMID- 2779172 TI - Determination of 1,2,4-trimethylbenzene (pseudocumene) in serum of a person exposed to liquid scintillation counting solutions by GC/MS. AB - 1,2,4-Trimethylbenzene (pseudocumene) is often used as the solvent for liquid scintillation counting solutions. In the present work, the determination of 1,2,4 trimethylbenzene in the serum of a person exposed to the solvent vapor during the handling of liquid scintillation counting cocktails is described. The identification of 1,2,4-trimethylbenzene was carried out by GC/MS. The analyte was quantified by GC with flame ionization detection. The detection limit of the method is 0.01 ppm. Two hours after exposure of a person to the solvent vapor, the concentration of 1,2,4-trimethylbenzene in her serum was found to be 0.20 ppm. PMID- 2779173 TI - The effect of experimental parameters on the cold-vapor mercury atomic absorption determination. Speciation analysis of sulfhydryl-bound mercury. AB - Two schools of thought have dominated the reduction procedure in cold-vapor atomic absorption: acidic reduction following the method of Hatch and Ott (4), and alkaline reduction as devised by Magos and Cernik (5). Our study investigates the effect of cysteine added to both mercury stock solutions and reducing solutions in combination with acidic and alkaline reduction procedures. The results allow the separate identification of mercury in the sulfhydryl complexed and uncomplexed form. PMID- 2779174 TI - A single-step extraction for screening whole blood for basic drugs by capillary GC/NPD. AB - Basic drugs were routinely extracted from whole blood under alkaline conditions into n-butyl acetate. An aliquot of the n-butyl acetate was injected into a gas chromatograph equipped with a nitrogen-phosphorous detector and a wide-bore cross linked 50% phenylmethyl silicone capillary column. Absolute and relative retention times were recorded for more than 100 extracted drug standards. Recovery from whole blood was determined for some of the more frequently encountered drugs. This one-step extraction proved to be reliable for general screening and has been used routinely in forensic and clinical toxicological analyses. PMID- 2779175 TI - The determination of the anticoagulant rodenticide brodifacoum in blood serum by liquid chromatography with fluorescence detection. AB - A sensitive method utilizing reversed-phase liquid chromatography with fluorescence detection has been developed for the analysis of the anticoagulant rodenticide brodifacoum in blood serum. The serum proteins are precipitated with acetonitrile and the supernatant mixed with ethyl ether. The organic phase is separated, evaporated to dryness, and the residue subjected to chromatographic analysis. Extraction efficiencies of brodifacoum at concentrations of 20, 60, and 300 ng/mL were 82.9, 93.4, and 93.8%, respectively, with coefficients of variation (CVs) of 3.52, 4.07, and 3.68%, respectively. The intrarun precision (CV) without an internal standard at concentrations of 20, 60, and 300 ng/mL were 1.93, 4.89, and 1.51%, respectively, and 3.56, 5.94, and 3.66% with an internal standard. The interrun precision over the concentration range of 20-1000 ng/mL ranged from 1.88-6.22% without an internal standard and from 2.07-12.6% with an internal standard. Brodifacoum was measurable to at least the 1-ng/mL level. PMID- 2779176 TI - Evaluation of the ETS and ADx urine drug screening immunoassay analyzers. AB - The Syva ETS and Abbott ADx urine drug testing immunoassay systems were evaluated for analytical performance, ease of operation, data processing, and time of analysis. Urine specimens were analyzed by each system for six drugs of abuse. Discrepancies in drug detection were due to variations in the cut-off concentrations between ADx and EMIT d.a.u. (ETS) reagents. The ETS was found to have several major advantages over the ADx: greater sample load, more convenient "random access," and real time data processing. When analyzing multiple specimens, the turnaround time for the ETS as compared to the ADx was twice as fast for the six-analyte assay. The ADx assay calibrations were stable for two weeks, while the ETS required daily calibration with verification by cut-off calibrators every eight hours. The ETS was found superior to the ADx for multianalyte urine drug screening. PMID- 2779177 TI - Fatal intoxication by dextromoramide: a report on two cases. AB - Two cases involving an overdose resulting from the abuse of dextromoramide are presented. The drug was quantified with a gas chromatograph equipped with a nitrogen phosphorous detector (NPD). The whole blood dextromoramide concentrations were 984.3 ng/mL for case 1 and 871.1 ng/mL for case 2. No correlations could be established with the postmortem levels in blood and in bile. PMID- 2779178 TI - Assessing breath test estimation of blood alcohol concentration. PMID- 2779180 TI - Social anxiety among Jewish and Arab students in Israel. PMID- 2779179 TI - Inquiry mode, occupational stress, and preferred leadership style among American elementary school teachers. AB - The relationship between teachers' cognitive styles and the kind of leadership style they prefer and the types of occupational stress they experience was explored by obtaining self-reports from 70 elementary school teachers. Analytic teachers preferred principals who were task rather than relationship oriented. Preferences in leadership style appeared to be related to subjects' tendencies to perceive and evaluate situations in particular ways. Compatibility with a principal's leadership style may have depended on how closely the style matched a teacher's fundamental affective and cognitive characteristics. PMID- 2779181 TI - Flow in a two-dimensional collapsible channel with rigid inlet and outlet. AB - This paper examines mainly oscillatory behavior of a fluid-conveying collapsible tube using a two-dimensional flexible channel made of a pair of membranes. The equation of equilibrium of the membrane in a large deflection theory is coupled with the equations of continuity and momentum of an incompressible flow in a one dimensional flow theory accounting for flow separation. An explicit finite difference method was used to solve the governing equations numerically. According to numerical results, the fluids in the inlet and outlet rigid channels have strong effects on the oscillation of the system. Depending on initial values for the numerical integration, there may exist both a stable static equilibrium and an oscillatory solution for the same parameter values, but only if the external pressure is sufficiently large. PMID- 2779182 TI - Oscillations in a collapsed-tube analog of the brachial artery under a sphygmomanometer cuff. AB - To determine whether self-excited oscillations in a Starling resistor are relevant to physiological situations, a collapsible tube conveying an aqueous flow was externally pressurized along only a central segment of its unsupported length. This was achieved by passing the tube through a shorter and wider collapsible sleeve which was mounted in Starling resistor fashion in a pressure chamber. The tube size and material, and all other experimental parameters, were as used in our previous Starling resistor studies. Both low- and high-frequency self-excited oscillations were observed, but the low-frequency oscillations were sensitive to the sleeve type and length relative to unsupported distance. Pressure-flow characteristics showed multiple oscillatory modes, which differed quantitatively from those observed in comparable Starling resistors. Slow variation of driving pressure gave differing behavior according to whether the pressure was rising or falling, in accord with the hysteresis noted on the characteristics and in the tube law. The results are discussed in terms of the various possible mechanisms of collapsible tube instability, and reasons are presented for the absence of the low-frequency mode under most physiological circumstances. PMID- 2779183 TI - Parametric evaluation of forced expiration using a numerical model. AB - Numerical calculations were performed to study the influence of several physiologic parameters on a forced expiration. It was found that the axial distribution of airway compliance produced profound changes in the detailed flow pattern, as characterized by the axial distributions of speed index and area ratio, but had little effect on the flow-volume curve. Similar results were obtained when the expression for frictional losses was changed to reflect new experimental results. In contrast, changes in airway size and geometry altered both the detailed flow pattern and the mean expiratory flow rate. The shape of the flow-volume curve remained unchanged. PMID- 2779184 TI - A new computational model for expiratory flow from nonhomogeneous human lungs. AB - A model has been developed for expiration from human lungs in which the mechanical properties of the airways and parenchyma can be varied between regions. The model is based on an existing homogeneous model. The fluid mechanical problem of the merging of dissimilar flows from adjacent regions is underspecified by the conservation laws of mass and energy. An existing, empirically derived result, provides the required extra equation. Model simulation of a nonhomogeneously distributed mild constriction of the peripheral airways gives results for maximal flows and alveolar pressure differences which are in good agreement with recent experimental findings. PMID- 2779185 TI - Flow of urine through the ureter: a collapsible, muscular tube undergoing peristalsis. AB - In steady flow through nonuniform collapsible tubes a key concept is the compressive zone, at which flow limitation can occur at both high and low Reynolds numbers. Ureteral peristalsis can be considered as a series of compressive zones, corresponding to waves of active muscular contraction, that move at near-constant speed along the ureter towards the bladder. One dimensional, lubrication-theory analysis shows that peristalsis can pump urine from kidney into the bladder only at relatively low mean rates of urine flow. Under these circumstances isolated boluses of urine are propelled steadily through the ureter (assumed uniform) by the contraction waves. At higher mean rates of flow the behavior depends on whether the frequency of peristalsis is higher or lower than a critical value. For frequencies above the critical value steady propagation of boluses that are in contact with contraction waves at both ends is possible. As the flow rate rises the urine begins to leak through the contraction waves and steady peristaltic flow breaks down. There is an upper limit to the mean flow rate that can be carried by steady peristalsis, which depends on the mechanical properties of the ureter. At high flow rates the peristaltic contractions do not pump but hinder the flow of urine through the ureter. PMID- 2779186 TI - Steady flow through a double converging-diverging tube model for mild coronary stenoses. AB - Velocity profiles and the pressure drop across two mild (62 percent) coronary stenoses in series have been investigated numerically and experimentally in a perspex-tube model. The mean flow rate was varied to correspond to a Reynolds number range of 50-400. The pressure drop across two identical (62 percent) stenoses show that for low Reynolds numbers the total effect of two stenoses equals that of two single stenoses. A reduction of 10 percent is found for the higher Reynolds numbers investigated. Numerical and experimental results obtained for the velocity profiles agree very well. The effect of varying the converging angle of a single mild (62 percent) coronary stenosis on the fluid flow has been determined numerically using a finite element method. Pressure-flow relation, especially with respect to relative short stenoses, is discussed. PMID- 2779187 TI - Flow visualization studies in a mold of the normal human aorta and renal arteries. AB - To study the flow behavior in regions where hemodynamic effects have been suggested to participate in atherogenesis, we evaluated flow in a mold of the aorta and renal arteries of a previously healthy 27-year-old woman who died of trauma. A birefringent solution (vanadium-pentoxide) was used. When diluted, this material behaves like a Newtonian fluid. This method gives a complete picture of the entire flow field. Zones of flow separation and disturbed flow can be seen and the location and size of disturbed areas observed. Unseparated flow regions downstream from disturbed zones can be properly visualized and the method can be used for pulsatile flow as well as steady flow. During steady flow (only at branch to-trunk flow ratios greater than 0.20), zones of flow separation were observed in the aorta distal to the renal arteries. During pulsatile flow, disturbances were found at nearly all branch-to-trunk flow ratios. PMID- 2779188 TI - Effect of tilting disk, heart valve orientation on flow through a curved aortic model. AB - The influence of tilting disk valve orientation on pulsatile flow through a curved tube model of the human aorta was studied. Simultaneous, two-component laser Doppler velocimeter measurements were made in a tube having a 22 mm diameter and 41 mm radius of curvature which simulated the average dimensions of the adult aorta. The blood analog fluid had a viscosity of 3.0 cp and matched the refractive index of the glass model aorta. Results at mid-arch showed low turbulence levels in early systole and no influence of valve orientation. During mid-systole, fluid from the ventricle reached mid-arch exhibiting strong influence of valve orientation and increased turbulence levels. With the major orifice of the valve adjacent to the inner curved wall, the peak turbulent shear stress was 307 dynes/cm2 at mid-arch during mid-systole. When the major orifice was rotated 180 degrees, the peak value was reduced to 91 dynes/cm2 at the same location and time. At the exit of the curved section, the flow was independent of the valve orientation and the turbulent shear the flow was independent of the value orientation and the turbulent shear stress levels were an order of magnitude lower than the peak value at the inlet. This study demonstrated that orienting the major orifice of a tilting disk valve adjacent to the outer curved wall minimized turbulent shear stress levels. PMID- 2779189 TI - A preliminary theoretical study of arterial pressure perturbations under shock acceleration. AB - The artero-venous system is often stressed by accelerative perturbation, not only during exceptional performances, but also in normal life. For example, when the body is subject to fast pressure changes, accelerative perturbations combined with a change in hydrostatic pressure could have severe effects on the circulation. In such cases a preliminary mathematical inquiry, whose results allow qualitative evaluation of the perturbation produced is useful. Pressure variations are studied in this work when the body is subjected both to rectilinear and rotational movements as well as posture change. The dominant modes of the hemodynamic oscillations are emphasized and the numerical simulation results presented. The artery model used for simulation is obviously simplified with respect to the anatomical structure of an artery. Nevertheless, behavior of the main arteries (like the common carotid and aorta) can be approximately described, choosing suitable model parameters. The frequency of blood oscillations strictly depends on the Young modulus of the arterial wall. This connection could be employed for new clinical tests on the state of the arteries. PMID- 2779190 TI - An analytical model of traumatic diffuse brain injury. AB - Diffuse axonal injury (DAI) with prolonged coma has been produced in the primate using an impulsive, rotational acceleration of the head without impact. This pathophysiological entity has been studied subsequently from a biomechanics perspective using physical models of the skull-brain structure. Subjected to identical loading conditions as the primate, these physical models permit one to measure the deformation within the surrogate brain tissue as a function of the forces applied to the head. An analytical model designed to approximate these experiments has been developed in order to facilitate an analysis of the parameters influencing brain deformation. These three models together are directed toward the development of injury tolerance criteria based upon the shear strain magnitude experienced by the deep white matter of the brain. The analytical model geometry consists of a rigid, right-circular cylindrical shell filled with a Kelvin-Voigt viscoelastic material. Allowing no slip on the boundary, the shell is subjected to a sudden, distributed, axisymmetric, rotational load. A Fourier series representation of the load allows unrestricted load-time histories. The exact solution for the relative angular displacement (V) and the infinitesimal shear strain (epsilon) at any radial location in the viscoelastic material with respect to the shell was determined.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2779191 TI - Biomechanical evaluation of the axial compressive responses of the human cadaveric and manikin necks. AB - Cervical spine injuries such as wedge, burst, and tear drop fractures are often associated with compressive axial loads delivered to the human head-neck complex. Understanding the injury mechanisms, the kinematics of the anatomic structure, and the tissue tolerances can improve clinical prognosis and facilitate a better design for anthropomorphic devices. The axial compressive response of human cadaveric preparations was compared with the 50th percentile anthropomorphic Hybrid III manikin under various loading rates. Ten fresh human cadavers were used in the study. Intact cadaver torsos, head-cervical spines, and ligamentous cervical columns were tested. The head-neck structure and the neck (without head) of the Hybrid III manikin were also tested. Responses of the human cadaveric preparations and manikin structures were nonlinear at all rates of loading. However, axial stiffness, a measure of the ability of the structure to withstand external force, was higher under all rates of loading for manikin preparations when compared with the human cadaveric tissues. PMID- 2779192 TI - Yield behavior of bovine cancellous bone. AB - The compressive yield strain was measured for 61 specimens of bovine cancellous bone from three distal femora. There was no significant relationship (p = 0.08, R2 = 0.051) between yield strain and the degree of trabecular orientation. There was a significant positive correlation (p less than 0.00001, R2 = 0.319) between yield strain and structural (apparent) density and significant negative correlation (p less than 0.0025, R2 = 0.145) between yield strain and bone density. Yield strain correlated best with bone solid volume fraction Vv (epsilon y = 0.592 +2- 1.446vv, R2 = 0.337). The quantity, yield strain, is highly dependent on specific definitions of the yield point and the point of zero strain. For this study the yield point was defined by a 0.0003 offset criterion, and the point of zero strain was defined as the point where the tangent at 15 percent of yield crosses zero. The results using these definitions were compared with results using yield strain values determined by other definitions of the yield point and zero strain. The correlations between yield strain and trabecular orientation, structural density and bone density changed very little for differing definitions of yield. The results suggest that yield strain in cancellous bone is isotropic or independent of textural anisotropy, so the yield behaviour may be characterized by a maximum strain yield criterion. The results also suggest that the primary mode of yield in cancellous bone is buckling of the trabeculae. PMID- 2779193 TI - Characteristics of speech breathing in young women. AB - Chest wall kinematic records were obtained from 10 healthy young women in the upright, seated position during resting breathing, conversation, and reading aloud. Breathing frequency, lung volume levels relative to resting end-expiratory level, and relative volume displacements of the rib cage and abdomen were measured. Compared to conversation, group results for reading revealed three differences: an increase in syllables spoken per breath, an absence of filled pauses, and a slight upward shift in end-inspiratory and end-expiratory lung volume levels. Compared to resting breathing, group results for speech revealed four differences: a background chest wall configuration characterized by a relatively larger rib cage and smaller abdomen, slight increases in breathing frequency and in lung volume expenditure, and a slight decrease in rib cage contribution to lung volume displacement. The physical characteristic most strongly associated with rib cage contribution to lung volume displacement in resting breathing was height (r = .76). In comparing the relationship between the same respiratory behavior during resting breathing and speech, a correlation of .83 was obtained for rib cage contribution to volume displacement in the two conditions and of .60 for end-inspiratory volume level in the two conditions. Somewhat weaker positive correlations were obtained for lung volume expenditure and for breathing frequency in the two conditions. Comparison of the present findings for women to those recently reported for comparable men (Hoit & Hixon, 1987) revealed no remarkable differences in speech breathing characteristics. Results suggest that certain physical characteristics and task variables may have greater functional importance than gender in determining normative speech breathing behaviors. PMID- 2779194 TI - Comprehension of lexical subcategory distinctions by aphasic patients: proper/common and mass/count nouns. AB - Previous research has found that agrammatic Broca aphasic patients have particular difficulty using determiners like "a" and "the" for the purposes of sentence comprehension. In this study, we test whether or not such difficulty extends to the level where lexical subcategories are distinguished by these articles. The absence or presence of a determiner distinguishes proper from common nouns (e.g., "ROSE" vs. "A ROSE"), and mass from count nouns (e.g., "GLASS" vs. "A GLASS"). Groups of agrammatic Broca and fluent aphasic subjects were required to point to one of two pictures in response to a sentence such as "Point to the picture of rose" or "Point to the picture of a rose". Sentences were presented in either printed or spoken form. Results indicated that for the agrammatic Broca patients, printed presentation yielded significant improvement over spoken presentation only for the proper noun/common noun distinction. Performance was significantly poorer for the mass noun/count noun distinction as compared to the proper/common distinction for these patients, and mass nouns proved particularly difficult. Interpretable patterns were not observed on either subcategory distinction for the fluent aphasic subjects. Current theories of agrammatism cannot fully explain these data. An independent explanation is offered that suggests proper noun/common noun is a universal semantic distinction. On the other hand, the mass noun/count noun distinction is more purely syntactic, and thus is particularly difficult for agrammatic Broca patients. PMID- 2779195 TI - Evaluation of a technique for training new speech contrasts: generalization across voices, but not word-position or task. AB - We used the perceptual fading technique (Jamieson & Morosan, 1986) to teach unilingual adult Canadian francophones to identify the voiceless and voiced linguadental fricatives, /0/ and /o/. Training began with the identification of synthetic consonant-vowel (CV) exemplars that contained exaggerated amounts of frication (140 ms), with feedback given to identify errors and correct responses. Subsequently, stimuli with progressively shorter fricative durations were added to the identification set. After just 90 min of such training, francophone adults were better able to identify both the training stimuli and an untrained set of natural CVs produced by four different speakers, two men and two women. These results replicate and extend those reported by Jamieson and Morosan, and establish that such training generalizes to the identification of natural CVs produced by a variety of voices, both male and female. Thus, the effects of training are not restricted to a small range of acoustic cues. However, such learning was still strongly sensitive both to other aspects of the acoustic context and to the testing situation: Training failed to improve identifications of /0/ and /o/ phonemes when these were presented in word-medial and word-final positions, and identifications of synthetic and natural examples of /o/ vs. /d/ did not improve, even though identifications of /0/ vs. /o/ were very good. PMID- 2779196 TI - Lip movement in apraxia of speech. AB - Peak articulatory velocity of the lower lip and temporal coordination between the upper and lower lips were studied in 5 neurologically impaired subjects with speech behaviors consistent with a diagnosis of apraxia of speech. Differences in velocity and the timing between the movement onset of the two lips were compared for accurate and inaccurate productions of words. Peak articulatory velocity also was measured during the productions of the syllable [pae] and during a nonverbal movement. There were no systematic differences across accurate and inaccurate productions of words in peak articulatory velocity or movement onsets of the two lips. Furthermore, there were no systematic changes in movement velocity related to speech rate. We conclude that some apraxic speakers do not have a defect in the ability to produce high movement velocities. PMID- 2779197 TI - The importance of consonant-vowel intensity ratio in the intelligibility of voiceless consonants. AB - The purpose of this study was to evaluate the extent to which variations in the consonant-vowel (C-V) intensity ratio could account for variations in speech intelligibility among the productions of 10 talkers. Fifty normal-hearing individuals listened in noise to syllables consisting of voiceless consonants followed by the vowel /a/ under three conditions in which: (a) C-V ratio varied naturally as produced by the talkers, and the stimuli were calibrated according to vowel intensity; (b) C-V ratios were increased and equated via digital signal processing; and (c) C-V ratios were unmodified, but the syllables were calibrated according to consonant level rather than vowel level. Results indicated that variations in C-V ratio explained a great deal of the variation in the intelligibility of some consonants (/s, S, tS/) but not others (the voiceless stops). This difference may well be due to differences in audibility between the two groups of consonants when they are presented at similar consonant-to-noise ratios. The majority of the data suggest that the importance of C-V ratio is related to the intensity of consonants but is independent of the ratio per se between consonant and vowel levels. PMID- 2779198 TI - The reliability of type-token ratios for the oral language of school age children. AB - This study investigated the alternate forms reliability of four type-token ratios (TTRs) of oral language samples obtained from 52 elementary school children (9 through 12 years of age). The four TTRs included the basic type-token ratio, the corrected type-token ratio, the root type-token ratio, and the bilogarithmic type token ratio. Language samples of 600 words were segmented into 50-word, 100-word, and 200-word samples. Within each TTR measure, there were no significant differences among the means for samples of the same size, but all means for a given sample size differed significantly from the means of all other sample sizes. Further, for samples of the same size the reliability coefficients calculated for each TTR measure were neither consistent nor significant. These findings indicate that under the conditions of the present study TTRs are not comparable when calculated for different sample sizes ranging from 50 to 600 words, and further, that they are not reliable measures of the language performance of individual elementary school children from regular classrooms for language samples of 50 to 200 words. PMID- 2779199 TI - Spectral correlates of glottal voice source waveform characteristics. AB - The relationships between the waveform and the spectrum of the pulsating transglottal airflow during vowel phonation are analyzed in singers and nonsingers. The waveform, called the flow glottogram, is analyzed by means of inverse filtering, and the spectrum is determined either directly, by submitting the flow glottogram to spectrum analysis, or indirectly, by measuring spectral changes accompanying phonatory changes under conditions of constant vowel articulation. The peak-to-peak amplitude of the flow glottogram pulses shows a strong relationship with the amplitude of the source spectrum fundamental and varies considerably during phonation, presumably depending on the degree of glottal ab/adduction. The negative peak amplitude of the differentiated flow glottogram shows a high correlation with the sound pressure level of the vowel. PMID- 2779200 TI - The speech regulating system: temporal and aerodynamic responses to velopharyngeal inadequacy. AB - Temporal and respiratory responses to a loss of velar resistance were measured in 107 subjects demonstrating varying degrees of velopharyngeal inadequacy. The subject data were compared to data generated by a mechanical model representing a passive system. The pressure-flow technique was used to estimate velopharyngeal orifice size and measure respiratory and temporal characteristics of aerodynamic events associated with the production of the nasal-plosive blend /mp/ in the word "hamper". Subjects were categorized as having adequate closure (less than 0.05 cm2), adequate/borderline closure (0.05-0.09 cm2), borderline/inadequate closure (0.10-0.19 cm2) and inadequate closure (greater than or equal to 0.20 cm2). The data revealed that intraoral pressure fell 10-fold in the model as velopharyngeal orifice area changed from adequate closure to inadequate. The subject data demonstrated only a 1.4-fold drop in pressure. Airflow data indicated that there was a 10-fold increase in respiratory volume in the subject data corresponding to the change from adequacy to inadequacy. When respiratory and temporal responses were assessed together, the findings revealed that airflow and temporal changes minimized the fall of pressure as velar resistance declined across groups. PMID- 2779201 TI - The effect of the heartbeat on vocal fundamental frequency perturbation. AB - Signal-averaging and autocorrelation analysis revealed that the cardiovascular system exerts a modest but consistent influence on vocal fundamental frequency (Fo), accounting for approximately 0.5% to 20% of the absolute Fo perturbation (jitter) measured during a sustained phonation. There was also a marked trend for this percentage to decrease with increasing vocal Fo. Estimated mean "deterministic jitter" (Jd) values of 3.7 microsec (SD = 3.2) and 0.9 microsec (SD = 0.5) were derived from 6 normal male and 6 normal female subjects, respectively, with an overall mean of 2.3 microsec (SD = 2.7). These values represent approximately 6.9% of the mean total jitter for men and 2.4% of the mean total jitter for women, or about 4.6% for all subjects. The results are discussed in terms of their significance regarding more reliable vocal jitter measurement. PMID- 2779202 TI - Unusual phonological behavior and the avoidance of homonymy in children. AB - Young children sometimes make use of unusual phonological patterns even when they already possess the appropriate sound or a suitable substitute in their phonological systems. In this investigation, we attempted to determine whether in such instances unusual sound changes enable children to avoid potential homonymy with other words in their lexicons. Novel words were presented to children, half serving as potential homonyms, half as unlikely homonyms. The children's acquisition of these words was monitored. For a group of normally developing children, unusual sound changes were found to be more frequent in the words with the potential for homonymy. In contrast, a group of children with specific language impairment showed the same degree of unusual usage for both types of words. The findings suggest that children with specific language impairment are especially limited in their ability to capitalize on the phonetic regularities of the language. PMID- 2779203 TI - Statistical differentiation of tracheoesophageal speech produced under four prosthetic/occlusion speaking conditions. AB - Twelve male and 12 female total laryngectomy patients who received the tracheoesophageal puncture (TEP) as a means of vocal rehabilitation served as subjects for this investigation. Recordings were made of these subjects' speech produced with four prosthetic/occlusion conditions: (1) duckbill prosthesis with tracheostoma valve; (2) duckbill prosthesis with digital occlusion of the tracheostoma; (3) low pressure prosthesis with tracheostoma valve; and (4) low pressure prosthesis with digital occlusion. Speech tasks consisted of three trials of maximum phonation time on /a/ and reading of a 98-word standard passage. Acoustic analysis of the recorded speech samples included a total of 34 frequency, intensity, temporal, and noise measures. Eight acoustic measures (words per minute, harmonics-to-noise ratio, percent jitter, intensity range during vowel phonation, percent periodic phonation, mean intensity during reading, directional jitter, and directional jitter, and directional shimmer) were chosen as dependent variables for a repeated measures MANOVA. The overall repeated measures MANOVA, a set of complex contrasts, and paired t tests revealed that TEP speech produced with the low pressure prosthesis was significantly different from that produced with the duckbill prosthesis on a weighted linear combination of the eight acoustic variables. Tracheoesophageal voice produced with a low pressure prosthesis had greater amounts of periodic phonation than tracheoesophageal voice produced with a duckbill prosthesis. The use of a tracheostoma valve did not have a significant impact on the subset of acoustic measures used in the repeated measures MANOVA. PMID- 2779204 TI - Speaking clearly for the hard of hearing. III: An attempt to determine the contribution of speaking rate to differences in intelligibility between clear and conversational speech. AB - Previous studies (Picheny, Durlach, & Braida, 1985, 1986) have demonstrated that substantial intelligibility differences exist for hearing-impaired listeners for speech spoken clearly compared to speech spoken conversationally. This paper presents the results of a probe experiment intended to determine the contribution of speaking rate to the intelligibility differences. Clear sentences were processed to have the durational properties of conversational speech, and conversational sentences were processed to have the durational properties of clear speech. Intelligibility testing with hearing-impaired listeners revealed both sets of materials to be degraded after processing. However, the degradation could not be attributable to processing artifacts because reprocessing the materials to restore their original durations produced intelligibility scores close to those observed for the unprocessed materials. We conclude that the simple processing to alter the relative durations of the speech materials was not adequate to assess the contribution of speaking rate to the intelligibility differences; further studies are proposed to address this question. PMID- 2779205 TI - A preliminary analysis of the ameliorative effects of time-out from speaking on stuttering. AB - Relatively few attempts have been made to systematically examine the processes responsible for the ameliorative effects of response-contingent stimulation (RCS) on stuttering. It was hypothesized that the reductions in stuttering that frequently accompany RCS are the result of the stutterer being encouraged to access extant fluent speech that may not be fully evident during "contingency free" (CF) conditions. A preliminary analysis of the hypothesis was conducted by monitoring RCS and CF stuttering frequency and speaking rate in 20 adult stutterers before, during, and after a program of fluency training. Subjects were divided into "high" and "low" responders on the basis of their baseline response to the RCS procedure of time-out from speaking, after which they participated in a 32-hour program of fluency training aimed at minimizing stuttering. After showing a degree of relapse during a subsequent 6-mon follow-up, high and low responders were found to be equally affected by time-out. This result contrasted the differential response shown by the two groups during the baseline phase, and is consistent with the hypothesis that improvements in fluency during RCS may occur when stutterers access extant fluent speech that is not otherwise being fully utilized. PMID- 2779206 TI - Phonatory reaction times of rheumatoid arthritic and normal females. AB - This study examined the degree to which rheumatoid arthritis affects a speaker's ability to accomplish rapid vocal fold adjustments. The phonatory initiation, phonatory termination, and manual reaction times of 14 rheumatoid arthritic (RA) and 14 normal (NL) speakers were compared during a morning and an afternoon session. In addition, electroglottographic (EGG) measures (0 Hz-10 kHz bandwidth and 30 Hz-10 kHz bandwidth) allowed us to explore the components of each subject's reaction times. For two speech reaction-time tasks, temporal measures that reflected primarily mechanical adjustments of the vocal folds were significantly longer in the RA group than in the NL group. The two groups also differed significantly on manual response time, phonatory initiation time, and medial movement initiation time. Neither group displayed evidence of laryngeal morning stiffness. PMID- 2779207 TI - Judgments of disfluency by mothers of stuttering and normally fluent children. AB - The purpose of this study was to examine the relation between selected aspects of speech disfluency and perceptual judgments of these events by mothers of young stutterers and mothers of age- and sex-matched normally fluent children. Each mother independently listened to and judged as either "stuttered" or "not stuttered" recorded examples of a young stutterer's imitated productions of: (a) five different types of speech disfluency, (b) sound prolongations, and (c) sound/syllable repetitions of five different durations each, along with a comparable number of fluent utterances. Results indicated that although some between-group differences in judgments were observed, both groups most frequently judged sound/syllable repetitions to be stuttered, followed by whole-word repetitions and broken words. Fluent utterances, interjections, and sound prolongations were most frequently judged to be not stuttered by all mothers. Both groups judged sound prolongations averaging 258 ms in duration to be stuttered an average of 25% of the time, increasing to 68% for sound prolongations averaging 1254 ms; however, both groups of mothers judged sound/syllable repetitions of two or more iterations to be stuttered an average of 93% of the time. Findings suggest that there are not appreciable differences between mothers of stuttering and normally fluent children regarding their perceptual judgments of speech disfluencies, but each group might more frequently judge as stuttered those types of speech disfluencies characteristic of their own children's speech. PMID- 2779208 TI - Some effects of variations in response time latency on speech rate, interruptions, and fluency in children's speech. AB - The present study was designed to examine adult-child interactions during conversation with respect to the effects of adult paralinguistic speech variations on the speech production of children. Four 4-year-old children served as subjects. A single-subject A-B-A design with counterbalancing and replication was implemented. Each subject participated in three 15-min conversations with an experimenter. The independent variable was the interspeaker pause time--the response time latency (RTL). During the 15-min conversations, the experimenter used either a 1-s or a 3-s RTL when responding to the child. RTL was measured for each subject in each condition. Data analysis revealed that each child's RTL was significantly longer when the experimenter's RTL was 3 s than when it was 1 s, and all differences between all conditions reached significance for these subjects. Other dependent variables included speech rate, the frequency of disfluencies, and the frequency of interruptions produced by the subjects within each condition. All 4 subjects varied the frequency of disfluencies and interruptions. However, each child varied rate and disfluencies in a highly individualistic manner. PMID- 2779209 TI - Surface recordings of respiratory muscle activity during speech: some preliminary findings. AB - Bipolar electromyographic (EMG) recordings were made from six chest wall and nasal sites with disk electrodes attached to the skin. Electrode locations were based on previous studies of nonspeech breathing and were designed to sample the activity of both primary and accessory respiratory muscles. EMG activity was sampled while subjects performed a series of speech and nonspeech tasks. The results revealed that surface electrodes could sample the activity of respiratory muscles during speech and other ventilatory tasks, particularly during the expiratory phases of the breathing cycle. PMID- 2779211 TI - Preliminary evaluation of a Weibull function for fitting slow-component eye velocity over the time course of caloric-induced nystagmus. AB - We describe preliminary attempts to fit a mathematical function to the slow component eye velocity (SCV) over the time course of caloric-induced nystagmus. Initially, we consider a Weibull equation with three parameters. These parameters are estimated by a least-squares procedure to fit digitized SCV data. We present examples of SCV data and fitted curves to show how adjustments in the parameters of the model affect the fitted curve. The best fitting parameters are presented for curves fit to 120 warm caloric responses. The fitting parameters and the efficacy of the fitted curves are compared before and after the SCV data were smoothed to reduce response variability. We also consider a more flexible four parameter Weibull equation that, for 98% of the smoothed caloric responses, yields fits that describe the data more precisely than a line through the mean. Finally, we consider advantages and problems in fitting the Weibull function to caloric data. PMID- 2779210 TI - Acoustic and physiological reaction times of stutterers and nonstutterers. AB - This study investigates reaction times in the fluent speech utterances of stutterers and nonstutterers under several experimental conditions. Twenty adult stutterers and twenty matched controls produced utterances of three lengths--one syllable words, polysyllabic words, and sentences--in two conditions of time pressure (high and low) and two conditions of preparation (delayed and immediate responding) in a reaction-time paradigm. Recordings were made of EMG signals from the orbicularis oris inferior and from the extrinsic laryngeal area, as well as electroglottographic and acoustic signals. Measures were made of the duration of intervals between the stimulus, the acoustical onset of voicing, the onset of laryngeal EMG activity, and the onset of lip EMG activity. The durations of subintervals between the stimulus, the three physiological signals, and the acoustic signal were also measured. The results suggest that the reaction times of stutterers and nonstutterers are both increased by longer utterances, and that the effect is proportionally greater for the stutterers. The requirement to respond with minimal preparation produced longer reaction times in both groups, particularly for longer utterances, but this finding was stronger for stutterers than for nonstutterers, particularly in the prelaryngeal subintervals. The high time-pressure condition produced an unusual pattern of responding in many subjects. The analysis of subintervals indicated that the additional time taken by stutterers in responding was located in the earlier parts of the response, particularly when the utterances were longer. The results are interpreted as suggesting that stutterers may have difficulty in the motor programming of speech behavior. PMID- 2779212 TI - Static acoustic-admittance measures in normal ears: a combined analysis for ears with and without notched tympanograms. AB - A preliminary database of acoustic-immittance measures in normal adults was provided in an earlier publication (Wiley, Oviatt, & Block, 1987). Here, an additional analysis of static acoustic-admittance measures, based on the original database, is provided. Specifically, compensated static acoustic-admittance data for a 220-Hz probe signal are provided for 239 ears including those that did (N = 55) and did not (N = 184) demonstrate tympanometric notching for a 660-Hz probe signal. PMID- 2779214 TI - Magnitude estimation and cross-modal matching of lingual vibrotactile and auditory sensation. AB - The present experiment was a preliminary attempt to use the psychophysical scaling methods of magnitude estimation and cross-modal matching to investigate suprathreshold judgments of lingual vibrotactile and auditory sensation magnitudes for 20 normal young adult subjects. A 250-Hz lingual vibrotactile stimulus and a 1000-Hz binaural auditory stimulus were employed. To obtain judgments for nonoral vibrotactile sensory magnitudes, the thenar eminence of the hand was also employed as a test site for 5 additional subjects. Eight stimulus intensities were presented during all experimental tasks. The results showed that the slopes of the log-log vibrotactile magnitude estimation functions decreased at higher stimulus intensity levels for both test sites. Auditory magnitude estimation functions were relatively constant throughout the stimulus range. Cross-modal matching functions for the two stimuli generally agreed with functions predicted from the magnitude estimation data, except when subjects adjusted vibration on the tongue to match auditory stimulus intensities. The results suggested that the methods of magnitude estimation and cross-modal matching may be useful for studying sensory processing in the speech production system. However, systematic investigation of response biases associated with vibrotactile-auditory psychophysical scaling tasks appears to be a prerequisite. PMID- 2779213 TI - The automatic extraction of pitch perturbation using microcomputers: some methodological considerations. AB - A program for the automatic extraction of jitter (PAEJ) was developed for the clinical measurement of pitch perturbations using a microcomputer. The program currently includes 12 implementations of an algorithm for marking the boundary criteria for a fundamental period of vocal fold vibration. The relative sensitivity of these extraction procedures for identifying the pitch period was compared using sine waves. Data obtained to date provide information for each procedure concerning the effects of waveform peakedness and slope, sample duration in cycles, noise level of the analysis system with both direct and tape recorded input, and the influence of interpolation. Zero crossing extraction procedures provided lower jitter values regardless of sine wave frequency or sample duration. The procedures making use of positive- or negative-going zero crossings with interpolation provided the lowest measures of jitter with the sine wave stimuli. Pilot data obtained with normal-speaking adults indicated that jitter measures varied as a function of the speaker, vowel, and sample duration. PMID- 2779215 TI - The craniofacial center: advances in the treatment of facial deformities. PMID- 2779217 TI - The Tennessee Board of Medical Examiners. PMID- 2779216 TI - Indications and applications of MRI Vs. CT scan in diagnosing lesions of the central nervous system. PMID- 2779218 TI - Peripartum congestive heart failure. PMID- 2779219 TI - Subcutaneous gas and shock. PMID- 2779220 TI - Health department implements care coordination. PMID- 2779221 TI - Unclass action. PMID- 2779222 TI - Differential regulation of androgen receptors in the separate rat prostate lobes: androgen independent expression in the lateral lobe. AB - In order to understand the hormonal regulation of androgen receptors (AR) in the separate lobes of the rat prostate gland, the present study examined AR levels in the ventral, dorsal and lateral prostate lobes as a function of androgen withdrawal to complete prostatic regression and subsequent testosterone replacement. In the intact rat, the 3 prostate lobes contained significantly different amounts of androgen binding sites. Mean number of total cellular AR in the ventral, dorsal and lateral lobes was 7370, 1690, and 1015 fm/mg DNA, respectively. These receptors were primarily localized within the nuclear fraction of homogenized tissue: ventral, 86%; dorsal, 83%; and lateral, 100% nuclear localization. Androgen withdrawal was initiated via castration and rats were sacrificed 1, 2, 3, 5, 7, 10 and 14 days thereafter. Nuclear AR levels fell rapidly to 5, 24 and 30% of intact values by 48 h in the ventral, dorsal and lateral lobes, respectively. Levels of nuclear AR continued to decline in the ventral and dorsal lobes to undetectable levels by Day 10. In marked contrast, lateral lobe nuclear AR began to increase on Day 3 postcastration, reaching intact values by Day 7 and 133% intact levels by Day 14. Cytosolic AR in the ventral and dorsal lobes initially increased following castration, but subsequently declined to low levels by Day 14. Cytosolic AR were not detectable in the lateral prostate at any time point following castration. To determine the nuclear AR response to testosterone at this time, 14 day castrate rats were given 2 cm testosterone implants and sacrificed 1, 3, 5, 7, 10 and 14 days thereafter. As expected, nuclear AR rapidly returned in the ventral and dorsal lobes by Day 1 and reached a plateau by Day 5. A short term response to androgen exposure occurred in the lateral lobe where an immediate 9-fold increase in nuclear AR quantity was observed; however, these levels rapidly declined to pre-implant values by Day 5 and remained at that level despite continued exposure to testosterone. These f findings indicate that while nuclear AR levels in the ventral and dorsal prostate are primarily regulated by androgens, a testosterone independent component exists within the lateral lobe. PMID- 2779223 TI - Altered estrogen receptor system in estrogen-unresponsive human endometrial adenocarcinoma cells. AB - Previous studies from our laboratories demonstrated that cells from a human endometrial adenocarcinoma cell line (Ishikawa) responded to estradiol whereas cells from another endometrial cancer line (HEC-50) did not. In an attempt to identify factors responsible for the observed estrogen insensitivity we compared the characteristics of the estradiol receptor (ER) systems in Ishikawa and HEC-50 cells. Saturation analyses of cytosolic estrogen binders were performed over a 0.1-70 nM range of [3H]estradiol concentrations. Equilibrium dissociation constants and number of binding sites were determined by graphic analysis of Scatchard plots or computed by applying Fourier-derived affinity spectrum analysis (FASA) of the binding data. No significant differences were noted in the dissociation constants (Kd approx. 0.6 nM) or number of binding sites (approx. 6 10 fmol/mg protein) for the single binder that could be evaluated by the graphic method in cytosol from the two cell lines. However, 2 binders in Ishikawa cells (Kd approx. 0.2 and 6 nM) could be detected by the FASA method; the higher affinity binder in HEC-50 cells could not be clearly demonstrated. Structural differences in the specific estrogen binders which might distinguish HEC-50 from Ishikawa cells or normal endometrial tissue were investigated by using the anti ER monoclonal antibody JS 34/32. Interaction of the antibody with [3H]estradiol binders of estrogen-responsive cells and tissue was evident from the formation of labeled complexes that were shown to sediment faster in glycerol density gradients and could be immunoprecipitated with Protein A attached to Sepharose beads. In contrast, the antibody did not recognize labeled specific binders in the HEC-50 cells. Furthermore, [3H]estradiol receptors in Ishikawa cells could be transformed into a species that exhibited increased hydrophilicity, evident from its binding to DNA-cellulose, whereas binders from HEC-50 could not. These results indicate that the lack of responsiveness of HEC-50 cells to estrogens might be due to structural or functional alterations in the ER protein resulting in a loss of its capability to undergo estrogen-directed conformational changes required for biological activity. PMID- 2779224 TI - Antiestrogen(4-hydroxytamoxifen)-charged estrogen receptor binding to nuclei from normal and neoplastic rat mammary tissues is not affected by host hormonal status. AB - Interaction of [3H]4-hydroxytamoxifen-charged estrogen receptor [( 3H]AER) with nuclei was compared to that of [3H]17 beta-estradiol-charged estrogen receptor [( 3H]ER) in vitro. Specificity of [3H]AER binding was demonstrated since more than 90% of [3H]AER binding was displaced by ten-fold excess estradiol-charged ER. For R3230AC tumors, the number of [3H]AER binding sites was approximately 40% lower than the number of [3H]ER binding sites. There were no differences in affinity of binding of these receptors complexes (Kd range 0.7-1.6 nM). In contrast 0.7-1.6 nM). In contrast to a reduction of [3H]ER binding after ovariectomy, no difference in the number of [3H]AER binding sites was seen among tumors from intact, ovex, or estrogen-treated ovex rats. These results suggest that [3H]AER bind to 60% of the sites that bind [3H]ER, and that neither tissue type nor host ovarian status affects the number of nuclear [3H]AER binding sites. PMID- 2779225 TI - Aromatase activity in microsomal preparations of human genital skin fibroblasts: influence of glucocorticoids. AB - Skin is an important site of estrogen production in men. Although the aromatase complex in these cells appears to be similar to that of other human cells, the regulation of aromatase by glucocorticoids in cultured human skin fibroblasts is unique. We examined aromatase activity in microsomal-enriched fractions of cultured human skin fibroblasts in order to characterize better the factors that regulate the aromatase in these cells. The optimum pH for aromatase activity in microsomal preparations ranged between 7.0 and 7.5. When androstenedione was the substrate, the mean Vmax was 0.58 pmol/mg protein/h (range: 0.09-1.26 pmol/mg protein/h) and the mean Km was 27 nM (range: 9-50 nM). When aromatase activity was determined as a function of NADPH concentration, the mean Vmax was 0.39 pmol/mg protein/h (range 0.11-0.82 pmol/mg protein/h) and the mean Km was 180 microM (range: 86-300 microM). For skin fibroblasts exposed to DEX, aromatase activity in isolated microsomes and intact cells was stimulated demonstrating a typical time course with peak levels at 14h and a decline toward baseline with prolonged (48-60 h) exposure. Cytosol from DEX-stimulated cells did not stimulate the aromatase activity in microsomal-enriched preparations from untreated cells. In addition, cytosol from cells incubated with DEX for a prolonged period (60 h) did not inhibit the higher aromatase activity of microsomes from cells incubated with DEX for only 14 h. We previously demonstrated that skin fibroblasts incubated with DEX and CHX produced a superinduction phenomenon for aromatase activity. This superinduction of enzyme activity also occurred in the microsomal enriched fraction and was unaffected by the cytosol of these cells. These studies exclude the possibility that the unique effects of DEX on the aromatase in human skin fibroblasts are due to the production of either inhibitory or stimulatory soluble factors within cytosol. PMID- 2779226 TI - Active immunization of rabbits against progesterone: increase in hormone levels, and changes in metabolic clearance rates and in genital tract tissues. AB - 11 alpha-Hemisuccinyl progesterone was coupled to rabbit serum albumin and injected into intact male rabbits, and into intact ovariectomized female rabbits, for a period of 52 weeks. The ovariectomized females and the intact males showed better immune responses than the intact females. Specificity of the antisera was tested against both progesterone and the carrier protein, and against 19 other selected steroids. Antibody titres and serum levels of progesterone in all groups, and testosterones in the males, showed characteristic changes with a first maximum 12-18 weeks after the beginning of immunization, a decrease despite booster injections and a second increase after 35-40 weeks. Hormone levels were 5 12 times higher by the end of immunization than before. High antibody titres were correlated with decreased metabolic clearance rates for progesterone, reflecting the binding of the steroid to the antibody. Increased production rates of progesterone in the immunized females and of testosterone in the immunized males showed that the antibody-bound hormone was not available for feedback control. Absence of primordial follicles, hyperplasia of the Leydig cells, decreased spermatogenesis and involution of the seminal vesicle epithelium were interpreted as direct or indirect effects of the removal of free progesterone. PMID- 2779227 TI - Calmodulin-binding proteins in subcellular fractions of zones of the adrenal cortex. AB - The guinea pig adrenal cortex consists of a steroidogenic ACTH-responsive outer zone and an ACTH-unresponsive inner zone. It has been suggested that calmodulin plays an important role in ACTH-stimulated steroidogenesis. Thus, in an effort to examine the calmodulin 'system' in the guinea pig adrenal cortex model, Ca2+ dependent binding of calmodulin to proteins in subcellular fractions of the outer and inner zones was examined by the [125I]iodocalmodulin overlay technique and compared to similar studies utilizing pancreas, brain and liver tissue. Although the general pattern of calmodulin-binding proteins was similar for the two adrenocortical zones, quantitatively there was a striking difference with greater binding in the outer zone; this was particularly noteworthy for the mitochondrial fraction. The two most prominent calmodulin-binding proteins isolated from cytosol by calmodulin-Sepharose column chromatography had Mr of 60,000 and 47,000. The size of these two proteins suggested the presence of Ca2+/calmodulin dependent protein kinase II. Western blot analysis, however, failed to demonstrate calmodulin kinase II in either zone, although it was clearly detectable in brain cytosol. The 60 K calmodulin-binding protein in the adrenal cortex also suggested the presence of the calmodulin-binding A subunit of the Ca2+/calmodulin-stimulated protein phosphatase, calcineurin. Western blot analysis did reveal the presence of calcineurin in the outer adrenocortical zone; it was not detectable, however, in the inner adrenocortical zone. The relation between the striking zonal differential for calmodulin-binding proteins and the zonal differential in ACTH-stimulated steroidogenesis in the guinea pig adrenal cortex will require further investigation. PMID- 2779228 TI - Concentration and turnover of estradiol in the rat uterus in vivo. AB - The concentrations and turnover of estradiol isolated from cytosolic and nuclear fractions of uteri from ovariectomized rats given estradiol, either in single injections or in continuous infusion, were analyzed by gas chromatography-mass spectrometry. The analytical method was validated for different organs and lower limits of analysis were established. After infusion of 20 ng x h-1 for 18-22 h, mean estradiol levels were 2.0-2.4 fmol x mg-1 uterine wet weight in the nuclear fraction, and 1.2-1.5 fmol x mg-1 in the cytosolic fraction. The concentrations were about five times higher after a single injection of one microgram estradiol but the distribution between nuclear and cytosolic fractions was almost the same. The concentrations of estradiol in nuclei from liver and spleen were 50-200 times lower than those in uterus. Taken together with previous knowledge, the results indicate that the distributions of estradiol and its receptor are not the same and that hormone response cannot be predicted from the concentration of receptors alone. The exchange of estradiol molecules in the uterus was followed after a change of the infusion from unlabelled to [11,12,12-2H3]-labelled estradiol, or vice versa. The uterine uptake of estradiol was calculated to be about 0.7 fmol x h-1 x mg-1 uterine wet weight. The half-life time was calculated to be at least 4 h for estradiol molecules isolated from the nuclear fraction and 3 h (significantly shorter) for those isolated from the cytosolic fraction. The results indicate an uptake of 40-90% of all estradiol passing through the uterus in proestrus with only about 10% of available receptors becoming occupied. When the infusion was changed from estradiol to ethynylestradiol, estradiol disappeared from the uterus at the same rate as in the experiments above. Ethynylestradiol was taken up at a rate of about 0.3-0.4 fmol x h-1 x mg-1 tissue. The percentage of total steroid found in the nuclear fraction was higher for ethynylestradiol, about 70%, than for estradiol, about 60%, indicative of a more stable association of receptor to nuclear binding sites when ethynylestradiol is the ligand. PMID- 2779229 TI - Photoaffinity labelling of nuclear steroid 5 alpha-reductase of rat ventral prostate. AB - In order to get more information on the molecular structure of the rat prostatic 5 alpha-reductase (3-oxo-5 alpha-steroid: NADP+ 4-ene-oxidoreductase, EC 1.3:1.22) a systematic photoaffinity labelling study has been performed. To irreversibly freeze the status quo of interaction, either testosterone, the physiological ligand, or diazo-MAPD (21-diazo-4-methyl-4-aza-5 alpha-pregnane 3,20-dione), a specific 5 alpha-reductase inhibitor, was irradiated with isolated nuclei or with purified nuclear membranes or with solubilized nuclear membrane proteins and checked for optimal labelling conditions. The principal substances covalently labelled were phospholipids and at a minor ratio proteins. Analysis by SDS-PAGE and autoradiofluorography revealed two labelled polypeptides with molecular weights of 20 kDa and 26 kDa. The following evidence indicates that these polypeptides might be derived from the enzyme 5 alpha-reductase: both proteins are labelled only when specific ligands for 5 alpha-reductase are used; binding can be reduced by the addition of an excess of unlabelled ligand; enzyme activity is irreversibly suppressed when irradiated in the presence of these ligands; only subcellular fractions containing 5 alpha-reductase reveal the labelled proteins; in all 5 alpha-reductase containing preparations with increasing specific activity, independent of the polypeptide pattern, the same proteins are labelled. PMID- 2779230 TI - The 56 kDa protein of human genital skin fibroblasts is identical to that radiolabelled by [3H]dihydrotestosterone 17 beta-bromoacetate. AB - Analysis of soluble proteins from human genital skin fibroblasts by two dimensional polyacrylamide gel electrophoresis reveals an abundant protein doublet of mol. wt 56,000 with isoelectric points (pI) of 6.7 and 6.5. This protein is absent in non-genital skin fibroblasts as well as in genital skin fibroblasts of most patients with complete forms of androgen insensitivity. The protein specifically binds androgen. A protein of similar estimated molecular weight (58,000) from human genital skin fibroblasts has recently been found to be covalently radiolabelled by the affinity ligand dihydrotestosterone 17 beta bromoacetate (DHT-BA). In the present study these proteins have been found to be indistinguishable on one- and two-dimensional gel electrophoresis. Antibodies raised against the 56 kDa pI 6.7/6.5 protein also recognized the protein covalently radiolabelled by DHT-BA. A third protein of estimated mol. wt 59,000 has been found to be associated with several steroid hormone receptor complexes but has no known ligand binding activity. This protein was found to be clearly separable from the 56/58 kDa protein on two-dimensional gel electrophoresis as it has a more acidic pI of approximately 5.4. Furthermore, antibodies against the 59 kDa protein do not recognize the 56 kDa species, and vice versa. PMID- 2779231 TI - Characterization of 19-nor-10-oxo-25-hydroxyvitamin D3 production by solubilized chick kidney mitochondria and bovine serum albumin. AB - The vitamin D3 metabolite obtained from the incubation of 3 [(cholamidopropyl)dimethylammonio]-2-hydroxy-1-propanesulfonate (CHAPSO) solubilized chick kidney mitochondria with 25-hydroxyvitamin D3 (25-OH-D3) was identified to be 5(E)-19-nor-10-oxo-25-hydroxyvitamin D3 (5(E)-19-nor). The production of 19-nor was dependent on time and on protein concentration, but was not dependent on the pH of the incubation. 19-Nor was not formed in the absence of protein or when protein had been heat-treated following detergent solubilization. 19-Nor was not further metabolized to any other product upon incubation with the CHAPSO-solubilized proteins. No 19-nor-10-oxo derivative of 1,25(OH)2D3 was formed when 1,25(OH)2D3 was used as substrate in the incubation. Kinetic analysis showed a substrate saturation with an apparent Vmax of about 4.1 pmol/min.mg and S0.5 of approximately 1.3 x 10(-6) M. The production of 19-nor was not restricted to the CHAPSO-soluble protein fraction of kidney mitochondria but was also found in both the CHAPSO-soluble and -insoluble fractions of chick liver mitochondria and CHAPSO-treated bovine serum albumin (BSA). 19-Nor production by detergent-treated BSA also showed saturation kinetics with a similar S0.5 and an apparent Vmax which was about 5-fold higher than that obtained with CHAPSO-solubilized mitochondria. The evidence suggests that the formation of 19-nor is not mediated by a traditional enzyme, but does require protein. A mechanism for the conversion of 25-OH-E3 to 19-nor is proposed, in which the naturally-occurring 5(Z)-25-OH-D3 substrate binds to protein, isomerizes to 5(E)-25-OH-D3 and is oxidized by hydrogen peroxide to 5(E)-19-nor via a dioxetane intermediate. PMID- 2779232 TI - Pretreatments with 5 alpha-dihydrotestosterone and the uptake of testosterone by cell nuclei in the brains of male rhesus monkeys. AB - An in vivo competition method was used in adult male rhesus monkeys to determine if testosterone binds to high affinity binding agents, notably androgen receptors, in brain cell nuclei. Castrated males received 5 alpha dihydrotestosterone propionate (DHTP, 20 mg, N = 6), testosterone propionate (TP, 100 mg, N = 3) or oil vehicle (controls, N = 6) followed 3 h later by 5 mCi [3H]testosterone [( 3H]T) as an intravenous bolus. Brain and peripheral tissue samples were removed after 60 min, homogenized and separated into supernatant and purified nuclear fractions. Radioactive metabolites of [3H]T [( 3H]estradiol, [3H]DHT) and unchanged [3H]T were identified by high performance liquid chromatography (HPLC). Androgen pretreatments reduced the nuclear uptake of [3H]T by 67-98% in hypothalamus (HYP), preoptic area (POA) and pituitary gland (PIT). This blockade was presumed to be due to prior occupation of nuclear androgen receptors by unlabeled androgens because pretreatments had no effects on levels of [3H]T in supernatants. Since [3H]T was the major radioactive androgen present in brain cell nuclei, results strongly suggested that the principal nuclear androgen receptor ligand in HYP, POA and PIT was unchanged [3H]T rather than [3H]DHT as occurs in the genital tract. In the amygdala the situation was quite different. Here, nuclear concentrations of [3H]T were reduced by 67% following TP pretreatment but were not changed following DHTP pretreatment, indicating a different uptake mechanism in this region that could have particular relevance for testosterone's central actions on behavior. PMID- 2779233 TI - Secretory pattern of growth hormone regulates steroid sulfatase activity in rat liver. AB - Steroid sulfatase activity was quantified in liver microsomes from hypophysectomized adult female rats treated with estradiol and continuous or intermittent human growth hormone (hGH). Hypophysectomy clearly enhanced sulfatase activity as compared to intact female rats. Normal female values were completely restored by continuous infusion of hGH (1.4 i.u./kg/day). Neither the same dose of hGH given as two daily injections nor estrogen replacement therapy had any effect. It is concluded that liver microsome sulfatase activity in the non-pregnant rat is regulated by the sexually dimorphic secretory pattern of GH. PMID- 2779234 TI - Temporal actions of 16 alpha-hydroxyestrone in the rat: comparisons of lordosis dynamics with other estrogen metabolites and between sexes. AB - 16 alpha-Hydroxyesterone (16OHE1), a metabolite of estradiol (E2) and precursor of estriol (E3), binds to the estrogen receptor (ER) with low affinity (3% of E2), but is estrogenic in both in vitro and in vivo systems. This metabolite is able to bind in a non-dissociable manner to the ER. We examined these properties in vivo by assessing the temporal dynamics of estrogen metabolite action in the rat brain, using lordosis score (LS) to manual stimulation as a serial bioassay of estrogen effect. Male and female castrate Fisher rats were implanted with osmotic minipumps containing either vehicle, E2, 16OHE1, or E3. 16OHE1-induced LS was delayed in onset in both sexes relative to E2 and E3. Male LS reached a similar plateau for all metabolites, whereas female LS reached an initial LS plateau similar in amplitude to the male plateau. Over the next several days, female LS increased to reach a secondary plateau of higher amplitude, which persisted until pump removal. Upon pump removal, E2- and E3-stimulated LS fell to baseline quickly in both sexes, whereas 16OHE1-stimulated LS in males demonstrated a prolongation of maximal LS for 6 days following pump removal. These results suggest that 16OHE1 is estrogenic in the brains of both sexes. The delay of onset of LS with 16OHE1 is consistent with its poor ER affinity. Females were able to augment LS with prolonged exposure to all metabolites, while males could not. The ability of 16OHE1 to maintain maximal LS in the male long after its withdrawal is consistent with its ability to bind non-dissociably to the ER and promote prolonged estrogenic activation. However, females do not exhibit this response, suggesting a sex specificity in the dynamics of ligand-receptor action in the rat brain. PMID- 2779235 TI - Evidence for separate sites for aromatisation of androstenedione and 16 alpha hydroxyandrostenedione in human placental microsomes. AB - Much greater quantities of 16 alpha-hydroxyoestrogens (e.g. oestriol) than of 16 deoxyoestrogens (e.g. oestradiol-17 beta) are formed in human pregnancy than might be expected from the relative availability to the placenta of the 16 alpha hydroxy- and 16-deoxy-C19 precursors. To investigate this further, 16 alpha hydroxyandrostenedione (16 alpha-OH-A4) and androstenedione (A4) were tested in vitro as substrates and mutual inhibitors of human placental aromatase. It was found that the Km for aromatisation of A4 (mean = 0.26 mumol/l) was very similar to Ki (0.30, 0.35 mumol/l) for the inhibition by A4 of the aromatisation of 16 alpha-OH-A4. Similarly, Km for aromatisation of 16 alpha-OH-A4 (mean = 1.21 mumol/l) had the same value as the Ki (1.0, 1.2 mumol/l) for the inhibition by 16 alpha-OH-A4 of the aromatisation of A4. From graphical analysis of Lineweaver Burk plots, both inhibitions were characterised as noncompetitive. Hence, it was concluded that the two 16-deoxy- and 16-hydroxy-C19 substrates bind at separate, but interactive, sites and that each substrate on binding inhibits the aromatisation of the other. Additional evidence for the separate but interactive substrate binding sites for the 16-deoxy- and 16-hydroxy-C19 steroids was obtained by use of the suicide inhibitor 4-hydroxyandrostenedione (4-OH-A4), which is recognised as binding to the aromatisation site for A4. Aromatisation of 16 alpha-OH-A4 was found to be inhibited by pre-incubation of the microsomes with 4-OH-A4 (0.1 mumol/l). The presence of A4 (4.6 mumol/l), but not of 16 alpha-OH A4 (4.0 mumol/l) during the pre-incubation successfully protected the subsequent aromatisation of 16 alpha-OH-A4 from this inhibition. In addition, the Km values, reported here, suggest also that the 16-deoxyandrogens are preferred to the 16 alpha-hydroxyandrogens as oestrogen precursors. In consequence, factors other than substrate affinity and plasma concentrations must be presumed to be involved in the overwhelming production of 16 alpha-hydroxyoestrogens in human pregnancy. PMID- 2779236 TI - Heterogeneity of [3H]estradiol binding sites in the rat prostate: properties and distribution of type I and type II sites. AB - In order to assess the rat prostate as a target tissue for receptor-mediated estrogen action, we have studied the properties and distributions of estrogen binding sites in the dorsolateral (DLP) and ventral (VP) prostate. Saturation analyses over a wide range of [3H]estradiol ([3H]E2) concentrations (0.5-100 nM) revealed two distinct types of binding sites in the cytosol and nuclear fractions of DLP of intact rats. The high affinity (type I) estrogen binding sites saturated at 2-4 nM of [3H]E2 and had a capacity of 170 fmol/mg DNA in the cytosol and 400 fmol/mg DNA in the nuclei. DLP type I sites had ligand specificity similar to that described for the classical estrogen receptors (ERs) found in female target tissues. The moderate affinity (type II) estrogen binding sites saturated at 15-30 nM of [3H]E2 and had a capacity of 850 fmol/mg DNA in the cytosol and 1600 fmol/mg DNA in the nuclei. DLP type II sites shared some characteristics of the type II ERs described for the rat uterus; they were estrogen specific, heat labile, and sensitive to reducing agents such as dithiothreitol. Saturation analyses on VP cytosols and nuclear fractions revealed only high affinity sites but no moderate affinity sites in the tissue preparations. Our finding that prostatic type II estrogen binding sites are present exclusively in the DLP supports the concept that basic biological differences exist between the two major prostatic lobes of the rat. Furthermore, our findings may help elucidate the observed differences in susceptibility between these two lobes to the hormonal induction of proliferative prostatic lesions. PMID- 2779237 TI - Biosynthesis of estradiol-17 beta fatty acyl esters by microsomes derived from bovine liver and adrenals. AB - A fatty acyl coenzyme A:estradiol-17 beta acyl transferase activity has been detected in bovine hepatic and adrenocortical microsomes. It is thoroughly increased when adenosine triphosphate (5 mM) and coenzyme A (1 mM) are added to incubation buffer. Using a substrate concentration of 185 microM, the hepatic and adrenocortical microsomal activities have been found to be to 2.4 +/- 0.1 and 5.5 +/- 0.2 nmol/h/mg prot., respectively. Five major estradiol-17-esters have been isolated by reverse phase high performance liquid chromatography from both microsomal incubations, the fatty acid moieties being: arachidonate, linoleate, oleate, palmitate and stearate. However, the distribution of hepatic metabolites is quite different from that obtained with adrenocortical membranes, this is well explained by the corresponding differences between the endogenous contents of free fatty acids. With any of the two types of microsomal membranes used, the results show that estradiol is more susceptible to be esterified to polyunsaturated fatty acids than saturated ones. The possible physiological implications of such an activity in liver and adrenals are discussed. PMID- 2779239 TI - The gene for alcoholism. PMID- 2779238 TI - Kinetic analysis of human placental, ovarian, and adrenal 3 beta-hydroxysteroid dehydrogenase inhibition by epostane in vitro. AB - The effect of epostane [(2 alpha,4 alpha,5 alpha,17 beta)-4,5-epoxy-17-hydroxy 4,17-dimethyl-3-oxo- androstane-2-carbonitrile] on the conversion of pregnenolone to progesterone and of dehydroepiandrosterone (DHA) to androstenedione was studied in human term placental microsomes and in comparison with human ovarian and adrenal microsomes. Using pregnenolone as substrate, 3 beta-hydroxysteroid dehydrogenase (3 beta-HSD) activity in the three tissues had a similar Km (3-6 microM) but Vmax ranged from 1.3 nmol/mg protein per min in ovary to 10 nmol/mg protein per min in placenta. Epostane inhibited 3 beta-HSD activity in all three tissues with the characteristics of a pure competitive inhibitor: mean Ki values were 1.7 microM for placenta, 0.5 microM for adrenal and 0.1 microM for ovary. Moreover, in placental microsomes epostane inhibited the conversion of DHA to androstenedione with a Ki of 0.6 microM. The mechanism of action of epostane explains its effectiveness in blocking progesterone synthesis during the luteal phase and in pregnancy in women, and its strong anti-steroidogenic effect in other endocrine tissues in vitro. PMID- 2779240 TI - Concurrent reinforcement and alcohol: interactive effects on human aggressive behavior. AB - The relationship between alcohol and human aggressive behavior was studied under conditions in which nonaggressive response requirements maintained by point presentation were manipulated. Six normal adult male recreational alcohol users pressed buttons that produced points (redeemable for money) on their own counters or ostensibly subtracted points (money) from another fictitious subject described as participating in the same study at another location. During random components of each session, subjects were required to press a button 50, 200 or 500 times in order to produce point increments on their own counters. Ten responses on a second button were required to subtract a point from the other subject during all components. Aggressive responding was engendered by occasional point subtractions which were attributed to the fictitious subject. Alcohol (0, 0.125, 0.25 and 0.5 g/kg of 95% ethanol) produced dose-related increases in aggressive responding. Aggressive responding was also significantly related to the concurrent schedule of point presentation. Finally, a significant interaction between alcohol and concurrent point presentation contingencies was observed. These results indicate that aggressive responding is affected by ongoing reinforcement contingencies not directly related to aggressive behavior and that reinforcement schedule interaction may be one factor mediating the situation-dependent nature of alcohol's effects on aggressive behavior. PMID- 2779241 TI - Alcoholism and depressive symptomatology among convicted DWI men and women. AB - Interrelationships between DSM-III-based alcoholism diagnostic groups and depressive symptomatology were assessed for a sample of 461 convicted DWI offenders. The highest rate of depressive symptomatology was reported by persons diagnosed as alcohol dependent, and such findings were robust across male and female offenders. However, a significant interaction effect was found in which alcohol-dependent women reported higher levels of depressive symptomatology than alcohol-dependent men. With the exception that men reported significantly more previous DWI arrests than women, few differences were found between the gender groups with respect to a range of demographic variables, alcohol use and alcohol related problems. PMID- 2779242 TI - Alcohol withdrawal in the elderly. AB - The phenomenon of alcohol withdrawal has seldom been studied in subgroups of patients in withdrawal. We developed a rating scale for measuring alcohol withdrawal that we found to be reliable and valid. The scale, when applied to young (ages 21-33, N = 24) and elderly (ages 58-77, N = 26) groups of patients in alcohol withdrawal, indicated that the elderly group initially had a more severe withdrawal for which they received higher doses of chlordiazepoxide. PMID- 2779243 TI - Risk factors for neuropsychological impairment in alcoholics: antisocial personality, age, years of drinking and gender. AB - One hundred eighty-two alcoholics were studied using subtests from the Halstead Reitan Neuropsychological Battery, Wechsler Adult Intelligence Scale and the Wechsler Memory Scale. Alcoholics who displayed antisocial personality disorder (ASPD) were more impaired on the Brain Age Quotient, a summary measure of neuropsychological impairment. Multivariate analyses indicated that presence of ASPD contributed significantly to this impairment, independent of age, length of drinking history or gender. Discriminant analysis using these variables as predictors allowed for clinically useful levels of prediction of neuropsychological impairment in individual subjects. PMID- 2779244 TI - Drinking, drinking styles and drug use in children of alcoholics, depressives and controls. AB - Adolescent children of alcoholic, depressive and normal control fathers were assessed with a variety of alcohol and drug use measures. Children of alcoholics were quite similar to the other two groups with regard to alcohol consumption, reasons for drinking, attitudes toward temperate and intemperate use of alcohol, and the typical drinking context. However, children of alcoholics, both male and female, were more likely to report drug use than children of depressives or children of normal controls. These findings suggest that although children of alcoholics are at risk for the development of alcoholism, deviant drinking practices may not be discernible in adolescence. PMID- 2779245 TI - Attitudes and expectancies as predictors of drinking habits: a comparison of three scales. AB - Research on expectations about the effects of alcohol has shown these expectancies to be related to drinking habits. Expectancies can be seen as components of attitudes toward alcohol, which are also related to drinking behavior. The relationships between attitudes, expectancies, and self-reported drinking behavior were examined. Three different measures of expectancies were included in order to compare their relative utility in predicting drinking variables. Two of the three measures performed equally in prediction. Although expectancies added significantly to explained variance in drinking when attitudes were controlled for, the increment was quite small. The improvement in prediction was larger when the measures of attitudes and behavior lacked correspondence. The results suggest that attention to the relationships between attitudes and expectancies can inform further research in this area. PMID- 2779246 TI - Blood alcohol level among emergency room patients: a multivariate analysis. AB - This article examines the distribution of positive blood alcohol levels (BALs) among emergency room patients and the relationship between intoxication and other variables. Approximately one-quarter of the 640 subjects had positive blood alcohol levels and 16.3% had BAL readings above 0.10%, the legal limit for operating a motor vehicle in most states. Chi-square tests and logistic regression analysis indicated a significant relationship between employment status, gender, educational attainment, age and BAL. There were no significant racial differences. Analysis of the role of the presenting problem with BAL revealed that being involved in an accident was significantly predictive of a high BAL in a multivariate context. However, patients presenting with psychiatric problems had overall higher levels of intoxication than other patients. These findings have major implications for public policy formulation vis-a-vis public health delivery. PMID- 2779247 TI - Expectancy and tolerance: a study of acute alcohol intoxication using the balanced placebo design. AB - Interactive effects of expectancy and alcohol dose on CNS functioning were examined in subjects differing in degree of dependence on alcohol, using the balanced placebo design. Male subjects (N = 30), 10 severely-, 10 moderately- and 10 nondependent on alcohol, were tested with the Klove-Matthews Motor Steadiness Battery before and after drinking. The administered alcohol dose yielded .07 mg/dl mean blood alcohol level. Expectations about alcohol resulted in impaired sensorimotor coordination in severely dependent alcoholics, as compared to expectations of soft drinks. Moderately dependent subjects showed an opposite response pattern. Such expectancy factors may counteract neuropharmacological tolerance effects, neutralizing real tolerance effects on moderate doses of alcohol for severely dependent alcoholics. High tolerance also makes larger quantities necessary, leading to increased consumption to obtain the same effect. PMID- 2779248 TI - Measurement of ethanol consumed in distilled spirits. AB - The amount of ethanol consumed in alcoholic beverages is often used as one indicator of alcohol's impact on health and society. An objective method of measuring the amount consumed in liquor can be derived in most years from the federal excise taxes and revenues that are levied on liquor according to proof or ethanol content. Similar measurement is not possible for wine and beer. Ethanol consumed in liquor and related statistics are provided from 1960 to 1986, as computed from liquor excise tax revenues. Per capita ethanol consumption increased 39.1% between 1960 and 1974, almost the same as the 41.4% increase of apparent liquor consumption. The average ethanol content of liquor remained almost unchanged in this period. In contrast, sustained trends of lower proof and of relatively lower ethanol consumption are shown after 1974. Between 1974 and 1986 average proof of liquor decreased 17.0% and total ethanol consumed fell 23.9%, considerably more than the 8.3% decline of total liquor consumption. Per capita ethanol consumption dropped 37.5%, half again more than the 25.1% decrease of liquor consumption. PMID- 2779250 TI - A reply to Cook, "Craftsman versus Professional: Analysis of the Controlled Drinking Controversy". AB - I agree with Cook that ideology may influence the selection and presentation of facts in behavioral science. But this is not a primary issue involved in the so called controlled drinking controversy. A primary issue is my allegation that the Sobells did not do what they said they did and they did not find what they said they found. I believe that the Sobells did not conduct their IBTA study in the manner in which they claimed. On the contrary, they have made mutually contradictory claims concerning the procedures employed. Evidence is also presented suggesting the nonrandom assignment of patients to experimental and control groups. PMID- 2779249 TI - Irrational beliefs, urges to drink and drinking among alcoholics. AB - The relationship of various irrational beliefs to alcohol dependence, urges to drink, anxiety and drinking after treatment was investigated for 63 male alcoholics, using Jones' Irrational Beliefs Test (IBT). Alcohol dependence was most strongly associated with problem avoidance. Urges to drink, anxiety and difficulty during alcohol-related role-plays were strongly correlated with problem avoidance and dwelling on negative events. The IBT was unrelated to pretreatment drinking measures but did predict 6-month posttreatment drinking (n = 48) which suggests these beliefs can mediate treatment response. Feeling doomed by the past was the best predictor of both frequency of drinking and average quantity consumed during follow-up. Treatment implications include targeting specific beliefs for intervention. PMID- 2779251 TI - Moratorium on Maltzman: an appeal to reason. AB - Maltzman's comment on Cook (1985), which appears elsewhere in this issue, is an unveiled attempt to resurrect the same allegations about our research that he made 7 years ago. None of the allegations are new! Over the past 7 years, those allegations have been the topic of 5 separate inquiries, in each of which we were vindicated. In this response, we review the multiple inquiries and we show how Maltzman continues to (1) cite our work out of context, (2) make false assumptions about the inquiries and our procedures and (3) disregard evidence contradicting his assertions. He relies on data that, to use his characterization, are a "tempest in a teapot." Having answered the same fundamental attack time and again over the past 7 years, we declare a unilateral moratorium on responding to Maltzman. Moreover, our repeated vindications, and research published over the last 20 years corroborating moderation outcomes, illustrate that, indeed, science is self-correcting. PMID- 2779252 TI - An open letter to Journal readers. PMID- 2779253 TI - A reply to Maltzman. PMID- 2779254 TI - The stability of coexisting psychiatric syndromes in alcoholic men after one year. PMID- 2779255 TI - Comments on a model of egg development and diapause. PMID- 2779256 TI - Comments on a model of egg development and diapause: a reply to Susan Scott. PMID- 2779257 TI - On the quantum physical theory of subjective antedating. AB - This paper explores the question of mental events causing neural events through the actions of the quantum physical probability field. After showing how quantum mechanical descriptions pertain to the influence that mental events have upon neural events, the question of Libet's "delay-and-antedating" observation is examined in the light of quantum mechanical description, specifically in the action of the probability field. The probability field is the product of two quantum wave functions. According to the transactional interpretation (TI) of quantum physics these wave functions can be pictured as offer and echo waves--the offer wave passing from an initial event to a future event and the echo wave passing from the future event back in time towards the initial event. I propose that two events so correlated are experienced as one and the same event; that is, any two quantum physically correlated events separated in time or space will constitute a single experience--an event in "consciousness." Using the TI then suggests a quantum physical resolution of the "delay-and-antedating" hypothesis/paradox put forward by Libet, B., Wright, E. W., Feinstein, B., & Pearl, D. K. (Brain, 1979, 102, 193). It also offers a first step towards the development of a quantum physical theory of subjective antedating based on the transactional interpretation of quantum mechanics. PMID- 2779258 TI - The distribution of wearout over evolved reliability structures. AB - A multiple-integral equation, termed the wearout equation, describes the distribution of wearout (or aging) over evolved reliability structures, such as organisms and self-replicating machines, and thus statistically governs virtually all aging properties of the systems. The equation is applied to the computation of ab initio ("from the beginning") life tables for four natural populations of ungulates--wild boar, Dall sheep, African buffalo, and hippopotamus--which represent a broad range of survival characteristics. The good agreement of the ab initio and empirical tables, the best available for testing the theory, demonstrates the basic realism of the wearout equation. If the equation withstands further experimental testing, its analysis may provide insight into fundamental questions in the biology of aging. PMID- 2779259 TI - Mistakes allow evolutionary stability in the repeated prisoner's dilemma game. AB - The repeated prisoner's dilemma game has been widely used in analyses of the evolution of reciprocal altruism. Recently it was shown that no pure strategy could be evolutionarily stable in the repeated prisoner's dilemma. Here I show that if there is always some probability that individuals will make a mistake, then a pure strategy can be evolutionarily stable provided that it is "strong perfect equilibria" against itself. To be a strong perfect equilibrium against itself, a strategy must be the best response to itself after every possible sequence of behavior. I show that both unconditional defection and a modified version of tit-for-tat have this property. PMID- 2779260 TI - Aggregation and the competitive exclusion principle. AB - A mathematical model for aggregation in a single animal population is set up. It relies on two premises. First, there is an advantage to individuals in the population in grouping together, for example for social purposes or to reduce the risk of predation. Second, the intra-specific competition at a point depends not simply on the population density at that point but on the average population density near the point, since the animals may move to find resources. The model is then extended to competing populations, and inter-specific competition is also assumed to depend on an average population density. It is shown that the resulting aggregation may lead to the co-existence of populations one of which would otherwise be excluded by the other. This finding is discussed with regard to the Competitive Exclusion Principle. PMID- 2779261 TI - Computer automated structure evaluation (CASE): a study of inhibitors of the thermolysin enzyme. AB - The Computer Automated Structure Evaluation (CASE) program has been applied to the analysis of the inhibition of the thermolysin enzyme by derivatives of di- and poly-peptides. The inhibition constant ki, was used as a measure of the activity of the inhibitors. The program successfully identified molecular fragments relevant to the inhibitory activity of the peptides, without any assumption regarding the mechanism of inhibitory action. Utilizing these major fragments, Quantitative Structure Activity Relationship (QSAR) calculations were performed yielding a multiple linear regression equation for the prediction of inhibitory activity. A comparison of the conclusions reported in the literature regarding the structural features involved in the inhibition of thermolysin with the major fragments identified by the program is also made. PMID- 2779262 TI - A zonal model of cortical functions. AB - A model of cortical functions is developed with the object of simulating the observed behavior of individual neurons organized in unit circuits and functional systems of the cerebellum, the cerebrum and the hippocampal formation. The neuronal model is capable of representing refractory and potentiated states, as well as the firing and lowest resting states. The unit circuits of each system consist of all common types of cells with known synaptic connections. In the cerebral system these unit circuits are interconnected to form columns as well as zones. A new discrete neural network equation, which takes account of interactions with the extracellular field, is proposed to simulate electrical activity in these circuits. A coherent theory of cortical activity and functions is derived that accounts for many of the observed phenomena, including those associated with the development of long-term potentiation and sequential memory. Three appendices are devoted to the theory of extracellular interactions, the derivation of non-linear network equations, and a computer program to simulate learning in the cortex. PMID- 2779263 TI - A mathematical model of the kinetics of blood coagulation. AB - Linear mathematical models of the kinetics of blood coagulation have previously been presented (Levine, 1966, Science, N.Y. 152, 651; Martorana & Moro, 1974, Math. Biosci. 21, 77). In this paper a non-linear mathematical model of the extrinsic pathway of blood coagulation is presented to take into account a positive feedback. The feedback is due to factor Va as a co-factor involved in thrombin formation. The extrinsic pathway is shown to function as an amplifier cascade if a vessel wall injury exceeds a threshold value. For sub-threshold stimulation, the extrinsic pathway does not function. PMID- 2779264 TI - Four strand recombination models. AB - A main point of this paper is to develop the idea that synapsis of DNA duplexes might take place by Watson-Crick base pairing between essentially intact duplex structure to form a four stranded intermediate. This intermediate is the same regular and compact four strand structure already discussed (e.g., McGavin, 1971a, J. molec. Biol., 55, 293-298; 1979, J. theor. Biol., 77, 83-99) and which has been used in several related recombination models (see, for example, McGavin, 1977, Heredity, 39, 15-25; 1984, J. theor. Biol., 107, 37-56; Wilson, 1979, Proc. natn. Acad. Sci. U.S.A., 76, 3641-3645; Nash et al., 1980, Cold Spring Harbor Symposium of Quantitative Biology, 45, 417-428; Nash, 1981, A. Rev. Genetics, 15, 143-167). These models can also be related to one recently suggested by Hopkins (1986, J. theor. Biol. 120, 215-222). An immediate stimulus to the development of the idea was the recent work of Griffith & Nash (1985, Proc. natn. Acad. Sci. U.S.A., 82, 3124-3128), on the site specific recombination system of the lambda bacteriophage. They observed trefoil knots with exclusively positive nodes among the products of the interaction of two relatively inverted attachment sites within circular molecules. The model discussed here may though be of interest in itself. The paper also compares several closely related models for recombination which involve formation of either identical or closely related four strand secondary structures. PMID- 2779265 TI - Foetal testosterone levels, homosexuality and handedness: a research proposal for jointly testing Geschwind's and Dorner's hypotheses. AB - Geschwind & Galaburda (1985a,b,c, Archs Neurol., Chicago 42, 428, 521, 634) and Dorner et al. (1983a,b, Expl. Clin. Endocrinol. 81, 88, 83) have hypothesised, respectively, that the testosterone levels to which foetuses are exposed in utero affect postnatal laterality and sexual orientation. A means of testing the two hypotheses jointly is proposed here. PMID- 2779266 TI - The matrix method of metabolic control analysis: its validity for complex pathway structures. AB - The sensitivities of the variables of a metabolic system (such as fluxes and concentrations) to variations in enzyme concentration are expressed in metabolic control analysis as control coefficients. The matrix method is a system of writing matrix equations that generate expressions for the control coefficients in terms of the characteristics of the components (principally the enzymes). Previously, the matrix method has been considered in terms of simple pathway structures; here we justify its applicability to complex pathways, such as those with multiple branches. It is shown that this requires modification of the branch point relationship to take account of changes of flux along the limbs of the branch and of stoichiometric factors. The method of deriving the flux control coefficients with respect to different fluxes in the system is extended to cope with these circumstances. PMID- 2779267 TI - Host density and the evolution of parasite virulence. AB - Social and cultural habits of human populations affect the biological evolution of the agents of infectious diseases. Measles and similar diseases have evolved in the Old World and cannot have existed in their present form before the rise of the great river valley civilizations. It is suggested that increased virulence of measles in white and indigenous communities in America 1500-1800 may be due to a rare strain of the virus, which was selected during transfer from Europe. The release of viruses for biological pest control has provided new material for the study of the co-evolution of host-parasite systems, which has upset the dogma "evolution tends to avirulence". It is pointed out that this issue is closely related to the group selection debate among ethologists, i.e. to the problem: how can group selection overcome individual selection? A model is proposed in which differential growth of two strains of a parasite within the host and their transmission to new hosts is considered. It is supposed that transmission stages excreted by infectious hosts enter a common pool where they are mixed before infecting new hosts. Under these conditions, selection of the slower strain is possible only if the mean size of parasite inoculum is very small, i.e. if the density of transmission stages in the environment is low. The impact of this result on host pathology depends on the relation between virulence and transmission efficiency of the parasite. PMID- 2779268 TI - Treatment of childhood anorexia with spleen deficiency by Qiang Zhuang Ling. AB - The authors' traditional Chinese herbal prescription, Qiang Zhuang Ling, was used to treat childhood anorexia with Spleen deficiency. For comparison, a group of cases treated by zinc sulphate solution was also set up as controls. After a course of treatment, the therapeutic effect in the Qiang Zhuang Ling group was significantly better than in the zinc sulphate group. Furthermore, in both groups, the level of hair zinc were markedly increased; the ultrastructure of hair was recovered; and the activity of macrophages was enhanced. PMID- 2779269 TI - The therapeutic efficacy of the choleretic mixture against the infantile hepatitis syndrome. AB - Observation was made on a control study of the therapeutic efficacy of the choleretic mixture in treating 35 cases of infantile hepatitis syndrome in comparison with that of the choleretic decoction. The ages, duration of the disease, severity of icterus and serum bilirubin level in both groups were comparable. The results showed that there was no significant difference in therapeutic efficacy between the two groups, however, the resolving time of skin icterus was faster in the choleretic mixture group than in the choleretic decoction group. The choleretic mixture was convenient, easy to store, and acceptable to infants for its small dosage, and no side effects, therefore, a desirable drug against infantile hepatitis syndrome. PMID- 2779270 TI - Acupuncture treatment for 30 cases of infantile chronic diarrhea. PMID- 2779271 TI - The short-term effect of childhood rheumatoid arthritis treated with combined western & Chinese herbal drugs. PMID- 2779272 TI - Further observations on the therapeutic effect of magnets and magnetized water against ascariasis in children--analysis of 114 cases. AB - Ascariasis, the most common intestinal parasitic disease in children, is commonly treated with ascaricides, which however often produce sitic disease in children, is commonly treated only simple appliances which are easy to use, economical and cause no side effects. Treatment is effective in most cases. PMID- 2779273 TI - A study on the anti-cancer effect of ningxia wolfberry. PMID- 2779274 TI - Influence of medicinal herbs decocted with different utensils on colony formation of gastric carcinoma cells. AB - In order to elucidate the different results obtained in cancer patients with similar condition and symptoms treated by the same medicinal herbs, an investigation of the utensils used for making decoctions was carried out. It was found that the decoction made by means of glassware, enamel and earthenware pots had the best effect of inhibiting the colony formation of human gastric carcinoma cells, the next were the decoctions made by means of unrefined iron pots, stainless steel pots and copper pots, and the worst was that made with aluminium pots. It was also found that there was no difference between the water contained in those utensils and normal saline in the influence on the colony formation of human gastric carcinoma cells. Therefore, it is believed that the difference in effect of the decoctions made by means of different kinds of utensils is not due to the trace dissolution of the utensil materials, but is most likely due to the occurrence of some chemical reactions while making the decoction. That the decoctions made by means of different utensils had different peak values in the absorption spectrum also supports this proposition. PMID- 2779275 TI - Clinical and experimental studies on paediatric pneumonia treated by lung easing tablets. AB - 197 cases of paediatric pneumonia from 2 hospitals were treated by Ning Fei Pian (NFP, the Lung Easing Tablets), a proprietary Chinese medicine for antipyresis, detoxication, blood invigoration, resolution of cough and phlegm; the control group was treated by penicillin, and the therapeutic results were comparable. Examinations of microcirculation and hemorrheology in the nailbed revealed improvements by NFP, which were conducive to the recovery of pneumonia. Electron microscopically, the tablets also produced improvements in microcirculation, relief of lung edema, and the ratio of ventilation and blood flow. PMID- 2779276 TI - Experimental and clinical studies of "Shen Yan Ling" in treatment of chronic glomerulonephritis. AB - "Shen Yan Ling" (SYL) is a compound herbal preparation consisting of 16 ingredients: Herba Ecliptae, Radix Rhemanniae, Rhizoma Cibotii, Radix Angelica Sinensis, Rhizoma Ligustici Chuanxiong, Radix Paeoniae Rubra, Rhizoma Diosocoreae, Poria, Radix Sanguisorbae, Radix Rubiae, Herba Portulacae, Fructus Gardeniae, Herba Cirsii Japonici, Herba Cephalanoploris, etc. In animal experiments, SYL was shown to have therapeutic effect for Masugi's nephritis models. It has also been used with satisfactory results in the treatment of 314 cases of chronic glomerulonephritis of the common type with manifestations of Yin deficiency and endogenous heat. PMID- 2779277 TI - Effects of digital acupressure on the capillary arteriolar flow in cerebral pia mater of the dog. AB - Effects of digital acupressure on the blood flow in the capillary arterioles of the cerebral pia mater covering the posterior sigmoidal gyrus in domestic dog (Canis familiaris) were observed. The speed of blood flow was found increased to 185% after continuous digital acupressure for 20 minutes. The increase was most prominent 15 minutes after the acupressure was completed; the effect subsided in 30 minutes. It was also found that in cases of low basal speed of flow before digital acupressure, the increase in the speed of blood flow after acupressure was more pronounced. PMID- 2779278 TI - Effect of needling sensation reaching the site of disease on the results of acupuncture treatment of bronchial asthma. PMID- 2779279 TI - Effect of electro-acupuncture of "Neiguan" on spontaneous discharges of single unit in amygdaloid nucleus in rabbits. AB - In this paper, the regularity on spontaneous discharges of the single unit in amygdaloid nucleus (AMYG) in rabbits were analyzed and whether the signal of Electro-acupuncture (EA) at Neiguan (P 6) can reach the AMYG was further observed with the technique of glass microelectrode. It was found that the signals of EA at Neiguan can reach AMYG and activate or inhibit the electrical activity of some neurons, manifesting two response patterns: frequency-increasing and frequency decreasing. Additionally, the same neuron had a different response to the signals of EA at Neiguan and Zusanli (St 36), suggesting that a relative specificity of acupoints is present. PMID- 2779280 TI - Traditional Chinese treatment of chronic gastritis with gastric dysplasia--a clinical analysis of 70 cases. PMID- 2779281 TI - Treatment of acute gastric pain by needling acupoints Liangqiu and Weishu. PMID- 2779282 TI - An observation on the therapeutic effect of acupuncture in the treatment of sciatica. PMID- 2779283 TI - The therapeutic effect of mulberry in the treatment of constipation and insomnia in the elderly. PMID- 2779284 TI - A report of 2 cases of type B AIDS treated with acupuncture. PMID- 2779285 TI - Clinical application of the Tinggong point. PMID- 2779286 TI - PMA-responsive 5' flanking sequences of the human TNF gene. AB - In order to define functional domains involved in the control of TNF-gene transcription, 5'-flanking sequences of the TNF-gene were analysed by TNF promoter deletion mutants linked to the CAT-gene and by gel retardation assays. To this, three TNF-promoter fragments of different length were fused to the CAT reporter gene and transiently transfected into several human cell lines. We found that a 315 bp long fragment encompassing positions -285 bp to +30 bp with respect to the TNF mRNA cap site is sufficient to function as a PMA inducible promoter/enhancer in all cell lines tested. By further deletion analysis of this clone we could narrow the PMA-inducible element within a 185 bp long sequence ( 285 to -110 bp). In addition, we investigated specific interactions between nuclear proteins and TNF promoter sequences using gel-retardation assays. Besides several constitutive binding activities, we could demonstrate in several cell lines a nuclear protein that is induced by PMA and binds to the fragment of the TNF promoter containing the PMA-inducible element. PMID- 2779287 TI - Phenotypic and genotypic heterogeneity in infant acute leukemia. II. Acute nonlymphoblastic leukemia. AB - We have studied the immunophenotypic and genotypic characteristic of acute nonlymphoblastic leukemias (ANLL) in infants aged less than one year. Sixty-four percent of cases (16/25) showed a myeloid or myelomonocytic differentiation pattern and 10 of these were classified as FAB M5 (7 M5a, 3 M5b). Only seven of the latter cases expressed the CD14 antigen. Acute megakaryocytic leukemia with a high number of glycoprotein IIb/IIIa or IIIa positive blasts were identified in five patients. Erythroleukemia with a high percentage of rather mature glycophorin A positive erythroblasts were diagnosed in two infants. Cytogenetic studies were successfully performed in all 20 cases investigated. Abnormalities involving chromosome 11 were present in 10 of 17 patients with an abnormal karyotype including five cases with a t(9;11)(p21;q23). Immunoglobulin (Ig) and T cell receptor (TCR) gene analyses were performed in 20 patients. A rearrangement of Ig heavy chain sequences was detected in five cases (20%), one of whom exhibited multiple rearranged fragments. Three of these patients showed additional TCR delta-chain gene rearrangements, while Ig kappa, TCR beta- as well as TCR gamma-chain genes showed a germline configuration in all cases analyzed. Our study confirms the high incidence of myelomonocytic and monoblastic subtypes in infants with ANLL, which are particularly closely associated with chromosome 11 abnormalities. However, we also observed an unexpected high frequency of megakaryoblastic leukemias as well as erythroleukemias. As previously reported for ALL in infants, ANLL of infancy shows a similar heterogeneity regarding phenotypic and genotypic features. PMID- 2779289 TI - Acute nonlymphocytic leukemia with marrow eosinophilia and chromosome 16 abnormality: a report of 18 cases. AB - This article reports 18 cases of acute nonlymphocytic leukemia (ANLL) and abnormal chromosome 16. Thirteen had the same hematological pattern at diagnosis, i.e., peripheral blood hyperleukocytosis with high percentage of monocytes and blast cells, and bone marrow showing three different cell populations: (a) myeloblasts, (b) monocytes and promonocytes, and (c) abnormal eosinophils. In these cases the diagnosis was acute myelomonocytic leukemia with bone marrow eosinophilia, as described. However three other cases were of the M5 type and two others of the M2 type, all showing an abnormal eosinophilia in their bone marrow. All cases showed an abnormal chromosome 16 in the bone marrow cells: inv (16) in 13 cases, t (16;16) in two, del (16) in one of poor quality, and in two other translocations involving band 16q22. In one case the inv (16) was found in a subclone, indicating that it could be a secondary cytogenetic defect. Five patients died soon after diagnosis; the other 13 had a median complete remission duration of 8 months. The central nervous system was frequently involved upon relapse. We do not support the hypothesis that patients with M4-Eo ANLL and chromosome 16 abnormality have a favorable prognosis. PMID- 2779288 TI - Multiple sclerosis in mothers of children with acute lymphoblastic leukemia. AB - The Childrens Cancer Study Group used data from a self-administered questionnaire to compare the observed and expected frequencies of multiple sclerosis (MS) in the parents of 1,027 children with acute lymphoblastic leukemia (ALL), 2,053 parents of children with other cancers, and in parents of 838 children without cancer. There were significant excesses seen for mothers of children with ALL (relative risk, RR = 4.0, p = 0.02), but no excess was found for acute nonlymphoblastic leukemia or lymphoma. There was no increase risk of MS for the fathers of these children. PMID- 2779290 TI - Acute lymphoblastic leukemia with a hypodiploid karyotype with less than 40 chromosomes: the basis for division into two subgroups. AB - This paper describes seven patients with ALL and a hypodiploid karyotype with less than 40 chromosomes. A consideration of these and 15 previously published cases indicates that they may be divided into two groups depending on chromosome number, i.e., less than 30 and 30-39. The less than 30 group are younger and predominantly female when compared with the 30-39 group, who are generally older than 40 years and mainly male. In addition, the two groups show different characteristic patterns of chromosome loss. Morphologically, both groups have populations of large and small lymphoblasts containing numerous small vacuoles, and both have common ALL antigen phenotypes. We present the possibility that the ALL patients in the less than 30 group are an example of an age restricted leukemia. There is insufficient data to assess any prognostic differences between the two patient groupings. PMID- 2779291 TI - The physiological role of the endogenous colony forming units-spleen (CFU-S) inhibitor acetyl-N-Ser-Asp-Lys-Pro (AcSDKP). AB - The physiological role of the colony forming units-spleen (CFU-S) inhibitor Acetyl-N-Ser-Asp-Lys-Pro (AcSDKP) has been studied by observing the effects of AcSDKP deprivation. This deprivation was obtained by injecting polyclonal antiserum directed against AcSDKP into normal untreated mice in order to neutralize the endogenous inhibitor. The dramatic increase in the percentage of CFU-S in DNA synthesis as compared to controls receiving anti-KLH antiserum suggests that AcSDKP plays an important role in the maintenance of CFU-S in physiological quiescent state. PMID- 2779292 TI - Motor unit power spectrum and firing rate. AB - Changes in the power density spectrum of myoelectric signal with contraction level have been reported in the literature. These changes can be induced by a number of possible factors including recruitment of differing types of units, conduction velocity changes and firing rate changes. In the paper the single unit power spectrum is investigated and the effects of firing rate mean and variance changes evaluated. Motor unit signal simulation and experiments are carried out to verify predictions. The results show that spectrum peaks will shift with firing rate and the median frequency is weakly dependent on firing rate. PMID- 2779293 TI - Multielectrode intrafascicular and extraneural stimulation. AB - The relationship between nerve stimulation, pulse amplitude and isometric muscle force was measured to investigate recruitment of motor units. Force addition experiments were performed to obtain insight in the intersection of motor unit groups recruited by different electrodes. Intrafascicular and extraneural multielectrode configurations were used for nerve stimulation. Experiments were performed on rats. The common peroneal nerve was stimulated and the forces of the tibial anterior and extensor digitorum longus muscles were measured isometrically. Recruitment was more stable for intrafascicular electrodes than for extraneural electrodes. Especially for intrafascicular electrodes no strict inverse recruitment was observed. Force addition experiments indicated that small overlap of recruited motor unit groups occurred more often for intrafascicular than for extraneural electrodes. PMID- 2779294 TI - Effect of radial position on volume measurements using the conductance catheter. AB - A finite-difference computer model has been used to determine the potential distributions arising from a dipole current source aligned parallel to the axis of bounding cylinders. The radial position of this source had large and nonlinear influence on the potentials along the dipole axis. The accuracy of the computer simulation was established from comparison with an analytic solution of a simple geometry. Measurements using a conductance catheter in saline-filled cylinders also demonstrated the dependence of the conductance on the radial position. The dependence of the potential distribution on the radial position of the dipole places limits on the ultimate accuracy of the conductance catheter technique when used for the measurement of ventricular volume. Radial movement of the catheter within the ventricular cavity, resulting in changes in the potential distribution, could explain some artefacts that appear on volume recordings from the conductance catheter. PMID- 2779295 TI - Data compression applied to dynamic electrocardiography. AB - We have tested some techniques of ECG compression on the BIH/MIT Arrhythmias database. We have applied the following methods: (1) method of differences; (2) compression by prediction; (3) sample skipping methods; with the following kinds of errors: amplitude error, amplitude and delay error, area error. In the first and second method the average code length found after application of the Huffmann encoding has been found to be about 4 bits sample-1. For the third method the final compression ratio varies according to the allowed error; with a limited error threshold, however, we have reached an average compression a little lower than 1:5. PMID- 2779296 TI - Microcomputer-based system for 24-hour recording of oesophageal motility and pH profile with automated analysis. AB - A system developed for long-term simultaneous recording of oesophageal motility and pH in the ambulant patient is described. The system consists of a microprocessor based data-acquisition and preprocessing device, a personal computer for postprocessing, report generation and data storage, a miniature two sensor pressure catheter and a pH electrode. Identification and classification of oesophageal contractions are performed in separate steps, using online preprocessing software for identification and offline postprocessing software for categorisation, classification and report generation. Contractions are categorised as peristaltic, simultaneous or nontransmitte and classified according to their amplitude, duration and propagation velocity. The method described reduces the amount of data from 870 kbyte to approximately 40 kbyte per 24 hours in a multiparameter recording device, and offers the opportunity for offline postprocessing with different sets of criteria. The system has been found to be accurate and reliable in 24-hour studies in both healthy volunteers and patients with non-cardiac chest pain. PMID- 2779298 TI - Adaptive method for cancellation of respiratory artefact in electrogastric measurements. AB - Electrogastric measurements are useful for medical research and in clinical diagnosis. The measurements, however, contain very heavy respiratory artefact. Existing conventional frequency-domain filters cannot be used because of the possible overlap of the frequencies of the gastric signals and respiratory artefact. In the paper, the methods of measuring cutaneous and intraluminal gastric signals and reference respiratory signals are described. An adaptive cancellation technique is developed, which is simple and easy to implement for online processing. It is proved by experiments to be very efficient, i.e. the respiratory artefact can be completely cancelled, while the gastric signal component is not affected. Other possible applications in biomedical signal analysis are also discussed. PMID- 2779297 TI - Algorithm for data reduction and automatic analysis of intestinal motility tracings and other smooth biological signals. AB - An algorithm is presented for the processing of smooth biological signals with an important implicit data reduction. It is a solid basis for an automatic analysis of these signals. The algorithm is based on the approximation of the signals with a linear combination of cubic B-splines. Depending on the parameters, a data reduction of between 8:1 and 12:1 can be achieved. The most important differences from conventional biological signal processing methods are the representation of the signal by the coefficients of the linear combination instead of a series of samples and the analysis by calculations of the time of the appearance of patterns instead of iterative searching. The approximation and analysis of long lasting multichannel signals can be performed online with a modern microprocessor. Approximating the signal with a linear combination of cubic B splines with equally spaced knots, according to the linear least-squares criterion gives the desired data reduction and an elegant way to perform an automatic analysis. A window calculation scheme makes it possible to handle very long signals online. PMID- 2779299 TI - Noninvasive beat-to-beat detection of ventricular late potentials. AB - The detection of ventricular late potentials is a subject of some clinical interest. Most techniques currently being investigated rely on signal averaging to extract the microvolt signals from the considerable amounts of noise which are present. Although this approach produces useful results, it does remove any beat to-beat variations from the signal, and also requires that the signal be present for a considerable number of beats. The paper describes a technique for detecting ventricular late potentials from the body surface, which preserves beat-to-beat variations. The most important aspect of this technique is the use of an adaptive signal enhancer to minimise random noise. Representative results for one normal and two pathological subjects are presented and discussed. A comparison with signal averaging is made and the effectiveness of adaptive signal enhancement is illustrated. PMID- 2779300 TI - Application of mechanical mobility of periodontal tissues to tooth mobility examination. AB - Tooth mobility examination is important in planning dental treatment, as it may give an indication of alveolar bone loss and the condition of the periodontal ligament. In clinical dental diagnosis a manual tooth mobility examination is useful. However, its determination of tooth mobility is subjective and depends on the skill and experience of the clinician. The authors have previously reported on a device for measuring the biomechanical properties of human periodontium using an impedance head. Using this device, the mechanical mobility of periodontium can be measured and the mechanical parameters of the periodontal physical model are obtained. Tooth mobility is defined objectively on the basis of discriminant scores of mechanical parameters, and a mobility triangle (MT) figure is drawn as a record for visual interpretation. The paper describes the validation of the mechanical mobility measurements and their interpretation using mobility parameters and a personal computer to produce a mobility triangle figure. The method is compared favourably with clinical mobility measurement. The relationship of the model to underlying pathology is tested by measurements performed on various tooth model systems. PMID- 2779301 TI - Biofeedback gait training system for temporal and distance factors. AB - A biofeedback gait-training system has been developed which can deal with the gait problems of all subjects in any phase of rehabilitation: measurement, analysis, training and/or evaluation. The system is composed of a measuring walkway and a training walker. The walkway can measure all the temporal and distance factors of gait. The walker, with two parallel grasping bars and a CRT monitor, moves automatically with the aid of servo-motors. The system provides visual feedback for distance factors of gait and audio feedback for temporal factors. During the single-support phase the desired foot position for the next step and the supporting foot position are displayed on the CRT. The actual position of the foot placement is then overlaid for the double support duration that follows. A trainee learns to place the foot in such a way as to overlap the desired with the actual foot stamps on the CRT. The desired temporal factors are provided by buzzer tones. A trainee tries to shorten or elongate the duration of the respective phase of the gait cycle in accordance with the tone. Some experiments on normal subjects and on some with degenerative knee joints verified that the biofeedback signals were utilised effectively and that the walker was of value for improving pathological gait. PMID- 2779302 TI - Pulsating blood flow in an initially stressed, anisotropic elastic tube: linear approximation of pressure waves. AB - A mathematical model for pulsating flow of a viscous incompressible fluid in an initially stressed elastic tube with anisotropic structure is developed and an analysis of the propagation of pressure waves is presented. The theoretical model can be applied to the study of blood flow in arteries, and its solution leads to a dispersion equation relating wave number with frequency and the rheological parameters of the wall. Determination of fluid velocities and displacement components is obtained. PMID- 2779303 TI - Encapsulating microelectronic implants in one-part silicone rubbers. PMID- 2779304 TI - Low-cost system for automated acquisition, display and analysis of transmembrane ionic currents. PMID- 2779305 TI - [The same goals in England and the USA. Increased quality control and better information]. PMID- 2779306 TI - [Can amputations be prevented?]. PMID- 2779307 TI - [Treatment of malignant diseases--how should the new methods be tested?]. PMID- 2779308 TI - [HIV status: what is obvious and what is hypothetical?]. PMID- 2779309 TI - [Why is Swedish albumin not used?]. PMID- 2779310 TI - [Amalgam poisoning--the evidence has been tampered with]. PMID- 2779311 TI - [Information on antilipemic agents is reported correctly]. PMID- 2779312 TI - [Embryonic research and humanity]. PMID- 2779313 TI - [HIV infection among intravenous drug users in Sweden]. PMID- 2779314 TI - [The future and health--an examination of an organization test]. PMID- 2779315 TI - [Does modified LDL cholesterol trigger the atherosclerotic process?]. PMID- 2779316 TI - [The county of Malmohus: changing trends in the number of leg amputations among patients with diabetes]. PMID- 2779317 TI - [Implantable artificial sphincter as an aid for patients with severe incontinence]. PMID- 2779318 TI - [Various methods of evaluating patients with heart failure]. PMID- 2779319 TI - [10 years' of psychiatric reform in Italy: deinstitutionalization is in progress. There are big regional differences]. PMID- 2779320 TI - [Birth asphyxia and cerebral palsy]. PMID- 2779322 TI - [Spirochete infected ticks (Ixodes ricinus)--risks even in Norrland]. PMID- 2779321 TI - [Toxins and colitis]. PMID- 2779324 TI - [Nuclear cardiology--a continuously developing discipline]. PMID- 2779323 TI - [Non-invasive respiratory therapy at home increases patients' quality of life]. PMID- 2779325 TI - [Intestinal flora of newborn infants is easily disturbed by iatrogenic factors]. PMID- 2779326 TI - [A new model for geriatric psychiatric care makes rapid intervention possible--5 years' data]. PMID- 2779328 TI - [Clinical psychologists are needed in primary health care. They improve the overall view and prevent fragmentation]. PMID- 2779327 TI - [Developing school health services--experiences from England]. PMID- 2779329 TI - [Can the occurrence of sudden infant death be decreased?]. PMID- 2779330 TI - [Social class and total mortality--findings from Dalby are different from findings from Gothenburg]. PMID- 2779331 TI - [The hypothesis that copper in water is hazardous for health is insufficiently documented]. PMID- 2779332 TI - [More studies on strength training should be done]. PMID- 2779333 TI - [Research fraud mean serious problems for the scientific community in the USA]. PMID- 2779334 TI - [It is correct from the pharmaceutical point of view to use piperacillin in acute cholecystitis]. PMID- 2779335 TI - [Soap and water as good disinfectants of the skin in vaginal labor]. PMID- 2779336 TI - [Oral doxycycline in tick-borne Borrelia infection of the CNS]. PMID- 2779338 TI - [CMR-70--a new cancer-environment registry available for research]. PMID- 2779339 TI - [Serum cholesterol in primary health care--the pattern of orders and resource needs]. PMID- 2779337 TI - [Smoking during pregnancy: is the risk of intrauterine death and death during the first year of life increased?]. PMID- 2779340 TI - [Gastroesophageal reflux in children is an underdiagnosed condition]. PMID- 2779342 TI - [One year's experience with transesophageal echocardiography]. PMID- 2779341 TI - [The Minnesota model in Runnagarden--background factors and results]. PMID- 2779344 TI - [Can we trust clinical trials? Keep treating with control of sample tests]. PMID- 2779343 TI - [Is freedom of research threatened by insufficient quality control? Politicians intervene if the guardians of science fail]. PMID- 2779345 TI - [Reflections on 2 cases of scientific fraud. Give norms for good research. Guard scientific ethics]. PMID- 2779346 TI - [Society and HIV/AIDS: anxiety over transmission via insects still exists]. PMID- 2779347 TI - [A campaign in the mass media aimed to give advice on chest pain is effective among the population]. PMID- 2779348 TI - [An applicant abortion appeals: look at us, think about us and help us otherwise too]. PMID- 2779350 TI - [Registration of postoperative wound infections. A tool for self scrutiny]. PMID- 2779349 TI - [A combination of various risk factors is of significance in the treatment of hypercholesterolemia]. PMID- 2779351 TI - [Amalgam sickness in dental care personnel--a pilot study]. PMID- 2779352 TI - [New principles for treating vertebral injuries. Increased stability gives advantages]. PMID- 2779353 TI - [Theme H 70. Aging and health. New experiences from the Gothenburg study]. PMID- 2779354 TI - [Registration of postoperative wound infections--a method to prevent infections]. PMID- 2779355 TI - [Mercury poisoning in goldsmiths after working with dental gold]. PMID- 2779356 TI - Taste aversion involving central opioid antagonism is potentiated in morphine dependent rats. AB - A sensitive taste conditioning test was used to measure the aversive effect of a single intraventricular (i.c.v.) or subcutaneous (s.c) injection of an opioid antagonist that readily crosses the blood brain barrier (naltrexone), and one of two that do not (methylnaltrexone and diallylnormorphinium). This was done in drug-naive rats and in rats implanted 5 days earlier with a pellet containing 75 mg morphine. It was found that the morphine exposure had no significant effect on the dose-response curve of the taste aversion produced by s.c. methylnaltrexone and s.c. diallynormorphinium but reduced the lowest effective dose for the other antagonist treatments from three to more than 100 times. Consideration of the data, together with the pharmacokinetic properties of the drugs and the routes of administration used, supported a conclusion that only those aversions involving central antagonist activity show the potentiation effect of chronic morphine treatment. The findings were also discussed with regard to the location of receptors important for aversions produced by opioid antagonists in naive rats. PMID- 2779357 TI - Luteinizing hormone secretion following intracerebroventricular administration of morphine in the prepuberal gilt. AB - Antagonism of endogenous opioids with naloxone stimulates luteinizing hormone (LH) release in mature but not prepuberal gilts. The present report demonstrates that the opiate agonist morphine (500 micrograms), administered intracerebroventricularly (ICV), reduced LH secretion in both ovariectomized mature and prepuberal gilts. We suggest that opioid receptors are functionally coupled to the GnRH secretory system in prepuberal gilts even though endogenous opioid peptide modulation of LH secretion was not demonstrable in our previous studies. PMID- 2779358 TI - [125I](+/-)FISCH: a new CNS D-1 dopamine receptor imaging ligand. AB - Radiolabeling and in vitro and in vivo evaluation of an iodinated benzazepine: [125I] FISCH 7-Chloro-8-hydroxy-1-(4'-iodophenyl)-3-methyl-2,3,4,5- tetrahydro-1H 3-benzazepine, as a potential imaging agent for CNS D-1 dopamine receptors in animals, were investigated. After an iv injection, this benzazepine derivative showed good brain uptake in rats (2.70, 1.28, 0.48 %dose/whole brain at 2, 15 and 60 min, respectively). The striatum/cerebellum ratio was 2.50 at 60 min after the injection. The regional distribution in rat brain, as measured by ex vivo autoradiography, displayed highest uptake in the regions of the striatal complex and the substantia nigra, regions known to have a high concentration of D-1 dopamine receptors. Furthermore, this localized regional cerebral distribution was blocked by pretreatment with SCH-23390, a selective D-1 dopamine receptor antagonist. The in vitro binding affinity of this agent in rat striatum tissue preparation displayed a Kd of 1.43 +/- 0.15 nM. Competition data (in vitro) showed the following rank order of potency: SCH-23390 greater than (+/-)IBZP much greater than apomorphine greater than WB 4101 greater than ketanserin approximately spiperone. The preliminary data suggest that this analog of SCH 23390 shows similar selectivity for the CNS D-1 receptor. PMID- 2779360 TI - The organ distribution of liposome-encapsulated and free cobalt in rats. Liposomes decrease the cardiac uptake of the metal. AB - Rats were administered intravenously liposome-encapsulated or free cobalt, and the organ distribution of the metal was explored using Co57 tracer. Two hours after administration, the cobalt level in the heart was about 40% of the control when given in sphingomyelin (SM)/cholesterol (CH) (1:1 mole ratio) liposomes. These vesicles also tended to decrease the uptake of cobalt in the kidney and the carcass, and to increase it in the spleen and the bones. Liposomes prepared from soybean phosphatidylcholine (SPC)/CH (1:1) had no effect on the uptake of cobalt in the heart, whereas increased its level in the spleen, liver and lung. The time course of cobalt deposition in the organs displayed substantial variation with the different preparations. Most importantly, no buildup of cobalt level was observed in the heart when the metal was administered in SM/CH vesicles. While confirming known effects of liposomes on the organ-distribution of entrapped drugs, our findings suggest that administration of cobalt in SM/CH liposome encapsulated form may result in decreased cardiotoxicity and thus increased safety of cobalt-treatment in some anemias. PMID- 2779359 TI - Potent convulsant actions of the adenosine receptor antagonist, xanthine amine congener (XAC). AB - The convulsant properties of xanthine amine congener (XAC, 8-(4-(2-aminoethyl) aminocarboxylmethyloxy)phenyl-1,3-dipropylxant hine) are compared to those of caffeine. Male Swiss albino mice were infused with convulsants through a lateral tail vein. Convulsion thresholds (i.e. the amount of convulsants required to elicit convulsions) of 39.8 +/- 2.0 mg/kg (n = 10) and 109.8 +/- 2.3 mg/kg (n = 10) were calculated for XAC and caffeine respectively. Pretreatment of animals with the adenosine receptor agonists 2-chloroadenosine, N6-cyclohexyladenosine or 5'-N-ethylcarboxamido-adenosine (1 mg/kg, i.p., 20 minutes prior to infusion) significantly decreased the seizure threshold of both XAC and caffeine. The adenosine uptake blockers, 6-nitrobenzylthioinosine or dipyridamole (0.25 mg/kg, i.p., 20 minutes prior to infusion) did not significantly affect the seizure threshold to either XAC or caffeine. The benzodiazepine agonist diazepam (5 mg/kg, i.p., 20 minutes prior to infusion) significantly increased the seizure threshold to both XAC (p less than 0.05) and caffeine (p less than 0.01), whereas the benzodiazepine antagonist Ro 15-1788 (10 mg/kg, i.p., 20 minutes prior to infusion) significantly increased the seizure threshold to caffeine (p less than 0.01), but not XAC. The results suggest that actions at benzodiazepine receptors may be a tenable hypothesis to explain the convulsant actions of caffeine, but not those of XAC. PMID- 2779361 TI - Reversible hearing impairment related to quinine blood concentrations in guinea pigs. AB - The hearing ability was measured in anaesthetised guinea pigs by recording cochlear evoked potentials induced by standardised sound stimulation. The animals were given quinine intravenously and blood samples were withdrawn for assay of quinine. The shift in hearing threshold was closely related to the quinine blood concentration. The effect-concentration relationships were analysed according to the equation L = 10 (log k+a.log (s-b] which can be viewed as a special case of the Hill equation assuming that the stimulation (s) is of very low intensity compared to the stimulus at which half of the maximum response would be obtained and introducing an absolute limit for a stimulus at which no response is obtained. PMID- 2779362 TI - Effect of essential fatty acid depletion on tissue phospholipid fatty acids in spontaneously hypertensive and normotensive rats. AB - Weanling male spontaneously hypertensive (SHR) and normotensive (WKY) rats were maintained on a fat-free semisynthetic diet and killed at various intervals. The effects of fat-depletion on the appearance of essential fatty acid (EFA) deficiency symptoms, the progressive changes of major fatty acids in plasma, liver, heart, and kidney phospholipids (PL), and in skin total lipids were compared between these two strains. After five weeks on the diet, the slower growth and the appearance of EFA deficiency symptoms became evident in SHR. In general, fat-depletion reduced the levels of n-6 fatty acids, whereas it increased those of 20:3n-9. However, the fat-depletion induced reduction of 18:2n 6 in heart PL and 20:4n-6 in kidney, while the elevation of 20:3n-9 in plasma, heart, and kidney PL were greater in WKY than in SHR. As a result, the elevation of biochemical EFA deficiency index--20:3n-9/20:4n-6 ratio--was greater in WKY than in SHR. In comparison with WKY, the concentrations of liver triacylglycerols and the weights of adipose tissues in SHR were reduced to a greater extent, indicating an active catabolism of triacylglycerols in SHR. This study suggests that the earlier appearance of morphological symptoms of EFA deficiency in SHR was not associated with the reducing n-6 EFA levels or with an elevation of triene/tetraene ratio, but possibly to a reduced supply of n-6 EFA for skin prostaglandin synthesis. PMID- 2779364 TI - Age-related changes in the lipid compositions of rat and human tissues. AB - The levels of cholesterol, ubiquinone, dolichol, dolichyl-P, and total phospholipids in human lung, heart, spleen, liver, kidney, pancreas, and adrenal from individuals from one-day-old to 81 years of age were investigated and compared with the corresponding organs from 2 to 300 day-old rats. The amount of cholesterol in human tissues did not change significantly during aging, but the level of this lipid in the rat was moderately elevated in the organs of the oldest animals. In human pancreas and adrenal the ubiquinone content was highest at one year of age, whereas in other organs the corresponding peak value was at 20 years of age, and was followed by a continuous decrease upon further aging. A similar pattern was observed in the rats, with the highest concentration of ubiquinone being observed at 30 days of age. Dolichol levels in human tissues increase with aging, but they increase to very different extents. In the lungs this increase is seven-fold, and in the pancreas it is 150-fold. The elevation in the dolichol contents of rat tissues ranges from 20 to 30-fold in our material. In contrast, the levels of the phosphorylated derivative of dolichol increased to a more limited extent, i.e., 2 to 6-fold in human tissues and even less in the rat. These results demonstrate that the levels of a number of lipids in human and rat organs are modified in a characteristic manner during the life-span. This is in contrast to phospholipids, which constitute the bulk of the cellular lipid mass. PMID- 2779363 TI - Increased biliary calcium in cholesterol and pigment gallstone disease: the role of altered bile acid composition. AB - The present study was undertaken to define the relationship between calcium metabolism and bile acid composition in animal models of diet induced cholesterol and pigment gallstones. Groups of prairie dogs were fed either a control non lithogenic chow (N = 12), a 1.2% cholesterol enriched chow (N = 6, XOL) for two weeks, or a high carbohydrate diet deficient in iron (N = 6, CHO-FeD), or a high carbohydrate diet with normal iron levels (N = 6, CHO) for eight weeks. Hepatic (HB) and gallbladder (GB) bile samples were analyzed for total calcium, cholesterol, phospholipids, total bile acids (TBA), and individual bile acid composition. In each of the four groups, TBA concentrations were essentially similar and taurine conjugates accounted for approximately 90% of TBA in HB bile and about 98% in GB bile. In the control group, cholic acid (CA) was the predominant bile acid and comprised 76% of TBA and chenodeoxycholic (CDCA) accounted for about 13% of the total. Feeding a diet rich in cholesterol caused a significant change in the relative concentrations of individual bile acids of hepatic bile--such that CA decreased significantly (p less than 0.001) while CDCA increased by 300% (p less than 0.001). The changes in secondary bile acids were insignificant. An identical shift in individual bile acid composition was noted in animals maintained on high carbohydrate diet, irrespective of iron content. Similar changes were observed in the GB in the experimental groups.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2779365 TI - Effect of alpha-tocopherol on the volatile thermal decomposition products of methyl linoleate hydroperoxides. AB - alpha-Tocopherol and 1,4-cyclohexadiene were tested for their effect on the thermal decomposition of methyl linoleate hydroperoxide isomers. The volatiles generated by thermolysis in the injector port of a gas chromatograph at 180 degrees C were analyzed by capillary gas chromatography. In the presence of either alpha-tocopherol or 1,4-cyclohexadiene, which are effective donors of hydrogen by radical abstraction, volatile formation decreased in all tests, and significant shifts were observed in the relative distribution of products in certain hydroperoxide samples. When an isomeric mixture of methyl linoleate hydroperoxides (cis, trans, and trans,trans 9- and 13-hydroperoxides) was decomposed by heat, the presence of alpha-tocopherol and 1,4-cyclohexadiene caused the relative amounts of pentane and methyl octanoate to decrease and hexanal and methyl 19-oxononanoate to increase. A similar effect of alpha tocopherol was observed on the distribution of volatiles formed from a mixture of the trans,trans 9- and 13-hydroperoxides. This effect of alpha-tocopherol was, however, insignificant with pure cis,trans 13-hydroperoxide of methyl linoleate. The decrease in total volatiles with the hydrogen donor compounds, alpha tocopherol and 1,4-cyclohexadiene, indicates a suppression of homolytic beta scission of the hydroperoxides, resulting in a change in relative distribution of volatiles. The increase in hexanal and methyl 9-oxononanoate at the expense of pentane and methyl octanoate in the presence of hydrogen donor compounds supports the presence of a heat-catalyzed heterolytic cleavage (also known as Hock cleavage), which seems to mainly affect the trans,trans isomers of linoleate hydroperoxides. PMID- 2779366 TI - Trans fatty acids. 3. Fatty acid composition of the brain and other organs in the newborn piglet. AB - The effects of dietary trans fatty acids on tissue fatty acid composition were studied in newborn piglets delivered from sows fed partially hydrogenated fish oil (PHFO) (28% trans) or partially hydrogenated soybean oil (PHSBO) (36% trans) in comparison with lard (0% trans) from 3 wk of age and through gestation in Experiment 1, or fed PHFO or "fully" hydrogenated fish oil (HFO) (19% trans) in comparison with coconut oil (CF) (0% trans) with two levels, 1 and 2.7%, of dietary linoleic acid from conception through gestation in Experiment 2. The piglets were sampled immediately after delivery, without having access to mothers' milk. Incorporation of trans fatty acids into brain PE (phosphatidylethanolamine) were non-detectable or very low (less than 0.1%). The incorporation of 18:1 trans into heart-PE, liver mitochondria-PE, total plasma lipids and adipose tissue was low, and 20:1 trans was not detected. Dietary trans fatty acids had no consistent effects on the overall fatty acid composition of the different tissue lipids. It is concluded that trans fatty acids from PHFO, HFO and PHSBO have no significant effects on the fatty acid accretion in the fetal piglet. PMID- 2779367 TI - Novel branched-chain fatty acids in certain fish oils. AB - Methyl-branched fatty acids, which are usually minor components (equal or less than 0.1%) in fish oils, were concentrated in the non-urea-complexing fraction along with polyunsaturated fatty acids during the enrichment of omega-3 fatty acids from certain fish oils via the urea complexation process. The methyl branched fatty acids in the omega-3 polyunsaturated fatty acid concentrates, which were prepared from three fish body oils, were characterized by gas chromatography and gas chromatography/mass spectrometry. Among the major branched chain fatty acids expected and identified were the known isoprenoid acids--mainly 4,8,12-trimethyltridecanoic, pristanic, and phytanic--and the well-known iso and anteiso structures. Two novel phytol-derived multimethyl-branched fatty acids, 2,2,6,10,14-pentamethylpentadecanoic and 2,3,7,11,15-pentamethylhexadecanoic, were identified in redfish (Sebastes sp.) oil. These two fatty acids were absent in oils from menhaden (Brevoortia tyrannus) and Pacific salmon (mixed, but mostly from sockeye, Oncorhynchus nerka). The major branched-chain fatty acid in the salmon oil, 7-methyl-7-hexadecenoic acid, was also present to a moderate extent in menhaden oil. A novel vicinal dimethyl-branched fatty acid, 7,8-dimethyl-7 hexadecenoic was detected in all of the fish oils examined, but was most important in the salmon oil. Three monomethyl-branched fatty acids, 11 methyltetradecanoic acid, and 11- and 13-methylhexadecanoic, hitherto undescribed in fish lipids, were also detected in salmon, redfish and menhaden oils. PMID- 2779369 TI - HPLC method for quantitation of cholesterol and four of its major oxidation products in muscle and liver tissues. AB - A fast, sensitive, high performance liquid chromatographic method was developed for the quantitation of cholesterol and four of its major oxidation products: 3 beta-hydroxycholest-5-en-7-one (7-ketocholesterol), cholest-5-ene-3 beta, 7 alpha diol (7 alpha-hydroxycholesterol), cholest-5-ene-3 beta, 7 beta-diol (7 beta hydroxycholesterol), and cholest-5-ene-3 beta,25-diol (25-hydroxycholesterol). In this procedure 2:1 chloroform:methanol (v/v) extracts of tissue homogenate were combined, dried over anhydrous Na2SO4, filtered, evaporated to dryness under N2 and dissolved with a mobile phase of either 97:3 or 93:7 hexane:isopropanol (v/v). After membrane filtration and without further purification, aliquots were directly injected onto a 10-microns pore size, 30 X 0.39 cm mu-Porasil normal phase column. The separation of cholesterol and its oxidation products was monitored by a UV detector at 206 and 233 nm. This method was successfully applied to pork muscle as well as mouse liver tissues and was able to detect cholesterol oxidation products (COP) in the ppm range. The identity of the COP was confirmed by mass spectroscopy. PMID- 2779368 TI - The effect of dietary n-6 and n-3 polyunsaturated fatty acids on blood pressure and tissue fatty acid composition in spontaneously hypertensive rats. AB - Effects of dietary n-6 and n-3 fatty acids (FAs) on blood pressure (BP) and tissue phospholipid (PL) FA composition in spontaneously hypertensive (SHR) and normotensive Wistar-Kyoto (WKY) rats were compared. Male weanling SHR and WKY were fed a fat-free semisynthetic diet supplemented with 10% (w/w) fats containing (a) 78% 18:2n-6 (LA-rich), (b) 20% LA and 55% 18:3n-3 (LN-rich), or (c) 11% LA and 3% LN (CON) for seven weeks. Dietary fats did not affect the BP elevation, but significantly altered the FA composition of brain, adrenal gland, renal medulla and cortex PL in SHR. The LA-rich diet increased n-6 FA while it reduced n-3 FA levels. The levels of 20:4n-6 were not significantly different between animals fed the LA-rich and the CON diets. LN-rich diet increased the levels of n-3 FAs, while it reduced those of n-6 FAs. However, the extent of change was significantly less in SHR than in WKY. In all dietary groups, SHR, as compared to WKY, had a relatively higher level of the 2 series prostaglandin (PG) precursor, 20:4n-6, and a relatively lower level of the 1 and 3 series PG precursors, 20:3n-6 and 20:5n-3. The possibility that the unbalanced eicosanoid FA precursor levels might contribute to the development of hypertension in this animal model is discussed. PMID- 2779370 TI - HPLC analysis of desmosterol, 7-dehydrocholesterol, and cholesterol. AB - A simple and sensitive method to analyze mixtures of desmosterol, 7 dehydrocholesterol and cholesterol is described. The method involves the oxidative conversion of the sterols with cholesterol oxidase, followed by high performance liquid chromatographic (HPLC) analysis. A C18 reversed phase column (3 microns, 75 X 4.6 mm) and a mixture of methanol and acetonitrile (1:1, v/v) at a rate of 1 ml/min are used to separate the sterols. The eluted sterols are quantified by measuring UV absorption at 240 nm. As little as 10 pmoles of sterol can be quantified under these conditions. PMID- 2779371 TI - A modification of the thiobarbituric acid reaction. AB - A simple modification of the thiobarbituric acid reaction, which removes nonspecific chromogenic reaction products, involves incubation at room temperature for 16-20 hr and a column chromatographic step. The chromogen concentrating capacity of the latter step is useful for determination of low concentrations of thiobarbituric acid-reactive materials in biological preparations. PMID- 2779372 TI - Antioxidant activity of beta-carotene-related carotenoids in solution. AB - The effect of the antioxidant activity of beta-carotene and related carotenoids on the free radical-oxidation of methyl linoleate in solution was examined by measuring the production of methyl linoleate hydroperoxides. Canthaxanthin and astaxanthin which possess oxo groups at the 4 and 4'-positions in the beta-ionone ring retarded the hydroperoxide formation more efficiently than beta-carotene and zeaxanthin which possess no oxo groups. The rates of autocatalytic oxidation of canthaxanthin and astaxanthin were also slower than those of beta-carotene and zeaxanthin. These results suggest that canthaxanthin and astaxanthin are more effective antioxidants than beta-carotene by stabilizing the trapped radicals. PMID- 2779373 TI - Identification of cholesta-7,24-dien-3 beta-ol and desmosterol in hamster cauda epididymal spermatozoa. AB - The sterol composition of hamster cauda epididymal spermatozoa was remarkably different from that of several other mammalian spermatozoa. Desmosterol and cholesta-7,24-dien-3 beta-ol account for as much as 90% of the total sterols. Cholesterol and desmosterol are the major components of mouse cauda epididymal spermatozoa, and rabbit, boar and bull ejaculated spermatozoa. Cholesta-7,24-dien 3 beta-ol was not detected. Furthermore, cholesterol was the main sterol in hamster caput epididymal spermatozoa, while only a trace amount of desmosterol was detected and cholesta-7,24-dien-3 beta-ol was hardly detected at all. The sterol content of cauda and caput epididymal spermatozoa was 0.17 +/- 0.05 mumol/10(8) spermatozoa. During maturation, the desmosterol and cholesta-7,24 dien-3 beta-ol levels increase and the cholesterol level decreases. Cholesta-7,24 dien-3 beta-ol appears as a sterol in mature spermatozoa and seems to be a characteristic sterol of hamster cauda epididymal spermatozoa. PMID- 2779374 TI - On the isolation of the new fatty acid 6,11-eicosadienoic (20:2) and related 6,11 dienoic acids from the sponge Euryspongia rosea. AB - The phospholipid fatty acids from the sponge Euryspongia rosea were studied revealing the presence of the new 6,11-eicosadienoic (20:2) acid and the rare 6,11-octadecadienoic acid (18:2). The isolation of these 6,11-dienoic acids reveals the presence of new biosynthetic possibilities in sponges and suggests the presence of an active delta 6 desaturase in E. rosea. Other acids isolated from E. rosea include 12-eicosenoic (20:1) and 17-tetracosenoic acid (24:1). The major phospholipids encountered in the sponge were phosphatidylethanolamine (PE), phosphatidylserine (PS), and phosphatidylcholine (PC). PMID- 2779376 TI - Product liability and the biomedical scientist. PMID- 2779377 TI - Clinical chemistry outside laboratories: report of a second survey. AB - The growth in the use of small portable analysers outside hospital laboratories has been a cause of concern to laboratory practitioners. This has been partly because of a perceived threat to laboratory careers and partly because of fears that the quality of testing would be poor, with a consequent danger of patients being placed at risk. The evidence in this paper indicates that the use of equipment outside laboratories is still increasing in many areas. Despite the fears which have been expressed, little attention is being given to operator training, service costs, safety and many other aspects; only rarely has responsibility for the quality of results been accepted. PMID- 2779375 TI - Interaction of potentially toxic bile acids with human plasma proteins: binding of lithocholic (3 alpha-hydroxy-5 beta-cholan-24-oic) acid to lipoproteins and albumin. AB - The binding of lithocholic acid to different plasma fractions was studied. When whole plasma was incubated for 8 hr, approximately 25% of the incubated [14C]lithocholic acid was bound to the lipoprotein and lipoprotein-free, albumin rich fractions. An average of 87.6% of the bound-lithocholic acid was present in the lipoprotein-free, albumin-rich fraction, 7.2% in high density lipoproteins, 2.2% in low density lipoproteins, 1.0% in intermediate density lipoproteins and 2.0% in very low density lipoproteins. Expressed as binding per microgram protein, considerably less [14C]lithocholic acid was bound to the lipoprotein free, albumin-rich fraction, than to the lipoproteins. The binding of [14C]lithocholic acid after the incubation of the isolated plasma fractions was similar to that found after the incubation of whole plasma. The highest transfer of [14C]lithocholic acid occurred from the lipoprotein-free, albumin-rich fraction to the lipoprotein fractions. The studies indicate, that, although the largest amount of lithocholic acid is bound to the lipoprotein-free, albumin-rich fraction, per microgram protein, the binding of lithocholic acid to lipoproteins is more pronounced and stable than that bound to the lipoprotein-free, albumin rich fraction. Since lipoproteins, in contrast to albumin, are internalized by most tissues, they may be important carriers into cells of lithocholic acid and other potentially toxic or tumorigenic bile acids. PMID- 2779378 TI - Methicillin resistance in staphylococci: an evaluation of conditions for detection. AB - Ninety-four strains of coagulase positive staphylococci and 73 strains of coagulase negative staphylococci were tested for their susceptibility to methicillin, using agar dilution and disc diffusion techniques with Diagnostic Sensitivity Test agar (DST) and DST supplemented with salt, incubated at 30 degrees C and 37 degrees C. Disc diffusion on salt-incorporated DST at 30 degrees C was most reliable for detecting methicillin resistance in both types of staphylococci. The agar dilution methods were particularly poor for detecting resistance with coagulase negative staphylococci. The simultaneous testing of coagulase positive and negative staphylococci by this method indicated the need for both DST and salt-incorporated DST agar plates, incubated at 30 degrees C. However, sensitive strains should still be tested by disc diffusion for confirmation. PMID- 2779379 TI - Automated haematology: construction of univariate reference ranges for blood cell count and size. AB - The theory of reference ranges advocated by the International Committee for Standardization in Haematology (ICSH) was tested experimentally for an aperture impedance and a flow cytometric system. The reference sample was drawn from volunteer blood donors and the sampling procedure carefully standardised. Subjects were partitioned for gender and smoking habits, and their ages noted. Reference ranges were constructed from Gaussian statistics, after objective evaluation of the data, based on an assumed occurrence of one false positive measurement in every twenty samples. Different reference ranges were obtained on the two different systems for some haematological parameters, and partitioning also produced differences in calculated reference ranges. We conclude that strict adherence to the ICSH recommendations is almost impossible. Nevertheless, it is important that all laboratories should construct their own local reference ranges for their specific analytical systems before cost effective clinical decisions can be made. PMID- 2779380 TI - The influence of sialic acid on the ESR. AB - To investigate whether changes in sialic acid levels contribute to the detrimental effect of storage on the ESR, cellular and plasma sialic acid levels were measured before and after storage and compared to the ESR. Overnight storage significantly decreased the mean control group ESR, while lower post-storage ESRs were observed for the randomly-selected patient group. Neuraminidase treatment of whole blood to decrease sialic acid content significantly increased the ESR. Approximately half of stored EDTA samples showed decreased ESRs with increased plasma sialic acid, while two-thirds with artificially increased plasma sialic acid showed a decreased ESR. Overnight storage at 5 degrees C did not affect red cell sialic acid, but significantly reduced that of platelets and leucocytes, and may therefore contribute to the significantly raised plasma sialic acid levels observed after storage. Storage also significantly increased total plasma protein levels in both control and patient groups. It is concluded that sialic acid contributes to the ESR, and that plasma sialic acid levels influence the effect of storage on the ESR. PMID- 2779381 TI - Protocol for the evaluation of automated blood coagulation instruments (coagulometers) for determination of the international normalised ratio. AB - Results of prothrombin time tests for the control of oral anticoagulant therapy, when using automated blood coagulation instruments (coagulometers), may not be the same as those obtained when using manual methods, and variation in coagulometer performance may affect clinical interpretation of data. The haematology advisory committee of the Institute of Medical Laboratory Sciences has recommended that coagulometers should be used for determination of prothrombin times only if it can be demonstrated that the results are valid when compared with those of a standardised manual method. A protocol for the evaluation of coagulometers, and details of the procedures, are given in this report, the main emphasis of which is on the assessment of instruments for determination of the International Normalised Ratio. Guidelines are also provided for the general use of machines of this type and for the assessment of safety. The principles of the protocol are applicable to other automated tests of blood coagulation. PMID- 2779382 TI - An enzyme-linked immunosorbent assay for measurement of protein S. AB - Protein S is an important component of the haemostatic balance mechanism, and deficiency of this protein predisposes to thrombotic risk. We describe an inexpensive and reliable enzyme-linked immunosorbent assay for measurement of protein S, which is suitable for use in routine hospital laboratories. PMID- 2779383 TI - An enzyme immunoassay for isotyping mouse monoclonal antibodies. AB - A rapid, simply performed and relatively inexpensive enzyme immunoassay for isotyping mouse monoclonal antibodies is described, based on the urease/urea system. Because of the high sensitivity (less than 0.1 microgram/ml of immunoglobulin can be detected in cell culture medium) no treatment of the hybridoma supernatant sample is required prior to assay, and the isotype of a mouse immunoglobulin can be determined in about thirty minutes. PMID- 2779384 TI - Anti-HBs screening tests: a method of cost saving. AB - In order to reduce the cost of anti-HBs testing, a simple ELISA method has been developed by re-cycling microtitre wells used for detection of hepatitis B surface antigen. PMID- 2779385 TI - Product liability in the medical laboratory. AB - Under recent product liability legislation patients who suffer damage from any treatment materials administered to them will not have to prove negligence in order to claim compensation for any injury suffered. Optimum quality assurance and detailed documentation will be necessary for defence against litigation by a patient. Transfusion medicine is the main area of laboratory practice where litigation can be expected, but implications for other medical laboratories are referred to. PMID- 2779386 TI - Buffered phenol formaldehyde (pH 7.0 and pH 5.5): improved fixation in an enclosed tissue processor. AB - The addition of 2% phenol has a marked adjuvant effect on 4% formaldehyde as a fixative. Sequential use of phenol formaldehyde buffered to pH 7.0 and pH 5.5 results in improved fixation in material rapidly advanced to paraffin in an enclosed tissue processor. Sections stained with alum haematoxylin and eosin show improved nuclear and cytoplasmic detail, reduced tissue shrinkage and an absence of formalin pigment. Excellent results are obtained with conventional special stains and immunoperoxidase methods. PMID- 2779387 TI - Long-term intra-individual variation of platelet parameters. AB - Mean platelet volume, platelet count and platelet distribution width were determined in eight male subjects at monthly intervals over a 4-6 month period. Measurements were made on a Coulter S Plus VTM exactly 15 min and 2 h after blood collection. Long-term intra-individual variability for mean platelet volume showed a mean coefficient of variation (CV) of 1.60% at 15 min and 2.01% at 2 h after blood collection; for platelet count a mean CV of 3.18% at 15 min and 2.40% at 2 h; and for platelet distribution width a mean CV of 7.3% at 15 min and 6.5% at 2 h. Platelet parameters are stable over time in the normal male individual. PMID- 2779388 TI - Platelet number and size in relation to serum orosomucoid concentration in Crohn's disease. AB - The relationship between platelet size and platelet count was investigated in 41 patients with Crohn's disease. A high platelet count was associated with a decrease in platelet size, but an overall increase in the platelet crit. There was also a significant correlation between the patient's platelet count and serum orosomucoids, which have traditionally been used to assess disease activity. PMID- 2779389 TI - Polyethylene glycol in the production of blood grouping reagents: some further advantages. AB - The use of various water-soluble non-ionic polymers, including polyethylene glycol (PEG) 8000, has been described in the preparation of diagnostic blood grouping reagents. The major advantages of using PEG in this way are ease of preparation and the ability to concentrate antibodies. We describe here two previously unreported advantages of using PEG: (i) substantial reductions in the volume of red cells required for adsorption of isoagglutinins; and (ii) the ability to store PEG precipitates in a 'dry' form substantially reduces storage requirements. PMID- 2779390 TI - Bleach and LISS: a potential hazard. AB - Investigation into the corrosion of a copper alloy inlet port of a vacuum aspirator revealed an exothermic reaction between copper, glycine--the primary constituent of low-ionic-strength-saline (LISS)--and the widely used disinfectant sodium hypochlorite (common bleach). The apparatus had been used for several years to aspirate LISS-wash supernatants during the preparation of LISS-suspended red cells for antibody detection tests. A small blue-rimmed hole had formed through the side of the inlet port of the equipment, which had been rinsed with bleach during periodic cleansing. Our observations indicate a need for caution when using bleach to decontaminate waste or spills containing glycine. Contact of such materials with base metal parts of laboratory apparatus should be avoided, especially when copper is involved. PMID- 2779391 TI - Rapid transfer of small volumes of serum into microplates. AB - A method has been devised to transfer small volumes of serum, as an adjunct to larger volume sampling, into microplates. The Costar Transplate 96 machine is used routinely in our laboratory for transferring serum samples into reaction wells for anti-HIV screening. Using this additional method a mean of 4 microliters of serum was transferred, within acceptable limits of error (coefficient of variation, c.v., 16%). PMID- 2779392 TI - Health care for the elderly: moral dilemmas, mortal choices. PMID- 2779393 TI - Effects of the recent NLRB ruling about appropriate health-care bargaining units for registered nurses. PMID- 2779394 TI - Remembrance, thanks, and welcome. PMID- 2779395 TI - A name is not enough. AB - The body of medical knowledge is so vast, and finding a fact within it is often so difficult and frustrating, that various systems have been proposed to help. reviewing the various approaches reveals some of the difficulties of the retrieval task and why it has not been easy to devise a general approach. The imprecision of medical terminology is a major stumbling block. The development of specialized systems to serve particular medical interests has hampered the wider applicability of many such systems. This article offers eight characteristics for an ideal medical knowledge system. The key is for each medical term to be coded and independently defined, with synonymous terms to be equated through term codes. Any coded term could become the nucleus of a cluster of related, coded terms. The knowledge system would encompass all of medicine, would be in the public domain, and would be independent of hardware and software. While such a system is utopian, consideration of its characteristics can further the development of better interim systems. PMID- 2779396 TI - Abbreviated burn severity index. PMID- 2779397 TI - [Personality characteristics of alcoholic subjects using the Minnesota Multiphasic Personality Inventory (MMPI)]. AB - The results obtained in an investigation carried out on male alcoholics who had not drunk for three years are presented and evaluated. The research was carried out on a sample of 200 subjects aged between 30 and 50, average schooling, belonging to AA groups. The purposes of the study were to identify the psychopathological features of the sample in relation to the neurotic and psychotic aspects of the personality. A comparison was subsequently made with a similar female sample selected from a previous research. An abbreviated form of the MMPI test was used in the clinical part. PMID- 2779398 TI - [Evaluation of the sexual role in a group of alcoholics]. AB - The sexual role, evaluated by administration of the Bem Sex Role Inventory in 33 alcoholics, proved significantly different from that seen in a typical Italian sample and that presented by subjects suffering from other organic pathology. No significant differences were observed in psychic symptomatology between alcoholics with sexual role of androginous type with respect to the non androginous. PMID- 2779399 TI - [Biopsychosocial profile of rural and metropolitan suicide in the Turin area]. AB - The differences and similarities between urban and rural suicides in the province of Turin were examined. The study covered the 899 suicides recognised as such by the judicial authorities in the city and province of Turin in 1977-1981. Subsequently certain parameters were related to the geographical location of the suicide. With some significant exceptions a certain uniformity was identified in the urban and rural approaches to suicide in the Turin area. PMID- 2779400 TI - [Intellectual efficiency and drug addiction]. AB - The intellectual efficiency of a group of drug addicts and a group of neurotic and senile subjects was tested against the Wechsler-Bellevue Intelligence Scale. Alongside an anxiety-related reduction in the efficiency of certain functions and a reduction in the ability to concentrate, the addicts evidenced a reduction in efficiency in the organisation of tasks and prediction of results related to depression of disharmony in the interaction of the various functions. PMID- 2779401 TI - [Naltrexone and prevention of opiate dependence relapse. An Italian experience]. AB - A group of 93 patients consecutively treated for Opiate Dependence (DSM) III) was examined and the relationship between detoxification outcome and treatment with an opiate antagonist (naltrexone), sociodemographic characteristics and clinical features was studied. The treatment with naltrexone followed detoxification in 46 cases (50%). Average retention is 16.7 weeks, much longer than reported in the literature. This outcome is ascribed to: 1) better social adjustment of the population considered, in terms of employment, relatives' involvement in the treatment and Opiate Dependence in partners; 2) introduction of naltrexone in a multimodal program, including psychological and social support. PMID- 2779402 TI - [Balint groups. Investigations on the significance of 2 methodologic variants]. AB - The paper describes how the Balint method may be used in a variety of contexts and for different purposes. The analysis of two experiments, one in Ascona (an intensive seminar) and one in Turin (permanent training courses) revealed certain characteristic aspects of both, in which the same traditional Balint technique was always used. The data emerging from the various aspects covered, from forms of group participation to structuring, from aims to assessment made it possible to examine the two experiences as models for the application of the method. And it was found that despite their different contexts both experiences provided the psychological training that is, in fact, training in interpersonal relationships. PMID- 2779403 TI - What is science? PMID- 2779404 TI - A biomechanical analysis of the sticking region in the bench press. AB - The performance of ten elite powerlifters were analyzed in a simulated competition environment using three-dimensional cinematography and surface electromyography while bench pressing approximately 80% of maximum, a maximal load, and an unsuccessful supramaximal attempt. The resultant moment arm (from the sagittal and transverse planes) of the weight about the shoulder axis decreased throughout the upward movement of the bar. The resultant moment arm of the weight about the elbow axis decreased throughout the initial portion of the ascent of the bar, recording a minimum value during the sticking region, and subsequently increased throughout the remainder of the ascent of the bar. The electromyograms produced by the prime mover muscles (sternal portion of pectoralis major, anterior deltoid, long head of triceps brachii) achieved maximal activation at the commencement of the ascent phase of the lift and maintained this level essentially unchanged throughout the upward movement of the bar. The sticking region, therefore, did not appear to be caused by an increase in the moment arm of the weight about the shoulder or elbow joints or by a minimization of muscular activity during this region. A possible mechanism which envisages the sticking region as a force-reduced transition phase between a strain energy-assisted acceleration phase and a mechanically advantageous maximum strength region is postulated. PMID- 2779406 TI - Nominal resistive power loads of cycle ergometers. PMID- 2779405 TI - A comparison of methods used to determine VO2 of exercising humans and animals. AB - The purpose of these experiments was to compare two systems for measuring oxygen uptake (VO2): the open circuit method of indirect calorimetry (Rv), which is commonly used in human studies, and the open flow method, which has been adopted in a variety of animal studies. VO2 measured using the Rv system (procedure 1) was accepted as the criterion value. Two procedures were used to calculate VO2 in the open flow system: MCO2 (where O2 and CO2 were measured in mixed expired gas) and MO2 (O2 measured only). VO2 was measured in ten human subjects during three continuous incremental cycling tests to peak power output administered on three separate occasions--once using each of the three procedures. The results indicated a relatively small difference in VO2 between the Rv and MCO2 procedures (6.2 +/- 4.5%) and between the Rv and MO2 procedures (3.7 +/- 1.7%), across a broad range of power outputs (40-100% VO2 peak). The difference between the Rv and MCO2 procedures decreased as power output increased, while that between the Rv and MO2 procedures remained relatively constant. Therefore, the open flow method is shown to be a valid and reproducible technique for assessment of the metabolic activity of humans and animals. PMID- 2779407 TI - Computing material-selective projection images in MR. AB - We detail a robust, general method for computing projection images of individual materials in a volume as linear combinations of MR projection images with different material-dependent weightings. Signal per unit volume for each material in each raw image is acquired directly for accurate cancellation of undesired, overlapping materials. The weighted sum of the input images is determined to maximize the signal-to-noise ratio (SNR) and minimize inhomogeneity effects in the material-selective images. We tested the implementation experimentally in both phantom and human studies, producing selective images with reasonable SNRs and material isolation. With further development of sequences to rapidly acquire input images having greater material differentiability, we envision the application of the selective projection imaging format to screening studies searching over large volumes for diseased tissues. PMID- 2779408 TI - Androgen sensitivity of rat prostate carcinoma studied by 31P NMR spectroscopy, 1H MR imaging, and 23Na MR imaging. AB - 31P NMR spectroscopy, 1H magnetic resonance (MR) imaging, and 23Na MR imaging were used to study the biochemical difference between nine hormone-sensitive and six hormone-resistant rat prostate cancers and to follow bioenergetic and morphologic changes subsequent to androgen deprivation in the hormone-sensitive model. Neither 1H nor 23Na MR image characteristics were useful in distinguishing androgen-sensitive from androgen-resistant prostate cancer nor in identifying androgen deprivation. 31P NMR spectroscopy did detect bioenergetic differences between the hormone-sensitive and hormone-resistant tumors. Baseline spectra showed a significantly higher PCr/ATP ratio (mean 0.86 +/- 0.09 SEM) for hormone sensitive tumors than for hormone-resistant tumors (mean 0.26 +/- 0.07 SEM). By 3 days after androgen deprivation (orchiectomy (castration], PCr/ATP ratios had decreased noticeably; by 1 week, the decrease was statistically significant and remained so for the rest of the study (3 weeks). It appears that 31P NMR spectroscopy is useful in detecting androgen sensitivity of prostatic carcinoma. PMID- 2779409 TI - Magnetic resonance imaging of estrogen-induced pituitary hypertrophy in rats. AB - Estrogen-induced pituitary hypertrophy has been studied using magnetic resonance imaging in a group of 15 control and 30 experimental rats. Following the subcutaneous implantation of an estrogen pellet, differences in the anatomical appearance of the pituitary gland of the implanted rats can be detected in as little as 16 days, when compared to the control animals. The gland in the experimental animals appears diffusely enlarged with rounded margins, when viewed in sagittal T1-weighted magnetic resonance images. Additionally, a uniform signal intensity is not detected in the hypertrophic pituitary glands of estrogen implanted rats, while in the control rats this is a common finding. A satellite study of 300 animals (treated in a manner identical to that in the imaging study) demonstrates that the weights of excised pituitaries in estrogen-treated rats increases to a statistically significant level in the interval 18 to 35 days. Changes in the appearance and volume of the pituitary gland observed with magnetic resonance imaging seem to have promise for the early detection of pituitary lesions in rats. PMID- 2779410 TI - The effect of gadolinium DTPA on tissue water compartments in slow- and fast twitch rabbit muscles. AB - Proton T2 relaxation and its biexponential components have been determined in rabbit skeletal muscle in the presence and absence of GdDTPA. The effect of GdDTPA, which distributes only in the extracellular space, was greatest in the longer-relaxing T2 component (T22). A 27% reduction in T22 was measured for slow twitch (red) muscle and 17% for fast-twitch (white) muscle, consistent with the larger extracellular space of the former. Magnetic resonance images demonstrated apparent contrast between red and white rabbit muscles. This contrast was instantaneously enhanced by administration of GdDTPA and returned to near normal levels after approximately 30 min. These functional changes in tissue contrast are consistent with differences in blood perfusion and biological water compartmentation between fast- and slow-twitch skeletal muscles. PMID- 2779411 TI - Relaxation measurements at 300 MHz using MR microscopy. AB - Previous data on changes in tissue T1 with field have suggested the convergence of tissue T1 values toward a common value at high (greater than 4.0 T) fields. Measures of T2 dependence have suggested reduction of T2 with field. The purpose of this study was to observe the T1 and T2 at 85.5 and 300 MHz of microstructures in excised rat kidneys by employing MR microscopy. This study represents the first attempt of MR microscopy at 7.0 T with regard to the subject of magnetic field dependence of T1 and T2. As expected, T1 did increase with increasing field strength but not as dramatically as might be expected. Subtle differences in the microstructures of the kidney and the binding of water in those structures were discernible on the basis of T1 differences at 300 MHz. T2 values decreased, raising speculation concerning the mechanism for this dependence. The improved SNR permits smaller samples to be examined at much higher resolutions (greater than 30 X 30 X 200 microns), further extending the potentials for MR microscopy. PMID- 2779412 TI - 1H NMR studies of urine from premature and sick babies. AB - High-frequency proton nuclear magnetic resonance (1H NMR) has been applied to a study of urine from premature and sick newborn babies with a variety of clinical disorders. These included severe birth asphyxia, necrotizing enterocolitis, ketosis, and drug treatment. Abnormal levels of metabolites such as lactate, ketone bodies, betaine, dicarboxylic acids, and 4-hydroxyphenolic acids were detected, as was the antibiotic metronidazole and one of its metabolites. The assignment of betaine was confirmed by two-dimensional 1H NMR studies of urine obtained from two adults with homocystinuria receiving treatment with oral betaine. High-resolution 1H NMR spectroscopy of urine is a potentially useful research technique for monitoring metabolism during early life. PMID- 2779413 TI - High-resolution NMR imaging of an antigen-induced arthritis in the rabbit knee. AB - High-resolution, serial, spin-echo images were obtained for an antigen-induced knee arthritis in six rabbits. The animals were imaged prior to intra-articular challenge and at various time points up to 14 weeks after challenge. Extensive high-signal inflammatory changes were seen at Day 1 in the lymph node, capsule, and surrounding muscle. The muscle and lymph node response decreased rapidly after the first week. The capsule high-signal area reached a maximum at Day 10, but was still extensive at Day 39. The infrapatellar fat pad was replaced more slowly by high signal and the appearance of high signal in both the tibia and femur was a late change. Terminal histological examination showed that the capsule and fat pad high-signal areas corresponded to fibrous and synovial proliferation. The bone changes were a result of edema and cyst formation. The separation of the various time courses of the inflammatory changes may be of value in understanding the model and evaluating potential anti-arthritic drugs. PMID- 2779414 TI - A liposomal MRI contrast agent: phosphatidylethanolamine-DTPA. AB - The chelating agent, diethylenetriaminepentaacetic acid (DTPA), was attached via one -COOH group to the amino headgroup of phosphatidylethanolamine to produce a phospholipid which is also a powerful chelating agent. It readily assembles into the walls of lipid bilayer structures as a liposome-associated carrier of cations for MR contrast or radioisotope studies. Freeze-etch electron microscopy showed that phosphatidylethanolamine-DTPA formed satisfactory sonicated vesicles when mixed with natural phospholipids at up to 50 wt%. The resultant structures with bound gadolinium effectively shortened T1 and T2 of surrounding water protons. When sonicated liposomes bearing chelating agent with bound 111In3+ were injected intravenously into rats, uptake was primarily by liver and spleen. By 24 h postinjection there was biliary excretion of this material. Phosphatidylethanolamine-DTPA may have some general utility as an amphiphilic liposomal chelating agent for polyvalent cations. PMID- 2779415 TI - Low-frequency restoration. AB - In magnetic resonance imaging, if the object of interest is known to be spatially bounded within the image field-of-view, then the high-intensity, low spatial frequencies can be determined by postprocessing. This allows the system receiver gain to be increased, thereby decreasing the quantitation noise from the analog to-digital converters. No imaging sequence modifications are required. PMID- 2779416 TI - In vivo 31P nuclear magnetic resonance spectroscopy of rat 9L gliosarcoma treated with BCNU: dose response of spectral changes. AB - The 9L gliosarcoma, grown subcutaneously in juvenile Fischer 344 rats, was studied by in vivo 31P NMR spectroscopy following treatment with 1,3-bis(2 chloroethyl)-1-nitrosourea. Dose-dependent increases in the proportion of high energy phosphates were observed for doses between 10 and 36 mg/kg (from 80% of the LD10 to greater than the LD50). These doses reduced clonogenic cell survival in a dose-dependent fashion by as much as 3 log orders and resulted in up to 16 days of growth delay (to pretreatment tumor volume). Increases in high-energy phosphates (relative to Pi) in the tumor were greater at higher doses despite the higher levels of clonogenic cell killing and the substantial host systemic toxicity. PMID- 2779417 TI - Toxicity of dysprosium shift reagents in the isolated perfused rat kidney. AB - Sodium and water spectra were acquired from the isolated perfused rat kidney by using a double-tuned probe designed to have high X nucleus sensitivity and low 1H sensitivity. Both DyTTHA and DyPPP were used to distinguish intra and extracellular 23Na resonances before and after the onset of hypoxia. Only DyPPP was useful in separating the two compartments, with a maximal chemical shift difference produced at a concentration of 4.5 mM. Both shift reagents were nephrotoxic at concentrations under 5 mM and produced an immediate decrease in renal-concentrating capacity and increases in fractional sodium and potassium excretion and increased renal vascular resistance. These disturbances of renal physiological parameters were accompanied by progressive broadening of the renal H2O resonance. 1H NMR may be a subtle means of monitoring nephrotoxicity. PMID- 2779418 TI - 1H COSY spectra of superfused brain slices of rat: ex vivo direct assignment of resonances. AB - Realization of 1D 1H spectra of superfused brain slices of rats is described. Two dimensional 1H-1H COSY spectra have been used for the direct assignment of resonances on living tissue (lactate, GABA, N-acetyl aspartate, aspartate, glutamine/glutamate, creatine/phosphocreatine, taurine, inositol, choline/ethanolamine). Utilization of the SUPERCOSY sequence permits simultaneously the enhancement of off-diagonal signals for small metabolites and the reduction of the signals for water and macromolecules. PMID- 2779419 TI - Continuous-flow 13C-filtered 1H NMR spectroscopy of ethanol metabolism in rat liver perfusate. AB - Using a 188.5-microliters continuous-flow dual probe 1H[13C] spin-echo difference spectra of rat liver perfusate were acquired. The conversion of [1-13C]ethanol to [1-13C]-acetaldehyde was readily monitored as a function of time. In combination with 1-1 water nonexcitation and WALTZ 13C decoupling, this method proved to be superior in sensitivity and selectivity to direct 1H or 13C detection. PMID- 2779420 TI - Precise relaxation time measurements of normal-appearing white matter in inflammatory central nervous system disease. AB - Precise relaxation time (RT) measurements have been made, with a standard deviation of 3% for T1 and T2 in white matter in normal volunteers. This sets an upper limit to the instrumental random errors (imprecision). Achieving this precision requires careful adjustment and use of the imager. The wide variation in RTs seen by other workers may be in part due to larger instrumental errors. We have measured RTs (both T1 and T2) in normal-appearing white matter in 16 normal controls and patients with multiple sclerosis (MS, 18), systemic lupus erythematosis (SLE, 16) and cerebral sarcoidosis (8). Both RTs were significantly higher in MS than in other patient groups and controls (P less than .05), possibly caused by microscopic lesions. T2 was elevated in SLE patients relative to controls and sarcoidosis patients (P less than .05), possibly because of microhemorrhages. Lesion RTs were abnormal but more variable and no significant differences between diseases were found. PMID- 2779421 TI - Assessment of demyelination, edema, and gliosis by in vivo determination of T1 and T2 in the brain of patients with acute attack of multiple sclerosis. AB - This study intended to investigate the possibility of magnetic resonance (MR) to characterize the acute plaque due to multiple sclerosis (MS). To obtain information, in vivo measurements of relaxation processes were performed in 10 patients with known acute MS plaques, using a whole-body superconductive MR scanner, operating at 1.5 T. The measurements were repeated several times, from onset of the disease and during remission by use of six-point partial saturation inversion recovery and 32-echo multiple spin-echo sequences, giving T1 and T2, respectively. We also focused on the issue, whether T1 and T2 relaxation processes in fact were monoexponential. The results of the first T1 and T2 measurements of the acute plaques were not clearly different from T1 and T2 of presumably chronic plaques obtained in a group of chronic MS patients previously (H.B.W. Larsson, J. Frederiksen, L. Kjar, O. Hendriksen, and J. Olesen, Magn. Reson. Med. 7, 43 (1988)). In some of the acute plaques a slight initial increase in T1 and T2 was seen, when the measurement was repeated in about 10 days. Thereafter T1 decreased slowly in all but one patient as a function of days. In all cases the T1 relaxation process followed a monoexponential course. The T2 relaxation process was a monoexponential function in the acute plaques, when measured within 20 days from onset of disease. After an average of 78 days, however, the T2 relaxation process clearly became biexponential in all but two patients. Later some of the relaxation curves changed back toward monoexponentiality. Thus, the study shows that it is possible to detect significant changes in MR parameters during the evolution of the disease, and these changes are discussed in relation to knowledge of pathoanatomical events in MS. PMID- 2779422 TI - 1H image-guided localized 31P MR spectroscopy of human brain: quantitative analysis of 31P MR spectra measured on volunteers and on intracranial tumor patients. AB - 1H image-guided 31P MR spectra of normal human brain and of intracranial tumors have been analyzed quantitatively. Tumor types examined include prolactinoma, lymphoma, and various grade gliomas. The experimental signals were processed by means of a time-domain least-square fitting procedure, which yields the spectral parameters, as well as a prediction of the standard deviations. Significant spectral variations are observed within both populations of normal brain and of intracranial tumor 31P MR spectra. The metabolic ratios derived from the glioma 31P MR spectra and from corresponding uninfiltrated brain tissue do not differ significantly. Significant differences are, however, observed between the metabolic ratios of prolactinoma and uninfiltrated tissue 31P MR spectra. Alkaline pH values are found for the prolactinoma and the high-grade gliomas. Furthermore, spectral differences are observed between the patient's uninfiltrated tissue 31P MR spectra and those of an unmatched population of volunteers. This underscores the necessity for control measurements on the uninfiltrated tissue of the patient and for controls from a matched population of healthy individuals. PMID- 2779423 TI - Exposure to a 1.5-T static magnetic field does not alter body and skin temperatures in man. AB - The literature has conflicting reports concerning the effect of static magnetic fields on body and skin temperatures in mammals. Since temperature changes induced by static magnetic fields would have important safety implications for clinical magnetic resonance imaging body (sublingual pocket) and skin (abdomen, forehead, chest, upper arm, forearm, thigh, and calf) temperatures were determined in six normal subjects using a fluoroptic thermometry system during a 20-min exposure to a 1.5-T static magnetic field. Ambient conditions were controlled and held constant. An analysis of variance for repeated measures revealed that there were no statistically significant changes in body or any of the skin temperatures recorded. We conclude that exposure for 20 min to a 1.5-T static magnetic field does not alter body and skin temperatures in man. PMID- 2779424 TI - Conformal NMR spectroscopy: accurate localization to noncuboidal volumes with optimum SNR. AB - "Conformal Spectroscopy" is a general method for the acquisition of accurately localized NMR spectra from noncuboidal regions with optimum signal-to-noise ratio (SNR). The method is based upon the localization of volumes defined by a number of intersecting oblique slices and may be implemented using standard imager hardware. Conformal techniques can enhance many existing localization sequences such as ISIS (31P) and STEAM (1H) resulting in typical SNR improvements of around 1.8, equivalent to a more than threefold reduction in acquisition time. Applications include in vivo tumor spectroscopy. PMID- 2779425 TI - A computer simulation of T2 decay effects in echo planar imaging. AB - The effect of spatially variant T2 decay in echo planar images has been investigated. A simple, direct method to remove T2 effects, requiring no knowledge of actual T2 values, is also reported. The method is based on taking the geometric mean of two Hermitian symmetric data points before Fourier transformation. PMID- 2779426 TI - Biomembranes. Part T. Cellular and subcellular transport: eukaryotic (nonepithelial) cells. PMID- 2779427 TI - Nucleoside transport across red cell membranes. PMID- 2779428 TI - Transport studies in red blood cells by measuring light scattering. PMID- 2779429 TI - Cation-anion cotransport. AB - Two methods have been described for the study of cation-chloride cotransport systems. The zero-trans efflux method is designed to determine stoichiometric relationships between cotransported ions under conditions where ion exchanges cannot occur. These exchanges (e.g., Na+/Na+, K+/K+) may occur as partial or incomplete reactions of a cotransport process and can lead to erroneous determinations of the stoichiometry of the cotransport process. The zero-trans efflux method can also be used to study the effects of cell volume, pH, and intracellular ion concentrations on cotransport processes. The valinomycin method is used to determine the electrogenicity or electroneutrality of transport, and in this regard can be used in conjunction with other methods such as those employing potential-sensitive dyes or microelectrodes. Other, more recently developed ionophores with specificity for lithium rather than potassium have now been used to study the effect of Em on the ATP-dependent Na+/K+ pump. It may be possible to use such ionophores to confirm the suspected electroneutrality of (K+ + Cl-) cotransport systems, as well as for other studies of specific potassium transport processes in which valinomycin obviously cannot be used. Both methods discussed in detail in this chapter, and particularly the valinomycin method, were originally devised for use in red blood cells in order to take advantage of (or circumvent) properties of the red cell membrane, such as its low permeability to sodium and potassium and relatively high permeability to chloride. However, valinomycin has been used successfully to demonstrate the electroneutrality of (Na+ + K+ + 2Cl-) cotransport in MDCK cells, and the zero-trans efflux method should be applicable to the study of transport processes in other types of cells in suspension, so long as the transport system being studied can be accurately defined (e.g., as an inhibitor-sensitive or chloride-dependent cation flux) and comprises a significant fraction of the total salt efflux. PMID- 2779430 TI - Preparation of resealable membranes maximally depleted of cytosolic components by gel filtration and tryptic digestion: resealable white ghosts. PMID- 2779431 TI - Ektacytometry of red blood cells. PMID- 2779432 TI - Hemolytic holes in human erythrocyte membrane ghosts. PMID- 2779433 TI - Preparation of red cell membrane skeleton proteins. PMID- 2779434 TI - Reconstitution of red blood cells: cytoskeletons coated with phospholipid membrane. PMID- 2779435 TI - Isolation, reconstitution, and assessment of transmembrane orientation of the anion-exchange protein. PMID- 2779436 TI - Proteolytic cleavage of the anion transporter and its orientation in the membrane. PMID- 2779437 TI - Purification and characterization of band 3 protein. PMID- 2779438 TI - Protein associations with band 3 at cytoplasmic surface of human erythrocyte membrane. PMID- 2779439 TI - Transport of glutathione, glutathione disulfide, and glutathione conjugates across the hepatocyte plasma membrane. PMID- 2779440 TI - Methods and analysis of erythrocyte anion fluxes. PMID- 2779441 TI - Isolation of calcium-tolerant atrial and ventricular myocytes from adult rat heart. PMID- 2779442 TI - Measurement of transport versus metabolism in cultured cells. PMID- 2779443 TI - Measurement of vacuolar pH and cytoplasmic calcium in living cells using fluorescence microscopy. PMID- 2779444 TI - Use of triphenylmethylphosphonium to measure membrane potentials in red blood cells. PMID- 2779445 TI - Vesicular transport. Part A. PMID- 2779446 TI - Perforated cells for studying intracellular membrane transport. PMID- 2779447 TI - Delivery of macromolecules into cells expressing a viral membrane fusion protein. PMID- 2779448 TI - Lectin-colloidal gold-induced density perturbation of membranes: application to affinity elimination of the plasma membrane. PMID- 2779449 TI - Immunoisolation using magnetic solid supports: subcellular fractionation for cell free functional studies. PMID- 2779450 TI - Lysed chromatophores: a model system for the study of bidirectional organelle transport. AB - The development of procedures to lyse and reactivate pigment granule movements in chromatophores has provided the only information to date concerning the mechanisms by which cells regulate the direction of organelle transport. Continued analysis of motility in these models as well as in a reconstituted system containing only the pigment granules, the appropriate cytoskeletal structures, and defined soluble cell components should contribute to our understanding of the mechanisms by which protein phosphorylation and dephosphorylation or Ca2+ regulate direction of transport and to the identification and characterization of the force-generating proteins responsible for producing bidirectional organelle movements. PMID- 2779451 TI - Endosome and lysosome purification by free-flow electrophoresis. PMID- 2779452 TI - Organic-anion transport inhibitors to facilitate measurement of cytosolic free Ca2+ with fura-2. PMID- 2779453 TI - Poration by alpha-toxin and streptolysin O: an approach to analyze intracellular processes. PMID- 2779454 TI - Preparation of semiintact Chinese hamster ovary cells for reconstitution of endoplasmic reticulum-to-Golgi transport in a cell-free system. PMID- 2779455 TI - Antibodies to Campylobacter pylori in patients with idiopathic dyspepsia. AB - We used Western Blotting analysis to determine the immune profile to Campylobacter pylori polypeptides in: A) sera from patients with idiopathic dyspepsia and bacteriological evidence of C. pylori gastric colonization, B) sera from patients with the same symptoms but no bacteriological evidence of C. pylori infection and C) healthy subjects. To avoid interference of aspecific reactions due to antigenic cross reactivity with other thermophilic Campylobacter species, antisera were raised in rabbits against C. pylori as well as against C. coli and C. jejuni. Some bands (with an approximate molecular weight of 118, 85, 40, 34, 28, 18 and 12 Kd) which can be considered specific for C. pylori were identified and the IgG reaction to some of them (40, 34, 28 Kd) was shown to be significantly higher in patients with bacteriological evidence of C. pylori infection than in the other two groups. IgM reactivity to two bacterial proteins of molecular weight 118 and 40 Kd was particularly evident in the second group of patients suggesting a possible diagnostic tool to identify C. pylori infection at a very early stage. PMID- 2779456 TI - Epidemiology of boutonneuse fever in western Sicily: demonstration of multiple spotted fever group-Rickettsiae subtypes. AB - Electrophoretic analysis of the proteins and genomic DNA of spotted fever-group Rickettsiae isolated from ticks and a human in Western Sicily show that at least two distinct subtypes other than R. conorii are present in this region. All of the spotted fever-group isolates share common features with other, well-defined spotted fever-group rickettsial species, e.g. R. sibirica, Thai Tick Typhus, and R. rickettsii. Based on these data, caution is recommended when identifying species by the more traditional and less specific tests. Studies of the ecology and epidemiology of spotted fever-group Rickettsiae in regions where R. conorii infections occur would benefit and be challenged by intensive antigenic analyses of the proteins and genomic DNA of the various strains of the spotted fever-group Rickettsiae present in those areas. PMID- 2779457 TI - Lymphocyte proliferative response to rabies virus antigen. AB - Rabies virus (RV) infection, as well as active immunisation using viral antigen, elicit both humoral and cellular reactions whose protective effects are still unclear. We evaluated both responses in order to find valuable monitoring parameters for the immunisation procedure. Three laboratory workers repetitively immunised with booster human diploid cell vaccine against rabies virus, 13 patients from the anti-rabies centre (vaccinated for the first time) and 10 healthy volunteers (not immunised nor exposed to rabies virus antigen), were monitored for: (i) in vivo RV-specific antibody production; (ii) in vitro anti-RV lymphocyte proliferative response and (iii) in vitro phenotype modulation induced by the viral antigen. In particular CD3, CD4, CD8, and surface immunoglobulins were monitored. All 3 subjects receiving the booster immunisation and, to a lesser extent, those receiving 4 doses of vaccine did recognise the antigen in vitro. The proliferation involved mainly CD4 positive cells leading to an increased number of cell bearing surface immunoglobulins, i.e. B cells. The proliferation index was in good correlation with the in vivo antibody production (p = less than 0.00009441). Nevertheless the presence of some cases without correlation between those parameters (in particular 5 out of 6 patients over 65 years of age failed to mount an adequate cellular proliferative response) reveals the need to use cellular response in parallel to the current humoral response, in order to evaluate and monitor the immunisation procedure. This conclusion is further stressed by the fact that protection against rabies infection is mainly cellular. PMID- 2779458 TI - The realities of practicing medicine in the 1990s. A look at the trends. PMID- 2779459 TI - Serving the needs of physicians. The number one goal of Physician Service Group, Inc. PMID- 2779460 TI - Practice management audit--a painless, and profitable, proposition. PMID- 2779461 TI - Five steps to unity. PMID- 2779463 TI - HIV infection/AIDS. PMID- 2779462 TI - Ethics and AIDS: can a nurse refuse to provide care for a person with HIV? PMID- 2779464 TI - Nurse's role in HIV education is challenging. PMID- 2779465 TI - Women with HIV disease and their children. PMID- 2779466 TI - HIV infection/AIDS. Risk assessment. PMID- 2779467 TI - Teens and AIDS: many teens are risking HIV infection. PMID- 2779468 TI - Research within nursing homes: more issues. PMID- 2779469 TI - Hemolytic Vibrio cholerae O1 that is sensitive to Mukerjee's cholera phage IV and the phage produced by the hemolytic vibrio lysogenized with the infection of Mukerjee's cholera phage IV. AB - Strains of hemolytic Vibrio cholerae O1 (El Tor vibrio) which are sensitive to Mukerjee's cholera phage group IV were isolated from cholera patients in North East Thailand in 1986. Plaques of the phage on these hemolytic V. cholerae O1 were usually translucent but almost transparent on some strains, just like the plaques on non-hemolytic V. cholerae O1 (classical vibrio). These hemolytic V. cholerae O1 were lysogenized with the infection of cholera phage IV, and the lysogenized strains produced phage different from cholera phage IV. These hemolytic strains were classified into Cured type in prophage typing of V. cholerae O1, El Tor, because they were also lysogenized with Kappa phage and were hemolytic. When Cured-type V. cholerae O1, El Tor previously isolated in various countries were examined for the sensitivity to cholera phage IV, some of the isolates were sensitive. PMID- 2779470 TI - Isolation and characterization of cytoplasmic fibrils from treponemes. AB - Electron microscopy of Triton X-100-treated whole cells of an oral treponeme, Treponema sp. strain E-21, revealed that six cytoplasmic fibrils (CFs) helically wound as a bundle in the cytoplasm. The CFs were isolated and purified by disruption and solubilization of the cells followed by CsCl density gradient centrifugation. The purified CF preparation contained mostly fibrils of about 9 nm in width and very small amounts of thinner strands of about 3 nm in diameter. The CFs were apparently seen to be a tubular structure, but the isolated CFs had narrowed sites of about 4-5 nm in width lacking lumen-like images, possibly representing twisted sites. Thus, the CF did not seem to be a tubular structure. The purified CFs were composed of one major 82 kDa protein and a few minor proteins. The CFs were destructed by treatment with proteases, 8 M urea or 4 M guanidine hydrochloride. Very low tyrosine content (0.76 mol %) and lack of methionine were characteristic features for the 82 kDa protein. The CF preparations from the other five treponemes including Treponema phagedenis and T. denticola also had 82 kDa proteins as a major component, and the 82 kDa proteins of all of the treponemes had a common antigen when examined by using antiserum against the 82 kDa protein from Treponema sp. strain E-21. Furthermore, the 82 kDa protein was demonstrated to be a principal component of the CFs of all the treponemes by immunoelectron microscopy. PMID- 2779471 TI - Deoxyribonucleic acid hybridization studies of Exophiala dermatitidis and Exophiala jeanselmei. AB - Exophiala dermatitidis and Exophiala jeanselmei share similar morphological features and have been confused with each other. To clarify the relationship between the two fungi, we conducted a deoxyribonucleic acid (DNA)-DNA hybridization study using a dot blot method. Between E. dermatitidis and E. jeanselmei, only a very low level of DNA relatedness was seen and it was confirmed that these two fungi are distinct species based on DNA similarity. Close correspondence of DNA from the isolates of E. dermatitidis was obtained, whereas the isolates of E. jeanselmei were divided into 6 groups according to their DNA similarity and a possibility was shown that E. jeanselmei is composed of genetically heterogeneous groups. The subdivision of the species E. jeanselmei by the DNA-DNA hybridization method was in agreement with serotyping exoantigens. This result suggests that DNA-DNA hybridization studies provide an excellent tool for the identification and grouping of pathogenic dematiaceous fungi. PMID- 2779472 TI - Sugar composition of the polysaccharide portion of lipopolysaccharides isolated from non-O1 Vibrio cholerae O2 to O41, O44, and O68. AB - The sugar composition of the polysaccharide portion of lipopolysaccharides (LPS) was determined for 42 serovars of non-O1 Vibrio cholerae, i.e., from serogroups O2 to O41, O44, and O68. On the basis of their compositional sugar pattern, they were classified into 24 chemotypes. 2-Keto-3-deoxyoctonate (KDO) was totally undetectable by the conventional color test (Weissbach's reaction) under the conventional hydrolysis conditions. Instead, a kind of KDO-like substance, which was positive in the reaction but not identical to KDO, was found in serogroup O19. Fructose, a characteristic sugar constituent of O1 V. cholerae LPS, was found in 33 serogroups but was absent from nine serogroups, approximately 20% of the members of this group so far examined. PMID- 2779473 TI - A case of dengue hemorrhagic fever in a Japanese child. AB - A 6-year-old Japanese girl contracted a febrile illness with hemorrhagic manifestations when she traveled in Indonesia. A remarkable decrease in the numbers of platelets and white blood cells was observed in her acute-phase blood specimens. Her father, who accompanied her, showed dengue fever-like symptoms at almost the same time as her illness. It was determined by serological tests that they were infected with dengue virus type 1. Moreover, she showed a secondary antibody response to the flavivirus due to the pre-existing antibody to Japanese encephalitis virus. This is the first confirmed case of dengue hemorrhagic fever (DHF) in Japanese people. PMID- 2779474 TI - Purification of cross-reacting protein antigen shared by Yersinia enterocolitica and other gram-negative bacteria with monoclonal antibody. AB - A monoclonal antibody against the Yersinia enterocolitica 60-kilodalton (kDa) antigen, designated cross-reacting protein antigen (CRPA), was obtained by cell fusion. The CRPA common to gram-negative bacteria was purified from Y. enterocolitica by the affinity chromatography with the monoclonal antibody (IgG1) thus obtained. The purified CRPA showed a single band of 60 kDa in SDS polyacrylamide gel electrophoresis (SDS-PAGE), and reacted with rabbit antisera against Y. enterocolitica, Vibrio cholerae, Escherichia coli, Pseudomonas aeruginosa, and Shigella sonnei in Western blot analysis. The monoclonal antibody, however, reacted with a 60 kDa peptide from Y. enterocolitica, but not with the antigens from other gram-negative bacteria such as V. cholerae, E. coli, S. sonnei, Salmonella enteritidis, Serratia marcescens, Klebsiella pneumoniae, Proteus mirabilis, and P. aeruginosa. The results suggested that both species specific and cross-reactive epitopes were present on a CRPA molecule. PMID- 2779475 TI - Tetrahydroaminoacridine (THA) as a pharmacological probe in Alzheimer's disease (AD) and other neurodegenerative disorders. AB - Unlike other potent enhancers of cholinergic function in the central nervous system (CNS), THA appears to sustain improved function in many moderately impaired AD patients when the Summers procedure is followed. THA has a complex pharmacology. In addition to its enhancement of cholinergic transmission a hydroxylated metabolite might chelate aluminum (A1), thereby removing multiple toxicological constraints on CNS function. This mobilized THA metabolite-A1 complex might either be re-distributed to less sensitive sites or removed from the CNS across the blood-brain barrier (BBB). Since the known presence of A1 in AD brain is not necessarily causal, a positivistic approach to research and treatment with THA and its metabolites might serve to clarify this difficult and challenging problem. PMID- 2779476 TI - A mechanism of peripheral spread or localization of inflammatory reactions--role of the localized ground substance adaptive phenomenon. AB - It is known that connective tissue-active peptides (CTAP) are released at sites of inflammation. Some of this material diffuses to immediately adjacent tissue and increases ground substance viscosity and fibroblast proliferation. This contributes to host protection against spread of infections and tumors. In a person with normal inflammatory reactivity, it should prevent spread of mediators and products of local inflammation. However, the host with an increased reactivity in sites of increased ground substance viscosity or who is highly reactive to dilution of tissue fluid would respond with more inflammation. A non infectious, non-malignant process in a host with a highly reactive inflammatory or immune response could end up with peripheral spread. This could occur in any tissue but it occurs with great vigor in the skin. It could present as a peripheral extension of a local disease process, such as psoriasis, or the migration of cyclic lesions with clearing of the central area. There are over a dozen variants of peripherally spreading, ringed lesions described in the dermatologic literature. This includes erythema marginatum of rheumatic fever, erythema gyratum repens associated with cancer, and erythema annulare centrificum associated with allergic reactions to fungi. Many of the ringed dermatologic lesions have an immunologic component. They tend to be associated with inflammatory immune reactions at distant sites. Dermatologists have been gathering information on the ringed phenomenon at least since Hebra in 1854. The acute localized ground substance adaptive phenomenon is a broadly beneficial biologic response.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2779477 TI - The phenomenon of latent pregnancy and cancer. AB - Based on empirical data on the phenomenon of latent pregnancy in some free living animal species the authors submit the hypothesis of a new approach to the biological basis and the control of the growth of malignant tumours. PMID- 2779478 TI - On the nature of growth and new growth based on experiments designed to reveal a structure and function for laboratory space. Part III. Vorticeal behaviour. Dielectrics and matter responsiveness to fields. The primacy of pressure. AB - This final paper in a series of three continues the discussion on experiments reported in the first which suggested a structure and function for laboratory space. The discussion is grouped under three heads. First a continuation of the discussion of vorticeal properties emphasises the ubiquity of non-observable vorticeal streets (filaments) at site of growth be this biological or hydrodynamic. Vorticeal patterns in pairs of streets can lead to stable or unstable behaviour. Stability of the pattern may underlie that filament subtending new growth in contrast to the instability leading to differentiation in growth manifest from unstable filaments. Rational treatment of the former would suggest exhibition of instability and this may underlie regimes as disparate as Lakhovsky's non-linear oscillators, Coley's bacterial digests and interferon used for cancer therapy. Secondly, study of dielectric properties of biomatter could be used to support the generalisation reached from vorticeal behaviour that the most ordered matter (high permittivity) is associated with growth and embryonic properties and the least ordered with differentiation and maturity. Finally those experiments are referred which showed a concurrence of atmospheric pressure and electrical effects at the remote site during action at a distance. Reasons making use of quantum field theory tenets are advanced for viewing pressure as a primary and the electrical effects as a secondary response to pressure in the non observable world. PMID- 2779479 TI - Two stage carcinogenesis by membrane potential changes. AB - The membrane potential theory is modified and extended. It is shown to be applicable to carcinogenesis by prolonged treatment of target tissues with an initiating external carcinogen or by a single sub-threshold exposure to the initiating external carcinogen followed by subsequent treatment with a phorbol ester internal promoter. PMID- 2779480 TI - The Reflotron for office chemistries. PMID- 2779481 TI - Type VI collagen: high yields of a molecule with multiple forms of alpha 3 chain from avian and human tissues. AB - A differential extraction procedure followed by molecular sieve column chromatography for the isolation of large quantities of the tissue form of type VI collagen is described. Recovery of the protein was more than 60% from both chick gizzard and human placenta. On reduced NaDodSO4-gels chick type VI collagen migrated as two major bands at Mr = 140,000 and 150,000 that were present in a 1:1 ratio and five less intense bands between Mr = 230,000 and 180,000. By immunoblotting with a polyclonal antibody against the pepsinized form of chick type VI collagen, all these bands were stained. Furthermore, the amino acid composition of the five higher Mr polypeptides indicated that they all contained hydroxyproline and hydroxylysine. In the chick type VI collagen molecule the five bands of higher Mr belong to the alpha 3 chain since they were recognized by monoclonal antibodies specific for the chick Mr = 260,000 alpha 3 chain. On examination of antigenic activity by solid-phase radioimmunobinding, densitometry of stained NaDodSO4 polyacrylamide gels, and protein content type VI was found to be an abundant collagen since it accounted for up to 0.1% of the tissue wet weight. The yields per tissue wet weight and the migration pattern of human type VI collagen polypeptides were similar to those of the chick. Agarose/polyacrylamide composite gels indicated that the molecular size of the tissue form of type VI collagen molecules under non-reduced conditions corresponded to a basic type of tetrameric molecule. PMID- 2779482 TI - Characterization and quantitation of wound matrix in the fetal rabbit. AB - Fetal response to injury has been characterized by the deposition of a matrix that is not primarily collagen. This study was designed to identify this matrix, in order to better understand the fetal mechanism of tissue repair. Silastic/polyvinyl alcohol sponge (PVA) wound implants were placed paravertebrally in 24-day gestation (31 days = term) fetal (n = 65) and adult (n = 43) rabbits and then harvested from one hour to 6 days post-wounding. Histologic analysis of the fetal wound matrix deposited in the PVA implants suggested the presence of glycosaminoglycans (GAG) rather than the collagen found in adult wound implants. To further analyze the fetal wound matrix, the GAG content was quantitated using an Alcian Blue dye-binding assay. Results showed significantly increased (p less than 0.05) GAG deposition on days 2-6 in the fetal wound compared to the adult wound. Fetal GAG levels were approximately three times those of the adult during this period. Separation of individual GAG species by cellulose acetate electrophoresis demonstrated that the GAG matrix of the fetal wound was composed predominantly of hyaluronic acid. This finding was confirmed by selective enzymatic digestion of separated GAG species using highly specific polysaccharidases. These observations of hyaluronic acid deposition in the fetal wound may be ascribed an important physiologic role by providing a more fluid and malleable matrix rather than a restrictive matrix composed of collagen. This new evidence coupled with earlier findings of the lack of an acute inflammatory response in the fetus further supports the hypothesis that the fetal response to injury is significantly different from the adult response. PMID- 2779483 TI - Immunoelectron microscopical evidence that type V collagen is a fibrillar collagen: importance for an aggregating capability of the preparation for reconstituting banding fibrils. AB - Type V collagen has already been shown, in many immunohistochemical studies, to be widely distributed in connective tissues. Its supramolecular structure, however, has been unclear. We demonstrate that the major aggregates formed from type V collagen solution in vitro are fine fibrils with a D-periodic banding pattern. Further, by using the immunogold labeling method, we find that these fibrils react strongly with anti-type V collagen antibody. Electronmicroscopic examination showed three kinds of aggregate: fine fibrils with periodic banding pattern, fine fibrils without banding pattern, and non-fibrillar materials. Both striated and nonstriated fibrils, when incubated with rat polyclonal anti-human type V collagen IgG followed by incubation with 15 nm-gold conjugated goat anti rat IgG, were labeled with colloidal gold. We conclude that type V can be classified as a fibrillar collagen. Also, from the present findings together with previous studies, we believe type V collagen may exist in vivo in various connective tissues as fine fibrils with a 67 nm-periodic banding pattern, by itself, or with type I or type III fibrillar collagen, being located between, and connecting the basal lamina and interstitial collagen fibers. PMID- 2779484 TI - Collagenolytic activity extracted from intestinal anastomoses of the rat. AB - The post-operative degradation of collagen has been postulated to play an important role in the development of anastomotic leakage in the intestine. However, collagenolytic activity in intestinal anastomoses has hardly been studied so far. We have measured collagenolytic activity, after extraction in an urea-containing medium, in both ileal and colonic anastomoses in the rat, from 12 hours to 31 days after operation. In ileum collagenolytic activity increased significantly, from 2 to 4 (average 2.7) times the control value, at 12 hours post-operatively followed by a steady decline to original levels. Four weeks after surgery the activity was still slightly, but significantly, enhanced. In colon collagenolytic activity also increased up to 4 times the pre-operative level (average 3.0) 12 hours after operation. Return to original levels was delayed in colon compared to ileum but here activities were similar to control values after one month. In both parts of the intestine there was only a small increase in activity at a segment proximal to the anastomosis during the first 24 hours after operation. The amount of protein extracted did not vary significantly between control and anastomotic samples. These data are the first to show a transiently increased extractable collagenolytic activity in intestinal anastomoses. PMID- 2779486 TI - Extracellular and surface-bound biological activities of Vibrio fluvialis, Vibrio furnissii and related species. AB - Twenty-seven Vibrio strains were assessed for virulence-associated biological activities, including iron chelation, hydrolases, haemolysis and haemagglutination. All strains hydrolysed DNA, chitin, gelatin and casein, produced siderophores, and lysed red blood cells. All V. fluvialis, V. cholerae and V. mimicus strains exhibited diverse lipolytic activity distinct from more discriminate lipolysis by V. furnissii. V. furnissii manifested fibrin and mucin hydrolysis but no phosphate or esculin hydrolysis, for which V. fluvialis varied. No strains hydrolysed urea, alginate or keratin. V. fluvialis, V. furnissii and V. mimicus strains failed to exhibit the mannose-sensitive haemagglutination typical of V. cholerae. Some activities may distinguish otherwise phenotypically similar species. Species tested commonly possessed biological activities that may contribute to virulence, although there was no apparent correlation with isolation from human sources. PMID- 2779485 TI - Production of monoclonal antibodies against thermostable direct hemolysin of Vibrio parahaemolyticus and application of the antibodies for enzyme-linked immunosorbent assay. AB - A total nine hybridoma cell lines that produced monoclonal antibodies against thermostable direct hemolysin (Vp-TDH), a possible pathogenic toxin, of Kanagawa phenomenon-positive Vibrio parahaemolyticus was isolated and characterized. These monoclonal antibodies (mAbs) were divided into a minimum of five different specificity groups, including mAbs specific to Vp-TDH and common to Vp-TDH and Vp TRH, a Vp-TDH-related hemolysin produced by Kanagawa phenomenon-negative V. parahaemolyticus. An enzyme-linked immunosorbent assay (ELISA) using mAb-1-D, a mAb specific for Vp-TDH, was developed for specific detection of Vp-TDH. On the other hand, the ELISA using mAb-9-D, and mAb common to both Vp-TDH and Vp-TRH, could be used for detection of both Vp-TDH and Vp-TRH. Thus, by combining these two ELISAs differential detection of Vp-TDH and Vp-TRH can be performed. Hence, the two ELISAs were applied for various strains of V. parahaemolyticus and it was found that most Kanagawa phenomenon-positive and -negative clinical isolates produced Vp-TDH and Vp-TRH, respectively, but all environmental strains, that were Kanagawa phenomenon-negative, produced neither toxin. PMID- 2779487 TI - Determinants of invasion and survival of Yersinia enterocolitica in intestinal tissue. An in vivo study. AB - The invasion of intestinal tissue by Yersinia enterocolitica was studied after infection of mice with plasmid-bearing or with plasmidless strains of serotype 08 and 03. Within the first 15 h of infection each strain colonized the mouse ileum to the same extent, indicating that the initial binding and invasion are not plasmid dependent. This conclusion is supported by the finding that the plasmidless and the plasmid-bearing Yersiniae (serotype 08) colonize the ileum in a quantitatively similar, dose-dependent manner. The data show that the virulence of Yersiniae depends primarily on their ability to survive and to proliferate within the tissue. This character was expressed by the plasmid-bearing 08 strain, but not by the plasmidless 08 and 03 strain nor by the plasmid-bearing 03 strain. An orally induced rabbit antiserum was used to identify plasmid-coded antigens (relative molecular masses = 47, 45 and 42 kDa), which are expressed in vivo by the plasmid-bearing 08 strain, but not by the three other strains investigated. These antigens may be crucial for virulence of the 08 strain. PMID- 2779488 TI - [Cyclicity and the prognosis of tick-borne encephalitis morbidity in the Krasnoyarsk Territory: expert and mathematical assessments]. AB - Long-term extrapolative prognosis is presented, which is based on 30-year data on tick-borne encephalitis infection rates in the Krasnoyarsk Territory. Mathematical analysis of many-year ranges was performed later by a maximum entropy method with further frequency filtration, its results allowing to predict the infection rate. Disease rate changes for the last 4 years demonstrated that extrapolative prognosis based both on expert and mathematical assessment (by the entropy maximum method) agreed well with the real data. PMID- 2779490 TI - [Effect of sewage on the viability of Opisthorchis eggs]. AB - Experiment with Opisthorchis ova demonstrated high ovicidal effect of sewage. Problems of the potential killing effect on opisthorchiasis causative agent's ova are discussed. PMID- 2779489 TI - [The role of various intermediate and definitive host species in the dissemination of Opisthorchis felineus from the Ob-Irtysh focus of opisthorchiasis]. AB - Opisthorchiasis irradiation from the Ob-Irtysh focus is possible at the social level only: migration of invaded humans, fish export. Invasion irradiation from the endemic area through intermediate hosts is practically impossible, while through the definite hosts, wild fish-eating mammals, it is limited. PMID- 2779491 TI - [Microparasitocenosis of the intestines and the activity of intestinal enzymes in patients with trichocephaliasis during treatment]. AB - Results of the studies of large intestine microflora, enterokinase and alkaline phosphatase activity in the feces of 298 children and adults suffering from trichocephaliasis are presented. Intestinal dysbacteriosis was observed in 51.7% cases, increased enterokinase activity, in 57.6% cases and increased alkaline phosphatase activity, in 55% cases. Enteric enzyme activity relation to the state of enteric microflora is demonstrated. Specific bephenium hydroxynaphthoate and mebendazole treatment was followed by increased dysbacteriosis and higher intestinal enzyme activity, especially in case of bephenium hydroxynaphthoate treatment. Normalization of the above-mentioned parameters was observed 90-120 days after the end of the treatment. PMID- 2779492 TI - [The fluorimetric determination of dabequin in biological fluids]. AB - A study of dabequin was performed to define its possible quantification by spectrofluorimetry. By this technique, dabequin was shown to present maximum excitation and emission wave length at 400 and 450 nm, respectively. Drug emission was determined at different concentrations of sulfuric acid and no changes were observed. Two quantification procedures are compared to determine, which one produces better results in quantifying total serum and blood levels in patients. Specificity of a thin-layer chromatography method, as well as the drug stability in 0.05 M sulfuric acid medium are shown. PMID- 2779493 TI - [The role of ixodid ticks in the epizootic process of tick-borne encephalitis in the Maritime Territory]. AB - Relative significance of Ixodidae in tick-borne encephalitis epizootic process in the Maritime Territory was determined from many years' data on the carriage of viruses by Ixodidae and results of experimental studies of the selective role of Ixodidae main species. Causes of low rates ow carriage of viruses by Ixodidae in the area under study are revealed. PMID- 2779494 TI - [The repellent action of the Mannich bases of phenol methoxy derivatives for Aedes aegypti mosquitoes and Xenopsylla cheopis fleas]. AB - Repellent effect of the Mannich bases (methoxyphenol derivatives) on Aedes aegypti mosquitoes and Xenopsylla cheopis fleas was revealed under laboratory and field conditions. The Mannich base L-methoxy-2-hydroxy-3-(dibutylaminomethyl) benzene turned to the most effective among the substances tested. PMID- 2779495 TI - [The effect of economic activities on the fauna and population count of malarial mosquitoes in an industrial city]. AB - During his practical activities man produces a considerable effect on the Anopheles urban population by changing areas and character of the breeding sites as well as urban conglomerates' microclimate. In the 80-s breeding site areas and number of Anopheles larvae were observed in the Il'ichevskii industrial district of Mariupol'. Domination indices have changed. An. hyrcanus has disappeared completely. The number of An. claviger has reduced to 2-5%. At present, the dominant species is An. maculipennis. PMID- 2779497 TI - Toward a policy for nurse education? PMID- 2779496 TI - [Experimental study of the role of male ixodid ticks in the circulation of the tick-borne encephalitis virus]. AB - Regular transmission of the tick-borne encephalitis virus by Ixodidae males feeding on laboratory animals is demonstrated. The virus titres in the male saliva were 0.1-1.5 lgLD50/0.03 ml. It was established that such doses didn't produce tense viremia in white mice or clinical tick-borne encephalitis. PMID- 2779498 TI - Forces influencing curriculum evaluation. AB - This article presents a retrospective examination of the process used in reviewing an existing baccalaureate nursing curriculum. Force field theory and relevant curriculum literature provide the framework for the discussion of this evaluation process. The factors which led to a state of disequilibrium in the existing program curriculum are identified. Driving and restraining forces which influences the review process are described. Change strategies, implemented in altering the direction of the forces towards equilibrium are presented with an emphasis on outcomes. Finally, guidelines which have evolved from the review process are suggested. PMID- 2779499 TI - A maternity care course component and evaluation. AB - A Maternity Care Component for Nursing Students has been developed within the Department of Nursing Studies in the University of Edinburgh, utilising an educational approach well-established within the Department. This paper describes the Component and its evaluation, which suggests that fears about certain problems were not justified and that all groups involved in the programme were satisfied with the way in which it operated. There may even have been certain benefits which had not been anticipated. PMID- 2779500 TI - Quality assurance in nurse education--the social context of learning. AB - In this article I will critically examine the social context of learning in nurse education from a sociological perspective. I will begin with a brief review of recent developments in the philosophy and practice of nurse education. The concepts of 'tokenism', 'relative autonomy', 'de-mystification', and 'social control' will be used to identify what the present socio-political status of the nurse-learner is. Whilst it is recognised that major improvements in the quality of nurse education have occurred over recent years, the application of these concepts helps to highlight the need for further radical developments before students can be said to have attained educational 'self-actualisation'. Finally, I will suggest positive strategies aimed at advancing the quality of learning for nurses in the future. PMID- 2779501 TI - Zambian student nurses' techniques and hindrances experienced in the process of learning. AB - This paper describes a report on the study carried out in Zambia on the attitudes and opinions of the third year nursing students towards studying and the hindrances experienced in the process of learning. A semi-structured questionnaire was completed by 162 student nurses from four schools of nursing. The results of the study indicate that students' interest in subjects was related to the way they were planned and presented. The study also suggests that studying by students can be more effective where time and attention are given to students' activities, and it is important for teachers to clarify the relationship between theory and practice in subjects which have both these components. Clarification is also required of the methods used by students to apply theory to practice. The author concludes that there is a need for carefully planned objectives and learning strategies which are of interest to students and that it is also important to involve students themselves when reviewing curricula. PMID- 2779502 TI - Student profiling as a basis for continuous assessment of clinical progress during a registered mental nurse course (1988). AB - Interest in profiling of student progress has spread in recent years from general education. Nurse educationalists have been searching for alternative methods of monitoring continuous assessment schemes. The advantages, disadvantages and rationale for the introduction of student profiling of clinical progress into a mental health nursing course are discussed. The role, function and support required by clinical supervisors are considered in the operationalisation of a 'Profile Grids' format of student profiling. An example of a student profile document for a psychodynamic nursing elective experience is included, depicting statements of competence set out in profile grids format. Guidelines for completion of documentation and monitoring of the Central Manchester Health Authority scheme are also described. PMID- 2779504 TI - Developing critical ability in nurse education. AB - This paper argues that all nurses need to develop critical ability, through the process of nurse education. The characteristics of critical ability are described and suggestions are offered for how nurse teachers may develop that ability in their learners. PMID- 2779503 TI - Contract learning in a clinical context: report of a case study. AB - Contract learning as a method of learning has created considerable interest in recent years. The author first discusses contract learning briefly, and reviews the literature, particularly with reference to contracts in nurse education in both the UK and USA; its application in the clinical area in the UK receives specific attention. Secondly the author discusses, the establishment, compilation and enactment of a learning contract with a student nurse within the author's workplace followed by a critical analysis and evaluation of the contract. PMID- 2779505 TI - Dealing with verbal abuse. AB - In the recent report by the Health and Safety Commission (HSC 1987) into violence in the Health Service, the group of staff who were identified as being most at risk, were student nurses. The highest incidence of aggression reported was verbal abuse, and in a 12-month-period 4 out of 10 students who responded to the study had experienced such abuse. Student nurses are in a very vulnerable position and are likely to be the recipients of verbal attack, such as anger, hostility or abuse. This vulnerability may be due to their front line position, their lack of skill and experience, or more often the lack of any training in handling such situations. PMID- 2779506 TI - Gagne's theory of instruction--its relevance to nurse education. AB - This paper examines Gagne's theory of instruction and its relevance to nurse education. The critique covers the use of objectives, the design of an educational unit and skills analysis. The authors argue that nurse educators should consider Gagne's theory during the education process, despite the fact that it may not be directly applicable in its entirety. The subject matter was studied following the educational psychology unit during the second year of the Bachelor of Nursing Studies degree course. PMID- 2779507 TI - A plea for visibility. PMID- 2779509 TI - Vaginal hysterectomy combined with liposuction. AB - Liposuction of the body has been safely combined with vaginal hysterectomy under certain guidelines. Morbidity and length of hospital stay were compared in 50 patients in whom vaginal hysterectomy was the sole procedure performed, with 50 patients in whom vaginal hysterectomy was combined with liposuction at the patient's request. These patients were enrolled in an experimental protocol to evaluate the safety of combining these two procedures. A statistical analysis showed no significant differences in the two groups, indicating that liposuction can be safely combined with uncomplicated vaginal hysterectomy. PMID- 2779508 TI - Splenosis masquerading as small bowel neoplasm. AB - Incidental discovery of a mass during laparoscopic surgery resulted in exploratory laparotomy for a young woman. The mass' uncharacteristic appearance belied its true identity as displaced splenic tissue. The authors suggest ways to identify splenosis without resorting to further surgery. PMID- 2779510 TI - Seeing the writing on the wall. And helping patients to make decisions regarding it. PMID- 2779511 TI - Human immunodeficiency virus infection. Clinical diagnosis. AB - Primary care physicians are likely to see HIV-infected individuals well before they develop full-blown AIDS or even AIDS-related complex. The author presents an overview of the symptoms that may appear in so-called "asymptomatic" patients with human immunodeficiency virus infection. PMID- 2779512 TI - Determination of death by neurological criteria. AB - Since 1981, Missouri law has defined death as occurring when cardiopulmonary function has ceased or when all brain and brain stem function is totally and irreversibly lost. The author reviews the current published guidelines for the determination of death by neurological criteria in order to assist physicians making the evaluation. PMID- 2779513 TI - Magnetic resonance imaging: failure to demonstrate spinal arteriovenous malformations in four patients. AB - Magnetic resonance imaging (MRI), often useful for detecting spinal lesions, was unsuccessful in revealing spinal arteriovenous malformations in four patients, as recorded here. Patients with persistent neurological symptoms after "normal" MRI scans should undergo additional imaging procedures. PMID- 2779514 TI - Translational regulation of the lysis gene in RNA bacteriophage fr requires a UUG initiation codon. AB - Single nucleotide substitutions identify a UUG triplet as the initiation codon of the lysis gene in RNA bacteriophage fr. This initiation codon is non-functional in de novo initiation but is activated by translational termination at the overlapping coat gene. The UUG initiation codon is crucial for gene regulation in the phage, as it excludes uncontrolled access of ribosomes to the start of the lysis gene. Replacement of UUG by either GUG or AUG results in the loss of genetic control of the lysis gene. A model is presented in which initiation factor IF3 proofreads de novo initiation at UUG codons. PMID- 2779515 TI - Excision of pIJ408 from the chromosome of Streptomyces glaucescens and its transfer into Streptomyces lividans. AB - Streptomyces glaucescens GLA000 contains the integrated 15 kb DNA element pIJ408 which, during mating of the parent strain with S. lividans, can be transferred into recipient cells. In S. lividans cells, pIJ408 was found in an autonomously replicating form and in a chromosomally integrated state. In the majority of the S. lividans transconjugants studied, a deletion derivative pIJ408.1 (12.4 kb) occurred. The deletion form was found in some strains only as a free plasmid, in others it was also chromosomally integrated. The integration region of pIJ408 was subcloned and precisely mapped by hybridization, restriction and sequencing analyses. The DNA junction fragments of the integrated plasmid in S. glaucescens, as well as the DNA fragment containing the attachment site of the S. lividans chromosome, were also cloned, submitted to detailed restriction analysis and sequenced. The attachment site of pIJ408 (attP) and the junctions of its integrated form with the chromosomal DNA in S. glaucescens (attL and attR) contain an identical 43 bp sequence. The chromosomal attachment site in S. lividans (attB) differs from the S. glaucescens att sequence by a single base substitution. The similarities between attachment sites of SLP1, pMEA100, pSAM2 and pIJ408 are discussed. PMID- 2779516 TI - Identification of nucleotides critical for activity of the Pseudomonas putida catBC promoter. AB - Pseudomonas putida utilizes the catBC operon, which encodes cis,cis-muconate lactonizing enzyme I (MLEI; EC 5.5.1.1) and muconolactone isomerase (MI; EC 5.3.3.4), for growth on benzoate as a sole carbon source. This operon is positively regulated, and the promoter is located 64 bp upstream of the catB translational start site. Using site-specific mutagenesis, we identified nucleotides that influenced the induction of this promoter. Promoter activity was monitored with the promoter probe vector pKT240. Transcription of mRNA from mutant promoters was determined by primer extension mapping. Comparison of the initiation start site of mutant promoters with that of the wild-type promoter identified a single functional promoter. PMID- 2779517 TI - Termination of transcription of ribosomal RNA genes of mung bean occurs within a 175 bp repetitive element of the spacer region. AB - In mung bean (Vigna radiata, formerly Phaseolus aureus) one length heterogeneity in the intergenic spacer (IGS) of the ribosomal DNA (rDNA) is due to a variable number of 175-bp subrepeats. This spacer region downstream of the 25S rRNA coding region was characterized by sequencing the 2.4 kb EcoRI/HindIII fragment of a 10.5 kb mung bean rDNA repeat. Within the 175-bp repetitive elements a sequence was detected showing strong similarity to the T2/T3-box (GACTTGC) found in Xenopus rDNA and involved in termination and enhancing transcription. In mung bean this sequence partly forms the stem of a possible stem-loop structure at the 3'end of each subrepeat. Nuclease mapping of transcription termination sites (TTS) results in two signals, 65 bp and 315 bp downstream of the 3'end of the 25S rRNA coding region. The longer transcript terminates 20 bp downstream of the stem loop structure at the end of the first 175-bp subrepeat. A spacer model is proposed which allows "readthrough enhancement". No cross-hybridization was observed between the 180-bp subrepeats in pea (Pisum sativum) rDNA and the mung bean 175-bp subrepeat. PMID- 2779519 TI - High efficiency transduction of single strand plasmid DNA into enteric bacteria. AB - This report demonstrates high efficiency transduction of enteric bacteria using single strand plasmids packaged in M13 phage capsids. Transformation by plasmid DNA is usually a very inefficient process in many enteric bacteria other than Escherichia coli K12. Plasmids carrying an M13 origin of replication can be replicated and packaged when cells carrying such plasmids are infected with M13 or a derivative helper phage. By introducing an F' plasmid into E. coli, Serratia marcescens, Citrobacter freundii, and Enterobacter aerogenes, these species can now be infected at high efficiency with M13 phage and with packaged single strand plasmids, yielding an efficient method to introduce cloned DNA fragments into these bacteria. The titer of colony forming units in a lysate was essentially equivalent in all the bacteria, demonstrating an equal efficiency of transduction of these other enteric bacteria compared to E. coli. PMID- 2779518 TI - The phosphoenolpyruvate carboxylase gene of Corynebacterium glutamicum: molecular cloning, nucleotide sequence, and expression. AB - The ppc gene of Corynebacterium glutamicum encoding phosphoenolpyruvate (PEP) carboxylase was isolated by complementation of a ppc mutant of Escherichia coli using a cosmid gene bank of chromosomal C. glutamicum DNA. By subsequent subcloning into the plasmid pUC8 and deletion analysis, the ppc gene could be located on a 3.3 kb SalI fragment. This fragment was able to complement the E. coli ppc mutant and conferred PEP carboxylase activity to the mutant. The complete nucleotide sequence of the ppc gene including 5' and 3' flanking regions has been determined and the primary structure of PEP carboxylase was deduced. The sequence predicts a 919 residue protein product (molecular weight of 103 154) which shows 34% similarity with the respective E. coli enzyme. PMID- 2779520 TI - Cloning and characterization of a gene cluster from Bacillus stearothermophilus comprising infC, rpmI and rplT. AB - Using two synthetic deoxyribonucleotide probes encoding segments of the primary structure of initiation factor IF3 from Bacillus stearothermophilus, we identified and cloned a segment of DNA which carries the infC gene. As in Escherichia coli, the infC gene begins with the unusual initiation triplet AUU, and is followed by the structural genes for ribosomal proteins L35 and L20 (rpmI and rplT, respectively). PMID- 2779521 TI - Onchidal: a naturally occurring irreversible inhibitor of acetylcholinesterase with a novel mechanism of action. AB - Onchidal has been identified as the major lipid-soluble component of the defensive secretion of the mollusc Onchidella binneyi, and it has been proposed as the compound responsible for the chemical protection of Onchidella [Bioorg. Chem. 7:125-131 (1978)]. In support of this hypothesis, we now report that onchidal can be found in several different species of Onchidella and that it is toxic to fish. Because onchidal is an acetate ester similar to acetylcholine, its ability to interact with nicotinic acetylcholine receptors and acetylcholinesterase was investigated. Although onchidal did not prevent the binding of 125I-alpha-bungarotoxin to nicotinic acetylcholine receptors, it inhibited acetylcholinesterase in a progressive, apparently irreversible, manner. The apparent affinity of onchidal for the initial reversible binding to acetylcholinesterase (Kd) was approximately 300 microM, and the apparent rate constant for the subsequent irreversible inhibition of enzyme activity (kintact) was approximately 0.1 min-1. Onchidal was a substrate for acetylcholinesterase, and approximately 3250 mol of onchidal were hydrolyzed/mol of enzyme irreversibly inhibited. The calculated kcat for onchidal was 325 min-1. Irreversible inhibition resulted from either onchidal itself or a reactive intermediate in the enzyme-catalyzed hydrolysis of onchidal, rather than from the hydrolysis products of onchidal. Irreversible inhibition of enzyme activity was prevented by coincubation with reversible agents that either sterically block (edrophonium and decamethonium) or allosterically modify (propidium) the acetylcholine binding site. Enzyme activity was not regenerated by incubation with oxime reactivators; therefore, the mechanism of irreversible inhibition does not appear to involve acylation of the active site serine. Because onchidal contains a potentially reactive alpha,beta-unsaturated aldehyde, irreversible inhibition of acetylcholinesterase may result from formation of a novel covalent bond between the toxin and the enzyme. Thus, this novel toxin could potentially be exploited in the design of a new class of anticholinesterase insecticides and in the identification of amino acids that contribute to the binding and hydrolysis of acetylcholine. PMID- 2779522 TI - ATP-sensitive binding of melittin to the catalytic domain of protein kinase C. AB - Protein kinase C (PKC) is a Ca2+- and phospholipid-dependent protein kinase that appears to play a critical role in the regulation of cell growth. Melittin was previously shown to inhibit Ca2+- and phosphatidylserine (PS)-dependent PKC activity with an inhibitory potency that was reduced as the PS concentration was elevated. In this report, we found that melittin could inhibit activation of PKC by Ca2+ and PS, with an IC50 of 3 microM. When the enzyme activity was released from regulation by Ca2+ and PS by the generation of an active catalytic fragment of PKC through limited proteolysis, melittin inhibited the enzyme activity with an IC50 of 25 microM. Through inhibitor binding studies and enzyme kinetics, we established that melittin binds directly to the catalytic domain of PKC and that the substrate MgATP can release bound melittin from PKC. Melittin bound to PKC in the absence of PKC cofactors, and MgATP completely disrupted the binding of melittin to PKC, whereas phosphoacceptor substrates did not. The catalytic fragment of PKC, which contains two potential ATP-binding sites according to sequence analysis of PKC-encoding cDNAs, also bound melittin. The kinetics of inhibition of the catalytic fragment were consistent with a noncompetitive inhibition with respect to the substrate ATP, providing evidence that the antagonism of the binding of melittin to PKC by MgATP is not due to a direct competition between MgATP and melittin at the active site of PKC. PMID- 2779523 TI - Purification and characterization of a mouse liver cytochrome P-450 induced by cannabidiol. AB - A cytochrome P-450 isozyme (Mr = 51,600) was purified to apparent homogeneity from hepatic microsomes of mice pretreated with cannabidiol (CBD), a major constituent of marijuana. The isozyme exhibited high pentoxyresorufin O dealkylase, hexobarbital hydroxylase, and 16 alpha- and 16 beta-testosterone hydroxylase activities and formed a Fe+2-metyrapone complex, properties characteristic of the major hepatic cytochrome P-450s previously purified from phenobarbital (PB)-pretreated animals. In addition, the CBD-induced cytochrome P 450 was immunoreactive with an antibody raised against the major rat hepatic PB inducible cytochrome P-450 and exhibited an NH2-terminal amino acid sequence greater than 90% homologous with that of the PB-inducible rat liver isozyme. Because of the many similarities between the CBD-induced isozyme and certain other isozymes previously purified from PB-pretreated animals, a cytochrome P-450 isozyme was purified from PB-pretreated mice by a chromatographic procedure similar to that employed for purification of the CBD-induced isozyme. The PB inducible isozyme was indistinguishable from the CBD-inducible cytochrome P-450 on the bases of apparent molecular weight, absorption spectra, NH2-terminal amino acid sequence, peptide mapping, immunoreactivity, and catalytic activity. Although the CBD- and PB-inducible P-450 isozymes appear to be qualitatively very similar, PB appears to be a quantitatively better inducer of the isozyme. Thus, CBD exposure results in the induction of an isozyme that is refractory to CBD mediated inactivation, thereby apparently altering the cytochrome P-450 isozymal composition of mouse hepatic microsomes. PMID- 2779524 TI - Quantitative high resolution 1H NMR urinalysis studies on the biochemical effects of cadmium in the rat. AB - Quantitative changes in the urinary excretion patterns of low molecular weight compounds were followed for up to 30 days after dosing of adult Sprague-Dawley rats with single intraperitoneal injections of CdCl2 (6-24 mumol/kg), using high resolution 1H NMR multicomponent urinalysis. There was a marked reduction in the rate of urinary excretion of citrate, 2-oxoglutarate, and succinate within 4.5 hr of the administration of 24 mumol/kg Cd2+. This continued for up to 4 days after dosing in male rats and was consistent with a renal tubular acidosis, caused by inhibition of carbonic anhydrase. Histological examination of the kidneys showed no evidence of structural abnormalities at any Cd2+ dose level. Creatinine excretion was not affected by Cd2+ treatment at any dose level but hippurate excretion was significantly reduced. Severe testicular damage was noted within 24 hr of Cd2+ treatment at doses of greater than 9 mumol/kg and the degree of damage appeared to be correlated with the presence of large amounts of creatine (up to 20 mM) in the urine. Analysis of homogenates of healthy testicular material indicated the presence of high concentrations of free creatine. Cadmium-induced creatinuria appears to result from direct release of creatine from the necrotic cells of the seminiferous tubules and, hence, the measurement of creatine excretion rates may provide a useful noninvasive indicator of testicular necrosis. Because NMR is nonselective in terms of metabolite detection, this work has shed new light on the changes in urinary composition arising from Cd toxicity. As such, the technique is potentially very valuable in the search for new metabolic markers of toxicity and organ dysfunction. PMID- 2779525 TI - Determination of the association and dissociation rate constants of muscarinic antagonists on rat pancreas: rank order of potency varies with time. AB - Antagonist binding to rat pancreatic muscarinic receptors was relatively slow at 25 degrees (tracer dissociation half-life, 50 to 60 min). We, therefore, chose this system to investigate the errors induced by nonequilibrium incubations on the estimates of receptor capacity and selectivity, in binding studies. We took advantage of the fact that muscarinic antagonists recognize only one receptor subtype in rat pancreatic homogenates and that association and dissociation kinetics conform to the law of mass action to analyze quantitatively the binding kinetics of [3H]N-methylscopolamine and of several unlabeled progressive to these receptors. We observed no correlation between the affinities of drugs for muscarinic receptors and their dissociation rate constants. As a result, the apparent receptor specificity (based on relative affinities for different antagonists) varied markedly with the incubation period. We, therefore, strongly recommend that in general competition curves established for receptor classification should be compared at different incubation periods to ensure that equilibrium is attained. The association rate constants of muscarinic antagonists for rat pancreas receptors were remarkably low, when compared with other ligand receptor systems. This suggests that the antagonist-pancreatic muscarinic receptor association reaction included a rate-limiting conformational change of the drug-receptor complex. This isomerization step was not directly detectable in our kinetic studies, due to the very low affinity and rapid dissociation rate of the initial nonisomerized complex. PMID- 2779526 TI - Effect of anesthetics on calcium stores and membrane order of brain microsomes. AB - The effects of anesthetic agents from different chemical classes and a nonanesthetic membrane-disordering agent, 2-[2-methoxyethoxy]ethyl-8-[cis-2-n octylcyclopropyl]octanoate (A2C), on calcium stores of whole brain microsomes and on order of microsomal membranes were compared. Calcium release was determined by measurement of the extramicrosomal calcium concentration and membrane order by the fluorescence polarization of diphenylhexatriene (membrane core) and trimethylammonium-diphenylhexatriene (membrane "surface"). n-Alkanols (methanol, ethanol, propanol, butanol, pentanol, and hexanol), benzyl alcohol (10-100 mM), and diethyl ether (30-300 mM) released calcium from brain microsomes and decreased the surface and interior membrane order of microsomal membranes. Pentobarbital (0.05-1 mM) did not release calcium from microsomes and did not alter the order of brain microsomal membranes. Halogenated anesthetics (halothane, methoxyflurane, and enflurane), 4-phenyl-1-butanol, and A2C decreased membrane order but failed to release calcium from brain microsomes. Comparison of the effects of these agents on microsomal calcium release and order of microsomal membranes revealed that decreases in membrane order are unrelated to the calcium mobilizing actions of anesthetic compounds. In addition, molecular size appeared to limit ability of anesthetic compounds to release calcium from microsomes. For n-alkanols, benzyl alcohol, and diethyl ether, the ability to release microsomal calcium was correlated with anesthetic potency. Our results demonstrate, for the first time, direct effects of anesthetic agents on intracellular calcium stores of brain tissue and indicate that these stores may be target sites for anesthetics. PMID- 2779527 TI - Ceftriaxone binding to human serum albumin: competition with bilirubin. AB - Ceftriaxone, a cephalosporin, is bound reversibly to defatted human serum albumin from adults, with a first stoichiometric binding constant of 60,000 M-1, as found by equilibrium dialysis at pH 7.4, 37 degrees. A second molecule is weakly bound, with a binding constant of 500 M-1. Possible cobinding with bilirubin was studied by the peroxidase method and by equilibrium dialysis with and without added bilirubin. Results indicated competitive binding; formation of an albumin complex containing both bilirubin and ceftriaxone could not be demonstrated. Light absorption spectra of bilirubin-albumin showed little change on addition of ceftriaxone, in agreement with the competitive biding mechanism. Binding to serum albumin from newborn infants is weaker than to the protein from adults, with the first binding constant being about 36,000 M-1. Cobinding of ceftriaxone and bilirubin to albumin from newborn infants is likewise competitive. It is concluded that ceftriaxone is a strong bilirubin displacer with a potential of inducing bilirubin encephalopathy in predisposed newborns. PMID- 2779528 TI - Elucidation of the mechanism by which homocysteine potentiates the anti-vaccinia virus effects of the S-adenosylhomocysteine hydrolase inhibitor 9-(trans-2',trans 3'-dihydroxycyclopent-4'-enyl)-adenine. AB - 9-(trans-2',trans-3'-dihydroxycyclopent-4'-enyl)-adenine (DHC), a specific inhibitor of S-adenosyl-L-homocysteine (AdoHcy) hydrolase, has been used in this study to elucidate the mechanism by which DL-homocysteine (Hcy) potentiates the antiviral effects of AdoHcy hydrolase inhibitors as reported by De Clercq [Biochem. Pharmacol. 36:2567-2575 (1987)]. The potentiating effects of Hcy on the antiviral effects of DHCA were determined using murine L929 cells infected with vaccinia virus. When virus-infected cells were incubated with DHCA alone or in combination with various concentrations of Hcy, the following IC50 values (concentrations of the drug required to reduce by 50% viral plaque formation) were observed: 0.30 microM (0 mM Hcy), 0.15 microM (0.3 mM Hcy), 0.09 microM (1.0 mM Hcy), and 0.04 microM (3.0 mM Hcy). In the drug combination studies, increased cellular toxicity, compared with DHCA alone, was observed only at the highest concentration of Hcy (3.0 mM); thus, at lower concentrations Hcy increased the antiviral effectiveness [ID50 (concentration of the drug required to reduce the increase in cell number by 50%)/IC50] of DHCA. For example the following ID50/IC50 values were observed for DHCA alone or in combination with Hcy: 64 (0 mM Hcy), 113 (0.3 mM Hcy), 151 (1.0 mM Hcy), and 88 (3.0 mM Hcy). In these studies, Hcy was also observed to potentiate the increase in cellular levels of AdoHcy and the ratio of AdoHcy/S-adenosyl-L-methionine (AdoMet) in DHCA-treated cells. In earlier studies, our laboratory has shown that antiviral effects of DHCA are caused by only slight elevations in intracellular levels of AdoHcy [from 50 pmol/mg of protein (controls) to 100-200 pmol/mg of protein (drug-treated)] and slight elevations in the ratios of AdoHcy/AdoMet [from 0.05-0.1 (control) to 0.15-0.20 (drug-treated)]. Thus, in the presence of Hcy, lower concentrations of DHCA are needed to increase the intracellular concentration of AdoHcy and the AdoHcy/AdoMet ratio to levels that suppress replication of vaccinia virus. Murine L929 cells were shown to contain DHCA-sensitive and DHCA-insensitive forms of AdoHcy hydrolase. Based on the results of labeling experiments using [2,8 3H]adenosine and [35S]methionine, the elevated levels of AdoHcy were shown to arise from the reaction of [2,8-3H]adenosine and Hcy, catalyzed by the DHCA insensitive form of AdoHcy hydrolase. PMID- 2779529 TI - Enantioselective N-oxygenation of verapamil by the hepatic flavin-containing monooxygenase. AB - The chemical and enzymatic N-oxygenation of verapamil was investigated. Verapamil N-oxide is readily synthesized by chemical means. It is not indefinitely stable, however, and undergoes Cope-type elimination to produce 3,4-dimethoxystyrene and a hydroxylamine. The major stable metabolite observed during the metabolism of verapamil with rat and hog liver microsomes and purified flavin-containing monooxygenase is 3,4-dimethoxystyrene. 3,4-Dimethoxystyrene is formed at a rate 4 times that of nor-verapamil. Studies suggest that N-oxygenation is catalyzed largely by the flavin-containing monooxygenase and N-demethylation is catalyzed by cytochrome P-450. This conclusion is based on the effects of cytochrome P-450 inhibitors and positive effectors for the flavin-containing monooxygenase as well as on studies with the purified enzyme. In the presence of rat and hog liver microsomes, significant stereoselectivity in N-oxygenation of verapamil is observed (S/R ratio of 3.1 and 4.1, respectively). With purified hog and rat hepatic flavin-containing monooxygenase, the stereoselectivity for verapamil N oxygenation (S/R ratio of 10.1 and 6.6, respectively) suggests a role for this enzyme in the stereoselective first-pass metabolism of verapamil. PMID- 2779530 TI - Lipid metabolism in normoxic and ischemic heart. PMID- 2779531 TI - Phospholipase C-evoked glycerol release in energy depleted rat myocardial cells. AB - Preincubation of rat myocardial cells in hypoxic substrate-free Krebs-Ringer bicarbonate buffer (pH 7.4, 37 degrees C) resulted in a substantial decline in high energy phosphates (ATP and CP). Thus, 20 and 60 min preincubation produced a 18 and 72% decline in ATP content, whereas the parallel decline in CP content was 51 and 73%. This energy depletion was accompanied by a change in cell morphology from the initial rod-shaped form to rounded up (hyper-contracted) myocytes. In cells preincubated in substrate-free normoxic buffer, both normal morphology and energy homeostasis were maintained. When energy depleted myocytes later were incubated in the presence of phospholipase C (PLC), this resulted in a substantial release of glycerol, amounting to 92 and 137 nmol/10(6) cells.2 h in 20 and 60 min energy depleted myocytes, respectively. In addition, PLC caused an increased leakage of lactate dehydrogenase in energy depleted myocytes. Normal cells, on the other hand, were apparently not affected by PLC. These data suggest that PLC selectively attacks energy depleted and/or structurally damaged myocytes. This could well enhance the breakdown of the natural barrier between the extra- and intracellular compartments and thus augment the cellular damage during ischemia. Moreover, energy depleted myocytes appeared exceptionally sensitive to this enzyme, since the levels required to cause glycerol or lactate dehydrogenase release were several orders of magnitude lower than that required to cause membrane permeation in other cell types. PMID- 2779532 TI - Effect of glucocorticoids on arachidonic acid metabolism and prostaglandin secretion by cultures of newborn rat heart cells. AB - We described that oxygen deprivation induced in cultures of heart muscle cells, biochemical events similar to those described in ischemic tissue: arachidonic acid liberation, loss of membrane phospholipids and increase in neutral lipids. Since glucocorticoids have been described to inhibit phospholipase activity and to exert beneficial effects during myocardial infarction, we studied in our experimental model the action of dexamethasone on the metabolism of arachidonic acid and on the synthesis of immunoreactive prostaglandins. Our results show that heart muscle cells produce prostaglandin E2 and 6-keto-prostaglandin-F1 alpha. This synthesis, inhibited by dexamethasone (70% inhibition), decreased after oxygen-deprivation (-45%). The effect of oxygen deprivation and dexamethasone ( 60%) are not additive. Moreover, steroid treatment failed to counteract the loss of polyunsaturated fatty acids from the phospholipids, the increase in neutral lipids and the liberation of arachidonic acid induced by oxygen deprivation in muscle cells. These results may indicate that the cardiovascular effects of glucosteroids are not the consequence of a direct effect on heart metabolism at cellular level. PMID- 2779533 TI - Effects of hypoxia on lipolysis in isolated rat myocardial cells. AB - The effect of hypoxia on myocardial lipolysis (glycerol release) was investigated in freshly isolated, calcium-tolerant rat ventricular myocytes. Hypoxia was produced by gassing the incubation medium (Joklik-minimum essential medium, supplemented with 1.2 mM MgSO4, 1 mM DL-carnitine, 1.5 mM CaCl2 and 0.6 mM palmitate bound to 0.15 mM fatty acid free bovine serum albumin) with 95% N2-5% CO2. Control (normoxic) incubations were carried out under air-5% CO2 atmosphere. Basal glycerol release increased from 46.6 +/- 3.0 nmol/10(6) cells.30 min in normoxia to 64.5 +/- 4.3 nmol/10(6) cells.30 min in hypoxia (p less than 0.05). Addition of isoprenaline (10 microM) resulted in a significant (p less than 0.05) stimulation of the glycerol release both in normoxia and in hypoxia, but the enhancement above basal rates was apparently lower in hypoxia (8.7 +/- 2.5 nmol/10(6) cells.30 min) than in normoxia (12.2 +/- 2.7 nmol/10(6) cells.30 min). Furthermore, whereas the isoprenaline-induced rise in lipolysis both in normoxia and hypoxia was prevented by inclusion of propranolol (10 microM), propranolol did not affect the hypoxia-induced increase in lipolysis. Thus, the above findings suggest that myocardial lipolysis may be stimulated by local non adrenergic mechanisms during hypoxia. PMID- 2779534 TI - Fatty acid oxidation and myocardial phospholipase A2 activity. AB - Cis-unsaturated fatty acids, but not saturated fatty acids, inhibited phospholipase A2 activity (PLA2) in vitro, and may function as endogenous suppressors of lipolysis. To probe the possible role of lipid peroxidation in the regulation of myocardial lipid catabolism, a neutral-active and Ca2+-dependent PLA2 was extracted from rat heart and was partially purified by sulfopropyl cation exchange chromatography. Myocardial PLA2 activity was inhibited in a dose dependent manner by oleic, linoleic, linolenic, and arachidonic acids; the IC50 for arachidonic acid was approx 65 microM. Palmitic acid was not inhibitory. When arachidonic acid was incubated at 37 degrees C, exposed to air, there was a time- and pH-dependent peroxidation of the arachidonic acid as monitored by turbidity, thiobarbituric acid reactivity, and thin layer chromatography. Peroxidation was increased as the pH was lowered from 7.5 to 4.5, and was accompanied by a decrease in PLA2 inhibitory potency. Thus, arachidonate incubated for 24 hours at pH's 4.5, 6.0 and 7.5 lost 84%, 32%, and 20% respectively, of its inhibitory potency. Therefore, in vitro acidosis promotes the oxidation of cis-unsaturated fatty acids and relieves their inhibitory or suppressive activity toward PLA2s. Increased lipid peroxidation of unesterified unsaturated fatty acids during acidosis may therefore promote lipolysis observed during myocardial ischemia and reperfusion injury. PMID- 2779536 TI - L-propionyl-carnitine protection of mitochondria in ischemic rat hearts. AB - The energy-linked processes (transmembrane potential and oxidative phosphorylation) resulted in impaired mitochondria isolated from ischemic perfused rat hearts. Addition of 1.5 mM L-propionyl-carnitine to the perfusate significantly reduced the ischemic damage and ameliorated mitochondrial Ca2+ homeostasis. In both normoxic and ischemic hearts perfused with L-propionyl carnitine a consistent amount of propionyl-CoA-otherwise undetectable-was produced. L-propionyl-carnitine treatment also prevented the decrease of succinyl CoA associated with the ischemic condition. These results and the decrease of myocardial acetyl-CoA induced by exogenous L-propionyl-carnitine points to the anaplerotic effect of this ester. The consequently improved flux in the tricarboxylic-acid cycle may account for the observed protection of mitochondrial functions afforded by L-propionyl-carnitine in the ischemic perfused hearts. PMID- 2779535 TI - Protective effect of propionyl-L-carnitine against ischaemia and reperfusion damage. AB - Reperfusion of isolated rabbit heart after 60 min of ischaemia resulted in poor recovery of mechanical function, release of reduced (GSH) and oxidized glutathione (GSSG), reduction of tissue GSH/GSSG ratio and shift of cellular thiol redox state toward oxidation, suggesting the occurrence of oxidative stress. Pretreatment of the isolated heart with propionyl-L-carnitine (10(-7) M) improved the functional recovery of the myocardium, reduced GSH and GSSG release and attenuated the accumulation of tissue GSSG. This effect was specific for propionyl-L-carnitine as L-carnitine and propionic acid did not modify myocardial damage. PMID- 2779537 TI - Glucose oxidation is stimulated in reperfused ischemic hearts with the carnitine palmitoyltransferase 1 inhibitor, Etomoxir. AB - The effect of the carnitine palmitoyltransferase 1 (CPT 1) inhibitor, Etomoxir, on glucose oxidation rates was determined in ischemic hearts reperfused in the presence of fatty acids. Isolated working rat hearts were perfused with 11 mM (14C)-glucose and 1.2 mM palmitate at a 15 cm H2O preload, 80 mm Hg afterload. Hearts were subjected to either 60 min aerobic perfusion, or 15 min work followed by 25 min global ischemia then 60 min of aerobic reperfusion. Steady state glucose oxidation rates in reperfused ischemic hearts were not significantly different from non-ischemic hearts. If 10(-9) M Etomoxir was added immediately prior to reperfusion no significant change in glucose oxidation occurred. Addition of 10(-8) M and 10(-6) M Etomoxir, however, significantly increased glucose oxidation. Etomoxir also significantly improved recovery of mechanical function at a concentration of 10(-8) M or greater. As we previously reported, no significant improvement of function was seen when 10(-9) M Etomoxir was added to the perfusate (Lopaschuk GD et al., Circ Res 63: 1036-1043, 1988). Long chain acylcarnitine levels were significantly reduced in the presence of both 10(-9) M and 10(-8) M Etomoxir. These data demonstrate that the beneficial effect of Etomoxir on reperfusion recovery of ischemic hearts is not due to a lowering of long chain acylcarnitine levels. Etomoxir may improve recovery of function by overcoming fatty acid inhibition of glucose oxidation. PMID- 2779538 TI - Fatty acid turnover in the ischaemic compared to the non-ischaemic human heart. AB - Cardiac extraction, oxidation and release of plasma free fatty acids (FFA) was measured by coronary sinus catheterization, utilizing infusions of 3H palmitate and 14C oleate, in patients with ischaemic heart disease (IHD) at rest and during pacing induced angina pectoris and, for comparison, in healthy men of similar and younger age and men with hypertriglyceridaemia (HTG). At rest IHD patients differed from healthy men only by greater cardiac fatty acid release, which correlated with a significant glycerol release. In IHD patients, unlike in healthy men, myocardial extraction of both palmitate and oleate decreased while fractional oxidation of oleate increased during pacing. Fatty acid release was unaltered. Men with HTG had at rest higher myocardial FFA extraction than IHD patients, which did not decrease during pacing, but like in the patients oleate fractional oxidation increased on pacing. It is concluded that, in the moderately ischaemic human heart, the restricted blood flow may contribute to limit the fatty acid flux into the myocardium. The augmented cardiac fatty acid release in IHD patients is not related to ischaemia per se but may derive from an increased amount of cardiac interstitial fat. PMID- 2779539 TI - Biochemistry of radioiodinated free fatty acids. AB - Radioiodinated free fatty acids have been developed to study myocardial metabolism non-invasively in man. In the present study the distribution of radiolabeled lipids in the myocardium and in arterial and coronary sinus blood was evaluated following injection of three commonly used iodinated fatty acids in fasted (n = 5) and lactate loaded (n = 3) dogs. Five minutes after simultaneous i.v. injection of radioiodinated 17-I-heptadecanoic acid (IHDA), 15-(p-I-phenyl) pentadecanoic acid (IPPA) and 15-(p-I-phenyl)-3,3-dimethyl-pentadecanoic acid (DMIPPA) a biopsy specimen and samples of arterial and coronary sinus blood were taken. After extraction and TLC the relative distribution of radioactivity in the aqueous phase (containing the oxidation products), pellet and organic phase was calculated. The organic phase was further divided into phospholipids, diglycerides, free fatty acids, triglycerides and cholesterol-esters. Seventy two percent of IHDA was oxidized, 36% of IPPA and 7% of DMIPPA. The organic phase consisted primarily of triglycerides and phospholipids. The ratios of triglycerides to phospholipids were about the same for IHDA, IPPA and DMIPPA (0.58, 0.65 and 0.50, respectively). Free IHDA in tissue samples was low (4%) and elevated for IPPA and DMIPPA, (17% and 37%). During lactate loading triglycerides were higher for all three fatty acids. For IHDA and IPPA this increase was paralleled by a decrease in the aqueous phase, in case of DMIPPA the aqueous phase remained the same. Five minutes after injection most of the organic phase of both arterial and coronary sinus blood consisted of the injected fatty acids, the aqueous phase contained oxidation products. There were only minor differences during lactate loading.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2779540 TI - Variables of myocardial backdiffusion, determined with 17-iodo-131 heptadecanoic acid in the normal dog heart. AB - Under normal and ischemic conditions backdiffusion of radiolabeled non-esterified fatty acids (NEFA) has been demonstrated. In the fasted normal canine heart the extraction fraction (EF) during interventions with glucose or lactate loading, vasodilation, and metabolic level augmentation was determined, and compared with the control EF. Backdiffusion alterations were deduced from the EF changes. After iv injection of 17-iodo-131 heptadecanoic acid (IHDA), 11 blood samples were drawn from aorta and coronary sinus in a time period of 60 minutes. In the control and vasodilation group the EF slowly decreased from 40 to 10%. In contrast, the EF in the noradrenaline group was constant. During glucose and lactate infusion the EF became negative within 10 min and remained negative. These results suggest that during physiological circumstances backdiffusion is determined by the metabolic level of the heart and its substrate availability. PMID- 2779541 TI - Intramyocardial fate of 15-p-iodophenyl-beta-methylpentadecanoic acid (IMPPA): is it a good tracer of fatty acid myocardial uptake? AB - Iodinated fatty acids (FAs) are now used in Nuclear Medicine to assess, by external detection, myocardial metabolism. Methylated FAs have been proposed as tracers of FA myocardial uptake. IMPPA is a new FA analogue in which a methyl group have been introduced in beta position to inhibit beta-oxidation and a terminal phenyl group prevents a possible omega oxidation. We have compared the intramyocardial behaviour of this FA with the 15-p-iodophenyl-pentadecanoic acid (IPPA), the straight chain analogue, and with the 15-phenyl-beta methylpentadecanoic acid (MPPA), the 3 of them being labelled with C14 on the carboxyl group, in isolated rat hearts perfused in a recirculating system. When IMPPA is compared to IPPA (influence of the methyl group), we observe 1--an inhibition of beta-oxidation (no significant production of labelled CO2 and very low radioactivity in the aqueous phase) leading to a reduced uptake, 2--a lower radioactivity in the organic phase due to a hindrance to the esterification process both into TGs and PLs, the free FAs level being higher. When IMPPA is compared to MPPA (influence of the iodine atom), we observe 1--the same inhibition of beta-oxidation, 2 - a higher myocardial radioactivity due to a much higher level of free FAs, the esterification into TGs and PLs being reduced. This study with IMPPA indicates that it is taken up by the heart and trapped there, as it is not oxydized. This long retention time, apart from giving good scintigraphic images, should make IMPPA useful to study the regional myocardial uptake of FAs. PMID- 2779542 TI - Is fatty acid uptake in cardiomyocytes determined by physicochemical fatty acid partition between albumin and membranes? AB - Palmitate uptake by isolated, calcium-resistant cardiomyocytes was measured by using a stimulation chamber in which cell contraction can be evoked electrically. Experiments were performed in a medium containing physiological interstitial concentration of albumin (2%) and palmitate/albumin (P/A) ratios ranging from 0.03 to 2.5, and were compared to experiments with fixed P/A ratio (= 1). Initial rate of uptake (Vi) was calculated from fitted uptake vs. time curves as measured by accumulation of radioactivity in the cells from 14C-labelled palmitate. Vi-vs. concentration curves exhibited a saturable component, if albumin concentration was kept constant. Almost no change in Vi was observed in experiments performed at constant P/A. This is in contrast to the albumin receptor hypothesis. The 14C palmitate content of the myocytes as estimated by thin-layer-chromatography did reach a plateau at less than or equal to 30s and had the same value at 30 min after administration. The cellular content of labelled palmitate could be attributed to the membrane compartment as calculated from partition coefficient (Kc) of fatty acids (FA) between albumin and membranes. With electrical stimulation Vi-vs.-palmitate concentration kinetics showed a shift in apparent Km from 62 microM (P/A = 0.22) to 23 microM (P/A = 0.08), and presence of 2,4 dinitrophenol increases Vi. Our results suggest that FA-transfer across the sarcolemmal membranes is determined by a physicochemical equilibrium between the compartments of extracellular FA-albumin complex, the membrane lipid phase, intracellular FA binding proteins and the respective aqueous phases.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2779544 TI - Fatty acids are not an important fuel for coronary microvascular endothelial cells. AB - The metabolism by coronary microvascular endothelial cells (CMEC) of the heart typical substrates palmitate and lactate was compared to that of glucose and glutamine. Confluent cultures of CMEC were used. Palmitate oxidation was saturable and independent of the exogenous albumin concentration. Palmitate, 300 microM, lactate, 1 mM, and glutamine, 0.5 mM, were oxidized to 35, 46, and 56 nmol CO2/h x mg protein. These oxidation rates were decreased by 80, 66, and 48% in presence of 5 mM glucose. The largest energy yield was obtained by glycolytic breakdown of glucose. Glucose, 5 mM, was degraded to lactate by 99%, and oxidized in the Krebs cycle by only 0.04%. 1% was catabolized via the hexose monophosphate pathway. The rate of glucose oxidation in the Krebs cycle could be 30-fold increased by the uncoupler 2,4-dinitrophenol, 30 microM. At concentrations lower than 1 mM the amount of glucose oxidized in the Krebs cycle also grew, indicating existence of the Crabtree effect. The energy demand of CMEC seems to be of the same order as that of the arrested heart. PMID- 2779545 TI - Role of phospholipases in myocardial ischemia: effect of cardioprotective agents on the phospholipases A of heart cytosol and sarcoplasmic reticulum in vitro. AB - Increased breakdown of myocardial phospholipids to fatty acids and lysophosphoglycerides is an early feature of myocardial ischemic injury and many investigators believe that enhanced phospholipase action is an important factor in the process. Several recent reports indicate that inhibitors of phospholipase A, such as mepacrine, chloroquine and chlorpromazine, can prevent heart phosphoglyceride breakdown in vivo. We isolated the phospholipases A from rat heart cytosol and sarcoplasmic reticulum and examined the effects of various cardioprotective substances on their activity. Most of the cardioprotective agents studied inhibited the heart phospholipases in vitro, providing further evidence that phospholipid degradation in ischemic myocardial injury may be modulated by pharmacologic agents. PMID- 2779546 TI - Tyrosination-detyrosination of tubulin and microtubules during the development of chick erythrocytes. AB - Chicken erythroid cells at different stages of maturation were incubated with [14C]tyrosine to analyze the incorporation of this amino acid into the COOH terminus of alpha-tubulin. The incorporated radioactivity was determined in the microtubule and nonassembled tubulin pools. At all maturation stages, nonassembled tubulin was more labeled than microtubules. Microtubules were significantly labeled in proerythroblasts, labeled to a lesser extent in erythroblasts and not labeled at all in mature erythrocytes. We also studied the distribution of the tyrosinating and detyrosinating enzymes, tubulin:tyrosine ligase and tubulin carboxypeptidase, respectively, between the assembled and nonassembled tubulin fractions. Tubulin:tyrosine ligase behaved as a soluble entity at all maturation stages, whereas tubulin carboxypeptidase was found partially associated with microtubules in chicken proerythroblasts and completely soluble in mature erythrocytes. The marginal band of toad erythrocytes was examined by immunofluorescence using antibodies specific to tyrosinated and to detyrosinated tubulin. This marginal band which is mainly tyrosinated could be detyrosinated by exposure of these cells, previously permeabilized, to exogenously supplied tubulin carboxypeptidase. Toad erythrocytes contained soluble tubulin carboxypeptidase which showed an activity similar to that of chicken erythrocytes. PMID- 2779543 TI - Does fatty acid-binding protein play a role in fatty acid transport? AB - The possible property of fatty acid-binding proteins (FABPs) to transport fatty acid was investigated in various model systems with FABP preparations from liver and heart. An effect of FABP, however, was not detectable with a combination of oleic acid-loaded mitochondria and vesicles or liposomes due to the rapid spontaneous transfer. Therefore, the mitochondria were separated from the vesicles in an equilibrium dialysis cell. The spontaneous fatty acid transfer was much lower and addition of FABP resulted in an increase of fatty acid transport. Oleic acid was withdrawn from different types of monolayers by FABP with rates up to 10%/min. When two separate monolayers were used, FABP increased fatty acid transfer between these monolayers and an equilibrium was reached. PMID- 2779547 TI - Phosphoglucoisomerase-catalyzed interconversion of hexose-phosphates. Isotopic discrimination between hydrogen and tritium. AB - The rate of conversion of D-glucose 6-phosphate to D-fructose 6-phosphate as catalyzed by yeast phosphoglucoisomerase is about fourfold lower when 3H, rather than 1H, is present on the C2 of D-glucose 6-phosphate. This difference appears to be due mainly to a change in maximal velocity, rather than affinity. Phosphoglucoisomerase also distinguishes between 1H and 3H in terms of either their intramolecular transfer from C2 to C1 or their incorporation from water on the C1 of D-fructose 6-phosphate. PMID- 2779548 TI - Regulated expression of nuclear protein(s) in myogenic cells that binds to a conserved 3' untranslated region in pro alpha 1 (I) collagen cDNA. AB - We describe the identification and DNA-binding properties of nuclear proteins from rat L6 myoblasts which recognize an interspecies conserved 3' untranslated segment of pro alpha 1 (I) collagen cDNA. Levels of the two pro alpha 1 (I) collagen RNAs, present in L6 myoblasts, decreased drastically between 54 and 75 h after induction of myotube formation in serum-free medium. Both mRNAs contained a conserved sequence segment of 135 nucleotides (termed tame sequence) in the 3' untranslated region that had 96% homology to the human and murine pro alpha 1 (I) collagen genes. The cDNA of this tame sequence was specifically recognized by nuclear protein(s) from L6 myoblasts, as judged by gel retardation assays and DNase I footprints. The tame-binding protein(s) was able to recognize its target sequence on double-stranded DNA but bound also to the appropriate single-stranded oligonucleotide. Protein that bound to the tame sequence was undetectable in nuclear extracts of L6 myotubes that did not accumulate the two collagen mRNAs. Therefore, the activity of this nuclear protein seems to be linked to accumulation of the sequences that it recognizes in vitro. The collagen RNAs and the nuclear tame-binding proteins reappeared after a change of medium, which further suggests that the RNAs and the protein(s) are coordinately regulated. PMID- 2779550 TI - Epidermal growth factor receptor binding is affected by structural determinants in the toxin domain of transforming growth factor-alpha-Pseudomonas exotoxin fusion proteins. AB - TGF-alpha-PE40 is a hybrid protein composed of transforming growth factor-alpha (TGF-alpha) fused to a 40,000-dalton segment of Pseudomonas exotoxin A (PE40). This hybrid protein possesses the receptor-binding activity of TGF-alpha and the cell-killing properties of PE40. These properties enable TGF-alpha-PE40 to bind to and kill tumor cells that possess epidermal growth factor (EGF) receptors. Unexpectedly, TGF-alpha-PE40 binds approximately 100-fold less effectively to EGF receptors than does native TGF-alpha (receptor-binding inhibition IC50 = 540 and 5.5 nM, respectively). To understand the factors governing receptor binding, deletions and site-specific substitutions were introduced into the PE40 domain of TGF-alpha-PE40. Removal of the N-terminal 59 or 130 amino acids from the PE40 domain of TGF-alpha-PE40 improved receptor binding (IC50 = 340 and 180 nM, respectively) but decreased cell-killing activity. Substitution of alanines for cysteines at positions 265 and 287 within the PE40 domain dramatically improved receptor binding (IC50 = 37 nM) but also decreased cell-killing activity. Similar substitutions of alanines for cysteines at positions 372 and 379 within the PE40 domain did not significantly affect receptor-binding or cell-killing activities. These studies indicate that the PE40 domain of TGF-alpha-PE40 interferes with EGF receptor binding. The cysteine residues at positions 265 and 287 of PE40 are responsible for a major part of this interference. PMID- 2779549 TI - Molecular cloning, sequence analysis, and functional expression of a novel growth regulator, oncostatin M. AB - Oncostatin M is a polypeptide of Mr approximately 28,000 that acts as a growth regulator for many cultured mammalian cells. We report the cDNA and genomic cloning, sequence analysis, and functional expression in heterologous cells of oncostatin M. cDNA clones were isolated from mRNA of U937 cells that had been induced to differentiate into macrophagelike cells by treatment with phorbol 12 myristate 13-acetate, and a genomic clone was also isolated from human brain DNA. Sequence analysis of these clones established the 1,814-base-pair cDNA sequence as well as exon boundaries. This sequence predicted that oncostatin M is synthesized as a 252-amino-acid polypeptide, with a 25-residue hydrophobic sequence resembling a signal peptide at the N terminus. The predicted oncostatin M amino acid sequence shared no homology with other known proteins, but the sequence of the 3' noncoding region of the cDNA contained an A + T-rich stretch with sequence motifs found in the 3' untranslated regions of many cytokine and lymphokine cDNAs. Oncostatin M mRNA of approximately 2 kilobase pairs was detected in phorbol 12-myristate 13-acetate-treated U937 cells and in activated human T cells. Transfection of cDNA encoding the oncostatin M precursor into COS cells resulted in the secretion of proteins with the structural and functional properties of oncostatin M. The unique amino acid sequence, expression by lymphoid cells, and growth-regulatory activities of oncostatin M suggest that it is a novel cytokine. PMID- 2779551 TI - Nonsense mutations in the dihydrofolate reductase gene affect RNA processing. AB - Steady-state dihydrofolate reductase (dhfr) mRNA levels were decreased as a result of nonsense mutations in the dhfr gene. Thirteen DHFR-deficient mutants were isolated after treatment of Chinese hamster ovary cells with UV irradiation. The positions of most point mutations were localized by RNA heteroduplex mapping, the mutated regions were isolated by cloning or by enzymatic amplification, and base changes were determined by DNA sequencing. Two of the mutants suffered large deletions that spanned the entire dhfr gene. The remaining 11 mutations consisted of nine single-base substitutions, one double-base substitution, and one single base insertion. All of the single-base substitutions took place at the 3' position of a pyrimidine dinucleotide, supporting the idea that UV mutagenesis proceeds through the formation of pyrimidine dimers in mammalian cells. Of the 11 point mutations, 10 resulted in nonsense codons, either directly or by a frameshift, suggesting that the selection method favored a null phenotype. An examination of steady-state RNA levels in cells carrying these mutations and a comparison with similar data from other dhfr mutants (A. M. Carothers, R. W. Steigerwalt, G. Urlaub, L. A. Chasin, and D. Grunberger, J. Mol. Biol., in press) showed that translation termination mutations in any of the internal exons of the gene gave rise to a low-RNA phenotype, whereas missense mutations in these exons or terminations in exon 6 (the final exon) did not affect dhfr mRNA levels. Nuclear run-on experiments showed that transcription of the mutant genes was normal. The stability of mature dhfr mRNA also was not affected, since (i) decay rates were the same in wild-type and mutant cells after inhibition of RNA synthesis with actinomycin D and (ii) intronless minigene versions of cloned wild type and nonsense mutant genes were expressed equally after stable transfection. We conclude that RNA processing has been affected by these nonsense mutations and present a model in which both splicing and nuclear transport of an RNA molecule are coupled to its translation. Curiously, the low-RNA mutant phenotype was not exhibited after transfer of the mutant genes, suggesting that the transcripts of transfected genes may be processed differently than are those of their endogenous counterparts. PMID- 2779552 TI - DNA interstrand cross-links promote chromosomal integration of a selected gene in human cells. AB - We have used integrative pSV2 plasmids to learn how DNA lesions affect nonhomologous recombination with human chromosomes. Enhanced stable transformation of fibrosarcoma cells with a selectable gene was observed after chemical modification of the plasmid DNA; thus, cells transfected with plasmid pSV2-gpt carrying photoadducts of the cross-linking agent 4'-hydroxymethyl-4,5',8 trimethylpsoralen (HMT) yielded four- to sevenfold-higher levels of Gpt+ transformants than were obtained with untreated plasmid. The enhancement due to HMT interstrand cross-links was at least as great as that due to the monoadducts. DNA hybridization analysis indicated that the enhanced transformation frequency resulted from an increased number of cells carrying integrated plasmid sequences rather than from a higher copy number per transformant. The enhancement was not seen with a plasmid missing the sequences flanking the minimal simian virus 40 gpt transcription unit. Cotransfection with untreated and HMT-treated plasmids suggested that the HMT-containing DNA interacted preferentially with some cellular factor that promoted chromosomal integration of the plasmid DNA. It is concluded that (i) interstrand cross-linking as well as intrastrand DNA adducts promote nonhomologous recombination in human chromatin and (ii) DNA sequences flanking the selectable genes are the targets for such recombinational events. PMID- 2779553 TI - Selective expression of alternative lck mRNAs in human malignant cell lines. AB - The lck protein tyrosine kinase is normally expressed in a cell type-specific fashion, with mRNA being confined to cells of lymphoid lineage. Despite this highly specific pattern of expression in normal tissues, lck mRNA has also been detected in selected cell lines derived from human nonlymphoid neoplasms. In this study we explored the mechanisms underlying the expression of lck mRNA within human nonlymphoid neoplastic cell lines. We determined that lck mRNA expression was correlated with transcriptional activation and that there was no evidence for genomic rearrangement or amplification within the lck coding region to account for the expression of lck mRNA in the nonlymphoid neoplastic cell lines. The lck gene has previously been shown to contain two distinct promoter elements. In this study, we demonstrated that lck-producing cell lines derived from human nonlymphoid neoplasms expressed transcripts initiated exclusively from the 3' most promoter element (3' promoter). In contrast, lymphoid cell lines derived from nonmalignant sources expressed lck transcripts exclusively initiated from the 5'-most promoter element (5' promoter). Most cell lines derived from human lymphoid neoplasms express lck transcripts initiated from both the 5' and 3' promoters in various ratios. Thus, lck expression in a variety of malignant cell lines results from a selective induction of transcription from the 3' promoter. PMID- 2779554 TI - Reversible cellular senescence: implications for immortalization of normal human diploid fibroblasts. AB - IMR-90 normal human diploid fibroblasts, transfected with a steroid inducible mouse mammary tumor virus-driven simian virus 40 T antigen, were carried through crisis to yield an immortal cell line. Growth was dependent on the presence of the inducer (dexamethasone) during both the extended precrisis life span of the cells and after immortalization. After dexamethasone removal, immortal cells divided once or twice and then accumulated in G1. These results are best explained by a two-stage model for cellular senescence. Mortality stage 1 (M1) causes a loss of mitogen responsiveness and arrest near the G1/S interface and can be bypassed or overcome by the cellular DNA synthesis-stimulating activity of T antigen. Mortality stage 2 (M2) is an independent mechanism that is responsible for the failure of cell division during crisis. The inactivation of M2 is a rare event, probably of mutational origin in human cells, independent of or only indirectly related to the expression of T antigen. Under this hypothesis, T antigen-immortalized cells contain an active but bypassed M1 mechanism and an inactivated M2 mechanism. These cells are dependent on the continued expression of T antigen for the maintenance of immortality for the same reason that precrisis cells are dependent on T antigen for growth: both contain an active M1 mechanism. PMID- 2779556 TI - Each of the conserved sequence elements flanking the cleavage site of mammalian histone pre-mRNAs has a distinct role in the 3'-end processing reaction. AB - To study the substrate requirements for the histone 3'-end processing reaction of mammalian histone pre-mRNAs, we created a set of mutations in the sequences flanking the processing site of a mouse H3 gene. We found that deletion of the downstream purine-rich element hypothesized to interact with U7 small nuclear RNA abolishes in vitro 3'-end processing. Somewhat surprisingly, however, mutations in the hairpin loop element which destabilize or destroy the secondary structure reduce but do not abolish 3'-end processing. This is in apparent contrast to results obtained for the sea urchin system, where both sequence elements appear to be absolutely required for 3'-end formation. PMID- 2779555 TI - Growth of immortal simian virus 40 tsA-transformed human fibroblasts is temperature dependent. AB - Simian virus 40 (SV40)-mediated transformation of human fibroblasts offers an experimental system for studying both carcinogenesis and cellular aging, since such transformants show the typical features of altered cellular growth but still have a limited life span in culture and undergo senescence. We have previously demonstrated (D. S. Neufeld, S. Ripley, A. Henderson, and H. L. Ozer, Mol. Cell. Biol. 7:2794-2802, 1987) that transformants generated with origin-defective mutants of SV40 show an increased frequency of overcoming senescence and becoming immortal. To clarify further the role of large T antigen, we have generated immortalized transformants by using origin-defective mutants of SV40 encoding a heat-labile large T antigen (tsA58 transformants). At a temperature permissive for large-T-antigen function (35 degrees C), the cell line AR5 had properties resembling those of cell lines transformed with wild-type SV40. However, the AR5 cells were unable to proliferate or form colonies at temperatures restrictive for large-T-antigen function (39 degrees C), demonstrating a continuous need for large T antigen even in immortalized human fibroblasts. Such immortal temperature dependent transformants should be useful cell lines for the identification of other cellular or viral gene products that induce cell proliferation in human cells. PMID- 2779557 TI - Developmental regulation of hypomethylation of delta-crystallin genes in chicken embryo lens cells. AB - Sequences in the two delta-crystallin genes become hypomethylated when they are expressed in the chick lens. This system is particularly advantageous for studying temporal changes in hypomethylation, since lens tissue can be isolated at all developmental stages. In previous work we have shown that most HpaII sites become hypomethylated within the delta 1-crystallin gene long after delta crystallin gene activation. One site is hypomethylated when crystallin mRNA begins to be synthesized at high levels at 50 h; we show here that this site maps to the 3' end (intron 15) of the delta 1-crystallin gene. In addition, we have examined the methylation status of HpaII and HhaI sites found near the 5' end of the delta 1-crystallin gene. Two HhaI sites adjacent to a viral core enhancer sequence in intron 2 are also first hypomethylated at 50 h. These findings point to regions of the delta 1 gene that should be investigated further for functional significance in regulating delta-crystallin transcription. PMID- 2779558 TI - Related proteins are phosphorylated at tyrosine in response to mitogenic stimuli and at meiosis. AB - Forty-two-kilodalton proteins that contain phosphotyrosine in metaphase-arrested Xenopus laevis eggs are closely related to p42, a protein that is phosphorylated at tyrosine when somatic cells are exposed to mitogenic stimuli. PMID- 2779559 TI - Alternative splicing of the platelet-derived growth factor A-chain transcript occurs in normal as well as tumor cells and is conserved among mammalian species. AB - Using a polymerase chain reaction approach, we have analyzed the alternative usage of the platelet-derived growth factor A-chain exon 6 in mRNA from various cell types. The results show that this sequence is utilized in a small fraction of the mRNA molecules in normal as well as transformed cells and that this phenomenon is conserved among mammalian species. PMID- 2779560 TI - Sequence identification of cytochrome b in Plasmodium gallinaceum. AB - We have identified a gene that encodes the polypeptide cytochrome b in the avian malarial parasite Plasmodium gallinaceum. The gene containing the open reading frame was found to be located on a 6.2-kilobase multimeric extrachromosomal element. The amino acid translation from this gene demonstrated significant similarities to cytochrome b sequences from yeast, mammal, and fungus genomes. We present evidence that the P. gallinaceum cytochrome b transcript is part of a larger primary transcript from the element that is subsequently processed. The message for P. gallinaceum cytochrome b was found to be 1.2 kilobases in size. This is the first report identifying a mitochondrial nucleic acid sequence in malaria-causing organisms and suggests that a functional cytochrome system may exist in these parasites. PMID- 2779561 TI - Characterization of a conserved extrachromosomal element isolated from the avian malarial parasite Plasmodium gallinaceum. AB - We have identified a conserved, repeated, and highly transcribed DNA element from the avian malarial parasite Plasmodium gallinaceum. The element produced multiple transcripts in both zygotes and asexual blood stages of this parasite. It was found to be highly conserved in all of five malarial species tested and hybridized at reduced stringency to other members of the phylum Apicomplexa, including the genera Babesia, Eimeria, Toxoplasma, and Theileria. The copy number of the element was about 15, and it had a circularly permuted restriction map with a repeat unit length of about 6.2 kilobases. It could be separated from the main genomic DNA by using sucrose gradients and agarose gels, and it migrated separately from the recognized Plasmodium chromosomes on pulse-field gels. In the accompanying paper (S. M. Aldritt, J. T. Joseph, and D. F. Wirth, Mol. Cell. Biol. 9:3614-3620, 1989), evidence is presented that element contains the mitochondrial genes for the protein cytochrome b and a fragment of the large rRNA. We postulate that this element is an episome in the mitochondria of the obligate parasites belonging to the phylum Apicomplexa. PMID- 2779563 TI - Translational initiation factor expression and ribosomal protein gene expression are repressed coordinately but by different mechanisms in murine lymphosarcoma cells treated with glucocorticoids. AB - P1798 murine lymphosarcoma cells cease to proliferate upon exposure to 10(-7) M dexamethasone and exhibit a dramatic inhibition of rRNA and ribosomal protein synthesis (O. Meyuhas, E. Thompson, Jr., and R. P. Perry, Mol. Cell Biol. 7:2691 2699, 1987). These workers demonstrated that ribosomal protein synthesis is regulated primarily at the level of translation, since dexamethasone did not alter mRNA levels but shifted the mRNAs from active polysomes into inactive messenger ribonucleoproteins. We have examined the effects of dexamethasone on the biosynthesis of initiation factor proteins in the same cell line. The relative protein synthesis rates of eIF-4A and eIF-2 alpha were inhibited by about 70% by the hormone, a reduction comparable to that for ribosomal proteins. The mRNA levels of eIF-4A, eIF-4D, and eIF-2 alpha also were reduced by 60 to 70%, indicating that synthesis rates are proportional to mRNA concentrations. Analysis of polysome profiles showed that the average number of ribosomes per initiation factor polysome was only slightly reduced by dexamethasone, and little or no mRNA was present in messenger ribonucleoproteins. The results indicate that initiation factor gene expression is coordinately regulated with ribosomal protein synthesis but is controlled primarily by modulating mRNA levels rather than mRNA efficiency. PMID- 2779562 TI - The conserved U.G pair in the 5' splice site duplex of a group I intron is required in the first but not the second step of self-splicing. AB - Group I self-splicing introns have a 5' splice site duplex (P1) that contains a single conserved base pair (U.G). The U is the last nucleotide of the 5' exon, and the G is part of the internal guide sequence within the intron. Using site specific mutagenesis and analysis of the rate and accuracy of splicing of the Tetrahymena thermophila group I intron, we found that both the U and the G of the U.G pair are important for the first step of self-splicing (attack of GTP at the 5' splice site). Mutation of the U to a purine activated cryptic 5' splice sites in which a U.G pair was restored; this result emphasizes the preference for a U.G at the splice site. Nevertheless, some splicing persisted at the normal site after introduction of a purine, suggesting that position within the P1 helix is another determinant of 5' splice site choice. When the U was changed to a C, the accuracy of splicing was not affected, but the Km for GTP was increased by a factor of 15 and the catalytic rate constant was decreased by a factor of 7. Substitution of U.A, U.U, G.G, or A.G for the conserved U.G decreased the rate of splicing by an even greater amount. In contrast, mutation of the conserved G enhanced the second step of splicing, as evidenced by a trans-splicing assay. Furthermore, a free 5' exon ending in A or C instead of the conserved U underwent efficient ligation. Thus, unlike the remainder of the P1 helix, which functions in both the first and second steps of self-splicing, the conserved U.G appears to be important only for the first step. PMID- 2779564 TI - Tse-2: a trans-dominant extinguisher of albumin gene expression in hepatoma hybrid cells. AB - Serum albumin gene expression is generally extinguished in hepatoma x fibroblast hybrids. To define the genetic basis of this phenomenon, we screened a panel of hepatoma hybrids retaining different fibroblast chromosomes for albumin production by immunofluorescence. We report that albumin extinction in these clones was strictly correlated with the retention of mouse chromosome 1. Furthermore, albumin was systematically reexpressed in chromosome 1 segregants. These data define a tissue-specific extinguisher locus (Tse-2) that affects albumin gene expression in trans. Two other liver genes, those encoding liver alcohol dehydrogenase and liv-10, were coordinately extinguished with albumin in monochromosomal hybrids that specifically retained mouse chromosome 1. PMID- 2779565 TI - Repair of a synthetic abasic site in DNA in a Xenopus laevis oocyte extract. AB - Covalently closed circular DNA containing a synthetic analog of an abasic site at a unique position was used as a substrate to study DNA repair. Incubation of this DNA in Xenopus laevis oocyte extracts resulted in rapid cleavage of the DNA at the abasic site by a class II apurinic-apyrimidinic endonuclease, followed by complete repair within 40 min. Nicked circular DNAs persisted for several minutes before repair by an ATP-dependent DNA synthesis reaction. The repair-related DNA synthesis was localized within 3 or 4 nucleotides surrounding the abasic site. These results are consistent with the short-patch repair reported for DNA damage at heterogeneous sites in human cells (J. D. Regan and R. B. Setlow, Cancer Res. 34:3318-3325, 1974). PMID- 2779566 TI - The Xenopus laevis ribosomal gene terminator contains sequences that both enhance and repress ribosomal transcription. AB - A DNA segment approximately 200 base pairs upstream of the Xenopus laevis ribosomal promoter acts both as an upstream promoter element that augments transcription and as a transcription terminator. It is, however, unclear to what extent these two activities are related. A segment of the X. laevis ribosomal DNA, containing the terminator and the upstream promoter element, was subjected to point mutation, and the effects of the resulting mutations were investigated by oocyte microinjection. Analysis of 26 point mutants revealed not only sequences that augment 40S transcription but also those that repress it. The sequences that augmented transcription lay within the T3 homology box and also near the site of 3'-end formation. These sequences also played a role in termination. The sequences that repressed transcription lay within the G+C-rich DNA flanking the T3 box. It can be concluded that termination is probably essential but may not be sufficient for the activity of the upstream promoter element. PMID- 2779567 TI - The chicken skeletal muscle alpha-actin promoter is tissue specific in transgenic mice. AB - We have generated transgenic mouse lines that carry the promoter region of the chicken skeletal muscle alpha (alpha sk) actin gene linked to the bacterial chloramphenicol acetyltransferase (CAT) gene. In adult mice, the pattern of transgene expression resembled that of the endogenous alpha sk actin gene. In most of the transgenic lines, high levels of CAT activity were detected in striated muscle (skeletal and cardiac) but not in the other tissues tested. In striated muscle, transcription of the transgene was initiated at the normal transcriptional start site of the chicken alpha sk actin gene. The region from nucleotides -191 to +27 of the chicken alpha sk actin gene was sufficient to direct the expression of CAT in striated muscle of transgenic mice. These observations suggest that the mechanism of tissue-specific actin gene expression is well conserved in higher vertebrate species. PMID- 2779568 TI - Binding of heat shock proteins to the avian progesterone receptor. AB - The protein composition of the avian progesterone receptor was analyzed by immune isolation of receptor complexes and gel electrophoresis of the isolated proteins. Nonactivated cytosol receptor was isolated in association with the 90-kilodalton (kDa) heat shock protein, hsp90, as has been described previously. A 70-kDa protein was also observed and was shown by Western immunoblotting to react with an antibody specific to the 70-kDa heat shock protein. Thus, two progesterone receptor-associated proteins are identical, or closely related, to heat shock proteins. When the two progesterone receptor species, A and B, were isolated separately in the absence of hormone, both were obtained in association with hsp90 and the 70-kDa protein. However, activated receptor isolated from oviduct nuclear extracts was associated with the 70-kDa protein, but not with hsp90. A hormone-dependent dissociation of hsp90 from the cytosolic form of the receptor complex was observed within the first hour of in vivo progesterone treatment, which could explain the lack of hsp90 in nuclear receptor complexes. In a cell free system, hsp90 binding to receptor was stabilized by molybdate but disrupted by high salt. These treatments, however, did not alter the binding of the 70-kDa protein to receptor. Association of the 70-kDa protein with the receptor could be disrupted by the addition of ATP at elevated temperatures (23 degrees C). The receptor-associated 70-kDa protein is an ATP-binding protein, as demonstrated by its affinity labeling with azido[32P]ATP. These results indicate that the two receptor-associated proteins interact with the progesterone receptor by different mechanisms and that they are likely to affect the structure or function of the receptor in different ways. PMID- 2779569 TI - Sequence and expression of chicken and mouse rsk: homologs of Xenopus laevis ribosomal S6 kinase. AB - We have previously reported the isolation of cDNAs encoding two closely related Xenopus ribosomal S6 kinases, S6KII alpha and -beta (S. W. Jones, E. Erikson, J. Blenis, J. L. Maller, and R. L. Erikson, Proc. Natl. Acad. Sci. USA 85:3377-3381, 1988). We report here the molecular cloning of one chicken and two mouse homologs of the Xenopus laevis cDNAs. As described for the Xenopus proteins, these cDNAs were found to predict polypeptides that contain two distinct kinase domains, of which one is most closely related to the catalytic subunit of cyclic AMP dependent protein kinase and the other is most closely related to the catalytic subunit of phosphorylase b kinase. The three predicted proteins were more than 79% identical to the Xenopus S6KII alpha protein. The chicken and one of the mouse cDNAs were, respectively, 3.7 and 3.1 kilobase pairs in length, predicted proteins of 752 and 724 amino acids with molecular weights of 84.4 and 81.6 kilodaltons, and hybridized to mRNAs in fibroblasts and tissues of approximately 3.6 and 3.4 kilobases (kb). The second mouse cDNA was approximately 6.1 kilobase pairs and was not full length but predicted the C-terminal 633 amino acids of a protein that is similar to the C-terminal portion of Xenopus S6KII alpha. This clone hybridized to mRNA transcripts of 7.6 and 3.4 kb. In vitro transcription and translation of the chicken and the mouse cDNAs that predict complete proteins produced major products with apparent molecular weights of 96 and 84 kilodaltons. Analysis of mRNA levels in chicken tissues showed significant quantities of the 3.6-kb transcript in small and large intestine, spleen, and bursa. Both mouse cDNA were similarly expressed at significant levels in intestine, thymus, and lung; however, the 7.6-kb mRNA was differentially and more highly expressed in heart and brain. The two mouse cDNAs represent two different S6 kinase genes, as shown by comparison of their protein sequences, mRNA transcript sizes, genomic organizations, and nucleic acid sequences. We propose that this family of genes be named rsk, for ribosomal S6 kinase. PMID- 2779570 TI - Unusual levels of heat shock element-binding activity in embryonal carcinoma cells. AB - In contrast to differentiated somatic cells, mouse embryonal carcinoma (EC) cell lines spontaneously express high levels of major members of the heat shock protein (HSP) family. In addition, some EC cell lines (noninducible) are not able to induce HSP gene transcription and HSP synthesis after a stress. However, after in vitro differentiation, constitutive HSP expression decreases and the differentiated derivatives become able to induce HSP gene transcription after a stress. These cells were tested by gel shift assays for the presence of an activity able to bind the heat shock element (HSE) before and after a stress. Control fibroblasts grown at 37 degrees C did not contain significant levels of HSE-binding activity, but heat shock dramatically increased the level of HSE binding activity. In contrast to control fibroblasts, all EC cells contained significant levels of HSE-binding activity at 37 degrees C. In the inducible EC cell line F9, as in fibroblasts, heat shock strongly increased the level of HSE binding activity. In the noninducible EC cells, however, HSE-binding activity markedly decreased upon heat shock. During in vitro differentiation of the noninducible cell line PCC7-S-1009, the constitutive HSE-binding activity found at 37 degrees C disappeared and heat induction of the HSE-binding activity appeared. Therefore, a good correlation exists between the high spontaneous expression of some members of the HSP family and the constitutive level of HSE binding activity in EC cells at 37 degrees C. Heat induction of HSP gene transcription correlates with a strong increase in HSE-binding activity, whereas a deficiency in heat induction of HSP gene transcription is associated with a loss of HSE-binding activity upon heat shock. PMID- 2779571 TI - Three light-inducible heat shock genes of Chlamydomonas reinhardtii. AB - Genomic clones representing three Chlamydomonas reinhardtii genes homologous to the Drosophila hsp70 heat shock gene were isolated. The mRNAs of genes hsp68, hsp70, and hsp80 could be translated in vitro into proteins of Mr 68,000, 70,000, and 80,000, respectively. Transcription of these genes increased dramatically upon heat shock, and the corresponding mRNAs rapidly accumulated, reaching a peak at around 30 min after a shift to the elevated temperature. Light also induced the accumulation of the mRNAs encoded by these heat shock genes. A shift of dark grown cells to light resulted in a drastic increase in mRNA levels, which reached a maximum at around 1 h after the shift. Thus, in Chlamydomonas, expression of hsp70-homologous heat shock genes appears to be regulated by thermal stress and light. PMID- 2779572 TI - In vivo construction of linear vectors based on killer plasmids from Kluyveromyces lactis: selection of a nuclear gene results in attachment of telomeres. AB - Linear vectors based on plasmids pGKL1 and pGKL2 from Kluyveromyces lactis were obtained by in vivo recombination in Saccharomyces cerevisiae and selected for integration of the nuclear LEU2 gene. The linear hybrid molecules obtained had no proteins attached to their 5' ends, as is found for native pGKL plasmids. However, telomere-specific sequences were added to the ends of pGKL1. In contrast to the cytoplasmically localized pGKL plasmids, the newly obtained linear hybrid vectors probably replicate within the nucleus and provide evidence that the nuclear LEU2 gene cannot be expressed in the cytoplasm. PMID- 2779575 TI - Trypanosoma brucei: enrichment by UV of intergenic transcripts from the variable surface glycoprotein gene expression site. AB - The expression site for the variable surface glycoprotein (VSG) gene AnTat 1.3A of Trypanosoma brucei is 45 kilobases long and encompasses seven expression site associated genes (ESAGs) (E. Pays, P. Tebabi, A. Pays, H. Coquelet, P. Revelard, D. Salmon, and M. Steinert, Cell 57:835-845, 1989). After UV irradiation, several large transcripts from the putative promoter region were strongly enriched. We report that one such major transcript starts near the poly(A) addition site of the first gene (ESAG 7), spans the intergenic region, and extends to the poly(A) addition site of the second gene (ESAG 6), thus bypassing the normal 3' splice site of the ESAG 6 mRNA. Since this transcript is spliced, we conclude that UV irradiation does not inhibit splicing but stabilizes unstable processing products. This demonstrates that at least some intergenic regions of the VSG gene expression site are continuously transcribed in accordance with a polycistronic transcription model. PMID- 2779574 TI - Trypanosoma brucei: posttranscriptional control of the variable surface glycoprotein gene expression site. AB - The arrest of variable surface glycoprotein (VSG) synthesis is one of the first events accompanying the differentiation of Trypanosoma brucei bloodstream forms into procyclic forms, which are characteristic of the insect vector. This is because of a very fast inhibition of VSG gene transcription which occurs as soon as the temperature is lowered. We report that this effect is probably not controlled at the level of transcription initiation, since the beginning of the VSG gene expression site, about 45 kilobases upstream from the antigen gene, remains transcribed in procyclic forms. The permanent activity of the promoter readily accounts for the systematic reappearance, upon return to the bloodstream form after cyclical transmission, of the antigen type present before passage to the tsetse fly. The abortive transcription of the VSG gene expression site appears linked to RNA processing abnormalities. Such posttranscriptional controls may allow the modulation of gene expression in a genome organized in large multigenic transcription units. PMID- 2779573 TI - The cyclic nucleotide phosphodiesterase gene of Dictyostelium discoideum utilizes alternate promoters and splicing for the synthesis of multiple mRNAs. AB - The cyclic nucleotide phosphodiesterase (phosphodiesterase) gene plays essential roles in the development of Dictyostelium discoideum during cellular aggregation and postaggregation morphogenesis. Genomic clones spanning the gene were isolated and used to determine the sequence and structure of the phosphodiesterase gene. We found an unusually complex organization for a gene of D. discoideum. Two transcripts of 2.4 and 1.9 kilobases (kb) were synthesized from start sites separated by 1.1 kb. A developmentally regulated promoter was utilized for the 2.4-kb mRNA, and a constitutive promoter regulated synthesis of the 1.9-kb transcript. The gene was found to be divided into four exons that are alternately spliced to give rise to the two mRNAs. The precursor of the 2.4-kb mRNA contained a 2.3-kb intron, whereas the precursor of the constitutive transcript was synthesized with a 1.7-kb intron. The two transcripts contained identical protein coding regions and 400-nucleotide 3' untranslated sequences. The 2.4-kb developmentally regulated mRNA was distinguished by a long 5' untranslated leader of 666 nucleotides. The complex structure of the gene may allow multiple levels of control of the expression of the phosphodiesterase during development. PMID- 2779576 TI - Isolation and characterization of three distinct cDNAs for the chicken c-ski gene. AB - Three types of c-ski cDNAs have been isolated from two different chicken cDNA libraries. Sequence comparisons suggest that the cDNAs derive from alternatively spliced mRNAs. A short stretch of sequence homology that exists between c-ski and avian leukosis virus may have played a role in viral transduction. PMID- 2779577 TI - Cloning and disruption of Ustilago maydis genes. AB - We have demonstrated that genes from Ustilago maydis can be cloned by direct complementation of mutants through the use of genomic libraries made in a high frequency transformation vector. We isolated a gene involved in amino acid biosynthesis as an illustrative example and showed that integrative and one-step disruption methods can be used to create null mutations in the chromosomal copy of the gene by homologous recombination. The results of this investigation make it clear that one-step gene disruption will be of general utility in investigations of U. maydis, since simple, precise replacement of the sequence under study was readily achieved. PMID- 2779578 TI - DNA determinants of structural and regulatory variation within the murine beta glucuronidase gene complex. AB - The murine beta-glucuronidase (GUS) gene complex, [Gus], encompasses the GUS structural element, Gus-s, and a set of regulatory elements which serve to modulate Gus-s expression. Three common GUS haplotypes representing virtually all inbred strains of laboratory mice have been compared with respect to GUS mRNA sequence. Results of such comparisons revealed sequence variations which target the location of one of the GUS regulatory elements to sequences within Gus-s and which account for known electrophoretic and heat stability differences among GUS allozymes of the three common GUS haplotypes. PMID- 2779580 TI - Hormonal regulation of the S14 gene in 3T3-F442A cells. AB - 3T3-F442A cells differentiate from preadipocytes to adipocytes when cultured in medium containing fetal calf serum and insulin. We examined the regulation of the S14 gene in 3T3-F442A preadipocytes and adipocytes to determine whether these cells would be a good in vitro model to define the regulation and function of the S14 protein (17,000 Mr; 4.9 pI). Expression of mRNAs14 (1.12 kilobases) in mouse liver is regulated by both thyroid hormone (T3) and glucocorticoids. Accordingly, we examined the T3 and glucocorticoid regulation of S14 gene expression in 3T3 F442A cells. Neither T3 or the glucocorticoid agonist, dexamethasone (DEX) induced mRNAs14 in 3T3-F442A fibroblasts. While DEX induced mRNAs14 greater than 60-fold in 3T3-F442A adipocytes after a 72-h treatment, T3 was found to have no effect on S14 gene expression in adipocytes. These results indicate: 1) that S14 gene expression is dependent on the differentiation state of 3T3-F442A cells; and 2) that of the two hormones regulating mRNAs14 expression in vivo, only the glucocorticoid regulatory mechanism is operative in 3T3-F442A adipocytes. Characterization of the glucocorticoid-mediated regulation of S14 gene expression showed that DEX induced mRNAs14 significantly within 30 min, but required 72 h of hormone treatment to reach maximal levels of expression. The glucocorticoid mediated increase in mRNAs14 was due to activation of S14 gene transcription. While glucocorticoid analogs induced mRNAs14, mineralocorticoids and sex steroids failed to induce mRNAs14 in adipocytes. These studies suggest that glucocorticoids act directly on the S14 gene through the glucocorticoid receptor to regulate S14 gene expression in 3T3-F442A.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2779581 TI - Evolution of androgen-regulated ornithine decarboxylase expression in mouse kidney. AB - The analysis of naturally occurring variations in hormone-regulated gene expression generates insights into the mechanisms governing evolutionary changes in hormone response. In the mouse (genus Mus), kidney ornithine decarboxylase (ODC) expression, which is regulated by androgens, has been modified during evolution. This has resulted in intra- and interspecies variations that have accumulated over a 10-15 million year time period. We have examined ODC expression and its response to androgens in eight Mus species. Induced ODC levels were found to be similar in six of these species. Two species (M. cookii, M. pahari) contain diminished enzyme levels that are the result of different mechanisms. In M. cookii, the low ODC levels reflect reduced ODC mRNA induction in response to hormone. In M. pahari, on the other hand, the low ODC levels are not derived from altered mRNA concentrations, but appear to be due to translational and/or posttranslational effects. Nuclear run-on assays indicate that ODC mRNA induction is associated with increases in rates of ODC gene transcription. The low ODC mRNA level in induced M. cookii reflects a low rate of ODC gene transcription. Thus, both transcriptional and posttranscriptional mechanisms have contributed to modification of the ODC expression phenotype during evolution. The significance of these findings to the evolution of androgen regulated ODC expression is discussed. PMID- 2779579 TI - The mouse thymidylate synthase promoter: essential elements are in close proximity to the transcriptional initiation sites. AB - The promoter region of the mouse thymidylate synthase gene was analyzed by deletion and site-directed mutagenesis. Elimination of an upstream Sp1 element reduced expression threefold, whereas elimination of an adenovirus upstream stimulatory factor element had little effect. All of the upstream elements that are essential for promoter activity are located within 22 nucleotides of the first transcriptional initiation site. PMID- 2779582 TI - Tissue-specific expression of two alternatively spliced insulin receptor mRNAs in man. AB - Two previously reported insulin receptor cDNA sequences differ by 36 base pairs (bp) in the distal alpha-subunit, suggesting that alternative mRNA splicing within the coding region may occur (two insulin receptor isoforms). We developed a quantitative modification of the polymerase chain reaction technique in order to detect and characterize differential mRNA splicing at this site within the distal alpha-subunit. Using RNA derived from a variety of human cell types, we detected two polymerase chain reaction-amplified cDNA species reflecting the presence or absence of the above 36 nucleotides. Identity of the two cDNA species was confirmed by Southern blots, the use of a BANI restriction site present only in the 36 base pair segment and dideoxy sequencing. The relative expression of the two mRNA forms varied markedly in a tissue-specific manner. Buffy coat leukocytes and Epstein-Barr virus-transformed lymphocytes express only the shorter mRNA. Placenta expresses both species equally; muscle, isolated adipocytes and cultured fibroblasts express somewhat more of the longer mRNA (relative ratios of mRNA abundance of 1.51, 3.18, and 2.77, respectively); liver expresses mostly the longer mRNA (relative ratio of 9.8). In RNA derived from cultured and fresh cells from patients with several states of insulin resistance, the relative expression of the two mRNA species was similar to results obtained with comparable normal tissues. Although the functional significance of alternative splicing of the insulin receptor mRNA is unknown, differential expression of these two receptor mRNAs may provide a structural basis for previously observed tissue-specific differences in insulin binding and action. PMID- 2779583 TI - Expression and estrogen regulation of progesterone receptor mRNA in neurons of the mediobasal hypothalamus: an in situ hybridization study. AB - Diverse effects of steroid hormones on different tissues result from the tissue specific regulation of target gene expression by steroid hormone receptors. These receptors belong to a family of transacting factors that regulate transcriptional activation of target genes by binding to DNA recognition sequences located in the 5'-flanking region of the target gene. In the brain, receptors for the gonadal steroid hormones estrogen (E) and progesterone (P) are present in discrete neuronal populations. These steroid hormone receptor-containing neurons mediate the effects of the gonadal steroids on a number of neural processes, including reproductive behavior. Using in situ hybridization we have found progesterone receptor (PR) mRNA-containing neurons present in specific hypothalamic nuclei and in the amygdala. E regulates PR mRNA levels in specific neuronal cell groups which express both ER and PR (in basomedial hypothalamus), but not in others (medial amygdala). The E-induced increase in P-responsive neurons in ventromedial hypothalamus can account for the permissive influence of E on P-facilitated reproductive behavior. This is the first demonstration that synthesis of a transcription factor (PR) can be related to a mammalian behavior. PMID- 2779584 TI - Characterization of cDNAs for human estradiol 17 beta-dehydrogenase and assignment of the gene to chromosome 17: evidence of two mRNA species with distinct 5'-termini in human placenta. AB - Human placenta estradiol 17 beta-dehydrogenase (E2DH) cDNA clones were isolated from a lambda gt11 expression library by screening with 33 mer synthetic oligonucleotides derived from the amino acid sequence of the catalytic site of E2DH and with polyclonal antibodies raised against the enzyme purified from human placenta. Using 32P-labeled fragments from the coding and 5'-untranslated regions, two mRNA species have been identified in poly(A)+ RNA from human placenta, a major species migrating at 1.3 kilobases (kb) while a minor one is found at 2.2 kb. Primer extension analysis identifies the major mRNA as starting 9-10 nucleotides upstream from the in-frame ATG initiating codon while the longer mRNA has at least 814 noncoding nucleotides at its 5'-terminus. Sequence analysis of the longest cDNA clone (2092 base pairs) shows that this clone possesses identical coding and noncoding sequences in the regions of overlap with the shorter cDNA clones. The 32P-labeled 5'-noncoding fragment hybridized only to the 2.2 kb band, thus providing additional evidence for the existence of two distinct mRNA species which differ only in their 5'-noncoding regions. Using hpE2DH36 cDNA as a probe for in situ hybridization, the human E2DH gene was localized to the q11-q12 region of chromosome 17. The cloned cDNAs encode E2DH, a 327-amino acid protein having a calculated molecular weight of 34,853. Since E2DH is the enzyme required for the formation of 17 beta-estradiol, the availability of the cDNA encoding the enzyme should permit a detailed investigation of the factors regulating the expression and activity of this crucial enzyme, in both normal and malignant tissues, especially breast cancer. PMID- 2779585 TI - Full length cDNA structure and deduced amino acid sequence of human 3 beta hydroxy-5-ene steroid dehydrogenase. AB - Polyclonal antibodies raised against 3 beta-hydroxysteroid dehydrogenase isolated from human placenta were used to screen a lambda gt11 expression cDNA library from the same tissue. The protein deduced from cDNA sequences contains 372 amino acids with a calculated mol wt of 42,216. Since 3 beta-hydroxysteroid dehydrogenase is the enzyme catalyzing the formation of all classes of hormonal steroids, the availability of the cDNA encoding this enzyme opens new possibilities for a detailed investigation of the factors regulating the expression and activity of this crucial enzyme in adrenal, gonadal as well as peripheral tissues. PMID- 2779586 TI - Similar binding properties of peptide ligands for a human immunoglobulin and its light chain dimer. AB - The urinary light chain dimer and serum monoclonal IgG1 protein from a patient (Mcg) with multiple myeloma and amyloidosis were systematically tested for their binding activities to peptides presented on solid supports. The system was validated using a series of enkephalins, beta-casomorphins and DNP-lysine derivatives which were known to complex with the dimer. Sets of peptide ligands binding to the proteins were constructed by incremental additions of amino acid residues to minimal binding units [Geysen et al., J. Immun. Meth. 102, 259-274 (1987)]. Both the amino acid sequences and the combinations of optical isomers were optimized at each stage of the syntheses. Binding could be demonstrated for ligands ranging in size from a tethered single amino acid to pentapeptides. At the dipeptide levels, the dimer and the IgG1 protein showed different preferences (Hp versus qf, where lower case letters designate D-amino acid residues). However, in a tetrapeptide ligand (qfHp) for the dimer, both of these initial preferences had converged. With few exceptions, the IgG1 molecule showed binding activity for the ligands developed for the dimer. Two sets of selected peptides, one based on Hp and the other on mW, were synthesized for diffusion into crystals of the dimer. X-ray analyses showed that these peptides bound exclusively in the main binding cavity between the "variable" domains of the dimer. As predicted from the ELISA results with tethered ligands, the relative occupancies in the crystals followed the order of tetrapeptide greater than tripeptide much greater than dipeptide. The crystallographic studies confirmed that peptides with very different sequences can bind in the same cavity. PMID- 2779587 TI - Enhancement of the phosphorylation of membrane bound myosin light chain by antigen stimulation in rat basophilic leukemia cells. AB - We have found that phosphorylation of the 18,000 mol. wt protein in rat basophilic leukemia cells (RBL-2H3 cells) is enhanced by stimulation by an antigen. This phenomenon was also observed when cells were treated with phorbol myristate (TPA) and a calcium ionophor, A23187. The phosphorylated 18,000 mol. wt protein was mainly located in the membrane fraction. It was identified as one of the myosin light chains as follows: (1) the mol. wt of one of the major myosin light chains of RBL-2H3 cells was 18,000; (2) more than half of the phosphorylated 18,000 mol. wt protein was recovered in an actomyosin fraction; (3) this phosphorylated 18,000 mol. wt protein was immunoprecipitated with anti myosin antibody. Since the presence of Ca2+ in the cell culture medium was essential for the phosphorylation of the 18,000 mol. wt protein and, since trifluoperazine (a potent inhibitor of calmodulin as well as of the degranulation process of RBL-2H3 cells) inhibited the reaction, the phosphorylation may be catalyzed by a Ca2+-calmodulin-dependent process, most likely by myosin light chain kinase. These results, together with our previous observation [Teshima et al. Molec Immun. 23, 279-284 (1986)], suggest that simultaneous phosphorylation of the 18,000 mol. wt myosin light chain and a 36,000 mol. wt membranous protein is a prerequisite for the degranulation of RBL-2H3 cells. PMID- 2779588 TI - Structural relationship between the soluble and membrane-bound forms of human monocyte surface glycoprotein CD14. AB - The carboxy-terminal amino acid sequence of the soluble form of the 53,000 mol. wt monocyte surface antigen, CD14, was determined by carboxypeptidase Y digestion and compared with the complete amino acid sequence of this protein as predicted from the structure of cloned cDNA [Goyert et al. Science 239, 497-500 (1988)]. The soluble antigen isolated from urine appears to lack eight C-terminal amino acid residues predicted for the full-size translation product, but possesses a major part of the C-terminal hydrophobic domain originally suggested as the membrane-spanning segment. The CD14 antigen can be removed from the monocyte surface by phosphatidylinositol-specific phospholipase C treatment, indicating that this glycoprotein is anchored in the membrane by a phospholipid and is not a transmembrane protein. The soluble form occurring in serum and in supernatants of cultured monocytes thus probably arises by phospholipase-mediated cleaving off the cell surface antigen. A sensitive sandwich ELISA was developed using a monoclonal anti-CD14 antibody, MEM-18, and polyclonal rabbit anti-CD14 antiserum for quantitation of the soluble antigen concns in sera and cell culture supernatants. Using this assay, the antigen present in the supernatant of phospholipase treated peripheral blood mononuclear cells could be estimated. The assay was also used for estimation of the concns of the soluble form of the CD14 antigen in human sera. PMID- 2779589 TI - Two forms of guinea pig factor B of the alternative complement pathway with different molecular weights. AB - Two forms of guinea pig factor B (B) of the alternative complement pathway with different mol. wts (Mr) have been isolated from plasma and characterized. The Mr of the two B species, tentatively termed B1 and B2, were estimated to be about 100,000 and 96,000, respectively, as determined by sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE). Incubation of B with guinea pig C3 and human factor D (D) in the presence of Mg2+ generated two cleavage fragments of B, namely Ba and Bb. Although the Bb fragments showed the same migration corresponding to an Mr of 62,000, Ba fragments showed different mobilities corresponding to an Mr of 38,000 from B1 and 34,000 from B2. Digestion of B1-Ba, the Ba fragment derived from B1, and B2-Ba, the Ba fragment derived from B2, with endoglycosidase F resulted in a band at Mr 30,000 on an SDS-PAGE in both cases, indicating a difference in structure of the asparagine-linked oligosaccharide moiety in B1-Ba and B2-Ba. No difference in antigenicity was noted between B1 and B2 on immunodiffusion with anti-B sera. Immunoblotting analysis showed that all individual Hartley guinea pigs examined in this study possessed both B1 and B2 at similar levels, as determined by the intensity of staining of their sera. Furthermore, treatment of their serum with zymosan led to the generation of two Ba species corresponding to the Ba fragments from B1 and B2. The capacity to form C3/C5 convertase, as determined by hemolytic assay, was found to be similar between B1 and B2. Furthermore, kinetics of the decay of C3 convertase showed the same half-life of 3.0 min at 30 degrees C. The NH2-terminal amino acid sequences of B1 and B2 and their Bb fragments were determined and found to be identical. PMID- 2779590 TI - Effects of etybenzatropine and diazepam on levodopa-induced diphasic dyskinesias in Parkinson's disease. AB - Levodopa-induced onset and end-of-dose dyskinesia are rare but disabling disorders. Although they can be attenuated by increasing and dividing the daily dose of levodopa, this does not constitute a therapeutic approach. In this pilot study, etybenzatropine, an anticholinergic drug, and diazepam, a selective benzodiazepine, were administered in addition to a single dose of levodopa in nine patients with Parkinson's disease. Both drugs tended to decrease the severity and the duration of onset and end-of-dose dyskinesia and to increase the duration of action of levodopa on parkinsonian symptoms. PMID- 2779591 TI - Treatment of movement disorders with trihexyphenidyl. AB - The clinical efficacy of the trihexyphenidyl was investigated in 100 patients with movement disorders. The study group consisted of 54 women and 46 men. Their ages ranged from 18 to 70 years, and their duration of illness varied from a few months to 36 years. Each patient had a videotape of the movements and a neurological examination, before administration of the drug, at the time of maximum or effective dosage, and one week after withdrawal from trihexyphenidyl. The drug was administered at an initial total daily dose of 2 mg and gradually increased to a total daily dose of 60 mg over a period of 4-6 weeks. Improvements were rated both clinically and from the videotapes. Three groups of movement disorders demonstrated a significant response to trihexyphenidyl: (1) dystonia 37%; tonic torticollis demonstrated a significantly better response than the clonic variant (80% vs. 22%). (2) rhythmic-oscillatory movements of brainstem cerebellar origin (palatal myoclonus, pendular nystagmus, facial myokymia) 90%; (3) cerebellar tremor 75%. Among 32 responders, 17 (56%) continued taking trihexyphenidyl beyond 24 months. Side effects consisted of dryness of the mouth, jitteriness, stomatitis, blurred vision, and forgetfulness. PMID- 2779592 TI - Familial hemifacial spasm. AB - We present a family in which hemifacial spasm involving in all cases the left side of the face occurred in five persons in three generations. Blink reflexes recorded in two cases demonstrated an unexpected R1 component on the affected side during stimulation of the contralateral side. PMID- 2779593 TI - The sz mutant hamster: a genetic model of epilepsy or of paroxysmal dystonia? AB - Attacks of sustained dystonic postures of limbs and trunk can be initiated by mild environmental stimuli in an inbred line of Syrian hamsters. The trait is determined by an autosomal simple recessive genetic mutation, originally designated by the gene symbol sz, because the abnormal movements were thought to represent epileptic seizures. The attacks, which can be reproducibly initiated by placing the sz mutant hamsters in a new environment, begin with rapid twitches of the vibrissae, flattened ears, and flattened posture of the trunk while walking, followed by facial contortions, rearing, and sustained posturing of trunk and limbs, often resulting in falling over to the side or backwards. In the final stage, the hamsters became immobile, which can last for hours. An increased tone of limbs and trunk muscles can be palpated during the attack. Electromyographical recordings in awake, unrestrained mutant hamsters showed that the onset of the attack coincided with continuous tonic muscle activity and phasic bursts, which were present even when the animals did not move. During the attack, the animals continue to react to external stimuli. Bilateral electroencephalographic (EEG) recordings before and during motor disturbances in sz mutant hamsters showed no abnormalities. The severity of the dystonic syndrome in hamsters is age dependent with a peak at about 30-40 days of age. A score system for grading type and severity of dystonic attack was developed for use in drug activity studies. The severity of the attack was reduced or attacks were completely prevented by diazepam (1-2.5 mg/kg i.p.) and valproic acid (100-400 mg/kg i.p.) in a dose dependent fashion. The latency to dystonic movements was significantly increased by diazepam but markedly reduced by subconvulsive doses of pentylenetetrazol (40 mg/kg s.c.). Diazepam antagonized the latency-reducing action of pentylenetetrazol in the hamsters. The pathophysiology and pharmacological sensitivity of the dystonic attacks in these animals remain to be further clarified, but the data indicate that the sz mutant hamsters might represent an interesting genetic model for paroxysmal dystonia. In view of these data, we propose that the hamster mutation should be re-named dystonic and that the new gene symbol should be designated dtsz. PMID- 2779595 TI - Lower body parkinsonism: evidence for vascular etiology. AB - We studied 10 patients with marked gait difficulty and no or only minimal upper limb involvement, defined here as lower body parkinsonism (LBP). They were compared to a control group of 100 patients with otherwise typical Parkinson's disease (PD). Both groups were of comparable age, but the mean duration of symptoms was significantly shorter in the LBP group (2.6 +/- 1.5 years versus 7.5 +/- 4.9 years). Gait disturbance was the initial symptom in 90% of LBP patients, as opposed to 7% of controls. Hypertension was present in 70% of LBP patients, and only 22% responded to levodopa. In contrast, only 21% of controls had a history of hypertension, and 96% improved with levodopa. We conclude that these 10 LBP patients constitute a homogenous group, distinct from typical PD. Besides their disproportionate gait disturbance, they are distinguished from PD patients by more rapid progression, higher incidence of hypertension, and a poor response to levodopa. Ischemic etiology for LBP is supported by abnormal neuroimaging studies. PMID- 2779594 TI - Stability of the head in pitch (neck flexion-extension): studies in normal subjects and patients with axial rigidity. AB - The dynamic stability of the head in pitch during normal upright posture has been studied in normal subjects and patients with neurological disease affecting neck muscle tone by examining angular head acceleration responses to unpredictable linear motion of the trunk in the direction of surge. Within the frequency range of natural head movements the transfer function between head and trunk for both normal subjects and patients approximated a second-order linear differential equation involving inertia and coefficients of viscosity and elasticity. The degree of neck rigidity was determined by the damping ratio (viscosity:elasticity), which averaged .35 for normal subjects and ranged from 0.6 to 0.96 for patients with rigid syndromes. A patient with absent labyrinthine function and a "floppy" head had a damping ratio 0.18. The technique gives a numerical measurement of neck rigidity, which could be of value in characterising severity of disorder and response to therapy. PMID- 2779597 TI - Cerebral sarcoidosis presenting as supranuclear gaze palsy with hypokinetic rigid syndrome. AB - A 31-year-old man with histologically documented pulmonary sarcoidosis developed a severe hypokinetic rigid syndrome with a supranuclear gaze palsy following recurrent lymphocytic meningitis and occlusive hydrocephalus. Magnetic resonance imaging (MRI) showed multiple hyperintense foci in the CNS, not detectable by computed tomography (CT). Long-term steroid therapy led to clinical complete remission. PMID- 2779596 TI - Hemichorea-hemiballismus associated with acquired immune deficiency syndrome and cerebral toxoplasmosis. AB - A young woman had hemichorea-hemiballismus subsequently found to be secondary to a cerebral toxoplasmosis infection complicating human immunodeficiency virus infection. This patient had the sixth reported case of acquired immune deficiency syndrome (AIDS) with hemichorea-hemiballismus, and each has been secondary to cerebral toxoplasmosis. The presence of hemichorea-hemiballismus in a young patient should suggest a diagnosis of AIDS and in particular the diagnosis of secondary cerebral toxoplasmosis. Other movement disorders that occur in AIDS are discussed. PMID- 2779598 TI - Sixth International Workshop on Natural Killer Cells. Goslar, FRG, July 26-29, 1989. Abstracts. PMID- 2779600 TI - Neuraminidases and hemagglutinins of influenza viruses augment cell-mediated cytotoxicity by activating NK cells. PMID- 2779599 TI - Persistently low natural killer cell activity in normal adults: immunological, hormonal and mood correlates. AB - This current study is concerned with the identification of the incidence of persistently low natural killer (NK) cell activity in an essentially healthy population of young adults, and the characterization of the psychological profile associated with this pattern of NK activity. Eighty-eight individuals, between the ages of 18 and 44 years, were accrued to this project. Subjects were tested serially, at baseline induction into the study, and at 2 and 4 weeks follow-up. Baseline assessment included a complete physical examination and laboratory work up in order to exclude anyone ill at the time of enrollment, and to have complete physical status information on all subjects at the time of accrual. NK activity, urinary catecholamine levels and psychological status were also assessed at baseline, and at the specified follow-up intervals. Individuals with low NK activity were operationally defined as those having NK function either below the group mean, or below the group lowest quartile, at baseline and at two follow-up assessments. Results showed that in both univariate analyses, as well as in logistic regression models, age and the perception of environmental stressors or 'hassles' predicted persistently low NK activity. Younger subjects, who perceived environmental events to which they were exposed as more serious in nature, were more likely to exhibit a persistently low NK profile over time than older individuals who perceived daily events as less important to them. PMID- 2779601 TI - Single-fiber EMG study of the flexor carpi radialis H reflex. AB - Late responses were studied in the flexor carpi radialis muscle by surface recording and single-fiber electromyography. By single-fiber studies we were able to distinguish 2 distinct components. One was an H reflex obtained without a preceding M response and with a stimulus response jitter of about 100 musec; its latency was shortened and jitter decreased with the Jendrassik maneuver. The other was an F wave always preceded by an M response and with a stimulus response jitter of under 50 musec; its jitter and latency are unaffected by the Jendrassik maneuver. At the single-fiber level it was possible to determine the rate of occurrence of individual H reflexes and F responses for a given number of surface applied stimuli. The H reflex had a very high rate of occurrence (up to 97%), whereas the F wave occurred very infrequently (less than 2% of the time). Using the H reflex rate of occurrence in conjunction with the maximal surface H/M amplitude ratios allowed us to determine the proportion of alpha motor neurons which participate in the H-reflex generation. The study of H-reflex jitter gives an estimate of the central synaptic jitter and effectiveness of the spatial and temporal summation of type 1a fiber inputs on the motor neurons. PMID- 2779602 TI - Accumulation of collagen and altered fiber-type ratios as indicators of abnormal muscle gene expression in the mdx dystrophic mouse. AB - The growth and development of the X-linked muscular dystrophy mutant mouse (mdx) was compared with a control group from 3 weeks to 1 year old. Quantitative cytological analysis of the soleus muscle revealed cycles of degeneration, regeneration, and hypertrophy, and at any one time it was difficult to assess the extent of the disease based on muscle fiber size. One noticeable difference even in the youngest muscles studied was the reduced numbers of slow oxidative fibers and the increased number of fast glycolytic fibers in the mdx soleus muscles. The collagen of the connective tissue components of selectively stained sections was determined by computerized image analysis. Marked accumulation of collagen was found in both the endomysium and perimysium of the dystrophic muscles as compared with age-matched controls. Since the mdx mouse is a result of the same type of genetic defect as in human Duchenne muscular dystrophy, this model could thus be used to assess the effectiveness of various therapeutic approaches, including gene therapy using muscle fibrosis and fiber type proportions as the indicators. PMID- 2779603 TI - SSEP and F-wave studies in acute inflammatory demyelinating polyradiculoneuropathy. AB - Somatosensory evoked potentials (SSEPs) and F-wave responses were compared after tibial (PTN) and median (MN) nerve stimulation in patients with acute inflammatory demyelinating polyradiculoneuropathy (AIDP). Nineteen patients were evaluated within 2 weeks of AIDP onset. Each had F-wave and PTN-SSEP studies; 18 had MN-SSEP studies. Ten patients had absent or prolonged MN-SSEP latencies, whereas 16 had abnormal MN F-wave studies. Seventeen patients had an abnormal PTN SSEP while 12 had abnormal PTN F waves. Every patient with an abnormal MN-SSEP also had an abnormal PTN-SSEP. The most common PTN-SSEP findings were an absent or prolonged latency of N8 or N22. All patients had either an abnormal MN F wave or PTN-SSEP. PMID- 2779604 TI - Effect of motor unit firing pattern on twitches obtained by spike-triggered averaging. AB - The spike-triggered averaging technique (STA) was used to determine the twitch profile of single motor units in human masseter during a voluntary isometric contraction. The effect of the immediate firing pattern of the unit on the twitch was assessed with a computer program which scanned the unit discharge records and selected valid trigger spikes for the averager on the basis of the interspike intervals preceding and following the trigger spike. Successive averages from the same data using different interval parameters revealed progressively more fusion of twitches as the instantaneous firing rate increased. When the data were averaged with interval parameters similar to those used in earlier studies, some fusion of the twitch profile was also evident. It is therefore likely that the degree of fusion of human motor unit twitches obtained by STA has been underestimated in the past. It is further concluded that masseter motor units are sufficiently fast-contracting to allow a relatively unfused twitch profile to be obtained with STA, provided trigger spikes are subjected to appropriate rate control. PMID- 2779605 TI - Autosomal recessive motor and sensory neuropathy with excessive myelin outfolding. AB - Two Japanese persons with consanguinous parents had a motor and sensory neuropathy of the hypertrophic type with excessive myelin outfolding in the myelinated fibers. A morphometric analysis of the biopsied sural nerve was made. Excessive myelin outfolding, segmental demyelination, and remyelination and decrease in the density of both large and small myelinated fibers were evident. Using linear regression, myelin spiral length was shorter relative to axonal area. These patients may have a new variant of hereditary motor sensory neuropathy. PMID- 2779606 TI - Optimal stimulus duration for the H reflex. AB - Authorities advocate different stimulus durations to produce an H reflex. In order to find the optimal stimulus duration for recording H reflexes, the recruitment curves for H reflexes and M responses were studied in 10 healthy subjects. The H reflex was recorded in the upper and lower extremities, and the durations of the electrical stimulus used ranged from 0.1 to 3 msec. The amplitude of the H reflex and the relation between the H reflex and M response changed with stimulus duration. H reflexes are brought out to advantage using a stimulus duration between 0.5 and 1 msec. PMID- 2779607 TI - Preferential activation of muscle fibers with peripheral magnetic stimulation of the limb. AB - Magnetic and electric activation of limb nerve and muscle were compared in normal subjects of different age, gender, and habitus. Direct stimulation of nerve and muscle showed that activation of intramuscular nerve fibers in the arm and leg occurs at a lower threshold for magnetic stimulation than for electric stimulation. Sensory nerve fibers had a lower threshold with electric stimulation. Muscle activation and stimulus artifact with magnetic stimulation precluded reliable recording of distal sensory nerve action potential in all subjects. PMID- 2779608 TI - HIV-associated CIDP. PMID- 2779609 TI - Spatial distribution of fiber types in skeletal muscle: test for a random distribution. PMID- 2779610 TI - Distribution of keratinophilic fungi in desert soil of Kuwait. AB - Forty soil samples from different desert localities in Kuwait were surveyed for keratinophilic and geophilic dermatophytic fungi. Sixteen species classified in 9 genera were recovered on wool baits. Chrysosporium species were the most common fungi: Chr. tropicum (60%), Chr. pannicola (32.5%), Chr. queenslandicum (27.5%), Chr. keratinophilum (25%), Chr. indicum (20%) and the Chrysosporium anamorph of Arthroderma cuniculi. The second dominant genus was Malbranchea (27%) represented by two species; followed by Myceliophthora (10%). A number of cleistothecial keratinophilic species were also reported in restricted areas. Ctenomyces serratus Eidam and its Myceliophthora anamorph were new records to Kuwait. The frequency and distribution of these fungi have been discussed in relation to ecological conditions of desert soils. PMID- 2779611 TI - [The dependence of the physiological properties of Trichophyton mentagrophytes on the pH value of the culture medium]. AB - The growth, the amino acid degradation in the medium and the incorporation of amino acid nitrogen as a function of the pH-value were studied. At a higher pH value, the growth and metabolism accelerate. During the growth, the pH-value of the medium temporarily increases. The results obtained will provide new possibilities for therapy and prophylaxis of dermatophytoses. PMID- 2779612 TI - Comparison of ketoconazole suspension and nystatin in the treatment of newborns and infants with oral candidosis. AB - Ketoconazole suspension (20 mg per ml) was compared with nystatin (100,000 units per ml) in the treatment of oral candidosis in newborns and infants. In all patients Candida infection was proven by culture. Twenty patients were treated with ketoconazole and 15 patients with nystatin. Treatment was discontinued 2 days after clinical cure, or after 3 weeks. The investigator assessed the severity of the thrush and accompanying symptoms at the start of the study and at weekly controls. After one week all 20 patients on ketoconazole (100%) and 8 (53%) patients on nystatin were cured clinically. At the end of the treatment 12 patients on nystatin (80%) were cured. Clinical cure was confirmed by negative culture in 94% of the patients on ketoconazole and in 73% of the patients on nystatin. No side-effects were observed in the patients on ketoconazole. Only in the case of one patient on nystatin, was vomiting observed. This study shows that ketoconazole cures thrush faster and more effectively than nystatin. PMID- 2779613 TI - Susceptibility of Candida species to cilofungin (LY-121019). AB - The antifungal activity of a new semi-synthetic lipopeptide named cilofungin (LY 121019) was studied in vitro on 102 strains of Candida and Torulopsis glabrata. A standardized protocol for susceptibility testing by means of a microtiter Sabouraud broth dilution was used. The minimal inhibitory concentrations of cilofungin for C. albicans (N = 50) ranged from 0.039 to 5.0 micrograms/ml with a geometric mean of 0.47 micrograms/ml. The same results were obtained with C. tropicalis but one strain showed higher resistance (40 micrograms/ml) suggesting an Eagle effect. The MIC for T. glabrata ranged from 5.0-40.0 micrograms/ml. C. parapsilosis and C. krusei were less susceptible (5.0-40.0 micrograms/ml). These results indicate that cilofungin exhibits a potent inhibitory action on C. albicans and C. tropicalis. This effect was lower against the other species of Candida and T. glabrata studied. PMID- 2779614 TI - The effect of cigarette smoking on neutrophil kinetics in human lungs. AB - Neutrophils may play a part in the pathogenesis of the centrilobular emphysema associated with cigarette smoking. The capillary bed of the lungs concentrates neutrophils approximately 100-fold with respect to erythrocytes, producing a large pool of marginated cells. We examined the effect of cigarette smoking on the kinetics of this pool of cells, using 99mTc-labeled erythrocytes to measure regional blood velocity and 111In-labeled neutrophils to measure the removal of neutrophils during the first passage through the pulmonary circulation, their subsequent washout from the lungs, and the effect of local blood velocity on the number of neutrophils retained in each lung region. We observed no difference in these measurements between subjects who had never smoked (n = 6) and smokers who did not smoke during the study (n = 12). However, subjects who did smoke during the study (n = 12) had a significantly slower rate of washout of radiolabeled neutrophils from the lung (0.08 +/- 0.04 of the total per minute, as compared with 0.13 +/- 0.06 in smokers who did not smoke during the experiment and 0.14 +/ 0.08 in non-smokers) (P = 0.02). We also observed an increase in the regional retention of labeled neutrophils with respect to blood velocity in 5 of the 12 subjects who smoked during the study, but in none of the other subjects. We conclude that the presence of cigarette smoke in the lungs of some subjects increases the local concentration of neutrophils, and suggest that the lesions that characterize emphysema may be a result of the destruction of lung tissue by neutrophils that remain within pulmonary microvessels. PMID- 2779615 TI - 111In-labeled nonspecific immunoglobulin scanning in the detection of focal infection. AB - We performed radionuclide scanning after the intravenous injection of human IgG labeled with indium-111 in 128 patients with suspected focal sites of inflammation. Localization of 111In-labeled IgG correlated with clinical findings in 51 infected patients (21 with abdominal or pelvic infections, 11 with intravascular infections, 7 with pulmonary infections, and 12 with skeletal infections). Infecting organisms included gram-positive bacteria, gram-negative bacteria, Pneumocystis carinii, Mycoplasma pneumoniae, and Candida albicans. No focal localization of 111In-labeled IgG was observed in 63 patients without infection. There were five false negative results, and nine results were unusable. Serial scans were carried out in eight patients: continued localization correctly predicted relapse in six, and the absence of localization indicated resolution in two. To determine whether 111In-labeled IgG localization was specific for inflammation, we studied 16 patients with cancer. Focal localization occurred in 13 of these patients (5 with melanomas, 5 with gynecologic cancers, and 1 each with lymphoma, prostate cancer, and malignant fibrous histiocytoma). No localization was seen in patients with renal or colon cancer or metastatic medullary carcinoma of the thyroid. We conclude that 111In-labeled IgG imaging is effective for the detection of focal infection and that serial scans may be useful in assessing therapeutic efficacy. This technique may also be helpful in the evaluation of certain cancers. PMID- 2779616 TI - Exposure of patients to human immunodeficiency virus through the transfusion of blood components that test antibody-negative. AB - The risk of transmission of the human immunodeficiency virus to recipients of blood transfusions exists chiefly during the period between the time a donor is infected and the time he or she has a positive blood test for HIV antibodies. Estimating the chance that blood will be donated during this period is an effective way to define the risk of HIV infection from transfusion. Using this approach, and employing data from over 17 million American Red Cross blood donations, we estimate that during 1987 the most likely number of units of blood infected with undetected HIV that were transfused was 131 (range, 67 to 227). For a patient, the odds of contracting HIV infection were 1:153,000 per unit transfused. A patient who received the average transfusion (5.4 units) had odds of 1:28,000. The risk has been decreasing by more than 30 percent a year. We estimate that donor-recruitment practices plus careful education and screening are eliminating 49 of every 50 donors likely to be HIV-positive and that testing is 92 to 97 percent effective, for a combined effectiveness of 99.9 percent. The risk of undetected infectious units can probably be further reduced by transfusing fewer units and units from fewer donors, recruiting more women and fewer men as new donors, and encouraging more frequent donations from donors who have been tested repeatedly. PMID- 2779617 TI - The natural history of transfusion-associated infection with human immunodeficiency virus. Factors influencing the rate of progression to disease. AB - Patients infected by the human immunodeficiency virus (HIV) as a result of blood transfusions are unique in that their dates of infection are well defined and their medical conditions before infection are known. To characterize the natural history of transfusion-associated HIV infection, we studied 694 recipients of blood from 112 donors in whom AIDS later developed and from 31 donors later found to be positive for HIV antibody. Of the recipients tested, 85 were seronegative, 116 were seropositive, and 19 had AIDS. Of 101 HIV-seropositive recipients followed for a median of 55 months after infection, 54 had Centers for Disease Control Class IV disease, including 43 with AIDS. Life-table analysis suggested that AIDS will develop in 49 percent of infected recipients (95 percent confidence limits, 36 to 62 percent) within seven years after infection. As compared with recipients without AIDS, the 43 recipients with AIDS had received more transfusions at the time of infection (median, 21 vs. 7; P = 0.01). HIV infected blood donors in whom AIDS developed were grouped according to whether AIDS developed within 29 months (the median) after donation (Group 1) or 29 or more months after donation (Group 2). As compared with the 31 recipients of blood from Group 2 blood donors, the 31 recipients of blood from Group 1 donors were more likely to have AIDS four years after infection (49 percent vs. 4 percent; P = 0.005) and illnesses resembling acute retroviral syndrome (14 of 24 vs. 5 of 22; P = 0.03). We conclude that most recipients of HIV-infected blood become seropositive, that AIDS develops in about half these recipients within seven years, and that the risk may be higher when AIDS develops in the blood donor soon after donation. PMID- 2779618 TI - Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 40-1989. A 40-year-old man with headache, fever, rash, and thrombocytopenia after a Caribbean trip. PMID- 2779619 TI - The decreasing risk of transfusion-associated AIDS. PMID- 2779620 TI - Neutrophils and emphysema. PMID- 2779621 TI - Training basic scientists to bridge the gap between basic science and its application to human disease. PMID- 2779622 TI - Prevalence of HIV antibody among blood donors in California. PMID- 2779623 TI - The physician's responsibility toward hopelessly ill patients. PMID- 2779624 TI - Use of penicillamine in children with small lead burdens. PMID- 2779625 TI - Diagnosing the health care crisis. PMID- 2779626 TI - Dangers of the Heimlich maneuver for esophageal obstruction. PMID- 2779627 TI - The cardinal manifestations of Bardet-Biedl syndrome, a form of Laurence-Moon Biedl syndrome. AB - To determine the interfamilial and intrafamilial variation in the expression of the Bardet-Biedl syndrome (a form of Laurence-Moon-Biedl syndrome), we looked for the five recognized features of the disorder (retinal dystrophy, obesity, polydactyly, mental retardation, and hypogonadism), plus possible renal manifestations, in some or all of 32 patients with this disorder. All 28 patients examined had severe retinal dystrophy, but only 2 had typical retinitis pigmentosa. Polydactyly was present in 18 of 31 patients, but syndactyly, brachydactyly, or both were present in all. Obesity was present in all but 1 of 25 patients. Only 13 of 32 patients were considered mentally retarded. Scores on verbal subtests of intelligence were usually lower than scores on performance tasks. Seven of eight men had small testes and genitalia, which was not due to hypogonadotropism. All 12 women studied had menstrual irregularities, and 3 had low serum estrogen levels (1 of these had hypogonadotropism, and 2 had primary gonadal failure). The remaining women who were of reproductive age had endocrinologic evidence of reproductive dysfunction. Diabetes mellitus was present in 9 of 20 patients. Renal structural or functional abnormalities were universal (n = 21), and three patients had end-stage renal failure. We conclude that the characteristic features of Bardet-Biedl syndrome are severe retinal dystrophy, dysmorphic extremities, obesity, renal abnormalities, and (in male patients only) hypogenitalism. Mental retardation, polydactyly, and hypogonadism in female patients are not necessarily present. PMID- 2779628 TI - Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 41-1989. A 65-year-old man with fever, bullae, erythema, and edema of the leg after wading in brackish water. PMID- 2779629 TI - Radiologic contributions to the investigation of fatal infant abuse. PMID- 2779630 TI - Screening and treatment of chlamydial infections. PMID- 2779631 TI - Effects of alcoholism on muscle. PMID- 2779632 TI - Risk groups among patients with mitral-valve prolapse. PMID- 2779633 TI - In vitro fertilization: how much is enough? PMID- 2779634 TI - Laron dwarfism and mutations of the growth hormone-receptor gene. AB - Laron dwarfism is associated with resistance to growth hormone (GH). To investigate its genetic basis, we used genetic linkage to test whether the disorder results from a defect in the gene for the human GH receptor. Denaturing gradient gel electrophoresis and sequencing of specific GH-receptor-gene fragments allowed us to characterize specific intragenic DNA markers in 35 control subjects of Mediterranean descent, for use in linkage studies. In two Mediterranean families in which the parents were consanguineous and some of the children had Laron dwarfism, the disease trait and DNA polymorphisms were inherited together. Moreover, an analysis of the GH-receptor-gene RNA transcripts in lymphocytes from one of these families allowed us to identify a thymidine-to cytosine substitution that generated a serine in place of a phenylalanine at position 96 in the extracellular coding domain of the mature protein. This defect probably affects the receptor adversely and is probably responsible for the lack of plasma GH-binding activity in the patients. This mutation was not found in the GH-receptor genomic sequences of seven unrelated subjects with Laron dwarfism who belonged to different population groups. An analysis of the GH-receptor markers in these patients indicated that different gene frameworks (polymorphic sites within the single gene) were associated with the mutant alleles. We conclude that Laron dwarfism is due to abnormalities in the gene for GH receptor, which may differ from family to family. PMID- 2779635 TI - Le Fort III osteotomy. PMID- 2779637 TI - Maximising resources. PMID- 2779636 TI - Project 2000--are there implications for theatres? PMID- 2779638 TI - Carcinoid tumours and the role of Sandostatin. PMID- 2779639 TI - Non-nursing duties in theatre. A need for research? PMID- 2779640 TI - Sugioka osteotomy--a turn for the better. PMID- 2779641 TI - A short but informative guide to survival for student and pupil nurses during their theatre allocation. PMID- 2779642 TI - The best incentive? PMID- 2779643 TI - Reasonable doubt. PMID- 2779644 TI - Cystic fibrosis: steady steps lead to the gene. PMID- 2779645 TI - Cystic fibrosis: protein joins transport family. PMID- 2779646 TI - Lipoprotein-remnant receptors: second receptor verified? PMID- 2779647 TI - Natural killer cells: a primitive immune system. PMID- 2779648 TI - Bamboo flowering and pandas. PMID- 2779649 TI - Basis of hepatitis delta virus disease? PMID- 2779650 TI - Lateral preference and longevity. PMID- 2779651 TI - Ecosystem-level patterns of primary productivity and herbivory in terrestrial habitats. AB - Ecosystems are structurally organized as food webs within which energy is transmitted between trophic levels and dissipated into the environment. Energy flow between two trophic levels is given by the amount of production at the lower level and by the proportion of production that is consumed, assimilated and respired at the higher level. Considerable evidence indicates that food-web structure varies predictably in different habitats, but much less is known about quantitative relationships among food web fluxes. Many of the energetic properties of herbivores in African game parks are associated with rainfall and, by inference, with net primary productivity. Respiratory costs per unit production at the consumer trophic level are higher for homeotherms than for heterotherms. Plant secondary chemicals affect herbivore dietary choices and the allocation of plant resources to those chemicals varies with resource availability. How these phenomena are translated into ecosystem fluxes is unknown. We present evidence that herbivore biomass, consumption and productivity are closely correlated with plant productivity, suggesting that the latter is a principal integrator and indicator of functional processes in food webs. PMID- 2779652 TI - Developmental alterations in the frequency map of the mammalian cochlea. AB - The position of an auditory hair cell along the length of the cochlea determines the sound frequency to which it is most sensitive. Receptors located near the proximal end (base) of the cochlea are maximally stimulated by high-frequency sounds; those occupying successively more distal (apical) positions respond best to progressively lower frequencies. At present, it is unclear how this frequency place map emerges with respect to the development of the cochlea. It has been suggested, on the basis of acoustic trauma experiments with developing chicks and cochlear potential recordings from developing gerbils, that this map may arise through systematic changes in the spatial encoding of frequency along the cochlea. Others have inferred from frequency tuning curves derived from auditory nerve recordings in developing mammals and chicks, that the cochlear frequency place map remains stable throughout development. We analysed frequency tuning curves obtained from gerbil spiral ganglion cells at a constant location within the basal cochlea, and report here that these cells undergo significant increases (up to 1.5 octaves) in their best-response frequencies between the second and third weeks of postnatal life. These recordings provide direct evidence for developmental changes in the tonotopic organization of the mammalian cochlea. PMID- 2779653 TI - Molecular cloning and expression of brain-derived neurotrophic factor. AB - During the development of the vertebrate nervous system, many neurons depend for survival on interactions with their target cells. Specific proteins are thought to be released by the target cells and to play an essential role in these interactions. So far, only one such protein, nerve growth factor, has been fully characterized. This has been possible because of the extraordinarily (and unexplained) large quantities of this protein in some adult tissues that are of no relevance to the developing nervous system. Whereas the dependency of many neurons on their target cells for normal development, and the restricted neuronal specificity of nerve growth factor have long suggested the existence of other such proteins, their low abundance has rendered their characterization difficult. Here we report the full primary structure of brain-derived neurotrophic factor. This very rare protein is known to promote the survival of neuronal populations that are all located either in the central nervous system or directly connected with it. The messenger RNA for brain-derived neurotrophic factor was found predominantly in the central nervous system, and the sequence of the protein indicates that it is structurally related to nerve growth factor. These results establish that these two neurotrophic factors are related both functionally and structurally. PMID- 2779655 TI - A new beginning? PMID- 2779654 TI - The LDL-receptor-related protein, LRP, is an apolipoprotein E-binding protein. AB - The low-density-lipoprotein (LDL) receptor is a cell-surface protein that plays an important part in the metabolism of cholesterol by mediating the uptake of LDL from plasma into cells. Although LDL particles bind to the LDL receptor through their apolipoprotein B (apo B) and apolipoprotein E (apo E) moieties, other apo E containing particles, like chylomicron remnants, are not dependent on the LDL receptor for uptake into cells. Chylomicrons formed in the intestinal mucosa during the absorption of the products of digestion, are processed by the peripheral circulation by lipoprotein lipase, which catalyses the breakdown of triglycerides in chylomicrons to free fatty acids and glycerol. The resulting chylomicron remnants, which are cholesterol-rich lipoproteins, are subsequently taken up in the liver. A second distinct protein that binds to apo E-containing lipoproteins, but not to LDL, has been proposed to be the receptor mediating the clearance of chylomicron remnants from the plasma. This protein has a relative molecular mass (Mr) of 56,000 (56K). More recent studies have failed, however, to establish whether this protein is a cell-surface receptor. Here we describe crosslinking experiments in which apo E liposomes were found to bind specifically to the cell surface of hepG2 cells and to human liver membranes. The size and immunological cross-reactivity of the protein to which the liposomes bound was indistinguishable from that of the recently cloned and sequenced LDL-receptor related protein, LRP. We therefore conclude that the LRP might function as an apo E receptor. PMID- 2779656 TI - New York State leads on genetic fingerprinting. PMID- 2779657 TI - Genetic screening: UK physicians demand action. PMID- 2779658 TI - Biotechnology licensing: Greens oppose EPO plant. PMID- 2779659 TI - Glasnost in publications: who's hiding the primary data? PMID- 2779661 TI - Reprints' function. PMID- 2779660 TI - Policing animal experiments. PMID- 2779662 TI - Indian AIDS. Penalties--and help--for victims. PMID- 2779663 TI - NIH restricts university links with industry. PMID- 2779664 TI - Human genome. Sequencing bargain in India? PMID- 2779665 TI - Sexual behaviour unsurveyed. PMID- 2779666 TI - DNA structure. Curves with a function. PMID- 2779667 TI - Cellulose biogenesis in bacteria and higher plants is disrupted by magnetic fields. PMID- 2779668 TI - At least eight types of sense receptors in an endoparasitic flatworm: a counter trend to sacculinization. PMID- 2779669 TI - A female Norway rat, Rattus norvegicus, with X0 sex chromosome constitution. PMID- 2779671 TI - Is there any hope for increasing the proportion of home dialysis patients over 20%? PMID- 2779670 TI - EPA proposes new contaminant standards. PMID- 2779672 TI - Pediatric & diabetic challenges are becoming pressing issues. PMID- 2779673 TI - [Shift work can be hard on health]. PMID- 2779674 TI - [Fewer thyroid operations in The Netherlands]. PMID- 2779675 TI - [Polyols as sweetening agents; swallowing everything?]. PMID- 2779676 TI - [A special consultation; a closer look at 'second opinion']. PMID- 2779677 TI - [A diminishing number of thyroid operations in The Netherlands in 1972-1986]. AB - The numbers of thyroidectomies in The Netherlands decreased by 35% in the period 1972-1986. The decline started in 1977 and was the result of a decrease in the numbers of thyroidectomies for nontoxic diffuse and nodular goitre, and for toxic diffuse and nodular goitre. The numbers of thyroidectomies for malignant and benign thyroid neoplasms remained unchanged. These findings can be explained by a decrease of the indication for surgery in nontoxic nodular goitre due to the introduction of fine needle aspiration cytology and an increase of the application of radioactive iodine in the treatment of toxic diffuse and nodular goitre. The decrease of the number of thyroidectomies for nontoxic goitre in the younger age groups is suggestive of a lower prevalence due to the improvement of the iodine supplementation. The mean hospital stay for thyroidectomy decreased from 19.5 to 10.1 days. The hospital mortality rate after partial thyroidectomies decreased from 6.6% to 0.9%. PMID- 2779678 TI - [Weil's disease, milker's fever and other leptospiroses, 1981-1987]. AB - In The Netherlands, human leptospirosis is mainly caused by the serovars icterohaemorrhagiae and copenhageni, both of which belong to the Icterohaemorrhagiae group and originate from rats, serovars hardjo from cattle and grippotyphosa from voles. In 1981-1987, 175 cases of leptospirosis were registered. In 17 of these cases the infection was acquired outside The Netherlands. Infections caused by serovars from the Icterohaemorrhagiae group were mainly observed in the province of Zuid-Holland, hardjo infections in the province of Friesland. The number of hardjo infections increased. Hardjo also causes problems in cattle. Infections caused by serovars icterohaemorrhagiae and copenhageni were mainly associated with exposure to inland surface waters in relation with recreational or professional activities or accidents. Hardjo infections were characteristically associated with dairy farming. The incidences of all types of leptospirosis were highest in late summer and early autumn. PMID- 2779680 TI - [The administration of health care]. PMID- 2779679 TI - [Can naproxen impair menstruation?]. AB - Two patients are described experiencing interruption of menstrual blood flow soon after taking a tablet of naproxen (250 or 275 mg). The patients were young women (19 and 34 years) with a diagnosis of primary dysmenorrhoea: menstruation had otherwise been regular and of normal duration. Normal menstruation is influenced by prostaglandins in a complex way. Non-steroidal anti-inflammatory drugs are known to reduce the amount of blood loss in menorrhagia. It is suggested that the effects of cyclo-oxygenase inhibitors on the metabolism of prostaglandins may occasionally interfere with the normal course of menstruation. PMID- 2779681 TI - [Orthomanual medicine]. PMID- 2779682 TI - [Depression in patients with somatic illnesses]. PMID- 2779683 TI - Pillars of fire or bash your buddy. PMID- 2779684 TI - Fracture of the proximal humerus--pitfalls of diagnosis and treatment. PMID- 2779685 TI - Dietary fluoride supplements for Nebraska's children--the role of the physician. AB - 1. All children should receive one form of systemic fluoride and appropriate forms of topical fluoride. 2. If a child is not receiving optimally fluoridated water, the physician or dentist should prescribe dietary fluoride supplements (tablets or drops). 3. The correct dosage must be determined based on patient age and fluoride content of the patient's main water source(s). 4. Special attention is necessary concerning fluoride intake for children breast-feeding or consuming infant formula. 5. To arrive at the correct fluoride dose, these steps should be followed: A. Always have a sample of the main drinking water source (usually home water) analyzed for the fluoride content before prescribing a fluoride supplement, if you do not have other specific knowledge of water fluoride content. The Laboratory Division of the Nebraska State Department of Health provides water fluoride assay services. B. When the fluoride content of the water has been determined, the fluoride level and the child's age should be matched on Table 1 to arrive at the correct supplement dose. 6. The Division of Dental Health of the Nebraska State Department of Health can provide lists of communities and schools in Nebraska that are optimally fluoridated. PMID- 2779686 TI - Beware the adult-onset seizure. Why evaluate adult-onset seizures? PMID- 2779688 TI - 402-393-3216. PMID- 2779687 TI - Physicians for rural Nebraska--a comment on the Report of the Commission on Medical Education. PMID- 2779689 TI - Heparin treatment: confusion still prevails. PMID- 2779690 TI - Cardiac manifestations of thrombotic thrombocytopenic purpura. AB - Three patients with thrombotic thrombocytopenic purpura and different cardiac complications are reported. Myocardial involvement due to microvascular thrombosis and haemorrhages, pericardial effusion and non-bacterial thrombotic endocarditis were found at autopsy. The importance of continuous cardiac monitoring in the treatment of these patients is emphasized. PMID- 2779691 TI - The usefulness of a sensitive thyrotrophin assay in the fine adjustment of thyroxine therapy following ablation for carcinoma. AB - The usefulness of FT4 and FT3 measurements as an index of adequate thyroxine treatment in differentiated thyroid cancer was evaluated in 25 athyreotic patients on two occasions with an interval of at least 6 months. The determinations were combined with a TRH test. The TSH measurements were performed using a sensitive immunoassay. The great interindividual differences in absorption and metabolism of thyroxine made the measurements of FT4 and FT3 unsuitable for fine adjustment of thyroxine substitution therapy. When all patients are divided into 4 categories according to their TRH test (1: delta TSH less than or equal to 1 mU/l; 2: greater than or equal to 1 less than or equal to 4 mU/l; 3: greater than 4 mU/l and 4: basal TSH greater than or equal to 6 mU/l), there is a considerable overlap between these categories in relation to FT4 and FT3. In the second TRH test all patients were found to belong to the same category when their thyroxine dose had not been changed. A basal TSH level below 0.30 mU/l suggests nearly complete suppression of TSH secretion. However, a TRH test is necessary to allow a definite conclusion to be drawn. It is argued that complete suppression of TSH is not necessarily desirable in patients with treated thyroid carcinoma. From the results of our study it would seem advisable to use the TRH test once to adjust the thyroxine dose in such a manner that subnormal basal TSH is achieved as in the second category. Once the dosage has been established, a determination of basal TSH suffices in follow-up. PMID- 2779692 TI - Comparison of beclomethasone dipropionate (2 and 3 mg) and prednisolone sodium phosphate enemas (30 mg) in the treatment of ulcerative proctitis. An adrenocortical approach. AB - Twenty-three patients with attacks of distal ulcerative colitis were treated randomly with either 2 or 3 mg of topically administered beclomethasone dipropionate (BDP) or 30 mg of prednisolone sodium phosphate (PP). The effect of the steroid enemas on adrenocortical function was assessed by ACTH tests, which were performed before and after treatment. Endoscopic, clinical and histological scores were comparable in the three treatment groups in this pilot trial. Fasting cortisol in the PP group decreased significantly from 0.47 +/- 0.12 mumol/l before to 0.22 +/- 0.14 mumol/l (P less than 0.05) after therapy; in the BDP group no significant changes were found. Urinary cortisol excretion in the PP group was not detectable after therapy; in the BDP group no changes were found. It is concluded that in the topical treatment of ulcerative colitis, BDP may be preferable to PP because it exerts a promising anti-inflammatory action without affecting adrenocortical function. PMID- 2779693 TI - Multi-organ damage in exertional heat stroke. AB - Exertion-induced heat stroke is a relatively rare disorder in the moderate maritime climate of The Netherlands. Serious complications of excessive physical activity rarely occur. We describe a marathon runner with multi-organ failure after exertion-induced heat stroke. The patient developed shock, diarrhoea, coma, rhabdomyolysis, acute renal failure, liver cell damage and disseminated intravascular coagulation but recovered completely. PMID- 2779694 TI - Thrombocythaemic erythromelalgia in chronic myeloproliferative and myelodysplastic disorders. AB - Erythromelalgia, which is specific for primary thrombocythaemia or polycythaemia with thrombocythaemia, is reported in a case of primary myelofibrosis at platelet counts of between 350 and 450 X 10(9)/l. In addition, the unexpected occurrence of thrombocythaemic erythromelalgia associated with Ph1 chromosome positive micromegakaryocytic myelofibrosis and with myelodysplastic syndrome type II is described. Therefore it is concluded that erythromelalgia may occur in all variants of myeloproliferative disease as well as myelodysplastic syndrome as long as they present with thrombocythaemia. PMID- 2779695 TI - Fish oil: fake, food or drug? PMID- 2779696 TI - Sucralphate-technetium scintigraphy in inflammatory bowel disease: experience in 23 patients. AB - Serial abdominal scanning after the oral administration of sucralphate-99mTc was performed in order to determine the extent of active inflammatory bowel disease in 15 patients with Crohn's disease and in 8 patients with ulcerative colitis. Scintigraphic data were compared with those obtained by endoscopy and radiology in all patients. True positive scans were obtained in 6 (40%) patients with Crohn's disease and in 3 (38%) patients with ulcerative colitis. Overall, sensitivity was higher in colonic disease than that in ileal disease. In 4 (17%) patients, false negative scans were obtained and in the remaining 10 (44%) patients, localisation of the inflammatory bowel disease by the isotope was completely inaccurate. Since sensitivity of the sucralphate-99mTc scintigraphy appears to be low, its widespread use in the screening for inflammatory bowel disease or in assessing the extent of disease involvement cannot be advocated at this moment. PMID- 2779697 TI - Primary hypothyroidism mimicking pituitary adenoma. AB - The case history is presented of a woman with secondary amenorrhoea, mild hyperprolactinaemia and pituitary enlargement with suprasellar extension, mimicking a pituitary adenoma. It appeared that she had primary hypothyroidism. After L-thyroxine treatment, all abnormalities disappeared. The literature on the combination of primary hypothyroidism, hyperprolactinaemia and pituitary enlargement is reviewed and the pathophysiology is discussed. It is concluded that determination of thyrotropin is essential in all patients with pituitary enlargement and hyperprolactinaemia. PMID- 2779698 TI - Brainstem auditory evoked responses in chronic renal failure and the effect of hemodialysis. AB - Brainstem auditory evoked responses (BAER) were recorded in patients with chronic renal failure before commencement of chronic dialysis treatment, and in patients with end-stage renal failure on chronic hemodialysis for several years. Both groups of patients had delayed latencies of the third and fifth waves. The patients on hemodialysis revealed delayed latency of interpeak I-V as well. There was no correlation between wave latency, serum urea, creatinine, PTH or duration of chronic hemodialysis treatment. A hemodialysis session led to a slight shortening of the third wave. This study suggests that neural conduction along the brainstem in patients with chronic renal failure is delayed even before hemodialysis is started. Although 1 dialysis session may have some beneficial effect, long-term hemodialysis treatment does not seem to shorten the delay in neural conduction observed in patients with chronic renal failure. PMID- 2779699 TI - Successful peritoneal dialysis using 0.9% sodium chloride with modified M/6 sodium lactate solution and recycled catheters. AB - Acute peritoneal dialysis (PD) was carried out in 8 patients with renal failure (5 acute, 3 chronic) using 2.076-litre cycles of 0.9% sodium chloride (1,250 ml) plus M/6 sodium lactate (600 ml) to which 5% dextrose (170 ml), 50% dextrose (40 ml) and 10% calcium gluconate (16 ml) were added. Two acute catheters were recycled amongst all the patients after sterilisation in 5% formaldehyde. In all 8 patients, there was progressive clinical and biochemical improvement during 12 88 cycles of PD performed over 0.5-35 days. 2 patients with acute renal failure recovered completely. Another patient had prostatectomy for obstruction and a 4th subsequently received a successful kidney transplant abroad. 3 patients died, 2 of them after discharge from hospital, and 1 defaulted from follow-up. Peritonitis occurred in 2 patients. No side effects attributable to the dialysis solution were observed. However, repeated chemical treatment resulted in catheter opacification and blockage of perforations, but reperforation using a sterile needle usually restored good drainage. In poor countries with limited dialysis facilities, the use of 0.9% sodium chloride with modified M/6 sodium lactate solutions for PD and reuse of acute PD catheters are effective, safe and cost saving. PMID- 2779701 TI - Urinary total protein estimation--fact or fiction? AB - In two recent surveys of urinary total protein assays, 370 laboratories in the United Kingdom were requested to determine the protein content of a simulated 24 hour urine (a solution of sodium and potassium salts and urea, with no added protein) and of a 24-hour urine from a healthy individual. The nature of these specimens was not revealed and participants used their routine methods and calibrants. Quantitative results (range 0.005-12.23 g/l, median 0.03 g/l) were received from 31% of the participants for the salt solution and from 43% for the normal urine (range 0.01-2.96 g/l, median 0.05 g/l). Nonquantitative results, i.e. those given as less than a detection limit (range less than 0.005 to less than 0.5 g/l) were received from 29% of the participants for the salt solution and from 33% for the normal urine. Statements of 'nil', 'zero' or 'not detected' were received from the remainder. Further analysis of the results indicated that 29% of the laboratories reported, or did not unequivocally exclude, significant proteinuria in the salt solution, and 41% of the laboratories similarly did not exclude proteinuria in the normal urine. It is proposed, for both clinical and analytical reasons, that consideration be given to the discontinuation of urinary total protein estimation and that urinary albumin, supplemented where appropriate by other selected protein or enzyme measurements, be determined instead. PMID- 2779700 TI - Perimembranous-type renal amyloidosis: a peculiar form of AL amyloidosis. AB - Six cases of perimembranous-type renal amyloidosis were reported. This type of renal amyloidosis was characterized by amyloid deposition predominantly involving the epithelial aspect of the glomerular capillary wall. Florid spicular arrangement was another representative feature. This type of amyloid deposition was found in 8% of autopsy cases of systemic amyloidosis. All cases were categorized as AL amyloidosis and developed the nephrotic syndrome irrespective of the amount of amyloid within the glomeruli. The results obtained suggest that perimembranous-type renal amyloidosis is a peculiar form of AL amyloidosis both in morphology and clinical manifestations. autopsy cases of systemic amyloidosis. All cases were categorized as AL amyloidosis and developed the nephrotic syndrome irrespective of the amount of amyloid within the glomeruli. The results obtained suggest that perimembranous-type renal amyloidosis is a peculiar form of AL amyloidosis both in morphology and clinical manifestations. autopsy cases of systemic amyloidosis. All cases were categorized as AL amyloidosis and developed the nephrotic syndrome irrespective of the amount of amyloid within the glomeruli. The results obtained suggest that perimembranous-type renal amyloidosis is a peculiar form of AL amyloidosis both in morphology and clinical manifestations. PMID- 2779702 TI - Vitamin D, desferrioxamine and aluminum-induced bone disease in uremic rats. AB - The effect of 100 ng 1 alpha-OH vitamin D/week alone and in combination with desferrioxamine (DFO), 150 mg/week, was evaluated in aluminum loaded uremic rats. Vitamin D (Vit D) caused an increase of Al in muscle and a decrease in serum Al. Bone histology showed mineralization defect and an increase in bone mass, due to an increase in unmineralized bone, induced both by Al and Vit D administration. Treatment with DFO enhanced urinary Al excretion and lowered tissue Al, without inducing major changes of static bone histology. It is concluded that in Al loaded uremic rats Vit D can redistribute body Al and that both Al and Vit D can cause a mineralization defect. A 6-week treatment with DFO lowers tissue Al without changing significantly static bone parameters. PMID- 2779703 TI - IgA nephropathy--Groote Schuur Hospital experience. AB - The prevalence of IgA nephropathy among 872 renal biopsies performed at Groote Schuur Hospital over a period of 7 years was retrospectively examined. Only 34 cases were shown to have IgA nephropathy. The features of these biopsies were compared with clinical and biochemical findings at the time of biopsy. The average age at histological diagnosis was 28.5 years (range 13-61 years); there were 25 males and 9 females. All patients had hematuria and in 44% it was macroscopic at some stage. Five of 25 patients in whom 24-hour urinary protein excretion was measured excreted more than 3.5 g/day. Histological changes ranged from mild proliferative changes (grade 1) to crescents and sclerosis (grades 4 and 5). There was a significant correlation between histological grade and serum creatinine (p less than 0.004) and proteinuria (p less than 0.005). The low prevalence of the disease in our total renal biopsy experience (3.8%) is similar to that reported from the United States (1.5) and England (4%). The age and clinical findings at the time of diagnosis were similar to most other series. The sex ratio was equal in the mixed-origin race group, while amongst the whites, males predominated. No IgA nephropathy was found in biopsies from blacks, which supports the observation of others that this condition is rare in the black population. PMID- 2779704 TI - Nephronophthisis-cystic renal medulla complex: diagnosis by computerized tomography. AB - A 19-year-old man with renal failure and mild hypertension was found to have juvenile nephronophthisis. The diagnosis was established by computerized tomography of the kidneys after other imaging techniques had proved inconclusive. Computerized tomography is advocated as the investigation of choice if this diagnosis is considered. PMID- 2779705 TI - Rhabdomyolysis and acute renal failure after terbutaline overdose. AB - A case of rhabdomyolysis-induced acute renal failure secondary to overdosage with the beta 2-adrenoceptor agonist terbutaline is described. This is a previously undocumented association. We propose that the hyperkinetic effects of intense beta-receptor stimulation may induce rhabdomyolysis. PMID- 2779706 TI - The hypocalcemic effect of inorganic sulfate infusions. AB - Inorganic sulfate is a divalent anion that forms a soluble ion-pair complex with serum calcium, but the extent to which infusions of sulfate salts may depress the concentration of ionized calcium has never been quantitated. In a study of 9 patients who received sodium sulfate infusions as part of a standard diagnostic workup for their renal tubular acidosis, we observed a decrease in mean ionized calcium (adjusted to pH 7.40) from 1.15 +/- 0.01 to 1.04 +/- 0.02 mmol/l (p less than 0.01). The changes in ionized calcium were highly correlated with those in serum sulfate (r2 = 0.95; p less than 0.01). Quantitatively, an increase of 1 mmol/l in serum sulfate was associated with a decrease of 0.017 mmol/l in ionized calcium, a result that is in close agreement with in vitro data based on simple salt solutions. Diagnostic sulfate infusions should be used with caution in any patient predisposed to hypocalcemia. PMID- 2779708 TI - Temperature effects on renal membrane ionic permeability. PMID- 2779707 TI - Dialysis after bilateral nephrectomy. A case report. PMID- 2779709 TI - Three-dimensional ultrastructural changes of acellular glomerular basement membrane in various types of human glomerulonephritis. AB - Using a cellular digestion technique combined with scanning electron microscopy, we examined the three-dimensional ultrastructural changes of the glomerular basement membrane (GBM) in various types of human glomerulonephritis (GN). Gaps of the GBM, which were not found by routine transmission electron microscopy, were observed in a patient with IgA nephropathy manifesting microscopic hematuria. The dense material of the GBM in dense deposit disease (DDD) was not affected by this cellular digestion technique, while the deposits in other immune complex diseases were almost removed. Thus the dense material in DDD differs in composition from the immune complex deposits in other GN. In membranous GN and lupus nephritis, the morphological changes of the urinary surface of the GBM varied from pinhole to craters and reticula, according to the severity of the disease stage. This technique is useful for examining ultrastructural changes of the GBM in various human GN. PMID- 2779710 TI - Campylobacter pylori in uremic dialyzed patients. PMID- 2779711 TI - Increased ultrafiltration after erythropoietin-induced correction of renal anemia in patients on continuous ambulatory peritoneal dialysis. PMID- 2779712 TI - [Chiasmatic apoplexy caused by rupture of a cavernoma]. PMID- 2779713 TI - [Cerebral cavernomas in infants and children]. PMID- 2779714 TI - [Cavernoma in the child. Apropos of a neonatal form with recurrence in childhood]. PMID- 2779715 TI - [Surgical treatment. General considerations]. PMID- 2779716 TI - [Different modalities for the treatment of hemispheric cavernomas]. PMID- 2779717 TI - [Surgical treatment of intracerebral cavernomas]. PMID- 2779718 TI - [Intracranial cavernomas. Round table. 38th congress of the French-speaking Society of Neurosurgery. Deauville, 15 June 1988. Proceedings]. PMID- 2779719 TI - [Neuropathologic study of cavernomas]. PMID- 2779720 TI - [Is there a relationship between the clinical manifestations and the pathologic image of cerebral cavernomas?]. PMID- 2779721 TI - [Imaging of cavernomas of the brain. Tomodensitometry and magnetic resonance imaging]. PMID- 2779722 TI - [Angiographically occult vascular malformations suggestive of cavernomas: clinical study of 18 cases]. PMID- 2779723 TI - [Rare localizations of cavernomas. 4 personal cases]. PMID- 2779724 TI - Effects of hemicholinium-3 and sodium ions on choline uptake system in excised superior cervical sympathetic ganglia of rats. AB - Active choline uptake by rat superior cervical sympathetic ganglia (SCG), which contain abundant cholinergic nerve terminals, was studied with respect to sensitivity to inhibition by hemicholinium-3 (HC-3) and dependence on extracellular Na under standard conditions of assay. Choline was taken up by a single saturable process with apparent Km = 3.07 x 10(-5) M and Vmax = 286 pmoles/min/mg protein. Neither denervation followed by degeneration of cholinergic nerve terminals nor axotomy with successive neuronal degeneration significantly decreased in choline uptake by the ganglia in vitro. HC-3 dose dependently inhibited ganglionic choline uptake more effectively at lower than at higher choline concentrations. HC-3 sensitive inhibition of ganglionic choline uptake was not seen in young rats one week after birth but appeared with maturity, attaining approximately 50% maximal inhibition in adult SCG. Extent of inhibition by HC-3 and Na dependence of ganglionic choline uptake was not altered by denervation or axotomy. PMID- 2779725 TI - Activity dependent characteristics of fast and slow muscle: biochemical and histochemical considerations. AB - The effects of denervation and hindlimb suspension induced disuse on concentrations of ATP, phosphocreatine (PC), and fiber type profile were investigated in slow twitch soleus and fast twitch extensor digitorum longus (EDL) muscles. The results show that the soleus and EDL muscles differ in their dependency on loadbearing as a stimulus for maintaining normal energy metabolism and the biochemical and morphological characteristics of muscle fibers. As determined by R-P methodology, suspension reduced ATP and PC concentrations of the soleus to 26% and 56%, respectively, while, in EDL only, PC is reduced to 71% of control with no change in ATP. Both muscles, however, show identical losses in ATP and PC following denervation. The energy charge, an indicator of Pi availability in muscle was reduced significantly in both denervated muscle to 82% and 85% in soleus and EDL, respectively. No significant reduction of the energy charge was seen in the muscles from suspended rats. Thus, in parallel with the indirect regulation through muscle loadbearing, the nerve can effectively modulate the levels of high-energy phosphates more directly by some regulatory mechanisms independent of muscle type. Denervation and suspension disuse increased the proportion of type 2 fibers in the soleus with a concomitant decrease in type 1 fibers and a relative rise in the number of very small diameter fibers. The EDL showed only variation in fiber size. PMID- 2779726 TI - Triiodothyronine bound to red blood cells is not available for transport through the blood-brain barrier. AB - Many steroid and thyroid hormones and some drugs are bound by circulating red cells. Red cell-bound ligand may not be physiologically inert, as recent studies show that red cell-bound drug is available for uptake by brain. To investigate whether triiodothyronine (T3) is available for uptake by brain in vivo from the circulating red cell pool, the present investigations measure the effects of human erythrocytes on rat brain uptake of [125I]T3 in vivo. The fraction of circulating T3 available for uptake in vivo in the presence of 0, 2, 5, 10, 22, or 44% red cells was essentially identical to the fraction of [125I]T3 unbound in vitro. Therefore, [125I]T3 bound to red cells obtained from normal volunteers is not available for uptake by brain in vivo. PMID- 2779727 TI - Lactate, 3-hydroxybutyrate, and glucose as substrates for the early postnatal rat brain. AB - The dependence of cerebral energy metabolism upon glucose, 3-hydroxybutyrate, and lactate as fuel sources during the postnatal period was investigated. The brain of 6 day old suckling pups used very little glucose, but by the 15th postnatal day glucose was the major catabolite. Hydroxybutyrate was not a major brain fuel at either 6 or 15 days of age. Its utilization accounted for only 19% of the brain's total energy needs at 15 days of age, even through blood ketone concentrations are near maximal at this time. Seventy percent of the cerebral metabolic requirements were met by lactate in animals aged 6 days. The major role played by lactate as a substrate for brain metabolism in young pups was not a result of abnormally elevated blood lactate concentrations. The slow catabolism of glucose in young brain can not be explained by low rates of influx or inadequate enzymatic capacity. PMID- 2779729 TI - Substrate specificity of phenol sulfotransferase from primary cultures of bovine brain microvessel endothelium. AB - The substrate specificity of the thermostable phenol sulfotransferase (PST) from primary cultures of brain microvessel endothelial cell monolayers was characterized. Selected catecholamines, catecholamine metabolites, and p nitrophenol at 5, 50, and 500 microM were used as substrates in PST assays of cytosol extracts. Endogenous catecholamines, epinephrine, norepinephrine, and dopamine, exhibited no detectable activity as substrates (500 microM) compared to 500 microM p-nitrophenol as substrate (1.8 pmol/mg/min specific activity) for the PST. In contrast, 500 microM of either deaminated or 3-O-methylated metabolites of catecholamines exhibited intermediate (approximately 1.0 pmol/mg/min specific activity) to low (approximately 0.2 pmol/mg/min specific activity) activity, respectively, as substrates compared to p-nitrophenol as substrate for the PST. Additionally, 500 microM of metabolites of catecholamines that were both deaminated and 3-O-methylated exhibited high activity (greater than 3.0 pmol/mg/min specific activity) as substrates compared to p-nitrophenol as substrate for the PST. Qualitatively similar results were observed at lower substrate concentrations. Therefore, results from this study suggest a potential role for PST as part of the "enzymatic" blood-brain barrier in regulating transendothelial passage of endogeneous catecholamines between the blood and the brain. PMID- 2779728 TI - Effect of ferric nitrilotriacetate on predominantly cortical neuronal cell cultures. AB - Predominately neuronal cell cultures were produced as described in previous communications. Neuronal cells were exposed to ferric nitrilotriacetate (Fe-NTA) at varying concentrations. Studies of the neuronal cells were performed at 13 and 20 days in culture. In addition to morphologic studies, biochemical assays including choline acetyltransferase (ChAT) activity, specific [3H]flunitrazepam (FLU) binding, clonazepam (CLO)-displaceable [3H]FLU binding, Ro5-4864 displaceable [3H]FLU binding, high-affinity [3H]GABA uptake, and protein determinations were performed. The data demonstrate that chelated ferric iron has an adverse effect on predominately neuronal cultures after 7 days of exposure as measured by choline acetyltransferase activity, while other measures remained unaffected; however, after 14 days of exposure all measures were significantly decreased. The effects of Fe-NTA exposure appear to be both concentration and duration-of-exposure related. PMID- 2779730 TI - [Intracranially recorded trigeminal compound action potential: with special reference to trigeminal neuralgia]. AB - To elucidate the origin of the early component of the trigeminal sensory evoked potential (TSEP) we reported in 1985, we recorded evoked potentials on the trigeminal root and the brain stem surface intracranially when suboccipital craniectomy was done for exploration of the C-P angle. Patients consisted of 4 who had idiopathic trigeminal neuralgia with microvascular decompression, 1 with glossopharyngeal neuralgia who also had microvascular decompression of the left glossopharyngeal nerve, and 5 patients with different tumors, specifically, Meckel's cave meningioma, two epidermoid cysts of the cerebello-pontine angle, an acoustic neurinoma and a trigeminal neurinoma. Among the tumor patients, all but the one with acoustic neurinoma had trigeminal neuralgia. So altogether, there were 8 patients with trigeminal neuralgia. Constant electrical current was applied to the lower and upper lip for stimulation of the second and third division, respectively. In some cases the electrical current was applied percutaneously to the infraorbital nerve for the stimulation of the second division. The supraorbital nerve was stimulated percutaneously for stimulation of the first division. To record and analyze the potentials, Evomatic 8000 (Dantec) was used. Analysis time was from 10 to 100 msec and the stimulation was repeated 200 times. Trigeminal compound action potential (TCAP) was recorded on the trigeminal nerve just distal to the entrance point to the pons. For the recording TCAP, a gold ball electrode of 1 mm diameter was used with indifferent needle electrode in the neck muscle. In some cases a digital filter was applied to the recorded TCAP. The TCAP evoked by stimulation of the second division had 2 to 8 positive potentials in 8 patients.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2779731 TI - [Effect of trihexyphenidyl-HCL on posttraumatic prolonged disturbance of consciousness: report of two cases]. AB - Cases involving two patients who presented post-traumatic prolonged disturbance of consciousness (PTPDC), namely akinetic mutism, and recovered from it after treatment with trihexyphenidyl were reported. Case 1: A seventy-one-year-old farmer. Five months after head injury, when he was first admitted to us, he was stable with signs of oligokinesia, katatonic posture, speechlessness, rigid muscle tones and positive cog-wheel phenomenon. One week after administration of the drug, his speech and voluntary movement improved remarkably. Two months after the treatment, he was able to walk, and was discharged from the hospital. Case 2: A forty-six-year-old man sustained major head trauma. In the acute stage, he was comatose with decerebrate posture. On the 15th hospital day, he showed a state of akinetic mutism with normal sleep - wakefulness cycle. Evacuation of the collected subdural fluid was done one month after the injury, which resulted in no change in his clinical state. Five months after the injury, trihexyphenidyl treatment was begun. A few days after the treatment, his motor activity and his facial expression obviously improved. One week after, he mimicked the word 'o-ha yo (good morning)' after the physician's greeting. CT scan and magnetic resonance imaging in the chronic state of these patients showed bifrontal cerebral white matter lesions, which indicated old cerebral contusion. No brain stem lesions were detected with these examinations. Our two cases clearly did not belong to the category of post-traumatic parkinsonism because of their clinical courses, and their features shown in radiological examinations. However the anti parkinsonian drug, trihexyphenidyl was effective.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2779732 TI - [A case of cerebrospinal fluid otorrhea 6 years after temporal bone fracture]. AB - A 16 year-old female was admitted to our hospital because of left temporal bone fracture and brain contusion in the left temporal lobe. CSF otorrhea was also present for a week. Four years later, when she was 20 years old, she was noticed to have a white mass in the left external auditory canal. One and a half year later, left CSF otorrhea reappeared, and she was readmitted to our hospital. High resolution coronal CT revealed that the left temporal bone fracture had opened widely and brain tissue had herniated into the left external auditory canal. Metrizamide CT cisternography showed that CSF was leaking around the mass. Operative findings have shown that there were two dural defects, both of which were 2 cm in diameter, and brain tissue surrounded by arachnoid membrane had herniated through these defect. The herniated brain tissue was removed, and both dural- and osteo-plasty were successfully carried out. This case indicates that dissociation of temporal bone fracture and laceration of dura mater may cause herniation of brain tissue and CSF otorrhea years later. PMID- 2779733 TI - [A case of repeated hematomyelia caused by cavernous hemangioma in the spinal cord]. AB - A case is reported of repeated hematomyelia caused by cavernous hemangioma in the spinal cord. A 47-year-old woman first noticed a sudden onset of numbness in her thigh and then it gradually disappeared. Four months after the onset, she began to experience weakness and numbness in both of her legs, and difficulty in voiding and defecating. She recovered gradually for several months, but felt numbness in both legs. Myelography showed swelling at Th5 level. T2-weighted MRI showed a reticulated core of mixed intensity with rims of decreased intensity. During the subsequent operation, a dark brown lesion was detected at Th5 level, which consisted of multicystic cavities with old hematoma. But there were no abnormal vessels, or active bleeding. This lesion was almost completely removed and was diagnosed as cavernous hemangioma. PMID- 2779734 TI - Immunocytochemical localization of the terminal complement complex in multiple sclerosis. AB - Granular deposits of C9 and the terminal complement complex, measuring 0.3-1.2 microns, have been demonstrated immunocytochemically in association with capillary endothelial cells, predominantly within plaques and adjacent white matter, in tissue obtained at autopsy from 5/7 patients with multiple sclerosis (MS) and one individual with subacute sclerosing panencephalitis but not from 7/7 controls. This finding suggests that the evolution of focal tissue damage in MS may involve complement activation associated with passage of humoral and cellular mediators of the immune system through the blood-brain barrier. PMID- 2779735 TI - Prognosis in malignant glioma: a retrospective study of biopsy specimens by flow cytometry. AB - The DNA ploidy of a series of 78 gliomas has been estimated by flow cytometry using cell suspensions prepared from paraffin embedded material. Apart from two oligodendrogliomas the tumours were all astrocytomas. Forty-nine (63%) tumours were found to have a diploid DNA distribution and 29 (37%) an aneuploid DNA distribution. The two oligodendrogliomas were both DNA aneuploid. No correlation was found between DNA ploidy and histological grade or DNA ploidy and survival. Both ploidy groups appear to have responded equally to therapy. In this study the factors associated with a short survival were advancing age and the presence of vascular endothelial proliferation, while the DNA ploidy and the cytological features do not appear as useful in predicting survival when examining biopsy material. PMID- 2779736 TI - Diabetic neuropathy: abnormalities of Schwann cell and perineurial basal laminae. Implications for diabetic vasculopathy. AB - During Wallerian degeneration, the Schwann cell basal laminal ensheathment around myelinated nerve fibres remains after the removal of myelin and axonal debris, forming a corrugated tube within which Schwann cell proliferation takes place. In nerve biopsies from patients with diabetic neuropathy, such residual basal laminal tubes tend to be circular rather than corrugated and appear to be more persistent during regeneration; this suggests increased rigidity and durability. These changes could be the result of increased cross-linkage of type IV collagen or alterations to other components of the basal lamina. A similar mechanism may be responsible for the thickening of perineurial basal laminae and the reduplication of basal laminae around endoneurial capillaries in diabetic patients; such reduplication may lead to reduced compliance of the vessel walls and impaired vascular perfusion. PMID- 2779737 TI - Ceroid-lipofuscinosis (Batten's disease): pathogenesis and sequential neuropathological changes in the ovine model. AB - A sequential morphological study of ovine ceroid-lipofuscinosis showed that brains of affected lambs were normal at birth, grew until four months of age but then atrophied. Laminar necrosis of cerebral cortex was noted at 10 weeks, occurring first in the parietal area, then spreading to involve frontal and occipital areas while the temporal lobe was least and last affected. With progression of the disease, the laminar pattern was lost. Neuronal necrosis was accompanied by a severe astrocytosis. The granular and multilamellar storage cytosomes increased in size with age. Their structure was interpreted as paracrystalline in which repeating molecules of the dominantly stored lipid binding subunit of mitochondrial ATP synthase interact with neutral lipids and phospholipids. Abnormal cytosomes in neurons of lamb fetuses and a neonate were interpreted as early lesions which contained whorls or stacks of bilayered membrane as well as the more complex multilamellar material. The underlying anomaly leading to the storage of the lipid binding subunit of mitochondrial ATPsynthase remains to be defined. However, it is noted that this disease should be regarded as a lipid binding protein proteinosis or alternatively as a proteolipid proteinosis. PMID- 2779740 TI - Free amino acids in the cerebrospinal fluid of children with febrile seizures. AB - The content of free amino acids in the cerebrospinal fluid from 52 children in different age groups with febrile seizures were determined and compared to 88 age matched children without seizures. We found that the concentrations of some amino acids in CSF in the control group decreased slowly with age, reaching the concentrations found in adults at the age of 3 to 6 years, and that the free amino acid levels were no significantly altered by temperature. The free amino acids in the CSF from patients with febrile seizures showed a different pattern of change with age. These results suggest that the same type of convulsive disorder may show a different alteration in amino acids in CSF depending on the patient's age, and that the degree of elevation of body temperature is not implicated in these changes. PMID- 2779739 TI - Neuropeptide Y-like immunoreactivity is present in boutons synapsing on vasopressin-containing neurons in rabbit supraoptic nucleus. AB - Ultrastructural immunocytochemical methods were used to examine the relationship between nerve terminals containing neuropeptide Y-like immunoreactivity and vasopressin-containing neurons in the rabbit supraoptic nucleus. Some boutons containing neuropeptide Y-like immunoreactivity formed synapses on the soma and proximal dendrites of vasopressin-containing neurons. PMID- 2779738 TI - Immunoreactive prolactin in the hypothalamus and cerebrospinal fluid of male and female rats. AB - Immunoreactive prolactin (ir-PRL) has been identified in the cerebrospinal fluid (CSF) and brain of the male and female rat. In this study we determined the concentration of ir-PRL in the CSF and hypothalamus under conditions known to increase or decrease serum PRL. Hypophysectomy (60 days) significantly decreased the concentration of ir-PRL in the CSF of male (4.9 +/- 0.7 vs. 3.0 +/- 0.3 ng/ml) and female (5.8 +/- 0.9 vs. 3.1 +/- 0.5 ng/ml) rats. However, the effect of long-term hypophysectomy on hypothalamic ir-PRL was gender-dependent. That is, in the male rat hypophysectomy did not affect the content of ir-PRL in the female rat, long-term hypophysectomy decreased the content of ir-PRL in the median eminence, ventral hypothalamus, and dorsal hypothalamus 37, 40, and 47%, respectively. Estradiol replacement to the hypophysectomized female rat normalized the content of ir-PRL in the median eminence (96 +/- 5.8 to 131 +/- 9.6 ng/mg protein), ventral hypothalamus (11 +/- 0.6 to 16.0 +/- 1.1 ng/mg protein), dorsal hypothalamus (4.7 +/- 0.4 to 8.6 +/- 0.4 ng/mg protein), and the concentration ir-PRL in the CSF (2.5 +/- 0.3 to 4.6 +/- 0.4 ng/ml). In intact female rats, administration of haloperidol induced a marked hyperprolactinemia, and significantly increased CSF ir-PRL (5.1 +/- 1.5 vs. 18.0 +/- 3.8 ng/ml). However, in the same rats, the content of ir-PRL in the median eminence was significantly decreased while the ir-PRL content in the ventral hypothalamus and dorsal hypothalamus was unaffected.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2779742 TI - Magnetic resonance imaging in autism: preliminary report. AB - MRI was performed for 18 autistic patients, 11 patients with uncomplicated mental retardation (MR) and 18 controls. In autism and MR, and altered left/right relationship of the frontal lobe volume was observed. The altered asymmetry was more severe in autism than in MR. The brain stem was smaller in MR than in the controls, and the right operculum was smaller in MR than in autism. These findings are consistent with the hypothesis that some autisms may involve a type of early developmental abnormality. Furthermore, our results suggest that autism may involve a type of structural brain impairment different from MR. PMID- 2779741 TI - Autosomal recessive microcephaly, mental retardation with nonpigmentary retinopathy and a distinctive electroretinogram. AB - The association of microcephaly and mental retardation with a non-pigmentary retinopathy is described in three siblings of consanguineous parents. The electroretinogram showed the distinctive appearance of markedly attenuated "b" wave but normal "a" wave suggestive of a retinal dystrophy primarily affecting post-receptoral elements in the inner retina. This appears to be an autosomal recessive condition which has not been previously reported. PMID- 2779743 TI - EEG monitoring of prolonged thiopentone administration for intractable seizures and status epilepticus in infants and young children. AB - Thiopentone anaesthesia was used in the treatment of seizures in 19 infants and young children. Nine had a pre-existing seizure disorder without acute cerebral injury and 10 had status epilepticus secondary to an acute cerebral illness. Clinical details, drug levels and findings from serial multichannel electroencephalograms (EEG) and continuous 1 to 2 channel signal processed EEGs using a Cerebral Function Analysing Monitor (CFAM) were reviewed to evaluate the contribution of these techniques to clinical management. Initial EEGs showed discharges that were not generalised in 16/19 patients. This necessitated the use of 7 different montages for continuous monitoring. Three different CFAM patterns representing particular EEG paroxysmal findings were seen. Acute seizure control was achieved in all 19 patients. All patients with a pre-existing seizure disorder survived, although 4/10 with an acute cerebral illness died. During treatment, patterns of burst-suppression to electrocerebral silence (ECS) were eventually seen in 16/19 patients and repeat EEGs demonstrated concordant multi channel findings in 8/8. Although increasing thiopentone levels (13 patients) correlated with deeper suppression of cortical electrical activity, there was marked inter-patient variability. Inotropic support was not required during the period of treatment even when ECS was induced. In young children a combination of multi-channel EEG and continuous 1 to 2 channel monitoring has advantages over either method used alone. In individual patients on-line monitoring can be easily incorporated in a protocol of controlled cortical suppression and drug titration for seizure control. PMID- 2779744 TI - Early onset leukodystrophy with distinct facial features in 2 siblings. AB - Two siblings with marked subcutaneous tissue atrophy, delayed dentition and a degenerative neurological condition characterised by nystagmus, ataxia and spasticity are described. Myelin was almost totally absent on the magnetic resonance image brain scan performed on one sibling. There was no history of photosensitivity and ultraviolet irradiation of cultured fibroblasts did not inhibit RNA synthesis. We believe that these children have a previously undescribed syndrome, which, although clinically similar to Cockayne syndrome, is readily distinguished from it. PMID- 2779745 TI - Evoked potentials show early and delayed abnormalities in children with congenital hypothyroidism. AB - To evaluate the effect of congenital hypothyroidism (CH) on nervous system development, we performed evoked potential studies on 7 CH infants at 3-8 weeks of age before treatment and at four months or more after treatment began. All infants were screened using filter paper determination of T4 and TSH, confirmed by serum specimen determinations. These infants had serum TSH concentrations greater than 100 microU/ml (normal less than 7), and the serum T4 range was 4.1 8.5 micrograms/dl. All had thyroid tissue on 99Tc scan; five had ectopic thyroid tissue, and two had a thyroid gland in the normal location. Four older CH children were tested after 3-6 years of treatment. Brainstem auditory evoked potentials (BAEP) were abnormal in three of the 7 infants and showed bilateral conduction delays in caudal brainstem regions. The BAEP became normal after 6 months of thyroxine treatment. Visual evoked potentials (VEP) were abnormally delayed and had an immature pattern in the four patients tested at four weeks of age. At age 8 weeks, even in untreated patients, the VEP was normal and remained so. Somatosensory evoked potentials (SSEP) were normal at the time of diagnosis. However, seven patients tested after at least five months of therapy had prolonged central conduction times. We conclude that infants with relatively mild CH (serum T4 values greater than 4 micrograms/dl at 3-8 weeks of age) have evidence of delayed visual system maturation that becomes normal even without treatment and of abnormal caudal brainstem development that resolves slowly with replacement therapy.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2779746 TI - Macrocephalies--a differentiated approach. AB - We present a clinical study of 43 macrocephalic children with a normal rate of headgrowth. The aims of the study were an evaluation of the usual criteria of macrocephaly and the drafting of a differentiated approach to the investigation of macrocephalics. Firstly, the value of head measurement in evaluating intracranial volume was assessed. As a golden standard for the intracranial volume the volume obtained by means of a CT-scan technique was used. It appeared that only about 30% of the variance of the intracranial volume was determined by the occipito-frontal circumference (OFC). A better estimation of the intracranial volume of the macrocephalic children was obtained by means of the "Utrecht Head Measure", the product of OFC-squared and the head height. Based on length measurements taken from CT-scans, the macrocephalic children were divided into three subgroups: megalencephaly (n = 15), extraventricular obstructive hydrocephalus (n = 5) and communicating hydrocephalus (n = 23). The clinical pictures of the megalencephalic and hydrocephalic children appeared to differ substantially. The megalencephalic subgroup had less neurological symptoms and physical abnormalities and showed a higher intelligence or a more advanced development or both. On the basis of our experience and theoretical considerations guidelines were developed for the assessment of patients with macrocephaly and a normal rate of head growth with a differentiated approach for megalencephalic and hydrocephalic patients. PMID- 2779747 TI - The Landau-Kleffner syndrome--case report and theoretical considerations. AB - The Landau-Kleffner syndrome is an acquired condition in children consisting of aphasia and epileptic discharges in the EEG with or without clinical manifestation of epilepsy. We describe a case of a very young child whose neurologic and language development before onset of the illness was uniquely well documented. Apart from her aphasia she showed several other disturbances of higher cortical functions in the acute phase of the illness. No anatomical basis has been discovered for this disease till the present day. We discuss the possibility of an electrical dysregulation in several parts of the cortex as a pathophysiological basis for this syndrome. PMID- 2779748 TI - Postinfectious encephalitis with multifocal white matter lesions. AB - Two cases of multifocal white matter lesions occurring after viral illness are reported. Evoked potentials study and cranial magnetic resonance imaging (T2 weighted image) showed early abnormalities while CT scan was initially normal. Patients improved dramatically with steroid therapy. It would seem that because of a considerable responsiveness to steroids this affection should be differentiated from other types of encephalitis. Relations with multiple sclerosis are discussed. PMID- 2779749 TI - Continuous spikes and waves during slow sleep: a 30 months follow-up study of neuropsychological recovery and EEG findings. AB - An eight-year-old boy is reported who presented with a progressive mental deterioration in the years following a nocturnal asymmetrical generalized tonic clonic seizure. The diagnosis of continuous spikes and waves during slow sleep (CSWS) was made. Once a month a sleep recording was made during twenty-two consecutive months and detailed neuropsychological studies were made over a period of 30 months. Intensive antiepileptic treatment resulted in the disappearance of the CSWS and in a recovery from intellectual-, language- and behavioural disturbances. The good results were still present at a follow-up examination 30 months later. PMID- 2779750 TI - Ischemic stroke due to fibromuscular dysplasia. AB - Fibromuscular dysplasia is a segmental, nonatheromatous angiopathy. A 13-year-old patient is reported with stroke. Left-sided carotid angiogram revealed typical findings of fibromuscular dysplasia in the left carotid artery. PMID- 2779751 TI - Effects of intranigral application of clinically-effective anticonvulsants on electroshock-induced seizures. AB - The authors sought to determine whether focal application of clinically-effective anticonvulsants to the substantia nigra produced anticonvulsant effects. To this end, the effects of phenobarbital, carbamazepine and phenytoin were examined on the electroshock seizure model in rats. Anticonvulsant efficacy was assessed by measuring the duration of tonic hindlimb extension before and after injection. It was found that application of phenobarbital into the nigra produced behavioral stereotypy and suppressed tonic hindlimb extension in a dose-dependent manner. These effects were spatially specific to the substantia nigra. By contrast, application of phenytoin or carbamazepine to the nigra produced neither anticonvulsant effects nor behavioral changes. Direct measurement of phenobarbital and carbamazepine in the substantia nigra showed that differences in concentration in the substantia nigra did not account for the lack of efficacy of carbamazepine. Moreover, concentrations of phenobarbital in the nigra after effective injection into the nigra exceeded concentrations in the nigra after effective systemic injections, by tenfold. Taken together, these data provide no compelling evidence that an action of the substantia nigra alone is sufficient to explain the therapeutic action of clinically-useful anticonvulsants. PMID- 2779752 TI - Serotonin-antagonist effects of 1-(1-naphthyl)piperazine on operant behavior of squirrel monkeys. AB - 1-(1-Naphthyl)piperazine (1-NP) has been reported to have serotonin antagonist properties at the 5-HT2 subtype of receptor, and it has been suggested that it may have agonist actions at the 5-HT1 site. In the present experiments, the effects of 1-NP alone and in combination with a variety of 5-HT agonists, were studied in squirrel monkeys performing under a number of reinforcement schedules. The phenalkylamine hallucinogen 4-bromo-2,5-dimethoxyamphetamine (DOB, 0.01-0.3 mg/kg), which is thought to have predominant actions at 5-HT2 sites, reduced responding under fixed-interval (FI) schedules of presentation of food, and these decreases were blocked by 1-NP (0.3-1.0 mg/kg) or by the selective 5-HT2 antagonist, ketanserin (0.3 mg/kg). 1-(1-Naphthyl)piperazine also antagonized the decreases in responding produced by quipazine (0.1-5.6 mg/kg), another agonist with predominant 5-HT2 actions. 1-(m-Chlorophenyl)piperazine (mCPP, 0.1-3.0 mg/kg) and 1-(m-trifluoromethylphenyl)piperazine (TFMPP, 0.1-3.0 mg/kg), both thought to act primarily at 5-HT1 sites, also decreased responding and this effect was blocked by methysergide and by 1-NP, but not by ketanserin. The effects of 1-NP (0.3-5.6 mg/kg) given alone were not like those of mCPP or TFMPP. 1-(1-Naphthyl)piperazine produced moderate increases in responding under shock avoidance schedules, whereas only decreases in responding were seen after mCPP and TFMPP.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2779753 TI - Long-term neurological assessment of the post-resuscitative effects of flunarizine, verapamil and nimodipine in a new model of global complete ischaemia. AB - In anesthetized rats, global complete ischaemia lasting for 9 min was induced by controlled hydraulic compression of the chest. A neurological score, based on cranial and spinal reflexes, postural tone, gait, movement and limb placement, was determined at 2 hr and 1, 2, 3, 7, 14, 21 and 28 days after resuscitation. Three doses of three calcium antagonists, flunarizine, verapamil and nimodipine and their respective solvents, were given intravenously during the resuscitation. The total neurological score was significantly better than solvent with 0.16 and 0.63 mg/kg of flunarizine and 0.04 and 0.16 mg/kg of verapamil; it was significantly better with solvent (10% ethanol) than with 0.04 and 0.16 mg/kg of nimodipine. The deficiency in tactile placing reactions of the hindpaws was the most resistant to therapy. This non-invasive model of global ischaemia in rats seems useful for the evaluation of drugs, since it requires minimal anesthesia and allows assessment of neurological recovery over an extended period of time. PMID- 2779754 TI - Colchicine administered into the area of the nucleus basalis decreases cortical nicotinic cholinergic receptors labelled by [3H]-acetylcholine. AB - Lesions in the nucleus basalis in the rat are known to decrease presynaptic markers for acetylcholine, including levels of cholineacetyltransferase (CHAT), high affinity uptake of choline and levels of acetylcholinesterase. Effects of lesions of the nucleus basalis on populations of nicotinic and muscarinic receptors are less well understood. After bilateral injection of the neurotoxic agent, colchicine into the nucleus basalis in the rat, levels of CHAT in the cerebral cortex were reduced 44%. Muscarinic cholinergic [( 3H]QNB) and dopaminergic [( 3H]spiroperidol) binding was not changed in the cortex, hippocampus or striatum. However, significant decreases in nicotinic binding sites, labelled by [( 3H]acetylcholine), were observed in the frontal cortex of nucleus basalis treated animals; scatchard plot analysis indicated a significant decrease in the number, but not affinity, of nicotinic binding sites. Colchicine injected into the nucleus basalis had no effect on the binding of [3H]acetylcholine in the hippocampus, but decreased binding of [3H]acetylcholine in the striatum. Subsequent experiments, in which colchicine was administered into the striatum at a site above the nucleus basalis had no significant effect on nicotinic binding in the striatum or frontal cortex. These results support the hypothesis that degeneration of the nucleus-basalis-cortical cholinergic pathway results in a loss of presynaptic nicotinic binding sites in the cortex as well as in the striatum (through transsynaptic degeneration of the cortico-striatal pathway). PMID- 2779755 TI - Anticonvulsant profile of an anesthetic steroid. AB - The synthetic steroids alphaxalone and alphadolone are combined for use as a veterinary anesthetic and marked under the trade name Saffan. This study evaluated the anticonvulsant activity of Saffan in 2 rat models of epilepsy: maximal electroshock and subcutaneous pentylenetetrazol seizures. Neurological deficit was tested in each animal just prior to the seizure test to differentiate selective antiepileptic effects from nonselective anticonvulsant or anesthetic activity. In both seizure models Saffan induced anticonvulsant activity only at doses associated with neurological deficit. PMID- 2779756 TI - L-glutamate stimulates the efflux of newly taken up glutamine from astroglia but not from synaptosomes of the rat. AB - Bulk isolated rat astrocytes loaded with [14C] glutamine (Gln) were superfused on glass fiber filters with a standard Krebs-Henseleit medium until the basal efflux of the radioactivity became constant. The samples were then pulse-treated with: L glutamate (Glu), gamma-aminobutyric acid (GABA), L-aspartate (Asp), cold Gln, or catecholamines, each at 0.5 mM concentration. Of the neurotransmitters tested, only Glu stimulated the efflux of radio-labelled Gln. The effect of Glu was sodium-dependent and was not mimicked by the Glu-receptor agonists: N-methyl-D aspartate (NMDA), quisqualate (Quis) or kainate (KA), indicating a transport mediated mechanism. Glu did not stimulate the efflux of newly taken up glutamine from either crude or purified brain synaptosomes, which is in keeping with the existing evidence that astrocytes function as a glutamine donor to other compartments of the central nervous system. PMID- 2779757 TI - Angiotensin II stimulates sympathetic output by a direct spinal action. AB - When administered intrathecally in a dose of 10 mu to the ninth thoracic segment of the spinal cord in the anesthetized rat, angiotensin II produced a transient increase in systolic and diastolic arterial pressures lasting 1-4 min. Heart rate was also increased, but in this case for more than 30 min. Similar administration of 5 micrograms or of CSF had no effect on either arterial pressure or heart rate. Neither the arterial pressure nor the heart rate response to 10 micrograms of angiotensin II was observed in rats given hexamethonium (10 mg/kg, i.v.), suggesting that the effects were mediated by spinal activation of sympathetic output. When the rats were pretreated with 10 micrograms of [Sar1, IIe8] angiotensin II three min prior to angiotensin II, there was a block of the increase in arterial pressure but not of the increase in heart rate. When the antagonist was given 15 min prior to angiotensin II, the full pressor response appeared, suggesting that the antagonist was effective for less than 15 min; in addition, after the antagonist alone, while arterial pressure remained unaltered, there was a gradual increase in heart rate suggesting that the analogue had agonistic effects on mechanisms regulating heart rate. These results suggest that angiotensin II activates sympathetic mechanisms by a spinal action and that arterial pressure and heart rate are regulated differentially, arterial pressure via a mechanism which is antagonized by [Sar1, IIe8]-angiotensin II, and heart rate via a mechanism in which the analog can act as an agonist. PMID- 2779758 TI - Strain differences in central nervous system concentrations of cholecystokinin between normotensive Wistar Kyoto (WKY) and spontaneously hypertensive (SH) rats. AB - The regional brain and spinal cord concentrations of cholecystokinin-octapeptide (CCK-8) were measured in age-matched normotensive Wistar-Kyoto (WKY) and spontaneously hypertensive (SH) rats. The relative order of distribution of CCK-8 in the WKY strain was hippocampus (20.5 +/- 1.3 pmol/g) greater than cortex greater than striatum = hypothalamus greater than midbrain = thalamus greater than spinal cord greater than medulla oblongata/pons (MO/P, 1.6 +/- 0.2 pmol/g) whereas in the SH strain this order was hippocampus (12.9 +/- 0.8 pmol/g) greater than cortex = striatum greater than hypothalamus greater than midbrain greater than thalamus = spinal cord greater than MO/P (1.4 +/- 0.2 pmol/g). The concentrations of CCK-8 in the cerebellum were at the level of assay sensitivity (0.5 pmol/g in both strains). In comparison to the WKY rats, the SH strain had significantly lower levels of CCK-8 in the hippocampus (-37%), cortex (-28%), spinal cord (-23%) and pituitary (-57%). The lowered levels of CCK-8 in the brain of the SH rat may be causally related to, or result from, the cardiovascular, behavioural or morphological abnormalities of this strain. PMID- 2779760 TI - Ultrastructural changes in neurons and interneuronal synapses of the hypothalamus in progeny of morphine-dependent rats. PMID- 2779759 TI - Possible mechanisms of synapse formation in ontogeny. PMID- 2779761 TI - Effect of weightlessness on some indices of brain development (results of residence of pregnant rats aboard the Cosmos-1514 biosatellite and investigation of subsequent development of their offspring on earth). PMID- 2779762 TI - Effect of laser radiation on post-traumatic restoration of interneuronal connections of the sympathetic trunk. PMID- 2779763 TI - Avesicular intercellular junctions in the neuropil of ganglia of the subpharyngeal complex and in nerves of the snail. PMID- 2779765 TI - Electrophysiological and clinical importance of early and late components of the winking reflex and their role in diagnosis. PMID- 2779764 TI - Level of glucocorticoid hormones in early postnatal ontogenesis and circadian rhythms of endocrine-metabolic functions in adult rats. AB - The disturbance of the glucocorticoid balance in early postnatal ontogenesis (17 19 days) as the result of prednisolone administration has been shown to lead to partial suppression of circadian adrenocortical activity in adult rats. The circadian rhythm of FFA in these groups of animals was not detectable and the circadian acrophase of blood glucose concentration changed, while diurnal urine periodicity remained unchanged. The diurnal rhythm of locomotor activity in prednisolone-pretreated rats was characterized by a later onset of increase in its activity and a shorter duration. PMID- 2779766 TI - Local changes in transmembrane ionic currents during plastic reorganizations of electrogenesis of isolated neurons of the pond snail. PMID- 2779767 TI - Influence of piracetam on activity of neurons of the neocortex of rabbits during learning. PMID- 2779768 TI - Cellular analog of "instrumental behavior" in individual neurons of a mollusk with intracellular automatic electrostimulation. PMID- 2779769 TI - Cortico-hippocampal relations of electrical activity in rabbits with a polarization-induced motor dominant focus. PMID- 2779770 TI - Short TR, variable flip angle, gradient echo scans of the cervical spine: comparison of 2DFT and 3DFT techniques. AB - A prospective study of 16 patients was performed to compare quantitatively a contiguous single slice 2DFT version with a 3DFT version of a short TR, variable flip angle, gradient echo (GRASS) pulse sequence. The 3DFT GRASS scans had higher signal-to-noise ratios (SNR) of cord and CSF compared to the single slice 2DFT GRASS scans. The 3DFT GRASS scans, however, had lower CSF-cord and CSF-disc contrast than the single slice 2DFT version. The 3DFT GRASS sequence demonstrated comparable contrast only on the end slices of an imaging volume suggesting influence of an entry phenomenon. The lower CSF-cord and CSF-disc contrast of the 3DFT GRASS technique diminished its usefulness in the diagnosis of cervical disc disease compared to the single slice 2DFT GRASS technique. Two different slice thicknesses (3 mm and 5 mm) were investigated with the 2DFT GRASS technique and found to be comparable although the 3 mm scans had sharper disc and dural margins because of less partial volume artifact. PMID- 2779771 TI - MRI assessment of unsuspected dural sinus thrombosis. AB - In three patients with clinically unsuspected diagnosis, MRI has afforded a positive and conspicuous demonstration of dural sinus thrombosis, allowing specific treatment and followed by improvement in the patients' condition. Even in retrospect, CT examinations were nondiagnostic. Presenting symptoms were usual and nonspecific. CT and radionuclide scanning have proved valuable when performed on a clinically oriented basis. Angiography cannot be carried out without clear indications. MRI offers advantages in being a non-invasive technique without ionising radiation, allowing direct visualization and accurate delineation of the thrombus. MRI is definitely the method of choice to assess clinically suspected cerebral venous occlusion. As MRI diagnosis relies on a routine examination protocol, we believe that it will detect other unsuspected cases of dural sinus thrombosis. PMID- 2779772 TI - Multiple cerebral aneurysms--a reappraisal. AB - 254 consecutive cases of angiographically demonstrated intracranial cerebral aneurysms occurring over a three year period were reviewed with specific reference to aneurysm multiplicity, site, patient age and the presence of infundibular abnormalities. The overall incidence of multiple aneurysms was 44.9%. Female patients accounted for 66.5% of all aneurysm cases. The incidence of multiplicity was higher in women (51.5%) than men (31.7%) and overall was higher in patients over 40 years of age (52.8%) compared to those under this age (26.3%). Infundibula occurred in 27.2% of all patients and 9.45% of all patients demonstrated infundibular dilatation of the origin of the posterior communicating artery. PMID- 2779773 TI - Estimation of vertebral arterial asymmetry by computed tomography. AB - In 80 patients with no stenotic lesions in the vertebrobasilar arterial system, a study was made of the relationship between the deviation of the basilar artery (BA) from the midline on computed tomography (CT) and the right-to-left vertebral arterial caliber difference on angiograms. In 66 patients (83%), the BA was visible on plain CT films, and 55 of them showed deviation of the BA to either side. In 44 of these patients (80%), the vertebral artery (VA) contralateral to the side of BA deviation had a larger caliber compared with the ipsilateral one on angiograms. In 6 patients whose unilateral VA terminated in the posterior inferior cerebellar artery (PICA) and showed an extremely small caliber compared to the contralateral one, the BA was always deviated to the side of the smaller VA. Our data suggest that the deviation of the BA on plain CT films may represent a good indicator for estimating the right-to-left VA caliber difference. At the time of vertebral angiography, injection of contrast medium should preferably be made from the larger VA in order to avoid laminar flow in the BA and to shorten the procedure. Prior estimation of the right-to-left VA caliber difference by CT may be of great benefit to the angiographic procedure. PMID- 2779774 TI - The reaction of cerebral arteries to non-ionic contrast media during cerebral angiography. AB - The purpose of this study was to evaluate possible vasoconstrictive or vasodilatator effects of the low osmolar non-ionic contrast medium iohexol (Omnipaque) on the calibre of cerebral arteries. The diameters of respectively 5 and 6 different locations of the vertebral and carotid arteries were recorded from angiograms of 3 successive injections. The material consisted of 18 patients. It could not be shown that Omnipaque induced vasoconstriction or vasodilatation when normal doses and adequate technique was applied. The difference in diameters found were not statistically significant and are probably due to natural pulsations and to the difficulties in performing exact measurements. PMID- 2779775 TI - Opsoclonus-myoclonus syndrome: correlation of radiographic and pathological observations. AB - We report a case of a child with opsoclonus-myoclonus syndrome. Neuroradiological studies indicated a lesion in the cerebellar vermis. A cerebellar biopsy revealed changes consisting of Purkinje and granular cell loss with gliosis. This case report documents the correlation of radiologic and pathological findings in a patient with opsoclonus-myoclonus syndrome. PMID- 2779777 TI - Brain stem type neuro-Behcet's syndrome. Correlation of enhanced CT scans and MRI during the acute and chronic stage of the illness. AB - Brain stem type neuro-Behcet's syndrome was studied with enhanced CT and MRI during the acute and chronic stage of the illness. During the acute stage, brain CT revealed a low density lesion in the brain stem extending from the lower pons up to the midbrain ventrolaterally with marginal enhancement effect. T2-weighted image showed a high signal intensity lesion in the brain stem which mainly involved the basis ponti, tegmentum, tectum and cerebral peduncle. During the chronic stage, the lesion became low in signal intensity with T2-weighted image and reduced in its size without enhancement in brain CT. The prolonged relaxation time of the lesions was gradually normalized with steroid treatment. Sequential brain CT with enhancement and MRI study with T1- and T2-weighted images were useful to detect the lesions and to evaluate the activity in the neuro-Behcet's syndrome. PMID- 2779776 TI - Computed tomographic features of esthesioneuroblastoma. AB - Esthesioneuroblastomas are uncommon neoplasms of the superior nasal cavity originating from olfactory epithelium. High resolution CT features of this neoplasm have not been well studied. Nine cases of esthesioneuroblastoma were reviewed to evaluate findings on high resolution CT. Homogeneous soft tissue masses with relatively uniform enhancement centered in the superior nasal cavity are characteristic. Bony erosion is frequent and usually accompanied by molding of bone. Staging, determined by extension and critical for treatment decisions, is well evaluated by CT. PMID- 2779778 TI - A new algorithm for deriving pulsatile blood flow waveforms tested using stimulated dynamic angiographic data. AB - In vascular pathology the assessment of disease severity and monitoring of treatment requires quantitative and reproducible measurements of arterial blood flow. We have developed a new technique for processing sequences of dynamic digital X-ray angiographic images. We have tested it using computer simulated angiographic data which includes the effect of pulsatile blood flow and X-ray quantum noise. A parametric image was formed in which the image grey-level represents dye concentration as a function of time and distance along a vessel segment. Adjacent concentration--distance profiles in the parametric image were re-registered along the vessel axis until a match occurred. A match was defined as the point where the sum of squares of the differences in the two profiles was a minimum. The distance translated per frame interval is equal to the bolus velocity. We have tested several contrast medium injection methods including constant flow and a range of discrete pulses per second. The technique proved to be robust and independent of injection technique. Average blood flow was measured for simulated pulsatile waveforms with mean flows of up to 650 ml/min (peak velocities up to 186 cm/s) in a range of diameters from 2 mm to 6 mm. The standard deviation of the error in the mean flow estimates over the whole range of velocities and vessel sizes was +/- 1.4 cm/s. PMID- 2779779 TI - Iatrogenic intraspinal epidermoid tumor: myelo-CT and MRI diagnosis. AB - An 11-year-old boy, treated for acute lymphatic leukemia at the age of 2 with intrathecal injections of Methotrexate, presented with a two year history of pain and signs of lumbo-sacral lesion. MRI, myelography and myelo-CT demonstrated an intradural L4-L5 epidermoid tumor which was removed. Iatrogenic implantation of epithelial cells at the age of two with lumbar punctures is most likely. Decline in incidence of lumbar iatrogenic epidermoid cysts, now an exceedingly rare event, is probably related to improved needles for lumbar punctures. PMID- 2779780 TI - MRI in Cockayne syndrome type I. AB - MRI findings are reported from two patients with Cockayne syndrome (CS) type I, aged 11 and 37 years. Changes were compatible with diffuse white matter hypomyelination. Basal ganglia calcification was present in both, marked cerebellar atrophy in the older patient. MRI may support the diagnosis of CS in the appropriate clinical context. The view that CS is a dysmyelinating disorder is further substantiated. PMID- 2779781 TI - Intracerebral and spinal vascular malformation in a patient without hereditary haemorrhagic telangiectasia. AB - A case of intracerebral and spinal vascular malformations in a patient without hereditary haemorrhagic telangiectasia is presented. The spinal vascular malformation was cryptic and its true nature was only revealed by MRI. PMID- 2779782 TI - Spinal brucellosis. A case with "cauliflower" appearance on CT. AB - In this case report, we present a patient with an unusual appearance on vertebral CT due to spinal brucellosis. This "cauliflower" sign may be specific to this disease. PMID- 2779783 TI - Bilateral giant intracavernous carotid aneurysms in a 16-year-old boy. AB - A case of bilateral, non-mycotic, giant intracavernous carotid aneurysms occurring in a hypertensive 16-year-old boy is reported. The pathogenesis of such aneurysms is discussed. PMID- 2779784 TI - Foraminal herniation of a thoracic calcified nucleus pulposus. AB - A case of T10-T11 level calcified disk herniation of foraminal location is reported. Radicular pain was not precisely stated at the onset of complaints. Diagnosis was evoked by plain films and established by CT. PMID- 2779786 TI - Traumatic pneumosaccus. PMID- 2779785 TI - Hemorrhagic abscess in a patient with the acquired immunodeficiency syndrome. PMID- 2779787 TI - Calcified cerebral metastasis from cervical carcinoma. PMID- 2779788 TI - A prospective study on acute spinal injuries. AB - This work examines demographic and clinical characteristics of 163 consecutive cases of acute spinal injuries in a small area of Western Turkey, since 1982. These include all spinal injuries with or without neurological symptoms. Combined conservative and surgical methods were used for treatment. Age, sex, etiology, site of injury, radiologic findings, neurological status, and outcome are compared with the other studies. The results have been found to be parallel to those of the other studies except for some regional differences like an excess of tractor accidents. PMID- 2779789 TI - Combined orbito-frontal injuries. AB - Our experiences in 55 patients suffering from orbitofrontal injuries are discussed. The prognosis is determined by the severity of the brain injuries and the cerebral complications. The relation of fronto-basal, orbital, and maxillofacial fractures to lesions of the brain tissue and contents of the orbita is best demonstrated in high-resolution CT scan. Surgery is usually possible in one interdisciplinary operating session. Penetrating injuries with CSF leakage primarily require operative therapy; indirect, open, frontobasal fractures should be covered secondarily within two weeks following trauma. A debridement of the paranasal sinuses is necessary if drainage is obstructed or infection is imminent. We found no improvement of visual function in eight patients following transethmoidal optic nerve decompression; the visus recovered only in one patient after removal of a bone fragment impressing on the eyeball. Typical complications are systematic or central nervous system infections; less frequent are traumatic cavernous-sinus fistulas and pneumato- or encephaloceles. PMID- 2779790 TI - Oculomotor nerve palsy in patients with cerebral aneurysms. AB - Twenty-six patients with oculomotor nerve palsy due to cerebral aneurysms were examined. There were six males and twenty females with a mean age of 55 years. 25 of the 26 aneurysms were located at the junction of the internal carotid and the posterior communicating artery and one was at the junction of the basilar artery and the superior cerebellar artery. Twelve patients had associated subarachnoid hemorrhage (SAH); the other 14 did not. The initial symptoms in many patients were ptosis and double vision. Twenty-one of the patients had total oculomotor nerve palsy, one had a sparing of medial rectus muscle; three patients had only ptosis and anisocoria, and one had oculomotor nerve palsy with pupillary sparing. All aneurysms, including giant aneurysms, were clipped under a microscope, and six oculomotor nerves were found to be decompressed at surgery. The follow-up periods were from six months to three years. Nine patients had a complete recovery of oculomotor function; thirteen had an incomplete recovery; and four remained unchanged. The mean interval between the onset of palsy and the time of surgery was 24 days in complete recovery cases, 42 days in incomplete recovery cases, and 119 days in unchanged cases. The recovery of oculomotor function started with the levator palpebrae muscle and followed by the medial rectus muscle. The recovery of pupillary function was, however, not consistent. Of the factors influencing recovery from oculomotor nerve palsy, the interval between the onset of palsy and the time of surgery was most important. Therefore, aneurysms with oculomotor nerve palsy should be operated on as early as possible, regardless of the presence or absence of SAH. PMID- 2779791 TI - Traumatic brain swelling studied by computerized tomography and densitometry. AB - Two-hundred and fifty-two computerized tomography (CT) scans of 107 patients with head injuries were analyzed. The most frequent consequence of trauma was a diffuse swelling of the brain in 91% of the cases. The severity of brain swelling and its course can be estimated by the compression of (or absence of) the intracranial cerebrospinal fluid space. These observations may be of prognostic value as well. By measurement of the Hounsfield units (HU) in 52 cases the blood or water content in the brain tissues was assessed. An increase in blood content of the tissues (hyperaemia) can account for an increase in Hounsfield values. A decrease in HU suggests brain edema. The density measurements showed that in the first hours and days following head injury, the diffuse brain swelling was caused by severe cerebrovascular congestion in the majority (53%) of the cases. Immediate brain edema without a preceding hyperaemic phase occurs less frequently (32%). Between the 1st and 4th day after injury, edema started to prevail, and between the 5th and 8th day the edematous type of brain swelling was present almost exclusively. PMID- 2779792 TI - Current therapeutic methods of dural arteriovenous malformation: are there any alternatives? Two case reports of infratentorial AVM's. AB - We describe two cases of infratentorial dural AVM, in which a successful surgical intervention was performed. This procedure was chosen as the repeated treatment by embolization proved to be ineffective. Theories as to the pathogenesis of dural AVM, the current treatment as well as options for new therapies are presented. PMID- 2779793 TI - Risk factors of recurrent disc herniation. AB - The causes of 100 disc herniation reoperations are analyzed and discussed in a review: we find a recurrence of disc herniation at the same level in 62% of the reoperated cases, a pseudorecurrence in 24% and a closely connected nerve route in 14%. We reoperated on 44% within the first two years and on 69% within the first five years. The interval between the operations is longer, when there is a short painfree interval following surgery and also a long history of pre operative symptoms. The variables of risk of prolapse recurrence are recorded as a risk score. Retrospectively, 64% belonged to a risk group according to this score. The correlation between operation intervals and scores show, that patients with a short interval have high scores. PMID- 2779794 TI - Degenerative and regenerative processes in the peripheral nerve after disconnection and reanastomosis using the Neodym Yag laser. AB - The development of neuroma after peripheral nerve surgery is still an unsolved problem. Such lesions are not yet controllable by conventional methods. Reports of results achieved using various types of laser surgery appear contradictory. In this experimental study on rats, the Neodym Yag laser was found to be superior the conventional methods. After severance and reanastomosis of the sciatic nerve using this type of laser, no development of neuroma was observed in any of the animals during the first three months of observation. PMID- 2779795 TI - Intracranial ependymomas: prognostic aspects. AB - According to the grading of brain tumors as proposed by the WHO in 1976, out of 128 ependymomas 83 tumors could be classified as grade II and 38 as grade III Only seven subependymomas were benign and could be assigned to grade I. In contrast to most series known from the literature, 73 ependymomas were located above the tentorium and only 55 in the posterior cranial fossa. The grade of malignancy rised with an increased distance from the ventricular level. Macroscopically complete exstirpations were usually possible in hemispheric ependymomas, whereas tumors arising from the floor of the fourth ventricle often allowed only a partial removal. The operative mortality in the infratentorial group was more than twice as that in the supratentorial group. Postoperative survival was predominantly dependent on the histologic grade of malignancy. The five year survival rate without recurrence was 57.4% in grade II ependymomas as compared to 24.1% in grade III ependymomas. It could be improved by postoperative radiation therapy in both groups of malignancy. The almost identical longterm results indicate that even in less malignant ependymomas new tumor growth will occur later on. PMID- 2779796 TI - Arterio-venous malformations in childhood: clinical presentation, results after operative treatment and long-term follow-up. AB - In a series of 182 arterio-venous malformations (AVM) recently published we found 33 children aged 1 to 16 years. In 28 cases, the admitting condition was hemorrhage. For 31 AVMs total excision was possible. We observed one postoperative death accounting for a mortality of 3%. All children but two were followed-up by personal examination. Two were not able to work due to severe neurological deficits and seven had not been able to get into their intended occupation. PMID- 2779797 TI - Tethered cord syndrome: progressive symptomatology in adults. Case report: symptoms, diagnosis, treatment. AB - Medical history and symptoms of a 37 year old woman showing progressive conus syndrome for nine months after a symptomless interval of 20 years are reported. NMR, myelography, and computed tomographic myelography verify a filum terminale with a paramedian fixation at the level of the lumbosacral angel and a further fixation at the caudal end of the dural sac at the lower end of the sacrum. The operative findings and procedures are described. The importance of control by neuro-stimulation of the filum terminale during surgery is stressed. The post operative remission of most of the symptoms proves the success of the treatment. PMID- 2779798 TI - Diastematomyelia combined with disc herniation at T 6/7 in an adult. Case report. AB - A case of thoracic diastematomyelia associated with acute disc herniation is reported. The female patient noted sensory and motor symptoms at 49 years of age, four months before hospitalization. Myelography, myelo-computerized tomography and nuclear resonance tomography of the thoracic spine and cord showed the region of diastematomyelia with an additional disc herniation at T 6/7. The bone spur and the disc was successfully excised. Post-operatively, the patient's deficits improved. PMID- 2779799 TI - [Radioisotopic angiographic study of left ventricular function in hypertensive disease]. AB - The aim of this study was to evaluate left ventricular function in 26 patients with essential arterial hypertension, compared with 33 normal subjects, using gated radionuclide ventriculography. The hypertensive patients had reduced values of ventricular ejection fraction (EF), peak ejection and peak filling (PRF) rates. A group of 10 hypertensive patients with normal EF, showed significantly reduced values of PFR, as compared to normal subjects. The older hypertensive patients had significantly reduced PRF values, compared to younger patients. PFR is a more sensitive index in evaluating the impairment of ventricular function in patients with hypertension, though it lacks real discriminating diagnostic value. In hypertrophic heart disease the association between arterial hypertension and old age contributed to accentuate the abnormality in ventricular diastolic filling. PMID- 2779800 TI - [Acute myocardial infarction in subjects under 40 years of age. Coronary risk factors]. AB - Myocardial infarction in the under-40s is rare. A series of 19 patients, 3.07% of a two-year series of coronary cases, is presented with a view to evaluating the incidence of risk factors, with special attention to familial factors and dyslipoproteinaemia. Risk factors are discussed together with the statistical importance of family aspects in two previous generations. Family factors and the abnormal lipoprotein profile are statistically important while other risk factors such as arterial hypertension, obesity and the use of oral contraceptive are insignificant. Cigarette smoking was a factor in more than 50% of cases and this strengthens the effects of other factors (obesity and hypertension) which, alone, do not appear to have any inductive importance in the genesis of coronary disease in this particular age segment. PMID- 2779801 TI - [Angina pectoris caused by dynamic coronary obstruction and beta-blockers]. AB - This review of the literature covers the clinical results of treatment with beta blockers in those forms of cardiac ischaemia characterised by a coronary vasomotor component. Particular consideration is given to a paper by Mulcahy et al. which confirms and reinforces the results of other clinical works on the therapeutic effectiveness of the cardioselective beta-blocker atenolol in these mixed forms of ischaemia (fixed coronary stenosis plus dynamic coronary stenosis). The effectiveness of atenolol proved greater or at least on a par with that of the calcium antagonist nifedipine. The probable mechanisms underlying these clinical results are described and it is concluded by noting the therapeutic potentiation obtainable using the beta-blocker together with nifedipine. PMID- 2779802 TI - [Postoperative constrictive pericarditis]. AB - Seven cases of postoperative constrictive pericarditis (PCP) were discovered in a retrospective study of patients given heart surgery in a hospital receiving patients from all over Italy in 1970-85. Five of those patients had received surgery for chronic rheumatic heart disease, 2 for congenital heart defects. Four had received a second heart operation before the pericardial condition was recognised. All were females and all presented systemic venous hypertension (one of them only after acute doses of physiological solution) with thickening of the pericardial layers revealed by sonography. In six cases the electrocardiographic ventricular complexes were normal or increased in amplitude and the heart/chest ratio was greater than 0.55. Pericardial knock was masked by natural or artificial atrioventricular valve opening noises in 6 cases. In one case only there were pericardial calcifications or signs of an earlier postpericardiotomy syndrome. The haemodynamic investigation revealed signs of ventricular diastolic constriction in 6 patients. Three patients died from complications of cardiac cirrhosis: 2 of them had previously received partial pericardiectomy. Another two, given the same operation, preserved a reasonable functional capacity 5 and 10 years after the pericardiectomy. One patient in NYHA functional class III has so far refused haemodynamic assessment (and surgical treatment) of the pericardial disease. Finally, the last patient complains only of attacks of heart palpitation caused by atrial flutter and controlled by antiarrhythmic treatment.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2779803 TI - [Chronic treatment of vascular diseases with indobufen]. AB - The effects of chronic treatment with indobufen, an inhibitor of platelet aggregation, was studied in a group of 1428 patients with vascular problems treated in a period of about 6 years in our Units. Venous problems were the major vascular problem in 313 patients, peripheral vascular diseases in 553 and cerebrovascular problems in 562. In patients with venous problems the range of the treatment period in different groups of patients varied from 2 to 42 months. The range was from 1 to 48 months in the group of patients with peripheral vascular diseases and from 2 to 48 in patients with cerebrovascular diseases. An analogic score was used to evaluate the efficacy of indobufen, which was also compared for the occurrence of side-effects with ASA (acetylsalicylic acid) and dipyridamole. Results obtained in this large, chronic open study confirmed the efficacy of indobufen in preventing (or reducing the occurrence) of vascular problems which was significantly greater than that observed with the other two drugs used for comparison. Indobufen also resulted in a lower incidence of side effects (particularly gastrointestinal disorders) and it was better tolerated than both dipyridamole and ASA. PMID- 2779804 TI - [Efficacy of ubidecarenone in the treatment of patients with cardiac insufficiency]. AB - In 11 patients suffering from medium to severe heart failure, we performed a clinical and instrumental study to evaluate the effectiveness of ubidecarenone (60 mg/die in a single oral dose), in addition to conventional treatment with digitalis and diuretics. After an 8-month follow-up in most patients we observed a significant improvement in clinical symptoms and in quality of life. Furthermore we were able to demonstrate a statistically significant decrease in left atrium dimensions (p less than 0.01), end-diastolic (p less than 0.01) and end-systolic (p less than 0.05) left ventricular diameters and a significative reduction in the distance of the septum from the e point of the mitral valve (p less than 0.05), expression of significant improvement of cardiac output. PMID- 2779805 TI - [Urokinase in the therapy of spontaneous angina]. AB - In an open non-comparative clinical study, 19 patients with spontaneous angina pectoris admitted to hospital with attacks lasting greater than 10 minutes, unresponsive to nitrate and/or calcium antagonist treatment, at least 2 ECG readings of raised (greater than or equal to 1.5 mm) or lowered (greater than or equal to 1 mm) ST segment not attributable to earlier AMI in the same area, were treated after the interruption of conventional treatment (mean 47 +/- 34.2 min) with 2 million IU endovenous UK in 15 mins followed by 1 million IU endovenous UK in 60 mins. Sixty minutes after UK administration was terminated, they were given a bolus of 5000 IU calcium heparin, followed by 1000 IU per hour for 2 days. Coronary angiography (Judkins technique) was performed before the start of UK treatment and 15, 30, 45, 60 and 75 minutes into it. RESULTS: Basal coronarography showed only "multiple organic stenosis" in 5 out of the 19 patients, a more complex situation suggestive of thrombi in the coronary arteries in 14. Subsequent angiographies (mean 30 mins later) revealed coronarographic improvement in 11 out of the 19 (58%), or 11 out of 14 (78.5%) if we exclude those with simple stenosis. Angina attacks were significantly lower in the 8 days after UK treatment than in the week before it in terms of number (4 v. 1; p less than 0.01), global severity (7 v. 1.5; p less than 0.01) and global duration (45 v. 4.25 min; p less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2779806 TI - [Venoruton and capillary permeability]. AB - A new system to evaluate capillary permeability, the vacuum suction chamber (VSC) device, was used to assess the effects of Venoruton in patients with venous hypertension. A temporary, superficial skin lesion (wheal) was produced with the VSC device by negative pressure (30 mmHg) applied for 10 minutes on the internal, perimalleolar region. Wheals disappear in less than 60 minutes in normals while in patients with venous hypertension the wheal is more persistent, requiring a significantly longer time to disappear. This new technique was used in association with laser-Doppler flowmetry to evaluate the efficacy of Venoruton (1000 mgs t.i.d.) administered for 2 weeks on venous hypertension. Results indicate a positive effect of Venoruton in reducing the abnormally increased capillary permeability in venous hypertension and are proportional to the changes observed in signs and symptoms after treatment. PMID- 2779807 TI - [Pre- and postoperative evaluation of plasma creatine kinase in 142 children subjected to "uncomplicated" anesthesia in muscle biopsy]. AB - Pre- and postoperative serum CK activity is evaluated in 142 children submitted, "uneventfully", to diagnostic muscle biopsy under halothane (77 patients), ketamine (50 patients) or "local" (15 patients) anaesthesia. The purpose was to ascertain whether or not anaesthesia-induced-rhabdomyolysis (AR) was an asymptomatic (and unrecognized) complication of "uneventful" anaesthesia. The majority of patients with low preoperative CK values showed a slight increase of serum CK activity on the first postoperative day. On the contrary, a postoperative decrease was observed in the majority of patients with high preoperative values (namely in almost all ketamine patients and in 2/3 of halothane-patients). In no case postoperative increase reached a value suggesting the occurrence of AR even though a postoperative value of 16480 U/I was observed in a patient with Duchenne muscular dystrophy after halothane anaesthesia. Sudden interruption of motor activity induced by general anaesthesia seems to be the most important factor in reducing the release of CK from muscle. When preoperative release is low, any further postoperative reduction is not sufficient to balance the moderate increase of CK produced by the surgical procedure; the opposite should happen in patients presenting with high preoperative release. So far as anaesthetics are concerned, our data seem to suggest that ketamine has a higher "protective" role compared to halothane. PMID- 2779808 TI - [A combination of buprenorphine and bupivacaine for peridural anesthesia. Our experience]. AB - The Authors report the results of a study on 204 patients anesthetized with epidural administration of buprenorphine with bupivacaine. The data obtained were compared with a sample of 236 patients treated with local anesthetic alone. On the whole, the first group of patients presented better anesthesia, with a significantly longer anesthetic effect and more effective sedative and postoperative analgesic effects. Side effects observed were of acceptable entity and incidence. PMID- 2779809 TI - [The use of atracurium in subjects with chronic renal insufficiency]. AB - Atracurium has been studied in 16 patients divided into two groups, the first of which suffering from chronic renal failure. The two groups were made standard for age, weight, type of intervention and duration of intervention. Arterial pressure, heart frequency, oesophageal temperature and blood gas were monitored. A neuromuscular stimulator was used to study the neuromuscular block. No difference was found in the treatment of two groups of patients and it is concluded that no contraindication emerges for the use of atracurium in patients with chronic renal failure. PMID- 2779810 TI - [Continuous intravenous infusion with patient-controlled anesthesia for postoperative analgesia in cesarean section: morphine versus buprenorphine]. AB - A double blind comparison between morphine and buprenorphine was performed in 20 patients using a new demand and continuous infusion analgesic system to provide analgesia after cesarean section. The patients were randomized in two equal groups to receive either morphine 1 mg/h or buprenorphine 0.03 mg/h. The PCA system was set to deliver bolus of either morphine 1 mg or buprenorphine 0.03 mg, with a lockout interval of 10 and 15 min respectively. A loading dose of morphine 5 mg or buprenorphine 0.15 mg was given if necessary. The quality of analgesia, assessed by a visual analogue and a subjective scale was good with both drugs. No difference in side effects between the groups was observed. The mean potency ratio between buprenorphine and morphine was 32:1. Patients receiving buprenorphine showed a more prolonged analgesia and a significant improvement of sedation score. PMID- 2779811 TI - [Cuff pressure in intratracheal tubes. Evaluation of the new Mallinckrodt-Brandt model]. AB - Cuff pressure of endotracheal tubes increases to dangerous levels during anesthesia with nitrous oxide. In a small clinical study the Authors conclude that Mallinckrodt-Brandt endotracheal tubes are the only "low pressure" tubes available at the moment. PMID- 2779812 TI - [Management and organization of postoperative cardiac intensive care units in Italy. Study Group for Anesthesia and Resuscitation in Cardiosurgery]. AB - The results of a fact-finding study carried out in 31 postoperative cardiac intensive care units are reported. The purpose of the investigation was to highlight the most important organisational problems and pinpoint the role of the anaesthetists employed there. The results show that: 1) management of postoperative cardiac intensive care units is in the hands of surgeons in 74% of cases; 2) assistance is generally run by anaesthetists and, alternatively, by surgeons; 3) the use of beds is irregular in the various centres; 4) medical and paramedical staff are insufficient everywhere; 5) updating activities are deficient almost everywhere and are generally unsatisfactory. PMID- 2779813 TI - [Congenital deficiency of metahemoglobin-reductases (diaphorases). A case of cyanosis during general anesthesia]. AB - A case of cyanosis during general anaesthesia in a patient suffering from congenital deficiency of metahaemoglobin-reductase (diaphorase) is reported. The anaesthesiological technique and the probable triggering cause are analysed. The investigation carried out in members of the family to obtain confirmation of the genetic origin of the enzymatic deficiency is also reported. PMID- 2779814 TI - Cholangiography during cholecystectomy: a plea for selective use. AB - Routine peroperative cholangiography was retrospectively studied in 376 patients who underwent elective cholecystectomy. Adequate cholangiograms were obtained in 325 patients using a C-arm image intensifier. Pre- and peroperative indications for common bile duct stones were correlated to the outcome of peroperative cholangiography. The sensitivity and specificity of the cholangiographic technique were 96 and 95 per cent respectively. A false-positive rate of 4.6% and a false-negative rate of 0.6% were found. No serious complications due to the method were observed. Peroperative cholangiography prevented unnecessary exploration of the common bile duct in 70 per cent of the patients with clinical indications for exploration. Abnormal cholangiograms were rare (0.8%) in the absence of clinical signs of stones in the bile ducts. These results demonstrate that selective rather than routine peroperative cholangiography should be performed. PMID- 2779815 TI - Surgical treatment of bronchopulmonary carcinoid tumours. AB - Based on histopathological characteristics bronchopulmonary carcinoid tumours can be divided into a typical and an atypical variant. Atypical carcinoid tumours often have regional lymph node metastases. A differentiation between the two types of tumours cannot be made preoperatively. A total of 23 patients underwent resectional therapy for carcinoid tumours of the lung. Eleven underwent pneumonectomy, eight patients lobectomy and three patients had bilobectomy. Segmental resection was performed in one patient. One patient died in the postoperative period. During the follow-up period, ranging from 5 to 22 years (median 11 years), neither local recurrences nor metastatic spread was observed. In eight patients the tumour was classified as the atypical variant. There was no correlation between the size of the tumour and the presence of regional lymph node metastases. All tumours with lymph node metastases were classified as atypical carcinoids. As in other studies, our data suggest that treatment based on standard resectional procedures is to be preferred for bronchopulmonary carcinoids since a preoperative distinction between the typical and atypical variants is as yet not possible. PMID- 2779817 TI - [Proceedings of the meeting of the Italian Section of the International College of Surgeons--I. Rome, 16-20 February 1987]. PMID- 2779816 TI - An unusual cause of an inferior vena cava syndrome. AB - Two patients are presented with an occlusion of the infrarenal vena cava caused by a vena cava aneurysm. This rare congenital vena caval anomaly may mimic retroperitoneal lymphadenopathy, especially on CT- imaging without contrast enhancement. PMID- 2779818 TI - [Tumor markers in the diagnosis of pancreatic carcinoma]. PMID- 2779819 TI - [Current trends in the diagnosis of acute pancreatitis]. PMID- 2779820 TI - [The treatment of acute pancreatitis today. The experience of 126 surgical cases]. PMID- 2779821 TI - [Bronchogenic carcinoma invading the thoracic wall. The results of surgical treatment]. PMID- 2779822 TI - [Preoperative functional assessment with a balloon catheter in fiber bronchoscopy of patients who are candidates for pneumonectomy in bronchial cancer]. PMID- 2779824 TI - [Preoperative staging of rectal cancer with computed tomography]. PMID- 2779823 TI - [Metachronous polyps after the excision of colorectal carcinoma]. PMID- 2779825 TI - [Colorectal carcinoma in the elderly. Our experience]. PMID- 2779826 TI - [The role of integrated radiosurgical therapy of rectal cancer]. PMID- 2779827 TI - [A follow-up protocol in rectal cancer. Preliminary results]. PMID- 2779828 TI - [Single-stage treatment of occlusion due to cancer of the left colon]. PMID- 2779829 TI - [Multiple primary tumors: the association between colorectal neoplasms and extracolonic neoplasms]. PMID- 2779830 TI - [Spontaneous esophagogastric perforation after fundoplication: an unusual complication of antireflux surgery]. PMID- 2779831 TI - [Current trends in the treatment of neoplastic occlusion of the colon]. PMID- 2779832 TI - [The surgical treatment of acute cholecystitis. Our experience]. PMID- 2779833 TI - [Treatment of acute cholecystitis]. PMID- 2779834 TI - [The targeted surgical approach in the treatment of hyperparathyroidism. A clinical contribution]. PMID- 2779835 TI - [Thyroid carcinoma in diving goiter. Its incidence and diagnostico-therapeutic problems]. PMID- 2779836 TI - [The treatment of caustic agent-induced lesions of the primary segment of the digestive tract]. PMID- 2779837 TI - [Alkaline esophageal reflux. Assessment of parietal damage in the evolution of the pathologic process]. PMID- 2779838 TI - [Meckel's diverticulum and its complications. Comments on 6 surgical patients]. PMID- 2779839 TI - [Complications from the use of mechanical suturing devices in digestive system surgery. Our experience]. PMID- 2779840 TI - [An analysis of the problems correlated with the use of mechanical suturing devices in surgery of the gastrointestinal tract]. PMID- 2779841 TI - Alterations in serotonin binding sites after 5,7-dihydroxytryptamine treatment in the rat spinal cord. AB - The 5-HT1B subtype of serotonin (5-HT) receptor regulates the release of 5-HT in the rat spinal cord. In an attempt to confirm the presynaptic location of the 5 HT1B receptor, serotonergic nerves were destroyed neurochemically with 5,7 dihydroxytryptamine (5,7-DHT) administered intrathecally. At 3, 7 and 14 days post 5,7-DHT, competitive radioligand binding assays were performed using 2 nM [3H]5-HT and varying concentrations of trifluoromethylphenylpiperazine (TFMPP), a drug which interacts with 5-HT1B and 5-HT1A binding sites (affinity of 5-HT1B site greater than 5-HT1A site for TFMPP). The decrease in 5-HT1B sites that was expected was not observed at any time following the lesion. However, the binding capacity of the 5-HT1B site, as well as the 5-HT1A site, increased significantly by 7 and 14 days postlesion, respectively. Thus, it appears that an up-regulation of 5-HT1B sites occurred that may have obscured the ability to observe a reduction in a small population of sites located on the serotonergic nerve terminals. PMID- 2779842 TI - Sensory nerve endings in the cat cruciate ligaments: a morphological investigation. AB - The histology of the cat anterior and posterior cruciate ligaments was studied using the modified Gairns gold chloride staining for neural elements. Ruffini endings, Pacinian corpuscles, Golgi tendon organ-like endings and free nerve endings were identified. All receptor types were most frequently found close to the tibial and femoral insertions. The results are consistent with our earlier findings that small increases in the tension of the ligaments can potently influence the fusimotor system to the muscles acting at the knee joint, and thereby participate in the regulation of their stiffness and the knee joint stability. PMID- 2779843 TI - Human hypothalamic neuronal system revealed with a salmon melanin-concentrating hormone (MCH) antiserum. AB - An antiserum raised against synthetic salmon melanin-concentrating hormone (MCH) reveals an extensive neuronal system in the posterior lateral areas of the human hypothalamus. These neurons correspond to those previously described in the rat, which are characterized by expression of MCH-like, alpha-melanotropin-like and human growth hormone-releasing factor (1-37)-like immunoreactivities. PMID- 2779844 TI - The A-type potassium current: methoxybenzenes increase the rate of inactivation in snail neurons. AB - The effects of anisole (methoxybenzene) and veratrole (1,2-dimethoxybenzene) on the resting membrane potential (RMP), action potential (AP) and membrane potassium currents were investigated in snail neurons under current- and voltage clamp conditions. Anisole (0.9-3 mM) scarcely influenced the AP, but it moderately depolarized the membrane and increased the neuronal excitability. Anisole accelerated the time-dependent inactivation of the A-current and decreased the time constant of the decay in a dose-dependent way (K1/2 = 1.2 mM). The potential-dependence of the steady-state activation or inactivation of the A current was not influenced by anisole. An analysis of the Hill plot of anisole action on the time constant of decay of the A-current showed a one-to-two binding stoichiometry (nH = 2.1). Veratrole (2-8 mM) was effective similarly to anisole on the A-current, but proved less potent. PMID- 2779845 TI - Post-natal development of burst firing behavior and the low-threshold transient calcium current examined using freshly isolated neurons from rat dorsal root ganglia. AB - Burst firing was triggered by an afterdepolarizing potential (ADP) in whole-cell recordings from neurons recently isolated from dorsal root ganglia (DRG) of adult rats, less frequently in neurons from 12-day-old rats, and not at all in neurons from 1-day-old rats. Both the ADP and voltage-activated transient (T-type) Ca2+ current which generates the ADP were present in neurons at all postnatal ages; however, the amplitude of the ADP and of the T-type current were greatest in neurons from adults, smaller in neurons from 12-day animals, and smallest in neurons from 1-day animals. These observations suggest that the increase in amplitude of the T-type current with age leads to the generation of an ADP of increased amplitude and those properties of the ADP which develop with age may contribute to or generate burst firing behavior. PMID- 2779846 TI - Topography of monosialoganglioside (GM1) in rat brain using monoclonal antibodies. AB - Immunohistochemical localization of ganglioside GM1 using 3 monoclonal antibodies (C3 and D3 reacting exclusively with GM1 and C4h2 reacting also with other gangliosides) showed different staining patterns in rat brain regions (cerebellum, cerebral cortex and hippocampus). Staining in all brain areas was punctate and appeared to be restricted to surfaces of cells and their processes. In spite of similar reactivity to GM1, C3 and D3 showed qualitatively and quantitatively different and highly selective localization in all regions with no staining in white matter. In cerebellum, staining with C3 was predominantly associated with granular layer; staining with D3 was limited to Purkinje cell surfaces and surrounding structures. In cortex, staining with C3 was seen outlining large pyramidal neurons and fibers in cross-section, whereas sites stained with D3 appeared to be fewer, smaller and differed in location. In hippocampus, staining patterns were similar with both C3 and D3, outlining large pyramidal neurons of Ammon's horn and granular cells of dentate gyrus as well as glomerular structures. Staining with C4h2 was topographically similar, but over 10-fold more extensive and was present in white matter. PMID- 2779847 TI - Responses of VPL thalamic neurones to peripheral stimulation in wakefulness and sleep. AB - In unanaesthetized, undrugged, normally respiring cats extracellular recordings were obtained from ventroposterolateral thalamic units through different states of the sleep-waking cycle. An air-puff peripheral stimulation was used to activate the recorded neurones. State-dependent changes of the response of thalamic neurones were shown, comparing slow-wave sleep (SWS) to wakefulness (W). During SWS an increase was observed in the strength of the discharge suppression, which follows the excitatory peak in the typical response pattern. Also the cell excitability is further reduced in slow-wave sleep during the 150-200 ms period following an excitatory response, suggesting that an enhancement of the post excitatory inhibition could be involved in the generation of the slow 5-6 Hz rhythms, observed during thalamic and cortical synchronization. PMID- 2779848 TI - Evidence of shared, direct input to motoneurons supplying synergist muscles in humans. AB - Cross-correlation techniques were used to test for the presence of shared, direct input to motoneurons innervating different synergist elbow flexor muscles in man. Motor unit activity was recorded intramuscularly from two elbow flexor muscles during steady isometric elbow flexion in normal and paretic subjects. To increase the probability of detecting weak synchrony, one of the intramuscular needles was positioned to record multiunit activity. Significant correlogram peaks were obtained in 25/57 runs in normal subjects, and the features of the correlograms were similar to those previously reported based on cross-correlation of two single units within the same muscle. Further, the characteristics of discharge synchrony measured in paretic stroke patients are consistent with other reports on the effects of stroke on synchrony among motoneurons belonging to the same pool, i.e. narrow correlogram peaks were rare in paretic subjects and significant correlogram peaks often had longer than normal durations. PMID- 2779849 TI - Higher mitochondrial density in slow versus fast lobster sensory neurons. AB - The stretch-sensitive muscle receptor organ (MRO) in the abdomen of the lobster Homarus americanus contains an identifiable fast and a slow sensory neuron. Morphometric analysis of electron micrographs of areas through the somata of these neurons revealed a higher density of mitochondria in the slow versus the fast cell (19 vs 15%). Such differences in oxidative capacity are closely matched with differences in their physiological performances. PMID- 2779850 TI - Distinct patterns of distribution among NADPH-diaphorase neurones of the guinea pig retina. AB - We have examined the morphology and distribution of nicotinamide adenine dinucleotide phosphate diaphorase (NADPH-diaphorase) cells in the retina of the guinea pig. Two morphologically distinct classes of labelled cells were detected, one with larger, darkly labelled somata commonly located in the inner nuclear layer (INL: NDa cells) and the other with smaller, lightly labelled somata in the ganglion cell layer (GCL: NDb cells). The somata of NDb cells did not vary in diameter with eccentricity, whereas those of the NDa cells were smallest in the visual streak. The number of NDa cells was approximately 3,500, with a mean density of 26/mm2 and NDb cells numbered approximately 4,400, with a mean density of 33 mm2. NDa cells were distributed relatively uniformly across the retina, whereas NDb cells concentrated in the visual streak and were restricted to the superior half of the retina. In these features of morphology and distribution. NADPH-diaphorase neurones of the guinea pig retina are distinct from those observed in other species. It remains to be elucidated whether the diversity in the morphology and distribution of NADPH-diaphorase neurones between species reflects a diversity in their function. PMID- 2779851 TI - Urethane as a sole general anaesthetic in cats used for electroretinogram studies. AB - Cats are very sensitive to induction of anaesthesia by urethane. To anaesthetize cats with urethane, 1.0-1.3 g/kg, of freshly prepared urethane is administered intravenously at a rate of 1.92 g/h, while anaesthesia is maintained with 0.5% halothane in a 66%/33% nitrous oxide/carbogen gas mixture. Cats can then be maintained for up to 3 days by intravenous infusion at a rate of 4 ml/h of a 100 ml solution containing 50 IU heparin, 2.4 mg atropine, 4.7 g anhydrous D-glucose, and 240 mg urethane/kg. Using this anaesthetic, excellent electroretinograms can be recorded with no interfering eye movements. PMID- 2779852 TI - Memory traces in spinal cord produced by H-reflex conditioning: effects of post tetanic potentiation. AB - Operant conditioning of the wholly spinal, largely monosynaptic triceps surae H reflex in monkeys causes changes in lumbosacral spinal cord that persist after removal of supraspinal influence. We evaluated the interaction between post tetanic potentiation and these memory traces. Animals in which the triceps surae H-reflex in one leg had been increased or decreased by conditioning were deeply anesthetized, and monosynaptic reflexes to L6-S1 dorsal root stimulation were recorded before and after tetanization from both legs for 3 days after thoracic cord transection. Animals remained anesthetized throughout and were sacrificed by overdose. Reflex asymmetries consistent with the effect of H-reflex conditioning were present after transection and persisted through the 3 days of study. Tetanization affected conditioned leg and control leg reflexes similarly. This finding suggests that, while post-tetanic potentiation and probably H-reflex conditioning alter Ia synaptic transmission, the two phenomena have different mechanisms. PMID- 2779853 TI - Nerve growth factor (NGF)-treated nitrocellulose enhances and directs the regeneration of adult rat dorsal root axons through intraspinal neural tissue transplants. AB - Severed adult rat dorsal roots were apposed to an intraspinal transplant of fetal spinal cord (FSC) tissue co-grafted with nerve growth factor (NGF)-treated nitrocellulose strips. Axonal regrowth from the injured roots was assessed by calcitonin gene-related peptide immunoreactivity (CGRP-IR). Dense fascicles of regenerating CGRP-IR axons lined the entire length of NGF-treated nitrocellulose, with many crossing the graft-host interface ventrally to extend into the host neuropil. In contrast, CGRP-IR axon regrowth was not promoted by untreated nitrocellulose implants. These results indicate that substrate bound NGF can promote and direct the intraspinal regeneration of a specific population of dorsal root axons. PMID- 2779854 TI - Power spectral analysis of spontaneous field potentials in hippocampal slice. AB - Spontaneous field potential oscillations were recorded from the CA3 distal apical dendritic region of guinea pig hippocampal slices maintained in 'normal' artificial cerebrospinal fluid in vitro. Power spectral analysis revealed a mixture of frequencies mainly under 20 Hz without distinct peaks. High concentrations of extracellular Mg2+ blocked the activity. These findings suggest that the intrinsic spontaneous activity of the hippocampus is produced by partially synchronized synaptic potentials. This in vitro system may provide a suitable model for studying the mechanisms underlying the generation of EEG rhythms. PMID- 2779855 TI - Activation of Golgi tendon organs by asynchronous contractions of motor units in cat leg muscles. AB - Discharges from individual tendon organs of peroneus tertius muscle activated by the isometric contractions of single motor units were recorded in anaesthetized cats. Pairs of motor units acting on the same tendon organ were stimulated asynchronously at frequencies eliciting unfused contractions. Tendon organ responses to such contractions did not display a linear relation between discharge frequency and contractile force recorded at the muscle tendon. In several instances, one of the motor units exerted a predominant influence on the response of the tendon organ, even though this unit did not produce the strongest activation of the receptor when stimulated on its own. PMID- 2779856 TI - Fluctuations in motor unit recruitment threshold during slow isometric contractions of wrist extensor muscles in man. AB - Motor unit activity was recorded in the two extensor carpi radialis muscles with metal microelectrodes during isometric contractions. When tested at different 'free' increasing contraction velocities the recruitment thresholds (rt) systematically decreased, whereas when tested at different 'imposed' increasing velocities the rt exhibited great variability, with no observable overall tendency. Moreover, when measured at a given test velocity imposed periodically during MU investigation, rt also displayed great variability. These results suggest that the notion of rt tends to be oversimplified. The motoneurone pool excitability is highly dependent on both the experimental situation and the complexity of the motor task. PMID- 2779857 TI - Serotonergic dorsal raphe neurons: changes in spontaneous neuronal activity and responsiveness to 5-MeODMT following long-term amphetamine administration. AB - Single-unit activity, characteristic of serotonergic neurons, was recorded in the dorsal raphe nucleus of urethane-anesthetized rats pretreated twice daily with saline or with 10.0 mg/kg D-amphetamine for 6 days. Compared to controls, amphetamine-pretreated animals showed a trend toward increased spontaneous firing rate and decreased responsiveness to 5-methoxy-N,N-dimethyltryptamine (5-MeODMT), a serotonergic autoreceptor agonist. The most pronounced effect of amphetamine pretreatment, however, was a highly significant correlation between spontaneous neuronal activity, measured as either firing rate or interspike interval, and the 5-MeODMT response. Faster firing cells required predictably higher doses of 5 MeODMT to produce an inhibition. No such relationship was observed in control animals. Taken together, these results suggest that repeated administration of relatively high doses of amphetamine produces complex changes in the dorsal raphe including a shift in the sensitivity of serotonergic autoreceptors. PMID- 2779858 TI - Effects of nerve growth factor and GM1 ganglioside on the number and size of cholinergic neurons in rats with unilateral lesion of the nucleus basalis. AB - Four groups of rats with a unilateral ibotenic acid lesion of the nucleus basalis were treated with saline, nerve growth factor (NGF) 10 micrograms administered intracerebroventricularly twice per week, sialoganglioside GM1 30 m/kg daily i.p. and NGF twice per week plus GM1 10 mg/kg i.p. daily, respectively, beginning immediately after lesioning. Twenty-one days later the rats treated with saline showed a marked impairment in negotiating a 'step through' passive avoidance conditioned response, a 32% decrease in the number of choline acetyltransferase (ChAT)-positive neurons in the lesioned nucleus basalis and a 12% decrease in their areas. The rats treated with NGF and NGF plus GM1 showed no difference from sham-operated rats. In the GM1-treated rats a 12% decrease only in the number of ChAT-positive neurons was detected while performance and neuronal areas were normal. These findings indicate that NGF and GM1 prevent the cholinergic deficit by protecting the cholinergic neurons of the nucleus basalis from ibotenic acid neurotoxicity. PMID- 2779859 TI - Cocaine increases extracellular dopamine in rat nucleus accumbens and ventral tegmental area as shown by in vivo microdialysis. AB - In vivo microdialysis measurements of extracellular dopamine (DA) were made simultaneously in nucleus accumbens (NAS) and ventral tegmental area (VTA) in anesthetized rats. Intravenous cocaine (1 mg/kg) resulted in rapid increases in DA in both NAS and VTA. The DA increase in NAS was greater in magnitude and persisted longer than that in VTA. The relevance of the observed effects to reported effects of cocaine on firing rate of mesoaccumbens DA neurons is discussed. PMID- 2779860 TI - Forging ahead into the 1990s. PMID- 2779861 TI - Retaining freshman nursing students. PMID- 2779862 TI - Losses incurred through minority student nurse attrition. PMID- 2779863 TI - Project L.I.N.C. (ladders in nursing careers). An innovative model of educational mobility. PMID- 2779864 TI - The culturally diverse student. PMID- 2779865 TI - Changes in the advertised demand for nurse practitioners in the United States, 1975-1986. AB - Legislative and reimbursement policies have presented barriers to employment and autonomy for nurse practitioners since the beginning of the nurse practitioner movement in 1965. Greater resistance to NPs in the 1980s was predicted because of a sluggish economy and burgeoning oversupply of physicians. In this study, quantitative content analysis was used to examine 1,022 job advertisements published in The Nurse Practitioner: The American Journal of Primary Health Care from 1975 to 1986. Unstandardized regression analysis was used to compare changes in the demand for nurse practitioners by region, employment setting, job duties, specialty, employment time (full- or part-time), degree required or preferred for the position, and whether the ad specified a joint practice arrangement. Contrary to the predictions of past research, the demand for nurse practitioners increased during this time period, with a greater tendency toward primary care. PMID- 2779866 TI - Conflict resolution: applying the political model to the RCT proposal. AB - The political model, as described by various authors, provides a powerful and effective approach to dealing with the complex issues that confront nursing. This article demonstrates that the political model may be employed as a useful method for reaching a favorable resultant action on the registered care technologist conflict issue. The problem-solving approach of the political model can be applied to individual, group or organizational conflict. The politically astute person using this model will gain insight into negotiating, policy-making and the allocation of scarce resources. PMID- 2779867 TI - Employment and salary characteristics of nurse practitioners. AB - Nurse practitioners provide high-quality, cost-effective care to health care consumers, yet they continue to experience low economic compensation and salary compression. The nursing literature is limited with respect to data regarding salaries, benefits and trends in compensation for nurse practitioners. In order to provide baseline data for nurse practitioners to use in negotiating compensation benefits and packages, 459 certified nurse practitioners in North Carolina were surveyed regarding demographic and employment characteristics and job satisfaction. Of the 83 percent who responded, nearly two-thirds earned less than $30,000 per year. Benefits and salary adjustment for certification are reported, and techniques for compensation negotiation are discussed. Although information obtained is specific to North Carolina, geographic similarities may be apparent. PMID- 2779868 TI - FDA approves Eprex for anemia related to AIDS. PMID- 2779869 TI - Endocrine nursing. How to treat diabetes mellitus. PMID- 2779870 TI - Endocrine nursing. Corticosteroid therapy. PMID- 2779871 TI - Let the children play. PMID- 2779872 TI - Careers in endocrine nursing. PMID- 2779873 TI - Counselling. Take a look into RELATE. PMID- 2779874 TI - Endocrine nursing. Treatment and care of thyroid problems. PMID- 2779875 TI - Endocrine nursing. Management of Addison's disease. PMID- 2779876 TI - Abstracts of the twelfth annual meeting of the Japan Neuroscience Society. Nagoya, Japan, December 7-9, 1988. PMID- 2779877 TI - Continuing competence in the medical profession. PMID- 2779878 TI - The impact of technology on the clinical decision making of house staff. PMID- 2779879 TI - Emergency room visit time: changes over a 16-year period. AB - A one-week time and motion study was conducted at a large urban hospital replicating a study performed in 1969 in the same hospital, allowing a longitudinal study of emergency room utilization to be reported. Despite a 36% increase in the number of emergency room patients over the 16-year period, the findings from both studies replicate many of the patterns previously reported. Over time, both length of stay and wait times to see physicians have increased, although the values are still well within the ranges found in the literature. As competition increases, hospitals and their emergency room managers will have to determine what constitutes acceptable visit and waiting times in order to compete effectively for emergency room "clientele." Studies such as this one serve as a foundation for hospitals to implement policy changes that will improve health care delivery, and, in fact, this institution has already implemented changes based on this study. PMID- 2779880 TI - Health, income, and activities of retired physicians. AB - Driven to retire mainly by changes in the health care delivery system, physicians nevertheless find it difficult to reduce their professional activities as they grow older. Retired physicians in a seven-county region of upstate New York were surveyed to discover how they were faring in retirement and to elicit information of possible value to doctors planning to retire. Good health and adequate income were the prime factors in successful retirement, along with active involvement in postretirement activities, especially nonmedical ones. Three quarters of respondents found annual incomes between $25,000 and $50,000 to be comfortable. All agreed that private investments must make up at least a third of this amount, supplementing Social Security, pensions, individual retirement accounts, and Keogh plan distributions. There was diversity of opinion on remaining active in medical affairs after retirement. A large majority of those who found retirement better than anticipated advised a clean break with medicine. Most of their colleagues who rated retirement about as expected or not as good as anticipated counseled continued involvement in professional activities. PMID- 2779881 TI - House staff stress. PMID- 2779882 TI - The impact of the new code regulations on postgraduate medical education in New York State. PMID- 2779883 TI - The education of physicians and the health of New York. Associated Medical Schools of New York position paper on the mission and responsibilities of medical schools and academic health centers in New York State. PMID- 2779884 TI - Temporal arteritis and intestinal perforation. Report of three cases. PMID- 2779885 TI - Physician recredentialing. PMID- 2779886 TI - The future of medicine: a resident's perspective. PMID- 2779887 TI - Alcohol and public health: implications for New York State. PMID- 2779889 TI - Essentials for practicing the art of nursing. PMID- 2779888 TI - Two-dose measles immunization recommendations. PMID- 2779890 TI - Sifting and sorting the stuff of nursing: primary and secondary sources. PMID- 2779891 TI - Neuman's model in practice. PMID- 2779892 TI - Dialogue on a theoretical issue: the future of theory development--commentary and response. PMID- 2779893 TI - Personalized nursing LIGHT model. Love, Intend, Give, Help, Touching. AB - The Personalized Nursing LIGHT model is a prescriptive model for nursing. It is a model for nursing practice derived from a synthesis of Aristotle's theory of ethics and Martha E. Rogers' science of unitary human beings. The LIGHT model provides a mechanism for nurses to assist clients to improve their sense of well being. The authors believe that improving well-being is the focus of nursing. Using principles synthesized from Aristotle and Rogers, clients are encouraged to use their talents in the pursuit of well-being and happiness in an increasingly complex world. PMID- 2779894 TI - An interpretation of family within Orem's general theory of nursing. AB - This article offers an interpretation of family from the perspective of Orem's theory of nursing. The family is conceptualized within this theory from three perspectives: (a) as a factor that conditions an individual's requirements for care and ability to provide care for self; (b) as a dependent-care unit; and (c) as a unit of service. The meaning of these perspectives to the nurse is examined. The different assessment questions are identified. The family is seen as having functions related to the members' development of self-care agency and the establishment of appropriate dependent care systems in such a way as to promote the health of the entire family. PMID- 2779895 TI - Social support and health: a theoretical formulation derived from King's conceptual framework. AB - This article describes the development and initial empirical testing of a theoretical formulation of social support, family, health, and child health derived from Imogene King's conceptual framework for nursing. A correlational design was used to test the formulation with 103 families who have children with diabetes mellitus. Three hypotheses were supported: parents' social support had a direct and positive effect on family health, parents' social support and child's social support were positively related, and illness factors had a direct and negative effect on child health. Both the supported and unsupported hypotheses are discussed in terms of the present substantive knowledge base and evidence of validity for King's framework. Direction for further theory development and research are identified. PMID- 2779897 TI - Area variation of avoidable causes of death in Auckland, 1977-85. AB - An area analysis is presented of deaths in Auckland that were ostensibly avoidable, by appropriate medical intervention and treatment. Mortality data from the National Health Statistics Centre for the period 1977-85 were used in the analysis. The definition of an avoidable death was based on the International Classification of Diseases (ICD) code using established criteria. Eight percent of deaths of people under 65 years of age met the criteria. The basic spatial entity for the analysis is the census area unit and maps of Auckland are presented to show the distribution of avoidable mortality. It is found that there are significant and consistent spatial variations. Three areas with avoidable mortality that is generally higher than elsewhere are apparent: in south Auckland; to the north-west of the central urban sector centered on Grey Lynn; and in the eastern parts of the central sector from Glenn Innes to Onehunga. PMID- 2779896 TI - Comparative costs of cataract surgery in a public and a private hospital. AB - A total of 119 patients undergoing cataract surgery in Wellington and Wellcare hospitals were studied for their demographic characteristics and the costs of their surgery. There were no significant age or sex differences between public and private sector patients and, although there were marital, ethnic and socioeconomic factors which were associated with a slightly longer stay in the public sector, these explain only a small proportion of the difference of 5.0 days in public as compared with 2.5 days stay in the private sector. The pattern of care adopted by the consultant and ward staff and medical profile affected the length of stay. The costs of the surgery were identical at $2560, including GST, in both public and private hospitals. Higher ward costs in public were offset by higher surgical costs in the private sector. A study of the marginal costs, on a day by day basis, indicated that a reduction in length of stay to 3.6 days, which has already occurred since the study, would lead to an 11% increase in throughout of cataract patients within a fixed budget. These costing data will be routinely provided by the RUS (resource utilisation system) now being implemented in New Zealand hospitals and will be an important tool for service management in making decisions about both quality of care and cost containment. PMID- 2779898 TI - Undergraduate medical education--a perspective. PMID- 2779899 TI - Paediatric attendance at Waikato Hospital accident and emergency department 1980 86. AB - All attendances at Waikato Hospital accident and emergency department since 1980 have been coded and stored in computer files. Fifty thousand children under age 15 years attended A&E between 1980 and 1986. Age-specific attendance rates were determined and major reasons for consultation examined. The attendance rate for illness was very high in infants with levels above 1200/10,000 for every year. This rate declined as children became older. Attendance rates for injury events were highest for infants (1601/10,000), with the 10-14 year olds second (1100/10,000). Age and ethnic group specific rates were determined and show a very high rate of attendance for Maori infants with 60% attending A&E in 1986. Respiratory illnesses form the major reason for consultation for illness, with the highest rate in children under five years. Thirty-two percent in the under one year group and 43% in the 1-4 year group came to A&E with respiratory illnesses. Injury involving falls or hitting an object are the major reasons for consultation in all age groups under 10 years. This involved 41% of all accidents in the under 1 year age group, 46% in 1-4 and 47% in the 5-9 age group. Sporting injuries dominated the 10-14 age group with 28% of all accidents being sports related. Road traffic injuries reflect the mobility of each age group with 7% of accidents in the under 1 group, rising to 14% for all children over 4 years. The implications of these patterns are discussed. PMID- 2779900 TI - Small-for-gestational age infants: perinatal, physical and social factors in the first year of life. AB - Perinatal factors and physical development in the first year were studied in a group of 30 small-for-gestational age (SGA) infants and matched controls. Mothers of small-for-gestational age infants were significantly lighter (p less than 0.01), had shorter labours (p less than 0.01), had higher reported caffeine intake (p less than 0.01) and were more likely to have smoked in pregnancy than mothers of control infants (p less than 0.05). Small-for-gestational age infants had lower ponderal indices (p less than 0.001), were more likely to exhibit head sparing at birth (p less than 0.02) and to be short-for-dates (p less than 0.001), and to have had hypoglycaemia in the first 24 hours (p less than 0.02). Their growth trajectories exhibited growth catchup in the first 3 months but at 12 months they remained lighter, shorter and had smaller head circumferences than the control infants (p less than 0.001) with mean weight and length percentiles of 23% each in small-for-gestational age infants and 50% and 57% in appropriately grown infants. PMID- 2779901 TI - Clinical trials are usually beneficial to patients and hospitals. AB - We examined the cost of antibiotics used prophylactically in the first 25 patients in a controlled clinical trial comparing different antibiotic regimens in the prophylaxis of sepsis. We compared this with the costs of prophylaxis in 25 similar patients immediately before the trial started and found that the costs in the pretrial patients were significantly greater than in the trial patients. The trial is therefore beneficial to the hospital. We also examined the dispensing errors in the same patients. We found none in the trial patients but there were 77 out of 627 doses prescribed in the pretrial patients. We concluded that the abolition of dispensing errors brought about by the trial must be beneficial to the patients. They were also benefitted by the close monitoring which reveals complications at an early stage, and the improved case notes. The Hawthorne effect on medical and nursing staff is the most likely cause of these phenomena. PMID- 2779902 TI - Popular diets and anthropological myths. PMID- 2779904 TI - Treatment of hypertension. PMID- 2779903 TI - Fenoterol. PMID- 2779905 TI - Is empathy unhealthy? PMID- 2779906 TI - Passive smoking in New Zealand. PMID- 2779907 TI - Treatment of Frey's syndrome (gustatory sweating) with topical glycopyrrolate: case report. PMID- 2779908 TI - A hypothesis about cot death. PMID- 2779909 TI - Did swimming wake up the worms? PMID- 2779910 TI - Is indapamide (Natrilix) 2.5mg a diuretic? PMID- 2779911 TI - Encouraging and reminding women to have cervical smears. PMID- 2779912 TI - Variability in antihypertensive drug costs. PMID- 2779914 TI - AIDS today. PMID- 2779913 TI - The costs of antibiotic therapy. PMID- 2779915 TI - Human resources or human assets? PMID- 2779916 TI - Nursing management diagnosis. PMID- 2779917 TI - The negligent hiring and retention doctrine. PMID- 2779919 TI - Nursing management according to Goren. PMID- 2779918 TI - Healthcare's lowest caste? PMID- 2779920 TI - Counseling nurse managers. PMID- 2779921 TI - Change-of-shift report: put it in writing! PMID- 2779923 TI - The nursing career tree. PMID- 2779922 TI - Preventing hospital incidents--what we can do. PMID- 2779924 TI - Telephone call-backs: final patient care evaluation. PMID- 2779926 TI - Conflictus avoidus: the humming birds of prey. PMID- 2779925 TI - A group approach to problem-solving. PMID- 2779927 TI - Resolving conflicts: leadership style sets the strategy. PMID- 2779928 TI - A thought-provoking exchange. PMID- 2779929 TI - Implementing nursing diagnosis. PMID- 2779930 TI - The changing role of British senior nurse managers. PMID- 2779931 TI - Streamlining supply management in operating rooms. PMID- 2779932 TI - Managing organizational transition. PMID- 2779933 TI - Nurse administrators experience job satisfaction. PMID- 2779934 TI - An "inside-out" approach to the nursing shortage. PMID- 2779935 TI - Blood aerosol hazard. PMID- 2779936 TI - Dress for survival: your life may depend on choosing correct protective clothing. PMID- 2779937 TI - Technologies improve strength of fibers, future of protective clothing industry. PMID- 2779938 TI - Work-place preventive programs cut costs of illness and injuries. PMID- 2779939 TI - Safety professionals need education to address multifaceted challenges. PMID- 2779940 TI - Personal energy profiles determine stress-management capabilities. PMID- 2779942 TI - Things your chemistry teacher taught that you didn't really understand. PMID- 2779941 TI - Higher radiation exposure levels dictate limiting work-place hazard. PMID- 2779943 TI - Obstetric and gynecologic infections. PMID- 2779944 TI - Phase II study of esorubicin in the treatment of patients with advanced sarcoma. AB - Esorubicin was administered to 12 patients with soft tissue sarcoma, 1 osteosarcoma and 1 desmoid tumor. Seven patients had never received chemotherapy before. Myelotoxicity was the main side effect, leukopenia being more pronounced than thrombocytopenia. No significant nonhematological toxicity occurred. Six patients had no change of median duration of 98 days and 7 patients progressed. The patient suffering from multiple-site lesions of a desmoid tumor obtained a long-lasting partial response. This study does not support further testing of esorubicin in sarcoma patients. PMID- 2779945 TI - Non-seminomatous testicular cancer clinical stage I: prediction of outcome by histopathological parameters. A multivariate analysis. AB - The clinical course of 186 orchiectomized patients with testicular non-seminoma clinical stage I (CSI) was reviewed together with a reevaluation of the haematoxylin-eosin-stained histological sections of the primary tumour. Treatment (1970-1980) was as follows: abdominal radiotherapy (group 1): 132 patients; observation only (group 2): 23 patients; retroperitoneal lymph node dissection (group 3): 31 patients. Failure of the management (diagnostic error/relapse after treatment) was defined as demonstration of retroperitoneal lymph node metastases (group 3) or relapse during follow-up (group 2 and 3). Ten of the 31 primarily operated patients had retroperitoneal lymph node metastases. (These patients received 3-4 cycles adjuvant cisplatin based on chemotherapy.) Forty-six patients relapsed after a median time of 6 months (range: 2-113). The 10-year cancer related survival rates for group 1 and 2 were 85 and 73%, respectively. No cancer related death occurred in group 3 within the first 5 years. In a univariate analysis the following parameters were significantly (p less than 0.05) correlated with management failure: vascular invasion (blood, lymphatic), the presence of syncytiotrophoblasts, the demonstration of the histological subtype MTU. In a multivariate analysis both lymphatic and blood vessel invasion significantly predicted management failure. In 80% of the non-seminoma patients with CSI and both lymphatic and blood vessels invasion in the primary tumour failure of the primary management must be expected. In the multivariate analysis the demonstration of MTU was a predictive factor only if no differentiation was made between lymphatic and blood vessel invasion. The presence or absence of endodermal sinus tumour was not correlated with the failure rate in non-seminoma CSI. Based on easily assessable histopathological parameters of the primary tumour (small vessel invasion in particular) it is possible to define subgroups of patients with non-seminoma CSI who have a high or a low risk of relapse or who are likely to have microscopic retroperitoneal lymph node metastases. Such a differentiation should have therapeutic consequences. PMID- 2779946 TI - Neoplastic characteristics of the DNA found in the plasma of cancer patients. AB - About one third of patients with various malignant diseases were found to have extractable amounts of DNA in their plasma whereas no DNA could be detected in normal controls. Using the test established by one of us (M.B.), which is based on decreased strand stability of cancer cell DNA, we have found that several plasma DNA originate from cancer cells. PMID- 2779947 TI - Non-Hodgkin's lymphoma: natural cell-mediated cytotoxicity correlated with histological classification and prognosis. AB - Non-Hodgkin's lymphoma (NHL) patients classified according to the Rappaport classification system had depressed natural killer (NK) and NK cytotoxic factor activities, antibody-dependent cellular cytotoxicity, active killing potential as well as recycling capacity. The suppression of these activities was not related to the favorable or unfavorable prognosis of the patients. Paramaters of the NK cytotoxic status of the NHL patients did not correlate with the histology or prognosis of the disease. PMID- 2779948 TI - Inhibition of interferon-alpha/beta induction in L-929 cells by benzene and benzene metabolites. AB - Murine L-929 cells were treated with benzene or a series of benzene metabolites, washed and then interferon-alpha/beta was induced with polyriboinosinic polyribocytidylic acid. Exposure of the cells to benzene or phenol, a monocyclic metabolite of benzene, did not affect interferon-alpha/beta induction. However, exposure of the cells to p-benzoquinone, hydroquinone or catechol, dihydroxy- and diketo-metabolites of benzene, resulted in a severe inhibition of interferon alpha/beta production. There was no significant loss of viability of the cell cultures. Additional studies with p-benzoquinone indicated that inhibition of interferon-alpha/beta was reversible and could be abrogated by addition of reduced glutathione to the cell cultures. PMID- 2779949 TI - Development of drug resistance in cultured clonogenic leukemic blast cells during the clinical course of myeloblastic leukemia. AB - We studied changes in the drug sensitivity of clonogenic leukemic blast cells from patients with acute myeloblastic leukemia during clinical courses. These cells were assayed using the colony formation technique in methylcellulose culture. Various doses of each of two chemotherapeutic agents, daunorubicin and aclarubicin, were added at the start of culture, and drug sensitivities were measured in terms of percentage inhibition of leukemic blast colony formation. Clonogenic leukemic blast cells became less sensitive to the drugs which were administered to the patients during the course of the disease, suggesting that development of drug resistance in vivo may reflect the presence of dominant resistant populations of clonogenic leukemic blast cells in vitro. PMID- 2779950 TI - Endocapsular phacoemulsification and aspiration (ECPEA)--recent surgical technique and clinical results. AB - We present our most recent technique of endocapsular phacoemulsification and aspiration (ECPEA) and report the results achieved using it in 50 consecutive eyes of 47 patients. Using a bent 0.9-mm Fragmatome tip, we removed relatively hard cataracts through 1.5-mm anterior capsular openings. With an average follow up period of 12 months, the success rate was 72%. Causes of failure were anterior capsular openings enlarged more than 2.6 mm in nine eyes, and posterior capsular rupture in five eyes. After the incisions were extended to 6 mm, 11-mm posterior chamber lenses were inserted into the capsular bags. In the successful 36 eyes, postoperative visual acuity of better than 20/20 was achieved in 20 eyes (56%), and better than 20/40 vision in 31 (86%). Average corneal endothelial cell loss was 3.7%. Ample anterior capsular transparency was retained in 26 eyes (72%). PMID- 2779951 TI - Nonabsorbable suture material in corneoscleral sections--a comparison of novafil and nylon. AB - We compared a newly available nonabsorbable monofilament ophthalmic suture, 9/0 Novafil (Davis & Geck), with 10/0 nylon (Alcon), currently the most popular suture for closure of corneoscleral sections. Surgery was performed on nine rats and ten rabbits. In each case a 120 degrees corneoscleral section was made in each eye and closed with interrupted sutures of 9/0 Novafil in one eye and 10/0 nylon in the other. We compared their handling qualities during surgery, as well as their effect on postoperative wound inflammation. In addition we examined the suture material from each eye of the rats by scanning electron microscopy (SEM) after 3 months, and we compared the surgically induced astigmatism in the rabbits in the two suture groups. Both suture materials were easy to handle and well tolerated. Nylon sutures from six of the eight rat eyes studied showed SEM evidence of surface disintegration after 3 months, whereas all the Novafil sutures remained intact. PMID- 2779952 TI - Dacryocystorhinostomy failure: association with nasolacrimal silicone intubation. AB - A retrospective review of 242 consecutive dacryocystorhinostomies (DCRs) revealed no association between failure and either age, gender, or etiology of the nasolacrimal obstruction. However, silicone intubation of the nasolacrimal system was associated with a statistically significant increase in the failure rate of primary DCR. We postulate that silicone tubing by inciting granuloma formation in the nose and lacrimal fossa, predisposes to DCR failure. Routine use of silicone tubing in DCR should be avoided unless there is canalicular scarring, a large valve of Rosenmueller occluding the common canaliculus, or a small contracted or scarred lacrimal sac. PMID- 2779953 TI - An unusual complication of nasolacrimal duct probing. AB - A 4-mm segment of the tip of a 0000 probe broke off inside the nasolacrimal duct of an 11-month-old girl during probing for congenital nasolacrimal duct obstruction. Despite numerous attempts, the tip could not be extracted. Examination of the 000 end of the double-ended probe showed a narrow neck approximately 4 mm from the bulbous tip. Choosing an appropriate probe design, inspecting the probe before use, and selecting the appropriate probe size will help prevent this unusual complication. PMID- 2779954 TI - A solitary conjunctival relapse of Hodgkin's disease treated by radiotherapy. AB - A 78-year-old woman had a conjunctival mass in the inferior fornix. The lesion was diagnosed as a solitary relapse of Hodgkin's disease (HD), lymphocytic predominance type, which had been diagnosed 6 years earlier as stage III-B. It was successfully treated by local irradiation, with no evidence of local recurrence or any local ocular complications during a follow-up period of 3 years. PMID- 2779955 TI - Association between cilioretinal arteries and juxtapapillary scars. AB - We examined the relationship of cilioretinal arteries (CRAs) to juxtapapillary chorioretinal scars, along with the developmental significance of the latter in relation to CRA formation. Both eyes of 360 patients were studied. Sixty-eight (18.9%) of these patients had a CRA in at least one eye, 13 of these 68 (19.1%) had one in both. The CRAs were distributed equally between right and left eyes. Two hundred eight patients (57.8%) had a scar in at least one eye; 157 of these (75.5%) had one in both. The presence of a CRA was significantly associated with the presence of a scar. Since both are common developmental variations, this correlation points to a common embryologic formation mechanism. PMID- 2779956 TI - Monochromatic endoillumination for epimacular membrane surgery. AB - We attempted to simultaneously increase visualization of epimacular membranes and minimize retinal phototoxicity by filtering the light of the endoilluminator during vitreous surgery. The monochromatic filters we employed to eliminate short wavelengths were not useful because they reduced the level of illumination. We advise using the lowest level of illumination possible and an ultraviolet/infrared filter over the light source when working close to the retinal surface. The filter can be adapted to replace the fluorescein filter in the Ocutome console to facilitate insertion and withdrawal. PMID- 2779957 TI - Treatment of pterygium using thermal cautery. AB - Reported therapies for primary pterygium have included surgical excision with or without adjunct radiation, antimitotic agents, and conjunctival transplants. The effectiveness of these strategies may be limited by recurrences, side effects of the treatment, or expensive and time-consuming procedures. We report the results of using thermal cautery to treat primary pterygium in three patients. In all cases the pterygia were successfully eliminated without recurrence. PMID- 2779958 TI - Use of a convex mirror in indirect ophthalmoscopy for patients in a prone position. AB - Fundus examination with the patient in a prone position sometimes requires the observer to assume an uncomfortable position. I describe using a convex rear-view mirror with an 800-mm radius of curvature in binocular indirect ophthalmoscopy to overcome this difficulty. This device is especially helpful in pneumatic retinopexy. PMID- 2779959 TI - Difficulty in removal of silicone punctum plugs. PMID- 2779961 TI - Does Nd:YAG cyclotherapy cause sympathetic ophthalmia? PMID- 2779960 TI - A technique for paracentesis. PMID- 2779962 TI - Sympathetic ophthalmia following neodymium:YAG cyclotherapy. AB - Neodymium:YAG cyclotherapy has been demonstrated to lower intraocular pressure dramatically in patients with uncontrolled glaucoma, with potentially fewer side effects than cyclocryotherapy. We report the clinical course and histopathological features of a case of sympathetic ophthalmia occurring soon after YAG cyclotherapy. PMID- 2779963 TI - Contact transscleral cyclophotocoagulation with Nd:YAG laser in uncontrolled glaucoma. AB - To evaluate the effectiveness of contact delivery systems, we treated 23 eyes with uncontrolled intraocular pressure using a continuous wave Nd:YAG laser delivered by a fiber optic. With the fiber's tip perpendicular to the surface of the conjunctiva, 1.5 mm from the corneal limbus, we applied 16 laser spots of 2 J/second energy. Patients were followed for at least 6 months (mean, 8.6 +/- 2.4 months). The mean pressure decreased from a pretreatment value of 43.7 mm Hg to a posttreatment value of 24.7 mm Hg (P = 0.000). A total of 66.6% of the treated eyes achieved a pressure on last follow-up visit of 25 mm Hg or less. Pain decreased in all the patients treated (P less than .005). Complications were minimal. PMID- 2779964 TI - Laser sclerostomy ab interno using a continuous wave Nd:YAG laser. AB - We report the use of a continuous wave Nd:YAG (CW-YAG) laser focused through a sapphire crystal to create a filtering bleb by ab-interno sclerostomy. A 2-mm clear corneal incision was made in each eye of five anesthetized Dutch Belted rabbits, and the 30-mm-long sapphire crystal with a 0.2-mm focal tip was passed across the anterior chamber until it came in contact with the opposite angle. Between two and three pulses of 0.8 J were required to produce a filtering bleb in each of the 10 eyes. The overlying conjunctiva was not damaged; the procedure time was under five minutes. Histological examination revealed a surrounding area of scleral melting that extended an average of 0.06 mm from the sclerostomy. These data suggest that the CW-YAG laser may be useful in performing glaucoma filtering surgery with minimal damage to surrounding ocular tissues. PMID- 2779965 TI - Trabeculectomy as an introduction to intraocular surgery in an ophthalmic training program. AB - Ninety seven trabeculectomies for open-angle glaucoma performed by either consultants (senior surgeons) or surgeons in training (resident junior staff) were retrospectively analyzed with reference to the outcome of surgery and the complication rate. The results obtained by the trainees were comparable with those obtained by experienced surgeons, suggesting that trabeculectomy is a suitable operation to be performed by surgeons in training. PMID- 2779966 TI - The effects of exercise on intraocular pressure in pigmentary glaucoma patients. AB - Previous studies of normal volunteers and open-angle glaucoma patients have shown that exercise temporarily lowers intraocular pressure. However, two case reports have described pigmentary dispersion syndrome patients who developed symptomatic increased intraocular pressure after exercise. We evaluated the intraocular pressure response to exercise in ten pigmentary glaucoma patients. An exercise protocol was designed to increase the likelihood of lens zonule-iris pigment epithelium contact. Intraocular pressure measurements during the first two hours after exercise showed no statistically significant elevation of mean intraocular pressure. The pressure rose 6 mm Hg and 7 mm Hg respectively at 15 minutes in two eyes, but returned to baseline by 30 minutes. Our results suggest that exercise may not significantly increase the clinical intraocular pressure in pigmentary glaucoma patients. PMID- 2779967 TI - Dysthyroid optic neuropathy without extraocular muscle involvement. AB - We present three atypical cases of dysthyroid optic neuropathy. The unique feature was progressive visual field loss with normal-sized or minimally enlarged extraocular muscles. Other atypical findings included optic nerves that appeared to be linearly on stretch with only moderate proptosis, good ocular motility, and only mildly reduced central visual acuity and color vision despite severe field loss. These cases responded rapidly to decompressive surgery after failing high dose corticosteroid therapy. While marked enlargement of the extraocular muscles with apical optic nerve compression has been documented to cause dysthyroid optic neuropathy, another etiology such as short optic nerves on stretch appears to be at work in these atypical cases. Although extraocular muscle enlargement is the most important diagnostic feature and indicator of the severity of Graves' ophthalmology, our atypical cases demonstrate that this sign alone is an inadequate basis for diagnosis and visual prognosis. PMID- 2779968 TI - Cicatricial entropion: an analysis of its treatment with transverse blepharotomy and marginal rotation. AB - Transverse blepharotomy with marginal rotation is a simple and effective procedure to treat cicatricial entropion of diverse etiology in upper and lower eyelids. The surgeon can vary the site of incision and suture placement to control the amount of marginal rotation required. We treated 152 eyelids (98 patients) with this technique, obtaining an 85% overall success rate. Eleven recurrences were found in 7 of 18 lids with ocular pemphigoid; the success rate for this subgroup was 39% compared with 92% for all others. We recommend this procedure as a technically easy treatment for cicatricial entropion not caused by ocular pemphigoid. PMID- 2779969 TI - Intravitreal injection of piperacillin. AB - Piperacillin was injected into the vitreous body of rabbit eyes to evaluate its suitability for intraocular injection and its toxicity on intraocular tissues. Doses ranged from 50 micrograms to 3,000 micrograms. Toxicity was determined through histology and electroretinograms by comparing the piperacillin-injected eyes with eyes injected with balanced saline solution. Retinal toxicity was noted in the outer layer of the retina when 3,000 micrograms was injected intravitreally. No toxicity was noted by histology with 1,500 micrograms of piperacillin. The minimal inhibitory concentration of piperacillin is 800 micrograms/cc for both gram negative and gram positive organisms. The large dose of intravitreal piperacillin tolerated by rabbit eyes makes piperacillin a potentially safe and effective broad spectrum antibiotic for the treatment of bacterial endophthalmitis in human eyes. PMID- 2779970 TI - Pupil size after extracapsular cataract extraction and posterior chamber lens implantation: a prospective randomized trial of epinephrine and acetylcholine. AB - The effects of using epinephrine in the irrigating fluid and intracameral acetylcholine were studied by measuring changes in pupil size in the 48 hours following extracapsular cataract extraction and intraocular lens implantation in 39 eyes. Epinephrine reduced peroperative pupil constriction, but its effect was insignificant thereafter. The pupil constriction following acetylcholine was maximal at 2 hours and was still significant at 4 hours, but pupils redilated by 6 hours. Neither drug had any effect after this time. The edge of most lens implants was visible at 6 hours, after which pupils steadily constricted. PMID- 2779971 TI - Longer haptic allows for better manipulation. PMID- 2779973 TI - Lysosomal enzyme activities in ocular tissues and adnexa of rabbits. AB - We examined biochemically the distribution of lysosomal enzyme activities in the ocular tissues and adnexa of albino rabbits using p-nitrophenyl derivatives. The pink and white lobes of Harderian gland disclosed the highest specific activities of acid phosphatase, N-acetyl-beta-D-glucosaminidase, and alpha-L-fucosidase. The lacrimal gland showed moderately high specific activities of acid phosphatase and N-acetyl-beta-D-glucosaminidase. The optic nerve, brain, ciliary body plus iris, and retina plus choroid exhibited nearly the same specific enzyme activities. The tear fluids showed higher lysosomal enzyme activities than did the serum. To our knowledge, this is the first reported measurement of lysosomal enzymes in Harderian gland, lacrimal gland, and optic nerve of the rabbit. PMID- 2779972 TI - Cholinergic receptors in the extraocular rectus muscle of the rabbit. AB - The cholinergic receptors in rabbit isolated rectus muscle preparations were characterized by means of cholinergic agonists and antagonists. The concentration dependent contraction induced by acetylcholine, carbachol or oxotremorine remained uninfluenced by atropine (10(-5) M), whereas the nicotinic receptor antagonist hexamethonium caused a parallel shift of the concentration-response curve. The agonists pilocarpine, methacholine and aceclidine, which are selective muscarinic receptor stimulants, did not cause contraction of the muscle preparation. However, the nicotinic receptor stimulant 1,1-dimethyl-4 phenylpiperazine iodide (DMPP) caused contraction similar to that induced by acetylcholine. DMPP-induced contractions were inhibited by hexamethonium, causing a parallel rightward shift of the concentration-response curve. This shift could be quantified by means of a Schild plot, indicating competitive antagonism with a PA2 value of 4.63 for hexamethonium. Atropine when applied together with hexamethonium did not cause a further shift of the concentration-response curve. The present results clearly indicate that the cholinergic receptors which mediate contraction in the rabbit isolated extraocular muscle preparation belong to the nicotinic subtype. PMID- 2779974 TI - Morphological observations of the apical surface of chick retinal pigment epithelium. AB - Chick embryonic retina was examined in order to investigate morphological changes of the apical portion of retinal pigment epithelial (RPE) cells. Whole retina and RPE sheets were observed by fluorescence microscopy (rhodamine-phalloidin preparation) and transmission electron microscopy. Photoreceptor cells had no inner and outer segments on the 8th day in ovo. The inner segments have been formed on the 15th day and the outer segments on the 19th day. RPE sheets had short and blunt apical processes on the 8th day, elongated and slender ones on the 15th day, and well-developed and melanin-containing processes on the 19th day. RPE of the 19th day had numerous bundles of actin filaments associated with melanin pigments in the basal portion of the apical processes and in the apical cytoplasm. In rhodamine-phalloidin preparations, intense fluorescence was localized in the RPE apical processes and cytoplasm on the 19th day. We concluded that RPE apical processes develop in accordance with the photoreceptor development. PMID- 2779975 TI - A study of the mechanisms of chloroquine retinopathy. I. Chloroquine effect on lipid peroxidation of retina. AB - The influence of chloroquine on lipid peroxidation in rat and rabbit retinas has been studied. Chloroquine retinopathy is not followed by an increase in lipid peroxidation, and the antioxidant ionol does not prevent the drug effect. Chloroquine has an inhibitory action on induced lipid peroxidation. PMID- 2779976 TI - Topical dexamethasone lowers rabbit ocular tension, as does topical mifepristone (RU 486), a peripheral blocker of dexamethasone and progesterone. AB - The variability of the response of the rabbit eye to topical 1% dexamethasone has been shown in two groups of 20 young albino rabbits each (total 40) tested in succession. The pressure anomalously fell significantly (but by only 1 mm Hg) in both groups in the first 4 weeks of administration, but not in subsequent weeks. Mifepristone (RU 486), a peripheral antagonist of dexamethasone and progesterone, reduced the pressure significantly, again by only 1 mm Hg, in the first group of 20 rabbits, not the second. Accordingly, no conclusion was possible on the originating question: does pre-treatment with mifepristone prevent the dexamethasone-induced rise in rabbit intra-ocular pressure? PMID- 2779977 TI - Improved biometry of the anterior eye segment. AB - In this paper, a method is presented to evaluate the true values of several optical parameters of the anterior eye segment. These are: the thicknesses of the cornea and lens, the depth of the anterior chamber and the anterior and posterior curvatures of the cornea and lens. First, a photo is taken of each patient's eye with a Topcon SL-45 Scheimpflug camera. There are two effects distorting the photo. As the film plane and the object plane are perpendicular to each other, the imaging scale is not constant over the photo, a phenomenon which is called the camera distortion. As the light passes through different refractive media on its way from the inner structures of the eye to the camera, the rays of light are refracted, which is called the refractive distortion of the eye. Following these distortions, the proportions on the photo do not correspond to those in the human eye. The intention of this paper is to calculate the true optical parameters of the anterior eye segment. The seeming optical parameters are taken from the photo and the path of light from a point in the film plane through the camera and the refracting surfaces into the eye is constructed by ray tracing. A set of representative points calculated according to ray tracing provides a basis to evaluate the true optical parameters. This work is done using a Basic program, that accepts the seeming parameters from the photo as input values and provides the true values as output. The adjectives seeming and true added to the optical parameters indicate a value correlating with a distorted photo and a value that was corrected by the theory. The two terms were chosen by mnemonic reasons, although another pair of adjectives such as distorted and corrected might have been of higher precision. For an average adult human eye the optical parameters from the photo were compared with the calculated ones. A phantom eye with well known optical parameters was constructed and photos were taken from this eye to verify the calculations. PMID- 2779978 TI - Quantification of glycation-induced browning in lens crystallins. A simple method for studying the advanced products of the Maillard reaction. AB - Differential scanning spectroscopy revealed a clear relationship between the degree of in vitro glycation of pig lens crystallins and its optical density at the range of 350-400 nm. This relationship is also shown in bovine serum albumin, used as a standard. In order to study the glycation browning in a large-scale number of samples, various spectroscopic indices have been tested, and the most discriminating became to include the absorbance at 375 nm with a correction of the background absorption at 300 and 500 nm (A3-W index). This index is proposed as a simple method for quantifying advanced products of the Maillard reaction in crystallins and other biological samples. PMID- 2779979 TI - A study of the mechanisms of chloroquine retinopathy. II. Chloroquine effect on protein synthesis of retina. AB - The influence of chloroquine on protein synthesis in rabbit retina has been studied. It is shown that chloroquine inhibits rhodopsin synthesis and the renewal of rod outer segment membranes. PMID- 2779980 TI - Retinoblastoma. Combined treatment of 21 cases. Critical review of the results. AB - The authors report their experience in the treatment of 21 children affected by retinoblastoma. There were 14 bilateral and seven unilateral cases of retinoblastoma; mean age at diagnosis was 16 months in males (16 patients) and 30 months in females (five patients). They were all staged according to Howarth et al. (1980) and treatment was correlated to the various stages. The treatment protocol was determined by a group of co-workers at the University of Padova. Among the 35 affected eyes, 26 were enucleated and the others were treated without surgery. One patient died of cerebral metastases and two patients are affected by a second tumor with an unfavorable prognosis for survival. Two other patients are affected by chronic liver disease, probably due to chemotherapy. The authors confirm the importance of early diagnosis and prompt and effective treatment in children affected by retinoblastoma. They also stress that recently developed genetic techniques allow diagnosis of retinoblastoma even before the symptoms appear. PMID- 2779981 TI - Chemotherapy for retinoblastoma. AB - Fourteen patients with retinoblastoma treated with chemotherapy in our hospital were surveyed to study the effects of chemotherapy on retinoblastoma. These patients were compared with those registered in 1980 and 1981 in Japan. In unilateral retinoblastoma limited to the eyeball, there was no significant difference in outcome between the chemotherapy and non-chemotherapy groups. In bilateral retinoblastoma, however, patients treated with chemotherapy within one month after the start of conservative therapy showed a better outcome than those whose chemotherapy was started more than one month after conservative therapy was begun. PMID- 2779982 TI - Genetic and cytogenetic analysis of patients showing reduced esterase-D levels and mental retardation from a survey of 500 individuals with retinoblastoma. AB - The authors have analysed the esterase-D levels in 500 retinoblastoma patients of whom 15 showed red cell enzyme activities of approximately 50% that of normal controls. Chromosome analysis of these 15 patients confirmed the presence of a deletion involving region 13q14 in all cases. Seven of the 15 cases had not previously been diagnosed and all of these showed sub-band deletions within 13q14. None of these seven patients were mentally retarded although the remaining eight who showed larger chromosome deletions demonstrated the full spectrum of psychomotor abnormalities associated with 13q deletions. Two other mentally retarded retinoblastoma patients with normal esterase-D activity showed no karyotypic abnormality, demonstrating that mental retardation cannot be taken to indicate a chromosome deletion in all cases. Eight of the 15 deletion cases were only unilaterally affected. The data presented in this article suggest that esterase-D quantitation could provide the primary means of detection of chromosome deletions in retinoblastoma patients. PMID- 2779983 TI - Demonstration of bias in series of retinoblastoma. AB - A register of retinoblastoma is being compiled with the aim of complete ascertainment of all cases with a recorded diagnosis of retinoblastoma in the United Kingdom. Sources of ascertainment include patients seen at St Bartholomew's and Moorfields Eye Hospitals, cases recorded in regional cancer registries, and pathology reports. Ascertainment of the Hospital series is complete, but that of the rest of the country is still incomplete. Comparison between the proportions of bilateral and unilateral cases in an age cohort in the Hospital series and the country as a whole shows that the Hospital series is biased towards an excess of bilateral cases. PMID- 2779984 TI - Chemotherapy in retinoblastoma management. AB - Chemotherapy, in addition to surgery, irradiation, cryothermy and light coagulation has been used in three groups of patients with retinoblastoma. In the first group it was used to try to prevent the development of metastases in cases with large tumours (Reese-Ellsworth Grade 4-5), in the second group to treat local extra-ocular spread and in the third group to treat bony metastases. In the first group there were 14 children with unilateral and eight with bilateral disease (grade 4 or 5 in one or both eyes), who were given prophylactic chemotherapy; there were no significant complications. One child died from congenital heart disease five years after treatment with no signs of metastatic disease. The mean survival of the other 21 children is now 6.0 years (range 2.5 11 years). Six children with local extra-ocular spread, one with CNS involvement as well, had chemotherapy with only minor complications. One child who did not complete the chemotherapy or radiotherapy coursed died from CNS disease but the remaining five have survived for four to 13 years. Three children with bone metastases were treated with high dosage chemotherapy after marrow harvesting and then reinfusion of marrow; in two children this did not eliminate the tumour and they died but one child has now survived free from disease for six years. In our cases we have had encouraging results from the use of chemotherapy with few complications but other authors have suggested that there is a possibility of new primary tumours being caused by this treatment. PMID- 2779985 TI - Comparison of cyclophosphamide and diaziquone in a retinoblastoma xenograft model. AB - The benefits and optimal applications of chemotherapy in the management of retinoblastoma remain to be defined. There are major obstacles to its further study in the clinical setting. A xenograft model of human retinoblastoma heterotransplanted directly into the anterior chamber of the nude mouse eye has been adapted for evaluation of therapeutic efficacy. Cyclophosphamide, the most effective conventional drug, and diaziquone, an experimental agent, both produced documented and comparable responses in each of four xenograft cell lines. There was no evidence of rapidly emerging drug resistance or cross-resistance between two agents when sequential chemotherapy courses were given. Diaziquone is an effective chemotherapeutic agent for retinoblastoma in the xenograft model, and may have applications in clinical management. PMID- 2779986 TI - Visolett magnifier without and with bifocal. AB - Visolett nonfocusable magnifiers are optically designed paperweights. The general magnification is 1.8X, and 4X through the bifocal. Using glass index 1.806, the general magnification is 2.47X. A Visolett is one of the most useful nonspectacle magnifiers because it diffusely concentrates the illumination on the field of vision, complementing the magnification. The optics differ from hand-held and stand magnifiers, in that the magnification does not increase with the dioptric power. However, the magnification of the bifocal does increase with the dioptric power and by decreasing the distance of the object from the focal point. The advantages are that they are simple to use, allow binocular vision, and almost double the magnification when used with a spectacle magnifier. Visoletts are preferred to stand magnifiers. PMID- 2779987 TI - Intraocular lens data. PMID- 2779989 TI - American Academy of Ophthalmology education programs. PMID- 2779990 TI - Ready-to-wear reading glasses. American Academy of Ophthalmology. PMID- 2779988 TI - Laser peripheral iridotomy for pupillary-block glaucoma. PMID- 2779992 TI - Laser trabecular surgery for open-angle glaucoma. American Academy of Ophthalmology. PMID- 2779991 TI - Botulinum toxin therapy of eye muscle disorders. Safety and effectiveness. American Academy of Ophthalmology. AB - BTX injection has been used for 11 years by 292 ophthalmologists in 8,854 patients aged three months to 90 years in a variety of eye muscle and eyelid disorders. No systemic toxic reaction has occurred, local complications are few, and visual loss has not occurred in any case. In blepharospasm and hemifacial spasm BTX appears to fill an important need, since no other drug is reliably effective and since surgical interventions have substantial side effects. Strabismus cases with active uveitis, hypotony, previous detachment surgery, active thyroid eye disease, and recent paralytic strabismus are often poor candidates for surgical intervention. Some patients in each of these categories were treated effectively and safely by BTX injection. Surgery is clearly the preferred treatment modality in large angle deviations, in chronic paralytic strabismus, in cases where diplopia for a month or two from injection would incapacitate the patient, in nystagmus, in oblique muscle disorders and A-V patterns, where muscles have been misplaced and where restrictions to alignment have been created by disease or prior surgery. Side by side comparisons of surgery and injection in congenital esotropia and in concomitant strabismus of 50 PD or less should result in further clarification of treatment choices as to effectiveness, side effects and cost. BTX is presently available only to clinical investigators using the drug under research protocols. PMID- 2779993 TI - Nd: YAG photodisruptors. American Academy of Ophthalmology. AB - Nd: YAG laser surgery can cut lens capsule, vitreous and capsular membranes, strands, and adhesions, and the iris within the surgically unopened eye, thereby avoiding infection, wound leaks, and other complications of conventional intraocular surgery. The technique has found its most widespread use in performing posterior capsulotomies after extracapsular cataract surgery. It has an extremely low complication rate when used in the anterior segment and is a preferred alternative to surgical discission. The uncertainties regarding its safety in creating iridotomies in phakic eyes have lessened with its extensive use in patients with pupillary-block glaucoma. However, caution is urged in other applications in phakic eyes. Following each Nd: YAG laser procedure, the eye should be monitored for elevation of intraocular pressure during the first two hours, and for retinal tears, retinal detachment, or cystoid macular edema during the first month after the procedure. Uncertainties persist regarding the circumstances under which the laser in its current configuration should be used in the vitreous cavity. PMID- 2779994 TI - Photographic slit-lamp biomicroscopes. PMID- 2779995 TI - Qualifications and responsibilities of authorship. PMID- 2779996 TI - Static threshold asymmetry in early glaucomatous visual field loss. AB - Ten normal subjects underwent static threshold visual field testing of both eyes with the Humphrey perimeter, with one eye tested twice. The mean sensitivity of the field seemed virtually identical in the two eyes, with the average difference between the right and left eyes (0.65 decibels [dB]) being no greater than the testing error as reflected in the difference between the same eye tested twice (0.7 dB). The authors provide the mathematical basis for recognizing that a right eye-left eye difference in mean sensitivity might be abnormal. Additional information is needed about the variance of the right eye-left eye difference in the population at large, but present information suggests that a 2-dB difference may be meaningful on a single examination. A 1.5-dB difference is statistically significant if confirmed on a second test, and a difference as small as 1 dB may be meaningful if shown consistently in a series of four examinations. In all cases, nonglaucomatous causes of field abnormality needs to be ruled out, and the generalized asymmetry is most meaningful if it is consistent with asymmetry of cupping or intraocular pressure. Several cases are reported in which a mild (1 dB) generalized depression of the visual field is the only recognizable abnormality in the visual field in eyes with early glaucoma. PMID- 2779997 TI - Effects of pupillary constriction on automated perimetry in normal eyes. AB - The authors studied the effects of pupillary constriction (pilocarpine 2%) on automated static threshold perimetry in 20 normal subjects using the Humphrey Field Analyzer 30-2 and STATPAC programs. The mean defect (MD) worsened by an average of 0.67 decibels (dB) (standard deviation, 0.67 dB) in constricted fields compared with baseline visual fields (P less than or equal to 0.001). Independent comparisons of the unweighted means of threshold values for the central 30 degrees, 24 degrees, and 10 degrees were also done and showed significant reductions in sensitivity after constriction (P less than or equal to 0.001). These findings indicate that changes in pupillary diameter may produce significant declines in threshold sensitivities and support the importance of consistent pupillary diameters on serial automated visual field examinations. PMID- 2779998 TI - Lens rim artifact in automated threshold perimetry. AB - In central static threshold visual fields (Humphrey 30-2 Program) performed with a corrective lens, lens rim artifact (LRA) was present in 10.4% of 704 fields examined retrospectively and 6.2% of 276 fields evaluated prospectively. Lens rim artifact most commonly presented as a combination of absolute and relative defects involving the temporal quadrant either alone or in combination with another quadrant. Lens rim artifact was related to seven different types of interpretational errors, five of which led to an overdiagnosis and two to an underdiagnosis. Risk factors for the occurrence of LRA include older age, high hyperopic correction, and location specific involvement probably due to a limitation in perimeter design. Field defects involving only the four targets at 27 degrees eccentricity in the temporal quadrant were due only to LRA in this series and may be disregarded when interpreting the Humphrey 30-2 Program. Recommendations are made toward minimizing the occurrence of LRA and avoiding interpretational errors associated with LRA. PMID- 2779999 TI - Unequal intraocular pressure and its relation to asymmetric visual field defects in low-tension glaucoma. AB - Fifty-nine low-tension glaucoma patients were reviewed with respect to asymmetry of intraocular pressure (IOP) and visual field defects. In the presence of unequal IOP the visual field damage is almost always greater on the side with higher mean IOP. However, only 13 of 47 patients with asymmetric visual field defects had a mean IOP difference between the two eyes of greater than or equal to 1 mmHg. Although in the case of IOP asymmetry visual field damage is greater in the eye with higher mean IOP, other factors must also play an important role in the development of visual field defects in low-tension glaucoma. PMID- 2780000 TI - Photogrammetric measurement of nerve fiber layer thickness. AB - To measure retinal nerve fiber layer (NFL) thickness, three sets of simultaneous stereophotographs of the optic disc, taken with the Donaldson fundus camera, were measured at 5 degrees intervals in a stereoplotter (Kern PG2) at the surface of the internal limiting membrane (ILM) and the retinal pigment epithelium (RPE) along the disc margin. The NFL thickness was expressed as a ratio of the vertical disc radius. The reproducibility of the method showed that the percent coefficients of variation (CV%) for 15 normal, 10 ocular hypertensive, and 10 glaucomatous subjects were 5.2%, 6.0%, and 3.9%, respectively. The presence of a halo or scleral crescent had no significant effect on reproducibility. The photogrammetric technique for measuring NFL thickness appears to be highly reproducible and sensitive and may be a valuable quantitative method for: (1) early detection of optic nerve damage from glaucoma and other optic neuropathies and (2) monitoring progression of retinal NFL defects. PMID- 2780001 TI - Reproducibility of topographic measurements of the optic nerve head with laser tomographic scanning. AB - Topographic analysis and measurement of the optic nerve head is important for the diagnosis and follow-up of glaucoma. To quantify structures of the optic nerve head the new technique of laser tomographic scanning was used. A laser beam was focused onto the surface of the optic nerve head and the reflected light was detected in a confocal detection unit. The consequent change of focus produced a tomographic scanning series and allowed measurement of three-dimensional structures. To analyze the reproducibility of optic cup measurements the authors did ten recordings of one eye of eight normal volunteers. The mean standard deviation of the measurements was +/- 0.015 mm3 and the mean coefficient of variation was 9.5%. Confocal laser tomographic scanning is a safe, effective, convenient method to measure and document the topography of the optic nerve head and should be a valuable technique for follow-up of glaucoma patients. PMID- 2780002 TI - The normal human optic nerve. Axon count and axon diameter distribution. AB - Computerized image analysis was used to determine the normal axonal count and axon diameter distribution in 12 normal human eyes. Mean axon count per nerve was 969,279 +/- 239,740 and mean axon diameter was 0.72 +/- 0.07 micron. Multiple linear regression disclosed 4909 axons lost yearly (P = 0.08). Statistical analysis did not show a relationship between axon diameter and age or time to fixation. The inferotemporal sector of the nerve had the highest fiber density (P = 0.02). The superonasal nerve had higher mean diameters (P = 0.02). This study may provide a baseline for future pathologic studies. PMID- 2780004 TI - Intraocular pressure measurement after pars plana vitrectomy. AB - The ability of various tonometers to measure intraocular pressure (IOP) accurately after pars plana vitrectomy was determined by using Schiotz, Goldmann, and Digilab pneumatic tonometers before and after the procedure in 47 eyes. Seventeen of these eyes underwent intraoperative fluid-gas exchange and had an intravitreal gas bubble on the first postoperative day. The Schiotz tonometer underestimated the Goldmann IOP by more than 10 mmHg in 6 (35%) of 17 eyes after vitrectomy with intravitreal gas and 4 (13%) of 30 eyes without intravitreal gas. The Digilab tonometer did not underestimate the Goldmann IOP by more than 10 mmHg in any eye postoperatively. However, the Digilab tonometer underestimated the Goldmann IOP by more than 5 mmHg in 3 (18%) of 17 eyes after vitrectomy with intravitreal gas and two (7%) of 30 eyes without intravitreal gas. PMID- 2780003 TI - Maintained reduction of intraocular pressure by prostaglandin F2 alpha-1 isopropyl ester applied in multiple doses in ocular hypertensive and glaucoma patients. AB - In a randomized, double-masked, placebo-controlled study, 0.25 microgram (n = 11) or 0.5 microgram (n = 13) of prostaglandin F2 alpha-1-isopropyl ester (PGF2 alpha IE) was applied topically twice daily for 8 days to one eye of ocular hypertensive or chronic open-angle glaucoma patients. Compared with contralateral, vehicle-treated eyes, PGF2 alpha-IE significantly (P less than 0.05) reduced intraocular pressure (IOP), beginning 4 hours after the first 0.5 microgram dose and lasting at least 12 hours after the fourteenth dose, with a significant (P less than 0.005) mean reduction of 4 to 6 mmHg maintained throughout the last day of therapy with either dose. A contralateral effect was not observed. Mean tonographic outflow facility was significantly (P less than 0.05) higher in PG-treated compared with vehicle-treated eyes (0.17 +/- 0.02 versus 0.12 +/- 0.01 microliter/minute/mmHg, respectively; +/- standard error of the mean) for the 0.5 microgram dose. Conjunctival hyperemia reached a maximum at 30 to 60 minutes after PGF2 alpha-IE application. Some patients reported mild irritation lasting several minutes after some doses. Visual acuity, accommodative amplitude, pupillary diameter, aqueous humor flare, anterior chamber cellular response, Schirmer's test, pulse rate, and blood pressure were not significantly altered. Our findings show that PGF2 alpha-IE is a potent ocular hypotensive agent and a promising drug for glaucoma therapy. PMID- 2780005 TI - Mechanisms of intraocular pressure elevation after pars plana vitrectomy. AB - A prospective study of 222 consecutive patients undergoing pars plana vitrectomy was done to determine the incidence and mechanisms of postoperative intraocular pressure (IOP) elevation. Within 48 hours of surgery, postoperative IOP increased by at least 5 to 22 mmHg in 136 eyes (61.3%) and to 30 mmHg or more in 79 eyes (35.6%). Presumed mechanisms of open-angle glaucoma included intraocular gas expansion (28.4%), inflammatory trabecular meshwork obstruction (4.5%), silicone oil-related glaucoma (3.6%), and erythroclastic glaucoma (2.2%). Closed-angle mechanisms included pupillary block glaucoma (6.8%) and ciliary body edema (3.6%). Factors which were associated with postvitrectomy pressure elevation included placement of a scleral buckle, either intraoperatively (P = 0.003) or before vitrectomy (P = 0.001), intraoperative scatter endophotocoagulation (P = 0.041), intra-operative lensectomy (P = 0.024), and development of postoperative fibrin membranes (P = 0.038). Surgery was required to lower IOP or relieve pupillary block in 25 eyes (11.3%). PMID- 2780006 TI - Malignant transformation of spontaneously regressed retinoblastoma, retinoma/retinocytoma variant. AB - The authors report on a case of a 7-year-old girl who was found on routine preschool screening at age 4 years to have unilateral decreased vision and a retinal lesion consistent clinically with the retinoma or retinocytoma variant of "spontaneously regressed retinoblastoma." The patient was followed closely with photographic documentation. After remaining stable for 3 years, her tumor grew rapidly and seeded the vitreous, prompting enucleation. Histopathologic examination disclosed that the newer elevated part of the tumor was an undifferentiated retinoblastoma, whereas the base of the tumor had the characteristic benign histopathologic features of retinoma/retinocytoma including bland nuclei, a fibrillar eosinophilic stroma, scattered fleurettes, calcific foci within viable tumor, and no mitoses. Immunohistochemical stains disclosed that immunoreactivity for retinal S antigen, S-100 protein, and glial fibrillary acidic protein was confined to cells in the differentiated basal part of the tumor. These histopathologic observations support the concept that tumors with the clinical characteristics of the patient's original lesion are benign variants of retinoblastoma that have arisen de novo rather than retinoblastomas that have undergone spontaneous regression. The clinical developments in this case suggest that retinomas or retinocytomas rarely undergo malignant transformation after a period of clinical dormancy and underscore the necessity for close follow-up of patients with presumed regressed retinoblastoma. PMID- 2780007 TI - Long-term natural history of lattice degeneration of the retina. AB - An initial series of patients with lattice degeneration was reported to the Academy in 1964 and a follow-up report given in 1973. A continuing prospective study of 276 consecutive untreated patients (423 eyes) is now reported with follow-up from 1 to 25 years (average, 10.8 years). Clinical retinal detachments (RDs) occurred in 3 (1.08%) of 276 patients and 0.7% of eyes. Tractional retinal tears were seen in eight (2.9%) patients and 1.9% of eyes; one of these led to a clinical RD. Clinical or progressive subclinical RD occurred in 3 (2%) of eyes with atrophic holes. Subclinical RD was seen in 10 (6.7%) of 150 eyes with atrophic holes, involving 9 (7.5%) of 120 patients, and had a much less serious prognosis than clinical detachment. Prophylactic treatment of lattice with or without holes in phakic, nonfellow eyes should be discontinued. PMID- 2780008 TI - Subretinal membranes in proliferative vitreoretinopathy. AB - Subretinal membranes (SRMs) are an important but rarely identified component of proliferative vitreoretinopathy (PRV). In 153 consecutive cases that had vitreoretinal surgery for this condition and were followed for at least 6 months, SRMs were encountered in 72 eyes (47%). In 20 (28%) of the 72 eyes, the SRMs prevented complete retinal reattachment and needed to be removed or excised through one or multiple retinotomies. Intraoperative complications related to the SRMs or their removal included choroidal or retinal hemorrhage in three eyes (15%), subretinal air in three eyes (15%), and unplanned extension of the retinotomies in two eyes (10%). The 20 eyes requiring SRMs removal were followed for a median of 11 months. Retinas were reattached in 13 eyes (65%), although only 4 eyes (20%) had a visual acuity of 5/200 or better. Recognizing SRMs as a component of PVR is important in helping to maximize the anatomic success rate although the effects on visual function are not fully known. PMID- 2780009 TI - Surgical management of vitreomacular traction syndromes. AB - A series of 106 consecutive symptomatic eyes considered to be at high risk for idiopathic macular holes developing underwent pars plana vitrectomy with membrane peeling. One of three types of vitreomacular traction was noted intraoperatively in all the eyes. The elimination of the vitreomacular traction resulted in improved vision in 89% of the eyes, no change in 7%, and decreased vision in 4%. A total of 62% of the patients were women (median age, 67 years). Follow-up ranged from 6 months to 118 months (average, 35 months). Complications included accelerated nuclear sclerosis in 16% and a 2% incidence of retinal detachment, macular pucker, and macular holes. PMID- 2780010 TI - Recovery of AIDS virus from ocular tissues. PMID- 2780011 TI - The three-step test. PMID- 2780012 TI - Comparative evaluation of screw configuration on the stability of the sagittal split osteotomy. AB - This study is a comparative evaluation of two commonly used screw configurations on the rigidity of the sagittal split osteotomy. A cadaver model was used to compare the immediate load strength of three screws placed horizontally above the neurovascular bundle (horizontal configuration) versus two screws placed horizontally above the bundle and one screw placed inferiorly below the bundle (triad configuration). The triad configuration was found to have a mean percentage increase in rigidity of 58% over the horizontal configuration. The paired t test was used to evaluate the data, disclosing a significant difference in load strength (p less than 0.01). PMID- 2780013 TI - Arthroscopic diagnosis of perforation and adhesions of the temporomandibular joint: correlation with postmortem morphology. AB - Arthoscopy was performed in the upper joint compartment of 28 temporomandibular joints in 16 fresh cadavers to investigate the accuracy of arthroscopic diagnoses of perforation and adhesion. Subsequent dissections revealed that only three of nine perforations were seen arthroscopically and that three of four joints with adhesions were arthroscopically diagnosed. There was no overdiagnosis of perforation or adhesions. Intra-articular hyperplastic soft tissue formation (crab meat) was arthroscopically seen in ten joints (36%) and was with only two exceptions associated with either a perforation or adhesions. Histologically, the adhesion and the hyperplastic soft tissue consisted of fibrous connective tissue with collagen fibers and fibroblasts. It was concluded that a positive arthroscopic diagnosis of adhesion or perforation is reliable whereas a negative diagnosis of perforation is not reliable. PMID- 2780014 TI - Short-term stability and muscle adaptation after mandibular advancement surgery with and without suprahyoid myotomy in juvenile Macaca mulatta. AB - The purpose of this study was to examine the short-term adaptations that occur within the mandible and anterior digastric muscle complex after mandibular advancement with and without suprahyoid myotomy in 20 juvenile rhesus monkeys. The results showed that the animals that did not undergo myotomy experienced relapse equivalent to 13% of the surgical advancement. Those animals that underwent a myotomy of the digastric muscle complex showed complete stability of the surgical lengthening of the mandible. Both groups of animals grew normally after the fixation period when compared to age-matched control animals. Analysis of adaptations within the digastric muscle complex was performed with the use of radiopaque muscle and tendon markers. The results showed an immediate lengthening of the entire digastric muscle complex with mandibular advancement surgery in the group that underwent advancement without myotomy. Further analysis showed that most lengthening in these animals occurred at the connective tissue interfaces of the complex--at the muscle-bone and muscle-tendon interfaces. No significant changes in sarcomere or fiber length were found in the group that did not undergo myotomy, although there was a significant shortening of muscle fibres resulting from loss of serial sarcomeres in the myotomy group. Comparison of histochemical characteristics of the anterior digastric muscle before and after surgery revealed the following findings: (1) there were no significant differences in percentage of composition between control and experimental muscles; (2) despite fixation of the jaws and myotomy, there was no evidence of atrophy of the anterior digastric muscle at any experimental interval; and (3) the type I fibers of the anterior digastric muscle underwent significant stretch-induced hypertrophy after lengthening. The results of this study support the hypothesis that tension produced by stretching of the connective tissues associated with the digastric muscle complex can contribute to postsurgical relapse of the surgically advanced mandible. However, no adverse effect on future growth of the mandible was observed from stretching the digastric muscle complex by mandibular advancement surgery in juvenile subjects. PMID- 2780015 TI - Passive rigid fixation of sagittal split osteotomy. AB - To provide increased stability and to decrease intermaxillary fixation time after sagittal split osteotomy, we have used passive rigid fixation. Our method has not only achieved a diminution of intermaxillary fixation time, but it has also resulted in excellent stability and retention. A total of 72 sagittal split osteotomies were performed on 36 patients from July 1985 through December 1986. Rigid fixation was accomplished with two superior border 2.7 mm bicortical screws. PMID- 2780016 TI - Bursitis: a factor in the differential diagnosis of orofacial neuralgias and myofascial pain dysfunction syndrome. AB - A woman had pain on swallowing and talking when initially seen. Previous diagnoses of glossopharyngeal, neuralgia and myofascial pain dysfunction syndrome had been made. Appropriate treatment for these conditions failed to produce any improvement. Palpation revealed two tender areas bilaterally, overlying the hamulus. Treatment with an injection of 1 ml of dexamethasone (Decadron) 4 mg/ml into each area of tenderness resulted in a dramatic improvement. An anatomic review disclosed the presence of a bursa on the hamulus to protect the tendon of tensor veli palatini. A diagnosis of bursitis was made because of the dramatic improvement in the patient's condition as the result of corticosteroid therapy. Bursitis should therefore be considered in the differential diagnoses of orofacial neuralgias, temporomandibular joint dysfunction, and myofascial pain dysfunction syndrome. PMID- 2780017 TI - Episodic supersalivation (idiopathic paroxysmal sialorrhea): description of a new clinical syndrome. AB - Four patients have been identified as experiencing a form of sialorrhea not previously described in the dental literature. The pattern of salivation is atypical in that it is excessive and is episodic in nature, with paroxysms of secretion occurring 1 to 2 times per week and lasting for 2 to 5 minutes. The episodes are preceded by a prodrome consisting of nausea or epigastric pain, but without progression to vomiting. Because of the unknown cause and spontaneous occurrence, the syndrome is being called idiopathic paroxysmal sialorrhea (IPS). PMID- 2780018 TI - Orofacial manifestations in a child with Fanconi's syndrome. AB - Orofacial and dental findings in a child with Fanconi's syndrome and accompanying glycogen storage disease are presented. Remarkable retardation of skeletal growth, resulting in dwarfism, was noted. Cephalometric analyses revealed that the size of the patient's craniofacial bones at 10 years of age was as small as that of the average 4-year-old child. Development of the permanent dentition was retarded for 3 to 4 years. Histologic examination of an exfoliated primary canine showed hypomineralization of the dentin structure. PMID- 2780019 TI - The inflammatory paradental cyst. AB - The inflammatory paradental cyst has previously been described as the collateral inflammatory cyst, the inflammatory lateral periodontal cyst, the paradental cyst, or the mandibular infected buccal cyst. Clinical, radiographic, and histologic features of 29 inflammatory paradental cysts diagnosed over a 5-year period were studied. The cysts occurred in relation to a partly or fully erupted tooth with a vital pulp. Twenty-seven of the cysts were located in the mandible and the remaining two in the maxilla. The mandibular cysts were in all cases associated with a molar. The observation that the cysts are diagnosed within a few years after tooth eruption and the demonstration of a statistically significant difference (p = 0.001) in age distribution and in the type of tooth involved suggest that eruption is important for the development of the cysts. The consistent finding of a hyperplastic, nonkeratinized stratified squamous epithelium with an intense inflammation in the connective tissue is in accordance with the hypothesis that inflammation is important for the development of these cysts. PMID- 2780020 TI - Cleidocranial dysplasia: a light microscope, electron microscope, and crystallographic study. AB - An unusual case of cleidocranial dysplasia associated with more than 60 unerupted teeth is presented and examined with light and scanning electron microscopes and crystallographic techniques. The present case revealed pseudoprognathism with facial asymmetry, the right side being larger than the left. The extracted teeth showed enamel hypoplasia in light and scanning electron microscopy, yet the crystalline composition did not differ from that of the normal teeth. The potential causes of lack of eruption and supernumerary tooth formation in cleidocranial dysplasia are discussed. PMID- 2780021 TI - Chondroma and osteochondroma of the tongue. AB - The first case of two separate tumors of the tongue, one cartilaginous and the other osteocartilaginous, is reported. The cartilaginous matrix of these two tumors contained elastic fibers and type II collagen. The histogenesis of these tumors is discussed. PMID- 2780022 TI - A comparison of dentinogenesis on pulp capping with calcium hydroxide in paste and cement form. PMID- 2780023 TI - Video enhancement of dental radiographic films. AB - A prototype video image display system, a real-time analog enhancer (RAE), was compared to conventional viewing conditions with the use of nonscreen dental films. When medium optical density films were evaluated, there was no significant difference in the number of radiographic details detected. Conventional viewing conditions allowed perception of more details when dark films were evaluated; however, the RAE unit allowed the perception of more details when light films were viewed. PMID- 2780024 TI - Presentation and physical evaluation of RadioVisioGraphy. AB - A comparison of physical properties has been made between conventional intraoral films and images made with the RadioVisioGraphy (RVG) system, a unit based on the charged coupled device. The RVG system uses considerably reduced levels of radiation to produce an image immediately after exposure. RVG resolution is slightly lower than that with silver halide emulsion films; however, radiographic information may be increased by electronic image treatment. PMID- 2780025 TI - Radiology of alveolar complications associated with dental extractions. PMID- 2780026 TI - [Value of computerized tomography methods in diagnosing various diseases of the spine and spinal cord]. AB - The authors generalize their 3-year experience in the employment of computer tomography at a multiprofile hospital and determine the diagnostic possibilities of this method in the treatment of degenerative and dystrophic diseases, primary and secondary tumours as well as some diseases of the spinal cord. The methods of improving the diagnostic efficiency of CT are discussed, particularly the employment of additional contrasting methods (CT epidurography and CT myelography). The indications for the employment of CT have been determined and the optimal sequence of performing the traditional X-ray methods of investigation, CT, CT epidurography and CT myelography in the lesions of the spinal column and the spinal cord has been worked out. PMID- 2780027 TI - [Effectiveness of local hypothermia in the complex treatment of patients with complicated injuries of the spine]. AB - Having analysed her observations of 84 scheduled patients with complicated injuries of the spinal column the author comes to the conclusion that local cooling of the spinal cord during the postoperative period exerts positive influence: it contributes to a decrease in excitability of alpha motoneurons of the spinal cord which is manifest by reduced muscular tension, improves the local blood flow in the spinal cord, raises the vascular tension and provides the analgetic effect. PMID- 2780028 TI - [Disorders of metabolism and their pathogenesis in patients with spinal cord injuries]. PMID- 2780029 TI - [Injuries of the lumbosacral segments of the spine]. AB - Having studied 470 case histories of patients with injuries of the spine the author found traumas of the 5th lumbar vertebra in 23 cases (4.9%). The characteristic injuries were compression wedge-shaped fractures, multiple fractures of the vertebrae, comminuted and traumatic spondylolistheses and dislocation fractures. A typical mechanism of the injury was a blow in the lumbar region or in the back with subsequent bending of the trunk. The tactics of surgical treatment of such lesions is presented, the main tasks of which are the reconstruction of the shape and the volume of the vertebral canal, the stabilization of the basis compartment of the spine and the prevention of subsequent degenerative changes. PMID- 2780030 TI - [Roentgenotopographic forms of aseptic necrosis of the femur head in adults]. AB - On the basis of the data of X-ray examination of 378 patients (466 joints) with aseptic necrosis of the femoral head and their surgical treatment (314 patients) the authors have distinguished four roentgenotopographic forms of avascular lesions: peripheral, central, segmental and total. Certain dependence of the localization of the necrotic focus on a number of determined etiologic factors has been pointed out, such as the character of the preceding injury and the type the hip lesion, supercooling or the patient's occupation. The authors believe that the choice of the most adequate type of surgical intervention should be based not only on the stage of the process, but also on the size and the localization of the femoral head lesion. PMID- 2780031 TI - [Corrective intertrochanteric osteotomy in the treatment of aseptic necrosis of the femur head in adults]. AB - Having analysed their experience in surgical treatment of 196 patients with aseptic necrosis of the femoral head (263 hip joint operations) the authors specify the indications for performing corrective intertrochanteric osteotomies of the femur, work out their tactics of differential approach and summarize the long-term results of the treatment. It has been established that the possibility of obtaining a positive result makes 84.5% if correct indications for the operation are observed. PMID- 2780032 TI - [Experimental substantiation of a transosseous approach in arthroplasty of the hip joint]. AB - The author analyses the results of 40 experimental operations on cadavers to work through and to improve the approach for the hip joint arthroplasty performed by means of intertrochanteric osteotomy of the femur. The main parameters of the approach at various stages of the procedure have been evaluated according to O. Y. Sozon--Yaroshevich, the traumatizing factors of the operation have been determined and the peculiarities of mobilization of the proximal part of the femur and the possibility of displacement of the femoral head in various directions have been studied. Variations of the approach have been proposed taking into consideration the degree of limitation of the movements and the character of pathologic changes in the joint for performing hip joint arthroplasty in clinical practice. An approach to the supraacetabular area from the part of the joint cavity has been worked out which preserves the gluteal muscles, at the same time allowing to perform the arthroplasty and to reconstruct the supraacetabular area. PMID- 2780033 TI - [A case of successful treatment of severe combined injuries of the spine and spinal cord]. PMID- 2780034 TI - [Our experience with the treatment of coxarthrosis]. PMID- 2780035 TI - [Osteosynthesis of femoral diaphysis using rod-like pins]. PMID- 2780036 TI - [A rod for the Ilizarov apparatus]. PMID- 2780037 TI - [Our experience with organizing a department of manual therapy in an urban hospital]. PMID- 2780038 TI - [Characteristics of roentgenologic examination of patients with ununited fractures and pseudarthroses of the femur neck]. PMID- 2780039 TI - [Agricultural trauma: its real meaning, determination of the causes and their classification]. PMID- 2780040 TI - [Hypothermia in spinal surgery]. AB - The authors present the clinical and experimental substantiation of the method of local cooling of the cerebrospinal formations and the evaluation of its efficiency in various surgical interventions on the spinal column and the spinal cord. The method of performing local hypothermia of the spinal cord in 64 patients is described. Having compared three versions of local cooling, the authors recognize that the optimum method was that with the cooling element placed directly on the dura mater and with compulsory neurovegetative protection during the performances. The high efficiency of local hypothermia of the spinal cord was confirmed by rapid stabilization during the postoperative period of the values of central hemodynamics and the oxygen budget of the patients' organisms, while there was regression of the neurologic deficiency, prevention and arresting of the brain tissue edema and analgesia. PMID- 2780042 TI - [A life-saving hemostatic procedure by ligation of the hypogastric artery in hemorrhage caused by cervix carcinoma]. AB - Ligation of the hypogastric arteries may be a lifesaving procedure for patients with intractable hemorrhage from pelvic viscera. This is especially true in the field of obstetrics and gynecology in which hemorrhage remains a major cause of mortality. Authors ligated both hypogastric arteries to control intractable hemorrhage in an advanced case of cervical carcinoma. It is emphasized that the technique of hypogastric artery ligation should be practised by all gynecologists. PMID- 2780041 TI - [Follow up of thyroglobulin levels in patients with surgically treated, highly differentiated thyroid cancer]. AB - The highly differentiated thyroid tumours account for 0.80 percent 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 thyreoglobulin. Thus 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 thyreoglobulin level in 153 patients with highly differentiated thyroid cancer. In 29 of 32 metastatic patients pathologically elevated (70 to 100 ng/ml) thyreoglobulin level was observed. This proves the 91 percent specificity of the method in verified metastatic tumours. Compared to the total body scintigraphy 3 false negative cases were found. The authors establish that, irrespective of the site of metastasis, the thyreoglobulin level is higher in the follicular than in the papillary subtype. It is concluded that the measurement of the serum thyreoglobulin level is a suitable marker of the highly differentiated thyroid cancer since it represents the local recurrence of distant metastases with a significant increase while the therapy-resultant tumour diminution with a marked decrease, respectively. PMID- 2780043 TI - [Superselective embolization of intrarenal arteriovenous shunt]. AB - A case of a successful catheter-embolization of an arteriovenosus fistula in the left kidney is reported. Following this procedure the massive hematuria requiring repeated transfusions previously is stopped. PMID- 2780044 TI - [Developmental bone abnormalities, their variants and the delay of osteogenesis in children with leukemia]. AB - When analyzing the Roentgen documentation of 102 leukaemic children, the prevalence of bone anomalies of the extremities, pelvis and vertebral column was studied. The frequency of the abnormal or unusual findings was compared with that of 660 control subjects. The frequency of osseous anomalies proved to be 2 to 3 times higher in leukaemic children tha in the controls. Considering the number of ossification centers and the presence nutritional canal of vertebrae, in leukaemic children the ossification seemed to be retarded. PMID- 2780045 TI - [Current diagnostic method for saccharose-isomaltose malabsorption]. AB - The authors present the cases of 4 children who suffered from saccharose isomaltose malabsorption. The clinical symptoms developed following artificial feeding. The diagnosis was made by the histological examination of small intestine samples and with the simultaneous measurement of disaccharide enzyme activity. The histological picture and activity of lactase enzyme were practically normal. The saccharose H2 breath test gave only in 1 case positive result. The treatment of the children required saccharose-free diet. The tolerance showed no improvement during the treatment. PMID- 2780046 TI - [Recurrent juvenile pancreatitis in dermatomyositis]. AB - The authors present the case history of an 11-year-old girl who suffered from the rarely occurring grave juvenile dermatomyositis associated with recurring pancreatitis. Factors which may cause pancreatitis: juvenile dermatomyositis as underlying disease, steroid-, cytostatic- and thiazide diuretic treatment are analysed. PMID- 2780047 TI - [Screening for congenital adrenal hyperplasia in Hungary]. AB - Measurement of blood-spot 17-hydroxyprogesterone (17-OHP) concentration was used to identify cases of congenital adrenal hyperplasia (CAH) among patients with inappropriate virilization and/or salt wasting. Between 1978 to 1986 61 cases with 21-hydroxylase deficiency among 707 patients (278 newborns, 204 infants and 225 children) were identified. The incidence of classical CAH was calculated for a seven year prospective trial period using the blood-spot 17-OHP method in selective screening. There were 38 salt-losers and 14 simple virilizers in 968,303 live births giving an incidence of 1 in 18,000 for CAH in the Hungarian population. The use of a central laboratory facility to measure the blood-spot 17 OHP concentrations is proposed as a valuable initial method to investigate patients at risk for CAH in countries where blood steroid assays are not readily available in hospitals. PMID- 2780049 TI - [Ethical implications of human experimentation]. PMID- 2780048 TI - [Management of critical ischemia of the leg by omentum transplantation in Buerger's disease]. AB - Author reviews cryptogenic etiology, and poor prognosis of endarteriitis obliterans (Buerger's disease), traditional salvage measures and their temporary effectivity. Based on theoretical, animal experimental and clinical studies chances of new operative measure: omental transplantation are suggested. Two own cases operated on and promising results of the short follow-up period (6 and 9 months) are reported. PMID- 2780051 TI - Detection of amplified oncogenes by differential polymerase chain reaction. AB - Oncogene amplification has been found in a variety of human cancers and may have prognostic importance. Therefore, techniques which facilitate detection of gene amplification could have wide applicability. We have devised a sensitive, rapid, and non-radioactive procedure for detecting alterations in gene copy number based on the polymerase chain reaction (PCR). In this technique, called differential PCR, a target gene and a single-copy reference gene are co-amplified by PCR in the same reaction vessel. The level of target gene amplification is reflected in the ratio between the two resulting PCR-product bands. We show that this method can detect as low as two-fold amplification of specific target genes. Furthermore, amplification of neu and the epidermal growth factor receptor gene could be detected in as few as 100 breast carcinoma cells or in single sections of formalin-fixed, embedded material. PMID- 2780050 TI - Amplification of N-myc and ornithine decarboxylase genes in human neuroblastoma and hydroxyurea-resistant hamster cell lines. AB - The genes for the M2 subunit of ribonucleotide reductase (RRM2), ornithine decarboxylase (ODC1), and 55,000-Daltons protein (P5), are amplified in hydroxyurea-resistant hamster and human cell lines. These genomic sequences have been mapped to hamster chromosome 7 and to human chromosome 2p24-25 near the cytogenetic location of the N-myc gene. We now report that genomic sequences homologous to N-myc are amplified in hydroxyurea-resistant hamster lung cell line, 600H, and the N-myc gene segregates with hamster chromosome 7 in mouse hamster somatic cell hybrids. The conserved linkage group consisting of the RRM2, ODC1, P5, and N-myc in the hamster and human genomes prompted our investigation of human neuroblastomas. We report here that genomic DNA from 1 of 6 primary neuroblastoma tumors containing amplified N-myc also contains amplified sequences homologous to a hamster ODC cDNA. PMID- 2780052 TI - Expression of the K-fgf protooncogene is repressed during differentiation of F9 cells. AB - Utilizing F9 embryonal carcinoma cells as a model system for early mammalian development, we have studied the pattern of expression of the endogenous murine homolog of the human K-fgf/hst oncogene, which encodes a new member of the fibroblast growth factors (FGFs) family. The K-fgf mRNA is expressed in undifferentiated F9 cells and its level becomes undetectable upon the induction of differentiation. Furthermore, a growth-promoting activity with properties identical to those of K-FGF is present in the conditioned medium of F9 cells, but absent in that of differentiated cells. Shut-off of K-fgf expression is mediated at the transcriptional level. The acidic FGF gene is also expressed in undifferentiated F9 cells and down modulated once differentiation is induced. In contrast, int-2, another member of the FGF gene family, is transcriptionally induced in differentiated F9 cells. Our data suggest that single members of the FGF gene family may perform distinct functions in vivo, and that the physiological role of K-FGF may be related to early development. PMID- 2780054 TI - PNA's strategic plan being readied for convention. PMID- 2780053 TI - Localization of cellular src mRNA during development and in the differentiated bipolar neurons of the adult neural retina in Xiphophorus. AB - The expression of the c-src gene in embryonic and adult tissue of the teleost fish Xiphophorus helleri was analyzed by in-situ hybridization. The highly conserved fish c-src gene was found to be expressed at high levels in midterm embryos, where c-src mRNA was localized in developing neurons of the sensory layer of the differentiating retina and in the developing brain. In adult tissues the expression of c-src was found to persist in certain cell types of the brain and the neural retina, especially in the bipolar cells of the inner nuclear layer, which are postmitotic, fully differentiated mature neurons. Thus c-src in Xiphophorus appears to be a developmentally regulated proto-oncogene which is important for neuronal differentiation during organogenesis, but whose persistence of expression in certain terminally differentiated neurons strongly suggests a particular maintenance function for c-src in these cells as well. PMID- 2780055 TI - Getting involved in local government. PMID- 2780056 TI - In the wake of Webster v. Repro. Health Services, nurses are urged to examine continuity of care. PMID- 2780057 TI - Central analgesic effect of ketoprofen in humans: electrophysiological evidence for a supraspinal mechanism in a double-blind and cross-over study. AB - The aims of this study were: (1) to test the hypothesis of a central analgesic effect of the aspirin-like drug ketoprofen and (2) to attempt to differentiate between a spinal and a supraspinal mechanism in this possible central action. The threshold of the nociceptive flexion reflex from the biceps femoris muscle elicited by sural nerve stimulation was studied before and after a double-blind, cross-over and randomized intravenous injection of ketoprofen (100 mg in 5 ml saline) and saline (5 ml) in 2 groups of volunteers. The first one was composed of 10 normal subjects while the second consisted of 8 paraplegic patients with complete spinal section of traumatic origin. In normal subjects, ketoprofen injection resulted in a rapid and significant increase (+68%) of the threshold of the nociceptive reflex, while saline injection produced a slow increase of only 17% of this threshold. In contrast, in paraplegic patients, neither ketoprofen nor saline produced any significant change in the nociceptive reflex threshold. A supraspinal involvement in the central analgesic effect of this drug is discussed. PMID- 2780058 TI - Conditioned response models of placebo phenomena: further support. AB - Following our earlier research, we further investigated a model that conceptualizes placebo phenomena as the result of conditioning and attempted to extend and replicate the finding that placebo responses can be conditioned in human subjects. Two groups of 10 subjects were told that they were receiving an analgesic which was in fact a placebo. During the conditioning, placebo administration was surreptitiously paired with an increase in the painful stimulus for half of the subjects and with a decrease for the other half. Subjects were tested pre and post conditioning for a placebo response. A second type of experimental pain was also used to determine stimulus generalization. The results confirmed a previous finding that placebo responses can be conditioned in human subjects. The implications for clinical practice of a learning model of placebo behavior are discussed. PMID- 2780059 TI - A novel approach to the diagnosis and assessment of symptomatic diabetic neuropathy. AB - The McGill Pain Questionnaire has previously been shown to be useful in the differential diagnosis of painful conditions and has also been used to assess the efficacy of therapeutic intervention. We have applied this simple test to 42 patients with painful diabetic neuropathy and 49 control subjects with painful legs or feet of varying aetiologies. Analysis of responses by stepwise linear discriminant analysis confirmed a significant difference between the 2 groups (Wilks' lambda, P less than 0.001). Each questionnaire was given a single score as a result of the analysis, and this score correctly classified a total of 91% to either the neuropathic or control groups, and when applied prospectively to a further 25 ungrouped questionnaires a useful probability of their belonging to a diagnostic group was obtained. Use of the questionnaire might be a useful aid to the differential diagnosis of the painful diabetic leg. PMID- 2780060 TI - Reliability and validity of the evaluation of pain in patients with total knee replacement. AB - Ninety-two knees in 46 patients were evaluated with regard to pain: in 51 of these knees, implantation of a hinged endoprosthesis had been performed. The reliability and validity of 2 pain evaluation methods were assessed: the knee pain questionnaire method (standard version including 10 questions and modified version including 14 questions) and the visual analogue scale method (standard version without numbering and 0-10 scale). The visual analogue scale--standard version and 0-10 scale--turned out to be more reliable than the questionnaires. The 0-10 scale was the most valid when compared to the patients' own opinions regarding pain. PMID- 2780061 TI - Anxiety and pain response changes across treatment: sensory decision analysis. AB - Relationships between anxiety and pain perception were investigated by comparing pre- and post-pain reactions of highly anxious detoxified substance abusers categorized on the basis of anxiety level changes over treatment. Sensory decision theory methodology was applied to measure discriminative and decisional aspects of pain response. Men exhibiting significant pre-post-anxiety state decreases showed greater discriminability index increases and greater response bias index decreases at post-test, compared to their counterparts exhibiting minimal changes in severe anxiety levels across treatment. Findings have relevance for understanding pain perception and interventions in clinical samples. PMID- 2780062 TI - Relationship of pain impact and significant other reinforcement of pain behaviors: the mediating role of gender, marital status and marital satisfaction. AB - The operant perspective of chronic pain emphasizes the important role of reinforcement contingencies in the maintenance of pain behaviors and the experience of pain. Patients' 'significant others' are viewed as primary reinforcing agents. The relationship between pain intensity, interference, and responses by significant others in maritally distressed, maritally satisfied, and unmarried samples of male and female pain patients and their significant others was examined in this study. Results revealed that only for married male patients significant other responses explained significant proportions of the variance in the impact of pain. Significant other responses failed to explain significant proportions of the variance for male patients living with non-married significant others. By way of contrast, for female patients pain impact and reinforcement variables were less highly associated in the married as compared to the unmarried patients. For both males and females, there were significantly higher correlations between significant other responses and pain impact levels for the maritally satisfied patients. These results provide qualified support for the operant formulation of the importance of reinforcement of pain behaviors by significant others, however, these responses appear to be dependent upon gender, marital status, and marital satisfaction. Thus, clinicians need to give greater attention to these variables when designing treatment plans. PMID- 2780063 TI - Pain perception in a man with total corpus callosum transection. AB - While classical and current theories of pain emphasize the critical role of central neural pathways that represent the contralateral body surface and cross within the spinal cord, the role of neural input representing the ipsilateral body surface is uncertain. In the present experiments with a complete corpus callosum-sectioned patient, both tactile and low intensity noxious stimuli (43-47 degrees C) ipsilateral to the responding cerebral hemisphere were poorly perceived and/or rated low on verbal and visual analogue scales (VAS). Surprisingly, however, high intensity noxious thermal stimuli (49-51 degrees C) were rated on verbal or visual analogue scales as very intense and unpleasant, thereby reflecting both sensory-discriminative and motivational-affective dimensions of pain. Thus, the pathways and mechanisms subserving this ipsilateral input have high thresholds for activation, but once activated are sufficient to evoke all of the critical dimensions of the experience of pain. PMID- 2780064 TI - Electrophysiological studies on the effects of opiates on dorsal horn nociceptive neurones at 51 atmospheres absolute. AB - The purpose of this study was to investigate the effects, if any, of high pressure on opiate analgesia. The interaction of high pressure with intrathecal morphine (2.5-15 micrograms) and pethidine (10-145 micrograms) was studied on the responses of 51 dorsal horn neurones in the intact rat under urethane anaesthesia to electrical stimulation applied to their receptive fields. Two types of response to the addition of the opiates were found. Cells were either rapidly and maximally inhibited by the lowest dose of morphine (2.5 micrograms) or pethidine (10 micrograms) or slowly inhibited in a dose-dependent manner with an ED50 of 13.6 nmol for morphine and 401 nmol for pethidine. Pressure did not significantly affect the time-response curves for these two types of response but did change the relative numbers of each type recorded. The number of cells totally inhibited by the lowest of drug concentrations was increased for morphine at pressure but decreased for pethidine. PMID- 2780065 TI - Blockade of tolerance to morphine analgesia by cocaine. AB - Tolerance to morphine analgesia was induced in male Sprague-Dawley rats by s.c. implantation of a morphine base pellet (75 mg) on the first and second day and determining the magnitude of tolerance 72 h after the first implant by s.c. injection of a test dose of morphine (5 mg/kg). Implantation of a cocaine hydrochloride pellet (25 mg), concurrently with morphine pellets or of a cocaine hydrochloride (50 mg) pellet after the development of tolerance, blocked both the development and expression of morphine analgesic tolerance. In morphine-pelleted animals pretreatment for 3 days with desipramine or zimelidine or phenoxybenzamine but not haloperidol produced no significant morphine tolerance. Pretreatment with a combination of desipramine and zimelidine, however, was as effective as cocaine in blocking morphine tolerance. Alpha-Methyl-p-tyrosine methyl ester counteracted the effect of cocaine in blocking morphine tolerance and potentiated the tolerance development. Blockade of morphine tolerance by cocaine was reinforced and facilitated by pretreatment with fenfluramine or p chlorophenylalanine ethyl ester and to a lesser extent by clonidine and haloperidol. Acute administration of fenfluramine or zimelidine or a combination of desipramine and zimelidine or alpha-methyl-p-tyrosine methyl ester or p chlorophenylalanine ethyl ester did not significantly affect morphine analgesia. The study suggests an important role of the concomitant depletion of both central noradrenaline and serotonin in the blockade of morphine tolerance by cocaine and stresses the importance of the counter-balancing functional relationship between these two neurotransmitters in the central nervous system. PMID- 2780066 TI - Sympathetic facilitation of sustained discharges of polymodal nociceptors. AB - Injection of a compound algogenic substance into a receptive field of the skin induced sustained discharges from single polymodal nociceptors (PMNs) in rats. Stimulation of the sympathetic nerve (SS) innervating the receptive field obviously increased the sustained discharges. Some units were first facilitated and then inhibited. The sympathetic effect could be activated repeatedly and lasted a long time. Injection of norepinephrine (NE, 5 micrograms) into the local artery caused a similar effect. The results indicate that the sympathetic nerve could facilitate sustained discharges of PMN. The possible causes of causalgia and different results of other experiments are discussed in this paper. PMID- 2780067 TI - Percutaneous procedures for trigeminal neuralgia: microcompression versus radiofrequency thermocoagulation. Personal experience. AB - This paper reports the results achieved in the treatment of trigeminal neuralgia using two different percutaneous procedures: radiofrequency (RF) thermocoagulation (33 patients) and the new percutaneous microcompression (PMC; 74 patients) of the trigeminal ganglion. Acute pain relief was accomplished in 93.2% of the patients treated with PMC and in 81.8% of those treated with the RF method. Two years after the operation, neuralgia had recurred in 56% of the PMC patients and in 42.4% of the RF patients. The average recurrence time was 6.5 months after PMC and 18.5 months after RF. Side effects were essentially of 2 kinds: marked dysaesthesia that occurred after RF lesion in 24.2% and after PMC in 6.7% of the patients, and weakness of the masticatory muscles that was fairly common after PMC, although clinically relevant in only 1 case. The procedure has the benefit of simplicity and fewer side effects. The results obtained by using different compression times in different patients indicates that the most suitable compression time is between 4 and 6 min. When pain recurred the procedure was repeated unless the pain was in the third division, in which case an RF lesion was made. If the pain recurred a second time, RF lesions were made if the pain was in the second or third division. PMID- 2780068 TI - Dose-dependent pain and mechanical hyperalgesia in humans after intradermal injection of capsaicin. AB - Psychophysical measurements of pain and mechanical hyperalgesia were obtained following different doses of capsaicin injected intradermally into the forearms of human subjects. Each subject received a 10 microliter injection of the vehicle and capsaicin doses of 0.01, 0.1, 1, 10 and 100 micrograms. The relationship between capsaicin dose and the magnitude and duration of pain was determined using the method of magnitude estimation. In addition to pain, capsaicin produced a flare and mechanical hyperalgesia. The area of flare and the area and time course of mechanical hyperalgesia were measured as a function of the dose of capsaicin. The magnitude and duration of pain, based on averaged responses of all subjects, increased as a negatively accelerating function of dose. The lowest dose of capsaicin to produce more pain than the vehicle was 0.1 micrograms. The area and duration of mechanical hyperalgesia also increased as a negatively accelerating function of dose. The lowest dose of capsaicin to produce an area of mechanical hyperalgesia was 0.1 micrograms. An area of hyperalgesia was present within seconds following injection. For doses of 10 and 100 micrograms, the area of hyperalgesia grew to reach a maximum within 5 and 7 min following the injection and gradually decreased, disappearing within 15 and 137 min, respectively. Capsaicin doses of 1, 10 and 100 micrograms produced successively greater areas of flare. The results demonstrate that humans can scale the magnitude of pain produced by capsaicin in a dose-dependent fashion. Further, the duration of pain, the area and duration of mechanical hyperalgesia, and the area of flare are dose-dependent.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2780069 TI - On central pain and central pain mechanisms. PMID- 2780070 TI - Ketanserin in reflex sympathetic dystrophy. A double-blind placebo controlled cross-over trial. AB - Ketanserin, a selective S2 serotonergic antagonist, was assessed against placebo in a double-blind cross-over study of 16 patients with chronic peripheral burning pain. Nine of these had signs of reflex sympathetic dystrophy (RSD). All patients underwent 4 intravenous regional treatments, 2 with ketanserin (10 mg for upper limb pain, 20 mg for lower limb pain) and 2 with placebo. In those patients with RSD ketanserin and not placebo provided significant (P less than 0.05) sustained pain relief as assessed by linear analogue scales. In patients who did not fulfil the criteria for RSD no significant relief was seen with placebo or ketanserin. Following tourniquet release, drowsiness, shakiness and faintness were reported at a higher (P less than 0.05) frequency after ketanserin than after placebo. All side effects were mild and transient, and no changes occurred in heart rate or blood pressure following ketanserin that were significantly different from those seen following placebo. A role for serotonin in the pathogenesis of RSD is proposed. PMID- 2780071 TI - Fear, alexithymia and cancer pain. AB - The purpose of this study was to examine the differential role of fear, anxiety, alexithymia, family factors and coping in cancer pain. Twenty-seven patients with pain related to cancer, 26 patients with chronic non-cancer pain, 26 patients with chronic illness but no pain (hypertensives) and 24 healthy controls completed a set of questionnaires during an initial interview and recorded severity and duration of pain, pain interference with activities, thoughts, behaviors and physiological responses associated with fear of pain, and coping strategies using a diary once daily for 7 days. In general, cancer patients reported lower pain levels than patients with chronic non-cancer pain. Contrary to anecdotal reports, cancer pain patients did not report fear of pain. Cancer patients and patients with chronic non-cancer pain reported similar levels of trait anxiety which was higher than non-pain patients. Alexithymia, as a measure of emotional expression, was associated with increased duration of pain in the cancer pain patients. Cancer pain patients also reported less use of coping strategies than patients with chronic non-cancer pain. Cancer patients did not report higher levels of family modeling of pain complaints or family use of medication. The perceived family environment of the cancer pain patient did not differ significantly from the 3 other groups. These results do not support anecdotal impressions that the level of reported pain and fear of pain is significantly greater in cancer pain in contrast to non-cancer pain. The results do indicate the importance of emotional expressivity in the modulation of cancer pain where the ability to assess and express emotions was associated with reduced pain. PMID- 2780072 TI - Post-axillary dissection pain in breast cancer due to a lesion of the intercostobrachial nerve. AB - Seven patients with breast carcinoma and post-axillary dissection pain are described. They complained about pain in the axilla, inner side of the upper arm and/or shoulder. All had undergone a partial or radical breast amputation including an axillary lymph node dissection. On neurological examination all had evidence of a lesion of the intercostobrachial nerve. The pain was not associated with lymphedema and only one patient had undergone radiotherapy to the axillary and supraclavicular area. Post-axillary dissection pain is probably a more appropriate name than the usual post-mastectomy pain for this syndrome. During the dissection, the intercostobrachial nerve is often lesioned, which may give rise to neuropathic pain of that nerve. PMID- 2780073 TI - The post-mastectomy pain syndrome and the effect of topical capsaicin. AB - Eighteen patients with the post-mastectomy pain syndrome (PMPS) form the basis of this study. PMPS probably occurs in a minority of women after mastectomy. The onset of persistent pain usually occurred immediately or very shortly after the operation. The pain location or sensory findings implied involvement of the territories of other cutaneous branches of the intercostal nerves as well as the intercostobrachial nerve. A variety of treatment approaches were unsatisfactory. Twelve of 14 patients completing treatment with topical 0.025% capsaicin showed improvement after 4 weeks and 8 (57%) were judged to be good or excellent responses. Six months after the trial's completion 50% of those followed continued to have good pain relief. This therapy should now be subjected to a randomized, double-blind, placebo-controlled trial. PMID- 2780074 TI - Pressure pain thresholds and thermal nociceptive thresholds in chronic tension type headache. AB - The nociceptive thresholds to mechanical and thermal stimuli in patients with chronic tension-type headache were compared. Palpation of pericranial tenderness was performed in 50 patients and a total tenderness score (TTS) was calculated. Palpation was repeated, and pressure pain thresholds (PPTs) were determined with a pressure algometer in the temporal and occipital regions. In 32 of the patients, pain thresholds for heat and cold and limens for detection of non painful temperature changes were determined in the hands and the temporal regions. Twenty-four healthy volunteers served as controls. Scores obtained by manual palpation (TTS) at the first and second visit were positively correlated. A negative correlation between headache severity and PPT was found in the temporal region. A positive correlation between PPT in the temporal and occipital region was found, and PPT and TTS were negatively correlated. Thermal pain thresholds were consistently less extreme in patients compared to controls, and patients reporting severe headache on the examination day were those most sensitive to thermal pain. No difference was found between patients and controls with respect to detection of temperature changes. A correlation was found between PPT and the corresponding cold pain thresholds, but no correlation could be demonstrated between TTS and thermal pain thresholds. In conclusion, headache patients had decreased pain perception thresholds. Chronic tension-type headache might be a result of dysmodulation of nociceptive impulses, but it is likely that sensitized nociceptors also play a role. PMID- 2780075 TI - Measurements of human pressure-pain thresholds on fingers and toes. AB - Pressure-pain thresholds (PPT) were measured on fingers and toes with a hand-held electronic pressure algometer in 15 males and 15 females. The pressure algometer offered easy control of pressure application rate. The intra-individual coefficient of variation, based on repeated PPT measurements with a 1 week interval was 14%. The inter-individual coefficient of variation was 28% for females and 33% for males. In the course of 10 consecutive PPT measurements with short intervals (10 and 20 sec), no significant change in PPT was observed. PPT was found to be 50% higher in males than in females (P less than 0.0001). Slightly but significantly higher PPT values were found on the dominant compared to the non-dominant side (P less than 0.005). PMID- 2780076 TI - The perceived structure of 176 pain descriptive words. AB - The semantic structure and the underlying dimensions of 176 common Dutch words used to describe various kinds of pain were studied. Seventy-seven subjects rated the intensity of the pain described by each of these words; another 53 subjects sorted the words with regard to their similarity in meaning. A unidimensional solution adequately represented the intensity ratings. The sorting data were analyzed by means of HOMALS, a program for multiple correspondence analysis, which yielded a 3-dimensional configuration differentiating evaluative/affective, sensory, temporal and spatial aspects of pain. Regression analysis showed intensity to be the main criterion for similarity within the affective/evaluative group, whereas intensity was not related to the similarities among the sensory words. Cluster analysis, using the distances in the 3-dimensional HOMALS space, yielded 32 clusters of words among which the subscales of both the original McGill Pain Questionnaire (MPQ) and the Dutch version by Vanderiet et al. could easily be identified. Since the present results were obtained in a different country and by completely different methods of data collection (i.e., similarity sortings without a priori categories), they strongly indicate the cross-cultural and cross-methodological generality of the structure of pain descriptions. PMID- 2780077 TI - Intrathecal Opioids, Potency and Lipophilicity. PMID- 2780078 TI - The quality of rehabilitation. PMID- 2780079 TI - Spinal cord injury and health locus of control beliefs. AB - Individual beliefs about control over their health were assessed in 53 patients with spinal cord injury. Patients who believed they exercised control over their health were less depressed than patients who were fatalistic. A significant number of patients were found to be higher in their internal attributions of health control (N = 31) than those who believed in chance (N = 5) and those who believed medical personnel were in control of their health (N = 11). The results are integrated with a past study of depression following spinal cord injury and locus of control beliefs. PMID- 2780080 TI - 'Duplicate limbs' sensation in acute traumatic quadriplegia. AB - A 64-year-old man sustained acute quadriplegia due to a traffic accident, while in the midst of a petit mal seizure. After recovery from the initial medical complications he developed a duplicate limb phenomenon. The patient felt that another pair of upper and lower limbs had grown from his body, parallel to the paralysed limbs. To the best of our knowledge this duplicate phenomenon in all limbs has not been described before in a traumatic quadriplegic patient. It is our impression that this phenomenon is a rare example of preoccupation with the paralytic limbs, of sensory deprivation with a (possible) unusual drug reaction. PMID- 2780082 TI - Minitracheotomy in the early respiratory management of patients with spinal injuries. AB - Minitracheotomy is a new technique of tracheal suction by the introduction under local anaesthetic of a small bore tube into the trachea through the cricothyroid membrane. The use of minitracheotomy in the early management of respiratory problems in patients with spinal injuries is described with a few illustrative cases. This technique is an adjunct to good physiotherapy in clearing secretions from the trachea. Its advantages and disadvantages are discussed. PMID- 2780081 TI - Aerobic capacity in early paraplegia: implications for rehabilitation. AB - Both strength (ability to develop tension) and endurance (aerobic capacity as measured by VO2 max) contribute to overall functional capacity. In the rehabilitation of individuals with major neuromuscular deficits such as paraplegia, primary emphasis is generally placed on strength training to develop functional independence. However, endurance training may also be important. To clarify the influence of paraplegia on the VO2, we studied 10 paraplegics between 2 to 12 weeks after injury to determine whether or not a deficit in arm VO2 max was present before the inception of a conventional rehabilitation programme, and whether it persisted in three subjects after its completion. Cardiorespiratory responses to progressive multi-stage arm ergometry were measured using standard open circuit calorimetry. Ten paraplegic subjects demonstrated a low VO2 max compared to control subjects. This deficit persisted when selected subjects (n = 3) were tested after completion of a conventional rehabilitation programme which emphasised strengthening exercises. Further research is needed to study the effects of complementary endurance training on the aerobic capacity as measured by VO2 max, and to assess their value in the rehabilitation process. PMID- 2780083 TI - Improved pulmonary function in chronic quadriplegics after pulmonary therapy and arm ergometry. AB - Quadriplegics suffer from restrictive lung disease due to neural damage, spasticity, and prolonged immobilisation. These studies were undertaken to see whether respiratory therapy can improve expiratory capacity in quadriplegics. Fifteen patients with chronic quadriplegia participated in a programme of pulmonary therapy and resistance exercise for 7 to 12 weeks. Pulmonary therapy consisted of incentive spirometry for 15 minutes a day 3 to 5 days per week. Resistance exercise consisted of pedalling an arm ergometer up to 30 minutes three times a week. Forced vital capacity was measured with the subject in a wheelchair wearing a nose clip. The volume of expired air (max Ve) was as determined with a paramagnetic analyser during arm ergometry. The volume of expired air was divided by the number of breaths, giving the volume of expired air per breath (Ve). The results indicated that a combination of incentive spirometry and arm ergometry improves vital capacity and increased the maximum volume of expired air during exercise. These methods are non-invasive, and such modalities should constitute part of the rehabilitation of patients with neuromuscular disease. PMID- 2780084 TI - Blood pressure variability in tetraplegic patients with autonomic hyperreflexia. AB - Autonomic hyperreflexia (AH) is a syndrome characterised by profound pressor responses, sweating and headache which occurs in tetraplegic patients in response to a variety of stimuli below the level of cord injury. The pathogenesis of this syndrome is unclear but may be associated with increased blood pressure (BP) variability in these patients. To investigate this possibility, 24 hour ambulatory BP monitoring was performed utilising the Spacelabs 5300 Ambulatory BP system in 30 patients: 10 normal subjects, 10 spinal cord injury (SCI) patients who had never experienced AH and 10 SCI patients who had experienced recent episodes of AH (but with no symptoms during the study period). There were no statistically significant differences in systolic BP (SBP), diastolic BP (DBP) or heart rate (HR) between the three groups. The average of the coefficients of variation of SBP, DBP and HR within each subject over the study period were calculated. Tetraplegic patients who had recently experienced episodes of AH had greater SBP, DBP and HR variability than normal persons (p less than 0.01, p less than 0.005, p less than 0.005) and greater DBP and HR variability than SCI patients who had never experienced AH (p less than 0.01, p less than 0.05). AH may represent the symptoms associated with the upper extremes of this BP variability. The increased variability may be the result of enhanced cardiovascular responsiveness to noradrenaline and arginine vasopressin or because of the absence of descending inhibitory pathways in the decentralised cord that would normally suppress spinal sympathetic reflexes. PMID- 2780085 TI - Thoracolumbar fracture dislocation: a study of 30 patients. AB - Open reduction and wiring of the spinous processes were carried out in patients with a thoracolumbar fracture dislocation. Clinical and X-ray examinations were performed on 30 patients 5 or more years following operation. At the time of the initial examination, an anterior angulation of 30 degrees or more was noted in 18 patients, but only in 4 cases at the time of the follow-up examination. Anterior displacement of the vertebral bodies was seen in 30 patients, but it was found to be normal in 26 patients at the time of follow-up. There were 7 patients with lateral angulation of 5 degrees or more, but only 2 patients at the time of follow-up. Lateral displacement of 5 mm or more was observed in 10 patients, but only 3 patients could be seen at the time of follow-up. In comparison with spinal instrumentation with the use of large long metallic materials, wiring of the spinous processes has several advantages such as limited surgical invasion, firm fixation, no effect on spinal mobility and no need for repeat surgery for removal of metallic materials. It is an adequate alternative method for the internal fixation of rotational fracture dislocations of the thoracolumbar region of the spine, without fracture of the posterior wall of the vertebral body and pedicle fracture. PMID- 2780086 TI - Pyomyositis in spinal cord injury patients. AB - Bacterial infections remain a major cause of morbidity and mortality among patients with longstanding spinal cord injury. Infection may occur in a number of different foci, often taxing the skill of the most accomplished diagnostician. Herein are described three patients with fever of unknown origin wherein extensive diagnostic workups ultimately led to the diagnosis of primary pyomyositis. These patients demonstrate the importance of repeated careful physician examination in determining the site of infection in patients with established sensorimotor deficits. Although primary pyomyositis is not a common occurrence in those with spinal cord injuries, it should be included as a potential cause of fever in this patient population. PMID- 2780087 TI - Arm crank versus wheelchair treadmill ergometry to evaluate the performance of paraplegics. AB - The purpose of this investigation was to compare peak performance capabilities of male paraplegics with arm crank and wheelchair ergometry. Eleven male paraplegics (aged 26.0 +/- 4.5 year) with spinal lesions at levels ranging from T5 to L4 were assessed during arm cranking and while propelling a wheelchair on a treadmill. Subjects completed both tests in randomised order within a 1 week period with a minimum of 48 hours between tests. Based on the data analysis, peak VO2 for the treadmill and arm crank were not significantly different while HR values for the treadmill were significantly greater (P less than 0.05) when compared to arm crank. A regression analysis indicated that wheelchair treadmill peak VO2 values can be accurately predicted from arm crank peak VO2 (r = 0.74). PMID- 2780088 TI - A new approach to catastrophic injury: spinal cord injury patients. AB - Catastrophic injuries and illnesses create great financial strains on patients who require lifetime care. Families, health care providers and insurers recognise that individual patient care needs require a closer look at the prudent allocation of health care benefit dollars. Blue Cross Blue Shield of Michigan has initiated an approach to this problem called 'case management'. Two ventilator dependent quadriplegics were discharged home utilising the case management concept. This system provides many advantages for patients. However, the health care team needs to be aware of the drawbacks of the system. PMID- 2780089 TI - Acute intermittent arteriomesenteric occlusion of the duodenum (AIAOD) may rarely occur in SCI patients. PMID- 2780090 TI - Vaccination trial against canine visceral leishmaniasis. Phocean Veterinary Study Group on Visceral Leishmaniasis. AB - In a double-blind study 393 seronegative dogs, residing in a holoendemic area for Leishmania donovani infantum infection, were randomly assigned to an immunization with a partly purified L.d. infantum-derived preparation, or received adjuvant only. During the first year of the study period the rate of infection was significantly higher in the vaccinated group than in the control one (P less than 0.05), but this difference disappeared during the second year (P = 0.44). Since a similar immunization protocol conferred resistance against experimental murine leishmaniasis, these results stress the differences that may exist between the natural hosts of Leishmania parasites and experimental animal substitutes. PMID- 2780091 TI - [Comparative bactericidal activity of fourteen antibiotics against Staphylococcus aureus]. AB - The bactericidal activity of LY 146032 (LY), Oxacillin (OXA), Cefamandole (CEF), Rifampin (RIF), Gentamicin (GEN) or Tobramycin (TOB), Pefloxacin (PEF), Vancomycin (VAN), Teicoplanin (TEI), Pristinamycin (PRI) was compared against 8 strains of S. aureus (4 Meth. sensitive, 4 Meth. resistant). Kill Kinetics studies were done: bacteria were incubated with antibiotics at their MICs, 2 X MIC, 4 X MIC and at concentrations obtained in vivo with usual therapeutic doses. With 4 X MIC, a 3 Log reduction of the initial inoculum was observed only at 24 h with OXA, CEF (MSSA), RIF, PEF, VAN, at 30 h with TEI and PRI. With LY, GEN or TOB at 2 X MIC the 3 Log reduction was observed at 3 h or 4 h, a greater than or equal to 5 Log reduction at 24 h: LY and Aminoglycosides are the most bactericidal antibiotics against S. aureus. PMID- 2780092 TI - [In vitro determination of the sensitivity of mycobacteria to fluoroquinolones]. AB - In vitro activity of four fluorinated quinolones: pefloxacin, norfloxacin, ciprofloxacin, ofloxacin were determined against various clinical isolates of mycobacteria. The method of agar dilution was used, seventy strains of ten species were tested: Mycobacterium tuberculosis (25), Mycobacterium bovis (5), Mycobacterium africanum (2), BCG (5), Mycobacterium kansasii (6), Mycobacterium marinum (5), Mycobacterium avium (11), Mycobacterium xenopi (6), Mycobacterium chelonae (3), Mycobacterium fortuitum (2). Except for Mycobacterium avium and Mycobacterium chelonae (CMI 100% greater than 8 mg/l) fluorinated quinolones showed activity against tested mycobacteria (CMI 100% less than or equal to 8 mg/l). Ofloxacin and ciprofloxacin where found to be the most active. Their activity against the different strains of Mycobacterium tuberculosis was unrelated to their susceptibility or resistance to the antituberculous drugs. PMID- 2780093 TI - [Peptidoglycan modification of Staphylococcus aureus P18 strain after use of 6 active antibiotics on the bacterial wall]. AB - Six antibiotics active on the cell-wall were tested against a methicillin resistant Staphylococcus aureus P18 strain at the start of exponential growth rate. The concentration was four-fold the MIC determined in a non-hypersaline liquid medium. The peptidoglycan amino-acid content of the various cell wall samples was determined. An antibiotic-free S. aureus P18 and the methicillin sensitive Cowan I. S. aureus strain were used a controls. Beta lactam antibiotic treatment, oxacillin and cephalothin, induced an increase of alanine content which suggests that only secondary-transpeptidation did not occur. Similar results were obtained using vancomycin. Amino-acid content was not modified by bacitracin, which is in agreement with the results expected. The results obtained for fosfomycin and cefamandole were not easy to interpret. PMID- 2780094 TI - [Comparison of the in vitro post-antibiotic effect of C14 macrolides (erythromycin and roxithromycin) and C16 macrolides (josamycin and spiramycin) against Staphylococcus aureus]. AB - In vitro post-antibiotic effect (PAE) induced by erythromycin, roxithromycin, josamycin and spiramycin has been compared on Staphylococcus aureus. Three MLSB sensitive and three MLSB inducible resistant S. aureus strains have been used. delta t was the time required for culture to increase by 1 log10 after drug removal in comparison with controls. For erythromycin and roxithromycin delta t ranged from 6 minutes at 1 x MIC to 48 minutes at 4 x MIC (average of the six strains at 4 x MIC: 33 minutes). For josamycin and spiramycin, delta t ranged from 36 at 1/2 x MIC to 138 minutes at 4 x MIC (average at 4 x MIC: 101 minutes). No difference was observed between MLSB sensitive and MLSB inducible resistant S. aureus strains. In our experimental conditions, PAEs observed with josamycin and spiramycin (16-membered-ring macrolides) were 2.5 to 3 times longer than those observed with erythromycin and roxithromycin (14-membered-ring macrolides). These results added to biological differences previously observed between 14-membered ring and 16-membered-ring macrolides. PMID- 2780095 TI - [Antibiotic sensitivity of 32 strains of Stomatococcus mucilaginosus in oral medicine patients in community practice]. AB - Susceptibility to eleven antibiotics of 32 strains of Stomatococcus mucilaginosus isolated from gingival or dental samples in patients who are nor hospitalized nor receiving antibiotics since six months was tested by diffusion and MIC. 12.5% of strains were resistant to macrolides and lincosamides. This result is significantly different from the result obtained with strains isolated from patients hospitalized for chronic pulmonary problems (36%). This resistance to antibiotics could be due to selection pressure as shown by the high incidence of resistant strains in antibiotic treated patients. PMID- 2780096 TI - [Intraocular passage of imipenem in man]. AB - Twenty two patients (mean age: 69 years) undergoing cataract surgery were perfused with imipenem (1g for 1 hour). The samples of serum and aqueous humor were taken simultaneously 0.5-1-2-5-7 hours after the end of perfusion and immediately stabilized by MES or MOPS buffers and ethylene glycol. The antibiotic concentrations were determined with Bacillus subtilis ATCC 6633. Aqueous humor levels increased from the end of perfusion to 2nd hour (peak 5.2 mg/l) and decreased after (mean level 2.8 mg/l). The concentrations were well above MIC-90 of the species commonly involved in bacterial endophthalmitis. Imipenem appears to have an exceptional penetration into ocular fluids. PMID- 2780097 TI - [Cefpiramide, a new cephalosporin with high hepatic elimination; experimental evaluation of its biliary passage and disposition in the liver]. AB - The biliary elimination and hepatic disposition of cefpiramide were studied using an isolated and perfused rabbit liver model. Five experiments were performed, each lasting 3 hours. After addition of 10 mg of cefpiramide to the circulating blood, the biliary concentration reached a mean peak of 741 +/- 15 micrograms/ml between the 30th and 60th minute; the cumulated biliary elimination of the drug amounted 4042 +/- 1099 micrograms, corresponding to 40.4% of the injected dose. The hepato-biliary clearance was 54.5 ml/hr and the biliary elimination rate constant 0.2019(hr-1). At the end of the perfusion, 21.7% of the dose was still present in the circulating blood and 1.4% is found in the liver. Control experiments showed that 36.2% of the cefpiramide added into the experimental device was submitted to degradation. Thus, it was possible to calculate the rate of liver biotransformation of cefpiramide, which accounted for 0.3%. These experimental results confirm the major role of the liver in the elimination of cefpiramide and prove that the drug is not submitted to hepatic metabolisation. PMID- 2780098 TI - [Roxithromycin passage in the cervix mucus]. AB - We studied the diffusion of roxithromycin in the cervix mucus of fifteen healthy normal women, aged 24 to 44 (median 37). They were consulting physician to have an IUD. After this intervention (between the 4 to 7 days of menstrual cycle) they received an antibiotic treatment with the standard dose of roxithromycin: 150 mg bd for a week. At the end of this treatment the cervix mucus was taken 1 to 12 hours after the last antibiotic dose. We dose the roxithromycin by a microbial assay (Bacillus subtilis ATCC 6633, antibiotic medium 1, pH 8) and the acid alpha 1-glycoprotein by an immunodiffusion assay. All women had drug measurable with levels from 0.45 to 2.07 mg/l (median: 0.80 mg/l). The acid alpha-1-glycoprotein levels were quite constant (median: 0.19 mg/l). The antibiotic concentrations observed are above the MIC of the major genital pathogens, mainly C. trachomatis, G. vaginalis, H. ducreyi and U. urealyticum, but lower than the MIC ov N. gonorrhoeae and M. hominis. PMID- 2780099 TI - [Tonsil diffusion of cefixime in children]. AB - Cefixime is a new oral cephalosporin antibiotic, with broad-spectrum of activity, near than of third generation cephalosporin, especially against betelactamase producers bacteria. Cefixime has been assayed with microbiological method in tonsils of 21 children (mean age 59 months). Tonsillectomy was performed 5 hours after a third dose of 4 mg/kg cefixime. Plasma levels were evaluated 10 hours after the second dose, with mean level of 0.84 micrograms/ml (0 to 1.35). Blood level was evaluated after third dose, during amygdalectomy was 1.24 micrograms/ml (0.1 to 3.9). Tonsils levels were: for right tonsils 0.74 micrograms/g and for left tonsils 0.53 micrograms/g. Cefixime was not detected in both tonsils of 6 children, and in one of the two tonsils in 11 of them. The tonsils penetration of cefixime was about 1 microgram/g in the case where cefixime was detectable. This penetration is not regular as for other betalactam antibiotics in relation with fibrosis of tonsils tissue inhibiting a good diffusion of antibiotic. PMID- 2780101 TI - [Meningeal diffusion of cefpirome in adults]. AB - Cefpirome is a new aminothiazolyl cephalosporin with a low protein binding, a long half-life of elimination and a wide antibacterial spectrum including pseudomonas and staphylococcus. We studied its diffusion into the cerebrospinal fluid (CSF). Cefpirome, 2 g, was administered intravenously over 3 min. Nineteen patients, aged 12-75 y (mean +/- SD = 40 +/- 20) were studied: 13 had meningitis (septic = 6; chronic = 2; viral = 4). Seric and CSF samples were assayed by the high pressure liquid chromatography (HPLC) procedure. Results at 1, 3, 6, 9 and 12 hours after the infusion were (mean +/- SD) 62.44 +/- 19.8 mg/l, 26.51 +/- 3.7 mg/l, 10.19 +/- 3.3 mg/l, 3.99 +/- 2.3 mg/l, 2 +/- 1.72 mg/l in the serum and 1.1 +/- 1 mg/l, 2.6 +/- 1.8 mg/l, 2.83 +/- 1.7 mg/l, 1.92 +/- 1 mg/l, 1.83 +/- 0.36 mg/l in CSF of bacterial meningitidis respectively. The half-life of elimination were 2.45 h and 9.8 h in the blood and CSF respectively. The area under the curve CSF/serum ratio was 28%. We conclude that cefpirome concentrations in the CSF were above the minimal inhibitory concentrations of almost all the bacteria causing meningitis. PMID- 2780100 TI - [Diffusion of ceftriaxone in healthy and infected peritoneal tissue]. AB - The authors studied the peritoneal diffusion of ceftriaxone in the four quadrants of the abdomen (right and left inguinal and right and left hypochondrium) in 50 adult patients divided into 4 groups: pre-operative IVD administration of ceftriaxone in patients with healthy peritoneum, 1 g (group I), 2 g (group II): pre-operative IVD administration of ceftriaxone in patients presenting peritonitis 1 g (group III), 2 g (group IV). After laparotomy, a fragment of peritoneal membrane was resected from each of the four quadrants, the product was extracted from the peritoneum by a crushing technique and the assayed by HPLC with concomitant blood level assay. The mean assayed concentrations in situ are respectively in groups I to IV: 27.2, 31.2, 31.36 and 43.65 micrograms/g, with a rapid time of appearance (30 minutes) and a homogeneous topographic distribution for all peritoneal sample sites. In cases of peritonitis, the concentrations are higher by a factor of 1.15 and 1.39 for the dosages of 1 and 2 g as compared to healthy peritoneum. Beyond the third hour after injection, peritoneal concentrations remained high at 9.8 micrograms/g in patients having received 1 g of ceftriaxone and very high at 22.6 micrograms/g in patients having received 2 g. These levels are therefore effective whatever the posology in antibioprophylaxis, taking into account the MIC of the product on Gram- bacilli. PMID- 2780103 TI - [Treatment of osteo-articular infections with ofloxacin. Preliminary study]. AB - Twenty-three patients with osteoarthritis were treated by ofloxacin. Antibiotic association was used for 22 patients. Five patients have had osteomyelitis without foreign material. Four of them recovered. Seventeen patients carried foreign material. Evaluation are in progress for 5 of them. In the 12 remaining patients, 8 recovered at a mean duration follow-up of 6 months. One patient have had arthralgia that may be attributable to the treatment. The mean duration of treatment was 6 months for the foreign material group of patient, and 3 for the other. PMID- 2780102 TI - [Frequency and severity of systemic infections caused by Streptococcus mitis and sanguis II in neutropenic children]. AB - We have retrospectively evaluated 24 sepsis episodes caused by viridans streptococci in 23 neutropenic children during a 21 months period at the Pediatric Hematology Unit of St. Louis Hospital. The underlying malignancies included acute lymphoblastic leukemia, acute non lymphoblastic leukemia, aplastic anemia and solid tumor. In 17 children neutropenia, defined as a neutrophil count of less than 500 per cubic millimeter, was caused by cytotoxic chemotherapy. For 6 other children neutropenia was consequential to pretransplant treatment regimen for autologous bone marrow transplantation including cytotoxic chemotherapy and total body irradiation. All patients had a silicone rubber atrial catheter. In 9 patients sepsis was associated only with fever for less than 48 hours. In 5 other children fever was prolonged more than 72 hours in spite of specific antimicrobial therapy. No other organism was isolated. In 10 patients, however, the infectious syndrome was severe and the features included cardiac failure (7 patients), pneumonia (7 patients) resembling adult respiratory distress syndrome, encephalopathy (3 patients) without meningitis and proteinuria, 7 of these patients needed a management in a pediatric intensive care unit and 2 died in spite of adapted antibiotics. Streptococci were isolated in blood cultures in 23 children. PMID- 2780104 TI - [Antibiotic prophylaxis in cardiac surgery in France]. AB - Prophylactic administration of antibiotics in patients undergoing cardiac surgery is now an established procedure. The interest of a short prophylaxis (less then 48 h), directed mainly against Gram positive cocci has been demonstrated. However, there is no general agreement as to the agent to be used. We thus conducted a survey of the current practice of antibiotic prophylaxis (ABP) by sending a detailed questionnaire to each of the 51 centers performing cardiac surgery in France. 48 replies (94%) were received. Monotherapy was used in 42 centers, with cephalosporins in 41 (cefamandole: 22, cefazolin: 10, cefuroxime: 4, cephalothin: 3, cefotiam: 2) and with minocycline in one center. Six centers used a combination including aminoglycoside. Mean duration of ABP was 1.8 +/- 1.2 d. First dose of antibiotic was given before cardiopulmonary (C-P) bypass intravenously. In 29 centers, AB was injected into the C-P pump. Mean dosage of cephalosporin before surgery was 25 mg/kg and total dosage was 70 mg/kg/24 h. We conclude that cephalosporins are almost exclusively chosen in France contrasting with other european countries such as the United Kingdom where the most used regimen is a combination of penicillinase-resistant penicillin and an aminoglycoside. PMID- 2780105 TI - [Antibiotic and antiseptic prophylaxis in thoracic surgery. Controlled study]. AB - The aim of this report was to evaluate perioperative antibiotherapy and antiseptic irrigation of the operative site in the prevention of post pneumonectomy empyema. From 1984 to 1986, 171 patients undergoing pneumonectomy at our institution for bronchogenic carcinoma were randomly selected in 2 groups: group I (85 patients) received a "classical" prophylaxis: irrigation of the operative site with saline, plus a 7-day antibiotherapy (minocycline 200 mg/24 h) started the evening following surgery; group II (86 patients): irrigation of the operative site was performed with Povidone iodine (dilution 5%); antibiotherapy (cefotiam was given for a short period (2 g intraoperatively, 2 g 12 hours and 24 hours following surgery). We used a "pragmatic" approach in order to choose, whatever the results would be, a type of perioperative antibiotherapy. We thus accepted the choice, without the help of statistical tests, of the therapy that would best prevent infection, and, if both regimens would demonstrate the same efficacy, to leave the choice at random. The only statistical test was to calculate the "gamma-risk" that we choose the worst among the 2 regimens. Although no significant difference in the overall infection rate was observed between the 2 groups, there were 9 empyemas (5 of those with bronchial fistula) in group I and 3 empyemas (2 of those with bronchial fistula) in group II. The cefotiam-povidone iodine regimen is thus better than the minocycline-saline regimen in the prevention of post-pneumonectomy empyema (3.5% v.s. 10.5%). The "gamma-risk", ie the probability that the minocycline-saline regimen is the best, calculated from these percentages, is 0.03. PMID- 2780106 TI - [Use of an antibioprophylaxis with pefloxacin and fosfomycin in cardiac surgery in patients with beta-lactam hypersensitivity]. AB - An association of pefloxacin plus fosfomycin was used as antibioprophylaxis in beta lactam allergic patients who underwent cardiac surgery with cardiovascular bypass. Pefloxacin (800 mg), was administered orally, one hour before anesthetic induction and fosfomycin (60 mg/kg) was injected at the time of induction. The whole course of prophylaxis wat 24 hours. Antibiotic concentrations were measured in serum before (P1, P2) during (C1, C2, C3, C4) and after cardiovascular-bypass (P3) and in bone, endocardiac and pleural tissues. The efficacy was evaluated on clinical and biological data. Antibiotic levels of pefloxacin were measured by HPLC and those of fosfomycin by bacteriological method. Antibiotic concentrations are high in blood and tissues, without evidence of cardiovascular-bypass influence. The tissue penetration of both drugs is excellent. Two patients have presented serious post-operative infections. The pharmacokinetic of pefloxacin associated with fosfomycin is appropriate during cardiovascular-bypass and the local antibiotic concentrations are above the MIC of the strains commonly responsible of post operative infections in cardiovascular surgery. The clinical efficacy of this prophylaxis must be studied in a large population of patients. PMID- 2780107 TI - [Treatment of superinfections caused by pyocyanic bacillus in patients with mucoviscidosis. Efficacy of cefsulodin in combination with an aminoglycoside]. AB - Cefsulodin is a third generation cephalosporin with specific antipseudomonas activity. We used cefsulodin in combination with aminoglycosides in 15 cystic fibrosis patients treatments. There were 13 children or adolescents, 4 to 19 years old with chronic Pseudomonas aeruginosa lung infections: 9 patients had acute exacerbations of infection with occasionally important respiratory insufficiency and 5 patients had a regimen of regular treatment every 3 months. Cefsulodin was given after record of bacterial sensitivity to antibiotics, at the mean posology of 100 mg/kg, IV, tid. The combination with aminoglycosides was systematic: tobramycin (6 mg/kg/day), netilmicin (6 mg/kg/day) or amikacin (30 mg/kg/day). Duration of treatment was 9 to 15 days. RESULTS: --clinical improvement in all patients, important in 13 patients and moderate in 2 patients; -respiratory function improvement in 11 patients;--pulmonary radiography improvement in 10 patients;--Pseudomonas were eradicated in 8 patients but temporarily and were found after treatment in 7 patients, 5 with lower number, 2 with higher number. Clinical and biological tolerance was excellent. The present study shows the interest of cefsulodin use in combination with aminoglycosides in this pathology. PMID- 2780108 TI - [The spectral component of electrogastrography (EGG): factors of variation in normal subjects, and in patients with cancer and ulcers]. AB - A study of the spectral analysis of the electrogastrography has been mad in man in a non-invasive condition: normal subjects in two groups: young and old subjects (n = 72) were compared with gastric cancers (n = 42) and ulcerous (n = 22) subjects. Morning recording (10-11 h a.m.), in fasting conditions, were repeated every three successive days. In normal subjects, the mean frequency of the spectral gastric component is very stable (2.8 +/- 0.2 cycles per min), whatever be the sex, the age of the body weight. In normal subjects, the mean spectral amplitude (y) varied with the derivation: in derivation 3-6 (according to the antro-pyloric axis) is the greatest amplitude (y = 52 +/- 22 microV). In the cancerous condition, the range of the frequencies increases, but the mean frequency does not change (2.8 +/- 0.3 cycles per min). However, in 7 cancerous subjects the frequencies (x) fell beyond the limits of the population with an (x) being either less than or equal to 2.4 or greater than or equal to 3.2 cycles per min. In a great proportion (forty-seven per cent) of the cancerous subjects, an important and significant increase of amplitude is recorded (at least in one derivation). In these cases, the location of the cancer is the cardia, the fundus or the pylorus. The amplitudes fall significantly beyond those observed in ulcerous patients. The possible explanations of these variations and the applications to the future monitoring of patients are discussed. PMID- 2780109 TI - [Biochemical markers of the tumor origin of ascites]. AB - In order to determine the best biochemical tests to detect cancer as the cause of ascites formation, ascitic fluid level of fibronectin, cholesterol, phospholipids and triglycerides were compared for 73 patients. The median values and the cut off concentrations of these parameters were determined on 53 ascitic fluids without malignant cytology and 20 ascitic fluids characterized by a malignant cytology. The results showed that ascitic fluid fibronectin and cholesterol levels had a higher discriminating value than phospholipids and triglycerides to separate ascites caused by neoplasms. Cholesterol and fibronectin gave the same sensitivity and negative predictive value but cholesterol showed the highest specificity and positive predictive value. PMID- 2780110 TI - Influence of in vitro lactic acidosis on central nervous system neurons. AB - Central nervous system (CNS) cultured neurons while exposed to different concentrations and pH of L-lactic acid exhibited in general chromatin clumping, vacuolization in the cytoplasm, appearance of lipid bodies, accumulation of polyribosomes, cytoplasmic lucency and swollen and aggregation of mitochondria. These alterations progressed with lower pH and longer exposure to lactic acid. At pH 7.4, there was no considerable pathologic changes in cultured neurons irrespective to concentrations of lactic acid added. Comparable results were obtained with the use of other weak acid (citric acid) indicating that the observed changes were due to acidic pH rather than lactate per se. PMID- 2780111 TI - [Intra aqueous humor penetration of ciprofloxacin in humans]. AB - Authors have studied the penetration of ciprofloxacin in the aqueous humor of 30 patients (30 eyes). The concentration in the anterior chamber was on average 0.73 mg/l (33% of serum level), from 1.30 hours after a single oral dose (1000 mg) till the 5th hour after this dose. The samples were assessed by a microbiological method. These results are over the minimal inhibitory concentration for many bacterial agents found in endophthalmitis. So this antibiotic may be proposed in the treatment of endophthalmitis, with further investigations assessing the safety of this procedure. PMID- 2780112 TI - [Research on connective tissue in France and Europe]. PMID- 2780113 TI - [Effect of procyanidolic oligomers on cultured mesenchymal cells. I. Effect on attachment, proliferation and detachment of cells]. AB - The effect of procyanidolic oligomers (OPC) was studied on mesenchymal cells in culture: human skin fibroblasts (FB) and porcine aorta smooth muscle cells (CML). In presence of OPC part of the freshly seeded FB did not attach. There was no significant effect on the attachment of CML. Proliferation of FB was also slowed down in a dose-dependent manner. Proliferation of CML-s was also decreased, but much less than for FB-s. The detachment of the cells was also studied by adding trypsin to previously attached cells. Detachment of FB-s was strongly inhibited in presence of OPC in a dose-dependent manner. Much less effect was seen on CML. It appears therefore that OPC may interact with some components of the FB cell membrane and modify the attachment, proliferation and detachment of these cells. The only cell kinetic parameter significantly influenced by OPC for CML was their rate of proliferation. This may be due to the different constitution of the CML cell surface as compared to the FB cell surface. PMID- 2780115 TI - A pediatrician's view. PMID- 2780114 TI - [Contribution of experimental models to the treatment of respiratory tract infections]. AB - The need for more effective and potentially less toxic antimicrobial agents than aminoglycosides for treatment of gram negative bacilli pneumonia specially Pseudomonas aeruginosa, explains the interest for experimental models of pneumonia. These models allow to study the efficacy and safety of antibiotics alone or in combination. Aminoglycosides and new quinolones are more effective than beta-lactams for life threatening infection with high inoculum, the only exception to this finding has been for N-formimidoyl thienamycin, whereas for less severe infections aminoglycosides and beta-lactams are equivalent in efficacy. In contrast to high inocula pneumonia, combining beta-lactams with aminoglycosides give additive of synergic benefits for treating low inocula. Experimental models allow to compare continuous versus intermittent administration of antibiotics, different regimens of the same antibiotics (single daily dose of aminoglycosides versus conventional administration) and new antiinfectious agents as anti-pseudomonas hyperimmune globulins. PMID- 2780116 TI - Pediatric hypertension: still more art than science. PMID- 2780117 TI - A pediatrician's approach to the evaluation of hypertension. PMID- 2780118 TI - Hypertension in infants. PMID- 2780119 TI - The hypertensive adolescent. AB - The hypertensive adolescent requires a careful blood pressure evaluation. In most cases, extensive diagnostic studies will not be necessary, particularly if the patient exhibits characteristics of early essential hypertension. On the other hand, further evaluation should not be withheld in the absence of risk factors or the presence of significant hypertension. A management plan that includes patient education is appropriate for all adolescents with hypertension. In some, but not all, hypertensive adolescents, a limited course of medication may be beneficial. PMID- 2780120 TI - Milk intolerance in children with persistent sleeplessness: a prospective double blind crossover evaluation. AB - From July 1986 to July 1988, 146 children less than 5 years of age were referred by their physicians to our university sleep clinic for continual waking and crying during sleep hours. For 85 children (58.2%), the sleeplessness was attributed to inappropriate sleep habits. For 17 children (11.6%), no explanation was found for the sleep difficulties in spite of an extensive workup. Their median age at referral was 13.5 months (range 2.5 to 29 months). Their persistent sleeplessness was tentatively attributed to an undiagnosed intolerance to cow's milk. Cow's milk was excluded from their diet. In 15 children sleep normalized after 5 weeks (range 4 to 6 weeks). As seen from the parents' logs, the median time needed by the children to fall asleep decreased from 15 minutes (range 15 to 60 minutes) to 10 minutes (range 10 to 15 minutes, P = .001). The number of complete arousals decreased from 5 (range 1 to 12) to less than 1 per night (range 0 to 2) (P = .001). Total sleep time per 24 hours increased from 5.5 hours (range 3 to 8.5 hours) to 13.0 hours (range 10 to 14.5 hours, P = .001). Sleep normalized in one child who continued to receive no cow's milk only after the hydrolyzed hypoallergenic diet was discontinued. In every child, a double-blind crossover challenge was conducted involving a control diet containing no cow's milk and a diet containing cow's milk. The challenge induced the reappearance of insomnia and agitated behavior in all except one child. The child's initial sleep difficulties were retrospectively attributed to inappropriate sleep habits.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2780121 TI - Fetal and infant lead exposure: effects on growth in stature. AB - The growth of a cohort of 260 infants was prospectively followed up from birth. Blood lead and stature measurements were obtained every 3 months until 15 months of age. Fetal lead exposure was indexed by measuring lead in maternal blood during pregnancy. A longitudinal analysis revealed that covariate adjusted growth rates in stature were negatively related to the infants' postnatal blood lead concentration, as indexed by increase in average blood lead values from 3 to 15 months. However, this relationship between growth rate and change in blood lead concentration was evidenced only among those infants whose mothers had prenatal blood lead levels greater than the maternal cohort median of 7.7 micrograms/dL is about 2 cm shorter at 15 months of age if, postnatally, the infant incurred a 10 micrograms/dL blood lead increase during the 3- to 15-month interval of life, compared with an infant who has no increase. PMID- 2780122 TI - Low birth weight and intrauterine growth retardation in Filipino infants. AB - Low birth weight, prematurity, and intrauterine growth retardation represent important health tasks for neonates. Pregnancy outcome risk categories based on combinations of these variables and a measure of body proportions were developed and tested with respect to how well they predict poor growth during infancy. Data were collected during a prospective community-based survey of births representative of the Cebu region of the Philippines. In the sample of 2139 births for which there were available birth weight and gestational age data, 20% of infants were classified as growth retarded and 12% were low birth weight. Low birth weight, the more conservative category, was a better predictor of small infant size at 12 months of age than intrauterine growth retardation. Rohrer's index, which captures information about patterns of intrauterine growth, improves the positive predictive value of categories based either on intrauterine growth retardation or low birth weight. Infants who had an adequate Rohrer's index, ie, were well proportioned at birth, were smaller at 12 months of age than infants who had a low Rohrer's index, ie, had weight deficits relative to their lengths at birth. Important questions about the value of the intrauterine growth retardation classification are raised by the results. PMID- 2780123 TI - Pharyngeal gonorrhea screening in adolescents: is it necessary? AB - A prospective study was performed to examine the prevalence of pharyngeal gonorrhea in two urban female adolescent populations and to compare pharyngeal infection with a history of orogenital activity and concurrent genital gonorrhea. Group I was drawn from a children's hospital adolescent clinic and group II was drawn from a public health clinic for sexually transmitted diseases. None of the 240 adolescents in group I had a pharyngeal culture positive for Neisseria gonorrhoeae compared with 3.4% in group II. Only 2.5% of group I had genital gonorrhea, but 33% of group II had positive genital cultures. In only two of the 20 patients with pharyngeal gonococcal infection was the pharynx the only infected site. The addition of routine pharyngeal culturing for gonorrhea yielded only 1% additional gonorrhea cases. There was a significant relationship between concurrent genital and pharyngeal gonorrhea. These findings indicate that routine screening for pharyngeal gonorrhea is not productive in some adolescent populations. A more economic approach would be to use gonorrhea treatment that is effective against both genital and pharyngeal gonorrhea or to obtain pharyngeal cultures in those adolescents returning for test-of-cure cultures after antibiotic treatment for genital gonorrhea. PMID- 2780124 TI - Breast-feeding intentions and practice among Hispanic mothers in southern California. AB - Breast-feeding intentions, breast-feeding in the hospital, and breast-feeding at home were studied among 132 Hispanic mothers participating in the Expanded Food and Nutrition Education Program in southern California. There was not a large difference between total breast-feeding intention (77.7%) and total breast feeding practice (63.8%). However, the 67.7% intention of exclusive breast feeding drastically decreased to 19.7% and 17.2% in the hospital and at home, respectively. Formula supplementation, increased by 4.5 times from intention to practice. Exclusive formula feeding increased from 10.0% to approximately 37.0% in the hospital and at home. Stepwise logistic regression identified that the likelihood of intending breast-feeding was greater for mothers who migrated from Mexico than for mothers born in the United States (odds ratio 4.75). The likelihood of breast-feeding practice was greater for mothers who initiated breast-feeding within the first 10 hours after birth as opposed to 11 or more hours (odds ratio 1.27), for mothers who had a vaginal rather than cesarean delivery (odds ratio 12.76), for mothers who did not return to work postpartum as opposed to working mothers (odds ratio 28.26), and for mothers who migrated from Mexico compared with mothers born in the United States (odds ratio 8.54). The importance of assessing and supporting mothers' breast-feeding intentions in the pre- and post-partum period is documented. Training in the clinical aspects of breast-feeding and improvement of hospital protocols is recommended. Mothers intending to breast-feed should be identified and supported. PMID- 2780125 TI - Childhood risk factors for high adult blood pressure: the Muscatine Study. AB - In adult populations, elevated blood pressure is related to the development of occlusive atherosclerosis, stroke, and renal disease. The significance of blood pressure levels in childhood, unless extremely elevated, has not been related to disease outcomes. In this study, the risk of high blood pressure in young adult life is evaluated based on the observations of blood pressure and other factors made during the school-aged years. Subjects, 2445 in number, were first observed at ages 7 through 18 years and again between 20 and 30 years. During childhood, measurements of blood pressure, height, and weight were made in alternate years. At adult ages, the same measurements were again made and a health questionnaire was administered. According to the data, adult blood pressure is correlated with childhood blood pressure, body size, and change in ponderosity from childhood to adult life. Adult ponderosity is related to childhood ponderosity, and those who are most obese as adults show the greatest increase in weight for height from their childhood years. These observations suggest that strategies to prevent the acquisition of excess ponderosity during adolescence may be useful in preventing adult hypertension. PMID- 2780126 TI - Diabetic microangiopathy in patients with cystic fibrosis. AB - Individuals with cystic fibrosis have a 1% to 7% incidence of insulin-dependent diabetes mellitus. The occurrence of diabetic microangiopathy in patients with cystic fibrosis has been reported recently. From 1978 to 1987, 19 patients with cystic fibrosis and diabetes mellitus were followed up. Four patients (21%) had evidence of diabetic microangiopathy. In one, peripheral neuropathy developed 5 years after the onset of diabetes mellitus, and the other 3 patients each had complications of retinopathy, nephropathy, and neuropathy which developed 10 years after the onset of diabetes mellitus. All were poorly compliant in their medical care. Significant morbidity was seen in the 3 patients with multisystem involvement--blindness, glaucoma, hypertension, and renal failure. The combination of long-standing diabetes mellitus, poor glycemic control, plus pathophysiologic features associated with cystic fibrosis may have contributed to the development of microangiopathy. The use of steroids in 4 other patients and dextrose infusions (as part of hyperalimentation) in another 4 patients precipitated or exacerbated diabetes. The data indicate that diabetic microangiopathy can occur in the individual with cystic fibrosis. Routine screening for diabetes and its complications in the population with cystic fibrosis, as well as optimal control of hyperglycemia, is warranted. PMID- 2780127 TI - Dose-response effects of methylphenidate on academic performance and overt behavior in hyperactive children. AB - In the present study, the effects of 0.3 mg/kg and 1.0 mg/kg of methylphenidate on the overt behavior and academic functioning of 12 children with an established diagnosis of attention deficit disorder with hyperactivity were evaluated. A double-blind, placebo-control, within-subject (crossover) design was used, in which each child was tested four times in each drug condition. Drug conditions were alternated on a bidaily basis and each child received two different drug conditions each day. The academic tasks were designed for evaluation of the relationship between task complexity and dose. Whereas overt behavior improved with increasing dose, academic functioning was improved with methylphenidate, but did not vary with either dose or task complexity. Also, investigated were potential carryover effects of a morning dose of methylphenidate on performance in the afternoon. Behavioral and academic improvements produced by a dose of 0.3 mg/kg in the morning were no longer evident in the afternoon, but a morning dose of 1.0 mg/kg produced behavioral improvements that were clinically and statistically discernible in the afternoon, although the academic improvements had dissipated. PMID- 2780128 TI - Kawasaki disease in families. AB - The rate of second-case Kawasaki disease occurring among 1788 siblings of children with the disease was derived from data obtained from questionnaires mailed to the members of the Japanese Association of Parents of Children With Kawasaki Disease. Within 1 year after the onset of the first case in a family, the overall second-case rate was 2.1% for siblings, as compared to an overall incidence of approximately 0.19% in the general population of children 0 to 4 years of age in Japan in the epidemic year 1982. For siblings younger than 1 year of age, it was 8.4%, and for those between 1 and 2 years of age, it was 9.3%. More than half (54.1%) of the second cases developed 10 days or less after the first cases occurred. PMID- 2780129 TI - Neck and body position effects on pulmonary mechanics in infants. AB - Pulmonary mechanics and ventilatory parameters were measured in 30 former preterm infants at a postterm age of 8 to 10 months. All subjects had required assisted ventilation in the neonatal period and 16 had a history of bronchopulmonary dysplasia. Each infant was studied in both supine and semisitting positions, and in each body position the infants were studied with neutral, flexed, and extended neck positions. Baseline measurements (body supine, neck neutral) and the response to postural changes did not differ between infants who had had bronchopulmonary dysplasia and those who had not. Change in body position from supine to semisitting decreased total pulmonary resistance (P less than .05) and increased specific lung compliance (P less than .01). Neck flexion increased resistance (P less than .001) in both body positions but did not influence compliance. These postural effects are consistent with an increase in functional residual capacity in the semisitting position and a decrease in pharyngeal area during neck flexion. Thus, posture needs to be precisely controlled during pulmonary function testing in infants. Furthermore, optimal neck and body position may improve their clinical status. PMID- 2780130 TI - Gross and fine motor development in 45,X and 47,XXX girls. AB - Neuromuscular deficits have been described in 47,XXY and 47,XYY boys, but gross and fine motor development of girls with sex chromosome aneuploidy has not been extensively studied. Twenty-one propositae 8 to 19 years of age, identified through newborn screening to be 45,X, 47,XXX, or 45,X mosaic, and 11 control girls were evaluated by a physical therapist unaware of their genetic constitution. The Bruininks-Oseretsky Test of Motor Proficiency (BOTMP) was administered, and the quality of neuromuscular function was determined. The 45,X and 47,XXX propositae exhibited both gross and fine motor dysfunction, with 12 of 15 BOTMP composite scores below the 10th percentile. The clinical assessment confirmed the BOTMP findings, with 13 propositae exhibiting dysfunctional sensory motor integration. A delay in the age of independent walking confirmed the consistency of motor developmental dysfunction throughout time. Sex chromosome mosaics were more similar to control girls. The gross and fine motor delays were frequently associated with a moderate to severe language dysfunction which adversely affected classroom performance. Regular developmental assessments of children with sex chromosome aneuploidy, including sensory-motor integration, should assist in the identification of early developmental delays and permit appropriate intervention. PMID- 2780131 TI - Pediatric organ donor maintenance: pathophysiologic derangements and nursing requirements. AB - A retrospective chart review was conducted of 26 organ donors to determine hemodynamic and metabolic derangements encountered and nursing requirements for donor organ maintenance. There were 15 boys and 11 girls with a mean age 6.57 +/- 5.46 years. Mean donor maintenance time was 10.5 +/- 6.7 hours. Cardiorespiratory derangements included hypotension in 16, hypertension in 6, arrhythmias in 17 (premature ventricular contraction in 4, bradycardia in 8, paroxysmal atrial tachycardia in 3, and ventricular tachycardia in 2), asystolic events in 5, pulmonary insufficiency in 6, anemia in 8, and thrombocytopenia in 8. Metabolic and hormonal derangements included hyperglycemia in 18, hypokalemia in 20, hyperkalemia in 4, hyponatremia in 3, hypernatremia in 17, metabolic acidosis in 10, and diabetes insipidus in 15. Hypothermia (temperature 33.3 degrees +/- 0.4 degrees C, mean +/- SD) occurred in 14 donors. The mean physiologic Stability Index score was 22.2 +/- 4.7 and mean Therapeutic Intervention Score was 46.7 +/- 5.8. Total number of nursing hours spent in donor maintenance was 424.5 hours. Therapies offered included diuretics in 10, sodium bicarbonate in 8, antibiotics in 6, insulin in 12, pitressin in 13, verapamil in 3, isoproterenol in 3, dopamine in 17, and intravenous potassium boluses in 14. Of the potential 26 donors, 46 kidneys, 8 hearts, 14 livers, 3 pancreas, and 9 corneas were retrieved in transplantable condition. With appropriate donor maintenance, organs suitable for transplantation can be retrieved despite significant pathophysiologic derangements. Physicians intending to provide donor support should be comfortable with invasive monitoring and cardiorespiratory support and be prepared to provide a nurse to patient ratio of 2:1 at the bedside. PMID- 2780132 TI - Three-wheel and four-wheel all-terrain vehicle injuries in children. AB - In January 1988, sales of new three-wheel all-terrain vehicles (ATVs) were banned in the United States because of the high incidence of injury associated with their use, especially by children. Four-wheel ATVs remain on the market. A retrospective review of all ATV injuries seen in a level I pediatric trauma center was conducted to compare the nature and severity of injuries in three wheel vehicles with those associated with four-wheelers. A total of 36 ATV injuries were seen from April 1986 to August 1988. All patients were less than 16 years of age; 72% were less than or equal to 12 years of age. Of the patients, 56% were boys; 44% were girls. Although 56% of incidents involved three-wheelers, a larger number of more serious injuries, defined as the presence of indicators of injury severity (eg, death, Injury Severity Score greater than or equal to 10, intensive care unit admission, or need for surgery), involved four-wheel vehicles. A total of 15 injuries occurred in 1987; 12 injuries, including the first death involving an ATV at the pediatric trauma center, occurred in the 7 months since the sales ban. Immature judgment and/or motor skills were the most common factors contributing to injury. Existing information regarding injuries involving three-wheel ATVs is supported by our data, according to which it is suggested that four-wheel vehicles may be dangerous in the hands of immature or unskilled operators less than 16 years of age. Injury prevention efforts should be directed at prohibiting any ATV use by persons less than 16 years of age. PMID- 2780133 TI - Health insurance status of adolescents in the United States. AB - This analysis of a sample of 15,181 adolescents aged 10 to 18 years from the National Health Interview Survey indicates that 86% of adolescents had some form of private or public health care coverage during 1984. Nevertheless, one in every seven adolescents, or nearly 4.5 million nationwide, were without any form of health insurance coverage. Adolescents without insurance coverage were concentrated in poor and near-poor households, families with little formal education, and were more likely to live in the South or West. Minorities, especially Hispanic adolescents, were less likely than white adolescents to have some form of health insurance coverage, but much of this difference was attributable to the smaller incomes of minorities. Similarly, although adolescents living in single-parent households were less likely to be insured, the reduced likelihood of coverage appears to be primarily attributable to smaller family income in single-parent households. That family economics plays a central role in determining whether an adolescent had some form of coverage was confirmed by interview results concerning the major reasons for absence of coverage; 8 of 10 uninsured families cited economic reasons for absence of coverage. Together, these results indicate the principal barriers to obtaining health insurance are economic in nature. Public and private sector initiatives for reducing the size of the uninsured adolescent population are discussed. PMID- 2780134 TI - Health insurance status of young adults in the United States. AB - Sociodemographic and health characteristics of young adults who are uninsured, publicly insured, and privately insured were examined using the 1984 National Health Interview Survey. The results indicated that 26% of 19 to 24-year-old persons had no health insurance protection, 65% were privately insured, 7% were publicly insured, and 1% had both private and public coverage. Young adults at greatest risk for being uninsured were male, Hispanic and black, poor and near poor, unemployed, high school dropouts, living with others, and residing in the South and West. All young adults predictably lose or change health insurance as they move from dependence to independence. It was concluded that greater use of new and existing transitional insurance options should be offered as well as targeted educational and communication strategies to assure that all young persons enter adulthood with some basic insurance protection. PMID- 2780135 TI - Body proportionality and head and length 'sparing' in growth-retarded neonates: a critical reappraisal. AB - Despite the popular current distinction between "proportional" and "disproportional" intrauterine growth retardation, it has never been shown that variation in body proportions is greater among growth-retarded than nongrowth retarded infants of the same birth weight, nor that proportionality is distributed bimodally among growth-retarded infants. Based on a cohort of 8719 neonates born between 1980 and 1986 of mothers with concordant (+/- 7 days) menstrual dating and early ultrasound estimates of gestational age, we used a continuous measure of birth weight for gestational age to define four study groups: nongrowth retarded (n = 5163) and mild (n = 411), moderate (n = 226), and severe (n = 147) intrauterine growth retardation. Compared with non-growth retarded infants of the same gestational age, growth-retarded infants had substantially lower lengths, head circumferences, and proportionality ratios, and the magnitude of the deficits increased significantly with increasing degrees of growth retardation. When the comparison was based on birth weight rather than gestational age, however, growth-retarded infants had slightly but significantly greater lengths and head circumferences, with increased variability in body proportions, but no evidence of the bimodality that would characterize two distinct subtypes. The analysis suggests that proportionality among intrauterine growth-retarded infants represents a continuum, with progressive disproportionality as severity of growth retardation increases. Moreover, despite evidence of some "sparing," the absolute magnitudes of the deficits in length and head growth remain substantial. PMID- 2780136 TI - On the relevance of poor judgement. PMID- 2780137 TI - Tin-protoporphyrin in the management of children with Crigler-Najjar disease. PMID- 2780138 TI - Successful fibrinolytic treatment of arterial thrombosis and hypertension in a cocaine-exposed neonate. PMID- 2780139 TI - American Academy of Pediatrics Committee on Community Health Services: Health care for children of migrant families. PMID- 2780140 TI - American Academy of Pediatrics Committee on Genetics: Prenatal diagnosis for pediatricians. PMID- 2780141 TI - Neonatal prevalence of anti-human immunodeficiency virus antibodies in California. PMID- 2780142 TI - Taurine supplementation of formulas. PMID- 2780143 TI - Twenty-four hour after-treatment lumbar puncture: should it be done? PMID- 2780144 TI - Attention deficit disorders and depression. PMID- 2780145 TI - Fire setting and Klinefelter syndrome. PMID- 2780146 TI - NutraSweet overdosage. PMID- 2780147 TI - [Problem of the classification of rickets in children]. PMID- 2780148 TI - [Measles in a 2-week-old infant]. PMID- 2780149 TI - [Glycogenosis type II (Pompe's disease) in a 6-month-old child]. PMID- 2780150 TI - [3 cases of cancer of the thyroid gland in children with congenital hypothyroidism]. PMID- 2780151 TI - [Diet therapy of children with chronic nonspecific diseases of the small intestine under outpatient care]. PMID- 2780153 TI - [Electrogastrography in chronic gastroduodenitis in children]. PMID- 2780152 TI - [Functional changes caused by low-intensity laser irradiation on the child's body]. PMID- 2780154 TI - [Lipid peroxidation and antioxidant protection in healthy children and in those with chronic glomerulonephritis in a tropical climate]. PMID- 2780155 TI - [Amino acid spectrum of the blood in children with total chronic renal failure]. PMID- 2780156 TI - [Significance of quantitative indicators of HBsAg in the pathogenesis and outcome of a malignant form of viral hepatitis B in children]. AB - The paper is concerned with the time-course of changes in the HBsAg concentration in 31 patients with malignant hepatitis B. No relationship was discovered between the disease outcome and the HBsAg concentration. At the same time in lethal outcomes, the HBsAg concentration dropped significantly more swiftly as compared to that in convalescents. The disease outcome was established to be related to the characteristics such as pregnancy pathology, acute respiratory viral infection, intestinal infections, pyoinflammatory diseases as well as these diseases in combination. PMID- 2780157 TI - [Evaluation of the activity of liver and spleen macrophages in children with hepatitis A and B]. AB - To form a judgement about function of liver and spleen macrophages (MP) in vivo, use was made of dynamic scintigraphy with Tc-colloid. Sixty-seven children aged 5 to 14 years were examined. Of these, 45 children were afflicted with virus hepatitis B (VHB), 16 with virus hepatitis A (VHA), and 6 children had VHA associated with asymptomatic HBsAg carriership. There was an appreciable decrease of the activity of liver MP attended by consistent compensatory activation of spleen MP in all the etiological types of virus hepatitis. The changes seen in patients with VHA and VHB turned out similar, differing in the rate of the recovery of normal correlations, which was more rapid in VHA. The characteristic feature of liver and spleen MP function in patients with VHA associated with HBsAg carriership consisted in the lack of the compensatory reaction on the part of spleen MP, which was likely to be connected with overstrain of long standing and depletion of the MP system due to permanent antigenic stimulation of HBsAg. The relationship was disclosed between the activity of organ MP and the phase of the infectious process, its gravity and course as well as the character of the patient's premorbid status and intercurrent infection. PMID- 2780158 TI - [Severe form of Rotavirus infection during the period of seasonal rise of its incidence]. AB - The authors describe the results of observation and clinico-laboratory examination of patients during seasonal rises of the rotavirus infection incidence in 5 districts of the Moscow region in 1984-1987. The diseases ran their courses in the form of gastroenteritis and enteritis and were marked by a great number of the grave patterns (42-46%), mainly in children of the first three years of life, by a high percentage (77.5%) of the aggravated premorbid status of patients with the grave patterns. The rotavirus nature of diarrheas was supported by the data of direct electron microscopy, ELISA, and solid-phase coagglutination test. The symptom-complex of the clinical manifestations of rotavirus infection was characterized in detail. The histologic and morphometric data pertaining to two lethal outcomes were discussed. It has been demonstrated that respiratory viral infections, primarily influenza, produced an adverse effect, promoting the formation of the severe patterns and the onset of unfavourable outcomes of rotavirus infection in children. PMID- 2780159 TI - [Morphologic changes of the nucleolar system of lymphocytes as the indicator of sensitivity to tuberculin and Toxoplasma antigen]. AB - A study was made of the nucleolar apparatus of peripheral blood lymphocytes of the newborns, infants and their mothers before and after incubation in vitro with tuberculin or toxoplasmic antigen. It was established that in the presence of sensitization to one or another antigen, there was an increase in the relative count of lymphocytes having a zone of clarification near nucleoli. In children vaccinated with BCG, such an effect was noted in 81.3% of the cases, whereas in children with verified toxoplasmosis, in all the cases. It is recommended that the method designed might be used as alternative for the complement fixation test in the diagnosis of toxoplasmosis. PMID- 2780160 TI - [Status and prospects of immunologic disease prevention]. PMID- 2780162 TI - [Kidney lesions in children with diabetes mellitus]. PMID- 2780161 TI - [A method of electropulse profilometry of the anal canal]. AB - At present no methods for the prediction of the possibility of using electrostimulation are applied, in spite of the fact that the latter technique is employed on a large scale for patients rehabilitation. The authors have designed a method for electropulse diagnosis of changes in the anus, permitting the detection of pathological alterations in the anus as well as the identification of its reserve potentialities along with the solution of the problem as to whether direct electrostimulation can be used for rehabilitation of one or another patient. The given paper is concerned with a study into electropulse diagnosis of changes in the anus in 31 patients without derangement of locking function, with immaterial functional disorders, and with gross organic pathology. The direct dynamic electrostimulation of the anus appeared little effective in gross organic pathology of the anus, producing a beneficial effect in patients with functional disorders. PMID- 2780163 TI - [Clinico-roentgenologic characteristics of syringomyelic osteo- and arthropathies in children]. PMID- 2780164 TI - [Extrapulmonary complications in children with mucoviscidosis]. PMID- 2780165 TI - [Viral hepatitis in children]. AB - The etiological structure of viral hepatitides in childhood is considered in the paper from current positions. The latest achievements in the field of the immunopathogenesis of acute, fulminant and chronic forms of the diseases are described. The etiotropic and immunocorrective therapy of chronic hepatitis B is pathogenetically grounded. The prospects of investigations of the problem are shown. The facts of the efficiency of the treatment of chronic hepatitis B with different drugs, human leukocytic interferon, BCG vaccine and T-activin, are provided. PMID- 2780166 TI - [Characteristics of the treatment of severe forms of neuroinfection in children with altered immunologic response]. PMID- 2780167 TI - [Infant mortality in the USSR: trends and expected indicators]. PMID- 2780168 TI - [A method of conducting practical work in pediatrics with students of the Chair of Therapeutics at a pediatric polyclinic]. PMID- 2780169 TI - [Idiopathic arterial calcinosis in children]. PMID- 2780170 TI - [Nephrotic syndrome in children]. PMID- 2780171 TI - Wechsler Digit Span subtest: diagnostic usefulness with dyslexic children. AB - The current study supports Levinson's contention (1988) that the diagnosis of dyslexia cannot be based solely on neurophysiological evidence but must be made in conjunction with reading and educational test scores. Contrary to much current research, in the present study specific WISC-R profiles are identified within a stringently defined subgroup of 57 9- to 12-yr-old dyslexic children. Well defined subtest scatter can differentiate dyslexics from proficient readers. In particular, the Digit Span subtest, which is not routinely administered by psychologists or included in computing Verbal IQ, can be considered an important component of a diagnostic battery. Unexpectedly, Coding emerged with Digit Span as a third factor in a principal component analysis; statistically significant sex differences appeared on the Coding task. Findings appear to confirm the phonological encoding deficiencies displayed by dyslexics on the Digit Span subtest. This study strongly supports consideration of WISC-R subtest differences, along with correlated factors, neurophysiological and perceptual evidence, when diagnosing dyslexic children. Cross-validation is planned. PMID- 2780172 TI - Reply to Cohn's comments on cones. PMID- 2780173 TI - An inquiry into the construct validity of the Vividness of Visual Imagery Questionnaire. AB - The construct validity of the Vividness of Visual Imagery Questionnaire (VVIQ) was investigated using a series of visual memory tasks. Subjects were shown a picture after completing the questionnaire. Their ability to recall that picture was probed through a free-recall procedure, drawing, two spatial-recall tasks, and a multiple-choice questionnaire. Scores on the VVIQ were statistically unrelated to performance on any of the memory tasks demonstrating a lack of support for construct validity as a measure of visual memory imagery. PMID- 2780174 TI - Estimating costs of diagnostic medical procedures: an informal look. AB - A recent survey of health care practitioners, conducted to assess their knowledge of the cost to patients of a number of medical diagnostic procedures, showed a lack of familiarity with prices. This inquiry was replicated using as a sample students and faculty at a collegiate school of business. As with the original study, the results suggest a tendency to underestimate patient billing costs. PMID- 2780175 TI - Some observations upon perceptual organization and the mere exposure effect. AB - The mere repetition of events tends to enhance subjective familiarity and subjective preference for those events. It has been shown that the enhancement of subjective preference is neither contingent upon a feeling of familiarity nor an awareness of the physical identity of the stimulus during learning. This finding is surprising since the weight of existing theoretical and empirical evidence suggests that subjective preference is derivative of familiarity. An experiment was conducted to test the hypothesis that at least one preattentive/preconscious product, figure-ground organization, is shared between the processes responsible for preference enhancement and those responsible for the enhancement of recognition memory. There were two significant findings. First, subjects were able to discriminate between objectively familiar stimuli and objectively unfamiliar stimuli on the basis of preference judgments but were unable to do so on the basis of familiarity judgments. Second, preference enhancement occurred only for those objectively familiar stimuli for which the figure-ground aspects had not been phenomenally reversed. The significance of these findings is discussed. PMID- 2780176 TI - Effect of colour on physical strength and mood in children. AB - The physical strength and mood of creative production were measured for six preschool children under six coloured room conditions in an ABACAB design. Physical strength and high positive mood were demonstrated in a pink-coloured room while the reverse was found in a blue-coloured room. The results were interpreted as supporting the differential arousal function of colours. PMID- 2780177 TI - Hypnotic suppression of conditioned electrodermal responses. PMID- 2780178 TI - Vibrotactile threshold shift during magnitude-estimation scaling on the hand: effects on magnitude-estimation responses and scaling behavior. AB - The purpose of the present study was to determine whether threshold shifts occurred during magnitude-estimation scaling of suprathreshold stimuli presented to the thenar eminence of the right hand. Possible relationships of the vibrotactile threshold shifts to suprathreshold stimulus intensity, magnitude estimation responses, and over-all scaling behavior were explored. A single group of 14 subjects whose ages ranged from 18 to 22 yr. participated. Each subject performed two magnitude-estimation tasks. In one of the tasks threshold of sensitivity was determined after every suprathreshold numerical response of the subject. If a threshold shift was recorded, threshold was allowed to return to pretest baseline level before continuation to the next suprathreshold stimulus presentation. Analysis showed that threshold shift did occur during vibrotactile magnitude-estimation scaling on the hand and that it was related to suprathreshold stimulus intensity. Results also showed that the subjects' numerical magnitude-estimation responses and over-all scaling behavior in the form of power function exponents were not statistically different for the two scaling tasks. PMID- 2780179 TI - Acquisition of self-control of a novel muscular activity with EMG and video feedback. AB - To examine the acquisition of voluntary control of a novel muscular activity from the initial stage to the self-control stage, the m. auricularis posterior, which had generally degenerated and had nearly lost its function of drawing an auricle backward in the human body, was selected as a target muscle to be studied. One female undergraduate student who could not move her auricles intentionally was required to activate her left m. auricularis posterior and underwent rest, pretest, training, and posttest sessions once a day for five days. At the subject's request, the electromyograph (EMG) from her left m. auricularis posterior on an oscillograph was provided for her as the feedback signal on each training trial. The picture of her left ear on television was handled in the same way. The EMG measures indicated that the subject could learn to activate her left m. auricularis posterior differentially. The number of training trials on which the subject requested the feedback signals suggested that EMG feedback signal was more useful to her than the video and that the usefulness of the feedback signals varied as the training sessions advanced. It was also concluded from analysis of the self-report data that the acquisition process of self-control of a novel muscular activity could be divided into at least four stages. PMID- 2780180 TI - Impairment of cognition, risk-taking, and self-perception by alcohol. AB - The effects of alcohol on risk-taking, visual signal detection, and perceptual motor skills were examined under controlled conditions. Skill in two videogame tasks (driving and racquetball simulations) was unaffected by a massive dose of alcohol, whereas risk-taking in the driving task was increased. Alcohol also impaired performance on the signal-detection task, decreasing both perceptual vigilance and caution (d' and beta). The dependent measures yielded minor correlations with personality and biographical variables, although men were more skilled and riskier in their behaviour than women. A second experiment employing the signal-detection task indicated that even moderate doses of alcohol can significantly impair visual perception and perceptual decision making. Both studies showed that subjects who receive a massive dose of alcohol (bac .12% or .16%) significantly underestimate the amount consumed, and rate themselves as being much less than totally drunk. PMID- 2780181 TI - Identification of self through olfaction. AB - To study olfactory communication in humans, 100 undergraduates ranging from age 18 to 45 yr. wore freshly washed, identical T-shirts continuously for 24 hr. During this time, the participants did not bathe or shower or apply any scent producing substance to their bodies, i.e., deodorants, perfumes. Upon retrieval, each shirt was placed in an identical brown bag. In groups of 10, each participant attempted to identify the T-shirt he had worn the previous 24 hr. The task was administered separately for each individual so that no participants knew the choice by a previous colleague. Analysis shows that the participants were able to identify correctly their own shirts on the first try three-quarters of the time. Furthermore, sex, age, smoking habit of the participant, and menstrual cycle phase in the women were factors in successful outcomes. PMID- 2780182 TI - Performance of the vertical position in synchronized swimming as a function of skill, proprioceptive and visual feedback. AB - This experiment assessed the efficacy of proprioceptive and visual information for the performance of "vertical position" by synchronized swimmers. Three skill groups of 5 senior, 5 intermediate, and 5 novice synchronized swimmers performed 40 vertical positions under four conditions. The conditions were: self-initiated with and without vision, and following experimenter perturbation, with and without vision. The dependent measure was degrees of error from true vertical. Analysis indicated that either proprioception or proprioception and vision may be used in performing vertical positions. A significant main effect was found among skill groups. PMID- 2780183 TI - Scent and sound of vision: expressing scent or sound as visual forms. AB - This article describes three experiments on the possibility of expressing scent or sound into visual forms made by design engineering students. The hypothesis tested was that people are able to pick up patterns in the energy flow that the students transposed from one perceptual sense to another. In Exp. 1 subjects were given different scents and were asked to choose a sculpture designed according these scents. In Exp. 2 subjects were given different musical pieces and asked to match them with portable cassette players designed according to this music. Exp. 3 was identical to Exp. 2 but different music selections, similar to the ones in Exp. 2, were used. In all three experiments subjects were indeed able to perform the tasks above chance level. Results are discussed within the framework of the theory of direct perception of Gibson. PMID- 2780185 TI - Readability of Alcoholics Anonymous: how accessible is the "Big Book"? PMID- 2780184 TI - Speech Sounds Perception Test: nonrandom response locations form a logical fallacy in structure. AB - The response format of the Speech Sounds Perception Test confounds speech perception with irrelevant method variance. To rectify this problem the response format was revised by randomizing the response locations. An empirical comparison of the revised and original forms was undertaken with forensic (n=59) and psychiatric (n=67) samples. The empirical results coupled with the logical problem in the original form indicates that a revision is necessary. PMID- 2780186 TI - Major league baseball performances of players who were later suicides or homicide victims. PMID- 2780187 TI - Reliability of the Frostig Test of visual perception in a South African sample. AB - The Marianne Frostig Developmental Test of Visual Perception was administered to 31 preschool children (19 boys and 12 girls) whose mean age was 68 mo. An item analysis showed that 52% of the test items satisfied the requirements with regard to degree of difficulty and discrimination. KR-20 reliability coefficients varied between 0.31 and 0.58 for the different subtests, with r=0.72 for the full scale. PMID- 2780188 TI - Do redundant visual and auditory target variables facilitate control behavior? AB - The compensatory tracking paradigm has been used extensively in pioneering work on Control Theory, a cybernetic model of behavior. In most studies subjects have been asked to control or maintain at a steady state a single variable or aspect of the stimulus display. The present study utilized three groups of subjects, comparing their performance effectiveness in controlling: (1) a visual stimulus (cursor) versus (2) an auditory stimulus (tone) versus (3) a combined, redundant cue condition employing both cursor and tone. Freshman volunteers responded to a computer display using a joystick controller; their task was to keep stationary a stimulus that was subject to a smoothed, quasirandom disturbance. Contrary to predictions, subjects in the cursor-alone group performed more effectively than subjects in the combined cursor-tone group. While speculative interpretations are offered, further research is needed to clarify these results. PMID- 2780189 TI - Phasic activity and dream recall in 5- to 8-yr.-olds. PMID- 2780190 TI - Problems in understanding prescription labels. AB - Reading prescription labels on medication bottles is often confusing. If medication is taken incorrectly, it may have deleterious effects. Questionnaires containing authentic prescription labels were administered to college students to interpret. Analysis suggests that less than half of those surveyed interpreted the labels correctly. Rated confidence in responding seemed to be a function of correctness. PMID- 2780191 TI - A pilot study on the effect of training parents of language-delayed children in pragmatic interaction strategies. AB - This pilot study investigated pragmatic language training on parental expansion of interactive strategies, and a corresponding decrease in using questions and imperatives in parental communication with their language-delayed preschool children. Seven parent-child dyads participated, with the parents receiving training in the acquisition of six pragmatic categories, including reference, model, imitation, description, parallel talk, and expansion. Training results showed a significant increase in the parents' use of parallel talk and a decrease in their use of questions. Apparently in many instances parallel talk may incorporate the strategies of referencing, modeling, imitation, description, and expansion. Findings are discussed in terms of parallel talk functioning as a facilitator for language-delayed children. PMID- 2780192 TI - The old English rune poem: elements of mnemonics and psychoneurologic beliefs. AB - Some rune verses are, apparently, thematically derived from Chinese Radical sequences. The 33 runes are, like the Sanskrit letters, mnemonically valenced and formally associated with the nervous system. PMID- 2780193 TI - Development of perceived adolescent relationship scale. AB - The purpose of the present study was to develop an easily administered scale to assess adolescents' perceptions of both their own social competence and social participation in relationships. Six items were used to generate two factors that accounted for about 68% of the variance. PMID- 2780194 TI - Taxonomy of 130 cases of youth suicide. PMID- 2780195 TI - Visual-motor ability of children with articulation disorders. AB - The present study was done to assess differences between children with diagnosed functional articulation disorders and a control group on the variable of visual motor ability. A group of 34 elementary children with articulation problems were matched with a control group of 34 for sex, age, and grade. Both groups were administered the Goldman-Fristoe Test of Articulation and the Minnesota Percepto Diagnostic Test--Revised. Analysis indicated that children with articulation problems performed significantly lower on visual-motor skills. PMID- 2780196 TI - Intermodal enhancement of stimulus localisation in infants born prematurely. AB - The interaction of auditory and visual modalities in the enhancement of orientation was examined in premature and near-term infants by presenting them auditory or visual stimuli or auditory-visual stimulus combinations at various positions in sensory space. In 4.5--15-mo-olds, brisk orienting responses could be elicited to very peripheral stimulus positions but only when the stimulus consisted of a spatially coherent auditory-visual combination (i.e., where a sound and a light occurred at the same point in space). This occurred for all infants, irrespective of age or gestational age at birth. First, the result shows that infants can respond to visual stimuli at eccentric positions, beyond the supposed limits of their effective visual fields as measured by standard perimetry. Second, the result extends earlier studies showing that intersensory integration and stimulus localisation develop relatively normally in prematurely born infants. The auditory-visual enhancement test as used here may have a number of further uses and applications in the clinic and laboratory. PMID- 2780197 TI - Relation of cognitive operational performance to comprehension and production of dimensional adjectives. AB - This study compared normal developing children, aged 34 to 51 mo., on comprehension and production of relative dimensional adjectives using object manipulations in a close elicitation procedure and on Piagetian operational tests of conservation of continuous quantity, length, reversibility and seriation. Analysis indicated a significant difference on the expressive language performance of the transitional and the concrete operational children over the preoperational children, but no significant differences occurred between the first two groups. Children who performed better on seriation were significantly better on expressive language performance. Children classified as operational for length performed better on all language measures than those classified as nonoperational. Reversibility and conservation of a continuous quantity did not differentiate children. PMID- 2780198 TI - Relation of sound intensity and accuracy of localization. AB - Tests were carried out on 17 subjects to determine the accuracy of monaural sound localization when the head is not free to turn toward the sound source. Maximum accuracy of localization for a constant-volume sound source coincided with the position for maximum perceived intensity of the sound in the front quadrant. There was a tendency for sounds to be perceived more often as coming from a position directly toward the ear. That is, for sounds in the front quadrant, errors of localization tended to be predominantly clockwise (i.e., biased toward a line directly facing the ear). Errors for sounds occurring in the rear quadrant tended to be anticlockwise. The pinna's differential effect on sound intensity between front and rear quadrants would assist in identifying the direction of movement of objects, for example an insect, passing the ear. PMID- 2780199 TI - Carolina Picture Vocabulary Test: validation with hearing-impaired students. AB - When mean Carolina Picture Vocabulary Test standard scores were compared with WISC-R Performance Scale IQs significant differences were observed. The Carolina test scores were also correlated with both Performance IQs and the Performance Scale subtest scores. Most correlations were minimal as the two tests were independent; only WISC-R Picture Arrangement scores correlated significantly with Carolina scores. These outcomes coupled with the technical limitations of the Carolina raise serious questions regarding its utility for hearing-impaired children. PMID- 2780200 TI - Visual identification rate in search of a missing stimulus. AB - Subjects searched for a digit which was not presented in an array of nine different digits. The identification rate was estimated from the percent correct. Well-trained subjects identified 6.5 digits with a 50-msec. exposure. This fast identification rate was expected from our procedure using a single answer, an inconsistent target, and equal probability that every digit would be a target. Naive subjects markedly improved their performance in the first two weeks of the trials which were given for a total of 24 days. PMID- 2780201 TI - Are fun runs fun for kids?: A survey of school-aged participants. PMID- 2780202 TI - Effect of short lateralized signals on arousal versus activation on tasks requiring visuospatial or elementary semantic stimulus processing, a replication with a modified experimental design. AB - In this experiment, which is basically a replication of an earlier experiment done in 1988, we tested the hypothesis that the brain self-regulates its own arousal and activation. When subjects perform a putative right-hemisphere task (visuospatial), the effect of a supplementary information-processing load is supposed to lead to a delayed reaction. The opposite is supposed to be true in a putative left-hemisphere task (semantic). The former effect is supposed to be the result of increased arousal, the latter is that of increased activation. In the present experiment the reactions subject to experimental treatment are compared with control reactions of the same subject. This was not the case in the earlier experiment. Still other improvements of the experimental design were made. The results clearly confirm the earlier findings. Additional evidence is offered to strengthen the plausibility of the basic hypothesis. PMID- 2780203 TI - Implementation of the NCA modified assessment instrument with a population of intoxicated drivers in two Wisconsin counties 1982-1985. AB - Upon completion of a 3-yr. research project which assessed the effects of Wisconsin's mandatory testing program for drunk drivers, the evaluation showed that a disproportionate number of repeated offenders who were being rearrested had been assessed initially as social drinkers. While there are several possible causes for this finding, the most probable one seems to be that of under assessment by the testing instrument. PMID- 2780204 TI - Clinical applications of Rorschach-based visual imagery reactivity. AB - A diverse set of findings from recent research suggests the value of visual imagery techniques in clinical practice. PMID- 2780205 TI - Are rods and cones of dyslexics anomalous? AB - Grosser and Spafford (in this journal, 1989) have advanced an hypothesis and presented measurements which they believe support the idea of an excess of cones in the peripheral retinae of dyslexics. This note points out that their hypothesis is based on the erroneous assumption that normals have no peripheral cones. Further, their data can be explained by at least two alternative, though uninteresting, methodological hypotheses, that uncontrolled eye movements or experimenter suggestion (or both) could have produced their results. Finally, the requisite methods for assessing color vision, and the cones, were not met in the study. PMID- 2780206 TI - Autokinetic movement and inverted vision. AB - It was considered that inverted vision could influence the condition of the subject's relative framework. The aim of this study was to investigate whether autokinetic movement observed during inverted vision might differ from that in normal vision. One subject wearing inverting spectacles and another one subject in normal vision observed autokinetic movement for five days. The results showed that directional changes increased with the time spent in visual inversion, while in normal vision such tendency was not observed. One speculative interpretation was suggested in terms of subject-related framework. PMID- 2780207 TI - Effects of two tasks and two levels of difficulty upon surface electrogastrograms. AB - The effects of differentiation, novelty, and difficulty of ability tasks upon electrogastrographic activity of healthy subjects during digestion were investigated. Electrical recording of activity of the stomach by means of surface electrodes was performed in 40 healthy volunteers before and after easy or hard tasks. 20 subjects had to complete puzzles; the others had mental arithmetic. Both groups were matched in terms of scores on easy and difficult tasks. Baseline recordings were performed before each trial. The number of waves with peak amplitude greater than 100 mu v on electrogastrographic recording during each time span was measured, using a visual analysis. There was a significant decrease in number of waves/min, during task performance. A more pronounced decrease was produced by subjects working on puzzles than those working on mental calculation and by subjects working on easy tasks than those working on difficult tasks when the easy preceded the difficult ones. A larger decrease was obtained when the tasks of comparable difficulty were performed first. Emotional correlates such as anger and irritability were suggested to play a role in the interpretation of results. PMID- 2780209 TI - Childhood precursors of the paranoid-depressive disorder. PMID- 2780208 TI - The doctor's dilemma: problems that do not go away. PMID- 2780210 TI - Accepted practices? A view from outside. PMID- 2780211 TI - Voltage- and time-dependent chloride currents in chick skeletal muscle cells grown in tissue culture. AB - Membrane chloride currents in chick skeletal muscle cells grown in tissue culture were studied by use of the whole cell variation of the patch electrode voltage clamp technique. Small diameter myoballs were obtained by adding colchicine to the growth media. To isolate the currents through the chloride channels, the currents through the sodium, calcium and potassium channels were minimized. With symmetrical chloride concentrations bathing the membrane, inward currents were activated by depolarizations above -45 mV. Above 0 mV, the currents became outward. The reversal potential for the currents shifted with the chloride concentration gradient in a manner consistent with the Nernst relation, indicating that the currents were predominantly carried by chloride ions. The instantaneous current-voltage relation obtained from tail current data was linear. The relationship between conductance and membrane potential was sigmoid. The conductance activated above -45 mV, increased steeply between -45 and -10 mV and saturated above +20 mV. Over the range of potentials where the conductance was just beginning to activate, the conductance increased e-fold for a 7 mV depolarization. The currents activated with an exponential time course and did not decline during step depolarizations. Tail currents declined slowly as the sum of two exponential components. The currents were reversibly suppressed by 100 microM SITS and were irreversibly suppressed by 10 microM DIDS. PMID- 2780212 TI - A calmodulin-binding peptide relaxes skinned muscle from guinea-pig taenia coli. AB - During smooth muscle activation the calcium calmodulin complex interacts with myosin light chain kinase (MLCK) whereby activating it. A synthetic peptide analogue (RS20) corresponding to the calmodulin recognition sequence of MLCK has been synthesized and previously found to inhibit the calmodulin stimulated light chain kinase activity. Here we studied the effect of this peptide on skinned fibers from guinea pig taenia coli. Maximal contractions induced by 30 microM Ca2+ at 0.1 microM calmodulin could be completely relaxed by the peptide at 1 microM. The inhibitory effect was accompanied by partial dephosphorylation only of the regulatory myosin light chain. Relaxation could be reversed by addition of calmodulin which also increased the extent of light chain phosphorylation. The calmodulin concentration required for reversing the inhibition depended on the concentration of the inhibitory peptide suggesting that the peptide competed with MLCK for the calmodulin binding site. As the calcium-calmodulin-peptide mixture constitutes a calmodulin buffer, our results suggest, that the peptide is a calmodulin antagonist unique in terms of its potency and that less than nanomolar concentrations of free calmodulin may be required for inducing smooth muscle contractions. PMID- 2780213 TI - Macula densa cells sense luminal NaCl concentration via furosemide sensitive Na+2Cl-K+ cotransport. AB - The macula densa cells of the juxtaglomerular apparatus probably serve as the sensor cells for the signal which leads to the appropriate tubuloglomerular feedback response. The present study reports basolateral membrane voltage (PDbl) measurements in macula densa cells. We isolated and perfused in vitro thick ascending limb segments with the glomerulus, and therefore the macula densa cells, and the early distal tubule still attached. Macula densa cells were impaled with microelectrodes under visual control. PDbl was recorded in order to examine how these cells sense changes in luminal NaCl concentrations. The addition of furosemide, a specific inhibitor of the Na+2Cl-K+ cotransporter in the thick ascending limb, to the lumen of the perfused thick ascending limb hyperpolarized PDbl from -55 +/- 5 mV to -79 +/- 4 mV (n = 7). Reduction of NaCl in the lumen perfusate from 150 mmol/l to 30 mmol/l also hyperpolarized PDbl from -48 +/- 3 mV to -66 +/- 5 mV (n = 4). A Cl- concentration step in the bath from 150 mmol/l to 30 mmol/l resulted in a 24 +/- 4 mV (n = 4) depolarization of PDbl. This depolarization of PDbl was absent when furosemide was present during the Cl- concentration step. These data suggest that the macula densa cells sense changes in luminal NaCl concentration via coupled uptake of Na+ and Cl-.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2780214 TI - Characterization of potassium channels in respiratory cells. I. General properties. AB - Potassium channels present in the basolateral membrane of respiratory epithelial cells play an important role in the process of chloride secretion. Utilizing the patch clamp technique, we examined human cultured respiratory epithelial cells derived from patients with cystic fibrosis (CF) and normals individual (N) for the existence of and for the properties of K+ channels. We obtained qualitatively and quantitatively identical results for both preparations (CF and N). K+ channels were spontaneously present in cell attached patches. The channels showed burst appearance with rapid flickering within the bursts. When the pipette was filled with 145 mmol/l KCl, a mean conductance of 131 +/- 25 pS (n = 15) was read from the I/V-curve at a clamp voltage (Vc) of 0 mV. After excision, the conductance read from the I/V-curve at Vc = 0 mV was 212 +/- 11 pS (Pipette: 145 mmol/l KCl, bath: 145 mmol/l NaCl) (n = 61). With NaCl in the pipette and KCl in the bath, a similar conductance was obtained (g = 210 pS; n = 2). When both, pipette and bath contained KCl, the conductance was increased to 302 +/- 19 (n = 7). The channel was highly selective for potassium over sodium: PK + /PNa + greater than 40. The channel open probability was only slightly voltage dependent i.e. the open probability increased slightly with depolarisation. For most of the channels one open time constant (to = 6.3 +/- 1.6 ms; n = 22) and one closed time constant (tc = 1.8 +/- 0.3 ms; n = 21) was obtained.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2780216 TI - Selective blockage of cell membrane K conductance by an antisecretory agent in guinea-pig gallbladder epithelium. AB - Loperamide inhibits PGE1-induced electrogenic HCO3 secretion in guinea-pig gallbladder. Underlying changes in epithelial cell membrane properties were investigated using intracellular microelectrode techniques in vitro. In the absence of PGE1, mucosal loperamide (10(-4) mol/l) reversibly depolarized both cell membranes by approximately 6 mV. The apparent ratio of membrane resistances (Ra/Rb) remained unchanged and so did voltage responses to luminal Cl removal and Na reduction. The depolarizing response to elevation of luminal K concentration from 5 to 76 mmol/l was decreased from 13 to 8 mV. In the presence of 1 PGE1, the apical membrane is mainly permeable to Cl and HCO3. Under these conditions, loperamide reduced membrane potentials by approximately 10 mV, Ra/Rb remaining constant at approximately 0.4. Effects on voltage responses to changes in luminal Na or K concentration were unchanged. Responses to luminal Cl removal (transient depolarization) were greatly enhanced (from 22 to 42 mV) as predictable from the fall in K permeability that hinders Cl efflux from cell into lumen. Less marked but significant effects were obtained with 10(-5) mol/l (mucosal side) and serosal loperamide (10(-4) mol/l). We suggest that loperamide inhibits electrogenic HCO3 secretion by reducing apical membrane K permeability. The resulting depolarization diminishes the driving force for conductive anion efflux from cell into lumen. This conclusion is supported by the ability of luminal K elevation to mimick loperamide inhibition of the secretory flux of HCO3 (pH-stat experiments). PMID- 2780217 TI - Peripheral chemoreceptor inputs to medullary inspiratory and postinspiratory neurons of cats. AB - The effect of peripheral chemoreceptor activation on inspiratory and postinspiratory medullary neurons was investigated using intracellular recording techniques. Peripheral chemoreceptors were activated by injecting CO2 saturated 1 N bicarbonate solution into the lingual artery or by electrically stimulating the carotid sinus nerve. Injections of 20-300 microliters bicarbonate solution evoked changes in respiratory frequency and in peak phrenic nerve discharge. The membrane potential of inspiratory alpha neurons, whether bulbospinal or not and independent of their anatomic location, was decreased during inspiration. A sequence of compound excitatory and inhibitory effects were observed when the stimulus was given during the postinspiratory and expiratory phases of the respiratory cycle. Inspiratory beta- and late-inspiratory neurons, however, were inhibited by peripheral chemoreceptor activation. Postinspiratory neurons were strongly activated during postinspiration. Neither class of respiratory neurons were shown to receive direct synaptic inputs from the peripheral chemoreceptors as tested by electrical stimulation of the carotid sinus nerve and signal averaging of the respiratory neuron membrane potential. The experiments revealed differential influences of afferent chemoreceptor activity on various components of the respiratory network. We conclude that chemoreceptor afferents activate non respiratory modulated medullary neurons which, in turn, activate or inhibit various neurons of the medullary respiratory control network. The responses of each type of respiratory neuron to chemoreceptors afferents may then be considered in the context of this direct interaction as well as the network interactions of the various cells. PMID- 2780215 TI - Characterization of potassium channels in respiratory cells. II. Inhibitors and regulation. AB - In a previous study [26] we described the properties of potassium channels in cultured respiratory cells derived from cystic fibrosis patients (CF) and normal individuals (N). In the present study we examine the regulatory mechanisms of these channels by the patch clamp technique. Since there were no apparent differences in the properties of CF and N K+ channels the results were pooled. In the excised inside/out configuration the channel was blocked by different K+ channel blockers. Barium (5.10(-3) mol/l), tetraethylammoniumchloride (5.10(-3) mol/l), quinidine (10(-3) mol/l) and lidocaine (5.10(-3) mol/l), when added to the cytosolic side, inhibited K+ channels reversibly. An increase in the calcium concentration from 10(-7) mol/l to 10(-6) mol/l led to a marked increase in the open channel probability (Po). Further increases in Ca2+ concentration increased Po only slightly. No pH effects on the cytosolic side of the channel were observed. The channel open probability was reduced when ATP was present on the cytosolic side at a concentration of 10(-4) mol/l to 10(-3) mol/l. Non hydrolysable adenosine 5'-[beta, gamma-methylene] triphosphate had the same inhibitory effect as ATP. The inhibition by ATP was blunted by the simultaneous addition of 1 mmol/l ADP. The inhibition of K+ channels by cytosolic ATP may represent a channel regulatory mechanism in the intact cell. This would allow for coupling between the activity of the (Na+ + K+)-pump and the basolateral K+ conductance. PMID- 2780219 TI - Renal tubular transport of glutathione in rat kidney. AB - Filtered glutathione (gamma-glutamyl-cysteinyl-glycine or GSH) is rapidly hydrolyzed by brush-border enzymes facing the tubular lumen and is reabsorbed in the form of the constituent amino acids. The first step of hydrolysis is catalyzed by gamma-glutamyltransferase (gamma-GT). We investigated localization and capacity of the rat renal glutathione degradation/reabsorption during elevation of the filtered load (intravenous infusion of 12 resp. 18 mumol GSH/min). Fractional excretion went up from about 0.003 to 0.31 +/- 0.02 SEM during infusion of the lower and to 0.49 +/- 0.03 SEM during infusion of the higher glutathione dose. GSH degradation/reabsorption took place along the entire proximal tubule and was partially saturated by a 150-200-fold elevation of the normal filtered load. Net reabsorption of GSH up to the last accessible superficial loop was significantly lower during infusion of 18 mumol GSH/min (0.3 mumol/min) than during infusion of 12 mumol GSH/min (1.6 mumol/min). In further experiments, infusion of 18 mumol GSH/min was preceded by the i.v. administration of acivicin (0.5 mmol/kg body wt.), an inhibitor of gamma-GT. In these experiments, fractional glutathione deliveries to late proximal and early distal tubules did not significantly differ from 1, fractional excretion of GSH at the same time was 1.46 +/- 0.11 SEM, revealing net secretion of GSH with the final urine. Tubular secretion of GSH in the acivicin-treated animals occurred either in distal tubules and/or collecting ducts or in the proximal tubules of deep nephrons which are not accessible to micropuncture.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2780218 TI - Electrogenic transport of neutral and dibasic amino acids in a cultured opossum kidney cell line (OK). AB - A study has been made of electrogenic cellular uptake of amino acids resulting in the depolarization of cell membrane potential (PDm) in confluent monolayers of an established opossum kidney (OK) cell line using conventional and pH-selective microelectrodes. Apical superfusion of neutral and dibasic amino acids rapidly depolarized the cell membrane, while application of acidic amino acids had no effect on PDm. The depolarization in response to L-phenylalanine and L-arginine was stereoselective, dose-dependent and saturable. 10 mmol/l of L-phenylalanine reduced PDm by 4.8 +/- 0.4 mV (n = 51) in a completely sodium-dependent way and the concentration necessary for half-maximal depolarization (C1/2) was about 1.5 mmol/l. On the other hand, the C1/2 for L-arginine was about 0.02 mmol/l. The maximal depolarization produced by L-arginine (measured at 10 mmol/l) amounted to 6.8 +/- 1.2 mV (n = 10) and this was not affected when extracellular sodium was replaced by choline (6.3 +/- 1.2 mV; n = 10). The depolarizations induced by L phenylalanine and L-arginine were significantly additive (p less than 0.001). The intracellular pH of OK cells was 7.09 +/- 0.03 (n = 11) and did not change during L-arginine application. We conclude that (1) carrier-mediated uptake of neutral and dibasic amino acids into OK cells is at least partially electrogenic. (2) L Phenylalanine is transported by a Na+-symport. (3) In contrast, L-arginine depolarizes PDm independently of extracellular sodium. (4) Electrogenic uptake of acidic amino acids is not detectable in OK cells. PMID- 2780220 TI - Direct effects of motilin on isolated smooth muscle from various regions of the human stomach. AB - The effects of motilin on gastrointestinal muscles show great variations in different organs and different species. For a precise regional differentiation, we recorded the mechanical activity of longitudinal and circular strips from fundus, corpus and antrum and of circular preparations from the inner and outer layer of the pyloric sphincter and from the duodenum (20 human stomachs). Motilin produced excitatory effects on the mechanical activity of the circular muscle strips from all regions of the human stomach including the pylorus. The effects on longitudinal preparations and on duodenal strips were weak. The most striking effect was an increase of phasic activity (amplitude) in circular antrum preparations, which exceeded the acetylcholine- and bombesin-induced activity. In pylorus preparations, a strong stimulation of phasic activity was observed with a transition to tonic activity in the inner layer of the pyloric ring at high motilin concentrations. The motilin-induced activity of the pyloric preparations was greater than the acetylcholine-induced contractions and even exceeded the bombesin-induced responses in the outer pylorus. The responses of the muscle strips of the proximal stomach (fundus and corpus) were weaker and did not exceed the acetylcholine-induced activity. All effects remained unaltered by atropine and tetrodotoxin application. The study confirms that motilin can interact directly with the smooth muscle of human stomach. PMID- 2780221 TI - Changes in vasomotion pattern and local arteriolar resistance during stepwise pressure reduction. AB - Changes in vasomotion parameters and their consequences for local arteriolar resistance were studied in transverse arterioles and their first order side branches in the tenuissimus muscle of 10 young urethane anesthetized rabbits during stepwise reduction of arterial pressure, using intravital microscopy. To assess the influence of vasomotion on mean local arteriolar resistance, the effective vascular diameter, as a measure of mean flow carrying capacity, was calculated. The contribution of vasomotion to the mean local resistance is limited in transverse arterioles, but important in first order side branches, dominating the flow fluctuations in the downstream capillaries. During pressure reduction, an over-all increase in vasomotion cycle length and amplitude was found in both transverse arterioles and first order side branches, concomitant with an increase in effective arteriolar diameter and a decrease in local blood flow and reduced velocity, as a measure of wall shear rate. Flow autoregulation was observed in 70% of the arterioles. The changes in cycle length and amplitude showed only limited correlations with local blood flow, reduced velocity, arterial pressure and effective arteriolar diameter. This indicates that it is unlikely that only one of these variables is responsible for the changes in the vasomotion parameters. PMID- 2780222 TI - Estimation of high K- and noradrenaline-induced 45Ca uptakes in isolated rat aorta: effects of washing in icecold solutions. AB - Isolated rat aorta rings, labelled for 10 min with 45Ca in control physiological saline solution (PSS), PSS with 10 microM noradrenaline (NA), or 80 mM potassium PSS (80 K), were washed out into non-labelled, icecold PSS. NA and 80 K increased tissue 45Ca. Retention of stimulated 45Ca uptake during washout was studied by subtracting the control washout curve from the washout curves of the stimulated tissues. The measured stimulated uptake fell rapidly during the initial 15 min of washout, thereafter decreasing more slowly. These results suggested that a lengthy wash in icecold PSS would lead to an underestimate of stimulated cellular 45Ca uptake. The cellular location of the stimulated uptake was confirmed by using diltiazem (10 microM) and forskolin (10 microM) to block specifically the 45Ca influxes caused by 80 K and NA, respectively. A similar biphasic loss of stimulated 45Ca uptake was seen in icecold lanthanum (50 mM) solution. These data suggest that established methods for measuring cellular Ca in isolated blood vessels may have markedly underestimated the amount of Ca entering cells during stimulation. PMID- 2780223 TI - A method for making solution changes in the sub-millisecond range at the tip of a patch pipette. AB - A method is described here for making multiple fast external solution changes at the tip of a patch pipette. The time for the change, 0.2 ms, has been established by measuring changes in liquid junction potential at the tip of an open patch pipette. This technique of producing an abrupt change in solution allows agonist/receptor reactions to be studied under non-equilibrium conditions. We have applied this technique to the nicotinic receptors in outside-out patches from skeletal muscle cell line C2 (Jaffe and Saxel 1979) and from bovine adrenal chromaffin cells. The application of step changes in acetylcholine concentration produces current traces with a characteristic shape, which may be compared with the predictions of established models for the activation and desensitisation of the nicotinic receptor. The results of making single steps and also short pulses in acetylcholine concentration are demonstrated. The direct comparison of two different cholinergic agonists is demonstrated. PMID- 2780224 TI - An oil-well method for time-resolved microfluorescence assays. AB - A simple fluorescence assay method has been devised for direct time-resolved recordings of NADH-coupled enzyme reactions in a microliter sample volume in an "oil-well". The apparatus allows practically instantaneous mixing and stirring of two droplets containing the enzyme and substrate, respectively, and which are viewed with a microscope spectrophotometer. This procedure can be used for instance for enzyme kinetic studies of ATPases on a microscale. Thus, by monitoring NADH-fluorescence changes we determined the time course of ATP splitting in nanogram quantities of myosin subfragment 1. In principle, the method can also be used to determine the time course of any other reaction causing fluorescence changes or luminescence changes. PMID- 2780225 TI - A thin slice preparation for patch clamp recordings from neurones of the mammalian central nervous system. AB - (1) A preparation is described which allows patch clamp recordings to be made on mammalian central nervous system (CNS) neurones in situ. (2) A vibrating tissue slicer was used to cut thin slices in which individual neurones could be identified visually. Localized cleaning of cell somata with physiological saline freed the cell membrane, allowing the formation of a high resistance seal between the membrane and the patch pipette. (3) The various configurations of the patch clamp technique were used to demonstrate recording of membrane potential, whole cell currents and single channel currents from neurones and isolated patches. (4) The patch clamp technique was used to record from neurones filled with fluorescent dyes. Staining was achieved by filling cells during recording or by previous retrograde labelling. (5) Thin slice cleaning and patch clamp techniques were shown to be applicable to the spinal cord and almost any brain region and to various species. These techniques are also applicable to animals of a wide variety of postnatal ages, from newborn to adult. PMID- 2780227 TI - K+ currents in developing hippocampal cells. PMID- 2780226 TI - Cromakalim (BRL 34915) acts on an inwardly rectifying neuronal K+ conductance, which is similar to that activated by adenosine. PMID- 2780228 TI - Effects of elevated potassium on neuronal death and network formation in neocortical cultures. PMID- 2780229 TI - Chloramine-T-induced modifications of K+ channel inactivation in neuroblastoma cells. PMID- 2780230 TI - K+ conductance of mechanically dissociated rat sensory neurones in long term cultures in a defined medium. PMID- 2780231 TI - Potassium channels in lizard nodes of Ranvier and motor endings. PMID- 2780232 TI - Ca2+-activated K+ current generating the after-hyperpolarization in mammalian nonmyelinated nerve fibres. PMID- 2780233 TI - Potassium channels in human glioma cells. PMID- 2780234 TI - The distribution of potassium and leakage channels in rat myelinated axons. PMID- 2780235 TI - Structure-activity relationships of aminopyridines and derivates on axonal K+ conductance. PMID- 2780236 TI - Involvement of calcium-activated K+ channels in the firing characteristics of molluscan neurones. PMID- 2780237 TI - Somata of giant and inhibitor motoneurones are prevented from spiking by different outward currents. PMID- 2780238 TI - Potassium current kinetics and single-channel currents in embryonic cultured insect neurones. PMID- 2780239 TI - Multiplicity of unitary potassium channels recorded in the somata of cultured neurones from cockroach embryos. PMID- 2780240 TI - Voltage-activated, delayed rectifier K+ current from pulvinar protoplasts of Mimosa pudica. PMID- 2780241 TI - Direct evidence for control by cytosolic Ca2+ of K+ currents in pituitary cells. PMID- 2780242 TI - Calcium-activated potassium channels from rat parotid acinar cells. PMID- 2780243 TI - Dopamine affects two voltage-dependent K+ currents of identified rat lactotroph cells. PMID- 2780245 TI - Three voltage-activated K+ conductances and an ATP-activated conductance in freshly isolated embryonic chick osteoclasts. PMID- 2780244 TI - Natural bile acids mimic hormonal action on K+ conductance in guinea-pig liver cells. PMID- 2780246 TI - A Ca2+-activated K+ current in guinea-pig atrial myocytes. PMID- 2780247 TI - Effect of external K+ on the delayed K+ current in single rabbit Purkinje cells. PMID- 2780248 TI - Different K+ channels in human atrial cells. PMID- 2780249 TI - Effect of diacetyl monoxime on transient outward current in rat ventricular myocytes. PMID- 2780250 TI - The potassium channel opener RP 49356 modifies the ATP-sensitivity of K+-ATP channels in cardiac myocytes. PMID- 2780251 TI - Activation of an ATP-sensitive K+ current is promoted by internal GDP in frog atrial myocytes. PMID- 2780252 TI - Cromakalim, pinacidil and RP 49356 activate a tolbutamide-sensitive K+ conductance in human skeletal muscle fibres. PMID- 2780253 TI - Blockers and inhibitors of ATP-sensitive K+ channels in adult mouse skeletal muscle. PMID- 2780254 TI - Ca2+-activated K+ channels contribute to the resting potential of vascular myocytes. Ca2+-sensitivity is increased by intracellular Mg2+-ions. PMID- 2780255 TI - Effects of quinine and of calmodulin inhibitors on calcium-dependent potassium channels of human aorta. PMID- 2780256 TI - Modulation of the spontaneous transient outward currents by histamine in single vascular smooth muscle cells. PMID- 2780257 TI - Comparison of the effects of RP 49356, cromakalim and nifedipine on guinea-pig trachea in vitro. PMID- 2780259 TI - Pulmonary vascular and renal effects of cromakalim in anaesthetized dogs. AB - 1) CROM reduced hypoxia-induced pulmonary vasoconstriction and maintained PaO2 with an increase in cardiac output. 2) Low doses of CROM infused into the kidney caused pronounced renal vasodilation, marked natriuresis and a significant increase in cardiac output with minor changes in blood pressure. In addition to its previously described systemic antihypertensive effects, CROM also reduces hypoxia-induced pulmonary hypertension and shows marked renal vasodilation with natriuresis in anaesthetized dogs. PMID- 2780258 TI - Characterization of a novel K+ channel activator, EMD 52962, in electrophysiological and pharmacological experiments. PMID- 2780260 TI - Potassium channels: function, regulation and pharmacology in neuronal, muscular, secretory and immune systems. Proceedings of the Rhone-Polenc Sante Foundation, 6th international round table. Paris, 23rd January 1989. PMID- 2780261 TI - Limb salvage in diabetics with foot ulcers. AB - The healing results in 491 ulcers in 272 diabetic patients are reported. Soft moulded insoles and shoe corrections were the main part of the therapy. There were 329 (67%) neuropathic, 87 (17%) traumatic, 44 (9%) ischaemic and 31 (6%) ulcers of other various pathogenesis. Thirty seven per cent of the ulcers were complicated with invasive infection. Within the period of observation of 18 months (3-39 months) healing was obtained in 79% of the patients (88% of the ulcers) and major amputation was carried out in 8% (4% of the ulcers). There were 21 major amputations, which in 18 cases was due to ischaemia. Thus in only 3 cases (1% of the patients) neuropathy as complicated by invasive infection caused major amputation. Fifty nine ulcers (12%) were classified as relapsing ulcers or ulcers with new localizations and were caused by severe deformity of the foot (58 cases) often in combination with neglect of prophylaxis (7 cases). Only one recurrent ulcer was caused by ischaemia. The series shows that shoe corrections and insoles are effective in treating diabetic neuropathic ulcers. Recurrent ulcerations are caused by severe foot deformity and neglect of therapy. Loss of limbs is caused by ischaemia and invasive infection. PMID- 2780262 TI - Primary survival and prosthetic fitting of lower limb amputees. AB - During the period 1984-1985 amputation of the lower limb at a level potentially requiring a prosthesis was performed on 577 patients in 16 operative units. The mean age was 75.7 years for females and 68.1 for males. The most common site of the amputation was above the knee (49.9%). The majority of amputations (93.8%) were performed for vascular diseases and diabetes. Survival figures showed that 25.5% of amputees died within 2 months of amputation, 60.7% were alive after one year and 43.2% after two years. Out of a total of 577 patients, 26.9% were fitted with a prosthesis. Out of below-knee and above-knee amputees surviving over 2 months, 61.5% and 27.2% respectively were fitted with a prosthesis. There were markedly fewer prosthetic fittings in the over-60 age group. Diabetic patients of both sexes were fitted with a prosthesis more often than arterio-sclerotic patients. Among tumour patients 82.4% received a prosthesis. In the study area more emphasis must be put on the concept of preserving the knee joint and preoperative assessment of vascular patients for selection of amputation level. Every effort must be made to avoid delay in the postoperative mobilization and rehabilitation. Prosthetic fitting of amputees could be improved by better liaison between surgical unit and specialized rehabilitation unit and by closer team approach of amputee care. PMID- 2780263 TI - The role of orthotics in the rehabilitation of patients with fracture of the calcaneum. PMID- 2780264 TI - Prosthetic limb use in Australia 1981-1985 under the Free Limb Scheme. AB - A study has been made of data on 19,421 prosthetic limbs prescribed for 12,143 Australians under the Free Limb Scheme in the years 1981-1985. These prostheses consisted of 18,119 legs and 1,302 arms. The mean age of the lower limb prosthesis user was 52.8 and the upper limb prosthesis user 31.3 years. Males outnumbered females by 3 to 1 in the upper limb prosthesis users, and 2.8 to 1 with lower limb prosthesis users. Below-knee prostheses, patellar-tendon-bearing and thigh-lacing prostheses, made up 58.7% of all prostheses prescribed in the time span. Below-elbow prostheses were the commonest upper limb prostheses with children being the most frequent users. Comparisons with other studies of large number of prosthesis users show an older mean age in Australia and more below knee prosthesis users than in American studies. PMID- 2780265 TI - Tumour related lower limb amputation: a 23 year experience. AB - This paper records the Dundee experience over 23 years and reports on 42 cases of tumour related lower limb amputations. There were 27 males and 15 females with 37 malignant and 5 benign tumours. Four of the 'benign' tumours proved to be osteoclastoma which were locally malignant. Prosthetic rehabilitation was achieved in all but one case. All patients fitted were able to use their prostheses. PMID- 2780266 TI - Temporary prosthetic fitting for below-knee amputation. AB - The problems encountered in fitting and using the permanent below-knee prosthesis in developing countries are the high price of the prosthesis, inadequate fitting and lack of proper rehabilitation. In Turkey, the preferred treatment of the stump post-operatively is by the soft dressing method with bandaging for maturation and shrinkage. Generally, the application of the permanent prosthesis is in the sixth month post-operatively. Since in patellar-tendon-bearing (PTB) sockets, stumps have to withstand high pressures in limited areas, the PTB socket can only tolerate small volume changes in the stump. For this reason bandaging over a long period may be insufficient for adequate stump shrinkage and amputees will need another below-knee prosthesis, which most of them cannot afford after only a few weeks use. In the authors' clinic, 19 amputees were fitted with simple, effective and inexpensive temporary prostheses following either conventional immediate post-operative dressing or the soft dressing method. The temporary prosthesis is worn for two months. It produces fast stump shrinkage, helps maturation and permits ambulatory discharge even in bilateral amputees. For economical reasons, only eight of nineteen patients were fitted with permanent prostheses, all wearing them successfully without the necessity of further rehabilitation. PMID- 2780267 TI - Biomechanics of orthoses for the subluxed shoulder. AB - Based on biomechanics several operational principles for the neutralization of a shoulder subluxation are described. The pros and cons of the operational principles are discussed. A detailed analysis of the forces acting on the upper and lower arm indicates a preference for only one of the operational principles and explains why the arm sling and hemisling fail in the elimination of subluxation. With the operational principle selected a shoulder orthosis has been developed. Clinical results are given. PMID- 2780268 TI - The Flek-shin: a composite material for use in flexible shank below-knee prostheses. PMID- 2780269 TI - How to succeed with your nurse executive. PMID- 2780270 TI - National Center for Nursing Research highlights 1986-1989 reported. PMID- 2780271 TI - AIDS resources for health-care professionals outlined. PMID- 2780272 TI - Ethics committees: where are the nurses? PMID- 2780273 TI - [Alcoholism in women--hidden abuse]. AB - While female alcoholism has increased particularly in the younger generation alcohol-related complications are now more frequently observed among older women. It is generally hard to identify an alcohol problem in a woman who tries at all costs to conceal it and often skillfully masks her difficulties. Such women repeatedly seek help from the medical services for diverse symptoms, both psychological and physical. PMID- 2780274 TI - [Intravenous contrast media]. AB - Adverse events occur in 5-7 per cent of patients after intravenous injection of a traditional contrast medium. Some diseases and procedures are associated with a higher frequency and more serious reactions. In recent years, contrast media with less adverse reactions have been marketed. From a pharmacologic point of view, these are preferable to the traditional media. However their prices are relatively high. In spite of this, use of the newer agents is steadily increasing. PMID- 2780275 TI - [Inflammation and free oxygen radicals]. AB - When mammalian phagocytes encounter appropriate stimuli, highly reactive oxygen derived free radicals (superoxide and hydroxyl) and related species (hydrogen peroxide and hypochlorous acid) may be produced as a normal mechanism in the defence of the host against invading microorganisms. The radicals are destructive to most biological molecules and are responsible for much of the damage inflicted by phagocytes on both microorganisms and surrounding tissues at sites of infection or inflammation. Increasing evidence suggests that the generation of oxygen metabolites plays an important role not only for perpetuation of chronic inflammation, but also for the etiology of other health problems i.e. ageing, cancer, ischemia, and radiationinduced injuries. The extent of tissue damage in inflammation may partly be the result of the balance between free radicals generated and the antioxidant/radical scavenger protective defence systems. The implication of oxygen free radicals in inflammation and future directions are briefly discussed in the present overview. PMID- 2780276 TI - [Acute myelocytic leukemia in 1989]. AB - A number of haematologists who were mustered as a "leukemia task force" recently attempted to summarise the current situation of acute myeloid haematology. This article comprises a resume. PMID- 2780277 TI - [Diagnostic delay in cancer of the nasal cavity and the paranasal sinuses]. AB - Malignant tumours of the nasal cavity and paranasal sinuses are rare. The incidence in the Western world is one per 100,000. The prognosis and therapeutic results are poor, as in most cases a considerable delay occurs before diagnosis. Doctor-delay is illustrated here by two cases a classical patient-delay by one. The etiology, histopathology, clinical manifestations and therapeutic possibilities are reviewed. PMID- 2780278 TI - [Fatal poisoning in Scandinavia--narcotic addicts are a high-risk group]. AB - This study on fatal intoxications in the Nordic countries indicates an over representation of drug addicts in Denmark, Norway and Sweden. All cases of fatal intoxications in persons 15-34 years of age submitted to medicolegal autopsy and subsequent toxicological examination in the Nordic countries during 1984-1985 included in the study. A comparison between the Nordic countries is possible because the same definition of a drug addict and classification of drugs are used. The numbers of fatal intoxications among drug addicts per 10(5) population were 6.3 in Denmark, 2.1 in Norway, 1.3 in Sweden, 0.6 in Finland and none in Iceland. About 70 per cent of the drug addicts in Norway and Sweden died from heroin/morphine intoxication. In Denmark only 55 per cent of the drug addicts died from heroin/morphine and 36 per cent died from overdoses of the legal drugs methadone, dextropropoxyphene and ketobemidone. PMID- 2780279 TI - [Swedish physicians and social workers in a fight for free syringes for narcotic addicts]. PMID- 2780280 TI - [Slang and jargon in drug addiction]. AB - Within the field of drug addiction has developed a body of slang and specialised terminology of international character. In certain situations, it may be important for physicians and other health care personnel to be familiar with this jargon, and the principal side effects of the various preparations in common use, as is discussed in the article. PMID- 2780281 TI - [Sexually transmitted diseases--a separate specialty?]. AB - Syphilis with its many manifestations on the skin in the secondary and tertiary stages of the disease has formed the basis of the traditional connection between dermatology and venereology. During recent years venereology has expanded to involve all sexually transmitted diseases. This development might raise the question whether the time has come to introduce sexually transmitted diseases as a separate specialty. This has been the case for years in England and seems well accepted. The problem is actualized by the present epidemic of HIV-infections and AIDS. PMID- 2780282 TI - [Evaluation of diagnostic test results to aid in probability and likelihood ratios]. PMID- 2780283 TI - An efficient strategy for cloning 5' extremities of rare transcripts permits isolation of multiple 5'-untranslated regions of rat tryptophan hydroxylase mRNA. AB - The 5' end mapping of rat tryptophan hydroxylase (TPH) mRNA indicated a diversity in 5'-untranslated regions. Corresponding sequences were isolated by a variant of the Polymerase Chain Reaction, recently designated as 'anchor PCR', and a 'cRNA enrichment' procedure. The latter circumvents the limitations of 'anchor PCR', which failed to yield minor TPH sequences: this novel strategy allows purification of specific DNA fragments by elimination of the unspecific products, generated by the PCR, which prevent further amplification. Analysis of TPH sequences strongly suggests that TPH mRNAs are synthesized from at least two promoters, the proximal one exhibiting two 'CCAAT homologies'. PMID- 2780284 TI - Hypervariability of simple sequences as a general source for polymorphic DNA markers. AB - Short simple sequence stretches occur as highly repetitive elements in all eukaryotic genomes and partially also in prokaryotes and eubacteria. They are thought to arise by slippage like events working on randomly occurring internally repetitive sequence stretches. This predicts that they should be generally hypervariable in length. I have used the polymerase chain reaction (PCR) process to show that several randomly chosen simple sequence loci with different nucleotide composition and from different species show extensive length polymorphisms. These simple sequence length polymorphisms (SSLP) may be usefully exploited for identity testing, population studies, linkage analysis and genome mapping. PMID- 2780285 TI - Efficient initiation of mammalian mRNA translation at a CUG codon. AB - Nucleotide substitutions were made at the initiation codon of an influenza virus NS cDNA clone in a vector carrying the bacteriophage T7 promoter. When capped mRNA transcripts of these constructs were translated in the rabbit reticulocyte lysate, a change in the initiation codon from...AUAAUGG...to...AUACUGG...reduced the in vitro translational efficiency by only 50-60%, and resulted in only a small increase in the yield of short products presumed to be initiated at downstream sites. Synthesis of the full-length product was initiated exclusively at the mutated codon, with negligible use either of in-frame upstream CUG or GUG codons, or of an in-frame downstream GUG codon. We conclude that CUG has the potential to function as an efficient initiation codon in mammalian systems, at least in certain contexts. PMID- 2780286 TI - The B-Z transition in supercoiled DNA depends on sequence beyond nearest neighbors. AB - In order to examine sequence-dependent structural effects in DNA, the ability of alternating purine-pyrimidine fragments to undergo a B-Z transition when cloned in a supercoiled plasmid was determined solely as a function of sequence, with base and nearest-neighbor composition held constant. Sequences of 22 GC and 2 AT base pairs were synthesized such that the AT base pairs varied between contiguous placement and separation by eight GC base pairs. Results show, surprisingly, that the ease of the B-Z transition varies with the position of the two AT base pairs, occurring at lower superhelical densities when AT base pairs are contiguous, and at higher torsional strain when the AT base pairs are moved further apart. PMID- 2780288 TI - Affinity purification and characterization of human O6-alkylguanine-DNA alkyltransferase complexed with BCNU-treated, synthetic oligonucleotide. AB - Tumor cells resistant to chloroethylnitrosourea (CENU) therapy contain high levels of O6-alkylguanine DNA-alkyltransferase (GATase), a DNA repair enzyme that aborts DNA interstrand cross-linking by removing CENU-induced O6-alkylguanine adducts. Because the transferase binds covalently to CENU-treated oligonucleotides, we reacted partially purified GATase from cultured human lymphoblasts with a BCNU-treated, 35S-5'-end-labeled, synthetic oligonucleotide designed to have a polyadenylated 3' terminus. Immunoprobing Western blots of this reaction mixture with GATase-specific monoclonal antibody indicated that 25 30% of the transferase became complexed. We purified this complex by affinity chromatography with oligo(dT) cellulose, recovering homogenous material that appeared as a discrete 35-kDa Coomassie blue or silver-stained band after SDS polyacrylamide gel electrophoresis. Autoradiography and Western immunoblotting confirmed that this band contained both the radiolabeled oligonucleotide and the GATase protein. PMID- 2780287 TI - Wheat phosphoglycerate kinase: evidence for recombination between the genes for the chloroplastic and cytosolic enzymes. AB - We have isolated and sequenced cDNA clones containing the entire coding region of both the chloroplast and cytosolic versions of phosphoglycerate kinase from wheat. Comparison of these sequences reveals a higher than expected level of similarity between the nucleic acids and encoded proteins. Analysis of this data in relation to that for phosphoglycerate kinase sequences of mammals, prokaryotes and yeasts suggests that the wheat genes have recombined. This has resulted in the chloroplast and cytosolic kinases being more similar to each other than would be expected if the chloroplast enzyme had evolved directly from that of a prokaryotic progenitor. PMID- 2780289 TI - Aberrant expression of platelet-derived growth factor A-chain cDNAs due to cryptic splicing of RNA transcripts in COS-1 cells. AB - Platelet-derived growth factor (PDGF) is a cationic dimer composed of two chains, designated A and B. All three dimeric isotypes of PDGF, PDGF-AA, -AB and -BB, are biologically active but may have distinct functional activities. Two A-chain precursors which differ by the presence of a highly basic 15 amino acid C terminal extension are derived from the A-chain by alternative RNA splicing. To compare the functional properties of these two different forms of the A-chain, expression vectors were generated in which the cDNAs were placed under the transcriptional control of a viral promoter (pSV2). Surprisingly, cryptic RNA splice donor sites were identified in both forms of the PDGF A-chain which modify the A-chain open reading frame and alter the structure of the expressed protein. Recognition of this phenomenon appears to explain the discrepancies between previous results regarding the secretory properties of the PDGF A-chain and may explain difficulties in expression vectors containing splice acceptor sites between the inserted sequence and the polyadenylation site. PMID- 2780290 TI - Protein kinase NII and the regulation of rDNA transcription in mammalian cells. AB - Transcription of ribosomal RNA genes is generally accepted to correlate with cell growth. Using primary cultures of adult bovine aortic endothelial (ABAE) cells, we have shown that transcription of rDNA in confluent cells falls to 5% of the transcription level in growing cells. Protein kinase NII appears to be a limiting factor to promote rDNA transcription in isolated nuclei of confluent cells. Protein kinase NII was detected by immunocytochemistry in the cytoplasm, nuclei and nucleoli of growing cells while it was no longer present in nucleoli of confluent cells. The kinase activity, in isolated nuclei, was estimated by endogenous phosphorylation of a specific substrate, nucleolin. A 10% residual activity was present in confluent cell nuclei compared to growing cell nuclei. Concomitantly, the transcription 'in vitro' of rDNA in the corresponding nuclei was also highly reduced (by 85%). Addition of exogenous protein kinase NII to confluent cell nuclei induced a strong increase in the phosphorylation of specific proteins including nucleolin. In parallel, the transcription of rDNA was increased by a factor of 5, to nearly the level observed in nuclei prepared from growing cells. These data suggest that, in confluent cells, factors necessary for rDNA transcription machinery are present but inactive in the nucleolus and that the phosphorylation of one or several of these factors (nucleolin, topoisomerase I,...) by protein kinase NII is a key event in the regulation of rDNA transcription. PMID- 2780291 TI - Rat gene 33: analysis of its structure, messenger RNA and basal promoter activity. AB - Several overlapping cDNA and genomic DNA clones corresponding to mRNA g33 and gene 33, respectively, were isolated and characterized. The mRNA g33 molecule is 2971 nt in length, exclusive of a poly(A+) tail, and encodes a putative 459 amino acid protein (49,946 daltons). The 13.2 kbp gene consists of four exons, three introns, and has two initiation sites located 27 and 30 bp downstream from a TATA box. Transfection of H4IIE cells with a fusion gene 33 (-1900 to +32)/luciferase construct (pSL330A) gave rise to readily detectable luciferase activity. In addition, primer extension analysis of the gene 33/luciferase mRNA transcribed in these experiments showed that transcription initiates in the gene 33 DNA at two sites consistent with those found in vivo. Analysis of the effect of 5' deletions on basal promoter activity showed that, in relation to the promoter activity of pSL330A, approximately 40% of the activity is lost between -1643 and -1050, another approximately 40% between -550 and -475, and deletion to -55 causes a total loss of detectable luciferase activity. PMID- 2780292 TI - Conformations in crystals and solutions of d(CACGTG), d(CCGCGG) and d(GGCGCC) studied by vibrational spectroscopy. AB - Crystals of self complementary DNA hexamers d(CACGTG), d(CCGCGG) and d(GGCGCC) were grown by vapour diffusion technique and studied by microRaman and microIR spectroscopies. The oligonucleotides were studied in parallel in solution by vibrational spectroscopy. A B- greater than Z transition was detected by Raman spectroscopy during the crystallization process for d(CACGTG). Vibrational spectroscopy shows that the d(GGCGCC) crystals adopt a B geometry. On the contrary the d(CCGCGG) sequence which is shown to be able to undergo in solution or in films quite easily the B- greater than Z transition, remains trapped in crystals in a geometry which may correspond to an intermediate conformation often proposed in models of the B- greater than Z transition. The crystals used in this study were characterized by X-ray diffraction. The unit cell and space group have been determined. PMID- 2780293 TI - Multiple protein binding sites within the ovalbumin gene 5'-flanking region: isolation and characterization of sequence-specific binding proteins. AB - To understand the molecular basis of the steroid hormone regulated expression of the ovalbumin gene, we sought to identify and isolate nuclear factors from chicken oviduct which interact specifically with the ovalbumin promoter. Using DNase I footprinting and mobility shift assays, we have defined at least four distinct protein binding sites, OV-150, OV-220, OV-250 and OV-330, in the promoter region between -100 to -400. Binding competition and protein fractionation studies revealed the existence of two distinct proteins, each recognizing two promoter sites: Both OV-330 and OV-250 are recognized by one protein factor which is distinct from the one binding to both OV-220 and OV-150. The location of the DNase I footprints coincides with those of in vivo chromatin hypersensitive sites. The OV-330 site is located in a sequence area required for the repression of the gene in the absence of hormone. The factor binding to OV 330 has been substantially purified and renaturation experiments indicate that the binding activity is associated with a polypeptide(s) of Mr 40K. PMID- 2780294 TI - A physical map of the genome of Ureaplasma urealyticum 960T with ribosomal RNA loci. AB - A physical map is presented for the 900 kilobase pair genome of Ureaplasma urealyticum 960T, locating 29 sites for 6 restriction endonucleases. The large restriction fragments were separated and sized by pulsed-field agarose gel electrophoresis (PFGE). Their locations on the map were determined by probing Southern blots of digests with individual fragments isolated from other digests and by correlating the products of double digestions and partial digestions. An end-labelling technique was used to detect small fragments not readily observed by PFGE. Two loci for rRNA genes have been determined by probing with cloned DNA. PMID- 2780295 TI - Sequence of the nucleoprotein (NP) gene of the influenza A virus reassortant 81/HO, carrying the NP originally derived from A/Hong Kong/1/68 (H3N2). PMID- 2780296 TI - Cloning and sequencing of mouse ribosomal protein S12 cDNA. PMID- 2780297 TI - A protein of unusual composition from Enterococcus faecium. PMID- 2780298 TI - The cDNA sequence of a human placental alpha-actinin. PMID- 2780299 TI - Nucleotide sequence of the gene encoding the small ribosomal RNA in the mitochondrial genome of the fission yeast Schizosaccharomyces pombe. PMID- 2780300 TI - Nucleotide sequence of cDNA for sulfhydryl-endopeptidase (SH-EP) from cotyledons of germinating Vigna mungo seeds. PMID- 2780301 TI - Drosophila simulans Cu-Zn superoxide dismutase gene sequence. PMID- 2780303 TI - A tRNA-like structure from a linear plasmid of the fungus Ascobolus immersus. PMID- 2780302 TI - A fourth trypsinogen (P23) in the rat pancreas induced by CCK. PMID- 2780304 TI - Nucleotide and amino acid sequences of the entire human alpha 1 (III) collagen. PMID- 2780305 TI - Nucleotide sequence of the Ppc2 gene encoding a housekeeping isoform of phosphoenolpyruvate carboxylase from Mesembryanthemum crystallinum. PMID- 2780306 TI - Nucleotide sequence of the gene encoding a CAM specific isoform of phosphoenolpyruvate carboxylase from Mesembryanthemum crystallinum. PMID- 2780307 TI - Chickens lack a homolog of mammalian U4A small nuclear RNA. PMID- 2780308 TI - The EMBL Network File Server. PMID- 2780309 TI - New nucleotide sequence data on the EMBL File Server. PMID- 2780310 TI - Happy mapping: a proposal for linkage mapping the human genome. AB - A theoretical approach for linkage mapping the genome of any higher eukaryote is described. It uses the polymerase chain reaction, oligonucleotides of random sequence and single haploid cells. Markers are defined and then the DNA of a single sperm is broken at random (eg by gamma-rays) and physically split into 3 aliquots. Each aliquot is screened for the presence of each marker. Closely linked markers are more likely to be found in the same aliquot than unlinked markers. The entire process is repeated with further sperm and the frequency that any two markers co-segregate determined. Closely-linked markers co-segregate from most cells; unlinked markers do so rarely. A map can then be constructed from these co-segregation frequencies. A specific application for determining the order and distance between sets of closely-linked and previously-defined markers is also described. PMID- 2780311 TI - The contrasting structures of mismatched DNA sequences containing looped-out bases (bulges) and multiple mismatches (bubbles). AB - We have studied the structure and reactivities of two kinds of mismatched DNA sequences--unopposed bases, or bulges, and multiple mismatched pairs of bases. These were generated in a constant sequence environment, in relatively long DNA fragments, using a technique based on heteroduplex formation between sequences cloned into single-stranded M13 phage. The mismatched sequences were studied from two points of view, viz 1. The mobility of the fragments on gel electrophoresis in polyacrylamide was studied in order to examine possible bending of the DNA due to the presence of the mismatch defect. Such bending would constitute a global effect on the conformation of the molecule. 2. Sequences in and around the mismatches were studied using enzyme and chemical probes of DNA structure. This would reveal more local structural effects of the mismatched sequences. We observed that the structures of the bulges and the multiple mismatches appear to be fundamentally different. The bulged sequences exhibited a large gel retardation, consistent with a significant bending of the DNA at the bulge, and whose magnitude depends on the number of mismatched bases. The larger bulges were sensitive to cleavage by single-strand specific nucleases, and modified by diethyl pyrocarbonate (adenines) or osmium tetroxide (thymines) in a non-uniform way, suggesting that the bulges have a precise structure that leads to exposure of some, but not all, of the bases. In contrast the multiple mismatches ('bubbles') cause very much less bending of the DNA fragment in which they occur, and uniform patterns of chemical reactivity along the length of the mismatched sequences, suggesting a less well defined, and possibly flexible, structure. The precise structure of the bulges suggests that such features may be especially significant for recognition by proteins. PMID- 2780312 TI - Detection and cloning of new HTLV-related endogenous sequences in man. AB - Human T-cell leukemia virus (HTLV) type I-related endogenous sequences (HRES) have been cloned from a human genomic library. HRES-1/1 is present in DNA of all normal donors examined. By nucleotide sequence analysis, HRES-1/1 contains two potential open reading frames capable of encoding a p25 and a p15. A 684 bp flanking region 5' from the first ATG codon of p25 contains a TATA-box, a poly adenylation signal, a putative tRNA primer binding site, and inverted repeats at locations which are typical of a retroviral long terminal repeat. Phylogenetic analysis suggests that HRES-1/1 entered the genome in primates, presumably as an exogenous retrovirus. From the deduced amino acid sequence of HRES-1/1 p25, residues 6-36 show a sequence homology of 32% and 39% to gag region segments of HTLV-I and HTLV-II, while residues 104-139 display a sequence homology of 33% and 28% to the gag regions of human immunodeficiency virus type 2 (HIV-2) and feline sarcoma virus (FSV), respectively. This suggests that the original exogenous virus infecting primate may be chimeric in structure. The HRES-1/1 genomic locus is transcriptionally active in lymphoid cells, melanoma cells, and embryonic tissues. PMID- 2780313 TI - Molecular dynamics of spermine-DNA interactions: sequence specificity and DNA bending for a simple ligand. AB - We used molecular dynamics to model interactions between the physiologically important polyamine spermine and two B-DNA oligomers, the homopolymer (dG)10 (dC)10 and the heteropolymer (dGdC)5-(dGdC)5. Water and counterions were included in the simulation. Starting coordinates for spermine-DNA complexes were structures obtained by molecular mechanics modeling of spermine with the two oligomers; in these models, spermine binding induced a bend in the heteropolymer but not in the homopolymer. During approximately 40 psec of molecular dynamics simulation, spermine moves away from the floor of the major groove and interacts nospecifically with d(G)10-d(C)10. In contrast, a spermine-induced bend in the helix of (dGdC)5-(dGdC)5 is maintained throughout the simulation and spermine remains closely associated with the major groove. These results provide further evidence that the binding of spermine to nucleic acids can be sequence specific and that bending of alternating purine-pyrimidine sequences may be a physiologically important result of spermine binding. PMID- 2780314 TI - Site-specific cleavage of supercoiled DNA by ascorbate/Cu(II). AB - We have investigated ascorbate/Cu(II) cleavage of double-stranded DNA in the presence and absence of DNA negative torsion. We found that ascorbate/Cu(II) cleavage shows a site-specificity that is dependent on negative torsion and is influenced by the nature of the salt, ionic strength, and pH. This provides strong evidence for involvement of local DNA conformation in ascorbate/Cu(II) specific cleavage sites, that differs from the previous reports on cleavage of linear double-stranded DNA and secondary structures assumed by single-stranded DNA. The data indicate specific binding of Cu(II) ions to sites in the negatively supercoiled DNA. Fining mapping of the cleavage sites does not reveal any known DNA conformation, nor does it indicate any sequence identity among the sites cleaved. However, identification of a major site of cleavage of supercoiled DNA at physiological ionic strength, pH and temperature, along with fact that ascorbate and Cu(II) are normal cell constituents, suggests the torsion dependent, site-specific interactions could have biological significance. PMID- 2780315 TI - Genetic instability of an oligomycin resistance mutation in yeast is associated with an amplification of a mitochondrial DNA segment. AB - In the yeast Kluyveromyces lactis, mutations affecting mitochondrial functions are often highly unstable. In order to understand the basis of this genetic instability, we examined the case of an oligomycin resistant mutant. When the mutant was grown in the absence of the drug, the resistance was rapidly lost. This character showed a typical cytoplasmic inheritance. The unstable resistance was found to be associated with the presence of a repetitive DNA in which the repeating unit was a specific segment of the mitochondrial DNA. The amplified molecules were co-replicating with the wild type genome in the mutant cells. The spontaneous loss of the drug resistance was accompanied by the disappearance of the amplified DNA. The repetitive sequence came from a 405 base-pair segment immediately downstream of a cluster of two transfer RNA genes (threonyl 2 and glutamyl). Modified processing of these tRNAs was detected in the mutant. A possible mechanism by which these events could lead to drug resistance is discussed. PMID- 2780316 TI - Rapid isolation of DNA from complex biological samples using a novel capture reagent--methidium-spermine-sepharose. AB - We have synthesized and analyzed the functional properties of a novel DNA capture reagent containing a methidium moiety attached to a sepharose bead by a spermine linker. DNA present in a biological fluid or other complex sample binds to the reagent. The DNA-capture reagent complex is then separated from the sample by centrifugation and the DNA is released from the reagent by brief incubation in 0.1 to 0.5 N NaOH or KOH. Capture of DNA from complex samples is independent of the salt concentration of the sample, and occurs in the presence of high concentrations of EDTA, proteinase K and detergents. Many samples can be processed simultaneously. The following specific applications, in which denatured DNA is quantitated or characterized, are demonstrated: 1). Isolation of hepatitis B virus DNA from serum and quantitation by dot-blot hybridization, 2). Isolation and quantitation of DNA from urine, 3). Isolation of human genomic DNA from one microliter of blood or 100 HeLa cells followed by amplification of a specific gene sequence using the Polymerase Chain Reaction, 4). Isolation of single stranded phage M13 sequencing templates from bacterial cultures. These investigations suggest that a capture reagent containing an intercalating moiety bound to a solid support may be useful for many applications in molecular biology and molecular diagnostics. PMID- 2780317 TI - Forks and combs and DNA: the synthesis of branched oligodeoxyribonucleotides. AB - Nucleoside phosphoramidite derivatives containing two protected primary hydroxyl functions have been incorporated into synthetic oligonucleotides as 'branching monomers'. With selective deprotection, multiple identical copies of an additional oligonucleotide can be incorporated to form fork- or comb-like structures for use as signal amplification materials in nucleic acid hybridization assays. PMID- 2780319 TI - Tandem trinucleotide repeats throughout the nucleotide sequence of a cDNA encoding an Eimeria tenella sporozoite antigen. PMID- 2780320 TI - cDNA sequence of human ribosomal protein L31. PMID- 2780318 TI - Structure of a mouse erythroid 5-aminolevulinate synthase gene and mapping of erythroid-specific DNAse I hypersensitive sites. AB - The enzyme 5-aminolevulinate synthase (ALA-S) catalyzes the first step in heme biosynthesis. In this study, the mouse erythroid gene has been cloned and analyzed in order to investigate the regulation of ALA-S expression during erythroid differentiation. The gene spans approximately kbp and consists of 11 exons and 10 introns. The first exon is 37 bp, non-coding, and followed by a 6kb intron. The mRNA capsite was mapped by primer extension and defines a promoter that contains no apparent TATA element. S1 nuclease analysis detects the presence at low levels of a 45 bp-deleted form of the ALA-S mRNA created by the use of an alternative splice site at the intron 2/exon 3 junction. Five DNAse I hypersensitive sites were detected in chromatin from uninduced and induced MEL cells. One site is at the promoter; the others are in the body of the gene. No significant differences were observed in the patterns or intensity of the hypersensitive sites in the uninduced and induced MEL cells, however, no sites in ALA-S were observed in NIH 3T3 cells or in deproteinized DNA. Thus, these sites are specific for erythroid chromatin but appear to be established at an earlier stage of differentiation than represented by the uninduced MEL cell. PMID- 2780321 TI - The nucleotide sequence of a full length cDNA encoding rat pituitary pyruvate kinase. PMID- 2780322 TI - Nucleotide sequence of a full-length cDNA for 90 kDa heat-shock protein from human peripheral blood lymphocytes. PMID- 2780323 TI - The construction of a highly efficient and versatile set of mammalian expression vectors. PMID- 2780324 TI - DNA sequencing artifacts in dITP reactions containing gene 32 protein. PMID- 2780325 TI - The testis-specific octamer-binding protein of the sea urchin has a molecular weight of 85 kDa. PMID- 2780326 TI - The amplification of B1 esterase gene in the mosquito Culex pipiens is present in gametes. PMID- 2780328 TI - [Committee of the German Society for Nuclear Medicine. Clinical quality control of in-vivo studies in nuclear medicine. 1. Recommendations]. PMID- 2780329 TI - Effect of solid-meal caloric content on gastric emptying kinetics of solids and liquids. AB - In this study, we have evaluated the effect of the caloric content of a physiological test meal on the gastric emptying kinetics of solids and liquids. 22 healthy male volunteers were studied in two groups matched for age. After an overnight fast, each volunteer underwent the same test procedure; in the first group (G I), 10 volunteers received a meal consisting of bread, 111In-DTPA water and 1 scrambled egg labeled with 99mTc-labelled sulphur colloid; in the second group (G II) 12 volunteers were given the same meal but with 2 labeled eggs in order to increase the caloric content of the solid phase meal. Simultaneous anterior and posterior images were recorded using a dual-headed gamma camera. Solid and liquid geometric mean data were analyzed to determine the lag phase, the emptying rate and the half-emptying time for both solids and liquids. Solid and liquid gastric half-emptying times were significantly prolonged in G II compared to G I volunteers. For the solid phased, the delay was accounted for by a longer lag phase and a decrease in the equilibrium emptying rate. The emptying rate of the liquid phase was significantly decreased in G II compared to G I. Within each group, no statistically significant difference was observed between solid and liquid emptying rates. We conclude that the caloric content of the solid portion of a meal not only alters the emptying of the solid phase but also affects the emptying of the liquid component of the meal. PMID- 2780330 TI - [The effect of inactivity-induced osteoporosis on the scintigraphic image of bone lesions of the wrist]. AB - In addition to its established oncological indications the sensitivity of bone scintigraphy is of steadily increasing significance in traumatology. Inactivity induced osteoporosis plays a major role during the immobilization period in the plaster cast. In the region of the joints remodelling intensity may reach such a high level that the non-injured bone shows a higher rate of accumulation than the fracture. This process already begins between the third and fourth week of immobilization. The highest uptake is found after fracture of the scaphoid bone at the end of twelve weeks of immobilization. Control scintigraphies at intervals of several days are indicated to differentiate between various clinical conditions (pseudoarthrosis, activated osteoarthrosis, algodystrophy in case of doubtful x-ray results). PMID- 2780331 TI - [Results of fractionated radioiodine therapy in 696 patients with hyperthyroidism and 690 patients with non-toxic goiter]. AB - During the course of twenty years 696 patients with hyperthyroidism and 690 cases of non-toxic goitre were treated with 131I in fractionated activities and controlled on an average 4,4 (1-18) years later. Treatment strategy included three special features: a. the first and any further activity amounted to not more than 1.85 MBq per g estimated thyroid weight; b. each therapeutic activity was accompanied by oral prednisone or prednisolone for 2-6 weeks; and c. after completion of radiotherapy each patient was put on thyroid medication which was not interrupted for purposes of control. Therefore, the rate of post-irradiation hypothyroidism could not be determined. All patients were found to be permanently euthyroid and none of the former hyperthyroid patients had relapsed. 84% of the hyperthyroid goitres and 78% of the non-toxic goitres had disappeared completely, 14% and 21%, respectively, were markedly reduced. Complete disappearance of the goitre was achieved with the first 131I activity in 35% of the patients with hyperthyroidism and in 48% of the non-toxic goitres, whereas 34% of the first and 35% of the second group required a second activity; the rest received three or more activities. The mean total activities of 131I necessary for complete reduction of the goitres depended on their size and amounted to 292, 507 and 1136 MBq, respectively, in euthyroid goitres with sizes, I, II and III. The corresponding figures in hyperthyroid goitres were 403, 577 and 1129 MBq, respectively. 314 patients had endocrine ophthalmopathy which was cured in 54% and significantly improved in 37%. PMID- 2780332 TI - [Immunoscintigraphy of blood cells. Symposium. 15-18 February 1989, Erlangen Nurnberg, FRG. Abstracts]. PMID- 2780333 TI - The imperative of a national health strategy for children: is there a political will? PMID- 2780327 TI - New nucleotide sequence data on the EMBL File Server. PMID- 2780334 TI - When hanging is imminent... PMID- 2780335 TI - What do nurses want? Priorities for action. PMID- 2780336 TI - Public health nursing: the neglected specialty. PMID- 2780337 TI - Wanted: leaders for public health. PMID- 2780338 TI - Public health content in nursing curricula. PMID- 2780339 TI - Ethical decision making Part I: Selecting a framework. PMID- 2780340 TI - Banishing cot death. PMID- 2780341 TI - Bright spots. PMID- 2780342 TI - Spanish acquisition. PMID- 2780343 TI - Delivering an idea. PMID- 2780344 TI - The breast alternative? PMID- 2780345 TI - Theatre of the absurd. PMID- 2780346 TI - New light on lasers. PMID- 2780347 TI - Enrolled nurses. Reach for the top. PMID- 2780348 TI - Silent sufferers. PMID- 2780349 TI - There is life after a stoma. PMID- 2780351 TI - Asexual patients. PMID- 2780350 TI - Making use of references. PMID- 2780353 TI - Fit for nursing. Puffed out. PMID- 2780352 TI - Liaison psychiatric nursing in oncology. PMID- 2780354 TI - Predictors of job satisfaction. PMID- 2780355 TI - Home care needs. PMID- 2780357 TI - The Journal of the Association of Continence Advisors. Getting the picture on continence. PMID- 2780356 TI - Nursing competencies and skill mix. PMID- 2780358 TI - Continence. Bed protectors: no easy choice. PMID- 2780359 TI - Daily reminder. PMID- 2780360 TI - Continence. Easing childhood shame. PMID- 2780362 TI - Wanting a say. PMID- 2780361 TI - Winners all. PMID- 2780363 TI - Decision time. PMID- 2780364 TI - Recruitment: selling nursing. PMID- 2780365 TI - A massive shake-up of postbasic education in nursing. PMID- 2780366 TI - Nursing an ambition. PMID- 2780367 TI - Myth and method. PMID- 2780368 TI - Laura's story. PMID- 2780369 TI - Enrolled nurses. Time to spring the trap. PMID- 2780370 TI - Computerize your ward. PMID- 2780371 TI - Community Health. Whose health for all? PMID- 2780372 TI - Supplements to the interview. PMID- 2780374 TI - Buried under paper. PMID- 2780373 TI - Educating for stoma care. PMID- 2780375 TI - Crazy words. PMID- 2780376 TI - Fit for nursing. Cycling for health. PMID- 2780377 TI - Stress and student nurse leavers. PMID- 2780378 TI - Families in ICU: their needs and anxiety levels. PMID- 2780379 TI - Dealing with patients' pain. PMID- 2780380 TI - The circle of care. PMID- 2780381 TI - Undaunted by the troubles. PMID- 2780383 TI - Services under scrutiny. PMID- 2780382 TI - Who should have a vote? PMID- 2780384 TI - Same differences. PMID- 2780385 TI - Tactics will triumph. PMID- 2780386 TI - Resuscitation. A matter of life and death. PMID- 2780387 TI - Brain death. PMID- 2780388 TI - Giving concern. PMID- 2780389 TI - After the interview. PMID- 2780390 TI - A card from Jenny. PMID- 2780391 TI - Method in mouth care. PMID- 2780392 TI - From theory to practice. PMID- 2780393 TI - Selling nursing. Analysing the response. PMID- 2780394 TI - Discharge of the elderly. PMID- 2780395 TI - Nurses' communication. PMID- 2780396 TI - Fit for nursing. Sorting out your yin and yang. PMID- 2780397 TI - Mental health. Face value. PMID- 2780398 TI - Weight gain with breast cancer--more questions. PMID- 2780399 TI - Accidental inhalation, skin or eye exposure to cyclophosphamide. PMID- 2780400 TI - Oncology nursing protocols: a step toward autonomy. AB - Many professional nurses see the lack of autonomy, an essential element in the definition of a professional, as a deterrent to achieving true professional status. Autonomy in nursing is seen in the context of self-governance, shared governance, and nurses' participation in the decision-making process with regard to patient care problems and/or responses to care. To promote staff nurses' decision-making participation and increase their responsibility and accountability on a 32-bed oncology unit, Oncology Nursing Protocols were developed and implemented. PMID- 2780401 TI - Ovarian failure and cancer treatment: incidence and interventions for premenopausal women. AB - Ovarian failure may be a long-term consequence of cancer treatment for premenopausal women. Caused by several treatments, including radiation therapy and the alkylating agents, it produces signs and symptoms associated with menopause: hot flashes, amenorrhea, dyspareunia, loss of libido, and irritability. Critical factors that determine ovarian functioning after treatment for cancer are the patient's age at the time of therapy, the amount of radiation that the ovaries received, and the dose of the antineoplastic agent(s). Medical interventions, such as hormonal therapy and surgical repositioning of the ovaries, may maintain ovarian function for some women. Nursing intervention includes assessment, education, and counseling. Counseling focuses on how the prematurely menopausal patient feels about herself as indicated by self-esteem, body image, and sexuality. PMID- 2780402 TI - Addressing the need for staff support among nurses caring for the AIDS population. AB - More and more nurses are caring for individuals with AIDS-spectrum disorders. When nurses become involved in hospital-based AIDS treatment, major psychosocial issues can arise. In settings where nursing personnel have limited or no experience working with patients with AIDS, fear of contagion is a major issue. This fear has both rational and irrational components. In general, providing up to-date information in a small group setting can effectively reduce irrational fears. Rational fears, which are not as easily dealt with, should be a stimulus for behavior change (e.g., adoption of precautionary guidelines for reducing the possibility of accidental infection). Different issues arise among nurses specializing in AIDS care and include burnout, a sense of professional isolation, and the need to establish personal boundaries in dealing with patients. Guidelines are offered for establishing a group approach to address these concerns and to handle the sensitive issues that may arise. PMID- 2780403 TI - Humor techniques for oncology nurses. AB - Oncology nurses cope with many stressors in their work environment. To prevent the long-term effects of stress, such as psychosomatic illnesses and burnout, nurses use self-care strategies to manage stress. One method of coping with stress is the use of humor. Oncology nurses can use humor techniques in their own stress management programs as well as in their interactions with patients, families, and other health professionals. Guidelines assist clinicians in determining when humor may be used as a therapeutic intervention. Overall, the use of humor in the work setting releases anxiety and tension and is an effective communication tool among patients and healthcare providers. PMID- 2780405 TI - Emotional responses to the diagnosis of cancer: age-related comparisons. AB - This study explored whether emotional responses to a cancer diagnosis differ among adult age groups. Following diagnosis and before treatment, newly diagnosed, hospitalized patients with cancer responded to five instruments. Data analysis indicated no differences in perceptions of health prior to diagnosis among four adult age groups but did reveal differences in post-diagnosis adjustment. The youngest group (less than 50 years of age) experienced the most distress in learning of their diagnosis, while the oldest group (greater than 70 years of age) experienced significantly less psychological distress than all other age groups. However, the oldest group was significantly less positive than the youngest group in their attitudes toward cancer. This information is valuable to nurses caring for adults newly diagnosed with cancer because individuals' beliefs about cancer will influence their behavior. PMID- 2780404 TI - Effect of aerobic exercise on body weight and composition in patients with breast cancer on adjuvant chemotherapy. AB - This study examined the effect of a supervised, aerobic exercise program on change in body weight and composition (multi-site subcutaneous skinfold measures, percent body fat, and lean body weight) of women undergoing adjuvant chemotherapy for breast cancer. Stage II patients with breast cancer (N = 24) were randomized to an exercise treatment group (EG, n = 12) and a control group (CG, n = 12). The EG participated in the individualized Winningham Aerobic Interval Training (WAIT) exercise program with exertional levels set at 60%-85% of maximal heart rate for 20-30 minutes, 3 times per week, for 10-12 weeks. The CG received no exercise treatment, but were asked to continue with their daily activities. Subjects were asked to maintain their customary eating patterns throughout their participation. Data were analyzed using covariate analysis, adjusting for age and pre-test values. Comparisons of pre- and post-test results indicated that exercise had a moderating effect on gain in body fat and altered the subcutaneous body fat profile in both obese (OB) and nonobese (NOB) subjects. Exercising OB subjects showed a greater increase in lean body weight than NOB subjects, indicating an increase in muscle tissue. Results from this study may be useful in designing safe and effective weight-control programs for patients with breast cancer on chemotherapy. PMID- 2780407 TI - Patient education. Safe management of chemotherapy at home. PMID- 2780406 TI - Role of the oncology nurse when the patient with cancer is transferred to the critical care unit. AB - Patients with cancer can become critically ill from treatment-related complications or from progressive disease. The oncology nurse can positively influence the care of the patient and family during and after transfer to the Intensive Care Unit (ICU) by maintaining a strong advocacy role. Patient and family education can prevent or alleviate many of the psychological discomforts precipitated by critical illness. Open communication between the oncology and critical care staff can ease discussion about ethical issues. PMID- 2780408 TI - Patient education. Home chemotherapy safety procedures. PMID- 2780409 TI - A dressing used for graft-versus-host disease skin desquamation. PMID- 2780410 TI - Applying for Oncology Nursing Society and Oncology Nursing Foundation grants. PMID- 2780411 TI - Applying for continuing education approval: demystifying the process. PMID- 2780412 TI - Radioimmunoassay for immunoreactive [des-Leu10]-angiotensin I. AB - A specific radioimmunoassay for the angiotensin-derived peptide [des-Leu10] angiotensin I (AI-dL) is described. Antisera obtained from rabbits injected with immunogen prepared by coupling bovine beta-thyroglobulin to the peptide with carbodiimide were specific to this peptide and did not recognise related angiotensin peptides such as AI, AII, AIII, nor did they recognise other peptides such as bradykinin, substance P, bombesin or dynorphin(1-8). Immunoreactive AI-dL was detected for the first time in the plasma of rats and humans following purification by HPLC at concentrations of 78 and 40 pg/ml, respectively. Concentrations of AI-dL are increased following chronic administration of captopril to rats. PMID- 2780413 TI - Bombesin-induced behavior in infant rats. AB - The behavioral effects of bombesin in 5-, 10- and 20-day-old rat pups have been investigated and the peptide was found to induce scratching (1, 10 mg/kg IP) and grooming (10 mg/kg IP) as early as 5 days after birth. Bombesin did not produce any other overt activities in the developing pups in doses of up to 10 mg/kg, however, lower doses of the peptide (0.1, 1 mg/kg IP) reduced intake of a wet mash diet in deprived 15-day-old rat pups resulting in significant decreases in body weight compared with control animals. These behavioral responses agree with the well-documented effects of bombesin in adult rats and are also in accordance with results from biochemical studies which have shown the existence of receptors for bombesin-like peptides in the rat central nervous system from an early age. PMID- 2780414 TI - Analgesic activity of morphiceptin, beta-casomorphin-4, and deltakephalin in normotensive Wistar-Glaxo and spontaneously hypertensive rats. AB - The effects of intraventricular injection of beta-casomorphin-4, morphiceptin and deltakephalin (DTLET) on hot water tail flick and tail compression responses were investigated in Wistar Albino Glaxo (WAG) and spontaneously hypertensive rats (SHR). The effects of the mu agonist morphiceptin (20 nmol/rat), as assessed by the tail compression test, were significantly greater in SHR rats but did not differ between both strains when measured by tail flick latency. Opioid agonist deltakephalin (2 nmol/rat) in both tests elicited stronger analgesic effects in SHR as compared to WAG and these effects were blocked by naloxone in both tests used. beta-Casomorphin-4 exhibits moderate activity for mu receptors. In the tail flick test peptide (60 nmol/rat) produced an increase in latencies in SHR rats that was significantly greater than was observed in WAG rats. Naloxone pretreatment abolished the analgesic activity of beta-casomorphin-4 solely in the tail compression test in SHR. Analysis of the slopes of the dose-response curves seems to suggest that differences between the activity of these opioid peptides in SHR and WAG rats are based on a difference in the density and affinity of the subpopulation of the opioid receptors in these strains of rats. PMID- 2780415 TI - Penile erection and yawning induced by oxytocin and related peptides: structure activity relationship. AB - The potency of several oxytocin-related peptides in inducing penile erection and yawning after injection into a lateral ventricle of male rats was compared. Substitution of two amino acids in the oxytocin molecule or deletion of the C terminal glycinamide as in des-GlyNH2-oxytocin [oxytocin(1-8)] reduced oxytocin potency in inducing both effects, the rank order being: oxytocin greater than [Thr4,Gly7]-oxytocin congruent to isotocin [( Ser4,Ile8]-oxytocin) greater than vasopressin [( Phe3,Arg8]-oxytocin) greater than des-GlyNH2-oxytocin. Oxytocin's ability to induce penile erection and yawning was abolished by permanent opening of the disulfide bridge by reduction and carboxymethylation. Oxytocin(1-6) and oxytocin(7-9) were also inactive. Penile erection and yawning induced by oxytocin related peptides were antagonized in a dose-dependent manner by nonapeptide antagonists with a rank order of potency that follows their antioxytocic activity (d[(CH2)5Tyr(Me)Orn8]-vasotocin congruent to [Pen1,Phe(Me)2,Thr4,Orn8]-oxytocin greater than d[(CH2)5Tyr(Me)Arg8]-vasopression). Carboxymethylated oxytocin, oxytocin(1-6), and oxytocin(7-9) were devoid of antagonistic activity. The present results suggest that central oxytocin receptors mediating the expression of penile erection and yawning are structurally related to those present in the uterus and in the mammary gland. PMID- 2780416 TI - A peptide with N-terminal histidine and C-terminal isoleucine amide (PHI) and vasoactive intestinal peptide (VIP) are copackaged in myenteric neurones of the guinea pig ileum. AB - When cytoplasmic extracts of the myenteric plexus of guinea pig ileum are submitted to centrifugal density gradient separation in a zonal rotor, conditions which separate storage particles containing substance P, somatostatin and VIP from each other, PHI copurifies with VIP. The two immunoreactivities cannot be separated by particle exclusion chromatography, which depends on size rather than density. It is concluded that the posttranslational cleavage of the propeptide or precursor to PHI and VIP occurs after packaging into these storage particles. PMID- 2780417 TI - Glycine-extended anglerfish peptide YG (aPY) a neuropeptide Y (NPY) homologue may be a precursor of a biologically active peptide. AB - The 37 residue peptide YG (aPY), isolated from anglerfish endocrine pancreas, bears distinct sequence homology to the pancreatic polypeptide family of hormones. However, instead of a carboxyl-terminal tyrosine-amide, aPY has a free carboxyl-terminus ending with glycine. Towards studying the structure-activity relationship of this hormone, we have synthesized aPY by solid phase methodology using Boc-amino acid derivatives and phenylacetamidomethyl resin. The crude peptide was purified to homogeneity in 20% yield by reversed phase chromatography. The purified peptide had the expected amino acid composition and sequence, and was found to be identical with the natural aPY by analytical HPLC and peptide mapping of proteolytic digests. Neither the snythetic nor the natural aPY exhibited the characteristic vasoconstrictor activity of the related pancreatic polypeptide family of hormones. However, [Des37-Gly]-aPY, isolated from the anglerfish pancreas, caused vasoconstriction in rats. Based on these results and by analogy to the glycine-extended gastrin peptides, it may be suggested that aPY is a precursor of a biologically active peptide, namely [Des37 Gly]-aPY-amide. PMID- 2780418 TI - Adrenal vein catecholamines and neuropeptides during splanchnic nerve stimulation in cats. AB - Splanchnic nerve stimulation in bursts at low (5 Hz) and high (50 Hz) frequency (30 V, 1 msec; train duration 1 sec; train rate 0.5/second) was employed in 10 cats under halothane anesthesia, during 10-minute periods, while blood samples were concurrently collected from the adrenal vein and femoral artery for the measurement of norepinephrine (NE), epinephrine (EPI), dopamine (DA), Met enkephalin (ME), neuropeptide Y (NPY), peptide YY (PYY) and neurotensin (NT). In Group I (n = 5), splanchnic nerve stimulation was initially applied at 5 Hz followed after 20 min by a 50 Hz stimulus, while in Group II (n = 5) the stimulation sequence was reversed. Adrenal vein and femoral artery plasma levels of catecholamines and neuropeptides were not significantly affected by the stimulation sequence, while a significant decrease in blood pressure response was observed in Group II during the 5 Hz stimulation as compared to Group I, indicating desensitization. Splanchnic nerve stimulation at 5 Hz caused a preferential increase in adrenal vein NE (9-fold) versus EPI (7-fold) levels as compared to baseline, while 50 Hz stimulation led to further comparable increases in NE (5-fold) and EPI (6-fold) levels. Significant increases in adrenal vein DA and neuropeptide levels were only observed during 50 Hz stimulation, with DA showing a 5-fold, ME a 2.6-fold and NPY a 3-fold increase as compared to 5 Hz stimulation, and NT a 3.6-fold increase as compared to baseline. Present findings indicate different dynamics in the movement of catecholamines and neuropeptides from the adrenal. PMID- 2780419 TI - Changes in levels of the tripeptide Tyr-Gly-Gly as an index of enkephalin release in the spinal cord: effects of noxious stimuli and parenterally-active peptidase inhibitors. AB - The tripeptide Tyr-Gly-Gly (YGG), representing the product of enkephalin hydrolysis by enkephalinase (EC 3.4.24.11), was characterized and its levels measured in spinal cord perfusates of halothane-anaesthetized rats. During noxious pinching of the muzzle, which is known to trigger enkephalin release, YGG levels were enhanced more markedly and for longer than were those of [Met5]enkephalin (YGGFM), in the same samples. By contrast, neither YGG nor YGGFM levels were affected by pinching the tail. Treatment with carbaphethiol, a parenterally-active aminopeptidase inhibitor, markedly increased YGG levels and lengthened the duration of the increase produced by pinching the muzzle. Treatment with acetorphan, a parenterally-active enkephalinase inhibitor, given alone or in combination with carbaphethiol, completely prevented the rise in YGG triggered by noxious stimulation. By contrast, [Met5]enkephalin levels in the perfusates were increased by the combined administration of the two peptidase inhibitors but these levels were not further enhanced by noxious stimulation. Thus, spinal cord YGG appears to be formed under the influence of enkephalinase and to constitute a sensitive index of enkephalin release. PMID- 2780420 TI - Sex differences in vasopressin neurons in the bed nucleus of the stria terminalis by in situ hybridization. AB - To determine whether a sex difference exists in the biosynthetic capacity of vasopressingergic (AVP) neurons in the bed nucleus of the stria terminalis (BNST), we have used in situ hybridization and quantitative autoradiography to measure propressophysin messenger RNA levels in these cells from adult male and female rats. We have found that significantly more (p less than 0.01) neurons are labeled in male rats than in female rats and that these labeled cells averaged more grains/cell (p less than 0.05) in males than in females. Therefore, the sexual dimorphism of AVP pathways in the BNST and lateral septum recently shown by immunohistochemistry results from a sex difference in the biosynthetic capacity of these AVP neurons. PMID- 2780421 TI - Vasoactive intestinal polypeptide carboxy-terminal fragment, VIP(22-28), and other fragments of VIP, in the central nervous system of the rat. AB - The possible existence in rat brain tissues of shorter peptides related to VIP has been examined. VIP and PHI both contain paired basic amino acid residues at which posttranslational cleavage of these peptides might occur. Antiserum to VIP(22-28) was raised in rabbits. The antiserum was carboxy-terminus directed, showing cross-reactivity with all tested peptides containing the VIP carboxy terminus sequences. Chromatographic analysis of rat brain extracts demonstrated that recovered VIP(22-28) immunoreactivity [VIP(22-28)-ir] was heterogeneous, consisting of a major fraction [60-70% of total VIP(22-28)-ir] which eluted as authentic VIP(1-28) on gel filtration and on reversed phase high performance liquid chromatography (HPLC) columns. A second fraction (30-35% of total VIP(22 28)-ir] eluted from gel filtration columns in the position of VIP(22-28). HPLC analysis of this fraction from extracts of rat cortex, hippocampus, and midbrain indicated that it was heterogeneous. One component corresponded to authentic VIP(22-28). The other two components have not been identified; one appears to be a VIP fragment intermediate in size between VIP(1-28) and VIP(22-28). PMID- 2780422 TI - Local application of neurotensin to abdominal organs triggers cardiovascular reflexes in guinea pigs: possible mechanisms. AB - Intraabdominal (IAB) injections or topical application of neurotensin (NT) to the serosal surface of the ileum or stomach evoked dose-dependent increases of blood pressure and of heart rate in anesthetized guinea pigs. These effects were markedly reduced by prior animal treatment with a ganglion blocker, alpha and beta adrenoceptor blockers, as well as by exposure of the abdominal organs to lidocaine, a local anesthetic. The blood pressure and heart rate responses to IAB injections or topical application of NT to the ileum or stomach were both inhibited by animal pretreatment with capsaicin. Cervical vagotomy or atropine pretreatment did not prevent or alter the cardiovascular responses to IAB injections of NT. These results suggest the presence in some organs and/or tissues of the abdominal cavity of sympathetic, capsaicin-sensitive sensory nerve fibers which, upon stimulation by NT, produce reflex increases of blood pressure and of heart rate. PMID- 2780424 TI - FMRFamide enhances acetylcholine-induced contractions of guinea pig ileum. AB - Isolated guinea pig ilea were contracted with acetylcholine (ACh) in the absence and presence of the neuropeptide FMRFamide (Phe-Met-Arg-Phe-NH2). FMRFamide (0.17 17 microM) enhanced ACh-induced contractions (observed as a leftward shift of the dose-response curve and increase in Emax) with maximal effect at 1.7 microM. FMRFamide had no effect when administered alone. These results extend the demonstration of a FMRFamide/ACh interaction to mammalian tissue and support the concept that FMRFamide, or mammalian equivalents, could play a modulatory role in mammals. PMID- 2780423 TI - Expression of cholecystokinin and enkephalin mRNA in discrete brain regions. AB - The levels of preprocholecystokinin mRNA were measured in several regions of rat brain using RNA blot analysis. In both species, high levels of expression were observed in the thalamus, amygdala, neocortical areas and hippocampus. Intermediate levels were observed in the periaqueductal grey, hypothalamus, substantia nigra, ventral tegmental area, and olfactory bulbs; little or no mRNA was detected in the caudate nucleus, nucleus accumbens, olfactory tubercle, cerebellum or a liver control. In contrast, the caudate and olfactory tubercle expressed large amounts of preproenkephalin mRNA. Other regions, such as the periaqueductal grey and olfactory bulbs, expressed both transcripts while regions like the hippocampus contained prominent amounts of preprocholecystokinin mRNA and relatively little preproenkephalin mRNA. PMID- 2780425 TI - Neurokinin B in a human pheochromocytoma measured with a specific radioimmunoassay. AB - An N-terminally directed antiserum to neurokinin B was raised in rabbits using an immunogen prepared by coupling the free-SH group of neurokinin B extended from its C-terminus by a cysteine residue (NKB-Cys) to an -NH2 group on human serum albumin using a heterobifunctional cross-linking reagent. In radioimmunoassay with 125I-Bolton-Hunter-labelled NKB-Cys as tracer, the antiserum showed no cross reactivity with other tachykinins. An extract of a human pheochromocytoma, previously shown to contain peptides derived from preprotachykinin A, contained NKB-LI (13 pmol/g wet weight). The retention time of tumor neurokinin on reversed phase HPLC was the same as that of synthetic neurokinin B. Peptides with the retention times of substance P, neurokinin A, neurokinin A (3-10)-peptide and neuropeptide K were also identified in the tumor extract. NKB-LI was not detected in extracts of a further nine pheochromocytomas or in five carcinoid tumors that expressed the preprotachykinin A gene. PMID- 2780426 TI - [Clinical information systems]. PMID- 2780427 TI - ["Health for all in 2000"--the strategy of the World Health Organization and its influence on health policy in Poland]. PMID- 2780428 TI - [Current legal and deontologic dilemmas of physicians]. PMID- 2780429 TI - [Acute drug poisoning: our experience 1966-1985]. PMID- 2780430 TI - Flow cytometric DNA measurement of gastric cancers. Clinico-pathological implication of DNA ploidy. AB - The relationship of DNA ploidy to clinical, pathological or prognostic data was investigated in 70 surgically removed gastric cancers, 60 of which were advanced cases. The cellular DNA content was measured by means of flow cytometry. Overall, DNA aneuploidy was seen in 43 of the cases (61%) while the normal gastric mucosa consisted of only a diploid line without any aneuploid population. Ploidy levels of gastric cancer spanned a wide range from a hypodiploid value to a hyperpentaploid value, although near-diploid and near-triploid cases were the majority in the series. No significant association between ploidy and either age or sex was found. The incidence of DNA aneuploidy was significantly higher in differentiated adenocarcinomas than in undifferentiated ones (p less than 0.05). However, DNA ploidy was not related to some pathologic characteristics such as the extent of tumor invasion and the frequency of lymph node metastasis. According to Kaplan-Meier survival plots, prognosis of the patients with DNA diploid tumors tended to be better than that of aneuploid tumors, but the difference was not statistically significant. PMID- 2780431 TI - Osteoclasts and bone remodeling in chronic myeloproliferative disorders. A histochemical and morphometric study on trephine biopsies in 165 patients. AB - In 165 patients with chronic myeloproliferative disorders (CMPD) a morphometric and histochemical study was performed on trephine biopsies of the bone marrow to elucidate osseous remodeling by assessment of trabecular bone area (planimetry) and number of osteoclasts. Osteoclastic elements were identified by the tartrate resistant acid phosphatase method. In addition to control specimens (n = 20) subtypes of CMPD included chronic myeloid leukemia (CML, n = 65), primary (essential) thrombocythemia (PTH, n = 25), polycythemia vera rubra (P. vera, n = 25) and agnogenic myeloid metaplasia (AMM, n = 50). AMM was discriminated into a so-called early hyperplastic stage without gross myelofibrosis (n = 19) and an overt or advanced stage showing fibro-osteosclerotic changes (n = 31). Total area of trabecular bone and counts for osteoclasts (uni- and multi-nucleated cells as well as a-nuclear cytoplasmic fragments) were not significantly increased in CML, PTH, P. vera and in the initial hypercellular stages of AMM. In contrast to these results, in advanced stages of AMM there was a significant increase in total bone area associated with a high count for all osteoclastic elements and apparently also an increased number of osteoblasts. It is speculated that the marked increase in osteoclastic-osteoblastic elements in late stages of AMM possibly reflects an imbalance of calcitriol (1.25-dihydroxyvitamin D 3) on skeletal homeostasis. This abnormal osseous remodeling may be mediated by the atypical megakaryocytic proliferation in this disorder, which is always a conspicuous feature of bone marrow biopsies. PMID- 2780432 TI - Immunohistochemical determination of growth fraction in human tumors. AB - The growth fraction in 93 cases of human tumors was estimated by an immunohistochemical staining using Ki-67. The tumors consisted of the following: 14 oral cancers, 14 breast cancers, 9 gastric cancers, 9 uterine cancers, 8 ovarian cancers, 6 colo-rectal cancers, 6 thyroid cancers, 5 esophagus cancers and 22 miscellaneous tumors. Regional labeled cells were predominantly found in the periphery of the tumor nests in squamous cell carcinomas. However, in adenocarcinomas the labeled cells were randomly distributed in tumor cell nests. The Ki-67 labeling index varied greatly from case to case (almost 0 to 50.9% with an average of 17.3%), even within the same organ group. The growth fraction was independent of the histological pattern, although thyroid cancers showed a lower labeling index than other malignant tumors. The labeling indices in benign tumors were lower than those in malignant tumors. The usefulness of this method for the estimation of biological behavior of human tumors is suggested. PMID- 2780433 TI - Extraadrenal intralymphonodular myelolipoma. AB - An extraadrenal myelolipoma inside a lymph node in a 70-year-old man is reported as the first description of this tumour in the given localization. PMID- 2780434 TI - Laryngeal botryoid rhabdomyosarcoma in an adult. Report of a case with electron microscopic study. AB - Light and electron microscopic studies of botryoid rhabdomyosarcoma of the larynx in an adult are presented. Differences in cellular composition of the central and peripheral regions of the tumor are described. The ultrastructure of the rhabdomyoblasts is discussed on the basis of criteria recently described. The findings support the hypothesis that botryoid rhabdomyosarcoma is a special subtype of rhabdomyosarcoma with low grade malignancy. PMID- 2780435 TI - Viral and bacterial conjunctivitis. Prevention of disastrous results. AB - Conjunctivitis has many bacterial and viral causes. If the cause is bacterial, treatment with a broad-spectrum antibiotic resolves the problem in 1 to 3 days in almost all cases. If signs and symptoms persist, referral to an ophthalmologist is wise. Most cases of viral conjunctivitis are accompanied by follicular reactions in the inferior fornix, as observed with adult inclusion disease. If dendrites are seen, trifluridine (Viroptic) is preferred for treatment. Referral to an ophthalmologist is advisable because recurrence with scarring and permanent loss of vision is possible. Many topical antibiotics include a corticosteroid component that never should be used unless the conjunctivitis or keratitis is proven to be nonherpetic. PMID- 2780436 TI - Acute iritis. How to preserve good vision. AB - Acute iritis, which is often seen in young adults, may cause red eye, photophobia, and aching discomfort. Many times, the condition can be ameliorated or completely reversed by cautious use of cycloplegic agents and corticosteroids. However, undiagnosed or improperly treated iritis can lead to glaucoma and loss of vision. PMID- 2780438 TI - Journey's beginning and end. PMID- 2780437 TI - How happy are you? PMID- 2780439 TI - AIDS information. PMID- 2780440 TI - Public spending. PMID- 2780441 TI - Solitary pulmonary nodule. What should be included in the workup? AB - Rapid, thorough diagnostic workup of patients with solitary pulmonary nodules is imperative. The optimal management for these patients is exploratory thoracotomy for biopsy and appropriate resection. Preliminary fiberoptic bronchoscopy and transthoracic needle aspiration do not rule out malignant tumors if negative and add only unnecessary complexity, delay, expense, and risk to the patient's management. PMID- 2780442 TI - Alcoholism in the elderly. How to spot and treat a problem the patient wants to hide. AB - Alcoholism is a disease that warrants a complete medical workup and vigorous intervention in all age-groups, including the elderly. Increased awareness of the problem, with early diagnosis and treatment, can reduce mortality and morbidity. Alcoholics are at risk for relapse, so physicians should be patient and positive in their approach. Especially in the elderly, obtaining a list of all prescribed and over-the-counter medications used is an important starting point. Nonessential drugs should be discontinued and use of any others closely monitored. If a withdrawal syndrome results from discontinuation of alcohol, thiamine, multivitamins, and sedatives should be prescribed as clinically indicated. Treatment of any underlying psychiatric disorder is important. Psychosocial intervention is essential in dealing with recovering elderly alcoholics to overcome loneliness and to enhance sobriety. A formal rehabilitative effort is mandatory. Long-term rehabilitation focuses on group support and may include use of disulfiram (Antabuse). PMID- 2780443 TI - Ocular disease from wearing contact lenses. A potentially devastating complication. AB - Because of the continued popularity of contact lenses in the United States, ocular inflammatory diseases are being encountered with increasing frequency by both ophthalmologists and primary care physicians. Distinction between minor noninfectious inflammation and serious, sight-threatening infection is crucial to the proper management of these patients. Symptoms of infectious keratitis are pain and loss of vision. Signs include infiltration or loss of clarity of the cornea, eyelid swelling, and purulent discharge. If an infectious process is suspected, the patient should be referred to an ophthalmologist immediately. If this is not possible, the contact lens should be removed and a culture performed, if possible. Aminoglycoside antibiotic drops should be applied frequently until ophthalmologic consultation is obtained. Patients should be reminded of the need for strict adherence to disinfection techniques and avoidance of homemade saline preparations. They should also be told to discontinue use of contact lenses at the first sign of ocular irritation or inflammation and to report to their physician if inflammation persists. PMID- 2780444 TI - When to advise surgery for severe obesity. AB - A typical severely obese patient will have about 50 kg excess weight to lose, which is equivalent to a store of 350,000 kcal. The optimum rate of weight loss in such a patient is about 1 kg/week, which involves an energy deficit of 1000 kcal/day for about a year. It is difficult to maintain this degree of dietary restriction over such a long period, and procedures such as jaw wiring or stomach stapling may help in some cases. Maintenance of weight loss is difficult to achieve and may be helped by fitting a nylon waist cord after weight loss. On theoretical grounds, patients who do not lose weight despite keeping to a properly-designed reducing diet would not benefit from surgery, but in practice this problem does not arise. It is dangerous to resort to surgery for the treatment of severely obese patients who cannot diet by reason of psychiatric disorder. PMID- 2780445 TI - Nephrotic syndrome and hepatitis in early syphilis. AB - A 54 year old man presented with features of acute hepatitis and the nephrotic syndrome. A diagnosis of active syphilis was only made by chance after extensive investigation. Syphilis should be considered in the differential diagnosis of both acute hepatitis and the nephrotic syndrome occurring separately as well as together. PMID- 2780446 TI - How do we know who has had deep vein thrombosis? AB - An attempt was made to identify all patients diagnosed as having deep vein thrombosis (DVT) in a large teaching hospital during one year. A review of the radiology records showed that 124 (81%) of the 154 venograms performed were for suspected DVT, and that the diagnosis was confirmed in 57 (46%). During the same period, the Hospital Activity Analysis (HAA) records revealed 174 episodes classified as 'phlebitis or thrombophlebitis' in 162 patients. Only 37 of these episodes (21%) had been confirmed by X-ray venography and at least 29 patients were incorrectly classified by HAA. 'Medical' patients accounted for 54% of the episodes of DVT, yet in only 25% of these was the diagnosis confirmed by venography, while 'surgical' DVTs were less frequent but were more often confirmed by venography. PMID- 2780447 TI - Blood alcohol levels in acute elderly admissions to hospital. AB - Blood alcohol levels were estimated in 141 patients admitted acutely over a one month period to a geriatric unit. Only four (2.8%) had alcohol detectable in their blood. The levels were low, suggesting that alcohol intoxication is not a major factor in the admission of the elderly to hospital. PMID- 2780448 TI - Unusual presentation of a large pituitary tumour in relation to diving. AB - A case of necrosis of a pituitary tumour occurring in the context of diving is described. The presenting features and subsequent course suggested a brain stem vascular event. The tumour was not detected by routine computerized tomographic scanning, but was identified with magnetic resonance imaging. The possible pathophysiological mechanism is discussed. PMID- 2780449 TI - The black thyroid: an unusual finding during neck exploration. AB - Black thyroid discolouration has been reported in post-mortem examinations on patients who have previously taken minocycline. The discovery of this phenomenon during neck exploration and a review of the possible mechanism of black thyroid discolouration are discussed in this paper. PMID- 2780450 TI - Diabetes insipidus complicating myelofibrosis. AB - A 68 year old man developed cranial diabetes insipidus 3 years after the diagnosis of myelofibrosis, coincident with a marked increase in nucleated cell count. No mass lesion was demonstrable on computed tomographic or magnetic resonance imaging. It is suggested that hypothalamic damage was caused by local infiltration or infarction, a complication of myelofibrosis which has not previously been reported. PMID- 2780452 TI - Ulceration of the entire small intestine accompanied by rash, hepatitis and pancytopenia. AB - A case of acute mucosal ulceration of the entire small intestine accompanied by skin rash, hepatitis and marrow suppression is reported. Recovery was complicated by a severe protein losing enteropathy and small intestinal strictures and the patient died post-operatively of a pulmonary embolism. The aetiology remains unknown. PMID- 2780451 TI - Massive haematemesis--presenting symptoms of cystadenocarcinoma of the pancreas. AB - A 43 year old woman presented with attacks of abdominal pain, haematemesis and hyperamylasaemia. Gastrointestinal X-rays and repeated upper gastrointestinal endoscopy failed to reveal the source of bleeding. Ultrasound and computed tomographic scan demonstrated a calcified mass in the tail of the pancreas. Surgical exploration revealed a solitary mass in the pancreas and histological examination showed cystadenocarcinoma. The patient died 2 years later because of local recurrence, but haematemesis and melaena did not recur. This case presents an unusual manifestation of cystadenocarcinoma of the pancreas with massive bleeding from the tumour via the pancreatic duct and associated pancreatitis. Other possible reasons for bleeding with cystadenocarcinoma of the pancreas are discussed. PMID- 2780453 TI - Fatal theophylline toxicity precipitated by in situ pulmonary artery thrombosis. AB - A 57 year old man developed theophylline toxicity in association with acute pulmonary artery thrombosis. The plasma half life of theophylline was prolonged suggesting impaired metabolism secondary to acute right heart failure. PMID- 2780454 TI - Protracted systemic illness and interstitial nephritis due to minocycline. AB - A severe hypersensitivity-like illness with acute renal failure, lymphadenopathy and skin rash is reported following minocycline treatment in a 16 year old male. Following haemodialysis and steroid therapy his illness remitted, only to recur on withdrawal of the steroids. With further steroid treatment he recovered completely. Lymphocyte function tests, performed in an attempt to positively incriminate minocycline, were inconclusive due to a general suppression of the patient's lymphocytes to in vitro stimulation. Hypersensitivity reactions attributed to minocycline include skin rashes, lymphadenopathy and one previous case of acute interstitial nephritis. PMID- 2780455 TI - Lactic acidosis due to metformin therapy in a low risk patient. PMID- 2780456 TI - Hypernatraemia in hospital populations. PMID- 2780457 TI - Acute inflammatory demyelinating polyradiculoneuropathy presenting as complete heart block and Stoke-Adams attacks. AB - A patient with acute inflammatory demyelinating polyradiculoneuropathy (AIDP, Guillain-Barre syndrome) whose presenting complaints were related to autonomic dysfunction in the form of parasympathetic and sympathetic overactivity is reported. Parasympathetic overactivity was severe enough to cause complete atrioventricular block (atropine-responsive) and Stoke-Adams attacks, for which a demand pacemaker was required. Limb weakness was apparent 48 hours later. To our knowledge no such presentation of AIDP has been previously recorded. PMID- 2780458 TI - Acute splenic sequestration crisis in a young woman with homozygous sickle cell anaemia. AB - Acute splenic sequestration crisis in a 20 year old female with homozygous sickle cell anaemia (Hb SS) is described. The resemblance of this complication to that of splenic vein ligation is discussed. This is the first case report known to the author of acute splenic sequestration crisis in an adult with homozygous sickle cell anaemia treated successfully. PMID- 2780459 TI - Angiofollicular lymph node hyperplasia with amyloidosis. AB - Two cases of angiofollicular lymph node hyperplasia are described, one of the solitary plasma cell type the other of the multicentric hyaline vascular type. Both cases illustrate the wide ranging clinical and pathological findings associated with this condition but both also have unusual features. The solitary plasma cell lesion had an exceptional 32 year clinical history and was associated with systemic amyloidosis of AL type. The multicentric hyaline vascular case was associated with coexistent multiple myeloma and amyloid deposition also of AL type. These cases are presented with a review of the relevant literature. PMID- 2780460 TI - Intestinal obstruction secondary to a congenital pre-iliac hernia. AB - A previously undescribed type of congenital abdominal wall hernia is described. Presentation was with the symptoms and signs of subacute large bowel obstruction. The diagnosis was suggested by barium enema and confirmed at laparotomy. PMID- 2780461 TI - Intermittent omental torsion--an unusual cause of recurrent abdominal pain? AB - A case of haemoperitoneum arising from an omental haematoma is described. Histology suggests that this resulted from an omental torsion. The omentum, however, was not torted at the time of laparotomy. Furthermore, there was a history of similar episodes of pain over the previous eighteen months. This suggests that spontaneous derotation of an omental torsion may occur, and may be an unusual cause of recurrent abdominal pain. PMID- 2780462 TI - Long-term symptomatic relief of postprandial hypoglycaemia following gastric surgery with a somatostatin analogue. AB - Somatostatin has been shown to be effective in the management of the dumping syndrome and there have been reports of the effective use of long acting somatostatin analogue in the management of this condition. However, there have been few reports of the prolonged use of a somatostatin analogue in the late dumping syndrome. We describe a patient in whom this management provided good long term symptomatic relief which was confirmed biochemically. PMID- 2780463 TI - An unusual case of shock in a young woman. PMID- 2780464 TI - Occupational medicine and the clinician. PMID- 2780466 TI - Pizotifen in deafferentation pain. AB - Deafferentation pain is known usually to be resistant to both narcotic and non narcotic analgesics. Four cases of this condition are reported here in which benefit was obtained with pizotifen, a 5-hydroxytryptamine antagonist. Further controlled clinical studies are required to verify this observation. PMID- 2780465 TI - Listeria monocytogenes meningitis in previously healthy adults. AB - A retrospective study of four sporadic cases of Listeria monocytogenes meningitis is reported. Contrary to the conventional epidemiology these patients were adults who were not immuno-compromised. Although all four cases produced positive cerebrospinal fluid cultures, in three, listeria was not microscopically identified. Protein and glucose contents of cerebrospinal fluids were variable and all samples showed lymphocytic pleocytosis. All four had neutrophil leucocytosis in peripheral blood. The unwary may dismiss lymphocytic meningitis as being of 'viral' origin, thereby making an important diagnostic misjudgement of vital therapeutic importance. Intravenous ampicillin is the drug of first choice for treatment of listeria meningitis; third generation cephalosporins are ineffective. PMID- 2780467 TI - Hypersplenism due to fungal infection of spleen in a successfully treated patient with Hodgkin's disease. AB - A 58 year old woman, with dermatitis herpetiformis was found to have Hodgkin's disease following the discovery of an abdominal mass and splenomegaly. Combination chemotherapy was given. Although the abdominal mass and systemic symptoms resolved, the splenomegaly did not and the patient developed severe prolonged anaemia and pancytopaenia. Splenectomy resulted in a complete reversal of the haematological abnormalities. Histopathological examination of the spleen revealed fungal granulomas of Candida albicans. No residual Hodgkin's disease was found. The patient thus had hypersplenism due to fungal granulomas in the spleen. This form of presentation of fungal granuloma is very rare and resulted in delay in diagnosis and considerable morbidity to the patient. PMID- 2780468 TI - Vascular injury after arterial catheterization. AB - Twenty-three cases of arterial injury after 8,208 arterial catheterizations for diagnostic or therapeutic indications at Glasgow Royal Infirmary are reviewed. Clinical presentation included haematoma formation, development of an acutely ischaemic limb or a false aneurysm. Patients with valvular heart disease are identified as a high risk group. Nine cases were managed by simple suture of the puncture site whereas thrombectomy and vein patch closure was required in 12 patients. The incidence of late complications requiring vascular reconstruction was 9%. The early recognition of complications after arterial catheterization and prompt referral to a specialized vascular unit is essential if morbidity is to be avoided. PMID- 2780469 TI - Occupational medicine as a specialty. AB - Occupational medicine is one of the more recently accepted specialties and is best defined by the social context in which it is practiced. The current structure of the specialty is more easily understood in the light of its historical background. Occupational medicine brings together knowledge from a wide spectrum of disciplines which is reflected in its academic and research bases. A great variety of activities and environments are covered and this has posed problems in defining and organizing higher specialist training. Occupational considerations impact on almost every aspect of medical practice and there is a need for wider understanding of occupational medicine principles in the profession as a whole both in this country and abroad. PMID- 2780470 TI - Pseudotumour of the scapula. PMID- 2780471 TI - Psychosis in mycoplasma infection. AB - This report describes a patient with psychosis due to a Mycoplasma pneumoniae infection. Although he received specific treatment for this infection, the diagnosis was only confirmed after clinical recovery. The neuropsychiatric complications of mycoplasma infection are discussed. PMID- 2780472 TI - Transvenous pacemaker electrodes placed unintentionally in the left ventricle: three cases. AB - Three patients are described in whom pacemaker electrodes were unintentionally placed within the left ventricle, followed by considerable delay before the error was recognized. In two cases temporary pacemaker wires were inserted into the subclavian artery and passed along a retrograde course. One patient required urgent surgery for acute arterial obstruction on removal of the wire. In the third case, a permanent wire was inserted correctly into a vein but traversed the atrial septum, probably via a patent foramen ovale, to enter the left ventricle. Twelve lead electrocardiograms in all three patients showed paced complexes with right bundle branch block configuration. This appearance should raise suspicion that the pacemaker electrode might be in the left ventricle, in which case its position should be defined by chest radiographs (including a lateral view) and echocardiography. PMID- 2780473 TI - Effect of narasin and roxarsone combinations on Eimeria tenella infections in floor pen-raised broilers. AB - A series of four floor pen trials was conducted to evaluate the effects of narasin and roxarsone, both alone and in combination, on their capacity to control severe Eimeria tenella infections in broilers. Three levels of narasin (0, 60, and 80 ppm) were fed to chickens receiving either 0, 25, or 50 ppm roxarsone in a factorial design. Cecal coccidiosis was induced by seeding the litter with ionophore-tolerant and ionophore-sensitive strains of E. tenella. After 8 days, 10 birds/pen were killed and their cecal lesions scored. Performance (body weight and feed consumption) and mortality were measured at the termination of the trials. Narasin reduced the severity of cecal coccidiosis as measured by a reduction in cecal lesions and an improvement in bird performance. Roxarsone also reduced cecal lesion scores. The highest level of roxarsone (50 ppm) in combination with 60 or 80 ppm narasin produced additive responses in the control of E. tenella infections. Maximum performance was obtained when narasin alone was fed at 80 ppm; drug combinations improved performance when compared with that of nontreated or roxarsone only-medicated groups. PMID- 2780474 TI - Three congenital anomalies of domestic fowl. AB - Of 35,000 necropsies performed on domestic poultry, three cases of anomalies were recorded. The anomalies observed were duplicate polydactyly, accessory hepatic lobe, and reduplication of caeca. PMID- 2780476 TI - Photoperiodic effects on performance and leg abnormalities in broiler chickens. AB - Three experiments were conducted to examine the impact of changing photoperiod length on the performance of chicken broilers. Effect of long, constant (23-h) photoperiod length (23H) was compared with treatments where photoperiod increased from 6 to 23 h abruptly after 21 days (6H) or gradually during the experiment (INC). The 6H program was used in all three experiments, whereas the INC treatment was included only in Experiment 3. Differences between total body weight gains of birds in the 6H and 23H treatments were inconsistent and small in the three experiments. In Experiment 3, there were no differences between total body weight gains for INC, 6H, and 23H treatments. Feed-to-gain ratios for 6H broilers were significantly superior to those for birds on the 23H treatment for Days 0 to 21 (all experiments), Days 21 to 42 and Days 0 to 42 (Experiment 2), and inferior for Days 21 to 42 (Experiment 3). The INC treatment was significantly superior to the 23H program for all time periods and to 6H birds for Days 21 to 42 and Days 0 to 42. The 6H treatment significantly reduced the incidence of leg abnormalities in comparison with the 23H program in all experiments; the INC and 6H treatments were equal in incidence in Experiment 3. When data from the three experiments were combined, mortality due to sudden death syndrome and other causes for the 6H treatment was significantly lower than that of the 23H program; values for the 6H and INC treatments were not different in Experiment 3.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2780475 TI - Influence of ochratoxin A and T-2 toxin singly and in combination on broiler chickens. AB - Effects of feeding diets containing ochratoxin A (OA) at 2.0 mg/kg and T-2 toxin at 4.0 mg/kg singly and in combination were characterized in male broiler chicks from 1 day to 3 wk of age. Body weights were depressed by feeding OA singly, T-2 singly, and the OA/T-2 combination. The efficiency of feed utilization was reduced in the OA and OA/T-2 combination-fed groups. The T-2 toxin caused oral lesions, anemia, and changes in some serum biochemical values. Feeding OA resulted in increases in relative liver, kidney, gizzard, and pancreas weights, a microcytic hypochromic anemia, and changed serum chemistries. The OA/T-2 combination caused increases in relative liver, kidney, proventriculus, and gizzard weights and variable serum biochemistries. The effects of OA and T-2 were additive for reduced body weight gains, mean corpuscular volume, and for reduced serum levels of total protein, and for reduced lactate dehydrogenase activity. A significant interaction occurred between OA and T-2 causing elevated serum triglyceride levels and decreased gamma glutamyl transferase activity and calcium levels. Degenerative renal tubular changes were observed in some OA and OA/T-2 combination-fed chicks. These data indicate that OA and T-2 in combination may be more toxic for some parameters than the individual mycotoxins, and may pose a greater problem for the poultry industry than either of the mycotoxins individually. PMID- 2780477 TI - Relationship between plasma corticosterone levels and poult mortality and the effects of feeding corticosterone on poult performance. AB - The study examined the relationship between plasma corticosterone (CS) levels and early mortality in Large White tom turkey poults. Trial 1 was conducted to compare the plasma CS levels of 3-day-old poults that subsequently lived or died during the first 2 wk posthatch. Blood samples were obtained from 100 poults at 3 days of age. By 2 wk of age 9% mortality had occurred. Plasma CS of poults that lived (7.1 ng/mL) was significantly greater (P less than .05) than in poults that died (3.2 ng/mL) between 3 and 14 days of age. A second trial was conducted to test the effects of feed-induced elevation of plasma CS on poult performance under stressful conditions. This trial consisted of three treatment groups: 1) control (C), poults placed immediately after removal from the hatcher with feed and water; 2) control-held (CH), poults held without feed and water at 28.9 C for 3 days posthatch; and 3) 40 mg CS/kg feed-held (40H), poults held without feed and water at 28.9 C for 3 days posthatch then fed 40 mg CS/kg feed. Mortality was monitored daily and body weights, feed consumption, and plasma CS levels were measured at 1 and 2 wk of age. The only performance parameter that was significantly affected was body weight; a significant reduction occurred at 2 wk of age in poults given the 40H treatment. It was concluded that poult death is associated with low plasma CS levels, but diet-induced increases in plasma CS did not significantly improve livability following a stressful condition. PMID- 2780478 TI - Dietary protein level and essential amino acid content: influence upon female broiler performance during the grower period. AB - Three experiments were conducted to determine effects of dietary CP level and essential amino acid (EAA) content upon female broiler performance during the grower period (21 to 42 days). In each experiment, the design included a diet containing a conventional CP level (17.8 to 19.0%) and a low CP diet (15.9 to 16.7%) supplemented with several EAA. Regardless of CP content, all diets were formulated to meet National Research Council requirements in 1984 of EAA and to be isocaloric. As additional treatments, modifications of the low CP diet were made in an attempt to improve broiler performance. In Experiments 1 and 2, body weight gain (BWG) and feed efficiency (FE) were significantly impaired by feeding the low CP diet despite various combinations of increased levels of methionine, lysine, arginine, threonine, isoleucine, and tryptophan. In Experiment 3, BWG and FE were not significantly influenced by dietary CP level. Feed intake was unaffected by treatment except when a high level of glutamic acid (GLU) was added; this lowered the intake. The low CP diets increased abdominal fat deposition, which was prevented by 5% GLU supplementation. Breast yield was not affected by diet composition. Plasma free amino acids responded, in some cases, to changes in dietary EAA content. PMID- 2780479 TI - Response of White Leghorn hens to various dietary levels of Cassia obtusifolia and nutrient fortification as a means of alleviating depressed performance. AB - Two 28-day experiments with White Leghorn hens were conducted to determine the adverse effect level of ground Cassia obtusifolia seed (coffeeweed) in the diet and to examine the nutrient fortification required to improve depressed performance due to the presence of the seed. In both experiments, five individually caged hens were used for each of the four treatment replications. Treatments for Experiment 1 consisted of a control and six diets with ground C. obtusifolia seed substituted for a filler at levels of 2, 3, 4, 5, 6, and 7%. In Experiment 2, a series of nutritionally fortified (15 to 20% higher nutrient levels) and unfortified diets coupled with seed levels of 0, 4, 6, and 8% for a total of eight treatments was used. Average daily feed intake, hen-day egg production, egg weight, egg specific gravity, and body weight change were determined during each experiment. For Experiment 1, average daily feed consumption was measured every 24 h for the first 3 days. Egg production and feed consumption were significantly reduced by 2% seed in Experiment 1. Within the first 24 h, feed intake was decreased to 37% below that of controls by increasing to the highest seed level. Egg specific gravity dropped significantly below that of controls when hens were fed 5% seed. In Experiment 2, fortification improved feed consumption, hen-day egg production, body weight change, and egg specific gravity over that of birds fed unfortified diets with the same seed level. Finished diets contaminated with 2%, or more, C. obtusifolia seed can cause reduced performance in laying hens, but nutritionally fortifying these diets can help to alleviate depressed performance. PMID- 2780481 TI - Symposium: The control of food intake in poultry. PMID- 2780480 TI - Severe feed restriction in pullets during the early growing period: performance and relationships among age, body weight, and egg weight at the onset of production. AB - The performance of egg type (Leghorn x Rhode Island Red) chickens that were feed restricted during the prelaying period was studied in two trials, each conducted with 300 hens. In Trial 1, treatments included 1) an ad libitum-fed control; 2) restriction for close to zero growth between 7 and 28 days of age; 3) the same restriction as (2) but continued by restriction of 50% growth up to 70 days; 4) restriction between 7 and 70 days for 50% growth; and 5) restriction for 50% growth between 7 and 98 days. In Trial 2, birds were restricted severely (close to zero growth) from 7 to 28 days of age, followed by restriction of 50% growth up to 28, 56, 84, and 112 days of age, respectively. In all cases, feed restriction resulted in a delay in the onset of egg production, leading to some increases in egg weight. Egg production rate and cumulative production were not affected, in most cases, by early feed restriction. The BW at the onset and after 20 mo of production was reduced when feed restriction was continued beyond the age of 84 days. Overall feed conversion (grams feed per egg) and feed efficiency (grams feed per gram egg mass) were not affected significantly by feed restriction, although feed efficiency (grams gain per gram feed) was improved during the prelaying period. Within each treatment, BW was positively correlated with age at onset of egg production. Egg weight was a function of both age and BW at the onset of production. The significant correlation between egg weight and BW was maintained even after a year of production. PMID- 2780482 TI - Symposium: Embryonic development: elucidation through biotechnology. PMID- 2780483 TI - Effects of ferrous sulfate consumption on the performance of broiler chicks. AB - Ferrous sulfate is often used as a litter treatment to control ammonia. A series of experiments was conducted to evaluate the effects of single high and multiple low doses of ferrous sulfate (FeSO4-7H2O) on broiler chicks. In Experiment 1, broiler chicks were administered a single oral dose of ferrous sulfate. A direct relationship between mortality and the amount of ferrous sulfate administered was evident. The lethal dose that caused 50% mortality (LD50) for ferrous sulfate was calculated to be 7,010 mg/kg of body weight. In Experiment 2, the addition of ferrous sulfate to the diet at levels from .75 to 12% decreased feed consumption. Ferrous sulfate levels of 3% or greater lowered average daily gain and gain:feed ratios. In a pair-wise comparison preference test in Experiment 3, chicks significantly decreased consumption of a diet containing 3% ferrous sulfate but not of a diet with .375% ferrous sulfate. The results of these experiments indicate that ferrous sulfate can have adverse effects on mortality, weight gain, and feed efficiency of broiler chicks. PMID- 2780484 TI - Bactericidal activity, eggshell conductance, and hatchability effects of ozone versus formaldehyde disinfection. AB - Ozone and formaldehyde were evaluated as disinfectants in a prototype laboratory setter against microorganisms that are naturally present on fertile, freshly laid, broiler hatching eggs. Significantly lower microbial counts of over 2.5 log10 (P less than .05) were observed for water-misted and ozonated (2.83% by weight) eggs or formaldehyde-fumigated (triple strength) eggs than for control and water-misted eggs. Eggshell conductance studies as measured by egg moisture losses in a desiccator showed no significant differences (P greater than .05) among untreated, water misted, ozonated (3.06% by weight) with water mist, or formaldehyde (triple strength)-fumigated eggs. Hatchability was significantly reduced (26.5 to 37.5%) following ozonation (3.03% ozone by weight, 2 h) in comparison with effects of no treatment or water misting. Misting with ozonation was equally as effective as formaldehyde fumigation in reducing microbial counts. However, ozone treatment at the concentrations tested significantly reduced hatchability when compared with results of either no treatment, water misting, or an average hatchability figure for formaldehyde fumigation. These findings indicate that ozone is a good disinfectant yet may adversely affect embryo development when given in the gaseous form. PMID- 2780485 TI - Effect of feed withdrawal on composition and quality of broiler meat. AB - The effect of feed withdrawal or total withdrawal (simultaneous feed and water withdrawal) on the composition and quality of broiler meat was evaluated. Feed or water or both were withdrawn 0, 6, 12, or 18 h before slaughter. A gradual and significant (P less than .05) increase in weight loss was seen as hours of withdrawal increased. Overall, birds subjected to feed withdrawal treatments experienced a 3.8% shrinkage; birds on total withdrawal treatments lost 4.4% in body weight. Percentage of water uptake during chilling increased gradually as feed withdrawal time increased. Birds on total withdrawal absorbed water in this fashion until 18 h of chilling, when there was a sharp and significant drop in water uptake. No significant differences were found among treatments for precook and cooked weights, cooking loss, total loss, proximate analysis, and shear. Withdrawal times for feed or feed and water did not influence the tenderness or flavor of breast or thigh meat. PMID- 2780486 TI - Effect of dietary protein, energy, and feed pelleting on the response of chicks to early feed restriction. AB - In three trials, male broiler chicks were subjected to a 6-day feed restriction regimen designed to retard growth severely. In one trial, the amino acid requirements during refeeding were evaluated by testing the adequacy of diets based on model calculations. In two additional trials, the response of feed restricted birds to increased dietary energy density and to feed pelleting was compared with that of birds fed ad libitum. Results of the first trial showed that weight gain and feed efficiency during the first 2 wk of refeeding were reduced when the diet contained less than the model-calculated protein level for this period. No improvement in performance could be obtained when dietary protein was increased by 1% above model-calculated requirements. An increase in dietary nutrient density resulted in an enhanced growth rate. Feed efficiency was improved by an increase in nutrient density and by early feed restriction with no significant feed restriction x diet density interactions. Pellet-feeding resulted in improved growth without affecting feed efficiency, whereas feed restriction resulted in improved feed efficiency only. Interaction between pelleting and feed restriction was not significant for any of the variables. In all three trials, abdominal fat was reduced by feed restriction without any interaction with energy, protein, or dietary form. The results suggest that the requirements for some amino acid increase after feed restriction and that feed consumption does not limit the accelerated growth response at that time. PMID- 2780487 TI - Effects of thyroidectomy on egg production, molt, and plasma thyroid hormone concentrations of turkey hens. AB - Turkey hens were thyroidectomized at different ages and phases of their reproductive cycles. Egg production, primary remige molting, and plasma thyroxine (T4) and triiodothyronine (T3) concentrations were monitored during each of three experiments. Thyroidectomy of hens (26 and 30 wk of age) prior to photoinduction of egg production prevented subsequent egg production and molting. Thyroidectomy of adult hens (36 wk of age) early in the egg production cycle caused a gradual termination of egg laying without the occurrence of molting. Thyroidectomy of mature hens (66 wk of age) during the light restriction period prior to their second egg production cycle prevented subsequent egg laying and molting. All successful thyroidectomies reduced plasma T4 and T3 to concentrations below the sensitivity levels of the assays. Feeding 1 ppm T4 to thyroidectomized hens resulted in resumption of normal egg production and molting. These results indicate that the thyroid is essential for the initiation and maintenance of egg production and for molting in turkey hens. PMID- 2780488 TI - Effect of subcutaneous infusion of pituitary-derived chicken growth hormone on growth performance of broiler pullets. AB - The effect of subcutaneous infusion of pituitary-derived chicken growth hormone (p-cGH) on plasma hormone/metabolite status and growth performance of young broiler pullets was investigated. Two-week-old pullets were surgically prepared and maintained via a fluid swivel/spring tether/harness system. Birds were subcutaneously infused 24 h a day for 21 days with 1.0 mL/day of either a p-cGH or vehicle (control) solution (20 micrograms/kg BW/day). Subcutaneous infusion of p-cGH had no significant effect on growth performance parameters in comparison with controls. Differences between levels of overall feed intake, net BW gain, feed efficiency, and carcass composition were not significant for treatments. However, dressing percentage was lower in p-cGH treated birds than in vehicle infused birds (P less than .04). Growth hormone treatment resulted in a modest degree of enlargement of the liver (P less than .06). However treatment had no effect upon wet weights of other measured organs or upon parameters of longitudinal bone growth, including length and mass of the tibiotarsus and width of the epiphyseal growth plate. Differences between treatment groups in preinfusion plasma concentration of GH, insulin, and glucose were not significant. Postinfusion plasma concentrations of GH were elevated over three fold by p-cGH treatment (P less than .0001), with no treatment differences in plasma insulin or glucose concentrations. This study indicated that a sustained, 24-h elevation in plasma GH concentration in response to a physiological dosage of exogenous p-cGH is ineffective in altering growth performance of young, rapidly growing meat type chickens. PMID- 2780489 TI - Effects of posthatch glucose on poults fed and fasted during yolk sac depletion. AB - The advantage of glucose administration after hatching was examined in terms of poult performance and body changes 3 days after administration. A .5-mL dose of 50% glucose in saline was either subcutaneously (sc) injected in the neck or intubated into the crop. Controls did not receive glucose nor were they handled. Controls and poults given glucose were divided into two groups and either brooded with feed and water or kept in transportation boxes and fasted. Poults that were fasted lost weight, and glucose treatments did not alter this loss; however, access to feed and water led to a gain in weight. Those poults given glucose had greater weight gains and feed consumption than controls. Liver, yolk sac, and carcass contained increased moisture in response to glucose when feed and water had been provided, whereas only the carcass expressed this change when the birds were fasted. Most changes to glucose were greater from sc than oral dosing, and neither egg weight of origin nor sex influenced the extent of poult response. PMID- 2780490 TI - Toe scratches cause scabby hip syndrome lesions. AB - Scabs and scratches in the hip region of chicken carcasses have become the single most common cause of downgrading and required trimming at processing in some areas of the United States. Repeatable correlations with microbiological agents, environment, and nutrition have not been observed. The present report provides evidence that scabs and scratches, present at processing, are the result of injuries inflicted by toenails of birds as they climb on one another. Onychectomy (removal of approximately two-thirds of the distal phalanx) of all four digits of each foot prior to chick placement resulted in 3.7 and 4.8-fold reduction in subjective lesion scores and 7 to 10-fold increases in the percentage of USDA Grade A carcasses at a commercial processing plant. PMID- 2780491 TI - Effect of low doses of gamma irradiation before incubation on hatchability and body weight of broiler chickens hatched under commercial conditions. AB - Three experiments were conducted to determine the effect of low doses of gamma irradiation before incubation on hatchability of eggs and body weight of chick at hatching. Commercial broiler parent stocks in their first laying year were used to supply hatching eggs. Five, four, and three independent trials of each dose were conducted at weekly intervals for a total of 10, 12, and 15 units for Experiments 1, 2, and 3, respectively. A unit was an incubation tray of 150 eggs each. Experiments 1 and 2 used eggs from Strain 1 of high (greater than 90%) or medium (80 to 84%) fertility. Eggs of medium fertility from Strain 2 were used in Experiment 3. About 22,000 settable eggs of the commercial broiler parent stocks were treated with doses of 0 to 1.2 Gray (Gy) of gamma irradiation before incubation with a medical 60Co-machine at a dose rate of about .12 Gy/min. In all three experiments there were no significant differences in hatchability of eggs and body weight of chick at hatching among treatments. PMID- 2780493 TI - A framework for planning public health nursing services to families. AB - We designed a model to assist public health nurses and nursing supervisory staff in planning, delivering, and evaluating their services to families. Specifically, the intent was to assist nurses to estimate the numbers and types of services required. The model includes a gradient of family health characteristics, an original delineation of nine basic public health nursing services, a coping index and scoring guidelines, and a methodology for integrating assessment of health needs and coping abilities. PMID- 2780494 TI - The nursing shortage: two sides of the equation. PMID- 2780492 TI - Effect of supplementary dietary phosphorus on the reproductive capacity and bone integrity of broiler breeder males fed a corn- soybean diet. AB - A 16-wk study was conducted to determine the effect of dietary phosphorus on the reproductive capacity and bone integrity of broiler breeder males (BBM). Forty five Arbor Acres BBM 32 wk of age were randomly divided into 3 treatments receiving either 0, .05 or .13% supplemental P. Each treatment had three replicates with five birds/replicate. Males were housed in individual cages. Birds were provided with 110 g feed/bird per day of corn-soybean meal diet containing approximately 12.4% CP and providing 3,260 kcal ME/kg. Birds were ejaculated weekly and their reproductive capacity evaluated by determining semen volume, sperm per ejaculate, intact sperm cells, and fertility and hatchability of fertile eggs. Bone integrity was evaluated by tibia bone ash at the end of the experiment. No significant treatment differences (P greater than .05) were observed among any criteria of semen quality, hatch of fertile eggs, bone integrity and body weight change. The results from this study indicate that BBM kept in cages, from 32 to 48 wk of age, can be maintained on a corn-soybean meal diet containing no supplemental P and with a daily intake of 300 mg total P/bird, without affecting their reproductive capacity and bone integrity. PMID- 2780495 TI - Year 2000 health objectives for the nation. AB - An historical account for the development of national health objectives is presented, followed by the current process of formulating year 2000 health objectives. Priority areas are included together with suggested strategies for involvement in the process of setting the objectives. PMID- 2780496 TI - Home health agency preferences for staff nurse qualifications, and practices in hiring and orientation. AB - The purpose of this study was to describe home health agency preferences with respect to staff nurse qualifications, and practices in hiring and orienting new staff. An 85-item home health staff nurse selection and orientation questionnaire was used to collect data from a random sample of 287 midwestern home health agencies in 12 states. Qualifications rated most highly were medical-surgical experience, venipuncture skills, completion of a physical assessment course, intravenous therapy skills, and patient-teaching skills. With agency sponsorship (traditional, proprietary, and hospital-based) as the independent variable, the three types of agencies were significantly different on ratings of six qualifications and six orientation topics. None of the agencies rated a BSN degree as very important or required, and the same was true for completion of a student experience in community health nursing. Preference for qualifications in this study is consistent with increasing acuteness of patients' illness and technologic complexity of home care. PMID- 2780497 TI - College students' knowledge about AIDS and attitudes toward condom use. AB - College students were surveyed to determine their knowledge about AIDS and attitudes toward condom use. Overall scores were high, with a mean of 22.5 on the 28-item true-false questionnaire. Of the 81 percent of respondents who indicated they were presently or had been sexually active, only 40 percent reported using condoms; 87 percent expressed an intention to have vaginal intercourse and 18 percent to have rectal intercourse. From the open-ended questions about condoms, 37 beliefs were elicited and the 10 most frequently mentioned were identified. The majority of subjects reported protection against sexually transmitted diseases and preventing pregnancy as the most important reasons for using condoms. Forty-seven percent also believed condoms important for preventing AIDS. Other significant beliefs about condom use included that they cause less worry, interfere with spontaneous sexual response, decrease pleasure for self and/or partner, are inconvenient and uncomfortable, and decrease feeling. The most significant referents for deciding about condom use were mothers in younger subjects and sexual partners for older subjects. These results indicate the need for influencing attitudes and normative beliefs to change condom use behavior. PMID- 2780498 TI - Cardiovascular risk assessment in school-age children: a school and community partnership in health promotion. AB - There is little doubt that the primary prevention of cardiovascular disease is a pediatric problem that nursing must address. Cardiovascular health-promotion activities for children have generally used an ecologic model, providing community-based education programs in the schools. The purpose of this study was to identify changes in cardiovascular risk among sixth-grade cohorts over eight years. Four variables known to be associated with such risk--weight (obesity), pulse rate recovery index, blood pressure, and total cholesterol level--were measured on 4900 students, and changes in their prevalence were analyzed. The data presented in this paper were compiled from a screening program conducted by a local health department in partnership with a school district's health education program. Although the school-based health-education program has been in existence for eight years, the prevalence of cardiovascular risk in sixth-grade students has not declined, suggesting the need for nurses to target the children at risk, and address more directly the motivational and affective domains in addition to cognitively focused programs. PMID- 2780499 TI - Home visiting and prenatal care: a survey of practical wisdom. AB - Public health nurses and other professional and paraprofessional workers have engaged in prenatal home visiting for many decades. Yet, the extent to which this and other prenatal interventions influence maternal behavior is largely unknown. This study was undertaken to collect and categorize perceptions of experts in the organization and delivery of prenatal care about the value of selected strategies for encouraging participation in care, for education, and for changing behavior, with special emphasis on home visiting. The survey sample consisted of 151 experts who were identified by directors of maternal and child health programs in 48 of the 50 states. One hundred eighteen of the experts, almost half of whom were nurses, responded to the survey. The findings suggest important discrepancies between respondents' perceptions about the effectiveness of some prenatal strategies and the actual extent of their use in practice. In addition, the results raise questions about the appropriate mix of type of home visitor and purpose of visit. These questions should form the basis for subsequent investigations. PMID- 2780500 TI - Evaluating nursing productivity in child health. AB - As nurses are increasingly concerned with assessing and improving their productivity in a variety of settings, they must make systematic use of an evaluation model. The Discrepancy Evaluation Model (DEM) was used to evaluate the productivity of nurses in child health clinics in five centers in the southeastern United States. The first step in any evaluation is to identify standards against which performance can be measured. In this project, no standards were available, and creating them was the first task. Standards for productivity in child health were developed that accounted for differences in clients and the experience level of nurses, while maintaining quality of care. They were situation specific and allowed for the constraints operating in each of the five centers. Discrepancies between the standards and observed performance were identified and underlying factors examined, resulting in a number of recommendations that could streamline the provision of services and improve nursing productivity. The evaluation process can be applied to public health nursing services in a variety of settings. PMID- 2780501 TI - The homeless experience: clinic building in a community health discovery-learning project. AB - The concept of discovery learning is exemplified in this account of four students and their instructor who began and developed a nurse-run clinic for the homeless in a community health project. The students were registered nurses returning for their bachelor's degrees. They experienced frustration at learning the difference between care based on their assessments of patients' needs and care geared to clients' assessments of desired interventions. The journals that they kept reveal self-discovery as well as new respect for other humans. In addition, a new type of community care emerged, which gives all indications of surviving. PMID- 2780502 TI - Fourth annual meeting and exposition. American Association of Pharmaceutical Scientists. October 22-26, 1989, Atlanta, Georgia. Abstracts. PMID- 2780503 TI - Brain, kidney and liver 203Hg-methyl mercury uptake in the rat: relationship to the neutral amino acid carrier. AB - To investigate the effect of L-neutral amino acids on tissue levels of methyl mercury in the adult animal, rats were infused into the external jugular vein with solutions containing a) 0.05 mM 203Hg-MeHgCl and saline, b) 0.05 mM 203Hg MgHgCl-0.1 mM L-cysteine, c) 0.05 mM 203Hg-MeHgCl-0.1 mM L-cysteine-0.1 mM L cysteine-0.1 mM L-methionine, d) 0.05 mM 203Hg-MeHgCl-0.1 mM L-leucine, or e) 0.05 mM 203Hg-MeHgCl-0.1 mM L-cysteine-0.1 mM L-leucine, Groups of animals were sacrificed at 3 min. 7 hr, and 96 hr. Brain, kidney, and liver 203Hg radioactivity was measured by means of gamma-scintillation spectrometry. Brain 203Hg concentrations L-cysteine treated animals were significantly higher compared with saline treated animals (P less than 0.05) at 3 min., 7 hr and 96 hr. The coinjection or coinfusion of methyl mercury with L-cysteine and L methionine abolished the L-cysteine-mediated brain 203Hg uptake (P less than 0.05), at each sacrifice time. Kidney and liver 203Hg concentrations were not significantly different in any of the treatment groups compared with controls, irrespective of the sacrifice time. Furthermore, the percentage of diffusible 203Hg (non-protein bound) at each sacrifice time was not statistically different irrespective of the treatment assigned. These results suggest that methyl mercury L-cysteine conjugates in the plasma may share a common transport step with the L neutral amino acid carrier transport system and indicate the presence in brain capillaries of a transport system capable of selectively mediating methyl mercury uptake across the capillary endothelial cell membrane. PMID- 2780504 TI - Chemical structure and toxicity of diuretics in isolated hepatocytes. AB - The effects of several diuretics, including tienilic acid and indacrinone, on isolated rat heaptocytes were examined. Addition of tienilic acid and indacrinone at 1 mM to a suspension of freshly isolated cells caused dose-dependent loss of cell viability as judged by the LDH-latency test. Survey of 19 structurally related compounds revealed that the extent of cell injury and chemical structure were correlated, and an intense adverse effect was attributed to the 2 thienylcarbonyl moiety. Several other factors influencing cell viability are also disclosed. Further study revealed that tienilic acid and indacrinone were toxic to the primary culture of hepatocytes at a lower dose than that a freshly isolated hepatocytes. Thus, an isolated hepatocyte system can be used to select compounds displaying low hepatotoxicity, as for example is needed when screening diuretics. PMID- 2780505 TI - Effects of alaproclate, potassium channel blockers, and lidocaine on the release of 3H-acetylcholine from the guinea-pig ileum myenteric plexus. AB - The guinea-pig ileum longitudinal muscle-myenteric plexus preparation, preincubated with 3H-choline or 3H-noradrenaline, was mounted in an organ bath and superfused with Tyrode's solution. Alaproclate (2-(4-chlorophenyl)-1,1 dimethyl 2-aminopropanoate) (0.01-0.5 mmol/l) reduced (IC50 = 0.1 mmol/l) and at about 0.5 mmol/l completely blocked the electrically evoked 3H-acetylcholine secretion. The depressing effect of alaproclate (0.2 mmol/l) was not counteracted by atropine (0.01, 1 or 10 mumol/l), hexamethonium (0.1 mmol/l), phentolamine (1 mumol/l) yohimbine (1 mumol/l), haloperidol (1 mumol/l), 8-phenyltheophylline (10 mumol/l), cyproheptadine (1 mumol/l), metitepine (1 mumol/l), bicuculline (10 mumol/l), picrotoxinin (0.1 mmol/l), forskolin (25 mumol/l), 3-isobutyl-1 methylxanthine (5 mmol/l), nifedipine (1 mumol/l), verapamil (1 mumol/l), dilitiazem (1 mumol/l), high calcium (6 mmol/l), high potassium (10 or 15 mmol/l), tetraethylammonium (2 mmol/l), 4-aminopyridine (0.5 mmol/l), apamin (0.5 mumol/l), barium (0.5 mmol/l) or quinine (0.1 mmol/l). Among the potassium channel blockers tested only quinine (at 0.5 or 1 mmol/l), in the same manner as lidocaine, reduced the evoked secretion of 3H-acetylcholine. The results are in agreement with the hypothesis that the effect of alaproclate on the evoked 3H acetylcholine secretion is not mediated by a neurotransmitter receptor, or a potassium channel sensitive to tetraethylammonium, 4-aminopyridine, apamin, or barium or quinine, but is due to a local anaesthetic effect. In contrast to the evoked secretion, the spontaneous release of 3H-acetylcholine was enhanced by high concentrations of alaproclate (0.4-1 mmol/l). The mechanism underlying the effect of alaproclate on the spontaneous release remains to be established. Alaproclate (0.25 or 0.5 mmol/l) also enhanced the spontaneous release and reduced the electrically evoked 3H-noradrenaline secretion. PMID- 2780506 TI - Glucuronidation of amitriptyline in man in vivo. AB - The urinary excretion of amitriptyline (AT) as N-glucuronide was studied in healthy volunteers after single oral doses of AT and in patients on continuous treatment with AT. In the volunteers, 8 +/- 3% of a 25 mg dose of AT was recovered in urine as glucuronide during 108 hr. No difference between slow and rapid debrisoquine hydroxylators with respect to the excretion of AT glucuronide was seen. 0.08 to 1.68% of the given AT dose was recovered in urine in unchanged form. The excretion of unchanged AT correlated with the debrisoquine metabolic ratio (rs = 0.61; p less than 0.01). In 5 patients on continuous treatment with AT (125-150 mg/day), 8 +/- 5% of the daily dose was recovered in 24-hr urine as AT glucuronide. The present study shows that direct glucuronidation is a minor metabolic pathway of AT in man in vivo both after single low doses and during continuous treatment with therapeutic doses. PMID- 2780508 TI - Deuterium isotope effects on ethanol oxidation in perfused rat liver and in rats and rabbits in vivo: application to determine the contribution of various pathways. AB - The kinetic deuterium isotope effect, D(V/K), on ethanol oxidation was measured by the radiometric, competitive method using 14C-labelled ethanol containing deuterium in the (1-R) position. Acetate was isolated and used for the determination. Experiments were performed on rats either anaesthetized and laparotomized, or provided with indwelling catheters in a. carotis, v. cava and v. portae. Experiments were also made on perfused liver from rats pretreated with acetone, or a mixture of acetone and phenobarbital. Finally, intact non anaesthetized rabbits were used. The apparent isotope effect in all in vivo experiments decreased rapidly in the presence of acetaldehyde as a consequence of the reversibility of the ADH reaction. In the case of rabbits and catheterized rats this problem was tackled by taking blood samples in quick succession, thus permitting extrapolation of the apparent isotope effect to the time of injection of the labelled ethanol. In anaesthetized rats injection of the ADH inhibitor isobutyramide was used to reduce the concentration of acetaldehyde and thereby the rate of decline of the apparent isotope effect. At high doses of isobutyramide the isotope effect was constant with time at about 1.9 suggesting the presence of non-ADH activity. In all three kinds of in vivo experiments the isotope effect ranged from 2.66 to 2.93. In the case of anaesthetized rats the mean value was 2.89 +/- 0.05 (S.D.). This figure is significantly different from that of rat liver ADH, P less than 0.001. As the figures for the initial isotope effects are minimum values the contribution of non-ADH ethanol oxidizing systems is likely to be small, probably less than 10 percent. PMID- 2780507 TI - Comparative study of demethoxydaunorubicin with other anthracyclines on generation of oxygen radicals and clonogenic survival of fibroblasts. AB - Demethoxydaunorubicin was compared to other anthracyclines (daunorubicin, doxorubicin, epirubicin) on its ability to generate free oxygen radicals when mixed with Fe2+ in solution and on its ability to reduce clonogenic survival of fibroblasts in culture. Oxygen electrode measurements of free radical generation showed that most of the consumed oxygen entered the monovalet oxygen reduction pathway. Catalase and superoxide dismutase additions inhibited oxygen consumption for all tested anthracyclines and diethylenetriaminepentacetic acid (DTPA) was also inhibitory except for demethoxydaunorubicin. Demethoxydaunorubicin and epirubicin dose-dependently reduced the clonogenic survival of fibroblasts. Addition of catalase or superoxide dismutase was without effect, whereas metal chelators DPTA, desferrioxamine and EDTA all protected against epirubicin-induced toxicity. Of the chelators, only desferrioxamine protected against demethoxydaunorubicin toxicity. Tests in vivo will further elucidate whether demethoxydaunorubicin also differs from the other anthracyclines in therapeutic effect as well as in side effects such as myocardial toxicity. PMID- 2780509 TI - Protective effect of anethol dithiolthione against acetaminophen hepatotoxicity in mice. AB - Anethol dithiolthione (ADT), usually prescribed as a choleretic drug, when given orally 1 hour prior to acetaminophen (AAP) (450 mg/kg intraperitoneally) in Swiss female mice, exhibited an hepatoprotective potency at doses as low as 10 mg/kg relative to serum aminotransferase activities and hepatic glutathione related enzyme system (glutathione reductase, peroxidase, transferase). These preliminary results are relevant with the use of pharmacologic dosage of ADT in hepatotoxicity prevention. PMID- 2780511 TI - Uptake and release of 3H-benzo(a)pyrene by arterial cells in vivo and in vitro. PMID- 2780510 TI - Effect of cadmium on lipid peroxidation and antioxidant enzymes in undernourished weanling rat brain. AB - The effect of early postnatal cadmium exposure on lipid peroxidation and antioxidant enzymes in undernourished weanling rat brain has been studied. The results suggest that undernutrition makes the weanling rat brain more susceptible to the neurotoxic effects of cadmium. Cadmium at a low dose of 1 mg/kg body weight did not produce any changes in lipid peroxidation and antioxidant enzymes in normal weanling rat brain, but caused a significant increase in lipid peroxidation and markedly decreased the activities of antioxidant enzymes like glutathione peroxidase, superoxide dismutase and catalase when subjected to undernutrition. PMID- 2780512 TI - Attenuation of water intake and operant responding by dopamine D2 antagonists: raclopride provides important cues for understanding the functional mechanism of action. AB - The selective dopamine (DA) D2 receptor antagonist raclopride was found to attenuate operant lever-pressing with water as reward in a dose dependent manner and more potently than the corresponding consummatory act, i.e. the unconditioned water intake. This is the same way as previously reported for other DA D2 antagonists. In screening experiments raclopride has been selected on the basis of great separation between antagonism of DA-agonist induced hyperactivity, stereotypies and production of catalepsy. We found that attenuation of lever pressing and water intake by raclopride were not more separated in dose than after, for example, haloperidol. We further found that attenuation of lever pressing and water intake occurred in doses relatively lower than those producing catalepsy, thus excluding catalepsy as a cause for the attenuation. Decreased water intake in thirsty animals caused by a low dose of apomorphine (APO) was counteracted by raclopride. This has previously been found with DA D2, but not with D1, antagonists, which further supports that this apomorphine-effect is mediated via D2 receptors. However, raclopride only showed this antagonism in a narrow dose-range, like haloperidol. The selective profile previously found for sulpiride, proposed to be related to low incidence of extrapyramidal side-effects in the clinic, was thus not replicated. PMID- 2780513 TI - Guard assists medical outreach mission to La Rosa, Honduras. PMID- 2780514 TI - Human chorionic somatomammotropin gene expression in primary placental cell cultures. AB - Mono-nucleated cytotrophoblasts (cytoTBs) were prepared by Percoll gradient fractionation of enzymically disaggregated human placental tissue. These cells were plated in monolayer culture in the presence of fetal calf and calf serum. Within 2-24 h, the cytoTBs aggregate, and by 48 h, they are clearly fused into multinucleated syncytia. The presence of human chorionic somatomammotropin (hCS) and chorionic gonadotropin (hCG) in the cells after 48 h was determined by immunohistochemistry. To assess whether hCS is synthesized in our cultures we examined hCS mRNA accumulation with time. The presence of hCS mRNA was detected at the time of plating but full length transcripts were seen only at later times indicating synthesis in culture. However, preparations at the time of plating contain fragments of syncytiotrophoblast (syncytioTB) generated by enzymic or mechanical disaggregation. These fragments could fuse with the cytoTBs. The inclusion of these fragments makes analysis of placental hormones by protein detection an unreliable assay for synthesis. Analysis of mRNA levels support hCS synthesis in culture and correlates with aggregation and fusion of cytoTBs. Thus, the fused cells in culture mimic the cellular site of hCS synthesis in vivo, the syncytioTB. PMID- 2780515 TI - Human embryonal extracts modulate placental function in the first trimester: effects of visceral tissues upon chorionic gonadotropin and progesterone secretion. AB - We investigated the effect of human first trimester fetal visceral organ extracts upon placental function, as evidenced by secretion of human chorionic gonadotropin and progesterone in explant cultures of 7-10 weeks gestational age trophoblast. Certain alcohol/water or water extracted embryonal tissues, in highly diluted solutions (1:100-1:2,000 final) had significant effects upon secretion of both hormones. The alcohol/water extract produced an opposite effect. This inhibitory effect was also seen when pulses of the water extract were added to the superfused trophoblast. Both heat inactivation at 57 degrees C and treatment with 10 microM p-chloromercurobenzoate eliminated the inhibitory effect, which suggests that the compounds in question are proteinaceous. Also dialysis with exclusion of less than 8,000 daltons abolished the inhibitory effect seen with the untreated water extract. The alcohol/water lung extract at 9 weeks inhibited, while at 10 weeks it stimulated P4 secretion. The water extracted lung had no effect upon P4 secretion. The alcohol/water extract of kidney had no consistent effect upon hCG secretion. The water extract effect was inhibitory. The effect of alcohol/water extract at 9 weeks upon P4 secretion was inhibitory while at 11 weeks it was stimulatory. The water extract had no effect upon P4 secretion. Both alcohol/water and water extracted adrenal inhibited hCG secretion. The alcohol/water extract also increased P4 secretion, while the water extract had no effect. The alcohol/water and water extract liver had no effect upon hCG secretion. The effect of alcohol/water upon P4 secretion was markedly stimulatory, while the water extract had no effect. In conclusion, fetal visceral organs in very dilute concentrations have a significant effect upon placental hormonal secretion in vitro. In case of the lung, the active compound(s) appears to be a protein with a molecular weight of less than 8,000 daltons. The role of the human embryo in modulating early trophoblastic function is suggested. PMID- 2780516 TI - Localization of mRNA for the oncotrophoblastic protein oncomodulin during implantation and early placentation in the rat. AB - The mRNA for the oncodevelopmental calcium-binding protein oncomodulin (MW 11,700) has been detected in tissues of the rat conceptus by in situ hybridization using biotinylated RNA probes. Oncomodulin mRNA was detected in the basal zone and labyrinth of rat placenta, following a similar distribution to that shown for oncomodulin by immunohistochemistry. Oncomodulin mRNA was also detected in rat ectoplacental cone at ten days and in amnion and PYS, but not VYS from 11 days onward. Previously oncomodulin was not detected embryonically from day 14 to birth, but in the present study of oncomodulin mRNA and protein, both were detected in implantation stages from blastula through egg cylinder. Staining was also present on decidual tissue. The suggestion is made that the oncomodulin gene is initially active in all cell types, but later its activity is confined to extraembryonic tissues. PMID- 2780517 TI - Isolation of human extravillous trophoblast cells by attachment to laminin-coated magnetic beads. AB - An isolation method has been developed based on laminin-coated magnetic beads which yields human trophoblast with a high degree of purity. Immunostaining with a panel of monoclonal antibodies indicates that these trophoblast cells are mainly of the extravillous variety. The mechanism for selection may be due to the expression of surface laminin receptors by these cells. This procedure, therefore, can provide appropriate cellular targets for in vitro assays against potential uterine effectors in studies on the local trophoblast-decidual interaction. PMID- 2780518 TI - Placental vanadium in gestational diabetes mellitus. AB - Although many studies in animal models and in cell cultures have shown that vanadate has insulin-like effects, it has not been studied in human diabetes mellitus. In this study the levels of vanadium in human placentae from 23 pregnancies complicated by gestational diabetes mellitus were compared with 18 uncomplicated non-diabetic pregnancies closely matched for maternal age, gravidity, and gestational age. Using the unpaired Student's t-test, the mid-disc placental levels in gestational diabetes (7.62 +/- 1.29 micrograms/g dry weight) were significantly lower (p less than 0.05) than controls (8.73 +/- 1.85 micrograms/g dry weight). These findings appear to be independent of placental size and birthweight. When these data were analyzed according to treatment, the vanadium levels in insulin-treated cases (8.07 +/- 1.32 micrograms/g dry weight) were not significantly different from the matched controls (8.84 +/- 1.69 micrograms/dry weight); the levels in noninsulin treated cases (7.08 +/- 1.25 micrograms/g dry weight), however, were significantly (p less than 0.005) lower than controls (8.99 +/- 1.96 micrograms/g dry weight). It is interesting to speculate that there may be increased binding of vanadium to maternal tissues in human diabetes mellitus when insulin is deficient. PMID- 2780519 TI - Study of the permeability of the intact guinea pig placenta to hydrophilic molecules. PMID- 2780520 TI - Abstracts of papers, 3rd meeting of the European Placenta Group. Dourdan, France, 27-30 September 1989. PMID- 2780521 TI - [Proceedings of the 2d Symposium on Oscillatory Measurement of Airway Resistance. Munich, 4-5 December 1988]. PMID- 2780522 TI - [The mechanics of forced oscillation--principles and use]. AB - The technique of forced oscillation is a basic method of investigation of electrical and mechanical systems. Various modifications may be used in the field of respiratory physiology and pathology. When applying the oscillations at the mouth, we will measure respiratory input impedance; when applying the oscillations at total body surface, we will measure respiratory transfer impedance. Combining both methods one can calculate airway impedance and tissue impedance separately. Despite of the large number of studies which have already been carried out, I am convinced that the potential of the method is not yet exhausted. PMID- 2780523 TI - [To what extent are oscillometric data of a simple resistor-volume model physically recordable?]. AB - To obtain data on the volume-dependence of the oscillatory parameters of the Siregnost FD 5, we investigated the course of iso-volume and iso-resistance lines in a simple mechanical resistor-volume model in the different coordinate systems, initially in the absence of additional superimposed stationary flow. While the P psi diagram reveals no uniform course, and no preferential relationship of changes in resistance to P or Ros, or of changes in volume to psi, such a relationship develops on transformation to the Rre-phi and the Rre-X diagram. Rre proves to contain not only the purely resistor component, but also a reactance proportional or inversely volume-proportional component, which is apparently due to internal friction resulting from volume compression. On the other hand, reactance is almost totally derivable from volume compression. With reference to the theoretical Franken model and others (1981), we discussed the influence of various physical factors on the impedance of a tube segment, and the different volume-dependence of impedance of closed- and open-ended cylindrical tubes. Further work on the theoretical consideration of the forced oscillation technique will examine the influence of additional superimposed stationary flow, which has a considerable effect on the resistor-volume model. Furthermore, the critical value of Reynold's number may be expected to be exceed in the FD 5 reference tube already at low respiratory flow. PMID- 2780524 TI - [Optimizing monofrequent oscillometry]. AB - Against the background of the working hypothesis of the 1-parametric Siregnost FD 5 forced oscillation technique-phase angle psi may be invariant in a clinical reference population-the hypothetical straight Ros-P line is in good agreement with the crowd of extremely nonlinear Rre-P-lines only within narrow limits. Neglecting phase angle measurements it might be useful to insert a known linear resistor into the airway to determine the pertaining Rre-P relation. In spite of selective tuning to the oscillation frequency of 10 Hz there is full sensitivity to stationary flow; alinear stationary flow characteristics of resistors can be readily determined by forced oscillation. There is a marked improvement in the P psi/Rre-phi-evaluating system with respect both to the symmetry of phase angle and unequivocality of pressure when the reference phase angle alpha is shifted from 81 degrees to 0 degrees. Using digital data acquisition and processing, a flexible evaluation technique with monitor-oriented test management, automatical calculation of secondary values and multidimensional presentation of results on a graphical display is provided, which has proved its worth in experimental and clinical-physiological studies. PMID- 2780525 TI - [Theoretical and experimental studies of the diagnostic relevance and comparability of mechanical oscillation parameters]. AB - The practical application of the forced oscillation technique for the analysis of the mechanics of respiration is hampered by the fact that the measured frequency dependent impedance values R(f) and X(f) cannot be related directly to the parameters airway resistance Raw and pulmonary compliance CL. Furthermore, various derived oscillatory parameters are employed which are not directly comparable even with one another. In order to be able to estimate the diagnostic relevance and comparability of the impedance curves R(f) and X(f), their form specific characteristics R = R(5)-R(20) and X(5), as also the equipment-specific parameters Ros (Siregnost FD5) and Rfo (custo vit), the relationships of these oscillatory parameters to Raw and CL were simulated in a structural model of the respiratory system, and tested in the real system. It was shown that already from frequencies of f greater than 10Hz upwards, R(f) no longer reacts to an increase in resistance in the peripheral region of the lung, and at 20 Hz indicates only the upper airway component of a global obstruction demonstrated body plethysmographically with Raw. The diagnostic information on peripheral airway obstruction is contained in both components R(f) and X(f) of the respiratory impedance; with increasing obstruction and increasing frequency, it progressively reverts to the X(f) curve. Therefore, by including X(f) in the resistance evaluation for the parameters Ros and Rfo, the underevaluation of R(f) as compared with Raw can in part be compensated for, although an overe stimation at low Raw values with Ros and a large scatter of the Rfo values in the case of large Raw figures has to be accepted.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2780526 TI - [Principle of solid-frequent oscillo-resistometry]. AB - A small device for the oscillatory measurement of both respiratory resistance and residual volume (SIRE-GNOST FD5), introduced in the late 70ies, found wide-spread use. It is working with a constant frequency of 10 Hz and uses a simple signal conditioning to combine the two components of the "complex" respiratory impedance into a single parameter "Ros", thus allowing to plot e.g. Resistance-Volume Curves. PMID- 2780527 TI - [Practical experiences with 2 oscillatory measuring procedures, Siregnost FD 5 and custo vit, in the assessment of chronic airway obstruction]. AB - In patients with chronic obstructive airway disease, comparative examinations using body plethysmography were performed with a view to evaluating the effectiveness of two forced oscillation techniques, fixed-frequency and poly frequency techniques in estimating disorders of respiration mechanics. At slight and moderate elevations in bronchial flow resistance, a better agreement was found between the custo vit resistance figure and body plethysmography. A differentiation of healthy subjects from patients with low-grade obstruction by means of the FD 5, requires the establishment of the phase angle (phi), too, while in the case of the custo vit unit, this is possible by demonstrating the frequency dependence of the impedance. Patients with more severe disease with secondary emphysematous changes, reveal a clear difference between the phase signal (psi) primarily measured on the FD 5, and the phase angle. Forced oscillation usefully supplements spirometery in the respiratory basic diagnostic work-up employed through-out treatment. Fixed-frequency techniques require the determination of the phase angle for assessment of peripheral obstructions; the advantage of the poly-frequency technique can be seen in the largely specific demonstration of the frequency dependency of the resistance. PMID- 2780529 TI - [Expanded oscillo-resistometry--an independent method for studying lung function tests]. AB - The lung is a complicated organ, both physiologically and from the point of view of carrying out measurements. The tissue is elastic, as also is the enclosed air. Since the alveolar pressure cannot be measured directly, various component factors or resistances are measured. While whole-body plethysmography measures almost exclusively the actual flow or airway resistance, the forced oscillation technique measures the acoustic resistance of the entire respiratory tract. Although the two methods correlate to a high degree, considered objectively, they are unable to produce identical results. The forced oscillation technique must be considered a separate measuring method, which belongs in the area for which it was developed - in the office of the privately practising internist or general practitioner. If the forced oscillation technique provides the physician with a technically simple method which does not put any stress on the patient, and which, quickly and largely independently of the cooperation of the patient, is capable of accurately differentiating or quantitatively assessing pulmonary emphysema and endobronchial obstruction - that is, the pulmonary diseases that are by far and away the most common - it will already have fulfilled a very important requirement. Pneumologists attach great diagnostic significance to the Ros-respiratory volume curve and the phase angle. While the physician is already able to interpret the Ros curve in terms of the pathological state of the patient, the significance of the phase angle still needs to be investigated in more detail. In addition, it must be confirmed that the forced oscillation technique reacts sensitively to, for example, the administration of theophylline, and established whether, in patients with allergic diseases, it can reveal early changes that might escape detection by whole-body plethysmography. PMID- 2780528 TI - [Oscillometric differentiation of lung fibrosis and lung emphysema]. AB - In three groups of healthy subjects and patients with pulmonary fibrosis or pulmonary emphysema, the secondary periodical oscillatory phenomena observed under conditions of normal breathing and a slow VC manoeuvre on the Siregnost FD 5 were broken down into a volume- and a flow-synchronous component, as also a third component with no correlation with either volume or flow, and which can be observed in the primary parameters Ros and psi, as also the secondary parameters Rre and phi. While both fibrotic patients and healthy subjects revealed a volume inverse phase behaviour, patients with pulmonary emphysema revealed a volume proportional phase behaviour. This difference in volume dependence is explained by the difference in elastic recoil in patients with fibrosis as compared with those suffering from emphysema, and the associated different influence on the filling of the lungs with air and blood. PMID- 2780530 TI - [Report of a trial of polyfrequent oscillo-resistometry with the custo vit equipment]. AB - With the aim of determining the significance of the principle of the multi frequency forced oscillation technique employed by the custo vit to determine the airway resistance, measurements were performed on a number of test subjects, employing a unit available with three different software modifications. A comparison with the resistance values obtained with other equipment (whole-body plethysmograph, Siregnost FD5), revealed the diagnostic usefulness of the technique of frequency-dependent resistance. It was also confirmed that the phase angles, also obtainable with the custo vit, play a considerable role in the significant differentiation of the degree of obstruction. The differences in comparison with other methods are critically examined, and proposals made for a further improvement of the forced oscillation technique employed by the custo vit. PMID- 2780531 TI - [Polyfrequent oscillometry measurement of airway resistance including the associated phase angle]. AB - In 52 subjects aged between 28 and 80 years (healthy subjects, patients with obstructive and restrictive pulmonary disease), the airway resistance including the associated phase angle was investigated employing the forced oscillation technique at various frequencies (8, 12 and 16 Hz). Measurements were performed using a device manufactured by the firm of Custo, which makes possible the direct determination of oscillatory pressure and alternating flow at the mouth. With the aid of the phase angle, the airway resistance Rfo was calculated in approximation on the basis of the recorded impedance. As a reference unit, a body plethysmograph manufactured by the firm of Jaeger was employed. The short-term intra-individual variability of the oscillatory resistance measurements was, at 15%, within the fluctuation range of Rtot. The best agreement of Rfo and Rtot was achieved at 8 Hz (r = 0.83). With increasing frequency, the correlation decreased appreciably. Even in the presence of normal Rfo, negative phase angles indicated a disturbance of the mechanics of respiration. In comparison with the oscillatory resistance the determination with a bridge circuit, the reference values measured were compatible with those obtained with whole-body plethysmography. Direct measurement of Rfo and the associated phase angle, compares favourably with the reference tube technique in terms of the lack of complexity of the apparatus and a reduction in operator effort, and is thus a measuring system that is suitable for use in the doctor's office. PMID- 2780532 TI - [Oscillatory measurement of airway resistance with the custo vit in comparison with Oscillaire and whole body plethysmography]. AB - The airway resistance was measured by forced oscillation technique with the pseudorandom noise method (Oscillaire, Jones) at multiple frequencies ranging from 6 to 26 Hz in steps of 2 Hz (Ros1). In addition, the oscillatory resistance was determined with the custo vit unit (Customed), the frequency of the pump generating the oscillation being selectable (Ros2), so that successive measurements were made at different frequencies. The custo vit is available in different technical versions. With the first version, a single frequency was used to measure the resonance frequency and to determine the associated resistance. By a different version, the impedance of various frequencies in the range between 6 and 16 Hz in steps of 2 Hz were determined for both methods. Finally, using 3 frequencies (8, 12 and 16 Hz) the total impedance was differentiated into resistance and reactance. In addition, the airway resistance was determined by bodyplethysmography. A clinical study was performed in a group of 21 healthy subjects and 34 patients with bronchial asthma and chronic obstructive lung disease. With both methods, the correlation of the resistance, determined by forced oscillation technique and Raw showed decreasing values with increasing frequency. In the case of the measurement of the airway resistance with the custo vit at resonance frequency, a poorer differentiation between normal subjects and patients with obstruction was obtained as compared with measurements made at a fixed frequency of 6 Hz. This is the result of a shift in the resonance frequency towards higher frequencies in the case of an obstruction, and the simultaneously occurring frequency-dependence of the resistance. A comparison of the impedance at different frequencies revealed comparable values with both methods, but in the case of the differentiation into resistance and reactance, it was seen that higher resonance frequencies were established with Ros1 as compared with Ros2 in the case of obstruction. PMID- 2780533 TI - [Measurement of nasal oscillatory resistance]. AB - The usefulness of a new forced oscillation measuring technique for establishing the airway resistance measured nasally, was investigated in 40 patients. Forced oscillation measurements of airway resistance employing the custo vit and Siregnost FD 5, the interruptor technique and classical rhinomanometry for the measurement of nasal resistance, were compared. The correlation of the data of the nasal and bronchial resistance is significant between custo vit on the one hand, and the Siregnost FD 5 and rhinometry on the other. The forced oscillation technique employing the custo vit and the use of a facemask under conditions of normal breathing is, accordingly, a reliable method for determining nasal resistance. The spectrum of application of the equipment is thus expanded from spirometry to rhinomanometry, and its usefulness in nasal provocation testing confirmed. PMID- 2780534 TI - [Oscillatory impedance measurement of the respiratory tract in children]. AB - The author reports on his own experiences with monofrequent and polyfrequent oscillatory impedance measurements of the respiratory tract in childhood. The monofrequent oscillatory process was tested in a total of 10 trials in respect of its suitability to estimate the complex respiratory resistance in the region of lower and upper respiratory tract in a total of 1071 children most of whom were healthy, some children having a diseased respiratory tract, between 3 and 19 years of age. In 268 children the nasal respiratory resistance was measured, in 803 the bronchial respiratory resistance. The polyfrequent oscillation method was compared in 2 examinations with body plethysmography and spirometry in respect of its discriminatory powers between healthy subjects and children suffering from asthma, and in respect of its suitability to prove bronchial hypersensitivity on carbachol provocation, using 93 healthy and 81 asthmatic children. The results of the 12 examinarions are surveyed and discussed. PMID- 2780535 TI - [Bronchial provocation in children: a comparison between the polyfrequent oscillation method and body plethysmography]. AB - With the aid of the forced oscillation technique (FOT), parameters of the mechanics of respiration are measured with a minimum requirement of patient cooperation. This means that this technique is particularly suitable for use in children. The resistance (Rrs) established with the FOT correlates well with the airway resistance (Raw) measured with whole-body plethysmography (BP) (2, 4). So far, the blind resistance (Xrs) also simultaneously measurable with FOT, has received but little attention. The objective of this investigation was, in children, to compare all the resistances measurable with FOT with the parameters of BP during bronchial provocations with carbachol. PMID- 2780536 TI - [Oscillo-resistometry in bicycle ergometry stress]. AB - With the aid of a Siregnost FD 5, modified with a reference resistance of 2 kPa/l/s, measurements of the oscillatory airway resistance were carried out in 16 healthy subjects and 22 patients with asthma aged between 7 and 22 years, during and after physical exercise. As a consequence of increasing turbulent flow, in the case of the patients with healthy airways, a significant increase in the airway resistance (RmOS) occurred under conditions of physical exercise, which was due to the most part to an increase in the phase angle. Initial measurements with the custo vit suggest that the used reference resistance in the FD 5 is responsible for this. In the case of asthmatic patients, the average increase in RmOS was more marked. However, two groups of patients were differentiable: in the first group, under conditions of exercise, a decrease in the initially slightly elevated airway resistance occurred, while in the other patient group the airway resistance remained unchanged at a high level, even after exercise. In two patients, marked obstruction occurred on conclusion of the exercise examination. In one of the subjects with supposedly healthy airways, a bronchospasm developed during physical exercise and made it necessary to abandon the examination. Thus, there can be no doubt as to the clinical relevance of such measurements during and after physical exercise. PMID- 2780537 TI - The amino acid sequence of plastocyanin from rice (Oryza sativa, subspecies japonica). AB - The amino acid sequence of plastocyanin from rice (subspecies japonica) was determined. It consists of a single polypeptide chain of 97 residues and has a molecular mass of 10,225 Da. The sequence shows 94.8% identity with barley plastocyanin. PMID- 2780538 TI - The following protein sequences were reprinted from the protein sequence database of the Protein Identification Resource (PIR). PMID- 2780539 TI - The crystal structure of the ternary complex of staphylococcal nuclease, Ca2+, and the inhibitor pdTp, refined at 1.65 A. AB - The structure of a complex of staphylococcal nuclease with Ca2+ and deoxythymidine 3',5'-bisphosphate (pdTp) has been refined by stereochemically restrained least-squares minimization to a crystallographic R value of 0.161 at 1.65 A resolution. The estimated root-mean-square (rms) error in the coordinates is 0.16 A. The final model comprises 1082 protein atoms, one calcium ion, the pdTp molecule, and 82 solvent water molecules; it displays an rms deviation from ideality of 0.017 A for bond distances and 1.8 degrees for bond angles. The mean distance between corresponding alpha carbons in the refined and unrefined structures is 0.6 A; we observe small but significant differences between the refined and unrefined models in the turn between residues 27 and 30, the loop between residues 44 and 50, the first helix, and the extended strand between residues 112 and 117 which forms part of the active site binding pocket. The details of the calcium liganding and solvent structure in the active site are clearly shown in the final electron density map. The structure of the catalytic site is consistent with the mechanism that has been proposed for this enzyme. However, we note that two lysines from a symmetry-related molecule in the crystal lattice may play an important role in determining the geometry of inhibitor binding, and that only one of the two required calcium ions is observed in the crystal structure; thus, caution is advised in extrapolating from the structure of the complex of enzyme and inhibitor to that of enzyme and substrate. PMID- 2780541 TI - PKB: a program system and data base for analysis of protein structure. AB - PKB is a computer program system that combines a data base of three-dimensional protein structures with a series of algorithms for pattern recognition, data analysis, and graphics. By typing relatively simple commands the user may search the data base for instances of a structural motif and analyze in detail the set of individual structures that are found. The application of PKB to the study of protein folding is illustrated in three examples. The first analysis compares the conformations observed for a short sequential motif, sequences similar to the cell-attachment signal Arg-Gly-Asp. The second compares sequences observed for a conformational motif, a 16-residue beta alpha beta unit. The third analysis considers a population of substructures containing ion-pair interactions, examining the relationship of frequency of occurrence to calculated electrostatic energy. PMID- 2780540 TI - Amino acid substitutions that increase the thermal stability of the lambda Cro protein. AB - A mutant Cro protein, which bears the Ile-30----Leu substitution, is thermally unstable and degraded more rapidly than wild-type Cro in vivo. Using an antibody screen, we have isolated five different second site suppressor substitutions that reduce the proteolytic hypersensitivity of this mutant Cro protein. Two of the suppressor substitutions increase the thermal stability of Cro by 12 degrees C to 14 degrees C. These amino acid substitutions affect residues 16 and 26, which are substantially exposed to solvent in the crystal structure of wild-type Cro. PMID- 2780542 TI - Criteria for the validity of clinical trials of treatments of cohorts of cancer patients based on the Hardin Jones principle. AB - With the assumption of the validity of the Hardin Jones principle that the death rate of members of a homogeneous cohort of cancer patients is constant, three criteria for the validity of clinical trials of cancer treatments are formulated. These criteria are satisfied by most published clinical trials, but one trial was found to violate all three, rendering the validity of its reported results uncertain. PMID- 2780543 TI - S-phase-specific regulation by deletion mutants of the human thymidine kinase promoter. AB - The levels of thymidine kinase (TK; EC 2.7.1.21) mRNA were determined in nine established cell lines derived from TK-ts13, a temperature-sensitive mutant cell line that arrests in late G1 phase of the cell cycle at the restrictive temperature. The derivative cell lines carried either a cDNA or a minigene of human TK under the control of TK promoters of different lengths. A tenth cell line carried a human TK cDNA under the control of a simian virus 40 promoter. Two different assays were used to determine the S-phase-specific regulation of human TK mRNA levels in quiescent cells stimulated to proliferate. Results from these two assays indicated that (i) the first two introns of the human TK gene had no effect on the S-phase-specific regulation of TK mRNA levels, although the presence of introns increased the amount of TK mRNA; (ii) similar amounts of TK mRNA were present in cells containing constructs with an 83-base-pair (bp) promoter as with other TK promoters comprising up to approximately 4000 bp of 5' flanking sequence; (iii) a 456-bp promoter was fully S-phase-regulated, whereas the 83-bp promoter was only partially regulated; (iv) a 63-bp promoter was much less regulated than an 83-bp promoter; and (v) the crucial element in the 20-bp fragment comprising bp -83 to -64 has been localized, by site-directed mutagenesis, to the CCAAT element at -70. PMID- 2780544 TI - The amino-terminal domain of LexA repressor is alpha-helical but differs from canonical helix-turn-helix proteins: a two-dimensional 1H NMR study. AB - The amino-terminal DNA binding domain of LexA repressor consisting of 84 amino acid residues has been studied by two-dimensional 1H NMR. Sequence-specific 1H resonance assignments were made for the first 60 amino acid residues. The secondary structure of this part of the protein contains three alpha-helices in the peptide segments 8-20, 28-35, and 41-54. The last helix has a distortion around residues 47-48. The peptide segment 28-47 shows weak homology with other helix-turn-helix proteins. To investigate the spatial structure of this region of the molecule distance-geometry calculations were performed based on proton-proton distance constraints from nuclear Overhauser effects. The resulting structure shows that the segment 28-47 contains two helices with a loop region between them. The relative orientation of the two helices is similar to that found in helix-turn-helix proteins, but the helices are further apart, with the phenyl ring of Phe-37 located between them. The Brookhaven Protein Data Bank was searched for structurally homologous peptide segments in other proteins. The result of this search was that the two-helical structure of LexA is not more closely related to the canonical helix-turn-helix motif than it is to similar substructures found in other classes of proteins. PMID- 2780545 TI - Three cytoplasmic loops of rhodopsin interact with transducin. AB - Rhodopsin is a member of an ancient class of receptors that transduce signals through their interaction with guanine nucleotide-binding proteins (G proteins). We have mapped the sites of interaction of rhodopsin with its G protein, which by analogy suggests how other members of this class of receptors may interact with their G proteins. Three regions of rhodopsin's cytoplasmic surface interact with the rod cell G protein transducin (Gt). These are (i) the second cytoplasmic loop, which connects rhodopsin helices III and IV, (ii) the third cytoplasmic loop, which connects rhodopsin helices V and VI, and (iii) a putative fourth cytoplasmic loop formed by amino acids 310-321, as the carboxyl-terminal sequence emerges from helix VII and anchors to the lipid bilayer via palmitoylcysteines 322 and 323. Evidence for these regions of interaction of rhodopsin and Gt comes from the ability of synthetic peptides comprising these regions to compete with metarhodopsin II for binding to Gt. A spectroscopic assay that measures the "extra MII" caused by Gt binding was used to measure the extent of binding of Gt in the presence of competing peptides. The three peptides corresponding to the second, third, and fourth cytoplasmic loops competed effectively with metarhodopsin II, exhibiting Kd values in the 2 microM range; 11 additional peptides comprising all remaining surface regions of rhodopsin failed to compete even at 200 microM. Any two peptides that were effective competitors showed a synergistic effect, having 15 times higher effectiveness when mixed than when assayed separately. A mathematical model was developed to describe this behavior. PMID- 2780546 TI - Vitamin K-dependent carboxylase: affinity purification from bovine liver by using a synthetic propeptide containing the gamma-carboxylation recognition site. AB - The vitamin K-dependent carboxylase catalyzes the posttranslational modification of specific glutamic acid residues to form gamma-carboxyglutamic acid residues within the vitamin K-dependent proteins. This enzyme recognizes the gamma carboxylation recognition site on the propeptide of the precursor forms of the vitamin K-dependent blood coagulation proteins. To purify this enzyme to homogeneity, the carboxylase from bovine liver microsomes was solubilized with 3 [(3-cholamidopropyl)dimethylammonio]-1-propanesulfonate (CHAPS), the protein was fractionated with ammonium sulfate, and then the enzyme was isolated by affinity chromatography using a synthetic peptide based upon the structure of the prothrombin propeptide. Elution with 10 mM propeptide yielded a single major band on SDS gel electrophoresis with a molecular weight of 77,000. In the presence of high concentrations of propeptide, only minimal carboxylase activity was measurable. Antibodies to the protein inhibited the carboxylase activity in crude preparations. In an alternative affinity purification strategy the propeptide was coupled through an NH2-terminal cysteine to an activated thiol-Sepharose column. The carboxylase-propeptide complex was eluted at 25 degrees C by reductive cleavage of the enzyme-propeptide complex in the presence of detergent and phospholipids. The eluted protein (Mr, 77,000) contained both stable vitamin K dependent carboxylase and vitamin K epoxidase activity. The protein, purified by either method, was detected as a single band (Mr, 77,000) in a Western blot using anti-carboxylase antibodies. A 10,000-fold purification of carboxylase activity from crude microsomes was estimated. Purified bovine liver vitamin K-dependent carboxylase should facilitate the study of its structure and of the mechanism of action of vitamin K as a cofactor in the reaction catalyzed by this enzyme. PMID- 2780548 TI - A strategy for high-volume sequencing of cosmid DNAs: random and directed priming with a library of oligonucleotides. AB - Direct sequencing of cosmid DNAs using a library of oligonucleotide primers of length 8, 9, or 10 is proposed. The statistics of priming indicate that a primer library sufficient for determining the sequence of the entire human genome (100,000 cosmids) would be small enough to be assembled and managed. Such a library would greatly reduce the cost and effort of high-volume sequencing: primers would be instantly available; the sequence of each cosmid DNA could be determined from a single DNA preparation without the necessity for mapping or subcloning; and, because each primer would be used repeatedly, the cost of primers would become a negligible fraction of other costs. A combination of random and directed priming could determine the sequence of a cosmid DNA in 1.2 1.5 times the minimum number of sequencing reactions required, and completely directed priming would be even more efficient. The success of this strategy requires that a considerable fraction of octamers, nonamers, or decamers be able to prime selectively in double-stranded DNAs 45,000 base pairs (bp) long; initial results indicate that this is likely to be the case. The strategy is not limited to cloned DNAs and would be useful for rapid identification and direct sequencing of viral nucleic acids. PMID- 2780547 TI - Expression in Xenopus oocytes of rat liver mRNA coding for a bile salt-dependent cholesteryl ester hydrolase. AB - A catalytically active bile salt-dependent cholesteryl ester hydrolase (CEH) was expressed when Xenopus oocytes were injected with rat liver mRNA. The expressed CEH activity was highly dependent on the presence of trihydroxy bile salts (cholate or one of its conjugates); maximum hydrolytic activity was observed in the presence of 10 mM sodium cholate. The expressed CEH was not activated by dihydroxy bile salts (deoxycholate and its conjugates). In the presence of 10 mM sodium cholate, the CEH activity was maximal near pH 7 but was significant between pH 6 and 8. Monospecific immune IgG raised against rat pancreatic CEH completely inhibited the CEH expressed in Xenopus oocytes. Phenylmethylsulfonyl fluoride, a serine enzyme inhibitor, was inhibitory to the expressed CEH activity, whereas p-chloromercuribenzoate (up to 5 mM), a potent thiol-blocking agent, did not significantly inhibit the expressed activity. These experiments clearly demonstrate that the liver contains an mRNA encoding a bile salt dependent CEH activity and suggest that the uptake of pancreatic enzyme is not necessarily the source of liver CEH as has been speculated. PMID- 2780549 TI - Crystal versus solution structure of enzymes: NMR spectroscopy of a peptide boronic acid-serine protease complex in the crystalline state. AB - The effectiveness of boronic acids as inhibitors of serine proteases has been widely ascribed to the ability of the boronyl group to form a tetrahedral adduct with the active-site serine that closely mimics the putative tetrahedral intermediate or transition state formed with substrates. However, recent 15N NMR studies of alpha-lytic protease (EC 3.4.21.12) in solution have shown that some boronic acids and peptide boronic acids form adducts with the active-site histidine instead of with the serine. Such histidine-boron adducts have not thus far been reported in x-ray diffraction studies of boronic acid-serine protease complexes. Here, we report an 15N NMR study of the MeOSuc-Ala-Ala-Pro-boroPhe complex of alpha-lytic protease in the crystalline state using magic-angle spinning. Previous 15N NMR studies have shown this complex involves the formation of a histidine-boron bond in solution. The 15N NMR spectra of the crystalline complex are essentially identical to those of the complex in solution, thereby showing that the structure of this complex is the same in solution and in the crystal and that both involve formation of a histidine-boron adduct. PMID- 2780550 TI - A CACGTG motif of the Antirrhinum majus chalcone synthase promoter is recognized by an evolutionarily conserved nuclear protein. AB - In the chalcone synthase gene of Antirrhinum majus (snapdragon), 150 base pairs of the 5' flanking region contain cis-acting signals for UV light-induced expression. A nuclear factor, designated CG-1, specifically recognizes a hexameric motif with internal dyad symmetry, CACGTG, located within this light responsive sequence. Binding of CG-1 is influenced by C-methylation of the CpG dinucleotide in the recognition sequence. CG-1 is a factor found in a variety of dicotyledonous plant species including Nicotiana tabacum, A. majus, Petunia hybrida, Arabidopsis thaliana, and Glycine max. CACGTG motifs contained within trans-acting factor recognition sites in various other plant promoters can interact with CG-1. In addition, the binding site of the human adenovirus major late transcription factor USF can compete for CG-1 binding to the chalcone synthase promoter. This suggests an evolutionary conservation of trans-acting factor recognition sites involved in divergent mechanisms of gene control. PMID- 2780551 TI - Melittin binding causes a large calcium-dependent conformational change in calmodulin. AB - The interaction between calmodulin and its target protein is a key step in many calcium-regulated cellular functions. Melittin binds tightly to calmodulin in the presence of calcium and is a competitive inhibitor of calmodulin function. Using melittin as a model for the target peptide of calmodulin, we have found a large Ca2+-dependent conformational change of calmodulin in solution induced by peptide binding. Mg2+ does not substitute for Ca2+ in producing the conformation change. Small-angle x-ray scattering has shown that calmodulin exists as a dumbbell in solution, similar to that observed in the crystalline state. Our present measurements reveal that the overall structure of the Ca2+-calmodulin-melittin complex is not a dumbbell but a globular shape. Upon binding melittin, the radius of gyration decreases from 20.9 to 18.0 A and the largest dimension decreases from 60 to 47.5 A. In the absence of calcium, however, melittin has little effect on the solution structure of calmodulin. PMID- 2780552 TI - Reaction path study of conformational transitions and helix formation in a tetrapeptide. AB - Conformational transitions between the 112 stable states of the tetrapeptide isobutyryl-Ala3-NH-methyl (IAN) are studied theoretically. The objective of the investigation is to advance the understanding of helix formation and of conformational transitions in polypeptides. The possible reaction paths between extended chain and helical configurations are examined in detail. The study of the multiple reaction paths in this 48-atom molecule became possible due to development of a new computational algorithm. It is shown that the helix-coil transitions in IAN follow a sequence of local dihedral flips and that the number of the available routes for the transition is significantly lower than in a random search. A quasi-melting point is obtained at 5 +/- 1 kcal (1 cal = 4.18 J)/mol above the lowest energy minimum. Below this point the molecule is trapped in one or very few minima, and above it the molecule hops between a large number of configurations. PMID- 2780553 TI - Mandelonitrile lyase from Ximenia americana L.: stereospecificity and lack of flavin prosthetic group. AB - A mandelonitrile lyase (EC 4.1.2.10) that catalyzes the dissociation of (S)-(-) mandelonitrile to benzaldehyde and hydrogen cyanide has been purified to apparent homogeneity from leaves of Ximenia americana L. (Olacaceae). The lyase was purified 122-fold with 38% yield by chromatography on carboxymethyl-cellulose and chromatofocusing. The enzyme had a pH optimum of 5.5, with a Km value of 280 microM. Activity toward 4-hydroxy-(R,S)-mandelonitrile was 77% of that observed with the endogenous substrate; no activity was observed toward the aliphatic substrate acetone cyanohydrin. The enzyme was stable at 4 degrees C and at room temperature for at least 1 month. Native and subunit molecular weights of 38,000 and 36,500, respectively, suggest the enzyme is a monomer. The isoelectric point was pH 3.9 as determined by isoelectric focusing. Staining with periodic acid Schiff and fluorescein-labeled concanavalin A reagents indicate this enzyme is a glycoprotein. In contrast to (R)-mandelonitrile lyases isolated from Prunus species, the Ximenia lyase does not appear to be a flavoprotein. A second enzyme that eluted from the chromatofocusing column at pH 4.0 was also active toward mandelonitrile. However, this form accounted for less than 10% of the total activity, and its specific activity was only 6% of that of the major component. Additional physical and kinetic studies suggested this activity may be due to a nonspecific enzyme that is active toward mandelonitrile. PMID- 2780554 TI - Efficient gene transfer into mammalian primary endocrine cells with lipopolyamine coated DNA. AB - A general and efficient transfection procedure, based on compacted lipopolyamine coated plasmids, has been developed. The active species is obtained by simple addition of excess synthetic lipospermine solution to the DNA and binds within minutes to the cell membrane. This technique has been developed on endocrine cells of the intermediate lobe of the pituitary as a general tool for physiological work on primary cells; it is not toxic and does not interfere with physiological regulations in melanotrope cells. A variety of eukaryotic cell cultures also have been transfected with success for transient and stable expression. PMID- 2780555 TI - Calcium sensitivity extends the length of ATP-reactivated ciliary axonemes. AB - We use the Ca-dependent activation response of macrocilia of the ctenophore Beroe to map the distribution of Ca sensitivity along axonemes of detergent-extracted ATP-reactivated models. Local iontophoretic application of Ca (or Sr or Ba) to any site along the length of demembranated macrocilia in ATP-Mg solution elicits oscillatory bending. Bending responses are localized to the site of application of these cations and do not propagate. Ca sensitivity for initiating bends is, therefore, distributed along the entire length of the axonemes. Since Ca triggers ATP-dependent microtubule sliding disintegration of macrociliary axonemes, a Ca sensitive mechanism for activating microtubule sliding extends the length of the axonemes. In contrast, local application of Ca to living dissociated macrociliary cells elicits beating only when applied to the base of the macrocilium, indicating that the effective site of Ca entry is localized to the membrane at the ciliary base. Therefore, the spatial distributions of membrane Ca permeability and axonemal Ca sensors do not coincide. PMID- 2780556 TI - Targeting and processing of glycophorins in murine erythroleukemia cells: use of brefeldin A as a perturbant of intracellular traffic. AB - We previously showed that glycophorins are expressed in virus-transformed, murine erythroleukemia cells; we detected four glycophorin precursors (two more than in normal erythroblasts) and found that two of them are not translocated or are inefficiently translocated across the endoplasmic reticulum (ER) membrane. By using the drug brefeldin A to block intracellular transport of proteins from the ER to the Golgi complex, the translocated precursors were shown to accumulate in the ER, while the untranslocated forms were rapidly degraded with an intracellular half-life of approximately 20 min. Brefeldin A did not inhibit the synthesis of fatty acylation of the precursors but substantially delayed their acquisition of O-linked oligosaccharides, which indicates that murine glycophorins are fatty acylated in the ER and O-glycosylated in the Golgi complex. Even after 6 hr in brefeldin A, glycophorins were only partially glycosylated, resulting in the accumulation of glycoproteins apparently sialylated but lower in apparent molecular mass than mature glycophorins. Complete glycophorin processing resumed only after removal of the drug. In murine erythroleukemia cells, brefeldin A caused a rapid and extensive disorganization of the entire Golgi complex accompanied by the accumulation of membranes in a part of the ER closely associated with ER transitional elements. These findings extend recently published results [Lippincott-Schwartz, J., Yuan, L. C., Bonifacino, J. S. & Klausner, R. D. (1989) Cell 56, 801-813] and suggest that brefeldin A induces net membrane flow from the entire Golgi complex to the ER. PMID- 2780557 TI - Molecular cloning and characterization of a mammalian excision repair gene that partially restores UV resistance to xeroderma pigmentosum complementation group D cells. AB - A hamster DNA repair gene has been isolated by cosmid rescue after two rounds of transfection of an immortalized xeroderma pigmentosum (XP) complementation group D cell line with neomycin-resistance gene (neo)-tagged normal hamster DNA and selection with G418 and ultraviolet irradiation. The functional length of the sequence has been defined as 11.5 kilobase pairs by measurement of the region of overlap between two hamster DNA-containing cosmids, cloned by selection for the integrated neo gene, that are able to confer an increase in resistance to ultraviolet irradiation on two XP-D cell line but not on an XP-A line. Detailed molecular characterization of the hamster repair gene has revealed no obvious similarities to two human excision repair genes (ERCC1 and ERCC2) that correct repair-defective hamster cells but have no effect on XP cells. Hybridization analyses of normal human and XP cell genomic DNAs and mRNAs, using a cosmid-clone probe from which repeated sequences have been removed, show that homologues are present and expressed in all cases. PMID- 2780558 TI - Different 3'-end processing produces two independently regulated mRNAs from a single H1 histone gene. AB - We describe the isolation of a mouse H1 histone gene that encodes two mRNA transcripts. One mRNA ends just beyond the coding region, near a highly conserved palindrome sequence typical of cell cycle-regulated histone genes. The level of this transcript is coupled to DNA replication. The second mRNA ends nearly 1 kilobase downstream near a polyadenylation signal. This mRNA is polyadenylylated, and its accumulation is not coupled to DNA replication. The two mRNAs are regulated independently and in some circumstances in opposite directions under several physiological conditions. The production of a polyadenylylated mRNA from an otherwise cell cycle-regulated histone gene may allow for continued synthesis of the histone protein when DNA synthesis ceases in nondividing cells. PMID- 2780559 TI - Cytoplasmic requirement for peroxisome biogenesis in Chinese hamster ovary cells. AB - Hybrids constructed by fusion of wild-type Chinese hamster ovary cells (CHO-K1) to peroxisome-deficient CHO mutants (ZR-78.1) contain normal peroxisomes, demonstrating that the mutation(s) are recessive. "Nuclear hybrids" prepared by fusion of CHO-K1 karyoplasts to mutant ZR-78.1 occasionally fail to regain intact peroxisomes (approximately 1/300 cells). These peroxisome-deficient nuclear hybrids closely resemble the original mutant cells by biochemical criteria, but their modal chromosome number is 36-38, the same as that of CHO hybrids generated from intact cells. When the peroxisome-deficient nuclear hybrids are fused to wild-type cytoplasts, a fraction of the fusion products (at least 70%) continue to propagate normal peroxisomes indefinitely. Peroxisome biogenesis cannot be reinitiated in cells of mutant ZR-78.1 by fusion to wild-type cytoplasts. Our results suggest that a wild-type nucleus by itself is necessary but not sufficient for restoration of normal peroxisome biogenesis and that a cytoplasmic component of wild-type cells, possibly a normal peroxisome, is also required. PMID- 2780560 TI - Cell sorting-out is modulated by both the specificity and amount of different cell adhesion molecules (CAMs) expressed on cell surfaces. AB - Cell adhesion molecules (CAMs) are cell surface glycoproteins that may play a variety of roles in morphogenesis and histogenesis, particularly in defining borders of discrete cell populations. To examine the influence of CAM expression on such cell segregation events in vitro, we have transfected cells with cDNAs coding for two calcium-dependent CAMs of different specificity, the liver CAM (L CAM) and the structurally related molecule N-cadherin. The cDNAs were introduced separately or together into murine sarcoma S180 cells, which normally do not express these molecules, to produce cell lines denoted S180L, S180cadN, and S180L/cadN, respectively. A number of cell lines of each type were produced that differed in their levels of CAM expression. In adhesion assays, S180L and S180cadN cells aggregated specifically via their respective CAMs, and S180L cells did not appear to adhere to S180cadN cells. Cells expressing high levels of each CAM aggregated more rapidly than cells expressing low levels. Segregation between two cell types occurred when they expressed CAMs of different specificity or different levels of the same CAM. S180L and S180cadN cells both sorted out from untransfected cells, and cells expressing high levels of either L-CAM or N cadherin segregated from cells expressing low levels of the same CAM; in all cases segregation was inhibited by antibodies specific for the transfected CAM. S180L cells sorted out from S180cadN cells, but this segregation was inhibited only when antibodies to both CAMs were applied together. Doubly transfected S180L/cadN cells also sorted out from S180L cells and from S180cadN cells, and the process was inhibited by antibodies to the unshared CAM (N-cadherin or L-CAM, respectively). Cytochalasin D and nocodazole inhibited sorting-out, consistent with the probable role of microfilaments and microtubules in cell movement and in accord with evidence that the action of these CAMs depends on interactions with cortical cytoplasmic components. Using cDNAs for only two CAMs in these studies, we could distinguish at least eight cell lines by their behavior in sorting-out assays. This suggests that qualitative and quantitative differences in the expression in vivo of a relatively small number of CAMs can lead to a large variety of patterns among cell collectives and their borders during tissue formation. PMID- 2780561 TI - Conservation of the human telomere sequence (TTAGGG)n among vertebrates. AB - To determine the evolutionary origin of the human telomere sequence (TTAGGG)n, biotinylated oligodeoxynucleotides of this sequence were hybridized to metaphase spreads from 91 different species, including representative orders of bony fish, reptiles, amphibians, birds, and mammals. Under stringent hybridization conditions, fluorescent signals were detected at the telomeres of all chromosomes, in all 91 species. The conservation of the (TTAGGG)n sequence and its telomeric location, in species thought to share a common ancestor over 400 million years ago, strongly suggest that this sequence is the functional vertebrate telomere. PMID- 2780562 TI - Host-independent evolution and a genetic classification of the hepadnavirus family based on nucleotide sequences. AB - An analysis of molecular phylogeny was undertaken to examine whether the evolution of the hepadnavirus family is host-dependent. Using the nucleotide sequences of 18 strains, we constructed phylogenetic trees. The trees obtained show that all 12 strains of hepatitis B virus can be classified into four subgroups that are not compatible with conventional subtypes. We estimated the rate of synonymous (silent) substitution for hepatitis B virus to be 4.57 x 10( 5) per site per year. Applying this rate to the phylogenetic tree, we estimated that duck hepatitis B virus diverged from a common ancestor about 30,000 years ago at the earliest, that woodchuck hepatitis virus and ground squirrel hepatitis virus diverged about 10,000 years ago, and that hepatitis B virus diverged within the last 3000 years. Because these divergence times of the viruses are much more recent than those of the host species, it suggests that the hepadnavirus family evolved independently of host-species divergence. PMID- 2780563 TI - Human beta-globin gene expression in transgenic mice is enhanced by a distant DNase I hypersensitive site. AB - Several lines of evidence suggest that erythroid-specific DNase I hypersensitive sites (HS) located far upstream of the human beta-globin gene are important in regulating beta-globin gene expression. We used the polymerase chain reaction technique to amplify and clone an 882-base-pair DNA fragment spanning one of these HS, designated HSII, which is located 54 kilobases upstream of the beta globin gene. The cloned HSII fragment was linked to a human beta-globin gene in either the genomic (HSII-beta) or antigenomic (HSII-beta) orientation. These two constructs and a beta-globin gene alone (beta) were injected into fertilized mouse eggs, and expression was analyzed in liver and brain from day-16 transgenic fetuses. Five of 7 beta-transgenic fetuses expressed human beta-globin mRNA, but the level of expression per gene copy was low, ranging from 0.93 to 22.4% of mouse alpha-globin mRNA (average 9.9%). In contrast, 11 of 12 HSII-beta transgenic fetuses expressed beta-globin mRNA at levels per gene copy ranging from 31.3 to 336.6% of mouse alpha-globin mRNA (average 139.5%). Only three fetuses containing intact copies of the HSII-beta construct were produced. Two of three expressed human beta-globin mRNA at levels per gene copy of 179.2 and 387.1%. Expression of human beta-globin mRNA was tissue-specific in all three types of transgenic fetuses. These studies demonstrate that a small DNA fragment containing a single erythroid-specific HS can stimulate high-level human beta globin gene expression in transgenic mice. PMID- 2780564 TI - Blocking of pregnancy in mice by immunization with anti-idiotype directed against monoclonal anti-progesterone antibody. AB - Passive transfer of monoclonal anti-progesterone antibodies shortly after mating blocks the onset of pregnancy in different species (mouse, rat, and ferret). Here we report that BALB/c mice can be actively immunized against progesterone, and hence against pregnancy, by means of rabbit anti-idiotypic antibodies specific for a mouse monoclonal anti-progesterone antibody, DB3. Some of the anti idiotypic antibodies reacted with the steroid-combining site on the DB3 molecule. In response to repeated anti-idiotypic immunization, mice produced serum anti progesterone antibodies (up to 100 micrograms/ml) that resembled DB3 in idiotypy, affinity, and specificity for progesterone and other steroid ligands. Thus an anti-idiotype can mimic the antigenicity of a steroid hormone with a high degree of accuracy. Compared with immunization with a progesterone-bovine serum albumin conjugate, the anti-progesterone response to anti-idiotype was considerably lower and clonally restricted. When mated after completion of the immunization course, the fertility rate of anti-idiotype-immunized mice was reduced to 30% from a control level of 91%. The anti-fertility effect was correlated with the circulating anti-progesterone concentration in individual animals and persisted for 4 or 5 estrous cycles. Active immunization with progesterone-bovine serum albumin was a highly effective means of rendering mice infertile; it reduced the fertility rate to zero over 16 or 17 estrous cycles. Our results suggest that anti-idiotypes may form the basis of contraceptive vaccines. PMID- 2780566 TI - Expression of an intrinsic growth strategy by mammalian retinal neurons. AB - Postnatal cat retinal ganglion cells (RGCs) were retrogradely labeled with fluorescent microspheres, dissociated from the retina using a peeling procedure, and monitored in cell culture with a time-lapse video microscopy system. The spatial patterns formed by the growing neurites were analyzed using conventional and fractal measures (Hausdorff dimension, H) of their extent and complexity. The results presented were obtained from the arborizations formed by the neurites of 48 labeled and isolated ganglion cells growing separate from each other and separate from a feeder layer of astrocytes. Cells were obtained from animals when the RGCs were postmitotic and after dendritic differentiation in vivo at age 0-1 week (4/48), 2-5 weeks (35/48), or 6-8 weeks (9/48). By 48 hr after plating, the number of surviving labeled RGCs was reduced to 22-28% of its initial value. After removal of all processes and isolation in vitro, these RGCs expressed neurite patterns strikingly similar to those seen in the intact retina, although the RGCs had been deprived of potential cues from the intact retina and target tissue. Self crossings of the growing neurites were rare (less than 0.5%, 20 cells, n = 2500 neurites). Calculation of the Hausdorff dimension, a metric for the space-filling capacity of the neurite patterns, revealed that after 3-day culture 77% (n = 56) of the RGCs achieved relatively uniform coverage of territory (1.6 less than H less than 1.9). This coverage was independent of the number of interbranchpoint segments and/or the total neurite length of a particular neurite pattern. A sample of dendritic arbors from RGCs in intact retina yielded similar values for the Hausdorff dimension (H = 1.73, SD = 0.12, n = 18, range 1.54-1.94). These results reveal that a mammalian central nervous system neuron, for at least 8 postnatal weeks, has the intrinsic capacity for reexpression of in vivo structure characteristic of that cell type in the absence of interaction with neighboring neurons, afferent input, and target tissue. These neurons exhibit stereotyped growth resulting in uniform coverage of a restricted territory by the strategic selection of the length, location, and orientation of interbranchpoint segments. PMID- 2780565 TI - Molecular structure and functional characterization of a human complement cytolysis inhibitor found in blood and seminal plasma: identity to sulfated glycoprotein 2, a constituent of rat testis fluid. AB - A component of soluble terminal complement complexes was identified and affinity purified to homogeneity by using a monoclonal antibody previously developed against the soluble C5b-9 complex. The protein, which we have designated complement cytolysis inhibitor (CLI), has a molecular mass of 70 kDa and consists of two nonidentical, disulfide-linked subunits of 35 kDa. Partial amino acid sequences determined for the amino-termini of the two subunits were identical with those of a recently characterized serum protein called SP-40,40. An almost full-length cDNA clone of 1651 base pairs was isolated from a human liver cDNA library by using long synthetic oligonucleotides as probes. The encoded amino acid sequence of CLI consists of 427 amino acid residues preceded by a 21-residue long typical signal peptide and shows an overall 75.6% amino acid sequence homology to sulfated glycoprotein 2 (SGP-2), a major Sertoli cell-derived protein of rat testis fluid. As in SGP-2, proteolytic processing between residues 206 and 207 yields the two disulfide-linked subunits of plasma CLI. CLI and SGP-2 were shown to be orthologous single-copy genes in humans and rats by Southern blotting experiments. In addition, CLI was immunologically identified in human seminal plasma. Functional studies with purified terminal complement components showed that CLI suppresses the cytolytic potential of nascent C5b-7 complexes at physiological blood plasma concentrations (approximately 50 micrograms/ml). Its presence on the surface of mature sperm cells and its relative abundance in seminal plasma (approximately 250 micrograms/ml) suggest that CLI protects sperm cells and epithelial tissues against complement attack in the male reproductive tract. PMID- 2780567 TI - Retinal transplant-mediated learning in a conditioned suppression task in rats. AB - Retinae were transplanted from embryonic rats to a location over the midbrain of unilaterally anucleated newborn rats. At maturity, the rats were trained to "lever-press" for a food reward. By using a Pavlovian conditioned suppression paradigm, it was found that light delivered to the transplant could be recognized by the host rat as a conditioned stimulus, resulting in a reduced rate of lever pressing. PMID- 2780568 TI - Differential expression of alpha and beta thyroid hormone receptor genes in rat brain and pituitary. AB - Multiple thyroid hormone receptor cDNAs have previously been identified in rat and are classified into alpha and beta subtypes. Alternative splicing of the alpha gene gives rise to the functional receptor, rTR alpha 1, and the non thyroid hormone-binding isotype, rTR alpha 2. Recent evidence suggests the beta gene encodes two functional receptors, rTR beta 1, and the pituitary-specific receptor, rTR beta 2. By using synthetic DNA probes common to rTR beta transcripts and specific for rTR alpha 1 and rTR alpha 2 mRNAs, we mapped the expression of these transcripts in adult rat brain and pituitary by hybridization histochemistry. We also localized mRNAs encoding the putative nuclear receptor REV-ErbA alpha, a portion of which is derived from the opposite strand of the rTR alpha gene. rTR alpha 1 and rTR alpha 2 transcripts were widely distributed in a similar, if not identical, pattern. Highest levels of rTR alpha 1 and rTR alpha 2 transcripts were found in the olfactory bulb, hippocampus, and granular layer of the cerebellar cortex. REV-ErbA alpha and rTR beta mRNAs were found in more restricted patterns of expression distinct from those of rTR alpha 1 and rTR alpha 2. REV-ErbA alpha mRNA was highest in the neocortex. High levels of rTR beta transcripts in the anterior pituitary and the parvocellular part of the paraventricular hypothalamic nucleus suggest rTR beta gene products may mediate thyroid hormone feedback regulation of thyroid-stimulating hormone and thyrotropin-releasing hormone. Our results identify nuclei and structures in the mammalian central nervous system in which regulation of gene expression by specific thyroid hormone receptor subtypes may occur. PMID- 2780569 TI - Snake acetylcholine receptor: cloning of the domain containing the four extracellular cysteines of the alpha subunit. AB - The acetylcholine receptor (AcChoR) at the neuromuscular junction of elapid snakes binds cholinergic ligands but unlike other muscle AcChoRs does not bind alpha-bungarotoxin. Numerous studies indicate that the ligand-binding site of the AcChoR includes cysteine residues at positions 192 and 193 of the alpha subunit. We have previously shown that a synthetic dodecapeptide corresponding to residues 185-196 of the Torpedo AcChoR alpha subunit contains the essential elements of the ligand-binding site. In an attempt to elucidate the structural basis for the precise binding properties of snake AcChoR, we sequenced a portion of the snake AcChoR alpha subunit. First, a mouse AcChoR alpha-subunit cDNA probe was used to screen a size-selected snake (Natrix tessellata) genomic library. A genomic clone was isolated and was found to contain sequences homologous to the exon including the first two cysteines (Cys-128 and -142) of AcChoR alpha subunit. The domain of the alpha subunit from Natrix and cobra AcChoR (amino acid residues 119-222), which contains the four extracellular cysteines (128, 142, 192, and 193), was amplified by reverse transcription of mRNA and the polymerase chain reaction and then sequenced. The deduced amino acid sequence showed that the snake alpha subunit contains the two tandem cysteines at positions 192 and 193, resembling all other AcChoR alpha subunits. Sequence comparison revealed that the cloned region of the snake alpha subunit is highly homologous (75-80%) to other muscle AcChoRs and not to neuronal AcChoR, which also does not bind alpha-bungarotoxin. In the presumed ligand-binding site, in the vicinity of Cys-192 and Cys-193, four major substitutions occur in the snake sequence--at positions 184 (Trp----Phe), 185 (Lys----Trp), 187 (Trp----Ser), and 194 (Pro----Leu). In addition, Asn-189 is a putative N-glycosylation site, present only in the snake. These changes, or part of them, may explain the lack of alpha-bungarotoxin-binding to snake AcChoR. PMID- 2780571 TI - Reentrant signaling among simulated neuronal groups leads to coherency in their oscillatory activity. AB - Recent experiments have revealed tightly synchronized oscillatory discharges in local assemblies of cortical neurons as well as phase coherency of oscillations at distant cortical sites. These findings are consistent with the theory of neuronal group selection, a population theory of brain function that is based on the properties of local groups of neurons. A set of computer simulations shows that cooperative interactions within and among neuronal groups can generate the observed phenomena. In the simulations, oscillations within neuronal groups are generated through local excitatory and inhibitory interactions. Different groups in general oscillate in an uncorrelated fashion. Coherency of the oscillatory activity of different neuronal groups depends crucially on reciprocal reentrant signaling and can reflect the spatial continuity of a stimulus. Separated or discontinuous features of a given stimulus can be transiently associated in a temporally coherent pattern through reentrant signaling between groups in networks responding to different aspects of that stimulus. A simulation of reentrant activity between arrays of neuronal groups selective for oriented lines and pattern motion displays cross-correlations between groups that are responsive to different parts of a stimulus contour if these parts move together. Such coherency among neuronal groups might be used in the discrimination of a stimulus from other stationary or differentially moving elements in a visual scene. PMID- 2780570 TI - Changes in brain gene expression shared by scrapie and Alzheimer disease. AB - We have isolated two recombinant cDNAs whose corresponding RNAs have an increased abundance in scrapie-infected hamster brain. DNA sequence analysis has shown that these two recombinants represent the genes for sulfated glycoprotein 2 and transferrin. The abundance of sulfated glycoprotein 2 RNA is increased in hippocampus from patients with Alzheimer disease and Pick disease, whereas transferrin RNA is not strongly modulated in these conditions. Expression of two previously identified scrapie-modulated genes, encoding glial fibrillary acidic protein and metallothionein, is also increased in both of these neurodegenerative diseases. PMID- 2780572 TI - Local influence of substrate molecules in determining distinctive growth patterns of identified neurons in culture. AB - The growth and branching patterns of individual identified leech neurons in culture depend upon the molecular composition of the substrate. These differences in morphology have been analyzed quantitatively for nerve cells growing on the plant lectin Con A, on extracellular matrix extract (ECM) containing laminin, and on patterned substrates. The total length of neurite outgrowth was about four times greater, and the number of branching points per unit length was three times smaller on ECM laminin extract than on Con A. Single cells placed on a sharp well defined border separating Con A and ECM-laminin extract sprouted neurites rapidly on both sides of the border without showing preference for either substrate. An individual nerve cell produced neurites with markedly different structure on the two substrates--curved and thick, with a higher branching frequency on Con A, but straight and slender with a lower branching frequency on ECM-laminin substrate. Similar changes were seen in individual neurites that crossed from one substrate to the other. These results show that local contact of the neuron with a particular substrate induces a particular pattern of local outgrowth. Hence, molecules anchored in extracellular matrix could provide information for regenerating or developing axons regarding the type of branching pattern to be produced in that region. PMID- 2780574 TI - The liposome in pharmacology. PMID- 2780573 TI - Substrate specificity of a novel growth factor-sensitive protein kinase. PMID- 2780575 TI - Recent advances in sustained release of antineoplastic drugs using liposomes which avoid uptake into the reticuloendothelial system. PMID- 2780576 TI - Cationic liposome mediated transfection. PMID- 2780577 TI - Quantitative experimental analysis of the emergence of opiate dependence. PMID- 2780578 TI - Chronic naltrexone enhances acquisition of the radial maze task in rats. PMID- 2780579 TI - Activation of adenosine receptors suppresses behavioral seizures induced by kainic acid in the rat prepiriform cortex. PMID- 2780580 TI - Tissue distribution of a novel growth factor sensitive protein kinase. PMID- 2780581 TI - Differences in adrenergic stimulated lipolysis in rat and human adipose tissue. PMID- 2780582 TI - Effects of ifenprodil tartrate on calcium flux in arteries and brain synaptosomes. PMID- 2780583 TI - 28-day toxicity in beagle dogs of physostigmine salicylate administered via subcutaneously implanted Alzet osmotic minipumps. PMID- 2780584 TI - Genetic sensitivity to convulsants is determined by seizure sign rather than pharmacologic specificity. PMID- 2780586 TI - Chronic marijuana (MJ) smoking and urinary cortisol (UC) excretion in the monkey. PMID- 2780588 TI - Capsaicin analgesia: predictions based on physico-chemical properties. PMID- 2780585 TI - Further studies into the ECG effects of tedisamil (KC 8857) in rats. PMID- 2780587 TI - Cardiotonic steroids extracted from rabbit uterine tissue and amnionic fluid. PMID- 2780589 TI - Interactive toxicity of cocaine with phenobarbital, morphine and ethanol in organ cultured human and rat liver slices. PMID- 2780591 TI - Epidemiology and pharmacology of chronic "crack" use: the growing problem of an inner-city hospital. PMID- 2780590 TI - Role of theophylline, verapamil, and diltiazem on rat fatigued diaphragmatic muscle in vitro. PMID- 2780592 TI - Inotropic effects of veratridine on the canine atria and ventricles in vivo and in vitro. PMID- 2780593 TI - Diuretic effects of an ACE inhibitor, RS-10085, and hydrochlorothiazide in the spontaneously hypertensive rat. PMID- 2780594 TI - Methodological approach to pharmacodynamic calculations of vascular responses in vivo. PMID- 2780595 TI - The efficacy of the abstinence model in the treatment of alcoholism. PMID- 2780597 TI - Effect of drugs on [3H]PK 11195 binding to human neuron-like cells. PMID- 2780596 TI - Effect of oral self-administration of cocaine on adrenal catecholamine levels and cardiovascular parameters in the conscious rat. PMID- 2780598 TI - Receptors mediating vasoconstrictor response in rabbit femoral artery. PMID- 2780599 TI - Further characterization of vascular muscarinic receptors using dicyclomine. PMID- 2780600 TI - The effect of glucagon on autoregulatory escape from hepatic arterial vasoconstriction in the cat. PMID- 2780601 TI - Heterogeneity of muscarinic receptors in bovine adrenal medulla. PMID- 2780602 TI - Cationic transport of amantadine by isolated renal proximal tubules. PMID- 2780603 TI - Regulation of renal function by central neuropeptide Y in the anesthetized rat. PMID- 2780604 TI - A comparative study of the antiarrhythmic properties of eicosanoid inhibitors, free radical scavengers and potassium channel blockers on reperfusion induced arrhythmias in the rat. PMID- 2780605 TI - Chronic diuretic effects of subcutaneous hydrochlorothiazide in the spontaneously hypertensive rat; validation of a simple model for chronic diuretic assessment. PMID- 2780606 TI - Total body capacitance (TBC) responses to vasopressin differ from those to angiotensin II and norepinephrine. PMID- 2780607 TI - The action of naloxone on the blood pressure and heart rate in conscious SHR and WKY rats. PMID- 2780608 TI - Compound 48/80 inhibits the plasma membrane Ca2+ pump of intact red blood cells. PMID- 2780610 TI - The effects of furosemide, piretanide and MK-196 on volume sensitive solute transport in fish erythrocytes. PMID- 2780609 TI - AK-2-38, a nifedipine analogue with potent smooth muscle calcium antagonist action and partial agonist effects on isolated guinea pig left atrium. PMID- 2780611 TI - Toxic effect of different viscosity hydrocarbons in the lung. PMID- 2780612 TI - Potentiation of norepinephrine-induced vasoconstrictions by neuropeptide Y in isolated canine carotid artery. PMID- 2780613 TI - Methodology for efficacy study of liposome bronchodilators in long duration experiments. PMID- 2780614 TI - Clearance of xenon-133 from the lung as an index of bronchomotor tone. PMID- 2780615 TI - Structure-activity relationships of N-substituted-2,3-dimethyl-1,4 endo or exo (3',4'-pyrrolidino)-1,4-dihydronaphthalenes. PMID- 2780616 TI - Effects of chronic cocaine administration on rat cardiac and splenic norepinephrine levels. PMID- 2780617 TI - Effects of bombesin on the micturition reflex of the anesthetized rat. PMID- 2780618 TI - The effect of suckling and diurnal influences on the concentrations of free amino acids in milk. PMID- 2780620 TI - Dopamine induced contraction of human prostate in vitro. PMID- 2780619 TI - On the mechanism of action of sarmesin and sarilesin at angiotensin receptors in smooth muscle. PMID- 2780621 TI - Effect of bidentate nitrogen heterocycles on dopamine beta-hydroxylase activity in vitro. PMID- 2780622 TI - Nucleotides, oxygen free radical scavengers, and brain protection: mouse model. PMID- 2780623 TI - Effects of capsaicinoids on platelet aggregation. PMID- 2780624 TI - The mRNA for alpha 1-acid glycoprotein is deadenylated during stimulation by dexamethasone. PMID- 2780625 TI - Expression of human alpha-1-acid glycoprotein in human cell lines. PMID- 2780626 TI - Multiple inflammation-inducible alpha 1-acid glycoprotein forms correlate with multiple genes in Mus caroli. PMID- 2780627 TI - Comparison of glycan microheterogeneities of alpha 1-acid glycoprotein between mothers and their newborns. PMID- 2780628 TI - Hyperfucosylation of alpha 1-acid glycoprotein during cirrhosis. PMID- 2780629 TI - Minor microheterogeneity of alpha 1-acid glycoprotein in rheumatoid arthritis. PMID- 2780630 TI - Enzyme-inducing drugs and rat alpha 1-acid glycoprotein--1--Response of SD and DA rats to the unique administration of phenobarbital. PMID- 2780631 TI - Circulatory life time and organ distribution of differently glycosylated forms (unglycosylated, high-mannose type, hybrid type, complex type) of rat alpha-1 acid glycoprotein. PMID- 2780632 TI - Alpha 1-acid glycoprotein promotes nerve growth in vitro. PMID- 2780633 TI - Alpha 1-acid glycoprotein effects on the permeability changes in reconstituted membranes. PMID- 2780634 TI - One step purification of rat alpha 1-acid glycoprotein by antibody affinity chromatography. Application to normal and inflamed rat sera. PMID- 2780635 TI - Changes in Con-A affinity of rat alpha 1-acid glycoprotein as detected by crossed affino immunoelectrophoresis do not correlate with biantennary glycan content. PMID- 2780636 TI - Comparison of drug binding capacities of two AAG peptidic variants of human origin. PMID- 2780637 TI - Anomalies in the plasma proteins that bind propranolol in sheep. PMID- 2780638 TI - 1-anilino-naphthalene 8-sulfonic acid (ANS) as a probe for the binding of antidepressant drugs to human alpha 1-acid glycoprotein (AAG). PMID- 2780639 TI - ANS-drug interactions to AAG and HSA fluorescence and equilibrium dialysis studies. PMID- 2780640 TI - Parallel induction of plasma alpha 1-acid glycoprotein concentration and antipyrine clearance by drugs. PMID- 2780641 TI - Influence of lidocaine on plasma protein binding and pharmacokinetics of verapamil in dogs. PMID- 2780642 TI - In vitro study of the binding of RU 486 and RU 42 633 to human serum proteins. PMID- 2780643 TI - Indapamide binding to alpha 1-acid glycoprotein: consequences on its blood distribution and plasma binding in disease states. PMID- 2780645 TI - Therapeutic progress in urological cancers. Proceedings of an international symposium. Paris, France, June 29-July 1, 1988. PMID- 2780646 TI - Parenchymal-sparing surgery for small renal cell cancer: are there any reasonable arguments? PMID- 2780644 TI - Plasma concentrations of alpha-1-acid glycoprotein following operations and its effect on the plasma protein binding of bupivacaine. PMID- 2780647 TI - Cytotoxicity and metabolism of E-DES-diphosphate. PMID- 2780648 TI - Hormonal chemotherapy. PMID- 2780649 TI - Is radiotherapy effective for locally advanced (stage C or T3) prostate cancer? PMID- 2780650 TI - Can prostatectomy add any benefit to the hormonal treatment of stage C prostatic carcinoma? PMID- 2780651 TI - Immunological response to prostatic cancer cryotherapy: certainties, controversies, hypotheses. PMID- 2780652 TI - Salvage prostatectomy. PMID- 2780653 TI - How to define hormone-resistance. PMID- 2780654 TI - Intravesical Bacillus Calmette Guerin therapy in patients with superficial bladder tumor. PMID- 2780656 TI - Tur vs TUR plus adriamycin in patients with superficial bladder cancer--a five year follow-up. PMID- 2780655 TI - Chemoimmune prophylaxis of superficial bladder carcinoma with cyclophosphamide and BCG. PMID- 2780657 TI - Epirubicin in treatment and recurrence prophylaxis of patients with superficial bladder cancer. PMID- 2780658 TI - Photodynamic therapy Tis and T1 transitional carcinoma of the bladder. PMID- 2780659 TI - When is a cystectomy necessary in carcinoma in situ? PMID- 2780660 TI - Cytological surveillance of carcinoma in situ during and after intravesical chemotherapy. PMID- 2780661 TI - Treatment of invasive bladder cancer (lymph node negative, metastases negative). PMID- 2780662 TI - Is chemotherapy a new form of radical treatment in infiltrating tumor localized to the bladder? PMID- 2780663 TI - Management of the urethra in patients undergoing radical cystectomy for bladder carcinoma. PMID- 2780664 TI - May radical cystectomy be able to cure advanced bladders' transitional cell carcinoma (T.C.C.) with lymph node spread? PMID- 2780665 TI - Radical cystectomy in patients over 70 years. PMID- 2780666 TI - Possible alternative treatment for advanced transitional cell carcinoma of the urothelium (N+ and/or M+) in 1988. PMID- 2780667 TI - The treatment of advanced renal cell carcinoma with a combination of human lymphoblastoid interferon-alpha and cimetidine. PMID- 2780668 TI - Surgical treatment of renal cell carcinoma. Current possibilities and results evaluated on a series of 507 operated patients. PMID- 2780669 TI - Lymphatic spread in renal cell carcinoma: have retroperitoneal lymph node dissection a therapeutic advantage? PMID- 2780671 TI - Retroperitoneal lymph node dissection (RPLND) post chemotherapy for non seminomatous testicular neoplasms: what is the significance of residual masses at scanner control after chemotherapy and should they be removed? PMID- 2780670 TI - Long-term results of conservative surgery for renal cell carcinoma: a 25-year experience. PMID- 2780672 TI - Can we cure testicular cancer and retain fertility? AB - 1. 30-40% of the patients with newly diagnosed testicular cancer want to father a child after the treatment. 2. At least half of the patients with testicular cancer who at the time of diagnosis state the desire for future paternity, can expect to father a child after treatment. 3. The intensity of treatment is the most determinant parameter for post-treatment fertility. Unnecessary over treatment, in particular extended retroperitoneal surgery, should be avoided. 4. The overall role of sperm banking is questionable in the management of testicular cancer. PMID- 2780673 TI - Management of yolk sac carcinoma of the testis clinical stage I: lymphadenectomy vs. no lymphadenectomy. AB - Thirty seven patients with Stage I yolk sac tumor of the testis were registered at the Instituto Nacional de Enfermedades Neoplasicas (I.N.E.N.), Lima-Peru from 1962 through 1980. Eighteen patients underwent retroperitoneal Lymph node dissection. The age incidence was 5 to 29 months except for two patients 50 and 84 months of age each. Bilateral retroperitoneal lymph node dissection was performed in seventeen patients; unilateral dissection was performed in one patient. In two patients both had one positive node at lymphadenectomy (2/18: 11%). Eleven patients (61.11%) are alive and with no evidence of disease in between 7 to 26 years post lymphadenectomy. Seven patients (38.89%) died: 4/18 (22.22%) because of progression of the disease and three patients because of no neoplastic cause. Nineteen patients did not have retroperitoneal lymph node dissection: seven patients (36.84%) are alive with no evidence of disease and 12 patients (63.16%) died: 8/19 (42.10%) because of progression of the disease and 4/19 (21%) with no neoplastic disease. In conclusion, patients with localized disease (Clinical Stage I) benefit from retroperitoneal lymph node dissection when compared to a similar group of patients not submitted to lymphadenectomy. PMID- 2780674 TI - Dissection of the prostatic apex for radical cystectomy and detubed ileocystoplasty. PMID- 2780675 TI - Bladder substitution with an ileal low-pressure reservoir. PMID- 2780676 TI - Bladder replacement by detubed ileo-caecal graft after radical cystectomy. PMID- 2780677 TI - Value of retroperitoneal lymphadenectomy after chemotherapy for non-seminomatous testicular tumor with lymph node metastases. PMID- 2780678 TI - A functional evaluation of ileocaecourethrostomy and ileourethrostomy with a reservoir after a total cystectomy for cancer. PMID- 2780679 TI - Nonenzymatic glycosylation (glycation) of lens crystallins in diabetes and aging. AB - Lens crystallin glycation, thiol oxidation and aggregation showed parallel changes in streptozotocin-diabetic and aging rats. The levels of the disulfide linked HMW aggregates were essentially the same in the diabetic and senile cataracts, but glycation was significantly lower in the latter. Inhibition of glycation by acetylating potential glycation sites by aspirin during in vitro glycation and in diabetic rats has led to inhibition of protein thiol oxidation and aggregation. A predominance of glycated crystallins, gamma crystallin in particular, was noticed in the HMW aggregates. Likewise, the glycate portion of the whole crystallin preparation showed an enrichment of the HMW aggregates. These observations strongly suggest a significant contribution by crystallin glycation in the formation of disulfide-linked aggregates. PMID- 2780680 TI - Nonenzymatic glycosylation of DNA by reducing sugars. AB - The process of nonenzymatic glycosylation has proven to be not only of interest to food chemists in the preservation of foodstuffs, but has become of increasing interest to biologists. The nonenzymatic glycosylation of biologically relevant proteins has become an important factor in explaining some of the posttranslational modifications of proteins observed in diabetes and aging. Using in vitro and in vivo models, we describe in this paper the implications that the nonenzymatic glycosylation of DNA may have in the biological aging process. PMID- 2780682 TI - Second Vienna Shock Forum. Proceedings. May 12-14, 1988. PMID- 2780681 TI - 3-Deoxyglucosone, an intermediate product of the Maillard reaction. AB - The Maillard reactions between proteins and glucose or fructose, in 0.2M phosphate buffer (pH 7.4) at 37 degrees C, were investigated and the following results were obtained: 1) 3-deoxyglucosone (3DG) is formed as the major carbonyl intermediate; 2) fructose has a higher reactivity than glucose and 3DG is formed also from fructose without involvement of amino groups; 3) 3DG is a crosslinker responsible for polymerization of proteins; 4) 3DG is involved in the formation of a fluorescent advanced-stage product named "Peak L1" in vitro and in vivo. PMID- 2780684 TI - Haemodynamic effects during treatment of sepsis and septic shock with immunoglobulins and plasma-pheresis. PMID- 2780683 TI - Thrombin-induced neutrophil adhesion. PMID- 2780685 TI - Determination of antibodies against bacterial lipopolysaccharides and lipid A by immunoblotting. PMID- 2780686 TI - Diltiazem prevents endotoxin-induced disturbances in intracellular Ca2+ regulation. PMID- 2780687 TI - Therapy of acute respiratory distress syndrome with nifedipine. PMID- 2780688 TI - Pharmacological effects of RA 642 on cerebrocortical perfusion in acute hemorrhagic shock in rats. PMID- 2780689 TI - Use of systolic time intervals to evaluate the effect of dopamine infusion in septic and burn shock. PMID- 2780690 TI - Tissue oxygen debt as a determinant of postoperative organ failure. PMID- 2780691 TI - Is skeletal muscle PO2 related to the severity of multiple organ failure and survival in critically ill patients? A preliminary study. PMID- 2780692 TI - Phase-related vascular reactivity in hemorrhagic shock. PMID- 2780693 TI - Ultrastructural study of the gastric mucosa after septic shock in the rat. PMID- 2780694 TI - Pulmonary pressure-flow relationship and peripheral oxygen supply in ARDS due to bacterial sepsis. PMID- 2780695 TI - Cardiac function changes monitored by radionuclide ventriculography in the septic shock baboon model. PMID- 2780697 TI - Negative inotropic and cardiovascular effects of a low molecular plasma fraction in prolonged canine hypovolemic traumatic shock--papillary muscle and isolated heart preparation. PMID- 2780699 TI - Pathophysiological correlates of cardiac overperformance in sepsis and septic shock. PMID- 2780696 TI - The influence of tachycardia during shock on changes in cardiac volumes. PMID- 2780698 TI - Evaluation of heart performance during septic shock in sheep. PMID- 2780700 TI - Complement activation and endotoxin in sepsis. PMID- 2780701 TI - Neutrophil stimulation by PMA increases alveolar permeability in rabbits. PMID- 2780702 TI - Changes of ceruloplasmin activity in patients with multiple organ failure. PMID- 2780703 TI - Chemiluminescence-inducing radicals in experimental porcine septic shock lung. PMID- 2780704 TI - Pulmonary fat embolism--an epiphenomenon of shock or a proper mediator mechanism? PMID- 2780705 TI - The effect of mucosal integrity and mesenteric blood flow on enteric translocation of microorganisms in cutaneous thermal injury. PMID- 2780706 TI - Dose related effect of endotoxin on the reticulo endothelial system (RES), the sinusoidal cells in the liver, and on hepatocytes from rats. PMID- 2780707 TI - The trigger for posttraumatic multiple organ failure: surgical sepsis or inflammation? PMID- 2780708 TI - Effect of platelet-activating factor (PAF) administration in chronically instrumented sheep--analysis of PAF in plasma. PMID- 2780709 TI - The role of tumor necrosis factor/cachectin in septic shock. PMID- 2780710 TI - The involvement of platelet-activating factor (PAF)-induced monocyte activation and tumor necrosis factor (TNF) production in shock. PMID- 2780711 TI - Cytological changes in alveolar cells with ARDS. PMID- 2780712 TI - Serum mediated depression of chemiluminescence response of granulocytes in hemorrhagic shock. AB - CL of PMNL was decreased in the early stage of hemorrhagic shock in the rat if evaluated from whole blood. When standardized PMNL were incubated with plasma of different shock states the same serum--mediated depression was observed. In all stages killing activity of PMNL per se from arterial blood (after passage of pulmonary endothelium) was nearly unchanged if measured in standardized pool plasma. Furthermore in the prefinal stage of uncompensated shock highly activated PMNL were obtained. These results support the hypothesis that plasmatic--cellular interactions play an important role in depression of killing activity of PMNL already in early hemorrhagic shock. Actual concepts mention protein cleavage products, fluid phase C3b and prostaglandins as potential mediators of this serum -mediated suppression. PMID- 2780713 TI - Breakdown of C3 complement and IgG in peritonitis exudate--pathophysiological aspects and therapeutic approach. PMID- 2780714 TI - Septic adult respiratory distress syndrome and multiple system organ failure. PMID- 2780715 TI - Modification of protein kinase C (PKC) activity and diacylglycerol (DAG) accumulation in hepatocytes in continuous endotoxemia. AB - On the basis of our work, the status of PKC-mediated signal transduction in hepatocytes in chronic endotoxemia can be summarized as follows: 1. Vasopressin (10(-8) M)-induced DAG accumulation is delayed and reduced by 50%, as compared with the response of cells of saline-infused rats. 2. Under basal conditions, total PKC activity (cytosol + pellet) is elevated due to a tendency for higher cytosolic fractional activity. 3. Both TPA- and hormonally-induced (in response to VP and PE) translocation are impaired. 4. Quantitative receptor autoradiography reveals a selective decrease in [3H-PDBu] binding sites in hepatic membranes. We conclude that modulation in endotoxemia of the DAG signal elicited by VP stimulation in hepatocytes could lead to altered transmembrane control of PKC-mediated protein phosphorylation, thereby contributing to the mechanism of impairments in the regulation of cellular metabolism. PMID- 2780716 TI - Influence of sepsis on perfused rat liver metabolism. PMID- 2780717 TI - Septic shock and acute respiratory failure. PMID- 2780718 TI - The use of scoring systems in patients with cardiogenic and septic shock. PMID- 2780719 TI - Efficiency of sepsis score, AT III- and endotoxin evaluation in predicting the prognosis of postoperative sepsis in the intensive care unit. PMID- 2780721 TI - Validity of the elastase assay in intensive care medicine. PMID- 2780720 TI - Risk factors of the multiple organ failure. PMID- 2780722 TI - Diiodotyrosine (DIT): a new marker of leukocyte phagocytic activity in sepsis and severe infections. PMID- 2780724 TI - Leukocyte induced pulmonary damage using intraperitoneal zymosan. PMID- 2780723 TI - The prognostic value of plasmaproteins in patients with abdominal sepsis. AB - In the course of the history of patients with severe peritonitis, opsonins, complements and other proteins of the plasma showed no significant difference between the data of the patients who later died or survived. We conclude that simple parameters like platelet count, creatinine and respiratory function are more sufficient. PMID- 2780725 TI - The PFI-index according to Aasen for prognosis and course of polytraumatized patients. PMID- 2780726 TI - Biochemical and hormonal parameters in patients with multiple trauma. AB - We measured amount, course and duration of different parameters in order to assess metabolic-endocrine changes in patients with multiple trauma and the final outcome. Injures were initially quantified according to the Injury Severity Score. Serum levels of lactate, creatinine, bilirubin, somatomedin and thyroid hormons were measured in 51 patients (39 survivors, 12 deceased patients) for six days following the injury. In addition, neopterin levels were measured in 26 patients (19 survivors, 7 deceased patients). The patients were devided into two groups (survivors vs non-survivors). Global Index Scores and Septic Severity Scores were significantly different at the 1% and 5% level (p less than 0.05 to p less than 0.01). The same statistical differences were shown for lactate, somatomedin, neopterin and thyroid hormones. PMID- 2780727 TI - Phospholipase A in severely ill patients. PMID- 2780729 TI - Lymphocyte/monocyte-ratio correlates with survival from infections and multi organ failure following polytrauma. PMID- 2780728 TI - The clinical significance of serum phospholipase A in patients with multiple trauma. PMID- 2780730 TI - A prospective study to evaluate posttraumatic liver function by scintigraphy as a possible predictor of organ failure. PMID- 2780731 TI - Exogenous surfactant in experimental aspiration trauma. PMID- 2780732 TI - Effect of an altered fluid regimen of extravascular lung water in advanced septic shock states. PMID- 2780733 TI - Effect of large volume replacement with crystalloids on extravascular lung water in human septic shock syndrome. PMID- 2780734 TI - Decontamination of the gastrointestinal tract and prevention of multiple organ failure. An experimental study. PMID- 2780735 TI - Nebulized corticosteroid in experimental respiratory distress. PMID- 2780736 TI - The 21-aminosteroid U74006F reduces systemic lipid peroxidation, improves neurologic function, and reduces mortality after cardiopulmonary arrest in dogs. PMID- 2780737 TI - Alpha-mercaptopropionylglycine in haemorrhagic shock. PMID- 2780738 TI - Dynamics of prostacyclin and thromboxane during myocardial ischemia. PMID- 2780739 TI - Effect of a new and specific PAF-antagonist, WEB 2086, on PAF and endotoxin/tumor necrosis factor induced changes in mortality and intestinal transit velocity. PMID- 2780740 TI - Effect of PAF-antagonists in endotoxin shock--ovine and rat experiments. PMID- 2780741 TI - Therapeutic effects of the combination of two proteinase inhibitors in endotoxin shock of the pig. AB - Thrombin activation is an important underlying pathomechanism for septic organ failure. The selective thrombin inhibitor, hirudin, reduces the endotoxin-induced fibrinogen consumption and thus the formation of fibrin monomer, as well as the pulmonary vasoconstriction in pigs at plasma concentrations of 70 to 100 nmol/l. PMN cell activation with subsequent release of digestive proteases is in part responsible for the loss of fluid and protein from the vascular compartment during septic shock. Administration of the inhibitor of PMN elastase, cathepsin G and mast cell chymase, eglin C, reduces the loss of intravascular protein during the first 4 hours of endotoxin shock at plasma concentrations in the range of 2 mumol/l. PMID- 2780742 TI - Reasons for the ineffectiveness of eglin C to ameliorate endotoxin shock in sheep. PMID- 2780743 TI - Therapeutic modalities to ameliorate endotoxin induced DIC in the rats. PMID- 2780744 TI - Hepatic iron stores in thalassemia: non-invasive magnetic measurements. PMID- 2780745 TI - Prospects for effective oral iron chelation therapy in man with 1,2-dimethyl-3 hydroxypyrid-4-one and other alpha-ketohydroxypyridines. PMID- 2780746 TI - High-dose intravenous chelation therapy with deferoxamine. PMID- 2780747 TI - Medical management of beta-thalassemia. PMID- 2780748 TI - Quality of life and life expectancy in thalassemic patients with complications. PMID- 2780749 TI - Compliance with therapy in Cooley's anaemia. PMID- 2780750 TI - Cardiac complications in homozygous beta-thalassemia. PMID- 2780752 TI - Endocrine complications in thalassaemia major. PMID- 2780751 TI - Sexual performance and fertility potential in patients with beta thalassemia major. PMID- 2780753 TI - Malaria and the red cell:2. Proceedings of the second workshop. Ann Arbor, Michigan, October 24, 1988. PMID- 2780754 TI - Possible roles for oxidants, through tumor necrosis factor, in malarial anemia. PMID- 2780756 TI - [A study by infrared spectroscopy of interactions between the time of disintegration of tablets and liberation of the active principal]. AB - It was shown that the study of the infrared spectra of a drug and of the mixture drug + additives facilitates the preliminary studies for a tablet formulation. Thus, any interaction that may occur or affect the product stability can be detected and located. Furthermore, it was noticed that an interaction between an active ingredient and the various additives may modify the tablet desintegration time, but not necessarily the dissolution rate of this substance. PMID- 2780755 TI - [Adsorbed plant extracts, use of extracts of dried seeds of Orthosiphon stamineus benth]. AB - The work presented is related to the elaboration and the control of spray dried vegetable extracts of Orthosiphon Stamineus Benth. From these studies, it feasibility of the spray dried extracts. The best result concerning a pulverulent structure and the stability under moisture conditions is obtained using Aerosil 200. Pharmacological studies on rats have shown a diuretic activity under our experimental conditions with alcoholic and water extracts. PMID- 2780757 TI - Bioadhesive dosage form for peroral administration of timolol base. AB - Timolol base was prepared from its maleate salt and checked for purity, pKa (9.03) and n-octanol/phosphate buffer pH 6.6 partition coefficient (1.72). The rate of swelling of sodium carboxymethylcellulose, Carbopol 934 (CP) and hydroxypropylcellulose (HPC) was examined prior to use in bioadhesive compacts with the model drug methylene blue to study their influence on device integrity and drug diffusion. A final compact containing a core of timolol base and Precirol, a bioadhesive layer of CP and HPC, and a cap of magnesium stearate gave sustained release of the drug in simulated saliva pH 6.6. After preliminary evaluation in dogs, the compact was evaluated in a panel of humans in whom it was shown that the flux of drug could be increased from 70 to 127 micrograms mm-2 h-1 by inclusion of the penetration enhancer sodium lauryl-sulphate into the core formulation. PMID- 2780758 TI - In-vitro dissolution behavior of some sustained-release theophylline dosage forms. AB - In-vitro dissolution of theophylline from six commercially sustained-release (SR) preparations (Euphyllin retard, Euphyllin retard mite, Theovent L.A. 125 mg, Theovent L.A. 250 mg, Phyllocontin and Uniphyllin) was determined by using rotating basket and rotating bottle apparatus. The effect of pH and rotating speed on the dissolution rate of these SR products was also studied. Scanning electron microscope was used to observe the change of surface topograph and inner texture of these products before, during and after dissolution. The results indicates that the dissolution behavior was pH-dependent which corresponding to the types of SR products. The rotating bottle method was only suitable for the evaluation of release rate of spansule-type SR products and was not suitable for matrix-type SR tablets due to the sticking occurred on the bottle surface leading to faster dissolution and larger variation. The release mechanism of these six SR products can be deduced into three models. Fickian transport (Phyllocontin), non Fickian transport (Euphyllin, Theovent L.A. 250 mg and Uniphyllin) and zero order transport (Theovent L.A. 125 mg). PMID- 2780759 TI - The optimal processing of plasma samples for the determination of bicyclo-PGE in patients with malignant maxillofacial tumors. AB - Prostaglandins (PGs) have been shown to be increased in several tumor tissues. PGE2 and PGF1-alpha Radioimmunoassays (RIAs) have been widely used for quantitative PG-measurements in cancer patients. Our results indicate that optimal processing of plasma samples for the determination of bicyclo-PGE2 is of the highest importance in order to get reproducible results. Therefore it is necessary to fulfill the following requirements: 1. 30 minutes rest before sampling; 2. Avoid venous occlusion; 3. Use constant needle diameter; 4. Precooled anticoagulant; 5. Addition of a cyclooxygenase inhibitor is necessary; 6. Control of processing temperature; 7. Storage at -70 degrees C less than -20 degrees C; 8. Control of storage time; 9. The samples have to be examined after thawing once; 10. Only blood samples processed under the above discovered optimal conditions are of clinical relevance; 11. An international standardization for the processing of plasma samples seems to be necessary considering all these requirements; 12. In 41 patients with maxillo-facial carcinomas the PG-value was significantly higher than in the controls; 13. A RIA-evaluation methodologically properly done may be used as an additional aid for clinical monitoring of the patients. PMID- 2780760 TI - Protection of the heart from ischemia by a new oligomeric derivative of prostaglandin E1. AB - A lipophilic oligomeric ester was synthesized from prostaglandin E1. The compound was found to protect a Langendorff perfused rat heart from ischemic insult. After 15 minutes cessation of perfusion, the flow was restarted, and the recovery of contraction was measured. In control experiments, the recovery was 16.1 +/- 7.3%. In the case of pre-ischemic addition of the compound (10 micrograms/ml at 10 minutes before ischemic insult), the recovery was 31 +/- 13.2% (n = 7; the difference was not significant). In post-ischemic addition (10 micrograms/ml), the recovery was 75.9 +/- 9.0% (n = 7; p less than 0.01). The compound was also effective in protecting rat heart myocytes against a 60 minutes anoxia/15 minutes reoxygenation injury as judged by the loss of "rod-shaped" intact myocytes. At a 10 micrograms/ml concentration, the compound protected against the loss of rod shaped myocytes by 30% in pre-anoxia addition and 35% in post-anoxia addition. The levels of significance in these experiments were p less than 0.001. Possible mechanisms of action of this compound are discussed. PMID- 2780761 TI - Relative effects of flurbiprofen on platelet 12-hydroxy-eicosatetraenoic acid and thromboxane A2 production: influence on collagen-induced platelet aggregation and adhesion. AB - Flurbiprofen has been shown to inhibit cyclo-oxygenase metabolism of arachidonic acid to thromboxane A2 (TxA2), resulting in the inhibition of platelet aggregation. Recently, our laboratory reported that the "irreversible" phase of platelet aggregation and adhesion were regulated, in part, by the lipoxygenase metabolism of arachidonic acid to 12-hydroxy-eicosatetraenoic acid (12-HETE) in platelets, and that selective inhibition of one enzyme i.e. either cyclo oxygenase or lipoxygenase, resulted in paradoxical effects on the metabolism of arachidonic acid and platelet response related to the other pathway. Therefore, we performed experiments to assess the relative effects of flurbiprofen on TxA2 and 12-HETE synthesis, and on collagen-induced platelet aggregation and platelet adhesion to collagen-coated surfaces. "Irreversible" collagen-induced platelet aggregation was only partially inhibited by pre-incubation with 1 x 10(-6) M flurbiprofen, while TxA2 production was elevated and 12-HETE production was maximally inhibited in these platelets. At this concentration of flurbiprofen (1 x 10(-6)M), collagen-induced platelet adhesion was also reduced by 50%. At higher concentrations of flurbiprofen, both platelet aggregation and adhesion were further reduced, with a corresponding inhibition of TxA2 production. Thus it appears that the lipoxygenase pathway of arachidonic acid metabolism in platelets is not only inhibited by flurbiprofen, but is more sensitive to inhibition by flurbiprofen than the cyclo-oxygenase pathway. This differential effect of flurbiprofen on arachidonic acid metabolism in the platelet is related to differential effects on platelet function. PMID- 2780762 TI - Preinduction cervical priming with PGE2 vaginal film in primigravidae--a randomised, double blind, placebo controlled study. AB - Previous reports with an 850 micrograms prostaglandin E2 film for cervical ripening before induction of labour in term pregnancy have been favourable. These studies however had no controls. The present study compares this PGE2 vaginal film with a nonmedicated similar vaginal film (placebo) for preinduction cervical ripening in primigravid women at term. A total of 69 women with modified Bishop's cervical scores 1-5 were assigned randomly to either the PGE2 group (33 women) or placebo group (36 women). Cervical score assessments were made at 12 and 24 hours after which labour was induced by amniotomy and oxytocin infusion. Although the cervical scores between placebo and PGE2 groups at 12 and 24 hours were not significantly different, the scores were marginally better with the prostaglandin film. Pregnancy outcome was satisfactory in both groups with no perinatal or maternal mortality and morbidity. The caesarean rate was 30.6% in the placebo group and 24.2% in the PGE2 group. This study emphasizes the need for a control group when studying the success of agents used for ripening the pregnant cervix at term. PMID- 2780763 TI - Role of prostanoids in respiratory failure during circulatory shock of intestinal origin in dogs. AB - The role of prostanoids in respiratory failure during circulatory shock of intestinal origin was investigated in anesthetized, non-ventilated dogs by measuring PGF2 alpha thromboxane B2 (TXB2) and 6-keto prostaglandin F1 alpha (PGF1 alpha) in arterial and mixed venous (right ventricle) blood samples during superior mesenteric artery occlusion-induced (SMAO) shock. Release of the SMAO caused a dramatic decrease in mean arterial blood pressure (MABP), arterial and mixed venous pO2, hyperventilation and a more than 2 fold increase in levels of prostanoid studied within 5 min. At the same time, arterial and mixed venous pCO2 and pH remained unchanged. Thereafter, 6-keto PGF1 alpha concentration decreased so that at 60 min post release it was not significantly different from that of control values. PGF2 alpha and TXB2 levels rose continuously during shock. Respiratory failure which occurred after declamping was characterized by low pO2 and oxygen saturation and hyperventilation throughout the experiment. Pulmonary metabolism of PGF2 alpha was significantly reduced in shock. Indomethacin significantly attenuated the magnitude of postocclusion hypotension and respiratory failure, furthermore reduced prostanoid production. The present results suggest that PGF2 alpha and thromboxane A2 released by intestinal tissues might play an important role in the development of respiratory failure in shock caused by intestinal ischemia. PMID- 2780764 TI - Endometrial content of prostaglandin precursors during the menstrual cycle. AB - Fractionated curettage was performed in 18 women with cervical intraepithelial neoplasia. Otherwise all appeared to be healthy. The histological examination showed 9 of them to have been sampled in the follicular phase and the other 9 in the luteal phase. Endometrial specimens were simultaneously taken for analysis of the fatty acid pattern of lecithin (PC) and phosphatidylethanolamine (PE) by means of gas-liquid chromatography (GLC). In the luteal phase we found increased concentrations of the total sum of essential fatty acids of the linoleic acid series both in PC and PE (p less than 0.01 in both cases). All the main fatty acid components within this series showed increased mean levels in the luteal phase but only arachidonic acid (20:4) in PE was significantly elevated (p less than 0.01). The total sum of the alpha-linolenic acid series was unaffected by the phase of menstrual cycle. These results seem to indicate that the endometrium accumulates prostaglandin precursors towards the time for menstruation. PMID- 2780765 TI - Inhibition of ischemic brain edema formation by post-ischemic administration of a prostaglandin oligomer. AB - We studied the efficacy of an oligomeric derivative of prostaglandin E1 in protecting the rat brain against focal ischemia. The degree of ischemic damage was evaluated from three parameters, namely, the degree of edema formation, reduction of motor performance, and memory disturbance as measured by a passive avoidance test. The pre-ischemic administration of the drug (6 mg/kg i.p.) had some effects, but the differences were not significant. The post-ischemic administration (6 mg/kg i.p.) produced significant improvement in all three parameters. The increase of water content of the ischemic hemisphere was reduced (p less than 0.05); the total motor score was improved (p less than 0.01); and the memory disturbance as estimated by the passive avoidance test was reduced (p less than 0.01). A possible mechanism of protection is discussed. PMID- 2780766 TI - Plasma thromboxane B2 levels and thromboxane B2 production by platelets are increased in patients during spinal and epidural anesthesia. AB - Concentrations of thromboxane (Tx) B2 in plasma and its production by platelets were measured in 20 spinal and 10 epidural anesthesia patients scheduled for small operations in the lower extremities. The main metabolite of prostacyclin, 6 keto-PGF1 alpha and prostaglandin (PG) E2 in plasma were also determined. Plasma TxB2 and TxB2 production by platelets increased during both spinal and epidural anesthesia. Plasma TxB2 levels also remained elevated 1 h after anesthesia. The plasma concentrations of 6-keto-PGF1 alpha and PGE2 did not change during spinal or epidural anesthesia. In in vitro studies, only low concentrations of lidocaine (0.5-1.0 micrograms/ml) and bupivacaine (0.5-3.0 micrograms/ml) increased platelet TxB2 production. In platelet rich plasma, neither lidocaine nor bupivacaine in concentrations of 0.5-3.0 micrograms/ml caused constant changes in ADP-induced platelet aggregation, but they inhibited it in toxic concentrations (12 micrograms/ml). The results suggest that the increased TxB2 plasma levels and platelet TxB2 production during regional anesthesia are not caused by local anesthetics itself but by other factors, e.g. tissue trauma. In clinically found concentrations, local anesthetics do not cause any constant changes in platelet aggregation. PMID- 2780767 TI - Wy-48,252 (1,1,1-trifluoro-N-[3-(2-quinolinylmethoxy)phenyl]methane sulfonamide) an orally active leukotriene D4 antagonist: pharmacological characterization in vitro and in vivo in the guinea pig. AB - The following communicates the pharmacology of Wy-48,252 (1,1,1-trifluoro-N-[3-(2 quinolinylmethoxy)phenyl]methanesulfonamide) a chemically novel and orally potent leukotriene (LT) D4 receptor antagonist. In the isolated guinea-pig trachea pretreated with indomethacin (5 microM) and L-cysteine (10 mM), Wy-48,252 antagonized TD4-induced contraction with a pKB = 7.6. Against LTC4 on tissues pretreated with IND and glutathione (10 mM), Wy-48,252 had a pKB greater than 5. Wy-48,252 (10 microM) did not antagonize pilocarpine-, histamine- or PGF2 alpha induced tracheal contraction. Further, in the presence of indomethacin and chlorpheniramine (1 microM), Wy-48,252 dose-dependently inhibited the antigen induced contraction of guinea-pig trachea in a manner consistent with antagonism at the LTD4 receptor and inhibition of LT synthesis. In the Konzett-Rossler model of i.v. LTD4-induced bronchoconstriction in indomethacin treated guinea pigs, intragastric Wy-48,252 (2 hr) had an ID50 of 100 micrograms/kg and a functional half-life of 5 hr. Against i.v. antigen-induced bronchoconstriction in guinea pigs treated with indomethacin and chlorpheniramine, intragastric Wy-48,252 (2 hr) had an ID50 of 0.6 mg/kg and a 5 hr half life. Intragastric Wy-48,252 also selectively blocked the cutaneous wheal reaction to intradermal LTD4 but not histamine. We conclude that Wy-48,252 is distinguished from other selective LTD4 receptor antagonists by its oral potency and should be useful in ascertaining the role of LTD4 mediated processes in asthma, allergy and animal models. PMID- 2780768 TI - Effects of prenatal nicotine exposure on rat striatal dopaminergic and nicotinic systems. AB - Previously we observed that chronic nicotine-treated adult rats developed locomotor hyperactivity which was mediated by changes in nicotinic and dopaminergic receptors in the striatum. In this study, we further examined if such changes would also occur in pups that were prenatally exposed to nicotine. Fourteen-day-old offspring from dams which were implanted with osmotic minipumps containing nicotine (1.5 mg/kg/day) throughout the entire gestational period were employed in this investigation. Prenatal nicotine treatment lowered the number of male pups born and reduced the postnatal gain in body weight and length of both male and female offspring. Prenatal exposure to nicotine did not alter the motor coordination of the pups. A decrease in the number of striatal dopaminergic receptor binding sites (Bmax) was detected in the male pups, however an increase in the ligand affinity to the receptors (1/KD) had been simultaneously detected. No change in the characteristics of nicotinic receptor binding sites and the levels of dopamine and its metabolite, 3,4-dihydroxyphenylacetic acid was found in the striatal region. The present study indicates that prenatal exposure to nicotine may cause changes in growth and development of the animals. However, in comparison to chronic nicotine-treated adult rats, prenatal exposure to nicotine had only modified the dopaminergic receptor system in the striatal region of male offspring. PMID- 2780769 TI - Pentylenetetrazol-induced seizures in pigeons and the effects of ethosuximide thereon. AB - Previous research has shown that ethosuximide in high enough doses disrupts operant responding in pigeons. Whether or not these same doses protect against seizure activity in this species has not been determined. In the present study a system for scoring pentylenetetrazol-induced seizures in pigeons was developed and the effects of ethosuximide on such seizures were evaluated. Pentylenetetrazol at 15, 27 and 47 mg/kg reliably induced seizures in Experiment 1. In Experiment 2 six doses of ethosuximide were tested for their seizure controlling effectiveness. Doses of 20, 40, 80, 160 and 320 mg/kg ethosuximide had little effect on seizures induced by 27 mg/kg pentylenetetrazol; 640 mg/kg significantly reduced but did not completely eliminate seizures. This dose (640 mg/kg) is several times higher than the doses found to disrupt operant behavior in our previous studies. PMID- 2780770 TI - Comparative study of the behavioral changes evoked by d-amphetamine and apomorphine in adult cats. Dose-response relationship. AB - The behavioral effects of d-amphetamine and apomorphine administration were studied in 17 adult cats. The doses of amphetamine administered were 0.1, 0.5, 1.0 and 5.0 mg/kg; those of apomorphine, 0.1, 0.5, 1.0 and 2.0 mg/kg. These two drugs evoked in the same animal marked differences in behavioral responses. Amphetamine induced a dose-dependent hypomotility, which was marked with the higher doses. In addition, rhythmic, bilateral slow movements of the head as a mode of stereotypy, indifference to the environment and dose-dependent increase in respiratory rate. Apomorphine elicited limb flicking, dose-dependent hypermotility and increase in olfactory behavior, the last two reactions with stereotypy characteristics. The animals appeared as if being scared, hyperreacting to sudden stimuli and showing total indifference to the surrounding environment. There were marked differences in behavioral responses evoked by these two agonists of the catecholaminergic system. These data do not conform with the behavioral reactions reported in the rat by other investigators. The disagreement with other communications is probably due to differences in reactivity of the species employed. The processes involved in the diversity of the behavioral responses of the cat to the administration of amphetamine and apomorphine have not been delucidated. PMID- 2780772 TI - Acute electrophysiologic effects of inhaled toluene on adult male Long-Evans rats. AB - Experiments were carried out in Long-Evans rats to verify and extend previous findings about the effects of toluene on sensory-evoked potentials (EPs) of Fischer-344 rats. Inhalation exposures to 3000 and 8000 ppm in Long-Evans rats confirmed that toluene 1) transiently enhances certain components of somatosensory, flash- and click-evoked (brainstem) potentials, 2) increases the latencies and interwave times of brainstem auditory-evoked responses, 3) depresses late components of the flash EP, 4) induces high frequency oscillations in the visual cortex, and 5) produces both facilitatory and suppressant effects on EPs, dependent on exposure concentration and time. New results indicated that toluene 1) has similar effects on Long-Evans as it does on Fischer-344 rats, 2) increases EEG theta activity, 3) has minor effects on cortical auditory and pattern-reversal EPs (PREP), but suppresses the steady-state PREP, and 4) induces oscillations in the visual cortex, irrespective of the presence of flashes. PMID- 2780771 TI - A permanent dopamine receptor up-regulation in the ovariectomized rat. AB - Although a permanent supersensitivity to dopamine agonists can be induced by lesions of the nigrostriatal dopamine tract, the ovariectomized rat is the first animal model of a permanent hypersensitivity to dopamine agonists in which the neurons survive. This permanent behavioral hypersensitivity to direct acting dopamine agonists is accompanied by an increase in D2 dopamine receptor density in the striatum. PMID- 2780773 TI - Comparison of oral and subcutaneous routes of cocaine administration on behavior, plasma drug concentration and toxicity in female rats. AB - Oral and subcutaneous routes of administration of cocaine HCl were investigated in female Wistar rats for food and water consumption, locomotor activity, stereotypic behaviors, plasma drug concentrations and injection site pathology. Animals received either 40 or 80 mg/kg/day by gastric intubation (PO-40 and PO-80 respectively) or 20 or 40 mg/kg/day subcutaneously (SC-20 and SC-40). All groups received the drug or the vehicle for 16 consecutive days. Locomotor activity and stereotypy were evaluated on Days 1, 5, 10, and 15. Plasma drug concentrations and injection site pathology were determined on Day 16. Subcutaneous administration was associated with a sensitization to the effects of cocaine on locomotion and stereotypy, higher blood levels than oral administration at the same dose, and severe dermal lesions. However, there were no differences in any measure between the SC-20 and SC-40 groups. Oral cocaine was also associated with behavioral sensitization. However, unlike the SC route, oral cocaine was characterized by dose-related increases in locomotion and stereotypy in the absence of gastrointestinal pathology. Inasmuch as oral administration resulted in dose-response relationships and low toxicity while subcutaneous administration did not, these factors should be considered in future studies utilizing chronic cocaine administration. PMID- 2780774 TI - Effects of naltrexone on food preference and concurrent behavioral responses in food-deprived rats. AB - Naltrexone (0.05-5.0 mg/kg, SC) was administered to food-deprived rats prior to a 15-min food-preference test. Total food intake and feeding duration was reduced following administration of the opiate antagonist. However, while naltrexone reduced the consumption of the initially-preferred chocolate-coated cookies, the ingestion of the nonpreferred standard laboratory chow pellets was significantly enhanced. These data cannot be explained in terms of a general anorexic effect and nonspecific suppression of feeding responses. Instead, they indicate that naltrexone reduced preference for the highly palatable cookies, so that a feeding response to the chow pellets emerged. Under the conditions of test-familiarity, naltrexone did not reduce grooming, locomotion or rearing duration. An increase in locomotion may have been secondary to the reduction in feeding. The results agree with previous data from animal and human studies in suggesting that endogenous opioid peptide activity is involved in the palatability of preferred foods. PMID- 2780776 TI - How does puffing behavior alter during the smoking of a single cigarette? AB - We examined changes in puffing behavior during the course of a single cigarette in 76 subjects seen on 6 occasions each (456 cigarettes). The puff volume fell on average by 33% during a cigarette and puff duration by 39%, the interpuff interval rose by 75%, but the pressure drop and the maximum flow and pressure achieved during puffing hardly changed. There were highly significant differences between subjects but not between sessions, or when subjects were grouped according to tar yield of the cigarette or by sex. Individual puff volumes with a single cigarette were highly correlated with puff duration (except in a few individuals with irregular puffing patterns), but not generally with maximum flow rate, suggesting that most smokers reduce volume by taking shorter puffs. This is unlikely to reflect mechanical factors or smoke temperature, and may be a response to changing smoke composition. Variation in puffing patterns between individuals may reflect differences in sensitivity to smoke components and individuals who show little fall in puff volume also show small responses on switching to cigarettes with different tar and nicotine yields. The individual response to smoke might be assessed by an analysis of puffing on a single cigarette. PMID- 2780775 TI - Amphetamine enantiomers and rat consummatory behavior: a new perspective. AB - The anorectic actions of amphetamine have been known for over forty years, yet the precise relationship(s) between the enantiomeric forms of the drug and anorexia is not clearly understood. Previous studies have utilized primarily racemic amphetamine or its d-isomer in the analysis of feeding behavior. In the present investigation, a detailed examination of the effects of single and repeated equiactive doses of d- and l-amphetamine on food consumption by adult male rats was undertaken with emphasis on aspects of tolerance development. Weight loss and pattern of daily food intake differed depending upon the isomer, dose, and degree of tolerance. Two types of tolerance were seen with both isomers, an initial tolerance with a decrease in efficacy between days 1 and 2, and a later gradual decrease in efficacy over 12 days of repeated dosage. Rats tolerant to the anorectic effects of d-amphetamine were only minimally affected when challenged with an equiactive anorectic dose of l-amphetamine, while rats tolerant to the anorectic effects of l-amphetamine showed a significantly depressed food intake and modified eating pattern when challenged with an equiactive dose of d-amphetamine. Therefore two-way cross tolerance, as previously assumed, does not completely exist between low equiactive doses of d- and l-amphetamine. PMID- 2780777 TI - The actions of nicotine and cocaine in a mouse model of anxiety. AB - The acute administration of nicotine (0.01-1.0 mg/kg IP) to the mouse increased the time spent and rearings and line crossings in the aversive brightly illuminated white area of a two compartment white/black test box, with a corresponding decrease in the black. This profile of change was maintained during twice daily administration (0.1 mg/kg IP) for 14 days. Eight to 96 hr following withdrawal of nicotine (14-day treatment), the behavioural profile was reversed to a preference for the black area: by 240 hr values had returned to control levels. In contrast to the effects of nicotine, an acute injection of cocaine (0.1-10 mg/kg IP) exacerbated the aversive response to the white area. However, similarly to nicotine, the administration of cocaine (1.0 mg/kg IP) twice daily for 14 days reduced the aversion to the white area and exacerbated the response following cocaine withdrawal. The effects of nicotine and cocaine to reduce and enhance responsiveness to the aversive properties of the white area are discussed in terms of an anxiolytic and anxiogenic response and the possibility of a serotonergic involvement. PMID- 2780778 TI - Reinforcing and subjective effects of diazepam in nondrug-abusing volunteers. AB - Preference for diazepam was assessed in 18 light and 12 moderate social drinkers using a cumulative dosing procedure. The 7-session procedure consisted of: 1) four sampling sessions, during which participants ingested color-coded capsules containing either diazepam (five 4-mg capsules administered at 30-min intervals; total dose 20 mg) or placebo, and 2) three choice sessions, during which they could ingest up to 7 capsules of their preferred color of capsule, each separated by 30 min. Subjective (mood) and behavioral (performance) measures were obtained throughout the 4-hour sessions. The light social drinkers chose diazepam over placebo on 66% of the choice sessions, and ingested a mean dose per session of about 16 mg. The moderate drinkers chose diazepam on 100% of the choice sessions, and ingested an average dose of 25 mg per session. Diazepam produced sedation in both groups, but in the moderate drinkers it also increased measures of subjective effects suggestive of "euphoria." The results indicate that diazepam can serve as a positive reinforcer under laboratory conditions in nondrug-abusing individuals who are moderate users of alcohol and other drugs. Greater reinforcing efficacy may be indicative of higher risk of abuse. The results illustrate the usefulness of the cumulative dosing procedure to measure both drug preference and dose preference. PMID- 2780779 TI - Dissociation of naloxone-sensitive and naloxone-insensitive effects of U-50,488H. AB - This study was designed to compare the dose-related effects of U-50,488H on the cortical electroencephalogram (EEG) and behavior, following either saline or naloxone pretreatment. Adult female Sprague-Dawley rats were implanted with chronic cortical EEG and temporalis muscle electromyographic (EMG) recording electrodes and with permanent cannulae in the external jugular vein. U-50,488H injection produced initial "psychotomimetic-like" EEG and behavioral effects for about 10-20 min, followed by a predominance of behavioral stupor and associated EEG slow-wave bursts for about 20 min. Naloxone pretreatment completely antagonized the behavioral stupor and associated EEG slow-wave bursts. However, the "psychotomimetic-like" effects were not antagonized by naloxone pretreatment. Thus, dissociation between naloxone-sensitive and naloxone-insensitive effects of U-50,488H was demonstrated. PMID- 2780780 TI - Attenuation of conditioned taste aversions by external stressors. AB - Conditioned taste aversions (CTAs) were produced by low doses of toxins injected 30 or 60 min after rats finished drinking saccharin solution. Attempts were made to attenuate these CTAs by subjecting the rats to stress or to injections of glucocorticoids (primarily dexamethasone) during the interval between saccharin consumption and injection of the toxin. The stressors used were statistically indistinguishable in their effects: swimming, constant footshock (for 2 min), or intermittent footshock (for 10 min). The extent to which different agents attenuated CTAs depended on which toxin was used to produce the CTA as follows. The stressors produced marked CTA attenuation when lithium was the toxin, but none when cisplatin was the toxin. The glucocorticoids exhibited an opposite pattern of marginal CTA attenuation with lithium and marked CTA attenuation with cisplatin. CTAs produced by morphine were more like those produced by cisplatin than like those produced by lithium. Our belief that the CTA attenuation demonstrated here indicates alleviation of the distress produced by the toxin was supported by the results of the final two experiments as follows: 1) The stress does not raise saccharin preference independently of interference with the aversiveness of the toxin since, in similar experiments in which toxins were not administered, footshock administered in conjunction with exposure to saccharin solution reduced later saccharin preference. 2) Probably CTA attenuation does not occur because stress interferes with the taste-toxin association since footshock administered before the saccharin drinking session (instead of after it) also produced CTA attenuation. PMID- 2780781 TI - Interactions between pentazocine and tripelennamine on autonomic and nociceptive measures in the dog. AB - Pentazocine and tripelennamine, which have been abused in combination by humans, were evaluated for pharmacologic interactions on autonomic, behavioral, and antinociceptive measures in chronic spinal dogs. Pentazocine (0.31-5 mg/kg, IV) produced miosis, hypothermia and antinociception which was mediated by spinal and supraspinal reflexes; these effects were antagonized by naltrexone. Tripelennamine (0.63-2.5 mg/kg, IV) elicited mydriasis, hyperthermia and antinociception; these effects were not blocked by naltrexone. Tripelennamine produced antinociception only on the supraspinally-mediated skin twitch reflex. Interactions between pentazocine and tripelennamine varied depending on the response measured. Effects of both drugs on pupils were additive. Temperature effects were infra-additive, with the hyperthermic effects of tripelennamine predominating over the pentazocine hypothermia, resulting in a complete physiologic antagonism of pentazocine hypothermia. Antinociception, measured by flexor reflex depression, represented only the effect of pentazocine, whereas skin twitch reflex antinociception reflected either infra-additive or additive properties. The coadministration of nonconvulsive doses of pentazocine and tripelennamine produced seizures indicating a potentiated adverse interaction. In summary, the patterns of the pentazocine-triplennamine interactions were complex and the effects of tripelennamine could not be attributed to opioid activity. PMID- 2780782 TI - The differentiation of NSAIDs and prostaglandin action using a mechanical visceral pain model in the rat. AB - In order to determine the role of peripheral prostanoids in a newly developed mechanical visceral pain model, several NSAIDs were studied. Systemic acetylsalicylic acid and mefenamic acid, in doses known to produce cyclooxygenase inhibition, produced limited or no analgesia using a duodenal distension model and a behavioral scale for assessment. In contrast, indomethacin at 1 mg/kg, a dose 1/100th of the highest dose of the above compounds, had a marked analgesic effect in the visceral pain model (32% of control response). These data suggest that a duodenal distension stimulus does not have a peripheral prostaglandin E2 mediated nociceptive mechanism. Furthermore, the results obtained with indomethacin support an alternate, possibly central nonprostanoid visceral antinociceptive action. PMID- 2780783 TI - Differential effect of clomipramine treatment on m-chlorophenylpiperazine-induced increases in plasma prolactin and corticosterone in rats. AB - Intravenous administration of m-chlorophenylpiperazine (m-CPP, a serotonin agonist) to rats increased plasma prolactin and corticosterone concentrations. Long-term (21-day) and short-term (3-day) treatment with the tricyclic antidepressant, clomipramine, did not have any significant effect on baseline levels of either prolactin or corticosterone. Long-term but not short-term clomipramine treatment significantly potentiated m-CPP's effect on plasma prolactin. On the other hand, both long-term and short-term clomipramine treatment significantly attenuated m-CPP's effect on plasma corticosterone. These findings are consistent with other animal and clinical studies demonstrating a differential effect of antidepressant treatment on two different serotonin mediated neuroendocrine functions. PMID- 2780784 TI - Administration of a GABA antagonist selectively attenuates an ethanol-induced conditioned taste aversion. AB - Pretreatment with the GABA antagonist picrotoxin attenuated the development of an ethanol-induced conditioned taste aversion (CTA), while no effect of this compound was observed on the development of an amphetamine-induced CTA. These findings suggested some specificity of the effects of picrotoxin to the psychopharmacological properties of ethanol related to CTA. On the other hand, the benzodiazepine inverse agonist, Ro15-4513, purported to a specific ethanol antagonist, was shown to attenuate both an ethanol- and amphetamine-induced CTA. The results support the notion that ethanol intoxication may be mediated in part by GABAergic mechanisms. These GABA-mediated properties of ethanol may in fact underlie the development of an ethanol-induced CTA. PMID- 2780785 TI - Amnesia induced by short-term treatment with ethanol: attenuation by pretest oxotremorine. AB - CD-1 mice were administered a series of tones paired with footshock in the closed arm of a Y maze. On a test session 8 days later the animals were tested for retention of the conditioned emotional response (CER). On the 2-min test session, the three arms of the maze were open and the number of entries into the arms was counted. Retention of the CER was measured by the decrease in the number of entries in comparison with animals trained with no footshock. Starting 24 hr after training, and continuing for the 7 days between training and testing, the animals in different groups received a daily IP injection of saline, 3.6 g/kg of ethanol, 150 micrograms/kg of the cholinergic muscarinic agonist oxotremorine, or ethanol plus oxotremorine. Retention was evaluated 24 hr after the last injection. Ethanol reduced retention of the conditioned emotional response. This effect was attenuated by oxotremorine (150 micrograms/kg) given IP 6 min prior to testing, but not by the same dose of oxotremorine given daily together with the ethanol treatment. Oxotremorine injections administered prior to the retention test also enhanced the retention performance of the control group. Daily oxotremorine administration had no effect. These findings suggest that ethanol weakened retention of the conditioned emotional response, that this effect was unrelated to acquisition or consolidation, and that the deleterious effect of the ethanol treatment can be attenuated by oxotremorine administered prior to the retention test. PMID- 2780786 TI - Mechanism of the body weight increase induced by systemic sulpiride. AB - Long-term intraperitoneal administration of sulpiride induced body weight increase in female but not in male rats. The hypothesis that systemic sulpiride causes an endocrine unbalance which in turn causes body weight gain and hyperphagia was tested in four experiments. First, it was shown that even when they are on a high-fat diet male rats do not show body weight gain induced by systemic sulpiride. Second, sulpiride suppressed the estrous cycle. Third, gonadectomy prevented the body weight gain induced by systemic sulpiride in female rats. Fourth, estradiol simultaneously administered with sulpiride prevented the expected sulpiride-induced body weight gain. These results are discussed in terms of an hypothetical functional castration produced by systemic sulpiride. The well known hyperprolactinemia, induced by the pituitary D2 dopamine receptor blockade, might bring about an impairment of the steroidogenesis with subsequent decrease in estrogens level, which in turn might be responsible for the hyperphagia and body weight increase induced by systemic injections of sulpiride. PMID- 2780787 TI - Persistence of retrieval enhancement by amphetamine following scopolamine-induced amnesia. AB - Little information is available on the permanence of pharmacologically-induced retrieval enhancement following amnesia. This was studied by comparing the rate of forgetting of a memory reactivated by d-amphetamine after amnesia with spontaneous forgetting of undisturbed fear conditioning. Mice were treated with either saline or scopolamine before conditioning and retention was tested three days later. Scopolamine-treated mice received either saline or amphetamine before testing while the saline controls received a second saline injection. The scopolamine-saline group exhibited robust amnesia, whereas both saline-saline and scopolamine-amphetamine groups showed good retention. To test the persistence of these effects mice in the three groups were subdivided and given a second retention test either 1 day, 1 week or 1 month after the first test. Amphetamine was not administered before the second test. The scopolamine-saline mice continued to exhibit amnesia for up to 1 month while the scopolamine-amphetamine and saline-saline groups continued to show strong memory with only a modest decrement in performance by 1 month after the first test. These results show that amphetamine results in a permanent recovery from scopolamine amnesia. PMID- 2780788 TI - Alteration of the effects of caffeine by prenatal stress. AB - We examined the effect of prenatal stress exposure on sensitivity to caffeine using behavioral and physiological measures. Pregnant rats were handled 5 minutes daily from the 14th to 21st day of gestation. Male offspring were tested when 60 days of age in a modified open field apparatus 30 and 90 minutes after injection with caffeine (0, 10, 30 mg/kg). Caffeine increased crossover frequency and duration at the 10 mg/kg dose. Rearing frequency and duration were increased by the 10 mg/kg dose while the 30 mg/kg dose was ineffective. Gnawing was increased by caffeine, especially 90 minutes postinjection. Headpoke activity was decreased by caffeine treatment. Caffeine had no effect on defecation and urination. Gnawing activity was increased by caffeine in prenatally nonstressed animals, but was depressed in prenatally stressed animals. Prenatal stress increased sensitivity to caffeine on corner activity and rearing. The other measures were not affected differentially by prenatal stress exposure. Rectal temperature was depressed 0.75 degrees C in both prenatally stressed and nonstressed animals, by the 30 mg/kg dose of caffeine. Thus, our results indicate that prenatal stress affects sensitivity to caffeine in the adult offspring. However, the long-term effects of prenatal stress exposure are dependent on the measures employed. PMID- 2780789 TI - Sustained nicotine release comparisons in six inbred rat strains. AB - The utility of an implantable nicotine reservoir for rats (INRr) in both sexes of several rat strains is described. INRrs with similar nicotine release rates produced higher blood nicotine levels in small female rats compared to larger male Sprague-Dawley rats. Blood nicotine levels declined significantly over a 32 day exposure to the INRr in female Sprague-Dawley rats. In several inbred rat strains (Sprague-Dawley, Fischer, Buffalo, Marshall, Irish, Maudsley), 15-day INRr exposure produced characteristic body weight changes and blood nicotine level changes. Blood nicotine levels in both sexes of various strains are primarily dependent upon body weight characteristics. We conclude that the INRr can be an important tool for the study of the chronic effects of nicotine in rats. PMID- 2780790 TI - Long-lasting alterations in behavior and brain neurochemistry following continuous low-level LSD administration. AB - Groups of rats were administered either 80 micrograms LSD-25 continuously over seven days using subcutaneous minipumps, or were given the same total amount of drug in seven daily injections, or were administered vehicle. When tested long after cessation of drug administration, persisting alterations in behavior and brain were found in the continuous LSD groups. In social open-field tests, this consisted of decreased social distance between animals; this effect increased upon repeated testing. In uptake of labeled ligands, this was reflected predominantly by decreased 3H-LSD binding in several limbic regions. LSD appears to have especially persisting neurotoxic effects when administered in a continuous, low-level fashion. PMID- 2780791 TI - Microinjection of neurotensin into the CNS induces hyperdipsia in the rat. AB - Neurotensin (NT) is a neuropeptide and putative neurotransmitter that has been shown to exert a variety of effects on digestive and ingestive processes. In order to address the possibility that NT might play a role in the regulation of water intake as well, the peptide was infused into the lateral cerebral ventricle, amygdala, ventral tegmental area, lateral hypothalamus, and preoptic area of the anterior hypothalamus of rats deprived of water for 16 hours. Neurotensin produced a significant and dose-dependent increase in water intake when injected into the ventricular system but had no effect when it was applied to the other brain sites. It was concluded that this peptide may play a physiological role in the control of water ingestion and that central sites of action remain to be determined. PMID- 2780792 TI - Acute intracerebroventricular injections of the mast cell degranulator compound 48/80 and behavior in rats. AB - The intracerebroventricular (ICV) injection of the mast cell degranulator Compound 48/80 (2.5-2.0 micrograms/kg) produced a marked behavioral syndrome in normotensive rats. The behaviors included head and body shakes, paw tremor, excessive grooming, unusual posture and gait, mild diarrhoea, piloerection, extreme agitation and irritability to touch, and a later phase of sedation. The highest doses (15 and 20 micrograms/kg) also produced catalepsy and episodes of "barrel rolling" (continuous rolling of 1-8 turns around the longitudinal axis). These behaviors were observed for approximately 15-30 min although the sedation and catalepsy were maintained for 90-120 min. A second ICV injection of the 10 micrograms/kg dose of Compound 48/80 given 2 hr after an initial injection of this dose, produced a much reduced response and the numbers of head and body shakes, and episodes of paw tremor and grooming were between 20-30% of those produced by the first injection. The reduced effect of the second injection indicates that the behavioral effects of Compound 48/80 may arise from the acute degranulation of mast cells rather than direct effects on neuronal populations or the cerebral vasculature. PMID- 2780793 TI - Apomorphine stimulation of male copulatory behavior is prevented by the oxytocin antagonist d(CH2)5 Tyr(Me)-Orn8-vasotocin in rats. AB - The effect of the intracerebroventricular (ICV) injection of the oxytocin antagonist d(CH2)5Tyr(Me)-Orn8-vasotocin on the stimulation of copulatory behavior induced by the dopamine (DA) agonist apomorphine was studied in male rats. Apomorphine (80 micrograms/kg SC) given 5 min before mating tests decreased intromission frequency and ejaculation latency in experienced male rats. Such effects were abolished and reversed by pretreatment with 50 and 1000 ng of the oxytocin antagonist given ICV 5 min before apomorphine. The peptide per se markedly increased intromission and ejaculation latency and abolished ejaculation in control rats. The results suggest that brain oxytocin is implicated in the expression of sexual behavior, and apomorphine might improve male copulatory behavior by releasing oxytocin in brain. PMID- 2780795 TI - Philippine Nurses Association 1989 program thrust. PMID- 2780794 TI - Effects of caffeine, cocaine and their combination on fixed-interval behavior in rats. AB - The effects of the central nervous system stimulants, caffeine and cocaine, on schedule-controlled behavior were determined in rats trained to perform a fixed interval (FI) 5-minute task. When given alone caffeine produced a doubling of FI response rate at a dose of 10 mg/kg and reduced responding at a dose of 32 mg/kg. Cocaine, which was also expected to increase FI responding, did not increase response rate at doses of 3.2 or 10 mg/kg and decreased the rate of responding at a dose of 32 mg/kg. Caffeine had minimal effects on quarter life and appeared to increase local rates of responding across the interval. Cocaine decreased quarter life dramatically at a dose that had no effect on overall response rate. Local rates of responding were increased early in the interval and decreased in the later segments. The effects of both drugs were found to be rate-dependent. When these compounds were given in combination the results obtained appeared to be related to the rate of responding that caffeine alone would produce. PMID- 2780796 TI - Community health nursing--an overview (continuing education credit). PMID- 2780797 TI - The health of youth. PMID- 2780798 TI - Blood flow through the human arterial system in the presence of a steady magnetic field. AB - The effects of the interaction between a magnetic field and the haemodynamics of the arterial system have been studied. An analysis of a supine subject has been carried out in the presence of an externally applied magnetic field. A finite element technique has been used to solve the magnetohydrodynamics of the fluid flow problem in a network of rigid tubes. The analysis is carried out by considering arteries as rigid tubes, i.e. the arterial expansion is neglected. In real situations, the arteries are elastic. The method requires the derivation of an expression of the conductance of a single artery in the presence of a transverse magnetic field. Computational results corresponding to two different sets of boundary conditions have been obtained. The quantitative effects of intensity and orientation of the applied magnetic field in the presence and absence of stenosis in the aortic arch are presented and discussed. PMID- 2780799 TI - A portable scanning reflectance spectrophotometer using visible wavelengths for the rapid measurement of skin pigments. AB - A portable rapid scan reflectance spectrometer (400-700 nm in 2.8 s) has been developed for the measurement of cutaneous pigments. The instrument incorporates a tungsten halogen lamp light source, light transmission by fibre optics and wavelength selection by a circular variable wavelength interference filter. A microcomputer controls the instrument and processes the data. The performance of the instrument was evaluated by undertaking in vitro measurements of the reflectance spectra of blood. An index of the haemoglobin content of the sample based on the gradients of the log inverse reflectance spectrum between isobestic points at 527.5, 544 and 573 nm was devised and shown to be independent of the oxygenation of the haemoglobin. The haemoglobin index was combined with measurements at 558.5 nm, a wavelength at which absorbance is sensitive to the oxygenation of haemoglobin, to give a measure of oxygen saturation. The parameter was validated by determining the oxygen dissociation curve of red cells in plasma in vitro at pH 7.33, 37 degrees C and under a partial pressure of 40 mmHg of CO2. PMID- 2780800 TI - The quality of ionising radiations emitted by radionuclides incorporated into mammalian cells. AB - Radionuclides which decay by electron capture accompanied by Auger electron cascades, or by beta emission are thought to be excessively damaging when incorporated into the molecular structure of mammalian cell nuclei and thereby pose a radiation hazard which is not assessable by conventional dosimetry. Survival data, from the literature, for 125I, 77Br, 3H and 131I have been re analysed to extract cross sections for inactivation, by the slowing down charged particle fluence, as these are absolute specifications of the radiation quality. When comparison is made with results similarly expressed for external irradiation with heavy particle and photon beams, the qualities of the low-energy emitters 125I, 77Br and 3H are found to approach those for heavy particles. An explanation for the damage mechanism is sought in a recently developed model for radiation action. The results are consistent with the interpretation that electron damage is caused predominantly at the end of the tracks, and the actual incorporation simply ensures that the slowing down fluence of low-energy tracks interacts preferentially in the vicinity of the radiosensitive sites. The absolute biological effectiveness of these radiations can be expressed quantitatively in terms of the model parameters. PMID- 2780801 TI - A generalised algorithm for spectral reconstruction in Compton spectroscopy with corrections for coherent scattering. AB - Reconstruction of primary-photon energy spectra from pulse-height distributions obtained in a Compton spectrometer has earlier been performed under the assumption that coherent scattering in the scatterer is negligible. This holds for most clinical x-ray units operated in the range 40-150 kV. In mammography, and to some extent in dental radiography, the relatively high frequency of low energy photons (less than 30 keV) in the primary beam makes it necessary to extend the algorithms to allow for significant contribution of coherent scattering. This extension is performed as a perturbation calculation to the algorithms developed earlier in which a modified Klein-Nishina scattering cross section was taken as the total scattering cross section. Comparison with energy spectra measured in the primary beam indicates that the Compton spectrometer with the extended algorithm is an excellent instrument for measuring energy spectra with energies down to a few keV. PMID- 2780802 TI - Theoretical basis for equivalent circuit descriptions of the electric coupling between NMR coils and samples. AB - We derive an expression describing the electric interaction between an NMR coil and sample which is the analogue of the well known Hoult-Richards expression for the magnetic interaction. The expression is used to describe the electric interaction between a conducting dielectric sphere and a long solenoid. PMID- 2780803 TI - Grey level linearising circuit for computer-interfaced display devices. AB - An earlier paper by the authors on the linearisation of computer-interfaced display devices has described a radiometric procedure for quantifying device non linearity and a software technique for using the data to linearise screen luminance with respect to display grey level. As the display non-linearity varies with the particular settings of the brightness and contrast controls, any change in these settings requires that the data used with the software also be modified. While it is possible to store data for a number of selected control settings, it would be more convenient if linearisation could be performed using hardware for all relevant settings of these controls. The electronic circuit described in this paper makes use of the same non-linearity data to achieve device linearity with the added advantage of increased flexibility of use. The circuit is suitable for connection immediately following the digital-to-analogue converter or video processor and provides two useful new controls. One of these determines the amount of non-linearity correction to be applied to the video signal, while the second enables screen contrast to be varied without affecting the linearity achieved. The standard brightness and contrast controls of the display device are left as initially preset and require no subsequent adjustment. PMID- 2780804 TI - A simple projector for superficial laser photodynamic therapy. PMID- 2780805 TI - Analytical approximation of depth-dose curves for electron beams. PMID- 2780806 TI - Reliability of a diabetic foot evaluation. AB - The purpose of this study was to establish the interrater and intrarater reliability of various ankle and foot measures common to a diabetic evaluation. Bilateral biomechanical, sensory, and wound-size measurements were obtained in 31 subjects with diabetes mellitus. Twenty-five subjects were retested by the initial examiner to determine intratester reliability, and all subjects were retested by another examiner to determine intertester reliability. Both examiners participated in an extensive training period prior to the initiation of this study to minimize variability between and within measurers. Intraclass correlation coefficients for interrater and intrarater measurements ranged from .58 to .89 and from .74 to .99, respectively. The results of this study indicate that ankle and foot measurements common to a diabetic evaluation can be taken reliably between testers. We believe extensive examiner training in these clinically relevant measures can improve reliability between testers. PMID- 2780807 TI - Isokinetic, electrophysiologic, and clinical function relationships following tourniquet-aided knee arthrotomy. AB - Few data exist pertaining to the validity of isokinetic muscle function tests, particularly in describing their interrelationships with other common clinical assessments. The purpose of this study was to critically analyze the maximal voluntary knee torque, motor unit activity, range of motion, and gait sequelae in a series of 95 patients who had tourniquet-aided meniscectomy or intra-articular loose-body removal. Prior to arthrotomy, affected and contralateral knee data differed minimally. In the first days following arthrotomy, the patients invariably demonstrated severe gait and muscle mechanical impairments, with grossly abnormal quadriceps femoris muscle motor unit activity. Of 32 patients consenting to one-month postoperative diagnostic electromyographic and nerve conduction velocity testing, 17 (53%) were found to have femoral neuropathies, with 8 of the 17 having other thigh and leg neuropathies as well. Patients with neuropathy recovered more slowly and scored significantly lower on functional and electrophysiological measures than patients without neuropathy. One month postarthrotomy, knee extensor torques, motor unit activity, and gait scores averaged about half the normal values, and knee flexion torques and ROM were about 75% of normal. Isokinetic device measurements were moderately related to other clinical measures of postarthrotomy outcome (.58 less than r less than .80). Knee torque measurements alone do not adequately characterize functional capacity. PMID- 2780808 TI - Inflammation, cellularity, and fibrillogenesis in regenerating tendon: implications for tendon rehabilitation. AB - The initial three weeks of tendon healing were followed via electron microscopy to elucidate the process of inflammation, fibrillogenesis, and the cellular and subcellular events in tenotomized Achilles tendons, a model that is commonly used to determine the biomechanical effects of electrical stimulation, physical activity, ultrasound, and other forms of physical therapy. The right Achilles tendons of 18 rabbits were tenotomized, sutured, and immobilized. On each of postoperative days 5, 7, 12, 15, 18, and 21, the right Achilles tendons of three experimental rabbits were excised and processed for electron microscopy. To compare these tendons to normal tendons, the Achilles tendons of three control rabbits were excised bilaterally without prior tenotomy and processed for electron microscopy. Electron micrographs thus obtained revealed 1) an initial period of inflammation lasting at least five days, 2) a subsequent period of fibroplasia and fibrillogenesis, and 3) a third period of progressive alignment and organization of the collagen fibrils into bundles that were oriented in the longitudinal axis of the tendon. Although healing in rabbits may not translate directly to healing in humans, the findings of this study indicate that healing begins soon after tenotomy and that the regenerating Achilles tendon undergoes different stages of healing. Because each stage entails a different set of ultrastructural events, therapeutic interventions should be modified to address the specific events of each stage. PMID- 2780810 TI - Stability of Bayley Motor Scale scores in the first year of life. AB - The purpose of this study was to determine whether Bayley Motor Scale scores were stable in infants during the first year of life, that is, whether each individual infant's score was essentially the same at each of the five test ages. Subjects were 15 low-risk and 8 high-risk infants with Bayley Scales of Infant Development Motor Scale scores at 2, 3, 4, 8, and 12 months. All high-risk and most low-risk infants also had outcome scores at either 24 or 36 months. For the group as a whole, and for all infants with "normal" outcomes, subjects did not change ranks over the six test ages (ie, high-scoring infants' ranks remained high and low scoring infants' ranks remained low), but scores varied significantly from test to test. Scores of infants with "non-normal" outcomes did not vary significantly from test to test. The highest and lowest scores of 75% of the infants with normal outcomes and 57% of the infants with non-normal outcomes differed significantly. Four patterns of variations of Bayley Motor Scale scores over the five test ages of the first year after birth were identified. The first pattern included three infants with the most stable scores. The three remaining patterns were different from each other, but a consistent feature of each was a peak at 4 months. Finally, scores at 3 and 8 months were best able to correctly identify outcome. A single Bayley Motor Scale score may not reflect an infant's true abilities; some factor may be inflating scores at age 4 months. PMID- 2780809 TI - Autonomy-based informed consent: ethical implications for patient noncompliance. AB - The problems presented by the noncompliant patient are not new to health care professionals, including physical therapists. Although many of the factors that influence the incidence of noncompliance have been studied, important ethical concerns are often overlooked. This fact has led many health care professionals to make the following assumptions: 1) All cases of noncompliance are problems in need of a solution, 2) the solution to the problem of noncompliance is compliance, 3) all instances of compliance are nonproblematical, and 4) the locus of the problem of noncompliance is the patient. In this article, the issue of patient noncompliance is examined based on an analysis of the moral foundations of informed consent. The above assumptions are shown to be problematic from the moral point of view. Three patient cases are presented to highlight some of the implications for physical therapists who encounter noncompliant patients. Understanding the moral foundation of informed consent can help guide therapists in their communication with all patients, and especially in their interactions with noncompliant patients. PMID- 2780811 TI - Outpatient views on direct access to physical therapy in Indiana. AB - The purpose of this study was to determine the opinions of outpatients receiving physical therapy in Indiana about physical therapy evaluation and treatment without referral (direct access). Subjects were 361 individuals being treated at one of 25 privately owned clinics. Each subject completed a 15-item questionnaire. Results showed that 82.8% of the respondents supported direct access to physical therapy. A majority indicated they would seek physical therapy services without referral if they were available. Physical therapists were cited as frequently as all other health care professionals combined as the practitioners providing the most thorough evaluation. Physical therapists were cited far more often than other health care professionals combined as the practitioners providing the best information about the control of symptoms. Subjects who had received more treatments than others were significantly more likely to support direct access (p less than .05). Conclusions were that individuals who have received physical therapy at private outpatient physical therapy clinics in Indiana are supportive of direct access to physical therapy services. PMID- 2780812 TI - Joint angle feedback and biomechanical gait analysis in stroke patients: a case report. AB - The purpose of this case report is to demonstrate the use of gait analysis and computer-assisted visual and auditory feedback (CAF) in the treatment of a patient with stroke secondary to hemiplegia. Two-dimensional kinematic and kinetic gait analyses were performed to determine the objectives of treatment and to evaluate the results. The CAF hardware and software permitted immediate visual feedback of performance relative to the desired target with auditory reinforcement if the target was reached in the desired phase of the gait cycle. The objective of the treatment was to increase knee flexion during push-off and pull-off. After four weekly treatments, the patient's gait velocity and stride length, in addition to transfers between kinetic energy and potential energy, were significantly improved. The patient demonstrated a downward trend in total mechanical energy costs and an upward trend in the amount of energy conservation, as well as increased knee flexion. These promising results indicate a need for further research into the use of CAF as a tool in motor learning for rehabilitation. PMID- 2780814 TI - Photoreactivation of lethal damage and damage leading to chromatid deletions induced in G1 phase hamster x Xenopus hybrid cells by UV. AB - A86 Xenopus cells, cloned from a Xenopus line that exhibited a high level of photoreactivation of UV-induced lethal damage, and V79M1 hamster cells, cloned from a hamster line that did not exhibit efficient photoreactivation of such damage, were fused to produce the V79M1 x A86 cell line--a hybrid line in which approximately 84% of the cells contained the entire V79M1 and A86 genomes. Ultraviolet and UV plus photoreactivation fluence-survival relations were then determined and compared for hybrid and parental G1 phase cells in a first attempt to elucidate interactions of the parental genetic potentials for photoreactivation in the hybrid. Specifically, it was anticipated that the combined V79M1 and A86 genomes in the hybrid would produce photoreactivating enzymes sufficient to efficiently photoreactivate UV-induced lethal damage in both A86 and V79M1 DNA and little difference would be observed in the levels of photoreactivation exhibited by V79M1 x A86 and A86 G1 phase cells. To the contrary, the level of photoreactivation observed for the hybrid did not closely approach that observed for the A86 line. To assist in the interpretation of this somewhat unexpected observation, three additional studies were performed: (1) comparison of 'optimal' schemes for photoreactivation of UV-induced lethal damage in the hybrid and parental G1 phase cells, (2) comparison of the effects of some different types of growth medium on photoreactivation of UV-induced lethal damage in hybrid and parental G1 phase cells, and (3) comparison of the levels of photoreactivation of UV-induced chromatid deletions in the V79M1 and A86 chromosomes of G1 phase hybrid cells.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2780813 TI - Determinants of photosensitization by purpurins. AB - Studies were carried out on two purpurins, NT2 and an analog, Sn.NT2H2. Both are photosensitizers, but the latter is substantially more effective against neoplastic cells in vivo. These hydrophobic dyes can be solubilized via Cremophor EL emulsions. We found both dyes to be approximately equitoxic to murine leukemia L1210 cells in culture, in terms of intracellular concentrations. But uptake of NT2 was 10-fold less efficient than Sn.NT2H2, i.e. a 10-fold higher extracellular level of NT2 was needed to produce an equitoxic response. Fluorescence measurements indicate that NT2 partitions to a very hydrophobic intracellular environments; its phototoxicity was related to inhibition of biosynthesis of DNA. In contrast, SN.NT2H2 was accumulated at more hydrophilic loci (the apparent dielectric constant is consistent with a membrane interface) and mediated photodamage at sites of membrane transport. PMID- 2780815 TI - Inhibition of the immune response to alloantigen in the rat by exposure to ultraviolet radiation. AB - Exposure of mice to ultraviolet radiation (UV) followed by alloantigen sensitization can suppress the immune response to that alloantigen. In order to assess the applicability of using UV-induced immunosuppression in organ transplantation, the effectiveness of UV in prolonging the survival of vascularized organ allografts must be determined. Because, for technical reasons, rats are better suited than mice for such experiments, we first wanted to determine whether UV suppresses the immune response of inbred rats to alloantigens. The data presented here demonstrate that exposure of rats to UV (115-129 kJ/m2) prior to alloantigenic sensitization decreases the mixed lymphocyte response to alloantigen. The depression of the proliferative response to alloantigen was selective in that spleen cells from the UV-treated rats could respond to mitogenic stimulation. In contrast to previous results with mice, suppressor cells could not be demonstrated in the spleens of the UV-treated rats. In addition, UV treatment after sensitization inhibited the response to alloantigen. These data suggest that treatment of the recipient with UV before or after alloantigenic sensitization may provide a novel method of inhibiting immune responses to allogeneic antigens. PMID- 2780816 TI - Effects of oral retinoid (vitamin A and etretinate) therapy on photocarcinogenesis in hairless mice. AB - Oral retinoid therapy has been considered for the prevention of skin carcinogenesis in humans, although animal studies have failed to provide any evidence of a protective effect of these drugs in the one-step photocarcinogenic system. In this study, oral therapy with vitamin A or a synthetic analogue, etretinate, was tested for ability to protect hairless mice (Skh-hr1) from the development of skin tumours following exposure to broad-band light (280-700 nm) for 25 weeks. Retinoids were given by gavage 3 times weekly either at low dosage (2000 IU vitamin A or 4 mg etretinate per kg body weight) or high dosage (10,000 IU vitamin A or 20 mg etretinate per kg body weight). None of the retinoid therapies compared to control mice (gavage vehicle only) modified skin tumour production in terms of time to onset of tumours, total tumour yield, or the types of tumours produced. PMID- 2780818 TI - Elicitation of spreading depression by rose bengal photodynamic action. AB - Spreading depression refers to a slowly propagating depression of the ordinary electrical activity of the nervous tissue. It can be elicited by different types of physical or chemical non-specific stimuli. Various evidences suggest that transient alterations of cell membranes are involved. For this reason, and considering the action of free radicals on cell membranes, the elicitation of the reaction by dye photoactivation has been investigated. Isolated chick retina superfused in the dark with Ringer solution was able to regularly exhibit spreading depression when submitted to 1 microM rose bengal pulse of 5 min in duration, followed by 2.1 x 10(4) to 4.2 x 10(4) Jm-2 light pulse. The phenomenon was monitored either by visual inspection of the light-scattering milky wave that accompanies the reaction or by recording its characteristic slow voltage variation. The reaction was not triggered if the retina, superfused with the dye, was (a) maintained in the dark; (b) illuminated with red light (3.75 x 10(2) to 2.25 x 10(4) Jm-2), or (c) stimulated by white light but superfused with nitrogen saturated solutions. It is concluded that, under the present conditions, the elicitation of spreading depression is contingent on the photoactivation of rose bengal in the presence of oxygen. PMID- 2780817 TI - Local suppression of contact hypersensitivity in mice by a monofunctional psoralen plus UVA radiation. AB - Monofunctional psoralens, plus UVA radiation are not erythemogenic and are less mutagenic than bifunctional psoralens plus UVA radiation. Thus, they have received considerable attention in recent years as potential therapeutic agents for various skin diseases. The purpose of this study was to examine the immunologic side effects following treatment of mice with a monofunctional psoralen plus UVA radiation. We report that angelicin plus UVA radiation suppressed the induction of contact hypersensitivity to dinitrofluorobenzene. This decreased immune response was associated with the presence of splenic suppressor cells that transferred suppression to normal recipients. Treatment with angelicin and UVA radiation also decreased the number of Thy-1+ and Ia+ dendritic epidermal cells in the treated site. We conclude that although this monofunctional psoralen is not phototoxic, it has immunosuppressive activity in mice. PMID- 2780820 TI - Spectroscopic studies of cutaneous photosensitizing agents--XIV. The spin trapping of free radicals formed during the photolysis of halogenated salicylanilide antibacterial agents. AB - Several antibacterial halogenated salicylanilides, including 3,3',4',5 tetrachlorosalicylanilide (TCSA) and 3,4',5-tribromosalicylanilide (TBSA) are known to cause photoallergy. We have carried out photochemical and spin trapping studies to determine whether free radicals may be involved in the photoallergic response. Irradiation (lambda greater than 300 nm) of TCSA in buffered (pH 7.4) 50% ethanol resulted in the rapid loss of the 3-chloro atom, followed by the much slower release of 5- and then the 4'-chloro atoms to give 3'-chlorosalicylanilide as a stable photoproduct. Under the same conditions TBSA successively lost the 3 , 5- and 4'-bromine atoms to give salicylanilide. When TCSA or TBSA were irradiated (lambda = 356 nm) in buffered (pH 7.4) 50% ethanol containing 2-methyl 2-nitrosopropane (MNP) only solvent-derived free radicals were detected. However, irradiation (lambda = 356 nm) of TCSA and MNP in 0.1 N NaOH generated an ESR spectrum consisting of a broad triplet (aN = 15.6 G). This spectrum was attributed to the adduct formed by the reaction of MNP with the aryl radical generated by the loss of a chlorine atom from the sterically hindered 3-(or 4'-) position. Under the same conditions TBSA initially generated a broad triplet (aN = 15.5 G) similar to that observed for TCSA. However, upon further irradiation a 21-line spectrum (aN = 14.4 G, a2H = 2.0 G and a2H = 0.9 G) appeared.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2780819 TI - Photoproperties of alkoxy-substituted phthalocyanines with deep-red optical absorbance. AB - Triplet-state properties of 1,4,8,11,15,18,22,25-octa-n-butoxyphthalocyanine and its zinc derivative were determined for the first time. The T1 state of the metal free phthalocyanine was characterized by a short lifetime (tau T = 17 microseconds) and low quantum yield (phi T = 0.095), and quenching of the triplet by O2 occurred with a bimolecular rate constant (kT sigma = 1.3 x 10(8) M-1 s-1) that is indicative of an endogonic reaction. The zinc complex (ZnPc(OBu)8) was markedly better as a triplet photosensitizer with respect to both tau T (60 microseconds) and phi T (0.5). Quenching by O2 produced singlet oxygen with nearly 100% efficiency, and kT sigma (1.7 x 10(9) M-1s-1) was close to the spin statistical diffusion-controlled limit. Phosphorescence measurements showed the energy of the T1 state of ZnPc(OBu)8 to be 100 kJ/mol, which is 6 kJ/mol above the 1 delta g state of O2. These photoproperties, together with Q-band absorption maxima in the mid-700 nm range indicate that metal-centered 1,4,8,11,15,18,22,25 octaalkoxyphthalocyanines have excellent potential as sensitizers in photodynamic therapy. PMID- 2780821 TI - Quantum yields for laser photocyclization of bilirubin in the presence of human serum albumin. Dependence of quantum yield on excitation wavelength. AB - The quantum yield for laser photocyclization of bilirubin to lumirubin in the presence of human serum albumin (phi LR) was measured at five monochromatic excitation wavelengths in the range 450-530 nm. Solutions used were optically thin throughout the wavelength range and precautions were taken to exclude contributions from photocyclization of bilirubin XIII alpha impurities. The values obtained (7.2-18 x 10(-4] were lower than those previously reported and showed the following wavelength dependence: 457.9 less than 488.0 less than 501.7 less than 514.5 approximately equal to 528.7. However, the rate of lumirubin formation, normalized to constant fluence, decreased with wavelength over the same wavelength range and no evidence was found that photoisomerization of bilirubin to lumirubin is faster with green (514.5 or 528.7 nm) than with blue (457.9 or 488.0 nm) light. The stereoselectivity of the configurational isomerization of bilirubin to 4Z,15E and 4E,15Z isomers also was studied. This reaction became less regioselective for the 4Z,15E isomer with increasing wavelength. The observed wavelength dependence of phi LR and of the [4E,15Z]: [4Z,15E] ratio at photoequilibrium are consistent with an exciton coupling model in which intramolecular energy transfer can occur between the two pyrromethenone chromophores of the bilirubin molecule in the excited state. Relative rates of lumirubin formation in vivo at different excitation wavelengths and constant fluence were estimated for different optical thicknesses and for different skin thicknesses. These estimates suggest that the recently reported clinical equivalence of blue and green phototherapy lights probably reflects the marked variation of skin transmittance with wavelength more than wavelength-dependent photochemistry. The calculations also indicated that the optimal wavelength for phototherapy is probably on the long wavelength side of the bilirubin absorption maximum. PMID- 2780822 TI - Singlet molecular oxygen quenching by saturated and unsaturated fatty-acids and by cholesterol. AB - The rate constants of molecular singlet oxygen quenching by saturated and unsaturated fatty-acids and by cholesterol-membrane critical components - membrane critical components - have been measured by time resolved detection of the 1270 nm phosphorescence of singlet molecular oxygen [O2(1deltag)]. We have determined (i) an increment of 5.7 x 10(2)M(-1)s(-1) per -CH2- in C6D6 and CD3OD for saturated fatty acids between C4 and C20, (ii) an increment of 3 x 10(4)M( 1)s(-1) per non-conjugated cis-double bond for C18 unsaturated fatty acids, identical in C6D6 and DC3OD, (iii) a lower quenching rate constant by a factor of 2.7 for the trans-C16 and trans-C18 as compared to the corresponding cis monounsaturated fatty acids, (iv) a rate constant of O2x(1deltag) quenching by cholesterol of 5.7 x 10(4)M(-1)s(-1) in benzene. These rate constants are compared to those obtained for other membrane cellular components. PMID- 2780823 TI - Critical importance of the triplet lifetime of photosensitizer in photodynamic therapy of tumor. AB - The relation between the lifetimes of the triplet states of various porphyrins and their photosensitizing effects on the photodynamic therapy (PDT) of tumor has been examined. Diethylene-triamine pentaacetic acid ester of 4-[1-(2-hydroxy ethyloxy)ethyl]-2-vinyl deuteroporphyrin-IX gallium (III) complex (Ga-DP), zinc (II) complex (Zn-DP), and manganese (III) complex (Mn-DP) and Photofrin II (PII) are used as the photosensitizer. The triplet lifetimes have been measured for the samples adsorbed on filter paper (FP) and found to be 57 ms (Ga-DP), 26 ms (Zn DP), less than or equal to 10 microseconds (Mn-DP) and 9 ms (PII). The phosphorescence of Ga-DP in tumor-bearing golden hamsters are measured both in tumor tissue and in liver. They show bi-exponential decay with the lifetimes of about 5 and 20 ms. From the values, the generation rate, kct[3O2], of singlet molecular oxygen in living animal tissue may be estimated to be an order of 10(2) s-1. The PDT effects have been quantitatively investigated for in vitro experiments; upon irradiation the growth inhibitions of mouse p388 leukemia cells are obtained as a function of concentration of Ga-DP, Zn-DP, Mn-DP and PII. The experimental results indicate that the PDT effects depend essentially on the triplet lifetimes of the photosensitizers. PMID- 2780824 TI - Probing the structure of HPD by fluorescence spectroscopy. AB - Fluorescence emission spectra indicate that oligomers containing both hematoporphyrin and its dehydration products (vinyl porphyrins) comprise the tumor-localizing fraction of HPD. In the relatively polar solvent methanol, the vinyl porphyrins exhibit reduced fluorescence yields while the hematoporphyrin residues are relatively resistant to fluorescence quenching by Fe+3. In the less polar solvent tetrahydrofuran, fluorescence from oligomeric vinyl porphyrins was enhanced, and Fe+3-induced quenching of oligomeric hematoporphyrin promoted. These, together with other studies in biological systems, suggest a substantial degree of interaction among the porphyrin units contained in these oligomers, as a function of the polarity of the environment. PMID- 2780825 TI - Photodynamic inactivation of rubella virus enhances recombination with a latent virus of a baby hamster kidney cell line BHK21. AB - Rubella virus is very sensitive to photodynamic action. When tested with 1.2 X 10(-5) M toluidine blue and 8 W fluorescent lamp at a fluence of 11 W/m2, inactivation kinetics showed a linear single hit curve with a k value of 1.48 min 1. Photodynamic inactivation of rubella virus greatly enhanced recombination with a latent virus (R-virus) of baby hamster kidney BHK21 cells. In contrast, no hybrids were detected in lysates of the cells infected with either UV-treated or untreated rubella virus. Therefore, hybrid viruses were readily detected only in lysates of BHK21 cells infected with photodynamically treated rubella virus. Photodynamic damage of rubella virus genomes generated a new hybrid type (hybrid type 3) in addition to a previously described type 2 hybrid (formerly designated as HPV-RV variant). Although both of these hybrid types carry the CF antigens of rubella virus, plaque forming ability of type 3 hybrid is neutralized neither by anti-rubella serum nor by anti-latent virus serum while type 2 hybrid is neutralized by anti-latent virus serum. PMID- 2780826 TI - Molecular mechanism of drug photosensitization--II. Photohemolysis sensitized by ketoprofen. AB - Red blood cell lysis photosensitized by ketoprofen (KPF) was investigated. The photohemolysis was inhibited by butylated hydroxyanisole, reduced glutathione, superoxide dismutase and mannitol, and was unaffected by sodium azide; the presence of oxygen markedly enhanced the lysis. Photohemolysis was also observed under anaerobic conditions. Ketoprofen, irradiated in aqueous buffer solution at pH 7.4, underwent a decarboxylation process via intermediate radicals, leading to the compounds (3-benzoylphenyl)ethane, (3-benzoylphenyl)ethyl hydroperoxide, (3 benzoylphenyl)ethanol and (3-benzoylphenyl)ethanone under aerobic conditions and only to the compound (3-benzoylphenyl)ethane under anaerobic conditions. The four photoproducts showed lytic activity, particularly high for the alcohol and hydroperoxide. The overall results suggest for KPF-photosensitized hemolysis a molecular mechanism involving free radicals, superoxide anion and sensitizer photodegradation products. PMID- 2780827 TI - Inactivation and mutagenesis of herpes virus by photodynamic treatment with therapeutic dyes. AB - Dyes which photosensitize membranes may be clinically useful for photodynamic treatment (PDT) of Herpes simplex virus (HSV) infections. It is important to determine whether the enveloped HSV can be inactivated via membrane damage without affecting the genetic material. Selection of appropriate PDT conditions, including the choice of dye, could minimize viral mutagenesis. We determined the mutagenesis caused by PDT employing three membrane-photosensitizing dyes of potential use in cancer photochemotherapy (Photofrin II, polyhematoporphyrin esters, zinc phthalocyanine tetrasulfonates) and a DNA-photosensitizing dye (proflavine sulfate). The effects were compared to those caused by exposure of HSV to ultraviolet radiation (UV). The procedure consisted of incubating HSV with microgram/ml (microM) concentrations of the dye, irradiating the samples with broad spectrum visible/near-UV radiation (Daylight fluorescent lamps) and assaying the survival of the treated HSV. Zinc phthalocyanine was the most potent dye per absorbed photon for inactivating HSV. In parallel with determination of survival, progeny of the surviving virus were grown for determination of mutagenesis. The progeny virus was harvested and subsequently assayed in the presence and absence of 40 micrograms/ml iododeoxycytidine (ICrd) to determine the frequency of mutation to ICrd resistance. Mutation frequencies were determined for progeny from the 1-4% survival level. For PDT with each membrane photosensitizing dye, only zinc phthalocyanine increased the mutation frequency over the untreated control. This increase was less than 2-fold. Proflavine increased the mutation frequency 2-3 fold over the untreated control. Ultraviolet produced a 15-20 fold increase over the untreated control.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2780828 TI - DNA lesions and DNA degradation in mouse lymphoma L5178Y cells after photodynamic treatment sensitized by chloroaluminum phthalocyanine. AB - Two closely related strains of mouse lymphoma L5178Y cells, LY-R and LY-S, have been found to differ in their sensitivity to the cytotoxic effects of photodynamic treatment (PDT) with chloroaluminum phthalocyanine (CAPC) and red light. Strain LY-R is more sensitive to photodynamic cell killing than strain LY S. Differences in uptake of CAPC could not account for the differences in cytotoxic effects. There was no marked difference between the two strains in the induction of single-strand breaks (which includes frank single-strand breaks and alkali-labile lesions), but substantially more DNA-protein cross-links were formed in strain LY-R by CAPC and light. Repair of single-strand breaks proceeded with similar kinetics in both strains for the first 30 min post-irradiation, suggesting that these lesions are not responsible for the differential sensitivity of the two strains to the lethal effects of photodynamic treatment. Thereafter, alkaline elution revealed the presence of increasing DNA strand breakage in strain LY-R. DNA degradation, as measured by the conversion of prelabeled [14C] DNA to acid-soluble radioactivity, was more rapid and extensive in strain LY-R. PMID- 2780829 TI - Convex curvatures of alkaline elution profiles of DNA from human cells irradiated with 405 nm UVA: evidence for induction of slowly developing alkali-labile sites. AB - The alkaline (pH 12.1) elution profiles of DNA from human P3 cells exposed to monochromatic 405 nm UVA radiation deviate from exponential: on a logarithmic plot of eluted fraction of DNA vs time of elution, the rate of elution accelerates for the first 6 h. Following this period, the profiles become exponential. In contrast, the elution profiles of DNA after 520 nm green light or ionizing radiation exposures (x- and gamma rays, and fission spectrum neutrons) are always strictly exponential, evidence that the convex profiles were not due to an artifact caused by elution technique. Holding the DNA at pH 12.1 for 6 h after 405-nm exposures before initiating elution resulted in profiles that were close to exponential, with slopes similar to the final slopes observed following the 6-h elution period in the original experiments. This is evidence that some DNA breaks develop slowly during the first 6 h of elution, as a result of exposure to alkali. Therefore, the DNA lesions induced by 405-nm light as measured by the alkaline elution technique are apparently heterogeneous and include a major class of alkali-labile sites that develop slowly during incubation at pH 12.1. Convex profiles also occur following exposure of the cells to visible light at 434 and 512 nm. PMID- 2780831 TI - The epidermal cell kinetic response to ultraviolet B irradiation combines regenerative proliferation and carcinogen associated cell cycle delay. AB - The cell cycle traverse of epidermal basal cells 24 h after in vivo exposure of ultraviolet B (UVB) irradiation was studied by immunochemical staining of incorporated bromodeoxyuridine (BrdU) and bivariate BrdU/DNA flow cytometric analysis. The results were compared with the cell kinetic patterns following topical application of the skin carcinogen methylnitrosourea (MNU) as well as the skin irritant cantharidin. Hairless mice were injected intraperitoneally with BrdU 24 h after treatment of their back skin with either a minimal erythema dose of UVB, or a single application of MNU or cantharidin dissolved in acetone. The cell cycle traverse of the BrdU-labelled cohorts of epidermal basal cells were then followed for the subsequent 12 h. At 6 h after BrdU-injection, when all labelled cells in the control group as well as in the cantharidin group had left the S phase, the bivariate distributions of the UVB-exposed and the MNU group showed that BrdU-positive cells were still present in S phase. Hence, UVB irradiation, similar to the carcinogen MNU, prolonged the S phase duration in some of the basal cells. At 12 h after pulse labelling, however, BrdU-positive cells from UVB-exposed mice were re-entering S phase from G1 phase, indicating that UVB irradiation induced a shortening of the cell cycle time as well, similar to the response observed after cantharidin. The present data can not tell whether these cells also were delayed in S phase. Thus, the cell cycle traverse in hairless mouse epidermis 24 h after in vivo exposure to UVB seemed to be a combination of the cell kinetic effects following chemical skin carcinogens and skin irritants. UVB irradiation induced both a delay in transit time through S phase, probably due to DNA damage and subsequent repair, as well as a reduction in the total cell cycle time consistent with rapid regenerative proliferation. PMID- 2780830 TI - Cytotoxicity and mutagenicity of ophthalmic solution preservatives and UVA radiation in L5178Y cells. AB - Four chemical preservatives commonly used in ophthalmic solutions were tested for their toxic and mutagenic potential in mouse lymphoma cells with and without exposure of the cells to ultraviolet A (UVA) radiation. The preservatives tested were benzalkonium chloride (BAK), chlorhexidine, thimerosal and ethylenediaminetetraacetic acid (EDTA). Cell survival and mutagenesis were measured using the L5178Y mouse lymphoma (TK +/-) system. Cells were exposed to varying amounts of preservatives for 1 h at 37 degrees C, and then aliquots were irradiated with UVA radiation (during the exposure to preservative). Cells were then assayed for survival, and for mutagenesis at the thymidine kinase (TK) locus. In concentrations commonly found in ophthalmic solutions, BAK, chlorhexidine, and thimerosal were toxic to cells, and thimerosal was slightly mutagenic. When cells were exposed to preservative and UVA radiation, chlorhexidine was mutagenic and the mutagenic activity of thimerosal was enhanced. PMID- 2780832 TI - Red edge excitation effect in intact eye lens. AB - Shift in the wavelength of emission upon shift in the excitation wavelength towards the red edge of the absorption band is termed Red Edge Excitation Shift (REES). This effect is observed only in situation where the fluorophore mobility with respect to the surrounding matrix is considerably reduced. We have observed such red edge excitation effect in the intact eye lens. The REES observed for a normal lens is different from that seen in a photodamaged lens and hence appears to be a potential tool to monitor the changes in the state of the lens. Photodamage experiments with tryptophan in polyethylene glycol (PEG) and intact eye lens indicate that the red edge photon can also cause photodamage. PMID- 2780833 TI - Relation between gastric emptying and short-term regulation of food intake in the pig. AB - The relation between gastric emptying (GE), measured by gastric evacuation, and food intake (FI) was studied in pigs fed two meals to appetite per day. Duodenal infusion of emulsified fat (Intralipid; KabiVitrum) inhibited both FI and GE of digestible energy by more than the energy infused, but the gastric volume at satiety was more than 20% below the control. Duodenal infusions of glucose inhibited FI calorically, and generally inhibited GE calorically; but gastric volume at satiety was always equal to control volume. Thus GE (via gastric distension) may regulate FI to duodenal infusion of glucose but not to Intralipid. In pigs given no infusions, removal of the gastric contents immediately prior to the p.m. meal increased intake by 10%, However, when the contents were retained the pigs ate two equal-sized meals in the day, even though the gastric volume after the p.m. meal was 24% greater than after the a.m. meal. Therefore, although gastric volume may influence intake it cannot be the only factor determining satiety on this diet. PMID- 2780835 TI - Odor masking in the rat. AB - A computer controlled behavioral apparatus and olfactometer were used to determine the olfactory threshold of rats for propionic acid and to determine their ability to discriminate propionic acid in binary mixtures that contained the dissimilar odorants, limonene or carvone, or a similar odorant, acetic acid. The concentration of propionic acid that rats required to discriminate this substance from the other odorants was substantially above that of the threshold concentration, the increase being greatest with acetic acid. The increased levels of propionic acid needed for detection of this odorant in mixtures is attributed to masking by the other components. This study represents the first time behavioral methods have been used to demonstrate masking with odor mixtures in a rodent. The results indicate that it should be possible to use behavioral methods to define conditions for odor masking in animals so that physiological studies of the underlying mechanisms can be achieved. PMID- 2780834 TI - Effects of gustation and gastric loading on rapid calorie metering in rats. AB - On gustation/intubation of nutritive sucrose or glucose solution, both ad lib and meal-time rats reduced their subsequent 1 hr calorie intake via stock diet. But gustation/intubation of calorically-inert water had no effect on 1 hr calorie intake of either group of rats. In contrast, on tasting calorically-inert but sweet saccharin, the 1 hr intake of meal-time rats was reduced, though not the intake of ad lib rats. However, on intubation of saccharin solution no reduction in 1 hr intake was shown by either meal-time or ad lib rats. Quinine also showed differential effects on calorie intake. On intubation, but not on gustation of quinine, both ad lib and meal-time rats evidenced increase in their 1 hr calorie intake. Daily (24 hr) calorie intake via stock diet of ad lib rats, in contrast to 1 hr intake was unaffected by gustation/intubation of any test solution, including nutritive sucrose and glucose. Meal-time rats daily (3 hr) intake, on the other hand, was similar to 1 hr calorie intake following test solution treatment. It was reduced on gustation/intubation of calorically-rich solution as well as on tasting the sweet, but calorically-inert saccharin. Taste/intubation of quinine did not cause any change in daily calorie intake of either ad lib or meal-time rats. PMID- 2780837 TI - Chronic intracerebral cannula can affect feeding behavior in the rat. AB - Intracerebral cannulae were placed in the lateral ventricle of rats. It was shown that the cannulae per se can affect feeding behavior. After recovery from surgery, rats displayed an unusual eating rate which consisted of very long, slow and large meals. This slow eating rate led to a modification of the circadian pattern; it induced a decrease in night-time and increase in day-time cumulative intakes. This phenomenon appeared when cannulae crossed the cortical motor area concerned with forelimb movements. Different stereotaxic coordinates had to be used in order to place cannulae in the lateral ventricle without disturbing the feeding pattern. This observation underlines the importance of recording feeding pattern before any surgery in any study of feeding behavior. PMID- 2780836 TI - Stimulus-induced eating when satiated. AB - Two studies investigated factors that promote the desire for food when people are not energy depleted. In Study 1, 20 male and female subjects, tested under conditions of either hunger or satiety, were exposed to one of two palatable foods (pizza or ice cream) and then given more of that food to eat. Operationally satiated subjects still ate pizza or ice cream, and the sight of these foods enhanced reported desire for them. The amount of these foods consumed was predicted by the subjects' self-reported desire for the food. In Study 2, 28 male subjects were fed to satiety, then primed with either pizza or ice cream (or not primed at all) and then given both pizza and ice cream to eat. Results showed that a brief taste of a desirable food enhanced its intake relative to the other, equally-preferred food. The data are discussed in the context of the effects of priming as a form of appetite whetting. Also, it is suggested that our operations for eliciting stimulus-induced eating in sated subjects may be useful for future examinations of the psychological properties of craving. PMID- 2780838 TI - The influence of prenatal and/or postnatal exposure to lead on behavior of preweanling mice. AB - Binghamton Heterogeneous (HET) Stock mice received prenatal exposure to either water or a 0.5% lead acetate solution via their biological dam. At birth, litters were cross-fostered so that they were postnatally exposed to either water or lead via their foster dam. Early preweaning measures of square crossing and standups in an open field and time to return to home cage nest showed that the effects of lead on behavior depend on: the developmental stage(s) during which the individual is exposed to the toxin, as well as age and conditions when tested. PMID- 2780839 TI - Diabetes and a high-fat/low-carbohydrate diet enhance the acceptability of oil emulsions to rats. AB - Acceptability of corn oil and coconut oil emulsions was examined in streptozotocin-diabetic (55 mg/kg, IP) and normal rats fed either a high-fat/low carbohydrate (HF/LC) or low-fat/high-carbohydrate (LF/HC) diet. Intake of five concentrations of the emulsions (2.5, 5, 10, 20 and 40%) was measured in 30-min, one bottle intake tests. Diabetic rats consumed more of the oil emulsions than did normal rats. Emulsion intake by diabetic rats increased, then decreased across concentrations, whereas emulsion intake by normal rats showed little change across concentrations. No differences in the intake of corn and coconut oil emulsions were observed. Total oil consumption was higher in diabetic than in normal rats at the three highest emulsion concentrations. Total oil consumption was also higher in rats fed the HF/LC diet as compared to those fed the LF/HC diet. These findings suggest that the presence of diabetes or feeding a HF/LC diet can enhance oil emulsion intake of rats in short-term tests. PMID- 2780840 TI - Competitive experience activates testosterone-dependent social aggression toward unfamiliar males. AB - Male hooded rats (350 to 450 g) were castrated and given subcutaneous implants of testosterone-filled or empty Silastic tubes. Four weeks later, half of the animals with testosterone implants were housed with an animal with an empty implant and left for 6 weeks. The other animals were adapted to a food deprivation schedule, housed in testosterone-implant/sham-implant pairs and given a series of food-competition tests. Following the competition tests, all animals were observed individually in their living cage for aggression toward an unfamiliar intruder. Within the competitive situation, animals with testosterone implants were more aggressive and more successful at maintaining access to food than their cagemates with sham implants. In the unfamiliar intruder test, animals with testosterone implants that had been subjected to food competition were more aggressive toward an unfamiliar intruder than were animals with testosterone implants that had not been given competitive experience. Animals with testosterone implants given competitive experience were more aggressive than their castrated cagemates, but animals with testosterone implants not given competitive experience were not more aggressive than their cagemates. These results demonstrate that testosterone-dependent social aggression fostered by a competitive situation is elicited by an unfamiliar male intruder. They also confirm other evidence that activation of social aggression does not appear to require increased testicular testosterone secretion. PMID- 2780841 TI - Behavioral and cardiac responses to a sudden change in environmental stimuli: effect of forced shift in food intake. AB - In order to test the possibility of a change in stress susceptibility induced by a forced change in activity rhythm, during control weeks food availability was restricted to the dark period only (fa-D) and to the light period only during the test week (fa-L). Stress susceptibility was measured on the basis of the decrease in heart rate (bradycardia) and an increase in freezing behavior in response to a sudden reduction in background noise. A significant increase in bradycardia both in magnitude and duration was observed during fa-L conditions as compared to the control fa-D condition. Also the duration of freezing behavior was increased during the fa-L condition. These results support the hypothesis that forced changes in circadian activities affect stress susceptibility. The significance of this finding for the incidence of stress pathologies is discussed. PMID- 2780843 TI - A microcomputer controlled data acquisition system for research on feeding and drinking behavior in rats. AB - This paper describes an inexpensive, reliable computer controlled data collection system designed for the continuous monitoring of feeding and drinking behavior in rats. This system will be useful in areas of behavioral pharmacology research requiring a detailed analysis of food and fluid intake. The configuration described herein was developed for research on the "microstructure" of alcohol drinking behavior. Variables examined include: alcohol bout size, frequency and duration, interbout intervals as well as the temporal pattern of intake and its relationship to food and water consumption. Detailed analysis of behavior using this technique will enhance our ability to interpret the nature of changes in alcohol oriented behavior produced by pharmacological manipulations, aid in the development of specific hypotheses related to the regulation of alcohol drinking behavior and provide a means of testing these hypotheses. PMID- 2780842 TI - Mechanisms of conditioned meal initiation. AB - Three experiments investigate behavioral and biological mechanisms of meal initiation controlled by learning. Animals were classically conditioned to initiate a meal in response to a conditioned stimulus paired with food. We demonstrate that: a) aversion to the signalled food markedly reduces consumption but has no effect on eating-related behaviors anticipatory to ingestion; b) naloxone reduces the amount eaten but has no impact on food-anticipatory behaviors; c) dopamine antagonism attenuates food-anticipatory behaviors without influencing amount eaten, and d) satiety signals arising from food in the gut reduce both food-anticipatory behaviors and amount eaten. These results demonstrate that anticipatory (appetitive) and consummatory components of meal initiation can be dissociated and are controlled by different biological mechanisms. Cues conditioned to food elicit eating by selectively activating appetitive systems. The implications of the appetitive/consummatory distinction for contemporary theories of meal initiation are discussed. PMID- 2780844 TI - Refeeding after various times of ingestion of a low protein diet: effects on food intake and body weight in rats. AB - Rats born of protein-deprived mothers were fed on a low protein (LP) diet (5% casein) from weaning. In each time sequence (0, 1, 3, 5, 8 and 16 weeks after weaning), 12 of them were refed on an isocaloric well-balanced diet (18% casein) for 2 weeks. Food intake, body and adipose tissue weights and protein efficiency ratio (PER) were measured in the refed rats as well as in 12 LP rats. At weaning and after one week, refed (RF) rats immediately increased their food intake. This increase was delayed at weeks 3, 5 and 8 occurred during the second week of refeeding only. At week 16, there was a significant decrease during the first week when compared with LP rats. Body weight increased regularly during each refeeding period without any significant augmentation of the proportion of adipose tissue. During all the experiment (except at week 16), PER in the RF group remained high (about 3 g body weight/g protein) during the first week of refeeding, and fell to 2.0-2.5 g/g during the second week. It was particularly significantly greater than that of the LP rats between week 3 and 5 where an important decrease was observed in this group (1.99 +/- 0.36 vs. 3.23 +/- 0.58 g body weight/g protein during the 1-3 weeks period). It appeared therefore that protein restriction during gestation and lactation in dams had no effect on the mechanisms controlling food intake of their offspring at weaning.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2780845 TI - Open field behavior and cardiovascular responses to stress in normal rats. AB - Experiments were conducted in normal Wistar rats with different patterns of behavior to assess the effects of stress on cardiovascular reactivity. One week after weaning and one month later rats were tested in an open field. Animals that did not cross any square in both open fields were classified as HYPOACTIVE. Those crossing more than 43 squares in the first and any in the second open field were classified as HYPERACTIVE. No difference was found in the basal mean blood pressure (BP) or heart rate (HR) between both groups. After a stress (change of cage, electric shock or immobilization) BP and HR increased. The increase in BP was higher in HYPOACTIVE rats. The HR increase was similar in both groups. Therefore, the ambulatory activity in the open field allowed us to separate groups of rats with different cardiovascular reactivity to stress. PMID- 2780847 TI - Physiological correlates of the coronary-prone behavior pattern in women during examination stress. AB - This research is an assessment of the physiological correlates of Type A behavior in college-aged women. Subjects were monitored while they took a midterm statistics examination; the dependent variables were systolic and diastolic blood pressure, heart rate, and heart rate variability. Type A or B behavior was assessed with the student form of the Jenkins Activity Survey. The results indicated that Type A women had higher levels of systolic blood pressure and heart rate, and lower levels of heart rate variability. Thus, when the stressor was a genuine examination, Type A behavior in young women was associated with increased physiological response levels compared to Type B's, a finding consistent with the hypothesis that Type A behavior is associated with sympathetic nervous system activity. PMID- 2780846 TI - Estradiol and parental experience, but not prolactin are necessary for ultrasound recognition and pup-retrieving in the mouse. AB - The effects of estradiol, prolactin and experience with pups on pup-retrieving and on the recognition of ultrasonic distress calls of the young by adult ovariectomized female mice were studied. Treatment with estradiol benzoate or experience with pups (for 5 days) induced pup-retrieving in 40% and 60% of the animals, respectively, as compared to 0% in inexperienced ovariectomized females. However, if pup-experience was achieved in the presence of estradiol, retrieving was shown by 90.5% of the animals. In addition, in this case models of the ultrasonic distress calls of the pups were significantly preferred ("recognized") in a discrimination task by the females. These females also showed a sharp increase in serum prolactin concentrations. Depleting prolactin from the blood by cysteamine, however, neither reduced the retrieving score nor disturbed ultrasound recognition. Thus prolactin is dispensable for maintaining maternal pup-retrieving and ultrasound recognition. The process of achieving pup experience is enhanced by the presence of estradiol. Possible actions of estradiol in the brain are discussed. PMID- 2780848 TI - Sex-dependent effects of inescapable shock administration on behavior and subsequent escape performance in rats. AB - Stress-induced behavioral disturbances have widely been used as animal models of depression. Sex differences, however, have rarely been studied, even though evidence is available to show that males and females react differently after presentation of aversive stimuli. The present experiment investigated the behavioral effects of inescapable shocks on subsequent shuttlebox-escape performance in male and female rats. Exposure to inescapable shocks resulted in suppression of activity during shock administration, which was more severe when shock duration was increased. Females showed less behavioral suppression and they were also more active than males during the adaptation phase, prior to shuttlebox escape training. Shuttlebox-escape performance was less affected in females than in males compared to that of nonshocked control subjects. Shock duration as a factor only affected efficiency of shuttlebox-escape performance in males. PMID- 2780849 TI - Plasma catecholamine and corticosterone responses to predictable and unpredictable noise stress in rats. AB - Plasma noradrenaline (NA), adrenaline (A) and corticosterone (CS) increases were determined in individual rats subjected to either 20 regularly or irregularly scheduled white-noise stimulations (4 min, 100 dBA). Blood was frequently sampled during the first and twentieth noise exposure, and during a reexposure after 24 hr. During the sampling periods, behavioral activities of the rats were recorded. The initial noise-induced CS release was partially reduced following the regular noise presentations. The increase after irregular presentations remained high. The difference in adrenocortical responsiveness between regular and irregular exposure persisted for 24 hr. The NA response to noise was partially attenuated following irregular administration of noise. However, regular exposure produced increased NA levels prior to noise presentation and a subsequent decrease during stimulation. After 24 hr, noise evoked an exaggerated initial NA release in the regular group. The noise-elicited rise in A was completely abolished after 20 noise presentations irrespective of whether these were applied regularly or irregularly. Reexposure after 24 hr evoked again a significant A response in both groups. No differences were observed in the habituation pattern of behavioral reactions among the regular and irregular groups. The results show that the sympathetic neural, adrenomedullary and adrenocortical systems differ in degree and speed of adaptation to intermittent stressful stimuli and in sensitivity to the predictability of stressors. PMID- 2780850 TI - Behavioral asymmetries in visual learning of young chickens. AB - Two-week-old chicks were trained in a simultaneous color discrimination learning task using food reinforcement. They had to discriminate between two discs of a different color whose right-left position was alternated at random. Results showed that chicks made more errors when the nonreinforced color was placed on the left with respect to the animal's body rather than when it was placed on the right. When chicks were trained on a right-left discrimination with two discs of identical color the asymmetry disappeared. Results are discussed in relation to current evidence for functional lateralization in the avian brain. PMID- 2780851 TI - Cholecystokinin concentration in specific brain areas of rats fed during the light or dark phase of the circadian cycle. AB - Measurement of peptide concentration in specific areas can be used as an initial investigative method for identifying brain sites in which the peptides may be acting. In this study cholecystokinin (CCK) concentration in specific hypothalamic and hindbrain areas of male Sprague-Dawley rats was measured in order to determine whether changes occurred as a result of feeding activity during different portions of the circadian cycle. Three groups of 40 rats each were studied: Group 1 were fasted 16 hr during the dark phase then sacrificed immediately or after a 20 min light phase meal. Group 2 were fasted 16 hr during the light phase then sacrificed immediately after lights out or after a 20 min dark-onset meal. Group 3 were fed ad lib and sacrificed immediately after light out or after a 20 min dark-onset meal. CCK was extracted from dissected areas and concentration was measured by RIA. There was no difference in CCK concentration of any of the 9 brain areas in rats fasted during the dark phase and fed during the light phase. In rats fasted during the light phase CCK concentration of the paraventricular nucleus (PVN) was greater in those that subsequently ate a meal at dark-onset than in those that did not eat (p less than 0.05). In ad lib fed rats CCK concentration was less in the anterior hypothalamus (AH) and greater in the supraoptic nucleus (SON) in rats that ate a dark-onset meal than in rats that did not (p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2780852 TI - Stress-rest cyclicity in the pathogenesis of restraint-induced stress gastric ulcers in rats. AB - Temporal patterns of stress and rest have been shown to influence extent of shock induced pathology. In the present study, the influence of stress-rest cycles was studied on amount of gastric ulceration after two forms of immobilization stress in rats. In Experiment 1, rats were subjected to different patterns of cold supine restraint interspersed with rest periods. A single 180 minute exposure produced more extensive ulceration than did a series of six 30 minute stress periods interspersed with 30 minute rest periods in the home cage. Different results were found in Experiment 2 using the stress of restraint in water and stress/rest patterns parallel to those used in Experiment 1. Previous reports have suggested that a "priming" stress might activate mechanisms protective against gastric ulceration. This was also investigated in Experiment 2 when animals were subjected to either a single 150 minute stress period, a 30 minute priming exposure to the same stressor 150 minutes prior to a 150 minute second exposure, or a 30 minute priming exposure 30 minutes prior to a 150 minute second exposure. No evidence was found for protective effects. In fact, a priming stress 30 minutes prior to final exposure enhanced ulceration. The studies provide some supporting evidence for the role of cycles in determining extent of stress pathology. Such data must be accounted for in any description of the mechanisms of stress-related ulceration. PMID- 2780854 TI - Scopolamine inhibition of lordosis in naturally cycling female rats. AB - Cholinergic antagonists, such as scopolamine, atropine, and hemicholinium-3, have been found previously to inhibit lordosis in ovariectomized rats primed with estrogen and progesterone. The present study further examined this effect using intact cycling female rats. Cycling was determined by daily monitoring of sexual behavior and vaginal cytology. In the first experiment, intraventricular administration of the muscarinic receptor blocker, scopolamine, was found to significantly inhibit lordosis behavior during natural estrus (10 or 20 micrograms bilaterally). In the second experiment, systemic administration of scopolamine was also found to significantly inhibit lordosis behavior during natural estrus (4 mg/kg, IP). Administration of the cholinergic antagonist did not significantly interrupt cyclicity patterns. These results indicate that central cholinergic muscarinic systems contribute to the regulation of lordosis during natural behavioral estrus in intact female rats. PMID- 2780853 TI - Impaired hypophagia induced by fecal anorexigenic substance in Zucker obese rats. AB - Influence of fecal anorexigenic substance (FS-T) on feeding by Zucker obese rats was compared to that by their lean littermates and Wistar King A rats. FS-T, which has been found to suppress food intake mainly by activation of glucoreceptor neurons in the ventromedial hypothalamus, was injected intraperitoneally in a dose of 7 U/kg at 1930 hr, immediately before the dark period. Potency of FS-T in feeding suppression was much less in the obese rats than in their lean littermates or the Wistar King A rats. Meal size of the obese rats was decreased after the injection, but meal duration was unaffected. The suppressive effect on the lean rats and the Wistar King A rats included decrease of both size and duration of the meal. These results suggest that chemosensitivity in the ventromedial hypothalamus of Zucker obese rats may be impaired, which may be one explanation of the obesity in Zucker obese rats. PMID- 2780856 TI - Perinatal modification of a sexually dimorphic motor nucleus in the spinal cord of the B6D2F1 house mouse. AB - The sexually dimorphic dorsomedial nucleus (DM) of the spinal cord of mice is affected by gonadal steroids in adulthood and these effects are dependent upon genotype. Following castration of adult mice there is a decrease in DM cell size in DBA/2J and hybrid B6D2F1 strains and a decrease in the number of cells staining with thionin in C57B1/6J and B6D2F1 strains. The effects of androgens on development of the DM nucleus were examined in B6D2F1 mice, which exhibit both characteristics in adulthood. Testosterone propionate (TP) administered to females pre- or postnatally resulted in a significantly larger number of motoneurons in the region of the DM when compared to administration of the vehicle alone, while soma area remained unchanged. Adult males castrated on the day of birth had significantly fewer cells in the DM than did intact males. Differences in cell size between shams and castrates were dependent upon age. PMID- 2780855 TI - Preference threshold for NaCl solutions and sodium homeostasis in hypophysectomized rats. AB - The NaCl preference threshold concentrations of male hypophysectomized (hypox) and intact rats were determined using a two-bottle choice paradigm. Although hypox rats ingested more total fluid daily (ml/100 g body weight), including water and NaCl solution, than intact rats, there were no significant differences between groups in either preference threshold (8.0 mEq/l) or preference maximum (90 mEq/l) concentrations. Further, the ratio of NaCl to total fluid ingested did not differ between hypox and intact groups throughout the large range of concentrations of NaCl solution presented to them. To assess their ability to conserve sodium, both intact and hypox rats were maintained on a sodium-deficient diet and distilled water for 3 days. Both groups reduced their urinary sodium outputs significantly compared to counterparts maintained on a sodium-replete diet. This suggests that the functional integrity of the renin-angiotensin aldosterone system was maintained in the hypox rats. Resting plasma aldosterone concentrations, measured at the end of the experiment, did not differ significantly between groups. Assessment of completeness of hypophysectomy was made by measurement of daily urinary excretion of epinephrine and by change in body weight during the course of the experiment. Daily urinary excretion of epinephrine by hypox rats was reduced to one-tenth that of intact controls. Hypox rats also failed to grow during the course of the experiment. By application of both of these criteria, the rats were completely hypophysectomized. PMID- 2780857 TI - Goldblatt hypertension and operant thermoregulation in shaved, sialoadenectomized rats. AB - The thermobehavioral consequences of angiotensinogenic two-kidney (2K) and sodium volume dependent one-kidney (1K) forms of Goldblatt (one-clip) renovascular hypertension were assessed in shaved, sialoadenectomized rats. The 2K group (n = 8) underwent unilateral renal artery stenosis with the contralateral kidney left intact; whereas the Sham-Operation (Sham-Op) Control group (n = 7) received only a laparotomy. The 1K group (n = 8) underwent unilateral renal artery stenosis with contralateral nephrectomy, and the Uninephrectomy Control group (n = 6) was only unilaterally nephrectomized. Shaping and testing was conducted in a convective thermal controller that permitted the experimenters to control, through continuously reinforced bar-pressing, the ambient temperature during exposure to warm (37 degrees C) or cold (17 degrees C) temperatures. Testing at each temperature occurred over two 6-hr sessions with an interpolated 48-hr rest period. Both 2K and 1K hypertensive rats exhibited longer durations of heat escape than their appropriate normotensive controls across both testing sessions. No differences were detected in response frequency, duration of cold escape responding, or body temperature. The results suggest that either the increased vascular resistance or the neuroendocrine-sympathetic disorder linked to the pathogenesis of Goldblatt renovascular hypertension may promote heat retention or lower heat tolerance. PMID- 2780858 TI - Effects of two different patterns of estradiol replacement on the sexual behavior of rhesus monkeys. AB - Seven pairs of rhesus monkeys consisting of adult males and adult, ovariectomized females were tested for sexual behavior. Behavioral tests were conducted under two patterns of estradiol treatment of the females. Under the "constant estrogen" condition, females were given SC injections of 10 micrograms estradiol benzoate on 28 consecutive days. Under the "cyclic estrogen" condition, females were given 28 days of estradiol treatment at varying doses based upon the artificial menstrual cycle devised by Michael, Zumpe and Bonsall (6). Rates of male mounting, hip-touch (incomplete mounts), and male threaten-away behavior (redirected aggression) increased during estradiol administration. Mounting peaked at the time of the highest estrogen dosage in the cyclic treatment condition, but was highest during the first portion of the period of constant treatment. Hip-touch and threaten-away behaviors were more frequent in the constant condition than during cyclic treatment. The high levels of these behaviors during the constant treatment suggest a lack of coordination between male and female motivation which is overcome by providing estradiol stimulation in a pattern which mimics the menstrual cycle. PMID- 2780859 TI - Automated method for measuring fighting behavior and locomotor activity of mice. AB - A multiunit apparatus for automatic quantification of intermale fighting behavior and locomotor activity of mice is described. The method uses static charge sensitive beds (SCSB) to detect movement, and appropriate hard- and software for data acquisition and analysis. The data obtained with the SCSB-method correlated well with those observed from video-recordings of the same 60 aggression trials for determining both the total fighting times (r = .967) and the latencies to first fighting (r = .982). d-Amphetamine significantly increased locomotor activity counts on the SCSBs, and this increase was blocked by haloperidol. It is concluded, that the SCSB-method is an accurate and flexible technique for quantifying intermale fighting behavior and locomotor activity of mice. PMID- 2780861 TI - Effects of delayed monocular enucleation after birth upon black-white discrimination learning in the albino rat. AB - Many investigators have demonstrated that enucleation of one eye in rats and hamsters soon after birth results in an increased number of uncrossed optic nerve terminals in the main visual centers, and that they are physiologically functional. Such changes, however, became less evident as the time of enucleation is delayed after birth. We also have found that rats with one eye removed at birth were able to relearn a black-white discrimination task faster than rats monocularly enucleated at maturity when relearning was conducted after destruction of the visual cortex contralateral to the remaining eye. This faster relearning phenomenon is considered to be a behavioral expression of such morphological and physiological changes. The present study was then undertaken to examine the question of how this faster relearning phenomenon is affected by the delay of enucleation time after birth. Two experiments were conducted. In Experiment 1 the effects of the removal of one eye at 0, 5, 10, 15, 20 days and at three months of age were compared, and in Experiment 2 those at 10, 11, 12, 13, 14 and 15 days of age were compared. Experiment 1 showed that enucleation at 0, 5 and 10 but not at 15, 20 days and at three months of age facilitated relearning, and that the degree of facilitation decreased as age increased. And, although the results were not unequivocal, Experiment 2 did suggest that the removal of one eye at and beyond 13 days of age was no longer able to facilitate relearning.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2780860 TI - Lordosis inhibiting effects of endogenous progesterone in the male rat primed with estrogen. AB - The aim of this study was to investigate the mechanisms involved in the inhibitory action of progesterone on estrogen-induced facilitatory effects of estradiol benzoate on lordosis behavior in the male rat. Intact adult male rats were given 1) 25 micrograms estradiol benzoate (EB) and 100 micrograms progesterone (P) at an interval of 42 hr. EB injected animals served as controls 2) EB followed by 3 doses of 400 micrograms dexamethasone (DEXA) and P as above. EB + DEXA injected animals served as controls. Testing for lordosis behavior was performed by 50 +/- hr after EB injection. A significant decrease in the number of the males displaying lordosis in response to the mounts of stimulus males resulted from P injection following EB treatment as compared to EB controls. DEXA treatment significantly reduced the number of EB animals showing lordosis responses but completely prevented the inhibitory effects of exogenous P to occur. Blood P values appeared to be significantly lower in EB + DEXA males than in their EB counterparts. The results provide evidence that endogenous P is involved in the display of lordosis behavior by EB-treated intact males. They mainly suggest that the effects of exogenous P on estrogen-induced lordosis behavior in the intact male rat result from sequential inhibitory mechanisms involving exposure of the animals to the successive action of endogenous and exogenous P. PMID- 2780862 TI - Differential effects of sleep stage on coronary hemodynamic function during stenosis. AB - We have demonstrated in a previous study that in the normal heart REM sleep induces surges in heart rate and coronary blood flow which are abolished by bilateral stellectomy. To study the effects of sleep in the stenosed coronary circulation, dogs were instrumented with Doppler flow probes and hydraulic occluders around the left circumflex coronary artery to measure coronary blood flow and to produce a 60% flow reduction. Catheters were placed in the aorta to measure mean arterial blood pressure. Electrodes were implanted via the frontal sinus to identify sleep stages. In the absence of stenosis, mean blood pressure was 95 +/- 3 mmHg, HR was 111 +/- 4 bpm, and coronary blood flow was 33 +/- 2 ml/min. During stenosis, REM induced episodic increases in heart rate which were accompanied by 38% decreases in coronary blood flow. We conclude that in the stenosed coronary circulation, REM sleep produces episodic sinus tachycardia and coronary blood flow reduction. PMID- 2780863 TI - Nucleus basalis lesions impair memory in rats trained on nonspatial and spatial discrimination tasks. AB - Ibotenic acid-induced lesions of the nucleus basalis of Meynert (nbM) in rats produced severe memory impairments when subjects were required to acquire a brightness discrimination and learn its reversal (Experiment 1). Lesion-induced impairments were also observed when a complex (30-choice) spatial discrimination task served as the assessment instrument (Experiment 2). The memory deficits observed in Experiment 2 were evident despite an approximate 4-month postoperative recovery period and prior brightness discrimination training. Identical nbM lesions failed to produce memory decrements when rats were trained and tested 24 hr later on a simple (2-choice) right vs. left spatial discrimination task. It is concluded that nbM lesions impair memory for both nonspatial and spatial tasks and that, at least with tests of spatial memory, task difficulty may be an important determinant of this impairment. PMID- 2780864 TI - Lesions of the hypothalamic paraventricular nucleus disrupt the initiation of maternal behavior. AB - Electrolytic lesions of the paraventricular nucleus (PVN) of the hypothalamus were found to disrupt the initiation but not the maintenance of maternal behavior in primiparous Sprague-Dawley rats. Following lesions performed on Day 15 of gestation, measures of maternal behavior (grouping, crouching, and nest building), pup retrieval, and pup weight gain were all impaired, but only if the lesion included the most rostral and medial aspects of the PVN. Lesions sparing these regions and sham surgery were generally ineffective. In a separate experiment, PVN lesions performed on Day 4 postpartum had relatively little effect on maternal behavior. As females lesioned prepartum showed changes in open field behavior as well as maternal behavior, the PVN may be important for modulating responses not only to pups but to several kinds of novel stimuli. These results may also further implicate oxytocin, which is synthesized in the PVN, in the initiation of maternal behavior. PMID- 2780866 TI - Infrequent periodic sleep disruption: effects on sleep, performance and mood. AB - In the first of two experiments, 12 normal young adults had their sleep periodically disturbed for two nights in the laboratory at three different rates: 10 min of sleep followed by 20 min of disturbance, 20 min of sleep followed by 40 min of disturbance and 40 min of sleep followed by 80 min of disturbance. Sleep and disturbance alternated throughout the night. While all disturbance conditions resulted in decreased daytime performance and increased sleepiness, the disturbance conditions did not differ from each other. In the second experiment, sleep was periodically disturbed for two nights at three new rates to act as control conditions for Experiment 1. The three conditions were: 2 min of sleep followed by 4 min of disturbance, 20 min of sleep followed by a single awakening, and 40 min of sleep followed by a single awakening. Sleep and disturbance again alternated throughout the night. As expected, sleep was less disturbed and daytime decrements were smaller in the conditions allowing 20 and 40 min of sleep followed by a single awakening. The data from both experiments were interpreted as support for sleep continuity theory; i.e., as the length of periods of consolidated sleep decrease, residual decrements increase. PMID- 2780865 TI - The sweet taste in the calf. II. Glossopharyngeal nerve responses to taste stimulation of the tongue. AB - Recordings were obtained from the glossopharyngeal nerve in 1-5-week-old calves during stimulation of the circumvallate tongue area with NaCl, quinine hydrochloride, citric acid, and the sweet compounds: acesulfam-K, aspartame, fructose, galactose, glucose, glycine, lactose, maltose, monellin, Na-saccharin, sucrose, thaumatin, and xylitol. All compounds except aspartame, monellin and thaumatin gave a nerve response. Glycine, followed by Na-saccharin, elicited the largest responses. Sucrose gave the largest response among the disaccharides, while there was no significant difference between the monosaccharides. Expressed as percent of the NaCl responses, the responses to glycine, sucrose, xylitol, fructose, galactose, glucose, lactose and maltose were considerably larger in the glossopharyngeal nerve than in the chorda tympani nerve. This can be taken as an indication that the posterior region of the tongue serves as the major receptive area for sweet in cattle. PMID- 2780868 TI - Influence of ovariectomy, estradiol and progesterone on the behavior of mice in an experimental model of depression. AB - In the tail suspension test (an animal model of depression) the duration of immobility during the 6 min of observation was 56.84 +/- 6.54 sec in sham ovariectomized mice and 113.11 +/- 7.86 sec 30-32 days after ovariectomy. Estradiol (10, 100 or 1,000 micrograms/kg) and progesterone (50, 1,000 or 10,000 micrograms/kg), subcutaneously injected daily 4 times before the test, restored the duration of immobility in ovariectomized mice to normal, while having no effect on sham-operated animals. On the other hand, desipramine (20 mg/kg IP 1 hr before testing) significantly reduced the duration of immobility both in ovariectomized and in sham-operated mice. These data indicate that ovarian sex hormones, while having no "antidepressant," desipramine-like, effect on the behavior of intact adult female mice, have such an effect in ovariectomized mice, and enable the animal to cope in a "normal" way with adverse environmental situations. PMID- 2780867 TI - Methamphetamine induced locomotor rhythm entrains to restricted daily feeding in SCN lesioned rats. AB - Rats were lesioned in the SCN and treated with methamphetamine dissolved in drinking water. A robust rhythm appeared in spontaneous locomotor activity which was not affected by blinding. Periodic food restriction (RF) of a 24 hr period was imposed on SCN lesioned rats with free-access to food for 4 or 6 hr per day, while water was given ad lib. The locomotor rhythm induced by methamphetamine treatment was phase-set by RF immediately in most cases but with transients in some. The phase-angle difference (psi) between food presentation and the activity onset became more negative by increasing the dose of methamphetamine. Because there was a positive correlation between methamphetamine dose and the period of locomotor rhythm, the change in psi was most likely due to lengthening of the period. After the termination of the RF schedule, the locomotor rhythm started to free-run from the prior phase set by RF. These results indicate that the methamphetamine dependent locomotor rhythm entrains to RF. PMID- 2780869 TI - Alterations in stress-induced prolactin release in adult female and male rats exposed to stress, in utero. AB - Prenatal stress alters the endocrine as well as the behavioral responses of rodents. Because of the reductions in both estradiol-induced and ether-induced prolactin (Prl) release reported in prenatally-stressed (P-S) rats, we were interested in whether prenatal stress might also modify the prolactin response of male and female rats to a moderate stressor in adulthood, viz., restraint stress. Timed-mated Sprague-Dawley females were exposed to a daily regimen of heat and restraint stress from days 15-22 of gestation. Control animals remained undisturbed throughout pregnancy. In adulthood, half of the male and female P-S and Control offspring were stressed by placing them in a Plexiglas restraint tube for 60 min (restraint stressed; S; referred to as P-SS and CS, respectively). The remaining half of the P-S and Control animals were left undisturbed (these were nonrestrained; NR; referred to as P-SNR and CNR, respectively). Blood samples (decapitation) were then collected from all animals and plasma was assayed for Prl content. P-SNR and CNR males did not differ in baseline Prl levels, nor did P SNR and CNR females. Following the restraint stress in adulthood, P-SS males as well as PSS females exhibited significantly less of an increase in Prl relative to CS males and CS females, respectively. In addition, baseline Prl levels differed between the sexes, with females--regardless of prenatal condition- having higher plasma Prl levels than males. These sex differences were no longer evident following restraint stress. These data, in combination with other work in P-S animals in the areas of Prl release and stress responses, demonstrate that prenatal stress renders the rat less hormonally (Prl) responsive to stress, with the effect being more pronounced in the female. PMID- 2780870 TI - Naloxone reversal of stress-induced suppression of LH release in the common marmoset. AB - There is considerable evidence suggesting that endogenous opioid peptides (EOP) might play a role in the defensive response to stressful stimuli. The stress associated with receipt of aggression from a female conspecific and physical restraint for collection of serial blood samples (at 10-min intervals) resulted in a significant (p less than 0.05) suppression of LH secretion in the oestradiol primed ovariectomized marmoset. Administration of the opioid receptor antagonist, Naloxone (1 mg/kg) immediately before and after receipt of aggression completely prevented the stress-induced decrease in LH release. This suggests that EOP may mediate, at least in part, this stress induced decline in LH release in the marmoset. PMID- 2780871 TI - The interactions of fluid and food intake in the spontaneous feeding and drinking patterns of rats. AB - Food and fluid intake are to some extent interdependent. In order to investigate the effect of food intake on the amount of fluid ingested and the intervals between draughts and the effect of fluid intake on the amount of food ingested and the intervals between meals, the eating, drinking, and core temperature of 15 adult male rats were continuously monitored for 14 days. Bouts of feeding and drinking were identified by three different definitions and the contents of the stomach at the beginning and end of these bouts was estimated with a computer model. The core temperature, estimated prebout stomach contents of food and fluid, and the amount of solid or water ingested during each bout were then used as predictors of the amounts ingested in draughts or meals using both univariate and multiple regression techniques. The bout sizes, core temperature, and postbout estimated stomach contents of food and fluid were used as predictors of the duration of the postdraught or postmeal intervals. The amount eaten in meals was found to be facilitated by both the amount of fluid in the stomach and the amount drunk during the meal, whereas the postmeal interval was not affected by fluid intake. Two different types of draughts were identified; draughts that occurred after brief interdraught intervals and appeared to be responsive to factors associated with fluid balance, and draughts that occurred with interdraught intervals over 15 min and appeared to be primarily determined in size and timing by eating. The results are similar to those found in humans and suggest that food intake is modified by fluid intake, whereas, fluid intake is primarily determined by food intake. PMID- 2780872 TI - Vomeronasal organ removal and female mouse aggression: the role of experience. AB - Removal of the vomeronasal organ (VNX) from female mice had little effect upon fecundity, nest building and pup retrieval. Surprisingly, VNX significantly affected aggression by lactating females. Normally, lactating females will attack and fight intruders placed into the home cage, especially if the intruder is an unfamiliar male. In Experiment 1, we determined that VNX prior to sexual experience totally eliminated this type of aggression. Intact females were highly aggressive, but much more so to unfamiliar than to familiar males. Copulation prior to surgery did not ameliorate the effects of VNX; again, none of the VNX females were aggressive (Experiment 2). In Experiment 3, attacks and fights by previously aggressive primiparous females also were eliminated or significantly suppressed following VNX. Even when the testing occurred later during the postpartum period and for extended periods of time, this same suppression of aggression held following VNX. We conclude that aggression by lactating female mice is under strict mediation by chemosignals detected by the vomeronasal organ. PMID- 2780873 TI - The effects of undernutrition during early life on spatial learning. AB - Recent research has shown that a lengthy period of undernutrition during early postnatal life can cause alterations in the morphological structure of the dentate gyrus. As this region is involved in the control of spatial memory, we decided to investigate whether undernourished rats also showed any deficits in this aspect of behaviour. Rats were undernourished from about birth until either 30 or 60 days of age and then nutritionally rehabilitated for a lengthy period before testing. There were significant differences in the body weight of control and undernourished rats in each experiment. The testing procedure involved rats being placed in a large pool of opaque water. They were required to swim to find a hidden platform located just below the water surface onto which they could escape. Each rat had to perform this test 20 times over a period of 3 days. The time taken and the total distance swum by each rat during each trial was measured. In Experiment 1, rats were familiarised with the water before testing took place, whereas in Experiment 2 they were not. There were no significant differences in the latency to find the platform or the distance swum between well fed control and previously undernourished rats in either experiment. In conclusion, in our experiments we could not demonstrate that undernutrition during early life caused any deficits in spatial memory performance. PMID- 2780874 TI - Hole board food search task in rats: effects of hole depths and food deprivation. AB - The hole board food search task has been used in rats to analyse their learning ability and different types of memory, IC working and reference memory. In the present experiments the effects of hole depth and level of food deprivation in this task was investigated. No marked differences with respect to the performance, learning and memory were found when rats were tested with a hole depth of 2.8 and 3.8 cm. But when a hole depth of 1.8 cm was used, these parameters were changed, suggesting a decreased learning and memory under this condition. A higher level of food deprivation resulted in a better performance of the animals, but the processes implicated in learning and memory were less affected. The data indicated that both external and internal characteristics can influence the results of the hole board food search task, and thus the calculated scores for learning and memory. PMID- 2780875 TI - Time course and response specificity of prolactin-induced hyperphagia in ring doves. AB - Intracranial injections of prolactin (PRL) have been previously shown to elevate food and water intake in ring doves. In an attempt to further characterize these PRL-induced behavioral responses and the time course of PRL action, food and/or water intake were measured as frequent intervals in male doves given a single intracerebroventricular (ICV) injection of ovine PRL (44 pmoles) or vehicle under food deprivation, water deprivation, or nondeprivation conditions. PRL increased food consumption by 35-50% over baseline levels in water deprived and nondeprived doves, although response latencies (10 hr) and durations (greater than 24 hr) were considerably longer than those reported for other orexigenic peptides. Behavioral observations of nondeprived doves further revealed that PRL significantly increased total time spent feeding and average feeding bout duration. In contrast to this pattern, water intake remained unchanged in food deprived doves and was only marginally increased in nondeprived doves following PRL treatment. Collectively, these results suggest that PRL promotes a selective and long-lasting hyperphagia which may in turn augment drinking activity. PMID- 2780876 TI - Lateralization of emotional expression under a neuroleptic drug. AB - Sixteen student volunteers were administered placebo and 50 mg of chlorpromazine (CPZ) in tablet form, on separate occasions, two hours before testing. Whilst volunteers related pleasant and unpleasant personal life events, the frequency and intensity of expressions on the left and right sides of the face were rated by independent observers. Subsequently the valence of the narration was also rated. Similar to a previous study facial expressions during negative emotions were expressed more often and intensely in the left face but positive emotions were bilaterally represented. CPZ neutralised the emotion on both sides of the face, irrespective of whether it was positive or negative. However, because negative emotions were almost completely lateralised to the left face the drug's effect on this emotion was most pronounced on this side. Independent ratings of the narration of the life events showed CPZ made them more pleasant. It is suggested that emotional arousal increases the asymmetry of behaviours when these are unilaterally represented or controlled. CPZ may equalize the symmetry of behaviour by reducing emotional arousal rather than by blocking all behaviour. PMID- 2780877 TI - Effort and stress influence the effect of lesion of the habenula complex in one way active avoidance learning. AB - Previous studies which have examined the effects of lesions of the habenula on active avoidance learning have not provided unambiguous support for response deficits. Moreover, interpretation of early studies is confounded by large lesions which damaged adjacent structures. We report the effects of smaller circumscribed lesions of the habenula complex on a simple one-way active avoidance paradigm in three separate experiments in which the required operant was a step or jump onto an elevated platform. In the first study involving avoidance of shock of low intensity (0.5 mA) with an average long intertrial interval of 8 minutes, lesioned animals were not significantly different from sham operated controls. However, in following experiments in which stress levels were increased by raising the shock intensity and reducing the intertrial interval, or in which the operant was made considerably more demanding by raising the height the animals had to jump to make an avoidance response, there were large lesion induced deficits in avoidance responding. The absence of significant differences between lesioned and sham operated controls in escape latencies suggested no lesion induced impairment of the response to the shock. It is suggested that the data not only support an effect of habenular lesions on active avoidance learning but also are consistent with a previous suggestion that the functional effects of lesion of the habenula on behaviour are effected through changes in dopaminergic function. PMID- 2780878 TI - Dietary fat-induced hyperphagia in rats as a function of fat type and physical form. AB - The influence of dietary fat on food intake and weight gain was assessed by feeding adult female rats diets that differed in the type and form of fat, as well as in the availability of other macro- and micronutrients. Compared to chow fed controls, the various fat diets increased total food intake by 4% to 27%. Specifically, rats fed chow and a separate source of fat (fat option diet) consumed more fat and total calories, and gained more weight when the fat source was emulsified corn oil rather than pure corn oil or was vegetable shortening rather than corn oil. However, corn oil and shortening had similar effects on caloric intake and weight gain when presented as emulsified gels. Also, pure and emulsified-gel forms of shortening did not differ in their effects on caloric intake and weight gain. Supplementing the vegetable shortening with micronutrients, however, enhanced its hyperphagia-promoting effect. The results of two-choice tests revealed that the rats' preferences for the orosensory properties of the various fat sources did not account for the differential hyperphagias obtained. Rather, it appears that long-term fat selection and caloric intake are influenced primarily by postingestive factors. Fat selection and total intake were determined not only by the fat source itself, but also by the other diet options. That is, rats selected more fat and consumed more calories when chow was the alternative food than when separate sources of carbohydrate and protein were available. PMID- 2780879 TI - Enhancement of memory by auditory stimulation during postlearning REM sleep in humans. AB - REM sleep involvement in memory processes was demonstrated in animals and humans: 1) REM sleep deprivation impairs the memory fixation, 2) learning sessions are followed by modifications of REM sleep characteristics. Moreover, sleep patterns can be modified by applying auditory stimulations during REM sleep. We show that REM actual auditory stimulations significantly improve the retention of a Morse code learning task. These results are discussed in terms of brain activation. PMID- 2780881 TI - Early development in mice. VI: Additive and interactive effects of offspring genotype and maternal environments. AB - Ovarian transplantation (OT) and fostering (F) methods were used concomitantly to test for genotype effects and cytoplasmic, uterine and postnatal maternal effects on nine sensori-motor responses employed for measuring development in two inbred stains of mice: NZB (N) and CBA/H (H). Parental strain differences were observed for six responses: forelimb placing, hindlimb placing, visual placing, crossed extensor, vibrissae placing and bar holding. Reciprocal F1 comparison alone indicates a single H vs. N global maternal effect (visual placing), whereas the joint use of the OT and F methods shows a parental vs. F1 global maternal effect on parental pups for three responses (hindlimb placing, grasping and visual placing) and on F1 pups for two responses (forelimb placing and visual placing). Moreover, a postnatal maternal effect is reported for five responses; righting, forelimb placing, grasping, crossed extensor and visual placing. The effect of the maternal genotype via the uterine environment is observed for four responses: righting, fore- and hindlimb placing and visual placing. Genotypic effects are also demonstrated on fore-and hindlimb placing, bar holding and visual placing. These results confirm the absence of a general genetic factor and demonstrate the absence of a general environmental factor the rate of the early sensori-motor development. PMID- 2780880 TI - Third ventricular chloride infusions enhance drinking in water deprived rats. AB - The influence of intraventricularly infused anions on drinking was studied in 54 water deprived male rats, divided in 9 equal groups. Stainless steel cannulae were chronically implanted into the anteroventral part of the third ventricle (AV3V) and the animals were water deprived for 24 hr prior to the infusions. Control group (n = 6) was given 10 microliters of artificial cerebrospinal fluid. The rats of the remaining 8 groups received similar quantity of equiosmolar chloride or bicarbonate solution of either sodium, potassium, calcium or barium. Cumulative quantity of water consumed in 30 min, 1 hr, and 24 hr after the infusion was recorded. All the chloride solutions, irrespective of the associated cation, enhanced drinking. Effects of the bicarbonates were relatively weak and transient. Dipsogenic effects of the solutions depended on their anionic composition. Thus, chlorides of all the cations elicited greater drinking than their bicarbonates. Responses of the similar anionic solutions were comparable. It appears that intraventricularly infused chloride ions stimulate drinking in water deprived rats. PMID- 2780882 TI - Microinjection of cholecystokinin into the medial preoptic nucleus facilitates lordosis behavior in the female rat. AB - We examined the effect of cholecystokinin (CCK) on lordosis behavior when administered into the medial preoptic area or the nucleus accumbens (NAcc) of ovariectomized estrogen-primed female rats. The frequency of lordotic responses was measured subsequent to unilateral microinjections of sulphated octapeptide CCK (sCCK-8) into the medial preoptic nucleus (MPN) or the NAcc. In the first experiment, three doses of sCCK-8 (1, 5, and 50 ng) microinjected into the MPN, and 50 ng injected into the NAcc produced a marked facilitation of lordosis. In a separate experiment, unilateral injections of an undiluted sCCK-8 antiserum into the MPN produced significant reduction in lordosis behavior in highly receptive females when compared with a normal rabbit serum injected control group. The results of the present study indicate that the CCK innervation of the MPN is involved in the neural regulation of lordosis behavior in the female rat. PMID- 2780883 TI - Suppression of feeding and body weight by inescapable shock: modulation by quinine adulteration, stress reinstatement, and controllability. AB - Three experiments examined food intake and body weight in rats after exposure to one session of intermittent, inescapable electric shock. Quinine adulteration and shock both suppressed feeding (Experiment 1); recovery of feeding after shock was impeded when quinine adulteration was combined with a mild daily stress reinstatement (Experiment 2). Body weight also was suppressed by shock (Experiments 1 and 2); control over shock provided some protection against this deficit (Experiment 3). These results suggest roles for "finickiness" and vulnerability to mild stressors in the maintenance of eating disorders associated with stress and depression. The findings also may have implications for interpretation of deficits in appetitively motivated behaviors after stress. PMID- 2780884 TI - Characteristics of psychomotor performance and time cognition in moderately obese patients. AB - To clarify adherence of obese subjects to external food-relevant stimuli, we examined time cognition and psychomotor functioning of the obese under noneating conditions in the present study. Matched on the basis of age, sex, height, intelligence quotient and education, 13 moderately, but adult-onset obese (mean obesity index +/- SEM, 53.9 +/- 5.0% by Matsuki's method) and 13 normal weight subjects (-6.3 +/- 2.3%) were tested. Obese females were slower than normal weight control subjects in alternate tapping of two metal plates (p less than 0.01) and in transfer of a dowel (p less than 0.05). Normal subjects were slightly but significantly (p less than 0.05) more efficient in a self-cued traverse movement test, whereas the obese subjects were very much less efficient in the self-cued than in the externally-cued test. These findings suggest that evaluation of deficits of the obese must consider other factors in addition to simple physical slowness due to fattening. In time cognition tests, cognitive levels of the obese were more accurate when initiated by time cues than when they were self-cued (p less than 0.01). The results indicate that obese (even after adult-onset) may exhibit impairment in internal time cognition when deprived of external modulating time cues. PMID- 2780885 TI - Effects of fasting on plasma catecholamine, corticosterone and glucose concentrations under basal and stress conditions in individual rats. AB - Plasma noradrenaline (NA), adrenaline (A), corticosterone (CS) and glucose concentrations were determined in blood sampled via a cardiac catheter from freely moving male rats under ad lib fed and 24 hr food deprived conditions using a repeated measures within-subject design. Resting plasma NA and glucose levels were lower in the fasted condition as compared to the fed situation. One day of refeeding reinstated the decreased NA and glucose values to prefasting level. Exposing 24 hr food deprived animals to the psychological stress of a novel environment resulted in larger NA and glucose increases, an unchanged A release and a lower CS rise in comparison with the responses during the free feeding state. The results show the usefulness of a within-subject design to detect subtle changes in plasma NA contents. Additionally, the data support the concept of selective control of the sympathetic nervous system and adrenal medullae. It is argued that hypothalamic noradrenergic mechanisms may be linked to the fasting induced effects on the sympatho-adrenal system. PMID- 2780887 TI - A nurse is .... PMID- 2780886 TI - Olfactory bulb size, odor discrimination and magnetic insensitivity in hummingbirds. AB - Relative olfactory bulb size with respect to telencephalic hemispheres (olfactory ratio) was measured in five species of hummingbirds. Trochiliformes were found to be next to last among 25 avian orders with respect to olfactory bulb development. One hummingbird species, the White-vented Violetear (Colibri serrirostris), was trained in a successive go/no-go discrimination task, and learned to feed or not to feed from a container dependent on the olfactory stimuli associated with it. Test birds learned to discriminate amyl acetate vs. turpentine essence, jasmine essence vs. lavender essence, eucalyptus essence vs. no odor, beta-ionone vs. no odor, carvone vs. eucalyptol. In contrast, 1-phenylethanol vs. beta-ionone discrimination, two odorants which appear similar to humans, was unsuccessful. Using a similar procedure, attempts were made to condition a White-vented Violetear and a Versicolored Emerald (Amazilia versicolor) to magnetic stimuli. The birds were unable to discriminate between a normal field and an oscillating field (square wave, 1 Hz, amplitude +/- 0.40 G). PMID- 2780888 TI - The popular press: required reading for nurses? PMID- 2780889 TI - Reuse of disposable items: liability is the key issue. Part II: Cross contamination. PMID- 2780890 TI - Rhinoplasty. PMID- 2780891 TI - Craniofacial anomalies in the neonate. PMID- 2780892 TI - Personality of a test taker. PMID- 2780893 TI - A mass postreduction mammaplasty. PMID- 2780895 TI - A unique deletion in pBR322 DNA caused by insertion of poly(dA).poly(dT). AB - A unique deletion covering around 43% of the pBR322 genome was found after attempting to insert 100 or 200 bp poly(dA).poly(dT) into the EcoRV site of pBR322 DNA. This result was not observed if an equivalent size heterologous DNA or a larger poly(dA).poly(dT) fragment of 10-20,000 bp was introduced at the same site. DNA sequencing analysis at the junctions suggests that a specific intramolecular pairing may be involved in the formation of this deletion mutant. PMID- 2780894 TI - Detection of killer-independent dsRNA plasmids in Ustilago maydis by a simple and rapid method of extraction of dsRNA. AB - A novel method for efficient and rapid isolation of dsRNA molecules was developed. The dsRNA content of Ustilago maydis was reexamined; two distinct dsRNA classes were identified. Class I includes the dsRNA segments reported earlier for U. maydis virus systems and class II includes unencapsidated dsRNA molecules that were barely detected by the conventional extraction methods despite their high titer. Segments of the class II, some of which are reported for the first time, were further characterized; all the segments are independent of the killer system and other encapsidated dsRNA molecules. These segments are cytoplasmically transmitted and, in sharp contrast with class I-encapsidated dsRNA segments, their relative copy number decreases rapidly while entering the stationary phase. PMID- 2780896 TI - Specificity of deletion events in pBR322. AB - The reversion of mutations due to inserts of identical palindromic DNAs just 1-bp apart in the amp gene of plasmid pBR322 varied up to 3000-fold (U. DasGupta, K. Weston-Hafer, and D.E. Berg (1987) Genetics 115, 41-49). The experiments reported here show that the intrinsic frequencies of deletion from these sites are truly very different. Deletions were selected by the joint loss of sacB (sucrose sensitivity) and lacZ alpa genes cloned together at these sites, without requiring restoration of the ampr allele. We found that greater than 90% of deletions at each of these sites do restore the ampr allele. This result reinforces the view that the probability of forming a particular deletion depends strongly on the DNA sequence at its prospective endpoints. PMID- 2780897 TI - Stretching and tissue expansion for rhytidectomy: an improved approach. AB - Intraoperative expansion of the skin of the face supplies additional tissue that permits closure of the face lift incision with minimal tension. This paper presents the findings in rhytidectomy patients over the last 3 years using both intraoperative stretching and intraoperative stretching combined with tissue expansion utilizing the Man face lift expander. Sixty-seven patients underwent rhytidectomy surgery, of whom 50 were treated with stretching techniques alone and 17 were treated with the combined stretching and expansion method. The patients' ages ranged from 28 to 78 years. Results indicate that the patients treated with combined stretching and expansion had significantly more skin removed. This new technique appears to offer significant clinical advantages over usual face lifts. PMID- 2780898 TI - The value of tear film breakup and Schirmer's tests in preoperative blepharoplasty evaluation. AB - The results of tear film breakup (BUT) and Schirmer's I and II tests were retrospectively analyzed on 146 patients undergoing elective blepharoplasty over a 41-month period. These tests were evaluated in conjunction with ocular history, orbital and periorbital anatomy, and Bell's phenomenon in order to determine their value, if any, in identifying patients at risk of developing a post blepharoplasty dry eye complication. One-hundred and six patients (73 percent) had test results that were within normal limits, and two of these patients (1.9 percent) complained postoperatively of a transient gritty or burning sensation. Forty patients (27 percent) had abnormal results to one, two, or all three tests, and two of these patients (5 percent) also complained postoperatively of a transient gritty or burning sensation. These four symptomatic patients all had preoperative dry eye histories and abnormal orbital and periorbital anatomy. When analyzed alone, an abnormal tear film breakup (BUT) or Schirmer's test was not a good predictor of possible postblepharoplasty dry eye complications. An abnormal preoperative ocular history or abnormal orbital and periorbital anatomy proved to be the best predictor for the possible development of a postblepharoplasty dry eye complication. PMID- 2780899 TI - The role of rigid skeletal fixation in bone-graft augmentation of the craniofacial skeleton. AB - The type of fixation (rigid skeletal vs. wire) was assessed against embryologic origin (membranous vs. endochondral) and recipient site (depository vs. resorptive) as variables affecting inlay and onlay bone-graft survival in 20 mature dogs. Wet weight and volume measurements were made at operation and at sacrifice (16 weeks). The results were as follows: (1) Rigid skeletal fixation increased bone-graft volume survival over wire fixation (p less than 0.05). (2) Fixation (i.e., rigid skeletal) and embryologic origin (i.e., membranous) were equal determinants of bone-graft volume survival (p less than 0.001); the recipient site was not significant for onlay bone graft survival. (3) Embryologic origin was the only significant determinant of weight survival (p less than 0.001). (4) Inlay bone grafts demonstrated greater weight and volume survival than onlay bone grafts (p less than 0.05). (5) Histologic and microradiographic studies demonstrated bony union of bone grafts fixed with rigid skeletal fixation, while fibrous union predominated in bone grafts fixed with wire technique. PMID- 2780900 TI - Jejunal free autograft: analysis of complications and their resolution. AB - Review of 101 patients who underwent 111 free jejunal autografts has demonstrated an absolute procedural failure rate of 13.5 percent. Salvage reconstruction with a second jejunum was successful in six of nine patients and one third-time jejunum was successful, giving an overall salvage rate of 70 percent. There were 33 patients experiencing pharyngocutaneous fistulas, 20 of whom had been previously irradiated. Of these patients, 15 experienced spontaneous closure and 9 others had successful surgical correction. The mortality rate was 5 percent. Eighty-three percent of patients were restored to adequate per oral alimentation. The jejunum, despite its relatively high complication rate, is an excellent method for pharyngoesophageal reconstruction, expeditiously providing return to function for patients with late-stage disease. PMID- 2780901 TI - The medial periareolar approach to submuscular augmentation mammaplasty under local anesthesia. AB - The medial approach to submuscular augmentation mammaplasty under local anesthesia begins with a medial periareolar incision around one-half or more of the areola. A subcutaneous tunnel is made toward the medial breast border, avoiding mammary ducts and sensory nerves to the nipple. The breast is reflected laterally, exposing a patch of pectoralis major muscle. A submuscular pocket is then created beneath portions of the pectoralis major, rectus abdominis, external oblique abdominis, and serratus anterior muscles, after which the implant is inserted and the muscle, dermis, and skin are closed sequentially. The periareolar incision allows for favorable scars without compromising the access or exposure necessary for accurate implant placement. Complete muscle coverage of the implant should contribute to a lower rate of capsular contracture. With a medial submuscular approach, nipple sensation is rarely altered, and revisions, if necessary, can be done through the same incision, still under local anesthesia, for increased safety, economy, and convenience. The medial approach to breast augmentation is a highly versatile, safe, and consistent method of achieving excellent results in breast augmentation in terms of scar, symmetry, and softness. PMID- 2780902 TI - Use of a permanent tissue expander for breast reconstruction. AB - The use of tissue expansion in breast reconstruction is a recognized alternative surgical approach. The second generation of tissue-expanding prostheses is the permanent reverse double-lumen expander. In a series of 100 breast reconstructions using a permanent tissue expander, the clinical benefits of producing a moderate degree of mound ptosis along with observed reduction in pain during expansion are discussed. Additional advantages to the use of the device are the cost savings realized, elimination of a second procedure and a second anesthetic exposure, and a high degree of patient acceptance and satisfaction. This study includes breast reconstruction following mastectomies for malignant and premalignant disease, as demonstrated in 75 delayed and 25 immediate reconstructions, with the longest follow-up being 3 years. Complications of infection (3 percent), significant capsular contracture (4 percent), and implant failure (3 percent) are the most frequent and major complications observed yet. In no instance was breast reconstruction rendered unachievable in the face of these complications. The demonstrated results achieved with permanent tissue expanding prosthesis, complemented by the obvious benefits and a low rate of significant complications, endorse this method as a viable alternative approach in reconstructive breast surgery. PMID- 2780903 TI - Lidocaine permeability in silicone tissue expanders: an in vitro analysis. AB - Tissue expansion has achieved a prominent role in soft-tissue reconstruction. Expansion-induced pain is often a limiting factor in this process and can affect patients for as long as 24 to 48 hours following each expansion session. Although lidocaine is known to be an effective analgesic, only anecdotal reports of its usefulness when placed within a tissue expander currently exist. This two-part study was designed first to determine if in fact silicone is readily permeable to lidocaine, and second to determine if the potential diffusion dynamics can be defined. In part 1 of the study, the silicone polymer was indeed found to be readily permeable to lidocaine as measured with fluorescence immunoassay technique. In part 2, two groups of Surgitek and Dow Corning expanders were filled with saline and lidocaine and placed in saline baths. At several intervals over a 48-hour period, aliquots of the surrounding saline were sampled and the lidocaine levels subsequently determined. A rather predictable and consistent diffusion curve was demonstrated. The significant difference in diffusion characteristics between the two expander types was apparently due to wall thickness differences inherent in the manufacturing. In this in vitro study, filler-valve leakage did not significantly contribute to lidocaine migration from within these tissue expanders. This basic in vitro work will now set the stage for further in vivo and clinical investigations to more precisely define the role of lidocaine in the tissue-expansion process. PMID- 2780904 TI - Plasma lidocaine levels during augmentation mammaplasty and suction-assisted lipectomy. AB - Many plastic surgical procedures are dependent on or aided by the use of local anesthetics. Drug toxicity, although uncommon, is the most feared complication of this technique. There are multiple factors that lead to varying drug levels. These include drug concentration, speed of injection, rate of degradation, total dosage, site of injection or application, rate of administration, and the adjunctive use of vasoconstrictors. This study evaluates the use of subcutaneously injected lidocaine in patients undergoing suction-assisted lipectomy and augmentation mammaplasty. Lidocaine in the concentration of 0.5% containing either 1:100,000 or 1:200,000 epinephrine was used in doses up to 500 mg. Serial lidocaine levels were then obtained up to 1 1/2 hours after injection utilizing two different assay techniques. Our findings demonstrate consistently nondectable serum lidocaine levels despite the use of doses in excess of recommended "safe" amounts. This suggests that under specific circumstances and with certain operative procedures, lidocaine dosing can be liberalized. PMID- 2780905 TI - A reliable approach to the closure of large acquired midline defects of the back. AB - A systematic regionalized approach for the reconstruction of acquired thoracic and lumbar midline defects of the back is described. Twenty-three patients with wounds resulting from pressure necrosis, radiation injury, and postoperative wound infection and dehiscence were successfully reconstructed. The latissimus dorsi, trapezius, gluteus maximus, and paraspinous muscles are utilized individually or in combination as advancement, rotation, island, unipedicle, turnover, or bipedicle flaps. All flaps are designed so that their vascular pedicles are out of the field of injury. After thorough debridement, large, deep wounds are closed with two layers of muscle, while smaller, more superficial wounds are reconstructed with one layer. The trapezius muscle is utilized in the high thoracic area for the deep wound layer, while the paraspinous muscle is used for this layer in the thoracic and lumbar regions. Superficial layer and small wounds in the high thoracic area are reconstructed with either latissimus dorsi or trapezius muscle. Corresponding wounds in the thoracic and lumbar areas are closed with latissimus dorsi muscle alone or in combination with gluteus maximus muscle. The rationale for systematic regionalized reconstruction of acquired midline back wounds is described. PMID- 2780906 TI - Combined second and third toe transfer. AB - Historically, restoration of hand function following multiple digital amputation has been unsatisfactory. The evolution of digital reconstruction with toe transfer has enabled surgeons to reestablish prehension in these severely injured hands. A 4-year experience with 26 consecutive combined second and third toe transfers to replace missing adjacent fingers was reviewed in order to delineate the indications and technical considerations and to emphasize prevention of donor site complications. Combined second and third toe transfer is reserved for adjacent finger amputations proximal to the digital web space with remaining fingers no longer than the small finger. Radial amputations are replaced with contralateral combined toe units, while ipsilateral toes are more ideal for ulnar amputations. Limited dorsal and plantar skin flaps extending only to the midpoint of the first and third digital web spaces allow for direct donor-site closure and uncomplicated healing. Maintenance of the plantar metatarsal arch by avoiding metatarsal shaft osteotomies or bone grafting-shortened metatarsals eliminates potential gait disturbances. When properly applied in selected patients, this single-stage microsurgical procedure can restore prehensile function, improve the appearance of the hand with multiple digital amputations, and preserve near normal donor-foot function. PMID- 2780907 TI - Autologous blood transfusions and plastic surgery. PMID- 2780908 TI - Completely successful replantation of an amputated ear by microvascular anastomosis. AB - A completely successful microvascular replantation of an avulsed ear using the superficial temporal bundle is presented, and the advantages of this procedure are discussed. PMID- 2780910 TI - Revising the nasal tip: a new approach. AB - After a very cautious dissection, the crossing of cartilages is going to produce a "spring effect" which, in pushing them to the right position, will consequently correct the pinch. This is a simple procedure, indicated only for nose tips or, if associated with other techniques, to correct secondary rhinoplasty patients. PMID- 2780909 TI - Maintenance of airway patency following treatment of choanal atresia. AB - Airway patency following repair for choanal atresia is effectively maintained utilizing Argyle polyethylene chest tubes as stents. Retrograde placement of the tubes from the mouth into the nasal passage is accomplished so that once secured, the largest diameter of the tubes is wedged against the posterior portion of the nasal ostium. This approach limits anterior migration of the tubes, preserving the columella and nasal rims while ensuring maintenance of airway patency following treatment of choanal atresia. PMID- 2780911 TI - Tattooing in reconstruction of the nipple and areola: a new method. AB - In order to produce the characteristic color of the nipple-areola complex and in unilateral reconstructions to match the other side, a modified tattooing method has been introduced. The quite different requirements between reconstruction and ornamental studio tattooing can only be satisfied by different techniques. For the first time, pigment particles have been suspended in a gel rather than adsorbed on an opaque mineral. Our porcine study has shown how the pigment is distributed in the dermis without penetration of the gel particles. The first 16 of the authors' 29 patients have been reviewed with an analysis of their appearance. Using this new method, a third achieved a completely natural appearance and two-thirds were judged to be intermediate, compared with an unnatural, although sometimes acceptable, result in all the earlier conventional tattoos. PMID- 2780912 TI - Diagnosing malignant hyperthermia. PMID- 2780913 TI - Subcutaneous forehead lift. PMID- 2780914 TI - Passot and fat grafts. PMID- 2780915 TI - Anterior chamber paracentesis. PMID- 2780916 TI - The use of surgilube for inserting the polyurethane-covered gel-filled mammary implant. PMID- 2780917 TI - Peripheral in-continuity tissue examination and Mohs' surgery. PMID- 2780918 TI - Professional courtesy. PMID- 2780920 TI - Deep dermis. PMID- 2780919 TI - Quantitative analysis of the thickness of human skin and subcutaneous tissue following controlled expansion with a silicone implant. PMID- 2780921 TI - Relation of divorce to self-concepts and grade point averages of fifth grade school children. AB - Data from 31 children (age 10.7 yr.) of divorced parents showed lower self concept scores on the Piers-Harris Children's Self-concept Scale than 19 children of nondivorced parents, although the two sets of scores fall within the expected range. PMID- 2780922 TI - Deprivation/enhancement fantasy patterns in children. AB - Previous studies have shown that females tell stories that change from negative experiences (deprivation) to positive experiences (enhancement) and males tell stories that change in the opposite direction. The current study examines this phenomenon in children using a different story-telling procedure. Results were not consistent with those of previous studies. PMID- 2780923 TI - Depression and attributions for problems and solutions in college students. AB - 50 adult clients at college counseling centers completed scales measuring depression, attributions for their primary problem and its expected improvement, and locus of control. Subjects who were more depressed made relatively internal and stable attributions for their primary problems, were less likely to believe they would improve, and expressed more belief in the importance of chance and powerful others. As a group, subjects tended to view their improvement as more internal and controllable than the cause of their problems. The results suggest that knowledge of clients' attributions for their problems could prove relevant to the treatment of depression. PMID- 2780924 TI - Fee practices of different psychotherapeutic orientations. PMID- 2780925 TI - Intercorrelations among general arousability, emerging and current sexual desire, and severity of sexual dysfunction in women. AB - Intercorrelations among general trait arousability, emerging sexual desire, current sexual desire, lack of sexual desire perceived as a problem, and sexual dysfunction were assessed in 65 women currently involved in marital or de facto heterosexual relationships. The Stimulus Screening Test was used to measure general arousability and the Assessment of Sexual Function and Dysfunction Questionnaire was used to measure emerging sexual desire, current sexual desire lack of sexual desire, and sexual dysfunction. Analysis showed that arousability was positively associated with current levels of sexual desire which was negatively associated with sexual dysfunction. There was a curvilinear relationship between arousability and sexual dysfunction, with women experiencing both high and low levels of arousability being more likely to score higher on measures of sexual dysfunction than those experiencing medium levels of arousal. The possible implications of these results are discussed. PMID- 2780926 TI - University students' support for heterosexual women with AIDS. AB - Support for a woman heterosexual AIDS victim was examined among 237 university students, 54% female and 54% upper division, with a mean age of 23.7 yr. A questionnaire containing one of four scenarios (AIDS resulting from unsafe sex, unsafe drug use, sex with an unfaithful husband, or a blood transfusion) measured support by people's willingness to sign or circulate a petition supporting the victim's right to attend college classes. A five-way mixed-design analysis of variance showed that victims who took risks received less support, that respondents were more willing to sign than to circulate a petition, and, while men did not discriminate among the four scenarios, women were most likely to offer support to "innocent" victims who contracted AIDS without sexual behavior. In addition, respondents who knew someone with AIDS were more likely to sign the petition. AIDS, particularly when contracted through risky behavior, is a disease with social ramifications beyond its threat to public health. PMID- 2780927 TI - Is media information that smoking causes illness a self-fulfilling prophecy? AB - Of 528 men, those 72 who derived information from the media, showed a lower rate of survival, i.e., more deaths from cancer, coronary heart disease, etc. Stress increased by constant repetition of evil consequences of smoking might constitute a self-fulfilling prophecy. PMID- 2780928 TI - Will premenstrual syndrome produce a Ms. Hyde?: evidence from daily administrations of the Emotions Profile Index. AB - 22 women participated in a study that required daily completion of the Emotions Profile Index and a short diary form for 49 consecutive days. The Emotions Profile Index for 868 subject-days was factor-analyzed. Differences in Factor 1 (friendly extraversion) were related to menstrual cycle position while differences in Factor 2 (timidity) were not. Evidence for a premenstrual move in the direction of aggressive, depressed distrust (irritable introversion) is discussed. It is noted that premenstrual differences in emotion are much weaker than the other significant effects discovered in the experiment (individual differences, unusual events, stress): the potentially cumulative effects of these variables are discussed. PMID- 2780929 TI - Which states have the death penalty: data from 1980. AB - A factor analysis of social characteristics of the states in 1980 showed that states with a death penalty were less socially integrated and more southern. PMID- 2780930 TI - Combined medical and psychological treatment of postchemotherapy nausea and vomiting: a case study. AB - The current case study illustrates the innovative potential of combined medical and psychological treatment of postchemotherapy nausea and vomiting for cancer patients. A 58-yr-old male patient diagnosed with leukemia and on a weekly cytosine arabinoside (Ara-C) treatment protocol, experienced violent vomiting episodes approximately 3 hr. after each injection. Emesis was so severe that the patient considered terminating treatment. Control was attempted with antiemetics (Compazine, Reglan), an antianxiety agent (Valium), an hypnotic (Dalmane), canabinol, hypnosis, and relaxation training without success. A re-examination of these strategies employing experimental rigor and data-responsive experimental designs indicated how success can be achieved without the necessity of new interventions. The patient experienced complete emetic relief and at 3-yr. follow up remained symptom-free. PMID- 2780931 TI - Comparisons of parents', teachers', and students' perceptions of self-concept in children from one- and two-parent families. AB - 19 pairs of third grade children from intact and single-parent families matched for sex, intellectual ability, and academic achievement were administered a brief self-concept measure. Teachers and parents rated the students' self-concept on similar measures. There were no significant differences in scores between the groups; however, within each group the teachers and parents consistently overestimated students' self-esteem. PMID- 2780932 TI - Trait-anxiety and sense of coherence: a longitudinal study. AB - A study of trait-anxiety and sense of coherence on a group of medical students over 18 mo. shows that, although both characteristics are rather stable over time, the measure of sense of coherence is more sensitive to stressors than A trait and is better predicted by A-trait than the opposite. PMID- 2780933 TI - Profiles of youthful suicide: disrupted development and current stressors. PMID- 2780934 TI - Reliability of parental reports using the Katz Adjustment Scales: before and after hospital admission for schizophrenia. AB - We examined the interrater and test-retest reliability of the KATZ Adjustment Scale (Relative rated or R form) longitudinally in a sample of schizophrenic patients, assessing their function before hospital admission, as well as at 1 and 9 mo. after discharge. Changes in mean scores over those assessments suggested sensitivity to change while mothers and fathers both completed the measure with moderate consistency over time. Interrater reliability was moderate at best and quite poor at initial testing, when the subjects were most disturbed clinically, suggesting that the scales may be acceptable when the individual is stable but that ratings may be unreliable when there is an exacerbation in clinical state. PMID- 2780935 TI - Correlation of scores of maximum security inmates on Wechsler Adult Intelligence Scale--Revised and the Peabody Picture Vocabulary Test--Revised. AB - 29 men (15 white, 14 black) who were inmates at a maximum security penitentiary were given the Wechsler Adult Intelligence Scale-Revised and the Peabody Picture Vocabulary Test-Revised on which the full scale IQs correlated .80. This suggests the Peabody would serve as an effective screening test for this population. PMID- 2780936 TI - Postdischarge observations by parents of adolescent patients hospitalized for acute conditions. AB - Parents' observations of their adolescent at two points (75 at 3 days and 24 at 28 days) during recovery from hospitalization for an acute condition were made. Whereas the majority of comments described changes in mood and negative behavior during this process, examples of positive coping and adaptive behavior by adolescents following discharge were provided. PMID- 2780937 TI - Comparability of WAIS and WAIS--R scores among mentally retarded adults. AB - This study compared the performance on the WAIS and WAIS--R of 21 mentally retarded adults residing in an Intermediate Care Facility. Tests were administered in one order, the WAIS initially and the WAIS--R second, with approximately two years between testings. Significant differences were found on the WAIS and WAIS--R for Verbal, Performance and Full Scale IQs. This finding contrasts with the differences between the measures as reported in the WAIS--R manual. PMID- 2780938 TI - Mediators of perceptions of stress among community-based elders. AB - Research focusing on the relationship between the frequency of stressful life events and perceptions of stress among the aged has increased considerably over the past few decades. The present research focused on expanding the simple life events/stress-perceptions paradigm by including several other variables that have previously been assumed to be associated with an increase in perceptions of stress among elderly persons. More specifically, the present investigation concerned evaluation of mediating effects of levels of social support, problem solving, and frequency of daily hassles on the perceptions of stress by elderly individuals. A prospective design evaluated over a 24-mo. period was used to assess the mediating effects. A conceptual model of mediating effects was tested using path analysis statistical techniques on data from a sample of 80 community based elderly volunteers. The postulated model accounted for 53% of the variance associated with the prediction of perceptions of stress among the elderly subjects. Implications for current theory and research in the study of mediating variables in the stress symptomatology of older adults are discussed. PMID- 2780939 TI - Length of survival and lymphocyte percentage in women with mammary cancer as a function of psychotherapy. AB - 50 patients suffering from terminal mammary cancer and visceral metastases received chemotherapy, and in addition half of them received psychotherapy, while half did not. A lymphocyte count was undertaken seven times in all, once before initiation of chemotherapy, the others after six applications of the therapy. As hypothesized, the 25 women who received psychotherapy lived longer and had significantly higher lymphocyte counts on Occasions 5, 6 and 7 than did the 25 women who did not receive psychotherapy. Of the types of psychotherapy employed, a specially designed form of behaviour therapy was significantly more helpful than dynamic psychotherapy in prolonging life. PMID- 2780940 TI - Childhood photographs of homosexual and heterosexual men. AB - 20 homosexual men and 20 heterosexual men, including a pair of discordant identical twins, contributed photographs of themselves at 6 mo. to 6 yr. of age for judging on personality. 18 traits were rated successfully. Factor analysis yielded two factors, Extroversion and Toughness. Data for only 19 homosexual and 11 heterosexual men were usable for the t tests; no significant differences were found, although trends for the homosexual group suggested less Extroversion and less Toughness. For the twins, photographs the mother identified as the homosexual twin were rated as showing less Extroversion and less Toughness. In conclusion, no obvious differences were found in the ratings of homosexuals' childhood photographs but slight differences were hinted at. PMID- 2780941 TI - Academic locus of control, type A behavior, and college absenteeism. AB - Responses from 40 women and 56 men to the Academic Locus of Control Scale and the Framingham Type A Scale were unrelated to each other but correlated .49 and .55 and -.32 and -.37, respectively, with absences from class. Elimination of illness related absences raised the correlations. PMID- 2780942 TI - Relations between preventive health behavior and hardiness. AB - To estimate the relationship between hardiness and preventive health behaviors a hardiness scale and a health hazard appraisal were administered to 211 college students. Multiple regression analysis indicated that modest amounts of variance on the hardiness measures were explained by the components of the health-hazard appraisals. Indications are that the concepts of hardiness and preventive health behavior are related and need further clarification. PMID- 2780943 TI - Type A behaviour pattern among Indian children. PMID- 2780944 TI - Relationships between adaptation-innovation, experienced control, and state-trait anxiety. AB - This study examines correlations among scores on the Kirton Adaption-Innovation Inventory, the Tiffany Control Scales, and the Spielberger State-Trait Anxiety Inventory for 104 undergraduates enrolled in the general psychology classes at a middle-sized midwestern university. Analysis indicated that adaptors and innovators perceive control from and/or over some aspects of their lives differently. Innovators feel control over internal (self) and over external (environment) while adaptors feel control from internal (self) and from external (environment). These results suggest innovators generally feel that they are in control of both themselves and the environment. Adaptors, however, generally feel they are controlled by internal drives and impulses or environmental events. The present study yielded no correlation between choice of college major and adaption innovation but more research is needed. A relation between adaption and state anxiety was found, which may suggest adaptors feel more pressure when completing a novel task (answering questionnaires) than innovators. Finally, no significant correlation was found between the Kirton scores and trait anxiety. PMID- 2780945 TI - Sex differences in psychological burnout in teachers. AB - Sex differences in levels of experienced psychological burnout, and in antecedents and consequences, were examined among teachers and department heads. Male teachers reported greater burnout and less job satisfaction than did female teachers. Although male department heads scored significantly higher on psychological burnout, there were no sex differences on measures of satisfaction and emotional well-being. The findings are explained in terms of sex differences in levels of social support. PMID- 2780946 TI - Self-reported expected emotional changes as a function of alcohol intoxication by alcoholic men and women. AB - 80 alcoholic men and women registered for counseling at different Swedish outpatient units volunteered to complete semantic differential scales related to emotional expected effects of alcohol intoxication. Analyses indicated that alcoholics expect large doses of alcohol to increase pleasure, dominance, and arousal. These results were discussed in comparison with the results from previous related studies with nonalcoholic samples. PMID- 2780947 TI - The importance of ethnicity in the development of identity of black adolescents. AB - Ego-identity status was examined in 20 male and 20 female black junior and senior high school students. Ego-identity was assessed by a semistructured interview measuring questioning and commitment in the traditional areas of occupation, ideology (religion and politics), sexual-interpersonal attitudes and behavior, and the newly added area of ethnicity. The greatest questioning and commitment occurred in the area of ethnicity. Ethnicity was most predictive of over-all identity-status and was seen as most important to self-definition. The other area of central importance was occupation. While the ideological and sexual interpersonal areas have been found in previous research to have central importance for white adolescents, they were found in this sample of black adolescents to show the lowest concordance with over-all identity and to be cited as having least importance in self-definition. The lowest amount of questioning and commitment occurred in these areas. PMID- 2780948 TI - Spanish version of the Revised Children's Manifest Anxiety Scale in Uruguay: reliability and concurrent validity. PMID- 2780949 TI - Family interaction and outcome IQ in high-risk boys. AB - This study examined the relationship between measures of family interaction and outcome for 97 boys at risk for psychopathology from having one parent previously hospitalized for psychiatric illness. Measures of communication deviance and of activity, balance and warmth, derived from two family activities, correlated significantly with 3-yr. follow-up adaptive functioning, measured by IQ. Poor family interaction, in previous studies associated with schizophrenic symptomatology, was here correlated with poor cognitive/social/emotional functioning, suggesting that family interaction may be a broad predictor of adequacy of functioning. PMID- 2780950 TI - Characteristics of spontaneous obesity in the Cayo Santiago rhesus macaque: preliminary report. AB - As part of the January, 1988 trapping of the Cayo Santiago rhesus colony a number of morphometric measurements and serum were collected to examine metabolic and hormonal changes associated with spontaneous obesity. Measurements included body weights, crown-rump lengths, abdominal and scapular skinfolds and circumferences of the upper arm, upper leg, abdomen and chest. Overall, males had a significantly greater body weight and Quetelet Index (body weight/crown-rump) than females but abdominal skinfolds did not differ. Pregnant females exhibited suppressed cholesterol levels relative to non-lactating and lactating females and males. Approximately 10% of the sample (N = 12) were defined as obese according to morphometric criteria. There were no differences in cholesterol and triglyceride levels between obese and nonobese animals nor were differences observed for testosterone and estradiol levels in obese and nonobese males. All obese animals fell within 7 matrilines, several of which were high ranking. These data confirm previous findings that spontaneous obesity occurs in the Cayo Santiago colony. The absence of obesity-related metabolic and hormonal changes may be related to the free ranging environment of the colony. PMID- 2780951 TI - Adult-onset macular degeneration in the Cayo Santiago macaques. AB - Since 1985 a group from the University of Florida has examined 136 rhesus monkeys from the Cayo Santiago colony. From the sample, 97 are older than nine years (approximately 30 human years) and 39 are younger. Drusen were found in 17% of the younger eyes and in 46% of the older eyes. All animals over 25 years of age had drusen in the central fundus. The incidence of drusen varied from 19-77% between five social groups. Incidence reported in random-source colonies in the continental U.S.A. is about six percent. Compared to near-age matched controls without drusen, selected rhesus exhibited visual resolution losses amounting to two Snellen-lines or more. The end-stage disciform changes and ultrastructural similarities are comparable with human macular disease. Future prospective studies may include therapies, surgical intervention, environmental manipulation and genetic research. PMID- 2780952 TI - Demographic and descriptive studies at La Parguera, Puerto Rico. AB - The La Parguera facility was established in part to contrast the social behavior of free-ranging groups with that in enclosures, as well as to compare the seasonal events linked to reproduction with those at Cayo Santiago. Onset of breeding was correlated with onset of the rainy season at both sites. Male rank in new social groups was correlated with seniority, and males often joined groups containing older brothers. Dominant males had little influence on group movements or group rank. Maternal rank influenced the likelihood that male offspring would survive and reproduce: sons of dominant females had higher survival. High-ranking females and high-ranking groups produced more sons than daughters at birth. Observational techniques employed at La Parguera demonstrated the biases of using ad lib. field notes and the need to correct for observability of individuals as a function of their age, sex, and social rank. Although social behavior was qualitatively similar in enclosed and free-ranging groups, significant quantitative differences existed. During its 18 years of existence the La Parguera colony proved to be a fertile site for both descriptive and experimental studies. In this paper we briefly review behavioral and ecological findings from the free-ranging population, review the demographic analysis of a cohort of monkeys born early in the colony's history and followed until death, and, finally, focus on methodology in the study of free-ranging primates. PMID- 2780953 TI - Studies of free-ranging and corralled patas monkeys at La Parguera, Puerto Rico. AB - Patas monkeys (Erythrocebus patas) were maintained and studied at the La Parguera primate colony between 1971 and 1982. This paper describes the founding of the patas population, its growth, and its eventual termination. The behavioral and biological studies conducted on the La Parguera patas monkeys are also described. PMID- 2780954 TI - Opening remarks of President Fernando E. Agrait on the occasion of the 50th anniversary of the Cayo Santiago macaque colony. PMID- 2780955 TI - Studies of free-ranging patas monkeys at La Parguera, Puerto Rico: 1977 problems and 1988 issues. AB - The first portion of this paper addresses problems associated with studying the free-ranging patas monkeys on the island of Guayacan (La Parguera). Problems included those of the habitat, the animal records and markings, and the behavioral characteristics of the patas. The second portion of this paper addresses the recurring question of the role of kinship as a variable that organizes patas social behavior. As mother-infant interactions comprise the largest proportion of intragenealogical interactions, the organizing effects of kinship beyond this level of relatedness need to be more extensively studied. PMID- 2780956 TI - Ecology and removal of introduced rhesus monkeys: Desecheo Island National Wildlife Refuge, Puerto Rico. AB - A field project was conducted to remove an introduced population of rhesus macaques (Macaca mulatta) from Desecheo Island National Wildlife Refuge, Puerto Rico. A group of 57 monkeys from Cayo Santiago was released on Desecheo Island in 1966 to study processes of adaptation. Observations in 1969 and 1970 implicated the monkeys in a drastic decline of the nesting populations of brown boobies (Sula leucogaster) and red-footed boobies (Sula sula). Previous efforts at trapping and removal had been conducted in 1977, 1979, and 1981. The present removal project began in 1985 and continued through 1987. During this period, field investigations were conducted regarding ecology and behavior, simultaneous with the removal of 66 monkeys from the island. Estimates of the monkey population size have been inaccurate. The total number present on the island has been extremely difficult to determine due to the rugged terrain and the furtiveness of the monkeys. The population did increase since introduction and was composed of apparently healthy individuals, generally in excellent physical condition. The population was well adapted to the harsh environment of Desecheo Island. No permanent sources of fresh water exist on the island and feeding adaptations focused on consumption of the wood pulp of the almacigo tree (Bursera simaruba) as a result. Huge amounts of this wood pulp were consumed daily for both nutrition and as a source of moisture. Cactus and other plant species were utilized as secondary sources of moisture and nutrition, including lesser amounts of almacigo fruit and leaves. Circumstantial evidence indicates the monkeys are egg predators. Social adaptations involved dispersal into small groups to optimize foraging conditions. PMID- 2780957 TI - The FDA rhesus breeding colony at La Parguera, Puerto Rico. AB - Experiences of the Caribbean Primate Research Center (CPRC) with the Food and Drug Administration's (FDA) rhesus monkey breeding contract at La Parguera and lessons which should have been learned are discussed. Onset of the rainy season and timing of rhesus monkey conceptions for 1973-79 showed random association. Electrocardiographic recordings of a male rhesus monkey during reproductive activity indicated extremely high and highly variable heart rates following ejaculation. PMID- 2780958 TI - Development of the Morgan Island rhesus monkey colony. AB - During the summer of 1979, the rhesus monkey breeding colony of the La Parguera facility of the Caribbean Primate Research Center was shipped to Morgan Island, South Carolina. During six shipments in 1979, and three more in 1980, over 1400 animals were translocated. Mortality from shipping, primarily in infants, was approximately 0.65%. Although the monkeys were not shipped in intact social groups, they restablished their groups shortly after subunits were released onto Morgan Island (MI). Since 1979 the colony has grown almost four-fold and now numbers almost 4000 animals. There has always been a strong female bias in the colony and today females comprise 75% of the total population. That portion of the colony comprising the aged animals, especially females, has grown steadily and today is 13% of the total. Except for the first year, when the colony was translocated during its mating season, reproduction at MI has been good, with a pooled average pregnancy rate of almost 80% and live birth rate of 71%. Juvenile females have also reproduced well, averaging 76% pregnancy and 70% live birth rates. This experience demonstrates that with proper planning and execution, a large, free-ranging colony can be moved long distances with minimal stress, trauma, mortality or disruption of social structure and reproduction. PMID- 2780959 TI - Future research on Cayo Santiago-derived group M rhesus monkeys at Sabana Seca: the socioendocrinology of male reproductive development. AB - Group M is an intact social group transferred from Cayo Santiago to Sabana Seca in 1984 and will be used for research integrating biomedical and behavioral investigations. The initial research planned for Group M will assess how social factors mediate the interactions between hormones and behavior as they affect male reproductive maturation. Preliminary data indicate that social status can accelerate endocrine maturation in males and that high ranking males may have a head start in initiating their reproductive careers. Elucidating the socioendocrinology of male reproductive development will complement the many studies that have been undertaken on the sociobiology of male rhesus macaques at Cayo Santiago. PMID- 2780960 TI - DNA fingerprinting for paternity and maternity in group O Cayo Santiago-derived rhesus monkeys at the German Primate Center: results of a pilot study. PMID- 2780961 TI - National Science Foundation support of the Cayo Santiago primate skeletal collection. PMID- 2780962 TI - Current status of the Caribbean Primate Research Center Museum. AB - The history of the Caribbean Primate Research Center Museum, including the Cayo Santiago Skeletal Collection, is briefly reviewed. Since 1971 skeletons of free ranging rhesus monkeys from Cayo Santiago have been systematically collected for osteological research. Since 1981 the skeletons from the six species of New and Old World monkeys maintained at Sabana Seca have also been collected. The CPRC Museum was established the following year to house this comparative skeletal collection, as well as alcohol-stored tissue specimens and a library. The current status of the collection, including numbers and types of specimens, and use policies, are presented to give an overview of the research potential of the Museum for biological, anthropological, pathological, and biomedical research. PMID- 2780963 TI - Bone growth and remodeling in Cayo Santiago--derived Macaca mulatta. AB - This paper examines similarities between rhesus macaques and humans in growth and remodeling of the long bones of the extremities. Cross-sectional moments of inertia were measured in three locations of the femur, humerus and tibia of M. mulatta using photon absorptiometry. Differences between males and females were evaluated with respect to age and weight. Remodeling was assessed from histologic sections at the same locations. Sex differences in structural properties of the long bones occur only at mid-diaphysis. Differences reflect the greater need for powerful hindlimb propulsion in males. The growth rate in males is twice as fast as that in females. Several periods of growth acceleration were detected in both males and females. Intracortical remodeling in growing macaques is relatively slow and may be more like that in elderly humans than that in growing children. PMID- 2780964 TI - Bone mineral and osteoporosis in aging rhesus monkeys. AB - 55 femora of free ranging rhesus monkeys from the Caribbean Primate Research Center ranging in age from 2-25 years were analyzed using histology, density fractionation and chemical analysis and correlated with morphometric data. The vertebral density was determined by photon absorptiometry. 119 caudal vertebrae from the skeletal collection were analyzed chemically. Cortical mineral density and porosity increased with age, and vertebral density and cortical area increased with weight. There was significant sexual dimorphism in many histological variables reflecting size differences and cortical porosity was greater in males. The chemical analysis showed no influence of the diet on bone mineral but that Ca increase with age in females but not in males. Finally a subgroup of aged, animals had hypermineralized, and more porous bone. This subpopulation may prove to be a valuable model for senile osteoporosis. PMID- 2780965 TI - Validation of single photon absorptiometry in estimating bone mineral mass in rhesus monkey skeletons. AB - Recent emphasis on age-related morbidity addresses the increasing life expectancy of Western countries. Osteopenia is a multi-factorial process affecting a sizeable number of elderly individuals, with bone fractures producing significant morbidity and related mortality. A non-human primate would be a very useful experimental model for the study of age-related osteopenia, if it could be shown that it is similarly afflicted by age and if non-invasive methods utilized among humans could give a valid estimation of bone mineral content in the animal. Our previous studies utilizing SPA (single-photon absorptiometry) suggest age-related decrease in BMC (bone mineral content) among rhesus macaque skeletons, similar to that observed in humans. The present studies were done in order to further validate the utilization of bone densitometry (SPA) in the rhesus macaque, comparing their BMC and bone density (BD) with the size and weight of their corresponding bones. Both radii and the right femur of 102 adult rhesus monkey skeletons (5 to 23 years old), were obtained from the Caribbean Primate Research Center (CPRC) Skeletal Collection. There were 55 females and 47 males. Bone parameters were obtained using a Norland Digital Bone Densitometer, model 2780 at 2 scanning sites: distal 1/3 of radii and proximal 1/3 of femurs. Bone lengths (cm) and weights (gm) were compared and correlated with densitometric parameters. Excellent correlations were consistently found, with r values 0.74 to 0.96 and p less than 0.0001. Thus it appears that SPA at distal 1/3 radius or proximal 1/3 femur are a valid estimate of total bone mineral mass in rhesus monkeys. PMID- 2780966 TI - NIH support for the Caribbean Primate Research Center (1975 to present). AB - The Animal Resources Branch, Division of Research Resources, National Institutes of Health, has provided contract and/or grant support to the Caribbean Primate Research Center since 1972. A portion of this core support has undergirded resources and research activities at Cayo Santiago. Significant events related to this support from 1975 to the present time are discussed. PMID- 2780967 TI - Future plans for the Caribbean Primate Research Center. PMID- 2780968 TI - A brief description of the Cayo Santiago rhesus monkey colony. AB - A description of the Cayo Santiago rhesus monkey (Macaca mulatta) colony is provided including an aerial photograph and map. PMID- 2780969 TI - Life histories of male Cayo Santiago macaques. PMID- 2780970 TI - Heart rate and endocrine responses to stress in adolescent male rhesus monkeys on Cayo Santiago. AB - Patterns of stress-responsiveness were studied in 19 adolescent male rhesus monkeys (Macaca mulatta) who are part of the free-ranging colony on Cayo Santiago, PR. Morphometric and blood samples were obtained as each male was captured and after holding overnight. Subject heart rate was recorded on Day 2, using surface EKG telemetry. Males showed marked individual differences in cardiac and endocrine profiles which were generally unrelated to their age, size or maternal rank. Heart rate patterns were correlated with several endocrine measures: males with low and variable heart rates showed lower cortisol, higher prolactin and higher growth hormone levels on Day 2 relative to males with higher and less variable heart rates, and their testosterone levels increased rather than decreased. Males with low and variable heart rates appear to have an endocrine response profile that is less adversely affected by acute stress, and which may potentially give them a competitive advantage in social interactions. PMID- 2780971 TI - Trapping activities and mother-infant relationships on Cayo Santiago: a cautionary tale. AB - Trapping activities in the Cayo Santiago rhesus monkey colony are normally limited to January and February of each year. The year 1984 was exceptional in that the trapping period was extended until early May. This paper examines the effects of the extended trapping period on mothers and infants who observed trapping activities but were not directly involved in them. Mother-infant pairs exposed to extended trapping activities spent significantly more time in contact and less time at a distance from each other than those not exposed, both during the time of exposure and for several weeks afterward. There were also consistent nonsignificant tendencies for exposed mothers to reject their infants less, to initiate a higher proportion of their contact and to play a larger role in maintaining proximity. This pattern of differences is consistent with the suggestion that mothers reacted to the extended trapping period by protecting their infants more and by encouraging independence less. The results demonstrate the sensitivity of mothers to human disturbance and illustrate the value of management policies like those on Cayo Santiago, that minimize human disturbance and restrict trapping to a consistent and limited period each year. PMID- 2780972 TI - Locomotor behavior of rhesus macaques (Macaca mulatta) on Cayo Santiago. AB - The locomotor behaviors of Cayo Santiago rhesus monkeys (Macaca mulatta) were studied in order to determine qualitatively some of the similarities and differences in movement patterns between free-ranging and captive primates. Super 8mm cinefilms of locomotor sequences by all age groups were analyzed frame-by frame. Cayo Santiago macaques use locomotor behaviors on the ground, large diametered branches, and vines that correspond to captive monkey locomotion on comparable supports (floors, suspended poles, ropes). Cayo Santiago macaques differ from captive monkeys, however, in that most infants begin to walk using the diagonal-sequence pattern, swimming is common, and infants and juveniles practice a variety of locomotor behaviors among the small-diametered tree branches. Therefore, the Cayo Santiago facility provides 1) insights into the full repertoire of infant and juvenile locomotor behaviors that are essential for studies of motor development and its neural control, and 2) models for designing small-branch supports for captive colonies. PMID- 2780973 TI - An overview of the food intake patterns of the Cayo Santiago rhesus monkeys (Macaca mulatta): report of a pilot study. AB - The food ingestion patterns of the rhesus monkeys (Macaca mulatta) of Group L on Cayo Santiago were quantitatively recorded during two months which coincided with the annual breeding season. Three methods of sampling were used concurrently: interval scan sampling, group location mapping and focal animal observation. These data generated time budgets and specifics about foods selected by six age/sex classes of animals. Overall the animals spent 10.8% of their time engaged in eating. This eating time was distributed as 50.2% on commercial diet/other non naturally occurring food items and 49.8% on natural vegetation of known or unknown plant part. Distinct diurnal rhythms were observed in overall behaviors and food selection patterns. Soil was part of the daily food intake of all animals. Age/sex class differences in volume of food intake and eating bout interruptions indicated that juveniles may adaptively focus on vegetative food sources during times of social stress. The changing environmental conditions on Cayo Santiago are viewed as presenting the opportunity for future studies of perceptual learning and adaptation by groups and the entire population. PMID- 2780974 TI - Rhesus macaques as an experimental model for degenerative arthritis. AB - To understand the pathogenesis of degenerative arthritis, an experimental model of the disease in which systemic factors can be investigated is required. This study reviews the evidence that the spontaneous degenerative arthritis in free ranging rhesus macaques at the Caribbean Primate Research Center meets the criteria for such a model. Two forms of degenerative arthritis in rhesus macaques have been identified: osteoarthritis and calcium pyrophosphate dihydrate crystal deposition disease. These diseases resemble spontaneous human arthritis with respect to age, sex, joint histology and cartilage composition. The availability of large numbers of affected primates as well as the availability of age/sex matched controls free of disease are additional factors that make spontaneous degenerative arthritis in rhesus macaques a suitable experimental model for the study of the human disease. PMID- 2780975 TI - [Patterns in the degradation of individual genes of thymocytes in irradiated rats]. AB - Degradation of genes of actin, albumin, histones, heat shock protein, and ribosomal RNA within DNA of irradiated animal thymocytes has been investigated. It has been shown that single strand enzymatic breaks occurred in thymocyte DNA 2 h following irradiation are localized in linker sites of nucleosomes. All the transcribed genes under study degrade to fragments that correspond by their length to DNA of nucleosomes and their oligomers. The albumin gene nontranscribed in thymocytes also degrades; however, no low molecular weight fragments are found. The degree of gene degradation is invariable in time. PMID- 2780976 TI - [Changes in the composition of DNA-bound nonhistone protein in the thymus and liver of gamma-irradiated rats]. AB - A supramolecular DNA complex (SC DNA) and DNA of a phenol nuclear matrix (PNM DNA) were extracted, by the phenol method, from rat thymus and liver 15 min following 10 Gy gamma-irradiation. The method of electrophoresis in polyacrylamide gel was used to study a composition of nonhistone proteins firmly bound to these DNA fractions. Irradiation was shown to induce the occurrence of new proteins and redistribution of proteins between SC DNA and PNN DNA of rat organs. PMID- 2780978 TI - [The interphase death of dividing cells. The effect of oxygen and the pH of the medium on the interphase death of Ehrlich ascites carcinoma cells under the action of ionizing radiation]. AB - Interphase death of in vitro irradiated (200 Gy) Ehrlich ascites tumor cells was studied as a function of oxygenation level and medium pH. The presence of oxygen both during and after irradiation as well as the increase in pH from 7.4 to 8.1 were shown to increase interphase death rate. The pronounced threshold dependence of interphase death of cells upon their concentration may be attributed to hypoxia occurring in a pericellular medium when cells concentration exceeds the threshold. PMID- 2780977 TI - [The formation and repair of DNA breaks in subpopulations of irradiated rat bone marrow cells]. AB - Using the method of viscosimetry of alkaline lysates it was shown that the saturable DNA repair system was present in rat bone marrow cells which was described by a complex kinetics. Isokinetic fractionation in a sucrose and dextran gradient permitted to isolate three fractions differing in the ratio between differentiated cells and cells capable of division. The estimation of the postirradiation DNA repair kinetics in these cells revealed a comparatively high level of repair in normocytes which confirmed the presence of the relationship between the level of DNA repair in cells and their proliferative potency. PMID- 2780979 TI - [The dynamics of the histochemical activity of the oxidoreductases in the myocardium of mature and old rats undergoing whole-body gamma irradiation at a dose of 1 Gy]. AB - The effect of gamma radiation (1 Gy) on redox enzyme activity in heart cells of adult and old rats was studied during a month following the exposure. It was shown that the activity of diaphorases and succinate dehydrogenase decreased whereas that of other tricarboxylic acid cycle enzymes and lactate dehydrogenase underwent phase changes. PMID- 2780980 TI - [The stimulating action of low doses of ionizing radiation on glucokinase synthesis in the liver of developing rats]. AB - Taking spontaneous glucokinase synthesis as an example the authors showed an increase in the rate of enzymatic differentiation against the insignificantly increased natural radiation background, which might serve as a supporting evidence of the previously obtained data confirming the necessity of the natural radioactive background for the development of mammals. PMID- 2780981 TI - [The distribution of chromosome aberrations after gamma and neutron irradiation among cells in various stages of the mitotic cycle in a human lymphocyte culture]. AB - Distribution of chromosome aberrations among cells depending on radiation dose, stage of mitotic cycle of human lymphocyte culture, time of cell fixation under the effect of 6 MeV neutrons and their combination with postirradiation hyperthermia has been investigated. The regularities in the distribution of aberrations within cells are similar with both neutron- and gamma-radiation. In experiments with both types of radiation delivered at the S stage and fixation 52 h after the onset of incubation, distribution of aberrations follows Poisson formula whereas with 62-hour fixation, the correlation is disturbed. This is due to the presence of cells dividing for the second time after irradiation which makes the data obtained with delayed fixation scantily informative. Additional hyperthermia does not affect substantially the structure of cell population with both radiation types. PMID- 2780982 TI - [Characteristics of drug pharmacodynamics in irradiated rats]. AB - A whole-body exposure of rats to 8 Gy radiation is ineffective in 3 days, and in 6 days, it prolongs considerably the effect and increases the pharmacological activity of hexenal, meprobamate, ethylmorphine, and amidopyrine, inhibits the activity of amidopyrine demethylase, aniline hydroxylase, NADPH-cytochrome c reductase, and reduces the content of protein, cytochromes P-450 and b5 in a microsomal liver fraction. PMID- 2780984 TI - [Modification of the effect of fast neutrons in an experiment and in radiation practice]. AB - The data are obtained indicating that it is possible to increase the cytogenetic effects of 6 MeV neutrons by the additional effect of hyperthermia and caffeine. A combination of gamma rays and neutrons produced a superadditive effect, in estimating the level of chromosome aberrations in human lymphocytes, and in radiation practice when estimating the degree of tumor regression. It is suggested that a different mechanism is involved in the formation of chromosome aberrations after the combined effect of gamma and neutron radiation. PMID- 2780983 TI - [Quantitative assessment of inhalation exposure to various transuranium radionuclide compounds by integral nonstochastic criteria]. AB - The comparison of the danger from inhalation of radionuclide transuranium compounds differently transferred within the body was made by the results of an examination of 169 mongrel dogs and 2000 Wistar rats. Effective and ineffective levels of the radionuclide inhaled were determined by integral nonstochastic criteria, that is, 50 per cent death rate, shortening and increase of the average life and reduction of body mass. PMID- 2780985 TI - [The therapeutic properties of an alcohol extract of plasma in a combined radiation-thermal lesion]. AB - The intravenous injection of an alcoholic plasma extract to mice after the combined exposure to radiation and heat decreases lethality, restores the investigation-and-orientation activities and oxygen consumption, favors the growth of body mass and healing of burns. The antioxidant effect of the extract manifests itself by the decreased rate of formation of lipid peroxidation products in the liver and the suppressed spontaneous and latex-induced chemiluminescence of neutrophils. PMID- 2780986 TI - [Possible mechanisms of the radiomodifying action of exogenous hypoxia and electromagnetic radiation in the SHF range]. AB - It was shown that biologically active substances formed in the liver tissue under the effect of hypoxia and SHF electromagnetic radiation produce a radioprotective effect when administered 15 min before exposure and have no protective effect when administered after irradiation. PMID- 2780987 TI - [The postradiation radiosensitivity of rats following uniform external irradiation]. AB - In experiments with mongrel male rats exposed to double uniform gamma-irradiation (60Co), the postirradiation radiosensitivity was studied by the criterion of a median lethal dose; clinical and laboratory indices were investigated after preirradiation with doses of 1-5 Gy. A function was proposed to link the dynamics of the postirradiation radiosensitivity of rats to the proliferative activity of bone marrow and its total cellularity. PMID- 2780988 TI - [The postradiation radiosensitivity of rats following partial external irradiation of the abdominal area]. AB - After double partial X irradiation of abdomen the postirradiation radiosensitivity of mongrel male rats was studied by the criterion of a median lethal dose; clinical and laboratory parameters were investigated after preirradiation with 4.6 and 8 Gy. A function is proposed linking the dynamics of the postirradiation radiosensitivity of rats with the proliferative activity of small intestine and its total cellularity. PMID- 2780989 TI - [Evaluation of changes in the median life span of animals following separate and combined exposures to external 137Cs gamma irradiation and incorporated 239Pu]. PMID- 2780990 TI - [An approach for determining the capacity of human cells to repair gamma-induced DNA damage using interferon]. AB - The method of ultracentrifugation of a nucleoid in a neutral sucrose gradient in the presence of ethidium bromide was used to detect gamma radiation-induced DNA breaks and their resynthesis in human HEp-2 cells and fibroblasts taken from a skin biopsy of patients with homocystinuria (HCN). In HEp-2 cells pretreated with interferon the nucleoid sedimentation rate after gamma irradiation did not differ from that in intact cells, that is, interferon exerted its protective effect whereas in HCN cells interferon was ineffective. After incubation with interferon, the resynthesis of the induced breaks was enhanced in these cells as well. PMID- 2780991 TI - [The interphase death of dividing cells. The kinetics of the death of cultured Chinese hamster fibroblasts after irradiation at various doses]. AB - In studying the kinetics of interphase death (ID) of cultured Chinese hamster cells after irradiation with doses of 100 to 800 Gy the authors showed an increase in the ID rate with increasing radiation dose; the presence of serum in the medium both during and after irradiation prevents the cell death. PMID- 2780992 TI - [The modifying action of methylmethane sulfonate on unscheduled DNA synthesis in the UV irradiation of human peripheral blood lymphocytes]. AB - The value of the unscheduled DNA synthesis after the combined effect of UV radiation and methyl methanesulfonate (MMS) was considerably lower than that upon exposure to UV radiation alone and after two-hour incubation of the culture. These differences were insignificant after 26 h incubation. The result can be attributed to the alkylating effect of MMS on the repair DNA polymerase. With MMS delivered prior to UV irradiation there was an even larger decrease in the unscheduled DNA synthesis with both 2- and 26-hour incubation. The data obtained can be explained by the fact that MMS inhibits an excision endonuclease. PMID- 2780993 TI - [Effect of irradiation on the cellular sensitivity of separate NKLy tumor subpopulations to the membrane-toxic action of natural killers]. AB - A study was made of sensitivity of NKLy tumor fractions, differing in the proliferative activity, position in the cell cycle, and ploidy, to membrane-toxic action of natural killer cells from mouse spleen. The membrane toxicity index for cells of three out of five fractions under study was shown to decrease after exposure to 4 Gy radiation. It is concluded that there is no correlation between NKLy cell sensitivity to membrane-toxic effect of natural killer cells and their radiosensitivity as well as their ability to repair potentially lethal damages. PMID- 2780994 TI - [The role of the autonomic nervous system in regulating the excretory function of the stomach in irradiated dogs]. AB - Dogs and rats were exposed to gamma/neutron- and X-radiation. The anterior part of dog's stomach was exposed to 10 Gy and 13 Gy respectively; rats were subjected to whole-body irradiation with absolutely lethal doses. Prior to irradiation, various parts of the vegetative nervous system of both types of animals were "switched off" pharmacologically. In addition to clinical investigation of radiation sickness, the excretory function of the stomach was studied by the excretion of intravenously injected neutral red. The "switching-off" of the parasympathetic nervous system prior to irradiation stabilized the excretory processes in the stomach, increased the resistance of animals, and, vice versa, the "switching-off" of the sympathetic nervous system destabilized the excretory processes and decreased the resistance of the organism. PMID- 2780996 TI - Forty-millisecond MR imaging of the abdomen at 2.0 T. AB - The ability of an ultrafast magnetic resonance (MR) imaging technique to provide abdominal MR images free of motion artifacts was studied. Individual T2-weighted transverse MR images were acquired in as little as 40 msec on a whole-body system operating at 2.0 T. Clinical evaluation was undertaken with fat-suppressed images in which only protons of water molecules contributed to image signal intensity. The ultrafast MR images were compared with conventional MR images obtained at 0.6 T. In 22 patients and two healthy volunteers, ultrafast MR images were of diagnostic quality and free of motion artifacts. Images obtained at an echo time (TE) of 30 msec (imaging time, 40 msec) had liver signal-to-noise ratios of 56.3 +/- 22.6 (n = 19). Because of a smaller data matrix, ultrafast MR images had soft tissue interfaces that were less sharp than those of the highest-quality conventional MR images in which no motion artifacts were present. However, ultrafast MR images demonstrated high T2-dependent soft-tissue contrast, and pathologic and normal anatomies were readily detected with both imaging techniques. This ultrafast imaging technique has significant promise in whole body MR imaging, in which motion artifacts often degrade image quality. PMID- 2780995 TI - [The RBE of 0.85-MeV neutrons in the cerebral form of radiation sickness in guinea pigs]. AB - The RBE coefficient of neutrons (0.85 MeV) was 1.87 in comparison with that of electron radiation (8 MeV) as determined by the death rate of guinea pigs with the cerebral form of radiation sickness. LD50/1.5 amounted to 43.2 and 80.7 Gy. The dynamics of clinical symptoms at the height of the disease is discussed. PMID- 2780997 TI - In vitro dissolution of gallstones with MTBE: correlation with characteristics at CT and MR imaging. AB - The authors undertook a study to determine whether in vitro computed tomography (CT) or magnetic resonance (MR) imaging could enable the prediction of the outcome of gallstone dissolution with methyl tert-butyl ether (MTBE). In vitro CT and MR images were obtained of gallstones removed at surgery from 40 and 30 patients, respectively. The patterns of the gallstones seen on CT scans were categorized as dense, moderately dense, faint, isodense, rimmed, and laminated. Gallstones were categorized by maximal signal intensities seen on T1-weighted MR images. After imaging, gallstones underwent in vitro MTBE dissolution. CT appearances correlated well with dissolution rates. Greatest weight change was noted in gallstones with homogeneously faint and isodense patterns, and least weight change was seen in stones with a homogeneously dense pattern. Rimmed and laminated stones with foci of high attenuation dissolved significantly to 5% or less of the original weight, a finding indicating that such foci do not preclude dissolution. Dissolution rates correlated with attenuation values of homogeneous stones (r = .8) and of the rim portion of rimmed stones (r = .8). No correlation was found between T1-weighted signal intensities on MR images and MTBE dissolution rates. PMID- 2780998 TI - Cystic pulmonary lesions in patients with AIDS. PMID- 2781000 TI - Bowel and mesenteric injury following blunt abdominal trauma: evaluation with CT. AB - Computed tomography (CT) used in cases of blunt abdominal trauma has been found sensitive in detection of bowel and mesenteric injuries and discrimination of operable from nonoperable candidates. In 51 patients with suspected bowel or mesenteric injury following blunt abdominal trauma, CT correctly depicted bowel hematoma or mesenteric injury in 17 of 19 nonoperable patients (89%) and severe injuries in one patient who died preoperatively. In 26 of 28 patients who underwent therapeutic laparotomy (93%), initial CT enabled identification of surgically confirmed injuries. In two cases, initial scan misinterpretation delayed diagnosis of serious bowel injuries. The correct interpretation was rendered preoperatively and at blind retrospective review. CT findings that correlated with bowel or mesenteric injury requiring surgery were free peritoneal fluid (27 of 28, 96%), mesenteric infiltration (24 of 28, 86%), thick-walled bowel (17 of 28, 61%), associated abdominal injuries (12 of 28, 43%), and free air (nine of 28, 32%). In nonoperable cases, CT scans demonstrated bowel thickening (84%) but less frequently peritoneal fluid (21%), mesenteric infiltration (26%), or associated injuries (5%). In three of four patients who underwent nontherapeutic laparotomy, preoperative CT correctly imaged the limited abdominal injuries. PMID- 2780999 TI - Anorectal function: defecographic measurement in asymptomatic subjects. AB - A study of anorectal function during fluoroscopically monitored defecation was conducted in 32 asymptomatic subjects. Two observers independently measured various parameters on defecograms and reviewed video recordings during the subjects' squeezing, rest, and straining. There was a wide range of measurements for the anorectal angle, the position of the anorectal junction, perineal motility, and anal canal width. Interobserver variation of these measurements was large. In 17 subjects, both observers agreed that rectal emptying was incomplete. In 10 patients, there was agreement on the presence of rectal wall changes such as intussusception, rectocele, and mucosal prolapse. Defecographic measurements should be interpreted with caution and should not be used as the only criteria for treatment. Anatomic changes of the anorectal region during straining at defecation do not necessarily cause symptoms but may be a precursor of clinical disorders. Defecography is useful in the detection of these abnormalities. PMID- 2781001 TI - CT of bronchogenic carcinoma: indeterminate mediastinal invasion. PMID- 2781002 TI - Tc-99m antifibrin Fab' fragments for imaging venous thrombi: evaluation in a canine model. AB - An antifibrin antibody (T2G1s) Fab' fragment labeled with technetium-99m was tested for its ability to produce images of fresh thrombi in dogs. In gamma camera images, all thrombi were evident by 2-4 hours after injection. Mean thrombus-to-blood and thrombus-to-muscle ratios averaged 4.0 and 69 at four hours after injection and increased to 24 and 270, respectively, by 24 hours after injection. When compared with I-125 fibrinogen injected into the same dogs, Tc 99m-antifibrin Fab' had lower absolute uptake in thrombus but higher thrombus-to blood ratios due to a faster rate of disappearance from the blood. The primary route of excretion was through the kidneys. Tc-99m-antifibrin Fab' was highly stable in vivo, with an average of 82% of the circulating radioactivity able to bind to fibrin at 4 hours after injection. When compared with an In-111-labeled Fab fragment of antifibrin antibody 59D8, thrombus-to-blood and thrombus-to muscle ratios were slightly higher for the Tc-99m-labeled antibody, and the blood disappearance rate was slightly faster. The absolute uptake in thrombus, however, was not significantly different, and the thrombus was visualized at about the same time after injection. These studies suggest that Tc-99m T2G1s Fab' is a potential agent for detecting thrombi in a clinical setting. PMID- 2781003 TI - Time and disease: the fourth dimension of radiology. PMID- 2781004 TI - Arthritis associated with HIV infection: radiographic manifestations. AB - Radiographs of symptomatic joints were retrospectively evaluated in 24 patients with inflammatory arthritis and human immunodeficiency virus (HIV) infection. Clinically, 20 patients had a seronegative arthritis including Reiter syndrome (54%), psoriatic arthritis (17%), and undifferentiated forms of spondyloarthropathy (13%). These patients were indistinguishable radiographically from patients with typical seronegative disorders except for the predominance of lower-extremity abnormalities. Four patients (17%) had a rheumatoidlike arthritis defined as acute symmetric polyarthritis (ASP). With the exception of extensive proliferative periostitis, ASP simulated classic rheumatoid arthritis. HIV associated arthritis was manifest during various stages of HIV infection. It preceded acquired immunodeficiency syndrome in 64% of patients with stage IV HIV infection. Awareness of the coexistence of HIV infection in patients with the above-mentioned arthritides is important, since immunosuppressive therapy, commonly used in the treatment of arthritis, can have detrimental effects in patients with HIV infection. PMID- 2781005 TI - Scaphoid anatomy: evaluation with complex motion tomography. AB - Complex motion tomography was used to study the normal orientation of the axes of the proximal and distal scaphoid poles as a basis for comparison with displaced or malunited scaphoid fractures. Biplanar tomograms of 10 normal wrists were evaluated by seven physicians with the use of two standardized measurement techniques. The reference planes used for the first technique were the volar cortical surface of the proximal scaphoid and the dorsal cortical surface of the distal scaphoid. The apparent angulation between the reference planes with this technique averaged 32 degrees +/- 5 degrees on the sagittal view and 40 degrees +/- 3 degrees on the coronal view. The second technique used the orientation of the proximal articular surface relative to the distal articular surface of the scaphoid. The angulation between the axes averaged 24 degrees +/- 5 degrees in the sagittal plane and 40 degrees +/- 4 degrees in the coronal plane. PMID- 2781006 TI - Lipohemarthrosis of the knee: a review of recent experiences. AB - The radiographs of 268 patients with knee trauma were retrospectively reviewed. In 15 patients with intraarticular fracture, the images demonstrated fat-fluid levels. In 28 other patients with intraarticular fracture, only joint effusion without a fat-fluid level was depicted. The presence of a fat-fluid level in the knee indicated fracture in all patients in whom it was seen. The absence of such a level, however, did not exclude intraarticular fracture. PMID- 2781008 TI - Knee arthrography: comparison of iotrolan and ioxaglate sodium meglumine. AB - Arthrographic image quality and relative morbidity resulting from use of the nonionic dimer iotrolan and the ionic dimer ioxaglate sodium meglumine were compared in a prospective double-blind study performed in 80 patients. Radiographs obtained 2, 5, 10, 15, 20, and 25 minutes after injection of contrast agent were graded for diagnostic quality. Relative morbidity was evaluated by the physician during the examination and later by the patient by means of a questionnaire. Iotrolan demonstrated better image quality on serial radiographs in knee joints without previous effusions. Most differences were not significant. The mean duration of diagnostic-quality images for both contrast media was about 23 minutes. Iotrolan and ioxaglate caused equal postprocedural pain (in about 50% of patients). Other types of discomfort were less when iotrolan was used, but the differences were not significant. With regard to long-lasting image quality, both contrast media are suitable for arthrography. PMID- 2781007 TI - Intraosseous fat necrosis associated with acute pancreatitis: MR imaging. AB - Necrosis of fatty bone marrow, caused by lipolytic enzymes, is a rare complication of several pancreatic disorders. A 44-year-old man with polyarthritis, subcutaneous nodules, and osteolysis associated with alcoholic pancreatitis underwent magnetic resonance (MR) imaging of the knees. In the marrow of the distal femur and proximal tibia, the images showed multiple foci of abnormal signal intensity compatible with the diagnosis of fat necrosis secondary to acute pancreatitis. Because MR imaging can depict abnormalities in fatty marrow that seem to precede necrosis, this modality may add early diagnostic information. PMID- 2781009 TI - Hypertrophy of C-1 anterior arch: useful sign to distinguish os odontoideum from acute dens fracture. AB - Dens fractures are often difficult to detect radiographically because of overlapping structures. The lateral radiographs were examined of all patients at the authors' institution who demonstrated an abnormal odontoid process or an abnormal anterior arch of C-1. Six patients were found: Four had os odontoideum, one had rheumatoid arthritis, and one had a congenital defect in the posterior arch of C-1. All had hypertrophy of the C-1 anterior arch on the lateral view. The width of the anterior arch of C-1 and the cortical thickness of the anterior arch in these six patients were measured and compared with the findings in a control group of 20 patients; the measurements from the six patients were found to be significantly greater. Hypertrophy of the anterior arch of C-1 is a useful sign of a chronic pathologic condition at the atlantoaxial articulation, and in the setting of acute trauma it may be an important clue that prevents unnecessary invasive treatment for a mistaken diagnosis of fractured dens. PMID- 2781010 TI - Temporomandibular joint injuries. AB - The clinical and radiologic findings in 30 patients who sustained injuries to the temporomandibular joint (TMJ) were retrospectively analyzed. Imaging consisted of variable combinations of radiography, tomography, two-compartment arthrography, computed tomography, and magnetic resonance imaging and was performed 2 days to 24 months after injury. Indications for imaging included acquired and/or unstable occlusal disturbances, cephalalgia, facial pain, otalgia, TMJ pain, tinnitus, dizziness, hearing disturbance, masticatory dysfunction, and muscle atrophy. Radiologic findings included internal derangement of the TMJ meniscus, swelling of retrodiskal tissues, joint effusion, mandibular condyle and condylar neck fractures, osteochondritis dissecans, avascular necrosis, degenerative condylar remodeling, osteoarthritis, musculotendinous injuries, and atrophy of masticatory muscles. After imaging studies, seven patients underwent surgery, at which time imaging findings were confirmed; one patient underwent successful aspiration of a painful hemarthrosis. TMJ injuries may result in joint derangement, radiologically demonstrable joint degeneration, masticatory muscle dysfunction, pain, and progressive clinical disability. PMID- 2781012 TI - Radionuclide thrombus imaging: an idea whose time has come? PMID- 2781011 TI - Chronic cervical cord compression: clinical significance of increased signal intensity on MR images. AB - Magnetic resonance (MR) imaging was performed in 668 patients with chronic compressive lesions of the cervical spinal canal. High signal intensity was observed within the spinal cord on T2-weighted or proton density spin-echo images in 99 patients (14.8%). Frequency of this finding was directly proportional to severity of clinical myelopathy and degree of spinal canal compression seen on MR images. Patients with a high-signal-intensity area responded less favorably than those without to surgical or medical treatment. More than 60% of the patients had this finding when grade of myelopathy or degree of canal compression was moderate to marked. Among 10 patients who received contrast material during MR imaging, one patient had definite enhancement and another had questionable enhancement in the high-signal-intensity area. The finding disappeared after decompressive surgery and medical treatment in some cases: Three of four of the patients who underwent surgery showed good clinical improvement. High signal intensity of the spinal cord produced by compressive lesions appears to be an important indicator for predicting prognosis. PMID- 2781013 TI - Premature bullous pulmonary damage in AIDS: CT diagnosis. AB - The computed tomographic (CT) scans of 55 patients with the acquired immunodeficiency syndrome (AIDS) were reviewed for evidence of pulmonary bullous damage. Although the average age of patients in this series was only 37 years, 42% (23 of 55) had CT evidence of pulmonary bullous changes. In contrast, the frequency of bullous changes detected at CT in a comparable number of immuno compromised patients with acute leukemia was 16% (eight of 50) (P less than .01). CT findings of bullous damage included bullae or cystic spaces, areas of low attenuation, and vascular disruption. A visual scoring system was used to grade CT scans according to the percentage of lung demonstrating bullous change. Of the 23 AIDS patients with CT evidence of pulmonary bullous damage, 16 (70%) had one or more documented pulmonary infections, while three (13%) had no prior history of lung infection (P less than .05). Spontaneous pneumothorax was a complication of pulmonary bullous damage in three patients. Destruction of pulmonary parenchyma in patients with AIDS may represent the response of the lung to repeated infection. PMID- 2781015 TI - Cerebrospinal fluid shunts: flow measurements with MR imaging. AB - The authors describe a technique for determination of shunt patency by quantifying cerebrospinal fluid shunt flow rates with magnetic resonance (MR) imaging. This method uses a modified clinical sequence that is both sensitive to slow flow perpendicular to the imaging plane and capable of achieving oblique angles with a 4-cm field of view. Velocity-dependent phase images were used to quantify flow rates within the shunt. A preliminary study was performed in seven patients with hydrocephalus and cerebrospinal fluid shunts. Two patients were found to have zero flow in the shunt, while the remaining five had flow rates ranging from 4 to 19 mL/h. Results showed that the measurement of flow rates within the shunt lumen with MR imaging is clinically feasible. PMID- 2781014 TI - Is Gd-DTPA required for routine cranial MR imaging? AB - Gadopentetate dimeglumine (gadolinium diethylenetriaminepentaacetic acid [DTPA]) was administered prospectively to 500 consecutive children and adults referred for routine cranial magnetic resonance (MR) imaging over a 4-month period. Pre- and postcontrast images were blindly and independently interpreted by two experienced neuroradiologists. Specific criteria were provided to the readers to define objectively when contrast material enhancement (or lack thereof) would be considered "radiologically helpful." Contrast-enhancing lesions were observed in 99 cases (20%). In only 15 cases (3%) did Gd-DTPA permit detection of lesions not also apparent on the precontrast studies. Contrast enhancement was considered radiologically helpful in 74 of the 99 cases. Lack of enhancement was considered helpful in 112 of the 500 cases (22%). Factors that may indicate increased usefulness of Gd-DTPA include increased patient age, definite lesion seen at computed tomography or precontrast MR imaging, prior craniotomy for tumor, and clinically documented systemic or central nervous system disease. Gd-DTPA should probably be used routinely for cranial MR imaging in most patients, except, perhaps, children and young adults with normal precontrast images. PMID- 2781016 TI - True water and fat MR imaging with use of multiple-echo acquisition. AB - The original Dixon method for chemical shift imaging of a two-component system is extended to a multiple-echo technique. Four echoes are used to gain all the information required to remove non-chemical shift-dependent phase changes and produce true fat and water images. Applications of the method both to a phantom and to human tissue are shown. This technique results in information comparable to that obtained from the Dixon method in half the imaging time and also gives an equivalent, if not slightly improved, signal-to-noise ratio. PMID- 2781017 TI - Adaptive technique for high-definition MR imaging of moving structures. AB - An adaptive technique for measuring and correcting the effects of patient motion during magnetic resonance image acquisition was developed and tested. A set of algorithms that can reverse the effects of object displacements and phase shifts was used. These algorithms essentially transfer the frame of reference of the image reconstruction from the static frame of the imager couch to the moving "visceral frame." An accurate record of tissue motion during image acquisition is required. To achieve this, the authors used specially encoded "navigator" echoes that are interleaved with the imaging sequence. Postprocessing of the navigator echo data provides a highly detailed record of the displacements and phase shifts that occur during imaging. Phantom studies demonstrated that the technique can directly correct image degradation caused by motion. In contrast to conventional artifact reduction techniques, such as ordered phase encoding and gradient moment nulling, this new method has a unique capacity to reduce motion unsharpness. Preliminary in vivo studies have demonstrated that the technique can markedly improve images degraded by voluntary motion and shows promise for addressing the problem of respiratory motion in thoracoabdominal imaging. PMID- 2781018 TI - Measuring signal-to-noise ratios in MR imaging. AB - The signal-to-noise ratio (S/N) in magnetic resonance imagining is one of the variables that must be measured when comparing the relative performance of different techniques. Although various investigators and official groups have proposed different methods for measuring S/N, these are generally not practical for use by a physician working in a clinical situation. The authors present a simple method that should serve for estimating S/N in most cases. PMID- 2781019 TI - Blood MR signal suppression by preexcitation with inverting pulses. AB - A cardiac-gated sequence has been developed for functional cardiac imaging. It uses a nonselective 180 degrees preinverting pulse before a spin-echo (SE) readout sequence with an echo time (TE) of 28 msec. In seven healthy volunteers this sequence provided superior wall-to-chamber contrast in end diastole and end systole when compared with the following sequences: SE, TE = 28 msec; SE, TE = 28 msec with dephasing gradients; and SE, TE = 28 msec with presaturation bands. PMID- 2781020 TI - New universal precaution aspiration tray. AB - A new tray has been designed for use during procedures involving needles and other sharp objects. The tray includes a foam adhesive pad, marked into 10 sections, into which the sharp objects can be placed point first. After the procedure, the objects can be safely withdrawn by their handles and then discarded. The tray has been used in more than 250 procedures. PMID- 2781021 TI - New projection for portography. AB - The right anterior caudocranial oblique (RACCO) view is proposed for improved depiction of the portal venous system. It is achieved by tilting the image intensifier 25 degrees caudal and 25 degrees-30 degrees to the right and maintaining the patient in the supine position. Transarterial portography with digital subtraction angiography was performed in the RACCO and posteroanterior (PA) views in 22 patients. Comparison of the two views revealed that the RACCO view was superior to the PA view of the left main branch in 15 patients (68%) and of the right posterior lobe branch in 19 patients (86%). The RACCO view will be useful for the evaluation of the portal system in patients with primary and secondary hepatic neoplasms in whom detailed images are important for diagnosis treatment planning. PMID- 2781023 TI - A further simulator of a breast mass on a mammogram. PMID- 2781022 TI - Aid for safer sclerotherapy of the internal spermatic vein. AB - A device was developed for use during sclerotherapy to treat spermatic varicoceles. It is used to provide external compression of the internal spermatic vein, to prevent distal flow of the sclerosing agent into the scrotal venous network. The device has been successfully used in 27 patients (43 spermatic veins). In no case did sclerosing agent leak past the compressor, and no complications related to the compressor itself have been encountered. PMID- 2781025 TI - Magnification spot compression of the breast. PMID- 2781024 TI - Esophageal disruption: evaluation with iohexol esophagography. PMID- 2781026 TI - Follow-up as an alternative to biopsy for mammographically detected lesions interpreted as probably benign. PMID- 2781027 TI - Blunt hepatic/splenic trauma in adults: CT-based classification and correlation with prognosis and treatment. PMID- 2781028 TI - Indeterminate mediastinal invasion in bronchogenic carcinoma: CT evaluation. AB - The computed tomographic (CT) scans of 80 patients with bronchogenic carcinoma classified as indeterminate for direct mediastinal invasion were retrospectively reviewed after the patients had undergone thoracotomy. Forty-eight (60%) of the masses were resectable, without invasion of the mediastinum, 18 (22%) focally invaded the mediastinum but were technically resectable, and 14 (18%) invaded the mediastinum and were not technically resectable. Although in most circumstances in this relatively small subset of patients CT was not helpful in differentiating masses with and without mediastinal invasion, CT was able to separate a large group of masses that were likely to be technically resectable. Thirty-six (97%) of 37 masses with one or more of these CT findings were considered technically resectable: contact of 3 cm or less with mediastinum, less than 90 degrees of contact with aorta, and mediastinal fat between mass and mediastinal structures. Of these 36 masses, 28 were resectable without mediastinal invasion, and eight were resectable with focal limited mediastinal invasion. PMID- 2781029 TI - Right phrenic nerve: anatomy, CT appearance, and differentiation from the pulmonary ligament. AB - The pulmonary ligament appears on computed tomographic (CT) sections as a thin, high-attenuation line, frequently seen above or at the level of the diaphragm and usually extending from the region of the esophagus. However, another line coursing laterally from the midportion of the inferior vena cava has also been identified as the pulmonary ligament. The authors examined sections from eight cadavers and 80 chest CT examinations to more clearly delineate the pulmonary ligament from this second structure. Anatomic and CT correlation proves that the line seen at the midportion of the inferior vena cava represents the right phrenic nerve and that the right pulmonary ligament is located posterior to it. PMID- 2781030 TI - Zones of increased perfusion (hot spots) on perfusion lung scans: correlation with pulmonary arteriograms. AB - Perfusion lung scans are occasionally characterized by focal zones of apparent hyperperfusion ("hot spots"). To investigate the frequency and significance of this phenomenon, ventilation-perfusion lung scans and pulmonary arteriograms were reviewed in 72 patients who underwent both procedures for the evaluation of suspected pulmonary embolism. Hot spots were present in the scans of 13 patients and usually occupied less than one pulmonary segment. Most hot spots were detected within a region of atelectasis identified on chest radiographs (38%). A substantial number of the remaining hot spots were located in the lung adjacent to regions of embolus. In patients with massive embolus, hot spots actually represented normally preserved perfusion in the presence of globally reduced perfusion elsewhere. PMID- 2781031 TI - Mammographic screening in southern California: 2 1/2-year longitudinal survey of fees. AB - The American Cancer Society sponsored a community-wide low-cost mammographic screening project in March 1986. One of the major goals was to effect a decrease in mammographic screening fees. To evaluate the effectiveness of the project, a telephone survey of 58 facilities was conducted six times over 2 1/2 years, beginning January 1986 and at 6-month intervals thereafter. The number of facilities offering lower fees for screening than for consultative mammography increased from two with a mean fee of $50.00 in January 1986 to 16 with a mean fee of $68.71 in July 1988. The trend for differentiating screening and consultative examination fees occurred at both hospital- and office-based practices, but fees were significantly lower in the office-based practices. There was also a statistically significant increase in the number of facilities accepting self-referred patients between January 1986 (15.5% of facilities) and July 1988 (34.5%). At the time of the last survey, 60% of office-based practices were accepting self-referred patients. PMID- 2781032 TI - Processing of mammographic films: technical and clinical considerations. AB - Sensitometrically exposed film strips and clinical mammograms from single emulsion Kodak Ortho M SO-177 and double-emulsion Kodak T-Mat M II films were processed in separate film processors set up for standard and extended-cycle processing. For the extended-cycle method, it is necessary to use a process that is dedicated to mammographic films only. Radiation dose reductions of approximately 30% for Ortho M film and 13% for T-Mat M II film were achieved with the extended-cycle process. In the mammogram comparisons, higher-contrast images were obtained with Ortho M film in the extended-cycle process, which allowed for improved demonstration of marginal structural characteristics of soft-tissue masses and better differentiation of benign and malignant tumors. No significant differences in contrast were observed in the T-Mat M II mammograms obtained with the extended-cycle process. PMID- 2781033 TI - Dynamic probabilistic model for determination of optimal timing of surveillance chest radiography in pediatric Hodgkin disease. AB - A dynamic probabilistic model based on hazard rate analysis, Monte Carlo modeling, and lead-time estimation techniques was developed to determine the optimal timing and frequency of chest radiography in the monitoring for relapse of children with treated Hodgkin disease. The analysis incorporates the performance characteristics of chest radiography, the natural history of the disease process, and therapeutic efficacy as a function of earliness of detection in the determination of optimal strategy. Examples of the model applied to the experiences of Stanford Medical Center and St. Jude Children's Research Hospital illustrate the utility of such a model in customizing an optimal monitoring strategy for a specific institution and clinical experience. The results suggest that monitoring protocols significantly overutilize chest radiography in the evaluation for recurrent Hodgkin disease in children. PMID- 2781034 TI - Malignant neoplasms arising in cystic hamartomas of the lung in childhood. AB - Cystic lesions of the lung may be developmental or acquired. The authors describe two cases of developmental cystic lung lesions (mesenchymal cystic hamartomas) that harbored unsuspected mesenchymal sarcomas. Although in children the natural history of this lesion is incompletely characterized, there is a definite risk for malignant change. The initial appearance of these cystic lung lesions on the chest radiograph is generally benign. It is important to establish the nature of cystic lung lesions (developmental vs acquired) and recognize the potential risk of malignant change in mesenchymal cystic hamartoma. Cystic lung lesions of uncertain type should be resected. PMID- 2781035 TI - Pediatric choroid plexus neoplasms: MR, CT, and pathologic correlation. AB - Choroid plexus papillomas are rare, constituting approximately 0.5% of all intracranial neoplasms. Four benign choroid plexus papillomas and one choroid plexus carcinoma were retrospectively reviewed in patients aged 4-20 months who had been examined with magnetic resonance (MR) imaging with a field strength of 0.5 T or 1.0 T and with computed tomography (CT) before and after the administration of contrast material. In general, the tumors were of intermediate signal intensity on T1-weighted images and of either intermediate or increased signal intensity (T2 lengthening) with T2 weighting. All demonstrated variable areas of internal signal void interpreted as signifying regional blood flow, calcification, or old hemorrhage. CT findings included relatively uniform contrast enhancement. Microscopic pathologic changes of the benign lesions mimicked the appearance of normal choroid plexus and confirmed the highly vascular nature of these tumors. MR imaging, with its high-resolution multiplanar techniques, offers direct visualization of these lesions in relation to normal anatomy and better discrimination and confirmation of their intraventricular location, facilitating surgery and postoperative follow-up. PMID- 2781037 TI - Implications of perturbation strategies: a philosopher of science's perspective. AB - Shifts in the classification of multiple variables can contribute to change in psychiatry's concept of a disorder. These shifts or transitions can occur as a consequence of the expansion of knowledge. A concomitant change in the literal form of diagnostic labels is not required. For example, the definitions of "mass" within the framework of Newtonian and Einsteinian theories are conceptually incompatible even though the same label is used to denote both concepts. Implications of the principles discussed for theory and practice in psychiatry are emphasized. PMID- 2781036 TI - Incompatibility of contrast agents with intravascular medications. Work in progress. AB - In vitro and in vivo precipitation of iodinated contrast agents when ioxaglate and papaverine are given together has been reported. To verify these reports and to investigate other medications not previously tested, the authors analyzed mixtures of contrast agents and medications in vitro with a light spectrophotometer and observed them for visible precipitates for up to 120 minutes. Previously reported incompatibilities between ionic or low-osmolality contrast media and medications were verified, and several new incompatibilities were discovered. No incompatibilities were found when the drugs tested were mixed with the new nonionic contrast media. PMID- 2781038 TI - Childhood separation anxiety and panic disorder: a comparative study. AB - 1. The relationship between childhood separation anxiety and panic disorder in adults is analyzed using data from a multicenter trial in 107 patients. 2. The patients included in this study presented anxiety disorder with or without agoraphobia, diagnosed according to DSM-III criteria. 3. The percentage of patients with antecedents of separation anxiety was 17.8% in patients without agoraphobia and 21.7% in patients with agoraphobia. These rates are significantly higher than those encountered in a group of normal controls (4%). 4. The existence of separation anxiety in childhood does not seem to significantly modify the clinical manifestations or severity of panic disorder in the adult. PMID- 2781039 TI - Oxiracetam in the treatment of multi-infarct dementia. AB - 1. Initial clinical trials in approximately 200 patients with dementias of diverse etiology suggested that oxiracetam, a structural analogue of the nootropic piracetam, was of some benefit in the treatment of cognitive dysfunction. 2. Because previous studies had not specifically examined the effects of oxiracetam upon dementias of vascular origin, the present study evaluated the therapeutic efficacy and safety of oxiracetam in the treatment of symptoms of multi-infarct dementia (MID) of mild to moderate severity. 3. Incremental doses of up to 1200 mg oxiracetam daily were tested in a dose-range finding design in a group of patients with clinically and neuropsychologically confirmed MID. 4. Based on improvement in global evaluations of clinical change, our analysis suggests that the drug may be of some benefit in MID. PMID- 2781040 TI - Event-related brain potentials in depressed patients treated with electroconvulsive therapy. AB - 1. As impairment of attention has long been recognized as a clinical feature of depression, we undertook to evaluate in depressed subjects and controls a feature of the event-related brain potentials (ERP) the N100 wave which has been linked to attentional processes. 2. This study involved collection of EEG data in an "auditory oddball" ERP paradigm in 9 depressed subjects prior to and following a course of 6 electroconvulsive therapy (ECT) treatments, as well as 11 controls. Concurrent Hamilton depression rating scales provided a measure of symptomatic severity. 3. Pretreatment N100 amplitude was significantly lower in the depressed group while N100 latency was greater than among controls, with treatment differences from control values disappeared. Further a robust correlation (r = 0.85 p less than or equal to .0038) emerged between N100 amplitude (increased amplitude being lower) and severity of depression. 4. Those results provide evidence for a physiological attentional disturbance in depression and suggest that certain features of this disturbance relate directly to symptom severity. PMID- 2781041 TI - Reduction of post-ECT memory complaints through brief, partial restricted environmental stimulation (REST). AB - 1. A previous paper (Suedfeld, et al. 1987) reported on preliminary results of placing patients into a room with substantially reduced environmental stimulation (REST) immediately after recovery from ECT. 2. Comparing two depressed patients who had undergone this experience with three who had instead returned to their own hospital room (Ward), Suedfeld et al. (1987) found that the former registered much fewer complaints concerning memory loss related to ECT administration than the latter. 3. The current report extends this finding to a total of 19 patients, of whom 13 completed four testing sessions. Once again, objective tests of memory showed no significant change as a function of ECT. Both groups of patients complained of substantial memory disruption after the first ECT. By the one-week follow-up, such complaints were minimal among REST patients but showed only a slight decline among the Ward group. This was the only significant intergroup difference. PMID- 2781042 TI - Low MHPG and continuing treatment in panic disorder. AB - 1. The paper presents a naturalistic study of 3-Methoxy-4-hydroxyphenylglycol and treatment response in panic disorder. 2. Twenty-eight patients unmedicated for at least one month were entered in a study of MHPG in panic disorder, and given the option of continuing or not continuing treatment. 3. At baseline and on average follow-up 6.8 months later, patients continuing in treatment had significantly lower MHPG than those who did not. 4. At baseline, the two groups of patients did not differ significantly as to number of panic attacks, Zung anxiety scale, and Beck and Hamilton Depression scales. 5. Treated patients did better on all clinical measures at follow-up. 6. Low MHPG may be related to persistence in seeking treatment for panic disorder, and perhaps to treatment response. PMID- 2781043 TI - Effects of lithium on appetitive discrimination in the rat. AB - 1. The present study attempted to test the hypothesis that lithium (as chloride, 0.15 mEq/kg) promotes an attentional focus onto stimulation of high salience (Cappeliez and Moore 1988). 2. The effect of lithium treatment was studied within the context of discrimination learning in a Y-maze. 3. When the brightness cue (illuminated/dark goal arm) signalled reinforcement (food) and the spatial cue (right/left location of goal arm) acted as a distractor, lithium-treated rats showed evidence of increased readiness to focus onto the brightness cue. 4. When these experimental conditions were reversed in a second experiment, with the brightness cue now acting as a distractor, the performance of the lithium-treated rats was adversely affected. 5. These results are interpreted as supporting the hypothesis that, under the influence of this dose of lithium, rats are more likely to maintain their attention on stimulation of high salience, with accompanying reduction in the processing of peripheral stimulation. The implications of this theory for the understanding of lithium's action and manic depressive conditions are discussed. PMID- 2781044 TI - Antidepressant effect of lithium: a neurochemical study on neuronal uptake of norepinephrine and serotonin. AB - 1. The effect of lithium chloride on neuronal uptake of norepinephrine and serotonin was explored on a pure culture of chicken neurons. While an acute lithium treatment (25 minutes) proves ineffective, a long-term treatment (7 days) decreases the uptake of serotonin and increases the uptake of norepinephrine. 2. The combined administration of lithium (7 days) and clomipramine (25 minutes) appears to have a greater effect on the uptake of serotonin than a treatment limited to only one of the two products. 3. The clinical implications of these results are discussed while emphasizing the interest of lithium in the treatment of depression. PMID- 2781045 TI - Ovine trophoblast protein-1 and human interferon alpha reduce prostaglandin synthesis by ovine endometrial cells. AB - Ovine trophoblast protein-1 (oTP-1), a protein secreted by the sheep conceptus immediately prior to implantation has sequence homology with alpha interferon. We have previously shown that, in parallel with human alpha interferon (IFN), oTP-1 reduces the release of prostaglandins (PG) E and F2 alpha from cultured ovine endometrial cells. Here we have examined the time and dose dependence of these actions and the possible site of action of the peptides. The concentrations of oTP-1 and IFN required for 50% inhibition of PGE release were 92 pg/ml and 0.88 pg/ml and for PGF2 alpha release, 165 pg/ml and 1.12 pg/ml respectively. Significant effects on PG release were not measured before 12 h after addition of peptide to culture dishes. Following removal of the peptides, the cells released less PGs for a further 18 h but then recovered. A large increase in PG synthesis and release occurred from cells cultured with added serum or arachidonic acid (AA) and an interactive effect was demonstrated between them, AA having a greater stimulatory effect on PG released in the presence of serum. However, in all cases oTP-1 and IFN continued to attenuate prostaglandin release. We conclude that the IFNs act directly or indirectly on the prostaglandin synthase enzyme. PMID- 2781046 TI - Prostaglandin F2 alpha, oxytocin and progesterone secretion by bovine luteal cells at several stages of luteal development: effects of oxytocin, luteinizing hormone, prostaglandin F2 alpha and estradiol-17 beta. AB - Bovine luteal cells from Days 4, 8, 14 and 18 of the estrous cycle were incubated for 2 h (1 x 10(5) cells/ml) in serum-free media with one or a combination of treatments [control (no hormone), prostaglandin F2 alpha (PGF), oxytocin (OT), estradiol-17 beta (E) or luteinizing hormone (LH)]. Luteal cell conditioned media were then assayed by RIA for progesterone (P), PGF, and OT. Basal secretion of PGF on Days 4, 8, 14 and 18 was 173.8 +/- 66.2, 111.1 +/- 37.8, 57.7 +/- 15.4 and 124.3 +/- 29.9 pg/ml, respectively. Basal release of OT and P was greater on Day 4 (P less than 0.01) than on Day 8, 14 and 18 (OT: 17.5 +/- 2.6 versus 5.6 +/- 0.7, 6.0 +/- 1.4 and 3.1 +/- 0.4 pg/ml; P: 138.9 +/- 19.5 versus 23.2 +/- 7.5, 35.4 +/- 6.5 and 43.6 +/- 8.1 ng/ml, respectively). Oxytocin increased (P less than 0.01) PGF release by luteal cells compared with control cultures irrespective of day of estrous cycle. Estradiol-17 beta stimulated (P less than 0.05) PGF secretion on Days 8, 14 and 18, and LH increased (P less than 0.01) PGF production only on Day 14. Prostaglandin F2 alpha, E and LH had no effect on OT release by luteal cells from any day. Luteinizing hormone alone or in combination with PGF, OT or E increased (P less than 0.01) P secretion by cells from Days 8, 14 and 18. However on Day 8, a combination of PGF + OT and PGF + E decreased (P less than 0.05) LH-stimulated P secretion. These data demonstrate that OT stimulates PGF secretion by bovine luteal cells in vitro. In addition, LH and E also stimulate PGF release but effects may vary with stage of estrous cycle. PMID- 2781047 TI - [AIDS-complex and our Leviathan. Can and should the state educate us about AIDS?]. AB - Sigusch pleads for removing AIDS education from the jurisdiction of the state. He reasons that as caretaker of citizens' sexual lives the state cannot avoid consolidating their status as its subjects. PMID- 2781048 TI - [HIV infection--psychological coping and political reality]. AB - The authors warn against a trivialization of the AIDS problem and against the call for state control. Since sexuality is ultimately uncontrollable, they plead instead for the greater clarification of the conflicts which those who are infected with HIV and those who are not infected experience in dealing with each other. The continuing mystification of these conflicts would result in mutual jeopardy through acting-out. PMID- 2781049 TI - [Reflections on transference and countertransference reactions in the treatment of AIDS patients]. AB - Proceeding from experiences she made in the treatment of AIDS and pre-AIDS patients the author describes the psychodynamics of their situation and subsequently discusses the specific problems of transference and countertransference reactions. She also suggests the possible coincidence of social and personal fear of contact in the course of treatment. PMID- 2781050 TI - [HIV infection: trauma and coping with trauma]. AB - The initial results of a German-Swedish research project demonstrate the at times active-resistant and at times passive-resigned approaches of AIDS patients toward their illness. PMID- 2781051 TI - [Therapeutic insight and tolerance of ambiguity]. AB - The author discusses the implications of the psychoanalytic concept of insight. He refers to it as an "action-steering utopia of the psychoanalytic process". PMID- 2781052 TI - [The image of the world before the Renaissance and the discovery of America]. PMID- 2781053 TI - [The factor of magnification in mammography]. AB - The last generation of mammographic equipment allows mammography to be performed with direct magnification techniques, thanks to such technical features as microfocus, high focus-film distance, high-power generators. The authors compared the diagnostic yield of two different equipment sets, with 1.4x and 2x magnification respectively, and verified the utility of magnification radiography. A significant reduction was obtained in questionable diagnoses (42 to 18) in a group of 63 patients, with no evidence of substantial differences in the diagnostic yield of the images obtained with different magnification ratios. An objective analysis of the system resolution power privileges 2x magnification ratio, which however implies an increase in the average dose to the breast. The use of faster recording systems reduces the dose by 50%, though maintaining good image quality. PMID- 2781054 TI - [The use of the Daylight System in mammography]. AB - It is widely known that Daylight film handling has yielded several benefits to diagnostic radiology, that is, reduction in exam duration, thus improving both efficiency and productivity; space saving in departments, by minimizing darkroom spaces; improved working conditions for the staff. This paper reports on the study of the application of a Daylight system to mammography. For this purpose, the authors used an X-ray unit (Senographe 500 T-CGR) and a Dupont Daylight unit, whose diagnostic yield was compared to that of "vacuum" and cassettes units. The results of our experience confirmed the well-known advantages DDS yields to diagnostic radiology. In particular, the use of Daylight rather than vacuum system allowed a considerable reduction in exam duration (10 to 2 minutes). Moreover, the new Dupont screen-film system allowed a reduction in average whole breast dose by about 28% if compared to the conventional recording system employed in our department. Mammograms with high contrast resolution, sensitivity, and good spatial resolution were thus obtained, as shown in the analysis of quality image. The Daylight system allowed a marked improvement to be made in efficiency, productivity, and organization, as well as a reduction in whole breast dose and high-quality mammographic images. PMID- 2781055 TI - [CT in the study of the thymus]. PMID- 2781056 TI - [Calcified cavernous hemangioma of the stomach. A case report]. PMID- 2781057 TI - [Ileocolonic tuberculosis: a diagnostic trap for Crohn's disease. A case report]. PMID- 2781058 TI - [Duodenal phytobezoar in annular pancreas: an association or a complication?]. PMID- 2781059 TI - [A case of Merkel-cell cutaneous neuroendocrine carcinoma treated with radiotherapy]. PMID- 2781061 TI - [Radiological examination of the thorax in intensive therapy centers]. AB - Bedside chest radiography plays a considerable role in the whole of the exams carried out in hospitals, especially in intensive care units. Many clinical problems (pulmonary, cardiac, and mediastinal) are related to this examination and can be dealt with only when the radiologist is provided with high-quality radiographs. Therefore, it is extremely important for the radiologist himself to be aware of the various factors implied in the making and reproducing of bedside chest radiographs, which is a fundamental step in the monitoring of the patients undergoing intensive care. These factors can be divided into methodological factors (patient positioning, focus-film distance, and exposure) and technical factors (portable units, survey system). In this paper, a special emphasis is put on a survey system consisting in double differentiated screens and double film, which allows the acquisition of a normo-exposed radiograph of the parenchyma and of one of the mediastinum with a single exposure. Besides these technical and methodological elements, the radiologist must pay attention to the diagnostic therapeutical means (such as tubes, small probes, and catheters) used on most patients in intensive care units. Their exact positioning must always be checked, and possible incorrect positioning and complications must be detected promptly. All these factors, as well as their scrupulous and constant application, contribute to markedly improve the dialogue between clinician and radiologist, by allowing a rapid evaluation of the cause of the clinical case under examination and its adequate treatment. PMID- 2781060 TI - [Magnetic resonance study of lesions of the cervical spinal cord in multiple sclerosis]. AB - Lesions consistent with demyelinating plaques were retrospectively identified in the cervical spinal cord of 15/49 patients (31%) with multiple sclerosis examined with cranial and cervical MR imaging. The lesions appeared as hyperintense areas on proton-density and T2-weighted images. Clinical signs and symptoms suggestive of spinal cord location of the demyelinating plaques were observed in 14 of the 15 patients presenting with spinal cord lesions at MR, and also in 11 of the 34 patients with negative MR findings. In 2 patients the cervical lesion was not associated with brain lesions at MR, while in 1 patient it was associated with medullary dilatation. Serial MRs revealed disappearance of the cervical hyperintense area in both patients, and reduction in medullary volume in the latter. Therefore, MR imaging of the cervical spinal cord is suggested as an useful examination in patients with suspected multiple sclerosis, particularly in those presenting with clinical signs and symptoms suggestive of spinal cord involvement. PMID- 2781063 TI - [Dynamic cavernosography. A proposed new method]. AB - The excessive blood outflow from the corpora cavernosa during erection ("venous leakage") is a frequent cause of impotence. Dynamic cavernosography, a recent technique, is able to both evaluate such venous leakage and detect the veins concerned. After a critical review of the literature and on the basis of their own experience (64 cases), the authors suggest a 2-phase method. A conventional cavernosography is performed and flows of physiological solution necessary to induce and maintain an artificial erection are separately measured. Subsequently, only the patients with increased flow rates undergo a second angiography of the corpora cavernosa and drainage paths, after being given and intracavernous injection of papaverine. A simple, more rational and less invasive examination can thus be performed. All useful parameters can nevertheless be examined when surgical/radio-interventionist treatment is considered. PMID- 2781062 TI - [The side effects of phlebography of the lower extremities using iohexol. A prospective study]. AB - In this prospective study 463 consecutive outpatients, who had undergone phlebography because of clinically suspected deep venous thrombosis (DVT) were examined with clinical follow-up and impedance plethysmography to evaluate the rate of contrast media complications. Seventy-nine patients had immediate and mild side effects, and one had moderate side effects (bronchospasm); no patient suffered from severe life-threatening conditions. There was only one case of DVT which occurred after an initially negative phlebography. In a subgroup of 40 patients, who underwent iodine-125-fibrinogen scanning after phlebography, the study was positive in 9 cases. None of them presented with any evidence of DVT at follow-up phlebography. Contrast phlebography with iohexol is a safe and comfortable procedure. Low-osmolality nonionic contrast media are well tolerated by the patient. PMID- 2781064 TI - [Carcinomatous neuropathy in recurrent rectal carcinoma. The results of radiotherapy and the role of CT]. AB - More than 60% of the patients with recurrent rectal carcinoma complain of pain after radical surgery. Pelvic carcinomatous neuropathy (PCN) is a frequent cause of pain in such patients. Although the effectiveness of radiotherapy in the palliative treatment of local recurrences of rectal carcinoma is well recognized, its results in PCN are less known. The authors have evaluated the results of high energy radiotherapy in 12 patients with recurrent rectal carcinoma and PCN, who were treated with doses between 35 and 55 Gy. Although the survival of these patients is always poor, about 50% of them achieved a significant and prolonged palliative result by radiation treatment. In patients with PCN, CT is an effective tool to detect recurrences, define their volume and relationship to critical organs, show sites of neural involvement, and optimize radiation treatment planning. PMID- 2781065 TI - Predicting pesticide residues to reduce crop contamination. AB - The system of dynamics between pesticides and plants is reviewed, and a conceptual model capable of reflecting the necessary qualitative and structural peculiarities is proposed as a means of predicting residue levels. The degradation processes of various chemical classes of pesticides in plants under different conditions of use are analyzed. Formulas are developed that enable recognition and estimation of residue levels and duration of retention for "new" pesticides and "old" substances under varying treatment conditions. Estimated data are verified to provide positive assessments of the accuracy of the predictions. Mathematical modeling as a means of perception is stressed. With this method, the outlet value can be controlled by changing such inlet parameters as application rate, frequency of treatments, types of plants, and so on. Residue levels are predicted for different combinations of use conditions in various climatic-geographical regions. The method of estimation also enables the development of important standards such as post-treatment waiting intervals. A more flexible technique can be employed, in which specific periods are established for different plants under various treatment conditions. Thus, both unjustified shortened waiting intervals or unnecessarily elongated intervals periods can be avoided. The greatest value of the modeling approach is that information can be obtained on the degree of potential food contamination and major standards can be developed without the need for extensive experimental use of pesticides under actual conditions. This technique fully considers optimal use conditions for agrochemicals in terms of human requirements and protection of plants. Mathematical modeling protects the environment while enabling the speedy selection of safe parameters for pesticide use conditions nd realization of significant savings in manpower and time. Overall, this estimation method appears to be an efficient link in the broad system of preventing environmental pesticide contamination and protecting human health. PMID- 2781066 TI - [Radiologic changes of anatomic parameters of the proximal femur as a function of its position in rotation]. AB - Twelve anatomical values of the proximal femur and theirs variations in rotation (internal 12 degrees, neutral, external 12 degrees) have been measured radiologically by digitalization on a group of ten anatomical units. A computerized analysis has been performed considering the errors in the X-ray amplification and dispersion factors, as well as the methodological imprecisions. It came out that, except for the width of the medullary canal in AP view, all anatomical parameters were very sensitive to the different positions of the femur in rotation and were subject to significant variations. These fluctuations lead the authors to the following conclusion: during the pre-operating planning of cementless hip arthroplasties, the radiology still allows to choose the size of the femoral component so as to improve the fitting with the internal geometry of the femur. However, the radiology still remains insufficient as a basis to conceive and design a custom implant. PMID- 2781067 TI - [Fluorotic cervical spinal cord disease]. AB - Skeletal fluorosis was reported as a disease endemic to an area in the Madras Presidency of Indian in 1937 and prior to this, it was known as an occasional disease. There are two endemic areas in India, one in Punjab and the other in Andhra Pradesh State. This disease is also endemic in some parts of China and Africa. The manual labourers are more frequently affected as they consume huge quantities of water with high fluoride levels. The cervical spine is often affected, manifesting as cord compression. Forty cases of fluorotic cervical cord compression, who underwent surgery are studied regarding their clinical features, radiological aspects and outcome following surgery. In selected cases of cervical fluorotic myelopathy, surgical decompression appears to be necessary and also rewarding. PMID- 2781068 TI - [Role of acetabuloplasty in the treatment of residual cotyloid dysplasia before 4 years of age. Apropos of 14 cases followed over 5 years]. AB - Concerning 14 cases with a follow-up of over 5 years, the authors describe their acetabuloplasty technique which is applied to dysplastic sockets with normal cotyloid cavity anteversion, innominate osteotomy is reserved for cases in which this anteversion is excessive; results have been excellent for 11 cases with adequate lowering of the roof-edge of the cavity and improvement of the C and CE angles as well as satisfactory subsequent bone growth; the result was insufficient in 3 cases in which either the head of the femur was off-centre or deformed by osteochondritis. The age of the patients was between 16 and 37 months. No growth disorder caused by the operation has been observed. Three failures may be related to pre-existing abnormalities in the growing areas of the acetabulum or to ischaemic troubles in the femoral head. PMID- 2781069 TI - [Orthopedic treatment of regular dorsal and dorsolumbar hyperkyphosis. New principles of active correction]. AB - The orthopaedic treatment of hyper-kyphosis should not be unique. If the principles of treatment are different in relation with the thoracic or thoraco lumbar localisation of the apex of the deformity, it is necessary to distinguish for the middle thoracic curve two types of patients: these in whom the kyphosis and the lordosis are balanced (the cast must diminish the lumbar lordosis and the imbalanced posterior types with a great kyphotic curve and a short compensatory lordosis which is important not to be diminish by the treatment. The principles of plaster casting are described in the two types; emphasizing on the unlucky aspect of the sternal support in the middle thoracic kyphosis and in the necessity of the thoracic modification if we wish to obtain a good result. The active expiratory reeducation is capital before and during the treatment. PMID- 2781070 TI - [Vertebral hydatid cyst. Apropos of 2 cases]. AB - The hydatid disease is rare in osseous locations, especially in our country (2.2 per cent). It has some particularities: clinical latency, diagnosis difficulties, surgical treatment often unsatisfactory because of the difficulty of total excision. Pain and sometimes deformity are often the only clinical features at the beginning of the disease. But, the evolution is unfavourable as soon as neurological symptoms appear. Multiple recurrences lead to unavoidable paraplegia. The antihelminthic drug (mebendazole) is disappointing in osseous location. Surgery is the only hope but the excision must be carcinologic. Spinal instrumentation can be improved by the use of acrylic cement whereas osseous grafts can be invaded by hydatidosis extension or recurrence. At present, the prognosis is still poor with constant apparition of cord compression. The authors report two cases of patients with osseous hydatidosis of the spine which illustrate these difficulties. PMID- 2781071 TI - [Venous thromboembolism]. PMID- 2781072 TI - [Usefulness of sialic acid as a tumor marker]. AB - In order to analyze the utility of sialic acid as a tumor mass marker, its levels have been determined in 253 neoplastic patients, 57 patients with non-tumoral pathology and 60 healthy controls. Significant differences in the sialic acid values were observed between the control group and the rest (p less than 0.001). When the neoplastic patients were studied according to the extension of their disease, we found that the SA levels in patients under complete remission were significantly lower than in the other stages (p less than 0.01) and that patients in stage IV presented the highest levels (p less than 0.05). Differences between stages I, II and III were not detected. Furthermore, no differences were observed regarding either the type of neoplasia or if the patients had or did not have tumor pathology. We conclude that sialic acid is a tumor marker with poor specificity that grossly relates with the tumor size. PMID- 2781074 TI - [Thrombosis of the superior vena cava as an early manifestation of Behcet's disease. Presentation of 2 cases]. AB - The vascular involvement of Behcet's disease is nowadays considered as an important sign of the clinical evolution of these patients. It can affect both the arterial and the venous territories. Superficial thrombophlebitis is the most common vascular manifestation. Thrombosis of deep veins is relatively rare and it generally appears within the inferior vena cava territory as a late manifestation in the evolution of the disease. We describe two cases of Behcet's disease which presented, at an early stage, thrombosis of the superior vena cava as the more relevant manifestation of the disease. The evolution of both patients was satisfactory with the combination of cyclophosphamide and colchicine. The etiopathogenesis of this manifestation and its therapeutic possibilities are discussed. PMID- 2781073 TI - [Pilot study of arterial blood pressure in the school children of Girona and its province]. AB - The arterial blood pressure was measured in 1,494 school children (810 boys and 684 girls) 5 to 14 years old who attended 46 schools in the province of Girona. OBJECTIVE OF THE STUDY: to establish the distribution of arterial blood pressure in school children in our community in empirical percentiles according to chronologic and anthropometric variables (age, height, weight and body surface). In our study the systolic arterial blood pressure increased significantly (p less than 0.001) in both sexes in all the variables studied. The simple correlations in decreasing order were, in boys: body surface, weight, height and age, and in girls: weight, body surface, height and age. However, there was no correlation between the diastolic arterial blood pressure in either sex with the variables studied. PMID- 2781075 TI - [Description of Wolfram syndrome (DIDMOAD) on the basis of a new case]. AB - We present a new clinical case of a 25-year-old man with Wolfram's syndrome. Partial central diabetes insipidus was found to cause polyuria, polydipsia and enuresis. The patient had diabetes mellitus for the last 18 years, controlled with diet and/or chlorpropamide during 10 years and showed no typical complications of the disease. The patient was also shown to have a dilated urinary tract and perceptive hypoacusis for high frequencies. The fifth classical component of this syndrome, primary optic atrophy, was not found. Based on the report of this case, Wolfram's syndrome is briefly described. PMID- 2781076 TI - [Facial asymmetry in a 14-year-old girl]. PMID- 2781077 TI - [Causes of death in tuberculosis: role of disseminated intravascular coagulation]. PMID- 2781078 TI - [Papulonodular mucinosis and late-onset systemic lupus erythematosus associated with Hashimoto's thyroiditis and Sjogren's syndrome]. PMID- 2781079 TI - [Myositis ossificans presenting clinically as acute arthritis. Apropos of a case]. PMID- 2781080 TI - [Giant choledochal cyst]. PMID- 2781081 TI - [Mesencephalic hematoma as the presenting form of cerebral lymphoma]. PMID- 2781082 TI - [A new presenting form of poisoning]. PMID- 2781083 TI - [Acute bronchiolitis in the adult and Q fever]. PMID- 2781084 TI - [Our experience in fiberoptic intubation in anesthesia]. AB - Fiberoptic endotracheal intubation is a procedure recently introduced that allows a safe and atraumatic intubation in those patients with anatomic difficulties and associated pathology. Our experience on 30 patients submitted to fiberoptic endotracheal intubation is described. No complication is reported. Due to fibroscope handling conditions and the careful procedure, it is not recommended in emergency situations. We conclude that the method is simple and safe and that its knowledge would spread among anesthesiologists. PMID- 2781085 TI - [Pulmonary atelectasis in bent lateral decubital position (nephrectomy). Apropos of a case]. AB - Here we have the case of a right nephrectomy ureterectomy for urothelial neoformations in the upper urinary apparatus, in the position of a left flexed lateral decubitus (nephrectomy) practised to a patient, in which a small right pleural aperture was unnoticed until the end of the operation when the closing was being carried out. In the immediate postoperative, the patient developed hypoxia and hypercapnia, as well as an atelectasis of the lower lobus in the left lung, that appeared in the radiological test. We comment now the causes that could have originated this picture, such as overweight, the position of the patient during the operation, its length and the pleural aperture throughout the surgical act, focusing the study in this latter point. PMID- 2781086 TI - [Localization of the interpleural space using the "hanging drop" method]. AB - "Hanging drop" method was used in 45 patients to determine interpleural needle placement which was easily achieved in 100% of the cases, advancing a catheter through the needle without any difficulty. No pneumothorax was observed. In conclusion, we consider that "hanging drop" method is effective to determine interpleural needle placement, with little disturbance to the patient. PMID- 2781088 TI - [Anesthesia and pain treatment in experimental animals. Bibliographic contribution]. PMID- 2781087 TI - [Lathyrism and anesthesia: apropos of a case]. PMID- 2781089 TI - [Possible subdural block after saline injection]. PMID- 2781091 TI - [Hepatic rupture in pregnancy]. PMID- 2781090 TI - [Postpuncture pseudoaneurysm of the radial artery]. PMID- 2781092 TI - [Minor complications in anesthesia]. PMID- 2781093 TI - [Chemonucleolysis. Peridural anesthesia versus general anesthesia]. AB - A prospective comparative study was carried out between two anesthetic techniques for chemonucleolysis. Patients were divided into 2 groups of 50 patients each. Group A were submitted to general anesthesia and group B to epidural anesthesia with 0.5% bupivacaine, 2% mepivacaine and buprenorphine. Group B was divided into 2 subgroups: in B1, buprenorphine was administered with the local anesthetics, while in B2 buprenorphine was administered postoperatively when pain appeared. Postoperative pain and side effects like anaphylaxis were evaluated. No anaphylactic reactions occurred. Severe lumbar pain appeared in 22% of patients in group A in spite of systematic analgesics, while group B lumbalgia was not severe in any case. Patients in subgroup B1 did not have pain during the 24 first hours and 47.8% of patients in subgroup B2 needed in most of the cases only a dose of buprenorphine. We conclude that epidural anesthesia is a good technique in chemonucleolysis and that the association bupivacaine, mepivacaine and buprenorphine provides a good postoperative pain relief. PMID- 2781094 TI - [Effect of succinylcholine on serum levels of potassium in patients treated for intracranial aneurysm]. AB - A prospective study was carried out on 10 patients who were submitted to intracranial aneurysm clipping and who had bled some days before the operation. All patients received a precurarization dose of pancuronium (0.01 mg/kg) and lidocaine (1.5 mg/kg) during the preinduction and succinylcholine (1 mg/kg) to facilitate orotracheal intubation. The operation took place between the days 5 and 27 following the subarachnoid hemorrhage. Basal potassium plasma levels were determined at 1, 3, 5 and 10 minutes after succinylcholine had been administered. The levels (media +/- SD), expressed in mEq/l, were: basal 3.77 +/- 0.31; at first minute 3.64 +/- 0.38: 3 minutes 3.69 +/- 0.35; 5 minutes 3.78 +/- 0.31, and 10 minutes 3.82 +/- 0.39. Using the analysis of variance, no significant differences (p = 0.11) were observed among the average levels of potassium in the intervals of time studied. There is no significant correlations either between the potassium figures and the time elapsed since the subarachnoid hemorrhage occurred. PMID- 2781095 TI - [The current situation of Anesthesiology-Resuscitation in Spain. A national survey (III): Resuscitation]. AB - The results of a national inquest concerning clinical care to critically ill patients by anaesthesiology staff are presented. Data were collected from the 170 questionnaires received, corresponding to an equal number of Anaesthesia departments. It should be remembered that, for the present time in Spain, the responsibility of administering intensive therapy is being shared among two different groups of certified medical specialists, each of them receiving separate training. Intensive Medicine specialists and anaesthesiologists. The units are respectively designed as Unidades de Cuidados Intensivos and Unidades de Reanimacion. Room availability, human resources, and technical equipment, as well as the final clinical utilisation of these units, are presented. PMID- 2781096 TI - [Informative guide for the resident physician in anesthesiology and resuscitation. Directors Board of the Spanish Society of Anaesthesiology Resuscitation and Pain Therapy]. PMID- 2781097 TI - [Anatomy and surgical implications of incomplete forms of atrioventricular septal defects]. AB - We present an anatomic intraoperative study of 93 consecutive operated cases with an ostium primum defect. The type of the ostium primum, size of interauricular defect, position of the coronary sinus, tricuspid valve, mitral valve and subvalvular apparatus, are analyzed. Inside the mitral valve apparatus, the size, form, type and number of clefts are described as well as septal valve anomalies. We point out the importance of performing a detailed and fast anatomic study within a surgical protocol to obtain the optimal anatomic correction of the cardiopathy. PMID- 2781098 TI - [Familial malformation recurrence in congenital heart disease]. AB - The intensity and degree of familial association in a series of congenital heart diseases has provided 204 cases of familial malformation recurrence. There was total concordance for 27% of first degree relatives, 18.5% of those of second degree, and 9% of third degree; partial concordance was present in 15, 18 and 41%; system concordance in 27, 44, and 43%; total discordance in 31, 18.5, and 5%. Anencephaly, hydrocephaly, cleft lip-palate, pyloric stenosis, and cryptorchidism were repeatedly present with a highly significant incidence. PMID- 2781099 TI - [Diagnostic usefulness of 2-dimensional echocardiography in eosinophilic endomyocardial disease (Loeffler disease)]. AB - We present an uncommon case of idiopathic hypereosinophilic syndrome with cardiac involvement (fibroplastic parietal endocarditis --Loffler's disease--) in a 48 year-old female with congestive heart failure and hypereosinophilia. The 2-D echo findings (biventricular apical obliteration by echogenic endomyocardial proliferations with normal systolic inward motion) were the clue for the diagnosis that was hemodynamically and pathologically confirmed subsequently. We emphasize the diagnostic value of two-dimensional echocardiography in this condition and review the literature on it. PMID- 2781101 TI - [Concealed conduction and fatigue phenomenon in an accessory pathway]. AB - We report the appearance of concealed conduction and fatigue phenomenon in the accessory pathway of a patient with WPW syndrome. Both phenomena were demonstrated by the loss of delta wave during and after rapid atrial pacing. The mechanisms involved in these unusual properties of accessory pathways are discussed. PMID- 2781100 TI - [Study of diastolic regurgitation of the atrioventricular valves using Doppler echocardiography]. AB - In order to evaluate diastolic regurgitant flows in atrioventricular valves, we studied by Doppler echocardiography four patients in whom electric abnormalities like third degree atrioventricular block, pacemaker dysfunction and ventricular arrhythmias with atrioventricular dissociation were detected. In all of them, mitral and tricuspid high velocity regurgitant flows were found in systole. A second regurgitant atrioventricular flow was also registered, this flow being diastolic, intermittent, and with a lower velocity profile than the systolic regurgitation. The hemodynamic importance of this diastolic regurgitant flow over the cardiac output has not been well defined; in our cases the ventricular filling was not substantially modified by diastolic regurgitant flow. PMID- 2781102 TI - [Atypical bidirectional tachycardias]. AB - Two cases of bidirectional tachycardia are presented. The ventricular origin of these arrhythmias was assessed by His bundle recordings. Because of the V1 morphology of the ventricular complexes during tachycardia in one case and the unknown etiology in the other, these arrhythmias were considered to be atypical. The involved mechanisms and the causes inducing these tachycardias are discussed. Whatever the involved mechanism, our cases reaffirm the opinion that the terminology bidirectional tachycardia should be used only to describe an electrocardiographic pattern that may be caused by different electrophysiological mechanisms. PMID- 2781103 TI - [Pulsed Doppler in the diagnosis of obstruction of the superior vena cava. Apropos of a case]. AB - We report the case of a patient diagnosed as superior vena cava syndrome 8 years after surgical resection of a breast malignancy and treatment with radiotherapy. The study with pulsed Eco-Doppler detected the presence of obstruction to the systemic venous return, allowing us to establish the diagnosis. Confirmation was achieved by means of venography and venous pressure manometry. Usefulness of the Doppler technique in the assessment of systemic venous return is confirmed. PMID- 2781105 TI - [Retrograde conduction and auricular fibrillation]. PMID- 2781104 TI - [Traumatic tricuspid insufficiency]. AB - Isolated tricuspid valve regurgitation is a rare finding after nonpenetrating chest trauma. The clinical course is usually benign and the time of surgery can be delayed for many years. Two-dimensional Doppler echocardiography is an essential procedure in the diagnosis of chordae tendineae or papillary muscle traumatic injury. We present two cases of traumatic tricuspid regurgitation with mild symptoms undiagnosed for sixteen and forty-three years, respectively. PMID- 2781106 TI - [Ischemic heart disease, neoplasms and risk factors: ecological correlation]. AB - In this paper, correlations between ischaemic heart disease and several cancers associated with cigarette smoking are examined. Also, tobacco consumption data are correlated against ischaemic heart disease mortality incidence rates. Furthermore, correlations between ischaemic heart disease incidences and per capita consumption of fattening foods (meat, milk and eggs) are analyzed. In this work, results referring to Spain, and at an ecologic level, confirm conclusions of observational and experimental studies carried out in other countries, which points out a strong association between ischaemic heart disease, cigarette consumption and fattening diet. PMID- 2781107 TI - [Diagnosis of pulmonary hypertension by means of continuous, pulsed and color Doppler, and its correlation with hemodynamics]. AB - We have performed a study on 28 patients (20 with valve disease and eight with Eisenmenger syndrome) to evaluate the degree of pulmonary hypertension by means of continuous, pulsed and color Doppler, comparing these results with those obtained at cardiac catheterisation. Invasive systolic pulmonary pressure corresponded excellently with the transtricuspid gradient determined by continuous Doppler (r = 0.97). The study by pulsed Doppler of pulmonary artery flow enabled us to establish a good correlation between total pulmonary resistance with the quotient time to peak flow/ejection time and time to peak flow (r = 0.87 and r = -0.81), and between systolic pulmonary pressure and the time to peak flow (r = -0.80). Color Doppler enabled us to easily establish the presence of tricuspid and pulmonary regurgitation. PMID- 2781108 TI - [Pericardiocentesis: usefulness in the routine determination of intrapericardial pressure]. AB - The usefulness of routine intrapericardial pressure determination and hemodynamic monitoring during therapeutic (n = 22) or diagnostic (n = 2) pericardiocentesis was analyzed. Hemodynamic data confirmed the presence of cardiac tamponade in all cases, including the 2 patients without clinical suspicion. Prior to fluid evacuation, abnormally elevated levels of intrapericardial (13 +/- 5 mmHg), right atrial (14 +/- 4 mmHg) and pulmonary capillary (16 +/- 3 mmHg) pressures were observed. A significant correlation was found between intrapericardial and right atrial pressures (r = 0.97, p less than 0.05) and also between intrapericardial and pulmonary capillary pressures (r = 0.69, p less than 0.05). The basal cardiac output was low (3 +/- 1 l/min) and increased after the pericardiocentesis in all but one patient. According to the results of pericardiocentesis, patients were classified into three groups. Group I: intrapericardial and right atrial pressures decreased to normal levels. The increment of cardiac output was high (72%) and the procedure was considered successful. Group II: right atrial and intrapericardial pressures remained elevated (7.7 +/- 4 and 7 +/- 2 mmHg, respectively) and the cardiac output increment was less marked (52%), thus indicating incomplete drainage. Group III: intrapericardial pressure decreased to normal levels but right atrial pressure remained elevated. All these patients were found to have associated cardiac disease, most frequently constriction. We conclude that routine determination of intrapericardial pressure: 1) reveals the presence of tamponade in cases without clinical suspicion; 2) indicates the efficacy of drainage; and 3) together with right atrial pressure recording, provides early diagnosis of associated cardiac disease, especially effusive constrictive pericarditis. PMID- 2781109 TI - [Double orifice mitral valve. Study with two-dimensional echocardiography]. AB - Double orifice mitral valve is a rare congenital anomaly which is frequently associated with atrioventricular defects. According to its structure it is classified as central, commissural or valvar. Diagnosis by cross-sectional echocardiography was verified in 4 patients with a double orifice mitral valve of the central type. Age of the patients at the time of diagnosis ranged from 3 months to 17 years. Three of them had an associated ostium primum atrial septal defect. The defect was observed in parasternal long-short axis views and subcostal 4 chamber axis views. The parasternal short axis gave information on the central type but subvalvular structures of the double orifice and insertion of the chords in papillary muscle were best observed in parasternal long and subcostal four chamber axis views. PMID- 2781110 TI - [Comparative studies of diatrizoate, ioxaglate and iohexol as angiocardiographic contrast media]. AB - We did 2 consecutive randomized studies to compare the effects of diatrizoate, ioxaglate, and iohexol. Sixty patients were studied: 15 with diatrizoate (group I) versus 15 with ioxaglate (IIA), and 15 with ioxaglate (IIB) versus 15 with iohexol (III). Group I had hypotension and severe increase in end-diastolic pressure. Severe bradycardia was seen in 27% of the cases. Group IIA and IIB had identical changes, with a moderate increase in systolic and end-diastolic pressure. Group III only presented a mild increase in end-diastolic pressure. None of the low-osmolar contrast media produced severe bradycardia, but ioxaglate induced frequent (20%) nausea. Our results suggest the best contrast media for angiocardiography is, in decreasing order: iohexol, ioxaglate, and diatrizoate. PMID- 2781111 TI - [Efficacy of various antihypertensive agents according to age and initial arterial pressure]. AB - 210 patients with mild-moderate high blood pressure have been studied. These patients were followed up for 4-6 weeks. Fifty patients were treated with 50 mg hydrochlorothiazide + 5 mg amiloride daily; 40 with 160 mg oxprenolol daily; 22 with 30-40 mg nifedipine daily; 38 with 240 mg verapamil daily and 60 with 50-100 mg captopril daily. We have observed: 1. All treatments have similar antihypertensive effectiveness. 2. Decrement in blood pressure was correlated with initial blood pressure in all treatments, directly. 3. This effectiveness was correlated positively with age in treatment with both diuretics and calcium antagonists, and an inverse correlation with both beta-blockers and captopril. 4. It had no correlation between age and initial blood pressure in diuretic or beta blocker treated groups. So diuretics shall be suggested in elderly patients and beta-blockers in younger patients. 5. The greater effectiveness of calcium antagonists in the elderly should be explained because these patients have a higher initial blood pressure. 6. In this work there is an inverse correlation between age and initial blood pressure in the captopril-treated group; it should explain the greater effectiveness in younger persons. 7. Nothing opposes the use of calcium-antagonists or angiotensin converting enzyme inhibitor in all age groups. PMID- 2781112 TI - [Effect of nitrendipine in the treatment of mild or moderate essential arterial hypertension]. AB - We studied 30 ambulatory patients with mild to moderate essential arterial hypertension, treated with the new calcium antagonist nitrendipine, during a follow-up period of six months and after a three week placebo period was completed. Nitrendipine initial dosage was 20 mg, given once daily in the morning. Normalization of blood pressure was achieved in every patient after three months of treatment, with a p less than 0.0001 since the first month and throughout the whole period. No concomitant changes in heart rate or vascular risk factors were observed. Eight patients needed their individual dosages to be doubled (40 mg) to achieve a complete normalization of their blood pressure values; four of them took the whole dosage once daily. We had to stop treatment in three patients because of significant worsening of previous symptoms. Although there was a 16.6% total incidence of secondary effects, the compliance was over 90%, which tells us about the relatively small importance of secondary effects observed. Flushing, which was present in five patients, was the most common secondary effect. Nitrendipine is an excellent antihypertensive drug, easy to use and responsible for a low number of disabling secondary effects, usually appearing in previously very symptomatic patients. PMID- 2781113 TI - [Regional differences in the contractile function of the subendocardium and subepicardium of the left ventricle in the dog]. AB - With the objective to study the regional differences in myocardial function of different left ventricular (LV) segments, twelve pairs of ultrasound crystals were implanted in six open-chest dogs. Six pairs in the subendocardium and six in the subepicardium in three zones of the left ventricle (4 in the apex, 4 in the left anterior descending region and 4 in the circumflex region). In each zone of subendocardium one pair was placed parallel to the epicardial fibers (long axis) and the other following the circumferential plane of the left ventricle (short axis); the same orientation was followed in the subepicardium. Left ventricular pressure, coronary flow (electromagnetic flow-meters), peripheral ECG leads, dp/dt, and segmental shortening were measured. The extent of shortening and the fraction of shortening were considered. The extent of shortening is always higher in the long axis than in the short axis crystals. Similarly, the shortening in the subendocardium is higher than in the subepicardium. The greater extent of shortening and fraction of shortening appeared in the apex, above all in the subendocardium. There are differences in the time-course of fibrillar shortening between subepicardium and subendocardium; the subendocardial contraction was simultaneous with a lengthening of the subepicardial segments. In conclusion, there are differences in myocardial contraction depending on the myocardial region and the layer. Also the shortening of the subendocardium is not synchronous with the subepicardium. PMID- 2781114 TI - [Resection with removal of a primary fibrosarcoma of the left auricle. Value of two-dimensional echocardiography in the clinical diagnosis]. AB - A primary fibrosarcoma was removed from the left atrium in a 58-year-old woman. We comment on the rareness of this cardiac neoplasm, the usefulness of two dimensional echocardiogram in the clinical diagnosis of all cardiac tumors, and also the necessity for surgical treatment. PMID- 2781116 TI - [Dynamic intracavitary echoes from non-slow flow in a patient with a mitral prosthesis]. AB - The infrequent finding of visualization of circulating blood by two-dimensional echocardiography in the left ventricle in a patient with a mitral prosthetic valve is reported. In contrast to most of the reports on dynamic intracavitary echoes, no correlation with blood stasis or diminished flow velocity is found, being normal in this pulsed Doppler study. PMID- 2781115 TI - [The ergonovine test: an episode of hallucinations]. AB - The ergonovine maleate provocation test for the diagnosis of coronary spasm is widely used in patients with rest angina. A patient who developed an episode of psychotomimetic symptoms after the administration of intravenous ergonovine is presented. This side effect of ergonovine maleate had not been previously reported. PMID- 2781117 TI - [Dysfunction in a Hancock mitral valve bioprosthesis caused by thrombosis and resolved with heparin]. AB - Thrombotic malfunction is a rare and shortly documented complication of cardiac bioprostheses. Surgical treatment is usually needed. We report a patient with thrombotic occlusion of a Hancock mitral prosthesis which was resolved with heparin. Clinical and therapeutic features are discussed. To our knowledge, this is the first case of a bioprosthetic thrombotic obstruction successfully managed with heparin therapy. PMID- 2781118 TI - [Value of the stress test in patients with coronary spasm]. AB - Ninety-one consecutive patients with angiographically documented spasm who performed a bicycle stress test within one week before diagnostic coronary angiography are studied. Stress test induced ST elevation in 8 patients (9%), ST depression in 37 (41%) and no ST shifts in 46 (50%). ST response to exercise did not correlate with any of the clinical variables assessed except for coronary anatomy. ST depression was a highly specific sign of underlying coronary lesions, with a high positive predictive value (89%). Patients were stratified according to the type of angina and their post-test probability of significant coronary disease was calculated following Bayes' theorem. The post-test likelihoods of significant coronary stenosis (positive and negative test, respectively) were: 82 and 37% for patients with angina at rest; 90 and 53% for those with effort angina, and 98 and 85% for those with mixed angina. IN CONCLUSION: 1) stress testing in patients with coronary spasm correlates well with coronary anatomy; 2) ST depression strongly suggests the presence of underlying coronary stenosis; 3) stress testing is especially useful in patients with angina exclusively at rest. PMID- 2781119 TI - [Intravenous streptokinase in acute myocardial infarction. Reduction of early in hospital mortality]. AB - A randomized study of the effects of intravenous streptokinase was performed in 214 patients with an acute myocardial infarction of less than 4 hours of whom 110 were included in the therapeutic group (SK) and 104 in the control group (C). Incidence of angiographic recanalization was higher in SK group (71 vs 28%, p less than 0.001) as that of non-significant residual coronary artery stenosis (less than 70%, 16% vs 3%, p less than 0.005), particularly in young patients (less than 45 years; 42% vs 8%, p less than 0.05). However, SK group presented a higher incidence of severe residual stenosis (90-99%) (SK, 42% vs C, 22%, p less than 0.01). Ejection fraction was higher among recanalized patients in both groups. Peak CPK-MB occurred earlier in SK group (13 vs 19 hours, p less than 0.001) and also among the recanalized patients of each group (SK, 12 vs 16 hours, p less than 0.001; C, 15 vs 21 hours, 0.002). The course of ST segment was similar in the 2 groups. The occurrence of ventricular arrhythmias within the first hour was greater in SK group (40% vs 20%, p less than 0.002), whereas the incidence of pericarditis (14% vs 35%, p less than 0.001) and of early mortality (less than 5 days, 2% vs 10%, p less than 0.02) was lower in SK group. The incidence of cardiac rupture, confirmed at necropsy in each of the 5 cases studied, was also lower in SK group (1 vs 8).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2781121 TI - [Aortic valvuloplasty using the transatrial route in aortic valve stenosis]. AB - We describe a new technique for aortic valvuloplasty in four patients. The balloon catheter was inserted percutaneously from the right femoral vein over a long guidewire introduced into the right femoral vein and advanced transseptally to the left atrium and left ventricle and drawn out of the body through the left femoral artery using an intravascular retriever set. With both ends of the long guidewire under manual control outside the body, the balloon could be easily fixed during inflation. The procedure was easy to perform and caused no complications. PMID- 2781122 TI - [Aneurysm of the interauricular septum and Klinefelter's syndrome]. AB - Atrial septal aneurysms are reported secondary to congenital cardiopathies with an increased gradient between the two atrial chambers or primary, usually associated with an alteration in the connective tissues of the heart. We describe a patient with an atrial septal aneurysm and Klinefelter's syndrome, an association not previously reported, that reinforces the relationship of this aneurysm to a connective tissue abnormality. PMID- 2781120 TI - [Combination of quinidine and verapamil in auricular fibrillation]. AB - The efficacy of the association of verapamil plus quinidine in 70 patients with atrial fibrillation, 64 of them after having cardiac surgery, was assessed. Oral dosage ranged from 825 mg to 1,100 mg for quinidine polygalacturonate and 240 mg to 320 mg for verapamil. All patients but two reached a good control of heart rate (mean heart rate less than 110 beats/min) while arrhythmia persisted. Sixty patients (85.7%) reverted to normal sinus rhythm in a period of 2.4 +/- 1.5 days (mean +/- SD). According to the atrial fibrillation duration three subsets of patients with different conversion rates to sinus rhythm were established (p less than 0.01): group A (lasting from 1 day to 3 months) 31/39 (96%); group B (lasting 3 to 6 months) 18/21 (85.7%) and group C (lasting 6 to 12 months) 5/10 (50%) (p less than 0.01). Plasma quinidine levels were maintained at either near to or therapeutic range (2.6 +/- 0.94 micrograms/ml). Adverse effects comprised one ventricular arrhythmia-induced syncope (quinidine syncope) and two cases of systemic hypotension. Quinidine-verapamil association is a good alternative in the treatment of atrial fibrillation, particularly in those of recent onset, according to the high rates of conversion to normal sinus rhythm, affording control of heart rate while atrial fibrillation persists. Adverse reactions did not differ in severity from those observed with quinidine monotherapy. PMID- 2781123 TI - [Free thrombus in the left atrium associated with mitral stenosis. Diagnostic and therapeutic aspects. Apropos of a case]. AB - A patient with a history of transient cerebral ischemic episodes had two dimensional echocardiographic findings consistent with mitral stenosis associated with a spherical free-floating left atrial thrombus. The patient was operated on in the next few days, performing a mitral commissurotomy, and the left atrial thrombus was removed, without intra- or postoperative complications. The patient was discharged from the hospital on an antiplatelet drug regimen. Free-floating left atrial thrombi are a very rare finding with an easy echocardiographic diagnosis. Prompt surgical treatment is mandatory because the risk of systemic embolization and sudden death are inherent in this entity. PMID- 2781124 TI - [Scope of the cardiology specialty: point of view of the Spanish Society of Cardiology]. PMID- 2781125 TI - [Classification and treatment of angina pectoris]. PMID- 2781126 TI - The future is now. PMID- 2781127 TI - Tom's story: a quadriplegic who refused rehabilitation. AB - A C3 quadriplegic was admitted to our unit, and the whole team went into action to set up a full program of rehabilitation. But the patient decided that he preferred to die. This case raised important ethical questions about patient autonomy and the right to refuse treatment versus medical paternalism, by which the healthcare provider makes decisions on the patient's behalf. This article discusses the ethical principles involved and draws comparisons with other cases cited in the literature. "Tom" is a pseudonym, used to protect the patient's identity. Two Ethical Perspectives follow the article. PMID- 2781128 TI - Ethical perspective: in favor of autonomy. PMID- 2781129 TI - Clinical validation of Braden and Bergstrom's conceptual schema of pressure sore risk factors. AB - Pressure sores are a health problem that crosses clinical practice settings. Today, emphasis is on prevention by identification of risk factors associated with pressure sore development. The Braden and Bergstrom (1987) schema of etiologies of pressure sores has been reported to be a useful predictor of client risk for pressure sore development. This clinical validation study examined relevance of the 13 schema factors to a rehabilitation setting. Using Fehring's (1986) validation model to analyze responses, the findings suggested that in the rehabilitation setting, four schema factors were critical risk factors (decreased mobility, decreased activity, decreased sensory perception, and increased friction), five were risk factors (increased moisture, increased shear, decreased nutrition, decreased arteriolar pressure, and decreased interstitial fluid flow), and four were not considered risk factors (increased age, emotional stress, smoking, and skin temperature). Fifteen additional risk factors, many of which are psychosocial, were suggested. PMID- 2781130 TI - The user--friendliness of protective support surfaces in prevention of pressure sores. AB - Special mattress overlays and seat cushions for the prevention of pressure sores constitute a large portion of the rehabilitation products market. Consumers frequently face economic concerns in choosing among these products. This article summarizes the favorable and unfavorable features of major support surface types: foam, air-filled, flotation, and alternating air. A careful consideration of characteristics, such as fire safety, patient comfort, and ease of transfer and handling, may facilitate selection and result in more satisfied users and caregivers. PMID- 2781131 TI - Pharmacologic erection programs: a treatment option for erectile dysfunction. AB - Pharmacologic erection programs involve the self-injection of vasoactive agents directly into the penis to create an erection. Used with success for erectile dysfunction, this technique has provided another nonsurgical option for rehabilitation patients experiencing sexual dysfunction. The use of these vasoactive agents also has altered understanding of erectile physiology and the associated ability to make accurate diagnoses. PMID- 2781132 TI - Complex wound management: a case study. AB - Mr. G.'s situation was challenging, because it did not readily conform to the management techniques currently available and required consideration of psychosocial and other physical factors. To meet individual patient needs, nurses must be creative in finding solutions to unusual problems. By focusing on the short-term goals for wound management and the goals for family-centered home care as a guide to interventions, adaptations were made to fit this patient's needs. PMID- 2781134 TI - Breaking the quality barrier. PMID- 2781133 TI - Comparison of capillary blood flow using a regular hospital bed mattress, ROHO mattress, and Mediscus bed. PMID- 2781135 TI - Polypeptide-antibody binding mechanism: conformational adaptation investigated by equilibrium and kinetic analysis. AB - The mechanism of polypeptide-antibody binding was analysed by kinetic and equilibrium studies to find out whether or not the binding of an antibody to a large protein or a polypeptide antigen behaves as a one-step reaction or involves conformational adaptation. Three monoclonal antibodies recognizing 3 distinct epitopes on the C-terminal domain (F2) of Escherichia coli tryptophan synthase beta 2 subunit were used. The dissociation equilibrium constant (KD), the association rate constant (kon) and the dissociation rate constant (koff) of these antibodies for the native beta 2 subunit, its C-terminal fragment (F2) and different polypeptides obtained by chemical cleavage of the F2 fragment were measured. It was found that for some polypeptide-antibody complexes, binding could not be described as a one-step association-dissociation reaction, thus indicating the existence of conformational adaptation upon antibody-antigen complex formation. It was also shown that differences in affinities of a given antibody for its epitope carried by different polypeptides were mainly due to differences in the dissociation rate constant (koff) and not in the association rate constant (kon). Moreover, the immunoreactivity of various polypeptides obtained by cleavage of the F2 fragment enabled us to localize the 3 epitopes on the beta chain in light of the 3-dimensional structure of tryptophan synthase described recently by Hyde et al. (1988). PMID- 2781136 TI - Evidence for dual infection of rabbits with the human retroviruses HTLV-I and HIV 1. AB - Rabbits experimentally infected with HTLV-I and HIV-1 produced antibody to various viral proteins, and viral DNA could be detected by gene amplification using the polymerase chain reaction. HTLV-I genes were detected in cell lines derived from infected rabbits, and in some cases, both HIV-1 and HTLV-I DNA sequences were demonstrated in peripheral blood cells taken from rabbits one year after experimental infection. The polymerase chain reaction procedure was used to demonstrate the presence of HTLV-I gag, env and tax genes and HIV-1 gag and env genes. The amplified fragments were identified by size and by hybridization to specific probes. The ability of rabbits to support simultaneous infection with HTLV-I and HIV-1 will allow in vivo studies of the possible synergistic effects of these important human pathogens. PMID- 2781137 TI - Cross-reactive binding patterns of monoclonal antibodies to DNA are often caused by DNA/anti-DNA immune complexes. AB - Recently, the role of antibodies to DNA in the pathogenesis of systemic lupus erythematosus (SLE) has been reevaluated, since observed cross-reactive binding of anti-DNA to tissue-related antigens might substantially contribute to the inflammatory process of the disease. Evidence of this cross-reactivity has, in part, been obtained from studies with monoclonal anti-DNA. However, we now report that the presence of DNA/anti-DNA immune complexes in monoclonal antibody preparations may be the cause of the observed cross-reactive binding patterns. Studying a panel of anti-DNA producing hybridomas (n = 63), we detected such immune complexes in 76% of the obtained culture supernatants by using an anti protamine sulphate (PS) ELISA; complexes formed with 1 microgram/ml DNA or more were traced in this assay. In cultures of anti-DNA-producing hybridomas, complexes were detected from day 3 on. Treatment of supernatants with DNase reduced the anti-PS reactivity to an average of only 20% of the original reactivity. Contaminating DNA/anti-DNA immune complexes were found to play no role in the cross-reactivity of anti-DNA antibodies with cardiolipin, a minor role in cross-reactivity with dextran sulphate, but a substantial role in the cross-reactivity with heparan sulphate, histones and other nuclear or cytoplasmic antigens. Our results clearly demonstrate that exclusion of the presence of immune complexes in antibody preparations is a prerequisite when cross-reactivity patterns of anti-DNA antibodies are studied. PMID- 2781138 TI - Cardiovascular performance in anesthetized rats pretreated with 1,3-bis(2 chloroethyl)-1-Nitrosourea (BCNU). AB - Cardiovascular function was studied in anesthetized rats at weekly intervals following their pretreatment with single i.p. doses of BCNU (20 mg/kg). Over the first two weeks post-treatment the predominant effects were on total peripheral resistance. Femoral artery diastolic and mean pressures increased with a corresponding decrease in pulse pressure. Thereafter, apparent cardiac effects were also manifest by decreases in systolic and mean pressures, and possibly heartrate. Diastolic and pulse pressures also declined in this second phase. The water content of caudal artery segments from these rats decreased from 82.3 +/- 0.6% in controls to 78.4 +/- 0.6% (P less than 0.05) at 4 weeks post treatment. The total collagen content of these segments had increased 35% over controls as early as 2 weeks after BCNU while total protein content remained unchanged. Whole body responsiveness to the pressor effects of bolus injections of norepinephrine was significantly diminished only at the 4-week sampling time. The cardiovascular toxicity of BCNU may be a complex of direct effects of the drug on vascular endothelia and secondary effects associated with the cholestasis which develops over a similar time course. PMID- 2781139 TI - Studies on the mechanism of action of 1-(2-methyl-3-hydroxy-5-hydroxy-methyl-4 pyridyl)-6,7-dihydroxy-1,2,3, 4- tetrahydroisoquinoline (PTIQ) on blood pressure in the anesthetized dog. AB - The mechanism of action of PTIQ in lowering the arterial blood pressure in the anesthetized dog was studied using pharmacological and physiological techniques. The hypotensive activity of PTIQ was significantly inhibited by pretreatment with bilateral vagotomy, propranolol, prazosin and mecamylamine. Pretreatment with either yohimbine or reserpine had no significant effect on PTIQ activity. PTIQ produced a significant decrease in the force of contraction of myocardial tissue and a transient increase in the aortic blood flow of the anesthetized dog. These results indicate a multiplicity of action of PTIQ in controlling arterial blood pressure. PMID- 2781140 TI - In-vitro plasma protein binding of propafenone and protein profile in eight mammalian species. AB - The protein binding of propafenone in vitro was assessed in plasma of mouse, rat, rabbit, dog, sheep, man, cow, and horse at two concentration levels. In all species and at both concentrations propafenone was found highly bound (86-99%) to plasma proteins. No significant relationship was found between free propafenone and the plasma protein fractions. A concentration-dependency was seen in plasma of mouse, sheep, man, and horse, in which the free fraction of propafenone became larger on raising the concentration. Qualitative and quantitative differences were observed in the protein plasma profile of studied species. The protein plasma profile and propafenone concentration may affect the free fraction of the drug to different extents in different species. Thus the pharmacological activity of propafenone may be different in different species even at the same propafenone plasma concentration. PMID- 2781141 TI - Pharmacokinetics of the cyclosporine-ketoconazole interaction in dogs. AB - Numerous clinical reports have documented an increase in trough blood concentrations of cyclosporine in transplant recipients treated concomitantly with ketoconazole. The objective of this study was to elucidate the mechanism(s) underlying the cyclosporine-ketoconazole interaction using a choledochoureterostomy dog model. Five male beagle dogs received a 4 mg/kg, i.v. bolus dose of cyclosporine either alone or on day seven of a 10-day, 13 mg/kg/day, oral dosing regimen of ketoconazole. Blood samples were collected prior to and at predetermined times for 60 hrs after the cyclosporine dose, while the bile/urine mixture was collected quantitatively for 96 hours after the cyclosporine dose. Ketoconazole decreased the systemic clearance of cyclosporine from 7.0 ml/min/kg to 2.5 ml/min/kg. The terminal disposition rate constant was also decreased significantly from 0.0794 to 0.0354 hrs-1. Ketoconazole caused no significant changes in cyclosporine steady state volume of distribution, or plasma unbound fraction. Ketoconazole did not significantly alter the excretion of cyclosporine and various cyclosporine metabolites in the bile/urine mixture. Inhibition of hepatic drug metabolizing enzymes appears to be the primary reason for the ketoconazole induced elevation in cyclosporine concentration. PMID- 2781142 TI - The effect of moderate fluosol-DA hemodilution on gender specific metabolism of antipyrine. AB - Antipyrine metabolism was determined after hemodilution with 40 ml/kg of Fluosol in conscious, unrestrained female and male rats. Rats received an intravenous antipyrine dose (20 mg/kg) 24, 48, or 72 hours after hemodilution and the pharmacokinetic parameters were compared to non-exchanged control animals. Changes in the plasma disposition parameters were the same in both genders but the specific characteristic of a greater half-life in female rats was retained. A significant increase in antipyrine clearance was found at 48 hours after hemodilution. 3OHME clearance was increased in both female and male rats but 4OH clearance was increased only in female rats at that time. The data also suggested that the Fluosol emulsion induced a different microsomal enzyme activity change than its most studied component, perfluorodecalin. PMID- 2781143 TI - Effects of Ca2+ antagonists on 45Ca2+ uptake by rat whole brain P1 and P2 fractions. AB - Voltage-dependent 45Ca2+ uptake into rat whole brain P1 (nonsynaptosomal) and P2 (synaptosomal) fractions was measured after 60-s KCl-stimulated depolarization to investigate possible inhibitory effects of Ca2+ antagonists, nitrendipine, diltiazem, verapamil and ifenprodil tartrate. All drugs (10(-5)M) had little influence on 45Ca2+ uptake by whole brain P1 fraction in both nondepolarizing and depolarizing mediums. Diltiazem (10(-5)M) had no influence on 45Ca2+ uptake by whole brain P2 fraction under both conditions. However, nitrendipine (10(-5)M) verapamil (10(-5)M) and ifenprodil tartrate inhibited depolarization-dependent 45Ca2+ uptake by whole brain P2 fraction, while nondepolarization-dependent 45Ca2+ uptake was not affected by these drugs. The inhibitory sequence of depolarization-dependent 45Ca2+ uptake by P2 fraction was: ifenprodil tartrate greater than nitrendipine greater than verapamil. These results suggest that ifenprodil tartrate, nitrendipine and verapamil specifically inhibit depolarization-dependent synaptosomal 45Ca2+ uptake, but that diltiazem has little influence on it. PMID- 2781145 TI - Simple aliphatic diamines: acute neurotoxicity. AB - The acute neurotoxicity of a homologous series of diamines (ethylenediamine to 1,6-diaminohexane) was tested by injection into the lateral ventricle of conscious rats, documented as changes in behavior and electroencephalogram (EEG). Three distinct response patterns were seen ranging from prostration and EEG depression, to EEG seizures and convulsions, to a mixture of the patterns. All compounds were acutely lethal after micromole doses. PMID- 2781144 TI - Comparative effects of chelating agents on distribution, excretion, and renal toxicity of inorganic mercury in rats. AB - The effects of three chelating agents, sodium N-benzyl-D-glucamine dithiocarbamate(NBG-DTC), 2,3-dimercaptopropanol(BAL), and D-penicillamine(D PEN), on the distribution, excretion, and renal toxicity of inorganic mercury were compared in rats exposed to HgCl2. Rats were injected i.p. with 203HgCl2 (300 micrograms of Hg and 2 microCi of 203Hg/kg) and 30 min or 24 h later they were injected with a chelating agent (a quarter of an LD50). The injection of the chelating agents significantly enhanced the biliary and urinary excretions of mercury. BAL was the most effective for removal of mercury from the body at 30 min after mercury treatment. The extent of enhancing effect of the chelating agents for removal of mercury at 24 h after mercury was in the order NBG-DTC = BAL greater than D-PEN. The injection of BAL at 24 h after mercury treatment caused the redistribution of mercury to the heart and lung. NBG-DTC did not result in the redistribution of mercury to the heart, lung, and brain. Urinary excretion of protein and AST significantly increased 24-48 h after mercury treatment and decreased to the control values 72 h after mercury. The injection of the chelating agents at 30 min after mercury treatment significantly decreased the urinary excretion of protein and AST. In rats pretreated with mercury 24 h earlier, the chelating agents significantly decreased the urinary protein at 48 h after mercury treatment, but did not decrease the urinary AST. The results of this study indicate that the chelating agents are effective in removing mercury from the body, resulting in the protective effect against the mercury-induced renal damage. PMID- 2781146 TI - Inhibition of yeast glyoxalase I by biologically active peptides. AB - The antiglyoxylase activity of biologically active peptides f-Met-Leu-Phe-OCH3 and Boc-Phe-Leu-Phe-OCH3 has been evaluated and compared with those of standard inhibitors s-octylglutathione and squaric acid. The inhibitory properties of these peptides are discussed in terms of biological and pharmacological aspects. PMID- 2781147 TI - Relationship between liver microsomal function and serum thyroid hormones in rats treated with carbon tetrachloride. AB - Liver cytochrome P-450, b5, and serum thyroid hormones were measured before and 2 6 h after intra-peritoneal injections of CCl4 (1 mg/kg) in rats, to elucidate the relationship between serum thyroid hormones and liver microsomal function. Serum total protein, thyroxine (T4), free T4, triiodothyronine (T3), and cytochrome P 450 and b5 were decreased significantly after CCl4 administration, whereas reverse T3 (rT3) was unchanged. In addition to decreased conversion of T4 to T3 in liver microsomes, decreased serum binding capacities appeared to contribute to the change in serum hormone levels, since serum T4 correlated significantly with serum total protein. Serum T3, the T3/T3 + rT3 ratio, and the rT3/T3 ratio correlated significantly with cytochrome P-450 or b5, whereas the T3/T4 and T3/free T4 ratios did not. These results suggest that serum T3, the T3/T3 + rT3 ratio, and the rT3/T3 ratio are closely correlated with microsomal dysfunction in the severe case of CCl4-induced liver injury where serum binding proteins of thyroid hormones are decreased. PMID- 2781148 TI - The effect of endotoxin on nociception in mice. AB - The possible antinociceptive activity of endotoxin was studied in mice. The antinociceptive properties of endotoxin (0.0003, 0.003, 0.03, 0.3 and 3 mg/kg, i.p.) were evaluated using the phenylbenzoquinone-induced writhing test. The antinociceptive activity of endotoxin was more potent than that of aminopyrine and morphine. PMID- 2781149 TI - Doxofylline, an adenosine-nonblocking xanthine, does not induce cardiostimulant effects. AB - Doxofylline (ANSIMAR) is a new adenosine-nonblocking anti-asthmatic drug with potent bronchodilator activity that does not display the typical extrapulmonary side effects of theophylline--a potent adenosine antagonist. The cardiac activity of doxofilline and theophylline was investigated in guinea pig right and left atrial preparations and in anestetized cat. In spontaneously beating right atria doxofylline slightly increased the atrial rate only at 0.3 mM, while theophylline induced a concentration-dependent positive chronotropic effect starting at 0.03 mM. The contractile force of electrically stimulated left atria was affected by doxofylline starting at 0.3 mM. Theophylline induced the same effect already at 0.03 mM. In the anesthetized cat, doxofylline (1-30 mg/kg.i.v.) did not affect the diastolic blood pressure, but the heart rate increased slightly at a dose of 30 mg/kg i.v. On the contrary, theophylline induced a marked dose-dependent hypotensive and positive chronotropic effect. Doxofylline was 10 times less potent that theophylline is its ability to antagonize the cardiodepressant activity induced by adenosine in isolated guinea pig atria. The pharmacodynamic differences between doxofylline and theophylline may bring new insights to the understanding of the mechanisms underlying the positive chronotropic effects of xanthines, and the functional importance of endogenous adenosine. Additionally, the lack of cardiostimulant effects makes doxofylline highly suitable for the treatment of chronic obstructive lung disease particularly in combination with beta 2-adrenergic agonists. PMID- 2781151 TI - Hypothyroidism enhances carbachol-induced hypothermia in the rat. AB - We studied cholinergic regulation of body temperature in hypothyroid rats. Thyroidectomy caused a progressive decrease in core temperature. Intraventricular injection of carbachol in a dose of 10 nmol did not change core temperature of the normal rat, whereas the same dose of carbachol significantly decreased the temperature of thyroidectomized rats. One hundred nmol carbachol decreased to a greater extent core temperature of the thyroidectomized rats than that of normal rats. Intraventricular injection of atropine significantly increased core temperature of thyroidectomized rats. The present data indicate that brain cholinergic mechanisms participate in controlling temperature in the hypothyroid status and thyroid hormones play a significant role in the brain cholinergic regulation of body temperature. PMID- 2781150 TI - Effects of perphenazine, chlorpromazine or CoCl2 on the activities of delta aminolevulinic acid synthetase and heme oxygenase and on the content of hemoprotein in rat liver. AB - Administration of CoCl2 caused a marked decrease of hepatic drug-metabolizing enzymes and the induction of delta-aminolevulinic acid (delta-ALA) synthetase and heme oxygenase. Under the same experimental condition, the inverse relationship between the decrease of hepatic drug-metabolizing enzymes and delta-ALA synthetase activity and the increase of heme oxygenase activity was observed in perphenazine (PPZ)- or chlorpromazine (CPZ)-treated rats. However, the decrease of cytochrome P-450 and aniline hydroxylase by CPZ was later restored or increased over the control level. In addition, CPZ resulted in a marked decrease of total heme content, but this content was not changed by PPZ. PMID- 2781152 TI - [Pulmonary Raynaud's phenomenon]. PMID- 2781153 TI - [Surgical approaches to tachyarrhythmias]. PMID- 2781154 TI - [Coronary arteriographic findings in the patients with atrial septal defect and pulmonary hypertension (ASD + PH)--compression of left main coronary artery by pulmonary trunk]. AB - The characteristic narrowing of left main coronary artery (LMCA) was found in 44% of patients (pts) with atrial septal defect and pulmonary hypertension (ASD + PH). The cause of the narrowing is thought to be the compression by pulmonary trunk (PT). Cardiac catheterization and coronary arteriography (CAG) were performed in 38 pts with ASD ranging in age from 15 to 62 years. We defined abnormal narrowing as 50% or more stenosis of AHA classification. Sixteen pts (42%) had PH, and of these pts 7 show the abnormal narrowing of LMCA. (18% of all pts with ASD, 44% of pts with ASD + PH). They had no signs of syphilis or aortitis. Of the pts with PH, those with abnormal LMCA revealed higher pulmonary artery mean pressure than those with normal LMCA (43.6 +/- 17.3 and 27.1 +/- 5.5 mmHg respectively. p less than 0.01). Other parts of coronary arteries are intact in all pts. These findings suggest that the LMCA abnormality relates to PH. In all cases with LMCA abnormality the narrowing revealed some special features indicate the cause of narrowing is compression. First, the most severe part of narrowing was the coronary ostium, and severity reduced gradually as distal LMCA. Second, the narrowing was estimated most severely in the view of LAO 20, but almost normal in the view of RAO 30. This finding suggests the narrowing is ellipsoid. Third, the shape of LMCA changed in the different phase of cardiac cycle. In the systole, the cranial border of LMCA was convex, but in the diastole it was concave. This indicates LMCA was soft and compressed.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2781156 TI - [Effect of mexiletine on human atrial vulnerability]. AB - The effect of mexiletine on human atrial vulnerability was investigated in 14 subjects (8 with paroxysmal atrial fibrillation, 2 with paroxysmal atrial tachycardia, 2 with ventricular tachycardia, 1 with sick sinus syndrome and 1 with Wolff-Parkinson-White syndrome). During the electrophysiologic study, after 8 consecutive stimuli (A1) were delivered through the electrode catheter positioned at high right atrium, premature stimulus (A2) was introduced, and following measurements were made; 1) Aw: atrial activity width of A1, 2) maximum atrial fragmentation (MAF): the longest atrial activity width of A2, which was expressed by the relative value against Aw, 3) fragmented atrial activity zone (FAZ): the zone of the coupling interval (A1A2) with the prolongation of the atrial activity width at A2 more than 150% against Aw, 4) conduction delay zone (CDZ): the zone of A1A2 with the prolongation more than 20 msec of the intraatrial conduction time at A2 from high right atrium to coronary sinus or low right atrium against the intraatrial conduction time at A1, and 5) right atrial effective refractory period (RAERP). These measurements were repeated after the intravenous administration of mexiletine (2 mg/kg/10 min). 3 cases (case 12, 13 and 14), whose FAZ and CDZ were 0 msec, were excluded from the following evaluation. Mexiletine showed little effect on Aw and RAERP, but significantly shortened MAF and FAZ (p less than 0.001 and p less than 0.05, respectively). CDZ were also reduced in 3 cases and remained unchanged in 6 cases, though no statistical difference of CDZ was recognized between before and after the administration of mexiletine.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2781155 TI - [Relationship between left atrial diameter and cardiac function in myocardial infarction--assessment of left ventricular end-diastolic pressure by the left atrial index]. AB - To study the assessment of cardiac function in acute myocardial infarction (AMI), we measured left atrial diameter, left ventricular end-diastolic pressure (LVEDP), pulmonary capillary wedge pressure (PCWP), ejection fraction (EF) in 20 patients with acute myocardial infarction. Left atrial diameter was measured using echocardiography and was expressed as left atrial index (LAI, mm/m2) dividing by body surface area. LAI in AMI was 21.3 +/- 2.7 mm/m2 and significantly larger than LAI in normal subject (19.9 +/- 2.0 mm/m2) (p less than 0.05), In AMI, LVEDP was 13.3 +/- 3.4 mmHg, PCWP was 9.0 +/- 2.8 mmHg and EF was 52.3 +/- 14.8%, Relationship (r value) between LAI and LVEDP (r = 0.70, p less than 0.001, y = 0.87 x-5.4 x; LAI, y; LVEDP) was greater than PCWP and LVEDP (r = 0.60, p less than 0.01). LVEDP calculated from LAI using this method was directly measured LVEDP directly measured +/- 2.4 mmHg. In 9 patients, LAI was larger than 20.9 mm/m2, in 8 patients of them LVEDP was higher than 13 mmHg. In 11 patients LAI was smaller than 20.9 mmHg, only in 2 of them LVEDP was lower than 13 mmHg. It concluded that sensitivity was 88.9%, specificity was 81.8%, accuracy was 85.0%. Relationship between LAI and PCWP (r = 0.30), LAI and EF (r = -0.36) were not significant. We can measure LAI repeatedly in AMI non-invasively, and predict LVEDP. Thus, the measurement of LAI is useful in treatment of AMI. PMID- 2781157 TI - [The role of protein kinase C in left ventricular relaxation impaired by global ischemia]. AB - The role of protein kinase C (C kinase) in the left ventricular relaxation impaired by global ischemia was investigated in anesthetised dogs. Left ventricular global ischemia model was made by coronary blood flow reduction and atrial pacing (100-180 beats/min). By this maneuver, the time constant T and left ventricular end-diastolic pressure (LVEDP) were increased in a pacing-rate dependent manner. Intracoronary infusion of H-7, an inhibitor of C kinase, suppressed the magnitudes of the increments of T and LVEDP, while intracoronary infusion of 12-O-tetradecanoyl-phorbol-13-acetate, an activator of C kinase, enhanced the increases of T and LVEDP caused by ischemia. In non-ischemic group, H-7 did not influenced T and LVEDP. The results indicate that C kinase is activated by myocardial ischemia and enhances impairment of left ventricular relaxation. PMID- 2781158 TI - Efficiency of parabronchial gas exchange in deep hypoxia: measurements in the resting duck. AB - Cardio-respiratory parameters and air sac and blood gases were measured in the unrestrained, unanesthetized duck during exposure to varied levels of inspired hypoxia. As ventilation increased with hypoxia, the gas partial pressures in the air sacs and in arterial blood approached the inspired values, the differences being less than 3 Torr for air sacs and less than 5 Torr for arterial blood. To analyze the relative significance of ventilation, diffusion and perfusion in limiting parabronchial gas exchange, the conductances for ventilation (Gvent), diffusion (Gdiff = O2 diffusing capacity) and perfusion (Gperf) were calculated at all hypoxic levels. With increasing hypoxia, down to PIO2 = 50 Torr, all three conductances increased. Whereas Gvent continued to increase beyond this level, Gdiff remained constant, at about 0.27 mmol.min-1.Torr-1, while Gperf decreased, from a value of 0.22 mmol.min-1.Torr-1 at PIO2 = 50 Torr to 0.12 mmol.min-1.Torr 1 at PIO2 = 30 Torr. This reduction in Gperf may result from a direct hypoxic effect on the heart. Whereas ventilation is the main limiting factor for parabronchial gas exchange at rest down to hypoxia levels of PIO2 = 50 Torr, perfusion becomes the main limiting factor at deeper hypoxia. It is suggested that the higher tolerance of hypoxia exhibited by birds compared to mammals is not due to the higher efficiency of parabronchial compared with alveolar gas exchange, but reflects the ability of birds to tolerate lower arterial PCO2 levels than mammals. PMID- 2781159 TI - Platelet-activating factor-induced functional changes in the guinea pig trachea in vitro. AB - The role of platelet-activating factor (PAF) in airway hyperresponsiveness was investigated in guinea pigs challenged in vivo for 7 days, 10 min per day, with aerosolized PAF. Tracheal smooth muscle strips set up in vitro for measuring isometric force exhibited increased sensitivity to histamine as compared to tissues from saline-challenged control animals. No significant differences in the concentration-response relationships in tissues from control and PAF-treated animals were seen for acetylcholine or KCl. The threshold concentration of histamine to elicit contraction was 10(-7) M for control and 10(-10) M for the PAF-treated tissues, and these changes persisted for several days following the last exposure to PAF. The histamine H2 receptor antagonist cimetidine, and the arachidonate cyclooxygenase inhibitor indomethacin potentiated histamine-induced contractions in tissues from both the control and the PAF-treated animals to similar magnitudes. Intracellular microelectrode studies showed similar resting membrane potentials (-51 mV) and maximum depolarizations to the three agonists in the cells from control and PAF-treated tissues. However, histamine depolarized the membrane greater in the range of 10(-7)-10(-5) M in the PAF-treated tissues than in the controls. Contractions to threshold concentrations of histamine were unaccompanied by any detectable changes in membrane potential. Histological studies showed eosinophilic infiltration of the submucosa of the trachea. The results suggest hypersensitivity to histamine in vitro following in vivo PAF challenge in guinea pig tracheal smooth muscle, with characteristic changes in the excitation-contraction coupling. These changes may be related to inflammation and cellular infiltration into the airways. PMID- 2781160 TI - Diazepam potentiates postsynaptic inhibition in bulbar respiratory neurons of cats. AB - The purpose of this study was to assess the effect of benzodiazepine on inhibitory postsynaptic potentials (IPSPs) of medullary respiratory neurons in decerebrate, paralyzed cats. Diazepam (0.05 and 0.1 mg/kg i.v.) reversibly increased the IPSP waves occurring during the inactive phase of the respiratory cycle in all inspiratory and postinspiratory neurons examined. Input resistances of these neurons were reduced at that phase. The reversal potential for the IPSP wave was unaltered. Intracellular injection of chloride ions reversed the IPSP to depolarization, and diazepam produced a purely depolarizing effect. The drug effects observed during the active phase of each neuron include a decrease in the firing rate and a shortening of the burst activity. The firing threshold and shape of these spikes, however, remained unaltered. These results suggest that diazepam depresses the bulbar respiratory neuronal activities specifically by potentiating the periodic postsynaptic inhibition. PMID- 2781161 TI - Activities of pulmonary stretch receptors during ventilatory cycles without lung inflation. AB - When lung inflation is temporarily withheld in paralyzed, ventilated cats with intact vagi, the activities of inspiratory motor nerves are greater during the second cycle without inflation than during the first. This response is not easily attributable to increasing drive from chemoreceptors as it is abolished by vagotomy. We examined the hypothesis that the increasing inspiratory activity is the result of decreasing inhibitory feedback from pulmonary stretch receptors (PSRs). Decerebrate, paralyzed cats were ventilated by a servo-respirator in accordance with their own phrenic nerve activity. Afferent activities from individual PSRs were recorded from a few cut fibers of one vagus nerve; the vagi were otherwise intact. When lung inflation was withheld, phrenic and hypoglossal nerve activities and the durations of inspiration and expiration all increased and were significantly greater during the second cycle without inflation than during the first. The frequency of PSR discharge was also greater during the second cycle and thus did not account for the responses recorded from the motor nerves. We conclude that the latter responses probably reflect neural processes within the brain stem, involving a persistent inhibitory influence from lung inflation, which outlasts the inflation itself. PMID- 2781162 TI - Reflex inhibition of crural diaphragmatic activity by esophageal distention in cats. AB - Distention of the esophagus has been shown to result in selective inhibition of phasic inspiratory activity in the crural portion of the diaphragm, with no effect on costal diaphragmatic activity. The purpose of this study was to determine rigourously the afferent pathways that mediate this response. Bipolar EMG electrodes were placed in the costal and crural portions of the diaphragm in decerebrate, spontaneously breathing cats. Distention of the esophagus by inflation of a Foley catheter balloon with 20 ml of air resulted in a selective inhibition of crural hiatal EMG activity, while costal EMG activity was maintained at predistention levels. The distention was accompanied by a reduction in respiratory frequency. Transection of the spinal cord at the C8-T1 level did not obliterate the crural inhibition produced by inflation. Section of the C4-C8 dorsal roots also failed to abolish the response. However, after bilateral cervical vagotomy, esophageal distention no longer influenced diaphragmatic EMG activity. These results indicate that the crural inhibition observed with esophageal distention is vagally mediated and is not influenced importantly by intercostal or phrenic afferents. Records of activity of the phrenic nerve branch innervating the crural portion of the diaphragm showed a similar response pattern, confirming that the inhibition is central in origin and that the crural fibers inhibited by distention are only a fraction of the total population of crural phrenic motoneurons. PMID- 2781163 TI - Projection of low-threshold afferents from human intercostal muscles to the cerebral cortex. AB - Low-threshold afferents from human limb muscles are known to project to the sensorimotor cortex and to contribute to proprioception. However, there are few data on the cortical projection of afferents from human respiratory muscles. The present study employed evoked-potential techniques to determine whether low threshold muscle afferents from the chest wall project to cortical levels in conscious human subjects. In four subjects intramuscular afferents of the second parasternal and fifth lateral intercostal muscles were selectively stimulated through an insulated microelectrode inserted percutaneously at the respective motor point. Evoked potentials were recorded and averaged from eight scalp sites. The initial cortical component of the cerebral response to intramuscular stimulation of the second and fifth interspaces was a negative potential commencing at 19.2 +/- 2.1 msec and 20.7 +/- 1.1 msec respectively. The dominant early cortical potential was largest at the vertex, and was comparable in amplitude (0.58 +/- 0.23 microV) to that for individual muscles of the upper and lower limbs. The cortical focus was distributed differently from that for cutaneous afferents of the chest wall and for both muscle and cutaneous afferents from the upper and lower limbs. This study provides direct evidence for a short latency projection from intercostal muscle afferents (group I and/or II) to the human cerebral cortex. PMID- 2781164 TI - Responses of pulmonary slowly adapting receptors to airway occlusion in cat. AB - To determine if phasic pulmonary slowly adapting stretch receptor (SAR) activity is abolished by the no-inflation test, we monitored the discharge patterns of individual SAR during respiratory cycles with and without lung inflation. In spontaneously breathing, anesthetized cats, the airway was occluded at end expiration at both control functional residual capacity (FRC) and an end expiratory lung volume elevated with an expiratory threshold load (ETL). We recorded from 67 SAR at FRC and from 32 of these while on the ETL. At FRC, 29 (43%) continued to fire during occluded inspiratory efforts. Of 20 afferents which did not fire during occlusions at FRC, 13 discharged during occlusions on ETL. At FRC, 39% of SAR had modulation indices (MI; difference between peak and minimum discharge frequencies during occlusion expressed as a fraction of the same change during a non-occluded breath) greater than 0.2; on ETL, 72% of SAR had MI greater than 0.2. Identification of medullary inspiratory neurons as ones with (I beta) and without (I alpha) SAR input depends on vagally-mediated respiratory drive to the airway smooth muscle in which SAR are located, the response characteristics of SAR projecting to that neuron, and end-expiratory lung volume. PMID- 2781165 TI - High rate of O2 consumption in exercising foxes: large PO2 difference drives diffusion across the lung. AB - The fox has one of the highest mass specific rates of maximal oxygen consumption (VO2max/Mb) that has been measured, yet its specific pulmonary diffusing capacity (DLO2/Mb, measured morphometrically) is similar to that of most mammalian species. It achieves a high O2 flux per unit DLO2 with a large partial pressure difference driving O2 diffusion from alveolar gas to capillary blood (PAO2-PbO2). This paper explores the mechanisms that the fox utilizes to achieve this large pressure difference and the extent to which it exploits its structural diffusing capacity. Foxes were exercised on a treadmill at maximal rates of O2 uptake. The following parameters were measured or calculated: arterial and mixed venous PO2, PCO2, pH and O2 concentration of the blood, cardiac output, hemoglobin concentration and O2 equilibrium curve of the blood, and morphometric estimates of pulmonary capillary volume and pulmonary diffusing capacity for O2. These data were used to calculate pulmonary capillary transit time and the time course of the change in O2 concentration and PO2 of the blood as it transits the lung. The fox has a morphometric pulmonary diffusing capacity of 0.098 ml O2.sec-1.mm Hg 1.kg-1. At VO2 max (3.6 ml O2.sec-1.kg-1) the fox hyperventilates, resulting in a high PAO2 (124 mm Hg); it also maintains a low PbO2 (88 mm Hg) by having a short transit time (0.13 sec) due to a high specific cardiac output (25 ml.sec-1.kg-1). Our calculations indicate that at VO2max the fox uses almost all of the pulmonary capillary transit time for O2 equilibration, in contrast to other species. PMID- 2781166 TI - Glottic dimensions in healthy men and women. AB - Glottic aperture is important in modulating respiratory system resistance. Male patients with obstructive sleep apnea (OSA) have a smaller glottic cross sectional area compared to controls. Since OSA has a strong male predominance, we reasoned that glottic dimensions may differ between healthy men and women. Therefore, we utilized the acoustic reflection to measure glottic cross-sectional area in 44 non-smoking, non-obese, healthy subjects, 25 men and 19 women. Glottic area was measured during a continuous slow expiration from total lung capacity (TLC) to residual volume (RV). We compared glottic areas in men and women at three lung volumes: TLC, 50% of vital capacity (VC), and RV. We found that in all but 2 subjects, glottic areas at TLC was greater than at 50% VC or RV. At any given lung volume, there was no significant difference in glottic area between men and women. The reduction in glottic area between TLC and RV was also similar between men and women (36 +/- 24% and 33 +/- 21%, respectively). However, this reduction in glottic area occurred mainly at low lung volumes in women, and more uniformly throughout the vital capacity range in men. We conclude that changes in glottic dimensions are dependent on lung volume, that healthy men and women have similar glottic areas, and that the glottic aperture shows similar variation with lung volume among both sexes. PMID- 2781168 TI - Gas exchange in the lung of a dasyurid marsupial: morphometric estimation of diffusion capacity and blood oxygen uptake kinetics. AB - Placental and marsupial mammals differ in the balance of their cardio-respiratory systems. To determine if differences also occur in lung structure, a morphometric study of the lungs of a dasyurid marsupial, Dasyuroides byrnei, was undertaken. The total lung volume was large, but a comparatively smaller proportion was devoted to gas exchange tissue. Eighty-seven percent of lung parenchyma was air space. The volume of capillary blood was lower than would be predicted on a body mass basis, but the hematocrit was high (55%). The rate of oxygen uptake by the blood of D. byrnei was not different from that of recent determinations on human blood. However, a large oxygen capacity resulted in a high theta O2. Morphometric data were used, with theta O2 calculated for D. byrnei, to estimate the pulmonary diffusion capacity. Mass specific DLO2 was high by comparison to those reported for placentals. The erythrocytes contributed 70% of the diffusion resistance to oxygen transfer, with the large theta O2 counteracting the low Vc. We conclude that, similarly to placentals, lung structure is unlikely to limit oxygen transport in this animal, although the structural emphasis appears to be geared towards maximising alveolar ventilation. PMID- 2781167 TI - Effects of ammonia and histamine on lung irritant receptors in the rabbit. AB - The effects of ammonia and histamine on the responses of rapidly adapting pulmonary stretch receptor (RAR) activity before and after administration of isoprenaline or atropine were studied in spontaneously breathing rabbits. Inhalation of vapor from 15% ammonia solution increased the activity of RARs and this increased activity was not significantly altered by isoprenaline (50 micrograms/kg) or atropine (0.3 mg/kg). The RARs increased their activity following intravenous injections of histamine (20, 40 and 60 micrograms/kg). The excitatory responses to histamine at different doses were blocked by prior treatment with isoprenaline (50 micrograms/kg). In 8 of the tested 11 different RAR preparations on 11 rabbits, atropine (0.3 mg/kg) greatly diminished the increases of RAR activity produced by histamine at different doses. These results suggest that the ammonia-induced RAR stimulation results in a direct action of the endings whereas the activation of RARs by histamine is probably due to the combined influence of both local airway constriction and postganglionic parasympathetic pathway-mediated bronchoconstriction. PMID- 2781169 TI - Hemolymph oxygen transport during environmental hypoxia in the shore crab, Carcinus maenas. AB - Pre- and postbranchial blood was sampled from crabs, Carcinus maenas, in control normoxic conditions and after 3, 24 and 72 hours exposure to hypoxic water (PWO2 = 30 Torr) at 15 degrees C. Oxygen partial pressures, pH and the concentrations of L-lactate, urate and hemocyanin were measured and an in vitro relationship between P50 and pH was determined on a pooled sample for each series, allowing an estimation of the average in vivo oxygen affinity. In separate experiments, in vitro additions of urate was found to increase hemocyanin oxygen affinity in dialyzed hemolymph. In normoxia acclimated animals, high PaO2 values (107 +/- 8 Torr) prevailed and oxygen transport relied mainly on physically dissolved oxygen (80%). During hypoxic exposure, the fall of both PaO2 (down to 8-17 Torr) and PvO2 (4-8 Torr) was accompanied by an increase in in vivo hemocyanin oxygen affinity (delta P50 = -3 to -6 Torr, compared to normoxic blood). This increase was almost fully explained by the concomitant action of elevated blood pH, urate concentration and, to a lesser extent, L-lactate concentration. As a result, the difference between pre- and postbranchial oxygen concentration was maintained, or even increased, during hypoxia, the major part of the oxygen being transported as oxyhemocyanin (94-98%). We conclude that pH and urate are the most effective modulators in enhancing oxygen binding to hemocyanin during moderate ambient hypoxia. Whether an increase in hemocyanin oxygen affinity is essential to hypoxia adaptation in crustaceans is discussed. PMID- 2781170 TI - Evidence that hypoxemia promotes catecholamine release during hypercapnic acidosis in rainbow trout (Salmo gairdneri). AB - The concentrations of plasma catecholamines, epinephrine and norepinephrine, were monitored in rainbow trout (Salmo gairdneri) after acute (30 min) exposure to various levels of external hypercapnia (water PCO2 (PwCO2) = 0-11.3 Torr) under normoxic (water PO2 (PwO2) = 153 +/- 1.1 Torr) or hyperoxic (PwO2 = 653 +/- 27.0 Torr) conditions. Whole blood pH decreased to a similar extent as a function of external carbon dioxide tensions in both the normoxic and hyperoxic hypercapnic groups. Arterial oxygen content, however, declined only during normoxic hypercapnia. Similarly, plasma catecholamines (primarily epinephrine) increased only during normoxic hypercapnia in proportion to the severity of the whole blood acidosis. Epinephrine levels were elevated 10-fold from 0.70 +/- 0.06 nM to 7.06 +/- 3.7 nM at the highest concentration of external CO2 (11.3 Torr) whereas norepinephrine increased 3-fold from 0.56 +/- 0.07 nM to 1.62 +/- 0.40 nM. The absence of catecholamine release into the circulation during hyperoxic hypercapnia was not due to inhibition of the 'catecholamine-releasing process' by abnormally elevated arterial oxygen tensions (PaO2 = approximately 400 Torr) because acutely anaemic and thus hypoxemic fish (haematocrit = 4.9 +/- 0.7%) displayed identical elevations of plasma catecholamines under both normoxic and hyperoxic conditions. The results of these experiments demonstrate that arterial hypoxemia, rather than blood acidosis per se, is the proximate stimulus causing catecholamine mobilization in rainbow trout during short-term environmental hypercapnia. PMID- 2781172 TI - Lung border sweep upon phrenic stimulation: dynamic fall in pleural liquid pressure. AB - Pleural pressure was measured by a capsule in 9th or 10th intercostal space (ics) of dogs during tetanic stimulation of phrenic nerves (PS). When lung border passed under capsule (bor.I) a marked negative spike occurred, reflecting pleural liquid pressure (Pliq). In 9th ics spike was briefer than during spontaneous breathing (SB), speed of lung border being 4.6 times greater. During PS spike was greater and longer in 10th than in 9th ics, lung volume at bor.I being 228 ml greater. Lung volume at bor.I was smaller during PS than passive inflation because of chest wall deformation. Dynamic fall in Pliq at bor.I has been estimated about 4 cm H2O during SB, and at least 12 and 16 cm H2O (in 9th and 10th ics, respectively) during PS. Dynamic fall in Pliq seems essentially a viscous loss: it increased with thinning of pleural liquid (increase in lung volume), and with speed and displacement of lung border. Results suggest that at ordinary lung volume viscous loss of pleural liquid in this region is about 2 cm H2O per cm displacement at a speed of 1 cm/sec. PMID- 2781171 TI - The role of catecholamines in regulating arterial oxygen content during acute hypercapnic acidosis in rainbow trout (Salmo gairdneri). AB - The involvement of catecholamines in regulating arterial oxygen content (CaO2) during hypercapnic acidosis in rainbow trout (Salmo gairdneri) was investigated by comparing physiological responses during acute normoxic hypercapnia (a condition in which plasma epinephrine is elevated) and acute hyperoxic hypercapnia (a condition in which plasma epinephrine is not elevated). Red blood cell pH (rbc pH) was maintained significantly higher in the normoxic hypercapnic fish despite similar reductions in whole blood pH (pHe) in both groups. Elevation of rbc pH in the normoxic hypercapnic fish was abolished by pre-treatment with the beta-adrenoceptor antagonist, propranolol, whereas injection of epinephrine into hyperoxic hypercapnic fish significantly raised rbc pH. Arterial blood oxygen carrying capacity increased only in the normoxic hypercapnic fish due to significant increases in blood haemoglobin (Hb) levels. The ability of trout to elevate blood Hb was abolished by pre-treatment with the alpha-adrenoceptor antagonist, phentolamine. Injections of epinephrine into normocapnic fish caused increases in blood Hb and concomitant decreases in spleen wet weight and Hb content. Adrenergic elevation of blood Hb was not observed in splenectomized fish. CaO2, although depressed during normoxic hypercapnia, was indeed regulated when compared to CaO2 values predicted from the in vitro Root effect. Pre treatment with phentolamine, but not propranolol, abolished the ability of trout to regulate CaO2. PMID- 2781173 TI - ["Occupational" infection caused by the human immunodeficiency virus in 6 members of a single family]. AB - The risk groups for AIDS have been defined and include homosexuals, bisexuals, polytransfused patients, drug addicts, sexual partners of any of the above groups and sons of infected fathers. We have previously proposed that paid donors should be considered also as high risk individuals. We report here a family in which six of its eight members had HIV infection without other risk factor than being paid blood donors. PMID- 2781174 TI - [Immunoreactive urinary thromboxane B2 in experimental mesenteric thrombosis in dogs]. AB - Thromboxane B2 (TxB2) the stable metabolite of thromboxane A2 may be released as a response to ischemia. With the aim of investigating its role as an early diagnostic test in mesenteric thrombosis, immunoreactive TxB2 was measured in urine aliquotes in six sham operated dogs, nine dogs subjected to superior mesenteric artery ligation, and twelve dogs with superior mesenteric vein ligation. One hour urine volumes were collected before surgery and during the eight hours after the experimental procedures, and urinary osmolarities were also determined in each sample. Basal TxB2 levels were comparable in all groups. Although all groups showed a significant and rapid (one hour) increase in TxB2 as a response to surgery, in the controls it returned to normal after six hours, whereas in the rest a continuously increased production persisted throughout the study period. There was no difference in t-test comparisons depending on the sort of thrombosis. In spite of the urinary dilution induced during the study, a persistent increase in TxB2 excretion was found. We conclude that urinary TxB2 levels could prove useful in the early diagnosis of mesenteric ischemia. PMID- 2781175 TI - [Antigens of the human immunodeficiency virus in serum of high risk people in the city of Monterrey]. AB - One hundred forty human sera distributed in 2 groups were analyzed. In group I, 50 serum samples from healthy individuals that did not belong to the high-risk acquired immune deficiency syndrome (AIDS) population were included. In group II, there were 90 individuals, most of whom were apparently healthy but were at high risk of getting AIDS through their life styles or by transfusion. Of the 90 persons, 5 had a clinical picture of AIDS. All sera were analyzed by the enzyme - linked immunosorbent assay (ELISA) for the anti VIH antibodies. The positive cases were confirmed by the Western blot assay. In all samples the presence of the human immune deficiency virus antigens was sought. The results showed that the 50 healthy individuals (control group) were negative for both HIV antigens and antibodies. Of the 90 sera for the high-risk group, 50 were negative for antibodies, and 2 of them (4%) were positive for HIV antigens. Forty sera were positive for anti HIV antibody and among them, 5 patients were diagnosed as AIDS, and showed positive for antigen and antibody. The other 35 patients were all positive for HIV antibody and in 8 of them HIV antigen was also present. PMID- 2781176 TI - [Induction of protective antiamebic immunity in hamsters with heterologous antigens]. AB - Two hundred and twenty-five Syrian golden hamsters were used. Twenty five of them served as the control group. All other hamsters were intradermal immunized, once a week for four weeks, with a mixture of amebic proteins, mixed with complete Freund adjuvant, obtained from 5 x 10(5) homogenized dead amebic trophozoites from five different strains. Each group of hamsters (five groups of 40 animals each) were immunized with one of the following strains: E. histolytica HM-531, HJ 1, HM1-IMSS, E. chattoni PM-4 and PM-5. All hamsters, including those from the control group, were later inoculated with 0.2 mL equivalent to 1 x 10(5) live trophozoites from the different strains grown in axenic TYI-S-33 medium. Inoculation was performed by direct injection into the liver. The hamsters were sacrificed eight days later and their livers examined. All non-immunized animals showed extensive gross hepatic nodular abscesses. The liver of immunized hamsters showed mild to moderate lesions: the histopathological striking feature was non specific granulomata. It is concluded that the immunized animals inoculated with homologous stock showed protective immunity to amebic infections. In other cases, immunity was seen though they were inoculated with a heterologous stock. PMID- 2781178 TI - Chronic cholecystitis with lymphoid hyperplasia. AB - The clinico-pathologic features of six cases of chronic cholecystitis with focal lymphoid hyperplasia (CCLH) are described and compared with five examples of malignant lymphoma involving the gallbladder. The clinical presentation of CCLH was identical to that of conventional chronic cholecystitis with cholelithiasis. Microscopically there was chronic inflammation and fibrosis in the wall of the gallbladder as well as extensive lymphoid hyperplasia with many lymphoid follicles having germinal centers. The five patients with malignant lymphoma also had chronic cholecystitis; four had a previous diagnosis of lymphoma established by a lymph node biopsy and were also found to have liver involvement during cholecystectomy. The gallbladders with malignant lymphoma showed acute and chronic cholecystitis and a monotonous lymphoid proliferation easily distinguishable from CCLH. We conclude that CCLH displays characteristic pathologic features and should be separated from the chronic and xanthogranulomatous types of cholecystitis. PMID- 2781177 TI - [High prevalence of acquired immunodeficiency syndrome (AIDS) associated with transfusion in Puebla, Mexico]. AB - The salient clinical and epidemiological features of the first cases of AIDS diagnosed in the city of Puebla, Mexico, are reviewed. Puebla has 2 million inhabitants and 37 cases of AIDS have been diagnosed since 1984. Thirty-two percent of patients acquired AIDS by blood transfusion, 20% were paid blood donors and 48% acquired the HIV infection by the sexual route, thus making a 52% prevalence of transfusion-related HIV infection. These data are substantially different from those reported in other countries and in other cities within Mexico, where the prevalence of transfusion-associated HIV infection is about 11.5%. The high prevalence of transfusion-related AIDS seems to be due to existence of "blood centers" where paid donors are bled using non-disposable material, and they are poorly selected. HIV infection is thus transmitted to paid blood donors which in turn become transmitters of the disease. The new regulations on blood donation adopted in Mexico abolish paid blood-donation and the selection of blood donors is more stringent. This should result in reducing the serious problem of transfusion-associated HIV infection in the city of Puebla, Mexico. PMID- 2781179 TI - [47-year-old male with refractory anemia, neurologic disorders, jaundice and hepatomegaly]. PMID- 2781180 TI - [Iatrogenic trends as indicator of clinical competence in courses of specialization in medicine]. AB - Iatrogenesis, understood here as an unfavourable effect to the health of patients provoked by the medical institution, has risen little interest in the researchers of the health area in spite of its growing presence. The present study had the aim of exploring the iatrogenic behavior of 659 recently graduated physicians by a questionnaire composed by clinical cases which described diagnostic and/or therapeutic situations that required the making of decisions. The questionnaire consisted of 600 general medical knowledge questions of which 112 explored commission of iatrogenic behavior. The group showed a iatrogenicity index of 39.5% ranging between 15.2% and 74.1%. When this iatrogenicity index was compared to that of global medical knowledge (600 questions) no correlation was found. It is concluded that the "iatrogenicity" index of this group is high and lacks correlation with the global medical knowledge. This suggests that the individualized and careful use of the diagnostic and therapeutic resources suitable for specific situations in patients does not receive sufficient emphasis during the teaching-learning process nor does it play a prominent role within the priorities of knowledge that are learned in the school of medicine. The need to deepen our understanding of the iatrogenic behavior of the physicians at different levels of their professional training is emphasized. PMID- 2781181 TI - [Indications of immunologic evaluation in recurrent otorhinolaryngologic infections in children]. AB - Happening of 3 to 5 E.N.T. infections per year is often the price to pay by the young child to obtain his immunological maturity. Frequency and seriousness of the recurrencies leading to surgical interventions, results of which being doubtful and temporary (specially in ear infections) enforce differentiated immunological evaluations: graduating in methodology will be in accordance with the seriousness of happening cases. Our method involves different steps. Usual investigations will lead to easy and efficient treatment: research of the deficiency of iron, titration of immunoglobulin and IgG2, screening for inhalant allergy (Phadiatop test), eventually completed by allergological check up. Suppurations due to unusual microbial agents or fungus, must lead to a wider immunological check up, specially in case of multiple localizations, and in familial background. This check up, testing humoral and cellular immunity (lymphocytes and polynuclears) is mandatory heavy due to the number, the cost and recurrence of needed investigations. Its purpose is to show congenital or hereditary immunological deficiencies, which, however, happen scarcely. PMID- 2781183 TI - [Malignant midline granuloma, diagnostic and therapeutic problems]. AB - This is an analysis of 4 patients with suspicion of centro-facial granulomatosis. Diagnosis is difficult, mainly based upon clinical data, without precise histopathological presentation. The main differential diagnosis is Wegener's granulomatosis. The etiology of centrofacial granulomatosis is still unknown but multiple theories have been proposed: systemic disease, lymphoma. In one case, the initial histopathological diagnosis was undifferentiated carcinoma and the patient received chemotherapy (i.e., Adriamycin, Vincristine, Bleomycin and Steroids). A complete response was achieved. The interest of chemotherapy in the treatment of centro-facial granulomatosis is discussed. PMID- 2781182 TI - [Diffuse spontaneous cervical cellulitis caused by anaerobic bacteria]. AB - Nine cases of diffusal cervical cellulitis due to anaerobes were analysed. Some of them had right away extensions (to the inferior mediastinum or to the face). From these cases, the authors argue their treatment protocol. Surgery was performed immediately after diagnosis, and associated with intensive management. The excision of the necrotic tissue and the aperture of all cervical spaces (particularly the floor to the buccal cavity and the prevertebral space) were made. The source of infection was looked for (most often this being the teeth) and treated at the same time. Bacteriologic aero and anaerobic prelevements were done. A thoracic or facial surgery, being necessary because of persistency or appearance of extension, was performed secondary, after the patient was better prepared with a hyperoxygenation and a triple antibiotic therapy. Life prognosis improved with this treatment protocol. The gravity of the conditions presented by our patients depended more on the presence of an underlying disease (diabetes, immunosuppression, age...) or the delay of the diagnosis than on the cellulitis extension. PMID- 2781184 TI - [Cervicofacial actinomycosis. Apropos of 5 cases]. AB - Concerning five observations of cervico-facial actinomycosis in the O.R.L. ward of Charles-Nicolle hospital, authors report sings, diagnosis and bacteriology. The cure consists in the extracting of the teeth concerned, the removal of the necrosed tissues and an antibiotherapic treatment based on ligh doses of penicillin relaying with cyclins. PMID- 2781186 TI - [Lymph node tuberculosis]. AB - Ganglionic tuberculosis with a cervicofacial location is still frequent in Tunisia. The main problem posed is bacteriological. Over the last nine years, we have treated 110 patients. There is a clear male predominance. The preferential location is the jugulocarotid and upper spinal chain. The notions of contamination and a secondary location, particularly in the lungs, are rarely encountered. Extended cellulolymphadenectomy is the basis of surgical treatment, backed up by polychemotherapy over a period of 6 months. PMID- 2781185 TI - [Cervicofacial hydatidosis. Apropos of 7 cases]. AB - The authors report seven cases of hydatidosis located in neck region. They reviewed components of positive diagnosis, particularly serological one. Surgery is the treatment in all cases, and preventive treatment is the best one before apparition of cysts. PMID- 2781187 TI - [Treatment of Dubreuilh's melanosis. Apropos of 30 cases]. AB - Dubreuilh's melanosis or circumscribed melanosis is a current disease of the old patient's face. The therapeutical attitude should be surgical and as earlier as possible. A 5 millimeter cutaneous margin must be resected around this lesion. A review of 30 cases is made. PMID- 2781188 TI - [Malignant non-Hodgkin's lymphoma of the bony cavity of the face. Apropos of 17 cases]. AB - Malignant non Hodgkin lymphomas (NHL) are fairly frequent, but involvement of the bony cavities of the face is less common than invasion of the cervical lymph nodes and the lymphoid components of Waldeyer's ring. In connection with a series of 17 personal observations, the authors discuss the main features of NHL and review the diagnostic problems and therapeutic alternatives. Two histologic clinical entities can be defined: orbital NHL: generally stage I, with a low or intermediate histoprognostic grade and a good prognosis; naso-sinusal NHL: often locally advanced, these lesions are often associated with other visceral disease sites; the prognosis for these intermediate or high histo-prognostic grade lesions is much more somber. PMID- 2781189 TI - [Induction chemotherapy with Cis DDP-5FU in cancers of the upper respiratory and digestive tract after 70 years of age]. AB - Sixty one aged patients with advanced squamous cell carcinoma of the upper aerodigestive tract were given a chemotherapy Cis DDP-5 FU before any local treatment. The objective response rate was 77% which included 46% of complete response. Toxic manifestations were more severe than those observed in the general population with the same protocol (nine deaths during the course of the treatment). A few appropriate measures may contribute for the improvement of the therapeutic index: consideration of nutritional and cardiac status, reduction of doses according to age, pharmacokinetic monitoring of 5 FU. An acceptable level of toxicity will be necessary in the design of future, intensive induction trials. The possibility of conservative treatment with a high level of reliability would justify the use of induction chemotherapy in the aged subjects. PMID- 2781190 TI - [Contribution of immunohistochemistry to the diagnosis of cervicofacial cancers]. AB - In spite of classical morphological studies, a good number of cervico-facial cancers remain classified as undifferentiated. Thanks to the use of intracellular antigens, immunohistochemistry (IHC) allows for a differentiation of tumoral growths. 33 patients were used in this study within the last three years. After studying the different markers used, the authors consider their specificity and their reactivity, than their respective usefulness in the three main diagnostic cancer of the face. In 22 patients, IHC alone allowed a diagnosis and a specific therapeutic orientation. Material, technical and human demands must be considered along with the efficacity to the technique. PMID- 2781191 TI - [Partial laryngectomies in the old patient (more than 70 years of age). Apropos of 25 cases]. AB - Over a six-year period, from 1981 to 1985, the authors operated on 25 patient aged 70 years or more for infiltrative cancer of the larynx. Indications for surgery are identical to those for a younger patient. Contraindications of a general nature are scrupulously observed and the exploration of respiratory function is one of the key complementary examinations. Survival figures are very encouraging, as the increase in intercurrent mortality seen in this age group is balanced by the lesser degree of aggressivity of the initial tumour and of its ganglionic metastases. PMID- 2781192 TI - [Pitfalls of extracapsular thyroid surgery]. AB - The usual landmarks of thyroid surgery are often altered with a goiter. The surrounding tissue may also be subject to variation. Different anomalies the surgeon may encounter are presented along with their management: the recurrent nerve, the external laryngeal nerve, the parathyroids and an intrathoracic goiter. Each case of thyroid surgery must be considered individually, and the ENT surgeon must devote particular attention to assure perfect postoperative vocal cord function. PMID- 2781193 TI - [Use of a temporoparietal fascial flap in difficult reconstructions of the external ear]. AB - Temporo parietal fascial flap is a way of total ear reconstruction when there is not a sufficient quantity of available skin in auricular region. This flap very thin, supplied by superficial temporal vessels is located above the auricle and can cover the framework's convolutions. This technique has been well described by Burt Brent. Our experience is based upon 12 total ear reconstruction with this kind of flap. When there is an extreme skin shortage, but of good quality, we discuss the technique of skin expander. PMID- 2781195 TI - Hypertension in childhood. PMID- 2781194 TI - [Primary malignant melanoma of ORL mucosa. Apropos of 5 cases]. AB - Based on five observations of primary mucosal melanomas recently treated in the department, the authors describe the main features of this very rare condition, and particularly the evolutive aspects in diagnosis and prognosis. Histological diagnosis is sometimes difficult, and must involve specific argentic staining and a search for the presence of the protein S100. Tumor thickness was systematically examined. No prognostic interpretation, however, is possible, given the small number of cases in the series. Evolution is unpredictable; there is very commonly a series of local recurrences which may be well controlled, followed by remote metastases remaining long quiescent, bypassing the cervical ganglion relay. Treatment is surgical whenever possible, with palliative radiotherapy for local recurrences and chemotherapy for metastatic forms. Other therapies have yet to prove their effectiveness. PMID- 2781196 TI - Growth and blood pressure. PMID- 2781197 TI - Consistency of blood pressure levels in children. PMID- 2781198 TI - Factors related to blood pressure in a sample of Italian children age 5 to 14: the Gubbio Population Study. PMID- 2781199 TI - Epidemiology of blood pressure in childhood: an international perspective. PMID- 2781200 TI - [Encephalopathy secondary to severe craniocerebral trauma: incidence--prognosis]. PMID- 2781201 TI - [The significance of psychological risk "patterns" in the recovery of the cerebrovascular patient]. AB - The authors have applied the Jenkins Activity Survey test in 117 patients with residual and sequelae cerebrovascular disorders. Three behavioural types, A, B, and non-A--non-B were determined. A slight prevalence of type A (39.32%) was disclosed by comparison with the two other types, when considered separately although when type-B and type non-A--non-B subjects were lumped together the type A subjects remained a minority. Subjects with marked behavioural patterns were better represented (69.20%), especially those showing factor H. (31.62%), and factor S + H (27.35%). PMID- 2781202 TI - [The epidemiology of autolytic behavior]. PMID- 2781203 TI - [Structural dynamics of morbidity at the psychiatry departments of the Gh. Marinescu Hospital in 1967 and 1987]. PMID- 2781204 TI - [Papaverine and erectile disorders]. PMID- 2781205 TI - Factors affecting compliance in the NASA/Johnson Space Center fitness programme. PMID- 2781206 TI - [Changes in the antibacterial activity of nitrofurantoin preparations induced by peptone and hydrolysates]. AB - The determination of the activity of the product nitrofurantoin (10 and 100 mcg) versus 324 strains of Gram-negative bacteria showed that the diameter of the inhibition zones and the MIC values on a medium with a definite composition (7SG) are considerably larger than on the Mueller-Hinton (MH) medium, in the bacto tryptose (BT) medium. An increase with 8-12 mm phi or with 2-4 binary dilutions changes the interpretation from resistant, on the MH and BT media into sensitive on the 7SG medium. The low results recorded on the conventional media reveal the existence of an antagonism between peptone and nitrofurantoin, similar to that known for sulfamides. The authors believe that the peptone antagonism has hindered the knowledge of the activity of the nitrofurfural derivatives and the correct assessment of the bacteria sensitivity. They also consider questionable the elimination tendency of the small dosage of microtablets of nitrofurantoin (10 mcg) and sulfamide (30 mcg), since their apparent insufficiency might be due less to the inadequate contraction of substances and more to the inadequate testing media. The results plead for the use of the media with definite chemical composition sulfamide and nitrofuran antagonists free and for reconsideration of several methodologic problems: use of the media with definite chemical composition; introduction of an intermediary dosage of maximum 100 mcg/microtablet; reassessment of the sensitivity categories for sulphafurazole and nitrofurantoin. PMID- 2781207 TI - [The risks of transmitting viral hepatitis in a section of the city of Bucharest]. AB - The authors of the present paper consider that 82.3% of all cases of viral hepatitis in a Bucharest district were transmitted nonparenterally and only 17.7% were transmitted parenterally. They used the information on the way and mode of transmission, recorded in the epidemiologic investigations, of the cases of viral hepatitis without HBsAg in 1987 and of those with HBsAg in 1983-1987, respectively. The highest values of the risk of catching the disease were calculated for the infective social contact in family, in the viral hepatitis with HBsAg (60.9%), and for the infective social contact in collectivities (46.4%) in the viral hepatitis without HBsAg. These data have to be checked up by prospective epidemiologic studies, randomized and controlled. PMID- 2781208 TI - [The incidence of Hymenolepis nana infestation in Dolj County]. AB - The present paper reports on the incidence of the Hymenolepis nana cestode in the Dolj County, in 45,725 cases, in the polyclinic and hospital, between 1985 and 1987, with several variation, on age-groups and as a function of sex. Our remarks, made during this period and on the whole group of the subjects investigated in the polyclinic and hospital show the low incidence, of 2.34% of Hymenolepis nana, versus 97.16%, a value found for the following parasites investigated: Giardia lamblia, Entamoeba coli, Enterobius vermicularis, Ascaris lumbricoides and Trichuris trichiura. Mention should be made that this incidence has been increasing since 1985, when it recorded 28.21%. In 1986 this value reached 36.63%, and in 1987 it remained almost the same, 35.25%. Analysis of the seasonal evolution of hymenolepiasis shows a maximum during autumn and a minimum during winter in the polyclinic, and also during spring in the hospital. Increase or diminution of the incidence of this parasitosis, irrespective of season, is a function of the age group and of the children's sex: the male sex was is prevalent in the hospital and the female sex in the polyclinic (in 1987). The greater incidence of Hymenolepis nana in the adult requires the investigation of his immunity state. PMID- 2781209 TI - [Surveillance and control of occupational contamination by the human immunodeficiency virus. Possible prevention measures]. PMID- 2781210 TI - Give us your tired, your poor, your huddled masses. PMID- 2781211 TI - Message to Rhode Island physicians. PMID- 2781212 TI - Health screening of a RI Cambodian refugee population. PMID- 2781214 TI - The influence of the caudal process on the formation of septal deformities. AB - The aim of the paper was to confirm the variations in the length of the caudal process and its relationship to the skull shape (occipitopetal or frontopetal) in various pathological septal deformities according to Mladina's classification. The length of the caudal process was measured during septal surgery in a group of 46 patients suffering from nasal obstructions caused by septal deformities. Measurements were made with an indirect method: the distance between the lower anterior rim of the pyriform aperture and the deepest point of the caudal process, which could still be surgically prepared, was taken as a function of its length (so called X-value). To establish the skull shape lateral cranial X-rays were made for each patient. Certain types of septal deformities were found to be more frequent in patients with longer caudal processes (type 2 and 5), than in cases when they were shorter (type 1 and 6). Twentyseven out of 46 patients were found to have frontopetal skulls, and X values were smaller than 3 cm. The occipitopetal skull shape was found in 19 patients whose values exceeded 3 cm. Caudal process and the skull shape, therefore, may affect development of particular types of septal deformities. Even more, it can be presumed that the septal response to trauma will depend upon some of these factors. PMID- 2781213 TI - Nasal surgery: does the type of nasal pack influence the results? AB - A prospective study was performed on 106 patients undergoing routine nasal surgery to compare the influence of three different packing methods on the final outcome. Pneumatic balloons were found to cause persistent nasal obstruction and an increased incidence of adhesion formation, while lubricated ribbon gauze was more uncomfortable for the patient. Glove finger packs were associated with the least problems. PMID- 2781215 TI - A vascular leiomyoma of the ethmoid. Report of case. PMID- 2781216 TI - Improvement of the nasal airflow by the nasal dilator Nozovent. PMID- 2781217 TI - Hyperreactivity of the nasal mucosa--which drug, when and how? PMID- 2781218 TI - Nasal obstruction in the neonate. AB - At birth, the neonate is an obligate nasal breather and any compromise of the nasal passages is potentially life threatening. It is important for the otorhinolaryngologist to quickly recognize and manage even subtle constrictions or obstructions of the nasal passages in this age group. Many times the nasal airway is disregarded as the source of airway difficulty if small catheters can be passed. Conversely, the inability to pass nasal catheters is often arbitrarily diagnosed as choanal atresia or stenosis. This limited outlook can delay appropriate therapy. The differential diagnosis of nasal obstruction in the neonate is presented wit emphasis on evaluation of nasal obstruction in anatomically normal appearing noses. PMID- 2781219 TI - Secretory leukocyte protease inhibitor in normal, allergic and virus induced nasal secretions. AB - Secretory leukocyte protease inhibitor (SLPI) and alpha-1-proteinase inhibitor (alpha-1-PI), both inhibitors of granulocyte elastase, were studied in nasal secretions from healthy persons and from patients with allergic rhinitis and common cold. SLPI and granulocyte elastase were found in all samples, while alpha 1-PI was lacking in several. In all three groups SLPI was found in an active form and in excess of granulocyte elastase, which thus was completely inhibited. The results indicate that SLPI is the main inhibitor in nasal secretions and that alpha-1-PI plays a minor role. PMID- 2781220 TI - Hydrophobicity and lectin affinity of alkaline phosphatase isozymes in seminoma and normal testis. AB - Isozymes of alkaline phosphatases (ALP) in seminoma and normal testis were separated by use of high-performance liquid chromatography and a TSK-gel phenyl 5PW column. The tissue-nonspecific (liver) ALP (LAP) was the dominating isozyme, consisting of more than 90% ALP activity. The placental ALP (PLAP)-like enzyme contributed to 4-8% of the total ALP activity. The intestinal isozyme (IAP) could not be identified. The glycosylation patterns of the isozymes were studied using concanavalin A (Con A) affinity chromatography and batch elution with competing sugar. All PLAP activity in placental extracts and LAP activity in liver extracts was bound to Con A-Sepharose. In the tumor extracts, only 50-70% of the PLAP-like enzyme and 20-50% of the LAP activity from seminomas were bound to Con A Sepharose. A similar binding pattern of the PLAP-like enzyme and LAP was also seen in the normal testes. This variability in Con A reactivity with PLAP or the PLAP-like enzyme was also reflected in serum of seminoma patients and of pregnant women. Thus, ALP expressed in seminoma has different lectin affinity characteristics compared with the same isozyme from placenta and liver, but almost identical to ALP in the normal testes. These findings imply that the PLAP like enzyme and LAP in the testis can be discriminated from PLAP of placenta and LAP of liver by carbohydrate lectin affinity. It also supports the concept that the increased amounts of ALP in seminomas result from the enhanced eutopic expression of enzymes normally expressed in the testis. PMID- 2781221 TI - Electrophoretic heterogeneity of alkaline phosphatase isozymes in seminoma and normal testis. AB - Electrophoretic patterns of seminoma- and normal-testis-derived alkaline phosphatase isozymes, the placental alkaline phosphatase (PLAP)-like enzyme and the tissue-nonspecific (liver) alkaline phosphatase (LAP), were studied on starch gel and isoelectric focusing (IEF). Different migration patterns of the PLAP-like enzyme were observed with respect to both seminomas and normal testes on starch gel electrophoresis. On IEF, seminomas showed different staining patterns among different tumors; however, a common main activity was focused at pIs of 4.3-4.6, corresponding to pIs of PLAP. Normal testes showed two enzyme-staining regions, at pIs of 4.1 and 5.0-5.2, which were discriminated from pIs of PLAP and the PLAP like enzyme in seminoma. The PLAP-like enzyme in seminoma was differentiated from PLAP by digestion with neuraminidase. Neuraminidase treatment simplified the distribution patterns of the PLAP-like enzyme in normal testis, but did not alter the pattern of microheterogeneity in seminoma. Two factors other than sialylation, namely structural modification of the carbohydrate moiety and variation of hydrophobicity, were shown to contribute to the microheterogeneity of the PLAP-like enzyme in seminoma. LAP in seminoma and in normal testis also showed marked electrophoretic heterogeneity and differences in pI distributions from LAP of liver. However, the migration patterns after desialylation were very similar to each other. The findings imply that electrophoretic heterogeneity demonstrated in LAP in seminoma and in normal testis is caused by a difference in sialic acid content in the molecule, and the heterogeneity of the PLAP-like enzyme in seminoma is considerable. PMID- 2781222 TI - Nurse to nurse: telephone orders. PMID- 2781223 TI - Mobile breast screening van to serve remote areas of province. PMID- 2781224 TI - HIV testing: to test or not to test. PMID- 2781225 TI - HIV testing: counselling: tips for nurses. PMID- 2781226 TI - Summer sizzle. PMID- 2781227 TI - Daycare dilemma. PMID- 2781228 TI - From the office: what is happening here? PMID- 2781230 TI - The importance of cerebral lesions of vascular origin in the morphopathologic picture of old age dementia. AB - Our study refers to the complex neuropathologic examination of 70 demented patients (40 males and 30 females) above 60 years of age. Proportion of different types of cerebral damage with vascular pathogeny showed that 78% of the vascular dementia cases had as morphological background various aspects of multi-infarct dementia; softenings of variable size and lacunae, associated or not with myelinic rarefactions and pallor specific to subcortical arteriosclerotic encephalopathy; the remaining cases pointed to single anoxic lesion and/or subcortical encephalopathy. Perfect clinico-morphological diagnostic concordance has not always been reached in our sample--as in literature cases--often due to the dementia subtypes overlapping, and to the fact that the same clinical syndrome may show in different cerebral lesions. Likewise, no correlation has been found between lesion type, site or size and clinical picture or dementia course, which was also reported by other authors. On a morphopathogenic basis, we support the view that necrotic lesions of ischemic origin--multi-infarct and lacunar dementias--should be distinguished from myelinic rarefactions and pallor in the white matter, whose pathogeny is still controversial. Due attention is paid to the importance of the venous factor in the development of subcortical encephalopathy. PMID- 2781229 TI - Adenohypophyseal hormones and catecholamines in patients with diencephalic pathology. AB - The study involved 75 patients with diencephalic pathology (58 females and 17 males, mean age 39 years). All patients underwent thorough somatic and neurological check up and examination of the autonomic nervous system as well. The etiology was considered to be infection in 60 patients (60%) and brain injury in the other 15 (20%). Paroxysmal disturbances were established in 23 patients, while in the other 52, the clinical manifestation had a permanent course. Changes in adenohypophyseal (TTH, GH, FSH, LH, ACTH and RRL) hormones were established and for mean basal plasma levels of FSH these changes were statistically significant (p less than 0.05). Catecholamine metabolism was impaired in the patients with diencephalic pathology, manifested by elevation of the urinary levels of dopamine, noradrenaline and adrenalin. The role of adenohypophyseal hormones and catecholamines for the pathogenesis of diencephalic dysfunctions is discussed. PMID- 2781232 TI - A rare case of haemangioblastoma of the medulla oblongata with atypical clinical course. AB - An autopsy case of haemangioblastoma of the medulla oblongata is presented. The clinical course was atypical and suggested a.l.s., demyelinization process of the CNS, or systemic disease. Two years before, paresis of IX, X, XII cranial nerves, left-side paresis and positive extensor plantar responses had been found. Pathological EEG recordings from both temporal regions with more pronounced changes on the left side had been observed too. In this case, we have not found any other tumours apart from that in the medulla oblongata. PMID- 2781231 TI - Personality traits of psychotic and nonpsychotic depressive patients. AB - Personality traits of 46 psychotic depressive patients (PD) were compared with those of two matched control groups of nonpsychotic endogenous (NPED) and nonpsychotic nonendogenous (NPNED) depressive patients. Discriminant analyses using personality variables point to more marked differences between PD and NPNED patients than between PD and NPED ones. PD and NPNED groups had opposite traits on the bipolar personality scales of obsessionality vs. hysteria and self sufficiency vs. group dependence; anxiety, present in both groups, was more pronounced in the NPNED patients. The dependence, introversion and prominent obsessional traits were the distinctive attributes of PD patients when compared with NPED patients. The results are discussed in terms of the two alternative hypotheses concerning psychotic depression: one considering delusions as a function of depression severity and the other as a distinct pathological trait. Our data do not support the exclusive validity of either of these two models. PMID- 2781233 TI - Intracerebral hematoma as the complication of the surgical removal of chronic subdural hematoma. Case report. AB - The authors present a case of spontaneous intracerebral hematoma which developed after evacuation of chronic subdural hematoma. Possible mechanisms of the development of this rare complication are discussed. PMID- 2781234 TI - The prognostic value of ventricular rupture in cerebral hemorrhage. AB - Analysis of 41 cerebral hemorrhage cases associated or not with intraparenchymatous hematoma and ventricular rupture shows the role played by these associated phenomena in the evaluation and prognosis of these patients. The death rate was 56.25% in simple cerebral hemorrhage, 100% in hemorrhage associated with hematoma, 30.76% in hemorrhage associated with ventricular rupture and 80% in hemorrhage associated with hematoma and ventricular rupture. The authors point out that the mere presence of ventricular rupture is not a really aggravating factor. A particular severity resulting from association of hemorrhage with hematoma seems to be due to the extension of the cerebral lesion produced by the two conditions associated. PMID- 2781235 TI - Effects of oral S-adenosyl-L-methionine on hepatic glutathione in patients with liver disease. AB - S-Adenosyl-L-methionine (SAMe) is a physiologic precursor of thiols and sulfurated compounds, which are known to be decreased in patients with liver disease. The effect of its administration on the hepatic glutathione content of liver patients was investigated. Four groups of subjects were selected: a) 9 patients with alcoholic liver disease treated with SAMe (1.2 g/day orally for 6 months); b) 7 patients with non-alcoholic liver disease treated as above; c) 8 placebo-treated patients with alcoholic liver disease; and d) 15 normal subjects as a control group. Total and oxidized glutathione were assayed by high performance liquid chromatography of liver biopsy specimens before and after the treatment period. In all patients pre-treatment hepatic glutathione was significantly decreased as compared with controls. SAMe therapy resulted in a significant increase of hepatic glutathione levels both in patients with alcoholic and in those with non-alcoholic liver diseases as compared with placebo treated patients. SAMe may therefore exert an important role in reversing hepatic glutathione depletion in patients with liver disease. PMID- 2781236 TI - The value of a follow-up programme after radical surgery for colorectal carcinoma. AB - To evaluate the effectiveness of a follow-up programme after curative surgery for colorectal carcinoma, a 10-year series of 402 patients was surveyed for the detection rate of potentially curative recurrences and metachronous neoplasms. There were 120 recurrences (30%), and 100 of them (83%) were detected at scheduled check ups. Initial suspicion of recurrence was most often based on physical examination, carcinoembryonic antigen assay, or sigmoidoscopy. Reoperation was undertaken in 62 patients, in 26 cases (22%) for cure. The 5-year survival was 48% after curative reoperations. Metachronous adenomas and carcinomas occurred in 38 and 11 patients, respectively, giving corresponding cumulative 5-year incidences of 13% and 3.8%. Altogether, 37 patients (9.2%) had a curative reoperation for recurrent or metachronous carcinoma, and a further 38 patients (9.5%) had adenomas removed by polypectomy. It is concluded that regular follow-up is useful for the patients, and the follow-up schedule must be planned to detect both early recurrences and metachronous neoplasms. PMID- 2781237 TI - Follow-up study of erosive prepyloric changes. AB - A follow-up study of erosive prepyloric changes (EPC) was undertaken in 60 patients who originally presented with non-ulcer dyspepsia and EPC grade 2 or 3. After 45 (range, 24-60) months EPC grade 2 or 3 was still present in 80% of the patients, and 82% had unchanged dyspeptic symptoms. Most of the patients (77%) experienced a 'stressful' life situation. None of the patients had developed peptic ulceration during the follow-up period, and there were no indications of active or healed ulcerations or cancer at the follow-up study. The results indicate that EPC are chronic changes in the gastric mucosa closely associated with long-lasting dyspeptic symptoms. PMID- 2781238 TI - Gastric aspiration versus antimony and glass pH electrodes. A simultaneous comparative in vivo study. AB - To carry out a simultaneous comparison of the 24-h in vivo performance of antimony and glass electrodes and the findings of intermittent gastric aspiration, a triple-probe system with closely adjacent tips was positioned in the gastric corpus of 10 subjects representing different clinical and pharmacologic conditions. We showed that pH values measured with the antimony and the glass units were well correlated to those assessed in gastric aspirates (rs = 0.87; b = 1.079; a = -0.33; and rs = 0.85; b = 1.121; a = -0.38, respectively). A proportional correlation (rs = 0.86; b = 0.97; a = 0.02) was also found between the two intraluminal pH measurements. With regard to the error frequency distributions obtained by comparing the three measuring systems two at a time, the pH pairs differed by no more than 1 pH unit in most cases (greater than 90%). It can be concluded that antimony and glass pH electrodes can be used interchangeably in 24-h intragastric acidity studies in man. PMID- 2781239 TI - Predictors for the course of chronic non-organic upper abdominal pain. AB - A group of outpatients with chronic non-organic upper abdominal pain was followed up 5-7 years after the index investigation, to evaluate the predictive value of several variables on the basis of a questionnaire and a laboratory pain study. Fifty-four per cent had symptoms of irritable bowel syndrome. A low pain tolerance measured with an ischemic pain technique significantly predicted a poor course of the disease (P = 0.03). So did a high score indicating psychic vulnerability (P = 0.02) and two social factors: poor school and vocational education (P less than 0.01). Without significant predictive value were level of abdominal pain rated on a visual analogue scale, length of dyspepsia history, bowel habits, relation of pain to meals and to life events, heartburn, headache, back pain, dysmenorrhea, paresthesias in fingers or feet, present occupation, sex, marital status, days absent from work because of the disease, and consumption of tranquilizers, cigarettes, and alcohol. The findings indicate that psychologic factors and a low pain tolerance may be elements in this poorly understood syndrome. This is supported by earlier findings of a decreased pain tolerance and an elevated psychologic score in this group compared with controls. PMID- 2781240 TI - Studies of the release of gastrin from the human duodenum induced by gastrin releasing peptide. AB - In the present study the influence of duodenal exclusion and vagotomy on basal release of gastrin from extra-antral stores has been investigated in addition to the consequences of these procedures on the gastrin response to gastrin-releasing peptide (GRP) infusion. Basal gastrin concentrations and the response to GRP were measured in seven patients after a Whipple operation, in seven patients after antrectomy combined with selective gastric vagotomy and B I reconstruction, in seven patients operated on with antrectomy, selective gastric vagotomy, and Roux en-Y reconstruction, and finally in seven patients after antrectomy, truncal vagotomy, and Roux-en-Y reconstruction. Gastrin was measured by a highly specific radioimmunoassay. Very low concentrations were obtained after a Whipple operation, and no increase followed GRP infusion. The basal gastrin concentrations were slightly higher in antrectomized patients, irrespective of whether a selective gastric vagotomy had been added. However, in these patients a significant gastrin response followed GRP infusion. Duodenal exclusion seemed not to influence the response to GRP. On the other hand, extragastric vagotomy was followed by low gastrin concentrations in the basal state and only a marginal response to GRP administration. These results strongly suggest that GRP releases gastrin from the human duodenal mucosa and that duodenal exclusion does not alter the response of the duodenal gastrin cells to GRP stimulation. Vagal denervation of the duodenal mucosa seems to suppress the gastrin response to GRP, indicating an excitatory influence of the vagus nerve. PMID- 2781241 TI - Evidence of the intact hepatocyte theory in alcoholic cirrhosis. AB - To improve our understanding of the predominant operational model involved in the decreased clearance in cirrhosis, hepatic clearance, the extraction ratio of indocyanine green, and liver plasma flow were estimated in cirrhosis, either with a method based on the Fick principle or with a pharmacokinetic method assuming a bicompartmental plasma elimination of the dye. The two methods gave similar values for clearance. In contrast, the pharmacokinetic analysis gave significantly (p less than 0.01) lower hepatic plasma flow values and significantly (p less than 0.01) higher extraction values than those obtained with the reference (Fick principle) method. The main finding of this work is that in these cirrhotic patients, as in normal subjects, 'cellular' extraction estimated by the pharmacokinetic method is in the range of 0.60-0.80, whereas the extraction by the entire liver, assessed by the reference method, is low. In chronic liver diseases such as cirrhosis these data support the predominance of the intact hepatocyte theory, which assumes the existence of intrahepatic shunts associated with normally perfused and normally extracting hepatocytes. In acute liver disease, a cellular damage could be superadded. PMID- 2781244 TI - XXII Scandinavian Conference on Gastroenterology and XIII Scandinavian Meeting on Gastrointestinal Endoscopy. Umea, Sweden, June 1-3, 1989. Abstracts. PMID- 2781242 TI - Malignancy in ulcerative colitis. AB - All patients with ulcerative colitis referred to Rigshospitalet, Copenhagen, from 1 April 1964 to 1 January 1983 (18 years and 9 months) were studied from time of referral until death, proctocolectomy, or end of the study (1983). There were 759 patients, 423 females (56%) and 336 males (44%). None was lost to follow-up study. Median time from onset of disease until death, proctocolectomy, or end of the study was 11 years (range, 0-54 years). Median age at onset was 28 years (range, 0-83) among the males and 28 years (range, 4-83) among the females. Pancolitis was present in 312 patients (41%), left-sided colitis in 212 (28%), and haemorrhagic proctitis in 235 (31%). Surgical treatment was performed in 299 patients (39%): proctocolectomy in 197 (26%), colectomy with occluded rectal stump in 72 (9%), and colectomy with ileorectal anastomosis in 30 (4%). Altogether, 49 patients developed cancer, 20 being intestinal and 29 extraintestinal cancer. Compared with the general population matched for age, sex, and calendar time, there was an excessive number with intestinal cancer in both sexes (p less than 0.05). In females the number with extraintestinal cancer was higher than in the general population (p less than 0.01), a finding that has not been reported elsewhere. We found a similar, significantly increased incidence of extraintestinal cancer in females with Crohn's disease in a previous report. We found no increased risk of colorectal cancer in patients with early onset of ulcerative colitis. For all age classes we found that the age of appearance of colorectal cancer followed the equation: age at colorectal cancer = 14 + age at onset of ulcerative colitis. We found no higher potential for development of colorectal cancer in patients with pancolitis. In our series the incidence of colorectal cancer in pancolitis and left-sided colitis was equal. The incidence in patients with haemorrhagic proctitis was zero. PMID- 2781243 TI - Pancreatic secretion and the release of cholecystokinin after a meal in dogs with and without exclusion of pancreatic juice. AB - Pancreatic secretion and plasma levels of cholecystokinin-33/39 (CCK) were measured for 5 h after a meal in dogs with and without exclusion of pancreatic juice. Significant and prolonged increases in pancreatic secretion and plasma CCK levels were observed irrespective of pancreatic juice exclusion. The integrated responses of pancreatic protein output (2.6 +/- 0.6 g/300 min), plasma CCK (1.3 +/- 0.5 nmol.l-1 .300 min) with exclusion of pancreatic juice showed no significant differences from those without exclusion (2.8 +/- 0.3 g/300 min and 1.3 +/- 0.3 nmol.l-1.300 min for protein output and CCK, respectively). These results suggest that the CCK-mediated feedback mechanism of pancreatic enzyme secretion does not work, at least not in the postprandial state in dogs. PMID- 2781245 TI - Studies on active immunization with self antigens. I. Production of antibody to unmodified proteins by neonatal immunization. AB - Newborn BALB/c mice were repeatedly injected either with syngeneic (BALB/c) or xenogeneic (bovine) myosin, albumin, or actin in sterile physiological saline. The serum antibody response was evaluated by enzyme immunoassay 1 and 2 months after birth and after two booster injections. At 1 month, higher antibody titres were found in the sera of mice injected with syngeneic than with xenogeneic antigens. At 2 months and after boosting, anti-syngeneic actin antibodies were present in equal or higher amounts, anti-syngeneic albumin antibodies were not detected, and anti-syngeneic myosin antibodies were considerably decreased. Antibodies produced after booster injections of syngeneic actin were found to be highly specific and to belong mainly to the IgG isotype. These results suggest that newborn mice are better able than adult mice to respond to stimulation with self antigens, and that administration of self proteins during neonatal life may lead to the induction of immunological memory. They also indicate that one of the primary functions of the immune system in newborn mice is the recognition of self antigens. PMID- 2781246 TI - Studies on active immunization with self antigens. II. Production of antibody related to hapten substitution. AB - BALB/c mice were injected during neonatal life with conjugates in buffered physiological saline, prepared by coupling trinitrophenyl groups (TNP) at various densities to either syngeneic mouse serum albumin (TNP-MSA) or xenogeneic bovine serum albumin (TNP-BSA). Serum samples were obtained on days 30 and 60 after birth, on days 75 and 88 after two booster injections, and monoclonal antibodies were prepared from spleens of neonatally treated mice. The antibody titres, isotypes, and specificities were evaluated by enzyme-immunoassay. It was found that the extent of the anti-TNP immune response to TNP-MSA conjugates depends on the degree of hapten substitution, which is not the case for the anti-TNP-BSA. All the TNP-MSA conjugates induced mainly IgG and only a few IgM antibodies. These antibodies reacted essentially with the TNP group but seemed to have a higher avidity for the TNP-protein conjugate used in their induction. During the course of the immunization, decreasing quantities of TNP-MSA conjugates were needed to inhibit antibody binding. A large amount of monoclonal anti-TNP antibodies was found in hybridomas obtained after neonatal treatment either with TNP-MSA or TNP-BSA. Therefore, it appears that the anti-TNP immune response obtained after antigenic stimulation with sufficiently substituted TNP-MSA conjugates possesses all the characteristics of a normally occurring humoral immune response. PMID- 2781247 TI - Complement activation is associated with the presence of specific human immunodeficiency virus (HIV)-anti-HIV immune complexes in patients with acquired immunodeficiency syndrome-related complex or lymphoadenopathy syndrome. AB - The complement system was examined in a group of eight patients (six with lymphoadenopathy syndrome (LAS); two with acquired immunodeficiency syndrome (AIDS)-related complex (ARC], who were found to be human immunodeficiency virus (HIV)-positive, for the presence of specific HIV-anti-HIV complexes. A significant impairment of the classical and/or alternative pathway was found associated with the presence of cleavage fragments of C3 and/or B and a significant reduction in the complement factors studied. Ultracentrifugation fractions of serum samples obtained from one of the patients were assessed for the detection of specific HIV-anti-HIV (GP41-anti-GP41) complexes and were incubated with normal human serum to determine their complement activation capacity. A clear complement activation was found with the fraction in which a clear peak of HIV-anti-HIV (GP41-anti-GP41) immune complexes was present. The results demonstrate that specific immune complexes and complement activation are sometimes concomitantly present in patients with AIDS-related disease and that specific immune complexes may be one of the causal factors of the pathogenesis of complement activation in these patients. Possible consequences for the severe immune regulation with relevance to the dramatic failure in treating the virus effectively are discussed. PMID- 2781248 TI - Respiratory health of brickworkers in Cape Town, South Africa. Symptoms, signs and pulmonary function abnormalities. AB - The respiratory health of 268 brickworkers in five brickworks was investigated by means of a questionnaire, a physical examination, and pulmonary function testing. The prevalence of respiratory symptoms ranged from 7% for chronic bronchitis to 52% for morning cough to 27% for both chest tightness and wheeze and 9% for dyspnea at effort. A stepwise logistic regression analysis showed the symptoms to be significantly predicted by combinations of smoking and exposure to dust, while a multiple linear regression showed an effect of dust exposure on forced vital capacity and forced expiratory volume in 1 s but no smoking effect. Smoking generally had less of an effect than dust and predicted early/mild symptoms only. PMID- 2781249 TI - Respiratory health of brickworkers in Cape Town, South Africa. Radiographic abnormalities. AB - A cross-sectional study utilizing internal controls based on dust exposure determinations was performed on 268 brickworkers. Smoking, age, and other information from a detailed respiratory questionnaire and results from a physical examination and pulmonary function tests were investigated in relation to radiographic abnormality. The prevalence of pneumoconiosis was near 4%. The roles of smoking, workplace dust exposure, and age as factors predicting radiographic abnormality are discussed. PMID- 2781250 TI - Cancer risk in a cohort of licensed pesticide users. AB - First admissions to the hospital among 25,945 men living in southern Piedmont and holding a license authorizing them to use pesticides were analyzed in a study of the cancer risk related to exposure to pesticides. Standardized incidence ratios significantly higher than one were encountered for malignant skin cancers and lymphomas. The risk of lymphoma was particularly high in predominantly arable areas. The standardized incidence ratios for tumors of the nervous system and hematopoietic tissue showed an interesting age-related pattern and a higher risk in areas primarily devoted to forest tree plantation, but did not reach significance. Certain hypotheses are advanced to explain these findings. PMID- 2781251 TI - Absence of toxic effects in silver reclamation workers. AB - Recent reports have alleged that silver presents a toxic hazard to exposed workers. To define the potential risks of long-term exposure to silver better, a cross-sectional investigation was conducted of 27 Caucasian males occupationally exposed to primarily insoluble silver compounds and 27 matched referents. Physical examination and electron microscopy of skin biopsies revealed no cases of generalized argyria. Measurements of facial discoloration, judged from color photographs by panels of laymen and physicians, showed no significant difference between the two groups. Although 29% of the silver workers and none of the referents exhibited ocular silver deposition, optometric and contrast sensitivity test results revealed no significant deficits in visual performance. The kidney and respiratory findings were essentially normal in both populations. Despite the increased presence of silver in the blood, feces, and hair of the recovery workers versus the referents, there was no evidence that chronic silver exposure adversely affected the health of these employees. PMID- 2781252 TI - Time to pregnancy among Danish pharmacy assistants. AB - Time to pregnancy was studied as a parameter of couple fertility in a national cohort of all female members (less than 40 years) of the union of pharmacy assistants from 1979 to 1984. A total of 4 924 women were included in the study. Information on time to pregnancy and exposure was obtained by postal questionnaires in April 1985 (response rate 92%). Prolonged time to pregnancy according to occupation in production or a dispensary or in product control, bottling, and packing is presented, unexposed pharmacy assistants being used as referents. It was possible to use time to pregnancy in an occupational setting as 95% of the women were able to state their time to pregnancy and as 90% of all pregnancies were planned. No association was found between type of work or pharmacy and time to pregnancy, but pharmacy assistants exposed to antibiotics had a slightly increased risk of prolonged time to pregnancy. PMID- 2781253 TI - Pregnancy outcome among working women. AB - The influence of occupational factors on the outcome of pregnancy was investigated in a prospective study of 3901 women who worked during their pregnancy and received prenatal care in Orebro County from October 1980 to June 1983. Data on occupational factors, social circumstances, and life-style factors were obtained from questionnaires. There were no significant differences in the incidence of adverse pregnancy outcome (spontaneous abortion, perinatal death, birth defects, or low birthweight) between the nine occupational categories used when nonoccupational factors were accounted for. No increased risk was found for exposure to organic solvents, but the adjusted risk ratio of adverse outcome was 1.28 (95% CI 0.91-1.80) for "other chemical exposures." The work conditions in this county have been generally favorable in recent years, and the results therefore cannot be generalized to conditions with higher exposures. Methodological problems such as misclassification of exposure and the possible bias resulting from different rates of legal abortions among occupational groups are discussed. PMID- 2781254 TI - Isocyanate exposure and hypersensitivity pneumonitis--report of a probable case and prevalence of specific immunoglobulin G antibodies among exposed individuals. AB - A car painter experienced three episodes of a hypersensitivity pneumonitis-like disease after exposure to two-component acrylic lacquers with hexamethylene diisocyanate (HDI) as the curing agent. High titers of HDI-specific immunoglobulin (Ig) G antibodies were found in the patient's serum by means of enzyme-linked immunosorbent assay (ELISA). In the ELISA, 5 to 10% of the sera from 455 isocyanate-exposed but asymptomatic workers were positive, depending on the criterion used for a positive test, whereas 0% of the sera from 157 unexposed referents was found to be positive. Among 10 subjects with isocyanate-induced asthma and isocyanate-specific IgE antibodies, 50% had specific IgG. It was concluded that the presence of isocyanate-specific IgG antibodies in serum is correlated with isocyanate exposure rather than with symptoms of isocyanate induced disease. PMID- 2781255 TI - Menstrual disorders among dry-cleaning workers. PMID- 2781256 TI - Who's minding the store? Central gene-research facility is nearly lost in NIH shuffle. PMID- 2781258 TI - Sudden impact. Why a little heart disease can be worse than a lot. PMID- 2781257 TI - First impressions. Genes from mother don't equal genes from father. PMID- 2781259 TI - Status symbol. Affluent women have cesareans more often than poor women do. PMID- 2781260 TI - The mitotic spindle. PMID- 2781261 TI - The piscine bioconcentration characteristics of cyclic and linear oligomeric permethylsiloxanes. AB - Using a conventional "resaturation" method whereby aquarium water was continuously passed through a column containing sand or fine glass beads coated with cyclic and linear permethylsiloxanes, their uptake levels by rainbow trout and fathead minnows have been compared. Because of the uncertainty associated with defining the actual aqueous concentrations of such poorly soluble substances, this study was focused on defining the "attainable uptake" levels from saturated solutions rather than precise definition of actual bioconcentration factor values. Although cyclic Me2SiO-oligomers accumulated to a greater extent in fish than did comparable linear oligomers, uptake decreased sharply with increasing molecular weight. Thus, in the cyclic series (Dx), order of magnitude decreases were observed for each incremental molecular weight increase; i.e., for the compounds D4, D5, and D6 uptake levels of approximately 200, 20 and 2 ppm, respectively, were observed. Uptake of D8 was below our detection limit of 300 ppb. In the linear series, uptake of the tetramer MD2M was an order of magnitude less than observed for D4 and little or no uptake (i.e., less than 0.5 ppm) was observed for MD3M, MD4M and MD7M. The branched oligomer M3T exhibited levels comparable to its unbranched isomer MD2M, while M4Q was more comparable to the D6 uptake of 1-2 ppm. Very similar uptake levels of D5 resulted with and without a surfactant, even though the surfactant afforded a 20-fold increase in the D5 content of the water. This suggests that bio-availability is defined by the amount present in true solution as individual molecules and is not affected by the presence of aggregates or micelles. The highly inverse relationship observed in this study between uptake and molecular weight is strongly supportive of earlier estimates of a limiting molecular weight of about 600. These findings also strongly contradict a recent Japanese study, which concluded that bioconcentration not only occurred but actually increased with molecular weight in a series of commercial polydimethylsiloxane fluids. Also contrary to a recently published inference of biotransformation in fish, no evidence for such phenomena was observed in this study. PMID- 2781262 TI - Temporal and spatial variations of the Vienna aerosol. AB - For several intensive sampling periods the mass concentration, light extinction, light scattering and light absorption coefficients, and the mass size distribution of the aerosol have been determined at up to eleven location in the non-industrial town of Vienna. Obviously, large variations of the measured values have been found. The following factors influenced the aerosol markedly: wind speed, wind direction, increased aerosol production such as by space heating or traffic and resuspension. Most of the variations in aerosol were found to be caused by these factors. A comparison of the mass concentration and light absorption of the aerosol upwind and downwind of Vienna permitted the estimation of locally produced aerosols: about 50% of the mass of the aerosol and 75% of the light-absorbing aerosol appears to be produced locally. PMID- 2781263 TI - The assessment of air and soil as contributors of some trace metals to vegetable plants. I. Use of a filtered air growth cabinet. AB - The sources of heavy metals in a number of consumer crops were investigated in the laboratory by growing plants in a dual growth cabinet supplied with both clean and ambient air. Under these conditions, plants were exposed separately to filtered and normal ambient air to assess the influences of soil and atmosphere on the accumulation of Cd, Pb, Zn, Cr and Ni. Radish, carrot, pea, spinach and lettuce plants were successfully grown in the cabinet. Analysis of the metals in the plant tissues showed that the foliar route is potentially of similar importance to the soil-root pathway as a route of transport to the exposed parts of the plants. Whilst the exposed parts showed the highest metal accumulation from the air, the levels of metals in fruits and storage roots resulting from foliar translocation of the airborne component appeared to be low generally. The metal which achieved highest translocation from foliar deposition was Pb. The effect of spraying plants with rain-water was to enhance slightly the total content of all trace metals analysed. PMID- 2781264 TI - The presence of chlorophenols and their conjugates in Finnish human adipose and liver tissues. AB - The concentrations of 2,4,6-trichlorophenol, 2,3,4,6-tetrachlorophenol, pentachlorophenol and their conjugates were analysed in tissues of 58 people from the southern and northern parts of Finland, none of whom were known to be occupationally exposed. The tissue samples consisted of 44 adipose and 13 liver samples. The ages of the donors varied from 3 months to 91 years. Only very small residues of chlorophenols were found: the median concentration of tetra- or pentachlorophenol in adipose tissue samples was 0.002 micrograms g-1 fat, ranging from a trace amount to 0.031 micrograms g-1, while none of the samples contained measurable amounts of trichlorophenol. In liver samples, the median concentration of pentachlorophenol was 0.004 micrograms g-1. Only two liver samples were positive for tetrachlorophenol and none for trichlorophenol. The age, smoking habit or fish intake of the donor did not have any relation to the chlorophenol concentration found in the tissue sample. PMID- 2781265 TI - Contribution of SO2 sorption on particulate surface to the air pollution level in the vicinity of coal-fired power plants. AB - The area under study is influenced by three lignite-fired power plants. The distribution of SO2 concentrations in the air over the area has been calculated. The calculations include SO2 sorption on the surface area of the emitted particulates--stack dust and fly ash. The surface sorption process has been investigated on a laboratory scale. PMID- 2781266 TI - Uptake of 210Pb and 210Po by Brazilian Bunodosoma caissarum Correa, 1964 (cnidaria, actinidae). AB - Bunodosoma caissarum, a carnivorous marine species exclusive to the Brazilian southern coast, recognized as a sensitive bioindicator of artificial radioactive pollution, also shows a great capacity for concentrating natural alpha-emitters. The authors have measured the alpha-emitters 210Po and its precursor 210Pb in this animal. The average concentrations found are greater (by a factor of 4.6) for 210Po measured in samples gathered on Ponta Negra Beach (protected outer coast) than the values obtained in specimens collected on Boa Viagem Beach (closed bay) along the Rio de Janeiro coast, Brazil. The same was also found for 210Pb (a factor of 2.5). PMID- 2781267 TI - The assessment of air and soil as contributors of some trace metals to vegetable plants. II. Translocation of atmospheric and laboratory-generated cadmium aerosols to and within vegetable plants. AB - Radish, spinach and lettuce were grown in the field on 109Cd-labelled soil. Efficient transfer to the plant was observed with concentration factors [Cd concn. in plant (dry wt) divided by Cd concn. in soil (dry wt)] of between 0.30 and 2.00. Soil uptake of Cd accounted for only 69-64% of Cd in the plants, the remainder arising from atmospheric deposition. By fumigating radish, lettuce and carrot with Cd aerosol in a wind tunnel and harvesting and analysis subsequent to further growth, translocation of Cd to non-exposed parts of plants was demonstrated. The percentage of deposited Cd which is translocated in the wind tunnel-fumigated plants is small (0.6-4%), but is larger in plants grown in the field (28-36%) or in a laboratory growth cabinet (12-35%). PMID- 2781268 TI - The assessment of air and soil as contributors of some trace metals to vegetable plants. III. Experiments with field-grown plants. AB - Plants have been grown on common soils at a number of field sites with differing air metal concentrations. Moss bags were co-located with the plants to evaluate atmospheric deposition. Values of the concentration factor (CF) have been estimated (soil-derived metal in plant divided by soil metal concentration) and are generally found to be in the order Zn greater than Cd greater than Ni greater than Cr greater than Pb (sometimes Cd greater than Zn), with values for Pb comparable with earlier studies in which the atmospheric contribution was subtracted. Values of the air accumulation factor (AAF) (air-derived metal in plant divided by air metal concentration) showed values of 15-30 m3g-1 for Cd and Pb for the exposed parts of plants, and lower values for non-exposed parts. Values of both CF and AAF are comparable with those determined in Part I, using a laboratory growth chamber. PMID- 2781269 TI - The accumulation of organotins in adult and seed oysters from selected estuaries prior to the introduction of U.K. regulations governing the use of tributyltin based antifouling paints. AB - Between April and November, 1985, a study of the levels of organotins in adult and seed Crassostrea gigas grown in the southwest and southeast of England was carried out. This work corresponds with a similar study of organotin water levels (reported separately). The analytical procedure used was directly coupled high performance liquid chromatography-flame atomic absorption spectrometry. Individual adult oysters and groups of 20-40 seed oysters were taken for analysis on a monthly basis. The profiles of tributyltin (TBT), dibutyltin (DBT) and monobutyltin (MBT) are discussed in relation to each other and levels found in the waters. In general, levels of all three organotin species were found to be higher in the seed oysters. Mean levels of TBT reached 3.1 micrograms g-1 in seed oysters from the Exe, Devon, in October, whereas mean levels of DBT and MBT reached 16.1 and 16.7 micrograms g-1 in Teign, Devon, seed oysters in October. Bioconcentration factors of approximately 1000 were found, but seem to be greater when lower levels of TBT were present in the water, perhaps indicating a more 'efficient' removal from the water. The degree of shell thickening was calculated for all oysters submitted for analysis. The highest percentage of adult oysters with severely thickened shells was found at Tollesbury Fleet, where 61% of oysters showed shell thickness index values of six or less. Generally, two peaks in TBT levels in the oysters were observed, in the late spring and early summer: these seem to correlate with peak levels of TBT in the waters immediately preceding these times. A large proportion of the DBT and MBT found in the oysters seems to come from the metabolism of the TBT ingested. It is suggested that high sediment loadings may contribute to the severe deformation of oysters grown at Tollesbury Fleet, but only in the presence of TBT. PMID- 2781270 TI - Manganese in scalp hair: problems of exogenous manganese and implications for manganese monitoring in Groote Eylandt Aborigines. AB - The use of scalp hair to monitor manganese was studied as part of an investigation of manganese intoxication amongst a group of Aborigines living on manganese-rich soil on Groote Eylandt, in the Northern Territory of Australia. High scalp-hair manganese values were due largely to manganese from exogenous sources. Manganese (IV) dioxide in dust, trapped in hair, was reduced by the components of sweat, leading to the diffusion of manganese (II) into the hair shaft. At least 15 micrograms Mn g-1 hair could be incorporated into hair via this exogenous route. To overcome the problems of manganese contamination, the ability of a number of leaching agents to remove exogenous manganese selectively from hair was tested. Measurements of manganese along the length of hair strands were extrapolated back to zero length to estimate the amount of manganese in the hair as it emerged from the scalp. Using this extrapolation technique, Aborigines on Groote Eylandt had a mean scalp-hair manganese of 16 ppm. Aborigines in non manganese areas had 2 ppm manganese in hair. Caucasians living in the same manganese-rich area had 2.5 ppm manganese in hair, compared to 0.5 ppm manganese in non-manganese areas. Measurements of manganese in hair and blood of Groote Eylandt Aborigines showed that the population had a high exposure to manganese, but did not distinguish between those individuals affected/unaffected by the neurological condition, Groote Eylandt Syndrome. PMID- 2781271 TI - The biodistribution and toxicity of plutonium, americium and neptunium. AB - In the nuclear fuel cycle the transuranic radionuclides plutonium-239, americium 241 and neptunium-237 would probably present the most serious hazard to human health if released into the environment. Despite differences in their solution chemistry the three elements exhibit remarkable similarity in their biochemical behaviour, apparently sharing similar transport pathways in blood and cells. After entering the blood the elements deposit predominantly in liver and skeleton, where retention appears to be prolonged, with half-times of the order of years. The principal late effects of all three radionuclides are the induction of cancers of bone, lung or liver. For the latter tumours the induction risk per unit radiation dose appears similar for the three radionuclides. But in bone there are indications that, due to microscopic differences in the distribution of the alpha-particle radiation dose, the efficiency of bone cancer induction may increase in the order americium-241 less than plutonium-239 less than neptunium 237. No case of human cancer induced by these radionuclides is known. PMID- 2781272 TI - The solubility and colloidal behaviour of neptunium (IV). AB - The solubility and colloidal particle formation of Np(IV) in 10(-1) M Na2S2O4 solution in the pH range 2-10 were studied by sequential filtration with decreasing filter pore size. With the help of spectrophotometry and an extraction technique, the species remaining in the final filtrate were found to be Np(V) at pH less than 6 and Np(IV) at pH greater than 8; particle species were attributed to Np(IV). The solubility data obtained at pH less than 6 were interpreted using the reaction: Np(OH)4(am)----NpO2+ + e- + 2H2O, log K = -6.7 +/- 0.4 At pH greater than 8, the solubility increased rapidly with increasing pH in the presence of air, and this was interpreted as being due to the formation of the negatively charged species Np(CO3)4x - 2x. The formation constants beta 3 and beta 4 were estimated to be similar to those reported for Pu(IV). The size distribution of colloidal Np(IV) was also obtained. Some simple models used to describe the observed size distributions and to estimate the equilibrium size distributions of colloidal Np(IV) were examined. PMID- 2781273 TI - Investigations of the binding of 239Pu to liver cell membranes. AB - The binding of Pu to liver cell membranes was studied and compared with that of iron with which plutonium shares some physiological properties. The binding of both metals is sensitive to pH changes and they can be dissociated from their binding sites by chelating agents and transferrin. The metal-binding proteins can be extracted with detergents. Both metals have at least two binding sites, the molecular weights of which lie between 150 and 400 kDa; the isoelectric points for iron are 5.5 and 6.5, and for plutonium 6.0 and 6.5. The significance of these results for plutonium uptake into liver cells is discussed. PMID- 2781275 TI - O'Toole's charges. PMID- 2781274 TI - Sleep research. PMID- 2781276 TI - The missing crystallography data. PMID- 2781277 TI - Help wanted: Director, NIH. PMID- 2781278 TI - Old bones solve new problems. PMID- 2781279 TI - Molecular structure of DNA by scanning tunneling microscopy. AB - Uncoated DNA molecules marked with an activated tris(l-aziridinyl) phosphine oxide (TAPO) solution were deposited on gold substrates and imaged in air with the use of a high-resolution scanning tunneling microscope (STM). Constant current and gap-modulated STM images show clear evidence of the helicity of the DNA structure: pitch periodicity ranges from 25 to 35 angstroms, whereas the average diameter is 20 angstroms. Molecular structure within a single helix turn was also observed. PMID- 2781280 TI - The pill of choice? PMID- 2781281 TI - Gene transfer test: so far, so good. PMID- 2781282 TI - Contragestion and other clinical applications of RU 486, an antiprogesterone at the receptor. AB - RU 486, a steroid with high affinity for the progesterone receptor, is the first available active antiprogesterone. It has been used successfully as a medical alternative for early pregnancy interruption, and it also has other potential applications in medicine and for biochemical and pathophysiological endocrine research. PMID- 2781283 TI - Spontaneous vesicle formation in aqueous mixtures of single-tailed surfactants. AB - Spontaneous, single-walled, equilibrium vesicles can be prepared from aqueous mixtures of simple, commercially available, single-tailed cationic and anionic surfactants. Vesicle size, surface charge, or permeability can be readily adjusted by varying the ratio of anionic to cationic surfactant. Vesicle formation apparently results from the production of anion-cation surfactant pairs that then act as double-tailed zwitterionic surfactants. These vesicles are quite stable in comparison to conventional vesicles prepared by mechanical disruption of insoluble liquid crystalline dispersions. PMID- 2781284 TI - Bacterial blight of soybean: regulation of a pathogen gene determining host cultivar specificity. AB - Soybean cultivars resistant to Pseudomonas syringae pathovar glycinea (Psg), the causal agent of bacterial blight, exhibit a hypersensitive (necrosis) reaction (HR) to infection. Psg strains carrying the avrB gene elicit the HR in soybean cultivars carrying the resistance gene Rpg1. Psg expressing avrB at a high level and capable of eliciting the HR in the absence of de novo bacterial RNA synthesis have been obtained in in vitro culture. Nutritional signals and regions within the Psg hrp gene cluster, an approximately 20-kilobase genomic region also necessary for pathogenicity, control avrB transcription. PMID- 2781285 TI - A common language for physical mapping of the human genome. PMID- 2781286 TI - Preventing fraud. PMID- 2781287 TI - Animal experimentation: context of a quote. PMID- 2781288 TI - New game plan for genome mapping. PMID- 2781289 TI - The epilepsy "cure": bold claims, weak data. PMID- 2781290 TI - Drosophila nuclear proteins bind to regions of alternating C and T residues in gene promoters. AB - Proteins from Drosophila nuclei that bind to regions of alternating C and T residues present in the promoters of the heat shock genes hsp70 and hsp26 and the histone genes his3 and his4 have been purified. These proteins bind to isolated linear DNA, and genomic footprinting analyses indicate that they are bound to DNA in nuclei. In supercoiled plasmids at low pH, some of these DNA sequences adopt triple-helical structures which, if they form in vivo, could significantly affect chromatin structure. The nuclear proteins described here, and not necessarily the deformed conformation of the DNA, may be responsible for maintaining a potentially inducible promoter structure before transcriptional activation. PMID- 2781291 TI - Identification of monocyte chemotactic activity produced by malignant cells. AB - Human malignant cells secrete low molecular size proteins that attract peripheral blood monocytes and may be responsible for the accumulation of tumor-associated macrophages observed in vivo. Similar chemotactic proteins are secreted by cultured vascular smooth muscle cells. The predominant monocyte chemoattractants produced by tumor cells of differing origin were demonstrated to be related to smooth muscle cell-derived chemotactic factor. Thus, a single class of chemotactic proteins is produced by different cell types, which suggests a common mechanism for the recruitment of monocytes and macrophages. These results are significant in view of the potential of macrophages to affect tumor growth. PMID- 2781292 TI - Effects of glucocorticoids and norepinephrine on the excitability in the hippocampus. AB - The CA1 pyramidal neurons in the hippocampus contain a high density of adrenal corticosteroid receptors. By intracellular recording, CA1 neurons in slices from adrenalectomized rats have been found to display a markedly reduced afterhyperpolarization (that is, the hyperpolarizing phase after a brief depolarizing current pulse) when compared with their sham controls. No differences were found for other tested membrane properties. Brief exposure of hippocampal slices from adrenalectomized rats to glucocorticoid agonists, 30 to 90 minutes before recording, greatly enhanced the afterhyperpolarization. In addition, glucocorticoids attenuated the norepinephrine-induced blockade of action potential accommodation in CA1 neurons. The findings indicate that glucocorticoids can reduce transmitter-evoked excitability in the hippocampus, presumably via a receptor-mediated genomic action. PMID- 2781293 TI - Corticosteroid modulation of hippocampal potentials: increased effect with aging. AB - Adrenal steroids bind specifically to hippocampal neurons under normal conditions and may contribute to hippocampal cell loss during aging, but little is known about the neurophysiological mechanisms by which they may change hippocampal cell functions. In the present studies, adrenal steroids have been shown to modulate a well-defined membrane conductance in hippocampal pyramidal cells. The calcium dependent slow afterhyperpolarization is reduced in hippocampal slices from adrenalectomized rats, and it is increased after in vivo or in vitro administration of the adrenal steroid, corticosterone. Calcium action potentials are also reduced in adrenalectomized animals, indicating that the primary effect of corticosteroids may be on calcium conductance. The afterhyperpolarization component reduced by adrenalectomy is greater in aged rats than in young rats, suggesting that, with aging, there is an increased effect of corticosteroids on some calcium-mediated brain processes. Because elevated concentrations of intracellular calcium can be cytotoxic, these observations may increase the understanding of glucocorticoid involvement in brain aging as well as of the normal functions of these steroids in the brain. PMID- 2781294 TI - Postponement of satiety by blockade of brain cholecystokinin (CCK-B) receptors. AB - Exogenous cholecystokinin (CCK) decreases food intake and causes satiety in animals and man. However, it has not been established that endogenous CCK causes satiety or whether the response is mediated by peripheral-type (CCK-A) or brain type (CCK-B) receptors. The development of potent and selective antagonists for CCK-A (MK-329) and CCK-B (L-365,260) receptors now allows these issues to be addressed. The CCK-A antagonist MK-329 and the CCK-B antagonist L-365,260 increased food intake in partially satiated rats and postponed the onset of satiety; however, L-365,260 was 100 times more potent than MK-329 in increasing feeding and preventing satiety. These results suggest that endogenous CCK causes satiety by an agonist action on CCK-B receptors in the brain. PMID- 2781295 TI - Factors that predict individual vulnerability to amphetamine self-administration. AB - Clinical observations show that there is considerable individual variability in the response to the addictive properties of drugs. This individual variability needs to be taken into account in animal models of addiction. Like humans, only some rats readily self-administer low doses of psychostimulants. The individual animals at risk can be identified on the basis of their response to environmental or pharmacological challenges. This predisposition to develop self-administration can be induced by repeated treatment with amphetamine. These results may help elucidate the neurobiological basis of addiction liability observed in both rats and humans. PMID- 2781296 TI - Amplification and Molecular Cloning of HTLV-I Sequences from DNA of Multiple Sclerosis Patients. Correction. PMID- 2781298 TI - AZT reverses AIDS dementia in children. PMID- 2781297 TI - Symbiotic marine bacteria chemically defend crustacean embryos from a pathogenic fungus. AB - Embryos of the shrimp Palaemon macrodactylus are remarkably resistant to infection by the fungus Lagenidium callinectes, a recognized pathogen of many crustaceans. An Alteromonas sp. bacterial strain consistently isolated from the surface of the embryos, produces 2,3-indolinedione (isatin), a compound that inhibits the pathogenic fungus. If exposed to the fungus, bacteria-free embryos quickly die, whereas similar embryos reinoculated with the bacteria or treated only with 2,3-indolinedione live well. The commensal Alteromonas sp. bacteria protect shrimp embryos from fungal infection by producing and liberating the antifungal metabolite 2,3-indolinedione. PMID- 2781300 TI - Abortion: litmus test for NIH director. PMID- 2781299 TI - Hope for AIDS vaccines. PMID- 2781301 TI - Protein chemists gain a new analytical tool. PMID- 2781302 TI - ANA statement addresses issues of rural health. PMID- 2781303 TI - Improving the image of nursing through certification. PMID- 2781304 TI - Do not resuscitate. PMID- 2781305 TI - Nonmalignant clonal disorders. PMID- 2781306 TI - [The distribution, characteristics and effects of ir-BNP in central and peripheral tissues in rat]. AB - The present study first investigated the distribution, biochemical characteristics, receptor binding and biological effects of immunoreactive brain natriuretic peptide (ir-BNP), in the central nervous system and some peripheral tissues in rats, using highly specific radioimmunoassay, radioreceptor assay and immunohistochemical method. The results suggest that BNP may be a novel neurotransmitter or circulatory hormone, which is widely distributed in various tissues and involved in the regulation of water electrolyte balance and cardiovascular activity. PMID- 2781307 TI - [The learning dependent long-term synaptic potentiation in the rat hippocampal CA3 region]. AB - The purpose of this study is to investigate the changes of synaptic efficacy in the rat hippocampal CA3 region during establishment, extinction and re establishment of conditioned drink response by means of implanted electrodes and behavioral observation. The monosynaptic population excitatory postsynaptic potential (EPSPs) and population spike (PS) elicited by stimulating the perforant path were recorded. The results showed that the long-term potentiation (LTP) in the hippocampal CA3 region appeared with the establishment of conditioned response, the LTP extinguished with experimental extinction of conditioned response and reappeared during the re-establishment of conditioned response. Moreover, both maximal level of LTP and its complete extinction preceded those of conditioned behavior, suggesting that the LTP was learning-dependent. In addition, the enhanced PS was not presented immediately after behavioral training, and developed within subsequent 24 h, with a maximum at the 4th hour. The magnitude of conditioned response depended on the level of LTP. A cross correlation analysis of the slopes of PS and EPSPs indicated that the changes of PS were caused by alterations of synaptic transmission. These results suggest that the learning-dependent LTP might be one of the neuronal substrates underlying behavioral learning and memory. PMID- 2781308 TI - [Hippocampus-cerebellar cortex-cerebellar nuclei projection in the rat: electrophysiological and HRP studies]. AB - The spatial distribution of the hippocampus-cerebellar projection and the connection between the projection area of hippocampus in the cerebellum and cerebellar nuclei were studied by means of electrophysiological and HRP labelling techniques. Polysynaptic responses of Purkinje cell's simple and complex spike in the lobule VI could be evoked by stimulation of the area CA1/CA3 of the dorsal hippocampus. These results suggest that there are polysynaptic projections from CA1 and CA3 areas of dorsal hippocampus to the lobule VI of cerebellar cortex, and the last relay fibers for these projections are mossy fiber and/or climbing fiber. It is also shown that this hippocampus-cerebellar projection predominantly terminates at the lobule VI of cerebellar cortex, 0.8-1.4 mm lateral to the midline. The projection from CA1 area is mainly contralateral, whereas the projection from CA3 area is mainly ipsilateral. The results with HRP labelling indicate that the projection area of hippocampus is an interpositus zone of the lobule VI. Reciprocal connections may exist between this cortical area and the interpositus nucleus. PMID- 2781309 TI - [Content, location and action site of enkephalins in arterial walls]. AB - Contents of L-enkephalin (L-ENK) and M-enkephalin (M-ENK) in arteries of rabbit were measured by radioimmunoassay. Mean values of L-ENK and M-ENK (pg/mg of wet tissue) were 38.99 +/- 17.29 and 134.67 +/- 8.11 in the rabbit ear artery; 31.10 +/- 7.76 and 93.60 +/- 18.22 in the renal artery; 25.70 +/- 13.60 and 88.43 +/- 18.16 in the mesenteric artery, respectively. L-ENK in these arteries decreased significantly (P less than 0.001) after chemicosympathectomy by injection of 6 OHDA; ENK in the ear artery were reduced significantly (P less than 0.001) following the excision of the superior cervical ganglion or electrical-field stimulation, but not changed after injection of reserpine. Content of NE in the artery strip bath medium was measured by fluorimetric assay. NE in the medium was decreased significantly after administration of L-ENK or M-ENK. The results suggest that enkephalins may exist in the sympathetic nerve terminals innervating arterial walls and may be released by electrical-field stimulation. Enkephalins inhibit the contracting activity of artery strips probably by decreasing the release of NE from sympathetic nerve endings. PMID- 2781310 TI - [Pressor response induced by glutamate injection into caudal ventrolateral part of periaqueductal gray matter and its efferent pathway in brain-stem]. AB - In urethane-anesthetized, tubocurarine-immobilized artificially ventilated rats, the following results were observed: (1) Sodium glutamate (Glu) microinjection into the caudal ventrolateral part of the periaqueductal gray matter (PAG) produced a marked rise in blood pressure. (2) This effect was attenuated by phentolamine or propranolol but not by atropine, injected bilaterally into the rostral ventrolateral medulla (RVL), indicating that this pressor response is mediated by RVL and alpha- and beta-receptors. (3) Propranolol-injection into RVL also attenuated the pressor response induced by electrical stimulation of the nucleus parabrachialis ventralis (NPV), while the pressor response initiated by injecting Glu into the same area (NPV) was not affected. Taken together with the previous findings that phentolamine blocks the pressor response produced by NPV electrostimulation, but not of Glu-injection into NPV, the above results suggest that neurons in the caudal ventrolateral part of PAG may either send axons passing through the nucleus parabrachialis (NPB) and directly acting upon beta receptors in RVL, or relay in NPB and act indirectly on alpha-receptors in RVL to produce the pressor response. PMID- 2781311 TI - [The relationship between coronary artery stenosis and myocardial metabolism of oxygen demand in dogs]. AB - In open chest dogs, a micrometer constrictor was used to produce three different coronary artery stenosis (AS) on left circumflex coronary artery, and hemodynamics, blood gas and coronary sinus pH, lactate were then measured. In mild coronary AS, resting coronary artery flow (CBF) did not decrease; but lactate increased. In critical coronary AS, CBF slightly decreased, MVO2 decreased and lactate increased. There was a decrease in CBF, O2 supply/consumption ratio, coronary sinus pH and an increase in oxygen extraction and lactate with severe coronary AS. The percent area stenosis (%AS) was highly correlated with O2 supply (r = -0.92), poorly correlated with MVO2 (r = -0.58) when it was higher than 75%. PMID- 2781312 TI - [The role of medial medulla in the depressive responses in pulmonary and carotid arteries to injection of acetylcholine at fourth ventricle]. AB - The role of medial medulla in the depressive responses in pulmonary and carotid arteries to injection of acetylcholine (ACh) at the fourth ventricle was studied by means of electrolytic destruction and microinjection of drugs at the relevant brain areas. It was found that (1) electrolytic destruction of medial medulla significantly diminished the depressive responses to ACh in pulmonary and carotid arteries; (2) destruction of nucleus tractus solitarius (NTS) at the level of the medullary obex did not affect the depressive responses in both arteries; obex did not affect the depressive responses in both arteries; (3) microinjection of 5 hydroxytryptamine (5-HT) blockers, cyproheptadine and 2-bromolysergic acid diethylamide (BOL), into the fourth ventricle or medial medulla could lessen the depressive responses to ACh in pulmonary and carotid arteries; (4) microinjection of naloxone in the same way could partially abolish the depressive responses. It is thus assumed that the ACh-induced depressive responses in pulmonary and carotid arteries are associated with the structural integrity of the medial medulla but not related to the central projection area of the buffer nerves. Therefore, the depressive responses in pulmonary and carotid arteries initiated by injection of ACh at the fourth ventrical are mediated by activating the 5-HT and endorphin systems of the medial medulla which in turn inhibits the tonic activities of the sympathetic preganglionic neurons in the spinal cord. PMID- 2781313 TI - [Accelerated angiotensinogen gene expression in the rat brain made tolerant to morphine or electroacupuncture stimulation]. AB - The aim of the present study was to explore whether the expression of angiotensinogen (Ang) gene was accelerated during the development of morphine tolerance or electroacupuncture tolerance. The total rat brain RNA was extracted by phenol, and dot blot hybridization with synthetic Ang oligo-DNA was adopted for measuring Ang mRNA. Autoradiographic examination revealed a marked increase in Ang mRNA in rats receiving multiple injections of morphine or continuous electroacupuncture (EA) stimulation for several hours. The integrated O.D. (I.O.D.) of the hybridized dots revealed a 1-fold and 8-fold increase in Ang mNRA in rats receiving morphine injection for 1 and 4 days, respectively, and a 5-fold and 13-fold increase in rats receiving 3 and 6h EA stimulation, respectively. The results suggest that transcription of Ang gene in rat brain can be accelerated within 3-4h by continuous morphine or EA stimulation and that a longer lasting stimulation resulted in a stronger gene expression. PMID- 2781314 TI - [Anoxia-reoxygenation injury in isolated rat myocytes is modulated by cell sodium during the anoxia period]. AB - Using the model of anoxia-reoxygenation injury in isolated rat myocytes, we observed that incubation of myocytes with ouabain, inhibitor of Na+-K+ ATPase, during anoxia period significantly increased the cell sodium content. These myocytes demonstrated severe injury and intracellular calcium overload during reoxygenation period. The sodium content of myocytes at the end of anoxia period was positively correlated with the overload of intracellular calcium at reoxygenation (r = 0.882, P less than 0.01). Mn2+, an inhibitor of Na+-Ca2+ exchange, significantly attenuated the anoxia-reoxygenation injury when given during reoxygenation period. Mn2+ also inhibited the cell injury caused by incubation of myocytes with Na+-free medium. These results suggest that anoxia reoxygenation injury of rat myocytes is modulated by cell sodium during the anoxia period, and the Na+-Ca2+ exchange mechanism plays an important role in influx of extracellular calcium during reoxygenation period. PMID- 2781315 TI - [Origin of the auditory middle latency response Pa in guinea pig]. AB - The cortex of guinea pig was divided into five regions and respective ablation of the different regions combined with local infiltration of kainic acid on the cortex was made to investigate the relationship between the different part of the cortex and MLR. The results of ablation showed that the main component of the MLR, wave Pa, still appeared unless the primary auditory cortex contralateral to the stimulated ear was removed. With local application of kainic acid it was further suggested that the Pa mainly originates from the neurons in the primary auditory cortex and that subcortical auditory structures and their projected fibers do not contribute to the Pa. PMID- 2781316 TI - A urostomy patient visiting program. AB - The thrust of this article has been to focus on one type of surgical patient (urostomy). This patient should have the opportunity to learn about the UOA visiting program. In many cases it could help make his or her disease less threatening and the surgery and resultant hospital stay much more acceptable. At the time of diagnosis, you and the urologist could suggest to the patient that he or she consider the benefits of a urostomy visitor before surgery. Use of the preoperative visit could be in the best interests of both the patient and the health care providers. PMID- 2781317 TI - Group research: pearls and perils. PMID- 2781318 TI - Pacemaker patients as candidates for shock wave lithotripsy. AB - Performing SWL on patients with an implanted cardiac pacemaker can be done successfully, especially if a cautious approach is used. Of 3000 patients treated since 1987, 10 had pacemakers. The institution of the review committee (PC), the development of guidelines to assist with the review and selection of candidates for SWL, and the presence of a nurse coordinator to act as liaison between the urologist and the team and to prepare the patient, have all contributed to the successful treatment of stone patients with a pacemaker. PMID- 2781319 TI - Securing indwelling ureteral catheters during lithotripsy. PMID- 2781320 TI - Subspecialty practice in urologic health care. PMID- 2781321 TI - Getting ready for certification. PMID- 2781322 TI - Ethical issues surrounding informed consent: Part III. The crucial role of nursing in insuring valid consent. AB - Three ethical principles upon which informed consent is founded are respect for persons, promotion of the best consequences, and rights. A valid informed consent -that is, one given by a person who has been informed, is competent, and has not been coerced--is one way of respecting persons, of enabling their rights. Consent given in the absence of information and competence, or in the presence of coercion, does not achieve these ends. Hence, it is not valid. The nurse is in a unique position to ensure the validity of consent. Nurses do this both by enhancing patients' opportunities for becoming informed and by observing for signs of incompetence and coercion. When the ability of a patient to execute a valid consent is compromised, the nurse needs to act to restore the patient's decision making capacities to the greatest level possible. Nursing's efforts in promoting morally valid consents are one way the profession recognizes the importance of each individual. This importance has been formally acknowledged by the American Nurses Association Code of Ethics (6). It is informally acknowledged when individual nurses act to maximize their patients' understanding and participation in the decisions surrounding health care. In helping patients to participate to the fullest possible extent, nurses show respect for the very unique human nature we all share. It is for this reason that insuring informed consent is worth whatever time and effort it takes. PMID- 2781323 TI - Fibrous metaphyseal defects. Magnetic resonance imaging appearances. AB - Sixteen patients with fibrous metaphyseal defects were examined with both plain radiography and magnetic resonance (MR) imaging. Depending on the age of the fibrous metaphyseal defects, characteristic radiomorphologic changes were found which correlated well with MR images. Following intravenous Gadolinium-DTPA injection, fibrous metaphyseal defects invariably exhibited a hyperintense border and signal enhancement. Healed lesions exhibited a transition to normal bone marrow. A line through the maximum longitudinal diameter of a fibrous metaphyseal defect invariably led to a point of tendinous or ligamentous insertion. Coronal MR images demonstrated the maximum longitudinal extension and the respective inserting tendon or ligamentous structure at the epiphyseal line. PMID- 2781324 TI - Solitary (unicameral) bone cyst. The fallen fragment sign revisited. AB - The fallen fragment sign is a prominent radiologic feature in a minority of cases of unicameral bone cyst (20% in this series). This sign is always associated with pathologic fracture. Intramedullary fracture fragments may be single or multiple and may or may not be entirely dislodged from overlying periosteum. The finding appears limited to unicameral bone cysts in patients with open physes. When present, the fallen fragment is a pathognomonic finding as it defines the interior of the cyst as nonsolid. This is particularly helpful in cases where absence of the cyst wall secondary to fracture can simulate an intramedullary malignancy with cortical erosion. PMID- 2781325 TI - Osteo-articular tuberculosis. A radiological study in a Malaysian hospital. AB - Various authors have reported differences in the radiological features of skeletal tuberculosis in the coloured patient. We studied retrospectively the radiographs of 71 patients with proven skeletal tuberculosis seen in our hospital, over a 6 year period. Sclerotic bone reactions and periosteal new bone formations were unusual findings but multiple bone involvement occurred about 15% of our patients. There was also a high in incidence of tuberculosis of the ankle and foot compared to that reported in white Caucasian patients. PMID- 2781326 TI - Identification of avascular necrosis in the dysplastic proximal femoral epiphysis. AB - Bilateral radiographic irregularities and deformities of the proximal femoral epiphyses are features of both multiple epiphyseal dysplasia and bilateral idiopathic avascular necrosis. In the past these entities have been difficult to differentiate. This report documents radiographically the occurrence of avascular necrosis in 10 patients with multiple epiphyseal dysplasia by recognizing the super-imposition of sclerosis and subchondral fissuring on pre-existing symmetrically irregular proximal femoral ossification centers. Scintigraphic (photopenia) or magnetic resonance (loss of signal) criteria of avascular necrosis confirm its added presence and help to establish an imaging scheme to identify avascular necrosis superimposed on multiple epiphyseal dysplasia. PMID- 2781327 TI - Hyperextension injuries of the cervical spine. Magnetic resonance findings. AB - Eleven patients with acute cervical hyper-extension injury underwent magnetic resonance examination. Magnetic resonance was particularly helpful in diagnosing both intrinsic cord contusion and extradural compression. When spinal cord compromise was present, surgery was undertaken without resort to myelography. PMID- 2781328 TI - Shoulder deformities from obstetrical brachial plexus paralysis. AB - Abnormalities are described in the shoulders of 11 patients up to 17 years of age who have chronic brachial plexus paralyses from birth injuries. These abnormalities include a poorly formed and hypoplastic humeral head, a short abnormally formed clavicle, and a hypoplastic elevated scapula with a shallow glenoid fossa, inferiorly directed coracoid process, and abnormally tapered acromion. Four also had subluxated shoulders. PMID- 2781329 TI - Case report 544: Metastatic chordoma to humeri (originating in sacrum). PMID- 2781330 TI - Case report 546: Endosteal hyperostosis (Worth type). PMID- 2781331 TI - Case report 547: Plexiform neurofibroma involving a dorsal root ganglion. PMID- 2781332 TI - Case report 549: Case 1: Ischemic necrosis femoral heads with pathological fracture right femur. Case 2: Ischemic necrosis femoral heads with fracture bilaterally. PMID- 2781333 TI - Case report 550: Snapping right iliopsoas tendon. PMID- 2781334 TI - Case report 551: Intraosseous ganglion of olecranon with vacuum phenomenon. PMID- 2781335 TI - Case report 552: Post-traumatic remodelling of the distal tibial epiphysis: a form of aseptic osteonecrosis. PMID- 2781336 TI - Acute injuries of the axis vertebra. AB - A retrospective analysis of 165 patients admitted to Hermann Hospital with acute injuries of the axis vertebra revealed 68 (41%) dens fractures, 62 (38%) cases of traumatic spondylolisthesis ("hangman's" fracture), 21 (13%) extension teardrop fractures, 10 (6%) hyperextension dislocations, and 2 (1.0%) fractures each of the laminae and spinous processes. Of the 68 dens fractures, none (0%) were of the Anderson and D'Alonzo Type I; 21 (31%) were Type II ("high"); and 47 (69%) were Type III ("low"). The 62 traumatic spondylolistheses included 13 (21%) Effendi type I, 35 (56%) type II and 3 (5%) type III. This review disclosed an additional 11 (18%) patients with an atypical variety of traumatic spondylolisthesis, not previously reported, in which one or both fractures involved the posterior cortex of the axis body. Of the axis injuries 31 (18%) were limited to the axis body alone. Of these, 21 (61%) were hyperextension teardrop fractures and 10 (32%) were hyperextension dislocations. Axis injuries were associated with acute injuries of other cervical vertebrae in 14 (8%) of the patients. PMID- 2781337 TI - Magnetic resonance imaging of para-articular and ectopic ganglia. AB - This study was undertaken to evaluate the efficacy of magnetic resonance imaging in (1) improving preoperative identification of soft tissue ganglia and in (2) enhancing management by defining their origins, attachments, and extensions. Magnetic resonance images of 17 ganglia were evaluated for intrinsic signal, internal structure, overall shape, and relationship to joints and tendon sheaths using a Philips 0.5 Tesla superconductive magnet with receiver dedicated surface coils. Magnetic resonance imaging proved particularly well suited to delineating soft tissue ganglia and characterizing several of their distinctive diagnostic features which are not optimally imaged by other modalities such as computed tomography and ultrasound. PMID- 2781338 TI - NOMID--a neonatal syndrome of multisystem inflammation. AB - Neonatal onset multisystem inflammatory disease is a rare disorder first described by Lorber in 1973. An additional 29 cases have been recorded. Two patients are described here, one with a 17 year follow-up. The typical features are a rash, fever, adenopathy, hepatosplenomegaly, and a severe, deforming arthropathy predominantly affecting large joints. The most striking feature is the onset in the neonatal period. Other associated features include inflammation, chronic meningitis, anemia, and persistent leukocytosis. Most, if not all, patients develop bizarre epiphyseal radiographic findings that are virtually pathognomonic. This disease is distinct from Still disease. PMID- 2781339 TI - Primary tumors of the patella. A review of 42 cases. AB - This study reports 42 cases of histologically proven and radiographically correlated primary patellar tumors. Despite diverse histologic diagnoses, the radiographic appearances of benign as opposed to malignant patellar neoplasms are essentially indistinguishable. Although the literature suggests that giant cell tumor is the most frequent benign tumor of the patella, the most common benign neoplasm in this series is chondroblastoma (16 cases). Only four primary malignant lesions were encountered, three cases of lymphoma and one case of hemangioendothelioma. Since 38 (90%) of the 42 cases were benign, a benign etiology should be strongly favored, notwithstanding the radiographic appearance, whenever a primary patellar tumor is encountered. PMID- 2781340 TI - The "lamellated" skull in beta-thalassaemia. AB - The skull in homozygous beta-thalassaemia may present several abnormalities, such as osteopenia, widening of the diploic space, and a "hair-on-end" appearance. In some cases it presents also a particular stratified appearance caused by a variable number of osseous lamellae, parallel with the inner table. This "lamellated skull" was observed in 16 out of 150 patients affected by the disease (10.6%). Possible mechanisms are discussed. The lamellar osseous changes could be due to repeated periosteal osteoblastic reactions to the sinusoidal neovascularization associated with marrow hyperplasia in poorly transfused patients. PMID- 2781341 TI - Case report 536: Chronic tophaceous gout in a 17-year-old male. PMID- 2781342 TI - Case report 554: Osteonecrosis at multiple sites as noted. PMID- 2781343 TI - Case report 555: Intraosseous ganglion cyst of the distal end of tibia. PMID- 2781344 TI - Case report 557: Solitary intramuscular myxoma in a patient with polyostotic fibrous dysplasia. PMID- 2781345 TI - Case report 559: Chondrosarcoma of proximal humeral epiphysis. PMID- 2781346 TI - Case report 560: Parosteal osteoma of tibia. PMID- 2781348 TI - Secretion and its control. Society of General Physiologists, 42nd annual symposium. Woods Hole, Massachusetts, 7-10 September 1988. Proceedings. PMID- 2781349 TI - The neuronal growth cone: calcium regulation of a presecretory structure. PMID- 2781347 TI - Case report 561: Systemic mastocytosis. PMID- 2781350 TI - Modulation of potassium channels by dopamine in rat pituitary lactotrophs: a role in the regulation of prolactin secretion? PMID- 2781351 TI - Sorting of apical surface proteins and lipids by epithelial cells: is there a common mechanism? PMID- 2781352 TI - Protein secretion by constitutive and regulated pathways. PMID- 2781353 TI - Mechanisms underlying the inverse control of parathyroid hormone secretion by calcium. PMID- 2781354 TI - The mechanism of exocytosis during secretion in mast cells. PMID- 2781355 TI - Stimulus-secretion coupling in mast cells. PMID- 2781356 TI - Excitation and secretion at the nerve terminals of vertebrates: optical measurements with and without voltage-sensitive dyes. PMID- 2781357 TI - [Use of a simplified method of calculating mean life expectancy by regions in the Ukraine]. PMID- 2781358 TI - [Operational management of emergency hospitalization using automated systems]. PMID- 2781359 TI - [Improving the structure of public health administration]. PMID- 2781360 TI - [Use of automated information systems for improving and accelerating communication between hospital units]. AB - The article tackles the problems of interaction between the units of multidisciplinary hospitals and the feasibility of its improvement by means of introduction of a modern automated information system (AHIS). In the AHIS structure highlighted are the systems of order input and data communications ensuring more rapid interrelation of clinical departments with a pharmacy, laboratory, nutrition and other auxiliary services. The experience gained in the application of the system of order input in the central clinical hospital and abroad has been analyzed along with the role of organizational activities during the introduction of such systems. Additional functions of the order input system are pointed out. They assist not only in intensifying the curative and diagnostic process but also in raising its quality. PMID- 2781361 TI - [Health status of pregnant women and infants in their first year of life in the Lithuanian S.S.R]. AB - The analysis of a modern demographic situation, dynamics and causes of child mortality, the levels and patterns of pregnancy and childbirth pathology, the newborn and infants' disease rates in the Baltic Republics and the Byelorussian SSR enabled one to determine priority directions for the development of a complex programme on the improvement of mother and child health and reduction of child mortality in the Baltic Republics, these directions involve intensification of antenatal fetus protection due to the improvement of females' working conditions, development of medico-genetic counselling and wide application of prenatal diagnostic procedures for the detection of fetus developmental defects, optimization of women reproductive behavior under the conditions of complete provision with modern contraceptive means, propaganda of breast feeding. PMID- 2781362 TI - [On the term "health education" and its synonyms]. PMID- 2781363 TI - [Prospects of developing a computerized public health system in the COMECON countries]. AB - The results of predicting the development of automated information systems for public health in the CMEA member-countries up to 2010 are presented. Priority trends of computerization in the CMEA countries have been determined along with its key tasks. Specific computerization problems are listed for various levels of public health administration. The study results can be used for the development of the long-term coordinated strategy of public health computerization in the CMEA countries. The strategy should be aimed at the intensification of curative, diagnostic, managerial and research processes in public health. PMID- 2781364 TI - [A method of automated classification of the working collective of an industrial plant by socio-hygienic factors]. AB - The presented procedure of automated classification enables one to provide an integral assessment of the influence of a number of socio-hygienic factors on health of chemists engaged in by-product coke industry and proceeding from its findings to divide the workers' collectives into homogeneous groups according to the cumulative effect of the above factors. PMID- 2781365 TI - [Lesions of the coronary bed in patients with ischemic heart disease and ECG changes at rest]. AB - The data of ECG at rest and of coronary angiography have been analyzed in 184 patients. Correlations between various ECG changes and the coronary bed involvement have been revealed. The authors have calculated the sensitivities and specificities of some ECG symptoms for the prediction of an atherosclerotic involvement of the coronary arteries. A sufficiently high specificity of ECG examination (89.1%) makes it useful for active detection of coronary patients, whereas its low specificity (54.2%) necessitates employment of supplementary methods of investigation. PMID- 2781366 TI - [Surgical treatment of diseases of the leg veins in elderly patients]. PMID- 2781367 TI - [Functional status of the cytochrome P-450-dependent monooxygenase system in multiple sclerosis and amyotrophic lateral sclerosis]. PMID- 2781368 TI - [The course of skin diseases in the treatment of chronic alcoholism]. PMID- 2781369 TI - [Status of the reproductive function in men with varicocele]. PMID- 2781370 TI - [Surgical treatment of valgus deformity of the hallux in polydactyly]. PMID- 2781371 TI - [Gaucher's disease associated with peritoneal leiomyomatosis]. PMID- 2781372 TI - [A case of Wegener's granulomatosis associated with rheumatism]. PMID- 2781373 TI - [Atypical cardiac pain syndrome in chronic ischemic heart disease]. PMID- 2781374 TI - [Tamoxifen in the treatment of cancer of the uterine body]. PMID- 2781375 TI - [Rehabilitation and expert evaluation of work capacity of patients after total hip endoprosthesis using Shersher's construction]. AB - The authors analyze the clinical and x-ray data on 282 patients before and after surgery. On the basis of this analysis they have developed criteria for expert evaluation of the working abilities of the patients after total hip arthroplasty. These criteria have helped a rational employment of these patients after surgery. PMID- 2781376 TI - [Biologically active substance levels in exhaled air from patients with pre asthma and bronchial asthma]. AB - Acetylcholine, serotonin, and histamine levels have been measured in exhaled air humor condensate in 65 patients aged 18 to 60, 44 ones with bronchial asthma and 21 with preasthma. Nonuniform release of biogenic amines and acetylcholine in pulmonologic patients depended on the severity of the inflammatory process in the bronchi, hypoxemia, bronchial obstruction, and reactivity of the bronchi examined during cold air breathing. PMID- 2781377 TI - [Value of determining the activity of cholesterol esterase in the duodenal contents]. AB - Cholesterol esterase, a pancreatic enzyme, activity has been measured in the duodenal contents of patients with chronic pancreatitis by fluorometry with the use of o-coumaric acid, a cholesteryl ether substrate, manufactured in this country. The measurements have revealed a significant difference in the values of the enzyme secretion debit after pancreozymin-secretin stimulation of the pancreas in chronic pancreatitis patients and in the controls. Hypo- and hypersecretion of cholesterolesterase have been revealed in the patients. The disease severity had a most marked effect on the hyposecretion degree. These data evidence a high value of cholesterolesterase measurements for the assessment of the pancreatic exosecretion: such tests may help detect the early stages of exosecretory disturbances, assess the disease severity and progress. PMID- 2781378 TI - [Evaluation of the excretory function of the liver in inflammatory diseases of the biliary tract (data of radioimmunologic analysis of cholylglycine level)]. AB - Radioimmunoassays of ++choleglycine in 41 healthy donors, 37 patients with gastroduodenal diseases and 41 ones with inflammatory diseases of the bile ducts have revealed that impaired excretory function of the liver is associated with a reduced coefficient of the bile acid extraction and a decreased bactericidal activity of the bile. The latter fact is conducive to active growth of microorganisms in the bile and thus promotes postoperative septic complications. Early detection of cholestasis resultant from impaired excretory function with the use of choleglycine radioimmunoassays permits administration of early measures to restore the bile passage and of rational antibacterial therapy to prevent postoperative pyoseptic complications. PMID- 2781379 TI - [Medical secrecy and openness in physician-patient relations]. PMID- 2781380 TI - [Prestige in the roentgenologists' profession]. PMID- 2781381 TI - [Organization and management of emergency surgery for the rural population of an agricultural-industrial region]. PMID- 2781382 TI - [Abdominal aspects of myocardial infarction]. PMID- 2781383 TI - [Early diagnosis of hypertension in continuous ambulatory care]. PMID- 2781384 TI - [Prevention of acute respiratory viral infections and tonsillitis]. PMID- 2781385 TI - [Local secretory immunity and its significance in the diagnosis of cancer and chronic suppurative-inflammatory diseases of the lungs]. PMID- 2781386 TI - [Yellow-light laser therapy of peptic ulcer]. PMID- 2781387 TI - [Lung cancer in patients under 40 years of age]. PMID- 2781388 TI - [Drainage of the abdominal cavity in peritonitis]. PMID- 2781389 TI - [Principles of pathogenetic treatment of cyclic migraine-like cephalalgia in women]. PMID- 2781390 TI - The effect of angled insertion on halo pin fixation. AB - This study evaluated the effect of angled insertion of halo pins on the biomechanical characteristics of the halo pin-calvarium complex. Halo pins were inserted into isolated calvarium sections at 90 degrees, 75 degrees, and 60 degrees to the surface of the bone at an insertional torque of 0.68 N-m (6 inch pounds). Initial rigidity, load at failure, and deformation at failure of the pin bone complex were assessed during transverse shear loading. The structural properties of the pin-bone complex were maximized at loads approaching failure when pins were inserted perpendicular (90 degrees) to the bony surface and significantly decreased at more acute angles of insertion. Perpendicular insertion of halo pins maximizes the structural properties of the complex formed by the halo pin and the calvarium. This improved structural behavior may minimize the incidence of pin loosening clinically, and may reduce the frequency of other complications currently associated with the use of the halo orthosis. PMID- 2781391 TI - Bone scintigraphy in patients with breast cancer, pulmonary cancer, uterine cervix cancer, and prostatic cancer. Statistical study of spinal accumulation cases. AB - This is a review of bone scintigraphy performed in patients with breast cancer, pulmonary cancer, uterine cervix cancer, and prostatic cancer from 1980 to 1985. The incidence of accumulation in the spine was 25.0% in breast cancer, 29.5% in lung cancer, 24.3% in cervical cancer, and 47.0% in prostatic cancer. The predominant location of the accumulation was the lumbar vertebra (68.9%), followed by the thoracic vertebra (45.0%), sacral vertebra (37.5%), and cervical vertebra (23.6%). The survivability after spinal accumulation was determined by the Kaplan-Meyer survival curve. The 1-year survival rate of breast cancer, pulmonary cancer, cervical cancer, and prostatic cancer was 88%, 19%, 74%, and 90%, respectively, the record of pulmonary cancer being significantly lower. Hence, in the treatment of patients with metastatic spinal tumors, the therapeutic method should be selected according to the underlying disease. PMID- 2781392 TI - Variability of somatosensory cortical evoked potential monitoring during spinal surgery. AB - The intraoperative variability of somatosensory cortical evoked potentials (SCEPs) has been measured for 320 consecutive spinal surgeries and found to be a function of patient diagnosis, neuromuscular status, age, and procedural factors. In many cases, it is likely that this variability severely limits the reliability and usefulness of spinal cord monitoring in detecting early cord compromise. Patients with idiopathic scoliosis, spondylolisthesis, and pseudarthrosis have the smallest spontaneous variability and strongest amplitudes, while those with congenital, paralytic scoliosis, stenosis, or tumor have very variable, weak SCEPs. Patients with neurologic disorders, particularly cerebral palsy, myelomeningocele, Friedreich's ataxia, and peripheral deficits, also have high variability and weak amplitudes. A monitoring quality scoring system is proposed that may be useful during surgery in judging how well the SCEPs can discern surgically related changes in cord function from background variations. PMID- 2781393 TI - Significance of acute posttraumatic bony encroachment of the neural canal. AB - Neurologic status (NS) of 80 consecutive patients with acute, traumatic thoracic, thoracolumbar, or lumbar fractures was correlated with the amount of neural canal impingement (NCI) demonstrated by computerized axial tomography (CT). Average NCI was significantly higher in the 34 patients with neurologic deficits, but the range of NCI was similar to that observed in the 46 patients with no deficits. Burst fractures and fractures in the lumbar spine had the highest average NCI but the lowest percentage of patients with neurologic deficits. The immediate, posttraumatic NS of the 80 patients studied did not directly correlate with the percent of NCI demonstrated on their CT scans. PMID- 2781394 TI - Fractures of the spine in ankylosing spondylitis. Diagnosis, treatment, and complications. AB - Spinal injuries in patients with previous ankylosing spondylitis were reviewed retrospectively. Fractures frequently occurred as a result of minimal trauma and were associated with severe neurologic deficits in 75% of cases. A characteristic fracture pattern was seen radiographically, and appeared to result from the altered biomechanics of the ankylosed spine. Although the fractures were markedly unstable, nonoperative treatment was uniformly successful in achieving union. The incidence of complications and mortality in this group was significantly lower than that reported in other studies, and the authors attribute this to conservative management within a spinal cord injury unit. PMID- 2781395 TI - Gunshot wounds to the spine associated with a perforated viscus. AB - The cases of 42 patients with low-velocity gunshot wounds to the spine with an associated perforated viscus were reviewed. All viscus perforations occurred prior to the spinal injury. There were a total of 51 perforations, including 14 of the colon, 15 of the small bowel, 15 of the stomach, five of the esophagus, and two of the pharynx. All patients had significant neurologic deficits, with 23 patients suffering a complete neurologic injury. Average clinical follow-up was 18 months (range: 4-64 months). Only three patients developed documented spinal or paraspinal infections. One case of acute meningitis occurred after an isolated stomach perforation, while two other patients developed psoas abscesses after colon injuries. The roles of initial antibiotic therapy and of early bullet removal were evaluated in regard to infection. An extended course of broad spectrum antibiotics combined with bedrest appeared to significantly reduce the risk of spinal or paraspinal infection as compared with a previous study. Early bullet removal did not appear to be a significant factor in the prevention of infection. Prospective studies are needed to accurately delineate the role of initial antibiotic therapy for the prevention of spinal infection in these injuries. PMID- 2781396 TI - The role of spinal flexion and extension in changing nerve root compression in disc herniations. AB - Changes in nerve root compression forces with spinal motion were measured on six freshly frozen adult cadaver spine specimens. A model was devised to represent a herniated disc at the L4-5 level. This was done using an anterior approach placing a compression-measuring device through the disc at the L4-5 level and against the L5 root. An accelerometer was used to monitor the range of motion of the spine. Because the compression device was held in a static position, the only variable was the tautness of the nerve root across the tip of the device. By simultaneously monitoring motion and force delivered at the tip of the compression meter placed at the nerve root, we were able to quantitate nerve root tension forces across the tip of the measuring device in relation to spinal motion. The force was measured with controls as well as in flexion and extension. In addition, the force was measured as traction was applied to the L5 root. The amount of compressive force and tension in the nerve root increased with flexion of the spine and decreased with extension of the spine. In conclusion, flexion of the lumbar spine increased the compressive force on the L5 root and extension decreased the compressive force on the L5 root. PMID- 2781397 TI - Electrophysiological studies of intermittent claudication in lumbar stenosis. AB - To clarify the pathophysiology of intermittent claudication in 37 patients with lumbar spinal stenosis, neural function was evaluated by examining somatosensory evoked potentials (stress-SEPs), and nerve action potentials (stress-NAPs) before and after walking stress. It was shown preoperatively that the stress-SEPs became abnormal immediately after walking in 31 of 37 patients. In seven of nine operated patients, the assessment clearly shows that SEPs had reverted to normal after surgery. The present method is noninvasive, simple in technique, painless, and safe, a procedure therefore that is useful as the initial step in the diagnosis and treatment of patients with lumbar canal stenosis. It also may help to differentiate neurogenic from vascular intermittent claudication. PMID- 2781398 TI - End-plate lesions of the lumbar spine. AB - It has been suggested that the pattern of development and attrition of blood vessels and notochord remnants leaves congenitally weak points in the cartilage disc plates. There is strong presumptive evidence that nuclear prolapse can take place through these weak spots in the cartilage plates to form Schmorl's nodes. It has been postulated that the development of Schmorl's nodes may also lead to anomalies of the vasculature in the end-plates, which may lead to further end plate lesions. In the present study, we have examined lumbar intervertebral discs and vertebrae from eight specimens with Schmorl's nodes and 12 specimens without nodes. The specimens examined were from individuals ranging in age from 17 to 90 years. The specimens were sectioned at 150 microns, stained, and the percentage of the bone cartilage interface occupied by marrow spaces was measured using a microscope with an ocular micrometer. The specimens with Schmorl's nodes had a significantly greater proportion of disc marrow contacts than did the normal vertebrae. PMID- 2781399 TI - Surgical treatment for symptomatic spinal adhesive arachnoiditis. AB - This report concerns the outcome of 36 operations for spinal adhesive arachnoiditis (SAA) performed at Kyoto University Hospital since 1956; the follow up period ranged from 1 to 25 years (average, 4 years 8 months). The original procedure involved intradural neurolysis after extradural decompression, but more recently microlysis was performed. The percentage of cases in which good results were obtained by nonmicroscopic lysis and microlysis was only 54.8%, however, when microlysis was followed by spondylodesis, the ratio increased to 80%, clearly showing the benefits of this new procedure. The authors therefore emphasize the value of spondylodesis following microlysis for symptomatic SAA. PMID- 2781400 TI - Comparison of disc space heights after anterior lumbar interbody fusion. AB - Thirty-one consecutive patients underwent anterior interbody fusion of 40 levels of the lumbar spine using autogenous, autologous, or mixed iliac crest graft. Each patient's disc space height was measured preoperatively, immediately postoperatively, and an average of 29 months postoperatively. The immediate postoperative radiograph demonstrated an average increase in disc space height of 89%, or 9.5 mm for each operated level. The late radiographic evaluation, from 7 to 54 months postoperatively, showed an average decrease of 1%, or 0.1 mm for each level. At late follow-up, no correlation could be found between the time from the operation and disc space height. One hundred percent of patients developed disc space height decreases during the postoperative period, with 46% of levels being narrower than their preoperative height at last follow-up. Loss of distraction is a normal postoperative occurrence of the procedure. Disc space distraction is temporary with anterior interbody fusion. PMID- 2781401 TI - Placement of transpedicular vertebral screws close to anterior vertebral cortex. Description of methods. AB - Strengthening of the screw-vertebra interface has been shown to occur with implantation of longer transpedicular screws, the tips of which are placed closer to the anterior cortex of the vertebral body. Such implantation probably results in increased risk for anterior cortex penetration and associated vascular or pulmonary damage. Typically recommended lateral and posterior-anterior radiography is shown here to provide potentially misleading visualization during implantation. To reduce the risk of anterior cortical penetration, presented here are 1) a radiographic method ("near approach view") that avoids this problem and allows direct visualization of the relationship between drill bit or screw tip and anterior vertebral cortex, and 2) a surgical technique ("mallet method") that provides both an audible and a palpable change when the drill bit contacts the anterior cortex. PMID- 2781402 TI - Vertebral arch hemangioma producing spinal cord compression in pregnancy. Diagnosis by magnetic resonance imaging. PMID- 2781403 TI - Tethered cord syndrome in the adult postoperative myelomeningocele patient. A case report. AB - Tethered cord syndrome in the post-myelomeningocele repair pediatric patient has been previously described. The common presentation is unexplained progressive spasticity and a history of urinary dysfunction. Two series, in particular, looked at the onset of tethered cord following myelomeningocele repair in childhood. We have described delayed presentation in an adult with evidence of the tethered spinal cord syndrome following myelomeningocele repair. This patient's presenting complaints are similar to that of the childhood variety, despite many earlier symptom-free years. Further studies of adults who have had low-level myelomeningocele repair early in life may delineate a more common problem than is realized at present. PMID- 2781404 TI - Sequestrated lumbar intervertebral disc associated with vertebral erosion. PMID- 2781405 TI - Spontaneous spinal epidural hematoma complicating Paget's disease of the spine. Case report. PMID- 2781406 TI - How does posture affect coupling in the lumbar spine? AB - There is evidence to suggest that abnormal coupling patterns in the lumbar spine may be an indicator of low-back problems. To quantify the normal coupling patterns, fresh cadaveric human lumbar spine specimens (L1-S1) were used. A pure axial torque or lateral bending moment of 10 N-m (in five equal steps) was applied to the specimen, in five spinal postures, and three-dimensional motions were measured at the five vertebral levels. The results indicated that the coupling patterns changed significantly with the intervertebral level. For example, in neutral posture, the left axial torque produced coupled lateral bending, which varied from approximately 2 degrees right lateral bending at L1-2, to approximately 0 degrees at L3-4, and to approximately 2.5 degrees left lateral bending at L5-S1. Additionally, there was coupled flexion of approximately 1 degrees to 2 degrees at all levels. Application of left lateral bending moment resulted in approximately 1.7 degrees of coupled right axial rotation at all levels, except at L1-L2, where it was 0 degrees. Additionally, there was coupled flexion of 0.7 degrees to 2 degrees at all levels. For example, at the L2-3 level, the left axial torque produced coupled right lateral bending that ranged from approximately 0.5 degrees at full extension to approximately 2.5 degrees at full flexion. There was also accompanying coupled flexion of approximately 0.4 degrees to 1.7 degrees. Application of left lateral bending moment at the L2-3 level produced axial rotation of approximately 2.5 degrees, which did not vary with the posture, while the other coupled motion varied from approximately 1.7 degrees flexion at full extension posture to approximately 0.8 degrees extension at full flexion posture. PMID- 2781407 TI - Regional variations in the compressive properties of lumbar vertebral trabeculae. Effects of disc degeneration. AB - The compressive mechanical properties of human lumbar vertebral trabeculae were examined on the basis of anatomic origin, bone density, and intervertebral disc properties. Trabecular bone compressive strength and stiffness increased with increasing bone density, the latter proportional to strength and stiffness to the one-half power. Regional variations within each segment were found, the most prevalent differences occurring in regions of bone overlying the disc nucleus in comparison with bone overlying the disc anulus. For normal discs, the ratio of strength of bone overlying the disc nucleus to bone overlying the disc anulus was 1.25, decreasing to 1.0 for moderately degenerated discs. These results suggest that an interdependency of trabecular bone properties and intervertebral disc properties may exist. PMID- 2781408 TI - Iatrogenic discitis: the role of intravenous antibiotics in prevention and treatment. An experimental study. AB - The role of antibiotics in the treatment of iatrogenic discitis remains controversial. This study was carried out to assess the ability of cephazolin (a first-generation cephalosporin) to penetrate the intervertebral disc and to establish the role of intravenous antibiotics in the prevention and treatment of iatrogenic discitis. Six sheep had 1 g of intravenous antibiotic administered between 30 minutes and 120 minutes before being killed. Two adjacent lumbar intervertebral discs were harvested and assayed for antibiotic concentration. Cephazolin could only be detected in the animals killed at 30 minutes. Intravenous cephazolin was administered 30 minutes before bacterial inoculation in 46 discs of nine sheep. In five animals, the bacterial suspension contained radiographic contrast and, in four sheep, reconstituted chymopapain. No evidence of discitis was found at any level at death. Eight sheep were treated with intravenous cephazolin commencing 1, 2, or 3 weeks after bacterial intradiscal inoculation and for periods of up to 21 days. All discs developed discitis, and the lesions appeared to be similar, irrespective of time between inoculation and the commencement, duration, and dosage of antibiotic therapy. Our study supports the use of a suitable broad-spectrum antibiotic during any surgical procedure that invades the intervertebral disc. Antibiotics, however, are unable to arrest the progression of discitis once it is established PMID- 2781409 TI - 1989 Volvo Award in basic science. Device-related osteoporosis with spinal instrumentation. AB - An animal model of anterior and posterior column instability was developed to allow in vivo observation of bone remodeling and arthrodesis after spinal instrumentation. After an initial anterior and posterior destabilizing lesion was created at the L5-L6 vertebral levels in 42 adult beagles, various spinal reconstructive surgical procedures were performed--with or without bilateral posterolateral bone grafting, and with or without spinal instrumentation (Harrington distraction; Luque rectangular, or Cotrel-Dubousset transpedicular methods). After 6 months' postoperative observation, there was a significantly improved probability of achieving a spinal fusion if spinal instrumentation had been used (P = 0.058). Nondestructive mechanical testing after removal of all metal instrumentation in torsion, axial compression, and flexion revealed that the fusions performed in conjunction with spinal instrumentation were more rigid (P less than 0.05). Quantitative histomorphometry showed that the volumetric density of bone was significantly lower (ie, device-related osteoporosis occurred) for fused versus unfused spines; and Harrington- and Cotrel-Dubousset instrumented dogs became more osteoporotic than the other three groups. The rigidity of spinal instrumentation led to device-related osteoporosis (stress shielding) of the vertebra. However, as the rigidity of spinal instrumentation increased, there was an increased probability of achieving a successful spinal fusion. The improved mechanical properties of spinal instrumentation on spinal arthrodesis more than compensate for the occurrence of device-related osteoporosis in the spine. PMID- 2781410 TI - 1989 Volvo Award in biomechanics. Mechanical recruitment of low-back muscles. Theoretical predictions and experimental validation. AB - A biomechanical model for studying lumbar muscle load sharing for a class of physical tasks that involve gravitational loading (holding weights) of the upper body in an erect posture is presented. The model assumes that the lumbar muscles balance the externally applied flexion and lateral bending moments. The concept of a 'loading plane' whose axes are the two bending moments is introduced. Any point in the plane can be viewed as a 'loading-point' describing a combination of bending moments that are applied to the body. The study of lumbar-muscle load sharing revealed loading conditions that required activation or deactivation of a particular muscle. The loading plane thus could be divided into regions of activity and inactivity for each muscle, separated by a 'switching curve.' The concept of 'switching curves' proved very useful for examining previously described physiologic assumptions on the loading conditions of particular muscle groups, and for grouping the 22 muscles described in the model into ten functional units. Electromyographic validation studies were conducted and showed a high degree of correlation between the model predictions and actual measurements for the contralateral (with respect to the load) muscles and to a lesser degree of correlation for the ipsilateral muscles. PMID- 2781411 TI - Isolated spinous process deviation. A pitfall in the interpretation of AP radiographs of the lumbar spine. AB - A new type of spinous process deviation is described. This variant may cause confusion in the interpretation of anteroposterior (AP) radiographs of the lumbar spine. In the literature, two types of lumbar spinous process deviation (SPD) have been described: 1) SPD due to rotation of the entire vertebra (as in rotatory scoliosis and degenerative arthritis), and 2) SPD as a consequence of developmental asymmetries of the neural arch. The present study demonstrates that spinous process deviation in the AP radiograph is not a reliable diagnostic guide. The authors' quantitative morphologic analysis of computed tomographic (CT) sections of over 200 lower lumbar vertebrae in vivo revealed a third type of SPD, namely isolated deviation of the spinous process, ie, deviation without any associated rotation or asymmetry of the vertebral body or arch. Since the oval shadow cast by the spinous process in AP radiographs is caused by its tip, rather than by its base (as was demonstrated by in vitro tests), it is concluded that the position of the spinous process shadow in AP radiographs cannot be used as a reliable landmark to differentiate between the three types of SPD. This is only possible by means of a CT examination. PMID- 2781412 TI - Lumbar myoelectric spectral analysis for endurance assessment. A comparison of normals with deconditioned patients. AB - A myoelectric protocol to objectively discriminate between test subjects based on trunk muscular performance differences (endurance) was investigated in a group of 11 healthy volunteers and ten industrial patients undergoing functional restoration for chronic disabling spinal disorders. The subjects performed a standardized exercise protocol, holding their upper torso unsupported for successive fixed-time trials while electromyographic (EMG) signals were recorded from erector spinae. A Fast Fourier Transform allowed calculation of the initial mean power frequency (MPF) for each trial. Isokinetic extensor trunk strength was independently measured at each session for comparison with myoelectric signal analysis. The investigation revealed significant differences in group statistics between patients in early rehabilitation and their subsequent tests, as well as between their initial test and the normal subject scores. However, test sensitivity for identifying patients with "low endurance" is questionable. There was no significant correlation between EMG initial MPF measures and isokinetic extensor trunk strength measures, even though all patients showed isokinetic improvement. Data suggest that the protocol used and myoelectric power spectrum temporal shifts may have some value for identification of individual subjects with endurance limitations (or fatigue resistance) in patients of this type. However, lack of a "gold standard" for comparison presents difficulties in documenting the value and validity with respect to endurance. The test may be of value to measure relative loads. PMID- 2781413 TI - Involvement of unstable chromosomal regions containing C-heterochromatin and fragile sites in the integration of amplified dhfr domains. AB - A 10(-3) M methotrexate (MTX)-resistant variant (H2), selected from the murine fibrosarcoma line B77-3T3/AA12, was characterized after 5 (H2 MTXRes I) and 9 (H2 MTXRes II) months of in vitro propagation in the presence of the drug. Southern blot hybridization of wild-type and H2 MTXRes DNAs confirmed amplification of the dhfr gene without apparent rearrangements in its structure. Cytogenetic analysis revealed that double minutes (DMs) predominated in H2 MTXRes I, whereas homogeneously staining regions (HSRs) were the main feature of H2 MTXRes II cells. HSRs, shown to contain dhfr sequences by in situ chromosome hybridization, were localized within two rearranged chromosomes, designated as m1 and m2 because of their derivation from the marker chromosome m of AA12 cells. This chromosome, characterized by two interstitial C bands adjacent to two nonstaining gaps, was no longer observed in H2 MTXRes II cells. A role for nonrandom involvement of chromosome m in the integration of amplified DNA is suggested by the finding of another HSR-chromosome, m3, derived from m, in an independent MTXRes clone (B1). Rearrangement in one of the unstable C-band/gap regions of chromosome m is proposed as the unifying mechanism that may account for the outcome of the three HSR chromosomes observed. PMID- 2781414 TI - Perspectives on UV light mutagenesis: investigation of the CHO aprt gene carried on a retroviral shuttle vector. AB - The extent to which the cellular processing of shuttle vector-carried genes reflects that of endogenous chromosomal loci has been a subject of considerable controversy. In order to address this issue, we have developed a retroviral-based shuttle vector carrying the Chinese hamster ovary (CHO) adenine phosphoribosyltransferase (aprt) gene stably integrated into the genome to be used for studying mutational specificity in mammalian cells. Initially, we have characterized a collection of UV-induced mutants in a CHO cell background. We have therefore been able to directly compare this shuttle vector data to that previously obtained for UV-induced mutation at the endogenous CHO (aprt) locus. Although some potential differences between the two spectra have been noted, there appears to be a remarkable similarity in the distribution and site specificity of UV-induced mutations. These similarities extend to extrachromosomal shuttle vectors as well and consolidate the role of shuttle vectors as powerful analytical tools for studying mechanisms of point mutagenesis in mammalian cells. PMID- 2781415 TI - Molecular characterization of human minichromosomes with centromere from chromosome 1 in human-hamster hybrid cells. AB - In this study we examine the amounts of four different human satellite DNA sequences in a series of human-hamster hybrid cells, which contain a human minichromosome including the centromere of human chromosome 1. Comparisons with the corresponding amounts in an intact human chromosome 1 suggest that the minichromosomes have lost satellite DNA sequences, and in one case a substantial fraction of several satellite DNAs is lost, without affecting the stability and normal mitotic segregation of the minichromosome. The smallest minichromosome appears to have lost all of the long arm and a significant portion of centromeric heterochromatin, while retaining 1000-2000 kb of the short arm of human chromosome 1. The satellite sequences examined include: a chromosome 1-specific satellite III probe, a chromosome 1-specific alpha satellite DNA, another alpha satellite DNA originally derived from the X chromosome, and an alphoid EcoRI dimer whose isolation from one of the minichromosomes and characterization is also described in this paper. One interpretation of these data indicates that an interspersion of blocks of satellite sequences occurs in the centromere region of chromosome 1. If these satellite sequences have functional significance, then there may be redundancy in the system that allows for a variation in the size of the kinetochore and the number of attachment sites for microtubules. PMID- 2781416 TI - Assignment of retinoblastoma susceptibility gene to mouse chromosome 14. AB - A human cDNA probe was used to screen a panel of mouse-Chinese hamster somatic cell hybrids to determine the chromosomal location of the retinoblastoma susceptibility gene (Rb-1) in mouse. The Rb-1 gene mapped to mouse chromosome 14. Thus, the retinoblastoma susceptibility gene is syntenic with esterase 10 (the mouse homolog of human esterase D). The chromosomal assignment of the mouse Rb-1 gene was further confirmed by using the same probe to study mouse-rat microcell hybrids. Since the human retinoblastoma susceptibility gene (RB1) along with the gene for esterase D is on chromosome 13q14, these data indicate this linkage group is conserved in man and mouse. PMID- 2781417 TI - Genes for HMG-CoA reductase and serotonin 1a receptor are on mouse chromosome 13. AB - 3-Hydroxy-3-methylglutaryl-coenzyme A (HMG-CoA) reductase is the key regulatory enzyme for cholesterol biosynthesis. The human gene (HMGCR) has been assigned to the q13.3-q14 region of chromosome 5 (HSA5). We have now mapped the mouse gene Hmgcr to mouse chromosome 13 by Southern analysis of somatic cell hybrids. We also report the mapping to mouse chromosome 13 of the murine homolog of the gene for an intronless beta 2-adrenergic-like receptor, which is also located on human chromosome 5 region q11.2-q13 and has recently been identified as the serotonin 1a receptor. Our results confirm the existence of an evolutionarily conserved syntenic group of genes on the proximal long arm of HSA5 and on MMU13 that also includes the loci for arylsulfatase B, hexosaminidase B and dihydrofolate reductase. PMID- 2781418 TI - Gene for alpha 2(I) collagen is on mouse chromosome 6 not 16. AB - Collagen is the most abundant protein in the animal world and a principal component, of the extracellular matrix of tissues. Type I collagen is composed of two alpha 1 chains and one alpha 2 chain. The human alpha 2(I) locus (COL1A2) has been assigned to human chromosome 7q21.3-q22.1. Here, we report the mapping of its murine counterpart Colla-2 to mouse chromosome 6 (MMU6) by Southern blotting using somatic cell hybrids. This result disagrees with the previously reported mapping of Colla-2 to MMU16 by immunochemical techniques. Our results are supported by comparative mapping data showing conserved homology between regions of human chromosome 7 and mouse chromosome 6. PMID- 2781419 TI - Improving peri-operative pain control. PMID- 2781420 TI - Screening antenatal blood samples for anti-human immunodeficiency virus antibodies by a large-pool enzyme-linked immunosorbent assay system. Results of an 18-month investigation. AB - Blood samples submitted for routine antenatal testing from 104,683 pregnant women resident in the southern Transvaal were screened for antibodies to the human immunodeficiency virus (HIV) during an 18-month period--1 May 1987 - 31 October 1988. All blood samples were initially screened by a modified enzyme-linked immunosorbent assay whereby 48 samples are tested simultaneously in one microtitre well. Each positive 48-pool was subdivided and retested in a 12-pool system. The individual positively reacting sample, having been identified, was submitted to a reference laboratory for confirmatory testing which included Western blotting. In the cohort of 84,527 black women tested, the incidence of confirmed anti-HIV positivity was 1:2753 (0.036%) in the first 3 months of the study and increased to 1:461 (0.217%) in the last 3-month period. PMID- 2781422 TI - Nutritional assessment in rheumatoid arthritis. AB - The nutritional status was assessed in a group of 220 patients with rheumatoid arthritis from three communities (coloured 89 patients, white 88 and black 43). The triceps skinfold (TSF) thickness, upper arm muscle circumference (UAMC), body mass index (BMI) and percentage of ideal body weight (% IBW) were measured and the serum albumin value determined. The mean age of the coloured patients was 49.8 years, white 57.7 years and black 44.8 years. Forty-five patients (20.5%) had a reduction of one or more anthropometric measurements (TSF, UAMC and/or %IBW) and a further 6 patients (2.7%) had a reduction of the serum albumin value alone. These 51 patients were considered to be malnourished and had a higher mean erythrocyte sedimentation rate and more severe functional disability than the remainder of the patients. The prevalence of malnutrition was lower if diagnosed only on abnormality of the TSF, UAMC and %IBW, since 25 patients (11.4%) had a reduction of only one measurement, 12 (5.5%) had a reduction of 2 and 8 (3.6%) had a reduction of all three measurements. Obesity (BMI greater than 30) was noted in 10.5% and there were no differences in the functional disability, disease activity and use of steroid therapy in the obese patients compared with the rest of the patients. PMID- 2781421 TI - Nifedipine in acute hypertensive emergencies in pregnancy. AB - The effect of nifedipine (Adalat; Bayer-Miles)--a calcium channel blocker, which has a well-established place in nonobstetric hypertension--was compared with dihydralazine in 33 primigravidas with severe hypertension of pregnancy. Patients with a diastolic blood pressure greater than 110 mmHg before drug administration were randomly assigned to treatment with either nifedipine or dihydralazine. Both drugs were found to be equally efficacious. Nifedipine, however, showed an earlier onset of action in lowering systolic blood pressure and had the advantage of oral administration. PMID- 2781423 TI - Functional endoscopic sinus surgery. A critical long-term evaluation. AB - Functional endoscopic sinus surgery (FESS) has been hailed as a breakthrough in the surgical management of chronic recurring sinusitis. A study was conducted and the results scrutinised to determine the validity of this claim. A long-term evaluation of patients who had undergone FESS was conducted in order to determine the most common pre-operative symptoms and signs, intra-operative findings and postoperative progress. These details were analysed by computer to identify common factors in the small percentage of patients who present with persistent recurring sinusitis after FESS. Suggestions that will minimise the risk of failure are presented. PMID- 2781424 TI - Effect of opioid antagonism on the ability to tolerate maximal anaerobic exercise. AB - The effect of naloxone-induced endogenous opioid antagonism on the ability to tolerate maximal anaerobic exercise was studied in 11 young men. Volume-matched infusions of placebo or naloxone 4 mg were administered in a randomised double blind crossover trial before a 30-second maximal cycle ergometer test (Wingate test). Mechanical power output was calculated for each 5 seconds of cycling and expressed as peak power (highest output during any 5-second period), average power (average output during the 30 seconds of cycling) and power decline (difference between peak power and the lowest 5-second power output divided by time). Naloxone did not significantly modify (P greater than 0.05) any index of anaerobic power. Similarly, the perception of leg pain during exercise was similar with placebo and naloxone. Therefore, insofar as naloxone may be used to examine the functional role of opioid-mediated mechanisms, these findings are not tenable with the hypothesis that endogenous opioids modulate the ability to tolerate maximal anaerobic exercise. PMID- 2781425 TI - Eye injuries associated with 'war games'. AB - Eye injuries sustained by 4 patients who took part in 'war games' (in which young men shoot at each other with pistols powered by compressed carbon dioxide and firing latex rubber bullets filled with non-toxic paint) are described. In 3 cases the injuries were severe, including traumatic cataract, and 1 of these patients has a permanent macula scar with vision reduced to 6/36. Although eye protection is recommended, it was found that in the 'battle situation' combatants did not always follow regulations. Attention is drawn to the seriousness of disregarding the need for correct protective glasses. PMID- 2781426 TI - Haemorrhage in cerebral toxoplasmosis. A report on a patient with the acquired immunodeficiency syndrome. AB - A patient with the acquired immunodeficiency syndrome (AIDS) presented to hospital with a haemorrhagic cerebral lesion. The lesion was biopsied and electron microscopy confirmed a diagnosis of toxoplasmosis. Although known in congenital cases, haemorrhagic infarction is unknown in adults suffering from cerebral toxoplasmosis. Severe vasculitis with subsequent thrombosis and extensive fibrinoid necrosis of the vessel wall or direct parasitism of endothelial cells with subsequent destruction and seepage of blood appear to be the possible mechanisms in a situation where the T-cell immune mechanism and tissue cell response are compromised. Other intracerebral haemorrhagic lesions in AIDS were reviewed. PMID- 2781427 TI - [Primary echinococcus cyst of the heart. A case report]. AB - A young male commercial pilot, completely asymptomatic of heart disease, was found to have an abnormal ECG on routine examination. This consisted of a bifascicular block (left anterior hemiblock plus a complete right bundle-branch block). Aviation regulations demanded further examination to rule out possible cardiac disease. On two occasions in 1984 and again in 1986 cardiac catheterisation was performed and revealed normal left ventricular function and normal coronary arteries. On 15 April 1986 an echocardiogram revealed a large cystic mass in the right ventricle, which was further delineated by right-sided cine-angiography. The patient was referred for cardiac surgery with the diagnosis of an Echinococcus cyst as the most likely possibility. Open-heart surgery was performed on 16 July 1986 and a 4 x 4 cm hydatid cyst, originating from the right ventricle septum and projecting into the right ventricular cavity, was removed. The diagnosis of Echinococcus granulosus was confirmed by histological examination. PMID- 2781428 TI - Reconstruction of the penis using a radial forearm free flap. A case report. AB - The total reconstruction of a penis using an innervated radial forearm osteofasciocutaneous free flap is described. Essentially, this procedure is completed in a single stage and satisfies all criteria for good penis reconstruction: the urethra opens at the distal end of the shaft allowing normal micturition; and sensory innervation of the flap, together with the inclusion of vascularised autogenous bone as a stiffener, facilitates normal sexual function. PMID- 2781429 TI - [The treatment of congenital syphilis with penicillin]. PMID- 2781430 TI - Selective screening for high cholesterol levels. PMID- 2781431 TI - [Analysis of the qualitative care indices as a prerequisite to further improvement in fundamental outpatient medical care]. AB - The paper is aimed at finding the possibilities of increasing the quality of outpatient care, especially of home care and of the specific forms of specialized dispensary care. Authors emphasize the importance of organizing a unitary and long-term medical and social care for chronic, disabled and old patients. Likewise, they consider medical home-care as a basic principle of outpatient care -and important factor for the harmonious physical and mental development of men, for maintenance of working capacity. PMID- 2781432 TI - Complex evaluation of health status, occupational and non-occupational working conditions of women employed in the textile industry. PMID- 2781433 TI - A reform concept for performance assessment and cost accounting in health care. PMID- 2781434 TI - [The dental component of the integrated program of preventing chronic noninfectious diseases in the Latvian SSR. I. Epidemiologic study of dental caries and periodontal diseases in the whole population of the Latvian SSR]. AB - The frequency and severity of dental caries and periodontal diseases among the population of the Latvian SSR, as well as the risk factors which contribute to the development of these morbid processes were studied. It was found that dental caries are present in 98 per cent of pupils aged 12 years, the CFE index (Caries Filling Extraction Index) representing 6.7. Among adolescent aged 15 years, a healthy periodontium and a good hygienic state of the oral cavity were found only in 2 per cent. Taking into account the high frequency of these diseases, the primary prophylaxis programme of dental caries and periodontopathies was included as a component in the integrated WHO programme of prevention and control of noninfectious chronic diseases in the Latvian SSR. PMID- 2781435 TI - [Ergonomic study of neuropsychic impairment in relation to health status in printing occupations]. AB - The exertion and risk factors in relation with the state of health, with the psychophysiological reactivity and with the adaptation and fatigue symptomatology were studied by means of complex psychological, psychophysiological, medical) methods in two professional groups that perform an activity implying important mental and sensorial components: monotasterers and correctors, from three polygraphic enterprises and two publishing houses, totalling 167 subjects (74 monotasterers and 93 correctors). The ergonomic work analysis demonstrated that the exertion and risk factors are conditioned both by the contents of work and by the working environment. The occupational exertion is more complex in monotasterers (mental, sensorial and physical) and predominantly sensorial (visual) in correctors. The work hazards are especially brought about by overstraining of the attention and of the visual analyser, with consequences both on the health of workers and on the quality of production. The investigation of the state of health, of the psychophysiological reactivity, as well as of the adaptation and fatigue symptomatology has detected maladjustment and fatigue phenomena, with impairments of the psychosomatic balance, more marked in monotasterers. The suggestions regarding improvement measures were directed both towards aspects of medico-psychological prophylaxis and elements of corrective ergonomics. PMID- 2781437 TI - Language aspects of the health-education message. PMID- 2781436 TI - Alcoholism with women, origin, characteristics and effects. PMID- 2781438 TI - [The results of a study of general morbidity in the population of the People's Republic of Mongolia]. AB - A complex study on general morbidity of the population residing in areas different both from economic and geographic viewpoints has been carried out in the Mongolian People's Republic. The results got from the processing of the data regarding the population's coming to the physician (addressability) and from the data on the complex medical check-ups (screening) brought about the following morbidity values: 1,449.6% with urban population, 1,582.7% with the population in aimak centers and of 1,342.3% with rural population. Within the morbidity structure, the prevalent diseases are: of the respiratory system, of the circulatory system, of the digestive tract, infectious diseases, and of the genital-urinary organs. PMID- 2781440 TI - Economic aspects in developing the health care system in Hungary. PMID- 2781439 TI - Achievements and prospects in the social medicine research. PMID- 2781441 TI - Delayed discharges for medical and surgical patients in an acute care hospital. AB - A study of social work-coordinated discharges from medical and surgical units at a 387-bed tertiary care hospital in Seattle, Washington examines social, medical and organizational factors associated with overstays. Social and medical variables included an absence of social supports, multiple diagnoses, and patient/family decision-making problems. Though organizational factors within and outside the hospital were identified, the most frequent systems delay was due to lack of post-hospital beds. PMID- 2781442 TI - Discharge planning strategies for acutely homeless inpatients. AB - Medical and psychiatric inpatients who become unexpectedly homeless during the course of the hospital stay present an extremely complex and time-consuming challenge to social work staff. The sudden shift from domiciled to undomiciled status creates a crisis for both the patient and the institution. Unanticipated homelessness among inpatients is usually associated with multiple high-risk factors which contribute to the rejection of such patients by numerous community facilities and services. Social workers are under pressure to both effect a timely and safe discharge when acute care ends, and to avoid placing such persons in the shelter system where follow-up care is nonexistent or inadequate. This paper reviews characteristics of persons who become acutely homeless during a hospital admission and suggests approaches which may be used to identify and prevent this perplexing syndrome. PMID- 2781443 TI - Alzheimer's disease support groups: an analysis of their structure, format and perceived benefits. AB - The focus of this article is the identification and assessment of the strengths and weaknesses of Alzheimer's disease support groups' predominant model of service delivery. Based on information from 47 support group leaders and 301 members, Alzheimer's disease support groups' structure, format, member composition and perceived benefits are examined. The data suggest that support groups have primarily focused on education and peer support and less attention has been directed towards caregivers' own emotional needs and the effects of the disease on the whole family system. Findings also revealed that families with relatives in the early disease stages are underrepresented in support groups. Practice implications of the findings are discussed. PMID- 2781444 TI - Reminiscence groups with confused nursing center residents: an experimental study. AB - Reminiscence groups have been used successfully in several types of elder-care settings. This article is a study of the use of reminiscence groups with confused elderly residents of nursing centers in an attempt to improve the quality of subjects' social behaviors. Results partially supported the hypotheses. Social and demographic data were correlated with improvement or lack of it. The study suggests that the skills of the therapist are an important variable in reminiscence therapy as is true with other types of professional intervention. PMID- 2781446 TI - Chest-wall reconstruction. PMID- 2781445 TI - Use of the omentum in chest-wall reconstruction. AB - Increased use of the omentum in chest-wall reconstruction has paralleled the refinement of anatomic knowledge and the development of safe mobilization techniques. Important anatomic points are the omental attachments to surrounding structures, the major blood supply from the left and right gastroepiploic vessels, and the collateral circulation via the gastroepiploic arch and Barkow's marginal artery. Mobilization of the omentum to the thorax involves division of its attachments to the transverse colon and separation from the greater curvature to fabricate a bipedicled flap. Most anterior chest wounds and virtually all mediastinal wounds can be covered with the omentum based on both sets of gastroepiploic vessels. The arc of transposition is increased when the omentum is based on a single pedicle, allowing coverage of virtually all chest-wall defects. The final method of increasing flap length involves division of the gastroepiploic arch and reliance on Barkow's marginal artery as collateral circulation to maintain flap viability. With regard to chest-wall reconstruction, we have included the omentum in the armamentarium of flaps used to cover mediastinal wounds. The omentum is our flap of choice for the reconstruction of most radiation injuries of the chest wall. The omentum may also be used to provide protection to visceral anastomoses, vascular conduits, and damaged structures in the chest, as well as to cover defects secondary to tumor excision or trauma. In brief, the omentum has proved to be a most dependable and versatile flap, particularly applicable to chest-wall reconstruction. PMID- 2781447 TI - Intraoperative intra-arterial thrombolytic therapy for salvage of limbs in patients with distal arterial thrombosis. AB - Acute arterial embolic or thrombotic occlusion of the runoff vessels is associated with an incomplete operative thromboembolectomy and an unacceptably high rate of amputation. This report presents a six year analysis of the use of intraoperative intra-arterial thrombolytic therapy, evaluating 38 patients who presented with impending loss of limb because of an acute occlusion of the runoff vessels. All of the patients had extensive thrombosis of a distal vessel and a complete distal thromboembolectomy was not possible. Fourteen patients received infusion of streptokinase, maximum dose of 50,000 units; 26 received urokinase (UK), maximum dose of 150,000 units, and two underwent an isolated limb perfusion technique using one million units of UK. Thirty-four lower and four upper extremities were treated. Twenty-eight of 38 patients had successful revascularization procedures that resulted in salvage of the limbs, and ten of the 38 underwent an extensive amputation. In 18 of the 28 who were successfully revascularized, lysis was clearly obtained, which contributed to the ultimate success; in ten of the 28, it was unclear whether or not lysis significantly contributed to salvage of the limbs. Although four of the 38 died within 30 days postoperatively and one patient had a hemorrhagic complication, neither the deaths nor the complication could be attributed to a lytic agent. There was no evidence of systemic thrombolysis in these patients. Intraoperative intra arterial thrombolytic therapy administered by the slow bolus injection technique is safe. It can be an important adjunct to mechanical thromboembolectomy and bypass procedures in patients with limb-threatening ischemia caused by thrombosis of the distal part of the vessel. The isolated limb perfusion technique using high dose UK is particularly valuable in acute, small vessel, multiarterial occlusion. Intraoperative intra-arterial infusion of thrombolytic agents may make the difference between salvage or amputation of the limb without causing additional risk for the patient. PMID- 2781449 TI - Agonal hepatic arterial vasospasm. AB - The effect of donor pretreatment with Dibenzyline (phenoxybenzamine) on hepatic arterial vasospasm was studied in a porcine asphyxia model. Nine pigs underwent hepatectomy without pretreatment, while six were given 2 milligrams per kilogram of Dibenzyline prior to hepatic dissection. Hepatic arterial blood flow was monitored with an electromagnetic flow probe, and after cardiac arrest, arteriograms of the hepatic circulation were obtained. Hepatic arterial vasospasm occurred in seven of the pigs in group 1 and in only one of group 2 (p less than 0.05). Agonal hepatic arterial blood flow remained constant (415 +/- 30 milliliters per minute) in pretreated pigs during asphyxia, but was markedly reduced (98.6 +/- 63.3 milliliters per minute) in nonpretreated pigs (p less than 0.05). Results of this study demonstrate the agonal occurrence of hepatic arterial vasospasm and its prevention with Dibenzyline. Donor pretreatment with alpha-adrenergic antagonists may be indicated in clinical organ procurement to prevent agonal arterial vasospasm and its potentially adverse effect on early hepatic allograft function. PMID- 2781448 TI - Postoperative renal dysfunction can be predicted. AB - The two prior hypotheses of the study were that, among a high risk population of patients who were hypertensive, who had diabetes and who underwent elective general surgical treatment, the duration of intraoperative hypotension and hypertension (greater than 20 millimeters of mercury above or below the preoperative base line) and intraoperative administration of less than 300 milliliters per hour of saline solution containing fluids would identify patients at higher risk for postoperative renal dysfunction. Among those who had an intraoperative mean arterial pressure (MAP) that fell more than 20 millimeters of mercury below the base line, 15 per cent of those with fall of MAP lasting for greater than or equal to 60 minutes had postoperative renal dysfunction, whereas those with drops in pressure lasting for less than 60 minutes did not sustain increased postoperative renal dysfunction. Patients who had intraoperative MAP rise to greater than 20 millimeters of mercury above the preoperative base line value for greater than 30 minutes also had twice the rate of postoperative renal dysfunction. Fifteen per cent of the patients who received less than 300 milliliters per hour of isotonic saline-like fluids had postoperative renal dysfunction, significantly more than the 8 per cent of those who received greater than or equal to 300 milliliters per hour. Two intraoperative events also significantly increased postoperative renal dysfunction rates: cardiac arrest and the drainage of massive ascites. Patients with decompensated congestive heart failure at admission to the hospital had significantly increased postoperative renal dysfunction; these patients and probably should not undergo an operation unless it is an emergency. All of the patients, regardless of the magnitude of the operation and of its projected length or type of anesthesia, should be given greater than 300 milliliters per hour of isotonic saline-like solutions. PMID- 2781450 TI - Idiopathic facial palsy in pregnancy and the puerperium. AB - An association between pregnancy and idiopathic facial palsy has been observed previously. A five year review of patients admitted to the Brigham and Women's Hospital disclosed 18 new instances of pregnancy associated Bell's palsy. Twelve patients became symptomatic during the third trimester and six during the first two weeks post partum. Primiparity was not a risk factor for pregnancy-associated facial palsy, but pre-eclampsia was six times more prevalent among patients in this study than among the general population of gravid women. Of 14 patients observed, eight had complete return of mimetic function within three months of the onset of symptoms. The remaining six patients had only mild residual facial weakness after a mean interval of 22 months. The administration of steroids did not appear to influence recovery. PMID- 2781451 TI - Method of measurement for volume of an extremity. PMID- 2781452 TI - A technique for choledochojejunostomy with one anastomosis. PMID- 2781453 TI - Introflexion as a method of surgical treatment for hydatid disease. AB - For the management of the residual cavity after removal of a hydatid cyst, several surgical methods have been suggested. To prevent the undesirable results of the previously suggested techniques, we have been using a new method called introflexion. This simple, safe and effective method has been described and discussed herein. PMID- 2781455 TI - Diverting cervical esophagostomy and construction and primary reconstitution of esophageal continuity. AB - A simple technique has been described herein that will allow the surgeon to construct a temporary, totally diverting, cervical esophagostomy, and then allow the surgeon to take down the esophagostomy with primary cervical esophageal reconstitution. Crucial to the success of this method is the careful preparation of the esophagus for a tension-free reconstruction at the time of the initial diversion procedure. PMID- 2781454 TI - Finding the wire during a localized needle biopsy of the breast. PMID- 2781456 TI - Transduodenal sphincteroplasty for impacted stone made unnecessary by electrohydraulic lithotripsy. AB - Electrohydraulic lithotripsy has been safely applied in two patients with impacted stones at the lower end of the common bile duct. If definitive biliary drainage operation is not indicated, electrohydraulic lithotripsy is an effective alternative to transduodenal sphincteroplasty. PMID- 2781457 TI - Use of a new retractor for the upper part of the abdomen. PMID- 2781458 TI - Surgical management of syringomyelia--current results. AB - A retrospective study of the surgical results of 98 patients with syringomyelia was carried out. As primary surgical management, 38 cases were treated by craniovertebral decompression, 28 cases by craniovertebral decompression with syringotomy, and 22 cases in which Gardner's operation was performed. Primary syringoperitoneal shunt was done on six patients and the other primary procedures were performed on four. As the secondary operation, syringostomy was performed on nine patients and syringoperitoneal shunt on seven. Better results were obtained in patients managed by craniovertebral decompression with syringotomy or Gardner's operation. However, Gardner's operation had a higher mortality rate and a higher incidence of complication. If a second operation was required, syringoperitoneal shunt had a higher rate of stabilization than syringostomy. PMID- 2781459 TI - Transplantation of cultured embryonic spinal cord grafts into the hemisected spinal cord of adult rabbits. AB - Spinal cord fragments from 20-day-old rabbit embryos cultivated for 1 week were transplanted into the hemisected and intact spinal cord of adult rabbits. The morphological changes at the site of intervention were investigated by light and electron microscopy 3, 12, and 29 weeks following implantation. In 80% of the animals the procedure was successful. The implants grew in volume, the cells matured, and many new neural processes with myelinization and synapse formation appeared. The histological findings indicate the survival, maturation, and integration of transplanted cultured embryonic spinal cord tissue in the lesioned adult spinal cord. PMID- 2781460 TI - Pressure changes within a chronic subdural hematoma during hemodialysis. AB - Spontaneous intracranial hemorrhage is not an infrequent complication of systemic anticoagulation, as occurs in hemodialysis. The neurological symptoms of subdural hematoma may be similar to those of dialysis disequilibrium. The pressure within a subdural fluid collection was monitored in a patient undergoing hemodialysis. The patient was known to become unresponsive during previous dialysis treatments. The initial pressure within the subdural cavity was measured to be -10.0 cm H2O prior to dialysis. The pressure within the collection decreased to a minimum value of -19.4 cm H2O during dialysis and stabilized at -16.4 cm H2O at the termination of dialysis. The neurological status changed subjectively during the procedure, with the patient becoming unresponsive to verbal stimuli as the intracranial pressure reached a minimum. These findings represent a syndrome similar to aliquorrhea, or low cerebrospinal fluid pressure within an otherwise asymptomatic subdural hematoma. Previously only increased intracranial pressure has been reported with hemodialysis. PMID- 2781461 TI - Extradural hematomas of the posterior cranial fossa. Observations on a series of 32 consecutive cases treated after the introduction of computed tomography scanning. AB - A series of 32 patients with posterior fossa epidural hematoma treated after the introduction of computed tomography scanning between 1975 and March 1988 is presented. Sixteen patients harbored "pure" epidural hematomas, whereas 16 had other infratentorial or supratentorial traumatic lesions. Glasgow Coma Scale on admission was 7 or less in 10 patients, 8-12 in 11, and 13-14 in 11. Only six patients had a lucid interval. Thirty patients were treated surgically; two patients with small hematomas were treated conservatively. Overall mortality was 15.6%, with 0% for "pure" and 31.2% for "complicated" posterior fossa epidural hematomas. The value of routine computed tomography scanning is emphasized in cases with occipital skull fracture or when such fracture is found in patients undergoing emergency evacuation of supratentorial hematomas. The pertinent literature is addressed with special regard to the delayed occurrence, associated lesions, and mortality of posterior fossa epidural hematomas and to the role of computed tomography scanning. PMID- 2781462 TI - Posterior epidural migration of extruded lumbar disk. AB - Migration of herniated lumbar disks is discussed, and the case of a 61-year-old man with acute lower back pain is reviewed. PMID- 2781464 TI - Quantitative autoradiographic distribution of [3H]AF-DX 116 muscarinic-M2 receptor binding sites in rat brain. AB - The distribution of muscarinic-M2 receptors in rat brain was investigated by in vitro autoradiography using [3H]AF-DX 116, a putative probe for the muscarinic-M2 receptor subtype. Incubation of rat brain coronal sections with 10 nM [3H]AF-DX 116 showed highest binding site densities in discrete areas such as the superior colliculus and certain thalamic and brainstem nuclei, similar to the distribution reported for [2H]acetylcholine/M2 sites. [3H]AF-DX 116 site densities were markedly lower in forebrain areas such as cortex, striatum, and hippocampus, in contrast to the distribution seen for [3H]pirenzepine-M1 binding sites, which were concentrated in these forebrain areas; however, differential patterns of labeling were observed for the two muscarinic-M2 probes, [3H]AF-DX 116 and [3H]acetylcholine, in the hippocampal formation. Although [3H]AF-DX 116 binding was broadly distributed in multiple subfields of the hippocampus, [3H]acetylcholine binding was discretely distributed in a manner resembling that of acetylcholinesterase staining. This suggests the existence of muscarinic-M2 subtypes in the CNS, especially in the hippocampal formation. PMID- 2781463 TI - Characterization of [3H]AF-DX 116 binding sites in the rat brain: evidence for heterogeneity of muscarinic-M2 receptor sites. AB - This study shows that [3H]AF-DX 116 binds specifically, saturably, and with high affinity to putative muscarinic-M2 receptor sites in the rat brain. In homogenates of the hippocampus, cerebral cortex, striatum, thalamus, and cerebellum, [3H]AF-DX 116 appears to bind two subpopulations of muscarinic sites: one class of higher affinity sites (Kd less than 4.0 nM) and one class of lower affinity sites (Kd greater than 50 nM, except in the cerebellum). The apparent maximal capacities (Bmax) of [3H]AF-DX 116 sites in forebrain tissues ranged between 34 and 69 fmol/mg protein for the higher affinity site, and between 197 and 451 fmol/mg protein for the lower affinity site. In cerebellar homogenates, the maximal capacity of [3H]AF-DX 116 binding sites was 10.4 +/- 0.4 (Kd = 1.9 +/ 0.2 nM) and 39.1 +/- 2.6 (Kd = 26 +/- 7 nM) fmol/mg protein for the higher and the lower affinity site, respectively. Determination of the Kd for the higher and lower affinity [3H]AF-DX 116 sites from association and dissociation constants yielded similar values to those obtained from the saturation data. The ligand selectivity pattern reveals that AF-DX 116 is more potent than (-)QNB greater than atropine greater than methoctramine greater than 4-DAMP greater than gallamine greater than NMS greater than carbamylcholine greater than oxotremorine greater than pirenzepine much greater than nicotine in competing for the higher affinity [3H]AF-DX 116 sites. With few exceptions, the pattern was similar for the lower affinity sites.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2781465 TI - Long-term potentiation in hippocampal CA3 neurons: tetanized input regulates heterosynaptic efficacy. AB - Three excitatory synaptic inputs to hippocampal CA3 neurons--the mossy fibers, Schaffer collateral/commissural fibers, and fimbrial fibers--were determined to be separate and independent in the pharmacologically disinhibited in vitro slice. Long-term synaptic potentiation (LTP) was induced in one of these three synaptic inputs, and subsequent synaptic efficacy changes in the other two nontetanized inputs were characterized using current and voltage clamp techniques. LTP in the mossy fiber input was accompanied by potentiation of Schaffer and fimbrial responses, whereas the induction of LTP in the Schaffer pathway was associated with the potentiation of fimbria responses and a depression of mossy fiber responses. LTP induced in the fimbrial response was confined to that input alone. PMID- 2781466 TI - Differential effect of cocaine on extracellular dopamine levels in rat medial prefrontal cortex and nucleus accumbens: comparison to amphetamine. AB - The technique of in vivo microdialysis was used to measure the extracellular levels of dopamine in the nucleus accumbens septi and medial prefrontal cortex of chloral-hydrate-anaesthetized rats following systemic administration of cocaine and amphetamine. Intravenous injection of cocaine increased the extracellular levels of dopamine in the medial prefrontal cortex and the nucleus accumbens septi in a dose-dependent manner. However, the magnitude of increase was significantly greater in nucleus accumbens than in medial prefrontal cortex. In comparison to cocaine, amphetamine increased the extracellular levels of dopamine in the nucleus accumbens and medial prefrontal cortex to the same degree. Based on the relatively small increase of extracellular dopamine levels in medial prefrontal cortex by cocaine, it is postulated that dopaminergic innervation of other structures besides medial prefrontal cortex may be involved in maintenance of cocaine self-administration. PMID- 2781467 TI - Failure to block responses of locus coeruleus neurons to somatosensory stimuli by destruction of two major afferent nuclei. PMID- 2781468 TI - Retardation of amygdaloid kindling in the rat by the excitatory amino acid antagonist kynurenic acid. PMID- 2781469 TI - Identification of L-dopa-dopamine and L-dopa cell bodies in the rat mesencephalic dopaminergic cell systems. AB - An immunocytochemical technique for simultaneously visualizing two different antigens, dihydroxyphenylalanine (L-DOPA) and dopamine (DA), has been used to investigate the presence of cell bodies containing both compounds L-DOPA and DA and those having only L-DOPA in rat mesencephalon areas. The brain slices were processed with a double peroxidase-antiperoxidase method using simultaneously an incubation of a rabbit anti-L-DOPA serum and a monoclonal anti-DA antibody raised in mouse. Both antigens were revealed by the peroxidase reaction but with different chromogens that are easily distinguishable. In this staining procedure, the first antigen, conjugated DA was stained using the 3,3'-diaminobenzidine (DAB)-Nickel complex; while the second antigen, conjugated L-DOPA, was localized using DAB. The yellow-brown color due to DAB was masked by that of DAB-nickel. The possible existence of both single and double labelings could be worked. We have found many L-DOPA-positive/DA-positive and a few L-DOPA-positive/DA-negative cell bodies in dopaminergic regions in the rat midbrain: substantia nigra, ventral tegmental area, and raphe nuclei. In the locus coeruleus, we noted only L DOPA-positive/DA-positive cell bodies. These results confirm those previously described for rat and cat hypothalamus, where both immunoreactive-cell body types have been detected: L-DOPA positive/DA positive and L-DOPA positive/DA negative. The existence of neuronal cells containing only L-DOPA is a new neuroanatomic finding, accounting better for the heterogeneity of dopamine systems with respect to physiologic, pharmacologic, and molecular data. PMID- 2781470 TI - [Hemosorption in systemic vasculitis]. AB - The present work summarises the experience gained with the use of extracorporeal hemoperfusion in 45 patients suffering from rheumatic diseases. During hemoperfusion, there was a decrease in the initially activated LDH, CPK, AST, ALT and AP. The reduction of the content of phospholipids and cholesterol in plasma and red blood cells is assessed as an adverse effect of hemoperfusion, since the content of phospholipids and cholesterol was under normal before hemoperfusion. The changes indicated point to the necessity of administering antioxidants and exogenous phospholipids. PMID- 2781472 TI - [Periarthrosis of the knee joint in patients with gonarthrosis]. PMID- 2781471 TI - [Features of the diagnosis and treatment of paracancerous pneumonia in bronchogenic pulmonary carcinoma]. AB - Based on the clinical observations and post mortem examinations the data are provided on the development, diagnosis and treatment of secondary pneumonias in bronchogenic pulmonary carcinoma. The authors describe the local immunological disorders in patients suffering from pneumonia: the morphologic changes, alterations in the content of lysozyme and protein, acid phosphatase activity, and in the NBT-test for neutrophils of the bronchoalveolar lavage fluid. Demonstrate the clinical efficacy of endobronchial administration of the incubated leukocyte and platelet mass stimulated with tactivin. PMID- 2781473 TI - [Intra-articular administration of glucocorticoids in rheumatoid arthritis from the doctor and patient's viewpoint]. AB - Based on the opinions of 20 expert rheumatologists from two rheumatological hospitals a number of important assumptions are provided relative to the intraarticular administration of glucocorticoids in patients suffering from rheumatoid arthritis. The viewpoints appeared to be many and varied even within the frameworks of the same hospital. The ranging of some rehabilitation factors in certain parameters (efficacy, danger, availability, and so forth) demonstrated that the technique of intraarticular punctures is an effective and popular enough method for the treatment of patients suffering from rheumatoid arthritis. The doctors' assessments of the method were on the whole higher as compared to the patients' assessment (66 patients with rheumatoid arthritis). There were appreciable differences in the correlation ratios among the doctors as regards the assessments "effective--ineffective" and "I know it very well based on my own experience"--I know it poorly". These differences (from 0.10 to 0.89) evidence the existence of both authoritative doctors and doctors who rely on the generally accepted opinions rather than on their own experience, accounting for controversies in subjective estimates. PMID- 2781475 TI - [A rapidly progressing variant of subacute infectious endocarditis]. AB - A total of 122 patients with subacute infectious endocarditis (SIE) were examined. Of these, 33 patients demonstrated an extremely severe disease course. In spite of adequate antibacterial treatment, the lethal outcome ensued within the first 2-2.5 years of the disease. A rapidly progressing variant of SIE was characterized by persistent fever, predominance of aortal heart diseases, renal injuries with an early development of renal failure, hemorrhagic vasculitis, relapsing thromboembolism, refractory heart failure, persistent anemia, lymphopenia, and by the presence of large movable vegetations discovered on echocardiography. PMID- 2781474 TI - [Medico-social aspects of the identification of high risk groups for the development of osteoarthrosis deformans]. PMID- 2781476 TI - [Hemosorption in infectious pathology]. AB - Hemosorption was used for the treatment of 152 patients with purulent meningitis, sepsis complicated by shock, virus hepatitis and leptospirosis. A favorable effect of hemosorption in infections was based on highly effective correction of microcirculatory disorders as a result of the removal of high molecular substances of microbic and endogenous origin. PMID- 2781477 TI - [A rare case of generalized angiosarcomatosis, masked by pulmonary tuberculosis and systemic vasculitis]. PMID- 2781478 TI - [Soundness of the assimilation of knowledge by students as a criterion for the effectiveness of teaching]. PMID- 2781479 TI - [Topical planning in internal diseases at medical institutes and internists' practice]. PMID- 2781480 TI - [Interferon in rheumatoid arthritis]. AB - The paper is concerned with the role played by interferon (IF) in rheumatoid arthritis (RA). The content of IF was measured in the patients' blood serum and the possibility of the use of the preparations of exogenous interferon for the treatment of RA patients was demonstrated. Assay of serum IF in RA patients showed that its content did not exceed normal. The results of the treatment with IF preparations has demonstrated their beneficial effect on certain parameters. Further study of the role played by IF in the management of rheumatic diseases is required in order to develop the drug doses and schedules for the treatment. PMID- 2781481 TI - [The main principles of the program and system control of the quality of preparing specialists in the study of clinical pharmacology]. PMID- 2781482 TI - [Some features of the effect of voltaren on the coronary blood flow in patients with rheumatoid arthritis]. AB - Electrocardiography and tetrapolar rheoplethysmography of the finger have demonstrated that voltaren and 5-NK activity produce an adverse action on the coronary blood flow in patients with rheumatoid arthritis. It has been found possible to correct the induced disorders by cordarone. PMID- 2781483 TI - [Clinical effectiveness of prospidin in systemic lupus erythematosus (results of a 6-month follow-up)]. AB - The efficacy of the new Soviet antirheumatoid drug prospidin (the long-term treatment dose 1.4-6.0 g) was studied in 22 patients with significant lupus erythematosus (SLE). As a result of prospidin therapy administered for a month, 3 patients considerably improved and 19 patients improved. For 6 months the maintenance therapy was given to 15 patients. Considerable improvement was recorded in 4 and improvement in 9 patients. No effect was marked in one patient and one female patient died. The drug was tolerated well. No side effects requiring prospidin withdrawal were recorded. Prospidin exerted the most powerful effect with respect to lupoid nephritis, the articulation syndrome, and cytopenias. In accordance with the clinical improvement, the drug was established to return the immunological shifts common to SLE to normal. The drug may be viewed as a new basic agent for the treatment of SLE. PMID- 2781484 TI - [Subgroups of patients with systemic lupus erythematosus]. AB - As a result of a careful study of 150 patients with systemic lupus erythematosus (SLE) they could be distributed in 8 clinico-immunologic groups of the disease. Group I included patients with lupus nephritis manifesting by the nephrotic syndrome, group II patients with systemic vasculitis, group III patients with CNS injuries, group IV was made up of patients with discoid lupus, group V of patients with the prevailing damage to the respiratory organs, group VI of patients with hematologic disorders, group VII of patients with generalized visceral SLE, and group VIII included patients with generalized "peripheral" SLE. It was established on HLA typing that on the whole the patients with SLE manifested the increased frequency of HLAA11, B7, B35, DR2 and DR3 antigens. The patients' groups differed in primary carriership of certain antigens. Group I demonstrated a significant increase of the frequency of HLAA9, B13 and DR3, group II of HLADR2, group III of HLAB7, B12 and DR2, group IV of HLAB12, B13 and DR3, group V of HLAA1 and B8, group VII of HLADR1, and group VIII of HLAB35 and DR3. Group VI which was not numerous did not show any clinicogenetic association. The clinicoimmunologic polymorphism can be partially due to the genetic heterogeneity of certain patients' groups with SLE. PMID- 2781485 TI - [Role of the All-Union Scientific Society of Rheumatologists in the development of the practice of rheumatology]. PMID- 2781486 TI - [Immunologic and immunogenetic heterogeneity of systemic and discoid lupus erythematosus]. AB - The immune and endocrine systems and HLA genotype were subjected to a comparative study in patients with systemic and discoid lupus erythematosus (SLE, DLE). The patients suffering from these diseases were found to differ in a number of the parameters of the immune status including the content in blood serum and supernatant of the cultivated mononuclear cells of the soluble molecules HLA-A, HLA-B and HLA-DR. The degree of the SLE and DLE association with the genes and haplotypes of class I HLA complex was different as was the character of the association of HLA-A and HLA-B specificities with the activity of the immune system cells and with hydrocortisone content in plasma. The common immunogenetic syndrome characteristic of SLE and DLE patients has been identified. PMID- 2781488 TI - [Circulating immune complexes and clinico-immunologic subtypes of systemic lupus erythematosus. II]. AB - Characterization of clinicoimmunological subtypes of systemic lupus erythematosus was based on a detailed serological investigation of 90 SLE patients. Association between excessive formation of circulating immune complexes and the development of some clinical and serological manifestations of systemic lupus erythematosus including active lupus nephritis without the nephrotic syndrome, systemic vasculitis and Sjogren's syndrome was established. PMID- 2781487 TI - [Aortal defects in systemic lupus erythematosus]. AB - Five patients with significant lupus erythematosus (SLE) are described. The use of ECG, PCG and ultracardiosonography made it possible to verify the diagnosis of aortal valvular disease. On recognition of the damage to the aortal valves the question arises as to the genesis of its occurrence: does it occur because of the lupoid process proper or superaddition of bacterial endocarditis? The similar signs of SLE and bacterial endocarditis are described as are differential and diagnostic criteria. The main mechanisms by which the aortal valvular disease develops in SLE are depicted. Four out of the 5 patients described had bilateral sacroileitis and were not HIA-B27 carriers. PMID- 2781490 TI - [Hemorheologic disturbances and circulating immune complexes in patients with rheumatic diseases]. PMID- 2781489 TI - [The status of the pituitary-gonadal system and immunologic parameters in patients with rheumatoid arthritis]. AB - Male and female patients suffering from rheumatoid arthritis demonstrated disorders in the pituitary-gonadal system, which manifested in the body estrogenization in the presence of androgenic deficiency. The correlations between the levels of estradiol, testosterone and the parameters of the cellular and humoral immunity were analyzed. The authors discuss the problem of the participation of the disorders in the pituitary-gonadal system in the development of an autoimmune process underlying rheumatoid arthritis. PMID- 2781491 TI - [Importance of beta-glucuronidase activity and glycosaminoglycan concentration in synovial fluid in patients with rheumatoid arthritis in estimating local inflammation]. AB - In 30 patients with rheumatoid arthritis, the activity of beta-glucuronidase and the content of sulfated and non-sulfated glycosaminoglycans (GAG) were measured in synovial fluid (SF) and in the cells of SF. It has been established that as the local inflammation increases, the activity of the enzyme and the content of sulfated GAG in SF also rise. This is accompanied by simultaneous reduction of beta-glucuronidase activity in the cells and by the drop of the hyaluronic acid content in SF. PMID- 2781492 TI - [Radioisotope synovectomy in multi-modality treatment of rheumatoid arthritis]. AB - The colloid solution of radioactive gold 198 was administered to 91 knee joints of 50 patients with rheumatoid arthritis in a dose of 5-7 mCu. The patients were examined before and 6-12 months after radionuclide synovectomy. The treatment turned out effective in 35% of the cases, while in 19% of the cases, the effect was assessed as beneficial, and in 16% as satisfactory. The treatment efficacy decreased with age and disease standing. Three groups of the joints were distinguished in relation to the absorbed dose of ionizing radiation. In group I, this parameter constituted less than 80 Gy, in group II, from 80 to 100 Gy, and in group III, over 100 Gy. The efficacy of the different absorbed doses was assessed by the double blind method. In group I, the increase of the absorbed dose to over 100 Gy maintained 25%, and in group III, in 72% of the cases. Therefore, the increase of the absorbed dose to over 100 Gy maintained a significant (p less than 0.01) rise of the treatment efficacy. PMID- 2781494 TI - [Respiratory-hemodynamic features in patients with systemic scleroderma]. AB - The authors provide the results of the clinical and functional studies in 25 patients with systemic scleroderma. The patients were examined for the diffusion lung capacity separated into the constituent components (membrane and blood ones), for the uniformity of alveolar ventilation, for pulmonary artery pressure and pulmonary blood flow. They also underwent echocardiography. The use of the combination of non-invasive research methods makes it possible to obtain quantitative and quantitative information pertaining to the involvement of the lungs at the level of the alveolocapillary membranes and microvascular bed, myocardium and to their interrelations at the early stages of systematic scleroderma. In patients with the pronounced clinical picture of the disease, of paramount importance is the use of these methods for proper interpretation of certain symptoms in the estimation of lung and heart injuries and of their prevailing significance in the general clinical picture of the disease. The new trends in the present work are related to the demonstration of the compensatory and pathological changes in the respiratory and hemodynamic system in sclerodermia systematica at the early enough stages of the illness. PMID- 2781493 TI - [Myocardial reaction and lung ventilation response to inhalation of the gaseous hypoxic mixture GGS-10 in patients with rheumatoid arthritis]. AB - The initial and end parts of the ventricular complex of the ECG and the roentgenopneumopolygraphy data were assayed in 22 patients with rheumatoid arthritis before and after inhalation of the gaseous hypoxic mixture (GGS-10) consisting of 90% of nitrogen and 10% of oxygen. After the inhalation of the mixture the area of the ST-T segment significantly increased as compared with the initial data, mainly in the AVR, V2 and V5 leads of the ECG. In addition, individual features of the changes in respiratory pulmonary function were discovered, which directly correlated with the disease stage. PMID- 2781495 TI - [Changes in xanthine oxidase activity in patients with circulatory failure]. AB - As many as 76 patients suffering from inactive rheumatic fever associated with different stages of heart failure were examined for uricemia, diurnal uricosuria, and xanthine oxidase activity in blood serum. It was established that in rheumatic fever, the activity of xanthine oxidase increased even at the early stages of heart failure. The presence in some of the patient of the enzyme activation combined with hyperuricosuria and normal content of uric acid in blood serum suggests "latent" hyperuricemia. In patients with severe heart decompensation, there was an appreciable activation of xanthine oxidase, which correlated, as a rule, with high hyperuricemia. Activation of xanthine oxidase in patients with rheumatic fever evidences hyperproduction of uric acid. It is advisable that in such cases the uricodepressive treatment may be indicated. PMID- 2781496 TI - [Genetic variants of acid erythrocytic phosphatase as a risk factor of rheumatic fever]. AB - A study was made of the genetic variants (isoenzymes, phenotypes) of acid erythrocytic phosphatase (AcP) in 120 patients with rheumatic fever. There were 78 women and 42 men aged 16 to 57 years. The population data concerned with distribution of the AcP variants among the population of Moscow were used as control. As compared with control, the patients suffering from rheumatic fever demonstrated the accumulation of the rarely occurring variants of AcP (AC, BC and CC, in particular). A significant direct correlation was established between the activity of isoenzymes and relative risk of rheumatic fever incidence. The definite regularities in the distribution of AcP variants were found to depend on the disease clinical patterns (the articular syndrome, the times of the formation of heart diseases, the character of recurrent rheumocarditis). The data obtained can used for distinguishing the rheumatic fever risk groups and forecasting the rheumatic process (to a certain degree of probability). PMID- 2781497 TI - [Epidemiology of ischemic heart disease and its risk factors in men 20-54 years of age engaged in mental and physical activity, in various populations of the Soviet Union (a cooperative study)]. PMID- 2781498 TI - [Effectiveness of treating patients with cortico-dependent bronchial asthma by means of endolymphatic and intrapulmonary administration of glucocorticosteroids]. PMID- 2781499 TI - [Disorders of the mechanisms of hormonal regulation in patients with bronchial asthma]. AB - A total of 31 patients with bronchial asthma were examined with the use of the brief dexamethasone test. Some patients with bronchial asthma seemed to have impaired glucocorticoid function of the adrenals. Based on the own investigations and the reported data it is concluded that patients with bronchial asthma may have different types of glucocorticoid deficiency, particularly at the expense of the impairment of the central mechanism of the regulation of glucocorticoid hormones. It has been demonstrated that the brief dexamethasone test can be used for studying the disorders of glucocorticoid function of the adrenals. PMID- 2781500 TI - [The role of eosinophils in bronchial asthma]. AB - A total of 65 patients with infection-dependent bronchial asthma (BA) in the phase of exacerbation were examined for eosinophil number in the peripheral blood, forced expiration volume within the first second (FEV1), systolic pressure in the pulmonary artery (SPPA), the content of endogenous hydrocortisone and IgE, and for the titre of circulating immune complexes (CIC). The group of patients with eosinophilia over 600/mm3 showed a more grave course of BA. As the number of eosinophils in the blood increased, the SPPA and the CIC titre significantly rose. A marked tendency was discovered towards enhancement of bronchial obstruction as well as towards the increase of the content of endogenous hydrocortisone. A good agreement was demonstrated between the number of eosinophils in the blood and hydrocortisone content in the serum as was a negative correlation of the mean strength between the eosinophilia level and FEV1. On the patients' distribution into groups in terms of the gravity of obstructive abnormalities a significant rise of eosinophilia was noticed in patients with marked respiratory disorders. It is concluded that eosinophilia in BA patients is an unfavourable symptom evidencing that the patients are prone to a graver disease course, whereas the level of initial eosinophilia may be regarded as one of objective criteria for glucocorticosteroid administration. PMID- 2781501 TI - [Various aspects of the differential diagnosis of pulmonary dissemination in managing occupational diseases]. PMID- 2781503 TI - Gerontologic nurse practitioners: serving the older adults' needs. PMID- 2781502 TI - [Mechanisms of asthma of effort]. AB - Forty-six patients with bronchial asthma and preasthma and 6 normal persons were examined before and after graded exercise. Measurements were made of changes in glycogenolysis in peripheral lymphocytes, in blood plasma osmolarity, external respiration function ad diffusion capacity of the lungs, and of blood and sputum eosinophilia. Some of the patients were also examined for blood content of catecholamines. The group of patients with asthma of effort showed, in contrast to those without that illness, the signs of allergic inflammation of the distal parts of the bronchi and a direct correlation between changes in plasma osmolarity and glycogen content in lymphocytes, a decrease in the grade of the glycogenolytic response to adrenaline after exercise. It seems likely that in the pathogenesis of asthma of effort, of certain importance is inadequate reaction of the adrenoreceptor apparatus of the cells to the changes in the microenvironment provoked by exercise, which is manifested by the lack of the rise of beta adrenoreactivity. PMID- 2781505 TI - [Acute intestinal occlusion and calcium antagonists]. AB - A 41 years old male patient suffering from angina pectoris was treated with diltiazem (Tildiem). He was administered with nifedipine (Adalate) 3 times in succession and each time either complete or partial intestinal occlusion occurred. A laparotomy was carried out after the first occlusion, but no organic lesions were found. The search for an alternate non-drug related explanation proved negative. The most likely hypothesis is that of a direct relaxant activity on intestinal smooth muscle, which would explain the functional nature of the occlusion. Therefore it must be considered that the two drugs acted synergistically. PMID- 2781504 TI - Moral reasoning among medical geneticists in eighteen nations. AB - We surveyed the approaches of 661 geneticists in 18 nations to 14 clinical cases and asked them to give their ethical reasons for choosing these approaches. Patient autonomy was the dominant value in clinical decision-making, with 59% of responses, followed by non-maleficence (20%), beneficence (11%) and justice (5%). In all, 39% described the consequences of their actions, 26% mentioned conflicts of interest between different parties and 72% placed patient welfare above the welfare of others. The U.S., Canada, Sweden, and U.K. led in responses favoring autonomy. There were substantial international differences in moral reasoning. Gender differences in responses reflected women's greater attention to relationships and supported feminist ethical theories. PMID- 2781506 TI - [Vasodilator effects of LF 2.0254, a new 1,4-dihydropyridine. Comparison with nifedipine]. AB - LF 2.0254 is a new 1.4 dihydropyridine that relaxes vascular smooth muscles by blockade of calcium entry mediated by depolarisation. In rabbit aortas contracted by KCl (15 to 55 mM) or CaCl2 (2 mM), LF 2.0254 differs markedly from nifedipine and nicardipine because of its slow onset of action, the inhibitory effect increasing with the duration of tissular contact. LF 2.0254 has only slight negative chronotropic and inotropic effects on isolated guinea-pig atria as well as in anesthetized dogs after intravenous administration. Furthermore, in open chest anesthetized dogs, LF 2.0254 decreases mean arterial blood pressure and since cardiac output is maintained total peripheral resistance is decreased. LF 2.0254 administered orally to perinephritic hypertensive dogs (0.1 and 0.3 mg/kg) and to spontaneously hypertensive rats (0.3 to 10 mg/kg) induces a more pronounced and long-lasting hypotensive action than nifedipine. In conclusion, these results suggest that LF 2.0254 could be useful in the treatment of hypertension associated or not with cardiac insufficiency. PMID- 2781508 TI - Plasma fibrinolytic activity after ingestion of omega-3 fatty acids in human subjects. AB - Plasma fibrinolytic activity was measured in human volunteers after 30 day periods of ingestion of a fish oil product (Max Vita) containing eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) and a wheat germ oil product containing alpha linolenic acid. Compliance was confirmed by significant increases in plasma levels of EPA and DHA and by significant falls in serum triglyceride levels. Platelet aggregation in platelet rich plasma and in whole blood was not altered significantly by fish oil or wheat germ oil. Neither fish oil or wheat germ oil caused any significant change in tissue plasminogen activator (tPA) or its inhibitor (PAI) measured enzymatically or in tPA antigen measured by an ELISA method. All these analytes (tPA, PAI, and tPA antigen) were measured before and after venous compression. PMID- 2781507 TI - [Drug-induced respiratory complications. Study of 27 cases]. AB - Over 8 1/2 years, we observed 27 patients with drug-induced respiratory disease (DIRD). The inducer drugs were mainly those used in cardiology (9 patients, of whom 8 had amiodarone pneumonitis), in oncology (8 patients), in rheumatology (4 patients; 3 from d-penicillamine and 1 from gold), and in neurology (4 cases from ergoline derivatives). The main pattern of DIRD was a diffuse interstitial lung disease having either a rapid, a slowly progressive or a chronic course. Only the two former patterns offered clearing following withdrawal of the drug. Severe bronchiolitis obliterans from d-penicillamine (2 cases) and pulmonary eosinophilia (2 cases) was also observed. The onset of DIRD occurred earlier, i.e. following shorter periods of drug administration (months), in the acute interstitial lung disease variant, while it occurred after years of drug exposure in subacute and chronic forms. In contrast to other reports, bronchoalveolar lavage lymphocytosis was not a prominent feature in amiodarone pneumonitis. The outcome was favourable in 16 patients; deaths was encountered during the florid phase of DIRD in 3; incapacitating sequelae were noted in 6 patients, leading to subsequent death in 2; the underlying disease accounted for 7 additional deaths. Therefore, DIRD are relatively common, develop often in patients with severe underlying conditions, and interstitial pneumonitis is their pattern of predilection. Amiodarone emerges as a common inducer, and accounted for more cases than all chemotherapeutic agents grouped together in our series. PMID- 2781509 TI - Antithrombin Chicago, amino acid substitution of arginine 393 to histidine. AB - Antithrombin Chicago is a functionally inactive antithrombin variant whose inheritance is associated with thrombotic disease. The variant antithrombin was isolated from plasma of the propositus by chromatography on heparin-Sepharose, followed by passage through thrombin-Sepharose to remove the normal antithrombin component that is present. A pool of fragments ("CNBr pool 4") containing the reactive site region was prepared from the reduced and S-carboxymethylated variant by cleavage with cyanogen bromide followed by reverse-phase HPLC. Sequential treatment of CNBr pool 4 with trypsin and V8 protease produced peptides whose molecular masses were then determined by fast atom bombardment mass spectrometry. The variant protein digests were characterised by a reduction of a peptide of mass 1086, corresponding to the normal antithrombin sequence Ala382-Arg393. However, they contained a peptide of mass 1748, which arises when Arg393 is replaced by His in the sequence Ala382-Arg399. It is concluded that the functional and clinical abnormalities of antithrombin Chicago are all probably caused by a single amino acid substitution, Arg393 to His. PMID- 2781510 TI - Methylene blue for neutralization of heparin. AB - Patients with protamine allergy present a difficult dilemma when reversal of heparin is required for excessive bleeding. Premedication with steroids and antihistamines has not been shown to effectively prevent anaphylactic reactions in patients with hypersensitivity to protamine. Other heparin antagonists are either not available or are too toxic for human use. This report describes a patient in whom methylene blue was used effectively to neutralize heparin and decrease bleeding due to heparinization. In vitro testing was then done to further define the interaction of heparin and methylene blue. This testing demonstrated that methylene blue neutralized heparin levels of 1 u/ml as well as 10 u/ml. Methylene blue acted as an anticoagulant when present at levels of 3000 micrograms/ml. However, it acted as a coagulant when present in intermediate levels of 800 micrograms/ml and 1600 micrograms/ml. The plasma levels necessary for neutralization of heparin levels of 1 unit/ml (the levels achieved in patient therapeutically anticoagulated) are easily achieved using doses routinely used in treatment of methemoglobinemia. Although the toxicity of methylene blue has been well defined at the lower doses of 2-4 mg/Kg, work still needs to be done to determine safety of the drug at the higher doses necessary to neutralize heparin levels achieved in bypass patients. PMID- 2781512 TI - Transient aggregation resistance of human blood platelets in fresh plasma. I. Methodology. AB - A novel analytical method, using turbidometry, for reporting the time-dependent decay in the threshold concentration of adenosine diphosphate (ADP), required to elicit a secondary aggregation response in fresh human citrated platelet-rich plasma (PRP), is described. The phenomenon, called "transient aggregation resistance" (TAR) ends, usually within one hour after venepuncture, in a steady state or "baseline aggregation resistance" (BAR). Back extrapolation of the mathematically transformed data to t = 0, yields a maximal threshold concentration of ADP, representing the initial aggregation resistance (TARmax) at the time of blood withdrawal, which threshold is usually many orders of magnitude higher than the BAR-value. The exponential decay of TAR can be characterized by its half-life (t1/2). Mixing fresh, rapidly prepared, plasma with PRP, kept long enough to show only the stable low BAR-value, could restore the initial high (transient) aggregation resistance found in fresh PRP, suggesting that it concerns a natural, labile plasmatic factor. One hour old PRP, deliberately made refractory to ADP, did not show the TAR phenomenon again, but had a higher BAR value. It is suggested that the level of clinical relevance of these early in vitro aggregation measurements is higher than that of classical, delayed aggregometry (e.g. BAR-values). PMID- 2781511 TI - Disseminated intravascular coagulation with multiple arterial thromboses responding to antithrombin-III concentrate infusion. AB - Disseminated intravascular coagulation (DIC) most often manifests itself through hemorrhagic episodes following thrombotic consumption of platelets and coagulation factors in the microvasculature. Rarely patients suffer major arterial thrombosis in the setting of disseminated intravascular coagulation. We treated such a patient, whose thrombotic diathesis was refractory to traditional heparin and fresh frozen plasma therapy, with infusion of anti-thrombin III concentrate. The response was a prompt improvement in both clinical and laboratory parameters followed by recurrent thrombosis when concentrate therapy was discontinued. This is the first reported case where DIC complicated by major arterial thrombosis was treated with antithrombin III concentrate. Our findings demonstrate that antithrombin III concentrates are useful in treating patients with DIC complicated by major arterial thrombosis. PMID- 2781513 TI - Red blood cell lipid alterations in type II diabetes mellitus. AB - Alterations in blood rheological properties have been reported in diabetes mellitus. Changes in lipid composition of red blood cell (RBC) membranes resulting in an impairment of RBC deformability may play a role in the altered blood rheological pattern. The aim of this study was to investigate the lipid composition of RBC membrane in a group of patients affected by type II diabetes (age 21-45 years), selected on the basis of the absence of complications and good metabolic control, and in a group of suitable control subjects. Saturated fatty acid amounts in the different phospholipid fractions were significantly higher in diabetics than in controls (p less than 0.05), whereas polyunsaturated fatty acids were decreased (p less than 0.05). Cholesterol/phospholipid molar ratio was not altered. On the contrary, sphingomyelin/phosphatidylcholine ratio was higher in diabetics than in controls (1.10 +/- 0.08 vs 0.96 +/- 0.10, p less than 0.01) due specially to high levels of sphingomyelin. These alterations could account for the impairement of RBC deformability frequently reported in diabetes mellitus, independently of metabolic control and the presence of severe atherosclerotic lesions. PMID- 2781514 TI - DDAVP effect on factor XII activity levels. PMID- 2781515 TI - Rapid purification of factor IX, factor X and prothrombin by immunoaffinity and ion exchange chromatography. AB - This study describes a rapid purification of factor IX, factor X and prothrombin by immunoaffinity and ion exchange chromatography. Human factor IX was purified from plasma in 34% yield using barium sulfate adsorption and immunoaffinity purification. The specific clotting activity of purified factor IX was 269 units/mg, with an apparent molecular weight of 57,000 in the presence of sodium dodecyl sulfate on polyacrylamide gels. The immunodepleted, factor-IX deficient plasma was chromatographed on a dextran sulfate agarose column which resolved prothrombin and factor X in highly purified states and with approximately 50% yield. The specific activities of prothrombin and factor X obtained by this procedure were 24 units/mg and 147 units/mg respectively. Both proteins isolated by this method showed a single component on SDS gel electrophoresis and the molecular weights of intact prothrombin and factor X were 72,000 and 67,000 respectively. PMID- 2781516 TI - The influence of physical exercise and intravenous heparin on plasmatic concentration of platelet factor 4 in young survivors of myocardial infarction. PMID- 2781517 TI - Fibrinogen and pentoxifylline. PMID- 2781518 TI - Platelet free catecholamines in healthy women. PMID- 2781519 TI - Stability of gels formed following coagulation of Limulus amebocyte lysate: lack of covalent crosslinking of coagulin. AB - Incubation of lysates prepared from amebocytes of the horseshoe crab (Limulus polyphemus) with bacterial endotoxin results in coagulation and formation of a solid gel. Although Limulus gels remained solid indefinitely, if undisturbed, they were easily disrupted by mechanical agitation. Chemical solubility studies of gelled lysates demonstrated rapid solubilization of gels in monochloroacetic acid, a property of clots that have not been covalently stabilized; but in contrast demonstrated resistance to solubilization by urea, a property of stabilized clots. Analysis of solubilized proteins by polyacrylamide gel electrophoresis in SDS demonstrated coagulin, the designation for the activated form of coagulogen (the clottable protein) that forms a gel, only in samples derived from clotted lysate that had been previously incubated with monochloroacetic acid, but not in samples following incubation with urea, confirming the results of the chemical solubility studies. Enzymatic assays for transpeptidase (Factor XIII-like) activity in either native or gelled Limulus lysates were negative. Furthermore, analysis for covalently crosslinked peptides in gelled coagulin confirmed the absence of intermolecular gamma-glutamyl-epsilon lysyl bonds. Therefore, the stable gels formed following coagulation of Limulus lysate by bacterial endotoxin are not covalently crosslinked. PMID- 2781520 TI - Identification of the 1.4 kb and 4.0 kb messages for the lipoprotein associated coagulation inhibitor and expression of the encoded protein. AB - Lipoprotein-Associated Coagulation Inhibitor (LACI) is a factor Xa dependent inhibitor of the factor VII(a)/Tissue Factor catalytic complex. Deduced from partial cDNA sequence, LACI's amino acid sequence has recently been reported. Northern blot analysis showed LACI cDNA hybridizes to RNAs of 1.4 and 4.0 kb in size. To complete the characterization of the LACI message(s), overlapping LACI cDNAs were isolated from a human endothelial cell library. Sequence analysis revealed the clones' inserts span 4023 bases of sequence, consisting of 381 bases of 5' untranslated sequence, an open reading frame of 912 bases, 2682 bases of 3' untranslated sequence and 48 bases of poly(A) sequence. In addition, a short 1.4 kb insert which encodes for LACI was found to contain 49 bases of 3' untranslated sequence and a 3' poly(A) tail. The 1.4 kb of sequence is contained in the 4.0 kb sequence, except for 14 bases of 5' sequence, suggesting that the LACI messages arise by the use of alternative termination and polyadenylation signals during processing. Northern blot analysis of RNA isolated from cells treated with actinomycin D showed both RNA species appear to be relatively stable. Using a bovine papilloma virus vector, LACI cDNA was transfected into mouse C127 fibroblasts. The recombinant LACI is recognized by polyclonal anti-LACI IgG, binds to factor Xa and inhibits VII(a)/Tissue Factor activity in a similar fashion as LACI purified from HepG2 cell conditioned media. PMID- 2781521 TI - Changes of spontaneous and induced platelet aggregation in the presence of a human endothelial cell monolayer. AB - A new, simple method has been developed for the investigation of platelet aggregation in the presence of a cultured confluent human endothelial cell monolayer, in disk shaped rotating cuvettes, without magnetic stirring. The endothelial cells inhibited the aggregating effect of several inducers in a concentration dependent manner. At a platelet count of 5 x 10(5)/microliter in PRP e.g. the aggregating effect of 1 microgram/microliter thrombin was completely abolished. Spontaneous aggregation was also prevented by the EC-monolayer. A correlation could be established between the inhibitory effect of ECs and the number of platelets. In PRP with a platelet count of 7 x 10(-5)/microliters the inhibitory effect of the endothelial cell monolayer significantly decreased. PMID- 2781522 TI - Correlation between antigenic and functional expression of tissue factor on the surface of cultured human endothelial cells following stimulation by lipopolysaccharide endotoxin. AB - Previous studies indicated that E. coli lipopolysaccharide (LPS) induces human umbilical vein endothelial cells (HUVEC) to express tissue factor activity. Using a radiolabeled anti-tissue factor monoclonal antibody to assess cell-surface tissue factor apoprotein antigen and a two-stage amidolytic assay to assess functional tissue factor activity, we have investigated the temporal relationship between antigenic expression and functional expression of tissue factor on the surface of LPS-stimulated HUVEC. Maximum tissue factor apoprotein antigenic expression on the surface of LPS-stimulated HUVEC was achieved in four hours after LPS treatment, while maximum functional tissue factor activity occurred after 6 hours. Specific binding of radiolabelled human factor VIIa to LPS stimulated HUVEC paralleled the time course of the expression of tissue factor functional activity. Thus, these data indicate that the presence of of newly synthesized tissue factor apoprotein antigen on the cell surface is insufficient by itself for maximal factor VIIa binding to occur, and provide presumptive evidence for the posttranslational processing of tissue factor apoprotein on the cell surface prior to its acquisition of ligand binding function. PMID- 2781523 TI - Changes in coagulation and fibrinolysis during pregnancy: evidence of activation of coagulation preceding spontaneous abortion. AB - In order to monitor physiological changes in coagulation and fibrinolysis that occur during normal pregnancy, blood samples were collected in each trimester of pregnancy from 17 volunteers. Control samples were collected from 12 non-pregnant female volunteers. As pregnancy advanced there was a rise in the basal levels of fibrinopeptide A, cross linked D-dimer fragment and the B beta 15-42 fragment and an increase in the in vitro rate of fibrinopeptide A generation. These results were consistent with an increased activation of coagulation during normal pregnancy, compensated for by a concomitant rise in fibrinolytic activity. In two patients who spontaneously aborted, evidence of uncompensated activation of coagulation could be detected before the manifestation of any clinical signs. In a second pregnancy in one of these patients similar changes were observed, but were reversed by heparin treatment and the pregnancy progressed to full-term delivery of a normal infant. PMID- 2781525 TI - Prothrombin times and clottable fibrinogen determination on an automated coagulation laboratory (ACL-810). AB - Our laboratory evaluated an Automated Coagulation Laboratory (ACL-810) by Instrumentation Laboratory. Prothrombin times and fibrinogen levels from the ACL 810 were compared to results from a Fibrometer and another automated coagulation instrument - either the Coag-A-Mate (prothrombin times) or the Multistat III centrifugal analyzer (fibrinogen). The performance of different thromboplastins on the ACL-810 was also evaluated. Correlation studies revealed excellent performance characteristics and precisions for both the prothrombin time and fibrinogen not only with different instruments, but also with different thromboplastins on the ACL-810. Overall, we found the instrument to be quick, efficient, and easy to operate. PMID- 2781524 TI - Monocyte procoagulant activity and membrane-associated D dimer after knee replacement surgery. AB - We have recently shown that monocyte membrane-associated cross-linked fibrin derivatives (D dimer) can be evidenced by immunogold staining. Using this method, the procoagulant activity (PCA) expressed in vitro by endotoxin-stimulated monocytes has been found to correlate significantly with the number of D dimer positive monocytes. The incidence of postoperative thrombosis in patients undergoing total knee replacement has been reported by Stulberg et al to be 57%. Since monocytes can play a role, via increased PCA, in the activation of intravascular coagulation, we sought to determine the level of monocyte PCA ex vivo after knee replacement surgery and its possible correlation with the number of D dimer-positive monocytes. Finally, we examined the possible link between these modifications and the occurrence of postoperative deep vein thrombosis (DVT). The PCA expressed by monocytes with or without suboptimal stimulation, the number of D dimer-positive monocytes and the plasma level of D dimer were measured pre- and post-operatively in 11 patients undergoing total knee replacement. Phlebography was performed on day 10 after surgery. A significant increase in the PCA of stimulated monocytes was observed on day 10 after surgery. Moreover, both the number of D dimer-positive monocytes and the plasma level of D dimer increased significantly post-operatively. The number of D dimer-positive monocytes correlated with both monocyte PCA and the plasma D dimer level. The relation between these parameters is discussed. However, neither monocyte PCA nor the number of D dimer-positive monocytes was found to correlate with the occurrence of deep vein thrombosis. PMID- 2781526 TI - Fractionation of plasmic fibrin(ogen) digests by lectin affinity chromatography. AB - A method for the fractionation of plasmic digests of both fibrinogen and fibrin was developed by taking advantage of the different chromatographic behaviour of fibrinogen and its fragments on immobilized concanavalin A and Lens culinaris agglutinin. Columns with different lectin concentration but with the same total lectin content were tested. Fragment E was retained on all the concanavalin A Sepharose preparations while fragment D was mostly eluted in the unbound fraction. However, the binding of fragment DD depended on the lectin concentration of the gel. Thus, the percentage of fragment DD specifically bound to concanavalin A-Sepharose increased from 5-10% to 67% as the lectin density of the gel increased from 0.9 to 8.7 mg/ml gel. On the other hand, Lens culinaris agglutinin-Sepharose retained fibrinogen and high molecular weight fragments depending on the lectin concentration of the gel while neither fragment E nor fragment D were bound to any of the columns. PMID- 2781527 TI - Paraproteinaemias and platelet aggregation: role of whole blood aggregometry. AB - Whole blood and optical platelet aggregation were measured in normals and in patients with paraproteinaemias; extent of aggregation was correlated with paraprotein concentrations in patients and in normals after addition of different doses of paraproteins; threshold aggregating concentrations of several agonists were also determined in whole blood and in PRP from both groups of subjects. The results indicate that patients with macromolecular monoclonal component bear a "hyperaggregable" state which can be probably ascribed also to plasma hyperviscosity and which is better detected with the impedance aggregometer. PMID- 2781529 TI - Heparin-induced thrombocytopenia: effects of rabbit IgG, and its Fab and FC fragments on antibody-heparin-platelet interaction. PMID- 2781528 TI - Absence of components of coagulation and fibrinolysis pathways in situ in mesothelioma. PMID- 2781530 TI - Protein C activity levels in endotoxin-induced disseminated intravascular coagulation in a dog model. AB - The levels of protein C (PC) and other coagulation factors were monitored during endotoxin-induced disseminated intravascular coagulation (DIC) in the dog. Initial evaluation of the effectiveness of intradermal administration of bolus endotoxin quantities into the dog, demonstrated induction of DIC in the canine, without the severe side effects associated with bacterial sepsis. Quantitative determination of canine plasma protein C levels were performed using a multiple step amidolytic assay, that included a specific precipitation of the vitamin K dependent proteins from citrated plasma, followed by thrombin activation (and neutralization) and subsequent measurement of the activated protein C (APC) by chromogen hydrolysis. This investigation demonstrated, that over a twenty-four hour interval, intradermal administration of endotoxin produces a gradual decrease in the PC activity levels, concomitant with a significant reduction in the Factor V, Factor VIII and fibrinogen levels and platelet count, and a prolongation of the Prothrombin Time and Partial Thromboplastin Time. During the first 6 hours, protein C levels fell below the pre-levels and remained significantly lower in the surviving dogs. Thus, this endotoxin-induced DIC animal model permits evaluation of various hemostatic parameters, yet diminishes the severe clinical findings associated with DIC. PMID- 2781531 TI - Phorbol ester stimulates platelet spreading and thrombi-like aggregate formation on the surface of immobilized type V collagen. AB - We have studied the effect of the tumor-promoting phorbol ester, 4 beta-phorbol 12 beta-myristate-13 a-acetate (PMA), and of the stable prostaglandin endoperoxide analogue U46619 on the interaction of human blood platelets with surfaces coated with monomeric human type V collagen (CV) and on free calcium concentration in platelet cytoplasm. It was shown by scanning electron microscopy that native resting platelets sparingly attach to CV and fail to spread or aggregate on the collagenous substrate in the absence of PMA and U46619. Addition of 0.15-1.5 nM PMA or 1.5 microM U46619 stimulates platelet spreading and formation of multilayer (thrombi-like) platelet aggregates on the per se non thrombogenic type V collagen substrate. It was further demonstrated using the fluorescent indicator quin2 that U46619 (0.1 microM) increases cytoplasmic free calcium concentration from basal level (100-120 nM) up to 600 nM, whereas PMA (0.75-15 nM) exerts only a minor effect, increasing free calcium level by 30-40 nM. These results indicate that the tumor-promoting phorbol ester PMA induces massive platelet spreading and aggregation on surfaces coated with non thrombogenic type V collagen via activation of protein kinase C with little or no apparent change in free cytoplasmic calcium. PMID- 2781532 TI - Phosphotungstate shows a heparin-like anticoagulant effect but inhibits heparin. AB - We examined the anticoagulant effects of phosphotungstate (PTA). PTA inhibited factors IIa and Xa activity only in the presence of antithrombin III (ATIII). The inhibitory effect of PTA on IIa was much smaller than that on Xa. When PTA was added to heparin (Hep), the inhibitory effect of Hep on IIa was reduced. As a result of charge interaction, PTA showed an inhibitory effect on anion transport activity of the erythrocyte, a potent salting-in effect and a metachromatic reaction on toluidine blue (TolB). Silicotungstate (STA) showed almost the same results as PTA. These effects of PTA and STA were not replaced by their constituents, tungstate, silicate and phosphate, but may arise from their high anionic valency. PMID- 2781533 TI - A new assay for the determination of factor XII in plasma using a chromogenic substrate and a selective inhibitor of plasma kallikrein. AB - A new chromogenic assay for factor XII in plasma was designed by the use of the soluble activator Kalliplastin, the substrate H-D-HHT-Gly-Arg-pNA and a synthetic inhibitor of plasma kallikrein (Pefabloc PK). The assay was carried out in one and the same cuvette and did not require factor XII-deficient plasma. There was a good correlation between F XII coagulant and amidolytic assays. PMID- 2781534 TI - On the location in the thrombin B chain of substrate recognition sites for fibrinopeptide release and factor XIII activation. AB - Thrombin, a serine proteinase comprised of two disulfide-linked subunits (A chain and B chain), induces clotting by releasing fibrinopeptide A from fibrinogen and then influences the character of the resulting fibrin by releasing fibrinopeptide B and by activating factor XIII. While the active center of thrombin is known to reside in its B chain, the subunit location of the structural determinants that govern the specific release of fibrinopeptides A and B and the activation of factor XIII have not been established. We have investigated the subunit location within the thrombin molecule of the determinants of substrate specificity for these actions using an isolated, immobilized B-chain preparation. Isolated B chain was prepared by covalently linking the intact thrombin molecule to Sepharose beads via the carbohydrate chain attached to asparagine 53 of its B chain, then reducing the single interchain disulfide bond to release the A chain, and finally reoxidizing the intrachain disulfide bonds of the immobilized B chain, allowing it to refold. The isolated, immobilized B chain of thrombin induced clotting of purified fibrinogen, releasing both fibrinopeptides A and B as demonstrated by HPLC and by electrophoresis of reduced fibrin chains. In addition, the B-chain preparation activated added factor XIII, yielding electrophoretically characteristic cross-linked fibrin chains. PMID- 2781535 TI - Electron microscopic study of platelet agglutination induced by thrombotic thrombocytopenic purpura plasma containing 37-KDa platelet agglutinating protein. AB - It has been demonstrated that plasma from a patient with thrombotic thrombocytopenic purpura (TTP) and 37-KDa platelet-agglutinating protein (PAP p37) purified from the same plasma caused the agglutination of platelets from normal subjects as well as from the same patient after recovery without the requirement of extracellular Ca++ and fibrinogen. Experiments were designed to study the morphologic changes of platelets as a result of agglutination and the distribution of platelet receptors for PAP p37 under transmission electron microscope. Following incubation with TTP plasma or PAP p37 with stirring, platelets showed shape change, pseudopod formation, variable degrees of degranulation, dilatation of open canalicular systems and formation of agglutinates composed of a few to several hundred platelets. After platelets were incubated with TTP plasma or PAP p37 they were washed and further incubated with rabbit anti-PAP p37 serum without stirring followed by immuno-staining. Abundant electron dense reaction products were bound directly and randomly to the outer surface of the membrane of solitary platelets. When the reaction mixture was stirred, electron dense particles were also present between the platelet membranes in the agglutinates. No staining was observed in control experiments using normal plasma or non-immune rabbit serum. These results indicate that the TTP plasma containing PAP p37 causes agglutination, shape change, and variable degrees degranulation in platelets and that PAP p37 binds randomly to the outer surface of platelet membrane. PMID- 2781536 TI - The fraction of high molecular weight (HMW) fibrinogen and phosphorylated fibrinopeptide A in fetal fibrinogen. PMID- 2781537 TI - Heparin inhibits mammalian, but not leech, hyaluronidase. PMID- 2781538 TI - An eight year experience with gradually longer interval postremission therapy for adults with acute leukemia. AB - Between January 1980 and March 1983, a study was conducted into the effects of postremission therapy on 20 patients with acute leukemia who had achieved complete remission through induction therapy. Postremission therapy consisted of cyclic administration of six combination therapies given at gradually longer intervals. Postremission therapy used DCMP (D, daunorubicin; C, cytosine arabinoside; M, 6-mercaptopurine; P, prednisolone), DCyMP (Cy, cyclocytidine), DCVP (V, vincristine), BHAC-DMP (BHAC, behenoyl-ara-c), BHAC-AMP (A, aclarubicin) and ACM-MP (ACM, aclacinomycin). Six combinations were given sequentially starting at one month interval, and then at 2, 3, 4, 5 and eventually 6 month intervals until 5 year survival was reached. The median remission duration was 38 months for acute myelogenous leukemia (AML), and 17 months for acute lymphoblastic leukemia (ALL). The median survival was 66 months for AML, and 33 months for ALL. The survival rate at 5 years was 60% for AML., 40% for ALL, and 50% in all 20 patients. Methotrexate and prednisolone were administered intrathecally for prophylaxis of CNS leukemia on Day 4 of each stage of postremission therapy. There was no CNS leukemia. This postremission therapy was shown to be effective in improving the prognosis of adults with acute leukemia. PMID- 2781540 TI - Effect of duration of vagal stimulation on shortening velocity of in vivo canine trachealis muscle. AB - We studied shortening velocity of in vivo canine trachealis muscle contracted by bilateral vagus nerve stimulation, as a function of duration of contraction. The cervical trachea was transected at two locations, cut at the ventral portion, and opened. One side of the cartilage cut was connected to a force transducer and the other to a lever with a given weight as an afterload, the length of which was measured by a linear displacement transducer. Bilateral vagosympathetic trunks were stimulated by supramaximal electrical impulses. With vagal stimulation, the trachealis muscle started to contract isometrically and at a given time the muscle was allowed to contract isotonically by unlocking a stopper at a given afterload. The shortening velocity was reduced with longer duration of active state. Ten sec after vagal stimulation the maximum force was 730 +/- 105 g/cm2 (mean +/- S.D.) and maximum velocity at zero load calculated by Hill's equation was 0.092 l0/sec. We conclude that the force-velocity relationship of in vivo canine trachealis muscle stimulated by vagus nerves exhibits a time-dependency similar to that in vitro. PMID- 2781539 TI - Effects of glycyrrhizin (SNMC: stronger Neo-Minophagen C) in hemophilia patients with HIV infection. AB - Glycyrrhizin (GL) not only has an inhibitory effect on HIV replication but also exhibits interferon-inducing and natural killer (NK)-enhancing effects and improves liver dysfunction. Thus, large doses of GL (200-800 mg/day) were intravenously administered for more than 8 weeks to 9 hemophilia A patients with HIV infection (asymptomatic carrier, AC). Lymphocyte count increased in all 9 cases. OKT4 OKT8 ratio was elevated in 6 out of the 9 cases and OKT4-positive lymphocytes increased in 8 out of the 9 cases; 66.7% and 88.9% improvement, respectively. Changes in NK cell activity and mitogenic responsiveness to PHA, Con A and PWM were not significant. Liver dysfunction, noted in 4 cases, clearly improved. Serum electrolytes, protein, lipids, and renal function were within normal levels and no serious side-effects were observed during treatment. On the other hand, in 3 cases of hemophilia without HIV infection, the number of OKT4 lymphocytes was not significantly altered during treatment. From these results, large dose administration of GL to HIV-positive hemophilia patients (AC) seems to be effective in preventing development of AC into AIDS by raising the number of decreased OKT4 lymphocytes and improving liver dysfunction. PMID- 2781541 TI - Urban-rural difference in the acceptance of mass health examination in north eastern Japan. AB - Over 40,000 residents (less than or equal to 40 years of age) in a city (Sendai; the city group), a town (Shiroishi; the town group) and two villages (Wakuya and Tajiri; the village group) in Miyagi prefecture in north-eastern Japan responded in a questionnaire survey on their attitude towards mass health examinations (i.e., whether they underwent in the previous year and if so where) on 4 items of blood pressure measurement, chest x-ray examination and screening tests for stomach and cervical cancer. The coverage rates were about 70% on an average both for blood pressure measurement and for chest x-ray examination, whereas the rates for cancer screening were between 30-40%. As for the opportunity of the former two examinations, the workplace mass examination played a large role in the case of the city and town groups (especially among men but not women) in addition to visit to clinics, in contrast to the case of the village group in which people depended much on regional mass examination service. The trend was essentially reproducible in stomach cancer screening although the over-all coverage rate was low, whereas women in the three groups almost exclusively utilized clinics for cervical cancer screening with one exception that the mobile unit service appeared to be equally accepted in the village group. PMID- 2781542 TI - State of hepatitis B virus DNA in peripheral blood mononuclear cells from persistently infected individuals: correlation with e antigen and viral DNA in the serum as well as with the activity of liver disease. AB - Peripheral blood mononuclear cells (PBMC) were harvested from 76 asymptomatic carriers of hepatitis B virus (HBV) and 100 patients with type B chronic liver disease. DNA was extracted from cells and tested for the binding with radiolabeled HBV DNA probe by Southern blot hybridization technique. Among 34 asymptomatic carriers who had hepatitis B e antigen (HBeAg) and HBV DNA in the serum, HBV DNA was detected in 29 (85%) PBMC. In remarkable contrast, of the remaining 42 carriers seronegative for HBeAg, only 1 (2%) had HBV DNA in the serum, and none exhibited HBV DNA in PBMC. Among 32 patients seropositive for HBeAg, HBV DNA was detected in 28 (88%) sera, and in 24 (75%) PBMC. Of 68 patients seronegative for HBeAg, HBV DNA was found in 10 (15%) sera, and in 7 (10%) PBMC. Among 62 cases with HBV DNA in PBMC, only 1 had it integrated into the host's DNA. The remaining 61 had free HBV DNA in PBMC. Only 8 of them possessed replicative intermediate forms of HBV DNA, with molecular sizes less than 2.0 kilobases as observed in liver infected with HBV, and they all were patients with chronic active hepatitis. HBV DNA was not detectable in PBMC from 172 controls comprising 44 healthy individuals and 128 patients with non-A, non-B hepatitis. Based on these results, the state of HBV DNA in PBMC reflects the phase of HBV infection with HBeAg in the serum, and a high activity of hepatitis accompanied by active HBV replication. PMID- 2781543 TI - Loss of reaction time specificity for movement direction in Parkinson's disease. AB - Electromyographic (EMG) reaction times (RTs) of the right biceps brachii muscle and its integrated EMG (iEMG) from the onset until 50 msec after the start of activities for elbow flexion and forearm supination in the condition with or without warning signal were examined in seven patients with Parkinson's disease and seven age- and sex-matched normal subjects. In the control group RT of forearm supination with warning tended to be faster than that of elbow flexion and the reverse occurred without warning, and iEMG of forearm supination were significantly small compared to those of elbow flexion in each condition. In the Parkinson group both RT and iEMG of elbow flexion were nearly the same as that of forearm supination regardless the presence or absence of warning signal, indicating the loss of RT and iEMG specificity for the two direction of movement in Parkinson's disease. PMID- 2781544 TI - Acute cerebellar ataxia after influenza vaccination with recurrence and marked cerebellar atrophy. AB - A 5-year-old, previously healthy girl developed symptoms and signs of acute cerebellar ataxia (ACA) 8 days after having received an influenza vaccination. Brain CT was normal, but the CSF showed moderate pleocytosis. Symptoms almost disappeared within 4 months. Thirty-three months later, cerebellar symptoms recurred without apparent preceding episode, and persisted. Sixteen months after the recurrence of ataxia, CT and MRI revealed marked cerebellar atrophy. No further augmentation of ataxia or of cerebellar atrophy was observed during following 30 months. The patient appears to be the first documented case of ACA with recurrence of ataxia and severe atrophy of the cerebellum, though the etiology and pathogenesis are still to be determined. Clinical pictures and the course of the patient were compared with follow-up data on 8 cases of ACA. PMID- 2781546 TI - Critical health care liability issues. PMID- 2781545 TI - Introduction to critical health care liability issues. PMID- 2781548 TI - General and medical professional liability. PMID- 2781547 TI - Claims-made versus occurrence coverage. PMID- 2781549 TI - Directors' and officers' liability. PMID- 2781550 TI - Umbrella or excess liability. PMID- 2781552 TI - Public and private sector responses. PMID- 2781551 TI - Risk control and risk financing. PMID- 2781553 TI - Mono-2-ethylhexyl phthalate, a metabolite of di-(2-ethylhexyl) phthalate, causally linked to testicular atrophy in rats. AB - Acute testicular atrophy results when appropriate dosages of di-(2-ethylhexyl) phthalate (DEHP) or its hydrolysis product mono-2-ethylhexyl phthalate (MEHP) are given to male rats. Events thought to be involved in this pathological effect also occur in cultures of testicular cells in vitro, but require MEHP rather than DEHP. Primary cultures of hepatocytes, Sertoli cells, and Leydig cells were incubated with 14C-labeled MEHP [8 microM] for up to 24 hr. No significant reduction in viability was produced under these conditions. In contrast to the hepatocytes, which extensively metabolized MEHP to a variety of products in 1 hr, the testicular cell cultures were apparently unable to metabolize MEHP (beyond a slight hydrolysis to phthalic acid by Sertoli cells) in 18-24 hr. MEHP was efficiently taken up by hepatocytes, but much less so by testicular cells. These results, combined with related observations from the literature, support the hypothesis that MEHP itself is the metabolite of DEHP responsible for testicular atrophy in rats. PMID- 2781554 TI - 2,3,7,8-Tetrachlorodibenzo-p-dioxin-induced porphyria in genetically inbred mice: partial antagonism and mechanistic studies. AB - 2,3,7,8-Tetrachlorodibenzo-p-dioxin (TCDD) (233 nmol/kg) causes a significant increase of hepatic uroporphyrin, heptacarboxyporphyrin, and total porphyrins in female C57BL/6 mice, ovariectomized C57BL/6 mice, male C57BL/10 mice, and male C57BL/6 mice 3 weeks after treatment. In contrast, 6-methyl-1,3,8 trichlorodibenzofuran (MCDF) was inactive at a dose of 750 mumol/kg. Cotreatment of the mice with TCDD (233 mol/kg) plus MCDF (750 mumol/kg) resulted in partial antagonism of TCDD-induced hepatic porphyrin accumulation only in the female mice. Parallel studies in female C57BL/6 mice showed that the TCDD-induced porphyria was accompanied by the induction of hepatic microsomal aryl hydrocarbon hydroxylase (AHH) and ethoxyresorufin O-deethylase (EROD) activities and the depression of uroporphyrinogen decarboxylase (UROD). MCDF (750 mumol/kg) did not significantly affect these enzymes. In the cotreatment studies (MCDF plus TCDD), MCDF partially antagonized TCDD-induced hepatic porphyrin accumulation but did not affect the levels of hepatic AHH, EROD, or UROD. These results indicate that other factors, in addition to the induction of cytochrome P450-dependent monooxygenases and depressed UROD activity, are important in TCDD-induced porphyria in C57BL/6 female mice. PMID- 2781555 TI - Induction of hepatic metallothionein in male B6C3F1 mice exposed to hepatic tumor promoters: effects of phenobarbital, acetaminophen, sodium barbital, and di(2 ethylhexyl) phthalate. AB - The effects of various compounds known to be hepatic tumor promoters and toxins in the male B6C3F1 mouse liver, including di(2-ethylhexyl)phthalate (DEHP), acetaminophen (ACT), barbital (BB), and phenobarbital (PB) on hepatic metallothionein (MT) concentrations were assessed after chronic exposure. From 6 weeks of age, male mice were maintained on diets containing DEHP at 12,000 or 6000 ppm, ACT at 10,000 or 5000 ppm, BB at 1,000 ppm, or drinking water with PB at 500 ppm for up to 24 weeks. MT was measured in hepatic cytosol at 0, 2, 8, and 24 weeks of exposure. DEHP proved a very effective inducer, producing elevations of MT as high as 11-fold. The increases in hepatic MT with DEHP were both dose- and time-related. ACT was likewise effective in producing hepatic MT elevations (maximum 6.7-fold) in a dose- and time-related fashion. BB and PB, however, had no effect on hepatic MT levels at any time point. While DEHP, BB, and PB treatments produced hepatomegaly, histopathological analysis at 24 weeks revealed that in both DEHP- and ACT-treated livers hepatocellular proliferation was prominent while livers exposed to BB or PB showed predominantly hepatocellular hypertrophy. Gel-filtration of DEHP-treated liver cytosol revealed that zinc was associated with the MT peak. This peak also bound cadmium in vitro and could be extracted by heat treatment and selective acetone precipitation, both typical characteristics of MT. Further confirmation of the presence of MT after DEHP treatment was obtained by sodium dodecyl sulfate-polyacrylamide gel electrophoresis (10 to 20% acrylamide). Results indicate that some, but not all, tumor promoters can induce target organ MT and that such an induction appears associated with those promoters inducing persistent cellular hyperplasia but not those inducing cellular hypertrophy. PMID- 2781556 TI - Characteristics of weekly pulmonary hypersensitivity responses elicited in the guinea pig by inhalation of ovalbumin aerosols. AB - We have reported the development of a guinea pig animal model for pulmonary hypersensitivity to inhaled chemicals in which respirations of animals are monitored continuously for 24 hr permitting detection of immediate- (IAR) and late-onset (LAR) airway reactions. Additionally implanted temperature transmitters allow determination of accompanying febrile responses. The current study investigated the relationship between severity of IAR and occurrence of LAR in individual animals. To quantify severity, a grading system was devised which took into account time to response, increase in breathing rate, and occurrence of airway constriction (ACR). Guinea pigs were sensitized by ip injection with 1 mg ovalbumin (OA). On Day 14, inhalation challenge with 12 mg/m3 OA resulted in severe IAR in all animals. No LAR were detected. Subsequent weekly inhalation challenges with OA resulted in less severe IARs and occasionally in absence of response. Febrile reactions were not detected. On one occasion a LAR was observed. It occurred in the animal demonstrating the most severe IARs and having the highest titer of specific homocytotropic antibody. These results are consistent with the mechanism of IAR involving release of spasmogenic mediators from mast cells as a result of antigen crosslinking of surface antibody. The mechanism of the LAR is addressed in the accompanying paper in which LARs are more consistently produced in OA-sensitized guinea pigs. PMID- 2781557 TI - Association of fever with late-onset pulmonary hypersensitivity responses in the guinea pig. AB - The guinea pig model of pulmonary hypersensitivity, developed in this laboratory, was used to study the relationship of fever with late-onset airway responses (LAR). The preceding paper M. H. Karol, J. A. Hillebrand, and P. S. Thorne. (1989). Toxicol. Appl. Pharmacol. 100, 234-246 described production of immediate onset responses (IAR) to ovalbumin (OA) with infrequent production of LAR (Karol et al., 1989). In the current study, LAR was produced on each of two occasions in the same animals using a sensitization regimen consisting of ip injection with 1 mg OA followed by exposure to 63 mg/m3 OA aerosol on Day 8. On Days 15 and 29, pyrilamine maleate was administered prior to inhalation challenges to block H1 receptors and to allow exposure for 20 min to 63 mg/m3 OA without histamine shock and fatal anaphylactic reactions. Each of the seven guinea pigs demonstrated IAR; four of seven additionally underwent LAR on both occasions. Late-onset responses were maximal at 4-5 hr postchallenge. Febrile responses of approximately 1 degree C (maximum 1.6 degrees C) accompanied the LAR in six of seven cases. Histopathology performed at the height of response revealed peribronchiolar eosinophilia. Pulmonary function determination indicated airflow disturbance during exhalation. These results are consistent with LAR being an airway response which is accompanied by fever and demonstrate the applicability of the guinea pig animal model to the study of mechanisms underlying IAR and LAR hypersensitivities. PMID- 2781558 TI - Studies on the mechanism of haloacetonitriles toxicity: inhibition of rat hepatic glutathione S-transferases in vitro. AB - Acetonitrile (AN) and seven of its halogenated derivatives known to be water disinfectant by-products were evaluated for their action on hepatic cytosolic glutathione S-transferase (GST) activity using 1-chloro-2,4-dinitrobenzene (CDNB) as substrate. Increasing concentrations of acetonitrile, monofluoroacetonitrile (MFAN), monochloroacetonitrile (MCAN), and monobromoacetonitrile (MBAN) up to 10 mM failed to produced 50% inhibition of the activity of GST enzyme. However, dichloroacetonitrile (DCAN), trichloroacetonitrile (TCAN), dibromoacetonitrile (DBAN), and monoiodoacetonitrile (MIAN) were potent inhibitors with 150 values of 2.49, 0.34, 0.82, and 4.44 mM, respectively. At concentrations equivalent to their 150, MIAN, DCAN, and DBAN decrease both apparent Km and Vmax of the enzyme activity toward glutathione (GSH) to 20-50% of control. TCAN significantly increases both apparent Km and Vmax for GSH to 650 and 120% of control values, respectively. The inhibitory effect of haloacetonitriles (HAN) on hepatic GST activity toward CDNB was found to be a mixed type. The inhibitory effect of DCAN, DBAN, and TCAN on the hepatic GST activity was found to be reversible and the activity was completely recovered after dialysis of the inhibited enzyme. MIAN, however, inhibited GST activity in an irreversible manner. Haloacetonitriles' induced inhibition of hepatic GST activity in vitro is consistent with that observed in vivo. The data presented in this study show that haloacetonitriles induced reversible inhibition of hepatic GST activities, and this effect may lead to decreased detoxification of other electrophilic chemicals. PMID- 2781559 TI - In vivo and in vitro cardiotoxicity of a gold-containing antineoplastic drug candidate in the rabbit. AB - Bis[1,2-bis(diphenylphosphino)ethane] gold(I) chloride (Au(DPPE)+2), a cytotoxic antineoplastic drug candidate, was cardiotoxic in rabbits. Intravenous administration of Au(DPPE)+2 (15 mg/kg) as a single dose produced multiple, 2- to 5-mm subendocardial and myocardial lesions, macroscopically appearing as pale tan foci. Histologically, these lesions consisted of widely scattered zones of myocardial cell necrosis and mineralization. The myocardium also contained multifocal areas of contraction band necrosis in which aggregated clumps of disorganized myofilaments were contiguous with areas of sarcoplasm which were relatively devoid of myofilaments. In a series of in vitro studies, electron microscopic examination of isolated rabbit myocytes treated with 30 microM Au(DPPE)+2 for 15 min showed evidence of mitochondrial swelling and electron translucent mitochondrial matrices. After 60 min of incubation, myocytes had mitochondria that were condensed and disrupted but the cristae had retained their tubular profiles. Isolated rabbit myocytes exposed to 30 microM Au(DPPE)+2 had significant increases in the leakage of lactate dehydrogenase, an index of cell death. Cellular ATP content in myocytes exposed to 30 microM Au(DPPE)+2 was significantly reduced by 30 min. State 4 respiration in isolated rabbit mitochondria was significantly increased by Au(DPPE)+2 (30 microM) while state 3 respiration was unaffected. Au(DPPE)+2 also caused a rapid dissipation of the mitochondrial inner membrane electrochemical potential in a concentration dependent manner and was accompanied by a ruthenium red-sensitive calcium efflux. These data suggest that disruption of mitochondrial function, leading to uncoupling of oxidative phosphorylation, decreased ATP synthesis, and altered mitochondrial calcium homeostasis, may be a contributing factor leading to cardiac myofibril necrosis produced by Au(DPPE)+2. PMID- 2781560 TI - The fate of inhaled octane and the nephrotoxicant, isooctane, in rats. AB - To determine if inhaled nephrotoxic branched and nonnephrotoxic straight chain alkanes differ substantially in their biological fate, male F344 rats were exposed to 14C-labeled isooctane and octane vapors at approximately 1 and 350 ppm by the nose-only mode for 2 hr. Radioactivity in exhalant, urine, and feces was determined for 70 hr post exposure, after which residual radioactivity in the rat carcasses was determined. Absorbed [14C]isooctane equivalents were eliminated almost exclusively via the kidneys, while absorbed [14C]octane equivalents were excreted about equally via the kidneys and as 14CO2. Kidney excretion of isooctane-introduced 14C was protracted over the entire 70 hr postexposure observation period whereas for octane-introduced 14C, kidney excretion was essentially complete after 10-20 hr. About 5% of the [14C]octane equivalents inhaled at 1 ppm remained in the carcass 70 hr after inhalation exposure. Two percent of the [14C]octane equivalents inhaled at 350 ppm and 1-2% of the [14C]isooctane equivalents inhaled at either 1 or 350 ppm remained in the carcass 70 hr after inhalation exposure. The different patterns of excretion of metabolites of isooctane compared to octane may be a factor affecting the differences in nephrotoxicity between these two compounds. PMID- 2781561 TI - Induction of cytochromes P450IIE1 and P450IIB1 by secondary ketones and the role of P450IIE1 in chloroform metabolism. AB - It has been shown previously that the potentiation of chloroform-induced hepatotoxicity by linear secondary ketones increases with the carbon-chain length. The present work examines the possibility that this potentiation is due to the induction of P450IIE1. The metabolism of chloroform, as measured using headspace gas chromatography, in the presence of microsomes from acetone-treated rats was elevated threefold compared to controls. Inclusion of monoclonal antibody against P450IIE1 inhibited the metabolism by 81%. Alternate substrates of P450IIE1 were also inhibitory. Chloroform metabolism was observed using purified, reconstituted P450IIE1 plus cytochrome b5, but was not detected using P450IIB1. The inductive effect of 18-hr oral pretreatment (15 mmol/kg body wt) with each of three secondary ketones on two isozymes of rat liver microsomal cytochrome P450, P450IIE1, and P450IIB1 was studied. The content of total microsomal P450 and NADPH-dependent cytochrome c reductase, the rates of oxidation of N-nitrosodimethylamine, benzphetamine, and pentoxyresorufin, as well as levels of immunoreactive protein for both of the isozymes were elevated by the pretreatments in the rank order of acetone less than or equal to 2-butanone less than 2-hexanone, in agreement with other trends noted by previous investigators. The results provide further evidence for the role of P450IIE1 induction in the potentiation phenomenon. PMID- 2781562 TI - Pulmonary fibrosis induced in the hamster by amiodarone and desethylamiodarone. AB - Associated with amiodarone use is pneumonitis which may progress to life threatening pulmonary fibrosis. Desethylamiodarone, a metabolite, whose role in the etiology of amiodarone-induced pulmonary toxicity has been unclear, also possesses antiarrhythmic activity and could potentially be used as an antiarrhythmic drug itself. We have used a single intratracheal administration of equimolar amounts of amiodarone or desethylamiodarone (1.83 mumol) to male golden Syrian hamsters to investigate the fibrogenicity of desethylamiodarone. Animals were terminated at 1, 7, 14, 21, and 28 days post-treatment, and toxicity was assessed by measurement of lung hydroxyproline content and by histological techniques. Amiodarone and desethylamiodarone significantly increased lung hydroxyproline content over vehicle control animals by 21 days (33 and 58% respectively). While amiodarone-treated lungs had hydroxyproline contents similar to control levels at 28 days, desethylamiodarone-treated lungs remained elevated (44% over control values). Quantitative histologic examination revealed that lungs from desethylamiodarone-treated animals displayed a greater toxic effect, while trichrome staining confirmed the increased deposition of interstitial collagen in these same animals. These results may be due to the higher affinity of the lung for desethylamiodarone and thus a prolonged exposure. The findings indicate that, in the hamster, both compounds are toxic by this route and that desethylamiodarone is not a nontoxic metabolite. Further, use of desethylamiodarone as an antiarrhythmic agent may not be devoid of the adverse effects associated with amiodarone. PMID- 2781564 TI - Nephrotoxicity assessment by measuring cellular ATP content. II. Intranephron site of ochratoxin A nephrotoxicity. AB - To clarify the nephrotoxic site and potency of ochratoxin A (OCTA), we measured cellular ATP contents in nine nephron segments incubated with or without OCTA in vitro. Cellular ATP contents of nephron segments isolated under stereomicroscopic observation after treatment of renal slices with 0.1% collagenase were measured by the microchemiluminescence method. OCTA decreased cellular ATP content in a dose-dependent manner. A concentration-response study of OCTA showed that the minimum concentration of OCTA needed to cause a significant decrease in ATP was 10(-8) M in the middle portion of the proximal tubule (S2; p less than 0.05) and 5 x 10(-4) M in the medullary collecting tubule (MCT; p less than 0.01). Among nine nephron segments, OCTA at 5 x 10(-5) M significantly decreased cellular ATP content in only S2 and the terminal portion of the proximal tubule (S3; p less than 0.01). ATP synthesis in mitochondria isolated from the renal cortex was significantly inhibited by 10(-6) M OCTA (p less than 0.05). Probenecid at 4 x 10(-4) M protected against the OCTA-induced cellular ATP decrease. These results suggest that OCTA might enter the plasma membrane in S2 and S3 through the organic anion transport pathway and inhibit mitochondrial oxidative phosphorylation. This newly established method would be applicable to evaluation of the intrarenal toxic site and potency of various chemical compounds. PMID- 2781563 TI - Metabolism of trans, trans-muconaldehyde, a microsomal hematotoxic metabolite of benzene, by purified yeast aldehyde dehydrogenase and a mouse liver soluble fraction. AB - Aldehyde dehydrogenase (ALDH) from yeast, in the presence of NAD+, oxidizes trans, trans-muconaldehyde (MUC) in a biphasic manner with apparent Km values of 0.48 and 3.2 microM and corresponding Vmax values of 604 and 1227 nmol/min/mg protein. Concentrations above 10 microM trans,trans-muconaldehyde produce an inhibition of enzyme activity. Removal of NAD+, MUC, or use of boiled enzyme results in no oxidation. Using thin-layer chromatography and high-pressure liquid chromatography techniques, a product with polarity intermediate between that of the dialdehyde trans,trans-muconaldehyde and the diacid trans,trans-muconic acid (MA) was detected in the ALDH incubation mixtures. The same product was also detected in a DBA/2J mouse liver soluble fraction supplemented with NAD+ and incubated with MUC. This product was isolated from a scaled-up incubation mixture containing trans,trans-muconaldehyde, purified yeast aldehyde dehydrogenase, and NAD+. Mass spectral analysis of the compound indicates a molecular weight of 126 and an empirical formula C6H6O3 containing four double bonds. This product also tested positive with reagents specific for carboxylic and aldehydic functional groups. In the presence of the mouse liver soluble fraction supplemented with NAD+, this intermediate was metabolized to MA. These findings indicate that MUC is oxidized by yeast aldehyde dehydrogenase to the monocarboxylic acid derivative which is an intermediate in the conversion of MUC to MA. The role of the monocarboxylic acid alpha,beta-unsaturated aldehyde in benzene hematotoxicity remains to be explored. PMID- 2781565 TI - Effect of ethanol on hepatotoxicity of acetaminophen in mice and on reactive metabolite formation by mouse and human liver microsomes. AB - The protective effect of a single dose of ethanol with regard to hepatotoxicity caused by acetaminophen (APAP) can be a consequence of either direct or indirect inhibition of APAP oxidation to its hepatotoxic intermediate (N-acetyl-p benzoquinoneimine, NAPQI), or augmentation of repair mechanisms following the hepatotoxic insult. The mechanism of hepatoprotection appears to be species dependent. By varying the time of ethanol administration relative to APAP in mice (30 min before to 240 min after APAP), it was shown that ethanol must be administered early relative to APAP for hepatoprotection to be maximized. The role of direct inhibition of cytochrome P450 in the hepatoprotective effect of ethanol was evaluated by comparing the hepatoprotection afforded by ethanol and 4 methylpyrazole (4-MP) in vivo to the inhibition of APAP oxidation to NAPQI caused by each in mouse liver microsomes. At their respective peak in vivo concentrations attained following hepatoprotective doses, both ethanol and 4-MP inhibited the oxidation of APAP in microsomes by 25-30%. This result suggests that direct inhibition of cytochrome P450 by ethanol plays a role in the protection against acetaminophen-induced hepatotoxicity in mice. In human liver microsomes the inhibition of APAP oxidation to the hepatotoxic intermediate by 48 mM ethanol is less than half of the apparent inhibition of APAP oxidation reported in clinical studies in which the maximum ethanol concentration would have been 15-20 mM. Thus, in contrast to the mouse, inhibition of APAP oxidation to NAPQI in humans appears to be largely indirect, as has been reported previously in the rat. PMID- 2781566 TI - Microinjection of cultured rat embryos: a new technique for studies in chemical dysmorphogenesis. AB - The utility of a new technique for exposure of cultured whole rat embryos to potential dysmorphogens was demonstrated with nitrosofluorene (NF), a cytotoxic and mutagenic metabolite of 2-acetylaminofluorene (AAF). At an initial concentration in the culture medium of 41 microM, NF produced a 100% incidence of defects in axial rotation with no significant effect on prosencephalic development, consistent with previous reports. This route of exposure was also associated with a significant decrease in yolk sac vasculature and protein content. However, when 2 to 20 ng of NF was microinjected directly into the amniotic space, the predominant malformation observed was prosencephalic hypoplasia. Injection of 10 ng NF resulted in approximately equivalent decreases in viability as 41 microM NF dissolved in the culture medium, but produced only a 41% incidence of rotation defects and a 27% incidence of open neural tubes in the rhombencephalic region. The protein content of injected conceptuses was significantly reduced in the embryo, but not in the visceral yolk sac. When 10 ng of NF was injected inside the yolk sac but outside the amnion, the incidence of abnormal rotation was increased to 75%, and the severity of prosencephalic hypoplasia as well as the incidence of neural tube abnormalities was attenuated. The protein content of both the embryo and yolk sac was significantly decreased relative to that of the controls. The data are consistent with the suggestion that NF elicits defects in axial rotation primarily via its effects on the visceral yolk sac and demonstrate the capacity of this technique to provide insights into mechanistic aspects of chemical dysmorphogenesis. PMID- 2781567 TI - In vitro percutaneous absorption and stratum corneum binding of alachlor: effect of formulation dilution with water. AB - The effect of vehicle dilution on the percutaneous absorption of alachlor, 2 chloro-2',6'-diethyl-N-(methoxymethyl)acetanilide, through excised human skin was determined using flowthrough design glass penetration cells and 14C radiotracer methodology. Three dilutions of alachlor (in the solubilizing commercial formulation) with distilled water were utilized: 1:20, 1:40, and 1:80 (v/v); corresponding to concentrations of 23.0, 11.8, and 5.98 mg alachlor per milliliter, respectively. Skin from the penetration studies and human powdered stratum corneum from the binding studies demonstrated a high capacity for alachlor. A soap and water (1:1, v/v) solution effectively decontaminated powdered stratum corneum. Using plasma as the receptor solution, penetration ranged from 0.5 to 4% of the applied dose for an 8-hr exposure period. Lag times of 1.2 to 1.8 hr were observed. Increasing dilution resulted in significant enhancement (p less than 0.01) in the rate and extent of alachlor penetration. Although the biological significance of this observation is unclear, this phenomenon might be explored in future studies because of its ramifications for human toxicity and for decontamination opportunities. PMID- 2781568 TI - Delayed neurotoxicity of triphenyl phosphite in hens: pharmacokinetic and biochemical studies. AB - The organophosphorus compound, triphenyl phosphite (TPP), caused ataxia in chickens 8-14 days after single po or iv administration. The po and iv ED50 values were 1414 and 35.4 mg/kg, respectively. Chickens which developed ataxia lost 14.4 +/- 2.5% (mean +/- SEM, n = 14) of their initial weight at 28 days and the paralyzed birds showed a severe reduction of 29.3 +/- 2.9% (n = 13) of their initial weight at death or at 28 days after dosing. For the first 4-hr interval after iv injection of 50 mg/kg, the elimination of TPP from plasma consisted of at least two exponential phases; the half-lives of the first and second phases were approximately 30 and 60 min, respectively. When the birds received 100 mg/kg (iv) fatty tissue showed the highest TPP concentration, e.g., 215 micrograms/g fresh wt at 6 hr postdosing. The half-life was approximately 24 hr. Among neural tissues, the sciatic nerve had the highest concentration, followed by the spinal cord, the cerebellum, and the cerebrum. The red muscles, such as adductor magnus, contained about 4-30 times as much TPP as did the white muscles, such as biceps brachii, 6 hr after treatment. Time course effects of TPP treatment on mitochondrial enzymes in leg skeletal muscles were examined by treating hens with 50 mg/kg (iv) and euthanizing the birds at 6 hr to 8 days postdosing. The creatine kinase (CK) activities of the adductor and the soleus were significantly decreased at 2 (48 hr), 4, and 8 days, and at 4 and 8 days postdosing, respectively. Adductor magnus and soleus succinate dehydrogenase (SDH) activities were decreased markedly at 24 and 48 hr, and at 2 (48 hr), 4, and 8 days, respectively. Cytochrome oxidase (COD) activity in adductor magnus and soleus did not decrease during the time course. Biceps femoris CK, SDH, and COD activities were not affected by TPP treatment at this dosage. These results suggest that TPP administration affects the mitochondrial metabolism in skeletal muscle, especially red muscle of chickens. PMID- 2781569 TI - Effects of culture duration on hydrogen peroxide-induced hepatocyte toxicity. AB - The effects of culture duration on primary cultured mouse hepatocyte antioxidant levels (superoxide dismutase, catalase, glutathione peroxidase, vitamin E, and glutathione) and susceptibility to glucose oxidase (GO)- and hydrogen peroxide (H2O2)-induced cell killing and lipid peroxidation were examined. Membrane fatty acid composition was also evaluated. Adult male B6C3F1/CrlBR mouse hepatocytes were isolated by collagenase perfusion of the liver and cultured on 60-mm plastic dishes in Leibovitz's L-15 medium supplemented with glucose (1 mg/ml), dexamethasone (1 microM), fetal bovine serum (10%, v/v), and gentamicin sulfate (50 micrograms/ml) for 0 hr (freshly isolated cells) to 96 hr. Hepatocyte toxicity (determined by lactate dehydrogenase release and lipid peroxidation) after a 2-hr exposure to GO (0.8-80 micrograms/ml) or H2O2 (1-5 mM) decreased with increased time in culture. This decreased hepatocyte sensitivity to GO and H2O2 toxicity was not related to antioxidant enzyme activity since superoxide dismutase, catalase, and glutathione peroxidase declined during the 96-hr culture period. In contrast, glutathione and vitamin E levels in the cultured hepatocytes rose to 274.9 +/- 8.3% and 220.6 +/- 18.6% of the levels in freshly isolated cells (129.6 +/- 11.5 nmol and 0.10 +/- 0.01 nmol per 10(6) hepatocytes, respectively). The percentage of polyunsaturated fatty acids in hepatocyte phospholipids and triglycerides decreased with culture duration while the percentage of oleic acid increased in esterified and free fatty acid pools after 2 hr in culture. Total fatty acids were not affected by time in culture. These results suggest that the decreased hepatocyte susceptibility to the toxic effects of hydrogen peroxide may have been due to elevations in cellular GSH and vitamin E levels and decreases in membrane polyunsaturated fatty acids. The data also indicate that hepatocytes in primary culture undergo changes in antioxidant levels and fatty acid composition that may affect free radical toxicity at different times in culture. PMID- 2781570 TI - Pharmacokinetics of triethylamine and triethylamine-N-oxide in man. AB - The pharmacokinetics of the industrially important compound triethylamine (TEA) and its metabolite triethylamine-N-oxide (TEAO) were studied in four volunteers after oral and intravenous administration. TEA was efficiently absorbed from the gastrointestinal (GI) tract, rapidly distributed, and in part metabolized into TEAO. There was no significant first pass metabolism. TEAO was also well absorbed from the GI tract. Within the GI tract, TEAO was reduced into TEA (19%) and dealkylated into diethylamine (DEA; 10%). The apparent volumes of distribution during the elimination phase were 192 liters for TEA and 103 liters for TEAO. Gastric intubation showed that there was a close association between levels of TEA in plasma and gastric juice, the latter levels being 30 times higher. The TEA and TEAO in plasma had half-lives of about 3 and 4 hr, respectively. Exhalation of TEA was minimal. More than 90% of the dose was recovered in the urine as TEA and TEAO. The urinary clearances of TEA and TEAO indicated that in addition to glomerular filtration, tubular secretion takes place. For TEAO at high levels, the secretion appears to be saturable. The present data, in combination with those of earlier studies, indicate that the sum of TEA and TEAO in urine may be used for biological monitoring of exposure to TEA. PMID- 2781571 TI - The toxin tetramine from the "edible" whelk Neptunea antiqua. AB - The chemical nature of extracts of the marine gastropod Neptunea antiqua collected in the North Sea has been investigated. Amino acid analysis and spectroscopical studies (FAB MS, 1H NMR, 13C NMR and IR) on fractions purified by Biogel P-2 and Amberlite IR 120 column chromatography allowed the identification of 19 components. It was established that the water-soluble toxin responsible for poisonings, following ingestion of this snail, is tetramine (the tetramethylammonium ion present as an unknown salt). Contrary to what occurs in other Neptunea species (N. arthritica and N. intersculpta), tetramine was found not only in the salivary gland, but also in the remaining part of the animal, albeit in smaller concentration. In the isolated guinea-pig ileum assay, synergistic effects with other main components present (betaine, homarine) could not be demonstrated. Choline esters, believed to act synergistically in other Neptunea species, were not detected in Neptunea antiqua. PMID- 2781572 TI - A new muscle damaging toxin, myotoxin II, from the venom of the snake Bothrops asper (terciopelo). AB - A new muscle damaging toxin, myotoxin II, was purified from the venom of Bothrops asper by ion-exchange chromatography on CM-Sephadex C-25. The toxin is a dimeric, basic protein with a monomer mol.wt of 13,341, according to the amino acid composition, and 16,000 on the basis of SDS-polyacrylamide gel electrophoretic mobility. It has a high number of aspartate and lysine residues, as well as of hydrophobic amino acids. Upon i.m. injection into mice, the toxin induces myonecrosis and increase in serum creatine kinase levels. In addition, myotoxin II induces edema in the mouse foot pad. Immunochemical tests, mol.wt, and amino acid composition indicate a high degree of homology between myotoxin II and a previously characterized myotoxin from this venom, myotoxin I. However, in contrast to myotoxin I, myotoxin II lacks phospholipase A2 and anticoagulant activities in vitro. PMID- 2781574 TI - Purification and some characteristics of a zinc metalloprotease from the venom of Bothrops jararaca (jararaca). AB - A metalloprotease from Bothrops jararaca venom (J protease) was purified by DEAE Sephacel, CM-cellulose, Sephacryl S-200 and Sephadex G-75 chromatograph. The proteolytic activity was inactivated by EDTA, o-phenanthroline and DTNB. Phosphoramidon and cysteine protease inhibitors (leupeptin, E64 and its derivatives) were inactive on this enzyme. J protease was activated by calcium and the metal content analysis showed the presence of one mole each of tightly bond zinc and calcium per mole of this J protease. The amino acid composition, N terminal amino acid sequence (29 residues) and the cleavage sites on the oxidized insulin B chain and angiotensin I were determined. PMID- 2781573 TI - Myonecrosis induced in mice by a basic myotoxin isolated from the venom of the snake Bothrops nummifer (jumping viper) from Costa Rica. AB - The mode of action of a basic myotoxin isolated from Bothrops nummifer venom was studied. This myotoxin is a basic polypeptide of 13,000 mol.wt, with a high content of lysine and aspartate, as well as of hydrophobic amino acids. It lacked phospholipase A2 activity when tested on several substrates at different pH values. Upon i.m. injection into mice, the toxin induced early morphological alterations typified by 'delta lesions' in the periphery of muscle fibers, an indication that the plasma membrane was the first cellular structure to be affected. Afterwards, necrotic cells had a clumped appearance, which then changed to a more hyaline histological pattern. Removal of necrotic material by phagocytes was followed by skeletal muscle regeneration, with the presence of myoblasts, myotubes and fully regenerated myofibers. The toxin induced a rapid and drastic drop in muscle creatine and creatine kinase contents of injected muscle, as well as an increase in serum levels of the enzymes lactic dehydrogenase and creatine kinase. Moreover, total muscle calcium increased significantly after toxin administration. Myotoxin induced a dose-dependent release of peroxidase entrapped in liposomes made from muscle phospholipids. The lack of phospholipase A2 activity in this toxin, together with the observation that it behaved as an amphiphilic protein in charge-shift electrophoresis, suggests that it might penetrate and disorganize muscle plasma membrane by means of a hydrophobic interaction. PMID- 2781575 TI - The developmental toxicity of an isolate from the plant Solanum dimidiatum (potato-weed) in Syrian golden hamsters. AB - The developmental toxicity of an ethanol extract from Solanum dimidiatum was investigated in date-bred Syrian golden hamsters. Neural tube defects were seen in three Syrian golden hamster fetuses, from one litter out of 12, at a maternal dose of 1.52 mg of plant isolate per g of body weight. Other malformations observed were syndactyly in a single fetus, from one litter out of ten, in the 0.45 mg/g dose group and gastroschisis in a single fetus, from one litter out of nine, in the 1.01 mg/g dose group. These findings suggest minimal developmental toxicity for this plant isolate. PMID- 2781576 TI - A gyroxin analog from the venom of the bushmaster (Lachesis muta muta). AB - Clinical observations of possible neurotoxic activity in bushmaster (Lachesis muta muta) envenomations, coupled with the accepted ancestral relationship of Lachesis to other crotalids, suggested that Lachesis venom might contain a crotoxin-like molecule. Crude venom and gel-filtration fractions showed modest reactivity in enzyme-linked immunosorbent assays using rabbit polyclonal antibodies raised against the basic subunit of crotoxin, but no reaction was detected with a murine monoclonal antibody raised against the same antigen. Phospholipase assays, LD50 determinations and SDS-polyacrylamide gel electrophoresis indicated the presence of non-toxic phospholipases, but no crotoxin homologs. A higher mol.wt, toxic protein (60,000) with an LD50 of 0.07 micrograms/g in mice was isolated and purified, which induced gyroxin-like, rapid rolling motions in mice. Its amino terminal sequence shows considerable amino acid sequence identity with gyroxin from the venom of Crotalus durissus terrificus and other serine proteases. PMID- 2781577 TI - Purification and properties of a procoagulant from peninsula tiger snake (Notechis ater niger) venom. AB - The procoagulant from Notechis ater niger was purified by gel filtration and anion exchange chromatography. It is a protein with an approximate mol.wt of 58,000 and in the presence of B mercaptoethanol is reduced to two chains with mol.wts of 37,000 and 23,000. The procoagulant has a pI of 7.3. The whole venom requires factor V to be present to bring about coagulation while Ca2+ and phospholipid are not essential, but when present stimulate this process. Normal prothrombin, but not decarboxyprothrombin, is converted by the venom. The activity of the procoagulant from Notechis species has been equated with factor Xa and in this study the similarity is noted, while ecarin-like characteristics in not requiring Ca2+ and phospholipid and an ability to clot heparinised plasma were also noted. PMID- 2781578 TI - High resolution of honey bee (Apis mellifera) venom peptides by propionic acid/urea polyacrylamide gel electrophoresis after ethanol precipitation. AB - A new and simple gel electrophoretic method is described which enables the protein and polypeptide components of bee venom to be resolved on a single gel. The electrophoretic method allows octapeptides to be resolved and species as small as decapeptides can be detected at high sensitivity using the Coomassie blue staining method without prior fixation. This has been achieved by replacing acetic acid by propionic acid in acid/urea polyacrylamide gels and by controlling the amount of TEMED catalyst for the polymerisation of high concentration gels in order to obtain a low effective pore size. We demonstrated the value of ethanol precipitation as a rapid and efficient desalting the fractionation technique and propose that it could be used in combination with gel filtration to purify many of the peptides to homogeneity. PMID- 2781579 TI - Histopathological observations on organs from rabbits injected with the skin toxin of the Arabian Gulf catfish (Arius bilineatus, Valenciennes). AB - Toxicity of soluble protein extracts (skin toxin) from epidermal skin secretions of the catfish, Arius bilineatus (previously identified as Arius thalassinus), was examined in rabbits. Intravenous injections containing doses as low as 2 mg protein/kg body weight caused mortality in most animals tested. Histopathological examination of lung, heart, liver and kidney tissues of rabbits injected with skin toxin indicated that the lungs and livers of treated animals were adversely affected, while heart and kidney tissues appeared to be normal. Lethality of skin toxin was prevented by pretreatment of the rabbits with indomethacin. Histopathological examination of lung and liver tissues of indomethacin pretreated animals showed a significant reduction in the damage observed after injection of skin toxin. PMID- 2781580 TI - Effects of Pasteurella haemolytica leukotoxin on isolated bovine neutrophils. AB - P. haemolytica leukotoxin caused rapid leakage of intracellular K+ (greater than 90% in 30 sec) from and cell swelling (approximately 100% increase in 15 min) of isolated bovine neutrophils. Incubation media made hypertonic by the addition of raffinose, dextran or inulin (carbohydrates with mol. wts of greater than or equal to 505) prevented leukotoxin-induced cell swelling, but not K+ leakage. Assuming that leukotoxin acts as a transmembrane molecular sieve, then the leukotoxin-induced functional transmembrane pore size in bovine neutrophil plasma membranes is slightly smaller than the molecular size of raffinose, i.e. 1.2 nm. Morphologically, leukotoxin caused bovine neutrophils to swell, lose their membrane ruffling, develop a finely porous surface, and form large plasma membrane defects. Exposure of neutrophils to leukotoxin caused slower (5-50 min) leakage of 80% of the cellular L-lactate: NAD oxidoreductase (E.C. 1.1.27, lactate dehydrogenase, LDH). Leukotoxin-induced K+ leakage and cell swelling developed in Ca2+-free medium, whereas leakage of lactate dehydrogenase develop only in medium containing Ca2+ and was inhibited by the addition of ethylene glycol-bis(B-aminoethyl ether)N,N,N1,N1-tetraacetic acid (EGTA). This sequence of leukotoxin-induced changes in neutrophils is compatible with the mechanism of action of pore-forming cytolysins. PMID- 2781581 TI - Occurrence of tetrodotoxin in the frog Atelopus oxyrhynchus. AB - Alcohol extracts from the frog Atelopus oxyrhynchus were toxic to mice when injected intraperitoneally. The toxin was purified by gel filtration on a Sephadex G-15 column, and was identified as tetrodotoxin by thin-layer chromatography and GC-MS analysis of the alkali-hydrolyzed and trimethylsilylated derivative giving the same pattern as the C9-base of tetrodotoxin. PMID- 2781582 TI - 2nd International Symposium on Neurotoxins in Neurobiology. December 1988, Solis, Uruguay. Abstracts. PMID- 2781583 TI - Comparative study on coagulant, defibrinating, fibrinolytic and fibrinogenolytic activities of Costa Rican crotaline snake venoms and their neutralization by a polyvalent antivenom. AB - The coagulant, defibrinating, fibrino lytic and fibrinogenolytic activities of venoms from ten species of Costa Rican crotaline snakes were studied, together with the neutralization of these effects by a polyvalent antivenom. The venoms of Bothrops asper, B. schlegelii, B. nummifer, B. godmani, Lachesis muta and Crotalus durissus induced a coagulant effect in vitro, and all of them, with the exception of B. nummifer, also induced defibrination in vivo. The four non coagulant venoms (B. lateralis, B. ophryomegas, B. nasuta and B. picadoi) induced a degradation of the alpha (A) chain of fibrinogen, thereby inhibiting coagulation. However, they did not induce defibrination upon i.v. injection. All of the venoms showed fibrinolytic activity in vitro. Polyvalent antivenom was effective in the neutralization of coagulant, defibrinating, fibrinolytic and fibrinogenolytic activities of these venoms, with the exception of coagulant effect induced by C. durissus venom. Since only three venoms are used in the immunization of horses, these results demonstrate the high degree of immunological cross reactivity between components affecting coagulation in Costa Rican crotaline snake venoms. PMID- 2781584 TI - Gangliosides mediate inhibitory effects of tetanus and botulinum A neurotoxins on exocytosis in chromaffin cells. AB - Bovine chromaffin cells in monolayer culture were preloaded with 3H-NA (noradrenaline) and subsequently stimulated with carbachol. Botulinum A neurotoxin partially inhibited the evoked release of 3H-NA and the basal efflux of the hormone. The inhibition of evoked release did not exceed 40%, although the cells were exposed to 10 micrograms/ml of toxin for 6 days. The inhibitory effect of botulinum A neurotoxin was neutralized by its antibodies. In contrast to botulinum A neurotoxin, tetanus toxin at even higher concentrations did not influence evoked release. This difference in sensitivity could be explained by the ganglioside pattern of chromaffin cells. Ganglioside GD1a, a putative receptor for botulinum A neurotoxin, could be identified in lipophilic extracts, whereas the tetanus toxin binding gangliosides GT1b and GD1b could not be detected by means of thin-layer chromatography. Treatment of the cells with neuraminidase abolished both, GD1a and the inhibitory effect of botulinum A neurotoxin. Incubation of chromaffin cells with a mixture of gangliosides (21% GM1, 44% GD1a, 15% GD1b, 20% GT1b) not only increased the efficacy of botulinum A neurotoxin but also made the cells sensitive towards tetanus toxin. The concentration-response curve of botulinum A neurotoxin was shifted to the left about five-fold and the maximum inhibition of evoked release was increased up to 60%, even though the cells were exposed to the toxin for 3 days only. In contrast, the maximum inhibition that could be achieved by tetanus toxin was 40%. The results indicate that polysialogangliosides are important for the intracellular accumulation of these clostridial neurotoxins. PMID- 2781585 TI - Purification and characterization of a myotoxic phospholipase A2 from Indian cobra (Naja naja naja) venom. AB - A major phospholipase A2 (NN-XIII-PLA2) which constitutes 20% of the whole Naja naja naja venom was purified to homogeneity on CM-Sephadex C-25 column chromatography. NN-XIII-PLA2 is a basic protein with a mol. wt of 11,200 by SDS PAGE. This enzyme has low enzymatic activity but is more toxic to mice than the whole venom. The LD50 value (i.p.) of NN-XIII-PLA2 is 2.4 mg/kg body weight (whole venoms LD50 is 2.8 mg/kg body weight). It induces neurotoxic-like signs in experimental animals. It induces myotoxicity when injected i.m. into the thigh muscle of mice and edema when injected into the foot pads of mice. This enzyme has a fluorescence maxima between 310-316 nm which is typical of tyrosine residues. PMID- 2781586 TI - Dissociation of catalytic activity and neurotoxicity of a basic phospholipase A2 from Russell's viper (Vipera russelli) venom. AB - A neurotoxic phospholipase A2, VRV PL-V was purified from Vipera russelli venom in a single step by CM-Sephadex C-25 column chromatography. VRV PL-V is a basic PLA2 with a mol. wt of approximately 10,000. The lethal potency of VRV PL-V was greater than that of the crude V. russelli venom. VRV PL-V showed anticoagulant activity and induced edema in the foot pad of the mouse. VRV PL-V undergoes aggregation at pH 4.8. The size of the aggregate increased as the temperature at which the enzyme was incubated was raised. A highly aggregated form with a mol. wt of 53,100 was formed at 96 degrees C. This aggregate showed a two-fold increase in its catalytic activity, while its neurotoxic activity disappeared. The aggregate also showed a significant increase in its anticoagulant activity when compared to the monomeric form. Edema-inducing activity decreased upon association to higher molecular form. PMID- 2781587 TI - A sensitive enzyme-linked immunosorbent assay of ochratoxin A based on monoclonal antibodies. AB - We prepared seven monoclonal antibodies (mAbs, OTA.1, 2, 3, 4, 5, 6 and 7) which were reacted with ochratoxin A (OTA), and have developed a specific and highly sensitive enzyme-linked immunosorbent assay (ELISA) for detection of OTA. The mAbs, OTA.1, 3, 4, 5 and 7, specifically reacted with OTA but much less with its analogs, ochratoxin B (OTB, about 1% of OTA) and ochratoxin alpha (OT alpha, less than 0.1% of OTA). One of the mAbs, OTA.2, equally reacted with OTA and OTB but hardly at all with (4R)-4-hydroxyochratoxin A or OT alpha (less than 0.1% of OTA). All of the mAbs reacted with ochratoxin C. None of the mAbs reacted with coumarin, 4-hydroxycoumarin or L-beta-phenylalanine. In the competitive ELISA with OTA.1 and OTA.7, the lowest detectable amount of standard OTA in solution was 50 pg/ml (2.5 pg per assay). This assay was applied for the quantitation of OTA added to chicken meat, wheat flour, porcine plasma and bovine serum. With minimal sample preparation, reliable and reproducible determinations were possible when concentrations of OTA were higher than 0.1-1 ng/g. PMID- 2781588 TI - Edema-producing proteins isolated from Trimeresurus mucrosquamatus snake venom. AB - Seven edema-producing fractions were isolated from Trimeresurus mucrosquamatus snake venom by CM-Sephadex C-50 chromatography and further purified by gel filtration on a Sephadex G-75 column. They were homogeneous as judged by electrophoresis on polyacrylamide gels. The mol. wts were estimated to be 26,900 (Fr. IV-2), 21,500 (Fr. X-2), 23,000 (Fr. XII-2), 21,800 (Fr. XIII-2), 24,600 (Fr. XIV-2), 80,000 (Fr. XVIII-1) and 22,500 (Fr. XXII-2). Fraction IV-2 had weak esterase activity, fractions X-2, XII-2, XIII-2 and XIV-2 possessed proteolytic activity toward casein and fibrinogen, while fractions XVIII-1 and XXII-2 possessed phospholipase A2 activity. Fractions with phospholipase A2 activity had greater edema-producing activity than those with protease and/or esterase activity. It is concluded that the edema caused by T. mucrosquamatus venom may be due to phospholipases A2, proteases and esterases. PMID- 2781589 TI - A simplified procedure for the fractionation of Tityus serrulatus venom: isolation and partial characterization of TsTX-IV, a new neurotoxin. AB - Five toxins from the venom of the Brazilian scorpion Tityus serrulatus were purified to homogeneity by a combination of ion exchange chromatography with ammonium bicarbonate buffer (pH 7.8) on CM-cellulose-52 and rechromatography on the same resin equilibrated with ammonium acetate buffer (pH 4.7). Four of these proteins, obtained in one or two steps in high yield and lethality (named toxins IX3, IX5, and X4 and XIII) were shown to be identical with other toxins already described. A fifth one, TsTX-IV, is reported as a new toxin. Except for IX3, which showed Gly as the sole N-terminal residue, the other four toxins showed Lys. TsTX-IV has an approximate mol. wt of 6880, an i.v. LD50, in mice, of 826 +/ 156 micrograms/kg and an intracisternal LD50 of 11 +/- 9 micrograms/kg, compared to 375 +/- 45 and 4.9 +/- 0.8, respectively, for the whole venom extract. It has 61 amino acid residues and an amino acid composition different from that of any other toxin from Tityus serrulatus venom so far described. Toxins IX5, TsTX-IV and XIII induced a prejunctional type of supersensitivity on the guinea pig vas deferens, probably due to an increased release of noradrenaline. PMID- 2781591 TI - Toxicity of echinulin from Aspergillus chevalieri in rabbits. AB - Rabbits were injected intraperitoneally with purified echinulin, a product of Aspergillus chevalieri. After 2 h, the rabbits were bled and enzyme analyses were carried out on the supernates of liver homogenates and citrated plasma. Elevated levels of total plasma lactate dehydrogenase, cardiac derived isozyme, glutamic oxaloacetic and glutamic-pyruvic transaminase activities in animals receiving toxin were observed. These levels were statistically significant compared to the vehicle control. A significant increase in liver lactate dehydrogenase of toxin treated rabbits was also observed. Light-microscopic examination of lung and liver showed a significant degree of damage. The increase in plasma enzyme levels is indicative of damage to these organs. PMID- 2781590 TI - Acute nephrotoxicity induced by N-(3,5-dichlorophenyl)-3-hydroxysuccinamic acid in Fischer 344 rats. AB - N-(3,5-Dichlorophenyl)succinimide (NDPS) induces nephrotoxicity via one or more metabolites which arise from oxidation of the succinimide ring. The purpose of this study was to examine the nephrotoxic potential of N-(3,5-dichlorophenyl)-3 hydroxysuccinamic acid (3-NDHSA), a potential metabolite of NDPS and a positional isomer of N-(3,5-dichlorophenyl)-2-hydroxysuccinamic acid (2-NDHSA), a known nephrotoxic metabolite of NDPS. Male Fischer 344 rats were administered a single intraperitoneal injection of 3-NDHSA (0.2 or 0.4 mmol/kg) or sesame oil (2.5 mmol/kg), and renal function was monitored at 24 and 48 h. Both doses of 3-NDHSA induced diuresis, increased proteinuria, glucosuria and hematuria, elevated blood urea nitrogen (BUN) concentrations and kidney weights, decreased organic ion accumulation by renal cortical slices, and induced proximal tubular necrosis. The characteristics of 3-NDHSA-induced nephrotoxicity were identical to NDPS-induced nephropathy, but were evident at lower doses with 3-NDHSA. These results demonstrate that 3-NDHSA is a nephrotoxicant which might contribute to NDPS induced nephropathy. PMID- 2781592 TI - Toxicological effects of monocrotophos on microorganisms in the rumen of Bubalus bubalis. AB - Repeated oral administration of monocrotophos in doses of 0.5 and 2.0 mg.kg-1.d-1 produced a significant reduction in the total number of protozoa (31-40%) in the rumen of buffalo calves. However, the insecticide has no appreciable effect on the total bacterial count. Rumen pH declined significantly with both doses of insecticide. In the differential protozoal count, different doses of monocrotophos caused an increase in the percentage of Dasytrichia, Epidinium and other protozoa; however, the percentage of Isotrichia and Diplodinium significantly decreased. PMID- 2781593 TI - The ability of the murine erythron to respond to hemolytic doses of phenylhydrazine is significantly impaired by exposures to 10 ppm benzene. AB - Male C57Bl mice were given 50 exposures (6 h/d x 5 d/wk x 10 wk) to 10 ppm benzene. At regular intervals during the course of the exposures, the numbers of erythroid colony-forming cells (CFU-E) and the numbers of granulocytic colony forming cells (GM-CFU-C) were assayed. At the end of the benzene exposures, additional groups of mice were given 4 daily injections of phenylhydrazine (PHZ) to induce anemia. During the course of the exposures, the numbers of colony forming cells from benzene-exposed mice were, with infrequent exceptions, statistically indistinguishable from the numbers of these cells in air-exposed mice. However, in response to the PHZ-induced anemia, the numbers of late erythroid (CFU-E) and granulocytic (GM-CFU-C) progenitor cells were about 30% lower among benzene-exposed mice than among air-exposed mice. These results suggest that concentrations of benzene that induce little or no observable hematopoietic changes may, in fact, greatly alter the hematopoietic capacity of an exposed individual. PMID- 2781594 TI - Role of GSSG-reductase and a thiol oxidant diethylmaleate (DEM) in skin tumorigenesis induced by jute batching oil. AB - Single topical application of jute batching oil (JBO-P) elevated the status of enzyme GSSG-reductase in mouse skin and multiple applications produced a persistent increase in the enzyme levels. Also an increase in NADPH-dependent GSSG-reductase activity was registered after single topical application of known carcinogenic polyaromatic hydrocarbons (PAHs), e.g. benzo(a)pyrene (BaP), 7,12 dimethyl-benzanthracene (DMBA) and 3-methylcholanthrene (3-MC). This suggests that the change in GSSG-reductase activity induced by JBO-P is intrinsic to its tumorigenic activity rather than the toxic effect of the oil. Pretreatment of mouse skin with diethylmaleate (DEM), an SH-inactivating agent, increases the latent period of JBO-P induced tumorigenesis. No tumour was recorded in animals belonging to Group IV (DEM + JBO) while in animals belonging to Group II (JBO-P alone) 100% tumorigenesis was recorded during the period of study (i.e. up to 20 wk). PMID- 2781595 TI - V79 Chinese hamster cells express cytochrome P-450 activity after simultaneous exposure to polycyclic aromatic hydrocarbons and aminophylline. AB - V79 Chinese hamster lung cells expressed low but significant aryl hydrocarbon hydroxylase activities when treated with an inducer of cytochrome P-450I, such as benz[alpha]anthracene or 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD), together with aminophylline. Inducibility by polycyclic aromatic hydrocarbons and inhibition by a specific monoclonal antibody indicated that the observed enzyme activity was mediated by cytochrome P-450I. Intact V79 cells pretreated with TCDD and aminophylline for 24 h metabolized benzo[alpha]pyrene to phenolic products which accumulated linearly in the growth medium for at least the same time period. Exposure of V79 cells to 10 microM benzo[alpha]pyrene and aminophylline for 72 h reduced subsequent cell growth by about 40%. The results demonstrate that V79 cells, under specific conditions, express PAH-inducible cytochrome P 450I and are capable of activating benzo[alpha]pyrene to cytotoxic products. PMID- 2781596 TI - Effect of nickel(II)acetate on distribution of calmodulin in the rat kidney. AB - The effect of subcutaneous injection of a single dose of nickel(II)acetate (95 mumol/kg body wt.) on the distribution of calmodulin in the membrane and cytosolic fractions of kidneys of F344/NCr rats was studied with the use of radioimmunoassay. Over the first 8 h post-injection, the membrane-bound calmodulin concentration increased by 20% versus the control value of 3.84 +/- 0.54 SE micrograms/g wet tissue. That increase was then followed by a gradual decrease to the control value in 7 d. At the same time intervals, the cytosolic calmodulin concentration first decreased by 13% from the control value of 8.81 +/ 2.1 SE micrograms/g wet tissue and then slowly increased, reaching a level of 12% above the control at day 7 post-injection. Statistical analysis of the results after 8 h revealed a downward trend in the membrane-bound (P less than 0.0014) and upward trend in the cytosolic (P less than 0.0207) calmodulin concentrations until day 7. However, the total renal calmodulin calculated from the membrane/cytosolic distribution data did not show any statistically significant treatment-related differences among the mean values (13.39 micrograms/g for the nickel(II)acetate-treated rats vs. 12.56 micrograms/g wet tissue for the controls between days 1 and 7). Therefore, the observed effect of nickel(II)acetate must be attributed only to temporary transfer of calmodulin from the soluble cytosolic form into an insoluble, membrane-bound form, without any detectable influence on its degradation or synthesis rate. PMID- 2781597 TI - Dose- and time-response of colon carcinogenesis in Fischer-344 rats after a single dose of 1,2-dimethylhydrazine. AB - The purpose of this experiment was to examine the development of colon tumors after the injection of a single dose of 1,2-dimethylhydrazine (DMH) in rats. Male Fischer-344 rats were injected with 0, 10, 30, 100 or 200 mg/kg of DMH dihydrochloride. No tumors were seen after 3 or 5 months at any dose, but were seen after 7 or 9 months. At 9 months, tumors were induced in a dose-dependent manner, with 64.7% of rats receiving the 200 mg/kg dose developing tumors. This study shows that a high incidence of colon tumors can be induced by a single dose of DMH after a 9-month latency period. PMID- 2781598 TI - Species differences in estrogen receptors and in the response to 2,3,7,8 tetrachlorodibenzo-p-dioxin exposure. AB - The acute toxicity of 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) exhibits marked interspecies variability, with the guinea-pig, rat and hamster representing the species most sensitive, intermediate and most resistant to acute toxicity. Prepubertal guinea-pigs, rats and hamsters were treated with a single intraperitoneal injection of TCDD in olive oil at doses of 4, 50 and 1500 micrograms/kg, respectively. These exposures were chosen to produce acute toxicity and all 3 species exhibited a decrease in the rate of body weight gain during the 7 days following TCDD exposure when compared with control (olive oil treated) animals. On the 7th day after exposure, the density and affinity of 17 beta-estradiol receptors were determined in the uterus and liver of TCDD-treated and control animals. The treatment with TCDD did not alter the affinity of the receptors in these 3 species. The density of hepatic 17 beta-estradiol receptors was decreased 65% in the guinea pig and 92% in the rat following exposure to TCDD. In contrast, TCDD-treated hamsters exhibited no change in the density of hepatic 17 beta-estradiol receptors. The uterine 17 beta-estradiol receptors were increased in density by TCDD treatment in the hamster and in the rat when expressed per mg protein. Uterine wet weights in the guinea-pig and rat were also significantly decreased by TCDD treatment but were not changed in the hamster. When the Bmax for uterine 17 beta-estradiol receptors was expressed as pmol/g tissue wet weight. TCDD exposure was found to produce an 11% decrease in density in the rat, while producing a 44% increase in the hamster. In control animals, the density of uterine 17 beta-estradiol receptors correlated inversely with the lethal dose of TCDD in these 3 species (i.e., the guinea-pig has the lowest LD50 and highest density of uterine 17 beta-estradiol receptors). The different responses to TCDD in the 3 species suggest that the changes in 17 beta-estradiol receptors may be related to species-specific toxic responses associated with TCDD exposure. PMID- 2781599 TI - Acute toxicity and urinary excretion of diphenyldiselenide. AB - The acute toxicity of diphenyldiselenide (DPDS) in the male Swiss mouse was found to be enhanced by pretreatment with phenobarbital of SKF-525A. DPDS decreased hepatic glutathione content by 50% at 1 h after administration. Following administration of 14C-DPDS, labelled metabolites were found in urine but not in bile or feces. Analysis of the urinary metabolites of 14C-DPDS showed that selenium-containing metabolites elute from a DEAE-Sephadex column in two fractions: the first has not been chemically characterized, while the second peak contained the glucuronide conjugates of C6H4(OH)SeH and C6H5SeH. Virtually all of the administered selenium is excreted within 5 days, while only about 36% of the 14C is excreted in the same time period. This discrepancy indicates metabolic scission of the carbon-selenium bond. PMID- 2781601 TI - Co-carcinogenic effect of carbon black ingestion with dietary fat on the development of colon tumor in rats. PMID- 2781600 TI - Effect of pesticides on the growth of aquatic hyphomycetes. AB - The effect of two herbicides (paraquat and 2,4-dichlorophenoxybutyric acid) and two fungicides (mancozeb and captafol) was studied on the growth of Flagellospora penicillioides, Lunulospora curvula and Phalangispora constricta using the poisoned-food technique. The pesticides did not produce any inhibition of growth at concentrations up to 5 mg/l. The required concentration to bring about total inhibition of growth varied among the chemicals and the cultures. The herbicides produced a slight enhancement of culture growth at concentrations ranging from 1 to 25 mg/l. PMID- 2781602 TI - Caveat emptor: how to evaluate products. AB - 1. The first two questions to consider when evaluating a product are: will it provide better patient care, and will it save time? 2. The cost effectiveness of the product is also an important consideration in addition to how well it will protect healthcare personnel. 3. Carefully examine the data supplied to support the product's efficacy, particularly the methods of studies. 4. Above all, common sense and experience are the best guides to product evaluation. PMID- 2781603 TI - OR nursing in the 1990s. A look at the forces shaping our future. PMID- 2781604 TI - Cellular mechanisms of rejection and regeneration in peripheral nerve allografts. AB - A model of rejection and regeneration of peripheral nerve allografts in rats is presented. A 2.5-cm segment of 28 right sciatic nerves was transplanted orthotopically from LEW.1W to DA and from DA to LEW.1W. With a microsurgical technique, proximal and distal coaptations were performed. In an autologous control group the same surgical procedure was applied. Evaluation included clinical estimation of motor recovery and macroscopic appearance of the graft, electrophysiological examination, conventional histology, and immunohistology. The latter concentrated on demonstration of monomorphic and polymorphic determinants of MHC class I and II antigens and of macrophages. By functional, electrophysiological, and histological parameters it was demonstrated that after rejection a certain degree of regeneration took place in the allografts. Both rejection and subsequent regeneration were studied in detail by immunohistology. During the course of Wallerian degeneration MHC class I expression on myelin sheaths could be demonstrated. When the rejection response occurred, additional MHC class II expression on myelin sheaths and on vascular endothelial was observed. Recipient specific class I-positive macrophages were infiltrating the graft from the epineurium and the coaptation sites, and were later present at the sites of myelin degradation. At 6 weeks postoperatively donor-specific MHC products were no longer detectable, but recipient-specific Schwann cells were present in the allograft tissue. We conclude that a rejection response renders a peripheral nerve allograft acellular but does not destroy the nerve architecture, still enabling it to function as an axon conduit. The regeneration in the rejected allograft however lacks the positive neurotropic and -trophic influence physiologically provided by viable Schwann cells. PMID- 2781606 TI - An inexpensive and versatile computer-controlled PCR machine using a Peltier Element as a thermoelectric heat pump. PMID- 2781607 TI - The control of chronic infectious patients with pulmonary tuberculosis in a rural area of China. AB - The aim of this study was to reduce the prevalence of chronic infectious cases (CIC) in a rural area of China by fully supervised chemotherapy of newly diagnosed smear-positive cases and by reducing the number of existing old CIC through fully supervised retreatment. From 1980 to 1985, 83.3% of 1828 new, smear positive cases were given fully supervised chemotherapy. In 1980, 95.2% of 565 old CIC started fully supervised retreatment. The prevalence of CIC had dropped from 40.5/100,000 in 1980 to 6.7/100,000 by the end of 1986. PMID- 2781605 TI - Relevance of additive components of University of Wisconsin cold-storage solution. An experimental study in the rat. AB - The purpose of this study was to evaluate the value of additive components and colloid included in the University of Wisconsin (UW) solution. Therefore, this solution was compared with a solution consisting of the basic components of the UW solution (potassium lactobionate, raffinose, phosphate buffer and MgSO4). We employed a method of measuring the amount of chromium-51-labeled erythrocyte trapped in the medullary vasculature 20 min after reperfusion of kidney grafts cold-stored for 24-48 h in either the basic UW (bUW) or the original UW (oUW) solution. The amount of trapping has been shown to correlate well with the degree of cold ischemic injury. Both hemodiluted (hct 20-27%) and normal (hct 41-45%) recipients were used. Long-term viability of grafts stored in either bUW or oUW was investigated in survival experiments and the flow rates during in situ flush out were also measured, as well as weight changes during the storage period. The results showed no significant difference between the two solutions, regardless of ischemia time or whether hemodiluted or normal recipients were used. However, the flow rate and weight measurements showed that flushing was more rapid and kidney swelling less pronounced using oUW. Survival rates in long-term transplantation experiments were similar. It was concluded that the inclusion of a colloid improves the rheological properties of the UW solution and that the additives besides the basic components did not offer any advantage. PMID- 2781608 TI - Skin test responsiveness to a series of new tuberculins of children living in three Vietnamese cities. AB - A skin test survey was conducted among 1035 children aged 7-19 years living in three cities in Vietnam. Fifteen new tuberculins, including leprosin-A, were applied; an induration of 2 mm diameter or more was considered positive. Compared to some other tropical countries, low levels of sensitisation were recorded and remarkable regional differences were found. Positivity to any tuberculins (pooled data) among non-BCG-vaccinated children was significantly lower in Hanoi (13.1%) and HoChiMinh-City [HCMC] (15.5%) than in Nha Trang (25.7%) [p = 0.001 and p = 0.012, respectively]. The proportion of non-vaccinated children responding to Tuberculin ranged from 18.4% in Hanoi to 54.5% in Nha Trang. Leprosin-A elicited a response in 14.9% of the children in Nha Trang, but in very few of those in Hanoi (4.3%) or HCMC (3.0%). Thus, of the three cities studied, significant sensitisation to both M. tuberculosis and M. leprae was demonstrable only in Nha Trang. In Hanoi most of the response was to fast-growing species whilst in HCMC and Nha Trang it was mainly to slow-growing species. These results may account in part for the observed differences in the prevalence of tuberculosis and leprosy between the north and the south of Vietnam. PMID- 2781609 TI - Tuberculosis in Kenya 1984: a third national survey and a comparison with earlier surveys in 1964 and 1974. A Kenyan/British Medical Research Council Co-operative Investigation. AB - A survey of all patients newly registered in a 6 month period was carried out in 1984 in the same random sample of 11 of the 30 districts in Kenya that were surveyed in 1964 and 1974. Of the 1961 patients included, 85.4% had pulmonary tuberculosis, 12.1% had extra-pulmonary tuberculosis and 2.5% had both. About half (52%) of the 286 patients with extra-pulmonary disease had lymph node involvement, 22% bone and joint disease and 7% meningitis. A sputum specimen was collected from 1159 (67%) of the 1724 patients with pulmonary tuberculosis. Of the patients with no history of previous chemotherapy, 66% of 997 with a smear result and 76% of 981 with a culture were positive; 7.1% of the 748 strains tested were resistant to isoniazid, 0.5% to streptomycin and 1.3% to both drugs (none of these strains was resistant to rifampicin). A comparison of the data with those from 1964 and 1974 suggested that the characteristics of the registered patients and of their disease were, on the whole, similar. Between 1964 and 1974 there had been a modest decline in the estimated annual registration rate of pulmonary tuberculosis; the decline was greatest in children and there was a marked increase in the older age groups. Between 1974 and 1984 there was a further small decline in the overall rate but an increase in the youngest age groups (0-9 years) and in the oldest age group (60 years or more). PMID- 2781610 TI - Severe 'flu'-like symptoms due to isoniazid--a report of three cases. AB - We present three cases of severe 'flu'-like symptoms in Chinese patients given isoniazid alone. The time course and clinical presentation of these drug reactions were very similar to those observed in the widely recognised 'flu' syndrome due to rifampicin. PMID- 2781611 TI - Internuclear ophthalmoplegia in tuberculous meningitis. AB - Two patients with tuberculous meningitis and internuclear ophthalmoplegia are described. Despite treatment with anti-tuberculosis chemotherapy and corticosteroids, both patients died. In one case autopsy showed severe basal meningitis with diffuse brain stem infarction secondary to widespread vasculitis. PMID- 2781612 TI - An unusual manifestation of tuberculous hypersensitivity. AB - This report describes a 6-year-old boy with symmetrical, painful soft tissue swelling of all the fingers and toes, without apparent joint involvement. The Mantoux test was strongly positive. A dramatic response was observed with anti tuberculosis chemotherapy. PMID- 2781613 TI - Addisonian crisis induced by treatment with rifampicin. AB - A patient with spinal tuberculosis and subclinical adrenal tuberculosis who developed acute Addisonian crisis on starting anti-tuberculosis therapy including rifampicin is reported. The possibility that many patients with tuberculosis have adrenal involvement with limited hormonal reserve and that they may develop incipient adrenal failure on commencing treatment is discussed. PMID- 2781614 TI - [New forms of cooperation between primary and secondary health care services]. PMID- 2781615 TI - [Macro creatine kinase. A cause of diagnostic problems in acute myocardial infarction]. AB - Macro-creatine-kinase type 1 consists of complexes of CKBB isoenzyme and an immunoglobulin, most frequently IgG, while type 2 is probably aggregates of mitochondrial CK. The prevalences of type 1 and 2 have been found to be 0.9%-1.6% and 0.5%-2.9%, respectively, depending on the patient population investigated and the methods of analyses used. Problably a maximum of 1% of patients with suspected AMI, has macro-CK in concentrations causing diagnostic difficulties. In such patients, increased absolute and relative activities of CKB residual as measured by the immuno-inhibition method are found. In specific immunological methods for measuring CKMB concentrations in serum, macro-CK is not measured. However, it has been published, that these methods may underestimate the CKMB concentration in patients with free antibodies to CKB in the blood. In this department, we have evaluated a new analysis for measuring CKMB, without finding any evidence of such interference. PMID- 2781616 TI - [The attitude of Danish health staff to HIV. Knowledge, attitudes and reactions to HIV of doctors, nurses and nurses' aides]. PMID- 2781617 TI - [Social psychiatric therapeutic possibilities for long-term psychiatric patients]. AB - The Vesterbro project in a small community psychiatric unit in Vesterbro in Copenhagen where the therapeutic offers are directed towards long-term and chronic psychiatric patients in the district. The article mentions the social psychiatric basis of the Vesterbro project and the results of follow-up examinations of the patients for the period 1979-1984 are presented. This investigation is arranged as a retrospective investigation and is carried out with interviews with a total of 60 patients. The conditions of mental health and of the individual patients their social circumstances at the time of interview in 1984 are compared with corresponding parameters at the time the patient was referred to the Vesterbro project. The results of the investigation confirm, not unexpectedly, that the patients in this project, who belong to the most severely affected clientele of institutional psychiatry, live mostly alone (86%) with poor contact with their surroundings. They are distributed corresponding to the general population as regards education, housing, material and economy and it is calculated that they will be admitted to psychiatric hospitals for an average of five weeks per annum. The Vesterbro project attempts to improve the patients' general conditions of life and strengthen their contact with their surroundings and their social network. It is apparent from the results of the investigation that the majority had improved material conditions following contact with the Vesterbro project but that no direct effect is registered concerning the work on the social network made by the project. The total contribution has, however, reduced the number of bed-days employed.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2781618 TI - [A case of intermittent hypermethioninemia as the cause of disagreeable body odour]. AB - A physically and mentally healthy man aged 22 years was referred for biochemical investigation in a department for clinical biochemistry on account of disagreeable body odour. Ion-exchange chromatographic amino acid analysis revealed intermittent hypermethioninaemia. Dietary treatment with a methionine poor diet solved the problem both subjectively and objectively. Amino-acidopathy should be borne in mind in cases of individuals with abnormal body odours. PMID- 2781619 TI - [Injuries due to lap seat belts]. AB - A case of lap seat belt injury with damage to the small intestine is presented. The lap seat belt induces a sense of false security. This type of seat belt should be forbidden and should be replaced by the better three-point-restraint. Patients with seat belt lesions should be admitted to hospital. PMID- 2781620 TI - [Tuberculous appendicitis]. AB - A case of probable tuberculous appendicitis and associated pulmonary tuberculosis is reported. The latest literature concerning abdominal tuberculosis is reviewed. PMID- 2781622 TI - [Children and dietary supplementation]. PMID- 2781621 TI - [Ulcer surgery at the cross-road?]. PMID- 2781623 TI - [Human recombinant erythropoietin]. PMID- 2781624 TI - [Drug information on ofloxacin]. PMID- 2781625 TI - [Prevention seen from underneath]. PMID- 2781626 TI - [Acetylsalicylic acid in acute ischemic coronary and cerebral diseases]. PMID- 2781627 TI - [Choice of treatment in very premature deliveries. A nation-wide questionnaire study]. AB - The principles for treatment of very premature deliveries in obstetric, surgical and paediatric departments were investigated by means of a questionnaire. This contained fictitious case histories about transfer in cases of threatened delivery, caesarean section in cases of interuterine asphyxia, resuscitation after delivery, transfer to a paediatric department and employment of respirators in cases of increasing respiratory difficulty following deliveries after 24, 26 and 28 full weeks of pregnancy. Replies were obtained from 26 out of 29 maternity departments, 28 out of 33 surgical departments with more than 100 deliveries in 1985, and 18 out of 18 paediatric departments. In all of the situations, considerable restraint was expressed as regard the most premature deliveries. For example, only two obstetric departments, two surgical and four paediatric departments stated that they would, as a rule, attempt resuscitation after deliveries at gestational ages of 24 weeks. For deliveries at 26 weeks, the figures were 18, 12 and 12, respectively. A certain tendency was observed for less restraint in 1985 as compared with 1979. Tendencies to centralize the very premature deliveries were greater in East Denmark than in West Denmark where respirator treatment was more frequently employed for the smallest infants. PMID- 2781628 TI - [Fetal systolic time intervals. A non-invasive parameter for assessing the intrauterine condition of the fetus]. AB - Various methods are employed in obstetric prophylaxis and treatment to assess the intrauterine condition of the foetus. The systolic time-intervals appear to be a promising new method because they reflect the contractility of the foetal heart which is a reflection of various physiological factors indluding hypoxia and asphyxia. Monitoring of the foetal systolic time intervals is therefore a more sensitive parameter of cardiac function than the foetal heart rate alone. By measurement of the foetal systolic time-intervals, it is therefore theoretically possible to evaluate the intrauterine situation of the foetus as abbreviated pre exjection time (PEP) is a normal physiological reaction to scalp compressions, uterine contractions, or umbilical cord complications. Finally, the relationship between PEP and the ejection time (PEP/VET) is raised in asphyxia and greatly raised in imminent foetal death. PMID- 2781629 TI - [Pain in acute myocardial infarction]. AB - Pain is the most constant symptom in acute myocardial infarction (AMI) but there are considerable variations. It is possible that pain may indirectly cause extension of the infarct. The authors have, therefore, undertaken a retrospective investigation of 87 unselected patients admitted consecutively with the first episode of AMI. In these patients, the presence of any clinical and paraclinical parameters which could predict the employment of analgesics and the duration of pain while hospitalized were investigated. A significant connection was found between the presence of pulmonary stasis on administration to hospital and the total employment of analgesics during hospitalization. Patients with pulmonary stasis have frequently extensive infarcts and a significant connection was found between the enzyme-estimated extent of the infarct and the employment of analgesics and duration of pain. In contrast to previous investigations which were carried out on selected patient materials with exclusion of large infarcts, no significant connection was found between heart rate, systolic blood-pressure, electrocardiographic signs of AMI on admission and total amount of analgesics employed and the duration of pain. PMID- 2781630 TI - [Hepatitis B--an endemic sexually transmitted infection in a local community in Greenland]. AB - Sera from 1,893 persons from the Sisimiut medical district in West Greenland were examined for Hepatitis B virus (HBV) markers and 11.5% were found to be HBsAg positive. HBeAg and HBV-DNA were found in 6.9% and 5%, respectively of the HBsAg positive persons. In the population examined, 75% of those aged 25 years had signs of current or previous HBV-infection and an increase in the marker prevalence from 35 to 75% was observed in the age interval 15-25 years. Corresponding to this, the highest incidence of clinically manifest hepatitis was found in this age group: 185 cases per 100,000 per annum. Serological evidence of Hepatitis D virus was found in 10.6% of the HBsAg-positive individuals, electively in young adults. All sera were negative for HIV antibody. In contrast to other arctic populations where perinatal transmission is the most significant mode of infection, sexual transmission appears to be the most important mode of infection in the population investigated here. Prophylaxis of Hepatitis B and further spread of Hepatitis D virus in the HBsAg-positive fraction of the population may be obtained by increased use of condoms and reduction of the number of casual sexual contacts. Secondary prophylaxis in the form of vaccination of neonates born to HBsAg-positive mothers combined with vaccination of school children before puberty will probably be effective in this population. PMID- 2781632 TI - [Subtalar luxation]. AB - Fourteen cases of subtalar dislocation were reviewed after an average period of observation of 13 years (5-27 years). Ten dislocations were medial and four were lateral. Two dislocations were open and, in seven of the cases, dislocation fractures were present. No cases of avascular necrosis of the talus were found. Three patients developed severe arthrosis and arthrodesis was performed in two of these. In cases of subtalar dislocation without fractures or dislocation fractures which did not involve the joints surrounding the talus, the prognoses were good. In cases of open dislocations or dislocations with intra-articular fractures, the prognoses were less favorable. PMID- 2781631 TI - [Prevalence of positive gonococcal and chlamydial findings in women applying for termination of pregnancy. A screening evaluation]. AB - All 335 pregnant women referred for termination of pregnancy in the first trimester were examined preoperatively for infection with Neisseria gonorrhoeae (NG) and Chlamydia trachomatis (CT) and were questioned about symptoms of gynaecological infection. Only 0.6% had positive cultures for gonorrhoeae while CT infection was demonstrated in 7.8%. Half of the women with infection had one of the following symptoms: discharge, pain or dysuria. These same symptoms were, however, also found in half of the women without infection. All gynaecological special departments in Denmark and a few of the surgical departments which carry out termination of pregnancy replied to a questionnaire about routine examinations for NG and CT in cases of termination of pregnancy. Only 29.2% of the departments made routine preoperative examinations for CT, NG or both. It is concluded that there are no indications for routine examination for gonococcal infection whereas screening for CT infection appears to be indicated. PMID- 2781633 TI - [The reliability of the Danish translation of the Gottfires-Brane-Steen scale]. AB - The Gottfries-Brane-Steen scale (GBS) is assessed for use in evaluating functional deficiencies in demented persons. The scale is translated into different languages, and reliability studies have been published from Sweden and Norway. This investigation is a reliability study of the Danish version. Fourty nine patients were rated by several independent raters from the staff at the same time. Preceding this, all raters had been video-trained in the use of the scale. The results show that the scale has sufficient and satisfactory inter-rater reliability. It is concluded that the Danish version of the GBS-scale is also a useful tool for evaluating dementia processes and therapeutic measures. PMID- 2781634 TI - [Use of helium spirometric pulmonary function tests by general practitioners at a hospital outpatient department]. AB - The case records of 94 helium spirometric pulmonary function investigations on patients referred by their general practitioners to the clinical-physiological department, Svendborg Hospital during 1985 and 1986 are reviewed. In 35% of the cases, the diagnosis on referral was "dyspnoea of unknown origen". Half of the results of the investigation were abnormal and it is concluded that this investigation is suitable for differentiating the patients who have reduced ventilatory capacity as the reason for the dyspnoea. 11% of the material consists of patients with bronchial asthma. According to the literature, these patients could be monitored advantageously instead with current peak-flow measurements. 18% of the investigations were carried out on patients with chronic bronchitis. The authors consider that a single spirometric measurement should be replaced by current monitoring of the forced expiration in litres and the forced vital capacity. Investigations undertaken as part of assessment for pensioning constotuted 18%. It was apparent from a questionnaire investigation that the general practitioners obtained considerable information from the result of the investigation. This information was independent of the result of the investigation. The profits were greatest when the investigation resulted in alteration of medication than when this was not the case. PMID- 2781635 TI - [Applicants for disability pensions in the municipality of Tarnby before and after the pension reform of 1984. Social characteristics and abuse of alcohol and drugs]. AB - One hundred and eighty-eight and 167 first applications for disability pensions in 1981 and 1985 respectively were examined. Social parameters, diagnoses and the occurrence of alcohol and drug abuse were studied. There was a decrease in the number of male applicants and a small increase of female applicants from 1981 til 1985. Unskilled workers were overrepresented. Most applicants had been working within the last two years before the pension was awarded, and generally they had had long job periods. In 1985, had only 27% of the applicants under 50 attempted rehabilitation, and 12% had received social security allowances. The new types of social pensions were mostly awareded to married women of more than 50 years of age. Pensioning caused by a combination of social and health circumstances was rare. Female applicants were generally awarded lower pensions than male applicants. More than half of the diagnoses included mental diseases, diseases of the musculo-skeletal system and disease of the circulation. In 1985, 15% of the applicants were abusers, mainly of alcohol. 50% of male applicants younger than 50 years of age were abusers. The abusers were very disabled. PMID- 2781636 TI - [Anticoagulants in treating patients with atrial fibrillation]. PMID- 2781638 TI - [The concept of quality of life in clinical work and research--seen from a critical point of view]. PMID- 2781637 TI - [Incest and sexual abuse]. PMID- 2781639 TI - [Physical, psychological and social conditions of patients with cancer as parameters in clinical examinations]. AB - Measurement of the quality of life should be employed as a parameter of equal value to the response rate, duration of response and survival in clinically controlled investigations in cancer patients. The quality of life must be considered to be composed of a series of various key factors including functional status, physical symptoms, psychological problems, social interaction and the economical situation. Questionnaires which are completed by the patient are the best solution in clinically controlled investigations. These should be made specially for cancer patients and the questions should be made specially for cancer patients and the questions should have a limited number of well defined possible answers. Measurement of the quality of life is a technology under development and should, therefore, be assessed as regards validity and reliability. Investigations of the quality of life in cancer patients should be undertaken as longitudinal investigations among patients with the same diagnoses. Examples of measuring of the quality of life are Karnofsky & Burchenal's performance status which assesses the level of functional status, the Sickness Impact Profile which is a superior assessment of the general health and the "EORTC core questionnaire" which is an assessment of key factors of the quality of life adjusted specially for cancer patients. PMID- 2781640 TI - [Pregnancy and disseminated sclerosis. A retrospective study]. AB - A retrospective investigation was undertaken on 64 female patients with disseminated sclerosis (DS) on the Island of Funen. The object was to investigate whether pregnancy and delivery influenced the course of the disease. The results were standardized for the age of commencement and the duration of the disease. In addition, the available literature on the subject is reviewed. It was found that the group of women in whom the disease commenced before or in connection with pregnancy or delivery had more severe physical handicaps than women without children or in whom the disease commenced after the last delivery. Women in whom the disease commenced in connection with the last delivery were most severely handicapped. In women in whom the disease commenced more than six months after the last delivery, the long term prognosis is not poorer than for women without children. PMID- 2781641 TI - [The value of 1-year follow-up after total cemented hip alloplasty. Clinical and economic consequences of a routine check-up]. AB - The need for, expenses of and consequences of one year follow-up after total cemented hip replacements with posterior access are reviewed. A total of 150 patients were registered prospectively and consecutively with Charnley scores preoperatively, three months and one year after operation. The Charnley scores increased significantly from the preoperative values till the follow-up at three months and from the follow-up at three months till follow-up at one year (p less than 0.001). In five patients, (3%) follow-up examination after one year was of significance. Anisomelia was corrected in all three by means of adjustment of footwear. The cost of follow-up examination after one year is estimated to be 630 Danish crowns (approximately 53 pounds) per patient. It is concluded that follow up examination after total cemented hip replacement is not necessary. Alteration of follow-up examination after one year to follow-up examination after five years for patients who were under 60 years at the time of operation in order to reveal aseptic loosening would imply that only 10% of the patients in this material should be followed-up. PMID- 2781642 TI - [Liposuction in cosmetic surgery]. AB - Liposuction, removal of subcutaneous fat by a suction cannula introduced through small incisions was performed in 382 patients, in all 621 procedures. An even subcutaneous layer of fat was found in 72% of the 221 patients, who came to the planned follow up control visit. In 12.3% of the cases, repeated liposuction was necessary. No infections or haematomas occurred. In two cases a seroma was aspirated postoperatively. In an anonymous questionnaire, 2/3 of the patients expressed satisfaction with the result. Lack of satisfaction was due to uneven skin or removal of too little fat. There was no correlation between satisfaction and patient age, time since operation, localisation of operation, sex or volume of fat removed. PMID- 2781643 TI - [The leopard syndrome]. AB - A man aged 32 years was referred to a dermatological department for alopecia areata. In addition, the patient had multiple lentigines which, together with other abnormalities, suggested the leopard syndrome. Alopecia areata does not appear to have been described previously in this syndrome. PMID- 2781644 TI - [Pyogenic spinal osteomyelitis with right-sided retroperitoneal abscess]. AB - A case of osteomyelitis in the lumbar spine in a 66 year old man is reported. On account of high fever and low back pain a focus of infection was searched for in the urinary tracts, in the abdominal cavity and in the hip joint. Not until an abscess in front of the right hip was detected X-ray of the spine was performed and revealed the focus of infection in LII and LIII. After treatment with plaster immobilisation and antibiotics, he recovered completely also as regards neurologic symptoms. However, the stay at hospital lasted six months and the patient was submitted to many investigations including operative procedures before the exact diagnosis and treatment could be carried out. PMID- 2781645 TI - [Rotatory atlanto-axial luxation in children]. AB - Two cases of atlanto-axial rotatory dislocation following ear and head surgery are presented. Reduction was followed by Halo bandage in one, and by wedge C1-2 arthrodesis and Halo bandage in the other. The importance of early recognition by diagnostic CT-scan is emphasized. PMID- 2781647 TI - [Breast surgery]. PMID- 2781646 TI - [Vermiform appendix used as a segment of the ureter]. AB - A man aged 67 with a single kidney was admitted on account of haematuria and raised serum creatinine. Investigation revealed a poorly differentiated invasive transitional cell tumour at the middle of the right ureter. After resection of the tumour, a space of 10 cm remained between the two ends of the ureter. During the operation, it had become apparent that the usual methods of reconstruction could not be employed and, therefore, the vermiform appendix was employed as an intermediate segment of the ureter. The appendicular graft functioned satisfactorily until recurrence of the cancer occurred and the patient died one year later. This method may be employed in selected cases where Boariflap, uretero-trans-ureterostomy or autotransplantation of the kidney cannot be employed. PMID- 2781648 TI - [Mastectomy incisions and biopsy technics in view of subsequent reconstructive surgery in breast cancer]. AB - Patients are referred to departments for plastic surgery increasingly frequently for breast reconstruction following mastectomy for cancer of the breast. Successful results depend greatly on the primary mastectomy carried out by surgeons without experience in reconstruction. It is particularly important that the incisions are suitably placed so that the final result can be satisfactory. Our material consists of 119 patients who had been submitted to unilateral mastectomy for cancer of the breast at least one year previously. One fifth of the patients had hypertrophic breasts. The unequal distribution of weight following unilateral mastectomy is followed by such considerable discomfort from the remaining breast that this alone makes a reduction plastic operation necessary. Simultaneously, reconstruction is carried out on the side of the mastectomy. As the method of reconstruction, introduction of silicone prosthesis were carried out in 110 patients. Nine patients were, in addition, submitted to more complicated plastic flap procedures. The postoperative course was uncomplicated in 112 patients (94%). Reoperation proved necessary on seven occasions; in four patients on account of haematoma formation and rupture of the wound in three patients. In four patients, the prosthesis had to be renewed on account of rupture during the subsequent years. Guidelines for placing the incisions at the primary mastectomy are suggested to facilitate successful reconstruction. Finally, a suitable biopsy technique is described. PMID- 2781649 TI - [Knowledge of AIDS and of transmission risks of HIV infection in a group of homosexual people. A questionnaire study]. AB - A questionnaire investigation among 430 homosexual persons all of whom were members of an organization for homosexuals was completed by 144 (33%). These replies showed that they knew about HIV infection, risk behaviour and "safe sex". Their knowledge about the signs of HIV infection and AIDS was, however, more limited. The replies were compared with an age-matched group of the male population. The results of the investigation provide reasons to suppose that the information campaigns have been of value but information to prevent spread of infection is still necessary. In addition, further information is necessary about the subjective signs of HIV-infection so that persons in whom these signs develop may be offered the best possible treatment as early as possible. PMID- 2781651 TI - [Computer-assisted anesthesia in children]. AB - Anaesthesia for children demands insight into the physiological and pharmacological differences between children and adults and knowledge of the differences in anaesthetic equipment and the principles of treatment. A computer programme which calculates diverse data in connection with anasthesia in children is demonstrated after which the advantages and disadvantages of employing aids of this type are briefly discussed. PMID- 2781650 TI - [A group of homosexuals change their sex habits after information about AIDS. A questionnaire survey]. AB - A questionnaire investigation to which 144 homosexual persons replied anonomously revealed alterations in the sexual habits after information about AIDS. Significant reduction in the annual number of partners and significantly fewer employ the more dangerous sexual practices which now occur particularly in more permanent partnerships are among the alterations started. An unchanged number still employ active anal and orogenital coitus. Employment of condoms has increased significantly, particularly in anal coitus and "casual" partners (from 3% to 82%). The majority accept the use of condoms and state that they employ more "safe sex" than prior to information about AIDS. 12% stated that they had sex with both sexes and the possibility of spread of infection from homosexual to heterosexual groups is present. The intensive informative work from the homosexuals own organisation and from public health authorities appear to have had some effect but further information and influencing are necessary if the spread of HIV infection is to be stopped. PMID- 2781652 TI - [Chronic subdural hematoma. A frequently suspected diagnosis]. AB - A retrospective investigation was undertaken in which the clinical picture in 43 patients in whom chronic subdural haematoma (CSH) was diagnosed during a period of 11 years in a large central hospital were compared with the clinical picture in 97 patients referred for neurological assessment on account of suspected CSH during a period of three years. Thirteen out of the 97 patients referred with suspected CSH had the disease. All of the patients with CSH had focal neurological symptoms or complained of headache. None presented only mental symptoms and/or impaired consciousness. On this basis, the diagnosis could have been repudiated in 30% of the patients referred who presented neither focal neurological symptoms nor complained of headache. Information about previous head injury was not found to be of any significant value for the diagnosis. Probably, no or only few cases of CHS are overlooked. PMID- 2781653 TI - [Accumulated microbiological data. Surveillance of infection/antibiotic policy]. AB - Database reviews of the findings in bacteriological specimens from a period of six years from patients in a department of haematology are employed as a model of how cumulative data about the microorganisms isolated may be employed for surveillance of accumulated infections and in the organization of the antibiotic policy of a department. During the period of observation, the standard treatment with antibiotics for febrile episodes in granulocytopenic patients was altered to piperacillin and netilimicin on the basis of the frequent occurrence of Gram negative rods including Pseudomonas aeruginosa in blood cultures. It is concluded that accumulated microbiological data is of value for a clinical department and that analysis of the data does not constitute an increased work-load provided that the microbiological reports are routinely registered in a database. PMID- 2781654 TI - [Bioimpedance analysis in determining body composition. Testing of a new simple apparatus]. AB - In the assessment of human body composition, only expensive and time consuming methods have hitherto been available. Recently, the new bioimpedance method has been introduced. It offers an easy, quick, inexpensive and noninvasive measurement with an accuracy comparable to that of the classical methods. A new inexpensive Danish apparatus was tested against the most used and validated equipment. Fifteen normal subjects underwent measurements with both apparatuses. The two methods gave identical results with a coefficient of correlation of 0.99 and a coefficient of variation of 5.6%. The apparatus can be recommended for clinical and scientific purposes. PMID- 2781655 TI - [The LUF syndrome. A possible cause of unexplained infertility]. AB - It is probable that one or several conditions may exist in which the oocyte is not released at the expected time of ovulation but where the follicle luteinizes around it. This cannot be demonstrated with the usual criteria for ovulation. A diphasic temperature curve, normal increase in progesterone and secretory development in the endometrium are observed. The reason for this phenomenon is not known but it may be induced experimentally by intake of prostaglandin synthesis-inhibitors. It is difficult to determine with certainty in the individual case whether the egg has been released. The presence of an ovulation opening, a stigma which may be seen on the follicle by laparoscopy, marked increase in the concentration of progesterone and 17-beta-oestradiol in the peritoneal fluid and ultrasound demonstration of a collapsed follicle are good indicies. Defective release of the egg cell probably occurs periodically in cycli in normal fertile women but the condition appears to be more frequent in infertile women with endometriosis, with changes after pelvic inflammation and with "unexplained" infertility. As definite criteria for the condition are not available, no convincing investigations of the frequency are available and no controlled investigations of therapeutic method exist. Gametic intrafallopian transfer and in vitro fertilization and embryo transfer have been proposed as therapeutic measures. PMID- 2781656 TI - [Ocular torticollis]. AB - On account of the therapeutic consequences, it is important to determine whether a case of torticollis is oculogenic. This may involve problems as shown by the case reported here. Bielschowsky's head-inclination test is an important method of diagnosing paresis of the superior oblique muscle. In cases of paresis of this muscle, good cosmetic results can frequently be obtained by operative intervention. PMID- 2781658 TI - [Prescription of benzodiazepines among practicing physicians]. PMID- 2781657 TI - [Low-dose laser treatment of pain of the locomotor apparatus]. PMID- 2781660 TI - [Insurance conditions of people with impaired health]. PMID- 2781659 TI - [Thorotrast]. PMID- 2781661 TI - [Colloids or crystalloids in the treatment of hypovolemic conditions]. PMID- 2781662 TI - [Complicated malaria]. AB - An increasing number of cases of malaria, imported to Denmark, are caused by Plasmodium falciparum and severe and complicated cases are more often seen. In the Department of Infectious Diseases, Rigshospitalet, 23 out of 32 cases, hospitalized from 1.1-30.6.1988, i.e. 72%, were caused by P. falciparum; of these, seven (30%) were complicated, according to the definition by WHO. The importance of prompt diagnosis and treatment with intravenous quinine is stressed, and more recent supporting therapies including blood exchange transfusion are reviewed. PMID- 2781663 TI - [Running injuries sustained in a marathon race. Registration of the occurrence and types of injuries in the 1986 Arhus Marathon]. AB - A questionnaire investigation was undertaken in connection with the Arhus Marathon Race in 1986, with the object of registering experience, previous running injuries, amount of training, running injuries, treatment and causes. A total of 831 replies were obtained (90%). Of these, there were 731 men and 100 women with an average age of 34.6 (11-77) years, duration og training 5.5 months, training distance 47.5 km/week and tempo 10.8 km/hour. Among these, 193 injuries were registered in 161 runners (19%). Eighty-nine had to stop sports for more than one week and 26 still had injuries which limited participation in sport after eight weeks. The injuries consisted of blisters (25%) and stress injuries (66%) particularly in the knee (37%) and leg (23%). Runners who sustained injuries were found to be significantly younger than non-injured runners, their training distance was less and training tempo lower. The causes of the injuries were mainly overexertion. The significance for the types of shoes for stress injuries was investigated and a tendency to increased risk of overexertion injuries was demonstrated on employing competition shoes and cheap jogging shoes. PMID- 2781664 TI - [Wound infection following heart surgery]. AB - Two hundred patients who had been submitted to cardiac surgery were subdivided at random into two groups with removal of the dressings on the first or fifth postoperative day. The risk of wound infection was demonstrated to be identical in the two groups. Early removal of the dressings is therefore recommended. PMID- 2781665 TI - [Psychosocial strain among patients at a psychiatric emergency unit]. AB - The frequency of psychosocial strain was systematically registered concerning 330 consecutive patients in the psychiatric emergency unit in Odense. Psychosocial strain was found in 211 patients (63.9%). In all, 551 stressful events were reported, which corresponds 2.5 per patient. Distribution of psychosocial strain by age, sex and civil status revealed no statistically significant correlation at the level of p less than 0.05, but there was a tendency towards greater strain among young persons, women and married/cohabiant patients. All those seeking education had psychosocial strain, while there were significantly fewer patients with psychosocial strain among early retirees and old age pensioners. The investigation showed that there were significantly fewer schizophrenic patients with psychosocial strain, and significantly more patients with strain were found among those with affective reactions and attempted suicides compared with the other patient categories. The most frequently occurring form of strain in all diagnosis groups was interpersonal conflict with a close person. In most cases the strain was not the result of an external catastrophe, and often the patient may himself have contributed in causing the psychosocial strain. This opens the possibility for socialpsychiatric intervention. PMID- 2781666 TI - [Long-term survival of patients with angina pectoris admitted with suspected myocardial infarction]. AB - The long-term survival in 240 patients with severe angina pectoris was assessed. All of these patients had been admitted on account of suspected acute myocardial infarction but this diagnosis could be excluded. The mean age was 64.5 years, range 37-87 years. The one, five and ten year survivals were 83.9, 58.5 and 37.2%, respectively. During the first year after discharge, the risk of dying was 16% and decreases to 9% during the subsequent nine years. By means of univariat analysis, previous AMI and duration of ischaemic heart disease were shown to be of prognostic importance. The variables during hospitalization which were found to provide prognostic information were those concerning congestive heart failure, ventricular ectopic activity and type of angina pectoris. After inclusion of age and previous manifestations of ischaemic heart disease, only variables describing congestive heart failure and ventricular ectopic activity were found to provide prognostic information, by stepwise multivariate analysis. PMID- 2781667 TI - [Dietary advice in hypercholesterolemia. Relation of selected dietary factors to total serum cholesterol and high density lipoprotein cholesterol]. AB - Forty patients (14 women and 26 men) with slight to moderate hypercholesterolaemia received dietary advice and were followed-up for 12 weeks, the majority for 26 weeks. After 12 weeks, the total cholesterol had decreased by an average of 12% (from 7.92 to 6.97 mmol/l), the high density lipoprotein (HDL) cholesterol had increased by 5.3% (from 1.14 to 1.20 mmol/l) and thus the ratio of total cholesterol/HDL cholesterol had decreased by 17% (from 7.42 to 6.15). In the 35 patients who were followed-up for 26 weeks, the total cholesterol/HDL cholesterol decreased further (to 22% below the original value). HDL cholesterol was found by univariate regression analysis to be correlated significantly with the dietary content of the patients of fats (negative), polyunsaturated fatty acids (positive), sugar (negative), fibre (positive) and the total value (positive). Employing multivariate analysis with stepwise reduction, fats and fish sandwich spreads were found to be significantly correlated. The ratio of total cholesterol/HDL cholesterol by means of univariate analysis was found to be inversely correlated with the same dietary factors as HDL cholesterol while multivariate analysis revealed the content of polyunsaturated fatty acids, sugar and alcohol intake to be significantly correlated. PMID- 2781668 TI - [Salpingo-enteric fistula demonstrated by hysterosalpingography (HSG)]. AB - A case of fistula between the right salpinx and appendix, most probably caused by untreated appendicitis, is presented. The patient was admitted to hospital because of involuntary infertility. PMID- 2781669 TI - [Tardive anaphylactic shock caused by intolerance to aspirin]. AB - A case of tardive anaphylactic shock resulting from intolerance of acetyl salicylic acid is presented. The precipitating mechanism of ASA-intolerance is complex and not yet fully elucidated but possibly involves anaphylate toxins activated by mast cells. The symptoms may occur immediately or after a prolonged latent period and are dependent on the dosage. Patients with asthma and chronic urticaria/angiooedema show increased prevalence of ASA-intolerance and these patients should be advised to be careful with ASA/NSAID preparations. PMID- 2781670 TI - [Colonoscopic appendectomy. Removal of a persisting iatrogenic invaginated appendix with colonoscopy]. AB - A case in which the appendix was invaginated with the object of incidental appendectomy but survived is described. Colonoscopic appendectomy was successfully performed. PMID- 2781671 TI - [Psychological diagnosis of mental disorders. Problems concerning the validity and reproducibility]. PMID- 2781672 TI - [Treatment of pinworms]. PMID- 2781673 TI - [Suicide in patients with disseminated sclerosis. 5 case reports]. PMID- 2781674 TI - [Flaws and deficiencies in debates about drug abuse]. PMID- 2781675 TI - [Development of Danish psychiatry]. PMID- 2781676 TI - [Community psychiatry in big cities in England. A study trip]. PMID- 2781677 TI - Temperature elevation in the rat fetus due to ultrasound exposure. AB - The temperature elevation resulting from sonically generated heat in rat fetuses was measured for various intensity levels. The temperature elevation produced inside the fetus was higher than that on the outside surface. In live fetuses, a portion of the heat generated was carried off by the circulating blood. The temperature elevation curves were used to estimate the absorption coefficient of rat fetuses. Absorption coefficient values range from 0.065 to 0.086 Np/cm at 1 MHz. The present results are consistent with a theoretical model of temperature elevation in a heated sphere. PMID- 2781678 TI - Histopathology of shock wave treated tumor cell suspensions and multicell tumor spheroids. AB - L1210 mouse leukemia cell suspensions exposed to 500 shock waves (SW) in an experimental lithotripter (XL1, Dornier) revealed severe cellular damage. Apart from cell fragments and cellular debris, cells exhibited alterations of shape, vacuolization of the cytoplasm, perinuclear cisternae, swelling of mitochondria or rupture of the mitochondrial fine structure, and permeabilization of the cell membrane. Treatment of multicell tumor spheroids of both HeLa and EMT6/Ro cells in suspension with 500 SW resulted either in loss of peripheral cells and serious cellular damage in the outer regions or in a fragmentation of the spheroids. Many of the geometrically intact cells exhibited the same histopathological alterations as the suspended L1210 cells. Immobilization of the spheroids in agar or gelatine, however, prevented spheroids from being agitated and accelerated during SW-exposure. After treatment with 500 SW, spheroids immobilized in gelatine were not different from control cultures, as investigated with light- and electronmicroscopy. From our results we conclude that spheroids in suspension are subject to cavitation and liquid jet formation, causing not only acceleration and shearing forces but also collisions which account for the observed cell damage. PMID- 2781679 TI - Losses in tissue associated with finite amplitude ultrasound transmission. AB - The ultrasonic absorption coefficient of freshly-excised rat liver is measured as a function of intensity in a 1 MHz focused field. The 7 cm diameter source has a geometric focus of 20 cm and a half-intensity linear focal beamwidth of 4.65 mm. Free-field harmonic content and radiation force measurements within the focal region indicate that quasilinear shock (sigma = 1) is attained in the intensity range of 225 W cm-2 to 275 W cm-2 SPTP intensity. Radiometric measurements of focal beamwidth and intensity response (focal intensity versus transducer input voltage squared) demonstrated beam narrowing up to 700 W cm-2 and focal intensities greater than would be expected from linear theory. This nonlinear acoustic field is employed to measure the absorption coefficient of liver at the beam focus. The pressure absorption coefficient, measured via the transient thermoelectric technique, was 0.038 Np cm-1 at low intensities (below 100 W cm-2 SPTP) and rose to approximately 0.117 Np cm-1 at 750 W cm-2 SPTP intensity. The absorption predicted using spherically converging beam theory is in agreement with the experimental data at the lower (below 200 W cm-2) and the higher (above 650 W cm-2) intensities. Gaussian theory provided a poor fit to the experimental data even after deficiencies in the model were considered. PMID- 2781680 TI - Ultrasound irradiation of pregnant mice. PMID- 2781681 TI - Inflammatory cell infiltrate in distal ureteral segments from patients with reflux. AB - A total of 110 reimplanted ureters from 61 patients were examined by light microscopy. Twenty-four distal segments from nonrefluxing ureters were used as control group. Overall, 55 of 110 specimens (50%) had inflammatory cell infiltrates (ICI) consisting of lymphocytes and plasma cells in the submucosa and adjacent muscularis. Forty-five ureters (82%) had mild ICI, and 10 ureters (18%) had moderate or severe ICI only in patients with history of infection. ICI increased with grade of reflux in both infected and noninfected groups. Of 75 ureters (68%) from patients with history of infection, 45 (60%) had ICI. Ten of 35 ureters (29%) from patients without history of infection had ICI. A causal relationship between reflux and ICI remains speculative and needs further study. PMID- 2781682 TI - Management of cystine nephrolithiasis by endourologic methods and shock-wave lithotripsy. AB - Cystinuria is a rare cause of renal calculi, accounting for about 1 percent of cases. Herein we describe our experience with a series of 10 patients with cystinuria and highlight the particular problems of the use of extracorporeal shock-wave lithotripsy (ESWL) to treat these types of stones and our resultant emphasis on percutaneous techniques. PMID- 2781683 TI - Leiomyosarcoma of scrotum. AB - Leiomyosarcoma of the scrotum is a rare tumor that is best treated by wide local excision. Lymphatic metastasis is rare. To date a total of 14 cases have been reported. PMID- 2781684 TI - Prostatic malakoplakia associated with prostatic adenocarcinoma and multiple prostatic abscesses. AB - Two cases of prostatic malakoplakia are presented. One case was associated with adenocarcinoma of the prostate and the second was noted with multiple prostatic abscesses. The literature on malakoplakia of the prostate is reviewed. PMID- 2781685 TI - A new antegrade ureteral stent. PMID- 2781686 TI - Renal vein thrombosis presenting as renal mass. AB - The excretory urogram of patients with acute renal vein thrombosis typically demonstrates symmetric enlargement of the involved kidney. We report a case of renal vein thrombosis that presented as a discrete renal mass on excretory urography and abdominal computerized tomography. The entity of renal vein thrombosis is briefly reviewed along with the computerized tomography findings seen in this setting. PMID- 2781687 TI - Corticosteroid-induced alkaline phosphatase isoenzyme in the diagnosis of canine hypercorticism. AB - Corticosteroid-induced isoenzyme of alkaline phosphatase (AP) can easily be demonstrated in canine plasma as a routine procedure because of its greater heat stability at 65 degrees C in comparison with that of other AP-isoenzymes. In this study the accuracy of this test for the diagnosis of hypercorticism was investigated. The AP-65 degrees C test had its highest efficiency when applied to plasma AP levels exceeding 150 units/litre. In a group of 146 dogs, clinically suspected of having hyperadrenocorticism, the test had a sensitivity of 0.92 and a positive predictive value for a positive test result of 0.89. Its lack of specificity (0.44) makes it unsuitable as a diagnostic test. The main application of AP-65 degrees C is in detecting hypercorticism in dogs by routine laboratory measurements, as was demonstrated in 711 dogs, in which a positive predictive value for the presence of hypercorticism of 0.89 was found. PMID- 2781688 TI - Protection of cattle from infection with vaccinia virus by bovine interferon alpha C. AB - The efficacy of bovine interferon alpha C as an antiviral compound was evaluated in calves infected with vaccinia virus. Calves treated with the interferon did not develop characteristic vaccinia lesions, demonstrating a clear protective effect of treatment. The only side effect observed was hyperthermia. After intramuscular injection, interferon appeared quickly in the blood and was cleared within 24 hours. The in vivo antiviral activity of bovine interferon alpha C was confirmed by its ability to induce 2'5' A synthetase, an enzyme implicated in the antiviral state, in lymphocytes. PMID- 2781689 TI - Sporadic feline hypokalaemic polymyopathy. PMID- 2781690 TI - Recurrent infestation of a cat by Cheyletus eruditus (Shrank 1781). PMID- 2781691 TI - Ectopic pregnancy in a cat. PMID- 2781692 TI - Fly strike in a dog. PMID- 2781693 TI - Castration and docking. PMID- 2781694 TI - Allergic response to proligestone. PMID- 2781695 TI - Baled silage-associated uveitis in cows. PMID- 2781696 TI - Salmonella arizona in a chinchilla. PMID- 2781697 TI - Veterinary attendance at driving trials. PMID- 2781698 TI - Dangerous dogs. PMID- 2781700 TI - Right to dispense. PMID- 2781699 TI - Prostaglandins and clostridial vaccines. PMID- 2781701 TI - Urate urolithiasis in bulldogs. PMID- 2781702 TI - Veterinary services to smaller poultry flocks. PMID- 2781703 TI - Auditory brainstem responses in the normal beagle. AB - The latencies of the peaks in brainstem responses and the threshold response were determined in 18 healthy beagles. In the first series of measurements the dogs were sedated and the stimulus was delivered via an in-the-ear transducer. The latencies, the threshold levels, and the influence of the stimulus repetition rate on the latencies were measured. Using a miniature electric microphone in the outer ear canal near the tympanic membrane, it was found that at a level setting corresponding to 0 dB human level (HL) the major peak in damped oscillation during condensation reached a sound pressure level (SPL) of about 27 dB and the secondary rarefaction peak reached 24 dB SPL. In the second series of measurements the dogs were not sedated and the stimulus was delivered via a headphone. The wave forms, the mean latencies for peaks I to V as a function of the stimulus level, and the threshold of each wave are presented from both series. In the first series the latency values at 80 dB HL (107 dB SPL) were 1.21, 1.97, 2.67, 3.12 and 3.61 ms for peaks I, II, III, IV and V, respectively. The thresholds for peaks I to V were 47.5 +/- 9.5, 47.5 +/- 11.5, 41.3 +/- 13.0, 63.3 +/- 17.4 and 28.0 +/- 9.7 dB HL, respectively. The difference in peak latency between the first and the second series was 0.065 ms. This difference corresponded to the difference in length of the acoustic pathways.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2781704 TI - O-demethylation and N4-acetylation of sulphadimethoxine by the turtle Pseudemys scripta elegans. AB - After an oral dose of 350 mg of sulphadimethoxine, the turtle Pseudemys scripta elegans O-dealkylates sulphadimethoxine at the 2- and 6-position at 38% and 19% respectively, the 2-position being favoured. Acetylation of sulphadimethoxine and its hydroxy metabolites occurs for 57.4%. PMID- 2781705 TI - Arteriographical and pathological changes in chronic laminitis in dairy cattle. AB - The arteriographic appearance of 76 bovine hind digits, obtained from a slaughterhouse, was related to the macroscopic signs of chronic laminitis in the digits. There were statistically significant correlations between the macroscopic and the arteriographic appearance of the claws. Subsequent histological examination of the radiographically abnormal arteries revealed features indicative of arteriosclerosis. The results of this study indicate that chronic laminitis develops following a subclinical attack of laminitis due to a continous hypoperfusion of the digit. PMID- 2781706 TI - Relation between selenium content and glutathione-peroxidase activity in blood of cattle. AB - To identify a simple method for assessing the selenium demand in cattle, the relationship between selenium content in whole blood and the concentration of the selenium containing enzyme glutathione peroxidase (EC 1.11.1.9; GSH-Px) in red blood cells was studied. On six farms with suspected low soil selenium content, blood samples were collected from groups of calves, yearlings and adults at the end of the housing period and of the grazing period. The data obtained showed a highly significant correlation between the parameters mentioned: GSH-Px (U/g Hb) = 3.261 * Se (micrograms/kg) - 40.553. In growing animals there was a decline in Se supply with age, followed by a gradual recovery in heifers. This was most pronounced on some sandy soils and on peat soil. Seasonal effects could not be demonstrated. PMID- 2781707 TI - German shepherd dog pyoderma: a genetic disorder. AB - In this study the pedigrees of 42 German Shepherd dogs with German Shepherd dog Pyoderma (GSP) were analysed. Parents, littermates and offspring of the affected dogs were traced and their owners were questioned on characteristic skin lesions. Evidence suggesting an autosomal recessive trait was found. Breeders are advised to exclude affected animals and their relatives from further breeding. PMID- 2781709 TI - Pregnancy rate of heifers bred by an immunotolerant bull persistently infected with bovine viral diarrhoea virus. AB - Twenty four maiden heifers were bred by natural route by a specific immunotolerant bull, that was persistently infected with Bovine Viral Diarrhoea virus (BVD virus). The quality of the bull's semen was normal. Twelve heifers became pregnant in the first oestrus cycle and the remaining twelve in the second oestrus cycle. This leads to the conclusion that such persistently infected bulls may have good fertilisation results. Nevertheless, it is felt that bulls persistently infected with the BVD virus must be excluded from artificial insemination centres because of the risk of introducing BVD virus in a herd by the semen. PMID- 2781708 TI - Thyroidal radioiodine uptake in hyperthyroid cats. AB - Thyroidal radioiodine uptake was measured in 10 healthy domestic cats and in 20 hyperthyroid cats. Compared with those in the healthy cats, the uptake curves in the hyperthyroid cats were characterised by elevated uptake and rapid thyroidal iodine turnover. For diagnostic purpose uptake measurements at 4 hours after administration of the tracer were found to be preferable to measurements at 24 hours or later. PMID- 2781710 TI - Clinical Leptospira interrogans serogroup Australis serovar lora infection in a stud farm in The Netherlands. AB - A Leptospira interrogans serogroup australis serovar lora infection in a stud farm is reported. During three successive years (1984-1986) clinical leptospirosis with a severe often rapid, fatal course was seen in 12 foals. Clinical examination revealed severe respiratory distress, depression and pyrexia. Other symptoms were diarrhea (2), jaundice (1), and an unsteady gait (1). Morphological characteristics of the disease were massive pulmonary haemorrhage and haemorrhagic-thrombotic or extracapillary glomerulonephritis with tubulonephrosis and interstitial oedema. In most foals high or increasing MAT titres to serovar bratislava were found; from one foal Leptospira interrogans serovar lora was isolated. Serological examination of all 56 mares at the farm (August 1986) revealed antibodies to serovar bratislava in 64 per cent of the animals. These findings support the idea that Leptospira interrogans serovar bratislava and closely related strains (in this study serovar lora) may be adapted to and maintained by the horse population. PMID- 2781711 TI - Depletion of colistin in eggs following medication of laying hens. AB - The depletion of colistin in eggs was determined separately for the albumen, the yolk and the whole egg after oral and intramuscular administrations of colistin sulphate. Residues were assayed by an agar plate diffusion method with Bordetella bronchoseptica ATCC 4617 as test organism. Colistin residues were not detected after drug administration by the oral route, but could be detected in the yolk until eight days after intramuscular injection. The total amount excreted represented 0.9% of the dose applied. PMID- 2781712 TI - Oxidation and O-dealkylation of sulphamonomethoxine by the turtle Pseudemys scripta elegans. AB - Sulphamonomethoxine is O-demethylated at the 6 position and oxidised at the 2 position of the pyrimidine substituent by Pseudemys scripta elegans. No N4 acetylation takes place. The yield of the oxidation reaction is twice that of the O-demethylation reaction. PMID- 2781713 TI - Inactivated oil emulsion vaccines from selected clones of Newcastle disease virus. AB - The immunogenicity of oil emulsion (OE) vaccines prepared from two selected clones of a Nigerian strain of Newcastle disease virus and two commercial vaccine strains were compared. Geometric mean haemagglutination inhibition titre was lowest in OE-Lasota, although all four vaccines gave 100% protection against clinical Newcastle disease. The use of OE vaccines is recommended for commercial use in Nigeria. PMID- 2781714 TI - The effect of three planes of nutrition on natural coccidial infections in Awassi sheep yearlings. AB - Faecal samples from three groups of yearling Awassi sheep fed three different nutritional planes were taken at 2-week intervals over a period of 3 months. Eimerian oocysts were found in 252 (80%) of the 315 samples collected. The species of Eimeria were identified and 30.2% of the samples contained three or four species, 27.3% had two species and 22.2% had one species. The prevalences in decreasing order were: E. pallida (37.1%); E. parva (28.9%); E. crandallis (17.8%); E. marsica (15.6%); E. bakuensis (syn. E. ovina) (13.7%); E. ovinoidalis (11.4%); E. intricata (11.1%); E. ahsata (9.2%); E. faurei (7.0%); E. granulosa (4.4%). The prevalence of E. bakuensis was significantly (P less than 0.05) higher in sheep fed the high and moderate planes of nutrition, while the prevalence of E. faurei was significantly (P less than 0.05) lower in sheep fed on the moderate plane. The numbers of E. marsica were also significantly higher (P less than 0.05) than other Eimeria species in the moderate plane group. PMID- 2781715 TI - Camel trypanosomiasis and its vectors in Somalia. AB - Blood samples from 3000 Somali camels (Camelus dromedarius) were examined for trypanosome infection. Of these, 160 (5.33%) were infected with Trypanosoma evansi, one (0.03%) with T. congolense and one (0.03%) with T. brucei. Camel trypanosomiasis occurred in most areas of tabanid infestation throughout the country. The tabanids Philoliche zonata and P. magretti are incriminated as the major vectors of the disease. PMID- 2781716 TI - A rapid method for detecting Trichinella spiralis larvae in pork using a monoclonal antibody-latex conjugate. AB - A simple, non-microscopic method was developed for the direct detection of Trichinella spiralis in pork. Samples of meat were treated with pepsin for 2 h to liberate the larvae, and sonicates were made from the deposit and used in an antigen detection system. In this system, latex particles, sensitized with a parasite-specific monoclonal antibody, were utilized in a slide or tube agglutination test. The efficiencies of these immunological methods were compared with that of trichinelloscopy in the examination of 102 pork specimens, 35 of which contained varying numbers of larvae after enzymatic digestion of 2 g of the meat. Trichinelloscopy detected 77.1% of these positive samples, but this was lower (55.5 and 41.7%) for those samples with a low larval burden (less than 50 or less than 10 larvae g-1 tissue, respectively). Better results (88.6, 76.5 and 60.0%) were obtained with the slide latex agglutination technique. The efficiency of detection was further improved (100%) using the more sensitive tube agglutination method. However, this was based on a small number (20) of samples examined and the limit of detection of this technique was subsequently found to be three larvae in total. No false-positives were seen with the latex agglutination methods from a total of 67 uninfected specimens examined. PMID- 2781717 TI - Lactate dehydrogenase from adult Setaria digitata (Nematoda: Onchocercidae). AB - Lactate dehydrogenase of Setaria digitata exhibited an optimum pH of 7.0-8.0 and showed resistance to high temperature. The inhibition/activation of various anions differed in both the forward and backward directions. Filarin (a drug used in Siddha medicine) and diethylcarbamazine (DEC) inhibited pyruvate reduction rather than lactate oxidation. High pyruvate reduction:lactate oxidation at Vmax and Vmax/Km favoured pyruvate reduction in vivo. The enzyme exists as isozymes (four in the female and three in the male) and their separation depended on the percentage of gel and on pH. The mobility of the 700 X g supernatant fraction in the gel was less than that of the 10,000 X g supernatant. PMID- 2781718 TI - Factors affecting the efficacy of ivermectin against Heligmosomoides polygyrus (Nematospiroides dubius) in mice. AB - The efficacy of ivermectin against Heligmosomoides polygyrus was investigated in 5 mouse strains (CFLP, NIH, C57Bl10, BALB/c and CBA) using a variety of dose levels, and subcutaneous and oral administration. Heligmosomoides polygyrus were not completely eliminated when 5 mg kg-1 of ivermectin was given 6 days after infection, but 10 mg kg-1 was totally effective. Significant mouse-strain variation in drug efficacy was detected, NIH mice requiring treatment with higher doses than CFLP mice in order to bring about a comparable level of larvicidal activity. Ivermectin was more effective when given subcutaneously than when given orally, regardless of the dose administered or the strain of mouse tested. The anthelmintic effect of the treatment was more persistent in CFLP mice given 20 mg kg-1 subcutaneously than in NIH mice or in mice treated orally, and a 20-day interval between administration and infection was insufficient to prevent inhibition of parasite survival. Ivermectin was shown to be totally effective at 20 mg kg-1 given subcutaneously in killing immune arrested larvae of H. polygyrus. PMID- 2781719 TI - Effect of ovine urine and some of its components on viability of nematode eggs and larvae in sheep faeces. AB - Sheep faeces incubated for 7 days at 27 degrees C for cultivation of third-stage nematode larvae were sprinkled daily with urine from sheep or with solutions of components normally occurring in sheep urine. Larval development was completely blocked in cultures sprinkled either with sheep urine, with solutions of 2 or 4% urea, or with urine from which urea or the phenol components had been extracted. Only a few third-stage larvae developed in cultures sprinkled with 1% urea. Normal larval development occurred in cultures sprinkled with either the phenol component from urine, or with solutions of 0.035% phenol, 0.035% p-cresol, 0.3% allantoin, 0.3% hippuric acid or 2.8% NaCl. Normal larval development also occurred in all control cultures sprinkled with water, including one culture where there was urine in the space between the outer and inner beaker used for cultivation. It is suggested that the inhibitory effect of urine on larval development is mainly caused by ammonia produced when urinary urea is brought into contact with urease of faecal origin. It is, however, an unsolved question why urine, from which urea had been removed, also inhibited larval development. PMID- 2781720 TI - Analysis of cat retina for dopamine, dihydroxyphenylacetic acid, 3 methoxytyramine and homovanillic acid. AB - Twenty retinas from 10 cats were evaluated for dopamine (DA) and its metabolites dihydroxyphenylacetic acid (DOPAC), 3-methoxytyramine (3-MT) and homovanillic acid (HVA) by high pressure liquid chromatography and electrochemical detection. Dopamine was present in all 20 retinas at a mean concentration of 3.00 +/- 0.54 ng/mg protein. Dihydroxyphenylacetic acid, 3-MT and HVA were detected in 16, 14 and 9 retinas respectively. In retinas in which these metabolites were detectable, they were present in the following mean concentrations: DOPAC, 1.07 +/- 0.21 ng/mg protein; 3-MT, 3.44 +/- 0.97 ng/mg protein and HVA, 4.54 +/- 1.05 ng/mg protein. Significantly higher concentrations of 3-MT (p = 0.0108, paired t test) and HVA (p = 0.0166, paired t test) than DOPAC were present in cat retina. Linear correlation analysis between DA and its metabolites indicated that the 3 MT and DOPAC concentrations correlated well with each other and with the amount of DA in cat retina. The concentrations of the end product metabolite, HVA, had poor correlations with the concentrations of 3-MT, DOPAC or DA. These data indicated that once DA is released in cat retina it can be metabolized to 3-MT, DOPAC and HVA. PMID- 2781721 TI - The influence of Trypanosoma congolense infection on the disposition kinetics of diminazene aceturate in the dog. AB - Diminazene aceturate was administered intravenously at 3.5 mg/kg body weight to mongrel dogs before and after infection with Trypanosoma congolense. Plasma and urine were collected at varying intervals thereafter and analysed for the compound. The mean area under the concentration-time curve (AUC) of diminazene in healthy dogs was 25.8 h.micrograms/ml but was significantly increased (p less than 0.05) to 35.7 h.micrograms/ml after infection with T. congolense. The distribution half-life was significantly reduced (p less than 0.05) in dogs after infection, being 0.12 h compared to 0.17 h in the same dogs before infection. The mean proportion of the diminazene recovered in the urine of infected dogs (25.1%) was not significantly different from that recovered in the urine of healthy dogs (26.8%). These results indicate that infection with T. congolense increases the rate at which diminazene is distributed in the body but that the infection has no marked influence on the urinary excretion of the drug. PMID- 2781722 TI - Effect of trypsin in semen on in vivo fertilization and early embryonic development in superovulated heifers. AB - The effect of trypsin on the fertilizing capacity of bull semen was investigated as part of the evaluation of the addition of trypsin to semen as a method for destroying or inactivating infectious agents. Parts of the ejaculates from four bulls were treated with 0.3% trypsin solution. Both the treated and untreated aliquots of semen were frozen, thawed and used for the artificial insemination of superovulated heifers. Two hundred and thirty ova and embryos were collected from 22 heifers on day 7 after oestrus (insemination). One hundred and ten out of 164 (67%) embryos and ova from 15 heifers inseminated with trypsin-treated semen were classified as of transferable quality compared to 46 out of 66 (70%) in the control group of 7 heifers (p greater than 0.05). There was no difference in the proportion of fertilized ova or degenerated embryos resulting from the control or trypsin-treated samples of frozen-thawed semen, which is consistent with results obtained previously using fresh semen. PMID- 2781723 TI - Disposition and dosage regimen of cephaloridine in calves. AB - The disposition and dosage regimen of cephaloridine were investigated in healthy calves following a single intramuscular administration of 10 mg/kg. The absorption halflife, elimination halflife, apparent volume of distribution and total body clearance were 0.107 +/- 0.025 h, 2.08 +/- 0.14 h, 0.70 +/- 0.07 L kg 1 and 235.8 +/- 21.9 ml kg-1 h-1, respectively. Therapeutic plasma levels (greater than or equal to 1 micrograms/ml) were maintained for up to 7 h. A satisfactory intramuscular dosage regimen for cephaloridine in calves would be 10 mg/kg repeated at 8 h intervals. PMID- 2781724 TI - Disposition kinetics and urinary excretion of gentamicin in buffalo bulls (Bubalus bubalis). AB - The disposition kinetics and urinary excretion of gentamicin sulphate were studied in young buffalo bulls following a single intramuscular administration of the drug at 5 mg kg-1 body weight. The time course of the serum gentamicin concentration was adequately described by the one-compartment open model. The values of the absorption and elimination halflives were 12.2 +/- 2.2 and 167.0 +/ 29.7 min respectively. The apparent volume of distribution was 0.29 +/- 0.01 L kg-1. During the first 12 h, 63% of the total administered dose was excreted in urine. On the basis of the kinetic data, a satisfactory intramuscular dosage regimen for gentamicin sulphate would be at least 6 mg kg-1 body weight repeated at 8 h intervals. PMID- 2781725 TI - [Viral pollution studies of water environments]. AB - Virus pollution was studied in 734 water samples collected from the Dimbovita River (310), lakes inside the town of Bucharest (136) and swimming pools (288). The results showed that the works carried out these last years to regularize the Dimbovita led to a reduction of the virus pollution rate from 16.6-26.9% in 1984 to 4.16-5% in 1988. As for the lake and swimming pool waters, the pollution rate is directly proportional to the applied general hygiene measures. In summer, in drained lakes strictly controlled from the domestic and industrial sewage discharge point of view, the pollution rate was no higher than 6%, while in the lakes receiving sewage the frequency of isolations was between 12.5 and 18.75%. The same situation was found for swimming pools. A microepidemics of blepharoconjunctivitis was recorded in 1988 at a sport base: viruses were isolated from 20% of the water samples collected from its swimming pool, while virus pollution was about zero in the swimming pool water of some big hotels in Bucharest. PMID- 2781727 TI - [The potentials for immunization against influenza using liposome-incorporated viral surface antigens]. AB - Studies were conducted using uni- and multilamellar liposomes to establish optimum conditions for influenza antigen incorporation in view of their transport to the target cells for experimental influenza prophylaxis in hybrid white mice. Radiometric determinations showed a good level of preparation purification, a good efficiency of incorporation in liposomes of the active biological material, the liposome linked radioactivity distribution among different organs. Charged liposomes induced solid and long lasting resistance against influenza control infection. PMID- 2781728 TI - Dynamics of signal conduction from soma to axon terminal of the teleost retinal horizontal cell: in vivo, in vitro and model studies. AB - A quantitative study is made on dynamic (frequency-sensitive) properties of the signal conduction between soma and axon terminal of the retinal horizontal cell. Dim flashes of same intensity produced nearly identical responses in soma and axon terminal, indicating that the voltage signal is conducted from soma to axon terminal with little attenuation or distortion. The membrane impedance of axon terminal was measured in solitary-cell preparations under voltage clamp, in order to determine parameters of a resistive-capacitive cable model for the horizontal cell. The simulation analysis shows that passive linear cable models of the present type confront inherent difficulty in predicting dynamical properties of actual flash responses of axon terminal. A nonlinear mechanism is believed to facilitate high-frequency signal conduction along the slender axon that connects soma and axon terminal. PMID- 2781726 TI - [The action of a Chamenerion angustifolium extract in experimental influenza virus infection in mice]. AB - V-2 and V-8, two preparations containing an extract from Chamenerion angustifolium, were tested in vitro and in vivo, for their anti-influenza properties. In vitro, the two preparations induced a significant reduction of the hemagglutinating titers. In vivo, administration of each of the two products, three times before the influenza virus inoculation significantly reduced (27%) the mortality rate and the hemagglutinating titers, and increased the survival mean time (SMT) (about 3.5 times). These effects were more striking when control infection was done seven days after the last administration of the extract: the mortality rate reduces by 50%, the HA titers lowered to zero and the SMT increased by about 5 times. PMID- 2781729 TI - Rods trigger light adaptive retinomotor movements in all spectral cone types of a teleost fish. AB - Action spectra for light induced cone contraction are described for the two spectral cone types of a dichromatic (red/green) cichlid species (Aequidens pulcher). Criterion response thresholds (50% of maximal response amplitude) were determined for seven wavelengths. After correcting for absorption by cornea and lens, the resulting action spectra were compared with the absorption spectra of the rod and cone visual pigments. We find (i) that the action spectra of red and green sensitive cones are almost identical and (ii) matched most closely the absorption spectrum of the rod visual pigment. We therefore conclude that light adaptive cone contraction is triggered by light absorption in rods, which in the dark adapted state are located next to the external limiting membrane and are therefore in an optimal position to capture the incident light during early dawn. Possible mechanisms of signal transfer from rods to cones are discussed. PMID- 2781730 TI - The development of monocular and binocular VEP acuity. AB - The development of monocular and binocular grating acuity was measured in 87 infants, 2-52 weeks of age, using the sweep VEP technique. Average monocular and binocular acuity growth functions were nearly identical, with a small (less than 0.2 octaves) binocular acuity superiority occurring only under 6 months. Interocular acuity differences were small (averaging less than 1/4 octave, unsigned, with a 95% confidence interval of less than +/- 0.6 octaves) and were not significant at any age. These characteristics make the sweep VEP technique a potentially sensitive tool for the detection of monocular visual losses in the early stages of amblyopia. PMID- 2781731 TI - Two pulses seen as three flashes: a superposition analysis. AB - If a single brief light pulse follows the offset of a light field by 0.1-0.3 sec, the pulse is seen as a double flash. This "double flash effect" is a suprathreshold phenomenon: the pulse must exceed detection threshold by 10 times or more for this temporal illusion to occur. A special case of this effect is demonstrated here: two brief, high-luminance pulses separated by 0.1 sec appear as three flashes. In a superposition analysis, hypothetical impulse response functions were added together with various delays to model flash perception. A biphasic impulse response (congruent with threshold flicker and pulse sensitivity) fails to predict perception of three flashes from two pulses. The analysis instead suggests that the visual response to a suprathreshold pulse has several alternating phases of excitation and inhibition. PMID- 2781732 TI - Evidence for edge and bar detectors in human vision. AB - The structure of receptive fields of human visual detectors was investigated by studying their phase response. Observers were required to discriminate between pairs of periodic stimuli that differed in phase by 180 degrees (reversed in contrast). The stimuli comprised 256 harmonics, smoothly filtered in amplitude, and congruent in phase at the origin. Reversal discrimination thresholds were measured as a function of the phase of the harmonics. Thresholds were slightly higher for phases around 45 degrees, consistent with the idea that all discriminations were mediated by independent detectors with 0 or 90 degrees phase response (assuming probability summation between them). Discrimination thresholds were also measured with a pedestal stimulus, of phase complementary to that of the test gratings. For discriminations between 0 and 180 degrees (cosine phase), or 90 and 270 degrees (sine phase), the complementary pedestal had little effect, implying independence of detectors in sine and cosine phase. However, for discrimination between 45 and 225 degrees (stimuli containing both sine and cosine components) the complementary pedestal, which also contained both sine and cosine components, facilitated greatly discrimination thresholds. The results suggest that there exist two classes of detectors, one with a Fourier phase spectrum of 0, the other with a Fourier phase spectrum of 90 degrees. This implies that the receptive fields are symmetric, one class having even-symmetry (line-detectors), the other odd-symmetry (edge-detectors). PMID- 2781733 TI - Discrimination of spatial phase in central and peripheral vision. AB - Sensitivity to relative phase was measured for central and peripheral vision using stimuli comprising 256 harmonics, smoothly filtered in amplitude. With these stimuli, peripheral phase sensitivity was much higher than that previously reported with two-harmonic stimuli. Sensitivity did not depend on the average phase of the stimuli, nor on their second-order statistics, irrespective of the spatial frequency of the stimulus or the position in the visual field. After scaling for size, peripheral sensitivity was as high as central sensitivity. The scaling factor required to equate phase sensitivity was the same as that required to equate contrast sensitivity and grating acuity. These results suggest that phase sensitivity decreases with eccentricity at a similar rate as contrast sensitivity and grating acuity, much more slowly than the positional acuities. This is consistent with the suggestion that phase discrimination is mediated by discriminating the amplitude of the response of quasi-linear filters, and does not require mechanisms that evaluate position. It is suggested that previous measurements on peripheral phase sensitivity may reflect positional uncertainty in the periphery, rather than a deficit in phase sensitivity per se. PMID- 2781734 TI - Visibility of blobs with a Gaussian luminance profile. AB - Contrast detection thresholds for circular symmetric stimuli with a Gaussian luminance profile and Gaussian temporal modulation were measured as a function of their spatial scale parameter (varied over two and a half decades) for four different presentation times. The stimulus was presented on a very large uniform background field. For sufficiently large stimuli the threshold is constant over a size variation of at least one and a half decades. When the stimulus is presented on a restricted background field, a loss of sensitivity is found at long presentation times when the stimulus size exceeds a certain fraction of the background diameter. The measurements show (i) that the visual system has a very large bandwidth and (ii) that the presence of edges or luminance transitions in the visual field can diminish the sensitivity to a stimulus considerably, even when they are rather distant. The results can be explained in a natural way with a multi-layer receptive field model. PMID- 2781735 TI - The role of spatial filtering in sensitivity regulation. AB - The role of spatial filtering in controlling sensitivity to increments is hard to evaluate under normal viewing conditions because eye movements lead to a confounding of spatial and temporal transients. We measured sensitivity to increments on different sized backgrounds in photopic and scotopic vision when the backgrounds were stabilized on the retina, thus eliminating temporal transients. The saturating effect of small fields on photopic thresholds was preserved under these conditions indicating that spatial filtering by retinal cells is critical in maintaining photopic sensitivity. Some effect of spatial pattern on sensitivity in stabilized vision was also observed in scotopic vision, although it was much smaller than was observed in photopic vision. The interaction effects between rod and cone systems that are observed with small backgrounds were also preserved in stabilized vision, implicating a very peripheral site for the generation of these interactions. PMID- 2781736 TI - The perception of target motion during smooth pursuit eye movements in the open loop condition: characteristics of retinal and extraretinal signals. AB - During smooth pursuit eye movement, the perception of target motion appears to come from retinal and extraretinal influences. To explore this, two open-loop conditions (experimental stimuli stabilized at the retina) were used: one to look at the combined effect of retinal and extraretinal signals on perception (using sinusoidal target motion); and the other to look at the characteristics of an extraretinal signal alone (using a complex target and square-wave motion). In both conditions subjects tracked target motion in the dark, and subsequently compared it to motion of a similar target in the light. The main findings of the study are that the magnitude of the extraretinal signal decreases with frequency, and that the retinal and extraretinal signals combine additively. This system appears to involve a transport-time, which could be in the form of a time advance. These features of perception have a variety of implications for motor control. PMID- 2781737 TI - Comparison of saccadic eye movements in humans and macaques to single-step and double-step target movements. AB - Human and monkey saccade amplitude and latency, in response to 12-36 degrees target steps, differed substantially despite nearly identical experimental conditions. On single-step trials, monkeys did not undershoot targets, and latencies were insensitive to stimulus and contextual factors. Human saccades did undershoot, their latency was longer, and both undershoot and latency were affected by stimulus variables and experimental context. On double-step trials, the second target step altered primary saccade amplitude when the step occurred as little as 40 msec prior to saccade onset for both humans and monkeys. However, humans and monkeys showed somewhat different amplitude transition functions, and monkeys showed little evidence of parallel programming. PMID- 2781738 TI - The effect of stationary, random phase discontinuities, on spatial frequency discrimination. AB - We measured spatial frequency discrimination for sine wave gratings that had stationary, periodic, random phase shifts. Testing was conducted at 2.5, 5.0 and 10.0 c/deg. The effects of introducing phase shifts that occurred after a phase continuity in the range 1-8 cycles of the parent sine wave were examined in different experiments. We found that the Weber fraction for spatial frequency was an inverse linear function of the logarithm of the number of cycles of the sine wave in continuous phase. Discrimination performance improved as the number of cycles before the phase shift was increased. The results are compatible with models of spatial frequency discrimination that are based on the averaging of estimates of the spatial intervals between characteristic luminance features (Heeley, 1987a, b), and show also that performance on this task is related to the amount of information available in the retinal image. PMID- 2781739 TI - In vitro and in vivo evaluation of platelet concentrates after cotton wool filtration. AB - Removal of leukocytes from platelet concentrates (PC) may decrease the incidence of alloimmunization to HLA antigens on white cells and prevent or delay refractoriness. Cotton wool filtration, which effectively removes leukocytes from PC with minimal platelet loss, may cause platelet or complement activation. In this study, the effect of cotton wool filtration (Imugard IG-500) on platelet activation, in vitro function, posttransfusion survival, and complement activation was investigated. Five paired autologous in vivo percent recovery and survival studies were performed with fresh (6-8h) PC or with 5-day-stored PC prepared from CPD-anticoagulated blood and stored in PL-732(TM) containers using standard methods. In the paired design, PC from the same donor were filtered on one occasion, and not filtered on another, prior to labeling with indium-III oxine and reinfusion. Percent recovery and survival were then determined by the standardized method. Filtration had no statistically significant effect on percent recovery on PC stored for 6-8h or for 5 days. There was, however, a slight decrease in survival hours of the filtered PC which was statistically significant at 6-8h (203 +/- 14 vs. 179 +/- 18h; p less than 0.05) but not at 5 days (166 +/- 28 vs. 132 +/- 27h; p greater than 0.05). Samples taken before and after filtration of single units (fresh and 5-day) and pooled units (3-day) for measurement of release of granular content (beta-thromboglobulin), lysis (LDH), and in vitro viability - ATP, extent of shape change with ADP, and hypotonic shock response (3-day only)-demonstrated no effect of filtration on these parameters.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2781740 TI - Storage of platelets in earth orbit. Effect of gravity and the formulation of plastic storage containers on platelet IgG and C3. AB - We investigated the effects of gravitational force and three different plastic formulations of the storage bags on the quality of stored platelets by measuring the changes in platelet-associated immunoglobulin G (IgG) and two antigenic markers of the third component of human complement (C3), C3d and C3c. Pooled platelets were stored in parallel at microgravity (MG) and on the ground (1 g) using three different plastic polymers: (1) polyvinylchloride (PVC) plasticized with di-2-ethylhexyl phthalate (DEHP); (2) PVC plasticized with trioctyl trimellitate (TOTM), and (3) unplasticized polyolefin (PO). The IgG and C3 were quantified by an automated antiglobulin consumption test in freeze/thaw disrupted platelets (total IgG or C3). The baseline values for platelet associated IgG and C3, measured after 2.5 days of storage at 1 g just prior to the launch, fell within the normal range. Following an additional 6.5 day storage, platelets stored at MG had accumulated significantly less C3d than those stored at 1 g, suggesting that MG storage was beneficial. Specific plastic formulations also exerted a significant effect on the accumulation of these immunoproteins, the effect being particularly pronounced at MG. The smallest increases of IgG and C3 were seen in platelets stored in TOTM and the largest in those stored in DEHP. It is possible that further studies at MG would permit a clear characterization of the effects of other independent storage variables. PMID- 2781741 TI - Identification, by immunoblotting, of the structures carrying Lutheran and para Lutheran blood group antigens. AB - Immunoblotting was performed, after sodium dodecyl sulphate polyacrylamide gel electrophoresis of solubilised red cell membranes under non-reducing conditions, with human Lutheran antibodies, anti-Lua, -Lub, -Lu3, -Lu6 and -Lu8, and with human para-Lutheran antibodies, -Lu4, -Lu12 and -Lu17. On antigen-positive red cells all antibodies revealed two components of apparent molecular weight (Mr) 83,000 and 76,000. Anti-Lua and -Lub gave no bands with Lu(a-b+) or Lu(a+b-) cells, respectively. With the exception of anti-Lu17, which reacted normally, and anti-Lu3, which reacted weakly, none of the antibodies showed bands with membranes from Lu(a-b-) cells of the In(Lu) type. Treatment of the red cells with sialidase led to a small reduction in the apparent Mr of the Lutheran glycoproteins which, therefore, appear to contain sialic acid bearing O-linked oligosaccharides. PMID- 2781742 TI - Implications of utilization of a maximum surgical blood order schedule. PMID- 2781743 TI - Lewis antibody following a massive blood transfusion. PMID- 2781744 TI - [Optimization of chemotherapy of stomach cancer]. AB - Results are analyzed of the treatment of 520 patients with diffuse gastric cancer using different schemes that included chemotherapy with fluorouracil, intraabdominal polychemotherapy with fluorouracil and adriablastin, immunotherapy with yeast polysaccharides and thymus hormone--taktivin. Chemotherapy supplemented by immunotherapy essentially increases survival. Intraabdominal administration of antitumour drugs in gastric cancer is anatomically more adequate than the intravenous route. PMID- 2781745 TI - [Prevention of the harmful action of laser radiation]. PMID- 2781746 TI - [Quantitative assessment of body resistance to exposure to chemical substances]. AB - In the quantitative evaluation of resistance of the body in parts or totally to the effect of chemical substances, in evaluation of the significance of separate responses for the resistance of the body (information value) it is recommended to analyze the values and signs of increases of information entropy in separate responses and total entropy-antientropy balance in their systemic and general complexes simultaneously considering the value and direction of reactions. PMID- 2781747 TI - [Hepatitis B morbidity in families]. AB - In regions with a low endemic incidence of hepatitis B familial foci of those with a history of viral hepatitis B and HBsAg carriers are less actual objects of epidemiological surveillance than foci of group diseases, chronic carrier state of HBsAg. PMID- 2781748 TI - [The active form of training managers of public institutions in universal ambulatory care]. PMID- 2781749 TI - [The use of an expert consultative testing system in the medical education process]. PMID- 2781750 TI - [Cholate-forming function of the liver in patients with chronic alcoholism]. AB - The level of bile acids was studied in the bile and feces in 119 patients with chronic alcoholism using thin-layer chromatography. The cholate-forming function of the liver was found to increase in patients with short alcohol anamnesis in chronic alcoholism. With advance of the alcohol anamnesis the number of patients with reduced cholate-forming function of the liver increased. PMID- 2781751 TI - [Effect of fenicaberan on liver function in patients with chronic noncalculous cholecystitis]. AB - The author studied the effect of fenicaberan on the functional state of the liver in 34 patients with chronic noncalculous cholecystitis. It was found that fenicaberan favours improvement of the functional state of the liver but complete normalization of all liver values indicates necessity continuation of treatment in outpatient conditions. PMID- 2781752 TI - [Ambulatory care problems of patients with chronic pancreatitis]. AB - Problems of dispensary management of patients with chronic pancreatitis are analyzed on the basis of 186 cases. The role was determined of some risk factors, chronicity and recurrence of the disease, status of the general adaptation reaction, psychoemotional background, significance of the status of the adjacent digestive organs, period of exacerbation, unstable remissions, terms of prehospital treatment, hospital treatment, presence of continuity of treatment at its stages. The authors propose a scheme of treatment, dispensary management and secondary prophylaxis in outpatient conditions directed to increase the efficacy of medical measures and ensuring thus working capacity and stabilization of the process. PMID- 2781753 TI - [The health resort balneotherapy of patients with chronic hepatitis]. AB - A single intake of 200-250 ml of the mineral water "Naftusia" may lead to a negative balneological reaction manifested in an increase of pain and activity of the indicator enzyme alanine aminotransferase in the blood. On the contrary small amounts of this mineral water taken not long before meals prevents the above negative effects. PMID- 2781754 TI - [The use of thermography in clinical practice]. AB - A study is presented of the role of thermography (thermovision) in evaluation of disorders of microcirculation and objectivization of the pain syndrome in some chronic digestive diseases. It is shown that thermography enables to evaluate the functional state of microvessels. Thermovision makes it possible in most cases to objectivize pain, especially in the painful zones on the middle abdominal wall that is registered by an elevated infrared radiation. PMID- 2781755 TI - [Determination of the location of the greater curvature of the stomach by superficial sliding palpation]. PMID- 2781756 TI - [The role of diseases of the digestive organs in the development of dermatoses]. AB - A study of 800 gastroenterological patients revealed dermatoses in 176 of them. Skin lesions were most frequent in chronic hepatitis (84%), rarer in chronic enterocolitis (accompanied by constipation (58%) and chronic gastritis with secretory insufficiency (70%). The expediency is shown of complex treatment including detoxication, immunomodulatory, substitutive and corrective therapy. PMID- 2781758 TI - [Morphologic changes of the kidneys in patients with vasorenal hypertension]. AB - A study is presented of the state of blood vessels and parenchyma of the kidneys in patients with vasorenal hypertension. Morphological changes of the renal parenchyma at different stages of the disease are described. The authors compared clinico-morphological findings and give practical recommendations for the improvement of diagnosis of the disease and timing of surgical treatment of vasorenal hypertension. PMID- 2781757 TI - [The diagnosis of nephropathies in patients with chronic alcoholism]. AB - A clinico-laboratory study of 60 patients with chronic alcoholism (stage II) revealed changes of the kidneys and urinary system in a half of all patients. Radionuclide examination revealed renal function disorders in 78.3% of patients indicating its value in the early diagnosis of alcohol nephropathy. Autopsy data in 246 cases revealed morphological changes in the kidneys in 2/3 of them (dystrophy, necrotic nephrosis, chronic glomerulonephritis, pyelonephritis). PMID- 2781759 TI - [Characteristics of electrocardiographic indices in adolescents with aggravated cardiovascular heredity]. PMID- 2781761 TI - [Intravital diagnosis of thromboembolism of the pulmonary artery branches]. AB - The authors describe two cases of during life diagnosis of thromboembolism of pulmonary artery branches confirmed at autopsy. Certain criteria or such diagnosis are discussed, namely: latent cor pulmonale, reduction of ECG voltage, ECG signs of interventricular septum infarction, hemorrhagic syndrome as a manifestation of intravascular coagulation. PMID- 2781760 TI - [Spectral analysis of the heart rhythm of elderly patients with hypertension]. AB - Spectral analysis of the cardiac rhythm was employed to investigate the vegetative regulation of the cardiac function in patients of elderly age suffering of hypertensive disease without and association with chronic circulatory insufficiency. The necessity is substantiated of differential use of hypotensive agents depending on the individual peculiar aspects of vegetative regulation of the cardiac activity. PMID- 2781762 TI - [The significance of the blood kinin system indices for the diagnosis of latent forms of rheumatism]. AB - A study of the kinin and fibrinolytic systems of the blood in 280 rheumatic patients with isolated or prevailing stenosis revealed that latent forms of rheumatism were characterized by an increase of kininogenesis, reduction of kininase capacity of the blood and depression of fibrinolysis in the absence of acute-phase reactions which allows to use these data a supplementary informative test for the diagnosis of the latent course of rheumatism. PMID- 2781763 TI - [Morphologic changes of the contractile structures of the heart and walls of the major blood vessels during physical loading]. AB - The author carried out a complex of macroscopical, histological and morphometric methods of examination of the heart, wall of the aorta, posterior caval vein and femoral artery of mature rats in conditions of experimental modelling of physical loads of various volume and intensity. It was established that the process of adaptation to physical loads consists not only of local changes occurring in the myocardial and smooth myocytes of the examined artery and vein walls but also in the formation of definite qualitative and quantitative relationships between the contractile structures of the heart and major blood vessels evidencing, thus, the importance of systemic morphofunctional transformations in the process of adaptation. PMID- 2781764 TI - [Pathomorphologic diagnosis of restrictive cardiomyopathy]. AB - The authors studied 14 hearts of patients who died of restrictive cardiomyopathy with purpose of finding distinct diagnostic criteria. Modern clinical and morphological methods were used. Characteristic changes in the ventricles were noted. Pathognomonic volumetric and planimetric cardiometric criteria were found. The endomyocardium showed a characteristic layer-like structure including loose, dense connective and granulation tissue with signs of calcification. The essence of the restriction syndrome in cardiomyopathy is defined. PMID- 2781765 TI - [Evaluation of the surgical treatment of peptic ulcer patients]. AB - The authors examined 134 patients after different methods of surgical treatment of gastric and duodenal ulcer. Examination included determination of blood erythrocytes and hemoglobin, serum plasma, changes of body weight, coprology, ECG and EEG. Normalization of above values was earlier in patients after selective proximal vagotomy. These data should be considered in the postoperative and outpatient treatment. PMID- 2781766 TI - [The types of cerebral circulatory disorders in ischemic stroke]. AB - An analysis is presented of the correlation between the cerebral circulation and systemic hemodynamics in 206 patients with ischemic stroke with the hypokinetic type of circulation. Correlation analysis showed that disorders of the intrasystemic relationships may appear in different degrees of reduction of the cardiac index but autoregulation reserves are particularly vulnerable when the index reduces on average to 1.55 l(min.m2). PMID- 2781767 TI - [Indirect endolymphatic chemotherapy of patients with lymphoma]. AB - Treated were 103 patients with malignant lymphomas (lymphogranulomatosis--87; non Hodgkin lymphomas--16 patients). The treatment was complex including chemotherapy by means of endolymphatic administration of cyclophosphane, prospidin, methotrexate). The technique may be widely used and may be associated with other treatment methods. The efficacy of the method is substantiated and emphasized. PMID- 2781768 TI - [Characteristics of the blood serum proteinogram in patients with acute leukemia]. PMID- 2781770 TI - [Determination of the level of middle molecules in diseases of the respiratory organs]. AB - The authors compared the content of middle molecules in the blood in 67 patients with diseases of the respiratory organs showing signs of inflammation. A dependence was found between the content of middle molecules and activity of the inflammatory process. It is recommended to determine the level of middle molecules for evaluating the degree of inflammation, intoxication and evaluation of the dynamics of the disease, prognosis, efficiency of treatment. PMID- 2781769 TI - [The treatment of patients with nonspecific inflammatory lung diseases under outpatient conditions]. AB - A study is presented of 245 patients with unspecific inflammatory pulmonary diseases (124 men, 121 women): with chronic bronchitis--39, chronic bronchitis and pneumonia at the phase of incomplete remission, bronchial asthma--107, convalescents--51. They were treated in out-patient conditions. Routine treatment methods were supplemented by different methods of treatment of the obstructive syndrome (blood transfusion, electrotherapy on the chest region, pyrogenal, electrophoresis with honey, etc.). This supplementary treatment of the obstructive syndrome in inflammatory unspecific pulmonary diseases essentially improved the treatment efficacy. PMID- 2781771 TI - [Treatment efficacy in destructive forms of pulmonary tuberculosis in relation to the methods of administering rifadin and isoniazid]. AB - The efficacy was studied of 130 patients with freshly detected destructive forms of pulmonary tuberculosis depending on the method of administration of rifadin and isoniazid. Treatment of pulmonary tuberculosis was realized with rifadin, isoniazid and streptomycin. Three groups of patients were distinguished. In group I rifadin and isoniazide was taken orally, in group II--rifadin was administered orally and intrabronchially, isoniazid--orally. In group III rifadin was orally and intrabronchially, isoniazid--intravenously. The treatment was more effective with combined administration of rifadin and intravenous administration of isoniazid. PMID- 2781772 TI - [Treatment of patients with bronchial asthma at an allergology hospital]. AB - The authors report their experience of using several therapeutic and prophylactic measures directed to increase the efficacy of treatment of patients with bronchial asthma. PMID- 2781774 TI - [Fat metabolism in hypocorticism patients]. PMID- 2781773 TI - [A method for treating reflux gastritis after vagotomy]. AB - The authors propose a method of treatment of reflux gastritis developing after vagotomy. This method includes diet N5, cerucal (0.01 g) and allanton (1.0 g) three times daily before meals as well as 30 ml of almagel every 2 hours. The result was positive in 55 of 56 patients. Average hospitalization time was 12.9 days, out-patient treatment--14.5 days. PMID- 2781775 TI - [Biological sorption in immunoneurologic diseases]. AB - A study is presented of 17 patients--9 with myasthenia, 8 with the Guillain- Barre syndrome. The complex treatment program of intensive therapy and reanimation included in all patients the operation of extracorporal heterospleen. Forty-one perfusions were carried out. The operation of splenic sorption allowed to reduce treatment time under conditions of intensive care and reanimation 1.5 times, lethality--by 33%. Employment of biological sorption in patients with such immunoneurological diseases as myasthenia and the Guillain--Barre syndrome removes the humoral autoallergic factor and, thus, favours restoration of nervous system function. PMID- 2781776 TI - [The endonasopalpebral reflex]. AB - The authors describe the endonasopalpebral reflex which is evoked from the nasal mucosa. Reduction of this reflex may be used as a fine index of involvement of the trigeminus in patients with acoustic neuromas. This makes it possible to differentiate this tumour at early stages of its development from neuritis of the acoustic nerve. This is of great importance for this pathological situation. PMID- 2781778 TI - [The need for ambulatory care of persons with minimal brain dysfunction syndrome]. AB - The severity and character of somatomorphic disorders determined by the author as the syndrome of minor brain dysfunction in persons whose relatives suffer of schizophrenia furthers their mental decompensation. Therapy with neurometabolic stimulators and cerebral vasoactive substances normalizes their condition. The author suggests the necessity of prophylactic medical management of this contingent of patients. PMID- 2781777 TI - [Clinical characteristics of acute alcoholic psychoses in adolescents and youth]. PMID- 2781779 TI - [The pathogenesis of vitiligo]. AB - Clinical examination of 74 patients vitiligo revealed concomitant diseases of the skin, endocrine system, nervous system and chronic diseases of the digestive organs. Biochemical studies revealed marked changes at different stages of protein metabolism. Considering this, the authors worked out a method of pathogenetic treatment. PMID- 2781780 TI - [Combined treatment of patients with chronic prostatitis]. AB - Health resort treatment with the purpose of rehabilitation was carried out in 129 patients with chronic prostatitis at health resorts of Lvov Province. Results of the treatment: recovery was noted in 105, improvement--in 19 patients, failures- in 5 patients. The author suggests that it is more rational to treat patients with chronic prostatitis in three stages; stage I--out patient or hospital treatment; stage II--health resort treatment; stage III--treatment at home. Such three-stage treatment of patients with chronic prostatitis increases the recovery rate, prolongs the remission time, reduces the number of readmissions, decrease the time of working capacity loss. PMID- 2781781 TI - Vasectomy complications at a family practice center. AB - Vasectomy is a safe, effective, economical, and convenient form of permanent sterilization since it can be performed in an outpatient setting. Seventy-three vasectomies were performed during a nine-year period at the Kanawha Valley Family Practice Center. The procedures were performed by family practice residents under the active instruction and supervision of the attending staff. The complication type and frequency are as follows: epididymitis, 5.5 per cent; sperm granuloma, 2.7 per cent; wound infection, 1.4 per cent, and hematoma, 12 per cent. No failures occurred in this study group. All of the complications were minor and responded to conservative medical management. The results of this study reveal that vasectomy complications at this teaching family practice center are comparable to those reported in the medical literature. This study therefore supports the opinion that vasectomies can be performed safely and taught by trained family practitioners in the outpatient setting. PMID- 2781782 TI - Gifts of the land. PMID- 2781784 TI - Patients and prescriptions. PMID- 2781783 TI - Impaired physicians who are seeking help. Peer assistance, not public identification. PMID- 2781785 TI - The wildlife fund. PMID- 2781786 TI - [A sarcoma-static new species of Pseudomonas, Pseudomonas jinanensis sp. nov]. AB - A strain of Gram negative bacteria was isolated from the surface soil of Wuying Hill at Jinan, Shandong province with Gause's medium in 1973. It is a strain of antagonistic bacteria for hysterocervicoma, hepatoma and melanoma of mice screened from 2100 strains of bacteria. It is also antagonistic to Staphylococcus aureus, Bacillus subtilis and Micrococcus. It is a Gram negative bacterium with lophotrichous polar flagella. Straight rods in shape or with a little slightly curved rods, 0.5-0.6 X 1-2 microns, randomly arranged, poly-beta-hydroxybutyrate granules are accumulated in cells after 2-5 days cultivation. Water green soluble pigment and green fluorescent pigment are produced. Respiratory metabolism, chemoorganotroph, many carbon-containing organic compounds can be used as carbon sources, such as glucose, trehalose, ethanol, cellulobiose, fucose, arginine and betaine, but propionic acid or tartaric acid is not utilized. Inorganic nitrogen containing compounds can be used ae the sole source of nitrogen. No growth factor is necessary for growth. Gelatin is hydrolyzed. Starch and cellulose are not hydrolyzed. Nitrate is not reduced. Arginine dihydrolase is produced. Levan is produced from sucrose. Growth occurs from 7 degrees C to 37 degrees C and from pH 5.65-8.40. No growth occurs at 40 degrees C and at pH value below 4.86. It can not grow autotrophically with hydrogen. Its G + C contents in DNA is 58.1 mol%. DNA-DNA hybridization experiments reveals a relatedness value of 58.6% between this strain and Ps. fluorescens. The above evidence shows that this strain differs from all species known in Pseudomonas, such as Pseudomonas fluorescens group. Pseudomonas caryophylli, Pseudomonas cepacia, Pseudomonas marginata, Pseudomonas acidovorans, Pseudomonas testosteroni and Pseudomonas delafieldii.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2781787 TI - [Studies on harmful microbes in recirculating cooling water system of oil refinery]. AB - The microbiol counts, type, distribution as well as interrelation between microbial counts and biofouling of the main harmful microbes including slimeforming heterotrophic bacteria, sulfate reducing bacteria, iron bacteria and fungi has been studies in 16 oil refineries of China. The control guideline of the harmful microbes for recirculating cooling water system of refinery were suggested, that is slime-forming bacteria less than 10(5)/ml, sulfate reducing bacteria less than 10(2)/ml. iron bacteria less than 10(3)/ml, fungi less than 10/ml. The appearing rate of the predominant strains from cooling water system of various refineries were calculated and identified and the composition of the main harmful representative microbes in cooling water system were determined. PMID- 2781788 TI - [An electron microscopic study on the ultrastructure and enzyme cytochemistry of Pseudomonas putrefaciens]. AB - In this paper, PTA staining, ultrathin sectioning and electron microscopic enzyme cytochemistry techniques were used to study the ultrastructure, as well as reactivity and localization of catalase and peroxidase in Ps. putrefaciens. Its ultrastructure is similar to that of other gram-negative bacilli. Catalase is distributed in the cytoplasm, while peroxidase localized at cytoplasmic membrane and mesosomes. PMID- 2781789 TI - A philosophy of nursing. PMID- 2781790 TI - Developing questions of substance for nursing science. PMID- 2781791 TI - Issues related to the unit of analysis in family nursing research. PMID- 2781792 TI - The interviewer's experience as data in phenomenological research. PMID- 2781793 TI - Method triangulation to index change in clinical phenomena. PMID- 2781794 TI - Informed consent process in research protocols: dilemmas for clinical nurses. PMID- 2781795 TI - Assessment of perceptual processing deficits in persons with Alzheimer's disease. PMID- 2781796 TI - Nursing assessment: what do nurses want to know? PMID- 2781797 TI - Research in cultural diversity. Qualitative methods in cultural research. II. PMID- 2781798 TI - [Health and its formation]. PMID- 2781799 TI - [Paroxysmal atrial fibrillation as an integral part of sick (damaged) sinus syndrome]. AB - In a studied group of 1727 subjects in 101 cases (of either sex) the sick sinus syndrome with MAS attacks++ was diagnosed on the basis of clinical and electrocardiographic criteria. The most frequent cause of the syndrome with paroxysmal atrial fibrillation was ischaemic heart disease. In 42 cases atrial pacing was applied measuring the time of own rhythm return after the end of pacing, and His bundle potentials were recorded. For practical reasons the patients were divided in two groups. Trials of treatment with atropine or isopropylnoradrenaline derivatives++ were undertaken in group A, and in group B antiarrhythmic++ drugs were used (beta-blockers, quinidine, isoptin etc). In group I (38 patients with striking bradycardia) a good therapeutic effect was observed after pharmacological treatment in 8 cases (21%). In group II (63 cases of the tachy-bradycardia syndrome) a good effect was observed in 11 cases (17.4%). PMID- 2781800 TI - [Triiodothyronine (T3) and thyroxine (T4) levels in patients with bronchial asthma]. AB - In 212 patients with bronchial asthma and 115 healthy controls the serum levels of T4 and T3 were determined. In patients not treated with corticosteroids a statistically significant rise of T3 and fall of T4 were noted. These changes were non-significantly smaller in the patients with pronounced dyspnea . During long-term corticoid++ therapy a tendency was observed for normalization of these changes. PMID- 2781801 TI - [Usefulness of thermographic examination in the diagnosis of early peripheral ischemia of the extremities in patients with diabetes mellitus]. AB - Vascular damage is the main complication of diabetes. An early sign of this complication is damage to the arterial and capillary vessels in the lower extremities with later impairment of peripheral blood flow. The aim of the present study was evaluation of the usefulness of thermography in the detection of early circulatory disturbances in the lower extremities during diabetes, and comparison of its results with those obtained in oscillometry. The study comprised 28 patients with type I diabetes aged from 16 to 57 years and 27 patients with type II diabetes aged from 35 to 65 years. The control group included 10 clinically health subjects in similar age group. It was found that thermographic changes were much more frequent than pains in the extremities and abnormal values of oscillometric++ index in diabetes type I and II. Nearly half the patients with evident thermographic disturbances had no oscillometric changes, and 2/3 of the patients felt no pains in the extremities. PMID- 2781803 TI - [Use of partusisten in cases of placenta praevia and the incidence of respiratory distress syndrome in newborn infants]. AB - Partusisten (Th 1165a, fenoterol) was given to 40 pregnant women aged from 19 to 39 years in whom ultrasonography demonstrated placenta praevia. Bleeding occurred between 21 and 36 weeks of pregnancy. The control group consisted of 44 pregnant women aged from 21 to 43 years not treated with partusisten. Bleeding in this group developed between 22 and 40 weeks of pregnancy. The authors conclude that partusisten use in cases of bleeding from placenta praevia in adequate doses and at adequate time make possible prolongation of pregnancy duration which increases the progression of lung maturation in the fetus and enabling reaching of relative biological maturity. This reduces the incidence of neonatal respiratory distress syndrome, and is the method of choice if genital bleeding develops prior to the 32nd week of pregnancy. PMID- 2781804 TI - [Parathyroid hormone and blood pressure in patients with chronic renal failure treated by repeated hemodialysis]. AB - In 36 patients with chronic renal failure treated with repeated haemodialyses the relationship was studied between the level of the C-terminal fragment of the parathyroid hormone in the serum and arterial blood pressure. Depending on the value of the concentration of this C-fragment the patients were divided into three groups: I with concentration below 200 pg/ml, II with concentration 2000 5000 pg/ml, III over 500 pg/ml. In the first group a statistically significant correlation was found between the concentration of the C-terminal fragment of the hormone in the serum and the values of systolic arterial pressure (r = 0.687; p less than 0.05) and diastlic pressure (0 = 0.637; p less than 0.05). PMID- 2781802 TI - [CA 19-9 and CA 125 antigens in the sera of patients with cancer of the large intestine in relation to its clinical progress]. AB - By radioimmunoassay the concentration of the CA 19-9 antigen was determined in the serum of 68 patients with large bowel cancer, while the CA 125 antigen was determined in 26 patients with this disease. Both markers were determined with CIS kits. In all, 127 determinations were done. The results were as follows: 1) CA 19-9 concentration increased with disease progression from 21% (in grade I of local-regional progression, A, B, C according to Dukes), through 41% above-normal results in group II (with metastases--Dukes' grade D), to 67% in case of recurrence of the tumor, and to 0% in group IV--with absent recurrence sign after radical surgical intervention. 2) CA 125 is without clinical value in large bowel cancer. PMID- 2781805 TI - [Bilateral parathyroid adenoma]. AB - A patient with multiple parathyroid adenomas is reported. Their size was considerable, and the course of primary hyperparathyroidism was stormy. A rapid regression of symptoms followed surgical treatment. The rarity of multiple parathyroid adenomas of large size is stressed. PMID- 2781806 TI - [Bilateral testicular neoplasms]. AB - Three cases of bilateral testicular neoplasms were found in 112 patients treated in the last 7 years. In two patients bilateral seminoma developed at various time periods. In one case seminoma coexisted with germinal carcinoma. PMID- 2781807 TI - [Treatment of acute diarrhea in infants and young children with a new formulated oral rehydration solution]. AB - 49 infants and children with acute diarrhea with mild to moderate dehydration have been rehydrated orally with a newly composed oral rehydration solution. This solution differs from the traditional WHO recommended rehydration solution in a lower sodium content of 60 mval/l and replacement of bicarbonate 25 mval/l by an equimolar amount of citrate. The taste of the solution was improved by addition of flavour. All infants and children - including 8 infants less than 3 months of age - were successfully rehydrated. The solution was well accepted; no side effects have been observed. The sodium content remained normal in all patients. PMID- 2781808 TI - [Morphology, clinical aspects and therapy of perinatal hypoxic central nervous system damage. A pedoneuropsychiatric follow-up analysis in relation to the neurohistologic spectrum of findings]. AB - The histological localization and extent of ZNS-lesions caused by perinatal hypoxia has been examined in 83 cases. The neuropsychiatrical patterns of 71 in preschool and school age children after perinatal hypoxia were also investigated. Predominantly a brain stem damage with nerve cells lesions, hemorrhages and disturbance of neuroglia are found. In 1 fourth of the cases, nerve cell damage was localized in the medulla spinalis. Intramedullar hemorrhages can be observed in 10% of the cases. 41% of the cases showed subarachnoidal bleedings. Neuropsychiatrical examinations showed varying degrees of brain stem dysfunction in accordance with neurohistological findings. 1 third of the risk children demonstrated minimal brain dysfunction. In 10% an early rehabilitation of resulted in an amelioration of the ZNS-function. Special attention should be drawn to partial ZNS-disturbance-children. The problems of therapy are discussed. PMID- 2781809 TI - Proportions of cancer deaths attributable to cigarette smoking in women. AB - Over two-thirds of a million American women mostly over age 45 were enrolled in a prospective mortality study in 1982 and followed up for four years. In this time period 1,527 women died of six smoking-related cancer sites: oral cavity, esophagus, pancreas, larynx, lung, and bladder. Age-adjusted death rates in nonsmokers were used to obtain smoking-attributable risks and numbers of deaths due to these six cancers. Among current smokers, 601 deaths (85.5% of current smokers' deaths) were attributable to cigarette smoking, and among former smokers 284 (69.3% of ex-smokers' deaths) were attributable to smoking. Cigarette smoking accounted for 885 excess deaths at these sites, giving a population-attributable risk of 57.9%. Over three-quarters of these excess deaths were due to lung cancer. Cigarette smoking, despite increases in smoking cessation, is still responsible for well over half of the deaths from these six types of cancer in women. PMID- 2781810 TI - Childbearing and women's choice of nurse-midwives in Washington, D.C. hospitals. AB - This research focuses on the extent to which choosing a certified nurse-midwife (CNM) for the management of birth in the hospital is an option. Licensing laws affect this option by determining access to hospitals for CNMs in the form of hospital practice privileges. Data for this descriptive case study of Washington, D.C. hospitals were collected from interviews with CNMs and hospital personnel, including physicians, and from secondary sources, including legislative acts and hospital bylaws. Our findings suggest that although the option for a CNM managed birth has increased in the District with the granting of hospital privileges to CNMs in 3 of 9 hospitals providing obstetrical services, restrictions on CNM practice still exist. These are the capacity to admit patients in the CNMs' name and the issue of supervision of CNMs by a physician in the hospital. PMID- 2781811 TI - Choice of a childbirth method after cesarean. AB - Concern about the rising cesarean-section rate and the high percentage of elective repeat cesareans led to an exploratory, retrospective examination of women's decision-making about a childbirth method after cesarean. Fifty women who had delivered by a repeat cesarean (RC) or vaginal birth after cesarean (VBAC) participated in a telephone interview. Three questions were addressed: (1) who made the decision for a birth method; (2) what factors were associated with the choice of method; and (3) was the choice of method associated with the actual method of delivery? The majority of women (90%) perceived that they were the primary decision-maker for a birth method, and choice of birth method was positively associated with actual method of delivery. The major reason for VBAC choice was to experience a vaginal birth, whereas the primary reason for RC choice was to avoid an unsuccessful labor. Other factors associated with choice of a birth method were: sources of information and support, beliefs, previous cesarean experience and locus of control. These findings have important implications for enhancing women's health-care decision-making, as well as for reducing the rate of repeat-cesarean deliveries. PMID- 2781812 TI - Feminism and regulation collide: the Food and Drug Administration's approval of the cervical cap. AB - In May 1988, the Prentif Cavity Rim cervical cap, a barrier method of contraception, was approved by the Food and Drug Administration (FDA) for contraceptive purposes in the United States. This paper describes some of the events leading to the approval of the cervical cap as a contraceptive. Of major interest is the unprecedented involvement of the feminist health movement in clinic-based research, policy making, and distribution of the cervical cap. The recall of the Vimule cervical cap, the use of lay health workers in fitting an experimental device, and the feminist providers' response to the FDA's regulation of the cervical cap are detailed. PMID- 2781813 TI - Testing and reporting of AIDS and HIV. PMID- 2781814 TI - OCI rules. PMID- 2781816 TI - Information and testing sites. PMID- 2781815 TI - Wisconsin's AZT reimbursement program. PMID- 2781817 TI - Wisconsin's partner referral program. PMID- 2781819 TI - Lyme hysteria. PMID- 2781820 TI - Observations of the liability crisis. PMID- 2781818 TI - AMA policy on treating AIDS patients. PMID- 2781822 TI - [2d national meeting of the East German Society of Emergency Medicine. 14-16 January, Dresden]. PMID- 2781821 TI - Passive euthanasia and dying with dignity. PMID- 2781823 TI - [Responsibilities of socialist law within the scope of emergency medicine and basic requirements of medical responsibility in an emergency]. PMID- 2781824 TI - [Responsibility of the medical specialty faculty and employees of the emergency medicine patient transport system in organized emergency medicine]. PMID- 2781825 TI - [Legal and ethical questions of emergency medicine with reference to exceptions]. PMID- 2781826 TI - [Emergency medicine, a medical and social responsibility]. PMID- 2781827 TI - [Responsibility of emergency medical service dispatchers for indications relevant intervention]. PMID- 2781828 TI - [Improving emergency medicine management is a function of emergency medicine education: criteria for use and qualification markers for physicians in emergency medical service]. PMID- 2781829 TI - [Medical management of the alcohol intoxicated patient--stepchild of emergency medicine?]. PMID- 2781830 TI - [Experiences of 10 years' cooperation between emergency medical service, forensic medicine and the German public police]. PMID- 2781831 TI - [Administration of drugs in emergency medical care]. PMID- 2781832 TI - [Possibilities and limits of toxicologic analysis in the concept of treatment]. PMID- 2781833 TI - [Treatment of poisoning with anti-arrhythmia agents and glycosides]. PMID- 2781834 TI - Isolated acinar cells from rat pancreas in pathogenic studies on acute pancreatitis. AB - In the pathogenesis of acute pancreatitis the events and mechanisms increasing the digestibility of the acinar cells are widely unknown. To study these processes at cellular level, isolated exocrine cells from rat pancreas were utilized as experimental tool. The investigations revealed that extracellularly acting noxae seem to be of less importance to triggering autodigestion. The plasma membrane of the acinar cells was relatively resistant to extracellular trypsin, while anoxia or uncoupling of oxidative phosphorylation obviously reduced the survival of these cells. Combined action of small amounts of trypsin and partial uncoupling resulted in a potentiated cell destruction. The findings presented stress the importance of a well-functioning energy metabolism for the protective potential of acinar cells to further harmful conditions. PMID- 2781835 TI - Biostability of polyurethanes. AB - Aside from the medical requirements a material has to fulfill to qualify as biocompatible, for the bioengineer, who is involved in the design, construction and fabrication of prosthetic devices, the mechanical, physical and chemical properties of the material as well as its possible manufacturing procedures and, last but not least, its biostability are of the same importance. In the very aggressive biological environment, the material should behave inertly, showing no surface erosions, molecular chain disruptions, uptake of low molecular weight biological materials, local chemical imbalances, tendency to calcification or negative changes of mechanical properties. With regard to this aspect, different polyurethanes have been evaluated in-vitro and in-vivo as basic materials and already fabricated devices (blood pumps and heart valves). The comparison of the results stresses the necessity of further efforts to achieve a standardized test protocol for the prove of the biostability of polymers, containing appropriate, well-defined in-vitro and in-vivo test methods to establish the necessary data basa for the materials' clinical approval. PMID- 2781836 TI - [Comparative animal experiments of different tissue adhesives. I. Tensile strength studies. II. Histologic and morphometric studies]. AB - This paper for the first time presents the results of extensive histological and histomorphometric studies investigating the tensile strength of tissue adhesives in model experiments on animals. The material used in comparative studies were TISSEEL, a human adhesive based on fibrinogen, HISTOACRYL-blue, a cyanoacrylate, and KL-3, a type of urethane adhesive. All the materials used in these studies were shown to be principally suitable as tissue adhesives. TISSEEL, the biological adhesive, was obviously superior to all the other adhesives whereas the two synthetic adhesives HISTOACRYL-blue and KL-3 were found to be roughly equal in their properties. The animal model described in the present paper is recommended for use as a standard technique for testing the suitability of new tissue adhesives. PMID- 2781837 TI - [Histochemical determination of vitality limits after the use of neodymium-YAG lasers on parenchymatous organs]. AB - Specific pediatric surgical problems, specially the hemisplenectomy and the partial liver resection in newborns and small children, offer a new indication for the laser beam. Special morphologic characteristics, like small organs and small vessels diameter, make the laser an useful procedure in children. With help of a histochemical technic could be shown a defined necrosis area - in dependence of the laser dose - in liver, spleen and kidney of rabbits under standard laser photocoagulation. Five days after the partial organ resection one could observe a well defined vital border, and after one week an invasive growing fibrotic tissue into the necrosis area, which would form the new capsula. No cases of infection or bleeding were present (84 partial organ resections). Using known doses one can exactly calculate the area of necrosis and evaporation. PMID- 2781839 TI - [The configuration frequency analysis. Victor's singular types and syndromes]. AB - A new concept on configural frequency analysis (CFA) is presented under the title: CFA, Victor's singular types and syndromes. The new concept is suitable and highly effective if one and only one type, a singular type, is present within a population of subjects or patients. It is based on the nullhypothesis of quasi independence which assumes that a type-population with coincident variables is superimposed to a residual population with independent variables. The singular type CFA is illustrated by a set of data where a subgroup of dyslexics is mixed up with a residual group of non-dyslexics who have been evaluated as to reading, vocabulary and spelling. The resulting type, not to be identified by classical CFA, was shown to be singular and clear-cut with weakness in all 3 verbal tests. The importance of singular types and syndromes for psychopathology is discussed clinically and theoretically. PMID- 2781838 TI - [Clinico-experimental studies of the effect of the form of anesthesia on the postoperative small intestinal absorption]. AB - The behaviour of the small bowel absorption in the immediate postoperative phase after cholecystectomy was tested in 20 patients by means of the modified D-xylose test. Either the conventional insufflation anesthesia with halothane or the neuroleptic analgesia was used in 10 patients in each case. Characteristic changes of the small bowel absorption were provable after the operation. The postoperative restriction of the absorption was not changed statistically significantly in dependence on the different anesthesia methods. An absorption without restriction exists in both groups at the beginning of the 3rd post operative day. PMID- 2781840 TI - [Compliance in forms of drug therapy with special reference to aspects of trust]. AB - This study investigates the compliance in respect to medication. Because of the so far wide ranging and often methodologically differing ways of documentation and description of compliance, we first had to start by determining the term in accordance with the current scientific discussion. The following step was to demonstrate similarities and differences of the compliance in relation to trust by empirical data. Empirical methods: A sample of ten persons was interviewed by a semi-standardized questionnaire, in order to find the constructs of compliance and trust in reference to the medication. These interviews were based on a theoretical analysis. The evaluation of the interview showed 21 constructs for compliance and 14 constructs for the description of trust in the therapeutic situation. These constructs were combined with control questions in a likert rated questionnaire, which was answered by 160 representative test persons. From the thus required data 6 factors of compliance and 5 factors of the trust were isolated in a factor analysis. A comparison of compliance and trust by a regression-analysis showed that it is not possible to exchange both constructs completely. The limit of the exchangeability is given by medical factors such as side-effects or the knowledge about a given medication. Thus it was demonstrated that it is possible to increase compliance by trust. However, compliance is made up by different factors which are hardly modified by trust. PMID- 2781841 TI - [Motivation and emotional disorders: a cognitive science approach. II: Strategies for intervention]. AB - In this paper, a Cognitive Science theory of motivational cognitive and emotional processes is applied to clinical psychology. We are demonstrating that a dynamic view of psychiatric disturbances and diagnoses can be derived from this theory (part I). In part II it is shown that-as a by-product-the theory allows to classify from a neutral "meta-perspective" different psychotherapeutic approaches in treating motivational and emotional disturbances (e.g., classical behaviour therapy, cognitive psychotherapy, client centered therapy, medical treatments, creative therapies and psychoanalysis). This is illustrated by theoretical analyses and a clinical example. We are intending to contribute to a deeper dialogue between the different psychotherapeutic schools in understanding in detail the communalities and the differences of some psychotherapeutic approaches. PMID- 2781842 TI - [A case report on the phenomenology and psychodynamics of pain in acute myocardial infarct]. AB - The experience of pain during an acute heart attack is analysed from a phenomenological perspective. It can be shown that the intensity of the pain challenges the myocardial infarction patient's ideal of autonomy and confronts him with dependencies-the dependency on one's body, the dependency on other people-that make him feel ashamed. Thus, emotions of anxiety and shame are often present during the process of coping with pain. The interactional relationships of the patient seem to play an important role in the development of these feelings. PMID- 2781843 TI - [Biography and transcendence within the human psychotherapy image]. AB - However "psychical" is defined it presumes a view of man, his personality and incarnation of the world, that may no longer be justified by psychology itself. Disclosing of the according conception of man in the philosophical sense fortunately therefore belongs today to a critical self-understanding of the various schools in psychotherapy. Besides the attempt of profiting universally from this plurality of methods there may be seen a certain tendency of rediscovering a faithful biographics as anthropological consensus. It is without any doubt a necessary part of rehumanized education of psychiatrists to elucidate it beyond its immediate affective, cognitive and social importance. PMID- 2781844 TI - [Abstracts of the autumn meeting of the German Society for Cardiovascular Research. 5-7 October 1989, Wurzburg]. PMID- 2781845 TI - [Use of analytic density gradient ultracentrifugation for the study of cholesterol distribution between the lipoprotein fractions of serum]. AB - 1 ml serum were fractionated by analytical ultracentrifugation in a density gradient in the lipoproteins chylomicron/VLDL, LDL, HDL-2 and HDL-3 and the bottom-fraction. The sudan black prestained lipoprotein fractions were separated under visual control. The cholesterol content in the different lipoproteins was determined with the methods according AB (D.L.) and with the cholesterol oxidase/catalase-method. Both methods gives good reproducible and highly correlated results. With the AB (D.L.) method about 97% of the serum cholesterol concentration can be found in the lipoprotein fractions whereas with the enzymatic method about 87% can be detected. By a correlation coefficient of r = 0.989 the AB (D.L.) method gives about 0.30 mmol/l higher cholesterol values compared with the cholesterol oxidase catalase-method. The analytical ultracentrifugation can be recommended for the investigation of the cholesterol distribution between the lipoproteins also in clinical and smaller epidemiological studies. PMID- 2781846 TI - [The behavior of C-reactive protein in tumor patients]. AB - Within a standardized therapy programme in 110 tumour patients the concentrations of CRP were investigated in order to allow an estimation of the prognostic value of this parameter. In the group of patients with a bad prognosis under clinical aspects the concentrations of CRP were clearly above the range of reference throughout the period of therapy, whereas the group with a good clinical prognosis showed a continuous falling of the concentrations. PMID- 2781847 TI - [Post-proline hydrolysis activities in cerebrospinal fluid]. AB - Post-proline hydrolytic-activity exists in various tissues and body fluids of human organism. Using electrophoretic techniques, column chromatographic methods and kinetic investigations two peaks of proteolytic activity towards glycyl prolyl-p-nitroanilide were detected in human cerebrospinal fluid. The identity of one enzyme with dipeptidylpeptidase IV (EC 3.4.14.5) must now constitute proof of this. Among 650 patients with cerebral diseases, characterised by post-proline hydrolytic activity in cerebrospinal fluid, high enzyme activity coincide with bacterial meningitis. Furthermore, all bacteria which could be isolated from cerebrospinal fluid exhibit high activities of post-proline cleaving hydrolases. Until now, the origin of the cerebrospinal post proline hydrolytic activity is not clear, although our investigations suggested, that lymphocytes, cerebral parenchyma and bacteria may be involved in the enzyme secretion. PMID- 2781848 TI - [The measuring of the spontaneous migration of granulocytes in capillaries]. AB - The spontaneous migration of polymorphonuclear granulocytes can be measured exactly in capillaries of 50 mm length, 0.92 mm innerdiameter and capacity of 33 +/- 0.5 microliters. The following conditions revealed to be the optimum: 1 x 10(6) cells per capillary and incubation at 37 degrees C for 3 h. PMID- 2781849 TI - [Orienting determination of the therapeutic effectiveness of blood transfusions]. PMID- 2781850 TI - [Use of vertical photometry in clinical chemistry]. PMID- 2781851 TI - [Possibilities for the assembly of a cuvette tempering system for a spectral photometer of the SPECORD, VSU-2 and SPEKOL type]. PMID- 2781852 TI - [Autofluorescence of sera--a trouble factor in the KAPA test]. PMID- 2781853 TI - [Experiences with the enrichment of cerebrospinal fluid proteins by the Sartorius Centrisart system]. PMID- 2781854 TI - Pertussis. PMID- 2781855 TI - Effect of the administration of oral poliovirus vaccine on infantile diarrhoea mortality. AB - Infectious diarrhoea is one leading cause of infantile mortality in developing countries. Rotaviruses and other enteroviruses have an important role in diarrhoea but, currently, there are no vaccines available to immunize infants. The use of oral poliovirus vaccine (OPV) over two decades has shown that, besides protecting effectively against poliomyelitis, it can interfere with intestinal infection by other enteroviruses. This interference by the vaccine viruses could explain two epidemiological observations showing that repeated and massive administration of OPV was followed by a statistically significant decrease of infantile diarrhoea mortality. OPV administration could have two objectives: to prevent poliomyelitis and to reduce infantile diarrhoea of viral aetiology. PMID- 2781856 TI - Poly(butyl-2-cyanoacrylate) particles as adjuvants for oral immunization. AB - The potential oral adjuvanticity of a colloidal carrier system for an adsorbed antigen was investigated and the effect of particle size of the carrier was partially determined. Ovalbumin was adsorbed onto poly(butyl-2-cyanoacrylate) particles of two different sizes and administered orally to rats previously primed by intraperitoneal injection. After 14 and 50 days, the secretory immune responses were significantly increased for animals gastrically intubated with ovalbumin adsorbed to 100 nm particles, relative to a control group response to soluble antigen. PMID- 2781857 TI - Effect of hyperreactivity to endotoxin on the toxicity of pertussis vaccine and pertussis toxin in mice. AB - In mice, greatly enhanced susceptibility to the lethal toxicity of whole-cell pertussis vaccine (PV) was produced by agents known to induce hypersusceptibility to endotoxin (LPS). The decreases in LD50 were 100-fold, 125-fold and 16-fold with galactosamine (GalN), actinomycin D (AcD) and lead acetate (PbAc) respectively and the animals died within 1-2 days. However, these decreases were less than those observed with extracted E. coli LPS, the LD50 of which was reduced approximately 500-fold, 800-fold and 50-fold respectively by these agents. In control mice, without drugs, the main lethal factor in the PV used here seemed to be pertussis toxin (PT), since deaths occurred at 3-5 days after injection, and heating the vaccine at 80 degrees C for 30 min raised the LD50 from 4 to greater than 6 single human doses (SHD) per mouse. In GalN and PbAc treated mice, the toxicity of PV can be explained by its LPS content in view of the failure of heating at 80 degrees C to reduce toxicity. However, in AcD treated mice, the 80 degrees C heated vaccine was threefold less toxic than the unheated material, suggesting a contribution of PT to vaccine toxicity in these animals. Indeed the toxicity of PT was increased by AcD. The possible bearing of these observations on children who appear to show serious adverse reactions to PV is discussed. Two acellular vaccines were devoid of lethal toxicity in either normal mice or in mice treated with any of the three drugs. PMID- 2781858 TI - Immunoenhancement with combined rabies and aluminium-adjuvanted tetanus vaccines. AB - The effect of combining tetanus toxoid in the same syringe with purified Vero cell rabies vaccine (PVRV) was investigated in the 2-1-1 regimen of PVRV. The 2-1 1 regimen alone was as immunogenic as the five-dose regimen, while saving one dose of vaccine and two clinic visits. When aluminium hydroxide-adsorbed tetanus toxoid was used to dissolve PVRV on days 0 (one of the two doses) and 21, the anti-rabies antibody was significantly increased. Aluminium-free tetanus toxoid was ineffective, suggesting that immunoenhancement was due to aluminium adjuvant. In addition, anti-tetanus antibody was unaffected and the side-effects were not increased by such mixing. PMID- 2781859 TI - Enhancement of protective antibody responses by cholera toxin B subunit inoculated intranasally with influenza vaccine. AB - Effects of the B subunit of cholera toxin (CTB) on the primary antibody responses to influenza virus A/PR/8/34 (PR-8) (H1N1) HA vaccine and on protection against viral challenge were investigated in Balb/c mice which were immunized intranasally with both the vaccine and CTB. The dose of CTB (greater than or equal to 1 microgram) inoculated with the vaccine (greater than or equal to 0.15 microgram) induced high responses of both antiviral IgA antibodies in the nasal wash and haemagglutinin-inhibiting (HI) antibody in the serum, enough to provide complete protection against viral challenge four weeks after immunization. High levels of antibody were maintained for more than 16 weeks after inoculation, affording complete protection during this interval. The inoculation of HA vaccine prepared from influenza viruses A/Yamagata/120/86 (H1N1) or A/Fukuoka/C29/85 (H3N2) together with CTB provided partial protection against PR-8 infection, with production of antiviral IgA antibodies which were cross-reactive to PR-8 antigens whereas immunization with CTB and HA vaccine prepared from a different type of influenza virus (B/Ibaraki/2/85) failed to protect against PR-8 infection. These results indicate that CTB can produce an augmented and persistent antibody response to PR-8 HA vaccine, which is cross-protective to other A-type virus infections. The mechanisms by which CTB enhances the protective antibody responses to the nasally inoculated vaccine were investigated. The ability of CTB to augment antibody responses was lost, either when CTB was inoculated via the intravenous or subcutaneous route, or when CTB was introduced into nasal site one day before or after the vaccine inoculation.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2781861 TI - Physical fitness and the high school athlete. PMID- 2781860 TI - Lethal toxicity and adjuvant activities of synthetic TDM and its related compounds in mice. AB - Trehalose-6,6'-dimycolate (TDM) and its monosaccharide-type analogues were synthesized, and their lethal and adjuvant activities were examined in mice. All the monosaccharide-type analogues with a glucose or N-acetylglucosamine moiety were devoid of lethal toxicity to mice; in particular, D-GlcNAcM(1-deoxy) and D GlcNM did not cause any loss of body weight at an early stage after intravenous administration as a 9% oil-in-water emulsion. Intraperitoneal administration of D GlcNAcM(1-deoxy) in aqueous suspension, as well as TDM, could activate macrophages to become tumoricidal against tumour cells, whereas D-GlcNAcM(1 deoxy) in oil emulsion, unlike TDM, caused no granulomatous formation in the lung after intravenous injection. Squalane-treated D-GlcNAcM(1-deoxy) showed significant inhibition of spontaneous lung metastases by B16-BL6 melanoma cells when it was administered twice intratumorally. The non-toxic monosaccharide-type analogue of TDM [D-GlcNAcM(1-deoxy)] was a beneficial adjuvant for the activation of macrophages and the prevention of cancer metastasis. PMID- 2781862 TI - New medical standards for Virginia's high school athletes. AB - Virginia physicians administering preparticipation physicals to high school athletes this fall are using the new, expanded examination form that appears in this issue. Representing multidisciplinary input and incorporating current sports medicine information, the form is designed to identify the student at high risk for injury and to evaluate for a specific sport. After a two-year pilot program conducted by the authors the new form was officially adopted by the Virginia High School League. PMID- 2781863 TI - Urinary calculus: high-tech changes a urology practice. PMID- 2781865 TI - Medical students. PMID- 2781866 TI - Making a decision. PMID- 2781864 TI - Consultation patterns in an urban hospital setting. PMID- 2781867 TI - Growth of Staphylococcus aureus and synthesis of enterotoxins in home-made yoghurt. AB - Staphylococcus aureus strains FRI-100, S6, FRI-137 and FRI 472 were inoculated into milk to study growth and enterotoxin production in home-made yogurts. The yogurt used as starter was progressively weakened by successive inoculations (up to four) in milk to prepare other yogurts in order to study the ability of yogurt microflora to inhibit staphylococci. After elaboration, yogurts were stored at 4 degrees C, 22 degrees C, and 37 degrees C for a maximum of 21 days. Periodically, staphylococcal counts, pH and the production of enterotoxins A, B, C, and D were determined. Enterotoxins were only detected in the last batch. It was concluded that the inhibitory effect of the starter culture is not only due to the decrease of pH, but also to other factors. PMID- 2781868 TI - Headspace--gas chromatographic determination of inorganic bromide residues in vegetables. AB - This study describes a headspace gas-chromatographic method for the quantitative determination of inorganic bromide in vegetables. Different parameters influencing the reaction of the bromide ion into 2-bromoethanol have been investigated. The analysis of 2-bromoethanol is performed by the headspace- electron capture--gas chromatographic technique using a fused silica capillary column CP wax 52 CB. Recoveries of 99.75% +/- 4.1% have been obtained for bromide concentrations of 5 up to 350 mg/kg. Sixty-nine samples have been analysed by this method. The results are in good agreement with the normal bromide extraction method. The absolute detection limit is 2 ng corresponding to 0.5 mg Br-/kg for a slit ratio of 1:10. PMID- 2781869 TI - Radioactivity in total diet before and after the Chernobyl reactor accident. The situation in the Federal Republic of Germany. AB - Radioactivity in total diet samples (1-day rations of adults) has been determined in the Federal Republic of Germany since 1960. Average intake of cesium-137 was 8.9 Bq per day and per person (Bq/d.p) in 1964, 0.15 in 1985, 4.2 in 1986, 7.2 in 1987, and 2.0 in 1988. Cesium-134, not measureable in pre-Chernobyl fallout, averaged 2.0 Bq/d.p in 1986, 3.0 in 1987, and 0.6 in 1988. Intake of strontium-90 was in the same range as in the years preceding the Chernobyl accident. It is estimated that the total effective equivalent dose for adults due to ingestion of Chernobyl-released radionuclides, including iodine-131, will be 0.14 +/- 0.08 mSv. PMID- 2781870 TI - Chemometric studies of some trace elements in cows' milk. AB - The matrix of the correlation between the concentrations of 11 trace elements determined in 45 samples of cows' milk was used as a starting matrix for principal component analysis. The space dimension was reduced from 11 variables to 5 principal components, accounting for about 80% of the total variance. After an orthogonal rotation, the first factor (F1) was found to be positively correlated with Cr, Mn, and Fe, F2 positively correlated with Ni and negatively with Cu, F3 positively with Cd and Pb, F4 positively with Zn, Sr, and Mo and F5 positively correlated with A1 and Sr. Element clusters appear to be determined by their origin. Some clusters are confirmed by principal factor analysis. A plot of the principal component scores was also applied to the differentiation of Italian Milk from different geographical origins. PMID- 2781871 TI - Clenbuterol residue analysis by HPLC-HPTLC in urine and animal tissues. AB - A method for clenbuterol residue analysis in urine and animal tissues has been developed. The detection limits are 0.25 micrograms/l and 0.5 micrograms/kg, respectively. The recovery in urine varies from 85% to 90% and in animal tissues from 70% to 74%. The beta 2-agonist was liberated from the tissues by an enzymatic digestion, purified on Chem Elut columns using alkaline conditions and extracted with 0.01 mol/l HCl. Clenbuterol was quantified by high-performance liquid chromatography (HPLC) on a RP-8 column and a post-column reaction procedure. High-performance thin-layer chromatography (HPTLC) was performed on silica gel 60 plates and clenbuterol visualized by means of the modified Ehrlich's TLC spray reagent. Since this method is sensitive, as is HPLC, it was used to obtain a confirmation and to exclude false positive results. PMID- 2781872 TI - Automated turbidimetry for the rapid differentiation and enumeration of bacteria in food. AB - A fully automated analysis system has been used to determine bacterial contamination in food, both qualitatively and quantitatively. Growth curves of bacterial flora were monitored using differential media, and a correlation was established between growth curve parameters and colony-forming units derived from drop-plating as the reference method. Optimal correlation was reached by multiple linear regression. The results were already obtained 16 h. PMID- 2781873 TI - [Localized pressure pain in the diagnosis of generalized tendomyopathy (fibromyalgia)]. AB - 56 tender points were examined in 100 patients and 50 age- and sex-matched healthy volunteers using a dolorimeter. 24 of the 56 points were especially selected according to ability of discrimination, best possible distribution on the body, and easy localization. All 56 points as well as the 24 specially selected points were examined as to their sensitivity and specificity in the diagnosis of generalized tendomyopathy. The sensitivity and the specificity for both point-combinations were acceptable. The sensitivity and specificity of the 24 points were superior to the 56 points in the case of discrimination ability. A 100% sensitivity and specificity could not, however, be achieved. It remains to be considered if functional and vegetative symptoms must still be used to support the diagnosis of generalized tendomyopathy (fibromyalgia). PMID- 2781874 TI - [Assessment of the functional origin of shoulder pain in chronic polyarthritis by diagnostic local anesthesia of inflamed distal joints. A pilot study]. AB - We examined 40 patients with rheumatoid arthritis suffering from painful shoulder. While the shoulder itself was not treated, Mepivacain was injected into an arthritic joint of wrist or elbow. In 36 out of 40 patients we achieved full or partial improvement of pain and movement of the shoulder. We conclude that pain in the shoulder of these patients was caused by a regulatory mechanism, triggered by nociceptors in an arthritic distal joint in order to protect this damaged structure. The therapeutic consequence implies treatment of the distal joint rather than treatment of the painful shoulder itself. PMID- 2781875 TI - [Familial Mediterranean fever--an important differential diagnosis in systemic juvenile chronic arthritis]. AB - Familial Mediterranean Fever (FMF), characterized by recurring episodes of fever, serositis, arthritis, skin changes and complicated by amyloidosis in 30%-60% of cases frequently begins in childhood. Systemic juvenile rheumatoid arthritis (systemic JRA, Still's disease) is the most important differential diagnosis. In our series of 10 patients the mean age of onset was 4.9 +/- 2.2 years (range 2-9 years). The mean time period elapsed before the diagnosis was established was 4.1 +/- 2.7 years (range 1.5-10 years). Three of our 10 patients already had developed renal amyloidosis at the time of diagnosis. Essential criteria for differential diagnosis against systemic JRA were positive family history for FMF (4/10), ethnic background (9/10 of Turkish decent), typical erysipeloid skin rashes (4/10), attacks of abdominal pain accompanied by fever (10/10) and the characteristic pattern of recurrent episodes lasting only a few days each (a patient's diary monitoring the attacks may be helpful). In problematic cases the metaraminol provocative test can be helpful. If an elevated plasma dopamine beta hydroxylase activity appears to be a specific finding in FMF patients, this may well open up new avenues in the early diagnosis of the disease. Since amyloidosis can be prevented by prophylactic long lasting treatment with colchicine, a timely diagnosis of FMF is the physician's challenge. PMID- 2781876 TI - [The special case. Thyrogenic acropachy]. AB - Thyroid acropachy is a typical, though rare complication, of Graves' disease. It is seen in about 1% patients, often after a course of several years. It may occur while the patient is euthyroid, hyper- or hypothyroid. In most cases it is part of a syndrome including exophthalmos and pretibial myxedema. We describe the course of a patient's disease and discuss the criteria of diagnosis as well as the possible pathogenetic role of antithyroid immunoglobulins in thyroid acropachy. PMID- 2781877 TI - [Microbiological development studies in a clinically healthy, closed primate colony (Macaca mulatta, Macaca arctoides) after the establishment of a Salmonella infection]. AB - A case of a Salmonella infantis septicemia in a primate (Macaca mulatta) probably induced by shipment stress gave rise to microbiological examination of fecal samples from all animals of a since 1976 closed colony of Macaca mulatta and Macaca arctoides. During 3 investigations carried out in 3 week intervals salmonella-positive animals were separated immediately from the stock. At the first examination 3 of 52, and at the second 2 of 49 samples were found to be salmonella-positive. At the third series all of the remaining 47 animals proved to be salmonella-negative. All isolates were identified as S. infantis. Feeding of contaminated, dried prawns was suspected as the most probable source of infection. A simultaneous examination of 96 of the stool specimens revealed Y. enterocolitica in 4 samples. Additionally, electron-microscopy of pooled fecal samples (3 to 4 animals each) led to demonstration of corona-, adenovirus and small round virus-like particles in one pool each. Moreover, coronavirus-like particles could be detected in 7 of 13 (1st examination series), 5 of 15 (2nd series) and 1 of 13 pools (3rd series). PMID- 2781878 TI - Reduction of fluid intake in the guineapig as a measure of adaptability to new housing conditions. AB - Adult male guineapigs transferred from colony housing with access to water bottles with a 1.4 mm (inner diameter) spout to individual metabolic cages with access to water from water bottles with a 0.7 mm spout reduce their fluid intake and body weight considerably during the 2-day experimental period. When bottles with a reduced spout were replaced by easily attainable water cups, animals show a drastic increase of fluid intake within one day. These results show that new housing conditions, e.g., the combination of novel environment and reduced spout size, strongly reduce fluid intake. As a consequence, animals reduce food intake as well as body weight. PMID- 2781879 TI - Intestinal lymphomas in golden hamsters (Mesocricetus auratus). AB - Pathological examination of 226 adult hamsters culled in a commercial breeding colony because of health deterioration revealed malignant lymphomas arising from the intestines of 24 animals. Histologically the tumours were classified as centrocytic-centroblastic lymphomas. They were transplantable with cellular suspension, but not with serum or cell-free ascitic fluid of the tumour bearers. The tumor did not metastasize into the spleen. Other types of lymphomas were not diagnosed. PMID- 2781880 TI - [Morphometric studies of histologically classified chorionic villi of human placentas. 1. Placentas of eutrophic and hypotrophic full-term infants]. AB - Occurrence of mature and immature chorionic villi was morphometrically analysed in 30 human placentae of children born on term. The following results were obtained from a method specially developed for surface determination of villus cross-section: The surface of mature villi (end or absorption villi) in children born on term with low birth weight was much smaller than that of immature villi. Total surfaces of mature and immature villi were almost equal in size as of the 25th percentile of child weight. The importance is underlined of a "transitional" class between hypotrophic and eutrophic children born on term, and a pattern of results is suggested. PMID- 2781881 TI - [Histogenetic classification of exocrine pancreatic carcinomas]. AB - The structures of normal ductal and ductular epithelium were compared with cytological peculiarities of pancreas carcinoma. This provided the basis on which to propose histogenetic classification of exocrine pancreas carcinoma. Most of the pancreas carcinomas are adenocarcinomas and originate from small lateral ductules. Preneoplastic ductal alterations, such as proliferation of ductal epithelium, adenomatous dysplasia, and light-cell transformation, may be topographically distinguished from ductular changes, including centroacinic hyperplasia, oncocytic transformation, microglandular metaplasia, ductulo-acinic metaplasia, hepatocellular metaplasia, and peri-insular metaplasia. The close correlations that exist between ductular and acinic cells may be summarised under the cover term of terminal ductulo-acinic intercalated duct complex. Dysplasia is generally accompanied by decline in neutral glycosaminoglycans and occurrence of unsubstituted sialomucin of the embryonic type. PMID- 2781882 TI - Nature of yellow-brown bodies. Histochemical and ultrastructural studies on the brown pigment. AB - Yellow-brown bodies were observed in the sinusoids of lymph nodes and in histiocytes. The authors examined their histochemical characteristics. They were similar to lipofuscin pigments in the liver. However, ultrastructurally, yellow brown bodies were different from lipofuscin and melanin pigments. The electron microscopic investigation suggested that degradation products of yellow-brown bodies in histiocytes resemble brown pigments in the black thyroid. PMID- 2781883 TI - [Malignant oncocytoma of the mammary gland]. AB - Described in this paper is the morphological pattern of a malignant oncocytoma in the breast of a woman aged 70 years. The tumour parenchyma consisted mainly of epithelial cells grouped in nests or cords and surrounded by sparse fibrous stroma. The cells were quite large and pleomorphic, their nuclei being round or bizarre with prominent nucleoli. Electron microscopy revealed a conspicuously increased number of mitochondria and bundles of intracytoplasmic microfilaments. PMID- 2781884 TI - [Oncocytic paraganglioma of the carotid body]. AB - One case of benign oncocytic paraganglioma which had originated from the non chromaffin cells of the carotid body in a woman, 66 years of age, is described in this paper. The microscopic pattern of the tumor consisted mainly of large, round, eosinophilic cells arranged in solid nests and sheets. Pale rather than eosinophilic cells of polygonal shape were predominant in the peripheral areas. Ultrastructural analysis revealed the presence of three cell types: oncocytes, cells with electron-dense granules, 150 to 200 nm in size, and transitional forms between these two. Possible development of oncocytes from APUD cells is discussed. PMID- 2781885 TI - [Therapy and course in 105 borderline tumors of the ovary]. AB - A report is given on 105 patients with borderline tumours of the ovary who were treated from 1953 till 1984. 78 patients suffered from epithelial, 27 from sex cord stromal or germ cell tumours. The average age of all patients was 47.7 years. 67 patients (63.8%) underwent radical operation, whereas 38 patients (36.2%) only underwent unilateral adnexectomy. Additional treatment was applied in 10 cases. Out of 78 woman with epithelial tumours 69 (88.4%) survived 5 years, 58 (74.4%) 10 years, at which the 10-years survival time is significantly higher after radical operation, which is shown by a percentage of 81.3%, compared with 51.9% after conservative operation. Over 90% of the 27 woman suffering from nonepithelial tumours survived 5 years, 87.5% 10 years, out of whom 91% had undergone conservative and 76% radical operation. Due to the existing risk radical operation is recommended in case of borderline tumours of the ovary, especially of those with epithelial origin. However, in case of young woman wanting to have children a conservative operative approach appears to be justified with observance of strict safety precautions. PMID- 2781886 TI - [Therapy and results of healing of stage Ia cervix cancer]. AB - A report is given on therapy and healing results of 226 patients with stage I a cervical carcinoma from 1966 to 1986. The five-years-survival-rate is 94%. Two patients (1%) had a recurrence, another patient died from tumor progression. The tendency of more conservative operation procedures is to be expected during the examination period. Because of a frequency of lymph node metastases of less than 1% lymphadenectomy is not indicated. When having practised cone biopsy and checking clinical and histomorphological parameters by a tumor-score there are given therapeutic recommendations for stage I a cervical carcinoma. PMID- 2781887 TI - [Adenocarcinoma of the uterine cervix in patients using hormonal contraceptives]. AB - Among 360 patients with cervical cancer af stage I b to IV 26 (7.2%) primary adenocarcinomas were observed. 51 patients stated to use hormonal contraceptives. In this group the frequency of adenocarcinomas run to 19.6% (10 women) contrary to 7.8% in patients of the same age non using contraceptives. Morphological and clinical particularities of the adenocarcinoma in pill users are discussed. The early detection of the predominantly intracervically localized adenocarcinomas can only be improved by careful colposcopy combined with obligatory ecto- and endocervical cytological swabs and palpation of the cervix. Atypical bleedings in women using longterm hormonal contraceptives particularly of the gestagen prevailing type need special attention. PMID- 2781888 TI - [Placental protein 12 (PP 12) in cyst and peritoneal fluids and serum samples of patients with ovarian cysts and cystic ovarian tumors]. AB - Placental Protein 12 (PP 12) concentrations were measured by a radioimmunoassay in cyst and peritoneal fluids and in serum samples respectively of patients with tumor like conditions and benign and malignant cystic ovarian tumours. PP 12 can not recommended as a serum tumour marker in ovarian cancer. It must be proved the value of PP 12 in follow up of ovarian cancer with help of more extensive sample material. There are many cysts in tumour like conditions with measurable PP 12 concentrations. PMID- 2781889 TI - Cartilaginous teratoma of the ovary. AB - A case of ovarian teratoma of unique differentiation in a woman of 35 years is reported. Within the histologic structure of the tumor there is predominated cartilaginous tissue with signs of nuclear atypia. The microscopic appearance of the tumor resembled structures seen in chondroblastoma embryonale or even chondrosarcoma. Despite of cellular atypica there are no symptoms of malignant clinical course. PMID- 2781890 TI - [Is it really necessary to discontinue hormonal contraceptives before carrying out a planned operation?]. PMID- 2781891 TI - Fish viruses: isolation of an icosahedral cytoplasmic deoxyribovirus from sheatfish (Silurus glanis). AB - An icosahedral cytoplasmic deoxyvirus has been isolated from moribund sheatfish (Silurus glanis) fry of a commercial warm water recirculation aquaculture unit with cumulative mortalities of up to 100%. The agent replicated in BF-2 and in FHM cells at 20-30 degrees C producing cytoplasmatic inclusion bodies followed by lysis of the cells. The DNA containing virus proved to be labile to chloroform. Infected BF-2 cells revealed hexagonal particles in the cytoplasm measuring about 125-135 nm in diameter. The virus consisted of a central electron-dense core and a electron-translucent zone. The isolate shares characteristics with the Iridoviridae. PMID- 2781893 TI - [Modification of avian humoral immunoreactions by Influex and Echinacea angustifolia extract]. AB - Medicinal complex drugs as well as single ethanolic or aqueous extracts of several plants are commonly used to increase the natural resistance to various infections, though their efficacy and mechanism of action are not yet well elucidated. In the present study, we investigated two problems: firstly, whether the complex drug (Influex) and Echinacea angustifolia extract do stimulate the immunoglobulin and antibody synthesis in chickens immunized with human serum albumin; and secondly, whether a restoration of IgG-synthesis in immunodefective (dysgammaglobulinemic) UM-B 19 chickens is possible with these plant preparations, i.e. if the BG cells which may possibly be present can be polyclonally or antigen specifically stimulated. The preparations were administered orally in two doses, after which the complete immunoglobulin concentration was determined by rocket immunoelectrophoresis and the antibody production by ELISA. The effect of ethanolic solvent was taken into account. The administration of the complex drug to normal Leghorn chickens induced a rise in the serum immunoglobulin concentration, as well as an increase in the three classes of antibody. By the immunodeficient chickens (IgG concentration was below the level of test sensitivity at the start), the administration of the drug led to a slight production in IgG and antibody. PMID- 2781892 TI - Alterations in neutrophil phagocytosis and lymphocyte blastogenesis in dairy cows around parturition. AB - The bovine blood neutrophil phagocytosis and the blood and milk lymphocyte proliferative response upon stimulation with Phytohaemagglutinin, Concanavalin A and Pokeweed mitogens was studied from 3 weeks prior to calving until 3 weeks after calving. Neutrophil phagocytosis and the total and differential blood leukocyte counts were performed by flow cytometry. A gradual increase in the percentage of phagocytized bacteria and the average number of bacteria per phagocyte was observed before calving followed by a sharp fall on the first postpartum. This was followed by a steady increase in the above parameters reaching the highest levels at two weeks postpartum. There was a gradual increase in the number of neutrophils in blood as calving approached followed by a sharp decrease after calving. The number of lymphocytes in blood dropped before calving, being at the lowest level on the day before calving. The proliferative response of blood and milk lymphocytes upon stimulation with the three mitogens was low during the week preceding parturition with the lowest value on the day before calving. The response of blood lymphocytes returned to a higher level the second week after calving while that of milk lymphocytes remained at a low level during the first and the second postpartum weeks. PMID- 2781894 TI - Characterization of some parameters of non-specific immunity in dairy cattle (I). AB - The concentrations of serum protein and immunoglobulin, complement, lysozyme, serum bactericidal activity and blast transformation of peripheral blood lymphocytes were assessed in dairy cattle in different herds and age groups. The study aimed at defining fundamental aspects of non-specific defence under the field conditions, related to age/season/management influences. The observed differences in the expression of these parameters are discussed, with regard to their role in the immune defence of calves and their relation to colostrum uptake. The possible use of these parameters in the control of animal welfare is stressed and the possibility is put forward of predicting possible unfavourable interactions with environmental pathogens. PMID- 2781895 TI - 19s and 7s antibody response of Mastomys natalensis in experimental filarial (Litomosoides carinii, Acanthocheilonema viteae, Brugia malayi, B. pahangi) infections. AB - Specific total antibody (ab), 19s and 7s ab levels in the serum of M. natalensis were investigated after infection with L. carinii, A. viteae, B. malayi and B. pahangi for period of about 500 days p.i., using ELISA (homologous adult antigen) and indirect immunofluorescence tests (IIFT: homologous adult and microfilariae antigen). Total ab levels in L. carinii infected animals rose moderately during prepatency Maximum levels occurred during patency. The response during prepatency was stronger in A. viteae and Brugia spp. infected hosts. Lateron ab levels increased continuously in Brugia infections; in A. viteae infection they decreased with decreasing parasitaemia. 19s abs were stimulated during prepatency and at the beginning of patency, or were found at moderate levels throughout to period of investigation (Brugia infections). 7s abs predominated beginning at the period of late prepatency (IIFT) or at the beginning of patency (ELISA). The time courses of 7s abs corresponded to those of total abs. As obvious by IIFT (adult worm antigen) total and 19s titres were higher against cuticle antigens, egg shell antigens and intrauterine amorphous material than against antigens located in the hypodermis and musculature. 7s abs showed best reactivity with cuticle antigens. Using microfilarial antigens 19s abs reacted predominantly with cuticle antigens whereas 7s abs often showed higher titres against antigens which were localized within the larvae than against cuticle antigens. PMID- 2781896 TI - Changes in the relative concentrations of surfactant phospholipids in young pigs with experimental pneumonia. AB - Lung lavage fluids of 23 young pigs were investigated prior to and after experimental infection with Pasteurella multocida. Comparison of the phospholipid patterns showed an increase in the relative concentration of phosphatidylinositol and a decrease in that of phosphatidylglycerol in the diseased animals. The phosphatidylcholine-to-phosphatidylinositol and phosphatidylglycerol-to phosphatidylethanolamine ratios were used as parameters to characterize the changing patterns. The reductions in these ratios following infection were found to be useful indicators of bacterial pneumonia. Immunization did not affect the characteristic variations. A rapid screening procedure involving solid-phase extraction, one-dimensional thin-layer chromatography and densitometric scanning of the plates was used. PMID- 2781897 TI - Sequential changes of IgG and antitrypsin in different compartments during the colostral-intestinal transfusion of immunity to the newborn foal. AB - IgG levels and tryptic inhibition were investigated in sequentially collected mare's colostrum and milk, foal serum and urine. The colostral trypsin-inhibitor was "transfused" to the newborn foal by the colostral intestinal route in parallel with IgG. However, the trypsin-inhibitor as a small molecular weight inhibitor became excreted into urine peaking at about 20 hours. The physiological proteinuria in foals during the first 2 days is mostly due to immunoglobulin fragments and colostral-derived trypsin-inhibitor. Analysis of urine for IgG light chains or trypsin inhibitor will therefore reveal ingestion of colostrum. PMID- 2781898 TI - [Experience in the teaching of selected questions of applied immunology to students of a department of physician advanced training]. PMID- 2781899 TI - [Let us improve the training of physicians with an epidemiological profile]. PMID- 2781900 TI - [Catalog of the monoclonal antibodies available in the institutions of Comecon member countries. The German Democratic Republic]. PMID- 2781901 TI - [Comparative spectral study of the ribosomal proteins of coagulase-negative staphylococci]. PMID- 2781902 TI - [The role of nonsporulating anaerobic bacteria in the etiology of postabortion and postpartal endometritis]. AB - As the result of the study carried out by the authors, a conclusion has been made on the leading role of polymicrobial aerobic-anaerobic complexes, capable of producing a synergic effect, in the etiology of endometritis, anaerobic microorganisms prevailing in their importance. In the etiology of endometritis the most important organisms are bacteroids and peptostreptococci among anaerobes, enterobacteria and group D streptococci among aerobes. Anaerobic bacteria causing endometritis are most sensitive to dalacin and lincomycin, least sensitive to benzylpenicillin, resistant to aminoglycosides. The amounts of aerobic and anaerobic microflora contaminating the uterine cavity correlate with the severity of endometritis. PMID- 2781904 TI - [Further comment on the opportunistic pathogenicity of microorganisms (a reply to an opponent)]. PMID- 2781903 TI - [Clinico-immunological characteristics of patients with ocular toxoplasmosis]. AB - The results of clinical observations on 34 patients with toxoplasmosis affecting mainly eyes over the period of 2-6 years are presented. The presence of antibodies to Toxoplasma, the content of IgA, IgM and IgG, as well as a number of characteristics of the T and B immunity systems in these patients were determined in their dynamics. For control, similar characteristics were determined in 28 practically healthy persons. During the period of observation the patients showed multiple fluctuations in the level of titers of serological reactions with toxoplasmic antigens and changes in the severity of the clinical picture. In contrast to healthy persons, toxoplasmosis patients were found to have statistically significant changes in a number of characteristics of the T immunity system. The content of B lymphocytes remained within normal limits. Complex treatment with the use of immunostimulating agents proved to be effective only in some of the patients. PMID- 2781905 TI - [Phagocytosis of immune complexes by leukocytes in patients with schizophrenia]. AB - Comparative investigation of the leukocytes' in vitro capabilities of attacking the immune complexes was performed in 20 schizophrenic patients and 20 healthy individuals. The patients' leukocytes were considerably less active against the immune complexes that those of healthy persons that was probably related to both primary defect in the phagocytic cells and their overload (block) by different biologically active factors. Levamisole in vitro stimulated these events. PMID- 2781906 TI - [Comparative evaluation of the levels of water-soluble glial fibrillary acidic protein in the human brain in the normal state and in schizophrenia]. AB - The concentration of water-soluble glial fibrillary acidic protein was measured in several regions of human brains (12 schizophrenic patients and 13 patients without any signs of mental disease) using ELISA technique. The content of this protein was lower in thalamus and gyrus cinguli in schizophrenics as compared to normals (p less than 0.01). The protein showed no correlation with sex, age and the terms of autopsy (5 to 7 h after death). The findings suggest that decreasing concentration of the protein might reflect the changes of its synthesis, posttranslational modifications, assembling and disassembling of glial filaments and possibly the effect of psychotropic drugs. PMID- 2781907 TI - [Lipid peroxidation processes in patients with schizophrenia]. AB - In schizophrenic patients, the course of lipid peroxidation (LP) was investigated as indicated by pentane contents in the expired air (gas chromatography) during a course of psychotropic drug therapy. In 80% of the patients LP was activated before the therapy and reduced in its course with the levels in remission comparable to those characteristic of healthy controls. The LP decreased in a "leap-like" manner with episodes far exceeding the control levels. These leaps' rate and the baseline LP increase before therapy positively correlated with severity of the signs of the disease, its duration, and pre-existing level of negative disorders. PMID- 2781908 TI - [Clinico-anatomic correlations in traumatic ventricular hemorrhage]. AB - A total of 265 patients with intracerebroventricular hemorrhages were investigated for correlation between clinical manifestations and craniographic, echoencephaloscopic and cerebral angiographic data and brain pathomorphology. Intracerebroventricular hemorrhages were found in cases of severe craniocerebral trauma complicated, as a rule, with skull bones fractures, polar-basal cantusional foci, and intracerebral (rarely meningeal) hematomas. Relationship was established between the severity of craniocerebral lesions and intesites of intracerebroventricular hemorrhages which varied in character depending on the volume of adjacent intracerebral hemorrhage and the area covered by contusional polar-basal foci. PMID- 2781909 TI - [Mental disadaptation in emergency situations (accident at the Chernobyl nuclear power station)]. AB - Phenomenology and time course of psychic disorders in persons exposed to life threatening emergency situations provoked by the Chernobyl accident have been analyzed. Three states could be identified according to differences in their psychogenic impact: acute, delayed and long-term. Psychic dysadaptation and disorders might be presented as results of a single process beginning with acute anxiety responses followed by asthenic disorders which backed the relatively steady neurotic and psychopathic states. PMID- 2781910 TI - [Prostaglandin E levels in patients with pain syndromes of the face and head]. AB - The levels of E-type prostaglandins were measured in patients with facial and headaches. The data on the prostaglandin levels suggest that the severity of pain syndrome should be taken into consideration in relieving the pain, and then the nosology should be considered. The use of drugs influencing the prostaglandin turnover in treating patients with facial and headaches is discussed. PMID- 2781911 TI - [Discussion aspects of the concept "mental disease" in present-day psychiatry]. PMID- 2781912 TI - [Open injuries of the brain from the anatomo-clinical aspect]. AB - A combined clinico-pathological and experimental investigation of the open traumatic brain lesions was performed. Clinical investigation of 266 patients is presented along with pathological findings in 9 autopsied brains of victims of craniocerebral trauma which died at different terms after the injury. Experimentally investigated were 25 cats with brain lesioned at various sites. The comparative characterization of the brain efferent systems' nervous fibers degeneration was presented and the topography of their distribution in the brainstem nuclear loci clarified. The data suggest that the state of brain conduction pathways is an important determinant of the pathogenesis of brainstem related symptoms of acute brain hemisphere trauma. PMID- 2781913 TI - [Detection of the site of traumatic intracranial hematoma by clinical symptoms]. AB - Unilateral local lesions of head soft tissues and skull bones suggest the hematoma localization. Mydriasis and pyramidal signs are no reliable indications of the site of intracranial hemorrhage. This makes it necessary to juxtapose all the signs of brain and skull lesions with due consideration of the severity of the patient's state and the time of trauma. PMID- 2781914 TI - [Post-dislocation lesions of the midbrain and pons in neurosurgical patients]. AB - The study of clinico-neurological, electroencephalographical and pathological data in 37 patients with post-dislocation lesions of midbrain and pons Varolii yielded identification of the syndroms of isolated functioning of brainstem cerebral and brainstem-spinal systems: mesencephalo-pontine, supramesencephalic, unilateral. Clinico-physiological features characteristic of these syndromes are discussed as different from those of acute brain dislocations. Their value in diagnosis and prediction of the death of brain as an organ. PMID- 2781915 TI - [Perestroika in neurology, psychiatry and narcology at the present-day stage]. PMID- 2781916 TI - [H3-dopamine release in experimental mild cranio-cerebral trauma]. AB - The studies of ELCCT influence on spontaneous and KCl-stimulated 3H-dopamine release by synaptosomes isolated from the rabbit brain hemispheres and diencephalic-brainstem areas are presented in this paper. Kinetic characteristics of the releasing system (Bm and Vo) were shown to decrease at earlier stages (15 minutes to 2 hrs) and increase at later stages (1 to 14 days). No substantial difference was shown in release responses of the synaptosomes derived from brain hemispheres and diencephalic-brainstem regions. The data suggest the major alterations in the mechanisms of dopamine release in ELCCT. PMID- 2781917 TI - [Clinico-psychopathologic and electroencephalographic correlations in patients with cranio-cerebral trauma during laser therapy]. AB - A total of 96 patients with severe craniocerebral trauma were treated and divided into 3 groups: 1, with prevailing left brain hemisphere lesions manifested by right-sided pyramidal symptoms (N = 32); 2, prevailing right brain hemispheric lesions and left hemisyndrome (N = 35); 3, lacking in distinct focal interhemispheric differences in trauma localization with prevalent general cerebral signs. Control group consisted of 45 patients conventionally drug treated without laser. Laser therapy was performed as a course of 12 to 15 sessions according to regimens settled for each group of patients. Positive result was an accelerated regression of both neurological and psychopathological manifestations of severe trauma. The treatment proved most efficient (with considerable improvement) in 85% of the Group 2 patients. Considerable improvement was noted in 23% of Group 1 patients; improvement was evident in 58% of the Group 3 patients. As a whole, laser treatment proved 25% more effective as related to the control group. PMID- 2781918 TI - [Characteristics of the effect of a constant electromagnetic field on reparative processes in spinal cord injuries]. AB - In 171 white rats the spinal cord was completely sectioned in the upper thoracic region. In 46 control rats an early crude spinal cord scar was identified which precluded the growth of nervous fibers. On the contrary, in animals exposed to constant magnetic field a smooth spinal cord scar was found with collaterals of anterior spinal arteria, recrease of the destruction zone and nervous fiber growth across the scar, This resulted in restored hind paw motility by 56 +/- 4.8% as related to control rats in which motility did not restore. Magnet therapy applied as a part in combined restitutional therapy in 104 patients in early restitution period yielded a 46.15 +/- 4.89% to 76.32 +/- 4.87% increase in the rate of restoration of motor and sensory functions. With the therapy applied in late periods, the restitution was 48.1 +/- 5.6% and 78.1 +/- 3.9%, respectively. The magnetic field is considered as a reparation booster in spinal cord trauma applicable in any stage of the disease. PMID- 2781919 TI - [Unusual pyramidal pathology syndrome]. AB - A syndrome is described comprising: 1, impossibility to close only one eye (right or left) at a time, or each eye alternatively with intact capability of closing both eyes; 2, unvoluntary screwing up of an eye during voluntary closing of another (palpebro-palpebral synkinesia); 3, head turning to the side of an eye closed (palpebrocervical synkinesia); 4, with the hands clenched, left thumb is over the right, as is the left arm over the right when folded. The syndrome is supposed to be related with consealed lefthandedness which is presumably indicative of lateralization of the dominant speech center. If this is correct, the syndrome may have a distinct topical diagnostic value. PMID- 2781920 TI - [ECG changes in ruptured cerebral aneurysm]. AB - With ECG of the patients with arterial brain aneurysms ruptures analyzed in the pre- and postsurgical periods, 5 characteristic types of changes could be identified. Functional (secondary) nature of ECG changes was established and their dependence on the severity of the patients' state, aneurysm localization, disease duration, presence of angiospasm and intracranial hematoma were evidenced. The increase in the markedness of ECG disorders did not correspond to hemodynamic impairment. ECG changes are no contraindications for urgent surgery of the aneurysm. Nevertheless, distinct ECG changes were noted which could serve as prognostic criteria for the fatal outcome of the surgery. PMID- 2781921 TI - [Hyperbaric oxygenation in experimental toxic brain edema]. AB - Hyperbaric oxygenation (HO) was used to treat the brain toxic edema excited by triethyltin++ chloride. Microscopic examination of the brains of two groups of animals (with and without HO) revealed the decay of pathologic signs of brain edema and reparative responses in the nervous tissue induced by HO. PMID- 2781922 TI - [Effect of social factors on the prevalence and course of schizophrenia]. AB - The results of comparative clinico-epidemiological study of schizophrenic patients in the three populations differing in their socioeconomic and cultural conditions allowed us to identify the disease characteristics determined by general pathogenic mechanisms (relationship of initiation and prevalence of one or another course types with age and sex of the patients) and characteristics liable to changes under impact of social factors (the prevalence of the disease, its representation in different age groups. Relationship of the forms of its course, syndromological structure, clinical features, nature of social and labor adaptation). Migration, cultural features, socioeconomic level of the region, educational level are stressed among the factors influencing the incidence of schizophrenia, its course and social and labor adaptation. PMID- 2781923 TI - [Short-term prognosis of schizophrenia in developed and developing countries. WHO international study program]. AB - Two years of the catamnestic study of primary schizophrenia in a number of developed and underdeveloped countries using a common technique yielded a conclusion of likehood in short-term prognosis of the disease manifested in common types of its course. Nevertheless, a range of parameters reflecting clinical and social characteristics taken into account, the prognosis proved more benign in the developing countries. In discussion the possible explanation implying an increased rate of acute manifestations of schizophrenia in developing countries is rejected, for the benign prognosis of the disease takes shape in any type of the debute, regardless of its acuteness. The role of socio-cultural factors is assumed to be most pronounced in the above prognostic divergences. PMID- 2781924 TI - [Mental disorders and the characteristics of development of young children (up to 3 years of age) with a high risk of schizophrenia]. AB - Prospective clinico-psychopathological investigation of 50 young children born to schizophrenic parents revealed that 83% of the children had a common feature: dissociation of mental development that could be termed as a "Schizotypal diathesis" (SD). SD has 3 major course patterns: (1), regredient; (2), stable; (3), progredient. Psychopathologic signs are characteristic for only the 3rd type of SD that is indicative of the schizophrenic character of this dysontogeny. The children with 3rd and 2nd (stable with spontaneous phases) type SD patterns seem to be most vulnerable. PMID- 2781926 TI - [Clinical aspects and the course of psychopathologic conditions simulating vertebrogenic pathology]. AB - The study of clinical picture and the course of unclear pathological states simulating the vertebral pathology suggested that the major signs were centered around the primary general and muscular sensory disorders. These served as a basis for development of more complicated psychosensory and psychomotor disorders and creation of an interpretative hypochondriac++ delirium system. Domination of psychomotor disorders led to a high incidence of social and labor dysadaptation of the patients. Thus, the study of this unclear mental pathology has a major theoretic, clinico-psychopathological and also practical medico-social importance. PMID- 2781925 TI - [Slowly-progressing schizophrenia and cyclothymic disorder with phobic manifestations in patients under a general practitioner's care]. AB - A total of 90 patients were investigated in the general practice out-patient clinics. The patients had not been earlier studied by a psychiatrist and had unclear forms of endogenous diseases and phobic disorders: 70 patients with slow progredient schizophrenia, 20 with cyclothymia. Despite the phobic manifestations of slow progredient schizophrenia and cyclothymia being identical on the phenomenological level, their structure and time course were different. Favorable++ and unfavorable clinico-psychopathological prognostic signs were determined for each of the diseases. The principles of therapeutic and rehabilitation tactics are discussed with special reference to the patients with slow progredient schizophrenia and cyclothymia with phobic disorders in primary health care units. Out-patient group was compared to the patients of dispensary departments. PMID- 2781928 TI - [Genetico-mathematical analysis of manifested schizophrenia with a permanent and attack-like course]. AB - The parameters of multifactorial and monolocal models were evaluated according to the incidence indices of the manifested forms of schizophrenia in three population groups of Tomsk regions among the relatives of probands with permanent and attack-like course of the disease. Higher occurrence of mutant homozygotes and increase of the share of these genotypes were detected in permanent course of the manifested schizophrenia. The authors suggest that the differences in genetical parameters of susceptibility to the disease with permanent and attack like course are caused by influence of constitutional factors on the mutant genes penetrant ability. PMID- 2781927 TI - [Borderline schizophrenia and cyclothymic disorder associated with disorders of the menstrual cycle]. AB - Clinico-pathological investigation of borderline schizophrenia (42 women) and cyclothymia (22 women) with concomitant disorders in menstrual function was performed in a regional out-patient gynecological department. Major types of the course of mild psychopathology were identified which involve the endocrine gynecological dysfunction. Functional disorders of the menstrual cycle are seen as a class of numerous somatic signs masking the psychopathology in its proper sense in mental diseases and emerging at the edge of "soft" endogenous mental disorder. The authors postulate that the central nervous system regions responsible for child birth are involved into these forms of mental pathology. The issues of differentiating these ailments involving gynecological dysfunction from the true endocrine-gynecological pathology are discussed. PMID- 2781930 TI - [Diagnosis and treatment of encephalitis caused by herpes simplex virus]. AB - The article is reviewing various diagnostic and treatment techniques in encephalitis caused by the virus of herpes simplex. Clinical symptoms and variants of the course of the disease are considered together with laboratory investigations of cerebrospinal fluid, electroencephalography and computerized tomography. The patients with the herpetic encephalitis suspected, need intensive treatment measures. Besides the conventional techniques, the early use of Acyclovir is recommended. PMID- 2781929 TI - [Study of somatic sex maturation based on various anthropometric indicators]. AB - Clinico-anthropometric investigation was performed in 840 schizophrenic patients and 135 patients with other mental disorders. Somatic sex differentiation was assessed using the Tanner index, biacromial and bicristal diameters. Body building deviations towards non-differentiated adolescent-type patterns were observed only in schizophrenic patients with multiple regional morphologic dysplasias. This could be repeatedly confirmed in three samples of schizophrenic patients observed in different regions of this country. The retardation in the somatic sex differentiation is supposedly related to constitutional-biological features of the disease independent on the speciaficity of schizophrenic process. PMID- 2781931 TI - [Analysis of "scalp potential fields" and the tridimensional location of the sources of epileptic activation in humans]. AB - The method of multi-step dipole localization with potential charts preanalysis was applied to EEG spatial localization of discharge activity in 24 epileptic patients. The results were juxtaposed to the X-ray contrasting techniques and computerized tomography. Spherical symmetrical 8-layer head model was used to interprete the results. The data on three-dimensional localization of focal and generalized paroxysmal activities are presented. The role of this technique in differentiating the primarily generalized activity from secondary foci is outlined. The generation and recording sites epileptic activity could diverge largely due to the primary source orientation. For correct EEG interpretation, it is important that the primary generation zone be reconstructed. This is an additional field of application of this technique. PMID- 2781932 TI - [Radiotherapy of trigeminal neuralgia and post-neuritic contracture of the mimetic muscles]. AB - The results of antiinflammatory radiation therapy were analyzed in 17 patients with trigeminal neuralgia and 7 patients with post-neuritic++ contractures of mimetic muscles. The therapy yielded positive results and was adequately tolerated by all patients. In the follow-up, no changes of the patients' general status or hematological indices were detected. PMID- 2781933 TI - [Trends in the development of the theory of current American psychiatry (data of the DSM-III-R)]. PMID- 2781934 TI - [Comparative analysis of various clinico-electrophysiologic manifestations in patients with epilepsy and in their relatives]. AB - This is a comparative analysis of clinico-electrophysiological correlations in epileptic patients with different degrees of severity of the disease, and their close relatives. A total of 44 families of epileptic patients were investigated as were 84 of their relatives. Most benign course of the disease was noted in the patients whose relatives had epilepsy-related changes. In these cases the EEG patterns were to a several extent similar in probands and their relatives. On the contrary, in patients with severe disease which had relatives without epileptic disorders, the EEG pictures showed no similarities. In these patients the cortical rhythm changes were supposedly due to the shifts in relationships of the brain pathological and compensatory processes. EEG changes reflected the preponderance of pathology. PMID- 2781935 TI - [Morphologic characteristics of cortical synapses in patients with epilepsy]. AB - Ultrastructural examination of 70 human cerebral cortex specimens was carried out. The material was obtained during operations for brain tumours in patients with or without epileptic attacks and during stereotaxic biopsy for unexplained epilepsy (E). Morphometric techniques were employed in the study. The findings were processed statistically. In tumours without E synaptic vesicles were light, uniformly distributed in the axoplasm, of rounded oval shape, and filled the presynaptic process by 80.6 +/- 1.6%. When tumours were attended by epileptic attacks there were considerable alterations in the form, size, distribution and osmiophilia of the vesicles, including polymorphism, hypertrophy, accumulation predominantly at the presynaptic membrane or aggregation, pronounced osmiophilia of the capsule, "fringed vesicles", general osmiophilia. The number of vesicles was decreased (54.2 +/- 1.4%). PMID- 2781936 TI - [Basal secretion of hormones of the anterior lobe of the pituitary gland, thyroid gland and adrenal cortex in children and adolescents with epilepsy]. AB - The article presents the results of measuring the anterior hypophysis lobe, thyroid and adrenocortical hormones basal secretion in epileptic children and adolescents measured during the anticonvulsant therapy. The peculiarities of functional state of endocrine glands in epileptic patients were compared to those in healthy adolescents and children. Analyzed was their dependence on the nature, course and clinical manifestations of the disease, the course and efficiency of anticonvulsant therapy. PMID- 2781937 TI - [Functional asymmetry of the brain in patients with epilepsy]. AB - Individual functional brain asymmetry profiles were different in epileptic patients and healthy individuals. The patients displayed reduced from 39.6% to 17.8% incidence of left profile and increased incidence of combined profile (from 60.4% to 81.5%). The relationship of functional asymmetry profiles to sex, lateralization of epileptic focus and clinical course of the disease was described, the regularities of the profiles' changes in the course of the disease analyzed. PMID- 2781938 TI - [Epilepsy risk factors in children and adolescents with a history of neuroinfection]. AB - Long-term follow-up was performed in 500 children and adolescents convalescent of neuroinfections. Special attention was attracted to 187 subjects featuring the risk factors of epilepsy. The majority of these had nonparoxysmal and paroxysmal sleep disorders and various paroxysmal states characteristic of patients with epilepsy at different stages of the disease. In order to prevent epilepsy, the patients displaying the risk factors should be put on the list for dispensary investigation. PMID- 2781939 TI - [Isolation of informative factors regarding the development of epilepsy by the method of image recognition]. AB - A complex of factors carrying major information on the epileptogenesis was recognized and their interrelation analyzed. Initial sample comprised 14 signs of the patients' constitutional features (532 individuals) and their relatives' mental health (10858 individuals). A model was constructed to represent the interrelation of the signs using an algorithm of logical-+-mathematical image detection realized on an SM-4 computer. Eight signs were entered into a most informative group. The model helped to formulate new theoretical notions of the relationship of constitutional and hereditary factors in epileptogenesis. PMID- 2781940 TI - [Pneumoencephalography in the first year from the onset of epileptic seizures]. AB - Pneumoencephalography was performed in 88 patients within the first year since their first epileptic seizure (of these, 53 were studied during the first 6 months). The control group comprised 31 patients with 12 to 30 months history of the seizures. Pronounced changes in the subarachnoidal space in 30 patients were found to be related to clinical signs and the disease history more closely than did the ventricular system pathology. The latter was generally considered to be a result of past ailments, not reflecting the course of the early stages of epileptic process. The pronounced subarachnoidal pathology proved to be an unfavorable prognostic sign. More close relation of the establishing epileptic process with the subarachnoidal changes could possibly confirm the cortical localization of the primary epileptic foci. PMID- 2781941 TI - [Effect of the cholinergic system on EEG-detected paroxysmal activity in West syndrome]. AB - Sixteen patients or convalescents of West syndrome (WS) were studied. The function of cholinergic neurons was investigated by means of physostigmine or atropine testing. In all the cases physostigmine had a considerable inhibitory effect and atropine++ supported the EEG paroxysmal++ activity. Cholinergic system has an important role to play in the WS pathogenesis. PMID- 2781942 TI - [Characteristics of the clinical manifestations of mesofrontal epileptic seizures]. AB - The patients with mesofrontal epilepsy (ME) were under this study. Idiopathic atrophic events in the cerebral cortex are the major etiology factors. ME seizures develop as a sequence of epileptic discharges in the supplementary motor zone (SMZ) and have some characteristic features as tonic convulsions in one or both hands with concomitant adversive spells, short seizures with prompt after seizure orientation and the proprioceptive afferent signals being capable of provoking the spells. Such peculiarities of ME manifestations depend on both structural-functional SMZ organization and the state of epileptic focus trigger channel. The whole brain functional state is also of major importance. PMID- 2781943 TI - [Pathomorphosis of personality changes in patients with epilepsy]. AB - Psychical features of 600 epileptic patients aged 5 to 40 were investigated in a long term clinical follow-up. Social changes, environmental factors, education faults had major effects on the patients. Classical personality traits were subject to a considerable pathomorphosis in these patients. Along with some positive traits as accuracy, economy, marked were egoism, egocentrism, dependency trends and other negative traits preventing social adaptation. The author stresses that correct education is crucial for prevention of pathological personality changes. This requires joint efforts of psychiatrists, teachers and sociologists. PMID- 2781944 TI - [Clinico-electroencephalographic correlations in the process of rehabilitation of patients with epilepsy]. AB - A total of 50 patients with epilepsy underwent an electroencephalographic investigation at the rehabilitation stage during remission. EEG tests established that the discontinuation of epileptic seizures was followed by a stepwise compensatory EEG rearrangement. In patients that had had rare seizures, the EEG normalization was characteristic of the 2 to 3 years-long remissions. With frequent polymorphic seizures, the background activity was normalized in the steady remission of many (5 and more) years duration. The cessation of antiepileptic therapy should be effected under a mandatory EEG control. The absence of negative EEG changes on anticonvulsants discontinuation is a sign of correct treatment paradigm. PMID- 2781945 TI - [Tolerance of antiepileptic therapy]. AB - In 207 epileptic patients with unfavorable course of the disease the results of tolerance to antiepileptic therapy were investigated. The intolerance appeared at different stages of treatment as allergy (15%), intoxication (45%), hypovitaminosis (40%). The tolerance to combined therapy dosages was changing because of: the severity of organic CNS damage which manifested the epilepsy (head trauma, neuroinfection), residual signs of the pathology, progredience of the epileptic process and the therapy tactical drawbacks. The principles controlling the anticonvulsant therapy tolerance were formulated with due account of therapeutic tactics in progredient and slow-progredient epilepsy at its different stages. PMID- 2781946 TI - [Clinical picture and dynamics of neurologic complications of drug therapy in epilepsy]. AB - The authors have investigated the neurological complications in 108 epileptic patients treated for many years with anticonvulsants. The early diagnostic criteria were determined and the course of clinical manifestations described. The principles of treatment of the disease were grounded in terms of pathogenic diversity of its complications. PMID- 2781947 TI - [Contractile properties of crural muscles in patients with post-stroke movement disorders]. AB - Disorders were detected in the contractile properties of tibial muscles in the patients with stroke-related motor disturbances depending on the degree of functional deficit. Maximum slow-down in the fast muscles and speeding of the slow ones was detected within half-year since the stroke. PMID- 2781948 TI - [Rheologic properties of the blood and the system of hemostasis in patients with circulatory encephalopathy treated by hemosorption]. AB - In patients with atherosclerotic encephalopathy (AE) the major indices of blood rheology, hemostasis and its cells' functional state were under investigation. Different patterns of blood rheology changes were detected with increased counts of pathological red blood cells and hypercoagulability. These disorders correlated with the rate of major neurological signs and syndromes, and with the disease stage as well. A multilevel positive effect of hemosorption was shown in different pathogenic links of AE related to disorders in lipid metabolism, blood rheology, shape and functional activity of erythrocytes, shifts in the homeostatic systems. This suggested the use of hemosorption as a tool in prevention of ischemic stroke. PMID- 2781949 TI - [Mental disorders as late sequelae of closed cranio-cerebral trauma]. AB - In a total of 308 patients with late sequelae of closed craniocerebral trauma inflicted during war or peace time studied in hospital conditions were the peculiarities of the course of trauma-related disease as related to various additional factors. The course of several syndromes was followed with special reference to the nature, severity and repetitiveness of the trauma, the age of affliction, and such additional determinants as alcoholism and vascular pathology. The risk factors of vascular disorders and alcoholism were determined and measures designed for their prevention and treatment. PMID- 2781950 TI - [Hypothalamic epileptogenesis]. AB - In cats the hypothalamus proved capable of the primary epileptogenesis. It suggests the principal feasibility of diencephalic (hypothalamic) epilepsy. PMID- 2781951 TI - [Motivational-emotional disorders in astrocytoma of the temporal lobe]. AB - Motivational and emotional disorders were studied in 42 patients with temporal lobe astrocytomas. The peculiarities of intensity and direction of biological motivations and emotions, background moods, and several personality traits were studied in relation to the tumor localisation in anterior parts of mediobasal and baso-convex structures of the right of left lobes. The course of motivational and emotional disorders was followed at different stages of the disease and postsurgical period. PMID- 2781952 TI - [Psychopathologic complex symptoms in disorders of cognitive activity in mental diseases: factor structure and diagnostic informative value]. AB - Mathematical-+-statistical analysis of experimental psychological investigation of 150 schizophrenic patients, patients with organic brain diseases and psychopathology revealed the contents of psychopathological syndromes of disturbances in cognitive activity in these diseases. Their factor structure was determined as well. Organic psychopathological complex of signs was determined by a "reduction" of all mental functions, the schizophrenic one by mental "dissociation", and psychopathic one by a lability and deficiency in structuring the sphere of meaning. The tables were designed in order to evaluate the data of experimental psychological investigation in clinical differential diagnosis. The efficiency of the tables was demonstrated. PMID- 2781953 TI - [Transcranial Doppler sonography combined with other ultrasonic methods in the diagnosis of stroke]. AB - The use of transcranial Doppler sonography (TDS) in combined ultrasound diagnosis was the first to allow a noninvasive assessment of cerebral circulation. Altogether 50 patients in acute stroke period were examined. The results obtained were verified at surgery, cerebral angiography or autopsy. Changes in the velocity of the blood flow, its reversal, different Doppler sonogram pattern appeared controversial for cerebral and subarachnoid haemorrhages caused by the occlusion of the internal carotid artery or other factors of encephalomalacia. TDS employment promotes the improvement in the diagnosis of the cause underlying the acute impairment of cerebral circulation and in the prognosis of cerebral coma. The findings are correlated with routine echo-pulsography and Doppler sonography. PMID- 2781954 TI - Fluoroscopic differentiation between leaflet escape (LE) and valve thrombosis (VT) of the Edwards-Duromedics mitral valve. AB - Although differential diagnosis between LE and VT of an Edwards-Duromedics mitral valve can be suspected on clinical, phonocardiographic and echocardiographic bases, we propose that fluoroscopy is the rapid, non-invasive test to distinguish between both conditions if properly conducted and interpreted: with adequate orientation of the X-ray beam, the presence of both leaflets and their range of motion can be reliably assessed. PMID- 2781955 TI - Dexamethasone treatment of amiodarone-induced thyrotoxicosis (AIT) with or without persistent administration of the drug. AB - Treatment of amiodarone-induced thyrotoxicosis (AIT) with thionamide, lithium or radioactive iodine is ineffective. This particular form of hyperthyroidism is long-lasting because of the slow elimination of amiodarone. Therefore, an alternative therapy is necessary, especially for patients who need to continue permanent administration of the drug. We report 2 cases of AIT: in one case, amiodarone was interrupted; in the other case, amiodarone was continued because of recurrent ventricular tachycardia resistant to classical antiarrhythmic drugs. Both patients were successfully treated with propylthiouracil (PTU) and dexamethasone (DXT). PMID- 2781956 TI - Belgian Working Group on Cardiac Pacing and Electrophysiology, 8th annual meeting. 1st October 1988. Abstracts. PMID- 2781957 TI - The 1988 Bethesda System for reporting cervical/vaginal cytologic diagnoses. Developed and approved at the National Cancer Institute Workshop, Bethesda, Maryland, U.S.A., December 12-13, 1988. PMID- 2781958 TI - Analysis of immunoglobulin and T-cell receptor gene rearrangement in cytologic specimens. AB - Recombinant DNA techniques to detect the rearrangement of genes encoding immunoglobulins and T-cell-antigen receptors have been used to identify clonality in lymphoid lesions. To determine the utility of such techniques in cytologic specimens, DNA was analyzed in 24 effusions and 6 fine needle aspirates. Immunophenotypic studies were also performed on the 19 specimens with suspected hematopoietic malignancies. Sufficient material for DNA analysis was present in 28 of the 30 specimens. Immunoglobulin or T-cell-receptor gene rearrangement was present in 13 specimens with atypical cytologic findings; DNA studies provided more information than did the immunologic studies in 3 cases. One T-cell malignancy showed T-cell receptor and heavy-chain gene rearrangement, and one B cell malignancy showed immunoglobulin and T-cell receptor gene rearrangement. In all patients except one with no evidence of gene rearrangement, the morphologic and immunologic studies also favored a reactive process. Control specimens showed a germline configuration. This study demonstrated that DNA gene rearrangement studies are feasible on many cytologic specimens and may be useful in diagnostically difficult cases. PMID- 2781959 TI - Lavage fluid from continuous ambulatory peritoneal dialysis. A model for mesothelial cell changes. AB - Continuous ambulatory peritoneal dialysis (CAPD) lavage can be interpreted as an artificial short-term ascites. The cellular content of 362 CAPD specimens from 32 patients was investigated. Irregular inflammatory reactions were seen in 85.3% of the specimens and eosinophilia in 27.6%. Mesothelial aggregates of great variability were registered in 59.4% of the specimens and mainly atypical mitoses in 7.5%. The cytologic changes seen in those patients from whom lavage fluids were examined over 10 to 12 months did not correlate with the changes in blood chemistry (BUN and creatinine) in those cases. PMID- 2781960 TI - Cytology of peritoneal fluid from patients on continuous ambulatory peritoneal dialysis. AB - Peritoneal fluids from 41 patients on continuous ambulatory peritoneal dialysis (CAPD) were examined. The patients were divided into a short-term group (18 patients with CAPD up to one year) and a long-term group (23 patients with CAPD for one to seven years). Peritoneal fluids from a control group, consisting of ten nondialysis patients with ascites, were also examined. The cellular background of the peritoneal fluids and, in particular, the morphology of the mesothelial cells were studied. The following were found to be significantly increased in the CAPD groups: background lymphocytes, mesothelial exfoliation in three-dimensional clusters, mesothelial nuclear size and the number of mesothelial nucleoli. All of these features increased slightly with an increased duration of the dialysis. These findings emphasize that peritoneal dialysis of any duration can induce significantly atypical changes in mesothelial cells. PMID- 2781961 TI - Fine needle aspiration biopsy in uveal melanoma. AB - Fine needle aspiration (FNA) biopsies were performed in a series of patients with uveal tumors. Cytopathologic examination established the correct diagnosis in 26 of 29 uveal melanomas. FNA biopsy was able to exclude the diagnosis of a malignant neoplasm in five nonmelanoma tumefactions. Histologic and FNA cytologic typing of melanomas as epithelioid or predominantly spindle cell showed good agreement, with the same classifications made in 14 of 18 cases. FNA biopsy specimens also proved to be adequate for DNA-content and cell-cycling studies. The cessation of cell cycling in successfully irradiated melanomas may be useful in establishing the postradiation status of tumors that have questionable growths after therapy, as was shown using FNA samples in three such cases in this study. The results of this study show that FNA biopsy is a useful diagnostic adjunct in patients with atypical lesions that require therapy. PMID- 2781962 TI - Fine needle aspiration of breast masses. An analysis of 276 aspirates. AB - A study of 276 consecutive fine needle aspirations (FNAs) of the breast in 240 cases is presented. Of these cases, 108 underwent subsequent biopsy of the breast; correlations between the FNA cytology and the surgical pathology findings revealed that FNA had a sensitivity of 79.4%, a specificity of 100% and a predictive value of a positive diagnosis of 100%. The overall diagnostic accuracy was 92.4%. These results are compared with those in other published series, and the pitfalls in and methods of improvement of breast FNA are discussed. PMID- 2781963 TI - Primary osteogenic sarcoma and osteogenic metaplastic carcinoma of the breast. Immunocytochemical identification in fine needle aspirates. AB - Pleomorphic spindle cells, osteoclastlike giant cells and plaques of osteoidlike material were the cytologic features observed in fine needle aspirates of the breast tumors from two patients. This cytologic pattern suggested a diagnosis of osteogenic sarcoma, a rare neoplasm in the breast. Immunoperoxidase staining performed on the original smears showed reactivity for vimentin in both cases. One tumor was also positive for epithelial membrane antigen (EMA); reactivity for this marker revealed the metaplastic nature of the sarcomatous cells in this tumor, suggesting a diagnosis of metaplastic carcinoma. Histologically, both tumors showed a sarcomatous pattern, with osteoid and chondroid formation, with no evidence of epithelial differentiation. Polyclonal and monoclonal antibodies against epithelial and mesenchymal markers used in tissue sections confirmed the immunophenotypes identified cytologically. Based on the immunochemical findings, the final diagnoses were osteogenic sarcoma of the breast in one case and osteogenic metaplastic carcinoma of the breast in the second case. Both patients died of metastatic disease within one year. These cases (1) show the reliability and accuracy of the immunoperoxidase method in making a differential diagnosis of ambiguous cytologic patterns in fine needle aspirates, (2) support the occurrence of a true osteogenic sarcoma of the breast (comparable to its skeletal counterpart) and (3) demonstrate that metaplastic carcinomas may closely simulate sarcomas of the breast, morphologically as well as biologically. Immunochemical staining techniques play an important role in the differential diagnosis of these neoplasms. PMID- 2781964 TI - Value of fine needle aspiration cytology in the diagnosis of testicular neoplasms. AB - In 403 patients with a clinical suspicion of a testicular neoplasm, fine needle aspiration (FNA) was performed on the scrotal mass in 380 cases and on an extrascrotal swelling in 23 cases. There were 109 unsatisfactory aspirates. Fluid was aspirated in 50 cases, and only normal testicular elements were obtained in 82 cases. The aspirate showed an inflammatory lesion in 104 cases. A diagnosis of malignancy or suspicious for malignancy was given in 52 and 6 cases, respectively. Histopathologic confirmation of malignancy was available for 30 cases, for which the aspirate had been reported as malignant in 23, suspicious for malignancy in 3, unsatisfactory in 2 and negative for malignancy in 2. There were no false-positive FNA cytodiagnoses. No local seeding of tumor by the FNA procedure was observed. Typing of the testicular tumors on the aspirates showed a problem in classifying teratocarcinomas. PMID- 2781965 TI - Cytologic diagnosis of a case of recurrent adamantinoma. AB - The cytologic features of a case of recurrent adamantinoma of the tibia diagnosed by fine needle aspiration (FNA) in a 31-year-old patient are described. The FNA smears contained single-lying cells and cells arranged in small clusters and Indian files, with some nuclear molding. Three cell types were present: (1) large polygonal cells with chromatin clearing, (2) smaller cells with poorly defined cytoplasm and dense chromatin and (3) fusiform cells. The first two were interpreted as epithelial in nature and the third one as being derived from the stroma. These cytologic features appear to be sufficiently characteristic to suggest an FNA diagnosis of adamantinoma, especially in the case of a recurrent tumor. PMID- 2781967 TI - Diagnosis of acute bacterial osteomyelitis of the pubis by means of fine needle aspiration. AB - Fine needle aspiration (FNA) was used to make a definitive diagnosis of osteomyelitis of the pubis with negligible trauma to an elderly patient. The material obtained was adequate to resolve the differential diagnosis of osteomyelitis versus osteitis pubis occurring after urologic surgery. The three basic components of acute bacterial osteomyelitis, an acute inflammatory cell exudate of neutrophils, necrotic bone and bacteria in cells, were present in the FNA smears and cell blocks; the presence of bacteria was shown by Gram staining of FNA smears and culture of part of the FNA specimen. PMID- 2781966 TI - Parathyroid carcinoma with occult bone metastases diagnosed by fine needle aspiration cytology. AB - A case with persistent hypercalcemia following complete resection of a primary parathyroid carcinoma is presented. An occult bone metastasis was diagnosed by fine needle aspiration (FNA) cytology of a lytic bone lesion clinically presumed to be a "brown tumor" of hyperparathyroidism. The cytologic features of the metastatic lesion were similar to those of the resected primary lesion and of a previously identified metastasis. The potential usefulness of FNA cytology in this clinical setting is discussed. PMID- 2781968 TI - Cytologic findings in aspirated hydatid fluid. AB - A case of hydatid disease of the liver diagnosed by accidental needle aspiration of a cyst is reported. The patient presented with multiple symptoms, whose cause could not be readily determined. Since an amoebic abscess of the tender and enlarged liver was one possibility, that organ was aspirated with an 18-gauge needle, producing about 200 mL of slightly turbid fluid; the patient went into anaphylactic shock following the procedure, but was revived. Smears of the fluid showed brood capsules, free scolices and scattered hooklets pathognomonic of Echinococcus. The cytologic diagnosis of echinococcosis was confirmed by histopathologic examination of the surgically removed cysts. PMID- 2781969 TI - An unusual pulmonary and renal presentation of echinococcosis. Report of a case. AB - Echinococcosis, although relatively rare in North America, is becoming more prevalent. The rapid diagnosis of hydatid disease, using a noninvasive approach, is highly desirable. This paper describes a rare case of simultaneous pulmonary and renal echinococcosis, without demonstrable liver involvement, diagnosed by cytologic examination of a bronchial aspirate and sputum. This case emphasizes the importance of cytologic evaluation of a variety of body fluids to diagnose multiorgan infection by Echinococcus granulosus. PMID- 2781970 TI - Fine needle aspiration cytology of subcutaneous cysticercosis of the breast. Case report and pathogenic discussion. AB - A case of subcutaneous cysticercosis of the breast diagnosed by fine needle aspiration cytology is reported. The cytologic preparations showed the presence of many inflammatory cells mixed with spiked spherules resembling the rambutan tropical fruit. These spherules arose from the degenerated integument of the parasite found in the histologically excised cyst. They are suggestive of the presence of an encysted flat worm, but are not specific for cysticercosis, whose identification is based on the study of the cephalic extremity of the parasite. PMID- 2781971 TI - Fine needle aspiration diagnosis of cysticercosis in soft tissue swellings. AB - The cytomorphologic criteria for diagnosing cysticercosis in fine needle aspirates are described. A retrospective analysis of aspirates from 62 cases with subcutaneous swellings in various sites showed the presence of the parasite in 25 cases. In another 31 cases, the aspiration smears contained no larval parts, but did contain an inflammatory reaction (consisting of large numbers of eosinophils and palasading histiocytes) suggestive of a parasitic cyst. Corresponding histologic material from 19 of these cases were diagnostic of cysticercosis in 9 cases and suggestive of cysticercosis in 10. However, histology was diagnostic of cysticercosis in six cases that produced acellular aspirates. These results show that fine needle aspiration cytology can diagnose or suggest cysticercosis in many cases, but may be falsely negative in a few. PMID- 2781972 TI - The cytology of malignant histiocytosis (sinusoidal hematolymphoid malignancy). AB - Malignant histiocytosis (MH: sinusoidal hematolymphoid malignancy) is a rare lymphoreticular disorder characterized by an aggressive clinical course in younger patients with weight loss, hepatosplenomegaly, generalized lymphadenopathy and pancytopenia. Five cases of MH were identified over a five year period (1982 to 1987) at Indiana University Medical Center. The patients' ages were 12, 16, 20, 30 and 57 years; all presented with classic clinical symptoms. Four cases were diagnosed by fine needle aspiration biopsy; one case was diagnosed by the examination of ascitic fluid. All patients had confirmatory surgical biopsies. The salient cytologic features of MH included (1) a lack of background lymphoglandular bodies, (2) a population of variably sized dyscohesive cells, (3) a component of large bizarre cells with abundant eccentric, deep-blue cytoplasm on Wright-Giemsa-stained preparations, (4) prominent cytoplasmic vacuolization and (5) inconspicuous erythrophagocytosis occurring in the most benign-appearing histiocytic cells. Ancillary studies on cytologic and histologic material (immunostaining for alpha-1-antichymotrypsin and alpha-1-antitrypsin and staining for nonspecific esterases) confirmed the histiocytic nature of the malignant cells. Recognition of the distinctive morphology of MH and the performance of ancillary studies on cytologic preparations should facilitate the rapid diagnosis and early treatment of this aggressive disease. PMID- 2781973 TI - Fine needle aspiration of carotid body paraganglioma. PMID- 2781974 TI - Carotid body tumor initially diagnosed by fine needle aspiration cytology. PMID- 2781975 TI - Cytopathologic diagnosis of an eosinophilic granuloma of bone by needle aspiration biopsy. PMID- 2781976 TI - Criteria for adequacy of cervical cytologic sampling. PMID- 2781977 TI - On the microbiologic classification of cervicovaginal flora in Papanicolaou smears. PMID- 2781978 TI - Predictive value of phenotypic cytologic characteristics in early dysplastic cervical lesions. PMID- 2781979 TI - Clinical and pharmacological characterization of anomalous metoclopramide-induced growth hormone secretion in insulin-dependent diabetes mellitus. AB - An abnormal growth hormone (GH) increase after non-specific stimuli (such as TRH, LHRH and, in a few cases, metoclopramide), has been described in insulin dependent diabetes. Sixty-nine non-hypogonadic male insulin-dependent diabetic patients (mean age 38.6 years, range 18-54; mean duration of diabetes 11.1 years, range 1.3-28, in different degree of metabolic control, some of them with retinopathy, nephropathy and peripheral and/or autonomic neuropathy) were tested twice with 10 mg i.v. metoclopramide (MCP), an antidopaminergic agent with weak serotoninergic activity. Anomalous GH response (i.e. GH increment equal to or higher than 5 ng/ml from basal level) occurred in 33 patients (47.8%). Mean (+/- SE) MCP-induced GH release in these 'responder' patients peaked up to 17.2 +/- 1.7 ng/ml in comparison with no variation found in 'non-responders' and in 25 healthy control men. Abnormal GH secretion appeared to be unrelated to age, metabolic control, basal GH values and duration of diabetes. Moreover, it remained unmodified by pretreatments with placebo, cimetidine, meclastine, propranolol, acetylsalicylic acid and naloxone, while it was enhanced by metergoline, significantly reduced by bromocriptine and almost completely blunted by pirenzepine, a cholinergic muscarinic receptor antagonist. Neuropathy and nephropathy were equally distributed in the two groups, while retinopathy was more frequent in 'responders'. In conclusion, the exact mechanism(s) by which MCP may induce a paradoxical GH release in many insulin-dependent diabetic patients, is still unclear; it might be dependent, at least in part, on the activation of cholinergic pathways. Indeed, it seems to indicate the presence, in diabetes, of a rather complex derangement in the regulatory mechanisms of GH secretion. PMID- 2781980 TI - 'Microalbuminuria' in type I (insulin-dependent) diabetic patients with and without retinopathy. AB - We investigated the frequency of microalbuminuria (albumin excretion rate, AER greater than 15 micrograms/min) ('overnight' urine collection and radioimmunological evaluation) and its relation to retinopathy (assessed by fluorangiography) in 113 type I (insulin-dependent) diabetic subjects (aged 31 +/ 13 years; diabetes duration 11 +/- 7 years), all Albustix-negative. Sixty eight patients (60.2%) were free of retinal lesions, 31 (27.4%) had background retinopathy and 14 (12.4%) had proliferative retinopathy. Microalbuminuria was found in 25 patients (22%). Fifteen patients (13%) showed both retinopathy and microalbuminuria. Fifteen % (10/68) of the patients with no retinopathy and sixteen % (5/31) of those with background retinal lesions had microalbuminuria, while 29% (4/14) of the patients with proliferative retinopathy were normoalbuminuric. Among the 29 patients with diabetes for less than five years, 1 had retinopathy and 4 had microalbuminuria. Out of 15 patients with both retinopathy and microalbuminuria, 13 (87%) had had diabetes for more than 10 years. Diabetic retinopathy is more frequent than microalbuminuria (40 vs 22%). Although the linkage between retinopathy and microalbuminuria is weak, after ten years of diabetes the two complications may frequently coincide. PMID- 2781981 TI - A comparison of maternal and cord blood glucose levels in diabetic and non diabetic Nigerians in relation to birth weight and maternal body mass index. AB - Maternal and cord blood glucose levels in diabetic multiparous Nigerian women were compared in relation to variable parameters such as birth weight, maternal body mass index (BMI), age and number of births, in order to ascertain the effect of diabetes on parity among women of pure Negro race. Pregnant women of pure Negro origin who were native to Nigeria or other African countries were selected for the study. The subjects were age-matched into three age groups of 20-24, 25 35, and 36 or over years, respectively and then were further divided into diabetics and non-diabetics following a 75 g OGTT. Umbilical cord blood and maternal blood samples were collected immediately after each delivery. The amount of glucose in blood was determined by means of Dextrostix reagent strips read in a glucometer. Birth weight, umbilical cord blood glucose and maternal blood glucose increased slightly with increasing age in the diabetics. There was no effect of age on umbilical cord and maternal blood glucose levels in non diabetics. Maternal BMI also increased with age in the diabetics whereas it increased only slightly but not significantly at the age of 36 years and over in the non-diabetics. However, there was a slight increase in birth weight with increasing age among the non-diabetics. The correlation coefficients (r) of the relationship between maternal blood glucose and baby weight were +0.905 for the diabetic and +0.155 for non-diabetic groups.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2781983 TI - Estrogen and progesterone receptors in leiomyomas and normal uterine tissues during reproductive life. AB - Estrogen and progesterone receptors (ER, PR) were measured in leiomyomas and normal uterine tissues. Estrogen receptors concentration was higher in endometrium than in leiomyomas, lowest in normal myometrium. In the case of progesterone receptors, the concentrations in endometrium and leiomyomas were similar whereas that of myometrium was lower. ER and PR concentration were similar in leiomyomas of the uterine fundus, body and isthmus and steroid receptor content in the inner parts of large myomas was the same as in the outer parts. ER and PR concentrations in tumor-bearing myometrium were not different from those in myometrium of a control group. PMID- 2781982 TI - Uterine fibromyoma and sterility: role of myomectomy. AB - The role of abdominal myomectomy with regard to surgical technique, subsequent conception and term pregnancy was evaluated. Of 30 patients undergoing myomectomy 13 conceived and 10 had a good pregnancy. It should be noted that 10 of 30 patients considered in this study had a leiomyomas associated disease, representing another cause of infertility. Thus, a preoperative evaluation of the reproductive capability of the couple would allow a selection of patients who are to undergo myomectomy resulting in a better pregnancy rate. In the present series, the ages of the patients and the size of the leiomyomas did not significantly influence the pregnancy rate. The most important correlation with subsequent fertility was the duration of infertility prior to myomectomy. The general principles of reproductive microsurgery should be kept in mind when performing myomectomy. PMID- 2781984 TI - Post-RN degree at Athabasca University. PMID- 2781985 TI - Pain corner. "Could I have an order for?". PMID- 2781986 TI - Articulation and baccalaureate entry into nursing practice in Alberta. (Part Two- Study methodology). PMID- 2781987 TI - Nursing--a changing profession. PMID- 2781988 TI - Growing in the light--Edmonton--a personal response to nursing dis-ease. PMID- 2781989 TI - Transcultural nursing: a community based perspective. PMID- 2781991 TI - Reliability of the testing for the "strength of the nervous system" in humans. PMID- 2781990 TI - Motor skill acquisition influences brain responsiveness in sprinters. AB - Contingent negative variation (CNV) and reaction time were examined in four groups of eight young adult men: controls, witnesses, students in physical and athletic education, and sprinters. Subjects, except the control group, were asked to detect and respond quickly by pressing a button in the following experimental conditions: 1) simple auditory stimuli, 2) paired auditory stimuli, 3) mixed simple and paired auditory stimuli.- A higher CNV voltage and lower reaction time and reaction time variability were obvious in students in physical and athletic education and sprinters, compared to controls and witnesses. In all the groups CNV amplitude declined in the third condition, reaction time and reaction time variability augmented from condition 1 to condition 3. These results show that relationships couple attentiveness and motor activation processes. The motor activation differed for simple starter and presignalled starter conditions (conditions 1 and 2). An increase of discrimination difficulty diminished the performance. PMID- 2781993 TI - The efficacy of mianserin (Lerivon) in various forms of depression. PMID- 2781994 TI - Lithium in the prophylaxis of affective disorders: a twenty years experience. PMID- 2781995 TI - Influence of imipramine and amitriptyline on the hypothalamic function in affective disorders. PMID- 2781992 TI - 30th International Annual Psychopharmacology Meeting. Jesenik Spa, January 1988. Proceedings. PMID- 2781996 TI - Alprazolam in the treatment of endogenous depressions. PMID- 2781997 TI - Different cardiovascular effects of tricyclic antidepressants in the conscious and anesthetized rats. PMID- 2781998 TI - Additive interaction of haloperidol with morphine in the guinea pig ileum. PMID- 2781999 TI - An alternative approach to the evaluation of the DST results. PMID- 2782001 TI - Borderline symptomatology: differences between depressive and nondepressive patients fully or partly hospitalised. PMID- 2782000 TI - EEG changes after mesocarb in respondent and nonrespondent hyperkinetic children. PMID- 2782002 TI - Controlled study of dihydroergotoxine in gerontopsychiatric patients. PMID- 2782003 TI - AWD 52-39, an ergot derivative with potential nootropic activity. PMID- 2782004 TI - Oxazepam to stomatologic patients who do not cooperate. PMID- 2782005 TI - Bioequivalence testing of formulations of alprazolam and chlordiazepoxide. PMID- 2782006 TI - Behavioural effects of fluprazine in aggressive and timid mice during intraspecies conflict. PMID- 2782007 TI - Effects of muscimol, cetyl-GABA, pentetrazol and picrotoxin on timidity during intraspecies conflict in mice. PMID- 2782009 TI - Pramiracetam and epileptic after-discharges in young rats after hypoxia. PMID- 2782008 TI - Piracetam and metrazol-induced ECoG phenomena. PMID- 2782010 TI - Differences in the duration of the anticonvulsant action of clonazepam during ontogenesis in rats. PMID- 2782011 TI - Strictly simultaneous classical eyelid conditioning in man. AB - Strictly simultaneous eyelid conditioning in human Ss on the one hand and forward (ISI: 0.45 s), backward (ISI: -0.45 s), and pseudoconditioning on the other hand were compared in two different experimental situations: one-session experiment (100 reinforcements, 20 isolated CS randomly interspersed), and ten-sessions experiment (20 reinforcements, 4 isolated CS in each session), UCS was a light flash (0.5 J, 20 microseconds duration), CS a tone (1000 Hz, 50 ms, 73 dB). In both the experiments, strictly simultaneous conditioning was significantly different from pseudoconditioning, but significantly less effective than forward conditioning. In the ten-sessions experiment, it was also less effective than backward conditioning, while in the one-session experiment, it did not differ from backward conditioning. Statistical mixture decomposition method applied to the one-session- and the ten-sessions- experimental samples of individual acquisition curves resulted into the division of both samples into 4 subgroups according to the trend of acquisition curves. A significant positive association between the conditioning procedure and the distribution of individual curves into the four subgroups was found. PMID- 2782013 TI - Effect of physostigmine and its combination with some drugs on the process of verbal learning. PMID- 2782012 TI - Behavioural consequences of NaNO2-induced hypoxia in male rats. PMID- 2782014 TI - Biochemical and behavioral effects of alaptide, a spirocyclic dipeptide derived from Pro-Leu-Gly-NH2. PMID- 2782015 TI - Growth of the clavicle and development of clavicular secondary cartilage in the embryonic mouse. AB - Whether secondary cartilage develops in the mammalian clavicle has been a matter of controversy. This study documents, in the embryonic mouse: (a) the onset of clavicular osteogenesis at 14 days of gestation (Theiler stage 22); (b) the appearance of secondary cartilage at 16 days of gestation (Theiler stage 24) and its persistence as a prominent cartilage until 18 days of gestation; (c) that the relative growth rate of the clavicle is much higher (0.097 mg/g body weight/day) between 16 and 17 days of gestation than at later ages (mean of 0.005 mg/g/day between 17 days of gestation and 4 days postnatally), and (d) that secondary cartilage failed to form in clavicles from 15-day-old embryos maintained in vitro. We conclude that secondary cartilage is a feature of the developing mouse clavicle, that it arises when the relative growth rate of the clavicle is highest, and that the most likely stimulus for differentiation of this cartilage is mechanical, muscle-based and associated with rapid relative clavicular growth. PMID- 2782016 TI - Microscopic study of cortical explants from lamb kidney in culture. AB - Cortical explants from lamb kidney have been maintained in organ culture for up to 12 days. Early in culture, the tissue showed limited necrosis, but most tissue elements, especially those closest to the medium, significantly recovered by day 5. Glomerular peripolar cells were present for at least the first 3 days of culture. Neotubular formation was noted by day 5, often appearing as cyst-like structures. Glomerular podocytes lost their foot processes early in culture but apparently remained viable throughout the total culture period. PMID- 2782017 TI - Automatic external rotation during passive glenohumeral abduction. AB - A study of human cadaveric glenohumeral joints was undertaken to investigate the mechanism of external rotation during abduction. Previously explored extra articular influences such as the coracoacromial arch and the rotator cuff muscles were removed from the specimens. A specially designed device was used to measure abduction in the scapular plane as well as any rotation of the humerus. The findings show that external rotation is a consistent feature of passive abduction in the plane of the scapula and could take place in the absence of extra articular influences. The mechanism appears to lie either in the nature of the capsule or of the articular contours. A role for the intra-articular part of the long head of the biceps cannot be excluded. PMID- 2782018 TI - Three-dimensional arrangement of dense connective tissue around the human major duodenal papilla. Including the ampullary region and the distal choledochal duct. AB - Directionally arranged dense connective tissue fibres were investigated in 21 specimens of the major duodenal papilla. Specimens were examined using a stereoscope, polarization microscopy and serial histological sections at three different planes. Directionally arranged dense connective tissue fibres spread in a deltoid pattern from the orifice of the major duodenal papilla and its intraduodenal part to the circular duodenal musculature. Connective tissue fibres crossing at different angles form a texture from the orifice of the major duodenal papilla to the distal choledochal duct. The functional significance of the dense connective tissue fibres, e.g. for the muscular system in the investigated area, is discussed as well as possible reasons for gallstone impactions. PMID- 2782020 TI - Anatomy of the recurrent laryngeal nerve in normal Iraqis. AB - A study of the anatomy of the recurrent laryngeal nerve was made on 106 post mortem cases and fixed dissecting-room cadavers. The usual position of the nerve was in the tracheo-oesophageal groove. The nerve lay posterior to the inferior thyroid artery on the left side in most cases, while its relation was very variable on the right side. The inferior cornu of the thyroid cartilage was the best guide to the site of entry of the nerve into the larynx. PMID- 2782019 TI - Distribution of putative elastic fibers in rabbit temporomandibular joint tissues. AB - This study describes the general distribution of putative elastic fibers in the connective tissues that comprise the articular disk and some of the adnexal tissues of the rabbit temporomandibular joint. Joints were removed en bloc and processed for light-microscopic study. The fibroelastic tissues of the bilaminar zone of the articular disk and the various attachments of the disk to the mandibular condyle contained numerous elastic fibers. Since these morphologic data indicate the presence of many elastic fibers, we suggest that the rabbit temporomandibular joint may serve as a model system to study the functional consequences of selectively altering the quality or quantity of elastic fibers in these tissues. PMID- 2782021 TI - A reevaluation of the distribution of 3H-proline in the transseptal ligament of the mouse in radioautography. AB - It is generally accepted that there is uniform collagen metabolism within the periodontal and transseptal ligaments. The present study suggested regional variations in the incorporation and removal of 3H-proline within the transseptal ligament in radioautography, suggesting variable rates of collagenous protein remodeling coincident with physiological tooth movements. Highest numbers of silver grains were over the middle third of the ligament during both incorporation and removal phases (p less than 0.001). Rates of grain removal were greater in the middle than in mesial or distal thirds (p less than 0.001). The half-life of labeled proteins was significantly less in the middle than in mesial or distal thirds (p less than 0.005). Because there were no significant regional differences in cell numbers, regional variability in grain incorporation and removal within the transseptal ligament likely indicates regional differences in cellular synthetic or degradative activity coincident with remodeling of the transseptal ligament during physiological drift and suggests that the center of this ligament may experience more stress and, thus, remodels more rapidly. PMID- 2782022 TI - Morphology of the release of vitamin A-containing lipid droplets by perisinusoidal lipocytes in the rat liver. AB - Vitamin A-containing lipid droplets in perisinsoidal lipocytes (or fat-storing cells) of rat liver were found to be exocytotically released from the cells in the form of a 'lipid droplet-protein complex' following intraportal injection of retinol (17, 33, 67 or 100 micrograms). Intraportal injection of retinol produced varied numbers and sizes of vacuoles with a limiting membrane in perisinusoidal lipocytes. The substance within the vacuoles exhibited a meshwork-like configuration in sections from slices incubated in a medium for revealing acid phosphatase activity or the corresponding control medium, and was immunoreactive to retinol-binding protein and proteinaceous in nature. The occurrence and number of the vacuoles depended on the dosage of injected retinol, being greatest at a dosage of 100 micrograms of retinol and becoming progressively less at dosages of 67, 33 and 17 micrograms. The vacuoles appeared to be formed by vacuolization of cisternae of the rough endoplasmic reticulum. Little or no esterase activity was found in lipid droplets in perisinusoidal lipocytes before the intraportal injection of retinol, but after the injection lipid droplets which had fused with the vacuoles became strongly positive for this enzyme activity. This suggests that hydrolysis of retinyl esters may occur in the process of complex formation in perisinusoidal lipocytes. PMID- 2782024 TI - Arterial supply and venous drainage of the brain of the black bear (Ursus americanus). I. Gross anatomical distribution. AB - A morphological study of the intracranial vessels of the Black bear (Ursus americanus) was undertaken. The object was to provide basic information related to the vascular pattern in these animals as compared with other carnivores and with the human. Vascular casts were prepared from 6 animals. The vasculature of the brain disclosed patterns comparable to other species previously studied. PMID- 2782023 TI - Co-existence of gametic and agametic seminiferous tubules in a chimeric mouse. A light- and electron-microscopic study. AB - Six chimeras, including 4 phenotypic males and 2 females, were produced by aggregation of F1 (C57BL x BALB/c) and Swiss white embryos. All were fertile, except 1 male, whose deviation in testicular structure prompted this light- and electron-microscopic study. This chimera had a well-developed sperm-conducting system, sperm in the epididymis and active accessory sex glands. The testes displayed typical parenchymal and stromal components with the important exception of co-existence of gametic and agametic seminiferous tubules. These tubules were organized in territories of quasi-lobular configurations which appeared to open separately into rete testis. The former corresponded to normally developed and active seminiferous tubules, while the latter were solid testicular cords devoid of any germ cells and embedded in solid masses of interstitial (Leydig) cells. Special mitochondrial transformations were identified in sustentacular (Sertoli) cells of both types of tubules, in maturing spermatids and sperm. These and other submicroscopic sperm defects might be the cause of infertility. PMID- 2782025 TI - Arterial supply and venous drainage of the brain of the black bear (Ursus americanus). II. Intracranial microvasculature. AB - A morphological study of the intracranial microvasculature of the Black bear (Ursus americanus) using vascular casts was undertaken. The object was to provide basic information regarding structural modifications of the microvasculature that might provide insight into the ability to cope with low blood flow states that occur during winter sleep. Vascular casts were prepared from 6 animals. The microvasculature of the brain disclosed characteristic features of the small vessels in mammals, including vascular sphincters of two types and numerous arterial and arteriolar anastomoses. PMID- 2782026 TI - Spinal cord injury in rats: inability of nimodipine or anti-neutrophil serum to improve spinal cord blood flow or neurologic status. AB - The role of a calcium-mediated increase in vascular resistance and of vascular damage caused by polymorphonuclear leukocytes (PMNLs) in the development of neurologic deficit and disturbance of spinal cord circulation following spinal cord compression was studied in the rat. Spinal cord injury was induced by 5 min of compression with a load of 35 g on a 2.2 X 5.0 mm compression plate. This caused transient paraparesis. The rats received either the calcium receptor antagonist nimodipine or an anti-rat neutrophil serum (ANS). Nimodipine was infused i.v. for 4 h in an amount of 1.5 micrograms/kg/min starting 60 min after trauma. The number of circulating PMNLs was depleted by intraperitoneal injection of an ANS raised in sheep given 12 h before trauma. This caused a reduction to about 2% of the pre-ANS value. Controls received saline or normal sheep serum. The motor performance was assessed daily on the inclined plane. On day one, the day after injury, the capacity angle had decreased from about 63 degrees preoperatively to close to 32 degrees in the experimental groups. There was then a slow improvement in both the control and experimental groups and on day 4 the capacity angle was close to 43 degrees in all 3 groups. Spinal cord blood flow, as measured with the 14C-iodoantipyrine autoradiography method, was similar in all groups on day 4. As neither the neurologic dysfunction nor the spinal cord blood flow was affected by post-trauma treatment with nimodipine or pretreatment with ANS, the possibility that calcium-mediated vasoconstriction or PMNLs play a role in the development of posttraumatic neurologic disability was not supported by this study. PMID- 2782027 TI - Glutamate metabolism of leukocytes and skin fibroblasts in spinocerebellar degeneration with lowered glutamate dehydrogenase activity. AB - From 21 patients with spinocerebellar degeneration 5 had markedly decreased glutamate dehydrogenase (GDH) activities and high values of serum plasma glutamate level after oral glutamate loading tests. Skin fibroblasts from patients with GHD deficiency showed intracellularly higher glutamate and lower glutathione contents than those from controls and showed significantly decreased viability in L-glutamate-containing medium. These data suggest that glutamate toxicity may at least play a part in this degeneration process. PMID- 2782028 TI - Positive autoradiographic findings in brains of four MS patients. AB - Autoradiography of brain slices from 4 multiple sclerosis (MS) and 9 control patients was performed. After 6 weeks of exposure the exact picture of the white matter appeared on the X-ray films in all cases with MS, but only in one of the controls. The high level of autoradiographic signal from MS white matter suggests that an abnormal accumulation of radioactive trace elements takes place within the brains of MS victims. PMID- 2782029 TI - Cerebral computed tomography in paroxysmal atrial fibrillation. AB - Atrial fibrillation (AF) is associated with an increased risk of stroke. In patients with chronic AF, without clinically known cerebrovascular disease, computed tomography (CT) has revealed a high frequency of abnormal low-density areas suggesting old asymptomatic infarcts. To investigate the frequency of such lesions in paroxysmal AF, 30 patients with paroxysmal AF and 30 controls matched in sinus rhythm, without history of cerebrovascular disease, were CT scanned. Four patients with paroxysmal AF (13%) and 3 controls (10%) had abnormal CT scans with areas of low density with sharp demarcation from surrounding tissue. The abnormal areas probably reflected small, clinically silent infarcts. There were no differences between paroxysmal AF and controls in number and size of abnormal areas with apparent tissue loss. In contrast to chronic AF, the risk of such lesions in paroxysmal AF does not seem to be increased compared with matched sinus rhythm controls. This is in agreement with the clinical experience of a low risk of stroke in paroxysmal AF. PMID- 2782031 TI - Absence of the cystatin C amyloid in the cerebral amyloid angiopathy, senile plaque, and extra-CNS amyloid deposits of aged Japanese. AB - Amyloid protein in Icelandic patients with hereditary cerebral amyloid angiopathy (CAA) is a variant of cystatin C. Immunoreactivities of the cystatin C and other amyloid proteins were investigated in CAA and other senile amyloid deposits in the Japanese sporadic aged cases including patients with dementia of Alzheimer type, and compared with those in Icelandic hereditary CAA. Compared with positive reaction of cystatin C in Icelandic hereditary CAA, no immunoreactivity of cystatin C was found in senile amyloid deposits of the Japanese aged including CAA. Immunoreactivity of the amyloid beta protein was negative in Icelandic hereditary CAA, for which CAA and senile plaque amyloid in the Japanese senile brains were positive. Our data suggest that the cystatin C amyloid would be present only in hereditary CAA, but not in the CAA and other senile amyloid deposits of the sporadic aged cases. PMID- 2782030 TI - Manifesting carrier of Becker muscular dystrophy (BMD): clinical and recombinant DNA studies. AB - We studied a Becker muscular dystrophy (BMD) family with a manifesting carrier. Proximal muscle weakness, pseudohypertrophy of the calves, significantly elevated serum creatine kinase and dystrophic alterations in the muscle biopsy were the characteristic phenotypical features of this manifesting carrier. The recombinant DNA study showed a recombinant chromosome with a crossover between pERT 87-8 and pERT J-Bir in the manifesting carrier. However, the proximal part of the short arm of her X chromosome was identical to a non-manifesting carrier (her sister) and to her affected brother. For this reason, we assumed the BMD mutation was proximal to the crossover. The dystrophin cDNA probes showed no deletion of DMD/BMD gene. PMID- 2782032 TI - Critical fusion frequency in MS during mild induced hyperthermia. AB - By raising the body temperature of 0.5 degrees C the critical fusion frequency of a flickering light increases in normal subjects but decreases in multiple sclerosis (MS) patients. The change was present in 14 patients with definite MS and in 5 of 10 patients with probable MS. No clinical worsening was observed during the procedure or in the following hours. PMID- 2782033 TI - No HLA association in organic brain dysfunction due to solvents. PMID- 2782035 TI - Electroencephalography in dizzy patients. PMID- 2782034 TI - Mixed solvent exposure and organic damage: the missing table. PMID- 2782036 TI - Prognosis in solitary intraventricular haemorrhage. Clinical and computed tomographic observations. AB - Isolated intraventricular haemorrhage (IVH) in the absence of parenchymal haematoma is unusual. Fifteen patients with solitary IVH among 170 with intracranial haemorrhage were studied. Clinical details and computed tomographic features were analysed to evaluate the prognostic significance of various clinical and CT parameters. Outcome is affected by hypertension, level of consciousness, clinical progression, pupillary changes and restriction of eye movements. Factors found on CT to have prognostic significance included degree of ventricular bleed, presence of cisternal bleed, hydrocephalus and cerebral atrophy. PMID- 2782037 TI - Brain edema after middle cerebral artery occlusion. A comparison between normotensive and spontaneously hypertensive rats. AB - The right middle cerebral artery (MCA) was occluded either during 30 min or permanently, in normotensive Wistar Kyoto (WKY) and spontaneously hypertensive (SHR) rats. The rats were killed 2, 6 or 24 h later. Brain specific gravity, an indicator of brain edema, was determined on samples from the prefrontal, frontal, parietal and occipital cortex and the caudate nucleus. In SHR the brain specific gravity was significantly reduced in the right hemisphere at 2, but not at 6 or 24 h after a temporary occlusion. After permanent ligation, the specific gravity markedly decreased with time in the right hemisphere in SHR with significant difference from WKY, as well as from the left hemisphere, at all intervals. Our data support the concept that chronic hypertension aggravates ischemic brain edema after an arterial ligation. PMID- 2782038 TI - Effects of dietary linoleic acid and gamma linolenic acid on platelets of patients with multiple sclerosis. AB - The effects of dietary evening primrose oil (rich in linoleic acid and gamma linolenic acid) were studied on platelets of multiple sclerosis (MS) patients and controls. It was found that platelet aggregation (ADP, thrombin and collagen), platelet fibrinogen binding and platelet glycoprotein (sialic acid and N-acetyl glucosamine) content were not significantly modified by evening primrose oil in MS patients and controls. Moreover, platelet fibrinogen binding and platelet glycoprotein (sialic acid and N-acetyl glucosamine) content were determined for the first time in MS patients and found similar to controls. Platelets of MS patients aggregated more to thrombin and collagen compared to controls, but the difference was only significant with thrombin aggregation after the oil treatment. This study does not show a significant effect of evening primrose oil on platelets of MS patients. PMID- 2782039 TI - Ischemic stroke in young adults. I. Analysis of the etiological subgroups. AB - An ischemic stroke (IS) group including 386 patients under 50 years old is analysed taking into account different etiological subgroups and comparing risk factors against a control group of 100 people. The series points out the presence of 66.1% patients included in the inconclusive-atherothrombosis group, of which 22.7% had defined criteria of atheromatosis, while 11.6% were diagnosed of lacunar infarct. 13.5% of cases were considered as cardiac origin embolisms, and 14.1% were affected of mitral valve prolapse. The migraine group includes 4.9% of the patients while 17.6% belong to the miscellaneous group. The comparison of each of these groups with the control group showed significant differences for family history of stroke, personal history of peripheral arteriopathy, tobacco, arterial hypertension and previous IS. PMID- 2782040 TI - Acetazolamide effects on cerebral blood flow in acute reversible ischemia. AB - Cerebral blood flow (CBF) was studied in 4 patients with acute reversible ischemia (RIND). To test the ischemic areas' vasoreactivity, CBF was measured by the Xenon-133 inhalation method, before and after acetazolamide injected intravenously. At the baseline CBF study, 3 patients presented hypoperfused areas while one patient had increased CBF over the affected hemisphere. The acetazolamide test, showed in this latter case a "steal phenomenon" while in the other 3 an increase of perfusion was evidenced, in areas of normal flow, as well as in areas with reduced flow. These results suggest that in the acute phase of patients with RIND, when brain regions of hypoperfusion and neurological signs are still present, the vasomotor response may be preserved. PMID- 2782041 TI - Risk factors in multiple sclerosis: a population-based case-control study in Hautes-Pyrenees, France. AB - A population-based study of the prevalence and risk factors of multiple sclerosis (MS) was conducted in the Hautes-Pyrenees, the southwestern region of France. The prevalence rate per 100,000 was equal to 40. Data on the past medical history of 63 MS patients and matched controls were collected. The frequency and age at occurrence of common childhood infections were similar for both the MS cases and controls. There was no difference between the frequency of vaccination for MS patients and for controls. However, the age at which MS patients were immunized against poliomyelitis was significantly higher than the corresponding age for controls (15.8 years versus 8.9 years, P less than 0.01). Antibody titers for various viruses were measured. The mumps antibody titer was significantly higher in the MS patients than in the controls. Also, MS patients tended to have higher titers for measles antibodies. PMID- 2782042 TI - Status epilepticus in the elderly: etiology, seizure type and outcome. AB - We have studied status epilepticus among 342 patients who had their first seizures after the age of 60 years. One hundred and two patients (30%) had status epilepticus. Cerebrovascular disease (35%) was the leading cause of status, followed by head trauma (21%), multifactorial etiology (11%), metabolic disorders (10%), brain tumors (8%) and CNS infection (2%). The etiology of status remained undetermined in 13 patients (13%). The majority (80%) had partial status or generalized status with focal onset. Overall mortality was 35%. PMID- 2782043 TI - Effect of L-dopa on dementia-related rigidity. AB - L-dopa 100 mg plus benserazide 25 mg versus placebo were given 3 times daily to 14 consecutive patients with dementia and rigidity. The treatment was crossed over to the alternative therapy after a 7-day period. Despite a mean 60% raise in CSF-HVA during L-dopa administration, no patient responded to the treatment. These data suggest that dementia-associated rigidity differs, at least, pharmacologically from parkinsonian rigidity. PMID- 2782044 TI - Tactile extinction to simple (elementary) and complex stimuli. AB - Thirty patients with cerebrovascular disease and 85 control subjects were examined using both the classical tactile extinction test and a modified Quality Extinction Test (modified QET) in order to investigate the so-called tactile extinction phenomenon to complex stimuli from the qualitative standpoint. As a result, 1) the patients with tactile extinction to simple (elementary) stimuli also manifested extinction to complex tactile stimuli in the modified QET; 2) there were patients who exhibited extinction only to complex tactile stimuli. Our results provide support for the concept that the so-called tactile extinction phenomenon could result from competition between tactile stimuli presented to both hands at at least 2 different levels of tactile processing, i.e. the process of perception and the process of recognition. When discussing the phenomenon of extinction to complex tactile stimuli, therefore, one should consider these 2 forms of extinction separately. PMID- 2782045 TI - Eating epilepsy. AB - Fifty cases of eating epilepsy (EE) are reported. Mastication of food produced seizures in 49 (98%) and swallowing in 1 (2%). Complex partial seizure was found in 48 cases, the commonest form encountered (96%). EEG was abnormal in 15 cases (30%). The literature and possible mechanisms for seizure are discussed. PMID- 2782046 TI - Formation of microglia-derived brain macrophages is blocked by adriamycin. AB - Injection of ricin, the toxic lectin from Ricinus communis, into the rat facial nerve leads to rapid degeneration of motor neurons and concomitant proliferation and transformation of endogenous microglia into brain macrophages. Using [3H] thymidine autoradiography, immunocytochemistry for microglial markers and electron microscopy, we could show that when ricin was administered together with the cytostatic drug adriamycin, the retrogradely transported adriamycin inhibits the macrophage response induced by toxic ricin. It is concluded that under conditions of neuronal degeneration, e.g., following ricin intoxication, brain macrophages are predominantly, if not exclusively, derived from endogenous microglia. PMID- 2782049 TI - Degeneration of neuronal processes in rats induced by a protease inhibitor, leupeptin. AB - Severe degeneration of neuronal processes, including axons and dendrites, as well as accumulation of lipofuscin-like dense bodies have been induced in rats by continuous intraventricular administration by infusion of a protase inhibitor, leupeptin. The aggregation of degenerated processes in neuropils mingled with glial cells and their processes resembled the aggregation of degenerated neurites that are important constituents of the senile plaque of Alzheimer's disease. The present findings provide morphological evidence supporting the hypothesis that protease inhibitors participate in the process of senile plaque formation. PMID- 2782047 TI - Sites of egress of inflammatory cells and horseradish peroxidase transport across the blood-brain barrier in a murine model of chronic relapsing experimental allergic encephalomyelitis. AB - Results are reported of experiments designed to focus at attachment sites of inflammatory cells (ICs) on the luminal surface of brain endothelial cells (ECs) and on the mechanisms of horseradish peroxidase (HRP) transport across the altered blood-brain barrier (BBB) in a murine model of chronic relapsing experimental allergic encephalomyelitis. Cationized ferritin (CF) served as a marker for evaluating the electrostatic nature of brain microblood vessels (MBVs) on the plasma membranes of ICs or normal mouse peripheral white blood cells and erythrocytes. SJL/J mice demonstrating clinical illness were given HRP or CF, in vivo or in situ, respectively. Light microscopy and conventional transmission electron microscopy of cerebellum or thoracic and lumbar spinal cord regions demonstrated HRP leakage most pronounced in MBVs with perivascular infiltrates. HRP traversed across the ECs via numerous vesicles and tubular profiles located mostly in the parajunctional regions, while EC junctions appeared closed. Scanning electron microscopy demonstrated that IC attachment was primarily at parajunctional sites on the EC surface. We also observed increased microvillar projections extending from the EC surface into the lumen. CF demonstrated a patchy decoration on both the luminal EC surface and IC membranes but did not label uncoated invaginating membrane pits or tubular structures. Our data indicate that the points of attachment of the ICs on the EC surface may reflect specific receptor sites where the ICs eventually gain entrance into CNS across the BBB during brain inflammation. PMID- 2782050 TI - Antibody-induced generation of reactive oxygen radicals by brain macrophages in canine distemper encephalitis: a mechanism for bystander demyelination. AB - The mechanism of inflammatory demyelination in canine distemper encephalitis (CDE) is uncertain but macrophages are thought to play an important effector role in this lesion. Serum and cerebrospinal fluid (CSF), containing anti-canine distemper virus and anti-myelin antibodies from dogs with CDE were tested for their ability to generate reactive oxygen species (ROS) in macrophages in primary dog brain cell cultures using a chemiluminescence (CL) assay. The majority of serum samples and several CSF samples from animals with inflammatory demyelination elicited a CL signal in infected dog brain cell cultures. In contrast, none of these samples induced a positive response in uninfected cultures which contained large numbers of myelin antigen-presenting cells, although defined anti-myelin antibodies lead to a marked secretion of ROS in this system. It was concluded that antiviral antibody-induced secretion of ROS, known to be highly toxic for brain tissue, may play an important role in white matter damage in inflammatory lesions supporting a previous hypothesis of bystander demyelination in CDE. No evidence was found for a similar antibody-dependent cellular cytotoxicity-like mechanism mediated by anti-myelin antibodies in CDE, which does not support the concept of autoimmunity in this disease. PMID- 2782051 TI - Cytological investigations on the cerebellar cortex of sudden infant death victims. AB - The study was based on the hypothesis that cerebellar hypoxia may play a role in sudden infant death syndrome resulting in morphological changes of the cerebellar cortex, especially with respect to Purkinje cell density. In the morphological evaluation of the Purkinje cell layer, special consideration was additionally given to secondary alterations (i.e., macrophage and/or astrocyte reaction). A total of 12 sudden infant death syndrome cases were compared with an age- and sex matched control group. The Purkinje cell density was evaluated by determining the number of these cells per surface unit on parasagittal sections in both hemispheres. The myelomonocytic and glial reaction was demonstrated by immunohistochemical methods using lysozyme as leukocyte and macrophage markers and glial fibrillary acidic protein as an astrocyte marker. Qualitatively, no alterations resembling a macrophage or glial cell reaction were detected in sudden infant death syndrome. No differences between the right and left cerebellar hemisphere could be established in the victims of sudden infant death syndrome nor in the controls. The number of Purkinje cells per 0.352 mm2 cortex was higher in the younger victims of sudden infant death (younger than 45 weeks of gestation) than in all matched controls. A statistically significant difference in Purkinje cell density, however, could not be established, and, especially, no indications of hypoxia were observed in the cerebellar cortex. PMID- 2782048 TI - An immunohistochemical study of somatostatin-containing nerves in the aganglionic colon of human and rat. AB - The distribution of somatostatin-like immunoreactive (SOM-LI) nerves was elucidated immunohistochemically in the gut tissues from patients with Hirschsprung's disease and congenital aganglionosis rats. In the normoganglionic human colon, SOM-LI nerve cell bodies were found to a greater extent in the submucous plexus and to a lesser extent in the myenteric plexus. However, they were rarely observed in both the plexuses of the oligoganglionic segment. SOM-LI nerve fibres were widely distributed in the aganglionic bowel. The circular muscle layer of the distal aganglionic segment was densely innervated by SOM-LI nerve fibres which are probably derived from the extrinsic, hypertrophic nerve bundles. A decreased number of the intramuscular nerves fibres were seen in the proximal aganglionic segment. In the colon and rectum from adult and 21-day-old rats, SOM-LI cell bodies were numerous in both plexuses. On the other hand, enteric neurons were completely lacking from the colon and rectum of congenital aganglionosis rats of 21 days old. No neuronal elements staining for SOM were disclosed in these aganglionic segments of mutant rats. A possible origin and pathophysiological role of the extrinsic nerve fibres containing SOM in the diseased bowel are discussed. It is concluded that SOM-LI nerves in the human distal colon comprise both intrinsic and extrinsic elements, while SOM nerves in the rat colon and rectum are of only intrinsic origin. PMID- 2782053 TI - Changes in the hippocampus and the cerebellum resulting from hypoxic insults: frequency and distribution. AB - Detailed neurohistological studies were undertaken on 35 cases of cardiac arrest, 17 of hypoglycaemia and 16 of status epilepticus. It was found that the frequency and pattern of selective vulnerability in the hippocampus were similar following cardiac arrest, hypoglycaemia and status epilepticus with the exception that the lateral limb of the dentate fascia was more frequently involved in hypoglycaemia than in the other two groups of cases. Within each group, however, CA1 was the most vulnerable. The cerebellum was less frequently affected in hypoglycaemia and status epilepticus than after cardiac arrest. These findings are compared with recent experimental studies in the rodent which have suggested that the pattern of neuronal damage in each of the three conditions is different. PMID- 2782052 TI - Pathology of the dentate nucleus in progressive supranuclear palsy: a histological, immunohistochemical and ultrastructural study. AB - Dentate nucleus pathology was studied histologically and immunohistochemically in four cases and ultrastructurally in three cases of progressive supranuclear palsy (PSP). In addition to neurofibrillary changes, there were ill-defined clumps of eosinophilic granular structures, named grumose degeneration (GD). GD was observed in three of the four cases; it was not seen in a case exhibiting severe Purkinje cell loss. In areas with prominent GD, neuronal loss was also marked and the remaining neurons were atrophic. GD, which was once believed to represent degenerated cell bodies of dentate neurons, could be histologically distinguished from perikarya of dentate neurons. Argentophilic rings and knobs were only a part of GD and the rest of GD was only faintly or not argentophilic. Immunostain for phosphorylated neurofilament proteins positively stained round structures of various sizes in GD, but a large part of GD did not react with the antibody. As described in other disorders, electron microscopy revealed that the GD consisted of clusters of numerous axon terminals and preterminal axons. Many appeared swollen to a varying extent and contained mitochondria, synaptic vesicles, neurofilaments, lamellar bodies, multivesicular structures, vacuoles or combinations of these organelles. A few were markedly swollen with accumulation of neurofilaments and other organelles, corresponding to the round structures which stained positively for phosphorylated neurofilament proteins. A considerable number of axon terminals with no apparent abnormal accumulations of organelles were found in areas of GD. PMID- 2782054 TI - Myeloblastoma of the brain. AB - Two patients developed intraparenchymal myeloblastomas (granulocytic sarcomas) of the brain. One patient with acute myelogenous leukemia in hematological remission had multiple myeloblastomas in the cerebrum and thalamus. The second patient, who had Philadelphia-chromosome-positive chronic myelogenous leukemia, developed a solitary lesion of the cerebrum without systemic evidence of blastic transformation of leukemia. By light microscopy, each biopsy specimen revealed a tendency for the malignant cells to appear in perivascular locations, and the presence of cytoplasmic naphthol AS-D chloroacetate esterase activity in some cells. Ultrastructural analysis demonstrated the presence of primary granule-like lysosomal structures in these cells, confirming their granulocytic origin. The lack of continuity of the myeloblastomas with the dura mater and the perivascular clusters of blast cells suggest that the pathogenesis of these lesions in the present cases could best be accounted for by the direct, hematogenous spread of mitotically competent leukemic cells to brain parenchyma. PMID- 2782055 TI - Occurrence of neurofibrillary tangles in the celiac ganglia. PMID- 2782057 TI - The suitability of a new index for the evaluation of dental wear. AB - The suitability of a new index for rating dental wear by different observers was tested. Four dentists, who were first calibrated using the scoring system and then subjected to an inter-examiner agreement test before and after a field study, rated 167 individuals in total in their private dental practices. The incisal/occlusal state of the teeth with regard to restorations and dental wear was recorded. The inter-examiner agreement test proved satisfactory when rating main groups of wear but not so good when rating subcategories. However, a marked improvement in agreement developed between the first and the second test. The individuals composing the field study group are probably not representative of Scandinavian populations in general. Relatively few teeth were missing, and the teeth were well restored. Only the highest age group (80-89 years) displayed the most severe degree of wear to any extent. However, wear into the dentin was observed in 20% of the teeth already in the youngest age group (20-29 years). These teeth were solely incisors and canines of both jaws. In conclusion, we found that the index should be well suited for the evaluation of dental wear in large groups of people by different investigators after adequate training in use of the system has been provided and that tooth wear may be a relatively small problem in urban Scandinavian populations with regular dental care. PMID- 2782058 TI - Individual changes in malocclusion from adolescence to 35 years of age. AB - It was the aim of this follow-up study to assess the extent of individual changes in the occurrence of specific pronounced traits of malocclusion in a sample of 176 subjects who were selected from a catchment population examined in adolescence in 1965-66 and who were re-examined in 1986-87 (mean age, 35.5 years). Orthodontic treatment had been received by 10% of the subjects, and extraction rates were low. Deep overbite and mandibular crowding, especially in the incisor segment, tended to increase in frequency. However, on the whole, the various malocclusion traits remained remarkably stable in the orthodontically untreated individuals. PMID- 2782056 TI - Head posture and dentofacial asymmetries in surgically treated muscular torticollis patients. AB - Muscular torticollis is a medically well-known condition that is usually diagnosed in early childhood and in which early surgical intervention is recommended to prevent the development of facial asymmetries. The purpose of this study is to examine head posture and possible dentofacial asymmetries in patients who have undergone surgical treatment for muscular torticollis in early childhood. Natural head position roentgenograms were taken in frontal projection, a clinical examination of oral status was performed, and dental casts were made. Marked craniofacial and dental asymmetries were observed, combined with a deviant head posture, in spite of surgical treatment for muscular torticollis earlier in childhood. PMID- 2782059 TI - Causal relation between malocclusion and caries. AB - In this second report of a follow-up study of long-term adverse oral health effects of malocclusion it is assessed whether various occlusal and space anomalies imply an increased risk of caries. In 1965-66 malocclusion was recorded in 176 adolescents who were re-examined in 1986-87 at the age of 33-39 years. DMFS scores, in the dentition as a whole and in the segments of the dental arches, were compared between subjects displaying specified traits of malocclusion at both examinations and a comparison group comprising subjects without malocclusion at both examinations. No relationship was found between the malocclusion traits and caries prevalence. PMID- 2782060 TI - Causal relation between malocclusion and periodontal health. AB - The purpose of this 20-year follow-up study was to assess whether persistent traits of morphologic malocclusion imply an increased risk of periodontal disease. In 1965-66 malocclusion was recorded in 176 adolescents who were re examined in 1986-87 at the age of 33-39 years. Markedly healthier periodontal conditions were found in women than men, in the higher social group than the lower one, and in the maxilla than the mandible. Subjects with specified malocclusion traits at both examinations were compared with subjects without malocclusion for the occurrence of calculus, gingivitis (bleeding), and pocketing. Controlling for the effect of sex and social group, periodontal disease was significantly more frequent in the maxilla in connection with crowding, extreme maxillary overjet, and cross-bite (p less than 0.05). No association was found in the mandible. The presence of certain malocclusion traits in adolescence may probably often call for special professional efforts of oral hygiene education rather than orthodontic therapy. PMID- 2782061 TI - Abrasives in snuff? AB - The purpose of this study was to determine and calculate the inorganic contents of four brands of snuff. Visual inspection of wet snuff showed fairly large, yellow crystal-like particles. Scanning electron microscopy and X-ray dispersive (EDX) analyses were used to study both wet snuff and ashes of snuff, whereas light emission spectrography was used to determine elements in the ashes. The crystal-like particles did not dissolve in distilled water or in ethanol heated to 60 degrees C. EDX analyses showed that most elements remained in the particles after washing. The total weight percentage of inorganic material in snuff was calculated after burning dried snuff until constant weight was obtained. The ashes of snuff did not contain any crystal-like particles but consisted of a small-grained amorphous mass. The following elements were detected: Ag, Al, Ba, Ca, Co, Cr, Cu, Fe, K, Li, Mg, Mn, Na, P, Pb, Si, Sr, Ti, Va, and Zr. Other elements such as rare earths were not searched for. The weight percentage of inorganic elements ranged between 12.35 +/- 0.69 and 20.95 +/- 0.81. Provided snuff is used in the same manner as chewing tobacco, and some people admit to doing so, there is a risk that its relatively high contents of inorganic material and heavily soluble salts may be conducive to excessive abrasion of teeth and restorations. PMID- 2782062 TI - Protein adsorption to hydroxyapatite and to calcium fluoride in vitro and amino acid analyses of pellicle formed on normal enamel and on calcium-fluoride-covered enamel in vivo. AB - Fluoride treatment of enamel has been reported to result in the formation of a layer of a CaF2-like material on the enamel surface. Protein adsorption to enamel is a specific process dependent on the nature of the surface, and little is known about protein adsorption to CaF2. Albumin and lysozyme were adsorbed to hydroxyapatite (HA) and CaF2 powder in vitro, and protein adsorption patterns constructed. In vivo pellicle was collected from three volunteers from fluoride treated enamel and from normal enamel, and the amino acid compositions analyzed separately. The results showed that CaF2 took up small amounts of proteins as compared with HA. When the CaF2 was pretreated with a phosphate buffer, pH 6.8, the protein adsorption increased markedly. The amino acid analyses showed no major differences in the amino acid compositions between pellicle collected from CaF2-covered enamel and pellicle collected from normal enamel. This lack of difference is presumably due to the adsorption of phosphate ions to the CaF2 crystals and hence changed surface properties. PMID- 2782063 TI - Non-protein nitrogen and true protein in infant formulas. AB - Protein and nitrogen (N) requirements of infants and the optimum protein level of infant formulas are still under debate. Human milk (HM) N is considered adequate although 25% of the N is provided as non-protein nitrogen (NPN), half in the form of urea. Soluble N, insoluble N, NPN and urea N were determined in HM and cow's milk (CM), 5 CM-based infant formulas, 4 soy protein-based formulas (SF), and manufacturers' skim milk and whey protein sources. Total, peptide and free amino acids were also determined in all samples. Levels of NPN and urea N in formulas were highly dependent on the type of whey used, with ion-exchange whey being highest, followed by electrodialyzed and ultrafiltered whey, respectively. SF contained very little NPN with the exception of Soyalac. Consequently, true protein [(Total N-NPN) x 6.38] was lower than the reported levels in several formulas. Levels of peptide and free amino acids were also affected by the method of whey preparation. While it has been recognized that "casein-predominant" CM formulas will have different effects on metabolic indices than "whey-predominant" formulas, this study demonstrates that there are also pronounced differences among "whey-predominant" formulas. PMID- 2782064 TI - Breast-milk IgA and lactoferrin survival in the gastrointestinal tract--a study in rural Gambian children. AB - The survival of breast-milk secretory-IgA and lactoferrin has been investigated in 23 Gambian children aged 1.5, 3 and 17 months. Endogenous excretion of these immune proteins was measured in 7 weaned 34-month-old children. Defaecation rate was the prime determinant of faecal secretory-IgA and lactoferrin outputs, indicating that partial degradation occurs in the large intestine. Calculations showed that at least 30% of IgA and 2% of lactoferrin ingested from breast-milk must survive in the small intestine. Variations in faecal immune protein outputs were related to differences in intake and defaecation rate and were not affected by age or solid food consumption. The raised faecal outputs of 5 children with diarrhoea were a consequence of their high stool frequencies. IgA disappearance in the large intestine proceeded twice as fast in Gambian breast-fed children as in comparable Cambridge infants, suggesting that differences in gut flora may influence IgA survival. Thus breast-feeding, irrespective of age or additional food, can deliver significant quantities of these antimicrobial proteins to the small intestine but differences in defaecation rate and gut flora may affect their protective potential in the large intestine. PMID- 2782066 TI - Thymosin alpha 1 in milk specimens from Guatemalan women. AB - Thymosin alpha 1 was determined in milk samples obtained from 67 Guatemalan women 5 days, and 1-3 and 6-18 months postpartum. All the specimens collected 5 days after delivery contained measurable levels (583 +/- 304 pg/ml) of thymosin alpha 1 but only 33% of those obtained 1-3 months postpartum and none collected thereafter did. Since thymosin alpha 1 has been shown to increase T-cell mediated immunity, and to enhance host resistance to infection, it may play an important role in the maturation of mucosal immunity and host resistance in general in the neonate. This study is the first to document the presence of a thymic hormone in early postpartum milk. PMID- 2782065 TI - Fat content and fatty acid composition of infant formulas. AB - Fat content and fatty acid composition of 25 commercial infant formulas sold in the Federal Republic of Germany and of 3 home-made milk formulas were analysed, using gravimetry of extracted lipids and high-resolution capillary gas chromatography. Results were compared with the composition of human milk. Fat contents of all commercial formulas were similar to human milk values and met current recommendations, but 2 home-made preparations were at the upper and lower limits of the recommended range. Milk formulas tended to contain higher percentages of saturated and lower ones of cis-monounsaturated and trans-isomeric fatty acids than human milk. Linoleic acid (C18:2n-6) content was similar to human milk in most products but deviated clearly from recommended values in 2 home-made mixtures. Alpha-linolenic acid (C18:3n-3) values were often low in formulas, resulting a high n-6/n-3-ratios. In contrast to human milk, all formulas contained only minor amounts of the physiologically important long-chain polyunsaturated fatty acids with 20 and 22 carbon atoms. Some seasonal variation in the content of palmitic (C16:0), oleic (C18:1n-9), linoleic and trans-fatty acids was found when five arbitrarily selected adapted formulas were analysed repeatedly over one year. The composition of a home-made formula made from fresh cow's milk was markedly different in winter and in summer, when percentages of saturated and trans-fatty acids were higher and of linoleic acid were lower. We conclude that the composition of most commercial formulas is better suited to meet the lipid requirements of young infants than the home-made preparations investigated.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2782067 TI - Effect of calcium supplementation on calcium and phosphorus balance and renal net acid excretion in preterm infants fed a standard formula. AB - In 19 preterm infants fed a standard formula for prematures (calcium (Ca) 13.5 mmol/l; phosphorus (P) 12.9 mmol/l), biochemical parameters of blood, serum and urine were determined before and during supplementation with Ca-L-lactate (final Ca concentration 20 mmol/l). In 8 preterm boys Ca and P balance were evaluated in addition. During Ca supplementation, the serum Ca levels, urine pH (without supplement 6.31, with supplement 6.73), and calciuria (46 mumol/kg/d vs. 98 mumol/kg/d) were increased, and urinary P (1.05 mmol/kg/d vs. 0.65 mmol/kg/d) and net acid excretion (1.70 mEq/kg/d vs. 0.89 mEq/kg/d) were decreased. Balance studies showed increased net intestinal Ca absorption during supplementation (37% vs. 56%) as well as improved Ca (0.8 mmol/kg/d vs. 1.85 mmol/kg/d) and P retention (0.97 mmol/kg/d vs. 1.45 mmol/kg/d). These data show that increased Ca intake given to optimize the Ca:P ratio improves mineral retention in preterm infants fed a standard formula. Ca and P intake should be thoroughly balanced to avoid side-effects like hypercalciuria or high renal net acid excretion. PMID- 2782068 TI - Macromolecular absorption in preterm and term infants. AB - Human alpha-lactalbumin (alpha-LA) has been used as a marker for measuring macromolecular absorption. The serum concentration of human alpha-LA after a human milk feed has been studied in 32 healthy very low birthweight infants (VLBW), fed human milk (gestational age 26-32 weeks) and in 56 term, breast-fed infants, age 3-140 days. At 31 weeks of gestation the serum concentration of human alpha-LA was more than 10 times higher (mean value 3,000 and median value 2,101 micrograms/l serum/l human milk/kg body weight, n = 11) than in the term infants aged 3-30 days (mean value 257 and median value 152, n = 29). The serum concentration of alpha-LA decreased with increasing maturity in the VLBW-infants. At a postconceptional age of 37 weeks the values were similar (mean value 200 and median value 99, n = 8) to those found for term infants during the first month. In the term infants a decreasing absorption of alpha-LA was found with increasing postnatal age. PMID- 2782069 TI - The relationship between decreased iron stores, serum iron and neonatal hypoglycemia in large-for-date newborn infants. AB - We assessed the relationship between neonatal hypoglycemia and newborn iron status in 15 hypoglycemic, large-for-date newborn infants, 12 of whom were infants of diabetic mothers. These infants had significantly lower mean serum iron concentrations, ferritin concentrations, percent iron-binding saturation and calculated iron stores, and significantly higher mean transferrin concentrations, total iron-binding capacity concentrations and mid-arm circumference:head circumference ratios when compared with either 15 euglycemic large-for-date or 15 euglycemic appropriate-for-date control infants (p less than 0.001 for all comparisons). All hypoglycemic infants had ferritin concentrations below the 5th percentile as compared to 3% of controls (p less than 0.001), and 67% had transferrin concentrations above the 95th percentile (controls: 0%; p less than 0.001). Only the hypoglycemic infants demonstrated a significant negative linear correlation between ferritin and transferrin concentrations (r = -0.83; p less than 0.001). Decreased serum iron concentrations were associated with size at birth (r = -0.60; p = 0.01) and with increased red cell iron (r = -0.60; p = 0.01), implying a redistribution of iron dependent on the degree of fetal hyperglycemia and hyperinsulinemia. Infants with increased red cell iron had more profound neonatal hypoglycemia. These results show a significant association between decreased iron stores and neonatal hypoglycemia in macrosomic newborn infants associated with a significant shift of iron into red blood cells. PMID- 2782070 TI - Scanning electron microscopy of histological relapse after gluten-challenge in coeliac disease. AB - The steps of the morphological relapse occurring during gluten-challenge in coeliac children were for the first time investigated by scanning electron microscopy and compared with the morphological changes observed in untreated and treated coeliac patients, in pathological and normal controls. Some peculiar morphological changes, not reported up to now, were observed in treated and relapsed coeliac patients. No relationship was found among the degrees of mucosal atrophy observed by SEM and the duration of the challenge performed by an uncontrolled ingestion of gluten. PMID- 2782071 TI - Improved growth response to GH treatment in irradiated children. AB - The growth response to two years of GH treatment was studied in fifteen children after radiotherapy for a cranial tumor. The growth response was compared to that of short children (-2 SD) and that of children with idiopathic growth hormone deficiency (GHD) of similar ages. All children were treated with hGH 0.1 IU/kg/day s.c.; which is a higher dose and frequency than previously reported for irradiated children. On this protocol the growth rate increased 5.0 +/- 0.5 cm/y (mean +/- SEM) the first year and 3.8 +/- 0.7 cm/y the second year compared to the growth rate the year before GH-treatment. Although the net gain in growth was higher than previously reported, the first year growth response was significantly reduced (p less than 0.05) compared to that of GHD-children (7.6 +/- 0.5 cm/y) but exceeded (p less than 0.05) that of short children (3.4 +/- 0.3 cm/y). The median spontaneous 24 h-GH secretion was 209 mU/l in the short children, 52 mU/l in the irradiated children and 16 mU/l in the idiopathic GHD children. Thus the growth increment varied inversely to the spontaneous GH secretion observed in the three groups. PMID- 2782072 TI - Rapidly developing overweight in school children as an indicator of psychosocial stress. AB - From a cohort of 971 Swedish children followed up from birth through 15 years of age, all the children who had shown an increment in relative weight of more than 15% (measured weight in % of standard weight for height) between the ages of 7 and 10 years (group A, n = 25), 10 and 13 years (group B, n = 23), and 7 and 13 years (group C, n = 22) were selected for the present study. For each case a control matched for sex and relative weight at 7 (groups A and C) or 10 years (group B) was selected. The degree of psychosocial stress was estimated by two raters on the basis of all the accumulated data in the school health records and of the personal knowledge of the school nurses. There was good agreement between the raters. A significant difference in the degree of psychosocial stress was found between cases and controls. An analysis of specific items revealed differences with respect not only to soft data, but also to objective facts (continuation of school after completion of the nine years of compulsory school). It is concluded that a rapid weight gain during school years may be an indicator of psychosocial problems. PMID- 2782073 TI - Further evidence of an association between psychosocial problems and increase in relative weight between 7 and 10 years of age. AB - A sample of 5,399 Swedish schoolchildren was subdivided into five groups according to the change in relative weight between the ages of 7 and 10 years and the relative weight attained at 10 years. Information on indicators of psychosocial problems was obtained by teacher interviews. There was a significant variation between groups with regard to the prevalence of behavioral and learning problems, and in girls also concerning social problems. The highest prevalence of problems was consistently found in the group with a rapid gain in relative weight. The association was stronger for serious than for mild problems. A causal mechanism is assumed to be the most probable explanation. The implications with respect to research and clinical practice are discussed. PMID- 2782074 TI - Changing pattern of cerebral palsy in the southwest region of Finland. AB - The prevalence of cerebral palsy (CP) increased significantly from 1968-72 to 1978-82 in the region of the University Central Hospital of Turku, Finland, from 1.6/1,000 live births during the first five-year period to 2.5/1,000 live births during the second. The increase was due to an increase of CP in low birthweight children (p = 0.0002). The distribution of CP patterns did not change significantly. During the second period the diagnosis was made earlier in all groups (except that of spastic tetraplegia), though it reached statistical significance only in the hemi- and diplegic groups. While the perinatal mortality rate declined greatly during this period (especially in low birthweight groups), the increase in CP prevalence was due to increased survival rather than to a real change in prevalence. As a net gain, the decline resulted in an increased absolute figure in non-CP children, in spite of the rising prevalence of the disease. PMID- 2782075 TI - Urinary lactic dehydrogenase isoenzyme analysis in children with spinal lesions. AB - In 48 children with spinal lesions and micturition problems urinary lactic dehydrogenase (LDH) isoenzymes were analyzed. They had higher total LDH activities (716.8 +/- 1,050.2 nkat/I), isoenzymes V percents (22.2 +/- 13.0%) and isoenzyme V activities (203.4 +/- 308.4 nkat/I) than those of healthy children (150.0 +/- 83.4 nkat/I, 1.9 +/- 1.0%, 5.0 +/- 3.3 nkat/I). Many subjects had an isoenzyme V-dominant LDH isoenzyme pattern. Among 48 subjects the patients with pyuria, bacteriuria or abnormal pyelograms had markedly high total LDH activities, isoenzyme V percents and isoenzyme V activities. The rise in LDH isoenzyme V levels may reflect the renal damage in the patients with neurogenic bladders. PMID- 2782076 TI - The distribution of the gene for the juvenile type of Gaucher disease in Sweden. AB - A study of 30 Swedish families with the Norrbottnian type of Gaucher disease provides evidence for two clusters of the gene, one close to Overkalix in the northern part of the county of Norrbotten and the other in the vicinity of Arvidsjaur in the southern part of the same county. The gene for Gaucher disease in Overkalix appeared later than that in Arvidsjaur. A founder moving from Arvidsjaur to Overkalix during the seventeenth century or two different mutations are the most likely explanations of this finding. PMID- 2782077 TI - Risk of progressive kidney damage after acute leukemia. AB - In order to evaluate potential long-term renal sequelae of childhood leukemia, we studied 62 consecutive patients successfully treated for acute leukemia in 1971 83. At the time of this follow-up study they had been off therapy for 1-9 years and they were all in complete remission. Relative renal length was measured from X-ray films of intravenous pyelograms. Median relative renal length prior to the start of chemotherapy was +1.0 SD (range -1.5 to +4.0, n = 35), at discontinuation of therapy +0.5 SD (range -1.5 to +2.2, n = 22), and at follow-up -0.3 SD (range -3.9 to +2.6, n = 61). The mean calculated decrease in relative kidney size was 0.1 SD unit per year during the follow-up time. The median glomerular filtration rate was 110 ml/min/1.73 m2 (range 70 to 164). Six of 60 patients had glomerular filtration rates below 85 ml/min/1.73 m2. Three patients had some evidence of tubular dysfunction documented by increased excretion of urinary amino acids and/or beta-2-microglobulin or by reduced concentrating capacity. In spite of these abnormalities, we conclude that in most long-term survivors of childhood leukemia renal size and function are relatively well preserved. However, slightly reduced glomerular filtration rates in some patients indicated renal damage. A longer follow-up time is needed to find out whether the decrease in relative renal length is still continuing. PMID- 2782078 TI - Follow-up study on children with infective endocarditis. AB - A follow-up study on 36 children having had infective endocarditis during the time period 1971-80 was performed. All answered a questionnaire and 33 underwent a complete non-invasive cardiac examination including exercise test. The study comprised 406 patient years. During this time there were four late deaths and three recurrent attacks of endocarditis. Seventeen (47%) took prophylactic antibiotics. Two patients had been operated on because of the initial infection and another five had developed intracardiac sequelae. An ability index given to each patient before the infection and at the follow-up showed that as a group these patients were doing well. PMID- 2782079 TI - Human alpha-lactalbumin in infant serum has the same molecular size as the protein purified from human milk. PMID- 2782080 TI - Clubbing due to neonatal lung disease. PMID- 2782081 TI - Thyroid gland volume as measured by ultrasonography in healthy children and adolescents in a non-iodine deficient area. PMID- 2782082 TI - Oral prostaglandin E2 for the management of ductus dependent congenital heart diseases. Is there a role for home therapy? PMID- 2782083 TI - Alpha/beta interferon in serum from children with the hemolytic uremic syndrome. PMID- 2782084 TI - Serum immunoglobulin and IgG subclass levels in children and adolescents with insulin dependent diabetes mellitus. PMID- 2782085 TI - Lethal respiratory failure in preterm infants due to cystic fibrosis. The first case reports. AB - We present the first report of two preterm infants who died from respiratory failure secondary to cystic fibrosis which presented in the early neonatal period. PMID- 2782086 TI - Multiple idiopathic emboli in a full term neonate. AB - We report a case of multiple idiopathic emboli leading to cerebral infarction and to limb ischaemia in a full term neonate. The increased frequency of diagnosis of cerebral infarction is highlighted. Treatment of cerebral and limb emboli is discussed and the need for further research into the causes and treatment of cerebral infarction is stressed. PMID- 2782087 TI - Crohn's disease penetrating into the spinal canal. AB - An 11-year-old boy who had suffered from Crohn's disease of the large bowel for 4 years developed high fever, severe back pain and flexion-contracture of the right hip joint with inability to walk. After several weeks radicular irritation also became apparent. CT-scan demonstrated an abscess of the right psoas muscle that had also infiltrated the spinal canal, leading to a spinal extradural abscess extending from L2-S4. Therapy comprised surgical drainage of the psoas abscess and conservative therapy (mainly steroids and hypercaloric diet) and resulted in complete cure of the psoas and the spinal abscess. Spinal infiltration is a rare and serious complication of Crohn's disease and must be considered in every case of significant back pain with or without obvious neurological signs. PMID- 2782088 TI - Typhoid fever diagnosed by isolation of S. typhi from gastric aspirate. AB - The diagnosis of typhoid fever (TF) is usually established by culturing S. typhi from the blood or by serology. In this report we describe three patients in whom the diagnosis of TF was made by the isolation of S. typhi from gastric contents, despite negative blood urine and stool cultures. Culture of gastric contents has not previously been recognized as a diagnostic tool in this disease. PMID- 2782089 TI - Regional and species differences in vascular reactivity to extracellular potassium. AB - In-vitro vasoreactivity to extracellular potassium (Ko+) was tested in isolated human pial and mesenteric arteries as well as basilar and mesenteric arteries from rabbits and rats. Contractions were induced by stepwise increases in [K+]o and were measured isometrically with a force-displacement transducer, in small volume organ baths. Significant differences between species as well as between regions were found. The threshold of [K+]o for eliciting contraction in human cerebral arteries in hyperosmotic solutions was 10 mM, in rabbit cerebral arteries 17 mM and in rat cerebral arteries 27 mM. The threshold concentration for contraction in mesenteric arteries was significantly higher compared to cerebral arteries in humans and rabbits, but lower in rats: 20 mM in humans, 26 mM in rabbits and 25 mM in rats. In all species the contractile amplitudes were significantly higher in both cerebral and mesenteric arteries when [K+]o was increased under isotonic conditions in the buffer solution than when hyperosomolality was created. This difference increased with increasing hyperosmolality. In hyperosmotic solutions, the EC50 for [K+]o was lower in cerebral and mesenteric arteries from man than in vessels from rabbit and rat. When the solutions were isotonic, this pattern was seen only in mesenteric arteries. It is concluded that significant species and regional differences in vascular responses to [K+]o exist. Considering that [K+]o is increased in cerebral ischaemia, the observed significantly lower threshold for K+-induced contractions in human cerebral arteries may be of importance, especially in human cerebral ischaemic events. PMID- 2782090 TI - Increased cardiac contractility in rats exposed to 5 bar. AB - The left ventricular pressure, arterial blood pressure and heart rate were studied in three series of pentobarbital-anaesthetized rats exposed to 5-bar normoxic (PO2 = 0.2 bar) environments: nitrogen-oxygen (15 and 60 min) and helium oxygen (15 min). The maximal left ventricular pressure (LVP max) and the maximal velocities of LVP rise (+ dP/dt max) and fall (- dP/dt) were significantly (P less than 0.01) increased immediately after reaching normoxic 5 bar (He, 13-28%; N2, 13-23%) and during the exposure at 5 bar (He, 22-44%; N2, 13-18%). The pulse pressure increased significantly (He, 50-62%; N2, 30-34%; P less than 0.01) during the hyperbaric exposure. No changes in heart rate or end-diastolic and mean arterial pressure were detected. The present findings indicate an enhanced cardiac contractility (+ dP/dt max) at 5 bar, with the greatest increase found when He was used as inert gas. The increased contractility was of significant duration (at least 60 min), and was not completely reversed until 5-10 min after decompression. PMID- 2782091 TI - Maximal voluntary force of bilateral and unilateral leg extension. AB - The aims were: (1) to investigate whether the 10-20% lower force during bilateral (BL) as compared to unilateral (UL) leg extension could be due to a general inability to activate fully a large number of muscles simultaneously, (2) to analyse the EMG signal of the quadriceps femoris during leg extensions, (3) to study the BL/UL force ratio in extension of the knee, and (4) to study the BL/UL leg extension force ratio in untrained and trained subjects. A 10% lower maximal voluntary isometric force was demonstrated during BL as compared to UL leg extension. This force discrepancy did not change when a total arm load of 250 N was applied simultaneously. Nor did the absolute force levels change, which indicates that the lower BL leg extension force is not due to a general mechanism of reduced activation with an increased number of muscles recruited in maximal voluntary contractions. Integrated EMG activity, mean power frequency and root mean square value of the EMG amplitude did not differ between UL and BL leg extensions. The knee extension force was slightly greater (4%) during BL than UL contractions. These findings are arguments against a reduced activation of the knee extensor muscles being the cause of the lower bilateral leg extension force. No differences in BL/UL force ratio were noted between groups of untrained and trained subjects despite the fact that several of the trained groups do different forms of BL leg extensions regularly. Thus, it does not appear that training readily affects the BL/UL leg extension force ratio. PMID- 2782092 TI - Formation of inosine monophosphate (IMP) in human skeletal muscle during incremental dynamic exercise. AB - The influence of exercise intensity on the accumulation of inosine monophosphate (IMP) in human skeletal muscle has been investigated. Ten men cycled at workloads corresponding to 40%, 75% and 100% of their maximal oxygen uptake (VO2 max). Muscle IMP was below the detection limit (less than 0.01 mmol kg-1 dry wt) at rest and after exercise at 40% of VO2 max, but increased to 0.26 +/- 0.06 (mean +/- SEM) and 3.50 +/- 0.51 mmol kg-1 dry wt after exercise at 75% and 100% of VO2 max respectively. Accumulation of IMP corresponded to a similar decrease in the total adenine nucleotide content. The muscle content of IMP was positively related to lactate and negatively related to phosphocreatine (PCr). IMP was formed in both fibre types, but the IMP content at fatigue was about twice as high in type II fibres as in type I fibres. It was concluded that the IMP content of human skeletal muscle is very low at rest and after low-intensity exercise, but increases after moderate and high-intensity exercise. In contrast to rat muscle, where deamination of AMP predominantly occurs in the fast-twitch muscle fibres, IMP is formed during exercise in both fibre types in human muscle. Accumulation of IMP appears to reflect an imbalance between the rate of utilization and the rate of regeneration of ATP. PMID- 2782093 TI - Hypoxaemia increases the accumulation of inosine monophosphate (IMP) in human skeletal muscle during submaximal exercise. AB - The effect of hypoxaemia on the muscle content of inosine monophosphate (IMP) during short-term, low-intensity exercise has been investigated. Six men cycled twice for 5 min at 120 +/- 6 W (mean +/- SE), which corresponded to approximately 50% of their maximal normoxic O2 uptake, breathing air (N) on one occasion and 11% O2 in N2 (H) on the other. Oxygen uptake at the end of the exercise period was similar between treatments. No significant difference was observed between H and N in the muscle metabolite contents at rest. Muscle content of phosphocreatine (PCr) decreased and lactate increased during exercise. Post exercise PCr during H was 80% of the value during N (P greater than 0.05) and post-exercise muscle lactate was fourfold higher during H than during N (P less than 0.001). Post-exercise muscle content of ADP was significantly higher during H than during N (P less than 0.01), while ATP and AMP remained constant under both H and N exercise (P greater than 0.05 H vs N). IMP was not detectable in pre exercise muscle samples (less than 0.01 mmol kg-1 dry wt) but increased during N exercise (0.03 +/- 0.01 mmol kg-1 dry wt, wt, P less than 0.05) and even more during H exercise (0.16 +/- 0.05 mmol kg-1 dry wt, P less than 0.05, H vs N). Post-exercise IMP was negatively related to PCr (r = -0.90) and positively related to lactate (r = 0.88). It is concluded that hypoxaemia results in an enhanced accumulation of IMP during submaximal exercise and that the IMP level is related to the degree of anaerobic energy utilization. PMID- 2782094 TI - Ground reaction forces at different speeds of human walking and running. AB - In this study the variation in ground reaction force parameters was investigated with respect to adaptations to speed and mode of progression, and to type of foot strike. Twelve healthy male subjects were studied during walking (1.0-3.0 m s-1) and running (1.5-6.0 m s-1). The subjects were selected with respect to foot strike pattern during running. Six subjects were classified as rearfoot strikers and six as forefoot strikers. Constant speeds were accomplished by pacer lights beside an indoor straightway and controlled by means of a photo-electronic device. The vertical, anteroposterior and mediolateral force components were recorded with a force platform. Computer software was used to calculate durations, amplitudes and impulses of the reaction forces. The amplitudes were normalized with respect to body weight (b.w.). Increased speed was accompanied by shorter force periods and larger peak forces. The peak amplitude of the vertical reaction force in walking and running increased with speed from approximately 1.0 to 1.5 b.w. and 2.0 to 2.9 b.w. respectively. The anteroposterior peak force and mediolateral peak-to-peak force increased about 2 times with speed in walking and about 2-4 times in running (the absolute values were on average about 10 times smaller than the vertical). The transition from walking to running resulted in a shorter support phase duration and a change in the shape of the vertical reaction force curve. The vertical peak force increased whereas the vertical impulse and the anteroposterior impulses and peak forces decreased. In running the vertical force showed an impact peak at touch-down among the rearfoot strikers but generally not among the forefoot strikers. The first mediolateral force peak was laterally directed (as in walking) for the rearfoot strikers but medially for the forefoot strikers. Thus, there is a change with speed in the complex interaction between vertical and horizontal forces needed for propulsion and equilibrium during human locomotion. The differences present between walking and running are consequences of fundamental differences in motor strategies between the two major forms of human progression. PMID- 2782095 TI - Adrenaline-mediated glycogenolysis in different skeletal muscle fibre types in the anaesthetized rat. AB - The effect of adrenaline infusion on glycogen breakdown in different muscle fibres types in resting extensor digitorum longus (EDL) and soleus was investigated with histochemical methods. During adrenaline infusion the glycogen content in type IIB and type IIA fibres in EDL, as measured in PAS-stained sections, decreased 24.5% and 11.5% respectively. The glycogen content in type I fibres in EDL and in type I, type IIA and T-fibres in soleus did not change during adrenaline infusion. The present study shows that adrenaline infusion has different effects on glycogen breakdown in the different fibre types in EDL and a different effect on type IIA fibres in EDL and soleus. So far, the reason for these differences is unknown. PMID- 2782096 TI - Villous sodium gradient associated with volume absorption in the feline intestine: an electron-microprobe study on freeze-dried tissue. AB - Water transport in biological tissue is driven by local osmotic gradients created by accumulation of actively transported ions in tissue compartments. To localize and measure such gradients, jejunal segments from the small intestine of anaesthetized cats were perfused with modified isotonic Krebs-Henseleit electrolyte solution, and net fluid transport was measured with a volumetric technique. The segments were then rapidly frozen, freeze-dried, and prepared for X-ray micro-analysis of elemental content. Whenever the lumen perfusate contained sodium, the apical third of the villus was found to have a sodium gradient rising to a tip concentration more than twice that at the base of the villus. This sodium gradient was associated with a chloride gradient and fluid absorption. No similar potassium gradient was found. When choline replaced sodium in the intestinal lumen, no gradient of sodium chloride was found and no net fluid absorption occurred. Absorption of fluid was thus apparently coupled to absorption of sodium through creation of a local osmotic gradient in the tip of the intestinal villus. PMID- 2782097 TI - Age-related variations in the relative importance of noradrenaline and ATP as mediators of the contractile response of rat tail artery to sympathetic nerve stimulation. PMID- 2782098 TI - Effects of transient forebrain ischaemia on vasoactive intestinal polypeptide immunoreactive neuronal populations in the frontoparietal cortex and hippocampal formation of the male rat. PMID- 2782099 TI - Release of K+ from muscle during prolonged dynamic exercise. PMID- 2782100 TI - Cd2+ may inhibit ATP secretion from sympathetic nerves in rat tail artery by an 'upstream' effect without blocking the Ca2+ component of the action potential in the terminals. PMID- 2782101 TI - Correlation of plasma erythropoiesis stimulating factor(s) and immunoreactive erythropoietin levels during rapid growth in the mouse. AB - During the early neonatal period of rapid growth in the mouse, increased plasma levels of erythropoiesis stimulating factor(s) (ESF) have been found when measured by an in-vitro bioassay technique. It is unclear whether these increased ESF levels represent increased levels of circulating erythropoietin (Ep) alone or Ep in combination with other less-defined erythropoietic stimulatory factors. To examine this issue, plasma from neonatal mice of varying post-natal ages and from normoxic and hypoxic adult mice was studied. We found that plasma Ep levels measured by radioimmunoassay (RIA) correlated significantly with in-vitro bioassayed ESF levels (r = 0.84, P less than 0.0001, n = 21). Although an in-vivo bioassay for plasma Ep proved too insensitive for rigorous correlation with data from the RIA and in-vitro bioassay, the in-vivo data were in qualitative agreement with the other two, more sensitive, assays. In all three assays the highest plasma levels were observed in the 20-day-old mice and in adult mice which had been subjected to hypobaric hypoxia for 8 h. Based on the strong agreement of the results obtained with the RIA and the in-vitro bioassay in both neonatal and adult mouse plasma, we conclude that the high plasma ESF levels of 20-day-old mice measured with the in-vitro bioassay are largely immunochemically identifiable Ep. However, the data also suggest the presence of non-Ep factors in neonatal plasma which stimulate the in-vitro bioassay. PMID- 2782102 TI - Temporal relationship between blood flow changes and release of ions and metabolites from muscles upon single weak contractions. AB - The temporal changes in muscular blood flow and in the release of ions and metabolites have been studied during and after short-lasting isometric contractions. Blood velocities in the human femoral artery were measured using pulsed bidirectional Doppler ultrasound equipment during single contractions of the quadriceps muscle group. Contractions of 5 s and 30 s duration and at a tension of 10% MVC (maximal voluntary contraction) were investigated. Even the contractions of 5 s duration caused conspicuous post-contraction increases in femoral arterial flow. The following substances were analysed in the femoral vein during and following the contractions: potassium, lactate, inorganic phosphate, calcium, sodium, oxygen and haemoglobin. Following contractions of 5 s duration, an increase in the venous potassium concentration (by 0.9 mM) was found, but there was no change in concentration of any of the other substances analysed. Following contractions of 30 s duration a more marked increase in the venous potassium concentration (by 1.5 mM) was found, and in addition substantial changes in venous lactate concentration and oxygen saturation. There were small but statistically significant changes in the concentrations of inorganic phosphate and calcium, but no change in the sodium concentration. The time-course and magnitude of the changes in venous potassium concentration fit well with the idea that potassium is important in the initiation and regulation of the functional hyperaemia in contracting muscles. PMID- 2782103 TI - Functional development of the visual system in normal and protein-deprived rats. VII. Lamination of oxidative enzyme activity in the visual cortex during post natal development. AB - Lamination of activity of two mitochondrial enzymes-succinate dehydrogenase (SDH) and menadione-dependent alpha-glycerophosphate dehydrogenase (M-GPDH) - was examined in the visual cortex of control (C) and protein-deprived (PD) rats from 10 days old to adult. In C rats, lamination of enzyme activity was evident from 10 days by a band of higher activity in lamina IV. A band of higher SDH activity was seen in superficial lamina VI from 15 days. Lamination of M-GPDH activity became less pronounced with increasing age, whereas distinct bands of high SDH activity in lamina IV and VI remained also in adult rats. PD rats showed a developmental delay of approximately 5 days with regard to the general increase in neuropile activity. A band of higher enzyme activity in lamina IV was present from 10 days, but it was markedly less distinct in the PD rats compared to the C rats between 15 and 25 days. A band of higher SDH activity in superficial lamina VI was not seen until 25 days in PD rats. No apparent differences were seen between adult C and PD rats. The observed developmental alterations are discussed in relation to other delays, distortions and deficits found in the visual system of PD rats. PMID- 2782104 TI - Functional development of the visual system in normal and protein-deprived rats. VIII. Post-natal development of optic nerve axons. AB - Protein deprivation results in a persistent impairment of transmission of impulses from the specific cortical projection within the visual cortex. In order to evaluate changes in subcortical structures during pre-weaning development, a study was made on number, calibre and myelination of optic nerve axons in control (C) and protein-deprived (PD) rats 5, 12, 20 and 30 days of age. Protein deprivation was induced by giving rat mothers a diet containing 7% protein by weight (control diet 14%, during gestation and lactation. The cross-sectional area of the nerve was measured on a digitizer. Between 3000 and 4000 axons collected from 7-13 field areas sampled by a random, systematic procedure from a cross-shaped area of the nerve were counted and measured. Between 5 and 12 days after birth, the number of axons was reduced by 50% in C rats. The total number of optic nerve axons was not significantly different in PD compared to C rats, indicating that protein deprivation does not affect the formation or naturally occurring nerve cell death of retinal ganglion cells. At all ages examined there were significant reductions in the number of axons larger than 0.52 micron as well as the number of myelinated axons. The rates of growth/maturation and myelination of axons in C rats and PD rats suggested that the reductions seen in PD rats up to 20 days of age may represent a developmental delay of approximately 4 days. At 30 days, a delay or a distortion of development may present. The retarded development of optic nerve axons is discussed in relation to delays, distortions and deficits during visual system maturation in protein-deprived rats. PMID- 2782105 TI - Functional development of the visual system in normal and protein-deprived rats. IX. Visual evoked response in young rats. AB - Changes in latencies of the visual evoked response (VER) during early post-natal development were examined in protein-deprived (PD) rats. The evoked response to light-flash stimulation was recorded in the dorsal lateral geniculate nucleus (dLGN) and on the surface of the visual cortex. In control rats, latencies of the cortical VER decreased rapidly up to 20 days and slowly thereafter. In PD rats, the latencies of the cortical VER were increased by 10-15 ms at 17 days; the developmental decrease was delayed by approximately 3 days. After 20 days, PD rats also went into a phase with slow decrease of the latencies, and the onset latency of the cortical VER was still increased by some 10 ms at 26/27 days. At this age, PD rats showed an increase in the latencies of the VER in the dLGN which was of similar magnitude to that in the cortical VER, indicating that alterations were more marked in the peripheral parts of the visual system at this stage of development. The findings are in agreement with previous studies indicating that there is a delay of visual system development in PD rats before 20 days. A maturational event which turns rapid into slow development at approximately 20 days in both C and PD rats turns this delay into a distortion of development. The delays and distortions of visual system development may be one causative factor for the functional deficit present in the visual cortex of adult PD rats. PMID- 2782106 TI - Bioluminescent assay of bacterial ATP for rapid detection of bacterial growth in clinical blood cultures. AB - A bioluminescent assay of bacterial ATP for rapid detection of bacterial growth in 512 clinical aerobic blood cultures was evaluated. At the detection limit of bacterial ATP (10(-10) mol/l) in the blood cultures 94.2% of the true positive blood cultures were detected (sensitivity) and the specificity was 85.8%. If the cut-off limit was increased the sensitivity decreased and the specificity increased and at 2 x 10(-9) mol/l ATP the maximum correctly classified blood cultures was reached. At this cut-off limit the sensitivity was 82.9% and the specificity was 99.6%. In 54.3% of the true positive blood cultures bacterial growth was detected more rapidly with the bioluminescent assay than with macroscopic examination and subculture. PMID- 2782107 TI - Free fatty acid determination by peroxidase catalysed luminol chemiluminescence. AB - A sensitive, specific, and partly automatic method for the analysis of free fatty acids is described. The assay involves activation of free fatty acids by acyl-CoA synthetase (EC 6.2.1.3) followed by oxidation of the thioesters by acyl-CoA oxidase. The H2O2 formed is determined in a reaction catalysed by horseradish peroxidase (EC 1.11.1.7) using luminol as electron donor. The assay has a linear range of 0.05 to 5 nmol of different free fatty acids (C10-C18) in the original sample. The efficiency of the method toward capric, lauric, myristic, palmitic, palmitoleic, stearic, oleic, and linoleic acid measured as recovery of light emission compared to that of H2O2 standards, was over 90%. AffiGel 501 was used to covalently bind the free thiol group in CoASH eliminating interference of this substance in the peroxidase-luminol reaction. PMID- 2782108 TI - Determination of oil oxidation by an aldehyde-requiring mutant of luminous bacteria. AB - A simple, rapid bioluminescence test (BT) for the determination of lipid oxidation is described. The test utilizes an aldehyde-requiring dark mutant of Vibrio harveyi (M42) that emits light in the presence of long chain (C8-C16) aliphatic aldehydes. The procedure consists of treating the oil or fat with CO2+ ion in ethanolic medium at alkaline pH. This treatment facilitates the decomposition of the hydroperoxides into long-chain aldehydes, part of which is used by the bacteria to produce light. The test was evaluated with corn, soybean and safflower oils, and shows excellent correlation with the commonly used peroxide value assay. PMID- 2782109 TI - An evaluation of the performance of ten commercial luminometers. AB - An assessment has been carried out of the relative performance of ten instruments for quantification of adenosine triphosphate (ATP) by the firefly luciferase assay. The instruments evaluated were Amersham Amerlite Analyser, Dynatech Tube Luminometer, Dynatech Multiplate Luminometer, Dynatech Camera Luminometer, Hamilton Lumicon, LKB 1250 Luminometer, LKB 1251 Luminometer, Lumac Biocounter M2010A, Turner 20 TD Luminometer and a prototype version of the CLEAR SpeedTech 2000. An 800-fold difference in sensitivity was found between the most sensitive (Lumac, Turner) and the least sensitive (Dynatech Tube) of the conventional instruments. The Dynatech Camera Luminometer which worked on a completely different principle to the other instruments was about 5000 times less sensitive than the best of the photomultiplier tube instruments. The relative sensitivity of the instruments was maintained regardless of whether solutions of ATP in water or trichloroacetic acid extracts of bacteria were analysed. An analysis of 960 ATP bioluminescence assays showed that data obtained from such measurements are normally distributed. PMID- 2782110 TI - Determination of absolute chemiluminescence quantum yields for reactions of bis (pentachlorophenyl) oxalate, hydrogen peroxide and fluorescent compounds. AB - Absolute chemiluminescence quantum yields (phi CL) for reactions of bis (pentachlorophenyl) oxalate (PCPO), hydrogen peroxide (H2O2) and 9:10 diphenyl anthracene (DPA) have been determined. A fully corrected chemiluminescence monitoring spectrometer was calibrated for spectral sensitivity using the chemiluminescence of the bis-(pentachlorophenyl) oxalate system as a liquid light source, the total photon output of which had previously been determined by chemical actinometry. At high (PCPO)/(H2O2) ratios phi CL was found to be independent of PCPO and H2O2 concentrations. PMID- 2782111 TI - Method for reducing the rate of light emission from chemiluminescent and bioluminescent reactions using frozen reagents. AB - Frozen assay reagents have been used to reduce the rate of light emission from the rapid chemiluminescent acridinium ester and the bioluminescent firefly luciferase reactions. Melting of the assay reagent delays the initiation of the light emission, thus eliminating the need to initiate these rapid reactions by injection of the assay reagents in front of the photodetector. PMID- 2782112 TI - [Clinico-developmental aspects in 44 cases of polymyositis/dermatomyositis]. AB - A retrospective study, paying particular attention to the clinical and evolutive aspects of the disease, was performed on 44 subjects affected by polymyositis/dermatomyositis (PM/DM) and hospitalized at the Institute of Medical Clinics of the 1st School of Medicine of Naples University. On the basis of the different clinical pictures, the cases were classified into the following groups: primary PM (4); primary DM (19); DM/PM associated with malignancy (6); childhood DM/PM (3); PM/DM associated with connective tissue disorders (12). Diagnosis was established in terms of the following criteria: a) symmetrical and mostly proximal bilateral muscle weakness (100%); b) elevation of serum enzymes (86.3%); c) electromyographic findings of myopathy sometimes with fibrillation potentials, increased insertional irritability and pseudo-myotonic discharges (93.1%); d) muscle biopsy changes compatible with a clinical form of polymyositis (83.3% out of 30 cases); e) dermatological manifestations including particularly pink or lilac edema-erythema over the periorbital areas, wine-red maculae, Gottron's sign, "poikiloderma vasculare atrophicans", telangiectasias and skin vasculitis (86.3%). An involvement of the extraneural apparatus and organs was present in 40 patients; the most damaged was the osteoarticular apparatus, followed by esophagus, lung, heart and kidney; such pathology was rarely present in the childhood form. A follow-up of the disease has been performed in 36 cases and the therapy consisted fundamentally of high dose corticosteroids (mostly prednisone), associated, in a minority of cases, with methotrexate. A clinical improvement was observed in most cases and a remission of the disease in part of the latter. However, a worsening of the illness was noticed only in the patients suffering from PM/DM associated with malignancy, and mortality rate was 11.1% in all. PMID- 2782113 TI - [Behcet's disease. Apropos of a clinical case]. PMID- 2782114 TI - [Multiple sclerosis at an early age]. PMID- 2782115 TI - [Usefulness of a standardized method for collecting anamnestic data in multiple sclerosis (MS)]. AB - In order to improve the collection of historical data and the evaluation of the clinical course of the disease in MS patients, a standard questionnaire was structured using precise criteria for definition of the disease phase, type of course and symptoms, respectively. A preliminary validation resulted in significant inter- and intra-observer agreement on all collected historical data and definition of lesion localization. Such structured interviews, included in day-to-day clinical care as well as in computerized databases for MS, could improve the possibility of collecting data shareable between different studies and centers. PMID- 2782116 TI - [Plasmapheresis in neuromuscular diseases. Personal cases]. AB - The authors used plasmapheresis to treat 8 patients with myasthenia gravis and 26 with polyradiculoneuropathy. In myasthenia the treatment was effective in 85% of the cases, as reported in other studies. Good results occurred in some 80% of the cases with acute and relapsing polyradiculoneuropathy. In all cases plasma exchange was started in the early stage. In chronic polyradiculoneuropathy the treatment was less effective. The authors discuss the advantages, disadvantages and prospects of this kind of therapy. PMID- 2782117 TI - [Therapy of subacute sclerosing panencephalitis with intrathecal alpha interferon]. AB - Clinical benefits were noted in subacute sclerosing panencephalitis patients treated with a total of 15 x 10(6) I.U. of alpha-interferon administered intrathecally over a period of one month. Improvements did not correlate with major variations in anti-measles IgG titers or variation of pattern, IgG subclass or light chain composition of CSF oligoclonal bands. PMID- 2782118 TI - [Proceedings of the fifth interregional meeting of sections of the Italian Society of Neurology. Bari, October 15, 1989]. PMID- 2782119 TI - Smoking cessation by mail: a comparison of standard and personalized correspondence course formats. AB - Self-Instructional behavior-change programs for reducing risks to health are potentially widely available, acceptable and cost-effective. This paper reports outcomes of a smoking cessation program administered by mail. Two hundred and eight smokers were allocated systematically to a quit kit control condition (n = 40), to a standard correspondence course (n = 86) and to a personalized correspondence course prepared with the aid of a microcomputer (n = 82). There were significantly higher rates of abstinence after the course for correspondence course participants compared to controls, but these differences did not persist at three-month and nine-month follow-ups. There were no differences between the personalized and standard courses on abstinence rates, number of cigarettes smoked per day, or return of feedback forms on each lesson. There were associations between self-efficacy strength and reduced rates of smoking, and active participation in the course was associated with lower smoking rates. PMID- 2782120 TI - The quitting experience for smokers in sixth through twelfth grades. AB - The present study examined the withdrawal process for adolescents who had attempted to quit smoking. A sample of 622 6th through 12th graders were interviewed. Smoking status was reported prior to attempting to quit and its relationship with the withdrawal experience was evaluated. Although over half of those who smoked regularly reported trying to quit, 78% of the "quitters" were smoking six months after their quit attempt. Experiencing adverse withdrawal symptoms was related to smoking at daily levels before quitting; delaying trying to quit was associated with initiation of smoking at an early age; and quitting success was predicted by early quitting age, lower pre-quitting smoking levels, a lack of a prior quitting failure, and peer smoking. The results suggest that smoking intervention programs for adolescents should include components facilitating the quitting process that take into consideration youngsters' smoking and quitting histories. PMID- 2782121 TI - Anxiolytic effects of smoking associated with four stressors. AB - There is a widespread belief that cigarette smoking alleviates stress. The literature reveals conflicting results on the anxiolytic effects of smoking. This study was designed to replicate a report that smoking (a) reduced subjective anxiety induced by stressful anagrams and (b) increased pain threshold for a cold pain task. This study (N = 15) included two other stressors: white noise and an auditory vigilance task. A significant Time x Condition (smoking vs. deprived) interaction was found for Spielberger State Anxiety Inventory scores in the anagram task. A borderline significant interaction effect was found for the cold pain task. No significant effects were found with the two other tasks. These results provide partial support for the popular notion that smoking mitigates stress-induced anxiety. No difference was found between the smoking and deprived conditions for either pain threshold or pain endurance. PMID- 2782122 TI - Breakdown of dietary restraint following mere exposure to food stimuli: interrelationships between restraint, hunger, salivation, and food intake. AB - It was hypothesised that the hunger-enhancing effects of exposure to the sight and smell of palatable food would disinhibit eating in restrained eaters (self reported dieters). In two experiments exposure to palatable food stimuli led to increases in motivational (hunger) ratings and salivation, and was followed by overeating in restrained subjects compared with the control condition (no food during exposure) and a condition in which nonpreferred food was presented during the exposure phase. The food intake of unrestrained subjects, on the other hand, was reduced following exposure to palatable food in the first experiment. This shows that breakdown of dietary restraint can be induced by food stimuli even when the food does not constitute a preload. Mere exposure to the sight and smell of palatable food is sufficient to precipitate loss of dieting motivation. The effects of exposure on hunger and salivation were, in general, unrelated to food intake or degree of dietary restraint. Therefore, changes in hunger do not appear to directly mediate increased food intake in dieters. Instead, it is tentatively suggested that anxiety resulting from exposure to liked food may play a role both in disinhibiting eating and suppressing salivation in restrained subjects. PMID- 2782123 TI - Evidence for two paths of alcohol use onset in adolescents. AB - Research is needed to identify risk factors specifically associated with the development of substance abuse. The current study explored the possibility that adolescents classified as having a problem behavior prone orientation (Type II) are predisposed to more rapid alcohol use onset compared to more normally socialized (Type I) adolescents. It was hypothesized that both types of adolescents would increase their alcohol use over time, but that problem behavior prone adolescents would increase their rates of alcohol consumption more rapidly than would normally socialized adolescents. Using ANCOVA (with baseline alcohol use as a covariate) and t tests (examining only nondrinkers at baseline), the hypotheses were strongly supported. Both Type I and Type II adolescents significantly increased their alcohol use over a one-year period. Type II adolescents, in comparison to Type I adolescents, had significantly higher alcohol use. The greater alcohol use among Type II adolescents was attributed to their problem behavior prone orientation. The findings suggest the existence of two different developmental pathways of alcohol use onset, one initiated by normally socialized adolescents and the other by adolescents with a problem behavior prone orientation. Future alcohol abuse prevention programs may benefit from tailored intervention strategies which take into account population specific risk factors. PMID- 2782124 TI - Responses to smoking-related stimuli and early relapse to smoking. AB - Prior to engaging in treatment for smoking cessation, subjects were tested for their responsiveness to cigarette smoking cues. Subjects performed a role-play with a confederate who lit their preferred brand of cigarette. Heart rate (HR) and galvanic skin conductance were assessed continuously, while urge to smoke and anxiety were rated subjectively after the role-play. Three months after treatment ended, subjects were divided into groups of continuous quitters, verified by expired carbon monoxide measurement, and relapsers. The results showed a significant difference between the groups in the pattern of pretreatment HR response to the lighting of the cigarette; relapsers displayed a sharp HR deceleration in response to the stimulus, while quitters' HR did not decelerate. The theoretical and clinical significance of these results is discussed. PMID- 2782125 TI - "Cravings" are ambiguous: ask about urges or desires. AB - Despite the dictionary definition of "craving" (a strong desire), two studies indicate that a substantial percentage of persons with alcohol and drug problems use the word "craving" to mean any desire or urge, even a weak one, to use substances. Researchers and clinicians are advised to beware of this ambiguity of "craving" and to consider the conceptual status of "craving" in their work. PMID- 2782126 TI - Sensitivity, specificity and predictive value of saliva thiocyanate among pregnant women. PMID- 2782127 TI - Smoking habits in early pregnancy. AB - In a prospective study, 2051 women were interviewed in early pregnancy regarding their own smoking habits as well as smoking habits among closely related persons. Fifty-five percent of the women had at one time or another been daily smokers. Of the 673 women (33%) smoking at the time of conception, 150 had quit smoking at the time of the interview (6 to 10 weeks later). Continued smoking was more common among women, whose parents had been smokers and among those whose husbands were smokers. Continued smoking was also more common among heavy smoking women (greater than 10 cigarettes per day), women who started to smoke at an early age and among women with previous births. PMID- 2782128 TI - Alcohol use and its relationship to other addictive and preventive behaviors. AB - Immoderate consumption of alcohol was found to be related to three other potentially addictive behaviors (illicit drug use, smoking, and caffeine consumption) in a randomly drawn sample (n = 1253) of American adults. In addition, alcohol consumption was found to be related to nutritional, life style, safety, and health monitoring preventive behaviors. Although the underlying mechanism for these behaviors is not clear, possibilities include the subsumption of both addictive and other preventive behaviors under a more generalized risk taking (or risk avoidance) dimension. PMID- 2782129 TI - The self-reported effects of PCP on human aggression. AB - The elicitation of violent of psychotic behavior by phencyclidine (PCP) administration is well documented. There are indications, however, that behavioral responses to PCP may differ among PCP users as a function of background or personality characteristics. The present study examined 35 male jail inmates with histories of PCP use. Estimates of the nature and extent of drug use and self-reports of previous psychiatric hospitalizations were obtained in these subjects. The Buss-Durkee Hostility Inventory was modified to reflect behaviors under the two simulated conditions of "No PCP" and "PCP" use. Results showed that PCP use was related to increased levels of hostility in our subjects when present age, age of first use, the frequency of use and suspicion and assaultive behavior when not using PCP was considered. Also, subjects with a history of psychiatric hospitalizations reported higher levels of assault when using PCP than those without psychiatric histories. These data suggest that the self-reported behavioral results of PCP use are associated with certain personality traits and background features. PMID- 2782130 TI - The effects of alcohol, expectancy, and sensation seeking on driving risk taking. AB - Using a cover story of the effects of alcohol on perceptual and motor abilities, two levels of alcohol consumed (moderate and none), two levels of alcohol expectancy (moderate and none), and two levels of sensation seeking (high and low) were combined to determine their effect on risk taking in a driving simulator. Ninety-six subjects were randomly assigned to eight conditions. Dependent variables were lane changes-cars passed and time at maximum speed. Results on lane-changes-cars passed indicated greater risk-taking in driving by high sensation seekers. Interaction of alcohol expectancy and sensation seeking indicated high sensation seekers took more risks when they believed they had consumed alcohol. Low sensation seekers became more cautious in driving when they believed they had consumed alcohol. Alcohol consumed did not produce a significant main effect or interaction. PMID- 2782131 TI - A randomized comparative study of three IUDs: Nova-T, MLCu375 and MLAgCu250 in New Zealand: 1-year results. AB - A randomized comparative study was made in New Zealand of three models of copper IUDs, the Nova-T, MLCu375 and MLAgCu250, with interval acceptors. At 1 year, the Multiloads (MLs) had lower net termination rates for accidental pregnancy, expulsion, pain/bleeding, other medical removals and infections (use-related terminations) than the Nova-T. These rates were significantly lower for the MLAgCu250 than the Nova-T for accidental pregnancy, expulsion and infection. The MLCu375 had significantly fewer removals for pain/bleeding and for other medical removals than the Nova-T. The MLAgCu250 had a significantly lower accidental pregnancy rate than the MLCu375. The Multiloads had significantly higher relevant use-related continuation rates than the Nova-T. PMID- 2782132 TI - Antisperm antibodies in young oral contraceptive users. AB - Thirty-five young oral contraceptive users (group A) and twenty-four non-users (group B) of comparable age and background were screened for the presence of serum antisperm antibodies, antibodies to Chlamydia trachomatis and vaginal infections. Twenty-three per cent (8/35) of the oral contraceptive users were found to have significant titers of antisperm antibodies as compared to none in the non-user group (p less than 0.05). In 17% of group A patients (6/35) the presence of antisperm antibodies coincided with the presence of serum antibodies to chlamydia and vaginal candidiasis. One of these patients had E. coli in her vaginal culture in addition to the serum antichlamydia antibodies. The other two patients harboring serum antisperm antibodies were free of any sign of vaginal infection. A significant correlation (r = 0.7038, p less than 0.0000005) was found between the presence of antisperm antibodies and antichlamydia antibodies. There appears to be an increased frequency of serum antisperm antibodies in oral contraceptive users. This finding coincides with infections or colonizations with potential pathogens of the lower genital tract. PMID- 2782133 TI - Bladder perforation: uncommon complication with a misplaced IUD. AB - We report a unique case of uterine and bladder perforation by a copper intrauterine device (Nova-T). The patient presented with recurrent cystitis, which led to cystoscopy, where the horizontal arm of the IUD was seen intravesically. The IUD was removed vaginally by pulling the locator strings. The patient recovered without complications. The case shows that the new, second generation IUDs may also cause bladder perforation. PMID- 2782134 TI - Uterine bleeding with an IUD requiring emergency hysterectomy. AB - A case is described of profuse uterine bleeding with a dislodged Multiload Cu 250 intrauterine device (IUD). Multiple blood transfusions were necessary, and ultimately, an emergency hysterectomy was performed. PMID- 2782135 TI - Oxygen transport to tissue XI. Proceedings of the 16th annual meeting of the International Society on Oxygen Transport to Tissue. August 7-11, 1988, Ottawa, Ontario, Canada. PMID- 2782137 TI - Oxygen distribution in isolated perfused liver observed by phosphorescence imaging. PMID- 2782136 TI - New instrument for monitoring hemoglobin oxygenation. AB - A new compact high-performance instrument for monitoring the oxygenation state of the human newborn are developed. First we applied this instrument to the rat head, and next to the human arm. We could confirm that the volume of Oxy-Hb, Deoxy-Hb and total blood volume were well monitored by using our instrument. Now we started to apply this technique to the human newborn. Furthermore, we started the experiments of the near-infrared tomography for the small animals on the basis of this technique. PMID- 2782138 TI - The use of conductive thermoplastic wires as oxygen sensors in microwave fields. PMID- 2782139 TI - Microelectrode studies of facilitated O2 transport across hemoglobin and myoglobin layers. AB - Experimentally measured PO2 profiles across layers of hemoglobin and myoglobin solutions were compared with profiles predicted from facilitated transport theory assuming chemical equilibrium. Measurements across myoglobin layers were in excellent agreement with theory, but measurements across hemoglobin layers departed from theory at low PO2. This departure was greatest for salt-free hemoglobin solution, which may be caused by an electrical potential formed by a pH gradient in the layer as oxyhemoglobin is deoxygenated. PMID- 2782140 TI - Potentiometric polarographic PO2 electrode (PO2-PPE). PMID- 2782141 TI - The hydrogen gas clearance method for liver blood flow examination: inhalation or local application of hydrogen? AB - The combined method of hydrogen inhalation and local hydrogen production enable the determination of hepatic blood flow (HBF) and local hepatic blood flow (LHBF). LHBF was registered within a small superficial tissue volume of 0.5 mm in diameter by means of a multi-wire electrode having 200 microns producing and 100 microns measuring wires arranged within less than 300 microns distance between the measuring wires. The feeding current for hydrogen production was 1 microA, the potential less than 10 V. The clearance in response to inhalation was registered by means of the same measuring electrodes within the same tissue volume. Spontaneously breathing rats (Wistar-Fromter strain, 180-230 g bw, N = 19, ketamin-xylazine anesthesia, artificial respiration) showed the following flow values: HBF +/- SD = 0.50 +/- 0.26 ml/g.min, n = 48 registrations; LHBF +/- SD = 4.66 +/- 2.13 ml/g.min, n = 43. The validity of the combined method is demonstrated in the LHBF/HBF graph which summarizes the data of hemorrhagic and control animals, m = 0.1 and yo = 0.001. The correlation coefficient of r = 0.685 shows a reasonable correlation of the combined data despite the wide scattering of the individual values. PMID- 2782142 TI - Evaluation of a heparin-coated PO2 electrode for continuous intravasal PO2 monitoring. PMID- 2782143 TI - Buffering of muscle tissue PO2 levels by the superposition of the oxygen field from many capillaries. AB - High resolution measurement in both exercised skeletal and cardiac tissue made radially outward from capillaries and longitudinally parallel to capillaries by Gayeski and Honig (1986, 1986a,b) and Honig and Gayeski (1987) indicate shallow variation of tissue PO2 and the absence of strong causal relation between the PO2 at a point and the proximity of that point to the nearest active capillary. Proposed as a model for the analysis of this tissue PO2 distribution, so contrary to the expectations of Krogh type models, are a class of multicellular tissue cylinder models. Each cylinder is penetrated by many parallel capillaries. In order to better represent the natural irregularities of the skeletal and cardiac tissue both with regard to radial placement and the stagger of the capillary inlets, the following types of models both with and without yoglobin are examined: regular square arrays where the capillary PO2 levels are random, uniform capillary PO2 levels but random capillary positions, and those with both the capillary PO2 levels and the positions are random. The results of the model calculations show that the superposition of the oxygen diffusion fields of all the capillaries produce a tissue PO2 distribution with the properties: (1) lower tissue PO2 levels than those predicted by Krogh theory, (2) significant non-local contributions to the PO2 at a point in the tissue which greatly reduces this correlation between PO2 at a point and its proximity to an active capillary, (3) shallow transcellular PO2 variation. PMID- 2782144 TI - Effects of red cell spacing and red cell movement upon oxygen release under conditions of maximally working skeletal muscle. AB - RBC spacing in capillaries plays an important role in that it determines the total number of RBCs contained in a capillary and, therefore, the total O2 flux out of the capillary. The detrimental effects of increased RBC spacing upon capillary O2 release are in part compensated for by enhanced O2 release out of single RBCs due to improved diffusion geometry and RBC movement. Non-uniformity of O2 flux brought about by the particulate nature of blood is considerably smaller than calculations which do not consider RBC movement indicate. It creates oscillations in the O2 supply to the tissue, the periodicity of which is fast, however, compared to the time constant of the PO2 decay in a temporarily unsupplied tissue. We conclude that non-uniformity of O2 flux out of capillaries due to large inter-erythrocytic plasma gaps does not play an important role for tissue O2 supply as long as average RBC spacing is sufficiently small to guarantee an appropriate overall capillary O2 flux. PMID- 2782145 TI - Calculation of oxygen pressures and fluxes in a flat plane perpendicular to any capillary distribution. PMID- 2782146 TI - Structured modeling and simulation of oxygen transport to hybridoma cell in a suspension culture: theoretical analysis. AB - The importance of the consideration of micro-anatomical and cytological observation for the oxygen utilization by hybridoma cells are emphasized. Tumor cells have considerably lower content of mitochondria and that cells metabolize much of their carbon source by anaerobic pathway, therefore, consumes much less oxygen. Because of the fact that hybridoma cells are derived from a myeloma cell, which is a type of tumor cell, there may be possibility that the oxygen demand could be closely related to mitochondrial content of the resulting cell. Possible correlation between the optimum DOT and mitochondrial content of the hybridoma cells is hypothesized. By simulating oxygen transport inside of a single hybridoma cells for the cases of three different mitochondrial contents, possible differences in the optimum DOT according to the mitochondrial contents were studied and the results reported. PMID- 2782147 TI - Time resolved spectroscopic (TRS) and continuous wave spectroscopic (CWS) studies of photon migration in human arms and limbs. AB - The combination of continuous light spectrophotometry (CWS) and time resolved spectrophotometry (TRS) afford for the first time a quantitation of the optical path and the concentration changes detected by the CWS instrument. The application of these two techniques and magnetic resonance spectroscopy (MRS) to muscle during exercise affords a correlation of the biochemical activation and the response of the peripheral circulation (NRS) to the exercise stress (MRS). In preliminary experiments, the well-trained endurance performance limb shows a near perfect homeostasis to exercise stress while ischemia will cause a significant deoxygenation and an impairment of the work output. The use of this device in evaluation of peripheral vascular disease is obvious and hemoglobin deoxygenation may well occur at work levels less than those at which the diseased limb is capable. PMID- 2782148 TI - Measurements of oxygen flux from arterioles imply high permeability of perfused tissue to oxygen. PMID- 2782150 TI - Capillary spatial pattern and muscle fiber geometry in three hamster striated muscles. AB - The primary goal of this project was to elucidate the spatial pattern of capillaries in three hamster striated muscles according to statistical techniques of pattern analysis. The spatial pattern of capillaries and traditional measures of capillarity are important to understanding the supply and distribution of oxygen and nutrients in a tissue. Statistical tests based on the distance between nearest neighbor capillaries are the most sensitive for detecting regularity in a pattern. A mathematical model was created to simulate the observed muscle fields. The same statistical tests that were performed on the empirical data were performed on the modelled data. The results of the analysis of the modelled data agree sufficiently with those of the empirical data to justify overall confidence in the assumptions. Conclusions that may be drawn from this investigation are (1) the spatial pattern of capillaries tends to be more regular than random and never was there evidence for aggregation using the test statistics; (2) as many as 60 75% of capillaries are located at the corners of muscle fibers indicating that there is some preferential placement for capillaries, and (3) the model developed is a good first approximation to the real situation. PMID- 2782151 TI - Quantifying capillary distribution in four dimensions. AB - Analysis of spatial distribution using numerical (O-D) distribution is limited to global estimates, while linear (1-D) separation of capillaries may be used to describe unrealistic spatial patterns. Intramuscular diffusion is best viewed as an integration of all distances between surrounding capillaries, or area (2-D) of influence for individual vessels. True planar analysis also accommodates other forms of heterogeneity, and may be extrapolated to give the volume (3-D) of tissue supplied by capillaries. Temporal (4-D) heterogeneity in functional spacing may then be quantified. PMID- 2782149 TI - Fractal networks explain regional myocardial flow heterogeneity. PMID- 2782152 TI - Influence of muscle phenotype on local capillary supply. AB - The general method used to compute a local capillary fibre ratio for each fibre is as follows. The selected area of the section is covered by a tessellation of domains. For each fibre, the contribution of each capillary whose domain intersects the fibre is computed as the proportion of the domain area which overlaps the fibre. The sum of all the contributions from overlapping domains is taken to be the effective number of capillaries contributing to that fibre, and is called here the local capillary fibre ratio (LCFR). This parameter may be normalised by dividing by fibre area to give an index, independent of fibre size, which is capable of identifying the differential capillary supply to fibre types within a mixed muscle. PMID- 2782153 TI - Computer simulation of cerebral microhemodynamics. AB - Microvascular network hemodynamics was simulated by computer in an anatomically reconstructed cerebral microvascular network. A video microscope system was used for three-dimensional mapping of the vessel network in the rat brain cortex. The complete topology, length and mean diameter of the microvessels were determined. The distribution of blood flow and red cell flux in the network was calculated based on vessel resistance estimated from geometrical data and a rheological model of blood. This model described apparent relative blood viscosity as a function of vessel diameter and local discharge hematocrit. The calculations predicted highly heterogeneous cell flux distribution at any feed hematocrit between 10 and 40 percent. The frequency distribution of microvessel hematocrit was bimodal and included values exceeding the feed hematocrit value. A probabilistic simulation of cell transit resulted in transit time distributions which agree with experimental findings. The most probable transit time and capillary path length and 4s and 300 microns, respectively. PMID- 2782154 TI - Muscle fiber size and chronic exposure to hypoxia. AB - Sarcomere length is practically never considered when fiber size and dependent variables are compared between muscles or experimental conditions. Because of the direct dependence of fiber cross-sectional area on muscle shortening, it is imperative to normalize measurements of fiber size, and related variables (e.g. capillary number/mm2 of fiber) to sarcomere length. We examined the relationship between fiber cross-sectional area and sarcomere length in muscles of animals chronically exposed to high altitude (deer mice, Peromyscus maniculatus, native to 3800 m, and rats, Sprague-Dawley, kept at the same altitude for 5 months) compared to sea-level controls. We found no difference in fiber cross-sectional area, normalized to sarcomere length, between high altitude and control animals in either species. It has been demonstrated that sarcomere length can vary by as much as 30-44% and 43-76% in biopsy and perfusion-fixed muscles, respectively. Therefore, identifying relatively small changes in fiber size in response to a given experimental condition in such material without normalizing for sarcomere length is difficult if not impossible. Furthermore, if the conditions of the investigation induce differences in sarcomere length between experimental and control animals, artifactual changes in fiber cross-sectional area will be produced. PMID- 2782155 TI - Capillary lengths and anastomoses in rat hindlimb muscles, studied by Aquablak perfusion during rest versus exercise. AB - This investigation shows that provided an adequate perfusion time of the capillary network is allowed following injection of Aquablak, the presence of arterioles and capillaries having zero or near-zero flow rates can be demonstrated in resting muscle. During hyperemia, "flow recruitment" occurs in these vessels, as indicated by their perfusion with Aquablak. Our observations of Aquablak perfusion in hyperemic muscles show that in medial gastrocnemius, gracilis, and soleus the mean arteriolar-to-venular distances, and also the mean capillary pathlengths, were not dramatically different. What was striking, however, was the fact that capillary pathlengths in soleus were divided into twice the number of segments found in gastrocnemius and gracilis. This suggests the possibility that in oxidative muscles the capillary network may exhibit a much higher degree of branching than in glycolytic muscles. This would increase the area for diffusional exchange between blood and tissue in oxidative compared to glycolytic muscle. PMID- 2782156 TI - Myocardial oxygen transport during leftward shifts of the oxygen dissociation curve by carbamylation or hypothermia. AB - An isolated dog heart preparation was used to study the effect of left-shifting the O2 dissociation curve by carbamylation or hypothermia. The two interventions had a similar effect on the variables of O2 delivery. There were significant decreases in myocardial O2 consumption, coronary sinus PO2, and O2 extraction. There was no compensatory increase in O2 transport. Coronary flow autoregulation was somewhat blunted by hypothermia but not by carbamylation. We conclude that an increase in hemoglobin-O2 affinity is capable of limiting myocardial O2 delivery and that increases in convective O2 transport play a minor role at best in the coronary adaptation to small decreases in P50. PMID- 2782158 TI - The effect of fluorocarbon emulsion on placental insufficiency. PMID- 2782157 TI - The nature of fluorocarbon enhanced cerebral oxygen transport. PMID- 2782159 TI - Adenosine deaminase in stroma-free hemoglobin solution is not responsible for coronary vasoconstriction. AB - Erythrocytes contain a high concentration of cytosolic adenosine deaminase and this enzyme activity is present in preparations of stroma-free hemoglobin (SFHS). The documented vasoconstrictor activity of SFHS preparations does not appear to be due to interference with endogenous adenosine-mediated mechanisms, because removal of greater than 80% of adenosine deaminase activity failed to affect the vasoconstrictor potency of SFHS preparations. We have also demonstrated the presence of a contractility-depressant activity in SFHS when the latter was added to aqueous buffer perfusing rat Langendorff-hearts. This activity is diminished in phosphocellulose-purified preparations with reduced adenosine deaminase activity but is not necessarily causally related to this enzyme. PMID- 2782160 TI - Oxygen binding of modified hemoglobins in solution. AB - SFHS modified by covalent incorporation of pyridoxal phosphate using NaCNBH3 as reducing agent had P50 values of 21-25mm Hg, and was insensitive to the addition of BPG. The Hill slope of the modified product was 2.34, demonstrating good functional cooperativity of the subunits. Oxygen carrying capacity, calculated as the ratio of O2 content to the concentration of functional hemoglobin, was found to be about 1.3, very close to the "textbook" ratio of 1.34 for whole blood. These values were achieved with oxygen saturation values over 90% and methemoglobin levels of less than 3%. The results obtained from pyridoxalation using NaCNBH3 contrasted sharply with those obtained using NaBH4, which yielded a product having high oxygen affinity and high methemoglobin values. This latter product was poorly saturated with oxygen at ambient pressures and demonstrated a significantly lowered oxygen carrying capacity. The NaBH4 product was also insensitive to the addition of BPG; the reason for this was not ascertained. SFHS P by the borohydride method thus exhibited marked deficiencies relative to that prepared with cyanoborohydride, as defined by the characterizations employed for this study. PMID- 2782161 TI - Tissue oxygenation after prolonged ischemia in skeletal muscle: therapeutic effect of prophylactic isovolemic hemodilution. AB - Prolonged ischemia is known to cause severe damage in skeletal muscle and skin as a result of reperfusion failure. Isovolemic hemodilution has been suggested as a modality to reverse microcirculatory disorders by improving flow properties and flow conditions of the blood. The aim of the present study was to investigate whether prophylactic isovolemic hemodilution could improve tissue oxygenation after 4h of pressure induced ischemia in skeletal muscle. In 17 Syrian golden hamsters a dorsal skin fold chamber and two permanent arterial and venous catheters were implanted. Following a recovery period of 48h ischemia was induced for 4h by means of a transparent stamp compressing the tissue within the chamber. In 9 animals (control, hct 43%) measurements of tissue PO2 (platinum multiwire electrode) were performed prior to and 15 min, 2h and 24h after release of ischemia. In 8 animals isovolemic hemodilution with Dextran 60 (hct 29%) was carried out prior to ischemia and measurements of local tissue PO2 were performed as reported for the control group with an additional measurement 30 min after hemodilution. In control animals tissue PO2 decreased significantly (p less than 0.01) from 20.7 +/- 2.4 mmHg prior to ischemia to 8.8 +/- 3.1 mmHg after 15 min of reperfusion; after 24h tissue PO2 was 15.6 +/- 6.1 mmHg. In hemodiluted animals tissue PO2 increased due to hemodilution from 20.9 +/- 1.6 mmHg to 23.5 +/- 2.5 mmHg (p less than 0.05); after 15 min of reperfusion tissue PO2 was 19.8 +/- 6.8 mmHg and remained unchanged for 24h (20.0 +/- 2.5 mmHg).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2782162 TI - Fractionation of oxygen isotopes due to equilibration of oxygen with hemoglobin. AB - The aim of the study was to answer the question as to whether the chemical reaction of oxygen with hemoglobin exhibits a source of isotopic fractionation, which could be of significance in forming the overall fractionation effect of respiration recently determined in man. Investigations were performed on bovine hemoglobin solutions adjusted to normal values of Hb concentration and pH. After degassing in vacuo, the hemoglobin solution was equilibrated in a closed system with pure oxygen of suitable pressure so that oxygen saturation levels of 30, 50 and 100% were achieved. After complete equilibration, isotope analysis of oxygen by mass spectrometry resulted in 16O18O/16O2 ratios which were 0.35 +/- 0.02% lower in the oxygen bound to hemoglobin than that of the gas phase during all levels of oxygenation. Model calculations suggest the following: (1) the fractionation during oxygen uptake in the lung at rest is primarily determined by the reaction with hemoglobin, (2) the overall fractionation effect of respiration can be explained as due to single effects of the constituent processes when assuming the oxygen transport to be limited by utilization. PMID- 2782163 TI - The effect of hyperchylomicronaemia on oxygen affinity in human blood. AB - Evidence for a leftward shift of the oxygen dissociation curve in HC patients was first described by Ditzel and Dyerberg. These results were challenged by Robertson et al., who saw no shift using a different technique to obtain P-50. Both methods are open to possible errors. In order to clarify the mechanism whereby HC blood shows an increased affinity for O2, the method of Longmuir and Chow was used since it is unaffected by these problems. Exposure of blood to various lipid emulsions was shown to exhibit a slow fall in pO2 due to increased binding of oxygen to haemoglobin. During the same period the pH difference across the cell membrane is largely abolished. As a result the oxygen dissociation curve is displaced to the left by the Bohr shift. This is an acute and dramatic event. We postulate that this increased affinity of red blood cells for O2 may predispose patients in the HC state to myocardial ischaemia by this mechanism. PMID- 2782164 TI - Effects of nimodipine on the responses to cerebral ischemia in the Mongolian gerbil. PMID- 2782165 TI - Hematocrit changes in the extra- and intraparenchymal circulation of the feline brain cortex in the course of global cerebral ischemia. AB - Based on distinctly different hemodynamic behavior of erythrocytes and plasma affecting properties of the circulating blood in vivo, such as apparent viscosity, flow resistance, axial streaming of erythrocytes, plasma skimming, etc., hematocrit (Htc) can have an apparent impact on tissue perfusion. Hematocrit also shows a diameter dependent decrease along the extraparenchymal arterial vascular routes that levels off being markedly lower in the microcirculation than in the central arterial blood. It was postulated that the impact of Hct may become a critical aspect of the macro- and microcirculatory compensatory mechanisms under ischemic conditions, when excessive fluid shifts between the extra- and intravascular compartments can in fact alter both systemic and local Htc, and when a decreased perfusion pressure sets the stage for sluggish flow velocities at which orientation of erythrocytes in the plasma stream can abruptly change and impair the macro- and microcirculation alike. To test this hypothesis, systemic (Htcs), feed (Htcf) and local hematocrit (Htcl) were simultaneously monitored in anesthetized and mechanically ventilated cats from the abdominal aorta, a pial artery of 100 micra in diameter and 500-600 cerebrocortical microareas of 0.01 cubic mm each respectively, by a television densitometric method while global cerebral ischemia was induced and maintained by adjusting the systemic mean arterial blood pressure to 40-50 mmHg by controlled arterial hemorrhage. Global cerebral ischemia was terminated when cerebrocortical microcirculation collapsed or shed blood completely got reinfused to the animal. The data show that under control conditions Htcf is 44% of Htcs, while hemoconcentration in the tissue brings Htcl up to 67% of Htcs. Under ischemic conditions, in cases of short survival time, the extraparenchymal arterial hemoconcentration can not be sufficiently compensated by intraparenchymal hemodilution and the microcirculation collapses under the conditions of lowering or moderately rising local tissue hematocrit. In case of longer survival , the rate of extraparenchymal hemoconcentration is increasingly lower and therefore the intraparenchymal hemodilution becomes more effective and prolonged. Due to factors most likely pertinent to the tissue proper, microcirculation collapses under abruptly developing secondary tissue hemoconcentration. Since terminal Htcl was only slightly higher than that at the beginning of the ischemic episode, attention to other hemodynamic and rheological factors in the microcirculation- not directly influenced by Htc--have been turned to.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2782166 TI - The effect of calcium entry blocker S-emopamil on cerebrocortical metabolism and blood flow changes evoked by graded hypotension. AB - Our studies demonstrate that in the explanation of the protective effect of the calcium antagonist (S)-emopamil the possibility of beneficial metabolic causes (lower O2 consumption) must also be considered beside of blood flow increasing effects. It is suggested that (S)-emopamil may be a useful drug for the treatment of cerebro-ischemic disorders. PMID- 2782167 TI - Determination of cerebral venous hemoglobin saturation by derivative near infrared spectroscopy. AB - An "in vivo" method for non-invasive determination of cerebral venous hemoglobin O2 saturation (SvO2) was developed. A specially designed spectrophotometer recorded the Td near IR spectra of transilluminated brain tissue surrounding the SS. The accuracy of the method, based on the principle of DNIRS was tested on eight pentobarbital anesthetized dogs during hypoxic hypoxia (inspired O2 6-21%). Spectral data were transformed into first derivative for correlation with SvO2 data measured from the SS. Linear regression analyses were applied using data from 5 dogs, with SvO2 ranging from 1.5%-70%, to build a 3 wavelength algorithm for predicting brain SvO2. In three dogs, this regression equation was employed to predict SvO2 in 31 separate spectra of varying HH intensity. The standard deviation of differences between SvO2 and predicted values was 3.2%. The predicted values, when regressed against the sampled SvO2, yielded an r value of 0.97. The results demonstrate that it is possible to noninvasively quantify SvO2 utilizing IR spectroscopy. PMID- 2782168 TI - Effect of emopamil on cerebrocortical microcirculation during hypoxia and reactive hyperemia and on [K+]e, pH, pO2 changes during and after N2 anoxia. PMID- 2782169 TI - Hypoxia in saline-perfused heart may be due to mismatch of regional metabolism and perfusion. PMID- 2782170 TI - The effect of IABP ventricular contractility of the normal and ischemic canine heart assessed in situ by T-Emax. AB - The effects of IABP on the contractile state of the in situ canine heart was evaluated under control conditions and conditions of regional ischemia by determining the transient slope of the end-systolic pressure-volume line, T-Emax. For comparison, the conventional index reflecting contractility, dP/dtmax and other related hemodynamic parameters were also assessed. The results showed that, T-Emax, rather than dP/dtmax, reflected more appropriately the changes in contractile state during activation of the IABP under both conditions. It suggests that IABP has a positive inotropic influence only in the ischemic-state and this is a positive inotropic influence only in the ischemic-state and this is a result of the improvement in the myocardial oxygen supply and demand relation. In addition, the limitations of the new indicator, T-Emax, is discussed. PMID- 2782171 TI - The influence of different anesthetics on the oxygen delivery to and consumption of the heart. PMID- 2782172 TI - Mechanism of hemoglobin-induced spasm in the isolated middle cerebral artery of the cat. AB - a./Great regional differences were observed in the vasospastic effect of hemoglobin. Namely, hemoglobin was far more potent in the middle cerebral artery than in the mesenteric artery. b./The role of potassium ions as well as activation of calcium mobilizing adrenergic, serotoninergic and PGF2 alpha smooth muscle receptors were excluded in the mechanism of cerebral vasospasm induced by hemoglobin. c./First in the literature we showed that atropine significantly attenuates the vasospastic effect of hemoglobin, and hemoglobin releases peptidergic neurotransmitters and modulators from nerve terminals that are located in the adventitia of the middle cerebral artery. PMID- 2782173 TI - Variation in axial velocity profile of red cells passing through a single capillary. AB - We have used an analysis of the velocity of individual red cells as the cells pass through a capillary in order to estimate the variability in cross-sectional area of the capillary lumen available for flow along the length of the vessel. The purpose of the study was to determine if there were irregularities of sufficient magnitude and frequency to support Secomb's hypothesis that local constrictions in the capillary lumen could hinder blood flow at low driving pressure, due to the energy required to deform red cells as they pass through the constriction. All capillary segments analyzed to date, in both rat and frog, have shown regions where the velocity of individual cells is consistently faster or slower than that of the mean velocity of all other cells in the same segment. There are approximately two constrictions per 100 microns in the rat and one per 100 microns in the frog. On average these constrictions appear to reduce the cross-sectional area by 30% in the rat and 16% in the frog. These results provide evidence in support of Secomb's hypothesis. In addition, our results from one bifurcation indicate that the capillary lumen increases in cross-sectional area as one moves from the parent vessel to the region of the bifurcation. Downstream of the bifurcation the lumen rapidly decreases in area by 45 to 54%. Thus a red cell must undergo even greater deformation as it passes through a capillary bifurcation than it will in most other sections of the capillary network.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2782174 TI - Near infrared determined cerebral transit time and oxy- and deoxyhemoglobin relationships during hemorrhagic hypotension in the dog. AB - The goal of the present study was to investigate the relationships among CBF, CMRO2, MTT and tissue/superior sagittal sinus hemoglobin saturations over a wide range of CPP using a canine model of hypotension. Microsphere-determined CBF was autoregulated in all tested cerebral regions over the 40-130 mmHg CPP range, but it decreased 50% around 30 mmHg. MTT, calculated by an indicator-dilution technique, progressively and proportionately increased over the 40-130 mmHg CPP range. The HbO2 content, measured in the same area by an optical method, parallely decreased. Around 30 mmHg CPP, MTT disproportionately lengthened (700% of control). CMRO2 maintenance was accompanied by a progressive decrease of tissue HbO2 and sagittal sinus hemoglobin saturation. In this framework, MTT measurement and tissue HbO2 monitoring by NIRS might give a sensitive evaluation of the hemodynamic reserve than CBF measurement in anesthesia and intensive care. PMID- 2782175 TI - The interaction between oxygen and vascular wall. AB - In vascular strips of canine carotid arteries stepwise lowering of oxygen tension from hyperoxic levels of 550 mmHg to 20 mmHg caused in preparations with endothelium a dose-dependent hyperpolarization and relaxation of smooth muscle cells when oxygen tensions between approximately 150 mmHg and 35 mmHg were attained. Pronounced hypoxia with oxygen tensions below 30 mmHg induced a depolarisation and an increase in force generation. During comparable investigations on vessel preparations without endothelium only a slight hyperpolarization and relaxation of the smooth muscle were observed when decreasing the oxygen tension from 550 mmHg to approx. 35 mmHg. In the presence of indomethacin (10(-5) M) a small but significant reduction in the hypoxia induced hyperpolarization and decrease in smooth muscle tone was found in intact vascular strips with endothelium. Depolarisation and contraction occurred at oxygen tensions below approx. 50-60 mmHg. PMID- 2782176 TI - Regulation of capillary blood flow: a new concept. PMID- 2782177 TI - Precapillary O2 loss and arteriovenous O2 diffusion shunt are below limit of detection in myocardium. AB - 1. Mean intracellular PO2 is much lower than mean venous PO2 in subepicardium. 2. The drop in Hb saturation between aorta and terminal arterioles is within the 5% error of our method. 3. Arteriolar O2 has no effect on saturation in paired countercurrent venules in myocardium. 4. Saturation in coronary venules is independent of venule diameter and indistinguishable from saturation in macroscopic epicardial veins. 5. Since diffusive O2 shunting is negligible and PO2 is approximately linearly related to saturations over the observed range, mean coronary venous PO2 should closely approximate mean-end capillary PO2. 6. O2 mass transport from blood to tissue requires a steep PO2 gradient between the capillary and the surface of a tissue cell. PMID- 2782178 TI - Regional differences in the regulation of contraction-relaxation machinery of vascular smooth muscle. AB - In the present study we revealed substantial differences in the regulation of the contraction-relaxation machinery of the middle cerebral and mesenteric arteries. a. Although K+-Krebs solution resulted in similar contractile responses in both vascular beds, norepinephrine, serotonin and PGF2 alpha were more potent in inducing contraction in the mesenteric artery than in the middle cerebral artery. Contrary, extremely high concentrations of acetylcholine produced negligible contractions in the mesenteric artery as compared to the middle cerebral artery. b. In more than 50% of the cases a considerable spontaneous tone developed in the middle cerebral artery, which was not due to the activation of adrenergic alpha receptors or some arachidonic acid metabolite. A similar phenomenon never occurred in the mesenteric artery. c. Acetylcholine, adenosine triphosphate and adenosine brought about similar dilatory concentration-response curves in the middle cerebral artery, but greatly different ones in the mesenteric artery where acetylcholine was the most, adenosine triphosphate the least potent dilator. PMID- 2782179 TI - Hemodynamic responses to vasoactive compounds in chronically alcohol treated rats. PMID- 2782180 TI - Does the area at risk of infarction change over time? PMID- 2782181 TI - Hemodilution and myocardial oxygen supply. The influence of fluosol-DA. PMID- 2782182 TI - How phosphocreatine buffers cyclic changes in ATP demand in working muscle. AB - 1. Spatial buffering is hardly necessary for maintaining ATP concentration. 2. Temporal buffering may be essential to defend concentration of products of ATP hydrolysis. ADP would vary 4-fold and AMP would vary 16-fold during a single twitch without buffering. 3. The principal function of the transphosphorylating reaction may be to buffer temporally the concentrations of controlling reactants. PMID- 2782183 TI - Maximal O2 uptake limitation in contracting skeletal muscle during carbon monoxide hypoxia. PMID- 2782184 TI - Development of muscular tissue PO2 after vascular reconstructive surgery. AB - Using a fast responding polarographic pO2-probe of the hypodermic needle type with a tip diameter of 300 microns we investigated the influence of vascular reconstructive surgery on the tissue pO2 of the tibialis ant. muscle. In 10 patients suffering from a peripheral occlusive disease state II-III according to FONTAINE measurements of tissue pO2, pain free walking distance and doppler-index were done preoperatively, 2 weeks and 6 weeks after surgery. The results show that reconstructive vascular surgery leads to an immediate improvement of the doppler-index. In contrast to that there is a time dependent increase of the mean tissue pO2 in the tibialis ant. muscle. This development of muscular oxygenation coincides with an increasing walking distance. PMID- 2782185 TI - Spatial and temporal variability of blood flow in stimulated dog gastrocnemius muscle. AB - The distribution of blood flow in skeletal muscle stimulated to rhythmic isotonic contractions was studied by injections of radioactive microspheres into the arterial supply of gastrocnemius muscles (mean weight 88 g) subsequently cut into 0.5 g pieces for determination of radioactivity. The coefficient of variation (CV = SD/mean) of the ratio of simultaneously injected 10 microns and 15 microns microspheres, 0.12, was taken as the inherent scatter of the method. The average spatial distribution inequality of 10-15 microns microspheres corresponded to a CV of 0.45 and the specific local blood flow inhomogeneity to a CV = 0.43 (= square root of 0.45(2) - 0.12(2)), but there were marked differences between muscles. The temporal variability of blood flow in individual muscle pieces was obtained from the comparison of fractional trapping of 4 to 5 differently labeled microspheres injected at intervals of 2 minutes into steadily stimulated muscles. The mean CV for the variations in time was 0.23 and that corrected for methodological scatter, 0.19. There were large differences between muscle pieces within a muscle and between muscles. The presence of considerable spatial and temporal variations of blood flow in exercising muscle during apparent steady state may be important in limiting and/or modulating tissue O2 supply. PMID- 2782186 TI - Muscle O2 uptake while perfused at constant pressure with normoxic blood during global hypoxia. PMID- 2782187 TI - Exponential attenuation of light along nonlinear path through the biological model. PMID- 2782188 TI - Electrochemical study of oxygen behaviour with lung surfactant. AB - At the very beginning of its way to any tissue oxygen has to cross the lung surfactant surface layer LSSL. The influence of LSSL on oxygen was studied in vitro at model interfaces using sensitive d.c. electrochemical techniques. LSSL adsorbed from lung washings at the dropping mercury electrode/saline interface shifted the half-wave potential of oxygen reduction E1/2 towards more negative values. The magnitude of delta E1/2 was dependent on the lung washing concentration and showed a saturation tendency. The intensity of the reduction current was higher in saline samples with surfactant than without and had a rather rising tendency. Lipids extracted from lung washings or amniotic fluid being spread as a condensed multilayer at the saline/air interface and re adsorbed on a hanging mercury electrode surface produced a several time bigger shift of oxygen reduction E1/2 towards negative potential values than the lung washings did. The surfactant specific 34 kD protein and lung washing proteins injected beneath the lipid layer produced a positive potential shift. Dust treatment-caused changes in surfactant quality/quantity resulted in bigger delta E1/2 values. The data suggest that the LSSL represents a certain energetic barrier or even an one-way gate to the crossing oxygen the efficiency of which depends on the composition/structure of the LSSL and that the aqueous hypophase under the LSSL in the alveoli is a place of storage for the oxygen. PMID- 2782189 TI - Chinese herbal medicine increases tissue oxygen tension. AB - An herbal medicine widely used in China, anisodamine, was investigated to determine its effect on the tissue PO2 of an important neural tissue, the retina. The anisodamine was injected intravenously over 10 min into anesthetized cats. Although it reduced mean blood pressure an average of 26%, anisodamine simultaneously increased tissue PO2 an average of 20%. It may therefore be useful in treating clinical conditions thought to be secondary to tissue hypoxia, such as diabetic retinopathy and sickle cell crises. PMID- 2782190 TI - Oxygen gradients in two regions of the epiphyseal growth plate. PMID- 2782191 TI - Contribution of diffusion to the oxygen dependence of energy metabolism in human neuroblastoma cells. AB - In suspensions of normally respiring human neuroblastoma cells respiration has an oxygen dependence similar to that of suspensions of isolated mitochondria in a comparable metabolic state. When mitochondrial oxidative phosphorylation is uncoupled, respiration at limiting oxygen pressures is indicative of the oxygen pressure difference between the extracellular medium and the mitochondria. Diffusion gives a P50 proportional to the cellular respiratory rate, with a value of 0.15 torr for the respiratory rate of normal cells. The oxygen pressure difference between the cytoplasm and the mitochondria is probable only a few tens of millitorr. PMID- 2782192 TI - Blood flow, tissue oxygenation, pH distribution, and energy metabolism of murine mammary adenocarcinomas during growth. PMID- 2782193 TI - Interrelationship among morphology, metabolism, and proliferation of tumor cells in monolayer and spheroid culture. AB - The proliferative activity of tumor cells is positively correlated with the cellular respiration rate. Thus, a decrease in the proliferative fraction during monolayer growth of EMT6 cells is associated with a decrease in the oxygen consumption rate both per cell and per cellular volume. These changes are paralleled by variations in the morphology of the tumor cells. The cellular volume, the cytoplasmic volume, the number and volume of mitochondria is decreased, whereas the volume of the nucleus remains relatively constant during the transition of cells from the exponential to the plateau growth phase. Similar observations have been made in outer, highly proliferative and inner non proliferating cells in EMT6 spheroids. However, the local oxygen consumption in this three dimensional, tissue-like assemblage of cells is obviously modified by the cellular packing density leading to a rather uniform oxygen uptake in the proliferating and non-proliferating cell areas. PMID- 2782194 TI - Toward absolute reflectance oximetry: I. Theoretical consideration for noninvasive tissue reflectance oximetry. AB - The photon diffusion theory can yield quantitative estimation of tissue hemoglobin saturation, provided that the medium is homogeneous and that one calibration data is available. The error in detection of tissue OS of the gut mucosa ranged from 5 to 10% in oxygen saturation. In application to skin, the two layer tissue model suggests that by properly designing the optical sensor and by appropriately selecting the illumination wavelengths, it is possible to capture mainly the light returning from the specific depth in tissue. Since the skin layer thickness is roughly in the order of 1 mm, the source and detector separation distance of approximately 3 mm or larger would ensure that the measured reflectance is truly returning from the deeper layer. When such reflectances are normalized to the blood-free reflectance obtained by squeezing the blood out of the tissue, the normalized reflectance truly represents the deeper layer characteristics. In application to head, since the skin and skull thickness is considerable large, separation distance of 40 mm or greater is required to ensure the reflectance is actually returning from the brain. Closely spaced optical sensor would measure the scattering and absorption characteristics of the skin and skull of the head. As for directional changes in optical propagation due to tissue inhomogeneities, multiple light sources at the equi distance around the detector can be placed to average out the effect. The resultant reflectance can be analyzed based on the similar mathematical treatment as presented in this study. However, since the absolute reflectance level calculated by the theory and the actual reflectance for a given transducer geometry have some deviation, again one point calibration is required to close the gap between them. This can be accomplished through arterialization of the tissue and ventilating with pure oxygen to yield reflectance from tissue containing 100% saturated blood. As for hemoglobin content, isosbestic reflectance, for example at 805 nm, can be utilized to estimate tissue hemoglobin content. Once one point calibration is accomplished, reflectance changes thereafter due to changes in HbT and OST can be fairly accurately predicted by the photon diffusion theory in combination with linear analysis. Concerning separation of arterial and venous blood in tissue, the diastolic and systolic phases of the optical plethysmographic signal can be assumed to relate to venous or DC level, and to arterial or AC component. Since the four components, arterial and venous OS and Hb, are unknowns in the system, four equations or four wavelength measurements are required to sort out each effect.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2782195 TI - Prognostic determinants in lupus nephritis. PMID- 2782196 TI - Glomerular lesions and opportunistic infections of the kidney in AIDS: an autopsy study of 47 cases. AB - AIDS-associated nephropathy (AAN) causing acute renal failure has been described in patients with AIDS. It is characterized by massive proteinuria and focal segmental glomerulosclerosis. From 1982 until 1987, 177 patients with AIDS were seen in our center. Most of them were homosexual or bisexual men. One patient was also an intravenous drug addict. One patient was a black female. None suffered from a nephrotic syndrome or needed hemodialysis during their illness. In 47 of the 110 patients who died an autopsy was performed. On microscopical examination of kidney tissue obtained at autopsy, no abnormalities were seen in 12 patients and slight abnormalities were found in 35 patients. Glomerular changes, mostly fibrous caps in Bowman's space, were present in 22 patients. Mesangial and intracapillary lesions were seen in only 5 patients. Tubular atrophy was found in 14 patients and sparse interstitial inflammation in 15 patients. A renal localisation of disseminated opportunistic infections was found in 11 patients: CMV (n = 4), tuberculosis (n = 2), Mycobacterium avium intracellulare (n = 1) and Cryptococcal infection (n = 4). In one patient a renal localisation of a Kaposi sarcoma and in another patient a renal localisation of a disseminated non-Hodgkin lymphoma was found. In conclusion the clinical picture of AAN with acute renal failure was not found in our center. As is the case with heroin associated nephropathy, AAN seems to be confined to certain areas in the USA, suggesting that racial or local co-factors, are important for the pathogenesis of AAN in AIDS. PMID- 2782197 TI - The natural course of gold and penicillamine nephropathy: a longterm study of 54 patients. AB - To elucidate the natural course of gold and penicillamine nephropathy and to facilitate appropriate clinical management 54 patients with rheumatoid arthritis who developed proteinuria during treatment with intramuscular gold thiomalate (21) or oral D penicillamine (33) were studied in detail throughout the whole of their renal illnesses. Renal biopsy was performed and creatinine clearance and proteinuria were measured serially for a median period of 60 months (range 16-130 months) in the gold treated and 74 months (range 13-158 months) in the penicillamine treated patients. During gold (penicillamine) treatment 48% (43%), 71% (82%) and 86% (91%) of patients had presented with proteinuria by 6, 12 and 24 months of treatment. After stopping gold (penicillamine) treatment proteinuria reached a median maximum of 2.1 g/day (4.2 g/day) at 2 months (1 month) before resolving spontaneously so that by 6, 12 and 18 months 38% (36%), 62% (64%) and 76% (88%) of patients were free of proteinuria. The median initial and most recent creatinine clearances of the gold (penicillamine) treated patients were 77 ml/min (80 ml/min) and 59 ml/min (78 ml/min) respectively and no patients died from or needed treatment for chronic renal failure. HLA B8 and/or DR3 alloantigens were identified in 64% of the gold treated and 56% of the penicillamine treated patients. In the gold (penicillamine) treated patients renal biopsy revealed membranous glomerulonephritis (GN) in 72% (88%), an immune complex mesangial glomerulonephritis in 10% (6%), minimal change nephropathy in 10% (6%) and no significant glomerular abnormalities in 8% (0%). The study has demonstrated the close similarity between gold and penicillamine nephropathy. It has also demonstrated that some 75% of cases develop during the first year of treatment, the proteinuria resolves completely when treatment is withdrawn, progressive deterioration of renal function is most uncommon, corticosteroid therapy is unnecessary and several different types of glomerulonephritis are associated with gold and penicillamine treatment. PMID- 2782198 TI - Effects of contrast media on renal hemodynamics and tubular function: comparison between diatrizoate and iopamidol. PMID- 2782200 TI - A case of relapsing renal micropolyarteritis: a possible association with assumption of non steroidal antiinflammatory drugs (NSAID). PMID- 2782199 TI - Nephrotoxicity of fumaric acid monoethylester (FA ME). AB - The nephrotoxic actions of high single oral doses of fumaric acid monoethylester (FA ME) have been investigated in the rat. Fifty mg of this substance produced morphologic lesions of the glomeruli without reducing GFR. Following 100 mg, the lesions were more pronounced and GFR was diminished by about 40%. Despite of hemorrhages in kidney cortex the urines did not contain erythrocytes. Urinary protein was augmented in single cases only. Fifty to 100 mg FA ME induced a marked concentration defect after water deprivation. In parallel FA ME reduced lactate production from glucose by kidney inner medulla in vitro. After in vivo application, however, no morphologic lesions were found in this zone of the kidney. FA ME had no effect on oxygen consumption of kidney slices despite of proximal tubular lesions observed histologically after 100 mg orally. Thus, 100 mg of FA ME have distinct nephrotoxic effects in the rat. PMID- 2782201 TI - Mechanism of the mitochondrial respiratory toxicity of cephalosporin antibiotics. AB - In summary, cephaloglycin, a nephrotoxic cephalosporin, produces a specific pattern of mitochondrial toxicity, decreasing both respiration with and the net uptake of succinate in renal cortical mitochondria after either in vivo or in vitro exposure, with no effect on succinate efflux. There is little or no reduction of ADP uptake by the same toxic exposures. Cephalexin, which is not toxic in vivo, inhibits respiration and uptake only with in vitro exposure. Fragmentation of mitochondria, which allows access of succinate to intramitochondrial enzymes without the need for carrier-mediated uptake, partially corrects the respiratory toxicity of cephaloglycin. We conclude that cephalosporin toxicity to succinate transport parallels the pattern of injury to mitochondrial respiration and may be pathogenic in this respiratory toxicity. These observations are consistent with the hypothesis that a) both nephrotoxic and nontoxic cephalosporins can fit the carriers for mitochondrial anionic substrate transport, and b) in situ nephrotoxicity develops as inhibition of transport becomes irreversible through acylation of these carriers. PMID- 2782202 TI - Drugs-induced renal diseases: personal contribution. PMID- 2782204 TI - The effects of hydrocortisone on the mesonephros proximal tubule cells. PMID- 2782203 TI - The effect of parathyroid hormone on cisplatin nephrotoxicity. PMID- 2782205 TI - Oxalate deposits in the kidney of 5/6 nephrectomised rats supplemented by large doses of vitamin C. PMID- 2782206 TI - Renal excretion of arginine-vasopressin in microalbuminuric diabetic patients. PMID- 2782207 TI - CAVH in myorenal syndrome. PMID- 2782208 TI - Effect of imidazole 2-hydroxybenzoate on erythrocyte charge: a possible explanation of its hypoalbuminuric action. PMID- 2782209 TI - Atheroembolic renal disease: clinico-pathologic correlations. PMID- 2782211 TI - Ageing and nutrition: questions needing answers. PMID- 2782210 TI - Severe renal involvement in primary Sjogren's syndrome. PMID- 2782212 TI - The effects of old age and immobility on protein turnover in human subjects with some observations on the possible role of hormones. AB - Protein turnover (PT), synthesis (PS) and breakdown (PB) were studied using L-(1 14C)-leucine and primed continuous infusion of 14C-HCO3 over a 6-h study period in three groups: group 1 (n = 9) fit old; group 2 (n = 6) fit young; and group 3 (n = 13) immobile old. Plasma cortisol, growth hormone (GH) and insulin levels were measured during the studies. There were significant reductions in PT (p less than 0.02), PB (p less than 0.02) and PS (p less than 0.01) in fit old compared to fit young subjects. Comparison between fit old versus immobile old subjects revealed that the immobile group (Group 3) had higher PT (p less than 0.05), PB (p less than 0.05) and PS (p less than 0.01) rates. The rates of protein turnover and components in group 3 were similar to those in group 2. There was greater variance in protein balance in the immobile subjects. Significantly higher plasma cortisols were found in the immobile than in the healthy old subjects. The immobile group had higher GH levels in response to feeding but there was no difference in insulin response to feeding. These higher plasma cortisol and GH levels may be partly responsible for the changes in PT found in immobile elderly patients. PMID- 2782213 TI - Respiratory patterns associated with swallowing: Part 1. The normal adult pattern and changes with age. AB - Simple, non-invasive equipment was designed to record respiratory patterns associated with swallowing food or drink in young and elderly healthy adults, to compare with neurologically impaired patients who complained of dysphagia. The timing of the entry of the test drink from a spoon into the mouth, the swallow event and respiration were recorded electronically and were presented in chart form. The equipment proved to be easy to use and the results were consistent. All 33 subjects showed a well-defined respiratory pattern, with individual minor variations, but different from the pattern of their resting respiration. The direction of respiration during spoon contact was consistent for each individual and the pharyngeal stage of swallowing was almost always followed by a large expiration. Thus the resting respiration is not simply arrested during swallowing, but is substituted by a different, well-controlled pattern. PMID- 2782214 TI - Respiratory patterns associated with swallowing: Part 2. Neurologically impaired dysphagic patients. AB - The co-ordination of respiration and swallowing was recorded electronically in three groups of patients who complained of dysphagia following a stroke, or associated with multiple sclerosis or motor neurone disease. The test used was simple and the equipment easily taken to the patient, in bed if necessary. All the patients showed differences from normal subjects and there were differences between each of the neurologically impaired groups. The technique appears to allow an assessment of the state of oropharyngeal motor and sensory functions separately during swallowing. PMID- 2782215 TI - Response bias in a health status survey of elderly people. AB - This paper compares respondents and non-respondents from the community sample of the Saskatchewan Health Status Survey of the Elderly. Response bias was assessed by comparing the demographic characteristics and use of health care services of the two groups. A stratified two-stage area probability sample was drawn from a comprehensive sampling frame. There were 1614 subjects eligible; interviews were completed with 1267 (78.5%). In the very elderly (85+ years) cohort, disproportionately more urban dwellers and more males were interviewed; the sample was otherwise demographically representative of the elderly population. Non-respondents, especially the very elderly, used significantly more medical services than respondents, and had a higher number of hospital admissions. Non respondents over age 75 experienced significantly longer average lengths of stay. On average, non-respondents used approximately 15% more hospital days. Non respondents over age 75 appear to be more likely to experience ill health than respondents. Hence, statistics from this survey are conservative estimates of the ill health of the elderly. PMID- 2782216 TI - Continence after stroke: useful predictor or goal of therapy? AB - Natural-history data from 362 conscious stroke victims, taking part in an acute intervention trial, were used to explore the prevalence and time course of recovery of urinary incontinence, associations with other variables and the relationship between bladder control and neurological, functional and overall outcome. More than half the patients were incontinent when first seen, at a mean of 24 h after onset, but this proportion fell to 29% by 1 month and was halved again by 6 months. Outcome was so much better in those who remained or became dry that it seems possible that recovery of continence may promote morale and self esteem which could actually hasten overall recovery. A controlled trial of a rehabilitation programme, concentrating on restoration of bladder control in the early stages of stroke, is now needed to test this possibility. PMID- 2782218 TI - Why does regular relief care end? AB - In a retrospective survey, patients whose regular hospital relief care came to an end were found to be similar to those in whom it continued in their medical and social features, and in the frequency of admissions, although their rota care did not last so long. The most frequent factors in ending rota care were acute illness leading to death, increased disability, and refusal by carers, the last two of which were often associated. Alternative care, refusal by patients and illness of carers affected smaller numbers. Patients whose rota care ended had a high mortality (56%) and seldom needed long-stay care, though only a minority of deaths (4/28) occurred during or shortly after a relief admission. PMID- 2782217 TI - Long-term follow-up of habit retraining for bladder instability in elderly patients. AB - Sixty patients with detrusor instability were contacted 2 to 3 years after their initial diagnosis and treatment. When first treated, 40 had improved, nine were catheterized and the remainder were unchanged. By the time of the first outpatient appointment 1 month later, a further 6% had been catheterized and 26% had lost control. Two to 3 years later, 17 of the 40 who had improved initially had maintained their improvement. The control in all the remainder had deteriorated and ten of the original 60 had died. Four of these deaths occurred in the group initially catheterized, only two of this group still had their catheter in situ, but were experiencing problems from it, and the remaining three had removed their catheter and were managing with pants and pads. Thus, two thirds of elderly patients with bladder instability respond initially to treatment, but 2 to 3 years later only two-fifths of these are still deriving benefit. PMID- 2782219 TI - Radiological features of pulmonary tuberculosis in elderly patients. AB - We reviewed the radiological findings in 55 hospital inpatients aged 60 and over with bacteriologically proven tuberculosis over a 5-year period 1981-5. Since most of the patients were infected during childhood it was expected that the majority would show the 'typical' findings of post-primary disease with apicoposterior lung lesions. This was found in 43 of the patients (78%). Unusual features were found in 12 patients: solitary pleural effusion (1), miliary tuberculosis (2), tuberculoma (1), isolated mediastinal or hilar lymphadenopathy (1), solitary ventrobasal and middle-lobe or lingular lesions (7). No major differences were found in comparison with a group of 59 younger patients with proven pulmonary tuberculosis. Amongst these 15 (25%) had 'atypical' radiological findings. We conclude that the radiological manifestations of pulmonary tuberculosis in elderly patients do not differ in frequency or distribution from those seen in younger adults. PMID- 2782220 TI - Caffeine and postprandial blood pressure changes in elderly people. PMID- 2782221 TI - Benoxaprofen inhibits the adhesion of human monocytes to cultured vascular endothelium. AB - Pretreatment of human monocytes with benoxaprofen for at least 2 h produced a dose-dependent abrogation of their adhesion to monolayers of cultured porcine endothelium with 0.05 microgram/ml and 50.0 micrograms/ml of the drug inducing a mean 33% and 83% inhibition of adhesion respectively. When the endothelium was treated with the drug there was no modification of monocyte adhesion. In contrast, pretreatment of endothelium with 5.0 and 50.0 micrograms/ml benoxaprofen for at least 6 h resulted in a mean 35% and 31% inhibition of polymorphonuclear cell (PMN) adhesion in 6/11 experiments. This inhibitory effect was not seen when drug-treated PMNs were added to endothelium. An impairment of monocyte chemotactic migration was only apparent with high concentrations of the drug (50 micrograms/ml). These results suggest that an important anti inflammatory property of benoxaprofen is the inhibition of monocyte adhesion to vascular endothelium. PMID- 2782222 TI - Venostasis-induced thrombosis in rats is not influenced by circulating platelet or leukocyte number. AB - In this paper experiments were designed to evaluate the role of platelet and leukocyte number in experimental venous thrombosis in rats. For this purpose venous thrombosis was induced by ligature of the inferior vena cava in animals made thrombocytopenic (5% of control) by antiplatelet antiserum or leukopenic (5 10% of control), by myelotoxic drugs. In normal animals the platelet count did not change after 2 or 3 hours of venous stasis, independently of whether a thrombus was present or not; the leukocyte count was significantly raised after ligature depending mainly on the duration of the stasis. Neither thrombocytopenia nor leukopenia, on the other hand, did influence the development of venous thrombosis. PMID- 2782224 TI - Quantitative criteria for evaluating the early development of osteoarthritis and the effect of diclofenac sodium. AB - In assessing the possible efficacy of drugs for the treatment of osteoarthritis (OA), it may be helpful to have a model, in animals, of the early development of the disease prior to the expression of secondary phenomena. It is also necessary that such effects are quantifiable. To this end, the natural development of OA in the STR/ORT mouse has been investigated. It has been shown that very early events in the development of the disease are disturbances in the activity of chondrocytic glucose 6-phosphate dehydrogenase, the initial step in the pentose phosphate pathway, and in the orientation of the proteoglycans of the matrix of the articular cartilage. The study has been done by reference to the effect of diclofenac sodium, which previously has been reported to retard the destruction of articular cartilage. The results appear to indicate that these markers may provide quantitative measures for assessing potential therapeutic agents. PMID- 2782223 TI - Histamine methyltransferase in dispersed cells from rabbit fundic mucosa. AB - The cellular distribution of histamine N-methyltransferase was studied in rabbit gastric mucosa. The fundic mucosa was dispersed by collagenase treatment in Hanks' or calcium-free medium. In calcium-free medium, the number of dispersed cells/g wet tissue, as well as their viability was increased; histamine N methyltransferase recovery was up to three-fold larger than in cells prepared in Hanks' medium. Furthermore, the calcium-free medium led to a greater acid secretory response, whereas the cellular pepsinogen content tended to be lower. Histamine N-methyltransferase activity was found in all cell fractions but was higher in the larger cell types. The enzyme activity showed only a partial correlation with either oxyntic or chief cells. These results indicate that the use of calcium-free medium to disperse and isolate rabbit mucosal cells improves cell quality. Histamine N-methyltransferase in the rabbit fundic mucosa, is found in more than one cell type, primarily the oxyntic and chief cells. PMID- 2782226 TI - Effect of transportation and relocation in post-weaning anoestrous primiparous sows. AB - The object of this investigation was to study the clinical and endocrine responses to transportation and relocation in 8 post-weaning anoestrous sows. They had been anoestrous for at least 24 days after weaning before transportation/relocation was performed. Laparoscopy, performed at the beginning of the experiment, revealed that the ovaries contained many follicles (less than or equal to 6 mm in diameter), but no corpora lutea. Blood samples, taken before and after transportation/relocation, showed that LH activity was low at the beginning of the experiment and increased after transportation/relocation in the majority of the sows. Peripheral plasma concentrations of of oestradiol-17 beta increased 1-4 days after transportation/relocation in 6 out of 8 sows which was followed by oestrus and ovulation. Progesterone concentrations were also below the practical detection limit until the end of oestrus. This study has demonstrated that a change in environment by transportation and relocation can induce oestrus by increasing the LH activity in post-weaning anoestrous sows. PMID- 2782225 TI - Changes in histamine and prostaglandins in acute inflammatory air pouch in mice. AB - The changes in histamine and prostaglandins (PGE2 and PGF) in carrageenan-induced acute inflammation were studied in 6 day old air pouches in mice. A significant elevation of exudate histamine was found 1 hour after the carrageenan injection. Highest vascular permeability at the site of inflammation was also found at 1 hour. Both PGE2 and PGF showed steady increases in the pouch exudate and reached significantly higher levels at 24 hours. The present findings thus suggest that histamine is involved in the early phase of carrageenan-induced inflammation by enhancing vascular permeability. The increases in PGE2 and PGF appear to be closely correlated with the increased exudate cell accumulation. This leads us to suggest that they are likely to be involved in the exudate cell activity rather than in enhancing the vascular permeability which was found to decrease at 4 hours after the carrageenan injection. PMID- 2782227 TI - A seroepidemiological investigation of Corynebacterium pseudotuberculosis infection in sheep flocks in southern Norway. PMID- 2782228 TI - Plasma amino acids in dogs with osteochondrosis or hip dysplasia. PMID- 2782229 TI - The influence of regular physical activity on the cell-mediated immunity in pigs. AB - The influence of moderate regular physical activity on the cell-mediated immunity was studied in growing pigs. Ten animals were subjected to physical training on a large animal treadmill, and 10 were kept in their pens throughout a 12-week experimental period. Regardless of whether the pigs underwent training or not, a whole blood lymphocyte stimulation test performed at 3 stages of the experiment revealed an equal ability of the cells to respond to stimulation induced by pokeweed mitogen and phytohaemaglutinin. The influence of serum from the pigs of the trained and untrained groups was studied in a stimulation test with purified mononuclear cells obtained from 2 healthy control pigs. The results indicated that no additional serum factors released by the physical training altered the blastogenic response of these lymphocytes. It is concluded that moderate exercise should not be regarded as a stressor which alters the cellular immunity in pigs. PMID- 2782230 TI - Effects of phenylbutazone and indomethacin on the post-operative course following experimental orthopaedic surgery in dogs. AB - Randomized placebo-controlled crossover studies were carried out in dogs to evaluate how two non-steroidal anti-inflammatory drugs (NSAID) might modulate an acute post-traumatic inflammatory reaction. Two "identical" surgical interventions were performed on the forelimbs of each animal with an interval of 28 days, to enable a paired comparison of the inflammatory signs and the wound/bone healing processes. At one operation 8 dogs received 300 mg phenylbutazone twice daily for 8 days starting on the day before surgery, and at the other operation matching placebo tablets were given. In a similar placebo controlled trial another group of 8 dogs received 5 mg indomethacin twice daily. With phenylbutazone the post-operative swelling was not significantly reduced compared to placebo, but there was less pain and limping. With indomethacin the swelling was somewhat reduced, but there was no consistent difference to placebo in the pain and limping assessments. None of the drugs appeared to distinctly effect the wound or fracture healing, as evaluated by clinical inspection, comparison of radiographs and comparison of bone sections from the sites of surgery. It proved difficult to select an appropriate dosage of indomethacin due to its high potential to induce GI ulceration and bleeding in dogs. In this experimental surgical model with an acute inflammation, neither phenylbutazone nor indomethacin showed impressive anti-inflammatory or analgesic properties. In the same model paracetamol has proved to significantly and more efficiently, reduce both swelling and pain without any noticeable adverse effects, and appears to be a better alternative than the two presently tested NSAID. PMID- 2782231 TI - Removal risks in Swedish Friesian dairy cows according to parity, stage of lactation, and occurrence of clinical mastitis. AB - The removal risk of Swedish Friesian dairy cows was analysed. The risk of removal increased with parity, and first parity cows were removed earlier in lactation than cows of higher parities. A positive report of clinical mastitis increased the risk of removal, both in the month of developing mastitis and during subsequent part of lactation. The consequences of different removal pattern for epidemiologic analyses of observational studies are discussed. PMID- 2782232 TI - Epidemiological studies of piglet diarrhoea in intensively managed Danish sow herds. I. Pre-weaning diarrhoea. AB - The study comprised 70,796 litters in 104 sow herds, observed from 1976 through 1982. Weaning age decreased from approx. 42 days to approx. 30 days during the observation period. Diseases and symptoms were recorded together with production parameters (feeding, barn construction, economic returns etc.). The mean incidence rate of pre-weaning diarrhoea was 6.8% of litters, with considerable inter-herd differences (incidence rates from 0 to approx. 50%). There was a slight increase in incidence during the autumn (August through October). Incidence rates increased with litter size, with a peak incidence in litters of 11-13 piglets, and decreased with increasing parity of the sow. There was a positive association between occurrence of arthritis and pre-weaning diarrhoea in the litters, and litters from sows with post parturient disease (MMA complex) had 1.8 times higher risk of getting diarrhoea than litters from healthy sows. No important differences among breeds were found. Small herds (less than 200 farrowings per year) had higher incidence rates than large herds (400-499 farrowings per year). Herds with a gilt proportion above 30% had an incidence rate of 12.3%, i.e. nearly twice as high as the overall mean (6.8%). There was a trend towards a higher incidence rate in litters kept in traditional pens (i.e. large pens with solid floor and loose sows) than in intensive pens (i.e. small pens with slatted flooring and tethered sows). The overall pre-weaning mortality rate was 16.2% of pigs born, half of which was due to stillbirths (6.3%) and overlaid piglets (2.2%). In litters with pre-weaning diarrhoea, the mortality rate was 19%, compared to 13% in litters without occurrence of diarrhoea. This difference accounts for an excess loss of 0.6 piglets from birth to weaning in diarrhoeic vs. non-diarrhoeic litters. Piglets from litters with pre-weaning diarrhoea had reduced weight gain. Thus, on the average, they were 2.2 days older at 25 kg bodyweight and weighed 0.4 kg less at 30 days than piglets from non diarrhoeic litters. Also, litters with pre-weaning diarrhoea had a significantly increased risk of post-weaning diarrhoea. The present information forms a basis for defining acceptable disease thresholds in suckling litters in intensively managed herds. PMID- 2782233 TI - Epidemiological studies of piglet diarrhoea in intensively managed Danish sow herds. II. Post-weaning diarrhoea. AB - This study comprised 48,931 litters in 89 sow herds. During the study (1976-82) weaning age decreased from approx. 42 days to approx. 30 days. The mean incidence of post-weaning diarrhoea was 6.0% of litters weaned, with little variation by year but with considerable variation among herds. Within the individual herd increased incidence occurred over limited periods, probably associated with specific infections. Litters with diarrhoea during the suckling period had increased risk of post-weaning diarrhoea. The incidence of post-weaning diarrhoea increased with litter size at weaning. Thus, a litter of 11-12 piglets at weaning had 1.2 times higher risk than litters with 8-10 piglets. In contrast to pre weaning diarrhoea, there was no association between parity of the sow and diarrhoea in the litter after weaning. Litters weaned below 2 weeks of age had a 2-fold risk of developing diarrhoea after weaning and a 2.4-fold higher mortality rate than did litters weaned at 6-7 weeks. Similarly, litters weaned at an individual piglet weight below 3 kg bodyweight had a 3-fold higher risk of developing diarrhoea after weaning and a 5-fold higher mortality rate than did pigs from litters weaned at a bodyweight of 7-8 kg. The incidence of post-weaning diarrhoea decreased with increasing herd size. Piglets from litters with post weaning diarrhoea had reduced weight gains after weaning and were 2.3 days older at 25 kg bodyweight than piglets from non-diarrhoeic litters. Likewise, diarrhoea after weaning was associated with an increased incidence of diseases of the skin and respiratory tract. Thus the risk of contracting respiratory disease was 4 times greater in diarrhoeic litters. PMID- 2782234 TI - Epidemiological studies of piglet diarrhoea in intensively managed Danish sow herds. III. Rotavirus infection. AB - The prevalence of rotavirus infection was studied in 1090 litters from 26 sow herds. Samples of normal, semifluid and watery stools were examined for rotavirus by an ELISA-test on faeces. Rotavirus was detected in 77% of the herds and in 30.5% of the litters (prevalence rates). The highest prevalence rate was seen in piglets between 21 and 41 days of age. Gilts' litters had a very high prevalence during the first week of life. Apart from this, no difference was found between litters from gilts and older sows. Rotavirus was detected more frequently in semiliquid, loose stools than in normal or watery stools, and an association between virus detection and diarrhoea could not be demonstrated. However, litters which shedded rotavirus during the suckling period had lower weight gains and higher incidence rates of respiratory diseases than virus-free litters. Litters weaned at 2 weeks in battery cages had slightly increased risk of shedding rotavirus compared to litters weaned in more traditional systems. The study revealed that rotavirus is widespread in Danish swine herds. The findings give evidence to suggest that the type of mild diarrhoea in 3-week-old piglets known as steatorrhoea or "white scours" may be associated with rotavirus infection, possibly in combination with E. coli and other agents. The high prevalence in piglets weaned at 2 weeks plus the higher morbidity and mortality among such piglets sustain the conclusion that piglets should not be weaned before 3 weeks of age or below a body weight of 6-7 kg. PMID- 2782235 TI - Induction of nematode-trapping organs in the predacious fungus Arthrobotrys oligospora (Hyphomycetales) by infective larvae of Ostertagia ostertagi (Trichostrongylidae). AB - Laboratory experiments were designed to study the influence of temperature, concentrations of nematodes, oxygen tension, light, and nutrient levels, on the induction of nematode-trapping hyphal nets in the predacious fungus Arthrobotrys oligospora. When induced by infective Ostertagia ostertagi larvae, a maximum number of nets was produced at 20 degrees C, at which temperature nets in surplus were produced at larval concentrations up to 1,000 larvae per cm2. A. oligospora did not produce nets in an anaerobic atmosphere containing 21% CO2 (v/v), and net induction was suppressed to a certain degree by exposure to light. The composition of the medium had an important influence on the saprophytic growth and the net-forming capability of A. oligospora as a maximum number of nets was induced at a relatively low concentration of corn meal supporting the relatively sparse mycelium. It was shown that a proportion of trapping nets in A. oligospora maintained their trapping potential for more than 7 weeks when the temperature was below 25 degrees C. Induction of nematode-trapping organs in A. oligospora is discussed in relation to control of infective nematode parasite larvae in cow pats. PMID- 2782236 TI - Congenital myasthenic syndrome in the dog breed Gammel Dansk Honsehund: clinical, electrophysiological, pharmacological and immunological comparison with acquired myasthenia gravis. AB - The effect of anticholinesterase drugs on the clinical and electrophysiological features in a canine congenital myasthenic syndrome is compared with findings in acquired myasthenia gravis in dogs. Anticholinesterase treatment had no effect on muscle weakness or electrophysiological parameters in the congenital myasthenic syndrome in contrast to its effect on clinical signs and electrophysiological parameters in acquired myasthenia gravis. The lack of effect of anticholinesterase in congenital myasthenia suggests a presynaptic defect as the aetiological factor. No antibodies to acetylcholine receptors were found in the Danish dog breed Gammel Dansk Honsehund with the myasthenic syndrome. This classifies the disease in the group of canine and human congenital myasthenic diseases. PMID- 2782237 TI - A long term study of the health status and performance of sows on different feed allowances during late pregnancy. I. Clinical observations, with special reference to agalactia post partum. AB - Thirty nine pairs of full sibs were investigated over 6 parities in a long term study on the effects of late pregnancy feed allowance on the occurrence of agalactia post partum and on the performance of sows and piglets. A careful examination of all sows with a rectal temperature exceeding 39.5 degrees C was performed by a veterinarian within the first 48 h after farrowing. Milk-samples were taken from sows with elevated rectal temperatures and showing clinical symptoms of agalactia. During the last 15 days of gestation the sows in the control group were fed 3.4 kg daily and the sows in the experimental group 1.0 kg daily of a commercial type of diet. In 26.6% of the farrowings in the control group the sows were agalactic whereas the corresponding figure in the experimental group was 14.4%. On clinical examination udder changes were observed in a majority of the diseased sows in both groups. However, the agalactic sows in the control group were generally more affected, with lower water and feed consumption than in the experimental group. No effects of age of the sow (parity number) or length of the gestation period on the incidence of agalactia were demonstrated. The rectal temperature of agalactic sows was significantly higher than in the healthy sows already 1 day before farrowing. The agalactic sows farrowed a larger number of stillborn piglets, which indicates an early establishment of the disease. The number of weaned piglets at 6 weeks did not differ between agalactic and healthy animals. The interval from weaning to first oestrus was not influenced by agalactia in the preceding lactation. PMID- 2782238 TI - Pharmacists' participation in professional organizations. PMID- 2782239 TI - Mail-order pharmacy: a challenge to pharmacy practitioners and educators. PMID- 2782240 TI - Model regulations for mail-order pharmacy. Only 20 states currently regulate the practice. PMID- 2782241 TI - The mood of health care: a small inquiry. PMID- 2782242 TI - Concerning the case of American Pharmaceutical Association and Michigan State Pharmaceutical Association. PMID- 2782243 TI - Meeting the needs of the elderly. PMID- 2782244 TI - Adverse reactions must not be ignored. PMID- 2782245 TI - Coronary risk associated with age and sex of parental heart disease in the Framingham Study. AB - Data from the Framingham Study, a population-based prospective study of 5,209 persons, were analyzed to determine whether a parental history of death by coronary artery disease (CAD) before or after 65 years of age was an independent risk factor for CAD of early onset (age younger than 60 years) or late onset (age 60 years or older) among the men and women in the cohort. Death due to CAD in parents was associated with a 30% increase in the risk of CAD. The effect was apparently stronger for an early CAD outcome, with adjusted relative risks of 1.5 for early and 1.2 for late outcome CAD. The effect of parental CAD death on risk was not mediated by other shared risk factors for CAD. These findings were similar for those with either a mother or a father with CAD, if CAD onset in the offspring occurred before the age of 60 years. For persons with CAD at age 60 years or older, maternal CAD death was a stronger predictor of CAD than paternal CAD death. The association with parental history of CAD was similar among men and women in the cohort, with adjusted relative risks of 1.3 and 1.2, respectively. However, early age of parental CAD death may account for the association among women (RR = 1.6), whereas late age of CAD death for either parent was associated with the risk of CAD among men (RR = 1.4). PMID- 2782246 TI - Effects of sublingual nitrate in patients receiving sustained therapy of isosorbide dinitrate for coronary artery disease. AB - To examine the effects of sublingual isosorbide dinitrate (ISDN) in patients receiving sustained ISDN therapy, 24 patients with coronary artery disease were divided into 2 groups. Group C comprised 12 patients without sustained ISDN therapy and group N included 12 patients with sustained ISDN therapy. Before and during administration of sublingual ISDN in both groups, aortic systolic pressure, left ventricular end-diastolic pressure and coronary artery diameter were examined at cardiac catheterization. During sublingual ISDN, the aortic systolic pressure decreased by 20 +/- 6% (138 +/- 26 to 112 +/- 27 mm Hg, p less than 0.01) in group C and 10 +/- 6% (127 +/- 26 to 113 +/- 23 mm Hg, p less than 0.01) in group N (p less than 0.01, group C vs group N). The left ventricular end diastolic pressure decreased by 65 +/- 16% (11 +/- 5 to 4 +/- 3 mm Hg, p less than 0.01) in group C and 43 +/- 14% (12 +/- 5 to 7 +/- 3 mm Hg, p less than 0.01) in group N (p less than 0.01, group C vs group N). During sublingual ISDN, the diameters of the proximal and distal segments of the left anterior descending and circumflex coronary arteries increased more significantly in group C than in group N (p less than 0.01, group C vs group N). Thus, sublingual ISDN produced less reduction of aortic systolic pressure and left ventricular end-diastolic pressure, and less dilation of coronary artery diameter in patients receiving sustained therapy with ISDN than in those without sustained therapy.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2782247 TI - Sustained effect of and lack of development of tolerance to controlled-release isosorbide-5-mononitrate in chronic stable angina pectoris. AB - Tolerance has been shown to develop when nitrate preparations are used in such a manner as to produce plasma levels within the therapeutic range continuously over a 24-hour period. However, a period of reduced or low nitrate plasma levels of a few hours per day may limit or completely prevent tolerance development. In 18 patients with chronic stable angina pectoris, a single 60-mg daily dose of a controlled-release preparation of isosorbide-5-mononitrate (ISMN) was compared with the administration of 30 mg, 4 times daily, of immediate-release isosorbide dinitrate (ISDN) in a double-blind, randomized, placebo-controlled, crossover study. The comparisons were carried out on the first day of therapy and after 11 to 14 days of continuous therapy to assess the duration of effectiveness and the development of tolerance. On short-term therapy, both drugs produced a significant improvement in treadmill walking times to moderate angina in comparison with placebo. The values for ISMN were 87 +/- 99 seconds (23%) at 12:30 P.M., 72 +/- 91 seconds (19%) at 5 P.M. and 51 +/- 81 seconds (13%) at 8:30 P.M. For ISDN, the respective values were 71 +/- 83 seconds (19%), 89 +/- 98 seconds (24%) and 79 +/- 87 seconds (21%). There were no significant differences between drugs. Plasma nitrate levels for each drug paralleled the improvements in exercise performance.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2782248 TI - Influence of thrombolytic treatment followed by full dose anticoagulation on the frequency of left ventricular thrombi in acute myocardial infarction. AB - This study evaluated the influence of thrombolysis followed by full anticoagulation on the frequency of left ventricular (LV) thrombi after acute myocardial infarction (AMI). Nineteen consecutive patients with a first anterior wall AMI who received 1,500,000 IU of streptokinase within 3 hours of symptom onset, followed by full anticoagulation, underwent echocardiographic studies within 24 hours of symptoms, and then on days 2, 3, 5, 7, 12, 30 and 90. Forty four patients, with comparable clinical features and echocardiographic protocol but without antithrombotic therapy, served as the control group. LV thrombi developed in 4 of 19 (21%) treated patients and in 23 of 44 (52%) control subjects (p = 0.02). LV aneurysm or major wall motion abnormalities were noted in 8 of 19 (42%) treated patients and in 30 of 44 (68%) control subjects (p less than 0.05). No significant difference was found between treated and untreated patients when comparing the incidence of thrombi in the subgroups of patients with aneurysm or major wall motion abnormalities (3 of 8 vs 21 of 30) and in the subgroups with less extensive LV dysfunction. Thrombi disappeared during hospitalization in 3 of 4 treated patients, but in none of the controls. Fewer patients treated with intravenous streptokinase followed by full anticoagulation developed LV thrombi compared to patients treated with conventional therapy. This difference may be related to a reduced occurrence of major LV wall motion abnormalities. Resolution of thrombi frequently occurs in the hospital phase of AMI; therefore, only frequent echocardiographic examinations can assess the true frequency of LV thrombi. PMID- 2782249 TI - Intravenous amiodarone for the rapid treatment of life-threatening ventricular arrhythmias in critically ill patients with coronary artery disease. AB - This study examined the effectiveness of intravenous amiodarone for rapid control and prevention of recurrent life-threatening ventricular tachyarrhythmias associated with cardiovascular collapse. In 22 critically ill patients with coronary artery disease (mean ejection fraction 27 +/- 13%), recurrent ventricular tachyarrhythmias proved refractory to 3.7 +/- 1.1 (mean +/- standard deviation) conventional antiarrhythmic drugs. In the 24-hour period before intravenous amiodarone treatment, patients experienced 2.4 +/- 2.3 (range 1 to 9) episodes of life-threatening ventricular tachycardia, ventricular fibrillation or both, requiring 4.0 +/- 3.9 direct current cardioversions. Within the 24 hours after initiation of intravenous amiodarone therapy (900 to 1,600 mg/day), 20 of 22 patients remained alive and had 1.1 +/- 1.6 episodes of life-threatening ventricular arrhythmias, requiring 1.9 +/- 3.1 direct current cardioversions. In the second 24-hour period, there were 19 survivors and life-threatening arrhythmias were reduced to 0.4 +/- 0.7 episode/patient requiring 0.4 +/- 0.9 direct current cardioversion. Overall, arrhythmias were controlled in 11 of 22 (50%) patients within the first 24 hours, and in 14 of 22 (64%) in the second 24 hours. Intravenous amiodarone therapy was well tolerated. Twelve patients were discharged from the hospital and 8 remained alive at a mean follow-up of 22 +/- 14 months. Thus, in critically ill patients, intravenous amiodarone may be useful for rapid control of spontaneous, refractory, life-threatening ventricular tachyarrhythmias. PMID- 2782250 TI - Usefulness of twenty-four-hour blood pressure patterns and response to short-term sodium restriction in normotensive subjects in detecting a predisposition to systemic arterial hypertension. AB - Twenty clinically healthy subjects were studied to identify normotensive adults with a predisposition to arterial hypertension by monitoring blood pressure (BP) and restricting dietary sodium intake. Short-term restriction in sodium intake resulted in a decrease of the mean level for the circadian rhythm of BP. The phenomenon is visible in subjects without familial hypertension but not in individuals with a positive history for high BP. The response of the 24-hour BP patterns to abrupt sodium deprivation seems to be an indicator for discovering normotensive subjects at risk of developing arterial hypertension. PMID- 2782251 TI - Relation between plasma norepinephrine and response to medical therapy in men with congestive heart failure secondary to coronary artery disease or idiopathic dilated cardiomyopathy. AB - This study examines the relation between the change in clinical status and the change in plasma norepinephrine concentration in patients with congestive heart failure (CHF) receiving standard medical therapy. Hemodynamic measurements in 11 patients with CHF (ejection fraction 19 +/- 4%) were obtained before and immediately after the administration of digoxin and angiotensin-converting enzyme inhibitors. Patients were then followed for 1 year. Clinical status was determined using the Boston Clinical Heart Failure scoring system. Of the 11 patients, 6 demonstrated significant clinical improvement after therapy, based on the Boston score, over a 1-year period. Five patients did not respond to therapy: 4 died and the remaining patient had worsening CHF. There was no difference between responders and nonresponders in either baseline hemodynamics or acute response to the administration of digoxin and an angiotensin-converting enzyme inhibitor. In the patients who improved, plasma norepinephrine decreased from 706 +/- 235 to 545 +/- 223 pg/ml (p = 0.08) after 1 year of medical therapy. In patients whose CHF worsened or who died, plasma norepinephrine increased from 715 +/- 275 at baseline to 1,237 +/- 671 pg/ml at their last measurement (p = 0.06). Although at baseline the plasma norepinephrine levels were similar in both groups of patients, a significant difference between responders and nonresponders was observed at final follow-up (p less than 0.002). Change in plasma norepinephrine correlated with change in CHF score (r = 0.79, p less than 0.004). Thus, in patients with CHF, serial measurements of plasma norepinephrine correlate with changes in clinical status. PMID- 2782252 TI - Influence of transmitral filling dynamics on continuous-wave Doppler assessment of aortic regurgitation by half-time methods. AB - The influence of transmitral filling dynamics on the evaluation of aortic regurgitation (AR) by continuous-wave Doppler pressure half-time was assessed in 30 consecutive patients in sinus rhythm with chronic moderate to severe AR. Pulsed-wave Doppler-derived regurgitant fraction (obtained from aortic and pulmonary stroke volumes) and color flow mapping relative regurgitant area (obtained from the parasternal short-axis view) were chosen as reference standards for the severity of AR. An excellent correlation was found between these 2 parameters (r = 0.98), while correlations were poor between pressure half time and either regurgitant fraction (r = -0.74) or relative regurgitant jet area (r = -0.69). The ratio of early (E) to late (A) transmitral peak velocities was used to divide the study population into 2 groups: group A (n = 16) with E/A less than 1 and group B (n = 14) with E/A greater than 1. In patients with a similar degree of AR (estimated from Doppler regurgitant fraction or relative regurgitant jet area), the pressure half-time was found to be significantly shorter. Thus, the severity of AR in group A patients was overestimated (p less than 0.01). Compared to group B, group A patients were significantly shorter. Thus, the severity of AR in group A patients was overestimated (p less than 0.01). Compared to group B, group A patients were significantly older (p less than 0.02) and had a larger left ventricular mass (p less than 0.005).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2782253 TI - Combined percutaneous mitral and aortic balloon valvuloplasty. AB - Between August 1987 and November 1988, combined mitral and aortic balloon valvuloplasty was performed in 10 patients (mean age 42 +/- 9 years), all of whom had symptomatic mitral and aortic stenosis. The procedure was performed using a transarterial approach with a multiballoon catheter and an exteriorized intracardiac long guidewire circuit. The procedure could be considered successful in 9 patients where significant increases in the mean mitral (0.97 +/- 0.19 to 1.80 +/- 0.26 cm2) and aortic (0.63 +/- 0.18 to 1.15 +/- 0.32 cm2) areas were achieved. Severe mitral regurgitation that required surgery developed in 1 patient in the following 24 hours. Femoral vascular surgery was necessary in 1 patient. Mid-term follow-up was available in 8 patients for a period averaging 8 +/- 3 months. The 9 patients in whom the procedure was successful showed persistent clinical improvement in functional class, Doppler echocardiography showed 2 cases of aortic restenosis and none of mitral restenosis. Combined mitral and aortic balloon valvuloplasty could be a valid alternative treatment in selected patients with both mitral and aortic rheumatic stenosis. Further experience and long-term hemodynamic follow-up are necessary to define the role of this mode of treatment. PMID- 2782254 TI - Continuous spectral analysis of heart murmurs for evaluating stenotic cardiac lesions. AB - Severity of stenotic heart lesions affects timing, quality and pitch of associated heart murmurs. This quantitative study investigated the relation between instantaneous sound frequencies contained in heart murmurs and magnitudes of Doppler jet velocities measured distal to associated obstructions. Heart murmurs were recorded from 18 patients, ages 1 day to 23 years, with 21 separate murmurs resulting from abnormal valves (18 studies) or left-to-right shunts (3 studies). Recorded murmurs were digitized and divided into 12.3-ms time segments for computer frequency analysis using the maximum entropy method. Murmur spectra were plotted in gray scale against time. All murmurs contained dominant frequencies that varied with time. Dominant murmur frequencies and associated Doppler jet velocities at equivalent points in time were measured at 50-ms intervals. For 88 points analyzed, instantaneous dominant frequencies ranged from 130 to 410 Hz (mean +/- standard deviation 282 +/- 70 Hz) and instantaneous jet velocities ranged from 110 to 460 cm/s (290 +/- 80 cm/s). For the 21 murmurs studied, peak murmur frequencies ranged from 200 to 410 Hz (308 +/- 70 Hz) and peak jet velocities ranged from 165 to 460 cm/s (320 +/- 78 cm/s). Instantaneous dominant frequency correlated to instantaneous jet velocity (r = 0.85) and peak dominant frequency correlated to peak jet velocity (r = 0.89). This in vivo study demonstrates that dominant frequencies contained in heart murmurs are related to instantaneous jet velocities distal to associated obstructions. PMID- 2782255 TI - Influence of age and sex on left ventricular filling at rest in subjects without clinical cardiac disease. AB - Left ventricular (LV) filling at rest was studied by radionuclide ventriculography using alternate R-wave gating in 42 patients (29 men, 13 women) who had a low likelihood of cardiac disease. LV filling measurements differed little between men and women. Age was correlated positively with atrial filling duration (r = 0.55), atrial filling duration fraction (r = 0.52) and atrial filling fraction (r = 0.56) and negatively with rapid filling fraction (r = 0.58). Age was not correlated with peak filling rate, time to peak filling rate and first-half filling fraction. The heart rate at rest was significantly negatively correlated with rapid (r = -0.62), slow (r = -0.81) and atrial (r = 0.72) filling durations, but not with isovolumic duration. The heart rate at rest was weakly positively correlated with peak filling rate in end-diastolic volume per second (r = 0.36) and negatively correlated with first-half filling fraction (r = -0.35). Systolic pressure at rest influenced atrial filling duration. LV ejection fraction and end-diastolic volume index were not correlated significantly with LV filling in relatively normal subjects. PMID- 2782256 TI - A brief self-administered questionnaire to determine functional capacity (the Duke Activity Status Index). AB - To develop a brief, self-administered questionnaire that accurately measures functional capacity and assesses aspects of quality of life, 50 subjects undergoing exercise testing with measurement of peak oxygen uptake were studied. All subjects were questioned about their ability to perform a variety of common activities by an interviewer blinded to exercise test findings. A 12-item scale (the Duke Activity Status Index) was then developed that correlated well with peak oxygen uptake (Spearman correlation coefficient 0.80). To test this new index, an independent group of 50 subjects completed a self-administered questionnaire to determine functional capacity and underwent exercise testing with measurement of peak oxygen uptake. The Duke Activity Status Index correlated significantly (p less than 0.0001) with peak oxygen uptake (Spearman correlation coefficient 0.58) in this independent sample. The Duke Activity Status Index is a valid measure of functional capacity that can be obtained by self-administered questionnaire. PMID- 2782257 TI - Noninvasive measurement of left ventricular filling pressures by means of transmitral pulsed Doppler ultrasound. AB - In 54 consecutive patients, ages 59 +/- 11 years, the transmitral diastolic flow velocity profile was derived by means of pulsed Doppler echocardiography simultaneously with right-sided heart catheterization. In 30 of them, ages 57 +/- 10 years, left-sided heart catheterization was performed at the same time. The sample volume was positioned exactly in the mitral anulus plane, bisecting the anulus. The ratio of the time-velocity integrals of the A wave (atrial contraction) and E wave (early filling) was calculated (A/E ratio of integrals). Linear regression analysis showed a highly significant linear correlation of the A/E ratio of integrals with regard to left ventricular (LV) end-diastolic pressure (r = 0.98, p less than 0.001) and pulmonary capillary wedge pressure (r = 0.98, p less than 0.001). The A/E ratio of integrals also correlated with other hemodynamic parameters, such as cardiac output (r = -0.73, p less than 0.001), cardiac index (r = -0.74, p less than 0.001) and stroke volume index (r = -0.65, p less than 0.001). For 19 additional patients, ages 55 +/- 8 years, the values of LV end-diastolic pressure and pulmonary capillary wedge pressure were calculated by means of the corresponding formulas from the first data set. The correlation between the calculated and invasively measured LV filling pressures expressed in terms of intraclass correlation coefficients shows highly significant correlations for both LV end-diastolic pressure (intraclass correlation coefficient = 0.99, p less than 0.001) and pulmonary capillary wedge pressure (intraclass correlation coefficient = 0.99, p less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2782258 TI - Factors influencing accuracy in left ventricular volume determination. AB - The accuracy with which left ventricular volume is determined from contrast ventriculograms depends on the care with which the analysis protocol is followed. Therefore, the effect of variations in the method used for calculating the correction factor (CF) that adjusts for magnification and image distortion on volume calculation was measured. The results showed that error in the CF is caused by (in order of decreasing importance): filming the calibration figure at a different magnification mode from that of the ventriculogram, at a different height from the table than the level of the ventricle, or with the image intensifier at a different height than used during ventriculography; use of a calibration figure less than half the size of the ventricle; calculation of the CF from only 1 band pair of a banded catheter; or placement of the calibration figure at the periphery rather than the center of the imaging field. Error in volume determination was proportional to error in the CF. With care, the error in volume can be reduced to that due to interobserver variability in tracing the endocardial contours. PMID- 2782259 TI - Assessment by Doppler color flow mapping of ventricular septal defect after acute myocardial infarction. PMID- 2782260 TI - Macroreentrant ventricular tachycardia and coronary artery disease in cerebrotendinous xanthomatosis. PMID- 2782261 TI - Adenosine in altering short- and long-term treatment of supraventricular tachycardia in infants. PMID- 2782262 TI - Operative correction of subcarinal left pulmonary artery originating from the right pulmonary artery. PMID- 2782263 TI - Evaluation of coronary arterial fistula by color-coded Doppler echocardiography. PMID- 2782264 TI - Use of venous contrast echocardiography for diagnosis of cardiac tamponade. PMID- 2782265 TI - Lipid-lowering therapy after an atherosclerotic event. PMID- 2782266 TI - Cardiac denervation and long QT interval. PMID- 2782267 TI - A symposium: Cardiovascular therapy--the next step. Southampton, Bermuda. Proceedings. PMID- 2782268 TI - What factors predict recovery of contractile function in the canine model of the stunned myocardium? AB - Recovery of contractile function of myocardium stunned by a brief, transient period of regional ischemia is highly variable. In our experience, segment shortening (an index of regional systolic contractile function) assessed during the initial hours after a 15-minute period of coronary artery occlusion in anesthetized open-chest dogs ranged from -84 to +99% of normal preocclusion values. In this retrospective study, regression analysis was used to assess the effects of various parameters on segment shortening 2 hours after reperfusion. Parameters assessed included regional myocardial blood flow both during occlusion and after reperfusion, high-energy phosphate content of previously ischemic tissue, systemic hemodynamic parameters (heart rate, mean arterial pressure and double product), occluded bed size and segment shortening measured during coronary artery occlusion. Recovery of systolic contractile function was not influenced by the degree of ischemia during coronary artery occlusion, myocardial blood flow after reperfusion, high-energy phosphate content, hemodynamic parameters or occluded bed size (correlation coefficients, r, ranged from 0.001 to 0.37 [p = not significant]). Only the degree of dyskinesia/hypokinesia exhibited during coronary occlusion significantly and reliably predicted recovery of segment shortening measured 2 hours after reflow (r = 0.70, p less than 0.001). Thus, recovery of systolic contractile function in the anesthetized canine model of the stunned myocardium is determined primarily by the degree of dysfunction exhibited during the preceding period of ischemia. PMID- 2782269 TI - Comparative study of the effect of nifedipine versus diltiazem on exercise performance, serum propranolol levels, and ST-segment abnormalities in patients with chronic stable angina taking propranolol. AB - Twelve patients (10 men and 2 women), mean age 60.6 years (range 50 to 75), with stable angina pectoris were administered propranolol until beta blockade was evident. Treadmill exercise testing was performed, 24-hour ambulatory electrocardiograms were recorded, and serum propranolol levels were assessed at 1 and 2 hours after dosing with propranolol alone, and after 2 weeks of combined therapy with either nifedipine, 10 or 20 mg, or diltiazem, 60 or 120 mg, administered every 8 hours. Patients were assigned to treatment regimens in randomized, double-blind, crossover fashion. At the time of exercise testing, maximal exercise time, time to angina, peak exercise heart rate and systolic blood pressure and time to 1 mm of ST-segment depression were measured. The rate pressure product was also calculated. Maximal exercise time increased from 708 +/ 140 seconds with propranolol alone to 795 +/- 156 seconds after combined propranolol-nifedipine therapy (p less than 0.05), and to 790 +/- 107 seconds (p less than 0.05) after propranolol-diltiazem therapy. Time to onset of angina increased from 472 +/- 191 seconds with propranolol alone to 564 +/- 123 seconds (p = NS) after propranolol-nifedipine treatment and to 607 +/- 197 seconds (p less than 0.05) after propranolol-diltiazem treatment. Peak exercise heart rate remained unchanged with propranolol-nifedipine therapy (103 +/- 16 beats/min vs 104 +/- 17 with propranolol alone). However, with propranolol-diltiazem therapy, peak exercise heart rate significantly decreased to 95 +/- 14 beats/min (p less than 0.05); peak systolic blood pressure and rate-pressure products were comparable on all treatment regimens.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2782270 TI - Renal hemodynamic effects of calcium antagonists. AB - Recently, attention has focused on the effects of calcium antagonists on renal function. When administered in vitro to the isolated perfused kidney, calcium antagonists exhibit predictable actions allowing for characterization of their renal effects. Calcium antagonists do not affect the vasodilated isolated perfused kidney; however, they do dramatically alter the response of the kidney to vasoconstrictor agents. In the presence of norepinephrine, calcium antagonists markedly augment the glomerular filtration rate but produce only a modest improvement in renal perfusion. A study using the postischemic hydronephrotic rat kidney model that permits direct visualization of afferent and efferent arterioles, this study demonstrated that this preferential augmentation of the glomerular filtration rate is primarily attributable to a selective vasodilation of pre-glomerular vessels. Although the clinical implications of such observations are not yet clear, preliminary studies in experimental animal models indicate that calcium antagonists might exert salutary effects on renal function in clinical settings characterized by impaired renal hemodynamics. The possible benefits of calcium antagonists in ameliorating the development of renal dysfunction in patients in whom there is increased risk of acute renal insufficiency remain to be evaluated. PMID- 2782271 TI - Nifedipine, but not propranolol, improves left ventricular systolic and diastolic function in patients with hypertension. AB - The effects of nifedipine and propranolol on cardiac function both at rest and at peak exercise were compared in 22 hypertensive patients whose diastolic blood pressures remained in excess of 95 mm Hg despite diuretic therapy. In this double blind, placebo-controlled study, left ventricular systolic and diastolic function at rest and at peak exercise during bicycle ergometry was assessed by first-pass radionuclide angiography using the Baird Scinticor before and after treatment with either nifedipine or propranolol. Both agents effectively reduced blood pressure in the supine and upright positions and at peak exercise. Nifedipine was associated with a significant increase in cardiac output and stroke volume at rest and at peak exercise, while propranolol decreased cardiac output at rest and at peak exercise. Systemic vascular resistance decreased with nifedipine treatment at rest and at peak exercise, but increased significantly with propranolol. Nifedipine increased ejection fraction in patients at rest and also increased maximal oxygen consumption at peak exercise, while propranolol decreased maximal oxygen consumption at peak exercise. At rest and at peak exercise, nifedipine increased peak filling rate, but time to peak filling rate was not affected by either drug. The fraction of total diastolic filling at the midpoint of diastole was significantly increased by nifedipine therapy at rest but was not affected by propranolol therapy. Nifedipine significantly decreased atrial filling volume while propranolol had no effect. Propranolol therapy did not result in any improvement in left ventricular function. In contrast, nifedipine improved left ventricular systolic and diastolic function at rest and peak exercise. Future selection of an antihypertensive agent should include consideration of the impact of therapy on left ventricular function. PMID- 2782272 TI - Noninvasive ambulatory blood pressure monitoring in patients with recently detected systemic hypertension. AB - Noninvasive ambulatory blood pressure monitoring and Doppler echocardiography were used in a recent study evaluating persons aged 18 to 50 years who were initially found to have mild hypertension by casual blood pressure determination. Ambulatory blood pressure recordings were performed on a day of usual activity in 54 subjects; a subgroup of 24 patients had evaluation of left ventricular dimensions and diastolic filling patterns by Doppler echocardiography. Average ambulatory systolic pressures of 42% of subjects were greater than or equal to 130 mm Hg. Only 35% had average diastolic pressures greater than or equal to 85 mm Hg, and 57% had either systolic or diastolic pressures greater than or equal to 130/85 mm Hg. Correlation between casual and ambulatory pressures was not significant. No subject had left ventricular hypertrophy determined by echocardiography. Abnormal left ventricular diastolic filling was noted in 38% of those patients with average ambulatory pressures greater than or equal to 130/85 mm Hg, but in no patients with average pressures less than 130/85 mm Hg (p less than 0.05). These results suggest that ambulatory blood pressure monitoring may be a specific method for detecting those patients with mild hypertension who may have early and potentially reversible cardiac abnormalities. PMID- 2782273 TI - The nifedipine gastrointestinal therapeutic system in the treatment of hypertension. AB - As the number of antihypertensive agents increases, the choice of optimal therapy becomes more difficult. Certainly, hemodynamic derangements caused by the disease state as well as therapy must be considered. Patient convenience and quality of life are also issues that must be addressed. Preliminary experience suggests that the gastrointestinal therapeutic system (GITS) push-pull osmotic pump formulation of nifedipine is safe and efficacious in the treatment of hypertension. In 1 study, nifedipine GITS was compared with sustained-release propranolol in patients with mild to moderate hypertension already receiving diuretics. Using a 2-week placebo run-in, double-blind study design, patients were randomly assigned to receive nifedipine GITS (n = 31) in doses of 30, 60 or 90 mg once daily, or sustained-release propranolol (n = 32) in doses of 80, 160 or 240 mg once daily. Previous diuretic therapy was continued. Sitting and 5-minute standing blood pressure and heart rate measurements were obtained 24 hours after dosing. At the end point of treatment, both nifedipine GITS and sustained-release propranolol reduced blood pressure compared with placebo (p less than 0.001) in the sitting and standing positions. Nifedipine GITS was more effective than sustained-release propranolol in reducing standing (p less than 0.005) and sitting (p less than 0.001) systolic blood pressure and sitting diastolic blood pressure (p less than 0.02). Sustained-release propranolol caused a greater reduction in standing (p less than 0.001) and sitting (p less than 0.0006) resting heart rate than nifedipine GITS. Both drugs were well tolerated.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2782274 TI - Three methods for producing fertile hemopoietic chimeras in mice. AB - Three methods for producing semiallogeneic (F1----parental) hemopoietic chimeras with retained or regained fertility are detailed here. Prenatal (PN) chimeras were produced by injecting F1 ([BALB/c female x C3H/HeJ male] or [CBA/J female x C57BL/6 male]) fetal liver (days 13-18) or adult bone marrow cells (10(6)-10(7) cells/20 microliters/embryo) into the yolk-sac cavities of days 13-17 gestation BALB/c or CBA/J embryos, respectively, and allowing them to be born naturally. Neonatal (NN) chimeras were made by introducing F1 bone marrow cells (1-2 x 10(7) cells/0.25 ml) into newborn (less than 24 hr old) female mice through the anterior facial vein. Female mice were raised to maturity in both cases. Ovary transplanted (OT) chimeras were made by first irradiating (9.5 Gy) and repopulating young female adult mice with 10(7) F1 bone marrow cells, followed by bilateral orthotopic transplantation of syngeneic ovarian tissue six weeks later. Females reconstituted with the above three methods were mated with normal syngeneic males and sacrificed at 11-16 days of pregnancy to evaluate hemopoietic chimerism. This was determined in all cases by a radioautographic evaluation of the extent of donor H-2 phenotype marker expression on splenic small lymphocytes, after an indirect labelling of single-cell suspensions with monospecific antibody and [125I]protein-A. Results indicate that hemopoietic chimerism was best in the PN group (0.3-78.1%, mean = 27.1); intermediate in the OT group (5.8-38.2%, mean = 18.1); and low in the NN group (0-14%, with one exception, which was 83.6%). Observed fertility was best for BALB/c host PN chimeras.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2782275 TI - Cell death by apoptosis during involution of the lactating breast in mice and rats. AB - The role of cell death in involution of lactating breast was investigated in mice and rats by light and electron microscopy. Apoptosis, recognized by sharply demarcated compaction of chromatin against the nuclear envelope and by shrinkage and budding of the whole cell to form membrane-bounded apoptotic bodies, was responsible for major loss of cells in both species. In the mouse, rapid involution during the first 2 days was associated with shedding of large numbers of apoptotic bodies derived from alveolar epithelial cells into alveolar lumens. This was followed by more gradual regression, during which the bodies were mostly phagocytosed by macrophages within the epithelium. In the rat, glandular involution was a more gradual and uniform process, with shedding of apoptotic epithelial cells into alveolar lumens being much less conspicuous. Apoptosis of myoepithelial cells was observed in mice, the resulting apoptotic bodies being phagocytosed by intraepithelial macrophages, but was not detected in rats. Apoptosis of capillary endothelial cells caused rapid regression of the capillary beds in both mice and rats. Intraepithelial macrophages increased in number during involution, developed cytoplasmic lipofuscin pigment, and either remained within the epithelium or migrated to the interstitium and regional nodes. Cell loss by apoptosis has been demonstrated during involution and atrophy of a variety of other glands. It characteristically results in shrinkage of a tissue without disruption of its basic architecture. PMID- 2782276 TI - Structural changes in the luminal epithelium of the porcine uterus between days 10 and 19 of the estrous cycle. AB - Light and electron microscopy were used to study the morphology of uterine luminal epithelium from 4 or 5 gilts slaughtered on each of days 10, 13, 16, and 19 of the estrous cycle. Ultrastructural evidence indicated that metabolic activity and accumulation of glycogen by the uterine epithelium increased between days 10 and 16 of the estrous cycle. This phase of high synthetic activity had been terminated by day 19, as evidenced by the reduction or absence of glycogen deposits and decreased incidence of organelles associated with synthetic activity. Diffuse degeneration of epithelial cells occurred throughout the period of study but was maximal between days 16 and 19. Mitotic activity indicated that cell replacement also occurred between day 16 and day 19. PMID- 2782277 TI - Functional units in rainbow trout (Salmo gairdneri, Richardson) liver: III. Morphometric analysis of parenchyma, stroma, and component cell types. AB - Hepatic stroma and parenchyma with its component cell types were quantitatively described in adult male and female actively-spawning 5-year-old rainbow trout (Salmo gairdneri, Richardson). Point-count morphometry of glycol methacrylate sections estimated volume compartments for stroma and parenchyma. Veins composed 85% of the stroma while arteries and bile ducts occupied approximately 6-7% each. Parenchyma accounted for 95% of hepatic volume. Point-count morphometry of transmission electron micrographs estimated volume compartments as well as numerical and surface density measurements for parenchymal components. Within the hepatic parenchymal compartment, hepatocytes occupied 85% and showed significant sex differences. Female hepatocytes were significantly more numerous but were smaller, only 60% of the volume of male hepatocytes. Since hepatocyte nuclear volume was equal in both sexes, differences were due to reduced cytoplasmic volume in females. Perisinusoidal macrophages of females occupied larger volumes of their respective parenchymal compartments, and their larger mean cytoplasmic volumes suggested activation. Biliary epithelial cells of preductules and ductules were numerous. Ratios of numerical density of hepatocytes to biliary epithelial cells were consistent with a tubular arrangement of hepatocytes. Factors possibly mediating the sexual dimorphism are discussed. PMID- 2782279 TI - Electron microscopic study of subcutaneous and intraperitoneal splenules in the mouse. AB - The development of splenules derived from slices of freshly removed autologous spleen implanted subcutaneously or intraperitoneally was followed by light and electron microscopy from day 2 to day 70. Within 48 hr after transplantation, a rough space filled with blood, unlined by endothelium, formed just under the surface of the splenic fragment. The tissue central to this vascular space was disrupted and necrotic. In the outer portion of the vascular space, fibroblasts appeared and created locules which developed into a highly vascular, hematopoietic red pulp. From the inner portion, blood percolated into the central necrotic tissue. At 1 week the splenule was divisible into concentric structures. The capsule was outermost. A shell of vascularized, highly hematopoietic red pulp lay within the capsule, having replaced the vascular space. Central to the red pulp lay a band of fibroblasts and macrophages. Next was a layer of fibroblasts in a matrix of degenerating cells, and, at the center, a necrotic core. As fibroblasts and macrophages moved centrad, the red pulp moved with them, expanding and replacing the necrotic tissue. The splenule differed in character from the original spleen. Splenular red pulp, especially near the surface, was unusually hematopoietic. The circumferential reticulum of white pulp was reduced or absent, and the boundary between red and white pulp was sometimes indistinct. Some white pulp was subcapsular, and the capsule and surrounding connective tissue were infiltrated by lymphocytes. The necrotic core of the splenule was typically surrounded by a zone containing large blood vessels, connective tissue, and adipocytes. PMID- 2782278 TI - Morphological study of the innervation pattern of the rabbit sinoatrial node. AB - The pattern of nerves, ganglia, and fine nerve processes in the adult rabbit sinoatrial node, identified by microelectrode recording, was defined by staining histochemically for cholinesterase followed by silver impregnation. A generalized repeatable pattern of innervation was recognized, including 1) a large ganglionic complex inferior to the sinoatrial node; 2) two or three moderately large nerves traversing the sinoatrial node parallel to the crista terminalis; 3) nerves entering the region from the atrial septum, the superior vena cava, and the inferior vena cava; and 4) a fine network of nerve processes, particularly extensive in the morphologically dense small-cell part of the sinoatrial node. When the site of initial depolarization in the node was located and marked by a broken-off electrode tip, it was found, after cholinesterase staining, to be characterized by a cluster of cells enclosed in a nest or basket of fine nerves. Similar nested cell clusters were observed elsewhere in the sinoatrial node in this same preparation and in other hearts. A complex interweaving of atrial muscle fibers was observed medial and inferomedial to the sinoatrial node, which may form the anatomical basis for the lack of conduction through this region. The morphological pattern of nerves, ganglia, and myocardial cells described in this study emphasizes the complexity of innervation of the sinoatrial node, including its intrinsic neural elements. Cholinesterase/silver staining can be useful in the definition and comparison of electrophysiologically identified sites within the sinoatrial node. PMID- 2782280 TI - Hemopoietic origin of certain decidual cell precursors in murine pregnancy. AB - The possible hemopoietic origin of certain precursors of uterine decidual cells appearing during normal murine pregnancy was investigated in semiallogeneic hemopoietic chimeras with retained or regained fertility. Chimeras were produced by three different methods in two donor-host combinations: F1 [BALB/c female x C3H/HeJ male] cells introduced into the parental strain BALB/c female hosts or F1 [CBA/J female x C57BL/6 male] cells introduced into CBA/J female hosts. Prenatal chimeras (PN) were made by reconstituting mouse fetuses (day 13-17) with 10(6) 10(7) adult bone marrow or fetal liver cells through the yolk sac and they were allowed to be delivered naturally. Neonatal chimeras (NN) were made by injecting 1-2 x 10(7) adult bone marrow cells into the anterior facial vein of neonatal mice (less than 24 hr old). In both cases, experimental animals were raised to maturity. Ovary-transplanted chimeras (OT) were made by injecting 10(7) bone marrow cells into lethally irradiated (9.5 Gy) young adult female mice, followed 6 weeks later with bilateral orthotopic transplants of syngeneic ovary grafts to restore fertility. All female chimeras produced by the three different methods were mated with syngeneic male partners to produce normal pregnancy. The extent of chimerism at the cellular level was determined in all cases by a radioautographic identification of the H-2 phenotype of splenic lymphocytes and decidual cells and macrophages in the collagenase-dispersed decidua at day 11-16 of normal pregnancy, following a sandwich labelling with monospecific anti-H-2 antibodies and 125I-protein A. Morphological discrimination of typical decidual cells from macrophages in the collagenase-dispersed decidua was carried out on the basis of several distinctive markers: presence of surface Dec-1 and Thy-1 and absence of surface F4/80 or latex phagocytosis for decidual cells, in contrast to macrophages which were phagocytic and expressed F4/80 but not Dec-1 or Thy-1. While the degree of hemopoietic chimerism (judged by the incidence of donor derived lymphocytes in the spleen) varied from animal to animal, in all three groups (PN, NN, and OT) comprising a total of 26 chimeras, the percentage of typical decidual cells expressing donor H-2 phenotype showed an excellent correlation with that for small lymphocytes in the spleen. These results reveal that at least a subpopulation of typical decidual cells of the pregnant uterus has a hemopoietic genealogy. A possible familial relationship of these cells to granulated metrial gland cells remains unclear. PMID- 2782281 TI - Light and electron microscopic observations on the cervical epithelium of the rabbit: II. AB - The endocervical epithelium of long-term ovariectomized rabbits treated for 1-10 days with 5 micrograms of estradiol benzoate every 12 hr has been studied by light and electron microscopy. In addition, morphometric data on ciliated and nonciliated cells of rabbits treated for 2, 6, and 10 days are compared to those on untreated ovariectomized, estrous, and ovulatory rabbits. The percentage of ciliated cells increases after ovariectomy to 76.3% and that of secretory cells decreases to 23.7% as compared to estrous controls. Treatment of ovariectomized rabbits with estradiol results in a gradual increase in ciliated and secretory cell area, height, and nuclear area. After 10 days of treatment, cell areas are significantly larger than those in the ovulatory or estrous controls; cell height and nuclear areas have returned to preovariectomized levels; and the percentages of ciliated and secretory cells have reached those of estrous levels. Estradiol stimulates mitotic division of secretory cells but affects ciliogenesis minimally. In ciliated cells, estradiol treatment results in a modest increase in polysomes and granular endoplasmic reticulum and in striking increases in the size of the Golgi complex and in the number of lipofuscin bodies as compared to those in the ovariectomized controls. In secretory cells, estradiol treatment brings about an increase in the numbers of polysomes, Golgi complexes, and cisternae of the granular endoplasmic reticulum, in the sizes of the nucleoli, and in the amount of euchromatin. Secretory granules appear in some cells after 2 days of estradiol stimulation and increase in number through 10 days of treatment. Perinuclear granules are more pleomorphic and heterogeneous in structure and more numerous in the 6- to 10-day-estradiol-treated than in ovulatory animals, and they may function as lysosomes degrading excess secretory product. Deep apical concavities of the secretory cells occur most often after 2 and 6 days of treatment. PMID- 2782283 TI - Ultrastructure of the pronephric kidney in upstream migrant sea lamprey, Petromyzon marinus L. AB - The pronephric kidneys were examined in upstream migrant sea lampreys, Petromyzon marinus L., by transmission and scanning electron microscopy. Each pronephros consists of an enlarged renal corpuscle (glomus) and ciliated nephrostomes, but there are no renal tubules. The renal corpuscle contains an extensive mesangium, which consists of a highly fibrous extracellular matrix, numerous mesangial cells, granulocytes, and macrophages. The extracellular matrix contains microfibrils with a morphology similar to amyloid P microfibrils, fibrils with a periodicity similar to fibrin, and abundant collagen. Often these fibrillar components are aggregated in the region of the basement membrane, giving it a thickened appearance. Some podocytes of the visceral epithelium appear swollen, and their cytoplasm contains numerous vacuolar inclusions, and many have only primary major processes with only a few or no foot processes. The morphological features of the pronephric kidney of the lamprey at this time in the life cycle reflect the regression of this organ, but some features also resemble those seen in renal pathologies of higher vertebrates. PMID- 2782282 TI - In vivo ciliogenesis in human fetal tracheal epithelium. AB - Development of ciliated cells (CC) in the fetal human trachea was studied by light and electron microscopy in specimens obtained from 45 embryos or fetuses aged from 9 to 27 weeks of gestation (menstrual age). Four stages could be recognized during tracheal development. Up to 11 weeks (stage I), the trachea was covered with a columnar undifferentiated epithelium with abundant glycogen, apical microvilli, and primary cilia. From 12 to 18-19 weeks (stage II), centriologenesis and secondary ciliogenesis were very active, and the percentage of CC and secretory cells (SC) progressively increased. From 20 to 22-23 weeks, the density of CC was higher but, in parallel, the percentage of SC decreased (stage III). Throughout this period, the different steps of ciliogenesis could be identified in the same field, and the ciliated borders consisted of ciliary shafts with a disorderly arrangement. Megacilia were identified. Some of the preciliated cells had both cilia and secretory granules in their apical cytoplasm. After 24 weeks (stage IV), the ciliated border was apparently mature, the rootlets lengthened, and the cilia were correctly orientated. Whatever the fetal age, the density of CC was significantly higher (P less than .01) in the dorsal trachea compared to the ventral trachea. There are many similarities between animal and human ciliogenesis, but in human fetuses, most of the ciliary differentiation occurs early, during the first half of gestation. As demonstrated in experimental models, SC likely play a major role in genesis of CC during the fetal development of the human trachea. PMID- 2782284 TI - Characterization by morphometric model of liver regeneration in the rat. AB - A new stereological approach to the study of liver regeneration in the rat is described. The method employs a morphometric model consisting of number and size, as well as surface and volume fractions of hepatocytes, their nuclei, cytoplasm, and their relation to the sinusoidal bed. With this technique, it was found that 8 hr after partial hepatectomy, the number of nuclei increased as did the nucleus/cytoplasm ratio, suggesting an early hyperplastic phase. These data, which have not been reported in other studies, underline the importance of evaluating the complex phenomenon of liver regeneration using a stereological approach, which is more representative of all morphometric changes occurring inside and outside the hepatocyte. PMID- 2782285 TI - Individual rabbit cardiac myocytes have different thresholds for alpha myosin heavy chain regulation by thyroid hormone. AB - Myocytes in adult rabbit ventricle express and alpha and a beta form of myosin heavy chain (MHC). The alpha-MHC distribution detected with indirect immunofluorescence has been found in different proportions in adjacent myocytes producing a mosaic staining pattern. The basis for cell-specific expression of the alpha-MHC isoform is not known. Since thyroid hormone is a major regulator of myosin gene expression, we varied the plasma thyroid level and followed the alpha MHC content within a population of myocytes. Ventricular myocytes were induced to become 100% beta-MHC by placing the rabbits on a 0.15% propylthiouracil diet for 70 days. L-triiodothyronine (LT3) over a dose range of 1 to 10 micrograms/kg/day was delivered by an osmotic minipump for 5 days, with actual serum levels confirmed by LT3 radioimmunoassay to be in the range of from 115 to 1,230 ng/dl. The amount of alpha-MHC that returned was estimated in randomly selected cells by measuring the relative intensity of the fluorescence-tagged secondary antibody. The normal mosaic pattern of alpha-MHC expression in the left ventricle returned with an LT3 dose of 2-5 micrograms/kg/day. The first myocytes to express alpha MHC were in the subepicardium and did so at a LT3 serum level of 115 of ng/dl. All myocytes of the ventricular wall expressed alpha-MHC at serum levels above 1,230 ng/dl. These data are interpreted to show that the variation of myosin isoform content seen in the adult heart is indicative of heterogeneity of thyroid sensitivity, with the threshold for serum LT3 being between 115 and 370 ng/dl. PMID- 2782286 TI - Histologic, morphometric, and immunocytochemical analysis of myometrial development in rats and mice: I. Normal development. AB - Myometrial development from the prenatal to adult period was examined in rats and mice 1) by histologic and immunocytochemical methods with anti-actin, -vimentin, and -laminin to assess cytodifferentiation of smooth muscle and fibroblastic cells; and 2) by morphometric procedures to assess quantitatively the expression of cellular orientation in the emerging inner circular myometrial layer. Uterine mesenchymal cells initially were uniformly vimentin-positive, undifferentiated, and randomly oriented during the late fetal period. By the early neonatal period, three mesenchymal layers became recognizable histologically, the middle one of which (prospective circular myometrium) developed distinct circular orientation and differentiated into a layer composed of actin-positive smooth muscle cells. The cells of the inner mesenchymal layer initially exhibited radial orientation. By 10 days postpartum, the outer longitudinal mesenchymal layer differentiated into bundles of smooth muscle cells representing the longitudinal myometrium. The inner mesenchymal layer remained vimentin-positive and differentiated into the randomly ordered endometrial stroma. The cells of the middle and outer mesenchymal layers that were destined to form myometrium initially expressed vimentin throughout and then coexpressed vimentin and actin, but with time vimentin staining disappeared in the maturing smooth muscle cells as they expressed actin. PMID- 2782287 TI - Histologic, morphometric, and immunocytochemical analysis of myometrial development in rats and mice: II. Effects of DES on development. AB - The effects of diethylstilbestrol (DES) treatment on myometrial development from the prenatal to adult period were examined in rats and mice by histologic and immunocytochemical methods using anti-actin, -vimentin, and -laminin to assess cytodifferentiation of smooth muscle and fibroblastic cells, and by morphometric procedures to assess quantitatively the effect of DES on the expression of cellular orientation in the emerging inner circular myometrial layer. Neonatal rats and mice were treated with DES from day 0 (day of birth) to day 2 with dosages known to perturb myometrial development. Neonatal treatment with DES increased the degree of circular orientation within the uterine mesenchyme, an effect detectable following as little as 24 hr of DES treatment. This effect on spatial organization of the mesenchyme was followed by an increase in the thickness of the actin-positive middle layer (prospective circular myometrium) of uterine mesenchyme during days 3-15; from day 15 onward, however, the circular myometrial layer began to fragment into irregular bundles of smooth muscle, and the longitudinal myometrial layer became thinner and more irregularly organized than controls. Vimentin localization in rats treated with DES neonatally was more intense than in controls within the circularly orientated uterine mesenchyme at 5 days. By 60 days the circular and longitudinal myometrial layers of DES-treated animals showed strands and bundles of vimentin-positive cells, which were not present in controls. Both rats and mice show comparable effects of DES treatment. PMID- 2782288 TI - Postnatal growth of pulmonary acini and alveoli in normal and oxygen-exposed rats studied by serial section reconstructions. AB - Three-dimensional reconstructions from serial sections were used to examine postnatal lung development of rats reared in air (control) or oxygen. From birth to age 21 days, control lung volume increased ninefold, and the average volume of each ventilatory unit (all airspaces distal to a single respiratory bronchiole) increased seven times. There were approximately 5,000 ventilatory units at birth and on day 21, indicating that the lung grew by enlargement and subdivision of ventilatory units and not by their multiplication. Growth in hyperoxia (greater than 97%) for 7 days had no effect on the number of ventilatory units but, compared to controls, total lung volume and ventilatory unit volume were reduced 32% and 16%, respectively. At birth there were 0.6 x 10(6) alveoli, and at age 7 days in controls alveolar number increased 16-fold while the average volume of a single alveolus fell to one-sixth that at birth. Exposure to hyperoxia for 7 days stopped alveolarization; the surface area to volume ratio (Sa/V) of the ventilatory unit was lower, alveolar number was the same as at birth, and the alveoli present were large. At age 21 days, after 14 days of recovery in air, lung volume and ventilatory unit volume were greater than in controls but the Sa/V of the ventilatory unit was still depressed 20%. Alveoli from oxygen-exposed lungs were larger than in controls, and a greater size distribution coefficient showed them to be more variable. A shape coefficient for alveoli did not change as a function of the animal's age or oxygen treatment; it demonstrated proportional growth of alveolar height and diameter. PMID- 2782289 TI - An electron microscopic study of mitosis in mouse duodenal crypt cells confirms that the prophasic condensation of chromatin begins during the DNA-synthesizing (S) stage of the cycle. AB - The phases of mitosis were examined in the columnar cells at the base of duodenal crypts in adult male mice given an intravenous injection of 3H-thymidine and sacrificed 20 min later. The duodenum was fixed by immersion into glutaraldehyde formaldehyde, and the cells were examined in the electron microscope, with or without processing for radioautography. Interphase nuclei are characterized by the distribution of chromatin; aside from the cortical chromatin spread along nuclear envelope and nucleolus, there are chromatin accumulations that belong mainly in two different classes: 1) numerous chromatin "specks" ranging in size from about 5 to 70 nm and averaging 47 nm; 2) a few roughly circular or elongated chromatin "packets" measuring from 70 to 230 nm. Early prophase nuclei differ mainly by a large increase in the number of chromatin packets to 20-30 or more per nuclear profile; their average diameter is 128 nm. During mid-prophase, the chromatin packets enlarge gradually to an average 221 nm diameter. Between mid- and late prophase, there is a further increase in diameter to 679 nm. At metaphase, the packets take on the appearance of mature chromosomes, and their diameter increases to 767 nm. At anaphase, daughter chromosomes migrate to each pole, where they fuse into a compact chromatin mass. At telophase, nucleoplasmic areas progressively enlarge within the chromatin mass and separate strands of chromatin, which gradually become segmented into chromatin clumps. Counts of mitotic cells show a high proportion of prophase and telophase nuclei. Calculation from the counts yields the duration of the phases, that is, 5.6, 0.2, 0.1, and 1.6 hr, respectively, for pro-, meta-, ana-, and telophase. Finally, radioautography 20 min after 3H-thymidine injection shows labeling in 54% of the interphase nuclei, 85% of early prophase nuclei, and 73% of mid-prophase nuclei, while there is no label in late prophase, metaphase, anaphase and telophase nuclei. In confirmation of previous light microscopic work, the S stage of the cycle begins when a cell is in interphase and continues through the early prophase and part of mid-prophase. Moreover, the main sites of DNA synthesis are the chromatin specks during interphase and the cortical chromatin during early and mid-prophase. The chromosome condensation taking place in the meantime may be separated into two main steps: 1) a slow, moderate condensation of the chromatin packets during early and mid-prophase and 2) a rapid, pronounced one during late prophase and prometaphase when the packets become chromosomes. PMID- 2782290 TI - Trophoblast differentiation during the transition from trophoblastic plate to lacunar stage of implantation in the rhesus monkey and human. AB - The transition from the trophoblastic plate stage to the early lacunar stage was examined in a series of implantation sites from the rhesus monkey, timed on the basis of the preovulatory estrogen peak, and prepared for transmission electron microscopy. This transition was compared with specimens from stage 5a, b, and c in the Carnegie collection of human embryos. The transition was marked by the differentiation of a new type of syncytial trophoblast--namely, a unilaminar microvillous polarized syncytium, which developed throughout the trophoblastic plate, forming characteristic intrasyncytial clefts. The rapid development of this type of syncytium created a nonclotting chamber for maternal blood wherever trophoblast intrusion into maternal vessels created confluence. Although the nature of the material in the Carnegie series precluded cytological characterization of the trophoblast, there is evidence that a similar transition occurs in human trophoblast and that in the human also the appearance of lacunae marks a change from an early invasive trophoblast to a situation in which growth is more significant. PMID- 2782291 TI - Reconstitution of endoplasmic reticulum in rapidly dividing cells of early Xenopus embryos. AB - The cytology of early blastomeres of Xenopus laevis embryos was examined. Particular attention was given to the organization of the nuclear envelope of karyomeres (chromosome vesicles) and the endoplasmic reticulum (ER) at different stages in early cleavage cycles of frog development. Nuclear envelope formation was observed to occur rapidly around individual chromosomes during early anaphase, and karyomeres fused subsequently to yield the final nucleus during telophase. Endoplasmic reticulum in the perinuclear cytoplasm was observed to be vesicular during metaphase and cisternal in form during telophase. Following microinjection of rat liver rough microsomes into early blastomeres, heterologous ER components were identified by electron microscope immunocytochemistry. The foreign ER was observed as large, reconstituted cisternae at stages in the cell cycle when the nuclear envelope was intact. Therefore, transplanted ER maintained the capacity to reconstitute in the cytoplasm of a rapidly dividing cell. In an attempt to better assess ER structure at the metaphase stage of the cell cycle, we next slowed down the division process by treating Xenopus embryos with anti microtubule agents. Treatment with critical concentrations of colchicine, nocodazole, or vinblastine led to cleavage arrest but not to inhibition of the nuclear cycle. Following such treatment, homologous ER was observed in a vesicular form at all stages of the nuclear cycle. Heterologous ER, however, identified by immunocytochemistry in microinjected cells treated with nocodazole, displayed both vesicular and cisternal forms. We conclude that microinjected ER membranes exhibit cell-cycle-specific behavior, which is different from that of the host cell ER. PMID- 2782292 TI - Medicolegal investigations in hospital environments. PMID- 2782294 TI - Road crash cervical injuries. A radiological study of fatalities. AB - A lateral radiograph of the cervical spine was obtained for 174 of the 207 persons killed in road crashes in Adelaide, South Australia, during the 12-month period of June 1, 1987 to May 31, 1988. Of the total of 57 cases of cervical injury, routine postmortem examination identified 30 cases (52.6%), and the radiographic examinations identified 51 cases (89.5%). In the cases where it was performed, radiography identified 96.2% of injuries. One-half of injuries of level C3 and above were not reported at postmortem examination, compared with 22% of those occurring below this level. This finding correlates with the physical difficulties of examining the upper part of the cervical spine. This study has shown that lateral cervical radiography is a simple and effective method of more accurately identifying significant cervical spinal injuries, thus improving greatly the value of postmortem examinations in determining the patterns and mechanisms of these injuries. PMID- 2782293 TI - Fatal accidents and blood ethanol levels in adolescents and adults. The Wayne County experience, 1978-1988. AB - The files of 874 fatal traumatic accident victims, aged 12-25 years, examined at the Wayne County Medical Examiner's Office during the period 1978-1988 were reviewed. Postmortem blood alcohol results of individuals who died after less than 15 min of hospitalization were utilized to approximate alcohol levels at the time of the fatal injury. Relationships between types of accidents, sex, age, race, and time of accident were examined. White victims were far more likely to have been drinking than blacks, and the data indicated that underaged drinkers were involved in fatal accidents at lower levels of blood alcohol than their counterparts of legal drinking age. Consistent racial differences in average alcohol levels were not observed, however. Unlike female and black victims, who much less frequently tested positive for alcohol when underage, white male victims 16-21 years of age were just as likely to have been drinking as those aged 21-25. The results of the study show that postmortem blood alcohol level can be used to identify differences in alcohol consumption among groups of accident victims in a major metropolitan area. PMID- 2782295 TI - Accidental railway-related fatalities. The Metro Dade County experience, 1980 1984. AB - A study of accidental railway-related fatalities was performed using the case files of the Office of the Medical Examiner of Metropolitan Dade County in Miami, Florida, during the years 1980-1984. The nine cases that were collected are presented here in some detail. A discussion ensues concerning the most common type of accidental railway-related fatalities, why they occur, and what future work remains in order to avoid such fatalities. Evidently, fatalities more frequently result from victims' disregard for safety--either by crossing the tracks despite warning, or by utilizing railroad trestles as a fishing pier--than from mass disaster. Future work involving forensic engineers, forensic pathologists, and lawyers along with community activists should include both public education and a design of less accessible trestles to avoid such tragedies. In conclusion, it is hoped that this article will serve as a catalyst for further research on this subject. PMID- 2782296 TI - The fallacy of the simultaneous sudden infant death syndrome in twins. AB - The likelihood of twin infants dying suddenly and simultaneously of SIDS, a natural disorder, defies credibility. However, injuries associated with environmental hazards provide possible mechanisms of sudden death. A search for hazards in the homes of 13 pairs of healthy twins who died together of no apparent cause formed the basis of this study. Ten of the 13 sets were certified by medical examiners as simultaneous twin SIDS. The findings in this study suggest that all 13 sets died from injuries, either unintentional or otherwise, and that these deaths could have been prevented. PMID- 2782297 TI - Multiple homicides. AB - A study of multiple homicides or multiple deaths involving a solitary incident of violence by another individual was performed on the case files of the Office of the Medical Examiner of Metropolitan Dade County in Miami, Florida, during 1983 1987. A total of 107 multiple homicides were studied: 88 double, 17 triple, one quadruple, and one quintuple. The 236 victims were analyzed regarding age, race, sex, cause of death, toxicologic data, perpetrator, locale of the incident, and reason for the incident. This article compares this type of slaying with other types of homicide including those perpetrated by serial killers. Suggestions for future research in this field are offered. PMID- 2782298 TI - Postmortem cerebrospinal fluid pleocytosis. AB - We show that postmortem cerebrospinal fluid (CSF) pleocytosis is a common event. Postmortem cerebrospinal or ventricular fluid was obtained from children and adults. The cells were counted and morphologically characterized using several histochemical markers. Infants exhibit a brisk postmortem CSF pleocytosis. Sudden infant death cases have relatively high CSF counts. Typeable cells are mononuclear and consist of approximately 60%-70% lymphocytes and 20%-40% macrophages. When postmortem duration is greater than 12 h, the cells become vacuolated and cannot be identified. The etiology of these findings requires further study. PMID- 2782299 TI - Clustering of multiple sclerosis in Galion, Ohio, 1982-1985. AB - Epidemiologic evidence indicates that the outbreak of 30-40 cases of multiple sclerosis and other demyelinating syndromes in Galion, Ohio, USA, during 1982 1985 was related to an excess concentration of heavy-metal wastes, especially of cadmium and chromium in sewage and river water. Both multiple sclerosis and myasthenia gravis were diagnosed by board-certified neurologists. PMID- 2782300 TI - Pesticide mortality. A Jordanian experience. AB - During the 13-year period of 1973-1985, at least 329 deaths in Jordan resulted from poisoning by pesticides. Organophosphates were the major compounds incriminated in 93.6% of the cases. The annual mortality rate compared with that of other countries is relatively high, and was 5.97%, 17.35%, and 2.6% per 1 million people in 1973, 1979, and 1985, respectively. The annual mortality rates due to suicidal and accidental poisoning are 61% and 35.3%, respectively: 74% of the accidentally poisoned group are children less than 10 years, while 60.7% of the suicides are 15-24 years of age. To minimize such high mortality rates from pesticide poisoning, Jordan needs to adopt more protective measures by rigorous regulation. PMID- 2782301 TI - Narcolepsy mimicking suicidal carbon monoxide poisoning. AB - We present a case of narcolepsy mimicking suicidal carbon monoxide poisoning. The signs and symptoms of narcolepsy in this previously undiagnosed man were initially missed, which emphasizes the importance of extracting a detailed history of a decedent's behavior prior to his or her death. Narcoleptics are often involved in motor vehicle accidents. This report again demonstrates that narcolepsy and driving don't mix, even when the vehicle is stationary. We also briefly review the various sleep disorders. PMID- 2782302 TI - Immolation after drinking kerosene. AB - An unusual suicide is described in which analysis of circulating kerosene components at autopsy suggested that the victim had drunk kerosene and then had poured it over his body, ignited it, and burned to death. PMID- 2782303 TI - Fetal skull fracture from an automobile accident. AB - This is a case report of a fetal skull fracture that resulted in fetal death caused by a high-velocity automobile accident. As a 25-year old gravida 3, para 2, was pulling out of a driveway onto a highway, her car was struck in the left front end by a car traveling perpendicular to her vehicle. She died almost instantly from shock caused by massive injuries and internal hemorrhage. She had a fractured rib and multiple fractures of the pelvis as well as bilateral hemothorax and ruptured splenic and renal vessels. The fetus had depressed multiple skull fractures. The probable mechanism of fetal injury, as well as the influence of seat restraints on injury to the mother and fetus, are discussed. PMID- 2782304 TI - Asphyxiation by glottic impaction of nasal secretions. AB - An 84-year-old woman died suddenly 20 days after a head injury; a medical witness to the death described laboured breathing consistent with stridor. At postmortem examination, her larynx was found to be occluded by a firm mass of jelly-like material considered initially to be regurgitated food material. The microscopic features of this material were consistent with inspissated mucoid secretions from the nasopharynx. Relationship to cafe coronary and passage of a nasogastric tube are discussed. PMID- 2782305 TI - Necrotizing fasciitis: a fatal outcome following minor trauma. Case report and literature review. AB - The death of a young healthy man, 11 days after he sustained minor trauma, illustrates the potential disaster of undiagnosed necrotizing fasciitis. Difficulty in early diagnosis often arises because the skin is initially spared and only later becomes secondarily involved. In this case, because of the lack of external manifestations, the diagnosis of necrotizing fasciitis was not considered until the postmortem examination. Necrotizing fasciitis should be considered a potentially serious problem that can follow minor trauma and eventually lead to death. The need for a high index of suspicion to make this diagnosis, along with the medicolegal implication of a diagnosis of necrotizing fasciitis, are both addressed in this report. Also of note is the fact that this patient was treated with nonsteroidal antiinflammatory drugs for pain and inflammation, which has recently been reported to be associated with an increased incidence of fulminant evolution of necrotizing fasciitis. PMID- 2782306 TI - The case of the sitting corpse. Accident or homicide? AB - Discussed are the unusual position of a body at a death scene and plausible mechanisms responsible for this positioning. PMID- 2782307 TI - Sudden death by Lepomis macrochirus (the killer fish). AB - In this unusual case, death was not caused by either anaphylactoid reaction to fish or by fish poisoning. Death was due to asphyxia caused by a live, whole fish occluding the mouth and upper airway. PMID- 2782308 TI - Suicide attempted by aiming slaughtering gun at pacemaker. PMID- 2782309 TI - Fetal development and cocaine. PMID- 2782310 TI - Iatrogenic vagina dentata. PMID- 2782311 TI - Gastric emptying time. PMID- 2782312 TI - International trade and worker rights. PMID- 2782313 TI - Mineral fiber concentration in lung tissue of mesothelioma patients in Finland. AB - The mineral fibers in lung tissue samples of 19 mesothelioma patients and 15 randomly selected autopsy cases were analyzed using low-temperature ashing, scanning electron microscopy (SEM) and x-ray microanalysis. The fiber concentration ranged from 0.5 to 370 million fibers per gram of dry tissue in the mesothelioma group and from less than 0.01 to 3.2 million fibers per gram of dry tissue in the autopsy group. In 80% of the mesothelioma patients and in 20% of the autopsy cases, the fiber concentration exceeded 1 million fibers per gram of dry tissue. Amphibole asbestos fibers predominated in both groups, and only a few chrysotile fibers were found. In the lungs of six mesothelioma patients, anthophyllite was the main fiber type. The overall analytical precision of sample preparation and fiber counting with SEM was 22%. PMID- 2782314 TI - Metabolism of triethylamine in polyurethane foam manufacturing workers. AB - In 20 workers studied before, during, and after exposure to triethylamine (TEA) in a polyurethane-foam producing plant the amount of TEA and its metabolite triethylamine-N-oxide (TEAO) excreted in urine corresponded to an average of 80% of the inhaled amount. An average of 27% was TEAO, but with a pronounced interindividual variation. Older subjects excreted more than younger ones; less than 0.3% was excreted as diethylamine. The data indicate half-lives for TEA and TEAO excretion in urine of about 3 hr. The postshift level of TEA in urine and plasma are good indicators of the time-weighted average air level during the preceding work day, and might thus be used for biological monitoring. An air level of 10 mg/m3 (proposed occupational standard) corresponds to a urinary excretion of 65 mmol TEA/mol creatinine and a plasma level of 1.9 mumol/liter (biological exposure indices). PMID- 2782315 TI - Corporate response to reproductive hazards in the workplace: results of the Family, Work, and Health Survey. AB - As a part of a Family, Work, and Health Survey, we analyzed corporate practices regarding reproductive hazards in the chemical and electronics manufacturing industries in Massachusetts. Over half of the 198 firms surveyed had at least one of four designated reproductive hazards in use. Among these firms, 57% provided information on reproductive risks to employees. Nearly 20% of companies excluded certain classes of workers from substances, work areas, or occupations on the basis of reproductive health concerns. Another 13% offered voluntary transfers to workers concerned about reproductive risks. With one exception, all restrictions and transfers applied to women only--even when scientific evidence supports potential reproductive risk to both sexes. Analysis of corporate practices by industry type, and size, gender stratification, and unionization of the workforce was carried out. Results of the survey raise important public health concerns about corporate practices that may restrict women's job opportunities on the basis of reproductive status while underprotecting the health of male workers. PMID- 2782316 TI - Mortality among employees of an Ontario factory that manufactured construction materials using chrysotile asbestos and coal tar pitch. AB - This paper describes mortality in a cohort of 324 men exposed to chrysotile asbestos and coal tar pitch used in the manufacture of electrical conduit pipe from a mixture of newsprint, bentonite, and asbestos. One death in a factory worker was attributed to pleural mesothelioma, and long-term employees experienced an increased risk of lung cancer (Standardized Mortality Ratio (SMR) 221; six deaths) and non-malignant respiratory disease (SMR 215; four deaths). In a case-control analysis, men whose jobs involved adding asbestos to the mix of raw materials were found to have a risk of lung cancer sevenfold higher (lower 95% confidence limit: 2.3) than men who had never worked at this job. Exposure to coal tar pitch is presumed to be responsible for the death of one worker from squamous cell carcinoma of the scrotum. PMID- 2782317 TI - Lung functions in phosphate miners in Jordan: a pilot study. AB - Phosphate mining and processing is a major industry in Jordan. In this study of 56 workers in this industry, there was significant occurrence of cough, chronic bronchitis, and abnormal spirometry among smokers (p less than 0.1). There was no correlation between the spirometry, A-aDO2, and chest x-ray changes in this occupational group. Smoking was noted to be more detrimental to these workers than was their occupational exposure. Many parameters must be examined when evaluating this pneumoconiosis. PMID- 2782318 TI - Diagnostic value of exercise testing in asbestosis. AB - The diagnostic value of simple exercise testing was examined in 81 current male asbestos-cement workers, divided into four groups according to the International Labour Office (ILO) category of irregular opacities: 0/0, 25; 1/1, 24; 1/2, 22; and 2/2, 10 men. An increasing X-ray score was accompanied by more severe functional abnormality in keeping with the development of a restrictive defect. Symptom-limited oxygen uptake (VO2SL) did not depend on the X-ray grade and was 76.7, 71.9, 68.7, and 73.5% pv, respectively, for the four groups. Subjects with ILO score 1/1 had significantly higher exercise ventilation at O2 uptake of 1.01.min-1 (VE 1.0) than those with grade 0/0. End-exercise tidal volume (VTSL in 1) decreased with an increasing X-ray score: 2.14, 1.98, 1.85, and 1.62, respectively. VTSL standardized for vital capacity (VTSL/VC) followed the same pattern. Asbestosis was diagnosed in 25 men, in whom VE 1.0 was significantly higher (p less than .02) and VTSL lower (p less than .01) than in the 0/0 group. VO2SL was similar in both groups. The findings suggest that VE 1.0 and VTSL may be early functional indicators of asbestos-related interstitial lung fibrosis. The measurement of both exercise indices may increase the certainty of clinical diagnosis of asbestosis in subjects with less advanced disease. PMID- 2782319 TI - Social and economic determinants of occupational health policies and services. AB - Current changes in technology and in economic, social, and demographic trends must be taken into account in the formulation or reformulation and implementation of policies and programs for the prevention and control of occupational disease and dysfunction. PMID- 2782320 TI - Formaldehyde case reports. PMID- 2782321 TI - Formaldehyde exposure reports. PMID- 2782322 TI - Second International Symposium on Rilmenidine. Paris, March 11, 1988. Proceedings. PMID- 2782323 TI - Pharmacokinetics of rilmenidine. AB - Rilmenidine is a novel antihypertensive agent related to alpha 2-adrenoceptor agonist, used in the treatment of mild or moderate hypertension at the oral dose of 1 mg once a day or 1 mg twice a day. The pharmacokinetic parameters were investigated after single or repeated administration in healthy subjects, using labeled and unlabeled compounds. Rilmenidine was rapidly and extensively absorbed, with an absolute bioavailability close to one and a time to peak plasma concentration of two hours. Rilmenidine was not subjected to presystemic metabolism. Distribution was independent of the free fraction since rilmenidine was weakly bound to plasma proteins (less than 10 percent). The volume of distribution was approximately 5 liters/kg (315 liters). Elimination was rapid, with a total body plasma clearance of approximately 450 ml/minute and an elimination half-life of approximately eight hours. Renal excretion was the major elimination process (two thirds of the total clearance); the parent drug in urine accounted for about 65 percent of the dose administered. Metabolism was very poor; few metabolites were found in urine and no metabolites were detected in plasma. Linear pharmacokinetics was demonstrated for rilmenidine from 0.5 to 2 mg; at 3 mg, a slight deviation from linearity was observed. In repeated administration, the linearity with dose of the pharmacokinetics of rilmenidine was confirmed. PMID- 2782324 TI - Treatment of hypertension in diabetic patients. AB - Hypertension, common in diabetic patients, worsens not only the risk of cardiovascular complications, but also that of microangiopathic complications (nephropathy, retinopathy) of diabetes mellitus. It is thus important to ensure the perfect control of even mild hypertension in diabetic patients. However, treatment sometimes becomes difficult given that certain categories of antihypertensive drugs interfere with blood glucose control and/or lipid metabolism, interfere with the symptomatology of hypoglycemia, or promote orthostatic hypotension, a complication of autonomic neuropathy. A study was undertaken to determine the effects of rilmenidine, administered for 16 weeks, in 29 diabetic patients treated with insulin and experiencing mild-to-moderate hypertension (supine diastolic blood pressure, 96.7 +/- 0.5 mmHg). Administered as single-drug therapy, rilmenidine rapidly normalized blood pressure (systolic blood pressure, less than 160 mmHg; diastolic blood pressure, no more than 90 mmHg--supine) in 17 patients; this persisted throughout the trial period. Addition of a diuretic after 12 weeks in the remaining 12 patients led to normalization of blood pressure in nine additional patients. Blood glucose control (evaluated at home by weekly blood glucose measurements and by glycosylated hemoglobin levels) was unaffected by treatment. Plasma levels of cholesterol (total, high-density lipoprotein and low-density lipoprotein), triglycerides and proteinuria (or microalbuminuria) showed no change during the course of the trial. In conclusion, rilmenidine offers an effective and safe treatment for mild-to-moderate hypertension in diabetic patients treated with insulin and does not interfere with their blood glucose control. PMID- 2782325 TI - Hypertension in the elderly. AB - The relation between hypertension, cerebrovascular disease, and heart failure in the elderly is well established. The concept that this was entirely due to hardening of the arteries and, therefore, an essential feature of aging has been revised in the last 15 years to show that there are groups of elderly people in whom hypertension is not a problem, and in this group stroke disease and heart failure are relatively uncommon. The treatment of hypertension in the elderly attracts increasing attention. The successful lowering of blood pressure in the elderly has now been reported by many authors with a variety of therapeutic agents. The case for treatment has been demonstrated in those up to 80 years of age by the European Working Party in Hypertension in the Elderly, and relevant data on compliance are also available in the older age group in the Sub-Group Analysis of the Hypertension Detection and Follow-up Programme. A similar reduction of blood pressure, both systolic and diastolic, can be safely achieved with thiazides, beta-blockade, calcium channel blockade, angiotensin-converting enzyme inhibitors, and centrally acting drugs. The differentiation between these groups is largely a matter of the side effects that occur and any concurrent existing illness from which the patient suffers, e.g., diabetes, bronchitis, heart failure, and so on. From the information available to date, the problem of choice of the most suitable drug remains a clinical decision for the prescribing doctor. PMID- 2782326 TI - Acceptability of rilmenidine and long-term surveillance of plasma concentrations in hypertensive patients with renal insufficiency. AB - Acceptability and plasma concentrations of rilmenidine, a new antihypertensive agent mainly eliminated via the kidney, were evaluated in 17 hypertensive patients (supine diastolic blood pressure, 104 +/- 3 mmHg) with renal insufficiency (creatinine clearance, 35 +/- 4 ml.minute-1/1.73 m2; range, 12 to 58). Patients were treated for six months with rilmenidine at the dose of 1 mg in the morning or 1 mg twice daily as single-drug therapy in untreated patients, or in combination or as substitution in patients already treated. Plasma concentrations of rilmenidine were measured by gas chromatography combined with mass spectrometry at Days 0, 1, 5, 7, 9, and 11, and Months 1.5, 3, 4.5, and 6 before administration. Supine and erect blood pressure (sphygmomanometer) measurements and side effects were noted at the same times. Laboratory and electrocardiographic parameters were evaluated at Days 0 and 11, and Months 1.5 and 6. Blood pressure was effectively controlled during the trial in 12 patients (mean decrease in systolic/diastolic blood pressure of 12/8 mmHg). Five patients were removed from the trial after Month 1.5 because of a rise in blood pressure (three cases) or noncompliance (two cases). Side effects were moderate and transient (dry mouth, constipation, daytime drowsiness, mood disturbances, insomnia) never requiring treatment withdrawal. Surveillance of renal function revealed no significant mean variation. Rilmenidine plasma concentrations reached steady state the fifth day at the latest and were related to the degree of renal insufficiency. When renal function was stable (13 cases), plasma concentrations did not vary until the end of the trial. When renal function was progressive (four cases), plasma concentrations increased in parallel in two patients, without the onset of side effects, and remained stable in the other two patients. In conclusion, this study confirmed the good acceptability of rilmenidine in hypertensive patients with chronic renal insufficiency. It showed stable plasma concentrations of rilmenidine during a six-month treatment in hypertensive patients with renal insufficiency, reflecting the absence of accumulation of the drug. PMID- 2782328 TI - Transactions of the fifty-first annual meeting of the South Atlantic Association of Obstetricians and Gynecologists. Hot Springs, Virginia, January 29-February 1, 1989. PMID- 2782327 TI - Effort blood pressure control in the course of antihypertensive treatment. AB - In 30 patients with mild hypertension (diastolic blood pressure, 95 to 105 mmHg), the antihypertensive effect of rilmenidine 1 mg was compared in a double-blind study, with the effect of hydrochlorothiazide 25 mg. Patients not satisfactorily controlled received a combined therapy on the same doses of the two drugs used. Rilmenidine and hydrochlorothiazide induced a significant reduction (p = 0.01) of supine and erect systolic/diastolic blood pressure 23 hours after drug intake with no change in heart rate. This effect was due to a reduction in cardiac output (bioimpedance method) significant (p = 0.05) only for rilmenidine. Both drugs controlled the increase of effort systolic blood pressure in comparison with placebo on systemic vascular resistance treadmill exercise testing. Effort cardiac output was increased by each treatment in comparison with baseline values. Both at rest and on exertion, there was no effect on systemic vascular resistance induced by the two drugs. In a second group of 10 patients with moderate hypertension (diastolic blood pressure, 105 to 115 mmHg), rilmenidine 1 mg was administered in order to evaluate its efficacy and hemodynamic effects (bioimpedance and radionuclide ventriculography), at rest and during a lying cycloergometer effort test. The drug induced a significant decrease in blood pressure at rest and on exertion four hours after drug intake. This effect was due to a reduction (p = 0.05) in systemic vascular resistance, whereas cardiac output and heart rate remained unchanged. Our results show that the reduction in systolic/diastolic blood pressure induced by rilmenidine 1 mg is comparable with that induced by the well-known antihypertensive drug hydrochlorothiazide in mild hypertension. In moderate hypertension, the 1-mg dose appears to be insufficient in controlling the blood pressure in all patients. The drug exerts its antihypertensive effect through the normalization of the altered hemodynamic parameters of hypertension (high cardiac output and/or increased systemic vascular resistance). Rilmenidine also respects the physiologic increase in blood pressure and cardiac output on exertion. PMID- 2782329 TI - The challenge of change revisited. PMID- 2782330 TI - Effects of terbutaline sulfate on fetal cardiac function. AB - An isolated heart preparation was used to study the effects of terbutaline sulfate (Brethine) on fetal cardiac function. Pregnant guinea pigs received daily subcutaneous injections of terbutaline for 10 day, whereas a control group received placebo injections. Fetal guinea pig hearts were evaluated for cariodynamic and pathologic differences. Fetuses exposed to terbutaline demonstrated a higher mean heart rate (p less than 0.01), a higher mean heart weight (p less than 0.05), a higher mean heart weight/body weight ratio (p less than 0.01), and a trend toward higher left ventricular systolic pressure levels (p less than 0.1). These hemodynamic responses in fetuses exposed to terbutaline may result in increased functional demands that may predispose myocardial tissue to damage. PMID- 2782331 TI - The effects of vibroacoustic stimulation on baseline heart rate, breathing activity, and body movements of normal term fetuses. AB - To determine the fetal biophysical effects of vibroacoustic stimulation produced by an electronic artificial larynx we studied 20 normal term pregnancies assigned either to control (no stimulus) or experimental (stimulus) groups. Each fetus was observed for 3 hours; either no stimulus or a 3-second stimulus was delivered after the first hour. Fetal heart rate baseline and variation, breathing movement incidence, rate, and variation, and body movement incidence data were acquired concurrently and analyzed at 15-minute intervals. Intergroup comparisons showed that, after stimulation, fetal heart rate baseline and variation increased significantly, whereas breathing incidence fell during the first 15 minutes. Within-group analyses showed that poststimulus elevation of fetal heart rate baseline was the only significant time interaction over the 3 hours. Vibroacoustic stimulation appears to be primarily associated with transient alterations in fetal heart rate baseline; concomitant changes in breathing activity probably reflect normal biologic cycles. PMID- 2782332 TI - Seminoma in pubertal patient with androgen insensitivity syndrome. AB - The case of a 14-year-old girl with complete androgen insensitivity syndrome and metastatic seminoma is reported. She was treated by bilateral adnexectomy, removal of paraaortic lymph nodes, postoperative radiation, and estrogen replacement therapy. She represents the fourth case of gonadal malignancy to be reported in a teenage patient with androgen insensitivity syndrome. PMID- 2782333 TI - Outpatient triplet management: a contemporary review. AB - The antepartum management of 198 women who were delivered of triplets between 1985 and 1988 is reviewed. Women were managed with the assistance of ambulatory perinatal nursing to provide outpatient surveillance. Modified bed rest, prophylactic tocolysis, and betamethasone were liberally used and patients were hospitalized only when obstetrically indicated. The most common antepartum complication was preterm labor (66.2%) and the success of therapy with tocolytic agents is described. The mean gestational age and birth weight at delivery were 33.6 +/- 3 weeks (mean +/- SD) and 1871 +/- 555 gm, respectively. Comparison of the gestational age distribution at delivery with previous reviews demonstrates fewer deliveries less than 29 weeks' gestation and significantly more deliveries between 32 and 37 weeks' gestation. Cesarean delivery occurred in 94% of the triplets, which eliminated birth order as a factor that affects survival. The corrected perinatal survival rate was 95% in this contemporary review of outpatient triplet management and represents a major improvement in the expected outcome for triplets. PMID- 2782334 TI - Maternal mortality in North Carolina: a forty-year experience. AB - An analysis of 67 maternal deaths from January 1, 1981, through December 31, 1985, are reported in detail and in the perspective of 3780 maternal deaths previously reviewed in North Carolina since January 1, 1946. Although the direct obstetric mortality rate has decreased 95% over the 40 years, within causal mortality groups the rates have changed variably during the past 5 years. For the first time, no deaths from obstetric infection occurred. Whereas deaths from toxemia continue to decline, those from hemorrhage, embolism, and anesthetic complications remain unchanged. Within the hemorrhage causal group, deaths from ectopic pregnancy have risen to 70%. The maternal death rate after 20 weeks' gestation is almost 10 times that associated with pregnancy interruptions. Of particular concern is the relative risk of death between the nonwhite and white patients. The North Carolina data are reviewed in the light of those in the South Atlantic region and in the nation as a whole. PMID- 2782335 TI - Risk factors for intraamniotic infection: a prospective epidemiologic study. AB - To determine the cumulative incidence of intraamniotic infection in our hospital and to identify potential risk factors for infection, 408 consecutive patients were followed up prospectively to determine development of intraamniotic infection. The clinical diagnosis of intraamniotic infection was made in 43 (10.5%) patients. Patients with intraamniotic infection were younger, of lower gravidity and parity, more likely to require oxytocin augmentation, and more likely to be monitored internally than were patients who were not infected. They also had longer durations of labor, ruptured membranes, and hospitalization before delivery, had significantly more vaginal examinations, and were more likely to be delivered of infants by cesarean section, as compared with patients without infection. Logistic regression analysis identified four variables independently associated with intraamniotic infection: the number of vaginal examinations, duration of ruptured membranes, use of internal monitors, and duration of total labor. Further study is necessary to clarify the role of these risk factors in the pathogenesis of intraamniotic infection so that infection control strategies can be developed. PMID- 2782336 TI - Short course of antibiotic therapy in treatment of postpartum endomyometritis. AB - To evaluate the safety and efficacy of an abbreviated course of antibiotic therapy in postpartum endomyometritis, 109 patients with endomyometritis were randomized to three study groups. All were treated with clindamycin and tobramycin until afebrility and clinical signs of disease were absent. Patients in group I received antibiotics for greater than or equal to 24 hours, group II received therapy for greater than or equal to 48 hours, and group III received antibiotic therapy for greater than or equal to 48 hours that preceded a 7-day course of oral Augmentin. The groups were similar in size and in demographic and clinical parameters. Two patients from each group required a third antibiotic, and no patient required rehospitalization. Group III required more days of antibiotic therapy than did group I, 2.9 versus 2.1 days (p less than 0.01), and cost $412.00 more per patient. This data strongly suggest that a short course of antibiotic therapy is efficacious and safe and would result in substantial monetary savings. PMID- 2782337 TI - Subsequent fertility in women who undergo cardiac surgery. AB - A retrospective review was undertaken on all pediatric and reproductive-aged females who underwent cardiac surgery and required cardiopulmonary bypass from 1958 through 1986. The purpose of this study was to define the fertility of these patients after surgery and to compare their reproductive performance with that in the general population. Analysis was complete for 208 patients. These patients make up the following cardiac surgical categories: septal defect repairs, 92; commissurotomies, 60; valve replacements, 46; tetralogy of Fallot repairs, 6; and coronary artery bypass procedures, 4. Of 208 patients, 68 (32.7%) attempted pregnancy after surgery. Infertility was defined in five women as follows: endometriosis, 3; ovulatory dysfunction, 1; unknown, 1. A total of 64 patients conceived 121 pregnancies with the following outcomes: live births, 98; spontaneous abortion, 9; ectopic pregnancy, 2; therapeutic abortion, 12. Our results suggest that infertility is not an apparent disorder after cardiac surgery and that subsequent pregnancy outcomes are similar to those in the general population. PMID- 2782338 TI - Fertility after ectopic pregnancy. AB - In the period July 1983 to March 1985, 264 women had surgery for ectopic pregnancy at Grady Memorial Hospital; 76 had postoperative hysterosalpingograms. Of these, 55 (76.4%) women were followed up for 3 to 41 months (mean, 23.8) to determine subsequent fertility. During the follow-up period, 30 pregnancies occurred among the 55 patients; 24 were intrauterine and 6 were repeat ectopic pregnancies. In the surgical group of 39 patients with salpingectomy, 60.8% of those desiring pregnancy achieved an intrauterine pregnancy. Of the 12 patients with salpingostomy, the three who desired pregnancy achieved it (100%). In the tubal abortion group, the two women desiring pregnancy conceived (100%). There were six repeat ectopic pregnancies (10.9%). Of the ectopic pregnancies, one occurred in the salpingectomy group (2.6%), four in the salpingostomy group (33.3%), and one in the tubal abortion group (25%). Five of the six ectopic gestations were found in the contralateral fallopian tube. Hysterosalpingographic evidence of contralateral tubal patency was a good prognostic indicator for subsequent intrauterine pregnancy. By contrast, one half of study patients with findings suggesting tubal occlusion still achieved an intrauterine pregnancy. PMID- 2782340 TI - Transactions of the ninth annual meeting of the Society of Perinatal Obstetricians. New Orleans, Louisiana, February 2-4, 1989. PMID- 2782339 TI - Effects of clomiphene citrate on episodic luteinizing hormone secretion throughout the menstrual cycle. AB - Pituitary luteinizing hormone secretory dynamics (pulse frequency and amplitude) were evaluated in eight normal women administered clomiphene citrate or placebo. After 5 days of treatment clomiphene citrate was found to increase mean luteinizing hormone secretion by increasing the amount of pituitary luteinizing hormone released per pulse. No change in pituitary luteinizing hormone interpulse interval was found in the follicular phase of the cycle, although a faster pulse frequency in the luteal phase was found after clomiphene citrate when compared with placebo. No differences were found in the luteal phase (pulse frequency, amplitude, and mean luteinizing hormone level) after clomiphene citrate versus placebo in the volunteers. These data suggest that the principal mechanism of action of clomiphene citrate is an increase in the concentration of hypothalamic gonadotropin releasing hormone into the hypothalamic-pituitary portal circulation, with a resultant increase in pituitary luteinizing hormone secretion. PMID- 2782341 TI - Routine umbilical cord blood gas determinations? AB - Between 1986 and 1988, 1924 term nulliparous patients with spontaneous onset of labor were studied to assess the importance of obtaining umbilical cord blood gas levels on all deliveries. The umbilical cord arterial and venous pH values (expressed as mean +/- 2 SD) were 7.24 +/- 0.14 (n = 1694) and 7.32 +/- 0.12 (n = 1820), respectively. The incidence of newborn depression (1- or 5-minute Apgar score less than 7) was 14.1%; of these depressed newborns, the incidence of normal umbilical cord arterial pH values (greater than or equal to -2 SD) was 77.8%. Of the vigorous newborns, there was a 2.1% incidence of umbilical cord arterial blood acidemia. Umbilical cord arterial blood acidemia in vigorous newborns was not highly predictive of specific morbidity in the immediate newborn period. Regression analysis demonstrated the umbilical cord arterial pH to correlate best with the Apgar scores when compared with all other arterial or venous blood gas measurements. We reached the following conclusions: (1) that obtaining cord arterial pH values in vigorous newborns should be considered since the values will provide objective documentation or normal fetal acid base balance in 98% of infants. (2) Only a cord arterial pH determination is recommended since it reflects fetal or newborn status more accurately than all other measurements. Additional measurements increase the likelihood of abnormal results and do not contribute to neonatal management. (3) An umbilical cord blood pH value is extremely useful in ruling out the diagnosis of birth asphyxia in the depressed newborn. PMID- 2782342 TI - Prophylactic amnioinfusion during labor complicated by meconium: a preliminary report. AB - The purpose of this prospective and randomized study is to evaluate the safety and efficacy of prophylactic transcervical amnioinfusion in the management of labor complicated by meconium. A preexisting intrauterine pressure catheter was used for amnioinfusion. The incidence of thick meconium was significantly lower after amnioinfusion, compared with standard management (5% versus 62% p less than 0.0005). This was also demonstrated with spectrophotometry. Significant differences between the amnioinfusion group and the control group were found for the following: arterial cord pH less than 7.20 (16% versus 38%, p less than 0.05); meconium more than trace below the vocal cords at delivery (0% versus 29%, p less than 0.05) and need for positive pressure ventilation at birth (16% versus 48%, p less than 0.05). No complications related to amnioinfusion were observed. We conclude that (1) transcervical amnioinfusion during labor complicated by meconium is a simple and apparently safe procedure, and that (2) amnioinfusion effectively decreases the frequency of thick meconium, the frequency of neonatal acidemia, the frequency of more than trace meconium below the vocal cords, and the need for positive pressure ventilation. PMID- 2782343 TI - Lack of evidence of a vasodepressor role for relaxin in spontaneously hypertensive and normotensive pregnant rats. AB - To test the possibility that the ovarian polypeptide hormone relaxin mediates the vasodepressor effect of pregnancy, we measured changes in blood pressure in three groups of spontaneously hypertensive and Wistar-Kyoto normotensive rats: (1) pregnant, bilaterally oophorectomized rats on postmating day 13, (2) pregnant, sham-oophorectomized rats on postmating day 13, and (3) nonpregnant, sham oophorectomized rats after 13 days. The day before parturition we also measured the pressor responsiveness to angiotensin II and norepinephrine. Systolic blood pressure fell significantly during the last week of gestation in both strains, reaching normotensive levels in the hypertensive rats by term. The pressor responsiveness to angiotensin II, but not norepinephrine, of the pregnant rats was reduced compared with that of the nonpregnant rats in both strains. Oophorectomy did not prevent the fall in blood pressure or the decrease in vascular reactivity to angiotensin II. Therefore, although ovarian relaxin secretion increases during pregnancy, it apparently does not decrease vascular sensitivity to angiotensin II or cause vasodilation. PMID- 2782344 TI - Cocaine abuse during pregnancy: peripartum prevalence and perinatal outcome. AB - The frequency of cocaine abuse during pregnancy has increased markedly in recent years. Cocaine abuse during pregnancy has been associated with significant perinatal morbidity and mortality. In this study a large population of pregnant women were tested for drug use at the time of their admission to the hospital for labor and delivery. During the study period a total of 138 (8%) of 1776 patients who were delivered of infants had positive urine toxicologic screening tests for cocaine. Moreover, the prevalence of peripartum cocaine abuse increased considerably during the study period. The perinatal outcomes of the 138 patients whose urine samples yielded positive test results for cocaine were compared with those of the 88 control patients with negative results. Cocaine use was associated with lower gestational age at delivery and higher incidences of preterm delivery, premature rupture of the membranes, and small-for-gestational age infants. When compared with control infants, infants of mothers who used cocaine had more instances of neonatal morbidity and longer hospitalizations. In this study peripartum cocaine abuse was common, increased during the study period, and was associated with perinatal morbidity. PMID- 2782345 TI - Do the current standards for glucose tolerance testing in pregnancy represent a valid conversion of O'Sullivan's original criteria? AB - The venous plasma values for the 100 gm glucose tolerance test endorsed by the Second International Workshop-Conference on Gestational Diabetes represent an arbitrary conversion from O'Sullivan's original values. The latter were calculated from whole blood by means of the Somogyi-Nelson method. The factor used to convert the whole blood values to plasma glucose values was empirically derived in a population in whom pregnancy status was not stated. A conversion factor derived from a nonpregnant population may systematically overestimate plasma glucose concentration when applied to a pregnant population. Paired specimens obtained from 995 consecutive pregnant patients were analyzed by the Somogyi-Nelson method on whole blood and the glucose oxidase method on plasma. A conversion formula was derived and was used to estimate plasma glucose values and 95% confidence limits equivalent to whole blood values. Application of this formula yields plasma glucose oxidase glucose tolerance test values of fasting, 96 mg/dl; 1 hour, 172 mg/dl; 2 hours, 152 mg/dl, and 3 hours, 131 mg/dl. These values are all lower than those currently endorsed. PMID- 2782346 TI - How reliable is the fifty-gram, one-hour glucose screening test? AB - The Second International Workshop-Conference on Gestational Diabetes recommended screening all pregnant women with a 1-hour 50 gm oral glucose screening test, given without regard to time of day or time elapsed from the last meal. This study was designed to evaluate the reproducibility of that test, given under those clinical conditions. Thirty women with gestational diabetes and 80 control volunteers between 24 and 28 weeks' gestation were tested at the same time of day on two successive days. Of the 30 women with diabetes, three (10%) had glucose screening test results below the 135 mg/dl threshold on both days and 10 (33%) had results that straddled the threshold on successive days. Test results of 11 control women also straddled the threshold. Among these 21 women with results that straddled the threshold, there was no difference in mean glucose screening test results in diabetic women compared with nondiabetic ones. We conclude that, as currently recommended, the 1-hour glucose screening test is moderately reproducible. Reliance should not be placed on a single normal test result, particularly among patients with risk factors. PMID- 2782347 TI - Glycemic control in gestational diabetes mellitus--how tight is tight enough: small for gestational age versus large for gestational age? AB - The relationship between optimal levels of glycemic control and perinatal outcome was assessed in a prospective study of 334 gestational diabetic women and 334 subjects matched for control of obesity, race, and parity. All women with gestational diabetes mellitus were instructed in the use of a memory-based reflectance meter. They were treated with the same metabolic goal according to a predetermined protocol. Three groups were identified on the basis of mean blood glucose level throughout pregnancy (low, less than or equal to 86 mg/dl; mid, 87 to 104 mg/dl; and high, greater than or equal to 105 mg/dl). The low group had a significantly higher incidence of small-for-gestational-age infants (20%). In contrast, the incidence of large-for-gestational-age infants was 21-fold higher in the mean blood glucose category than in the low mean blood glucose category (24% vs. 1.4%, p less than 0.0001). An overall incidence of 11% small-for gestational-age and 12% large-for-gestational-age infants was calculated for the control group. A significantly higher incidence of small-for-gestational-age infants (20% vs. 11%, p less than 0.001) was found between the control and the low category. In the high mean blood glucose category an approximate twofold increase was found in the incidence of large-for-gestational-age infants when compared with the control group (p less than 0.03). No significant difference was found between the control and mean blood glucose categories (87 to 104 mg/dl). Our data suggest that a relationship exists between level of glycemic control and neonatal weight. This information is helpful in targeting the level of glycemic control while optimizing pregnancy outcome in gestational diabetes comparable to the general population. PMID- 2782348 TI - Pneumonia during pregnancy: has modern technology improved maternal and fetal outcome? AB - The maternal death rate and rate of preterm delivery associated with pneumonia during pregnancy have not decreased since the introduction of antibiotics four decades ago. We retrospectively reviewed 25 cases of pneumonia during pregnancy; these cases occurred among 32,179 deliveries. Medical complications included: bacteremia, 16%; empyema, 8%; atrial fibrillation, 4%; respiratory failure necessitating mechanical ventilation, 20%. Obstetric complications occurring during the pneumonia episode included: preterm labor, 44%; preterm delivery, 36%. A patient with cystic fibrosis died; one stillbirth and two neonatal deaths occurred. Underlying maternal disease was significantly associated with maternal medical complications (p = 0.023) and preterm delivery (p = 0.012). Significant medical and obstetric complications continue to occur frequently despite modern antimicrobial, tocolytic, and supportive therapy. Underlying maternal disease, including acquired immunodeficiency syndrome and cystic fibrosis, was associated with preterm delivery and neonatal and maternal death. PMID- 2782349 TI - Uterine rupture: are intrauterine pressure catheters useful in the diagnosis? AB - The usefulness of the intrauterine pressure catheter in the diagnosis of uterine rupture was assessed by review of 76 cases of uterine rupture, 39 of which were monitored with an intrauterine pressure catheter. The classic description of a loss of intrauterine pressure or cessation of labor was not observed in any of the patients. However, an increase in baseline intrauterine pressure was observed in four patients with an intrauterine pressure catheter. The increase in pressure was associated with severe variable decelerations such that by itself the intrauterine pressure catheter added little to the diagnosis of uterine rupture. PMID- 2782350 TI - The effect of continuous epidural analgesia on cesarean section for dystocia in nulliparous women. AB - Epidural analgesia in labor is generally accepted as safe and effective and therefore has become increasingly popular. However, little is known regarding the effect of epidural analgesia on the incidence of cesarean section for dystocia in nulliparous women. During the first 6 months of 1987 we studied 711 consecutive nulliparous women at term, with cephalic fetal presentations and spontaneous onset of labor. Comparison of 447 patients who received epidural analgesia in labor with 264 patients who received either narcotics or no analgesia was performed. The incidence of cesarean section for dystocia was significantly greater (p less than 0.005) in the epidural group (10.3%) than in the nonepidural group (3.8%). There remained a significantly increased incidence (p less than 0.005) of cesarean section for dystocia in the epidural group after selection bias was corrected and the following confounding variables were controlled by multivariate analysis: maternal age, race, gestational age, cervical dilatation on admission, use of oxytocin, duration of oxytocin use, maximum infusion rate of oxytocin, duration of labor, presence of meconium, and birth weight. The incidence of cesarean section for fetal distress was similar (p greater than 0.20) in both groups. There were no clinically significant differences in frequency of low Apgar scores at 5 minutes or cord arterial and venous blood gas parameters between the two groups. This study suggests that epidural analgesia in labor may increase the incidence of cesarean section for dystocia in nulliparous women. PMID- 2782351 TI - Can platelet volume predict progressive hypertensive disease in pregnancy? AB - Increase in platelet size has been found in conditions with increased platelet destruction and use. This increase in platelet size can be found in patients with moderate or severe hypertension in pregnancy, even in the presence of a normal platelet count. The goal of this study was to investigate whether an increase in platelet size was present before the manifestation of the disease and therefore could be used to predict the progression of the disease before it is clinically apparent. Three hundred normal primigravid pregnancies were studied between 28 and 30 weeks' gestation, and blood was taken to assess platelet count and mean platelet volume. Two hundred sixteen patients had no hypertensive problems during their pregnancy, 84 developed hypertension, 62 had mild hypertension only with diastolic blood pressures between 90 and 99 mm Hg, 13 had moderate hypertension with diastolic blood pressures between 100 and 109, and nine had severe hypertension with diastolic blood pressure above 110. No difference was found between these groups in the parameters measured. Therefore it was felt that platelet volume may not be a useful screening test in a low-risk population. A second study was carried out to investigate the serial changes in these parameters in patients at risk of progressive disease. Thirty-four patients with essential hypertension were followed from 24 weeks with serial blood sampling to study changes in platelet size. An additional 40 patients with mild pregnancy induced hypertension were also studied. From these patient groups, 20 patients developed severe hypertension. The mean platelet volume increased significantly at least 1 week before the hypertension became clinically apparent. There was no change in platelet count at this time. It is concluded that increasing platelet size can predict which patients are likely to progress to severe disease before it becomes clinically obvious. PMID- 2782352 TI - Measurement of cardiac output in pregnancy by thoracic electrical bioimpedance and thermodilution. A preliminary report. AB - Thoracic electrical bioimpedance is a noninvasive, continuous method of obtaining cardiac output that requires no operator skill. However, the most recent thoracic electrical bioimpedance technology has not been validated in pregnancy. We therefore compared two methods of measuring cardiac output in pregnancy, thoracic electrical bioimpedance and thermodilution. We studied 11 patients who required pulmonary artery catheterization for peripartum management and measured cardiac output simultaneously by thoracic electrical bioimpedance and thermodilution. Among eight of nine patients, there was agreement (within +/- 20%) between the two methods. Bivariate linear regression with these nine cases showed excellent correlation (r = 0.91, p less than 0.001) with a slope of 1.04, which indicated a one-to-one relationship between thoracic electrical bioimpedance and thermodilution. The remaining two cases were removed from analysis because of septic shock in one case (which invalidates thoracic electrical bioimpedance) and 4+ tricuspid regurgitation in another case (which invalidates thermodilution). These data support that thoracic electrical bioimpedance measurement of cardiac output may be valid in most peripartum patients. PMID- 2782353 TI - Rapid determination of fetal sex by deoxyribonucleic acid amplification of Y chromosome-specific sequences. AB - Rapid fetal sex tests use either dot blot hybridization to Y chromosome-specific (male) repeat sequences or polymerase chain reaction deoxyribonucleic acid amplification of these Y-specific sequences. We have performed 35 fetal sex determinations, 16 by dot blot alone, 13 by polymerase chain reaction alone, and 6 by dot blot and polymerase chain reaction on samples of fetal blood, amniotic fluid, and chorionic villi. All results have been confirmed by karyotyping. Dot blots have given false-positive "male" results three times. In contrast, the polymerase chain reaction has correctly determined fetal sex in every case, even when the dot blot was in error. The Y-specific polymerase chain reaction has been applied to fetal deoxyribonucleic DNA with a chromosome 15; Y translocation to identify the origin of the translocated material. Thus the polymerase chain reaction appears to be a reliable method to rapidly determine fetal sex that also can be used diagnostically to identify translocated Y-chromosomal material. PMID- 2782354 TI - Amniotic fluid acetylcholinesterase ratios in prenatal diagnosis of fetal abnormalities. AB - This study examined 141 pregnancies with acetylcholinesterase in the amniotic fluid to determine if an acetylcholinesterase/pseudocholinesterase ratio cutoff could be set to distinguish between neural tube defects, ventral wall defects, other fetal defects, and pregnancy problems. Amniotic fluid specimens with positive or faintly positive acetylcholinesterase bands were studied. They were scanned and analyzed for the acetylcholinesterase/pseudocholinesterase ratio. In 62 of 65 fluid samples from open neural tube defects, the acetylcholinesterase/pseudocholinesterase ratios were greater than 0.13. All cases with ventral wall defects (n = 29), fetal blood contamination (n = 16), or fetal ascites (n = 2) had acetylcholinesterase/pseudocholinesterase ratios less than 0.13. Samples of cystic hygroma fluid (n = 10) had acetylcholinesterase/pseudocholinesterase ratios greater than 0.13. Two patients with fetal teratomas had intermediate values. All patients with normal outcomes but positive acetylcholinesterase had ratios of less than 0.12. Acetylcholinesterase/pseudocholinesterase ratios are a valuable part of a prenatal program to accurately diagnose fetal abnormalities. PMID- 2782355 TI - Ovine fetal cardiorespiratory response to nicardipine. AB - Nicardipine, a calcium antagonist associated with decreased uterine blood flow in near-term pregnant rabbits and fetal asphyxia after maternal administration in the rhesus monkey and sheep, was infused directly to the fetus in six chronically prepared pregnant ewes at 128 days' gestation. Changes in fetal mean arterial and diastolic blood pressure levels at 2 and 30 minutes after bolus injection of 50 micrograms were minimal; by 60 minutes these values had returned to preinfusion levels. No significant changes were observed after infusion of 100 micrograms of nicardipine. Fetal heart rate, fetal arterial blood gas values, and maternal cardiovascular variables did not change at either dose. Fetal plasma concentrations of nicardipine were 78 +/- 28 ng/ml and 114 +/- 48 ng/ml at 30 minutes after infusion of 50 micrograms and 100 micrograms, respectively, well within the range previously reported to be associated with fetal asphyxia. These data suggest that the previously reported fetal acidosis from maternal infusion of nicardipine may be primarily due to a decrease in maternal uterine blood flow rather than a direct fetal effect of the drug. PMID- 2782356 TI - Effect of prolonged hypoxemia on fetal heart rate accelerations and decelerations in sheep. AB - Experiments were conducted in 10 chronically catheterized fetal sheep to determine the effect of 24 hours of hypoxemia in the absence of progressive acidemia on fetal heart rate accelerations and decelerations. Fetal hypoxemia was produced by mechanically restricting uterine blood flow with a vascular clamp placed around the maternal common internal iliac artery. Fetal arterial oxygen tension decreased from 22.3 +/- 1.8 to 17.8 +/- 1.5 mm Hg at 2 hours and remained low for the 24-hour experimental period. Fetal pH decreased from 7.34 +/- 0.01 to 7.20 +/- 0.05 at 2 hours and returned to normal values by 12 hours. No significant change was observed in the number or characteristics of fetal heart rate accelerations or decelerations during the 24-hour control period. There was a significant increase in the number of accelerations from 48 +/- 4 to 63 +/- 4 per hour at 8 hours of hypoxemia followed by a return to control values by 12 hours. There was no significant change in the mean amplitude or duration of accelerations. There was a significant increase in the number of decelerations per hour with an associated increase in the mean amplitude but a decrease in the mean duration of decelerations during the first 16 hours of hypoxemia. We conclude that prolonged hypoxemia in fetal sheep leads to an initial increase in the number of both accelerations and decelerations in fetal heart rate followed by a return to normal patterns indistinguishable from those of the normoexemic fetus. PMID- 2782357 TI - Prolonged hyperinsulinemia reduces plasma fatty acid levels in the major lipid groups in fetal sheep. AB - The offspring of women with poorly controlled diabetes have increased total body fat. Experimental fetal hyperinsulinemia has previously been associated with increased fat accumulation in rhesus monkey fetuses and increased lipid content and lipogenesis in rat fetuses. We hypothesized that prolonged fetal hyperinsulinemia would alter plasma total fatty acids and the individual fatty acids in each major lipid group. Fatty acids determined by gas-liquid chromatography were measured in the arterial blood of 12 chronically catheterized fetal sheep after 10 to 12 days of insulin (n = 7) or placebo (n = 5) infusion. Plasma concentrations of insulin were 412 +/- 63 microU/ml and 9 +/- 3 microU/ml (mean +/- SE) in the insulin- and placebo-treated fetal sheep, respectively. Prolonged fetal hyperinsulinemia was associated with lower circulating total fatty acid levels in each lipid class except cholesterol esters. Although the precursor of arachidonic acid, 18:2 (linoleic acid), was not decreased in any lipid class, insulin infusion was associated with reduced arachidonic acid in each lipid class. We conclude that prolonged fetal hyperinsulinemia decreases circulating total fatty acid and the individual fatty acids in each of the major lipid classes, except for the cholesterol esters. We speculate that these reductions in circulating fatty acids represent an insulin-mediated increase in tissue deposition. PMID- 2782358 TI - Pharmacokinetics of azidothymidine during late pregnancy in Long-Evans rats. AB - Azidothymidine (Zidovudine) is used to treat symptomatic human immunodeficiency virus infection. It has the ability to reverse seropositivity as well as decrease serum viral titers, and perhaps decrease potential for transmission of the virus. An animal model (pregnant Long-Evans rats) was used to investigate the potential for placental transmission of azidothymidine. The drug crosses the placenta to reach concentrations in the placenta and fetus that are comparable to 75% and 58%, respectively, of those in the maternal serum by 2 hours after administration. By 4 to 6 hours after administration azidothymidine concentrations in the placenta and fetal liver significantly exceed maternal concentrations. PMID- 2782359 TI - Ultrastructural aspects of preeclampsia. I. Placental bed and uterine boundary vessels. AB - Biopsy specimens were obtained under direct vision at the time of cesarean section from 42 patients (33 preeclamptic and nine normotensive patients) and from three hysterectomies (all in normotensive patients). Mean gestational age was 32.8 +/- 0.9 week (range, 26 to 40 weeks) in women with preeclampsia and 36.1 +/- 1.1 weeks in normotensive women (range, 32 to 41 weeks). Tissues were obtained from the central placental bed and from nonplacental sites. Specimens were examined histologically and by electron microscopy. Ultrastructural changes in small vessels, primarily venules, were compared with preeclamptic blood pressure. Extensive ultrastructural endothelial injury was found consistently in both site and nonsite areas in all of the specimens from women with preeclampsia but not in normotensive women (p less than 0.0001). There was no apparent correlation between the type or degree of endothelial damage and maternal hypertension. The same types and relative severity of specific vascular injury were present in both placental and nonplacental sites. Endothelial and derivative vascular injury occurs more or less uniformly in the uterus in preeclampsia, especially along the boundary zone between maternal and fetal tissues. PMID- 2782360 TI - The effect of magnesium sulfate tocolysis on the fetal biophysical profile. AB - The biophysical profile has proved to be a valuable tool for the assessment of fetal well-being, independent of gestational age. Magnesium sulfate is commonly used as a tocolytic agent, yet relatively little is known about its effects on the biophysical activities of the fetus. To investigate the effects of magnesium sulfate on the biophysical profile, we performed serial studies on patients who received tocolytic therapy with this agent because of preterm labor. A total of 16 women with 22 fetuses at 26 to 34 weeks' gestation in spontaneous preterm labor were studied. An initial biophysical profile was performed at the time of admission, and a second examination was performed when maternal serum magnesium levels reached 6 to 8 mg/dl. On admission all fetuses had reactive nonstress test results and 21 of 22 (95%) demonstrated sustained fetal breathing movements. With magnesium sulfate tocolysis, 50% of fetuses had nonreactive nonstress test results, and only 4 of 22 (18%) demonstrated sustained fetal breathing movements. Fetal tone, gross body movements, and amniotic fluid volume were found to be unaffected by magnesium sulfate tocolysis. PMID- 2782361 TI - Controlled trial of hydration and bed rest versus bed rest alone in the evaluation of preterm uterine contractions. AB - Patients who are seen with uterine contractions but without documented change in cervical dilation or effacement are often treated with intravenous hydration before the initiation of intravenous tocolytic therapy. This is done with the intention of stopping uterine activity in patients with false preterm labor. A prospective randomized study was conducted to evaluate the effect of hydration on preterm uterine contractions in patients without proved preterm labor. A total of 28 patients were treated with bed rest and an intravenous bolus and subsequent continuous infusion of 5% dextrose in lactated Ringer's solution. A control group of 20 patients were treated with bed rest alone. Uterine activity and arrest of uterine contractions were compared between the two groups. Contractions stopped in 54% of the patients treated with hydration, whereas contractions stopped in 40% of the patients in the control group. This difference was not statistically significant. As a crossover study, those in the control group with contractions that continued after the initial observation period were subsequently treated with intravenous fluids. Only one patient in this group stopped contracting. Of all patients whose contractions with either therapy, 18% eventually were delivered of preterm infants. This included 20% of the hydration group and 14% of the control group. The use of hydration as a pretherapy indicator to differentiate true preterm labor from false preterm labor could not be supported by this study. In addition, patients whose contractions stopped with either hydration or bed rest are at increased risk of subsequent preterm delivery. PMID- 2782363 TI - Prolactin levels in umbilical cord blood of human infants: relation to gestational age, maternal complications, and neonatal lung function. AB - The ontogeny of serum prolactin and its relation to several variables, especially lung function, in 543 neonates was studied. Umbilical cord serum prolactin levels rose between 24 and 42 weeks' gestation, correlating significantly (p less than 0.001) with gestational age (r = 0.44) and birth weight (r = 0.32). Among infants of similar ages, however, there was no variation in serum prolactin level as a function of birth weight, sex, Apgar scores, or delivery method. Infants of women with pregnancy-induced hypertension had higher than normal prolactin levels; infants of diabetic women had normal prolactin levels. At 31.5 to 37 weeks' gestation, infants who developed respiratory distress syndrome had lower serum prolactin levels than those whose lung function was normal or else was abnormal from causes other respiratory distress syndrome. The risk for respiratory distress syndrome was higher in newborns whose prolactin level was low (10th percentile) than in infants whose prolactin level was high (90th percentile). These results are suggestive that prolactin may play a role in fetal lung maturation. PMID- 2782364 TI - Amniotic fluid leukotaxis assay as an early indicator of chorioamnionitis. AB - A characteristic feature of histologic chorioamnionitis caused by ascending infection is the amniotropism displayed by polymorphonuclear leukocytes in the placental membranes. We tested the hypothesis that amniotic fluid from patients with histologic chorioamnionitis and intact membranes without clinical infection contains leukoattractants detectable by an in vitro leukotactic assay. Leukoattractants were detected in 13 cases (87%) and absent in 2 cases (13%) with histologic chorioamnionitis (p less than 0.005). The two cases with histologic chorioamnionitis that had negative leukotaxis were classified as stage l/mild severity. A positive leukotactic response was a better predictor of histologic chorioamnionitis (87%) than positive Gram stain (33%), amniotic fluid culture (53%), gas-liquid chromatography (40%), or a combination of these three methods (60%). These results suggest that demonstration of leukoattractants in amniotic fluid is an earlier and more sensitive predictor of chorioamnionitis than is presently available. PMID- 2782362 TI - Cardiovascular and metabolic effects associated with nifedipine and ritodrine tocolysis. AB - Recent investigations have indicated that nifedipine, a calcium channel entry blocker, may be useful in the treatment of preterm labor. This prospective, randomized study compares cardiovascular and metabolic effects measured in association with sublingual and oral administration of nifedipine with those noted with the intravenous and oral administration of the beta-adrenergic agent ritodrine. Serial measurements of cardiovascular parameters, hematocrit, electrolytes, glucose, blood urea nitrogen, creatinine, calcium, and serum glutamic-oxaloacetic and glutamic-pyruvic transaminase were compared between groups. Sublingual and oral nifedipine caused minimal cardiovascular alterations. At doses sufficient to achieve tocolysis, ritodrine caused more pronounced cardiovascular changes than nifedipine. Both agents had a hemodilutional effect, but nifedipine was not associated with alterations in serum electrolytes or a dramatic hyperglycemia. On the basis of this study, it appears that the use of nifedipine for preterm labor management is associated with hemodilutional changes but not the adverse cardiovascular or metabolic effects often associated with ritodrine tocolysis. PMID- 2782365 TI - Evidence relating bacterial vaginosis to intraamniotic infection. AB - We performed a two-part study to determine relationships of bacterial vaginosis and intraamniotic infection. In the first part of the study, we determined whether bacterial vaginosis organisms (Gardnerella vaginalis, Mycoplasma hominis, and anaerobes) were associated with each other in the amniotic fluid of 408 cases of intraamniotic infection. In the second part, we determined the association of bacterial vaginosis itself with intraamniotic infection in 125 cases at high risk for intraamniotic infection. Strong associations were observed among the bacterial vaginosis organisms in amniotic fluid (p less than 0.01 to p less than 0.001). Women with bacterial vaginosis were more likely to develop intraamniotic infection than those without bacterial vaginosis (69% vs. 46%, p = 0.03). Women with bacterial vaginosis were more likely to have G. vaginalis and M. hominis in the amniotic fluid (p less than 0.01 and 0.04, respectively). These observations implicate bacterial vaginosis as a cause of intraamniotic infection. PMID- 2782366 TI - The incidence of positive amniotic fluid cultures in patients preterm labor with intact membranes. AB - The possible relationship between intrauterine infection and preterm labor has received considerable attention in recent years. The purpose of this study was twofold: first, to determine the frequency of asymptomatic infection in patients who came to the hospital in preterm labor, and second, to determine the significance of a positive amniotic fluid culture in relation to latency period and likelihood of preterm delivery. Patients who came to the hospital in preterm labor with intact membranes between 20 and 35 weeks' gestation underwent transabdominal amniocentesis. Amniotic fluid was sent for Gram stain and culture. Patients received tocolytic therapy as clinically indicated. Of 127 patients cultured, seven (5.5%) had positive amniotic fluid cultures. These patients had a significantly decreased latency period from amniocentesis to delivery (4.4 days versus 28.6 days), and a significantly increased chance of being delivered of preterm infants (100% versus 52.5%), as compared with patients with negative cultures. The rate of positive Gram stain was 7 of 125 positive. However, there was no correlation between positive Gram stain and positive culture results. Similarly, positive Gram stain results were not associated with any difference in the latency period or rate of preterm delivery. PMID- 2782367 TI - Diagnosis of birth asphyxia on the basis of fetal pH, Apgar score, and newborn cerebral dysfunction. AB - Imprecise diagnosis of birth asphyxia coupled with uncertainties about causal factors for neurologic abnormalities in the newborn have greatly fueled the current litigation crisis in obstetrics. Our goal was to more precisely define birth asphyxia based on fetal condition as measured by umbilical artery blood pH, Apgar scores, and neurologic condition of newborns. We selected for study 2738 patients with singleton pregnancies with cephalic presentations who were delivered of infants at term to avoid complications such as prematurity, which may affect infant outcome independent of birth condition. The basis for study of these particular patients were defined criteria for high risk and an indicated arterial cord pH value. A total of five infants demonstrated cerebral dysfunction as evidenced by seizures during the neonatal period. Infection was linked to seizures in three of these infants; one infant had neonatal asphyxia and only one infant's clinical course could be attributed solely to birth events (uterine rupture). Stratification of umbilical artery blood pH values, Apgar scores, and combinations of these dependent variables in relation to newborn clinical outcomes revealed that infants must be severely depressed at delivery before birth asphyxia can be reliably diagnosed. Such depression includes Apgar scores less than or equal to 3 at 1 and 5 minutes plus umbilical artery pH values less than 7.00. PMID- 2782368 TI - Calcium intake and pregnancy-induced hypertension. PMID- 2782369 TI - Neonatal seizures and cesarean section. PMID- 2782370 TI - Is central venous pressure monitoring "contraindicated" in patients with severe preeclampsia? PMID- 2782371 TI - Criticism of publication of pharmaceutical-supported research results draws response. PMID- 2782372 TI - Regulation of mesangial cell growth by polypeptide mitogens. Inhibitory role of transforming growth factor beta. AB - Proliferation of mesangial cells is a common histologic abnormality in glomerular diseases. In vivo studies suggest a role for platelets and monocytes-macrophages in mediating glomerular hypercellularity. The authors recently reported that several peptide growth factors stimulate DNA synthesis and growth of human mesangial cells. This article reports that transforming growth factor beta (TGF beta), a peptide released by inflammatory cells and platelets, inhibits DNA synthesis and growth of human mesangial cells. The stimulatory and inhibitory effects of these mitogens on DNA synthesis and growth was confirmed by autoradiography and cell counting. The inhibitory effect of TGF-beta is not mediated at the receptor level because TGF-beta did not inhibit the binding of epidermal growth factor (EGF) or platelet-derived growth factor (PDGF) to mesangial cells. Because peptide growth factors that stimulate DNA synthesis in mesangial cells induce expression of PDGF mRNAs, the effect of TGF-beta on PDGF mRNAs expression induced by peptide growth factors was studied. TGF-beta did not lower the increased levels of PDGF mRNAs caused by EGF or PDGF. These data show that TGF-beta is a potent inhibitor of DNA synthesis and growth of mesangial cells. The mechanism of the inhibitory effect of TGF-beta remains to be determined. PMID- 2782373 TI - Analysis of granulomatous arteritis in MRL/Mp autoimmune disease mice bearing lymphoproliferative genes. The use of mouse genetics to dissociate the development of arteritis and glomerulonephritis. AB - MRL/Mp mice bearing the lymphoproliferation gene (lpr) spontaneously develop systemic granulomatous arteritis coincident with glomerulonephritis (GNP). Although the association of lpr-dependent lymphoproliferation in these mice seems to be a prerequisite for the development of granulomatous arteritis, the genetic basis is poorly understood. The first approach to this problem was to study the ability of another, nonallelic, lymphoproliferative gene, gld (generalized lymphoproliferative disease), inducing arteritis in MRL/Mp mice. The gld gene was placed on an MRL/Mp background by producing reciprocal (MRL/Mp-+/+ X C3H/Hej gld/gld)F2 hybrid mice. Seventeen percent of these mice with lymphoproliferation had arteritis and GNP, suggesting that more than one lymphoproliferative gene could induce GNP and arteritis in an MRL/Mp background. Next, the effect of rearrangements in the genetic background of MRL/Mp-lpr/lpr mice by hybridization with non-autoimmune lpr-bearing mice was examined. This was done by making MRL/Mp lpr/lpr X reciprocal (MRL/Mp-lpr/lpr X C57BL/6-lpr/lpr)F1 mice. Thirty-three percent of these mice developed arteritis, but one third of these did not get GNP, thus showing that susceptibility to arteritis was separate from GNP. The histopathologic features of the arteritis in both the F2 hybrids and the backcross mice were granulomatous and were identical to those seen in MRL/Mp lpr/lpr mice. These findings suggested that it might be possible to dissociated two components (arteritis and GNP) of a severe autoimmune disease of MRL/Mp mice and to study their pathogenesis separately. PMID- 2782374 TI - Malignant lymphoma of the gastrointestinal tract and mesentery. A clinico pathologic study of the significance of histologic classification. NHL Study Group of the Comprehensive Cancer Center West. AB - A series of 92 malignant lymphomas of the gastrointestinal tract and mesentery obtained from a population-based registry was studied to assess whether the newly defined concept of mucosa-associated lymphoma has clinical relevance. The cases were grouped according to localization; gastric, intestinal, and mesenteric lymphoma. All cases were reviewed histologically, graded according to the Working Formulation, and reclassified according to the Kiel classification, which was modified to include the categories low- and high-grade mucosa-associated lymphoma. Clinical data, as well as staging and follow-up data, were related to both the original diagnosis and the diagnosis after reclassification. The results showed that the distribution of the types of lymphoma is related to site: centroblastic lymphoma was predominant in the stomach, lymphoblastic in the bowel, and follicular centroblastic-centrocytic in the mesentery. Gastrointestinal lymphoma was disseminated in approximately 50% of the patients at presentation. Survival analysis revealed that classification according to the original Kiel classification and grading according to the Working Formulation provided important prognostic information, whereas introduction of mucosa associated lymphoma as an entity did not. It was concluded that modification of current classifications to include a separate category for mucosa-associated lymphoma is not useful. PMID- 2782375 TI - Histologic studies on the hepatic lesions induced by graft-versus-host reaction in MHC class II disparate hosts compared with primary biliary cirrhosis. AB - By light and electron microscopic examinations, histologic changes in the liver of mice with graft-versus-host reaction (GVHR) were analyzed. To induce GVHR, C57BL/6 (B6) spleen cells were injected into (B6Xbm1)F1, (B6Xbm12)F1, and (bm1Xbm12)F1 mice. In (B6Xbm12)F1 recipient mice, bile duct changes resembling chronic non-suppurative destructive cholangitis (CNSDC) and a formation of epithelioid granulomas were observed during the course of GVHR. An epithelioid granuloma in the liver of (B6Xbm1)F1 or (bm1.Xbm12)F1 recipients was not detected. By electron microscopy, the bile duct epithelia were seen to be in close contact with infiltrating cells, and marked alterations of their cytoplasm and microvilli were demonstrated; ie, vacuolation of the cytoplasm, deterioration of microvilli, and bleb formation were frequently observed in the liver of class II-disparate hosts. Concerning the basement membrane, no marked changes characteristic of primary biliary cirrhosis (PBC), such as many-layered basement membranes containing osmium positive substance, were detected. Because the major histocompatibility complex (MHC) class II-disparate system was used in our experimental system in the GVHR, the antigen expressed on the bile duct might be a target and be associated with the formation of the initial hepatic lesions in PBC such as CNSDC and epithelioid granuloma formation. Thus, GVHR across the MHC class II antigen is believed to play an important role in the development of PBC. PMID- 2782376 TI - Parathyroid histology and cytology with monoclonal antibodies recognizing a calcium sensor of parathyroid cells. AB - Two monoclonal antibodies reacting with surface structures on exclusively parathyroid cells and proximal kidney tubule cells were evaluated in the microscopic diagnosis of parathyroid disease. Immunostained cryosections of adenomatous and hyperplastic parathyroid glands from 30 hypercalcemic patients with primary or uremic hyperparathroidism (HPT) showed a reduced and heterogeneous staining with the antibodies. This contrasted with the intense and even staining of normal and suppressed human parathyroid glands, as well as lymph node metastases of parathyroid carcinoma. Fine-needle aspiration biopsies and imprints of the parathyroid glands showed a conspicuous antibody staining that enabled the identification of parathyroid cells. The antibodies seem to provide new means for histologic and cytologic identification of normal and pathologic parathyroid tissue, in conjunction with their highly restricted tissue reactivity. Because one of the antibodies interacts with a surface receptor mechanism of the parathyroid cells that is involved in the sensing and gating of calcium and, thereby, also with the regulation of parathyroid hormone release, the unequivocal demonstration of reduced staining of the adenomatous and hyperplastic parathyroid tissue suggests that HPT is associated with reduced expression of the calcium sensoring mechanism of the pathologic parathyroid tissue. PMID- 2782378 TI - Age-related changes in the temporomandibular joint of the senescence accelerated mouse. SAM-P/3 as a new murine model of degenerative joint disease. AB - Age-related changes of the condyle of the temporomandibular joint (TMJ) in strains of Senescence Accelerated Mouse (SAM) were investigated. With advancing age, all strains of SAM showed degenerative joint disease initiated by degenerative changes such as eg, roughness, fissure, and erosion on the condylar surface. These degenerative changes were in concert with an active remodeling that can lead to deformation of the condyle. Moreover, the short-lived SAM-P (accelerated senescence prone mouse) strains developed these degenerative changes earlier than did the SAM-R (accelerated senescence resistant mouse) strains. Thus, development of degenerative joint disease in SAM was closely related not only to chronological age but also to the accelerated senescence phenomenon. Of the SAM-P series, the SAM-P/3 strain was the first to manifest degenerative changes (approximately 50% at 7 to 9 months of age and 100% over 12 months of age) and thereafter showed the highest incidence of severe changes with overt deformity. As a model of degenerative joint disease, this strain of SAM should prove useful. PMID- 2782377 TI - Vasoactive intestinal peptide in the human pituitary gland and adenomas. An immunocytochemical study. AB - Recent evidence indicates that vasoactive intestinal peptide (VIP) may be involved in normal pituitary function. Immunocytochemistry was used to localize VIP in human biopsied pituitary adenomas and postmortem anterior pituitary glands. Paraffin sections were immunostained for VIP with the avidin-biotin peroxidase technique. Strong VIP-like immunoreactivity (VIP-LI) was observed in 16 of 17 prolactinomas, 12 of 14 growth hormone-secreting tumors associated with acromegaly, four of 12 ACTH-secreting tumors, and 14 of 18 nonfunctioning pituitary adenomas. In most cases, VIP was colocalized with the classical pituitary hormones. Six of the 18 nonfunctioning tumors had no demonstrable hormone immunoreactivity; five of these stained strongly for VIP, whereas one was negative. Of 18 normal anterior pituitaries, 12 showed strong diffuse staining for VIP throughout the gland. One pituitary with VIP-LI came from an individual who had undergone pituitary stalk transection. Double-immunoenzyme labeling and immunoelectron microscopy demonstrated VIP-LI in many lactotrophs, scattered thyrotrophs, corticotrophs, and in an occasional gonadotroph. These results suggest the following: 1) VIP is present in more than one cell type in normal and adenomatous human pituitaries; and 2) VIP may be involved in the function and development of pituitary tumors. PMID- 2782379 TI - Metal-inducible pathology in the liver, pancreas, and kidney of transgenic mice expressing SV40 early region genes. AB - Transgenic mice (SV-202) that carry the SV40 early region genes under the control of an inverted metallothionein promoter developed islet cell adenomas, hepatocellular carcinomas, and a generalized peripheral neuropathy. Both the islet cell adenomas and the hepatocellular carcinomas developed from the proliferation of T antigen-positive cells. However, T antigen expression was not seen in either the peripheral or central nervous systems. Stimulation of the metallothionein promoter with heavy metals altered the temporal onset of hepatic expression and broadened the distribution of oncogene expression to include exocrine pancreas and renal tubular epithelium. Although solid tumors were not seen in the exocrine pancreas or kidneys of SV-202 mice, all immunopositive tissues developed histologic changes. These results indicate that metallothionein directed T antigen expression can induce abnormal cellular growth in a variety of tissues, and the distribution of these tissues can be manipulated with heavy metals. PMID- 2782381 TI - Deendothelialization in vivo initiates a thrombogenic reaction at the rabbit aorta surface. Correlation of uptake of fibrinogen and antithrombin III with thrombin generation by the exposed subendothelium. AB - Purified radiolabeled fibrinogen and antithrombin III (ATIII) were injected intravenously into rabbits before a deendothelializing injury to the aorta, and allowed to circulate for 0.1 to 6 hours before exsanguination, excision of the aorta, and quantification of each protein/unit area of subendothelium (intima media). Uptake of fibrinogen was rapid (saturation 10 minutes after injury was approximately 13.0 pmol/cm2) compared with that of ATIII (45 to 60 minutes; 3.5 to 4.3 pmol/cm2). Both proteins associated primarily (greater than 90%) with the subendothelium rather than the platelet monolayer. The avidity of the deendothelialized vessel of these proteins was measured after a 20-minute circulation time at various intervals after injury. Whereas turnover of fibrinogen was fairly constant (approximately 100% per hour), that of ATIII was maximal (approximately 200% per hour) at 1 hour, decreasing to approximately 105% per hour at 5 hours after injury. The profile of ATIII turnover mirrored that of thrombin released in vitro from the deendothelialized aorta up to 10 days after injury, whereas the uninjured aorta and the aorta deendothelialized ex vivo adsorbed fibrinogen poorly and released negligible thrombin. Pretreatment of the aorta, deendothelialized ex vivo with thrombin in vitro increased fibrinogen uptake significantly. It is possible that, after deendothelialization in vivo, fibrinogen adsorption is determined largely by thrombin generation at the vessel wall. ATIII binding is limited by the availability of binding sites in the subendothelium, although the rate of thrombin generation influences ATIII turnover. PMID- 2782380 TI - Serum amyloid A in the mouse. Sites of uptake and mRNA expression. AB - Murine serum amyloid A1 (SAA1) and serum amyloid A2 (SAA2) are circulating, acute phase, high density apolipoproteins of unknown function. To pursue issues relating to their possible function their uptake and formation were studied. Kinetics of SAA protein distribution and gene expression after acute phase stimulation by casein or lipopolysaccharide were examined using immunocytochemistry for protein and RNA blot and in situ hybridization with probes for SAA1 and SAA2 mRNA. After casein injection, interstitial cells of testes, cells of adrenal cortex, kidney proximal convoluted tubule epithelia, and some parafollicular cells of spleen took up SAA in a time pattern related to plasma SAA levels. Extrahepatic SAA1 and SAA2 mRNA were induced by lipopolysaccharide in kidney proximal and distal convoluted tubule epithelia, and SAA1 mRNA was induced in epithelial lining the mucosa of the ileum and large intestine, indicating that there may be more than one function for the apoSAA gene family related to site of and stimulus for expression. PMID- 2782383 TI - Infection-induced struvite urolithiasis in rats. PMID- 2782382 TI - An evaluation of the neutrophil as a mediator of in vivo renal ischemic reperfusion injury. AB - Previous studies indicated that administration of a monoclonal antibody (MoAb 60.3), which blocks neutrophil adherence to rabbit endothelial cells, prevents ischemic-reperfusion (I-R) injury in multiple extrarenal organs. These findings indicated that the neutrophil can be a critical mediator of I-R tissue damage. To assess whether the neutrophil affects renal I-R injury, MoAb 60.3 was given to rabbits that were then subjected to either 50 minutes or 38 minutes of renal ischemia induced by renal artery occlusion (RAO). The severity of kidney damage was assessed 24 and 48 hours later by blood urea nitrogen and plasma creatinine concentrations and by renal histology. The results were compared with those obtained in time-matched RAO controls. MoAb 60.3 conferred no functional or morphologic protection against either severe or mild ischemic insults. To further evaluate whether neutrophils affect renal I-R injury, rats were depleted of neutrophils (less than 200 cells/mm3) by anti-neutrophil serum administration and then they were subjected to either 37 minutes or 29 minutes of RAO. Neutrophil depletion conferred neither functional nor morphologic protection when compared with time-matched RAO controls. It was concluded that the uniform lack of protection noted in these experiments, despite that two different animals, two different ways of interfering with neutrophil function, and differing severities of ischemic injury were studied, strongly suggests that the neutrophil is not a critical participant in the renal I-R injury process. PMID- 2782384 TI - Forskolin and caffeine induce Ca2+ release from intracellular stores in rabbit aorta. AB - We combined techniques of 45Ca efflux and computer-assisted kinetic analysis to investigate the effects of forskolin and caffeine on intracellular Ca2+ metabolism in intact rabbit aortic segments. When either 1 microM forskolin or 10 mM caffeine was present during the 45Ca load and efflux, the amount of 45Ca released from the tissue was reduced during the interval between 50 and 250 min of efflux. In contrast caffeine but not forskolin induced an acute increase in 45Ca efflux when added to the perfusion medium after 1 h of efflux in physiological salt solution. Preincubation with caffeine abolished phenylephrine stimulated 45Ca release, but preincubation with forskolin had no effect. Kinetic analysis of these data indicated that caffeine reduced the Ca2+ content of the same intracellular compartment depleted by phenylephrine, whereas forskolin depleted a different intracellular Ca2+ store. Forskolin-induced depletion of an intracellular Ca2+ store was surprising in light of current evidence suggesting adenosine 3',5'-cyclic monophosphate stimulation of sarcoplasmic reticular Ca2+ uptake, but hypotheses that included only this mechanism are inconsistent with our findings. PMID- 2782385 TI - Effect of pH on growth of mouse renal cortical tubule cells in primary culture. AB - We examined the effect of the medium pH on growth of primary cultures of mouse cortical tubule cells grown in defined medium. A significantly higher DNA content was observed within 24 h of lowering medium pH from 7.4 to 6.8 or 7.1 and persisted for the duration of the study. Further studies revealed that either medium acidification or insulin plus prostaglandin E1 nearly doubled uptake of [3H]thymidine in cells deprived of other growth factors for the previous 72-110 h. Moreover, the effects of insulin, prostaglandin E1, and medium acidification on [3H]thymidine uptake of quiescent cells were additive. An alkaline medium pH appeared to have a small but significant effect on cell hypertrophy, since cells exposed to pH 7.4 and 7.7 had a higher protein-to-DNA ratio than cells incubated at a lower pH. Cell pH of monolayers grown on glass slides determined from fluorescence of the carboxyfluorescein analogue 2',7'-biscarboxyethyl-5(6) carboxyfluorescein (BCECF) was linearly correlated with medium pH, and changes in medium pH resulted in changes in steady-state cell pH of a similar magnitude. Four hours after medium acidification, relative increases in cell Na+ and water content occurred, whereas medium alkalinization led to decreases in cell Na+ and water content. The increases in cell Na+ and cell water content at pH 6.8 could be inhibited by amiloride. We conclude that decreasing the cell pH can be a mitogenic stimulus for renal tubule cells. Medium acidification is accompanied by changes in cell Na+ transport, which may be mediated in part by altered Na+-H+ antiporter activity. PMID- 2782386 TI - Energy depletion-repletion and calcium transients in single cardiomyocytes. AB - Rapid fluctuations of intracellular free calcium in single adult rat heart myocytes were monitored by time-resolved fura-2 fluorescence microscopy. Under controlled aerobic conditions (35 degrees C, pH 7.3), electrical stimulation at 0.5 Hz produced a concave negative staircase of calcium transients. When the myocytes were challenged with 3 mM amobarbital (Amytal) and 2 microM carbonyl cyanide m-chlorophenylhydrazone (CCCP) to deplete ATP, the cells became unresponsive to electrical stimulation within 1 min but responded to 10 mM caffeine with a large increase in free calcium. After the development of rigor contracture, the cellular response to caffeine was blunted. Free calcium increased at a variable rate in individual cells, reaching values of 300-1,000 nM after 15 min. When the inhibitors were removed, calcium declined toward control values, and spontaneous contractile activity and calcium transients were invariably observed. During subsequent electrical stimulation, there was a decrease in the half-widths of the calcium transients and an attenuation of the negative staircase. Parallel experiments with cells in suspension indicated that Amytal and CCCP caused ATP to fall from 27.6 +/- 1.6 to 0.7 +/- 0.2 nmol/mg protein, and the percent rod-shaped cells to fall from 70 to 0% in 5 min. Removal of the inhibitors after 15 min caused a rebound in ATP to 5.3 +/- 1.5 nmol/mg within 2 min and 6.6 +/- 1.3 nmol/mg after 10 min. PMID- 2782387 TI - Cyanide toxicity in hepatocytes under aerobic and anaerobic conditions. AB - The effect of cyanide on cell viability and mitochondrial function was studied in hepatocytes exposed to air or argon. Cells were more susceptible to cyanide toxicity under air than under argon. Analysis of the disposition of cyanide showed that the difference in susceptibility to KCN was not due to O2-dependent differences in cyanide metabolism or elimination. Studies of mitochondrial function revealed that cyanide under aerobic conditions resulted in substantial swelling of the mitochondria, which corresponded to a matrix loading of phosphate. In addition, cyanide caused a loss of the mitochondrial protonmotive force. This was in contrast to the results for cells exposed to 30 min of anoxia alone in which there was no loss of mitochondrial delta pH, no detectable change in mitochondrial volume, and little matrix loading of phosphate. These results show that at least some of the protective mechanisms elicited by anoxia (B. S. Andersson, T. Y. Aw, and D. P. Jones. Am. J. Physiol. 252 (Cell Physiol. 21): C349-C355, 1987) are not elicited by cyanide alone. Thus cyanide under aerobic conditions does not provide a completely valid model for simple anoxia. Moreover, the results suggest that the molecular sensor necessary to signal suppression of metabolic and transport functions during neahypoxia is dependent on O2 and is neither stimulated nor antagonized by KCN. PMID- 2782388 TI - L-glutamate transport in internally dialyzed barnacle muscle fibers. AB - The transport of L-glutamate (Glu) by single muscle fibers of Balanus nubilus was studied by means of internal dialysis in an effort to obtain transport data under well-defined intracellular conditions. It is shown that the method effectively controls the sarcoplasmic amino acid composition and Glu metabolism. It was found that the classic neutral amino acid transport systems are either absent or inactive, while Glu is strongly transported by a single system. Nonsaturable Glu "leak" is small relative to mediated transport. Glu influx under 0-trans conditions obeys simple Michaelis-Menten kinetics and shows simple competition with aspartate. Influx is strictly dependent on external Na. Trans-Na reduces influx, whereas trans-Glu has a small stimulatory effect. The preparation may serve as a general model for muscle Glu transport and can be used for a thorough study of the kinetic mechanism. PMID- 2782389 TI - Participation of Ca currents in colonic electrical activity. AB - Canine colonic myocytes were studied with the whole cell patch-clamp technique. In 1.8 mM Ca2+, inward currents were evoked by depolarization. Currents activated positive to -50 mV, peaked at approximately 0 mV, and reversed at approximately +50 mV. Inward current was potentiated by high external Ca2+ concentration and BAY K8644 and was decreased by low external Ca2+, nifedipine, and Mn2+, indicating that the current was carried by Ca2+. Overlap of the activation inactivation properties indicated a "window current" range (-40 to -20 mV) in which inward current might be sustained for long durations at potentials achieved during electrical slow waves. Voltage-clamp protocols simulating physiological depolarizations elicited sustained inward currents. Maximum changes in intracellular Ca2+ resulting from sustained inward currents were calculated, which suggested that depolarizations at the level of slow waves may increase cell Ca2+ sufficiently to cause contraction. The data suggest that electrical slow waves in colonic myocytes are due in part to inward Ca current. This current appears to be sufficient to explain the relationship between slow waves and contractions and provides an explanation for the mechanical threshold in colonic muscles. PMID- 2782390 TI - Ca2+-activated K channels of canine colonic myocytes. AB - K channels in enzymatically dispersed circular smooth muscle cells from the canine proximal colon were studied with the patch-clamp technique. The most prominent channel in cell-attached and excised, inside-out patches was a K channel, which had slope conductances of approximately 100 pS at a holding potential of 0 mV in a physiological K+ gradient and approximately 200 pS in symmetrical 140 mM K+ solutions. The relative permeabilities of the channel for monovalent cations were 1.0 K+:0.5 Rb+: less than 0.07 Li+:less than 0.07 Na+. The channels were activated by potential and intracellular Ca2+. At Ca2+ concentrations less than 10(-7) M, channel openings were rare except at very positive potentials. At Ca2+ concentrations between 10(-7) and 10(-6) M the probability of channel opening increased steeply, and the voltage for channel activation shifted to a negative potential range, which cells experience during electrical slow wave events in situ. The effect of Ca2+ on the open-state probability of single channels was mainly due to a decrease in mean close time. Channels were blocked by 1 mM tetraethylammonium applied to the outside of the patch but up to 10 mM tetraethylammonium applied to the inside of the patch, and 4-aminopyridine applied to either side did not block the channel. The data suggest that this channel mediates a current important in the termination of electrical slow waves, which are the primary excitable event in colonic circular muscles. PMID- 2782391 TI - Muscarinic suppression of Ca2+-dependent K current in colonic smooth muscle. AB - Acetylcholine (ACh) increases the amplitude and duration of colonic electrical slow waves. This suggests that ACh either increases an inward current or suppresses an outward current. The latter hypothesis was tested in whole cell voltage-clamp experiments performed on freshly dispersed smooth muscle cells from canine proximal colon. Addition of ACh (10(-5) M) to solutions bathing cells reduced time-dependent outward currents elicited by depolarizing test pulses in the range of -45 to +30 mV. Analysis of tail currents showed that ACh caused a 10 to 15-mV positive shift in voltage-dependent activation. When cells were pretreated with 10(-6) M nifedipine to abolish the Ca2+-dependent component of the outward current, the reduction of outward current by ACh was blocked. Single channel experiments were performed to determine whether ACh had a direct effect on Ca2+-activated K channels. ACh, 10(-5) M, added to bath and pipette solutions caused a positive shift in voltage-dependent activation in on-cell experiments. This effect of ACh on Ca2+-activated K channels provides a mechanism for the effects of muscarinic, excitatory stimulation of circular muscle of the colon. PMID- 2782392 TI - Utility of AICAr for metabolic studies is diminished by systemic effects in situ. AB - It has been reported that intraperitoneal infusion of 5-amino-4 imidazolecarboxamide riboside (AICAr) inhibits the purine nucleotide cycle, resulting in rapid fatigue of isometric twitch force during stimulation of rat muscle. In this study, peak isometric twitch force was recorded from gastrocnemius muscles of pentobarbital-anesthetized rats stimulated in situ at 0.75 Hz after intraperitoneal infusion of 9ml/100 g body wt of 250 mM AICAr or isotonic saline. Excluding the two AICAr-infused rats that died during infusion or stimulation, there was no difference in twitch force between groups, although mean arterial pressure in the AICAr group declined to values 20 Torr below those of the control group during drug infusion. High-resolution 1H nuclear magnetic resonance (NMR) spectroscopy of extracts verified the presence of AICAr and AICA ribotide (AICAR) in muscles of experimental animals. In a second study in which rats were mounted head down in an NMR spectrometer, AICAr infusion resulted in decreased mean arterial pressure and impairment of phosphocreatine recovery after stimulation but no significant difference in twitch force during stimulation. These results demonstrate that AICAr infusion has systemic effects and that the previously reported decline in muscle force with AICAr infusion may not be attributable to purine nucleotide cycle inhibition. PMID- 2782393 TI - Cl-Cl exchange in promyelocytic HL-60 cells follows simultaneous rather than ping pong kinetics. AB - The intra- and extracellular chloride concentration dependencies of the rate of Cl-Cl exchange in human promyelocytic leukemic HL-60 cells were studied by means of radioactive isotope (36Cl) efflux measurements. Efflux of isotope from cells follows an exponential time course. The Cl-Cl exchange flux follows Michaelis Menten kinetics as a function of both intra- and extracellular chloride concentrations. The ratio of the maximum exchange velocity to the apparent Michaelis constant for both extracellular and intracellular substrate increases as a function of trans Cl concentration, indicating that Cl-Cl exchange in the HL 60 cell does not follow ping-pong kinetics. A kinetic scheme in which extracellular and intracellular chloride ions bind in random order to the transporter and are then translocated simultaneously can adequately model the experimental data. PMID- 2782394 TI - Flow cytometric identification and isolation of hypertrophic type II pneumocytes after partial pneumonectomy. AB - Type II pneumocytes were isolated by either Percoll density gradient centrifugation or by immunoglobulin G (IgG) panning from the lungs of normal rats and the right lung of rats subjected to left pneumonectomy. Cells were studied at 7- (pnx-7) and 15- (pnx-15) days postoperative, times during and after, respectively, rapid compensatory growth of the right lung. Acridine orange staining permitted resolution of type II cells from contaminants on the basis of high red fluorescence (greater than 590 nm). Simultaneous measurement of forward angle light scatter (FALS) suggested a shift of pnx-7 cells toward greater size, which was reversed in pnx-15 cells. By Percoll gradient isolation, approximately 15% of pnx-7 cells analyzed were above the mean FALS of control cells. In contrast, approximately 30% of the pnx-7 cells isolated by IgG panning were above the mean FALS of corresponding control cells. Biochemical analyses of pnx-7 cells separated by cell sorting into "high FALS" and "low FALS" subgroups revealed that high FALS type II cells contained 50% more protein (P less than 0.05) and 140% more RNA (P less than 0.01) than low FALS cells, with no significant change in cellular DNA content. These data are consistent with previous studies of type II cells isolated from the lungs of pneumonectomized animals and confirm the presence of hypertrophic cells in these preparations. They provide a foundation from which to design further flow cytometric studies of the role of hypertrophic type II pneumocytes in compensatory lung growth. PMID- 2782396 TI - Phallacidin prevents thrombin-induced increases in endothelial permeability to albumin. AB - Calf pulmonary artery endothelial monolayers cultured on polycarbonate filters were utilized to study 125I-labeled albumin permeability and actin filament distribution in response to thrombin challenge. Thirty-minute exposure to alpha thrombin (10(-7) M) significantly increased albumin clearance rates. These changes were associated with marked alterations in actin filament distribution, resulting in loss of peripheral actin bands and an increase in the number of cytoplasmic stress fibers. Because the actin peripheral filaments are thought to play an important role in junctional stability, we postulated that stabilization of actin filaments should protect against thrombin-induced barrier disruptions. Pretreatment of cells with 0.3 microM 7-nitrobenz-2-oxa-1,3-diazole (NBD) phallacidin, a specific actin-stabilizing agent, prevented the changes in actin filament distribution and markedly attenuated the increase in albumin permeability. Because of the potential toxicity of phallatoxins, we evaluated the effects of pretreatment on cell viability and growth parameters. There were no differences in viability, seeding efficiency, or doubling times in cells treated with 0.3 microM NBD-phallacidin in comparison to controls. Our data support the hypothesis that actin filaments, particularly peripheral bands, contribute significantly to the maintenance of barrier function in cultured endothelial cells. PMID- 2782395 TI - Properties and physiological function of the polyamine transport system. AB - Polyamine transport was examined in Chinese hamster ovary (CHO) cells because of the unique potential these cells hold for utilizing genetic approaches to study the mechanisms of polyamine transport, its regulation, and its function. Parental (control) CHO cells were shown to contain a polyamine transport system with characteristics consistent with polyamine-uptake properties described in other cell types. Polyamines appear to cross the plasma membrane via an energy requiring transport system specific for putrescine, spermidine, spermine, and their analogues. A mutant line, CHOMG, selected for resistance to the toxicity of methylglyoxal bis(guanylhydrazone), was shown to lack a functional polyamine transport system. CHOMG cells provided the negative controls necessary to examine the role of polyamine transport in maintenance of intracellular polyamine levels and in the regulation of the polyamine metabolic enzymes. It was found that the repression of ornithine decarboxylase activity by polyamines and the induction of spermidine/spermine-N1 acetyltransferase by polyamine analogues including bis(ethyl)spermine derivatives required the presence of a functional polyamine transport system. The CHO-CHOMG model was also shown to provide a means for establishing the importance of the polyamine transport system in the toxicity of polyamine analogues. The inability of alpha-difluoromethylornithine-treated CHOMG cells to utilize extracellular polyamines to replenish depleted intracellular polyamine levels suggested a means by which polyamine transport-positive cells may be identified. Such a selection procedure will permit the use of CHOMG cells in the isolation of genes encoding proteins involved in polyamine transport. PMID- 2782397 TI - Localization of spermidine uptake in rabbit lung slices. AB - The lungs have a high polyamine transport capability, and the type II pneumocyte has recently been identified as a major site of putrescine uptake and localization (N. A. Saunders, P. J. Rigby, K. F. Ilett, and R. F. Minchin. Lab. Invest. 59: 380-386, 1988). However, recent evidence suggests that multiple polyamine transport systems exist. In the present study, localization of spermidine uptake in rabbit lung was investigated. Although [14C]spermidine was rapidly accumulated by lung slices, it was not significantly metabolized, and no efflux of the accumulated polyamine was apparent. Autoradiographs prepared after [3H]spermidine transport revealed a localization of uptake activity to cells identified by electron microscopy as type II pneumocytes. Spermidine uptake occurred in all type II cells examined and thus appeared to be a characteristic function of this cell type. In contrast, spermidine uptake was virtually absent in the major airways and blood vessels, whereas moderate uptake was associated with pulmonary alveolar macrophages and alveolar tissue. Subsequent purification and culture of type II pneumocytes showed these cells to have significant polyamine uptake activity. In addition, spermidine uptake activity was positively correlated with the proportion of type II cells present at the various stages of their purification. In other studies, cultured pulmonary alveolar macrophages possessed similar uptake activity to that of cultured type II cells. Combined, these data suggest that both type II cells and pulmonary alveolar macrophages may represent major sites of spermidine uptake in vivo. We also suggest that the transport of polyamines by type II cells may reflect a critical role for polyamines in a characteristic function of this cell type. PMID- 2782398 TI - Coronary hemodynamics and myocardial metabolism during and after pacing stress in normal humans. AB - We investigated coronary hemodynamics, myocardial utilization of circulating substrates (by coronary sinus catheterization), and overall use of oxidative fuels (by regional indirect calorimetry) in healthy adults during incremental atrial pacing (up to 159 +/- 9 beats/min), and during 25 min of recovery. Great cardiac vein flow (thermodilution) increased from 52 +/- 9 to 115 +/- 15 ml/min (P less than 0.001) with pacing; myocardial O2 uptake (301 +/- 53 to 593 +/- 71 mumol/min, P less than 0.001) and CO2 production (225 +/- 37 to 518 +/- 66 mumol/min, P less than 0.005) paralleled the pacing-induced rise in rate-pressure product (9.4 +/- 0.9 to 21.1 +/- 1.1 mmHg.beat. min-1.10(-3), P less than 0.001). During recovery, all the above variables returned to base line within 5 min, but myocardial O2 extraction remained depressed (67 +/- 2 vs. 71 +/- 3%, P less than 0.05). Circulating glucose uptake rose linearly with pacing (P less than 0.05) and remained above base line throughout recovery. By contrast, free fatty acid (FFA) uptake (10 mumol/min) did not increase with pacing and fell during recovery (P less than 0.01). Calorimetry, however, showed that net lipid oxidation exceeded FFA uptake throughout the study, whereas net carbohydrate oxidation was small at base line, rose significantly at maximal pacing (62% of myocardial energy output), and remained above base line during recovery (32% of energy output). In the basal state as well as during recovery, myocardial uptake of glucose equivalents (lactate plus glucose plus pyruvate) was in excess of carbohydrate oxidation, indicating nonoxidative disposal of these substrates.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2782399 TI - Epinephrine mediates facultative carbohydrate-induced thermogenesis in human skeletal muscle. AB - The thermic effect of carbohydrate has a component mediated by the sympathoadrenal system but of unknown anatomical localization. We have studied the contribution of skeletal muscle to the thermic effect of a carbohydrate-rich natural meal (115 g of carbohydrate, approximately 80% of energy) by means of the forearm technique on two occasions, with and without intravenous beta-blockade with propranolol. The meal-induced thermogenesis was reduced from 9.6 to 7.1% by beta-blockade (P less than 0.04), the major difference was found 90 to 240 min after the meal. The postprandial increments in plasma glucose and lactate did not change by beta-blockade, but there was a trend toward a decreased insulin response (P = 0.06). The carbohydrate-induced increase in forearm oxygen consumption was reduced by 23% after beta-blockade (P less than 0.05), the entire difference being present 90-180 min postprandially and coinciding with the peak in arterial epinephrine. The present study provides evidence of a facultative thermogenic component in skeletal muscle, mediated by epinephrine via beta 2 adrenoreceptors. However, it also points to a nonmuscle component mediated through beta 1-adrenoceptors by norepinephrine released from the sympathetic nervous system. Consequently, the sympathoadrenal system seems to play a physiological role in the daily energy balance. PMID- 2782400 TI - Glucose recycling and production in glycogenosis type I and III: stable isotope technique study. AB - Glucose carbon recycling, endogenous glucose production, and glucose turnover rates were measured, by stable isotope methodology, in five patients with glycogen storage disease type I (GSD-I), two patients with glycogen storage disease type III (GSD-III), and three control children. A primed-constant infusion of D-[U-13C]glucose was administered nasogastrically to fasted subjects. The isotopic enrichments and 13C isotopomer distribution of plasma glucose were measured by chemical ionization gas chromatography mass spectroscopy. In response to increasing rates of glucose infusion, endogenous glucose production decreased, whereas the rate of glucose appearance or total glucose flux increased. Recycling of infused D-[U-13C]-glucose, calculated from changes in the isotopomer distribution of plasma [13C]glucose, was not detectable in GSD-I but reached 50% in GSD-III. In GSD-I the gluconeogenic pool was found to be highly labeled and recycled, whereas plasma glucose was diluted but not recycled. It is suggested that in GSD-I dilution of plasma glucose is due to release of glucose from branch points in glycogen. We propose that studies of the extent of glucose recycling and of isotopic enrichment of gluconeogenic precursors can be used as a noninvasive test for diagnosis of GSD-I and other defects in glucose production. PMID- 2782401 TI - Vasopressin is metabolized by a trypsinlike enzyme in guinea pig amniotic fluid. AB - We have demonstrated that arginine vasopressin (AVP) is degraded to desglycinamide AVP by a trypsinlike enzyme found in guinea pig amniotic fluid. Incubation of [3H]AVP with guinea pig amniotic fluid in vivo or in vitro produced a metabolite that comigrated on high-pressure liquid chromatography with desglycinamide AVP in three different buffer systems. Also, AVP antisera that cross-reacted with standard desglycinamide AVP could detect this amniotic fluid metabolite. Because the enzyme responsible for the cleavage of glycinamide from AVP was likely to be trypsin, experiments with aprotinin, a trypsin inhibitor, were conducted. Results demonstrated that the production of the amniotic fluid AVP metabolite could be completely blocked in the presence of the trypsin inhibitor. In addition, examination of amniotic fluid collected from fetuses in the second half of gestation (term = 68 days) showed that AVP could not be metabolized to desglycinamide AVP until after 52 days of gestation. In conclusion, AVP appears to be metabolized by a trypsinlike enzyme in amniotic fluid, and because trypsin is a general proteolytic enzyme, the amniotic compartment may also serve as a clearance site for other proteins. PMID- 2782402 TI - Plasma reciprocal pool specific activity predicts that of intracellular free leucine for protein synthesis. AB - We previously proposed that, during the infusion of either labeled leucine or its alpha-ketoacid, alpha-ketoisocaproate (KIC), the plasma specific activity (SA) of the transaminated product of the infused tracer ("reciprocal pool SA") may better reflect the intracellular leucine SA than the plasma SA of either infused tracer ("primary pool SA"). To test this hypothesis, 14 dogs were simultaneously infused intravenously with [3H]leucine and [14C]KIC, and blood and tissue compartments were sampled. The ratios of [3H]-leucine to [14C]leucine [( 3H]/[14C]leucine) in mixed tissue proteins and in the intracellular space of striated muscle were the same as the ratio of the isotope infusion rates and similar, although slightly lower (P less than 0.01), than [3H]KIC/[14C]leucine SA (ratio of reciprocal pool SA) in plasma. Plasma [3H]KIC/[14C]leucine SA were essentially identical to the [3H]/[14C] of leucine in 1) mixed liver proteins, 2) intrahepatic free leucine, and 3) fibrin. The [3H]/[14C]leucine in mixed renal proteins and in the intracellular space of kidney and erythrocytes were similar to those of the venous plasma [3H]/[14C]leucine SA. The plasma [3H]KIC and [14C]leucine SA (the reciprocal pool SA) were similar to the SA of [3H]- and [14C]leucine in the intracellular space of all organs investigated with the exception of kidney. Therefore, in postabsorptive dogs, the plasma SA of the transaminated product of the infused labeled KIC or leucine is an excellent predictor of the intracellular leucine SA in all tissues investigated with the exception of kidney. PMID- 2782403 TI - Stimulation of protein turnover by carbohydrate overfeeding in men. AB - The effect of carbohydrate overfeeding on protein metabolism was studied in 11 healthy men. Total urinary nitrogen output during 10 days of carbohydrate overfeeding (1,600 extra kcal/day) decreased 27% relative to nitrogen excretion during 10 days of weight maintenance, indicating protein accretion during over feeding. However, postabsorptive nitrogen excretion did not change, which means that the positive nitrogen balance associated with overfeeding results from enhanced postprandial nitrogen retention. Overfeeding reduced postabsorptive glucose concentrations 4 +/- 1% and increased glucose production rate 14 +/- 2% and glucose clearance 17 +/- 4%. Overfeeding increased plasma concentrations of insulin, glucagon, and 3,5,3'-triiodothyronine approximately 20%. Alanine and branched-chain amino acid concentrations were increased after overfeeding, but serine, threonine, and asparagine concentrations were reduced. Postabsorptive leucine flux, which is an index of proteolysis, was measured using L-[1 13C]leucine as a tracer. Overfeeding increased leucine flux 13 +/- 2% compared with values after 10 days on a weight-maintenance diet. If it is assumed that overfeeding did not alter the fraction of 13CO2 not recovered in breath, there was no change in the portion of leucine flux that was oxidized. Thus the difference between flux and oxidation, which is a theoretical index of protein synthesis, increased 12 +/- 3% after overfeeding. These data suggest that excess caloric intake, without an increase in protein intake, stimulates post-absorptive proteolysis and protein synthesis. PMID- 2782404 TI - Optimal design of sampling schedules for studying glucose kinetics with tracers. AB - Minimum size sampling schedules for estimating glucose kinetic parameters from an impulsive (bolus) tracer injection in normal humans and rats are presented. Glucose kinetics are described by a two-compartment linear model, and reference values of the parameters are estimated from a data base with many samples. The optimal sampling schedule (OSS) is determined in each individual by using a D optimal criterion and consists of four samples. A population optimal sampling schedule (POSS) applicable to all the individuals of a given population is then determined, and its reliability and efficiency in recovering kinetic parameters (e.g., rate constants, plasma clearance rate, and mean residence time) is assessed. The influence of model and measurement error on OSS is discussed. Moreover, the adoption of an enhanced POSS (EPOSS, 8 samples) is shown to improve accuracy and precision of parameter estimates in a predictable manner. Finally some suggestions are given for obtaining more information from turnover studies using a constant infusion of tracer, with or without a priming pulse of tracer. PMID- 2782405 TI - Human insulin receptor radioimmunoassay: applicability to insulin-resistant states. AB - A radioimmunoassay of the human insulin receptor was developed employing a potent rabbit polyclonal antibody to the human insulin receptor and a highly purified human placental insulin receptor preparation. The receptor, obtained by sequential affinity chromatography with insulin receptor monoclonal antibody agarose and wheat germ agglutinin-agarose, was radiolabeled with 125I-Bolton Hunter reagent at specific activities of 2,100-3,300 Ci/mmol. Over 75% of this ligand was immunoprecipitable with the polyclonal antireceptor antibody and remained immunoprecipitable for greater than 45 days. The assay was sensitive to unlabeled receptor concentrations as low as 0.2 ng/0.5 ml; unlabeled insulin did not cross-react and unlabeled insulin-like growth factor (IGF)-I receptor cross reacted weakly. The radioimmunoassay was applicable to the measurement of insulin receptors in tissues and cells that were extracted by solubilization in 1% Triton X-100; no purification of the extracted receptor was necessary. Of the three major target tissues for insulin action studied, liver had the highest concentration of receptors (47.6 ng/mg protein); fat and muscle had lower levels. Other studies with the radioimmunoassay indicated that insulin receptors were decreased both in monocytes from obese hyperinsulinemic subjects and in fibroblasts from patients with leprechaunism. PMID- 2782406 TI - Inhibition of antral gastrin cells by peptide histidine isoleucine. AB - The present studies were directed to determine whether peptide histidine isoleucine (PHI), like its structural analogues secretin and gastric inhibitory peptide, inhibits antral gastrin. In separate experiments, the effects of PHI on medium gastrin concentrations, the incorporation of [35S]methionine into newly synthesized gastrin, and steady-state gastrin mRNA were determined. The inclusion of PHI in the incubation medium decreased medium gastrin levels at all concentrations examined, an effect that was not altered by the addition of 10(-6) M tetrodotoxin to the medium. PHI also inhibited the incorporation of [35S]methionine into newly synthesized gastrin in a concentration-dependent manner. Steady-state levels of gastrin mRNA were determined by dot-blot hybridization, using a 32P-labeled gastrin cRNA probe. PHI inhibited gastrin mRNA levels in a concentration-dependent manner; in contrast, no effect on the levels of actin and ubiquitin mRNA could be detected, indicating specificity of PHI on gastrin mRNA. The results of these studies indicate that PHI may exert a physiological inhibitory effect on antral gastrin cells and that this inhibition may occur at several steps along the biosynthetic pathway. PMID- 2782407 TI - A microelectrode study of responses to secretagogues by epithelial cells on villus and crypt of rat small intestine. AB - The cellular origin of the response to secretagogues in small bowel epithelium was investigated by recording the effect of 5-hydroxytryptamine (5-HT, 10(-4) mol/l), acetylcholine (10(-4) mol/l), and prostaglandin E2 (PGE2, 10(-5) or 10( 4) mol/l) on apical membrane potentials (Va) of crypt and villus cells of rat ileum and jejunum in vitro using intracellular microelectrodes. Experiments were performed under visual control; addition of secretagogues and other manipulations were carried out during single impalements. Under basal conditions, apical membrane potential differences were consistently higher in jejunum than ileum ( 72 +/- 1 vs. -47 +/- 2 mV, respectively, for villus impalements; -61 +/- 2 mV vs. -57 +/- 1 mV, respectively, for crypt impalements), and in jejunum villous membrane potentials exceeded those in the crypt. In the ileum, this crypt-villus gradient was reversed. The three secretagogues increased transmural potential difference and transiently reduced Va in cells in both crypt and villus regions by 8 mV or more. Fractional apical membrane resistance (FR) declined in ileum by approximately 30% in response to 5-HT and PGE2, whereas little change in FR was observed in jejunal recordings. PGE2 was ineffective in crypt and villus when Cl- was replaced by gluconate in both the luminal and serosal perfusates but depolarized the apical membrane in both regions after serosal restoration of Cl- from -76 +/- 4 to -56 +/- 8 mV in villus and from -58 +/- 4 to -45 +/- 6 mV in crypt. Rapid luminal Cl- substitution depolarized Va on the villus from -77 +/- 2 to -74 +/- 3 mV, but this effect was enhanced in the presence of PGE2, reducing Va from -65 +/- 8 to -43 +/- 12 mV. Prior to PGE2 addition, Va was -81 +/- 4 mV for this group of experiments. FR rose in the nominal absence of luminal Cl- from 0.69 +/- 0.09 to 0.77 +/- 0.06. It is concluded that because a Cl(-)-dependent depolarization of apical membrane potentials occurs in villi and crypts, net secretion in the small bowel is probably not confined to the crypts and may also occur from villous epithelium. PMID- 2782408 TI - Gastric and pancreatic intrinsic factor-mediated absorption of cobalamin in the dog. AB - The effects of canine gastric and pancreatic intrinsic factors on uptake and subcellular localization of cobalamin have been investigated in vivo to determine whether these proteins could mediate the physiological absorption of cobalamin in the dog. Cyano [57Co]cobalamin was introduced into ileal loops in dogs under general anesthesia, either free (control) or bound to gastric or pancreatic intrinsic factor. At 2 h, total uptake of cobalamin by ileal mucosa was significantly enhanced after prior binding to either gastric or pancreatic intrinsic factor compared with controls. Displacement of receptor-bound cobalamin with EDTA showed that enhanced total uptake reflected increased internalization of cobalamin by both proteins. Findings after reorienting sucrose density gradient centrifugation of ileal mucosa from loops containing intrinsic factor cobalamin complexes were consistent with a major lysosomal and perhaps endosomal localization of internalized cobalamin, in agreement with results after oral administration of cobalamin. In marked contrast, cobalamin was recovered predominantly in the soluble fractions and was not associated with particulate subcellular organelles in ileal mucosa from control loops. These findings suggest that both gastric and pancreatic intrinsic factors can promote the physiological absorption of cobalamin by receptor-mediated endocytosis in the dog. PMID- 2782409 TI - Na-HCO3 cotransport in rabbit parietal cells. AB - Na- and HCO3-coupled recovery of intracellular pH (pHi) after acid loading was demonstrated in rabbit parietal cells. Intracellular pH of individual resting (i.e., cimetidine treated) parietal cells was continuously measured using microspectrofluorometry of the pH sensitive dye 2',7'-bis(2-carboxyethyl)-5(6) carboxyfluorescein, acetoxymethylester. Parietal cells were acidified utilizing NH4Cl or by lowering external pH to 6.2. By means of either technique pHi decreased from 7.1 to approximately 6.6. In solutions containing 1 mM amiloride, which blocked Na-H exchange, pHi recovered only if Na and HCO3 were both present. This amiloride-resistant, Na- and HCO3-dependent pHi recovery was inhibited by 100 microM H2 4,4'-diisothiocyanostilbene-2,2'-disulfonic acid (reversibly) and occurred at equal rates in Cl-containing and Cl-free solutions. In NaCl solutions buffered with HCO3-CO2 and containing amiloride, after an acid load pHi recovers to pHi 7.0-7.1 solely through the activity of the Na-HCO3 cotransporter. Therefore, resting parietal cells appear to have a Na-HCO3 cotransporter that serves as a base loader under physiological conditions. PMID- 2782410 TI - Blockade of 5-HT-mediated enteric slow EPSPs by BRL 24924: gastrokinetic effects. AB - Two types of 5-hydroxytryptamine (5-HT) receptor, 5-HT1P and 5-HT3, have been identified physiologically on enteric neurons impaled by intracellular microelectrodes. Activation of 5-HT1P receptors evokes a long-lasting membrane depolarization associated with an increased input resistance, whereas stimulation of 5-HT3 receptors results in a brief depolarization during which the input resistance falls. Slow excitatory postsynaptic potentials (EPSPs) in myenteric type II-hyperpolarizing afterpotential (AH) neurons have been demonstrated to be mediated by 5-HT1P receptors. The current experiments were done to determine whether the substituted benzamide, BRL 24924, is a specific antagonist at 5-HT1P receptors and can be used as a probe to investigate the role played by serotoninergic neurons in the control of gastrointestinal motility. Intracellular microelectrodes were used to analyze the effects of BRL 24924 on guinea pig myenteric neurons. Microejection of BRL 24924 mimicked neither the long-lasting nor the brief response to 5-HT; however, BRL 24924 (0.5-1.0 microM) reversibly antagonized both the long-lasting 5-HT1P receptor-mediated responses of myenteric neurons to 5-HT and 5-HT-mediated slow EPSPs. A greater than 10-fold higher concentration of BRL 24924 was required to reduce the short-lived responses mediated by 5-HT3 receptors. BRL 24924 did not affect the response of myenteric neurons to substance P. These results indicate that BRL 24924 is primarily a 5 HT1P antagonist. Unlike other 5-HT1P agonists or antagonists, BRL 24924 did not block the binding of 5-[3H]HT to 5-HT1P receptors. This observation suggests that specific antagonism of physiological responses to 5-HT by BRL 24924 may be the result of an action on the coupling of the 5-HT1P receptor to its effector mechanism. BRL 24924 (0.5-1 mg/kg) and another 5-HT1P antagonist, N-acetyl-5 hydroxytryptophyl-5-hydroxytryptophan amide (5 mg/kg), significantly increased the rate of emptying of a 51Cr-labeled liquid meal from the murine stomach. In contrast, the 5-HT3 antagonist, ICS 205-930 (0.1-0.5 mg/kg), did not affect the rate of gastric emptying. These observations are consistent with the hypothesis that intrinsic inhibitory neurons of the murine stomach are activated by serotoninergic axons acting through 5-HT1P receptors. Antagonism of an excitatory drive to neurons in a relaxant pathway may thus explain the gastrokinetic effects of BRL 24924. PMID- 2782411 TI - Effect of duodenectomy on interdigestive pancreatic secretion, gastrointestinal motility, and hormones in dogs. AB - We tested the hypothesis that the duodenum is necessary to coordinate interdigestive pancreatic trypsin secretion with gastrointestinal motility and determined whether duodenectomy altered interdigestive cycles of plasma motilin and pancreatic polypeptide and their relationship to trypsin secretion and motility. Consequently, in normal and duodenectomized dogs, we measured trypsin secretion, gastrointestinal motility, and plasma concentrations of motilin and pancreatic polypeptide during the interdigestive period. After duodenectomy, peaks of trypsin secretion continued to cycle at normal intervals (102 +/- 15 min), but the amounts of trypsin were reduced during peaks of secretion (P = 0.02) and throughout the entire cycle (P = 0.02). Trypsin secretory cycles after duodenectomy, however, were not coordinated with cycles of interdigestive motility, and the plasma concentrations of motilin (P = 0.02) and pancreatic polypeptide (P = 0.05) were reduced and had no cyclic pattern. In addition, we confirmed that duodenectomy alters canine interdigestive antral motility, interrupts coordination between antral and intestinal motility, and shortens the period of jejunal migrating motor complexes. We conclude that duodenectomy disrupts the relationship between the cycles of interdigestive gastrointestinal motility and trypsin secretion and reduces the amount of interdigestive trypsin secretion. These effects of duodenectomy may be due to interruption of the duodenopancreatic neural connections or the hormonal abnormalities we have described. The loss of the cyclic pattern of plasma pancreatic polypeptide after duodenectomy suggests that the duodenum controls the release of pancreatic polypeptide by either a neural or hormonal mechanism. PMID- 2782412 TI - Spatial and temporal patterns of human jejunal contractions. AB - We recorded human jejunal motor activity by a 12-lumen manometric tube with recording sites 2 cm apart. The contractile activity in the fasted and the fed state was analyzed by computer to define the spatial and temporal patterns of contractions. Mean duration and area of single contractions during phase III activity were not different from those during phase II activity. By contrast, the frequency and amplitude of contractions, their propagation distance, and the percentage of contractions that propagated for greater than or equal to 2 cm were significantly greater during phase III than during phase II activity. The mean frequency and percentage of propagated contractions in the fed state were intermediate between those during phase II and phase III activity. Mean propagation distance of postprandial contractions was not different from that of phase II contractions. Most contractions in the fed state were uncoordinated at adjacent recording sites. Occasionally, large-amplitude and long-duration contractions, called individual migrating contractions, propagated over long distances and frequently over the entire 22-cm study segment. We conclude that there are some significant differences between the spatial and temporal patterns of contractions between the fed state and phase II and phase III activity. The largely disorganized phasic contractions in the fed state may cause mostly mixing of the ingested meal and its slow distal propagation, whereas the infrequent individual migrating contractions may rapidly propel intestinal contents over longer distances. PMID- 2782413 TI - Effect of aluminum on bidirectional calcium flux in rat everted intestinal sacs. AB - The effect of aluminum on intestinal calcium absorption was determined in male Sprague-Dawley rats using an everted intestinal sac technique. Bidirectional calcium flux in the duodena and ilea of normal rats was assessed by means of dual calcium isotopes. Two micromolar aluminum significantly inhibited net calcium absorption (J net) in the duodenum through suppression of mucosato-serosa flux (J m----s). Jm----s was reduced from 2.21 +/- 0.50 mumol Ca.h-1.g wet wt-1 in controls to 0.93 +/- 0.35 mumol Ca.h-1.g-1 in aluminum exposed sacs, and Jnet was reduced from 1.88 +/- 0.14 mumol Ca.h-1.g-1 to 0.55 +/- 0.41 mumol Ca.h-1.g-1 (P less than 0.001). Serosa-to-mucosa calcium flux (Js----m) was not similarly influenced by aluminum. Inhibition of Jm----s occurred whether aluminum was initially present on the mucosal or serosal side of the duodenal sac and inhibition of Jnet calcium by 2 muM A1 occurred at all ambient concentrations of calcium studied. In the ileum, aluminum had no effect on any component of calcium flux. Aluminum did not induce any suppression of glucose transport in either the duodenum or ileum, suggesting that the effect on calcium transport is relatively specific. These results suggest that aluminum inhibits calcium absorption in the duodenum through an effect on active mucosa-to-serosa transport, but has no effect on ileal calcium absorption, which in the rat is not mediated by an active process. PMID- 2782414 TI - Rat intestinal lymph osmolarity during glucose and oleic acid absorption. AB - The two major purposes of this study were to determine 1) how glucose and oleic acid absorption by the intestinal villi influenced the osmotic composition of lymph as it exited the villus base and 2) what if any changes in lymph osmolarity occurred as the lymph traversed through the bowel wall. The rat jejunum was used in all studies and lymph was collected from individual lymphatics at 0.5-1 nl/min during control states and luminal exposure to 35-550 mg% glucose solutions (isotonic in saline) and 5 and 20 mM oleic acidtaurocholate solutions. Lymph collected from the base of villi during vigorous motility had an osmolarity of 403 +/- 15 mosM at rest and was only increased 30-50 mosM more except during exposure to 550 mg% glucose, where osmolarity increased over 100 mosM. Under comparable conditions, the submucosal lymph osmolarity at rest was 302 +/- 3.5 mosM and increased to 330-350 mosM during exposure to all of the solutions tested. When intestinal motility was virtually stopped, the submucosal lymph osmolarity was isotonic for all solutions tested. These observations indicate that absorption of glucose and oleic acid increased the osmolarity of lymph, leaving the villus only 30-50 mosM unless a glucose concentration of 550 mg% was present. Furthermore, the increased flow of villus lymph during absorption raised the osmolarity of the submucosal lymph when bowel motility assisted the lymph propulsion. This movement of materials from the villus to the submucosa by venular blood and lymph flow provides an opportunity for the villus tissue to influence the composition of the submucosal interstitial environment. PMID- 2782415 TI - Postprandial changes in intestinal slow-wave propagation reflect a decrease in cell coupling. AB - The purpose of these studies was to determine the effects of feeding on jejunal slow-wave propagation velocity (SWPV). Nine cats were instrumented with six pairs of electrodes implanted 4 cm apart on the jejunum. Electrical activity was recorded at the end of an 18-h fast after which each animal was fed 60 g of canned cat food. Recordings were continued during feeding and for several hours thereafter. This procedure was repeated at least twice for each cat. Average SWPV (cm/s) decreased from a fasting level of 2.28 +/- 0.20 (mean of means +/- SE) to 1.93 +/- 0.16 at 10-20 min, 1.51 +/- 0.11 at 1 h, and 1.37 +/- 0.10 at 3 h postprandially. Corresponding SW frequencies (SWFs) were 19.6 +/- 0.3, 18.7 +/- 0.2, 19.2 +/- 0.2, and 19.0 +/- 0.2 cycles/min, respectively. The differences between the fasting SWPV and that at 1 and 3 h were significant (P less than 0.05). When SWPV was plotted as a function of SWF, the slopes of the corresponding curves were also found to decrease postprandially (P less than 0.05, fasting vs. 1 and 3 h). There was no apparent change in SW amplitude, maximum rate of SW depolarization, or threshold. In the absence of changes in these parameters, the divergence of the slopes at lower SWFs indicates that the decrease in SWPV is because of increased internal resistance, probably the result of uncoupling of intestinal muscle cells. The change is rapid in onset and long in duration, suggesting that an uncoupling factor is released during ingestion of a meal, and that its effect persists for several hours. PMID- 2782416 TI - Erythromycin is a motilin receptor agonist. AB - Erythromycin A (EMA) is a potent stimulator of gastrointestinal motor activity. In vitro studies suggest that it mimics motilin, a peptide that stimulates motor activity in human and in rabbit via smooth muscle receptors. We have compared the in vitro contractile effect of EMA and two derivatives, 8,9-anhydro-EMA-6,9 hemiketal (EM201) and EMA N-oxide, on rabbit duodenal smooth-muscle strips with their ability to displace iodinated motilin bound to crude smooth-muscle membrane fractions. The concentrations required to induce 50% of the maximum contractile response to a supramaximal dose of acetylcholine were 5.0 x 10(-8), 2.0 x 10(-6), and 1.0 x 10(-4) M for, respectively, EM201, EMA, and EMA N-oxide. The concentrations required to displace 50% of the labeled motilin were, in the same order, 1.0 x 10(-8), 1.3 x 10(-7), and 4.0 x 10(-6) M. Both parameters were well correlated. The dose-response curve of the EMA was parallel to that of motilin and the effects of motilin and EMA were additive. Contractions induced by EMA were insensitive to pretreatment with tetrodotoxin or atropine. EMA had no effect on muscle strips of rat or dog duodenum but did induce contractions in human strips. EMA was totally ineffective on ileal preparations, which are also unresponsive to motilin and in which motilin binding is absent. EMA has therefore the same regional and species specificity as motilin. We conclude that EMA is a motilin receptor agonist. PMID- 2782417 TI - Network thermodynamic model of rat lingual epithelium: effects of hyperosmotic NaCl. AB - A network thermodynamic model was developed to describe steady-state and transient ion flows (Na+, K+, and Cl-) and related electrical events in the rat lingual epithelium. The model, which uses only standard assumptions about topology and membrane ion transport processes from other tight epithelia, successfully simulates steady-state transepithelial electrical measurements seen in the in vitro rat dorsal lingual epithelium for a wide range (50-2,000 mM) of mucosal NaCl concentrations. It also simulates the intracellular depolarization and subsequent repolarization observed in situ in rat taste cells in response to a mucosal hyperosmotic NaCl stimulus. Because the intracellular potential has been identified with the receptor potential for gustation, the depolarization and repolarization may explain both the phasic and tonic components of taste nerve excitation in response to a salt stimulus. This study suggests that a better understanding of taste transduction may be gained by focusing more attention on the transport properties and mechanisms of lingual epithelia. PMID- 2782418 TI - Volume receptors in guinea pig labyrinth: relevance with respect to ADH and Na control. AB - We tested the hypothesis that changes in extracellular fluid volume are reflected by pressure changes within structures of the inner ear and that through neural pathways, a control mechanism exerts an influence on antidiuretic hormone (ADH) release and Na excretion. The study was performed on 35 guinea pigs. In protocol 1, 13 animals were studied before and after decompression of the inner ear by bilateral fluid withdrawal in an experimental setting of sustained isotonic expansion that kept the osmoreceptor partially activated and the intrathoracic volume receptors suppressed. A group of six sham-operated animals served as control. In protocol 2, nine animals were studied before and after a unilateral rise in their inner ear pressure during slightly hypertonic low-rate infusions that kept the osmoreceptor and thoracic volume receptors stimulated. A group of seven sham-operated guinea pigs served as controls. Decompression of the inner ear was attended by a rise in plasma ADH from 11.9 +/- 2.4 to 29.1 +/- 6.9 pg/ml, in urine osmolality (Uosmol) from 470 +/- 48 to 712 +/- 46 mosmol/kg (P less than 0.001), and a fall in urine flow rate (V) from 184 +/- 47 to 71 +/- 11 microliters/min (P less than 0.01), whereas plasma Na (PNa) and osmolality (Posmol) did not change. During inner ear hypertension, plasma ADH fell from 25.6 +/- 3.9 to 18.4 +/- 3.1, Uosmol from 829 +/- 58 to 627 +/- 43 (P less than 0.001), and V rose from 51 +/- 11 to 130 +/- 23 (P less than 0.001), whereas glomerular filtration rate, PNa, and Posmol did not change.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2782419 TI - Membrane stretch: a physiological stimulator of Ca2+-activated K+ channels in thick ascending limb. AB - The effects of membrane stretch on Ca2+-activated (maxi) K+ channels were examined in the apical membrane of cultured medullary thick ascending limb (MTAL) cells. Using cell-attached patchclamp technique, we found that negative pressure (-33 +/- 5 cmH2O) applied to the patch membrane increased fractional open probability (NPo) from 0.3 +/- 0.2 to 29.9 +/- 7.6% (n = 12) in the presence of 1.8 mM Ca2+ in the pipette. The activity returned to control on releasing the negative pressure. Reduction of extracellular osmolality from 293.2 +/- 1.6 to 219.8 +/- 1.1 mosmol/kg also activated K+ channels (NPo = 43.8 +/- 12.2%, n = 8) in cell-attached patches. Removal of Ca2+ from both pipette and bathing solution inhibited osmotic activation of K+ channels. K+ channels were shown to be Ca2+ activated K+ channels by their conductance (146 +/- 7 pS, n = 5) and Ca2+ dependence. Our data suggest that membrane stretch caused by swelling or possibly by tubular flow enhances Ca2+ entry across the apical cell membrane of MTAL cells activating maxi K+ channels. PMID- 2782420 TI - Effect of changes in sodium or water intake on glomerular B2-kinin-binding sites. AB - In a previous study, we characterized a B2-kinin-binding site in rat glomerular membranes. We have now investigated the density and affinity of this binding site for bradykinin (BK) in rat glomerular membranes, in relation to the renal and urinary levels of kallikrein during changes in sodium and water intake. The density of BK-binding sites was reduced after 28 days of low-sodium diet (12.5 +/ 1.3 vs. control: 32.1 +/- 5.2 fmol/mg protein, P less than 0.05), whereas the concentration and activity of kallikrein was increased in the renal tissue and in the urine. Water deprivation for 4 days also resulted in a decreased density of binding sites (13.2 +/- 1.2 vs. control 32.1 +/- 5.2 fmol/mg protein, P less than 0.05) and, interestingly, renal kallikrein levels increased. During high salt consumption, urinary kallikrein activity increased but the renal concentration and activity of kallikrein was unchanged. In this high-sodium-loaded group, BK binding site density was similar to controls receiving a normal-sodium diet (41.6 +/- 8.4 vs. control 32.1 +/- 5.2 fmol/mg protein). On the other hand, the binding affinity of BK did not change significantly in all experimental groups, and the binding specificity was not altered as BK remained the most potent agonist. Sodium depletion and water deprivation led to the same effects on BK-binding sites and on renal kallikrein. The renal glomerular BK-binding site density decreased in both conditions, whereas the renal level of kallikrein was enhanced. An inverse relationship between renal kinin levels and the density of glomerular BK-binding sites is therefore suggested. PMID- 2782421 TI - Evidence that mouse renal proximal tubule cells produce nephrocalcin. AB - Nephrocalcin (NC) is a glycoprotein inhibitor of calcium oxalate monohydrate crystal growth present in urine and kidney tissue. To determine if kidney cells can produce NC, we have isolated proximal tubules from mouse kidney and cultured them in a serum-free medium containing supplements. The tubules accumulate p aminohippurate and respond with increase in adenosine 3',5'-cyclic monophosphate to parathyroid hormone but not to arginine vasopressin. They produce 1,25 dihydroxyvitamin D3 when 25 hydroxyvitamin D3 is added as substrate. Medium conditioned for 3 days reacted by direct enzyme-linked immunosorbent assay (ELISA) with a rabbit antiserum to human urinary NC; the same antiserum was localized to the cells using immunoperoxidase staining. Using ion exchange and molecular sieve chromatography, we purified a glycoprotein calcium oxalate crystal-growth inhibitor the chromatographic behavior and amino acid and carbohydrate compositions of which closely resembled that of purified human urinary NC. Its dissociation constant toward the calcium oxalate crystal was 0.4 10 X 10(-7) M. Purified fractions of the protein cross-reacted with the antiserum tested by ELISA. Cultured proximal tubule cells produce a molecule that resembles NC from human urine, rat urine, and rat kidneys; proximal tubule is a probable site of NC production in vivo. PMID- 2782422 TI - Electrolyte, urea, and water transport in a two-nephron central core model of the renal medulla. AB - A one-nephron model has been extended to include both short-looped and long looped nephrons. Variables are volume flow, Na+, K+, Cl-, urea, hydrostatic pressure, and electric potential. The ratio of short-to-long-looped nephrons, one of the parameters of the model, is 5 to 1. With either rabbit or hamster permeability data from perfusion experiments, the model develops an osmolality of approximately 600 mosmol/l at the junction of inner and outer medulla but no osmolality gradient in the inner medulla. With the rabbit data, osmolalities in excess of 1,000 mosmol/l can be generated in the papilla with no active transport if urea permeabilities are less than 10(-5) cm/s; with the hamster data, electrolyte permeabilities must also be reduced. With these modified parameters, urea concentrations are less in the long loops than has been found on micropuncture. These can be increased to experimental levels by increasing the urea permeability and decreasing the hydraulic permeability of thin descending limbs in the inner half of the inner medulla, but to maintain loop osmolality at 1,000 mosmol/l it is necessary to postulate active NaCl transport in thin ascending limbs in the outer half of the inner medulla. This gives an alternative mode of concentration without active transport in the inner half of the inner medulla, in which electrolytes diffuse out of and urea diffuses into both limbs of Henle's loop and mix in the core with urea and water entering from the collecting duct. Concentration in either mode requires significant modification of perfusion data. PMID- 2782423 TI - Enhanced in vivo H2O2 generation by rat kidney in glycerol-induced renal failure. AB - Aminotriazole-mediated inhibition of catalase has been used in previous studies as a measure of in vivo changes in the hydrogen peroxide generation. Using this method, we found a significantly higher inhibition of renal catalase activity at various time points (30, 60, and 90 min) in glycerol-treated rats (a well established model for myoglobinuric acute renal failure) compared with rats treated with aminotriazole alone. The greater inhibition in the glycerol-treated group was not due to differences in aminotriazole levels. We confirmed that catalase inactivation by aminotriazole was due to formation of catalase-hydrogen peroxide intermediate (compound I) because catalase inactivation was prevented by ethanol, a competitive substrate for compound I. There were no significant differences in the aminotriazole-induced inhibition of renal cortical catalase activity in control and uranyl nitrate-treated rats, suggesting that there was no enhanced generation of hydrogen peroxide in this model of acute renal failure. Taken together, these data provide evidence for enhanced generation of hydrogen peroxide in glycerol-induced acute renal failure and suggest that the enhanced generation of hydrogen peroxide in the glycerol-induced acute renal failure is not a result of nonspecific response to tissue injury. PMID- 2782424 TI - Calcium uptake by brush-border membrane vesicles from the rat intestine. AB - Uptake of calcium by brush-border membrane vesicles from rat small intestine is composed of saturable and nonsaturable components. We studied regulation of calcium uptake using the divalent cations strontium, a foreign ion that mimics calcium biologically and magnesium, a physiologically important ion that resembles calcium physically, although not biologically. Strontium present outside the vesicle inhibited saturable calcium uptake competitively, consistent with binding to the transporter at the same site as calcium. Strontium inside the vesicle accelerated saturable calcium uptake from the outside (countertransport), also consistent with binding to the same transporter site as calcium. Thus the calcium transporter shows functional characteristics of a mobile carrier. In the uptake medium (extracellular), magnesium was a noncompetitive inhibitor of saturable calcium transport, consistent with a regulatory role in calcium uptake by binding to the transporter at a locus other than that for calcium. Magnesium at 1 mM concentration inside the vesicle had no effect on saturable calcium uptake and a high concentrations functioned as a week uncompetitive inhibitor. Thus intracellular magnesium appears to have no major role in regulating saturable calcium uptake at the brush border of the enterocyte. PMID- 2782425 TI - Immunocytochemical localization of intracellular acidic compartments: rat proximal nephron. AB - There is evidence that components of the endosomal-lysosomal system of most cells have an acidic interior. The weak base, N-(3-[(2,4-dinitrophenyl)amino]propyl)-N (3-aminopropyl)methylamine dihydrochloride (DAMP) has been shown to accumulate in acidic compartments in cultured cells and in isolated perfused proximal tubules. We infused DAMP intravascularly in vivo and used colloidal gold immunocytochemistry to identify acidic compartments in cells of the rat glomerulus and proximal tubule. Sprague-Dawley rats were infused intra-arterially with DAMP. The kidneys were fixed by intravascular perfusion with 1% glutaraldehyde and embedded in Lowicryl K4M. Sections were exposed to a mouse anti-dinitrophenol (DNP) monoclonal antibody that cross-reacts with DAMP, followed by gold-conjugated goat anti-mouse immunoglobulin G. Transmission electron microscopy revealed positive labeling of the lysosome-like structures of the various cells of the glomerulus and lysosomes, endosomes, and numerous endocytic vesicles of all segments of the proximal tubule. We conclude that 1) DAMP can be used in vivo to identify acidic compartments in the kidney and 2) lysosomes, endosomes, and many endocytic vesicles of the rat proximal tubule as well as lysosome-like structures in cells of the glomerulus have an acidic interior. PMID- 2782426 TI - Direct measurement of basolateral membrane potentials from cells of the macula densa. AB - At the present time, little is known concerning the electrophysiology of the cells of the macula densa and whether or not these cells are electrically responsive to alterations in luminal fluid composition. To investigate this issue, cortical thick ascending limbs (CTAL) containing macula densa and attached glomeruli were dissected from rabbit kidney and the CTAL perfused in vitro. Basolateral membrane potential (Vbl) was measured with microelectrodes in macula densa cells and, for comparison, in cells of the CTAL. Macula densa Vbl averaged 56.5 +/- 7.6 mV (n = 4) at a (n = 22) at 20 mM NaCl, -35.6 +/- 3.9 mV (n = 16) at 45 mM NaCl, and -25.5 +/- 2.6 mV (n = 32) at 150 mm NaCl. Thus macula densa Vbl depolarized markedly (31 mV) when luminal perfusate [NaCl] was increased from low to high values. In contrast, Vbl measured in CTAL cells averaged -62 +/- 6.1 mV (n = 6) in 45 mM NaCl and did not change significantly as perfusate NaCl was increased to 150 mM. In the presence of 150 mM NaCl, luminal application of furosemide (50 microM) produced a small (3.5 +/- 1.1 mV, n = 16) but statistically significant (P less than 0.02) hyperpolarization in macula densa cells, whereas CTAL cell Vbl hyperpolarized markedly (20 +/- 5.7 mV, n = 6) with addition of furosemide. Finally, neither macula densa cells nor the CTAL cells changed Vbl when 45 mM NaCl solution was made hypotonic by removing mannitol.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2782427 TI - Left ventricular coordinate systems. AB - Three-dimensional kinematics of radiopaque markers in anterior, posterior, septal, and lateral regions of a major equatorial plane were evaluated in anesthetized dogs by biplane fluoroscopy. Stationary coordinate systems measured marker locations recorded during diastole and systole from a contractile origin at the center of contraction at end systole and from a geometric origin at the intersection with the equatorial plane of the ventricular long axis at end diastole. A time-indexed system measured marker locations at end diastole and at end systole, respectively, from the locations of the geometric origin at end diastole and end systole. Compared to the stationary system with the geometric origin, both the stationary system with the contractile origin and the time indexed system reduced the variability of the radial components of the contractile displacements between ventricular regions. In contrast to the other two systems, the system with the contractile origin reduced circumferential components to values not significantly different from zero. These results indicate that 1) abnormally contracting regions of the ventricle may be located and their size measured by determining the region where the radial component differs from that in the rest of the equatorial plane and 2) rotation in a major equatorial plane of the ventricle is significant, but the influence of rotation can be minimized by referencing ventricular dimensions to a coordinate system with an origin at the center of contraction. PMID- 2782428 TI - Estimation of capillary reflection coefficients and unique PS products in dog paw. AB - Lymphatic protein flux (Js) obtained in canine hindpaws at low lymph flows were used to determine the capillary osmotic reflection coefficients (sigma d) and unique permeability surface area (PS) products for total proteins, albumin, immunoglobulin (Ig)G, and IgM. This new analysis is based on the phenomenon that when maximal diffusion occurs across the capillary membrane, the Peclet number [x = Jv(1 - sigma d)/PS] attains a unique value defined only by sigma d. The diffusive flux is maximal when the relationship between protein flux and transcapillary fluid flux (Jv) changes from a curvilinear to a linear relationship. The slope of the linear portion of this protein flux relationship was used to determine sigma d as (1 - sigma d) = delta Js/(delta JvCp), where Cp is the plasma protein concentration. With the use of sigma d, the Jv at which the maximal diffusion occurred, and the corresponding Peclet number, a unique value is obtained for the PS product. Experiments performed using lymph from canine hindpaws (n = 6) yielded sigma d's (mean +/- SD) of 0.91 +/- 0.03, 0.83 +/- 0.11, 0.96 +/- 0.03, and virtually 1 for total protein, albumin, IgG, and IgM, respectively. The corresponding PS products for total protein, albumin, and IgG were 25.0 +/- 13.2, 28.4 +/- 6.6, and 14.0 +/- 7.9 microliters.min-1.100 g-1, respectively; PS for IgM was almost zero.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2782429 TI - Extent of rapid baroreceptor resetting during first hours of hypertension. AB - Rapid or acute resetting of the aortic baroreceptors was studied in anesthetized rats during the onset and maintenance of hypertension produced by subdiaphragmatic aortic constriction for up to 6 h. After 2 min of hypertension, the systolic threshold pressure for activation of the baroreceptors increased by 33% of the total 27-mmHg increase of the control diastolic pressure. Maximal resetting of 46 and 52% was demonstrable after 20 and 30 min of hypertension. The shifts in pressure threshold were accompanied by parallel shifts in the entire baroreceptor function curves. After 30 min of hypertension, resetting was only partially (60%) reversed within the 30 min of pressure normalization. Resetting did not progress with time. Six hours after aortic constriction, resetting was only 38% (vs. 32% after 30 min). The data indicate that acute or rapid resetting of the aortic baroreceptors reaches a maximum within 20-30 min (40-50%) and remains stable for up to 6 h, with no apparent change in the baroreceptor gain. PMID- 2782430 TI - Collateral influence on pressure-flow characteristics of coronary circulation. AB - The purpose of this study was to determine the role of the coronary collateral circulation on the shape of the coronary pressure-flow (P-F) relationship and its effects on the pressure at zero flow (PZF) or pressure intercept. We investigated the P-F characteristics of the coronary circulation under two conditions. 1) To minimize the influence of collaterals, we measured coronary flow by timed collections of coronary sinus outflow in 15 dog hearts, as perfusion pressure to all vessels was varied; 2) to maximize the effect of collaterals, we measured circumflex artery flow in six dog hearts, as perfusion pressure to only the circumflex coronary artery was varied and the pressure in the remaining vessels was maintained constant. We used an isolated heart preparation in which ventricular chamber and venous outflow pressures equalled atmospheric pressure and the vessels were maximally dilated with adenosine. In the first condition, the P-F relationship was curvilinear with a PZF of 0 mmHg; in the second condition, the P-F relationship was curvilinear with a PZF of 16 +/- 2 mmHg, and flow was retrograde at pressures below PZF. We conclude that in both conditions the curvilinearity of the coronary P-F relationship was the result of nonlinear elastic properties of blood vessels, not requiring the "waterfall" concept to be invoked, and that in the second condition the influence of collateral vessels produced the positive pressure intercept. PMID- 2782431 TI - Myocardial and systemic responses to arterial hypoxemia during cardiac tamponade. AB - Experiments were performed on 14 anesthetized, open-chest dogs to assess myocardial and systemic responses to cardiac tamponade alone (TAMP) and combined with arterial hypoxemia (HYP). Regional blood flow (RBF) was measured with radioactive microspheres and used to compute regional O2 supply. Myocardial oxygen and lactate extraction were determined. Myocardial oxygen consumption (MVO2) was calculated with Fick equation. An increase in pericardial pressure, sufficient to reduce mean aortic pressure (MAP) by 20%, caused proportional decreases in myocardial RBF and MVO2 but had no effect on endo-to-epi flow ratio or on myocardial lactate extraction. TAMP alone decreased RBF and O2 supply in kidney, splanchnic organs, skeletal muscle, and skin, but it had no effect in brain. HYP (arterial PO2, 35 +/- 2 mmHg) during TAMP restored MAP and caused transmurally uniform increases in myocardial RBF that were adequate to maintain MVO2 and lactate extraction. RBF increased sufficiently in brain to maintain regional O2 supply, whereas unchanged or inadequate increases in RBF in other tissues accentuated reductions in O2 supply. During combined TAMP and HYP, local vasodilator mechanisms were capable of maintaining adequate oxygen supply in myocardium and brain but not apparently in the nonvital tissues where these mechanisms were antagonized by reflex vasoconstriction. PMID- 2782432 TI - Fetal neuromuscular blockade: effect on oxygen demand and placental transport. AB - To study mechanisms by which variations in fetal oxygen demand alter fetal oxygen saturation and PO2, we measured uterine and umbilical blood flow and transplacental oxygen diffusion rate in eight chronically prepared pregnant ewes before and during fetal neuromuscular blockade with pancuronium bromide (0.2 mg/kg). Uterine and umbilical blood flows were measured by applying the steady state method using ethanol as the test substance. Fetal oxygen uptake decreased 7.5% (P less than 0.05). Umbilical blood flow increased 6% (P less than 0.05), whereas uterine blood flow did not change significantly. Fetal arterial oxygen saturation increased markedly (54.8-60.9%; P less than 0.001). There were also significant increases in umbilical vein oxygen saturation (83.6-86.9%; P less than 0.01), uterine vein oxygen saturation (70.7-72.2%; P less than 0.01), umbilical vein PO2 (29.4-32.1 Torr; P less than 0.001), and uterine vein PO2 (49.4-50.7 Torr; P less than 0.01). The uterine-umbilical venous PO2 difference decreased significantly (20.0-18.6 Torr; P less than 0.001), whereas there was no significant change in the uterine-umbilical venous PCO2 difference or in the umbilical ethanol shunt. The data indicate that follows a small decrease in fetal oxygen demand is caused by two aspects of placental oxygen transport: 1) umbilical and uterine blood flow do not react homeostatically to prevent the rise of PO2 in the placental circulation, and 2) the decrease in oxygen flux from placenta to fetus is associated with a decrease in the transplacental PO2 gradient. PMID- 2782433 TI - Voltage and beat dependence of Ca2+ transient in feline ventricular myocytes. AB - The positive contractile staircase after a period of rest is attributable to a positive staircase in the magnitude of the Ca2+ transient. The present study used voltage-clamp techniques and the fluorescent Ca2+ indicator, indo-1, to examine the effects of membrane potential, the duration of depolarization, and the slow inward Ca2+ current (Isi) in the regulation of the magnitude of the steady-state Ca2+ transient and the development of the steady state during the positive staircase. In the steady state, the Ca2+ transient was greatest at +10 mV, the potential at which Isi was also the greatest. However, the Isi-voltage relationship was much more bell-shaped than the Ca2+ transient-voltage relationship. The magnitude and duration of the steady-state Ca2+ transient was not affected by pulse durations as short as 25 ms. However, prolonged voltage pulses were essential to maintain the steady state. The development of the positive staircase was very voltage dependent. After a rest period, a positive staircase was seen when voltage-clamp drives were done to +30 mV but not when done to -10 mV, potentials that elicit Isi of comparable magnitude. These results support the idea that the early peak of Isi can act as a trigger for release of Ca2+ from the sarcoplasmic reticulum. However, sarcoplasmic reticulum Ca2+ loading is dependent on prolonged depolarization and may be mediated through Na+ Ca2+ exchange. PMID- 2782434 TI - Single potassium channels recorded from vascular smooth muscle cells. AB - Single-channel activities were recorded from smooth muscle cells of vascular fragments isolated from rat pancreas. Three K-selective channel types were identified and characterized from cell-attached and inside-out membrane patches. Mean single-channel slope conductances of the three channel types, under conditions of symmetrical K (145 mM), were 43, 91, and 276 pS. The channel types exhibited differential sensitivity to tetraethylammonium (TEA) and intracellular Ca concentrations ([Ca2+]i). Intracellular TEA (10 mM) was effective in blocking the small conductance channel whereas the large conductance channel was found to be sensitive to [Ca2+]i. The properties of the large-conductance K channel are consistent with its identification as a calcium-activated maxi K channel described in a variety of tissues. Each of the channel types showed sensitivity to membrane potential, with increasing opening transitions at depolarizing membrane potentials. The small conductance channel type was observed to be active at resting membrane potentials. The generality of each of these channel types to other smooth muscle cell preparations and possible physiological implications are discussed. PMID- 2782435 TI - Dependence of delayed afterdepolarizations on diastolic potentials in ischemic Purkinje fibers. AB - The mechanism of focal rhythms 1 day after myocardial infarction has been ascribed to both abnormal automaticity and triggered activity arising from delayed after-depolarizations (DADs). During the course of superfusion in vitro, diastolic potentials repolarize to more negative resting potentials. The dependence of DADs and triggered activity on diastolic potentials was studied using extrinsic currents. During sustained activity (maximum diastolic potential = -61 +/- 7 mV), hyperpolarizing current decreased the DADs, rendered them subthreshold, and terminated triggered activity. During the quiescence caused by constant hyperpolarizing current, a stimulated train of action potentials produced DADs. Decreasing the current permitted augmented DADs. In quiescent preparations (resting potential = -68 +/- 7 mV), a train of stimulated action potentials was followed by subthreshold DADs. Depolarizing current increased the DAD amplitude. To exclude depolarization-induced automaticity, constant currents were applied without a previous train of stimuli. Neither DADs nor triggered activity were evoked. Therefore, DADs and triggered activity, postinfarction, depend on the diastolic potential. There is a continuity between subthreshold DADs and sustained activity. DADs may reach a magnitude in which extrinsic interventions may not adequately terminate sustained triggered activity. PMID- 2782436 TI - Effect of membrane potential on cytosolic calcium of bovine aortic endothelial cells. AB - The effect of bradykinin on membrane potential of cultured bovine aortic endothelial cells (BAECs) was estimated by measuring the uptake of the lipophilic cation, tetra[3H]phenylphosphonium ([3H]TPP+). Uptake of [3H]TPP+ was found to be 1) a function of extracellular K+ concentration, 2) sensitive to valinomycin, and 3) decreased by the K+ channel inhibitor, Ba2+, suggesting that the uptake of [3H]TPP+ responds to changes in membrane potential of the BAEC. Bradykinin (50 nM) produced an increase in [3H]TPP+ uptake in low K+ buffer consistent with a bradykinin-induced membrane hyperpolarization. The effect of membrane depolarization with high K+ buffer on the bradykinin-stimulated changes in cytosolic Ca2+ was determined using the fluorescent Ca2+ indicator, fura-2. The results of these experiments demonstrated that both basal cytosolic Ca2+ and bradykinin-stimulated release of Ca2+ from internal stores were not affected by membrane depolarization. However, bradykinin-stimulated influx of Ca2+ from the extracellular space decreased with membrane depolarization in a manner consistent with the movement of Ca2+ through a channel. PMID- 2782437 TI - Regional blood flow in the brain and spinal cord of hypothermic rats. AB - [14C]butanol tissue uptake was used to measure simultaneously regional blood flow in three regions of the brain (cerebral and cerebellar hemispheres and brain stem) and in five levels of the spinal cord in 10 normothermic rats (group A) and in 10 rats in which rectal temperature had been lowered to 27.7 +/- 0.3 degrees C by applying ice to the torso (group B). Pentobarbital sodium anesthesia was used. Mean arterial blood pressure varied minimally between groups as did arterial pH, PO2, and PCO2. In group A, regional spinal cord blood flow (rSCBF) varied from 49.7 +/- 1.6 to 62.6 +/- 2.1 ml.min-1.100 g-1; in brain, regional blood flow (rBBF) averaged 74.4 +/- 2.3 ml.min-1.100 g-1 in the whole brain and was highest in the brain stem. rSCBF in group B was elevated in all levels of the cord by 21 34% (P less than 0.05). rBBF, however, was lowered by 21% in the cerebral hemispheres (P less than 0.001) and by 14% in the brain as a whole (P less than 0.05). The changes in calculated vascular resistance tended to be inversely related to blood flow in all tissues. We conclude that rBBF is depressed in acutely hypothermic pentobarbital sodium-anesthetized rats, as has been noted before, but that rSCBF rises under these experimental conditions. The elevation of rSCBF in hypothermic rats confirms our previous observations. PMID- 2782438 TI - Mechanism of pressor response to posterior hypothalamic injection of neuropeptide Y. AB - Unilateral microinjection of neuropeptide Y (NPY) into the posterior hypothalamic nucleus was previously found to evoke an increase in mean arterial pressure (MAP) in urethan-anesthetized rats. In this study, the mechanism by which this increase occurs was examined. Pretreatment of rats with 2.0 mg/kg (iv) of phenoxybenzamine, or 7.5 mg/kg (iv) of pentolinium, resulted in a significant reduction in the peak MAP evoked by microinjection of NPY (2.35 nmol) into the posterior hypothalamic nucleus. Administration of the vasopressin V1-receptor antagonist [d(CH2)5Tyr(Me)]AVP (10 micrograms/kg iv) before microinjection of NPY failed to attenuate the increase in MAP. Similar results were obtained with respect to the effect of these three antagonists on the increase in MAP evoked by injection of the cholinergic muscarinic agonist carbachol (5.48 nmol) into the posterior hypothalamic nucleus. Furthermore, microinjection of NPY or carbachol elicited a significant elevation of renal sympathetic nerve activity and an increase in resistance of the hindquarter vascular bed. However, NPY elicited a decrease and carbachol an increase in the resistance of the mesenteric bed, whereas NPY elicited an increase and carbachol a decrease in the resistance of the renal bed. These results suggest that NPY elicits an increase in MAP via centrally mediated sympathetic excitation. Furthermore, NPY and carbachol differentially affect sympathetic outflow to peripheral vascular beds after microinjection into the posterior hypothalamic nucleus. PMID- 2782439 TI - Brief vagal stimuli and AV conduction in dogs: effects on retrograde exceed antegrade. AB - We opened the chests of 20 mongrel dogs (16-28 kg) that were anesthetized with pentobarbital sodium (22 mg/kg), given propranolol (1 mg/kg), and bipolar catheters placed into the right atrium and ventricle. We crushed the sinoatrial (SA) node and paced the heart to produce either an antegrade (A-V) or a retrograde (V-A) conduction (where A is atrial activation and V is ventricular activation). Both cervical vagosympathetic trunks were ligated and connected to electrodes that were driven by a computer-controlled, isolated stimulators. Three brief vagal stimulus bursts (at the same intensity but at different times in the cardiac cycle) were given at least 1 min apart, the pacing site was changed, and the identical three-stimulus bursts were again applied. This procedure was continued until the phase of the stimulus had scanned the entire cardiac cycle. Forty-four sets of vagal effect curves were generated. The composite data indicate that brief vagal stimuli have about twice the effect on the peak amplitude of the change in retrograde than in antegrade AV nodal conduction in the dog. Unexpectedly, the duration of the parasympathetic effect is also considerably greater (approximately 40%) and the decay is slower (approximately 48%) for retrograde than for antegrade conduction, even when the vagal effect curves have been normalized to the same amplitude. This latter result suggests that some factor other than diffusion and inactivation of ACh determines the duration of the A-V conduction response to a brief vagal stimulus. PMID- 2782440 TI - Effect of leukotriene D4 on blood flow to cerebrum and choroid plexus. AB - The purpose of this study was to examine effects of leukotriene D4 on blood flow to the cerebrum and choroid plexus. Blood flow was measured with microspheres in anesthetized rabbits. Under control conditions, blood flow to the cerebrum was 37 +/- 4 ml. min-1.100 g-1 (mean +/- SE) and blood flow to the choroid plexus was 428 +/- 52 ml.min-1.100 g-1. Intra-atrial infusion of leukotriene D4 at 0.1 and 1.0 microgram.kg-1.min-1 did not alter blood flow to the brain or choroid plexus, but produced a 49 +/- 3% and 69 +/- 5% decrease in blood flow to the bowel. We also examined effects of intracerebroventricular administration of leukotriene D4. Intraventricular injection of 1.0 microgram of leukotriene D4 did not affect blood flow to the cerebrum or choroid plexus. In contrast, intraventricular injection of 1.0 microgram of angiotensin II produced a 42 +/- 4% decrease in blood flow to the choroid plexus. In summary, neither intravascular nor intraventricular administration of leukotriene D4 affects blood flow to the brain or choroid plexus. PMID- 2782442 TI - Transformation of neutrophils as indicator of irreversibility in hemorrhagic shock. AB - Recent evidence shows that the presence of circulating neutrophils (PMNs) influences the lethal course and extent of ischemic injury associated with hemorrhagic shock. The objective of this study was to use the Wiggers shock model to investigate the correlation between the appearance of activated circulating PMNs as measured by the spontaneous reduction of nitro blue tetrazolium [(NBT) positive PMNs] and survival rate. Rats were maintained at 35-mmHg arterial pressure for 90 min and then observed over 24 h for survival. This protocol resulted in 50% mortality. In all animals in which levels of circulating NBT positive PMNs before bleeding were greater than 225 cells/mm3, the experimental procedure was lethal. Animals that initially had low numbers of NBT-positive PMNs (to approximately 135 cells/mm3) and maintained low counts during the hypotensive period consistently survived. Animals, which before bleeding had low NBT-positive PMN counts but during the course of hypotension significantly elevated their circulating count, have low probability for survival. In those cases in which high NBT-positive PMN counts occurred only later in the course of the hypotensive period, the rats survived. These results suggest that the number of circulating NBT-positive PMNs is a singular index for the trend toward irreversibility in this shock model. PMID- 2782441 TI - Training increases cardiac glucose uptake during rest and exercise in rats. AB - The effect of chronic exercise on the regional glucose uptake in the left ventricle of the heart was studied in resting and swimming rats using the 2 deoxyglucose method. The left ventricular glucose uptake of untrained resting controls averaged 1.7 +/- 0.1 mumol.min-1.g protein-1 and that of chronically trained resting rats 3.5 +/- 0.3 mumol.min-1.g protein-1 (P less than 0.001). During a 20-min swimming period the glucose uptake rate of untrained rats was 2.3 +/- 0.1 mumol.min-1.g protein-1 and that of trained rats 3.4 +/- 0.3 mumol.min 1.g protein-1 (P less than 0.01). The subendocardial glucose uptake was 25% higher than the subepicardial uptake in the resting control group, whereas no gradient was observed in the other groups. The product of heart rate and blood pressure during swimming increased by 60-70% in the untrained and trained groups. The increase in total left ventricular glucose uptake and its transmural distribution by training seemed to be independent of the actual oxygen consumption or supply of major alternative myocardial substrates. PMID- 2782443 TI - Influence of sympathetic discharge pattern on norepinephrine and neuropeptide Y release. AB - The effects of sympathetic nerve stimulation on vasoconstrictor responses and overflow of norepinephrine (NE) and neuropeptide Y-like immunoreactivity (NPY-LI) were studied in the dog gracilis muscle and pig spleen in vivo. A continuous regular impulse activity was compared with irregular human sympathetic and regular bursting patterns. During control conditions, stimulation with the irregular activity induced larger peak vasoconstriction than the regular activity at 0.59 Hz, but not at higher frequencies in the muscle, at 0.59 and 2.0 Hz in the spleen. The nerve stimulation-evoked overflow of NE and NPY-LI from the muscle were not influenced by the pattern of stimulation. The overflow of NPY-LI, but not that of NE, from the spleen was enhanced by the irregular activity at 0.59 and 2.0 Hz, and both NPY-LI and NE overflows were enhanced by regular burst activity at 2.0 Hz. After blockade of alpha- and beta-adrenoceptors by phenoxybenzamine and propranolol, respectively, which enhanced nerve stimulation evoked overflow of both NE and NPY-LI, the NE overflow from the muscle evoked by the irregular activity was slightly larger at 0.59 Hz but smaller at higher frequencies compared with that evoked by regular activity, whereas the detectable overflow of NPY-LI was not largely influenced by the stimulation pattern. In conclusion, both the vasoconstrictor response and the overflow of NPY-LI and NE seem to be influenced by the pattern and frequency of sympathetic nerve stimulation. PMID- 2782444 TI - Thromboxane A2 and serotonin mediate coronary blood flow reductions in unsedated dogs. AB - We have shown in anesthetized open-chest dogs that recurrent platelet aggregation at the site of coronary artery stenosis and endothelial injury results in a pattern of cyclical variations in coronary blood flow (CFVs) and that serotonin and thromboxane A2 are important mediators of CFVs. In the present study, we tested the following hypotheses: 1) severe spontaneous reductions in coronary blood flow occur in awake closed-chest dogs with coronary artery stenoses and endothelial injury; 2) there is a progression from CFVs to persistent low coronary blood flow; and 3) serotonin and thromboxane A2 are important mediators of coronary blood flow reductions in this model. In 17 of 20 awake closed-chest unsedated dogs with experimental coronary artery stenoses and endothelial injury, either intermittent CFVs (n = 3), persistent low flow (n = 4), or progression from CFVs to low flow (n = 10) occurred during the first postoperative week. A serotonin receptor antagonist (ketanserin or LY 53857) or a thromboxane synthesis inhibitor (dazoxiben) or receptor antagonist (SQ 29548) abolished platelet dependent CFVs in 80% of dogs. Thus 1) severe spontaneous reductions in coronary blood flow occur in awake closed-chest unsedated dogs with coronary artery stenoses and endothelial injury; 2) there is a progression from CFVs to persistent low coronary blood flow and final coronary artery occlusion; and 3) serotonin and thromboxane A2 are important mediators of coronary blood flow reductions in this experimental model. PMID- 2782445 TI - Wall motion asynchrony prolongs time constant of left ventricular relaxation. AB - To evaluate the effects of wall motion asynchrony on left ventricular (LV) relaxation, we performed atrioventricular sequential pacing with the second stimulation at six epicardial sites in open-chest anesthetized dogs. Myocardial segment lengths in the basal, mid, and apical LV free wall were measured by ultrasonic crystals. The standard deviation of interval from the onset of the QRS complex to that of elongation in each segment length was used as a quantitative index for asynchrony (asynchrony index, AI). The AI increased significantly in all sequential pacing modes compared with the control right atrial pacing. The time constant (T) of LV relaxation derived from exponential fit with zero asymptote was prolonged significantly in all sequential pacing modes except for pacing at the LV base. In each dog there was a good correlation between changes in AI and T [r = 0.61 - 0.98 (mean = 0.84)]. Since the regional inactivation process of the myocardium is considered to be unchanged during these interventions, we concluded that asynchronous wall motion plays an important role in the impairment of LV relaxation. PMID- 2782446 TI - Arterial hemodynamics in a rabbit model of atherosclerosis. AB - Although atherosclerosis significantly alters the structural characteristics of the arterial tree, its effect on arterial impedance, which is a means of quantifying the functional characteristics of the arterial system, has not been characterized. To assess how one type of atherosclerosis affects impedance, we studied arterial impedance in New Zealand White rabbits after 11 wk on a 2% cholesterol diet. From open-chest aortic pressures and flows, impedance data were obtained from spectral analysis of randomly paced and Fourier analysis of nonpaced beats. Compliance was calculated from the low-frequency impedance moduli by assuming a windkessel model for the arterial system. Under base-line conditions, the atherosclerotic impedance phase spectrum in the low-frequency range remained negative for higher values of frequency than in controls. There was no difference between the groups in mean arterial blood pressure, impedance modulus spectrum, characteristic impedance, compliance, or total peripheral resistance. Wave reflections were, however, increased in the atherosclerotic animals. The differences between the two groups in phase and wave reflection were completely abolished after phenylephrine (3 micrograms.kg-1.min-1). Thus this study demonstrates that under base-line conditions atherosclerosis increases wave reflection at the input to the arterial system in the absence of an alteration in global arterial compliance, total peripheral resistance, or mean blood pressure. This increase is presumably secondary to atherosclerotic changes at arterial sites, which produce local impedance mismatching. PMID- 2782447 TI - Pentobarbital attenuates pulmonary vasoconstriction in isolated sheep lungs. AB - Pentobarbital sodium is a widely used anesthetic agent that has been demonstrated to attenuate systemic vascular responses to multiple pressors. To determine whether pentobarbital affected pulmonary vasoreactivity we determined the pulmonary vascular response to hypoxia and potassium in isolated in situ perfused sheep lungs. The flow resistive characteristics of the pulmonary vasculature were assessed by determining mean instantaneous pressure-flow relationships over a wide range of flows (20-120 ml.min-1.kg body wt-1) with PIO2 of 200 and 30 Torr, with and without pentobarbital. Pentobarbital attenuated hypoxic pulmonary vasoconstriction (P less than 0.001) in a concentration-dependent fashion (50% effective concentration = 0.42 mM). In addition, the pulmonary constrictor response to potassium was markedly blunted by pentobarbital (P less than 0.001). We conclude that pentobarbital inhibits hypoxic pulmonary vasoconstriction in a concentration-dependent fashion and that this inhibition of pulmonary vasoconstriction in isolated sheep lungs is not specific for hypoxia. PMID- 2782448 TI - Hemodilution causes size-dependent constriction of pial arterioles in the cat. AB - Cerebral blood flow (CBF) rises as hematocrit (Hct) falls. We previously attributed this rise in CBF to two independent factors of equal importance, decreased arterial O2 content and decreased blood viscosity. We hypothesized that decreased arterial O2 content would dilate cerebral arterioles and that the magnitude of the vasodilation would depend on the magnitude of the passive fall in vascular resistance attributable to decreased viscosity. The present study was designed to test the hypothesis that anemia is accompanied by cerebral vasodilation. Using a closed cranial window, we measured the diameters of 42 pial arterioles (35-305 microns) in 7 cats as serial isovolemic hemodilution lowered Hct by 44% from 31 +/- 4 to 17 +/- 3%. Hemodilution increased CBF (microsphere technique) but did not change mean arterial blood pressure or arterial blood gases. Anticipated vasodilation did not occur; instead, pial arterioles constricted as Hct fell. Maximum vasoconstriction was observed when Hct reached 65-70% of the initial value. Vasoconstriction lessened as Hct was lowered further, but arteriolar diameters at the lowest Hcts remained less than base-line levels. Constriction was greater in small (less than 100 microns) than in large (greater than or equal to 100 microns) arterioles. The initial constriction of pial arterioles may represent myogenic vasoconstriction in response to flow induced vasodilation of more proximal portions of the cerebrovascular bed and/or to washout of an endogenous vasodilator. Arteriolar relaxation with more profound hemodilution may reflect superimposed metabolic vasodilation. PMID- 2782449 TI - Brief vagal bursts can induce Wenckebach arrhythmia. AB - We hypothesized that a brief burst of vagal stimulation applied in each cardiac cycle could elicit an atrioventricular (AV) nodal Wenckebach arrhythmia. Twenty six dogs were anesthetized with pentobarbital sodium (30 mg/kg iv) and were given propranolol (1 mg/kg iv). We varied the timing of a vagal stimulus burst in steps of 25-50 ms relative to the onset of atrial or ventricular depolarization. In four of nine experiments, a Wenckebach arrhythmia occurred despite changing the timing of stimuli. By prolonging the effects of vagal stimulation on AV conduction with physostigmine, the timing of the stimuli no longer influenced the severity of the arrhythmia. We did experiments to open one of the feedback control loops; these results indicated that this arrhythmia has elements of a positive feedback control system. We also studied the effects of vagal stimulation on the arrhythmia during retrograde conduction. We found that the timing of vagal stimulation was critical in eliciting the arrhythmia in only 4 of the 10 dogs. PMID- 2782450 TI - Cardiovascular effects of dobutamine during exercise in dogs. AB - To test the hypothesis that stimulation of adrenergic receptors in the heart is maximal during maximal exercise, and to determine whether generalized stimulation of adrenergic receptors during strenuous exercise produces significant alterations in the normal regional distribution of blood flow that occurs during exercise, we evaluated the cardiovascular effects of the infusion of dobutamine (40 micrograms.kg-1.min-1) in mongrel dogs during treadmill running. During maximal exercise, the dobutamine infusion resulted in a significant (P less than 0.05) increase in heart rate. Exercise capacity, total body O2 consumption (VO2), and maximal arteriovenous O2 difference, however, each were reduced during the infusion of this drug. A concomitant reduction in maximal blood flow to locomotive skeletal muscle occurred. The infusion of dobutamine also resulted in an increase in heart rate at a strenuous level of submaximal exercise. However, unlike during maximal exercise, VO2 was unchanged. Blood flow to locomotive skeletal muscle increased, and there was a concomitant reduction in arteriovenous O2 difference. Blood flow reductions that normally occur in splanchnic circulations during strenuous and during maximal exercise were generally somewhat attenuated during the infusion of this drug. Thus, dobutamine, a sympathomimetic agent, produces significant cardiovascular effects when infused in high doses during exercise. Our results demonstrate that beta-adrenergic receptor reserve exists in the heart during maximal exercise in dogs. In addition, the peripheral responses that occur during the infusion of the drug provide additional evidence that different degrees of adrenergic receptor reserve normally appear to be present within different regional circulations during strenuous and during maximal exercise. PMID- 2782451 TI - Influence of mean pressure on aortic impedance and reflections in the systemic arterial system. AB - The present investigation sought to determine the extent to which primary changes in mean arterial pressure (MAP) might influence the calculated aortic impedance. In seven open-chest, anesthetized, autonomically blocked dogs, we measured aortic impedance using white-noise analysis at various levels of MAP achieved by adjusting the height of a left atrial reservoir rather than by pharmacological intervention. Impedance spectra so obtained were parameterized according to best fit wind-kessel models (Ra, Rc, Ca) and three parameters to characterize wave reflections: the frequency at which the phase of the impedance approached or crossed through 0 degree (phi 0), the frequency of the first minimum of the impedance modulus (fmin), and the amplitude of the first oscillation of the impedance modulus (a 1). The dependency of each of these parameters on MAP was investigated. In addition, we calculated the reflection coefficient spectrum (RCS). Results show that windkessel parameters were not significantly influenced by MAP and that the reflection parameters and the RCS depended on increased levels of MAP in a manner consistent with an increase in pulsewave velocity. PMID- 2782452 TI - Acidosis depresses delayed afterdepolarization in guinea pig myocardium. AB - We examined the relationship among intracellular sodium activity (aiNa), intracellular pH (pHi), and delayed afterdepolarization (DAD) in guinea pig ventricular papillary muscle fibers exposed to K-free solution in vitro, using Na+- and H+-selective microelectrodes. In unstimulated papillary muscles, exposure to K-free solution caused a rapid increase in aiNa of 16.2-22 mM at the end of a 20-min superfusion period with rates of 0.51-0.73 mM/min. This was paralleled by a decrease in intracellular pH of 0.10-0.15 units. DADs were induced after a train of driven action potentials 5-15 min after superfusion with K-free solution at the elevated aiNa from the steady-state level. Prevention of intracellular acidosis associated with the increased aiNa in K-free solution by external alkalosis at pH 8.0 enhanced the amplitude of the DAD, whereas restoration of external pH to 7.4 and a further acidification of external pH to 6.4 suppressed DADs. We concluded that intracellular acidosis associated with the increased aiNa per se increased the likelihood for inhibition of sarcoplasmic reticulum Ca2+ release in spite of increased cytosolic Ca2+. PMID- 2782453 TI - Brush-border amino acid transport mechanisms in carnivorous eel intestine. AB - Brush-border membrane vesicles (BBMV) were prepared from European eel (Anguilla anguilla) intestinal epithelium by a magnesium-ethylene glycolbis(beta-aminoethyl ether)-N,N,N',N'-tetraacetic acid (EGTA) precipitation technique. Amino acid transport by these purified vesicle preparations was investigated using either radiolabeled substrates or the voltage-sensitive fluorescent dye 3,3' diethylthiadicarbocyanine iodide [DiSC2(5)]. All amino acids tested exhibited carrier-mediated, Na+-dependent and Na+-independent transfer processes plus diffusion. The only exceptions were glutamic acid and proline, which displayed Na+ dependency and diffusion but did not appear to be transported by Na+ independent agencies. Carrier-mediated transport kinetic constants (Kapp and Jmax) for several amino acids are reported. Cis-inhibition experiments suggested the presence of at least four distinct Na+-dependent transport systems in eel intestinal BBMV: 1) an anionic transport process for glutamic and aspartic acids; 2) a cationic mechanism for lysine and arginine; 3) a relatively specific neutral amino acid carrier for proline and alpha-(methylamino)isobutyric acid; and 4) a nonspecific neutral amino acid system for most other substrates of this group. This scheme for carnivorous fish intestine most closely approximates that reported for mammalian gut with minor dissimilarities that may relate to metabolic differences or specific dietary requirements of the two vertebrate groups. PMID- 2782454 TI - Adaptability of marine teleost renal inorganic sulfate excretion: evidence for glucocorticoid involvement. AB - The marine winter flounder, Pseudopleuronectes americanus, ingests seawater (SW) and excretes most of the resultant divalent ion load by renal tubule secretion. The site of secretion is generally thought to be the proximal tubule. Although sulfate clearance ratios (C ratio-sulfate clearance/polyethylene glycol clearance) have been reported as high as 12 in SW-acclimated animals, the present study shows that net secretion ceases after acclimation to 10% SW (SO4 free). Intravenous infusion of sulfate into the latter induced net secretion within 5 h (C ratio increased from 0.83 +/- 0.23 to 2.12 +/- 0.33). Increased sulfate secretion coincided with an increase in the magnitude of HCO3-SO4 exchange in brush-border membrane vesicles (BBMV) isolated from flounder renal tubules. Treatment of 10% SW-acclimated flounder with 60 micrograms dexamethasone/100 g body wt also caused an increase in the HCO3-SO4 exchange in BBMV to a level comparable to that of BBMV from SW fish. The glucocorticoid effect was further tested in flounder renal tubule primary monolayer cultures. Measurement of unidirectional sulfate fluxes (J) showed that in the presence of cortisol net secretion (serosal-to-mucosal flux) dominated (Js----m = 111 +/- 6.5, Jm----s = 9 +/- 4.3, Jnet = 102 +/- 2.2 nmol.h-1.cm-2). Removal of cortisol from the culture medium significantly reduced net sulfate secretion to one-third of control (Js--- m = 39 +/- 13.9, Jm----s = 6 +/- 1.0, Jnet = 33 +/- 14.1 nmol.h-1.cm-2). PMID- 2782455 TI - Effect of stimulation of facial nerve on regional cerebral blood flow and glucose utilization in cats. AB - Regional cerebral blood flow was determined using the tracer [14C]iodoantipyrine and regional brain dissection, and regional cerebral glucose utilization was determined using the 2-deoxyglucose method in the alpha-chloralose-anesthetized cat to evaluate the effect of electrical stimulation of the facial nerve. The nerve was sectioned intracranially to isolate it from the brain stem and the distal portion stimulated before entry into the internal auditory meatus. Stimulation led to a global increase in cortical (frontal, parietal, temporal, occipital, and cingulate cortex) and white matter blood flow. This effect was predominantly ipsilateral to the side stimulated, although significant effects were also noted on the contralateral side. The latter were confined to the more anterior cortical structures. In contrast, there were no significant changes in regional metabolic activity as assessed by the rate of glucose utilization. This study provides direct evidence for a neurogenic vasodilator effect of activation of the facial-greater superficial petrosal pathway that is independent of regional brain metabolic activity. PMID- 2782456 TI - Brown fat GDP binding and circulating metabolites during hibernation and arousal. AB - The effect of hibernation and arousal on brown adipose tissue (BAT) cytochrome-c oxidase activity and GDP binding, as well-circulating metabolites, have been studied in the 13-lined ground squirrel. Control animals (warm adapted) were housed continuously at 23 degrees C, while the remaining animals were transferred into a cold room (4 degrees C) for 8 days to induce hibernation. Hibernating animals were killed while deeply hibernating. Aroused animals were manually stimulated to induce arousal or had spontaneously aroused on the day of the experiment. BAT weight as well as mitochondrial mass were increased in both groups of cold-adapted animals, relative to controls. A substantial increase in GDP binding, however, was seen only in aroused animals, an observation confirmed by Scatchard analysis. Arousal was also accompanied by marked alterations in the levels of several circulating metabolites. Plasma free fatty acids declined by approximately 20% despite a three- to fourfold increase in plasma glycerol concentrations. Plasma lactate levels increased eightfold, while concentrations of beta-hydroxybutyrate were five times lower during arousal than hibernation. These data are consistent with the idea that the oxidation of free fatty acids, glucose, and ketone bodies are all increased during arousal. In conclusion, we have found that cold adaptation and subsequent hibernation increases BAT thermogenic capacity in the 13-lined ground squirrel. However, this increase in thermogenic potential is not manifested as a substantial increase in BAT thermogenic activity until arousal is initiated. PMID- 2782457 TI - Decreasing pH of rat embryos and fluids estimated by transplacental distribution of DMO. AB - Utilizing the transplacental distribution of a weak acid, 5,5-dimethyloxazolidine 2,4-dione (DMO), we have measured the pH of cells within the rat embryo in vivo on days 11.5-14 of gestation. This is a period of rapid organogenesis in this species when the cells of many organ systems begin to change from a proliferative mode into a differentiated state. We found that intracellular pH of the day 11.5 rat embryo is 7.47 +/- 0.03 and decreases steadily to day 14 at which time it reaches 7.11 +/- 0.03. Because there is a concomitant fall in proliferative rate over this span of development, we suggest this correlation to be additional evidence of an association between proliferation and alkalinization of the cell interior. A number of other compartments including embryo plasma, amniotic fluid, exocoelomic fluid, and yolk sac have a decreasing concentration of DMO as development advances, indicative of a steadily declining pH. These changes could have developmental and pharmacokinetic implications. PMID- 2782458 TI - Effect of exercise training on energy balance of orchidectomized rats. AB - The purpose of the present study was to investigate both the respective and interactive roles of exercise training and testosterone on energy balance. Male rats were divided into sedentary and exercise-trained groups. Each group formed was further divided into a sham-operated group, an orchidectomized group, or an orchidectomized group treated with testosterone. Rats were exercised on a motor driven treadmill for 1 h/day over 28 consecutive days, after which rats were killed. Energy balance measurements, body composition analyses, and serum testosterone assay were then performed. The weight, protein content, and cytochrome-c oxidase activity of interscapular brown adipose tissue (IBAT) were also measured. Results indicate that total food intake, final body weight, and body weight gain were generally lower in exercise-trained rats than in sedentary animals. In orchidectomized rats treated with testosterone, gains of both fat and protein were lower in exercise-trained than in sedentary animals. There was no difference in metabolizable energy intake and body energy gain between trained and sedentary rats that underwent orchidectomy without replacement therapy. In orchidectomized groups of rats, energy gain was lower in trained rats that were treated with testosterone than in those that did not receive any treatment. Furthermore, in trained orchidectomized rats treated with testosterone, both energetic efficiency and energy density of body weight gain were lower than those of trained orchidectomized rats that were not treated. Finally, a significant reduction in IBAT weight was observed in exercise-trained animals, whereas neither exercise nor the various hormonal manipulations affected IBAT protein content and cytochrome-c oxidase activity.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2782459 TI - Cardiovascular responses during feeding in newborn lambs. AB - We examined the cardiovascular responses to bottle feeding in newborn lambs. Feeding induced a persistent rise in blood pressure, from 76.3 +/- 1.9 mmHg to 114 +/- 3.8 mmHg, that lasted for the duration of the feeding episode. This was accompanied by a transient tachycardia that lasted for approximately 10 s at the beginning of each feeding episode. Vasoconstriction of the hindlimb circulation, the gastrointestinal tract, kidneys, and adrenal and thyroid glands contributed to the pressor response, whereas changes in skeletal muscle resistance were not statistically significant. Of tissues assessed, only those actively involved in feeding (tongue and esophagus) vasodilated. Feeding tachycardia was greatly inhibited or abolished by the beta-blocker propranolol but the alpha-blocker phentolamine caused only moderate inhibition of the pressor response. Furthermore, chemical sympathectomy with 6-hydroxydopamine delayed the onset of the pressor response but did not abolish the ultimate rise in pressure. These findings indicate that feeding causes a significant pressor response in newborn lambs that is only partially mediated by sympathetic innervation. PMID- 2782460 TI - Modulation of fetal cardiovascular responsiveness to norepinephrine by autonomic nervous system. AB - To determine the extent to which the autonomic nervous system modifies the fetal cardiovascular responses to exogenous norepinephrine (NE), NE was infused intravenously (0.39-39 micrograms/min) for 30 min into chronically catheterized sheep fetuses averaging 132 days gestation. The resulting changes in arterial pressure, venous pressure, heart rate, and blood volume were compared between fetuses with and without ganglionic blockade. Autonomic blockade did not alter the relationship between the rise in NE concentration and NE infusion rate. In fetuses with a blocked autonomic nervous system, the arterial pressure response to exogenous NE was shifted 0.8 log units to the left when compared with normal fetuses. The venous pressure response to NE infusion was not altered in the blocked fetuses when compared with normal fetuses. Heart rate in the autonomically blocked fetuses increased with plasma NE concentration, which was opposite to the initial suppression of heart rate during NE infusion in control fetuses. Fetal blood volume decreased progressively with increasing NE infusion rate in the blocked fetuses, which was similar in autonomically intact fetuses, except for an increase in blood volume at low NE infusion rates. Thus it appears that the autonomic nervous system modifies the fetal arterial pressure, heart rate, and blood volume responses to exogenous NE but not the response of venous pressure. PMID- 2782461 TI - Volume expansion attenuates baroreflex sensitivity in the conscious nonhuman primate. AB - We examined the effect of intravascular volume expansion (VE) on the arterial baroreflex control of pulse rate (PR) in conscious, chronically instrumented monkeys tethered in their cages. A total of five monkeys was studied after surgical implantation of catheters in the descending aorta, the left atrium, and the internal jugular vein. Mean arterial blood pressure (MABP)-PR stimulus response curves were constructed by decreasing and increasing blood pressure with nitroprusside and phenylephrine, respectively. The data were analyzed with a regression analysis that generated a sigmoid curve and the maximum sensitivity (slope) of the curve. The data were obtained before and after VE with an isotonic isoncotic dextran solution equal to 20% of the estimated blood volume. After VE, the MABP-PR curve shifted to the right at the high blood pressures, and there was a significant decrease in the maximum sensitivity from 5.65 +/- 1.44 for control to 2.14 +/- 0.63 after VE (P less than 0.05). We concluded that VE attenuates the baroreflex control of heart rate in the conscious nonhuman primate. PMID- 2782462 TI - Sarcoplasmic reticulum, potassium, and cardiac force in rainbow trout and plaice. AB - The role played by the sarcoplasmic reticulum in force development and in cellular Ca2+ balance and its dependence on extracellular K+ were examined in heart ventricular tissue of rainbow trout and plaice. Compared with the steady state twitch at a stimulation rate of 0.2 Hz, a 30-s rest led to a similar increase in twitch force in trout heart, regardless of whether [K+] was 2.5 or 5 mM. At 5 mM (but not at 2.5 mM) post-rest potentiation increased with increasing rest periods (from 30 to 900 s). These post-rest potentiations were removed or transformed into a loss of force by 10 microM ryanodine or 8 mM caffeine. In the plaice heart, where the sarcoplasmic reticulum is claimed to be sparse, the post rest potentiation and the influence of ryanodine were small. The Ca2+ uptake measured during 5 min with 45Ca in the trout heart was higher in 5 than in 2.5 mM K+, regardless of the concomitant stimulation rate. This effect of K+ was removed by 10 microM ryanodine. The twitch force after 5 min of rest correlated significantly with the Ca2+ uptake, whereas the twitch force developed at a rate of 0.2 or 1.0 Hz did not. In conclusion, an elevation of K+ appears to stimulate the Ca2+ uptake of the sarcoplasmic reticulum. The twitch force after prolonged rest seems to relate to the Ca2+ contained in this organelle, whereas this does not apply to the twitch force developed at more physiological rates (0.2 or 1 Hz). PMID- 2782464 TI - Physiological role of HMG-CoA reductase in regulating egg production by Schistosoma mansoni. AB - Pathological lesions observed in humans infected with Schistosoma mansoni are due to the eggs produced by the female parasite. Mevinolin, a potent inhibitor of the enzyme hydroxymethylglutaryl-CoA (HMG-CoA) reductase, blocks egg production by this parasite. In this report, we demonstrate that cholesterol precursors, mevalonate and farnesol, stimulate egg production by the female parasite and that these precursors can reverse the mevinolin-induced inhibition of egg production. Because the parasite cannot synthesize cholesterol, we incubated parasites in a culture media containing radiolabeled acetate with and without mevinolin. We isolated nonsterol lipids from the parasite and observed that mevinolin dramatically reduced the conversion of acetate into the polyisoprenoid (dolichols) lipids of the parasite. Dolichols and other nonsterol lipids did not stimulate egg production. HMG-CoA reductase activity was observed in homogenates of the parasite and was inhibited by mevinolin (Ki = 52 nM), but its activity was tripled when the parasite was chronically exposed to low doses of the drug. Parasites with increased reductase activity produced five to six times more eggs. Lastly, chronic administration of large doses of mevinolin to infected mice resulted in a marked reduction of the pathology associated with the infection. These results suggest that egg production in S. mansoni is associated with the parasite's HMG-CoA reductase activity and that a nonsterol lipid produced in the biochemical pathway regulated by this enzyme stimulates egg production. PMID- 2782463 TI - Suprachiasmatic nucleus: phase-dependent activation during the hibernation cycle. AB - The suprachiasmatic nucleus (SCN) of the golden-mantled ground squirrel undergoes a phase-dependent change in its accumulation of 2-[14C]deoxy-D-glucose (2-DG) relative to other brain structures during the hibernation cycle. The greatest relative 2-DG uptake (R2DGU) is observed in the SCN during entrance into and during deep hibernation. A circadian fluctuation in R2DGU of the SCN is not evident in the euthermic ground squirrel but can be increased during the subjective day by photic stimulation. An increase in R2DGU by the paraventricular nucleus (PVN) correlates with the increase in R2DGU by the SCN during entrance to hibernation but not with the increase in SCN R2DGU evoked by photic stimulation during euthermia. The periventricular nuclei of the hypothalamus (PEV) also have high levels of R2DGU during the latter phase of the entrance. These observations support the hypothesis that the SCN, PEV, and PVN may play important roles in hibernation and suggest progressive activation of synaptic input to and within the SCN during entrance into this state. PMID- 2782465 TI - Mechanisms of respiration-induced changes in vasomotor control exerted by rostral ventrolateral medulla. AB - Efferent and afferent mechanisms involved in the differential depressor response to inactivating rostral ventrolateral medulla (RVLM) under conditions of normal (2.5 ml) and reduced (1.5 ml) tidal volume were examined in urethan-anesthetized rats. Under conditions of reduced tidal volume, bilateral microinjection of lidocaine (200 nl, 4%) into RVLM produced an attenuated fall in both mean arterial pressure (MAP) and renal sympathetic nerve activity (RSNA) despite the fact that base-line levels of both are unchanged. The specificity of the differential response was tested by examination of regional hemodynamics. Microinjecting lidocaine into RVLM produced an attenuated fall in renal, mesenteric, and hindquarter vascular resistances in parallel with the attenuated fall in MAP produced by reducing tidal volume. Microelectrode stimulation of RVLM produced an increase in resistance in all three vascular beds. Of the neural sensory systems examined, both vagal and chest wall afferents appear to be involved in mediating the differential depressor response. These results demonstrate the importance of afferent sensory input to the medulla in determining sites of generation and maintenance of sympathetic vasomotor tone. PMID- 2782466 TI - Subregions of rostral ventral medulla control arterial pressure and regional hemodynamics. AB - The cardiovascular effects of inactivating rostral ventromedial medulla (RVMM) under conditions of normal (2.5 ml) and reduced (1.5 ml) tidal volume were studied in urethan-anesthetized rats. Bilateral microinjection of lidocaine (200 nl, 4%) reduced mean arterial pressure (MAP), renal, mesenteric, and particularly hindquarter vascular resistance. These effects were not significantly altered by reducing tidal volume. Electrical stimulation of RVMM increased MAP and regional vascular resistances, again with the hindquarter change most prominent. The integrated cardiovascular response to stimulating rostral ventrolateral medulla (RVLM) appears to require integrity of RVMM; however, the converse is not true. Overall, these studies indicate that 1) the potential for RVMM to maintain neurogenic control of arterial pressure is as great as RVLM; 2) RVMM is capable of playing a proportionally greater role in the controlling hindquarter vascular resistance; 3) the integrity of RVMM appears to be important for responses elicited from RVLM; and 4) unlike RVLM, neural control of arterial pressure is sustained by RVMM under conditions of reduced tidal volume. We conclude that RVLM and RVMM are functionally and anatomically distinct subregions of rostral ventral medulla with equivalent capacity to maintain vasomotor tone. PMID- 2782468 TI - Simple and inexpensive delivery of halogenated inhalation anesthetics to rodents. AB - Halogenated inhalation anesthetics offer several advantages over injectable anesthetics for small-animal surgery. Benefits include rapid induction, easy adjustment of anesthetic depth, and a short period of recovery. Although the cost of most inhalation anesthetics is low, present delivery systems are often prohibitively expensive for rodent uses. This report describes a low-cost, portable system that can be used with halothane or isoflurane for general surgery or stereotaxic applications with or without intubation. Also included is a description of rodent nose cones for both general surgery and stereotaxic surgery that allow for simple evacuation of waste gases. PMID- 2782467 TI - Breath-by-breath respiratory timing and volume control during periodic breathing. AB - We examined the control of respiratory pattern during non-rapid-eye-movement sleep-related periodic breathing (PB) in adults, with and without hypoxia. We analyzed 186 cycles of PB from 18 epochs occurring in eight subjects; the mean (+/- SD) cycle duration was 30.8 +/- 8.4 s. Significant oscillations occurred in inspired tidal volume (VT), inspiratory duration (TI), mean inspired flow, inspired minute ventilation, and expiratory duration (TE) (P less than 0.005). For each epoch of PB, moving cross-correlation (MCC) functions were employed to describe the time-dependent intervariable relationships between 1) TI vs. TE, 2) VT vs. TE, and 3) VT vs. breath duration (TT) as synchronization, a strong and consistent intervariable correlation; relative coordination (RC), a weaker interaction characterized by an unstable MCC function oscillating at a subharmonic of the PB frequency; or as independence, with no statistical evidence of interaction. Fourteen epochs showed RC between TI and TE, 11 and 12 of which also showed RC between VT and TE, and VT and TT, respectively. In 4 epochs negative synchronization was exhibited by all three variable pairs. In no case were the oscillations between any pair of variables independent. The modes of coupling between variables were not correlated to O2 saturation, end-tidal CO2 levels, or inspired O2 level. We conclude that during sleep-related PB a nonrandom but weak coupling usually exists between TI and TE, VT and TE, and VT and TT.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2782469 TI - The chronically mentally ill, residency training, and psychiatry. PMID- 2782471 TI - Risk of schizophrenia in character disordered patients. AB - Inpatients from the Chestnut Lodge follow-up study diagnosed with character disorder were studied to predict future schizophrenic decompensation. Individually, three DSM-III criteria for schizotypal personality disorder predicted schizophrenia at long-term follow-up: magical thinking, suspiciousness or paranoid ideation, and social isolation. Additionally, lower IQ, poorer premorbid quality of work, and transient delusional experiences were predictive. No borderline personality disorder criterion was predictive. This suggests that schizotypal but not borderline personality disorder belongs in the schizophrenic spectrum. Within schizotypal personality disorder, criteria from both familial and clinical traditions appear to be dimensions of vulnerability to psychosis. PMID- 2782472 TI - Study of 60 patients with AIDS or AIDS-related complex requiring psychiatric hospitalization. AB - Sixty patients with acquired immune deficiency syndrome (AIDS) or AIDS-related complex were treated on a locked inpatient psychiatric unit over a 30-month period. The wide range of mental disorders exhibited by these patients, key aspects of patient management, and the difficulty in psychiatric differential diagnosis are described. PMID- 2782470 TI - Cognitive-behavioral treatment of depressed inpatients: six- and twelve-month follow-up. AB - The authors report 6- and 12-month follow-up data for 45 depressed inpatients who were randomly assigned to either standard treatment (hospital milieu therapy, pharmacotherapy, clinical management sessions), cognitive therapy plus standard treatment, or social skills training plus standard treatment. All treatments began in the hospital and continued for 4 months after discharge on an outpatient basis. Significantly higher proportions of the patients who received additional cognitive-behavioral treatment (cognitive therapy or social skills) had responded by the end of the formal treatment period and did not relapse for the remainder of the 1-year follow-up period. PMID- 2782473 TI - Defining and measuring stabilization of patients during 4 years of intensive community support. AB - The first 4 years of an intensive community support program were evaluated in terms of key variables of patient stabilization. Patients (N = 196) had previously demonstrated an inability to manage themselves without repeated and/or lengthy hospitalizations. During program participation, there were significant reductions in hospital days and events (80%), jail incarcerations and charges, billings per patient, and stressful events. Patients reported increased satisfaction both with their lives and the program. The results support the value of continued multidimensional and multimethod examinations of patient stabilization. PMID- 2782474 TI - Panic disorder and the menstrual cycle: panic disorder patients, healthy control subjects, and patients with premenstrual syndrome. AB - The authors prospectively evaluated 20 normally menstruating women with panic disorder across a minimum of two drug-free menstrual cycles. There were no significant effects of menstrual cycle phase on anxiety ratings in the panic disorder patients or in 20 healthy control subjects; this contrasted with a robust increase in premenstrual anxiety in 20 subjects with premenstrual syndrome. These findings suggest that the symptoms of panic disorder are not commonly exacerbated by the premenstrual phase of the menstrual cycle and highlight the need for prospective evaluation in the attempt to document an association between psychiatric symptoms and the menstrual cycle. PMID- 2782475 TI - Family history of anxiety disorders in control subjects with lactate-induced panic attacks. AB - The authors infused 45 control subjects with sodium lactate. Eight of 10 subjects with lactate-induced panic attacks and 26 of 35 without panic attacks were interviewed. An investigator, blind to the outcome of the infusion study, obtained family histories of 160 relatives. There was a high prevalence of anxiety disorders among first-degree relatives of subjects with panic attacks. There was no significant difference in the prevalence of mood disorders and substance abuse between first-degree relatives of subjects with (N = 45) and without (N = 115) panic attacks. The results suggest that individuals with a family history of anxiety disorders may be vulnerable to lactate-induced panic attacks. PMID- 2782476 TI - A longitudinal assessment of haloperidol doses and serum concentrations in Asian and Caucasian schizophrenic patients. AB - Over 3 months, 13 Caucasian and 16 Asian schizophrenic patients were sequentially treated with weight-adjusted fixed doses and clinically determined, variable doses of haloperidol. During the fixed-dose phase, Asians had a slightly higher mean serum haloperidol concentration and a significantly higher rating for extrapyramidal symptoms. During the variable-dose phase, the Asian patients' mean required dose was significantly lower, resulting in lower serum haloperidol concentrations at the first emergence of extrapyramidal symptoms and for optimal clinical response. These results indicate pharmacodynamic differences in therapeutic response but no significant difference in steady-state serum concentration between the two groups. PMID- 2782478 TI - A crosswalk from DSM-III-R to ICD-9-CM. AB - The authors describe a crosswalk, or translation, from DSM-III-R to ICD-9-CM. They present differences in the purposes and formatting of these two documents and discuss different levels of compatibility between the two. They demonstrate several problems at the code, rubric, and case levels of compatibility. Ninety seven percent of DSM-III-R codes are compatible with ICD-9-CM at the case level. The problems in most cases are minor, and in the authors' opinion are not problems in actual clinical or medical records use. The development of DSM-IV and ICD-10 should include attention to translation issues early in the process from the perspectives of clinical work, research, and medical records. PMID- 2782477 TI - Diagnostic legitimacy of factitious disorder with psychological symptoms. AB - The authors question the clinical status of factitious disorder with psychological symptoms as a mental disorder. In particular, they argue that unresolved issues regarding the motivational basis of this disorder and the lack of clearly delineated inclusion, exclusion, and outcome criteria seriously compromise its diagnostic legitimacy. Two case reports are presented to illustrate these difficulties. Future studies should consider these empirical and conceptual difficulties in refining the diagnosis of factitious disorder with psychological symptoms for DSM-IV. PMID- 2782479 TI - Sex differences in olfactory function in schizophrenia. AB - Olfactory identification and olfactory acuity were measured in 41 schizophrenic patients receiving neuroleptic medication and in 43 normal control subjects. The performance of the male schizophrenic patients was significantly lower than that of the female patients and the male and female normal control subjects. The last three subgroups performed at equivalent levels. These findings are discussed with respect to other reported sex differences in schizophrenia, including frequency of specific neurological signs and structural brain abnormalities, response to neuroleptic medication, and long-term outcome. The findings suggest that the sex of the patient may be a critical variable in understanding the processes of schizophrenia. PMID- 2782481 TI - Parental alcoholism as a risk factor in benzodiazepine abuse: a pilot study. AB - Nine of 12 men with a family history of alcoholism but only two of 12 control subjects had euphoric responses to alprazolam. The authors conclude that sons of alcoholics may be at high risk to abuse alprazolam. PMID- 2782480 TI - A basic residency curriculum concerning the chronically mentally ill. AB - In this paper a group of knowledgeable individuals with expertise in psychiatric education present their recommendations for a basic psychiatric residency curriculum concerning the chronically mentally ill. The proposed curriculum consists of knowledge, skill, and attitude educational objectives, as well as clinical experiences, faculty supervision, didactics and seminars, and evaluation mechanisms. Recommendations are also made concerning changes in the Accreditation Council for Graduate Medical Education's Special Requirements for Residency Training in Psychiatry, which would require residency programs to place more emphasis on training to meet the needs of the chronically mentally ill. Obstacles to the implementation of the proposed recommendations are presented and possible solutions are discussed. PMID- 2782482 TI - Illicit substance use by acutely psychotic patients. PMID- 2782483 TI - Pathophysiology of obsessive-compulsive disorder. PMID- 2782484 TI - Higher frequency of separation anxiety in panic disorder patients. PMID- 2782485 TI - The case for the diagnosis of organic catatonic syndrome. PMID- 2782486 TI - Psychotherapy with schizophrenic patients. PMID- 2782487 TI - Reporting seizures and blackouts. PMID- 2782488 TI - Double depression and somatization. PMID- 2782489 TI - Photophobia in depression. PMID- 2782490 TI - Comorbidity versus misdiagnosis of axis II and axis III disorders. PMID- 2782492 TI - Effects of lithium on thyroid function. PMID- 2782491 TI - Therapist-patient sexual involvement. PMID- 2782493 TI - Neurobiology of panic disorder. PMID- 2782494 TI - Exercise and anxiety disorders. PMID- 2782495 TI - Verifying patients' reports of childhood abuse. PMID- 2782496 TI - Derealization without depersonalization. PMID- 2782497 TI - Problems in measurement of accuracy of cause-of-death statistics. PMID- 2782498 TI - Needle exchange programs: a medical or a policy dilemma? PMID- 2782499 TI - State spending for AIDS programs increased during 1989. PMID- 2782500 TI - Quality of death certificates in Valencia, Spain. AB - Certificates of 1,454 deaths occurring over 11 months were retrieved from the Civil Register in Valencia, Spain. Relevant medical information was systematically gathered from hospital records, questionnaires, and Coroner reports. We compared the underlying cause of death (UCD) from the original death certificate, and a reference cause of death (RCD) determined by a panel of experts based on all available information. Overall, 80.2 percent of the certificates were concordant for disease category, but there was a great disparity among some specific disease categories. PMID- 2782501 TI - Risk reduction among intravenous drug users in Amsterdam under the influence of AIDS. AB - We evaluated the impact of a needle/syringe exchange program among 263 drug users in the period December 1985 to April 1988. Participants in this study were asked about their risk-behavior at three different visits. We found no increase in the proportion injecting drugs or in the frequency of intravenous drug use. A strong decrease in borrowing and lending of used needle/syringes was found and this behavioral change was not dependent on learning human immunodeficiency virus (HIV) serostatus. Although use of the exchange program increased over time, reduction in needle sharing was mainly an effect of the study with only a limited impact of the exchange program. We conclude that ample provision of needles and syringes is an important starting point but in itself not enough to produce the necessary drastic change in risk behavior. Intensive counseling of the drug user is also needed. PMID- 2782502 TI - Impact of the AIDS epidemic on morbidity and mortality among intravenous drug users in a New York City methadone maintenance program. AB - To examine the impact of the AIDS epidemic on morbidity and mortality in a defined population of intravenous drug users, we analyzed overall and cause specific death rates, AIDS incidence, and acute medical hospitalizations among patients in a long-term methadone maintenance program in New York City for the years 1984 through 1987 (midyear population for each year 828 to 891; demographic characteristics did not differ). The number of deaths while in treatment increased from 11 (13.3/1000) in 1984 to 39 (44.2/1000) in 1987. Deaths from AIDS increased from 3.6/1000 to 14.7/1000, deaths due to bacterial pneumonia/sepsis from 3.6/1000 to 13.6/1000; deaths from cirrhosis, drug overdose, trauma, and other causes remained relatively stable. AIDS incidence rose from six cases/1000 in 1984 to 20.4.1000 in 1987. Hospitalizations for AIDS, pneumonia, tuberculosis, and endocarditis/sepsis increased from 84.9/1000 in 1986 to 144.8/1000 in 1987. These data suggest that the AIDS epidemic has had a profound effect on patterns of morbidity and mortality among intravenous drug users in this methadone program population. Drug treatment programs may be important sites for targeting clinical services for drug users with AIDS, although the increasing burden of AIDS-related disease will require expansion of existing funding and treatment resources. PMID- 2782504 TI - Business recession, alcohol consumption, drinking and driving laws: impact on Oklahoma motor vehicle fatalities and fatal crashes. AB - In 1982, Oklahoma enacted a series of drinking and driving laws. In the ensuing years, motor vehicle fatalities and fatal crashes were reduced by one-third. Factors contributing to this reduction were examined using interrupted time series analysis of monthly rates of motor vehicle deaths and fatal crashes for the period January 1980 to December 1986. Decreasing per capita alcohol consumption and increased unemployment apparently account for most of the fatality and fatal crash reduction in Oklahoma. The enactment of two traffic safety laws--one specifying the illegal blood alcohol concentration level (BAC law) and the other facilitating license withdrawal from suspected drunk drivers (administrative per se law)--together reduced Oklahoma traffic deaths and fatal crashes by about 9 percent. The effectiveness of the laws appeared to be greatest in the first two years following their enactment. PMID- 2782503 TI - Suicide risk among women with alcohol problems. AB - The current study compares 301 alcoholic women, ages 20 to 50, interviewed in 21 treatment facilities, and a control group of nonalcoholic women matched for age and socioeconomic status of family of origin. A significantly higher percentage of alcoholic women (40.0% vs 8.8%) reported having made suicide attempts, a difference of 31.2 percentage points (95% CI = 23.9, 38.5). Age comparisons within the alcoholic sample show the percentage of younger alcoholic women attempting suicide to be twice as great as the percentage of the alcoholic women suicide attempters in their forties. Such age differences were not found among the nonalcoholic control group. The findings suggest that youthfulness and alcohol/drug abuse are the critical combination for high risk. Awareness of the suicide attempt risk potential is necessary both for emergency room personnel and for substance abuse facility workers. PMID- 2782505 TI - Six-year follow-up of the first Waterloo school smoking prevention trial. AB - This paper reports six-year follow-up data from the first large-scale randomized trial of the social influences approach to smoking prevention. In 1979, 22 schools were randomly assigned to program or control conditions. Students in program schools received a social influences curriculum in six core and two maintenance sessions in grade 6, two booster sessions in grade 7, and one booster session in grade 8. All students were assessed at pretest (T1), immediate posttest (T2), end of grade 6 (T3), beginning and end of grade 7 (T4 and T5), end of grade 8 (T6), and grades 11 and 12 (T7 and T8). Ninety percent of study students were relocated and data obtained from over 80 percent of them at T8. Program effects on experimental smoking observed in grades 7 and 8 had completely decayed by T8, six years after the beginning of the program. Grade 6 smoking experience and social risk were each strong predictors of T8 smoking behavior. Subjects who had left school were smoking at more than twice the rate of subjects still in high school (grade 12) at T8. We discuss implications of the results. PMID- 2782506 TI - One year follow-up of the Chicago televised smoking cessation program. AB - We compared the relative effectiveness of four different conditions of self-help and social support provided to people attempting to quit smoking in conjunction with a televised cessation program: Smokers ready to quit were able to request written manuals from hardware stores to accompany a televised program. At worksites we provided the written manual to all workers. At a random half of the worksites, we also provided training to discussion leaders who subsequently led discussions among smokers attempting to quit with the program. At health maintenance organization sites we invited smokers who had requested program materials to participate in similar group discussions at health centers. In this paper we report one year follow-up results for the above four groups and compare them with previously reported results of a self-help manual alone. Results for the television plus manual condition were better than those of past studies (25 percent nonsmoking prevalence and 10 percent continuous cessation one year after the program) and considerably better than the manual alone. None of the other conditions designed to supplement the manual plus television produced better long term outcomes; we explore the reasons for this. The program did encourage and help over 50,000 Chicago smokers to attempt quitting with the American Lung Association manual, 100 times as many as would have done so without the televised program. At least 15 other similar programs implemented since 1984 multiply this effect. PMID- 2782507 TI - Elevated blood levels of carcinogens in passive smokers. AB - The hypothesis that involuntary exposure to tobacco smoke--passive smoking- results in greater risk of cancer was assessed by measuring the levels of two known carcinogens in the blood of 57 nonsmokers with varying degrees of involuntary exposure, including six heavily exposed bartenders. The concentrations of hemoglobin adducts of 4-aminobiphenyl, a bladder carcinogen, were significantly higher in subjects with confirmed involuntary exposure (plasma cotinine concentrations between 2 and 23 ng/ml) compared with subjects with undetectable levels of cotinine. Similarly, adducts of 3-aminobiphenyl were significantly elevated in subjects with confirmed exposure. The odds of 3 aminobiphenyl adduct levels exceeding 2 pg/g of hemoglobin were 6:7 among the confirmed exposed, compared with the odds of 2:42 among subjects with undetectable cotinine (odds ratio = 18; 95 percent confidence interval = 3.3, 94). The validity of the assay was demonstrated by showing striking declines in adduct levels among quitting smokers. PMID- 2782508 TI - Delayed blood regeneration in lead exposure: an effect on reserve capacity. AB - Twenty-five lead-exposed Danish battery production workers and 25-age-matched controls were examined to evaluate subclinical effects on blood formation. Blood lead levels averaged 2.14 mumol/L and 0.35 mumol/L in the two groups; the lead workers also showed high levels of erythrocyte protoporphyrin, as compared to the controls. Otherwise, the hematological parameters indicated an appropriate iron status and no other deviations. From all subjects, 0.45 L of blood was bled as part of a normal blood donation. Five and 11 days later, reticulocyte counts were significantly higher in the control group than in the lead-exposed workers. On day 15, the lead workers showed a significant delay in blood regeneration, as evidenced by lower hemoglobin concentration, and erythrocyte and reticulocyte counts. The lead exposure in the present study was within legal limits, and lead induced anemia would be expected only at much higher exposure levels. Thus, despite the normal hematological findings in the initial examination, the lead exposure caused a decreased reserve capacity for blood formation, and this effect became evident only after the blood loss. PMID- 2782509 TI - The expense of testing in a teaching hospital: the predominant role of high-cost tests. AB - We analyzed all 32,206 tests ordered in a random sample of 1,000 patients admitted to a teaching hospital. The analysis examined costs instead of charges, included professional costs in addition to hospital costs, and considered the effect of combining tests that are ordered as a panel (e.g., cardiac enzymes) or as part of a procedure (e.g., bronchoscopy). High-cost tests (costing more than $100) accounted for only 4 percent of the total number of tests ordered, but for nearly 50 percent of total test costs. The pattern varied by clinical service: high-cost tests accounted for 31, 47, and 51 percents of total test costs on the obstetrics, medicine, and surgery services, respectively. It would seem to be efficient to concentrate on the use of high-cost tests in attempting to foster cost-effective use of diagnostic technologies. PMID- 2782510 TI - The mortality consequences of raising the speed limit to 65 mph on rural interstates. AB - As of April 1987, states were permitted to raise the speed limit on rural interstates to 65 mph without incurring federal sanctions; 38 states elected to do so in 1987. Fatality data for the months when the new limit was in effect in 1987 were compared with fatalities in the same months of 1982-86 on rural interstates and other rural roads. Fatalities on rural interstates in the states with increased speed limits in 1987 were conservatively estimated to be 15 percent higher than they would have been if the states had retained the 55 mph limit (95% CI = 6, 24). Among states that retained the 55 mph limit, fatalities on rural interstates were 6 percent lower than expected (95% CI = -23, 13). PMID- 2782512 TI - Fluoridation referendum in La Crosse, Wisconsin: contributing factors to success. AB - Residents of La Crosse, Wisconsin approved a public referendum in favor of water fluoridation on April 5, 1988. The vote, 57 percent supportive, culminated a two year community effort. Three public referenda had been defeated in the past. Contributing to the success of this recent campaign were: broad-based community support led by a 34-member Citizens for Better Dental Health in La Crosse Committee; American Dental Association/Wisconsin Division of Health/US Public Health Service consultation and support; knowledgeable and supportive press coverage; the timing of the ballot to coincide with the Wisconsin Presidential Primary; and local chiropractic support to offset chiropractic anti-fluoridation leadership. La Crosse, population 50,000, was the largest fluoride-deficient community in a nine-state upper Midwest area. PMID- 2782511 TI - Homicide, suicide, motor vehicle crash, and fall mortality: United States' experience in comparative perspective. AB - US mortality data on motor vehicle crashes, falls, suicide, and homicide for 1980 are compared with corresponding data for France, Japan, West Germany, and the United Kingdom. Unadjusted and age-specific death rates are presented, together with age-adjusted rates of years of life lost (YLL). A large male excess in rates is typical outside the fall category. Motor vehicle crashes are the predominant cause of YLL, and the United States manifests the highest YLL rates for each sex. US fall death rates at the older ages are exceeded by those of France and West Germany. The elderly generally manifest the greatest risk of suicide; American females exhibit a unique rate decline after ages 45-54 years, however. Beyond early adulthood, US suicide rates are lower than those of France, Japan, and West Germany. US homicide rates dwarf those of the comparison countries with 16- to 29 fold differentials separating prime-risk American males aged 25-34 years from their foreign counterparts. PMID- 2782513 TI - Cocaine and heroin dependence compared: evidence from an epidemiologic field survey. AB - Analyzing self-report interview data from a multi-site collaborative study of mental disorders in the community, we examined suspected differences between 611 cocaine users and 126 heroin users in relation to indicators of drug dependence. Cocaine users were less likely to report dependence-related problems as compared to heroin users. These epidemiologic sample data underscore concerns about the generalizability of published clinical sample data on self-reported cocaine dependence. PMID- 2782514 TI - Improving patient comprehension of literature on smoking. AB - This study was designed to determine if simplification of smoking literature improved patient comprehension. Subjects (N = 129) were randomized in three groups: to receive no smoking booklet, receive one written at the 5th grade, or the 10th grade reading level. Subjects receiving the 5th grade booklet showed 13 percent better comprehension than those receiving the 10th grade booklet, and 18 percent better than the controls. Comprehension of written smoking materials can be improved by adjustment of the reading grade level. PMID- 2782515 TI - Cigarette and smokeless tobacco use among Connecticut adolescents. AB - Despite data that the rate of boys' cigarette use has declined nationwide, boys' total tobacco use may actually have remained high because of their substantial use of smokeless tobacco. We surveyed anonymously a random sample of entire classes of grade 7-12 boys and girls from 59 Connecticut towns concerning tobacco use. Despite girls' higher daily cigarette use, boys' total daily tobacco use was higher than that of girls in grades 7-9, and only slightly lower in grades 10-12. PMID- 2782516 TI - Mentholated cigarette use among multiphasic examinees, 1979-86. AB - Mentholated cigarette use was studied in relation to age and race in 29,037 current smokers who were Kaiser Permanente Medical Care Program members. The percentages of mentholated cigarette users were much higher in Blacks and Asians than in Whites, especially in the younger age groups. A marked inverse relationship between mentholated cigarette use and age was present in Blacks and Asians; mentholated cigarette use showed little difference with age in Whites. PMID- 2782517 TI - State-specific progress toward the 1990 objective for the nation for cigarette smoking prevalence. AB - We predicted the smoking prevalences for 1990 for each state in the US, assuming that the decline in each state from 1985-1990 would be the same as the decline in the US from 1965-1985. In 1985, only three states had smoking prevalences less than 25 percent. Based upon the observed decline in smoking in the US from 1965 1985 of 0.5 percent per year, we predict that only seven states will have smoking prevalences less than 25 percent by 1990. States need to consider current smoking prevalence and achievable rates of decline when setting objectives for 1990 and beyond. PMID- 2782518 TI - The news on smoking: newspaper coverage of smoking and health in Australia, 1987 88. AB - All newspaper articles (n = 1601) mentioning tobacco or smoking drawn from a 12 month census of 30 Australian capital city newspapers in 1987-88 were coded for content, "slant," and apparent origin. Overall, 62 percent of articles were positive in their orientation toward smoking control objectives, 17 percent were negative, and 21 percent were neutral. Newspapers owned by Rupert Murdoch published 55.7 percent positive and 23.7 percent negative articles compared to 68.0 percent positive and 13.7 percent negative articles in the other large chain of Australian newspapers. PMID- 2782519 TI - Influenza immunization in the elderly: knowledge and attitudes do not explain physician behavior. AB - The records of 847 elderly clinic patients were reviewed and the 95 primary care physicians who managed their care were surveyed to determine factors related to their ordering of influenza immunization. Overall, 41 percent of the eligible patients were offered vaccine (range 0-90 percent). Physician offering of vaccine was unrelated to patient age, sex, or race but was higher in patients seen on multiple visits (47 vs 39 percent) and in those vaccinated during the prior year (61 vs 35 percent). Physician offering of vaccine was not associated with perceived incidence of severe side effects or estimates of vaccine efficacy. PMID- 2782521 TI - A nation of suspects: drug testing and the Fourth Amendment. PMID- 2782520 TI - Occupational exposure to human immunodeficiency virus (HIV) and hepatitis B virus (HBV) among embalmers: a pilot seroprevalence study. AB - We performed a serosurvey of 133 embalmers in an urban area where human immunodeficiency virus (HIV) infection is prevalent. Although we found histories of needlesticks to be common, and the seropositivity rate of hepatitis B virus (HBV) (13%) was approximately twice that of a blood donor comparison group, HIV antibody was uniformly absent in 129 embalmers who denied HIV risk factors, and present in one of four with self-described risk behaviors. The risk of HBV infection was higher among embalmers who have worked more than 10 years, relative risk (RR) 16.2 (95% confidence interval 2.1, 126.5), did not routinely wear gloves, RR 9.8 (CI 3.4, 28.5), or are employed in the city of Boston, RR 4.7 (CI 1.8, 12.0). PMID- 2782522 TI - Risk to passive smokers. PMID- 2782523 TI - Environmental tobacco smoke and legal issues. PMID- 2782524 TI - Mail surveys of physicians. PMID- 2782525 TI - Sport fish consumption advisories. PMID- 2782526 TI - Health care for the indigent. PMID- 2782527 TI - Rupture of the pectoralis major muscle. AB - Nineteen cases of rupture of the pectoralis major muscle are presented. In 16 cases the rupture was repaired; in 3 cases repair was not performed. Physical findings and surgical technique are described and the anatomy of the insertion of the pectoralis major muscle is reviewed. Nine of the patients in this series sustained their injury while performing the bench press. The majority of the remaining patients were also involved in sports when injury occurred. Eleven of the ruptures were in the nondominant arm and eight in the dominant arm. All of the patients complained of weakness, pain, and deformity, with weakness being the major complaint. Following surgery and rehabilitation, all 16 patients who underwent repair were relieved of pain. The deformity was corrected in all 16 patients, although 2 patients who had a 5 year interval from repair to rupture did not achieve a completely normal contour. Thirteen of the 16 patients reported a full return to strength. The others had significant improvements. Ruptures of the pectoralis major muscle are uncommon, but not rare. Ruptures occurring under tension tear at or near the insertion onto the humerus, as in all 19 cases in this series. Distal ruptures are usually complete, despite physical signs that may be misleading. Distal tears are reparable, even after a delay to treatment. After surgical repair, the majority of patients may expect relief of pain, return of strength and normal contour, and maintenance of range of motion. PMID- 2782529 TI - Three-dimensional dynamic motion analysis of the anterior cruciate ligament deficient knee joint. AB - Dynamic three-dimensional motion analyses of 15 fresh human knee joints subjected to combinations of flexion velocity and moment, internal and external femoral torque, and horizontal shear before and after sectioning the ACL were performed. ACL deficient specimens demonstrated marked anterior instability without rotational instability. The pivot shift phenomenon occurred with an isolated ACL deficiency and was the result of anterior instability. The pivot shift was accentuated by external femoral torque, decreased by internal femoral torque, and was present in the absence of any applied torque. The pivot shift produced a sudden directional change in the motion of both femoral condyles and may be responsible for the meniscal degeneration that accompanies chronic ACL deficiency. PMID- 2782528 TI - Carbon fiber as a prosthetic anterior cruciate ligament. A biochemical and histological analysis in pigs. AB - Connective tissue ingrowth into a carbon fiber prosthesis inserted as a substitute for the ACL was biochemically quantified in an experimental pig model with a followup of 16 weeks. During this time, the net collagen amount expressed as hydroxyproline increased to only half that of the normal control ligament. Histological studies revealed relatively few fibroblasts capable of producing collagen inside the alloplastic ligament. When these results are considered in conjunction with those of our earlier report of the disappointing mechanical strength of the carbon fiber substitutes, it seems evident that carbon fiber is not a suitable replacement for the ACL, mainly because of its failure to produce a "neoligament" before it disintegrates. PMID- 2782530 TI - Enhancement of blood lactate clearance following maximal swimming. Effect of velocity of recovery swimming. AB - Swimming is an endurance-intensive sport resulting in accumulation of lactate. Repeat performances are often necessary in championship events. Lactate produced during a maximal effort requires time to metabolize to a base level. If this does not occur, performance in a repeat effort may be impaired. Thus, techniques to enhance lactate clearance are of potential benefit to the athlete. We have demonstrated previously that swimming at 65% of maximum velocity significantly improved lactate clearance over passive resting. This study tested the effect of various swimming velocities on lactate clearance. Following a maximal swim, blood lactate clearance was tracked during a 15 minute cool down swim. Velocities of 55%, 65%, and 75% of maximum were tested. The results confirmed that cool down swimming will return lactate values to near resting levels in the test interval. However, statistical superiority of any of the test velocities was not demonstrated. The intensity of the swim should be below the lactate accumulation level. The 65% of maximum velocity was felt by all swimmers to be most comfortable and is a good target velocity for the athlete to reference. PMID- 2782531 TI - Saphenous nerve entrapment at the adductor canal. AB - A retrospective study of 30 patients who met the clinical criteria for saphenous nerve entrapment at the adductor canal is described. Patients experienced symptoms, usually anterior knee pain, for an average of 36 +/- 7 months. Each patient received an average of 1.9 +/- 0.4 saphenous nerve blocks at the adductor canal during treatment. Baseline pain level (measured by the visual analog scale) was 6.4 +/- 0.3. Final pain level at followup was significantly decreased (2.8 +/ 0.5, P less than 0.001). Eighty percent of patients had improved after a series of blocks. Age, medications taken, number of blocks performed, and length of followup were unrelated to outcome. Length of symptoms did significantly correlate with final pain level (r = 0.39, P less than 0.05). The diagnosis of this syndrome, description of the saphenous nerve block at the adductor canal, and the possible etiology are presented. PMID- 2782532 TI - Injuries in elite pair skaters and ice dancers. AB - Figure skating coaches have become concerned about the increasing number of injuries among competitive skaters, particularly pair skaters. This study prospectively examines the incidence, severity, and cause of injuries sustained by a group of elite pair skaters and ice dancers. Thirty-three serious injuries, causing the skater to alter training significantly or to cease training completely for at least 7 consecutive days, were recorded over a 9 month period. Female senior pair skaters reported an average of 1.4 serious injuries, and other groups averaged greater than 0.5 serious injury per skater. The lower extremities were injured most frequently, and 7 of the 33 serious injuries were directly related to the skating boot. Eleven serious injuries were caused by lifts. Few of the serious injuries appeared preventable. Changes in boot design and the training for lifting maneuvers should be initiated and studied prospectively to attempt to reduce the unacceptably high injury rate among elite pair skaters and ice dancers. PMID- 2782533 TI - Passive tension of the ankle before and after stretching. AB - The passive tension resulting from dorsiflexion of the ankle was measured in relation to stretching in six handball players and six soccer players. Corresponding values of ankle angle and passive tension were measured by a strain gauge and a potentiometer connected to a pedal system. The passive tension versus ankle angle was measured before and 90 minutes after a single contract-relax stretching program of the plantar flexors. Stretching lowered the passive tension by up to 18%. Contract-relax stretching performed twice a day for 3 weeks lowered the passive tension in the plantar flexors by up to 36%. Before the last measurements, no stretching was performed for 20 hours or more. Stretching thus had both a short-term effect, matching the length of a training session, and a long-term effect, shown in a reduction of passive tension after 3 weeks. The relative decrease in passive tension after stretching exercises was constant from a neutral position of the ankle to maximal dorsiflexion. There was no correlation between 1) flexibility and the short-term effect of stretching, 2) flexibility and the long-term effect of stretching, or 3) the short-term and long-term effects of stretching. This indicates that passive tension was decreased in all subjects irrespective of their flexibility, and that subjects who had short-term effects after stretching did not necessarily demonstrate a long-term effect. PMID- 2782534 TI - Noninvasive diagnosis of cruciate ligament damage with particular reference to computed tomography with arthrography. AB - Computed tomography (CT) with arthrography, a method not requiring anesthesia, has worked well in cruciate ligament damage diagnosis, particularly in the detection of PCL damage and in differentiation between ACL and PCL lesions. Evidence has been produced of its superior accuracy by comparison, in the study of 40 patients, among clinical findings, findings obtained from initial radiography, and diagnostic data produced by CT alone. Reference is also made to false interpretations in the context of clinical examination and CT. PMID- 2782535 TI - A dynamic analysis of a functional brace for anterior cruciate ligament insufficiency. AB - A dynamic, in vivo, functional analysis of braces designed for ACL insufficiency has never been reported. In this study, 14 athletes who had arthroscopically proven absent ACLs were evaluated in the Biomechanics Laboratory at the Centinela Hospital Medical Center. None of the ligaments were repaired or reconstructed. Footswitch, high speed photography, and force place data were recorded while the athletes performed running and cutting maneuvers with and without their custom fitted C.Ti. braces (Innovation Sports, Irvine, CA). Cybex testing, KT-1000 evaluation, and radiographs were collected for each subject. Statistical analysis showed that while performing cutting maneuvers, braced limbs generated significantly increased shear forces compared to the same limb unbraced. During straight line running, braced limbs generated significantly less lateral and aft shear forces compared to the same limb unbraced. Running velocity increased while wearing a brace for most athletes, but this was not statistically significant. As expected, the sound limb generated significantly greater shear forces than the unbraced involved limb during most cutting maneuvers. Athletes who did not achieve 80% of the Cybex (Cybex, Division of Lumex, Ronkonkoma, NY) quadriceps torque of the sound limb generated significantly more forces during cutting maneuvers while wearing their braces. The cutting angle, approach time to the cut, and time on the force plate showed no significant differences during brace wear. We conclude that the C.Ti brace allows significantly better running and cutting performances for athletes who have torn ACLs. Athletes who have not achieved 80% of quadricep strength as measured by Cybex testing showed even more improvement while wearing their braces.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2782536 TI - A musculoskeletal approach to the preparticipation physical examination. Preventing injury and improving performance. AB - Preparticipation physical examinations provide information concerning an athlete's ability to participate safely in sports. By collecting information specific to the musculoskeletal system in addition to that from a general medical examination, information can be gained that may improve performance and help prevent certain injuries. Two thousand one hundred seven athletes from a variety of sports from the junior high to the college level were examined using specific tests for flexibility, strength, and endurance. Females were significantly more flexible than were males on all flexibility measurements, and males were significantly stronger than were females on all strength measurements. Upper-body athletes were tighter in dominant side internal rotation and significantly looser in dominant side external rotation. Lower-body athletes, especially females, were significantly tighter in the leg muscles. These results indicate that the adaptations of the musculo-skeletal system are sport specific and depend on the body area that is placed under stress. PMID- 2782537 TI - Corticosteroids and anterior cruciate ligament repair. AB - A two group (N = 62) historical comparative design was used to study patients undergoing ACL repair. This retrospective study examined the effect of corticosteroids on analgesic use during hospitalization, the length of hospitalization, and the 1st day of ambulation. Thirty-one ACL repair patients receiving a standard protocol of intravenous intraoperative and oral postoperative corticosteroids (experimental group) were compared to 31 similarly aged ACL repair patients who received similar surgical repair and medical therapy but no steroids (control group). Patients with chronic disease or current steroid use were not included in the study. Even though the experimental group had a higher incidence of coincidental injuries of the knee (meniscal and/or collateral ligament injuries), the group used 50% less analgesics while hospitalized (means = 14.19 doses) than the control group (means = 21.29). Similarly, the experimental group had a length of stay 59% less long (means = 3.61 days versus means = 5.74 days) and ambulated 38% more quickly (means = 1.93 days versus means = 2.67 days) than the control group. No differences were noted between groups in incidence of postoperative infection or problems with wound healing after a 1 year followup. PMID- 2782538 TI - The forces in a knee brace as a function of hinge design and placement. AB - Customized knee braces for three normal subjects were instrumented to monitor the forces and moments across the hinges as the subjects performed various activities. The forces and moments were taken to represent a mismatch between actual knee motion and the motion the brace sought to impose. The different hinge designs studied were fixed axis, gear-on-gear, rack-and-pinion, and natural 3-D; they showed only moderate differences in forces. Much larger differences were seen if the hinges were offset 12 mm from the ideal placement. Posterior placement resulted in the least force and anterior placement the highest. The mismatch of knee motion to brace motion would probably lead to abnormal ligament lengths and tensions and other internal mechanical changes, as well as to pistoning and discomfort. The results of this study have implications on brace design, selection, and placement. PMID- 2782539 TI - External stabilization of the anterior cruciate ligament deficient knee during rehabilitation. AB - Using cadaveric specimens, we studied the effect of ACL deficiency upon anterior tibial translation during extension of the knee joint. Five knees were loaded via the quadriceps mechanism until flexion angles of 10 degrees, 25 degrees, 40 degrees, and 60 degrees were attained. At each angle, the anterior-posterior position of the tibia was documented with biplane radiography, both before and after division of the ACL. In every specimen, anterior tibial translation increased with loss of the ACL and was greatest at 25 degrees of flexion, where an average displacement of 3.3 mm was observed. Subluxation was not significant at flexion angles exceeding 60 degrees, regardless of ACL deficiency. We also examined the effect of an external restraining force on tibial subluxation in the ACL deficient knee. Posteriorly directed forces of 0 N, 45 N (10 pounds), 90 N (20 pounds), 135 N (30 pounds), and 225 N (50 pounds) were applied to the tibia at the level of the tibial tubercle. Anterior subluxation was eliminated through application of forces ranging from a maximum of 106 N (23.6 pounds) at 10 degrees to only 13 N (2.9 pounds) at 60 degrees. PMID- 2782540 TI - Chronic anterolateral instability of the knee. A roentgen stereophotogrammetric evaluation. AB - The rotatory stability of the knee was investigated in 20 patients with a previous tear of the ACL. The three-dimensional movements of the tibia during the testing procedure were registered using roentgen stereophotogrammetric analysis. Changes of the tibial movements between an intermediate, an anterior, or a posterior tibial position were registered using tibial tractions in combination with a simultaneous external or internal rotatory torque. At 20 degrees of flexion the internal rotatory laxity was increased on the injured side. The external rotatory laxity did not significantly differ between the two sides. With anterior traction, the internal rotatory laxity increased on both the injured and the normal sides and became almost equal. The external rotatory laxity manifested a decrease which was most pronounced on the injured side. With posterior traction, the rotatory laxities decreased and did not significantly differ between the two sides. Analysis of the simultaneously occurring translations of the tibial plateau disclosed abnormal displacements of both the medial and the lateral tibial condyles on the injured side. PMID- 2782541 TI - Metacarpal fractures in the athlete. AB - Fifty-six fractures of the metacarpal occurring in 53 athletes were studied from September 1985 to December 1986, regarding mechanism of injury, type of fracture, type of treatment, and time lost from sport. Age range of the patients was 8 to 28 years with greater than 77% being in the 14 to 18 year age range, the high school athlete. Twenty-nine of the fractures occurred in football, 14 in basketball, and the remainder were divided between various other sports. The most common mechanism of injury involved falls or hitting an object such as a helmet or another player. Fractures were evenly divided regarding which digit was involved in football, whereas most basketball injuries occurred in the fourth and fifth metacarpal. Fractures were analyzed as to type of radiographic appearance and this was correlated with time lost from competition or participation. No significant difference among fracture type regarding time lost was noted. Forty six of the fractures (82%) were minimally displaced or undisplaced and were treated by means of simple casting and/or splinting whereas 10 were displaced. Two of the 10 underwent closed reduction and casting; 3 underwent closed reduction and percutaneous pin fixation; and 5 (9%) underwent open reduction internal fixation using AO type plates and screws. All fractures healed primarily clinically and radiographically. The average time lost from practice or competition in this group overall was 13.7 days, (range, 0 to 56 days). Average time lost from basketball was 19.8 days and from football 10.63 days overall. Average time lost from sport in stable fractures treated with casting or splinting was 12.3 days.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2782542 TI - Soccer injuries to the brain. A neurologic and electroencephalographic study of active football players. AB - Sixty-nine football players from six Norwegian First Division League Clubs underwent a neurologic and EEG examination to investigate the incidence of head injuries. A significantly increased incidence of EEG disturbances were found in the football players compared to matched controls. The disturbances were most pronounced among the youngest players. The higher incidence of EEG disturbances found in the football players is most likely due to neuronal damage caused by repeated minor head traumas. PMID- 2782543 TI - Stress fracture of the patella. AB - Stress fractures are rarely an indication for surgical treatment. In our case we decided to operate on the patient because of distraction of the fragments. Solid bony healing took longer than in traumatic fractures, but the good functional result confirmed our regimen. PMID- 2782544 TI - Osteoid osteoma of the neck of the talus. AB - The authors present three cases of osteoid osteoma of the neck of the talus presenting with pain and restriction of ankle movement affecting athletic performance in young adults. If this condition is suspected in a patient, a bone scan will confirm the diagnosis. The result of treatment is positive in terms of relief of pain and return to activities in our patients. PMID- 2782545 TI - Middle ear adenoma. A tumor displaying mucinous and neuroendocrine differentiation. AB - Middle ear adenoma (MEA) is a distinctive, rare entity that appears to be derived from the lining epithelium of the middle ear mucosa. We report four cases of MEA displaying the typical histologic growth pattern. Two distinct tumor cell immunophenotypes were identified in all cases; the first type exhibited positivity with anti-epithelial membrane antigen and anti-keratin antibodies, and the second type showed immunoreactivity with anti-keratin, anti-vimentin, and anti-neuron-specific enolase antibodies. Ultrastructural studies revealed bidirectional mucinous and neuroendocrine differentiation, demonstrated by the presence of two distinct cell types containing apically located mucous granules and basally concentrated neuroendocrine granules, respectively. The presence of neuroendocrine differentiation was supported by the immunohistochemical detection of vasoactive intestinal polypeptide in the tumor cells in one case and neuron specific enolase in three cases. These findings suggest that the potential for mixed mucinous/neuroendocrine differentiation described in other endodermally derived tumors also exists in middle ear mucosa. We also believe that the rare lesions diagnosed as primary carcinoid tumors of the middle ear might in fact be MEA with predominant or only neuroendocrine differentiation. The clinical course of our four cases and our review of the pertinent literature confirm the benign nature of MEA and indicate that these tumors should be treated by complete local excision without additional therapy. PMID- 2782547 TI - To go or not to go. PMID- 2782546 TI - Myofibromatosis in adults (adult counterpart of infantile myofibromatosis). AB - Five solitary, benign, soft-tissue tumors histologically resembling infantile myofibromatosis but which occurred in adults were found among more than 5,000 benign soft-tissue tumors from a tumor registry. The tumors clinically presented as superficial, painless, and slowly enlarging nodules, usually of more than 10 years' duration, that occurred in the upper (two cases) and lower (two cases) extremities or the buccal mucosa (one case). They developed in the dermis and subcutis as well-circumscribed nodules with an average diameter of 1.2 cm. They were composed of discrete and confluent fibrous tissue with a mixture of bundles of smooth muscle-like cells and a hemangiopericytoma-like area of immature mesenchymal cells. Immunostaining for actin and intermediate filaments revealed the myofibroblastic nature of the tumor cells. The tumors were surgically excised, and there has been no recurrence. Clinicians and pathologists should note that the lesion of infantile myofibromatosis can and does occur in adults. PMID- 2782548 TI - Kimura's disease. PMID- 2782549 TI - [Responses of the psychotherapeutic center of Bondy to emergency requests]. AB - The following statement presents how a psychotherapeutic team undertakes the requests sent by the emergency service from the general hospital. Since 1982, the psychotherapeutic center of Bondy and Pavillons-Sous-Bois can be reached by the emergency service of the hospital Jean Verdier 24 hours a day, every day. Established in Bondy, it also commissioned to undertake every psychiatric problem issued by the two towns. Motorized, the team can either reach the center or move around. Its interventions are polyvalency associating an intern (resident medical student) and a psychiatric nurse. They are themselves supported with another psychiatrist, together with a nurse, both on "phone duty". The polyvalency approach avoid to over-estimate questions upon orientation and danger, and procure a structure leading off a psychopathological understanding upon the problematical pointed out. The autonomy of the team gives the possibility to manage, together with the doctor of the general hospital, for the best solution. If admission to hospital is decided in one of the Jean Verdier service (when medical supervision is necessary) the psychiatric treatment will be assured by the psychiatrist in charge of "secteur". The local implantation of the team and its integration in a general psychiatric service, allow his intervention in a continuity of treatment, including immediately a diagnosis problem together with the elaboration of a therapeutic project. Such a conception of emergencies gives to the public psychiatrist the possibility to answer to demands. His own technics and his own ways of practical organisation are respected. Concerned by emergencies the psychiatrist shares the answer to be given. PMID- 2782550 TI - [Rearrangement of an emergency department. Reflections on a structure]. AB - Since 1986, a new conception of the emergency department in the hospital of Saint Denis comes out. It would adapt with a greater efficiency plan to the needs and has entailed a sudden awareness, reflections and critical analysis of the situation. The disposition of the emergency ward, the formal procedures that prevailed over the act of care and the deficiency of the first global relationship with the patient were impediments to the mission of emergency department. A new department that gathers both reception and emergency duties was inaugurated in May 1987. It puts three aims in concrete form: to make the emergency ward more functional, to improve quality and capacities of reception and to improve the medical act. PMID- 2782551 TI - [Hyperoxia test during attempts to withdraw artificial ventilation]. AB - A 30 minute test of hyperoxia (10 l.min-1) was conducted in patients (n = 21) with chronic obstructive lung disease during the weaning trials from mechanical ventilation. Two groups were formed according to whether the occlusion pressure at 100 ms (PO.1), index of central stimulation, decreased or not during the test. The first group lowered PO.1 and increased PaCO2 by decreasing VE (minute ventilation), VA (alveolar ventilation) and increasing the VD/VT ratio; the others had a lower PO.1 and did not modify it after administration of 02 despite a lowered PaO2 initially identical to that in the first group. They held PaCO2 constant by increasing VE and by maintaining VA in relationship with an improvement in diaphragm contractility and/or a better response to hypercapnia stimulus. All the patients is this group were successfully weaned eight days after the study period. PMID- 2782552 TI - Adjustment to amputation among adolescent oncology patients. AB - With increased patient survival, the psychosocial consequences of amputation in cancer patients has become increasingly important. The following study examined the psychosocial correlates of amputation in 16 male and 17 female Brazilian adolescent patients aged 10-20 years who had lost a limb to cancer. Interviews were conducted within 12 months of amputation. Eighty-two percent indicated that they were involved in preoperative decision making, but only 58% understood the limitations in functioning after undergoing an amputation. Before surgery, the most frequently chosen confidante was the mother, followed by a sibling, staff member, and a friend. The major postoperative problems in these patients were walking, pain, and social issues. Overall, 75% of the amputees felt they were independent in and out of the home. Most individuals (66.6%) had, but fewer (58%) wore, their prosthesis. Prior to amputation, 30 patients were enrolled in school and 13 had a job. Of 15 who returned to school, 67% could not keep up with the school work and 93% had problems getting along with their classmates. Of five patients who returned to their jobs, no one reported discrimination in hiring or promotion; however, four workers felt they had lost a job because of their amputation, and two reproted having to change jobs. Many had altered their lifestyles to suit their disability, but the social and educational adjustment of these patients appears promising. Proper education of school faculty, classmates, and medical staff may enhance the adjustment of adolescent cancer amputees. PMID- 2782553 TI - Pulmonary and pleural involvements at initial diagnosis in children with malignant neoplasm. AB - Seventeen cases of pediatric malignant neoplasm with pulmonary and/or pleural lesions shown by chest radiography at initial diagnosis were reviewed and analyzed. Respiratory symptoms such as dyspnea, tachypnea, and chest pain were observed on admission in approximately one-half of them. The initial chest radiography showed pleural lesions in 7 of the 17, pulmonary lesions in 8, and both pulmonary and pleural lesions in 2. Unilateral or bilateral pleural fluids were observed in all of the seven patients with pleural lesions, and malignant cells were confirmed in the pleural fluid of all patients. The radiographic patterns of the eight patients with pulmonary lesions were solitary nodule in two, multiple nodules in two, diffuse miliary nodules in three, and diffuse honeycomb in one. Histological examination of the pulmonary lesion was performed in six patients at the initial diagnosis or after death, while in the remaining two primary or other metastatic sites were examined. The two patients with both pulmonary and pleural lesions showed multiple nodules or infiltrates with pleural fluid on chest radiography. Increased malignant cells were detected in the pleural fluid of both patients. In all cases, the lesions gradually or rapidly disappeared with multidrug chemotherapy. The review confirms the need for a combination of complete radiographic and pathological analysis at the time of initial diagnosis of malignant neoplasm in children to distinguish other causes such as infectious complications. PMID- 2782554 TI - Comparative effects of mezlocillin and carbenicillin on platelet function and thromboxane generation in patients with cancer. AB - Carbenicillin and mezlocillin are widely used for treatment of Pseudomonas infections in patients with cancer. Carbenicillin has been reported to cause platelet dysfunction and bleeding diathesis in some individuals. We evaluated whether carbenicillin causes deterioration of platelet function in patients with cancer and whether mezlocillin causes similar effects on platelets from normal subjects or from patients with cancer. In these in vitro studies, carbenicillin and mezlocillin decreased ADP and epinephrine-induced platelet aggregation and thromboxane A2 generation similarly, but only in concentrations of 3.2 mg/ml or higher. In contrast, carbenicillin was more potent than mezlocillin in decreasing ristocetin-induced platelet aggregation. We also evaluated effects of these antibiotics on platelet function in 19 patients with cancer who developed fever and neutropenia. These patients received either mezlocillin (10 patients) or carbenicillin (nine patients) in combination with nafcillin and gentamycin. Neither carbenicillin nor mezlocillin had any significant effect on platelet aggregation or thromboxane A2 generation. Lack of effects in vivo was due to defective platelet function in these patients prior to any antibiotics. These defects were most probably related to underlying disease and/or prior chemotherapy. Thus, carbenicillin and mezlocillin can both safely be used in patients with cancer who develop fever and neutropenia, and neither seems to have advantage over the other in terms of platelet function. PMID- 2782556 TI - Experience with minimal complications in implanted catheters in children. AB - Eighty-two patients, ranging in age from 11 months to 24 years, underwent the percutaneous placement of an implanted catheter in order to have improved venous access. Thirty-five patients (43%) were beginning chemotherapy for cancer, four (5%) had a chronic hematologic disorder, and the remaining 43 (52%) were on chemotherapy for cancer. The mean duration of catheter function was 168 days (range of 7-1,030 days), with a cumulative experience of 18,812 days of catheter use. Complications were minimal. Only four catheters (5%) required removal secondary to infection, infiltration, or tissue breakdown. Substantially reduced complication rates were observed as compared to other studies using implanted central venous catheters. Implanted central venous catheters were proven to be safe in patients with hematologic disorders. These catheters enhance the ability to infuse chemotherapy, hyperalimentation, blood products, anesthesia, and imaging solutions and are safe to use in patients with a hemostatic or host defense deficiency. PMID- 2782555 TI - Growth failure in boys with hemophilia and HIV infection. AB - The growth of 22 boys with hemophilia, infection with human immunodeficiency virus (HIV), and lymphadenopathy, but not overt acquired immunodeficiency syndrome (AIDS) was evaluated. Three patients were found to have significant growth failure for 3-4 years with the onset after HIV infection. Extensive endocrine evaluation revealed that two of the three had neurodysregulation of growth hormone release with hyposomatomedinemia. None had classical growth hormone deficiency, thyroid deficiency, or evidence of malnutrition/malabsorption or other systemic illness. It appears that growth failure is not rare in boys with hemophilia and HIV infection and that this might be due to a direct effect on the physiologic secretion of growth hormone. PMID- 2782557 TI - Splenectomy in mild hereditary spherocytosis: is it worth the risk? AB - Patients with mild hereditary spherocytosis (HS) often undergo splenectomy for the sole purpose of preventing gallstone formation. Splenectomy carries a surgical risk as well as the risk of postsplenectomy sepsis. Gallstones develop in less than half of mild HS patients and do not always cause symptomatic biliary tract disease. Using decision analysis, a quantitative approach to problem solving under conditions of uncertainty, we have compared the likelihood of surviving the complications of gallstones with the likelihood of surviving routine splenectomy. Probability figures for critical events were obtained from the medical literature; final outcome is recovery (utility = 1.0) or death (utility = 0.0). Our analysis shows that expectant management of gallstones is the preferred choice, being associated with a higher utility than is routine splenectomy (0.9980 vs 0.9755, respectively). The utility values for the two choices become equivalent only when the risk of postsplenectomy sepsis is lowered from 0.022 to 0.0001. PMID- 2782558 TI - Blister cells in children with sickle hemoglobinopathies. AB - The presence of blister cells in the peripheral blood of patients with sickle hemoglobinopathies was investigated to assess whether their presence was predictive of the patients' clinical state and would be diagnostically useful. Peripheral blood smears (PBS) were examined from 23 children with sickle hemoglobinopathies, 20 children with iron deficiency, and 29 healthy control children. The number of blister cells per 1,000 red blood cells was then correlated with the child's health state: well, minor illness, and illness requiring hospitalization. The presence or number of blister cells was found to be unreliable to predict the state of health or the cause of a pulmonary insult in children with sickle hemoglobinopathies. PMID- 2782559 TI - Variability in rates of alloimmunization in different groups of children with sickle cell disease: effect of ethnic background. AB - We evaluated the incidence of red blood cell alloimmunization in children with sickle cell disease from different backgrounds using standard blood banking techniques. Transfusion number, sequence of antibody formation, and antigen phenotyping were analyzed. Children with non-American ethnic origins had a 42.9% incidence of alloimmunization compared to 17.6% in American patients. Antigen frequencies were similar in the two groups. Fewer transfusions resulted in more antibodies in the non-American children. We recommend that all sickle cell patients be fully phenotyped prior to initiation of transfusion therapy. Phenotypically matched units do not appear to be indicated for the majority of sickle cell patients receiving either simple or hypertransfusion, but should be considered for patients of non-American ethnic origin once such patients become immunized. PMID- 2782560 TI - Plasma protein C levels in children with sickle cell disease. AB - Since thrombotic phenomena have important roles in the vasoocclusive manifestations in sickle cell disease (SCD), protein C (PC) was determined in 32 children with SCD during steady state and vasoocclusive crisis (VOC) and in controls. Children with SCD during steady state had significantly lower PC levels as compared to controls. During VOC there was marked decrease in PC as compared to levels during steady state, and these levels increased to initial levels or higher with clinical improvement. It is postulated that the decreased levels of PC in SCD are probably secondary to increased consumption as well as decreased production because of altered liver function. This data suggests that decreased levels of PC may increase the risk of thrombosis in these patients. PMID- 2782561 TI - Chronopharmacokinetics of oral methotrexate and 6-mercaptopurine: is there diurnal variation in the disposition of antileukemic therapy? AB - The chronopharmacokinetics of the orally administered antileukemic drugs, 6 mercaptopurine and methotrexate, were examined in 13 children with acute lymphoblastic leukemia (ALL) to establish if there is a pharmacokinetic basis for the lower relapse rate associated with administration of these agents in the evening. Children with ALL in complete remission had plasma drug concentrations monitored for 8 h following an oral dose of either methotrexate or 6 mercaptopurine administered in the morning (8 a.m.) and the evening (8 p.m.). Total drug exposure to oral methotrexate, as measured by the mean area under the plasma concentration-time curve (AUC), was 2.75 microM.h following the morning dose and 2.77 microM.h in the evening. For 6-mercaptopurine, the mean morning AUC (198 ng.h/ml) was higher than that following the evening dose (167 ng.h/ml) (p greater than 0.05); but compared to the wide interpatient variability observed with this drug, this 20% difference is not likely to be clinically significant. These results indicate that the suggested benefit of evening drug administration is not likely to be a result of diurnal variation in drug disposition. PMID- 2782562 TI - Cranial computed tomography findings in children with acute lymphoblastic leukemia at diagnosis. AB - Forty children newly diagnosed with acute lymphoblastic leukemia (ALL) were examined by computed tomography (CT) of the central nervous system (CNS) on hospital admission before any medication was started. The results of the CT scans were defined as normal, borderline (slight or moderate dilatation of the ventricular system and/or basal cisterns and/or convolutional sulci), or pathologic (severe cerebral atrophy). The mean age of the patients was 5.8 years (range 1.7-15 years). Sixteen of the 40 patients (40%) had CT scan abnormalities with 14 patients having borderline scans and two patients pathologic scans. No child presented with neurologic symptoms or CNS leukemia. These data suggest that CT abnormalities of the brain are common in children with ALL at diagnosis and may represent clinically unsuspected lesions secondary to leukemia. PMID- 2782563 TI - Survival after isolated cerebral mucormycosis. AB - Cerebral mucormycosis is a rare disorder caused by several genera of the family Mucoraceae. The genera Rhizopus, Absidia, and Mucor are the predominant pathogenic groups. Disease caused by these organisms usually complicates an underlying chronic illness, such as diabetes mellitus or malignancy. Cerebral involvement usually occurs from an ascending infection from the paranasal sinuses via the orbit and is usually associated with poorly controlled diabetes. The pulmonary system is the most common site of infection in patients with leukemia. Isolated cerebral mucormycosis not associated with head trauma or intravenous drug abuse is a rare disorder. We report what we believe to be the first successfully treated case of isolated cerebral mucormycosis in a patient with acute lymphocytic leukemia in remission. PMID- 2782564 TI - Thrombocytosis and hyperkalemia revisited. AB - A major concern of physicians caring for patients is the development of hyperkalemia, a potentially life-threatening event requiring accurate determination of its etiology. After metabolic and iatrogenic causes have been excluded, factitious hyperkalemia must be considered, one cause of which may be the method of laboratory determination. Hyperkalemia associated with thrombocytosis has been previously described but is a fact commonly overlooked in the evaluation of a patient with hyperkalemia. We compared the potassium levels in simultaneous serum and plasma samples from patients with normal and elevated platelet counts, since platelet activation during clot formation is associated with release of potassium. We found consistently higher potassium levels in serum (containing products of activated platelets) than in plasma (containing nonactivated platelets). The greatest discrepancy in potassium levels was in patients with thrombocytosis. This preliminary study suggests that if there is no obvious explanation for an elevated serum potassium the plasma potassium level should be measured, particularly in patients with elevated platelet counts. PMID- 2782565 TI - Identification of myeloid origin in undifferentiated congenital leukemia by in vitro marrow culture study. AB - A case of congenital leukemia that originally did not express any lineage specific antigenic markers is presented. The blast cell morphologic appearance was L1 according to French-American-British (FAB) classification and showed lymphoid characteristics by cytochemical staining and transmission electron microscopy. However, immunophenotyping using a variety of monoclonal antibodies did not confirm the lymphoid origin. Furthermore, the immunoglobulin heavy chain and T-cell receptor beta-chain genes were in germ-line configuration. The in vitro culture study defined the leukemia as of myeloid origin. The semisolid methylcellulose culture showed an acute non-lymphocytic leukemia-type growth pattern. Bone marrow blasts underwent myeloid differentiation with positive myeloperoxidase and butyrate esterase activity during a suspension culture. These findings indicate that this case represents an acute undifferentiated leukemia that has probably arisen from the malignant transformation of stem cells of myeloid progeny. PMID- 2782566 TI - Primary pericardial sarcoma in a neonate. AB - A 9-day-old infant was found to have an undifferentiated pericardial sarcoma. Despite intensive surgery and chemotherapy, the child died of progressive disease. This is the first report to our knowledge of a primary pericardial sarcoma in a newborn. PMID- 2782567 TI - Evaluation of individual lymphoblasts or population heterogeneity: current systems to subclassify ALL morphologically. PMID- 2782568 TI - Should treatment of acute lymphoblastic leukemia be a model for therapeutic strategy in metastatic neuroblastoma? PMID- 2782569 TI - Fluid deprivation before operation. The effect of a small drink. AB - The effect of oral fluids before operation, followed by intramuscular morphine, on gastric volume and pH was examined in 150 elective surgical patients, ASA physical status 1 and 2, who were randomly assigned to one of the three groups of 50 each. Group 1 (control) continued their overnight fast; patients in Groups 2 and 3 received 150 ml water 2 hours before the scheduled time of surgery. Patients in Group 3 received intramuscular morphine 0.15 mg/kg and promethazine 0.5 mg/kg one hour before operation. The residual gastric volume was obtained by suction and its volume and pH measured immediately after induction of anaesthesia. Statistically significant (p less than 0.05) decrease in residual gastric volume was observed in Groups 2 and 3 as compared to Group 1. However, the difference between these two groups was not statistically significant. There was no statistically significant difference in pH among the three groups. Overnight fluid fasting is not justified in elective surgical patients. Morphine can be safely given one hour before surgery in patients who have received water (150 ml) 2 hours before operation. PMID- 2782570 TI - Comparison of anxiety before induction of anaesthesia in the anaesthetic room or operating theatre. AB - Anxiety before induction of anaesthesia was studied in 100 patients who were allocated randomly to one of two groups. Patients in one group were anaesthetised in an anaesthetic room and those in the other group were anaesthetised inside the operating theatre. Both subjective and objective induces of anxiety were used in the comparison. Other factors that contributed to anxiety were assessed by a simple questionnaire. There was no significant difference in the level of anxiety between the two groups. The site of induction did not emerge as a major contributory factor to anxiety. The advantages and disadvantages of anaesthetic rooms are discussed. PMID- 2782571 TI - Laryngeal mask anaesthesia for repair of cleft palate. AB - A method of anaesthesia for repair of cleft palate is described. The baby had Pierre Robin syndrome and tracheal intubation had proved to be impossible. PMID- 2782572 TI - Heat stroke--an uncommon presentation. AB - A case of heat stroke is reported in which there was a delayed diagnosis and a fatal outcome. Recent literature is reviewed. PMID- 2782573 TI - Pneumothorax caused by minitracheotomy. AB - We describe a case in which misplacement of a minitracheotomy tube produced a pneumothorax, a complication which has not been reported previously. Methods to identify correct placement of the minitracheotomy tube are discussed. PMID- 2782574 TI - The attitudes of junior anaesthetists to research. A survey. AB - A survey was undertaken to investigate aspects of research work undertaken by junior anaesthetists. Two hundred and ninety-five junior anaesthetists were surveyed. Forty-seven percent of respondents were involved actively in research activities at the time of the survey, although 57% of senior house officers and registrars and 30% of senior registrars would not attempt to acquire publications except to improve their curriculum vitae. Few had received any formal training in research methods. The significance of these findings is discussed with regard to current training opportunities. PMID- 2782575 TI - Epidural anaesthesia for day care surgery. A retrospective study. AB - The records of 682 patients who received epidural anaesthesia for day care surgery were reviewed. The advantages and disadvantages of this form of anaesthesia is discussed. No major complications were recorded. PMID- 2782577 TI - Anaesthetists, lawyers and the public. PMID- 2782576 TI - Pain on injection of methohexitone. The use of lignocaine to modify pain on injection of methohexitone during anaesthesia for electroconvulsive therapy. AB - The present study was designed to assess the incidence of pain when methohexitone was administered to 35 depressed patients who had electroconvulsive therapy, and to determine whether the use of lignocaine could modify this, without affecting seizure duration. The same patients were studied during three separate treatment sessions; they received either methohexitone alone or mixed with, or preceded by, lignocaine 10 mg. Six (17%) patients spontaneously complained of pain during injection of methohexitone alone; the use of lignocaine prior to methohexitone reduced this to zero (p less than 0.05). A total of 49% patients reported pain during injection of methohexitone; the use of lignocaine either mixed with, or given prior to, methohexitone significantly reduced this to 23% and 20% respectively (p less than 0.05). Seizure duration was not significantly different during the three treatments. PMID- 2782578 TI - Treatment of epidural morphine-induced pruritus with buprenorphine. PMID- 2782579 TI - A complication of povidone-iodine. PMID- 2782580 TI - A postoperative neurological problem. PMID- 2782581 TI - Headache after dural puncture. PMID- 2782582 TI - The choice of anaesthesia for the very old. PMID- 2782583 TI - Anaesthesia in myotonia dystrophica. PMID- 2782584 TI - Failure of Heimlich manoeuvre. PMID- 2782585 TI - Keeping the position of the 29-gauge spinal needle. PMID- 2782586 TI - Debris in a breathing system. PMID- 2782587 TI - Large tonsils and the laryngeal mask airway. PMID- 2782588 TI - Chain of errors. PMID- 2782589 TI - Embolectomy without bypass. PMID- 2782590 TI - Unusual cause of obstructed expiration. PMID- 2782591 TI - The oesophageal detector device. PMID- 2782592 TI - The use of a transparent mouthguard at induction. PMID- 2782593 TI - Another use of the pulse oximeter. PMID- 2782594 TI - 'Talking in their sleep'--a defensive practice. PMID- 2782595 TI - Subarachnoid anaesthesia with 0.25% isotonic bupivacaine for caesarean section. PMID- 2782596 TI - [10 years' experience with heart surgery in Jehovah's witnesses]. AB - As a result of their interpretation of the Bible, members of Jehovah's Witnesses do not accept blood transfusions under any circumstances. Consequently, they present moral and ethical problems to surgeons and anesthetists, especially in cardiac surgery. PATIENTS and METHODS. From November 1978 to November 1988, 66 members Jehovah's Witnesses were scheduled for cardiac surgery; 57 patients were operated upon (mean age 33.3 years, 14 days to 70.4 years; mean body weight 51 kg, 0.7 to 95.5 kg); 21 were younger than 14 years. Patients with hematocrit (Hct) less than 35%, expected high intra- and postoperative blood loss, compromised left ventricular function, ST-segment alterations, critical aortic stenosis, severe unstable angina pectoris, complex heart defects, especially in children, extreme body weight, severe diabetes, renal insufficiency, coagulopathies, severe pulmonary disease, and heavy smokers were excluded from operation. Whereas in nonbypass patients no special blood-saving techniques were used, in bypass patients a modified version of isovolemic hemodilution, with a hypothermic, bloodless priming technique of extracorporeal circulation (ECC) was performed after induction of anesthesia. At the end of the ECC all blood collected in the pericardial and pleural cavities was returned to the oxygenator and the entire content of the extracorporeal circuit was infused into the patient through the aortic cannula. All patients receiving ECC were ventilated for 24 h postoperatively and received dopamine (2-5 micrograms/kg) and antibiotics routinely. RESULTS: Due to the above mentioned contraindications, 9 patients were not accepted for surgery, 10 were operated upon without cardiopulmonary bypass or blood-saving techniques. In 47 patients open heart surgery with ECC and moderate or deep hypothermia was performed. In the adult patients (n = 36) Hct values decreased from 44.4% (35-70%) preoperatively to 32.1% (21-46%) after hemodilution, reached their lowest levels during cardiopulmonary bypass at 17.9% (9.9-43%), and increased to 33.7% (22%-43%) at the end of the operation. Hct averaged 28.2% (20%-39%) on the 3rd and 33.2% (23%-46%) on the 12th postoperative day. In children (n = 11) Hct decreased from 47.2% (36.9%-70%) to 33.6% (27.2% 49.1%) after hemodilution, during bypass to 16.1% (10.5%-25.5%) and increased to 32.1% (24.4%-37.4%) at the end of the operation. On the 3rd postoperative day Hct was 25% (21.4%-39%) and increased to 29.4% (25.1%-40%) on the 12th postoperative day. No statistical differences in Hct values were found between both groups. (ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2782597 TI - [The washout behavior of isoflurane following balanced anesthesia and its effect on postoperative oxygen supply]. AB - Few studies have described the pharmacokinetics and pharmacodynamics of isoflurane (I) during the postoperative recovery room stay. In this study the influence of balanced anesthesia with I on the postoperative course was investigated by studying pulmonary washout of I and its effect on arterial oxygen saturation. METHODS. Following institutional approval and informed consent, 50 patients (ASA I and II) scheduled for lateral fenestration for intervertebral disc herniation participated; all had no previous record of cardiopulmonary problems. Induction of anesthesia was achieved with intravenous alcuronium 0.03 mg/kg, fentanyl 0.003 mg/kg, thiopental 5 mg/kg, and succinylcholine 1.5 mg/kg followed by alcuronium 0.09 mg/kg before changing to the prone position. Anesthesia was maintained with controlled ventilation in a rebreathing system (fresh gas flow FGF) = 3.01/min, FIO2 = 0.3 in N2O, plus 0.8 Vol.-% cIet = 1.3 MAC). Near the end of surgery I was discontinued and IGI was increased to 61/min O2 for 10 min. Patients then returned to breathing ambient air. Extubation was carried out as soon as a minimum tidal volume of 400 ml was obtained. End tidal I concentration (cIet; Vol.-%) was measured by infrared absorption (Normac, Datex) and O2 saturation by pulse oximetry (Biox III, Ohmeda). Datum point of the pulmonary I-washout curve was the mean end-tidal I concentration obtained 15 min before terminating I (cIAW). Effects of duration of anesthesia, Broca index, and amount of I administered (tidal volume x inspiratory I concentration x min; ml) on I-washout were assessed. A pulse-oximetric O2 saturation of less than 90% was regarded as hypoxygenation. RESULTS. Mean duration of anesthesia for both males and females was 85 +/- 25 min, mean Broca index 102 +/- 13. The amount of I administered with the inspiratory volume was 5.661 +/- 2.194 1 I (1.0 +/- 0.4 Vol.-%). Mean I-regression (Fig. 3) was 236 x 10(-5) Vol.-%/min (Figs. 1 and 3). Mean I-washout 60 min after extubation was 44.6 +/- 15.2% of the administered amount. Adequate spontaneous breathing began a mean of 17 min after the end of I exposure, corresponding to 20% cIet of washout. All patients were extubated after a mean of 22 min at a mean etI of 17% of washout. After extubation, pulse oximetry indicated hypoxygenation in 18 patients (= 36%) during 2 periods (Fig. 4): (1) at a mean cIet of 0.1 Vol.-% (= 15% of washout) after a mean of 8 min; and (2) at a mean cIet of 0.08 Vol.-% (= 12% of washout) a mean of 19 min following extubation. Further episodes of hypoxygenation occurred as much as 40 min post-extubation. (ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2782599 TI - [The physical compatibility of ketamine and diazepam in infusion solutions]. AB - Physical compatibilities of infusion solutions containing ketamine and diazepam or midazolam in different concentrations were studied by visual examination and by light-scattering measurements. The isotonic infusion solutions used were fructose 5%, glucose 5%, and NaCl 0.9%. The concentration of additive were between 500 and 600 mg ketamine, 60 and 100 mg diazepam and 30 and 60 mg midazolam (Dormicum) per liter intravenous solution. During a period of 24 h the solutions remained colorless without demixing, precipitation, or changes in pH. The light-scattering measurements were performed immediately after preparation of the solution and repeated after 1, 4, 8, and 24 h using monochromatic light at a wavelength lambda 0 = 546 nm and temperatures T = 20 degrees and 37 degrees C. The light-scattering measurements showed that all intravenous solutions were physically true, homogeneous solutions with no change over a period of 24 h within experimental error, i.e. the solution behavior remained constant. A small amount of the dissolved particles (less than 0.5%) had diameters of 1-4 microns whereas those of all other particles were smaller than 0.02 microns. The particles with 1 to 4 microns diameter consisted of aggregates of the dissolved substances called microgels. Removal of both microgels and inorganic and organic dust is possible with filters of pore size 0.5 microns or by centrifugation at 10,000 rpm. In clinical practice filtering is much more feasible. PMID- 2782600 TI - [The use of a transcutaneous pO2/pCO2 combination electrode during volume therapy in a child in shock]. AB - We report a 1-year-old boy in hemorrhagic shock due to a large subgaleatic hematoma following severe head trauma (blood pressure (BP) 30/15 mmHg; heart rate (HR) 110; Hb 45 g/l; arterial pH 7.16; BE-20 mEq/l). The child was intubated and ventilated; initial FIO2 was 0.9. In an attempt to monitor the cardiovascular system noninvasively a transcutaneous oxygen/carbon dioxide combielectrode was placed on the chest. Initially we observed a large difference between arterial pO2 (paO2 = 166 mmHg) and transcutaneous pO2 (tcpO2 = 7 mmHg) and arterial pCO2 (paCO2 = 16 mmHg) and transcutaneous pCO2 (tcpCO2 = 55 mmHg), reflecting poor skin perfusion and severe tissue acidosis. Under aggressive volume replacement tcpO2 rose along with BP and tcpCO2 returned to near arterial values. Even after stabilization of gross hemodynamic parameters such as HR and BP and despite reductions in FIO2, tcpO2 continued to increase with further volume replacement, reflecting an existing volume deficit. PMID- 2782602 TI - [Proven safety of the Drager circuit? Improvement of the absorber is desired]. PMID- 2782601 TI - [A new metal tube for laser surgery of the laryngotracheal region]. AB - Various measures have been taken to minimize laser-specific hazards during laryngotracheal microsurgery with CO2-laser equipment. Endorsing Norton's view that only a metal tube ensures complete safety during laser surgery, we tested the "Laser-Flex", a new endotracheal tube (ETT) of high-grade stainless steel. This reconstructed, flexible, gas-tight ETT was designed to avoid perforation and even ignition of the tube with consecutive inhalation of combustion products known to be very strong lung irritants. The dull surface of the spiral ETT prevents damage to the surrounding mucosa by diverging the laser beam. The flexibility and greater stability compared with PVC- or silicone armored tubes makes intubation possible without a guide even under difficult conditions. A small PVC-tube with two high-volume-low-pressure cuffs is attached to the distal end of the metal ETT. The cuffs are filled via different inlets clearly distinguished by color as well as by the inscriptions "proximal" and "distal". Both inlet lines float inside the metal tube, thus being protected from accidental laser beams. The cuffs are filled with saline solution. In case of inflammation and destruction of the proximal cuff, the discharged solution will extinguish the flame and also protect the distal cuff, ensuring normal ventilation. Thus none of the laser operations had to be interrupted during our test period if accidentally perforation of the proximal cuff occurred. The high price of the "Laser-Flex" should not be a reason to abstain from using this tube. In view of the higher margin of patient safety, this tube might be used even from an economic point of view. In our tests we reused each tube five to eight times, thus lowering the costs with each reuse. Checks following sterilization after each use did not show any dysfunction of the cuffs or valves. PMID- 2782598 TI - [The effect of subtherapeutic quantities of native gelatin and Haemaccel 35 (polygeline) on the fibronectin level and wound healing. An experimental animal study in rats with burn wounds]. AB - Posttraumatically, opsonic plasma fibronectin is consumed by collagen-like degradation products that enter the vascular system. Additional administration of gelatin (= denatured collagen) results in an essential lack of fibronectin with subsequent retardation of wound healing even when subtherapeutic amounts are given. Therefore, in an experiment with rats we studied the question of whether similar effects are evoked by equal amounts of Haemaccel 35 (cross-linked polypeptides from degraded gelatin). The animals received standardized third degree burn injuries of about 1% of body surface. Immediately after wounding and on the following 2 days native gelatin or Haemaccel was applied intraperitoneally in 2 different dosages (61 mg/kg and 122 mg/kg). The burn injury by itself did not cause a significant decrease of plasma fibronectin. After injection of gelatin a dramatic deprivation of plasma fibronectin occurred and, in consequence, a delay of the healing process. After administration of equal amounts of Haemaccel 35, however, there was neither a depletion of plasma fibronectin nor any significant effect on wound healing. PMID- 2782603 TI - Mathematical outline-analysis of eminence and fossa of the TMJ of Cercopithecus aethiops (Cercopithecidae, primates, Mammalia). AB - The contours of the eminence and the fossa of the temporomandibular joint (TMJ) of Cercopithecus aethiops, a monkey species, are analyzed in sagittal-vertical sections. The functionally relevant contours can be approximated by catenates for both the eminence as the protrusive guidance and the fossa as the retrusive guidance. This study reveals the more general character of the contour formula y = a cosh(x/a) - a. This may be true because all these catenates are similar to one another and since they can be found in the guiding contours of the components of the stomatognatic system in man as well as in Cercopithecus aethiops. PMID- 2782604 TI - [The effect of a modified blood supply on the craniofacial growth of rabbits. 2. Masticatory muscles]. AB - After ligation of the right common carotid artery, the dry weight of the muscles of mastication on the ligated side did not differ from that of the control animals between the 45th and 225th d of life. On the opposite side, however, the muscles were in some cases significantly heavier than those of the control animals, particularly in male rabbits with ligated common carotid arteries. The methodical application of these results is proposed. PMID- 2782605 TI - [The distance between the ductus nasolacrimus and the canalis palatinus major on the sidewall of the nasal septum and the distances between the ostium pharyngeum tubae auditivae and canalis palatinus major and the upper side of the soft palate]. AB - Estimated are the distances between the nasolacrimal duct and the Canalis palatinus major on the side-wall of the nose cavity. Included are measurements of distances of the Ostium pharyngeum tubae auditivae to the Canalis palatinus major and the upper surface of the Palatum molle. PMID- 2782606 TI - The frenulum labii inferioris laterale. AB - A lateral counterpart to the frenulum of the lower lip, located between the dens caninus and the area of the angle of the mouth is reviewed. Anatomical considerations are discussed and the term frenulum labii inferioris laterale is suggested. PMID- 2782608 TI - On the A. thymica suprema, a provisionally named branch of the superior thyroid artery in the human. AB - Four cases (1 in an adult and 3 in fetuses) of a thymic artery arising from the superior thyroid artery were observed in 77 adult cadavers and 45 fetuses. These arteries were distinguished from the anterior and posterior rami, because they reached the thymus directly and, in most cases, had a sternomastoid ramus. Thus, the superior thyroid artery may supply both the thyroid gland and the thymus. The thymic artery in question might disappear in the earlier stage of development. The proximal portion of this thymic artery may remain either as the stem of the sternomastoid ramus or as a lateral ramus of the superior thyroid artery. This thymic artery is suggested to be called the "supreme thymic artery", A. thymica suprema, according to its location and anatomical significance. PMID- 2782607 TI - [Functional morphology of the maxillo-mandibular apparatus in the miniature swine MINI-LEWE. 10. Dentition]. AB - In the miniature pig MINI-LEWE the canines and 3rd incisors are already present at birth. Deciduous dentition is completed by the age of 3 months, and the denture consists of 28 teeth. The "replacement milk teeth" (Stehlin 1899) appear between the age of 6 and 8 months. Eruption of the permanent teeth (44 teeth altogether) is not yet over by the 24th month of life. PMID- 2782609 TI - Development of the cloacal bursa in the domestic fowl. I. An allometric and morphological study of the interfollicular surface epithelium (ISE). AB - The allometric relation applied between the body weight and the volume increment of the interfollicular surface epithelium (ISE) showed just one developmental stage during the period analysed (from 16d old embryos through 28 old d chicks). In this single allometric developmental stage the ISE growth is relatively more pronounced than that of the bursa as a whole due to profound cellular modifications which that epithelium undergoes from the primitive undifferentiated epithelial cells through goblet and prismatic cells. The latter could have an endocytic capability due to their primary and secondary lysosomes content. A possible cellular differentiation of the ISE during the histogenesis of the cloacal bursa is also discussed. PMID- 2782610 TI - Photoperiodic influence on the innervation of the ductus epididymidis and ductus deferens of Phodopus sungorus--light microscopic studies. AB - The influence of long (LD 16:8) and short (LD 8:16) photoperiods on the autonomic innervation of the ductus epididymidis and ductus deferens of Phodopus sungorus was studied using the glyoxylic acid-induced catecholamine fluorescence and acetylcholinesterase (ACHE) histochemical methods. ACHE-positive nerve fibres could be demonstrated in the smooth muscle layer along the whole sperm transporting duct, in the lamina propria and within the epithelium of the ductus deferens. The extent and intensity of enzymatic reaction did not change between LD 16:8 and LD 8:16 conditions. An adrenergic nerve plexus was found in the smooth muscle layer of the sperm transporting duct. Especially in the ductus deferens, the intensity of fluorescence and the number of adrenergic nerves decreased in animals kept at short photoperiods. The influence of androgens on the sympathetic innervation of the ductus epididymidis and ductus deferens was discussed. PMID- 2782611 TI - [Stresses on the patellofemoral joint]. AB - The patello-femoral joint is balanced by 2 tension forces of opposite direction, which are represented by the geometrical position of M. quadriceps femoris and Lig. patellae. The resultant is the vector sum of both forces and is shown by a computer simulation. Its action line runs through the center of rotation and is perpendicular to the articular point, the total torque is zero. At higher degrees of knee flexion, quadriceps tendon contacts the femur and changes direction. This effect has important influence on the amount of the resultant. The articular point of the patella moves from distal to further proximal during flexion. PMID- 2782612 TI - Distribution of the neural crest cells in the heart of birds: a three dimensional analysis. AB - The distribution of neural crest derived cells (NC) in the heart of quail-chick chimeric embryos was analyzed three-dimensionally after computer reconstruction. During the division of the truncus arteriosus into the aorta and the pulmonary trunk, ventral and dorsal columns of NC-derived cells were found in the truncal swellings. These columns were elongations from the aorticopulmonary (AP) septum. The dorsal column extended more proximally than did the ventral column. Around hatching, NC-derived cells located between the proximal aorta and the pulmonary trunk, differentiated into cartilage and connective tissue. They formed a part of the cardiac skeleton. A small number of NC-derived cells were scattered in the cusps of the arterial valves. Cells derived from the right NC were located around the aorta and the right arch arteries but not around the distal pulmonary trunk and the left arch arteries. At the proximal level, cells derived from the right NC were located in both the dorsal and ventral columns. These results suggest that the AP septum is mainly formed by NC-derived cells, right and left NC cells migrating into assigned areas in the heart. Location of two columns of NC-derived cells may support a translocation hypothesis for the AP septum during truncal division. PMID- 2782613 TI - Topography of the pelvic autonomic nerves in human fetuses between 21-29 weeks of gestation. AB - A topographical study concerning the autonomic nerves in the pelvis of human fetuses was performed by investigating 300-600 microns thick sections through fetal pelves, impregnated with the epoxy resin E 12 and cut with a diamond wire saw. In addition the inferior hypogastric plexus of a 26-week old male fetus was dissected by lateral approach. In 21-29-week old fetuses the pelvic autonomic nerves are relatively thick. Thus the nerves stand out well against surrounding structures and their topographical relationships can exactly be determined. The inferior hypogastric plexus of 21-29-week old fetuses is situated on a curved line between the rectum and the ventrally adjacent structure. It constitutes a rectangular plate, which cannot be subdivided into individual plexuses for the different pelvic organs. The fetal plexus is heavily ganglionated. Large ganglia, forming the so-called ganglion of "Frankenhaeuser", are found in the female as well as in the male fetus. In the fetal pelvis the connective tissue compartments are still clearly arranged, because adipose tissue is not yet abundant. The greater part of the inferior hypogastric plexus is situated exactly at the border between a dense visceral tissue medially and a loose parietal tissue laterally. The plexus does not share a common connective tissue cover with the pelvic blood vessels. In fetuses the inferior hypogastric plexus lies in close vicinity to serveral organs, but the pelvic floor is the only region where the nerves can hardly be separated from the surrounding structures. PMID- 2782614 TI - Immunohistochemistry of laminin in early chicken and quail blastoderms. AB - We have used immunohistochemical techniques to study laminin in quail blastoderms milked from the oviduct and the distribution of laminin in laid chicken and quail blastoderms. Laminin is a constituent of the basement membrane in both chicken and quail blastoderms. It is found at the ventral side of the upper layer cells. Laminin is first observed under individual upper layer cells in prelaid quail blastoderms 15 h post-ovulation, but is absent at the ingression site of endophyll cells. The presence of a continuous laminin layer coincides with the epithelialization of the epiblast after 5-10 h incubation. The laminin layer is discontinuous at the primitive streak and at Hensen's node. It is thinner and partly discontinuous at the median part of the neural plate. By induction, either of an ectopic primitive streak or a neural plate, we have demonstrated, using the chicken-quail nucleolar marker technique, that at these sites the laminin layer is interrupted. A laminin layer might confer rigidity onto the epiblast, whereas disruption of a laminin layer seems to be correlated with ingression of cells or bending of the neural plate. PMID- 2782615 TI - Cortico-cortical and subcortico-cortical afferent connection of the rabbit's primary visual cortex. A horseradish peroxidase study. AB - Neuroanatomical studies were carried out on the visual system of the adult rabbit brain. Either horseradish peroxidase (HRP) or wheat germ agglutinine-horseradish peroxidase (WGA-HRP) was injected into the area occipitalis 1. Several cortico cortical, ipsi- and contralateral, and subcortico-cortical projections were demonstrated. In the ipsilateral telencephalon several patches of labelled cell groups, some single HRP-positive cell bodies and some labelled fibres were observed in the area retrosplenialis granularis dorsalis, the areas occipitales, the areas temporales, the area perirhinalis, the area entorhinalis, the area praecentralis 1, the regio cingularis 1 and in the regio diagonalis, as well as in the dorsal part of the claustrum. Efferent preterminal fibres and terminal knobs were seen in the nucleus caudatus. Contralaterally, groups of labelled cell bodies and single HRP-positive neurons were found in the area retrosplenialis granularis dorsalis, the areas occipitales and the areas temporales. In the ipsilateral diencephalon, labelled cell bodies were observed in the corpus geniculatum laterale (pars dorsalis and ventralis), the nucleus lateralis thalami, the nucleus reticularis thalami and in nonspecific nuclei of the midline. Contralaterally, very few labelled cell bodies were seen in the nonspecific nuclei of the midline. Some labelled cell bodies were observed in the ipsilateral substantia griseum centrale and in the nucleus reticularis mesencephali. Numerous anterogradely labelled preterminal fibres and terminal knobs but very few labelled cell bodies were seen in the nucleus praetectalis posterior. In the nucleus of the optic tract and in the colliculus superior, numerous labelled fibres could be observed. In the ipsilateral nuclei pontis numerous labelled fibres were detectable. PMID- 2782616 TI - Retinofugal projections in the rufous horseshoe bat, Rhinolophus rouxi. AB - The retinal projections in the horseshoe bat were studied with anterograde transport of wheat germ agglutinin conjugated to horseradish peroxidase. Retinal fibers clearly terminate bilaterally in the lateral geniculate nuclei, superior colliculus, pretectal area, and nucleus of the optic tract. The suprachiasmatic nucleus and the lateral terminal nucleus of the accessory optic tract receive extremely weak, through bilateral retinal input. No projections to medial and dorsal accessory optic nuclei were found. There was a limited retinal projection to the ipsilateral dorsal geniculate nucleus. The focus of the ipsilateral projection corresponded to a less densely labeled region on the contralateral side. In this study an ipsilateral retinal projection to the anterior superior colliculus is documented for the first time in a Microchiropteran bat. In the contralateral superior colliculus retinal fibers terminate in a patch-like pattern at caudal levels. PMID- 2782617 TI - Elastic strain energy in the low back muscles during human walking. AB - A simple model of the thorax, pelvis and three columns of the intrinsic lumbar back muscles (= ILBM) was constructed. The model was used to study the length of the ILBM during the different stages of the walking cycle. The length of the right ILBM (especially the lateral column) was largest at right toe off, exactly the stage of the walking cycle in which most force was needed to prevent the torso from falling forwards and laterally. PMID- 2782619 TI - Atrioventricular node and input pathways: a correlated gross anatomical and histological study of the canine atrioventricular junctional region. AB - To determine the architecture of the atrioventricular (AV) junctional region, structures in atrial preparations were correlated to those in serial sections made either parallel or perpendicular to the long axis of the AV node (AVN)/AV bundle complex. The results demonstrated the following for the first time: 1) A right medial atrial wall (MAW) extends anteriorly from the interatrial septum, superior to the interventricular septum (IVS). 2) An atrial interventricular septum (A-IVS) groove is located between the base of the MAW and the crest of the IVS. 3) Three atrionodal bundles converge to form a proximal AV bundle (PAVB), which in turn is contiguous with the AVN. The atrionodal bundles are associated with the MAW or the superomedial and inferolateral margins of the coronory sinus. Terminal portions of the atrionodal bundles and the PAVB reside within the A-IVS groove. The AV bundle was termed distal (DAVB) to avoid confusion. 4) The location of the AVN/DAVB complex topographically is deep to the apex of the septal cusp of the tricuspid valve subjacent to the MAW. Intracardially, the AVN/DAVB complex is within the central fibrous body. Significantly, this study resulted in the first unequivocal demonstration of discrete bundles of myocardial fibers associated with the atrial end of the AV node. Moreover, it appears likely that the atrionodal AV bundles are continuous with the sinoatrial nodal extensions, thereby forming internodal tracts. PMID- 2782618 TI - Morphometric analysis of bone marrow sinus cell elements after induction of monomyelocytic leukemia in BALB/c mice. AB - Morphometric measurements of bone marrow sinus wall adventitial and endothelial cells were made in normal and leukemic samples by using a Bioquant II computer image analysis program (R & M Biometrics, Nashville TN). Electron micrographs of bone marrow from at least eight mice per group were studied in normal and day-2, day-4, and day-6 leukemic postinoculation groups. The adventitial cells abuting the sinus endothelium was found to be significantly reduced with disease progression. In addition, adventitial cell area and perimeter were found to be drastically reduced with disease progression whereas endothelial cell area and perimeter showed no significant differences. Other investigators have suggested that the marrow sinus adventitial cell cover is drastically reduced in rodent leukemias (Chen et al.; Blood, 39:99-112, 1972; Campbell; Am. J. Anat., 142:319 334, 1975). Our findings give quantitative data to support this hypothesis. PMID- 2782620 TI - Studies on the vasculogenesis in rat cerebral cortex. AB - The cerebral cortices are nourished by blood circulating through a capillary network branching from parent arteries. In this paper, vasculogenesis of the cerebral cortices in developing rats (11-18 days after birth) was studied by light and electron microscopy after intravenous administration of horseradish peroxidase (HRP). In the first phase of vasculogenesis, tentacles grew out from the distal end of the vascular cord (tip cells), and in the second phase, they extended to the afferent blood vessel. The reaction product of HRP was distributed not only in the primitive vascular lumen, but also in the peripheral extravascular space of the vascular cord. Most tentacles were free from reaction product, but, in some cases where reaction product was detected, the intercellular spaces had spread into the tip cells and reached the root of the tentacles. After the tentacles contacted the afferent vascular cord, the two vascular cords approached and fused with each other. Blood serum was able to circulate between the two vascular cords via the irregular interstices formed among the endothelial cells, cytoplasmic processes, and tentacles. Later, the primitive vascular lumen developed to a sufficient size to allow for the circulation of blood cells. The sequential events in the process of fusion between two vascular cords are illustrated. The following two points were also noticed in this study: 1) during cerebral vasculogenesis, degeneration and vacuolization in primitive endothelial cells occurred only in some of the serial sections and did not play a significant role in the formation of vascular lumen, and 2) cerebral pericytal macrophages (CPM) (classified as fluorescent granular perithelial cells by the authors) appeared close to the vascular cord, although the biological meaning of it remained unknown in the present investigation. PMID- 2782621 TI - Isomyosin expression patterns during rat heart morphogenesis: an immunohistochemical study. AB - An immunohistochemical study of cardiac alpha and beta myosin heavy chain (MHC) expression during rat heart morphogenesis was performed. In tubular hearts (embryonic days, ED10-11) coexpression of both cardiac alpha and beta MHC was found throughout the heart, except for the left free wall of the atrium, where only cardiac alpha MHC is detected. A transition of coexpression to single expression of either cardiac alpha or beta MHC begins at the same time in both atria and ventricles but requires a longer time for completion in the ventricules; in the atria transition takes place during the period ED 12-13 and in the ventricles during ED12-15. Furthermore, expression of cardiac alpha and beta MHC was detected in the sinus venosus, and cardiac alpha MHC expression was detected in the pulmonary veins. A comparison of the results obtained in chicken embryos revealed that in tubular hearts the expression pattern is similar, whereas in later developmental stages two major differences were observed: 1) transition of coexpression to single expression in rat ventricles appears to take a longer developmental period; 2) the persistence of areas of coexpression in the sinoatrial junction, dorsal mesocardium, atrioventricular junction, and outflow tract, as found in the chicken embryo in later developmental stages, is not found in the rat heart. PMID- 2782623 TI - Three-dimensional reconstruction of the myofiber pattern in the fetal and neonatal mouse heart. AB - A methodology for three-dimensional reconstruction from serial sections and interactive computer graphics is described briefly. This methodology was applied to study the morphogenesis of the cardiac myofiber pattern in the fetal and neonatal mouse heart (ventricles). Few organized in-plane myofibers were found in the myocardial wall before 12 days postconception, but many fibers were observed in the very numerous trabeculae at all times up to birth. However, beginning at about 12 days, the number of fibers in the myocardial wall increases rapidly: these are seen predominantly in the transverse plane. The neonatal mouse heart, especially the left ventricle, resembles a small adult muscular artery. But the global myofiber pattern in the mouse heart at these stages appears to be more complex than might be inferred from earlier studies of the local myofiber pattern at a few sites in the ventricles of a few species of adult mammals. In particular, the pattern in and adjacent to the interventricular septum appears quite complex. PMID- 2782622 TI - Multinucleated cells formed on calcified dentine from mouse bone marrow cells treated with 1 alpha,25-dihydroxyvitamin D3 have ruffled borders and resorb dentine. AB - Osteoclast-like multinucleated cells were formed from mouse bone marrow mononuclear cells, and their morphology on coverslips and on calcified dentine slices was compared by means of transmission electron microscopy. Addition of 1 alpha,25-dihydroxyvitamin D3 [1 alpha,25(OH)2D3] to bone marrow cells cultured on coverslips greatly stimulated the formation of multinucleated cells within 8 days. These multinucleated cells had the cytological features of osteoclasts (abundant pleomorphic mitochondria, a large number of vacuoles and lysosomes, many stacks of Golgi membranes, and an extensive canalicular system), but they developed neither ruffled borders nor clear zones. The multinucleated cells appeared to result from direct fusion of mononuclear progenitor cells, whose structural features were similar to those of multinucleated cells. Like isolated osteoclasts, both multinucleated cells and their precursors exhibited an intense reaction for tartrate-resistant acid phosphatase (TRACP) in the cisterns of endoplasmic reticulum and lysosomes. Multinucleated cells formed from alveolar macrophages in the presence of 1 alpha,25(OH)2D3 were totally negative for TRACP reaction. When marrow cells were cultured on dentine slices in the presence of 1 alpha,25(OH)2D3, some of the multinucleated cells were located in the shallow resorption lacunae of dentine surfaces, and they developed the characteristic ruffled borders and clear zones. The narrow extracellular spaces of the ruffled borders, the adjacent pale endocytotic vacuoles, and the dark lysosomes located in the perinuclear cytoplasm of the multinucleated cells contained numerous apatite crystals delete in resorption lacunae. These results indicate that 1) the multinucleated cells formed on coverslips from mouse marrow cells treated with 1 alpha,25(OH)2D3 exhibit non-functional basic features of osteoclast morphology, and 2) differentiation of the multinucleated cells into functional osteoclasts requires some components of calcified dentine. PMID- 2782624 TI - Jaw movements and muscle activity during mastication in growing rabbits. AB - To investigate the biomechanical effects of juvenile growth changes in the rabbit masticatory apparatus a comparison was made of mastication in just-weaned and adult animals. Mandibular movements in two planes were registered by cineradiography. Masticatory muscle activity was recorded by fine-wire electromyography. The same pattern of unilateral mastication was present in the two ages. The most important changes in the jaw movements are 1) a decrease of jaw opening speed and chewing frequency and an increase in jaw opening time, 2) a decrease in maximum gape in soft food and an unaltered gape in small-particle hard food, and 3) an increase in lateral jaw excursion, mainly due to a more pronounced movement of the jaw to the balancing side (lingual phase). The contraction patterns were basically similar in the two ages. The higher chewing frequency in young animals was attained by a larger degree of overlap between opening and closing muscle activities. Young animals used relatively more EMG activity to chew hay, the hardest food. The changes in opening speed, gape, and chewing frequency are consistent with earlier predictions from the morphological changes, and so is the extra activity needed to chew hard food. The increase in lateral excursion was not predicted. It is suggested to be caused by cheek teeth wear, making possible smooth occlusal guidance of the jaw at the balancing side. Some of the changes in juvenile morphology can be viewed as adaptations to a changing diet. PMID- 2782625 TI - Neuromuscular organization of the pectoralis (pars thoracicus) of the pigeon (Columba livia): implications for motor control. AB - The pectoralis (pars thoracicus) of the domestic pigeon (Columba livia) is divisible into two anatomical parts, the pars sternobrachialis (SB) and the pars thoracobrachialis (TB). Innervation to this complex is from rostral and caudal branches of the brachial ventral cord. In four anesthetized pigeons, the distribution of muscle units associated with each nerve branch was mapped after prolonged stimulation of each nerve and subsequent analysis for muscle fiber glycogen. An additional three animals were used to analyze the morphology, distribution, and histochemical profiles of the muscle fibers in the SB and TB subregions. Fibers were characterized on the basis of their reactions for myofibrillar adenosine triphosphates (alkaline and acid preincubation) and reduced nicotinamide adenine dinucleotide diaphorase (NADH-D). The SB is primarily innervated by the rostral nerve branch and the TB by the caudal nerve branch. For two-thirds of the muscle's length, the SB is separated from the TB by an aponeurosis, the membrana intermuscularis (MI). SB and TB fibers located posteroventral to the caudal margin of the MI are innervated variously by both nerves. Two populations of fibers were recognized, distinguishable primarily by 1) fiber diameter and 2) density of the NADH-D reaction product. Compared to the TB, the SB possesses a higher average percentage of large fibers. Within the SB but not the TB the percentage of large fibers increases from deep to superficial. These data support our previous findings that the pars thoracicus of the pigeon is partitioned into at least two functional subunits, each with a potential for independent action on the wing during flight. PMID- 2782626 TI - Deformation-corrected computer-aided three-dimensional reconstruction of immunohistochemically stained organs: application to the rat heart during early organogenesis. AB - The application of a computer-assisted, three-dimensional reconstruction procedure for serial sections to embryonic rat hearts during the period of cardiac looping and compartmentalization is described. The procedure relies on immunohistochemical staining for the introduction of selective contrast and on episcopic and diascopic images of each of the sections for alignment and correction of compression due to sectioning. Episcopic (reference) images are taken from the embedding block just before the cutting of a slice and are still aligned and undeformed. Diascopic images are taken from the sections after immunohistochemical processing and, hence, contain selective contrast but are deformed and no longer aligned. The three-dimensional images are visualized as shaded voxel models. This approach allowed the unequivocal delineation of the developing myocardium and the inspection of its changing architecture both from the outside and from within. Furthermore, it allowed a quantification of myocardial volume. Because standardized and hence comparable views of three different stages were generated, changes in the shape of the cardiac loop, the atria, and the ventricles as well as changes in the position of the atrioventricular canal and interventricular foramen could be accurately described. Characteristic changes in the position of both the right ventricle and the atrioventricular canal that are essential for the formation of a correctly functioning four-chambered heart could be observed. These changes in shape occur while the myocardial size increases dramatically. PMID- 2782627 TI - S-100 protein in white preadipocytes: an immunoelectronmicroscopic study. AB - Differentiation of adipocytes from their precursor cells (preadipocytes) is an important problem in the study of the pathogenesis of obesity. Unfortunately, among the immature stages of adipocytes, only relatively differentiated forms can be identified by their fine structure; because early preadipocytes cannot be distinguished from fibroblasts solely on the basis of their morphology, it is impossible to assess the size of the preadipocyte population. S-100 protein has been identified in various mammalian tissues and recently mature adipocytes have been shown to be positive for this protein. Because fibroblasts are negative for S-100 protein, the present study tested the S-100 immunoreactivity of preadipocytes by the peroxidase-antiperoxidase (PAP) preembedding method at the ultrastructural level both in vivo and in culture. Mature adipocytes and early preadipocytes, including fibroblast-like cells devoid of lipid droplets, were positive both in vivo and in culture. Endothelial cells and pericytes were negative; but flattened, lipid-free, fibroblast-like cells surrounding the pericytes were positive. True fibroblasts both in vivo and in culture were negative. Therefore, S-100 protein can be a useful biochemical marker in distinguishing fibroblasts from early preadipocytes. PMID- 2782628 TI - Insect hemolymph factor promotes muscle histolysis in Solenopsis. AB - Hemolymph was collected from both normal (virgin) females (control hemolymph) and artificially inseminated females (experimental hemolymph) of Solenopsis, ssp., the imported fire ant (primarily S. invicta and S. geminata). When the control hemolymph was injected into normal females, breakdown of the thoracic flight musculature was not seen 24 hr postinjection. In contrast, when the experimental hemolymph was injected into normal females, flight muscle histolysis was marked 24 hr postinjection. When the experimental hemolymph was heated to 70 degrees C prior to injection into normal females, subsequent flight muscle breakdown was not seen. The injection of freshly collected semen into normal females produced no effect on flight muscle structure. Also, the injection of the experimental hemolymph into normal, alate males produced no muscle histolysis. These observations suggest that the hemolymph from inseminated females contains a factor (or factors) that induces the specific breakdown and subsequent dissolution of the complex thoracic flight musculature. Other thoracic muscles (leg muscles, intersegmental muscles, etc.) are not affected. Based on observations made in both insect muscles as well as vertebrate skeletal muscles, it is suggested that such a hemolymph factor may act by disrupting the structural integrity of muscle cell membranes, resulting in significant changes in membrane permeability, especially with regard to calcium ions. PMID- 2782629 TI - Morphometric analysis of the development of sexual dimorphism of the mouse pelvis. AB - Sex differences in the innominate bone of C57BL/Tw mice were studied morphometrically from the day of birth to 120 days of age. In neonatal male and female mice, a small cartilaginous spine was found on the basal part of ischium. This process disappeared in males within 24 hours after birth, whereas in females it remained until at least 30 days. Other sexual differences in the pubis and the ischium appeared at 30 and 120 days, respectively. The pubis in female mice was longer and thinner than that in the males, and the ischium in male mice was shorter and thicker than that in the females. Thirty-day-old female mice treated neonatally with testosterone or 5 alpha-dihydrotestosterone possessed pubic bones shorter and thicker than those of the age-matched untreated females. Pubes in male mice castrated at the day of birth were thinner than those in intact males. These findings suggest that the shape of the innominate bone is transformed to the male type under the influence of early postnatal androgen. PMID- 2782630 TI - Quantitative assessment of the biological effects of follicle regulatory protein on dihydrotestosterone-maintained spermatogenesis in hypophysectomized rat. AB - Follicle regulatory protein (FRP) isolated from porcine ovarian follicles influences folliculogenesis through a paracrine mechanism. A similar protein has been found in the testes and seems to have some inhibitory effects on spermatogenesis when administered to intact male experimental animals. On the basis of female and male studies, it has been ascertained that the effects of FRP are at the level of gonads and not the pituitary or the hypothalamus. In the studies with intact males it was not possible to determine the exact site of FRP action on the testes. Dihydrotestosterone (DHT) has been shown to maintain spermatogenesis in hypophysectomized rats. In order to determine if the inhibitory effects of FRP are at steps prior to the formation of DHT, FRP was administered to hypophysectomized rats that were injected with DHT. Groups of adult rats were hypophysectomized and treated daily with FRP, DHT, FRP + DHT, or vehicle alone for 30 days. At necropsy, body, testes, prostate glands, and seminal vesicle weights were recorded. One testis and sexual accessory glands were fixed for histological evaluation. The contralateral testis was decapsulated, six 2 mm segments of seminiferous tubules, representing defined stages of spermatogenesis, were isolated by transillumination-assisted microdissection, and spermatogenic cells were quantified by DNA flow cytometry. Histologically, the seminiferous tubules of vehicle-treated hypophysectomized controls showed advanced regression. Rats treated with FRP alone showed similar degeneration. On the other hand, rats treated with DHT showed maintenance of spermatogenesis comparable to normal controls. The testes of rats treated with FRP + DHT were indistinguishable from those treated with DHT only. Flow cytometric quantification of germinal cells from all groups confirmed the histological findings. In this study FRP did not exert deleterious effects on DHT maintained spermatogenesis. This finding suggests that the inhibitory effects of FRP on spermatogenesis in intact animals may not be a direct effect on spermatogenic cells but may impair androgen action or production or DHT formation. PMID- 2782631 TI - Scanning electron microscope study of the morphology of the reptilian lung: the Savanna monitor lizard Varanus exanthematicus and the pancake tortoise Malacochersus tornieri. AB - The morphology of the lungs of two reptilian species, Varanus exanthematicus and Malacochersus tornieri, have been studied on gross preparations, latex casts, and critical-point-dried tissues. The shape of these lungs was observed to conform with that of the body, the lung of the monitor lizard (Varanus) being long and ovoid while that of the pancake tortoise (Malacochersus) was rounded and laterally indented. With respect to the size distribution of the gas exchange compartments, the lungs were observed to be notably heterogenous. In both species these units were generally smaller in diameter in the cranial region of the lung while those in the caudal region were larger. The gas exchange compartments in the tortoise were more profusely compartmented with the primary, secondary, and tertiary septa being well developed while in the lizard only the primary and secondary septa were observed. The tertiary septa in the tortoise lung and the secondary septa in that of the monitor lizard defined the terminal gas exchange units, the faveoli. The cast impressions closely resembled the actual lung tissue and convincingly revealed the hierarchical design of the gas exchange compartments as they radiate from the air chambers and ducts, terminally giving rise to the faveoli. This stratification clearly increases the surface area available for gas exchange in these lungs. Disparate refinements of the basic reptilian lung design, as noted here, may lead to differing anatomic pulmonary diffusing capacities for oxygen to which characteristics like energetics and mode of respiration in this taxon may be attributed. PMID- 2782632 TI - Intercellular communication between rat anterior pituitary cells. AB - Cell-to-cell communication within the rat anterior pituitary was investigated in 60-day-old male rats with immunohistochemistry, scanning electron microscopy, freeze-fracture electron microscopy, and conventional transmission electron microscopy. A dense cytoreticular network of cytoplasmic processes from the folliculostellate cells was found to contain immunoreactive S-100 protein and was observed throughout the anterior pituitary. Nonimmunoreactive cells, which were granular, were situated in the center of each network. Almost all of the granulated cells were situated in close proximity to the folliculostellate cells. Scanning electron microscopy revealed that the gland consisted of microlobules enclosed by a basal lamina. On the surface of the microlobules were blood vessels whose branches invaded its internal structures. Cytoplasmic processes from folliculostellate cells projected outside the microlobule. Freeze-fracture electron microscopy demonstrated the presence of numerous intramembranous particles on the P-face of the plasma membrane. Scattered on the cell surface were groups of particles forming gap junctions. Meshworks of ridges which were representations of tight junctions were also observed near clusters of microvillous fragments. Clusters of particles forming small gap junctions were located between the meshworks of tight junctions. Small gap junctions were clearly observed by conventional electron microscopy between junctional complexes in a manner similar to that seen by freeze-fracture electron microscopy. Slender cytoplasmic processes of folliculostellate cells came in contact near the basal lamina and were adjoined by small gap junctions. The ratio of nongranular cells which contained gap junctions to those in which the junctions were absent was about 1:1. The size of the gap junctions ranged from 50 nm to 3 microns. No gap junctions were observed along the plasma membranes of the granular cells. The significance of an intercellular communication system within the anterior pituitary gland of the rat is to establish a mechanism for rapid transmission of information in an organ which lacks direct innervation. PMID- 2782633 TI - Vasoconstriction in telencephalic microvessels: a response to one model for intraventricular hemorrhage in beagle pups. AB - Telencephalic microvessels were morphologically and morphometrically evaluated in beagle pups at 24, 48, and 72 hours of age following an experimental insult consisting of exposure to acute hypovolemic hypotension followed by rapid corrective blood reinfusion. Animals were anesthetized throughout the procedure and maintained for 75 minutes prior to sacrifice. Microvessels from the germinal matrix, where intraventricular hemorrhage (IVH) most commonly occurs, were compared to those of the adjacent cerebral cortex and choroid plexus. Perfusion, fixation and processing of the tissue followed our previously published protocol (Leuschen et al.: Anatomical Record 208:435-443, 1984). Both germinal matrix and cortical microvessels had collapsed lumens and normal endothelial cell morphology; mitochondria contained distinct cristae, junctional complexes were present and a basement lamina completely surrounded most vessels. Morphometric data on matrical and cortical microvessels supported vasoconstriction. Microvessels from choroid plexus were not vasoconstricted; tight junctions were infrequently seen and microvesicular elements were present. An increased cerebral blood flow to the germinal matrix and the adjacent cerebral cortex has been reported during and immediately following hypovolemic hypotensive insult. By 75 minutes following insult, our ultrastructural studies support a rebound phenomena including vasoconstriction of microvessels. The resulting vasoconstriction and associated cerebral ischemia may play an important role in subsequent tissue damage to the matrical area and ultimately to the etiology of IVH. PMID- 2782634 TI - Technique for reconstituting fixed cadaveric tissue. AB - Dissecting room cadavers used over a prolonged period inevitably become desiccated, especially in well-ventilated surroundings. It is particularly desirable that dissections used for end-of-year examinations be restored to their original condition. We describe here a quick and simple procedure designed to restore neglected specimens to their former condition at dissection. Specimens were either soaked for 24 hr in a standard solution of fabric conditioner or sprayed with the same standard solution. The specimens were then wrapped with muslin soaked in the conditioner and covered with polythene sheeting for 1 week. The results obtained were excellent and much superior to a short soak in water. The results further indicate that this technique may have other applications in the preparation of fixed histological material. PMID- 2782635 TI - Survival of human sperm following controlled- and noncontrolled-rate cryopreservation. AB - The purpose of this study was to develop a noncontrolled-rate (NCR) method of freezing semen in cryovials which could be used as a backup to controlled-rate (CR) freezing when the CR freezer was being utilized for freezing of human embryos or oocytes. Semen was frozen with three concentrations of glycerol (0%, 3.75%, 7.5%) in cryoprotective media in a CR freezer or using a newly developed NCR method of freezing. Semen was thawed in 40 degrees C water or in air at room temperature (RT). Controlled-rate freezing and 40 degrees C thawing resulted in significantly greater postthaw sperm motility and motility index compared with NCR freezing and RT thawing. Sperm velocity and linearity were not significantly effected by rate of freezing or thawing except when there was no glycerol present in the cryoprotective media. Postthaw motilities following CR-40 degrees C, NCR 40 degrees C, CR-RT and NCR-RT freezing-thawing were 25.6%, 24.8%, 21.6% and 18.3%, respectively. Because NCR freezing resulted in only a 0.8% decline in motility compared with CR freezing when semen was thawed at 40 degrees C it appears that this new NCR method of freezing can be successfully used as a backup to CR freezing when the CR freezer is being used for embryo or oocyte cryopreservation. PMID- 2782636 TI - The characterisation of non-sperm cells in the ejaculates of fertile men using transmission electron microscopy. AB - The non-spermatozoal cells (NSC) in the semen samples of 20 fertile human males have been studied by transmission electron microscopy (TEM), in order to accurately distinguish between the different types of cell present and to give a quantitative profile of their relative proportions. The main seminal constituents of the average fertile man were found to be the germinal elements, accounting for 84.0% of the total NSC population. Of this percentage the anucleate bodies, designated "CM" in this study, were the greatest component (43.0%, SEM +/- 4.7). Spermatids were the next commonly occurring cell (22.2%, SEM +/- 2.9), the anucleate cellular masses with organelles, CM(O)'s and the spermatocytes making up the remaining 18.8%. Leucocytes accounted for 13% of the total NSC, respectively: neutrophils - 12% (SEM +/- 4.5); macrophages - 0.9% (SEM +/- 0.3) lymphocytes - 0.1% (SEM +/- 0.1). The remaining 3% consisted of 2.3% (SEM +/- 0.7) epithelial cells and 0.7% (SEM +/- 0.4) Sertoli cells. The principal conclusions reached were: that some normal ejaculates host active phagocytosis and possibly macrophage activation; that anucleate bodies which form a major component of the ejaculate merit further quantitative study and that the shedding of spermatids is an interesting and important aspect of ejaculation. PMID- 2782637 TI - Computer assisted measurement in normal and pathological human semen, fresh and post swim-up technique. AB - A total of 429 semen samples were studied. Two hundred and twenty-nine samples with normal characteristics were processed following a basic procedure; the remaining 200 were normal and pathological samples that were analyzed pre and post swim-up. Semen specimens were allowed to liquefy for 30 minutes and sperm count, motility, velocity and linearity were determined using the Cellsoft Automatic Semen Analyzer. In normal patients, a significant increase of motility, velocity and linearity (p less than 0.001) post swim-up, was observed. Sperm recovery in this group was 13.9 +/- 1% of the whole motile sperm population. In the polyzoospermic group, recovery of motile spermatozoa post swim-up was significantly decreased as compared with the normal group (p less than 0.001). In the asthenozoospermic group (plus either hypospermia or hyperspermia, or with more than 30% of motile spermatozoa or less than 30% of motility), no variations of velocity or linearity as compared to the normal group were observed. In all the pathological groups studied, a significant increase in velocity and linearity (p less than 0.001) post swim-up, was observed. PMID- 2782638 TI - Autonomic neuropathy and sexual impotence in diabetic patients: analysis of cardiovascular reflexes. AB - Four cardiovascular tests exploring autonomic nervous function (Deep Breathing, 30:15 ratio, Lying to Standing, Hand Grip) have been performed in 38 diabetic patients with erectile failure (mean age 53.2 years, range 34.5-60.5) and in 35 diabetic subjects without sexual dysfunctions (mean age 52.8 years, range 45 60.5). In our study Deep Breathing test was abnormal in 21 patients with erectile failure (55.3%) and in 9 patients without sexual dysfunction (25.7%) (P less than 0.05). Seven patients with sexual impotence (18.4%) and 2 subjects without sexual dysfunction (5.7%) showed abnormal results of 30:15 ratio test. The Lying to Standing test was not abnormal both in impotent and in non impotent subjects, while the Hand Grip test was abnormal in 7 patients with impotence (18.4%) and in 8 patients without sexual dysfunction (22.9%). Results obtained from Deep Breathing test were significantly lower (P less than 0.01) in impotent (10.25 +/- 6.10 beats/min) than in non impotent patients (14.63 +/- 6.85 beats/min). Lower 30:15 ratios were also found in patients with erectile failure (1.09 +/- 0.10 vs 1.12 +/- 0.09). The tests exploring the sympathetic function did not show any difference between the two groups of patients. The present study confirms the major role of parasympathetic impairment in the pathogenesis of sexual dysfunctions in diabetic men. Cardiovascular tests can be a first-step diagnostic tool in the assessment of diabetic impotence. PMID- 2782639 TI - Andrological parameters in human semen of high (greater than or equal to 6 ml) and low (less than or equal to 1 ml) volume. AB - A study was carried out to evaluate 792 semen of high (greater than or equal to 6 ml) and low (less than or equal to 1 ml) volume and sperm counts ranging from 0.1 to 200 x 10(6) per ml. Particularly emphasized were: motility percentage and grade, percentage viability, morphologically normal sperm and immature cells, and the concentration of fructose in semen (mg/ml). The Duncan multiple range test and the Kruskal-Wallis test with multiple comparison of ranks were used in the statistical analyses. The results show that abnormal semen volume influence neither the basic tendency of andrological parameters to change in accordance with sperm counts of semen nor to correlate with each other. The quality of motility was significantly higher in specimens of high semen volume as compared to those of low semen volume. The concentration of fructose in semen was generally higher in specimens of high volumes than in those of low volumes, including semen devoid of sperm. It was assumed that in general increased semen volume does not affect the quality of other andrological parameters, thus being probably unrelated with fertility potential. The considerably lower values of both motility and viability characterizing the semen of low volume would suggest a lower fertility potential of specimens affected by this type of abnormality. PMID- 2782640 TI - Sperm motile efficiency (SME) of fresh spermatozoa in a hypotonic medium correlates with their cryosurvival in fertile men and infertility patients (predicting test). AB - The sperm motile efficiency (SME) of fresh spermatozoa in a hypotonic medium was investigated concerning the prediction of post thaw motility and the differentiation between fertile men and infertility patients. A total of 95 semen samples were collected for this study. Twenty of these samples were obtained from semen donors of proven fertility and 75 samples were collected from male partners of infertile couples. There were no significant differences between the SME after mixture of the fresh semen with a 140 mOsm saline in equivalent volumes and after cryopreservation (Wilcoxon-matched pairs signed ranks-test) but a significant positive correlation between the SME after both treatments of semen samples was notable. Significant differences between the fertile control group and group of infertility patients could be determined concerning the SME after mixing of fresh semen with 140 mOsm saline as well as after cryopreservation (Mann-Whitney-U test). The discriminant analysis revealed a most discriminating effectiveness for SME immediately after the addition of hypoosmotic saline. PMID- 2782641 TI - Standards for halothane/caffeine contracture test. PMID- 2782642 TI - Hemodynamic changes and oxygen consumption in burned patients during enflurane or isoflurane anesthesia. AB - The effects of enflurane or isoflurane anesthesia on the systemic circulation and whole-body oxygen (O2) uptake (VO2) of 15 burn patients undergoing wound excision and skin grafting procedures were studied. The possibility that burn wound excision might adversely affect pulmonary circulation was also investigated. The patients were preanesthetically in a hyperdynamic-hypermetabolic state, characterized by a resting cardiac index (CI) of 6.2 +/- 0.9 L.min-1.m-2 (mean +/ SD), a VO2 (calculated using the Fick principle) of 213 +/- 44 mL.min-1.m-2, a normal mean systemic arterial pressure (MAP) (92 +/- 15 mm Hg), and markedly decreased systemic vascular resistance (SVR) (570 +/- 162 dynes.sec.cm-5). Mean pulmonary arterial pressure (MPAP) preanesthetically was slightly increased (21 +/- 3 mm Hg), while pulmonary vascular resistance (PVR) was in the low-normal range (59 +/- 16 dynes.sec.cm-5). No difference among the effects of enflurane and isoflurane on systemic and pulmonary hemodynamics and metabolic rate was detected. Induction of anesthesia was associated with a decrease in VO2, CI, MAP, and MPAP (P less than 0.001), while SVR and PVR did not change. The decrease in CI paralleled the decrease in VO2, thereby maintaining whole-body O2 supply demand balance. VO2 decreased most likely because of lessened tissue O2 requirements. When anesthesia was discontinued, all metabolic and hemodynamic variables promptly returned to preanesthetic values. No effect of burn wound excision on pulmonary circulation was detected. PMID- 2782643 TI - Malignant hyperthermia in humans--standardization of contracture testing protocol. AB - Malignant hyperthermia (MH) diagnostic biopsy centers across North America have not previously been standardized in regard to protocols and specific muscles. Recent standardization criteria prompted this study of the vastus and rectus abdominis muscles. This study evaluated changes in contracture tension after electrical stimulation of 271 bundles taken from the vastus (n = 16) and rectus abdominus (n = 19) muscle biopsies of normal individuals when exposed to tissue baths in the absence of and in the presence of caffeine (0.5, 1.0, 2.0, 4.0, 8.0, and 32.0 mM) alone, halothane (1% or 3%) alone, or the combination of halothane (1%) plus caffeine (0.25, 0.5, 1.0, 2.0, 4.0, and 32.0). Caffeine threshold concentration was that concentration of caffeine that produced a 7% increase in tension. Caffeine specific concentration (CSC) and halothane caffeine specific concentration (HCSC) were those concentrations of caffeine alone or of halothane plus caffeine that produced a 1 g increase in tension. The concentration of caffeine alone that increased the contracture tension by 7% averaged 6.7 +/- 0.3 mM for vastus, significantly greater than 4.1 +/- 0.2 mM for the rectus muscle biopsies. Caffeine specific concentration was significantly greater for vastus muscle (7.7 +/- 0.7 mM) than it was for rectus muscle (4.9 +/- 0.4 mM). Three percent halothane alone showed contractures in 3/41 vastus (all less than 0.5 g) and 18/54 rectus muscle bundles (8 greater than 0.5 g). Mean HCSC was statistically significantly greater for vastus muscle (1.9 +/- 0.2 mM) than for rectus muscle (1.2 +/- 0.2 mM).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2782645 TI - Spinal needle determinants of rate of transdural fluid leak. AB - Using a new in vitro model and samples of human dura, a number of factors related to spinal needle design and use were examined with respect to their effects on the rate of transdural fluid leak. These included needle size, bevel design, bevel orientation, and angle of approach. Using 25-gauge Quincke needles, a 30 degree approach caused a rate of leak across the dura significantly less than those following 60 degree and 90 degree approaches. A significant increase in leak rate was found with 22-gauge Quincke needles when the bevels were oriented so as to be perpendicular rather than parallel to the long axis of the dura. Also, 22-gauge Whitacre needles caused significantly less leak than did 22-gauge Quincke needles, and 25-gauge Quincke needles produced significantly less leak than 22-gauge Quincke needles. If human dura behaves in vivo as it does in this in vitro model, it would be advantageous to perform lumbar puncture using oblique approaches and small needles with conical tips. PMID- 2782644 TI - Nitrous oxide augments sympathetic outflow: direct evidence from human peroneal nerve recordings. AB - Direct evidence for postganglionic sympathetic nerve activation to blood vessels supplying skeletal muscle was sought by recording from the peroneal nerve of 13 volunteers with a 5-mu tipped tungsten needle. Eight subjects breathed through an anesthesia face mask connected to a semiclosed anesthesia circuit for two consecutive 10-min periods while 25% and 40% nitrous oxide (N2O) was administered sequentially. Five subjects served as controls and breathed equivalent concentrations of nitrogen. Blood pressure and central venous pressure were recorded from radial artery and jugular vein catheters. Forearm blood flow was measured by venous occlusion plethysmography. Peroneal nerve recordings were amplified 100,000-fold and integrated for analysis of burst frequency. N2O did not significantly alter respiratory rate, end-tidal CO2 (mass spectrometry), and diastolic or central venous pressures but did produce small but significant increases in heart rate and systolic pressure compared to time-control (P less than 0.05). In contrast, N2O was associated with progressive, large increases in muscle sympathetic nerve activity (peak % delta = 69 +/- 22 burst/min [X +/- SEM]) and forearm vascular resistance (30 +/- 4%) and a nonsignificant increase in plasma norepinephrine levels. Thus, brief exposure to 25% and 40% N2O produces striking increases in sympathetic outflow to skeletal muscle in humans. PMID- 2782646 TI - First-pass uptake of verapamil, diazepam, and thiopental in the human lung. AB - The first-pass uptake of verapamil, diazepam, and thiopental in the human lung was determined using multiple-indicator dilution techniques. These three drugs represent lipid-soluble agents that differ in their ionic characteristics at physiological pH. Verapamil, a basic lipophilic amine, underwent significant uptake, with 50% of the drug accumulating in lung tissue during the first pass. With diazepam, a nonbasic lipophilic amine, there was 30% uptake during the first pass through the human lung--significantly less than that observed with verapamil. With thiopental, an acidic lipophilic barbiturate, only 14% of the injected drug accumulated in the lung during the first pass. Taken together, these data are consistent with observations from animal studies, which indicate that extensive pulmonary uptake is greater with basic amine drugs that are moderately to highly lipid-soluble. Also, the relatively high first-pass uptake of verapamil in the human lung suggests a quantitatively significant role of this nonrespiratory function of the lung in the early pharmacokinetics of intravenous verapamil. PMID- 2782648 TI - Assessment of spontaneous ventilation in anesthetized children with use of a pediatric circle or a Jackson-Rees system. AB - To compare respiratory workloads, inspiratory efforts were evaluated in 11 children anesthetized with halothane while breathing through a pediatric circle or a Jackson-Rees system. All underwent urogenital surgery and received caudal analgesia after tracheal intubation. Anesthesia was maintained with O2/air at an end-tidal halothane concentration of 0.8%. A pediatric circle system at a fresh gas flow (FGF) of 0.5 and 1.5 x min ventilation (VE) (C0.5 and C1.5, respectively) and a Jackson-Rees system at FGF of 1.5 and 3.0 x VE (JR1.5 and JR3.0, respectively) were used in each patient in a random order. Tidal volume (VT), mean inspiratory flow (VT divided by the duration of inspiration TI, VT/TI), and the initial fast slopes of the airway occlusion pressure phase (delta P degrees/delta t FAST) were significantly lower (P less than 0.05) with the Jackson-Rees than with the circle system, indicating greater impedence to spontaneous breathing with the Jackson-Rees system. The Jackson-Rees system also required a greater peak transpulmonary pressure (PtpMAXe) than did the circle system to achieve the same peak expiratory flows (VMAXe, P less than 0.05), again suggesting an increased resistance with the Jackson-Rees system. These results are most likely explained by the difference in elastic loads (two to three times more with the Jackson-Rees systems) between the two systems. The pediatric circle system appears to be a reliable alternative to the Jackson-Rees system. PMID- 2782647 TI - Hypotensive anesthesia with isoflurane and enflurane during total hip replacement: a comparative study of catecholamine and renin angiotensin responses. AB - Catecholamine and renin-angiotensin responses to enflurane- or isoflurane hypotensive anesthesia were compared in a randomized study. Two groups of 10 patients undergoing total hip arthroplasty were premedicated with morphine hydrochloride (0.1 mg/kg). Anesthesia was induced with thiopental and the trachea intubated after pancuronium. Equal concentrations of each volatile agent (1.3 MAC) were administered until mean arterial blood pressure decreased to 50-60 mm Hg. Hemodynamic data and blood samples for measurements of plasma renin activity (PRA) and plasma epinephrine (E) and norepinephrine (NE) concentrations were collected 1) after induction and intubation but before the start of isoflurane or enflurane; 2) 15 min (T15) after the start of isoflurane or enflurane administration; and 3) 45 min (T45) after the start of isoflurane or enflurane administration. The desired level of hypotension was achieved at T15 with isoflurane and at T45 with both anesthetics. When hypotension was achieved, cardiac index and stroke index were significantly lower in the enflurane group while systemic vascular resistance index was lower in the isoflurane group. Increases in E and NE levels above baseline levels were significantly greater in the isoflurane group than in the enflurane group. Use of isoflurane to induce hypotension is associated with more rapid induction of hypotension, less depression of cardiac output, and better preservation of homeostatic responses than is use of enflurane. PMID- 2782649 TI - Comparative effects of halothane and isoflurane anesthesia on the ultrastructure of human hepatic cells. AB - The effects of halothane and isoflurane on the ultrastructure of the liver cells in adult patients with normal liver-function tests were compared. After induction of anesthesia with thiopental, fentanyl, and pancuronium, 18 patients were randomly divided into three groups of six each. Anesthesia was maintained with droperidol (droperidol group), with halothane (1.7 MAC, halothane group), or with isoflurane (1.7 MAC, isoflurane group). During the surgical procedure, 1 hr after the induction, a liver biopsy was performed in each patient and processed for light and electron microscopy. All biopsies were normal on light microscopy. On electron microscopy, no mitochondrial abnormalities were found. In all three groups, irregular nuclear membranes, dilation of the rough endoplasmic reticulum, and vesiculation of the smooth endoplasmic reticulum were seen, without any significant differences between the groups. There were significantly more lysosomes in the hepatocytes of patients receiving halothane than in the hepatocytes of patients receiving isoflurane or droperidol. This study shows that halothane can induce ultrastructure abnormalities very early after the beginning of its administration while, under the same conditions, isoflurane does not. PMID- 2782650 TI - Effect of injection rate on level and duration of hypobaric spinal anesthesia. AB - The purpose of this study was to determine whether injection rate affects the spread of hypobaric spinal anesthesia. Hypobaric spinal anesthesia was performed on 20 patients for total hip arthroplasty. Dural puncture was performed with a 22 gauge Whitacre needle. All patients received 10 mg of hypobaric tetracaine with epinephrine. An electrically driven syringe pump was used to inject the anesthetic solution at either slow (250 sec) or fast (10 sec) rates. Ten patients received slow injections, and 10 received fast injections. Anesthetic levels, duration of anesthesia, and specific gravities of injectate and CSF were measured. Slow injection resulted in less spread of spinal anesthesia. Four segment regression of anesthetic levels took significantly longer in the slow injection group. Local anesthetic mixtures used were consistently hypobaric compared to patient CSF. We conclude that slow injection of hypobaric tetracaine through a 22-gauge Whitacre needle produces lower levels of spinal anesthesia that tend to be of longer duration than levels resulting from fast injection. PMID- 2782651 TI - Ketamine does not trigger malignant hyperthermia in susceptible swine. AB - The use of ketamine in individuals susceptible to malignant hyperthermia (MH) is controversial. We describe our experience with ketamine used for induction and/or maintenance of anesthesia in our herd of swine inbred for susceptibility to MH. A total of 76 MH-susceptible swine were given a total of 112 general anesthetics using ketamine as the induction drug. In 34 of these anesthetics, anesthesia was also maintained with ketamine. Signs of MH did not develop in response to ketamine in any of the pigs. PMID- 2782652 TI - Smooth muscle contraction and local anesthetics: calmodulin-dependent myosin light-chain kinase. AB - Myocardial depressant action of local anesthetics at toxic concentrations is well documented. Their effect on vascular smooth muscle, however, remains controversial. This study analyzed local anesthetic action on the subcellular smooth-muscle contractile system. Highly purified smooth-muscle myosin and myosin light-chain kinase (MLCK) were prepared from fresh turkey gizzards, and the phosphorylation of the myosin light-chain in the presence of Ca++ and calmodulin was evaluated by the urea gel-electrophoresis. Tetracaine 1.3.10(-3) M and bupivacaine 7.5.10(-3) M inhibited the MLCK 50%, whereas lidocaine 2.5.10(-2) M inhibited the MLCK 40%. The inhibitory action was partially reversed by increasing the calcium ion concentration from 1.10(-5) to 2.10(-4) M. On the other hand, raising the calmodulin concentration from 1.10(-7) M to 6.10(-7) M completely reversed the inhibition. A possible cause of the discrepancy in the anesthetic concentrations between subcellular and in vivo studies is discussed. PMID- 2782653 TI - Accidental subarachnoid injection of pancuronium. PMID- 2782654 TI - Hemoptysis in a child during extracorporeal shock wave lithotripsy. PMID- 2782655 TI - Thoracic epidural anesthesia for transsternal thymectomy in myasthenia gravis. PMID- 2782656 TI - Esophageal perforation--a complication of neonatal resuscitation. PMID- 2782657 TI - Management of a newborn infant with congenital laryngeal atresia. PMID- 2782658 TI - Transient left bundle branch block following lidocaine. PMID- 2782659 TI - Endotracheal tube extension for endobronchial intubation. PMID- 2782660 TI - Tourniquet use and intraoperative hypothermia. PMID- 2782661 TI - Interpleural anesthesia for extracorporeal shock wave lithotripsy. PMID- 2782662 TI - Oral reinforced endotracheal tube crushed and perforated from biting. PMID- 2782663 TI - [The protein pattern of Gasterophilus intestinalis larva (Diptera: Gasterophilidae), Psoroptes cuniculi and Chorioptes bovis (Acarida: Psoroptidae)]. AB - SDS-PAGE and chromatography of the mange mites Chorioptes bovis and Psoroptes cuniculi and Gasterophilus intestinalis instars revealed a species and stage specific distribution of proteins. This specific protein pattern is responsible for an immune response depending on the course of the parasitic infection. Therefore, identification and isolation of the adequate antigens are necessary for diagnostic purposes. PMID- 2782664 TI - [The observation of coccidia in swine]. AB - The coccidia species of domestic pig and wild boar were compared and defined morphologically and the sporogony of both was examined. No difference could be detected between the coccidia species of domestic pig and wild boar. Six Eimeria and one Isospora species were found: Eimeria debliecki, E. polita, E. porci, E. scabra, E. spinosa, E. suis and Isospora suis. E porci could be found in Austria for the first time. E. cerdonis Vetterling, 1965 is a synonym of E. polita Pellerdy, 1949. PMID- 2782665 TI - [Finding Setaria equina in horses]. AB - For the first time findings of Setaria equina (Abildgaard, 1789) in horses are reported from the German Democratic Republic. The nematodes, located in the peritoneum, were discovered in the course of autopsy. Based on a thorough analysis of the international literature, the paper discusses geographical distribution, morphology, cycle and diagnosis of this nematode as well as clinical symptoms mainly caused by the stages of the larvae. PMID- 2782666 TI - [The infection process with Sphaerospora renicola (Myxosporidia)]. AB - New data are presented on the development of infection by S. renicola in common carp within the first 15 weeks of their life. The infection of parasite-free common carp succeeded by myxospores as well as by feeding carp kidneys with and without spores in laboratory experiments. In field experiments one year-old parasite-free common carp were successfully infected. PMID- 2782667 TI - [Size differences in Demodex bovis (Acari)]. AB - Demodex bovis females were isolated from the skin surface of an experimentally infected calf. The were designated "Size Variation 'Short"' (GVK). With a length of 132...149 microns they were significantly smaller than D. bovis females isolated from skin nodules of the same calf. These mites were 154...168 microns long and named "Size Variation 'Normal"' (GVN). All measurings were carried out in living mites. PMID- 2782668 TI - [Insecticide resistance in the Musca domestica populations of the GDR 1976-1988]. AB - Data have been compiled concerning insecticide-resistance in native populations of Musca domestica from 10 districts of the GDR for the period between 1976 and 1988. The insecticides tested were trichlorfon, dimethoate, bromophos, and trichlophenidine, i.e. those insecticides commonly used in house fly control on animal production farms. Pyrethrum and permethrin were also tested. Since the test strains were frequently selected in connection with control failures, the data may not be representative for all populations. But they allow some conclusions concerning the development of resistance. A stage of development has been reached which required a departure from the exclusive use of conventional procedures (residual spraying of surfaces with persistent contact pesticides). Intensified research on non-chemical or special chemical methods is urgently needed. PMID- 2782669 TI - [Toxoplasma gondii infections and oocyst shedding in domestic cats and the significance of this for the epidemiology and epizootiology of toxoplasmosis]. AB - Because of the dissemination of oocysts the cat and other felines have a central position within Toxoplasma gondii epidemiology and epizootiology. From 1984 to 1986, 267 cats between 2 months and 15 years old were serologically examined (SFT) for Toxoplasma antibodies. The rate of infection was 59.9 per cent. The infection rate of stray cats (72.5%) was significantly higher than that of domestic cats (40%). The high infection rate of herbivores results from behaviour of stray cats. In faeces of 264 animals Toxoplasma oocysts could not be proved by flotation technique. But in 39 samples of faeces Toxocara mystax eggs were found, in one sample Toxascaris leonina eggs. Coproscopical examinations did not reflect the real degree of parasitization of cats. The rate of disseminators of oocysts is drainable by Toxoplasma gondii infection found serologically. About 40% of the animals at the age of up to one year were found to excrete Toxoplasma oocysts. PMID- 2782670 TI - [Fascioliasis in moufflons]. AB - Subacute fascioliasis was diagnosed by pathomorphological and parasitological investigations on 13 dead moufflons (Ovis ammon musimon) from a herd of 21 animals (mortality 62%) which had succumbed between January and April 1988. The flock had been kept on meadow in the so-called Leipziger Auenwald. The main findings like severe hepatitis traumatica fasciolosa, fibrinous and fibrous perihepatitis, chronic interstitial hepatitis (pseudocirrhosis), cholangitis fasciolosa (X 13), wasting (X 8), heart dilatation (X 10), lung oedema (X 12), anemia (X 5), ascites (X 3), gut oedema (X 3) and occasionally observed lesions are described in detail and discussed with regard to diagnosis and pathogenicity. Beside severe infection with Fasciola hepatica (juvenile and adult flukes) the parasitological investigation demonstrated, in some cases, various additional but unimportant infections with protostrongylids, gastro-intestinal nematodes, coccidia (X 2) and Moniezia expansa (X 1). The analysis of meteorological data (January 1987 till March 1988) established optimal conditions for F. hepatica development stages and Galba truncatula so that high multiplication and infection rates of the snails and long surviving of metacercariae must be assumed. PMID- 2782671 TI - [Determination of free thyroxine by adsorption on Sephadex gel]. AB - The authors describe a simplified method for the measurement of free thyroxine based on the affinity of Sephadex gel for thyroxine. Radiolabeled thyroxine added to diluted serum is adsorbed by the gel proportionally to the free thyroxine concentration of the sample. The concentration of binding proteins present in the sample does not affect the adsorption of free thyroxine on the gel. The adsorbed thyroxine is separated by centrifugation and filtration using a rigid filter. Calibration is made against the equilibrium dialysis method. The intra (CV of 4.9 p. cent, 6.1 p. cent, 10.2 p. cent for concentrations of free thyroxine of 14.1, 27.1 and 67.6 pmol/l respectively) and interassay (CV of 5.3 p. cent, 8.2 p. cent, 9.2 p. cent at 9.4, 23.0 and 83.1 pmol/l respectively) imprecisions are comparable to equilibrium dialysis. The results obtained with this method show a good correlation with those of a two-step radioimmunoassay for patients without non-thyroidal diseases or pregnancy (r2 = 0.85, n = 50). The reference range (mean +/- two standard deviations) determined in 108 euthyroid adults is 10.3 to 21.9 pmol/l. Results obtained for hypothyroid patients (7.7 +/- 2.3 pmol/l, mean +/- one standard deviation, n = 26), hyperthyroid patients (47.4 +/- 22.9 pmol/l, n = 32), patients with non-thyroidal illnesses (18.7 +/- 4.9 pmol/l, n = 35) and pregnant women (10.8 +/- 1.7 pmol/l, n = 20) are in good agreement with those reported using equilibrium dialysis or ultrafiltration. Our method offers an alternative to more tedious techniques of free thyroxine determination in the hospitalized population for which the use of analog methods has been criticized. PMID- 2782672 TI - [Evaluation of the Coulter S + II in neonatology]. AB - The Coulter Counter S + II is one of the most frequently used automatic counter in France. The authors evaluated its performances by analysing 116 blood samples from newborn infants aged less than one month. The reliability of this counter is impaired by the numerous rejects of lymphocytes or platelets and by the failure to recognize erythroblasts or circulating immature granulocytes. Moreover, abnormal cellular populations are notified which sometimes do not appear to be linked to any clinical disorder and are not evidenced by microscope examination control. These constatations bound the utilisation of this counter at least as far as the newborn's hematology is concerned. PMID- 2782674 TI - [Specific IgG and immunotherapy]. AB - The authors discuss about the functions and the evolution of total specific IgG antibodies and specific antibodies of the IgG1 and IgG4 isotype during desensitization treatment. PMID- 2782673 TI - [A recommended method for determination of uric acid in serum]. AB - SFBC work group on uric acid propose a method for evaluation in blood serum which is modeled on the one defined by American Association for Clinical Chemistry. Serum is deproteinized by trichoracetic acid and the supernatant, buffered to pH 8.5, is submitted to uricase action. The disappearing of the strong band of uric acid in UV is measured by derivative spectrophotometry; this procedure vanished the effect of trouble which remains in the supernatant. This spectrophotometric technic permit to reach, in multiple sites, a variation coefficient near of 1 p. cent. PMID- 2782675 TI - International Federation of Clinical Chemistry, Scientific Division, Committee on pH, Blood Gases and Electrolytes. IFCC Document Stage 3, Draft 1, dated 1989-02 01. An approved IFCC recommendation. IFCC method (1988) for theory of blood: reference materials for PCO2 and PO2. PMID- 2782676 TI - [Nosocomial infections in intensive care]. PMID- 2782677 TI - [4th Seminar on Anesthesia and Resuscitation in the Northeast Provinces. Nancy, 21-22 October 1988]. PMID- 2782678 TI - [Monitoring the depth of anesthesia. Common clinical and instrumental means]. PMID- 2782679 TI - [Monitoring and management of anesthesia with EEG, evoked potentials, electromyography of the frontal muscle or monitoring esophageal contractility]. PMID- 2782680 TI - [The Datex ABM brain activity monitor]. PMID- 2782681 TI - [Pulse oximetry]. PMID- 2782682 TI - [Monitoring of nitrous oxide and anesthetic gases]. PMID- 2782683 TI - [Peroperative thermometry]. PMID- 2782684 TI - [Minimal monitoring in the operating room]. PMID- 2782685 TI - [Effect of shaking the bag receiving the blood on blood cell elements and various plasma coagulation factors]. PMID- 2782686 TI - [Autotransfusion after blood salvage in emergency circumstances]. PMID- 2782688 TI - [A national survey on technics of reducing the number of prescriptions for homologous blood and the role of peroperative collection]. PMID- 2782687 TI - [Autologous transfusion. The Italian experience]. PMID- 2782689 TI - [Development of autologous blood transfusion in France. Comparison of 2 retrospective surveys carried out at a year's interval]. PMID- 2782690 TI - [Autotransfusion: a synthesis report]. PMID- 2782691 TI - [The future of blood transfusion. European dates]. PMID- 2782692 TI - [Difficult catheterization of the radial artery. Comparison of a new arterial catheter and Seldinger's technic]. AB - Sixty difficult radial artery cannulations were carried out using either the Seldinger technique (Seldicath Plastimed, FG 3, 80 mm long; group S; n = 30) or a new arterial catheter (Arrow, Critikon, gauge 20, 44 mm long; group A; n = 30) in patients scheduled for coronary arterial surgery or cardiac valve replacement (age: 54.8 +/- 11.8 yr). The technique was chosen at random after failure of radial artery catheterization with a short intravenous catheter (Quick-Cath Travenol, gauge 20, 31 or 51 mm long, or Insite W Beckton-Dickinson, gauge, 20, 30 mm long). The second attempt was carried out on the same artery, a few centimeters higher up than the first one. Heparinized normal saline was infused through this arterial line. All the catheters were removed after extubation. There was no arterial thrombosis, nor any displacement of the catheter with loss of the arterial pressure curve. No difference was found between the two techniques regarding the number of catheterization failures, the duration of cannulation, and the quality of the blood pressure curve. For difficult radial artery cannulations, the arterial catheter Arrow associated the advantages of the Seldinger technique with those of short intravenous catheters. PMID- 2782693 TI - [Peroperative anaphylactic shock caused by latex]. AB - A case is reported of severe anaphylactic shock occurring in a 32 yr old woman after foetal extraction during caesarean section. The agent responsible was the latex from the surgical gloves used. This was proved by the different allergological tests carried out: positive prick-tests to the latex, positive human basophil degranulation test and the finding of specific anti-latex IgE. All the tests carried out using the anaesthetic drugs were negative. PMID- 2782694 TI - [Nociceptive flexion reflex. Principles and applications of the threshold determination]. AB - The threshold for the pain flexion reflex in the lower limb can be used to determine the potency in man of analgesic drugs acting centrally. A new apparatus is, the "algometre", described. Bipolar electrical stimulation (5 stimuli of 1 ms over a period of 10 ms) is applied to the saphenous nerve just behind the external malleolus. An amplifier detects the muscle response (electromyogramme; EMG) at the muscle-tendon junction in the popliteal space; this occurs about 70 130 ms after the painful stimulus. The whole system is linked to a microcomputer. The EMG and EMG/intensity curves are displayed on a colour screen, and can be copied by a colour tracing table. The whole machine is mobile and can be moved from bed to bed. An increase in the threshold during inhalation of 50% nitrous oxide in oxygen was shown. However, the usefulness of the "algometre" in clinical practice remains to be assessed by further studies. PMID- 2782695 TI - [Lumbar epidural catheterization: estimation of the length of the inserted catheter]. AB - A catheter in the epidural space can be the cause of various iatrogenic complications. In order to avoid leaving too great a length in the lumbar epidural space during epidural anaesthesia, graduated Tuohy needles can be used (Perifix), together with graduated epidural catheters. On the latter, a special marking shows that, when it reaches the needle hub, the catheter tip is at the needle bevel. Approximately 5 to 7 cm of catheter length are introduced into the epidural space. The needle is removed and placed upside down next to the catheter, with the hub in contact with the patient's skin. In this position, the distance between the special marking on the catheter and the graduation on the needle which marked the skin level is equivalent to the length of catheter in the epidural space. This distance, and therefore catheter length, can then be reduced to about 4 cm by carefully withdrawing the catheter. Some possible improvements of catheters and needles are discussed. Knowing exactly how much catheter is within the epidural space could be of particular importance whenever that space is uncommonly far from the patient's skin: obesity, oedema, use of the paramedian route or a very oblique angle of the needle in the sagittal plane. PMID- 2782696 TI - [Syringe pumps: be careful with syringes!]. PMID- 2782697 TI - [Formation of a knot between 2 intracardiac catheters during their removal]. PMID- 2782698 TI - [Locoregional anesthesia in children]. PMID- 2782699 TI - [Arterial thrombosis and infection in prolonged catheterization of the dorsal artery of the foot]. PMID- 2782700 TI - [Complications in the anesthesia recovery period: a retrospective stud of 4910 patients admitted during a year]. PMID- 2782701 TI - Numbers of Sertoli cells, quantitative rates of sperm production, and the efficiency of spermatogenesis in relation to the daily sperm output and seminal quality of young beef bulls. AB - Data from 34 yearling Hereford or Angus bulls were used to investigate relationships of testicular size, quantitative rates of sperm production, Sertoli cell numbers, numbers of germ cells supported per Sertoli cell, and the efficiency of spermatogenesis to daily sperm output and seminal quality. Two ejaculates were collected by electroejaculation from each bull on each of 2 days/week throughout the study. The percentage of progressively motile sperm and the percentage of morphologically normal sperm were determined from aliquots of fresh semen. Additional aliquots of semen were frozen in glass ampules or plastic straws and subsequently evaluated for postthaw motility and percentage of sperm with intact acrosomes. Sertoli cell numbers, the numbers of germ-cells per Sertoli cell, and the efficiency of spermatogenesis were unrelated to the quality of fresh or frozen semen (P greater than 0.05). In first ejaculates, the numbers of sperm and motile sperm were related (P less than 0.05) to testicular parenchymal weight (r = 0.38 and 0.50), daily sperm production (r = 0.45 and 0.53), and spermatids per gram of testicular parenchyma (r = 0.35 and 0.34). Testicular parenchymal weight and daily sperm production also were related to daily sperm output and to the average daily motile sperm output of these bulls (P less than 0.05), but could account for less than 25% of the variability in these end points among bulls. PMID- 2782702 TI - Effect of weight loading on the coronary band interstitial fluid pressure in horses. AB - Interstitial fluid pressures, as a possible function of limb load, were measured at 2 sites within the digital coronary dermis of both cranial digits in 10 standing horses. Fluid pressure changes and digital load measurements were simultaneously detected and recorded by use of, respectively, modified wick-in needle and force plate transducers coupled to a microcomputer. Mean pressures, recorded at limb loads between 50 and 80 kg, were 2.29 +/- 3.17 mm of Hg at the toe and 2.49 +/- 5.91 mm of Hg at the heel. Mean pressures, recorded between 150 and 180 kg, were 5.01 +/- 5.23 mm of Hg at the toe and 1.28 +/- 7.69 mm of Hg at the heel. These data indicate that, in the static limb, no statistically significant change in interstitial fluid pressure occurs at loads up to 180 kg. PMID- 2782703 TI - Effects of butorphanol tartrate on arterial pressure, jejunal blood flow, vascular resistance, O2 extraction, and O2 uptake in halothane-anesthetized ponies. AB - The effects of butorphanol tartrate on arterial pressure, jejunal blood flow, vascular resistance, oxygen extraction, and oxygen uptake were determined in 10 anesthetized ponies ventilated with a mixture of halothane and 100% oxygen, using isolated autoperfused jejunal segments. Physiologic saline solution or butorphanol tartrate (0.2 mg/kg of body weight) was administered as a single bolus into the left jugular vein. By 2 minutes, butorphanol decreased arterial blood pressure and intestinal blood flow, and increased intestinal oxygen extraction. However, intestinal vascular resistance and oxygen uptake were unaffected. Results of this study indicate that butorphanol tartrate induces a hypotension that secondarily decreases intestinal blood flow, but intestinal vascular resistance and metabolism are not adversely affected. We conclude that butorphanol tartrate does not compromise intestinal viability in halothane anesthetized ponies and, therefore, may be a good analgesic choice for the equid destined for abdominal surgery. PMID- 2782704 TI - Evaluation of normal triiodothyronine and tetraiodothyronine concentrations in llamas (Lama glama). AB - Basal serum triiodothyronine (T3) and tetraiodothyronine (T4) concentrations have not been established for the llama (Lama glama). In addition, changes in T3 and T4 concentrations in response to thyroid-stimulating hormone (TSH) administration have not been determined, making clinical evaluation of problems referable to thyroid dysfunction difficult. In study 1, basal T3 and T4 concentrations were determined in serum samples collected from 132 clinically healthy llamas. The llamas were allotted to 3 groups: mature intact or neutered males (group I, n = 25), nonpregnant sexually mature females (group II, n = 21), and pregnant females (group III, n = 86). A mean concentration and a 95% confidence interval were computed for each group. An analysis of variance (ANOVA) indicated that a single confidence interval range (0.45 to 4.18, mean = 1.37 ng T3/ml) adequately defined the normal T3 concentrations for all groups. An ANOVA indicated that the T4 concentrations for the female populations (groups II and III) could be combined with a normal confidence interval range of 39 to 204 ng/ml (mean = 88 ng/ml), whereas a separate range (70 to 220 ng/ml, mean = 124 ng/ml) was determined for the male population. An ANOVA indicated that a single confidence interval range (0.0066 to 0.0321, mean = 0.0146) adequately defined the normal T3/T4 ratio for all groups. In study 2, T3 and T4 concentrations were evaluated in 10 healthy llamas immediately preceding and at 2, 4, 6, 8, and 24 hours after the IV administration of 3 IU of TSH/44 kg of body weight. The T3 and T4 concentrations were significantly higher by 2 hours after TSH administration in both groups.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2782705 TI - Relationship of plasma gastrin immunoreactivity and gastroesophageal sphincter pressure in clinically normal dogs and in dogs with previous gastric dilatation volvulus. AB - Fasting and postprandial gastroesophageal sphincter pressure (GESP) and plasma gastrin immunoreactivity were measured in 6 dogs from 9 through 60 months after treatment for and recovery from gastric dilatation-volvulus (GDV). The GESP was not significantly increased in these dogs, compared with that in clinically normal dogs in either the fasting or postprandial state. Corresponding plasma gastrin immunoreactivity was not significantly increased in dogs of the GDV recovered group, compared with that in clinically normal dogs (fasting or postprandial). An exaggerated increase in GESP in response to food-induced gastrin release was not observed in dogs of the GDV-recovered group. Exogenously administered pentagastrin (3-micrograms/kg bolus, IV) increased fasting GESP in clinically normal dogs over a 4-minute test period (P = 0.01). Gastric distention in response to oral administration of isosmolar saline solution (500 ml) did not significantly increase GESP or plasma gastrin immunoreactivity in clinically normal dogs. In anesthetized clinically normal dogs, gastric distention in response to use of balloons filled to exert intragastric pressure of 30 mm of Hg also did not cause significant increase in plasma gastrin immunoreactivity. Increased GESP, secondary to hypergastrinemia or gastric distention, is an unlikely cause of eructation failure in dogs with GDV. PMID- 2782706 TI - Effect of exocrine pancreatic insufficiency on cobalamin absorption in dogs. AB - The possibility that the canine pancreas might have an important role in the physiologic absorption of cobalamin (vitamin B12) has been explored by determining the effect of exocrine pancreatic insufficiency on cobalamin absorption and by examining the subsequent influence of bovine pancreatic enzymes and canine pancreatic juice. Exocrine pancreatic insufficiency was induced by ligation of pancreatic ducts and confirmed by indirect assessment of exocrine pancreatic function. Cobalamin absorption was determined by oral administration of cyano[58Co]cobalamin and quantitation of radioactivity in blood, urine, and feces during 48 hours. Pancreatic duct ligation resulted in a significant (P less than 0.001) decrease in cobalamin absorption, which was not restored by oral administration of bovine pancreatic enzymes, despite considerable improvements in steatorrhea and in vivo proteolytic activities. In marked contrast, malabsorption of cobalamin was significantly (P less than 0.05) reversed by oral administration of canine pancreatic juice. These results indicate that pancreatic secretions have an important role in the normal absorption of cobalamin in the dog, a role that does not appear to be attributable to pancreatic enzymes, but is consistent with the existence of a pancreatic intrinsic factor in this species. PMID- 2782708 TI - Alteration of neutrophil function associated with coccidiosis in cattle: influence of decoquinate and dexamethasone. AB - Twenty Holstein steers subclinically infected with coccidia were allotted to 2 groups of 10 steers each. One group received a diet containing 0.5 mg of decoquinate/kg of body weight. After 25 days on the diet, there was no difference between the groups in lymphocyte blastogenic responsiveness to mitogens; however, there were differences in neutrophil function. Lymphocytes from steers of the decoquinate-fed group had decreased random migration under agarose, enhanced cytochrome C reduction, and enhanced iodination activity. Other measures of neutrophil function evaluated (chemotactic index, Staphylococcus aureus ingestion, and antibody-dependent and -independent cell-mediated cytotoxicity) were not affected. After 30 days of decoquinate feeding, half of the cattle in each group received 5 daily IM injections of dexamethasone (0.04 mg/kg of body weight). The dexamethasone-treated steers from the group that did not have decoquinate in the diet developed clinical coccidiosis, whereas the decoquinate treated steers remained clinically normal. Lymphocyte and neutrophil function were again evaluated for a 3-day period beginning 4 days after dexamethasone treatment was halted. Neutrophils from the steers that developed clinical coccidiosis after dexamethasone administration had significantly (P less than 0.05) inhibited random migration under agarose, cytochrome C reduction, and iodination activity, but significantly (P less than 0.01) enhanced S aureus ingestion. The feeding of decoquinate prevented the inhibition of neutrophil cytochrome C reduction and lessened the inhibition of neutrophil iodination in the dexamethasone-treated group. Dexamethasone treatment was associated with an inhibition of lymphocyte blastogenic responsiveness to phytohemagglutinin in principals as well as controls. PMID- 2782707 TI - Bovine serum and nasal secretion immunoglobulins against Pasteurella haemolytica serotype 1 antigens. AB - Experimental intranasal inoculation of cattle with Pasteurella haemolytica serotype 1 resulted in a group that shed the bacteria in their nasal secretions (colonized) and a group that did not shed (uncolonized). After inoculation, antibody titers in serum and nasal secretions against the total P haemolytica increased significantly, and the proportions of total antibody against specific P haemolytica antigens changed so that the proportion directed against the 94- and 62-kD antigens increased. Prior to inoculation, the proportion of total antibody in the serum against 94- and 62-kD antigens of P haemolytica was higher in calves that remained uncolonized than in those that became colonized with P haemolytica after exposure. Antibody specificity of serum and nasal secretions differed in the relative amounts directed against each P haemolytica antigen. The specificity against P haemolytica antigens differed between IgG and IgA isotypes of serum and nasal secretions, with IgA being directed against fewer antigens than was IgG. PMID- 2782710 TI - Separation of bovine lymphocytes and granulocytes from blood by use of elutriation. AB - Bovine blood mononuclear cells were separated into 2 fractions by use of centrifugal elutriation. Total recovery, as well as recovery of each fraction, was greater than that obtained by use of Ficoll-sodium diatrizoate separation. The lymphocyte fraction contained less than 1% granulocytes, and the granulocyte fraction contained only 7% lymphocyte contamination. The technique was reproducible and results proved to be comparable with those of Ficoll-sodium diatrizoate density-gradient centrifugation; furthermore, the method is considerably cheaper and less time-consuming for processing large volumes of blood. Viability of cells separated by elutriation always was greater than 98%, whereas viability of cells separated by Ficoll-sodium diatrizaote was greater than 95%. Also, mitogen activation of lymphocytes separated by elutriation was superior to that of lymphocytes separated by Ficoll-sodium diatrizoate centrifugation. PMID- 2782709 TI - Prostaglandin and thromboxane concentrations in plasma and lung lavage fluids during sequential infection of vaccinated and nonvaccinated calves with bovine respiratory syncytial virus. AB - The potential action of immunologic reactions and mediators released during the course of bovine respiratory syncytial virus infection in pathogenesis of the ensuing disease process was examined in an experimental infection study. Prostaglandin (PG) E2, PGF2 alpha 6-keto-PGF1 alpha, and thromboxane B2 (TxB2) concentrations were quantitated in plasma and lung lavage fluid by radioimmunoassay at 3- to 4-day intervals during a primary and secondary virus infection of vaccinated, nonvaccinated, and control (mock-infected) calves. A significant increase in the plasma PGE2 concentration for the nonvaccinated calves was noticed on day 3 after primary infection and on day 7 after secondary infection. The PGF2 alpha plasma concentrations increased significantly for the nonvaccinated groups on day 10 after primary infection. Plasma 6-keto-PGF1 alpha concentrations increased for nonvaccinated and vaccinated calves 3 days after the secondary infection. Plasma TxB2 concentrations during the primary exposure did not vary significantly. However, 14 days after the secondary exposure, both experimental groups had concentrations significantly greater than did the control group. Lung lavage fluid concentrations of TxB2 had peaks of activity 7 days after primary and secondary viral infections for the nonvaccinated group. Increases in plasma PG concentrations corresponded variably with disease expression, whereas plasma TxB2 concentrations did not have any correlation with disease expression. However, there was a significant correlation between TxB2 concentration in lung lavage fluid of the nonvaccinated group with disease expression 7 days after primary and secondary virus infection.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2782711 TI - Immune response of the llama (Lama glama) to tetanus toxoid vaccination. AB - An ELISA was developed to measure serum concentrations of tetanus toxoid-specific immunoglobulins. The titers obtained with this assay were compatible with those obtained by the standard mouse toxin-neutralization test. Serum samples from 123 llamas were analyzed for ELISA titers to tetanus toxoid. Of the 82 vaccinated adults, 75 (91%) had titers greater than or equal to 1:50. The vaccination status and titers of weanlings and juveniles (3 to 12 months old) varied; of the 21 vaccinated, 17 (81%) had titers greater than or equal to 1:50 and 7 of 9 (78%) unvaccinated llamas had titers less than 1:50. The ELISA titers of unvaccinated llamas less than 8 weeks old (crias) were matched with the maternal titers. All crias with titers less than 1:50 had dams with titers greater than or equal to 1:50. PMID- 2782712 TI - Detection of infectious hematopoietic necrosis virus in an invertebrate (Callibaetis sp). AB - Infectious hematopoietic necrosis virus (IHNV) was detected in the common Mayfly (Callibaetis sp) by western immunoblot assay and was propagated in fish cells (CHSE-214) in culture. When propagated in cell culture, cytopathic effect characteristic of IHNV infection was observed. Antibody specific for IHNV was used to detect all of the major proteins of IHNV in the western immunoblot assay. When the crude lysate was subjected to electron microscopy, bullet-shaped particles (84 nm x 194 nm) characteristic of IHNV were observed. The data suggested that the Mayfly may be a factor in the dissemination of IHNV. PMID- 2782713 TI - Purification of the phospholipase D of Corynebacterium pseudotuberculosis by recycling isoelectric focusing. AB - Recycling isoelectric focusing was investigated as a method for purification of phospholipase D (PLD) from cultures of Corynebacterium pseudotuberculosis. Supernatant fluids from cultures of equine isolate 155 in brain-heart infusion broth were dialyzed against distilled water, concentrated by lyophilization, and fractionated by preparative isoelectric focusing in free solution in a pH 3 to 13 gradient with 6M urea. Protein concentration, pH, and PLD activity of the 10 resulting fractions were determined. Two PLD activity assays were used: release of 14C choline from labeled sphingomyelin and synergistic hemolytic activity with Rhodococcus equi factors. Enzyme activity focused in 2 fractions at pH 8.5 to 9.8. The synergistic hemolytic assay was simple and rapid for detecting PLD in partially purified fractions. Electrophoretic examination of the fraction containing the highest concentration of PLD activity revealed protein bands at 14, 21, and 31.7 kD Mr, suggesting purification to near-homogeneity. Proteins from the 31.7-kD band were labeled by antibodies in serum from a goat with chronic C pseudotuberculosis infection. PMID- 2782714 TI - Udder edema in cattle: effects of diuretics (furosemide, hydrochlorothiazide, acetazolamide, and 50% dextrose) on serum and urine electrolytes. AB - Blood and urine chemical values at parturition in clinically normal Holstein cows (n = 12) were compared with the same values in Holstein cows developing udder edema (n = 12). There was no statistically significant mean difference between the 2 groups for the serum and urine chemical data. Furosemide (500 mg) given IV caused a significant increase in serum calcium and sodium, urine chloride, potassium, and sodium, and fractional excretional ratio of chloride, potassium, and sodium. There was a significant mean decrease in the serum potassium, urine creatinine, osmolality, pH, and specific gravity. Hydrochlorothiazide (250 mg) given IV caused a significant mean increase in serum chloride, urine chloride, potassium, and sodium, and fractional excretion ratio of chloride, potassium, and sodium. There was a significant mean decrease in serum potassium and sodium, urine osmolality, pH, and specific gravity. Acetazolamide (500 mg) given IV caused a significant mean increase in blood urea nitrogen, serum chloride and glucose, urine sodium, and fractional excretion ratio of sodium, while causing a significant mean decrease in serum potassium, sodium, and phosphorus, and urine creatinine. Dextrose (500 g) given IV as a 50% solution caused a statistical mean increase in serum glucose, urine chloride, potassium, and sodium, and fractional excretion ratio of chloride and potassium. A statistical mean decrease occurred in the packed cell volume, blood urea nitrogen, serum calcium, potassium, sodium, and phosphorus, urine creatinine, osmolality, and pH. PMID- 2782715 TI - Pharmacokinetics and metabolic inertness of doxycycline in calves with mature or immature rumen function. AB - The pharmacokinetic determinants of doxycycline were calculated after a single IV administration of the drug (20 mg/kg of body weight) in 5 Angus calves with mature rumen function and 4 Holstein calves with immature rumen function. Doxycycline disposition was best described by means of an open 2-compartment model. Median elimination half-life was 14.17 hours (Angus) and 9.84 hours (Holstein). Mean (+/- SEM) total body clearance was 1.07 (+/- 0.06) and 2.20 (+/- 0.21) ml/min/kg in Angus and Holstein calves, respectively. Mean extent of doxycycline binding to serum proteins was 92.3% (+/- 0.8%). The large steady state volume of distribution (1.31 +/- 0.11 L/kg in Angus and 1.81 +/- 0.24 L/kg in Holstein calves), despite the small free fraction in serum, suggested a relatively unrestricted access of drug into the intracellular compartment and/or appreciable tissue binding. Results of mass spectrometric analysis of serum and urine from calves administered doxycycline IV revealed absence of biotransformation, because only parent drug could be detected. Thus, doxycycline may be a valuable antibiotic for use in food animals pending further studies on tissue residues, safety, and efficacy. PMID- 2782716 TI - Cardiovascular effects of butorphanol administration in isoflurane-O2 anesthetized healthy dogs. AB - Cardiovascular consequences of butorphanol tartrate (0.2 mg/kg of body weight, IV) administration during isoflurane (1.7% end-tidal concentration) anesthesia were determined in mechanically ventilated healthy dogs. Butorphanol administration caused significant (P less than or equal to 0.05) reductions in mean, systolic, and diastolic arterial blood pressures; cardiac output; and rate pressure product. PMID- 2782717 TI - Pharmacokinetics of phenobarbital in dogs given multiple doses. AB - Studies were conducted to examine the temporal changes in phenobarbital pharmacokinetics during chronic dosing in dogs. Ten dogs were allotted into 2 groups, administered a single oral dose, rested for 35 days, and then given the drug for 90 consecutive days. After single administration of 5.5 mg/kg of body weight or 15 mg/kg, the total body clearance (Clt/F) was 5.58 +/- 1.89 ml/h/kg and 7.28 +/- 1.07 ml/h/kg, respectively. The half-lives (t1/2) for the 2 groups were 88.7 +/- 19.6 hours for the 5.5-mg/kg dose and 99.6 +/- 22.6 hours for the 15-mg/kg dose. Significant differences in Clt/F or t1/2 were not observed between the 2 groups. Multiple-dosing regimens (5.5 mg/kg/day or 11 mg/kg/day) were initiated in the same dogs for 90 days. The Clt/F was significantly (P less than 0.05) greater on days 30, 60, and 90 than the single dose for both groups. After the last dose on day 90, several blood samples were obtained to determine phenobarbital t1/2. On day 90, the t1/2 was significantly (P less than 0.05) shorter and the Clt/F was significantly greater than single-dose values. The Clt/F and t1/2 were 10.2 +/- 1.7 ml/h/kg and 47.3 +/- 10.7 hours for the group given the low dose and 15.6 +/- 2.5 ml/h/kg and 31.1 +/- 4.4 hours for the group given the high dose, respectively. Both Clt/F and t1/2 were significantly (P less than 0.05) different between the 2 groups on day 90.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2782718 TI - Development of an enzyme-linked immunosorbent assay to detect IgG, IgM, and complement (C3) on canine erythrocytes. AB - An ELISA was used to detect IgG, IgM, and complement (C3) on the surface of canine erythrocytes. Erythrocytes were placed in wells of a microtitration plate and incubated with affinity purified, alkaline phosphatase-conjugated anti-canine IgG, IgM, or C3. Results of the ELISA were compared with the direct antiglobulin test (DAT) by preparing standard reference curves from canine blood type A erythrocytes that had been incubated with serial dilutions (1:2 to 1:8, 192) of canine anti-A serum. The ELISA detected increased erythrocyte-bound immunoglobulin and complement at two- to fourfold dilutions greater than those required for positive results with the DAT. The ELISA required small sample and reagent volumes and detected lower concentrations of immune components than did the DAT. PMID- 2782719 TI - Transstadial and attempted transovarial transmission of Anaplasma marginale by Dermacentor variabilis. AB - Transstadial and transovarial transmission of Anaplasma marginale by Dermacentor variabilis were attempted with with ticks exposed to the organism once by feeding as larvae or nymphs, and twice by feeding as larvae and nymphs. Typical colonies of A marginale were in gut tissues of adults that were infected as larvae, larvae and nymphs, and as nymphs; repeated exposure of ticks did not appear to result in an increase in the number of colonies in the gut of subsequently molted adults nor did it affect severity of the clinical disease that developed in cattle they fed on. In contrast, colonies of A marginale were not found in the midgut epithelium of unfed nymphs exposed as larvae, even though companion nymphs transmitted the parasite, causing severe clinical anaplasmosis in susceptible calves. The organism was not transmitted transovarially by F1 larvae or nymphs from the groups exposed as parent larvae, nymphs, larvae and nymphs, and as adults. Some of the calves fed on by F1 progeny had a few erythrocytic marginale bodies that looked suspiciously like A marginale, as well as postchallenge exposure prepatent periods that were longer than other calves in the transovarial transmission study. Sera from these calves were tested for antibody to A marginale, using a highly sensitive immunoblot technique. Antibodies were not detected in any of the sera. PMID- 2782720 TI - Detection of colonies of Anaplasma marginale in salivary glands of three Dermacentor spp infected as nymphs or adults. AB - Salivary glands from males of 3 Dermacentor species (D andersoni, D variabilis and D occidentalis) that were infected with either the Virginia or Idaho isolate of Anaplasma marginale as nymphs or adults were examined for colonies of A marginale by use of light and electron microscopy. Prior to dissection of salivary glands, exposed ticks were held at 25 C for 15 to 18 days, followed by a 3-day incubation at 37 C. Ticks of 2 species transmitted A marginale to calves; the third tick species was confirmed infected by demonstration of typical colonies in tick gut cells, but transmission was not attempted; Colonies of A marginale were seen with light microscopy in salivary glands of all 3 species of ticks; they were located in acinar cells that contained simple granules. Colonies varied morphologically from small, compact ones to larger structures that contained distinct organisms and often were adjacent to the host cell nucleus. Electron microscopy confirmed that the colonies were rickettsial organisms. Morphologic features of A marginale varied and included reticulated forms, forms with electron-dense centers, and small particles; these various forms were similar to those described previously in midgut epithelial cells of ticks. We believe that the organism seen within tick salivary glands may replicate in the glands before its transmission to the vertebrate host. PMID- 2782721 TI - Immunologic and hematologic responses in ponies with experimentally induced Strongylus vulgaris infection. AB - Immunologic and hematologic responses were examined in 4 ponies with experimentally induced Strongylus vulgaris infection and in 5 helminth-free ponies. Two ponies were inoculated with 200 larvae and 2 were inoculated with 700 larvae of S vulgaris and then were reinoculated with the same numbers of larvae 34 weeks later. Initial response of the ponies inoculated with S vulgaris was S vulgaris antigen-induced lymphocyte response that developed 1.5 to 3 weeks after inoculation and did not persist. Development of antigen-reactive lymphocytes was followed sequentially by a biphasic complement-fixing antibody response, then biphasic eosinophilia. Antibody titer to S vulgaris antigen was higher in ponies inoculated with 700 larvae, compared with that in ponies given 200 larvae of S vulgaris. Also, the second peak in antibody titer and in absolute number of eosinophils was observed earlier in ponies inoculated with 700 larvae, compared with ponies inoculated with 200 S vulgaris larvae, and subsided before or from about 24 weeks after inoculation. The prepatent period for S vulgaris infection was 24 to 25 weeks. After reinoculation with S vulgaris, a degree of increased lymphocyte responsiveness was apparent but, by 17 weeks after reinoculation, only the primary peak in the absolute number of eosinophils indicated an anamnestic response. Essentially, antibody was not detectable after reinoculation. PMID- 2782722 TI - Efficacy of an in-feed ivermectin formulation against gastrointestinal helminths, lungworms, and sarcoptic mites in swine. AB - The efficacy of ivermectin as an in-feed formulation was evaluated against naturally acquired gastrointestinal helminths, lungworms, and sarcoptic mites (experiment 1; n = 24) and against induced infection with intestinal nematodes (experiment 2; n = 24) in pigs. Treatments consisted of ivermectin administered in feed at concentrations calculated to provide 100 or 200 micrograms/kg of body weight/d for 7 days or of nonmedicated feed (controls) for 7 days. At concentration of 100 micrograms of ivermectin/kg/d, efficacy against naturally acquired infections was 97.7% for Ascaris suum, 97.8% for Metastrongylus spp, greater than 99% for Oesophagostomum spp, 100% for Macracanthorhynchus hirudinaceus, and 89.7% for Ascarops strongylina. Against induced infections (fourth-stage larvae), efficacy was 100% for A suum and 96.9% for Oesophagostomum spp. At concentration of 200 micrograms of ivermectin/kg/d, efficacy against naturally acquired infections was 100% for A suum, Hyostrongylus rubidus, Metastrongylus spp, and Ascarops strongylina; greater than 99% for Oesophagostomum spp; and 85.9% for Macracanthorhynchus hirudinaceus. Against induced infections (fourth-stage larvae), efficacy was 100% for A suum and 95% for Oesophagostomum spp. At concentrations of 100 and 200 micrograms of ivermectin/kg/d, efficacy against Sarcoptes scabiei var suis was evidenced by elimination of the mite by posttreatment day 14. PMID- 2782723 TI - Toxicosis in pigs fed selenium-accumulating Astragalus plant species or sodium selenate. AB - Three groups of 5 pigs each were fed a high selenium (Se) diet by mixing either Astragalus praelongus (31.6 ppm Se in feed), A bisulcatus (31.7 ppm Se in feed), or sodium selenate (26.6 ppm Se in feed) with commercial hog feed. Ten control pigs were fed only commercial hog chow containing trace selenium (0.44 ppm Se). Pigs were fed for 9 weeks and necropsied when they had ataxia or paralysis. Blood was collected for hematologic and serum biochemical determinations, and samples of various tissues were collected and fixed in neutral-buffered 10% formalin for histologic evaluation or frozen for determination of selenium concentration. All forms of selenium induced clinical signs of weight and hair loss, with cracked hooves and inflamed coronary bands developing in all Na2SeO4-fed pigs and 1 A praelongus-fed pig, but not in A bisulcatus-fed pigs. Serum calcium, phosphorus, and albumin concentrations were unchanged or significantly decreased from prefeeding values in groups fed selenium. Serum aspartate transaminase (AST) activities in Astragalus species-fed groups, and amylase activities and PCV in all groups of pigs fed selenium, were increased. Serum alkaline phosphatase and creatine kinase activities were significantly increased in the A praelongus-fed pigs and significantly decreased in Na2SeO4-fed pigs. Terminal tissue and body fluid selenium concentrations were determined in all groups of pigs fed selenium and compared with values in control pigs. Urine and bile concentrations were increased by the greatest factor (40 to 100x), with tissue concentrations of selenium increased by a lesser factor (6 to 17x).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2782724 TI - Evaluation of diets contaminated with aflatoxin and ochratoxin fed to growing pigs. AB - The effects of dietary aflatoxin and ochratoxin, fed singly and in combination, were evaluated in growing crossbred pigs. Five barrows (7 weeks old at beginning of study) per group were fed either control feed, 2.0 mg of aflatoxin (AF)/kg of feed, 2.0 mg of ochratoxin (OA/kg of feed, or 2.0 mg of AF and 2.0 mg of OA/kg of feed for 28 days. Production performance, serum biochemical, hematologic, and pathologic evaluations were made. Body weights were reduced by the combination treatment, whereas body weight gain was decreased by all toxin treatments. The effect of AF and OA in combination on body weight gain was additive. Liver weights were increased by the combination treatment, whereas kidney weights were increased only in the OA group. Aflatoxin caused decreases in serum calcium, sodium, phosphorus, urea nitrogen, cholesterol, and glucose concentrations, whereas OA alone caused decreases in serum phosphorus, cholesterol, and hematologic values. The AF-OA treatment induced decreases in mean corpuscular volume, packed cell volume, and in serum concentrations of phosphorus, cholesterol, and urea nitrogen. The AF-OA treatment increased serum alkaline phosphatase activities and triglycerides. It was concluded that AF and OA, singly or in combination, can affect clinical performance, serum biochemical and hematologic values, and organ weights of barrows. Although values of some measurements were affected more by the combination than by either toxin alone and suggested synergism or antagonism, the toxic interactions could best be described as additive. PMID- 2782725 TI - Kinematic analysis of cutting horses working a mechanical flag. AB - High-speed cinematography was used to record the movements of 12 cutting horses performing a standard test with a mechanical flag. Based on their previous competitive performances, horses were classified into 2 groups: group 1, composed of 5 moderately successful or average performers that had won less than $35,000 in purse money; and group 2, composed of 7 highly successful or elite performances that had amassed greater than $35,000 in competition earnings. Analysis of the results indicated that, compared with horses of the average group, the elite horses had faster reaction times in response to the start and cessation of flag movement (P less than 0.01), and were positioned closer to the flag during all stages of the trial (P less than 0.05). Discriminant analysis was used to construct a mathematical formula that could be used to classify an individual horse into 1 of the 2 alternative groups, based on the set of measurements. Two predictor variables were selected that described the maximal distance between the horse and the flag during the run and the part of the body that was moved first in response to the initial flag movement. The accuracy of the predicted group membership, compared with the actual group membership, was 100%. PMID- 2782726 TI - Corrections for prognostic index equation. PMID- 2782727 TI - Human agency in social cognitive theory. AB - The present article examines the nature and function of human agency within the conceptual model of triadic reciprocal causation. In analyzing the operation of human agency in this interactional causal structure, social cognitive theory accords a central role to cognitive, vicarious, self-reflective, and self regulatory processes. The issues addressed concern the psychological mechanisms through which personal agency is exercised, the hierarchical structure of self regulatory systems, eschewal of the dichotomous construal of self as agent and self as object, and the properties of a nondualistic but nonreductional conception of human agency. The relation of agent causality to the fundamental issues of freedom and determinism is also analyzed. PMID- 2782728 TI - Brain development, plasticity, and behavior. AB - Damage to the infant brain is associated with a complex array of behavioral and anatomical effects. Recent research is leading to a new understanding of the nature of, and mechanisms underlying, recovery from brain damage. PMID- 2782729 TI - The family, the courts, and mental health professionals. PMID- 2782731 TI - Thrombosis and lung cancer. PMID- 2782730 TI - Psychologists' involvement in cases of child maltreatment. Limits of role and expertise. AB - As psychologists have become increasingly involved in the investigatory and adjudicative phases of child maltreatment cases and as criminal prosecutions have become increasingly common in such cases, the ethical problems facing psychologists have become more acute. Psychologists involved in cases of child maltreatment should remember their primary duty to promote human dignity. In that regard, care must be taken to protect the rights of the various parties, assist the parties to make use of the legal process, and keep implicit or express promises, including those emanating from professional roles. Psychologists must be careful to avoid intruding into the province of legitimate decision-making authorities. PMID- 2782732 TI - If a tree falls in the middle of the forest. Isoniazid and hepatitis. PMID- 2782733 TI - Asthma education: a national strategy. PMID- 2782734 TI - Tachyphylaxis to systemic but not to airway responses during prolonged therapy with high dose inhaled salbutamol in asthmatics. AB - High doses of inhaled salbutamol produce substantial improvements in airway response in patients with asthma, and are associated with dose-dependent systemic beta-adrenoceptor responses. The purpose of the present study was to investigate whether tachyphylaxis occurs during prolonged treatment with high dose inhaled salbutamol. Twelve asthmatic patients (FEV1, 81 +/- 4% predicted), requiring only occasional inhaled beta-agonists as their sole therapy, were given a 14-day treatment with high dose inhaled salbutamol (HDS), 4,000 micrograms daily, low dose inhaled salbutamol (LDS), 800 micrograms daily, or placebo (PI) by metered dose inhaler in a double-blind, randomized crossover design. During the 14-day run-in and during washout periods, inhaled beta-agonists were withheld and ipratropium bromide was substituted for rescue purposes. At the end of each 14 day treatment, a dose-response curve (DRC) was performed, and airway (FEV1, FEF25 75) chronotropic (HR), tremor, and metabolic (K, Glu) responses were measured at each step (from 100 to 4,000 micrograms). Treatment had no significant effect on baseline values. There were dose-dependent increases in FEV1 and FEF25-75 (p less than 0.001), and pretreatment with HDS did not displace the DRC to the right. DRC for HR (p less than 0.001), K (p less than 0.001), and Glu (p less than 0.005) were attenuated after treatment with HDS compared with PI. There were also differences between HDS and LDS for HR (p less than 0.001) and Glu (p less than 0.05) responses. Frequency and severity of subjective adverse effects were also reduced after HDS: tremor (p less than 0.001), palpitations (p less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2782735 TI - An investigation of the effects of heat and water exchange in the recovery period after exercise in children with asthma. AB - It has been reported that asthma provoked by breathing subfreezing air during exercise is enhanced when air at BTPS is inhaled in the recovery period (1). It was concluded that the rate of airway rewarming is an important event in asthma provoked by exercise. It is also possible, however, that the enhanced response was due to hypo-osmolarity caused by condensation of water from inspired air at BTPS on the cooled mucosa. We examined, in a group of boys with asthma, the response to rapid rewarming of the airways after exercise, with and without the potential for condensation. On two test days, two exercise tests were performed 4 h apart on a cycle ergometer. On Day 1 (n = 17), the inspired air during exercise was -5 degrees C, dry. During recovery, the air was either -5 degrees C, dry or 50 degrees C, 23 mg H2O/L. On Day 2 (n = 11), the inspired air during exercise was -15 degrees C, dry, and during recovery was either -15 degrees C, dry or at BTPS. We did not find enhancement of the response with either condition designed to cause rapid airway rewarming. On Day 1 the mean (+/- 1 SD) percent fall in FEV1 was 23 +/- 22 (-5 degrees C, dry) and 24 +/- 21 (50 degrees C, 23 mg H2O/L) (r = 0.92), and on Day 2 it was 19 +/- 17 (-15 degrees C, dry) and 18 +/- 17 (BTPS) (r = 0.96).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2782736 TI - Expiratory glottic widening in asthmatic subjects during exercise-induced bronchoconstriction. AB - Glottic caliber is modulated in a way that optimizes the airway resistance and the work of breathing. The midexpiratory glottic narrowing that normally occurs during tidal breathing is enhanced during histamine- or methacholine-induced airway narrowing. Exercise is associated with increased ventilatory demand and midexpiratory glottic widening in healthy subjects. However, the relative contribution of glottic aperture to airflow limitation during exercise-induced asthma is unknown. Consequently, we used the acoustic reflection technique to test whether a decrease in midexpiratory glottic size occurred also during exercise-induced bronchoconstriction in seven asthmatic subjects. Exercise resulted in a 38 +/- 16% (SD) fall in FEV1 from the baseline value (p less than 0.001) and a significant increase in midexpiratory glottic cross-sectional area from 1.89 +/- 0.45 cm2 before to 2.36 +/- 0.71 cm2 during bronchoconstriction (p less than 0.05). This midexpiratory glottic widening was also associated with increased tidal flow rates. We conclude that in marked contrast to airway obstruction induced by histamine or methacholine, exercise-induced asthma is associated with midexpiratory glottic widening, which occurs concomitantly with a decrease in lower airway caliber. We suggest that modulation of glottic aperture during acute asthma is heterogeneous and depends partly on the initiating stimulus. PMID- 2782737 TI - On the temporal relationships between lung function and somatic growth. AB - A sample population of healthy nonsmoking male (n = 416) and female (n = 608) subjects derived from all non-Hispanic white subjects 5 to 60 yr of age enrolled in the Tucson Epidemiological Study of Airway Obstructive Disease was studied to evaluate the temporal relationships between various pulmonary function measures and somatic growth. Pulmonary function measures derived from the maximal expiratory flow volume (MEFV) curve included FVC, FEV1, maximal expiratory flow after 50% of vital capacity had been expired (Vmax50), and maximal midexpiratory flow (FEF25-75). The lung function and somatic growth longitudinal data were characterized by a nonparametric polynomial smoothing spline model. This procedure yields an optimal fitted curve through the data, an estimate of the growth velocity curve, and 95% confidence bands. Temporal relationships between the fitted growth curves were determined examining the ages at which the growth velocity peaks (GVP) occur. In addition, the age of growth cessation was estimated using lower limits of the 95% confidence bands of each growth velocity curve. The results indicate that the point estimates of the somatic GVPs precede all peak lung function measurements derived from the MEFV curve in both males and females. The only statistically significant difference between when the GVPs for somatic growth and functional lung growth occurred was for FEV1 and FEF25-75 in males, though similar trends were apparent in all other variables, suggesting that the timing of maximal body growth velocity precedes that of maximal lung functional growth and that the early growth spurt in females includes the lungs.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2782738 TI - The effects of cigarette smoking and smoking cessation on the carbon monoxide diffusing capacity of the lung in asymptomatic subjects. AB - The single-breath carbon monoxide diffusing capacity (DL) was measured together with standard spirometry as part of a survey of a randomly selected community population sample. Based on answers to a self-administered questionnaire, subjects free of respiratory symptoms or disease were identified. Data from subjects who had never regularly smoked cigarettes had been used to derive reference equations for the test variables, and data from the remaining subjects who had smoked were examined to determine the effect of smoking and smoking cessation on the DL. From this cross-sectional analysis, it is apparent that cigarette smoking is associated with a decrease in DL that occurs very soon after beginning the cigarette habit. There is an irreversible decrease in DL with cumulative cigarette consumption, but also a reversible phenomenon that leads to rapid improvement in DL on smoking cessation. PMID- 2782739 TI - Mechanisms of late hemodynamic and airway dynamic responses to endotoxin in awake sheep. AB - The mechanism of sustained alterations in pulmonary hemodynamics and lung mechanics after endotoxin infusion in sheep remains unclear. We examined the effects of metaproterenol, propranolol, atropine, and ibuprofen on pulmonary artery pressure (Ppa), dynamic compliance (Cdyn), resistance to airflow across the lungs (RL), specific airway conductance (SGaw), and alveolar-arterial oxygen difference (delta AaPO2) (room air) given 2.5 h after endotoxemia (except for propranolol, which was given 1 h after metaproterenol) in awake sheep. Atropine infusion had no effect on any of the variables measured. Ibuprofen infusion immediately reduced mean Ppa from 31 +/- 2 (mean +/- SEM) to 24 +/- 2 cm H2O (p less than 0.05). Metaproterenol and ibuprofen immediately increased Cdyn and SGaw and decreased RL to near baseline (p less than 0.05). No intervention affected delta AaPO2 (p greater than 0.05). In sheep treated with metaproterenol, propranolol immediately returned lung mechanics (p less than 0.05) to premetaproterenol levels without affecting delta AaPO2 (p greater than 0.05). Ibuprofen reduced lung lymph thromboxane-B2 towards baseline levels (p less than 0.05). We conclude that endotoxemia causes prolonged bronchoconstriction and pulmonary hypertension in sheep, which is largely mediated by constrictor prostanoids rather than by cholinergic mechanisms and is reversible with ibuprofen given 2.5 h after endotoxin. PMID- 2782740 TI - Five-year follow-up of Micropolyspora faeni antibody in smoking and nonsmoking farmers. AB - To examine factors that influence changes in Micropolyspora faeni (MF) antibody titer in farmer's lung disease (FLD), we followed for 5 yr the prevalence of serum MF antibody and the epidemiologic factors (years on farm, hours in barn, and hay-handling time) among 92 dairy farmers in Hokkaido, Japan. The prevalence of MF antibody among nonsmokers was significantly higher than that among smokers: 27.1% versus 7.7% in 1979, 31.3% versus 2.9% in 1984. There was no remarkable change in overall prevalences of MF antibody between 1979 and 1984 (18.5 and 19.6%, respectively). However, out of 17 seropositive farmers, six (35%) became seronegative, and out of 75 seronegative farmers, seven (9.3%) became seropositive after 5 yr. The nonsmoking farmers who remained seronegative throughout the follow-up period were older and had worked longer on farms than the farmers with seroconversion. These results suggest that in addition to smoking habits, age and exposure time to MF influence the immune response to MF in dairy farmers. Out of 11 farmers who remained seropositive throughout the 5-yr period, two (18.2%) developed FLD. Therefore, continuously positive MF antibody is one of the risk factors in the development of FLD. PMID- 2782741 TI - Twenty isoniazid-associated deaths in one state. AB - Twenty deaths from isoniazid-associated hepatitis are known to have occurred in California over a 14-yr period in persons ranging in age from 5 to 73 yr. Because no comprehensive survey was carried out, more such deaths probably occurred. With one exception, the patients were not seen or contacted monthly throughout the course of treatment. However, in 16 patients where the information was known, eight were seen by a member of the group giving the isoniazid (INH) within 30 days prior to the patients presenting with hepatitis. In 12 of 17 cases, symptoms were present for 7 days or more before the patient presented for medical care. In at least 35% of cases where the information was known, a management error occurred, usually failing to immediately stop INH when the patient presented with symptoms. The duration of treatment before hepatitis developed varied from 9 to 53 wk. Four of the 20 patients had cholelithiasis or a history of cholelithiasis. With one possible exception, no excessive alcohol use was noted. Concomitant acetaminophen, barbiturate, and tetracycline use occurred in several cases. There were no deaths in Orientals. Sixteen of the 20 deaths occurred in women who had started to receive INH between the ages of 15 and 55. Four of these women began receiving INH during pregnancy and continued it postpartum. Eight deaths occurred in persons starting INH before 35 yr of age. The continued occurrence of INH associated deaths suggests that indications and precautions for INH preventive treatment be carefully reconsidered. PMID- 2782742 TI - Prolonged relaxation rate of inspiratory muscles in patients with sleep apnea. AB - To evaluate whether inspiratory muscle function is impaired in patients with sleep apnea, we measured inspiratory muscle strength and relaxation rate before and after sleep in 13 patients. The sleep apnea group was composed of eight patients with severe obstructive sleep apnea, and the non-apnea group was composed of five patients without significant sleep apnea. We chose the time constant of relaxation (TauR) as an index of impaired inspiratory muscle contractility, and in subsets of each group, we measured the inspiratory pressure time index as an indicator of a fatiguing breathing pattern. In patients with sleep apnea, presleep TauR was 79 +/- 22 ms (SD), longer than that of normal subjects (normal, 59 +/- 7 ms) (p less than 0.05). TauR increased by 21 +/- 16 ms during sleep (p less than 0.01). In patients without apnea, presleep TauR was 67 +/- 7 ms and it did not change after sleep. Maximal inspiratory and expiratory pressures were unchanged after sleep. We conclude that patients with sleep apnea do not develop overt inspiratory muscle failure but do have impaired contractility. We speculate that hypoxemia as well as increased work load was responsible. PMID- 2782744 TI - Nasal mucosal response to repeated challenges with pollen allergen. AB - In order to explore the dynamics of the cellular response of the airway mucosa to allergen exposure, controlled daily allergen challenges were performed for 7 days during the pollen-free winter months in nine patients with strictly seasonal allergic rhinitis caused by birch pollen allergen. Symptoms obtained after the challenge were related to morphologic changes within and on the surface of the nasal mucosa. Cell samples were obtained daily prior to challenge from the nasal mucosa using mucosal imprints on plastic strips, brush samplings from the nasal mucosa, and nasal lavage. For light microscopy, the cellular material obtained by brushing and nasal lavage were cytocentrifuged onto object slides. Histamine was measured in the cell pellets that were obtained using the lavage and brush procedures as well as in the lavage supernatant fluid. Four symptoms (sneezes, itching, secretion, and blockage) were recorded and expressed individually as well as in the form of a composite symptom score. Nasal blockage was measured using a nasal peak flow meter. The patients displayed an increase in nasal symptoms after the allergen challenge, which was further increased between Days 2 to 7 (p less than 0.05). The light microscopic evaluation of the lavage revealed an immediate increase in eosinophils from 2.3 to 13.1% and was maintained on the same level throughout the period of challenges. A similar increase was noted in the brush specimens, and a strong correlation was obtained between these two methods of sampling.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2782743 TI - Morphology of the uvula in obstructive sleep apnea. AB - Alterations in pharyngeal structure and function are considered fundamental in the pathogenesis of obstructive sleep apnea (OSA). However, little is known about morphologic features of the pharynx in patients with OSA. We therefore studied the tissue composition of the uvula (midsagittal section) in patients with OSA, using a quantitative, morphometric point-counting technique. Uvula tissue was obtained by uvulopalatopharyngoplasty (UPPP) in 33 patients (mean number of apneas per hour of sleep = 32.7 +/- 5.2) and by autopsy in 22 normal subjects not known to have OSA. All statistical comparisons were controlled for differences caused by age and body mass index. Patients with OSA had a significantly greater percentage of muscle in the uvula (18.1 +/- 1.9% versus 9.3 +/- 2.1%, p = 0.02) than did normal subjects. A significant difference in fat content was also found (9.5 +/- 1.4% in patients versus 4.0 +/- 1.0% in normal subjects, p less than 0.02). These differences between patients with OSA and control subjects could not be accounted for by anthropometric or sex differences. The percentage of uvula fat tissue was significantly related to the frequency of apneas and hypopneas in sleep (r = 0.43, p less than 0.01). Uvula morphology in 6 nonapneic snorers undergoing UPPP was similar to that of patients with OSA. We conclude that the uvula in patients with OSA contains more muscle and fat than the uvula in control subjects, possibly contributing to pharyngeal narrowing in OSA. PMID- 2782745 TI - Effect of alveolar hypoxia on pulmonary mast cells in vivo. AB - This study was undertaken to explore the effects of alveolar hypoxia on perivascular and periairway mast cell populations. Pulmonary mast cells were exposed to unilateral alveolar hypoxia by ventilating one lung of a cat with nitrogen. Mast cells from the contralateral lung, which was simultaneously ventilated with air, were used as a control. The granule content of perivascular and airway mast cells was determined from electron micrographs using morphometric methods. In response to alveolar hypoxia there was a 12% (p less than 0.005) decrease in the granule content of perivascular mast cells but no statistically significant change in periairway mast cell content. Perivascular mast cells from the hypoxic lungs did not show any of the morphological changes seen in IgE mediated mast cell degranulation, such as granule swelling, fusion, or exocytosis. In the hypoxic lung, morphometric analysis revealed a significant decrease in the proportion of heterogeneous-appearing granules in the perivascular mast cells. The different reactivity of perivascular and periairway mast cells may explain why alveolar hypoxia does not induce significant bronchospasm. PMID- 2782746 TI - Pleural effusions associated with ethchlorvynol lung injury result from visceral pleural leak. AB - Traditional thinking suggests that pleural fluid develops on the basis of systemic venous hypertension or a primary pleural process. Recent investigations, however, indicate that both acute lung injury and pulmonary venous hypertension can be important in the pathogenesis of pleural effusions. To evaluate the role of acute lung injury in the formation of pleural effusions, we developed a model of acute, reversible lung injury in NZW rabbits. Intravenous ethchlorvynol (ECV), known to produce permeability edema in humans, was used to produce permeability pulmonary edema in rabbits. The injury was examined over 14 days with bronchoalveolar lavage, pleural fluid analysis, and morphologic analysis. Ethchlorvynol injection (40 mg/kg) produced a PMN-predominant, exudative alveolitis (2 h), alveolar hemorrhage (6 to 10 h), and pleural effusions by 2 h (peak, 10 h). Pathologic findings included a patchy, subpleural, hemorrhagic PMN inflammatory response, which peaked by 24 h, and an acute PMN vasculitis of small arterioles and capillaries; these changes resolved in 5 to 7 days. No parietal pleural abnormalities were observed. We conclude that ECV induces an acute, reversible parenchymal lung injury resulting in a capillary leak and that fluid moves from the interstitium of the lung into the pleural space along a pressure gradient through a relatively permeable mesothelium. The data support the concept that diffuse or localized lung injury can result in pleural effusions. PMID- 2782747 TI - Presence of thrombosis-inducing activity in plasma from patients with lung cancer. AB - Thrombosis-inducing activity (TIA) was detected in the peripheral blood of some patients with advanced lung cancer. When plasma from the patients was given intravenously to mice or to guinea pigs, the animals became immobile within 2 min and died at 3 to 30 min after the injection. Multiple thrombosis was found in the lungs and was considered to be the cause of the death. Thrombosis was not formed and the mice survived when heparin was given intravenously 5 min before the injection of the plasma. This TIA was present in plasma from 13 of 42 patients with lung cancer. On the contrary, only two of 32 with chronic lung diseases and two of 31 healthy control subjects had this activity in the plasma. The coagulation system in the 13 patients was considered to be chronically activated, as revealed by elevation of plasma fibrinogen levels, fibrin degradation product levels, and/or peripheral platelet counts. The TIA shared characteristics with tissue factor in that it was heat labile, nondialyzable through a dialysis membrane with a 10,000 molecular weight exclusion limit, sensitive to phospholipase C treatment, precipitated by 50% ammonium sulfate, and bound to concanavalin-A Sepharose. PMID- 2782748 TI - Aortic arch anomaly presenting as exercise-induced asthma. AB - We present the case of a young woman with a right aortic arch who first became symptomatic when she began a vigorous exercise program. Her symptoms were very suggestive of exercise-induced bronchospasm. Her flow-volume curves, however, showed evidence of variable intrathoracic large airways obstruction. A magnetic resonance imaging scan confirmed the presence of severe tracheal narrowing caused by her right aortic arch. PMID- 2782749 TI - Duration of action of inhaled terbutaline at two different doses and of albuterol in protecting against bronchoconstriction induced by hyperventilation of dry cold air in asthmatic subjects. AB - Although several studies have examined the duration of the bronchodilator effect of several inhaled beta-2-adrenergic agents, the duration of the blocking effect on bronchial hyperresponsiveness, another key feature of asthma, has seldom been studied. We investigated this problem in eight adult asthmatic subjects who underwent hyperventilation tests with dry cold air on 4 different days. On the first day, five hyperventilation tests with assessment of the level of ventilation causing a 20% fall in FEV1 (PD20) were obtained to evaluate the within-day variability of the test. On the three other visits, after a baseline hyperventilation test, albuterol 200 micrograms, terbutaline 500 micrograms, and terbutaline 1,500 micrograms were administered in a double-blind, randomized way. Hyperventilation tests were carried out 1, 2, 4, and 6 h later. The blocking effect on the treatment days, as assessed by the differences in PD20 for each test compared with baseline PD20 for that day, was corrected for the within-day variability of the control day. There was a significant bronchodilator effect 1 h after administering the drug; it was equivalent for albuterol 200 micrograms (25.6 +/- 14.7%) and terbutaline 1,500 micrograms (21.7 +/- 13.5%) and significantly less for terbutaline 500 micrograms (14.1 +/- 10.0%). Complete or partial blockade on bronchial responsiveness was obtained in the majority (six to seven of eight) of the subjects 1 h after inhaling the bronchodilator, with progressive reduction in the effect later on. Four subjects still showed a blocking effect 6 h after terbutaline 1,500 micrograms was administered, one subject after terbutaline 500 micrograms, and no subjects after albuterol (chi square = 6.6, p = 0.04).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2782750 TI - NHLBI workshop summary. Asthma education: a national strategy. PMID- 2782751 TI - HLA typing in the Hong Kong Chest Service/British Medical Research Council Study of factors associated with the breakdown to active tuberculosis of inactive pulmonary lesions. PMID- 2782752 TI - Quantitative bacterial cultures of bronchoalveolar lavage fluids. PMID- 2782753 TI - Sex and race differences in the development of lung function. PMID- 2782754 TI - The rise in chronic obstructive disease mortality. PMID- 2782755 TI - Prognosis of chronic obstructive pulmonary disease: the Dutch experience. AB - This article summarizes the Dutch experience with prognosis in three groups of patient with chronic obstructive pulmonary disease. (1) 129 patients with severe chronic airflow obstruction (mean FEV1 1,880 ml, range 1,200 to 2,500 ml); (3) 81 patients out of group 2 with decline in FEV1 over time, without oral corticosteroids. It is clear that, at least in the presence of regular therapy, next to cessation of smoking, a higher reversibility of airflow obstruction and lower degree of airway hyperreactivity are important predictors of a slower decline in FEV1. In our opinion these findings point to the urgency for clinicians to change the nihilistic attitude towards patients with CAO, in that both smoking cessation and an early therapy directed at the reversible part of airflow obstruction and airway hyperreactivity may be able to prevent deterioration. Future studies have to show whether long-term, ongoing therapy with corticosteroids may even change the progression and survival in far advanced disease. PMID- 2782756 TI - Morbidity and mortality from chronic obstructive pulmonary disease. AB - The National Mortality Database of Statistics Canada was used to study chronic obstructive pulmonary disease (COPD) mortality trends between 1950 and 1984 by age, sex, birth cohort, and province. Provincial hospital statistics were combined for the period 1971 to 1984 to determine age-specific hospital separation rates for COPD. Utilization of physician services for COPD was determined for one province using physicians' claims for payment. Results of these analyses indicate that mortality from COPD has leveled off for men and is increasing for women; the trend is different for combined chronic bronchitis emphysema and for asthma. Mortality from COPD varies by age, sex, birth cohort, and province. Mortality from COPD stopped increasing with the 1910 to 1914 birth cohort in men and the 1920 to 1924 in women. Male and female birth cohorts born after 1920 to 1924 have decreased mortality. It is speculated that the age standardized mortality will decrease in the near future. Surveys of smoking habits over time support the hypothesis that a proportion of sex, birth cohort, regional, and socio-economic variation of COPD mortality is due to smoking. Hospital morbidity is higher for men than for women particularly for those more than 65 yr of age. Between 1971 and 1983, mortality/morbidity ratios were relatively stable. Asthma mortality and morbidity are increasing; changing concepts about the disease may be one reason for this observation. PMID- 2782757 TI - International comparisons in COPD mortality. AB - In 31 developed countries, chronic obstructive pulmonary disease (COPD) and allied conditions comprise a major cause of death, but they cause less than 10% of all deaths, even in older persons. COPD mortality is highest in the Eastern European countries and Ireland, Scotland, and England/Wales, and is lowest in southern Europe, Japan, and Israel. That these differences are large and real is a likelihood but not a certainty, due to problems in comparability of cause-of death statistics. In the past, the trend in COPD mortality has been upwards. Over the short time period of 1980 to 1985, there have been substantial declines in death rates in most countries for the major causes of death, but not for COPD or lung cancer. It is not clear, however, whether COPD mortality is continuing to increase everywhere. In only nine countries is the trend upwards and only in women above age 55 and in men above age 75. In the other 22 countries, trends are not clearly upwards or downwards. Longer time trend statistics are needed to corroborate and explain these patterns and the apparent intercountry differences. PMID- 2782758 TI - The trends in airway obstructive disease morbidity in the Tucson Epidemiological Study. AB - An analysis of the incidence and prevalence rates of airway obstructive diseases (AOD) has been conducted in adults in the Tucson community population under study, covering nine surveys, 1972 to 1985 inclusive. It was found that rates of diagnoses increased from initial surveys within each age group, possibly due to the effect of the study per se. The rates increased even more in each age cohort until age 65, demonstrating the effects of aging. Cohort changes in smoking were greater than cross-sectional differences between age groups. The incidence rates of diagnoses with functional impairment are about 7/1000 and are greater in smokers and in males. The new cases of AOD were defined both by functional impairment and/or physician diagnoses. They had lower pulmonary function at the initial examination. This implies a natural history of AOD that starts well before clinical diagnoses. New cases of diseases had a variegated set of associated risk factors. In addition to smoking, there were contributions made by reports of childhood respiratory disease, family history, occupational exposures, alcohol consumption, and IgE (in asthma alone or with other AOD). Use of reported diagnostic endpoints as well as functional impairment contributed more to the understanding of the possible etiology of AOD. Some increases in AOD rates may be a function of more careful study, but cohort rate increases seen in a careful longitudinal study show that a real increase in AOD is likely. PMID- 2782759 TI - Trends in COPD morbidity and mortality in Tecumseh, Michigan. AB - Trends in COPD morbidity and mortality were investigated among the population of Tecumseh, Michigan, for the period 1959 to 1987. COPD was mentioned on the death certificates of 11% (102) of deceased men and 13% (24) of deceased women. Forty one percent of these deaths was attributed to COPD as the underlying cause and the remainder to COPD as a contributory cause. Usage of diagnostic terms changed during the course of the study; emphysema was mentioned on 81% of certificates completed prior to 1968, whereas COPD was entered on 77% of the certificates written after 1978. Proportional mortality rates of COPD increased from 8% during 1959 to 1967 to 13.3% during 1979 to 1987 among men, and from 2.7% during the earlier years to 4.3% during the later years among women. Death rates for COPD and for all causes combined increased among men from the early 1960s to the late 1970s, then declined. Death rates for all causes combined were stable among women, but COPD death rates may have increased. Prevalence rates for chronic bronchitis were lower at the third examination than at the second in both sexes. Prevalence of obstructive airway disease was highest at the first and lower at the second and third examinations in men but not in women. Agreement between study diagnoses of COPD and entry of COPD on death certificates was poor. COPD was recorded on the death certificate for only 21% of men and only 6% of women who had COPD diagnosed at a study examination.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2782760 TI - Chronic obstructive pulmonary disease mortality in six U.S. cities. AB - Results are presented from a 9- to 12-yr mortality follow-up of 8,427 white adults in six U.S. cities between 25 and 74 yr of age at enrollment. Survival analyses were performed for all causes on 941 confirmed deaths, and for specific primary causes for the subset of 851 death with death certificates. Relative level of FEV1 compared with predicted was a strong predictor of sex-specific chronic obstructive pulmonary disease (COPD), cardiovascular (CV), and all-cause mortality, even after adjusting for age, respiratory symptoms, and smoking. Even in this relatively large cohort, the total number of respiratory deaths was small, and no trend in COPD mortality could be determined over the period of study. PMID- 2782761 TI - Respiratory risk factors and mortality: longitudinal studies in Washington County, Maryland. AB - Risk factors for temporal changes in chronic respiratory disease mortality were evaluated from two studies conducted in Washington County, Maryland. The first examined the mortality of a private census population (greater than 35,000 whites) enumerated in 1963 over two subsequent time periods by age, sex, and initial smoking status. The second examined the 10-yr mortality of a subset of the 1963 census (884 men who had undergone spirometry). We observed a fall in age adjusted mortality from all causes and from arteriosclerotic heart disease (ASHD), but an increase in COPD mortality. However, the increase in these chronic pulmonary deaths is essentially confined to persons who were smoking cigarettes at the beginning of the study period. Furthermore, while smokers showed an increased mortality risk for all causes, the excess mortality risk did not fall uniformly across cigarette smokers. It is a major observation of this study that all-cause and cardiovascular (as well as pulmonary) mortality are significantly more often found among subjects with ventilatory impairment (independent of smoking status). Reasons for the association of ASHD mortality with impaired forced expiration are discussed. Thus, men at increased risk for three (ASHD, lung cancer, COPD) of the five leading causes of death (three of eight for women) may be identified by spirometry. Perhaps it is time that this test was more generally applied. PMID- 2782762 TI - Twenty-year trends in mortality from chronic obstructive pulmonary disease: the Honolulu Heart Program. AB - There is evidence of a rising trend in COPD mortality. Whether this is due to changes in coding or diagnostic practices, increase in disease incidence or severity, or other causes is unknown. The Honolulu Heart Program (HHP) has followed a cohort of 11,136 Japanese-American men, 45 to 65 yr of age at onset, from 1965 to 1984. Following a fixed protocol, study physicians assigned cause of death after review of hospital records, pathology and autopsy reports, the death certificate, and, in doubtful cases, after interview with family and personal physician. The eighth revision of the international Classification of Diseases was used throughout. During 20 yr of follow-up, 2,624 men died, 113 from COPD by HHP coding and 105 from COPD by State Health Department (HD) coding. There was no change in age-adjusted or age-specific COPD mortality rates from 1965 to 1984 by HHP coding (tests for trend, p greater than 0.05). In contrast, when HD coding was used there was a significant decline in COPD mortality over the same time period. The frequency with which COPD was found on the death certificate decreased significantly for diagnoses listed in Section 1 and increased for those in Section 2. Current smokers showed increasing trends and past smokers decreasing trends in COPD mortality. When HHP and HD codings were compared, there was agreement in only 46% (69 of 149) of the cases. Agreement was greater in 1965 1974 than in 1975-1984. This study found no evidence of increasing mortality rates from 1965 to 1984 in this cohort of Japanese-American men.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2782763 TI - Trends in mortality from chronic obstructive pulmonary disease among U.S. veterans: 1954 to 1979. AB - Recent trends in chronic obstructive pulmonary disease (COPD) mortality are described for a cohort of nearly 300,000 insured veterans who were followed for survival from 1954 through 1979. Death rates from COPD for the veterans by smoking status were compared with U.S. death rates for white males 55 to 84 yr of age over the same period. The main findings were that the veterans experienced sharp increases in COPD mortality over the 26-yr study period, much like the U.S. findings. However, the observed increases were not as great as those for the United States. The COPD rates for veterans who were cigarette smokers showed the same pattern as for all veterans. Some important differences by age were noted. Thus, for ages 60 to 64 and 65 to 69, the direction of the trend among veterans appeared to change from initial increases in the COPD death rate to later decreases while at the same time the three oldest age groups (70-74, 75-79, and 80-84) continued to experience increases in mortality over the whole period. These findings were similar to those for the United States. Several possible explanatory factors for these changes are discussed. PMID- 2782764 TI - The epidemiology of pulmonary function and COPD mortality in the multiple risk factor intervention trial. AB - The potential determinants of the changes in chronic obstructive pulmonary disease (COPD) mortality were evaluated using both the Multiple Risk Factor Intervention Trial (MRFIT) screenees, the longitudinal analysis of the participants, and the differences in special intervention (SI) and usual care (UC) groups. COPD was the underlying cause for only one third of all death certificates listing COPD. Small changes in classification will have a major impact on reported COPD death rates. Cigarette smoking is clearly the primary determinant of COPD mortality. Decreased pulmonary function is an independent risk factor for coronary heart disease (CHD) mortality. Smoking cessation results in a slower rate of decline in pulmonary function over time, especially among heavy smokers. Careful evaluation of smoking cessation, including repeat chemical measures, suggest that the percentage of long-term quitters, especially among heavy smokers has been overestimated. The low percentage of quitters substantially reduced the power to detect an intervention effect. The increased cigarette smoking among recent older cohorts, and failure to substantially reduce smoking, especially among heavy smokers, may be an important factor accounting for the failure to note a decline in COPD mortality among older persons. PMID- 2782765 TI - The epidemiology of cigarette smoking and its impact on chronic obstructive pulmonary disease. AB - Since the first Surgeon General's report on smoking and health was released in 1964, the United States has achieved substantial progress in curtailing smoking. Per capita cigarette sales for persons 18 yr of age or older have declined each year since 1973. Total cigarette sales have fallen an average of 1.8% each year since 1982, despite the increasing size of the population. National population based surveys show that the prevalence of smoking has fallen steadily among adults during the past quarter century. Unfortunately, a parallel decrease in mortality from chronic obstructive pulmonary disease (COPD), one of the most important smoking-related diseases, has not occurred. To estimate the current impact of smoking on mortality from COPD, we used a modified formula for population attributable risk to calculate the mortality and years of potential life lost due to COPD caused by smoking. In 1984, an estimated 51,013 deaths occurred from COPD caused by smoking: 35,638 among men (85% of total COPD mortality) and 15,376 among women (69% of total COPD mortality) (sum does not equal total due to rounding). These deaths resulted in a total loss of 501,290 yr of life before the average life expectancy. We conclude that cigarette smoking continues to cause a heavy burden of premature death from COPD in the United States. This burden may increase in the coming years despite decreasing smoking rates because the residual risk of COPD mortality among former smokers persists for many years. PMID- 2782766 TI - Trends in COPD morbidity and mortality in the United States. AB - This paper describes patterns and trends in COPD morbidity and mortality based on data from several data systems of the National Center for Health Statistics (NCHS), as follows: mortality data from the National Vital Statistics System; and morbidity data from the National Health Interview Survey, the National Hospital Discharge Survey, and the National Ambulatory Medical Care Survey. The paper focuses on the period 1979 to 1985 and the age groups 55 years old and over. old and over. Data are also presented separately for men and women. In addition to presenting rates for prevalence, hospital discharges, office visits, and deaths on a population basis, the paper also presents rates and analyses on a per case basis, using a "pseudo-natural history model." This paper also describes some of the methodological issues associated with analyzing comparative data from several NCHS data systems. PMID- 2782768 TI - [Comment on the article "Continuing education as part of quality assurance" by M. Popovic]. PMID- 2782767 TI - The course and prognosis of different types of chronic airflow limitation in a general population sample from Arizona: comparison with the Chicago "COPD" series. AB - Recently reported data from a general population study in Tucson, Arizona have shown that subjects who have an "asthmatic bronchitic" type of chronic airways obstruction have a much more benign course than equally impaired subjects who have the typical smoking-induced, and presumably emphysematous, form of disease. These data are reviewed briefly. Findings in these subjects are then compared with those in "COPD" patients enrolled in an "emphysema clinic" in Chicago many years ago; patients with asthmatic features had been systematically excluded from the Chicago series. The rate of decline in FEV1 and mortality of Arizona subjects considered to have "typical COPD" were remarkably similar to those in the Chicago series after accounting for age and initial FEV1, but Arizona subjects with features suggesting "chronic asthmatic bronchitis" had a much more favorable prognosis than either of the "COPD" groups. These different forms of chronic airways obstruction should be distinguished in clinical or epidemiologic studies of airways obstructive disorders. PMID- 2782770 TI - [Current aspects of pulmonary tuberculosis in the hospital milieu]. PMID- 2782769 TI - [Patients hospitalized with pulmonary tuberculosis presenting Koch's bacillus in direct sputum examination. Clinical, radiologic and bacteriologic characteristics]. AB - To determine the influence of socio-economic, clinical and radiological factors on the detection of a Mycobacterium tuberculosis-positive direct sputum smear, we studied 531 patients hospitalized for pleuropulmonary tuberculosis over a 5 year period. M. tuberculosis positivity of the expectorate smear was found more frequently in clinically detected (43%) than in radiologically detected (26%) tuberculosis (P less than 0.001). On admission, a M. tuberculosis-positive sputum smear was more common in patients under 40 years old (P less than 0.02), blacks (P less than 0.05) and alcoholics (P = 0.001). M. tuberculosis positivity on direct sputum smears was more often associated with general (asthenia, sweating, fever greater than 38 degrees C) and functional respiratory symptoms (cough and sputum production) (P less than 0.003), bilateral diffusion of lung lesions and/or excavation on chest roentgenography (P less than 0.0001). Nevertheless, 21% of the asymptomatic radiologically detected tuberculosis patients had positive direct expectorate smears and should be considered contagious. PMID- 2782771 TI - [Anatomo-clinical conference. Hopital Cochin. Case No. 3-1989. Cerebral meningioma and adrenal mass in a 70-year-old woman]. PMID- 2782772 TI - [Prevention of human Loa loa filariasis]. PMID- 2782774 TI - [Rupture, after a long phase of clinical latency, of intracranial arteriovenous aneurysm]. PMID- 2782773 TI - [Loa loa filariasis, encephalitis and treatment with Notezine: an underestimated complication?]. PMID- 2782775 TI - [Encephalopathy caused by cefotaxime. A case in an aged patient with renal failure]. PMID- 2782776 TI - [Antidiuresis syndrome caused by psychotropic drugs. A case caused by viloxazine]. PMID- 2782777 TI - [Acute renal failure and nephrotic syndrome caused by rifampicin: polymorphism of the nephrotoxicity of rifampicin]. PMID- 2782778 TI - [The fibrocystic form of hyperparathyroidism of renal origin. Apropos of 2 cases]. PMID- 2782779 TI - [Agranulocytosis caused by paracetamol: a case, with positive readministration]. PMID- 2782780 TI - [Chronic eosinophilic infiltrating pneumonia followed by Churg and Strauss angiitis]. PMID- 2782781 TI - [Myeloma complicated by amyloidosis of the temporal artery simulating Horton's disease]. PMID- 2782782 TI - [Hereditary pachydermoperiostosis]. PMID- 2782783 TI - [Bronchial cancer associated with upper respiratory and digestive tract cancers]. AB - The authors report a series of 63 cases, all operated, of bronchial cancer associated with upper airway cancer. The laryngeal portion of the upper airways was the site of cancer in 50% of cases. The two cancers occurred synchronously in 13% and at different times in 87% of cases. Operative mortality was 3%. Post operative complications were dominated by bronchopulmonary congestion. Long-term survival was similar to that in series of operated bronchial cancer alone and was 70% at one year and 30% at five years. These results should lead to all isolated pulmonary lesions being considered as second primary cancers with early surgical resection being proposed. PMID- 2782784 TI - [Tumors of the nasal fossa. Retrospective study of a series of 67 cases]. AB - This retrospective study reviews 67 tumors of the nasal fossa treated at hospital Laennec (Paris). The clinical significance of histology and the therapeutic results for each pathological tumor (mainly, carcinoma, melanoma, lymphosarcoma, neuroma, malignant plasmocytoma, inverted papilloma, vascular tumors) are described. Treatment and surgical procedure will be analyzed. PMID- 2782785 TI - [Anatomic considerations on the pyramid and nasal septum. Quantitative data apropos of 33 dissections on fresh corpses]. AB - The authors have dissected a series of nasal pyramids and septum. The various a anatomical structures have been measured and their relations with surgical landmarks have been recorded. Histograms show their findings. Surgical interest was emphasized for each stage of dissection. Some important points have been noticed during this study. They could bring some explanations to certain failures encountered after a septorhinoplasty. PMID- 2782786 TI - [Life-threatening complications and severe neurologic sequelae in surgery of acoustic neurinoma]. AB - Surgical treatment of acoustic neurinoma carries a high risk of mortality. Recent history of successful management sparing the facial, mixed, and even cochlear nerves, as well as of a substantially lower incidence of postoperative complications or neurological sequelae, should not give grounds for any false sense of security to undermine one's alertness during the pre, peri- and postoperative phases of the intervention. The overall mortality rate for surgical neurinoma cases was 0.7%. Severe, disabling CNS-related neurological sequelae, chiefly affecting the cerebellum, occurred in 0.4% of cases. PMID- 2782787 TI - [Surgical treatment of severe laryngeal stenoses in children]. AB - This article constitutes a short review of the experience of the ENT service at the Hopital Bretonneau, in Paris, with regards to laryngeal stenosis in children. Since 1974, 115 cases of severe stenosis have been operated on. 70 cases presented acquired lesions, primarily related to endotracheal intubation, while congenital malformations accounted for another 45 cases. 41% of the patients had stenosis that reduced the laryngeal lumen by 90%, or more. The different surgical approach (consisting in castellated incision of the anterior wall, or in anterior, or more rarely posterior, cartilage supplementation), as well as the various stenting methods used are briefly described and discussed. PMID- 2782788 TI - [Anatomic characteristics of the mastoid in children. Pneumatization of the subfacial region]. AB - Three specific features of the mastoid in the pediatric population appeared to us to be important in view of our per-operative findings on mastoidectomy for chronic suppurative otitis, cholesteatoma or middle ear effusion with chronic persistent mastoiditis in the older child. These included the position of the facial nerve, the superficial nature of its third part being well known, but also the existence of the Korner septum and especially the pneumatization of the sub facial region which explains the similarity between certain infectious lesions of the retro-tympanic structures and infectious lesions of the anterior portion of the mastoid process. An experimental study of staining of preserved petrous bones in the adult enabled the sub-facial permeability of the mastoid to be demonstrated in certain cases. Awareness of these small details should help to avoid per or post-operative complications in surgery for chronic otitis media in children. PMID- 2782789 TI - [Choice of surgical technic for correcting the nose tip]. AB - The surgical approach should be adapted to the type of correction needed. There is no room of standard technics. The various selection criteria that have to be considered are: the structure of the alar cartilages and the infra-and suprastructural characteristics thereof, determining the upper triangle of the lobule; the relative incidence of the abnormalities encountered in rhinoplastic practice; an analysis of the failures leading to secondary rhinoplastic operations, among which the most frequent are lobule and/or irregularities and drooping apex or insufficient projection thereof. Currently, the authors' conclusions are that: Most of the times, the upper triangle of the lobule is overdeveloped: reduction is carried out by resecting a superior strip laterally, while additionally trimming the cupulae, if necessary. Much more rarely, a globally hypertrophied lobule will be found that requires management by section reconstruction of the cupulae. In case of a "normal", excessively projected lobule, the technic of choice is apex retraction. Primary apex projection defects should be recognized and treated with molding grafts. The nose tip should be prevented from drooping by means of columellar supporting grafts. PMID- 2782790 TI - [Factors of quantitative variation in taste sensitivity]. AB - Under well controlled experimental conditions, it is possible to accurately and reproducibly measure taste thresholds as well as supraliminal intensity matches in individual subjects. It is therefore possible to evaluate interindividual differences. Some factors influencing sweetening potencies remain obscure unless individual data are processed. Sweetening potency depends on the taster, the stimulus concentration, pH and temperature, but also on all the components of the mixture into which the sweetener is incorporated. PMID- 2782791 TI - [Monitoring of thyroid function in patients treated for cancer of the upper respiratory and digestive tract]. AB - A study was carried out at Hopital Boucicaut to determine the incidence of iatrogenic biological thyroid dysfunction in patients treated for cancer of the upper digestive and respiratory tracts, and to define the risk profile (tumor localisations, practical therapeutical procedures). Two studies were conducted: a prospective on including 18 patients and a retrospective one including 58 patients. Only partial results are currently available. They permit emphasizing the frequency of biological thyroid dysfunction associated both with combination surgical and radiotherapeutical regimens and radiotherapy or radiotherapy alone for the treatment of lesions of the piriform sinus, although they fail to provide conclusive evidence regarding the real frequency of this type pathology or the time of its occurrence. PMID- 2782792 TI - [Evaluation of cochlear function in otospongiosis. Preliminary study]. AB - One of the major therapeutical problems encountered in the natural history of otospongiosis are lesions affecting Corti's organ. We obtained audiometric measurements, including pure-tone and speech audiograms, tympanograms, and spontaneous and provoked otoemission determinations in 26 patients (40 ears), who benefited from total platinectomy and collumellar effect recuperation by means of temporal aponeurosis interposition and piston-cupping. Results show that the piston-cup procedure does not appear to modify the transfer function of the middle ear. On the other hand, even at a stage when pure-tone and speech audiograms show little alteration, there seems to be some lesion of the external ciliated cells of Corti'organ. PMID- 2782793 TI - [Lymph node failure in epithelioma of the glottic floor treated by partial laryngeal surgery. Apropos of 432 patients]. AB - The authors assessed ganglionic failure in a series of 432 cases of N0 M0 epidermoid carcinomas of the glottic floor following partial laryngeal surgery. The overall of ganglionic failure was 7.8%. This rate of failure is related to 64.7% death rate, i.e. 5.1% of the 432 patients under study. This retrospective study differentiates between primary ganglionic failure and secondary ganglionic failure. Primary ganglionic failure is the first local/regional carcinologic event to develop after treatment of any glottic lesion. Secondary ganglionic failure is related to isolated local failures. The percentage of primary ganglionic failure was 5.1%. It was responsible for deaths occurring in 54.5% of cases. The percentage of secondary ganglionic failure was 2.7% and it was responsible for deaths occurring in 83.3% of cases. Factors promoting ganglionic failure (real tumor extension, tumor infiltration, altered laryngeal mobility, local control and efficacy of retakes of local failures) are discussed. The importance of prophylactic surgical procedures guarding from ganglionic failure, such as the ipsilateral jugular-carotid and recurrent nerve approaches is emphasized. Although such procedures can be of aid in cases of T2 or T3 N0 M0 epitheliomas of the glottic floor, they present no alternative in the course of retake operations of local failures. PMID- 2782794 TI - [An approach to tumors of the face by degloving. An elegant treatment of inverted papillomas and various sinus cancers. Values. Limitations and extension]. AB - Degloving constitutes a hidden route of access to the middle third of the face. It combines a bilateral sublabial incision with a rhinoplastic approach, whereby all the soft tissues of the face can be undermined subperiosteally, leaving no external scar. This method offers an extended bilateral route of access to lesions of the nasal cavities and ethmoid/sphenoid/maxillary sinuses, deep to the clivus. Its exposing features at least compare with conventional technics, including bone resection or the creation of a valve. This procedure may be associated with other neurosurgical approaches in the treatment of extended lesions of the basis of the skull. Its use is particularly recommended in the treatment of inverted papillomas, although it applies as well to malignant tumors of the sinuses under certain conditions. We present here a review of our experience. PMID- 2782795 TI - [Prefabricated free transplants. Experimentation]. AB - The principle of prefabricated transplants consists in the manufacturing of compound transplants complete with a vascular pedicle containing an artery, a vein, a muscle and its nerve, some cell tissue, bone tissue, cartilage, periosteum and innerved skin. This transplant is constructed and modeled in accordance with its intended use, around the preselected vascular pedicle, whence the term prefabricated. Neovascularization revascularizes these different structures. The free transplants together with their vasculonervous pedicles are excised five weeks after manufacture and then transplanted to the recipient site. Experimentally, we grafted 15 free prefabricated transplants in Wistar rats. One failure was observed due to thrombosis of the anastomoses. Experimental data from macroscopic, arteriographic, microangiographic, and histological examinations, with injection of a staining material, show that neovascularization develops at the level of the transplant. The emphasis is on creating free transplants selectively using various tissues and selected vascular pedicles. These transplants constitute a useful prospective alternative for very elaborate reconstructive surgery. PMID- 2782796 TI - [The Chinese flap in reconstructing the posterior pharyngolaryngeal wall, mouth cavity and in reoperation after failure of pedicled digestive transfer]. AB - The Chinese flap has already been recommended in the context of circular pharyngolaryngectomy. The authors studied its vascularization from an anatomy focusing project carried out on 40 dissection cases. They broaden the applications of this material to posterior reconstructive pharyngectomy, for which they specify the methods and routes of access. Other applications are proposed: this flap may represent an alternative for reconstitution of the oral cavity, or even as a second-intent surgical procedure where other technics have failed. PMID- 2782797 TI - [Voice restoration after total laryngectomy by tracheoesophageal fistula]. AB - Between December 1985 and December 1988, 34 patients with total laryngectomy had their voice restored by creation of tracheoesophageal fistula. A shunt was created in 13 cases of total laryngectomy. In 21 others, the technique used was tracheosophageal puncture with placement of a Blom-Singer prosthesis. This puncture was carried out either at the time of the laryngectomy or a few weeks later, or when production of esophageal voice failed. Results were assessed on the basis of criteria such as quality of voice, its use and the patient's autonomy. Indications for both procedures, their respective limits and difficulties are exposed. Immediate results following voice recovery were satisfactory in 82% of cases. PMID- 2782798 TI - Fifteenth Daniel C. Baker, Jr, memorial lecture. What have whole organ sections contributed to the treatment of laryngeal cancer? AB - The study of whole organ sections of laryngectomy specimens has demonstrated the patterns by which cancer spreads from one part of the larynx and hypopharynx to another. These studies have also demonstrated the fibroelastic membranes and ligaments that form the boundaries of intralaryngeal compartments within which cancer is confined in its early stages. They thus have added support to the concept of partial laryngectomy for selected lesions and have illustrated the features of those types of laryngeal cancer that have not responded well to radiotherapy. Whole organ sections of laryngectomy specimens have allowed a more accurate interpretation of preoperative computed tomography and magnetic resonance imaging and have provided a reliable basis for clinical staging. PMID- 2782799 TI - Phonosurgical studies: fat-graft reconstruction of injured canine vocal cords. AB - Damage to the vocal cords can result in scarring and impaired vibration and can manifest clinically as hoarseness and loss of vocal power. If the vibratory characteristics could be restored in these scarred vocal cords, the vocal intensity and efficiency of phonation also should improve. In an effort to enhance the vibration of damaged vocal cords, we implanted a submucosal fat autograft within the injured vocal cord cover layer of dogs 6 weeks after unilateral mucosal excision had been performed. Three months postoperatively these animals were compared to normal dogs and those with mucosal excision but no fat-grafting. Acoustic and biomechanical measures of phonation were collected from an excised larynx preparation. We found that the fat-augmented vocal cords had lower threshold pressures for phonation, greater vocal intensity, and more efficient acoustic output than injured vocal cords without the fat-grafting. These results provide a foundation for further research on reconstructive surgery of damaged vocal cords. PMID- 2782800 TI - Long-term results of nerve-muscle pedicle reinnervation for laryngeal paralysis. AB - Between 1976 and 1986, 214 patients with bilateral vocal fold paralysis and 73 patients with unilateral vocal fold paralysis were managed by the author using the nerve-muscle pedicle technique for reinnervation. Follow-up of at least 2 years has been obtained on 202 of the bilaterally and 70 of the unilaterally involved patients. Long-term success has been achieved in 74% of the bilateral group and 88% of the unilateral group. Successful reinnervation of unilateral paralyses usually maintains voice correction indefinitely, but there is late (2 to 5 years postsurgery) deterioration of successful airway restoration in approximately 17% of bilateral cases, which appears to be due to development of cricoarytenoid arthritis. PMID- 2782801 TI - Laryngeal brain stem evoked response. AB - Sensory stimuli to the larynx evoke a laryngeal adductor reflex mediated by the brain stem via superior and recurrent laryngeal nerves. Aberrant laryngeal reflexes have been proposed to explain a number of poorly understood disorders, including "reflex apnea," idiopathic laryngospasm, and sudden infant death syndrome. The purpose of the present study was to evaluate far field brain stem recordings following stimulation of the superior laryngeal nerve to determine whether laryngeal brain stem response is a valid measure of laryngeal activity at the brain stem level. The nerve was stimulated electrically in adult cats, and the resultant laryngeal adductor response as well as far field brain stem activity was recorded. For the latter, six reproducible positive and five reproducible negative waves were obtained via posterior pharyngeal (+) and posterior cervical (-) recording electrodes. Response threshold and latencies were measured and evaluated as a function of stimulus parameters. Wave latencies corresponded closely to those reported in prior near and far field evoked response recordings. PMID- 2782802 TI - Complications following rhinotomy. Review of 148 patients. AB - For the period 1974 to 1988, 148 patients undergoing 162 rhinotomies at The Mount Sinai Medical Center, New York, for a variety of benign and malignant neoplasms were reviewed with particular attention to postoperative complications. The effects of certain predisposing factors such as prior rhinotomy, lateral versus total rhinotomy, additional medial maxillectomy or craniofacial resection, and preoperative irradiation or nasal bone erosion are discussed. In addition, a surgical technique of rhinotomy with medial maxillectomy is presented that includes maneuvers designed to prevent these complications. PMID- 2782803 TI - Indirect videolaryngoscopy versus direct endoscopy for larynx and pharynx cancer staging. Toward elimination of preliminary direct laryngoscopy. AB - Thirty-nine patients with cancer of the larynx and pharynx (33 untreated and six previously treated patients) underwent tumor mapping by both direct laryngoscopy (DL) and indirect videolaryngoscopy (IVL). The examiner in each case was unaware of the findings of the other evaluation method. After definitive treatment had been carried out so that pathologic and operative information was also available, comparisons of the accuracies of the two methods of staging were made. In 32 cases, IVL provided information equal to or better than that provided by DL, and a tissue sample also could be obtained during IVL. On the basis of these findings, we conclude that aggressive, office-based IVL can guide initial treatment planning (partial or total laryngectomy versus irradiation) and patient counseling. A confirmatory DL can be performed without surprises at the time of definitive surgery, rather than as a separate procedure - a cost-effective modification of standard practice. PMID- 2782804 TI - Long-term results of ethmoid surgery. AB - This paper investigates the results of nonendoscopic intranasal ethmoid surgery on 146 patients who were followed up for 6 to 13 years. These patients are divided into four groups: 1) infection without allergy, 2) infection with allergy, 3) infection with polyps and no allergy, and 4) infection with polyps and allergy. These groups are evaluated as to the long-term results of surgical treatment with or without concurrent allergic desensitization. The great majority of patients benefited from the surgical treatment regardless of their allergic status. Postoperatively, the allergic patients had more subjective symptoms than those having only infection. A major conclusion was that the long-term benefit to the patient as a result of the operation performed by experienced hands does override the potential risks of ethmoid surgery. PMID- 2782805 TI - Congenital subglottic stenosis: the elliptical cricoid cartilage. AB - Various malformations of the cricoid cartilage produce congenital subglottic stenosis. The elliptical cricoid cartilage first was demonstrated histopathologically in horizontal sections of six postmortem specimens and now has been identified clinically in ten patients. The clinical diagnosis of the elliptical cricoid cartilage, suggested by anteroposterior soft tissue neck films, is confirmed at direct laryngoscopy. Delineation of the precise location, extent, and histopathology of subglottic stenosis provides the basis for rational management. PMID- 2782806 TI - Thickness of the lateral surface of the temporal bone in children. AB - The placement of implantable auditory prostheses in children has raised questions concerning the thickness of the temporal bone in the region of implantation. The purpose of this study is to describe the thickness at specific sites of the lateral surface of the temporal bone in children of different ages. One hundred twenty-five intact temporal bones from 83 children of known sex, race, and age between birth and 20 years were measured. Thickness was measured with a specially designed micrometer at specific locations from a fixed reference point by use of a surface projected grid for site identification. Thickness was plotted against age on scattergraphs for each site, and regression analysis revealed a bimodal linear relationship. Sites medial to the temporalis muscle were the thinnest; sites associated with the posteroinferior insertion of the temporalis muscle, along the supramastoid crest, were the thickest. However, wide interindividual variability was the rule. PMID- 2782807 TI - Hyaluronan in experimental serous and purulent otitis media. AB - The concentration of hyaluronan (hyaluronic acid; sodium hyaluronate; HA), a major component of connective tissue, was analyzed by a specific radioassay in tissue samples from normal rat middle ears and in tissue and effusions from middle ears affected by experimentally induced otitis media. In normal ears the pars flaccida of the tympanic membrane contained a considerably higher concentration of HA (60 to 200 micrograms/g) than the pars tensa and areas of the medial wall (2 to 7 micrograms/g). In purulent otitis media the pars flaccida contained less HA than in normal ears. The HA concentrations were lower in purulent (3 to 40 micrograms/mL) than in serous (20 to 190 micrograms/mL) effusions. The weight average molecular weight of HA in serous fluid was high (greater than 10(6] and comparable to that in lymph. It is inferred from the study that the subepithelial tissue and its matrix components, eg, HA, must be considered when attempting to understand the function of the middle ear normally and in otitis media. PMID- 2782808 TI - Optokinetic afternystagmus in humans: normal values of amplitude, time constant, and asymmetry. AB - It has been suggested that the appearance of directional asymmetry and/or a reduced time constant of optokinetic afternystagmus (OKAN) might be a clinical index of vestibular imbalance. However, we do not know the limits for OKAN parameters in normal humans. Accordingly, we studied OKAN in 30 normal subjects using a "sampling" method, in which a number of values of OKAN are obtained by turning out the lights periodically during optokinetic stimulation. We found that the initial velocity of OKAN has a large intrasubject variability. Accordingly, if precision is desired so as to obtain 95% confidence that the measured mean of the initial velocity of OKAN is within 25% of the true mean in an individual subject, at least eight measurements of the initial OKAN velocity must be taken. When 12 measurements are made, all subjects had a minimum value of 5 degrees/s initial OKAN, and there was little directional asymmetry (mean of -0.47 degree/s +/- 3.13 degrees/s). The intrasubject variability of the time constant of OKAN was similar to the variability of initial OKAN velocity. However, because it is not possible to obtain repeated measures of the time constant in a short period of time, the time constant of OKAN is less likely to be useful in clinical testing. PMID- 2782809 TI - Adenomatous tumors of the middle ear. AB - Primary adenomatous tumors of the middle ear are preponderantly benign, resectable lesions and arise from the mucosa (adenomas) or salivary tissue (choristomas). Malignant variants are ill defined, are not characterized histologically, and represent less than 10% of the adenomatous tumors. Their presence may be signaled clinically by facial nerve paralysis, invasion of bone, and chronic otorrhea. PMID- 2782810 TI - Blood transfusions and recurrence in head and neck cancer. PMID- 2782811 TI - Alternate and simultaneous binaural bithermal testing: a comparison. PMID- 2782812 TI - Medical or surgical complications related to the Nucleus Multichannel Cochlear Implant. PMID- 2782813 TI - [Acquired disseminated elastolysis of the reticularis dermis]. PMID- 2782814 TI - [What is your diagnosis? Fibrous hamartoma in children]. PMID- 2782815 TI - [Invasive and non-invasive studies of the protective action of a silicon containing cream and its excipient in skin irritation induced by sodium laurylsulfate]. AB - The purpose of our study was to evaluate the protective effect of a new silicone containing barrier-cream (Anthydro) and its vehicle (Anthydro without silicone) in the prevention of cutaneous irritation by detergents. We therefore planned a study in several stages, using an anionic surfactant well known for its irritant properties: sodium laurylsulphate (SLS) in aqueous solution. In a first series of experiments, the protective effect of the Anthydro cream against SLS was studied by invasive methods on guinea-pigs in order to determine histologically the protective effect of the cream when a 10 p. 100 SLS solution was applied on the skin under occlusion during 24 hours (Square chambers, Van der Bend). Typical and reproducible lesions were apparent, and the protected sites were compared with the unprotected sites. In parallel, we used non-invasive methods (conductivity, transepidermal water loss and cutaneous blood flow) to determine in humans the protective effect of Anthydro cream in comparison with unprotected sites after application during 24 hours of patches soaked with a 5 p. 100 SLS solution on the forearms of 13 adult and healthy volunteers (Silver patch tests, Van der Bend). In both experiments the Anthydro cream was effective in reducing the SLS-induced cutaneous irritation. In a second series of experiments, the Anthydro barrier cream was compared with its "base" (Anthydro without silicone) in terms of effectiveness, following the same experimental procedure (invasive on guinea pigs, and non-invasive on humans). The base was shown to be effective in protecting against irritation. However, the histological lesions were less intense when the skin was protected by Anthydro than by its vehicle. Concerning the non-invasive methods in humans, no significant statistical differences appeared in the measurement of various parameters between the sites protected by Anthydro and the sites protected by the vehicle. These results lead us to suggest the existence of an essentially mechanical protective effect in which the silicone plays a very small part in terms of effectiveness. These experimental results necessitates further investigations to be extrapolated to occupational conditions without tests performed in industries and well-conducted epidemiological investigations. PMID- 2782816 TI - [Cutaneous melanosiderosis in patches]. PMID- 2782817 TI - [What is your diagnosis? Skin burns caused by a transcutaneous oximeter]. PMID- 2782818 TI - Selection of the appropriate parameter to measure neural regeneration. AB - A rat sciatic nerve model of regeneration was assessed by multiple techniques to determine the relationship between parameters of neural regeneration in common use today. The results demonstrated significant correlation and internal consistency between electrophysiological and morphological parameters (i.e., conduction velocity and fiber diameter) but not necessarily a correlation between these physiological parameters and overall nerve function as assessed by a modified walking track technique. Guidelines for parameter selection are suggested based upon the specific question being investigated (e.g., sensory and/or motor function versus axoplasmic flow and/or neurotropism) rather than the nonspecific "neural regeneration." PMID- 2782819 TI - The inferior dermal-pyramidal type breast reduction: long-term evaluation. AB - The evolution of the technique of breast reduction using an inferior dermal pyramidal flap is discussed, including the changes we have found to enhance this procedure. The recommended use of a wide-based pyramidal breast parenchyma with a dermal pedicle nipple-areola flap is based on our 12-year study of 1,001 breast reductions in 519 patients ranging in age from 13 to 73 years; 37 of the patients underwent a unilateral breast reduction. The weight of tissue excised ranged from 207 g to 3,350 g from each breast. Occult carcinomas were found in two of the breast specimens. The longest sternal notch-to-nipple distance was 52 cm. The essential goals of predictability of the result, retainment of nipple sensitivity, excellent aesthetic results, and the possibility of lactation are satisfied by the use of this surgical technique. This technique appears to have continued application in younger women, in whom nipple sensation and lactation are particularly important. PMID- 2782820 TI - Staphylococcal wound infection in the pig: Part I. Course. AB - Full-thickness excision wounds infected with Staphylococcus hyicus, a pig pathogen, or Staphylococcus aureus, a human pathogen, were produced in pigs. The inoculated wounds were kept occluded for 2 days and then exposed and biopsied at intervals for 9 to 12 days. The exposed lesions were edematous and exudative. The S. aureus model was experimentally advantageous because the infection remained localized to the wound without systemic infection or signs of discomfort. The S. hyicus infection caused a rash with skin blisters; thus, its use is discouraged. The concentration of S. hyicus in the wound on day 2 was log 8.6 +/- 0.4 CFU/g (mean +/- standard deviation). On day 4 the mean was log 9.2. For S. aureus the values were log 8.0 +/- 0.9 on day 2 and 6.9 on day 4 (p less than 0.05). Of the 50 individual values in the S. aureus series, 45 were above log 5. The inflammatory reaction was more pronounced after the infection with S. hyicus, whereas with S. aureus the fibroblast response came earlier and was more pronounced. The model parallels typical clinical courses of staphylococcal infection. PMID- 2782821 TI - Staphylococcal wound infection in the pig: Part II. Inoculation, quantification of bacteria, and reproducibility. AB - Bacteria from full-thickness excision wounds with staphylococcal infection in the pig were cultured quantitatively. The bacterial concentration increased with the size of the inoculum, and after 2 days it had already reached a stable, maximal level of approximately log 8 CFU/g in the tissue. The correlation coefficient was 0.753 in comparing concentrations from superficial and deep biopsy halves and 0.145 from "surface wash" and superficial biopsies. The "within wound" sample distribution was logarithmic. The gain in precision when assessing the mean bacterial concentration from three instead of one biopsy was 45%. The coefficient of variation of between wound and within wound determinations was in the same range (i.e., 7.1-12.5%). Paired observations from a sample population with 7 sites (wounds) were needed to determine a 10% change in the bacterial concentration at a significance level of p less than 0.05, and a similar change could be determined from unpaired observations based on two populations with eleven sites. PMID- 2782822 TI - Efficacy of debridement and primary closure of contaminated wounds: a comparison of methods. AB - Proper management of highly contaminated traumatic wounds frequently requires delayed primary closure of healing by secondary intention to prevent subsequent infection. This animal study compares the efficacy of various wound debridement methodologies to prevent infection following primary closure of treated contaminated wounds. Forty-four Sprague-Dawley rats with uniform, paravertebral incisions were studied. Each wound was inoculated with a standard amount of Staphylococcus aureus bacteria and allowed to remain open for two hours. Each wound was treated before wound closure by one of four debridement methods: (1) surgical scrubbing, (2) high-pressure irrigation, (3) ultrasonication, or (4) soaking. The control animals' wounds were closed without debridement. At 7 days, each animal was evaluated for the presence of gross infection and wound induration. Ultrasound, with a 25% incidence of gross infection, compared with irrigation (75%), scrubbing (82%), and soaking (89%) provided significant protection from subsequent abscess formation. The control group uniformly developed infection (100%). The average amount of induration after ultrasonication (1.35 +/- 0.56 cm) was also significantly less than irrigation (2.07 +/- 0.75 cm), scrubbing (1.95 +/- 0.34 cm), and soaking (1.73 +/- 0.22 cm). Our data demonstrate that ultrasonic wound debridement has exciting potential as a new debridement technique for contaminated traumatic wounds. PMID- 2782823 TI - Segmental latissimus dorsi free flap: clinical applications. AB - For 15 years, the latissimus dorsi muscle has enjoyed a consistent reputation with reconstructive surgeons as a reliable pedicle or free flap transferred with or without a skin island. Previous laboratory investigation has delineated the neurovascular intramuscular anatomy. The segmental latissimus transfer makes use of the intramuscular anatomy such that a lateral segment of the muscle is denervated and transferred with the thoracodorsal vascular pedicle while the medial segment of the muscle remains in situ innervated normally and perfused by the dorsal perforating branches of the ninth, tenth, and eleventh intercostal vessels. In this article we report our results using segmental free flap transfer of the latissimus dorsi muscle in 11 patients. Electromyographic studies have been performed more than a year postoperatively to document the function of the residual latissimus left in situ. Our clinical observations show that the segmental free transfer of the latissimus dorsi muscle can be accomplished with little risk in those situations not requiring the entire muscle, and that the portion of the muscle not transferred continues to function well and improves the contour of the back. PMID- 2782824 TI - Subcutaneous V-Y advancement flap for closure of nasal tip defect. AB - Our experience with V-Y subcutaneous flaps for nasal tip closure after tumor resection in 10 patients is reported. This method has distinct advantages over previously used methods such as skin graft, rotation, or transposition flap. It allows primary closure of recipient and donor site without the formation of dog ear or trapdoor deformity. It is easy to design, reliable, and offers good cosmetic results. This method is performed under local anesthesia as an office procedure. It is recommended to plastic surgeons for the closure of nasal tip defects. PMID- 2782825 TI - Topical growth factors and wound contraction in the rat: Part II. Platelet derived growth factor and wound contraction in normal and steroid-impaired rats. AB - The wound contraction model described in Part I was used to study topically applied, recombinant platelet-derived growth factor (rPDGF-BB) and wound contraction in normal and steroid-impaired rats. Circular wounds 4 cm in size were made on the dorsum of the rats with halothane anesthesia. Five groups of 20 normal rats each were treated with the vehicle alone and four concentrations of rPDGF-BB (0.5, 1.0, 3.0, and 10.0 micrograms/ml). Four groups of 20 steroid impaired rats each were treated with the vehicle alone and three concentrations of rPDGF-BB (0.5, 1.0, and 3.0 micrograms/ml). The wounds were dressed with 2 x 2 gauze, Adaptic, 4 x 4 gauze, and Tubigrip. The investigators were blinded to the treatments until the completion of the experiment, and the treatments were applied in random order. Dressings were changed every 2 to 3 days for 14 days and the wound areas were determined, expressed as a fraction of the original, and plotted versus time. The areas under the curves and the means of the fraction open each day were compared between groups using Student's t-test. The treatment with 3.0-micrograms/ml rPDGF-BB accelerated the rate of wound contraction in the steroid-impaired animals (p less than 0.05). PMID- 2782826 TI - Distally based ulnar artery island forearm flap for the large defect of the ulnar side of the hand. AB - After wide excision of the squamous cell carcinoma, the large defect of the ulnar side of the left hand was treated successfully by a distally based ulnar artery island forearm flap. The flap has excellent circulation and can cover the wide defect of the hand. PMID- 2782827 TI - Correction of penile curvatures caused by unsuccessful hypospadias repair using the scrotal septum pedicled skin tube principle combined with corporoplasty and a modified meatoglanuloplasty. AB - Scrotal septum pedicled skin tube urethroplasty combined with a modified meatoglanuloplasty and corporoplsty were used in 2 adults. They had three previous hypospadias repair attempts in their childhood, leaving them with a meatus near the glans but with severe ventral penile curvature. Scrotal septum pedicled skin flaps used for the repair, by providing natural vascularization and offering more flexibility, allow the surgeon to reconstruct long urethral defects. The cosmetic and functional results of this combined technique are satisfactory. This principle can also be applied in adult hypospadias cases with deficient preputium in which the midanterior scrotum contains a shiny non-hair bearing skin. PMID- 2782828 TI - Re: Woods et al: lymphoscintigraphy as a guide to treatment in malignant melanoma. PMID- 2782829 TI - [MRI features of expansive processes of soft tissues. Contribution to etiologic diagnosis. Apropos of 32 cases]. AB - This study concerns the investigation of 32 soft-tissue tumors by MRI, subsequently verified by biopsies or surgery (n = 28) or other investigations (n = 4). MRI can suggest the diagnosis in some cases: lipomas cysts, hematomas, neuromas, desmoid tumors, hemangiomas, by contrast analysis and morphologic aspects; sometimes, malignant lesions are suspected on particular anatomic criteria. MRI is excellent in the evaluation of local extension. MRI can therefore be performed when the staging of soft tissue tumor is incompletely provided by other investigations (CT or US). PMID- 2782830 TI - [The STIR sequence. Comparison with other MRI sequences and scintigraphy in detecting spinal metastases]. AB - A prospective MRI study of the spine comparing short inversion-recovery sequences (STIR)-one the features of which is to potentiate the contrast of both long T1 and T2 sequences-with other spin echo and/or gradient echo MRI sequences, was conducted in 20 patients with suspected vertebral metastases. The features of the signal on STIR sequences were initially defined in 14 healthy volunteers. In the patients, the various MRI sequences were also compared to each other and to standard x-rays and bone scans. The sensitivity of detection of vertebral metastases did not appear to be significantly different between T1 sequences and the STIR sequence. However, these two sequences appeared to be significantly more sensitive than T2-weighted sequences. The STIR sequences therefore appears to be a logical complement to T1-weighted sequences in the detection of vertebral secondaries. This sequence even appears to be superior in the following situations: investigation of the cervical vertebrae, follow-up of irradiated bone, early detection of periduritis and lesions of the posterior arch. PMID- 2782831 TI - [Intrarenal kinetics of Gd-DOTA in sequential MRI in rabbits. Reproducibility study]. AB - Ten normal rabbits and seven rabbits with experimental acute renal failure by tubular necrosis were studied with dynamic MR to evaluate the reproducibility of intrarenal kinetics of Gd-DOTA. Sequential spin-echo sequences with short TR (200 msec)/TE (26 msec) were used yielding a 29 sec acquisition time. A usual semi quantitative analysis of intrarenal contrast demonstrated the reproducibility of some phases of the dynamic sequence in particular a drop in the signal within inner medulla between the third and the fourth minute after infusion. This effect, related to a high concentration of Gd-DOTA within the tubules was observed in 9 over 10 normal rabbits and in none of the rabbits with acute renal failure. The quantitative analysis calculation was based on relative signal intensity and contrast-to-noise ratio from the absolute signal intensity measure on regions-of-interest (ROI) on the cortex, outer medulla and inner medulla. No reproducibility of the variations with time of these parameters could be assessed. A great number of factors of variations or error, mainly during the measurements of signal intensity with ROI, could explain this lack of reproducibility. At the present, dynamic MR is therefore not able to quantitatively evaluate the renal function. Only a semi-quantitative estimation of tubular concentration can be deduced. PMID- 2782832 TI - Value of plain chest film in predicting traumatic aortic rupture. AB - Plain chest film performed after blunt chest trauma showed blurring of the left pulmonary hilum in 53% of cases of traumatic aortic rupture (Group A, n = 15), and in no cases with negative aortography (Group B, n = 10). This sign can be explained by diffusion of mediastinal hemorrhage through the peri-bronchovascular connective tissue; the close relationship between aortic isthmus, the side of most frequent rupture, and the left pulmonary hilum is the anatomical basis for this asymmetrical finding. Review of all radiological alterations of the plain chest film shows a statistically significant difference between groups A and B only for mediastinal widening and aortic knob alterations (p less than 0.05). A combination of some findings due to aortic injury (mediastinal widening, aortic knob alterations, shift of trachea and left main bronchus, left apical cap, left hilar blurring, obscuring of descending aorta) was typical of aortic rupture when four or more signs were found (33%); these findings were absent only in patients with negative aortogram (8%). In the remaining cases (60%), the plain chest film showed two or three of these signs in both groups, making it impossible to differentiate between patients with and without aortic injury. PMID- 2782833 TI - [Radiologic aspects of pneumonectomies]. AB - Pneumonectomy is very important in the treatment of bronchial cancer and is responsible for considerable changes in thoracic images. A study based on 28 pneumonectomy cases has enabled us to define the normal radiographic and scanographic features of pneumonectomy sites as well as the main specific complications. Primary follow-up consists of standard X-rays, while computed tomography allows a good analysis of the anatomical course. Computed tomography is also useful in late medical follow-up, especially when a recurrence is noticed clinically. PMID- 2782834 TI - [Total abdominal radiotherapy in epithelial cancer of the ovary]. AB - The prognosis of ovarian cancers, which are frequently diagnosed at a late stage, can probably be improved by whole abdominal radiotherapy. 45 patients in Lyon and 8 patients in Montelimar (7 stage I or C, 10 stage II and 36 stage III) were treated by whole abdominal radiotherapy, generally after 6 courses of chemotherapy (46 cases). The overall 5-year survival of this group of patients was 48% (Kaplan-Meier method). When the patients treated by complete resection at 1st look surgery (19 cases) are compared with those in whom 1st look surgery was incomplete (34 cases), the actuarial survival was 83% versus 27%. This study demonstrates that whole abdominal radiotherapy is feasible without any serious long-term complications after two operations and 6 courses of chemotherapy. These encouraging results need to be confirmed by randomised prospective studies. PMID- 2782835 TI - [Effects of radiotherapy on the course of cerebral metastases: contribution of x ray computed tomography]. AB - The clinical and radiological responses after irradiation of brain metastases were compared in 50 patients. A complete response as evidenced by CT scan was achieved in 11 patients, whereas a clinical complete response was observed in 16 cases. There was only 35% agreement between the clinical and the radiological responses. In terms of patient survival, those in whom complete radiological response was obtained has a significantly longer survival time (p = 0.004). Therefore, in evaluating the treatment of brain metastases, it is preferable to determine both the clinical and the radiological responses. The latter seems to be more accurate and justifies the use of repeated CT scans in the follow-up of these patients. PMID- 2782836 TI - [Post-traumatic dissecting aortic aneurysm in adolescents]. AB - The authors report a case of chronic post-traumatic dissecting aneurysm associated with myocardial contusion in a 13 year old adolescent. They stress the rarity of this condition in children and discuss the diagnostic contribution of various imaging techniques. PMID- 2782837 TI - [Celiac neurolysis. Anterior approach and x-ray computed tomographic guidance: a simple and logical technic]. AB - Two cases of celiac plexus neurolysis under CT guidance by an anterior approach are reported. This technique was performed on two patients who complained of epigastric pain due to a pancreatic carcinoma. Alcoholization was performed with 50 cc of a 50% solution of ethyl alcohol. The tip of the needle was located just above the origin of the coeliac axis in front of the aorta. In the two cases the block was successful, leading to suspension of morphine administration. Computed tomography scans after injection showed that the space of diffusion corresponds to the presumed location of the celiac plexus and confirms that the anterior approach is valid providing that a sufficient dose is injected. This technique, can be easily performed and deserves a more important place in the management of pancreatic pain. PMID- 2782838 TI - The economics of dentistry continue to improve into the second half of the 1980's. AB - A review of federal agency and American Dental Association reports reveals a consistent favorable picture of dental economics into the second half of the 1980's. It's unanimous - the economics of dentistry continue to improve through the 1980s. That's the result of reports from the Internal Revenue Service, the Bureau of the Census, the Health Care Financing Administration (HCFA), the Department of Labor and the American Dental Association. And these reports of improving economic developments forms of dental practice. But most important, projections through the year 2000 from the Health Care Financing Administration continue this favorable chorus. PMID- 2782839 TI - Xeroderma pigmentosum--report of four cases. AB - Four typical cases of Xeroderma Pigmentosum (XP) showing involvement of skin, eyes and oral mucous membrane are described. History of consanguinity was found in two cases. However, family history of XP was seen in only one case. The disease is often fatal before age of 10, but longevity in our patients is interesting. PMID- 2782840 TI - Infectious mononucleosis first manifest by pericoronitis: two case reports. AB - Two cases of infectious mononucleosis first presenting with pericoronitis are described. Resistant or unexplained oral symptoms, for example resistant bilateral pericoronitis as in our cases, should alert the dental practitioner to the possibility of IM. PMID- 2782841 TI - Ossifying fibroma of the maxillary sinus: a case report. AB - A case of ossifying fibroma of the maxillary sinus that occurred in a 45-year-old white female is reported. The lesion's radiographic, histologic and clinical behavior are examined. The clinical and radiographic features of ossifying fibroma distinguish it from monostatic fibrous dysplasia despite histologic similarities. The uncommon location of this ossifying fibroma in the maxillary sinus accounts for its large size, aggressive behavior and widespread osseous destruction. The prognosis is excellent after complete enucleation of the ossifying fibroma has been achieved. The benign fibro-osseous lesions of the jaws share similarities in radiographic and clinical appearance, histogenesis and histopathology, and consequently, pose difficulty in classification and treatment. Common histologic features of these lesions include an active proliferation of fibroblats, young and mature collagenous connective tissue, focal areas of mineralization which may resemble small cemeticles and/or irregular bone trabeculae, and multinucleated giant cells. Differential diagnosis of benign fibro-osseous lesions can therefore be made if clinical behavior, radiographic features, and hematologic changes are correlated with the histologic picture. Representatives of this group include true fibrous dysplasia, ossifying fibroma (both central and peripheral types), osteoid osteoma, osteoblastoma, cementifying fibroma, florid osseous dysplasia, proliferative periostitis of Garre, focal sclerosing osteomyelitis and osteitis deformans (Paget's disease). PMID- 2782842 TI - Angiolipoma of the tongue: report of a case. AB - Angiolipoma is a rare variety of lipoma in the maxillofacial region. Only eight cases have been documented so far. A case in which an angiolipoma occurred within the tongue of a 49-year-old man is described here. The difference from earlier cases occurring in the tongue is noted. Close follow-up has, as yet, revealed no recurrence. PMID- 2782843 TI - Erythema multiforme following cardizem therapy: report of a case. AB - A 63-year-old male developed severe, painful ulcerations shortly after beginning therapy for angina with diltiazem (Cardizem). Erythema multiforme is a common adverse reaction to medications. The case report, as well as the role of the dentist in diagnosis and management of these clinical presentations, is discussed. PMID- 2782844 TI - Normal values for range of shoulder abduction in men and women aged over 65 years. AB - The range of movement of the shoulder in abduction at 45 degrees of flexion was objectively measured using a standard technique in a demographically representative survey of 1000 men and women living in their own homes. Sampling was stratified to obtain approximately equal numbers of those aged 65-74 years and those aged 75 and over. The response rate was 80%. Normal values for shoulder abduction grouped by age and sex are presented as frequency distributions, means and deciles. Information about health problems was also recorded in the survey; the prevalences of these problems and their associations with shoulder abduction have been investigated. Women had significantly lower values for shoulder abduction than men. For both sexes values were on average about 30 degrees lower than those found in younger adults, and about half of the elderly group had values below 120 degrees. The prevalence of specified health problems was high with only 3% of the older group and 6% of the younger group being free from all the specified health problems. There was a significant independent negative association between shoulder abduction and both age and reported health. The associations were more marked in women than in men. This was so for both a cumulated 14-item health index and selected individual health items which included arthritis, lack of mobility and incontinence. The decile values for shoulder abduction for women without these health problems are presented. This provides more appropriate normal data for them; it is more normally distributed and reduces the percentage with a shoulder abduction less than 120 degrees to 30%.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2782845 TI - Mitochondrial antigenic structure and enzyme activity in ageing human diploid fibroblasts. AB - It has been proposed that cellular ageing may be caused by loss of mitochondrial function due to the action of free radicals. To investigate this hypothesis, antigenic structures of the mitochondrial inner membrane/matrix and of the outer mitochondrial membrane of human diploid fibroblasts were monitored by immunoblotting at four stages during cellular lifespan in vitro. At the same time, specific activities of the enzymes oligomycin-sensitive ATPase (O-S ATPase), malate dehydrogenase (MDH) and glutamate dehydrogenase (GDH) were assayed to assess the functional capacity of cellular oxidative phosphorylation and of the tricarboxylic acid cycle. No changes were found with ageing in inner mitochondrial membrane-associated matrix components, or in the activities of O-S ATPase and MDH. However GDH activity increased significantly with ageing in vitro, possibly indicating greater amino acid utilization for energy production in older cells. There was loss of an outer mitochondrial membrane antigen, of approximate molecular weight 60 kilodaltons (kDa), in the oldest cells tested, which may influence outer membrane transport capacity late in the cellular lifespan. Overall, the results fail to provide support for the hypothesis that ageing primarily results from free radical-induced impairment of mitochondrial function. PMID- 2782846 TI - Heart-rate variation, age, and behaviour in elderly women. AB - Minute-by-minute heart-rate recordings over a period of 24 hours were obtained once for each of a group of 29 elderly women, 14 of whom lived in private accommodation, and 15 of whom lived in institutionalized homes for the aged. Activity diaries were kept on the subjects during the measurement period. A comparison of individual 24-hour profiles, diaries, and group averages was made. Strong positive correlations were found in both groups between average waking and sleeping heart-rates, and between the standard deviations of the two periods. A marked predominance of sedentary activities among the institutionalized women was found to correspond with lower waking heart-rates, and flatter 24-hour profiles. However, these characteristics could also be explained as an age effect. Cosinor analysis indicates that, for the majority of these subjects, a curve made up of a combination of two periodic components with maxima around midday and 8 pm affords a reasonable representation of diurnal variation. PMID- 2782847 TI - The adolescent growth spurt of height among rural Indian boys in relation to childhood nutritional background: an 18 year longitudinal study. AB - The Adolescent Growth Spurt (AGS) was studied in rural Hyderabad boys of 5+ years of age with known childhood nutritional background. Longitudinal data on height measurements of pre-school children available for 13 to 16 points of follow-up, during an 18 year period of study (i.e., from 1965-66 to 1983-84) were utilized for this purpose. A Preece and Baines model 1 (PB 1) function was fitted for height measurements of 323 boys aged 19-24 years in 1984. The boys were classified into three groups according to degree of under-nutrition at the age of 5+ years, using Boston reference values for height. Boys with severe height deficit at age 5+ were considered to have had a background of severe undernutrition and were referred as Group III. Boys with normal range height measurements at age 5+ were considered to have a normal nutritional background and were referred to as Group I. Group II boys had height deficits in between the above two groups and were considered to have milk to moderate undernutrition backgrounds. Group I boys had similar timing, intensity, duration of Adolescent Growth Spurt Period (AGSP) and gained a similar amount of height during puberty as did British boys. Group III boys differed significantly from British boys for AGS. They entered late into puberty, with significantly depressed intensity, but gained a similar amount of height, as a result of prolonged AGSP, which continued till 19.2 years. Thus a childhood background of undernutrition did not lead to any additional deficit in height during puberty. However, pre-pubertal height deficits were carried into adult height. The growth curves of rural Hyderabad children were parallel to the British distance height curve after 12 years of age. The mean constant height velocity curve of group I boys was superimposable on the British curve during puberty. PMID- 2782848 TI - Some multivariate tests for differences in sexual dimorphism between human populations. AB - Two multivariate statistical tests are presented for examining differences in sexual dimorphism between human populations. One test refers to general differences in sexual dimorphism; the other, only to differences in size aspects of sexual dimorphism. There is no current resolution to the complementary problem of testing for differences of direction in sexual dimorphism. By applying the tests to a comparison of sexual dimorphism in 26 samples of skulls from a world wide distribution of human populations, significant results (at alpha = 0.05) were found in the majority of cases with the general test, and in a minority of cases with the size test. PMID- 2782849 TI - Breast feeding and post-partum amenorrhea in Serere women in Senegal. AB - The duration of post-partum amenorrhea and of breast-feeding was studied in a population of Serere people in Senegal, using an actuarial method. The use of the Cox method enabled us to show a positive correlation between these two factors and a negative correlation between the duration of amenorrhea, the survival of the breast-fed child, and the weaned status of the child. The characteristics of the diet of these sedentary women were similar to those found for amenorrheic American marathon runners. Given the results of other studies of African populations, these observations are discussed in the light of recent models of gonadotrophic involvement in the possible regulatory mechanisms in women who breast-feed for long periods whilst having an energy balance which is close to zero or even negative. PMID- 2782850 TI - Genetic differentiation among four groups of fishermen of the eastern coast, India. AB - The four endogamous groups of fishermen living around the city of Puri, located on the eastern coast of India, were studied for blood groups, red cell enzymes and serum proteins (11 loci). Only 1.3% of the total diversity among the groups studied is due to differences between them (GST = 0.013). The genetic distances between populations were estimated using Edwards and Cavalli-Sforza's method. The pattern of genetic distance reflects the geographical distribution of these groups. In general, these observations support the patterns of variation based on anthropometric and dermatoglyphic variables. PMID- 2782851 TI - Effects of early maturation on fetal growth. AB - While the association of young maternal age with low birthweight (LBW) is well known, the contribution of early menarche to this association has never been studied. We examined the effects of early menarche (less than or equal to 11 years) on LBW and its two major underlying causes: pre-term delivery and smallness-for-gestational-age (SGA). Results represent a narrow chronological age range, 17-18 years, of a larger geographically based cohort of 2789 pregnant adolescents. Adjusted odds ratios (AOR) indicated that early menarche was significantly associated with an increased risk of LBW which was specific to SGA. The attributable risk of SGA with early menarche exceeded 20%. Early age at menarche is also correlated with an earlier onset of sexual activity, pregnancy, and childbearing. Consequently, adolescents with early menarche are over represented in a sample limited to young gravidae or a sample that contains a stratum of young gravidae. This may have previously obscured the effects or early menarche on foetal growth and attributed them to a more frequently measured characteristic, young maternal age. Thus, effects of secular change in age at menarche may not be wholly benign. Improvements in maternal fertility and nutritional status appear to be offset by intrauterine growth retardation in the offspring. PMID- 2782852 TI - Age at menarche and postmenarcheal growth in rural Bangladeshi females. AB - This study examines the role of chronological age and time since menarche (TSM) as determinants of postmenarcheal growth in height and weight in a chronically malnourished population of rural Bangladeshi females aged 10-20 years. Height and weight measurements were collected for 12 months from 290 postmenarcheal girls, with known times since menarche, and on 118 girls who reached menarche during the one year follow-up. Two stage regression analysis was employed to study the relationship of age and time since menarche to postmenarcheal growth in height and weight, while adjusting for socioeconomic status. TSM is a more important determinant of postmenarcheal growth in height and weight than is age. For postmenarcheal growth in weight, the regression coefficient for TSM is six times greater then the coefficient for age. The effect of TSM was twice as strong as the age effect for postmenarcheal growth in height. Age has a statistically significant negative influence on statural growth and weight gain, but its practical effect on weight gain is small. An interaction between TSM and age suggests that TSM does not have the same implications for biological maturity for all ages at menarche. Findings demonstrate that Bangladeshi adolescents are still in active growth in height and weight into their late teens and past 20 years in some girls. This extended growth period may pose increased health risks to young mothers and their offspring. PMID- 2782853 TI - Principal component analysis of shape variables in adult individuals. AB - Human body shape variables were obtained by adjusting 34 distances between trunk/limbs, and head/face, landmarks, for an overall appropriate body size measurement. The adjustment was based on regression analysis. Principal component analysis was applied to thus defined shape variables to obtain shape dimensions in 99 normal adult males and 103 females. The first principal component either for trunk/limbs shape variables, or for head/face variables (considered separately in the analyses) is similar in both sexes in that it represents relative proportions between trunk and limb lengths and widths, and between midfacial lengths and widths, respectively. However there are appreciable differences in the succeeding components. The problem of interpretation of body shape dimensions, especially those accounting for less than 20% of the sample variance, as well as difficulties in assessing the biological meaning of dependence structures determined by principal component analysis in humans, are discussed. PMID- 2782854 TI - Population and biochemical genetics of the human mitochondrial malic enzyme. AB - The phenotypic variation of the mitochondrial malic enzyme (MEM) was examined in 121 brains and 46 heart tissue samples from the population of north-east England. There was no difference in gene frequency distribution between sexes and the two tissues. However, a significant variation has been observed in males compared with a Scottish study. The three common phenotypes of brain were partially purified on a DEAE Sephadex column. The kinetics, heat stability and dicumarol inhibition studies show no biochemical advantage for any of the phenotypes in human brain. The extensive polymorphism of MEM suggests a possible, yet unknown, selective factor for the spread of this polymorphism. With the existing evidence of regional and racial differences, the role of random genetic drift cannot be ruled out. PMID- 2782855 TI - 2nd European Symposium on Purine and Pyrimidine Metabolism in Man. Gut Ising/Chiemsee, September 5-8, 1989. Abstracts. PMID- 2782856 TI - Antibiotic susceptibilities of two Coxiella burnetii isolates implicated in distinct clinical syndromes. AB - Antibiotic susceptibility testing of two isolates of the Q-fever agent, Coxiella burnetii, was performed with recently and persistently infected L929 fibroblast cells. The two genetically distinct isolates, Nine Mile and Priscilla, are implicated in two different clinical disease syndromes, acute and chronic Q fever, respectively. We compared the efficacies of rifampin, doxycycline, and five 4-quinolone compounds (ciprofloxacin, difloxacin, ofloxacin, norfloxacin, and pefloxacin) in reducing persistent C. burnetii infection of L929 fibroblasts. In persistently infected cells, the Priscilla isolate was less susceptible to all antibiotics tested when compared with the Nine Mile isolate. The most effective antibiotics against the Priscilla isolate were ofloxacin, pefloxacin, and ciprofloxacin (50% inhibitory concentrations of 0.5, 2.2, and 2.5 micrograms/ml, respectively). In persistently infected cells, the Nine Mile isolate was highly susceptible to all antibiotics tested except doxycycline. In contrast, the Priscilla and Nine Mile isolates in recently infected cells were somewhat susceptible to doxycycline; the Priscilla isolate was significantly more susceptible to ofloxacin and rifampin in recently infected host cells than in persistently infected cells. Persistently infected L929 cells were also treated with antibiotic combinations. Although ciprofloxacin and doxycycline had no synergistic effect on the Priscilla isolate, ciprofloxacin and rifampin acted synergistically. Collectively, these in vitro results are in accord with the fact that chronic Q fever in humans is generally not successfully managed with antibiotics. They also indicate that early diagnosis may be essential and that combination antibiotic therapy that includes quinolones may be effective in treating chronic Q fever. PMID- 2782857 TI - In vitro activities of a dual-action antibacterial agent, Ro 23-9424, and comparative agents. AB - The in vitro activity of the dual-action antibacterial agent Ro 23-9424 was compared with those of cefotaxime, ceftazidime, ciprofloxacin, fleroxacin, imipenem, and amikacin against 358 aerobes and anaerobes. The MIC ranges, MICs for 50 and 90% of the strains (MIC50s and MIC90s), and percentage of strains susceptible for each agent at the recommended susceptible MIC breakpoint were determined for each genus. The MIC90s (micrograms per milliliter) of the agents against members of the family Enterobacteriaceae were as follows: ciprofloxacin, 0.063; Ro 23-9424, fleroxacin, and imipenem, 0.5; ceftazidime, 2; amikacin, 4; and cefotaxime, 16. The MIC90s (micrograms per milliliter) against Pseudomonas and Acinetobacter spp. were as follows: ciprofloxacin, 2; ceftazidime and imipenem, 8; Ro 23-9424, 16; fleroxacin, 32; amikacin, 64; and cefotaxime, 128. Against gram-positive bacteria, excluding the enterococci, the MIC90s (micrograms per milliliter) were as follows: ciprofloxacin, 1; imipenem, 4; Ro 23-9424 and fleroxacin, 8; amikacin, 64; and ceftazidime and cefotaxime, greater than 128. Against gram-positive bacteria, including the enterococci, the MIC90s changed only for the following agents: Ro 23-9424, 16 micrograms/ml; and amikacin, 128 micrograms/ml. Strains of Branhamella catarrhalis, Haemophilus influenzae, and Neisseria gonorrhoeae were 100% susceptible to Ro 23-9424, cefotaxime, ciprofloxacin, and fleroxacin, while the other three agents showed somewhat less activity only against N. gonorrhoeae. Against anaerobes, imipenem was the most effective agent, while the activities of the other six agents were variable. PMID- 2782858 TI - Penetration of doxycycline into cerebrospinal fluid in patients treated for suspected Lyme neuroborreliosis. AB - Twelve patients were treated orally with 100 mg of doxycycline twice a day (b.i.d.) and 10 patients were treated with 200 mg b.i.d. for suspected tick-borne neuroborreliosis (Lyme borreliosis). At 5 to 8 days after the start of therapy, the mean concentrations in serum were 4.7 micrograms/ml for the doxycycline dose of 100 mg b.i.d. and 7.5 micrograms/ml for 200 mg b.i.d., 2 to 3 h after the last drug administration. The corresponding levels for cerebrospinal fluid were 0.6 and 1.1 micrograms/ml. Since a doxycycline concentration in cerebrospinal fluid above the estimated MIC for Borrelia burgdorferi (0.6 to 0.7 microgram/ml) is wanted in patients treated for severe neuroborreliosis, the higher dose is preferable. PMID- 2782859 TI - Crystal and molecular structure of the antimalarial agent enpiroline. AB - To identify common spatial and structural features of amino alcohol antimalarial agents with the eventual goal of designing more effective drugs and a better understanding of the mechanism of action of this class of antimalarial agents, the three-dimensional crystal and molecular structure of enpiroline, a new antimalarial agent active against chloroquine-resistant Plasmodium falciparum, was determined by X-ray crystallography and compared with the crystal structures of the cinchona alkaloids and of the new antimalarial agent WR 194,965. The aromatic rings of the phenyl-pyridine ring system of enpiroline are twisted from each other by approximately 18 degrees. The intramolecular aliphatic N-O distance in enpiroline was 2.80 A (1 A = 0.1 nm), which is close to the N-O distance found in the antimalarial cinchona alkaloids. Enpiroline contains both an intramolecular hydrogen bond between the aliphatic nitrogen and oxygen atoms and an intermolecular hydrogen bond between the aliphatic nitrogen and oxygen atoms of two neighboring molecules. One enantiomer of enpiroline superimposed best with quinine, and the other enantiomer of enpiroline superimposed best with quinidine, suggesting that both enantiomers of enpiroline possess antimalarial activity. Since a common feature of the crystal structures of the amino alcohol antimalarial agents is the formation of intermolecular hydrogen bonds, the common spatial direction of hydrogen bond formation indicates the potential ability of these antimalarial agents to bind to a common receptor site. The crystallographic parameters were as follows: C19H18F6N5O; Mr = 404.3; symmetry of unit cell, monoclinic; space group, P2(1)/a; parameters of unit cell---a = 9.454 +/- 0.004 A, b = 18.908 +/- 0.008 A, c = 10.300 +/- 0.004 A, and beta = 96.55 +/- 0.03 degrees: V (volume of unit cell) = 1829.2 A3; Z (number of molecules per unit cell) = 4; Dchi (calculated density) = 1.46 g cm-3; source of radiation, CuK alpha (lambda = 1.54178 A); mu (absorption coefficient) = 11.49 cm-1; F(000) (sum of atomic scattering factors at zero scattering angle) = 832; room temperature; final R = 8.7% for 1,798 reflections with [F0] > 3 sigma. PMID- 2782860 TI - Penetration of cefuroxime into ventricular fluid in cerebrospinal fluid shunt infections. AB - The penetration of intravenously administered cefuroxime into ventricular fluid was assessed in five pediatric patients with ventriculoperitoneal shunt infections and in one with a ventriculostomy infection. Patients received a total dose of 200 to 230 mg of cefuroxime per kg of body weight per day administered at 8-h intervals. Levels of cefuroxime in ventricular fluid ranged from 1.6 to 22.5 micrograms/ml and were associated with cerebrospinal fluid bactericidal titers ranging from less than 1:2 to 1:16 against infecting staphylococcal isolates. Five infections were cured with cefuroxime monotherapy. On the basis of MIC data, one patient had vancomycin substituted for cefuroxime and the infection was cured. PMID- 2782861 TI - Penicillin susceptibility of Streptococcus pneumoniae in a private pediatric hospital in Houston, Texas. AB - Of 493 isolates of Streptococcus pneumoniae, 14 were found to have decreased penicillin susceptibility as determined by the oxacillin disk test. Of these 14 isolates, 4 were relatively resistant by quantitative susceptibility studies and 1 was penicillin resistant (MIC, 2 micrograms/ml). This is the first confirmed penicillin-resistant isolate in the Houston, Tex., area. PMID- 2782863 TI - Orosensory suppression of saccharin drinking in rat: the response, not the taste. AB - Hungry rats drink saccharin solutions with avidity, but the ingestion is self limited: rate of lapping slows down progressively. Since postingestive changes do not produce this suppression, it must depend on a feedback signal generated by lapping the fluid. We show that the suppression depends on the number of laps emitted, not on the taste of the fluid; a given number of laps early in the session produces the same suppression later in the session, whether those early laps are accompanied by a moderate saccharin taste, a weak taste, or no sweet taste at all. Therefore, the feedback signal is provided by the act of lapping; taste does not contribute to it. Yet taste does influence amount ingested. Perhaps it provides a feed-forward signal, that in turn sets the amount of feedback required to end the bout. PMID- 2782862 TI - Permeability and penicillin-binding protein alterations in Salmonella muenchen: stepwise resistance acquired during beta-lactam therapy. AB - A patient with Salmonella muenchen sepsis was unsuccessfully treated with ampicillin. During therapy, four strains that showed stepwise ampicillin resistance and affected other beta-lactams and unrelated antibiotics were isolated sequentially. Resistance was caused by decreased outer membrane permeability associated with diminished expression of porin OmpF. Furthermore, the most resistant isolate overproduced the PBP 3 target molecule. PMID- 2782864 TI - Intake of greasy diets in hypothalamic obesity: a re-assessment. AB - Rats with medial hypothalamic lesions are known to prefer greasy diets. Past research has suggested that this is based on the oily texture rather than caloric content of these foods. We have re-examined this appetite in rats with bilateral parasagittal knife-cuts between the medial and lateral hypothalamus. Following knife cuts vs. sham surgery, the body weight and food consumption of adult female rats were monitored during four experimental phases. During the first month post surgery rats were fed powdered Chow (3.61 kcal/g) and showed the usual hyperphagia and obesity. Each group was then subdivided and fed either a high-fat diet (5.5 kcal/g) or a similarly greasy mineral-oil diet (3.61 kcal/g) for a second month. The knife-cut group fed high-fat showed significantly higher intake than both sham-cut controls and knife-cut rats fed the mineral-oil diet. The latter group showed only a non-significant feeding increase over controls. Following a third month when all groups again received Chow, animals were given the opposite greasy diet for a final month. Knife-cut rats previously fed the high-fat diet showed significant overeating of the mineral-oil diet and defended their obesity, while those fed the mineral-oil free diet first now showed significant hyperphagia and obesity on the high-fat diet. Across both target phases (months 2 and 4) knife-cut rats always ate significantly more of the high fat diet than of the mineral-oil diet. The latter only elicited hyperphagia in animals that had been previously exposed to the high-fat diet. These findings suggest that the hyperphagic response to greasy foods relatively low in calories and digestible fats by rats with hypothalamic injury is a function of prior experience with the sensory and/or metabolic consequences of having first eaten highly caloric fatty foods. If that is true, it may be that such animals are capable of learning positive food-associated cues in addition to negative ones (i.e. enhanced taste aversions) documented earlier by other investigators. PMID- 2782865 TI - Obesity, adipose tissue distribution and health in men--the study of men born in 1913. AB - Recent studies suggest that cardiovascular disease is associated with abdominal distribution of adipose tissue rather than obesity in terms of total body fat. A number of other variables, known to be associated with obesity, were therefore examined in a cohort of randomly selected middle-aged men in relation to abdominal distribution of adipose tissue, measured as the ratio of the circumferences of the waist and hips (WHR), as well as to degree of obesity, measured as body mass index (BMI). These variables included anthropometric variables, cardiovascular risk factors as well as socioeconomic factors and physical health. Increased WHR, independent of BMI, was negatively associated with height, and hip circumference. Positive associations were found with blood pressure, cholesterol, triglycerides, fibrinogen and smoking. In addition positive associations were found with low social class and social group, illness in terms of sick leave, frequent use of health facilities such as X-rays, as well as diseases such as peptic ulcer. In sharp contrast to this, BMI, independent of WHR, was not associated with physical health variables or social class. Generalized obesity seemed to be associated with good health in the variables measured. There were positive associations to various anthropometric variables, including lean body mass. High BMI was also associated with elevated blood pressure and triglycerides. Several of the indicators of poor health traditionally associated with obesity thus do not seem to be characteristic for obesity in middle-aged men selected at random from the population but rather for an abdominal fat distribution, independent of obesity. PMID- 2782866 TI - Responses of lean and obese subjects to preloads, deprivation, and palatability. AB - The effects of preloads, deprivation, and palatability on the eating behavior of non-dieting lean and obese subjects were studied during laboratory meals, using small solid food units (SFUs) to measure the rate of ingestion over the time course of the meals. In both weight groups, rate of intake decreased from the beginning to the end of meals. The smaller the preloads and the longer the deprivation interval, the faster subjects ate at the beginning of meals and the higher their hunger ratings were. The longest deprivation interval also increased palatability ratings, meal length, and the total amount that subjects ate. Increasing the palatability of the food increased the rate of intake at the beginning of meals, meal length, and the amount of food that subjects ate. Obese subjects were more sensitive to palatability and less responsive to deprivation than lean subjects. For example, while lean subjects became less discriminating about the palatability of the food at the beginning of meals as deprivation increased, obese subjects did not. The satiation mechanism of obese subjects was also different from lean subjects. For example, obese subjects overate after preloads while lean subjects underate compared to their baselines. PMID- 2782867 TI - Perception of appetite and weight change during treatment for depression. AB - As part of the Pittsburgh Appetite Test, 50 depressed outpatients reported their perceptions of appetite and weight change prior to and during chronic treatment with imipramine and psychotherapy. At the end of 4 months, as a group, patients were significantly more conscious of what they were eating, and reported a significant change in the frequency of regular meal consumption. No group changes were noted in frequency of snacking or late night eating, although weight change during treatment and obesity status modified these responses. Clinical response was unrelated to eating behavior. Perception of weight change varied with treatment: a 5 pound weight gain became highly problematic during recovery compared to the depressive episode. The interaction of these factors and antidepressant-induced weight gain are discussed. PMID- 2782868 TI - Plasmid expression and maintenance during long-term starvation-survival of bacteria in well water. AB - Strains of enteric bacteria and pseudomonads containing plasmid R388::Tnl721 (Tpr, Tcr) or pRO101 (Hgr, Tcr) were starved for over 250 days in sterile well water to evaluate effects of starvation-survival on plasmid expression and maintenance. Viable populations dropped to between approximately 0.1 and 1% of the initial populations. Escherichia coli(pRO101) and Pseudomonas cepacia(pRO101) lost both viability and plasmid expression at a lower rate than strains containing R388::Tnl721. Three patterns of host-plasmid interaction were detected: (i) no apparent loss of plasmid expression, (ii) loss of plasmid expression on initial recovery with subsequent expression upon resuscitation, and (iii) loss of capability to produce functional plasmid resistance. PMID- 2782870 TI - Antibacterial activity of Lactobacillus sake isolated from meat. AB - A total of 221 strains of Lactobacillus isolated from meat and meat products were screened for antagonistic activities under conditions that eliminated the effects of organic acids and hydrogen peroxide. Nineteen strains of Lactobacillus sake, three strains of Lactobacillus plantarum, and one strain of Lactobacillus curvatus were shown to inhibit the growth of some other lactobacilli in an agar spot test; and cell-free supernatants from 6 of the 19 strains of L. sake exhibited inhibitory activity against indicator organisms. Comparison of the antimicrobial spectra of the supernatants suggested that the inhibitory compounds were not identical. One of the six strains, L. sake Lb 706, was chosen for further study. The compound excreted by L. sake Lb 706 was active against various lactic acid bacteria and Listeria monocytogenes. Its proteinaceous nature, narrow inhibitory spectrum, and bactericidal mode of action indicated that this substance is a bacteriocin, which we designated sakacin A. Curing experiments with two bacteriocin-producing strains of L. sake resulted in mutants that lacked both bacteriocin activity and immunity to the bacteriocin. Plasmid profile analysis of L. sake Lb 706 and two bacteriocin-negative variants of this strain indicated that a plasmid of about 18 megadaltons may be involved in the formation of bacteriocin and immunity to this antibacterial compound. In mixed culture, the bacteriocin-sensitive organisms were killed after the bacteriocin-producing strain reached maximal cell density, whereas there was no decrease in cell number in the presence of the bacteriocin-negative variant. PMID- 2782869 TI - Comparison of Vibrio parahaemolyticus grown in estuarine water and rich medium. AB - Cell envelope composition and selected physiological traits of Vibrio parahaemolyticus were studied in regard to the Kanagawa phenomenon and growth conditions. Cell envelopes were prepared from cells cultured in Proteose Peptone beef extract (Difco Laboratories, Detroit, Mich.) medium or filtered estuarine water. Protein, phospholipid, and lipopolysaccharide contents varied with culture conditions. The phospholipids present in the cell envelopes were identified as phosphatidylethanolamine, phosphatidylglycerol, and cardiolipin. Phosphatidylethanolamine decreased and phosphatidylglycerol increased in cells grown in estuarine water. Profiles of proteins separated by sodium dodecyl sulfate-polyacrylamide gel electrophoresis demonstrated numerous protein species, with four to six predominant proteins ranging from 26,000 to 120,000 in molecular weight. The profile of V. parahaemolyticus cell envelope proteins was unique and might be useful in the identification of the organism. Alkaline phosphatase activity was slightly higher in Kanagawa-negative strains and was higher in cells grown in estuarine water than in cells grown in rich laboratory medium. The DNA levels in estuarine water-grown cells increased, while RNA levels and cell volume decreased. Bacteriophage sensitivity typing demonstrated a close intraspecies relationship. Results indicated that Kanagawa-positive and -negative strains were closely related, but they could be grouped separately and may have undergone starvation-related physiological changes when cultured in estuarine water. PMID- 2782871 TI - Identification of Vibrio anguillarum in fish by using partial 16S rRNA sequences and a specific 16S rRNA oligonucleotide probe. AB - 16S rRNA from seven different Vibrio anguillarum strains was partially sequenced and compared. From this sequence information we could design a 25-base-long oligonucleotide and use it as a specific probe for identification of V. anguillarum. This was determined by RNA-DNA colony hybridization and slot-blot hybridization. Strong, specific hybridization to the probe was observed for all V. anguillarum strains tested. Furthermore, no cross-hybridization could be seen against five other bacterial species. The detection limit was 5 x 10(3) bacteria per ml. It was even possible to detect V. anguillarum, by slot-blot hybridization, directly in a homogenized kidney from a fish that had died of vibriosis. The partial sequence information revealed small but significant differences between strains of the same species. These sequence differences are sufficiently significant to allow serotyping on the RNA level. Comparing strains of different serotypes revealed a 10-base and an 11-base difference in V. anguillarum serotypes O8 and O9, respectively, in a 122-base partial sequence. PMID- 2782872 TI - Lyme disease and migrating birds in the Saint Croix River Valley. AB - During a study of migrating land birds in 1987, we examined over 9,200 individual birds representing 99 species from the Saint Croix River Valley, a Lyme disease endemic area of east central Minnesota and northwestern Wisconsin. We found that 250 deer tick (Ixodes dammini) larvae and nymphs infested 58 birds from 15 migrant species; 56 ticks (22.4%) were positive for the Lyme disease spirochete Borrelia burgdorferi. Five ground-foraging migrant bird species favoring mesic habitats, veery (Catharus fuscescens), ovenbird (Seiurus aurocapillus), northern waterthrush (S. novaboracensis), common yellowthroat (Geothlypis trichas), and swamp sparrow (Melospiza georgiana), accounted for nearly three-quarters of parasitized individuals. Nearly half of the spirochete-positive ticks were removed from migrating birds taken in a riparian floodplain forest. Recaptured migrants with infected ticks indicate that they transmit B. burgdorferi to hexapod larvae. We suggest that birds may be both an important local reservoir in the upper Mississippi Valley and long-distance dispersal agents for B. burgdorferi-infected ticks to other regions of the continent. PMID- 2782873 TI - Estimation of microbial densities from dilution count experiments. AB - Although dilution counts have been widely used in quantitative microbiology, their interpretation has always been widely discussed both in microbiology and in applied statistics. Maximum-likelihood (most-probable-number) methods hae generally been used to estimate densities from dilution experiments. It has not been widely recognized that these methods are intrinsically and statistically biased at the sample sizes used in microbiology. This paper presents an analysis of proposed method for correction of such biases, and the method was found to be robust for moderate deviations from Poisson behavior. For analyses at greater variance with the Poisson assumptions, the use of the Spearman-Karber method is analyzed and shown to yield an estimate of density of lesser bias than that produced by the most-probable-number method. Revised methods of constructing confidence limits proposed by Loyer and Hamilton (M.W. Loyer and M.A. Hamilton, Biometrics 40:907-916, 1984) are also discussed, and charts for the three- and four-decimal dilution series with five tubes per dilution are presented. PMID- 2782874 TI - Polycyclic aromatic hydrocarbon degradation by a Mycobacterium sp. in microcosms containing sediment and water from a pristine ecosystem. AB - Microcosm studies were conducted to evaluate the survival and performance of a recently discovered polycyclic aromatic hydrocarbon (PAH)-degrading Mycobacterium sp. when this organism was added to sediment and water from a pristine ecosystem. Microcosms inoculated with the Mycobacterium sp. showed enhanced mineralization, singly and as components in a mixture, of 2-methylnaphthalene, phenanthrene, pyrene, and benzo[alpha]pyrene. Studies utilizing pyrene as the sole added PAH showed that the Mycobacterium sp. survived in microcosms for 6 weeks both with and without preexposure to PAH and mineralized multiple doses of pyrene. Pyrene mineralization rates for sterilized microcosms inoculated with the Mycobacterium sp. showed that competition with indigenous microorganisms did not adversely affect survival of or pyrene degradation by the Mycobacterium sp. Pyrene mineralization by the Mycobacterium sp. was not enhanced by inorganic nutrient enrichment and was hindered by organic nutrient enrichment, which appeared to result from overgrowth of indigenous bacteria. This study demonstrates the versatility of the PAH-degrading Mycobacterium sp. and expands its potential applications to include the degradation of two-, three-, four-, and five-ringed PAHs in sediments. PMID- 2782875 TI - 31P nuclear magnetic resonance study of the effect of azide on xylose fermentation by Candida tropicalis. AB - Maximal ethanol production by Candida tropicalis grown on xylose was obtained at an oxygen transfer rate of 5 to 7 mmol/liter per h. Addition of 0.2 mM azide increased the ethanol yield by a factor of 3 to 4, based on the cell mass produced, and decreased the formation of the by-product xylitol by 80%. In the presence of azide, ethanol was reassimilated before the carbon source was depleted. At all oxygenation levels studied, azide caused 25 to 60% of the carbon to be lost, most probably as carbon dioxide. Identical spectra were obtained with 31P nuclear magnetic resonance spectroscopy performed on extracts of C. tropicalis grown on xylose in the absence and presence of azide. Azide lowered the levels of sugar phosphates. Enzymatic analysis showed extremely low levels of fructose 1,6-diphosphate compared with the levels obtained in the absence of azide, while the level of malate, a citric acid cycle intermediate, was not influenced by azide. 31P nuclear magnetic resonance spectroscopy performed on xylose-grown whole cells of C. tropicalis showed that azide lowered the intracellular pH, inhibited the uptake of external Pi, and decreased the buildup of polyphosphate in relation to results with untreated cells. Similar results were obtained with the uncoupler of oxidative phosphorylation carbonyl cyanide m chlorophenylhydrazone (CCCP), except that CCCP treatment led to extremely high levels of internal Pi. The dual effect of azide as a respiratory inhibitor and as an uncoupler is discussed with respect to the metabolism and product formation in xylose-assimilating C. tropicalis. PMID- 2782876 TI - Evaluation of media for monitoring fecal streptococci in seawater. AB - The selectivity of KF streptococcus agar (KF) for monitoring fecal streptococci (FS) in seawater was examined in 234 samples of Mediterranean water and compared with the selectivity of M-Enterococcus agar (M-Ent) for 124 samples and with bile esculin-azide agar (BEA) for 17 samples. KF was found to be unsuitable for marine water because Vibrio alginolyticus and other gram-negative bacilli indigenous to this environment grew well on it and produced red colonies identical to those of FS. In 26% of samples, some with high counts of red colonies on the membrane filters (MF), there were no streptococci, only gram-negative bacilli and staphylococci, and in an additional 23.1% the streptococci constituted less than 50% of the "typical" red colonies on the MF. V. alginolyticus also produced FS like colonies on MF incubated on BEA but was not isolated from MF incubated on M Ent. Although staphylococci grew and produced FS-like colonies on all three media, M-Ent was the most selective since no gram-negative bacilli were isolated from MF incubated on it. PMID- 2782877 TI - Heterotrophic nitrification by Alcaligenes faecalis: NO2-, NO3-, N2O, and NO production in exponentially growing cultures. AB - Heterotrophic nitrification by Alcaligenes faecalis DSM 30030 was not restricted to media containing organic forms of nitrogen. In both peptone-meat extract and defined media with ammonium and citrate as the sole nitrogen and carbon sources, respectively, NO2-, NO3-, NO, and N2O were produced under aerobic growth conditions. Heterotrophic nitrification was not attributable to old or dying cell populations. Production of NO2-, NO3-, NO, and N2O was detectable shortly after cultures started growth and proceeded exponentially during the logarithmic growth phase. NO2- and NO3- production rates were higher for cultures inoculated in media with pH values below 7 than for those in media at alkaline pH. Neither assimilatory nor dissimilatory nitrate or nitrite reductase activities were detectable in aerobic cultures. PMID- 2782878 TI - Ecology of Vibrio mimicus in aquatic environments. AB - An environmental study was done to examine the prevalence of Vibrio mimicus in some aquatic environments of Dhaka, Bangladesh, and of Okayama, Japan. Water samples from Dhaka environments and water and plankton samples from Okayama environments were quantitatively as well as qualitatively analyzed throughout the seasons for V. mimicus. The organism was isolated from Bangladesh environments throughout the year, whereas it was not isolated in Okayama when the water temperature fell below 10 degrees C. Samples with as many as 9.0 x 10(2) CFU of V. mimicus per 100 ml of water in Dhaka and 1.5 x 10(4) CFU of V. mimicus per 100 ml of water in Okayama were detected during the study period. V. mimicus was not found in any environment with an average salinity of 10% or more. Brackish environments with an average salinity of 4% were observed to be the optimal natural condition for the pathogen. Using the API 20E system with the conventional test methods, we observed variations in biochemical properties within the V. mimicus species. This study reveals the inefficacy of the API 20E system to identify a significant percentage of V. mimicus. Therefore, in addition to the API 20E system, a salt tolerance test and a string test are recommended for identification of this species. Susceptibility testing of strains isolated from Okayama environments showed higher resistance to ampicillin and susceptibility to trimethoprim-sulfamethoxazole when compared with environmental isolates of V. mimicus from Bangladesh. PMID- 2782879 TI - Improved assay for quantitating adherence of ruminal bacteria to cellulose. AB - A quantitative technique suitable for the determination of adherence of ruminal bacteria to cellulose was developed. This technique employs adherence of cells to cellulose disks and alleviates the problem of nonspecific cell entrapment within cellulose particles. By using this technique, it was demonstrated that the adherence of Ruminococcus flavefaciens FD1 to cellulose was inhibited by formaldehyde, methylcellulose, and carboxymethyl cellulose. Adherence was unaffected by acid hydrolysates of methylcellulose, glucose, and cellobiose. PMID- 2782880 TI - Expression of a Clostridium thermocellum endoglucanase gene in Lactobacillus plantarum. AB - Recombinant plasmid pM25 containing the celE gene of Clostridium thermocellum, which codes for an enzymatically active endoglucanase, was transformed into Lactobacillus plantarum by electroporation. Strains harboring pM25 expressed thermostable endoglucanase, which was found predominantly in the culture medium. Two other plasmids, pGK12 and pSA3, were transformed into L. plantarum, and the stability of each plasmid was evaluated. PMID- 2782881 TI - [5-FU intra-arterial infusion and simultaneous irradiation in the treatment of esophageal cancer and metastatic lung cancer]. AB - Precise 5-FU intra-arterial infusion and simultaneous irradiation are considered to reduce most tumors, with no functional disturbance occurring as a rule. We performed this therapy in 2 patients. One patient had lower esophageal cancer (T2N0M0) and the other had metastatic cancer of both lungs. We inserted a catheter into the lower periphery of the aortic arch via the left superficial temporal artery in the former patient, and into the upper thoracic aorta via the thyrocervical trunk in the latter patient, before infusing 5-FU together with simultaneous irradiation. Dysphagia disappeared and there was significant improvement of the esophagram, X-ray appearance, and endoscopic appearance in the former patient, who remains under observation. The latter patient showed remarkable regression of the tumor but died after a recurrence. Good efficacy is observed with the use of radiotherapy for the treatment of esophageal cancer at first. However, recurrences occur which carry a bad prognosis. The temporary favorable effect of radiotherapy suggests a promising future for this new therapy, since 5-FU is a strong radiosensitizer. We have a favorable impression of this mode of therapy in comparison with radiotherapy alone, though we have experience with only one patient. There was also a better response than expected when we used it for the treatment of metastatic lung cancer. PMID- 2782882 TI - [Preoperative continuous intra-arterial infusion chemotherapy as part of a local regional treatment of osteosarcoma of the extremities]. AB - Preoperative continuous intra-arterial chemotherapy combined with surgery in the treatment of osteosarcoma has been since 1968 in our clinic. Sixty-three cases with osteosarcoma of the extremities were evaluated in this study. Eighteen of these cases underwent limb salvage procedures. There were three intralesional, eleven marginal and four wide excision cases. From the standpoint of local failures, there were only two recurrent cases. One occurred after a marginal excision and the other after an intralesional excision. The 5-year cumulative survival rate for limb salvage cases was 56.0%, as compared with 40.6% of the amputation cases. Therefore we conclude that preoperative continuous intra arterial infusion chemotherapy is a very effective method as a local regional therapy for osteosarcoma of the extremities. PMID- 2782883 TI - [Post-operative intra-arterial chemotherapy in patients with malignant bone and soft tissue tumors]. AB - Fourteen patients with bone and soft tissue sarcoma were treated with post operative intra-arterial chemotherapy. Three drugs (Adriamycin, vincristine, carboquone or THP-adriamycin, cisplatin, vindesine) or two drugs (cisplatin, vindesine) were used post-operatively for patients with local recurrence, patients with poor response of pre-operative intra-arterial chemotherapy or patients with intra-lesional or marginal surgical margin. Of the 14 patients treated with post-operative intra-arterial chemotherapy, 8 (57.1%) were continuously disease-free (7.1%) were disease-free after treatment of lung metastasis, 2 (14.3%) had a local recurrence and/or multiple distant metastasis, and 3 (21.4%) died with multiple distant metastases. The rate of local recurrence was 14.3%. The Kaplar-Meier disease free survival curves showed 59.6%). Evaluation of limb function were excellent or good in 9 (69.2%) of 13 patients treated with limb-saving procedures. PMID- 2782884 TI - [Clinical study of platinum accumulation in gastric cancer after preoperative intra-arterial injection of cisplatin]. AB - In order to deliver a high concentration of CDDP in tumor tissue, we attempted to infuse CDDP intra-arterially for preoperative patients with resectable gastric cancer. Thirty-two patients (21 males and 11 females) were treated. The concentration of platinum was measured in cancer tissue, normal mucosa, lymph nodes without metastasis at the greater curvature. These were gathered operatively and in serum just before operation. The serum concentration of free CDDP was also measured. Student's-t test was performed with the data. After intra arterial injection of 60 mg CDDP, the mean concentration of platinum in cancer tissue was 1.11 +/- 0.45 microgram/g and after intravenous injection of 40 mg CDDP that was 0.30 +/- 0.11 microgram/g. After intra-arterial injection of 40 mg CDDP, the mean concentration of platinum in cancer tissue was 0.64 +/- 0.12 microgram/g, which was significantly higher than in normal gastric mucosa (0.27 +/- 0.06 micrograms/g) or serum (0.37 +/- 0.10 micrograms/ml) (p less than 0.025). The mean concentration of platinum in cancer tissue was higher than in the lymph nodes (0.45 +/- 0.10 micrograms/g), but there was no significant difference. In sera the concentrations of free-CDDP were all under the detectable limit. It was concluded that intra-arterial injection therapy of CDDP was an effective method to maintain a high concentration of CDDP in gastric cancer tissue. PMID- 2782886 TI - [Intraperitoneal chemotherapy in gastric cancer with peritoneal metastasis using totally implantable peritoneal access system]. AB - Fifteen patients with peritoneal metastasis of gastric cancer were treated with mainly ip-ETP (Etoposide: i.p., THP-ADM: i.v. and CDDP: i.p.) or other drugs by the use of a totally implantable peritoneal access system. In principle, intraperitoneal drug delivery was carried out every two weeks. CDDP was administered into the intraperitoneal cavity with intravenous sodium thiosulfate delivered simultaneously to protect against cisplatin-induced nephrotoxicity. RI scintigram showed that the intraperitoneal catheter was fully useful even six months after the operation. As a result, performance status has been improved in 12 out of 15 cases, and ascites disappeared in 3 out of 6 cases with same. Ten cases have been alive for more than 6 months after operation. There have been no severe complications (e.g., nephrotoxicity or myelosuppression) even in the cases treated at frequent intervals for more than 8 months. The findings in this study indicated that ip-ETP using totally implantable peritoneal access system is beneficial for advanced gastric cancer with peritoneal metastasis. PMID- 2782885 TI - [A 5-FU, ADR, MMC combined hepatic arterial infusion therapy in non-resectable liver metastases from colon and gastric cancer]. AB - Fifty-seven patients with non-resectable liver metastases (31 from colon cancer, 26 from gastric cancer) received 5-FU, ADR, MMC combined hepatic arterial infusion therapy. (FAMia: 5-FU 334 mg/m2 qw, ADR 20 mg/m2 q4w, MMC 2.7 mg/m2 q2w; in colon cancer, 5-FU 167 mg/m2/day continuously for 3 months and then 334 mg/m2 qw). Myelo-suppression, hepatic arterial occlusion, gastroduodenal toxicity and elevation of biliary enzyme were observed at 29%, 39%, 32% and 13% in colon cancer, respectively, and at 35%, 8%, 0% and 0% in gastric cancer, respectively. Response rates evaluated by CT-scan were 63% (1 CR + 18 PR/30) in colon cancer and 79% (4 CR + 15 PR/24) in gastric cancer. Overall median survival was 352 days in colon cancer and 449 days in gastric cancer. Concerning background factors, the response rate in the well-differentiated type of colon cancer was significantly higher than in the moderately differentiated type, and significantly low in poorly differentiated medullary type gastric cancer. The existence of extra-hepatic lesions was the most important factor in survival in both cancers. [colon cancer: (-) 740 days vs (+) 267 days; gastric cancer: (-) 517 days vs (+) 245 days]. In conclusion, this therapy yields favorable direct effects on liver metastases from colon and gastric cancer without major side effects and complications, but effective therapy of extrahepatic lesions is required for longer survival. Now, to release colon cancer patients from restrictions of continuous infusion pumps, a phase I study of weekly high dose 5 FU HAI therapy is under way. PMID- 2782888 TI - [Clinical efficacy of intratumoral administration of BRM in advanced cancer and their mechanism of actions]. AB - The clinical efficacy of intratumoral (IT) administration of BRM in 157 patients with unresectable or recurrent tumors was investigated, and the infiltration of lymphocyte subsets into tumor tissues after IT administration of BRM was immunohistologically examined, to analyse its action mechanism. BRMs used in this study were OK-432, tumor necrosing factor (TNF), whole peptide glucagon (WPG), interferon (IFN)-alpha, IFN-beta, IFN-gamma and interleukin-2 (IL-2). Among them, one hundred thirty-one patients were evaluable for clinical effects, and the therapeutic response rate (CR + PR) was determined in 11/131 (8.4%). Higher therapeutic responses were found in the patients with esophageal cancer, pancreatic cancer and breast cancer, respectively. As for the relationship between the clinical efficacy of IT administration of BRM and the injected sites, the injection into metastatic lesions was more effective than that into the primary or local recurrence. A increase of lymphocyte infiltration after IT BRM immunotherapy and a variety of lymphocyte subsets in tumor tissue injected with any BRMs were found immunohistologically. These results suggest that IT BRM immunotherapy may be effective for the control of tumor growth locally through host-mediated action. PMID- 2782887 TI - [Clinical efficacy of two-route chemotherapy with CDDP and STS in patients with peritonitis carcinomatosa]. AB - Two-route chemotherapy of cisdiamminedichloroplatinum (CDDP) and sodium thiosulfate (STS) was performed in 32 patients with peritonitis carcinomatosa, originated from 21 gastric cancers, 4 colorectal cancers, 3 pancreatic cancers, 2 leiomyosarcomas of small intestine, one ovarian cancer and one bile duct cancer. CDDP was administered into the peritoneal cavity at the dose of 150 mg while STS was injected i.v., at the dose of 20 g to inactivate CDDP in peripheral blood. Out of 13 patients with malignant ascites, ascites disappeared completely in 3 cases and markedly decreased in 2 cases, and the efficacy rate was 38.5%. Five out of 32 registered patients with peritoneal disseminated tumors were evaluated. One complete response (CR), 1 partial response (PR), 2 with no change (NC) and 1 case of progressive disease (PD), were observed. The efficacy rate was 40%. The one-year and two-year cumulative survival rate was 18.2% and 13.7%, respectively. Nausea and vomiting were observed as side effects in about half of the patients, but these symptoms were mild and improved in a few days. These results indicate that this method is a useful therapy for peritonitis carcinomatosa. PMID- 2782889 TI - [Basic studies on optimal intra-arterial infusion rate of cisplatin]. AB - The relationship between platinum concentration in tissues, free CDDP concentration in plasma and infusion rate was investigated in order to determine the optimal intra-arterial infusion rate of CDDP for chemotherapy of cervical carcinoma. Platinum concentrations in uterus were in the same level in the intravenous infusion groups independent of the infusion rate. In the intra arterial infusion groups, platinum concentrations in the uterus increased as the infusion rate decreased from 24 to 0.8 mg/hr, although Cmax and AUC were decreased. Platinum concentrations in the ovary supplied by another artery were not influenced by the intra-arterial infusion rate. It is suggested that uptake of CDDP in the targeted tissues can be increased by control of intra-arterial infusion rate. PMID- 2782890 TI - [Intra-arterial chemotherapy with cisplatin in advanced urothelial cancer]. AB - Thirty-two patients with advanced bladder cancer received intraarterial infusion of chemotherapy with cis-platin (CDDP). For twenty-one patients, the intraarterial infusion was carried out using Seldinger's method. On the other hand, for the eleven patients who were diagnosed as inoperable cases, the intraarterial infusion was carried out using the reservoir system. The mean regression in the size of the tumor was 64%, which was statistically superior to the mean regression in the intravenous administration group, was 45%. According to Shimosato's criteria, the pathological response was evaluated. Seven patients (22%) were detected as having more than grade III. On the other hand, among the intravenous administration group, only one case (11%) was detected as more than grade III. Following the intraarterial infusion of chemotherapy, subsequent surgical treatment was performed on 21 patients. Fourteen patients underwent the organ-preserving operation, either transurethral resection or segmental resection of the bladder, and seven patients underwent radical cystectomy. In seventeen patients (53%), there was no evidence of the disease. Especially, eleven patients (79%) who under went the organ-preserving operation had no evidence of the disease. The intraarterial infusion method of chemotherapy with CDDP showed a high response, both in terms of regression of tumor size and the pathological degeneration, compared to intravenous administration of CDDP. The subsequent surgical treatment following chemotherapy issues not only a better survival rate, but also makes possible preservation of organs. PMID- 2782891 TI - [Loco-regional cancer chemotherapy with a new drug delivery system, "anticancer drug-fibrin clot"]. AB - Five different types of anticancer drugs were individually entrapped into fibrin clots using our own material, "G.T.XIII" to provide an "anticancer drug-fibrin clot" for regional cancer chemotherapy. Anticancer drugs used in the present study were ADM, MMC, MTX, 5-FU and cDDP. The release of drugs from fibrin clots was studied in vitro. Each fibrin clot was intraperitoneally administered to cancer (AH-130)-bearing rats to evaluate the oncolytic effects. The activities of anticancer drugs delivered from the clots were maintained for more than two weeks. Survival terms of cancer bearing rats were remarkably prolonged with the anticancer drug-fibrin clots. Neither recurrence of ascites nor metastases of malignant cells was observed in the rats treated with such clots. Our newly devised anticancer drug-fibrin clots showed a sustained release of oncolytic drugs and favorable antineoplastic effects. This newly devised drug delivery system suggested a clinical potential for regional cancer chemotherapy. PMID- 2782892 TI - [Experimental studies on drug uptake by metastatic liver tumor after intra arterial, intraportal and intravenous administration of BrdU]. AB - To compare the pharmacological advantage of intra-arterial, intraportal and intravenous administration of anticancer drug for metastatic liver tumor, BrdU was administered to rabbits with metastatic liver tumor of VX2 from various routes and taken up into the nuclei of tumor cells. Both one-shot injection and continuous infusion (30 min) of BrdU was performed from celiac artery, portal vein or peripheral vein. In some rabbits, the portal vein or the celiac artery was ligated to form one blood supply to the liver. After the administration of BrdU, the liver was removed. The samples were stained by the immunohistochemical procedure using monoclonal antibody to BrdU. The result was that the drug uptake of small metastatic liver tumor by both arterial and portal one-shot injection was good, and the uptake following intra-arterial injection of BrdU was superior to its intraportal injection in large metastatic tumor. However, only peripheral cells of large tumor took up BrdU after intra-arterial injection and inner cells of large tumor did not take up BrdU after any continuous infusions. The intraportal and intravenous administration of BrdU without ligation of celiac artery had the same effect as its intra-arterial administration. PMID- 2782893 TI - [Hepatic artery and portal vein infusion of adriamycin in experimental liver metastasis]. AB - Hepatic artery and portal vein infusion of adriamycin (ADM) to normal rabbit and the experimental liver metastasis model of VX2 tumor were discussed in this study. The concentration of ADM in the peripheral blood, liver, myocardium, lung of normal rabbit and metastatic tumor were measured in the HPLC method. There was no difference between arterial infusion and portal infusion in the normal rabbits. In the metastatic tumor, one hour after the infusion, concentration of ADM showed no difference between arterial and portal infusion, but two and three hours later, the concentration was significantly higher after portal infusion than arterial infusion. It was suspected that portal infusion would be more effective for liver metastasis. The number of tumor nodules for estimation of the anti-tumor effect on metastatic models was decreased significantly after arterial and portal infusion compared with the controls, but there was no statistical difference between arterial and portal infusion. PMID- 2782894 TI - [Hepatic arterial infusion chemotherapy using totally implantable reservoir in liver metastases in colorectal cancer]. AB - Hepatic arterial infusion chemotherapy using totally implantable reservoir was performed for the treatment of liver metastases of colo-rectal cancers, and the therapeutic effects, side effects and complications were evaluated. Reservoir catheters were implanted into hepatic artery via gastroduodenal artery during operation. Mitomycin C (MMC), adriamycin (ADM), and 5-fluorouracil (5-FU) were used as chemotherapeutic agents. Eleven cases of H1 (metastases in one lobe only), 7 cases of H2 (a few scattered metastases in both lobes) and 12 cases of H3 (multiple metastases in both lobes) were treated intermittently with one-shot administration of MMC or ADM (A-group). Ten cases (H1: 1, H2: 2, H3: 7) were treated with intermittent one-shot administration of MMC or ADM following two week continuous infusion of 5-FU through infusion pump after operation (B-group). In 5 of 10 cases of B-group, serum CEA level fell below the preoperative level, and the tumor size regressed in 3 of those 5 cases which were evaluated on the basis of CT scan. But no remarkable change in CEA level or tumor size on CT scan was seen in A-group. No particular side effect such as leucopenia, liver dysfunction or gastroduodenal symptom was noted except one case developing multiple gastric ulcers and pancreatitis in B-group. Five cases (25%) showed obstruction of catheter and 3 cases (14%) evidence leakage of chemotherapeutic agents in A-group. Three cases (30%) in agents in A-group. Three cases (30%) in B group displayed obstruction of gastroduodenal artery beyond the tip of catheter. Median survival time of both groups (A, B) was 6 months and 12 months, respectively. The treatment seemed effective for the improvement of serum CEA level and tumor size, and there was a tendency toward prolongation of survival time in B-group. PMID- 2782895 TI - [Two-route chemotherapy under AT-II induced hypertension using totally implanted injection port system in liver metastases derived from digestive cancers]. AB - Two-route chemotherapy (TRC) with intraarterial infusion of cis diamminedichloroplatinum and intravenous infusion of sodium thiosulfate was carried out on 8 cases of digestive cancer with liver metastases, using totally implanted injection port system. The metastases occurred from gastric cancer in 3 cases and from colonic cancer in 5 cases. Computed tomography and/or ultra sonography revealed an overall response rate of 50% (4/8). Complete response (CR) was obtained in two cases. The therapy was repeated 12 times in one case of gastric cancer with multiple liver metastases and 5 times in another rectal cancer with a solid metastatic tumor. In the latter case, a right hepatic lobectomy was performed thereafter. The histology of the hepatic tumor showed mucin lakes and necrotic lesions, and no viable cancer cells were observed. This mode of chemotherapy was therefore considered a useful measure for the treatment of liver metastases derived from digestive cancers. Furthermore, no serious side effects occurred. PMID- 2782896 TI - [Prognostic significance of intra-arterial infusion chemotherapy in the treatment of locally advanced breast cancer]. AB - Intra-arterial infusion chemotherapy of adriamycin (ADM) was performed in 31 cases with locally advanced breast cancer. The overall response rate for ADM was as high as 71% (22/31) in the primary lesions and histological response rate was obtained in 54.8% (17/31). Five-year survival rates for patients with stage IIIa, IIIb and IV breast cancer were 100%, 37.5% and 40.0%, respectively, compared with 63.8%, 35.7% and 12.5%, respectively, for 80 cases of control group. Although there was no correlation between local response rate and longer survival time, a more favorable prognosis seems possible with this treatment compared with other forms of therapy. PMID- 2782897 TI - [Long-term survival in patients with breast cancer after intra-arterial infusion chemotherapy]. AB - Twenty two patients with locally advanced breast cancer survived for more than 5 years after intra-arterial infusion chemotherapy (IA). In this study, we compared these long-term-survivors with thirteen cases who died within 2 years. The results were as follows. (1) ER positive rate of the long-term-survivors (90%) was significantly higher than in short-term-survivors (25.0%). (2) There was no difference between the response rates of each group; 63.2% in long-term-survivors vs. 53.8% in short-term-survivors. (3) Adjuvant endocrine therapies were carried out in the former group, and their D.F.I. were considerably longer than in the latter group. (4) Common sites of recurrence in long-term-survivors were soft tissues and bones, compared with visceral in short-term-survivors. Post recurrence survivals of the former were, also, longer than in the latter. From these results, we confirmed that preoperative IA and following adjuvant endocrine therapies induces favorable results in the treatment of hormone sensitive breast cancer. PMID- 2782898 TI - [Long-term follow-up study of transcatheter arterial chemotherapy in patients with advanced breast cancer]. AB - Intra-arterial infusion chemotherapy (I.A) was applied to 32 cases with advanced breast cancer. The subclavian artery was intubated and one shot of 30 mg of adriamycin was given every 3 days, with a total dose of over 150 mg. Then mastectomy was performed after this chemotherapy. Long-term follow-up study revealed that the response rates of the primary tumor to I.A chemotherapy provided the prospects for their prognosis. The 3-and 5-year survival of good responders (% tumor regression greater than or equal to 70%) was significantly better than those of poor responders (% tumor regression less than 70%). Then, four patients with advanced breast cancer were treated with combination of I.A infusion chemotherapy of Adriamycin and photoradiation by argon laser. The mean interval time for 50% tumor regression was shorter than in the cases treated with Adriamycin alone. In vitro, the effects of the photoradiation for MCF-7 breast cancer cell line were observed only at a high concentration of Adriamycin. PMID- 2782899 TI - [Long-term results of intra-arterial infusion therapy using cis-DDP (CDDP) in thoracic esophageal cancer]. AB - The effects of intra arterial infusion therapy using CDDP for patients with thoracic esophageal cancer were investigated. From June 1984 to December 1988, 25 of 146 resected patients with thoracic esophageal cancer underwent preoperative therapy in our institute. All of these patients it was suspected preoperatively that their chief lesion had invaded to the aorta, trachea or main bronchi. Preoperative radio-chemotherapy with intra arterial infusion therapy was given to 10 of 25 patients (A group), and without intra arterial infusion therapy to 15 of 25 patients (B group). CDDP 75 mg was infused into the proper esophageal artery. In A group, 7 of 10 (70%) showed moderately or marked effects in histologic study, although in B group, only 4 of 15 (27%) did so. As for long-term results, the 2-year survival rates were 50% in A group and 13% in B group (Kaplan-Meier method. Preoperative intra arterial infusion therapy using CDDP with radio chemotherapy showed markedly better effects in histologic study and survival rates than preoperative radio-chemotherapy without intra arterial infusion therapy. We consider that this therapy is very useful for controlling the local lesion in advanced esophageal cancer. PMID- 2782900 TI - [Clinical effectiveness of arterial infusion chemotherapy in advanced and recurrent gastric cancer]. AB - Arterial infusion therapy was applied to 77 patients with 18 unresectable, 29 non curatively resected and 20 recurrent gastric cancers. 5-fluorouracil (5-FU) was administered by arterial continuous infusion, and adriamycin (ADM) and mitomycin C (MMC) by bolus infusion. The clinical effectiveness of each was evaluated. One year cumulative survival rate of primary case by Kaplan-Meier method was 19.2%, and that of recurrent gastric cancer was 5.3%. Median survival time of primary case was 6.5 months, showing prolongation compared with recurrent ones. Also, in primary cases, the arterial infusion therapy was more effective in non-curatively resected cases than in unresectable ones. Two of the patients are now alive and another is apparently free of tumor and the remaining one had a recurrence. Continuous arterial 5-FU infusion and ADM low-dose intermittent bolus infusion chemotherapy (AF therapy) were considered an effective supportive treatment without any serious side effects for unresectable, noncuratively resected and recurrent gastric cancer. PMID- 2782901 TI - [The long-term prognosis of intra-arterial chemotherapy in invasive bladder cancer]. AB - During the period from August 1980 to April 1989, preoperative intra-arterial infusion chemotherapy was performed in 22 patients with resectable bladder cancer. An oblique incision approximately 12 cm long was made in the gluteal lesion to expose the inferior gluteal artery, into which a Teflon catheter was inserted and fixed. Via this catheter, a single dose of 10-20 mg CDDP and/or 10 mg ADM was injected 1-2/week. The majority of patients were treated with radiation and/or hyperthermia as a combined therapy. The 5-year survival rates (Kaplan-Meier method) were 81.6% in patients treated with intra-arterial infusion chemotherapy as an adjuvant to total cystectomy, compared with 37.5% in patients treated with total cystectomy only. There was a statistically significant difference between the two groups (p less than 0.01). Therefore, inferior-gluteal artery infusion chemotherapy is effective as a preoperative adjuvant therapy with no serious side effects. PMID- 2782902 TI - [Intra-arterial chemotherapy with angiotensin II in metastatic carcinoma of the liver using implantable pump]. AB - Nine patients with metastatic carcinoma involving the liver were treated by hepatic arterial chemotherapy with Angiotensin II (AGT II) using a subcutaneous implanted pump. There were two primary lesions in the breast, one in the stomach, three in the colon and three in the rectum. Every patient received intra-arterial bolus injection of 5-FU and Adriamycin with 3 mcg of AGT II weekly at our outclinic. Of 7 evaluable patients, 6 responded clinically with PR (response rate, 85.7%). No adverse effects were noted in relation to AGT II. AGT II combined with chemotherapy is therefore a safe and effective method for even outpatients with liver metastases. PMID- 2782903 TI - [Continuous arterial infusion chemotherapy in cancer cases followed as outpatients]. AB - Continuous arterial infusion chemotherapy is associated with a significantly greater tumor response rate, though patients must be hospitalized for a long time. This paper describes techniques and our experience with arterial continuous infusion chemotherapy for outpatients using implantable port and ambulatory pump. Eleven patients (liver metastasis of colorectal cancer, hepatocellular carcinoma and local recurrence of rectal cancer) were treated with continuous arterial infusion chemotherapy at our outpatient clinic. The chemotherapy infusions were carried out repeatedly for 5.7 months on average (10-2 months) with 5-FU or CDDP. Total periods of infusions were 64.8 days on the average (136-24 days). The infusion dose and frequency of drug refilling were limited by pump quality. A major complication occurred only in one patient who developed arterial thrombosis. Minor complications were mainly gastrointestinal symptoms (nausea, vomiting) and abdominal pain, which were easily corrected with drugs. The tumor responses were as follows: PR 1 case, MR 1 case, NC 7 cases and PD 2 cases. Home arterial continuous infusion chemotherapy reduced the hospitalized period and helped patients return to work. Therefore it may well contribute to improve the quality of life of cancer patients. PMID- 2782905 TI - [Intra-arterial infusion chemotherapy of advanced breast cancer--effects and side effects of adriamycin, 4'-epi-adriamycin and THP-adriamycin]. AB - In 34 patients with primary advanced breast cancer, intra-arterial administration of ADR (50 mg X 3, total dose 150 mg, 10 cases), 4' epi ADR (50 mg X 3, 150 mg, 8 cases; 70 mg X 3, 210 mg, 10 cases) and THP-ADR (50 mg X 3, 150 mg, 6 cases) was performed, and its effects and side effect were analyzed. The clinical and histological response rate were superior in the ADR (150 mg) regimen and 4'-epi ADR (150 mg) regimen. Signs of systemic toxicity such as gastrointestinal disorders, leukocytopenia and thrombocytopenia were the side effects in patients treated with THP-ADR, but the frequency of alopecia was lower. No cardiotoxicity was recorded in any of the patients. These results indicated that 4'-epi-ADR given the total dose of 150 mg in a single dosage of 50 mg was the most effective agent in intra-arterial infusion chemotherapy for advanced breast cancer. PMID- 2782904 TI - [A case of carcinoma corporis by intra-arterial hypertension chemotherapy]. AB - We report a case in which bone metastasis from carcinoma corporis was treated by intra-arterial hypertension chemotherapy. The patient was a 53-year-old female whom we treated by intra-arterial hypertension chemotherapy of CDDP 80 mg and ADM 30 mg with Angiotensin II. Four weeks later she underwent abdominal total hysterectomy, bilateral salpingo-oophorectomy and right common iliac lymph nodes resection. The response of intra-arterial hypertension chemotherapy was charged microscopically. About half (Grade I b) the carcinoma tissue was necrosed. PMID- 2782906 TI - [Portal vein infusion therapy of the prevention of liver metastasis from colorectal carcinomas]. AB - For patients who underwent curative resections for primary colorectal carcinomas, locally recurrent tumors and metastatic liver tumors, we applied portal vein infusion therapy to prevent further metastases to the liver. Following radical resection of the tumor, dissecting the umbilical vein from the falciform ligament made it possible to recanalize and insert a 18 G catheter into the portal vein. Intraportal chemotherapy (5-FU 750 mg/day) was carried out for the first 7 postoperative days. There were 17 patients who received this therapy, 10 with curative resection for the primary cancers, 1 with curative resection for the locally recurrent tumor and 7 with the curative resection for the metastatic liver tumors. The follow-up period is rather short (17 months) but no patients have had the liver metastases. So we suggest that this adjuvant liver infusion may reduce the liver metastases without any mortality or morbidity. PMID- 2782907 TI - [Intra-hepato-arterial chemotherapy combined with hyperthermic treatment: clinical results of metastatic cancer of the liver and effects on correct (but not at all necessary) hepatic blood flow]. AB - In treating cancerous metastases to the liver, we combined hyperthermic treatment with chemotherapy via the intra-hepato-arterial injection (IHAI) of cis diamminedichloroplatinum (II) plus 5-fluorouracil. The subjects were 14 patients having metastases to the liver: 3 from gastric cancer and 11 from colorectal cancer. In metastases of colorectal origin, the response rate (partial response) was 55%; the 1-year survival rate was 80%; the 50%-survival period was 23 months. The response rate and the 50%-survival period in metastases of gastric origin were 67% and 11 months, respectively. When IHAI chemotherapy was combined with hyperthermic treatment, antitumor effects were generated in 3 of 6 metastatic patients from colorectal cancer, who had received no benefit from the IHAI chemotherapy alone. Better results were produced by thermochemotherapy than by IHAI chemotherapy alone. Hepatic blood flow, which influences the antitumor effect of hyperthermic treatment or chemotherapy, was measured using the 133Xe clearance method. Over the long term, the hepatic blood flow, especially that of the portal-venous route, showed a decreasing tendency after repeated sessions of the present regimen. This fact suggests the increased retainability of arterial injected carcinostatics in cancerous tissues. PMID- 2782909 TI - [Intra-arterial infusion chemotherapy under flow occlusion using a double lumen reservoir]. AB - Recently, we developed an intrahepatic artery catheter and a device attached with an implantable double lumen reservoir. In this paper, we present clinical experience with this device in 15 cases of hepatocellular carcinoma and the results of an experimental study using canine regarding the significance of arterial infusion therapy with occlusion of hepatic arterial flow. Adriamycin and CDDP were used as anticancer agents, and in 3 out of 15 cases IL-2 and LAK cell were used as chemoimmunotherapy. Twenty-one infusions were possible without any severe side effects. This treatment was also safely done even in the out-patient clinic. In one case extravasation of drug and another case of fever caused by catheter were seen, which was easily diminished by conservative treatment. Ten cases were estimated for antitumor effects and 5 showed partial remission. In experimental study, augmentation of the intrahepatic tissue level of adriamycin was found with occlusion of arterial flow. Intra-arterial infusion therapy using this device promises to be a most useful routine method for cancer control in the outpatient clinic. PMID- 2782908 TI - [Arterial infusion cancer chemotherapy in liver tumor using implantable reservoir]. AB - Four primary liver tumors and 19 secondary ones (8 gastric, 8 colorectal, 2 esophageal and 1 gall bladder cancer) were treated by intra-arterial infusion chemotherapy intermittently using implantable reservoir. Drugs used in this series were 5-Fluorouracil, Mitomycin C, Adriamycin, and Cis-platinum. They were infused every 2 weeks for outpatients. The antitumor efficacy was evaluated in terms of tumor regression measured by CT scan. The toxicity was slight and temporary. The total response rate was 23.1%, 50% survival period was 7 months, and 1-year survival rate was 24.2%. The response rate was 33.3%, and the 50% survival period was 7 months for 8 gastric cancer patients with liver metastasis. The result was not good, and we must improve the criteria of indication and devise a regimen. But the implantable drug delivery system has made it possible to lengthen the time that patients may stay home and assure good quality of life because of the freedom of movement, normal physical appearance, protection from infection, and reduction of mental burden, due to subcutaneous placement. PMID- 2782910 TI - [Basis of radiotherapy for improved tumor control and preservation of normal function]. AB - Historical overview of development of radiotherapy, its biological basis and radiation sources since the discovery of x-ray are presented. The present status and problems as well as future direction of radiation oncology studies such as clinical cyclotron for heavy ions, predictive assays and indicators, and various fractionation schemes are discussed. Better understanding of the current status and problems of various disciplines by each specialist is important for the improvement of combination treatment using different modalities. Also, better understanding of radiotherapy by other specialists and cooperation with each other are the key to the development of rather weak radiation oncology programs in the Japanese medical system. PMID- 2782911 TI - [Cis-radiation therapy of locally advanced bladder cancer]. AB - Locally advanced bladder cancer (clinical stage T2-T4) of 11 patients and ureteral cancer (clinical stage T3) of 3 patients was treated concurrently by CDDP and irradiation. CDDP, total 200 mg, was administered 20 mg/day X5 day on the 1st week and 4th week combined with 2 GY/day irradiation, total doses 40 GY. CDDP was given on one or 2 hours after irradiation on the day. The results were significantly improved that the tumor could be controlled by TUR, and the pathological specimens showed marked tumor necrosis or degeneration. In 63.6% of 11 invasive bladder cancers, bladder function was preserved without any evidence of tumor recurrence or metastasis during 15-37 months. From these results, it is concluded that cis-radiation therapy may preserve the bladder with locally invasive cancer. PMID- 2782912 TI - [Various methods of catheter placement in hepatic arterial infusion--technique of catheter placement via a femoral artery]. AB - A comparative analysis of the individual techniques was performed on a total of 106 cases undergoing various methods of catheter placement in hepatic infusion. The comparison of laparatomy (n = 44) with a percutaneous method (n = 62) disclosed a higher incidence of peptic ulcer in the latter. When two modes of percutaneous approach, including a trans-left subclavian arterial method (n = 36) and a trans-femoral arterial method (n = 26), were compared, a shorter average catheterization time (approximately 70 minutes) and a higher selective insertion rate (92.3%) were noted in the trans-femoral approach. For these reasons, our department adopts the trans-femoral method as the percutaneous method of choice. It is advisable for further studies to be made in order to clarify indications for the individual techniques and for anti-complication measures. PMID- 2782913 TI - [Effects of combined therapy with irradiation, cisplatin and vindesine in lymph node recurrence of esophageal cancer]. AB - The effects of combined therapy with irradiation, cisplatin and vindesine for lymph node recurrence of esophageal cancer was studied. The subjects were 95 patients with lymph node recurrence, who were divided into the following four treatment groups: Group I: Radiotherapy alone (R) (n = 31); Group II: cisplatin (CDDP) alone (n = 18); Group III: R + CDDP(n = 9); Group IV: R + CDDP + VDS (n = 10). The response rate (CR + PR) of Groups III and IV was 66.7% and 100%, respectively, which was significantly more favorable than 11.1% of Group II. The survival duration after recurrence was prolonged in the order of Group IV, Group III, Group II and Group I. In conclusion, combination therapy using R, CDDP and VDS will be effective for lymph node recurrence of esophageal cancer. PMID- 2782914 TI - [Clinical evaluation of serum level of NCC-ST-439 as a new tumor marker for colorectal diseases--fluctuation of serum NCC-ST-439 in patients with colorectal cancers before and after surgery]. AB - Serum level of NCC-ST-439, a new tumor marker, was clinically evaluated in patients with benign and malignant colorectal diseases in comparison with serum CEA and CA 19-9. Fluctuation of serum levels of NCC-ST-439 in patients with colorectal cancers was especially studied. Serum level of NCC-ST-439 was determined by sandwich type NCC-ST-439 EIA kit, which was developed by Nippon Kayaku Co., Ltd., in 93 cases of primary colorectal cancers, 98 cases of recurrent colorectal cancers and 60 cases of benign colorectal diseases. Positive rate of serum NCC-ST-439 in patients with primary colorectal cancers was 8.6% in Dukes A cases, 14.3% in Dukes B cases, 37.5% in Dukes C cases and 78.9% in Dukes D cases. Positive rate in patients with recurrent colorectal cancers was 42.8%. On the other hand, false positive rate in patients with benign colorectal diseases was 5.0%, which was relatively low in comparison with serum CEA and CA 19-9. While serum NCC-ST-439 was well correlated with serum CEA and CA 19-9 in primary colorectal cancers, NCC-ST-439 value in benign colorectal diseases showed no correlation with serum CEA and CA 19-9. In patients with primary colorectal cancers, curative resection was applied for in 40 cases in which the value recovered to the normal range after resection. In contrast, all 8 cases, which received non-curative resection, showed the increase of serum NCC-ST-439 value. In cases of recurrent colorectal cancers, some cases, which responded against chemotherapy, obviously showed a decrease of NCC-ST-439 value. These facts indicated that serum level of NCC-ST-439 could monitor the clinical effects of surgical treatment, chemotherapy and radiation therapies and it could be used as a marker for colorectal cancers. In conclusion, determination of serum NCC-ST-439 value was clinically useful for the diagnosis and monitoring for patients with colorectal cancers as a new distinct tumor marker. PMID- 2782916 TI - [Antitumor effects of 5-fluorouracil-bound organic silicon compound]. AB - 5-fluoro-3,4-dihydro-2,4-dioxo-N-[2-2- (dimethylphenylsilyl)ethylthioethyl]-1(2H) pyrimidinocarb oxamide (SDK-12B-5), a novel antitumor agent, is covalently linked with 5-fluorouracil (5-FU) and 2-[(2-dimethylphenylsilyl)ethylthio] ethylamine(SDK-103) which possesses itself antitumor activity against murine solid tumors. It has a broad antitumor spectrum in experimental tumor systems including murine leukemias. Furthermore, SDK-12B-5 administered p.o. with various treatment schedules inhibited significantly the tumor growth of human breast cancer (MX-1), colon cancer (Co-4) and lung cancer (LX-1 and OAT) cells in BALB/c nu/nu mice and the chemotherapeutic index was about 10 for 4 different human cancer xenografts. In the Lewis lung carcinoma (LLC) metastasis model, SDK-12B-5 in combination with amputation of tumors inhibited significantly both the lymph node metastases and lung metastases of LLC and prolonged the life span (%ILS:91%) of BDF1 mice. We also found that the cell killing effect of SDK-12B-5 was affected by both concentration and exposure time in cultured human lung cancer (OAT) cells using soft-agar colony assay. A significant augmentation of delayed type hypersensitivity (DTH) response induced by SDK-12B-5 in comparison with the mixture of SDK-103 and 5-FU was seen when it was administered p.o. simultaneously with the immunization of sheep red blood cell (SRBC) in retired CD1 mice. From the studies on tissue distribution and pharmaco-kinetics of SDK-12B-5 by HPLC and ICP analysis. the persistence of SDK-12B-5 levels in serum and tumors was correlated with the findings that a maximum chemotherapeutic effect was obtained when SDK-12B-5 was administered p.o. repeatedly with every other day to avoid the cumulative toxicity. PMID- 2782915 TI - [Basic and clinical evaluation of an immunoradiometric competitive inhibition assay for sialyl Tn antigen: (1). Evaluation of assay conditions and normal values. STN Study Group]. AB - An immunoradiometric competitive inhibition assay of the serum levels of the sialyl Tn antigen using "STN Otsuka" kits is described. The assay required only duplicate 50-microliters samples, and the concentration of sialyl Tn antigen in serum was determined by reference to a standard curve ranging from 0 to 400 arbitrary units/ml. The intra-and inter-assay reproducibilities were largely satisfactory. The serum levels of the antigen in normal individuals were not affected by ABO and Lewis blood type status of the tested individuals. Normal values were 25.5 +/- 9.8 in male, and 21.3 +/- 8.0 in female, and the difference was statistically significant at p less than 0.001. The serum level of the antigen was not affected by menstrual cycle or pregnancy in female, whereas the level of other tumor markers such as CA 125 was highly variable depending upon these conditions. PMID- 2782917 TI - [Questionnaire results on implantable catheter systems]. AB - Recent advance of intra-arterial chemotherapy can be attributed to improvement of devices, especially implantable catheter systems. In May 1989, a questionnaire was set out through the Japanese Association of Arterial Cancer Chemotherapy to find out the current use of arterial as well as intravenous implantable systems. The results revealed that: 1) Arterial implantable systems were widely used in 1879 patients at 91 institutes, mainly to treat patients with primary and secondary liver cancers. Intravenous systems were used in 88 patients at 17 institutes. 2) Implantable catheter systems were used for long-term intermittent or continuous infusion. 3) Compared with percutaneous catheters, a decrease in infection and occlusion rates and less daily care were noted. 4) Due to the development of implantable systems, 890 out of 1,879 patients on arterial therapy and 60 out of 88 patients on intravenous therapy could switch over to an outpatient basis. 5) Improvement of "quality of life" was found at all but one institute. 6) All questionnaires (except unanswered) requested health insurance reimbursement for totally implantable catheter systems. PMID- 2782918 TI - [A case report of an advanced and recurrent stomach cancer in a patient manifesting response to cisplatinum-based chemotherapy]. AB - In an advanced stomach cancer with recurrence of regional lymph node metastasis, cis-diamminedichloro-platinum (CDDP) was administered intravenously (IV) according to the following doses and schedules. This treatment schedule consisted of CDDP at a dosage of 100 mg/body/time. This dosage was infused seven times for 24 months (total CDDP dose, 700 mg/body). The overall response rate to chemotherapy was determined as follows. Partial response (PR) was defined as a reduction of at least 50% in the sum of the products of the two greatest perpendicular diameters of all measurable lesions within 15 months of commencing therapy and the absence of disease progression elsewhere. The 56-year-old, male patient is being treated with an outpatient regimen at our Hospital. PMID- 2782919 TI - [A case of recurrent uterine cervical cancer successfully treated with etoposide]. AB - A 69 year-old woman with recurrent uterine cervical cancer was treated by etoposide because of ascites retention and elevated serum SCC level. The etoposide (50 mg/day, for 14 consecutive days followed by 2-week suspension by oral administration) was given for 8 months and more. After 3 months of treatment, a complete response has been found by echography (disappearance of ascites and negative intraperitoneal smear test) and the serum SCC level became normal at 0.8 ng/ml from 4.1 ng/ml prior to treatment. No particular side effects were found in this patient during treatment. These results demonstrate that etoposide (cyclic per os therapy) may be effective for the patient with recurrent uterine cervical cancer, and this treatment could be acceptable in the outpatient department. PMID- 2782920 TI - [Pharmacokinetics of cisplatin and vindesine in a patient with chronic renal failure undergoing hemodialysis]. AB - Plasma total platinum and vindesine levels were monitored in a patient with chronic renal failure undergoing hemodialysis. Plasma levels of cisplatin were determined as platinum by atomic absorption spectrophotometry, and plasma vindesine levels were measured by radioimmunoassay. Fifty mg. of cisplatin in combination with 3 mg. of vindesine were infused for 60 minutes before dialysis. During dialysis, plasma total platinum levels decreased rapidly in a biphasic fashion and 1.76 at 30 hours after infusion. Plasma vindesine levels declined with higher concentration. In conclusion, it is considered that cisplatin and vindesine can be given to anuric patients undergoing hemodialysis. However, it is suggested that smaller doses should be given to prevent side effects. PMID- 2782921 TI - [A case of malignant ovarian tumor complicated by pregnancy, from the standpoint of tumor marker and quality of life]. AB - It has been reported that malignant ovarian tumor is complicated in a ratio of one to 25,000 pregnancies. In the present study, a 22-year-old, nulliparous woman was presented, who had had her right ovary extirpated for serous cystadenoma (low potential for malignancy) and had undergone chemotherapy previously. Seven years later, she was subjected to celiotomy in the fourth month of gestational age because of left ovarian tumor. Intraoperative work-up disclosed a mucinous cystadenoma (low potential for malignancy) of stage Ia (FIGO). Left salpingo oophorectomy and omentectomy were undertaken, and fetus-bearing uterus was preserved for the sake of the patient. Serum CA 19-9, with a preoperative level of 106.7 U/ml, fell exponentially into the normal range one month after the operation, and she successfully gave birth to a baby at term. After that, combination chemotherapy was instituted against an elevated level of CA 19-9, and she has been in remission while caring for her child. PMID- 2782922 TI - [The effect of EAP (etoposide, adriamycin, cis-platinum) on patients with advanced gastric cancer: the role of EAP as neoadjuvant chemotherapy and histopathological study on its effect]. PMID- 2782923 TI - [Pharmacokinetics of stearyl-ara-CMP (YNK-01) in patients with hematologic neoplasms]. PMID- 2782924 TI - Does early intervention 'work'? PMID- 2782925 TI - Click evoked otoacoustic emissions compared with brain stem electric response. AB - The hearing of 346 babies taken largely from a neonatal intensive care unit has been tested by otoacoustic emissions and brain stem electric response audiometry. A total of 336 (97%) of the babies have been followed up by hearing tests from the age of 8 months. The otoacoustic emission test has been found to be practical with a mean test time of 12.1 minutes compared with 21.0 minutes for brain stem electric response. An otoacoustic emission was recorded bilaterally in 274 (79%) babies. Twenty of the 21 surviving infants who failed brain stem electric response in the neonatal period did not produce an emission. It is concluded that the otoacoustic emission test would make a good first screen to be followed by the brain stem electric response if no otoacoustic emission was present. There is poor agreement between the test results in the neonatal period and those of the follow up period, however, indicating the need for continuous monitoring of those babies failed by brain stem electric response. PMID- 2782926 TI - Prevalence of respiratory symptoms among 7 and 11 year old schoolchildren and association with asthma. AB - A new self administered questionnaire completed by parents was used to study the prevalences of wheeze, shortness of breath, and cough in 2503 Southampton schoolchildren aged 7 and 11 together with exacerbating factors and background information including treatment and diagnosis. The questionnaire had a response rate of 84% and was found to be highly repeatable with respect to current symptoms. The overall prevalences of wheeze and shortness of breath in the current year (1986) were 12.1% and 8.5% respectively. Social class, home ownership, parental smoking, and presence of a family pet were unrelated to symptom prevalence. According to the parents the overall diagnosis rate for asthma was 9.5%. In common with other studies, however, we found considerable evidence for undertreatment. The symptoms of wheeze and nocturnal and morning breathlessness occurred more commonly in boys, but this sex ratio decreased with increasing age. The prevalences of wheeze and shortness of breath were similar in the two age groups. In contrast, there were only small differences between the sexes with respect to cough whereas, among children without wheeze or shortness of breath, there was a fall in the prevalence of cough from 18.9% at 7 years to 8.7% at 11 years. When controlling for the other respiratory symptoms, wheeze was the only symptom significantly related to parental asthma. The fall in the prevalence of cough between the two age groups is unlikely to be related to changes in asthma prevalence and, when not associated with wheeze, may be an indicator of separate pathology. PMID- 2782927 TI - Vertical transmission of HIV: a prospective study. AB - Forty nine infants of HIV seropositive women were followed up for a median of 24 months, together with 24 controls. The infection status of 11 index children under 18 months of age was indeterminate; 34 were presumed uninfected while four showed clinical and laboratory evidence of HIV disease. Based on current definitions of HIV infection and excluding children under 18 months old as well as those who had not been studied from birth, two out of 28 children were infected. The estimated rate of maternofetal transmission was therefore 7.1%. In children with proved infection, sequential laboratory data showed that hypergammaglobulinaemia was noted as early as 6 months and often predated clinical signs. This observation, in the presence of non-specific clinical findings, was helpful in alerting the paediatrician to a diagnosis of HIV infection. PMID- 2782928 TI - Intravenous immunoglobulin in HIV infection: evidence for the efficacy of treatment. AB - Eight children with symptoms of HIV infection were treated for 12-26 months (median 14 months) with infusions of intravenous immunoglobulin (200 mg/kg) every three weeks. Significant improvement was noted in all children in terms of weight gain, number of infectious episodes, and days spent in hospital. This resulted in a 49% saving in cost on treatment compared with costs accrued previously during inpatient admissions. Immunoglobulin concentrations, which were raised at the start of treatment were not altered, and T4 counts continued to decline slowly. HIV core antigen was detected in four children before treatment, but all became core antigen negative after treatment was commenced, this effect being sustained in three. Intravenous immunoglobulin therefore has major clinical benefit, and by reducing viral activity may delay disease progression. PMID- 2782929 TI - Rise and fall of coeliac disease 1960-85. AB - A total of 192 children who presented with coeliac disease to Queen Elizabeth Hospital for Children from 1960-85 were reviewed in order to investigate the frequency and the age of presentation. There was a clear peak in the number of children presenting from 1971-5, and although the numbers declined subsequently they have remained at a level similar to numbers found before 1971. There was no difference in the mode of presentation but there was a definite increase in the age of presentation over the time period reviewed. Breast fed babies presented later than bottle fed babies (14 compared with 9 months) despite a similar age of gluten introduction. Similarly bottle fed babies and breast fed babies presented later after 1975 (10.5 compared with 7 months, and 18 compared with 9.5 months, respectively). Before 1975 the median age of gluten introduction was significantly less than that after 1975 (2 compared with 4 months) and the age of gluten introduction correlated with the age of presentation. It is concluded that breast feeding and the age of gluten introduction may influence the age of presentation of childhood coeliac disease but no clear reasons for the rise in incidence in the 1970s have been determined. It does not appear that the disease is declining, however, in recent years children have tended to present later in life. PMID- 2782930 TI - Diarrhoea in jaundiced neonates treated with phototherapy: role of intestinal secretion. AB - Thirty jaundiced neonates with diarrhoea who were being treated with phototherapy and 30 matched control infants were studied to try and find out the cause of the diarrhoea. Faecal osmolality and electrolyte concentrations were measured, which gave clear evidence that the diarrhoea arose from intestinal secretion. Rectal water and electrolyte absorption in 10 jaundiced infants receiving phototherapy, in 10 jaundiced infants not receiving phototherapy, and in 10 healthy controls was measured with a rectal dialysis bag. A further group of eight jaundiced infants was also studied both during and after phototherapy to document the reversal of ion transport changes. Absorption of water, sodium chloride, and potassium was significantly impaired in the patients receiving phototherapy compared with each of the control groups. Such impairment was transient, as it was not apparent when the jaundice faded and phototherapy was stopped. These data show that the colon plays a part in the pathogenesis of secretory diarrhoea and that both hyperbilirubinaemia and phototherapy are necessary for such an effect to develop. PMID- 2782931 TI - Serological and histological follow up of chronic hepatitis B infection. AB - In order to study the clinical, serological, and morphological evolution of chronic hepatitis B virus infection in childhood, a prospective study has been carried out. A total of 90 children with a chronic infection were followed up for a mean (SD) of 3 (1.8) years. At the beginning of the study, 61 children were asymptomatic and 77 were household contacts of chronic carriers. Serologically 77 were hepatitis B e antigen (HBeAg) positive and 71 of them were positive to hepatitis B virus DNA. The mean alanine aminotransferase activities were higher among HBeAg positive patients than in antihepatitis B e (anti-HBe) positive ones. The most severe histological damage was also found among HBeAg positive patients. The annual seroconversion rate was 14%. A significant increase in the alanine aminotransferase activity was observed 13 (5.6) months before appearance of anti HBe in the 85% of cases. Among anti-HBe positive patients, the alanine aminotransferase activities were normal in all except three (19%), two of whom had intrahepatic delta antigen. An increase in the histological activity was observed among patients who maintained HBeAg presence while an amelioration of liver damage was observed in anti-HBe carriers. PMID- 2782932 TI - Precocious puberty in girls: early diagnosis of a slowly progressing variant. AB - An attempt was made to identify the less severe cases of precocious puberty and to describe their natural course. A group of 17 girls with precocious puberty and a bone age advance over chronological age of less than two years (group 1) was compared with a group of 19 patients with severe precocious puberty and bone age advance of two years or more (group 2). Mean (SEM) plasma oestradiol concentrations were 82 (30) pmol/l and 164 (21) pmol/l (p less than 0.05), vaginal maturation indexes were 16 (5) and 41 (4), and plasma somatomedin C concentrations were 1.0 (0.2) U/ml (n = 8) and 2.1 (0.3) U/ml (n = 16) in groups 1 and 2, respectively. The time between onset and diagnosis of secondary sexual characteristics was about one year in both groups. After two years' follow up the untreated patients in group 1 had maintained their predicted final height. These changes were in contrast to those observed at first examination in patients in group 2 who had a mean (SD) predicted final height of -1.3 (0.2) and a mean bone age advance of 3.0 (0.2) years. These data show that bone age advance to chronological age, and plasma somatomedin C concentrations measured at initial evaluation are helpful in identifying less severe and potentially slow progressing forms of central precocious puberty. PMID- 2782933 TI - Transient infantile hyperthyrotrophinaemia. AB - Sixteen cases of transient infantile hyperthyrotrophinaemia were followed up for two to seven years. Concentrations of serum triiodothyronine, thyroxine, and free thyroxine were maintained within the normal range in all cases. All but one child, who had a hearing disturbance, showed normal mental development with normal physical and skeletal maturation. Eleven children had normal concentrations of serum thyroid stimulating hormone and no signs or symptoms of thyroid dysfunction; in three children, diffuse small goitres developed and two further children showed relapse with slightly raised concentrations of thyroid stimulating hormone. It is concluded that 'transient infantile hyperthyrotrophinaemia' is a syndrome, which differs from typical transient neonatal hypothyroidism, and that careful follow up is necessary because some children show signs of mild pituitary-thyroid dysfunction in later childhood. PMID- 2782934 TI - Calcium intake and cows' milk free diets. AB - In children with atopic eczema on elimination diets, the calcium intake was below the estimated requirement in 15 out of 20 who avoided cows' milk and received no milk substitute, and in three out of 26 who avoided cows' milk but were provided with a soya or casein hydrolysate formula. PMID- 2782935 TI - Absence of Y specific DNA sequences in two siblings with 46XX hermaphroditism. AB - We report two siblings with 46XX hermaphroditism in whom we were unable to show the presence of Y specific DNA sequences using the DNA probes Y-190, GMGY-7, pHY2.1, pDP34, and 27a. We conclude that an autosomal or X chromosome gene mutation is the most likely mechanism of inheritance in this family with 46XX hermaphroditism. PMID- 2782936 TI - Psychological care of survivors of a fire. AB - A mother and daughter were the sole survivors of a house fire. Support, maintenance of the parent-child relationship, and monitoring and facilitating the grieving process in a way that was consistent with the developmental stages of the patients were the basis of management. PMID- 2782937 TI - Neonatal pneumatosis cystoides intestinalis caused by volvulus of the mid intestine. AB - A case of malrotation of the mid intestine with volvulus is reported in an infant in whom the clinical and radiological appearances were unusual, and had led to a misdiagnosis of necrotising enterocolitis. If the correct diagnosis had been made earlier, operation might have saved the infant's life. PMID- 2782938 TI - Treatment for refractory myasthenia gravis. AB - An 8 year old girl with ocular myasthenia gravis was treated with high dose intravenous immunoglobulin and high dose intravenous methylprednisolone. Ocular symptoms recurred seven months after the start of the immunoglobulin. She has been in remission for more than 12 months after two courses of intravenous methylprednisolone, and administration of oral prednisolone was discontinued. PMID- 2782939 TI - Aetiology of severe pneumonia in developing countries. PMID- 2782940 TI - Seizures presenting as apnoea. PMID- 2782942 TI - Autosomal recessive hypophosphataemia. PMID- 2782941 TI - Breath hydrogen excretion in infants with colic. PMID- 2782943 TI - British Paediatric Association, annual general meeting. York, 11-14 April 1989. Abstracts. PMID- 2782945 TI - Duration of enhanced responsiveness upon re-exposure to ozone. AB - It has been repeatedly observed that ozone (O3) re-exposure within 24 h elicits enhanced pulmonary function responses. However, there are only limited observations concerning re-exposure to O3 at intervals between 24 h and several days. The present study was designed to assess the effects of re-exposure to 0.35 ppm O3 at intervals of 24, 48, 72, and 120 h. Forty young adult male subjects were assigned randomly to one of four groups in ascending order of time to re exposure (groups 1-4). Each exercised on a bicycle ergometer for 60 min at a workload that elicited a mean ventilation of 60 l/min on three occasions: protocol 1 (P1), filtered air (FA); protocol 2 (P2), 0.35 ppm O3; and protocol 3 (P3), 0.35 ppm O3. In addition to standard pulmonary function measures, specific airway resistance (SRaw); exercise ventilatory pattern, i.e., respiratory frequency (fR) and tidal volume (VT); and subjective symptoms (SS) were assessed. Statistical analysis revealed significant differences (p less than .05) for all groups between the FA (P1) responses and those for the two O3 exposures (P2, P3) for forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1.0), SRaw, fR, VT, and SS. When the two O3 exposures (P2 and P3) were compared, only group 1 (24 h) responses were statistically significant upon re-exposure: FEV1.0, -16.1 vs. -30.4% (p less than .003); SRaw, 20.5 vs. 34.5% (p less than .05); fR, 44.2 vs. 65.3% (p less than .001); and SS (p less than .015).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2782944 TI - Biological monitoring of dichloropropene: air concentrations, urinary metabolite, and renal enzyme excretion. AB - Fifteen applicators of dichloropropene (DCP) were studied for personal air exposure to DCP, excretion of the metabolite of DCP (3CNAC), and excretion of the renal tubular enzyme, N-acetyl glucosaminidase (NAG). Each was studied for four 6 8 h consecutive intervals following baseline determinations of 3CNAC and NAG excretion. In accord with pilot data, 24-h urinary excretion of 3CNAC (mg) correlated well with exposure product for DCP (min exposed.mg/m3), r = 0.854, p less than .001. A more precise correlation of the air exposure product with urinary excretion of 3CNAC was discerned by using the morning urine after the previous day of exposure (micrograms/mg of creatinine), r = 0.914, p less than .001. Four workers had clinically elevated activity of NAG (greater than 4 mU/mg creatinine) in any of their urine collections after baseline. Nine workers showed greater than 25% increases in NAG excretion when compared to baseline. Dichloropropene air exposure products of greater than 700 mg.min/m3 or excretion of greater than 1.5 mg 3CNAC/d distinguished abnormally high daily excretion of NAG. These data demonstrate a firm positive relationship between air exposure and internal exposure, and a possible subclinical nephrotoxic effect in DCP workers. PMID- 2782946 TI - Air lead exposures and blood lead levels within a large automobile manufacturing workforce, 1980-1985. AB - Recent (1980-1985) trends in air lead (PbA) exposures and blood lead (PbB) levels experienced by approximately 10,000 workers employed in various stages of the automobile manufacturing process (i.e., auto assembly, lead-acid battery manufacture, foundry work, and "other" manufacturing-related operations) are described. Between 1980-1985, the mean PbB levels of assembly, battery, foundry, and "other" workers decreased by 28, 24, 3, and 27%, respectively, to 16.6, 23.6, 15.9, and 11.8 micrograms Pb/dl. Workers in the following job categories experienced the highest annual mean PbB levels: paste machine operators (battery plants), solder-grinders (assembly plants), and crane operators (foundries). During the same period, median 8-h Time Weighted Average PbA exposures (micrograms Pb/m3) in assembly plants, battery plants, and foundries decreased by 10, 12, and 20%, respectively, to 8.1, 13.6, and 10.9 micrograms/m3. PMID- 2782947 TI - Chlorinated drinking water and bladder cancer: effect of misclassification on risk estimates. AB - Data are presented from the Iowa portion of the National Bladder Cancer Case Control Study demonstrating the effect of misclassification on depressing odds ratio estimates for years of exposure to chlorinated drinking water and bladder cancer. Four methods (METHODS 1 through 4) of quantifying chlorination exposure with sequentially decreasing degrees of misclassification are presented for the 268 bladder cancer cases and 658 population-based controls fulfilling criteria for inclusion in this study. Twenty-eight other risk factors for bladder cancer were considered along with chlorinated drinking water exposure estimated by METHOD 4. Stepwise regression models included as significant factors cigarette smoking (p less than .001), chlorination exposure (p = .038), and irradiation to the pelvic area (p = .040). Replacement of chlorinated drinking water exposure estimated by METHOD 4 with any of the remaining three methods resulted in models that included cigarette smoking and irradiation to the pelvic area, but not chlorination exposure. Thus, misclassification of chlorination exposure signified the difference between observing and not observing an association with bladder cancer. PMID- 2782948 TI - Relationship between tracheobronchial particle clearance rates and sites of initial deposition in man. AB - Mucociliary clearance was compared in three groups of normal subjects; each group inhaled a different type of aerosol (sebecate, iron oxide, and aqueous) labelled with 99Tc, to determine the relationship between deposition pattern and the subsequent total lung clearance. Standardization for deposition was accomplished by measuring a central to peripheral ratio (C/P) of deposited radioactivity in the thorax. Lung particle retention at 30, 60, 90, 120 min, and 24 h was measured, and compared at each time period to the C/P ratio. A linear relationship between the retention of aerosol at each time period and the C/P ratio was seen among all aerosols, e.g., aerosol with high C/P ratios had less retention of aerosol at a given time period than aerosols with more diffuse deposition patterns and lower C/P ratios. Furthermore, the relationship was similar to that of the more traditional measurement of regional deposition, the 24-h percentage retention. Lung particle retention was compared among aerosols, using analysis of covariance to standardize for C/P ratio. The intersubject variability was similar among all three aerosol groups. Thus, mucociliary clearance can be standardized in healthy subjects by using an initial deposition index, the C/P ratio, with similar accuracy to the 24-h percentage retention, as an index of aerosol deposition. The use of the C/P ratio, however, has distinct advantages over the 24-h retention, in that studies can be conveniently shortened, used with short lived isotopes, and be adapted to techniques investigating lung permeability instead of tracheobronchial clearance. An unexpected finding was the more rapid clearance of sebecate particles, compared with iron oxide or aqueous particles.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2782949 TI - Immunoscintigraphy using CA 125 antibodies in the management of ovarian cancer. AB - Radioimmundetection (RID) using anti-CA 125 antibodies proved to be a valuable tool in the follow-up of metastasizing ovarian cancer. Sensitivity, specificity, and accuracy were high. RID had no clinical side effects. But some patients formed antibodies which interfered a) with the evaluation of the scintigram and b) with further measurement of CA 125 levels. We found 2 cm diameter metastases that were not detected by computed tomography. However, the heterogeneity of tumor metastases limits the sensitivity of this method. CA 125 serum levels, immunohistochemistry, and immunoscintigraphy did not always correlate. Monitoring serum levels of CA 125 was most valuable in clinical management of tumor spread and in the optimal use of RID. PMID- 2782950 TI - Prolactin and cortisol levels during spontaneous and oxytocin induced labour and the effect of meperidine. AB - The effect of stress during labour on the plasma concentration of prolactin and cortisol was studied in 30 healthy multiparous women. The plasma concentrations of prolactin and cortisol were measured by radioimmunoassay during oxytocin induced labour, spontaneous labour, delivery and postpartum 24 h. The parturients were divided into three groups. The first group was given oxytocin for the induction of labour, the second group was also given oxytocin for the induction of labour and 100 mg of meperidine was administered intramuscularly for relief of pain and anxiety, and the third group was the control group with normal parturients who did not receive any medication. The prolactin levels showed a fall during labour in all the groups, but this fall was more marked in the first group where stress was evident. The concentrations of cortisol tended to increase during labour and reached a maximum at delivery in all three groups but in the meperidine group this level was significantly lower than the first and control groups. These results give further support to the hypothesis that maternal stress leads to a reduced concentration of prolactin and increased concentration of cortisol whereas relief of pain and maternal anxiety with meperidine lessens both effects. PMID- 2782952 TI - [Carcinoma of the penis]. PMID- 2782951 TI - Successful colposuspension in stress urinary incontinence reduces bladder neck mobility and increases pressure transmission to the urethra. AB - Twenty-nine consecutive patients with stress urinary incontinence were investigated by bead chain urethrocystography (UCG) and single cough urethrocystometry before operation and 8-12 months after a Burch colposuspension producing clinical improvement. The operation significantly elevated the bladder neck and reduced its mobility during acute stress. The urethral inclination angle and the posterior urethrovesical angle also became smaller at rest and on straining. A significant negative correlation was found between the postoperative mobility of the bladder neck and the post-operative pressure transmission ratio (PTR), indicating that correction of the urethrovesical anatomical disorder eliminates the functional disorder in this disease and restores continence. PMID- 2782953 TI - [Cholinergic innervation of the prostate in the white rat (Rattus norvegicus)]. AB - We studied the cholinergic innervation of the prostate in male albino rats using a technic for demonstrating acetylcholinesterase (AChE) activity. We observed AChE-positive nerve fibers surrounding the acini and blood vessels. In the prostatic ventral lobe, a large number of AChE-reactive neurons (isolated or forming microganglia) were observed. However, no neurons were observed in the dorsal-lateral prostatic lobe. The foregoing findings suggest a different cholinergic innervation for these prostatic lobes. PMID- 2782954 TI - [Experimental study of reconstruction of the vas deferens in the rat]. AB - We performed vasectomy and microsurgical repair of the vas deferens in 20 rats utilizing absorbable and non-absorbable 10-0 sutures. At 40 days the results of the repair procedure were evaluated by seminal fluid and fertility analyses, deferentography, and histologic examination of the anastomoses. The procedure failed in one case that presented occlusion of the spermatic cord from a granuloma. PMID- 2782955 TI - [Reconstructive plastic surgery of urethral stenosis: urethroplasty with lyophilized dura mater]. AB - The author reports on his experience in the treatment of urethral stenosis using lyophilized human dura mater for urethral augmentation and replacement. The excellent results achieved in experiments using lyophilized human dura mater as a homoplastic material for tissue augmentation and replacement has led to its use in clinical application. The results achieved utilizing this material in the treatment of 20 patients with urethral stenosis further corroborate its usefulness as an alloplastic material, and as an alternative to autologous grafts. PMID- 2782956 TI - [Technical modification in the surgical treatment of curvature of the penis]. AB - Congenital curvature of the penis without hypospadias is not an uncommon condition whose treatment is by surgery. We report on 10 cases with congenital penile curvature submitted to the Nesbit procedure using our modified approach, which has achieved good results. PMID- 2782957 TI - [Congenital inward curvature of the penis without hypospadias. Report of 3 new cases]. AB - We report on 3 young patients with congenital curvature of the penis without hypospadias (a rare disease entity) who consulted us for erectile deviation causing difficulty or inability to achieve vaginal penetration. No patient referred pain and the deviation was ventral, left lateral and ventral, and left lateral, respectively. These patients underwent surgical correction with the technic described by Nesbit in 1965. Good results were achieved in all patients; correction permitted patients to resume normal sexual activity. The literature is reviewed highlighting the good results afforded by this simple yet effective technic for surgical correction of this condition. PMID- 2782958 TI - [Mortality and complications from cystectomy of bladder cancer]. AB - The operative mortality and early and late complications were analyzed in 241 patients submitted to cystectomy for bladder cancer over a 7.5-year period. Of these, 92% were males and 8% females; mean patient age was 60 years. Preoperative radiotherapy of 2,500-6,000 rads was given to 114 patients. There were 33 (13.7%) operative deaths; the incidence being statistically significantly higher for those who had previously received radiotherapy. Early complications presented in 39% of the cases, and 44% had late complications. The complication rates were not influenced by preoperative radiotherapy. PMID- 2782959 TI - [Our experience in the treatment of superficial cancer of the bladder with BCG]. AB - We report on our experience with 21 patients with superficial bladder cancer who were treated with intravesical BCG instillation. The BCG vaccine was effective in the treatment of carcinoma in situ. Tumor regression was achieved in 83.3% at 3 months, and 61.1% at 24 months. It is advisable to follow patients closely because of the possibility of tumor progression. PMID- 2782961 TI - [Bladder carcinoma in patients under 40 years of age]. AB - A retrospective study was undertaken on 147 cases of bladder tumors T1 GI-II that were treated over the period 1984-1987. Of these, 9 (6.1%) were tumors in patients under 40 years of age. All the foregoing 9 cases, and only 97 of the remaining 138 cases could be evaluated and compared. The male to female ratio was 8:1. Both patient groups were similar with respect to tumor grade, number, and size. All patients were treated by TUR and received chemotherapy post operatively. Of the 9 patients under 40 years of age, 2 (22.2%) patients classed as GII had tumor recurrence and total cystectomy was performed in one (11.1%) due to tumor upgrading; whereas for the remaining patient group tumor recurrence was 37.7% and tumor progression was 6.6%. This finding shows that the choice of treatment or the decision to follow patients more or less closely cannot be based on patient age. Treatment should be based on patient overall condition and tumor grade and stage. PMID- 2782960 TI - [Combination of interstitial implants of Au-198 seeds and external irradiation in the treatment of prostatic carcinoma. Preliminary communication]. AB - The usefulness of external and interstitial radiotherapy in the treatment of prostatic carcinoma is well-documented. We report on our experience in 23 cases using interstitial Au-198 seed implants in combination with external radiation. The diagnostic protocol and therapeutic approach are described. Local control was achieved in 73% and the disease-free survival at 36 months was 49%. The mean follow-up was 44 months. The problems resulting from TUR and the different factors that might be responsible for the failure of local treatment are discussed. PMID- 2782962 TI - [Radiotherapy as the definitive treatment of patients with carcinoma of the bladder]. AB - Sixty-one patients, who refused surgery or whose overall medical status advised against radical cystectomy, were submitted to radical radiotherapy at the Oncology Radiotherapy Service of the General Hospital of Asturias. Irradiation was performed in a cobalt therapy unit. Radiation dose ranged from 50-70 Gy, with a daily dose of 190-200 cGy. Local control was achieved in 71% for stage A, 68% for B1. 17% for B2, and 0% for stage C. Disease-free survival was 63% for stage A, 48% for B1, 14% for B2, 0% for C, and 17% for D1. Overall disease-free survival was 20%, and the morbidity and mortality rates were 11.4% and 3.2%, respectively. In view of the poor results achieved in our setting, we have considered using combined external and interstitial radiation for tumors localized in the muscle layer, and adjuvant chemotherapy for stage C tumors (or those infiltrating perivesical fat). PMID- 2782963 TI - [Transitional infiltrating carcinoma of the bladder. Local recurrence and metastases. Analysis of 175 cases treated with radical cystectomy]. AB - Although much has been written on transitional cell carcinoma of the bladder, little has been reported on its metastasis. We reviewed the records of 175 patients, 4 of whom died postoperatively. All patients had been followed until their death and the surviving patients recently evaluated. Sixteen patients were lost after a long follow-up. Most of the metastases were diagnosed within 18 months after the cystectomy. Sixty-one percent of the patients presented bony metastases. The risk of metastasis is greater for sessile tumors, and increases with the degree of vesical wall infiltration, anaplasia and lymph node involvement. Evidence of lymph node involvement is not necessary for metastasis to exist. There were significantly fewer patients who died with metastasis in the patient group that did not receive preoperative radiotherapy in comparison with the other two patient groups. Of the 11 patients who revealed no evidence of tumor in the surgical specimen, 2 metastasized, indicating that metastasis was present prior to cystectomy. Treatment with cytostatic agents is the only effective therapy against distant metastasis. In our view, all patients with a tumor invading perivesical fat or who present lymph node involvement, regardless of tumor stage, should receive chemotherapy after cystectomy as early as patient condition permits. PMID- 2782964 TI - [Transitional infiltrating carcinoma of the bladder significant in its spread to regional lymph nodes]. AB - We analyzed the course of 170 patients, 136 of whom underwent bilateral lymphadenectomy. Data was obtained to define N of the TNM classification in 126 patients. The remaining patients (10 whose pathologic work-up was unavailable; 32 who did not undergo lymphadenectomy) were classified as Nx. Metastasis was diagnosed during follow-up in 60% of those with positive lymph nodes. In our view, metastasis was already present in these patients prior to the surgical procedure. The survival rate is significantly higher for the patient group without lymphatic spread compared to the group with negative lymph nodes and Nx. Evaluation of the patient group without lymphatic spread revealed a higher survivorship for those who received 2,000 rads (24%) prior to cystectomy compared to those who received 4,500 rads (17%) and those who received no irradiation (12%). However, there is a lower incidence of metastasis for the patient group submitted to surgery alone (50%) compared to those that received preoperative radiotherapy (73% and 67% for those treated with 2,000 and 4,500 rads, respectively). Furthermore, preoperative radiotherapy did not reduce the mortality rate which was 83% for those who received no radiotherapy, 73% for those who received 2,000 rads, and 75% for those who received 4,500 rads. However, it may seem contradictory that a radiation dose of 2,000 rads appears to be more effective in these patients than a dose of 4,500 rads which is theoretically closer to the ideal dose for treatment of node involvement. Patients with positive lymph nodes must be treated with chemotherapy as soon as they have recovered from the surgical procedure since 3 out of 5 patients have undetected micrometastases. PMID- 2782965 TI - [New ultrasonic images in patients with lithiasis after undergoing extracorporeal shock wave lithotripsy]. AB - Evaluation and follow-up of patients submitted to extracorporeal shock wave lithotripsy (ESWL) by ultrasonography is a good adjunct to radiology. Plain x-ray and ultrasound imaging permit following the course of stone patients submitted to treatment by ESWL without recurring to IVP in most of the cases. One-thousand kidney units corresponding to 931 stone patients were submitted to ESWL. Patient evaluation by ultrasound was performed prior to and 24 hours after treatment. Ultrasonographic evaluation is important because it permits: 1. Detection of changes in size, number, and site of the hyperechogenic image. 2. Evaluation and follow-up of urinary tract dilatation. 3. Control of radiolucent calculi thereby avoiding repeated explorations using contrast medium. 4. Detection of possible perirenal hematoma post-ESWL. 5. Diagnosis of other renal or extrarenal disorders. PMID- 2782966 TI - [Gingival metastasis: a rare presenting form of renal adenocarcinoma]. AB - Malignant tumors metastasizing to the oral cavity are rare and account for 3.6% to 15.2% for renal adenocarcinoma. These tumors have gross features compatible with benign tumors or inflammatory hyperplasia. Due to the frequency of ulceration and infection of these metastatic tumors, surgical treatment is advocated. PMID- 2782967 TI - [Retroperitoneal schwannoma: report of a case]. AB - We report on a patient with a benign retroperitoneal schwannoma whose course had been followed clinically and pathologically for 11 years. The clinical features, diagnosis, prognosis, and treatment of this uncommon tumor type are discussed. PMID- 2782968 TI - [Plasmacytoma of the testis: report of a case]. AB - We report on a case of testicular plasmacytoma in a patient with multiple myeloma (MM), who is currently in a state of remission following chemotherapy and radiotherapy. The literature is reviewed, and testicular involvement in plasma cell neoplasms is discussed. PMID- 2782969 TI - [Genital rhabdomyosarcoma. Diagnostic and therapeutic considerations. Apropos of a case of cavernous origin]. AB - A case of perineal rhabdomyosarcoma possibly originating in the corpus cavernosum penis is reported. Treatment was by surgery first followed by chemotherapy. The poor outcome prompted us to review the literature on the diagnosis and treatment of this condition. We can conclude from data published elsewhere that rhabdomyosarcoma localized to the GU tract is a tumor that is amenable to treatment by chemotherapy combined with radiotherapy in most of the cases. When planning treatment, diagnosis must be well-established histologically and staging must be precise in order to avoid unwarranted radical surgery. PMID- 2782970 TI - Nesbit procedure in the treatment of congenital penile deviation. AB - We reviewed 19 patients presenting erectile deformities of the penis. Sixteen patients with congenital penile deviation were treated with the Nesbit procedure. All patients presented pronounced curvature of the penis and most of them were unable to achieve vaginal penetration. Five patients were submitted to original Nesbit procedure and eleven to a modified Nesbit technique, without excising the tunica albuginea. The modified Nesbit operation gave excellent results in all patients; straightening the penis and permitting patients to resume normal coitus. It was a simpler procedure; there were no complications or postoperative impotence. The length of hospital stay was 24 hours. PMID- 2782972 TI - Pathogenesis of square bodies in ankylosing spondylitis. AB - The pathogenesis of squaring of the vertebral bodies is analysed in a 25 year old patient with ankylosing spondylitis. The squaring derives from a straightening of the anterior contour. The disease was diagnosed five years before the patient's death. The remodelling of bone that explains squaring of the vertebral bodies is described for the first time. Histologically, an acute and chronic spondylitis with destruction and simultaneous rebuilding of the cortex and the spongiosa of the vertebral bodies has been found. The development of square vertebral bodies is shown to be based on a combination of a destructive osteitis and repair. PMID- 2782971 TI - Effect of indomethacin on swelling, lymphocyte influx, and cartilage proteoglycan depletion in experimental arthritis. AB - The effects of indomethacin on antigen induced arthritis in rabbits have been investigated. Arthritis was induced in the knee joints of sensitised rabbits by intra-articular injection of antigen. Swelling of the joints was measured for 14 days after antigen challenge, and groups of animals were killed on days 1, 7, or 14 for collection of synovial fluids and tissues. Indomethacin (1 mg/kg, three times daily) reduced joint swelling and the prostaglandin E2 concentrations in synovial fluid. In addition, indomethacin increased the loss of proteoglycan from articular cartilage and the numbers of lymphocytes in the inflamed synovial lining. These findings suggest that the symptomatic benefits of indomethacin and related drugs in inflammatory arthritis may be achieved at the expense of significant adverse effects on joint tissues. PMID- 2782973 TI - Pulmonary function and maximal transrespiratory pressures in ankylosing spondylitis. AB - Clinical measurements and pulmonary functions, including maximal transrespiratory pressures, were studied in 30 patients (age 43 (SD 10) years) with ankylosing spondylitis. Vital capacity (VC) was slightly reduced to 79 (16)% and forced expiratory volume in one second (FEV1) was similarly reduced to 82 (20)% such that the average FEV1/VC ratio was 77.8 (6.65). Total lung capacity was slightly reduced to 85 (13)%. Transfer factor of the lung for carbon monoxide (TLCO) averaged 88 (17)% and TLCO per unit lung volume was 114 (26)%. Reductions in lung volumes correlated well with clinical measurements. Both maximal expiratory pressures (PEmax) and inspiratory pressures (PImax) were clearly reduced to 56 (17)% and 76 (28)% respectively. This suggests that spirometrically determined volumes were better preserved than respiratory muscle strength in ankylosing spondylitis. It is speculated that the reduction in respiratory muscle strength may be due to intercostal muscle atrophy. PMID- 2782974 TI - Correlation between synovial neopterin and inflammatory activity in rheumatoid arthritis. AB - According to recent investigations neopterin (a pyrazinopyrimidine derivative) is a biochemical marker that reflects the activity of the proinflammatory immunocellular system of the synovial tissue in rheumatoid arthritis (RA). Interferon gamma, derived from antigen activated T lymphocytes, stimulates macrophages to synthesise and release neopterin into the culture supernatant in vitro. To extend this in vitro model to a clinical level a sensitive new radioimmunoassay technique was used to measure neopterin concentrations in the synovial fluid (SF) of 17 patients with active RA, nine with osteoarthritis, and six with acute gout, and in that of 12 controls undergoing meniscectomy. The SF neopterin concentrations were significantly higher in patients with RA than in the other groups of patients, particularly the controls. Multivariant analysis showed that SF neopterin concentrations correspond better with the systemic inflammatory activity of RA than with the local disease activity of the knee joints. Thus the study strengthens the hypothesis that neopterin reflects the essential role of the activated immunocellular reaction in the pathogenesis of RA. PMID- 2782975 TI - Treatment of polymyalgia rheumatica and giant cell arteritis. I. Steroid regimens in the first two months. AB - Thirty nine patients with polymyalgia rheumatica (PMR) and 35 with giant cell arteritis (GCA) were treated with high or low dose steroid regimens in a prospective study of the first two months of treatment. Patients with PMR needed 15-20 mg prednisolone initially; 13/20 (65%) relapsed on an initial dose of 10 mg/day. All but two patients with GCA were successfully treated with 40 mg/day prednisolone initially but relapsed on a reduction to 20 mg/day. One patient with GCA receiving 30 mg/day relapsed after four weeks. Six patients with PMR developed GCA during the first two months and required an increased prednisolone dose to control symptoms. The erythrocyte sedimentation rate or C reactive protein did not predict relapse. PMID- 2782976 TI - Treatment of polymyalgia rheumatica and giant cell arteritis. II. Relation between steroid dose and steroid associated side effects. AB - In a prospective study of 74 patients and a retrospective study of 35 patients with polymyalgia rheumatica/giant cell arteritis steroid related side effects occurred in at least one third of patients, and in two thirds if weight gain was included. Side effects were significantly related to an initial prednisolone dose of more than 30 mg and to the cumulative prednisolone dose. Patients taking a mean daily dose of 5 mg prednisolone or less were significantly less likely to develop side effects. PMID- 2782977 TI - Erythrocyte sedimentation rate and C reactive protein in the assessment of polymyalgia rheumatica/giant cell arteritis on presentation and during follow up. AB - The erythrocyte sedimentation rate (ESR) and C reactive protein (CRP) were measured in 74 patients with polymyalgia rheumatica (PMR)/giant cell arteritis (GCA) on presentation, in the first month of treatment, and at long term follow up (up to 177 weeks). Before treatment the ESR was raised (greater than 30 mm/h) in all cases and the CRP was raised (greater than 6 mg/l) in 49/55 cases. The ESR was a better indicator of clinical disease activity except in patients who felt completely well at week 1. 'False positive' increases of ESR or CRP were rare. During relapses ESR was normal in 37/77 (48%) of cases and CRP in 41/73 (56%). It is suggested that ESR is the most useful laboratory parameter in assessing PMR/GCA. PMID- 2782978 TI - Auricular chondritis and diffuse proliferative glomerulonephritis in primary Sjogren's syndrome. AB - Bilateral auricular inflammation with histological changes of relapsing polychondritis was observed in a female patient with primary Sjogren's syndrome. This was accompanied by rapidly progressive renal insufficiency due to diffuse proliferative glomerulonephritis. To our knowledge this is the first well documented case of primary Sjogren's syndrome associated with chondritis and glomerulonephritis, further emphasising the wide spectrum of extraglandular manifestations in this autoimmune disorder. PMID- 2782979 TI - Scintimetric assessment of synovitis activity. PMID- 2782980 TI - Does the wash-up and swim-up method of semen preparation play a role in sex selection? AB - Because of the higher built ratio of boys to girls (1.5 : 1) by in vitro fertilization (IVF) and gamete intrafallopian transfer (GIFT) at Tygerberg Hospital, the question arose as to whether the wash-up and swim-up method of semen preparation, used for our IVF procedure, plays a role in sex selection. Semen samples of 20 men were evaluated at different time intervals to determine the percentage of F-body-positive spermatozoa. It was found that the swim-up time affects the relationship between Y- and X-bearing spermatozoa, especially at time intervals of 30 and 45 min, where an optimum percentage of Y-bearing spermatozoa (p = 0.0039 and p = 0.0092, respectively) was found. Sperm obtained at these specific time intervals may influence the outcome of sex by IVF and GIFT in favor of males. PMID- 2782981 TI - Murine oocyte cryopreservation: comparison between fertilization success rates of fresh and frozen metaphase I and II oocytes. AB - The surplus of oocytes obtained during in vitro and gamete intrafallopian transfer creates the need to either (1) cryopreserve (196 degrees C) or (2) fertilize these surplus oocytes and then freeze the resulting embryos. During this pilot study, C57BL6 X CBA female mice (F1 generation) were superovulated by means of hormone stimulation, resulting in adequate numbers of murine oocytes. Oocytes thus obtained were classified according to their nuclear status. The maturation stage of oocytes was evaluated and classified as metaphase I and metaphase II. The success of oocyte cryopreservation in each group was evaluated according to fertilization rate after the insemination procedure. Metaphase II oocytes had a fertilization rate of 33% (frozen) and 84% (fresh), whereas metaphase I oocytes had a 24% (frozen) and a 79% (fresh) fertilization rate. Metaphase I oocytes can mature to the metaphase II stage after having been frozen, metaphase II oocytes may be more vulnerable to chromosome damage, and the nuclear stage prior to freezing has no significant effect on the fertilizability of the frozen-thawed oocytes. PMID- 2782982 TI - Zona-free hamster egg penetration assay: prognostic indicator in an IVF program. AB - Fertility potential measurements of the zona-free hamster egg bioassay were compared with the in vitro fertilization of human eggs. Sperm from 31 husbands or donors participating in an in vitro fertilization-embryo transfer program was used in 38 simultaneous inseminations of human and hamster eggs. In 7 out of 31 cases, a positive penetration (hamster) test fertility assessment was obtained in the absence of fertilization of the human eggs, attributable to egg immaturity and in one case to equipment failure. In the remaining 30 cases, fertilization was achieved with at least one egg per case. There were no false-negative assessments. Our results indicate that this bioassay is highly correlated with the fertilization of human eggs in vitro. PMID- 2782983 TI - Cigarette smoking and male reproduction. AB - The effects of cigarette smoking on male reproduction were studied through measuring the serum estradiol (E2), prolactin (PRL), and total testosterone (T). Smoking men had higher levels of E2 and PRL but normal T compared to nonsmokers. Raised E2 and PRL may be among the mechanisms through which cigarette smoking impairs male reproduction. PMID- 2782984 TI - Intrauterine insemination with washed sperm. AB - Intrauterine insemination with washed semen has been carried out in our department since the beginning of 1986. Couples are examined carefully according to the principles of WHO before entering the program. The cycles of those couples treated by intrauterine insemination were monitored. Oestradiol values showed the highest levels on days 13 and 14, such as the size of folliculi, and serum progesterone level increased on days 14 and 15 ovulatory cycle. Insemination was performed with washed sperm after cleansing from it different albumin components and bacteria; the insemination was carried out in two groups. Good results were achieved in cases where the poor quality or hostility of the cervical mucus was the cause of infertility. The treatment can be successful if the spermiogram does not show severe deviation. No success can be expected in severe deviation of the spermiogram. PMID- 2782985 TI - [Systolic stress in mitral stenosis]. AB - Left ventricular systolic stress was studied in nineteen patients with mitral stenosis, twelve in sinus rhythm and seven in atrial fibrillation. Left ventricular dimensions and volumes and septal and posterior wall thickness were measured by means of M and two bidimensional echocardiography at rest and during isometric exercise. Expulsive indices: fractional shortening, ejection fraction and mean circumferential shortening rate were calculated. Ventricular mass, meridional stress and several end-systolic stress or pressure/volume relationships were estimated. Patients with atrial fibrillation were older and had systolic dysfunction: greater end-systolic volumes and depression of both expulsive fractions and some of the end-systolic indices. Preload and wall thickness were normal. Patients with atrial fibrillation showed higher ventricular stress as a consequence of greater ventricular dimensions. Ejection fraction correlates directly with mitral valve area and inversely with inotropic state and heart rate. It is concluded that systolic dysfunction in mitral stenosis is multifactorial. The most important determinants of the abnormality are heart rate and inotropic state. The study did not show any primary abnormality of afterload or hypotrophy of the left ventricle. PMID- 2782986 TI - [Amiodarone keratopathy. Prospective longitudinal study]. AB - In order to investigate the frequency of corneal micro-deposits of amiodarone and its relationship to age, sex, dose and treatment duration, we studied one-hundred fifty consecutive patients from 1982 to 1986. The average age was 33.8 +/- 17.5 years for eighty woman and seventy men. The mean weekly dose was of 1.1 +/- 0.3 g and the duration was 23.7 +/- 15.3 months. A complete eye examination was performed in all cases. The corneal micro-deposits were classified in three levels according to their density. In one-hundred-fourteen cases there were corneal micro-deposits; sixty-nine had grade I, thirty grade II and fifteen grade III. None had visual disturbances. There was only a direct statistical correlation between age and micro-deposit levels. Nine cases had also deposits of pigment in the lens. Two cases presented atypical keratopathy which by their involution after withdrawal of the drug was considered to be amiodarone-related. Fifteen cases presented chronic blepharitis, and ten, chronic non-secreting conjunctivitis. Therefore, age is a determinant factor for corneal accumulation of amiodarone micro-deposits. PMID- 2782987 TI - [Study of calcification of the mitral annulus. Importance of echocardiographic analysis]. AB - Mitral annulus calcification is a common finding in old people. In order to know the association of mitral annulus calcification with other pathologic conditions, 25 patients were studied by echocardiography, 20 females and 5 males. No significant differences _ere observed with respect to sex. The average age was 67 +/- 15 years. Mitral annulus calcification was associated with aortic sclerosis in 100% of the cases, to arterial hypertension in 19 (76%), to obstructive pulmonary disease in 8 (32%), to diabetes mellitus in 5 (20%), and to peripheral arterial insufficiency in 5 (20%). Mitral regurgitation was found in 14 cases, atrial fibrillation in 2 (8%). Complete A-V block was not observed, but there was enlargement of the left ventricle in 23 (92%) and of the left atrium in 17 (68%). The chest X-ray showed mitral annulus calcification in 5 (20%) with a sensitivity of 25% and a specificity of 100%. The M-mode echocardiogram showed LA-Ao ratio of 1.4 +/- 0.3, the mitral valve D-E excursion was reduced 11.9 +/- 3.1 mm. and also the E-F slope 28.6 mm/seg +/- 16.7 with appearance of mitral stenosis, but the two-dimensional study demonstrated that this was false. In all patients the left ventricle was dilated and fractional shortening was diminished. Echocardiography not only is a good diagnostic method for mitral annulus calcification, it also allow us to evaluate the hemodynamic consequences of this pathology which occurs in older patients and is often associated with other common illnesses of advanced age. In our study 56% of mitral annulus calcification cases were associated with mitral regurgitation. PMID- 2782988 TI - [X syndrome. Angiographic findings]. AB - Coronary artery spasm is the most frequent cause of ischemic heart disease without coronary atherosclerosis once other causes such as cardiomyopathy, arteritis, coronary ectasia, valvular heart disease or hypertensive heart disease are eliminated. We report 23 patients, 15 males and 8 females, whose ages ranged from 34 to 63 years, with a mean age of 47 years, with demonstrated angina pectoris and myocardial ischemia, whose cardiac cineangiography showed no signs of atherosclerosis. Nevertheless, a significant retardation in the progression speed of the contrast medium was observed, as indirect evidence of the increment in coronary resistance at the arteriole level. Coronary spasm was ruled out by administration of intracoronary ergonovine, and other causes of myocardial ischemia, such as muscular bridges, were also discarded. The clinical presentation of the ischemic heart disease was unstable angina (UA) in 21 patients and myocardial infarction (MI) in 2. In the UA group, 14 patients showed ischemic changes in the ECG while the pain lasted, and in 8 patients the changes were present during the stress test. In all of them, the stress test perfusion scan with thallium 201 showed myocardial ischemia. In the IM group, the diagnosis was based on the clinical findings, the ECG, the enzyme curve, and the technetium 99 cardiac scintigram. In the two-year follow-up the prognosis has been favorable with treatment based on calcium antagonists. Nowadays 18 patients are asymptomatic, four have stable angina and only one has unstable angina. PMID- 2782989 TI - [Hemodynamic and prognostic evaluation of total anomalous pulmonary venous return by means of echocardiographic measurement of the heart cavities]. AB - The purpose was to demonstrate the relationship between cardiac cavity size, measured by echocardiography, with the hemodynamic overload and short-term prognosis in children with total anomalous pulmonary venous return (TAPVR). Ten children were studied; the age varied from 2 weeks to 4 months. The clinical and cardiac catheterization findings were compared with echocardiographic measurements. Children with a smaller left atrium showed severe pulmonary resistance and lower systemic cardiac output (P less than 0.01). Right ventricular dilatation was bigger when pulmonary resistance was more elevated (P less than 0.05). Children with end-diastolic diameter of the left ventricle less than 12.8 mm had lower cardiac output (P less than 0.01) and death rate was significantly elevated during the first twenty weeks of life (80%). Doppler echocardiography is useful in the recognition of TAPVR type, as well as to evaluate the hemodynamic changes and detect the high risk group. PMID- 2782990 TI - [Direct and indirect maximum oxygen consumption in sedentary subjects living at a moderate altitude]. AB - In order to compare 1) predicted values of aerobic capacity (VO2Max) and, 2) direct VO2Max reported in the literature for sedentary subjects, direct VO2Max was measured in 27 sedentary males (18-25 years old), residents at 2240 meters (588.5 +/- 1.0 mmHg). To get direct VO2Max, ventilation and expired gases were measured while the subjects performed maximal exercise on a motor treadmill. Predicted VO2Max was estimated from the Astrand and Ryhming nomogram by measuring submaximal heart rate (HR) during a step test protocol. The mean results from the maximal protocol were: HR 194.9 +/- 5.4 beats/min, direct VO2Max 3.15 +/- 0.46 L/min and 47.67 +/- 5.07 ml/min/Kg, absolute and relative to body weight, respectively. From the submaximal protocol, mean HR was 171 +/- 8.3 beats/min and predicted VO2Max 2.50 +/- 0.39 L/min. In spite of a good correlation (r = 0.79) between predicted and direct VO2Max, the predicted values underestimated 20.3 +/- 7.2% direct measurements. Our data point out that 1) indirect measuring of aerobic capacity from the Astrand and Ryhming nomogram is discouraged in sedentary subjects living at moderate altitudes and, 2) in contrast to other author's suggestions, aerobic capacity is not diminished by chronic exposure to moderate hypoxia. PMID- 2782991 TI - [A low-level stress test, in the early phase of myocardial infarction and its correlation with coronary angiography]. AB - In a prospective 24-month trial at the Instituto Nacional de Cardiologia, 56 patients were studied. All patients had acute myocardial infarction (AMI), diagnosed by clinical, electrocardiographic and enzymatic means. They were studied in two groups: Group A with single localized AMI (n = 30) and Group B with AMI at two locations (n = 26); a resting electrocardiogram (EKG) was analyzed in each case and a low level stress test was performed within the 2nd and 3rd postinfarction weeks; coronary angiography was done between the 8th and 9th postinfarction weeks. In Group A the low level stress test (LLST) was positive for ischemia at a distance from the infarction site in 21, and eighteen of them had multi-vessel injuries (MVI); in 9 the LLST was negative; of these 7 had single-vessel injury; only the remaining 2 had MVI (p less than 0.001) with 90% sensitivity and 78% specificity. In Group B there was no significant relationship between LLST and coronary angiography (64% sensitivity, and 62% specificity). Relating the ischemic change at a distance in the resting EKG with coronary angiography, we found 75% sensitivity and 55% specificity in Group A. In Group B, sensitivity and specificity were even lower. We conclude that LLST in the early postinfarction phase in Group A is a safe and reliable method to suspect MVI, allowing the early identification of patients with lesions that could be treated by surgical means. PMID- 2782992 TI - [Etiology of infectious endocarditis at the Instituto Nacional de Cardiologia Ignacio Chavez from 1976 to 1986]. AB - We studied 85 cases of infectious endocarditis (IE) with an anatomical diagnosis (biopsy or necropsy). Most cases occur between the second and fourth decade of life; male/female ratio was 1/0.8; 45 had IE in a natural valve; 40 had prosthetic IE. Clinical diagnosis was established or at least suspected in 61 cases (72%); the most common misdiagnosis was acute rheumatic fever. Blood cultures were positive in 25 cases of natural valve IE (56%) and in 25 cases of prosthetic IE (63%). Half of those negative culture cases had a history of antimicrobial use before their arrival at the hospital. Those microorganisms which cause natural valve IE were: staphylococci (9), streptococci (8), Gram negatives (5), Candida sp (1), and two non-identified cases; 1 patient had a polymicrobial infection. Prosthetic IE was divided into early and late infections. The former was due to: staphylococci (4), streptococci (1), Candida sp (1); the latter: staphylococci (7), streptococci (4), Gram negatives (4), Candida sp, Mycobacterium fortuitum and Peptococcus (1 each), and in a single case Lactobacillus sp, presumably a contaminant. PMID- 2782993 TI - [Study of ventricular function by means of echocardiographic quantification of the thickness/radius (h/r) ratio of the left ventricle in healthy subjects]. AB - We studied 72 healthy subjects; 31 of them were adults and 41 children. By means of two-dimensional echocardiography we obtained a short axis view at the papillary muscle level of the ratio of the thickness (h) of the ventricular wall and the radius (r) of the cavity. We analysed ventricular performance determinants (pre-load, after-load and contractility). This non-invasive method gives information similar to pressure-volume curves. Thus, we propose it for the study of left ventricular overloads. PMID- 2782994 TI - [Cardiovascular abnormalities in Ehlers-Danlos syndrome. Report of a case]. AB - This is the case of a 34-year-old woman with Ehlers-Danlos syndrome whose cardiopulmonary manifestations are the following: Prolapse of mitral and tricuspid valves. Aneurysmal dilatation of main arteries without aortic or pulmonary insufficiency. Disturbances in pulmonary function tests and pulmonary arterial hypertension. The diagnosis was verified by skin biopsy and an electron microscopic study. Due to the clinical and histopathological characteristics, we have considered this case to be a non-specified type of the 10 varieties described up to now, and have decided to report it also because of the interesting findings in the hemodynamic and pulmonary function tests. PMID- 2782995 TI - Cortisone extends life span in the rotifer Asplanchna brightwelli. AB - Cortisone at 100 and 200 microM concentrations produced a significant increase in both life span and reproduction in the rotifer Asplanchna brightwelli. Two possible mechanisms are discussed to explain these results: (1) cortisone stabilization of lysosomal membranes, or (2) recognition of cortisone as a hormone capable of altering resource allocation by the rotifers. PMID- 2782996 TI - The collection of health data from the elderly in primary care using a postal questionnaire. AB - Standardised information on patients in a general practice, suitable for preventive, case-finding or epidemiological study is rarely available. This paper describes a simple postal questionnaire method of obtaining information cheaply and accurately for the development of a practice basic records system. PMID- 2782998 TI - Effects of retirement on aspects of self-perception. AB - In this study some effects of retirement have been assessed from the viewpoint of the retired person. The study is based on an Open University national survey from which a sub-sample of 210 men over 55 years (133 working and 77 retired) was obtained. Self-perception was assessed using 14 seven point semantic differential scales from which five dimensions (social standing, contentment, self-reliance, outlook, and dependence) were identified by factor analysis. Differences in the five dimensions between the working and retired men were examined. No differences in these aspects of self-perception were found and the results support the view that, for most people, retirement is not sufficiently disruptive to damage their self-image. PMID- 2782997 TI - Alkaline phosphatase activity in striated muscle: the effect of aging and long term training in female mice. AB - Alkaline pNPPase (Alk'ase) activity was measured in bicarbonate buffer and in Triton buffer of striated muscles of aging mice. Between young age (4-9 months) and middle age (13-15 months) the enzyme specific activity increased by 41.8% in the bicarbonate buffer and by 22.6% in the Triton extraction. Thereafter, between middle age and old age (32 months), a marked decrease in enzyme activity took place in both the bicarbonate and Triton extractions (23.5% and 31.4%, respectively). Alk'ase activity in muscles of old mice that had been exposed for prolonged training (12-18 months), did not differ from that of age-matched controls in both types of extracts. However, cysteine, an Alk'ase inhibitor, affected the enzymatic activity in the various samples tested differently: in the bicarbonate buffer its inhibitory effect increased with age and training, whereas in the Triton extraction its effect decreased with age and following training. Thus, it seems conceivable that with age and following long-term physical exercise an overall functional change is taking place in muscle which makes Alk'ase more vulnerable. The membranous Alk'ase, however, appears more resistant to external inhibitors in the form of endurance training and to the aging process. PMID- 2782999 TI - [Sudden infant death syndrome]. PMID- 2783000 TI - [Care and outcome of 55 children born to HIV seropositive mothers]. AB - We report our experience with vertically transmitted HIV infection in infants. Fifty-five children were prospectively followed for a period of 3 years. The neonatal diagnosis of HIV infection is not always possible and doubts about contamination may create familial anxiety which requires support by a multidisciplinary structure. Long-term prognosis is difficult to predict and it depends on the severity of the immune deficiency, the early onset of neurologic disease and the frequency of opportunistic infections. PMID- 2783001 TI - [Neonatal exchange transfusion with irradiated whole blood. Preliminary results]. AB - Some clinical manifestations following exchange transfusion (ET) could result from graft versus host disease secondary to the introduction of viable foreign T lymphocytes: skin rash, fever, acute and sometimes bloody diarrhea or enterocolitis. Between February 1985 and January 1989 the blood used for 31 ET was irradiated at 40 grays. We compared the manifestations occurring during the days following ET to those occurring after 44 previous ET with non irradiated blood during the period January 1981 to January 1985. From 1981 to 1985, 13 of 44 infants developed problems within 3 days following ET: an erythematous macular skin rash in 4; gastrointestinal manifestations (diarrhea, vomiting and rectal bleeding, necrotizing enterocolitis) in 7; both skin lesions and a gastrointestinal problem in 2. Since 1985, 27 infants had no problems whereas only 4 developed gastrointestinal or cutaneous manifestations: NEC in a preterm infant, abdominal distension with rectal bleeding, fever and petechial rash in 2 infected infants. These data show a dramatic decrease of complications since the irradiation of blood products has been started: 30% with non irradiated, 13% with irradiated blood. PMID- 2783002 TI - [Parathyroidectomy in children with renal failure. Retrospective study of 17 cases]. AB - Parathyroidectomy (PTX) is rarely needed in children with end-stage renal disease and the new forms of vitamin D decrease its frequency. We report 17 cases of patients (14 with dialysis and 3 with functional renal graft) suffering from renal insufficiency in the pediatric age group who required a PTX. The surgical indications and techniques (partial PTX, total PTX with or without graft) varied with time and circumstances. After partial PTX, 3/10 patients were reoperated on. After PTX + graft one patient needed a second graft and another a graft curettage. Whatever the method, we noted normalization of clinical and radiological signs and a decrease in biological signs. The growth rate improved in most children during puberty, but outside of this period, no effect was noted. There is a definite indication for a PTX in cases with tertiary hyperparathyroidism. The indication seems questionable in cases with secondary hyperparathyroidism which can now be effectively treated with 1 alpha hydroxylated forms of vitamin D. When necessary, total PTX with or without graft should be performed. PMID- 2783003 TI - [Familial osteochondrodysplatic dwarfism associated with deafness and tapeto retinal heredo-degeneration]. AB - Two cases of a new type of hereditary chondrodysplasia are reported. The main features were: severe dwarfism, progressive scoliosis and bilateral dislocation of the hip. A neurosensory type of deafness with retinitis pigmentosa was also present. Radiographs showed diffuse osteoporosis, severe retardation of bone-age and dysplasia of the femoral head. There was no associated metabolic abnormality. The disease seems to have a dominant autosomal pattern of inheritance with a variable degree of penetrance. PMID- 2783004 TI - [Type V acrocephalosyndactylia (Pfeiffer's syndrome). Apropos of 3 cases in the same family]. AB - We report 3 cases of acrocephalosyndactyly V (Pfeiffer syndrome) in the same family. This syndrome is characterized by coronal craniosynostosis with facial dysmorphism and specific malformations of the extremities (wide stubly adducted thumbs). The pattern of inheritance in autosomal dominant. The place of this syndrome is discussed in the group of disorders associated with acrocephalopolysyndactyly. PMID- 2783005 TI - [The Kasabach-Merritt syndrome with pancreatic localization in a newborn infant]. AB - The case of a neonate with a large pancreatic hemangioma belonging to the Kasabach-Merritt syndrome is reported. Selective embolization of one of the main vessels originating from the gastroduodenal artery resulted in a progressive increase of blood platelet levels and in a concomitant change in the hemangiomatous structure at ultrasound examination, as well as in a subsequent acceleration of somatic growth. At 8 months of age, there were no more clinical, radiological, ultrasonographic or biological signs of the hemangioma. This case report emphasizes the interest of embolization in the Kasabach-Merritt syndrome. PMID- 2783006 TI - [Iconographic graphic. Aortic aneurysm]. PMID- 2783007 TI - [Infantile mortality in Ile-et-Vilaine (1970-1986)]. AB - The rates and the causes of infantile mortality between 1970 and 1986 in the district of Ille-et-Vilaine are reported. During that period, infantile mortality rate decreased from 18.7 to 7.06% and from 12.4 to 3.6% during the first week (0 6 days), thereby suggesting the efficacy of medical care programs for this pediatric age group in France. Since 1980, with more accurate record keeping, using the recommended international classifications, there is a relative stagnation in the rate or early neonatal deaths (3.97 to 3.67) as compared to a sizable drop in the rates of late neonatal deaths (1.90 to 0.73) and post neonatal deaths (4.63 to 2.57). Congenital abnormalities have become the most important cause of death (34%) before prematurity (24.58%). However, the number of congenital anomalies should quickly decrease with prenatal screening programs leading to interruption of pregnancies. Although the percentage of infantile deaths due to prematurity has decreased from 66% between 1970 and 1974 to 24.58% in recent years, prematurity remains an important cause of death. Infections have decreased and the Sudden Infant Death Syndrome is currently the most important cause of death during the postneonatal period. The well known factors of risks are confirmed and particularly increased vulnerability of the population with a low socio-economic status which should lead to appropriate prevention programs. Despite these very impressive results, birth remains the most vulnerable period of life and current efforts should continue. Priority must be given to the improvement of prenatal care which requires good ongoing collaboration between obstetrics and pediatrics and the use of the Maternity Health Booklet. PMID- 2783008 TI - [Regulation of perinatal pulmonary circulation]. PMID- 2783009 TI - [Onychodystrophy, sensory and mental deficits, neonatal seizures ("DOORS syndrome")]. PMID- 2783010 TI - [Value of indirect calorimetry in very low birthweight newborn infants]. PMID- 2783011 TI - Synthesis of novel benzylimidazolines possessing antihypertensive and sedative activity. AB - In the course of a study to produce new long acting local anaesthetics, a number of novel benzylimidazoline derivatives were synthesised and tested for local anaesthetic activity, vasoconstrictor effect and ease of displacement of p aminoclonidine. The synthesis is shown in Scheme 1.- The synthesised compounds do not exhibit a significant local anaesthetic effect, but display an antihypertensive action with considerable alpha-2 adrenoceptor binding affinity. PMID- 2783013 TI - [Stereospecific hydroxylation of (+)-sparteine (pachycarpine) in the rat]. AB - Pachycarpine (4), the optical antipode of the lupine alkaloid (-)-sparteine (1), has been prepared from (-)-lupanine; its metabolism was studied in rats. After isolation and chromatographic purification, streochemically homogeneous (+)-(4S) hydroxysparteine (7) was identified as the major urinary metabolite by use of mass spectrometry and high-field NMR-spectroscopy. PMID- 2783012 TI - [The development of pharmacophore models for thymidine kinase-dependent virostatic nucleoside analogs]. AB - The most potent drugs in the therapy of Herpes Simplex virus infections belong to the class of guanosine derivatives which bear an acyclic ether substitutent at N 9 (I,II). The initial step in the mode of action was shown to be a monophosphorylation at the primary hydroxyl group of the side chain. The selectivity of the antiviral activity results from the fact that only the virus encoded thymidine kinase is able to bind the acyclic guanosine derivatives. In order to understand this mechanism we try to describe the common pharmacophoric pattern of pyrimidine and purine substrates by molecular modeling methods. It can be shown that a specific binding of guanine could be provided by the enzyme and that flexible side chains are needed instead of deoxyribose to fulfill the requirements of the pharmacophore. PMID- 2783014 TI - [Localization of the essential structure for binding of antiviral agents to thymidine kinase by studying sequence homologies]. AB - The amino acid sequence of 14 thymidine kinases and three other nucleotide binding enzymes have been compared by alignment of their primary and secondary structure. The overall alignment revealed five homologous regions, which are supposed to be part of the active site with a common three dimensional structure. Analysis of mutant enzymes brings further evidence for the importance of those regions. Single point mutations are responsible for an amino acid exchange within the homologous sequences thereby affecting the normal function of the enzymes. The substituted amino acids are essential for the binding function and, therefore, building part of an active site. After identification of the homologous regions we tried to fit the HSV 1 thymidine kinase on the known 3D structure of adenylate kinase to reconstruct the essential binding regions of thymidine kinase as far as possible. PMID- 2783015 TI - [Biotransformation of benzamidine and benzamidoxime by microsomal enzymes of the rabbit]. AB - At pH 7.4 neither benzamidine (1) is ring-hydroxylated nor benzamidoxime (2) is N hydroxylated, reduced or ring-hydroxylated by aerobic incubations with microsomal fractions (12000 g supernatant, microsomes) of rabbit liver homogenates and NADPH. Products of hydrolytic processes are also not detected. A very long incubation period and a pH 6.3 are necessary for the detection of a slight reduction of benzamidoxime (2) to benzamidine (1). Results are obtained by use of synthetic reference material and by newly developed HPLC methods. Thus, kinetic studies of the microsomal N-hydroxylation of benzamidine (1) to benzamidoxime (2) in the presence of N-methylbenzamidine (3) performed at pH 7.4 are not influenced by other transformations and provide evidence for the involvement of the same isoenzyme of cytochrome P-450 for both the N-hydroxylation of 1 and the N dealkylation of 3. PMID- 2783016 TI - [The effect of the culture medium on the testing of antimycobacterial compounds]. PMID- 2783017 TI - Anterior rib strut grafting for the treatment of malignant lesions in the thoracic spine. AB - Anterior stabilization during thoracotomy, using the patient's own ribs, was carried out seven times in six subjects with malignant lesions of the thoracic vertebrae. The primary malignancy was lung carcinoma in four cases, thyroid carcinoma in one case, and alveolar soft tissue sarcoma in one. Resection of the lung tumor and spinal surgery were carried out simultaneously. Four of the six patients had complete paraplegia and two had partial paraplegia prior to the operation. After the decompression and anterior stabilization, three subjects responded well and three responded poorly because of respiratory insufficiency. PMID- 2783018 TI - Inversion trauma of the ankle. AB - By means of a questionnaire, an inventory was made of the residual complaints and possible handicaps 9 months post-injury in 1012 patients who had been treated for distortion or lateral ankle ligament injury. The response rate was 81% and responses were equally distributed among the various grades of distortion. Residual complaints were reported by 30% of the patients. The injuries were classified into three grades. For all grades, the nature and frequency of the residual complaints were the same. Explanations for the study results or guidelines for treatment cannot be derived from this study. PMID- 2783019 TI - Comparative study of cemented and cementless hip prostheses in the same patient. AB - In 20 patients with bilateral total hip replacements a cementless prosthetic implantation on one side and a cemented arthroplasty on the other side were performed. The mean follow-up period was 6 years for the cementless and 7.5 years for the cemented hip. The only significant difference found was concerning pain, which was more frequent on the cementless side. Otherwise we were unable to ascertain a significant difference concerning mobility, walking capacity, complications, and patient assessment. A longer observation time will be required. Where pain relief is concerned, the cemented version will continue to be the gold standard. PMID- 2783020 TI - Resection arthroplasty: middle- and long-term results. AB - Conclusions on results after resection arthroplasty were made by analyzing patient records with regard to completed questionnaires. Sixty-four patients were followed up for 2.1-15.9 years postoperatively. The indications for explanation were septic or aseptic loosening with extensive bony destruction. The average age of the patients was 69.7 years. A specially prepared questionnaire summarized each patient's condition at that time. Twenty-five patients had no discomfort in the operated hip: 25 others reported occassional mild pain during increased strain, and six patients complained of constant pain. All patients were able to walk with aids. In six cases the infection recurred. In summary, we can say that the goal of maintaining an infection- and pain-free hip was achieved in over 90% of cases, but the functional weight-bearing capacity was limited. Resection arthroplasty appears to be a successful treatment; it relieves the patients from pain and infection and can often end a long series of surgical operations. PMID- 2783022 TI - Micromotions in the primary fixation of cementless femoral stem prostheses. AB - Thirty cementless femoral stems of six different types of hip endoprostheses were implanted in femurs taken at autopsy and underwent static loading and afterwards dynamic loading of 50,000 cycles to simulate walking during the early months after implantation. After that, the static load tests were performed again. During both static load series a certain amount of micromotion between stem and implantation bed occurred in the frontal and sagittal planes and also during rotation. The six prostheses exhibited clearly differing results. The influence of dynamic load on the extent of micromotion was small. PMID- 2783021 TI - Bilateral total hip and knee replacement in rheumatoid arthritis patients. AB - Between 1978 and 1983, 14 patients suffering from rheumatoid arthritis were treated by bilateral total hip and knee replacement. At the time of this follow up study (32-92 months postoperatively) one patient had died of concomitant disease and was excluded. The postoperative results regarding pain relief, improvement in performing daily activities, and function were studied in the remaining 13 patients. A 200-point rating scale was used, which compared the pre- and postoperative findings at follow-up. All patients showed marked relief from pain, good function and a good functional score. Although walking ability did not always improve, all patients were enthusiastic. PMID- 2783023 TI - Flucloxacillin compared with cefazolin in short-term prophylaxis for clean orthopedic surgery. AB - Two-hundred and fifty-two patients were included in a prospective, randomized, double-blind trial comparing the efficacy of flucloxacillin with that of cefazolin for clean orthopedic surgery. The preventive antibiotic regimen consisted of three 1-g injections perioperatively. There were 126 patients in each group, and the follow-up period was at least 6 months. Two deep (1.6%) and five superficial (4.0%) infections occurred in the flucloxacillin group. Three deep (2.4%) and five superficial (4.0%) infections developed in the cefazolin group. PMID- 2783024 TI - Acetabular cup-siting device for total hip arthroplasty. AB - A method for improving acetabular cup positioning at arthroplasty is introduced. The anatomic and engineering principles involved are explained. The device used for this method of siting is described. The method was tested in cadaver experiments and resulted in a 380% improvement of anteversion-retroversion position and a 370% improvement in abduction position over conventional siting. The value of this method in conventional and revision arthroplasty is suggested. PMID- 2783025 TI - Avulsion fracture. Special type of meniscal damage. AB - Avulsion fracture is more likely the result of a trauma to ligamentous structures than division of their continuity. The presented case of an avulsion fracture of the posterior horn of the medial meniscus from the intercondylar eminence illustrates the actual possibilities of arthroscopic surgery. It demonstrates the advantages of a diathermic cutting hook. PMID- 2783026 TI - Traumatic anterior dislocation of the hip. Case report. AB - An unusual traumatic anterior dislocation of the hip in a 47-year-old woman is reported. The mechanism of trauma behind anterior hip dislocations and their diagnosis are described and the prognosis of hip dislocations in general is mentioned. PMID- 2783027 TI - Neuralgic amyotrophy of the lumbar area. Case report. AB - Two cases of a rare peripheral neurological disease (neuralgic amyotrophy of the lower extremity) are presented, with clinical symptoms (severe sciatic pain with motor paresis) that pose differential diagnostic difficulties against a hernia of a lumbar disk. Because of a tendency to heal by itself, the disease has a good prognosis. The diagnosis is based on a process of exclusion of herniated disks, lesions of the lumbar plexus in tumors or after radiation therapy, hematoma of the psoas after coagulation disturbances, birth, or trauma, and nutritive disruptions of the nervous system as in diabetes mellitus. Knowledge of the symptoms of this--in orthopedics--mostly unknown disease and critical interpretation of the clinical and medical-technical data are important to avoid wrong indications for surgery. PMID- 2783028 TI - Radial ray defect with vascular and vertebral anomalies. AB - A new case with combined intercalary radial ray defect, high origin of the radial and ulnar arteries, and anomalies of the thoracic vertebrae is presented. The diagnosis was based on roentgenography, arteriography, and electroneuromyography. The case was regarded as a thoracic outlet syndrome due to the first rib abnormality and was treated surgically. PMID- 2783029 TI - Acute-on-chronic bilateral reversed slipped capital femoral epiphysis managed by Imhauser-Weber osteotomy. AB - In a rare case of progressive bilateral valgus-slipped capital femoral epiphysis, modified Imhauser-Weber osteotomies were carried out. The osteotomies allowed for significant varus correction and thus included shortening of the neck and distal transfer of the greater trochanter. The planning technique of the complex osteotomy is discussed. At 5-year follow-up the patient had a gratifying result. PMID- 2783030 TI - [Physiologic and nutritional studies in pigs with ileorectal anastomoses. 3. Nitrogen retention and utilization following energy an electrolyte supplementation]. AB - In order to guarantee an equally good development of ileorectostomized pigs (IRA) used for the determination of precaecal protein digestibility and the absorption of amino acids as for intact animals (INT), the supplementation of their rations with easily soluble carbohydrates and minerals is necessary. The effects of these supplements on live weight development, nitrogen balance and N utilization level were the subject of the assessment of 21 rations with 129 and 117 balance measuring resp. with growing IRA and INT pigs. Without any supplementation of the rations the N balances of the IRA pigs showed significantly lower and partly negative N balances and N utilization levels in comparison to the INT pigs. The combined supplement of easily soluble carbohydrates (100 g/kg DM intake) and 300 ... 400 ml electrolyte solution per day (approximately 1 ... 1.3 g additional Na) resulted in N balances almost equal to those of INT pigs. The supplement of both electrolyte solution and NaHCO3 (approximately 2 g Na per animal and day additionally) to a barley + lysine ration resulted in a significant increase of the N balance and N utilization in IRA pigs of a live weight between 120 and 140 kg in contrast to the control period. A supplement of carbohydrates to a ration consisting of barley + fish meal + grass meal and electrolyte supplements of 400 ml per animal and day only resulted in significantly higher N balances and N utilization levels in the live weight range up to 70 kg in comparison to the control periods, which then corresponded to those of INT pigs. There was no essential influence of carbohydrate supplementations on pigs of more than 70 kg live weight. The postileal digestibility of the crude carbohydrates (CC) of 14 rations calculated from the difference between total digestibility (faecal analysis) and precaecal digestibility (analysis of the ileal chyme of IRA pigs) showed that between 40 and 100 g (70 g on average) out of the 780 g CC per kg DM consumed disappear in the large intestine. These studies show that in the testing of concentrates and mixed feed rations the supplementation of 100 g easily soluble carbohydrates/kg DM intake should be sufficient to guarantee a normal development of IRA pigs. In addition, an oral supply of 1 to 2 g sodium in the form of electrolyte solution exceeding the requirement of INT pigs is necessary as this supplementation significantly improves the N retention of IRA pigs even heavier than 100 kg. PMID- 2783031 TI - The cadmium status of horses from central Europe depending on breed, sex, age and living area. AB - The Cd status of animals is best reflected by kidneys and much worse by liver and hair. Breed (heavy- and warm-blooded horses) only took an insignificant effect on the Cd content of kidneys and liver. On the average, however, warm-blooded horses stored more Cd than heavy ones. Geldings from Cd-exposed living areas accumulated insignificantly more Cd in liver, kidneys and hair than mares. The influence of age on the Cd content of kidneys and liver of Cd-exposed horses was significant. The Cd exposure of a living area was very well reflected by kidneys and liver. On the average, horses from two areas with nonferrous metal smelting stored 1000 mg Cd/kg kidney dry matter and 100 to 200 mg Cd/kg liver dry matter. The highest Cd concentration of the kidneys of horses amounted to 2.6 and 2.3 g/kg dry matter, resp. PMID- 2783032 TI - The lead status of horses from central Europe depending on breed, sex, age and living area. AB - The breed of horses took a significant effect on the Pb content of animals with a normal Pb supply. Warm-blooded horses stored more Pb in skeleton, kidneys, liver and cerebrum than heavy horses. The sex only had the trend of influencing the Pb status. Mares with a normal Pb supply incorporated more Pb than geldings. Age only took a slight effect on the skeleton. Older horses stored more Pb in the metatarsal bone than younger ones. The Pb content of horse meat was not influenced by Pb exposure. Pb was not additionally deposited in the musculature. The Pb offer of the living area took a significant effect on the Pb status of horses. Skeleton, liver and kidneys indicated the site-specific influences significantly. PMID- 2783033 TI - [Allergen-induced late bronchoconstriction and airway hyperresponsiveness in guinea pigs]. AB - Allergen-induced bronchoconstrictive responses were examined in a guinea pig model actively sensitized by the inhalation of aerosolized ovalbumin (OA), which showed reproducible late bronchial responses (LBR). OA-challenge was performed under cover of mepyramine through the inhaled route in spontaneous breathing without anesthesia. The respiratory resistance (Rrs) was measured by the oscillation method for 96 h after OA challenge. All of the 22 guinea pigs displayed immediate bronchial responses (IBR), followed by 2 or 3 phase LBR that peaked at 6-8 h and 24 h after OA challenge. Examination of bronchoalveolar lavage fluid (BALF) revealed a significant increase in neutrophils at 1 h (p less than 0.01) and eosinophils at 7 h and 96 h (each p less than 0.01) after OA challenge. OA-challenge induced airway hyperresponsiveness to histamine (p less than 0.01) at 96 h that was associated with a significant increase in eosinophils (p less than 0.01) in BALF compared with lavages at 7 h. Intravenous administration of 1% OA induced a significant increase of leukotriene (LT)B4, C4, D4 in tracheal lavage fluids at IBR phase in each control (p less than 0.01). The increases of Rrs in LBR were inhibited almost completely by the pretreatment of KC-404, which is reported to have antagonistic action against LTC4/D4. These results suggest that allergen-induced late broncho-constrictions accompanied by airway hyperresponsiveness in guinea pigs are associated with the extensive infiltration into the airway lumen of inflammatory cells, and are concerned with the release of LTs. We also suggest that this LBR guinea pig model is useful in studying the mechanisms of the occurrence of LAR in humans, and in evaluating the action of anti-allergic drugs in LAR. PMID- 2783034 TI - [Allergological study of breast feeding, ovalbumin and specific IgG, IgM and IgA antibodies to ovalbumin in human milk]. AB - Ovalbumin (OA) and specific antibodies to OA were evaluated by ELISA in 92 colostrum, 366 mature milk and 12 cord blood samples. Anti-OA IgG antibody titers in colostrum were lower than those in cord blood and were not detectable in several samples. Anti-OA IgM antibody titers in colostrum were comparatively high and decreased on the days following postpartum. Anti-OA IgA antibody titers were the highest in the colostrum and decreased on the following days, but remained constant in mature milk. On the other hand, OA was detected in 27.2% of colostrum and 17.2% of mature milk samples, in concentrations from 0.5-59.0 ng/ml. In mature milk, the positive rates of OA were significantly elevated by egg ingestion by the mothers. OA in mature milk from allergic mothers tended to be more readily detectable than that from non-allergic mothers. These results suggest that avoidance of the specific food antigens by mothers is important for therapy and prevention on allergic disease in their breast-fed infants. PMID- 2783035 TI - [Allergenic and antigenic activities of the osmophilic fungus Wallemia sebi asthmatic patients]. AB - Recently large amounts of Wallemia sebi, a species of osmophilic fungi, have been detected in house dust by low water activity media. The allergenic activity of W. sebi was examined by skin prick tests and radioallergosorbent tests (RAST) in 74 asthmatic patients (mean age 11.7, range 6-32). Aspergillus fumigatus and house dust were used for comparison. In the skin prick tests, W. sebi extract, A. fumigatus extract and house dust extract elicited positive reactions in 4 (5.4%), 4 (5.4%) and 51 (68.9%) patients, respectively. RAST showed positive results in 14 subjects (18.9%) for W. sebi extract, in 8 (10.8%) for A. fumigatus extract and in 59 (79.7%) for house dust extract. These results indicated that some asthmatic individuals showed immediate type hypersensitivity to W. sebi, which means this fungal species may be important as a causative agent in atopic diseases. Additionally, the authors measured W. sebi-specific IgG by enzyme linked immunosorbent assay in asthmatic (n = 28) and non-atopic patients (n = 28). W. sebi-specific IgG was found in sera from all subjects in each group. W. sebi-specific IgG in asthmatics (mean +/- SD = 0.686 +/- 0.160) was significantly higher than that in non-atopics (mean +/- SD = 0.572 +/- 0.188) (p less than 0.01). PMID- 2783036 TI - [Study on the clinical significance of pharmacia rast RIA in animal allergy]. AB - To study the usefulness of Pharmacia animal allergen discs, the specific IgE antibodies in the sera of patients with allergy to pet or laboratory animals were measured with the use of those discs. The coincidental ratio between skin test to cat hair and RAST to cat epithelium was 73.3%, however between skin test to dog hair and RAST to dog epithelium or dog dander it was 66.7% or 60.0%, respectively. The rate of RAST positive do dog dander was higher than to dog epithelium, and so it seems to be the optimum allergen for screening. The correlation between RAST value to dog epithelium and dog dander was good, but there was no relationship between cat and dog epithelium, it seems that cross antigenicity is low. In laboratory animals, the rate of RAST positive was in decreasing order: guinea pig, mouse, rabbit, rat, hamster. The rate of RAST positive to serum proteins of rat and mouse was lower than to epithelium and urine proteins. It seems not to be useful. PMID- 2783037 TI - [Effect of glycyrrhizin on the production of platelet-activating factor from rat peritoneal exudate cells]. AB - We examined the effect of glycyrrhizin (GL) on the production of platelet activating factor (PAF) from rat peritoneal exudate cells. GL was shown to significantly suppress the production of PAF from the rat peritoneal exudate cells stimulated with calcium ionophore A23187. This result suggests that GL have an anti-inflammatory or allergic action by the suppression of PAF production. PMID- 2783038 TI - [39th meeting of the Japanese Society of Allergology. Tokyo, 29-30 September 1989. Abstracts]. PMID- 2783039 TI - Differentiation of odontoblasts in grafted recombinants of murine epithelial root sheath and dental mesenchyme. AB - The epithelial root sheath (ERS) was isolated from first molars of 5-day-old post natal CD-1 mice using trypsin. After isolation, ERS cells remained viable in vitro and immunohistochemical examination of cultures confirmed the epithelial phenotype and the absence of mesenchymal contamination. Recombinants of isolated ERS and dental papilla resulted in odontoblast differentiation within cells of the dental papilla, and the formation of root-like fragments of dentine after 2 weeks of intra-ocular grafting. These findings indicate the inductive influence of the ERS on dental papilla cells. PMID- 2783040 TI - The detection of platelet-activating factor in inflamed human gingival tissue. AB - Platelet-activating factor (1-O-alkyl-2-acetyl-sn-glycero-3-phosphocholine; PAF) is a biologically active lipid, like the prostaglandins, which mediates allergic and inflammatory reactions. Aggregation of washed rabbit platelets was induced by a lipid prepared from inflamed gingiva. The mobility of the active lipid was coincident with that of authentic PAF on thin-layer chromatography. The aggregation was dose-dependent and inhibited by pretreatment with a specific PAF antagonist, ONO 6240, but not by indomethacin or creatine phosphate/creatine phosphokinase, which inhibit the platelet aggregation due to arachidonic acid or ADP, respectively. Thus the active lipid was identified as PAF; the amount of PAF detected was 118.1 +/- 79.7 pg/50 mg tissue (n = 6, mean +/- SD), the amount in normal tissue being 13.0 +/- 11.3 pg/50 mg tissue (n = 6). There was therefore a significant difference between the tissues. Lyso PAF, the metabolite of PAF with acetylhydrolase, was not detectable in either gingival tissue. Thus PAF was produced more in inflamed gingival tissue than in normal tissue; PAF may be involved in the occurrence and maintenance of periodontal disease. PMID- 2783041 TI - Immunocytochemical detection of proliferating cells in the rat tooth germ by monoclonal antibodies against 5-bromo-2'-deoxyuridine. AB - 5-Bromo-2'-deoxyuridine incorporated into DNA synthesizing cells in vivo is detected by a monoclonal antibody. The results are similar to those obtained with cytoautoradiography, but show variance with data from some past autoradiographic studies. This immunocytochemical technique may be a useful tool for study of cell kinetics in the oral tissues. PMID- 2783042 TI - Elemental and cytochemical localization of calcium in rat cheek epithelium. AB - Energy-dispersive X-ray microanalysis, combined with scanning electron microscopy, was applied to 18 microns thick freeze-dried cryosections to determine the level of calcium in successive layers of the epithelium. This indicated low levels of calcium in basal cells, high in spinous cells, moderate in granular cells, lowest in the inner keratin and highest in the outer keratin layers. The potassium pyroantimonate technique was used to study the cytochemical distribution of Ca2+. The reaction product, calcium pyroantimonate (Ca-PA), was generated from cellular and intercellular calcium by perfusion of the anaesthetized rat with a solution of potassium pyroantimonate in glutaraldehyde. Ca-PA was localized in nuclei, mitochondria, lysosomal-type bodies and membrane coating granules. A denser Ca-PA distribution was found between upper spinous and lower granular cells. The proposed identification of Ca2+ as a major component in Ca-PA was confirmed by EDTA decalcification and X-ray microprobe analysis of the reaction product. Thus X-ray microanalysis in combination with cytochemistry can localize Ca2+ in a growing and differentiating tissue such as stratified squamous epithelium. PMID- 2783043 TI - Studies on the transmembrane migration of fluoride and its effects on proliferation of L-929 fibroblasts (L cells) in vitro. AB - A decrease in the pH of the medium facilitated fluoride (F-) influx but depressed its efflux, which is consistent with the hypothesis that simple diffusion of hydrogen fluoride (HF) contributes to F- migration across the cell membrane. Long term exposure to F- (greater than 1 mM) induced F- accumulation and, as a result, inhibited cell proliferation. In contrast, short-term exposure to F- (greater than 1 mM), followed by careful washing, did not inhibit cell proliferation but rather stimulated it. Moreover, this stimulatory effect was enhanced by 1 microM Al3+ and was inhibited by 1 microM H-7, a specific inhibitor of protein kinase C. Thus F- may stimulate cell proliferation by activating protein kinase C through GTP-binding protein. The stimulatory effect of F- on cell proliferation, which is usually hidden by its inhibitory effect, can be observed by preventing the accumulation of F- in the cytoplasm. PMID- 2783044 TI - Lack of acute effects of methotrexate on rat parotid salivary gland function. AB - Like other cytotoxic drugs, methotrexate (MTX) produces adverse reactions in oral tissues. Parotid gland function was examined, in vivo and in vitro, 18 h after MTX administration (15 mg/kg, i.p.). No salivary effects could be detected consistently. In addition, the integrity of the oral mucosa remained intact. Thus, at this dose, MTX does not exert an acute cytotoxic effect either on a rapidly replicating oral tissue like the mucosa, or on tissue with a slow turnover rate like the parotid. PMID- 2783045 TI - Isolation and characterization of six proteins from rabbit parotid saliva belonging to a unique family of proline-rich proteins. AB - Proline-rich proteins are major components of salivary secretion from humans non human primates, rats, hamsters and rabbits. They are also synthesized in mice in response to chronic stimulation by beta agonists. This study to provide an understanding of the structural and genetic relationships within these families of proteins to determine the possible function of the proline-rich proteins. Rabbit parotid saliva was collected and proline-rich proteins were affinity purified using goat antibodies to human proline-rich proteins. Purification was achieved by repeated cation exchange chromatography on a Mono S column a Fast Protein Liquid Chromatography system. Six basic proline-rich proteins were purified. The apparent molecular weights were between 75,000 and 125,000, based on their mobilities in sodium dodecyl sulphate-polyacrylamide gel electrophoresis. Glycine, glutamine (and glutamate) and proline accounted for 79 87% of total amino acids in all proteins, but proline was present in smaller amounts (17-21%) than in proline-rich proteins from other species. All proteins were glycosylated but not phosphorylated. Circular dichroism of two proline-rich proteins, MS7A and MS5B, indicated the absence of secondary structure. The N terminal sequences of three proteins electro-eluted after preparative gel electrophoresis were determined. A high degree of similarity was found in various regions of mouse, rat, monkey and human proline-rich proteins. Rabbits thus synthesize constitutively a family of proteins that are immununologically and structurally related to proline-rich proteins other species. PMID- 2783046 TI - A longitudinal cephalometric study of incisor supra-eruption in young and adult rhesus monkeys (Macaca mulatta). AB - Supra-eruption was examined in 28 adult (N = 19 experimental and 9 control) and 12 juvenile monkeys (N = 7 experimental and 5 control). The experimental animals had a bite splint cemented to the posterior maxillary teeth which opened the bite inter-incisally by 15 mm and was worn continuously for 48 weeks. Lateral cephalograms were taken prior to the cementation and at 12-week intervals thereafter. Radio-opaque bone implants placed in the basal bone of the jaws served as fixed reference points from which to assess the vertical and horizontal components of central incisor movement. Significantly greater movement of both upper and lower incisors towards the occlusal plane occurred in the experimental animals of both age groups over the 48 weeks when compared to the same aged controls (p less than 0.01). Mean vertical movement ranged from 4 mm (about 40% of crown length) in the juvenile upper incisors to 1.5 mm (15%) in the adult lower incisors. The overall pattern of movement of upper and lower incisors in the experimental juveniles differed from that in the controls only in the vertical component (p less than 0.01), indicating that the supra-eruptive response was superimposed on the antero-occlusally directed tooth movement and alveolar growth that normally occurs in rhesus monkeys of this age. In contrast to the more evenly distributed response found in the juveniles, the majority of the supra-eruptive response occurred during the first 12 weeks in the experimental adults.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2783047 TI - Morphological changes in the myoepithelial cells of the rat sublingual salivary gland during differentiation as shown by the nitrobenzoxadiazole-phallacidin fluorescent method. AB - Changes in myoepithelial cells (MECs) during perinatal development were examined by using the fluorescent probe for actin, nitrobenzoxadiazole (NBD)-phallacidin. By the twentieth day of gestation, there was no distinct fluorescent pattern suggestive of MECs. In newborn and 1-day-old rats, cells with diffuse fluorescence occurred around the acini, representing incipient MECs. Between 3 and 4 days after birth, actin staining was concentrated in strands which were arranged parallel to the long axis of the cell processes. MECs had developed further by the tenth day after birth with an increased number and thickness of their processes. Fully developed MECs were found between the thirtieth and fortieth day. These were stellate and encompassed individual acini. PMID- 2783048 TI - Disturbances of tooth form and eruption in the microphthalmic (mi) mouse: a light and electron microscopic study. AB - Changes in the surrounding alveolar bone occur during tooth eruption. The microphthalmic (mi/mi) mouse suffers from osteopetrosis and lack of bone resorption; tooth form and eruption were examined in both affected mi/mi mice and unaffected litter-mates to determine the effect of osteopetrosis on tooth development and eruption. Paraffin sections of mandibles from 3, 7, 10, 13, 15 and 20-day-old mice were examined by light microscopy after staining with haematoxylin and eosin and for stable acid phosphatase activity. Mandibles from 15- and 20-day-old mice were examined by scanning electron microscopy. The ultrastructure of odontoblasts was observed in 15-day-old mice. Tooth eruption was significantly reduced in the mi/mi mice; the bone of affected mice increased in area with increasing age and marrow spaces narrowed. There was little bony remodeling in the mi/mi mouse, as indicated by layers of reversal lines. This lack of bone resorption affected tooth eruption and root formation. No abnormalities were detected in odontoblasts, suggesting functional normality, but the wide predentine layer in the mi/mi mouse may indicate an alteration in dentine mineralization. PMID- 2783049 TI - Ultrastructure of the tibial epiphyseal growth plate in microphthalmic (mi/mi) mice. AB - Osteoclasts from growth plates of affected (mi/mi) and control (mi/+) microphthalmic mice, from newborn to 15 days old, were examined. Osteoclasts from unaffected mice were generally large, multinucleated cells with distinct ruffled borders and clear zones. Osteoclasts from the mi/mi litter mates were predominantly mononucleated, lacking in ruffled borders, clear zones and an abundance of organelles, features not normally associated with a functioning resorptive cell. The lamina limitans was more distinct in mi/mi mice. By 15 days, no evidence of bone resorption was seen in mi/mi mice. The immature appearance of osteoclasts and the lack of bone marrow cavity formation in mi/mi mice may result from either a fusion defect or from a limited life span of osteoclasts. PMID- 2783050 TI - Mineralization differences between human deciduous and permanent enamel measured by quantitative microradiography. AB - The mineralization levels of erupted buccal enamel from 24 deciduous teeth were compared to those of 28 permanent teeth. Sections were prepared in a defined plane using a lapping machine which gave plano-parallel sections. Mineralization levels were recorded by quantitative microradiography at 25 equivalent anatomical sites in each section. Deciduous incisors and canines were compared with their homologous successors: overall mineralization levels were lower in the deciduous dentition, with no significant differences being found close to the amelo dentinal junction, but highly significant differences being found in the outermost sites. Deciduous molars were compared with premolars, and were also relatively less mineralized. However, deciduous molars did not show the consistent diminishing occlusocervical gradient observed in all other tooth types tested; on the contrary, they showed a cervical reversal with higher values than permanent premolar enamel. These results confirm the generally lower mineral levels in deciduous enamel, and provide quantitative information on site-specific mineralization levels. PMID- 2783051 TI - Changes in levels of osteonectin in bovine dentine during tooth development. AB - Bovine incisors were classified into three developmental stages and non collagenous proteins extracted from them. Sodium dodecyl sulphate gel electrophoresis of the extracts showed a reduction in osteonectin with the various stages. The reduction was confirmed by enzyme immunoassay using antiserum against bone osteonectin. This change is in contrast to dentine phosphoprotein, indicating functional differences between these two proteins. PMID- 2783052 TI - Studies on the influx of [3H]-histidine and 45Ca through a surgical opening to rat incisor ameloblasts and adjacent enamel. AB - Considerable controversy exists about the role of ameloblasts in transport of calcium to mineralizing enamel. The rate and pattern of incorporation of calcium and an enamel precursor (histidine) were studied autoradiographically by introducing the isotopes through a surgically created defect in the lower border of the rat mandible. Influx of the isotopes to both secretory and maturation ameloblasts and adjacent enamel was examined in large survey sections of the entire incisor at intervals of 3 min to 2 h. Substantial concentrations of silver grains were observed over both secretory and maturation ameloblasts within 5 min of placement of either isotope. 45Ca was also present in secretory and maturation enamel within this short time. The overall patterns of influx and uptake of both precursors were similar to those found when such isotopes have been administered parenterally. The amount of influx of 45Ca across secretory, smooth-ended, and ruffle-ended maturation ameloblasts was compared qualitatively and found to be similar. The reproducibility of this surgical technique was demonstrated as well as its usefulness in combination with survey sections for multi-method investigations of rat incisor enamel formation and mineralization. PMID- 2783053 TI - Intraoperative crushed ice compresses during oculoplastic surgery. PMID- 2783055 TI - Fashionable patches. PMID- 2783054 TI - Concentration change and activity of fluorouracil in the external segment of the eye after subconjunctival injection. PMID- 2783056 TI - DNA content analysis of uveal melanoma. PMID- 2783057 TI - Ocular pneumoplethysmography in giant-cell arteritis. PMID- 2783058 TI - Guillain-Barre syndrome presenting as a paralysis of accommodation. Case report. PMID- 2783059 TI - Aminoglycoside macular toxicity after subconjunctival injection. Case report. PMID- 2783060 TI - The Association of University Professors of Ophthalmology. The organization in transition. PMID- 2783061 TI - A quality assurance program for an inpatient department of ophthalmology. 'Indicators and criteria'. PMID- 2783062 TI - Macular grid photocoagulation for macular edema in central retinal vein occlusion. AB - To obtain pilot information regarding possible benefits of photocoagulation grid treatment for macular edema secondary to nonischemic central retinal vein occlusion, records were reviewed for patients who demonstrated well-documented prompt improvement in edema after treatment. In each of the five selected patients who demonstrated this association, macular edema had been present for a minimum of 6 months. Also, preoperative visual acuity was 20/60 or less, good macular capillary perfusion was present on the fluorescein angiogram, and substantial reduction of edema was demonstrated on clinical examination and by decreased leakage and late staining on fluorescein angiography within 8 weeks following treatment. Postoperative visual acuity either improved or remained unchanged for each eye. These results indicate that, in certain eyes, grid photocoagulation can lessen macular edema, thus supporting the rationale for a randomized clinical trial to determine possible benefits of this therapy. PMID- 2783063 TI - Superior segmental optic hypoplasia. A sign of maternal diabetes. AB - In a review of 10 patients with superior segmental optic nerve hypoplasia, all of whom were the children of diabetic mothers, 17 of 20 eyes had one or more of four characteristic findings in the optic disc: relative superior entrance of the central retinal artery, pallor of the superior disc, superior peripapillary halo, and thinning of the superior peripapillary nerve fiber layer. We believe that the presence of these four signs of superior segmental optic nerve hypoplasia strongly suggests maternal diabetes. PMID- 2783064 TI - Automated kinetic perimetry with two peripheral isopters in glaucoma. AB - An automated perimeter (Fieldmaster 5000) was used to measure the central 30 degrees of vision with static targets (suprathresholding with quantification of defects) and the peripheral visual field with two kinetic stimuli in 599 eyes of 362 patients with glaucoma or a suspicion of glaucoma. The purpose of the study was to compare the additional information gained by measuring the peripheral visual field with two isopters against the time required for this extra examination. The peripheral visual field supported the diagnosis made by central testing in approximately one fourth of all eyes and added additional diagnostic information in another quarter of the cases. In 7% of the total population, or 11% of eyes with abnormal fields, a normal central field was associated with a glaucomatous peripheral defect. Half of the latter eyes had corresponding glaucomatous optic disc changes. The more sensitive isopter uncovered the vast majority of the peripheral field defects. Measurement of each isopter accounted for 22% of the total testing time. PMID- 2783065 TI - Posterior vitreous fluorophotometry. I. Description of a new analysis procedure and results in normal subjects. AB - A new automated analysis procedure was used to evaluate the apparent blood retinal barrier permeability (mean +/- SD = 1.31 = 0.31 X 10(-7) cm/s at 60 minutes after intravenous dye administration) and the effective diffusivity (mean +/- SD = 0.88 +/- 0.40 X 10(-5) cm2/s) for fluorescein in the vitreous of 21 normal subjects. The analysis improvements include (1) use of an individualized convolution (spread) function for each eye in comparing simulated and experimental scans, (2) separation of vitreous and chorioretinal fluorescence, and (3) precise determination of vitreous position relative to the retina. The average reproducibility in six subjects was 23% for permeability and 22% for diffusivity based on repeated determinations separated in time by at least a week. Diffusivity values, but not permeability values, significantly associated in comparisons of first and second determinations, suggesting permeability may fluctuate in time while diffusivity remains relatively constant. The fluorescence at 3 mm anterior to the retina (commonly employed as a measure of blood-retinal barrier leakiness) was strongly associated with diffusivity. In contrast, the anticipated association between permeability and 3-mm fluorescence was weak or absent. PMID- 2783066 TI - Circumscribed choroidal hemangiomas. AB - We report observations of 71 patients with circumscribed choroidal hemangiomas. Each of these patients had a unilateral choroidal tumor with characteristic ophthalmoscopic, fluorescein angiographic, and ultrasonographic features. The affected patients ranged in age from 9 to 86 years when diagnosed. Sixty-four (90%) of the 71 patients were followed up by use after their initial diagnostic examination. The median follow-up was 45.5 months (range, 6 weeks to 12 years). Forty-two of the 64 patients were treated with scatter photocoagulation to the tumor surface on one or more occasions for vision-impairing or vision-threatening nonrhegmatogenous retinal detachment. The subretinal fluid resolved following photocoagulation in all of these eyes, and the vision stabilized in 34 patients (53%). However, the visual acuity at the most recent follow-up was less than 6/15 in 46 (72%) of the 64 affected eyes. Scatter photocoagulation, as employed in this group of patients, frequently results in retinal reattachment and temporary visual improvement, but many patients have permanently decreased vision in the affected eye, particularly when the tumor or the retinal detachment affects the foveal area. One third of the patients with 6/60 or better visual acuity at presentation are estimated to deteriorate to less than 6/60 visual acuity within 10 years. PMID- 2783067 TI - Antioxidant enzymes reduce loss of blood-brain barrier integrity in experimental optic neuritis. AB - We studied the effect of antioxidant enzymes on the loss of integrity of the blood-brain barrier in the optic nerves of strain-13 guinea pigs with chronic experimental allergic encephalomyelitis, a demyelinating disorder with neurologic and histopathologic characteristics similar to multiple sclerosis. Animals with experimental allergic encephalomyelitis received daily intraperitoneal injections of either preservative-free saline (group 1), catalase (group 2), or glutathione peroxidase (group 3) for 2.2 months after the onset of appendicular paralysis. Following intravascular administration, extravascular leakage of horseradish peroxidase was histopathologically graded as mild, moderate, or severe within the optic nerve head and myelinated retrolaminar nerve. Severe extravasation of horseradish peroxidase was exclusive to group 1, in addition to moderate and mild leakage. In groups 2 and 3, leakage of horseradish peroxidase was infrequent, and when detected, it was graded as mild. Detoxification of hydrogen peroxide with catalase and glutathione peroxidase substantially reduced horseradish peroxidase leakage in experimental optic neuritis, suggesting a role for hydrogen peroxide and its reactive by-products in the pathogenesis of increased vascular permeability of the blood-brain barrier in experimental allergic encephalomyelitis. PMID- 2783068 TI - Intravitreous injection of adenosine or its agonists causes breakdown of the blood-retinal barrier. AB - Pigmented rabbits were anesthetized and given an intravitreous injection of 0.1 mL of a test substance or vehicle alone. Vitreous fluorophotometry was performed before injections and at various time points after injections. Compared with pretreatment scans, vehicle-injected eyes showed no change in intravitreous fluorescein sodium leakage at 6 and 24 hours after injection. Injection of adenosine (10(-2) mol/L) resulted in fluorescein leakage that was significantly greater than that which occurred in control eyes at 6 hours after injection, but returned to baseline at 24 hours. This effect was significantly attenuated by an adenosine receptor antagonist (BW-A1433U), suggesting that it was mediated by specific adenosine receptors. A nonselective adenosine receptor agonist, N ethylcarboxamidoadenosine, and two relatively A1 selective receptor agonists, N6 cyclopentyladenosine and N6-phenylisopropyladenosine, also caused dose-dependent intravitreous fluorescein leakage. The relative order of potency was N ethylcarboxamidoadenosine much greater than N6-phenylisopropyladenosine, which was greater than N6-cyclopentyladenosine, implicating A2 adenosine receptors. Intravitreous injection of dipyridamole, an adenosine uptake inhibitor, caused enhanced fluorescein leakage, presumably from extracellular accumulation of endogenous adenosine. The results of this study suggest that adenosine may be a mediator of blood-retinal barrier breakdown. PMID- 2783069 TI - Transscleral iontophoresis of dexamethasone. AB - Transscleral iontophoresis has been suggested to be a potentially useful noninvasive technique in intravitreal introduction of ionizable drugs, such as cefazolin sodium, ticarcillin disodium, and gentamicin sulfate. To investigate the usefulness of this technique in the administration of corticosteroids, we performed transscleral iontophoresis of dexamethasone sodium phosphate (300 mg/mL, 20 mmol/L edetic acid [EDTA]) into rabbits at a current of 1.6 mA for 25 minutes. Eyes were enucleated at different time intervals and frozen in liquid nitrogen. The frozen vitreous bodies and adherent sensory retina were collected and sonicated, and dexamethasone levels were measured using high-pressure liquid chromatography. In addition, to study the facilitation of drug transport by cryotherapy, a second group of rabbits were given a single application of cryotherapy (-78 degrees C, 45 seconds) 3, 7, and 14 days before iontophoresis in the same region. Without cryotherapy, the initial level of dexamethasone in the vitreous body-sensory retina after iontophoresis was 139.3 +/- 51.5 mg/L (mean +/ SE) (n = 6) with a half-life of less than 2 hours. In the cryotreated group, the levels of dexamethasone immediately after iontophoresis 3, 7, and 14 days after cryotherapy were 61.5 +/- 31.7 (n = 6), 88.4 +/- 55.1 (n = 6), and 112.2 +/- 32.5 (n = 6) mg/L, respectively, indicating that levels were lower compared with the group without cryotherapy. Our results suggest that a high dose of dexamethasone can be delivered by using this noninvasive technique and that cryotherapy before iontophoresis does not increase drug levels in the vitreous body. PMID- 2783070 TI - Immunocytochemical localization of ornithine aminotransferase in human ocular tissues. AB - Gyrate atrophy of the choroid and retina is a rare inherited form chorioretinal degeneration caused by a deficiency of ornithine aminotransferase. We localized the enzyme in human ocular tissues using immunocytochemical procedures. Immunoreactivity was observed in the nonpigmented epithelium of the ciliary body and lens epithelium. In the retina, ganglion cells and some amacrine cells were immunoreactive. Pigmented granules made it difficult to identify immunoreactive products in the iris, pigmented epithelium of the ciliary body, choroid, and retinal pigment epithelium. Our findings suggested that ornithine aminotransferase plays an important role in ornithine metabolism in these oculartissues. PMID- 2783071 TI - Collagen shield enhancement of topical dexamethasone penetration. AB - Collagen corneal shields were investigated as a vehicle for enhancing the ocular penetration of topical 0.1% dexamethasone alcohol in rabbit eyes. Four protocols were compared: a single dexamethasone drop, hourly drops, a 24-hour collagen shield presoaked in 0.1% dexamethasone, and a presoaked collagen shield followed by hourly drops. Dexamethasone concentrations in the cornea, aqueous, iris, and vitreous were measured by radioassay at six time intervals, and cumulative drug delivery over 6 hours was calculated for each tissue. Treatment with a presoaked collagen shield plus hourly drops resulted in peak and cumulative drug delivery to the cornea, aqueous, iris, and vitreous that was twofold to fourfold higher than delivery achieved with hourly drops alone. A presoaked shield by itself yielded equivalent or superior peak and cumulative drug delivery compared with a regimen of hourly drops. Collagen shields significantly enhance topical dexamethasone penetration and may be useful for maximizing the intraocular delivery of dexamethasone and for decreasing the required frequency of topical dexamethasone administration. PMID- 2783072 TI - Photo essay. Avoiding inferior oblique injury during lower blepharoplasty. PMID- 2783073 TI - A caliper-hook for strabismus surgery. AB - An instrument to assist in resection surgery consists of a telescoping hook within a second hook that can be spread a calibrated distance. Its primary purpose is to maintain a constant tension and an accurate measure of tendon length during suture passage. Additionally, the grooved distal hook supports the needle and protects the globe from needle trauma. PMID- 2783074 TI - Low density lipoprotein subfractions and relationship to other risk factors for coronary artery disease in healthy individuals. AB - By a recently developed sensitive density gradient ultracentrifugation method, the distribution of low density lipoprotein (LDL) subfractions was studied in the serum of healthy blood donors (20 to 62 years old). For each subject, we observed a specific LDL subfraction distribution characterized by the relative contribution of the three major LDL subfractions, LDL-1 (1.020 to 1.028 g/ml), LDL-2 (1.027 to 1.034 g/ml), and LDL-3 (1.033 to 1.039 g/ml), to total LDL. Statistical analysis was performed by using the LDL density variable defined as: (% of LDL-1) x 1.024 + (% of LDL-2) x 1.0305 + (% of LDL-3) x 1.036 as a continuous variable. Controlling for age, smoking habits, relative body weight and, when appropriate, for gender, it appeared that: 1) dense LDL subfraction patterns characterized by a predominant LDL-3 subfraction and a decreased LDL particle size were more likely to be found among men than among women, 2) with increasing density of LDL, the levels of serum triglycerides increased, whereas the concentration of HDL cholesterol and the ratio of LDL cholesterol to LDL apolipoprotein (apo) B decreased, and 3) the best model with significant contribution in the prediction of the LDL subfraction distribution was the three variable model: total cholesterol, serum triglycerides, and LDL apo B (R2 = 0.40), whereas the best two-variable model consisted of serum triglycerides and high density lipoprotein cholesterol (R2 = 0.37). These data are consistent with results from a study described previously in which a different approach based on LDL subfraction quantification by gradient gel electrophoresis of whole plasma was used. PMID- 2783075 TI - Alimentary lipemia-induced redistribution of cholesteryl ester between lipoproteins. Studies in normolipidemic, combined hyperlipidemic, and hypercholesterolemic men. AB - Alimentary lipemia stimulates the transfer of cholesteryl ester between lipoproteins in vitro and may alter lipoprotein cholesteryl ester distribution in vivo. The effect of a single, large oral fat load on lipoprotein cholesteryl ester redistribution and the activity of cholesteryl ester transfer protein was investigated in six normolipidemic men (Group A), six combined hyperlipidemic men (Group B), and six hypercholesterolemic men (Group C). Fasting triglyceride-rich lipoprotein cholesteryl ester was high in Group B, low in Group A, and intermediate in Group C (A less than C less than B, p less than 0.05). After an oral fat load, total plasma cholesteryl ester was unchanged in all groups. In Group A, cholesteryl ester increased in smaller triglyceride-rich lipoproteins and remained so at 24 hours. Conversely, low density and high density lipoprotein cholesteryl ester decreased and returned to fasting values at 24 hours. In Group B, cholesteryl ester increased in large triglyceride-rich lipoproteins. Low density and high density lipoprotein cholesteryl ester (expressed as percentage of plasma cholesteryl ester) decreased. By contrast, in Group C, triglyceride rich lipoprotein and low density lipoprotein cholesteryl ester remained unaltered, and only high density lipoprotein cholesteryl ester decreased. The activity of cholesteryl ester transfer protein increased in all groups and returned to fasting values at 24 hours. No differences in response were observed among the three groups. It is concluded that an oral fat load can induce a shift in lipoprotein cholesteryl ester distribution from high and low density lipoproteins to triglyceride-rich lipoproteins without affecting total plasma cholesteryl ester.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2783076 TI - Effects of exercise-induced weight loss on low density lipoprotein subfractions in healthy men. AB - One-year changes in low density lipoprotein (LDL) peak flotation (Sf) rate and serum mass concentrations of LDL of Sf 0 to 7 (small LDL), LDL of Sf 7 to 12 (large LDL), intermediate density lipoprotein (IDL) of Sf 12 to 20, and very low density lipoprotein (VLDL) of Sf 20 to 400 were compared between men assigned at random to a 1-year exercise program (N = 48) or to a sedentary control condition (N = 31). Distance run among exercisers varied substantially (mean +/- SD: 12.7 +/- 8.9 km/week). Mean changes were not significantly different between the exercise and control groups for any of the low to very low density lipoprotein measurements. However, within the exercise group: 1) distance run correlated negatively with changes in the mass concentrations of small LDL; and 2) weight loss and reduced upper body obesity correlated positively with changes in small LDL, IDL, and VLDL mass and negatively with change in LDL peak flotation rate. Analyses with partial correlations suggest that weight loss may primarily affect LDL mass distributions through metabolic processes associated with high density lipoprotein2 or small VLDL (Sf 20 to 60). The decrease in small LDL concentrations and the increase in LDL peak flotation rate suggest that exercise induced weight loss may be effective in reducing coronary heart disease risk in persons genetically predisposed to a high-risk lipoprotein profile. PMID- 2783078 TI - Enhanced lipoprotein lipase secretion from human monocyte-derived macrophages caused by hypertriglyceridemic very low density lipoproteins. AB - We studied the effects of very low density lipoprotein (VDL) obtained from hypertriglyceridemic subjects on the secretion of lipoprotein lipase and lipid accumulation in human monocyte-derived macrophages. The incubation of macrophages with VLDL obtained from different subjects caused different effects on the secretion of lipoprotein lipase (6.8 to 137.7 nM free fatty acid/min/mg cell protein) and triglyceride accumulation (184 to 507 micrograms/mg cell protein) in human monocyte-derived macrophages. VLDL from subjects with marked hypertriglyceridemia (approximately 1000 mg/dl) had a fourfold greater effect on lipoprotein lipase activity and a twofold greater effect on cellular triglyceride accumulation when compared with the effects of VLDL from normolipidemic subjects. Both lipoprotein lipase activity and triglyceride accumulation correlated positively with plasma VLDL triglyceride levels (r = 0.50 and 0.45, respectively, p less than 0.05). From these data, we suggest that the activity of lipoprotein lipase secreted from macrophages incubated with VLDL was dependent on triglyceride concentrations, and that the secretion of lipoprotein lipase enhanced by hypertriglyceridemic VLDL was closely related to the intracellular accumulation of triglyceride. PMID- 2783077 TI - Metabolism of acetylated low density lipoproteins by monocyte-derived macrophages from patients with Werner's syndrome. AB - Accumulation of lipid-laden foam cells of monocyte origin plays an important role in atherogenesis. Therefore, for determination of the mechanism of accelerated atherogenesis in Werner's syndrome, studies were carried out on the metabolism of acetylated low density lipoprotein (LDL) by monocyte-derived macrophages from patients with this syndrome. These macrophages showed abnormally high activities for degradation and uptake of 125I-acetylated LDL, incorporation of 14C-oleate into cellular cholesteryl ester in the presence of acetylated LDL, and accumulation of cholesteryl ester derived from internalized 3H-cholesteryl linoleate-labeled acetylated LDL. However, these macrophages showed normal binding of 125I-acetylated LDL. These results indicate that in monocyte-derived macrophages of patients with Werner's syndrome, the uptake, lysosomal hydrolysis, and re-esterification of free cholesterol are enhanced with no change in the receptor binding of acetylated LDL. As a result, these macrophages show increased accumulation of cholesteryl ester derived from acetylated LDL. This abnormal enhancement of cholesteryl ester accumulation may cause an accelerated conversion of macrophages to foam cells in Werner's syndrome. PMID- 2783079 TI - Distribution of lipoproteins and apolipoproteins in young adults The CARDIA Study. AB - While there are many studies of the distribution of coronary heart disease risk factors in children, adolescents, and middle-aged adults, little information is available on this topic in young adults. The Coronary Artery Risk Development in Young Adults Study (CARDIA) examined 4858 men and women who fasted 10 or more hours, were ages 18 to 30, and were representative of black and white residents of four U.S. communities. Compared with white men, black men had higher age adjusted mean levels of high density lipoprotein cholesterol (HDL-C) (6.7 mg/dl, p less than 0.001) and apolipoprotein A-l (apo A-l) (9.1 mg/dl, p less than 0.001) and lower concentrations of triglycerides (-19.7 mg/dl, p less than 0.001) and apolipoprotein B (apo B) (-3.3 mg/dl, p less than 0.001). Compared with white women, black women displayed higher concentrations of low density lipoprotein cholesterol (LDL-C) (5.7 mg/dl, p less than 0.001), apo A-l (2.6 mg/dl, p = 0.001), and apo B (3.0 mg/dl, p less than 0.001), but lower triglycerides (-5.8 mg/dl, p=0.001). Gender differences were more pronounced among whites: white men displayed lower mean levels of HDL-C and apo A-l (-9.2 and -7.3 mg/dl, p less than 0.001) and higher concentrations of LDL-C, triglycerides, and apo B (5.2 20.3, and 5.3 mg/dl, p less than 0.001) than white women. Attained level of education was significantly associated with a favorable lipoprotein/apolipoprotein profile, particularly among white women. These data indicate substantial variation in the distribution of lipoproteins and apolipoproteins in young adults, which may be important determinants of future coronary disease risk. PMID- 2783080 TI - Beta-VLDL metabolism by pigeon macrophages. Evidence for two binding sites with different potentials promoting cholesterol accumulation. AB - Previous studies from our laboratory (J Lipid Res 1988;29:643-656) have shown that thioglycolate-elicited peritoneal macrophages from White Carneau and Show Racer pigeons, like mammalian macrophages, have on their surfaces specific receptors for acetylated low density lipoprotein (acLDL) and beta-migrating very low density lipoproteins (beta-VLDL). The binding kinetics of beta-VLDL were complex, however, suggesting more than one binding site. The purpose of the present study was to further characterize these beta-VLDL binding sites. Scatchard analysis of 125I-beta-VLDL binding curves indicated at least two classes of binding sites. The first binds pigeon beta-VLDL and LDL with high affinity (Kd approximately 7 micrograms/ml), is down-regulated by cholesterol loading, requires calcium, and is destroyed by the proteolytic enzyme, pronase. This pigeon beta-VLDL receptor is specific for pigeon beta-VLDL and LDL and does not recognize HDL, acLDL, methyl LDL, cynomolgus monkey LDL, or rabbit beta-VLDL. Like the mammalian macrophage beta-VLDL receptor, the "pigeon beta-VLDL receptor" has many of the characteristics of an LDL receptor. The second class of binding sites is relatively nonspecific, recognizing both pigeon and rabbit beta-VLDL, LDL, acLDL, methyl LDL, and HDL. Binding to this site is not altered by incubation of macrophages with pronase or by cholesterol loading. This binding site has low affinity for beta-VLDL (Kd approximately 100 micrograms/ml), but high capacity. We have called this the "lipoprotein binding site," a term used by others to describe similar lipoprotein binding characteristics on a variety of cells. Not only does binding to this site promote the internalization and degradation of lipoproteins, but it may also facilitate the independent uptake of cholesterol. This conclusion is based on the observation that more cholesterol accumulates in cells incubated with rabbit beta-VLDL, which binds only to the lipoprotein binding site, than can be accounted for by beta-VLDL uptake and degradation. Since the lipoprotein binding site recognizes a variety of normal, as well as abnormal, lipoproteins, it would not require the generation of abnormal lipoprotein products, as must occur with the scavenger receptor, to promote the accumulation of cholesteryl esters in macrophages of atherosclerotic lesions. This, coupled with the fact that the lipoprotein binding site is not down-regulated by cholesterol loading, suggests that it could provide an alternative mechanism to the scavenger receptor pathway for the formation of foam cells. PMID- 2783081 TI - A role for intracellular histamine in ultrastructural changes induced in platelets by phorbol esters. AB - In human platelets, phorbol esters, such as phorbol-12-myristate-13-acetate (PMA), induce morphological changes, including pseudopod formation and the swelling and fusion of intracellular granule membranes with those of the surface connected canalicular system, effects which have been attributed to activation of protein kinase C. However, a novel intracellular histamine antagonist, N,N diethyl-2-[4-(phenylmethyl)phenoxy]-ethanamine. HCl (DPPE), previously has been shown to block PMA-induced aggregation independently of protein kinase C interaction, an effect reversible in permeabilized platelets by the addition of histamine. We now demonstrate that DPPE inhibits, in a concentration-dependent manner, the effects of PMA on human platelet ultrastructure. In permeabilized platelets, histamine reverses this inhibition, although it alone induces minimal effects on morphology. The results support a role for this amine to promote the labilization of platelet granules and pseudopod formation induced by PMA, presumably by acting in concert with additional PMA-activated pathways. PMID- 2783082 TI - [24th conference of the Japanese Medical Society of Alcohol Studies. Tokyo, 21-23 September 1989. Abstracts]. PMID- 2783083 TI - A new broom, moving the dust around a little bit... PMID- 2783084 TI - Prognosis of patients who present with an episode of myelopathy of unknown origin in Malaysia: a retrospective study of 52 patients. AB - Fifty-four per cent of 52 patients presenting to the University of Malaya Medical Centre with a myelopathy for which appropriate investigations uncovered no definite etiology, subsequently developed clinically definite or probable multiple sclerosis. In the subgroup of patients with a presentation indicative of acute/subacute transverse myelopathy, 14 or 52% also went on to develop clinically definite or probable multiple sclerosis, a far higher proportion than previously recorded in the literature. This finding is probably a further manifestation of racial difference in the behaviour of multiple sclerosis. For the group as a whole, the only factor which appeared to be associated with an increased risk of developing multiple sclerosis was female sex; 67% of 33 female patients went on to develop multiple sclerosis after a mean follow-up period of 5.5 years. Other factors such as age of onset, racial composition, level of spinal cord involvement, presence of fever and CSF finding were found not to be important. PMID- 2783086 TI - Allergic fungal sinusitis presenting as a paranasal sinus tumour. AB - Allergic fungal rhinosinusitis is a rare complication of atopic upper airways disease which may present initially as an expansive tumour of the paranasal sinuses. This reported case was caused by the rare fungal pathogen Bipolaris hawiiensis and illustrates typical clinical and laboratory features of this disorder. Although the optimum management of allergic fungal sinusitis is controversial, combined therapy with surgical clearance, antifungal agents and corticosteroids produced a favourable outcome. PMID- 2783085 TI - Nutritional status of home hemodialysis patients. AB - We studied the nutritional status of 32 patients (23 men), aged 50 (SD14) yr, on home hemodialysis (HHD) for one-138 months. No formal dietary restrictions were imposed. Anthropometric measurements were made using standard techniques, diet assessed by three-day dietetic diary and interview and plasma concentrations of nutrients were measured. Mean caloric intake was 29.4 (SD 10.7) kcal/kg; 24 (75%) patients had lower energy intakes than recommended for normals. Protein, vitamin C and folate intakes were above recommended minimum safe intakes. Intakes were less than recommended for calcium in four (13%) patients, iron in one (3%) and vitamin B12 in two (6%). One-third of both sexes had body mass indices (kg/m2) less than 25th percentile for normals, but none was less than 80% of ideal bodyweight. Arm muscle circumference was less than 10th percentile for normals in six men and three women. Triceps skin fold thickness was less than 10th percentile in four men (17%) and five women (55%). No anthropometric measurements were correlated with energy, protein or fat intake. Biochemical measurements were not useful in predicting protein intake. Neither nutritional intake nor anthropometric measurements were correlated with the duration of HHD. There was little evidence of malnutrition and wasting in this group of well rehabilitated HHD patients. PMID- 2783087 TI - Hypercalcemia and squamous cell carcinoma complicating chronic osteomyelitis. AB - A case of chronic osteomyelitis complicated by the development of squamous cell carcinoma in the sinus tract is described. This complication was itself associated with the development of humoral hypercalcemia of malignancy, a phenomenon not previously described in this context. Common misconceptions relating to the interpretation of serum parathyroid hormone levels led to the misdiagnosis of hyperparathyroidism and parathyroid exploration. Forced saline diuresis, mithramycin and oral phosphate supplements were not able to provide long-term control of the hypercalcemia but the patient was subsequently managed successfully with intravenous (3-amino-1-hydroxypropylidene)-1,1-bisphosphonate (APD) and resection of the causative tumour. PMID- 2783088 TI - Initial chemotherapy followed by surgery in malignant thymoma. AB - Initial combination chemotherapy with cisplatinum, adriamycin and cyclophosphamide was given prior to surgery in a young woman with an unresectable malignant thymoma. Complete remission was achieved following three cycles of chemotherapy. Subsequent thymectomy revealed no evidence of residual malignancy. Prolonged remissions following cisplatin-based chemotherapy have recently been achieved in metastatic thymoma. Initial chemotherapy should now be considered prior to surgery or radiotherapy in those patients presenting with very bulky or unresectable disease. PMID- 2783089 TI - Severe hypokalemic rhabdomyolysis due to ingestion of liquorice during Ramadan. AB - A 62-year-old man was admitted with severe hypokalemia following ingestion of a modest amount of liquorice during the Islamic holy month of Ramadan. Hypokalemia was associated with typical electrocardiographic changes, marked acid-base disturbance and complicated by rhabdomyolysis. All abnormalities improved with normalisation of serum potassium. The serum creatine kinase isoenzymes (CK-total and MB) returned to normal over a prolonged period. The potential danger of ingesting liquorice even in small amounts over short periods, and the role of concomitant diuretic therapy with the additional factor of fasting during Ramadan in precipitating hypokalemia during liquorice ingestion are discussed. PMID- 2783091 TI - Paediatric injuries. PMID- 2783090 TI - Colchicine therapy for idiopathic thrombocytopenic purpura--an inexpensive alternative. PMID- 2783092 TI - Extra-adrenal phaeochromocytoma: report of three interesting cases. AB - The clinical, laboratory and operative findings from three cases of extra-adrenal phaeochromocytoma are reviewed. Some of the difficulties encountered in localizing such a neoplasm are highlighted. Data from intraoperative catecholamine monitoring on the three patients are also presented. Adequate alpha and beta blockade produced stable cardiovascular parameters during surgery in all three individuals. PMID- 2783093 TI - Faecal incontinence: manometric and radiological changes following postanal repair. AB - Ten patients with idiopathic faecal incontinence underwent postanal repair based on clinical assessment of their symptoms. Their manometric and radiological values before surgery were compared with values from 10 normal volunteers and then the changes following surgery were examined and correlated with the clinical results. Anal manometry was performed using a multilumen, low compliance, perfused catheter system. Anorectal angles and perineal descent were established radiologically. Pre-operative manometry demonstrated significant reduction in maximum and squeeze pressure (median 77 mmHg versus 200 mmHg), the volume required to inhibit the rectoanal reflex (median 40 mL versus 70 mL), and the volume retained in the saline continence test (median 400 mL versus 1500 mL). The majority of patients had obtuse anorectal angles (six of 10 at rest), and abnormal perineal descent (eight of 10 on straining). Nine patients have been improved clinically following surgery. Postoperative manometry and radiology have been performed in seven patients and have shown no significant changes. Anal manometry and radiology are objective means of documenting faecal incontinence although their role in selecting patients for surgery is not yet determined. Postanal repair is effective in restoring continence, although the parameters measured have not explained the mechanism of this effect. PMID- 2783094 TI - Current surgical management of oesophageal atresia and/or tracheo-oesophageal fistula. AB - During the last 40 years, 579 babies with oesophageal atresia and/or tracheo oesophageal fistula have been admitted to the Royal Children's Hospital (RCH), Melbourne. There are 393 survivors. Advances in the surgical management have contributed to lowering the morbidity and mortality rates. This paper describes current surgical management of each anatomical variant at RCH; specific reference is made to the problems of the long gap oesophageal atresia and prematurity. PMID- 2783095 TI - Paediatric bicycle injuries. AB - Bicycle injuries are an important cause of trauma. Approximately 75% of such accidents occur in children and involve difficult decisions in the areas of education, engineering and legislation. A prospective 3-year study was undertaken to understand the range of injuries and in particular to concentrate on severe injuries. In all, 251 children were admitted to Westmead Hospital after receiving bicycle injuries. Most injuries were minor but there were 37 serious injuries and six deaths. Head injuries predominated, especially in the seriously injured. The rate of wearing helmets was low, with less than 10% of all admissions wearing a helmet. None of the seriously or fatally injured wore a helmet. Helmet-wearing remains the single most important preventative measure to be instituted if the serious morbidity and mortality rates associated with bicycle injuries are to decrease. PMID- 2783096 TI - Pharmacological manipulation of postoperative intestinal adhesions. AB - Paralytic ileus and intestinal adhesions are common events following intra abdominal surgery. The theoretical hypothesis 'that stimulation of the postoperative bowel will reduce intestinal adhesions' was studied in a rat model for intestinal adhesions in which postoperative bowel motility was pharmacologically manipulated. Immediate postoperative stimulation of gastrointestinal motility by the prokinetic agent, Cisapride, resulted in a significant reduction in both the number and extent of adhesions. Inhibition of postoperative intestinal motility with the anticholinergic agent, atropine, resulted in a greater number of more dense adhesions involving an increased length of bowel. PMID- 2783097 TI - Infrarenal aortic aneurysm: unusual cause of paraparesis. AB - A male patient recently presented to our Unit with anterior spinal artery syndrome involving his lower limbs. This neurological condition was an unusual manifestation of an infrarenal abdominal aortic aneurysm with local dissection occluding the infrarenal lumbar arteries. The incidence, anatomy, aetiology, and management of the condition associated with aortic aneurysms are described. PMID- 2783098 TI - Traumatic internal carotid artery aneurysm and massive epistaxis. AB - A case of traumatic internal carotid artery aneurysm (ICAA) is described. Although rare, the occurrence of rupture of traumatic ICAA with epistaxis has a high mortality. Successful management requires an awareness of the entity, prompt recognition, and aggressive first aid procedures. Definitive treatment involves trapping of the internal carotid artery either by a direct approach, or by balloon embolization. PMID- 2783099 TI - Report of four cases of aneurysm complicating patch aortoplasty for repair of coarctation of the aorta. AB - Patch aortoplastry, used almost routinely in the period 1972-86, except in infants in the operative treatment of coarctation of aorta, is sometimes complicated by late formation of true or false aneurysms. This complication, which seems likely to increase with longer follow-up, calls into question the advisability of patch aortoplasty except when it has specific advantages. Other surgical techniques such as subclavian flap angioplasty in infants and young children or radical excision with end-to-end anastomosis may be preferable where there is no anatomical contraindication. In any case, lifelong yearly review of postoperative patients should include chest X-ray and further investigation by computerized tomography scanning or other suitable imaging of those with suspicious findings. PMID- 2783100 TI - [Lameness of the hindlimbs of the cat]. AB - About six to seven per cent of cats presented at the clinic show neurological signs. The largest group consists of traumatized cats. A complete neurological examination is essential for localizing the lesion and establishing a prognosis. Differential diagnosis for paraparesis/paraplegia of pelvic limbs in cats are discussed. Cats are demonstrated which had spinal cord trauma, disc protrusion, aortic thromboembolism and lumbosacral stenosis and the importance of the evaluation of x-rays, cerebrospinal fluid examination and myelography is stressed. PMID- 2783101 TI - [The sperm quality of 4 boars during the assimilation of mycotoxin-containing feed (ochratoxin A) amd after changing the feed--a case study]. AB - In December 1987 and January 1988 in a small station two of four boars showed a marked breakdown in the sperm quality. At the same time the mycotoxin ochratoxin A was identified in the feed at a concentration of about 8 ppb and in the bloodserum of 1 ppb. The relatively low toxin level seemed not to be due to the bad sperm quality, but considering the circumstances and the chronological course it might be an indicator for a higher toxic pressure, which may had happened a few weeks before. As other factors were not visible, most probably the feed must have caused a disturbed sperm production, which could be seen in all four boars. Whether ochratoxin A or other not identified mycotoxins can be hold responsible, could not be clarified. Therefore it is recommended to examine the effects of ochratoxin A on sperm quality of boars in future times. PMID- 2783102 TI - [The isolation and differentiation of leptospires from cattle drinking water]. AB - The cultural isolation and identification of leptospires from three water samples of farm wells were described. All three strains isolated belong to the apathogenic species L. biflexa. The cattle stock of these farms (A, B, C) had reacted serologically to serovars hardjo and grippotyphosa. The strain isolated from farm A is a new serovar called krefeldi and belongs to serogroup Doberdo. The strain isolated from farm B belongs to serovar montefiascone of serogroup Botanica and the strain from farm C to serovar bessemans of serogroup Bessemans. It is remarkable that serovar krefeldi with all the sera of farm A (titre up to 1:40) and only with part of the sera of farm B reacted. PMID- 2783104 TI - Nutrition in the prevention of disease. 26th symposium of the Group of European Nutritionists. Prague, March 28-29, 1988. Proceedings. PMID- 2783103 TI - [Behavioral disorders and injuries in cattle raising]. AB - Disturbed behaviour is defined as 'deviation from normal behaviour by overloading the capacity of adaptation'. Disorders are arising as 'injuries of the organism by environmental factors which are not conform to the behavioural requirements of an individual'. Examples are given related to tying-stalls and to cubicle housing. More injuries do arise from short-standing than from cubicle-houses. The influence of the herdsman's qualification how to keep cattle concerning their behaviour and the quantity of injuries is shown. PMID- 2783105 TI - Iron fortification of infant cereals. PMID- 2783106 TI - Folate deficiency: morphological and functional consequences. PMID- 2783107 TI - Monitoring hemoglobin and iron status in blood donors to prevent iron deficiency. PMID- 2783108 TI - Intervention study on obese school-aged children. AB - Obesity is the visible result of a behavioral disease related to eating and drinking habits. Eating and drinking have to be considered as social activities, which means that an obese child cannot be treated separately but only as a part of his family. With respect to our programme, mother and father (usually one of them has some overweight, too) have to be prepared to join a 1-year therapeutic programme. The familial compliance may be strengthened and even guaranteed by the fact that fellow sufferers can be found in the closest circle. The compliance in question is enforced, moreover, because derision on the part of social environment, which results in isolation, brings obese people together. Generally, overweight children and adults try to overcome such difficulties resorting to pleasurable sensation by additional eating. Thus, a vicious circle is formed and sustained. Our behavioral programme takes 1 year. In the beginning those who are willing to participate are accepted into a 'club'. New members enter discussions and their family eating habits are revealed. As overweight people often eat hastily and alone, the programme starts by teaching them how to eat slowly, how to serve themselves (once per meal only) and that they have to take their meals in company. A 3-week camp organized and managed by a team of responsible therapists takes place in the mountains in July/August. The therapeutic team comprises a physician, a psychotherapist, a school psychologist, a home economics teacher, a gymnastics and swimming teacher, and a social worker.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2783109 TI - L-arginine is a precursor for nitrate biosynthesis in humans. AB - Nitrogen from L-arginine was incorporated into urinary nitrate in human subjects. Two subjects given an oral dose of [15N2]L-arginine excreted 24 and 17 umol [15N]nitrate/24 hr, respectively, in their urine in the 24 hr period following the dose. This work demonstrates that L-arginine, a nitrogen source for biosynthesized nitrate in cultured cells and research animals, is a precursor for endogenously synthesized nitrate in humans. PMID- 2783110 TI - Enzymic and nonenzymic mono ADP-ribosylation of proteins in skeletal muscle. AB - The acceptors of endogenously catalyzed monoADP-ribosylation in the cell free extract from rat skeletal muscle was searched. The main acceptor proteins in particulate were electrophoretically 52, 80, 100, and greater than 200 kDa proteins in the presence of SDS, while that in cytosol were 36 and 39 kDa proteins. Although no ADP-ribosylation was observed in particulate when the substrate NAD+ was replaced by ADP-ribose, the same ADP-ribose adducts were also formed with higher degree in cytosol. These results indicate that an enzymic and nonenzymic monoADP-ribosylation occur separately in cytosol and particulate. One acceptor, 36 kDa protein, appears to be glyceraldehyde-3-phosphate dehydrogenase. PMID- 2783111 TI - Connective tissue activation. XXXIII. Biologically active cleavage products of CTAP-III from human platelets. AB - Evidence for three new isoforms of CTAP-III from human platelets is presented; two NH2-terminal cleavage products were identified, CTAP-III (des 1-13) and CTAP III (des 1-15). CTAP-III (des 1-13) has a pI of 8.6 and is a relatively stable proteolytic cleavage product that retains the capacity to stimulate [14C]GAG synthesis in human synovial cell cultures. CTAP-III (des 1-15) appears to be an elastase or chymotrypsin cleavage product and identical to NAP-2, an entity thought to have neutrophil activating properties. PMID- 2783112 TI - Posttranslational and direct integration of heme oxygenase into microsomes. AB - Rat liver heme oxygenase has a large cytoplasmically exposed domain containing the N-terminus that can be cleaved from the membranes by a low concentration of trypsin, indicating that heme oxygenase is embedded in membranes with an insertion sequence near its C-terminal portion. Heme oxygenase synthesized in a cell-free system or purified from microsomes after detergent-solubilization was integrated into microsomal membranes posttranslationally and directly, like cytochrome b5. PMID- 2783113 TI - Increased level of apolipoprotein B mRNA in the liver of ventromedial hypothalamus lesioned obese rats. AB - The mRNA level of apolipoprotein B (apoB), which is a principal protein component of nascent very low density lipoprotein (VLDL), was determined in parallel with the measurement of acetyl-coenzyme A (Ac-CoA) carboxylase activity in the liver of ventromedial hypothalamus (VMH) lesioned obese rats. Eight weeks after the electrolysis of the bilateral VMH, the level of apoB mRNA in the VMH-lesioned rats was about 1.5-fold higher than that in the sham-operated rats, indicating increased apoB synthesis in the liver of the VMH-lesioned obese rats. The activity of Ac-CoA carboxylase, which is a rate-limiting enzyme for the fatty acid biosynthesis, was about 1.8-fold higher in the VMH-lesioned rats. These observations indicated that VLDL synthesis is increased in the liver of VMH lesioned obese rats. PMID- 2783114 TI - Deoxycytidine is salvaged not only into DNA but also into phospholipid precursors. II. Ara-C does not inhibit the later process in lymphoid cells. AB - dCTP formed from exogenous deoxycytidine via the salvage pathways was previously shown to serve deoxyliponucleotide synthesis in lymphocytes (Spasokukotskaja et al, Biochem. Biophys. Res. Commun. (1988) 155, 923-929) and now in lymphoma cells. After treatment with 1-beta-D-arabino-furanosylcytosine (ara-C), much more araCTP as well as araCDP-choline was formed in lymphoma cells than in lymphocytes explaining the high sensitivity of lymphoma cells to this drug. Ara-C did not inhibit labeling of 5-3H-dCDP-choline from exogenous 5-3H-deoxycytidine while inhibiting DNA synthesis. Excess of exogenous ribocytidine diminished labeling of araCDP-choline, without any effect on dCDP-choline. These data suggest that araCDP-choline and dCDP-choline were synthesized from separate pools in these cells. PMID- 2783115 TI - Peculiar effects of temperature and polyvinylalcohol on the activity of bovine serum amine oxidase. AB - An inflexion point of enzyme activity at 38 - 42 degrees C of the bovine serum amineoxidase was found. This result, associated with non-strict Arrhenius curves and slightly different activation energies in various temperature intervals, suggests some conformational transitions at the mentioned temperatures. The high molecular weight polyvinylalcohol (100,000 Da) generated an activatory effect and a sigmoidal (non-Michaelis) curve of the dependence of the activity on the substrate concentrations, while the low molecular weight polyvinylalcohol (20,000 Da) does not produce this effect. The different ratio of the two types of polyvinylalcohol/enzyme monomer sizes is considered to be responsible for these different effects on the enzyme kinetics. PMID- 2783116 TI - Hypoxia as a risk factor for doxorubicin-induced cardiotoxicity: a NMR evaluation. AB - Previous studies suggested that one possible mechanism of doxorubicin (DXR) induced cardiomyopathy involves the depletion of high-energy phosphate stores. In this study, we used 31P nuclear magnetic resonance to assess the high-energy phosphate content in Langendorff perfused rat hearts. Hearts were perfused in normoxic conditions (spontaneous flow) or in partially hypoxic conditions obtained by perfusing at 50% of the spontaneous flow. DXR was used at the subtoxic conditions of 50 mg/l for 15 min and at the cardiotoxic concentration of 100 mg/l for 60 min. Left ventricular pressure (dP/dt), heart rate, myocardial ATP and PCr levels and PCr/ATP ratio were measured. We found that, in normoxic conditions, DXR (50 mg/l, 15 min) does not impair cellular high-energy phosphate metabolism. However, in mild hypoxic conditions, DXR induces a significant decrease in PCr/ATP ratio, due to a decrease in PCr and to a simultaneous increase in ATP. Similar results are obtained after 60 min perfusion with the cardiotoxic dose of DXR. This study suggests that hypoxia may represent a risk factor for the development of DXR-induced acute cardiotoxicity. PMID- 2783117 TI - L-arginine availability determines the duration of acetylcholine-induced systemic vasodilation in vivo. AB - In vitro studies have shown that acetylcholine-induced vasorelaxation is mediated by endothelium-derived relaxing factor/nitric oxide (EDRF/NO). EDRF/NO is synthesized from L-arginine by an enzymatic pathway that is inhibited by L-NG methylarginine. To assess whether EDRF/NO also mediates the vasodilating action of acetylcholine in vivo, we have investigated the effect of L-arginine and L-NG methylarginine on the hypotensive response to acetylcholine in the anesthetized guinea pig. L-arginine prolonged the duration of the depressor response to acetylcholine and L-NG-methylarginine decreased it. However, neither L-arginine nor L-NG-methylarginine modified the magnitude of acetylcholine's hypotensive effect unless the blood pressure was previously elevated by infusion with norepinephrine. Thus, de novo synthesis of nitric oxide from L-arginine contributes importantly, but not exclusively, to acetylcholine's hypotensive effect in the guinea pig. Furthermore, the concentration of circulating L arginine may influence the duration and magnitude of acetylcholine-induced depressor responses under normotensive and hypertensive conditions. PMID- 2783118 TI - The effect of crosslinking by bis(3,5-dibromosalicyl) fumarate on the autoxidation of hemoglobin. AB - Bis(3,5-dibromosalicyl) fumarate was used to crosslink hemoglobin both in the oxy and deoxy states. This double headed diaspirin was known to crosslink oxy Hb A selectively between Lys 82 beta 1 and Lys 82 beta 2 (Walder, J. A., et al. (1979) Biochemistry 18, 4265) and deoxy Hb A between Lys 99 alpha 1 and Lys 99 alpha 2 (Chatterjee R. Y., et al. (1986) J. Biol. Chem. 261, 9929). The autoxidation at 37 degrees C of oxy alpha 99 crosslinked hemoglobin was found to be 1.8 times as fast as that of Hb A while that of the oxy beta 82 crosslinked hemoglobin was only 1.2 times as fast. After 5 hours the formation of methemoglobin in the alpha crosslinked Hb A is 21.3% compared to 10.8% in beta crosslinked Hb A and 6.4% in Hb A. These results may effect the proposed use of alpha 99 crosslinked hemoglobin as a blood substitute by demonstrating the need for protection from autoxidation during storage. PMID- 2783119 TI - Purification and spectroscopic characteristics in N-methylformamide of the Azotobacter vinelandii Fe-Mo cofactor. AB - The iron-molybdenum cofactor from Azotobacter vinelandii can be removed from significant amounts of extraneous iron and other contaminants using anaerobic gel filtration. Electronic absorption spectra of the so-purified FeMoco along with analysis of the so-called 'easily complexed' iron are suggestive that FeMoco occupies at least two different states in N-methylformamide solution. Batch related differences in spectral characteristics of independently isolated FeMoco samples are demonstrated. Non-cofactor iron, found in unpurified FeMoco, may affect the interpretation of ligand binding and other experiments probing FeMoco structure and reactivity. Oxidized FeMoco is shown to be clearly discernable from the semi-reduced species by means of electronic spectroscopy, and this method now forms a convenient analytical tool for study of the chemistry and electronic structure of FeMoco. PMID- 2783120 TI - Evidence for a regulatory action of vanadate on protein phosphorylation in brain microvessels. AB - We investigated the action of vanadate on protein phosphorylation in microvessels isolated from rat brain. We found that a stimulation of protein phosphorylation from 32P-ATP occurs, in the presence of different concentrations of vanadate, 10( 3) M being the most effective dose. This action was time-dependent, and it was more evident after 60 s of treatment. The contribution of ATPase inhibition caused by vanadate appears to be negligible. In addition a stimulation of cAMP dependent protein kinase activity was observed. The pattern of protein phosphorylation showed that exposure to 10(-3) M vanadate resulted in a nonspecific stimulation of protein phosphorylation concomitantly with a selective inhibition of the 55 KDa protein phosphorylation. The nature of this protein is also discussed. PMID- 2783121 TI - Irreversible inhibition of v-src tyrosine kinase activity by herbimycin A and its abrogation by sulfhydryl compounds. AB - Herbimycin A, an antibiotic which reverses Rous sarcoma virus transformation, inhibited irreversibly the auto- and trans-phosphorylation activities of p60v-src in in vitro immune complex kinase assays. The addition of a sulfhydryl compound such as dithiothreitol, 2-mercaptoethanol, glutathione (reduced form) or cysteine abolished the ability of herbimycin A to inactivate p60v-src kinase as well as the ability to reverse transformed cell morphology, whereas the addition of oxidized glutathione, cystine or methionine showed no effect. The sulfhydryl alkylating reagent N-ethylmaleimide also, although less effectively, inactivated p60v-src kinase activity in vitro. These results suggest the likelihood that sulfhydryl groups of p60v-src are involved in the inactivation of v-src tyrosine kinase activity by herbimycin A. PMID- 2783122 TI - Are undifferentiated PC12 rat pheochromocytoma cells electrically excitable? AB - Undifferentiated rat pheochromocytoma PC12 cells were current clamped using the whole cell technique. Measurements of cell membrane resting potentials (RMP) gave values in the -30 and -50 mV range. Cell input resistance was between 200 and 400 Mohm. After blockade of K+ currents with intracellular Cs+, cell membrane depolarization showed that PC12 cells are able to generate active responses (i.e., calcium action potentials followed by after-hyperpolarizations partially blocked by tetraethylammonium). Taken together, our results indicate that PC12 cells do not require exposure to nerve growth factor to become electrically excitable. PMID- 2783123 TI - Control of expression of the human glutathione S-transferase pi gene differs from its rat orthologue. AB - We have examined regulation of the glutathione S-transferase pi gene by transient expression assay, and find that a fragment from 8 to 99 bp upstream of the cap site promotes transcription, but there is no evidence for any enhancer activity in a further 6 kb of flanking sequence. Analysis of this sequence by reference to a primate sequence database and Southern blotting revealed that as much as 5 kb of this flanking DNA were composed of repetitive insertion elements including an Alu and a LINE 1 repeat. The promoter fragment has been sequenced (Cowell et al (1988) Biochem. J. 255, 79-83) and contains a consensus AP1 binding site; in some cases, these have been associated with transcriptional induction by phorbol esters and ras oncogenes. We measured the steady state levels of glutathione S transferase pi mRNA in human cell lines which were known to express ras oncogenes and compared them to human cell lines which have not been identified with ras activation. There was no correlation between expression of activated ras and expression of glutathione S-transferase pi mRNA. Treatment of HeLa cells, HepG2 cells and a small cell lung carcinoma line, GLC 8, with the phorbol ester 12-O tetradecanoylphorbol 13-acetate failed to alter the steady state levels of endogenous glutathione S-transferase pi mRNA. The differences between these results and those of similar studies on rat glutathione S-transferase subunit 7, a structural orthologue of glutathione S-transferase pi, are discussed. PMID- 2783124 TI - Liver cytosolic non-dialysable factor(s) can counteract GTP-dependent Ca2+ release in rat liver microsomal fractions. AB - Readdition to rat liver microsomes of dialysed liver post-microsomal supernatant resulted in an almost complete inhibition of the Ca2+-releasing effect of GTP. Such inhibition was heat-labile, and was associated with non-ultrafiltrable supernatant components with a molecular weight higher than 30,000 D. A preliminary fractionation of liver supernatant showed that the inhibitory effect is recovered in the 40-50% ammonium sulfate-precipitated proteins, with an approx. 10-fold enrichment. The active ammonium sulfate fraction did not modify the GTP-induced Ca2+ increase of passive Ca2+ efflux from microsomes, nor did it affect microsomal GTP hydrolysis, which is likely required for its Ca2+ releasing effect. The active ammonium sulfate fraction appears to markedly favour the translocation of GTP-released Ca2+ into a microsomal GTP-insensitive pool. Separation of liver microsomes in smooth and rough fractions revealed that such GTP-insensitive Ca2+ pool is almost completely associated with smooth microsomes. PMID- 2783125 TI - Protein kinase C involvement in lipid peroxidation and cell membrane damage induced by oxygen-based radicals in hepatocytes. AB - We investigated the effects of oxygen-based radicals induced by t-butyl hydroperoxide or H2O2/Cu2+ on cultured hepatocytes. Radical exposure caused membrane lesions (blebs), lactate dehydrogenase release and lipid peroxidation (i.e. formation of malondialdehyde) in cells. As expected, radical scavengers (catalase, alpha-tocopherol) strongly inhibited these phenomena. A similar or even superior inhibitory effect was achieved by the protein kinase C (PKC) inhibitors H-7 and phloretin. These agents did not reveal notable radical scavenging properties as assessed by their ability to break down H2O2. The PKC stimulators 4 beta-phorbol-12-myristate-13 and 1-olyeoyl-2-acetyl-sn-glycerol intensified the detrimental actions of the radical-inducing agents. [3H]Phorbol 12,13-dibutyrate-binding studies showed that membrane association of PKC is markedly increased in hepatocytes after exposure to H2O2/Cu2+ or t-butyl hydroperoxide. These results suggest that PKC membrane translocation and activation may be important for mediating membrane damage and lipid peroxidation after cells are exposed to oxygen-based radicals. PMID- 2783126 TI - Formation of a phosphoramide mustard-nucleotide adduct that is not by alkylation at the N7 position of guanine. AB - The reaction of 2'-deoxyguanosine 3'-monophosphate with phosphoramide mustard resulted in the formation of several adducts. One of these adducts was formed by linking phosphoramide mustard to the phosphate group of 2'-deoxyguanosine 3' monophosphate rather than by the generally accepted mechanism involving alkylation at the N7 position of guanine. This adduct served as an acceptor for the transfer of 32p from [gamma 32P]ATP by polynucleotide kinase and thus could be detected by the sensitive 32p-postlabeling assay. PMID- 2783127 TI - Perturbations in cerebral oxygen radical formation and membrane order following vitamin E deficiency. AB - The effects of dietary vitamin E deficiency on mouse cerebral membrane order and oxygen reactive species were studied. Quantitation of vitamin E levels in several brain regions showed greatest deficiencies in striatum and cerebellum, followed by substantia nigra, and cortex. Vitamin E deficiency increased central-core membrane order in cerebral P2 fraction, but was without effect in the superficial hydrophilic membrane domain. Oxygen radical formation was studied using the probe 2',7'-dichlorofluorescein diacetate. Basal generation rates of oxygen reactive species were 2.5-fold higher when compared to control animals. While hepatic levels of vitamin E are much more reduced than brain levels, in deficient mice, the rate of oxygen radical formation in the liver was unaltered. This implies an special susceptibility of the brain to deficiency of this lipophilic antioxidant vitamin. Data demonstrate that endogenous levels of free radical scavengers, such as vitamin E, may play an important role in maintaining basal oxygen radical levels and membrane integrity. The dietary vitamin E depletion paradigm suggests that a relation exists between elevated levels of oxygen radicals and more rigid hydrophobic central-cores in cerebral membranes, effects that may play a role in mechanisms underlying the neuropathologic lesions observed following vitamin E deficiency. PMID- 2783128 TI - Interferon effects upon fluorouracil metabolism by HL-60 cells. AB - In order to better understand the synergistic antiproliferative effects of interferon in combination with fluorouracil (FUra), we studied effects of alpha 2 interferon upon FUra induced inhibition of thymidylate synthase of HL-60 cells. The 50% inhibitory dose for FUra decreased from approximately 75 microM to 10 microM following interferon treatment, as measured by whole cell activity assays. Enhanced FUra inhibition of cytosolic [3H] - FdUMP binding of interferon treated cells was also noted. FdUMP accumulation following FUra treatment increased over 10 fold in interferon treated cells, but dUMP did not increase. These results suggest that interferon can sensitize cells to FUra inhibition of thymidylate synthase by enhancing accumulation of FdUMP. PMID- 2783129 TI - Purification of erythropoiesis-stimulating activity (ESA) from one Actinomycetes strain. AB - An Actinomycetes strain was found to produce a protein which stimulated the growth of murine erythroid progenitors in vitro. The protein was purified to homogeneity and was named Erythropoiesis-Stimulating Activity (ESA). ESA was an acidic glycoprotein with a molecular weight around 80,000. When mouse bone marrow cells were cultured in methylcellulose medium containing physiological concentrations of erythropoietin (0.048 units/ml), addition of ESA stimulated the growth of colony forming unit-erythroid (CFU-E) up to three-fold a in dose dependent manner. ESA was not active on the other hematopoietic progenitors. PMID- 2783130 TI - Growth hormone-induced alteration of morphology and tubulin expression in 3T3 preadipose cells. AB - Effects of growth hormone on morphology and cytoskeletal protein expression were examined in 3T3-F442A preadipocytes in serum-free medium. Between 2 and 5 days of culture 2 nM methionyl human growth hormone converted 3T3-F442A cells from a flat fibroblastic morphology to a rounded form with numerous membrane convolutions. Growth hormone treated cultures manifested a 30-40% reduction in cell volume. Growth hormone induced changes in morphology and volume preceded and were independent of lipogenesis. In cells treated with growth hormone, expression of alpha and beta-tubulin as determined by Western blotting was found to increase approximately 50% within 72 h as compared to untreated cells. After 7 days, tubulin levels in growth hormone treated cells were approximately 40% of control levels. This indicated that morphological changes and alteration of tubulin expression were signatures of growth hormone action on 3T3-F442A cells. PMID- 2783131 TI - Secreted alpha amidating enzymes are generated by specific posttranslational processing of precursors containing transmembrane domains. AB - The biosynthesis and secretion of alpha amidating enzymes from CA-77 cells has been investigated to determine the relationship among the various forms of alpha amidating enzyme seen after purification of alpha amidating enzyme activity from conditioned cell culture media. Initially 2 proteins of 104 kD and 94 kD are synthesized. With time the 104 kD precursor is processed to 41 kD and 43 kD, and the 94 kD precursor is processed to 75 kD. The 41 kD, 43 kD, and 75 kD proteins are secreted into the medium as functional enzymes. In comparing these data with known cDNA sequence for alpha amidating enzyme we conclude that the 104 kD and 94 kD precursors are membrane bound proteins which are posttranslationally processed to generate secreted alpha amidating enzyme. PMID- 2783132 TI - Pro----leu change at position 102 of prion protein is the most common but not the sole mutation related to Gerstmann-Straussler syndrome. AB - The host-encoded prion protein (PrP) is a component of transmissible amyloid deposited in the brains affected by Gerstmann-Straussler syndrome (GSS). Recently GSS in two unrelated Caucasian families has been reported to be linked to an amino acid change in PrP codon 102, proline to leucine (Leu102). However, it has not been clear whether the change is commonly found to GSS regardless of ethnic origin. We report here that Leu102 is also found in all the Japanese GSS patients tested. Interestingly, one French GSS patient was found to have another change, alanine to valine in codon 117 (Val117), instead of Leu102. Our results indicate that Leu102 is closely related to GSS irrespective of ethnic origin, but not the sole mutation related to GSS. Val117 may also be related to GSS. PMID- 2783133 TI - cDNA cloning demonstrates the expression of pregnancy-specific glycoprotein genes, a subgroup of the carcinoembryonic antigen gene family, in fetal liver. AB - The pregnancy-specific glycoprotein (PSG) genes constitute a subgroup of the carcinoembryonic antigen (CEA) gene family. Here we report the cloning of four cDNAs coding for different members of the PSG family from a human fetal liver cDNA library. They are derived from three closely related genes (PSG1, PSG4 and PSG6). Two of the cDNA clones represent splice variants of PSG1 (PSG1a, PSG1d) differing in their C-terminal domain and 3'-untranslated regions. All encoded proteins show the same domain arrangement (N-RA1-RA2-RB2-C). Transcripts of the genes PSG1 and PSG4 could be detected in placenta by hybridization with gene specific oligonucleotides. Expression of cDNA in a mouse and monkey cell line shows that the glycosylated PSG1a protein has a Mr of 65-66 kD and is released from the transfected cells. Sequence comparisons in the C-terminal domain and the 3'-untranslated regions of CEA/PSG-like genes suggests a complex splicing pattern to exist for various gene family members and a common evolutionary origin of these regions. PMID- 2783134 TI - Stabilization of ornithine decarboxylase in erythroleukemia cells depleted of ATP. AB - Ornithine decarboxylase activity in Friend erythroleukemia cells decayed with a half-life of 50 minutes after addition of cycloheximide and at a faster rate after addition of spermidine. Incubation with a medium containing dinitrophenol and 2-deoxy-glucose in place of glucose caused ATP depletion and blocked the turnover of ornithine decarboxylase, even after addition of spermidine. Dinitrophenol in the presence of glucose was able to provoke only a slight increase of the half-life of the enzyme. These results suggest that degradation of ornithine decarboxylase in erythroleukemia cells is ATP-dependent. PMID- 2783135 TI - Identification of an allatostatin from adult Diploptera punctata. AB - A peptide (allatostatin) causing strong and rapid inhibition of juvenile hormone synthesis in vitro by corpora allata from reproductively active females has been isolated from brain/retrocerebral complexes of the cockroach Diploptera punctata. The primary structure of this 13-residue peptide has been determined: Ala-Pro-Ser Gly-Ala-Gln-Arg-Leu-Tyr-Gly-Phe-Gly-Leu-NH2. Removal of the terminal amide group caused at least a ten thousandfold loss of activity. This neurohormone has no sequence similarity with any other known neuropeptide. Its target in the biosynthetic pathway is located prior to the conversion of farnesol to juvenile hormone. PMID- 2783136 TI - The fibrinogen-derived peptide (RGDS) prevents proteolytic degradation of protein kinase C in platelets by inhibiting platelet aggregation. AB - The effects of the fibrinogen-derived tetrapeptide, Arg-Gly-Asp-Ser (RGDS), on platelet activation processes was studied. At concentrations of 100-300 microM, RGDS completely prevented platelet aggregation induced by all the common platelet agonists, 'weak' and 'strong'. In agreement with earlier views on the aggregation dependency of weak agonist-induced thromboxane synthesis and 5-hydroxytryptamine (5HT) secretion, RGDS (100-300 microM) inhibited these events induced by ADP, adrenaline and low concentrations of thrombin and collagen but not that induced by high concentrations of thrombin and collagen. 5HT secretion induced by the protein kinase C (PKC) activator, phorbol 12-myristate 13-acetate (PMA), was also not affected by RGDS, but proteolytic degradation of the translocated membrane bound enzyme in PMA-treated platelets, due to the actions of the Ca2+-dependent protease (Ca-DP), was completely prevented such that in the presence of RGDS, sustained increases in membrane-bound PKC activity were observed. PMA alone caused only transient increases in membrane-bound PKC. This effect of RGDS was similar to the effect of E64-d, a recently described inhibitor of Ca-DP in platelets, or the effects seen with PMA in unstirred non-aggregating platelets. It is concluded that RGDS inhibits the actions of Ca-DP in platelets via inhibition of aggregation. PMID- 2783137 TI - Inhibition by 17 beta-estradiol of PTH stimulated resorption and prostaglandin production in cultured neonatal mouse calvariae. AB - Previous attempts to show a direct effect of physiological concentrations of 17 beta-estradiol (beta E2) on bone in vitro have been unsuccessful. We describe a culture system using neonatal mouse calvariae in which beta E2 in the range 1 pM to 1 nM inhibited parathyroid hormone (PTH) stimulated prostaglandin E2 (PGE2) release by 50 to 70% in the presence and absence of cortisol. In addition, beta E2 reduced medium calcium concentration and release of previously incorporated 45Ca by 10 and 20%, respectively, in PTH stimulated cultures. Indomethacin did not block beta E2 effects on resorption. 17 alpha-Estradiol (alpha E2) reduced PTH stimulated 45Ca release but not PGE2 release. Thus, beta E2 has direct effects on bone consistent with its known effects to decrease bone resorption in vivo. PMID- 2783138 TI - Plasma membrane hyperpolarization and [Ca2+]i increase induced by fibroblast growth factor in NIH-3T3 fibroblasts: resemblance to early signals generated by platelet-derived growth factor. AB - The effects of different substances on [Ca2+]i and membrane potential (measured by fura-2 and bis-oxonol fluorescence techniques, respectively) were studied in wild-type and NIH-3T3 fibroblasts transfected with the cDNA encoding the human epidermal growth factor receptor. Application of partially purified PDGF or FGF induced, after a lag (0.5-1 min), a [Ca2+]i increase composed by an initial, slow peak, sustained primarily by intracellular Ca2+ release followed by a plateau, sustained by Ca2+ influx from the medium. The [Ca2+]i changes were paralleled by plasma membrane hyperpolarization mainly due to the activation of a K+ efflux, since raising the extracellular K+ concentration progressively reversed the effect of both growth factors. These responses were much slower than those induced by other agents (bradykinin, extracellular ATP, and EGF). The close resemblance between PDGF- and FGF-induced early signals (time-course and insensitivity to phorbol esters) suggests similar transmembrane signalling mechanisms at the cognate receptor. PMID- 2783139 TI - Morphological alterations in erythrocyte membranes induced by 9-amino-1,2,3,4 tetrahydroacridine and 9-aminoacridine. AB - The effects of 9-amino-1,2,3,4-tetrahydroacridine (THA) and its fully aromatic analogue 9-aminoacridine (9-AA) on erythrocyte membrane morphology were investigated via scanning electron microscopy. The ghost population was categorized into four distinct classes and alterations in the relative amounts of these populations with drug addition were noted. The samples incubated in 9-AA had a significantly higher (p less than 0.001) flat, two-dimensional cell population. This shift in morphology may be attributable to the unwinding of spectrin and the subsequent collapse of the membrane. PMID- 2783140 TI - Synergistic interaction between 13-cis-retinoic acid and glucarate: activity against rat mammary tumor induction and MCF-7 cells. AB - At high dietary levels in vivo, both 13-cis-retinoic acid and calcium glucarate inhibit the induction of rat mammary tumors by 7,12-dimethylbenz(a)anthracene. The present study shows that sub-optimal dietary levels of each, which individually have no effect on tumor induction, when combined together in the diet, significantly increases tumor latency and suppresses tumor frequency in the rat system. Weight gain of animals was similar in control and experimental groups. Furthermore, ineffective sub-optimal dosages of glucarate and 13-cis retinoic acid interacted synergistically to inhibit the growth in vitro of the MCF-7 human breast cancer cells. By varying the concentrations of glucarate and 13-cis-retinoic acid independently, evidence was obtained that in combination glucarate may play an adjuvant role, with the retinoid as the effector. Thus, the results of this experimental animal study demonstrate for the first time the potential use in synergistic combination of 2 normal metabolites in non-toxic chemoprevention and chemotherapy. PMID- 2783141 TI - Modes of inhibition of protein kinase C by triphenylacrylonitrile antiestrogens. AB - Protein kinase C (PKC) I (gamma), II (beta) and III (alpha) subspecies' activities are inhibited by three triphenylacrylonitrile (TPE) antiestrogens at micromolar concentrations. TPE 1 (having a p-hydroxy and a p-diethylaminoethoxy group on the 3-, and 3'- phenyl rings respectively) and TPE 2 (having a p diethylaminoethoxy group on both the 3-, and 3'- phenyl rings) are competitive with the mechanism of activation by phosphatidylserine (PS). TPE 3 (having p hydroxy groups on each of the three phenyl rings) is non-competitive with PS and inhibits the Ca2+- and PS-independent phosphorylation of protamine sulfate by PKC subspecies. This evidence suggests that PKC activity can be inhibited by different routes depending on the TPE structure: diethylaminoethoxy side chain substituted TPEs (TPE 1 and 2) interact with PS as well as with the regulatory domain, whereas the trihydroxylated derivative (TPE 3) inhibits the enzyme by interacting with the catalytically active site. PMID- 2783142 TI - Calcium regulates folding and disulfide-bond formation in alpha-lactalbumin. AB - Refolding and disulfide bond formation in reduced denatured bovine alpha lactalbumin is shown to be Ca2+-dependent. Whereas in the absence of Ca2+ only about 2% of the native active protein is regenerated, in the presence of Ca2+, almost quantitative renaturation is obtained. A close coupling between Ca2+ binding and native disulfide bond formation is also indicated by spontaneous disulfide scrambling in the apoprotein in the presence of low concentrations of thiols. This phenomenon is not found in other disulfide-containing proteins including the homologous chicken lysozyme. It is proposed that the alpha lactalbumin Ca2+-binding site has the in vivo function of imposing Ca2+ regulation on the folding of nascent alpha-lactalbumin and thereby on lactose synthesis. PMID- 2783143 TI - 'Calcium-activated' intracellular calcium elevation: a novel mechanism of osteoclast regulation. AB - The osteoclast is unique in its capacity to resorb bone. An unbalanced increase in this activity causes osteoporosis, a crippling bone disease that poses a major public health problem. Despite this, our understanding of osteoclast regulation is very limited. Calcitonin is the only known physiological inhibitor of osteoclast function. We demonstrate here for the first time that the concentration of calcium ions at the resorptive site directly regulates osteoclast function by modulating the intracellular free calcium concentration. This represents an important feedback mechanism of osteoclast control. PMID- 2783144 TI - Protective role of intracellular glutathione against oxidized low density lipoprotein in cultured endothelial cells. AB - We examined the role of intracellular glutathione (GSH) in the defense of endothelial cells against oxidized low density lipoprotein (OX-LDL). Incubation of cultured bovine endothelial cells with OX-LDL produced a loss of intracellular GSH, followed by lysis. A decrease in the cellular stores of GSH by treating the endothelial cells with buthionine sulfoximine, an irreversible inhibitor of gamma glutamylcysteine synthetase, increased the susceptibility of endothelial cells to lysis by OX-LDL. In contrast, an increase in cellular GSH level by treatment with L-2-oxothiazolidine-4-caboxylate, an effective intracellular cysteine delivery agent, reduced the toxicity of OX-LDL. These findings suggest that intracellular GSH plays an important role in the defense of endothelial cells against OX-LDL, and that the mechanism of OX-LDL toxicity is related to the depletion of intracellular GSH. PMID- 2783145 TI - Stimulation of rat-kidney hexose monophosphate shunt dehydrogenase activity by chronic metabolic acidosis. AB - The effect of chronic metabolic acidosis on the kinetic behaviour of renal glucose 6-phosphate dehydrogenase and 6-phosphogluconate dehydrogenase have been investigated. Acidosis induced a significant increase in both enzyme activities at all substrate concentrations used. Saturation curves of both dehydrogenases were hyperbolic with no evidence of sigmoidicity. Maximum activities were found after 7 days of acidosis with no significant change in the Km values. The results suggest that stimulated renal hexose monophosphate dehydrogenases activities are probably due to an increased intracellular concentration of these enzymes. The relationship between these changes and those generated in the metabolic acidosis are also discussed. PMID- 2783146 TI - Effect of 36-hour starvation on in vivo amino acid and glucose uptake by rat brown adipose tissue. AB - The effect of 36-hour starvation on the net uptake/release of amino acids and glucose by interscapular brown adipose tissue (IBAT) of the rat has been studied by means of the determination of the arterio-venous differences in their blood concentrations. Starvation induced a net release of non-essential amino acids by the tissue, mainly alanine, glutamine, glycine and citrulline. In food deprived animals there was not a net glucose uptake by the IBAT. The results obtained in this study are in accordance with a typical peripheral tissue metabolic pattern of IBAT under food deprivation situations. PMID- 2783147 TI - Effect of manganese on some bioantioxidants in various organs of protein deficient rats. AB - The effect of manganese exposure (Mn2+ 4 mg Mn/kg intraperitoneally) on certain bioantioxidants in brain, liver, kidney and testes in growing rats maintained on 21% and 8% casein diet were investigated. Manganese administration for 30 days caused significant reduction in the level of GSH (reduced glutathione) in liver and testes and GR (glutathione reductase) and G-6-PDH (glucose-6-phosphate dehydrogenase) in brain, liver and testes. The magnitude of alteration was greater in 8% casein diet fed animals compared to rats maintained on 21% casein diet. These results indicate that protein deficient animals are more susceptible to the manganese induced biochemical changes in various tissues. The mechanism of such changes is discussed. PMID- 2783148 TI - Reduced sensitivity of peripheral cells to glucocorticoids in hypercholesterolemia. AB - It has been found that lymphocytes of hypercholesterolemic (HCh) subjects are characterized by a reduced number of glucocorticoid receptors (GcR) as compared with the cells of normolipidemics (N). Addition of HCh-sera or very low density lipoproteins, or low density lipoproteins isolated both from HCh-sera and N-sera to cultured human skin fibroblasts brought about a fall in the number of GcR in the cells. High density lipoproteins had no effect on GcR level. Dexamethasone was less effective in inhibiting cholesterol synthesis from [14C]acetate in the lymphocytes and fibroblasts with a reduced number of GcR. In the presence of dexamethasone (I x 10(-8)M) in fibroblast growth medium, reduced number of GcR (due to preincubation with very low density lipoproteins) led to a substantial increase in cholesterol synthesis. These findings indicate that the sensitivity of peripheral cells to glucocorticoids is decreased in HCh which might be one of the trigger mechanisms of atherogenesis. PMID- 2783149 TI - Possible generation of hydrogen peroxide and lipid peroxidation of erythrocyte membrane by asbestos: cytotoxic mechanism of asbestos. AB - We studied a mechanism of hemolysis induced by asbestos particles or silicic acid. This hemolysis was instantly initiated by mixing red blood cells with asbestos particles or silicic acid, and reached a plateau within 10 min. The hemolysis was suppressed by catalase, radical quenchers, deoxygenation, or phospholipids. The degree of the hemolysis was proportional to either the amount of asbestos added into red blood cell suspension or the amount of thiobarbituric acid-reacting substances formed. These findings suggest that in vitro hemolysis induced by asbestos particles (or silicic acid) is ascribed to membrane lipid peroxidation initiated by hydrogen peroxide which was generated by the interaction of the mineral particles with biological membranes. PMID- 2783150 TI - Effects of cytoskeleton-disrupting agents on tyrosine transport into cultured bovine adrenal chromaffin cells. AB - The effects of various cytoskeleton-disrupting agents on tyrosine transport into chromaffin cells were examined to assess the possibility of cytoskeleton involvement in the regulation of precursor supply for catecholamine synthesis. Tyrosine transport was markedly increased by cytochalasin B. Vinblastine also stimulated tyrosine transport, although its effect was less pronounced than that of cytochalasin B. While colchicine failed to cause any significant increase in the transport under the same conditions. These results therefore suggest a possible role of microfilaments as a factor regulating tyrosine transport into chromaffin cells. PMID- 2783151 TI - Propranolol-induced alterations in rat erythrocyte membrane fluidity and apparent phase-transition temperatures. A depth-dependent process. AB - Propranolol-induced alterations of membrane structure were studied in rat erythrocytes using electron spin resonance techniques. Propranolol produced a concentration-dependent change in membrane fluidity in hydrophobic membrane regions, while producing virtually no change in hydrophilic membrane regions. The changes were associated with depth-dependent alterations in "apparent" phase transition profiles and transition temperatures. The effects of propranolol on these membrane characteristics were similar to those produced by cholesterol. Propranolol fluidized erythrocyte membranes in a depth-specific fashion, by virtue of its association with the rigid phospholipid acyl chains and cholesterol sterol rings in the hydrophilic regions of the membrane, which produced distant perturbations within the hydrophilic regions of the membrane. PMID- 2783152 TI - Glutathione conjugation of nitro compounds by monkey glutathione S-transferases. AB - The distribution in Japanese monkey tissues of glutathione S-transferase activity toward some aromatic nitro compounds was examined by measuring the release of the nitro group as nitrite ion. The activity was especially high in liver, kidney and small intestine when compounds such as 4-nitroquinoline N-oxide, 5-nitrofurfural diacetal and o-dinitrobenzene were used as substrates. The nitrite-releasing activity of the major enzyme purified from rhesus monkey liver was also tested on fifty-two nitro compounds including nineteen nitrofuran derivatives. Among the thirty-three nitro compounds other than the nitrofuran derivatives tested as substrates, the purified enzyme showed activity only toward o-dinitrobenzene, 4 nitroquinoline N-oxide, 3,4-dinitrobenzoic acid, p-dinitrobenzene, 2,5 dinitrobenzoic acid, 2,5-dinitrophenol, tetra-chloronitrobenzene and 2,4 dinitrobenzoic acid. The crude supernatant fraction of rhesus monkey liver showed activity in substrate specificity roughly similar to that of the purified enzyme. On the other hand, among at least ten carcinogenic 2-substituted 5-nitrofran derivatives tested, 4,6-diamino-2-(5-nitro-2-furyl)-s-triazine, 5-nitro-2 furaldehyde semicarbazone, N-[[3-(5-nitro-2-furyl)-1,2,4-oxadiazol-5-yl]methyl] acetamide, and N-[5-(5-nitro-2-furyl)-1-3,4-thiadiazol-2-yl)acetamide were shown to be enzymatically conjugated with reduced glutathione. Among the other nine 2 substituted 5-nitrofuran derivatives tested, six compounds could be the substrates of the enzyme, and 5-nitrofurfural and 5-nitrofurfural diacetal were especially good substrates. There was, however, little apparent correlation between their carcinogenicity and susceptibility to glutathione S-transferase. The bulky substituents at position 2 appeared to decrease the susceptibility of these nitrofuran derivatives to the enzyme. Both Vmax and Km values of the purified enzyme varied greatly among the substrates, and the optimum pH fell between 7.5 and 9.0 in most cases. PMID- 2783153 TI - Deoxyuridylate effects on thymidylate synthase-5-fluorodeoxyuridylate-folate ternary complex formation. AB - The competitive basis and specificity of deoxyuridylate (dUMP)-mediated decreases in thymidylate synthase-5'-fluorodeoxyuridylate-folate (TS-FdUMP-folate) ternary complex formation at low concentrations of folates were investigated using charcoal isolation of protein-bound [3H]FuUMP ligand. Reaction conditions used 0.02 microM TS (Lactobacillus casei) and 0.10 microM [3H]FdUMP incubated for 10 min at 37 degrees and pH 7.4. Decreases in counts below control (C) values in dUMP-added samples (S) were expressed as C/S ratios. At CH2--H4PteGlu1 or H4PteGlu1 concentrations below 10 microM, highly linear relationships were found to exist between C/S value and dUMP concentrations, expressed as dUMP/FdUMP ratios. For H4PteGlu1, maximal C/S values for dUMP interference occurred at the lowest H4PteGlu1 concentrations, approaching the value of the TS-FdUMP binary complex. The efficiency of ternary complex formation by H4PteGlu1 was 28 +/- 5% of CH2--H4PteGlu1 values at concentrations below 1.0 microM. The protective effect of increasing H4PteGlu1 against dUMP interference resulted in a linear relationship between the logarithm of H4PteGlu1 concentration and the slope of dUMP interference (C/S vs dUMP/FdUMP). In contrast, the results with CH2- H4PteGlu1 were biphasic. At concentrations of CH2--H4PteGlu1 lower than 0.5 microM, C/S values were greater than those for binary complex alone, a result related to CH2--H4PteGlu1 consumption based on [5-3H]dUMP tritium-release studies. At concentrations of CH2--H4PteGlu1 above 1.0 microM, however, dUMP interference was nearly abolished. Kinetic analysis of the data suggests that this effect of the 5,10-methylene moiety may result in part from positive allosteric effects of first site TS-FdUMP-CH2--H4PteGlu1 ternary complex binding on acceleration of second site binding, in addition to slowed rates of dissociation. Other folylmonoglutamates showed relatively poor TS-[3H]FdUMP folate complex formation: at 500 microM folate, as a percentage of CH2--H4PteGlu1 values, these were 29.6% for dihydrofolate, 7.5% for 5-CH3--H4PteGlu1, 3.0% for CH = H4PteGlu1, 1.6% for folic acid, 1.1% for 5-CHO--H4PteGlu1 (leucovorin) and 0.9% for 10-CHO--H4PteGlu1. Inhibitory effects by dUMP were consistent with binary complex effects alone for these folates. Study of methotrexate, as the monoglutamate and the hexaglutamate, suggested that ternary complexes with dUMP are favored over those with FdUMP at high concentrations of the antifolate. Our results indicate that activation of leucovorin to over 0.5 microM in intracellular CH2--H4PteGlu1 equivalents may be a requirement for achieving complete TS inhibition by FdUMP in the presence of excess conce PMID- 2783154 TI - Selective delivery of drugs to macrophages through a highly specific receptor. An efficient chemotherapeutic approach against leishmaniasis. AB - Methotrexate (Mtx) conjugated with maleylated bovine serum albumin (Mtx-MBSA) was taken up and degraded by cultured hamster peritoneal macrophages through the polyanion binding site for acetylated low density lipoprotein. Mtx-MBSA also eliminated intracellular amastigotes of Leishmania donovani in cultured hamster peritoneal macrophages about three times more efficiently than free Mtx. The antileishmanial effect of Mtx-MBSA on parasitized macrophages was blocked by MBSA, lysosomal inhibitors (chloroquine and monensin), and metabolic antagonists of Mtx (folic and folinic acids). The primary sites of accumulation of radioactivity of injected 125I-labeled Mtx-MBSA were the macrophage rich tissues, viz. liver and spleen. These results suggest that Mtx-MBSA would ensure rapid and effective killing of intracellular parasites harbored by macrophages. Furthermore, these results also indicate the feasibility of a general approach for rapid intracellular delivery of desired agents to macrophages for various purposes. PMID- 2783155 TI - Sulphotransferase-mediated activation of the carcinogen 5-hydroxymethyl-chrysene. Species and sex differences in tissue distribution of the enzyme activity and a possible participation of hydroxysteroid sulphotransferases. AB - Sulphation of the carcinogen 5-hydroxymethyl-chrysene (5-HCR) to the active metabolite 5-HCR sulphate occurred at significant rates in all of hepatic cytosols prepared from the male and female experimental animals, rats, mice, guinea-pigs and hamsters. The 5-HCR-sulphating activity was also found in kidney cytosols of all the experimental animals used, while their activities were much less than those of hepatic cytosols. In the male mice, the enzyme activity of testis was higher than any other examined tissue. Small intestine and adrenal of male and female guinea-pigs had relatively high enzyme activities. Small enzyme activities were also found in a variety of extrahepatic tissues of some of these animals. Marked species and sex differences (female much greater than male in the rat and mouse) were observed in the hepatic enzyme activity. In the female rat liver which showed the highest 5-HCR-sulphating activity among the examined tissues of all the animals, a typical hydroxysteroid sulphotransferase inhibitor, dehydroepiandrosterone (DHA) sulphate (1 mM), potently and competitively inhibited the sulphation of 5-HCR as well as that of DHA, a typical substrate for hydroxysteroid sulphotransferases. On the contrary, the phenol sulphotransferase inhibitors, pentachlorophenol and 2,6-dichloro-4-nitrophenol, had only a little effect on these enzyme activities even at a concentration of 50 microM that showed a potent inhibition of the phenol sulphotransferase activity. These results suggest that 5-HCR be sulphated in the female rat liver by hydroxysteroid sulphotransferases, but not by phenol sulphotransferases. PMID- 2783156 TI - Binding of [G-3H]6-(4-nitrobenzylmercapto)purine ribonucleoside to isolated membranes. Inhibitory effect of mioflazine and its derivatives. AB - The binding of [G-3H]-6-(4-nitrobenzylmercapto)purine ribonucleoside [( G 3H]NBMPR) was investigated using a centrifugation assay with membrane preparations from hamster tissues including liver, lung, kidney and heart. Only liver and lung membranes showed high specific binding, with dissociation constants (Kd) values of 2.4 +/- 0.4 and 0.44 +/- 0.05 nM, and maximal binding (Bmax) of 3.7 +/- 0.4 and 1.04 +/- 0.01 pmol/mg, respectively. The binding of [G 3H]NBMPR was inhibited in a concentration dependent manner by unlabelled NBMPR, dilazep and a new group of chemically related nucleoside transport inhibitors, mioflazine, soluflazine and R57974, the latter being the most potent derivative. R57974 displaced bound [G-3H]NBMPR as effectively as unlabelled NBMPR suggesting a common binding site. The assay procedure used appears useful for the rapid screening of the effectiveness of nucleoside transport inhibitors which will be of value for the selection of inhibitors suitable for combination with cytotoxic nucleosides in the treatment of selected cancers or parasitic diseases. PMID- 2783157 TI - Influence of pH on the binding of suramin to human serum albumin. AB - The pH dependence of the binding of suramin to albumin has been studied by means of equilibrium dialysis and circular dichroism. Dialysis experiments have revealed that the association constants of the high and low affinity binding sites are strongly influenced by the pH. At pH 6.0 K1 = 1.4 x 10(6) M-1/n1 = 2.0 and K2 = 1.3 x 10(5) M-1/n2 = 1.0; at pH 9.2 K1 = 2.0 x 10(5) M-1/n1 = 2.0. At the high pH no low affinity sites could be demonstrated any more. The pH dependence of the induced ellipticity of the suramin-albumin complex at low molar drug-to-protein ratio r = 0.1 can be superimposed upon the neutral-to-base (N-B) transition of albumin alone. By means of the Linderstrom-Lang equation for electrostatic interaction and a two-state model for the N-B transition of albumin, evidence is obtained of a link of the pH dependent binding behaviour of suramin to albumin and the neutral-to-base transition of albumin. The possible correlation of this link with transport processes of suramin in the body and with selective uptake of suramin in cells and parasites is discussed. PMID- 2783158 TI - Some properties of an inhibitory cytochrome P-450 metabolic-intermediate complex existing in a spin-state equilibrium. AB - Incubation, in the presence of NADPH/O2, of the type II compound revenast with a partially solubilized, phenobarbital-induced rat liver microsomal cytochrome P 450 system results in the formation of a difference spectrum exhibiting a Soret band at 407 nm and a trough at 423 nm. Experiments with N2 and metyrapone suggest this spectral perturbation to originate from binding to the hemoprotein of a metabolic intermediate derived from the amine substrate. The percentage of pigment complexed can be assessed to be about 7%, with half-maximal complexation occurring at a revenast concentration of 125 microM. Adduct formation is inhibitory to the N-hydroxylation of 4-chloroaniline and N-demethylation of N,N dimethylaniline; kinetic analysis suggests a competitive interaction at the catalytic site of the reactive revenast derivative with the tertiary arylamine. Inhibition of the two monooxygenation reactions is reversible, indicating weak heme bonding of the active intermediate. This behaviour differs from that of most other product adducts so far examined. The aberrant functional properties of the metabolic adduct appear to reflect complex molecular organization of this compound, as is also evidenced by the unique position of the Soret region absorption maximum at 407 nm; this spectral data hints at the presence of a mixture of high- and low-spin forms. Indeed, chemical reduction or oxidation of the product complex reveals the existence of a low-spin component hidden in the metabolic spectrum. Model studies suggest that the product adduct possibly arises from N-oxidation of the revenast molecule. PMID- 2783159 TI - Energetic behaviour of mitochondria isolated from rat livers perfused with a perfluorodecalin + N,N-perfluorodiethylcyclohexylamine emulsion. AB - Rat livers have been perfused with a saline control medium or with a perfluorocarbon emulsion containing perfluorodecalin and N,N perfluorodiethylcyclohexylamine, and the respiratory rates and transmembrane electrical potentials of mitochondria isolated following perfusion have been evaluated. The results indicate that the perfluorocarbon emulsion used, by providing a good oxygen supply to the perfused liver, allowed to preserve the efficiency of mitochondrial oxidative phosphorylation. PMID- 2783160 TI - Evidence in vivo for elevation of intracellular free Ca2+ in the liver after diquat, acetaminophen, and CCl4. AB - Several hepatotoxic agents with varied chemical mechanisms of toxicity (acetaminophen, diquat, and CCl4) depress membrane calcium pumps and/or enhance the permeability of membranes to calcium. To probe the relevance of these findings to maintenance of calcium homeostasis after toxins in vivo, we measured the activity of glycogen phosphorylase a, as an index of cytosolic free [Ca2+], in freeze-clamped liver samples obtained at several times after the toxin dose. Both acetaminophen and diquat caused significant increases of phosphorylase a activity, and activity remained elevated for several hours after the dose. Significantly, the administration prior to diquat of desferrioxamine, which offers protection against the liver necrosis and depression of microsomal Ca2+ accumulation observed after diquat alone (Tsokos-Kuhn et al., Mol Pharmacol 34: 209-214, 1988), decreased phosphorylase activation. Activation of phosphorylase was observed also after CCl4 administration, as previously reported by Long and Moore (Biochem Pharmacol 35: 4131-4137, 1986). We conclude that perturbations in liver membrane Ca2+ regulation observed after administration of these hepatotoxins in vivo correlate directly with phosphorylase a activity, thereby providing additional in vivo evidence for an alteration of Ca2+ homeostasis early in the development of the liver damage produced by these chemicals. PMID- 2783161 TI - Monoclonal antibodies to rat liver cytochrome P-450 2c/RLM5 that regiospecifically inhibit steroid metabolism. AB - Hybridomas were formed from myeloma cells and spleen cells derived from BALB/c female mice immunized with purified liver microsomal cytochrome P-450 2c/RLM5 (P 450 gene IIC11) isolated from untreated adult male rats. Six hybridoma clones produced monoclonal antibodies (MAbs) of the IgM(kappa) type. All the MAbs bound strongly to P-450 2c/RLM5 when measured by radioimmunoassay, and four of the six specifically immunoprecipitated P-450 2c/RLM5 in an Ouchterlony double immunodiffusion test. These four MAbs also bound but did not immunoprecipitate P 450 RLM3. The MAbs that precipitated P-450 2c/RLM5 neither bound nor precipitated P-450 PB-B (gene IIB1) and P-450 BNF-B (gene IA1) of rats or P-450 LM2 and P-450 LM4 of rabbits. In contrast, mouse polyclonal anti-P-450 2c/RLM5 antibody strongly immunoprecipitated P-450 RLM3 as well as P-450 2c/RLM5 and to a lesser extent P-450 PB-B and P-450 LM2. The MAbs that precipitated P-450 2c/RLM5 also inhibited by more than 90% androstenedione 16 alpha-hydroxylase activity of untreated rat microsomes, but did not inhibit microsomal 6 beta- or 7 alpha hydroxylation. In addition, complete inhibition of both androstenedione 16 alpha hydroxylation and testosterone 16 alpha-hydroxylation was observed in a reconstituted system with P-450 2c/RLM5. Androstenedione 6 beta-hydroxylation catalyzed by P-450 2c/RLM5 was also inhibited, whereas P-450 3-catalyzed 7 alpha hydroxylation was not inhibited by the MAbs. P-450 2c/RLM5 catalyzed 2 alpha-, 16 alpha- and 6 beta-hydroxylation of progesterone in a reconstituted system were also inhibited by the MAb by 60-80%. These MAbs should prove useful for "reaction phenotyping," i.e. for defining the contribution of microsomal P-450 2c/RLM5 to the oxidative metabolism of endogenous steroids and other P-450 substrates in animal and human tissues. PMID- 2783162 TI - Induction of rat liver microsomal and nuclear cytochrome P-450 by dietary 2 acetylaminofluorene and butylated hydroxytoluene. AB - The influence of dietary 2-acetylaminofluorene (AAF) on the cytochrome P-450 content of rat liver microsomal and nuclear fractions was immunochemically probed with monoclonal and polyclonal antibodies to cytochromes P-450c and P-450d. Cytochrome P-450d but not P-450c was immunodetected in microsomes, nuclear envelopes, and nuclei from untreated rats. The levels of both cytochromes P-450c and P-450d were elevated after a diet of either 0.1% AAF for 1 week or 0.05% AAF for 3 weeks. However, the level of cytochrome P-450c relative to P-450d was lower after the more prolonged AAF feeding. Supplementation of AAF-containing diets with 0.3% butylated hydroxytoluene (BHT), which affords protection against AAF hepatocarcinogenesis in high-fat fed rats, protected and/or induced total (spectral) nuclear envelope cytochrome P-450 content. Immunochemical studies of liver fractions showed that BHT enhanced the AAF-dependent induction of cytochrome P-450c, but not of P-450d. This was a concerted effect of AAF + BHT since dietary BHT by itself did not affect the levels of cytochrome P-450c or P 450d as compared to control rats. Since 1- to 3-week dietary AAF had little effect on total (spectral analyses) microsomal cytochrome P-450 but markedly reduced total P-450 in nuclear envelopes, the coordinated induction of specific cytochrome P-450s in the different fractions suggests selective induction and depression of different forms of cytochrome P-450 and provides additional evidence for independent regulation of the drug-metabolizing system in nuclear envelope and microsomes. In addition, these results suggest that regulation of cytochrome P-450 may play a crucial role in the nutritional modulation of AAF hepatocarcinogenesis. PMID- 2783163 TI - Specific association of T-2 toxin with mammalian cells. AB - The binding of radiolabeled T-2 toxin to a mammalian cell line derived from a Chinese hamster ovary (CHO) was studied. The toxin bound to, or was taken up by, cells in a time-, temperature- and concentration-dependent manner. The binding was saturable, of high affinity (Kd approximately 0.1 to 1 nM), reversible at 37 degrees (half-time approximately 2 hr), and specific. The kinetics of T-2-cell association and the rate of toxin-induced inhibition of protein synthesis closely paralleled one another. Likewise, the concentration-response for inhibition of protein synthesis and the toxin binding isotherm were similar. A synthetically derived epimer of T-2 bound less tightly to cells, but apparently to the same site as authentic T-2. The epimer was also less potent at inducing inhibition of protein synthesis. Two other trichothecene toxins, one more and one less toxic than T-2, blocked labeled T-2 binding to cells in a manner reflective of their protein synthesis inhibitory potencies. We conclude that the binding we defined is an accurate measure of the toxin responsible for inhibition of protein synthesis in CHO cells. The data also suggested that, at equilibrium, the interaction of T-2 with cells is not static, but is the sum of a continuous uptake and release process. PMID- 2783164 TI - Binding of T-2 toxin to eukaryotic cell ribosomes. AB - The binding of radiolabeled T-2 to eukaryotic ribosomes was studied. The toxin bound to ribosomes in a time-, temperature- and concentration-dependent manner. The binding was saturable (0.3 nM), reversible at 37 degrees (half-time approximately 2.5 hr) and specific. The stoichiometry was one toxin molecule bound per ribosome. Binding of T-2 appeared to stablize the toxin recognition site to thermal degradation. A synthetically derived epimer of T-2 bound to the same ribosomal site as authentic T-2, but apparently with lower affinity. Two other trichothecene toxins tested blocked the binding of T-2 to ribosomes in a manner reflecting their protein synthesis inhibitory potencies. Anisomycin blocked the binding of T-2 to both isolated ribosomes and cells, whereas emetine blocked binding only to cells. Our data, together with that in the accompanying paper (Middlebrook JL and Leatherman DL, Biochem Pharmacol 38: 3093-3102, 1989), suggest that T-2 interaction with CHO cells is best viewed as a free, bidirectional movement of toxin across the plasma membrane and specific high affinity binding to ribosomes. PMID- 2783165 TI - Eupatoriopicrin-induced lipid peroxidation in liver and tumour tissue of the mouse. PMID- 2783166 TI - Dependence of mixed disulfide formation in alveolar macrophages upon production of oxidized glutathione: effect of selenium depletion. PMID- 2783167 TI - Correlation of resistance to nitrogen mustards in chronic lymphocytic leukemia with enhanced removal of melphalan-induced DNA cross-links. PMID- 2783168 TI - Active site solvation contributes significantly to inactivation of the glutathione-S-transferases (GST). PMID- 2783169 TI - Hydrolysis of phthalate esters by purified rat and human liver carboxylesterases. PMID- 2783170 TI - Warfarin resistance: biochemical evaluation of a warfarin-resistant wild brown rat. PMID- 2783171 TI - [Human embryonal prealbumin-1. Chemical and immunochemical characteristics]. AB - General chemical and immunochemical characterization of human embryonic prealbumin-1 (EPA-1) isolated from abortive blood is presented. EPA-1 was found to exist as glycosylated and non-glycosylated forms, which are immunochemically identical. Sugar moiety of the glycosylated form contains residues of fucose (3.0%), mannose (3.2%), galactose (7.8%), N-acetylglucosamine (5.4%), N acetylgalactosamine (1.2%) and N-acetylneuraminic acid. Using methylation studies, types of bonds between the sugar residues were elucidated. PMID- 2783172 TI - [Isolation and physico-chemical properties of a protein, included in an endotoxin from Yersinia pseudotuberculosis]. AB - A major protein of the endotoxin from Yersinia pseudotuberculosis was isolated from the complex lipid A--protein by treatment with SDS and triton X-100 followed by gel-chromatography on Sephacryl S-300. Protein has apparent molecular mass 40 kDa and alanine as N-terminal amino acid residue. CD and IR spectroscopy conformational changes of the protein molecule in the process of its isolation. The thermal and pH stabilities of the protein were investigated by the methods of intrinsic fluorescence and differential scanning microcalorimetry. The isolated protein revealed two thermal transitions (at 30-35 and 50-55 degrees C), which depend on Ca2+ concentration. PMID- 2783173 TI - [Amphibian bombesin and its analog alytesin]. AB - A convenient route of synthesis of amphibian bombesin and bombesin-like peptide alytesin was found. These tetradecapeptides were obtained by assembling the 1-5 and 6-14 fragments by means of DCC-HONB or mixed anhydrides methods. Structure of the tetradecapeptides was confirmed by high resolution NMR spectroscopy data. The bombesin and alytesin synthesized potently decrease body temperature and stimulate pancreatic juice secretion. PMID- 2783174 TI - [Ligase joining of oligodeoxynucleotides on a oligodeoxynucleotide analog matrix containing P-S-C(5')-internucleotide bonds]. AB - Joining of oligodeoxynucleotides by T4 polynucleotide ligase on an oligodeoxynucleotide template analogue having P--S--C(5') internucleotide bonds was investigated. The enzyme did ligate the oligodeoxynucleotides but with an extremely low rate. The major product of the enzymatic reaction proved to be the adenylylated intermediate of the 5'-phosphorylated oligodeoxynucleotide, the product of the second stage of the overall ligation reaction. It is noteworthy that this intermediate is not accumulated in ligase reactions under standard conditions when DNA templates rather than template analogues were used. PMID- 2783175 TI - [A carbohydrate component of alpha1-acid glycoprotein from normal and abortive blood]. AB - alpha 1-Acid glycoprotein (AGP) samples, viz., normal AGP (nAGP) and embryonic AGP (eAGP), were isolated from plasma of normal donor blood and abortive human blood, respectively. The materials possess similar amino acid composition and immunochemical properties. However, structural patterns of their sugar moieties differ substantially. nAGP contains only N-glycosidically bound sugar chains, whereas on eAGP some sugar chains are linked through O-glycosidic bonds. Disaccharide GlcNAc beta 1----3Gal was identified in considerable amounts in HF solvolysate of eAGP but only as traces in nAGP. PMID- 2783176 TI - [Principles of spatial organization of group-specific glycoproteins]. AB - Theoretical conformational analysis of O-glycosylated polypeptide chain has been carried out. It is shown that formation of a regular structure is possible, in which the peptide backbone is covered by a layer of well-packed carbohydrate side chains. A beta-barrel is proposed as the spatial model of blood group-specific glycoproteins; it consists of glycosylated beta-hairpins, which interact if they are sterically close. In this beta-barrel the peptide backbone forms an inner "tunnel" which is isolated by the compact carbohydrate coat. PMID- 2783177 TI - [Primary structure of the esterase s gene from Drosophila virilis]. AB - Complete nucleotide sequence of the esterase S gene of Drosophila virilis has been determined. The length of the gene from the transcription initiation site down to the polyadenylation signal is about 1850 bp. Conceptual translation of the DNA sequence reveals a protein 549 amino acid residues long, its presumptive active site being highly similar to active sites of the known esterases of insects and mammals. PMID- 2783178 TI - Immunomodulation by the new synthetic thiazole derivative tiprotimod. 1st communication: synthesis and structure-activity relationships. AB - A series of carboxyalkylthio-substituted thiazole-carboxylic acids was synthesized and examined for macrophage activation and stimulation of the DTH (delayed type of hypersensitivity)-reaction. The structure-activity relationship in this series of new immunomodulators is discussed. Broadest immunological activity was seen for [2-(3-carboxy-1-propylthio)-4-methyl-1,3-thiazole]acetic acid (tiprotimod, HBW 538) which was selected for further studies. PMID- 2783179 TI - The tetrazolium dye assay for rapid in vitro assessment of cytotoxicity. AB - The intracellular reduction of a tetrazolium salt (MTT) to a purple formazan is an indicator of cell viability. The MTT test represents a simple colorimetric method to determine cytotoxicity. The present paper describes a new method for solubilisation of the formazan crystals, which makes the assay simpler, more rapid and more reproducible. Different cell lines show different kinetics of formazan formation stressing the need for individual calibration curves. The clear-cut discrimination between cells resistant and non-resistant against oxazaphosphorines indicates that the assay has predictive value for in vivo drug sensitivities. It is concluded that the MTT test is a useful addition to anticancer compound screening programs. PMID- 2783180 TI - Superoxide dismutase in cestodes. Isoenzymatic characterization and studies of inhibition by a series of benzimidazoles and by pyrimidine derivatives of recent synthesis. AB - The activities of superoxide dismutase (SOD) (E.C.1.15.1.1) in extracts of five cestode parasites (Moniezia expansa, M. benedeni, Avitellina centripunctata. Taenia hydatigena and Dipylidium caninum) were investigated. The polyacrylamide gel electrophoretic patterns revealed that each of the five species had four isoenzyme bands; they could be differentiated principally by their displacements and, less clearly, by their intensities. Determinations were made of the inhibitory activities of four benzimidazoles and six recently synthesised pyrimidine derivatives on the SOD enzymes from the cestodes. The results confirm that the percentage of inhibitions of SOD by the same pyrimidine derivatives are markedly superior to those of the benzimidazoles. PMID- 2783181 TI - Cytoprotective and antiulcer activities of the antacid magaldrate in the rat. AB - The cytoprotective and antiulcer activities of the antacid magaldrate (ES Riopan) as well as its effects on gastric mucosal blood flow and mucus secretions, were determined in the rat. Magaldrate afforded protection against gastric necrotic lesions induced by absolute ethanol (ED50, as magaldrate, 419 mg/kg); gastric ulcers induced by acidified acetylsalicylic acid (ED50 540 mg/kg), stress (cold restraint, ED50 388 mg/kg), indometacin (ED50 281 mg/kg), and pylorus ligation; and intestinal ulcers induced by cysteamine (ED50 243 mg/kg) and indometacin (ED50 184 mg/kg). At a dose of 8 ml/kg (1728 mg/kg magaldrate), the cytoprotective effect of magaldrate against ethanol was evident 1 min after oral administration and lasted more than 8 h. The cytoprotection induced by magaldrate was decreased by pretreatments with the depletor of endogenous thiols, n ethylmaleimide, or with the cyclooxygenase inhibitor, indometacin. Magaldrate did not affect gastric mucosal blood flow, but it increased gastric mucus secretion. This later effect may be a factor responsible for the cytoprotective activity of the agent. The efficacy of magaldrate may be due not only to its antacid, bile sequestering, and antipeptic activities, but also to its cytoprotective activity. The present results suggest that magaldrate could be effective in preventing gastric damage caused by alcohol and antiinflammatory drugs. PMID- 2783182 TI - Influence of cimetidine on the pharmacokinetics of piroxicam in rat and man. AB - The influence of cimetidine on piroxicam plasma levels and pharmacokinetic parameters was studied in both rats and healthy volunteers. In male rats, intravenous injection of piroxicam (6 mg/kg) in animals pretreated with cimetidine (50 mg/kg intramuscular) resulted in plasma piroxicam concentrations significantly higher than those of animals which received piroxicam alone. The plasma half-life (1/2) of piroxicam in male rats was about 8.3 h and it was increased to 20.74 h by cimetidine pretreatment. The mean area under piroxicam plasma level-time curves was significantly (p less than 0.01) higher in case of rats pretreated with cimetidine compared with those treated with piroxicam alone. Similar results were obtained in male healthy volunteers, where administration of a single dose of piroxicam (20 mg orally) to subjects who received cimetidine (200 mg 3 times a day orally) resulted in plasma piroxicam concentrations significantly higher than those of subjects treated with piroxicam alone. The t1/2 of piroxicam was increased from 37.36 to 52.86 h with cimetidine administration. Also the mean area under piroxicam plasma level-time curves was significantly (p less than 0.05) increased by cimetidine administration. PMID- 2783183 TI - Tolerance and pharmacokinetics of a new antiulcer compound in man after single oral doses. AB - 5-[(2-Diethylamino)ethyl]amino-5,11-dihydro[1]benzoxepino[3,4- b]pyridine trihydrochloride (KW-5805) is a new antiulcer compound, which was effective in animal studies by increasing gastric mucus and stimulating defensive factors such as glucosamine-synthesizing enzymes rather than by inhibiting aggressive factors. In this placebo-controlled, double-blind study the tolerability and pharmacokinetics of KW-5805 have been evaluated first time in man. Single oral doses of 2.5 to 320 mg were administered to 3 healthy young male subjects per dose level. One additional subject received placebo at each dose level. Plasma and urine samples were collected up to 24 h after administration and analysed gaschromatographically respectively by a high performance liquid chromatography. The mean maximum concentrations in plasma of KW-5805 occurred between 1.17 and 3.33 h after administration, independent of the dose. The half-lives of elimination varied between 6.63 and 11.9 h. 13.4-23.7, 9.6-13.4 and 6.5-11.0% of the administered dose were recovered in the urine after 24 h as unchanged substance, as monodeethylated (M-1) and as hydroxylated (M-3) metabolite, respectively. KW-5805 was not associated with any clinically significant effect on vital signs, ECG or laboratory investigations. Subjectively and objectively the substance was well tolerated in the dose range administered. PMID- 2783184 TI - An alprostadil analogue and human gastric secretion. A double-blind placebo controlled study of the effects of a capsule and tablet formulation. AB - The effects of single oral doses of 800 and 1200 micrograms of the new alprostadil analogue mexiprostil (prostaglandin E1 16-methyl-16-methoxy derivative, MDL 646), presented as tablet and capsule formulation, on basal and pentagastrin-stimulated acid secretion, were studied in 10 healthy volunteers, using a randomized, double-blind, placebo-controlled, 5-way crossover design. Compared to placebo, administration of mexiprostil resulted in a significant inhibition of basal gastric acid secretion, at both doses and formulations. Pentagastrin-stimulated gastric secretion was reduced to a lesser degree and the differences compared to placebo did not achieve statistical significance when adjustments were made for basal effects present before starting stimulation. Total volume of gastric secretion, under basal conditions, was decreased by both doses and formulations, though the changes were significant only at 1200 micrograms for both formulation. The decrease in volume of gastric secretion during pentagastrin infusion did not reach statistical significance. Basal intragastric pH was increased by both doses and formulation, but the changes were significant only for the capsule formulation, at either dose. Neither dose of mexiprostil prevented the decrease in intragastric pH produced by pentagastrin infusion. Tolerability of mexiprostil was excellent with no unwanted effects reported either during or after the study. No changes in heart rate and systemic blood pressure were observed. Laboratory safety parameters were not altered by mexiprostil. There was no significant difference between the effects of both formulations of mexiprostil on any pharmacodynamic parameter. PMID- 2783185 TI - Pharmacokinetics of ketoprofen in man after repeated percutaneous administration. AB - A topical formulation of ketoprofen, a widely used nonsteroidal antiinflammatory drug, has recently been developed. Ten healthy young subjects (mean age 23.5 +/- 2.5 years) received daily 15 g of 2.5% ketoprofen gel, corresponding to 375 mg on the skin of the back over an area of 750 cm2. Plasma samples were collected after the first dose and after 10 days of chronic treatment. Urine was also collected. Ketoprofen was assayed by HPLC. The peak plasma concentration was 144 +/- 91 ng/ml after the first administration with apparent absorption and elimination half-lives of 3.2 +/- 2.4 h and 27.7 +/- 18.0 h, respectively. The total quantities of ketoprofen eliminated in the urine represented about 2.6% of the first dose applied. At the end of the study, the apparent half-life of unchanged ketoprofen was 17.1 +/- 9.1 h, and there was no accumulation. In this study, no sign of local intolerance was seen. PMID- 2783186 TI - [Genome analysis]. AB - So far, about 1% of human genes have been molecularly cloned and chromosomally mapped. Thus only a small proportion of the hereditary disorders of man are accessible to molecular genetic analysis. Such an analysis, however, is a prerequisite for the development of diagnostic and therapeutic measures. PMID- 2783187 TI - 1989 ASHA annual convention. American Speech-Language-Hearing Association. November 17-20, 1989, St. Louis. Abstracts. PMID- 2783188 TI - Rights of people with communication disorders. PMID- 2783189 TI - Talking to persons who stutter. PMID- 2783190 TI - Animal research: inhumane? PMID- 2783191 TI - Dyspraxia: try typing. PMID- 2783193 TI - Comments on the AuD degree proposal. PMID- 2783192 TI - Keeping abreast of infants, toddlers. PMID- 2783194 TI - E Pluribus Pluribus: multicultural imperatives for the 1990s and beyond. PMID- 2783195 TI - Enhanced procoagulatory activity (PCA) of human monocytes/macrophages after in vitro stimulation with chemically modified LDL. AB - In cultured human monocytes/macrophages, surface expression of procoagulatory activity (PCA) was induced by chemically modified LDL (acetyl-LDL and MDA-LDL) in a dose- and time-dependent manner. Maximum PCA (30-fold increase) was detected after 24 h of culture with modified LDL at doses of 25-750 micrograms protein/ml. Using factor VII deficient human plasma and phospholipase C this PCA was identified as tissue thromboplastin activity (factor III). These results suggest a further atherogenic potential for modified LDL through stimulation of the conversion of fibrinogen to fibrin in the atheromatous lesion. PMID- 2783196 TI - Influence of fish protein as compared to casein and soy protein on serum and liver lipids, and serum lipoprotein cholesterol levels in the rabbit. AB - Serum and hepatic cholesterol and triglyceride levels, and serum lipoprotein cholesterol were investigated in rabbits fed fish protein as compared to casein and soy protein as part of a 20% protein, low fat, cholesterol-free, semi purified diet. A nonpurified diet was used as a control. After a 28-day experimental period, rabbits fed casein developed hypercholesterolemia compared to those fed the soy protein diet. Serum cholesterol levels of rabbits fed fish protein was intermediate and not different from that of the casein or the soy protein group. However, serum triglycerides were higher in the fish group than in the casein group. Feeding of fish protein resulted in a reduction of hepatic cholesterol compared to casein, indicating no direct relationship between serum and hepatic cholesterol. In addition, fish protein induced a decrease of cholesterol in the low density lipoproteins (LDL) compared to casein and an increase of cholesterol in the high density lipoproteins (HDL) compared to casein and soy protein. Reduction in LDL-cholesterol (LDL-C) and elevation in HDL cholesterol (HDL-C) caused a 10-fold decrease in the LDL-C/HDL-C ratio of fish protein fed rabbits compared to those fed casein. This ratio was similar to that observed with soy protein which was also lower than the ratio of the casein group. Thus, since the LDL-C/HDL-C ratio has been shown to be a good indicator of the atherosclerosis risk, these results suggest that fish protein, as well as soy protein, may reduce the risk of atherosclerosis in rabbits, compared to casein. PMID- 2783197 TI - Cholesterol-fed heterozygous Watanabe heritable hyperlipidemic rabbits: a new model for atherosclerosis. AB - Homozygous Watanabe heritable hyperlipidemic (WHHL) rabbits are used widely to study atherosclerosis, but the WHHL heterozygous rabbit has received little attention. To study their potential as a model for atherosclerosis, heterozygous WHHL and New Zealand white (NZW) rabbits were fed diets containing 0%, 0.5% and 1.0% cholesterol. Plasma lipids were analyzed at 0, 4, 8, 12, 16 and 24 weeks, and animals were killed at 12 and 24 weeks. Plasma cholesterol levels were significantly higher in cholesterol-fed WHHL heterozygotes at 8 weeks compared with NZW rabbits, but no differences were apparent at other times. Atherosclerotic plaques in the aortas of cholesterol-fed WHHL heterozygous rabbits differed from those in NZW rabbits, in that the WHHL had complicated lesions with necrosis, cholesterol clefts, fibrous caps and calcification, similar to that found in humans and homozygous WHHL rabbits. In contrast, NZW rabbits had predominantly foam cell lesions. Heterozygous WHHL rabbits also had less extensive extravascular foam cell deposits. Our results suggest that the cholesterol-fed heterozygous WHHL rabbit may provide a promising model for studying the pathogenesis of atherosclerosis. PMID- 2783198 TI - Factor, present in plasma, inhibiting the interaction of low density lipoprotein with arterial proteoglycan. AB - The complex formation of LDL with arterial proteoglycan or glycosaminoglycan was quantitated as precipitation of LDL-cholesterol after incubation in a low ionic strength buffer containing CaCl2 and MgCl2. It was found that human plasma or serum contains a factor which inhibits this complex formation. Upon density gradient centrifugation this factor was found at d greater than 1.24 g/ml. It could be further purified from the d greater than 1.24 g/ml fraction by affinity chromatography on heparin-Sepharose and hydrophobic interaction chromatography on phenyl-Sepharose. The content of inhibitory activity was found to vary over a 4 fold range in sera of apparently healthy persons. PMID- 2783199 TI - Protective effect of BN 52021, a specific antagonist of platelet-activating factor (PAF-acether) against diet-induced cholesteryl ester deposition in rabbit aorta. AB - Platelet-activating factor (PAF-acether), a phospholipid mediator involved in inflammatory reactions, has been reported to induce endovascular surface lesions. We investigated the possible involvement of PAF-acether in the mechanism of arterial cholesterol deposition. Rabbits fed a normal or hypercholesterolic diet were treated orally for 1 month with BN 52021 (20 mg/kg per day), a specific PAF acether antagonist, and killed at the end of treatment. Cholesterol feeding resulted in a marked (50-fold) increase in plasma cholesterol. However, the drug had no significant effect on the diet-induced hypercholesterolemia. Free and esterified cholesterol were markedly increased (635%) in the aorta of animals receiving the atherogenic diet. This accumulation was reduced by 36% upon simultaneous administration of BN 52021 (P less than 0.02, n = 15). This decrease essentially affected the esterified cholesterol content. Conversely, BN 52021 showed no effect on the cellular cholesterol esterification, since liver acyl CoA: cholesterol acyltransferase activity remained unchanged. This study indicates that BN 52021 is effective in reducing cholesterol accumulation in rabbit atherosclerotic aorta, without changing the plasma cholesterol levels. PMID- 2783200 TI - Compositional changes in serum lipoproteins during developing hypercholesterolemia induced in rabbits by cholesterol-free, semipurified diets. AB - Changes in the concentration and composition of serum very low density lipoprotein (VLDL), low density lipoprotein (LDL) and high density lipoprotein (HDL) were studied in rabbits transferred from chow diet to cholesterol-free, semipurified diets containing casein or isolated soy protein. The fat and fibre content of these diets was similar to that of chow but a higher protein level was used to enhance the hypercholesterolemia. During the first week on the casein diet, there was a marked increased in LDL-cholesterol, protein and phospholipids, and these higher levels were maintained during the subsequent 3 weeks of the study. Similar but less marked changes were obtained with the soy protein diet. The components of VLDL showed relatively little change after introduction of the diets to the animals. In both VLDL and LDL, the proportion of cholesterol increased and that of triglycerides decreased after 1 week on the casein diet and a similar trend was seen in HDL. The concentration of HDL-cholesterol showed little change but triglycerides, protein and phospholipids all tended to decline on both casein and soy protein diets. PMID- 2783201 TI - Lipoprotein composition changes induced by fenofibrate in dysbetalipoproteinemia type III. AB - Fenofibrate (300 mg daily) was given to 9 subjects (7 men, 2 women) with dysbetalipoproteinemia type III. The treatment brought about important plasma level reductions in cholesterol (-35%), triglycerides (-56%), VLDL-cholesterol ( 63%) and VLDL-triglycerides (-59%). The VLDL-C/TG ratio, which was 0.40 before treatment, was 0.30 after 4 weeks of fenofibrate, still suggestive of type III. LDL-C, when measured by conventional methods, was unchanged but isolation of the IDL (1.006-1.019 g/ml) fraction from the 1.006 g/ml infranatant revealed that true LDL-C levels actually increased in 6 individuals while IDL-C decreased considerably. The total HDL-C increase was mostly due to a 33% HDL3-C change. Apolipoprotein levels were considerably modified, notably apo B, C-III and E which were decreased, as well as the lipoprotein particles containing combinations of these apolipoproteins, namely LpE:B and LpC-III:B. Apo A-I was slightly modified as LpA-I: A-II particle levels increased and LpA-I decreased. There were marked compositional modifications of apo B-containing lipoproteins which corresponded to changes of the whole lipoprotein profile. Some abnormal classes of lipoproteins (e.g., beta-VLDL, dense LDL), characteristic of this disease, tended to disappear and were in some cases replaced by material of different size and density. PMID- 2783202 TI - Primary prevention of atherosclerosis by lovastatin in a genetically hyperlipidaemic rabbit strain. AB - Lovastatin, a lipid-lowering drug which inhibits cholesterol synthesis, was administered to genetically hyperlipidaemic rabbits from the age of 2 months. Twenty rabbits were selected with similar plasma cholesterol levels and divided into matched treatment and control groups. The treated animals showed a 60% decrease in plasma cholesterol due to reduced levels of low density lipoprotein (LDL) and intermediate density lipoprotein (IDL). Levels of other lipoproteins remained unchanged. In untreated animals cholesterol levels in plasma, LDL and IDL increased with age. The area of aortic atherosclerosis-like lesions was quantified after 2-10.5 months of treatment. At each time point the extent of arterial disease was profoundly less in treated than in untreated animals. The findings demonstrate that primary prevention of arterial lesions resembling human atherosclerosis (increased amounts of fibrous tissue, smooth muscle cell proliferation, foam cell formation and necrosis at the base of the plaques) results from early effective reduction of elevated plasma lipids by lovastatin in this rabbit strain. PMID- 2783204 TI - Studies on hypocholesterolemic activity of rice bran oil. AB - The serum total, free esterified and (LDL + VLDL)-cholesterol levels of rats maintained on a 10% refined rice bran oil diet were significantly lower than those on a 10% groundnut oil diet; HDL-cholesterol showed a tendency to be higher. Addition of oryzanol at 0.5% level to the diet containing rice bran oil showed a further significant decrease in serum total cholesterol. Liver lipids of rats fed bran oil were also markedly lower than their groundnut oil fed counterparts. Though the liver lipids of rats fed oryzanol along with RBO showed a further lowering, it was not statistically significant. The cholesterol lowering ability of rice bran oil appears to be due to oryzanol and to some other components of the unsaponifiable matter. PMID- 2783205 TI - Relationship between serum cholesteryl ester composition, dietary habits and coronary risk factors in middle-aged men. AB - Serum cholesteryl palmitate, oleate, linoleate and arachidonate were measured using high performance liquid chromatography in 134 men aged 45-64 years, randomly selected from the population of Ghent, Belgium. No relationship was observed between these cholesteryl esters, expressed as a percentage of their total, and age, serum cholesterol, arterial blood pressure, smoking habits and body mass index. Dietary habits were assessed using a 3-day diary method. No relationship was found between dietary habits and serum lipids. Highly significant correlations were observed between diet and the serum cholesteryl esters. In multivariate analyses dietary variables account for significant proportions of the variances of the serum cholesteryl esters. The results indicate that measurements of cholesteryl esters can be used to differentiate on the population level between subgroups with different dietary habits particularly with respect to fat consumption. PMID- 2783203 TI - Carbon disulfide modification and impaired catabolism of low density lipoprotein. AB - Carbon disulfide interacts in vitro with low density lipoprotein (LDL), resulting in an increased electrophoretic mobility of the particle, due to a decrease in free amino groups of apolipoprotein B-100. The processing of carbon disulfide modified LDL through the apo B/E receptor pathway of cultured human fibroblasts is decreased as compared to that of native LDL, depending on the level of modification. Carbon disulfide-modified LDL is recognized and degraded by the scavenger pathway of macrophages, but to a lesser extent than acetylated LDL. Carbon disulfide modification decreases the ability of the LDL to down-regulate sterol synthesis and to stimulate cholesterol esterification in fibroblasts. Carbon disulfide-modified LDL markedly stimulates cholesteryl ester formation in macrophages, albeit to a lesser extent than acetylated LDL. These results indicate that after carbon disulfide modification the LDL catabolism is shifted to the scavenger pathway, and are consistent with the fact that carbon disulfide intoxication accelerates the appearance of atherosclerotic lesions. PMID- 2783206 TI - Quantitation of plasma free cholesterol and cholesteryl esters by high performance liquid chromatography. Study of a normal population. AB - We describe a convenient method for the separation and quantitation of plasma free cholesterol and cholesteryl esters by high performance liquid chromatography (HPLC). After extraction of 100 microliters plasma with isopropanol the plasma cholesteryl esters were resolved on a Zorbax ODS reversed-phase column by isocratic elution with acetonitrile/isopropanol (50:50, v/v). Baseline separation of the plasma cholesteryl esters including the internal standard was obtained within a 25-min run. The intra- and interassay CV was less than 4%. The results obtained by HPLC show good agreement with enzymatic and gas-liquid chromatographic methods. High performance liquid chromatography provides a simple method for the quantitation of individual cholesteryl esters avoiding tedious chromatographic and derivatisation steps inherent to GLC. Our HPLC method was applied to the monitoring of plasma cholesteryl esters in a normal population and can also be used for the study of cholesteryl esters from lipid extracts of biological samples. PMID- 2783207 TI - Effect of two week lymphatic occlusion on the mechanical properties of dog femoral arteries. AB - In order to study the long-term effect of impaired lymphatic drainage on the mechanical properties of the arterial wall, cylindrical femoral artery segments from 10 mongrel dogs after 2 weeks of hindlimb lymphatic occlusion were subjected to in vitro mechanical test and compared with the contralateral, sham-operated segments. Smooth muscle contraction was induced by norepinephrine (7.4 X 10(-6) M) and smooth muscle relaxation by papaverine (1.6 X 10(-4) M). As a result of 2 weeks of lymphatic occlusion, wall thickness increased from 243 +/- 18 to 343 +/- 35 microns (P less than 0.02), inner radius decreased from 1.69 +/- 0.11 to 1.42 +/- 0.12 mm (P less than 0.01) and elastic modulus decreased from 1.23 X 10(6) to 0.55 X 10(6) N/m2 (P less than 0.01), when determined at 100 mm Hg (13.3 kPa) intraluminal pressure and with relaxed smooth muscle. The contractile apparatus was able to produce active strain in the vessels with lymphostasis and at physiological pressures not significantly different from the controls (0.89 +/- 0.02 vs. 0.91 +/- 0.02), but at significantly lower levels of tangential stress. Active stress decreased significantly. This study shows that a reorganization of the vessel wall mechanical force-bearing elements occurs in lymphostasis, which, in some respects, resembles the mechanical alterations found in different forms of atherosclerosis. PMID- 2783208 TI - Influence of probucol on early experimental atherogenesis in hypercholesterolemic rats. AB - A possible cellular action for probucol in early atherogenesis was investigated. In diet-induced hypercholesterolemic rats, probucol reduced aortic accumulation of cholesterol without ameliorating monocyte attachment to the arterial endothelium. Under the imposed conditions, circulating cholesterol levels were not significantly altered by probucol. 125I-labeled acetyl LDL uptake and degradation studies with mouse peritoneal macrophages revealed that probucol had an inhibitory effect on the scavenger receptor pathway. The data suggested that the observed beneficial effects of probucol were not related to an early cholesterol-induced injury phase which might involve calcium. Instead, probucol probably through its free radical scavenging property, intervened at a subsequent cellular level to restrict lipid accumulation. PMID- 2783209 TI - Hypocholesterolemic effect of vegetable protein in a hypocaloric diet. AB - Eleven obese volunteers took part in a 12-week study during 8 weeks of which 2 meals of their control 1000 kcal diets were replaced by a soya based liquid formula (1 month) or a milk based liquid formula (1 month). The mean weight loss per month was 2.5 kg (P less than 0.05). On the soya formula total and LDL cholesterol levels were reduced significantly over the month by 10.0 +/- 2.7% (P less than 0.01) and 17.5 +/- 5.6% (P less than 0.02), respectively. Neither the milk based formula or the control low calorie diet lowered serum cholesterol significantly over the diet period. No change was seen in serum triglycerides on any of the 3 diets. No difference was seen between treatments in 24-h urinary C peptide excretion. The results indicated that use of a vegetable protein supplement in a weight loss program which induced moderate weight loss was associated with a reduction in blood lipids, whereas moderate weight loss on a control low calorie diet or milk based formula was not. PMID- 2783210 TI - Legal immunity for medical peer-review programs. New policies explored. PMID- 2783211 TI - Toward a biochemical classification of depressive disorders. X. Urinary catecholamines, their metabolites, and D-type scores in subgroups of depressive disorders. AB - Data on 24-hour urinary levels of catecholamines and metabolites were determined in 114 depressed patients. For each patient, a D-type score was calculated, using a discriminant function equation that was previously derived using data from an independent group of depressed patients. Of all measures, D-type scores provided the highest sensitivity and specificity for separating bipolar/schizoaffective depressed patients from all remaining patients or from those patients with unipolar nonendogenous depressions. Using Research Diagnostic Criteria (RDC), bipolar I patients demonstrated significantly lower D-type scores than did all other RDC depressive subtypes, including bipolar II disorders. Similar findings were observed using the Clinical Inventory for the Diagnosis and Classification of Affective Disorders (CIDCAD) system: bipolar/schizoaffective patients demonstrated significantly lower D-type scores than all remaining subtypes, including diagnostically unclassifiable, probable bipolar patients (a category somewhat akin to RDC bipolar II disorder). Data pointed to the heterogeneity of bipolar disorders. Catecholamine and metabolite data in this study were compared with recent studies of others. PMID- 2783212 TI - The role of skin testing in the use of collagen injectable materials. AB - The experience of 400 consecutive patients evaluated for soft tissue augmentation for a variety of contour defects is reviewed here. The first 200 patients were evaluated with only a single skin test prior to treatment, whereas the second group were skin tested twice. The rate of hypersensitivity to the first skin test was the same in both groups, 5 out of 200 (2.5%). In the 195 patients receiving treatment after a single negative skin test, 6 (3.1%) developed hypersensitivity reaction at treatment sites. In the second group, where double skin testing was employed, an additional 7 patients had a positive second skin test (3.5%). There were no allergic reactions in the 171 patients who received treatment after two negative skin tests. PMID- 2783213 TI - Hormonal influences on the middle-affinity estrogen-binding sites in the liver of the newt Pleurodeles waltl. AB - The effects of hormonal changes on the male-specific, middle-affinity, estrogen binding component (MEBC) were investigated in the Pleurodele. Induction of MEBC was shown to be under androgen control, similar to that observed for the cytoplasmic middle-affinity estrogen-binding sites in rat liver and human hepatoma cells. But, in contrast to the male-specific middle-affinity estrogen binding sites identified in the rat, the administration of estrogen to male Pleurodeles did not lead to the disappearance of MEBC but raised levels significantly. The MEBC displays the properties of type II middle-affinity estrogen-binding sites, which are characterized by an oestrogen-dependent rise, a sensitivity to reducing agents, a specificity for diethylstilbestrol, and a binding capacity enhanced by increasing dilutions of cytosol. In female Pleurodeles, MEBC can be induced by treatment with androgens. This induction appears to be modulated by the estrogen/androgen ratio. The induction of MEBC and the estrogen-dependent increase in the male were not found to be correlated with hepatocyte proliferation. PMID- 2783214 TI - Bowel-flora alteration: a potential cure for inflammatory bowel disease and irritable bowel syndrome? PMID- 2783215 TI - Postwar mortality among Australian World War II prisoners of the Japanese. AB - The impact of detention as a prisoner of war on postwar survival and disease specific mortality was examined in Australian veterans of World War II. A random sample of 908 ex-prisoners and 797 other veterans of the same theatre of war, all of whom had returned to Australia alive, was traced over the 40 years since the war. The date and cause of death were recorded for those who were found to have died. By means of the subject-years method, the mortality of the prisoners of war was compared with that of the non-prisoners of war while the analysis controlled for the length of follow-up and the subject's age at the close of the war. The prisoners of war showed a higher over-all mortality rate than did the non prisoners of war. This difference was pronounced in the period from five to 14 years after the war but diminished subsequently. There also was an indication that this effect varied with the subject's age at the end of the war: prisoners of war who were aged 25-29 years at that time had the highest mortality differential from non-prisoners of war, followed by prisoners of war who were aged 30-34 years. However, log-linear modelling, which controlled for age and the follow-up period, did not suggest that these mortality differences could be attributed to particular causes of death. PMID- 2783216 TI - 36 cases of bites by spiders, including the white-tailed spider, Lampona cylindrata. AB - Thirty-six cases of bites by spiders are reported; in all cases, the spider was identified. No cases resulted in the formation of local ulcers, in necrosis, or in serious systemic symptoms. Eight bites by Lampona cylindrata, the white-tailed spider, caused a mild sting to sharp pain of short duration, itchiness, erythema, local swelling or a lump, and either no systemic symptoms, or anxiety. Five bites by Badumna insignis, the black house-spider, caused local pain, erythema, swelling, and no systemic symptoms, or anxiety, or chest pain and shortness of breath of mild degree and of short duration. The other spiders to be reported as causing bites were Hadronyche adelaidensis, Misgolas andrewsi, Aganippe subtristis, Olios calligaster, Isopeda pessleri, Eriophora sp., Phonognatha graeffei, Holoplatys sp., Breda jovialis, Opisthoncus sp., Lycosa sp. and Achaearanea tepidariorum. PMID- 2783217 TI - Problems with referrals. PMID- 2783218 TI - Discontinuance of antiepileptic medications in patients with developmental disability and diagnosis of epilepsy. AB - Fifty patients with developmental disabilities and past history of epilepsy but without reported seizures fo several years underwent trial reductions of an antiepileptic drug. After an 8-year follow-up there was recurrence of seizures in 26 patients. Predictors for a seizure free state off medication were: few documented seizures in lifetime, no gross neurological abnormalities, medication below therapeutic levels at time of discontinuance, and persistently normal EEGs before and after discontinuance. Successful withdrawal of medication may have resulted from early control of seizures or early treatment; lack of actual epileptic seizures but presence of "pseudoseizures"; isolated event seizures; or seizures that could have resulted from nonepileptic, self-limiting factors. PMID- 2783219 TI - Consent for a minor's abortion. PMID- 2783220 TI - Screening laboratory tests for Crohn's disease. AB - The prevalence of abnormal values of initial screening laboratory tests was assessed for 24 children who eventually proved to have Crohn's disease. The screening tests included in this analysis were fecal alpha 1-antitrypsin (FA) concentration, erythrocyte sedimentation rate (ESR), total leukocyte count, serum albumin level, hemoglobin concentration, and qualitative testing of stool for the presence of blood. Of the 24 patients, 21 had abnormal FA values, 17 had anemia, 19 had an increased ESR, 14 had hypoalbuminemia, rectal bleeding was found in 8, and none had leukocytosis. All 24 patients had at least one abnormal screening test value; the most frequently abnormal result was the FA concentration. Pediatric patients without elevated FA values, anemia, a high ESR, bloody stools, or hypoalbuminemia are unlikely to have active Crohn's disease. PMID- 2783221 TI - Integrity in medicine. PMID- 2783222 TI - ST depression and elevation in vasospastic angina. PMID- 2783223 TI - Postmortem radiology in children with congenital heart disease. PMID- 2783224 TI - Left ventricular pressure-volume analysis by radionuclide angiography. PMID- 2783225 TI - Management of meconium-stained neonate. PMID- 2783226 TI - Bowel-flora alteration: a potential cure for inflammatory bowel disease and irritable bowel syndrome? PMID- 2783227 TI - Dapsone in the long-term treatment of temporal arteritis. PMID- 2783228 TI - In vivo fluorescence of human skin. PMID- 2783229 TI - Prevention in the era of high-tech medicine. PMID- 2783230 TI - Effects of corticosteroids, prostaglandin E2, and beta-agonists on adenylate cyclase activity in fetal rat lung fibroblasts and type II epithelial cells. AB - The effect of glucocorticoids on the response of adenylate cyclase in fetal rat lung fibroblast and Type II epithelial cell cultures to beta-agonists and prostaglandin E2 (PGE2) was investigated. There was significant stimulation of cyclic AMP synthesis by adrenalin in both fibroblasts and Type II cells, which was potentiated in a dose-dependent manner by cortisol. Stimulation of adenylate cyclase by PGE2 (10-1000 nM) was demonstrated in fibroblasts but not in Type II cells. The response to PGE2 was stimulated by pretreatment with cortisol only in fibroblasts (p less than .01), and no latent response to PGE2 was evident in Type II cells after cortisol treatment. These experiments suggest that both cell types isolated from late gestation fetal lung contain active beta-agonist and glucocorticoid receptors that synergize in raising intracellular cyclic AMP, which has multiple effects, including surfactant secretion from Type II cells. Since the adenylate cyclase response to PGE2 and its enhancement by glucocorticoids occurred only in fibroblasts, it is concluded that the reported effects of PGE2 on surfactant release are not mediated via raised intracellular cyclic AMP in Type II cells. PMID- 2783231 TI - Timing of embryo transfer and outcome. PMID- 2783232 TI - Chiropractic in the yellow pages: a content analysis study. PMID- 2783233 TI - Yersinia antigens in reactive arthritis. PMID- 2783234 TI - DNA amplification of a further exon of Duchenne muscular dystrophy locus increase possibilities for deletion screening. PMID- 2783235 TI - A comment on late-onset schizophrenia. PMID- 2783236 TI - Use of the cluster sign in the diagnosis of small pyogenic hepatic abscesses. PMID- 2783237 TI - Depression and negative symptoms in schizophrenia. PMID- 2783238 TI - New round in Dingell v. NIH? PMID- 2783239 TI - European Intestinal Transport Group. 9th meeting. Szeged, Hungary, May 25-27, 1989. Abstracts. PMID- 2783240 TI - Stimulation of tumor cell growth in vitro by a monoclonal antibody to a tumor specific protein (TSP-180) present on the cell surface of 3LL cells. AB - Proliferation capacity and MHC class I antigen expression of two Lewis lung carcinoma (3LL) metastatic variants (C87, BC215) grown under defined experimental conditions (serum-free defined medium or 10 per cent serum) have been studied following exposure to MoAb 135-13C which recognizes on these cells a tumor surface protein of 180,000 daltons (TSP-180). The results of this study indicate that the high metastatic clone (C87) binds higher amounts of MoAb to TSP-180 and Db antigens than does the low metastatic one (BC215), while both clones express very low amounts of Kb antigens. 3LL clones grown in 10 per cent serum or adapted in serum-free, defined medium show the same metastatic phenotype and MHC class I antigen expression, but when grown in defined medium exhibit increased capacity to bind MoAb 135-13C. However, the relative binding rate of 3LL clones grown in 10 per cent serum or in defined medium is unchanged: the high metastatic clone always showing higher capacity to bind MoAb to TSP-180. Furthermore, comparison of EGF binding sites on the cell surface of 3LL clones, grown in different culture conditions, demonstrates that the C87 clone binds higher amounts of labelled EGF and that this amount increases in serum-free defined medium, exactly as reported for TSP-180. In addition, competition experiments demonstrated that MoAb 135-13C does not compete for EGF binding sites on 3LL cell surface. Studies on cell proliferation following exposure to MoAb 135-13C, revealed that the low metastatic clone (BC215) is more actively stimulated than the high metastatic one. Moreover, similar data were obtained after exposure of 3LL clones to physiological amounts of different growth factors (i.e. EGF, MSA, insulin). Analysis of MHC class I antigen expression following exposure to MoAb 135-13C indicated that MoAb 135-13C induces on the cell surface of the C87 clone a transient low modulation of Db antigens. These results suggest that 3LL cells endowed with lower metastatic potential are more dependent on the microenvironmental conditions than the high metastasizing ones, and that MoAb 135 13C binding to 3LL cell surface stimulates proliferation as reported for several known growth factors. PMID- 2783242 TI - Effect of interleukin 1, inflammation, and surgery on the incidence of adhesion formation and death after abdominal irradiation in mice. AB - There is clinical evidence that prior surgery and inflammation can increase the risk of the chronic complications of radiotherapy delivered to the pelvic/abdominal region. We have established a murine model to study this interaction using as end points mortality and late gut-associated peritoneal adhesion formation. A single dose of 16 Gy of total abdominal irradiation (TAI) was used. This gave no early deaths (less than 1 mo) and a relatively low mortality over the period 1 to 6 mo after TAI. The incidence of adhesions, which is the most serious complication 2 to 6 mo after TAI, was also low. Injection of lipopolysaccharide (50 micrograms, i.p.) or human recombinant interleukin 1 (IL 1) in doses as low as 100 units prior to TAI greatly enhanced both radiation induced adhesion formation and death. Prior surgery also increased radiation induced mortality, so much so that adhesions could not be accurately quantified. The timing of administration of lipopolysaccharide and IL-1 and of surgery relative to TAI was important in determining the outcome. For example, IL-1 enhanced adhesion formation and death if given from 3 days before to 1 day after, but not 4 days or 4 wk after, TAI. If given 20 h or less before TAI, there was a dramatic increase in early mortality 1 to 3 wk later, which was not seen if IL-1 was given at other times. These early deaths were not caused by bone marrow or gut stem cell depletion and may be a result of fluid leakage. We propose that surgery, bacterial invasion, or other inflammatory signals might act through a common mechanism of stimulating IL-1 production to enhance radiation-induced adhesion formation and the early and late morbidity and mortality associated with abdominal irradiation. If this is the case, blocking IL-1 production might inhibit the development of these late complications. PMID- 2783241 TI - Synergy of human recombinant interleukin 1 with interleukin 2 in the generation of lymphokine-activated killer cells. AB - Peripheral blood mononuclear cells cultured in vitro with interleukin 2 (IL-2) become cytolytic towards both autologous and allogeneic tumor cells. We report here that IL-1 synergizes with IL-2 in serum-free conditions to produce increased (1.3-286-fold) lymphokine-activated killer (LAK) activity. The most dramatic synergy is seen with low IL-2 concentrations (10 U/ml, 222 pM) and 50-250 U/ml IL 1 alpha or beta. Kinetics of addition experiments demonstrate a specific requirement for IL-1 at or before addition of IL-2 to the culture. We postulate that one of the mechanisms whereby IL-1 augments LAK activity is by rendering LAK precursors more responsive to IL-2. Up-regulation of the IL-2 receptor beta chain (Tac) and increased [3H]thymidine incorporation in cultures containing IL-1 and IL-2 support this view. In some instances, IL-1 alone is capable of maintaining/generating a small degree of cytolytic activity. Collectively, our data demonstrate that IL-1 is capable of interacting with low dose IL-2 to significantly augment LAK activity, potentially playing an important role in the early stages of LAK activation and differentiation. Because synergy is observed with dramatically reduced IL-2 concentrations, this system may offer an alternative approach to high dose IL-2 therapy for the treatment of neoplastic disease. PMID- 2783243 TI - Influence of schedule of interleukin 2 administration on therapy with interleukin 2 and lymphokine activated killer cells. AB - The purpose of this study was to compare the toxicity, immunomodulatory changes, and antitumor efficacy of interleukin 2 (IL-2) and lymphokine activated killer (LAK) cell therapy with two durations of IL-2 infusion. Patients with progressive melanoma, non-Hodgkin's lymphoma, renal carcinoma, or colon carcinoma received IL 2 at 3 X 10(6) units/m2/day on days 1-5 and 13-17, either by bolus injection every 8 h (q8h) or by continuous i.v. (CIV) administration. Peripheral blood mononuclear cells were harvested by leukapheresis on days 8, 9, and 10, were incubated in vitro for 5 days for generation of LAK cells, and were infused on days 13, 14, and 15. The first 11 patients were treated with IL-2 q8h, and the subsequent 13 patients were treated by CIV infusion. Toxicity consisted primarily of fever, chills, emesis, diarrhea, weight gain, and edema but did not require intensive care unit support and did not differ significantly between treatment groups. IL-2-induced lymphocytosis on day 8 was higher with CIV than with q8h administration with a mean lymphocyte count/microliter of 5610 +/- 700 (SE) versus 3300 +/- 500. Immunomodulatory changes observed on days 8 and 20 were also greater with CIV IL-2 and included an increase in peripheral blood mononuclear cell IL-2 receptor expression as well as a marked rise in the number of Leu-11+ and Leu-19+ peripheral blood mononuclear cells. The total leukapheresis yield per patient and total number of LAK cells infused per patient were higher with CIV than q8h administration, with 49.8 +/- 4.9 X 10(9) versus 39.4 +/- 5.4 X 10(9) and 42.6 +/- 5.0 X 10(9) versus 34.0 +/- 5.4 X 10(9), respectively. The cells infused displayed phenotypic evidence of activation and exhibited marked lytic reactivity to Daudi, Raji, and HT-144 targets. One complete and one minimal response were observed in 2 of 8 patients with metastatic renal cell carcinoma who received CIV IL-2 and LAK cells. The results show that IL-2 is more biologically active by CIV than q8h administration, as demonstrated by greater rebound lymphocytosis, LAK cell yield, and in vivo immunostimulation. PMID- 2783245 TI - Inhibition of Moloney murine lymphoma and sarcoma growth in vivo by dietary retinoids. AB - The effects of dietary retinoids on the growth of Moloney lymphoma (LSTRA) and sarcoma (MSC) in BALB/c mice were evaluated. Transplantable syngeneic Moloney lymphoma and sarcoma tumors are immunogenic. Preimmunization with LSTRA cells provides protection against subsequent challenge and sarcomas spontaneously regress following injection of an appropriate inoculum of MSC cells. In normal mice fed varying concentrations of all-trans-retinoic acid (RA) and given injections of 10(3) LSTRA cells, RA caused a dose-dependent increase in the number of survivors; 50% of the mice fed RA at 50 mg/kg of diet were long-term survivors. All animals died that were fed a control diet and challenged with 10(3) LSTRA cells. Athymic (nu/nu) mice fed RA were not protected against lymphoma growth, whereas euthymic (nu/+) mice were; therefore, the antitumor effect of RA was thymus dependent. Primary immunization with irradiated LSTRA in the presence of RA caused a significant increase in cell-mediated cytotoxicity by spleen cells at 4 days after immunization. However, challenge of animals preimmunized with LSTRA in the presence of dietary RA revealed a dose-dependent inhibition of memory. A significant reduction in MSC growth was also observed in normal mice fed 13-cis-retinoic acid (cRA). A comparison of the primary antilymphoma effect of dietary RA, cRA, N-(all-trans-retinoyl)-DL-leucine (RL), and N-(4-hydroxyphenyl)retinamide (4-HPR) revealed an efficacy hierarchy of RL greater than RA greater than cRA greater than 4-HPR with RL producing 70% long term survivors at 115 days after challenge with 10(3) LSTRA cells. These studies indicate that retinoids can inhibit the growth of transplantable, retroviral induced, immunogenic tumors by thymus-dependent mechanisms and that a newly synthesized retinoylamino acid (RL) is more potent than RA at inhibiting Moloney lymphoma growth. PMID- 2783244 TI - Generation of antigenic variants from a nonantigenic murine tumor cell line by transfection with a gene encoding a novel tumor-specific transplantation antigen. AB - Tumors induced in mice by UV radiation often express highly immunogenic tumor specific transplantation antigens (TSTA). The 216 gene, which encodes a TSTA of the C3H tumor UV-1591, has been cloned and characterized as a novel major histocompatibility complex Class I antigen. The purpose of this study was to determine whether the 216 gene-encoded TSTA can function as a tumor rejection antigen when expressed on unrelated, nonantigenic murine tumor cells or whether its function is restricted to UV-induced tumors. A cell line (10T-1) derived from a spontaneous transformant of C3H 10T1/2 cells was cotransfected with DNA from p216 and pSV2-neo plasmids. About 2 wk after transfection, G418-resistant colonies were isolated randomly and tested for cell surface expression of the 216 gene product using a monoclonal antibody specific for 216 gene-encoded TSTA. Of 20 clones tested, four expressed high levels of 216 gene-encoded TSTA. These four clones were highly antigenic in that they were completely rejected in normal mice but grew progressively in nude mice. Furthermore, the 216-positive clones were immunologically cross-reactive with UV-1591, as determined by in vitro cytotoxic T-lymphocyte and in vivo immunization and challenge assays. Surprisingly, 216 positive 10T-1 transfectants also cross-reacted with 10T-1 cells, both in vitro and in vivo. These results demonstrate that the product of a cloned TSTA gene from a UV-induced murine tumor is capable of functioning as a tumor rejection antigen when expressed on unrelated, nonantigenic tumor cells. In addition, these results indicate that this approach could be used to augment the immune response against poorly antigenic tumors. PMID- 2783246 TI - Response of cultured hepatocytes to a hepatomitogen after initiation by conditioned medium or other factors. AB - Injection of a substantially purified hepatomitogen into recipient rats that had 40% of their liver removed resulted in a significant stimulation of hepatic DNA synthesis as determined by the labeling index and the mitotic index. Normal or sham-operated rats did not respond to the injection of the mitogen. The extraction and partial purification of this hepatomitogen have previously been reported (A. Francavilla et al., Cancer Res., 47:5600-5605, 1987). Addition of the factor to an epithelial-like liver-derived cell line in culture (clone 9) or to a hepatoma cell line (HTC-SR) resulted in a dose-dependent stimulation of DNA synthesis. Hepatocytes in primary culture, on the other hand, were not stimulated by the addition of the factor. However, when the mitogen was added to hepatocytes in primary culture, together with conditioned medium, obtained from the responsive cell lines, a significant stimulation of DNA synthesis could be demonstrated in hepatocytes in culture. The stimulation was dose dependent with respect to the mitogen, was abolished by 10 mM hydroxyurea, and was independent of epidermal growth factor. The conditioned medium could be replaced by a protein factor extracted from the two cell lines as previously reported (P. Ove et al., J. Cell. Physiol., 131: 165-174, 1987). It appears that a cofactor is provided by the conditioned medium or by the cell extract, enabling the hepatomitogen to act on hepatocytes in primary culture. PMID- 2783247 TI - The effect of recombinant human granulocyte-macrophage colony-stimulating factor (rGM-CSF) on 3'-azido-3'-deoxythymidine (AZT)-mediated biochemical and cytotoxic effects on normal human myeloid progenitor cells. AB - Administration of 3'-azido-3'-deoxythymidine (AZT) to patients with acquired immunodeficiency syndrome (AIDS) causes significant anemia and neutropenia. The bone marrow cytotoxicity of AZT has been attributed to deoxyribonucleotide pool perturbations that might result in impaired DNA synthesis in normal bone marrow elements. We examined the effect of human recombinant granulocyte-macrophage colony-stimulating factor (rGM-CSF) on AZT-mediated biochemical perturbations and in vitro growth inhibition of normal bone marrow myeloid progenitor cells. Exposure of nonadherent, bone marrow mononuclear cells (BMMC) to 100 ng/ml of rGM CSF for 6 h resulted in approximately twofold increments in the mean intracellular deoxycytidine triphosphate (dCTP) and thymidine triphosphate (dTTP) levels. Administration of 10 microM AZT alone to BMMC for 6 h markedly reduced dCTP and dTTP levels and generated significant levels of AZT triphosphate (AZT TP). Coadministration of rGM-CSF (100 ng/ml) along with AZT (10 microM) partly restored dCTP and dTTP levels and significantly reduced AZT-TP levels. Furthermore, simultaneous exposure of BMMC for 4 h to 100 ng/ml of rGM-CSF reduced the mean DNA incorporation of [3H]AZT (10 microM) from 27.2 to 19.1 pmol/micrograms of DNA. Additionally, the inhibitory effects of AZT (10 microM) on granulocyte-macrophage colony-forming unit (CFU-GM) colony growth were significantly reduced in the presence of 100 ng/ml of rGM-CSF. These in vitro studies suggest that rGM-CSF partly corrects AZT-mediated biochemical perturbations as well as reduces the cytotoxicity of AZT in normal human bone marrow myeloid progenitor cells. PMID- 2783248 TI - The roles of factors from lung in murine megakaryocytopoiesis. AB - The roles of factors from mouse lung in stimulating murine megakaryocytopoiesis were examined. Conditioned medium from normal mice was found to contain interleukin 3 (IL-3) activity in addition to granulocyte-macrophage colony stimulating factor (GM-CSF) and megakaryocyte potentiator (Mk-potentiator). The Mk-potentiator activity of mouse lung-conditioned medium (MLCM) was found to be immunologically distinct from IL-3. Biochemical separation of MLCM showed Mk potentiator activity with an activity profile distinct from IL-3 and GM-CSF. When titrated, Mk-potentiator was the major activity enhancing megakaryocyte colony formation in MLCM. By contrast, at high concentrations of MLCM, all factors were present and may play a role in megakaryocyte colony growth and development. PMID- 2783249 TI - Effect of recombinant GM-CSF and recombinant G-CSF on colony formation of blast progenitors in acute myeloblastic leukemia. AB - The colony-promoting activities of recombinant granulocyte-macrophage colony stimulating factor (rGM-CSF) and recombinant granulocyte colony-stimulating factor (rG-CSF) on primary and secondary colony formation by blast progenitors (leukemic colony-forming units [L-CFU]) from 21 patients with acute myeloblastic leukemia (AML) were examined using blast colony assay and compared to colony promotion stimulated by phytohemagglutinin-stimulated leukocyte-conditioned medium (PHA-LCM). Recombinant GM-CSF stimulated blast colonies in 13 out of 20 cases examined (1 case not done). The magnitude of stimulation by rGM-CSF varied significantly according to the type of AML, but in general was lower than that of PHA-LCM. Blast cells of type M1 did not form any colonies with rGM-CSF, although numerous colonies were produced with PHA-LCM. Type M4 blasts formed fairly large numbers of colonies, though slightly less than those stimulated by PHA-LCM. Blasts of type M2 and M5 formed colonies with the stimulation of rGM-CSF, but the numbers were considerably smaller than type M4 and those stimulated with PHA-LCM. Recombinant G-CSF stimulated blast colonies in only 5 out of 21 cases, 3 of them being type M2. The number of cases responding to rG-CSF was significantly smaller than that responding to rGM-CSF, and even in cases in which colonies were formed, the magnitude of stimulation was minimal. From these results it seems likely that blast cells of different types of AML require a different kind of CSF for their optimal growth; type M4 blasts responded to the stimulation of rGM-CSF well, but blasts of other types of AML responded poorly. Thus, except for type M4, CSF(s) other than rGM-CSF seems to be required for the sufficient growth of L-CFU. Recombinant G-CSF is not likely to play an essential role in the proliferation of leukemic blasts of most types. Previous exposure to rGM-CSF and rG-CSF did not alter the self-renewal capacity, cellular phenotype, and morphology of colony cells, indicating that the direction and degree of differentiation of L-CFU stimulated by rGM-CSF or rG-CSF were not different from those stimulated with PHA LCM. PMID- 2783250 TI - Purification of human urine colony-stimulating factor by affinity chromatography. AB - Antisera from rabbits immunized with murine macrophage colony-stimulating factor (CSF-1) were evaluated for cross-reactivity with human urine CSF-1. One cross reactive antiserum was used to purify CSF from human urine. The IgG fractions from normal rabbit serum and the anti-CSF serum were bound to cyanogen bromide activated sepharose. Ten-liter pools of human urine were concentrated by ultrafiltration and applied sequentially to the normal IgG and antiserum columns. Cross-reactive proteins were removed by the IgG column, whereas CSF was bound by the anti-CSF column. After extensive rinsing of the antibody column, the CSF was eluted with 4 M sodium thiocyanate. This fraction contained four to five contaminating proteins as judged by migration in sodium dodecyl sulfate acrylamide gel. In a further purification step, the CSF was retained selectively by concanavalin A sepharose and eluted with alpha-methylglucoside. This purified CSF had a specific activity of 0.8-2.3 x 10(7) U/mg protein. A single major contaminant was removed by reversed phase high performance liquid chromatography. Final specific activity of the purified CSF ranged from 2.5 to 4.4 x 10(7) U/mg protein. Each 10-liter pool of urine yielded 18-20 micrograms of pure material with a 15%-25% recovery. This technique is more rapid and provides a higher yield of pure human CSF-1 than the more tedious multi-step procedures that have been described previously. PMID- 2783251 TI - Recombinant and native human urinary colony-stimulating factor directly augments granulocytic and granulocyte-macrophage colony-stimulating factor production of human peripheral blood monocytes. AB - Colony-stimulating factor from human urine (CSF-HU) has been purified to a homogeneous protein, and its complementary DNA (cDNA) has been cloned. Recombinant CSF-HU was prepared from a serum-free medium conditioned by Chinese hamster ovary cells transfected with the cDNA and purified by the same method as that for the native protein. Purified CSF-HU stimulated human bone marrow cells to form macrophage colonies. It also stimulated human mature monocytes prepared from peripheral blood of healthy volunteers to produce human active colony stimulating activity that stimulates human bone marrow cells to form granulocyte and macrophage colonies. This activity was partially neutralized by the addition of both polyclonal antibodies against human granulocyte colony-stimulating factor and against human granulocyte-macrophage CSF, respectively. The stimulation of monocytes by CSF-HU was not inhibited by the addition of polymyxin-B, which is known as a potent inhibitor of endotoxin. On the other hand, CSF-HU did not stimulate monocyte production of interleukin-1 and interferon. These results indicate that recombinant and native CSF-HU stimulates immature cells as well as mature cells in the human monocyte lineage. PMID- 2783252 TI - The H-2 class II genes and the susceptibility to the development of pulmonary adenoma in mice. AB - To determine the locus in the H-2 complex that affects susceptibility to the development of pulmonary adenomas in mice, H-2 congenic and recombinant strains of mice with A/Wy, BALB/c, C3H, and B10 backgrounds were subjected to treatment with urethane. The average number and the incidence of adenoma foci were recorded five months after the treatment. In H-2 congenic strains on the A/Wy background, the average number of adenoma foci per mouse was significantly higher in mice of the A/Wy, A/J, and A-Tlab (H-2a) strains than in A.BY (H-2b) mice. In BALB/c and C3H congenic strains, the strains carrying the H-2k haplotype were more susceptible than those carrying the H-2b haplotype. In H-2 congenic strains on the B10 background, the average number and incidence of foci was also higher in haplotypes a, h2, k, and j than in haplotypes b, s, f, d, r, h4, i3, i5, and t4. The average numbers of adenoma foci in (A/J X A.BY)F1 (H-2a/H-2b) and (B10 X B10.A)F1 (H-2b/H-2a) were intermediate between the numbers in the parental strains. In [B10.A(4R) X B10.A (3R)]F1 (H-2h4/H-2i3) and [B10.A(4R) X B10.A(5R)]F1 (H-2h4/H-2i5), the numbers of adenoma foci were higher than in resistant parental recombinants. These patterns of response to urethane matched the patterns of the immune response to lactate dehydrogenase-B (LDH-B) and immunoglobulin gamma 2a (IgG2a) proteins. These differences between mice in their susceptibility to the development of pulmonary adenomas is probably due to the polymorphism of the class II genes in the H-2 complex. PMID- 2783253 TI - High affinity dopamine binding to mouse thymocytes and Mytilus edulis (Bivalvia) hemocytes. AB - The present report demonstrates that both mouse thymocytes and Mytilus edulis hemocytes contain a novel type of dopamine receptor. Scatchard analysis of these data revealed a single class of high-affinity binding sites with an affinity constant (Kd) of 6.6 nM, and a binding site density (Bmax) of 141 pmol/g protein in mice and a Kd of 7.6 nM and a Bmax of 66 pmol/g protein for the hemocytes. In older Mytilus the Kd was the same; however, there was a significant decrease in the Bmax (48 pmol/g protein; P greater than 0.05). Age changes were not evident for the mouse cells. The ability of a variety of other related drugs to displace specifically bound dopamine was investigated. The catecholamines (norepinephrine greater than epinephrine) and the dopamine agonist epinine were the most potent of the ligands tested and apomorphine and butaclamol were of moderate potency. This may serve to indicate that this dopamine binding site may be very different from the known D1 and D2 sites. This particular site may represent a third type of dopaminergic receptor. Furthermore, the hemocytes of Mytilus appear to be of two major types, namely, cells with a granular cytoplasm and those whose cytoplasm is agranular. Histofluorescence studies on the hemocytes reveal that a subpopulation of the granule-containing cells appears to contain serotonin. PMID- 2783254 TI - Metalloendoprotease inhibitors block fast axonal transport. AB - Metalloendoprotease activity that was sensitive to the metal chelator 1,10 phenanthroline and to synthetic dipeptide substrates of the enzyme was detected in homogenates of dorsal root ganglia (DRG) and spinal nerve from the bullfrog. Exposure of an intact in vitro preparation of DRG and spinal nerves to 1,10 phenanthroline led to a dose-dependent depression in the accumulation of fast transported 3H-labeled protein proximal to a nerve ligature. In nonligated preparations, the chelator treatment reduced the amount of transported protein entering the nerve; no marked effect on the transport rate was observed. Exposure of a desheathed region of spinal nerve to 1,10-phenanthroline, while DRG were maintained in control medium, resulted in a slight depression of fast transport. This effect was not dose dependent over the range that produced a dose response when both DRG and spinal nerve were exposed to the drug. Treatment of DRG and spinal nerve with the metalloendoprotease substrate analogues carbobenzoxy (CBZ) Ser-Leu-amide or CBZ-Gly-Leu-amide inhibited fast axonal transport, whereas treatment with CBZ-Gly-Gly-amide, which is not a substrate, had no detectable effect on transport. Selective exposure of desheathed nerve trunk to CBZ-Ser-Leu amide inhibited fast transport, but the effect was less marked than when DRG and nerve trunk were treated. Although previous studies have focused on the role of metalloendoprotease activity in exocytosis, the present data suggest that the enzyme may also be involved in earlier stages of intracellular transport. PMID- 2783255 TI - Nerve growth factor potentiates the hormone-stimulated intracellular accumulation of inositol phosphates and Ca2+ in rat PC12 pheochromocytoma cells: comparison with the effect of epidermal growth factor. AB - The effects of nerve growth factor (NGF) and epidermal growth factor (EGF) on the intracellular accumulation of inositol phosphates and on cytosolic free Ca2+ concentrations were studied in rat PC12 pheochromocytoma cells. Both NGF and EGF potentiate in these cells the increase in the accumulation of inositol phosphates that is elicited by bradykinin and carbachol. A corresponding potentiation was also found for the agonist-induced increase of cytosolic Ca2+ concentrations. The effect of NGF, but not that of EGF, is abolished when the cells are preincubated with 5'-deoxy-5'-methylthioadenosine, an inhibitor of S-adenosylhomocysteine hydrolase. These results suggest that an increased response to hormones, which act via phosphoinositide-derived second messengers, may be important in the mechanism of action of NGF and EGF. PMID- 2783256 TI - Expression and release of interleukin-1 by different human melanoma cell lines. AB - The influence of immunologic parameters on the clinical course of malignant melanoma is increasingly evident. However, it is not known which factors contribute to the immunologic host reaction against malignant melanoma. Because epidermal cells and, in particular, normal as well as transformed keratinocytes recently have been demonstrated to release various immunomodulating cytokines, the capacity of melanoma cells to produce interleukin-1 (IL-1) was examined. Accordingly, supernatants derived from different melanoma cell lines contained significant levels of IL-1 activity. Upon high-performance liquid chromatography (HPLC) gel filtration, melanoma cell-derived IL-1 (MEL-IL-1) exhibited molecular weight heterogeneity, and HPLC chromatofocusing revealed major activity at pH 5.0 and minor activity at pH 7.0. A monoclonal antibody directed against monocyte derived IL-1 blocked MEL-IL-1 activity significantly and was able to precipitate four species of biosynthetically radiolabeled MEL-IL-1 (25, 17, 6, and 4 kilodaltons), suggesting that MEL-IL-1 is identical to monocyte-derived IL-1. This was also confirmed by Northern blot analysis detecting IL-1 alpha specific mRNA in melanoma cells by hybridization with a cDNA fragment encoding for IL-1 alpha. Thus, melanoma cells, like other epidermal cells, exhibit the capacity to release the immunomodulating cytokine IL-1 and, therefore, probably have the potency to influence host defense mechanisms directed against malignant melanoma. PMID- 2783257 TI - Myocardial toxic effects during recombinant interleukin-2 therapy. AB - Arterial and pulmonary artery catheters were used to monitor the cardiopulmonary effects of recombinant interleukin-2 (rIL-2) given iv at a dose of 100,000 U/kg every 8 hours on days 1-5 to 10 patients with metastatic solid tumors. As anticipated, a severe capillary leak syndrome developed in all patients. Myocardial infarction (MI) occurred unexpectedly in three patients, as evidenced by a focal injury pattern on ECG and elevations of creatinine phosphokinase myocardial band fractions. All patients receiving rIL-2 exhibited major reductions in their left ventricular stroke work index (47 +/- 11 g.m/m2 to 29 +/ g.m/m2), an index of cardiac contractility. It remains uncertain whether the MIs were a byproduct of the capillary leak syndrome in patients with underlying coronary artery disease or whether rIL-2 directly or indirectly damages cardiac muscle. PMID- 2783258 TI - Other possible mechanisms of AIDS retrovirus pathenogenicity. PMID- 2783260 TI - Surface stimulation techniques for bladder management in the spinal dog. AB - Electrical stimulation of the bladder wall or sacral nerves may be effective for bladder management in the spinal cord injured patient. However, extensive surgery has been required for electrode implantation. We compared urodynamic responses using surface and minimally invasive epidural stimulating techniques in the chronic spinal male dog. Various surface stimulating techniques were effective: 1) sacral monopolar electrical stimulation with negative electrodes over S2 sacral foramina and positive electrodes on the legs, 2) sacral bipolar electrical stimulation with electrodes only over sacral foramina, 3) perineal monopolar electrical stimulation, and 4) perineal tactile stimulation. Urodynamic responses were similar to those for sacral epidural electrodes implanted adjacent to sacral nerves. Voiding was obtained both during stimulation and poststimulation. Stimulating parameters that were effective for daily voiding with sacral surface electrodes were 10 pps, 30 to 45 ma, 0.6 ms pulse duration, and 2 to 5 sec stimulation train duration. PMID- 2783261 TI - Increase of ectopic pregnancy in Finland--combination of time and cohort effects. AB - The marked increase of ectopic pregnancy in Finland was studied in 5-year age groups from 1968-1984. In the early 1970s, the overall increase was attributable to women under 30 years of age, and in the early 1980s to women aged 30 years or more. The increase in the incidence rate of ectopic pregnancy per 100,000 women has taken place somewhat successively since the late 1960s in women aged 20-24, 25-29, 30-34, and 35-39 years. The incidence of ectopic pregnancy per 100,000 women increased by every successive 5-year cohort born since the late 1930s up to the cohort born in 1954-1958; thereafter, the birth cohorts have experienced an equal or even lower risk of ectopic pregnancy. The findings suggest that the large "baby boom" cohort (born in 1945-1954), with its high risk of ectopic pregnancy, is mainly responsible for the overall increase in the number of ectopic pregnancies seen in the past decade. When these cohorts end their reproductive years, the marked increase in the number of ectopic pregnancies in Finland may decrease, but the incidence rates will probably stay stable. PMID- 2783259 TI - Distinct segments within the enhancer region collaborate to specify the type of leukemia induced by nondefective Friend and Moloney viruses. AB - The nondefective Moloney and Friend murine leukemia viruses induce T-cell lymphomas and erythroleukemias, respectively, after being injected into newborn NFS mice. In previous studies, we showed that the distinct disease specificities of the two viruses could be switched by exchanging a small segment, about 200 nucleotides in length, encompassing their enhancer regions. This segment included the direct repeat sequence and an adjacent GC-rich region of about 20 nucleotides defined in studies of Moloney murine sarcoma virus enhancer-promoter function (L. A. Laimins, P. Gruss, R. Pozzatti, and G. Khoury, J. Virol. 49:183-189, 1984). The direct repeats of Friend and Moloney viruses are identical in a central core sequence of 32 nucleotides but have sequence differences on either side of this core as well as in their GC-rich segments. To determine whether disease specificity resides in part or in all of the direct repeat and GC-rich region, we constructed recombinants between Friend and Moloney viruses within this segment and tested them for their disease-inducing phenotypes. We found that disease specificity, in particular the ability of Friend virus sequence to confer erythroleukemogenicity on Moloney virus, is encoded throughout the region in at least three separable segments: the 5' and 3' halves of the direct repeat and the GC-rich segment. When just one of these segments (either both 5' halves of the direct repeat, both 3' halves, or just the GC-rich segment) from Friend virus was substituted into a Moloney virus genome, it conferred only a negligible or low incidence of erythroleukemia (less than or equal to 5% to between 10 and 15%). Any two segments together were considerably more potent (35 to 95% erythroleukemia), with the most effective pair being the two halves of the direct repeat. Individual segments and pairs of segments were considerably more potent determinants when they were matched with a genome of the same origin. Thus, although sequences outside the enhancer region are minor determinants of disease specificity when the enhancer is derived entirely from either Friend or Moloney virus, they can play a significant role when the enhancer is of mixed origin. Some recombinant enhancers conferred a long latent period of disease induction. This was particularly striking when the 5' halves of each copy of the direct repeat sequence were derived from Moloney virus and the 3' halves were derived from Friend virus.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2783262 TI - Early postpartum endometritis: the role of bacteria, genital mycoplasmas, and Chlamydia trachomatis. AB - To characterize the flora of early postpartum endometritis and the clinical features of women with specific organisms, endometrial cultures for facultative and anaerobic bacteria, genital mycoplasmas, and Chlamydia trachomatis were taken with a triple-lumen sampling device. More than one organism was recovered from 80% of the women. Over 60% of the women had Gardnerella vaginalis and/or anaerobes associated with bacterial vaginosis isolated from the endometrium; these women were more likely to have severe illness and to develop a wound infection than were other women. Genital mycoplasmas were isolated frequently, but specific antibiotic therapy was not required for clinical cure in the 10% of patients who had Ureaplasma urealyticum only. Chlamydia trachomatis was infrequently isolated, but C trachomatis commonly remained after therapy. PMID- 2783263 TI - Stress-related rib and vertebral changes. AB - In the course of routine chest examination, 80 asymptomatic patients were observed to have localized hyperostosis of the posterior ribs and articulating transverse processes. The authors studied the distributions of lesions in these 80 patients, and records were reviewed in the 50 cases in which they were available. The occupational histories, male-to-female ratio (5:1), and ratio of right-to-left rib involvement (9:1)--in addition to results of electromyographic and histologic studies and the principles of bone remodeling--suggest that this hyperostosis occurs at sites most stressed with bending and rotation of the thorax. The authors hypothesize that this stress-related change occurs due to the pull of the iliocostalis thoracis muscle and is of no clinical significance. PMID- 2783264 TI - The laminar space in the diagnosis of rotational flexion injuries of the cervical spine. AB - We measured the distance between the spinolaminar line and the articular pillars of the cervical spine (the laminar space), identified on lateral radiograph, to determine the diagnostic value of changes in this measurement in cases of unilateral facet dislocation. Twenty-seven cases of unilateral facet dislocation were compared with 70 normal spines and with 29 cases of hyperflexion injuries without unilateral facet dislocation. Abrupt alteration of the laminar space between two adjacent levels was found to be an accurate measure of rotation of the spine at the levels concerned; on the basis of this alteration, we were able to correctly diagnose 23 of 27 cases of unilateral facet dislocation and 22 of 23 cases of unilateral facet dislocation between C2 and C6. In only two of the 70 normal cases was a similar alteration of the laminar space seen, and one of these was due to a previous fracture. In none of the 29 cases of hyperflexion injury without unilateral facet dislocation was there abrupt alteration of the laminar space. We conclude that abrupt alteration of the laminar space is an accurate determinant for rotational anomalies of the cervical spine and, in particular, for unilateral facet dislocation. PMID- 2783265 TI - Torsion of normal uterine adnexa before menarche: CT appearance. PMID- 2783266 TI - MR imaging of double-outlet right ventricle. PMID- 2783267 TI - Dyke award. Gd-DTPA-enhanced MR imaging of experimental bacterial meningitis: evaluation and comparison with CT. AB - Gd-DTPA-enhanced MR images of experimental bacterial meningitis were obtained after Staphylococcus aureus was inoculated directly into the cisterna magna of four dogs. Each animal was studied with both unenhanced and enhanced MR and CT with Gd-DTPA and meglumine iothalamate, respectively. The enhancement patterns resulting from these techniques were compared and images were correlated with histopathology. All animals demonstrated abnormal leptomeningeal enhancement on MR with Gd-DTPA, but only one of four dogs exhibited abnormal contrast enhancement on CT. In these animals Gd-DTPA-enhanced MR also identified complications of meningitis, such as ventriculitis and cerebritis, more effectively than CT did. Unenhanced MR was not helpful in identifying meningitis. Histologic evaluation demonstrated that the abnormal areas of contrast enhancement on MR and CT correlated with inflammatory cell infiltration. However, some regions of mild leptomeningitis, ependymitis, and cerebritis identified histologically did not demonstrate abnormal enhancement. Since the animal model used was clinically and pathologically similar to human meningitis, we propose that Gd-DTPA-enhanced MR will subsequently be found more effective than unenhanced MR and IV contrast-enhanced CT for demonstrating meningitis and its complications in humans. PMID- 2783268 TI - MR imaging of hemorrhagic intracranial neoplasms. AB - Thirty patients with intracranial tumors containing hemorrhage of varying stages were examined with high-field-strength MR imaging and CT to determine what differences might exist between hemorrhagic tumor and pure hemorrhage. Pathology was obtained in the six patients with primary tumors and in 14 of the 24 patients with metastases. Similar to evolving intraparenchymal hematomas, hemorrhagic neoplasms undergo changes in their appearance that can be categorized into three distinct intensity patterns, or stages. Stage 1 is characterized as iso- or hypointensity on short TR sequences and as hypointensity on long TR sequences; stage 2 as developing hyperintensity on both short and long TR sequences, without evidence of a well-defined black rim; and stage 3 as a hyperintense lesion with a well-defined black rim on long TR sequences. An additional mixed-intensity pattern was identified, which contained areas corresponding to more than one stage. In all of the cases exhibiting this pattern, pathology confirmed that the appearance was due to recurrent bleeding. We found several characteristics on MR that, when present, suggest an underlying neoplasm. These include delay in evolution between stages, central or eccentric hyperintensity in stage 2, and a mixed-intensity pattern. In addition, the presence of a hemosiderin rim does not exclude an underlying neoplasm. We found that the MR patterns that characterize hemorrhagic intracranial neoplasms should help to determine the cause of the hemorrhage. PMID- 2783269 TI - High-resolution MR imaging of pituitary microadenomas at 1.5 T: experience with Cushing disease. AB - The MR images of 27 patients with clinically and biochemically suspected Cushing disease were evaluated retrospectively in a blinded fashion. The MR interpretation was compared with detailed operative diagrams and operative and pathologic reports. The examinations were performed on a 1.5-T MR system with thin-section sagittal and coronal T1-weighted (short TR/TE) images. Each pituitary half was considered separately (54 "halves"). Twenty-one pituitary halves were considered to have glandular abnormalities on MR. Compared with surgical findings, 17 MR findings were true positives and four were false positives (one pars intermedia cyst, three normal tissue). Of the 33 pituitary halves considered normal on MR, 26 were true negatives and seven were false negatives. MR had an overall sensitivity of 71% and a specificity of 87% for these adrenocorticotropic hormone (ACTH)-secreting pituitary adenomas. A focal glandular hypointensity identified on coronal images was the most sensitive predictor of adenoma location. Sagittal images were not useful in either detection or localization. Upward convexity of the gland and deviation of the stalk were less useful indicators. Abnormalities of the sellar floor were the least reliable. In comparison with the capabilities of CT detection of microadenomas described in the current literature, it appears that high-field thin-section MR of the sella is the most sensitive imaging method for preoperative localization of ACTH-secreting adenomas in patients with Cushing disease. PMID- 2783270 TI - Histochemical characterization and functional significance of the hyperintense signal on MR images of the posterior pituitary. AB - MR imaging of the pituitary fossa characteristically shows a well-circumscribed area of high signal intensity in the posterior lobe on T1-weighted images. We used a combination of high-field MR, electron microscopy, and histologic techniques in experimental animals to determine whether the hyperintensity of the posterior lobe might be functionally related to hormone neurosecretory processes, and to attempt to establish its chemical nature. Histologic sections of a dog's pituitary gland processed with lipid-specific markers showed intense staining in the posterior lobe but not in the anterior lobe, thus documenting the location of fat in the posterior pituitary. Administration of vasoactive drugs known to influence vasopressin secretion to anesthetized cats produced changes in the volume of high-intensity signal in the posterior pituitary. Subsequent electron microscopy showed a significant increase in posterior lobe glial cell lipid droplets and neurosecretory granules in dehydration-stimulated cats. The data suggest that the pituitary hyperintensity represents intracellular lipid signal in the glial cell pituicytes of the posterior lobe or neurosecretory granules containing vasopressin. The volume of the signal may, in turn, reflect the functional state of hormonal release from the neurohypophysis. PMID- 2783271 TI - MR imaging of Parkinson disease with spin-echo and gradient-echo sequences. AB - High-field MR with both spin-echo and gradient-echo sequences was performed in 21 patients with (idiopathic, drug-responsive) Parkinson disease. The use of gradient echoes allowed more sensitive detection than did spin echoes of susceptibility changes in the putamina and substantia nigra. No statistically significant difference in putaminal hypointensity on long TR/long TE spin-echo sequences or on T2*-weighted images using gradient-echo sequences was observed between Parkinson patients and controls. There was also no statistically significant difference in the frequency of restoration of the signal intensity of the substantia nigra between the two groups of patients. The width of the pars compacta of the substantia nigra in patients with Parkinson disease was 2.12 + 0.82 mm (mean +/- SD). This value in age- and gender-matched controls was 2.67 +/ 0.5. Comparing these two groups with an unpaired t test resulted in a p value less than or equal to .005. Our MR study with spin-echo and gradient-echo images in Parkinson and control patients was able to substantiate and elaborate on previously described MR features of Parkinson disease. PMID- 2783272 TI - Superparamagnetic iron oxide: pharmacokinetics and toxicity. AB - The pharmacokinetics (distribution, metabolism, bioavailability, excretion) and toxicity (acute and subacute toxicity, mutagenicity) of a superparamagnetic iron oxide preparation (AMI-25), currently used in clinical trials, were evaluated by 59Fe radiotracer studies, measurements of relaxation times, the ability to reverse iron deficiency anemia, histologic examination, and laboratory parameters. One hour after administration of AMI-25 to rats (18 mumol Fe/kg; 1 mg Fe/kg), 82.6 +/- 0.3% of the administered dose was sequestered in the liver and 6.2 +/- 7.6% in the spleen. Peak concentrations of 59Fe were found in liver after 2 hr and in the spleen after 4 hr. 59Fe slowly cleared from liver (half-life, 3 days) and spleen (half-life, 4 days) and was incorporated into hemoglobin of erythrocytes in a time-dependent fashion. The half-time of the T2 effect on liver and spleen (24-48 hr) was shorter than the 59Fe clearance, indicating metabolism of AMI-25 into other forms of iron. IV administration of AMI-25 (30 mg Fe/kg) corrected iron-deficiency anemia and showed bioavailability similar to that of commercially available IV iron preparations within 7 days. No acute or subacute toxic effects were detected by histologic or serologic studies in rats or beagle dogs who received a total of 3000 mumol Fe/kg, 150 times the dose proposed for MR imaging of the liver. Our results indicate that AMI-25 is a fully biocompatible potential contrast agent for MR. PMID- 2783274 TI - The blunt needle: a new percutaneous access device. PMID- 2783273 TI - The diagnosis of splenic lymphoma by MR imaging: value of superparamagnetic iron oxide. AB - This study was designed to evaluate superparamagnetic iron oxide (AMI-25) as a contrast agent for MR to distinguish normal spleens from those diffusely infiltrated by lymphoma. As diffuse splenic involvement lacks visible tumor tissue boundaries, signal-intensity measurements of spleens were used as a diagnostic criterion in 33 patients (lymphoma, n = 8; benign splenomegaly, n = 5; normal subjects, n = 20). Unenhanced MR images were insensitive (four of eight patients) and nonspecific (20 of 25 patients) in the diagnosis of lymphoma. After injection of superparamagnetic iron oxide (40 mumol Fe/kg), lymphomatous spleens showed a significantly higher signal intensity (p less than .05) than did normal spleens or spleens enlarged by benign disease (hepatic cirrhosis, n = 4; spherocytosis, n = 1). Changes in splenic MR signal intensity unambiguously identified eight of eight lymphomatous spleens and 25 of 25 normal or enlarged spleens that did not contain lymphoma. Phagocytosis of superparamagnetic iron oxide in lymphomatous spleens is reduced because of diffuse displacement of splenic macrophages by lymphoma cells and/or by immunologic suppression of macrophage activity. Our results suggest that superparamagnetic iron oxide (AMI 25) can improve the accuracy of MR imaging in the diagnosis of splenic lymphoma. With further development, this noninvasive technique may reduce the need for diagnostic splenectomy in lymphoma patients. PMID- 2783275 TI - Industry support of radiologic journals and newsmagazines. PMID- 2783276 TI - Marketing radiology and radiologic services. PMID- 2783277 TI - An author's guide to the Guidelines for Authors. PMID- 2783278 TI - Whose turf is imaging? Professional responsibility for imaging procedures in hospital practice. PMID- 2783279 TI - The need for continued training of residents in cardiac imaging. PMID- 2783280 TI - Update on informed consent. PMID- 2783281 TI - Variations of normal glenoid labrum. PMID- 2783282 TI - Knee time in femoral arteriography. PMID- 2783283 TI - Successful transcatheter arterial embolization for the replaced right hepatic artery: a new technique using a balloon catheter and norepinephrine infusion. PMID- 2783284 TI - Versatility of the proximal Cope loop catheter. PMID- 2783285 TI - Third World medicine--tropical radiology and the problem of AIDS. PMID- 2783286 TI - Superior mediastinal widening from spine fractures mimicking aortic rupture on chest radiographs. AB - Mediastinal widening on chest radiographs associated with lower cervical and upper thoracic spine fractures can mimic the radiographic findings of aortic rupture. Frontal chest radiographs from 54 patients with traumatic fractures of at least one vertebral body from C6 to T8 were examined for signs suggestive of aortic rupture. These signs included (1) mediastinal width equal to or greater than 8 cm; (2) presence of a left apical cap; (3) a right paratracheal stripe of 5 mm or more; and (4) deviation of the nasogastric tube, when present, to the right of the T4 spinous process. Thirty-seven patients (69%) had radiographic signs suggestive of aortic rupture on the initial anteroposterior chest film. The single patient in this group who actually had an aortic rupture died in the emergency department shortly after admission. The spine fracture could be identified on the initial chest radiograph in 19 (51%) of the 37 patients. These results show that a widened mediastinum on chest radiographs after trauma is not a specific finding of aortic rupture. In these cases, the upper thoracic spine should be examined closely on the initial frontal chest radiograph for evidence of fracture. If a fracture of the upper thoracic spine is identified, an aortic rupture is unlikely in the absence of clinical signs and symptoms supporting this diagnosis. PMID- 2783287 TI - Transthoracic aspiration needle biopsy: value in the diagnosis of pulmonary infections. AB - We reviewed 441 transthoracic needle aspiration biopsies to evaluate the use of the procedure in the diagnosis of pulmonary infections. Sixty-seven (15%) of the biopsies were performed because pulmonary infection was suspected. In these 67 cases, a specific diagnosis was made in 45 (67%). In 46 cases in which infection was ultimately found to be present, aspiration biopsy identified the organism in 35 (76%). Overall, clinically useful information was obtained in 54 (81%) of the 67 biopsies performed for pulmonary infection. In 369 biopsies performed for suspected malignant neoplasm, pulmonary infection was diagnosed in 13. The only significant complication was pneumothorax, which occurred in 18% of the biopsies. Chest tube placement was required in 5% of the biopsies. We conclude that transthoracic aspiration needle biopsy is of value in the diagnosis of suspected pulmonary infections. PMID- 2783288 TI - Mammographic film-processor temperature, development time, and chemistry: effect on dose, contrast, and noise. AB - Six different combinations of film-processor temperature (33.3 degrees C, 35 degrees C), development time (22 sec, 44 sec), and chemistry (Du Pont medium contrast developer [MCD] and Kodak rapid process [RP] developer) were each evaluated by separate analyses with Hurter and Driffield curves, test images of plastic step wedges, noise variance analysis, and phantom images; each combination also was evaluated clinically. Du Pont MCD chemistry produced greater contrast than did Kodak RP chemistry. A change in temperature from 33.3 degrees C (92 degrees F) to 35 degrees C (95 degrees F) had the least effect on dose and image contrast. Temperatures of 36.7 degrees C (98 degrees F) and 38.3 degrees C (101 degrees F) also were tested with extended processing. The speed increased for 36.7 degrees C but decreased at 38.3 degrees C. Base plus fog increased, but contrast decreased for these higher temperatures. Increasing development time had the greatest effect on decreasing the dose required for equivalent film darkening when imaging BR12 breast equivalent test objects; ion chamber measurements showed a 32% reduction in dose when the development time was increased from 22 to 44 sec. Although noise variance doubled in images processed with the extended development time, diagnostic capability was not compromised. Extending the processing time for mammographic films was an effective method of dose reduction, whereas varying the processing temperature and chemicals had less effect on contrast and dose. PMID- 2783289 TI - The value of non-contrast-enhanced CT in blunt abdominal trauma. AB - The usefulness of non-contrast CT, limited to the upper abdomen, in conjunction with conventional IV contrast-enhanced scanning was studied prospectively in 190 patients who had sustained blunt abdominal trauma. In 78, visceral injuries were confirmed at surgery or at follow-up CT. Of the patients with injuries, 14 (18%) had hyperdense hematomas on the non-contrast studies that became isodense after IV administration of contrast material. These hematomas generally were small and posed an immediate threat to life in only one patient (0.5% of all subjects). In 13% of patients with injury (5% of the total), the additional information did influence treatment planning (surgery in two and intensive conservative treatment in eight). Compared with conventional contrast scanning, the combined non contrast-contrast technique increased the scanning time only by about 5 1/2 min, but it improved the sensitivity and accuracy of CT in detecting visceral injuries from 74% and 84% to 92% and 91%, respectively (p less than or equal to .003 and p less than or equal to .04). Although contrast-enhanced scanning alone accurately depicts visceral injuries requiring surgical treatment, the incorporation of a non-contrast sequence can detect a subgroup of patients who require intensive conservative management with bed rest and close observation. This additional information can be obtained expeditiously, with minimal additional effort or intervention. The use of non-contrast scanning alone is not recommended. PMID- 2783290 TI - Rectal involvement by prostatic carcinoma: barium enema findings. AB - A retrospective study was performed to determine the radiographic features of prostatic carcinoma invading the rectum on double-contrast barium enemas. In 11 such patients, these examinations revealed localized narrowing and/or speculation of the rectum (four cases); a smooth, extrinsic mass impression on the rectosigmoid colon (two cases); an umbilicated submucosal mass in the rectosigmoid colon (one case); and rectosigmoid narrowing with spiculated, pleated mucosal folds in the narrowed segment of bowel (four cases). Thus, most patients (64%) had localized involvement of the rectosigmoid colon with sparing of the distal rectum. The anatomic-pathologic basis for the localized spread of prostatic carcinoma to the rectosigmoid colon is illustrated on MR scans. Thus, prostatic carcinoma invading the rectum may be manifested on double-contrast barium enema by a spectrum of radiographic findings, and most patients have localized rectosigmoid involvement with sparing of the distal rectum. PMID- 2783291 TI - Heterotopic gastric mucosa in the duodenal bulb: relationship to peptic ulcer. AB - Heterotopic gastric mucosa in the duodenal bulb causes a characteristic radiologic abnormality consisting of multiple small, well-defined nodules in the mucosa. This finding was identified in 92 (5%) of 1873 consecutive standard biphasic barium examinations of the upper gastrointestinal tract. Of these 92, only one patient (1%) had an associated duodenal ulcer as compared with the other 1781 patients without heterotopic gastric mucosa of whom 225 (13%) had duodenal ulcers or scars (p = .002). No gastric ulcers or ulcer scars were identified in the patients with heterotopic gastric mucosa, whereas ulcers or scars were identified in 88 patients (5%) without heterotopic gastric mucosa (p = .05). These data raise the possibility that heterotopic gastric mucosa protects against peptic ulceration. PMID- 2783292 TI - Percutaneous transhepatic Oddi-sphincter dilatation for bile duct stone removal. PMID- 2783293 TI - Age-related changes of the prostate: evaluation by MR imaging. AB - The pelvic MR examinations of 40 men without known prostatic disease were reviewed retrospectively. Axial long TR/long TE images were evaluated with respect to prostatic zonal size and signal intensity. Findings were correlated with each patient's age (17-74 years). The central region of the prostate and the peripheral zone enlarged with age; the central gland increased in size by an average of 175% between the second and eighth decades and the peripheral zone increased by an average of 67%. The anterior fibromuscular stroma decreased with increasing age (from an average anteroposterior thickness of 1.2 cm in the second decade to 0.4 cm in the eighth decade) and also became thinner as a function of increasing gland size. The periprostatic venous plexus became less prominent as a function of increasing age, decreasing from 2.5 to 1.5 mm in average maximal diameter, but this venous caliber was not significantly correlated with gland size. The conspicuity of the peripheral zone with respect to the central gland was improved, both as a function of increasing age and increasing gland size, and conspicuity was greatest on long TR/long TE images because of excellent contrast resolution. We conclude that in older age groups, the zonal anatomy of the prostate is more clearly defined than in young patients, both because of morphologic changes in prostate structure and because of physiologic changes resulting in differing zonal MR signal intensities. PMID- 2783294 TI - Fluoroscopically guided pyeloureteral interventions by using a perurethral transvesical approach. AB - Using a perurethral transvesical approach, we attempted a total of 180 varied pyeloureteral uroradiologic interventional procedures during a 20-month period; 168 were successfully accomplished (93% success rate). We used standard interventional equipment, fluoroscopy, and (for access to the upper urinary tract) ureteral catheters that had been partially or completely inserted at cystoscopy by urologists. The successful procedures included insertion of double pigtail ureteral stents (42 procedures), insertion of single-pigtail ureteral stents (47), advancement of arrested or incompletely inserted retrograde ureteral catheters (42), urothelial biopsy (30), balloon dilatation of ureteral strictures (three), retrograde cannulation of ureteropelvic junction obstructions that could not be negotiated in a percutaneous antegrade fashion (three), and ureteral stone extraction (one). The method was unsuccessful in 12 patients. Failures were due to caudal migration of a ureteral catheter into the bladder in eight patients and to an inability to advance a guidewire beyond an area of ureteral obstruction or perforation in four. Although most commonly used as an adjunct to extracorporeal shock-wave lithotripsy of renal and proximal ureteral calculi, the perurethral approach was extremely valuable for a wide variety of other indications. Significant complications, encountered in 5% of the procedures, included urosepsis (two), ureteral perforations (five), and cannulation of a false ureteral lumen (two). These problems resolved without sequelae with conservative management. The perurethral transvesical approach represents a relatively simple, safe, and expeditious interventional uroradiologic method. It frequently obviated other more invasive interventions such as percutaneous nephrostomy, ureteroscopy, or surgery. PMID- 2783295 TI - Detection of coronary artery disease by dipyridamole thallium tomography in mitral valve stenosis. PMID- 2783296 TI - Prevalence of QTc prolongation in women with mitral valve prolapse. PMID- 2783297 TI - A birth cohort analysis of dental contact among elderly Americans. AB - We applied standard cohort and multiple regression techniques to data on the dental utilization rates of 129,191 elderly individuals taken from the 1972, 1973, 1976, 1977, 1980, and 1981 Health Interview Surveys. The results indicate that the marked variation in dental contact rates is a reflection of cohort succession, and not a function of aging per se. Older cohorts having lower dental contact rates are being replaced by younger cohorts having higher dental contact rates. The dental contact rates of the individual birth cohorts themselves are quite stable over time. The results also indicate that economic barriers (especially liquid assets) have become more important than ever before, especially for the oldest-old. These findings have important implications for public policy about the oral health and health care of elderly Americans. PMID- 2783298 TI - Kinetic studies of Haemophilus influenzae 6-phosphogluconate dehydrogenase. AB - Haemophilus influenzae 6-phosphogluconate dehydrogenase (6-phospho-D gluconate:NADP+ 2-oxidoreductase (decarboxylating), EC 1.1.1.44) was purified 308 fold to electrophoretic homogeneity with a 16% recovery through a five-step procedure involving salt fractionation and hydrophobic and affinity chromatography. The purified enzyme was demonstrated to be a dimer of Mr 70,000, and to catalyze a sequential reaction process. The enzyme was NADP-specific and kinetic parameters for the oxidation of 6-phosphogluconate were determined for NADP and four structural analogs of NADP. Coenzyme-competitive inhibition by adenosine derivatives was significantly enhanced by the presence of a 2' phosphoryl group consistent with the observed coenzyme specificity of the enzyme. The purified enzyme was effectively inhibited by 3-aminopyridine adenine dinucleotide phosphate, but at concentrations higher than that observed to inhibit growth of the organism. Rates of inactivation of the enzyme by N ethylmaleimide were suggestive of sulfhydryl involvement in the reaction catalyzed. PMID- 2783299 TI - False dogma about drivers with poor colour vision. PMID- 2783300 TI - Abrogation of antibody responses in rats to murine monoclonal antibody 791T/36 by treatment with daunomycin-cis-aconityl-791T/36 conjugates. AB - The majority of monoclonal antibodies in clinical use are of murine origin. It is now well-established that patients generate an antibody response to the mouse immunoglobulin which restricts repeated administration. Pre-sensitization of patients to mouse antibody is screened by hypersensitivity to i.d. administered antibody. This study shows that low doses of mouse antibody administered either i.d. or s.c. are highly immunogenic and suggests that a serological assay would be a safer method of screening for anti-mouse antibodies. Rats treated with monoclonal antibody linked via an acid labile cis-aconityl bond to daunomycin failed to produce a primary response to this conjugate. They were also rendered immunologically unresponsive to subsequent challenges with the unconjugated monoclonal antibody. The induced state of immunological unresponsiveness to free antibody persisted in the rats for 18 weeks and although antibody-cis-aconityl daunomycin pre-treated animals eventually responded to the fourth challenge with free antibody, at week 25, the response was still significantly less than in the free antibody-pre-treated and challenged animals. These studies show that the use of antibody-cis-aconityl-daunomycin conjugates may provide an approach for the control of human responses to mouse immunoglobulin. PMID- 2783301 TI - An immunotoxin for the treatment of T-acute lymphoblastic leukemic meningitis: studies in rhesus monkeys. AB - Monoclonal antibody WT1 (anti-CD7), conjugated to ricin A chain, was administered intrathecally to rhesus monkeys to test its suitability for use in the therapy of leukemic meningitis. The WT1-SMPT-dgRTA conjugate was cytotoxic to CEM (T lymphoblastic leukemia) cells in vitro with an ID50 of 53 pM. Immunoperoxidase testing showed no binding of WT1 to normal human tissues other than lymph nodes. Thirteen animals received one or more intrathecal 60-micrograms doses of WT1-SMPT dgRTA. All monkeys receiving repeated doses developed a cerebrospinal fluid (CSF) pleocytosis (primarily eosinophils), which was generally resolving by 3-4 weeks after therapy. Pharmacokinetic studies showed a half-life of 99 min, consistent with CSF clearance by bulk flow. Peak CSF immunotoxin concentrations exceeded the ID50 for CEM cells by more than 2 log units and a concentration exceeding the ID50 was maintained for as long as 24 h. All eight monkeys receiving repeated doses of immunotoxin developed serum antibodies against both WT1 and ricin A chain. In six of these monkeys antibodies were also present in the CSF. Both anti WT1 and anti-(ricin A chain) antibodies were able to inhibit in vitro cytotoxicity of the immunotoxin for CEM cells; however, only anti-WT1 antibodies could block immunotoxin binding to the cell surface. No monkey developed anti immunotoxin antibodies fewer than 7 days after the initiation of therapy, suggesting that repeated doses could be administered for up to 1 week without inhibition of clinical activity. PMID- 2783302 TI - Cytotoxicities of two disulfide-bond-linked conjugates of methotrexate with monoclonal anti-MM46 antibody. AB - In studies on (antitumor antibody)-drug conjugates as potential antitumor agents, the amide derivatives of methotrexate (MTX) with cysteine and with 2 mercaptoethylamine (cysteamine) (MTX-Cys and MTX-MEA, respectively) were linked via a disulfide bond with a monoclonal antibody (alpha MM46) to a mouse mammary tumor MM46 with attached 3-(2-pyridyldithio) propionyl groups to give conjugates of MTX with alpha MM46 (MTX-Cys-SS-alpha MM46 and MTX-MEA-SS-alpha MM46, respectively). These two conjugates are both linked by a disulfide bond and are very similar in structure, but MTX-MEA-SS-alpha MM46 showed only weak in vitro cytotoxicity against MM46 cells, whereas MTX-Cys-SS-alpha MM46 had strong cytotoxicity. The cytotoxicity of the latter was comparable to that of the conventional direct MTX-alpha MM46 conjugate prepared with an MTX-active ester. However, this conjugate had a greater selectivity than that of the direct conjugate, calculated as the IC50 (concentration of a conjugate by MTX equivalence required for suppression of the number of viable MM46 cells to 50% of that of the untreated control) for the corresponding nonspecific conjugate divided by the IC50 for the alpha MM46 conjugate. The inhibitory activities of MTX-Cys and MTX-MEA on dihydrofolate reductase were similar. The cytotoxicity of MTX-Cys-SS-alpha MM46 was not affected by thiamine pyrophosphate, an inhibitor of the active transport of MTX across the cell membrane, but was decreased significantly by ammonium chloride, a lysosomotropic amine. However, the cytotoxicity was decreased only to a small extent by leupeptin, an inhibitor of lysosomal cysteine proteases cathepsins B, H, and L. These results suggest that the cytotoxicity is mediated by lysosomes, and may involve lysosomal enzymes other than cathepsins B, H, and L. PMID- 2783303 TI - Treatment of acute Pneumocystis carinii pneumonia with corticosteroids in a patient with acquired immunodeficiency syndrome. PMID- 2783304 TI - Pulmonary infiltrates in immunocompromised patients. Diagnostic value of telescoping plugged catheter and bronchoalveolar lavage. AB - The usefulness of telescoping plugged catheter (TPC) together with bronchoalveolar lavage (BAL) in the same bronchoscopic act in the diagnosis of pulmonary infiltrates was studied in 113 fiberoptic bronchoscopic examinations performed on 96 immunocompromised patients. The TPC cultures detected pulmonary bacterial infections in 25 (22 percent) cases but showed a high frequency of false positive results (12 microorganisms, 27 percent). Bronchoalveolar lavage had an overall diagnostic yield of 49 percent (53 of 113 cases). Combining TPC and BAL diagnostic values, 78 of 113 pulmonary infiltrates (69 percent) were diagnosed. The results obtained by both techniques allowed us to modify the treatment in 35 (31 percent) cases. Combined, TPC and BAL show a good diagnostic yield in immunocompromised patients with pulmonary infiltrates. Both techniques should be performed as the first approach in the evaluation of these patients, and be done in the same bronchoscopic procedure. PMID- 2783305 TI - Diagnosis of Pneumocystis carinii pneumonia by induced sputum in a city with moderate incidence of AIDS. AB - Examination of induced sputum from AIDS patients has been reported to provide the noninvasive diagnosis of PCP in 10 to 76 percent of cases. Since previous studies were done in centers with a high incidence of AIDS, we asked whether this test could be implemented successfully in a center with a lower incidence of AIDS. Over a 13-month period 25 of 38 (66 percent) AIDS patients with PCP had positive Giemsa (Diff-Quik) stains of induced sputum. We were unable to predict before sputum induction which patients would be positive based on clinical severity (increased A-a gradient or serum LDH levels). We confirmed prior observations that a normal serum LDH level was found in only 5 percent of documented PCP cases. This noninvasive technique significantly decreased the number of bronchoscopies performed and led to a considerable cost savings. PMID- 2783306 TI - Pathogenesis of emphysema. Assessment of basic science concepts through clinical investigation. AB - It is clear that alpha 1AT deficiency leads to early onset pulmonary emphysema. With the lead provided by the deficiency state, studies aimed at the linkage between alpha 1AT and its target enzyme, neutrophil elastase, have provided useful information about the pathogenesis of emphysema due to cigarette smoking. alpha 1AT represents the predominant antielastase of the lower respiratory tract. This observation implicates neutrophil elastase as the enzyme responsible for lung destruction, since affinity studies demonstrate that alpha 1ATs physiologically relevant function is the inhibition of neutrophil elastase. However, because of the inexorably slow nature of the emphysema process, demonstration of the protease-antiprotease imbalance in the lungs of smokers has been difficult. Studies using sensitive assays for alpha 1AT function and for neutrophil elastase's presence have added new support for the protease antiprotease theory, and evaluation of related disorders such as the adult respiratory distress syndrome and cystic fibrosis have provided corraborative evidence. Finally, studies that have indicated that the major site of the protease-antiprotease imbalance is the microenvironment of protease-producing cells offer a new direction for future research into the pathogenesis of emphysema. PMID- 2783307 TI - Effect of interleukin-1 (IL-1) on thyroid hormone metabolism in mice: stimulation by IL-1 of iodothyronine 5'-deiodinating activity (type I) in the liver. AB - To elucidate the mechanism by which the low T3 and low T4 syndrome occurs in patients with infection, recombinant human interleukin-1 (IL-1) was administered to mice, and their thyroid hormone metabolism was studied. Continuous sc infusion of IL-1 alpha or IL-1 beta at a dose of 0.015-1 microgram/day for 3 days decreased food intake and serum T4, T3, and rT3 concentrations in a dose dependent manner. In pair-fed control (PFC) mice, serum T4 and T3 also decreased, but rT3 was reciprocally increased. The T3/T4 ratio was greater in IL-1-treated mice than in PFC mice. Although food intake was decreased by 65% in IL-1-treated mice (1 microgram/day) compared with that in fed control mice, type I iodothyronine 5'-deiodinating activity in liver was significantly increased compared with that in fed control mice. Furthermore, the T3 and T4 responses to TSH were greatly diminished in IL-1-treated mice. These findings suggest that IL 1 directly inhibited the effect of TSH on the thyroid gland and decreased the serum concentrations of T4 and T3, and that an increase in type I iodothyronine 5'-deiodinating activity in livers of IL-1-treated mice may account for the greater T3/T4 ratio and lower serum rT3 concentration than those in PFC mice. Since tumor necrosis factor-alpha has a similar effect, we speculate that both cytokines may be synergistically involved in the altered thyroid hormone metabolism in mice (decreased serum T4, T3, and rT3 concentrations) and hypercatabolism in a febrile state. PMID- 2783308 TI - Characterization of epidermal growth factor receptors in astrocytic glial and neuronal cells in primary culture. AB - Studies characterized the structure and function of epidermal growth factor (EGF) receptors in astrocytic glial cells and neuronal cells in primary culture from neonatal rat brain. [125I]EGF binding to membranes prepared from glial and neuronal cultures was specific and dependent on protein concentration; however, glial preparations bound 5-fold more [125I]EGF per mg protein. Unlabeled EGF competed for binding to both glial and neuronal membranes with an IC50 of 5 nM, whereas insulin, insulin-like growth factor I, and nerve growth factor failed to compete. Scatchard plot analysis of binding data for glial cells yielded a curvilinear plot with dissociation constants of 7.12 nM for high affinity and 6.2 microM for low affinity sites. The higher level of binding in glial compared to neuronal membranes reflected a greater number of binding sites rather than differences in receptor affinity. In glial membranes, [125I]EGF covalently cross linked to one major protein with a mol wt of 170,000, and EGF stimulated the phosphorylation of a 170,000 protein which was half-maximal at 20 nM. In contrast, neither covalent cross-linking nor receptor autophosphorylation could be detected in neuronal membranes. Culture of glial cells in the presence of EGF stimulated [35S]methionine incorporation into both cellular and secreted proteins, whereas no effect of EGF was observed in neuronal cultures. The addition of EGF to glial cultures produced a dose-dependent stimulation of [3H]thymidine incorporation as well as the multiplication of cells over a 6-day period. These observations show that functional EGF receptors in the neonatal brain are predominantly localized in glial cells. PMID- 2783309 TI - Effect of 24,25-dihydroxyvitamin D3 on 1,25-dihydroxyvitamin D3 [1,25-(OH)2D3] metabolism in vitamin D-deficient rats infused with 1,25-(OH)2D3. AB - Previous studies revealed that administration of 24,25-dihydroxyvitamin D3 [24,25 (OH)2D3] to calcium (Ca)-deficient rats causes a dose-dependent reduction in markedly elevated serum 1,25-(OH)2D3 level. Although the results suggested that the metabolism of 1,25-(OH)2D3 was accelerated by 24,25-(OH)2D3, those experiments could not define whether the enhanced metabolism of 1,25-(OH)2D3 played a role in the reduction in the serum 1,25-(OH)2D3 level. In the present study, in order to address this issue more specifically, serum 1,25-(OH)2D3 was maintained solely by exogenous administration through miniosmotic pumps of 1,25 (OH)2D3 into vitamin D-deficient rats. Thus, by measuring the serum 1,25-(OH)2D3 concentration, the effect of 24,25-(OH)2D3 on the MCR of 1,25-(OH)2D3 could be examined. Administration of 24,25-(OH)2D3 caused a dose-dependent enhancement in the MCR of 1,25-(OH)2D3, and 1 microgram/100 g rat.day 24,25-(OH)2D3, which elevated serum 24,25-(OH)2D3 to 8.6 +/- 1.3 ng/ml, significantly increased MCR and suppressed serum levels of 1,25-(OH)2D3. The effect of 24,25-(OH)2D3 on 1,25 (OH)2D3 metabolism developed with a rapid time course, and the recovery of iv injected [1 beta-3H]1,25-(OH)2D3 in blood was significantly reduced within 1 h. In addition, there was an increase in radioactivity in the water-soluble fraction of serum as well as in urine, suggesting that 1,25-(OH)2D3 is rapidly degraded to a water-soluble metabolite(s). Furthermore, the reduction in serum 1,25-(OH)2D3 was associated with a reduction in both serum and urinary Ca levels. Because the conversion of [3H]24,25-(OH)2D3 to [3H]1,24,25-(OH)2D3 or other metabolites was minimal in these rats, 24,25-(OH)2D3 appears to act without being converted into other metabolites. These results demonstrate that 24,25-(OH)2D3 rapidly stimulates the metabolism of 1,25-(OH)2D3 and reduces its serum level. It is suggested that 24,25-(OH)2D3 plays a role in modifying serum 1,25-(OH)2D3 concentrations by affecting the metabolism of 1,25-(OH)2D3 and may have a therapeutic values in the treatment of hypercalcemia or hypercalciuria caused by 1,25-(OH)2D3 excess. PMID- 2783310 TI - Ontogeny of expression of the corticotropin-releasing factor gene in the hypothalamic paraventricular nucleus and of the proopiomelanocortin gene in rat pituitary. AB - The ontogeny of expression of the CRF gene in the paraventricular hypothalamic nucleus and POMC gene in the pituitary was studied in rats using in situ hybridization histochemistry and Northern blotting techniques, respectively. CRF mRNA was first detected on day 17 of gestation (E17) in the paraventricular nucleus of the hypothalamus. The levels of hypothalamic CRF mRNA increased progressively from E17 to E19-E20, decreased during the perinatal period, and increased thereafter. The levels of POMC mRNA in the pituitary paralleled the variations in hypothalamic CRF mRNA, showing a peak on E20-E21. POMC mRNA levels in the anterior pituitary were decreased on days 4-7 after birth (P4-P7) and increased steadily thereafter. In contrast to levels in the anterior pituitary, POMC mRNA levels increased steadily from P1 to P21 in the neurointermediate lobe of the pituitary. These data indicate that the expression of both the CRF and POMC genes in the paraventricular nucleus and anterior pituitary, respectively, are reduced during the first week of life, i.e. within the so-called stress nonresponsive period. Our observations suggest that an impaired regulation of ACTH and CRF synthesis due to an immature neuronal pathway within the brain or increased glucocorticoid feedback may account for the stress nonresponsive period. PMID- 2783311 TI - Growth stimulation of 3T3 fibroblasts by cystatin. AB - Treatment of cultures of mouse 3T3 fibroblasts with Cystatin C, a thiol proteinase inhibitor isolated from chicken egg white, resulted in an enhanced rate of cell proliferation. This stimulation was demonstrated using two independent assay systems: (a) assessment of total cell number and (b) measurement of [3H]thymidine incorporated into acid-precipitable DNA. In both assays, the dose-response curves of Cystatin stimulation showed a rising function that plateaued at a concentration of approximately 120 micrograms/ml. The addition of Cystatin to cultures of Kirsten murine sarcoma virus-transformed 3T3 cells also enhanced DNA synthesis in these target cells. Control experiments showed that the presence of Cystatin did not alter the level of binding of radioactively labeled epidermal growth factor and platelet derived growth factor to 3T3 cells. These results argue against the possibility that the observed growth stimulation by Cystatin was due to growth factor contamination of the Cystatin preparation. PMID- 2783312 TI - Hepatic osteodystrophy. Static and dynamic bone histomorphometry and serum bone Gla-protein in 80 patients with chronic liver disease. AB - To study the pathogenesis of osteoporosis in patients with chronic liver disease, we performed dynamic bone histomorphometry and measured serum bone Gla-protein in 80 patients with various types of chronic liver disease. These results were compared with results obtained in 40 healthy controls. Mean trabecular bone volume and mean trabecular thickness were significantly reduced in both men and women with chronic liver disease (p less than 0.001 for both measurements in men and p less than 0.01 for both measurements in women). Osteoporosis as defined by histologic parameters was present in 17 (21%) patients with no significant differences in prevalence rates among the various hepatic disorders. No patient had histologic evidence of osteomalacia, although mineralization lag times were prolonged (p less than 0.01 for men and women). Bone formation rates were significantly reduced in 46 (57%) patients, and unlike the static measurements, were related to the type and severity of the underlying liver disease. Patients with alcoholic liver disease, hemochromatosis, and cholestatic liver disease had lower bone turnover rates and osteoblastic surfaces (p less than 0.001 and p less than 0.05, respectively) than patients with chronic active hepatitis. Furthermore, the presence of hepatic cirrhosis was associated with diminished bone formation and lower osteoblast surfaces. Serum bone Gla-protein levels were significantly correlated with bone formation rates and osteoblast surfaces (r = 0.585 and r = 0.434, respectively). A reduction in osteoblast surfaces has not previously been demonstrated in liver disease. This reduction and the associated impairment of osteoblastic activity may contribute to the pathogenesis of osteoporosis and can be assessed by the measurement of serum bone Gla-protein. PMID- 2783313 TI - Neonatal gut development and epidermal growth factor. PMID- 2783314 TI - Enhancement of antibacterial resistance of neutropenic, bone marrow-suppressed mice by interleukin-1 alpha. AB - The effect of recombinant human interleukin-1 alpha (IL-1) on the resistance of normal and bone marrow-suppressed mice against bacterial infection was evaluated. IL-1 induced neutrophilia and enhanced the resistance of normal mice against acute, systemic intraperitoneal infection with Klebsiella pneumoniae and methicillin-resistant Staphylococcus aureus. Mice with cyclophosphamide-induced bone marrow suppression were neutropenic and exhibited increased susceptibility to infection. Treatment of neutropenic C57BL/6 and C3H/HeJ mice with IL-1 before infection accelerated recovery of peripheral neutrophil counts and stimulated resistance against infection. Increases in neutrophils and enhancement of resistance induced by IL-1 were both dose and time dependent. Both neutrophilia and augmented resistance to infection were eliminated by a second dose of cyclophosphamide administered during the IL-1 treatments. Bone marrow-suppressed mice treated with IL-1 showed, at 4 h postinfection, greater increases in peripheral blood neutrophils and in numbers of peritoneal exudate neutrophils than suppressed mice treated with vehicle. The data suggest that the IL-1 stimulated recovery of myelopoiesis is an important factor in the enhancement of antibacterial resistance in bone marrow-suppressed, neutropenic mice. These findings indicate that IL-1 may be efficacious in limiting the duration of the neutropenia and of the increased risk for the development of bacterial infection associated with bone marrow suppression. PMID- 2783315 TI - Characteristics of bile acid-mediated Ca2+ release from permeabilized liver cells and liver microsomes. AB - Saponin-treated liver cells and a microsomal fraction were used to characterize the mechanism of the Ca2+ release induced by different bile acids. The saponin treated cells accumulated 0.8-1 nmol/mg of protein of the medium Ca2+ in a nonmitochondrial, high affinity, and inositol (1,4,5)-trisphosphate (Ins(1,4,5)P3)-sensitive Ca2+ pool. Three of five bile acids tested, lithocholate and the conjugates taurolithocholate and taurolithocholate sulfate, released 85% of the Ca2+ pool within 45-60 s and with ED50 from 16 to 28 microM. Ins(1,4,5)P3 released 80% from the same Ca2+ pool with an ED50 of 0.3 microM. The Ca2+-Mg2+ ATPase inhibitor vanadate (1 mM) had no effect on the Ca2+ released by the bile acids and Ins(1,4,5)P3. The Ins(1,4,5)P3-binding antibiotic neomycin (1 mM) and the receptor competitor heparin (16 micrograms/ml) abolished the releasing effect of Ins(1,4,5)P3 but had no effect on the bile acid-mediated Ca2+ release. The 45Ca2+ accumulated by the microsomal fraction (8 nmol of 45Ca2+/mg of protein) was released by the bile acids within 45-90 s and with an ED50 of 17 microM. In contrast, the bile acids had no effect on the Ca2+ permeability of other natural and artificial membranes. The resting 45Ca2+ influx of intact cells (0.45 nmol/mg of protein/min), the 45Ca2+ accumulated by mitochondria (2-13 nmol of 45Ca2+/mg of protein), and the 45Ca2+ trapped in sonicated phosphatidylcholine vesicles (5 mM 45Ca2+) were not altered by the different bile acids. These results suggest that the Ca2+ release initiated by lithocholate and its conjugates results from a direct action on the Ca2+ permeability of the Ins(1,4,5)P3-sensitive pool. It is not mediated by Ins(1,4,5)P3 or via activation of the Ins(1,4,5)P3 receptor, and it is specific for the membrane of the internal pool. PMID- 2783316 TI - Hormone-evoked calcium release from intracellular stores is a quantal process. AB - Ca2+ mobilization by hormones, ionomycin, and inositol 1,4,5-trisphosphate (Ins 1,4,5-P3) were studied to determine whether Ca2+ release is a continuous or a quantal process. Hormone-mediated Ca2+ release occurs only during the first 2-4 s of stimulation. Stimulation of acini with a maximal hormone concentration following stimulation with a submaximal concentration resulted in free cytosolic Ca2+ concentration ([Ca2+]i) increase and 45Ca efflux. The peak [Ca2+]i increase induced by a maximal concentration of agonist was nearly constant when cells were prestimulated with a submaximal dose for 1-15 min. Submaximal hormone concentrations release only a fraction of intracellular 45Ca2+, after which intracellular Ca2+ content remains constant. The partially released stores remain depleted until cell stimulation is terminated, at which time the stores reload with Ca2+. For comparison, increasing concentrations of ionomycin resulted in increasing rates of Ca2+ release. Each ionomycin concentration released all the Ca2+ from intracellular stores. We therefore conclude that hormone-evoked Ca2+ release is a quantal rather than a continuous process. In permeabilized cells, increasing concentrations of Ins-1,4,5-P3 resulted in an increased fraction of Ca2+ release. No submaximal Ins-1,4,5-P3 concentration was capable of releasing all the Ins-1,4,5-P3-mobilizable Ca2+. Therefore, it appears that the quantal properties of hormone-evoked Ca2+ release reflect the quantal properties of Ins 1,4,5-P3-mediated Ca2+ release from intracellular stores. PMID- 2783317 TI - Analysis of the methylation state of the T cell receptor beta chain gene in T cells and large granular lymphocytes. AB - We have evaluated the methylation state of the T cell receptor beta chain gene (TcR beta) in freshly isolated human large granular lymphocyte (LGL) and T cell DNA in order to investigate the relationship between LGL and T cells with regard to methylation of this region of genomic DNA. In addition, we wished to determine whether hypomethylation of specific regions of the beta chain gene DNA might account for the production of only a nonfunctional 1.0-kilobase (kb) TcR beta mRNA transcript in LGL. Our analysis indicates that the heterogeneous pattern of methylation seen in LGL DNA lies predominantly in the J beta 1 region of the TcR beta DNA structure. The CCGG sequences located at the beginning of the HTF island (CG-rich region) in the J beta 2 region are nonmethylated in both LGL and at least half of the T cell DNA, suggesting that the HTF island is nonmethylated in both LGL and T cell DNA. In addition, specific methylation differences between T cell and LGL DNA can be detected 0.7 kb 3' to the last exon of C beta 1, just 5' to the first exon and within the second exon of the C beta 2 region. The heterogeneous methylation state of the TcR beta J beta 1 region in LGL DNA may be due to and a result of the differential use of the J beta 1 segment for generation of the nonfunctional 1.0-kb mRNA in LGL. These results and our previous studies (Sakamoto, S., Ortaldo, J. R., and Young, H. A. (1988) J. Immunol. 140, 654-660 and Sakamoto, S., and Young, H. A. (1988) Nucleic Acid Res. 16, 2149-2163) indicate that DNA methylation may be one method by which functional gene expression is controlled in specific lymphoid cell populations. PMID- 2783318 TI - Comparison of serum placental protein hormone levels in diabetic and normal pregnancy. AB - Conflicting data exist concerning maternal serum concentrations of placental hormones during pregnancy in women with diabetes mellitus. To resolve some of these discrepancies, women participating in the NICHD-Diabetes in Early Pregnancy Study were studied. In this collaborative study, pregnancy was identified within 21 days of conception by serum hCG measurements. We prospectively collected 185 blood samples from 35 insulin-dependent diabetic women and 166 blood samples from 31 control women, all between 5 and 37 weeks gestation. Serum concentrations of hCG, pregnancy-specific beta-1-glycoprotein, placental lactogen, and hCG alpha were measured serially. The relationship between serum hormone, fasting blood glucose, 1-h postprandial blood glucose, and glycosylated hemoglobin concentrations was compared. Serum hCG alpha levels were significantly lower in the diabetic women than in control women at multiple time points during the first and second trimesters, while no consistent differences in the serum concentrations of hCG or pregnancy-specific beta-1-glycoprotein were found between pregnant diabetic and control women. Serum placental lactogen levels were significantly lower in diabetic women at 9-10 weeks and 20 weeks gestation. There were no correlations between fasting blood glucose, 1-h postprandial blood glucose, or glycosylated hemoglobin and any of the placental protein levels in the diabetic women. These data are consistent with a defect in synthesis and/or secretion of hCG alpha by the cytotrophoblast during the first two trimesters of pregnancy in insulin-requiring diabetic women. PMID- 2783319 TI - Human vascular smooth muscle cells. Target for and source of tumor necrosis factor. AB - TNF-alpha (also known as cachectin) may produce many of its important effects in vivo by actions on blood vessels. Endothelial cells are well known to respond to TNF-alpha. We investigated whether vascular smooth muscle cells (SMC), the most abundant cell type in most vessels, also respond to TNF-alpha and the related cytokine lymphotoxin (TNF-beta). Both human rTNF-alpha and beta (0.1 to 100 ng/ml) induced transient accumulation of IL-1 mRNA by adult human vascular SMC that peaked between 1 and 4 h. The inhibitor of RNA synthesis actinomycin D (1 microgram/ml) blocked the induction of IL-1 mRNA, whereas inhibition of protein synthesis with cycloheximide (1 microgram/ml) resulted in a marked "superinduction" of both IL-1 alpha and IL-1 beta mRNA species. TNF-alpha treatment also increased intracellular biologically active IL-1 and subsequent release of IL-1 activity from SMC. Metabolic labeling and immunoprecipitation with specific antibodies demonstrated de novo synthesis of IL-1 alpha and IL-1 beta precursors in TNF-treated or lymphotoxin-treated SMC. TNF-alpha also activated other SMC functions including the concentration-dependent release of PGE2 from SMC, and time-dependent induction of the gene for (2'-5') oligoadenylate synthetase, an enzyme thought to mediate the anti-viral and anti proliferative actions of IFN. We also explored whether SMC, which both produce and respond to IL-1, might also express either of the TNF genes. Bacterial LPS (10 micrograms/ml) caused slight accumulation of TNF-alpha transcripts. Incubation of SMC for 4 h with inhibitors of protein synthesis alone caused little or no elevation of TNF-alpha mRNA, but simultaneous addition of LPS ("superinduction" conditions) induced large amounts of TNF-alpha (but not TNF beta) mRNA. Cells treated with anisomycin (1 microgram/ml) and LPS, then washed to remove this reversible inhibitor of protein synthesis, released TNF-alpha into the medium, as assessed by the L929 cytotoxicity assay and by metabolic labeling and immunoprecipitation. Thus, SMC both respond to both TNF and lymphotoxin and can produce TNF-alpha, a cytokine with numerous effects on vascular cells of potential significance in the pathophysiology of septic shock and other inflammatory conditions. PMID- 2783320 TI - IL-1 and TNF transmodulate epidermal growth factor receptors by a protein kinase C-independent mechanism. AB - The effect of the human rIL-1 alpha and rTNF-alpha on the binding of 125I-labeled epidermal growth factor ([125I]EGF) to its receptor (EGF-R) has been studied in human gingival fibroblasts (HuGi). Incubation of these cells with recombinant cytokines at 37 degrees C caused a rapid, dose-dependent decrease in their ability to subsequently bind subsaturating levels of [125I]EGF at 4 degrees C. Inhibition was evident at 5 min after addition of cytokines, reached a maximal level (60-70% reduction) after 15 to 30 min, and declined thereafter. Normal EGF binding was attained by 2 h. Half-maximal inhibition of EGF binding occurred at 10 pM IL-1 and 50 pM TNF. The two cytokines were not additive in their effect. Competition experiments at 4 degrees C showed that the cytokines did not interact directly with EGF-R; Scatchard analysis of binding of [125I]EGF to HuGi after treatment with IL-1 and TNF revealed an increase in EGF-R Kd from 0.75 nM to 2.9 nM with no change in receptor number. The effect of IL-1 and TNF on EGF-R was compared with that of the tumor-promotor PMA which is known to "transmodulate" EGF-R affinity by activating protein kinase C which then phosphorylates EGF-R. PMA caused a greater inhibition of EGF binding to HuGi (80 to 85% inhibition; ED50 = 500 pM), and recovery of binding was much slower. Importantly, in HuGi made deficient in protein kinase C by prolonged incubation with PMA, addition of fresh PMA no longer affected EGF binding, while the response to IL-1 and TNF was intact. Cytokine- but not PMA-mediated EGF-R transmodulation was partially reversed by treatment of the cells with millimolar concentrations of the kinase inhibitor amiloride. HuGi were incubated with H3 32PO4, stimulated with PMA or cytokines, and EGF-R were immunoprecipitated; IL-1 and TNF, like PMA, caused a 2- to 5-fold increase in receptor phosphorylation. We conclude that occupation of IL 1 and TNF-R activates a protein kinase, distinct from kinase C, for which EGF-R is a substrate. PMID- 2783321 TI - Bacterial lipopolysaccharide and inflammatory mediators augment IL-6 secretion by human endothelial cells. AB - The interaction between human endothelial cells and leukocytes during immunologic and inflammatory responses is in part mediated through the release of soluble mediators. We report that cultured human umbilical vein endothelial cells secrete IL-6 when stimulated with LPS. This effect was inhibited by polymyxin-B. The monokines IL-1 and TNF-alpha were also potent inducers of IL-6, whereas lymphotoxin was only effective at much higher concentrations. Endothelial cell supernatant IL-6 was active as hybridoma-plasmacytoma growth factor and as B-cell stimulating factor. Endothelial IL-6 activity was neutralized by a specific anti IL-6 antibody and by immunoprecipitation it was shown to be identical in size to human fibroblast-derived IL-6. As IL-6 is possibly an important regulator of host defense responses, production of this cytokine by endothelial cells may contribute to the pathogenesis of various inflammatory and immunologic diseases. PMID- 2783322 TI - IL-3 and stromal cell-derived factor synergistically stimulate the growth of pre B cell lines cloned from long-term lymphoid bone marrow cultures. AB - The addition of IL-3 to modified Whitlock-Witte long-term lymphocyte cultures was found to enhance the growth of a small but significant number of B cell precursors supported by an adherent stromal cell monolayer. Several pre-B cell lines were cloned from IL-3-treated long-term lymphocyte cultures. The growth requirements and physical properties of one representative clone, BL/3, are described. BL/3 cells were shown to be unresponsive to IL-3 except when it is used at very high concentrations. In contrast, significant growth was stimulated by stromal cell conditioned medium previously shown to contain a pre-B cell growth factor. Optimal growth of the pre-B cell clone was stimulated by stromal cell conditioned medium plus IL-3. Synergy between the stromal cell-derived factor and IL-3 occurred when IL-3 was used over a wide range of concentrations including a relatively low amount that was ineffective as a growth stimulus by itself. The finding that more than one factor is required to sustain optimal growth of some pre-B cells parallels the complex growth requirements reported for some primitive myeloid/erythroid progenitors. PMID- 2783323 TI - Absence of induction of IL-1 production in human monocytes by complement fragments. AB - The ability of C fragments to induce IL-1 production in human monocytes was examined by using various approaches to carefully exclude the role of contaminating endotoxin. The presence of IL-1 activity in monocyte supernatants and lysates was assayed by the augmentation of PHA-induced proliferation of murine thymocytes. SRBC were opsonized with IgM rabbit antibodies and various human C components to prepare EAC reagents that contained less than 25 pg LPS/ml of EAC at 5 x 10(8) cells/ml. EAC1q, EAC4b, EAC4b2aoxy, EAC4b2aoxy C3b, EAC4b2aoxyC3bi, and EAC4b2aoxyC3d all failed to induce IL-1 production when incubated at 10- to 100-fold excess with adherent human monocytes. Similarly, LPS free purified C3a, C5a, and C5a des Arg all showed no IL-1-inducing activities at concentrations up to 25 micrograms/ml. However, the same C5a preparations were active on human monocytes in the induction of chemotaxis, and C3a and C5a both induced skin-blueing in guinea pigs. Fragment Ba and Bb preparations purified by gel filtration chromatography contained approximately 100 pg LPS/micrograms Ba or Bb. These Ba and Bb preparations at 10 and 50 micrograms/ml, respectively, induced IL-1 production in the presence of 5 micrograms/ml polymyxin B (PMB). However, Ba and Bb preparations purified by affinity chromatography and HPLC contained lower levels of endotoxin contamination and displayed IL-1-inducing activities at Ba and Bb concentrations of 50 and 100 micrograms/ml, respectively, that were almost completely inhibited by PMB. To explore further the role of contaminating endotoxin, a Bb preparation was adsorbed with PMB-4B in the presence of a dialyzable detergent to remove LPS bound to the Bb. This LPS-free Bb preparation failed to induce IL-1 production while maintaining intact enzymatic activities. These results indicate that various solid phase or soluble C fragments, including C3b, iC3b, C3d, C3a, C5a, Ba or Bb do not induce IL-1 production in human monocytes in the absence of contaminating endotoxin. PMID- 2783324 TI - Cellular basis of immunomodulation by cholera toxin in vitro with possible association to the adjuvant function in vivo. AB - Cholera toxin (CT) is a potent oral immunogen that also acts as a strong mucosal adjuvant for immune responses to related as well as unrelated Ag. To elucidate the immunomodulating effects of CT at the cellular level we have examined interactions of CT with APC and with B and T lymphocytes in vitro. CT markedly stimulated the production of IL-1 from APC (mouse peritoneal macrophages or macrophage cell line P388D1) but did not induce Ia-Ag and had marginal, if any, effect in potentiating Ia Ag expression stimulated by rIFN-gamma on these cells. CT had differential effect on T cell proliferation in vitro, usually strongly inhibitory but on Con A-stimulated spleen cells during prolonged (greater than or equal to 5 days) culture or when added on day 4 or later to these cultures up to a two- to three-fold enhancement of proliferation was seen. CT-induced inhibition of T cell proliferation was associated with decreased production of IL-2 and anergy to exogenously added IL-2 despite apparently normal expression of IL-2R. Similar to what was found with T cells LPS-stimulated spleen B cells demonstrated both inhibition and enhancement of proliferation in the presence of CT: in high concentrations (greater than or equal to 10(-8) M) and early in culture (day 3) CT had a strong inhibitory effect on the proliferation of B cells, whereas later (day 6) and/or at lower CT concentrations (10(-9) to 10(-11) M) the proliferation was increased up to 10-fold. The net effect of CT treatment on Ig-production by LPS-stimulated spleen B cells was seen as an enhanced level of IgA and IgG but not IgM in culture supernatants. The differential effects of CT on the cells of the immune system observed in vitro may, singly or in combination, explain the immunostimulatory function of CT. PMID- 2783325 TI - Idiotype variants emerging after anti-idiotype monoclonal antibody therapy of a murine B cell lymphoma. AB - One of the difficulties encountered with the treatment of human B cell malignancies with anti-Id antibodies is the emergence of Id variants. The current study was designed to investigate this phenomenon further by using the murine B cell lymphoma model 38C13. Tumors were harvested that developed despite treatment with the anti-Id antibody S1C5 in mice inoculated with 38C13 cells and evaluated by immunofluorescence. Various phenotypes were found among escaping tumor cells. Some cells continued to react with S1C5 whereas others lost S1C5 reactivity. Among these latter cells, some continued to express surface IgM kappa, whereas others no longer expressed surface mu or kappa. After Id variant cell lines were established, immunofluorescence and ELISA of cell lysates from the surface IgM kappa- lines revealed persistent intracellular mu H chain but no detectable kappa. Surface IgM kappa+ lines were fused with myeloma cells and the Ig proteins secreted by the resultant hybridomas analyzed. The apparent m.w. of the mu-chains of these rescued Ig was the same as wild-type 38C13, whereas the kappa-chains were either the same or different in m.w. from the wild type. The IgM kappa of the variant line, T3C, weakly reacted with S1C5 and did not react with other anti Id antibodies. The IgM kappa of the other variants were nonreactive with all the antibodies. Immunofluorescence of these surface Ig+ variants confirmed this finding. Some of the surface Ig+ and Ig- variant lines grew identically to wild type tumor in vivo, but only the weakly S1C5-reactive variant T3C was inhibited in its growth by S1C5. Moreover, T3C was the only one of these lines capable of being lysed in vitro with S1C5 by antibody-dependent cellular cytotoxicity. Further studies revealed that surface Ig+ and Ig- variants emerge in escaping tumors with similar frequency and that these variants represent a major mode of tumor escape from anti-Id treatment in this model. PMID- 2783326 TI - Precursor immigration and thymocyte succession during larval development and metamorphosis in Xenopus. AB - The developing thymus in Xenopus was examined at four different levels: 1) precursor immigration of cytogenetically distinct embryonic stem cells; 2) waves of colonization during tadpole life and metamorphosis; 3) inter-thymic exchange of cells between separate lobes; and 4) development of cortical and medullary thymocytes. Based on the flow cytometric analysis of cytogenetically distinct thymocytes, there were at least two periods of stem cell immigration into the thymus, one during early larval life and the second before or during metamorphosis. Within the thymus, cohorts of cells derived from the first wave of immigration expanded at different times. The initial expansion occurred before 35 days of development. Cells involved in the second period of expansion were also derived from the initial immigrants, expanded after 35 days, and resulted in a turnover of thymocytes during the larval period. Precursor cells entering the thymus during metamorphosis expanded and resulted in an additional replacement of thymocytes. Cortical and medullary thymocytes were isolated from animals that received embryonic stem cell grafts. No differences in the presence or absence, or in the percentages, of donor thymocytes in these different fractions were observed. When limiting numbers of stem cells were transplanted, several cases of asymmetrical thymic lobe colonization were observed. These data suggested that an inter-thymic exchange of cells did not occur during larval life. PMID- 2783327 TI - The expression of T cell receptor-associated proteins during T cell ontogeny in man. AB - The expression of TCR-associated molecules was examined in human fetal and postnatal tissues. From gestational wk 7 onward in the fetal liver, putative prothymocytes have been identified with cytoplasmic CD3 positivity (cCD3+). These immature cells are TdT- and do not express membrane CD3 (mCD3-) or TCR beta identified by beta F1, but show CD7 and CD45 positivity without CD1, CD2, CD5, CD4, CD8, CD10, and class II Ag. Their high proliferative activity is indicated by greater than 85% Ki67 positivity. After the 10th wk, beta F1+, mCD3+ cells also appear in the liver and these are mostly Ki67- but no TCR gamma delta bearing cells can be identified at such an early stage of extrathymic development. In the mCD3- TdT-fetal thymus (10 1/2 to 18th wk) cCD3+, mCD3- CD1 blasts proliferate (Ki67+) and lack TCR-beta or TCR-gamma delta. The TdT-, CD1+ cortical thymocytes develop into TCR-beta + and WT31-positive (TCR-alpha beta +) cells. Subsequently TdT-positive thymocytes become detectable around 19 to 20 wk, and in such glands the peak of proliferative activity is seen among TdT+, cCD3+ cells which appear to acquire, in a regular sequence, cytoplasmic beta F1 (TCR beta), mCD3, and TCR-alpha beta (WT31 positivity) together with the loss of TdT and Ki67 positivity. A newly described transitional population of cells is TdT-, beta F1+ but exhibits no detectable WT31 positivity. These cells correspond to the CD1+, mCD3+ thymocytes and are probably the targets of thymic selection. The cells of the TCR-gamma delta lineage, detected by mAb TCR-delta-1 and delta TCS1, are rare (0.02 to 0.5%) among thymocytes from gestational wk 10 1/2 onward through the whole span of thymic development, but these cells include a proportion (18 to 59%) of cells expressing CD1 Ag, suggesting that these TCR gamma delta cells differentiate in the thymus. Among the CD1+, TCR-gamma delta + thymocytes, no TdT positivity can be detected. PMID- 2783328 TI - Modulation of IL-2-induced human B cell proliferation in the presence of human 50 kDa B cell growth factor and IL-4. AB - Several human T cell derived factors capable of stimulating human B cells to synthesize DNA have been previously described. One such factor exhibits an apparent m.w. of 50,000 Da and has been termed 50-kDa-B cell growth factor (BCGF). In this report, we show that a human B cell proliferation pathway based on the sequential action of anti-mu antibody, 50-kDa-BCGF and IL-2 is inhibited in the presence of human rIL-4. Although IL-4 itself is capable of triggering B cell DNA synthesis as measured at 72 h, this lymphokine inhibits, in a dose related manner, the 50-kDa-BCGF driven response of B cells to IL-2 when such proliferation is determined after 144 h. This inhibition takes place at an early step of the B cell activation and does not require the presence of IL-4 during the whole culture period. Such inhibitory activity of IL-4 is specific to the IL 2-induced B cell proliferation because DNA synthesis measured in the presence of semi-purified human 12-kDa-BCGF is not affected by the presence of IL-4. Our results suggest that a particular pathway of human B cell activation leading to the proliferation of these cells in the presence of IL-2 could be either up- or down-modulated by 50-kDa-BCGF and IL-4, respectively. PMID- 2783329 TI - Differentiation of beta-lactamase variants of Staphylococcus aureus by substrate hydrolysis profiles. PMID- 2783330 TI - Plasminogen activator and plasminogen activator inhibitor activities in men with coronary artery disease. AB - Although elevated levels of plasminogen activator inhibitor-1 (PAI-1) have been associated with the development of myocardial infarction, the correlation between the presence of coronary artery disease and increased levels of PAI-1 is controversial. The present study evaluated the association between angiographically-documented coronary artery disease and plasma levels of PAI-1 and tissue-type plasminogen activator (t-PA) in 65 men (ages 35 to 65 years) who had no previous history of myocardial infarction, angioplasty, or other medical illnesses. PAI-1 activity in these 65 patients was inversely correlated with t-PA activity, which was measured before and after venous occlusion. PAI-1 activity correlated positively with levels of triglycerides. There was a significant negative correlation between PAI-1 activity and levels of high-density lipoprotein. Each patient was placed in one of five groups according to the severity of coronary atherosclerosis, which ranged from normal vessels (group I) to greater than 50% occlusion of three vessels (group V). There were no significant differences among the five groups with respect to mean activity of PAI-1 (p = 0.98) or t-PA activity measured before venous occlusion (p = 0.22) or after occlusion (p = 0.70). T-PA and PAI-1 activities in these five groups were not different from those in 35 healthy men. These data indicate that there is no association between activities of PAI-1 or t-PA and coronary artery disease in this well-characterized male population. PMID- 2783331 TI - Molecular genetic analysis of 178 I-Abm12-reactive T cells. AB - We have studied the genetic diversity of the TCR repertoire to the murine alloantigen I-Abm12 by generating a panel of 178 C57BL/10-derived I-Abm12 reactive T cell hybridomas. The expression of V alpha and V beta gene families was examined in this panel and the frequency of expression of V beta, but not ofV alpha, gene families differed significantly from that observed in a companion panel of random C57BL/10-derived hybridomas. The V beta 5 gene family was expressed significantly less frequently while the V beta 14, V beta 15, and V beta 16 genes were expressed significantly more frequently in the panel of I Abm12-reactive than in the panel of random hybridomas. The junctional regions (VJ alpha and VDJ beta) of TCR V alpha and V beta genes from selected I-Abm12 specific hybridomas were amplified using the polymerase chain reaction, and directly sequenced. Surprisingly, no conserved J alpha, D beta, J beta, or N region-encoded sequences among these selected I-Abm12-reactive TCRs were identified. Thus, the T cell response to an I-A alloantigen that differs by only three amino acid residues from the I-A molecule of the responding strain is genetically complex but nonrandom. We have estimated that the repertoire to this alloantigen is comprised of at least 37 different TCRs. PMID- 2783332 TI - Toxicity and therapeutic efficacy of high-dose interleukin 2. In vivo infusion of antibody to NK-1.1 attenuates toxicity without compromising efficacy against murine leukemia. AB - In the current study we used the therapy of established murine leukemia to identify the lymphocyte subsets responsible for toxicity and for therapeutic efficacy of high-dose IL-2. Initial results confirmed that high-dose IL-2 induces marked proliferation of a variety of host cells, including NK cells, Lyt-2+ T cells, L3T4+ T cells, and B cells. Infusion of antibody to NK-1.1 depleted NK 1.1+ cells in vivo and greatly reduced the toxicity of IL-2, but did not decrease therapeutic efficacy. By marked contrast, depletion of host T cells, either Lyt 2+ or L3T4+, had no effect on toxicity but greatly reduced therapeutic efficacy. The requirement for host T cells for the curative effect of IL-2 gives credence to the possibility that substantial efficacy of high-dose IL-2 against established malignancy may require existent host antitumor immunity. Since the human tumors that have been shown to have the most substantial responses to IL-2 (i.e., malignant melanoma and renal cell carcinoma) are those long considered to be immunogenic in the autochthonous host, the current study predicts that for these, as well as other immunogenic human tumors, it should be possible to decrease the toxicity and thus increase the therapeutic index of IL-2 by selectively depleting NK cells in vivo. PMID- 2783333 TI - Human eosinophils express CD4 protein and bind human immunodeficiency virus 1 gp120. AB - The CD4 glycoprotein, expressed on leukocytes belonging to subsets of T lymphocytes and to cells of monocyte/macrophage lineage, participates in the functioning of T cells and serves as a receptor for HIV-1 and HIV-2. Human eosinophils, a class of granulocytic leukocytes, have been found to express CD4. With anti-CD4 mAbs CD4 was demonstrable on eosinophils from both normal and eosinophilic donors. Eosinophils synthesized a 55-kD CD4 polypeptide immunoprecipitable with two anti-CD4 mAbs. Eosinophil CD4 bound HIV-1 gp120 as assessed by competition for anti-OKT4A, but not anti-OKT4, mAb binding. Eosinophils, normally rich in gastrointestinal and genitourinary tract tissues, increase in numbers in patients with metazoan parasitic infections. In these sites and diseases, CD4 expression by eosinophils may be pertinent to their immunologic functions and could make these cells susceptible to HIV infection. PMID- 2783334 TI - The complex pattern of cytokines in serum from patients with meningococcal septic shock. Association between interleukin 6, interleukin 1, and fatal outcome. AB - Serum samples from patients with meningococcal disease were examined for the presence of IL-6, TNF-alpha, and LPS. Median serum concentration of IL-6 was 1,000 times higher in patients with septic shock (189 ng/ml) than in patients with bacteriaemia, meningitis, or combined septic shock and meningitis. 11 of 21 patients with serum levels greater than 3.0 ng/ml died, whereas all 58 patients with serum levels at less than or equal to 3.0 ng/ml, survived. All four patients with serum IL-6 levels greater than 750 ng/ml, died. IL-1 was detected in serum from three patients who also had high serum levels of IL-6, TNF-alpha, and LPS, and rapidly fatal courses. IL-6 appeared to be released into serum later than TNF alpha, and was detected in serum for up to 36 h. The half-life of IL-6 and TNF alpha was calculated to be 103 +/- 27 min and 70 +/- 11 min, respectively. These data indicate that a complex pattern of cytokines exists in serum from patients with meningococcal septic shock, and that the release of IL-6 and IL-1, in addition to TNF-alpha, is associated with fatal outcome. PMID- 2783335 TI - Establishment of two interleukin 6 (B cell stimulatory factor 2/interferon beta 2)-dependent human bone marrow-derived myeloma cell lines. AB - Two IL-6-dependent human multiple myeloma cell lines, ILKM2 and ILKM3, were established from the bone marrow of patients with IgG-K multiple myeloma. Both cell lines had the typical morphology and immunocytochemical features of myeloma cells. The surface phenotype of both cell lines was PCA-1+, OKT10+, CD10(J-5)-, CD19(B4)-, CD20(B1)-, CD21(B2)-, and OKIa-1-. A monoclonal cytoplasmic Ig, IgG-K or K L chain, was positive in ILKM2 or ILKM3, respectively. EBV nuclear antigen was negative in both cell lines. They proliferated in the presence of macrophages or macrophage-derived factors (MDF). Among the recombinant cytokines examined, IL 6 most strongly augmented the growth of both cell lines. The anti-IL-6 antibody completely inhibited the IL-6-dependent growth and almost completely inhibited the MDF- or purified MDF-dependent growth of both cell lines, ILKM2 and ILKM3 are now being maintained in the culture medium containing 2 ng/ml rIL-6. These results suggest that IL-6 produced by macrophages may play an important role in the growth of myeloma cells in vivo and that macrophages or IL-6 can be used for establishing human myeloma cell lines. PMID- 2783337 TI - Interleukin-2 therapy of human cancer: potential benefits versus toxicity. PMID- 2783336 TI - A monoclonal antibody to a constant determinant of the rat T cell antigen receptor that induces T cell activation. Differential reactivity with subsets of immature and mature T lymphocytes. AB - mAb R73 detects a T cell-specific surface molecule consisting of two disulfide linked subunits of 40 and 46 kD, respectively, on 97% of peripheral rat T cells, as defined by the OX-52 marker. Of the few OX-52+ R73- cells, none are CD4+ but many express the CD8 antigen known to be present on rat NK cells. mAb R73 is mitogenic for unseparated spleen cells and for purified T cells. In the absence of non-T "accessory cells", stimulation by R73 requires artificial crosslinking of the mAb and is largely dependent on exogenous IL-2. Overnight incubation of purified T cells with crosslinked R73 mAb induces blastoid transformation, IL-2-R expression, and modulation of the R73 antigen. In the rat thymus, mature medullary cells express the R73 determinant at the same level as peripheral T cells, whereas 94% of CD4-CD8- thymocytes are R73-. The major CD4+8+ thymocyte population contains 25% R73- and 70% R73low cells. Thymocytes of the CD4-CD8+OX 44- subpopulation that are the direct precursors of CD4+CD8+ cells display a continuum of R73 antigen density from undetectable to very low levels. We conclude that R73 is most likely directed at a constant determinant of the rat alpha/beta heterodimeric TCR and suggest that CD8+ immature thymocytes are the first cells in the T cell differentiation pathway to express this molecule at their surface. PMID- 2783338 TI - Cardiorespiratory effects of immunotherapy with interleukin-2. AB - The administration of interleukin 2 (IL-2) and lymphokine-activated killer (LAK) cells can mediate the regression of cancer. Treatment with IL-2 is associated with significant cardiorespiratory effects, as well as a leaky capillary syndrome requiring careful fluid management. A mild reversible depression of cardiac function is also associated with IL-2 treatment. All patients treated with recombinant IL-2 alone, with transfer of LAK cells, or with cyclophosphamide between December 1984 and September 1987 (total of 423 treatment courses in 317 total patients) were evaluated as to the development of significant cardiorespiratory toxicity. Of the 423 treatment courses, only 1.8% were associated with severe peripheral edema and only 2.8% and 3.1% respectively, were associated with significant ascites or pleural effusions. Thirty-nine of 423 patients (9.2%) had severe respiratory distress and 27 patients required intubation (6.4%). Cardiovascular effects included tachycardia and hypotension requiring vasopressor administration in 65% and intravenous (IV) fluid administration. Weight gain greater than or equal to 10% of body weight was noted in 32% of the 423 patients. Arrhythmias were primarily supraventricular (9.7%) and responded well to conventional medical treatments. Angina or ischemic changes were noted in 2.6% of patients and myocardial infarction in 1.2%. IL-2 caused peripheral vasodilation, with a significant decrease in peripheral vascular resistance (2,254 +/- 398 v 1,303 +/- 351 dyne.s.cm-5, P less than .0001), and an increase in heart rate (66.2 +/- 10 v 104.3 +/- 9.6 beats/min, P less than .0001). There was also evidence of mild cardiac dysfunction, with a significant decrease in the left ventricular stroke work (LVSW) index (P less than .0001) and ejection fraction (LVEF) (from 58% +/- 10% to 52% +/- 9%, P less than .03). A repeat LVEF performed after 1 to 3 months, had returned to baseline values (60% +/- 10%). A mean 64% increase in the rate of disappearance of radioactive iodine (125I) albumin (P less than .05) consistent with the development of a leaky capillary syndrome was noted. Patients with underlying cardiorespiratory diseases may be at greater risk during IL-2 administration and should not be selected to undergo this treatment. PMID- 2783339 TI - Phase II trial of outpatient interleukin-2 in malignant lymphoma, chronic lymphocytic leukemia, and selected solid tumors. AB - High-dose interleukin-2 (IL-2) with or without lymphokine-activated killer (LAK) cells has been reported to have activity in certain solid tumors, but toxicity has usually required hospitalization for administration. The purpose of this trial was to determine the antineoplastic effect and toxicity of IL-2 administered at a lower dose in an outpatient setting. Eligibility criteria included measurable disease, Karnofsky performance greater than or equal to 70%, age greater than 18 years, and adequate bone marrow, renal, and hepatic function. The median age of 35 patients was 56 years (range, 20 to 75). Diagnoses included malignant lymphoma (ML), (nine patients), chronic lymphocytic leukemia (CLL) (eight), melanoma (eight), colorectal cancer (six), renal cancer (two), and breast cancer (two). The initial 18 patients were treated with 1 mg/m2 (3 x 10(6) U/m2 intravenous [IV] bolus) for five days every other week for a total of 4 treatment weeks (8 weeks total). The subsequent 17 patients were treated with 0.5 mg/m2 (1.5 x 10(6) U/m2). All patients were evaluable for toxicity, and 26 for tumor response. Toxicities included fatigue (71%), nausea (69%), hypotension (54%), fever (51%), chills (40%), weight gain (37%), pruritus or rash (31%), dyspnea (14%), azotemia (6%), confusion (6%), thrombocytopenia (6%), and myocardial infarction (3%). Four patients died from apparently unrelated causes within the first 2 weeks of treatment. Treatment was discontinued before the completion of 8 weeks of treatment because of progressive disease (12 patients), severe hypotension (three), azotemia (one), myocardial infarction (one), early death (four), and miscellaneous causes (two). IL-2 at 1 mg/m2 IV for five days is associated with moderate toxicity, but a dose of 0.5 mg/m2 is tolerable for outpatient administration. Three partial responses (PR) and one minor response (MR) lasting 1 to 17+ months have been observed in 12 patients with ML and CLL evaluable for response. One additional MR was observed in a patient with melanoma. IL-2 deserves further study in patients with ML and CLL. PMID- 2783340 TI - Release of endothelium-derived relaxing factor after subarachnoid hemorrhage. AB - The purpose of this study was to determine the cause of the loss of endothelium dependent relaxation observed in chronic cerebral vasospasm. A bioassay system was developed to measure the release of endothelium-derived relaxing factor (EDRF) from canine basilar arteries. Subarachnoid hemorrhage (SAH) was induced in dogs by two injections of autologous blood into the cisterna magna. Angiograms were performed on the 7th day after SAH to check the presence of chronic vasospasm. The animals were sacrificed on the 8th day, and in vitro experiments were performed on rings harvested from the basilar artery. These confirmed loss of endothelium-dependent relaxation in response to bradykinin and arginine vasopressin in the group with SAH. The basilar arteries were perfused with modified Krebs-Ringer solution. The perfusate was bioassayed with a ring of coronary artery without endothelium (bioassay ring). The release of the EDRF was detected by relaxation of the bioassay ring contracted with prostaglandin F2 alpha. Arginine vasopressin and bradykinin added to the perfusate upstream of the basilar artery caused concentration-dependent release of the EDRF. The direct effect of these peptides on the smooth muscle of the bioassay ring was to cause contraction. The release of the EDRF was identical in basilar arteries from the control and the SAH groups. These results indicate that the release of the EDRF is not impaired during chronic vasospasm, and thus that the loss of the endothelium-dependent relaxation is due to a decreased transfer of the EDRF or a reduced responsiveness of the smooth muscle to the factor. PMID- 2783341 TI - Intraventricular arachnoid cyst. PMID- 2783342 TI - Clinical results of extracranial-intracranial bypass surgery in patients with hemodynamic cerebrovascular disease. AB - The importance of hemodynamic factors in the pathogenesis and treatment of cerebrovascular disease remains uncertain. The extracranial-intracranial (EC-IC) bypass trial has been criticized for failing to identify and separately analyze those patients with chronic reduction in regional cerebral perfusion pressure (rCPP) who might be most likely to benefit from surgery. Positron emission tomography (PET) measurements of regional cerebral blood flow (rCBF) and blood volume (rCBV) were performed on 29 patients with symptomatic occlusion or intracranial stenosis of the carotid arterial system prior to undergoing EC-IC bypass surgery. Twenty-four patients had evidence of reduced rCPP (increased rCBV/rCBF ratio) distal to the arterial lesion. Of 21 patients who survived surgery without stroke, three suffered ipsilateral ischemic strokes during the 1st postoperative year. A nonrandomized control group of 23 nonsurgical patients' with similar clinical, arteriographic, and PET characteristics experienced no ipsilateral ischemic strokes during the 1st year following PET. Based on these results in 44 patients, the probability that successful surgery reduces the occurrence of ipsilateral ischemic stroke 1 year later was calculated. This probability ranged from 0.045 for a 50% reduction to 0.168 for a 10% reduction. Thus, there was little evidence to suggest that measurements of cerebral hemodynamics can identify a group of patients who would benefit from EC-IC bypass surgery. PMID- 2783343 TI - The effect of interleukin-2 on the blood-brain barrier in the 9L gliosarcoma rat model. AB - Carbon-14-labeled aminoisobutyric acid was used to determine local blood-to tissue transfer constants in 22 Fischer rats with intracerebral 9L gliosarcomas that received either high-dose parenteral interleukin-2 (IL-2) or a control injection. In tumor and peritumoral tissue, the transfer constants in the IL-2 treated animals (89.6 +/- 14.6 and 35.8 +/- 6.0, respectively, mean +/- standard error of the mean) were larger (p less than 0.05) than in control animals (61.4 +/- 6.4 and 14.6 +/- 2.2, respectively). In contrast, in normal frontal and occipital tissue contralateral to the tumor-bearing hemisphere, there was no significant difference between the transfer constants in IL-2-treated and control animals. Furthermore, treatment of animals with IL-2 excipient caused no change in permeability as compared to animals treated with Hanks' balanced salt solution. Parenteral injection of IL-2 increases blood-brain barrier disruption in tumor-bearing rat brain but does not increase the vascular permeability of normal brain. Methods to prevent this increased tumor vessel permeability are required before parenteral IL-2 can be used safely for the treatment of primary or metastatic brain tumors. PMID- 2783344 TI - Raynaud syndrome in childhood. AB - Twenty-seven patients with Raynaud syndrome (mean age at onset 11.7 years) were studied to determine the prevalence of primary Raynaud syndrome and to assess the predictive role of antinuclear antibody, nail-fold capillary microscopy, and photoelectric plethysmography in this population. Fourteen patients (52%) had a connective tissue disease, four (15%) had a probable connective tissue disease, and nine (33%) had primary Raynaud syndrome. In all patients with either a connective tissue disease or a probable connective tissue disease, there was a positive reaction to antinuclear antibody, in contrast to patients with primary Raynaud syndrome, in whom antinuclear antibody was not detected. Nail-fold capillary microscopy scores differed significantly between patients with either a connective tissue disease or a probable connective tissue disease and those with primary Raynaud syndrome for both enlarged loop score (p less than 0.025 and less than 0.05, respectively) and avascular score (p less than 0.005 and less than 0.01, respectively). Photoelectric plethysmography scores were reduced in all groups but did not differ significantly between groups. Our findings suggest that in children with Raynaud syndrome, the primary type is more common than was originally suspected, and that both antinuclear antibody and nail-fold capillary microscopy, but not photoelectric plethysmography, can distinguish patients with primary Raynaud syndrome from those with either a connective tissue disease or a probable connective tissue disease. PMID- 2783346 TI - Clinical manifestations of vaginal trichomoniasis. AB - Trichomonas vaginalis was detected by culture or wet-mount examination in 118 (15%) of 779 randomly selected women attending a sexually transmitted disease clinic. Vaginal trichomoniasis was significantly associated with symptoms of yellow discharge, abnormal vaginal odor, and vulvar itching and with signs of colpitis macularis ("strawberry cervix"), purulent vaginal discharge, and vaginal and vulvar erythema. A logistic regression model was used to adjust for coinfections, as well as for demographic, behavioral, and other possible confounding variables. Trichomonas vaginalis remained significantly associated with symptoms of yellow vaginal discharge (odds ratio [OR] = 2.4) and vulvar itching (OR = 3.0) and with signs of colpitis macularis (OR = 241), purulent vaginal discharge (OR = 8.0), vulvar erythema (OR = 2.5), and vaginal erythema (OR = 4.3). The sensitivity of symptoms and signs associated with trichomoniasis was relatively low. Nevertheless, clinical manifestations can be used to identify those patients for whom a wet-mount examination would likely have high yield. Careful clinical examination and selective use of wet-mount examination together with wider use of more sensitive tests for subclinical infection, such as culture or direct immunofluorescent staining of vaginal fluid, could lead to improved detection and control of this infection. PMID- 2783345 TI - Protective levels of serum antibodies stimulated in infants by two injections of Haemophilus influenzae type b capsular polysaccharide-tetanus toxoid conjugate. PMID- 2783347 TI - Acute lymphoblastic leukemia with the 4;11 translocation exhibiting early T cell features. AB - We describe a case of ALL with the t(4;11) (q21;q23) translocation in which both surface markers and molecular analyses suggest an unusual early T cell involvement. While the morphologic and cytochemical studies showed an undifferentiated pattern, immunophenotypic data were suggestive of a very immature cell population which stained only for TdT and CD7. Moreover, in contrast to previous reports but in agreement with the immunologic findings, the IgH gene region retained a germline configuration. T cell receptor beta and gamma chain gene loci also showed a germline pattern, in accordance with the expansion of immature CD7+, TdT+ T cells. PMID- 2783349 TI - Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 1-1989. A 50-year-old man with alcoholic cirrhosis and gastrointestinal hemorrhage. PMID- 2783348 TI - Trends in risk factors for vascular disease in Australia. AB - Data from the National Heart Foundation Risk Factor Prevalence Surveys of 1980 and 1983 were analysed to detect national trends in risk factors for vascular disease in Australia. After statistical adjustment for differences in the demographic characteristics of the two populations of survey participants, our results show trends in smoking and blood pressure that are likely to result in a continuing fall in the incidence of vascular disease. There was a fall in the prevalence of current smoking from 32% to 29% but little change in the average daily consumption of cigarettes by current smokers. The prevalence of previously undetected hypertension fell significantly from 10% to 7%. A small increase occurred in the proportion of all hypertensive patients who were treated and whose blood pressure was controlled, and a decline of 2.0 mmHg (P less than 0.0001) in mean diastolic blood pressures, but no significant change in mean systolic pressures. Mean total plasma cholesterol levels did not change; average levels of plasma triglycerides fell by 0.11 mmol/L (P less than 0.0001); and mean high-density lipoprotein cholesterol levels increased by 0.03 mol/L (P less than 0.0001). All indices of relative body weight increased between 1980 and 1983; mean body mass index rose by 0.23 with associated rises in the prevalence of obesity and of overweight status. The changes in other factors such as use of added salt, the consumption of alcohol, the level of physical activity and adherence to a special diet, all were in the desirable direction, although minor changes in the survey questionnaire might have served to exaggerate the apparent trends. PMID- 2783350 TI - Cerebral vasocapacitance and TIAs. AB - We report the vasocapacitance of the cerebral circulation, as determined by cerebral blood flow reactivity to induced hypercapnia using fluoromethane positron emission tomography, in 32 patients with unilateral anterior circulation transient ischemic attacks. A hemodynamic subset of eight patients, defined based on exertional, positional, orthostatic, or cardiac dysrhythmic induction of symptomatology, is characterized by multiple (median, 4.5 attacks per patient), brief (median, 2.5 minutes per attack), continued episodes of hemispheric ischemia including focal limb shaking. Symptomatic middle cerebral artery flow territories show significantly lower (p less than 0.04) and more asymmetric (p = 0.036) vasodilatory responses in the hemodynamic subset. Although ipsilateral internal carotid artery occlusion is more prevalent in the hemodynamic subset, the features of age, mean arterial blood pressure, carbon dioxide values, serum glucose, serum hematocrit, and number or type of risk factors do not differ significantly between groups. These studies of vasocapacitance help validate clinical criteria for cerebral hemodynamic events with an objective physiologic measurement. PMID- 2783351 TI - Criteria for termination of phase II chemotherapy for patients with progressive or recurrent brain tumor. AB - We report six patients with progressive primary tumors of the brain who had prolonged periods with stable contrast-enhancing CT lesions following initial responses to chemotherapy. Chemotherapy was discontinued after 21 to 36 months, despite the persistence of apparent disease in each patient. PET using (F-18) fluorodeoxyglucose was performed in three patients, revealing hypometabolic lesions. All six patients are alive and well, with no clinical or radiographic evidence of progressive disease at 24 to 57+ months following termination of treatment. The usual criteria for terminating phase II chemotherapy in patients with a recurrent brain tumor are evidence of progressive disease or unacceptable toxicity. However, chemotherapeutic success mandates that these criteria be expanded to include patients whose response following the initiation of phase II treatment is followed by prolonged (greater than 1 year) radiographic and clinical stability. Complete response, ie, disappearance of all evidence of disease, is unusual in patients with recurrent primary brain tumors, even with highly effective therapy. Continued improvement in the therapy of patients with these tumors will allow wider application of these criteria. PMID- 2783353 TI - Preemptive strike. PMID- 2783352 TI - Gastric lipolysis and fat absorption in preterm infants: effect of medium-chain triglyceride or long-chain triglyceride-containing formulas. AB - The extent of gastric lipolysis, fat absorption, and infant weight gain was studied in 12 preterm infants (gestational age 28.75 +/- 0.50 weeks, postnatal age 6.08 +/- 0.81 weeks) fed medium-chain triglyceride or long-chain triglyceride formula for 1 week in a crossover design. The former formula contained 42% of 8:0 and 10:0 and 19% of 12:0, 14:0, and 16:0; the latter formula contained only 7% of 8:0 and 10:0 and 46% of 12:0, 14:0, and 16:0. Gastric aspirates were obtained on the second and third day of formula feeding for quantitation of lipase activity and of the extent of gastric lipolysis. Fat balance studies were conducted during the last three days of each feeding regimen. The study showed that (1) there was marked hydrolysis of formula fat in the stomach during feeding of either medium chain triglyceride formula or long-chain triglyceride formula (20% and 16%, respectively); (2) lipase activity in the gastric aspirates was less during feeding of medium-chain triglyceride formula than before the meal, which suggested stimulation of lipase secretion by long-chain fatty acid released from long-chain triglyceride formula fat or more rapid binding of lipase to ingested lipid in the medium-chain triglyceride formula; (3) fatty acid distribution in glycerides and free fatty acids showed preferential release of medium-chain (8:0, 10:0) and long-chain unsaturated (18:1, 18:2) fatty acids in the stomach. The low content of 8:0 and 10:0 in gastric triglyceride and free fatty acids suggested that medium-chain fatty acids were absorbed directly in the stomach.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2783354 TI - Retroviral-mediated transfer and expression of hepatitis B e antigen in human primary skin fibroblasts and Epstein-Barr virus-transformed B lymphocytes. AB - Previously, an amphotropic retroviral expression system coding for the neomycin resistance gene was developed and used to synthesize hepatitis B e antigen (HBeAg) and hepatitis B core/e antigen (HBc/eAg) in transfected mouse NIH 3T3 fibroblasts (A. McLachlan et al., 1987, J. Virol. 61, 683-692). In the present study, these transfected cell lines were infected with a helper amphotropic murine leukemia virus resulting in the production of infectious recombinant retrovirus. The recombinant retrovirus was examined for its capacity to transmit resistance to the antibiotic, G418, and to express hepatitis B virus antigens in mouse NIH 3T3 fibroblasts, human primary skin fibroblasts, and Epstein-Barr virus (EBV)-transformed B lymphocytes. A mouse NIH 3T3 fibroblast clone was generated which produced recombinant retrovirus with the capacity to transmit HBeAg expression to these murine and human cell lines. In contrast, it was not possible to transmit HBc/eAg synthesis efficiently to these cell lines by recombinant retroviral infection. The difference between the efficiencies of transmission of HBeAg and HBc/eAg expression by recombinant retroviral-mediated infection was not predicted as the expression vector coding for HBc/eAg synthesis differs only by the deletion of approximately 90 nucleotides of HBV DNA sequence from the vector coding for HBeAg synthesis. PMID- 2783355 TI - Two- to eight-year survival rates in patients who refused coronary artery bypass grafting. AB - One hundred and fifty patients with coronary artery disease (CAD) who refused bypass grafting were followed prospectively from 2 to 8 years. Mean age was 57 +/ 8 (standard deviation) years. Ejection fraction averaged 70 +/- 14%. Eight percent of patients had 1-vessel CAD and 92% had multiple-vessel CAD. Medical treatment included propranolol, nifedipine, isosorbide dinitrate, dipyridamole and aspirin. Annual mortality was 0% for 1- and 2-vessel CAD and 1.3% for left main equivalent disease, 3-vessel and left main CAD. Treatment significantly reduced the incidence of stable and unstable angina. Fifty-two patients (34%) had a second hemodynamic study 4.2 +/- 1.3 years after initial evaluation. Stenosis progression or new significant obstructions (greater than or equal to 70%) in previously normal coronary arteries occurred in 61% of 123 arteries studied, whereas new occlusions were observed in 12% of the arteries. Nonfatal acute myocardial infarction incidence was 8%. No significant changes occurred in ejection fraction. In conclusion, proper medical treatment in selected patients with advanced CAD but preserved ventricular function is associated with good long term survival and remission of symptoms, although progression of coronary atherosclerosis does occur in some patients. PMID- 2783356 TI - Immunization after invasive Haemophilus influenzae type b disease. Serologic response to a conjugate vaccine. AB - Fifteen children with previous invasive Haemophilus influenzae type b disease were immunized with a Hemophilus-diphtheria toxin mutant protein conjugate vaccine. Serologic responses were compared with those of 31 newly immunized children without previous invasive H influenzae type b disease. Mean levels of antibody to polyribosylribitol phosphate among study children younger than 18 months were 0.086 mg/L before immunization, 0.737 mg/L after first immunization, and 4.453 mg/L after second immunization. In contrast, the comparable mean polyribosylribitol phosphate antibody levels among control children younger than 18 months were 0.107, 3.580, and 63.502 mg/L. A similar pattern of results was found among children aged 18 months or older. Although children with previous invasive H influenzae type b disease do not respond as vigorously to conjugate vaccine as do previously healthy controls, the response is sufficient to justify routine immunization of such children. PMID- 2783357 TI - Haemophilus influenzae pneumonia in young adults with AIDS, ARC, or risk of AIDS. AB - PURPOSE: Since the acquired immunodeficiency syndrome (AIDS) was first described in 1981, we have observed an increasing number of cases of Haemophilus influenzae pneumonia, particularly in young adult patients. To confirm this observation, we systematically identified and reviewed all cases of H. influenzae pneumonia that occurred in adult patients recently hospitalized at our institution. PATIENTS AND METHODS: Using a strict case definition, we identified all cases of adult H. influenzae pneumonia that were observed during a recent 32-month period at our institution, a large teaching hospital in New York City. We further reviewed each case record for evidence of AIDS, AIDS-related complex (ARC), or risk of AIDS. RESULTS: H. influenzae pneumonia was diagnosed in 51 adults. Thirty-four cases occurred in young adults (mean age = 33.9 years) with AIDS risk factors, including 23 (67 percent) intravenous drug abusers, six (18 percent) homosexual men, and five (15 percent) with both risks. Nine patients (26 percent) had a previous or concurrent diagnosis of AIDS, four (12 percent) developed AIDS later, and 13 (38 percent) others had ARC. The common presenting symptoms in young adult patients with H. influenzae pneumonia were fever (100 percent), productive cough (100 percent), chest pain (53 percent), and dyspnea (47 percent). Lung consolidation was detected on physical examination in 20 (59 percent), and chest radiograph demonstrated unilateral infiltrates in 18 (53 percent) and bilateral infiltrates in 16 (47 percent), with pleural effusions in three (nine percent). Most patients had an elevated white blood cell count (mean = 9.6 X 10(9)/liter) with a left shift in 22 (65 percent), and hypoxia on room air (mean partial pressure of oxygen = 69 mm Hg). Four patients with H. influenzae pneumonia and coexisting Pneumocystis carinii pneumonia had diffuse, bilateral infiltrates on chest radiograph, with significantly more dyspnea and a higher serum lactate dehydrogenase level than the others. All but one patient showed improvement with appropriate therapy. CONCLUSION: We conclude that potentially serious pneumonia caused by H. influenzae occurs in young adult patients with AIDS, ARC, or AIDS risk. PMID- 2783359 TI - Hypoglycemia and pentamidine. PMID- 2783358 TI - Elevated plasma levels of the anaphylatoxins C3a and C4a are associated with a fatal outcome in sepsis. AB - PURPOSE AND PATIENTS AND METHODS: Both complement and contact system of coagulation have been implicated in the pathophysiology of sepsis. We therefore measured levels of the complement activation products C1-C1-inhibitor complexes and C3a in serial plasma samples (obtained every six hours) from 48 patients with clinically suspected sepsis, and related these levels to the clinical outcome. C4a was also measured in samples obtained on admission. RESULTS: C3a levels were elevated in 47 patients at least once during the observation period. These levels appeared to be considerably higher in patients who died than in patients who survived. This difference was found for the levels on admission (p = 0.0003), as well as for the highest (p = 0.0010) and the lowest (p less than 0.0001) levels encountered in each patient. The mortality in patients with plasma C3a levels of 13 nmol/liter or less on admission (27 patients) was 33 percent, compared with 86 percent in patients with levels of 14 nmol/liter or more. Patients with septic shock had significantly higher C3a levels than normotensive patients (p values between 0.046 and 0.004). No significant differences in C3a were found between patients who had respiratory distress syndrome and those who did not. C4a levels in plasma samples obtained on admission were elevated in 43 patients. These levels correlated very significantly with C3a levels (p less than 0.0001), and showed similar associations with a fatal outcome. C1-C1-inhibitor complexes were elevated in 23 patients at least once during the observation period. These patients had significantly higher levels of C4a and C3a than patients with normal amounts of C1-C1-inhibitor complexes. Patients who died had higher levels of C1 C1-inhibitor complexes than patients who survived. However, this difference was not significant. CONCLUSION: On the basis of our results, we propose that activation of the complement system via the classical pathway is involved in the development of fatal complications in sepsis. PMID- 2783360 TI - Northeast jobfocus. Northeastern high points. PMID- 2783361 TI - Management of stress and prevention of burnout in emergency physicians. AB - We conducted a study to measure participating practitioners' burnout levels and to identify coping methods used by these physicians to manage stress. A cross sectional study was done with a sample of 77 physicians employed in emergency departments in 24 private, public, and university-affiliated teaching hospitals in the greater Los Angeles area. Data revealed that 60% of the physicians reported medium to high emotional exhaustion and 78% medium to high depersonalization, while 84% reported medium to high levels of personal achievement. Physicians who reported high levels of job satisfaction and personal accomplishment use a balanced number of short- and long-term coping methods in dealing with stress. Further studies should be undertaken to facilitate in-depth analysis of the characteristics of those emergency physicians who report low levels of emotional exhaustion and depersonalization as well as high levels of personal achievement to identify factors that lead to the successful practice of emergency medicine. PMID- 2783362 TI - Defective T-cell surface antigen expression after mitogen stimulation. An index of lymphocyte dysfunction after controlled murine injury. AB - Murine spleen T-cell activation in lectin-stimulated cultures after 25% body surface area burn injury or hind-limb amputation was studied by measuring the temporal expression of cell surface markers using monoclonal antibodies and two color flow cytometry. Lymphocyte activation has been shown to be accompanied by the appearance of new surface antigens, including Interleukin-2 (IL-2) deceptor (IL-2R) and Ia, and emergence of cells that coexpress helper (Th) and suppressor (Ts) surface markers. IL-2R has been shown to appear early on stimulated cells, before DNA synthesis, whereas Ia appears later. Surface markers (L3T4, Lyt2, Ia, and IL-2R) were analyzed at time 0 and after 24, 48, and 72 hours of mitogen stimulated culture. The appearance of IL-2R and Ia on Th (L3T4+) and Ts (Lyt-2+) populations was markedly depressed after burn injury, but minimal changes were seen after musculoskeletal injury. In addition, coexpression of L3T4/Lyt2 antigens was markedly reduced in burn-derived cells. Serum from burn-injured animals caused depression of surface antigen expression by stimulated normal cells. Recombinant IL-2, when added to burn-derived cell cultures, did not increase expression of these surface markers during culture, nor did it improve proliferation. PMID- 2783364 TI - Effect of timing of lymphokine presentation on generation of cytotoxic T lymphocytes. AB - Encouraging results of clinical trials with interleukin 2 therapy for advanced malignant neoplasms have led to efforts to reduce the toxicity and improve the efficacy of tumor immunotherapy. To begin to achieve this goal, we studied the lymphokine requirements for in vitro generation of polyclonal cytotoxic T lymphocytes (CTL) from C57BL/6 murine thymocytes. We found that both interleukin 2 and interleukin 6 are required for optimal generation of CTL from murine thymocytes. Timing studies show that neither lymphokine alone in culture will produce maximum CTL levels during the first 84 hours of culture. In addition, we found that thymocytes cultured with concanavalin A are unresponsive unless either interleukin 2 or interleukin 6 is present from the onset of culture. PMID- 2783363 TI - The rapid induction by interleukin-2 of pulmonary microvascular permeability. AB - The clinical use of interleukin-2 (IL-2) is limited by severe cardiopulmonary dysfunction. This study examines the mechanism of respiratory failure related to IL-2, using sheep with chronic lung lymph fistulae. Awake animals were infused with an intravenous (I.V.) bolus of IL-2 10(5) U/kg (n = 5) or its excipient (EXC) control (n = 3), every 8 hours for 4 to 5 days. Cardiopulmonary function was monitored daily for at least one 8-hour period. Within 2 hours after each IL 2 administration, mean pulmonary arterial pressure (MPAP) rose. On Day 1, the mean rise was from 13 to 26 mmHg (p less than 0.05), and on Day 5, to 29 mmHg (p less than 0.05). MPAP returned to baseline levels after 2-3 hours. Pulmonary arterial wedge pressure was unchanged from 4 mmHg. There were transient falls in arterial oxygen tension, from 88 to 77 mmHg on Day 1 and to 73 mmHg (p less than 0.05) on Day 5. Lung lymph flow (QL) rose from 2.4 to 6.8 ml/30 minutes (p less than 0.05) on Day 1, and from 4.7 to 10.2 ml/30 minutes (p less than 0.05) on Day 5, whereas the lymph/plasma protein ratio increased on Day 1 from 0.69 to 0.83 (p less than 0.05) and from 0.63 to 0.71 (p less than 0.05) on Day 5. This documents an increase in pulmonary microvascular permeability. Thromboxane (Tx)B2 levels increased transiently after each IL-2 injection in plasma from 195 to 340 pg/ml (p less than 0.05) and in lung lymph from 222 to 772 pg/ml (p less than 0.05) on Day 1, and to similar levels on Day 5. There was a progressive rise in cardiac output from 5.7 to 8.6 1/minute (p less than 0.05) during the 5 days of infusion. Systemic blood pressure did not change. Temperature rose from 39.1 to 41.2 C (p less than 0.05), and shaking chills were common. There was a progressive fall in leukocyte count, from 8.4 to 3.2 X 10(3)/mm3 (p less than 0.05) by Day 5, reflecting a 77% fall in lymphocytes. Lung lymph lymphocyte counts rose, and lymphocyte clearance increased.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2783365 TI - Cerebral glucose metabolism in Wernicke's, Broca's, and conduction aphasia. AB - Cerebral glucose metabolism was evaluated in patients with either Wernicke's (N = 7), Broca's (N = 11), or conduction (N = 10) aphasia using 18F-2-fluoro-2-deoxy-D glucose with positron emission tomography. The three aphasic syndromes differed in the degree of left-to-right frontal metabolic asymmetry, with Broca's aphasia showing severe asymmetry and Wernicke's aphasia mild-to-moderate metabolic asymmetry, while patients with conduction aphasia were metabolically symmetric. On the other hand, the three syndromes showed the same degree of metabolic decline in the left temporal region. The parietal region appeared to separate conduction aphasia from both Broca's and Wernicke's aphasias. Common aphasic features in the three syndromes appear to be due to common changes in the temporal region, while unique features were associated with frontal and parietal metabolic differences. PMID- 2783366 TI - Striatal dysfunction in attention deficit and hyperkinetic disorder. AB - We have previously reported that periventricular structures are hypoperfused in attention deficit and hyperactivity disorder (ADHD). This study has expanded the number of patients, who were divided into two groups: six patients with pure ADHD, and 13 patients with ADHD in combination with other neurologic symptoms. By using xenon 133 inhalation and emission tomography, the regional cerebral blood flow distribution was determined and compared with a control group. Striatal regions were found to be hypoperfused and, by inference, hypofunctional in both groups. This hypoperfusion was statistically significant in the right striatum in ADHD, and in both striatal regions in ADHD with other neuropsychologic and neurologic symptoms. The primary sensory and sensorimotor cortical regions were highly perfused. Methylphenidate increased flow to striatal and posterior periventricular regions, and tended to decrease flow to primary sensory regions. Low striatal activity, partially reversible with methylphenidate, appears to be a cardinal feature in ADHD. PMID- 2783367 TI - Cerebral glucose metabolism in the course of subacute sclerosing panencephalitis. AB - Regional cerebral glucose metabolism was studied in a 15-year-old boy with subacute sclerosing panencephalitis before and after therapy with human interferon beta, using positron emission tomography of fluorine 18-2-fluoro-2 deoxyglucose. At first examination, metabolism was symmetrically decreased in the thalamus, cerebellum, and all cortical areas except prerolandic motor cortex, but increased in lentiform nucleus. A computed tomographic scan was normal. Six months later, bilateral focal necrosis centered in the previously hypermetabolic putamen was demonstrated by computed tomography and magnetic resonance imaging. The caudate nucleus and the superoposterior part of the putamen were spared, still showing increased metabolism. Corresponding with some clinical improvement, cortical glucose consumption rates had returned to a normal level. PMID- 2783368 TI - Clinical significance, prevalence, and natural history of thrombocytopenia in pregnancy-induced hypertension. AB - The purpose of this study was to establish the prevalence and clinical significance of thrombocytopenia in pregnancy-induced hypertension (PIH). Thrombocytopenia, defined as a platelet count less than 100,000/mm3 was found in 11.6% of all patients with PIH. Logistic regression analysis was used to assess the relative contribution of thrombocytopenia, proteinuria, and the degree of hypertension to maternal and perinatal outcome. Thrombocytopenia was the principal contributor to the occurrence of abdominal pain, liver dysfunction, the presence of schistocytes in the peripheral smear, proteinuria, fetal distress, and the requirement for blood transfusions. Thrombocytopenia was also associated with a higher incidence of preterm delivery and intrauterine growth retardation. The nadir platelet count occurred within 48 hours of delivery in 56.7% (21 of 37) of cases. The median number of days for recovery of the thrombocytopenia was 2.0 days (range, 0 to 8 days). In five patients thrombocytopenia preceded the clinical manifestations of PIH. We conclude that thrombocytopenia is an independent and important risk factor for the occurrence of maternal and perinatal complications in PIH. PMID- 2783369 TI - The human interleukin-1 alpha gene is located on the long arm of chromosome 2 at band q13. AB - Interleukin-1 alpha (IL-1 alpha) and interleukin-1 beta (IL-1 beta) are two biochemically distinct, but distantly related, polypeptidic cytokines that play a key role in inflammation, immunologic reactions, and tissue repair. Recently, it has been shown that IL-1 alpha is identical to hematopoietin 1, which was described as a hematopoietic growth factor acting on early progenitor cells in synergy with other hematopoietic growth factors. In this report we discuss our use of in situ hybridization on human prometaphase cells with a human IL-1 alpha cDNA probe to localize the human IL-1 alpha gene on the proximal part of the long arm of chromosome 2 at band q13, in the same chromosomal region as the IL-1 beta gene. PMID- 2783370 TI - In vivo hematologic effects of recombinant interleukin-6 on hematopoiesis and circulating numbers of RBCs and WBCs. AB - Interleukin-6 (IL-6) administered as a single intravenous (IV) injection caused the following changes in the peripheral circulation of rats: (a) a biphasic neutrophilia with an initial peak at 1.5 hours and a second sustained wave of neutrophilia between four and 12 hours, (b) a mild lymphocytosis at 0.5 hours and a mild lymphopenia between 1.5 and four hours, and (c) a reticulocytosis between 12 and 24 hours. The bone marrow showed no significant changes at 1.5 hours, suggesting that the peripheral neutrophilia at that time is caused by demargination of intravascular neutrophils and not by release of marrow neutrophils. The bone marrow at 12 hours showed a mild left-shifted myeloid hyperplasia of myeloblasts and promyelocytes and a tremendous erythroid hyperplasia of intermediate and late normoblasts. The bone marrow at 24 hours showed a continued mild myeloid hyperplasia and striking erythroid hyperplasia. In conclusion, IL-6 in vivo acts as a stimulus for myelopoiesis and erythropoiesis and causes accompanying peripheral changes in the number of neutrophils, lymphocytes, and RBCs. PMID- 2783371 TI - Putative involvement of protein kinase C in proliferation of human myeloid progenitor cells. AB - The effects of two different potent inhibitors of protein kinase C, 1-(5 isoquinolinylsulfonyl)-2-methylpiperazine (H-7) and staurosporine on human myeloid (CFU-C) and late erythroid progenitor cells (CFU-E) were studied using an in vitro clonal assay. Our objective was to determine whether protein kinase C has a role in signal transduction related to proliferation of these committed progenitor cells. The presence of H-7 or staurosporine led to an inhibition of colony formation stimulated by crude colony-stimulating factor (CSF), interleukin 3 (IL-3), granulocyte-macrophage CSF (GM-CSF), granulocyte CSF (G-CSF), or macrophage CSF (M-CSF) in a dose-dependent manner. N-(2-guanidinoethyl)-5 isoquinolinesulfonamide (HA-1004), a weaker analog of H-7, did not inhibit proliferation of CFU-C. Neither H-7 nor staurosporine had any effect on CFU-E formation. H-7 and staurosporine dose-dependently inhibited the protein kinase C from K562 cells. The potential of these compounds to inhibit proliferation of CFU C correlated well with the magnitude of their inhibition of protein kinase C from K562 cells. The inhibition of proliferation of CFU-C appears to relate to the potential of these compounds to inhibit protein kinase C. Thus, activation of protein kinase C is presumably involved in the proliferation of CFU-C, and the regulatory system of CFU-E appears to differ from that of CFU-C. PMID- 2783372 TI - Human T-lymphotropic virus I-infected T cells constitutively express lymphotoxin in vitro. AB - We have studied the pattern of expression of the lymphokines tumor necrosis factor (TNF alpha) and lymphotoxin (TNF beta) in T-cell lines established by transformation with human T-lymphotropic virus, type I (HTLV-I), the etiologic agent of adult T-cell leukemia (ATL). We report here that nine of nine HTLV-I infected T-cell lines, established by in vitro infection with HTLV-I, including those with CD4+ or CD8+ as well as CD4-/CD8- phenotypes, constitutively produce high levels of TNF alpha and -beta mRNA and secrete biologically active TNF beta into the culture medium. Similar patterns of expression are seen in six of six HTLV-I-infected T-cell lines directly established from ATL patients. In contrast, several T-cell lines, either uninfected or infected with human immunodeficiency virus I, did not produce comparable levels of the TNF beta. Comparisons of a normal functional T-cell clone before and after infection with HTLV-I show that expression of TNF beta mRNA is induced in the infected cells. The high level expression in HTLV-I-infected cell lines dose not seem to involve perturbation of the TNF alpha/beta genetic loci by proviral integration. A cell line (81-66/45) nonproductively transformed with HTLV-I that produces tat-1 in the absence of viral structural proteins, produces both TNF alpha and -beta mRNA. This suggests that expression of these cytokines could be mediated in trans by the tat-1 gene product. PMID- 2783373 TI - Deoxycoformycin-induced immunosuppression in patients with hairy cell leukemia. AB - Immune function in patients with hairy cell leukemia (HCL) was examined serially during treatment with alternating monthly cycles of recombinant interferon alpha 2a and 2'-deoxycoformycin (dCF). At presentation, most patients had normal numbers of T lymphocytes and their cells had normal proliferative responses to mitogens [phytohemagglutinin (PHA) and concanavalin A (Con A)] and alloantigens. Patients had severe monocytopenia, decreased delayed-type hypersensitivity (DTH) reactions, and decreased peripheral blood natural killer (NK) activity. Treatment caused a profound decrease in all lymphocyte subpopulations. T cells were more affected than B cells or NK cells. Numbers of CD4+ and CD8+ lymphocytes decreased to levels less than 200 cells/microliters in all patients during treatment. This decrease in T cell number was associated with a marked decrease in proliferative responsiveness to PHA, Con A, and alloantigens. These abnormalities persisted throughout the 14 months of treatment and have continued for up to 6 months beyond discontinuation of treatment. NK cell activity increased during treatment, but cycled depending on the phase of treatment; highest activities were observed after interferon (IFN)-alpha and lower levels of activity were observed after dCF. DTH responses generally did not improve during therapy. Levels of IgM, IgG, IgA, and IgD did not change during treatment, but IgE levels rose in most patients. All immunosuppressive effects were attributable to dCF since patients receiving IFN-alpha 2a alone did not exhibit these same immunosuppressive effects, and patients receiving dCF alone after IFN failure exhibited similar abnormalities. Despite this severe immunosuppression from dCF, life-threatening opportunistic infections have not been observed in our patient population. Six patients developed localized Herpes zoster infection among 21 patients who had received dCF. Pending the results of long-term follow-up, we recommend that dCF be reserved for patients who have failed splenectomy and IFN therapy. PMID- 2783374 TI - Torsades de pointes during intravenous pentamidine isethionate therapy. PMID- 2783375 TI - Peripheral blood and bone marrow changes following 2'-deoxycoformycin therapy in hairy cell leukemia. Results of 200 weeks' follow-up. AB - Peripheral blood (PB) and bone marrow (BM) changes during 200 weeks' follow-up of 15 patients with hairy cell leukemia (HCL) undergoing low-dose 2'-deoxycoformycin (dCF) therapy are reported. Thirteen patients rapidly achieved complete remissions (CR) (median, 16 weeks). Previous splenectomy (two patients), or chemotherapy (two patients) had no effect on dCF response. Twelve patients have remained in CR. Patients with marked BM infiltration (hairy cell index [HCI] greater than 0.5; n = 5) had more pronounced pancytopenia and showed a slower hematologic recovery than those with a lesser degrees of infiltration. Additionally, patients with cytologic type II HCL (n = 5) had more pronounced pancytopenia with a greater tumor load in the BM, and exhibited slower hematologic recovery than those with type I (n = 5) HCL. There was a gradual decline in BM cellularity from 65% to 25% during year 1, a level which remained stable thereafter. Reticulin in the BM regressed in all nine patients in whom it was increased before dCF therapy. The authors have not seen any dysplastic changes in the hematopoietic cells during the period of follow-up. PMID- 2783376 TI - Peripheral T-cell lymphoma. AB - Peripheral T-cell lymphoma is the most common type of T-cell lymphoma seen in adults in the United States. Clinical data were reviewed from 134 cases of peripheral T-cell lymphoma diagnosed in three centers. The median age of the patients was 57 years (range, 4-97 years), 59% were male, and 36 patients (27%) had a history of a preceding disorder of the immune system. The tumors were grouped histologically into large cell (43%), mixed large and small cell (40%), and small cell (17%). The stage at diagnosis was I (7%), II (21%), III (22%), and IV (50%). B symptoms were present in 57%. The most frequent sites of extranodal involvement were bone marrow (35%), skin (13%), and lung (11%). Eighty patients were treated with a multiagent chemotherapy regimen with proven curative potential in aggressive non-Hodgkin's lymphomas and the remainder of the patients received less intensive chemotherapy (36 patients), radiotherapy (nine patients), or no treatment (nine patients). Fifty percent of the intensively treated patients achieved complete remission and the actuarial 4-year survival was 45%. However, the 4-year, disease-free survival in patients with Stage IV disease was only 10%. Although peripheral T-cell lymphomas appeared similar in many ways to their B-cell counterparts, disease-free survival by stage was low and patients with Stage IV disease had an especially poor outlook. PMID- 2783377 TI - Natural killer cells in children with malignant solid tumors. Effect of recombinant interferon-alpha and interleukin-2 on natural killer cell function against tumor cell lines. AB - Natural killer (NK) cells and NK cell activity were determined in three groups (newly diagnosed [n = 21], on therapy [n = 21], and off therapy [n = 18]) of children with various types of malignant solid tumors and in a control group (n = 26) by means of Leu-7 and Leu-11b monoclonal antibodies and a 4-hour 51Cr-release assay, respectively. The erythroleukemia cell line K562 was used as a target cell. The newly diagnosed group included eight patients with localized disease (Stage I-II), ten with bulky but nonmetastatic disease (Stage III), and three with metastases (Stage IV). The mean percent of NK cell activity in the newly diagnosed group was significantly higher than that of the control group. Children with Stage III tumors at diagnosis had higher mean NK cell function than those with Stage I-II and Stage IV. On therapy patients had significantly fewer NK cells and lower NK cell cytotoxicity than those in the other groups studied. We also studied the following: (1) the in vitro effect of recombinant interferon alpha (rIFN-alpha) and recombinant interleukin-2 (rIL-2) on NK cell function of peripheral blood lymphocytes (PBL) from children with solid malignancies; and (2) the susceptibility of neuroblastoma-derived (CHP-126 and SKNSH) and rhabdomyosarcoma-derived (A-204) cell lines to NK cell lysis. Both rIFN-alpha and rIL-2 enhanced NK cell activity of PBL from children with malignancies and healthy children against K562 and solid tumor cell lines. The enhancing effect or rIL-2 was greater than that of rIFN-alpha. CHP-126 and SKNSH cell lines were susceptible to NK cell lysis mediated by the PBL of children with neuroblastoma and the control group. The A-204 cell line was less sensitive than K562 to NK cell cytotoxicity. Our results suggest a potential therapeutic role for both cytokines in the treatment of malignant solid tumors of childhood. PMID- 2783379 TI - Marked reduction of subcutaneous tumor growth by intraperitoneal administration of recombinant human interleukin 2 with a cell accumulator, proteose-peptone, in mice. AB - The growth of 3-methylcholanthrene-induced fibrosarcomas, Meth 1 and Meth A, was strongly suppressed by a combination of recombinant human interleukin 2 (rIL-2) with proteose-peptone (PP) administered i.p. to syngeneic mice. When 1 ml of 10% PP was injected i.p. on Day 6 followed by rIL-2 (50 micrograms) administered i.p. on Days 7 and 8 after the s.c. inoculation of tumor cells into female BALB/c mice, the tumors regressed. A similar result was also obtained when 12.5 micrograms of rIL-2 were injected on Days 7, 8, and 9 after s.c. inoculation of Meth 1 cells. The treatment with an anti-asialo-GM1 antibody had no effect on the regression of the Meth 1 tumor induced by the combination. However, the combined treatment with rIL-2 and PP did not suppress the growth of the Meth 1 tumor in adult thymectomized, irradiated, and fetal liver cell-reconstituted BALB/c mice. Therefore, this suggests that the T-cells might be the principal effectors of this antitumor system. The cytolytic activity of splenocytes and peritoneal exudate cells from Meth 1 tumor-bearing mice against Meth 1 cells was significantly augmented by the combined treatment. This peritoneal exudate cell also showed cytolytic activity against other target cells such as Meth A, antigenically distinct from Meth 1, YAC-1, a leukemic cell line sensitive to natural killer cells, and EL-4, a lymphoma cell line resistant to natural killer cells. The cytolytic activity of these effectors was reduced by the treatment with anti-thy1.2 antibody plus complement. The adherent cells in this peritoneal cavity had only a small cytolytic activity on Meth 1 and Meth A targets. The mechanism of antitumor immunity by rIL-2 in combination with PP and the therapeutic availability of this lymphokine are discussed. PMID- 2783378 TI - Autoimmunity and B-cell dysfunction in chronic proliferative disorders of large granular lymphocytes/natural killer cells. AB - Clinical and laboratory findings of B-cell immune dysfunction were evaluated in ten patients with a large granular lymphocyte/natural killer cell proliferative disease (LGL/NK-PD). Increased immunoglobulin synthesis with autoantibody formation was documented: polyclonal hypergammaglobulinaemia (six patients), neutrophil autoantibody (one patient), antinuclear antibody (one patient), and rheumatoid factor (five patients). In addition, serum beta 2-microglobulin level was raised in seven patients, a benign monoclonal gammopathy was detected in one, and concurrent B-type hairy cell leukemia in another. Most patients experienced the complications of hemocytopenia, polyarthritis or rheumatoid arthritis, and immediate allergic reactions to drugs or environmental substances, rather than from symptoms of progressive LGL/NK-PD. A review of the literature confirms that an increased immunoglobulin production is common in LGL/NK-PD, and that patients are likely to develop multiple autoantibodies. The incapacity of proliferating, abnormal LGL/NK cells to suppress B-cell activation and immunoglobulin synthesis, documented by several in vitro studies, offers a pathogenetic explanation for these phenomena. This study shows that an anomalous B-cell function contributes greatly to the morbidity of disease in LGL/NK-PD, and points out the utility of investigating the LGL/NK cell system in patients with autoimmune pathologic characteristics of unclear origin. PMID- 2783380 TI - Immunospecific targeting of cytosine arabinonucleoside-containing liposomes to the idiotype on the surface of a murine B-cell tumor in vitro and in vivo. AB - A new tumor model is described that is suitable for the evaluation of antibody directed drug-delivery protocols and a modification in the procedure for covalently coupling antibody to the surface of drug-containing liposomes is presented. These immunospecific liposomes containing cytosine arabinonucleoside (Ara-C) have been tested in vitro and in vivo for their ability to kill a B-cell tumor. The target of the immunospecific-Ara-C liposomes is the idiotype associated with an antigen-specific immunoglobulin receptor on the cell surface of a murine B-cell hybrid (2C3). Affinity-purified antibodies specific for the idiotype were covalently coupled to modified lipid on the surface of the large unilamelar liposomes containing drug. These liposomes were shown to kill idiotype positive 2C3 cells in vitro, but not idiotype-negative variants of this same cell line. It was also established in vitro that the drug-containing liposomes were at least 40 times more efficient than free Ara-C in the killing of the tumor cells. The 2C3 tumor was also propagated in vivo following the i.p. administration of tumor cells. The tumor grew initially as multiple foci within the peritoneum and subsequently spread to the spleen. Tumor-bearing mice were treated either with free Ara-C or with immunospecific liposomes containing Ara-C. Tumor growth in the primary tumor nodules and in the spleen was monitored by the administration of bromodeoxyuridine to the tumor-bearing animals followed by the immunofluorescent staining of cells with a monoclonal anti-bromodeoxyuridine antibody to estimate the proportion of cells in S phase. Our data from five out of seven animal experiments shows that the immunospecific-Ara-C liposomes, but not free drug, reduced tumor growth in the spleen. However, neither the liposomes containing drug nor the free drug were able to alter the growth of the primary tumor nodules growing in the peritoneal cavity. These results suggest that immunospecific-Ara-C containing liposomes may be useful in conjunction with other cytoreductive protocols in controlling tumor growth or preventing the spread of the tumor to other sites, but that immunospecific-Ara-C containing liposomes by themselves are not likely to eliminate an established tumor in vivo. We also demonstrate here that the administration of immunospecific-Ara-C containing liposomes in an animal having high levels of circulating tumor-associated antigen (i.e., IgG containing the idiotype) represents a potential clinically relevant hazard which must be considered when designing antibody-directed drug-delivery protocols. PMID- 2783382 TI - Endogenous growth factor expression in T-47D, human breast cancer cells, associated with reduced sensitivity to antiproliferative effects of progestins and antiestrogens. AB - To determine the functional significance of the endogenous expression of the epidermal growth factor (EGF) and transforming growth factor-alpha genes in T 47D, human breast cancer cells, we have examined the effects of two types of antiproliferative agents, progestins and antiestrogens, on the expression of these growth factors and the effects of exogenous EGF on the antiproliferative action of these agents. Using Northern blot analysis, the regulation of expression of these two genes by the antiproliferative agents, tamoxifen and monohydroxytamoxifen, was examined. In T-47D cells the two antiestrogens did not affect the accumulation of EGF mRNA and decreased the accumulation of TGF alpha mRNA. As we have shown before, the progestin, medroxyprogesterone acetate, increased the level of both EGF mRNA and TGF alpha mRNA in this cell line. The regulation of expression of these endogenous growth factor genes was unrelated to the proliferative behavior of T-47D cells since both antiestrogens and progestins were antiproliferative under the conditions of the experiments. The variant cell line, T-47D-5, had no detectable EGF mRNA and contained about 1/10th the level of TGF alpha mRNA expressed by "wild type" T-47D cells. T-47D-5 cells were 2.5 times more sensitive to the antiproliferative effects of both progestins and antiestrogens when compared to the growth factor expressing T-47D cells. Exogenously added murine EGF was able to decrease slightly the sensitivity of both cell lines to the antiproliferative effects of both progestins and antiestrogens as well as increase the proliferation of T-47D but not T-47D-5 cells. These data suggest that endogenous expression of growth factors may be associated with decreased sensitivity of the cells to growth inhibitory agents. PMID- 2783381 TI - Decrease in estradiol-stimulated progesterone receptor production in MCF-7 cells by epidermal growth factor and possible clinical implication for paracrine regulated breast cancer growth. AB - These studies have evaluated the modulation by epidermal growth factor (EGF) of estrogen receptor (ER) levels and estradiol-stimulated progesterone receptor (PgR) synthesis. Short-term culture of MCF-7 cells in an "estrogen (phenol red indicator)-free" environment caused a rise in ER concentration that is inhibited by EGF at 10(-8) M and 10(-7) M. Estradiol at 10(-10) M induced a 5-fold increase of PgR over a 5-day assay period. However, the rise in PgR was diminished or prevented by increasing concentrations of EGF (10(-9) M to 10(-7) M). Similarly, the concentration-related rise in PgR caused by estradiol (10(-13) M to 10(-9) M) was abolished after a 7-day pretreatment with EGF (10(-7) M). For both the ER and PgR receptor, EGF treatment caused a decrease in receptor number without an apparent change in receptor affinity. Thus, EGF appears to down regulate the ER by approximately 50% and to diminish the ability of estradiol to induce PgR. In addition, a survey of ER+PgR+ and ER+PgR- values of primary breast tumors from women between the ages of 55 and 70 demonstrated significantly less (50%) (85 to 39 fmol/mg of cytosol protein) ER in ER+PgR- tumors (P = 0.0005). The median PgR values for the PgR-positive tumors were 139 fmol/mg of cytosol protein. We propose that ER+ breast cancer that has changed to a paracrine growth factor driven system (from stromal cells or ER- breast cancer cells) is less responsive to gonadal steroids. The loss of PgR in these ER+ carcinomas may be an indicator of this type of hormone independence. PMID- 2783383 TI - Recombinant ricin A chain conjugated to monoclonal antibodies: improved tumor cell inhibition in the presence of lysosomotropic compounds. AB - Recombinant ricin A chain was chemically linked to monoclonal antibodies directed toward human breast cancer cells, a human T-cell differentiation antigen, and mouse transferrin receptor. Three types of immunotoxins were prepared; in two of them the antibody was linked to recombinant ricin A chain by a disulfide bond and in the third, a nonreducible thioether bond was used. Immunotoxins containing a nonreducible linkage may have some advantage over conjugates containing a reducible linkage because of improved stability in vivo. Conjugation of recombinant ricin A chain through either the endogenous thiol group or through a derivatized amino group produced immunotoxins with comparable cytotoxicity. The thioether conjugate was 1000-fold less cytotoxic to target tumor cells than the respective disulfide-linked immunotoxin. However, addition of monensin, a monocarboxylic ionophore, greatly enhanced the cytotoxicity of the thioether linked immunotoxin. Monensin increased the immunotoxin activity better than other lysosomotropic reagents that were tested. The increase in activity of recombinant ricin A chain-containing immunotoxins mediated by monensin argues against a role for contaminating ricin B chain in potentiation. PMID- 2783384 TI - Establishment of ascitic tumor of human pre-B acute lymphoblastic leukemia in nonconditioned nude mice. AB - In the present study, an ascitic tumor of NALM-6, a human pre-B acute lymphoblastic leukemia cell line, was established in nude mice which had not been subjected to any preconditioning such as X-irradiation and/or splenectomy. The ascitic tumor was also established in X-irradiated mice. Under various conditions, the tumor transplantability was 100%. NALM-6 cells were initially inoculated i.p. into 8-day-old nude mice after being admixed with X-irradiated HT 1080, a human fibrosarcoma cell line. Then, the in vivo grown (for 10 wk) tumor cells were serially transplanted i.p. into X-irradiated adult (10 to 12 wk old) nude mice. After the serial passages, we succeeded in establishing a highly transplantable NALM-6 ascitic tumor in nonpreconditioned as well as X-irradiated nude mice without the addition of HT-1080 cells. The ascitic tumor cells do not lose transplantability after in vitro culture for 20 days. Cellular radioimmunoassay and fluorescence-activated cell sorter analysis indicated that the in vivo established NALM-6 tumor cells retained the antigenic phenotype of the parental NALM-6 cells. Titration experiments revealed a reciprocal relationship between survival time of the mice and the number of tumor cells inoculated. When appropriate numbers of tumor cells (e.g., 4 x 10(6) cells) were used for the inoculation, survival times of individual mice fell within a relatively narrow range; this narrow range will facilitate the experiments where the present tumor model is used for evaluating the in vivo efficacy of antitumor agents. The present ascitic tumor models, particularly the one established in nonpreconditioned nude mice, will be useful for evaluating the in vivo efficacy of anti-human leukemia agents as well as for studying the in vivo biological behavior of the transplanted leukemia cells. PMID- 2783385 TI - Phase I study of combination therapy with interleukin 2 and beta-interferon in patients with advanced malignancy. AB - Based on a preclinical study demonstrating the synergistic antitumor effect of recombinant interleukin 2 (rIL-2) and beta-interferon (IFN-beta) on mouse tumors and previous results of a phase I study of rIL-2, a phase I study of combination therapy with human rIL-2 and IFN-beta was conducted in 26 patients with advanced malignancy. Patients were given rIL-2 by 24-h continuous i.v. infusion and IFN beta by 2-h i.v. infusion for 5 days each week for 4 weeks. The common side effects were fever, malaise, chills, appetite loss, and diarrhea. Leukocytosis and eosinophilia were observed in 56% and 69% of the patients, respectively. Transient leukopenia and thrombocytopenia were also observed in some patients. Dose-limiting manifestations were intolerable fatigue and liver dysfunction, and it was concluded that the maximum tolerated doses of rIL-2 combined with IFN-beta were 1.1 x 10(6) U/m2/day for rIL-2 and 6.0 x 10(6) IU/m2/day for IFN-beta. No patients achieved complete and partial response to therapy in this study. One patient with pulmonary metastasis from pharyngeal cancer showed a minor response. Natural killer (NK) and lymphokine-activated killer (LAK) activities increased during the 5 days of treatment and decreased during the 2-day intermission. The percentage of IL-2 receptor-positive cells increased markedly until Day 12, and gradually decreased thereafter. The percentage of OKT 4-positive cells and the OKT 4/OKT 8 ratio increased. In contrast, the percentage of Leu 7- or Leu 11 positive cells decreased over the 4-week treatment. A phase II study of this combination therapy is ongoing against head and neck cancer, and renal cell carcinoma. PMID- 2783386 TI - Inhibition of an allospecific T cell hybridoma by soluble class I proteins and peptides: estimation of the affinity of a T cell receptor for MHC. AB - To investigate the molecular basis of the interaction between the T cell receptor and the MHC class I antigen in an allogeneic response, a soluble counterpart of the murine class I molecule, H-2Kb, was genetically engineered. Cells secreting this soluble molecule, H-2Kb/Q10b, inhibited stimulation of an H-2Kb-reactive T cell hybridoma by cells transfected with H-2Kbm10, a weak stimulus, but not by H 2Kb- or H-2Kbm6-transfected cells. Soluble purified H-2Kb/Q10b protein also blocked T cell stimulation. In addition, a peptide from the wild-type H-2Kb molecule spanning the region of the bm10 mutation specifically inhibited activation of the T cell hybridoma by H-2Kbm10 cells, thus suggesting that amino acid residues 163-174 of H-2Kb define a region important for T cell receptor binding. An estimate for the Kd of the T cell receptor for soluble H-2Kb/Q10b was 10(-7) M, while the Kd for soluble peptide 163-174 was 10(-4) M. PMID- 2783387 TI - Age-related changes in the degeneracy of the mouse T-cell repertoire. AB - Aging is associated with a decline in T-cell-dependent immune responses. As the number of T-cells remains relatively constant throughout life, the observed decline in T-cell function may reflect qualitative changes in the T-cells themselves or in the composition of the T-cell population. In this investigation, the quality of the T-cell response was studied in young-adult and aged B6C3F1 mice by assessing the degeneracy of the hapten-specific proliferative response to the antigen-MHC complex. Degeneracy was defined as the ability of lymph node cells from mice contact-sensitized to the hapten TNP to proliferate in response to in vitro stimulation with haptenated allogeneic antigen-presenting cells, thus escaping strict MHC restriction. It was found that, although degeneracy occurred in both age groups, it was more prevalent and of a greater magnitude in the young than in the old lymphocytes. These results suggest that there are qualitative differences in T-cell populations derived from young-adult and aged mice. PMID- 2783388 TI - IL-2 antibody production in lupus mice. AB - We show here that antibody responses to IL-2 were detected in NZBWF1 and BXSB mice but not in MRL/lpr mice in vivo and in vitro. Lipopolysaccharide (LPS), in the presence or in the absence of T cells, also induced anti-IL-2 antibody production in NZBWF1 and BXSB mouse spleen cells but not in MRL/lpr spleen cells in vitro. Anti-IL-2 antibody production increased progressively with age. Supernatants (SN) obtained from NZBWF1 B cell cultures were able to elicit anti IL-2 antibody production in LPS-stimulated spleen cells of normal BALB/c mice, whereas SN from NZBWF1 T cells culture had no detectable effect. PMID- 2783389 TI - In situ hybridization analysis of the age-associated decline in IL-2 mRNA expressing murine T cells. AB - Only a small decrease in the number of L3T4- cells was observed in the Con A stimulated splenocyte cultures of old mice as compared to young, which cannot account for the threefold decrease in IL-2 production. Northern and dot blot analysis of RNA from splenocytes containing equivalent numbers of L3T4+ cells from young and old mice showed that cells from old mice express less IL-2 mRNA after mitogenic stimulation than cells from young mice. Direct analysis by in situ hybridization of stimulated splenocytes from young and old mice then showed approximately a threefold decrease in the percentage of IL-2 mRNA expressing cells in the spleens of old mice as compared to young (8.7 +/- 4.1% old; 28.7 +/- 11.7% young). The average level of expression of IL-2 mRNA was not significantly different between cells from young and old mice; however, there were approximately 40% fewer cells expressing an intermediate to high amount of IL-2 mRNA in old mice as compared to young (26.3% vs 41.8%). These data suggest that the decrease in IL-2 production with age is associated primarily with a decrease in the frequency of IL-2 mRNA-expressing cells in old mice, especially in those cells expressing intermediate to high levels of IL-2 mRNA. PMID- 2783390 TI - A monoclonal antibody to human B lymphoblastoid cells activates human and murine T lymphocytes. AB - A B lymphoblastoid cell line can provide a comitogenic, accessory signal for mitogen-treated T cells. In a study evaluating the antigenic determinant of such cells that mediate this effect, a monoclonal antibody (I57) was raised against the Daudi cell line. This antibody was found to interact with a 30-kDa protein on these cells and had agonistic properties. It enhanced the B lymphoblastoid accessory cell and interleukin 1 (IL-1)-dependent stimulation of PHA-treated murine thymocytes. The stimulatory effect of I57 on PHA-treated thymocytes was more pronounced at high, supraoptimal concentrations of the lectin. This was in contrast with the effect of IL-1 that failed to stimulate these cells treated with PHA at high concentrations. I57 also enhanced stimulation of thymocytes treated with IL-2 alone or with both PHA and IL-2. I57 exhibited by itself mitogenic activity for human T cells. These cells, treated with IL-2, were further stimulated by I57. I57 seems to be different from other agonistic antibodies that have been described so far. PMID- 2783391 TI - Constitutive and PMA-induced interleukin-1 production by the human astrocytoma cell line T24. AB - Astrocytes and glial cells of different species produce interleukin-1 (IL-1) in vitro. In all cases, however, the evidence relied on the detection of IL-1 activity in biological assays. In this report we describe a human astrocytoma cell line (T24) which produces IL-1 constitutively and upon induction with phorbol myristate acetate in vitro. The IL-1 activity was detected in the culture supernatant by a modified assay measuring IL-1-dependent induction of IL-2 production by EL-4 cells. The active molecule had a molecular weight of 17 kDa on gel filtration and an isoelectric point of 5.2. The activity was not neutralized by a goat antibody reacting against pI 7 IL-1. In contrast, rabbit antibody reacting against pI 5 and pI 7 IL-1 neutralized all the IL-1 activity. Cell associated IL-1 activity was detected in the supernatant of freeze-thawed cell lysates. Serological evidence as well as isoelectric point determination further supported that the predominant form of IL-1 synthesized was of the pI 5 type, and immunoprecipitation of 35S-labeled cell lysate with monospecific polyclonal antibody to IL-1 alpha or IL-1 beta detected only IL-1 alpha precursor. However, Northern blot analysis of astrocytoma cells indicated that mRNA encoding for both IL-1 species were present. These results, therefore, provide unequivocal evidence that human astrocytoma cells synthesize both forms of IL-1 message and yet only activity corresponding to the pI 5 form is detectable inside and outside these cells, suggesting that the inactive pI 7 IL-1 precursor, if made, is not processed to the mature active 17-kDa form. PMID- 2783392 TI - Regulation of natural killer cytotoxicity by 1,25-dihydroxyvitamin D3. AB - The steroid hormone 1 alpha, 25-dihydroxyvitamin D3, calcitriol, is crucial in calcium homeostasis. Calcium plays a central role in T, B, and NK cell functions, and calcitriol is a known inhibitor of T cell proliferation and immunoglobulin production. We have analyzed here the immunoregulatory effects of calcitriol on NK cell function. We show that calcitriol specifically specifically inhibits, in a time- and dose-dependent fashion, the generation of cytotoxic activity from cultured CD16+ peripheral blood NK cells. It also suppresses, at similar molar concentrations (1-10 nM), interleukin 2 (IL-2) production by PHA-activated peripheral blood lymphocytes. Calcitriol does not interfere with the cytotoxic function of NK cells, whether fresh or generated in vitro, placing the inhibition at the level of NK cell activation. Interestingly enough, exogenous IL-2 can completely reverse the suppressive effect. These findings suggest that modulation of NK cell activation by control of the internal level of IL-2 may reflect an additional paracrine calcitriol-dependent circuit with immunoregulatory consequences. PMID- 2783393 TI - Selective stimulation of human thymocyte subpopulations by recombinant IL-4 and IL-3. AB - Human thymocytes and thymocyte subsets were examined for their proliferative response to recombinant interleukin-4 (IL-4) and interleukin-3 (IL-3) in serum free cultures. IL-4 induced marked proliferation of thymocytes after PHA and TPA stimulation, in contrast to the marginal response of T cells from adult peripheral blood. However, depletion of thymocytes bearing the CD3 antigen diminished the IL-4-induced proliferation of thymocytes, indicating that the response of thymocytes to IL-4 is mainly mediated by the CD3-positive cells. Phenotypic changes after culture with IL-4 showed an increase in the percentage of total thymocytes expressing mature T cell antigens (CD3, CD5, and TCR-1) and a decrease in CD1-positive cells. In addition there was an increase in the percentage of CD4+8- cells in both nylon wool-separated thymocytes and CD3 depleted cells with the disappearance of most of the CD4+8+ cells. However, an increase in the percentage of CD4-8- cells was also observed. The IL-4-responding cells do, however, express the mature T cell antigen, CD5, in high density. The effect of IL-3 on the proliferation of human thymocytes was very low and detected only when the thymocytes were cultured in serum-free medium. Depletion of CD3 positive cells did not diminish the IL-3-mediated proliferation of thymocytes, indicating that IL-3-responsive thymocytes are more immature than the subset of thymocytes which responds to IL-4. These results suggest that IL-4 and IL-3 play different roles in the development of human T cells. PMID- 2783394 TI - Experimental synovitis induced by collagen-specific T cell lines. AB - Type II collagen (CII) and ovalbumin (OV) reactive T cell lines were developed from the lymph node cells of Louvain rats previously immunized with the respective antigen. Histologic sections of rat knees injected intraarticularly (ia) with 10(6) cells from line CII (VA) or CII (VII) were graded blindly. Significant synovitis (P less than 0.000001 and 0.004, respectively) was evident compared to OV line recipients. Pannus developed within 48 hr, persisted for at least 4 to 6 weeks, was inducible with fewer than 10(3) CII cells, and required viable lymphocytes. The process was independent of anticollagen antibodies and was associated with the lines' capacity to elaborate a previously described 65 kDa CII-binding arthritogenic lymphokine. Line CII (VIII), which could not elicit a synovitis, did not produce detectable quantities of this factor. A line- and antigen-specific synovitis, comparable to the ia injection protocol, was also induced by intravenous administration of 2 x 10(7) CII (VA) cells and ia challenge with soluble collagen. These studies demonstrate that CII lines bearing the T helper phenotype can evoke a sustained synovitis and suggest that this experimental process is associated with the release of an arthritogenic lymphokine and not dependent on the formation of antibodies to CII. PMID- 2783395 TI - 1,N6-etheno-2'-deoxyadenosine and 3,N4-etheno-2'-deoxycytidine detected by monoclonal antibodies in lung and liver DNA of rats exposed to vinyl chloride. AB - 1,N6-Etheno-2'-deoxyadenosine (epsilon dAdo) and 3,N4-etheno-2'-deoxycytidine (epsilon dCyd) are formed in vitro by reaction of DNA with the electrophilic metabolites of vinyl chloride (VC), chloroethylene oxide and chloroacetaldehyde. To detect and quantitate these DNA adducts in vivo, we have raised a series of specific monoclonal antibodies (Mab). Among those, Mab EM-A-1 and Mab EM-C-1, respectively, were used for detection of epsilon dAdo and epsilon dCyd by competitive radioimmunoassay (RIA), following pre-separation of the etheno adducts from DNA hydrolysates by high performance liquid chromatography. At 50% inhibition of tracer-antibody binding, both Mab had a detection limit of 187 fmol and antibody affinity constants (K) of 2 x 10(9) l/mol. The levels of epsilon dAdo and epsilon dCyd were quantitated in the DNA of lung and liver tissue of young Sprague-Dawley rats exposed to 2000 p.p.m. of VC for 10 days. The epsilon dAdo/2'-deoxyadenosine and epsilon dCyd/2'-deoxycytidine molar ratios were 1.3 x 10(-7) and 3.3 x 10(-7), respectively, in lung DNA, and 5.0 x 10(-8) and 1.6 x 10(-7) in liver DNA. When hydrolysates of 3 mg of DNA were analyzed by RIA at 25% inhibition of tracer-antibody binding, epsilon dAdo and epsilon dCyd were not detected in liver DNA from untreated rats above the limiting epsilon dAdo/2' deoxyadenosine and epsilon dCyd/2'-deoxycytidine molar ratios of 2.2 x 10(-8) and 3.1 x 10(-8), respectively. PMID- 2783396 TI - Noninvasive quantitation of regional myocardial oxygen consumption in vivo with [1-11C]acetate and dynamic positron emission tomography. AB - The usefulness of [1-11C]acetate as a tracer of overall myocardial oxidative metabolism for use with positron emission tomography has been investigated in 12 closed-chest dogs. Myocardial 11C activity clearance kinetics after intravenous administration of [1-11C]acetate in dogs have been determined noninvasively by positron emission tomography. Biexponential fitting of regional myocardial 11C time-activity curves was performed to give clearance half-times and fractional distribution. The rate constant k1 for the early rapid phase of 11C activity clearance was found to correlate linearly with myocardial oxygen consumption (y = 0.0156x + 0.039; SEE = 0.023; r = 0.95). k1 was approximately 7% lower in septal sectors compared with the left ventricular free wall, suggesting that regional oxygen consumption in the septum was lower; a concomitant regional attenuation of blood flow in the septum relative to the left ventricular free wall was also observed. In dogs using carbohydrates as the predominant fuel, k1 oxygen consumption was somewhat more than in dogs using predominantly free fatty acids (0.021 +/- 0.002 compared with 0.018 +/- 0.002, p less than 0.01), indicating that increased carbohydrate consumption is associated with a small increase in k1 at constant oxygen consumption. It is concluded that measurement of myocardial [1 11C]acetate kinetics allows noninvasive determination of cardiac oxygen consumption by positron emission tomography and that the technique is relatively insensitive to myocardial fuel selection. PMID- 2783397 TI - Mechanism of action of human pancreatic and salivary alpha-amylase on 4,6 ethylidene-alpha-4-nitrophenyl-maltoheptaoside substrate. PMID- 2783398 TI - Purification of a glycosaminoglycan-stimulatory lymphokine from supernatants of in vitro-activated human mononuclear cells. AB - Glycosaminoglycans (GAGs), like collagens, are the major component of the connective tissue matrix. Fibroblasts are responsible for the production and maintenance of this matrix. Glycosaminoglycan-stimulatory factor (GAG-SF) from T lymphocytes is a lymphokine that selectively increases GAG synthesis in normal human dermal fibroblasts. Supernatants of mononuclear cells activated with a mitogen, concanavalin A, were used to purify GAG-SF to an apparent homogeneity. The GAG-SF proved to be a glycoprotein with a molecular weight of 67,000 and pI of 5.6. It was not mitogenic to fibroblasts and did not regulate collagen synthesis in confluent fibroblast cultures. The purified factor was distinct from interleukin-1 (IL-1), but it could synergize with IL-1, which was present in unpurified supernatants, in modulating the activation of fibroblasts. The purification and characterization of this lymphokine are important because it is a product of activated lymphocytes and thus may be involved in the immunopathogenesis of several human diseases characterized by the presence of lymphoid infiltrates in the target organ such as autoimmune diseases of the connective tissue, the stromal reactions in human tumors, and the fibrosis associated with chronic rejection of transplanted organs. PMID- 2783399 TI - Deficient interleukin-2-activated killer cell cytotoxicity in patients with systemic lupus erythematosus. AB - This study was undertaken to determine if the cytotoxic activity of interleukin-2 (IL-2)-activated killer (LAK) cells, which is induced by the direct activation of lymphocytes by IL-2, is defective in systemic lupus erythematosus (SLE). The killer cell activity of SLE patients, whether it be generated in autologous plasma or serum-free media, was significantly less than the controls against three different target cells. It was observed, by incubating control lymphocytes in 10% fresh SLE plasma, that soluble factors were responsible for a portion of the reduced generation of LAK cell cytotoxicity (P less than 0.05). Suppression ranges from 4 to 70% with a mean of 33%. However, when SLE LAK cells were generated in serum-free media, a greater reduction of generated LAK cell activity was observed (P less than 0.005). Using a disease activity score, it was determined that SLE cytotoxicity negatively correlated with disease activity only when the cells were cultured in serum-free media. Irrespective of the culture conditions, lytic activity did not correlate with levels of anti-DNA antibodies, anti-Sm antibodies, circulating immune complexes, or prednisone therapy. PMID- 2783400 TI - Natural anti-chondrocyte cytotoxicity of normal human peripheral blood mononuclear cells. AB - Natural cytotoxic activity of peripheral blood mononuclear cells (PBMC) from healthy humans against normal epiphyseal chondrocytes was assessed in the 51Cr release assay. PBMC lysed human fetal chondrocytes, while exerting only low activity against xenogeneic rat chondrocytes. Anti-human chondrocyte cytotoxicity was also demonstrated with normal human splenocytes. Peripheral blood anti chondrocyte effector cells were shown to be plastic nonadherent and nonphagocytic. Cell separation by sheep red blood cells rosette sedimentation has revealed that most of the anti-chondrocyte activity was found in the T cell depleted fraction. Only a low activity was present in the T cell-enriched fraction. Depletion of cells endowed with receptor for the Fc portion of the IgG molecule by either IgG-coated ox red blood cells rosette sedimentation or treatment with natural killer (NK) cell-specific anti-Leu-11b monoclonal antibody and complement resulted in almost complete elimination of cells responsible for chondrocyte lysis. Short-term (3-hr) preincubation of PBMC with interferon-alpha strongly augmented their anti-chondrocyte cytotoxicity. On the other hand, no stimulation of chondrocyte lysis was seen after a 3-hr preincubation with interleukin 2 although this treatment increased significantly NK cell-mediated lysis of K-562 leukemic cells. Using competitive assay it has been demonstrated that 51Cr-labeled chondrocyte lysis can be inhibited by addition of "cold" human chondrocytes as well as by cold K-562 cells. Only low inhibition of lysis was seen with cold xenogeneic rat chondrocytes. All these results show that natural anti-chondrocyte effectors share phenotypic and functional properties with typical NK cells. PMID- 2783402 TI - Characterization of activated lymphocytes in colon cancer. AB - The percentages of activated lymphocytes in colon cancers were compared to clinical features of the tumors and to functional characteristics of the tumor infiltrating lymphocytes (TIL) in order to evaluate the role of activated TIL in controlling tumor growth. The TIL isolated from colon cancers contained 80 +/- 6% T cells [cluster designation (CD) 2+], 42 +/- 9% CD4+ cells, 27 +/- 9% CD8+ cells, 17 +/- 5% cells (surface immunoglobulin or SIg+), 6 +/- 2% null cells (CD2 , SIg-), 6 +/- 4% Leu 7+ cells, 1 +/- 0% macrophages (CDw 14+), and no plasma cells (PCA+). The lamina propria lymphocytes (LPL) isolated from adjacent colonic mucosa contained a similar distribution but with fewer CD8+ (10 +/- 5%) and Leu 7+ (0.6 +/- 0.3%) lymphocytes (P less than 0.05). More TIL than LPL expressed the interleukin-2 (IL-2) receptor (9 +/- 8% vs 1 +/- 0.8% CD25+ cells; P less than 0.05) and the transferrin receptor (4 +/- 5% vs 0.3 +/- 0.6% T9+ cells; P less than 0.05). Those TIL expressing activation antigens were CD2+, SIg-. The percentage of TIL that were CD25+ did not correlate with the extent of tumor spread, with the degree of tumor differentiation, nor with the percentage of HLA DR+ tumor cells. However, there were significantly more CD25+ TIL from tumors located in the left colon, particularly small lesions, than from tumors located in the right colon (P less than 0.05). The proliferation of TIL preparations cultured with medium alone, with mitogens, or with IL-2 did not vary according to the percentage of CD25+ lymphocytes in the TIL. T cells may be activated by foreign surface determinants on tumor cells, particularly in small, left-sided lesions. PMID- 2783401 TI - Possible role of natural cytotoxic activity in the pathogenesis of AIDS. AB - In an attempt to assess the role of immune cytotoxic activity in the sequence of events leading to the acquired immunodeficiency syndrome (AIDS), natural cytotoxic activity was studied in 17 asymptomatic homosexual males, seropositive for anti-human immunodeficiency virus (HIV) antibodies, as compared to 16 of their seronegative counterparts and to 14 control healthy heterosexual individuals. Cell (contact)-mediated cytotoxicity (CMC) as well as cytotoxin (CTX) production by lipopolysaccharide (LPS)-stimulated, phytohemagglutinin (PHA) stimulated, HeLa tumor cell-stimulated, and unstimulated peripheral blood mononuclear cells (PBMC) were determined using HeLa cell monolayer cultures, sensitized with cycloheximide, as targets. The CMC was markedly enhanced in the seropositive group (28 +/- 21 (mean +/- SD) lytic units/10(6) PBMC) as compared to the seronegative group (17 +/- 7; P less than 0.005) and to the heterosexual group (13 +/- 6; P less than 0.05). Likewise, CTX production by unstimulated PBMC from seropositive homosexuals (19 +/- 26 units/ml) was higher than that observed in the other groups (both 4 +/- 4 units/ml; P less than 0.05). CTX production by PHA-stimulated, LPS-stimulated, and HeLa cell-stimulated PBMC was significantly enhanced in both the seropositive and seronegative groups in comparison to the normal heterosexual controls. These results suggest that increased cytotoxic activity may be present in homosexuals prior to their exposure to HIV, and may be further enhanced after HIV infection. PMID- 2783403 TI - The role of T cell phenotypes in decreased lymphoproliferation of the elderly. AB - A possible mechanism of the decreased mitogen-induced lymphoproliferation of the elderly is a shift in the relative numbers of T lymphocyte subpopulations. Results from studies examining such changes have been conflicting. In an effort to resolve this conflict, alterations in T cell subsets in the peripheral blood of a large number of relatively healthy, elderly subjects (149; mean age 84.6) were evaluated. Although there were several differences in percentages of subpopulations between elderly and young subjects, no significant differences in the absolute numbers of lymphocytes, monocytes, or T cell subsets between the groups were observed. In addition, there was no correlation between mitogen induced lymphoproliferation and T cell subsets. Since the decreased mitogen response could reflect a difference in the ability of one T cell subset to proliferate, the phenotype of the T cells after stimulation with PHA was determined. Although the elderly demonstrated a decreased number of all T cell subsets after PHA stimulation compared to young subjects, the most pronounced decrease was in CD8+ cells. Further, young individuals demonstrated a significant increase in the percentage of CD8+ cells (p less than 0.001) after 72 hr of culture with PHA; elderly subjects showed no change in the percentage of T cell subsets. Although both groups had an increase in interleukin 2 receptor (IL2R), transferrin receptor (TfR), and MHC class II Ag (HLA-DR) positive cells after PHA stimulation, the mean percentage of TfR+ cells was significantly greater in the young than in the elderly (p less than 0.05). This decreased expression of TfR+ cells in the elderly was reflected by a decreased percentage of CD8+ cells expressing TfR. In addition, the percentages of CD8+ cells, CD8+ cells expressing TfR, and CD8+ cells expressing IL2R after activation correlated with PHA-induced proliferation. These results suggest that the impaired lymphoproliferative ability of elderly cells is not related to the proportions of T cell subsets present in peripheral blood. Rather, there appears to be some defect in the ability of all T cells, but especially of the T suppressor/cytotoxic cells, of the elderly to respond to PHA manifested by a decreased expression of transferrin receptors. PMID- 2783404 TI - Sequential anti-idiotypes define reciprocal idiotopes on the same anti-DNA antibody. AB - Sequential anti-idiotypes have defined a pair of idiotypes with an idiotype-anti idiotype relationship to each other in the variable region of the monoclonal anti DNA antibody 16/6. A rabbit immunized with 16/6 made an antibody-1 (anti-Id 16/6R) and an antibody-2 (anti-anti-Id-16/6 or anti-anti-Id 16/6M). The latter bound to M-2, a monoclonal mouse anti-Id-16/6. M-2 was used to immunize a second mouse, which produced M-16. The variable region of M-16 mimics an antigenic surface on Id-16/6 and binds to a peptide contained within the first hypervariable region of the light chain of 16/6. The complementary idiotypes of 16/6 represent a reciprotope, an idiotype/anti-idiotype pair within the variable region of the same immunoglobulin molecule which may have functional importance. PMID- 2783405 TI - Control of IgE responses. AB - Peyer's patches (PP) in germ-free rats (GF) and in the hyper-IgE syndrome patient (HIES) differ from their conventional rat (C) and healthy human (HH) counterparts in that GF rats contained fewer (two-fold) PP and none was detected in HIES. Existing PP in GF rats had reduced cellularity (three-fold) and different B and T cell subsets: high numbers of IgE-bearing (sIgE+) B cells (approximately 15% of total cells), one-half of which also expressed sIgA, were present in GF rat PP while none was detected in C rat PP (less than 1%). GF rat PP also contained elevated numbers of sIgA+ cells and decreased sIgM+ cells, with elevated numbers of sThy 1+ RT 7.1+ Ig- T cells (suppressor phenotype) and reduced sThy 1- RT 7.1+ Ig- T cells (helper phenotype). The cellular composition of GF rat PP was converted to that resembling a C rat within 18 hr after (a) use of standard (unautoclaved) chow; (b) feeding with certain bacteria or "working" bacterial cell wall components (BCWC) and synthetic derivatives, murein, MTP-PE, and norMDP, but not with LPS, core lipid A, or lipoprotein; BCWC had no effect if injected intravenously; or (c) thymectomy. Each procedure resulted in (i) elimination of sIgE+ B cells and normalization of the other isotypes, and (ii) loss of T suppressor cells and normalization of T helper cells. After treatments, no sIgE+ cells were detected in bone marrow (BM), thymus, other lymphoid organs, or blood. PP were not detected in HIES, although they were present in HH (approximately 10/individual). P blood contained two distinct sIgE+ B cell subpopulations, the apparent source of which was mesenteric lymph node (MLN), the only organ in which high numbers of these cells (35%) (five nodes examined) were detected; far fewer IgE+ cells were found in spleen (less than 5%), and none was detected in BM, thymus, other LN, or appendix, which was virtually acellular. Virtually no IgE secreting plasma cells were detected in MLN, spleen, appendix, other lymphoid organs, or in gut lamina propria. IgE+ B cells in MLN were not detected in follicles (classical B cell areas); instead, they were found in high numbers in the thymus-dependent area and in medulla. Most follicles (greater than 98%) in MLN and spleen contained intercellular IgE complexed to bacterial antigen and/or CD23 (IgE-binding factor? antigen?), but contained no germinal centers.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2783406 TI - Preventive health care utilization. Prenatal and the first 3 years in a Utah population. AB - The utilization of preventive health care services prenatally and for children up to 3 years old was determined by mailed questionnaire. The parents surveyed were randomly chosen from birth records provided by the Utah Bureau of Vital Records. "Adequate use of preventive services" was defined as six prenatal visits for a full-term pregnancy and as seven well-child visits during the first 3 years of life. Responses, received from 219 (36.5%) parents, indicated only 1 percent did not utilize adequate prenatal care. Women made an average of 11.3 visits during their pregnancies; 83 percent saw their prenatal health care provider at least 10 times. Well-child visits were less adequately utilized, an average of 6.3 visits per child. Fifty-six percent made fewer than seven visits; only 23 percent made all of the nine visits recommended by the American Academy of Pediatrics. Patients who made seven or more well-child visits were more likely to have received their fourth diphtheria, pertussis, tetanus (DTP) immunization and to have health insurance policies that paid for preventive health care services. Results indicate that families use preventive services more consistently before the birth of their children than after. Use of preventive services is associated with adequate insurance coverage and results in more thorough immunization. PMID- 2783407 TI - Protein-losing enteropathy in systemic lupus erythematosus. Diagnosis and monitoring immunosuppressive therapy by alpha-1-antitrypsin clearance in stool. AB - Enteric protein loss resulting in profound hypoalbuminemia and anasarca is an uncommon manifestation of systemic lupus erythematosus and only rarely is the initial presentation of disease. A few patients with SLE and protein-losing enteropathy in the absence of increased central venous pressure or intestinal lymphangiectasia have been reported. We describe the utility alpha-1-antitrypsin clearance in stool for diagnosing and monitoring enteric protein loss during successful immunosuppressive drug therapy in a patient who presented with massive enteric protein loss as the initial manifestation of systemic lupus erythematosus. PMID- 2783408 TI - Molecular analyses of in vivo hprt mutant T cells from atomic bomb survivors. AB - In vivo-derived hprt-deficient mutant T cells isolated from three nonirradiated controls and two atomic bomb survivors were studied by Southern blot analysis to investigate the molecular spectra of the mutations. Mutant frequencies for the three controls were 1.8, 2.3, and 7.3 x 10(-6), and those for the two survivors (who had received radiation doses of 2.46 and 2.15 Gy, based upon the revised atomic bomb shielded kerma estimates) were 9.3 and 14.4 x 10(-6), respectively. Fourteen (13%) of 105 mutant T-cell colonies from the controls showed various structural changes in the hprt gene. The frequency of mutants with hprt gene structural changes in one atomic bomb survivor, who exhibited a mutant frequency of 9.3 x 10(-6), was 26% (16/61), which was significantly higher than that of the controls. However, the frequency of structural changes in the other survivor (14%, 8/59) was not higher than that of the controls. Two sets of mutants (in total, eight mutants) from the survivor, who showed a significantly higher frequency of mutants with hprt gross alterations than did the controls, had the same hprt changes and the same rearrangements of T-cell receptor (TcR) beta- and gamma-chain genes, indicating a clonal expansion from one progenitor mutant. This phenomenon may reflect an in vivo recovery process of T cells in the periphery after exposure to atomic bomb radiation. However, when comparing the frequency of mutations, these two sets of mutants should be reduced. After reducing the total number of mutants from the number of gross hprt changes, the frequency was not significantly higher than that of the controls. PMID- 2783410 TI - Pregnancy rate is significantly higher in in vitro fertilization procedure with spermatozoa isolated from nonliquefying semen in which liquefaction is induced by alpha-amylase. AB - In 115 patients (group I) in which normal liquefaction of semen occurred, the fertilization rate of the yielded oocytes was 71.2% after standard in vitro fertilization procedure, and the viable pregnancy rate per patient per cycle was 13.0%. In a comparable group of 26 patients (group II), in which semen liquefaction did not occur spontaneously, alpha-amylase was added in order to liquefy the semen. In this group, the fertilization rate was 86.7% of the yielded oocytes, and the viable pregnancy rate per patient per cycle was 26.9% (P less than 0.05). It is concluded that alpha-amylase can be of use to liquefy nonliquefying semen, and that the resultant spermatozoa have a positive effect on pregnancy results. PMID- 2783409 TI - Identification of aneuploidy-inducing agents using cytokinesis-blocked human lymphocytes and an antikinetochore antibody. AB - The identification of agents causing aneuploidy in humans, a condition associated with carcinogenesis and birth defects, is currently limited due to the highly skilled and time-consuming nature of cytogenetic analyses. We report the development of a new simple and rapid assay to identify aneuploidy-inducing agents (aneuploidogens). The assay involves the chemical- or radiation-induced formation of micronuclei in cytokinesis-blocked human lymphocytes and the use of an antikinetochore antibody to determine whether the micronuclei contain centromeres--a condition indicating a high potential for aneuploidy. All agents tested produced dose-related increases in the frequency of micronucleated cells. The micronucleated cells induced by the known aneuploidogens--colchicine, vincristine sulfate, and diethylstilbestrol--contained kinetochore-positive micronuclei 92, 87, and 76% of the time, respectively. In contrast, the micronucleated cells induced by the potent clastogens--ionizing radiation and sodium arsenite--contained kinetochore-positive micronuclei only 3 and 19% of the time, respectively. These results indicate that this relatively simple assay can discriminate between aneuploidogens and clastogens and may allow a more rapid identification of environmental and therapeutic agents with aneuploidy-inducing potential. PMID- 2783411 TI - Nuclear disintegration of target cells by killer B lymphocytes from tumor-bearing mice. AB - Normal murine B lymphocytes are not known to be effectors of the Fc receptor mediated, antibody-dependent cellular cytotoxicity (ADCC). In contrast, we report here that highly purified splenic B cells from mammary tumor-bearing mice develop the potential of lysing antibody-coated target cells. These lymphocytes are characterized by being G-10 nonadherent, nylon wool adherent, sIg+, FcR+, Thy 1.2 , asialo GM1-, and the immunoglobulin heavy-chain genes of both chromosomes are rearranged. The lytic reaction is characterized by a noninterdigitating binding and by the appearance of endocytotic vesicles in the target cells. Nuclear disintegration occurs 18 h after initial effector-target cell conjugate formation. At such time, only minor cytoplasmic membrane alterations are evident. The emergence of killer B cells in tumor-bearing hosts indicates that all lymphoreticular cell types bearing Fc receptors are capable of mediating ADCC. PMID- 2783412 TI - High-yield trapping of EGF-induced receptor dimers by chemical cross-linking. AB - The binding of epidermal growth factor (EGF) to its plasma membrane receptor results in the stimulation of a tyrosyl residue-specific protein kinase, which has been shown to be part of the receptor. The mechanism by which EGF binding give rise to the stimulation of kinase activity is not understood in detail; however, a number of recent studies have implicated receptor dimerization or oligomerization in this process. We prepared Triton X-100 extracts of A431 cells in which the concentration of EGF receptors was on the order of 10(-7) M. When samples of the extracts were incubated with or without EGF and then treated with the high-yield cross-linking reagent bis(sulfosuccinimidyl)suberate (BS3), covalent receptor dimers could be detected in high yield in samples that had been treated with both EGF and BS3, whereas only monomeric receptor was detected in untreated samples or in samples that had been treated with either EGF or BS3. The yield of receptor dimers trapped by cross-linking correlated with the stimulation of autophosphorylation by EGF and with the concentration of EGF present. EGF induced receptor dimers were also efficiently cross-linked in highly purified receptor preparations, suggesting that EGF-induced dimerization is a process intrinsic to the receptor, requiring no additional accessory proteins. PMID- 2783413 TI - Immunophenotypic similarities of mediastinal clear-cell lymphoma and sinusoidal (monocytoid) B cells. AB - Using 14 well-defined (clustered) monoclonal antibodies (MAbs) against B-cell restricted/associated differentiation and activation (CD) antigens and 12 mediastinal clear-cell lymphomas (MCCL), 46 follicular-center-cell lymphomas (FCCL), and 20 non-neoplastic lymph nodes--including toxoplasmic and HIV associated lymphadenitis--were immunohistochemically examined to determine the histogenesis of MCCL. Antigenically, MCCL was characterized as CD5-, CD10-, CD19+, CD20+, CD21-, CD22+, CD30-, CD37+, CDw40+, and by a frequent expression of CD11c and CD23, while other antigens were inconsistently expressed. The antigenic profiles of MCCL and FCCL showed statistically significant differences in 4/14 distinct antigens. When the neoplastic cells of both tumor groups were compared with morphologically defined normal B-cell types, the overall resemblance of their immunophenotypes was even closer between MCCL and sinusoidal (monocytoid) B cells than between FCCL and follicular-center B cells. We conclude that MCCL is a lymphoma type distinct from FCCL, most probably representing a highly malignant neoplasm corresponding to sinusoidal B-cell reaction. PMID- 2783414 TI - The influence of syngeneic anti-idiotypic antibody on the biodistribution of an anti-tumour monoclonal antibody in BALB/c mice. AB - BALB/c mice were immunized against syngeneic murine 791T/36 monoclonal antibody (MAb) by intraperitoneal (i.p.) injection of the antibody conjugated to ricin toxin A chain. Subsequently, in these and control mice, the biodistribution of radioiodinated 791T/36 antibody and isotype-matched (IgG2b) control immunoglobulin was examined. Pre-treated mice showed marked perturbation of biodistribution of the 791T/36 antibody but not of control IgG2b. This was manifest as rapid hepatic clearance of the antibody which was followed by accelerated catabolism and excretion of the radiolabel. Anti-idiotypic antibodies were identified in immunotoxin pretreated mice by their ability to inhibit the binding of FITC-labelled 791T/36 antibody to tumour target cells. These studies show that antibody responses, even to only the idiotype of a MAb, may produce marked perturbation of its biodistribution. This has implications for the clinical use of human or chimeric MAbs for tumour imaging or targeting of therapeutic agents since, if anti-idiotypic antibodies are evoked, they could still prevent tumour localization of antibody or conjugate. PMID- 2783415 TI - Selective killing of squamous carcinoma cells by an immunotoxin that recognizes the EGF receptor. AB - We have conjugated a murine monoclonal antibody (B4G7) against the human epidermal growth factor (EGF) receptor to gelonin, a 60S ribosome inactivating protein, via N-succinimidyl-3-(2-pyridyldithio)propionate (SPDP) and 2 iminothiolane. The B4G7-gelonin conjugate bound to the cell surface in proportion to the number of EGF receptors and competed with B4G7 antibody for binding to EGF receptors. The conjugate killed EGF receptor-hyperproducing squamous carcinoma cells (A431, NA, Ca9-22, TE5), and to some extent, human fibroblasts (HFO). It did not kill EGF receptor-deficient small-cell lung cancer cells (H69) and mouse fibroblasts (Swiss/3T3). Free B4G7, gelonin or a mixture of B4G7 and gelonin did not kill A431 cells. The number of EGF receptors was correlated to cytotoxicity at 10(-8) M of the conjugate, and the data were fitted to the regression equation: y = -35.83 log x +233.4 (correlation coefficient = -0.9995). These results suggest that the B4G7-gelonin conjugate may be a useful weapon for targeting therapy to squamous-cell carcinomas. PMID- 2783416 TI - Prevalence and clinical characteristics of borderline patients in an eating disordered population. AB - Ninety-four consecutive patients seeking treatment for eating disorders were evaluated for eating attitudes and behaviors, weight history, psychiatric symptoms, psychosocial stressors, social adaptation, family environment, and the presence of borderline personality organization. The patients were divided into borderline and nonborderline groups and were compared on the above dimensions, with 46% of the patients showing borderline personality features. The borderline patients and the nonborderline patients had relatively few differences in the severity of their symptomatic eating behaviors and attitudes. The borderline patients, however, were significantly more disturbed on a number of relevant dimensions, including general psychiatric symptoms, psychosocial adaptation, family environment, self-destructive behavior, and treatment history. The authors suggest, on the basis of their findings and the findings of previous studies, that about one third of eating-disordered patients have marked borderline characteristics. They recommend that research studies in the future control for the eating-disordered patients' character pathologies. They also recommend that clinicians use a combination of long-term relationship-oriented treatment and psychopharmacological treatment with eating-disordered patients who have borderline personality disorder. PMID- 2783417 TI - Structural and functional analysis of the promoter region of the gene encoding mouse steroid 11 beta-hydroxylase. AB - The mouse gene encoding adrenal steroid 11 beta-hydroxylase (11 beta-OHase) has been cloned and the nucleotide sequence of its 5' end has been determined. The coding regions sequenced are homologous (75%) to the sequence of bovine 11 beta OHase cDNA. The 5'-flanking region of the 11 beta-OHase gene contains a potential cAMP response element (TGACGTGA) located 56 base pairs upstream of the transcription initiation site (position -56) and two motifs at positions -249 and -148 which are similar to an element postulated to be required for the expression of 21-hydroxylase. Transfection of mouse Y1 adrenocortical tumor cells and MA-10 testicular Leydig cells with plasmids containing the 11 beta-OHase promoter linked to a growth hormone reporter gene showed that the 11 beta-OHase promoter can direct cell-specific expression. Deletion analyses of the 5'-flanking region suggest that multiple sequence elements, one of which is located between positions -425 and -338 and a second between positions -338 and -123, interact to produce full levels of promoter activity. Mutant Y1 cells defective in cAMP dependent protein kinase activity do not express growth hormone driven by the 11 beta-OHase promoter, indicating that expression of 11 beta-OHase in Y1 cells requires an intact cAMP second messenger system. Moreover, mutation of the putative cAMP response element at position -56 abolishes expression. These experiments thus present a useful system for the investigation of cis-acting elements involved in the transcriptional regulation of 11 beta-OHase. PMID- 2783419 TI - Basis for resistance to 3-deazaaristeromycin, an inhibitor of S adenosylhomocysteine hydrolase, in human B-lymphoblasts. AB - Clones resistant to 3-deazaaristeromycin, a potent inhibitor of S adenosylhomocysteine hydrolase, were selected from a nucleoside kinase-deficient derivative of the WIL-2 human B-lymphoblastoid cell line. The resistant clones took up 3-deazaaristeromycin and showed no alteration in the level of S adenosylhomocysteine hydrolase activity or in the sensitivity of the enzyme to inhibition by 3-deazaaristeromycin. However, they displayed markedly elevated S adenosylmethionine content during growth in 3-deazaaristeromycin and, following prolonged selection, enhanced export of S-adenosylhomocysteine. As a result they maintained a high ratio of S-adenosylmethionine to S-adenosylhomocysteine and thus were resistant to the inhibition of S-adenosylmethionine turnover and transmethylation caused by 3-deazaaristeromycin. Expanded S-adenosylmethionine pools declined over several weeks of nonselective growth, suggesting a metabolic adaptation rather than a mutational mechanism. No alterations in S adenosylmethionine synthetase activity were found in the 3-deazaaristeromycin resistant clones. S-Adenosylhomocysteine export appeared to be carrier-mediated and largely unidirectional. The resistant clones showed a 5-fold increased rate of S-adenosylhomocysteine export compared with parental cells, but a similar Km for intracellular S-adenosylhomocysteine, estimated to be approximately 1 mM. Our results highlight the opposing effects of S-adenosylmethionine and S adenosylhomocysteine on transmethylation and suggest that the ability to elevate S-adenosylmethionine pools and to export S-adenosylhomocysteine may provide for homeostatic control of transmethylation in lymphoid cells when S adenosylhomocysteine hydrolase activity is limited. PMID- 2783418 TI - Synthetic diacylglycerols trigger an increase of intracellular free calcium in promyelocytic HL60 cells. AB - Phosphoinositide turnover is known to play an important role in intracellular free calcium homeostasis through the inositol trisphophate-mediated release of calcium from intracellular stores. We find that the other product of phosphoinositide turnover, 1,2-diacylglycerol, elicits an increase in intracellular free calcium in HL60 cells which is due, at least in part, to release of calcium from intracellular stores. This effect is specific for calcium, since intracellular sodium and potassium levels and cellular volume were unaffected. Concomitant with the intracellular calcium increase, we find an increase in cellular inositol trisphosphate levels, suggesting that the effect of diacylglycerol on calcium may be mediated by inositol trisphosphate. Diacylglycerols also stimulate calcium efflux. This stimulation is not simply due to the increase in intracellular calcium. These effects appear not to be mediated through stimulation of a phorbol ester-activatable protein kinase C (Ca2+/phospholipid-dependent enzyme) since phorbol esters do not elicit an increase in cytoplasmic free calcium or an increase in calcium efflux. PMID- 2783420 TI - Inhibition of cytotoxic T lymphocyte-mediated lysis and cellular proliferation by isoquinoline sulfonamide protein kinase inhibitors. Evidence for the involvement of protein kinase C in lymphocyte function. AB - The effects of the isoquinoline sulfonamides, a class of synthetic protein kinase inhibitors, namely 1-(5-isoquinoline sulfonyl)-2-methylpiperazine dihydrochloride (H7), N-[2-(methylamino)ethyl]-5-isoquinoline sulfonamide dihydrochloride (H8), N (2-aminoethyl)-5-isoquinoline sulfonamide dihydrochloride (H9), and N-(2 guanidinoethyl)-5-isoquinoline sulfonamide hydrochloride (HA1004), on the lytic activity of in vivo-produced (H-2b anti-H-2d alloimmune) cytotoxic T lymphocytes (CTL) were investigated. The hierarchy of inhibition of lysis shown by these compounds resembled that of their inhibition of Ca2+/phospholipid-dependent enzyme (protein kinase C). H7 has the highest affinity for protein kinase C (Hidaka, H., Inagaki, M., Kawamoto, S., and Sasaki, Y. (1984) Biochemistry 23, 5036-5041) and gave the greatest inhibition of lysis by CTL. HA1004 has the weakest affinity for protein kinase C and gave very little inhibition of lysis, whereas H8 and H9 showed intermediate inhibition of lysis. In addition, the effect of the isoquinoline sulfonamides on cellular proliferation was examined. Interestingly, the pattern of inhibition observed for both lymphocytes and tumor cells closely mimicked the effects of these compounds on protein kinase C activity. These results demonstrate that modulation of an early biochemical signal affects both short-term (e.g. CTL-mediated lysis) and long-term (e.g. cellular proliferation) events. These data provide further evidence for the integral role of protein kinase C in the activation of the lytic signal in CTL. In addition, suggestive evidence is provided that protein kinase C, or some other enzyme with similar sensitivity to the isoquinoline sulfonamides, plays an important role in cellular proliferation. PMID- 2783421 TI - Structural significance of the C-terminal amphiphilic helix of interleukin-2. AB - The structural significance of C-terminal amphiphilic alpha-helix of human interleukin-2 has been investigated using principles of protein design. Employing disulfide-mediated semi-synthesis, several multiple residue substitution patterns were studied in order to provide rapid insight into the most appropriate features to incorporate into fully recombinant proteins. Substitutions directed toward both stabilization and destabilization of the helix resulted in proteins with modulated bioactivity. Circular dichroism verified the conformational integrity and thermal stability of the derivatives. The biologic characteristics of each derivative were evaluated in the standard murine CTLL-2 assay and compared to activities exhibited in both human T-cell bioactivity and binding assay. A strategy for the design of protein ligand agonists and antagonists without knowledge of receptor contact residues is discussed. PMID- 2783422 TI - Cachectin/TNF kills or inhibits the differentiation of 3T3-L1 cells according to developmental stage. AB - The effects of cachectin/tumor necrosis factor (TNF) on growth and differentiation of 3T3-L1 cells were examined. This fibroblastic cell line can be induced to differentiate into a mature cell type having the biochemical and morphological characteristics of normal adipocytes. At various stages of growth and differentiation, 3T3-L1 cells were exposed to 2.5 x 10(-16) to 2.5 x 10(-8) M (4.2 fg/ml to 420 ng/ml = ca. 1.2 x 10(-14) to 1.2 x 10(-16) U/ml) recombinant human cachectin/TNF for 24 hr, after which cytotoxicity or differentiation was evaluated. During log-phase cell growth, cachectin/TNF had no significant effect on cell viability, and the preadipocytic cells were also resistant to the cytotoxic effect of cachectin/TNF at the contact-inhibited confluent stage. However, when cachectin/TNF was added to the cells during induced differentiation, only 20% of the cells survived. After differentiation into adipocytes, cells regained their resistance to cachectin/TNF-induced cytotoxicity. Cachectin/TNF also markedly affected the differentiation of 3T3-L1 cells into adipocytes. When cells in the confluent phase of growth were exposed to cachectin/TNF for 24 hr, their subsequent hormone-induced differentiation to adipocytes was inhibited. Like cachectin/TNF, IL-1 also induces suppression of lipoprotein lipase and enhances lipolysis in differentiated 3T3-L1 adipocytes; however, in contrast to cachectin/TNF, IL-1 had no effect on the viability or differentiation of pre-adipocyte 3T3-L1 cells. These results indicate that the cytotoxic action of cachectin/TNF varies in the same cell type depending on the stage of growth or differentiation. The results also imply that cachectin/TNF may play a normal role in controlling the differentiation of certain types of cells in vivo including adipocyte lineages. PMID- 2783423 TI - Defective control of cytoplasmic calcium concentration in T lymphocytes from old mice. AB - Cytoplasmic calcium concentration ([Ca]i) rises within minutes of exposure of T lymphocytes to a mitogen. T cells from old mice are defective in this reaction, a defect that could reflect either altered signal transduction or instead a more general age-associated change in intracellular calcium regulation. We therefore tested the ability of T cells from old mice to regulate their [Ca]i concentration after exposure to low concentrations of ionomycin, an agent that raises [Ca]i but bypasses receptor-mediated signal transduction mechanisms. Exposure of T cells to ionomycin leads to an abrupt increase in [Ca]i followed by stabilization at a dose-dependent plateau level that is affected by extracellular EGTA, by calmodulin inhibitors, and by modulators of protein kinase C. Plateau levels of [Ca]i after ionomycin challenge were consistently lower in T cells from old mice than in T cells from young mice. Flow cytometric experiments showed that while essentially all T cells from both old and young mice responded to ionomycin, they did so to an extent that depended on donor age. The age-dependent increase in resistance to ionomycin-induced changes in [Ca]i cannot be attributed to diminished membrane permeability to the ionomycin-calcium complex. The data suggest that aging may lead, in T lymphocytes, to a relative resistance to increases in [Ca]i, a resistance that in turn prevents cell activation. PMID- 2783424 TI - Characterization of the inhibitory effect of glucocorticoids on the DNA replication of adult rat hepatocytes growing at various cell densities. AB - Dexamethasone inhibited the basal and EGF-stimulated DNA synthesis of adult rat hepatocytes in primary culture. The inhibition was glucocorticoid-specific: It was shown by dexamethasone and hydrocortisone, but not by progesterone, testosterone, or estradiol; and was counteracted by the glucocorticoid antagonist RU-38486 in a concentration-dependent manner. Dexamethasone acted by decreasing the rate of entry into S-phase (kG1/S), while cell cycle parameters were unaffected. The steroid was able to decrease the kG1/S severalfold even when added more than 20 hr after EGF, half-maximal effect occurring 11 hr after the addition of dexamethasone. Densely populated areas were much more sensitive to the inhibition by dexamethasone than sparsely populated areas within the same culture dish: A moderate (10 nM) concentration of dexamethasone nearly abolished the DNA synthesis in densely populated areas of hepatocyte cultures with only marginal effect on sparsely populated cells. PMID- 2783425 TI - A highly accurate method of localizing regions of neuronal activation in the human brain with positron emission tomography. AB - Functional mapping of the human brain with positron emission tomography (PET) can best be performed by obtaining multiple short measurements of cerebral blood flow in a single sitting. In this manner regional changes in blood flow accompanying the increased neuronal activity from a movement, sensation, or even cognition task, have been identified. However, localizing a functional region with PET has been severely limited by the poor resolving properties of PET devices. Using a new method of data analysis we recently reported the mapping of visual field stimuli on human visual cortex with surprisingly high reliability as measured by the low standard deviation in positions across different subjects (as low as 1 mm). In this work the analysis technique enabling such high-resolution functional brain mapping is fully described. Additionally, simulations are presented to illustrate its advantages and limitations. PMID- 2783426 TI - Interleukin 1 inhibits contraction of vascular smooth muscle. AB - Interleukin 1 has been implicated as a mediator of both systemic and local responses to infection and injury. Since systemic and local vasodilatation are hallmarks of sepsis and infection, we studied the direct effect of IL-1 on vascular contractility. We report here that human recombinant IL-1-beta potently inhibits the response of rat thoracic aorta to vasoconstrictor agents. Exposure of isolated rat aortic rings to IL-1 (20 ng/ml) for 1 h did not affect phenylephrine-induced contractions during the exposure period. However, when rings were retested 150-200 min after initiation of IL-1 exposure, contractions were markedly decreased. The cytokine had a similar effect in rings from which the endothelium was removed. Contractions caused by potassium depolarization also were depressed, indicating the effect of IL-1 is not specific to the alpha adrenoceptor agonist. The inhibitory effect of IL-1 was concentration-dependent (0.2 to 20 ng/ml), and eliminated by pretreatment with cycloheximide (20 micrograms/ml). Indomethacin (10(-5) M) did not prevent the inhibition caused by IL-1. These studies identify IL-1 as a potent inhibitor of vascular contraction, via an endothelium-independent mechanism. Studies with inhibitors suggest that the action of IL-1 is independent of prostanoid synthesis, and may involve synthesis of protein. PMID- 2783427 TI - Gastrohepatic ligament fibrosis following esophageal sclerotherapy: CT findings. AB - We describe a case in which CT demonstrated a nonenhancing mass within the gastrohepatic ligament following sclerotherapy of esophageal varices. At surgery this findings was demonstrated to represent multiple thrombosed veins and varices with surrounding fibrosis. PMID- 2783428 TI - A reference system for neuroanatomical localization on functional reconstructed cerebral images. AB - The correlation of anatomical with functional brain images is of critical importance for data analysis. We have designed and tested a reference system method that provides accurate localization of neuroanatomy on functional brain images. The method differs from prior techniques using headholding devices in that it does not require head fixation and is noninvasive. The reference system can be quickly, accurately, and reproducibly applied to the patient's head with respect to the surface anatomy of the head. The reference system is easily adaptable to multiple imaging modalities. The reference system is implemented with the aid of a computer algorithm that reconstructs the anatomic images into a new image matching a selected functional image. Accuracy and reproducibility of placement of the reference system was demonstrated by the application of the system on multiple subjects by two independent observers. The use of this method provides accurate correlation between functional and anatomical brain images. PMID- 2783429 TI - Stratified impairment of pulmonary ventilation in "diffuse panbronchiolitis:" PET and CT studies. AB - Positron emission tomography with radioactive nitrogen gas as well as CT were performed in seven patients with diffuse panbronchiolitis (DPB) to evaluate regional changes on pulmonary ventilation and lung attenuation values. Special focus of this study was on the difference between the central and peripheral parts of the lung. Mean ventilatory time constants measured in the peripheral parts of the lung were significantly greater than those in the central parts. Moreover, mean CT attenuation values in the peripheral parts were also significantly lower than those in the central parts, indicating that hyperinflation of the lung in DPB was located mainly in the peripheral parts. Such stratified distribution of ventilatory impairment is considered to be characteristic of diffuse bronchiolar narrowing because, in the peripheral parts of the lung, there are no large airways. In addition, different branching patterns of airways between the central and peripheral parts of the lung may play an important role in the mechanism of selective injury of bronchioles in the peripheral parts. PMID- 2783431 TI - National survey of caries prevalence in 6-15-year-old children in France. AB - The prevalence of dental caries in France is not known on a nationwide basis, despite the fact that a number of epidemiological studies have been conducted in various parts of the country. The aim of the present study was to provide a national baseline examination of the dental health of children in 1987 since, beginning in November, 1986, the sale of fluoridated salt began in France. A multi-stage probability sample of 19,366 children was selected as representative of the 6-to-15-year-old population. The sample covered all the 95 departments of France. Teams of well-calibrated examiners were constituted in each of the sixteen Faculties of Dental Surgery of France. The prevalence of caries for each age group was determined by means of DMFT, DMFS, dft, and dfs indices. Periodontal conditions were assessed by means of the Plaque Index (Silness and Loe, 1964), the Calculus Index (Marthaler, 1966), and the Gingival Index (Loe and Silness, 1963). Calculation of the mean DMFT index showed, respectively, 0.5 and 1.0 new carious teeth per year under and over the age of 11. The mean values of the DMFT index at ages 6, 12, and 15 were, respectively, 0.5, 4.2, and 6.9. Under the age of 11, the mean DMFS index increased by one between each successive age group and by nearly two over the age of 11. The mean values of the DMFS index at ages 6, 12, and 15 were, respectively, 0.8, 7.6, and 13.0. The percentage of caries-free children decreased from 32.2% at age 6 to 7.9% at age 15. PMID- 2783430 TI - Fibroblastic subpopulations in uninjured and wounded rabbit oral mucosa. AB - Fibroblast cultures derived from uninjured and reparative rabbit buccal mucosa were compared in terms of extracellular glycosaminoglycan (GAG) content and cellular response to interleukin-1 (IL-1). Under identical growth conditions, proliferation of both cell lines was the same. Both lines incorporated [3H] glucosamine into GAG in cellular, pericellular, and medium fractions, with the majority of incorporated label residing in the medium. Dermatan sulfate (DS) was the predominant GAG in the medium fraction of both normal and wound fibroblast cultures; however, the two cell lines differed in the identity of the medium fraction's secondary GAG: chondroitin sulfate (CS) for normal fibroblasts and hyaluronic acid (HA) for wound-derived cells. The GAG content of the pericellular matrix for all cultures was the same regardless of the tissue of origin: heparan sulfate (HS) accompanied by a very small amount of CS. Exposure to IL-1 produced limited but highly specific effects: It was not mitogenic for either cell line but did cause a quantitative change (increase) in overall incorporation into GAG for medium and pericellular fractions for both cell lines. Further, IL-1 induced a qualitative change in GAG composition for normal mucosal fibroblastic medium fractions by causing the synthesis/release of heparan sulfate (HS) and a variant form of DS. These data support the hypothesis that different fibroblastic substrains can populate a given oral site as a function of variables such as injury and/or healing status. PMID- 2783432 TI - Dizziness in a community elderly population. AB - Dizziness was studied in 1,622 community-dwelling adults aged 60 and older who were interviewed as part of the Duke Epidemiologic Catchment Area study. The lifetime prevalence of dizziness (defined as severe enough to see a physician, to take a medication, or to interfere with daily activities) was 29.3%; the 1-year prevalence was 18.2%. When the subgroup with dizziness was compared with those who never suffered dizziness, using logistic regression, four variables displayed the strongest associations: a constructed variable of risk for multiple neurosensory deficits, a cardiovascular risk score, a depression symptom inventory, and perception of self as a nervous person. In this population, dizziness was not associated with increased risk of death or institutionalization at the 1-year follow up. PMID- 2783433 TI - Behavioral disturbance, cognitive dysfunction, and functional skill. Prevalence and relationship in Alzheimer's disease. AB - The nature and severity of behavioral problems, and their relationship to cognitive and functional abilities, was investigated in 56 community-residing patients with Alzheimer's disease. Measures evaluated three domains of function: behavior, cognition and activities of daily living. Problems of cognitive functioning, such as memory loss, confusion, and disorientation were most prevalent, reported to occur in 84%, 82%, and 64% of the sample, respectively. Problems with activity and emotional distress were next, affecting 20 to 43% of the sample. The mean number of problems reported was 10 per patient. Twenty-two percent of caregivers reported a minimum of 15 problems occurring at least twice a week and no caregiver reported an absence of problems. Male patients were reported to have more behavioral difficulties. Level of behavioral disturbance was largely unrelated to cognitive or functional ability. Age was unrelated to cognitive or behavioral disturbance but significantly related to activities of daily living. Results indicated that behavioral problems are prevalent and pervasive in even moderately impaired community-residing Alzheimer disease patients, and that age may be more important than level of cognitive dysfunction in predicting difficulties with activities of daily living. PMID- 2783434 TI - Depression among institutionalized aged: assessment and prevalence estimation. AB - Aged nursing home and congregate apartment residents were screened for symptoms of depression and cognitive impairment. Of 708 survey respondents, 12.4% met DSM IIIR criteria (33) for major depression; about half this group also displayed significant cognitive deficits. Another 30.5% of the total sample reported less severe but nonetheless marked depressive symptoms. Such "minor" depressive syndromes were much more common among congregate housing than nursing home residents. Possible major depression was more prevalent among newly admitted residents of both housing components. Comparison of cognitively impaired vs intact respondents revealed that the two groups' self-reports of depression were equally internally consistent, and bore equivalent correlations with observer ratings made by interviewers and direct care staff. Checks of medical records of a group of survey nonrespondents (n = 203) indicated that, excepting the extremely demented, the active sample of 708 accurately represents institution residents as a whole. Finally, comparison with clinical diagnoses made by facility psychology and psychiatry department staff indicated good concurrent validity of research screening measures and methods. PMID- 2783435 TI - Regulation of CD4 and CD8 surface expression on human thymocyte subpopulations by triggering through CD2 and the CD3-T cell receptor. AB - Human thymocytes bearing the CD4 and/or CD8 antigens can be fractionated into cells with an immature and more mature phenotype based on their quantitative expression of the CD3 Ag (J. Immunol. 138:3108; J. Immunol. 139:1065). We show that the expression of CD4 and CD8 on thymocyte subpopulations with low CD3 (CD3L) and high CD3 (CD3H) is regulated by activation through the CD2 molecule and perturbation of the CD3-T cell receptor complex (CD3-Ti). Similar to its previously reported effects on peripheral T cells, PMA was able to induce the down-regulation of surface CD4, but not CD8, on thymocyte subpopulations. PMA could induce CD4 and CD8 phosphorylation in both CD3L and CD3H fractions. These results suggest that if changes in phosphorylation represent the mechanism by which CD4 and CD8 are able to transmit signals, this mechanism is operative in both CD3L and CD3H subpopulations. Treatment with anti-T11(2) and anti-T11(3) antibodies (CD2 activation pathway) resulted in partial down-regulation of CD4 but not CD8 surface expression on both CD3L and CD3H thymocytes. Similar treatment had no detectable effect on peripheral T cells. The down-regulation of surface CD4 induced by activation via CD2 could be inhibited by treatment of thymocytes with anti-CD3 antibodies. Treatment of thymocytes with anti-CD3 alone or following CD2 activation induced the selective down-regulation of surface CD8 within 15 minutes. These results suggest that CD2 and CD3-Ti triggering may regulate CD4 and CD8 surface expression on thymocytes. Furthermore, these results suggest that "cross-talk" between the CD2 and CD3-Ti pathway of activation may involve CD4 and CD8 molecules. PMID- 2783436 TI - Late events in B cell activation. Expression of membrane alkaline phosphatase activity. AB - Alkaline phosphatase (APase) has been previously described as a membrane marker correlating with B cell proliferation after stimulation by selected B cell mitogens. We have found, however, that the appearance of B cell membrane APase correlates more closely with differentiation than with proliferation. This conclusion has been drawn from the following observations: 1) APase activity appears well after peak B cell thymidine uptake, 2) mitogens which stimulate only B cell proliferation (Salmonella typhimurium mitogen) fail to induce expression of the enzyme, and 3) when proliferation of mitogen-activated B cells is inhibited, APase activity is not suppressed and may even be augmented. In addition to membrane expression, APase is also spontaneously shed into the surrounding milieu, perhaps as a result of endogenous phospholipase activity. By using a group of well-characterized inhibitors, the APase activity was shown to belong to class I (similar to the bone/liver/kidney class). Because APase always appears in differentiating but not proliferating cells, we would propose that the enzyme appearance is a late marker of B cell activation, associated with cell progression to differentiation and consequent IgM synthesis. PMID- 2783437 TI - Organ-specific autoimmune disease induced in mice by elimination of T cell subsets. V. Neonatal administration of cyclosporin A causes autoimmune disease. AB - Cyclosporin A (CsA), a potent immunosuppressive drug, caused organ-specific autoimmune disease, such as gastritis with anti-parietal cell autoantibodies or oophoritis with anti-oocyte autoantibodies, in BALB/c mice when the drug was administered daily for 1 wk to newborns. Administration to adult mice did not. CsA abrogated the production of L3T4+ T cells and Lyt-2+ T cells in the thymus. Consequently, these T cells were substantially depleted from the peripheral lymphoid organs, especially when the drug was administered from the day of birth. Autoimmune disease was prevented when CsA-treated newborn mice were inoculated with splenic T cells from normal syngeneic mice. However, removal of the thymus immediately after neonatal CsA treatment produced autoimmune disease with a higher incidence and in a wider spectrum of organs, i.e., thyroiditis, sialoadenitis of the salivary gland, gastritis, insulitis of the endocrine pancreas, adrenalitis, oophoritis, or orchitis. Each autoimmune disease was accompanied by the development of circulating autoantibodies specific for the corresponding organ Ag. Immunopathology of these autoimmune diseases was quite similar to that of human organ-specific autoimmune diseases. PMID- 2783438 TI - IL-2 receptors on circulating natural killer cells and T lymphocytes. Similarity in number and affinity but difference in transmission of the proliferation signal. AB - IL-2-binding sites expressed on purified circulating NK cells and high density T lymphocytes were enumerated in 125I-IL-2 binding assays and analyzed by autoradiography after chemical cross-linking of IL-2 to the cells. Quite similar profiles of IL-2R were exhibited by both types of cells consisting of the simultaneous expression of approximately 150 high affinity Tac+ receptors/cell (Kd congruent to 19 pM) and of approximately 540 intermediate affinity Tac- receptors/cell (Kd congruent to 800 pM) which appeared, in cross-linking experiments, to be the isolated 70-kDA protein (p70) subunit of the 55-kDa protein (p55)/p70 heterodimer. The high affinity receptors were distributed on less than 3% of the cells and could be eliminated by complement lysis with anti p55 mAb. In these conditions, Scatchard analysis no longer revealed two classes of binding sites but only one class of binding sites with intermediate affinity. Although expressed in equal numbers on the surface of NK cells and resting T lymphocytes, the constitutive p70 chains seemed to transmit differently the proliferation signal after effective ligand interaction. Thus, NK cells proliferated strongly in the presence of only 260 pM IL-2, (40 U/ml), whereas resting T cells remained unresponsive to IL-2 concentrations able to saturate the existing p70 receptors (6.5 nM IL-2, 1000 U/ml IL-2) unless monocytes were present. The initiation of cell division seemed to involve the synthesis of p55 chains and the constitution of high affinity receptors as introducing anti-Tac antibody at the start of the cultures inhibited IL-2-induced proliferation. Tac mRNA transcripts accumulated rapidly in NK cells during a 18-h observation period whether anti-Tac antibody was present or not during IL-2 stimulation. In contrast a weak Tac mRNA induction was observed in resting T cells in the same conditions. PMID- 2783439 TI - A synergistic interaction of IL-6 and IL-1 mediates the thymocyte-stimulating activity produced by recombinant IL-1-stimulated fibroblasts. AB - We characterized the ability of normal human lung fibroblasts to elaborate thymocyte-stimulating activity, spontaneously, and in response to rIL-1. Supernatants from unstimulated fibroblasts did not contain thymocyte-stimulating activity, whereas supernatants from fibroblasts incubated with rIL-1 alpha or rIL 1 beta contained more thymocyte-stimulating activity than could be accounted for by passively transferred rIL-1 alone. This heightened thymocyte-stimulating activity was mediated by fibroblast-derived IL-6 inasmuch as it was neutralized by anti-serum against human rIL-6, and rIL-1-stimulated fibroblasts to accumulate messenger RNA for IL-6 and produce soluble IL-6 protein. However, IL-6 alone could not account for the intensity of this effect because rIL-6 only weakly stimulated thymocyte proliferation. In addition, antisera against the rIL-1 moiety that was used to prepare the supernatant had different effects on supernatants that contained and did not contain active IL-6. In the presence of IL-6 these antisera caused a greater decrease in thymocyte-stimulating activity than could be accounted for by passively transferred rIL-1 alone. When the IL-6 was neutralized the remaining thymocyte-stimulating activity could be quantitatively accounted for and neutralized by antisera against the rIL-1 that was passively transferred. Furthermore, rIL-6 and rIL-1 (alpha or beta) synergized in stimulating thymocyte proliferation. Thus, rIL-1 stimulates fibroblasts to produce a thymocyte-stimulating activity that is largely mediated by a synergistic interaction of fibroblast-derived IL-6 and IL-1. These findings suggest that fibroblast production of IL-6 may mediate or amplify some of the tissue effects of IL-1. In addition they suggest that biologic effects previously attributed to IL-1 may be due to IL-6 alone or the concerted action of IL-1 and IL-6. PMID- 2783440 TI - Evidence against the existence of a membrane form of murine IL-1 alpha. AB - Previous studies have demonstrated that paraformaldehyde-treated macrophages possess IL-1 alpha activity in a variety of bioassay systems. However, no definitive biochemical data in support of the membrane IL-1 alpha concept has been reported. The purpose of the present study was to determine if the biologic activity associated with treated cells is due to a membrane form of IL-1 alpha or alternatively, to the leakage of IL-1 alpha. If the former case was true, then the exposed membrane IL-1 alpha should bind anti-IL-1 alpha antibodies or be cleaved by mild trypsin treatment. In both instances, IL-1 alpha activity should be lost when measured in a subsequent IL-1 bioassay. Our results indicate that pulsing paraformaldehyde-treated normal or cell line macrophages with anti-IL-1 alpha antibodies or treating the cells with trypsin did not affect the ability of the treated cells to function in a murine thymocyte proliferation assay. Furthermore, the standard short term treatment of cells with paraformaldehyde (15 min) did not prevent the leakage of IL-1 alpha from the cells or the processing of the precursor forms of the protein. When cells were treated with paraformaldehyde for 2 h, they no longer released IL-1 alpha or possessed thymocyte stimulatory activity. We also found that short term glutaraldehyde treatment of macrophages completely blocked the release of IL-1 alpha from cells as well as the appearance of cell-associated IL-1 alpha activity. Our results support the conclusion that the stimulatory activity of paraformaldehyde-treated macrophages is not due to a membrane form of IL-1 alpha but is, in fact, due to the continuous release of IL-1 alpha from the cells. PMID- 2783441 TI - Induction of IL-6 (B cell stimulatory factor-2/IFN-beta 2) production by HIV. AB - Polyclonal B cell activation is commonly observed in AIDS and in infection with HIV. The effect of HIV on the induction of B cell stimulatory factor 2 (BSF-2) production was examined, since BSF-2 plays an essential role in the differentiation of activated B cells to Ig-secreting cells. Increased BSF-2 mRNA levels and increased BSF-2 secretion were observed soon after exposure of mononuclear cells isolated from healthy donors to both "live" and inactivated HIV. HIV-induced BSF-2 production was seen in monocyte/macrophages, but not in T cells. These results suggest that the HIV-induced overproduction of BSF-2 might contribute to the polyclonal B cell activation seen in AIDS and in infection with HIV. PMID- 2783442 TI - IL-1 stimulates IL-6 production in endothelial cells. AB - Leukocytes and vascular cells interact closely in inflammation and immunity and lymphokines are important mediators of this interaction. The present study was designed to define the possible role of IL-6 as a communication signal between vascular and immunocompetent cells. IL-6 was measured as hybridoma growth factor (HGF) on the 7TD1 cell line in the supernatants of human endothelial cells (HEC). HEC released appreciable levels of HGF activity in the absence of deliberate stimulation. In vitro exposure to recombinant IL-1 beta markedly increased (usually 10 to 15-fold) HGF production by HEC. Optimal stimulation was observed with 0.1 to 50 U/ml for 4 to 20 h of incubation. Human and murine rIL-1 alpha stimulated HGF production in HEC. Anti-IL-6 antibodies inhibited the HGF activity of the HEC supernatants, thus confirming, together with the cytokine specificity of the assay, the nature of HEC-produced cytokine. IL-1-treated HEC expressed high levels of IL-6 mRNA as detected by Northern blot analysis. Inasmuch as IL-1 elicits a complex series of changes in HEC, it was important to assess whether IL 6, produced after exposure to IL-1, modified HEC function. Natural or rIL-6 did not affect the functional status of HEC as assessed by proliferative capacity, production of procoagulant activity and prostacyclin, ability to induce adhesion of polymorphonuclear leukocytes. The capacity to produce IL-6 may represent an important mechanism by which endothelial cells participate in inflammatory and immune reactions. PMID- 2783443 TI - The immunotherapeutic effects in tumor-bearing mice of Ly-6 monoclonal antibodies. AB - In vivo administration of Ly-6 mAb which recognize lymphoid differentiation Ag encoded for by the Ly-6 gene complex were found to have significant beneficial immunotherapeutic effects in tumor-bearing mice. The effectiveness of the mAb treatment in mice bearing sarcomas, leukemias, or melanomas was dependent on the host and not the tumor Ly-6 phenotype. The treatment was effective in nu/nu mice, although a more pronounced inhibition of tumor growth occurred in immunocompetent mice. The effectiveness of the therapy in immunocompetent mice was dependent on the dose of mAb and was influenced by the immunogenicity of the tumor. It ranged from significant growth inhibition of weakly immunogenic tumors to complete rejection of strongly immunogenic tumors. The results of cell-mediated cytotoxic assays of splenocytes from mAb-treated mice indicated that Ly-6 mAb treatment induced and/or augmented tumor-specific CTL as well as NK cell activity in these mice. Ly-6 mAb treatment represents a novel method for tumor immunotherapy using mAb recognizing lymphoid differentiation Ag with functional activities. PMID- 2783445 TI - Measurement of antigen-specific mouse IgE by a fluorometric reverse (IgE-capture) ELISA. AB - A reverse, or IgE-capture, enzyme-linked immunosorbent assay (ELISA) for measuring ovalbumin-specific IgE antibody in the serum of immunized mice has been developed. Microplate wells were first coated with a commercial anti-mouse IgE rat monoclonal antibody, and then incubated with two-fold serial dilutions of test sera with 10% normal mouse serum as diluent for the capturing of only IgE class molecules. Biotinylated ovalbumin and then beta-D-galactosidase-conjugated streptavidin were added and, finally, 4-methylumbelliferyl-beta-D-galactoside was used as the enzyme substrate. The fluorescence intensity of the reaction product (4-methylumbelliferone) was determined on a microplate fluorescence reader. The sensitivity of this assay was equal to that of passive cutaneous anaphylaxis (PCA). In contrast to indirect ELISAs this IgE-capture assay is free from competition by non-IgE antibodies. Furthermore, it requires much less antigen than the PCA assay. PMID- 2783444 TI - IL-4 regulation of murine lymphokine-activated killer activity in vitro. Effects on the IL-2-induced expansion, cytotoxicity, and phenotype of lymphokine activated killer effectors. AB - The in vitro incubation of B6 splenocytes with purified, mouse rIL-4 for 4 to 5 days was sufficient to generate lymphokine-activated killer (LAK) activity. In addition, rIL-4 augmented LAK cytotoxic activity when combined with rIL-2, as measured in a 4 h 51Cr-release assay against fresh, syngeneic MCA-sarcoma (MCA 102 and MCA-105) cells. Interestingly, this augmentation was not observed against the cultured YAC-1 target. LAK generation and augmentation of cytotoxicity by rIL 4 was species-specific, because human rIL-4 (up to 20,000 U/ml) failed to elicit these effects in the mouse splenocyte cultures. When 5-day B6 LAK cells (splenocytes incubated in rIL-2 at 1000 U/ml for 5 days) were split and recultured in the combination of rIL-2 plus rIL-4 for 4 additional days at least a twofold greater expansion in cell number resulted compared to similar cells cultured in either rIL-2 or rIL-4 alone. Moreover, LAK cells expanded in rIL-2 plus rIL-4 exhibited substantial increases in in vitro cytolytic activity (on a per cell basis) against MCA-102 and MCA-105 sarcoma cells, but not against YAC-1 targets. FACS analysis or negative selection using Lyt-2 or NK-1.1 mAb plus C revealed no differences in effector phenotype(s) of LAK cells expanded in rIL-2 alone compared to rIL-2 plus rIL-4 to account for the differences observed in both expansion and cytolytic activity by rIL-4. The majority of cells was Thy-1+, Lyt-2+, T3+, and ASGM-1+. However, a marked increase in the granule-associated serine esterase, BLT-E, was found only in LAK cells expanded in the combination of both lymphokines. Collectively, these studies show that rIL-4 has potent regulatory activities on splenic LAK generation, expansion, and cytotoxic function in the mouse. PMID- 2783446 TI - Increased proportion of B cell hybridomas secreting monoclonal antibodies of desired specificity in cultures containing macrophage-derived hybridoma growth factor (IL-6). AB - The addition of macrophage feeder cells or conditioned medium has been shown to increase the yield of murine hybridomas obtained after the fusion of myeloma cells and activated B lymphocytes. It has been shown recently that the conditioned medium contains a growth factor (HGF) active on newly formed hybridomas and that the human HGF is similar to B cell stimulatory factor 2 which can induce the synthesis of antibodies in transformed B cells. We have compared in several fusion experiments the stimulatory effects of HGF both on the yield of hybridomas and on the number of antibody-secreting hybridomas. The results obtained clearly showed that while the stimulatory effect of HGF on the yield of growth-positive wells was variable and sometimes barely detectable, the proportion of growth-positive wells containing monoclonal antibodies was consistently much higher in the HGF-containing cultures. These results suggest that the majority of the antibody-secreting newly formed hybridomas are sensitive to HGF and indicate that HGF is a very useful culture supplement for the generation of a high number of antibody-producing hybridomas even if it may not increase significantly the yield of viable hybridomas. PMID- 2783447 TI - Development and application of radioimmunoassays for interleukin-1 alpha and interleukin-1 beta. AB - Specific and sensitive radioimmunoassay (RIA) systems for human IL-1 alpha and IL 1 beta, using sheep polyclonal antisera, have been developed. The assays, which do not require prior extraction of IL-1, have been used to quantify IL-1 alpha and IL-1 beta in synovial fluid and plasma and to quantify intracellular and extracellular IL-1 alpha and IL-1 beta produced by human monocytes stimulated with endotoxin. PMID- 2783448 TI - Isolation and characterization of interleukin-1 from bovine polymorphonuclear leukocytes. AB - Interleukin-1 (IL-1 alpha and IL-1 beta collectively) has been shown to be produced by a wide variety of cell types. The purpose of this study was to evaluate the ability of bovine polymorphonuclear leukocytes (PMNs) to synthesize and release IL-1-like cytokines and characterize the active molecule(s). Purified peripheral blood PMNs were cultured for various periods of time in the presence of opsonized zymosan particles. The resulting culture supernatants exhibited IL-1 activity as determined by enhanced mitogen-induced proliferation of the D10 G4.1 murine T-helper cell line. Supernatants from nonstimulated PMNs or PMNs stimulated for less than 6 h did not enhance D10 G4.1 proliferation. The active molecule (PMNIL-1) was isolated by using gel filtration high-performance liquid chromatography (HPLC). Further characterization of the HPLC-purified molecule by SDS-PAGE and isoelectric focusing indicates bovine PMNIL-1 has a molecular weight of 17.8 kd and a pI of 4.1. PMID- 2783449 TI - In vivo neutrophil emigration in response to interleukin-1 and tumor necrosis factor-alpha. AB - The migration of polymorphonuclear leukocytes (PMN) in response to recombinant interleukin-1 (IL-1), tumor necrosis factor-alpha (TNF), C5a, and f-met-leu-phe lys (FMLPL) in vivo was studied using a mouse subcutaneous sponge implantation model. In this model sponges were implanted in C3H/OUJ mice, and 2 days later they were injected with the test sample. After varying times, sponges were removed and digested with collagenase, and total cell counts and differentials were enumerated. IL-1 was found to stimulate a significant influx of PMN, which peaked at 6 hr and declined to near baseline levels by 24 hr. This response was dose-dependent, with the greatest response observed when 5 units of IL-1 were injected. When the IL-1 concentration was increased to 10 U, the total number of PMN migrating into the sponge was decreased, compared with that observed with 5 U of IL-1. The overall number of PMN migrating into the sponge 6 hr after injecting 5 U of IL-1 averaged 269% of the number of PMN migrating randomly into the sponge. No difference in the total number of macrophages or lymphocytes in control or IL-1-injected sponges was observed in this time frame. Heat treatment of the IL-1 at 90 degrees C for 30 min ablated the response. Similar studies with TNF and C5a showed that both of these agents also stimulated an influx of PMN that peaked 6 hr postinjection. In contrast, FMLPL did not stimulate a PMN response. When IL-1 and TNF were injected simultaneously, an additive response was observed. These data indicate that IL-1, TNF, and C5a can all stimulate a PMN response in vivo and support the hypothesis that these substances are actively involved in the mobilization of PMN to inflammatory sites in vivo. PMID- 2783451 TI - Lack of expression of HLA-B27 gene in transgenic mouse trophoblast. Conserved genetic pressures underlying extra-embryonic development. AB - The mechanisms that regulate developmental control of the expression of MHC class I genes during generation of extra-embryonic tissues are largely unknown. In the present study, we studied the levels of transcripts of the human HLA-B27 gene in extra-embryonic tissues of transgenic mice containing the HLA-B27 (heavy chain) gene by in situ hybridization with biotinylated single-stranded RNA probes. In contrast to extra-embryonic stromal cells and embryonic tissues which contain (varying levels of) messenger RNA coding for HLA-B27, specific transcripts were not detected in labyrintho-, or spongiotrophoblast, nor in trophoblastic giant cells. These cells are devoid of HLA A and B locus class I transcripts in man. Regulation of expression of human MHC class I genes in extra-embryonic trophoblast in transgenic animals is thus under conserved selective pressure that is retained across a species barrier. Thus, in extra-embryonic tissues, regulation of expression of MHC class I genes is distinct from the mechanisms operating in developing embryonic cells. PMID- 2783450 TI - Spontaneous recovery of rats from experimental allergic encephalomyelitis is dependent on regulation of the immune system by endogenous adrenal corticosteroids. AB - Lewis rats with experimental allergic encephalomyelitis (EAE), induced either by the subcutaneous injection of guinea pig myelin basic protein (MBP) or by the adoptive transfer of MBP-primed spleen cells, suffer from a single episode of paralysis from which they recover spontaneously. Animals developing EAE were found to have greatly elevated levels of corticosterone in the blood. This endogenous increase in steroid production was accompanied by lymphopenia and depressed delayed-type hypersensitivity responses to OVA, indicating that rats with EAE are immunosuppressed in an antigen-nonspecific fashion. Adrenalectomized rats given subcutaneous implants of corticosterone to maintain basal steroid levels invariably died when EAE was induced. However, if the steroid replacement therapy was adjusted to mimic the hormone levels that were observed in intact rats developing EAE, then the disease followed a nonfatal course closely resembling that seen in the nonadrenalectomized controls. Replacement therapy that achieved serum corticosterone levels slightly higher than those found in intact rats with EAE virtually suppressed the disease completely. It is concluded that endogenous corticosterone release in rats with EAE plays an essential role in the spontaneous recovery that is observed in this condition. However, the subsequent refractory phase that is characteristic of rats that have recovered from EAE induced by active immunization with MBP is not associated with chronically elevated corticosterone levels. This finding is discussed in the light of other data that suggest that unlike the spontaneous recovery, the refractory state has an immunological basis rather than an endocrinological basis. PMID- 2783452 TI - Multiple factors influencing the in vitro release of [Met5]-enkephalin from rat hypothalamic slices. AB - This study examined several in vivo and in vitro factors which influence the release of [Met5]-enkephalin (Met-ENK) from male rat hypothalamic slices superfused in vitro. Met-ENK release was significantly stimulated by corticotropin-releasing hormone (CRH; 10(-12)-10(-8) M), an effect which was abolished in the presence of the CRH-receptor antagonist, alpha-helical CRF9-41 (10(-6) M). The amount of Met-ENK release diminished with time in experiments in which the slices were continuously exposed to CRH. The opioid receptor antagonist naloxone (10(-6) M) stimulated Met-ENK release, even in the presence of the Na+ channel blocker tetrodotoxin (10(-6) M), a result indicating presynaptic opioid feedback inhibition of Met-ENK release. The role of gonadal steroids in the control of Met-ENK release in vitro was also examined. It was found that the basal and CRH-induced release of Met-ENK was not changed 1 week after castration. However, a significant increase in the basal release of this peptide was observed 4 weeks after gonadectomy, and the Met-ENK-releasing efficacy of CRH was found to be reduced. The Met-ENK content of hypothalami from 1-week castrates was not significantly changed from control levels, but was significantly reduced in those from 4-week castrates. These long-term effects of castration could be overcome by the subcutaneous implantation of testosterone-containing capsules at the time of castration. PMID- 2783453 TI - Stimulation by ATP of inositol trisphosphate accumulation and calcium mobilization in cultured adrenal chromaffin cells. AB - Effects of ATP on accumulation of inositol phosphates and Ca2+ mobilization were investigated in cultured bovine adrenal chromaffin cells. When the cells were stimulated with 30 microM ATP, a rapid and transient rise in intracellular Ca2+ concentration was observed. At the same time, ATP rapidly increased accumulation of inositol phosphates. The concentration-response curve for the ATP-induced Ca2+ mobilization was similar to that for inositol trisphosphate (IP3) accumulation. ATP exerted its maximal effects at 30 microM for either IP3 accumulation or Ca2+ mobilization. The order of the efficacy of the agonists for IP3 accumulation and Ca2+ mobilization at 100 microM was ATP greater than ADP greater than AMP approximately adenosine, AMP (100 microM) and adenosine (300 microM) failed to induce IP3 accumulation and Ca2+ mobilization. Although 100 microM GTP and 100 microM UTP also induced IP3 accumulation and Ca2+ mobilization, their efficacy was less than that of ATP. CTP (100 microM) induced a slight IP3 accumulation, but it did not induce Ca2+ mobilization. Nifedipine (10 microM), a Ca2+ channel antagonist, and theophylline (100 microM), a P1-purinergic receptor antagonist, failed to inhibit the ATP-induced IP3 accumulation and Ca2+ mobilization. The above two cellular responses induced by ATP were also observed in the Ca2+ depleted medium. ATP induced a rapid and transient accumulation of 1,4,5-IP3 (5s), followed by a slower accumulation of 1,3,4-IP3. These results suggest that ATP induces the formation of 1,4,5-IP3 through the P2-purinergic receptor and consequently promotes Ca2+ mobilization from intracellular storage sites in cultured adrenal chromaffin cells. PMID- 2783454 TI - 1-Methyl-4-phenylpyridinium uptake by human and rat striatal synaptosomes. AB - 1-Methyl-4-phenylpyridinium (MPP+) was taken up into human and rat striatal synaptosomes by a saturable system, similar to that for dopamine, with Km values of 0.24 and 0.17 microM, respectively, and similar Vmax values. Uptake of MPP+ and dopamine into both rat and human synaptosomes was inhibited by cocaine and amfonelic acid, with the latter being five to 10 times more potent than the former. MPP+ uptake was potently inhibited by dopamine in preparations from both species. In general, the characteristics of human and rat synaptosomal MPP+ uptake were very similar It seems unlikely that species differences in toxicity to 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine or reaction to dopamine uptake blockers stem from this system. PMID- 2783455 TI - Imaging of brain tumors with L-3-[123I]iodo-alpha-methyl tyrosine and SPECT. AB - Carbon-11-labeled amino acids have been successfully used to image brain tumors by PET. This study was undertaken to evaluate the potential of L-3-[123I]-iodo alpha-methyl tyrosine (123IMT) for metabolic imaging of brain tumors. Ten patients (glioblastoma, oligodendroglioma, lymphoma, and metastases) had early and delayed brain SPECT with a rotating gamma camera after i.v.-injection of 200 300 MBq 123IMT. In nine patients the tumors showed intense uptake of the radiotracer. Tumor-to-brain tissue ratios were between 1.4 and 2.6. 123IMT shows potentials for monitoring the effects of brain tumor therapy. PMID- 2783456 TI - Three-dimensional attenuation coefficients distribution for SPECT of the chest. PMID- 2783457 TI - In vitro and in vivo evaluation of [123I]IBZM: a potential CNS D-2 dopamine receptor imaging agent. AB - In vitro binding characteristics of a CNS dopamine D-2 receptor imaging agent, (S)-N-[(1-ethyl-2-pyrrolidinyl)] methyl-2-hydroxy-3-iodo-6-methoxybenzamide [( 125I]IBZM), was carried out in rats. Also brain images, as well as organ biodistribution were determined in a monkey following the administration of 123I labeled compound. The S-(-)-I[125I]IBZM showed high specific dopamine D-2 receptor binding in rat striatum (Kd = 0.426 +/- 0.082 nM, Bmax = 480 +/- 22 fmol/mg of protein). Competition of various ligands for the IBZM binding displayed the following rank order of potency: spiperone greater than S(-)IBZM much greater than R(+)IBZM greater than or equal to S(-)BZM greater than dopamine greater than ketanserin greater than SCH-23390 much greater than propranolol, norepinephrine, serotonin. In vivo planar images of a monkey injected with [123I]IBZM demonstrated a high concentration in basal ganglia of brain. The ratios of activity in the basal ganglia to cerebellum and the cortex to cerebellum in monkey brain were 4.93 and 1.44, respectively, at 120 min postinjection. These preliminary results indicate that [123I]IBZM is a potentially promising imaging agent for the investigation of dopamine D-2 receptors in humans. PMID- 2783458 TI - Two behavioral states studied in a single PET/FDG procedure: error analysis. AB - In a previous publication the theory, procedure, and results of a method were described for making two sequential measurements of cerebral metabolic rate for glucose (CMRglc), within a 2-hr period, using [18F]fluorodeoxyglucose. The error that is specific to this technique was estimated using computer simulations. CMRglc for the second state was sensitive to errors in (a) the values of the rate constants, (b) alignment of PET slices between the two scans, and (c) subtraction of one PET image from another. The root mean square of the average error from each error source was 6.4%, which gives the theoretical reliability of this method. The measured reproducibility, taken from our previous publication, was 4.2-6.2%, which is in good agreement with the present result. This method contributes a small additional error above that expected for two independent scans. However, independent scans done on different days are likely to be subject to larger physiological variations in CMRglc than would occur using this method. PMID- 2783459 TI - A study of etiologic factors for cleft lip and palate in Sri Lanka. AB - Fifty-eight infants with cleft lip and/or cleft palate detected in a prospective study and 443 cleft patients in a retrospective study were investigated regarding seasonal variation of incidence, relation to birth rank, consanguinity of parents, and history of viral infections and drugs taken by mothers during the first trimester of gestation. The highest incidence was recorded in the month of April, but no reason for this could be found. No significant relation to birth rank and consanguinity of parents existed. Furthermore, the proportion of mothers of cleft patients who had taken drugs or who had viral infections was not significantly greater than in the control groups. These findings support the view that orofacial clefts probably have a multifactorial etiology. PMID- 2783460 TI - Primary canine hypoplasia in Head Start children. AB - Primary canine hypoplasia is an incomplete or defective development of the enamel matrix. The lesion is located on the labial surface and is seen more frequently on mandibular teeth. The purpose of this preliminary study was to determine the prevalence of this lesion among Head Start children. During a dental needs assessment of Mississippi Head Start children, 371 children from 11 centers were examined for this lesion. Of the centers, four were located in optimally fluoridated communities, and six were located in fluoride-deficient communities. Ages ranged from three to five years. There were 206 males and 165 females, 334 black and 37 white children. At ten centers all children were black, while all children at one center were white. Results indicated no significant differences in the black population between fluoridated (38.2%) and fluoride-deficient (36.3%) communities (P = .729) or between males (36.8%) and females (37.6%) (P = .877). When data were collapsed on sex and fluoridation status, the racial differences were highly significant (P = .001). The prevalence rate of dental caries associated with primary canine hypoplasia was 26.0 percent. These preliminary data indicate that the presence of primary canine hypoplasia may result in an increased potential for the tooth becoming carious. PMID- 2783461 TI - Reduction by anti-antibody administration of the radiotoxicity associated with 131I-labeled antibody to carcinoembryonic antigen in cancer radioimmunotherapy. AB - Radiolabeled antibodies have been shown to have a therapeutic potential in tumor bearing animal models. However, treatment with radiolabeled antibodies results in toxic effects to normal tissues, as monitored by losses in body weight and in peripheral wbcs. We have investigated the use of an anti-antibody, or second antibody (SA), as a means of reducing this toxicity. SA rapidly forms a complex with circulating radiolabeled antibody, causing an increase in the clearance rate of the radiolabeled antibody from the blood. Toxicity was significantly reduced in animals given the SA in comparison to the toxicity seen in animals given only the radiolabeled primary antibody (PA). The earlier the SA was administered, the lower was the toxicity. The therapeutic efficacy of radiolabeled antibody was not influenced by the administration of the SA given 48 hours after the PA. Thus, the controlled removal of circulating radiolabeled antibody by an anti-antibody can reduce the toxicity associated with radiolabeled antibody therapy without influencing the antitumor effect. PMID- 2783462 TI - Inhibition of growth of human lung adenocarcinoma cell lines by anti-transforming growth factor-alpha monoclonal antibody. AB - We previously reported that two human lung adenocarcinoma cell lines (A-549 and PC-9) produce human transforming growth factor-alpha (hTGF-alpha) and express its receptors. In the present study an exogenously added monoclonal antibody against recombinant hTGF-alpha inhibited growth of these cell lines in vitro. This result indicated that endogenous hTGF-alpha produced by the cancer cells can function as an autocrine growth factor. PMID- 2783463 TI - Sequence dependence of administration of human recombinant tumor necrosis factor and interleukin-2 in murine tumor therapy. AB - Simultaneous administration of recombinant human tumor necrosis factor (rhTNF) and interleukin-2 (rhIL-2) has been shown to block tumor take in murine models. We investigated the effects of sequence and schedule of administration as a function of tumor burden with two tumor models (B16 and Meth A). rhTNF followed by rhIL-2 had extraordinary antitumor efficacy, but rhIL-2 followed by rhTNF was much less effective. Sequential rhTNF/rhIL-2 therapy resulted in complete tumor regression, whereas simultaneous therapy resulted in complete tumor regression, whereas simultaneous therapy resulted in only reduced growth rate. Experiments with genetically immunodeficient mice suggested that T cell factors may be required for synergistic antitumor activity. PMID- 2783464 TI - Terminal B-cell maturation and immunoglobulin (Ig) synthesis in vitro in patients with major injury. AB - This study evaluated B-lymphocyte function in 30 patients following major trauma with frequent screening over a period of 21 days post-trauma. Peripheral blood mononuclear cells (PBMC) were phenotyped with monoclonal antibodies and in vitro B-cell function was tested both for unstimulated cells (spontaneous) and following stimulation with pokeweed mitogen (PWM). The capacity for terminal B cell maturation into plasma cells was assessed by the number of cells bearing cytoplasmic immunoglobulin (CIg+). Although the number of circulating B cells in the trauma patients was not decreased following injury (12 +/- 2%), the number of CIg+ cells was significantly decreased (0.2 +/- 0.1 to 3.0 +/- 1.5) compared to controls (5 +/- 1) up to 21 days post-trauma (p less than or equal to 0.01). Spontaneous B-cell synthesis of IgA, IgM, and IgG was significantly depressed on day 1, but IgA was within normal range (159 +/- 30 ng/ml) by day 3, and IgA levels were supranormal (118 to 300% of control) on days 5-10 before returning to normal on days 14 to 21. Synthesis of IgG was 100 +/- 20 ng/ml on day 3 (control, 165 +/- 31 ng/ml), and IgG levels were supranormal (+45 to +139%) thereafter. On the other hand, IgM synthesis was decreased on all days studied (120 +/- 35 to 220 +/- 70 ng/ml) compared to controls (366 +/- 105 ng/ml). Synthesis of all Ig subclasses in PWM cultures followed a similar pattern. There was a marked monocytosis (30 +/- 2% LeuM3 + PBMC's) compared to control values (13 +/- 2% LeuM3+ PBMC's).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2783465 TI - The reduced virulence of the thymotropic Moloney murine leukemia virus derivative MoMuLV-TB is mapped to 11 mutations within the U3 region of the long terminal repeat. AB - Chimeric constructs were generated by exchanging genomic fragments between the potent T-cell lymphoma inducer Moloney murine leukemia virus (MoMuLV) and its derivative MoMuLV-TB, which induces T-cell lymphoma after a relatively longer latent period. Analysis of the T-cell lymphoma-inducing potential of the hybrid viruses that were obtained localized the primary determinant critical to efficient T-cell lymphoma induction to the MoMuLV ClaI-XbaI fragment which comprises 48 nucleotides (nt) of p15E, p2E, the 3'-noncoding sequence, and 298 nt of U3. The 438-base-pair ClaI-XbaI fragments of MoMuLV and MoMuLV-TB differed in only 11 nt. Nine mutations were found within the enhancer. These mutations occurred within the two CORE, the two GRE-LVa, and two of the four NF1 nuclear factor-binding motifs. MoMuLV-TB replicated better than MoMuLV in thymus-bone marrow (TB) cells, a cultured cell line of lymphoid origin. In addition, MoMuLV TB and NwtTB-2, a recombinant virus with the ClaI-SmaI fragment of MoMuLV-TB in a MoMuLV background, replicated in thymocytes as efficiently as did MoMuLV or TBNwt 2, the reciprocal recombinant virus, with the ClaI-SmaI fragment of MoMuLV in a MoMuLV-TB background. Like NwtTB-4, a recombinant virus with the ClaI-XbaI fragment of MoMuLV-TB in a MoMuLV background, NwtTB-2 induced lymphoma after a long latent period. The finding given above suggests that thymotropism is not the only factor that determines the T-cell lymphoma-inducing potential of MoMuLV. It appears likely that mutations in one or more of the MoMuLV-TB nuclear factor binding motifs may have altered the interaction of the enhancer with specific nuclear factors; this, in turn, may affect the T-cell lymphoma-inducing potential of MoMuLV-TB. PMID- 2783467 TI - Simultaneous carotid and coronary disease: safety of the combined approach. AB - Invoking unacceptable operative risks, many institutions have adopted a conservative policy toward carotid stenosis in patients who require cardiopulmonary bypass (CPB). We have continued to apply simultaneous carotid endarterectomy/coronary artery bypass grafting (CEA/CABG) in selected patients, and in order to place operative risk in perspective, our experience with CEA/CABG was reviewed and contrasted with both CEA and CABG performed as isolated procedures. Seventy-one CEA/CABG were performed from 1978 to 1987, with the bulk of the experience (51/71) accumulated over the past 5 years. CEA/CABG was applied when the carotid lesion was severe (greater than or equal to 75% diameter stenosis). Clinical characteristics of patients with CEA/CABG (e.g., presence of unstable angina, left main coronary artery disease, and impairment of ventricular function) suggested these patients were at higher risk for complications when compared to patients with CABG alone. Yet, other factors influencing stroke risk during cardiopulmonary bypass (patient age, duration of CPB time) were similar between patients with CEA/CABG and patients with only CABG. Most complications in patients with CEA/CABG occurred in the early years of the study. Considering the recent (1983-87) patient cohorts of CEA/CABG and isolated CABG, respectively, there was no significant difference in either operative mortality (2.0% as compared to 2.2%) or perioperative stroke (2.0% as compared to 0.6%). Whereas precise patient selection criteria remain undefined, these findings verify the safety of the combined CEA/CABG approach for most patients who require treatment of both lesions. PMID- 2783466 TI - Vaccinia virus encodes two proteins that are structurally related to members of the plasma serine protease inhibitor superfamily. AB - Nucleotide sequencing adjacent to the right inverted terminal repetition of the vaccinia virus genome revealed two genes encoding polypeptides that are structurally related to members of the plasma serine protease inhibitor superfamily (SPI). Inclusion in the superfamily is based on extensive amino acid sequence similarities as well as a consensus sequence adjacent to the active-site region near the carboxyl ends of the proteins. The genes designated SPI-1 and SPI 2 are located 10,000 and 17,000 base pairs from the right end of the genome, respectively. The predicted SPI-1 polypeptide is 11 amino acids longer than that of SPI-2, and the deduced masses are 40,471 and 38,125 daltons, respectively. Similarities between SPI-1 and SPI-2 are indicated by the percentage of identical amino acids (44%) and corresponding hydrophobicity plots. The maximum amino acid sequence diversity occurs precisely in the putative active-site region, suggesting that SPI-1 and SPI-2 may inhibit different proteases. SPI-2 is homologous to a previously described cowpox virus gene (D. J. Pickup, B. S. Ink, W. Hu, C. A. Ray, and W. K. Joklik, Proc. Natl. Acad. Sci. USA 83:7698-7702, 1986). Evidence for a cowpox virus homolog of SPI-1 was obtained by DNA hybridization. Thus, the presence of two genes that belong to the plasma serine protease inhibitor superfamily may be characteristic of orthopoxviruses. PMID- 2783469 TI - Late results after intracoronary thrombolysis and early bypass grafting for acute myocardial infarction. AB - Successful thrombolysis for acute myocardial infarction reduces early mortality. For definite correction of the underlying arteriosclerotic lesion, invasive treatment is mandatory. Early bypass grafting has been performed in 70 patients with an ischemic interval of less than 4 hours before reperfusion by thrombolysis. Surgery was undertaken an average of 4.5 days after the streptokinase administration. The hospital mortality rate was 1.4%. At 8 years the actuarial survival rate was 88% and the complication-free survival rate, 84%. At the latest follow-up study, 90% of the patients were in functional class I or II. Because of advanced age, 37% of the survivors have retired and 29% are working. Thirty-four percent did not return to work after the operation. In 24 patients a transmural needle biopsy specimen was taken at operation to study the extent of ischemic damage. Surprisingly, the extent of necrosis did not correlate with the ischemic interval (r = 0.17), whereas enzyme activity and extent of necrosis did correlate (r = 0.76). Late angiography was done in 44 patients (56%). The correlation between ischemic interval and regional wall motion score was weak when the whole group was considered (r = 0.35), but 70% of the patients with an ischemic interval of less than 3 hours had normal or near normal regional wall motion. In patients with prolonged ischemia, distribution between normal function and severe damage was uniform. In patients with ultrastructural and wall motion studies, early necrosis and late left ventricular function correlated fairly well (r = 0.69). We conclude that additional early bypass grafting after successful thrombolysis yields excellent long-term clinical results, especially in patients with an ischemic interval of less than 3 hours. PMID- 2783468 TI - Differential effects of interleukin-1 and formylmethionylleucylphenylalanine on chemotaxis and human endothelium adhesivity for A549 tumor cells. AB - We investigated the effects of formylmethionylleucylphenylalanine (FMLP), interleukin-1 alpha (IL1 alpha) and interleukin-1 beta (IL1 beta) on tumor cell chemotaxis and tumor cell/endothelial cell adhesion. Chemotaxis of A549 human lung carcinoma cells was measured as the number of tumor cells which migrated across a nitrocellulose filter in a Boyden chamber. Tumor cell/endothelial cell adhesion was measured as the number of 125IUdR tumor cells adherent to monolayers of endothelial cells. Confluent monolayers of human umbilical endothelial cells were incubated from 10 to 240 minutes with FMLP, monocyte-derived interleukin-1, or recombinant IL1 alpha or IL1 beta. The endothelial cells were washed and then incubated with 125IUdR-tumor cells. Thirty minutes later the number of adherent tumor cells was assessed isotopically. Our results demonstrate that (a) interleukin-1 but not FMLP, has chemotactic activity for tumor cells, and (b) both FMLP and interleukin-1 enhance tumor cell adhesion to the endothelium independent of any chemotactic activity. Furthermore, we demonstrate that IL1 alpha and IL1 beta have different effects on tumor cell/endothelial cell adhesion, and raise the possibility that IL1 alpha but not IL1 beta is continuously synthesized and stored within the endothelium. We postulate that IL1 alpha and IL1 beta influence tumor cell/endothelial cell adhesion independent of chemotaxis through the expression of adhesive receptors on the endothelial cell surface. PMID- 2783470 TI - Effects of hypothermia and hemodilution on oxygen metabolism and hemodynamics in patients recovering from coronary artery bypass operations. AB - The coexistence of hypothermia and hemodilution in patients in the intensive care unit immediately postoperatively after coronary artery bypass graft operations presents concerns regarding the adequacy of hemodynamics and oxygen metabolism. We evaluated the hemodynamic status and oxygen metabolism during the postoperative recovery period in six patients with moderate hemodilution (hematocrit value 34% +/- 3%) and in eight patients with marked hemodilution (hematocrit value 23% +/- 2%). All patients were well sedated and paralyzed with pancuronium bromide during the study period, during which their body temperature was slowly returning toward normal. In both groups, cardiac index at 34 degrees C was about 40% lower than at 37 degrees C. This was associated with 50% higher systemic vascular resistance and 30% lower oxygen availability to tissue. Oxygen consumption, however, was proportionally lower (45%) and coronary perfusion pressure was higher (28%) at 34 degrees C than at 37 degrees C; thus neither mixed venous nor coronary sinus blood oxygen saturation was compromised under hypothermic conditions. Although the trends in hemodynamic changes were similar in both groups, cardiac indices in patients with marked hemodilution were higher than cardiac indices in those with moderate hemodilution at all temperatures. This observation indicates that the hemodilution-induced rise in cardiac index remains intact even under hypothermic conditions. Under the conditions we studied, hypothermia with or without hemodilution had no significant adverse effects on hemodynamics and oxygen metabolisms of the whole body or of the heart. PMID- 2783471 TI - Two-year follow-up study of coronary bypass surgery. Psychologic status, employment status, and quality of life. AB - This study is a prospective report of the cases of 135 patients who were slated for coronary artery bypass grafting and selected according to designated criteria. Patients received, in addition to an interview, a comprehensive cognitive, neuropsychologic, and personality assessment 2 weeks before operation and 3, 12, and 24 months after operation. Of the available sample, 82.3% completed the full study. There was no evidence of intellectual or neuropsychologic impairment after operation. Most patients returned to preoperative status 3 months after bypass grafting. Further improvement may continue 12 and 24 months after operation. The personality tests revealed that anticipation of the operation resulted in signs of emotional arousal and distress, which dissipated after a successful surgical outcome. Similarly, return to work and quality of life was enhanced. The current study represents the first systematic, longer-term follow-up of the psychologic and social consequences of coronary artery bypass grafting operations. The findings of this study are discussed within a model of social reconstitution after the successful resolution of a life-threatening medical condition. PMID- 2783472 TI - Lymphokine-activated killer cell plus recombinant interleukin-2 therapy of erythroleukemia in mice. AB - The antileukemic effects of lymphokine-activated killer (LAK) cells plus recombinant interleukin-2 (rIL-2) therapy were assessed in mice with Friend virus (FV)-induced erythroleukemia. LAK cells were generated by incubating normal spleen cells for 72 hr in the presence of rIL-2 (1000 units/ml). At the time of injection, the LAK cells were cytotoxic in vitro against FV-infected fibroblasts and NK-sensitive and -resistant tumor targets but not normal controls. To determine in vivo activity, fully leukemic mice (spleen weight greater than 0.75 g) were injected with either PBS or LAK cells (10(8) cells/mouse IV at 14 and 17 days post virus) and rIL-2 (10,000 units/mouse IP every 8 hr on days 14 through 18 post virus). More than 70% of the progressively leukemic mice experienced permanent leukemia regressions (disease-free for greater than 100 days) following LAK cell plus rIL-2 therapy. Regressions were characterized by return of spleen and liver weights to normal and elimination of virus-infected erythroid (CFU-E) and macrophage (CFU-C) progenitor cells from spleen and marrow. Leukemic animals treated with either LAK cells alone or IL-2 alone experienced only transient leukemia regressions. These results demonstrate that LAK cell plus rIL-2 treatment can induce permanent regressions in progressively leukemic mice and provide a responsive and manipulable model system to elucidate the mechanisms involved in this form of immunotherapy. PMID- 2783473 TI - dATP-mediated inhibition of DNA ligase by 2'-deoxycoformycin in T and B cell leukemia. AB - 2'-Deoxycoformycin (dCF), a potent adenosine deaminase inhibitor, has been reported to display greater toxicity for T than for B lymphoblasts. Since this compound can block DNA replication and since this effect is mediated by the intracellular ATP/dATP balance, its possible effect on DNA ligase was investigated. dCF at relatively low concentrations (1 microM), in association with dATP (100 microM), is a strong inhibitor of DNA ligase in T blasts, whereas it has no significant effect in B blasts at this concentration. The AMP-ligase complex is the target of the observed inhibition because the combined presence of the inhibitor and dATP results in a more stable dAMP-ligase complex. Because of this observation and of the greater adenosine deaminase activity observed in T cells, the dATP mediated dCF inhibition of ligase might be the crucial replication target of T cell toxicity. These observations are discussed in terms of T immunodeficiencies including Graft Versus Host Disease and related syndromes. PMID- 2783474 TI - [The prevalence of rheumatoid arthritis is lower than previously known]. PMID- 2783475 TI - Hprt mutations and karyotype abnormalities in T-cell clones from healthy subjects and melphalan-treated ovarian carcinoma patients. AB - In vivo mutations at the locus for hypoxanthine phosphoribosyl transferase (hprt) were studied in 6-thioguanine (TG)-resistant T-lymphocyte clones from healthy male and female subjects and ovarian carcinoma patients treated with melphalan. Southern blot analysis of 108 clones showed alterations in 14% (4/29) of the clones from healthy males, 4.3% (2/47) of the clones from healthy females and 3.1% (1/32) of the clones from melphalan-treated patients. 2 of the 7 abnormal clones had a total deletion of the hprt gene; the others had partial deletions. Karyotype analysis of 82 clones revealed 1 clonal abnormality in 29 mutant clones from healthy males (3.6%). Loss or structural aberration of 1 X-chromosome occurred in 6% of the clones from healthy females. The frequency of karyotypic abnormalities (excluding those affecting one of the X-chromosomes) was significantly higher in clones from patients (37%) as compared to healthy females (5.9%). No aberration was found to affect the hprt locus at Xq27 in any of the 82 clones studied. PMID- 2783476 TI - Persistent antibody response to the HIV-1-negative regulatory factor in HIV-1 infected seronegative persons. PMID- 2783477 TI - The effect of dietary supplementation with n-3 polyunsaturated fatty acids on the synthesis of interleukin-1 and tumor necrosis factor by mononuclear cells. AB - We examined whether the synthesis of interleukin-1 or tumor necrosis factor, two cytokines with potent inflammatory activities, is influenced by dietary supplementation with n-3 fatty acids. Nine healthy volunteers added 18 g of fish oil concentrate per day to their normal Western diet for six weeks. We used a radioimmunoassay to measure interleukin-1 (IL-1 beta and IL-1 alpha) and tumor necrosis factor produced in vitro by stimulated peripheral-blood mononuclear cells. With endotoxin as a stimulus, the synthesis of IL-1 beta was suppressed from 7.4 +/- 0.9 ng per milliliter at base line to 4.2 +/- 0.5 ng per milliliter after six weeks of supplementation (43 percent decrease; P = 0.048). Ten weeks after the end of n-3 supplementation, we observed a further decrease to 2.9 +/- 0.5 ng per milliliter (61 percent decrease; P = 0.005). The production of IL-1 alpha and tumor necrosis factor responded in a similar manner. Twenty weeks after the end of supplementation, the production of IL-1 beta, IL-1 alpha, and tumor necrosis factor had returned to the presupplement level. The decreased production of interleukin-1 and tumor necrosis factor was accompanied by a decreased ratio of arachidonic acid to eicosapentaenoic acid in the membrane phospholipids of mononuclear cells. We conclude that the synthesis of IL-1 beta, IL-1 alpha, and tumor necrosis factor can be suppressed by dietary supplementation with long chain n-3 fatty acids. The reported antiinflammatory effect of these n-3 fatty acids may be mediated in part by their inhibitory effect on the production of interleukin-1 and tumor necrosis factor. PMID- 2783479 TI - Postpartum hemorrhage. PMID- 2783478 TI - Phosphorylcholine acts as a Ca2+-dependent receptor molecule for lymphocyte perforin. AB - Large granular lymphocytes and cytolytic T-lymphocytes (CTL) contain numerous cytoplasmic granules thought to be responsible, at least in part, for the cytolytic activity of these effector cells. Isolated granules are lytic for a variety of target cells and the granule proteins are specifically released upon target-cell interaction. Major proteins in mouse CTL granules are a family of seven serine proteases designated granzymes A to G, and a pore-forming protein called perforin (cytolysin). Purified perforin is cytolytic in the presence of Ca2+ and shows ultrastructural, immunological and amino-acid sequence similarities to complement component C9. Despite these similarities, perforin and C9 are clearly distinct in their mode of target-cell recognition. Whereas C9 insertion is absolutely dependent on a receptor moiety assembled from the complement proteins C5b, C6, C7, and C8 on the target-cell membrane, no requirement for a receptor molecule has been reported for perforin. Here, we demonstrate that phosphorylcholine acts as a specific, Ca2+-dependent receptor molecule for perforin. PMID- 2783480 TI - Aerosolized pentamidine: a new weapon against P.C.P. PMID- 2783481 TI - Transcutaneous electrical nerve stimulation at acupuncture points in the induction of uterine contractions. AB - The effectiveness of transcutaneous electrical stimulation at acupuncture points for increasing uterine contractions in 20 post-dates pregnant women was assessed in a controlled study. Subjects were randomly assigned to either a treatment condition, consisting of the application via surface electrodes of a 30-Hz current to the points "spleen 6" (lower leg) and "liver 3" (foot), or a placebo condition, in which the equipment was attached but not activated. The frequency and strength of uterine contractions were monitored for 1 hour prior to stimulation and then for the final 2 hours of a 4-hour test period. A significant increase in frequency and strength of uterine contractions was found in the electrically stimulated women compared with the placebo-group women. The possible physiologic mechanisms underlying this effect, and its implication for labor induction, are discussed. PMID- 2783483 TI - A frequent RFLP identified by a human proenkephalin genomic clone [HGM9 symbol PENK]. PMID- 2783482 TI - Cre-stimulated recombination at loxP-containing DNA sequences placed into the mammalian genome. AB - The cre gene of coliphage P1 encodes a 38 kDa protein which efficiently promotes both intra- and intermolecular recombination at specific 34 bp sites called loxP. To demonstrate that the Cre protein can promote DNA recombination at loxP sites resident on a mammalian chromosome, a mouse cell line was constructed containing two directly repeated loxP sites flanking a 2.5 kb yeast DNA fragment and inserted between the SV40 promoter and the neo structural gene to disrupt expression of the neo gene. Expression of the cre gene in this cell line results in excision of the intervening yeast DNA and thus permits sufficient expression of the neo gene to allow cell growth in high concentrations of G418. Southern analysis indicated that Cre-mediated excision occurred at the loxP sites. In the absence of the cre gene such excisive events are quite rare. Cre-mediated recombination should thus be quite useful in effecting a variety of genomic rearrangements in eukaryotic cells. PMID- 2783484 TI - Lower gastrointestinal bleeding. A systematic approach to classification and management. AB - Early classification of lower gastrointestinal bleeding as occult, minor overt, or major overt allows a practical approach to evaluation and management. Localization of the bleeding site is the next step. In occult and minor overt bleeding, the cause can usually be determined from results of conventional diagnostic tests; however, angiography and even intraoperative endoscopy may be necessary in some particularly difficult cases. In contrast, major overt bleeding may only allow time for angiographic localization before surgery. Using this approach, the primary care physician can successfully manage most patients with lower gastrointestinal bleeding. PMID- 2783485 TI - Identification of murine complement receptor type 2. AB - A rabbit antiserum reactive with the human complement component C3d/Epstein-Barr virus receptor (complement receptor type 2, CR2) immunoprecipitates a Mr 155,000 murine B-cell surface antigen. The apparent molecular weight and cellular distribution of this murine antigen are similar to those of human CR2. Cells expressing the murine protein bind sheep erythrocytes coated with antibody and murine C1-C3d but do not bind Epstein-Barr virus at all. The monospecific antiserum to human CR2 together with goat F(ab')2 anti-rabbit IgG blocks attachment of the C3d-coated erythrocytes to receptor-bearing murine B lymphocytes. To further characterize murine CR2, a lambda gt11 library from the murine late pre-B-cell line 70Z/3 was screened with human CR2 cDNA. A partial cDNA clone of 3.5 kilobases with 79% amino acid sequence identity to human CR2 in the unique intracytoplasmic region and 63% identity to the sixth human CR2 repeat was obtained. Blot hybridization with the murine cDNA clone identified an RNA species of approximately 4.7 kilobases, similar in size to human CR2 mRNA, from a murine B-cell line but not from a murine T-cell line. PMID- 2783488 TI - Chiral synthesis of D- and L-myo-inositol 1,4,5-trisphosphate. AB - Chiral inositols (D-chiro-inositol from D-pinitol and L-chiro-inositol from L quebrachitol) were converted to the 3,4-di-O-benzyl ethers, which were selectively benzoylated to yield the 1,2,5-tri-O-benzoyl-3,4-di-O-benzyl-chiro inositols. The free hydroxyl group in each derivative was inverted by way of the trifluoromethane sulfonate ester to provide D- and L-1,2,4-tri-O-benzoyl-5,6-di-O benzyl-myo-inositol. Hydrogenolysis to remove the benzyl ether groups gave the enantiomeric 1,2,4-tri-O-benzoyl-myo-inositols, which were phosphorylated by a dibenzylphosphite triester method. After hydrogenolysis and saponification of the derivatives, the D- and L-myo-inositol 1,4,5-trisphosphates were isolated as the crystalline cyclohexylammonium salts in gram quantity. PMID- 2783486 TI - Cloning, analysis, and expression of murine perforin 1 cDNA, a component of cytolytic T-cell granules with homology to complement component C9. AB - The nucleotide sequence coding for the cytotoxic T-lymphocyte (CTL) protein perforin 1 (P1) has been determined and the corresponding protein sequence has been derived. Murine CTL cDNA libraries contained in the vector lambda gt11 were screened by using a monospecific antiserum to purified P1. Three recombinant phages were isolated and their cDNA inserts were sequenced. The derived protein sequence contains 554 amino acids and displays, as expected, considerable homology with certain functional domains in the complement components C9, C8 alpha, C8 beta, and C7. The identity of P1 cDNA clones was verified by prokaryotic expression and the reactivities of antisera produced to the expressed proteins. In addition, antisera were produced to two synthetic peptides located in the center and C-terminal portions of P1. All antisera reacted with purified P1. In Northern blot analyses, P1 cDNA probes recognized a 2.9-kilobase mRNA only in CTL. Perforin mRNA was found in all cloned CTL and in all mixed lymphocyte reactions that gave rise to cytotoxic cells. Perforin mRNA was also detected in virus-specific CTL that had been generated in vivo and isolated from liver tissue of mice infected with lymphocytic choriomeningitis virus. The cell-specific expression of perforin is consistent with its postulated role in cytolysis. PMID- 2783487 TI - Transplantation tolerance correlates with high levels of T- and B-lymphocyte activity. AB - Mice tolerized (treated to make them tolerant) at birth to transplantation antigens by injection of semiallogeneic cells contain very high numbers of activated T and B lymphocytes in their spleen. Lymphoid hyperactivity correlates with the tolerant state: it is present only in animals accepting skin allografts. Tolerized mice that reject the allogeneic skin graft have approximately the same numbers of total and activated lymphocytes as normal mice. The high level of lymphocyte activation in tolerant mice persists for up to 1 year of age, although it declines with age, and is markedly increased by a secondary allograft. The magnitudes of both primary and secondary tolerant responses are significantly higher than the immunological response of a normal mouse rejecting the same type of allograft. These observations contradict concepts of clonal deletion or anergy as the basis of neonatally induced transplantation tolerance and may contribute additional approaches to experimentation and control of transplantation reactions. PMID- 2783490 TI - Recognition of xeno-(HLA, SLA) major histocompatibility complex antigens by mouse cytotoxic T cells is not H-2 restricted: a study with transgenic mice. AB - Cytotoxic T lymphocytes (CTLs) recognize antigens in the context of major histocompatibility complex (MHC) class I gene products. The T-cell receptor (TCR) that mediates this MHC-restricted antigen recognition recognizes short peptide fragments rather than the intact antigen. Presentation of peptides to the TCR may thus be a major function of the MHC. An intriguing question emerging from this model is whether peptide presentation also applies to foreign MHC antigens and which of the available MHC molecules can present preferentially the peptides of the foreign MHC molecule. Allo- and xenoreactive CTLs might either recognize native MHC class I molecules or peptides presented by self MHC or by the foreign class I MHC itself. The finding that synthetic peptides corresponding to MHC class I regions are recognized by allo- and xenoreactive CTLs suggests that recognition of foreign MHC by CTLs might involve degraded fragments presented by syngeneic class I molecules. We used MHC transgenic mice as a tool to study these questions. The CTL responses against human (HLA) antigen B27 were analyzed by using HLA-B27 transgenic mice with various H-2 haplotypes. We report here that mouse xeno-MHC-specific (anti-B27) CTLs are perfectly able to kill human and mouse cells expressing the appropriate xenoantigen and that in primary and secondary responses to xeno-MHC, the mouse T-cell repertoire does not use self-H 2 as a restriction element. Absence of H-2 restriction was confirmed by the lack (less than 1/10(6] of H-2-restricted HLA-specific CTL precursors. Therefore, H-2 restricted recognition of xeno-MHC antigens cannot be generalized as part of a classical MHC class I-specific response. These results indicate that xenoreactive CTLs usually recognize intact MHC molecules or MHC peptides preferentially presented by their native MHC molecule. We suggest the latter possibility. PMID- 2783489 TI - Molecular analysis of a t(14;14) translocation in leukemic T-cells of an ataxia telangiectasia patient. AB - We have detected and cloned two rearrangements in the T-cell receptor alpha locus from a clone of somatic cell hybrids carrying a t(14;14)(q11;q32) chromosomal translocation derived from an ataxia telangiectasia patient with T-cell chronic lymphocytic leukemia. The T-cell clone carrying the t(14;14) chromosomal translocation was known to be present for greater than 10 years before the onset of overt leukemia. One molecular rearrangement of the T-cell receptor alpha locus corresponded to a functional variable-joining region (V-J) joining, whereas the other derived from the breakpoint of the t(14;14)(q11;q32) translocation. Chromosomal in situ hybridization of the probe derived from the t(14;14) breakpoint localized the breakpoint region to 14q32.1, apparently the same region that is involved in another ataxia telangiectasia characteristic chromosome translocation, t(7;14)(q35;q32). The 14q32.1 breakpoint is at least 10,000 kilobase pairs (kbp) centromeric to the immunoglobulin heavy chain locus. Sequence analysis of the breakpoint indicates the involvement of a J alpha sequence during the translocation. Comigration of high-molecular weight DNA fragments involved with t(7;14) and t(14;14) translocations suggests the presence of a cluster of breakpoints in the 14q32.1 region, the site of a putative oncogene, TCL1. PMID- 2783491 TI - Fate of aerosolized recombinant DNA-produced alpha 1-antitrypsin: use of the epithelial surface of the lower respiratory tract to administer proteins of therapeutic importance. AB - To evaluate the possibility of administering therapeutic proteins via the respiratory route, we administered an aerosol of recombinant DNA-produced human alpha 1-antitrypsin (rAAT) to anesthetized sheep and measured levels of the protein in epithelial lining fluid (ELF), lung lymph, blood, and urine. Using a nebulizer that generated aerosol droplets with a mass median aerodynamic diameter of 2.7 micron (55% of droplets were less than 3 micron, a particle size optimal for deposition on the alveolar epithelium), in vitro studies demonstrated that the aerosolized rAAT remained intact and fully functional as an inhibitor of neutrophil elastase. When aerosolized to sheep, the 45-kDa rAAT molecule diffused across the alveolar epithelium, as evidenced by its presence in lung lymph and in blood. Comparison of ELF, lymph, blood, and urine rAAT levels demonstrated that the process was concentration dependent, with highest levels in ELF and in descending concentrations with approximately 10-fold concentration differences in each consecutive compartment, respectively. Importantly, evaluation with aerosolized 125I-labeled rAAT demonstrated that the rAAT molecules that reached the lung lymph and the systemic circulation remained intact as a 45-kDa protein. These results demonstrate the feasibility of using aerosolization to the pulmonary epithelial surface to administer sizeable proteins of therapeutic interest, thus circumventing the necessity of the traditional parenteral modes of administration of such molecules. PMID- 2783492 TI - Effects of auricular transcutaneous electrical nerve stimulation on distal extremity pain: a pilot study. AB - The purpose of this pilot study was to determine the effectiveness of auricular acupuncture-like transcutaneous electrical nerve stimulation on pain. Fifteen subjects (6 men, 9 women) experiencing distal extremity pain received either one placebo pill or a 10-minute treatment of acupuncture-like TENS bilaterally to five acupuncture points on the auricle. Pain levels were measured before treatment and at 0, 10, and 30 minutes posttreatment using the visual analogue scale (VAS) and the pain rating index (PRI) of the McGill Pain Questionnaire. The VAS showed no statistically significant differences between Experimental Group (n = 8) and Control Group (n = 7) means at pretreatment or posttreatment; however, both groups showed a reduction in VAS means over time. The Experimental and Control Group means on the PRI were significantly different (p less than .05) at all three posttreatment measurements, but not at pretreatment baseline measurement. These results suggest that auricular acupuncture-like TENS could be an alternative for relief of distal extremity pain. Additional clinical studies are necessary to validate the results of this study. PMID- 2783494 TI - Recurrence of colorectal tumors: PET evaluation. AB - Positron emission tomography (PET) was used in the follow-up of patients with colorectal malignancies to differentiate between recurrent colorectal tumor and scar. Patients were examined with oxygen-15-labeled water and with fluorine-18 labeled deoxyglucose (FDG). FDG was injected intravenously to assess tumor metabolism. The tracer concentration was quantitatively evaluated by means of a region-of-interest technique and standardized for both injected dose and body volume. Of 29 patients, 21 had recurrent colorectal malignancy, and eight had a nonmalignant mass. All malignancies were seen on the PET cross sections. Nonmalignant lesions had a low FDG accumulation on images obtained 60 minutes after injection. While the tumor-soft tissue ratio was highest shortly after the intravenous injection of FDG, the tumor-scar ratio was highest 60 minutes after injection. It was possible to differentiate tumor from non-malignant tissue with FDG with the use of standardized concentration values and tumor-soft tissue ratios. Imaging with O-15-labeled water gave no additional information. PMID- 2783493 TI - Transcutaneous electrical nerve stimulation in the relief of primary dysmenorrhea. AB - The purpose of this study was to replicate a previous study to determine the effectiveness of acupuncture-like transcutaneous electrical nerve stimulation in treating primary dysmenorrhea. Twenty-one women with dysmenorrhea received a placebo pill or 30 minutes of acupuncture-like TENS. All subjects completed two pain questionnaires before treatment; immediately posttreatment; 30, 60, 120, and 180 minutes posttreatment; and the next morning upon awakening. Each woman also participated in a separate study measuring electrical resistance at four auricular acupuncture points before and immediately after treatment. The data were analyzed with a two-factor repeated-measures analysis of variance, which revealed statistical significance over time but not for group or interaction between group and time. Results revealed an average pain relief of at least 50% immediately posttreatment, indicating that acupuncture-like TENS may be useful for dysmenorrheic pain. This study also suggests that auriculotherapy via acupressure may relieve the pain of primary dysmenorrhea. PMID- 2783495 TI - Detection and quantification of chronic cerebrovascular disease: comparison of MR imaging, SPECT, and CT. AB - Twenty patients with angiographically proved occlusion of the internal carotid artery (ICA) (19 unilateral, one bilateral) were studied with magnetic resonance (MR) imaging, iodine-123 iodoamphetamine (IMP) single photon emission computed tomography (SPECT), xenon-133 SPECT, and computed tomography (CT). All patients had a history of stroke or prolonged reversible ischemic neurologic deficit for more than 4 weeks. By regions of interest, T1, T2, regional cerebral blood flow (rCBF), and the number and size of the lesions were determined. The data were expressed as interhemispheric ratios (diseased/nondiseased). The highest ratios obtained were for MR imaging (T1, 2.60 +/- 0.42; T2, 1.61 +/- 0.22 [mean +/- standard deviation]) followed by Xe-133 SPECT (0.58 +/- 0.13) and IMP SPECT (0.56 +/- 0.13). Correlation coefficients for MR imaging (1/T1, 1/T2) and IMP SPECT were below .21. The lesion size was greatest on IMP SPECT images, intermediate on MR images, and least on CT scans. However, MR imaging was superior in detection of pathologic areas (detection rates: MR, 100%; IMP SPECT, 91%; CT, 79%). Relaxation times do not correlate with rCBF. PMID- 2783496 TI - A novel vasodilatory peptide from the salivary glands of the sand fly Lutzomyia longipalpis. AB - Salivary gland lysates of the sand fly Lutzomyia longipalpis contain a potent vasodilator that aids the fly to feed on the blood of its vertebrate hosts. Chromatographic analysis, antibody reactivity, and data obtained from bioassays of the salivary erythema-inducing factor indicate striking similarity with human calcitonin gene-related peptide. The erythema-inducing factor is, however, at least one order of magnitude more potent than calcitonin gene-related peptide. PMID- 2783497 TI - Contingent genetic regulatory events in T lymphocyte activation. AB - Interaction of antigen in the proper histocompatibility context with the T lymphocyte antigen receptor leads to an orderly series of events resulting in morphologic change, proliferation, and the acquisition of immunologic function. In most T lymphocytes two signals are required to initiate this process, one supplied by the antigen receptor and the other by accessory cells or agents that activate protein kinase C. Recently, DNA sequences have been identified that act as response elements for one or the other of the two signals, but do not respond to both signals. The fact that these sequences lie within the control regions of the same genes suggests that signals originating from separate cell membrane receptors are integrated at the level of the responsive gene. The view is put forth that these signals initiate a contingent series of gene activations that bring about proliferation and impart immunologic function. PMID- 2783498 TI - Interleukin-1 mitogenic activity for fibroblasts and smooth muscle cells is due to PDGF-AA. AB - Both interleukin-1 (IL-1) and platelet-derived growth factor (PDGF) induce proliferation of cultured fibroblasts and smooth muscle cells. These polypeptide mediators are released by activated macrophages and other cell types in response to injury and are thought to have a role in tissue remodeling and a number of pathologic processes. Analysis of the kinetics of [3H]thymidine incorporation by cultured fibroblasts demonstrated that the response to IL-1 is delayed approximately 8 hours relative to their response to PDGF. IL-1 transiently stimulated expression of the PDGF A-chain gene, with maximum induction after approximately 2 hours. Subsequent synthesis and release of PDGF activity into the medium was detected as early as 4 hours after IL-1 stimulation, and downregulation of the binding site for the PDGF-AA isoform of PDGF followed PDGF AA secretion. Antibodies to PDGF completely block the mitogenic response to IL-1. Therefore, the mitogenic activity of IL-1 for fibroblasts and smooth muscle cells appears to be indirect and mediated by induction of the PDGF A-chain gene. PMID- 2783500 TI - [Histiocytosis X. Review of the literature and a case report]. AB - Histiocytosis X is a non-lipid reticuloendotheliosis, characterized by histiocyte proliferation. The proliferating cells resemble the Langerhan's cells in the epidermis. The main clinical types include eosinophile granuloma, Hand-Schuller Christian's disease (HSC) and Letterer-Siwe's disease (LS). Eosinophile granuloma is localized to the skeleton and runs a spontaneously benign course. HSC and LS are serious, generalized conditions. HSC runs a chronic and occasionally lethal course. LS usually runs a rapidly lethal course. LS commences before the age of three years while HSC occurs both in children and young adults. A case of HSC is described. PMID- 2783499 TI - Effect of subarachnoid hemorrhage on calcitonin gene-related peptide-induced relaxation in rabbit basilar artery. AB - An isometric tension measurement of ring segments was performed in the rabbit basilar and common carotid arteries in vitro to investigate the regional differences in the calcitonin gene-related peptide (CGRP)-induced vasodilation and the effect of subarachnoid hemorrhage on CGRP-induced vasodilation. CGRP elicited vasodilation of the rabbit basilar artery in a dose-dependent fashion when the artery was precontracted by 10(-5) M 5-hydroxytryptamine, whereas almost no relaxation occurred in the rabbit common carotid artery. The relaxation of the basilar artery was 64.03 +/- 1.85% at 3 x 10(-8) M CGRP, with an EC50 of 8.46 +/- 0.08. Two days after experimental subarachnoid hemorrhage, CGRP-induced relaxation of the rabbit basilar artery was 53.96 +/- 8.08% of the 10(-5) M 5 hydroxytryptamine-induced contraction, not significantly different from that of the basilar artery of the control rabbit. Our findings suggest that CGRP induces potent vasodilation in the rabbit basilar artery and that no impairment of vasodilation occurred after experimental subarachnoid hemorrhage. We speculate that CGRP may have therapeutic potential in cerebrovascular disease such as vasospasm after subarachnoid hemorrhage. PMID- 2783501 TI - The diagnosis of pulmonary nodules: comparison between standard and inverse digitized images and conventional chest radiographs. AB - We compared plain chest radiographs, standard (bones white) digitized images, and inverse-intensity (bones black) images to determine their ability to identify pathologically confirmed malignant pulmonary nodules. The images were digitized by using a photo-optical laser scanner and were displayed on a 1024 x 1024 x 8 bit system capable of operator-controlled magnification (2x or 4x) and nonlinear (logarithmic/exponential) contrast transformation in both standard and inverse intensity modes. Receiver-operator curve analysis was used to study the detection performance of six observers who viewed 40 images obtained in 15 normal subjects and 25 abnormal subjects. There was no statistically significant difference in the area under the ROC curve between the standard digital images and the plain chest radiographs. However, ROC areas were significantly greater (p less than or equal to .05) for inverse-intensity digital images when compared with either standard-intensity digital images or plain chest radiographs. These results suggest that inverse-intensity images may have some advantages in the detection of pulmonary nodules. PMID- 2783502 TI - Pulmonary edema due to ingestion of organophosphate insecticide. PMID- 2783504 TI - Dynamic hepatic CT scanning. PMID- 2783503 TI - CT evaluation of suspected hepatic metastases: comparison of techniques for i.v. contrast enhancement. AB - Although IV injection of contrast material is widely used for detection and follow-up of hepatic metastases on CT, the optimal method of contrast enhancement has not yet been defined. A prospective study was performed in 50 consecutive patients with suspected hepatic metastases. Lesion size and detectability were compared on unenhanced CT scans, scans obtained during a bolus injection of contrast material (early bolus phase), and scans obtained during a rapid infusion after the loading bolus. A total of 60 hepatic lesions were evaluated in 26 patients, 19 with histologic confirmation of metastases and seven with strong supportive evidence. The bolus phase allowed detection of 15% more lesions than did examination during the rapid-infusion phase. Lesion size varied, depending on the timing and method of contrast administration; the largest measurements were obtained during bolus injection of contrast material. In addition, bolus administration of contrast material subjectively resulted in the best lesion detection. Because the three techniques of IV contrast enhancement may produce different size measurements, sequential examinations must be tailored appropriately. Scanning during the bolus phase is technically possible with current CT equipment and is recommended as the primary CT screening examination for hepatic metastases. PMID- 2783505 TI - Percutaneous, large-bore, suprapubic cystostomy: technique and results. AB - A technique to insert large-bore suprapubic cystostomy catheters (18-French or larger) percutaneously, under radiologic imaging guidance, is described in 15 men who required long-term drainage of the bladder. This single-stage procedure is carried out under local anesthesia with optional IV sedation. It consists of rapid enlargement of the percutaneous track by means of a balloon dilatation catheter followed by insertion of a self-retaining Foley cystostomy catheter through a peel-away sheath. No complications associated with the placement of the catheters occurred, and long-term patient compliance has been satisfactory. Our results suggest that percutaneous, large-bore suprapubic cystostomy may be a preferred alternative to surgical cystostomy. PMID- 2783506 TI - Anticoagulant effects of contrast materials: in vitro study of iohexol, ioxaglate, and diatrizoate. AB - It has been reported that clot formation may occur when blood is mixed directly with nonionic contrast medium in a syringe during angiography. To investigate this possibility, we performed three in vitro experiments to determine the anticoagulant properties of a low-osmolar, nonionic contrast medium (iohexol); a low-osmolar, ionic medium (ioxaglate); and a high-osmolar, ionic medium (diatrizoate). In the first experiment, human arterial blood was incubated at room temperature in an angiographic syringe with each of the three media for 60 min, after which the mixture was filtered for clots. In the second experiment, the clotting times of venous blood in heparinized saline or serial dilutions of the three agents were determined. In the third experiment, the partial thromboplastin time of platelet-poor plasma in heparinized saline or serial dilutions of the three agents was measured. No clots were observed in any of the arterial blood samples. Iohexol prolonged the normal 15-min clotting time of venous blood to 160 min, compared with a clotting time of at least 330 min for ioxaglate and diatrizoate. Iohexol prolonged the normal 36-sec partial thromboplastin time of platelet-poor plasma to 40 sec, compared with 50 sec for diatrizoate and 54 sec for ioxaglate. Our data show that iohexol, like ioxaglate and diatrizoate, inhibits clot formation when mixed with blood in a syringe. It prolongs the clotting time to approximately the same degree as 600 U/l of heparinized saline, but to a lesser degree than the other two media. All three media have a minimal effect on the partial thromboplastin time. Our results do not show any risk of clot formation in the usual clinical setting in which there is inadvertent mixing of blood with iohexol, ioxaglate, or diatrizoate in an angiographic syringe. PMID- 2783507 TI - The subclavian triangle: CT analysis. PMID- 2783508 TI - Flexion teardrop fracture of the cervical spine: radiographic characteristics. AB - Teardrop fracture of the cervical spine is a confusing and loosely used term, often referring to any fracture with a triangular fragment in the involved body. The flexion teardrop fracture is a specific entity that should not be confused with other types of injury with a teardrop fragment. In a radiographic analysis of 45 patients with flexion teardrop fracture, the most characteristic feature was posterior displacement of the upper column of the divided cervical spine, observed in 78% of the cases. Other radiographic characteristics included backward displacement of the posterior fragment of the involved body, widening of the interlaminar and interspinous spaces, widening of the facet joint with backward displacement of the inferior facet, and kyphotic deformity of the cervical spine at the level of injury. The injury was frequently associated with sagittal-body and laminar fractures and occurred predominantly at the C5 level. PMID- 2783509 TI - MR imaging of the pars interarticularis. AB - MR imaging of the lumbar spine has become a useful method for the noninvasive evaluation of low back pain. However, bone abnormalities are more difficult to detect than soft-tissue lesions, such as herniated disk. We reviewed 14 MR images of the lumbar spine in adults with spondylolisthesis. These were correlated with CT scans and plain films in all cases. From the CT scans and plain films we found that seven patients had spondylolysis and that seven had other causes for their spondylolisthesis. It was our opinion that the MR images suggested an abnormality of the pars interarticularis in all seven of the cases confirmed to have spondylolysis and in six of the seven patients that did not have spondylolysis. We also studied four cadaver lumbar spine, obtained as blocks of tissue, and scanned in the coronal, sagittal, and axial planes with MR and in the sagittal and axial planes with CT. The tissue blocks were then sectioned in the sagittal plane. Spondylolysis is suggested on sagittal MR images when there is an inability to resolve the marrow signal in the pars as uninterrupted from the superior to the inferior facet. This is caused by a dark signal on all pulsing sequences in the pars resulting from marginal sclerosis at the site of the break. If there is also a gap at the site of the break then there will also be an increased signal in the gap resulting from the presence of soft tissue. We found four situations in which the pars can simulate spondylolysis on sagittal MR images: (1) sclerosis of the neck of the pars: (2) partial volume imaging of the degenerative spur of the superior facet slightly lateral to the pars; (3) partial facetectomy; and (4) osteoblastic metastatic replacement of the marrow of the pars. PMID- 2783510 TI - Incidental detection of hematopoietic hyperplasia on routine knee MR imaging. AB - An unusual appearance of the marrow of the distal femur, characterized by confluent foci of diminished signal intensity replacing the normally expected bright signal of fatty marrow on all pulse sequences, was encountered in 10 asymptomatic patients undergoing routine knee MR imaging. This prompted initial concern about the possibility that this appearance was due to lymphoma or occult myeloproliferative malignancy. All patients were mild to moderately obese, and all but one were women. Peripheral blood analysis was obtained in nine patients and was normal in five. The other four were cigarette smokers with a peripheral leukocytosis. Bone-marrow biopsy of the distal femur in two patients and of the iliac crest in three, performed to exclude malignancy, showed hypercellular but otherwise normal-appearing hematopoietic (red) marrow. The patients have been followed for 4-15 months without evidence of malignancy. We conclude that extensive foci of hematopoietic marrow may be encountered incidentally in patients undergoing MR examination. Careful follow-up to date suggests that this most likely represents a benign process and that patients in whom this appearance is encountered can be managed conservatively. PMID- 2783511 TI - Imaging of pigmented villonodular synovitis with emphasis on MR imaging. PMID- 2783512 TI - Cerebellar atrophy caused by high-dose cytosine arabinoside: CT and MR findings. PMID- 2783513 TI - Aortico-left ventricular tunnel: diagnosis by cine angiocardiography. PMID- 2783514 TI - Absence of the septum pellucidum: a useful sign in the diagnosis of congenital brain malformations. AB - In a review of more than 2000 MR images of the brain we identified 35 patients with absence of the septum pellucidum. These patients were divided into seven basic groups as follows: septooptic dysplasia; schizencephaly; holoprosencephaly; agenesis of the corpus callosum; chronic, severe hydrocephalus; basilar encephaloceles; and porencephaly/hydranencephaly. Absence of the septum pellucidum was never seen as an isolated finding. By using data gathered from the review of the MR scans of patients in this study, we devised a diagnostic algorithm to aid in the classification of these patients. Absence of the septum pellucidum can provide a valuable clue to the diagnosis of malformations of the brain. PMID- 2783515 TI - Intracranial oligodendrogliomas: imaging findings in 35 untreated cases. AB - The radiographic findings in 35 cases of untreated intracranial oligodendrogliomas were reviewed. The mean age of the patients was 34.6 years, and seizure disorder and headache were the most frequent presenting symptoms. Slightly less than two-thirds of the tumors were histologically pure and almost half were low-grade. Most lesions were cerebral and peripheral in location, and the majority were in the frontal lobes. On CT the tumors were usually hypo- or isodense. Contrast enhancement of tumor occurred in nearly half the cases, and was usually mild and poorly defined. Tumor calcification often occurred, and hemorrhage or cystic formation was not infrequent. Occasionally, calvarial erosion was associated with the tumors because of their peripheral location and slow-growing nature. The lesions were usually sharply demarcated and without edema. MR most frequently revealed hypointense lesions on T1-weighted images and abnormal hyperintensity on T2-weighted scans. In regard to grading or purity of oligodendrogliomas, no significant correlations were found except for a suggestion that higher-grade and mixed tumors tend to enhance more often on CT. The radiographic features of oligodendroglioma are quite characteristic but not pathognomic. A high preoperative suspicion might lead to more appropriate tumor management. MR, although less sensitive in detecting tumor calcification, is superior to CT in defining the tumor extent, which is beneficial for surgical and postsurgical radiotherapy planning. PMID- 2783516 TI - Embolotherapy of a high-flow false aneurysm by using an occlusion balloon, thrombin, steel coils, and a detachable balloon. PMID- 2783517 TI - Fat-shift artifact simulating aortic dissection on MR images. PMID- 2783518 TI - Chemotherapy and embolization via the inferior epigastric artery for the treatment of primary and metastatic cancer. AB - We evaluated the results of arterial chemotherapy and embolization via the inferior epigastric artery and its branches in 10 patients with a variety of primary and metastatic neoplasms supplied by that vessel. A total of 15 infusions and five occlusions were performed. There were no complications related to arteriography, indwelling catheters, or arterial occlusion. The effects on tumor bulk ranged from complete necrosis in one patient to partial necrosis in three patients. Surgical resection was facilitated in four of six patients. Local recurrence of tumor occurred in two of these patients. Three of four patients with intractable pain had effective relief. Our experience suggests that transarterial therapy of tumors supplied by the inferior epigastric artery or its branches is a safe procedure and may be useful in tumor management. PMID- 2783519 TI - Radiologic physics instruction for diagnostic radiologists: results of an opinion survey. Committee on Training of Radiologists, American Association of Physicists in Medicine. PMID- 2783520 TI - Physics instruction in radiology. PMID- 2783521 TI - Stress fracture of the os peroneum. PMID- 2783522 TI - Isolation of the right subclavian artery. PMID- 2783523 TI - A new radiologic sign of ruptured pulmonary hydatid cyst. PMID- 2783524 TI - Pelvic abscess complicated by a subarachnoid fistula. PMID- 2783525 TI - Angiographic demonstration of esophagojejunal venous shunt in a patient with esophagojejunostomy and esophageal varices. PMID- 2783526 TI - Periaortic leukemic infiltration. PMID- 2783527 TI - The hibernating myocardium. AB - The hibernating myocardium refers to resting LV dysfunction due to reduced coronary blood flow that can be partially or completely reversed by myocardial revascularization and/or by reducing myocardial oxygen demand. It is different from the stunned myocardium. Methods for its detection are not yet perfect. Hibernating myocardium has been demonstrated to be present in several clinical subgroups of patients; however, currently its full clinical presence and impact are not adequately defined. PMID- 2783528 TI - Acute gastrointestinal bleeding in anticoagulated patients: a prospective evaluation. AB - Acute gastrointestinal hemorrhage is one of the most feared complications of anticoagulation therapy. We prospectively evaluated 18 episodes of acute gastrointestinal bleeding in 17 patients anticoagulated with coumadin or heparin. Endoscopic examination revealed significant lesions irrespective of age, duration of anticoagulation, level of anticoagulation or symptoms. The high frequency of objective findings (e.g., 44% ulcers) suggests that diagnostic endoscopy should be performed in patients with acute gastrointestinal bleeding associated with anticoagulant therapy. PMID- 2783529 TI - Rectal bleeding due to enemas. PMID- 2783530 TI - Effect of umbilical vein oxytocin on puerperal blood loss and length of the third stage of labor. AB - The use of umbilical vein injection of oxytocin was compared with traditional management of the third stage of labor. Pregnant women were randomized to receive intravenous oxytocin after the delivery of the placenta (n = 25) or oxytocin via the umbilical vein immediately after cord clamping (n = 25). Those who received umbilical vein oxytocin had a shorter third stage of labor (4.1 versus 9.4 minutes), less measured blood loss (135 versus 373 ml), and a lower drop in hematocrit (3.9% versus 6.2%). Intraumbilical vein oxytocin appears to be a useful alternative to traditional management of the third stage of labor. PMID- 2783531 TI - Effect of physical activity on calcium and phosphorus metabolism in the rat. AB - Changes in skeletal mass, nutritional calcium and phosphorus balance, and intestinal calcium absorption were studied in four groups of rats: control, exercise allowing free access to food, exercise with pair-feeding to control levels, and immobilization. The exercise regimen consisted of treadmill running 25 m/min, 60 min/day, 5 days/wk for 13 wk; rats were immobilized by bilateral sciatic denervation. The total body Ca (TBCa) was measured by neutron activation analysis as an index of skeletal mass. Standard metabolic balance techniques were used to determine calcium and phosphorus balance, and an in situ duodenal loop ligation preparation was used to study the active and passive intestinal Ca transport processes. Exercise promoted a positive Ca and P balance and increased the skeletal mass, largely as a result of an increase in 1,25-dihydroxyvitamin D and an enhancement of the intestinal Ca absorption efficiency. Urinary excretion of Ca and P did not differ from control levels and food intake was not a factor because pair-fed rats responded to exercise almost identically to those fed ad libitum. Conversely, immobilization caused a decrease in TBCa and a lower Ca and P balance. These effects are the result of an increased urinary mineral excretion, greater endogenous fecal excretion, and decreased mineral absorption efficiency in the intestine. PMID- 2783533 TI - Pyrogenic and thermogenic effects of interleukin 1 beta in the rat. AB - Single injections of recombinant human interleukin 1 beta (IL-1 beta) caused large (up to 2 degrees C) and sustained (3 h) increases in body temperature in conscious rats. Intracerebroventricular injections (10-100 ng) were much more effective and elicited greater responses than intravenous injections (0.1-1 microgram). IL-1 beta increased resting oxygen consumption by 25-49% in a dose dependent manner. The activity of the thermogenic proton conductance pathway in brown adipose tissue (BAT) mitochondria was assessed from purine nucleotide (GDP) binding and was elevated by 40 and 86% 1 h after intravenous (1 microgram) or intracerebroventricular (100 ng) injection of IL-1 beta, respectively. Regional tissue blood flow was determined in anesthetized rats from the distribution of radiolabeled microspheres. Blood flow to liver (hepatic arterial), testes, skin, and white adipose tissue was unaffected by IL-1 beta injection. Blood flow to brain and kidney was increased (142 and 50%) but reduced (58%) to skeletal muscle after intravenous but not intracerebroventricular injection of interleukin. In contrast, blood flow to BAT was markedly elevated after intravenous (288%) or intracerebroventricular (382%) injection of IL-1 beta. Severing the sympathetic nerves supplying the interscapular BAT depot prevented the increase in blood flow. These data indicate that the potent pyrogenic effects of IL-1 beta in the rat are due largely to a central action. Fever is associated with increases in metabolic rate and BAT activity, and these results provide support for the involvement of brown fat in thermogenesis associated with fever. PMID- 2783532 TI - CRF is involved in the pyrogenic and thermogenic effects of interleukin 1 beta in the rat. AB - Interleukin 1 beta (IL-1 beta) is an endogenous peptide that induces fever, largely by central stimulation of sympathetically mediated thermogenesis. Microinjection (icv) of human recombinant IL-1 beta (50 ng) caused acute (response within 60 min) increases in colonic temperature (1.8 degrees C), oxygen consumption (Vo2; 36%), white blood cell count (96%), and brown adipose tissue (BAT) activity (mitochondrial GDP binding, 129%) in conscious rats. All of these effects were prevented or markedly inhibited by prior injection (icv) of an antagonist to corticotropin-releasing factor (CRF) [alpha-helical CRF-(9-41), 25 micrograms] and reduced by pretreatment with purified antibody to CRF. Injection of endotoxin (2 mg/kg ip), human recombinant tumor necrosis factor-alpha (TNF alpha; 5 micrograms icv) or prostaglandin E2 (PGE2; 100 ng icv) all stimulated body temperature (0.9-1.6 degrees C) and Vo2 (18-25%); TNF alpha did not affect white blood cell count but increased BAT activity by 38%. Prior injection of the CRF antagonist did not modify the actions of endotoxin, TNF alpha, or PGE2. Central injection of CRF (4 micrograms) produced a 23% increase in metabolic rate, which was unaffected by injection of the cycloxygenase inhibitor ibuprofen (5 mg/kg ip). These data indicate that the central effects of interleukin 1 beta on metabolic rate, body temperature, BAT activity, and white blood cell count are all mediated by release of CRF. The thermogenic effects of endotoxin, TNF alpha, and PGE2 are not dependent on CRF. PMID- 2783534 TI - Effects of hCGRP I and II on gastric blood flow and acid secretion in anesthetized rabbits. AB - Effects of intravenously administered human calcitonin gene-related peptides (hCGRP) I and II on regional blood flow and gastric acid secretion were examined in barbiturate-anesthetized rabbits. Blood flow was measured by injection of radioactively labeled microspheres at 0, 10, 20, 30, and 60 min. hCGRP I and II and vehicle were infused intravenously in five rabbits in rising doses of 0.01 (0 10th min), 0.03 (11-20th min), and 0.1 microgram.kg-1.min-1 (21-30th min). hCGRP I and II increased gastric blood flow dose dependently. Moreover, hCGRP I raised regional conductance (inverse of vascular resistance) in the stomach, duodenum, heart, brain, and skeletal muscle. As a result of the increased total peripheral conductance the mean arterial pressure was reduced, but the cardiac output remained unchanged. hCGRP II increased blood flow and conductance selectively in the stomach and the pancreas. The total peripheral conductance and mean arterial pressure remained unchanged. Apparently, hCGRP II exerts a more localized effect on the stomach than hCGRP I. hCGRP I and II did not affect basal gastric acid secretion. Pentagastrin-stimulated acid secretion was increased by 28% with hCGRP I (0.025 micrograms.kg-1.min-1) and decreased by 27% with hCGRP II (0.025 micrograms.kg-1.min-1). The inverse effect of hCGRP I and II and the parallel stimulation of blood flow brought about with hCGRP I and II indicate a different mode of action of the peptides on gastric blood flow and gastric acid secretion. PMID- 2783535 TI - Pathways mediating CRF-induced inhibition of gastric acid secretion in rats. AB - The pathways involved in mediating the central nervous system actions of corticotropin-releasing factor (CRF) on gastric acid secretion were examined in conscious rats. CRF (0.1-2.0 nmol) given cerebroventricularly inhibited gastric acid secretion stimulated by pentagastrin (P less than 0.01). This effect was abolished by cerebroventricular but not intravenous administration of a specific CRF receptor antagonist, alpha-helical CRF-(9-41). Ganglionic blockade with chlorisondamine chloride, noradrenergic blockade with bretylium, or adrenalectomy abolished the gastric inhibitory action of CRF whereas truncal vagotomy or opiate blockade with naloxone did not. A vasopressin receptor antagonist significantly inhibited but did not abolish the gastric inhibitory action of CRF. An intravenous infusion of epinephrine that mimicked the epinephrine plasma concentrations which were observed after cerebroventricular administration of CRF did not alter pentagastrin-stimulated gastric acid secretion. These results indicate that CRF acts within the central nervous system to inhibit gastric acid secretion by a specific receptor-mediated event. Inhibition of gastric acid secretion by CRF in conscious rats is mediated by efferent fibers of the sympathetic nervous system and in part by a vasopressin-dependent pathway but not by the parasympathetic nervous system, adrenal epinephrine release, or opiate sensitive pathways. PMID- 2783536 TI - Direct cardiac stimulation by arginine vasotocin in bullfrogs (Rana catesbeiana). AB - The antidiuretic and vasopressor effects of arginine vasotocin (AVT) in bullfrogs have been well documented. However, the direct cardiac stimulatory effects of AVT have not been previously reported. We found that AVT stimulates significant increases in heart rate, pulse pressure, and the maximal time derivative of ventricular pressure in anesthetized bullfrogs after the beta-adrenergic and muscarinic receptors in the heart were blocked by atropine and propranolol. In spontaneously beating isolated frog atria, AVT increased the beating rate by 20% and the contractile force by 100%. The inotropic effect of AVT was also demonstrated in electrically driven atria and ventricles. Propranolol was ineffective in blocking these cardiac responses in vitro. The Hill coefficients of the concentration-response curves did not differ from unity. In conclusion, AVT possesses both positive chronotropic and inotropic effects in bullfrogs, Rana catesbeiana, probably by direct stimulation of its specific receptors in the heart. PMID- 2783538 TI - Frequency of panic disorder in summer. PMID- 2783539 TI - The UCLA-University of Utah epidemiologic survey of autism: prevalence. AB - The authors conducted an epidemiologic survey in Utah using a four-level ascertainment system, blind current diagnostic assessments, and DSM-III criteria. Of 483 individuals ascertained, 241 were diagnosed as having autism. The best estimate for the prevalence rate was 4 per 10,000 population. Autism was not associated with parental education, occupation, racial origin, or religion. Sixty six percent of the autistic subjects scored below 70 on standardized IQ tests, and females scored proportionately lower than males. Twenty (9.7%) of 207 families had more than one autistic sibling, which supports the authors' previous finding that there may be a familial subtype of autism. PMID- 2783537 TI - Retinyl esters in the vertebrate neuroretina. AB - High-performance liquid chromatography (HPLC) was employed to measure retinyl esters in the vertebrate retina. Both retina and retinal pigment epithelium (RPE) from frog, chicken, and bovine eyes were studied. In comparison to the RPE, the retina possessed a significant level of 11-cis and all trans retinyl palmitate. Using a sensitive radioassay, we also detected the presence of retinyl ester hydrolase (REH) activity in homogenates prepared from both retina and RPE. The rate of retinyl ester hydrolysis in these retinas was sufficiently high to supply retinal chromophores for the metabolic renewal and for the regeneration of visual pigments. In comparison to retinyl esters in the RPE, retinyl esters in the retina are located much closer to the sites of visual pigment synthesis and regeneration. Hence it is possible that these retinyl esters play a more important role in the visual cycle than those in the RPE. PMID- 2783540 TI - DSM-III disorders in a large sample of psychiatric patients: frequency and specificity of diagnoses. AB - This study examined certain nosological features of DSM-III axis I diagnostic categories and subcategories as applied to 11,292 general psychiatric patients presenting for care, using a semistructured assessment procedure. The most frequently used major categories were affective, substance use, childhood-onset, and adjustment disorders. Secondary diagnoses were given to 26% of the patients. Male patients predominated in the categories of impulse-control, psychosexual, and substance use disorders, and female patients predominated in the categories of anxiety, affective, and somatoform disorders. Of the 329 five-digit subcategories available in DSM-III, 296 (90%) were actually used. Sixteen percent of the patients were given unspecific primary diagnoses. PMID- 2783541 TI - Positron emission tomography of the cerebellum in autism. AB - On the basis of neurological evidence that autistic patients have fewer Purkinje and granule cells in the cerebellum as well as vermal cerebellar hypoplasia, the authors tested the hypothesis that autistic patients have cerebellar hypofunctioning. They used positron emission tomography of the cerebellum with 18F-labeled 2-deoxyglucose to study seven autistic patients and eight age-matched control subjects. The results showed no significant difference in mean cerebellar glucose metabolism between the two groups, but all mean glucose rates of the autistic patients were either equal to or greater than those of the control subjects. The implications of these findings are discussed. PMID- 2783542 TI - Immune function in psychogenic depression. PMID- 2783544 TI - Isolation of a Staphylococcus aureus beta-lactamase-dicloxacillin complex and kinetic studies on the reactivation of the enzyme. AB - Exposure of the beta-lactamase from Staphylococcus aureus to the slowly reacting substrates cloxacillin or dicloxacillin results in time-dependent inactivation of the enzyme. Methods for the rapid separation of a beta-lactamase-dicloxacillin complex from excess inhibitor, using centrifuged columns of Sephadex G-25 or DEAE Sephadex G-25, are described. The enzyme-dicloxacillin complex releases active enzyme, with specific activity identical to that of untreated enzyme, after storage at pH 7.5 at 15 degrees C. Full reactivation was accompanied by the release of 0.8 eq of hydrolyzed dicloxacillin. The complex is stable for up to 40 h when stored at pH 3 at 4 degrees C. The reactivation process, which occurs with first-order kinetics at 15 degrees C and pH values between 4 and 8, displays a pH dependence with apparent pKa's of 4.6 and 8.5, and a limiting value of the reactivation rate constant of 0.022 min-1. Deviation from first-order kinetics at pH 9 is consistent with a competing irreversible inactivation of the enzyme at that pH. This behavior differs substantially from that of the similarly inactivated beta-lactamase I from Bacillus cereus, whose rate of reactivation is independent of pH, but which undergoes irreversible denaturation at acidic pH [A. L. Fink, K. M. Behner, and A. K. Tan (1987) Biochemistry 26, 4248-4258]. Addition of hydroxylamine to the S. aureus beta-lactamase-dicloxacillin, complex stimulates the rate of reactivation by a maximum of 35%. This effect is hyperbolically dependent on the concentration of hydroxylamine with half-maximal stimulation at 2.8 mM. The Km for ampicillin hydrolysis catalyzed by the partially reactivated enzyme is identical to that measured for catalysis by the untreated enzyme. We discuss our observations in relation to models for the transient inhibition process. PMID- 2783543 TI - Androgen receptor in rat liver: characterization and separation from a male specific estrogen-binding protein. AB - Many liver processes are sexually dimorphic. In particular, the microsomal content of specific enzymes and the synthesis of specific proteins are under sex steroid hormone control. Because the liver of male rats is strikingly androgen responsive, we sought evidence for an androgen receptor in this tissue. We detected and characterized both cytosolic and nuclear androgen-binding proteins. Both forms bind [3H]R1881 (methyltrienolone, 17 beta-hydroxy-17 alpha-methyl 4,9,11-estratriene-3-one) with the high affinity, low capacity, and specificity for androgens and antiandrogens characteristic of androgen receptors. No high affinity binding of [3H]DHT could be detected in unfractionated cytosol because of the rapid metabolism of this ligand; however, binding of a DHT metabolite to the high-capacity male-specific estrogen binder (MEB) of cytosol was observed. Both gel filtration and heparin-Sepharose affinity chromatography separate the cytosolic androgen receptor from MEB. Incubation of cytosol in the absence of sodium molybdate resulted in androgen-binding activity which was retained by DNA cellulose. Castration of male rats results in a time-dependent loss of both cytosolic and nuclear androgen binding, as well as a loss in MEB activity. Androgen-binding activity is low in livers from female rats, but can be induced by testosterone treatment. An intact pituitary is necessary for maintenance of androgen-binding activity, as hypophysectomy results in complete loss of activity. PMID- 2783545 TI - [Antitumor effect of IL-2 entrapped in liposomes on rat hepatoma, AH-66]. AB - The human recombinant interleukin 2 (IL-2) was entrapped in liposomes, and the therapeutic effects of the liposomes containing IL-2 (Lip-IL-2) were experimentally studied using the rat hepatoma strain, AH-66, maintained in donryu rats and challenged subcutaneously in the inguinal region. The peri-tumor injections of Lip-IL-2 (15 X 10(4)/kg units for the IL-2 dose) significantly inhibited the tumor growth as determined from the relative mean tumor weight, although no therapeutic effects were observed when the unentrapped IL-2 or liposomes containing saline was administered rats in the same way as the injections of Lip-IL-2. They also prolonged the survival time of rats. The studies of serum IL-2 values after i.v. or s.c. injections of Lip-IL-2 revealed that IL-2 was released gradually from the liposomes containing IL-2 into the circulation. As the result of the tumor tissue staining of the immunoperoxidase 18 hrs after the peri-tumor injection of IL-2, it was shown that a number of macrophages infiltrated into the tumor tissue and degenerated tumor cells were observed adjacent to those macrophages. It is suggested that Lip-IL-2 is useful as an antineoplastic agent in the immunotherapy and that the therapeutic effects of Lip-IL-2 would be related to both the slow release of IL-2 and the cytotoxicity on the tumor cells mediated by the macrophages. PMID- 2783546 TI - [Immune parameters of peripheral blood in chemoembolization with microencapsulated anticancer drugs]. AB - To investigate possible immunological consequences after arterial infusion of microencapsulated anticancer drug (chemoembolization), cellular immune parameters in peripheral blood were monitored for 4 weeks after chemoembolization in 20 patients with urological malignancies including 7 renal cell carcinomas, 2 renal pelvic carcinomas, 8 bladder carcinomas and 3 prostatic carcinomas. Natural killer (NK) cell activity and OKT4/8 ratio were augmented in 67% and 83% of the cases after chemoembolization respectively. Mature NK cell population (Leu7-OKT 16+) in these cases also showed a trend of continuous increase for more than 4 weeks. On the other hand, a small number of the patients showed an augmentation of OKT3+ cells, Ia-1+ cells or response to phytohemagglutinin. Histopathological examination of regional lymph nodes in 9 patients who underwent chemoembolization for renal cell carcinoma showed stimulating reactions in 8, while lymphocyte depletion in 1. These findings suggest that inhibition of micrometastasis by the enhanced natural killer cell activity could be anticipated in more than half of cases after chemoembolization. PMID- 2783547 TI - Improved early results after aortic valve replacement: analysis by surgical time frame. AB - Primary aortic valve replacement was performed in 430 patients. It was an isolated procedure in 339 and was combined with coronary artery bypass grafting in 91. Of these patients, 282 underwent operation from 1970 through 1976 (time frame 1) and 148 from 1980 through 1985 (time frame 2). They were divided into subgroups by age, New York Heart Association functional class, combined coronary artery bypass graft, and valvular lesion. Overall hospital mortality was 7.7% (time frame 1 = 10.6% versus time frame 2 = 2.0%; p less than 0.01). Overall, functional class III or IV was the strongest predictor of hospital mortality (p less than 0.001). Association of coronary artery bypass graft was the next strongest predictor of hospital mortality (p less than 0.01), and it retained its predictive value in time frame 2. Overall, hospital mortality was higher in patients older than 55 years (10.5% versus 3.5%; p less than 0.05). There were no hospital deaths in patients younger than 55 years in time frame 2. Type of valvular lesion was not a predictor of hospital mortality. Hospital mortality in patients receiving cardioplegia was 2%. Cardioplegia use has lessened the effect of age and functional class as predictors of hospital mortality after primary aortic valve replacement. Earlier operation in time frame 2 played a substantial role in the overall improvement of early results. PMID- 2783548 TI - Axial dependence of platelet-collagen interactions in flowing blood. Upstream thrombus growth impairs downstream platelet adhesion. AB - Vascular subendothelium and collagenous surfaces were exposed to flowing citrated blood. Platelet interactions with these surfaces were investigated at various axial distances from the upstream end of the exposed surfaces. A pronounced axial decrease in surface coverage with platelets and in thrombus dimensions was encountered on collagenous surfaces. This phenomenon was observed at shear rates of 200 to 2000 s-1, but was most pronounced at low shear rates (less than 650 s 1). After 5 minutes of perfusion at a shear rate of 650 s-1, 4.6 x 10(6) platelets were deposited on the most upstream 20 mm2 of the collagen surface, in contrast to 2.2 x 10(6) platelets/20 mm2 14 mm farther downstream. Depletion of von Willebrand factor and/or thrombospondin from the boundary layer of the blood flow was not responsible for this. Collagen-bound von Willebrand factor enhanced the surface coverage with platelets without affecting the axial decrement, while pretreatment of the collagen surface with thrombospondin had no effect at all. However, partial inhibition of thrombus growth by aspirin reduced the axial decrements, and less thrombogenic surfaces as human and rabbit subendothelium, which induced only a few small thrombi, produced virtually no axial differences in platelet adhesion. Raising the shear rate to 2600 s-1 also gave no axial differences in platelet-collagen adhesion; it did, however, give an axial increase in thrombus dimensions. This increase was neutralized after the addition of antibody against human platelet thrombospondin to the blood.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2783550 TI - Chemically induced Parkinson's disease. II: Intermediates in the oxidation and reduction reactions of the 1-methyl-4-phenyl-2,3-dihydropyridinium ion and its deprotonated form. AB - The one-electron reduction product of 1-methyl-4-phenyl-2,3-dihydropyridinium ion has been generated by pulse radiolysis and its absorption spectrum recorded. This radical was found to decay by second-order kinetics (2k = 9.5 x 10(8) M-1 s-1) to 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine and 1-methyl-4-phenyl-2,3 dihydropyridinium ion. Reactions of the above radical species and that formed by one-electron reduction of 1-methyl-4-phenylpyridinium ion, which can also be generated by one-electron oxidation of 1-methyl-4-phenyl-1,2-dihydropyridine, with a number of molecules of biochemical interest have been studied. The one electron reduction product of oxidised nicotinamide adenine dinucleotide efficiently reduced 1-methyl-4-phenyl-2,3-dihydropyridinium ion (k = 2.2 x 10(9) M-1 s-1). The relevance of these results in relation to redox cycling, a possible mechanism for 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine neurotoxicity, is discussed. PMID- 2783549 TI - The structure of the mouse lymphocyte pore-forming protein perforin. AB - Purified murine lymphocyte pore-forming protein (PFP or perforin) was partially sequenced. Oligonucleotides synthesized on the basis of this sequence information were used to screen a murine cytotoxic T lymphocyte (CTL) cDNA library. Seven clones were obtained, two of which were sequenced, providing full-length sequence information on PFP. Murine PFP (534 a.a.) is 68% identical to human PFP. Hydropathic analysis revealed a predominantly hydrophilic protein with some hydrophobic domains, including a region (a.a. 191-251) that could contain putative membrane-spanning domains. PFP is approx. 20% identical to human C7, C8 and C9 within a region encompassing 270 a.a., confirming previous immunological cross-reactivity studies. Northern blot analysis showed that expression of PFP but not of a serine esterase transcript is enhanced in a CTL line by antigen receptor-stimulation. Southern blot analysis of mouse genomic DNA indicated that PFP is encoded as a single-copy gene with the coding region contained within 10 kilobases of genomic DNA. PMID- 2783551 TI - Conformation of high molecular weight kininogen: effects of kallikrein and factor XIa cleavage. AB - The effect of kallikrein and factor XIa proteolysis of high molecular weight kininogen (HK) was investigated. Circular dichroism (CD) spectroscopy showed that cleavage of HK by plasma kallikrein or urinary kallikrein, both of which result in an active cofactor (HKa), results in conformational change that is characterized by increase in CD ellipticity at 222 nm. This suggests an increase in organized secondary structures. By contrast, cleavage of HK by factor XIa which results in an inactive cofactor (HKi) is characterized by a dramatic decrease in CD ellipticity at 222 nm suggesting an entirely different type of conformational change. The intrinsic fluorescence of HK is enhanced after cleavage by all three proteases. These conformational changes may play a role in determining the structure and function of HKa and HKi. PMID- 2783552 TI - Racial differences in antinuclear antibody patterns and clinical manifestations of scleroderma. AB - The profile of antinuclear antibodies (ANA) in 49 Thais with scleroderma (systemic sclerosis) was compared with that in 68 white Australians with scleroderma. Forty-eight (98%) of the Thais and all (100%) of the white Australians were positive for ANA, with the majority (100% and 97%, respectively) showing a diffuse speckled pattern of nuclear fluorescence. The distribution of the patterns was different in the 2 races; 35 (71%) of the Thais and 17 (25%) of the Australians showed staining of the nucleolus, and 1 (2%) of the Thais and 35 (51%) of the Australians showed staining of the centromeres. The frequency of precipitating antibodies to extractable nuclear antigens was also strikingly different: 86% in Thais and 26% in Australians (P less than 0.001). Precipitating antibodies to Scl-70 (topoisomerase I), the predominant extractable nuclear antigen in patients with scleroderma, were detected in 37 (76%) of the Thais and 18 (26%) of the Australians, and these were shown by Western blotting to react with the Scl-70 (topoisomerase I)-associated polypeptides. Differences in the frequencies of the ANA specificities in the 2 races were consistent with differences in the clinical manifestations of scleroderma; all of the Thai patients, in contrast to 15% of the Australian patients, had diffuse scleroderma with widespread skin involvement. This suggest that environmental or genetic factors may influence the expression of scleroderma. PMID- 2783554 TI - Abstracts of scientific presentations: 1988 regional meetings of the American College of Rheumatology. PMID- 2783553 TI - Urate-mediated inflammation in nodal osteoarthritis: clinical and roentgenographic correlations. AB - We studied 25 patients with crystal-proven gout or roentgenographic evidence of gouty arthritis, or both, in finger joints involved with nodal osteoarthritis (OA). These patients were elderly (mean age 71.4 years), and 72% of them were receiving diuretic therapy. Roentgenographic findings, in addition to features typical of OA, included soft tissue densities (tophi), with or without calcification, large intraarticular erosions, characteristic nonmarginal cortical erosions, and periarticular osteolysis. We conclude that urate crystals mediate episodes of acute inflammation in certain patients with nodal OA. This association is noted primarily in elderly patients of both sexes, especially in those receiving diuretic therapy. PMID- 2783555 TI - 'Oral blood blisters in angina bullosa haemorrhagica secondary to trauma of eating and dental injection'. PMID- 2783556 TI - Induction of colony-stimulating activity in mice by injection of liposomes containing lipophilic muramyl peptide derivatives. AB - Colony-stimulating factor (CSF) activity induction by lipophilic derivatives of three muramyl peptides, glyceryl dipalmitate-MDP derivatives, was studied in vivo and in vitro and compared to the activity of the same compounds incorporated within freeze-dried liposomes. Two lipophilic derivatives (MDP-GDP and MDPGBe GDP) were able to induce CSF activity in vivo and in vitro. The incorporation of these compounds within appropriately designed liposomes composed of distearoylphosphatidylcholine and phosphatidylserine (DSPC/PS) increased their ability to induce CSF activity in vivo but completely abrogated their ability to induce CSF activity in vitro. Furthermore, the phospholipid composition of liposomes influenced the efficacy of glycopeptide liposomal incorporation. Thus, the serum CSF-inducing effect of MDP-GDP was considerably enhanced by incorporation of this compound within liposomes composed of DSPC/PS at a molar ratio 7:0.3 but was not modified if the DSPC/PS molar ratio was 7:3. The lipophilic derivative of MDP (D-D), MDP (D-D)-GDP, was unable to induce CSF activity in vivo or in vitro but surprisingly became active in vivo after entrapment within DSPC/PS liposomes (molar ratio 7:0.3). Our results show that appropriate liposomes may be suitable carriers to deliver CSF activity-inducing agents to macrophages in vivo. PMID- 2783557 TI - Interleukin 2 requirement for the in vitro generation of antitumor cytotoxicity by thymocytes from melphalan-cured MOPC-315 tumor bearers. AB - We have previously shown that enhanced antitumor cytotoxicity is generated when thymocytes from melphalan (L-phenylalanine mustard; L-PAM)-treated MOPC-315 tumor bearers, but not thymocytes from normal mice, are added to the immunization culture of syngeneic normal spleen cells and MOPC-315 tumor cells (Bartik et al., Cancer Res., 47: 4848-4855, 1987). Here we show that normal spleen cells produce, upon stimulation with MOPC-315 tumor cells, helper-like factors which are sufficient for thymocytes from L-PAM-treated MOPC-315 tumor bearers, but not for thymocytes from normal mice, to develop antitumor cytotoxicity in response to stimulation with MOPC-315 tumor cells. Since one of the helper-like factors produced by in vitro-immunized spleen cells is interleukin 2 (IL-2), we assessed the exogenous IL-2 requirements for the development of anti-MOPC-315 cytotoxicity in thymocytes from L-PAM-treated MOPC-315 tumor bearers, relative to thymocytes from normal mice. Thymocytes from L-PAM-treated MOPC-315 tumor bearers were found to require a 10-fold lower concentration of recombinant IL-2 (rIL-2) than thymocytes from normal mice in order to develop antitumor cytotoxicity in response to stimulation with MOPC-315 tumor cells. The concentration of rIL-2 required for the development of anti-MOPC-315 cytotoxicity by thymocytes from L PAM-treated MOPC-315 tumor bearers was also 10-fold lower than the concentration of rIL-2 required by thymocytes from untreated MOPC-315 tumor bearers or thymocytes from L-PAM-treated normal mice. In addition, at any concentration of rIL-2 employed, thymocytes from L-PAM-treated MOPC-315 tumor bearers developed a higher level of anti-MOPC-315 cytotoxicity than did thymocytes from normal mice, L-PAM-treated normal mice, or untreated MOPC-315 tumor bearers. The enhanced antitumor cytotoxicity exhibited by thymocytes from L-PAM-treated MOPC-315 tumor bearers, following in vitro stimulation with MOPC-315 tumor cells plus rIL-2, was evident not only against MOPC-315 tumor cells but also against other syngeneic plasmacytomas but not an allogeneic thymoma. In addition, thymocytes from L-PAM treated MOPC-315 tumor bearers required less rIL-2 than thymocytes from normal mice to develop antitumor cytotoxicity in response to stimulation with MOPC-315 associated antigens but not in response to stimulation with an allogeneic antigenically unrelated thymoma (EL4).(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2783558 TI - Inhibition by retinoids of platelet growth factor-dependent stimulation of DNA synthesis and cell division in density-arrested C3H 10T1/2 fibroblasts. AB - The inhibition of neoplastic transformation by vitamin A and its natural and synthetic analogues, collectively called retinoids, is accomplished by an as yet unknown mechanism. In a recent report, the morphological transformation of carcinogen-treated C3H 10T1/2 fibroblasts to focus-forming transformed cells was shown to be a postconfluence event induced in density-arrested initiated cells by platelet growth factors in serum and was correlated with the mitogenic response of the preneoplastic cells to these polypeptides. The current study investigates the possibility that the inhibition of neoplastic transformation by retinoids is accomplished by blocking the mitogenic response of initiated cells to these growth factors. The results demonstrate that the stimulation by serum of DNA synthesis and cell division in normal and carcinogen-treated C3H 10T 1/2 fibroblasts after density-dependent growth arrest is inhibited in a dose dependent manner by retinyl acetate, all-trans retinoic acid, and 4-hydroxyphenyl retinamide over the same dose range and to the same extent that neoplastic transformation is inhibited by these retinoids. Cellular mitogenic processes sensitive to retinoid inhibition were shown to be induced specifically by platelet growth factors, rather than plasma growth factors, to occur within approximately 2 h of growth factor treatment, and to be common to cell division stimulated in density-arrested normal and initiated cells by highly purified platelet-derived or epidermal growth factor. These data suggest that the inhibition of neoplastic transformation by retinoids is accomplished by blocking the G0 to G1 transition in the mitotic response of initiated cells to platelet growth factors which act as endogenous promoters of transformation. PMID- 2783559 TI - Production of interleukin 1 activity by cultured human melanoma cells. AB - A panel of melanoma cell lines derived from 7 primary and 20 metastatic lesions was tested for the production of interleukin 1 (IL-1) in standard mouse thymocyte costimulation assays. Constitutively produced IL-1 activity was found in the conditioned media of 4 of 7 primary and 5 of 20 metastatic melanoma cell lines tested. Four of 9 cell lines secreting IL-1 were also shown to contain cell associated activity in their lysates. Melanoma-conditioned media were, however, unable to support the growth of CTLL, an interleukin 2-dependent cell line. The secreted IL-1 activity was significantly inhibited by antibodies to recombinant IL-1 alpha (3 of 3 lines), but not antibody to recombinant IL-1 beta. When conditioned medium from one cell line was fractionated on a Superose 12 column by fast protein liquid chromatography, a major peak of activity eluted at Mr 22,500 27,500. The presence of 2.2-kilobase mRNA hybridizing a probe for IL-1 alpha and 1.6-kilobase mRNA hybridizing a probe for IL-1 beta was detected by Northern blot in 3 of 4 secreting cell lines but not in a nonsecreting line. Taken together, these results suggest that cultured melanoma cells produce the cytokine IL-1 alpha, although the relationship between melanoma IL-1 and monocyte IL-1 is unclear. The production of IL-1 by melanoma cells is of interest because of its potential roles in the biology of melanoma through direct effects on tumor growth or through indirect effects on adjacent stromal and endothelial cells and infiltrating lymphoid cells. PMID- 2783560 TI - Cytokine gene expression during the generation of human lymphokine-activated killer cells: early induction of interleukin 1 beta by interleukin 2. AB - Culture of human peripheral blood leukocytes with interleukin 2 (IL-2) stimulates their differentiation into lymphokine-activated killer (LAK) cells, with a broad range of cytotoxicity against fresh tumor cells and tumor cell lines (Grimm et al., J. Exp. Med., 155: 1823-1841, 1982). We chose to utilize a molecular approach to determine whether IL-2 stimulates the expression of cytokine genes by the mixed cell population which may be involved in the generation or regulation of lytic activity. Northern blot analysis performed with total cellular RNA from LAK cells cultured for varying periods of time with IL-2 revealed that the genes which code for cytokines [interleukin 1 (IL-1)alpha and beta, gamma-interferon, tumor necrosis factor alpha, and lymphotoxin] were not spontaneously expressed. As soon as 2 h after IL-2 treatment, IL-1 alpha and IL-1 beta mRNAs were expressed. Both nonadherent and adherent populations of LAK cells express IL-1 beta mRNA; however, the adherent population produced more IL-1 beta mRNA and maintained its expression for a prolonged period of time. Other cytokine mRNAs (gamma-interferon, tumor necrosis factor alpha, and lymphotoxin) were expressed later than the IL-1 mRNAs with maximal levels between Days 2 through 7. Our results indicate that LAK cell populations can generate a variety of cytokines which may be involved in the generation of lytic activity. PMID- 2783561 TI - Decrease in interleukin 2-induced vascular leakage in the lungs of mice by administration of recombinant interleukin 1 alpha in vivo. AB - The administration of interleukin 2 (IL-2) to mice and humans is limited by the induction of a dose-dependent increase in vascular permeability causing a vascular leak syndrome (VLS). We have investigated the impact of the injection of recombinant interleukin 1 alpha (IL-1 alpha) on the VLS induced by IL-2 by measuring the extravasation of 125I-albumin into tissues and by assessing wet and dry lung weights. IL-1 alpha alone did not induce any significant extravasation of radiolabeled albumin. IL-2 alone, however, caused a significant increase in the extravasation compared to control lungs. IL-1 alpha injection along with IL-2 significantly reduced the IL-2-induced extravasation of radiolabeled albumin [9,886 +/- 533 (SEM) cpm were observed in IL-2 and IL-1 alpha-treated lungs compared to 14,172 +/- 2,628 cpm in lungs treated with IL-2 alone (P less than 0.02)]. IFN-alpha in combination with IL-2 produced more severe vascular leakage than caused by IL-2 alone. IL-1 alpha also significantly decreased (P less than 0.05) the vascular permeability induced by the combination of IFN-alpha and IL-2. We observed 44,811 +/- 13,131 cpm in IFN-alpha- and IL-2-treated lungs compared to 18,350 +/- 2,622 cpm in IFN-alpha-, IL-2-, and IL-1 alpha-treated lungs. The IL-2- and IFN-alpha-induced increase in lung water weight was also reduced significantly by the addition of IL-1 alpha. The decrease in vascular leakage was dependent on the dose and timing of IL-1 alpha administered. When recombinant IL 1 alpha was given as a single i.p. injection, 24 h before the injection of IL-2 (or Hanks' balanced salt solution) or IL-2 and IFN-alpha no abrogation of the VLS was observed. Although IL-1 alpha decreased VLS significantly in mice treated with IFN-alpha and IL-2 the survival of mice was not improved by the simultaneous administration of IL-1 alpha. Histologically, treatment with IFN-alpha and IL-2 produced marked perivascular and intraalveolar edema which was completely eliminated by the addition of IL-1 alpha. However, some perivascular edema in IL 1 alpha-treated mice remained which was equivalent to that caused by IL-2 alone. Treatment of MCA-106 induced pulmonary metastases was enhanced by the administration of IFN-alpha and IL-2 together.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2783562 TI - Angiography of right gastroepiploic artery for coronary artery bypass graft. AB - We describe the angiographic technique of grafting the right gastroepiploic artery to the coronary artery. With the femoral approach, our specially devised catheter was placed in the common hepatic artery or gastroduodenal artery. The gastroepiploic artery and graft to the coronary artery were visualized satisfactorily by manual injection of contrast media. PMID- 2783563 TI - Vagally induced block and delayed conduction as a mechanism for circus movement tachycardia in frog atria. AB - Episodes of tachycardia induced by strong vagal stimulation in spontaneously beating isolated atria of frog (Rana temporaria) were studied with multielectrode mapping technique. These episodes were inducible in 19 of 39 preparations. The arrhythmia started several seconds after cessation of vagal stimulation strong enough to cause sinus arrest, without electrical stimulation of the myocardium. The arrhythmia consisted of two to 20 beats (6 +/- 4, mean +/- SD, n = 42) with a cycle length of 100-500 msec. Recording from 32 sites with spatial resolution of 1-2 mm showed that the arrhythmia was due to intra-atrial circus movement. The estimated perimeter of the reentrant circuit ranged from 6 to 20 mm. In circuits of the minimal size, the average conduction velocity along the circuit was as low as 2-3 cm/sec. Paroxysms of the tachycardia were always preceded by vagally induced nonuniform depression of conduction, with some areas of atria being completely blocked. As the vagal influence decreased, the blocked areas recovered in an inhomogeneous manner, their unblocking being significantly (p less than 0.05) delayed after inhibition of tissue cholinesterase by proserine. The reentrant tachycardia was initiated when a sinus impulse arrived during certain phase of the unblocking. Unlike the well-known mechanism of reentrant excitation, which is based on inhomogeneous refractoriness and critically timed extrabeat(s), the circus movement in our model depended on vagally induced conduction block and could be launched by a single sinus impulse. PMID- 2783564 TI - Lipid alterations in isolated, working rat hearts during ischemia and reperfusion: its relation to myocardial damage. AB - Disturbances in lipid metabolism may play an important role in the onset of irreversible myocardial damage. To investigate the effect of ischemia and reperfusion on lipid homeostasis and to delineate its possible consequences for myocardial damage, Krebs-Henseleit-perfused, working rat hearts were subjected to various periods of no-flow ischemia (10 to 90 minutes) with or without 30 minutes of reperfusion. During ischemia, the rise in nonesterified fatty acids (NEFAs) was preceded by the accumulation of substantial amounts of glycerol, indicating the presence of an active triacylglycerol-NEFA cycle. The subsequent rise in NEFAs (from 0.25 to 1.64 mumol/g dry residue wt after 90 minutes [means]) coincided with the reduction of ATP to values lower than 10 mumol/g dry wt and the rise of AMP, a potent inhibitor of acyl-coenzyme A synthetase, to values exceeding 2 mumol/g dry wt, making the latter compound a good candidate to hamper the turnover of endogenous lipids during prolonged ischemia. Reperfusion resulted in an additional rise in NEFAs (up to 4.1 mumol/g dry residue wt after 60 minutes of ischemia). Neither ischemia nor reperfusion resulted in significant decreases in the tissue content of triacylglycerols and the various phospholipids. During reperfusion recovery of stroke volume was still adequate at tissue NEFA levels thought to be incompatible with normal mitochondrial function. A positive correlation (r = 0.81) was found between NEFA content of reperfused hearts and cumulative release of lactate dehydrogenase during reperfusion. Accordingly it is concluded that 1) reperfusion results in additional changes in myocardial lipid homeostasis, 2) the accumulating NEFAs are compartmentalized, possibly at the cellular level, and 3) the accumulation of NEFAs is a sensitive marker for myocardial cell damage. PMID- 2783566 TI - Brain and spinal stimulation: how and to whom! PMID- 2783565 TI - Multiple hereditary osteochondromata. AB - Multiple hereditary osteochondromata is a disorder consisting of multiple projections of bone (exostoses) capped by cartilage. The lesions are most numerous in the metaphyses of long bones but may appear on diaphyses of long bones and on flat bones and vertebrae. The transmission is autosomal dominant. Sarcomatous transformation is uncommon and probably occurs in fewer than 1% of patients. The more common indications for surgical excision of lesions are pain, growth disturbance, compromised joint motion, cosmesis, and secondary impingement of tendon, nerve, or vessel. Excision of the lesions is effective in relieving pain, improving cosmesis and joint motion, and removing secondary impingement of tendon, nerve, or vessel, and may retard or prevent progressive disturbance of osseous growth. Wrist and ankle deformities are often associated with relative shortening and bowing of the ulna and fibula, respectively; tilt and tapering of the distal radial and tibial epiphyses; and distal radioulnar and tibio-fibular diastasis. These deformities can be effectively treated by ulnar and fibular lengthening combined with hemiphyseal stapling of the distal radius and tibia. Progressive genu valgum is well corrected by placement of staples over the medial side of the physis of the distal femur or proximal tibia or both. PMID- 2783567 TI - [Immunocytochemical studies in the diagnosis of pulmonary histiocytosis X]. AB - The diagnostic value of immunocytochemical tests was analysed for 19 cases of pulmonary histiocytosis X (PHX) and eight of other types of fibrosing pulmonary disease (sarcoidosis, 3; exogenous allergic alveolitis, 3; chronic pneumonia, 1; fibrosing alveolitis, 1). The cellular, proliferative-fibroblastic and fibrocystic stages in the course of pulmonary changes were differentiated. PHX cells reacted with anti-S 100 protein in all stages. In three cases for which unfixed tissue was available, all PHX cells reacted with antibody Leu-6, and 35% of these cells also reacted with the proliferation marker Ki-67. The few S-100 positive cells from the eight controls were limited to peribronchial tissue. Thus the antibodies Leu-6 and S-100 are useful aids in the diagnosis of PHX. PMID- 2783568 TI - Secretion of corticotropin-releasing factor from cultured rat hypothalamic cells: effects of catecholamines. AB - An understanding of the regulation of CRF secretion in rats is currently incomplete, in part due to the lack of sensitive in vitro models available for studying this neuropeptide. In particular, the effects of catecholamines on CRF secretion, and the receptor subtypes mediating these actions have long been the subject of much debate. A cultured cell model has been adapted for studying secretory responses of hypothalamic cells of 1-week-old rats. Between 7-16 days in monolayer culture the cells secreted detectable levels of immunoreactive CRF, and this release was paralleled by the appearance of punctate bead-like regions of immunoreactivity along fine cellular processes. CRF secretion was increased up to 4-fold by norepinephrine (EC50, approximately 0.5 microM). The increase in CRF secretion produced by norepinephrine was blocked by the beta-receptor antagonist propranolol, but not by the alpha-antagonist prazosin. Moreover, the beta receptor agonist isoproterenol significantly elevated CRF secretion, whereas the alpha-agonist phenylephrine was without effect, except at high concentrations. Addition of phenylephrine, however, potentiated the effect of isoproterenol, but this response was still significantly less than that produced by norepinephrine. Forskolin (EC50, approximately 0.7 microM) and the active phorbol ester 12-O tetradecanoyl-phorbol-13-acetate (EC50, approximately 40 nM) also increased CRF secretion by 3- to 4-fold. Inactive phorbol derivatives had no effect on CRF release from these cultures. The results indicate that cultured neonatal rat hypothalamic cells are a powerful model for the study of CRF release in vitro, and that norepinephrine acts directly at the isolated cell level to stimulate secretion of this peptide, primarily by activating beta-adrenoceptors. The results also suggest that at least two functional second messenger systems (adenylate cyclase and protein kinase-C) are involved in CRF secretion and are already functional in the neonatal hypothalamus. PMID- 2783569 TI - Antiestrogens antagonize the stimulatory effect of epidermal growth factor on the induction of progesterone receptor in fetal uterine cells in culture. AB - In fetal uterine cells in culture, epidermal growth factor (EGF) increased progesterone receptor concentrations more than 2-fold. Two other growth factors, transforming growth factor-alpha and fibroblast growth factor, were not able to cause the same increase. This response to EGF was dose dependent; a half-maximal effect was obtained at 10(-10) M. The antiestrogens tamoxifen and 4 hydroxytamoxifen were able to antagonize the stimulatory effect of EGF on progesterone receptor concentrations, but they did not affect its mitogenic effect. The inhibitory effect of 4-hydroxytamoxifen depended on concentration; half-maximal inhibition was observed between 0.5-1 X 10(-9) M. 4-Hydroxytamoxifen could completely inhibit the progesterone receptor increase due to EGF even when added to cells already exposed to the growth factor for 6 days. EGF seems to be acting as an estrogen in increasing progesterone receptors in fetal uterine cells, and antiestrogens are potent antagonists of this response, indicating that growth factors may also be involved in some protein-inducing effects of estrogens. Since estrogen receptor levels were at the limits of detectability under all of the experimental conditions studied, nonestrogen receptor-mediated pathways may be involved. These observations show the potential importance of other factors acting in combination with estrogens in the modulation of progesterone receptor levels. PMID- 2783570 TI - Transcriptional regulation of osteocalcin production by transforming growth factor-beta in rat osteoblast-like cells. AB - Osteocalcin (OC) is one of the abundant non-collagenous bone matrix proteins produced exclusively by osteoblasts, and its serum level is used as an indicator of bone metabolism in patients. Transforming growth factor-beta (TGF beta) is abundant in bones and platelets, promotes wound healing in vivo, and is a potent stimulator of the production of extracellular matrix proteins in fibroblasts and osteoblasts. The effects of TGF beta on OC gene expression were examined in rat osteoblast-like cells, ROS17/2.8. TGF beta 1 decreased OC levels in the culture media 2- to 3-fold. TGF beta 1 also decreased the level of osteocalcin mRNA about 3-fold in a dose-dependent manner. TGF beta 2 and TGF beta 1,2 a heterodimeric form, showed similar effects on OC mRNA levels as TGF beta 1. The suppression of the OC message level was detectable at 24 h and lasted for up to 72 h. This effect on OC mRNA was blocked by cycloheximide. The stability of OC mRNA was not changed by TGF beta 1. On the other hand, the rate of OC gene transcription was reduced 4- to 5-fold, as estimated by in vitro nuclear transcription (run-on) assay. TGF beta 1 blocked the increase in the OC mRNA level induced by PTH or 1,25-dihydroxyvitamin D3. These results indicate that TGF beta inhibits osteocalcin gene expression at least in part through transcriptional control. PMID- 2783571 TI - Interleukin-1 stimulates growth and inhibits progesterone secretion in cultures of porcine granulosa cells. AB - Interleukin-1 (IL-1) significantly inhibited basal progesterone secretion and influenced the cell number in high density cultures of porcine granulosa cells harvested from small (1-2 mm) or medium (3-5 mm) follicles. These two effects of IL-1 showed similar but inverse dose-response relationships: Significant effects were observed at concentrations higher than 50 pg/ml, and the maximal effective concentration was 5 ng/ml, which reduced progesterone secretion by 53.5 +/- 2.1%. In contrast, IL-1 neither inhibited progesterone secretion nor did it influence cell number in cultures of fully mature granulosa cells harvested from the largest (8-11 mm) follicles. The growth-promoting effect of IL-1 on granulosa cells was further examined in the low density cultures, which revealed that IL-1 significantly stimulated proliferation of the less mature granulosa cells at concentrations higher than 50 pg/ml, and that at a maximal stimulatory concentration (25 ng/ml) it increased cell number to 206 +/- 11% of control. Although IL-1 increased cell number and reduced progesterone secretion of fully mature granulosa cells after 5 days in low density cultures, it seemed that the proliferating population were not the cells with luteinized morphology and positive 3 beta-hydroxysteroid dehydrogenase staining. The proliferating population of cells appeared to have less mature morphology and were negative for 3 beta-hydroxysteroid dehydrogenase staining. PMID- 2783572 TI - The Aspergillus toxin restriction is a suitable cytotoxic agent for generation of immunoconjugates with monoclonal antibodies directed against human carcinoma cells. AB - The protein toxin restriction, isolated from the mould Aspergillus restrictus, inactivates protein synthesis in eukaryotic cells by blocking the ribosome elongation cycle. This protein acts as a specific nuclease that cuts off a small fragment from the 28-S rRNA. Biochemical and biological characterization of this toxin indicated that it is a non-glycosylated polypeptide of Mr 16836, exhibiting in cell-free systems a protein synthesis inhibition capacity similar to that of the ricin A chain. This polypeptide seemed unable to penetrate most of the cancer cell lines tested, as measured by its low in vitro cytotoxicity. In addition in vivo studies in BALB/c mice demonstrated that restriction toxicity was very low and that in rabbits, after intravenous injection 15% of the toxin was still present in the blood stream 24 h later. After derivatization with N-succinimidyl 3-(2-pyridyldithio)propionate and reduction by dithiothreitol, the restrictocin maintained its protein synthesis inhibitory activity, as assayed in a cell-free system. This derivatized toxin was then coupled to monoclonal antibodies (MBr1, MLuC1, MLuC2, MOv17, MOv18, MOv19) which exhibited a restricted spectrum of reactivity against human carcinomas. The biochemical and biological characterization of the immunoconjugates indicated that (a) when restrictocin was coupled to monoclonal antibodies with an average molar ratio of about 2, the immunoconjugates maintained the binding activity of the antibody and protein synthesis inhibition activity of the toxin; (b) four immunoconjugates were tested for cytotoxicity and three of them obtained with the MBr1, MLuC1 and MOv17 monoclonal antibodies exhibited a good level of cytotoxicity for relevant target cells and low or no toxicity for the irrelevant cell lines. The MLuC2 monoclonal antibody which gave rise to a completely ineffective immunoconjugate, induced internalization of less than one tenth of the antigenic sites whereas the MBr1, MLuC1 and MOv17 monoclonal antibodies exhibited about one third of the antigenic sites interanalized. From these data it is concluded that, providing an appropriate target antigen and coupling procedure are selected, restrictocin can be considered a suitable toxin for immunoconjugate generation. PMID- 2783574 TI - Hematologic abnormalities of the immunodeficient mouse mutant, viable motheaten (mev). AB - We have studied the hematopoietic system of the immunodeficient mouse mutant, viable motheaten (mev/mev). These mice usually die by 9 weeks of age from severe pneumonitis. The lungs at that time are infiltrated with granulocytes, macrophages, and lymphocytes. Granulocyte and macrophage precursor cells (CFU-GM) are dramatically increased in the spleens of mev/mev mice, whereas the bone marrow population of these precursors is decreased when compared with littermate control animals. The CFU-GM population retained its normal dependence on granulocyte-macrophage colony-stimulating factor (GM-CSF) for proliferation and differentiation. In contrast, the frequency of an erythroid precursor (CFU-E) was dramatically increased in spleen and showed increased sensitivity to erythropoietin (Epo). Moreover, a splenic CFU-E subpopulation formed normally appearing erythroid colonies in the absence of exogenous Epo. The bone marrow CFU E population was significantly diminished in size when compared with either wildtype C57BL/6J mice or mice heterozygous for the mev allele. Unlike the CFU-E population, erythroid burst-forming unit (BFU-E) frequency in mev/mev mice was diminished both in bone marrow and in spleen, although the total number of splenic BFU-E was increased because of splenomegaly in these animals. BFU-E retained their dependence on the presence of both Epo and a source of interleukin 3 (IL-3) for proliferation and differentiation into erythroid bursts. Spleen cells from mev/mev mice, when stimulated in vitro with pokeweed mitogen, failed to produce significant quantities of IL-3. Comparison with medium or +/mev heterozygotes revealed that mev/mev spleen cell-conditioned medium showed a 40 fold reduction in burst-promoting activity. Thus, in viable motheaten mice, there is a major shift in hematopoiesis from bone marrow to spleen, which is accompanied by a diminished capacity of spleen cells to produce burst-promoting activity. These data and those from other studies suggest that the hematopoietic microenvironment of marrow may be impaired in this mutant. PMID- 2783573 TI - Reproducible establishment of hemopoietic supportive stromal cell lines from murine bone marrow. AB - Stromal cell lines, designated MS-1, -2, -3, -4, -5, -6, and -7 were established by irradiating the adherent cells in long-term bone marrow cultures with 900-rad x-rays. Two of the cell lines, MS-1 and MS-5, have the capacity to support the growth of hemopoietic stem cells (spleen colony-forming cells and granulocyte macrophage colony-forming cells) for greater than 2 months in vitro. These two cell lines were alkaline phosphatase-, peroxidase-, and factor VIII-negative and positive for periodic acid-Schiff and nonspecific esterase. Extracellular matrix proteins such as fibronectin, laminin, and collagen type I were produced by these two cell lines. Neither MS-1 cell- nor MS-5 cell-conditioned medium supported the growth of hemopoietic stem cells, and hemopoietic stem cells were found preferentially to be under and on MS-1 and MS-5 layers rather than in suspension. Close contact with the MS-1 cell layer or the MS-5 cell layer appears to be essential in maintaining hemopoiesis in vitro. Conditioned media from MS-1 cells and MS-5 cells stimulated granulocyte colony formation from murine bone marrow cells in semisolid culture. PMID- 2783575 TI - Inhibition of collagen synthesis by interleukin-1 in three-dimensional collagen lattice cultures of fibroblasts. AB - Interleukin-1 (Il-1) was added to collagen lattice cultures of human skin fibroblasts. No cell division was induced, the ability of fibroblasts to contract the lattices was decreased and a dose-related inhibition of collagen synthesis without effect on non-collagen proteins was found. Indomethacin had no influence on these effects. PMID- 2783576 TI - The nature of unexplained chronic aminotransferase elevations of a mild to moderate degree in asymptomatic patients. AB - To determine the nature of unexplained chronic serum aspartate aminotransferase elevations of a mild to moderate degree in asymptomatic patients, we performed systematic clinical, biochemical and histologic examinations in 47 individuals who had been screened for virus-, alcohol- or drug-related disease. Serum aspartate aminotransferase levels ranged from 3- to 8-fold normal (mean: 156 +/- 7 units per liter) for at least 6 months (mean: 30 +/- 6 months). Serum alanine aminotransferase levels were also increased but to a lesser degree in most patients. Thirty-four patients (72%) had histologic features of chronic active hepatitis, including 16 with cirrhosis. Ten patients (21%) had steatohepatitis and three (6%) had miscellaneous disorders. Patients with chronic active hepatitis and cirrhosis could not be distinguished from counterparts without cirrhosis by individual clinical or laboratory findings. Antinuclear or smooth muscle antibodies were detected in 18 of the patients with chronic active hepatitis (53%). All patients with steatohepatitis were women, and they had laboratory changes at presentation, including seropositivity for antinuclear antibodies, that overlapped with those of patients with chronic active hepatitis. We conclude that asymptomatic patients with unexplained chronic aspartate aminotransferase elevations of a mild to moderate degree frequently have chronic active hepatitis and that many have cirrhosis. Immunoserologic findings compatible with autoimmune hepatitis are commonly present. Steatohepatitis is the most frequent alternative diagnosis, especially in women, and it is not excluded by the presence of antinuclear antibodies. Differentiation of the disorders is possible only by histologic examination. PMID- 2783577 TI - Bone disease in chronic childhood cholestasis. I. Vitamin D absorption and metabolism. AB - Metabolic bone disease is common in children and adults with chronic cholestasis. We evaluated baseline vitamin D (vitamin D2 and D3), 25-OH vitamin D2 and D3, 1,25(OH)2 vitamin D, vitamin D-binding protein, bone mineral content and dietary mineral content in six children (mean age: 12.1 years) with cholestasis since infancy. Absorption of 25-OH vitamin D3 and vitamin D2 was evaluated by measuring serial serum concentrations after a test dose. Bone mineral content was reduced by greater than 2 S.D. in five of six subjects compared to age-specific controls; none had radiographic evidence of rickets but all had osteopenia. Dietary Ca and P content in the subjects was comparable to the recommended daily allowance for age-specific children. Baseline serum vitamin D2 concentrations were undetectable in all but one cholestatic subject despite oral supplementation with 2,500 to 50,000 IU per day vitamin D2. Baseline serum 25-OH vitamin D was 33.2 +/- 6.0 ng per ml (mean +/- S.E.) and comparable to our laboratory norms (15 to 50 ng per ml). Serum 1,25(OH)2 vitamin D and "free" 1,25(OH)2 vitamin D were both significantly (p less than 0.05) reduced compared to controls. A significantly blunted rise and reduced area under the absorption curve (both p less than 0.001) after 1,000 IU per kg vitamin D2 was found in cholestatic children (0.8 ng +/- 0.5 ng per ml and 18.0 +/- 14.3 ng hr per ml, respectively) compared to controls (59.5 +/- 10.0 ng per ml and 1,780 +/- 253 ng hr per ml, respectively).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2783579 TI - Class II antigens on retinal vascular endothelium, pericytes, macrophages, and lymphocytes of the rat. AB - Class II histocompatibility complex antigens on the retinal vascular endothelium may allow these cells to function as antigen-presenting cells to circulating T cells. The present study investigated induction of class II antigens in vitro to characterize the response under controlled conditions. Retinal vascular endothelium from Lewis and Brown Norway rats (high versus low responders in experimental autoimmune uveitis) were exposed in vitro to recombinant rat gamma interferon, interleukin-1, interleukin-2, or Concanavalin-A spleen supernatant. Retinal pericytes, macrophages and lymphocytes were studied in comparison. A newly adapted ELISA technique was used to assay levels of antigen expression. Class II antigens (I-A OX6, I-E OX17, polymorphic I-A OX3), class I antigens (OX18), macrophage marker (OX42), macrophage and T helper cell marker (W3/25), and T suppressor/cytotoxic cell marker (OX8) were studied. Results showed that retinal vascular endothelium normally expresses very little class II antigen. However, high levels of I-A and I-E were induced by interferon or spleen supernatant. The levels of class II antigen approached that of the traditional antigen-presenting cell (macrophage) and were much higher than levels for pericytes and lymphocytes. The same doses of interferon showed larger increases in the Lewis rat compared to Brown Norway. No effect was seen with interleukin-1 or -2. Therefore, retinal vascular endothelium may be induced by gamma interferon to express class II antigens with degree of induction greater than or equal to the macrophage, and higher levels of induction were seen in the high responder strain.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2783578 TI - Ataxia-telangiectasia fibroblasts have less fibronectin mRNA than control cells but have the same levels of integrin and beta-actin mRNA. AB - The expression of fibronectin, integrin and beta-actin genes in skin fibroblasts from patients with the genetic disorder ataxia-telangiectasia (A-T) was studied. These three genes were selected because their protein products contribute to the shape and function of the fibroblast. Expression of mRNA by these genes was compared with that in fibroblasts from normal individuals and from patients with the genetic disorder, hereditary hemorrhagic telangiectasia (HHT). A-T fibroblasts were found to produce less fibronectin mRNA than normal and HHT fibroblasts. A-T fibroblasts senesce around passage level 15 while normal and HHT fibroblasts can be propagated for many more passages in vitro. However, the expression of the integrin gene in A-T fibroblasts was similar to that in normal fibroblasts, while the beta-actin gene was expressed at a higher level. The increased beta-actin mRNA levels were similar in fibroblasts of patients with the two genetic disorders, A-T and HHT, but higher than in normal fibroblasts. HHT fibroblasts differed markedly from A-T fibroblasts in having a high level of fibronectin and integrin mRNA expression. The results indicate that regulation of the fibronectin gene in A-T fibroblasts differs from that of the integrin and beta-actin genes, and that the decline in fibronectin mRNA may be linked to the shortened in vitro life-span of these cells. PMID- 2783580 TI - A supportive-educative telephone program: impact on knowledge and anxiety after coronary artery bypass graft surgery. AB - The purpose of this study was to investigate the impact of a supportive-educative telephone program on the levels of knowledge and anxiety of patients undergoing coronary artery bypass graft surgery during the first 6 weeks after hospital discharge. With a posttest-only control group design, the first 74 patients scheduled, between September 1986 and February 1987, for coronary artery bypass graft surgery in a large, western Canadian teaching hospital were randomly assigned to either an experimental or a control group. The effect of the intervention, which was implemented by a cardiac rehabilitation nurse specialist, was assessed by a knowledge test and a state anxiety inventory. Data were collected without knowledge of the participants' group assignment. As hypothesized, data analysis with independent t tests revealed a statistically significant (p less than 0.05) difference between the knowledge level of the experimental and the control group in the areas of coronary artery disease, diet, medications, physical activity restrictions, exercise, and rest. A statistically significant difference between the state anxiety level of the experimental and the control group was also evident, as was a statistically significant inverse relationship between participants' knowledge and anxiety levels. From these findings, several implications and recommendations for nursing practice and research have been generated. PMID- 2783581 TI - Accentuated complement activation in patient plasma during the adult respiratory distress syndrome: a potential mechanism for pulmonary inflammation. AB - The adult respiratory distress syndrome (ARDS) represents an acute inflammatory lung disorder, characterized by both refractory hypoxemia and a mortality rate approaching 95%. Researchers have proposed that activation of the complement (C) system may play a role in the development of the pulmonary inflammation associated with ARDS. The purpose of this investigation was to determine whether complement activation occurs to a greater extent in patients with ARDS than in patients without ARDS, thereby providing a potential mechanism for the acute inflammation seen in ARDS. In this study, we assessed plasma complement activation by measuring complement activation by-products: C1rC1s-C1 inhibitor complex and C3b-P complex, generated subsequent to activation of the classical and alternative pathways, respectively, and also the terminal complement complex, formed after activation of either the classical or alternative complement pathway. Multivariate discriminant analysis revealed that these three complement activation complexes could distinguish patients with ARDS from those without ARDS (p less than 0.04). Furthermore, these three complexes provided a more sensitive discriminator of ARDS than did plasma levels of C3a desarginine (p greater than 0.30), C5a desarginine (p greater than 0.41) and total hemolytic complement activity (CH50) (p greater than 0.72). We conclude that a temporal association exists between the complement activation and the development of ARDS. Therefore, we suggest that complement activation by-products be included in the armamentarium for ARDS. PMID- 2783582 TI - Time course of intracellular associations, processing, and cleavages of Ii forms and class II major histocompatibility complex molecules. AB - To determine how changing forms of class II major histocompatibility complex proteins and associated Ii molecules in intracellular compartments of human B lymphocytes might regulate or catalyze antigen processing or presentation, we analyzed immunoprecipitates of such molecules from subcellular fractions of [35S]methionine pulse-chase-labeled, 3-day-activated B lymphocytes after homogenization and distribution in Percoll density gradients. Two-dimensional gel electrophoresis of immunoprecipitates of subcellular fractions demonstrated: 1) progressive sialic acid addition to class II major histocompatibility complex beta chains and Ii but not to gamma 2, gamma 2', gamma 3, gamma 3' (p35), or p41 and its satellites; 2) association of p35 and p41 with class II complexes at 30 60 min after pulse labeling; 3) cleavage of an immature form of Ii without sialic acid at 15-30 min after pulse labeling to a COOH-terminal, 25,000-dalton fragment, p25, with a 60-90-min half-life; 4) the presence of Ii-related p29 at only 30-min chase times; 5) an effect of chloroquine or monensin, at maximal nontoxic doses, to increase (a) the time for associations of p35 and p41 with class II complexes and (b) the half-life of p25, which was then formed from Ii at reduced levels. In addition, while the half-lives of class II alpha and beta chains and Ii were comparable within intracellular fractions of any one density, in intracellular fractions of intermediate densities the complexes appeared to be longer lived (much greater than 6 h) than in lighter fractions (2-3-h half lives). PMID- 2783583 TI - Persistence of measles virus in rat brain neurons is promoted by depletion of CD8+ T cells. AB - Fourteen-day-old Lewis rats were injected intracerebrally with the hamster neurotropic (HNT) strain of measles virus. At the same time, CD8+ T cytotoxic cells were eliminated by a single injection of a mouse monoclonal antibody (Ox8) directed against this lymphocyte phenotype. The lymphocyte depletion, which endured for more than 7 weeks, markedly reduced the elimination of measles virus antigen from the brain, but did not affect the induction of major histocompatibility complex (MHC) molecules in the early phase of infection. These results demonstrate a role for MHC class I-restricted CD8+ T cells in controlling persistence of measles virus infection in neurons. PMID- 2783584 TI - Analysis of immunoglobulin and T cell receptor gene rearrangements in the thymus of myasthenia gravis patients. AB - The thymus is an important site of sensitization of autoreactive B and T lymphocytes in myasthenia gravis (MG). We have investigated clonal diversity of B or T cells in the thymus of patients with MG by Southern blot experiments using probes specific for immunoglobulin heavy (IgH) and light chain (IgL) genes and for T cell receptor (TCR) beta- and gamma-chain genes. This method allows to detect individual clones of B or T cells if they represent at least 1% of the total cell population. We investigated thymus glands from 14 patients who underwent thymectomy. Single rearranged fragments could be demonstrated with a TCR gamma-specific probe in DNAs from both normal donors and MG patients. TCR beta gene rearrangements occurred mainly in the C beta 1 region. However, single rearranged bands could not be detected with either TCR beta, JH or with J kappa specific probes. Thus any single autoimmune B and T cell clone present in the myasthenic thymus represents presumably less than 1% of all thymocytes. PMID- 2783585 TI - Measles virus-polypeptide specificity of the cytotoxic T-lymphocyte response in multiple sclerosis. AB - Some patients with multiple sclerosis (MS) have been shown previously to have a reduced capacity to generate measles virus (MV)-specific cytotoxic T-lymphocytes (CTLs). The mechanism of this reduction is not understood. Possibilities include sequestration of MV-CTLs within the central nervous system (CNS), abnormalities in regulation of this response (e.g., suppression), a defect in the T-cell repertoire of MS patients and a defect in the induction or maintenance of the CTL response to MV. To examine these possibilities, the CTL response to three purified polypeptides of MV (hemagglutinin (HA), fusion (F), and nucleocapsid (NC] was studied in eight healthy controls and 14 patients with multiple sclerosis. A defect in the response to two polypeptides of the virus (HA and NC) was found in the MS patients with reduced MV-CTL response. The response to F was also reduced but to a lesser extent. Limiting dilution analysis of the MV polypeptide-specific CTL response indicated that suppression is an unlikely cause for the reduction in CTL activity. The lymphoproliferative response to MV, HA, F, and NC was comparable in three MS patients and three controls examined. Together, the results of these studies indicate that the reduced MV-CTL response in MS patients was not due to a defect in the T-cell repertoire or sequestration due to cross-reactivity with a single myelin antigen. More likely mechanisms include abnormalities in the induction or maintenance of the MV-CTL response or sequestration within the CNS due to recognition of MV antigens. PMID- 2783586 TI - T cell lines established from multiple sclerosis cerebrospinal fluid T cells using human retroviruses. AB - Cerebrospinal fluid (CSF) lymphocytes from patients with multiple sclerosis (MS) were transformed with human T cell leukemia/lymphoma virus (HTLV I and HTLV II) and the resulting cell lines characterized by cell surface phenotyping and functional assessment. The lines were predominantly of the CD4 helper/induce phenotype although the HTLV II lines contained 10-20% CD8+ cells. The lines appeared to be activated cells; the majority were TA1+, HLA-DR+, and TAC+ (CD25+). Interestingly, they were OKT10- (CD38-). Functionally, the lines contained no natural killer (NK) activity and were modestly cytotoxic in the antibody-dependent cellular cytotoxicity (ADCC) assay. They were poor proliferative responders to antigens and mitogens though the HTLV II lines did respond to interleukin 2 (IL2). The HTLV I lines were either nonresponsive to or were suppressed by IL2. Early passages of two of the lines produced IL2 but this was lost as the cells were passed in culture. The cell lines were capable of either directly or indirectly suppressing pokeweed mitogen (PWM)-driven immunoglobulin production by normal B cells. In addition, the lines were capable of producing gamma-interferon (IFN-gamma), lymphotoxin (LT), an interleukin 1 (IL1)-like factor, glial growth promoting factor (GGPF), and IL6. The advantage of these lines over clones or cell lines developed using other techniques is their growth in the absence of feeder layers or IL2 and their ability to be cloned and to grow in culture indefinitely. PMID- 2783587 TI - Cell surface endothelial proteins altered in experimental allergic encephalomyelitis. AB - Endothelial cells (EC) are increasingly being considered as important participants in the early evolution of inflammatory and immune responses in experimental allergic encephalomyelitis (EAE). We have found that a mouse monoclonal antibody, which reacts with the luminal plasma membrane of central nervous system endothelium, detects an alteration in the blood-brain barrier (BBB) in lesions in Lewis rats with EAE. Anti-endothelial barrier antigen (EBA) reacted with microvessels in normal rat brain and spinal cord. This reaction was abolished in 'EAE' microvessels surrounded by inflammatory cells. In rats that had recovered from one attack most EC reacted with the antibody, indicating that EBA was reexpressed during recovery. However, blood vessels in areas with residual inflammatory lesions were negative. The biochemical changes that lead to this absence of antibody binding and the cells or mediators responsible for producing this change are not yet known. However, anti-EBA should provide a useful tool for exploring molecular mechanisms underlying BBB breakdown. PMID- 2783588 TI - Identification of a point mutation resulting in a heat-labile adenosine deaminase (ADA) in two unrelated children with partial ADA deficiency. AB - We have determined the mutation in a child with partial adenosine deaminase (ADA) deficiency who is phenotypically homozygous for a mutant ADA gene encoding a heat labile enzyme (Am. J. Hum. Genet. 38: 13-25). Sequencing of cDNA demonstrated a C to A transversion that results in the replacement of a proline by a glutamine residue at codon 297. As this mutation generated a new recognition site in exon 10 of genomic DNA for the enzyme Alu I, Southern blot analysis was used to establish that this child was indeed homozygous for the mutation. The abnormal restriction fragment generated by this mutation was also found in a second partially ADA-deficient patient who phenotypically is a genetic compound and also expresses a heat-labile ADA (in addition to a more acidic than normal ADA) (Am. J. Hum. Genet. 38: 13-25). Sequencing of cDNA clones from the second patient established the identical codon 297 mutation. Transfection of the mutant cDNA into heterologous cells resulted in expression of a heat-labile ADA of normal electrophoretic mobility and isoelectric point, properties exhibited by the ADA in the patients' cells. PMID- 2783589 TI - Osteoclast-like cells form in long-term human bone marrow but not in peripheral blood cultures. AB - Transplantation studies have suggested that peripheral blood mononuclear cells contain precursors for osteoclasts. Thus we tested the capacity of peripheral blood monocytes to form osteoclasts in long-term culture. We have reported previously that mononuclear cells from feline, baboon, and human marrow form osteoclast-like cells in long term cultures. Further, the formation of these cells is increased in response to bone resorption stimulatory agents such as PTH, interleukin 1, and transforming growth factor alpha. We now report that these cells show characteristic cytoplasmic contraction with calcitonin and form resorption lacunae when cultured on sperm whale dentine. Thus, these bone marrow derived multinucleated cells fulfill the functional criteria for osteoclasts. Although cultured peripheral blood monocytes can be induced to form multinucleated cells with 1,25-dihydroxyvitamin D3, these cells did not show similar responses to the osteotropic factors as multinucleated cells formed in the bone marrow cultures multinucleated cells. These results indicate that osteoclasts or cells closely related to osteoclasts form in long-term human bone marrow cultures. In contrast, few mononuclear cells in the peripheral blood appear capable of forming osteoclasts under the culture conditions used in these experiments. PMID- 2783590 TI - Stimulation of glycosaminoglycan synthesis in cultured human dermal fibroblasts by interleukin 1. Induction of hyaluronic acid synthesis by natural and recombinant interleukin 1s and synthetic interleukin 1 beta peptide 163-171. AB - Hyaluronic acid (HA) is believed to play a critical role in wound healing and in morphogenesis. Factors controlling the production of HA by fibroblasts in normal and pathological states are not completely understood. In this report we have observed that natural human interleukin (IL-1)1 beta and human recombinant (hrIL) 1 alpha and beta are potent stimulators of HA production by fibroblasts in vitro. Hyaluronic acid is the major species of glycosaminoglycan (GAG) stimulated by IL 1 in fibroblasts. PGE2 does not appear to be involved directly in this IL-1 effect on fibroblasts, but stimulation of HA production by IL-1 is dependent on protein synthesis. The synthetic human IL-1 beta peptide 163-171 (Val-Gln-Gly-Glu Glu-Ser-Asn-Asp-Lys), which has been previously shown to stimulate thymocyte proliferation but not fibroblast PGE2 production, is also able to stimulate fibroblast HA production. The synthesis and secretion of IL-1 by mononuclear phagocytes at sites of inflammation and immune reactions in vivo could potentially serve as a signal for fibroblasts to synthesize HA, which in turn could serve to facilitate and modulate reparative and immune processes by virtue of its ability to alter cell-cell, cell matrix, and cell-membrane receptor interactions. PMID- 2783593 TI - Cerebral arterial innervation: II. Development of calcitonin-gene-related peptide and norepinephrine in the rat. AB - The pre- and postnatal development of trigeminal calcitonin-gene-related peptide (CGRP)- and sympathetic norepinephrine (NE)-containing nerves supplying the cerebral arteries was studied with immunohistochemistry in rats. At 18-19 days in utero (E 18-19), CGRP fibers were present only as one or two longitudinal bundles zigzagging along the anterior cerebral artery and anterior communicating artery. Growth-cone-like swellings were found at the terminals of individual fibers. In contrast, at this same prenatal age NE fibers were present as a meshwork on all cerebral arteries. The density of NE fibers was higher in the rostral than in the caudal parts of the circle of Willis; growth cones were present on individual fibers at the middle segment of the basilar artery and distal parts of major cerebral arteries. At postnatal day 1-2 (PND 1-2; date of birth = PND 1), the outgrowth of CGRP axons extended along the walls of the middle cerebral and internal carotid arteries. These axons were relatively straight and unbranched. At the same time, NE fibers increased in number and density and continued to form the meshwork pattern on all cerebral arteries. At the end of the first postnatal week, all the longitudinal NE bundles on the rostral part of the circle of Willis began to form circular arborizations. At the end of the second postnatal week, the pattern of NE innervation had completely changed, consisting almost entirely of circumferential rather than tangential fibers. Beginning in the first postnatal week, CGRP fibers increased greatly in number and density and began to form a meshwork pattern. At the second postnatal week, the pattern of CGRP innervation, compared to the pattern at fetal and neonatal stages, had changed significantly, consisting predominantly of a meshwork pattern. By 4 weeks after birth, both the NE and CGRP fiber systems achieved adult densities and patterns. The present results demonstrate the following: 1) Both sympathetic-NE and trigeminal-CGRP innervation of cerebral arteries begin in utero; the NE system innervates corresponding parts of the vessels earlier than the CGRP system. 2) Both NE and CGRP fibers are more dense in the rostral than in the caudal segments of the circle of Willis; this rostrocaudal gradient is expressed in both density and pattern by the earliest fibers of both neurochemical systems and is maintained throughout all developmental stages.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2783591 TI - Immunohistochemical detection and immunochemical analysis of type II collagen degradation in human normal, rheumatoid, and osteoarthritic articular cartilages and in explants of bovine articular cartilage cultured with interleukin 1. AB - Articular cartilage destruction and loss of function in arthritic diseases involves proteolytic degradation of the connective tissue matrix. We have investigated the degradation of cartilage collagen by developing immunochemical methods that permit the identification and analysis of type II collagen degradation in situ. Previously, a technique to specifically identify type II collagen degradation in situ in articular cartilage did not exist. These methods utilize a polyclonal antiserum (R181) that specifically reacts with unwound alpha chains and CNBr-derived peptides, alpha 1(II)CB11 and alpha 1(II)CB8, of human and bovine type II collagens. The experimental approach is based on the fact that when fibrillar collagens are cleaved the helical collagen molecule unwinds, exposing hidden epitopes. Here we demonstrate the use of R181 in studying type II collagen degradation in bovine articular cartilage that has been cultured with or without IL-1 and in human normal, rheumatoid, and osteoarthritic articular cartilages. Compared to cartilages either freshly isolated or cultured without IL 1, bovine cartilage cultured with IL-1 for 3-5 d showed an increase in both pericellular and intercellular immunohistochemical staining. Extracts of these cartilages contained type II collagen alpha chains that were increased in amount after culture with IL-1 for 11 d. In addition, culture with IL-1 resulted in the appearance of alpha chain fragments of lower molecular weight. All human arthritic tissues examined showed areas of pronounced pericellular and territorial staining for collagen degradation as compared with non-diseased tissues, indicating that chondrocytes are responsible in part for this degradation as compared with non-diseased tissues. In most cases rheumatoid cartilage was stained most intensely at the articular surface and in the deep and mid-zones, whereas osteoarthritic cartilage usually stained more in the superficial and mid-zones, but less intensely. Distinct patterns of sites of collagen degradation reflect differences in collagen destruction in these diseases, suggesting possible different sources of chondrocyte activation. These experiments demonstrate the application of immunological methods to detect collagen degradation and demonstrate an increase of collagen degradation in human arthritides and in IL-1-treated viable bovine cartilage. PMID- 2783592 TI - Interleukin-1 generates transmembrane signals from phospholipids through novel pathways in cultured rat mesangial cells. AB - Although IL-1 stimulates cellular responses in both lymphoid and nonlymphoid cells, the second messengers by which IL-1 activates cells are unknown. Recombinant IL-1 alpha (rIL-1) is a comitogen for glomerular mesangial cells. Using this model we explored potential transmembrane signals by which IL-1 stimulates cellular responses. Certain mitogens hydrolyze inositol phospholipids by phospholipase C to generate 1,2-diacylglycerol, a cofactor for protein kinase C, and inositol (1,4,5)-trisphosphate, which mobilizes intracellular calcium. rIL 1 induced a peak increase in [3H]1,2-diacylglycerol formation at 1 min. Production of 1,2-diacylglycerol often parallels the generation of phosphatidic acid; however, rIL-1 stimulated [32P]phosphatidate formation only after 60 min. rIL-1 did not change the inositol phosphate or cytosolic free calcium concentrations, demonstrating that rIL-1 does not activate an inositol phospholipid-specific phospholipase C. [3H]Phosphorylethanolamine, but not [3H]phosphorylserine or [3H]phosphorylcholine, was maximally elevated at 1 min in mesangial cells incubated with rIL-1. Radioactivity incorporated into phosphatidylethanolamine but not phosphatidylcholine was also decreased in IL-1 stimulated mesangial cells compared with control at 1 min. These data suggest that rIL-1 activates a phospholipase C predominantly linked to phosphatidylethanolamine. In contrast to other mitogens, rIL-1 did not alter intracellular pH. Both 12-0-tetradecanoyl-phorbol-13-acetate, a homologue of 1,2 diacylglycerol, and phosphatidate but not phosphatidylcholine in the presence of 0.5% fetal bovine serum stimulated mesangial cell proliferation. rIL-1-induced cellular activation may be mediated, at least in part, by phospholipid-derived second messengers generated through novel pathways. PMID- 2783594 TI - Unilesional mycosis fungoides: a distinct entity. AB - Four cases of solitary lesions showing the histologic features of mycosis fungoides are described. Three patients had an erythematous scaling plaque, whereas the fourth had a solitary nodule. The lesion was located on the arm in two patients, on the foot in one patient, and on the back in one patient. No preceding factors were noted, and no lymphadenopathy or other significant illness was found on examination. Histologic examination demonstrated features of a cutaneous T cell lymphoma with epidermotropism. Monoclonal markers on frozen and paraffin sections revealed a predominant T cell infiltrate. Three patients were treated with local excision. The remaining patient was treated with radiotherapy. The lesions have not recurred, and no new lesions have developed after individual follow-up of 7 months, 7 1/2 months, 13 years, and 18 years. These cases appear to be unique reports of solitary mycosis fungoides behaving in a biologically benign manner. The relationship to Woringer-Kolopp disease and lymphomatoid papulosis is discussed. PMID- 2783596 TI - Myocardial metabolism by positron emission tomography in hypertrophic cardiomyopathy. PMID- 2783597 TI - Burkitt's lymphoma developing in a 7-year-old boy with hyper-IgE syndrome. AB - We report a case of Burkitt's lymphoma developing in a 7-year-old boy with hyper IgE syndrome. This is the third reported case of malignancy in the hyper-IgE syndrome. The other two cases were an 18-year-old man with Hodgkin's disease and a 10-year-old girl with histiocytic lymphoma. The patient developed retroperitoneal Burkitt's lymphoma with probable metastasis to the brain. His short life was characterized by recurrent staphylococcal skin, middle ear, and lung infections associated with extremely elevated serum concentrations of IgE. There was also an associated disturbance of bone metabolism with osteoporosis and pathologic fractures and absence of parathormone, findings that have been observed in other patients with hyper-IgE syndrome and other forms of T cell immunodeficiency. At the age of 5 years, inadequate B cell responses to immunization with antigens derived from diphtheria, tetanus, and Haemophilus influenzae type b organisms and with the OX174 bacteriophage were demonstrated in the patient. In his terminal state his in vitro lymphocyte analysis demonstrated findings of anergy. Although the precise immunologic defect in hyper-IgE syndrome is unknown, these cases of associated malignancy stress the role that a completely normal immune system plays in preventing the premature appearance of cancer. PMID- 2783595 TI - Regional myocardial blood flow and metabolism at rest in mildly symptomatic patients with hypertrophic cardiomyopathy. AB - Previous observations and clinical manifestations suggest the presence of ischemia in the disproportionately thickened septum of patients with hypertrophic cardiomyopathy. Metabolic consequences of ischemia can be demonstrated with positron emission tomography. Therefore, 10 patients with hypertrophic cardiomyopathy and an echocardiographic septum to posterior wall thickness ratio of 1.8 +/- 0.4 cm (range 1.3 to 2.5) were studied with the use of nitrogen (N)-13 ammonia, carbon (C)-11 palmitate and fluoro (F)-18 2-deoxyglucose as tracers of myocardial blood flow, fatty acid metabolism and exogenous glucose utilization. The results of positron emission tomography in 9 patients with hypertrophic cardiomyopathy were compared with those in 10 normal volunteers. In the hypertrophic cardiomyopathy group, observed myocardial activity of N-13 ammonia and C-11 palmitate in the septum was similar to that in the lateral wall. Septum to lateral wall tissue activity ratios averaged 1.04 +/- 0.15 for N-13 ammonia and 1.04 +/- 0.18 for C-11 palmitate, and were similar to those in the normal volunteers (0.98 +/- 0.07 and 0.98 +/- 0.03, respectively; p = NS). Myocardial clearance half-time and residual fraction of C-11 palmitate did not differ significantly between the septum and lateral wall. However, F-18 2-deoxyglucose uptake was significantly lower in the septum than in the lateral wall (15,768 +/- 4,314 versus 19,818 +/- 5,234 counts/pixel; p less than 0.003). The mean septum to lateral wall activity ratio of 0.83 +/- 0.21 was less than that observed in normal volunteers (0.92 +/- 0.07; p = NS).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2783598 TI - Effect of LAK cells against three-dimensional tumor tissue. In vitro study using multi-cellular human glioma spheroids as targets. AB - The anti-tumor mechanisms of local LAK cell therapy are difficult to study in vivo. We describe a method to study in vitro the action of LAK cells against three-dimensional tumor tissue. Spherical cell aggregates (spheroids) grown from human glioma cell lines H-2 and U-251 were labeled with 51Cr and then incubated for up to 24 h with LAK cells. After the incubation, most spheroids were still macroscopically identifiable, and the measured reduction of volume did not correlate to the extent of damage. LAK cells infiltrated into spheroid tissue slowly as a frontier which explains why the specific 51Cr release was clearly slower from spheroids than corresponding single cell suspensions. The infiltrated area was at 1 to 2 h very thin but by 8 to 12 h consisted already of several cell layers. Most H-2 spheroids became totally infiltrated by 16 to 24 h whereas in U 251 spheroids the infiltration usually remained peripheral. In accordance with the different extent of infiltration, H-2 spheroids were clearly more sensitive to LAK cells than U-251 spheroids: at E/T ratio 10:1 the mean specific 51Cr release by 24 h was 63 and 36%, respectively. A single exposure to LAK cells released 51Cr from H-2 spheroids approximately 12 h but over 24 h from U-251 spheroids. The spheroid model can be used to study the infiltrative capacity and cytotoxicity of LAK cells against three-dimensional tumor tissue, and the method may help to find an optimal mode of local LAK cell therapy, i.e., proper combination of lymphokines and LAK cells, and proper timing of their administration. PMID- 2783599 TI - Characterization of "regulatory" idiotope-specific T cell clones to a monoclonal anti-idiotypic antibody mimicking a tumor-associated antigen (TAA). AB - As reported previously, 3A4 is a paratope-specific anti-idiotypic mAb and induces cellular and humoral anti-tumor-associated Ag (TAA) responses. In this study, the specificity, MHC restriction and Ag processing requirement of Th cell lines and clones were determined that recognize an idiotypic determinant (Id) on 3A4. The anti-Id-3A4 is part of a tumor-associated idiotypic network which is involved in the regulation of the immunity against the DBA/2 L1210/GZL tumor. These 3A4-Id specific T cell clones are phenotypically Th cells and recognize Id in the context of MHC class II molecules under MHC restriction. Moreover, the recognition of Id by these T cell clones is chloroquine sensitive, suggesting that they recognize processed Id. However, the 3A4-Id-specific T cell clones respond only to 3A4 and not to TAA. Because these clones do not recognize TAA, their biologic role in antitumor immunity could be as regulatory T cells involved in the idiotypic network regulation. PMID- 2783600 TI - Bone marrow progenitor cells induce a regulatory autologous proliferative T lymphocyte response. AB - The proliferative response of human T lymphocytes to autologous bone marrow progenitor cells was studied by in vitro coculture in autologous serum. Irradiated enriched bone marrow progenitor cells induced the proliferation of cocultured peripheral blood T cells, with maximal proliferation at 8 days and stimulator:proliferator ratios of 1/1. This autologous proliferative T lymphocyte response was completely abrogated by the inclusion of anti-HLA-DR, anti-CD2, or anti LFA-3 antibodies into the coculture, and partially inhibited by anti-CD4. Repetitive stimulation with autologous progenitors at days 14 and 28 expanded and further enriched the autoreactive T cells, which proliferated specifically in the presence of autologous progenitors. When incubated for 12 h with bone marrow before short term hematopoietic culture, these autoreactive T cells inhibited hematopoiesis 60 to 100%. These data indicate that a subset of T lymphocytes recognize proliferating hematopoietic progenitors and regulate the growth and differentiation of normal bone marrow cells. PMID- 2783601 TI - Derivation of a T cell line that is highly responsive to IL-4 and IL-2 (CT.4R) and of an IL-2 hyporesponsive mutant of that line (CT.4S). AB - The derivation of subline of CTLL cells that grow in IL-4/B cell stimulatory factor-1 is described. These cells, designated CT.4R cells, were obtained by extended culture of the CTLL line CT.EV in IL-4. CT.4R cells are highly responsive to both IL-4 and IL-2. Mutagenesis of CT.4R cells with ethylmethane sulfonate and selection for lack of expression of the p55 chain of the IL-2R was carried out and a clone was selected that was hyporesponsive to IL-2 but retained full sensitivity to IL-4. These cells, designated CT.4S cells, develop a very meager response to IL-2 at concentrations of 100 U/ml or less although that display vigorous responses to higher IL-2 concentrations. CT.4S cells give measurable responses to 3-10 U/ml (approximately 15-50 pg/ml) of IL-4. CT.4R and CT.4S cells fail to respond to IL-1, IL-3, IL-6, granulocyte-macrophage-CSF, granulocyte-CSF, CSF-1 or IFN-gamma. Thus, CT.4S cells can be used as a sensitive and specific bioassay for IL-4. ID CT.4R cells can be grown in either IL-4 or IL 2. When grown in IL-4, CT.4R cells express small amounts of the p55 chain of the IL-2R but rapidly upregulate their level of expression of p55 when IL-2 is added and rapidly diminish p55 expression when IL-2 is removed. Thus, although IL-2 and IL-4 both stimulate vigorous growth responses by CT.4R cells, they differ in their capacity to induce the expression of the p55 chain implying that their mechanisms of T cell stimulation are not identical. PMID- 2783603 TI - Polyamine oxidation down-regulates IL-2 production by human peripheral blood mononuclear cells. AB - Polyamine biosynthesis by mononuclear cells (MNC) appears to regulate T cell activity since 1) inhibition of polyamine biosynthesis increases IL-2 production and 2) H2O2 (a product of polyamine oxidase, PAO), suppresses lymphocyte proliferation. We investigated this immunoregulatory mechanism and find that catalase, an H2O2 inhibitor, also enhances IL-2 production by MNC. The addition of PAO, but only in the presence of either endogenous or exogenous spermidine (a polyamine), decreases IL-2 production; this effect is catalase inhibitable. Pre incubation with spermidine, but not any of three diamines tested, suppresses PHA stimulated IL-2 production and this effect requires monocytes. Three PAO inhibitors have an enhancing effect on IL-2 production which is again monocyte dependent. These results suggest that: 1) H2O2 produced by PHA-activated PBMC down-regulates IL-2 production; 2) products of the interaction between PAO and spermidine inhibit IL-2 production and H2O2 is essential but apparently not sufficient to mediate this effect; 3) human PBMC contain PAO activity. This polyamine-PAO-dependent inhibitory mechanism might constitute a feedback loop that limits human T cell proliferation and, consequently, also the immune responses mediated by these cells. PMID- 2783602 TI - Human B cell proliferation in response to IL-4 is associated with enhanced production of B cell-derived growth factors. AB - To investigate the capacity of human IL-4 to function as a B cell growth factor (BCGF), we studied its ability to promote proliferation of a selected B cell line. We show that the cell line, designated A4, proliferated in response to IL-4 in a dose-dependent manner. The A4 cells also proliferated in response to their own B cell derived growth factor (B. BCGF), suggesting autocrine-mediated growth. The ability of IL-4 to induce proliferation of the A4 cell line was dependent on the level of autocrine growth. At low cell density, IL-4 induced marked dose dependent proliferation. However, as A4 cell density increased, the ability of IL 4 to induce proliferation was diminished. The possibility that IL-4 may be mediating the autocrine growth of A4 cells was ruled out, because A4 cell-derived BCGF failed to induce CD23/low affinity receptors for the Fc region of IgE on activated tonsillar B cells and anti-IL-4 antibody did not block B. BCGF activity. We found that IL-4 stimulation of A4 cells and activated tonsillar B cells is associated with enhanced production of B. BCGF. These data indicate that human IL-4 has the capacity to promote proliferation of the B cell line A4, and that the ability of IL-4 to function as BCGF is associated with enhanced autocrine growth of activated B cells. PMID- 2783604 TI - Impact of genetically regulated T cell proliferation on acquired resistance to Listeria monocytogenes. AB - Two lines of mice genetically selected for high and low in vitro responses to PHA were used to evaluate the impact of T cell polyclonal expansion on acquired resistance to Listeria monocytogenes. The selective breeding induced two major consequences in low responder mice: (1) a reduction of the number of L3T4+ cells and (2) a restriction of T cell expansion upon PHA stimulation, predominantly affecting the Lyt-2+ subset, and associated with an abridgment of IL-2 production. In vivo PHA stimulation induced anti-Listeria protection in high responder mice, but was much less effective in low responder mice. Flow cytometer analysis revealed that T cell proliferation was also reduced in low responder mice during the course of Listeria infection, implying both L3T4+ and Lyt-2+ subsets. This defect did not apparently influence the kinetics of bacterial elimination in host tissues, which was similar in both lines during primary Listeria infection. In contrast, the expression of delayed-type hypersensitivity to Listeria antigens and the level of immunologic memory were significantly reduced in low responder mice. In vivo selective T cell depletion by anti-L3T4 or anti-Lyt-2 mAb allowed us to demonstrate the predominant role of Lyt-2+ cells in protection and that of L3T4+ cells in the expression of delayed-type hypersensitivity. PMID- 2783605 TI - Treatment with anti-L3T4 (CD4) monoclonal antibody reduces the inflammatory response in toxoplasmic encephalitis. AB - Toxoplasma gondii is an important cause of disease of the central nervous system in patients with AIDS. Among the variety of immunologic disorders encountered by AIDS patients is a depletion of CD4+ subpopulation of lymphocytes. In order to determine the role of this population of T lymphocytes in the generation of toxoplasmic encephalitis, mice chronically infected with T. gondii were treated with mAb GK1.5 directed against the cell surface glycoprotein L3T4 (CD4) of T lymphocytes. Histopathologic sections of brains of control and treated animals were examined at regular intervals during and after completion of treatment. The results demonstrated significantly less inflammation in brains of mice during treatment with GK1.5 mAb. In addition, recrudescence of the inflammatory process occurred after discontinuation of treatment. Similar results were observed in experiments in which different strains of mice and T. gondii were used. PMID- 2783606 TI - Research methodologies. PMID- 2783607 TI - Diverticular hemorrhage in an elderly patient. PMID- 2783608 TI - Improved tumor-specific immunotoxins in the treatment of CNS and leptomeningeal neoplasia. AB - A novel antibody-toxin conjugate has been developed for use in cancer therapy. This report demonstrates that this new reagent selectively kills glioblastoma- and medulloblastoma-derived cell lines, medulloblastoma cells in primary culture, and cell lines derived from tumors commonly metastatic to the cerebrospinal fluid (CSF). Efficient killing of human tumor cells occurred at concentrations between 3.9 X 10(-13) M and 1.1 X 10(-10) M, whereas guinea pigs and rhesus monkeys tolerated intrathecal levels of 2 X 10(-9) M. Cerebrospinal fluid from normal humans and from brain-tumor patients does not inhibit the in vitro efficacy of this reagent. The wide therapeutic window, extreme potency, and general applicability of this antibody-toxin conjugate against CSF-borne primary or metastatic tumors warrants clinical trials. PMID- 2783609 TI - Clinical evaluation of physical therapy in the management of internal derangement of the temporomandibular joint. AB - This clinical cross-sectional study examines the favorable functional improvement in patients undergoing physical therapy for mild to moderate internal disc derangements of the temporomandibular joint. Sixty-eight patients with internal derangements were treated with physical therapeutic modalities as described by Rocabado. A success rate of 86% was achieved in patients with early- to mid opening and late- to mid-closing clicks of the temporomandibular joint. Approximately one third of these patients required short-term occlusal bite appliances to assist in their management. A success rate of 7% was achieved in patients with late-opening and late-closing clicks. No patient with clicking on mediolateral movement was successfully managed with physical therapy. Likewise, patients with nonreducing anteriorly displaced discs of the temporomandibular joint did not respond well to physical therapy. Pain management was evaluated separately and showed subjective improvement in 82% of patients with mild to moderate disc dysfunction and pain. Only 29% of patients with late-opening clicking or locked joints experienced pain relief. When patients were classified according to occurrence of the clicking phenomenon, interesting trends relating to duration of symptoms were found. Twenty-two patients who did not respond favorably to physical therapy underwent surgical procedures. Findings in these patients offer suggestions about why nonsurgical therapy is not successful in certain cases. PMID- 2783610 TI - Contractile actions of epidermal growth factor-urogastrone in isolated smooth muscle preparations from guinea pig stomach: structure-activity relationships and comparison with the effects of human transforming growth factor-alpha. AB - In two distinct isolated guinea pig stomach smooth muscle preparations, we have studied the contractile effects of intact human epidermal growth factor urogastrone (mEGF-URO) and murine epidermal growth factor-urogastrone (mEGF-URO), along with the actions of derivatives (hEGF-URO1-47; mEGF-URO1-47) lacking the C terminal pentapeptide. The effects of these polypeptides were compared with the actions of human transforming growth factor-alpha (TGF-alpha). In the longitudinal muscle preparation, wherein the contractile actions of agonists were abolished by 1 microM indomethacin, the order of potency was: hEGF-URO = mEGF-URO greater than TGF-alpha greater than hEGF-URO1-47 greater than or equal to mEGF URO1-47. In this longitudinal muscle preparation, reproducible contractions could be obtained by rinsing the preparation free of agonist and by maintaining intermittent dose intervals of 1 hr or more. In contrast, in the circular muscle preparation, all agonists elicited a contractile effect that was present in the presence of 1 microM indomethacin. In this indomethacin-treated preparation, when an intermittent dosing regimen was used, repeated exposure to either human or murine EGF-URO caused a persistent desensitization. However, in the indomethacin treated circular muscle preparation, repeated exposure to TGF-alpha and hEGF-URO1 47 during an intermittent dosing schedule caused only a low degree of persistent desensitization. In the indomethacin-treated circular muscle preparation, the order of potency for the contractile effect was: TGF-alpha = hEGF-URO1-47 greater than or equal to hEGF-URO.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2783611 TI - Neurochemical profile of moclobemide, a short-acting and reversible inhibitor of monoamine oxidase type A. AB - Moclobemide belongs to a new generation of short-acting, reversible, monoamine oxidase (MAO) inhibitors. In vitro (rat brain homogenates) moclobemide inhibits MAO-A selectively with lower potency than many of the reference MAO inhibitors. However, when measured ex vivo in the rat, the potency of moclobemide is similar to that of reference compounds. In vivo the drug induces a dose-dependent, short lasting (8-16 hr) and preferential inhibition of MAO-A in the brain and both MAO A and MAO-B inhibition in extracerebral organs (liver, small intestine and kidney). In the extracerebral tissues of the rat moclobemide induces marked peripheral MAO-B inhibition due to rapid and extensive biotransformation of its morpholine ring. The active molecular species is probably the metabolite Ro 16 6491. The moderate MAO-B inhibition measured after moclobemide intake in human platelets indicates that only minor amounts of Ro 16-6491 are formed in humans. Virtually all metabolites of moclobemide so far identified have been tested in vitro and ex vivo in the rat and proved to be either equipotent or, mostly, less effective than moclobemide as MAO-A inhibitors. In liver homogenates of moclobemide-treated rats MAO-A activity recovers during dialysis or simple incubation at 37 degrees C, suggesting a biodegradation of moclobemide and/or the moclobemide-derived active metabolite(s) by MAO itself or a slow dissociation of the active inhibitory species from the enzyme. Similar to other MAO-A inhibitors, moclobemide induces an increase in the rat brain levels of 5-hydroxytryptamine, norepinephrine and dopamine and a concomitant decrease of their deaminated metabolites. These effects are of short duration (8-16 hr) and parallel the time course of MAO-A inhibition. Moclobemide administered subchronically down regulates beta adrenoceptors as shown by binding experiments with brain cortical membranes using dihydroalprenolol as ligand. In vitro MAO inhibition by moclobemide is specific in that the compound does not affect other amine oxidases or monoamine uptake mechanisms; furthermore, it does not interact with various neurotransmitter or drug receptor sites. In conclusion, a large body of preclinical evidence characterizes moclobemide as a short-acting and reversible MAO-inhibitor. The neurochemical profile of moclobemide indicates clearly that this nonhydrazine nonhepatotoxic MAO-A inhibitor represents a novel and safe drug for treatment of affective disorders. PMID- 2783612 TI - Calcitonin gene-related peptide and vasodilator nerves in large cerebral arteries of cats. AB - Calcitonin gene-related peptide's (CGRP) role(s) was examined in the transmural nerve stimulation (TNS)-induced vasodilator response of the large cerebral arteries of the cat in vitro. Numerous CGRP-like immunoreactive nerves were demonstrated to be present in the adventitial layer of the middle cerebral, anterior communicating and basilar arteries of the cat. An electron microscopic study revealed that immunoreactive material was contained in not only nerve axons but also in the button-like structures, i.e., varicosities, which were located close to smooth muscle cells. Exogenously applied CGRP induced a dose-dependent vasodilator response which was independent of the presence of endothelial cells and of nerve components. Nerve stimulation elicited transient hyperpolarization, i.e., inhibitory junction potential, which was of nonadrenergic, noncholinergic origin. Likewise, CGRP produced hyperpolarization of smooth muscle cells. After incubation of the tissue with capsaicin in vitro, the intensity of the CGRP-like immunoreactivity diminished greatly. The TNS-induced vasodilator response and inhibitory junction potentials were also attenuated after the incubation with capsaicin. These results suggest that CGRP is involved in the TNS-induced vasodilator response of the large cerebral arteries of the cat. PMID- 2783613 TI - Studies on semirigid tricyclic analogues of the nigrostriatal toxin 1-methyl-4 phenyl-1,2,3,6-tetrahydropyridine. AB - The tetrahydro-beta-carboline derived from the condensation of N-methyltryptamine and formaldehyde, a semirigid tricyclic analogue of 1-methyl-4-phenyl-1,2,3,6 tetrahydropyridine (MPTP) tha has been detected in the brains of normal laboratory rats, is biotransformed in a monoamine oxidase B (MAO-B) catalyzed reaction to the corresponding dihydro compound at a rate that is approximately 0.5% of that observed with MPTP. The corresponding tetrahydroindenopyridine in which the double bond beta,gamma to the nitrogen atom retains allylic character is a somewhat better MAO-B substrate. The steric bulk of the nitrogen and methylene bridges in addition to ring strain present in the proposed carbon centered radical intermediates derived from these types of tricyclic structures may contribute to their relatively poor MAO-B substrate properties. Although no MPTP-like neurotoxic properties were observed following acute administration of the test compounds to mice, we speculate that the chronic accumulation of beta carbolinium type metabolites could contribute to the rate of nigrostriatal cell loss associated with idiopathic Parkinson's disease. PMID- 2783614 TI - Diagnostic and therapeutic technology assessment (DATTA). Noninvasive electrical stimulation for nonunited bone fracture. PMID- 2783615 TI - Depressed PMNC blastogenic response in patients with cancer of the head and neck: a study of IL-2 production, IL-2 consumption, and IL-2 receptor expression. AB - Approximately two thirds of patients with head and neck cancer have been shown to have peripheral mononuclear cells that exhibit a lowered blastogenic response to the T-cell mitogens, concanavalin A and phytohemagglutinin. To investigate the possible mechanisms of this phenomenon, we measured the amount of activated T cell lymphokine interleukin-2 present in the supernatant of concanavalin A- or phytohemagglutinin-stimulated peripheral mononuclear cells taken from patients with squamous cell carcinoma of the upper aerodigestive tract. Concentrations were found that were similar to those of healthy subjects. The rate of interleukin-2 consumption and the degree of interleukin-2 receptor expression also were similar for patients and controls. In the course of these experiments, it was noted that differences in blastogenic response between patients and controls were abolished when, 24 hours after the beginning of either concanavalin A or phytohemagglutinin stimulation, the culture supernatant was removed and replaced by fresh medium, containing recombinant interleukin-2 to further sustain cell growth. This suggests that the lower blastogenic response found in patients with head and neck cancer is not due to global immune unresponsiveness, but instead, is caused by selective cell dysfunction(s), which may include the production of a suppressor factor following concanavalin A or phytohemagglutinin stimulation. PMID- 2783616 TI - Regeneration of the eighth cranial nerve. III. Central projections of the primary afferent fibers from individual vestibular receptors in the bullfrog. AB - The projection site in the central nervous system of individual end-organ branches of regenerated vestibular nerves was documented in bullfrogs. The eighth cranial nerve was surgically sectioned in 12 bullfrogs (Rana catesbeiana) and allowed to regenerate. Horseradish peroxidase was used to label the primary vestibular afferent fibers from the whole nerve (one frog) and the whole anterior branch (two frogs), and the individual receptor end-organ branches to the anterior semicircular canal (three frogs), the horizontal semicircular canal (three frogs), and the sacculus (three frogs). A sufficient number of fibers from the individual receptors were labeled in nine specimens to allow a description of their central projection pattern. The overall pattern of central projections of the regenerated nerves was similar to the pattern of normal nerves. In the eighth nerve root proper and in the area proximal to the vestibular nuclei, fibers from the anterior semicircular canal were ventral, fibers from the sacculus and posterior branch were dorsal, and fibers from the horizontal semicircular canal were in an intermediate position. In ventral, superior, and descending vestibular nuclei, a projection pattern was also identifiable in some specimens. The fibers of the anterior semicircular canal projected ventral to the fibers of the horizontal semicircular canal, with fibers from the posterior branch more dorsal. The saccular fibers projected to the dorsal aspect of the ventral nucleus and the ventral aspect of the dorsal nucleus. For the most part, projections in the regenerated specimens, as verified histologically, were comparable to individual end-organ projections previously identified in normal frogs. The only major discrepancy between the findings from the regenerated specimens and those from normal frogs was in the position of the vestibular tract and the innervation to the medial nucleus. The regenerated vestibular tract was shifted laterally in the brain stem. Regenerated thick and thin fibers were intermixed in the tract and projected to the medial nucleus. Normally, the thin fibers are lateral to the thick fibers in the tract. Therefore, the regenerated afferent fibers of the vestibular nerve selectively reinnervated the vestibular nuclei, and the fibers to the individual end-organs selectively reinnervated particular parts of the nuclei. In addition, the thick and thin regenerated fibers preserved the type of bouton endings normally found. The regenerated thick fibers had rare boutons en passant and a great number of collaterals, while the thin fibers had numerous boutons en passant and only a few collaterals.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2783617 TI - Phenytoin induces interleukin-1 production in vitro. AB - Human adherent mononuclear cells and subcloned cell lines established from the human histiocytic cell line U-937 were cultured with phenytoin (PHT) and/or lipopolysaccharide (LPS) purified from Bacteroides fragilis. After the cultivation period, the cell-free supernatants were tested for interleukin-1 (Il 1) activity. The results showed that PHT induces Il-1 activity and potentiates LPS-induced Il-1 production. In the monocytic cell line U-937, the induced Il-1 production was found to be clonally distributed indicating that the response to PHT may be exerted by a subpopulation of monocytes. The PHT-induced Il-1 activity may be of importance in the development of gingival overgrowth. The induced Il-1 could also contribute to other known side effects such as dermatologic reactions accompanied by transient fever seen in patients medicating the drug. PMID- 2783618 TI - Normal ionized calcium, parathyroid hypersecretion, and elevated osteocalcin in a family with fluorosis. AB - Sera from five patients with skeletal fluorosis were investigated for total calcium, ionized calcium, phosphate, alkaline phosphatase, 25 hydroxyvitamin D (25 OHD), 1,25 dihydroxyvitamin D (1,25[OH]2D), parathyroid hormone, and osteocalcin concentrations. Total and ionized calcium concentrations were normal in four and subnormal in one, but PTH concentration was elevated in all five. The patient with a subnormal calcium concentration also had subnormal 25 OHD and 1,25(OH)2D concentrations and a supranormal PTH concentration. The remaining four had supranormal PTH concentrations despite normal total and ionized calcium concentration, and normal 25 OHD and 1,25(OH)2D levels. Osteocalcin concentration was markedly elevated in all patients, as was alkaline phosphatase activity. These observations show for the first time that patients with fluorosis have markedly elevated osteocalcin, a marker of osteoblastic activity, and that they may have significantly elevated PTH concentrations in the presence of normal total and ionized calcium concentrations. PMID- 2783619 TI - Langerhans' cell histiocytosis (histiocytosis X): experience at the Children's Hospital of Philadelphia, 1970-1984. AB - Sixty-four patients with biopsy-proven Langerhans' cell histiocytosis (LCH, formerly designated as histiocytosis X) were managed at the Children's Hospital of Philadelphia from 1970 through 1984. Their median age was 3 yr (range, 0.1-22 yr). Thirty-three patients had localized lesions affecting a bone (27) or soft tissue region (6). Twenty-two patients had multifocal disease affecting bones (17) or soft, nonosseous tissues (5). None of these patients had evidence of dysfunction of liver or lungs, and none had abnormal peripheral blood cell counts. The remaining nine patients had multifocal LCH plus dysfunction of liver or lungs (6) or abnormal blood counts (3). Treatment consisted primarily of surgical excision for patients with localized lesions and of drug therapy with or without irradiation and surgery for those with multifocal disease. Recurrence was infrequent (7%) in those with localized LCH, and all survived. Recurrence was frequent (74%) in those with multifocal LCH but without organ dysfunction or abnormal blood counts, but 21 of the 22 survived. By contrast, only three of the nine patients with organ dysfunction or abnormal blood counts survived. Thus organ dysfunction and abnormal blood counts at diagnosis emerged as the major adverse prognostic factors in children with LCH. PMID- 2783620 TI - Specific inactivation by 17 beta-substituted steroids of rabbit and rat liver cytochromes P-450 responsible for progesterone 21-hydroxylation. AB - The selective inactivation by 17 beta-substituted steroids of rabbit and rat liver cytochromes P-450 involved in the 21-hydroxylation of progesterone has been investigated. Five derivatives each of pregnenolone and progesterone were prepared, in which the methylketo substituent of the 17 beta-position was replaced by a dichloromethylketo, chlorofluoromethylketo, difluoromethylketo, vinyl, or ethynyl group. The ability of the compounds to cause time-dependent (inactivation) and time-independent (inhibition) decreases in progesterone hydroxylase activity was assessed in vitro using intact liver microsomes as well as reconstituted systems containing the major forms of hepatic cytochrome P-450 responsible for progesterone 21-hydroxylation, P-450 1 in the rabbit and PB-C in the rat. In each species, one compound was identified that specifically inactivated the 21-hydroxylase, namely 21-chloro-21-fluoropregnenolone in the rabbit and pregn-4,20-diene-3-one in the rat, although both compounds inhibited several other hydroxylases as well. Moreover, the most effective and specific 21 hydroxylase inactivators were not necessarily the most effective or specific inhibitors. These results suggest that conversion of the enzyme-inhibitor complex to metabolites that inactivate the enzyme, rather than complex formation, is the crucial factor in determining the specificity of the compounds as cytochrome P 450 inactivators. The results indicate the feasibility of designing specific inactivators of hepatic cytochromes P-450 by utilizing the normal regioselectivity of the target enzyme towards steroids. PMID- 2783622 TI - Differences in interleukin-2 production in blacks and whites. PMID- 2783623 TI - Occlusive coronary-artery spasm as a cause of acute myocardial infarction after coronary-artery bypass grafting. PMID- 2783621 TI - Lymphocyte stem cell alterations following perinatal exposure to 2,3,7,8 tetrachlorodibenzo-p-dioxin. AB - Perinatal exposure of experimental animals to the environmental contaminant 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) leads to thymic atrophy and a suppression of cell-mediated immunity that is more severe and persistent than that caused by adult exposure, suggesting that events involved in the maturation of the immune system are particularly sensitive to TCDD. We report here that perinatal TCDD exposure produces an alteration in the lymphocyte stem cell population in the fetus and neonate, as evidenced by a significant reduction in the lymphocyte stem cell-specific enzyme terminal deoxynucleotidyl transferase (TdT). After maternal treatment with a single dose of TCDD (10 micrograms/kg of body weight) on gestational day (gd) 14, TdT biosynthesis and TdT-specific mRNA were reduced more than 50% in fetal liver lymphoid cells on gd 18. An even more extensive reduction was seen in neonatal bone marrow through postnatal day 18. In contrast, thymic TdT synthesis appeared to be relatively unaffected on a per cell basis by perinatal TCDD exposure, although the actual number of TdT-synthesizing thymocytes was diminished due to extensive thymic atrophy. These effects occurred at concentrations of 1-31 fg of TCDD/mg of thymus. Flow cytometric analysis of thymocyte surface marker expression revealed a slight decrease in the percentage of Lyt-2+L3T4+ thymocytes on gd 18 and postnatal day 4. This alteration was no longer apparent by postnatal day 11, when marrow TdT biosynthesis was most suppressed. These results suggest that TCDD-induced thymic atrophy during the perinatal period may be due, in part, to an effect on the prothymocyte. PMID- 2783624 TI - Relationship of benzyl alcohol to kernicterus, intraventricular hemorrhage, and mortality in preterm infants. AB - Intraventricular hemorrhage and death in preterm neonates has been associated with the use of fluid containing benzyl alcohol, a bacteriostatic agent, to flush intravascular catheters. The hospital and autopsy records of infants admitted to a nursery during the last 18 months that benzyl alcohol was in use (218 patients) were reviewed and compared with those of infants admitted in the first 18 months after benzyl alcohol was withdrawn (232 patients). The volume of flush solution administered to each patient was estimated. Exposure to benzyl alcohol was significantly associated with the development of kernicterus (P less than .005), and intraventricular hemorrhage (P less than .000,000,5). Kernicterus did not develop in any patient after benzyl alcohol was withdrawn. Many patients with kernicterus or intraventricular hemorrhages received small daily volumes of fluid containing benzyl alcohol. Withdrawal of benzyl alcohol from clinical use had no demonstrable effect on mortality. Medications intended for neonatal use should not contain benzyl alcohol. Our data indicate that patients not exposed to benzyl alcohol have a greatly reduced risk of kernicterus. If this finding is confirmed by other investigators, present indications for exchange transfusions in preterm infants with moderate elevations of serum bilirubin should be reconsidered. PMID- 2783625 TI - Increased prevalence of ventricular septal defect: epidemic or improved diagnosis. AB - The Baltimore-Washington Infant Study is an ongoing case-control study of congenital cardiovascular malformations in infants in whom the clinical diagnoses have been confirmed by echocardiography, catheterization, surgery, or autopsy. An increase in the prevalence of ventricular septal defects was detected in 1,494 infants with congenital cardiovascular malformations between 1981 and 1984. The prevalence of congenital cardiovascular malformations increased from 3.6 to 4.5 per 1,000 live births (P less than .025) and the prevalence of ventricular septal defect increased from 1.0 to 1.6 per 1,000 live births (P less than .001). The increase in ventricular septal defects accounted for the total increase in congenital cardiovascular malformations. The prevalence of isolated ventricular septal defect increased from 0.67 to 1.17 per 1,000 live births (P less than .001). The prevalence of ventricular septal defect with associated coarctation of the aorta, patent ductus arteriosus, atrial septal defect, and pulmonic stenosis did not change. The prevalence of ventricular septal defect diagnosed by catheterization, surgery, and autopsy did not change; however, defects diagnosed by echocardiography increased from 0.30 to 0.70 per 1,000 live births (P less than .001). It is concluded that the reported increase in prevalence of ventricular septal defect is due to improved detection of small, isolated ventricular septal defects and that there is no evidence of an "epidemic." PMID- 2783626 TI - Knowledge and concerns about acquired immunodeficiency syndrome and their relationship to behavior among adolescents with hemophilia. AB - The knowledge and concerns regarding acquired immunodeficiency syndrome (AIDS) and their relationship to certain behaviors among adolescents with hemophilia, a pediatric risk group with human immunodeficiency virus (HIV) antibody positivity rate as high as 70% to 90%, are described. Information was obtained from 26 patients, 13 to 19 years of age, through the use of a confidential self administered questionnaire and a semistructured interview. In general, subjects demonstrated a high level of factual knowledge regarding the cause, natural history, transmission, and prevention of AIDS. Despite this, participants frequently behaved in ways that were potentially harmful to themselves and others. Specifically, although aware of the importance of using condoms, sexually active adolescents with hemophilia were not practicing safe sex. Restriction in the use of heat-treated clotting factor because of concerns about AIDS was also frequently reported. Professionals providing AIDS education and counseling for these individuals need to be cognizant of the concerns and social skills of this population; they should focus not only on factual information but also on the social and situational pressures confronting these teenagers, which may be more immediate determinants of their behavior and well-being. As AIDS continues to spread into the general population, these findings have relevance to AIDS education and health policy efforts aimed at all adolescents. PMID- 2783627 TI - Injuries among preschool children enrolled in day-care centers. AB - In this study, 423 injury incidents among preschool children enrolled in day-care centers reported to the Los Angeles Unified School District during the 2-year period 1983 to 1984 are reviewed. The relative risk of sustaining an injury between boys and girls was 1.5:1. Among sex and age groups, younger boys (2 to 3 years of age) showed the highest injury rate and older girls (4 to 5 years of age) showed the lowest. The overall incidence was 19.7 injuries per 1,000 child years. The majority of the injuries were minor in severity, and medical attention was recommended in only 12.8% of the injuries. The highest incidence occurred during the late morning period (9 AM to 12 noon). A consumer product was involved in 53.7% of the incidents. Three of four injuries were considered preventable by training and/or education or by the Haddon injury reduction strategies. Additional prospective studies are needed to develop and implement preventive measures. PMID- 2783628 TI - Somatization among refugees: an epidemiologic study. AB - Somatization has been widely reported among refugee psychiatric patients since World War II, and some psychological theorists have viewed somatization as an alternative to depression. These and other theories were tested in a population survey of 97 Hmong refugees who had lived in the U.S. for several years. Four different measures of somatization were employed, including a 12-item self-rating scale, a single-item global rating based on the total interview, and somatic subscales of the two Hamilton interview-rating scales. These data demonstrate that somatization accompanies certain demographic characteristics that are associated with failure to acculturate. Somatization in this non-patient, refugee population was associated with treatment seeking and self-identified "medical problems" and with psychiatric symptoms and disorders, but not with objective evidence of medical disorder. PMID- 2783629 TI - Somatization symptoms in the community: a rural/urban comparison. AB - Somatization is conceptualized as a bodily or somatic expression of psychic distress. Unexplained somatic symptomatology was assessed by use of the National Institute of Mental Health Diagnostic Interview Schedule among community respondents in the Piedmont of North Carolina participating in the Epidemiologic Catchment Area program. Previous literature suggests that somatization is associated with rural residence, less education, lower socioeconomic class, and particular ethnicities. Through use of a multiple regression analysis, lifetime unexplained somatic-symptom counts were regressed on urban residence and other sociodemographic variables. Rural residence was not associated with somatization; rather, somatization was more common among urban residents. The urban/rural differences were greatest among women and high school graduates. Somatization was also associated with being aged 45 to 64, and being separated, widowed, or divorced; it was not associated with race. Overall, somatization was also associated with less education. PMID- 2783630 TI - Percutaneous dorsal column stimulator for chronic pain control. AB - This is a retrospective review of 26 patients with chronic intractable pain in which dorsal column stimulation was used as a salvage procedure. On follow-up of 12 to 42.7 months, 21 of the patients had diminished narcotic usage. Seventeen patients subjectively rated their pain relief as good to excellent. Another five patients reported some relief of pain. Two-thirds of the patients reported an increase in their ability to perform daily activities such as walking, stair climbing, and time spent sitting. There are still many technical problems that plague this procedure, as evidenced by a very high technical complication rate of lead migration and lead breakage. Whether or not results diminish over long-term follow-up remains to be seen. PMID- 2783631 TI - A cross-sectional prevalence study of lumbar disc degeneration in a working population. AB - The prevalence of lumbar degenerative discs (LDD) was determined in 38 ambulating and 21 sedentary employees of a Rocky Mountain company. Lumbar degenerative discs were identified by magnetic resonance imaging (MRI) performed with a sagittal T2 image of the lumbar spine using a .5 Tesla unit. The L5-S1 level was the most common disc with degenerative changes. Analysis of the two groups showed a significant association at the L5-S1 level between occupation and LDD, as evidenced by the ambulating females having no degenerative lumbar discs and sedentary females having a large number of degenerative discs. The males in the study did not demonstrate a significant difference in prevalence of LDD. Lumbar degenerative discs may be increased in less active females at the L5-S1 level. PMID- 2783633 TI - Risk factors for thromboembolic stroke in elderly patients with chronic atrial fibrillation. PMID- 2783632 TI - [The social medicine significance of rheumatic diseases]. AB - There is no doubt that the various rheumatoid diseases constitute a socio-medical and socio-economic problem of first order. Surely the importance of this problem will even grow till around the turn of the millenium because the share of older people in the total population of the German Federal Republic is continuing to increase. Concerning frequency and duration the rheumatoid diseases figure at the top of all the insurance benefits. The following measures are essentials to a successful combat of this popular disease: Purposive information, prevention, early diagnosis, adequate treatment and a fitting the patient back into the productive process. Among the rheumatoid diseases the degenerative changes are ranking foremost in the range of frequency, unchallenged and at a considerable distance from the primarily inflammatory diseases. Arthroses and spondyloses are by no means a simple "articular detrition" but a disease in which the time factor is not always of decisive importance. There are ascertainable degenerative articular changes to be found in every person virtually by the age of fifty-five although not everybody has physical complaints. As to the increase in frequency observed in the past few years regarding fillings of applications for therapies because of so-called rheumatic complaints, changes of the conditions at someone's workplace alone cannot be blamed for it at all, rather bad posture and unsound stresses in one's leisure time as well as a new kind of consciousness of being sick supervene. A prophylactic healthful conduct depends strongly upon a person's social status and upon socio-cultural conditions.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2783634 TI - Malignant chronic lymphocytic leukemia B cells elaborate soluble factors that down-regulate T cell and NK function. AB - To determine if the frequently observed T cell and natural killer dysfunction in B-chronic lymphocytic leukemia might be related to the presence of large numbers of malignant B cells, we studied the effects of secretory or shed products of CLL B cells on normal (control) T cell and NK function. The cell-free supernatants from CLL B cells cultured from 24 to 48 hr inhibited a variety of T cell functions including: PHA-induced proliferation, PHA-stimulated entry of T cells into the cell cycle, and PHA-induced production of interleukin-2. In addition, B CLL supernatants diminished control NK activity. Purified control B cells and other malignant cell lines produced little or no inhibitory activity toward these T cell or NK functions. The sera from these same B-CLL patients diminished PHA induced interleukin-2 production by control T cells. Initial molecular characterization of the inhibitory factor(s) revealed it to be of low molecular weight (less than 5000 daltons) with loss of functional activity after treatment with neuraminidase. This suggested that this substance might be either a ganglioside or glycoprotein whose inhibitory activity depends on the presence of a sialic acid moiety. If CLL B cells are capable of secreting or shedding immunosuppressive factor(s), then alteration of this property may result in a more normal immune system for these patients. PMID- 2783635 TI - Acquired immunodeficiency syndrome may present as severe restrictive lung disease. PMID- 2783636 TI - Immunohistochemical staining of sebaceous cell carcinoma of the eyelid. AB - We characterized the inflammatory infiltrate of two sebaceous cell carcinomas of the eyelid with immunohistochemical staining to determine the functional class of the mononuclear cells associated with the tumor. The results were compared with the inflammatory infiltrate associated with basal cell carcinomas. The subepithelial spaces and the area immediately surrounding the sebaceous cell neoplasms were free of mononuclear inflammatory cells, in contrast to the basal cell tumors, which had large numbers of subepithelial inflammatory cells and inflammatory cells in intimate contact with the neoplastic cells as previously reported. Inflammatory reaction in the sebaceous cell tumor was limited to a T cell infiltrate surrounding the vessels adjacent to the tumor. The predominant mononuclear inflammatory cell in both the sebaceous cell and the basal cell carcinomas was the T helper cell. The apparent difference in mononuclear cell infiltrate may be a significant factor in the clinical behavior of the tumors. PMID- 2783637 TI - Glomerular basement membrane-containing immune complexes stimulate tumor necrosis factor and interleukin-1 production by human monocytes. AB - The ability of human peripheral blood monocytes to produce tumor necrosis factor (TNF) and interleukin-1 (IL-1) in an in vitro model of immune complex-mediated glomerulonephritis was investigated. When isolated monocytes were incubated with human glomerular basement membrane (GBM) containing anti-GBM immune complexes, both TNF and IL-1 were produced and secreted into the medium. The time course of secretion differed, with IL-1 production being maximal after approximately 8 hours, whereas TNF levels continued to rise for 30 hours. The activities of the monocyte-derived TNF and IL-1 were inhibitable by specific antibodies. No effect was seen when monocytes were incubated separately with either GBM alone or anti GBM IgG. The levels of TNF and IL-1 released were comparable with those induced by high concentrations of LPS, indicating that production was close to the maximal levels reported for these cells. High levels of TNF and IL-1 also were produced in response to soluble immune complexes. The results show that monocytes can produce significant levels of TNF and IL-1 in response to both surface-bound and soluble immune complexes and provide support for the participation of these monokines in glomerulonephritis. PMID- 2783639 TI - Parental smoking and post-infancy wheezing in children: a prospective cohort study. AB - The contribution of parental smoking to wheezing in children was studied in a subset of all British births between April 5 and 11, 1970 (N = 9,670). Children of smoking mothers had an 18.0 per cent cumulative incidence of post-infancy wheezing through 10 years of age, compared with 16.2 per cent among children of nonsmoking mothers (risk ratio 1.11, 95% CI: 1.02, 1.21). This difference was confined to wheezing attributed to wheezy bronchitis, of which children of smokers had 7.4 per cent, and those of nonsmokers had 5.2 per cent (risk ratio 1.44, 95% CI: 1.24, 1.68). The incidence of wheezy bronchitis increased as mothers smoked more cigarettes. After multiple logistic regression analysis was used to control for paternal smoking, social status, sex, family allergy, crowding, breast-feeding, gas cooking and heating, and bedroom dampness, the association of maternal smoking with childhood wheezy bronchitis persisted. Some of this effect was explained by maternal respiratory symptoms and maternal depression, but not by neonatal problems, the child's allergic symptoms, or paternal respiratory symptoms. There was a 14 per cent increase in childhood wheezy bronchitis when mothers smoked over four cigarettes per day, and a 49 per cent increase when mothers smoked over 14 cigarettes daily. PMID- 2783641 TI - Relationship between hemodynamic and electroencephalographic changes during general anesthesia. PMID- 2783640 TI - Control of intraoperative hypertension with isoflurane in patients with coronary artery disease: effects on regional myocardial blood flow and metabolism. AB - The effect of isoflurane on regional myocardial metabolism and blood flow, when used as an adjunct to fentanyl-nitrous oxide anesthesia, to control intraoperative hypertension was investigated. Twenty-two patients with two- or three-vessel coronary artery disease with an ejection fraction greater than 0.5 and on beta-blockers up to the morning of surgery were studied during elective coronary artery by-pass grafting. Systemic and pulmonary hemodynamics, and regional (great cardiac vein, GCVF) myocardial blood flow and myocardial metabolic parameters were measured. In 10 patients, both GCVF and global (coronary sinus, CSF) myocardial blood flows were recorded. Measurements were made 1) after induction of anesthesia but prior to skin incision, 2) during sternotomy, and 3) during isoflurane administration after its use to reduce arterial pressure to the presternotomy level. The increase in systemic arterial pressure during sternotomy was due to an increase in systemic vascular resistance accompanied by increases in heart rate, pulmonary capillary wedge pressure, (PCWP) regional myocardial oxygen consumption and extraction, GCVF and total coronary vascular resistance. Isoflurane reduced systemic arterial pressure but not PCWP, to presternotomy levels within 6.9 +/- 0.7 minutes at an end-tidal concentration of 1.5 +/- 0.2%. Isoflurane induced a pronounced systemic and coronary vasodilatation and increases in cardiac index, heart rate and regional myocardial oxygen extraction while the GCVF/CSF ratio remained unchanged. While mean regional--MLE% values were not effected by sternotomy, in two patients myocardial lactate production was seen during sternotomy but not during isoflurane. In another two patients, isoflurane induced lactate production.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2783638 TI - Nuclear antigens in neoplastic lymphocytes of B cell and T cell non-Hodgkin's lymphomas. AB - Gross nuclear morphology is a major diagnostic feature in the identification of subtypes of non-Hodgkin's lymphoma (NHL). The authors have shown that the size, shape, and chromatin distribution of the lymphocyte nuclei vary extensively both within and between samples of a subtype, and have proposed that the variations may reflect qualitative and quantitative differences in extrachromatinic components. To test this hypothesis, the organization of individual nuclear antigens in NHL and in reactive hyperplasia biopsies was examined by immunofluorescence labeling of frozen sections with previously characterized monoclonal antibodies. The results have been correlated with observations of the staining patterns produced by the antibodies in mitogenically stimulated human peripheral blood lymphocytes. Labeling pattern and intensity with each antibody were consistent between preparations of blood lymphocytes, and all four antibodies labeled all blood lymphocyte samples tested. In contrast, only 15% of the 53 biopsies were labeled by all four antibodies, although all were stained by anti-peripherin, nearly 80% by I1, and almost 60% by PI1. Antibody PI2 labeling was detected in only 20% of the samples. Variation in labeling intensity was equally extensive both within and between biopsy samples. In general, there was little homogeneity between samples of an NHL subtype as to which antigens were detected, their labeling intensity, or their pattern of intranuclear distribution. These observations are consistent with earlier reports of significant diversity in the morphology of nonchromatin components in such samples. The data support the proposition that the heterogeneity of gross nuclear morphology in nuclei of NHL biopsies may be due in part to disordered expression or abnormal organization of nuclear proteins. PMID- 2783643 TI - Interleukin-2 and the chronic fatigue syndrome. PMID- 2783642 TI - Interleukin-2-induced tumor necrosis factor-alpha (TNF-alpha) gene expression in human alveolar macrophages and blood monocytes. AB - Recent investigations have demonstrated interleukin-2 receptor (IL-2R) expression on both human alveolar macrophages (AM phi) and blood monocytes (PBM), but the function of these receptors has not been fully elucidated. In this study, we demonstrate that human AM phi, as well as PBM, can be induced to express biologically active TNF-alpha after challenge with interleukin-2 (IL-2). Furthermore, we examined the expression of TNF-alpha at the mRNA level via Northern blot and in situ hybridization analysis. Normal AM phi, obtained by bronchoalveolar lavage, and PBM were stimulated with either IL-2 (2,000 U/ml) or lipopolysaccharide (LPS) (10 micrograms/ml) for 18 h. Specificity was demonstrated by neutralizing TNF-alpha activity with a polyclonal rabbit anti human TNF-alpha antibody. PBM TNF-alpha biologic activity from 11 subjects challenged with either IL-2 or LPS was 19 +/- 6 and 85 +/- 15 U/ml/10(6) cells, respectively, which represented 5-fold and 21-fold increases over control values. AM phi TNF-alpha biologic activity from nine subjects was 110 +/- 28 (IL-2 mediated) and 304 +/- 69 (LPS-mediated) U/ml/10(6) cells, which represented 2- and 6-fold increases over controls. AM phi exhibited statistically greater (p less than 0.05) TNF production in response to both IL-2 and LPS as compared to PBM. IL-2 challenge resulted in an induction of TNF-alpha mRNA accumulation, as demonstrated by Northern blot and in situ hybridization analyses. TNF-alpha mRNA was quantitated by laser densitometry for Northern blots or by counting the number of silver grains/mononuclear phagocytic cell in the in situ hybridization analysis.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2783644 TI - Epidermal growth factor (EGF) and monoclonal antibody to cell surface EGF receptor bind to the same chromatin receptor. AB - Cellular uptake, nuclear translocation, and chromatin binding of epidermal growth factor (EGF) and monoclonal antibodies (MAbs) against the protein domain of the EGF surface receptor (MAb 425) and against the carbohydrate Y determinant on the EGF receptor (MAb Br 15-6A) were analyzed in cell lines that express surface EGF receptor. Both EGF and MAb 425 were translocated to the nucleus and bound in nondegraded form to the chromatin of all cells tested. MAb Br 15-6A was taken up only by SW 948 colorectal carcinoma cells which express EGF receptor whereas neither EGF nor MAb 425 was taken up by SW 707 colorectal carcinoma cells which do not express EGF receptor. MAb 425 immunoprecipitated a 230- to 250-kDa chromatin protein, which appears to be the EGF chromatin receptor. EGF was localized in a single EcoRI DNA fragment suggesting that the chromatin binding was highly specific. Binding of EGF to primarily DNase II-sensitive chromatin regions protected these regions from nuclease action. The role of growth factor binding to chromatin in neoplastic transformation is discussed. PMID- 2783645 TI - Effects of in vivo administration of anti-Ia antibodies on contact sensitivity. AB - Our previous studies of the effects of the in vivo administration of anti-la (anti-class II major histocompatibility antigens) antibodies in mice demonstrated that, although the antibodies bind to epidermal Langerhans' cells, they do not affect their antigen-presenting capacity in vitro. In this study we investigated the effects of the in vivo administration of these antibodies on the induction and expression of contact sensitivity. We found that the antibodies inhibit the induction of contact sensitivity significantly and affect the elicitation phase to a much lesser extent. The inhibition is short-lived and probably not attributable to the induction of suppressor cells. PMID- 2783646 TI - Ringworm of the chin. Alopecia mucinosa (follicular mucinosis). PMID- 2783647 TI - Vein-to-artery grafts: the long-term development of neo-intimal hyperplasia and its relationship to vasa vasorum and sympathetic innervation. AB - A series of 14 vein-to-artery grafts, 1 mm in diameter and 5 mm long, were inserted microsurgically into iliac arteries of rats. They were analysed histologically 8-18 months later and compared with control iliac arteries in the same rats. Neo-intimal hyperplasia developed and was measured in all grafts but the values did not significantly exceed the equivalent intimal plus medial thicknesses of control arteries. Vasa vasorum developed and were quantitated as the number of vessels per mm2 of neo-intima, but also did not differ significantly from control values. The density of sympathetic innervation was quantitated using fluorescent catecholamines. There was an overall significant increase in the long-term graft innervation compared with control arteries. These results show that such small vein grafts adapt and function very effectively, in a manner remarkably similar to the artery they replace, for long periods of time. PMID- 2783648 TI - Bilateral testicular and adrenal malignant lymphoma of pre B-cell type. AB - A rare case of pre B-lymphoblastic lymphoma of the testes and adrenal glands is presented. No lymph node, central nervous system or bone marrow involvement was demonstrated at diagnosis. The primary presentation was of acute unilateral pain and swelling, mimicking simple orchitis. The diagnosis was made using aspiration cytology and the lymphoma characterized using immunohistochemical, electron microscopic and karyotype analysis techniques. Pre B-cell markers were clearly demonstrated by all criteria used. Monoclonal antibodies (FMC 29 and FMC 31) were used to define the early B-cell nature of the lymphoma. Confirmation using karyotype analysis in addition to immunoglobulin and T-cell beta-receptor gene rearrangement was obtained. Intrathecal chemotherapy was used prophylactically. Combination chemotherapy produced regression of the primary lymphomatous lesions, but subsequent bone marrow spread led to death. PMID- 2783649 TI - Kinetic analysis of the elimination process of human epidermal growth factor (hEGF) in rats. AB - Pharmacokinetic study of human epidermal growth factor (hEGF) in rats was performed in vivo. The hepatic extraction ratio (EH) of [125I]hEGF, determined from the difference between the artery and the hepatic vein plasma concentrations at steady state, was 0.19. The hepatic clearance (CLH:7.56 ml/min/kg body wt), calculated by multiplying EH by the hepatic plasma flow rate (QP,H), was approximately 70% of the total body clearance (CLtot: 10.8 ml/min/kg body wt), which was determined from the steady-state arterial plasma concentration and the infusion rate. These results indicated that the liver is the main organ responsible for the removal of [125I]hEGF from the systemic circulation in rats. The renal extraction ratio (ER) of [125I]hEGF was half of that of [14C]inulin; this may have resulted from the plasma protein binding of [125I]hEGF, which was approximately 50% as determined by the charcoal adsorption method and the equilibrium gel-filtration method. The renal clearance (CLR:2.65 ml/min/kg body wt), calculated by multiplying ER by the renal plasma flow rate (QPR), was approximately 17% of the CLtot (15.6 ml/min/kg body wt), indicating a minor contribution of CLR to CLtot compared with that of CLH to CLtot. The CLR of [125I]hEGF calculated from the urinary excretion data was one-tenth of that calculated from the plasma concentration difference between the femoral artery and the renal vein at steady state. These results suggest that the bulk of [125I]hEGF cleared from the plasma by the kidney may have been metabolized further in the renal tubules before appearing in the urine. PMID- 2783650 TI - Molecular cytochemistry of CD3 and CD4 antigens in human lymphocytes as studied by label-fracture and by fracture-label. AB - Label-fracture and fracture-label membrane immunocytochemistry are used to analyze the surface distribution, dynamics and partition on fracture of CD3 and CD4 antigens of human T lymphocytes. Redistribution of the antigens, induced by treatment at 37 degrees C with specific monoclonal antibodies, results in patching and capping of the labeling as observed in label-fractured specimens. Examination of platinum/carbon replicas of freeze-fractured plasma membranes of antibody-treated cells does not reveal recognizable domains of intramembrane particles. However, in cells where the aggregation of intramembrane particles is induced by incubation with glycerol, colloidal gold-labeled CD3 and CD4 molecules are seen confined to particulate domains of the membrane. Therefore, the lack of visible aggregation of intramembrane particles in patched or capped regions of the membrane implies that migration of CD3 and CD4 antigens with concentration in domains of the membrane is achieved contemporaneously with export of other non capped integral membrane proteins from the same regions, in a process of diffusional equilibrium. Examination of fracture-labeled specimens shows that CD4 molecules partition on fracture with the inner protoplasmic face of the plasma membrane. This partition illustrates the transmembrane attitude of the antigen molecule and is a probable consequence of interaction of the protein with other components of the membrane or with the cytoskeleton. PMID- 2783651 TI - [Effects of alkaline polypeptides, cytomedins, from the kidney tissue on the immunity and hemostasis and the course of Masugi nephritis]. AB - In vivo experiment alkaline polypeptide in kidney was established to have anticoagulant effect and increases the expression of receptors on T lymphocytes in burned patients. In the experiment renalin decreases the percentage of perished animals, normalizes the indices of homeostasis and energy metabolism in animals with the developed Mazugi nephritis. In rats, which received renalin, less proliferation of mesangial cells and the absence of balloon dystrophy was found histologically. PMID- 2783652 TI - [Lipid peroxidation in the caudate nuclei in experimental parkinsonian syndrome]. AB - Lipid peroxidation was investigated in adult (8-10 months of age) rat striatum with Parkinsonian syndrome induced by MPTP and its metabolite MPP+. MPTP 20 mg/kg i.p. 4 doses) produced a slight enhancement of lipid peroxidation and significant increase when MPP+ (0.04 mg/kg) was injected into the substantia nigra. PMID- 2783654 TI - [Phenotypic characteristics of the population of normal killers of autologous erythrocytes]. AB - The presence of antigenic markers of T-lymphocytes (Thy-1, HKO-10, HKO-11 antigens) in phenotype of normal killers of autologous erythrocytes (NKAE) has been shown. Heterogeneity of NKAE in respect to sensitivity to PHA activating the cytotoxic activity of NKAE of mouse thymus and NKAE of people peripheral blood, but not NKAE of mouse bone marrow has been registered. A part of lymphocytes of T row is supposed to possess the NKAE-function and to be responsible for homeostasis of red sprout of normal hemopoiesis. PMID- 2783653 TI - [Cellular mechanisms of transitory smooth muscle contraction of the coronary arteries during hypoxia: role of intracellular Ca2+]. AB - In experiments on isolated porcine and canine coronary artery rings it was shown that vascular smooth muscle (VSM) during hypoxia (decreasing bath PO2 with 147 to 20-15 mm Hg) response to biphasic constriction-dilation reaction. Transient hypoxic contractions (THC) of VSM preserved completely in Ca2+-free solution and partially (up 50-60%) in the presence of Ca2+-channel blockers, but abolished by procaine. THC of VSM skinned by saponin significantly depressed at depletion of Ca2+-store sarcoplasmic reticulum (SR) by caffeine nd abolished after SR destruction. THC is not linked with Na+-K+-ATPase inhibition because it preserved (or increased) at ouabain treatment. THC significantly depressed under selective glycolysis blockade by monoiodoacetic acid and pyruvate and also after inositol-1 monophosphatase inhibition by lithium (the phase of hypoxic relaxation of VSM was augmented in this condition). Our results indicate that transient contraction of coronary arteries under hypoxia may be mediated mainly by release of Ca2+ from SR and linked obviously with production of inositol-1,4,5-trisphosphate. The participation of glycolysis in this process is unknown. PMID- 2783656 TI - [Biosynthetic activity of parathyroid cells during different function of the parathyroid glands]. AB - By means of autoradiograph c and morphometric methods parathyroid glands of 31 rats after single injection of 3H-leucin (2,5 mc Cu/g of body mass 25 min. before killing) were investigated. Parathyroid glands were inhibited by multiple injections of calcium gluconate solution or by a diet with increased content of calcium and vitamin D2. Parathyroids were stimulated by multiple injections of Trilon B solution, by a diet with increased content of phosphates or by subtotal parathyroid resection. Straight correlation between parathyroid function, average section area of parathyrocytes and average number of silver granules per one parathyrocyte was revealed. Hence, average section area of parathyrocytes is objective morphometric criterion of parathyroid function. PMID- 2783655 TI - [Panel of monoclonal antibodies to CD38 antigen]. AB - The panel of monoclonal antibodies (MCA) ICO-16, ICO-17, ICO-18, ICO-19, ICO-20, ICO-27, ICO-28 IgG2a isotypes to CD38 antigen was obtained. MCA discovered the antigen with 45 kD molecular mass, expressed on the surface of 100% thymocytes, 43-53% lymphocytes, 32-46% monocytes. All obtained MCA blocked the binding each other with thymocyte of man. MCA reacts in complement-dependent cytotoxic test. The antigen CD38 is expressed on blast cells of patients with T-cells subset of ALL. PMID- 2783658 TI - In situ immunologic characterization of cutaneous involvement in Hodgkin's disease. AB - The current study assesses in situ the antigenic phenotype of cutaneous infiltrate in two cases of Hodgkin's disease affecting the skin. Immunostaining utilized monoclonal antibodies for T-lymphocyte and B-lymphocyte and mononuclear phagocyte markers. The same immunophenotypic pattern of cutaneous infiltrate was observed in both cases, despite a different histopathologic subtype (mixed cellularity in case one, nodular sclerosis in case two). The majority of infiltrating cells expressed T-lymphocyte markers, with a predominance of CD8+ phenotype. Few cells bore B-lymphocyte markers or had DRC-1+ phenotype. No CD1a+ dendritic cell was found in the dermal infiltrate. Variable numbers of cells reacted with mononuclear phagocyte markers. The authors believe that the antigenic phenotype of cutaneous Hodgkin's disease has not previously been reported. The immunophenotypic pattern of skin infiltrate is different from that described in lymphoid tissues. Such findings could be related to the previous therapy or to the possible influence of skin microenvironment. PMID- 2783657 TI - Recombinant human interleukin-2-induced mitogenic proliferation of in vitro unstimulated bovine intestinal lymphocytes. AB - Recombinant human interleukin-2 (rHIL-2) in the absence or presence of additional stimuli, was able to induce and support the proliferation of lymphocytes isolated from the intra-epithelium, lamina propria and Peyer's patches of the small intestine of normal adult cows. Although dose-dependent effects of rHIL-2 were observed with all three cell populations, concentrations as low as 2.5 U/mL were able to induce DNA synthesis as measured by tritiated thymidine incorporation. Furthermore, rHIL-2 as low as 5.0 U/mL was shown to significantly enhance lymphocyte proliferation in response to mitogenic stimulation. These proliferative responses to rHIL-2 were detected within two days of culture and peaked after five days. Although the extent of the blastogenic response was variable in individual animals, the general pattern of time-course and dose response to rHIL-2 was similar in all animals tested. The response of all three leukocyte populations to rHIL-2 was dependent on the presence of adherent accessory cells and/or 2-mercaptoethanol. Both nylon wool nonadherent (T cells, null cells) and adherent cells (B cells) were shown to be responsive to rHIL-2. These studies demonstrate that bovine lymphocytes isolated from different anatomical locations of the small intestine are capable of proliferation in response to xenogenic IL-2 without in vitro preactivation signals.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2783659 TI - Poor prognosis of mediastinal non-Hodgkin's lymphoma with an immature phenotype of CD2+, CD7 (or CD5)+, CD3-, CD4-, and CD8-. AB - Nine children with mediastinal non-Hodgkin's lymphoma (NHL) were treated according to our new regimen which is characterized by intensified therapy with high-dose cytosine arabinoside (HDCA). After induction therapy with a combination of five drugs, such as vincristine, doxorubicin, cyclophosphamide, 1 asparaginase, and prednisolone, intermediate dosages of methotrexate (MTX) (1 g/m2) and HDCA (1.5 g/m2 x 12 doses) were administered. All but one patient (88.9%) achieved complete remission and then received this intensified therapy. With a median follow-up period of 25.5 months, five patients are still in complete remission, but three patients have relapsed. From the phenotypic point of view, these relapsed patients showed only very immature T-cell differentiation antigens such as CD2 and CD7 (or CD5). These results suggest that HDCA as intensified therapy for children with mediastinal NHL seems to be effective. However, for patients with an immature phenotype of T-lineage cells, more sophisticated regimens should be prepared. PMID- 2783660 TI - Correlation of chromosome abnormalities with clinical characteristics in thyroid lymphoma. AB - Karyotypes from seven patients with thyroid lymphoma were studied before treatment. When the cytogenetic results were correlated with the clinical data, it became evident that there are two distinct groups of patients with thyroid lymphoma. In a group of patients with solely numerical abnormalities the disease is associated with a rather long duration from the onset of goiter to the time of operation for lymphoma, with abnormal thyroid function, and with positive tests for antithyroid autoantibodies. Two of four patients in this group showed trisomy 22; the remaining two showed a loss of a sex chromosome. The other group of patients with solely structural abnormalities is associated with a short duration from the onset of goiter to the time of operation, with normal thyroid function, and with the trend of negative tests for autoantibodies. Two of three patients in this group showed a 14q+ abnormality. These results indicate that there are two distinct type of thyroid lymphoma, chromosomal changes of which are implicated as pathogenetic factors in lymphomagenesis of different mechanisms. PMID- 2783661 TI - Spontaneous secretion of tumor necrosis factor-beta by human myeloma cell lines. AB - Abnormal bone remodelling in the vicinity of tumor cells is a common, early feature of multiple myeloma, characterized by excessive bone resorption which is mediated by local soluble factors called osteoclast activating factors (OAF). Since interleukin-1 (IL-1) and tumor necrosis factors (TNF) are potent, synergistic OAF produced by cells of the B-cell lineage, the authors investigated the spontaneous secretion of these cytokines by 11 human myeloma cell lines (HMCL). No HMCL secreted either IL-1, the most powerful OAF, or contra IL-1. In contrast, all of the lymphoblastoid cell lines assayed produced significant IL-1 activity. Ten of the 11 HMCL secreted a significant TNF activity. This was completely eliminated by an anti-TNF beta monoclonal antibody but not affected by an anti-TNF alpha antiserum. The data from this study suggest that TNF beta is involved in myeloma bone resorption, but not IL-1, which is, however, known as one of the most potent OAF. PMID- 2783662 TI - Suppression of experimental allergic encephalomyelitis in rats by mercuric chloride. AB - Brown-Norway (BN) rats are uniquely susceptible to development of autoimmune phenomena and enlargement of lymph nodes and spleen after repeated injections of mercuric chloride. Despite its ability to produce autoimmunity, HgCl2 inhibited the development in BN rats of experimental allergic encephalomyelitis (EAE), another autoimmune process. The inhibition by mercury was probably due to lack of the normal absorption and granulomatous reaction to the EAE inoculum in the enlarged lymph nodes draining the inoculation site. Lewis rats did not develop enlarged nodes from HgCl2 treatment. Lewis lymph nodes absorbed the EAE inoculum abundantly and developed an extensive granulomatous reaction despite the mercury treatment, and there was only a slight inhibition of EAE. Therefore, the ability of HgCl2 to produce lymphadenopathy in BN rats may be responsible for the inability of these rats to absorb the inoculated antigen. The mercury-induced failure of absorption was manifested as an inhibition of EAE in BN rats. PMID- 2783663 TI - Effects of tracheal extubation on coronary blood flow, myocardial metabolism and systemic haemodynamic responses. AB - Global coronary blood flow and metabolism were measured in seven patients on the first postoperative day following coronary revascularization to test the hypothesis that tracheal extubation produces adverse haemodynamic responses akin to those observed during tracheal intubation. Regional coronary flow and metabolic measurements were made in five of the seven patients. Extubation from a continuous positive airway pressure (CPAP) of 5 cm H2O was associated with a statistically significant rise in cardiac index from 3.44 +/- 0.23 L.min-1.m-2 to 3.73 +/- 0.15 L.min-1.m-2 related to an increase in stroke index, without significant changes in heart rate, mean arterial and pulmonary capillary wedge pressure. Consequently the changes in myocardial oxygen consumption (8.52 +/- 0.55 to 8.85 +/- 0.93 ml.min-1) and coronary blood flow (172 +/- 18 to 179 +/- 17 ml.min-1) were less prominent than those reported during intubation, where substantial rises in myocardial oxygen consumption and coronary flow occurred. Two patients experienced cardiac lactate production but there were no changes in systemic or coronary haemodynamics, nor were there clinical or electrocardiographic signs of ischaemia. We conclude that extubation does not appear to be associated with adverse systemic or coronary haemodynamic responses in patients following coronary bypass grafting. However, the revascularized myocardium may remain vulnerable to anaerobic metabolism in the immediate postoperative period. PMID- 2783664 TI - Alpha-amylase determination with the Reflotron reagent carrier system: use of whole blood, plasma, and serum, and effect of isoenzymes. AB - In the Reflotron Amylase dry-reagent carrier system (Boehringer Mannheim GmbH) a new substrate is used for determining total amylase (EC 3.2.1.1) activity:indolyl alpha-D-maltoheptaoside. The procedure shows low imprecision (median CV less than 3.2%), and results for sera, plasma, and capillary and venous blood (y) correlate well with those of a conventional alpha-amylase method involving p-nitrophenyl (PNP)-maltoheptaoside substrate (x) (for 209 blood samples: y = 0.981x + 9.7; r = 0.994). Correlation was also excellent with a method involving maltotetraose as substrate (r = 0.987). Attachment of an indoxyl residue rather than a PNP group to the maltoheptaoside did not affect the substrate response to pancreatic or salivary isoenzyme activity. Therefore, the relative proportion of these isoenzymes did not affect the correlation between the Reflotron Amylase reagent carrier and the alpha-amylase PNP-maltoheptaoside method. With a reaction time of less than 3 min, this system is especially suitable for amylase determination in situations where a prompt result is required. PMID- 2783666 TI - Induction of human B cell differentiation by Fc region activators. I. Identification of an active tetrapeptide. AB - Addition of pFc' fragments, composed of residues 334 to 446 in the Fc region of human IgG1, to cultures of human peripheral blood mononuclear cells resulted in the induction of Ig-secreting cells (ISC). Intact IgG1 and F(ab')2 fragments were inactive. The synthetic peptide p23, representing residues 335 to 357, retained the ISC-inducing property of pFc' fragments. The ISC response to p23 exhibited the isotype pattern IgMSC greater than IgGSC greater than or equal to IgASC. Results from cell depletion experiments revealed that the B cell response to p23 was T cell dependent but relatively monocyte independent. Cell proliferation was not increased in p23-stimulated PBMC cultures. Overlapping synthetic peptides based on the sequence of p23 were used to localize the active site in this molecule. These studies revealed that LPPSR (residues 351 to 355) was the sequence responsible for the ISC-inducing property of p23; however, expression of activity by this pentapeptide sequence could be dampened by N-flanking sequences. Finally, residue-deleted analogs of LPPSR were used to determine that LPPS was the minimum sequence retaining activity. Collectively, these data suggest that the fragmentation of IgG results in the expression of a tetrapeptide sequence with lymphocyte-stimulating properties. PMID- 2783665 TI - Adoptive immunotherapy with IL-2 results in the loss of delayed-type hypersensitivity responses and the development of immediate hypersensitivity to recall antigens. AB - Skin testing represents a direct method of assessing immune responses in vivo. Twenty-six patients with metastatic cancer of the lung, kidney, or melanoma were treated with adoptive transfers of autologous tumor-infiltrating or blood lymphocytes and continuous infusions of interleukin-2 (IL-2). Prior to therapy, cutaneous anergy to recall antigens was observed in 19 patients (73%), whereas 6 (27%) displayed normal delayed-type hypersensitivity (DTH) responses. When tested again at the end of therapy, DTH responses could not be elicited in any of the patients. Proliferative responses to skin test antigens, lectins, and IL-2 diminished progressively during therapy but returned to baseline values at 1 month. Unexpectedly, 14 of these patients (53%) developed immediate skin test responses to candida antigens and 5 (19%) to mumps antigens. These immediate responses were characterized by local erythema and induration that developed within minutes of injecting antigen. Biopsies displayed marked dermal edema and infiltration by eosinophils. Although serum IgE levels were not increased, immediate reactivity could be transferred by a heat-sensitive serum factor. The implications of this novel response are uncertain, and its development did not correlate directly with the anti-tumor effects of therapy. We conclude that adoptive immunotherapy with IL-2 produces a reduction in cutaneous DTH and diminished responses to mitogens while simultaneously promoting cutaneous allergy. We hypothesize that this may reflect diminished IL-2 production by antigen-specific helper T cells and that other lymphokines may promote these immediate hypersensitivity responses. PMID- 2783667 TI - The effect of withdrawal of phenacetin-containing analgesics on the incidence of kidney and urothelial cancer and renal failure. AB - Incidence data for cancers of the kidney and urinary tract (1973-83) and for end stage renal failure (ESRF) due to analgesic nephropathy (1973-86) were examined by loglinear regression to determine the effect of the withdrawal of phenacetin from analgesic preparations in New South Wales and the Australian Capital Territory. Allowing for the altered age and sex structure of the population, the incidence rate between 1973-83 for ESRF due to analgesic nephropathy, in persons aged between 5 and 54 years, decreased by 4.2% per year while that for ESRF excluding patients with analgesic nephropathy or diabetes increased annually by 1.3%. The incidence rates in persons over 14 years of age for cancer of the renal parenchyma (3.4% per year), renal pelvis (5.5%) and bladder (2.1%) increased significantly more than that for cancer at all sites (1.2%). Thus the decrease in ESRF due to analgesic nephropathy had not, by 1983, been paralleled by a decrease in renal parenchymal or urothelial cancer. PMID- 2783668 TI - Irreversible ocular toxicity from single "challenge" dose of deferoxamine. AB - Deferoxamine is a chelating agent used in the treatment of transfusional iron overload and more recently in the diagnosis and treatment of increased aluminum body stores in chronic renal failure patients. High dose chronic and short-term treatment has been associated with ocular toxicity. We present a case of irreversible visual loss that occurred with a single small "challenge" dose of deferoxamine. PMID- 2783669 TI - Occult gastrointestinal bleeding in high-risk intensive care unit patients receiving antacid prophylaxis: frequency and significance. AB - Gastroccult reagent was used every 4 h to detect blood in gastric juice in 41 ICU patients at risk of GI bleeding (GB) and receiving antacid prophylaxis (gastric pH greater than 3.5). Of the present patients, 27% (11/41) had at least one episode of occult GB (three consecutive positive determinations; a total of 14 episodes). Endoscopy identified acute gastroduodenal mucosal lesions (stress ulcers) as the most frequent lesion in this group (eight patients). Sepsis was the most frequent underlying condition associated with occult GB due to stress ulcer. Hematemesis occurred in 36% (4/11) of patients with occult GB and was due to stress ulcer in three patients and to benign gastric tumor in one. No overt GB occurred in the absence of previous occult GB. We conclude that: a) risk of GB persists in critically ill ICU patients in spite of antacid prophylaxis (gastric pH greater than 3.5); b) high-risk patients can be identified through periodic testing for the presence of blood in gastric juice using the reagent; c) when occult GB occurs, treatment should be based on the endoscopy results. In the absence of acute gastroduodenal mucosal lesions, antacid prophylaxis should not be modified, and specific treatment of the identified lesion(s) should be initiated. In the presence of stress lesions, antacid prophylaxis should be reinforced if the pH of the gastric content is less than 3.5 and a septic complication should be actively sought if the pH is greater than 3.5. PMID- 2783670 TI - Pericardial effusion mimicking left atrial thrombus after coronary bypass surgery. AB - This report describes a patient in whom pericardial effusion, two months after coronary bypass surgery, mimicked the presence of a left atrial mass on both echocardiography and cardiac angiography. PMID- 2783671 TI - Submucosal arterial malformation of the colon with massive hemorrhage. Report of a case. AB - The case of a 60-year-old man with massive lower intestinal bleeding, secondary to erosion of an abnormally large submucosal muscular artery in the ascending colon, is reported. The bleeding site was localized by angiography. The clinicopathologic presentation of this case is identical to Dieulafoy's disease, which occurs almost exclusively in the stomach. Three similar patients with lesions also located in the ascending colon have been reported in the English medical literature. PMID- 2783673 TI - Induction of expression of protein disulphide-isomerase during lymphocyte maturation stimulated by bacterial lipopolysaccharide. AB - Protein disulphide-isomerase (PDI) activity, and the level of immunodetectable PDI protein, were monitored in splenic lymphocytes and in BCL1 cells during culture in the presence of various activating factors. Bacterial lipopolysaccharide stimulated induction of PDI in splenic B cells and BCL1 cells. The time-course and specificity of induction indicated that the increase in expression of PDI is closely coupled to the final stages of B cell differentiation into antibody-producing plasma cells. The system will prove valuable in studies on the control of expression of PDI. PMID- 2783672 TI - Interleukin-1 and tumor necrosis factor production in acute non-lymphoid leukemia. AB - We have investigated interleukin-1 (IL-1) and tumor necrosis factor (TNF) release in 20 patients with acute non-lymphoid leukemia (ANLL) after culture with bacterial lipopolysaccharide (LPS) or in the absence of deliberate stimulation. IL-1 and TNF were identified by appropriate bioassays inhibitable by specific antibodies. The capacity to produce IL-1 was expressed by most ANLL cases investigated irrespective of the FAB (French, American, British) subtype. However, the M4 and M5 cases tended to be better producers of IL-1 than M1-M3 cases. In contrast, TNF release was only restricted to M5 leukemias (3 out of 4 cases examined). Cytokine production may therefore provide additional criteria for a functional classification of ANLL. A considerable proportion of ANLL cases (7/18 bone marrow samples and 12/20 blood samples) released appreciable quantities of IL-1 in culture in the absence of deliberate stimulation. "Spontaneous" TNF production was also detected in 1 out of 3 M5 cases. Cells were cultured under LPS-negative conditions and polymixin B did not affect spontaneous cytokine release. Moreover, Northern blot analysis showed that freshly isolated, non-cultured ANLL cells expressed IL-1 beta transcripts. Inasmuch as IL-1 is responsible for hemopoietin-1 activity and IL-1 induces colony stimulating factor production in various cell types, the observation of IL-1 production in ANLL suggests that this mediator may be involved in regulatory amplifying circuits of leukemic cell proliferation. PMID- 2783674 TI - Interaction between bacteriophage T4 coded gene 32 protein and poly(rA). AB - The cooperative binding of T4 gene 32 protein with polynucleotides, of which the quantitative aspects in the literature have not satisfied the requirements of thermodynamics, is studied by adopting a modified formula of the lattice theory. A moderate value is found for the cooperativity parameter (q approximately 200 at 0.2 M NaCl), which is weakly dependent on salt concentration. The cation effect on the binding suggests that the shielding of negative charges of the protein or a loose cation bridge between the bound protein molecules plays a role in the cooperative binding process. PMID- 2783676 TI - Influence of legume intake on biliary lipids and cholesterol saturation in young Chilean men. Identification of a dietary risk factor for cholesterol gallstone formation in a highly prevalent area. AB - Chileans and North American Indians have one of the highest prevalence rates of cholesterol gallstones in the world. The most common theory to explain this has been the operation of some as yet undefined genetic risk factor in these populations. Searching for some common environmental factor for gallstones in Chileans and North American Indians, we found that beans and other legumes are common foods consumed by both populations. In this study we tested the hypothesis that legume intake may favor the production of biliary cholesterol supersaturation. We studied 20 young men subjected to a diet containing 120 g/day of legumes and a control diet without legumes for a period of 1 mo each. Both diets supplied identical quantities of energy, carbohydrates, protein, total fat, fiber, and cholesterol. Low-density lipoprotein cholesterol concentration decreased by 16% (p less than 0.001) after the legume diet. Biliary cholesterol saturation increased in 19 of the 20 subjects; the mean of the group markedly increased from 110% to 169% (p less than 0.001) after the legume diet. These results are consistent with the hypothesis that legume intake is a potential risk factor for cholesterol gallstone disease. PMID- 2783675 TI - Modification of tissue-factor mRNA and protein response to thrombin and interleukin 1 by high glucose in cultured human endothelial cells. AB - Because diabetic vascular disease is accompanied by a state of hypercoagulability, manifested by increased thrombin activity and foci of intravascular coagulation, we investigated whether a specific procoagulant property of the endothelium--production and surface expression of tissue factor- is modified by elevated glucose concentrations. In unperturbed human vascular endothelial cells, tissue factor mRNA and expression of the functional protein were undetectable and were not induced by 10-12 days of exposure to 30 mM glucose. In thrombin-stimulated cultures, tissue-factor expression was related inversely to cellular density, with confluent cultures producing (per 10(5) cells) half the amount of tissue factor measured in sparse cultures. Cells exposed to high glucose and studied when cell number and thymidine incorporation were identical to control cells manifested increased tissue-factor mRNA level and functional protein production in response to thrombin (P = .002). This effect was not attributable to hypertonicity and was not observed after short exposure to high glucose. In contrast, the tissue-factor response to interleukin 1, a modulator of endothelial function in the context of host defense, was decreased in cells cultured in high glucose (P = .04). These findings indicate that exposure to high glucose can alter tissue-factor gene expression in perturbed vascular endothelium. The reciprocal effects of high glucose on the tissue-factor response to thrombin and interleukin 1 points to different pathways of tissue factor stimulation by the two agents and suggests functional consequences pertinent to the increased thrombin activity and compromised host-defense mechanisms observed in diabetes. PMID- 2783677 TI - Endoscopic measurement of variceal pressure in cirrhosis: correlation with portal pressure and variceal hemorrhage. AB - This study evaluated the clinical application of a pressure-sensitive gauge that allows the noninvasive measurement of the pressure of esophageal varices at endoscopy. The study was performed in 70 patients with cirrhosis and portal hypertension. Among them, 47 had bled from the varices and 23 had varices but had not bled. In addition to measurements of variceal pressure, the size of the varices was estimated semiquantitatively at endoscopy. This allowed an estimate of the tension on the wall of the varices as the product of the transmural pressure and the estimated radius of the varices. Most patients had a standard hemodynamic evaluation of portal hypertension, with measurements of wedged and free hepatic venous pressures, and of azygos blood flow. These were performed within 24 h of the variceal pressure measurements. Variceal pressure was significantly higher in bleeders than in nonbleeders (15.7 +/- 2.8 vs. 12.1 +/- 2.6 mmHg, p less than 0.001) in spite of a similar portal pressure in both groups (20.1 +/- 5.1 vs. 20.4 +/- 7.6 mmHg, NS). More than 60% of the bleeders, but only 22% of the nonbleeders had a variceal pressure greater than or equal to 15 mmHg (p less than 0.005). Among nonbleeders, variceal pressure was higher in patients with large varices (13.9 +/- 2 mmHg, n = 9) than in those with small varices (10.9 +/- 2.4 mmHg, n = 14) (p less than 0.01). Estimates of variceal wall tension further exaggerated the differences between bleeders and nonbleeders (66.1 +/- 22.6 vs. 32.0 +/- 19.8 mmHg.mm, p less than 0.001). More than 50% of bleeders, but just 9% of nonbleeders had an estimated variceal tension greater than 50 mmHg.mm (p less than 0.001). Our findings support the role of an increased variceal pressure in the pathogenesis of variceal hemorrhage, and suggest that this noninvasive technique can be valuable in assessing the risk of variceal hemorrhage in patients with portal hypertension. PMID- 2783678 TI - Comparison of three nonsurgical treatments for bleeding esophageal varices. AB - Ninety-seven patients with recent or active variceal bleeding were randomly assigned to oral propranolol, endoscopic sclerotherapy plus oral propranolol, or transhepatic sclerotherapy plus oral propranolol. The effects of treatment on the number of units transfused, rebleeding of any magnitude, major rebleeding, and death were assessed in these patients, 82% of whom were alcoholic and 81% Child's Class C. After a minimum follow-up interval of 2 yr (range, 27-65 mo), major rebleeding rates were 65% for propranolol alone, 45% for endoscopic sclerotherapy plus propranolol, and 60% for transhepatic sclerotherapy plus propranolol. The corresponding death rates were 81% for propranolol alone, 55% for endoscopic sclerotherapy plus propranolol, and 66% for transhepatic sclerotherapy plus propranolol (p = 0.03). Thirty-three patients (34%) never received propranolol; 8 due to medical contraindications and 25 because they died or bled enough to meet the definition of treatment failure within 3 or 4 days of randomizations (no significant differences among treatment groups). Patients assigned to propranolol alone bled sooner, bled more units, and had a higher mortality rate than patients treated by endoscopic sclerotherapy plus propranolol. Patients treated with transhepatic sclerotherapy plus propranolol had intermediate results. Propranolol alone is inadequate treatment for esophageal variceal bleeding in patients with advanced liver disease. PMID- 2783679 TI - Frequent recombination is observed in the distal end of the long arm of chromosome 14. AB - We have constructed a high-resolution map of the distal region (q32) of the long arm of human chromosome 14, with 11 loci including 6 variable number of tandem repeat markers. The map covers 66 cM in males and 53 cM in females. The recombination frequency in this region is more than five times that expected in a region of this physical size, and in our data set the frequency in males was higher than that in females at some intervals. This unusually high density of crossingover occurs in a part of chromosome 14 where translocations are frequently observed in somatic cells. PMID- 2783680 TI - An Oriental HLA-A2 subtype is closely related to a subset of Caucasoid HLA-A2 alleles. PMID- 2783681 TI - T cell-recognized antigenic peptides derived from the cellular genome are not protein degradation products but can be generated directly by transcription and translation of short subgenic regions. A hypothesis. AB - It is now widely accepted that cytolytic T cells recognize their antigens in the form of small peptides bound to major histocompatibility complex molecules at the surface of the target cells. We present here the hypothesis that, when these antigenic peptides are derived from the cellular genome, they are not degradation products of cellular proteins but can be generated directly by the autonomous transcription and translation of short subgenic regions that we propose to name "peptons". We discuss some consequences of the notion that antigenic peptides can be produced in the absence of synthesis of messenger RNA and protein from the corresponding genes. PMID- 2783683 TI - Bleeding gastric varices without obvious esophageal varices due to hepatic schistosomiasis. PMID- 2783682 TI - Post sclerotherapy esophageal ulcers: a prospective analysis of their behaviour. AB - The reported incidence of post sclerotherapy esophageal ulcers has shown marked variation, possibly due to lack of uniform criteria for their diagnosis. Using fixed criteria (size greater than or equal to 5 mm, duration greater than or equal to 2 weeks), we prospectively studied 82 patients with portal hypertension, who underwent four or more sessions of endoscopic sclerotherapy (EST), for the occurrence and behaviour of these ulcers. Post sclerotherapy ulcers occurred after 43 (9.2%) of 465 EST sessions in 30 (36.6%) of 82 patients. Ulcers were significantly associated with two complications: rebleed during the course of sclerotherapy (33% of ulcers bled compared to 3% from variceal rupture; p less than 0.001) and esophageal stricture formation (66.7% of strictures occurred in patients who had ulcers; p less than 0.05). Ulcers occurred more frequently in patients with poor liver function (61.5% in Child's C grade compared with 31.9% in Child's A or B grades; p less than 0.05) and after injection into larger varices (83.7% in varices grades 3 and 4, 16.3% in lower grades; p less than 0.005). Severe persistent chest pain (p less than 0.001) and pyrexia (p less than 0.01) after sclerotherapy were clinical pointers of ulcerogenesis. PMID- 2783684 TI - Carcinoma of tail of pancreas presenting with intra-abdominal hemorrhage. PMID- 2783685 TI - Prevalence of human immunodeficiency virus infection among voluntary blood donors. AB - HIV infection was found among voluntary blood donors at the Christian Medical College Hospital, Vellore (south India), the prevalence rate of infection among these donors being 1.63 per 1000. Based on these findings, the authors recommend that appropriate steps be taken immediately by all blood transfusion centres in India to evaluate the prevalence of HIV infection among blood donors and to prevent the transmission of the infection through blood transfusion. PMID- 2783686 TI - Epidemiology & clinical profile of genital herpes. AB - During 1983-86, genital herpes (GH) was diagnosed in 225 (19%) of 1194 patients attending the STD clinic, attached to a Medical College in south India. The patients included 169 men and 56 women; 50 had primary GH and 175 had recurrent GH. The prevalence of GH in men and women did not differ significantly but the proportion of primary GH was significantly higher in women. There was no seasonal variation. The clinical epidemiology of these patients is compared with those in other countries. Virological confirmation of GH was obtained in 38 per cent of patients through culture and in a further 12 percent through serological tests. Papanicolaou smears were positive in 30 per cent men regardless of the type of GH, and in 38.5 and 7.1 per cent women with primary and recurrent GH, respectively. Cultures were positive for herpes simplex virus (HSV) in 38.7 per cent of patients with primary and 38.2 per cent with recurrent GH. Among the 52 viral isolates typed, nine of the 10 isolates from primary GH and all 42 from recurrent GH, were HSV-2. The geometric mean titres of antibody against HSV were higher in patients than in controls. PMID- 2783687 TI - The effect of gentamicin on the glycocalyx and the ciliary interconnections in vestibular sensory cells: a high resolution scanning electron microscopic investigation. AB - Changes in glycocalyx structure and ciliary interconnections of the vestibular sensory cells are demonstrated after gentamicin administration. A special high resolution scanning electron microscope and a tannic acid-osmium staining technique giving an almost three dimensional view were used to achieve this purpose. Guinea pigs were injected with a single dose of 5 mg of gentamicin directly into the middle ear. Seven days after the injection, it was possible to observe the degenerative process of the glycocalyx and the ciliary interconnections. The first detectable change was a disarrangement of the cilia with a loosening of the interconnections. The ciliary membrane presented with an irregular appearance. The tip links connecting the tips of the stereocilia to their neighbours were also affected showing elongation or even disappearance. In the later stages of the degeneration process, the sensory hairs presented with different degrees of fusion whereafter they finally disappeared totally. These findings suggest that the glycocalyx acts to maintain a normal stability and shape of the ciliary membrane and to keep the regular distance between cilia in order to maintain the arrangement of the whole ciliary bundle. Gentamicin probably affects the glycocalyx and the ciliary interconnections resulting in a disarrangement, detachment and fusion of cilia. The tip links, which are suggested to be involved in sensory cell transduction, seem to be also affected by gentamicin. PMID- 2783688 TI - Establishment of human osteoblastic cells derived from periosteum in culture. AB - We isolated osteoblastic cells derived from human periosteum and established them in culture. Their growth depended on the presence of ascorbic acid, and the doubling time was 40 to 60 h. The requirement for ascorbic acid was used to high production of collagen. These cells produced mainly type I collagen and only small amounts of type III collagen determined by reducing sodium dodecyl sulfate SDS-polyacrylamide gel electrophoresis. The total collagen yield was about 10 mg from 2 X 10(7) cells. The cells could be continuously cultured in alpha-minimum essential medium supplemented with 10% fetal bovine serum for 18 to 40 population doubling levels, depending on the age of the donated periosteum. These cells have the ability to calcify when incubated with 2 mM alpha-glycerophosphate-Na2. Calcification as viewed by the naked eye appeared from Day 15 after treatment. Treatment with the active formed vitamin D3, 1, 25 dihydroxyvitamin D3 enhanced calcification significantly and stimulated osteocalcin production. By electron microscopy, cells with many projections on their surfaces showed well-developed rough endoplasmic reticulum and actinlike fibers, and larger numbers of lysosomes, mitochondria, and secretion granules. Many matrix vesicles, in which minerals were initially localized, and well-banded collagen fibrils were seen in the intercellular spaces. These observations demonstrate typical osteoblastic morphology. The above results indicate that cultured cells from human periostem are osteoblastic cells that have the capacity to differentiate into osteocytes and to deposit calcified minerals in response to 1,25 dihydroxyvitamin D3. PMID- 2783689 TI - Susceptibility of Rhodobacter sphaeroides to beta-lactam antibiotics: isolation and characterization of a periplasmic beta-lactamase (cephalosporinase). AB - Thirteen strains of the gram-negative, facultative phototrophic bacterium Rhodobacter sphaeroides were examined fro susceptibility to beta-lactam antibiotics. All strains were sensitive to the semisynthetic penicillins ampicillin, carbenicillin, oxacillin, cloxacillin, and methicillin, but 10 of the 13 strains were resistant to penicillin G, as well as a number of cephalosporins, such as cephalothin, cephapirin, and cephalosporin C. A beta-lactamase (EC 3.5.2.6) with strong cephalosporinase activity was detected in all of the resistant strains of R. sphaeroides. With strain Y-1 as a model, it was shown that the beta-lactamase was inducible by penicillin G, cephalosporin C, cephalothin, and to some minor extent, cephapirin. The beta-lactamase was located in the periplasmic space, from which it could be extracted by osmotic shock disruption. By using this fraction, the beta-lactamase was purified 34-fold to homogeneity by steps involving batch adsorption to and elution from DEAE-Sephadex A50, chromatography on Q-Sepharose, and preparative polyacrylamide gel electrophoresis. The molecular masses of the native and denatured enzymes were determined to be 38.5 kilodaltons by gel filtration and 40.5 kilodaltons by sodium dodecyl sulfate-polyacrylamide gel electrophoresis, respectively, indicating a monomeric structure. The isoelectric point was estimated to be at pH 4.3. In Tris hydrochloride buffer, optimum enzyme activity was measured at pH 8.5. The beta-lactamase showed high activity in the presence of the substrates cephalothin, cephapirin, cephalosporin C, and penicillin G, for which the apparent Km values were 144, 100, 65, and 110 microM, respectively. Cephalexin, cepharidine, and cephaloridine were poor substrates. The beta-lactamase was strongly inhibited by cloxacillin and oxacillin but only slightly inhibited by phenylmethylsulfonyl fluoride or thiol reagents such as iodoacetate and p chloromercuribenzoate. PMID- 2783690 TI - Physiological studies of the regulation of beta-lactamase expression in Pseudomonas maltophilia. AB - The kinetics of beta-lactamase induction in Pseudomonas maltophilia IID1275/873 were investigated. Upon induction with beta-lactam antibiotics, a correlation was seen between the increase in specific beta-lactamase activity and the generation time, as well as the concentration of inducer in the medium. The specific beta lactamase activity increased slowly within the first 0.5 generation and then more rapidly; it decreased regularly after about 2 generations of growth in the presence of inducer. This decrease could presumably be attributed to the continuous breakdown of inducer by beta-lactamases in the culture medium. In a chemostat culture with continuous supply of fresh inducer-containing medium, the specific beta-lactamase activity could be stabilized at a high level over several generations. Removal of the beta-lactam after a certain induction time showed that a short exposure of the bacteria to inducer caused induction kinetics comparable to those resulting from continuous exposure of the cells to inducer. The two beta-lactamases of P. maltophilia, L1 and L2, were induced simultaneously under various experimental conditions. PMID- 2783691 TI - Regions of the rat osteocalcin gene which mediate the effect of 1,25 dihydroxyvitamin D3 on gene transcription. AB - We have cloned the genomic DNA encoding rat osteocalcin and have isolated fragments in the 5' flanking region which mediate the effects of 1,25-(OH)2D3 (1,25-dihydroxyvitamin D3) on osteocalcin gene transcription. Approximately 3 kilobase pairs of the osteocalcin gene's 5' flanking region, including the promoter and transcription start site, were fused to the reporter gene chloramphenicol acetyltransferase. Transfection into ROS 17/2.8 rat osteosarcoma cells demonstrated low level basal expression of the chloramphenicol acetyltransferase gene. The expression increased markedly in the presence of 1,25 (OH)2D3; induction was observed at doses as low as 10(-11) M 1,25-(OH)2D3. Chloramphenicol acetyltransferase activity increased as early as 16 h after stimulation with 10(-9) M 1,25-(OH)2D3. Basal chloramphenicol acetyltransferase activity in ROS 24/1 and 25/1 cells was much lower than in ROS 17/2.8 cells. In these two cell lines, there was little induction of chloramphenicol acetyltransferase activity in the presence of 10(-9) M 1,25-(OH)2D3. Deletion studies of the 5' flanking region demonstrated two regions that contribute to the induction by 1,25-(OH)2D3. Deletion of a 650-base pair fragment ending 1.4 kilobase pairs upstream from the initiator ATG led to an 80% decrease in responsiveness. Removal of an additional 1.1 kilobase pairs, leaving a 300-base pair promoter containing fragment obliterated responsiveness to 1,25-(OH)2D3. PMID- 2783692 TI - Increases in intracellular Ca2+ regulate the binding of [3H]phorbol 12,13 dibutyrate to intact 1321N1 astrocytoma cells. AB - The redistribution of protein kinase C (Ca2+/phospholipid-dependent protein kinase) from a cytosolic or a loosely associated membrane compartment to a more integral membrane compartment is stimulated by Ca2+ in vitro. This event is thought to be necessary for activation of the enzyme. To determine whether such a redistribution of protein kinase C occurs following hormonally stimulated increases in cytoplasmic Ca2+, we measured [3H]phorbol 12,13-dibutyrate ([3H]PDB) binding to protein kinase C in intact 1321N1 astrocytoma cells. The muscarinic agonist carbachol causes a 2-fold increase in [3H]PDB binding. This increase is transient, peaking at 1 min and returning toward control levels by 5 min. Scatchard analysis of [3H]PDB binding in the presence of carbachol reveals a 2 fold increase in the Bmax and no change in the KD compared to control values. This increase in Bmax likely represents a redistribution of protein kinase C to the membrane because [3H]PDB binding in intact cells is predominantly to membrane associated enzyme. The Ca2+ ionophore ionomycin, and two other Ca2+-mobilizing hormones, bradykinin and histamine, mimic the effects of carbachol. Furthermore, when hormone-sensitive Ca2+ stores are depleted by prior agonist treatment, the carbachol-induced increases in intracellular [Ca2+] and [3H]PDB binding are completely blocked. Under these conditions, phosphoinositide hydrolysis and diacylglycerol (DAG) formation are not inhibited. We also examined the time course of DAG accumulation in response to carbachol. DAG is not yet significantly elevated when the increase in [3H]PDB binding is maximal. Furthermore, [3H]PDB binding has returned to control levels when DAG concentrations are maximally elevated. These data suggest that hormone-stimulated increases in cytoplasmic Ca2+ cause a marked and rapid redistribution of protein kinase C which precedes any significant increase in DAG. Our findings also demonstrate that [3H]PDB binding to intact cells may be a useful measure of the ability of Ca2+-mobilizing hormones to affect protein kinase C. PMID- 2783693 TI - Regulation of epidermal growth factor receptor gene expression by retinoic acid and epidermal growth factor. AB - In normal rat kidney fibroblasts, retinoic acid increases the level of epidermal growth factor (EGF) binding and synergizes with EGF and transforming growth factor-beta to stimulate anchorage-independent growth. We now demonstrate that retinoids act by increasing the rate of transcription of the EGF receptor gene, resulting in elevated mRNA levels. No effect of retinoic acid on EGF receptor mRNA half-life, measured after actinomycin D treatment, was observed. In the same system, EGF was also able to increase expression of its own receptor through an elevation in mRNA levels. These effects were specific since retinoids and EGF did not alter transcript levels for fibronectin, alpha-tubulin, or beta 2 microglobulin. These results demonstrate that the EGF receptor gene is a target for regulation by multiple growth-stimulating factors. PMID- 2783694 TI - Evidence that the interferon-induced Daudi cell human lupus inclusions are de novo synthesized complexes of ribonucleoprotein and membrane. AB - Quantitative electron microscope autoradiography has been used to define the macromolecular composition of the interferon-induced human lupus-type inclusions (LI) in the human B lymphoblastoid cell line, Daudi. LI were first apparent in Daudi cell cultures 12 h after the addition of 100 units/ml of the purified recombinant human leukocyte interferon, IFLrA. Radiolabels were added at this time and allowed to incorporate over the following 12 h during which an estimated greater than 99% of the LI material present at 24 h was formed. The LI incorporated radiolabels were present only during this discrete 12-h period after the interferon activation of LI cell pathways in order to detect LIs de novo synthesized macromolecular components. The estimate relative specific activities of the LI-incorporated radiolabels were: choline at 4.042, mannose at 2.631, uridine at 0.664, glucosamine at 0.578, and amino acids at 0.477. With thymidine the estimated LI specific activity was 0.000. LI isolated from whole cells retained the tubular elements and the interwoven membrane network. These results provide direct evidence that the interferon-induced Daudi cell LI are de novo synthesized complexes of ribonucleoprotein and membrane. PMID- 2783695 TI - Serum and bone vitamin D metabolites in elective patients and patients after fracture. AB - Vitamin D metabolite levels were measured in serum and bone samples obtained from 27 patients undergoing elective bony procedures and from 28 patients operated on after a fracture. Serum 25 hydroxyvitamin D3 (25-OH-D3) and 24,25 dihydroxyvitamin D3 (24,25(OH)2D3) did not differ significantly between the elective and fracture patients, but serum 1,25-dihydroxyvitamin D3 (1,25(OH)2D3) was significantly reduced in the fracture patients. Very little 25-OH-D3 was found in bone, although it was the major vitamin D metabolite in serum (90%). In elective patients bone levels of 24,25(OH)2D3 and 1,25(OH)2D3 were similar to those in serum; however, in bone from around pertrochanteric fractures, but not from subcapital or patellar fractures, the concentrations of these compounds were considerably increased. These findings may shed light on the mechanism of callus formation and on the role of vitamin D metabolites in bone healing. PMID- 2783696 TI - Prevalence and variation of astigmatism in a military population. AB - Astigmatism is a common refractive anomaly. Observations on 1112 consecutive patients from a military optometric clinical population were taken to establish the prevalence of astigmatism and the incidence of its different variations. Astigmatism was found to exist in about 63% of the eyes. It was found that with the-rule (WTR) and against-the-rule (ATR) astigmatism were the predominant types of astigmatism, and that approximately 70% of astigmatism found required 1.00D of correcting cylinder power or less. One objective of the study was to discover if a statistically significant difference existed between right and left eyes when comparing the mean correcting minus cylinder axes for WTR, ATR, and oblique types of astigmatism. This was shown to exist for WTR and ATR astigmatism. Further studies to determine the etiology of this difference are indicated. PMID- 2783697 TI - Efficacy and tolerability of fluoxetine in the elderly: a double-blind study versus amitryptiline. AB - Twenty-eight elderly in-patients suffering from major depressive episodes received randomly, on a double-blind basis, amitryptiline or fluoxetine for 5 weeks. There were 4 drop-outs in the amitryptiline group and 2 drop-outs in the fluoxetine group. Both groups showed a significant amelioration at the end point for HRS-D scores compared to the baseline value. Anticholinergic side-effects were significantly more severe in the amitryptiline group. Weight gain was detected only in patients receiving amitryptiline. PMID- 2783698 TI - Study on performance and alcohol interaction with the antidepressant fluoxetine. PMID- 2783699 TI - A double-blind parallel study to compare fluoxetine with doxepin in the treatment of major depressive disorders. PMID- 2783700 TI - Fluoxetine versus nomifensine in outpatients with neurotic or reactive depressive disorder. PMID- 2783701 TI - A double-blind study of fluoxetine and imipramine in major depression. AB - Eighteen outpatients with major depression (diagnosis was made according to DSM III criteria) were treated in a 5-week double-blind parallel group comparison of the new antidepressant fluoxetine with imipramine. From these results it can be shown that the drugs were comparable in efficacy, although because of the small sample size a moderate clinical difference between treatments may not have been detected. Imipramine and fluoxetine have already been compared in other studies, but never at such a low dosage (20 mg) for fluoxetine. At this dosage the fluoxetine safety profile seems to be very different from previous scheduled studies with higher dosages. In fact clinical efficacy seems to remain comparable while side-effects are significantly less frequent. PMID- 2783702 TI - Interactions of alcohol with amitriptyline, fluoxetine and placebo in normal subjects. AB - Amitriptyline (up to 75 mg/day), fluoxetine (up to 40 mg/day) and placebo were administered to 12 normal, healthy subjects for a period of 7 days. Subjects received each drug in random order and a minimum of 28 days was left between drug treatments. A battery of physiological, psychomotor and subjective tests was administered before drugs (day 1) and on days 4 and 8. On day 8 a measured dose of alcohol was given and the tests repeated at 1 and 3 h after alcohol. Tests before alcohol showed little effect on physiological or psychomotor activity either between drugs or between drugs and placebo. Subjective ratings did show some differences between drugs and in general amitriptyline was tolerated less well than fluoxetine. There were few differences between drugs after alcohol but with some measures the interaction with amitriptyline was subjective rather than additive or potentiating. This reflected the already substantial effects of amitriptyline alone. PMID- 2783703 TI - Fluoxetine versus imipramine. PMID- 2783704 TI - Binding to Ia protects an immunogenic peptide from proteolytic degradation. AB - A 34 amino acid hen egg-white lysozyme (HEL) peptide was designed and synthesized to investigate if an immunogenic peptide once bound to an Ia molecule becomes proteolytically inaccessible. The determinant recognized by T cells, HEL(52-61) was composed of L-amino acids whereas the 12 amino acid extension on each side of this core were composed of D-epimers. This peptide, HEL(40-73) was resistant to proteolysis, except in the core region, where any cleavage would destroy the determinant. Initially HEL(40-73) was shown to be able to stimulate the HEL specific T cell, 3A9, indicating that an I-Ak molecule can bind and present large peptides that extend beyond the theoretical binding groove. HEL(40-73) was then used to examine the proteolytic sensitivity of determinants recognized by T cells. If HEL(40-73) was treated with chymotrypsin before binding to I-Ak, the determinant was totally destroyed; however, if HEL(40-73) was allowed to first bind to I-Ak, then the determinant became resistant to chymotrypsin cleavage. Thus an Ia molecule can protect a determinant from proteolytic degradation, a finding that has important implications for proposed pathways of Ag processing. PMID- 2783705 TI - The effect of lipopolysaccharide desensitization on the regulation of in vivo induction of immunologic tolerance and antibody production and in vitro release of IL-1. AB - As previously reported, LPS and 8-derivatized guanosine (both generators of IL-1 release), as well as IL-1 itself interfere with the in vivo induction of tolerance to DHGG in A/J mice. In the present studies it was demonstrated that desensitization of either A/J or CBA/CaJ mice with LPS aborts the ability of LPS to interfere with the induction of tolerance to DHGG. The abrogation of the ability of LPS to interfere with tolerance by LPS desensitization is not the result of neutralization of LPS by antibody produced to LPS during desensitization. Desensitization with LPS also aborts the interference with tolerance induction by 7-methyl-8-oxoguanosine. LPS desensitization inhibits the ability of LPS and/or 7-methyl-8-oxoguanosine to both convert a tolerogenic signal to an immunogenic signal and interfere with the induction of a tolerant state to a subsequent injection of Ag. The effects resulting from desensitization may be in part attributed to the depletion of IL-1. LPS desensitization also modulates the antibody response to injection of the AG, AHGG. Desensitization with LPS markedly suppresses the antibody response to a subsequent injection of AHGG in CBA/CaJ mice. Desensitization with LPS also inhibits the anti-HGG antibody response in A/J mice, but in this strain its effect is dependent on the route of injection of AHGG. In an experiment directly comparing the responses of normal and desensitized A/J mice to either intravenous or intraperitoneal injection of AHGG, desensitization only suppressed the response in mice injected with AHGG i.p.. Desensitization with LPS also inhibits the ability of LPS to act as an adjuvant in a subsequent antibody response to AHGG. Not only does desensitization interfere with the primary antibody response to AHGG, but it also interferes with the secondary response, suggesting that the primary injection after desensitization induces a state of immunologic tolerance. PMID- 2783706 TI - T cell recognition of HIV synthetic peptides in a natural infection. AB - Because T cell responses are critical for defense against viral infections, a series of synthetic peptides derived from the predicted sequence for HIV-1 proteins gp41, pg120, gag, and viral polymerase were used to test the T cell proliferative response of HIV-1 seropositive individuals. Of HIV-1-infected donors from various clinical categories 90% (27/30) had sensitized cells that proliferated in response to at least one of 21 HIV peptides tested. Cells from HIV seronegative controls did not proliferate (0/9) in response to these HIV peptides. Individuals with fewer clinical manifestations of HIV-1 disease responded to a greater number of peptides (average for asymptomatic seropositives = 8.1 peptides; AIDS patients averaged 2.0). The number of peptides recognized also correlated with absolute number of CD4+ cells, but not with delayed cutaneous hypersensitivity to a (non-HIV) battery of Ag. However, clinical stage at no time correlated with the response to any particular peptide. Response patterns differed considerably among individuals, and some peptides stimulated proliferation in many (48%) HIV-infected donors (peptides gp41-2 and pol-3), whereas another peptide elicited no T cell response in any donor tested (peptide gp120-8). We have also begun to investigate the basis for individual heterogeneity of T lymphocyte proliferative responses of HIV-infected donors to the 21 HIV synthetic peptides. Peptide structure and HLA class II determinants both influenced patterns of lymphocyte responses. Reactivity correlated with peptide size, the presence of alpha and beta secondary structure and lack of reverse turn potential. Hydropathy and charge had no predictive value. Peptides derived from HIV sequences that vary highly among strains tended to be recognized less frequently. HIV-infected lymphocyte donors were HLA typed to examine the influence of the MHC on T lymphocyte proliferation. Analysis of the frequencies of individuals reacting to specific peptides, when compared to the allele frequencies in the population at large, indicated association of some responses to DR alleles. More DR association was observed with peptides that showed "moderate" reactivity than with those that were "highly" reactive. We suggest that highly reactive peptides are capable of forming a structure closer to an "ideal" T cell epitope that can associate with many DR alleles. In contrast, "moderately" reactive determinants have less favorable structures for interaction, are more limited in their ability to interact and therefore show more restriction to specific class II alleles. PMID- 2783707 TI - Thymic stroma-derived T cell growth factor (TSTGF). IV. Capacity of TSTGF to promote the growth of L3T4- Lyt-2- thymocytes by synergy with phorbol myristate acetate or various IL. AB - The present study investigates the role of thymic stroma-derived T cell growth factor (TSTGF) in promoting the growth of L3T4- Lyt2- (double-negative) thymocytes. Partially purified TSTGF samples were prepared from the culture supernatant of a newly established thymic stromal cell line, MRL104.8a. The TSTGF alone induced only marginal proliferation of double-negative thymocytes, whereas this factor exerted a potent growth-promoting effect on these cells in combination with PMA. Because such an enhanced proliferation was not inhibited by anti-IL-4 or anti-IL-2R antibody, this was not due to the stimulation of an autocrine mechanism involving the production and utilization of IL-4 or IL-2. In scrutinizing PMA-equivalent physiologic substance(s), IL-1 was revealed to be capable of replacing the role of PMA in the above co-stimulation cultures and including enhanced proliferation of double-negative thymocytes in combination with TSTGF. Although TSTGF plus IL-2 or IL-4 also exhibited an appreciable or moderate synergistic effect on the growth of double-negative thymocytes, its magnitude was weaker compared with that obtained by TSTGF plus IL-1. More important, the strikingly enhanced proliferation was induced in the combinations of TSTGF, IL-1, and IL-2 or IL-4 under conditions in which the proliferation induced by IL-1 plus IL-4 or IL-1 plus IL-2 was marginal or slight. Furthermore, such strongly enhanced proliferation was also observed in the double-negative thymocyte population which was additionally depleted of T3+ cells (namely, the L3T4- Lyt-2- T3- or dull population). These results indicate the crucial role of TSTGF in the proliferation of immature thymocytes by synergy with various cytokines. PMID- 2783708 TI - The activation of IL-2 transcription in L3T4+ and Lyt-2+ lymphocytes during virus infection in vivo. AB - During infection of mice with lymphocytic choriomeningitis virus (LCMV), activation and proliferation of NK cells occurs early, followed by the activation and proliferation of CTL. To investigate the role of endogenously produced growth factors in mediating proliferation of these effector cell types, the transcription of IL-2 during infection was studied. We report that IL-2 is transcribed in vivo by mouse spleen cells during infection with LCMV. The time course of transcription corresponds to CTL activation, to the accumulation of Lyt 2+ and L3T4+ T cells in the spleen, to the incorporation of [3H]TdR by B cell depleted spleen lymphocytes, and to production of IL-2 by these cells. At the peak of CTL activation and proliferation, both Lyt-2+ and L3T4+ populations transcribed IL-2. The results strongly support a role for IL-2 in mediating CTL proliferation during LCMV infection. Furthermore, the results demonstrate that Lyt-2+ cells can transcribe helper factors such as IL-2 in vivo, which may act to promote endogenous effector cell proliferation. PMID- 2783709 TI - Regulation of parasite antigen-induced T cell growth factor activity and proliferative responsiveness in Brugia pahangi-infected jirds. AB - Previous studies have demonstrated that the induction of immunoregulatory mechanisms in the spleens of Brugia pahangi-infected jirds is correlated with the onset of microfilaremia. This study investigated the relationship between production of a factor with IL-2-like activity and the regulation of T cell mediated responses in jirds experimentally infected with B. pahangi. A factor present in culture supernatants of mitogen-stimulated jird lymphocytes supported the proliferation of murine CTLL cells and provided the basis for an IL-2 assay. Mitogen induced proliferative responses and IL-2 production of spleen cells but not lymph node cells from pre-patent and microfilaremic jirds were suppressed. Both B. pahangi Ag-induced proliferative responsiveness and IL-2 production of spleen cells from microfilaremic jirds were also suppressed relative to lymph node cells from the same animals or spleen cells from B. pahangi immunized or prepatent jirds. Depletion of histamine receptor-bearing cells restored the ability of spleen cells from microfilaremic jirds to produce significant levels of IL-2. In addition, in add-mixture experiments, spleen cells from microfilaremic jirds suppressed Ag-induced IL-2 production by cells from either B. pahangi- or KHL-immunized jirds. Exogenous IL-2 failed to reconstitute the suppressed Ag-induced proliferative response of spleen cells from microfilaremic jirds. This study demonstrates that the down-regulation of immune responses in B. pahangi infection is a cell-mediated event and is associated with an inability to produce IL-2. PMID- 2783710 TI - MHC and non-MHC genes regulate elimination of lymphocytic choriomeningitis virus and antiviral cytotoxic T lymphocyte and delayed-type hypersensitivity mediating T lymphocyte activity in parallel. AB - The course of systemic infection with lymphocytic choriomeningitis virus was studied in mouse strains differing in the MHC or non-MHC background. Virus clearance rates differed significantly between H-2 identical strains as well as between congenic strains differing in the H-2L subregion, indicating that both H 2 and non-H-2 genes may influence the elimination of this virus. Differences in virus spread prior to appearance of the immune response could not explain the observed differences in clearance rate. On the other hand, inefficient clearance always correlated with low T cell responsiveness measured in terms of virus specific cytotoxicity and delayed-type hypersensitivity, whereas no correlation was found with regard to NK cell activity and antiviral antibody response. Analysis of F1 progeny between H-2 identical high and low responder strains showed that low responsiveness with regard to all three parameters was recessive, indicating that natural tolerance is not the mechanism explaining non-MHC dependent low responsiveness in this system. The implications of these findings are discussed with specific reference to the role of MHC genes in controlling resistance to infectious diseases. PMID- 2783711 TI - Prevalence of antigen receptor variants in human T cell lines and tumors. AB - Previously, we have shown that a human T acute lymphoblastic leukemia cell line, HPB-ALL, exhibits clonal heterogeneity within its Ag receptor, as revealed by varying reactivity patterns with a panel of anti-idiotype mAb. We now extend these findings to another human T acute lymphoblastic leukemia cell line, SUP T13, and to two fresh human chronic lymphocytic leukemias, JE and EF. In the two cell lines, two types of Ag receptor variants could be found: those that retained a receptor molecule but lost reactivity with an anti-idiotype mAb (idiotype variants), and those which had lost surface receptor expression completely (receptor-negative variants). The idiotype variants, at least in HPB-ALL, have differentially glycosylated receptor alpha-chains from the parent. The receptor negative cells, in HPB-ALL as well as in SUP-T13, produce cytoplasmic receptor and CD3 proteins but do not transport them to the surface. Neither idiotype nor receptor-negative variants could be detected in either of the fresh tumors of chronic lymphocytic leukemias. The limit of sensitivity in these analyses was about 0.05%. We conclude that antigen receptor variants can spontaneously occur in cell lines derived from acute lymphoblastic leukemias, but are infrequent in chronic lymphocytic leukemias in vivo, and that therapy with anti-idiotype mAb may be a viable strategy for these malignancies. PMID- 2783712 TI - Specific detection of antibodies in cancer patients following immunotherapy with anti-idiotype. AB - Assays were compared for specificity and sensitivity in detecting in cancer patients' sera antibodies (Ab) raised during the course of immunotherapy with goat anti-idiotypic antibodies (Ab2) bearing the internal image of a colon carcinoma-associated antigen defined by monoclonal antibody (MAb) CO17-1A (Ab1). The human Ab were tested for binding to tumor cells, isolated tumor antigen (Ag), and Ab2, and for the capacity to inhibit binding of Ab2 to Ab1. Chimeric (human/mouse) MAb CO17-1A was used as a positive control in all assays. Of the four different cell binding assays used, the mixed hemadsorption assay (MHA) showed the highest specificity and sensitivity. For detection of Ag-binding human Ab, the enzyme-linked immunosorbent assay (ELISA) with Ag as target and peroxidase (PO)-labeled anti-human IgG antibodies as tracer for detection of human Ab binding to the target, showed higher specificity and sensitivity as compared to radioimmunoassay (RIA). For detection of human Ab binding specifically to Ab2, three different ELISAs and three RIAs were used. Best results were obtained in the ELISA with anti-human IgG antibodies as target and biotinylated Ab2 as tracer for detection of human Ab binding to the target. Of four different inhibition assays used, the ELISA which measures inhibition of binding of biotinylated Ab2 to Ab1 by human Ab or chimeric antibody at 37 degrees C was the most sensitive and specific. These assays have general applicability for the characterization of human Ab responses in Ab2 vaccination approaches to various tumors and pathogens and therefore provide the basis for the establishment of a correlation between Ab responses and clinical outcome of the disease. PMID- 2783713 TI - Hydrophobic labelling of membrane-embedded proteins with lipophilic reagents. Incorporation of [125I]INA and [125I]TID into B lymphocyte membrane immunoglobulins. AB - Hydrophobic labelling is frequently used in the study of membrane-inserted domains of intrinsic proteins. However, the published procedures, fail to incorporate sufficient radioactivity into membrane immunoglobulins of B lymphocytes to permit investigation of their subunit structures and associations with other proteins. In order to increase the specific radioactivity of [125I]iodonaphthylazide ([125I]INA), an improved method for the synthesis of the reagent was developed. In addition, the optimal conditions for labelling B lymphocytes with [125I]INA and the commercially available reagent 3 (trifluoromethyl)-3-(3'-[125I]iodophenyl)diazirine ([125I]TID) were elaborated. Under these optimized conditions, Ig molecules labelled with [125I]INA and [125I]TID were isolated and analysed in detail by SDS-PAGE. The usefulness of the two reagents for the investigation of lipid-embedded domains of membrane proteins is discussed. PMID- 2783714 TI - Anticardiolipin antibody in the acquired immunodeficiency syndrome: a marker of Pneumocystis carinii infection? PMID- 2783715 TI - Gardnerella vaginalis in infections of the urinary tract. AB - During a period of 6 months, urine from 3576 patients was cultured for Gardnerella vaginalis. Specimens from 32 patients yielded this species. Eleven (0.3%) of the isolates were judged to be of clinical importance. Seven were from women and four from men. Two of these patients, both women, suffered from spontaneous cystitis. Hence G. vaginalis is very unusual as a primary pathogen in the urinary tract. More often it may cause infections related to urological abnormalities or as a complication of urological procedures. Two of the men in our series had chronic prostatitis, one an infected urinoma. All six remaining patients had either undergone a urological procedure or had had an indwelling urethral catheter for more than 6 hours. A selective medium for G. vaginalis is recommended for screening cultures before urological procedures and when this species is suspected on microscopy. The role of metronidazole in extravaginal infections is discussed and the use of an antibiotic more active against G. vaginalis is recommended. PMID- 2783716 TI - Zidovudine: experience at the Newcastle Haemophilia Centre. AB - Zidovudine was first prescribed for patients from the anti-human immunodeficiency virus (HIV) positive cohort of haemophiliacs in Newcastle in May 1987. Prior to this therapy, seven patients had died of acquired immune deficiency syndrome, and episodes of serious opportunistic infection were common. To date, 22 patients have received zidovudine, seven with or without acyclovir in a prospective Wellcome trial. Of the 22 patients, three were children and one was an adult female. All haemophilic patients were infected around 1982 as a result of factor VIII concentrate contamination with HIV. There have been five deaths, two occurring within 6 weeks of the start of zidovudine therapy. A third death was due to myocardial infarction in week 45. The other two deaths occurred at 41 weeks and 47 weeks in transfusion dependent patients. Only three serious opportunistic infections (pneumocystis pneumonia) have been observed in the remaining patients, one within a week of starting therapy and one in a non compliant patient at week 24. The latter patients had a further episode of Pneumocystis carinii pneumonia in week 51. The transfusion dependent patients who died presented with anaemia at weeks 5 and 13, and required 48 and 28 units of packed cells respectively. A further patient required a single transfusion at week 7 and at week 43 continues to maintain an acceptable haemoglobin level.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2783717 TI - Pneumonia in children in the Eastern Highlands of Papua New Guinea: a bacteriologic study of patients selected by standard clinical criteria. PMID- 2783718 TI - Production of interleukin-1 by peripheral blood mononuclear cells in patients with chronic fatigue syndrome. PMID- 2783719 TI - Nomenclature for Pneumocystis carinii. PMID- 2783720 TI - T lymphocytes in genital lymph nodes protect mice from intravaginal infection with herpes simplex virus type 2. AB - Herpes simplex virus type 2 (HSV-2) is a human venereal pathogen that causes lethal neurological illness after intravaginal inoculation into BALB/cJ mice. Intravaginal vaccination of mice with an attenuated strain of HSV-2 rapidly induces immunity to a lethal intravaginal challenge with wild-type HSV-2. This resistance is transferrable to syngeneic mice with genital lymph node (GLN) cells but not with cells from other lymphoid sources. Here we demonstrate that minimal numbers of HSV-2-stimulated GLN T lymphocytes are required for resistance to genital infection by HSV-2 and that such cells migrate preferentially into HSV-2 infected genital tissue. Furthermore, the results suggest that HSV-2-specific cytotoxic T lymphocytes from the GLN may be one effector cell population participating locally in genital immunity to the virus. These findings indicate that mucosal immunity to genital HSV-2 infection requires the antigen stimulation of migratory T cells in the GLN. PMID- 2783721 TI - Ferritin release by mononuclear cells in hereditary hemochromatosis. AB - An anomaly of the iron-loading disorder hereditary hemochromatosis is that bone marrow iron stores remain low until later stages of the disease. The possibility that this may be related to a disorder of reticuloendothelial ferritin metabolism was examined by studying ferritin release from mononuclear cells. Ferritin release was measured in peripheral blood mononuclear cells from four patients with hemochromatosis who had not received treatment, from six patients with hemochromatosis who had received treatment, and from 10 age- and gender-matched controls by using a modified hemolytic plaque assay. Ferritin release from the hemochromatotic cells was enhanced when compared with that of controls, and added iron stimulated ferritin release to a comparable degree in both groups. Enhanced ferritin release above matched control values was found both in cells from patients with hemochromatosis with partial phlebotomy who had high serum ferritin values and in cells from patients with hemochromatosis with full phlebotomy who had normal serum ferritin values. The increased ferritin release observed in these studies may signify abnormal reticuloendothelial iron metabolism in hemochromatosis. PMID- 2783723 TI - Vestibular dysfunction in learning disabilities: differences in definitions lead to different conclusions. PMID- 2783722 TI - Heparin-associated thrombocytopenia: observations on the mechanism of platelet aggregation. AB - We investigated the mechanism of heparin-mediated platelet aggregation in 11 patients with heparin-associated thrombocytopenia. Severe thrombocytopenia (16,000 to 66,000 platelets/microliters) developed in each patient during heparin therapy, and platelet aggregation occurred in vitro when heparin was added to mixtures of patient plasma and normal platelet-rich plasma. In 10 patients, heparin-initiated platelet aggregation was inhibited by preincubation of mixtures of normal platelet-rich plasma and heparin-associated thrombocytopenia plasma with monoclonal antiglycoprotein Ib antibodies 6D1 or LJ-Ib1. Both antibodies are directed against the von Willebrand factor binding site on glycoprotein Ib and inhibit only ristocetin-induced platelet agglutination. Purified immunoglobulin G (IgG) from patients with heparin-associated thrombocytopenia also supported heparin-induced aggregation, but equivalent amounts of antigen-binding fragments [F(ab')2] did not. We also found that F(ab')2 of LJ-Lb1 did not inhibit heparin induced platelet aggregation but retained inhibitory activity against ristocetin induced platelet agglutination. The monoclonal antibody 3G6, directed against the alpha-chain of glycoprotein Ib but not inhibitory of ristocetin-induced platelet agglutination, had no effect on heparin-induced platelet aggregation. Antibodies to von Willebrand factor that inhibit ristocetin-induced platelet agglutination did not inhibit heparin-mediated platelet aggregation, but antibodies to glycoprotein IIb-IIIa blocked aggregation. These data suggest that platelet aggregation in heparin-associated thrombocytopenia may be initiated by an interaction between patient IgG, heparin, and the platelet surface. Platelet activation appears to be mediated by a platelet surface crystallizable fragment (Fc) receptor.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2783724 TI - Requirements for histoplasmin presentation by accessory cells to a Histoplasma capsulatum-reactive T-cell line. AB - We examined the pathways involved in presentation of native histoplasmin by adherent splenocytes (as a source of accessory cells) to JC1, a Histoplasma capsulatum-reactive murine T-cell line that is CD4+. JC1 did not respond to accessory cells that had been fixed with paraformaldehyde and then exposed to histoplasmin but did proliferate to antigen-pulsed cells that were subsequently fixed. Accessory cells that were coincubated with histoplasmin and sodium azide or 2-deoxy-D-glucose failed to induce proliferation of JC1. Moreover, accessory cells exposed to the lysosomotropic agents, chloroquine and ammonium chloride, were unable to present antigen. Monensin also inhibited presentation of histoplasmin if added to accessory cells concomitant with antigen. In contrast, accessory cells that had been pulsed with antigen for 2 hr and then exposed to each inhibitor for 2 hr stimulated proliferation of JC1. The antigen-presenting capacity of accessory cells that had been pulsed with histoplasmin for 2 hr was diminished considerably by subsequent treatment with phospholipase A2. Additional studies demonstrated that cerulenin, which depresses posttranslational lipid modification of proteins, abolished presentation of histoplasmin. The reactivity of JC1 was sharply reduced by anti-L3T4 (CD4) or by anti-I-Ab monoclonal antibody. The results not only indicate that presentation of histoplasmin requires active metabolic events within accessory cells, they also delineate the pathways involved in handling this antigen. PMID- 2783726 TI - Efficacy of routine postpartum uterine exploration and manual sponge curettage. AB - Many physicians feel that manual exploration and sponge curettage of the uterus should be a routine part of all vaginal deliveries. Three hundred twenty uncomplicated routine vaginal deliveries (185 with exploration and sponge curettage, 135 without) were prospectively analyzed for differences in outcome with regard to postpartum hemorrhage, postpartum infection, and the patient's perception of pain. Results revealed there to be no clinically or statistically significant difference between these two groups in postpartum bleeding, postpartum white blood cell counts, and postpartum fever during the three-day postdelivery hospitalization. All patients were followed for six weeks. Five of 185 patients (2.7 percent) in the explored group returned for postpartum bleeding complications, one requiring hospital admission. Three of 135 (2.2 percent) returned for postpartum bleeding in the unexplored group, none requiring hospital admission. No patients in either group had complications with postpartum endometritis in the follow-up period. The patient's perception of pain was significantly higher in the explored and curettaged group as opposed to the unexplored group (P less than .0002). This study reveals that routine elective postpartum manual exploration and sponge curettage of the uterus is a painful procedure that is not clinically indicated for reducing the potential risk of postpartum hemorrhage or endometritis and is unnecessary following routine vaginal delivery. PMID- 2783725 TI - Comparative study of cytotoxicity, tumor necrosis factor, and prostaglandin release after stimulation of rat Kupffer cells, murine Kupffer cells, and murine inflammatory liver macrophages. AB - Macrophages (Mphi) and Mphi-depleted (nonadherent) nonparenchymal cells (NPC) of the liver were examined for their cytotoxic potential against tumor cells, production of tumor necrosis factor (TNF), and release of prostaglandins (PG) following stimulation by lipopolysaccharide (LPS), interferon-gamma (IFN gamma), and zymosan. Resident murine liver macrophages had no natural cytotoxicity for the TNF-resistant target cell line P815. Activation of these cells was only obtained by a combination of IFN gamma and LPS. Inflammatory murine macrophages were in a primed stage and could be activated by LPS alone in the absence of IFN gamma. Rat resident macrophages resembled functionally the inflammatory macrophages of the mouse liver rather than the resident macrophages. They displayed natural cytotoxicity against all targets tested and were further activated by LPS in the absence of IFN gamma. Similar results were obtained with respect to macrophage-depleted nonadherent NPC: Mouse NPC had a low level of NK activity against Yac-1 cells. Treatment with pyran copolymer resulted in a strong increase of cytotoxicity against Yac-1; furthermore, a TNF-dependent killing of Wehi 164 and TNF-independent cytotoxicity against P815 cells were now acquired. In the rat NPC prepared from unstimulated animals expressed high levels of natural cytotoxicity against all targets. No major differences could be observed between inflammatory Mphi and Kupffer cells of rat and mouse liver with regard to TNF production and TNF-dependent killing of Wehi 164 tumor cells. The same was true for the spectrum of secreted prostanoids. Upon activation of all cell populations a marked shift toward the production of PGE2 occurred. Experiments involving the cyclooxygenase inhibitor indomethacin showed enhanced TNF-dependent tumor cell killing by nonactivated Mphi in the absence of prostanoid production. PMID- 2783727 TI - Necrotizing enterocolitis and milk protein intolerance. Causes of rectal bleeding in a term infant. PMID- 2783729 TI - The prevalence of emotional disorder in children. AB - This report presents data from the Ontario Child Health Study on the prevalence of individual emotional symptoms, the variation of prevalence rates of emotional disorders as a function of demographic factors, and the rates of service utilization for children with these disorders. To survey Ontario children from 4 to 16 years of age, a stratified random sample of 3,294 children was drawn from all household dwellings listed in the 1981 Census. The prevalence rates for emotional disorders in male and female children aged 4 to 11 years were 10.1% and 10.7%, respectively. For adolescents aged 12 to 16 years, the prevalence rate rose to 13.7% for females and fell to 5.0% for males. Children with emotional disorders were frequently found to meet criteria for more than one disorder. Only one in five children with emotional disorders had received mental health or social services in the 6 months prior to the survey. PMID- 2783728 TI - Excitation of skinned muscle fibers by imposed ion gradients. III. Distribution of permeant ions in unstimulated and stimulated fibers. AB - Ion gradients imposed across an internal membrane system stimulate skinned muscle fibers; to evaluate the sarcoplasmic reticulum (SR) as the primary target site, SR polarization under resting and stimulatory conditions was assessed from fiber uptake of permeant probe ions. Solvent spaces were estimated from simultaneous [14C]urea (U) or [3H]deoxyglucose (DOG) uptake in segments of fibers from bullfrog semitendinosus muscle, skinned by microdissection. The distribution spaces, i.e., virtual solvent volumes at bath concentrations (Vu and VDOG), of these uncharged probes correlated well with the protein content of the same segments, which validated the tracer methodology for volume normalization. The membrane-bounded volume fraction (Vm), derived from the difference between total solvent volume (Vs) and the non-membrane-bounded solvent volume (Vc), was sufficient to detect appreciable SR ion accumulation. The Vm estimated from the difference between VU and VDOG assayed simultaneously with 2 or 5-6 min exposures was 10-11%, which is consistent with the morphometric volume fraction (mostly SR) in frog fibers; however, the change in this difference after membrane permeabilization corresponded to Vm only 5%. The change in permeant ion distribution space caused by member permeabilization was used to assess SR membrane polarization, assuming the free ions distribute across the intact membrane according to the Nernst ratio. Resting polarization (SR lumen positive) was assessed from [14C]SCN- or [14C]propionate- distribution spaces in unstimulated fibers, expressed relative to VDOG (assayed simultaneously). The ratios for (a) [14C]SCN- space (carrier 2 mM) and (b) [14C]propionate- space (carrier 120 mM) were not decreased by membrane permeabilization. This indicated that anion distribution was independent of membrane integrity and did not reflect an SR transmembrane potential, although a was more and b was less than 1. Polarization under stimulatory conditions (lumen negative) was assessed from 86Rb+ distribution, before and after an imposed ion gradient (choline Cl replacement of K methanesulfonate (KMes) at constant [K+] [Cl-]) that theoretically could generate a 48-fold transmembrane cation ratio; Ca release was minimized by EGTA. The ratio of 86Rb+ space to VU, greater than 1 in KMes (120 mM K, the effective carrier), was higher in choline Cl (2.5 mM K) but not decreased by membrane permeabilization; this indicated that 86Rb+ distribution did not reflect an SR transmembrane potential. Similar results in the presence of valinomycin ruled out the possibility of inadequate 86Rb+ equilibration.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2783730 TI - What is the choice of treatment for hairy cell leukemia? PMID- 2783731 TI - Pentostatin in the treatment of advanced hairy cell leukemia. AB - 2'-Deoxycoformycin (pentostatin [dCF]), a potent inhibitor of adenosine deaminase (ADA), was administered in a biweekly low-dose (2 to 4 mg/m2) intravenous (IV) schedule to patients with advanced hairy cell leukemia. Twenty-three patients were treated, including 12 patients previously treated by splenectomy and five patients treated with interferon. Twenty-one of 23 patients had objective responses, including 20 who achieved a complete remission (CR). Responses occurred rapidly, with an average time to CR of 5.4 months. Treatment was not continued once CR was achieved, and 15 of 20 patients remain in remission with an average duration of 12.6 months. CRs were achieved in both patients previously treated with interferon (three of five) and patients with marked splenomegaly (three of three). Relapses, when seen, have occurred in the bone marrow alone and the one patient who required retreatment was reinduced into CR. Toxicity has been mild and reversible, with nausea and vomiting, conjunctivitis, and skin rash as the main complications of treatment. dCF is the most effective single agent in the treatment of hairy cell leukemia, inducing a high percentage of CRs in all subgroups. Two multiinstitutional trials are now underway to compare its effectiveness v alpha interferon. PMID- 2783732 TI - A phase I clinical trial of recombinant interleukin-2 by periodic 24-hour intravenous infusions. AB - Recombinant interleukin-2 (rIL-2) (NSC# 600664; Hoffmann-La Roche, Inc., Nutley, NJ) was studied in a phase I clinical trial in 33 patients with advanced, measureable cancer of the colon or malignant melanoma, Eastern Cooperative Oncology Group (ECOG) performance status O-1, and no prior chemotherapy or radiotherapy. The goal of the study was to identify a dose and schedule of IL-2 to generate maximal immune modulation with tolerable toxicity. Such a regimen might allow the addition of other treatment modalities and/or prolonged treatment duration in later trials. Each patient received IL-2 as a continuous 24-hour infusion once weekly for 4 weeks and then twice weekly for 4 weeks. Five treatment groups received from 10(3) U/m2 to 3 x 10(7) U/m2 per 24-hour infusion. The maximal tolerated dose was 3 x 10(7) U/m2/d twice weekly. Patients treated twice weekly at 1 x 10(7) and 3 x 10(7) U/m2/d had immune modulation in terms of lymphocytosis, eosinophilia, increased natural killer (NK) activity, and elevated numbers of peripheral blood mononuclear cells expressing CD16, OKT10/Leu-17, and Leu-19 surface markers. Endogenous generation of peripheral blood lymphokine activated killer (LAK) activity was demonstrated by lysis of NK-resistant Daudi targets, in patients treated at 3 x 10(7) U/m2/d. Biochemical and hematological abnormalities were moderate and reversible. Clinical toxicity included hypotension, myalgia, arthralgia, stomatitis, fever, fatigue, nausea, headache, chills, diarrhea, and oliguria at high doses. Cardiovascular toxicity was tolerable for most patients and reversed after IL-2 was stopped. Two of six melanoma patients at 3 x 10(7) U/m2/d achieved partial responses by the end of the eighth week. This IL-2 schedule appears to produce potentially clinically useful immune enhancement with tolerable toxicity. PMID- 2783733 TI - Hemorrhagic shock and encephalopathy: clinical, pathologic, and biochemical features. AB - To further define the clinical, pathologic, and biochemical features of hemorrhagic shock and encephalopathy syndrome, we studied 25 affected children (aged 3 months to 14 years) admitted to a single center between 1982 and 1985. A prodromal illness comprising vomiting, diarrhea, listlessness, and fever was present in 84% of the cases. Acute onset of shock, convulsions and coma, bleeding (or laboratory evidence of disseminated intravascular coagulation), elevated plasma activity of hepatic enzymes, acidosis, and impaired renal function was present in every case. Twenty patients died, and all the survivors are neurologically damaged. At postmortem examination, intravascular microthrombi coexisting with hemorrhages and petechiae were found in most organs. Centrilobular liver necrosis and cerebral edema were prominent features. No microbiologic cause for the disorder was identified, but decreased plasma levels of the protease inhibitors alpha 1-antitrypsin and alpha 2-macroglobulin, together with increased levels of circulating proteolytic enzymes, were frequently present. An overrepresentation of the uncommon variant phenotypes of alpha 1-antitrypsin was found in first-degree relatives of affected patients (four had the MZ phenotype, and one each the MS or MC phenotype, of 19 relatives studied). Abnormal accumulation of alpha 1-antitrypsin was detected immunohistochemically in the livers of six of the patients. Defective protease inhibitor production or release may be involved in the pathogenesis of the disorder. PMID- 2783734 TI - Bone mineral content, serum vitamin D metabolite concentrations, and ultraviolet B light exposure in infants fed human milk with and without vitamin D2 supplements. AB - OBJECTIVE: To monitor ultraviolet B light exposure in human milk-fed infants both with and without supplemental vitamin D2, and to measure longitudinally the bone mineral content, growth, and serum concentrations of calcium, phosphorus, 25 hydroxyvitamin D3, 25-hydroxyvitamin D2, 1,25-dihydroxyvitamin D, and parathyroid hormone. DESIGN: Longitudinal, randomized, double-blind, placebo-controlled study of 6 months' duration. SETTING: Patients from private pediatric practice, Madison, Wisconsin. PATIENTS: Sequential sampling of 46 human milk-fed white infants; 24 received 400 IU/day of vitamin D2, and 22 received placebo. An additional 12 patients were followed who received standard infant formula. Eighty three percent of patients completed a full 6 months of the study. MEASUREMENTS AND RESULTS: Ultraviolet B light exposure and measurements of growth did not differ between groups. At 6 months, the human milk groups did not differ significantly in bone mineral content or serum concentrations of parathyroid hormone or 1,25-dihydroxyvitamin D, although total 25-hydroxyvitamin D values were significantly less in the unsupplemented human milk group (23.53 +/- 9.94 vs 36.96 +/- 11.86 ng/ml; p less than 0.01). However, 25-hydroxyvitamin D3 serum concentrations were significantly higher in the unsupplemented human milk-fed group compared with the supplemented group (21.77 +/- 9.73 vs 11.74 +/- 10.27 ng/ml, p less than 0.01) by 6 months of age. CONCLUSION: Unsupplemented, human milk-fed infants had no evidence of vitamin D deficiency during the first 6 months of life. PMID- 2783735 TI - Sturge-Weber syndrome: a study of cerebral glucose utilization with positron emission tomography. AB - We measured local cerebral metabolic rate for glucose (ICMRGIc) using positron emission tomography (PET) in six children with Sturge-Weber syndrome (SWS) and in six neurologically asymptomatic children with facial capillary hemangioma suggestive of SWS. Children with advanced SWS showed markedly depressed ICMRGIc in the anatomically affected cerebral hemisphere in a distribution that extended beyond the abnormalities depicted on computed tomography scan. In two infants with SWS and recent seizure onset, interictal PET revealed a paradoxical pattern of increased ICMRGIc in the cerebral cortex of the anatomically affected hemisphere. In one of these infants, ICMRGIc was also increased in the contralateral cerebellum, suggesting activation of the cortico-ponto-cerebellar circuitry. Subsequent PET (28 months later) in this child revealed the typical ICMRGIc pattern seen in advanced SWS. Further study of this transient ICMRGIc increase may be important in disclosing the pathogenesis of unilateral cerebral degeneration in SWS. In neurologically asymptomatic children with the facial stigmata of SWS and in children with early SWS, PET provides a sensitive measure of the extent and degree of cerebral metabolic impairment. Serial PET studies in children with SWS can be used to assess disease progression and, together with computed tomography or magnetic resonance imaging, may be useful in the selection of suitable candidates for cerebral hemispherectomy or focal cortical resection. PMID- 2783736 TI - A multidimensional study of infants' behaviors associated with assumed painful stimuli: Phase II. AB - Researchers have found that physiologic changes occur that indicate infants do perceive pain. In the study, infants were audiovideotaped while receiving the first diphtheria-pertussis-tetanus (DPT) injection to document their responses to an assumed painful stimulus. The vocalization of crying and some facial movements were identified as behaviors associated with receiving the DTP injection. These findings support the need for nurses to use a multidimensional assessment when caring for infants believed to be having pain. PMID- 2783737 TI - Use of a non-radioactive hybridisation assay for direct detection of gram negative bacteria carrying TEM beta-lactamase genes in infected urine. AB - DNA in infected urines from 81 patients with urinary tract infection was hybridised directly with a non-radioactive DNA probe specific for bacterial genes coding for TEM-type beta-lactamase. The results were assessed by means of a computerised image analysis system and compared with those obtained following isolation of the infecting organism, conventional sensitivity testing and isoelectric focusing (IEF) procedures for the detection of TEM-type beta lactamase. Of the 27 ampicillin-resistant gram-negative organisms isolated in pure culture from the urines, 14 were shown by both hybridisation and IEF to carry a gene for TEM beta-lactamase production. Only four discordant results were obtained: three "false positive" direct hybridisation results, one due to urine pigmentation, and one, possibly, to a TEM beta-lactamase gene which was not being expressed, and one "false negative" result due to insufficient cell numbers in the urine. The system is capable of screening large numbers of samples and is applicable to any gene for which a suitable DNA probe is available. PMID- 2783739 TI - Identification and some properties of a unique DNA polymerase from cells infected with human B-lymphotropic virus. AB - A new DNA polymerase and DNase activity were identified from cells infected with human B-lymphotropic herpesvirus (HBLV). DNA polymerase associated with HBLV infection was similar in its sensitivity to inhibition by ppi analogs as other herpesvirus-specific DNA polymerases but was dissimilar in its inhibition by certain nucleoside triphosphates. PMID- 2783738 TI - The rev (trs/art) protein of human immunodeficiency virus type 1 affects viral mRNA and protein expression via a cis-acting sequence in the env region. AB - The study of expression of several human immunodeficiency virus type 1 proviral mutants in human cells in the presence or absence of rev (trs/art) protein reveals that rev increases the levels of unspliced and env mRNA and the accumulated structural viral proteins. rev protein produced from appropriate expression vectors fully complements the rev-defective mutants. rev requires the presence of a specific cis-acting sequence for its function. This rev-responsive element sequence has been localized within a 520 base-pair fragment in the env region of human immunodeficiency virus type 1. gag and env expression is coordinately regulated by rev. Two independent cis-acting elements localized in the gag and env regions are responsible for the low levels of gag and env mRNA in the absence of rev. These elements are different than the rev-responsive element and act independent of each other. PMID- 2783741 TI - Experimental infections of waterfowl with Sphaeridiotrema globulus (Digenea). AB - Sphaeridiotrema globulus in experimentally infected mute swans (Cygnus olor), mallard ducks (Anas platyrhynchos) and Canada geese (Branta canadensis) induced ulcerative hemorrhagic enteritis. Sites of infection include the jejunum and ileum. The digeneans ulcerated the intestine. The inflammatory response was primarily lymphocytic with some eosinophils. Severe hemorrhage from damaged submucosal capillaries provided a blood meal for the parasite and caused anemia in the host. Extra-medullary hematopoiesis occurred in the liver, and an erythroid hyperplasia occurred in the bone marrow of infected birds. Infected birds exhibited muscular weakness and died from shock associated with severe blood loss. Mallards and Canada geese were less susceptible to fatal infection than the mute swan as evidenced by survivors in the higher dose groups. PMID- 2783742 TI - Dementias appear to have individual profiles in single photon emission computed tomography. PMID- 2783743 TI - Use of D4 peptide in HIV inhibition. PMID- 2783740 TI - In vitro mutagenesis of the human T-cell leukemia virus types I and II tax genes. AB - The tax gene of the human T-cell leukemia virus types I and II (HTLV-I and HTLV II) is essential for viral replication and acts by increasing the level of RNA transcription. The tax genes of HTLV-I and HTLV-II encode proteins of 40 and 37 kilodaltons, respectively. By in vitro mutagenesis of the tax gene, we have investigated those regions of the protein which are essential for its function. Mutation of either the amino- or carboxy-terminal domain of the protein resulted in loss of trans-activation ability. In addition, specificity of its activity with regard to trans-activation of either the HTLV-I or HTLV-II long terminal repeats was conferred by the first 59 amino acids. PMID- 2783744 TI - Leads from the MMWR. Update: Haemophilus influenzae type b vaccine. PMID- 2783745 TI - Haemophilus b polysaccharide vaccine. PMID- 2783746 TI - Pregnancy-associated deaths due to AIDS in the United States. AB - From 1981 to 1988, eighty percent of all women with the acquired immunodeficiency syndrome (AIDS) reported to the Centers for Disease Control were of reproductive age. Six pregnancy-associated deaths due to AIDS in this country have been reported in the medical literature. We identified 20 unpublished cases of women who died of AIDS during or within one year after termination of pregnancy. Analysis showed that these women were mostly black or Hispanic, half were intravenous drug abusers, and most died of Pneumocystis carinii pneumonia. Each pregnancy had an obstetric complication, primarily preterm delivery. The interval between diagnosis of AIDS and the death of these women ranged from one day to 15 months, with a mean interval of 113 days. Multiple reporting sources increased case detection and should be used for future investigations. Prospective case control studies are needed to determine any further relationship between pregnancy complications and AIDS. PMID- 2783747 TI - [Diagnostic imaging of cancer]. PMID- 2783748 TI - [Treatment of malignant lymphoma]. PMID- 2783749 TI - Inverse relationship between epidermal growth factor induced proliferation and expression of high affinity surface epidermal growth factor receptors in rat hepatocytes. AB - Rat hepatocytes express large numbers of high and low affinity surface membrane receptors (EGFR) for epidermal growth factor (EGF) but the roles of EGF and EGFRs in hepatocyte proliferation in vivo are unclear. F344 rat hepatocytes in primary culture proliferated maximally in response to continuous serum-free culture with 3.3 nM (20 ng/ml) EGF, as quantified by cumulative [3H]thymidine labeling index. However, serum concentrations of EGF in rats with normal livers or induced hepatocyte proliferation due to partial hepatectomy, carbon tetrachloride-induced necrosis, or hepatic neoplasia were consistently below 0.1 nM. The 3- or 6-hour pulse exposures to EGF (1.7 nM) between 0 to 16 hours had minimal effect on labeling index at 48 hours, but these pulse exposures at 24 or 32 hours were equivalent to continuous exposure. At 24 and 32 hours, the total specific surface binding of [125I]EGF to hepatocytes cultured free of EGF decreased to 43 and 24% of the initial values, respectively. Scatchard analysis of EGF binding indicated that hepatocytes lost all high affinity EGFRs (Kd of 0.08 nM) by 24 hours. Low affinity [125I]EGF binding at 0 hour (Kd 0.8 nM) was further reduced at 24 hours (Kd = 3.9 nM) and corresponded more closely to mitogenic concentrations of EGF in culture. These studies demonstrate that proliferative responsiveness of hepatocytes to EGF increases during culture by a process that involves prior loss of constitutive high affinity EGFRs. These results suggest that constitutive high affinity EGFRs do not elicit the proliferative response to EGF. PMID- 2783750 TI - Thrombogenicity of canine free internal mammary artery autografts. AB - Early patency of free internal mammary artery (IMA) grafts for coronary artery bypass (CAB) is lower than that of in situ IMA grafts, and proximal anastomotic problems have been implicated in the pathogenesis of graft occlusion. To determine whether thrombotic phenomena might account for proximal graft narrowing, we examined platelet and fibrinogen deposition in 23 free IMA grafts in a canine model of CAB. Twelve animals had no antiplatelet therapy and were controls. Eleven animals received dipyridamole, 55 mg p.o. daily, 2 days before and each day after operation; aspirin, 325 mg p.o. daily, was given after CAB. Six of the 12 untreated dogs and 5 of the 11 treated dogs were sacrificed at 1 day after surgery; the remainder of each group was sacrificed on the 14th postoperative day. Platelet and fibrinogen depositions were quantitated by indium 111 tropolone and Iodine-125 labeling, respectively. Grafts were sectioned into five parts: proximal anastomosis (PA), proximal graft (PG), midgraft (MG), distal graft (DG), and distal anastomosis (DA). Platelet deposition was highest at the PA of free IMA grafts, and fibrinogen deposition was high at both anastomoses. Antiplatelet therapy significantly reduced platelet deposition at the PA at 14 days, but not at 1 day; fibrinogen deposition was significantly reduced at the DA at 1 day, and at both the PA and DA at 14 days. The ratio of fibrinogen molecules per platelet was unaffected by antiplatelet therapy, but was observed to increase with time at the DG and DA.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2783751 TI - Effect of retained components of excised tumor upon coexisting tumor. AB - Effects of locally treated and retained tumor tissue on the growth of a tumor at another site were investigated using Lewis rats bearing syngeneic fibrosarcoma. When an established tumor had completely regressed upon repeated intratumoral injections of L-phenylalanine mustard (PhM), the growth of secondarily transplanted tumor cells was inhibited. However, early excision of the PhM injected tumor prevented the development of this effect. To study this effect directly, we excised one of the two established tumors in each thigh, and reinoculated into the excision wound either freeze-lysed 1 X 10(8) tumor cells (TC) or lysate chemically modified with PhM (PTC). We found that TC inoculation into the excision wound in 7 rats inhibited the growth of the remaining tumor and extended survival time (mean +/- SE, 27 +/- 1 days). With inoculation of PTC into the excision wound, the remaining tumor regressed and survival was significantly prolonged (32 +/- 2 days). In contrast, 7 untreated rats, each bearing two tumors, had a mean survival time of 22 +/- 0.1 days. Excision of one tumor (6 rats) did not affect the growth of the remaining tumor or survival time (23 +/- 1 days). We employed PhM to modify the immunogenicity of TC. However, if PhM dissociates from PTC, its cytotoxic effect may directly inhibit growth of the distant tumor. To examine this possibility, we divided 30 rats who had excision of one tumor, into three groups of 10 10.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2783753 TI - Reduction of blood utilization during myocardial revascularization. AB - The efficacy of four different blood conservation techniques in decreasing the homologous blood requirement in cardiac operations was studied prospectively in 100 patients undergoing myocardial revascularization. The patients were randomly assigned to four groups of 25 each as follows: group I, retransfusion of oxygenator blood after termination of extracorporeal circulation; group II, processing of oxygenator content by means of a cell separator; group III, predonation of autologous blood and isovolumetric substitution of hydroxyethyl starch (10 ml/kg bodyweight) after the induction of anesthesia in addition to the use of a cell separator; and group IV, predonation and the use of a cell separator plus postoperative retransfusion of shed mediastinal blood. To form homologous groups, we accepted only male patients without impairment of left ventricular function for the study. In addition, patients with internal mammary artery grafts and a duration of extracorporeal circulation less than 45 minutes or more than 90 minutes were excluded. The bank blood requirement during hospitalization was 2132 +/- 824 ml in group I, 1371 +/- 928 ml in group II, 833 +/- 599 ml in group III, and 408 +/- 559 ml in group IV. The use of blood conservation techniques resulted in reductions of homologous blood requirements of 34%, 60%, and 80%, respectively, in groups II to IV as compared with the requirement in group I. There were no complications related to autologous blood transfusion. We conclude that the use of blood conservation techniques can considerably reduce the homologous blood requirement in cardiac operations and therefore decrease transfusion-related risks. PMID- 2783752 TI - Multiple primary cancers in squamous cell cancer of the head and neck. AB - A retrospective review of 832 patients with squamous cell cancer of the head and neck between 1961 and 1985 was carried out to determine the incidence of multiple primary cancers (MPC) at the time of autopsy and the number who died of the second cancer. The overall risk of developing a second MPC of the head and neck, lung, or esophagus from treatment of first head and neck cancer to time of autopsy was 4.04% per year. PMID- 2783755 TI - [Computerized medical records and a quality study circle. Effective measures for ensuring quality in health care]. PMID- 2783754 TI - Monoclonal antibody directed to human T-cell malignancy antigen. AB - A murine monoclonal antibody (B2D) against a cultured pre-T acute lymphoblastic leukemia (ALL) cell line THP-6 has been produced. The antibody reacted with seven out of eight cultured T-ALL cell lines and with leukemic cells from three out of four T-ALL/lymphoma patients. The antibody did not react with normal T and B lymphocytes, monocytes, granulocytes, platelets, erythrocytes, bone marrow lymphoid-like precursor cells, thymocytes and other acute and chronic leukemic cells of non-T cell origin. Furthermore, B2D did not react with phytohemagglutinin-activated T cells nor with concanavalin A-activated T cells. The molecules immunoprecipitated with B2D had molecular weights of 50-55 kD. Thus, B2D seems to be highly specific for T-cell malignancies. These results show that B2D defines one of human leukemia antigens which are expressed on the cell surface of T-ALL cells. Monoclonal antibody B2D may be useful for the subclassification of T-ALL cells and has therapeutic potential for a certain type of T-ALL. PMID- 2783756 TI - The effect of immunization with protein-hapten conjugate on the intestinal uptake of p-aminobenzoic acid as a hapten. AB - Intestinal uptake of p-aminobenzoic acid was examined by means of an in vitro everted sac technique in rats immunized with ovalbumin-p-aminobenzoic acid conjugate. A dose-dependent and antigen-specific decrease in the serosal transfer of p-aminobenzoic acid was observed in rats immunized 6 times with protein-hapten conjugate compared with the control. There was a significant increase in the recovery of p-acetamidobenzoic acid, a metabolite of p-aminobenzoic acid, in mucosal fluid, tissue, and serosal fluid in the jejunum. In the case of ileum, increase of p-acetamidobenzoic acid was observed in mucosal fluid. However, there was no significant effect in the ileal p-acetamidobenzoic acid in tissue and serosal fluid between immunized and non-immunized rats. To examine the increased metabolism of immunized rats, N-acetyltransferase activity of the small intestinal mucosa was examined. There was a significant increase in mucosal N acetyltransferase activity in immunized rats compared with the control animals. These observations suggested that the mucosal immune system may play an important role in regulating the intestinal uptake of the low molecular weight compounds. PMID- 2783757 TI - Transforming growth factor alpha production and epidermal growth factor receptor expression in normal and oncogene transformed human mammary epithelial cells. AB - We have characterized the expression of transforming growth factor alpha (TGF alpha) and its receptor, the epidermal growth factor receptor (EGF-R), in normal and malignantly transformed human mammary epithelial cells. Human mammary epithelial cells were derived from a reduction mammoplasty (184), immortalized by benzo-a-pyrene (184A 1N4), and further transformed by the oncogenes simian virus 40 T (SV40 T), v-Ha-ras, and v-mos alone or in combination using retroviral vectors. 184 and 184A 1N4 cells require EGF for anchorage-dependent clonal growth. In mass culture, they secrete TGF alpha at high concentrations and exhibit an attenuated requirement for exogenous EGF/TGF alpha. SV40 T transformed cells have 4-fold increased EGF-R, have acquired the ability to clone in soft agar with EGF/TGF alpha supplementation, but are not tumorigenic. Cells transformed by v-mos or v-Ha-ras are weakly tumorigenic and capable of both anchorage dependent and independent growth in the absence of EGF/TGF alpha. Cells transformed by both SV40 T and v-Ha-ras are highly tumorigenic, are refractory to EGF/TGF alpha, and clone with high efficiency in soft agar. The expression of v Ha-ras is associated with a loss of the high (but not low) affinity binding component of the EGF-R. Malignant transformation and loss of TGF alpha/EGF responsiveness did not correlate with an increase in TGF alpha production. Thus, TGF alpha production does not appear to be a tumor specific marker for human mammary epithelial cells. Differential growth responses to EGF/TGF alpha, rather than enhanced production of TGF alpha, may determine the transition from normal to malignant human breast epithelium. PMID- 2783758 TI - Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 9-1989. A 32-year-old man with AIDS and a cavitary pulmonary lesion. PMID- 2783759 TI - HLA and insulin-dependent diabetes mellitus. PMID- 2783760 TI - Human T-cell receptor expression. PMID- 2783761 TI - Unproved AIDS drug is made available for limited use. PMID- 2783762 TI - Clonal deletion of B lymphocytes in a transgenic mouse bearing anti-MHC class I antibody genes. AB - B lymphocytes can be rendered specifically unresponsive to antigen by experimental manipulation in vivo and in vitro, but it remains unclear whether or not natural tolerance involves B-cell tolerance because B cells are controlled by T lymphocytes, and in their absence respond poorly to antigen (reviewed in ref. 7). In addition, autoantibody-producing cells can be found in normal mice and their formation is enhanced by B-cell mitogens such as lipopolysaccharides. We have studied B-cell tolerance in transgenic mice using genes for IgM anti-H-2k MHC class I antibody. In H-2d transgenic mice about 25-50% of the splenic B cells bear membrane immunoglobulin of this specificity, and abundant serum IgM encoded by the transgenes is produced. In contrast, H-2k x H-2d (H-2-d/k) transgenic mice lack B cells bearing the anti-H-2k idiotype and contain no detectable serum anti H-2k antibody, suggesting that very large numbers of autospecific B cells can be controlled by clonal deletion. PMID- 2783763 TI - Acute aluminum encephalopathy in an uremic patient. AB - A patient on maintenance hemodialysis developed an acute encephalopathy closely related to a rapid increase in serum aluminum levels. Aluminum hydroxide and sucralfate had been given in large amounts for the treatment of a gastrointestinal bleeding episode. The breach of the gastrointestinal barrier to aluminum absorption, the increase in gastric pH caused by cimetidine, and the presence of gastric telangiectasia acting together in a uremic patient could have precipitated the acute aluminum encephalopathy. PMID- 2783764 TI - Peritoneal calcification and calciphylaxis. PMID- 2783765 TI - Effect of supernatants derived from T lymphocyte culture in minimal change nephrotic syndrome on rat kidney capillaries. AB - The effect on the kidney capillaries of T lymphocyte culture supernatants from patients with minimal change nephrotic syndrome was studied by infusion into the left renal artery of rats. The supernatants of T lymphocyte cultures from nephrotic patients induced significant proteinuria and a reduction of anionic sites in the glomerular basement membrane of the kidneys in the rats. These changes were not produced in rats receiving equivalent supernatants from healthy controls. PMID- 2783766 TI - Persistence of dialysis osteomalacia despite treatment with 24R,25 dihydroxycholecalciferol. AB - Five patients with symptomatic osteomalacia undergoing chronic hemodialysis took 24R,25-dihydroxycholecalciferol, 10 micrograms/day, for periods of 6-20 months. Four patients took calcitriol simultaneously in doses consistent with normocalcemia, but the 5th was unable to do so because of recurrent hypercalcemia. In the group as a whole, despite achievement of physiologic plasma concentrations of 24,25-dihydroxyvitamin D, we could demonstrate no metabolic or histologic benefit of therapy. Substantial osteomalacia persisted in all posttreatment biopsy specimens, appearing more severe in some cases and less severe in others. At the doses prescribed, the results of treatment of dialysis osteomalacia with 24R,25-dihydroxycholecalciferol were clinically unsatisfactory. PMID- 2783767 TI - Idiopathic bilateral vestibulopathy. AB - We report the clinical features of 22 patients with acquired bilateral vestibulopathy of unknown cause. All had either absent or markedly decreased responses to both caloric and rotational testing. They presented with dysequilibrium and imbalance, worse at night; most reported oscillopsia but none had associated hearing loss or other neurologic symptoms. Nine reported prior prolonged episodes of vertigo consistent with the diagnosis of bilateral sequential vestibular neuritis. Of the remaining 13, none had exposure to known ototoxins or a positive family history. Idiopathic bilateral vestibulopathy is an important cause of progressive imbalance in adults and should be considered even though hearing is normal. PMID- 2783768 TI - Extended major histocompatibility complex haplotypes in patients with multiple sclerosis. AB - We derived complete haplotypes of the major histocompatibility complex for 33 patients with MS and their families. The DR2 allele and DR2-bearing extended haplotypes, in proportion, were overrepresented on chromosomes of MS patients compared with parental chromosomes not transmitted to MS offspring. We did not confirm previous reports that particular alleles at the BF locus are overrepresented in MS or that C2 hypocomplementemia is present. These results suggest that the DR2 allele is a risk factor for MS, and not merely a genetic marker of the population of origin. PMID- 2783770 TI - The prognostic value of antinuclear antibodies in women with recurrent pregnancy losses: a prospective controlled study. AB - Because autoimmune diseases are suspected of causing some cases of recurrent pregnancy loss, we sought clinical and serologic evidence of such diseases in a group of 277 women with recurrent pregnancy loss. Using HEp-2 cells as targets for an indirect immunofluorescence test for antinuclear antibodies, we compared the frequency of a positive antinuclear antibody test in the women with recurrent pregnancy loss to that in 299 pregnant controls and 119 nonpregnant controls. The frequency of positive antinuclear antibody tests at a titer of 1:40 or higher was 16.3% in cases, 16.6% in pregnant controls, and 16.8% in nonpregnant controls. Increasing the critical titer to 1:80, however, led to a statistically significant difference between cases (6.9%) and controls (0 and 0.8%, pregnant and nonpregnant, respectively; P less than .0001). Additional serologic tests failed to identify any subclinical autoimmune diseases, although two antinuclear antibody-negative patients later developed systemic lupus erythematosus. Pregnancy outcome in women with antinuclear antibody titers of 1:80 or higher included 52% live births, compared with 65.6% live births in women with three or more pregnancy losses and an entirely normal comprehensive evaluation, a nonsignificant difference. The combination of clinical evaluation and antinuclear antibody tests did not identify new cases of autoimmune disease in this population. PMID- 2783769 TI - The prevalence of development defects of enamel and dental caries in New Zealand children receiving differing fluoride supplementation, in 1982 and 1985. AB - Seven hundred and twenty-seven 9-year-old children resident in Hawke's Bay were examined in 1985, 3 years after a baseline survey of a cohort of the same age group. Children were allocated to one of four fluoride-history groups on the basis of the responses of parents to a questionnaire, which also gave information on infant feeding and household water source. Examination conditions were duplicated, and children were examined by the same examiner using a modification of the DDE Index. The prevalence of diffuse defects in the low fluoride (LF) group (24.3 percent) was lower (P less than 0.001) than in the fluoridated water (WF) group (50.8 percent), the PT group who had used tablets to 5 to 6 years of age (53.1 percent), and the CT group who had used tablets continuously (54.7 percent). There were 2.9 percent of children with contralateral pairs of teeth with diffuse opacities in the LF group compared with 22.9 percent in the WF group, 18.7 percent in the PT group, and 36.0 percent in the CT group. For European children, 9.7 percent had post-eruptive defect sub-types. Defect prevalence could not be related to infant feeding or water source in unfluoridated areas. There had been a significant increase in the prevalence of diffuse defects in the WF, PT, and CT groups, but not the LF group since the baseline survey. There was also an increase in the numbers of children considered to have an unsatisfactory appearance due to either continuous or diffuse opacities--from none in 1982, to 24 (3.7 percent) in 1985. In the 3 years since the baseline survey there had been considerable reductions in the caries prevalence in all groups (P less than 0.001). PMID- 2783771 TI - First-trimester maternal Listeria monocytogenes sepsis and chorioamnionitis with normal neonatal outcome. AB - A secundigravida developed culture-proved Listeria monocytogenes sepsis with signs and symptoms of chorioamnionitis at 13 weeks' gestation. Pregnancy termination was refused, and she was treated with intravenous ampicillin and gentamicin followed by oral trimethoprim/sulfamethoxazol. Fifteen days after initiation of therapy, an amniotic fluid culture was negative, although uterine tenderness persisted for 7 weeks. A healthy, culture-negative infant was delivered at term. PMID- 2783772 TI - Congenital heart block in successive pregnancies: a case report and evaluation of risk with therapeutic consideration. AB - SS-A antibody has been found to bind to fetal cardiac tissue and is thought to mediate congenital heart block via transplacental passage. Recent papers have identified various risk factors thought to define subclasses of SS-A antibody positive mothers at greater risk of delivering children with congenital heart block. Treatment modalities for antibody-mediated fetal insult are now expanding and being used clinically. We report a case of a clinically asymptomatic SS-A antibody-producing mother who gave birth to two SS-A antibody-positive children with congenital heart block. It is our hope that ongoing refinement of risk factors and effective therapy will result in successful in utero palliation of the effects of SS-A antibody. PMID- 2783773 TI - Introduction of a Ha-ras oncogene into rat liver epithelial cells and parenchymal hepatocytes confers resistance to the growth inhibitory effects of TGF-beta. AB - Growth of rat liver epithelial cells (RLEC) and primary cultures of parenchymal hepatocytes is potently inhibited by TGF-beta. Transfection of a mutated Ha-ras oncogene, but not a human c-myc oncogene, into RLEC resulted in cell lines resistant to growth inhibition by TGF-beta under anchorage-dependent conditions. Infection of primary rat hepatocyte cultures with v-Ha-ras yielded a cell line likewise insensitive to inhibition by TGF-beta. Binding of [125I]TGF-beta to Ha ras-transfected RLEC was reduced relative to control or c-myc-transfected cells. These data suggest that activation of a Ha-ras oncogene in epithelial cells may result in escape from negative growth control and hence be a critical step during carcinogenesis. However, although Ha-ras induced resistance to growth inhibition by TGF-beta under anchorage-dependent conditions, TGF-beta inhibited the spontaneous growth in soft agar of all cell lines containing the Ha-ras oncogene. This may reflect an alteration in regulation of extracellular matrix proteins and related enzymes responsible for anchorage-independent growth. PMID- 2783774 TI - Elevated serum levels of soluble interleukin-2 receptors in HIV infection: no correlation with activated T cells. AB - Serum levels of soluble interleukin-2 receptors (sIL-2R) were measured in 105 HIV seropositive individuals simultaneously with T cell subsets and activated T cells (CD3+ and HLA-DR+). Significantly elevated levels of serum sIL-2R were found (564 +/- 259 U/ml versus 258 +/- 87 U/ml in 70 controls, p less than 0.001), as well as increased numbers of activated T cells (mean numbers, 579/microliters in the patients versus 113/microliters in 26 controls, p less than 0.0001). Correlation analysis did not disclose any significant association between elevated sIL-2R and increased activated T cells, nor with decreased CD4+ lymphocytes. These data suggest that sIL-2R in HIV infection do not emanate from activated T cells and are not linked to CD4+ cell loss. PMID- 2783775 TI - The PreA4(695) precursor protein of Alzheimer's disease A4 amyloid is encoded by 16 exons. AB - Alzheimer's disease (AD) is characterized by the cerebral deposition of fibrillar aggregates of the amyloid A4 protein. Complementary DNA's coding for the precursor of the amyloid A4 protein have been described. In order to identify the structure of the precursor gene relevant clones from several human genomic libraries were isolated. Sequence analysis of the various clones revealed 16 exons to encode the 695 residue precursor protein (PreA4(695] of Alzheimer's disease amyloid A4 protein. The DNA sequence coding for the amyloid A4 protein is interrupted by an intron. This finding supports the idea that amyloid A4 protein arises by incomplete proteolysis of a larger precursor, and not by aberrant splicing. PMID- 2783778 TI - Current immunization practices. 2. Hemophilus influenzae, pneumococcal, and meningococcal infections, rabies, and hepatitis. PMID- 2783776 TI - Species variation in transcription factor IIIA. AB - Species variation in transcription factor IIIA (TFIIIA) was examined by comparing the abilities of TFIIIAs isolated from different Xenopus and Rana species to 1) bind rabbit anti-Xenopus laevis TFIIIA IgG, 2) specifically interact with the Xenopus borealis somatic 5S RNA gene, and 3) promote transcription of the Xenopus borealis 5S RNA gene in vitro. In immunoblot assays, Rana catesbeiana or Rana pipiens TFIIIA did not react readily with rabbit anti-Xenopus laevis TFIIIA IgG (assayed with anti-rabbit F(ab')2 fragment conjugated with alkaline phosphatase) whereas Xenopus borealis TFIIIA exhibited similar reactivity with this IgG as Xenopus laevis TFIIIA. When compared to Xenopus TFIIIAs, Rana TFIIIAs exhibited similar interactions with the 3' portion of the intragenic control region of the Xenopus 5S RNA gene (to residue +78 on the coding strand and up to and including +74 on the non-coding strand, nucleotides protected from DNase I digestion by the N-terminal half of Xenopus TFIIIA) and incomplete interactions with the remaining 5' portion of the control region (nucleotides protected from DNase I digestion by the C-terminal half of Xenopus TFIIIA). In a Xenopus laevis unfertilized egg extract, Rana catesbeiana and Rana pipiens TFIIIAs promoted transcription of the Xenopus borealis somatic 5S RNA gene less efficiently than Xenopus laevis and Xenopus borealis TFIIIAs. PMID- 2783777 TI - Current immunization practices. 1. Polio, diphtheria, tetanus, pertussis, measles, mumps, rubella, and influenza. AB - When used appropriately, immunization can effectively prevent many infections and diseases. Some vaccines, such as that for polio, are believed to produce lifelong immunity. Others, such as those for tetanus and diphtheria, may require that a booster injection be given upon exposure to assure full immunity. Still others, such as that for influenza, confer immunity for only a limited time. Inoculation is not without risk, particularly in immunosuppressed, allergic, febrile, or pregnant patients. However, in otherwise healthy patients, serious sequelae are so rare that they are far overshadowed by the enormous benefits of immunization. PMID- 2783779 TI - T-cell receptor delta-chain diversity in peripheral lymphocytes. AB - A small percentage (approximately 5%) of the cells in the adult thymus expresses a heterodimeric receptor, gamma delta, that exhibits extensive clonal diversity. The specificity and function of these cells are unclear. Furthermore, it is not known if their role in the immune system is primarily one that operates within the thymus during the selection of the T-cell repertoire or if they function primarily in an antigen-recognition capacity in the peripheral lymphoid system. To examine if gamma delta+ T cells in the periphery are as diverse as those in the thymus, we used the polymerase chain reaction to amplify delta-chain transcripts from polyclonal populations of thymic and splenic lymphocytes (the latter were derived from allogeneic mixed lymphocyte cultures). The nucleotide sequences of delta chains from the spleen, like those from the thymus, were all different. Most of the diversity was present in the region between the variable (V) and joining (J) gene segments and was generated through the use of the two known diversity (D) elements, D delta 1 and D delta 2, and by the addition or deletion of bases at the V delta D delta 1, D delta 1D delta 2, and D delta 2J delta junctions. The extensive gamma delta repertoire among peripheral cells suggests that they have the potential to recognize an array of ligands that could be as diverse as those recognized by alpha beta+ cells. The amplification strategy described here can be used to analyze rapidly the diversity exhibited by any of the members of the immunoglobulin-like gene families that undergo rearrangement. PMID- 2783780 TI - Mutational analysis of the HLA-DQ3.2 insulin-dependent diabetes mellitus susceptibility gene. AB - The human major histocompatibility complex includes approximately 14 class II HLA genes within the HLA-D region, most of which exist in multiple allelic forms. One of these genes, the DQ3.2 beta gene, accounts for the well-documented association of HLA-DR4 with insulin-dependent diabetes mellitus and is the single allele most highly correlated with this disease. We analyzed the amino acid substitutions that lead to the structural differences distinguishing DQ3.2 beta from its nondiabetogenic, but closely related allele, DQ3.1 beta. Site-directed mutagenesis of the DQ3.2 beta gene was used to convert key nucleotides into DQ3.1 beta codons. Subsequent expression studies of these mutated DQ3.2 beta clones using retroviral vectors defined amino acid 45 as critical for generating serologic epitopes characterizing the DQw3.1 beta and DQw3.2 beta molecules. PMID- 2783781 TI - Creation of H-2 class I epitopes using synthetic peptides: recognition by alloreactive cytotoxic T lymphocytes. AB - A major role that cytotoxic T lymphocytes (CTLs) play in the immune response is the specific destruction of viral-infected cells and tissue from foreign grafts. Class I molecules encoded within the major histocompatibility complex are the target structures for these CTLs. Recently, viral-restricted CTLs have been shown to recognize viral peptides in association with class I molecules, while several studies with cloned alloreactive CTLs have indicated that these T cells can recognize class I-derived peptides in association with class I molecules. Together, these observations suggest that peptide binding is an important function of class I molecules. In this paper, we show that the recognition of a particular class I molecule by a bulk population of alloreactive CTLs can be altered by incubating with it a peptide derived from another class I molecule. Specifically, we used the hybrid D/Ldm1 molecule as a target structure together with the peptide Ld61-85, and we have shown that their associative recognition by Ld-specific CTLs depends on sequence and configuration of the peptide and is specific for Ld using a cold-target inhibition assay. Our results are discussed in light of three possible models for the target structure(s) that can be recognized by alloreactive CTLs and in terms of the role peptides may play during allorecognition. PMID- 2783782 TI - Nonanesthetic alcohols dissolve in synaptic membranes without perturbing their lipids. AB - While many theories of general anesthesia postulate a lipid site of action, there has been no adequate explanation for the lack of anesthetic potency of the highly hydrophobic primary alkanols with more than 12 carbons (the cut-off). Some work suggests that these nonanesthetic alcohols do not dissolve in membranes. Other work contradicts this and suggests that an anesthetic site on a protein provides a better explanation. Here we show that both the anesthetic dodecanol and the nonanesthetic tetradecanol are taken up equally well into the tissues of animals and into isolated postsynaptic membranes. When a group of Rana pipiens tadpoles were treated with dodecanol, half were anesthetized by 4.7 microM (free aqueos concentration), and the corresponding concentration in the tissues was found to be 0.4 mmol per kg wet weight. Prolonged exposure (92 hr) to tetradecanol produced even higher tissue concentrations (0.7 mmol per kg wet weight), yet no anesthetic effects were observed. Furthermore, general anesthetics are thought to act on postsynaptic membranes but both alkanols partitioned into postsynaptic membranes from Torpedo electroplaques. The spin label, 12-doxyl stearate, was incorporated into these membranes. The lipid order parameter it reported was decreased by the anesthetic alcohols (octanol, decanol, and dodecanol), whereas the nonanesthetic alcohols either did not change it significantly (tetradecanol) or actually increased it (hexadecanol and octadecanol). Thus, although lipid solubility is unable to account for the pharmacology of the cut-off in potency of the long-chain alcohols, lipid perturbations provide an accurate description. PMID- 2783783 TI - Detection of abnormalities in febrile AIDS patients with In-111-labeled leukocyte and Ga-67 scintigraphy. AB - Thirty-six patients with acquired immunodeficiency syndrome (AIDS), who were febrile but without localizing signs, underwent indium-111 leukocyte scintigraphy 24 hours after injection of labeled white blood cells (WBCs) and were restudied 48 hours after injection of gallium-67 citrate. Fifty-six abnormalities were identified as possible sources of the fever; 27 were confirmed with biopsy. Of these 27, 15 were identified only on In-111 WBC scans (including colitis, sinusitis, and focal bacterial pneumonia); six, only on Ga-67 scans (predominantly Pneumocystis carinii pneumonia and lymphadenopathy); and six, on both studies (predominantly pulmonary lesions). In-111 WBC scanning revealed 21 of 27 abnormalities (78%) and gallium scanning, 12 of 27 (44%). If only one scintigraphic study has been performed, particularly with Ga-67, a significant number of lesions would not have been detected. The authors believe radionuclide evaluation of the febrile AIDS patient without localizing signs should begin with In-111 WBC scintigraphy. Gallium scanning may be used depending on results of In 111 WBC scans or if there is a high index of suspicion for P carinii pneumonia. PMID- 2783784 TI - Stomal varices: percutaneous transhepatic embolization. AB - Peristomal varices occasionally form in patients with chronic liver disease who have surgically created intestinal anastomoses and stomas. Hemorrhage from these varices carries an estimated mortality of 3%-4% per episode, as opposed to the 30%-40% mortality associated with gastroesophageal variceal bleeding. The cases of four patients who underwent transhepatic mesenteric vein catheterization with embolization of stomal varices for recurrent, intractable bleeding are presented. In three of the four patients there was no additional hemorrhage for at least 5 months. One patient was lost to follow-up. There were no complications. Since stomal variceal hemorrhage has a low mortality, transhepatic embolization is presented as a means of hemorrhage control when sclerotherapy fails and when shunt surgery presents an unacceptably high rate of morbidity and mortality relative to the underlying disease. PMID- 2783785 TI - Prevalence of rubella antibodies on the African continent. AB - Until recently, data on the epidemiology of rubella in Africa have been very scarce. However, several seroepidemiologic surveys within the last 10 years show that the virus is prevalent throughout Africa. In most of Africa rubella is contracted early in life; in areas such as the Gambia, Egypt, Zimbabwe, Mali, and parts of Kenya greater than 80% of children are immune to the virus by 10 years of age, and this level increases through adulthood. Most studies show that greater than 80% of pregnant women are immune to rubella. PMID- 2783786 TI - The state of South Dakota's child: 1988. AB - South Dakota's five year (1982-86) mean neonatal mortality rate (6.2) has achieved the Surgeon General's 1990 goal of 6.5 and is lower than the 7.1 national mean rate. The rate of post neonatal mortality continues to be an area of concern, especially for the non-white population whose five year mean rate is twice that of the nation. Inadequate utilization of prenatal care in South Dakota is significantly related to higher neonatal and post neonatal mortality, higher admission rates to neonatal intensive care and higher costs for neonatal intensive care. Improving access and utilization of prenatal care is advocated as a cost effective and humane investment of public resources. PMID- 2783787 TI - Detecting mutations in human genes. PMID- 2783788 TI - Initial antibiotic therapy for alligator bites: characterization of the oral flora of Alligator mississippiensis. AB - An open thumb fracture resulting from an alligator bite became infected with Aeromonas hydrophila, Enterobacter agglomerans, and Citrobacter diversus. The patient was treated by surgical debridement and antibiotic therapy. We obtained cultures from the mouth of ten alligators to characterize their oral flora. Initial empiric therapy after alligator bites should be directed at gram-negative species, in particular, Aeromonas hydrophila and anaerobic species including Clostridium. Of the numerous fungi that were isolated, none has been reported to result in wound infection after alligator bites. PMID- 2783789 TI - Mutant Chinese hamster ovary cells with defective methotrexate uptake are distinguishable by reversion analysis. AB - Chinese hamster ovary cells that are about 50x more resistant to the cytotoxic action of methotrexate than wild-type cells were deficient in the ability to take up methotrexate. In the absence of any exogeneous folates, these cells require 100-250x the level of folinic acid as wild-type cells to support growth at a similar level. Two classes of mutants were distinguishable by their revertability for growth on folinic acid. Revertants derived from one class were similar to wild-type cells in both their ability to grow in medium containing low levels of folinic acid and in their sensitivity to methotrexate. In contrast, partial revertants from a second class were able to grow in medium containing low or no folinic acid, but retained their methotrexate resistance. Furthermore, mutants of the first class were unable to take up folic acid while the second class of mutants accumulated folic acid to levels similar to that of wild-type cells. Somatic cell hybrids formed between these two classes of mutants were noncomplementing. These observations suggested that some, but not all, components may be shared between the transport systems mediating methotrexate and folic acid uptake. PMID- 2783790 TI - Incidence and management of complications after injection sclerotherapy: a ten year prospective evaluation. AB - The incidence and management of complications of injection sclerotherapy are reviewed in 304 consecutive patients with esophageal varices followed up prospectively for a 10-year period. The 304 patients were injected on 1336 occasions. Three hundred eleven local esophageal complications occurred in 140 patients (complication rate, 23% per injection and 46% per patient). Esophageal mucosal slough, which was diagnosed by endoscopy, occurred on 250 occasions in 126 patients but did not require specific treatment. An injection site leak occurred in 25 patients, was managed conservatively, and was associated with a mortality rate of 28%. Stenosis of the esophagus was found in 32 patients, but only five patients required dilatation for relief of symptoms. Rupture of the esophagus occurred in four patients, three of whom had surgical treatment, and was associated with a mortality rate of 50%. Serious complications were more frequent with the rigid esophagoscope. An injection site leak occurred more frequently after acute sclerotherapy via the rigid esophagoscope. All four patients with rupture of the esophagus were injected electively via the rigid esophagoscope. Although the incidence of serious complications after injection sclerotherapy in this series appears acceptable, complications have been noted to be cumulative with time. PMID- 2783791 TI - Management of upper gastrointestinal hemorrhage in patients with pseudoxanthoma elasticum. AB - Pseudoxanthoma elasticum is a rare inherited connective tissue disorder, which exhibits genetic heterogeneity. It is characterized by elastic tissue degeneration involving many organ systems, with typical cutaneous, ocular, arterial, and gastrointestinal manifestations. Upper gastrointestinal tract hemorrhage occurs in 13% of patients with pseudoxanthoma elasticum and is often resistant to conventional methods of treatment. A case report involving gastric hemorrhage in a patient with pseudoxanthoma elasticum is presented. The characteristics of pseudoxanthoma elasticum are reviewed, and the management of upper gastrointestinal tract hemorrhage in these patients is discussed. PMID- 2783792 TI - [Histiocytosis syndrome in children]. AB - The recommended classification of the histiocytosis syndromes in children is as follows: 1. Langerhans' cell histiocytoses. 2. histiocytoses of mononuclear phagocytes. 3. neoplastic histiocytoses. The previous term, histiocytosis X, including eosinophilic granuloma of bone, the Hand-Schuller-Christian syndrome and Letterer-Siwe's disease, is now more correctly called Langerhans' cell histiocytosis (LCH) since the infiltrating cell in histiocytosis X both histologically and immunophenotypically is identified as the Langerhans' cell. Local and generalized LCH differmarkedly with respect to treatment and outcome. It is therefore necessary to perform an extensive investigation at the time of the initial evaluation of the patient. The most common mononuclear phagocytic syndromes are the familial erythrophagocytic lymphohistiocytosis and infection associated or reactive hemophagocytic syndromes. The pathognomonic cell in familial erythrophagocytic lymphohistiocytosis is possibly a hybrid phenotype sharing characteristics of the two main types the mononuclear phagocyte system - i.e. the Langerhans' cells and phagocytic macrophages. Malignant histiocytosis is rarely seen in children and is a form of the Ki-1 positive anaplastic cell lymphoma. PMID- 2783794 TI - Clinical evaluation of propofol as an intravenous anaesthetic agent in cats and dogs. AB - The clinical efficacy and safety of an emulsion containing 10 mg/ml of the intravenous anaesthetic propofol were evaluated in cats and dogs by veterinary surgeons in eight practices in the United Kingdom. A total of 290 dogs and 207 cats were anaesthetised with propofol either as a single injection for procedures of short duration, or as an induction agent with maintenance provided by further incremental injections or as an induction agent with maintenance by gaseous agents. The mean induction doses of propofol for unpremedicated dogs and cats were respectively 6.55 mg/kg and 8.03 mg/kg. The mean induction doses after premedication with a tranquilliser were 4.5 mg/kg and 5.97 mg/kg for dogs and cats, respectively. Mean recovery times ranged, depending on the method of anaesthesia, from 23 to 40 minutes in dogs and from 27 to 38 minutes in cats; recovery was defined as the time at which the animals were alert and able to stand. Adverse side effects were infrequent, apnoea during induction being the commonest. Acepromazine and atropine were most often used as premedicants although in a few cases diazepam, xylazine and other agents were employed. No clinical incompatibility was observed between propofol and any of the other agents administered during the study. The rapid and usually excitement-free recovery of the animals was a valuable feature of anaesthesia with propofol. PMID- 2783793 TI - In vitro activation of lymphocytes by interleukin 2 in patients with renal cell carcinoma. AB - Interleukin-2-stimulated lymphocytes or lymphokine-activated killer cells (LAK) have been shown to have anti-tumor activity which is not present in the fresh untreated peripheral blood lymphocytes. This activity has been evaluated in our laboratory using renal cell carcinoma as a target tumor. Two of 8 patients demonstrated significant lysis of autologous tumor while an additional 3 patients lysed the target cells but to a less significant degree. It is not clear why the LAK phenomenon against autologous tumors occurs in vitro in some patients and not others. By identifying the response of patients in vitro, one might be able to select an appropriate population for meaningful clinical trials. PMID- 2783795 TI - Surgical procedures for choledochal cysts. AB - The case of a 27-year-old man who became symptomatic for a choledochal cyst at the age of 6 months is presented. Treatment of this patient mirrored the major surgical procedures recommended in the literature over the patient's lifetime. The surgical procedure that seems to be curative is excision of the cyst with Roux-Y hepaticojejunostomy. This procedure eliminates the major complications of this disease, which are biliary obstruction, ascending cholangitis, biliary cirrhosis, malignant degeneration, and, occasionally--as in this patient--erosive ulceration with bleeding. PMID- 2783796 TI - Tissue distribution and levels of gene expression of three steroid hydroxylases in ovine fetal adrenal glands. AB - Northern blotting and hybridization histochemistry were used to evaluate the ontogeny and cellular distribution of the mRNAs of the cytochrome P-450 enzymes: cholesterol side-chain cleavage (P-450scc), 17 alpha-hydroxylase (P-450(17 alpha] and 21-hydroxylase (P-450c21) in 40 ovine fetal adrenals from 42 days of gestation until term (151 days). The genes for P-450(17 alpha) and P-450scc were expressed strongly in tissue from young (40-60 days) and old fetuses (120 days to term), but to a very minor degree in 90-120 day fetuses. P-450c21 showed a steady increase throughout gestation. In the morphologically immature an unzoned adrenal of the 40-50 day fetus there was some differentiation in gene expression, all cells containing P-450scc and P-450c21 but a few lacking P-450(17 alpha). Once morphological zonation had occurred (80 days), P-450(17 alpha) was confined to the fasciculata. After 120 days there was a radial maturation pattern of the fasciculata cells morphologically, adult-type cells first appearing at the medullary border. However, P-450(17 alpha) and P-450scc mRNAs were equally well expressed in all sections of the fasciculata. The conclusions were: 1) the previously demonstrated triphasic cortisol biosynthetic capacity of ovine fetal adrenals was correlated with the presence, absence, and reappearance of mRNAs P 450(17 alpha) and P-450scc; 2) morphological appearance of fetal adrenocortical cells and expression of three major steroidogenic enzyme genes were not correlated. PMID- 2783797 TI - Cine-gradient-refocused MR imaging of central pulmonary emboli. AB - We studied the use of MR imaging with a limited-flip-angle, gradient-refocused pulse sequence to show central pulmonary emboli in 11 patients and to distinguish acute from chronic emboli. The central pulmonary vasculature was imaged by using a cine-limited-flip-angle (cine-MR) pulse sequence with 63/13 (TR/TE) and a 30 degrees flip angle (theta), as well as standard spin-echo sequences. Patients were selected on the basis of suspicion of central pulmonary embolism and correlative studies done within 24 hr of the MR examination. Correlations with other studies were based on the original MR report and blinded review of the MR images by two observers in consensus. Emboli were shown in all cases by cine-MR, and they corresponded to the locations of angiographic abnormalities and mismatched perfusion defects on scintigraphy. In three patients considered to have acute pulmonary embolus on the basis of angiography, the cine-MR studies were consistent with acute pulmonary embolus in two patients and chronic pulmonary embolus in one patient (however, in that patient pathologic examination showed chronic embolism). In one case in which angiography led to the diagnosis of acute and chronic pulmonary embolism, the cine-MR study showed acute embolism. In three patients thought to have chronic pulmonary embolus on the basis of angiography, the cine-MR study was interpreted as representing acute embolus in one patient and chronic embolus in two patients. In this highly selected, small group of patients, cine-MR imaging was accurate in showing central pulmonary embolism. PMID- 2783798 TI - Cardiac masses: assessment by MR imaging. AB - The purpose of this study was to assess the role of MR imaging for evaluating suspected cardiac tumors or paracardiac masses involving the heart. Sixty-one patients with clinical or radiologic evidence of cardiac masses were imaged with ECG-gated MR at 1.5 T (22 patients) or 0.15 T (39 patients). Fifty-one patients had echocardiography previously. Among the tissue diagnoses were myxoma (six); fibroma, rhabdomyoma, plasma cell granuloma, lipomatous hypertrophy of the atrial septum, mesothelioma, and thymoma (two each); and leiomyosarcoma, lymphoma, metastatic carcinoid, melanoma, malignant fibrous histiocytoma, hemangiopericytoma, and lung spindle cell sarcoma (one each). MR imaging demonstrated masses in 50 patients (82%); they were centered in the heart in 32, pericardial in nine, and juxtacardiac in nine. MR imaging provided diagnostic information that affected clinical management or surgical planning in 53 patients (87%), including 11 (18%) in whom cardiac mass was excluded by MR. The ability to provide a global view of cardiac anatomy and other unique capabilities of MR imaging give the procedure an important role in the diagnosis and preoperative assessment of cardiac masses. PMID- 2783799 TI - Pectoralis muscle simulating a breast mass. PMID- 2783800 TI - Evaluation of a dual-screen, dual-emulsion mammography system. AB - We compared a new dual-screen, dual-emulsion film system for X-ray mammography with a widely used single-screen, single-emulsion combination for routine contact mammography in 100 patients with a variety of mammographic findings. By using a five-point rating scale (1 = poor, 5 = excellent), four blinded readers found the conventional combination superior in density (by 0.46 points on the rating scale), resolution (by 0.64 points), contrast (by 0.46 points), visibility of calcification (by 0.50 points), visibility of soft-tissue masses (by 0.37 points), and overall quality (by 0.47 points). No difference was seen in the graininess of the films. In our study, the conventional system was consistently found to be slightly better than the dual-screen, dual-emulsion combination. The dual-emulsion mammograms required more careful scrutiny, particularly for detection of faint microcalcifications. PMID- 2783801 TI - Imaging of pancreatic neoplasms: comparison of MR and CT. AB - Thirty-two patients with pathologically proved pancreatic carcinomas or cystadenomas were evaluated with MR images obtained with T1-weighted spin echo (short TR/short TE), inversion recovery, and T2-weighted spin-echo (long TR/long TE) pulse sequences. CT was used as the reference standard to determine the ability of MR to delineate normal and abnormal pancreatic anatomy and thereby to exclude or detect pancreatic malignancy. Short TR/short TE spin-echo sequences were significantly better (p less than .05) than inversion recovery or T2 weighted spin-echo sequences in resolution of both normal and abnormal anatomy. Resolution of pancreatic anatomy correlated (r = .9) with the image signal-to noise ratio. In seven (22%) of 32 cases, MR visualized pancreatic tumors better than CT did because it showed a signal intensity difference between the tumor and normal pancreatic tissue. Overall, the slight superiority of MR over CT for tumor visualization tended to occur in larger tumors and was not statistically significant. On T1-weighted images, 63% (20 of 32) of pancreatic tumors studied had lower signal intensities than normal pancreatic tissue, whereas on T2 weighted sequences (TE = 60, 120, and 180 msec) only 41% (13 of 32) of tumors had increased signal intensities. Currently available MR imaging techniques offer no significant advantages over CT for evaluating the pancreas for neoplasia. PMID- 2783802 TI - Large colonic neoplasms missed by endoscopy. AB - Endoscopy is commonly accepted as the gold standard in the evaluation of neoplastic colonic disease. The procedure is used to confirm or exclude lesions detected on barium enemas, with the assumption that the endoscopist was successful in reaching the appropriate segment of the colon. We collected 18 cases, all with proved colonic neoplasm 2-8 cm in diameter that were detected by barium enema but overlooked on initial endoscopy. All of the lesions were relatively flat with little intraluminal protuberance. Histologic examination showed malignant foci in six of 11 tumors that were resected. In two of the other seven patients, unresected lesions progressed to advanced carcinomas. This experience suggests that a repeat barium enema is indicated when endoscopy fails to detect a colonic tumor suspected on barium enema examination. PMID- 2783803 TI - Giant fibrovascular polyp of the esophagus: CT and MR findings. PMID- 2783804 TI - Direct percutaneous drainage of an obstructed afferent loop. PMID- 2783805 TI - An internalized double-J catheter for percutaneous transgastric cystogastrostomy. PMID- 2783806 TI - A new technique for removing occluded double mushroom-tipped biliary endoprostheses. PMID- 2783807 TI - Digital skeletal radiography: spatial resolution requirements for detection of subperiosteal resorption. AB - Forty direct-magnification (2:1 enlargement) radiographs showing various severities of subperiosteal resorption and 40 normal studies were selected and digitized. Images were processed to produce varying resolution, from 1.42 to 11.4 Ip/mm, corresponding to pixel sizes ranging from 0.04 to 0.32 mm. The conventional and digitized images were evaluated by six radiologists giving their decision confidence on a graded scale. Receiver operating characteristic analyses were performed from these data to compare the digital images with the conventional films. The results show significant improvement in diagnostic accuracy as pixel size decreases to the level of 0.08 mm. Digital images with pixel sizes of 0.04 mm (11.4 Ip/mm) were not significantly different from the magnification radiographs in terms of observer performance. In conclusion, for high-resolution skeletal imaging as needed for detection of subperiosteal resorption, spatial resolution of 5.7 Ip/mm or less resulted in a significant loss of diagnostic accuracy, as compared with conventional films. PMID- 2783808 TI - Immature bone infarcts: findings on plain radiographs and MR scans. AB - We studied the plain film findings in eight patients with immature bone-marrow infarction and correlated the findings with those of MR imaging in four of the cases. Seven patients had underlying systemic disease, including sickle cell disease (two), systemic lupus erythematosus (two), acute lymphocytic leukemia (one), non-Hodgkin lymphoma (one), and renal transplantation (one). In one patient, the bone infarct was idiopathic. Plain films in three of the eight cases were misinterpreted as showing aggressive lesions (i.e., malignancy or infection), and these patients underwent a biopsy that proved the diagnosis of bone infarction. In the other five cases, the diagnoses were established by clinical follow-up. The plain film findings in all eight cases consisted of subtle, mottled, ill-defined radiolucencies in the diametaphyseal region. Four of the patients had mild sclerosis. MR imaging in all four cases in which it was performed showed a central area with high or intermediate signal with a serpentine, thin, low-signal border. The lesions shown by MR imaging corresponded to the areas of abnormality on the plain films and had an appearance similar to that of previously reported bone infarcts. Our experience suggests that in patients with nonspecific subtle radiographic bone changes and an underlying systemic disease, MR imaging is helpful in establishing the diagnosis of bone marrow infarction. PMID- 2783809 TI - MR of osteochondritis dissecans and avascular necrosis of the mandibular condyle. AB - We studied 40 patients exhibiting radiologic changes of either osteochondritis dissecans (OCD) or avascular necrosis (AVN) involving the mandibular condyle to evaluate the structural changes associated with these lesions when using high field-strength MR imaging. Various clinical indications for imaging each patient with routine radiography, tomography, and surface-coil MR included headache, temporomandibular joint (TMJ) and/or ilsilateral facial pain, joint crepitus, clicking, locking, and either recently acquired or changing (unstable) occlusal disorder. Radiologic findings included alterations in condyle morphology and MR signal characteristics compatible with either OCD or AVN or, in some cases, both. Previous nonsurgical mandibular trauma was temporally related to the onset of symptoms in eight patients. Five patients exhibiting either unilateral or bilateral AVN involving the condyles and condylar necks had undergone previous orthognathic surgery, including sagittal split mandibular osteotomies followed by intermaxillary fixation. One patient exhibiting condylar AVN with articular surface collapse and osseous destruction had undergone previous TMJ meniscectomy followed by insertion of a permanent Proplast implant. Thirty-one of 34 patients with no prior surgery and MR changes of condylar OCD/AVN had associated internal derangement of the TMJ meniscus. There was surgical confirmation of findings in 10 joints. We assert that OCD and AVN are relatively common, clinically significant lesions of the mandibular condyle often associated with preexisting internal derangement of the temporomandibular joint. PMID- 2783810 TI - Pre- and postoperative MR imaging of the craniocervical junction in rheumatoid arthritis. AB - Ten patients with severe chronic rheumatoid arthritis with atlantoaxial subluxation were examined with conventional radiography and MR imaging of the cervical spine before and at an average of 6 months after posterior occipitocervical fusion. Periodontoid pannus formation was revealed by MR preoperatively in nine patients, all with mobile horizontal atlantoaxial subluxation. Compression of the medulla and/or upper cervical cord, due to subluxation and periodontoid pannus bulging into the spinal canal, was seen in seven patients. After the stabilizing surgery the periodontoid pannus had decreased in size in all patients with preoperative pannus. This reduction in the pannus seems to be the result of the atlantoaxial immobility achieved by the posterior fusion. Postoperatively, three patients had some remaining compression of the medulla and/or cord secondary to immobile subluxation, while the pannus posterior to the odontoid process had disappeared. Artifacts from the surgical stainless steel fixation material were confined to the posterior part of the neck on short TR/short TE MR images and did not interfere with the evaluation of the periodontoid region and the anterior part of the medulla/cervical cord. We found that flexion and extension lateral radiographs, combined with sagittal short TR/short TE MR images in the neutral position, enable preoperative evaluation of patients with rheumatoid arthritis in the cervical spine. Postoperative MR should be performed only if there are residual or new symptoms. PMID- 2783811 TI - Diagnosis of pulmonary hemosiderosis by MR imaging. PMID- 2783812 TI - Efficacy of chest radiography in pediatric intensive care. AB - We prospectively evaluated the efficacy and clinical usefulness of bedside chest radiography in a pediatric intensive-care unit. Seven hundred ninety-five radiographs were evaluated in 126 patients over a 10-week period. Eighty-one percent of all radiographs showed one or more cardiopulmonary abnormalities, and 25% of routine radiographs had findings that altered management of patients. Nineteen percent of radiographs, including 17% of routine radiographs, showed a malpositioned tube or catheter. Thirty-five percent of endotracheal tubes shown on postintubation radiographs and 41% of central venous catheters shown on post catheter placement radiographs were malpositioned. Forty-five percent of radiographs with a previous reading showed a significant interval change. Radiographs in patients 1 year old or younger showed more cardiopulmonary abnormalities (p less than .04), tube or catheter malpositions (p less than .03), and significant interval changes (p less than .03), and they elicited more changes in clinical management (p less than .01) than did radiographs in patients over 1 year old. The frequency of management changes dictated by radiographs increased with increasing amounts of respiratory support (p less than .01). Our data indicate that bedside radiography in the pediatric intensive-care setting has a high efficacy and clinical utility. PMID- 2783814 TI - Herniation of the suprasellar visual system and third ventricle into empty sellae: morphologic and clinical considerations. AB - Intrasellar herniation of the optic nerve, optic chiasm, optic tract (suprasellar visual system, SVS), and anteroinferior third ventricle can occur into primary or secondary empty sellae. The anatomic part of this study evaluated the appearance of the SVS in subjects with normal sellae (n = 52), the patterns and prevalence of SVS herniation in enlarged primary empty sellae (n = 24), and the patterns of intrasellar herniation of the SVS in secondary empty sellae (n = 8). The clinical part of this study was to correlate the visual status with the anatomic patterns of the intrasellar herniated SVS. High-resolution MR and CT were used to define the anatomy. MR was superior to CT in all groups in defining accurately the SVS relationship to the sella turcica. In the normal group, the SVS invariably had a straight-line appearance formed by the optic nerve, optic chiasm, and floor of the third ventricle and was above the sella. The SVS was herniated in three of 24 enlarged primary empty sellae. A difference in the appearance of the hypothalamic and infundibular recesses in the primary empty sella group with SVS herniation (dilated recesses and formation of an obtuse angle) and in the secondary empty sella group with SVS herniation (nondilated recesses and formation of an acute angle) was observed. Visual disturbances in primary empty sellae with SVS herniation were present in two of three subjects. Visual disturbances may be absent or minimal in primary empty sellae and secondary empty sellae with herniation of the SVS. Progression of the symptoms--visual field defects, optic atrophy, and loss of vision--is not inevitable. There was no correlation between the severity of visual symptoms and the degree of herniation of the SVS in either the primary or secondary sellae. We found that intrasellar herniation of the SVS into a primary or secondary empty sella is well delineated with MR, and MR should facilitate decisions concerning surgery or therapy. Visual disturbances proved to be an unreliable indicator of herniation. PMID- 2783813 TI - MR imaging of periventricular leukomalacia in childhood. AB - Eight children with clinical and radiologic abnormalities consistent with periventricular leukomalacia were investigated with MR imaging of the brain that employed both inversion-recovery and T2-weighted spin-echo imaging sequences. The more precise delineation of white and gray matter on inversion-recovery images as compared with CT allows a detailed demonstration of the anatomic features of periventricular leukomalacia; specifically, a reduced quantity of white matter in the periventricular region and centrum semiovale and, in more severe cases, cavitated infarcts that replace the immediate periventricular white matter. The T2-weighted spin-echo and short inversion time inversion-recovery images demonstrated abnormally increased signal in white matter that appeared normal on CT scans and only minimally abnormal on conventional inversion-recovery images. These abnormalities most probably represent white matter gliosis that extends beyond the immediate periventricular regions. MR recognition of cerebral white matter abnormalities associated with periventricular leukomalacia may confirm the clinical suspicion of this diagnosis in children with spastic diplegia or quadriplegia. PMID- 2783815 TI - MR and CT of masses of the anterosuperior third ventricle. AB - Six patients with masses of the anterosuperior portion of the third ventricle were imaged with MR and CT. Four patients had proved colloid cysts, one patient had a proved astrocytoma, and one patient had a presumed colloid cyst. Multiplanar MR imaging provided accurate localization of the anterosuperior third ventricle mass in all cases. The MR intensity characteristics of the colloid cysts varied and the astrocytoma could not be differentiated from the colloid cysts on MR. The astrocytoma contained a calcification that was clearly demonstrated on CT but was difficult to appreciate on MR. Neither MR nor CT was useful in predicting success of stereotactic aspiration of the colloid cysts in this small series, but the presence of thin, low-viscosity cyst contents could be suggested by both examinations. PMID- 2783816 TI - Pseudoaneurysm and arteriovenous fistula after femoral artery catheterization: association with low femoral punctures. AB - We determined the location of arterial injury in 11 patients who had pseudoaneurysms with (six cases) or without (five cases) arteriovenous fistula as a complication of cardiac catheterization. Medical records and arteriograms were examined retrospectively. Ten of the 11 pseudoaneurysms identified were located below the level of the femoral head. Five of six patients with arteriovenous fistula had simultaneous catheterization of both the femoral artery and the femoral vein. Although we did not determine the location of arterial puncture used in uncomplicated angiograms during the 5-year study period, our experience in 11 patients with pseudoaneurysms with or without arteriovenous fistula suggests that there is an association between a puncture site below the level of the femoral head and arterial injury. In addition, arteriovenous fistulas appear to be associated with simultaneous catheterization of the femoral artery and adjacent femoral vein. PMID- 2783817 TI - Insertion of subclavian hemodialysis catheters in difficult cases: value of fluoroscopy and angiographic techniques. AB - Double-lumen hemodialysis catheters designed to be placed via a subclavian vein approach have gained rapid acceptance over the past several years. Several studies have shown a significant rate of subclavian vein stenosis or occlusion after placement of these catheters. A large number of these patients require repeat placement of catheters with access often becoming increasingly difficult to obtain. Over the past 5 years, we have been asked to place 38 catheters in 34 patients that could not be placed at the bedside. Our procedure consists of obtaining a preliminary venogram to evaluate the reason for difficulty. The subclavian vein is then cannulated under direct fluoroscopic visualization while the peripheral venous line is injected with contrast material. Percutaneous angiographic techniques are then used to position the catheter. Satisfactory placement was obtained in all 38 cases. There were no complications, which is surprising considering the number of complications seen with the standard methods of insertion. This represents a new role for the interventional radiologist, one that can be important in minimizing the number of new dialysis sites in any one patient. PMID- 2783818 TI - On journals: the competition for minds and money. PMID- 2783819 TI - Why we edit. PMID- 2783820 TI - On the value of non-contrast-enhanced CT in blunt abdominal trauma. PMID- 2783821 TI - Whose turf is imaging? Professional responsibility for imaging procedures in hospital practice. PMID- 2783822 TI - Traumatic subluxation of the interphalangeal joint of the hallux with interposition of the sesamoid bone. PMID- 2783823 TI - MR imaging as a trigger for persistent claustrophobia. PMID- 2783824 TI - Simpler music/audio system for patients having MR imaging. PMID- 2783825 TI - Combined 99mTc-sulfide colloid and 99mTc-RBC studies for localization of gastrointestinal bleeding sites. PMID- 2783826 TI - Progressive periventricular hyperintensity on MR imaging. PMID- 2783827 TI - The left hemidiaphragm and the position of the heart. PMID- 2783828 TI - Aortocoronary saphenous vein graft spasm inducing ventricular fibrillation. PMID- 2783829 TI - Myofiber turnover is used to retrofit frog jaw muscles during metamorphosis. AB - Metamorphic reorganization of the head in anuran amphibians entails abrupt restructuring of the jaw complex as larval feeding structures are transformed into their adult configurations. In this morphometric study, light microscopy wa used to analyze the larval maturation and metamorphic transfiguration of the adductor jaw muscles in the leopard frog (Rana pipiens). Larval jaw muscles, first established during embryogenesis, continue to grow by fiber addition until prometamorphosis, stage XII. Thereafter, fiber number remains stable but additional muscle growth continues by hypertrophy of the individual fibers until metamorphic climax. During metamorphic stages XIX-XXIII, a complete involution of all larval myofibers occurs. Simultaneously, within the same muscle beds, a second wave of myogenesis produces myoblasts which are the precursors of adult jaw myofibers. New muscle fibers continue to be added to these muscles well after the completion of metamorphosis; however, the total duration of the postmetamorphic myogenic period has not been defined. These observations provide clear evidence that the entir population of primary myofibers used in larval oral activity disappears from the adductor muscle beds and is replaced by a second wave of myogenesis commencing during climax. These findings indicate that the adductor jaw muscles are prepared for adult feeding by a complicated cellular process that retrofits existing muscle beds with a completely new complement of myofibers. PMID- 2783830 TI - Gastrointestinal milk intolerance of infancy. AB - During a period of 30 months, cow's milk- or soy protein-induced colitis was diagnosed in 22 infants. All patients presented with hematochezia. Only three patients had substantial diarrhea. Colonoscopic evaluations demonstrated a characteristic mucosal appearance, manifested by aphthoid ulcerations with intervening, normal-appearing mucosa. Histologic findings included surface ulcerations and associated inflammation of the lamina propria and submucosa, marked by substantial eosinophilic infiltration. Both clinical symptoms and colonoscopic abnormalities rapidly resolved in all patients after the elimination of cow's milk and/or soy protein from the diet. These data indicate that hematochezia may be the predominant symptom of cow's milk protein and soy protein intolerance in many affected infants, and that colonoscopy is the most effective means of establishing a definitive diagnosis in this patient population. PMID- 2783831 TI - Therapeutic challenge for Isospora belli enteritis in an AIDS patient who developed Lyell syndrome after co-trimoxazole therapy. PMID- 2783832 TI - Estrogen and androgen levels in women treated with radiation for cervical cancer- possible influence on breast cancer risk. AB - In 1984-1985, estrogen and androgen levels in blood sera were measured in 320 women who had been treated for cervical cancer in the early 1960s. Study subjects were from US clinics in Baltimore, Maryland; Boston and Norfolk, Massachusetts; Buffalo, New York; Houston, Texas; and San Juan, Puerto Rico. These clinics had participated in a larger international follow-up study of cervical cancer in which a 20-30% reduction in breast cancer risk was linked to prior pelvic irradiation, even when treatment occurred after menopause. Overall, the 203 irradiated and 117 nonirradiated women had similar mean levels of estradiol, estrone, androstenedione, and testosterone. However, there appeared to be negative, albeit inconsistent, trends for androstenedione, testosterone, and estrone, suggesting that the irradiated women had lower levels of these hormones when compared with the nonirradiated women. These differences did not reach the level of statistical significance. While chance could partially explain these findings, it is plausible that the frequently observed protective association of breast cancer with pelvic irradiation could be due in part to a decrease in steroid hormones that is secondary, perhaps, to adrenal irradiation. PMID- 2783833 TI - Spontaneous platelet aggregation in type IIB Tampa von Willebrand disease is inhibited by the 52/48-kDa fragment of normal von Willebrand factor, which contains the GPIb binding domain. AB - The association of Type IIB von Willebrand disease (vWD) with chronic persistent thrombocytopenia and spontaneous platelet aggregation has recently been recognized. It has been shown that IIB von Willebrand factor (vWF) can initiate platelet aggregation by binding to the platelet glycoprotein (GP) lb receptor and inducing exposure of the GpIIb/IIIa fibrinogen receptor. In this study we demonstrate the increased binding of Type IIB Tampa vWF with normal platelets when compared with nonthrombocytopenic Type IIB vWF. Studies further demonstrate that spontaneous platelet aggregation initiated by IIB Tampa vWF can be blocked by a 52/48-kDa fragment of normal vWF, which contains the binding domain. PMID- 2783835 TI - Who's using nursing diagnoses? PMID- 2783834 TI - Microgranular promyelocytic leukemia: a multiparameter examination. AB - Six cases of microgranular variant acute promyelocytic leukemia (M3v) were studied by use of a multiparameter approach including morphology, cytochemistry, flow cytochemistry, flow cytometry, cytogenetics, and gene rearrangement. Three of six cases demonstrated both myeloid and monocytoid associated surface markers by flow cytometry. One of six cases had strong alpha-naphthyl-butyrate esterase (alpha-NBE) activity in addition to myeloperoxidase activity. There was no correlation between percentage of positive monocytoid surface markers and intensity of cytoplasmic alpha-NBE activity. Four of six cases also had a T-cell associated surface antigen. Further studies indicated that the T-cell markers appeared to be on the promyelocytes and that the T-B receptor gene was not rearranged. Similarly, cytogenetics studies indicated only one clonal abnormality t(15q+; 17q-). Whether these cases represent true "lineage infidelity" remains to be answered. Future important studies are needed on normal hematopoietic progenitor cells at early stages of development and childhood to study lineage specific characteristics and to determine whether co-expression normally exists during early development. PMID- 2783836 TI - Role of hepatic histologic findings in the prognosis and treatment of bleeding esophageal varices. AB - In the period from 1976 to 1986, we performed 329 hepatic needle biopsies using a posterior extraperitoneal approach in patients with bleeding esophageal varices. The histologic findings subdivided according to a four-stage classification were correlated significantly with immediate survival. Specifically, 21 of 23 stage IV patients with severe degenerative and necrotic parenchymal lesions died after immediate emergency surgery, whereas 26 of 48 stage IV patients who did not undergo emergency surgery survived. Stage IV patients appeared unable to withstand major surgery. According to our data, histologic stage and Child's class are independent parameters, especially in emergency situations, since they quantify different aspects of functional liver failure. Therapeutic implications are presented based on cumulative analysis of histologic stages and Child's classes. PMID- 2783837 TI - Mitral leaflet billowing and prolapse: its prevalence around the world. AB - Primary mitral leaflet billowing, or so-called mitral valve prolapse, has become the most common valve anomaly in the United States and is also frequently found throughout the world. Its prevalence varies from less than 1% to 38%, differing not only between countries but also within the same country. The prevalence depends on whether the study is clinical or echocardiographic, based on autopsy or surgical material, or of hospital or non-care-seeking population. Other explanations for the varying prevalence are the age, sex and weight differences of the study population, imprecise terminology, the care with which auscultation and/or echocardiography are carried out and interpreted, and some selection biases. Although prevalent throughout the world, the condition is generally benign and can often be regarded as a normal variant. Among the complications of mitral valve prolapse, progressive mitral regurgitation and infective endocarditis are particularly noteworthy. Primary mitral valve prolapse is currently a leading cause of mitral regurgitation and also of infective endocarditis. PMID- 2783838 TI - Attitudes of patients and physicians regarding physician dress and demeanor in the emergency department. AB - To compare the opinions of patients and physicians regarding physician dress and demeanor in the emergency department, we conducted a cross-sectional survey of 190 ED patients and 129 medical specialists, family practitioners, surgeons, and emergency physicians in a community hospital. Seventy-three percent of physicians and 43% of patients thought that physical appearance influenced patient opinion of medical care. Forty-nine percent of patients believed emergency physicians should wear white coats, but only 18% disliked scrub suits. Patients were more tolerant of casual dress than were physicians. Both groups disliked excessive jewelry, prominent ruffles or ribbons, long fingernails, blue jeans, and sandals. Opinions and practices of emergency physicians were similar to those of other medical specialists. Most physicians (96%) addressed patients by surname or title, but 43% of patients preferred being called by their first names. The age, gender, income, and education of patients did not influence how they wished to be addressed. Larger studies are needed to assess the influence of age, sex, race, and depth of feeling regarding first-name address and physician attire in the ED. PMID- 2783839 TI - Coronary artery bypass surgery in patients on chronic hemodialysis. A case control study. AB - STUDY OBJECTIVE: To determine the morbidity and mortality of cardiac catheterization and coronary artery bypass surgery in patients on chronic hemodialysis. DESIGN: Retrospective case-control study. SETTING: A referral-based university hospital. PATIENTS: Sixteen consecutive patients on chronic hemodialysis who had catheterization and bypass surgery: 30 controls matched for age, sex, year of operation, severity of coronary disease, left ventricular function, hypertension, diabetes, and urgency of surgery: and 34 consecutive controls having bypass surgery. MEASUREMENTS AND MAIN RESULTS: No major complications of catheterization occurred. Of 16 patients on dialysis, 7 had urgent surgery within 24 hours of catheterization. One patient on dialysis and 3 consecutive controls died, but none of the matched controls died. Postoperative morbidity was increased in the hemodialysis group as measured by the duration of mechanical ventilation (4.7 +/- 2.3 compared with 1.5 +/- 0.8 days in matched controls [mean +/- SE]), the duration of hemodynamic support (4.2 +/- 2.3 compared with 0.8 +/- 0.2 days), the length of stay in the intensive care unit (6.4 +/- 2.4 compared with 2.8 +/- 0.9 days), and the length of postoperative stay in the hospital (15.4 +/- 2.1 compared with 10.8 +/- 1.1 days) (all P less than 0.05). Four intraoperative myocardial infarctions occurred in patients on dialysis compared with two patients in the case-matched controls. Differences in morbidity between the two control groups were not significant. CONCLUSIONS: Morbidity is increased in patients on hemodialysis having coronary artery bypass surgery compared with controls matched for severity of coronary disease; however, the outcome in all but one patient on dialysis was good. Bypass surgery is an acceptable treatment for patients on dialysis with advanced coronary artery disease. Because urgent surgery is often needed in these patients, earlier evaluation of the need for revascularization may improve clinical results. PMID- 2783840 TI - Implantation of a recurrent laryngeal nerve stimulator for the treatment of spastic dysphonia. AB - Spastic dysphonia, a rare speech disorder, is characterized by strained phonation with excessively adducted vocal cords. Recurrent laryngeal nerve section, botulinum toxin injection into the vocalis-thyroarytenoid muscle complex, and other techniques have been used to treat this disorder. We have used percutaneous electrical stimulation of the recurrent laryngeal nerve with good results. Previous dog studies demonstrated the relative safety of an implantable recurrent laryngeal nerve stimulator. In this study, we directly stimulated the recurrent laryngeal nerve and vagus nerve in a dog without change in cardiorespiratory status. A Medtronic peripheral nerve stimulator was implanted in a patient with abductor spastic dysphonia. The cuff electrode was positioned around the recurrent laryngeal nerve and stimulation resulted in improvement in her voice. Extensive cardiopulmonary monitoring did not reveal any adverse response to stimulation and there was no discomfort to the patient. On the basis of the good results of this preliminary study, further study with long-term follow-up is under way. PMID- 2783841 TI - Placental keratinocyte growth factor: partial purification and comparison with epidermal growth factor. AB - A water-soluble extract of term human placenta, which was previously shown to promote proliferative growth of human keratinocytes in defined medium, enhanced both cellular attachment and proliferative growth. We have partially purified the activity which enhanced cell growth and examined its action in keratinocytes. Activity was precipitated from the crude extract by (NH4)2SO4 between 33 and 60% saturation and chromatographed by gel filtration. The activity did not bind to heparin-Sepharose at low ionic strength but was adsorbed to DEAE-cellulose from which it was eluted with NaCl and then passed over phenyl-HPLC to remove bovine serum albumin previously added to protect the activity. The active fraction was applied to gel exclusion HPLC in the presence of 0.02% octyl-beta-D glucopyranoside, which yielded an apparent Mr 35,000 for the factor. Purification was approximately 200-fold with approximately 4% recovery. The factor appears to be a protein, since activity is destroyed by trypsin. Autoradiography of cultures treated with the placental factor or epidermal growth factor (EGF) revealed that approximately 50% of cells were labeled after treatment with either growth factor compared to 9% in control cultures after a [3H]thymidine pulse. Protein synthesis was increased by about 50% 42 h after treatment with either agent, consistent with a 50% increase in nuclear labeling. Cell number was increased fivefold after 6 days in the presence of the partially purified factor, whereas EGF increased cell number eightfold. Stimulation of [3H]thymidine incorporation by the partially purified factor, in contrast, was about twice that produced by EGF, indicating that thymidine incorporation is preferentially stimulated by the placental factor and does not correlate well with other parameters of proliferative growth. The placental keratinocyte growth factor is a unique factor with a novel effect on incorporation of thymidine into DNA. PMID- 2783842 TI - Evaluation and management of massive lower gastrointestinal hemorrhage. AB - Sixty-eight patients with massive lower gastrointestinal (G.I.) hemorrhage underwent emergency arteriography. Patients were transfused an average of six units of packed red blood cells within 24 hours of admission. The bleeding source was localized arteriographically in 27 (40%), with a sensitivity of 65% among patients requiring emergency resection. However, twelve of the 41 patients with a negative arteriogram still required emergency intestinal resection for continued hemorrhage. Radionuclide bleeding scans had a sensitivity of 86%. The right colon was the most common site of bleeding (35%). Diverticulosis and arteriovenous malformation were the most common etiologies. Selective intra-arterial infusion of vasopressin and embolization were successful in 36% of cases in which they were employed and contributed to fatality in two patients. Twenty-three patients underwent segmental resection, whereas seven patients required subtotal colectomy for multiple bleeding sites or negative studies in the face continued hemorrhage. Intraoperative infusion of methylene blue via angiographic catheters allowed successful localization and resection of bleeding small bowel segments in three patients. Overall mortality was 21%. The mortality for patients without a malignancy, with a positive preoperative arteriogram, and emergency segmental resection was 13%. PMID- 2783843 TI - Pamidronate sodium and calcitonin-resistant Paget's disease. Immediate response in a patient. AB - One three-day course of intravenous pamidronate sodium (3-amino-1 hydroxypropylidene-1,1-bisphosphonate), 30 mg/d, in a patient with calcitonin resistant Paget's disease resulted in the following: marked clinical improvement within two weeks; normalization of urinary hydroxyproline value; fall of serum alkaline phosphatase value (900 to 250 U/L); a rise in serum osteocalcin value by the tenth week that returned to pretreatment levels in the 16th week; transient hypocalcemia with elevation of parathyroid hormone value; reduction in urinary calcium excretion; and improvement in bone scans. No adverse reactions occurred, with the exception of mild and transient hyperpyrexia for 48 hours during pamidronate administration. White blood cell counts did not change and serum interleukin 1 was undetectable before and after treatment with pamidronate. Pamidronate seems to be highly effective in the treatment of Paget's disease of the bone, but its profound effects on mineral and bone metabolism require close monitoring during the short-term period of intravenous treatment. PMID- 2783844 TI - Scar or recurrent rectal cancer. Positron emission tomography is more helpful for diagnosis than immunoscintigraphy. AB - We used positron emission tomography and fludeoxyglucose F 18 to assess metabolic activity of a pelvic mass in 18 patients who had suspected recurrent rectal cancer. Computed tomography could not differentiate tumor from scar. All patients presenting increased uptake of fludeoxyglucose F 18 by the mass were proved by histologic studies to suffer from recurrent tumor. Six of seven patients with low fludeoxyglucose uptake had nonmalignant lesions. Using immunoscintigraphy in 14 patients with elevated carcinoembryonic antigen levels, only four of ten recurrences could be identified by increased antibody accumulation in the mass. On the other hand, two of four benign lesions were interpreted as being recurrent tumor because of high uptake. Therefore, only positron emission tomography seems to be a useful diagnostic tool in the differentiation of recurrent rectal cancer and scar by providing information about the metabolic activity of a mass. PMID- 2783846 TI - Bietti's crystalline dystrophy. A clinicopathologic correlative study. AB - We report the clinical and electrophysiologic findings in three patients with Bietti's crystalline corneal-retinal dystrophy. The initial evaluation in one patient demonstrated diffuse disease involving retinal pigment epithelium and choriocapillaris with severe widespread disturbance of retinal function. The patient's disease progressed greatly from the age of 36 to 47 years. Two brothers had regional involvement of the posterior pole with disturbances of retinal function attributable to localized disease, and there was only mild progression in these patients. A corneal biopsy specimen from the more severely affected patient and biopsy specimens from a patient whose case had been previously reported demonstrated crystals resembling cholesterol or cholesterol ester and complex lipid inclusions in corneal and conjunctival fibroblasts. Similar inclusions were present in circulating lymphocytes, suggesting that Bietti's crystalline corneal-retinal dystrophy may be due to a systemic abnormality of lipid metabolism. PMID- 2783845 TI - Predominant left hemisphere metabolic dysfunction in dementia. AB - Thirty-one patients with probable Alzheimer's disease and 11 patients with memory disorders, attributable to multiple cerebral infarctions, were studied using 18-F fluorodeoxyglucose-positron emission tomography scans. Asymmetry in cerebral glucose metabolism within these diagnostic groups was assessed by comparison with the metabolic rates obtained in age-equivalent healthy control subjects. A significantly greater number of individuals in both patient groups exhibited predominant left rather than right hemisphere hypometabolism. In addition, for patients with Alzheimer's disease, the degree of asymmetry was not related to either the severity or duration of dementia. These findings could be explained by greater susceptibility of the left hemisphere to degenerative or ischemic brain disease, by a specific sampling effect, or most likely, by greater metabolic deficits resulting from left rather than right hemisphere impairment. PMID- 2783847 TI - Determination of the primary structure of Paim II, an alpha-amylase inhibitor from Streptomyces coruchorushii, by high-performance tandem mass spectrometry. AB - This study indicates one of the advantages of tandem mass spectrometry; the primary structures of proteins with little structural difference can be determined by using tandem mass spectrometry without prior purification of each component. The primary structure of Paim II, a protein alpha-amylase inhibitor from Streptomyces coruchorushii, was determined by using tandem mass spectrometry. Paim II consists of two component proteins with ragged N-terminus, and was sequenced on the basis of the structure of Paim I, an analogous alpha amylase inhibitor from the same natural origin. PMID- 2783848 TI - Multi-copy introduction and high-level expression of interleukin-3 genes by retroviral vector superinfection. AB - We constructed a retroviral expression vector carrying multiple cloning sites. This vector was found to express efficiently the cloned gene. Using this vector and a helper virus-free system, a murine interleukin-3 (mlL-3) high-producing cell line was established by multiple cycles of infection with recombinant retroviruses carrying mlL-3 cDNA. The infected cells produced a considerable amount of mlL-3 and the concentration of mlL-3 in culture media increased as a function of the frequency of infection. High levels of mlL-3 cDNA, mRNA and protein in this cell line were confirmed by Southern, Northern and biological assays, respectively. These results suggest that artificial gene amplification is possible in a helper-free retroviral system. This should be applicable to efficient expression of bioactive molecules in a wide variety of mammalian cells including suspension cells. PMID- 2783849 TI - Immunotoxins: monoclonal antibody-toxin conjugates--a new approach to cancer therapy. PMID- 2783850 TI - High rate of fractures for men in nursing homes. AB - We have analyzed the history of institutional fractures in 153 men, age 48 to 96, 86% white, who had resided in this VA nursing home for an average of 6.3 years as of August 1984. At that time, we reviewed their medical charts to record the numbers and sites of fractures which had been diagnosed during the preceding 1 to 5 years of nursing home residence, the duration of this period depending on the duration of institutionalization. Fractures during the period of nursing home residence under review had occurred in 24 of the 153 men; 6 residents had experienced two or more fractures. Fracture rates during institutionalization in hip, spine, and wrist were 2,564, 366, and 549/100,000 patient years, respectively. The incidence at all sites was 5,861/100,000 patient years. These rates were 5 to 11 times higher than the figures previously reported in the age matched general population of white men in the United States, England, or Finland. The nursing home men who had experienced fractures at any site were significantly (nondirectional P less than 0.02) older than those who had not experienced any fracture. The hip fracture group, however, did not differ significantly (P greater than 0.05) in age from the no fracture group. PMID- 2783851 TI - Oxygen mask-acquired supraglottitis. PMID- 2783852 TI - Lip numbness--sometimes a sinister symptom. AB - Loss of sensation in the lower lip is a common symptom. Frequently, it can be ascribed to orosurgical procedures carried out in the region of the inferior alveolar nerve or its mental branch. Additionally, trauma, haematoma or acute infections may be the cause of the problem. Neoplasms, an excess of endodontic paste and some drugs are less frequently responsible. Three patients are described, in whom impaired sensation in the lip was the presenting symptom. In two of the cases, local factors were found to which this complaint could be ascribed. Further investigation, however, revealed that disease elsewhere was the underlying cause. PMID- 2783853 TI - Use of propofol in a patient with porphyria. PMID- 2783854 TI - Computer controlled infusion of propofol. AB - A computer controlled infusion pump was used to deliver propofol to two groups of eight patients undergoing body surface surgery. The patients were premedicated with morphine sulphate i.m. and anaesthesia was supplemented with 66% nitrous oxide in oxygen. Patients in group 1 breathed spontaneously, whereas patients in group 2 underwent artificial ventilation to a normal PaCO2. The computer program was designed to achieve and maintain a blood concentration of propofol 3 micrograms ml-1 as rapidly as possible, basing calculations on a three compartment pharmacokinetic model. Mean blood propofol concentrations were found to be close to the predicted target from 10 to 120 min in group 1, but were 5-20% higher from 20 min in group 2. PMID- 2783856 TI - Diagnostic differentiation of chronic B-cell malignancies using monoclonal antibody L161 (CD1c). AB - The expression of membrane CD1c, as defined by monoclonal antibody L161, was examined on malignant lymphoid cells from 191 cases of chronic lymphoproliferative disease and on eight 'normal' enriched tonsil B-cell extracts. Of 79 cases of chronic lymphocytic leukaemia (CLL) studied, 77 showed low (less than 20% positive cells) CD1c expression whereas 63/71 (89%) cases of B PLL, HCL and B-NHL showed increased CD1c+ (but not CD1a or CD1b) components. In contrast, malignancies corresponding to terminal stages of B-cell differentiation (immunocytoma and myeloma) generally showed low CD1c expression as did lymphoid cells from 10 cases of post-thymic malignancy. Although there was some correlation between the expression of membrane CD1c and immunoglobulin (SIg) light chain densities (P less than 0.001), it is relevant in diagnostic terms that seven cases of B-NHL with low SIg staining intensities more typically associated with CLL were CD1c+. CD1c expression was not, however, correlated with the presence of CD23 or FMC7 determinants but did show a similar pattern of expression to that previously reported for beta-2 microglobulin. Determination of cellular CD1c by APAAP immunocytochemistry confirmed the presence of higher antigen densities in malignant B-cells at intermediate/late stages of differentiation and this interpretation was further supported by the finding that the majority of phenotypically mature tonsil B-cells were also CD1c+. The determination of CD1c expression by malignant B-cells may therefore be of particular value in the diagnostic differentiation of chronic lymphoproliferative disorders. PMID- 2783855 TI - Propofol for induction and maintenance of anaesthesia: comparison between younger and older patients. AB - The propofol requirements for the induction and maintenance of anaesthesia were compared in groups of younger and older patients. Side effects, influence on the cardiovascular system and recovery times were compared between 20 unpremedicated ASA I-III, 25-40-yr-old patients and 20 65-80-yr-old patients all scheduled to undergo elective surgery. After induction with propofol, anaesthesia was maintained with a continuous infusion of the drug. Vecuronium and fentanyl were administered as required. In the young group propofol 2.2 mg kg-1 and in the elderly 1.7 mg kg-1 were needed for induction (P less than 0.05). The maintenance doses were 10.0 mg kg-1 h-1 and 8.6 mg kg-1 h-1, respectively (P less than 0.01). Side effects were more pronounced in the younger patients. Influences on the cardiovascular system were definite, but mild. The younger patients awoke sooner: 7.8 v. 14.3 min (P less than 0.01) after the discontinuation of the infusion of propofol. PMID- 2783857 TI - Changes in serum level and affinity for concanavalin A of human alpha 1 proteinase inhibitor in severe burn patients: relationship to natural killer cell activity. AB - In serum from five patients with severe burns, alpha 1-proteinase inhibitor (alpha 1-PI) was analyzed and then isolated by immunosorption chromatography. By Con A-Sepharose chromatography alpha 1-PI was separated into two types of fractions: the first containing the Con A-non-reactive isoforms and the second containing the Con A-reactive isoforms. The increase of alpha 1-PI serum level in burn patients is associated on the fifth day after the burn with a significant shift toward species enriched in bi-antennary oligosaccharides (Con A-reactive isoforms). This latter change passed very quickly and ten days after the burn, whereas the alpha 1-PI serum level was still high, the difference in proportions of Con A-reactive and non-reactive isoforms was not statistically significant. With respect to the difference in oligosaccharide structure, it appeared that the glycan moiety was involved in the inhibitory effect on natural killer cell activity. At the same concentration, purified alpha 1-PI and retained alpha 1-PI isoforms had an equal effect, whereas the non-retained alpha 1-PI isoforms were more efficient (P less than or equal to 0.01). Purified alpha 1-PI and its isoforms inhibited the natural killer cell activity in a dose-dependent manner. PMID- 2783858 TI - Ultraviolet B light inactivates bone marrow T lymphocytes but spares hematopoietic precursor cells. AB - Bone marrow cells from ten normal donors were exposed to ultraviolet (UV)C or UVB light for total exposures of 0.1 to 100 mJ/cm2, and assayed for granulocyte macrophage colony-forming units (CFU-GM), erythroid burst-forming units (BFU-E), and phytohemagglutinin (PHA)-stimulated proliferative responses. After exposure to UVC CFU-GM, BFU-E and PHA responses showed a UV dose-dependent sharp decrease to levels less than 1% of controls with 0.5, 2.0, and 10 mJ/cm2, respectively. With UVB, PHA responses were most sensitive, declining to less than 1% at 5 mJ/cm2. BFU-E decreased to less than 1% of control with 15 mJ/cm2 UVB. CFU-GM, at UVB doses of 0.1 to 2.0 mJ/cm2, increased to 125% to 130% of control and decreased to less than 1% only at exposures greater than 20 mJ/cm2. Thus, these studies show that UVB, but not UVC light, can be used to inactivate bone marrow T lymphocytes selectively while sparing hematopoietic precursor cells. The data suggest that UVB irradiation can be used for T-lymphocyte purging for allogeneic marrow transplantation. PMID- 2783859 TI - CD7+, CD4-, CD8- acute leukemia: a syndrome of malignant pluripotent lymphohematopoietic cells. AB - Following our initial observation of in vivo conversion of CD7+, CD4-, CD8- acute lymphoblastic leukemia (ALL) cells from lymphoid to myeloid lineages (Proc Natl Acad Sci (USA) 81:253, 1984) we have studied eight additional cases of ALL with this leukemic cell phenotype. The CD7+, CD4-, CD8- phenotype was associated with a distinct clinical entity with those affected predominantly male (either less than 35 years or greater than 65 years of age), with frequent mediastinal and/or thymic masses, skin and CNS disease, high peripheral WBC counts, and bone marrow blasts that were morphologically L1 or not ascribable to a specific lineage. These patients did not respond to conventional chemotherapeutic regimens for either acute lymphoid or myeloid leukemias. No common karyotype or T-cell gene rearrangement pattern could be defined. Importantly, seven of eight patient's leukemic cells studied were capable of multilineage (myeloid, erythroid, monocytoid, megakaryocytoid, and lymphoid) differentiation in vitro. Data is presented suggesting that CD7+, CD4-, CD8- leukemias, in many instances, are leukemias of immature hematopoietic cells. The development of novel therapeutic approaches to this form of leukemia will be necessary to alter its poor prognosis. PMID- 2783860 TI - Inhibition of platelet adhesion to fibronectin, fibrinogen, and von Willebrand factor substrates by complex gangliosides. AB - Gangliosides, which are complex glycosphingolipids containing sialic acid, are found in cell membranes and have been implicated in a variety of cell surface events including cellular adhesion. Complex gangliosides were observed to inhibit the adhesion of thrombin-activated platelets to substrates of fibronectin, von Willebrand factor, and fibrinogen. This adhesion, which is mediated by the glycoprotein IIb-IIIa complex, was differentially inhibited by gangliosides depending on the number of sialic acid residues present within the ganglioside. The observed order of effectiveness was GT1b greater than GD1a greater than GM1 greater than asialo-GM1. Another structurally related glycosphingolipid, globoside, exhibited little inhibitory activity. In contrast to the inhibition of platelet adhesion to von Willebrand factor mediated by the glycoprotein IIb-IIIa complex, gangliosides had no detectable effect on the ristocetin-dependent adhesion of platelets to von Willebrand factor mediated by glycoprotein Ib. These results suggest that the function of the glycoprotein IIb-IIIa complex may be modulated by gangliosides in a manner similar to that previously described for the closely related vitronectin receptor. PMID- 2783861 TI - Paracrine rather than autocrine regulation of myeloma-cell growth and differentiation by interleukin-6. AB - To explore the mechanisms involved in the pathogenesis of human multiple myeloma (MM), we investigated the potential role of interleukin-6 (IL-6), a B-cell differentiation factor in humans, and a growth factor for rat/mouse heterohybridomas and murine plasmacytomas. Using a heterohybridoma assay, we found that two well-documented human myeloma cell lines, RPMI 8226 and U266, did not secrete IL-6 and did not express RNA messengers for IL-6. Neutralizing antibodies to IL-6 did not inhibit their proliferation, and recombinant IL-6 did not stimulate it. Taken together, these data show that IL-6 is not the autocrine growth factor of these human myeloma cell lines. A high production of IL-6 was found in the bone marrows of patients with fulminating MM, compared with patients with inactive or slightly active MM, or to healthy donors. This IL-6 production was assigned to adherent cells of the bone-marrow environment but not to myeloma cells. A spontaneous proliferation of myeloma cells freshly isolated from patients was observed in short-term cultures. Recombinant IL-6 was able to amplify it two- to threefold. The spontaneous proliferation of the myeloma cells was inhibited by anti-IL-6 antibodies and reinduced by recombinant IL-6. After 2 to 3 weeks of culture, the myeloma-cell proliferation progressively declined and no IL-6-dependent myeloma cell lines could be obtained despite repeated additions of fresh IL-6 and costimulation with other cytokines such as tumor necrosis factor (TNF)beta, or IL-1 beta. These data demonstrated a paracrine but not autocrine regulation of the growth and differentiation of myeloma cells by IL-6. PMID- 2783862 TI - Monocytoid B-cell lymphoma: its evolution and relationship to other low-grade B cell neoplasms. AB - Monocytoid B-cell lymphoma (MBCL) is a newly recognized B-cell neoplasm of uncertain histogenesis. The cytologic features of the neoplastic monocytoid B lymphocytes are virtually identical to those of hairy cell leukemia (HCL). As with HCL, progression of MBCL to a higher histologic grade is very unusual. However, whereas circulating leukemic cells are a characteristic feature of HCL, peripheral blood involvement has not been reported in MBCL. We recently studied a patient with MBCL of the spleen and axillary lymph nodes who developed peripheral blood involvement by MBCL cells. Unlike the cells of HCL, the circulating MBCL cells exhibited strong acid phosphatase activity that was tartrate sensitive. The leukemic cells had the antigenic phenotype IgM lambda, CD20+, CD11c+, CD5-, CD25(TAC)-, and PCA-1-. Immunogenetic studies of both lymph node and peripheral blood cells revealed identical immunoglobulin heavy-chain gene rearrangements. When compared with a series of HCL, the immunophenotype was similar except for the absence of PCA-1 and TAC. Progression of the MBCL to a large cell lymphoma, also expressing IgM lambda, was documented in an abdominal lymph node of this patient. Therefore, although rare, peripheral blood involvement by lymphoma cells may occur during the course of MBCL and should be distinguished from HCL with cytochemical and immunophenotypic studies. In addition, comparison of the clinical, pathologic, and immunologic features of MBCL with those of other low grade B-cell neoplasms suggests that a close lineage relationship exists between MBCL and HCL. PMID- 2783864 TI - In vivo hematopoietic effects of recombinant interleukin-1 alpha in mice: stimulation of granulocytic, monocytic, megakaryocytic, and early erythroid progenitors, suppression of late-stage erythropoiesis, and reversal of erythroid suppression with erythropoietin. AB - Interleukin-1 alpha (IL-1 alpha) is a macrophage-derived, multifunctional cytokine that broadly potentiates myelopoiesis and induces the synthesis of hematopoietic colony-stimulating factors (CSF) in vitro and in vivo. To evaluate the possibility for use of IL-1 alpha in ameliorating in vivo bone marrow suppression induced by drugs or radiation, we examined the in vivo effects of the cytokine on erythropoietic and other hematopoietic progenitor cells. Normal mice were treated with a single intraperitoneal (IP) injection of recombinant human IL 1 alpha at varying doses and were assayed at various times post-treatment. By six hours postinjection, a significant suppression of mature erythroid progenitors (CFU-E) was observed in animals treated with IL-1 alpha (0.5 micrograms/mouse), with maximum suppression of CFU-E and peripheral blood reticulocyte counts occurring at 24 hours. Decreases in peripheral blood hematocrit did not occur after a single IL-1 alpha injection but were observed after multiple injections of the cytokine. The suppressive effects of IL-1 alpha on late-stage erythropoiesis were abrogated by simultaneous administration of erythropoietin (EPO). At 48 hours post-treatment, a marked stimulation was observed in the numbers of spleen and marrow immature erythroid (BFU-E), macrophage (CFU-M), granulocyte (CFU-G), granulocyte-macrophage (CFU-GM), and megakaryocyte (CFU-meg) progenitor cells. These results demonstrate the potential use of IL-1 alpha as a generalized stimulator of hematopoiesis and show that the cytokine-induced suppression of late-stage erythropoiesis can be prevented by EPO. PMID- 2783863 TI - Interleukin-4 and interleukin-5 map to human chromosome 5 in a region encoding growth factors and receptors and are deleted in myeloid leukemias with a del(5q). AB - Interleukin-4 (IL-4) is a potent mediator of growth and differentiation of cells of several hematopoietic lineages. Interleukin-5 (IL-5) is a lineage-specific hematopoietic growth factor that stimulates the production of eosinophils and eosinophil colonies from normal human bone marrow cells. By using somatic cell hybrids and in situ chromosomal hybridization, we localized the IL-4 and IL-5 genes to human chromosome 5 at bands q23-31, a chromosomal region that is frequently deleted [del(5q)] in patients with myeloid disorders. By in situ hybridization, the IL-4 and IL-5 genes were found to be deleted in the 5q- chromosome of four patients with refractory anemia (RA) or therapy-related acute nonlymphocytic leukemia (t-ANLL), who had a del(5q). Thus a small segment of chromosome 5 contains IL-4, IL-5, IL-3, and GM-CSF as well as other genes such as CD14 and EGR1. Our findings that each of these genes was deleted in the 5q- chromosome suggest that loss of function of one or more of these genes may play an important role in the pathogenesis of hematologic disorders associated with a del(5q). PMID- 2783865 TI - Effects of normal mouse serum on the IL-3-induced proliferation of bone marrow cells. AB - Normal mouse serum (NMS) devoid of colony-stimulating factor (CSF) was found to enhance the interleukin 3 (IL-3)-driven colony formation of bone marrow in vitro. Inclusion of NMS in bone marrow colony-forming assays resulted in greatly increased numbers of colonies and clusters following seven days incubation; however, incubation of bone marrow with NMS before the colony-forming assay had no effect on resultant colony number. The levels of serum-enhancing activity (SEA) did not appear to vary significantly with age and in part was species restricted, in that human and guinea pig serum did not enhance mouse bone marrow colony formation. Conversely, NMS had no effect on human bone marrow colony formation. Levels of SEA were found to vary between strains, as did the degree to which bone marrow from various strains was enhanced by the serum. Serum fractionation studies indicated three active fractions with molecular weights of 800-900 Kd, 60-70 Kd, and 20-30 Kd. The fraction at 800-900 Kd inhibited colony formation at high concentrations and enhanced colony formation on dilution, whereas the two other active fractions contained enhancing activity at all concentrations tested. These results would indicate that normal serum can play a greater role in colony-forming assays than nutritional supplements. The relationship of the SEA factors to other factors that have been reported to modulate bone marrow colony formation is discussed. PMID- 2783866 TI - von Willebrand factor biosynthesis and partitioning between constitutive and regulated pathways of secretion after thrombin stimulation. AB - The major part of von Willebrand factor (vWf) synthesized in cultured endothelial cells is secreted constitutively without stimulation and consists of all multimeric forms of vWf. In contrast, stimulation with secretagogues such as thrombin results in the release of vWf from the storage pool, the Weibel-Palade bodies which contain only the largest, most biologically potent multimeric forms of vWf. We wished to determine whether the signal for release of vWf might also function as a signal for replenishment of the vWf by enhancing de novo biosynthesis and if replenishment of the vWf storage pool involved a diversion of newly synthesized vWf from the constitutive pathway to the regulated pathway. vWf mRNA and protein levels in unstimulated human umbilical vein endothelial cells were compared with cells that were briefly stimulated with 1 U/mL thrombin for 15 minutes and then incubated without thrombin for periods up to 72 hours. A comparison was also made between unstimulated cells and cells continuously exposed to thrombin for up to 48 hours. Thrombin stimulation, brief or continuous, had no significant effect on subsequent biosynthesis of vWf protein or vWf-specific mRNA. Since thrombin releases vWf only from the storage pool, we examined the possibility of diversion of newly synthesized vWf from the constitutive pathway to the regulated pathway. Cells were pulse-labeled, incubated for 15 minutes with and without thrombin, chased for various periods in unlabeled media, and briefly restimulated with thrombin. No significant redistribution of vWf between the two pathways was observed as a result of thrombin stimulation for the time periods tested.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2783869 TI - Opium, heroin and South Asia. PMID- 2783868 TI - Hairy cells are not lysed by autologous LAK cells. PMID- 2783870 TI - Drinking in France 1965-1979. An analysis of household consumption data. AB - Alcohol consumption has diminished in France for three decades. In this France is an exception to other industrialized countries. However, in one respect France conforms to a regularity found in longitudinal time-series studies comparing different countries: traditional beverages, in this case wine, have given place to new drinks--beer and imported spirits. In this sense, drinking patterns have become modernized and now resemble those found in other Western industrialized countries. The article, based on a series of household consumption surveys that include purchases of alcoholic beverages by households, studies in what way this modernization is taking place. A break-down of the data by socio-demographic groups shows that saturation as such does not explain the change. The groups that already have been at the lowest level of consumption--the middle classes--have diminished their consumption further and the other groups--the peasantry and the working class--have followed them. The same is true as regards drinking styles, as much as they are revealed by the beverage types. The already modern middle classes have continued to decrease their consumption of wine and the other groups have done likewise but later. In contrast, the rural-urban dimension is and has been weakly related to alcohol use. The development has been parallel both in big cities and rural areas. The analysis by region reveals that in France the use of alcohol and especially wine is no longer related to alcohol production, the way it is in international comparisons--producing countries being also the heaviest consumers. On the other hand, consumption patterns, as reflected in the beverage composition, have not levelled out between regions. One conclusion of the study is that the culturally dominating social dimension in France is that of class. In so far as the lower social groups continue to follow the dominating ones, the development can be expected to continue still for a long time. PMID- 2783867 TI - In vitro fixation of C3d and C5b-9 on platelets by human platelet reactive antibodies. AB - Most platelet-reactive autoantibodies and alloantibodies are not able to fix complement in vitro. However, exceptions have been found. These antibodies are usually characterized by the conventional platelet complement fixation test. A recently developed competitive enzyme immunoassay for quantitation of platelet associated immunoglobulins and a modification thereof allowed the quantitative study of fixation of C3d and the membrane attack complex (C5b-9) on platelets by HLA antibodies, human platelet autoantibodies, and drug-dependent antibodies (ddab). The highest amounts of both complement products were fixed through ddabs, whereas autoantibodies only showed moderate complement fixation. This enzyme immunoassay is a valuable tool for the characterization of the complement-fixing properties of platelet-reactive antibodies. PMID- 2783871 TI - A controlled evaluation of diagnostic criteria in the development of a rheumatology expert system. AB - As an intermediate stage in the development of an expert system to support undergraduate teaching in rheumatology, a decision tree incorporating the diagnostic criteria to be used in the expert system was produced by a team of rheumatologists. In a controlled trial, 119 final-year medical students each diagnosed 10 rheumatology cases, drawn from a pool of 96 cases, with or without the aid of the decision tree. Students who used the decision tree correctly diagnosed the following conditions more frequently than the control group: polymyalgia rheumatica (p less than 0.05), myopathies (p less than 0.01), systemic lupus erythematosus (p less than 0.05), pyrophosphate arthropathy (p less than 0.05), seronegative spondylarthropathies (p less than 0.01), intra articular bleeding (p less than 0.05) and traumatic synovitis (p less than 0.05). The overall diagnostic accuracy of the students who used the decision tree was 81% compared with 68% for the control group (p less than 0.001). PMID- 2783872 TI - Joint size influence on the leucocyte count of inflammatory synovial fluids. AB - The mean leucocyte count (LC) of the synovial fluid (SF) obtained from 22 elbow joints of patients with chronic inflammatory polyarthritides was 23.4 +/- 17.8 x 10(9)/l while the mean LC of the SF from their paired larger knee joints with similar degree of clinically detectable inflammation was 10.9 +/- 9.9 x 10(9)/l (p less than 0.001). The mean of the ratios between the LC of the paired joints (LC elbow/LC knee) was 2.92 +/- 2.07, above the ratio 1.0 (p less than 0.001) which would be expected if the LCs of both joints were similar. Different sizes of the paired joints presumably explained the phenomenon, which may be due to dilution factors. The size of the joint should be considered when interpreting the leucocyte counts of synovial fluid. PMID- 2783873 TI - Interaction of ibuprofen and warfarin on primary haemostasis. AB - It has been stated that ibuprofen can be safely prescribed with concomitant warfarin. The effect of ibuprofen on primary haemostasis was investigated in 20 patients on warfarin for venous thromboembolism. Ibuprofen, 600 mg orally t.i.d., was added for 1 week. Bleeding time, prothrombin time, platelet count and urinalysis for haemoglobin were performed before and 90 minutes after the first dose and after 1 week. The bleeding time was significantly prolonged after 90 minutes (p less than 0.01) and after 1 week (p less than 0.05) and in four cases it was prolonged above the normal range. No clinical side-effects were observed apart from microscopic haematuria and haematoma. Thus, ibuprofen may cause clinical problems in some patients treated with warfarin, particularly in the elderly on complex drug regimens. It is advisable to check the bleeding time a few days after treatment with ibuprofen has been started in patients already on oral anticoagulation, and discontinue the former if the bleeding time is prolonged above the normal range. PMID- 2783874 TI - Genetics of osteoarthritis. PMID- 2783875 TI - Variceal haemorrhage after failed injection sclerotherapy: the role of emergency oesophageal transection. AB - In a planned sequential policy for the emergency control of continued bleeding from oesophageal varices, oesophageal transection was performed after failure of conservative treatment, including injection sclerotherapy. In 15 patients who underwent emergency oesophageal transection, bleeding was controlled by operation in the majority (87 per cent), but 11 of the 15 patients died in hospital. Mortality in patients with poor liver function (Child's C) was 100 per cent, the majority of deaths resulting from hepatic and renal failure. The results of this study suggest that emergency oesophageal transection to control acute variceal haemorrhage is associated with a poor prognosis in patients with poor liver function and questions its role in a sequential emergency treatment policy. PMID- 2783876 TI - Efficacy of wheat germ lectin-precipitated alkaline phosphatase in serum as an estimator of bone mineralization rate: comparison to serum total alkaline phosphatase and serum bone Gla-protein. AB - Serum levels of total alkaline phosphatase activity (S-T-AP), wheat germ lectin precipitated alkaline phosphatase activity (S-L-AP), and bone Gla-protein immunoreactivity (S-BGP) were measured in 26 patients (23 females and 3 males) aged 35-73 years (mean 59 years) with primary hyperparathyroidism (n = 7), hyperthyroidism (n = 9), and hypothyroidism (n = 10) in whom the bone mineralization rate (m) was determined by 47Ca-kinetics (continuously expanding calcium pool model). A weak positive correlation (r = 0.42, P less than 0.05) was found between S-T-AP and m, which in the range from 0-18 mmol Ca/day could be estimated with a standard error of 4.6 mmol/day. A closer correlation (r = 0.65, P less than 0.001) was found between S-L-AP and m which was estimated with an error of 3.9 mmol Ca/day. The AP activity in the supernatant showed no significant correlation to m (r = 0.11, P greater than 0.50). The highest correlation coefficient (r = 0.81, P less than 0.001) was found between S-BGP and m which could be predicted with an error of 3.4 mmol Ca/day. S-BGP showed a closer correlation to S-L-AP (r = 0.71, P less than 0.001) than to S-T-AP (r = 0.58, P less than 0.01). We concluded that S-L-AP predicts bone mineralization at organ level better than S-T-AP in selected metabolic bone disorders and that the supernatant activity shows no relation to bone turnover.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2783877 TI - Toxicity and antitumor activity of 5-fluorouracil in combination with leucovorin. Role of dose schedule and route of administration of leucovorin. AB - Clinically, 5-formyltetrahydrofolate (leucovorin, folinic acid, LV) in combination with 5-fluorouracil (5-FU) has been used at various doses, schedules, and routes of administration with therapeutic benefit to patients with advanced colorectal carcinoma and breast carcinoma. Clinical experiences have been primarily with LV doses of 25, 200, and 500 mg/m2 administered by either short term intravenous infusion, daily continuous infusion, or orally. In patients with lung carcinoma, oral administration of dl-LV at 125 mg/m2 hourly for 4 hours (total dose of 500 mg/m2) gave the following peak plasma folate concentrations: dl-LV, 4.6 + 1.9 microM; 5-methyltetrahydrofolate, 4.3 + 2.1 microM; and no detectable l-LV in most cases. The d-LV/5-methyltetrahydrofolate ratios, however, were lower for the oral route than for the same dl-LV dose administered by 2-hour intravenous infusion in the same patient. To determine if there is a relationship between the dose, schedule, or route of administration and the therapeutic efficacy of LV combined with 5-FU, studies were carried out in rats with transplantable colon carcinoma. 5-Formyltetrahydrofolate was administered at various doses by either 2-hour infusion, 2-day continuous intravenous infusion, or by divided hourly oral doses for 4 hours. In all cases, the total doses of dl LV administered were 100, 200, and 400 mg/kg. Data obtained to date indicate: (1) plasma folate concentrations by intravenous administration were dose dependent, but lower and saturable concentrations of folates were observed by oral administration; and (2) while the concentrations of 5-methyltetrahydrofolate achieved by the 2-hour infusion schedule were relatively constant and independent of the dose of dl-LV administered, conversion of dl-LV to 5 methyltetrahydrofolate with the 2-day infusion of 100, 200, and 400 mg/kg was dose dependent. In humans, however, conversion was independent of the route of administration of dl-LV (19% for the 2-hour infusion and 23% for the 5-day infusion of 500 mg/m2 dose). Preliminary results for antitumor activity of 5-FU in combination with dl-LV, administered by either 2-hour intravenous infusion (400 mg/kg/day for 5 days) or orally (100 mg/kg/hour for 4 hours), yielded similar inhibition of in vivo tumor growth, each being greater than what was achieved with 5-FU alone.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2783879 TI - Efficacy of high-dose oral leucovorin and 5-fluorouracil in advanced colorectal carcinoma. Plasma and tissue pharmacokinetics. AB - Thirty-one evaluable patients with advanced colorectal cancer were treated with oral leucovorin (LV) 500 mg/m2, administered hourly in four divided doses weekly for 6 weeks. Six patients received intravenous 5-FU at 450 mg/m2 and the remainder at 600 mg/m2 weekly for 6 weeks. This schedule was repeated after a 2 week rest period without medication. None of the patients had received previous chemotherapy. The results of the study showed a overall complete remission (CR) and partial remission (PR) of 45%. All responding patients received the 600-mg/m2 dose of 5-FU. There were five CR and nine PR. An additional seven (23%) patients had stable disease. Two of the seven received the 450-mg/m2 dose of 5-FU and the remainder received 600 mg/m2. The median disease-free interval for CR patients exceeded 25 months, while the interval for PR patients was 11.8 months. The median survival for CR patients was over 26.7 months and 16.5 months for the PR patients. The median survival for stable patients was 9.5 months and 5.5 months for patients with progressive disease. Toxicity included diarrhea in 70% of patients, excess lacrimal secretion in 35%, and nausea and vomiting in 25% There were no treatment-related deaths in this group. The authors conclude from this Phase I study that the optimal 5-FU dose in 600 mg/m2 combined with high-dose oral leucovorin for the treatment of advanced colorectal carcinoma. PMID- 2783878 TI - Clinical pharmacology of the stereoisomers of leucovorin during repeated oral dosing. AB - As part of a clinical trial of cisplatin, 5-fluorouracil (5-FU), and leucovorin (LV) for treatment of patients with advanced head and neck cancer, patients received 100 mg of LV (d,l-5-formyltetrahydrofolate) orally every 4 hours for 5 days. On days 2 and 4 of treatment, plasma samples were obtained 2 hours after (peak) and 30 minutes before (trough) a dose of LV. Total LV and 5 methyltetrahydrofolate (THF) concentrations were measured with high-performance liquid chromatography (HPLC) analysis. LV stereoisomer concentrations were determined by chiral HPLC on a bovine serum albumin-bonded silica column. Thus far, plasma folate levels have been analyzed for ten cycles of treatment administered to 7 patients (40 samples). Administration of LV in divided oral doses approximates a plasma steady state with no significant differences noted between peak and trough concentrations. Mean (+/- SD) plasma concentrations for all samples were (mumol): LV, 3.2 +/- 1.3; l-LV, 0.28 +/- 0.21; d-LV, 2.9 +/- 1.2; and THF, 4.25 +/- 2.5. Plasma levels of d-LV and THF tended to be approximately 10% higher on day 4 than day 2, although mean differences were not significantly different due to substantial interpatient variability. Of note was that the sum of THF and l-LV exceeds that of d-LV which was consistent with selective absorption of the l-isomer of LV. Mean ratios of d-LV/l-LV and d-LV/l LV and THF were 13.7 +/- 10 and 0.88 +/- 0.68, respectively. The authors conclude that oral administration of LV in divided dose (1) simulates a continuous intravenous infusion; (2) produces plasma levels of l-reduced folates in a range known to potentiate 5-FU cytotoxicity; and (3) results in low ratios of d/l reduced folates that may be important in maximizing the effectiveness of 5-FU-LV chemotherapy. PMID- 2783880 TI - Clinical experience with leucovorin and 5-fluorouracil. AB - Two trials of leucovorin (LV) and 5-fluorouracil (5-FU) in patients with metastatic colorectal cancer were done, both using a 3-day loading dose and then weekly doses to minimize toxicity. The first trial used LV administered by intravenous infusion with a constant dose of 5-FU 400 mg/m2, and the second trail used oral LV with increasing doses of 5-FU. In the first trail, 45 eligible patients (20 with and 25 without previous therapy) were treated. Toxicity usually consisted of diarrhea or weakness and was controlled by delaying or decreasing the 5-FU dose. Subjective responses occurred in 75% of patients but did not correlate with antineoplastic effect. Objective responses were seen in 36% and stabilization of disease in 31% of patients; these correlated with prolonged survival. Median survival was 8 months for patients with previous treatment and 10 for those without. Twelve-month survival was 32% and 40%, respectively. There was no correlation between the development of toxicity and response or survival. The second trial was conducted recently in cooperation with Duke University to determine toxicity and efficacy of oral LV with intravenous 5-FU before a randomized trial of this combination versus placebo with intravenous 5-FU. Eighteen patients were treated, and serum levels of folates were obtained on ten. First toxicity occurred at 5-FU doses ranging from 375 to 850 mg/m2, and consisted of diarrhea in nine, lethargy in seven, nausea/vomiting in four, dermatitis in four, conjunctivitis in two, hypersalivation in two, stomatitis in one, and profound granulocytopenia in one. Response rate was 35%, and stabilization was 35% with median survival of 14 months. Twelve-month survival was 56%. PMID- 2783881 TI - Cisplatin, 5-fluorouracil, and high-dose oral leucovorin for advanced head and neck cancer. AB - Both cisplatin and leucovorin may increase the activity of 5-fluorouracil (5-FU) by increasing the intracellular concentration of reduced folates. Therefore, a Phase I study was conducted in patients with recurrent or metastatic head and neck cancer in which high doses of oral leucovorin were added to the combination of cisplatin and 5-FU. Patients received intravenous cisplatin 100 mg/m2 on day 1, followed by a continuous intravenous infusion of 5-FU at 600 mg/m2/day for 5 days. Leucovorin 50 mg/m2 orally was administered from the start of the cisplatin infusion and then every 6 hours throughout the 5-FU infusion. The dose of 5-FU was increased to 800 mg/m2/day and 1 g/m2/day according to observed toxicity. In a second phase of the study, the dose of leucovorin was increased to 50 mg/m2 orally every 4 hours. Twenty-five patients were registered: 23 had recurrent head and neck cancer after extensive treatment; two had newly diagnosed metastatic disease. The maximum tolerated dose of 5-FU was 800 mg/m2/day with leucovorin administered every 6 hours. Toxicities at that level included mild-to-moderate myelosuppression. Mucositis in the previously irradiated field prevented the further increase of the 5-FU dose to 1 g/m2/day. Identical toxicities were observed when administering 5-FU at 800 mg/m2/day with 50 mg/m2 of leucovorin every 4 hours. Eighteen patients were evaluated for response: one had a pathologic complete response; nine had a partial response (including four who had previously received cisplatin and 5-FU as induction chemotherapy). Eight patients did not respond. The median survival for all 25 patients was 6.5 months. It was concluded that the combination of cisplatin, 5-FU, and leucovorin is active in the treatment of recurrent head and neck cancer. The maximum tolerated dose of 5 FU in previously treated patients is 800 mg/m2/day, with mucositis being the dose limiting toxicity. Further investigation of this regimen as neoadjuvant chemotherapy in previously untreated patients with locally advanced head and neck cancer is in progress. PMID- 2783882 TI - Advances in folate chemotherapy: status of 5-fluorouracil/leucovorin in advanced malignancies. August 3, 1988, Cleveland, Ohio. Proceedings. PMID- 2783883 TI - Epidermal growth factor receptor protein-tyrosine kinase activity in human cell lines established from squamous carcinomas of the head and neck. AB - Two cell lines established from tumors of the head and neck area at different clinical stages were found to differ in the expression and in the tyrosine kinase activity of the epidermal growth factor (EGF) receptor. Cell line 183A was derived from an early-stage tumor and cell line 1483 was derived from a tumor that had metastasized to lymph nodes. The 1483 cells displayed a higher plating efficiency and clonogenicity in soft agar, suggesting a more tumorigenic phenotype over the 183A cells. Analyses of EGF receptor levels by using R1 anti EGF receptor serum indicated that the 1483 cells expressed 5-fold more receptor than did the 183A cells. EGF receptors isolated from each cell line were active for kinase activity in an immune complex kinase assay, using monoclonal R1 anti EGF receptor antibody. The autophosphorylation activity of both receptors was stimulated by addition of EGF to isolated membrane preparations and intact cells, although the EGF receptor of the 1483 cells was much less responsive to EGF than the receptor from 183A cells. In addition, the 1483 receptor consistently incorporated about twice as much phosphate as did the 183A receptor in an immune complex kinase assay. These data suggest that the basal tyrosine kinase activity of the EGF receptor from 1483 cells may be more active than the EGF receptor kinase from 183 cells. PMID- 2783884 TI - Autocrine stimulation of interleukin 1 alpha in the growth of adult human T-cell leukemia cells. AB - In a previous study, we reported that adult T-cell leukemia (ATL) cells produce interleukin 1 (IL1)-like factors that stimulate murine thymocyte proliferation, the production of interleukin 2 (IL2), and the expression of IL2 receptors (IL2R) on normal human T-cells in the presence of concanavalin A. In this communication, we studied the effect of IL1 on the growth of ATL cells in vitro. When ATL cells freshly obtained from patients were cultured with recombinant (r) human IL1 alpha, IL1 beta, or IL1-like factors produced by ATL cell lines, the growth of ATL cells was stimulated in a concentration-dependent manner. Maximum stimulation was observed at a concentration of 50-100 units/ml of IL1. The expression of IL2R on ATL cells was also enhanced by IL1, but the production of IL2 was not induced. These effects of rIL1 alpha or beta were specifically inhibited by anti-IL1 alpha or anti-IL1 beta antibody. Furthermore, the spontaneous growth of ATL cells was also inhibited by anti-IL1 alpha antibody, but not by anti-IL1 beta antibody. ATL cells exhibited enhanced expression of IL1 receptors on their surface as detected by the binding of 125I-labeled rIL1 alpha. These results suggest that IL1 alpha produced by ATL cells stimulates the growth of ATL cells by an autocrine mechanism. PMID- 2783885 TI - Involvement of both Tac and non-Tac interleukin 2-binding peptides in the interleukin 2-dependent proliferation of human tumor-infiltrating lymphocytes. AB - Interleukin 2 (IL-2) receptor expression was examined on recombinant IL-2 (rIL-2) propagated tumor-infiltrating lymphocytes (TIL) from eight metastatic melanoma and three sarcoma samples. All 11 TIL expanded with similar growth rates. rIL-2 propagated TIL from five of eight metastatic melanoma specimens contained no Tac antigen-positive lymphocytes as determined by immunofluorescence and flow cytometry performed multiple times during the 4 to 8 week culture period. However, "Tac-negative" TIL did express the non-Tac IL-2-binding peptide, p70-75 as determined by [125I]IL-2 cross-linking and sodium dodecyl sulfate polyacrylamide gel electrophoresis. IL-2-binding assays revealed that these "Tac negative" TIL expressed only an intermediate affinity IL-2 receptor. In contrast, TIL from the other three of eight melanoma and all three sarcoma contained one third Tac-positive cells as assessed by flow cytometry analysis, and expressed surface non-Tac (p70-75) and Tac (p55) peptides by [125I]IL-2 cross-linking. These "Tac-positive" TIL displayed both the high and intermediate affinity IL-2 receptors. However, rIL-2-dependent growth of both "Tac-negative" and "Tac positive" TIL was significantly inhibited by anti-Tac mAb, suggesting a transient Tac expression on the "Tac-negative" TIL. Additionally, due to the limits of our methodology, we cannot rule out the possibility of a constitutive expression of a low level of Tac, with an indicible expression of higher levels. Addition of culture supernatants from phytohemagglutinin- and phorbol myristate acetate stimulated peripheral blood mononuclear cells to the "Tac-negative" TIL-induced detectable Tac expression within 48 h. These results indicate that both non-Tac and Tac IL-2 receptors play important roles during IL-2-dependent proliferation of TIL. PMID- 2783886 TI - Genetic control of resistance to 3-methylcholanthrene-induced T-cell lymphoma in mice. AB - Different strains of inbred mice exhibit different levels of susceptibility to T cell lymphoma induced by the carcinogen 3-methylcholanthrene (MCA). Resistance to MCA-induced lymphoma was dominant over susceptibility in all crosses tested, and in inbred strain mice MCA resistance was found to correlate with resistance to lymphoma induced by a fractionated dose of gamma irradiation. The susceptible RF/J strain was also found to be extraordinarily sensitive to lymphoma induction by low doses of X-irradiation; this low dose sensitivity was also recessive. Experiments on both first and second generation backcross populations supported the hypothesis that a single locus is the main determinant of MCA resistance. Studies examining the possible linkage of low lymphoma incidence to a number of loci failed to establish any clear association, but linkage was seen between the Lyt-2 locus and a significant delay in MCA-induced lymphoma development. We also examined the strain distribution of several activities which might have been expected to have an effect on susceptibility to induced lymphoma. No correlation was seen between resistance and either DNA repair ability, thymic superoxide dismutase levels, or natural killer activity. PMID- 2783887 TI - Factors influencing antibody-mediated cytotoxicity during the immunotherapy of Rauscher-virus-induced myeloid leukemic cells. AB - The present study was undertaken to determine the factors that influence antibody mediated cytotoxicity during immunotherapy of virally transformed tumor cells. As model a Rauscher-virus-induced myeloid leukemic cell line of BALB/c origin (RMB 1) was used, which forms disseminated tumors, when inoculated intravenously in BALB/c mice. As previously reported, prolonged survival was obtained when tumor bearing mice were treated in vivo with a single high dose of a tumor-specific IgG2a monoclonal antibody. This study shows that antibody-dependent cellular cytotoxicity is an important mechanism involved in tumor cell destruction. Since in vitro studies showed that peritoneal macrophages were capable of killing RMB-1 cells in the presence of tumor-specific monoclonal antibody and since in the tumors of mice treated with monoclonal antibody a high influx of macrophages was observed histologically, it is likely that macrophages play an important effector role in elimination of tumor cells. Successful therapy in C5-complement-deficient tumor-bearing mice suggests that complement-dependent cytotoxicity does not play a major role. In nude (T-cell-deficient) mice the therapeutic effect of tumor specific IgG2a antibody was significantly less than in immunocompetent mice. Although infiltration analysis of tumors of treated and untreated mice showed equally low numbers of helper-T and suppressor/cytotoxic T-cells, the mortality studies of T-cell-deficient and immunocompetent mice indicate that T-cells play a substantial, auxiliary role during antibody-mediated, tumor destruction in our model. PMID- 2783888 TI - Influence of the donors' clinical status on in vitro and in vivo tumor-cytotoxic activation of interleukin-2-exposed lymphocytes and their circulation in different organs. AB - In-vitro-generated lymphokine-activated killer (LAK) cells of BALB/c mice, bearing the syngeneic colon carcinoma C-26 for 7 days, were as efficient as those from normal mice in lysing C-26 cells whereas LAK cells from 14-day tumor-bearing and 5- and 14-day tumor-resected animals had a lower C-26 cytotoxicity. The level of C-26 lysis returned to normal values 30 days after surgery. To identify the best source of LAK cells in vivo, groups of normal mice were treated with 10(4), 3 x 10(4) or 10(5) U/day of interleukin 2 (EL-2) for 7 days intraperitoneally (i.p.) or intravenously (i.v.) (3 x 10(4) dose only). The highest lysis on C-26 was obtained from peritoneal exudate cells of mice given 3 x 10(4) and 10(5) U whereas spleen cells were lytic only when taken from mice treated with 10(5) U IL 2. Peripheral blood lymphocytes lacked any cytotoxicity except for the group of mice which received IL-2 i.v. The kinetics of in vivo LAK activation in different organs showed a peak of anti-(C-26) lytic activity at day 5 in peritoneal exudate cells and spleen cells of mice given IL-2 for 5 days whereas administration of LAK cells alone had no effect: IL-2 plus LAK cells gave a lower peak of LAK activity as compared with IL-2 alone. A lower level of in vivo LAK activation was found in mice whose tumor was resected 5 days before; such impairment was evident even 14 days after surgery. Homing experiments were carried out with i.v. injected 51Cr-labelled LAK cells in normal or tumor-resected mice. In normal mice the highest radioactivity at 30 min was found in the lungs; liver and spleen also showed high radioactivity whereas blood had a negligible amount of radioactivity. Radioactivity declined rapidly in lungs (less than 10% after 24 h) while remaining at appreciable levels in the liver after 24 h and 48 h; spleen showed constant levels of 12%-15%. Homing of LAK cells was altered in mice receiving IL 2 i.p. for 5 days with slower and lower radioactivity peaks in the lung and higher levels in liver. In tumor-excised mice lower levels of radioactivity were found in lungs. These results show that: (a) alterations in LAK activity occur in early-tumor-resected and large-tumor-bearing animals; (b) the route of IL-2 administration is critical in LAK activation in vivo; (c) treatment with IL-2 modifies LAK homing. PMID- 2783889 TI - Characterization of T-lymphocyte subpopulations infiltrating primary breast cancer. AB - Characterization of T-lymphocyte subpopulations adjacent to and infiltrating the primary tumor of breast cancer was carried out using a direct immunofluorescence procedure with the antibodies anti-(Leu-2a) for suppressor/cytotoxic (CD8+) and anti-(Leu-3a) for helper/inducer (CD4+) T-lymphocytes. Fifty-six primary malignant tumors with lymphoid infiltration were studied. The majority (58.9%) were infiltrating duct carcinoma. There were metastases to axillary lymph nodes in 6.67% of the patients. Massive lymphoid infiltration (greater than 40 lymphocytes per x 400 microscopic field) was found in 19.6% of the tumors and moderate infiltration (20-40 lymphocytes per field) in 51.8%. In all the tumors studied there was a reversed CD4+/CD8+ ratio as compared to that found in normal peripheral blood. In 66.1% the CD4+/CD8+ ratio (helper/suppressor) was less than 1.0. The reversed ratio was due to a significant decrease in the number of helper cells (P less than 0.0005). The most significant drop was in the stroma area (P less than 0.0001) as well as in the tumor tissue (P = 0.001). Of particular interest was the significant positive correlation between the age of the patients and an increased number of CD4+lymphocytes in the stroma (P = 0.02). Significant negative correlations were found between a reduced number of CD4+ lymphocytes or CD4+/CD8+ ratio and several histological parameters: tumor diameter, pleomorphism, nucleus/cytoplasm ratio. There was also a significant positive correlation between the total number of CD8+ lymphocytes infiltrating the tumor tissue and the number of axillary lymph nodes with metastatic disease (P = 0.03). It is suggested that the reversed ratio of CD4+/CD8+ lymphocytes may significantly affect the host/tumor immune surveillance. PMID- 2783890 TI - Recombinant human tumor necrosis factor mediates regression of a murine sarcoma in vivo via Lyt-2+ cells. AB - The role of an immune response in recombinant-human-tumor-necrosis-factor(rHTNF) mediated regression of a weakly immunogenic, MCA-106 sarcoma in vivo was examined. C57BL/6 mice bearing established 10-day s.c. tumor were treated with single i.v. doses (8 micrograms) of rHTNF. rHTNF administration resulted in marked hemorrhagic necrosis and subsequent regression of tumor in treated mice. Mice cured of MCA-106 sarcoma by rHTNF specifically rejected a subsequent challenge (5 x 10(5) cells) of the same tumor (P less than 0.01) but not of the antigenically distinct, syngeneic MCA-105 sarcoma. Tumor bearers were depleted in vivo of selective T-cell subsets by the systemic administration of specific monoclonal antibodies before rHTNF therapy. rHTNF-induced regression, but not hemorrhagic necrosis of the MCA-106 sarcoma was blocked in mice depleted of Lyt 2+ cells, but not of L3T4+ cells. The in vivo role of T-cell subsets in rHTNF mediated tumor regression is discussed. PMID- 2783891 TI - Effect of anticancer agents neothramycin, aclacinomycin, FK-565 and FK-156 on the release of interleukin-2 and interleukin-1 in vitro. AB - Four anticancer agents, neothramycin, aclacinomycin, FK-565 and FK-156, were tested for their effects on concanavalin-A-induced interleukin-2 release from rat splenocytes in vitro. Neothramycin showed an enhancement of the release of interleukin-2, whereas aclacinomycin had no effect. FK-565 and FK-156 were found to inhibit the release of interleukin-2 under similar conditions. The inhibition was much more marked with FK-565. These drugs were also tested for their effects on the release of interleukin-1 from rat peritoneal exudate cells stimulated by lipopolysaccharide in vitro. Neothramycin and aclacinomycin did not affect the release of interleukin-1; however, both FK-565 and FK-156 resulted in its enhanced release under these conditions. PMID- 2783892 TI - Molecular basis of complement activation in ischemic myocardium: identification of specific molecules of mitochondrial origin that bind human C1q and fix complement. AB - Mitochondria may be a source of molecules that activate complement during ischemic injury to myocardium, providing therewith a stimulus for infiltration of polymorphonuclear leukocytes. To identify specific molecules that activate the classical complement pathway, detergent lysates of canine cardiac mitochondria were fractionated by polyacrylamide gel electrophoresis and transferred electrophoretically to nitrocellulose paper (NCP). The NCP replicas of the gels were incubated with isolated C1q and fresh sera as a source of complement, washed briefly, and overlaid with sensitized sheep erythrocytes (RBC) in agarose. A cluster of four to six molecules between 45 and 53 kDa as well as four others, 34, 30, 26, and 23 kDa, consumed complement thereby preventing complement mediated lysis of sensitized sheep RBC in the agarose overlay. Additional molecules reactive with C1 were identified by their ability to bind isolated human C1q and to serve as assembly sites for later acting complement components. Sites of localization of complement were demonstrated by incubating NCP replicas of fractionated mitochondria with antisera specific for C1q, C3, C5, and C9, followed by peroxidase-conjugated anti-immunoglobulin and substrate. A total of 12 C1q binding molecules ranging in size from 67 kDa to 23 kDa, which can fix later acting complement components, were identified. At least two of these reacted with antisera prepared against canine cardiac lymph collected in the first 3-4 hours after a 45-minute coronary artery occlusion. These studies present direct evidence that specific molecules, released from subcellular fractions of myocardial cells rich in mitochondria, can activate the complement cascade. PMID- 2783893 TI - Trends for coronary heart disease and stroke and their risk factors in Japan. AB - Disease surveillance and population surveys of risk characteristics in a northeast rural community of Japan (1965 census population, 7,030) are combined in an attempt to relate morbidity and risk factor trends for coronary heart disease and stroke during the last 2 decades. Between 1964 and 1983, the incidence of coronary heart disease (i.e., combined myocardial infarction, angina pectoris, and sudden death) did not change significantly among men and women ages 40-69, and was lower than that for stroke. The incidence of all stroke declined about 60% for both men and women, ages 40-69, with a significant decrease in cerebral hemorrhage for both sexes and in cerebral infarction for men. Between 1963-1966 and 1980-1983, significant upward shifts occurred in the means and distributions of serum total cholesterol and serum total protein in every age and sex group, primarily during the 1st decade. Age-adjusted mean cholesterol levels rose 22 mg/dl to the 1980-1983 mean of 179 mg/dl in men ages 40-69. In women ages 40-69, the mean rose 29 mg/dl to 192 mg/dl. Among nutrients, animal fat intake doubled in men ages 40-59 from 4.5% of daily calories in 1969 to 9.6% in 1980 1983. Animal protein intake also increased, from 5.8% to 7.1%. Most of this increase occurred between 1969 and 1972-1975 and may be attributable to an increased intake of meat, eggs and dairy products. From 1963-1966 to 1980-1983, mean relative weight index rose significantly for all age-sex groups except men ages 50-69. Mean systolic and diastolic blood pressure levels declined for every age-sex group, with a 15-mm Hg age-adjusted decrease in systolic, 4-mm Hg decrease in diastolic pressure among men ages 40-69, and a 11-mm Hg systolic and 4-mm Hg diastolic decrease for women. Two cohorts of men and women ages 40-69 at baseline were followed for disease incidence: an early cohort (2,257 persons) followed from 1963-1966 to 1973 and a later cohort (2,711 persons) followed from 1972-1975 to 1983. In these cohorts, significant risk prediction for cerebral hemorrhage and infarction was obtained with blood pressure level and end organ effects in the electrocardiogram and fundus photographs. Serum cholesterol was inversely associated with cerebral hemorrhage in the early cohort but not in the later.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2783895 TI - Soluble interleukin 2 receptor molecules in the serum of patients with autoimmune diseases. AB - Lymphocytes upon activation release a soluble form of interleukin 2 receptor (IL 2R). Systemic autoimmune disorders are characterized by immune system disregulation associated with cellular activation; therefore we sought to determine the levels of soluble IL-2R molecules in the serum of patients with rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), and primary Sjogren's syndrome (1 degree SS). Utilizing an enzyme immunoassay method we found increased serum levels of soluble IL-2R in 65.4% (34/52) of RA, in 34.9% (15/43) of SLE, and in 25.0% (13/52) of 1 degree SS patients, compared to 4.2% (1/24) of healthy individuals. High serum levels of soluble IL-2R correlated with several indices of disease activity in RA and SLE patients, as well as with disease progression to extraglandular involvement and to pseudolymphoma or lymphoma in patients with 1 degree SS. By gel filtration analysis, the soluble IL-2R circulating in the serum of a RA patient corresponded to a high molecular weight molecule (greater than 90 kDa) compared to the 65-kDa soluble IL-2R molecule released by phytohemagglutinin-stimulated normal peripheral lymphocytes. PMID- 2783894 TI - Scintigraphic assessment of regional cardiac adrenergic innervation. AB - To assess the feasibility of noninvasively imaging the regional distribution of myocardial sympathetic innervation, we evaluated the distribution of sympathetic nerve endings, using 123I metaiodobenzylguanidine (MIBG), and compared this with the distribution of myocardial perfusion, using 201Tl. Twenty dogs were studied: 11 after regional denervation, and nine as controls. Regional denervation was done by left stellate ganglion removal, right stellate ganglion removal, and application of phenol to the epicardial surface. Computer-processed functional maps displayed the relative distribution of MIBG and thallium in multiple projections in vivo and excised heart slices in all animals. In six animals, dual isotope emission computed tomograms were acquired in vivo. Tissue samples taken from innervated and denervated regions of the MIBG images were analyzed for norepinephrine content to validate image findings. Normal controls showed homogeneous and parallel distributions of MIBG and thallium in the major left ventricular mass. In the left stellectomized hearts, MIBG was reduced relative to thallium in the posterior left ventricle; whereas in right stellectomized hearts, reduced MIBG was in the anterior left ventricle. Phenol-painted hearts showed a broad area of decreased MIBG extending beyond the area of phenol application. In both stellectomized and phenol-painted hearts, thallium distribution remained homogeneous and normal. Norepinephrine content was greater in regions showing normal MIBG (550 +/- 223 ng/g) compared with regions showing reduced MIBG (39 +/- 44 ng/g) (p less than 0.001), confirming regional denervation. Combined MIBG thallium functional maps display the regional distribution of sympathetic innervation. This new ability to noninvasively map the distribution of sympathetic nerves with simultaneous comparison to regional perfusion may provide important new insights into mechanisms, whereby an imbalance in sympathetic activity may relate to clinical disorders. PMID- 2783896 TI - 1,25-Dihydroxyvitamin D3 (calcitriol) suppresses concanavalin A-stimulated human T cell proliferation through monocytes. AB - 1,25-Dihydroxyvitamin D3 (calcitriol) inhibits mitogen-stimulated T cell proliferation by blocking the production of interleukin 2 (IL-2). The present study was initiated to determine the role of monocytes (Mo) in this process. Either Mo or T cells were preincubated with calcitriol for 24 or 48 hr and were thoroughly washed prior to concanavalin A (Con A)-stimulated coculture period. The inhibitory effect of calcitriol was Mo mediated; pretreatment of Mo resulted in inhibition of T cell proliferation, whereas pretreatment of T cells lacked the suppressive effect. Similar results were obtained by using 7- to 20-day-old IL-2 dependent human cultured T cells instead of fresh T cells. Calcitriol did not diminish the IL-1 secretion or intracellular IL-1 production of fresh Mo and actually increased the secretion of 24-hr-old Mo. Furthermore, addition of recombinant IL-1 to Mo-T cell coculture failed to reconstitute proliferative defect. Thus, these experiments clearly demonstrate that the suppression of Con A driven T cell proliferation by calcitriol is Mo mediated and works by a non-IL-1 mechanism. At least, under these experimental conditions of Con A-driven T cell proliferation in which Mo play an obligatory role, antiproliferative action of calcitriol is Mo dependent. PMID- 2783897 TI - Interleukin-6 in synovial fluid from patients with arthritis. AB - Synovial fluid and serum from patients with rheumatoid arthritis, other inflammatory arthritides, and traumatic arthritis were assayed for the presence of interleukin-6 (IL-6) by means of an IL-6-dependent mouse hybridoma cell line. The cytokine was detected in all the samples of synovial fluid (range 50-22000 U/ml). IL-6 in synovial fluid was positively correlated (r = 0.58, P = 0.03) with the erythrocyte sedimentation rate in patients with inflammatory arthritis. In serum, the concentration of IL-6 was slightly elevated in some patients with rheumatoid arthritis. The results demonstrate that IL-6 is released into synovial fluid in joints affected by arthritis, and there appears to be an association between the levels of IL-6 and disease activity. PMID- 2783898 TI - Multimodality approach to osteonecrosis of the femoral head. AB - Treatment of osteonecrosis of the femoral head appears to be effective when the disease is identified and treated early. Forty-one patients were evaluated with prospective laboratory assessment, anteroposterior and frog-lateral roentgenograms of both hips, intraosseous pressure measurements (IOP), magnetic resonance imaging (MRI), and 99mTc methylene diphosphonate planar and single photon emission computerized tomographic (SPECT) bone imaging. Pathologic specimens were obtained in most patients. Preradiographic disease was identified in 26 hips and 11 of these were asymptomatic. Fifteen clinically symptomatic hips had normal plain roentgenograms, but abnormal protocol studies. Evaluation of sensitivity, specificity, and predictive value (positive and negative), respectively, in diagnosing osteonecrosis of the femoral head revealed the following percentages: 83%, 83%, 96%, and 48% for planar bone scanning; 91%, 78%, 94%, and 70% for SPECT; 87%, 83%, 96%, and 55% for MRI; 80%, 60%, 95%, and 25% for IOP; and 88%, 100%, 100%, and 25% for core biopsy. (There were few true negatives, thus specificity values are approximations.) The identification of preradiographic stages is possible, but difficult. MRI appears appealing at present, particularly in identifying disease in asymptomatic hips. However, there is no definitive method for noninvasive diagnosis. Pathologic confirmation in early stages is difficult. PMID- 2783900 TI - Dental caries in 12-year-old urban and rural children in Zimbabwe. AB - 608 12-yr-old children in Harare, and 556 in rural areas of Mashonaland and Central Province, Zimbabwe, were examined for dental caries in 1985. 27.6% of children in the urban area, and 20.9% in the rural, had caries (P less than 0.01). The mean DMFT in urban and rural areas was 0.57 (+/- 1.13) and 0.49 (+/- 1.42), respectively (P = 0.29). Girls had higher levels of caries than boys. Most of the caries occurred on occlusal surfaces, and first molars were the most affected of all teeth. Caries experience was similar to that reported 10 yr previously in Zimbabwe, and similar to that found recently in 12-yr-olds in Kenya and Tanzania. The authors question whether in fact developing countries having high or increasing levels of caries in 12-yr-olds constitute the exception or the rule with regard to trends in dental caries prevalence. PMID- 2783899 TI - Salivary Streptococcus mutans and caries prevalence in Brazilian schoolchildren. AB - The aim of the present study was to determine the levels of salivary Streptococcus mutans in Brazilian schoolchildren, and its possible correlation with caries prevalence. A positive correlation between different levels of S. mutans and caries prevalence was observed, individuals with high levels of S. mutans (greater than 100 colonies) had a DMFS significantly higher than those with low or no detectable S. mutans (0, 1-20, 21-40 colonies). PMID- 2783901 TI - Caries experience of the primary dentition among groups of Tanzanian urban preschoolchildren. AB - Five hundred and forty-six urban Tanzanian preschoolchildren aged 5-7 were examined for dental caries in the primary dentition. Caries was diagnosed according to the WHO criteria (1977). The mean dft was 1.06 (1.76) for the whole sample and 62% of the children were caries free. Only three fillings were observed in the primary teeth, indicating a very low rate of conservative treatment in this population group. The results of this study call for both preventive and restorative care for this group. However, for these activities to be cost effective they will have to be focused on the 38% of children who have the experience of dental caries. Planning an appropriate oral care program for this risk group needs careful consideration within the Tanzanian context. PMID- 2783902 TI - The dmfs and dmft of young South African children. AB - As part of a series of frequent epidemiological field studies to determine caries prevalences in the primary dentition of young South African children, 1436 children of 1-4 yr of age from five ethnic groups were examined. Using WHO diagnostic criteria decayed, missing, and filled surfaces were determined with mirror and probe and caries free, dmfs, dfs, ds, mfs, and dmft scores were calculated. The investigation has shown that urban coloured and Indian children have the highest caries prevalences and urban white children have the lowest. It is suggested that the percentage of caries-free children should be used to set goals for reduction in caries. PMID- 2783903 TI - Per capita consumption of sugar-containing products and dental caries in Sweden from 1960 to 1985. AB - The aim of the present report was to analyze sugar consumption in relation to dental caries in Sweden from 1960 to 1985. Sugar consumption is based on official statistics from the National Swedish Agricultural Board and is expressed in grams per person and day. Over this quarter-century total sugar consumption decreased approximately 5%, from 116 to 110 g/person/day. A shift occurred from direct consumption to indirect (sugar used by the food industry), the former decreasing from 76 to 50 and the latter rising from 40 to 60 g/person/day. Available epidemiologic data on dental caries in children from the National Swedish Board of Health and Welfare indicate that the frequency of caries decreased dramatically from 1960 to 1985, though comparable data were difficult to obtain for the whole 25-yr period. The conclusion from this study is that these changes in caries prevalence in Sweden cannot be attributed to a corresponding decrease in the per capita consumption of sugar and sugar-containing products. On the contrary, the intake of some products traditionally related to dental caries, such as candy and soft drinks, increased during 1960-1985. PMID- 2783904 TI - The changing incidence of cancer of the oesophagus in Lesotho: real or improved diagnostic ability. AB - Cancer of the oesophagus has previously been reported as an exceedingly rare tumour in the Kingdom of Lesotho. This is in marked contrast to the extremely high incidence in the neighbouring South African homeland, Transkei. During 1984, gastroscopy was used as a diagnostic tool in determining a more accurate estimation of the true incidence of oesophageal cancer in Lesotho, and more specifically in the capital region of Maseru. The results of this study revealed that the incidence of this disease in Lesotho approaches that of the Transkei. PMID- 2783905 TI - Cultured bovine bone cells synthesize basic fibroblast growth factor and store it in their extracellular matrix. AB - Bone contains various growth factors, including fibroblast growth factor (FGF). The cellular origins of the growth factors found in bone are not known. We examined whether cultured fetal bovine bone cells synthesize FGF. These cells express characteristic markers of the osteoblast phenotype, including expression of bone Gla protein (osteocalcin) and mineralization. Heparin-Sepharose fractionation of cell extracts revealed that bone cells contained a basic FGF (bFGF)-like molecule, that displayed high affinity for heparin. The growth factor was mitogenic for adrenal cortex-derived endothelial cells and osteoblast-like bone cells. The major peak of biological activity corresponded to a peak of immunoreactive bFGF. When analyzed by Western blot, the active fractions contained a bFGF-like immunoreactive species with a mol wt of 15,000, a mass identical to that of (des-1-15)bFGF. Based on RIA, the bone cell extract contained an estimated 95 ng bFGF/mg cell protein. An acidic FGF-like molecule with lower affinity for heparin was also present in the purified bone cell extracts, although at an approximately 10-fold lower concentration than bFGF. These results demonstrate that bone cells synthesize a mitogen indistinguishable from bFGF. In addition, Northern analysis revealed that the bone cells expressed 3.5- and 7.0-kilobase bFGF gene transcripts. We next examined whether the bone cell-derived bFGF is stored in a bioactive form in the extracellular matrix. Bone cells synthesized an extracellular matrix which was mitogenic for adrenal cortex derived endothelial cells. However, if the bone cell extracellular matrix was preincubated with neutralizing anti-bFGF antibodies, its mitogenic properties were abolished. This suggests that bone cell-derived bFGF may function as an autocrine or paracrine mitogen via its deposition into the extracellular matrix of bone. PMID- 2783906 TI - RCBF-quantification with 99mTc-HMPAO-SPECT: theory and first results. AB - The activity concentrations of 99mTc-HMPAO in brain after intravenous injection were evaluated in 25 patients using SPECT. With additional first pass studies of heart and brain with the short lived isotope 195mAu, the cardiac output and the mean cerebral transit times of the patients were measured a short time before the HMPAO injection. The time dependence of 99mTc-HMPAO activity in the brain was registered during the first 5 min after injection over both hemispheres. Using a simplified three compartment model it was possible to calculate the mean retention fraction of HMPAO in brain from the time activity curves. It could be shown that the regional cerebral blood flow in ml/min per 100 g can be calculated from the activity concentration of HMPAO in the brain, the cardiac output and the retention fraction. In 15 of the 25 cases the rCBF was measured using the planar 133Xe inhalation method as a reference. We found a significant correlation between the mean hemisphere CBF from our method and the mean hemisphere grey matter CBF from the Xenon method with a correlation coefficient of 0.73. PMID- 2783907 TI - SPECT volume measurement using an automatic threshold selection method combined with a V filter. AB - The volume measurement of various organs by single photon emission computed tomography (SPECT) has generally been performed by summing up the voxels lying within the outer edge of the organ determined by thresholding as a function of the maximum reconstructed counts within a volume of interest. The optimum threshold level, however, is influenced by various factors. To eliminate this problem, Mortelmans et al. (1986) proposed to use an automatic threshold selection method (ATSM) based on discriminant criteria and to correct the errors induced by the imperfect system response using the method based on linear regression analysis, which has some problems in practical application. We tried to use ATSM combined with a V filter. The correlation coefficient (r) and the regression equation between the true (x) and the calculated volume (y) obtained by experimentation using 22 phantoms with a volume ranging between 26 ml and 380 ml were as follows: r = 0.994 and y(ml) = 1.015 x +1.09 using ATSM combined with a V filter, while r = 0.993 and y(ml) = 1.110 x +30.55 using only ATSM. The relative error between the true and the calculated volumes decreased significantly (P less than 0.01) from 37.7% +/- 26.9% to 5.5% +/- 4.2%. The results suggest that ATSM combined with a V filter is useful for correcting the errors caused by an imperfect system response, and is available and reliable for SPECT volume determination even when the organ volume is small. PMID- 2783908 TI - Quantification of myocardial ischemia and infarction with single photon emission computed tomography. AB - To evaluate the feasibility of 201Tl single photon emission computed tomography (SPECT) for quantitative detection of myocardial infarction and ischemia, scintigraphic studies were related to angiographic findings. In study A infarct sizes with SPECT were compared with the angiographic infarct sizes of 30 patients. A linear correlation was found for the % infarct of the left ventricular circumference between both methods (r = 0.73; P less than 0.001; mean infarct size 20.7% +/- 10.5% (angio) vs 19.8% +/- 12.9% (SPECT), mean +/- SD). Furthermore, a significant inverse correlation between scintigraphic infarct size and left ventricular ejection fraction (r = -0.87, P less than 0.001) was obtained. In study B exercise/rest 201Tl SPECT was used for quantification of myocardial ischemia. Forty-three patients underwent both stress 201Tl SPECT and biplane exercise left ventriculography. Ischemia was expressed as % defect size of the left ventricular circumference. Sensitivity and specificity for detection of ischemia were 96% and 100% respectively with stress SPECT. Extent of myocardial ischemia correlated significantly with both methods (r = 0.63; SPECT defect = 1.0 angiographic ischemia +2%; P less than 0.001). The regression followed the line of identity and the mean sizes of ischemia were identical (SPECT 12.2 +/- 7.6% vs 14.6 +/- 12.4% ventriculography, mean +/- SD) demonstrating the agreement of both methods. However, there was some intraindividual variance between the scintigraphic and the angiographic study. The sensitivity and specificity in single regions with SPECT were lower compared to the global test results.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2783909 TI - Clinical experience with Tc-99m HM-PAO high resolution SPECT of the brain in patients with cerebrovascular accidents. AB - In order to evaluate the diagnostic contribution of brain SPECT imaging with 99mTc-HMPAO in cerebrovascular disease, we examined 92 stroke cases (144 lesions), 2 hematoma cases and 30 cases with transient neurologic symptoms. Abnormal tracer distribution is visible as zones of either hypoactivity or hyperactivity (border zone hyperemia or luxury perfusion). Remote vascularization changes could also be found (crossed cerebellar diaschisis or ipsilateral cortical perfusion reduction in thalamic or capsula interna lesions). Both X-ray CT and blood flow SPECT have comparable sensitivity in the exploration of cerebral infarction, with detection in, respectively, 89.5% and 87.5% of the lesions. False negative scintitomographic images are frequently recorded in small lacunar infarcts within the basal ganglia and white matter (capsula interna). Some early infarcts and asymmetry of brain perfusion in patients with transient neurologic symptoms are frequently not detected by CT. An additional advantage of blood flow SPECT is its ability to visualize remote blood flow changes and the changing pattern of vascularization of ischemic lesions and their surrounding areas including hyperemia. PMID- 2783910 TI - Extracellular ATP mobilizes intracellular Ca2+ in T51B rat liver epithelial cells: a study involving single cell measurements. AB - T51B rat liver epithelial cells were stimulated with extracellular ATP. Changes in cytoplasmic free Ca2+ concentration [( Ca2+]i) were measured by fura-2 both in a large population of cells on coverslips in a cuvette and in single cells in a microscopic system. Extracellular ATP evoked a prompt increase in [Ca2+]i in both the presence and absence of extracellular Ca2+, although the effect was less pronounced in the latter case. These findings indicate that at least part of the [Ca2+]i increase is due to mobilization of intracellularly bound calcium. Stimulation with ATP did not mobilize the total pool of intracellular releasable Ca2+, as evidenced from experiments where subsequent addition of ionomycin evoked a pronounced increase in [Ca2+]i in the absence of extracellular Ca2+. The effect of ATP was maintained at room temperature but was markedly impaired in the absence of continuous stirring of the buffer solution. In the absence of stirring, ATP had to be increased to the millimolar range in order to evoke a pronounced effect. Single cell measurements revealed a heterogenous Ca2+ response to ATP, with some cells failing to respond with a detectable increase in [Ca2+]i. The actual increase in [Ca2+]i was not uniform throughout the cytoplasm, but seemed to start in one part of the cell. Even if part of the [Ca2+]i increase might be accounted for by ATP promoting the hydrolysis of phosphatidylinositol 4,5-bisphosphate and thereby a generation of InsP3 and diacylglycerol, there was no initiation of DNA synthesis under the present conditions. Hence, extracellular growth factors exert either a quantitative difference in second messenger production or additional stimulatory effects by activating intracellular signal pathways beyond these represented by [Ca2+]i and protein kinase C. PMID- 2783911 TI - Interleukin-2 regulates the activity of ornithine decarboxylase in a cloned murine T lymphocytic cell line: evidence for a protein kinase C-dependent pathway. AB - The role of protein kinase C (PKC) in the regulation of ornithine decarboxylase (ODC) activity during interleukin-2 (IL-2)-dependent cell growth was investigated. A large biphasic increase in the activity of ODC was observed after treatment of IL-2-deprived CTLL-2 cells with recombinant human IL-2 (rec IL-2). The PKC activators phorbol 12-myristate 13-acetate (PMA) and 4 beta-phorbol 12,13 didecanoate (4 beta-PDD), but not the inactive analog 4 alpha-PDD, induced ODC activity in exponentially growing cultures. Unlike IL-2, however, phorbol esters were poor inducers of IL-2-depleted cultures. H-7, a potent inhibitor of PKC and cyclic nucleotide-dependent protein kinases (CN-PK), suppressed the IL-2-induced ODC activity, while HA1004, a more potent inhibitor of CN-PK than of PKC, had opposite effects depending on its concentration. The results suggest that activation of PKC is involved in but is not the sole mechanism for the induction of ODC by rec IL-2. At concentrations which suppressed the induction of ODC activity by IL-2, H-7 inhibited DNA synthesis and HA1004 did not. PMID- 2783912 TI - Subtyping of Haemophilus influenzae type b strains from Europe and North America by SDS-PAGE of whole-cell polypeptides: the geographical distribution of subtypes. AB - One hundred and nine strains of Haemophilus influenzae type b were subtyped by sodium dodecyl sulphate polyacrylamide gel electrophoresis of whole-cell polypeptides. Twenty-one strains from England, 44 from Scotland, 8 from Sweden, 6 from the Netherlands and 30 from the USA were examined. Some of these strains had been subtyped by outer membrane protein analysis; most of the strains had been isolated from cases of invasive disease. Comparison of polypeptide profiles using the Dice coefficient of similarity showed that the majority of European strains were closely related and formed a single large group. Four smaller groups were identified; three of these included American and European strains, indicating a world-wide distribution of subtypes. However, the common European and American subtypes fell into different groups, indicating the existence of marked geographical variations in subtype frequency. PMID- 2783913 TI - Interleukin 1 plus interleukin 3 plus colony-stimulating factor 1 are essential for clonal proliferation of primitive myeloid bone marrow cells. AB - The clonal growth in nutrient agar at low cell densities of high-proliferative potential colony-forming cells (HPP-CFC) of bone marrow obtained from mice treated 2 days earlier with 5-fluorouracil (FU) (FU2dBM) has been shown to require a combination of three growth factors, interleukin 1 (IL-1), interleukin 3 (IL-3), and macrophage colony-stimulating factor (CSF-1). These HPP-CFC have been enriched 140-fold from FU2dBM by fluorescence-activated cell sorting of 7/4 , B220-, and L3T4-negative cells. The mean of the plating efficiencies of these enriched populations was 4.4% and no growth was observed when the factors were used singly. Similarly, enrichments of 16-fold were obtained from FU2dBM using immunomagnetic Dynabeads with anti-7/4 plus anti-B220 (meaning plating efficiency 0.5%). The further additions of human granulocyte CSF or mouse granulocyte macrophage CSF or both to IL-1 plus IL-3 plus CSF-1 did not increase HPP-CFC colony formation, but both augmented the small colony formation with IL-1 plus IL 3, IL-3 plus CSF-1, or IL-1 plus CSF-1. PMID- 2783914 TI - Interaction of transforming growth factor-beta 1 with hemopoietic growth factors in the regulation of human normal and leukemic myelopoiesis. AB - We studied the effect of transforming growth factor-beta 1 (TGF-beta 1) on the growth of normal and chronic myeloid leukemia (CML) granulo-monopoietic progenitors (CFU-GM) and erythroid progenitors (BFU-E) of different origins and degrees of maturation. In the presence of the supernatant of the 5637 cell line, used as a source of growth factors, TGF-beta 1 stimulates the growth of day-7 CFU GM from Ficoll-isolated normal bone marrow cells. Maximum stimulation (172% of controls) is observed with 2.5 ng/ml TGF-beta. The results with a highly enriched progenitor cell population stimulated by recombinant granulocyte colony stimulating factor (rG-CSF) and recombinant granulocyte-macrophage CSF (rGM-CSF) were similar, suggesting a direct effect of TGF-beta 1 on hemopoietic progenitors. In contrast to this stimulatory effect of TGF-beta 1 on normal day-7 bone marrow CFU-GM, TGF-beta 1 does not affect the growth of day-14 CFU-GM. The growth of normal bone marrow BFU-E is strongly inhibited. In the majority of cases (11/15) of CML, bone marrow day-7 CFU-GM growth is inhibited by TGF-beta 1. In few cases (4/15) leukemic progenitors respond to TGF-beta 1 as normal cells. TGF-beta 1 always inhibits the growth of day-14 bone marrow CFU-GM from CML patients. PMID- 2783915 TI - Cell-mediated inhibition of granulopoiesis in vitro in patients with acute myeloid leukemia in remission. AB - We investigated the in vitro granulopoiesis in 11 patients with acute myeloid leukemia (AML) in complete remission 3-80 months after diagnosis (median 8.5 months). 3 of the patients had subnormal levels of bone marrow-derived CFU-GM. 6 of 10 patients tested had defective recloning capacity of d-7 CFU-GM, suggesting a stem cell defect. Most patients (7/11) showed an increased colony growth of bone marrow-derived CFU-GM after T-cell depletion by E-rosetting, while readdition of isolated autologous T cells to T-cell depleted marrow caused a dose dependent inhibition of colony formation; bone marrow T cells were more effective in this inhibition than peripheral blood T cells. Experiments using cells depleted of either CD4- or CD8-positive cells and CD4/CD8-enriched cell populations showed that both CD4- and CD8-positive cells had the capacity to inhibit colony growth. Long-term culture of bone marrow cells in suspension showed that the production of CFU-GM declined at about the same rate as in normal controls. Our findings suggest that there are persisting stem cell defects in patients with AML in remission and that the cell growth regulatory systems may be altered. These abnormalities could possibly be an effect of residual damage to the hematopoietic system caused by intensive chemotherapy. PMID- 2783916 TI - Expression of the SmB' splicing protein in rodent cells capable of following an alternative RNA splicing pathway. AB - The expression of the SmB and SmB' spliceosome proteins in a variety of cell types and tissues has been investigated. Although SmB is found in all cells studied, the SmB' protein is found only in a small number of rodent cell types. The presence of this protein is correlated with the ability to utilize an alternative pathway of RNA splicing which is not available in most cell types. This is the first demonstration of tissue specific expression of a protein component of the spliceo-some and suggests a role for SmB' in the regulation of some cases of alternative RNA splicing. PMID- 2783917 TI - Preprocorticotropin releasing hormone: cDNA sequence and in vitro processing. AB - Human corticotropin releasing hormone (hCRH) is expressed in both hypothalamus and placenta. Its expression in placenta increases markedly in the latter part of gestation. We have isolated and characterized a human placental CRH cDNA clone and performed in vitro translation of sense-strand hCRH cRNA synthesized from this cDNA and co-translational processing of the resulting preproCRH peptide. Sequence analysis of the cDNA confirms the exon-intron junctions predicted from the gene sequence and establishes the presence of at least two sites of transcription initiation of the human CRH gene in placenta. The translated preproCRH gene product contains a hydrophobic, functional signal sequence which suggests that placental CRH peptide is capable of being secreted. These structural features of the preproCRH mRNA and peptide may help to understand the regulation of placental CRH observed during human gestation. PMID- 2783919 TI - Interleukin 2 and soluble interleukin 2-receptor secretion defect in vitro in newly diagnosed type I diabetic patients. AB - In this study, we investigated whether an interleukin 2 (IL-2) secretion defect by peripheral blood mononuclear cells (PBMCs) after in vitro stimulation with phytohemagglutinin (PHA-M) occurs in either newly diagnosed or long-standing type I (insulin-dependent) diabetic patients and whether it is accompanied by a dysregulation of soluble IL-2-receptor (IL-2RS) production. PBMC cultures (2.5 x 10(6) cells), unstimulated or stimulated with PHA-M (25 micrograms/ml), from 20 type I diabetic patients (10 with time since onset less than 3 mo and 10 with long-term diabetes of less than 3 yr) and 10 control subjects were studied for the production of IL-2 and IL-2RS in their respective supernatants. No difference was found in IL-2 production in unstimulated cultures of type I patients compared with control subjects, although a significant decrease from PHA-M-stimulated cultures were seen (newly diagnosed, 1.7 +/- 0.3 ng/2.5 x 10(6) cells; long standing, 2.2 +/- 0.3 ng/2.5 x 10(6) cells; P less than .001 and P less than .05, respectively) compared with control subjects (3.6 +/- 0.4 ng/2.5 x 10(6) cells). In regard to the production of IL-2RS, no difference exists for unstimulated cultures, whereas, after PHA-M stimulation, both newly diagnosed and long-term diabetic patients showed a decrease in the IL-2RS levels (318 +/- 50 and 331 +/- 62 U/2.5 x 10(6) cells; P less than .02 and P less than .05, respectively) compared with normal subjects (463 +/- 34.2 U/2.5 x 10(6) cells). Thymus activated cell phenotypes confirmed the T-lymphocyte activation after a 48-h culture period.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2783920 TI - Lower GI bleeding: updated diagnosis and management. AB - Lower GI bleeding in the elderly can be attributed to diverticula or vascular ectasias in most cases. Usually, a diagnosis is established by colonoscopy, but often this test must be supplemented by radiographic and additional endoscopic techniques, especially in the evaluation of obscure GI bleeding. Responsible lesions are frequently remediable by non-operative therapy. However, if surgical intervention is called for, it should not be delayed solely because of the patient's advanced age. PMID- 2783921 TI - Isolation and characterization of a mutant of Haemophilus influenzae type b deficient in outer membrane protein P1. AB - The gene for outer membrane protein P1 of Haemophilus influenzae type b has been previously cloned and expressed in Escherichia coli. To investigate the physiologic role of the P1 protein, the cloned P1 gene was insertionally inactivated with the Tn5 derivative Tn5tac1, and an isogenic P1-deficient Haemophilus mutant was then generated by transformation with linearized plasmid DNA containing the insertionally inactivated gene. The P1-deficient strain grew normally in vitro and induced bacteremia in the infant rat model. PMID- 2783918 TI - The emergence of the endothelial cell lineage in the chick embryo can be detected by uptake of acetylated low density lipoprotein and the presence of a von Willebrand-like factor. AB - Vascular endothelial cells from 3- to 10-day-old chicken embryos were identified by the uptake of acetylated low density lipoprotein (Ac-LDL) and the presence of a von Willebrand-like factor. These were determined on cross sections of aortic arches as well as in cell cultures prepared from the arches. To visualize the uptake of Ac-LDL, the fluorescent probe 1,1'-dioctadecyl-1-3,3,3',3'-tetramethyl indo-carbocyanine perchlorate-Ac-LDL (DiI-Ac-LDL) was used. Following injection of the DiI-Ac-LDL probe into the embryonic heart, the endothelium of the aortic arches became specifically labeled. Also, following the administration of the probe to cell cultures, about 5-10% of the cells became DiI-positive. Indirect immunofluorescence with an antibody against von Willebrand (vW) factor also revealed specific staining of the endothelium of the aortic arches as well as of a subset of cells in cultures from aortic arches. These two histochemical markers were further used to identify the emergence of the endothelial cell lineage in the chicken blastodisc. Cultured cells from embryos incubated in ovo for 16 hr exhibited both uptake of DiI-Ac-LDL and expression of a vW-like factor. The proportion of these cells was about 30% of the total cultured cells and increased to over 50% in cultures of embryos incubated in ovo for 20 hr. However, cells positive for uptake of DiI-Ac-LDL and expression of vW-like factor were lacking in cultures of unincubated eggs or eggs incubated for 6-10 hr. We conclude that the very early endothelial cells in the chick blastodisc are already capable of expressing characteristic properties of vascular endothelium. PMID- 2783923 TI - Recruitment and activation of tumor-specific immune T cells in situ: functional studies using a sponge matrix model. AB - The activation of tumor-specific precursor cytotoxic T lymphocytes (CTLP) into cytotoxic T cells (CTL) was demonstrated in situ using the well-defined, highly metastatic ESb tumor as murine model system. Ten days after optimal immunization of syngeneic mice with a sublethal dose of live ESb tumor cells in the pinna, tumor-sensitized non-cytotoxic CTLP were recovered from the spleen and lymph nodes. These cells mature into tumor-specific CTL upon restimulation in vitro. Using a confined sponge matrix compartment, in combination with a specific tumor vaccine (autologous inactivated tumor cells), we induced a CD8+ (Lyt 2+) T-cell mediated, highly cytotoxic anti-tumor immune response in situ in immunized mice. It was not possible to activate a similar response directly in lymphoid organs such as the spleen. The cytotoxic CD8+ T cells, recovered by simple mechanical pressing of the sponge, were active against the specific tumor cells in a 51Cr release assay in vitro and also in a Winn neutralization assay in vivo. CTL activity was increased and remained in the non-adherent fraction when the cell mixture, squeezed out of the sponges, was passed over nylon wool. In a cell recruitment assay, the delayed-type hypersensitivity (DTH) potential of the activated sponge-infiltrating T cells was demonstrated by their capacity to recruit circulating host lymphocytes to sites of tumor-cell location in situ. PMID- 2783922 TI - Adjuvant effects of trehalose dimycolate on the antibody response to type III pneumococcal polysaccharide. AB - Treatment with trehalose dimycolate (TDM) increases the magnitude of the immunoglobulin M (IgM) antibody response of mice to type III pneumococcal polysaccharide (SSS-III). Such enhancement is demonstrable over a wide range of immunizing doses and does not require thymus-derived (T) cells to be elicited. Although young adult mice immunized with SSS-III do not usually make anti-SSS-III antibodies of the IgG1 and IgG3 classes, antibodies of one or both isotypes were produced after immunization and treatment with TDM and/or monophosphoryl lipid A (MPL); the additive nature of the effect produced by both TDM and MPL suggests that the two immunomodulators act by different mechanisms. TDM and MPL have different effects on the induction and expression of low-dose immunological paralysis, a form of unresponsiveness known to be mediated by suppressor T cells. The relevance of these findings to the modes of action of TDM and MPL is discussed. PMID- 2783925 TI - In vivo measurements of vascular oxygen tension in tumors using MRI of a fluorinated blood substitute. AB - The authors measured the level of blood oxygenation in vivo in a series of rats with implanted mammary adenocarcinoma. The technique used was 19F magnetic resonance imaging of a perfluorochemical blood substitute. The method is based on the effect of oxygen on the T1 relaxation time of the fluorochemical and allows the determination of mean vascular PO2 independent of the blood volume in the tissue. The PO2 levels in the liver, lung, and spleen also were determined and were consistent with previously reported results. When the rats breathed air, the tumor PO2 levels were somewhat lower than in the other organs and were in a range typical of venous blood. When the rat was given 100% oxygen to breathe, the tumor PO2 levels increased far less than the PO2 levels of the other organs. This may indicate a greatly diminished blood flow to this particular tumor. PMID- 2783924 TI - Comprehensive evaluation of complement components in the course of type I (Lepra) and type II (ENL) reactions. AB - Complement components C1q and C4 of classic pathway; C3d, a breakdown product of C3, and factor B of alternate pathway: and C3, a component both of classic and alternate pathways, were studied in 35 patients, comprising 18 type I (Lepra) and 17 type II (ENL) reactions. There was a significant decrease in C3 and factor B with a concomitant rise of C3d during ENL. These changes indicate their preeminent role in immunogenesis of type II (ENL) reaction. The changes in the classic pathway components, on the other hand, were insignificant, apparently suggesting its limited involvement in ENL. Furthermore, reversion of factor B and C3d after subsidence of reaction is intriguing and may indicate that they are not substantially affected even with contemporary treatment. Complement components, of both classic and alternate pathways, showed no significant alterations either during type I (Lepra) reaction or after its amelioration. PMID- 2783926 TI - Pleural effusion as a presentation of AIDS-related lymphoma. PMID- 2783927 TI - The effect of acetazolamide on regional cerebral blood flow in patients with Alzheimer's disease or stroke as measured by single-photon emission computed tomography. AB - Regional cerebral blood flow (rCBF) was assessed in 35 patients with possible or probable Alzheimer's disease (AD) and in 16 patients known to have had at least one stroke. Patients were evaluated before and after the administration of 1 g acetazolamide (ACZ) by means of a rotating four-detector single-photon emission computed tomograph (SPECT) and inhaled Xe-133. RCBF values in mL/minute/100 g were derived from eight cortical regions of interest (ROI), and from the whole transverse section as a measure of whole brain flow (WBF). ROI/WBF ratios were calculated for each ROI in paired determinations done before and 15 minutes after the administration of ACZ. Results were compared with those previously obtained in a study of 15 normal, healthy volunteer subjects. ROI/WBF ratios greater than 2 standard deviations (SD) below the mean for a given ROI in the normal group were regarded as probably abnormal, whereas ratios greater than 4 SD below the mean were considered definitely abnormal. After ACZ administration, the number of ROI greater than 2 SD below the normal mean decreased significantly in the AD group and was unchanged in the stroke patients. However, the number of ROI/WBF ratios greater than 4 SD below the normal mean fell in the AD group and rose in the stroke group, with the difference in behavior highly statistically significant. Thus, the response of low-flow areas to ACZ differs in AD and in stroke, which could be of ultimate diagnostic significance. PMID- 2783928 TI - Cardiorespiratory and cellular changes with interleukin 2 infusion in sheep. AB - Recombinant interleukin 2 (rIL-2) administration, a new form of therapy for patients with far-advanced cancer, is associated with a "third space" syndrome, i.e., pulmonary edema, respiratory distress, and hypoxemia, which limits the dose and duration of treatment. To extend our knowledge regarding this toxicity, we established a sheep chronic lung lymph fistula model and measured hemodynamics, arterial blood gases, caudal mediastinal (lung) lymph flow (QL), and blood and lung lymph cellular changes before, during, and after (recovery) a 3-day continuous rIL-2 infusion (9 x 10(5) U/kg). Moderate systemic hypotension, mild pulmonary hypertension, and an increase in alveolar-arterial PO2 gradient was present on day 3 of rIL-2 infusion. QL increased from a base line of 1.9 +/- 0.2 to a maximum of 4.3 +/- 1.1 ml/15 min on day 3 of rIL-2 infusion. At no time was there a change in lymph-to-plasma protein ratio. The leukocyte count increased significantly to 16.1 +/- 4.5 x 10(3) cells/mm3 at recovery day 1. The percentage of blood lymphocytes decreased significantly by day 1 of rIL-2 infusion, returned to base-line levels on day 3, and significantly increased on day 2 of recovery. Lung lymph lymphocytes decreased significantly on days 1 and 2 of rIL-2 infusion. There was a shift in their size; i.e., their area increased from 32 +/- 7 to 57 +/- 19 micron 2 (P less than 0.05) by day 2 of rIL-2 infusion. By day 1 of recovery, lung lymph lymphocyte counts increased significantly.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2783929 TI - Synthetic peptides mimic the assembly of transmembrane glycoproteins. AB - The composition of the intramembranous domains of many receptors are remarkably uniform, yet there is evidence that many transmembrane proteins associate together to form specific noncovalent homo- or heterocomplexes within the membrane. We have synthesized peptides corresponding to transmembrane domains of glycophorin A, glycophorin C, and the interleukin 2-receptor Tac antigen to study the interactions between transmembrane domains in vitro. Synthetic transmembrane glycophorin A peptide formed a complex with native glycophorin and glycoproteins of erythrocyte and K562 cell membranes that was reversible, specific, and could be demonstrated in a natural bilayer system in the absence of detergents. Synthetic glycophorin C and interleukin 2-receptor Tac antigen transmembrane peptides, although similar in amino acid composition, did not interact with glycophorin and did not inhibit the binding of the synthetic glycophorin A transmembrane peptide to native glycophorin. It is proposed that the transmembrane segments of receptor proteins contain not only the structural information necessary for insertion and anchoring but specific binding sites that mediate interactions between transmembrane glycoproteins. PMID- 2783930 TI - Lipopolysaccharide-inducible macrophage early genes are induced in Balb/c 3T3 cells by platelet-derived growth factor. AB - We have previously described the isolation and characterization of a set of cDNA clones encoding lipopolysaccharide (LPS)-induced early genes in murine peritoneal macrophages. The treatment of macrophages with LPS also stimulates the expression of four early or competence genes (c-fos, c-myc, JE, and KC) described in platelet-derived growth factor-stimulated Balb/c 3T3 cells. These latter findings led to the hypothesis that long term, adaptive responses such as DNA synthesis in fibroblasts and functional activation of macrophages may share multiple mechanistic pathways. To test this possibility, we have examined the expression of four LPS-inducible macrophage genes in platelet-derived growth factor stimulated Balb/c 3T3 fibroblasts. The results demonstrate that three of these four genes are expressed in 3T3 cells in a fashion reminiscent of other growth factor-stimulated competence genes. All three mRNAs are expressed even in the presence of cycloheximide and two of the three exhibit superinducibility. The accumulation of these specific mRNA species was dependent upon the stimulation of transcription as determined by nuclear "run-off" studies. The platelet-derived growth factor dose dependence is comparable both for stimulation of DNA synthesis and expression of the three early genes. Furthermore, expression of all three genes preceded the entry of the cells into S phase, suggesting an association with cell cycle entry. Stimulation of 3T3 cells with epidermal growth factor resulted in DNA synthesis but not early gene expression. This latter result indicates that these early gene products are not necessary for 3T3 cell mitogenesis. Nevertheless, the expression of these genes in two different cell types in association with two distinct functional responses suggests that they contribute common functions either in terms of the physiologic response in which these cells participate (e.g. inflammation) or in the regulatory mechanisms which govern such responses. PMID- 2783931 TI - Treatment of castration-induced osteoporosis by a capacitively coupled electrical signal in rat vertebrae. AB - Castrated male Sprague Dawley rats were subjected to various capacitively coupled electrical fields for six and eight weeks at two and 4.5 months after castration, respectively, with pairs of electrodes that were located paraspinally on the surface of the skin dorsally at the eleventh thoracic and fourth lumbar levels. When the animals were killed, dry and ash weights per unit of volume (apparent density), elastic modulus, ultimate stress, work to failure, trabecular area fraction, and mean trabecular width were determined for selected vertebrae. The results indicated that a sixty-kilohertz, 100-microampere signal (a calculated current density of five microamperes root-mean-square per square centimeter and a field of twelve millivolts root-mean-square per centimeter) significantly reversed the castration-induced osteoporosis in the lumbar vertebrae and restored bone mass per unit of volume in rats that had been stimulated for eight weeks after castration. PMID- 2783932 TI - FGF and EGF act synergistically to induce proliferation in BC3H1 myoblasts. AB - BC3H1 muscle cells proliferate when grown in high concentrations of FBS (20%). Lowering the FBS concentration to 0.5% causes the cells to stop proliferating and is permissive for the morphological and biochemical differentiation of BC3H1 cells. Exposure of differentiated BC3H1 myocytes to high concentrations of serum or to the purified growth factors FGF or TGF-b induced a shutdown of this differentiation program but did not induce cell proliferation (Olson et al., J. Cell Biol., 103:1799-1805, 1986; Lathrop et al., J. Cell Biol., 100:1540-1547, 1985, and J. Cell Biol., 101:2194-2198, 1985). We explored the possibility that BC3H1 cells require factors to act synergistically to induce proliferation. We found that EGF and FGF function in a synergistic fashion to stimulate BC3H1 proliferation. Moreover, the temporal requirement for these growth factors suggest that they are functioning as competence and progression factors for BC3H1 cell proliferation. PMID- 2783933 TI - Expression of von Willebrand factor in porcine vessels: heterogeneity at the level of von Willebrand factor mRNA. AB - The expression of the von Willebrand factor (vWF) gene by cultured endothelial cells from the porcine pulmonary artery, aorta, and lung was compared at the levels of messenger (m)RNA and antigen. Steady-state levels of vWF mRNA were determined by dot-blot analysis using a partial human vWF cDNA as the hybridization probe; vWF mRNA from cultured aortic endothelial cells, and vWF antigen secreted into the culture supernatants were barely detectable. In contrast, vWF mRNA and antigen from the pulmonary artery endothelial cells were approximately eight to nine times that demonstrated by aortic cells. Levels of vWF mRNA and antigen in cultured lung cells were intermediate of those found in the pulmonary artery and aorta and correlated with the estimated number of cells demonstrated to be of endothelial origin in the mixed cell populations grown from the lung. Differences between the levels of vWF mRNA found in cultured cells from the pulmonary artery and those found in the aorta were maintained in cells processed directly from these vessels. Correlation between the levels of vWF mRNA and antigen in endothelial cells from different vessels of the pig suggests that the differential control of vWF synthesis is at the level of transcription. Furthermore, maintenance in cultured cells of the difference in transcription rates that were observed in vivo suggests that vWF gene expression is not exclusively regulated through environmental factors. PMID- 2783934 TI - Effects of estrogen in vivo and in vitro on spontaneous interleukin-1 release by monocytes from postmenopausal women. AB - Estrogen (E) inhibits bone resorption, but the mechanism of this effect is unknown. Interleukin-1 (IL-1) stimulates bone resorption in vitro and may be produced in bone by mononuclear phagocytes. Recently, the spontaneous release of IL-1 from peripheral monocytes was found to reflect bone formation in a subset of patients with idiopathic osteoporosis. We suspected that the action of E on bone is mediated indirectly by its effect on monocyte IL-1 activity. Eleven normal postmenopausal women taking no medications were given conjugated E (0.625 mg daily) for 3-9 weeks. Supernatants from cultured peripheral monocytes were analyzed for IL-1 production by stimulation of a cloned murine helper T-cell line. IL-1 release was expressed as a percentage of maximum release corrected for monocyte number. IL-1 release before E treatment was 11.0 +/- 0.2% (+/- SE), it was 7.8 +/- 1.6% after E treatment (P = NS). IL-1 release fell in each of the three women with the highest initial values (46% to 5%, 25% to 17%, and 18% to 12%). IL-1 release did not correlate with serum osteocalcin or fasting urinary calcium either before or after E treatment. Addition of 10(-7)-10(-10) mol/L 17 beta-estradiol to cultured monocytes obtained before E treatment caused an increase in IL-1 release that did not follow a dose-response relationship. Treatment of postmenopausal women with E did not affect spontaneous IL-1 release by peripheral monocytes in vitro. The addition of E in vitro did not produce consistent changes in IL-1 release by these cells. This does not exclude the possibility that E may affect monocyte IL-1 release in subsets of women with high spontaneous monocyte IL-1 release with or without osteoporosis. PMID- 2783935 TI - Gene conversions and rearrangements cause discordance between inheritance of forms of 21-hydroxylase deficiency and HLA types. AB - Congenital adrenal hyperplasia (CAH) can be caused by a variety of defects in the functional gene encoding 21-hydroxylase (P450c21), which lies in the midst of the human leukocyte antigen (HLA) locus on chromosome 6. As a result, Mendelian genetics permit clinically distinct forms of CAH to be traced genetically by HLA and complement typing of family members. The recent cloning of probes for P450c21 now permits tracing of the affected gene directly. A consanguineous family had three members affected with three clinically distinct forms of CAH. Two of these individuals had identical extended haplotypes, including nine HLA and complement loci. Despite this extensive identity, the patterns of genomic DNA fragments digested with endonuclease EcoRI and detected by a P450c21 cDNA probe differed greatly in these two individuals. Thus, the DNA diagnosis of allelic variation was much more sensitive than the HLA diagnosis. Genomic DNA digested with endonuclease TaqI and probed with P450c21 cDNA revealed the 3.2-kilobase (kb) band, which is generally associated with the nonfunctional P450c21 A pseudogene, in all family members, and also revealed the 3.7-kb band associated with the functional P450c21 B gene in all family members except the severely affected index case. Probing of the same blots with a genomic probe also permitted examination of the adjacent downstream TaqI fragments, showing retention of both the 2.4-kb (A pseudogene) and 2.5-kb (B gene) fragments. Similarly, BglII digested genomic DNA from all individuals contained both the 12-kb (A pseudogene) and 11-kb (B gene) bands. These data indicate that the basis of 21-hydroxylase deficiency in the index case was due to a homozygous gene conversion event and not to gene deletion. These results show that the DNA in and around the 21 hydroxylase gene is genetically very active, so that the usual generalization concerning linkage and inheritance may yield incorrect conclusions and diagnoses. PMID- 2783936 TI - Absence of a correlation between T lymphocyte subsets and clinical activity in relapsing-remitting multiple sclerosis. AB - Cytofluorographic analysis of CD3+, Tac+, HLA-DR+ peripheral blood lymphocytes and CD4/CD8 ratio was performed monthly, over a 10-month period, in a group of 16 patients with multiple sclerosis (MS). No correlation was found between clinical relapses and fluctuations in the lymphocyte subsets, although patients who were in remission throughout the study showed a number of CD3+ cells and a CD4/CD8 ratio significantly lower than those in normal controls. We concluded that changes in peripheral blood lymphocyte subsets are not related to the disease process and their measurement is not helpful in monitoring the illness. PMID- 2783937 TI - Amacrine and ganglion cells with corticotropin-releasing-factor-like immunoreactivity in the turtle retina. AB - This study, which uses immunocytochemical methods at the light microscopical, level, examines the cell types in the turtle retina that contain corticotropin releasing factor (CRF)-like immunoreactivity. Two anatomically distinct amacrine cell types are labeled when antiserum directed against ovine CRF is used to label the turtle retina. These cell types each have a different dendritic arborization pattern and regional distribution. Type A cells are found only in the visual streak and have elongated dendritic arborizations that run parallel to the visual streak. These cells arborize primarily in stratum 1 and near the border of strata 2 and 3, with some processes extending into stratum 5. Type B amacrine cells are found only ventral to the visual streak and arborize primarily in a wide band in strata 4 and 5 with sparse dendritic arborizations in stratum 1. No labeled amacrine cells of any type were found dorsal to the visual streak. The asymmetric dendritic arborizations of the type A amacrine cells and the different regional distributions of the A and B cell types suggest that these two amacrine cell types perform distinct physiological functions. In addition to these labeled amacrine cells, there are also some immunoreactive cell bodies in the ganglion cell layer. Rhodamine crystals were applied to the optic tectum to retrogradely label the ganglion cell bodies. Double label studies indicate that some of the rhodamine-labeled ganglion cells also contain CRF-like immunoreactivity. The localization of CRF-like immunoreactivity in two distinct amacrine cell types and in ganglion cells suggests that it may play multiple roles in visual processing in the turtle retina. PMID- 2783938 TI - The frog palate mucosa as a model for studying bacterial adhesion to mucus-coated respiratory epithelium. AB - Most of the methods proposed to quantify bacterial adherence to respiratory mucosa differ mainly from in vivo conditions in the absence of the mucus blanket and in the exposure of the sub-mucosal connective tissue (SMCT) to the micro organisms. We propose the frog palate as a model to study bacterial adhesion to the respiratory mucosa, with a system which allows the mucus to be preserved and the bacterial adhesion to be quantified in a standardized mucosal area, where mucociliary transport is still active. In order to evaluate the role of respiratory mucus in bacteria-mucosa interaction, we compared the adhesion of radiolabelled pneumococci to 12 mucus-coated and 10 non-mucus-coated frog palate mucosae. The presence or absence of mucus was controlled by scanning electron microscopy (SEM). After a 10 min incubation period, the bacterial adhesion to mucus-coated palate mucosa was five times greater (P less than 0.01) than that to uncoated mucosa. By SEM, bacteria were never seen attached to ciliated cells but could be detected on small areas where mucus was not totally eliminated. Even after a 120 min contact of bacteria to uncoated mucosa, bacterial adhesion remained only half that to mucus-coated epithelium. In order to ascertain whether the exposure of the SMCT represented a means of attraction to bacteria, we incubated the frog palate mucosa face-down with radiolabelled Pseudomonas aeruginosa. As much as 44 per cent of added bacteria adhered to exposed SMCT and, by SEM, numerous micro-organisms were seen attached to connective tissue. In contrast, only a few bacteria were observed adhering to the mucosa, mainly to granules of mucus. PMID- 2783939 TI - Interferon alfa-2a in the treatment of cutaneous T cell lymphoma. AB - Twenty-two patients with Stages Ia to IVa cutaneous T cell lymphoma were entered into a controlled trial of interferon alfa-2a (Roferon-A). Patients initially received either 3 million IU interferon alfa-2a, or their dosage was escalated to 36 million IU intramuscularly daily for a 10-week induction period. At the end of induction, 14/22 (64%) of patients had an objective antitumor response: three patients had a complete response, ten patients had a partial response (greater than or equal to 50% resolution of clinical disease), and one patient had a minor response. Responders included those with Stages Ia to IVa cutaneous T cell lymphoma, and remissions have lasted at least 4 to 27.5 months. Three patients progressed from a partial to complete response with further treatment, for an overall complete response rate of 27%. Acute flu-like side effects were generally minor and transient. Malaise/fatigue, depression, anorexia, and weight loss were common chronic dose-related side effects and the most frequent reasons for dose reduction or discontinuation of drug. Leukopenia was the most common laboratory side effect and was also dose-related. Recombinant human leukocyte interferon alfa-2a is an effective and well-tolerated single-agent therapy for early and advanced cutaneous T cell lymphoma. PMID- 2783940 TI - Medication for endocarditis prevention. PMID- 2783941 TI - Comparison of planar and tomographic exercise thallium-201 imaging methods for the evaluation of coronary artery disease. PMID- 2783942 TI - Phenotypic and functional analysis of gamma delta T cell receptor-positive murine dendritic epidermal clones. AB - Thy-1+ dendritic cells isolated from the epidermis of normal mice (dEC)3 bear the gamma delta TCR associated with the CD3 complex. We have analyzed the effects of antibodies directed against the TCR complex, Ly-6C, and Thy-1, as well as pharmacologic agents which have been shown to activate T cells without engagement of the TCR complex, on levels of intracellular free calcium, activation of protein kinase C, cytolysis, IL-2R expression, and secretion of lymphokines by dEC clones. We have found that the dEC cells express a fully functional TCR complex which can function to transmit signals upon perturbation leading to an increase in IL-2R expression, release of lymphokines, and cytolytic activity. These results indicate that the gamma delta TCR+ dEC are capable of responding to activation signals in the same manner as mature alpha beta TCR+ cells and suggests that they may play a functional role in the skin. PMID- 2783943 TI - Requirements for modulation of the CD4 molecule in response to phorbol myristate acetate. Role of the cytoplasmic domain. AB - CD4 (T4) is a 60 kD glycoprotein expressed on a subset of T lymphocytes. CD4 augments T cell responses to suboptimal Ag stimulation. In addition, the CD4 molecule is the receptor for HIV-1. CD4 is phosphorylated on serine residues within the cytoplasmic domain and its cell surface expression is decreased in response to PMA, APC bearing the appropriate Ag or HIV infection. The kinetics of CD4 phosphorylation and modulation are similar, suggesting that the two events may be related. L3T4, the murine CD4 equivalent, is not modulated from the surface of mature, peripheral T cells in response to PMA. The difference in the ability to modulate L3T4 and CD4 in response to PMA may be due to differences between the two molecules or to differences between the cells in which they are expressed. To further define the requirements for CD4 modulation, we used retroviral vectors to transfer the cDNA for CD4 and various mutants of CD4 into two murine T cell hybridomas that express L3T4. One of these hybridomas, By155.16, does not modulate L3T4 in response to PMA and the other, 5D5.63, does modulate L3T4 in response to PMA. When expressed by these hybridomas CD4 is not modulated from the surface of By155.16 and is modulated from the surface of 5D5.63 in response to PMA. In both of these hybridomas, CD4 is phosphorylated on serine residues in response to PMA. A mutant form of CD4, CD4 delta, was constructed in which the majority of the cytoplasmic domain was deleted. When expressed in 5D5.63, CD4 delta was not modulated in response to PMA. Replacing the cytoplasmic domain of CD4 with that of the human IL-2 receptor did not reconstitute the ability of CD4 to be modulated. These results suggest that the inability to modulate L3T4 from the surface of murine peripheral T cells is due to features of the cell and not the molecule. Furthermore, the cytoplasmic domain of CD4 is required for its modulation from the cell surface in response to PMA. PMID- 2783944 TI - Responses of B cells from autoimmune mice to IL-5. AB - Three strains of mice (NZB/W F1 X NZW (NZB/W), BXSB, and MRL/Mp-lpr/lpr (MRL/lpr] develop an autoimmune disease that is clinically and immunologically similar to human SLE. A characteristic of these mice is polyclonal B cell hyperactivity. To explore whether this may be related to hyper-responsiveness to B cell stimulatory factors, we investigated the proliferative and secretory responses of B cells from these mice to semi-purified natural and rIL-5, a major regulator of B cell development in the mouse. As this lymphokine stimulates growth and differentiation of activated B cells, attention was focused on in vivo-activated B cell populations, obtained from the interface of 50/65% Percoll density gradients, from normal or autoimmune mice. This cell population from NZB/W mice secreted IgM and incorporated [3H]TdR at significantly higher levels in response to IL-5, and was more sensitive to IL-5, than a comparable population from several normal murine strains. NZB/W female and male mice displayed heightened responses to IL-5, indicating that this is characteristic of the strain in general and is not associated with the accelerated severe disease of the females. Small resting B cells from NZB/W and normal mice were insensitive to IL-5 stimulation. In contrast to NZB/W mice, no difference was observed in the magnitude of either proliferative or Ig secretory responses between in vivo activated B cell populations from autoimmune BXSB and MRL/lpr or normal mice. Thus, B cell hyper-responsiveness to IL-5 is a characteristic of NZB/W mice but not of two other lupus-prone murine strains. As one unique feature of NZB/W mouse B cells compared to normal and other autoimmune B cells is an elevated proportion of Ly-1+ B cells, the possibility of IL-5 hyper-responsiveness being associated with this B cell subpopulation was investigated. Fluorescence-activated cell sorter sorted Ly-1+ and Ly-1- B cells both responded to IL-5, however Ly-1+ B cells consistently showed a higher stimulation index in both proliferative and Ig secretory responses to this lymphokine. PMID- 2783946 TI - Promotion of human T lymphocyte proliferation by IL-4. AB - The capacity of human rIL-4 to support the proliferation of mitogen-stimulated T cells directly as well as by increasing IL-2 production or enhancing IL-2 responsiveness was investigated. IL-4 augmented proliferation of T cells stimulated with PHA, Con A, immobilized mAb to the CD3 molecular complex (OKT3), or PMA. IL-4 increased the number of mitogen-stimulated cells entering the cell cycle as well as enhancing ongoing proliferation of mitogen-activated lymphoblasts. Facilitation of initial activation by IL-4 was not inhibited by mAb to the p55 component of the IL-2R, anti-Tac, and, therefore, was not dependent on endogenous IL-2 activity. However, IL-4-mediated enhancement of ongoing T cell proliferation stimulated by PHA or OKT3 was partially but not completely blocked by anti-Tac. Analysis of the supernatants from PHA-stimulated T cell cultures indicated that IL-4 increased the production of IL-2 by mitogen-activated cells. Moreover, IL-4 increased the amount of IL-2 mRNA that accumulated in mitogen stimulated T cells. In addition, IL-4 markedly augmented IL-2R expression by PHA stimulated T cells. Although IL-4 promoted ongoing DNA synthesis of mitogen stimulated T cells in an IL-2-dependent manner, it was also able to sustain their proliferation directly. Thus, IL-4 supported proliferation of PMA-activated T cells in a manner that was not inhibited by anti-Tac. Furthermore, IL-4 could augment proliferation and IL-2R expression of T cells stimulated with PHA in the presence of cyclosporin A, which blocks endogenous cytokine production or anti Tac. Finally, IL-4 was noted to enhance proliferation of both CD4+ and CD8+ T cell subsets. The results indicate that IL-4 enhances proliferation of mitogen activated human T cells by a number of mechanisms, including the direct promotion of cell cycle entry and subsequent DNA synthesis, enhanced production of IL-2, and increased responsiveness to IL-2 in part by up-regulation of IL-2R expression. PMID- 2783945 TI - IL-6/IFN-beta-2 as a circulating hormone. Induction by cytokine administration in humans. AB - IL-6/IFN-beta 2 is a family of phosphoglycoproteins ranging in size from 19 to 30 kDa which elicits a broad range of physiologic and immune responses. Several cytokines, including TNF, have been shown to stimulate IL-6 production in cell culture. In this report, we describe the rapid induction of circulating biologically active IL-6 by the systemic administration of rTNF to patients with cancer. Low levels of IL-6 activity could be detected in the sera of patients as early as 5 min after rTNF infusion. IL-6 levels peaked approximately 2 to 3 h after rTNF bolus administration and were undetectable in most cases within 8 h. IL-6 was detected in two separate bioassays--the hybridoma B9 proliferation and the hepatocyte-stimulating factor assay. Maximum detectable levels of IL-6 ranged from 160 to 310 hybridoma growth factor units and 11-82 ng/ml in the hepatocyte stimulating factor assay. IL-6 induction decreased after serial, daily doses of rTNF. Serial serum samples of patients receiving IL-2 or IFN-alpha were also assayed for IL-6 production. IL-2-treated but not IFN-alpha-treated patients generated low levels of IL-6 (range less than 20 to 95 hybridoma growth factor units/ml). Interestingly, in patients treated with IL-2, serum levels of TNF were detectable and peak TNF activity preceded measurable IL-6 levels. Serum levels of acute phase plasma proteins and of corticosteroid rose in response to rTNF administration. C-reactive protein increased (2.5 to 4.0-fold) within 8 h of rTNF administration and cortisol levels rose (10- to 20-fold) within 4 h after rTNF injection. We conclude that rTNF administration in man leads to the induction of circulating IL-6 which, due to its broad range of activities, may be an important physiologic signal regulating the immune response. PMID- 2783947 TI - Preferential proliferation of immature B lineage cells in long-term stromal cell dependent cultures with IL-4. AB - IL-4 influences the cellular composition of stromal cell dependent long term cultures. In bone marrow-derived long term lymphoid cultures initiated in presence of IL-4, the majority of cells exhibited a more immature phenotype than is usually seen in lymphoid cells grown in Whitlock-Witte type cultures. This immature cell population, lacking the B220 Ag, was purified by cell sorting. When transferred to mixed stromal layers used in conventional lymphoid long term cultures, these cells differentiated into B lineage cells that could be identified by expression of the B220 Ag and surface IgM. Abelson murine leukemia virus-transformed cell lines resulting from this immature cell population express a DJH rearrangement and contained RNA that hybridized with a VJ558 probe, suggesting transcription of germ-line V genes. A culture modification allowed selective proliferation of a non-transformed cell population with characteristics of very immature B lineage cells. The proliferation of these cells was supported by a homogeneous stromal cell line that was propagated with horse serum in presence of IL-4. The lymphoid cells proliferating under those culture conditions expressed the Ag detected by the BP-1 and 6C3 mAb and were Fc gamma RII and Ia positive. However, more mature B cell markers were lacking. DNA analysis of these cell lines revealed JH rearrangement without evidence for deletion of any member of the DSP-2 family. These cell lines retained their immature phenotype after transfer to mixed stromal layers of Whitlock-Witte type. The mechanisms providing these unique culture conditions initiated by IL-4 in bone marrow stromal cells are discussed. PMID- 2783948 TI - Transcriptional regulation of transferrin receptor expression by cultured lymphoblastoid T cells treated with phorbol diesters. AB - Expression of transferrin receptors (TFR) is required for lymphocyte proliferation. Treatment of lymphoblastic leukemia cell lines with phorbol diester tumor promoters decreases proliferation and induces differentiation. Among changes induced by phorbol diesters is decreased cell surface expression of TFR. To elucidate effects of phorbols on lymphocyte growth and differentiation, we examined TFR expression by measuring 125I-transferrin binding, levels of TFR mRNA by Northern analysis and dot-blot hybridization, and rates of TFR gene transcription by nuclear run-on experiments in CCRF-CEM lymphoblastoid T cells treated with PMA or phorbol dibutyrate. Cell surface expression of TFR was decreased 60 to 85% within 2 min of exposing cells to phorbols and remained decreased for 96 h. Steady state levels of TFR mRNA decreased to less than 30% of control after 48 h. After treating cells with actinomycin D, estimated TFR mRNA t 1/2 was 2.7 h and was unaltered in phorbol-treated cells. Levels of TFR mRNA were not affected by treatment of cells with cycloheximide in either control or phorbol-treated cells. Therefore, post transcriptional mRNA processing by protein factors did not account for decreased TFR mRNA in phorbol-treated cells. Compared to baseline levels, rates of TFR gene transcription in PMA-treated cells increased up to two-fold during the initial 6 h of culture, then decreased over the ensuing 12 h to less than 10% of baseline values. This pattern was not seen in control cultures. Therefore, regulation of TFR gene transcription is a consequence of treating CEM cells with phorbol diesters. Cell surface expression of TFR in phorbol-treated lymphoblastoid T cells may be mediated in part at the level of gene transcription. PMID- 2783949 TI - Molecular cloning and characterization of a novel murine T cell surface antigen, YE1/48. AB - YE1/48 is a murine cell surface disulphide-linked dimeric Ag consisting of two 45,000-50,000 Mr subunits. It is expressed on some T lymphoma lines at high levels but its expression on normal lymphocytes is very low. The functional significance of this Ag is currently unknown. We have now cloned a cDNA encoding the YE1/48. Sequence analysis revealed that it encodes a Type II membrane protein of 262 amino acids (30,500 MW), with 44 amino acids in the N-terminal cytoplasmic domain, 22 amino acids in the transmembrane domain and 196 amino acids in the C terminal extracellular domain. There are three potential N-linked glycosylation sites in the extracellular domain all of which are probably used in the mature protein. No significant homology can be identified with other known protein sequences in the data base or with human CD28(T44), a human T cell activation antigen consisting of two 44,000 Mr subunits. The protein sequence includes in its extracellular domain the arginine-glycine-aspartic acid tripeptide, a potential cell-adhesive binding site, and a sequence similar to the consensus domain of any metal-binding proteins. However, whether these sequences are functional is unknown. Genomic Southern analysis of C57BL/6, BALB/c and C3H mice has demonstrated a restriction fragment length polymorphism. The analysis has also strongly suggested the existence of some other genes with sequences highly homologous to the YE1/48 gene. The YE1/48 gene appears to be expressed at very low levels in a wide range of lymphoid cells with no restriction to their differentiation stages. Interestingly, YE1/48 expression appears to be induced in pre-B cells after transformation by Abelson virus, suggesting an association of YE1/48 expression with the transformation of T and pre-B Cells. PMID- 2783950 TI - Generation and characterization of purified adherent lymphokine-activated killer cells in mice. AB - During the incubation of murine spleen, lymph node, or bone marrow cells with IL 2 (1000 U/ml) a small percentage of cells became adherent to the surface of plastic tissue culture flasks. After removal of the non-adherent lymphoid cells, plastic adherent lymphokine-activated killer (LAK) cells could be efficiently expanded in the presence of IL-2. Plastic adherent-derived A-LAK cells were characterized by high rates of proliferation and their cytotoxic activity was more than 10 fold higher than LAK cells generated in the bulk (unfractionated) spleen cell cultures. A-LAK cells could be continuously generated from the non adherent cell population. Using multiple transfers (every 1 to 2 days) of non adherent LAK cells into new flasks, new rounds of plastic adherent cells were generated with high expansion capability and high levels of cytotoxic activity. Morphologically, A-LAK cells were large granular lymphocyte and phenotypically expressed markers characteristic of NK cells (asialo GM1+, NK1.1+, Qa5+, Ly-6.2+, Thy-1.2+, but negative for Lyt-2.2 and L3T4). A-LAK cells generated from mice of different strains expressing low and high levels of NK cell activity were equally highly cytotoxic. However, A-LAK cells obtained from nude or beige mice had relatively lower levels of cytotoxicity. Stimulation of NK cell activity by poly I:C or inhibition by in vivo or in vitro treatment with anti-asialo GM1 serum did not affect the generation of A-LAK cells. A-LAK cells derived from spleen or bone marrow of C57BL/6 or nude mice treated with anti-asialo GM1 serum were found to be asialo GM1+ suggesting that A-LAK cell could be generated from the asialo GM1- precursor cells. Expansion of plastic adherent A-LAK cells in the presence of IL 2 could provide large numbers of highly purified cytotoxic A-LAK cells suitable for cancer immunotherapy. PMID- 2783951 TI - Elevated plasma interleukin-1 levels in humans following ultraviolet light therapy for psoriasis. AB - Interleukin-1 (IL-1) is a potent cytokine with a wide range of biologic activities including induction of several acute phase responses. Ultraviolet radiation (UVR) is widely used as a therapeutic modality to treat many chronic skin diseases, including psoriasis. In the present study, we investigated whether ultraviolet B (UVB) radiation induced circulating IL-1 in the plasma of patients undergoing chronic UVB therapy. In order to remove plasma proteins which inhibit IL-1-induced T-cell proliferation, each plasma sample was chromatographed and each fraction was assayed for IL-1 activity. There was no detectable IL-1 before and 1 h after UVB radiation; IL-1 appeared 4 h after treatment and was absent after 24 h. Plasma IL-1 was neutralized by antibodies to recombinant human IL-1 beta and alpha. The anti-IL-1 alpha, but not anti-IL-1 beta, antibodies partially neutralized the IL-1 activity present in a keratinocyte cell line supernate. These results demonstrate that UVB therapy induces circulating IL-1 and that this IL-1 may originate from both keratinocyte and non-keratinocyte sources. PMID- 2783952 TI - Flow cytometrically-sorted residual HLA-DR+T6+ Langerhans cells in topical steroid-treated human skin express normal amounts of HLA-DR and CD1a/T6 antigens and exhibit normal alloantigen-presenting capacity. AB - Topical corticosteroids decrease the number of HLA-DR+T6+ Langerhans cells (LCs) and the antigen-presenting capacity of epidermal cells (ECs). We have investigated the properties of residual HLA-DR+T6+ LCs in steroid-treated human skin. Flow cytometric analysis revealed that clobetasol propionate 0.05% applied twice daily for 7 d reduced the percentage of HLA-DR+T6+ LCs in EC suspensions to 46% of control (from a mean percentage +/- sem of 2.49 +/- 0.30 in control skin to 1.15 +/- 0.22 in steroid-treated skin), but did not significantly alter the relative amounts of HLA-DR and CD1a/T6 antigens per individual HLA-DR+T6+ cell. HLA-DR+T6- and HLA-DR-T6+ cells were not detected in either group. Steroid therapy significantly decreased the allostimulatory capacity of unsorted ECs. By contrast, in parallel experiments in which the same EC suspensions were greatly enriched (85% to 90%) for HLA-DR+T6+ LCs by flow cytometric sorting, the allostimulatory capacity of purified LCs from steroid-treated skin was not significantly different from control. Residual HLA-DR+T6+ LCs, which preserve their antigenic markers and alloantigen-presenting function, may be relatively unaffected because they have only recently immigrated into the epidermis, or they may represent a subgroup of steroid-resistant LCs. Alternatively, given the dose response relationship between topical steroid potency and decrease in HLA-DR+T6+ LC numbers, the apparent steroid resistance of residual HLA-DR+T6+ LCs may reflect heterogenity in the density of expression of LC steroid receptors. PMID- 2783953 TI - Surface tension in the developing mammal: anisotropic tension generation in the dorsal skin of the perinatal rat. AB - It is common knowledge that skin biopsies retract following excision. The direction and the magnitude of this retraction is thought to be related to the field of tension previously experienced by the skin sections in vivo. We utilized this phenomenon to investigate the ontogeny, directionality, and regulation of skin tension in the perinatal rat from gestational day 20 to postnatal day 6. In this study, geometrically-precise biopsies (circles and rectangles) were excised from the dorsal skin of perinatal rats and placed in tissue culture media. The excised skin sections rapidly exhibited changes in shape (to ellipses and helices). These resulting conformations were characterized with regard to selected spatial attributes; i.e., the ratio of major to minor axes for elliptical figures and the "winding number" for helices. This simple methodological approach allowed the following conclusions: 1) skin retraction in the rat is anisotropic and is maximal in the rostral-caudal direction; 2) skin retraction is inversely related to postnatal age and to ambient temperature; 3) retraction is inhibited by in vivo treatment with epidermal growth factor (EGF) as well as by metabolic poisons such as sodium azide; 4) retraction is augmented in vitro by calcium chloride. Overall, these data support the hypothesis of a metabolically active, temperature-dependent, anisotropically organized retractile mechanism in the dorsal skin of the perinatal rat. PMID- 2783955 TI - Epidermal growth factor effect on serum-free growth of primary and metastatic human tumors. AB - The effect of epidermal growth factor (EGF) on the in vitro growth of human malignant tumors was compared in serum-supplemented (n = 54) and serum-free (N = 41) media at clonal density to determine the true EGF dependency of tumors. In the complete absence of serum at a 1,000 cells/cm2 seeding inoculation (approximately 100-200 adherent cells), EGF increased growth by greater than 50% in 27 of 41 specimens (66%), and growth increased by 100% or more in 18 of these EGF-sensitive tumors. In 12 serum-free cultures (29%), in vitro growth failed to occur without EGF. With 10% serum supplementation and a lower cell density (250 cells/cm2), EGF increased growth by greater than 50% in 34 of 54 specimens (63%), of which 25 had more than a 100% increase. The maximum growth induced by EGF in serum was usually seen in those tumors already capable of moderate in vitro growth. No difference in response to EGF was detected between specimens from primary tumors (n = 24) and those from metastases (n = 30). Under the stringent culture conditions of complete absence of serum and with tumors seeded at a low cell number, EGF stimulated most primary or metastatic human tumors to establish and sustain short-term in vitro growth successfully. PMID- 2783954 TI - Ultraviolet radiation-induced suppression of contact hypersensitivity in relation to padimate O and oxybenzone. AB - Contact hypersensitivity (CHS) in mice can be induced by cutaneous sensitization followed by elicitation via ear-painting with trinitrochlorobenzene (TNCB). This CHS reaction is systemic and can be suppressed by exposure of mice to suberythemogenic doses of 280-315 nm radiation. In this study, we investigated whether a commercially available water-resistant sunscreen, either SPF-6 or SPF 15, containing Padimate O (UVB absorber) and oxybenzone (UVA absorber), was effective in preventing systemic suppression of CHS induced by either FS36 sunlamp exposure or solar simulating radiation. We observed that these two sunscreen preparations were totally incapable of preventing the immunologic suppression of contact hypersensitivity by UV radiation. These results indicate that application of sunscreen does not retard the development of suppression of CHS following repeated UV exposure under conditions where erythema is not clinically observed. Thus, erythema may not be a good end point for assessing systemic immune suppression and its consequences. PMID- 2783956 TI - Trends in cause-specific infant mortality in Georgia. AB - We previously reported that almost one third of the potential for reduction (PFR) in infant mortality in Georgia would result from reduction in mortality of normal birthweight infants. To determine where reductions were made in the past and where gaps remain, we examined trends from 1960 to 1980-82 in cause-specific mortality for normal birthweight infants by race. In the neonatal period, mortality was reduced by 66% for white infants, 76% for black infants. In the postneonatal period, overall reductions were smaller than in the neonatal period, 50% for white and 71% for black infants. The majority of the remaining gap resulted from excess mortality in the infection, injury, and Sudden Infant Death categories. The widest gaps in infant mortality exists in the postneonatal period. There is a 12% potential for reduction in the black infant mortality rate if interventions directed at the normal birthweight infant in the postneonatal period are emphasized. PMID- 2783957 TI - Osteocalcin during the reproductive cycle in normal and diabetic rats. AB - Concentrations of osteocalcin were measured in plasma and bone of normal and diabetic rats during the reproductive cycle and compared with plasma 1,25 dihydroxyvitamin D3 (1,25-(OH)2D3) concentrations. The age-dependence of osteocalcin was also examined. Plasma concentrations of osteocalcin levels were low but detectable in 21-day-old fetuses (3.7 +/- 0.3 nmol/l); osteocalcin concentrations were highest in weaning rats (104 +/- 9 nmol/l) and decreased thereafter. In adult rats, plasma concentrations of both osteocalcin and 1,25 (OH)2D3 increased during the last days of normal pregnancy, and even more so in rats fed a diet low in calcium and phosphate. After an early post-partum decline, osteocalcin concentrations in plasma remained at non-pregnant levels in lactating rats fed a high calcium/phosphate diet while their 1,25-(OH)2D3 concentrations were higher than in non-pregnant rats; however, lactating rats fed a low calcium/phosphate diet showed increasing osteocalcin concentrations. In spontaneously diabetic BB rats, plasma osteocalcin concentrations were severely decreased compared with those in non-diabetic rats, more than would have been expected from their decreased 1,25-(OH)2D3 concentrations. Moreover, plasma osteocalcin did not increase during pregnancy or lactation in diabetic rats, even when fed a low calcium/phosphate diet. Fetuses of diabetic rats also had lower plasma osteocalcin levels than fetuses from non-diabetic rats or than weight matched fetuses from semistarved rats. In contrast to plasma osteocalcin concentrations, bone osteocalcin concentrations and content were not altered by pregnancy, lactation, low calcium/phosphate diet or diabetes.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2783958 TI - Abnormal proteolysis (DIC)--successful treatment with antithrombin III concentrate and a concentrate containing F XIII and native von Willebrand factor. AB - Two patients with life-threatening disseminated intravascular coagulation (DIC) syndrome, one caused by Gram-negative bacteria and one by premature separation of the placenta, are described. Specific substitution was given by antithrombin III concentrate and AHF-Kabi, a low purity factor VIII concentrate containing native von Willebrand factor and factor XIII. The treatment quickly returned the extremely low levels of antithrombin III, factor VIII:C, fibrinogen and factor XIII, initially found, to normal, and also returned the multimeric pattern of von Willebrand factor to normal. This resulted in diminished bleeding, enabling surgical treatment of the underlying disease. PMID- 2783959 TI - Formation of [3H]inositol metabolites in rat hippocampal formation slices prelabelled with [3H]inositol and stimulated with carbachol. AB - Rat hippocampal formation slices were prelabelled with [3H]inositol and stimulated with carbachol for times between 7 s and 3 min. The [3H]inositol metabolites in an acid extract of the slices were resolved with anion-exchange HPLC. Carbachol dramatically increased the concentration of [3H]inositol monophosphate, [3H]inositol bisphosphate (two isomers), [3H]inositol 1,3,4 trisphosphate, [3H]inositol 1,4,5-trisphosphate, and [3H]inositol 1,3,4,5 tetrakisphosphate. The levels of [3H]inositol 1,4,5-trisphosphate rose most rapidly; they were maximally elevated after only 7 s and declined toward control levels in 1 min followed by a more sustained elevation in levels for up to 3 min. When [3H]inositol 1,4,5-trisphosphate was incubated with hippocampal formation homogenates in an ATP-containing buffer it was very rapidly metabolised. After 5 min [3H]inositol 1,4-bisphosphate, [3H]inositol 1,3,4-trisphosphate, and [3H]inositol 1,3,4,5-tetrakisphosphate could be detected in the homogenates. Under similar experimental conditions [3H]inositol 1,3,4,5-tetrakisphosphate is metabolised to [3H]inositol 1,3,4-trisphosphate and an inositol bisphosphate isomer that is not [3H]inositol 1,4-bisphosphate. We conclude that like other tissues the primary event in the hippocampus following carbachol stimulation is the activation of phosphatidylinositol 4,5-bisphosphate selective phospholipase C. PMID- 2783960 TI - Inositol phospholipid metabolism during and following synaptic activation: role of adenosine. AB - The metabolic pathway of inositol phospholipids represents a series of synthetic and hydrolytic reactions with inositol as a by-product. Hence, the rate of [3H]inositol release from prelabeled phospholipids can be used as a reflection of activity of this pathway. In the frog sympathetic ganglion prelabeled with [3H]inositol, we studied the effect of synaptic activity (orthodromic stimulation) on release of 3H-label into the medium. This release was interpreted as [3H]inositol release. The value was low at rest and increased significantly by 32% during orthodromic stimulation (20 Hz for 5 min). However, on cessation of the stimulation, [3H]inositol release increased rapidly by 148% and remained elevated for at least 45 min. This increase in [3H]inositol release during and after the stimulation period was reduced by suffusion of the ganglia with adenosine. We hypothesized that synaptic activation releases a long-lasting stimulatory agonist and a short-lasting inhibitory (adenosine) agonist or agonists affecting [3H]inositol release. To demonstrate the presence of a stimulatory agonist, two sympathetic ganglia were used. One was prelabeled with [3H]inositol, and the other was not. The two ganglia were placed together in a 5 microliter droplet of Ringer's solution containing atropine. Orthodromic stimuli applied to the nonlabeled ganglion elicited release of [3H]inositol from the nonstimulated ganglion. To test whether the adenosine formed during orthodromic stimulation inhibits [3H]inositol release, we destroyed endogenous adenosine by suffusion of the ganglia with adenosine deaminase during the stimulation period. We found that adenosine deaminase induced large increases in [3H]inositol release during the stimulation period, in contrast to an increase seen only during the poststimulation period when adenosine deaminase was omitted. Because [3H]inositol release is assumed to parallel changes in content of inositol phosphates, we anticipated no changes of the levels of these compounds during orthodromic stimulation. However, measurements showed that levels of inositol phosphates and inositol phospholipids were all elevated except for phosphatidylinositol 4 phosphate. On termination of the stimulus, they remained elevated, with a further increase in levels of inositol trisphosphate and phosphatidylinositol 4 phosphate. We conclude that endogenous adenosine inhibits [3H]inositol release, possibly by modulating several of the steps of the inositol phospholipid pathway.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2783961 TI - Electrical properties and innervation of fibers in the orbital layer of rat extraocular muscles. AB - 1. The inferior rectus muscle of rat, one of the extraocular muscles, contains two populations of multiply innervated fibers (MIFs): orbital MIFs, located in the orbital layer of the muscle and global MIFs, found in the global layer. The electrical properties and the responses to nerve stimulation of orbital MIFs were studied with single intracellular electrodes and compared with those of twitch fibers of the orbital layer, MIFs of the global layer, and tonic fibers of the frog. 2. About 90% of the orbital MIFs did not produce overshooting action potentials. In these fibers the characteristics and time course of the responses to nerve stimulation varied along the length of the fibers. Within 2 mm of the end-plate band of the muscle, the responses consisted of several small end-plate potentials (EPPs) and a nonovershooting spike. Distal to 2 mm, the responses in most fibers consisted of large and small EPPs with no spiking response. Some fibers produced very small spikes surmounted on large EPPs. 3. Overshooting action potentials were observed in approximately 10% of the orbital MIFs recorded between the end-plate band and 2 mm distal. The presence or absence of action potentials was not related to the magnitude of the resting potential of the fibers. 4. The threshold of nerve stimulated responses in orbital MIFs was the same as that in orbital twitch fibers. A large number of orbital MIFs had latencies equal to those for the orbital twitch fibers recorded at the same distance from the end-plate band, but the average latency was greater in the MIFs. The latency of orbital MIFs was about one-half of that for the MIFs of the global layer. The values for the effective resistance and membrane time constant of orbital MIFs fell between those for orbital twitch fibers on the one hand, and global MIFs and frog tonic fibers on the other. 5. In order to compare electrical properties with innervation patterns, fibers identified electrophysiologically as orbital MIFs were injected with the fluorescent dye Lucifer yellow and then traced in Epon-embedded, serial transverse sections. In addition to numerous superficial endings distributed along the fibers, a single "en plaque" ending was also found in the end-plate band that resembled the end plates of the adjacent orbital twitch fibers. 6. From these results we conclude that the electrical activity of orbital MIFs varies along the length of the fibers.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2783962 TI - Kinetic analysis of acetylcholine-induced current in isolated frog sympathetic ganglion cells. AB - 1. Kinetic properties of activation and inactivation phases of the ACh-gated nicotinic current were investigated in isolated frog sympathetic ganglion cells using "concentration-clamp" technique under voltage-clamp conditions. This technique combines internal perfusion with a rapid change of the external solution within a few milliseconds. 2. The dose-response curve for the peak current induced by ACh showed a sigmoidal increase, in which the apparent dissociation constant Kd and Hill coefficient were 2.6 x 10(-5) M and 2.0, respectively. 3. The current-voltage relationship of ACh-induced currents were linear at potentials more negative than the reversal potential (EACh) of -5.5 +/- 1.3 mV (mean +/- SE) but showed a slight inward rectification at positive potentials over +20 mV. Since this current could be generated predominantly by an increase of Na+ and K+ conductances, the value of EACh was close to the theoretical potential, -1.3 mV, for the total amount of both Na+ and K+ or Cs+ in the extracellular and intracellular solutions. 4. There was no difference between the dose-response curves of ACh- and nicotine-induced currents. The ACh-induced current was suppressed in a competitive manner by the nicotinic antagonists, d tubocurarine and hexamethonium, but muscarine did not induce any response, indicating that the ACh-gated current might be mediated by the nicotinic ACh receptor-ionophore complex. 5. There was a latent period of the order of milliseconds in the ACh receptor activation phase before attaining exponential increase of activation process.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2783963 TI - Inositol trisphosphate and activators of protein kinase C modulate membrane currents in tail motor neurons of Aplysia. AB - 1. We have investigated how activation of the inositol lipid second messenger pathway may contribute to modulation of membrane currents in tail motor neurons of Aplysia. Specifically, we examined the effects of injected inositol 1,4,5 trisphosphate (IP3) and analogues of diacylglycerol (DAG), both of which are products of the hydrolysis of phosphatidylinositol 4,5-bisphosphate (PIP2). 2. Injection of IP3 produced an outward current associated with an apparent increase in membrane conductance. Ion substitution experiments, the sensitivity of the response to low concentrations of TEA and its attenuation by intracellular injections of EGTA suggest that the current produced by injection of IP3 is a calcium-activated K+ current (IK,Ca). 3. The response to IP3 was mimicked by intracellular injection of Ca2+. Injection of Ca2+ produced an outward current that was associated with an apparent increase in input conductance of the membrane. The same manipulations that affected the response to IP3 (see above) also affected the response to injections of Ca2+. 4. Injections of activators of protein kinase C (PKC) produced a relatively slow inward current. The inward current has not been fully analyzed, but it does not appear to be due to the actions of any single conventional ion channel. 5. Activators of PKC attenuated responses to subsequent injections of IP3 indicating that one component of PIP2 hydrolysis can attenuate the other. 6. The results suggest that hydrolysis of inositol phospholipids is a mechanism for regulation of membrane properties in tail motor neurons of Aplysia. PMID- 2783964 TI - Physiological and anatomical consequences of infraorbital nerve transection in the trigeminal ganglion and trigeminal spinal tract of the adult rat. AB - Single-unit recording and retrograde tracing techniques were used to assess the receptive field properties, topography, and projections of rat trigeminal primary afferent neurons subsequent to transection of the infraorbital (IO) nerve in adulthood. Four hundred and fifty-eight units were recorded in the trigeminal ganglion ipsilateral to nerve section. Of these, 66.6% had IO receptive fields. Thirty percent responded to innocuous stimulation of vibrissae, 39.1% to guard hair deflection, 8.2% to gentle indentation or stretch of the skin, and 22.3% to noxious stimuli (compared to 77.2% vibrissa, 12.0% guard hair, 4.5% skin, and 6.3% noxious in normal animals). An additional 15 units were driven by a stimulating electrode placed on the IO nerve proximal to the site of the lesion but had no receptive field. Of the cells with vibrissa receptive fields, 33.3% were slowly adapting type I (SAI), 6.6% were slowly adapting type II (SAII), 32.2% were low velocity rapidly adapting (RA-LV), 20.0% were high velocity rapidly adapting (RA-HV), and 7.7% were nociceptive (NX, in normal animals 43.8% were SAI, 10.3% SAII, 27.6% RA-LV, 16.8% RA-HV, and 1.5% NX). A number of cells had receptive field properties not seen in normal animals. The single-unit recordings indicated that the topography of mandibular and ophthalmic representations in the ganglion were essentially normal, while the organization of the maxillary region of the ganglion was slightly abnormal. The ganglion physiology experiments were augmented by records from primary afferents in the trigeminal spinal tract (TrV). Eighty-one (72.2%) of the 112 fibers recorded in the TrV of normal rats had IO receptive fields. Of these, 73.2% responded to innocuous vibrissal stimulation, 14.6% to guard hair deflection, 8.5% to gentle indentation of the skin, and 2.5% to noxious stimuli. Of the 61 vibrissa units, 37.8% were SAI, 19.7% SAII, 37.8% RA-LV, 3.3% RA-HV, and 1.6% NX. In adult lesioned animals, 81 (61.3%) of the recorded fibers had IO receptive fields. Of this number, 38.2% responded to vibrissae, 29.6% to guard hairs, 16.0% to skin, and 19.7% to noxious simuli. Of the vibrissa-sensitive units, 16.1% were SAI, 3.2% were SAII, 45.2% were RA-LV, 35.5% were RA-HV, and 3.2% NX. As in the ganglion recording studies, a number of abnormal receptive fields were documented.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2783965 TI - Effect of denervation on limb growth. AB - This study used Rana pipiens tadpoles to assess the effect of complete and partial sciatic denervation on tibial bone growth and foot growth. Complete sciatic denervation was performed in R. pipiens at Stages XIV, XVII, and XX and they were killed at Stages XVII, XX, and XXIV. Partial denervation consisted of peroneal or tibial nerve sectioning at Stages XVII and XX with killing at Stages XX and XXIV. Analysis of experimental animals and controls consisted of (a) quantitative axon counts, (b) tibial length, (c) midtibial cross-sectional area, (d) midtibial cortical thickness, (e) midtibial cartilage anlage cross-sectional area, (f) foot silhouette area, and (g) osteocyte number and osteocyte density. Both complete and partial denervation resulted in significant effects on bone and foot growth: (a) decreased bone length, (b) decreased cross-sectional bone area without cortical thinning, (c) increased cartilage anlage cross-sectional area, and (d) decreased foot size. This experiment demonstrated a trophic effect of nerve on bone growth and development and foot growth. The mechanism of this action is unknown but the data suggests a slowed rate of maturation in denervated bones. The possibility exists that defective peripheral nerve-limb tissue interactions may cause human deformities such as idiopathic clubfoot and idiopathic limb length discrepancy. PMID- 2783966 TI - Hyperimmune bovine colostrum neutralizes Cryptosporidium sporozoites and protects mice against oocyst challenge. AB - Activity of colostral whey, produced by a cow immunized with oocysts of Cryptosporidium parvum and found to provide prophylaxis against cryptosporidiosis in calves, was tested in 2 experiments. In one experiment BALB/c mice were given the immune whey (HW), whey from a nonimmunized cow (CW), or a balanced salt solution (HBSS) before, during, and after oral inoculation with oocysts of C. parvum. Significantly fewer (P less than 0.05) C. parvum were found in mice that received HW (undiluted, 1:20 or 1:50) than in those treated with similarly diluted CW or with HBSS. In the second experiment it was determined that protection was mediated by specific anti-sporozoite activity when significantly fewer (P less than 0.05) C. parvum were found in mice that received sporozoites treated with HW diluted 1:20 or 1:50 compared with mice that received sporozoites treated with similarly diluted CW or with HBSS. PMID- 2783967 TI - Decreased yield of Pneumocystis carinii from cortisonized rats. AB - Thirty-five male Sprague-Dawley rats were divided into 3 groups, including 1 control and 2 experimental groups, in order to compare the efficacy of using cortisone acetate alone or in addition to intranasal inoculation of Pneumocystis carinii organisms for the purpose of inducing acute P. carinii pneumonia. The presence of P. carinii was monitored in nasal secretions on a weekly basis and in lungs at autopsy. Titers of IgG antibody were also monitored by enzyme-linked immunosorbent assay. No rat receiving cortisone acetate injections alone and only 2 of the rats receiving both cortisone and intranasal inoculation of P. carinii organisms showed Pneumocystis organisms in the lungs. However, Pneumocystis cysts did appear in the nasal secretions of 3 of the 5 control rats, all 8 rats receiving cortisone acetate injections only, and 12 of 18 rats receiving both cortisone acetate injections and an intranasal inoculum. IgG titers of both cortisonized groups remained less than 1:4 throughout the course of the experiment. The titer of the control group increased from negative to 13 (geometric mean). PMID- 2783968 TI - Immunity patterns during acute infection by Eimeria bovis. AB - Cellular and humoral responses were investigated following gavage inoculation of 6-wk-old bull calves with 35,000-40,000 oocysts of Eimeria bovis. At 3-4-day intervals for 40 days after inoculation (DAI), blood was taken and assessed for serum IgG against merozoites and sporozoites of E. bovis. Proliferative responses of peripheral blood lymphocytes were measured following stimulation with either concanavalin A (Con A) or a soluble antigen derived from E. bovis oocysts (EbAg). Serum IgG against merozoites and sporozoites reached a peak of activity between 10 and 20 DAI, coinciding with oocyst shedding on days 17 to 24. Serum antibody titers had dropped to base levels by 40 DAI, although anti-merozoite titers remained elevated for the duration of the study (i.e., from days 12 and 20 to day 40). Con A stimulation of lymphocytes was not affected by infection; there was no evidence of suppressed or augmented responsiveness. Lymphocyte responses to EbAg had reached a maximum by day 20 and remained elevated throughout the study. These results indicate (a) that sporozoites and merozoites share antigens recognized by serum IgG, (b) that there is no episode of marked immunosuppression during acute infection, and (c) that cellular immunity is probably more important in resistance against reinfection than humoral immunity. PMID- 2783969 TI - HLA antigens are risk factors for development of AIDS. AB - HLA-A, -B, -C, -DR, and -DQ antigens were determined by serology and in cases of severe lymphopenia by RFLP-DNA typing in 51 Caucasians with a diagnosis of AIDS (32 with opportunistic infections and 19 with secondary cancers). In addition, 86 HIV-1 seropositive and 39 HIV-1 seronegative drug abusers and 148 healthy controls were also studied. No significant differences in HLA antigen frequencies were found in comparison of HIV-1 seropositive and HIV-1 seronegative drug abusers with controls, suggesting that HLA polymorphism does not represent a genetic risk for infection with HIV-1. In contrast, a significant increased frequency of B35 (p less than 0.01) and CW4 (p less than 0.01) was observed in both groups of AIDS patients as compared to controls. Moreover, DR2 was increased in frequency in patients with opportunistic infections (p less than 0.01) and DR3 was completely absent in patients with secondary cancers (p less than 0.05). In the latter group, the DR5 frequency was increased, although nonsignificantly. These findings provide strong evidence for the existence of HLA-linked factors of susceptibility and host resistance to AIDS. PMID- 2783970 TI - Surgery and human immunodeficiency virus disease. AB - People with human immunodeficiency virus disease (HIVD) frequently present to surgical services for consideration of surgical therapies. They may be counseled by physicians who introduce into the decision-making process their personal fear of contagion, uncertainty about potential therapeutic benefits of surgery for people with HIVD, and anecdotal impressions that the immunodeficiency of HIVD might be accelerated by surgical and anesthetic interventions. However, there are no studies that have investigated immunomodulating effects of surgery and anesthesia in people with HIVD. Also, clinical studies of surgical interventions in populations of people with HIVD do not clearly demonstrate adverse outcomes attributable to surgery alone. Review of immunomodulating effects of surgical procedures in populations of people without HIVD reveals that multiple alterations of immune parameters may occur in response to all phases of anesthesia, surgery, and postoperative recovery. These alterations often depend upon the type of anesthesia used and the degree of surgical trauma. Most notably, the alterations are transient and rarely correlated with adverse clinical outcomes. These facts mitigate against the current preconceived notion that surgery will superimpose a sustained and clinically significant detriment to the immunologic competence of people with HIVD. A proposal for rational exploration and study of this issue is presented. PMID- 2783971 TI - Patterns of T lymphocyte changes with human immunodeficiency virus infection: from seroconversion to the development of AIDS. AB - CD4 and CD8 T lymphocytes of three groups of men infected by the human immunodeficiency virus (HIV) were examined twice yearly for 36 months to elucidate the temporal trends in T lymphocytes during infection. The three groups were 37 HIV seroconverters, 304 prevalent HIV seropositives remaining free of the acquired immunodeficiency syndrome (AIDS), and 69 men who developed AIDS during observation. Six months before seroconversion, CD4 levels were similar among HIV seroconverters and 356 seronegative controls. Within 18 months of seroconversion, mean CD4 levels fell to the level of the prevalent seropositives at study entry. From there, the rate of decline slowed. CD8 lymphocyte counts rose dramatically at seroconversion. Among AIDS-free prevalent seropositives, CD4 levels fell steadily over 36 months of observation. By contrast, CD8 cell levels rose slowly. Among men who developed AIDS, mean CD4 levels fell more rapidly again during the 18 months prior to diagnosis. CD8 cell levels remained elevated until 6-12 months before diagnosis, when they began to fall. PMID- 2783972 TI - Serum neopterin changes in HIV-infected subjects: indicator of significant pathology, CD4 T cell changes, and the development of AIDS. AB - Serum neopterin is a metabolite of dihydroneopterin triphosphate, which is produced from GTP during immune activation. A study was undertaken in homosexual male subjects followed at 6 month intervals for 3 or more years to determine the value of serum neopterin changes induced by HIV infection. The significance of serum neopterin levels in evaluating prognosis of HIV-infected individuals was also assessed. Serum neopterin was found to be a useful indicator of the presence of HIV infection. Stratification of 29 HIV seroconverters showed a strong inverse correlation between the serum neopterin rise and the blood CD4 T cell fall in the first year following HIV infection. Thus, a small increase in neopterin (less than 5 nmol/L) at the time of HIV seroconversion was associated with minimal CD4 T cell reduction and a large increase (greater than 12 nmol/L) was associated with a much greater CD4 T cell fall. Neopterin levels were markedly different (lower) in individuals with little or no CD4 T cell fall when compared with those with moderate or marked rates of T cell fall. This relationship between serum neopterin and the CD4 T cell level was further confirmed by an evaluation of both parameters in a group of 799 seropositive homosexual men. In this analysis, serum neopterin was shown to have a significant predictive value for the development of AIDS within 3 years. Furthermore, when serum neopterin and CD4 T cell measurements were considered together, the prognostic value of the combination was significantly greater than either alone.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2783973 TI - Involvement of calcitonin gene-related peptide in the positive chronotropic and inotropic effects of piperine and development of cross-tachyphylaxis between piperine and capsaicin in the isolated rat atria. AB - Piperine as well as capsaicin showed positive chronotropic and inotropic effects in the isolated spontaneously beating right atria and electrically driven left atria of rats, respectively. The responses to piperine were not affected by the presence of the antagonists to norepinephrine, acetylcholine, histamine and serotonin. However, once the tissue was pretreated with piperine or capsaicin, the response to subsequent application of piperine was reduced significantly. Both positive chronotropic and inotropic effects of capsaicin were also attenuated after the tissue was treated with piperine or capsaicin. Thus, not only a tachyphylaxis to either piperine or capsaicin itself but also a cross tachyphylaxis between piperine and capsaicin developed. Nonadrenergic noncholinergic calcitonin gene-related peptide (CGRP)-like immunoreactive nerves were distributed in the muscle layers of both atria. CGRP-like immunoreactivity was depleted considerably by treatment of the tissue with piperine or capsaicin. When endogenous CGRP was depleted, although the positive chronotropic and inotropic effects of piperine and capsaicin were abolished, the effects of CGRP and isoproterenol were not affected. These results indicate that both piperine and capsaicin cause positive chronotropic and inotropic responses by releasing CGRP from nonadrenergic noncholinergic nerves, and that the development of cross tachyphylaxis between piperine and capsaicin is due to the depletion of endogenous CGRP. PMID- 2783974 TI - Toxic effects of potential environmental neurotoxins related to 1-methyl-4 phenylpyridinium on cultured rat dopaminergic neurons. AB - Dopaminergic rat mesencephalic neurons in culture were exposed to a group of potential environmental neurotoxins. These cultures, which contained 0.5 to 1% dopaminergic neurons, were a suitable tool for determining nonselective and selective dopaminergic cytotoxicity. Selective toxicity was quantitated as the concentration which destroyed half of the population of dopaminergic neurons as visualized by tyrosine hydroxylase immunocytochemistry. Nonselective toxicity was defined as the concentration of test drug which destroyed half of the entire population of cultured cells as visualized by phase contrast microscopy. The compounds tested were selected to fulfill two molecular criteria underlying the toxic activity of 1-methyl-4-phenylpyridinium (MPP+), the active metabolite of 1 methyl-4-phenyl-1,2,3,6-tetrahydropyridine toward dopaminergic cells: 1) to be a substrate for the selective uptake system of the dopaminergic neurons and 2) to possess a delocalized positive charge related to their ability to inhibit mitochondrial electron transport. Of a total number of 29 compounds tested, MPP+ and its close derivatives, 2'-methyl-MPP+ and p-amino-MPP+, exhibited highly selective dopaminergic toxicity, hence the requirements for a selective dopaminergic neurotoxin are rather strict. PMID- 2783975 TI - New antitumor monoclonal antibody-vinca conjugates LY203725 and related compounds: design, preparation, and representative in vivo activity. AB - A method has been developed to allow the direct coupling of the cytotoxic vinca alkaloid 4-desacetylvinblastine-3-carbohydrazide (DAVLB hydrazide) to a variety of murine monoclonal antibodies directed against human solid tumors. Periodate oxidation of carbohydrate residues on the antibodies, followed by reaction with DAVLB hydrazide in aqueous acid affords, in most cases, conjugates with conjugation ratios of 4-6 vincas per antibody in high yield without significantly impairing antigen binding or solubility. The outcome of the conjugation reaction is highly dependent on the concentration of, and time of exposure of the protein to, the oxidant. These conjugates exhibit potent antitumor activity in vivo against a number of human solid tumor-nude mouse xenografts, with efficacy and safety increased over unconjugated DAVLB hydrazide. This antitumor activity is also superior to that of similarly prepared but nontarget tumor binding antibody DAVLB hydrazide conjugates. MoAb-DAVLB hydrazide conjugates release DAVLB hydrazide in solution in a temperature- and pH-dependent manner. Hydrolytic release of unmodified DAVLB hydrazide from tumor-localized MoAb-DAVLB hydrazide conjugates in vivo may be an important factor in their antitumor activity. PMID- 2783976 TI - 21-hydroxylase deficiency families with HLA identical affected and unaffected sibs. AB - During our investigations of polymorphisms at, and in the immediate chromosomal vicinity of, the 21-hydroxylase locus in families with 21-hydroxylase deficiency, three families were found to show marked discordance in clinical features of HLA identical subjects. In one family, there is discordance between a boy with the simple virilising form of 21-hydroxylase deficiency and his two younger sisters, who are both HLA identical to their brother, but who have additional salt wasting features. In the other two families, one subject is severely affected and has very high 17-hydroxyprogesterone levels, but has an HLA identical sib who is asymptomatic and shows only slightly raised 17-hydroxyprogesterone levels. In all cases, HLA identity, as indicated by protein polymorphism studies (HLA-A, B, DR, C4A, C4B, and Bf typing), has been verified at the gene organisation level using 21-hydroxylase and complement C4 DNA probes. An HLA-Bw47 bearing haplotype in one of the latter families has not been transmitted to the affected child and appears to carry a normal 21-OHB allele and two genes which specify C4A allotypes. PMID- 2783977 TI - Congenital generalised bone dysplasias: a clinical, radiological, and epidemiological survey. AB - The point prevalence at birth of generalised bone dysplasias was estimated by a study of all children born between 1 January 1970 and 31 December 1983 in the county of Fyn (Denmark). Additionally the population prevalence on 31 December 1983 of all patients with generalised bone dysplasias in this county was determined. The county is a well defined, representative subregion of Denmark which demographically comprises a cross section of about 9% of the Danish population. In total, bone dysplasias were found to be more frequent than generally assumed. Achondroplasia was, however, less common with a point prevalence at birth of 1.3 per 100,000, while osteogenesis imperfecta (21.8), multiple epiphyseal dysplasia tarda (9.0), achondrogenesis (6.4), osteopetrosis (5.1), and thanatophoric dysplasia (3.8) were found more frequently. It is striking how many bone dysplasias are still erroneously classified as achondroplasia. Correct diagnosis is important for a valid prognosis, for treatment, and for genetic counselling. The diagnosis relies almost exclusively on the radiographical findings. PMID- 2783978 TI - Prevalence of cigarette smoking in the United States: estimates from the 1985 current population survey. AB - In September 1985, the Census Bureau collected health information on 114,342 individuals as part of its Current Population Survey (CPS). A special supplement that included questions on smoking practices was sponsored by the Office on Smoking and Health. The CPS, with its large sample size, provides a unique opportunity to examine region, division, and state estimates of smoking prevalence. The overall prevalence rate for males in the 1985 CPS was estimated at 31.3%, compared with 25.0% for females. For males, smoking rates were highest in the South (34.5%) and lowest in the West (28.0%). For females, smoking rates were highest in the North Central region (26.3%) and lowest in the West (22.7%). Among males, blacks reported higher smoking rates (37.2%) than whites (30.7%) or Hispanics (30.9%). In contrast, white females (25.8%) and black females (26.0%) reported virtually identical smoking rates, while Hispanic females reported a considerably lower rate (16.5%). White-collar workers (both males and females) also reported substantially lower smoking rates than service or blue-collar workers. For both males and females, peak smoking prevalence occurred in the 40 49-year age group (males = 38.1%, females = 30.6%). PMID- 2783979 TI - Cigarette smoking and lung cancer: reanalysis of the British doctors' data. AB - Attention has focused recently on the recessive oncogenesis model, according to which inactivation of both alleles of specific genes leads to cancer. A mathematical formulation of this model was fitted to the lung cancer incidence data from a cohort study among British doctors. The model described the data well. One implication is that age influences lung cancer risk among smokers independently of duration of smoking. A study of dose-response within the framework of the model shows that the data are consistent with various interpretations regarding the relative importance of daily level of smoking and duration of smoking in determining lung cancer risk. PMID- 2783980 TI - Pentostatin in hairy cell leukemia: treatment by the special exception mechanism. AB - An analysis of the clinical outcomes in 66 patients with hairy cell leukemia treated with pentostatin under the Special Exception mechanism of the Division of Cancer Treatment, National Cancer Institute, between 1983 and 1987 has revealed a favorable balance of risk and benefit. Hematologic parameters and performance status were improved in most patients treated outside the clinical trials mechanism. The treating physicians considered 37 patients (56%) to be complete responders and 15 patients (23%) to be partial responders. Four patients (6%) died while receiving pentostatin. Life-threatening leukopenia (wbc count, less than 1,000/mm3) was reported in 24% of patients, and severe or life-threatening infection occurred in 11%. The experience gained with these patients supplements the information presently being collected from the controlled clinical trials and supports the development of a group C treatment protocol. PMID- 2783981 TI - Murine studies with 5-fluorouracil and leucovorin. PMID- 2783982 TI - The relationship between the percentage of circulating B cells, corticosteroid levels, and other immunologic parameters in thermally injured patients. AB - Thermal injury is known to induce alterations in the immune system, but the precise mechanisms have yet to be elucidated. We investigated the temporal relationship between serum and urine corticosteroid levels, the number of circulating B cells, serum immunoglobulin levels, and delayed hypersensitivity reactions in the postburn period. Fifteen adult patients (mean age, 44 years) admitted with thermal burns greater than 20% body surface area (BSA) (mean, 50%) were evaluated during four postburn periods. Using a bacterial adherence assay in blood smears, we observed an increased percentage of B lymphocytes (20.3%) in the early postburn period compared to normal controls obtained during the same time period (13.1%). The percentage of B cells gradually decreased during the subsequent 4 weeks and was not influenced by the eventual clinical outcome. The changes in B-cell percentage were paralleled by changes in the level of urine 17 hydroxysteroids. Serum IgG concentrations were low during the initial postburn period in survivors and nonsurvivors and returned to normal and above-normal levels in the late postburn period in both groups. The delayed hypersensitivity skin test reactions were also depressed in the immediate postburn period and returned to normal only in the surviving group at the end of the second postburn week. We speculate that the increased endogenous secretion of stress hormones results in an increase in circulating B cells secondary to their release from lymphoid organs and that the normalization of hormone levels as wound healing ensued was associated with the return of B cells to the lymphoid organs. This lymphocyte redistribution may result in polyclonal cellular interactions, with subsequent B-cell activation, and increased IgG production. PMID- 2783983 TI - Renal toxicity of interleukin-2 administration in patients with metastatic renal cell cancer: effect of pre-therapy nephrectomy. AB - Systemic administration of interleukin-2 and lymphokine-activated killer cells is a new approach to the immunotherapy of advanced cancer. Metastatic renal cell cancer is one of the histological types of tumors particularly susceptible to this treatment approach although renal toxicity often is a dose-limiting side effect. We compared the renal functional changes observed during interleukin-2 therapy in 52 consecutive patients with advanced renal cancer to that of 83 consecutive patients with metastatic nonrenal cancer. Of the 52 patients with renal cancer 41 had recently undergone nephrectomy. The over-all peak serum creatinine values and the percentage increase of serum creatinine over baseline for all patients studied were significantly higher in cycle 2 of interleukin-2 therapy than in cycle 1: 3.8 +/- 0.2 versus 2.6 +/- 0.1 mg. per dl. and 241.7 +/- 16.5 versus 140.3 +/- 11.0 per cent, respectively. In patients with pre-therapy serum creatinine values of 0.4 to 0.9 mg. per dl. there were no significant differences in the mean peak serum creatinine nor in the percentage increase over baseline between renal and nonrenal cancer patients during cycle 1. In cycle 2 of therapy these values were higher in the renal cancer group (3.6 +/- 0.8 versus 2.4 +/- 0.2 mg. per dl. and 310.4 +/- 103.5 versus 214 +/- 30.4 per cent, respectively) but they did not reach statistical significance (P2 = 0.08 and 0.25, respectively). Renal and nonrenal cancer patients with pre-therapy serum creatinine levels of 1.0 to 1.4 mg. per dl. achieved similar high values in cycle 2 of interleukin-2 therapy (3.9 +/- 0.3 versus 3.9 +/- 0.4 mg. per dl. and 222.7 +/- 23.2 versus 248.7 +/- 33.5 per cent, respectively), although the initial increase (cycle 1) was higher in the renal cancer patients (3.3 +/- 0.3 versus 2.4 +/- 0.2 mg. per dl. and 172.3 +/- 25.9 versus 116.1 +/- 18.0 per cent, respectively). Baseline serum creatinine greater than or equal to 1.5 mg. per dl. was associated with an over-all higher peak serum creatinine and higher percentage increase of serum creatinine over baseline than that below 1.5 mg. per dl. baseline: 4.4 mg.per dl. and 171.1 +/- 36.3 per cent in cycle 1 and 6.5 +/- 0.7 mg. per dl. and 296.1 +/- 44.0 per cent in cycle 2, respectively (p less than 0.01). There was no association between peak serum creatinine and interval from nephrectomy to interleukin-2 therapy.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2783985 TI - The effect of ibuprofen on postburn metabolic and immunologic function. AB - Patients suffering severe trauma, including thermal injuries, demonstrate both a hypermetabolic response and an immunosuppressed state following the injury. Biochemically, these patients produce extremely large amounts of cyclooxygenase products, including prostaglandin E. We have investigated the effect of a drug, ibuprofen, which blocks the synthesis of prostaglandins in a burned rat model. Ibuprofen at high doses was found to significantly diminish the hypermetabolic response to burn injury and sepsis. The same dosage of ibuprofen increased the mortality rate in the same burn sepsis model. Prostaglandin E may therefore exert some beneficial effects in traumatized patients by altering their metabolism. PMID- 2783986 TI - [Vaccines today and tomorrow. New vaccines against Haemophilus influenzae type b]. PMID- 2783984 TI - Epidermal growth factor receptor in human bladder cancer: a comparison of immunohistochemistry and ligand binding. AB - Epidermal growth factor receptors were measured in biopsies from patients with newly diagnosed bladder cancer. Two methods to detect these receptors were compared: immunohistochemical staining of frozen sections, and a ligand binding study using radiolabeled epidermal growth factor and tumor cell membranes. We studied 101 patients by immunohistochemistry and 47 patients by both methods. An association was found between immunohistochemical positivity for epidermal growth factor receptors and high tumor stage (p less than 0.001). Thus, most of the muscle invasive tumors were positive (35 of 49, 71 per cent) and more stage pT1 tumors were positive (8 of 18, 44 per cent) than were stage pTa tumors (5 of 34, 15 per cent, p less than 0.05). The ligand binding study was slightly more sensitive in detecting receptors than immunohistochemistry (30 of 47, 64 per cent and 25 of 47, 53 per cent, respectively). Greater amounts of receptors were found in muscle invasive tumors compared to tumors not invading muscle (p less than 0.05). A significant association was found between the 2 methods in the detection of receptors (p less than 0.001) and no discrepancies were found between the 2 methods in tumors containing high levels of receptors. Immunohistochemistry provides a satisfactory method to detect receptors in tumors with high levels of receptors, although ligand binding is more sensitive in tumors with low levels of receptors. PMID- 2783987 TI - [Rheumatologic diagnoses--how long a life do patients have?]. PMID- 2783988 TI - Polymorphic reticulosis: a malignant lymphoma of B-cell lineage. AB - Whether the pathogenesis of polymorphic reticulosis is from T cells, B cells, or histiocytes has been controversial. In this study, the Southern blot hybridization technique was used to analyze immunoglobulin and T-cell receptor beta-chain genes and to perform the conventional surface marker analysis in two patients with polymorphic reticulosis. The immunophenotype demonstrated the presence of predominantly mature, activated T-lymphocytes, minimal B-cells, and no natural killer cells or monocytes/granulocytes. The mature T-cell phenotype could be due to either inflammatory infiltrates or neoplastic cells of peripheral T-cell type, because the two coexist in polymorphic reticulosis tumors. The value of surface marker examination is limited in the analysis of PMR tumors. However, genetic analysis revealed that only Ig genes were rearranged, with no rearrangement of the TCR beta gene. Rearrangement of immunoglobulin genes occurs in B-lineage lymphoid neoplasms and is thought to be a criterion for diagnosis of lymphoid neoplasms. Based on genetic analysis and clinicopathologic information, this study concluded that polymorphic reticulosis is a malignant lymphoma of B cell lineage. PMID- 2783990 TI - [A system for the automated description and recognition of liver scintigrams]. PMID- 2783991 TI - [Xeroradiographic scanning in clinical oncology]. AB - A combined method of xeroradiographic scanning (ERS) was used for the recognition of tumors of different organs. Altogether 645 cancer patients were investigated: 98 with head and neck tumors, 102--with pulmonary and mediastinal tumors, 254- with liver tumors, 86--with renal tumors, 52--with bone tumors, and 53--with prostatic tumors. Special methods of investigation and tumoritropic radiopharmaceuticals 75Se-methionine, 67Ga-citrate, 85Sr, 113In, 99Tc, etc. were used. Statistical data processing was done using Olivetti computer M-24. ERS was shown to be the most effective method for the detection of cancer of the lung mediastinum (90%), head and neck (89%), and prostate (89%). The method is particularly valuable for tumors developing in anatomical regions inaccessible for examination, biopsy, and x-ray findings are not sufficiently clear. The use of ERS excludes possible errors in diagnosing disease on the edges of an organ, especially in liver and kidney investigation. The method also proved to be valuable for the assessment of therapeutic efficacy and correction of fields of irradiation. PMID- 2783989 TI - Effect of retinyl palmitate and 13-cis retinoic acid on immune functions in immunodeficient, nude mice. AB - Nude mice are deficient in thymus gland development and hence lacking functional, mature T-lymphocytes. Weanling nude mice were given various deficient and high retinyl palmitate (RP) or 13-cis retinoic acid (CRA) diets. The high RP (vitamin A) diets stimulated phagocytosis in the absence of mature T-helper cells. However, T-cell dependent mitogens did not cause significant mitogenesis in any group, while LPS, a B-cell mitogen, did. RP had no effect on mitogenesis. NK cell activity was increased only at a very high level of RP, as has been reported with conventional mice. Macrophage production of cytotoxic factors was unaffected by high levels of RP or CRA. Direct cytotoxicity in vitro of tumor cells was increased only at very high RP levels. Thus, mature T cells may be needed for RP to produce normal activation of macrophage, except at very high RP levels. PMID- 2783992 TI - Does T-cell tolerance require a dedicated antigen-presenting cell? AB - Almost 30 years ago Burnet proposed that the immune system maintained self tolerance by deleting autoreactive lymphocytes. Recently it has become clear that for T cells this step occurs in the thymus, where developing T cells first express their antigen-specific receptors. Here a T-cell which encounters its antigen disappears--if it is not dead, it at least stops expressing its receptors. In the periphery by contrast, encounter with antigen leads to activation and proliferation of the responding T-cell. There are two possible explanations for this difference. Either the antigen-presenting cells in the thymus are different from those in the periphery and instead of producing positive signals they directly or indirectly kill the thymocytes; or the T cells themselves are different, and like immature B cells, may die after encounter with antigen. We tested the first possibility and found that dendritic cells from spleen, which are the most potent activators of mature T cells, are also the most potent inactivators of young developing T cells. Thus it is not the antigen presenting cell which determines whether a T-cell responds or dies, but the T cell itself or its thymic environment. PMID- 2783993 TI - Treatment of trigeminal neuralgia by thermocoagulation, glycerolization, and percutaneous compression of the gasserian ganglion and/or retrogasserian rootlets: long-term results and therapeutic protocol. AB - From 1976 to 1986, 681 patients with drug-refractory trigeminal neuralgia (TN)- typical in 641, symptomatic of multiple sclerosis in 23 and of tumor in 10, atypical in 5, and postherpetic in 2--were treated with various percutaneous procedures. Controlled differential thermocoagulation of the gasserian ganglion and/or retrogasserian rootlets was performed in 533 patients; glycerolization of the trigeminal cistern in 32; and compression of the gasserian ganglion by balloon catheter in 159. Results and complications of each procedure are assessed at a mean follow-up of 6.5 years for thermocoagulation, 5 years for glycerolization, and 3.5 years for compression. The following therapeutic protocol is proposed: 1) in TN patients at first operation: a) gasserian compression (or glycerolization, if experience warrants it) is indicated in all cases of typical TN, unless the 3rd division alone is affected; b) in the latter case and in symptomatic TN, we suggest thermocoagulation; 2) in recurrences: a) after glycerolization or gasserian compression, gasserian compression (or glycerolization) is indicated; b) after thermocoagulation or open surgery, thermocoagulation is suggested. PMID- 2783994 TI - An area analysis of major causes of death among under 65 year olds in Auckland- 1977-85. AB - Using deaths that were registered between 1977 and 1985, an area analysis of Auckland is presented of the major causes of death among under 65 year olds. The analysis is of all cause mortality and of deaths from specific causes (heart disease, stroke, cancer, respiratory disease, motor vehicle accidents and suicide). The basic spatial entity for the analysis is the census area unit. It is found that there are consistent spatial variations. Three areas where mortality is generally higher than elsewhere in the region are apparent: south Auckland; to the north west of the central urban sector centered on Grey Lynn; and in the eastern parts of the central sector from Glenn Innes to Onehunga. The mortality in these areas is above average for all causes and for heart disease, stroke, cancer and respiratory disease. PMID- 2783995 TI - Propionibacterium-associated endophthalmitis after extracapsular cataract extraction. Review of reported cases. AB - Sixteen cases of previously reported culture-proven Propionibacterium-associated endophthalmitis after extracapsular cataract extraction (ECCE) are reviewed. The inflammation was observed 2 to 10 months after surgery and occurred after laser posterior capsulotomy in four cases. Clinically, it appeared as a chronic iridocyclitis characterized by granulomatous-appearing keratic precipitates (5 cases), hypopyon (10 cases), and a white plaque on the posterior capsule or intraocular lens (IOL) implant (8 cases). Response to corticosteroid treatment was transient. Surgical intervention was required between 1 and 16 months after the inflammation began and included removal of the IOL and capsular bag via the limbus in 7 cases and pars plana vitrectomy in 11. Intravitreal antibiotics were administered in 12 cases. Postoperative visual acuity ranged from 20/20 to count fingers, with 11 of 16 patients recovering visual acuity of 20/40 or better. Propionibacterium-associated endophthalmitis should be suspected if chronic indolent intraocular inflammation develops after ECCE. Intraocular specimens should be obtained and submitted for aerobic and anaerobic culture and cytologic/histopathologic studies. Based on the clinical courses of these patients, recommendations for management are discussed. PMID- 2783996 TI - The treatment of postoperative endophthalmitis. Results of differing approaches to treatment. AB - The authors treated 26 patients with postoperative endophthalmitis over a 4-year period, between 1983 and 1986. Nineteen patients were culture-positive and seven were culture-negative. All patients received intravitreal antibiotics as part of their treatment regimen. Culture-negative patients generally responded well to a single intravitreal antibiotic injection. Five of seven (71.4%) culture-positive patients who were treated with a single intravitreal antibiotic injection and no vitrectomy suffered either a recurrence of their infection or did not respond to treatment. Four of five patients who received a vitrectomy in addition to a single intravitreal antibiotic injection were cured of their infections; the one patient who received repeated intravitreal antibiotic injections alone and all six patients who received repeated intravitreal antibiotic injections in combination with vitrectomy were cured of their infections. Although the intravitreal injection of antibiotics provides an extremely high initial level of antibiotics inside the eye, a single intravitreal antibiotic injection may only partially treat bacterial endophthalmitis. In culture-negative cases, a single intravitreal injection of antibiotics appears to be sufficient treatment. In culture-positive cases, a higher cure rate is achieved with an aggressive approach which includes the use of repeated intravitreal antibiotic injections and/or vitrectomy. PMID- 2783997 TI - Unilateral impairment of pupillary response to trigeminal nerve stimulation in cluster headache. AB - The pupillary constriction induced ipsilaterally by transcutaneous electrical nerve stimulation (TENS) of the infratrochlear nerve was measured, using an electronic pupillometer, in 26 episodic cluster headache (CH) and 15 migraine sufferers tested during an attack-free period and in 16 healthy controls. In controls, TENS gave rise to a miosis which was slow in onset and long-lasting in duration, and which was comparable to that mediated by tachykinins in animals. A similar miotic response was bilaterally observed in migraine patients and in CH patients examined during the inactive phase. In CH sufferers during the cluster period, TENS only elicited a normal pupillary constriction in the asymptomatic eye, whereas the resulting response in the symptomatic eye was markedly decreased. Although the exact mechanism underlying the dysfunction remains to be clarified, these results seem to indicate that ocular trigeminal pathways are involved in CH. PMID- 2783998 TI - Increased binding of epidermal growth factor to placental membranes of intrauterine growth restricted fetal rats. AB - To examine the relationship between nutrient supply and fetal and placental growth, we examined epidermal growth factor (EGF) binding to membranes prepared from placentas of growth-restricted fetal rats. Intrauterine growth retardation was accomplished by unilateral ligation of the uterine artery; fetal rats on the contralateral uterine horn served as controls. Fetal growth restriction was accompanied by decreased placental wt at 19 and 20 day's gestation and significantly decreased placental glycogen content at 20 and 21 days, 30% and 15%, respectively. Placental DNA content and protein/DNA ratios were similar in the growth-restricted and control groups. Specific binding of 125I-EGF was increased in growth-restricted placentas at 19 and 20 days' gestation by 32% and 16%, respectively. 125I-EGF binding at 20-21 days increased linearly with the extent of placental growth restriction. Competitive binding experiments yielded linear Scatchard plots with an increased receptor density in growth-restricted placenta at 19 and 20 days' gestation, 74% and 60%, respectively. Binding affinities for the EGF receptor were similar in the two groups. The increased binding of EGF to membranes prepared from growth-restricted fetal rats may serve to enhance nutrient uptake under conditions of decreased uterine blood flow. PMID- 2783999 TI - Cocaine exposure among children seen at a pediatric hospital. AB - The results of 1,680 consecutive urine and serum toxicologic screens from 1,120 patients, performed in a children's hospital during a 19-month period were surveyed. Among this sample, 52 (4.6%) patients had specimens that contained cocaine and/or metabolite. Fifteen specimens contained ethanol, a benzodiazepine, or a narcotic in addition to cocaine. Four patients were neonates, whereas three were infants from 1 to 7 months of age. The remaining 45 patients were adolescents with a mean age of 19 years. Among the adolescents, 11 had a significant chronic illness. In 19 patients (37%), cocaine exposure was unsuspected until the results of testing for toxic substances were known. The reasons for hospital evaluation included depression/attempted suicide in 19 patients, seizure in five, chest pain in 5, motor vehicle accident in three, syncope in three, abdominal pain in two, pneumomediastinum in two, accidental self-immolation in one, and apnea in one. Twenty patients required medical hospitalization for a total of 268 patient-days. One patient, a neonate, died. There is a striking prevalence of cocaine exposure in the pediatric age group. Among adolescents, this exposure may occur despite the presence of chronic illness. Although the age distribution appears bimodal, infants and young children may also have unsuspected exposure to this toxin. Greater awareness of cocaine exposure in childhood will be needed by primary and tertiary care pediatricians to identify affected children and provide appropriate intervention. PMID- 2784000 TI - Measles outbreak among unvaccinated preschool-aged children: opportunities missed by health care providers to administer measles vaccine. AB - A measles outbreak in an inner-city area primarily involved preschool-aged children younger than 5 years of age. The reasons why 31 unvaccinated preschool children with measles disease had not been vaccinated were investigated. For some patients, health care providers missed opportunities to vaccinate eligible patients against measles. Of the 26 patients whose full immunization status was known, ten (38%) were vaccinated with diphtheria and tetanus toxoids and pertussis vaccine and/or oral poliovirus vaccine at a time when they could have received measles vaccine simultaneously, according to recommendations of the Immunization Practices Advisory Committee and the American Academy of Pediatrics. In addition, five of ten health care providers interviewed missed at least one opportunity to administer measles vaccine because of a minor illness that was not a contraindication to vaccination. Unvaccinated patients were more likely to receive health care in the public sector, have single mothers, and have parents who had no knowledge of existing vaccines; they were less likely to be age appropriately immunized with other antigens. If measles immunization levels among preschool children in the United States are to be increased, education of both health care providers and parents, coupled with innovative strategies targeted to preschool children, particularly of low socioeconomic groups in inner cities, are needed. PMID- 2784001 TI - Human immunodeficiency virus type 1 negative factor is a transcriptional silencer. AB - The negative factor (nef) of human immunodeficiency virus (HIV) type 1 acts to down-regulate virus replication. To decipher the step in the virus life cycle affected by nef, functional proviral clones with (pHIV F-) or without (pHIV F+) a deletion mutation in the nef gene were constructed. In CD4+ cells, 30- to 50-fold more virus was produced over the course of 18-20 days with cultures infected with F- compared to F+ virus. In CD4- cell lines, 2- to 10-fold greater virus production was found from cultures transfected with pHIV F- than those transfected with pHIV F+. The negative regulatory effects of nef on pHIV F- could be supplied in trans with a plasmid expressing only the nef gene product. Virus produced by COS-1 cells transfected with pHIV F- or pHIV F+ showed similar binding, uptake, uncoating, and reverse transcription. Analysis of HIV-1 RNA and structural protein levels and rates of viral RNA synthesis in CD4- cells also showed 2- to 10-fold higher levels in cells transfected with pHIV F- compared to pHIV F+. The activity of a HIV-1-chloramphenicol acetyltransferase (CAT) plasmid was also suppressed by nef, whereas other CAT plasmids were unaffected. These findings demonstrate that nef acts as a specific silencer of HIV-1 transcription. This activity may be critical for maintenance of HIV-1 latency in vivo. PMID- 2784002 TI - Structure of the rat osteocalcin gene and regulation of vitamin D-dependent expression. AB - The osteocalcin gene encodes a 6-kDa polypeptide, which represents one of the most abundant noncollagenous bone proteins, and the present studies establish that osteocalcin mRNA is detected only in bone tissue. An osteocalcin gene was isolated from a rat genomic DNA library, and sequence analysis indicated that the mRNA is represented in a 953-nucleotide segment of DNA consisting of four exons and three introns. A modular organization of the 5' flanking sequences of the gene is reflected by the presence of at least three classes of regulatory elements, which include the following: (i) RNA polymerase II canonical sequences; (ii) a series of consensus sequences for hormone receptor binding sites and cyclic nucleotide responsive elements consistent with physiologic expression of the osteocalcin gene; and (iii) a 24-nucleotide sequence in the proximal promoter region with a CAAT motif as a central element. We have designated this highly conserved sequence as an "osteocalcin box" since only 2 nucleotide substitutions are found in the rat and human osteocalcin genes. We have demonstrated two factors regulating osteocalcin gene expression. First, a 200-fold increase occurs in normal fetal calvaria osteoblasts producing a mineralizing matrix, compared to confluent osteoblasts in a nonmineralizing matrix. Second, contained within the 600 nucleotides immediately upstream from the transcription start site are sequences that support a 10-fold stimulated transcription of the gene by 1,25 dihydroxyvitamin D. PMID- 2784004 TI - Highly attenuated vaccinia virus mutants for the generation of safe recombinant viruses. AB - An attenuated vaccinia virus mutant with specific genetic lesions has been used to develop a vehicle for safer live recombinant virus vaccines. The mutant virus 48-7 has an 8-MDa deletion starting 2.2 MDa from the left end of the viral genome and point mutations in the gene encoding the 14-kDa fusion protein that determines the plaque-size phenotype of the virus. Using the highly sensitive reporter gene luciferase, we have shown that this mutant can generate recombinant viruses that infect cultured cells and animals with normal vaccinia virus tropism. Insertion of the envelope and gag genes of human immunodeficiency virus type 1 into the attenuated vaccinia mutant resulted in their efficient expression and precursor processing in infected cultured cells. Infection of mice with human immunodeficiency virus-vaccinia recombinant viruses elicited human immunodeficiency virus-specific antibodies. Using mice pretreated with cyclophosphamide as a model for immunosuppression, the reduced virulence of the mutant recombinant virus was clearly evident. These findings demonstrate that the highly attenuated vaccinia virus mutant 48-7 can be used to generate effective and safer vaccines. PMID- 2784003 TI - v-cbl, an oncogene from a dual-recombinant murine retrovirus that induces early B lineage lymphomas. AB - Cas NS-1 is an acutely transforming murine retrovirus that induces pre-B and pro B cell lymphomas. Molecular cloning showed it was generated from the ecotropic Cas-Br-M virus by sequential recombinations with endogenous retroviral sequences and a cellular oncogene. The oncogene sequence shows no homology with known oncogenes but some similarity to the yeast transcriptional activator GCN4. A 100 kDa gag-cbl fusion protein, with no detectable kinase activity, is responsible for the cellular transformation. The cellular homologue of v-cbl, present in mouse and human DNA, is expressed in a range of hemopoietic lineages. PMID- 2784005 TI - Identity of human B-cell line cytotoxic lymphokine with tumor necrosis factor type beta. AB - A humoral cytotoxic protein that is spontaneously produced by a cloned human lymphoblastoid cell line (K160b) was partially purified by a simple three-step column chromatography procedure and NaDodSO4/polyacrylamide gel electrophoresis. Proteins were electrically blotted onto a polyvinylidene difluoride membrane, and a band of the cytotoxic protein was excised after staining with Coomassie brilliant blue. Direct analysis of the amino acid sequence of this protein showed the primary structure of its N-terminal region was identical to that of natural tumor necrosis factor type beta (TNF-beta). The 24-kDa molecular mass of the cytotoxic protein, determined by NaDodSO4/PAGE, and its elution profiles from various types of columns correlated with those of natural TNF-beta. Specific activity of the cytotoxicity, standardized with recombinant TNF-beta, was comparable to that of the purified factor. However, polyclonal antiserum to recombinant TNF-beta failed to react with the purified factor. Since recombinant TNF-beta, when used in patients, causes unacceptable side effects, which may be due to absence of glycosylation, the cell line K160b could be a useful source of natural TNF-beta for clinical trials. PMID- 2784007 TI - Stimulation of locus coeruleus in man. Preliminary trials for spasticity and epilepsy. AB - Stimulating electrodes were chronically implanted unilaterally (in 1975-1977) in the vicinity of the locus coeruleus (LC) in three patients, one with cerebral palsy-spastic quadriplegia, two with epilepsy (one grand mal, one psychomotor). Effective excitation of efferent LC axons was indicated by measuring rises in 3 methoxy-4-hydroxyphenylethyleneglycol in the jugular and systemic venous blood following a 6-min stimulus with discontinuous bursts of pulses. There was a substantial reduction of spasticity during and after stimulation. Improvement was verified by double-blind failures of the stimulator, and the stimulus therapy is still in use after 9 years. There appeared to be a reduction in incidence and severity of both types of epileptic seizures, although this was not rigorously established. The patient with psychomotor epilepsy reported a considerable lengthening of preseizure auras (to 15-30 min), an unusual number of which terminated without a seizure. PMID- 2784008 TI - Effect of spinal cord stimulation on motor performances in hemiplegics. AB - Spinal cord stimulation (SCS) was performed in 11 patients with stabilized spastic hemiparesis due to cerebrovascular ischaemic accident in order to improve their motor performances. The patients were studied before and after 5-7 days of stimulation of the cervical cord according to the following protocol: (1) clinical evaluation based on assessment of the neurological status and on Albert's motor scale and (2) neurophysiological evaluation of reflex voluntary and involuntary motor activity, obtained by means of surface electromyography. Improvement in motor performance following SCS occurred in 7 of the 11 patients. The effect appeared to be particularly evident during specific voluntary movements and gait. Analysis of the electromyography recordings showed that SCS mainly broke down pathological patterns of voluntary movement and reduced agonist antagonist coactivation and clonus. A relationship between motor outcome and status of the sensory function was noticed as well. We conclude that SCS may play a role in the motor rehabilitation of post-stroke patients with spastic hemiparesis, provided that a careful selection be made before surgery. PMID- 2784006 TI - Effect of recombinant factor VIIa on the hemostatic defect in dogs with hemophilia A, hemophilia B, and von Willebrand disease. AB - Recombinant factor VIIa (rF.VIIa) is a two-chain procoagulant enzyme (Mr, approximately 50,000) active only when complexed with tissue factor in the extrinsic clotting system. We administered human rF.VIIa to hemophilic and von Willebrand disease (vWD) dogs to determine its hemostatic effectiveness and survival in the circulation. Hemophilia A dogs lacking factor VIII demonstrated an immediate increase in plasma rF. VIIa and prompt stoppage of hemorrhage at bleeding time (BT) sites. In seven studies in two dogs, the range of dose of rF. VIIa was 50-220 micrograms/kg, with an apparent 7- to 11-fold increase in plasma factor VII and a mean recovery in plasma of 34%. The t1/2 was 2.8 +/- 0.5 hr. The BT was normalized except in an animal given the minimum dose. In four studies in two hemophilia B dogs lacking factor IX, BT was normalized. The elevation in plasma factor VII was by a factor of 8-30, with a mean recovery of rF.VIIa in plasma of 44%. In two studies in a homozygous vWD dog lacking von Willebrand factor, which is needed for platelet function, BT was not corrected even though large doses of rF. VIIa were given. The human rF. VIIa protein was immunogenic for dogs. These studies indicate that factor VIIa corrects the hemostatic defect in dogs with hemophilia A and B, diseases primarily of the intrinsic clotting system, but does not correct the hemostatic defect in vWD. PMID- 2784009 TI - Transcutaneous electrical nerve stimulation and spinal cord stimulation for pain relief in reflex sympathetic dystrophy. AB - 35 patients with the diagnosis of reflex sympathetic dystrophy in a late stage have been treated with transcutaneous electrical nerve stimulation (TENS). 6 out of the 35 were also submitted to spinal cord stimulation (SCS). The follow-up was from 10 to 36 months. The results obtained were TENS group: 25% excellent, 45% good, 10% fair, 20% poor; in the SCS group: 16.6% excellent; 66.6% good and 16.6% fair. In the long run these results are better than those obtained with sympathetic blocks and sympathectomy. TENS and SCS have no effect on osteoporosis or ankylosis. PMID- 2784010 TI - Analysis of neuroelectric implant integrity. AB - A 10-year follow-up study of neuroelectric implant integrity has been completed for 27 subjects who were treated for movement disorders associated with cerebral palsy. Data used for analysis included X-ray material, clinical data, and results from electrophysiological testing. Of the 21 subjects with subcutaneous receivers placed in the thoracic region, 81% experienced wire (67%) or receiver (14%) failure. Of the 6 subjects with subcutaneous receivers placed in the occipital region, there were no wire failures and one (17%) receiver failure. The occipital units lasted a minimum of 5.2 years without complications, whereas the thoracic units failed as early as 6 months after surgery, and lasted an average of 3.8 years. All wire fractures occurred between C1 and T1. Two types of fracture occurred, one consisting of a clean break and the other consisting of a scenario of bending and kinking, then thinning and fraying, and finally progressive multiple fragmentation. With a few exceptions the clean breaks occurred between C1 and C3, while the fraying scenario occurred between C6 and T1. Mechanisms for failure are discussed, as are results from material tests of wire samples. PMID- 2784011 TI - Differential alcohol-related mortality among American Indian tribes in Oklahoma, 1968-1978. AB - Tribal differences in alcohol-related mortality were examined among 11 Indian tribes living in Oklahoma. Data on alcohol-related deaths from 1968 to 1978 were compiled and assigned to various tribes on the basis of population distributions by county. Results showed significant differences in alcohol-related mortality among the various tribes. Of the 267,238 total deaths in Oklahoma during the study period, 9.3% of Indian deaths were alcohol-related while only 3.2% of those among blacks and 2.4% of those among whites were classified as such. Indian males and females are far more likely to die of alcohol-related deaths than their black and white counterparts. Cheyenne-Arapaho, Comanche and Kiowa areas (located in the western++ part of the state) have higher alcohol-related deaths than Cherokee, Choctaw, Creek, Seminole and Pawnee areas (located in eastern Oklahoma). Indian residents of the Seminole area have the lowest percentage of deaths identified as alcohol-related. The patterns which emerge may be due to different cultural and historical factors among the Indian tribes. PMID- 2784012 TI - Anonymous blood testing for AIDS. PMID- 2784013 TI - Quantification of regional cerebral blood flow with IMP-SPECT. Reproducibility and clinical relevance of flow values. AB - Single-photon emission computed tomography with N-isopropyl[123I]-p iodoamphetamine (IMP-SPECT) was performed in 14 normal volunteers (seven men and seven women aged 25.1 +/- 5.3 years) and 29 patients with cerebrovascular disease (18 men and 11 women aged 54.1 +/- 13.7 years). The fluid microsphere model was used to estimate cerebral blood flow (CBF). Normal subjects were scanned twice, 1 week apart, to determine the reproducibility of the CBF estimates. Hemispheric blood flow (hCBF) was calculated as the mean of regional cerebral blood flow (rCBF) values in 16 gray matter regions per hemisphere. In normal subjects mean hCBF was 68 ml/100 g/min. The highest rCBF was found in the occipital cortex, followed by the frontal, temporal, and parietal cortexes. CBF values were reproducible (p less than 0.001 except the right thalamic region, where p less than 0.01). Intraindividual variation ranged between 0.3% and 15%. Women exhibited significantly higher (16%, p less than 0.02) CBF than men. Patients were subdivided into groups with reversible (n = 19) and persistent (n = 10) symptoms. Significant hCBF differences between the affected and the contralateral hemispheres were recorded only in the group with reversible symptoms (p less than 0.005), whereas the group with persistent symptoms showed a significant bilateral decrease of hCBF compared with normal subjects and patients with reversible symptoms. Focal CBF was significantly lower in patients with completed stroke than in patients with transient symptoms (p less than 0.001). Our results indicate that IMP-SPECT can be used for the routine estimation of CBF in normal and pathologic states. PMID- 2784014 TI - SPECT analysis of recent cerebral infarction. AB - We measured regional cerebral blood flow and [123I]iodoamphetamine (IMP) uptake in 16 patients with unilateral brain infarcts during the subacute period (Day 3 to Day 50) and again after 3 months. Our results show that the central and peripheral areas described earlier in the chronic period were already differentiated in the subacute period. The central area presented a short phase of luxury perfusion and a longer phase of IMP hyperfixation. The peripheral area showed both a slight regional cerebral blood flow decrease and an early IMP uptake decrease similar to those previously found in the chronic period. Contralateral regional cerebral blood flow during the subacute period, considered normal, was significantly lower than that during the chronic period. PMID- 2784015 TI - Cerebrovascular disease and functional outcome after coronary artery bypass surgery. AB - A series of patients undergoing coronary artery bypass surgery was studied prospectively to see if angiographic evidence of cerebrovascular disease proved predictive of the incidence of neuropsychological deficit 8 days or 8 weeks after surgery. In 47 patients, intravenous digital subtraction angiography was carried out preoperatively to assess the presence and severity of atheromatous changes in the carotid arteries; 51% had evidence of vessel wall disease and 17% had stenosis of at least one carotid artery in the neck, although only one patient had severe narrowing. Overall, 77% of these 47 patients showed a neuropsychological deficit as defined by a significantly reduced score in at least two of 10 tests administered 8 days after surgery. Eight weeks after surgery 36% still showed a deficit. The incidence of neuropsychological deficit was not significantly greater among those patients with angiographically visible carotid artery disease. The mechanism of surgery-related cognitive impairment is briefly discussed in the light of these findings. PMID- 2784016 TI - Blocking of interleukin-2 production, but not the tissue destruction induced by cytotoxic T cells, by cyclosporine. AB - Cytotoxic T lymphocytes generated against epidermal alloantigen-1 (Epa-1), a tissue-restricted, non-H-2 alloantigen that is a target-cell determinant of both skin allograft rejection and cutaneous graft-versus-host reactions, directly produce full-thickness ulcerative skin lesions in Epa-1+ mice. Anti-Epa-1 CTL also indirectly cause extensive damage of "innocent bystander" tissue when injected admixed with Epa-1+ target cells into the skin of Epa-1- hosts. Unlike the direct destruction of host tissue by CTL in "immune lymphocyte transfer reactions" (TrR), "bystander reactions" (ByR) apparently are initiated by the release of lymphokines that recruit host inflammatory cells to the injection site. Treatment of CTL with cyclosporine in vitro prevents their production of lymphokines like interleukin 2 but has no effect on cell-mediated cytotoxicity. However, little is known about the function of CsA-treated CTL in vivo. We confirmed the differential effect of CsA on CTL function in vitro with bulk culture anti-Epa-1 CTL-CsA pretreatment of CTL abrogated IL-2 production but did not affect CMC. Moreover, we found that CsA pretreatment did not affect the ability of CTL to evoke TrR, nor did it significantly impair their ability to mediate ByR. Therefore, when CTL are treated with CsA in such a way that they lose their capacity to produce IL-2, their cytotoxic activity in vitro as well as their ability to directly and indirectly mediate tissue destruction in vivo are left intact. These results suggest that the ability of CTL to mediate allograft rejection is not dependent on their ability to produce IL-2 and that CMC plays a role in the rejection process. PMID- 2784017 TI - [A review of pulmonary histiocytosis X]. AB - The article contains a review and two case reports of pulmonary histiocytosis-X. This is a rare disease entity comprising about 3% of all chronic interstitial lung diseases. Diagnosis is confirmed by histological and electronmicroscopic demonstration of the typical histiocytosis-X cell. The course of the disease varies. About 25% of the patients show spontaneous remission, in 40% the changes remain stationary, while 35% progress and eventually die from respiratory insufficiency or cor pulmonale. Treatment with glucocorticoids and cytostatics should be initiated at high disease activity, with progressive X-ray changes and decreasing pulmonary function. PMID- 2784019 TI - Child neuromuscular disease in southern Norway. The prevalence and incidence of Duchenne muscular dystrophy. AB - In a survey carried out to determine the incidence of Duchenne muscular dystrophy in South East Norway, 38 cases were ascertained among 149,975 live male births during the years 1968-1978. The overall incidence is 1:3,917 in live male births (25.33 x 10(-5). This incidence is compared with those in other studies. There is an apparent drop in incidence in the last cohort studied, and the possible role of genetic counselling and antenatal sexing are discussed. PMID- 2784018 TI - Immunologic study of human recombinant interleukin-2 (low-dose) in patients with advanced renal cell carcinoma. AB - Immunologic and antitumor effects of human recombinant interleukin-2 was studied in patients with advanced renal cell carcinoma. Intravenous drip infusion for inpatients or subsequent subcutaneous injection for outpatients at a daily dose of 1 x 10(6) units of interleukin-2 was given over a period varying from twenty one to two hundred forty days to 13 patients. Natural killer cell activity increased 20 percent or more in 11 of the 13 patients, and lymphokine-activated killer cell activity increased 40 percent or more in 9 of the patients tested. Interleukin-2-receptor positive cells and HLA-DR positive cells in peripheral blood lymphocytes increased in 12 and 11 patients, respectively. Two patients achieved complete response; 1 had a partial response; 6 had no change; and 2 had progressive disease. Two patients were not evaluated because the therapy had been discontinued in less than four weeks. We conclude that low-dose interleukin-2 enhances patients' immunity and has a potential antitumor activity against renal cell carcinoma. PMID- 2784020 TI - Exocrine pancreatic function in children with mumps pancreatitis. PMID- 2784021 TI - Growth and plasma amino acid concentrations in very low birthweight infants fed either human milk protein fortified human milk or a whey-predominant formula. AB - In a prospective, study involving 20 VLBW-infants (AGA), divided into two study groups of 10 infants, we have evaluated the effects on growth and metabolism of human milk fortified with ultrafiltrated human milk protein and a whey predominant (whey/casein = 60/40) formula containing 2 g/dl of protein. The study was initiated at a mean age of 30 days when an oral intake of 180 ml/kg/d was tolerated and continued until a weight of 2 kg was reached. The protein intake in both groups was about 3.7 g/kg/d. All infants in both groups reached intrauterine rates of growth for the age, weight gain 18.0 g/kg/d, and length 1.2 cm/week. BUN, acid-base status, total protein and albumin were normal and similar in the two groups. Plasma levels of threonine, glycine, citrulline and methionine were significantly greater in the formula-fed infants. Taurine and proline had higher concentrations in the protein fortified human milk group. There was good tolerance of protein from both sources but the differences in plasma amino acid profiles suggest that the dietary protein quality in formulas for preterm infants must be further modified, if the goal of formula feeding is to achieve metabolic indices of protein metabolism similar to those found when human milk protein is used. PMID- 2784022 TI - Long-term follow-up after Carpentier tricuspid valvuloplasty. AB - To study the long-term results of tricuspid valvuloplasty, pre- and postoperative (51 +/- 17 months) echocardiographic and catheterization data were collected from 51 patients (aged 59 +/- 9 years). Because of severe mitral stenosis all patients received a heterograft in the mitral position and underwent reconstructive tricuspid surgery with Carpentier rings. With regard to postoperative clinical outcome three patient groups were distinguished: 37 patients (group A) showed clear clinical improvement; in seven patients mild, and in three patients moderate tricuspid regurgitation persisted. A mild tricuspid stenosis of less than 4 mm Hg mean diastolic gradient was found in 11 patients. Patients in group B (n = 8) showed no clinical improvement, but there was persistence of moderate tricuspid regurgitation associated with nearly unchanged pulmonary hypertension in five patients and moderate tricuspid stenosis in two. Six patients (group C) showed deterioration of their clinical status; in two patients a severe degree of tricuspid regurgitation persisted, and four patients were first seen with a tricuspid stenosis with a mean diastolic gradient greater than 7 mm Hg. Analysis of postoperative data showed that tricuspid stenosis may develop during surgery in patients with slightly shrunken valve leaflets. Although the area of the anterior tricuspid leaflet was slightly underestimated, we found that long-term results of tricuspid valve annuloplasty with a Carpentier ring were encouraging. Doppler echocardiography for detection of tricuspid regurgitation and transvalvular pressure gradient showed results identical to hemodynamic data and is a suitable and sensitive method for evaluating postoperative results after tricuspid valve annuloplasty. PMID- 2784023 TI - Prevalence of valvular regurgitation by Doppler echocardiography in patients with structurally normal hearts by two-dimensional echocardiography. AB - The prevalence of valvular regurgitation in a large population with structurally normal hearts remains unknown. From the computer database of the echocardiography laboratory of the hospital, 7209 records containing results of both two dimensional and Doppler echocardiographic examinations were identified, from which 867 (12%) with no structural abnormality on two-dimensional echocardiograms were obtained for analysis. Of these 867 records, 291 (34%) had evidence of regurgitation by Doppler technique in at least one cardiac valve. Mitral regurgitation was found in 167 (19%), tricuspid regurgitation in 151 (17%), pulmonic regurgitation in 45 (5%), and aortic regurgitation in 29 records (3%). Regurgitation of just one valve was the most common and occurred in 207 records (24%). This was followed by regurgitation of two valves (69 records, 8%), three valves (13 records, 2%), and four valves (two records, 0.2%). The prevalence of mitral, tricuspid, and aortic regurgitation was found to increase significantly with increasing age, as was the prevalence of regurgitation involving multiple valves. In 98% and 95% of mitral and tricuspid regurgitations, respectively, the jets were confined to the proximal one fourth of the atria, suggesting only trivial or mild regurgitation. Thus valvular regurgitation occurs not uncommonly in patients with structurally normal hearts referred for echocardiographic evaluation. These findings caution against the inappropriate diagnosis of clinical disease in the many patients who fall into this category. The increasing prevalence of valvular regurgitation with increasing age suggests that a wear-and tear phenomenon rather than a congenital cause is involved in most instances. PMID- 2784024 TI - Angiographic and clinical characteristics of patients with unstable angina showing an ECG pattern indicating critical narrowing of the proximal LAD coronary artery. AB - One hundred eighty of 1260 patients consecutively admitted to the hospital because of unstable angina pectoris had the typical ST-T segment changes suggestive of a critical stenosis in the proximal LAD. In 108 patients the ECG abnormalities were present at the time of admission. In the remaining 72 patients they developed shortly thereafter. The difference between these two groups was a longer duration of anginal complaints in the former (mean 2.3 days). Results of coronary angiography, performed a mean of 4.6 days after the last attack of chest pain, showed 50% or more narrowing in the proximal LAD in all patients. Thirty three patients had complete occlusion of the LAD and 75 had collateral circulation to the LAD. Results of left ventricular angiography showed abnormal systolic left ventricular wall motion in 137 patients and normal systolic motion in the remaining 43 patients. The difference between these two groups was a shorter mean time interval between the last attack of chest pain and angiography in the former group (p less than 0.001). Twenty-four patients had only abnormal diastolic wall motion. Twenty-one patients had a small increase in the creatine kinase level at the time of admission. Fifteen patients (nine before and six during early revascularization) had an anterior wall myocardial infarction in the hospital; these patients had a patent but severely narrowed LAD and a low incidence of collateral circulation to the LAD.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2784025 TI - Frequency and significance of complete atrioventricular block after coronary artery bypass grafting. AB - Three hundred forty-eight consecutive patients were evaluated during 1985 and 1986 for the development of complete atrioventricular (AV) block after coronary artery bypass grafting. Cold (4 degrees) asanguineous potassium cardioplegia with temperature monitoring was used uniformly. AV block developed in 56 instances (16%). In 32 patients (group 1) the block was transient (less than 6 hours) and in 24 it was persistent (group 2). Left main coronary artery stenosis in conjunction with total obstruction of a dominant right coronary artery occurred more commonly in patients manifesting AV block (18 of 56, 32%) than in those without it (35 of 292, 12%) (p less than 0.05). Complete occlusion of a dominant right coronary artery was observed with equal frequency in patients with and without AV block. The presence of an ungraftable right coronary artery, however, was significantly more frequent in the AV block group: 16 of 37 (47%) vs 6 of 194 (3%) (p less than 0.01). Endarterectomy of the right coronary artery was performed in 8 of 24 patients (33%) with persistent AV block versus none in the patients with transient AV block (n = 32) or normal sinus rhythm postoperatively (n = 292) (p less than 0.0001). Persistent AV block (greater than 6 hours) was associated with myocardial infarction in 6 patients (25%) (p less than 0.05) and with low cardiac output in 18 patients (75%) (p less than 0.0001). In conclusion, AV block after myocardial revascularization was frequently associated with the presence of multivessel coronary disease and an ungraftable dominant right coronary artery. Persistent (greater than 6 hours) AV block was correlated with both perioperative myocardial infarction and low cardiac output. PMID- 2784026 TI - Use of the exercise test to predict prognosis after coronary artery bypass grafting. AB - The objective of this study was to predict the prognosis of patients who become symptomatic after having undergone coronary artery bypass grafting (CABG) using clinical and exercise test responses. A retrospective analysis was performed of all veterans referred for clinical indications to a Veterans Administration Medical Center for a treadmill test after having undergone CABG. Of 2,044 patients who were exercise tested from April 1984 to May 1987, 296 had previously undergone CABG. Clinical data considered included age, sex, medication and symptom status, history of myocardial infarction, type of myocardial infarction and time from CABG. The exercise test responses considered were MET level, maximal heart rate, maximal systolic blood pressure, chest pain pattern and ST segment response. During a 2-year follow-up after exercise testing, there were 15 deaths, 11 nonfatal myocardial infarctions, 6 repeat CABGs and 3 percutaneous transluminal coronary angioplasties. Although MET level and maximal heart rate were significantly related to prognosis and no patient who exceeded 8 METs died, the predictive power of these exercise test responses was low and ST-segment depression was not predictive at all. The inability of the exercise electrocardiogram to predict cardiac events in patients after CABG requires the use of other methods of testing to identify those who need invasive studies and intervention. PMID- 2784027 TI - Estimation of jeopardized left ventricular myocardium in symptomatic and silent ischemia as determined by iodine-123 phenylpentadecanoic acid rotational tomography. AB - Whether patients with silent myocardial ischemia have a lesser mass of ischemic myocardium than patients with symptomatic ischemia is controversial. Forty-five patients with angiographic coronary artery disease (greater than or equal to 70% luminal diameter narrowing) were studied. All patients had ischemic patterns of myocardial uptake and clearance of the long-chain fatty acid perfusion/metabolic imaging agent iodine-123 phenylpentadecanoic acid after maximal exercise. Single photon emission computed tomography was performed and 25 myocardial segments were analyzed using circumferential activity profile curves. The 21 patients with silent treadmill ischemia exercised longer than the 24 patients with painful treadmill ischemia (430 +/- 137 vs 337 +/- 96 seconds, p less than 0.01) and to a higher heart rate (138 +/- 21 vs 125 +/- 18 beats/min, p less than 0.05). Patients with treadmill silent ischemia had the same number of abnormally perfused myocardial segments as patients with painful treadmill ischemia (8.6 +/- 4.5 vs 6.5 +/- 4.1 segments, difference not significant) and the same number of reversibly ischemic myocardial segments (4.0 +/- 1.4 vs 4.2 +/- 3.0 segments, difference not significant). The angiographic severity and extent of coronary artery disease were similar in the 2 groups. Thus, in this selected group of patients, those with silent treadmill ischemia appear to have at least as great an extent of ischemic myocardium as patients with painful exertional ischemia. PMID- 2784028 TI - Portal and mesenteric venous thrombosis as a complication of endoscopic sclerotherapy. AB - We report on the occurrence of portal and mesenteric venous thrombosis in two patients who underwent endoscopic injection sclerotherapy (EIS) for bleeding esophageal varices. One patient was diagnosed at autopsy, and portal and mesenteric venous thrombosis was not suspected during life. The second patient was suspected on ultrasound examination and was diagnosed by angiography. In the second case, therapy was effective and symptoms disappeared. He was treated by a distal splenorenal shunt after he had stabilized for 1 month. During the operation, no evidence of mesenteric infarction was found. The venous phase of the superior mesenteric arteriogram 1 month after surgery revealed an organized thrombosis in the right intrahepatic portal branches. No other thrombi were seen. This patient is the first reported who has survived portal and mesenteric venous thrombosis after sclerotherapy. PMID- 2784029 TI - Angiostrongyliasis: a rare cause of gastrointestinal hemorrhage. AB - Angiostrongylus costaricensis is an intestinal nematode, endemic to Central and South America. Affecting mostly children, it causes an eosinophilic gastroenteritis with involvement of the appendix, distal small bowel, and right colon. We report a case of a 41-yr-old man, from a non-endemic area, with the unique presentation of recurrent gastrointestinal bleeding. The diagnosis was made after surgical exploration. PMID- 2784030 TI - Reassessment of the association between gastrointestinal arteriovenous malformations and aortic stenosis. AB - PURPOSE AND PATIENTS AND METHODS: The purported association between aortic stenosis and gastrointestinal arteriovenous malformations (AVMs) has not been rigorously evaluated. The diagnosis of aortic stenosis in most the prior studies has been based on clinical examination. We therefore utilized two-dimensional and Doppler echocardiography to document the presence or absence of aortic stenosis in 29 men with gastrointestinal AVMs documented by endoscopy. RESULTS: Of the 29 patients studied, 22 (76 percent) had ejection systolic murmurs and 18 (62 percent) had echocardiographic evidence of aortic sclerosis. However, none of the patients had any evidence of aortic stenosis as assessed by Doppler echocardiography. CONCLUSION: Although previous case reports and retrospective studies have suggested an association between gastrointestinal AVMs and aortic stenosis, our study does not support this association and suggests the need for a prospective trial. PMID- 2784031 TI - Ethanol reduces bone formation and may cause osteoporosis. AB - INTRODUCTION: The etiology of ethanol-associated osteopenia is not fully understood. In order to define the role of ethanol in the pathogenesis of hepatic osteodystrophy, we compared two groups of alcoholic patients with histologically established alcoholic liver disease. PATIENTS AND METHODS: Twenty-eight patients currently drinking ethanol ("drinkers") and 12 claiming not to have consumed any ethanol for at least six months ("abstainers") were enrolled in the study. In addition, 35 non-alcoholic control subjects without clinical or biochemical evidence of liver disease were also studied. Bone mineral density and various biochemical and hormonal values were measured in each subject; iliac crest biopsies were taken under local anesthesia in the patients and under general anesthesia in the control subjects. RESULTS: Forearm bone mineral densities, spinal bone mineral densities, and iliac crest cancellous bone areas were significantly lower in the alcoholic patients compared with control subjects (p less than 0.01 for all measurements), but these values did not differ between the drinkers and the abstainers. The drinkers, however, had significantly less osteoblastic activity than the abstainers, as assessed by dynamic bone histomorphometry (p less than 0.001). Serum bone Gla-protein concentrations were higher in the abstainers than in the drinkers (p less than 0.001). No differences were seen relating to histologic parameters of bone resorption, although the alcoholic patients who had lower serum free testosterone concentrations than the control subjects also had higher urinary hydroxyproline excretion rates. CONCLUSION: These data suggest that ethanol may be responsible for osteoblastic dysfunction resulting in diminished bone formation and reduced bone mineralization. PMID- 2784032 TI - Dose-dependent systemic and regional hemodynamic effects of calcitonin gene related peptide. AB - The dose-response effects of infused calcitonin gene-related peptide (CGRP), a potent vasodilator, on systemic and regional hemodynamics in the conscious rat remain incompletely defined. The radioactive microsphere technique provided these determinations before and after the intravenous administration of vehicle or 22, 65, 220, and 2200 pmol of CGRP. Neither vehicle nor 22 pmol of CGRP significantly changed any systemic or regional hemodynamic parameter. Starting at the 65-pmol dose, CGRP significantly decreased mean blood pressure and total peripheral resistance, while increasing heart rate without changing cardiac output. CGRP produced selective regional vasodilatory effects, with the coronary circulation being unusually sensitive. In contrast, CGRP caused significant increases in blood flow to the mesenteric and cutaneous circulations only at the two highest doses. CGRP increased plasma norepinephrine, epinephrine, and renin activity significantly at only the 2200-pmol dose. In conclusion, CGRP decreases blood pressure by peripheral vasodilation, with a threshold dose occurring between 22 and 65 pmol. In addition, the coronary circulation appears to be particularly sensitive to the vasodilatory properties of CGRP. PMID- 2784033 TI - Cigarette smoking decreases interleukin 1 release by human alveolar macrophages. AB - To determine whether alveolar macrophages from smokers have an abnormal interleukin 1 beta (IL-1) release, we obtained macrophages by bronchoalveolar lavage (BAL) of otherwise healthy volunteers in three groups: nonsmokers (NS; n = 11), light smokers (LS, less than 10 pack-yr smoking history; n = 4) and heavy smokers (HS, greater than 10 pack-yr smoking history; n = 9). After 24 h in culture, unstimulated macrophages (from each group) released negligible amounts of IL-1. Lipopolysaccharide (LPS) (1 micrograms/ml) caused release of 21.77 +/- 4.33 ng IL-1/10(6) cells at 24 h from NS macrophages; IL-1 release from HS macrophages was significantly decreased (5.52 +/- 1.66 ng/10(6) cells; P less than 0.05), whereas LS macrophages released intermediate amounts (15.07 +/- 6.15 ng/10(6) cells). Release of IL-1 from HS macrophages was also decreased after 48 and 72 h in culture and was observed over a wide range of concentrations of LPS. The decreased amount of IL-1 in HS macrophage supernatants appeared to be due to a defect in release of IL-1 from the cells and not due to a defect in production of the mediator, since total IL-1 (IL-1 present in the cell lysates plus that in the cell supernatants) was similar in the NS and HS groups. In addition, after 24 h in culture, LPS-stimulated HS macrophages released significantly less prostaglandin E2 (PGE2) (which can suppress IL-1 production) than did NS macrophages; in the presence of indomethacin, which abolished macrophage PGE2 release, no augmentation of LPS-stimulated IL-1 release was observed. Cell viability, as measured by lactate dehydrogenase release, was not different between HS and NS macrophages under any conditions. We conclude that there is a defect in release but not production of IL-1 from the alveolar macrophages of chronic smokers. PMID- 2784035 TI - Dissociated effects of corticotropin-releasing factor on acid secretion and blood flow. AB - Peripherally administered corticotropin-releasing factor (CRF) inhibits gastric acid secretion in the rat via unknown mechanisms. Because intravenous CRF can produce marked systemic hypotension, the hypothesis that its antisecretory effect is due to a reduction in gastric mucosal blood flow (MBF) was tested. Corpus MBF was measured by hydrogen gas clearance in fasted, urethan-anesthetized rats. CRF (15 nmol.kg-1.h-1 iv) had no significant effect on MBF but significantly decreased systemic blood pressure (BP) by 21.8 +/- 3.4%. This dose of CRF significantly decreased acid secretion stimulated by 40 micrograms.kg-1.h-1 pentagastrin iv but did not decrease MBF despite a 30.3 +/- 2.3% decrease in BP. To avoid the confounding effect of systemic hypotension on MBF, close gastric intra-arterial infusions were performed. CRF (1.7 nmol/h ia) had no effect on BP and did not increase MBF. CRF (3.4 nmol/h ia) slightly decreased BP without modifying MBF. In contrast, histamine (200 micrograms/h ia) significantly increased MBF by 58 +/- 11%. We conclude that 1) the peripheral antisecretory effect of CRF is not related to a decrease in MBF, 2) the maintenance of MBF during CRF-induced hypotension is not due to a direct vasodilator effect of CRF on the gastric microvasculature. PMID- 2784034 TI - Homologous rat hepatic protease inhibitor genes show divergent functional responses to inflammation. AB - The genes encoding three distinct serine protease inhibitors (Spi) have been cloned from rat liver. These inhibitors are highly homologous with each other and are similar to alpha 1-antitrypsin at the nucleic and amino acid sequence level. Although previous investigators have examined the regulation of the Spi 2 locus by inflammation, the use of various techniques and the complexity of this genetic locus have led to incomplete and somewhat confusing results. Oligonucleotide probes specific for Spi 2.1, Spi 2.2, Spi 2.3, and a 3' mouse cDNA probe for alpha 1-antitrypsin mRNA were used to measure these mRNA after induction of inflammation with subcutaneous turpentine in Fischer rats. alpha 1-Antitrypsin mRNA increased 1.8-fold, and Spi 2.2 increased 7-fold. In contrast, Spi 2.1 and 2.3 mRNA sequences decreased fourfold. The maximal changes occurred between 24 and 48 h after inflammation, with a gradual return toward normal over the next 4 days. Since Spi 2.1, Spi 2.3, and alpha 1-antitrypsin mRNA sequences are responsive to growth hormone, two other growth hormone-responsive mRNA sequences, alpha 2u-globulin and insulin-like growth factor I, were measured, and they also decreased after induction of inflammation. The results of this study show that, despite a marked similarity of nucleotide sequence, Spi 2.1 and 2.3 genes respond very differently from Spi 2.2 and alpha 1-antitrypsin to both growth hormone and inflammation. We speculate that the functions of Spi 2.1 and 2.3 products are different from those of Spi 2.2 and alpha 1-antitrypsin and may involve the regulation of growth. PMID- 2784036 TI - Relationship between endometriosis and affective disorder. AB - Comparing 14 women with and 55 women without endometriosis, the authors found no significant differences in the prevalence of affective disorder. They discuss the discrepancy between their finding and Lewis et al.'s finding of an association between affective disorder and endometriosis. PMID- 2784037 TI - Cocaine use by senior medical students. AB - The authors studied 589 senior medical students' attitudes about and use of cocaine. Reported use was 36% in the students' lifetimes, 17% in the past year, and 6% in the past month. Overall, these rates were lower than those of an age matched cohort. PMID- 2784038 TI - Syndrome of inappropriate secretion of antidiuretic hormone due to fluoxetine. PMID- 2784039 TI - Extrapyramidal symptoms in a patient taking haloperidol and fluoxetine. PMID- 2784040 TI - Pharmacological dissection of panic and depersonalization. PMID- 2784041 TI - Prevalence of depressive symptoms in different races. PMID- 2784042 TI - Interleukin-2 in scleroderma: correlation of serum level with extent of skin involvement and disease duration. AB - STUDY OBJECTIVE: To assess whether interleukin-2 has a role in the pathogenesis of scleroderma. DESIGN: Observe serum effect on the in-vitro growth of an interleukin-2-dependent cytotoxic T-cell line and determine serum level by an enzyme-linked immunosorbent assay. SETTING: Outpatient rheumatology clinic of a university medical center. PATIENTS: Sera were collected from 47 patients with scleroderma, 20 patients with rheumatoid arthritis, and 14 matched control subjects. MEASUREMENTS AND MAIN RESULTS: A significant mitogenic effect was observed in sera from patients with scleroderma of recent onset; a lower proliferative response was seen in rheumatoid sera. Matched control sera had no mitogenic activity. Sera from patients with scleroderma of recent onset supported the in-vitro growth of an interleukin-2-dependent cytotoxic T-cell line. Matched control sera had no similar mitogenic activity. Interleukin-2 was found in sera from 41 of 47 patients with scleroderma (204 +/- 356 U/mL, mean +/- SD), in 9 of 20 patients with rheumatoid arthritis (2.04 +/- 5.16), and in none of 14 matched control subjects. There was a positive correlation between serum level and the skin progression index (skin score/disease duration). CONCLUSIONS: The presence of interleukin-2 in scleroderma sera strongly supports a role for T-cell activation in scleroderma. The association between serum levels and disease progression indicates that this T-cell process may participate in the progression of the disease. PMID- 2784044 TI - Left coronary ostial stenosis: comparison with left main coronary artery stenosis. AB - We compared 147 consecutive patients who had left coronary ostial stenosis with 254 consecutive patients who had left main coronary artery stenosis treated with coronary artery bypass grafting. Mean age for the left main group was 61.6 years versus 59.7 years for the left ostial group (p = not significant [NS]). In the left ostial group, 43.5% were female and in the left main group, 12% (p less than 0.005). Prior myocardial infarction had occurred in 53% of patients with left main stenosis and 36% of patients with left ostial stenosis (p less than 0.005). There were 2.45 +/- 1.00 diseased vessels in the left main group and 1.96 +/- 1.09 in the left ostial group (p less than 0.0005). Seven (3%) of the patients with left main stenosis had no associated coronary disease (greater than 50%) versus 24 (16%) of the left ostial group (p less than 0.005). The degree of left main stenosis was 90% or more in 28.3% of patients versus 42.8% with equivalent ostial narrowing (p less than 0.01). Left ventricular function was better in the left ostial group than in the left main group (1.61 +/- 0.93 versus 2.02 +/- 1.11, respectively; p less than 0.0005). One-month mortality was 10 patients (3.9%) in the left main group and 8 (5.4%) in the left ostial group (p = NS). Perioperative infarction occurred in 8.6% of patients with left main stenosis and 4.7% of patients with left ostial stenosis (p = NS). Mean follow-up was 6.1 years for the left main group and 5.4 years for the left ostial group.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2784043 TI - Positron tomography demonstrates frontal lobe hypometabolism in progressive supranuclear palsy. AB - A regional analysis of cerebral glucose metabolism was carried out in 9 patients with progressive supranuclear palsy by using positron emission tomography with fluorodeoxyglucose as the tracer. A consistent metabolic map of frontal hypometabolism was found in 7 patients. Brain metabolism was normal in 1 subject and diffusely decreased in another. In the 7 patients with selective hypofrontality, motor and premotor areas were severely hypometabolic, while heteromodal association cortex and paralimbic regions were comparatively less affected. Although this pattern of frontal alterations, probably due to disconnection, appeared consistent with the clinical features of the disease, it proved difficult to correlate the metabolic maps with neuropsychological disturbances. PMID- 2784045 TI - Successful management of aberrant subclavian artery-esophageal fistula in an infant. AB - This report describes a 4-month-old female infant with complex congenital heart disease and prolonged nasogastric intubation who developed an aberrant subclavian artery-esophageal fistula that was successfully managed in a two-staged procedure. To our knowledge, this is the first patient to survive correction of this problem after massive hemorrhage.